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HomeMy WebLinkAboutCOM 0996.000 2006-2008Harry Kim Wvyor February 5, 2008 County of Hawaii Finance Department 25 Aupuni Street, Room 118 • Hilo, Hawaii 96720 (808)961-8234 • Fax (808)961-8248 Pete Hoffmann, Chairman and Members of the Hawai'i County Council Hawai'i County Council 25 Aupuni Street Hilo, Hawai'i 96720 RE: NONPROFIT ORGANIZATIONS William Takaba Director Nancy E. Crawford Deputr Director In compliance with Chapter 2, Article 25 of the Hawaii County Code, I am submitting the applications from eligible nonprofit organizations for your review and appropriation of funds for the FY2008-09 nonprofit grant program. Also enclosed is a list of these eligible organizations with the name of their program and the amount they are requesting from the County. The list also reflects three (3) organizations that were ruled ineligible for consideration for a grant as they did meet all of the application requirements. We will be contacting these three organizations and inform them of their ineligibility. Should you have any questions, please feel free to call me. IV,y� William Tak ba Director of Finance Enc. Applications for Nonprofit Grant Funds List of Nonprofit Grant Applicants Ref. To, Ref, Dote �nDB Hawaii County is an Equal Opportunity Provider and Employer = c.o In compliance with Chapter 2, Article 25 of the Hawaii County Code, I am submitting the applications from eligible nonprofit organizations for your review and appropriation of funds for the FY2008-09 nonprofit grant program. Also enclosed is a list of these eligible organizations with the name of their program and the amount they are requesting from the County. The list also reflects three (3) organizations that were ruled ineligible for consideration for a grant as they did meet all of the application requirements. We will be contacting these three organizations and inform them of their ineligibility. Should you have any questions, please feel free to call me. IV,y� William Tak ba Director of Finance Enc. Applications for Nonprofit Grant Funds List of Nonprofit Grant Applicants Ref. To, Ref, Dote �nDB Hawaii County is an Equal Opportunity Provider and Employer NONPROFIT GRANT APPLICANTS FOR FY2008-09 ORGANIZATION NAME American Red Cross - Hawaii State Chapter The Arc of Hilo The Arc of Kona Big Island Resource Conservation and Development Council, Inc. Big Island Substance Abuse Council Big Island Substance Abuse Council Boys & Girls Club of the Big Island Boys & Girls Club of the Big Island Boys & Girls Club of the Big Island Boys & Girls Club of the Big Island Boys & Girls Club of the Big Island Boys & Girls Club of the Big Island Brantley Center, Inc. Bridge House, Inc. Child and Family Service Child and Family Service Child and Family Service Child and Family Service Family Support Services of West Hawai'i Friends of Big Island Drug Court Friends of the Children's Justice Center of East Hawai'i Friends of the Children's Justice Center of West Hawai Goodwill Industries of Hawai'i, Inc. Goodwill Industries of Hawai'i, Inc. Grassroots Community Development Group Grassroots Community Development Group Habitat for Humanity Kona Hawai'i Island Adult Care, Inc. Hawaii Island HIV/AIDS Foundation Hawaii Island HIV/AIDS Foundation The Island of Hawaii YMCA Ka Hale O No Keiki, Inc. Kapi olani Medical Center for Women & Children Ke Anuenue Area Health Education Center Keaukaha One Youth Development Kokua Counseling Services Kokua Counseling Services Kona Adult Day Center, Inc. Kona Literacy Council Ku'ikahi Mediation Center Laupahoehoe Train Museum Lyman Museum Lyman Museum Malaria No Mole PROGRAM NAME iness for Countv of Hawaii Day Health Life Skills Program irce Conservation and Development Program iawai'i Substance Abuse Program Hawaii Substance Abuse Program Live Youth Development Programs: Hilo Club [ive Youth Development Programs: Kea'au Club [ive Youth Development Programs: Ocean View Club five Youth Development Programs: Pahala Club [ive Youth Development Programs: Pahoa Club loyment Rehabilitation Program ttional Skills Building Program Transitional Housing Program ,to Lokahi apeutic Foster Home Program I Hawaii Domestic Abuse Shelter and North Kohala Family Centers stance to Drug Court Clients & Program :ial Needs and Enhancement, Center Support, Proven ting Programs ancement and Basic Needs Program Connections < Experience Program ikupu After -School & Summer Program Lehua Entrepreneurial After -School Program oral Operating Support/Staffing aii Advocate Program - East Hawai'i au Advocate Program - West Hawai'i pendent Living Services Adult Day Center -Disciplinary HIV Case Management, Hilo smission Prevention for HIV+ Women in West Hawai'i h Services ilies-At-Risk o'lani Child Protection Center - West Hawai'i IV -B -West Hli Counseling & Supportive Living Project imunity Health Education :h Development it Assistance Fund ,ice Area Expansion Education & REQUESTED 25.000 20,000 15,000 30,000 30,000 150,000 rr rrr rr rrr 65,000 10,000 20,000 20,000 30,000 29,500 30,000 20,000 20,000 60,000 5,000 10,000 54,114 11,500 10,000 15,000 30,000 2,000 13,000 50,000 Malama O Puna Puna Community Medical Center 270,315 Mental Health Kokua Residential Rehabilitation Services 30,000 Neighborhood Place of Puna Home Visiting and Community Connections 21,625 Office for Social Ministry Beyond Shelter 20,000 Office for Social Ministry Care -A -Van Homeless Outreach 35,000 Office for Social Ministry The Food Basket, Inc. (formerly Hawaii Island Food Bank) 40,000 Office for Social Ministry Kihei Poo Emergency Shelter 35,000 Office for Social Ministry Mobile Care Health Project 30,000 NONPROFIT GRANT APPLICANTS FOR FY2008-09 Office for Social Ministry Ponahawaiola : Community Re -integration Services 35,000 Palekana Kai Ocean Safety, LLC Palekana Kai Ocean Safety, LLC 25,000 Puna Friends of the Park Kapoho Vision Project 131,040 The Salvation Army - Family Intervention Services Prevention Programs - Honokaa 37,500 The Salvation Army - Family Intervention Services Prevention Programs - Pahoa 35,000 The Salvation Army - Family Intervention Services Services to Homeless Youth "Malama Kuewa Opio" Program - West Hawai'i 32,000 Special Olympics Hawai'i - East Hawaii Special Olympics Hawai'i - East Hawai'i 15,000 Special Olympics Hawaii - West Hawai'i Special Olympics West Hawai'i - General Funding 15,000 West Hawai'i Community Health Center West Hawaii Community Health Center Children's Clinic 60,000 West Hawai'i Mediation Center Mediation Services 15,000 YWCA of Hawai'i Island Empowering Alternatives Program 60,000 YWCA of Hawai'i Island Hamakua Youth Center 65,000 TOTAL $ 3,216,594 Note: The following non -qualifying organizations did not meet the application's requirement(s) Hawai'i First Federal Credit Union Individual Development Accounts/Community Financial Education - (Not a 501(c)3 tax exempt organization) Hawaii Japanese Center Musical Nostalgia - (No Financial Audit) Mala'ai: the Culinary Garden of Waimea Middle School Mala'ai: the Culinary Garden of Waimea Middle School - (No proof of IRS 501(c)3 status) 80,000 25,000 25,000 Agency Name: American Red Cross, Hawaii State Chapter Program Name: Disaster Response & Preparedness for County of Hawaii Agency Director: Coralie Chun Matayoshi, Chief Executive Officer Phone No.: 808-739-8101 Contact Person: Youline K. Kalima, County Executive Director Phone No.: 808-935-8305 Mailing Address: American Red Cross Hawaii County 55 Ululani St., Hilo Hawaii 96720 Facility/Site Address: Site One: Hilo 55 Ululani St., Hilo Hawaii 96720 Site Two: Kona 74-5615 Luhia St., Kailua-Kona, HI. 96714 Fax No.: 808-969-3673 Email address:ykalima(@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: 2005-06 2006-07 2007-08 $5,000 $5,000 $15,000 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. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008 — 2009 Page 1 2. Program Description: The Hawaii County Red Cross Disaster Preparedness & Response Program provides disaster relief assistance to local victims of disasters to meet their immediate emergency needs and provide physical and emotional support to help victims begin rebuilding their lives after a tragedy. This includes financial assistance for food, clothing, temporary shelter, rent, security deposit, and other services to aid families struggling to recover from a disaster. The Red Cross on the Big Island also teaches individuals and families how to prepare for disasters. Everyday disasters like fires, flooding, high surf and winds, occur about twice a week in the State of Hawaii. In a larger disaster or tragic event, crisis counseling, mass care, disaster welfare information, emergency first aid and other support services would also be provided to victims or anyone whose loved ones were directly affected by the event. Crisis counseling may also be extended to the community for secondary victims. Shelters are often set up to house those impacted in the community until they can return safety to their homes. When disasters strike our islands, you can count on the Hawaii Red Cross to be there, on the scene, providing assistance to the victims. Whether it's a fire in Hilo or a flood in Kona, 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. 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. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008 — 2009 Page 2 The Hawaii Red Cross provides compassionate aid to people in Hawaii who fall victim to natural and man-made disasters that occur about twice a week in Hawaii. A major portion of the disaster victims we serve have incomes below the Poverty Guidelines set by the U.S. Housing & Urban Development, Federal Register, Volumes 66, 67, 68, 69. Based on family income levels and size, our records show that at least 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; in FY05, 39% were below poverty level, and in FY06, 47% 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. According to the 2006 State of Hawaii Data Book, the bottom 16.7% of the families in Hawaii make less than $25,000. Our records for the past 4 fiscal years show that an average of 67% 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%; 2005 was 52.8% and 2006 was 70.6%. 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. The Red Cross is a safety net for victims of "every day" disasters who have nowhere else to tum. 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. 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. When disasters occur, the American Red Cross will be there to support the County of Hawaii by providing families with relief assistance in time of need. The Hawaii State Chapter is requesting $25,000 from the County of Hawaii to help subsidize the financial aid we provide to Big Island disaster victims and emergency responders, train volunteer disaster responders so that local communities on the Big Island are prepared, and to share important preparedness information to people on what to do before a disaster strikes. This amount does not even begin to cover the staff and volunteer training, equipment, and support needed to respond to every day disasters, as well as educate and prepare Big Island residents for the next major disaster that is sure to come. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008 — 2009 Page 3 Hawaii County Funding is critical to build resiliency and capacity for the communities of Maui County. 3. Total Budget and Position Count Total Program $128,400 Total Program Position Count 1.5 Budget for FY 08-09 Disaster Svcs Total Agency Budget $371,700 Total Agency Position Count 5 for FY 08-09 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), train volunteer responders and share critical preparedness information to the communities on the Big Island. Objectives: 1. Provide for the immediate emergency needs of Big Island disaster victims (food, clothing, shelter, crisis counseling). All disaster services are free 2. Support first responders like firefighters, police, civil defense, and others with food, water, and counseling during brush fires and other challenging incidents that threaten lives and property 3. Increase awareness of disaster preparedness to Big Island residents. Prepare families, businesses, and communities with essential preparedness material and information because a disaster can strike at any time without notice. 4. Train volunteer disaster responders to serve their local communities during times of disaster. We train volunteers to be able to conduct disaster assessment in neighborhoods, run shelters, conduct crisis counseling and emergency first aid, and provide financial assistance to those whose homes have been affected by disaster. Our volunteers actively exercise with federal, state, and county agencies to prepare for natural disasters, pandemics and acts of terrorism. All disaster volunteer training is free. 5. Program Highlights: In the past fiscal year (July 1, 2006 through June 30, 2007), the American Red Cross in Hawaii County provided the following services to Big Island individuals and families: NONPROFIT GRANT APPLICATION FISCAL YEAR 2008 — 2009 Page 4 • Responded to 17 disasters on the Big Island, enabling 58 individuals to recover from their losses and begin rebuilding their lives (does not include earthquake response) • Served 130 meals to emergency workers and affected individuals at brush fires or other disasters. • Opened a shelter due to brushfire where 17 people sought refuge • Trained 166 new disaster volunteers • Distributed 1,061 general disaster preparedness material and brochures, to inform and educate the community on how to be ready and prepared before a disaster strikes • In East Hawaii: provided 2,670 Hilo individuals first aid and CPR training, 555 individuals with aquatics training and 64 individuals with other health and safety trainings. In West Hawaii: provided 823 individuals first aid and CPR training, 753 individuals with aquatics training and 22 individuals with other health and safety trainings. In addition, the Red Cross provided services to victims of the November 2006 earthquake that caused major damage to West Hawaii. Emergency assistance was provided to 524 people and 622 meals were served in the response: • Over 10,000 homes were surveyed for residential disaster assessment 217 cases were opened for emergency assistance • 160 calls were received statewide via a hotline for requests for immediate aid and for family reunification information. ■ 126 individuals were provided crisis counseling services • 8 family reunification requests were fulfilled ■ 110 volunteers and staff participated in the disaster relief operation to include 4 volunteers from the mainland • Red Cross partnered with Salvation Army and Hawaii Pacific Baptists to serve over 500 meals at the Disaster Recovery Centers. ■ 100 clean-up kits were donated by Wal-Mart. ■ More than $600,000 was donated to the American Red Cross which well exceeded the costs of the disaster relief operation. Two-thirds of this donation was given to the Hawaii Community Foundation to manage for the Voluntary Organization Active in Disaster's Long -Term Recovery Committee, the Kona Community Hospital and The North Kohala Community Resource Center. The Red Cross partnered with these organizations to ensure the most effective response was provided to those in need. In the first half of this fiscal year (FY08) to date, the Red Cross has already responded to 13 incidents on the Big Island from house fires and flooding in Kailua-Kona, Mountain View, Ocean View, Hilo, Nanawale, Captain Cook and Honaunau. Our efforts have enabled over 65 individuals to recover from their losses and begin rebuilding their lives NONPROFIT GRANT APPLICATION FISCAL YEAR 2008 — 2009 Page 5 In August, 2007, Hurricane Flossie threatened the Big Island. Although it was downgraded from hurricane status, the Red Cross did prepare those on island for storm -like effects. Schools were closed and the Red Cross opened 11 evacuatioin shelters at Kau High & Intermediate, Keaau High School, Pahoa High School, Mountain View Elementary, Waikoloa Elementary, North Kohala State Office Building, Kealakehe High School, Konawaena High School, Waiakea High School, Honokaa High School, and Waikoloa Elementary. There were over 220 overnight stays in these shelters. This was another example where the Red Cross was prepared and ready to help the communities on the Big Island during a time of potential disaster. 6. Performance Measures: Disaster Response and Preparedness in Hawaii County - Performance Measures: 2006-07 includes October earthquake 7. Program Expenditures (Disaster Response and Preparedness): NOTE: It is important to note that expenses shown for FY07 and FY08 do NOT include significant administrative, technical and programmatic support provided by Headquarters staff on Oahu. FY 2006-07 Actual * FY 2007-08 Budget * FY 2008-09 Estimate Disaster Responses 18 23 18 Disaster Assistance Cases 275 63 58 Mass Shelters Opened 1 3 2 Numbers Reached through Disaster Presentations in Communities 1,061 1,500 1,500 Trained Individuals in Dis. Response 166 159 150 2006-07 includes October earthquake 7. Program Expenditures (Disaster Response and Preparedness): NOTE: It is important to note that expenses shown for FY07 and FY08 do NOT include significant administrative, technical and programmatic support provided by Headquarters staff on Oahu. * if applicable # Please explain in detail on separate sheet * $94,000 budgeted for entire state for disaster relief assistance as unknown where disasters will occur. As disasters occur on the Big Island, expenses will increase accordingly. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008 — 2009 Page 6 FY 2006-2007 Actual FY2007-2008 Budget FY2008-2009 Estimate Salaries and wages 66,088 76,128 78,500 Operations 27,240 25,456 27,000 Equipment Materials (Supplies) 22,963 10,067 10,700 Travel 3,887 11,440 12,200 Disaster Relief Assistance * 19,358 20,000 20,000 Total 139,5361 143,091 148,400 * if applicable # Please explain in detail on separate sheet * $94,000 budgeted for entire state for disaster relief assistance as unknown where disasters will occur. As disasters occur on the Big Island, expenses will increase accordingly. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008 — 2009 Page 6 8. Program Funding Source (Disaster Response & Preparedness) - Identify all funding sources (specific to this program only) Revenue Source for Dis Svcs Program FY2006-2007 Actual FY2007-2008 Budget FY2008-2009 Estimate Hawaii County 5,500 2,500 3,000 HI. Island United Way 25,000 25,000 25,000 Program Fees Program Material Sales Contributions (Direct Mail & Grants 30,530 30,000 30,500 Fundraising Hats O SUBTOTAL 61,030 57,500 58,500 Amount Hawaii Chapter must subsidize both Hilo and Kona offices to meet expenses for this program (dis svcs 78,506 65,591 69,900 TOTAL (equal to expenses) 139,536 123,091 128,400 NOTE: 1. HIUW. Total given is $50,000 but half for Disaster Services and half for Community Education (health and safety training) 2. Contributions and fundraising amounts subsidize both Disaster Services and our Health and Safety Services Program. In addition, amounts do not reflect any administrative or mailing expenses incurred by Financial Development at Headquarters in Honolulu ** We did get $9,500 from Hawaii County Research & Development in September 2007 specifically for disaster vests, comfort/clean-up kits and disaster brochures. 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 continue to work on increasing Red Cross visibility in the community in order to increase private individual and corporate donations from Big Island residents and businesses. We are look at possible fundraising opportunities on the Big Island such as special events, along with major donor cultivation. I (we) have read and understood all of the eligibility requirements, grant conditions, award procedures and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135-2-142.2, Hawaii County Code, relating to Appropriation of Funds to Nonprofit Organizations. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008 — 2009 Page 7 I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawaii Revised Statutes. If awarded a grant from the County of Hawai'i, I (we) understand and will comply with the requirement to submit a year-end report to the Legislative auditor within 60 days after June 30 of the fiscal year. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawai'i grant funds, and a listing of other funding sources and an\mounts obtained during the award period. Failure to submit a timely agency's future funding requests. �A074-"# il?-� William Wilson, Chapter Chair Signature of Board President/Chair Cora lie Chun Matavoshi, CEO Signature of Executive Director January 30, 2008 Date January 30, 2008 NONPROFIT GRANT APPLICATION FISCAL YEAR 2008 — 2009 Page 8 Date The Arc of Hilo- Agency Name Arc of Hilo Advocacy- Program Name Agency Director: Contact Person Mailing Address Facility/Site Address Fax No.: Email Address: M. Gleason Vicki Linter 1099 Waianuenue Ave Hilo, Hawaii 96720 Same as Above 961-0148 vlinter@hiloarc.org Phone No.: 935-8535 Phone No.: x 203 Name of Accountant/CPA (include name of firm if applicable): Ann Fukuhara, CPA, MBA, An Accountancy Phone No.: 961-5532 Mailing Address: 714 Kanoelehua Ave, P.O. Box 6691, Hilo, HI 96720 Amount of Request for County Funds: $40,000 Prior Year(s) Funding: 05-06 06-07 07-08 $29,000 $0 $29,000 Agency Mission Statement: To improve the quality of life for people with developmental disabilities who reside on Hawaii through Education, Vocational Rehabilitation, Job Training, Job Placement, Life Skills Training, and Recreational Programs. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 1 The Arc of Hilo - Agency Name Arc of Hilo Advocacy- Program Name Program Description: The Advocacy and Outreach Program is designed to assist people with disabilities and their families to access the social services they need in the community and State. Services to people with disabilities include: information and referral, advocacy, counseling, outreach, and education. Total Budget and Position Count Total Program Budget 1 $40,000 LTotal Program Position Count I 1 Total Agency Budget � $6.2 million Total Agency Position Count 1 175 Program Objectives: 1) Advocate for people with disabilities in the community to help them access services they need, such as job hunting and training, transportation, housing, and medical care. 2) Provide outreach in the community to identify people with disabilities who are not receiving services or who are underserved. 3) Provide education services to individuals and community groups including schools and colleges and service organizations about disability issues. 4) Serve as a community resource for anyone needing information and referral. 5) Counsel individuals and their families on transition, adjustment and any other disability related issues. Program Highlights: 1) This program proposes to assist hundreds of people in transition or in need of information guidance in our community to obtain the services they need. 2) This program proposes to expand The Arc of Hilo's ability to serve the community as an information broker for disabled individuals and their caregivers. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 2 The Arc of Hilo - Agency Name Arc of Hilo Advocacy - Program Name Performance Measures: *If applicable Program Expenditures FY 2006-07 FY 2007-08 Actual * Budget* FY 2006-07 FY 2007-08 FY 2008-09 Actual* Budget* Estimate Information and referral 180 Advocacy 120 Counseling 120 Outreach 90 Education 90 Total $40,000 Total initial client contacts 600 *If applicable Program Expenditures FY 2006-07 FY 2007-08 Actual * Budget* FY 2008-09 Estimate Salaries and Wages $40,000 Professional Fees Operations Equipment Other" Total $40,000 If applicable "Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2003-09 'ane 3 The Arc of Hilo - Agency Name Arc of Hilo Advocacy - Program Name Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2006-07 Actual * FY 2007-08 Budget* FY 2008-09 Estimate The Arc of Hilo (telephone, internet, electricity, office supplies) $1000 Total $1000 *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? Since this program will not directly generate revenue from the training sources The Arc of Hilo normally relies on, The Arc will need to build its annual general revenue reserves to the point that it can cover the costs of this community service. The Arc's goal is to make this program self-sustaining within a three year period. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 4 The Arc of Hilo - Agency Name Arc of Hilo Advocacy and Outreach - Program Name I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 — 2-142.2, Hawaii County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawaii Revised Statutes. If awarded a grant from the County of Hawai'i, I (we) understand and will comply with the requirement to submit a year-end report to the Legislative auditor within 60 days after June 30 of the fiscal year. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawai'i grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely, complete, and accurate year-end report will impact the evaluation of your program's or agency's future funding requests. Signature of Board President/Chair Si nature of Executive Director Date Z U9� Daie UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 5 Arc of Kona ADULT DAY HEALTH LIFE SKILLS PROGRAM Agency Director: Gretchen Lawson Phone No.: 808-323-2626 Contact Person: Jeani Navarro Phone No.: 808-775-1090 Mailing Address: PO Box 127 Kealakekua, HI 95640 Facility/Site Address: 81-1065 Konawaena School Road Kealakekua, HI 95640 Fax No.: 808-323-9444 Email Address: Jeani@arcofkona.org Name of Accountant/CPA: Ann N. Fukuhara, CPA MBA An Accountancy Corporation Phone No.: 808-961-5532 Fax: 808-934-8589 Mailing Address: PO Box 6691 Hilo, HI 96720 Amount of Request for County Funds: $20,000.00 Prior Year(s) Funding: 05-06 06-07 07-08 $20,000 $18,000 $20,000 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 2008-09 Page 1 of 6 Arc of Kona ADULT DAY HEALTH LIFE SKILLS PROGRAM Program Description: For nearly forty-one years the Arc of Kona has successfully operated an Adult Day Health (ADH) standard classroom program that serves 15-20 participants on a daily basis. Our population is a mix of Native Hawaiian, Asian/Pacific Islander, and Caucasian adults ranging from 21 to 59 years of age with a core group of young adults in their mid 20's. All of the participants in the ADH program have been identified as DD/MR (Developmentally Disabled/Mentally Retarded) by the State of Hawaii and have cognitive limitations that prevent them from living as independently as individually possible without extensive life skills training and other needed supports. These individuals do not make good judgments and therefore need the types of supports that insure their safety and help with activities of daily living. They require assistance gaining access to community services and activities that will allow them to begin integration into the communities where they reside. This population has several risk and protective factors that we consider when designing individual life skills training. First, this population is at risk of abuse, both sexual and physical, and need to be taught the skills for saying "NO" and reporting abuse. The DD/MR population is at risk for chronic disease and has a high incidence of diabetes and heart problems related to weight and diet. Finally, they are all at risk for homelessness and/or being unprepared to prove they can live independently both with daily living skills and finances to prevent homelessness. Protective factors we consider include training in social development, appropriate sexual behaviors, protection from abuse including family members as well as strangers, proper nutrition and preparing individuals to find their own housing accommodations and live as independently as possible, with or without other agency supports. The "community as a classroom" where participants can practice these skill sets becomes essential to strengthening the protective factors around this vulnerable population. When provided with community access services for their life skills component, our participants can share their many skills and gifts that benefit the larger community. Unfortunately, the funds received from the Department of Health per participant per day barely cover staff salaries and leaves the Arc of Kona with a need for additional funding to continue this successful program delivery. Specifically, the $20,000.00 requested from the County Non-profit grant would be spent to enhance service delivery by paying costs associated with life skills training supplies and access to and from home, classroom, and the community as well as portion of the staffing and payroll taxes attached to the salary. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 2 of 6 Arc of Kona ADULT DAY HEALTH LIFE SKILLS PROGRAM Total Budget and Position Count Total Program Bud et 280,867 Total Program Position Count 6 Total Agency Budget 3,450,000 Total Agency Position Count 111 Program Objectives: 1) Provide a safe, healthy, and supportive environment for daily living skills in the ADH classroom setting 6 hours per day 268 days per year from July 1, 2008 to June 30, 2009. (Thus relieving families of the stress of daily care giving and allowing them the opportunity to work if they desire and make a living). 2) Provide individualized life skills training programs, with measurable goals and objectives that allow each participant to develop at his or her own pace in order to live as independently as possible. 3) Insure access to community events and resources that will be a learning laboratory for independent living and reinforce skills taught in the classroom setting two times a week throughout the program year (7/08-6/09). 4) Provide needed classroom materials to assess, instruct and support life skills; specific training in health and safety areas relating to abuse and appropriate sexual behavior; as well as hygiene, money management, household safety issues and nutrition. 5) Provide needed supports for interacting appropriately with each other and the public within the community setting throughout the program year that supports the independent living skills required to function on a day to day basis. Program Highlights: (Adult Day Health Classroom) 1) 15 participants received daily lessons on health and safety as they pertain to daily living and toward independent living (including information on hygiene, appropriate sexual behavior, yoga for stretching and balance, fire safety, and classes on nutrition and weight maintenance). Training positively resulted in a reduced number of behavior outbursts and incident reports. 2) 15 participants have been able to access the community (as required by law) for practicum in independent living skills in real life community settings. This resulted in 85% of participants attaining one of their personalized goals and 100% of the participants meeting two or more objectives toward meeting their personal goals. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 3 of 6 Arc of Kona ADULT DAY HEALTH LIFE SKILLS PROGRAM 3) 15 participants were able to participate in yoga classes, walking and stretching training that has resulted in better balance, and body awareness and therefore less falling/tripping and more self esteem. 4) 15 participants received training in the nutritional value of foods and were trained to assist in the preparation of healthier lunches and snacks. This has positively resulted in 20% of the participants losing extra pounds and maintaining their goal weight. The remaining 80% maintained their goal weights this year and can make healthy food choices unsupervised. 5) 15 participants attended dental presentation from Dr. Alt, DDS, and received free dental cleanings. 6) 15 participants attended a free Kayak/Surf Day and were able to be in the water and participate in a water sport, many for the first time in their life. 7) 15 participants participated in earthquake safety training. Performance Measures: Adult Day Health Life Skills FY 2006-07 FY 2007-08 FY 2008-09 Actual * Budget * Estimate 1. Provide a safe, secure classroom 260 days of ADH 260 days 260 days environment with sufficient staff standard 5 days per 5 days per supervision, 5 days a week, 52 weeks classroom week for 52 week for 52 a year, for 15-20 DD/MR participants activities with a weeks weeks Note: The ADH program will see an one staff to four increase of five participants upon high participant ratio school graduation bringing total of a minimum of 20 participants. 2. Provide access to the community for 144 transports 144 144 hands-on life skills training experiences into the transports transports including food and clothing shopping, community for provided fire safety, ordering and eating in activities that public, handling money, making promote n appointments, nutrition and exercise, kills goaual ls skills goals and appropriate behaviors in public (including sexual behavior). 3. Provide on-going Life Skills 260 days of 260 days of 260 days of assessments and data collection for classroom instruction instruction each individual. This includes areas instruction for Life completed such as recognizing and reporting Skills and daily abuse, health, hygiene, safety, living activities with pre and post socialization, basic cooking skills, testing for behaviors, consumerism, basic literacy assessment of and job skills training. base line skills, data collection and quarterly and year end reporting on achieved results 'If applicable NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 4 of 6 Arc of Kona ADULT DAY HEALTH LIFE SKILLS PROGRAM Program Expenditures If applicable "Please explain in detail on separate sheet Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2006-07 Actual * FY 2007-08 FY 2008-09 Budget * Estimate Salaries and Wages 203,337 206,640 216,972 Professional Fees 20,000 Hawaii Island United Way 40,867 55,298 60,900 63,895 -Operations Equipment 194,897 217,540 Other" Fund Raising/Do nations 4,871 Total 258,635 267,540 280,867 If applicable "Please explain in detail on separate sheet Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2006-07 Actual * FY 2007-08 Budget * FY 2008-09 Estimate County of Hawaii 18,000 20,000 20,000 Hawaii Island United Way 40,867 30,000 40,867 State Medicaid Waiver 194,897 217,540 220,000 Fund Raising/Do nations 4,871 Total 258,635 267,540 280,867 *If applicable Explain what plans, if any, your agency and/or program has to increase revenues to support this program. When do you anticipate your program to become self-sustaining? The Arc of Kona is celebrating its 41" anniversary this year. We have been working diligently to find new and creative ways to raise unrestricted funds to support our numerous programs. Each year, the week before Thanksgiving, we hold a bazaar and craft sale that is our signature event. In June of this year we held a musical concert in conjunction with Hawaii Performing Arts, with plans to repeat the event again this year. We also have an upcoming Blue Grass benefit concert with Grammy award winning artists Laurie Lewis and Tom Rozum scheduled at the Aloha Theater on February 2, 2008. We will also be working with our donors for additional program support. We do not anticipate that this program will be self sustaining in the near future. However, the Arc of Kona is working diligently to offer events along with other fund raising activities throughout the year which will also educate the public about the needs of our population and generate a stronger donors' list. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 5 of 6 Arc of Kona ADULT DAY HEALTH LIFE SKILLS PROGRAM I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 — 2-142.2, Hawai'i County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawai'i Revised Statutes. If awarded a grant from the County of Hawai'i, I (we) understand and will comply with the requirement to submit a year-end report to the Legislative auditor within 60 days after June 30 of the fiscal year. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawai'i grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely, complete, and accurate year-end report will impact the evaluation of your program's or agency's future funding requests. Signature of Board President/Chair SigriAture of PresidenUCEO Date Date &4-8P UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 6 of 6 BIG ISLAND RESOURCE CONSERVATION AND DEVELOPMENT COUNCIL, Inc RESOURCE CONSERVATION AND DEVELOPMENT PROGRAM Agency Director: David Marquez Contact Person: David Marquez Mailing Address: Hilo Lagoon Centre 101 Aupuni Street, Ste 229-A Hilo, Hawaii 96720-4261 Facility/Site Address Fax No.: Email Address: As above Phone No.: 933-933-6996 Phone No.: 328-0343 Fax: (808) 933-6995 Email: bircd@interpac.net Name of Accountant/CPA (include name of firm if applicable): Alex Smith Phone No.: (808) 737-7761 Mailing Address: 1403 Frank St. Honolulu Hi. Amount of Request for County Funds: $15000.00 — Funds will be used to retain book keeper, upgrade council's computer system, provide for high speed internet access and create an improved community internet access system for the council to use and share with applicants and partners. Prior Year(s) Funding: 05-06 06-07 07-08 $NA $NA $NA NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 1 Agency Mission Statement: The Mission of the Big Island RC&D Council is to assist the people of the Big Island in achieving sustainable development while caring for and appreciating their natural environment; to ensure broadened economic opportunities, enriched communities, and better lives. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 2 BIG ISLAND RESOURCE CONSERVATION AND DEVELOPMENT COUNCIL, Inc RESOURCE CONSERVATION AND DEVELOPMENT PROGRAM Program Description: Nationwide, Statewide, and Local: There are 375 RC&D Areas authorized in the United States which cover approximately 70% of the nation. RC&D Areas are authorized by the U.S. Secretary of Agriculture and the RC&D Program is administered by the Natural Resources Conservation Service (NRCS) who provide technical assistance and information outreach support to the individual, private nonprofit copuncils. The State of Hawaii has four RC&D Areas --Oahu, Garden Island, Tri -Isle, and the Big Island. The Big Island RC&D, authorized in 1975, covers the entire island of Hawaii. The Council is incorporated and non-profit within the State of Hawaii. It is also tax-exempt, 501(c) (3) by Internal Revenue Service determination. Network: The RC&D volunteer program is strengthened through a nationwide network. The Big Island RC&D belongs to the National Association of RC&D Councils (nationwide), and the Pacific Rim RC&D Association (regional). This network allows the RC&D Council to have an active role with issues being addressed at regional and national levels. Total Budget and Position Count Total Program Budget $12,138.00 1 Total Program Position Count 2 Total A enc Bud et NA Total A enc Position Count 2 NOTE: Agency Budget is not directed to the non-profit council for administrative purposes. Council contracts 2 part time positions, 1- CPA and 1 Book keeper. Agency provides position support for program and community. Council is a private non-profit. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 3 Program Objectives: The Vision of the Big Island RC&D Council: Conserve, enhance, and promote the economic, cultural, and natural environment of Hawaii. Program Highlights: The Big Island RC&D Council has completed numerous projects since 1975. Many partnerships were formed as a result of the networking that the RC&D Program builds. In addition, the council coordinates educational workshops to develop community awareness and resources. Requests for assistance are accomplished through submission of the Big Island RC&D Council's basic concept application. Listed below are some of the activities the Council and its volunteer committees have done or are doing: • 2005 International Mycology Conference -Growers Class with Don Hemmes/ Paul Staments. • RC&D Coordinator and NRCS assisted in development of Hilo Bay Watershed Restoration Plan. • 2004 -2007 Hawaii Worid Heritage Festivals -Multi -cultural events celebrating & showcasing Big Island Cultural diversity. • Hilo Bay Watershed Advisory Group Storm Drain Stencil Project. • Downtown Hilo Community Visioning Plan by Friends of Downtown Hilo. • Hilo Bike/Pedestrian Park Pathway—Assistance in planning, mapping and layout. • Conservation Innovation Grant for Shade Grown Coffee study — This project explores interplanting in native caniopy and rduced clearcutting for coffee. • Hilo Inter -tribal Powwow - A Native American cultural event that features art culture crafts music and an exchange of Native American and Native Hawaiian cultural ceremony 2006 — 2007. • Hawaii Agricultural Development Program (HADP) 2004 - 2005 - 2006 - A series of grants successfully acquired by the RC&D Council through Senator Daniel Inouye have been used to fund and support 31 separate agribusiness enterprises throughout the county. Phases I and 11 are now completed with Phase III expected to be done in early FY 2008. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 4 BIG ISLAND RESOURCE CONSERVATION AND DEVELOPMENT COUNCIL,inc RESOURCE CONSERVATION AND DEVELOPMENT PROGRAM Performance Measures: *If applicable Program Expenditures: Council's fiscal calendar is January - December FY 2006-07 Actual * FY 2007-08 Budget* FY 2008-09 Estimate Totals (see attached detailed sheets $9980.00 $12138.00 $13,0000 Professional Fees Operations Equipment Other" Total *If applicable Program Expenditures: Council's fiscal calendar is January - December * If applicable "Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 5 FY 2006-07 Actual * FY 2007-08 Budget * FY 2008-09 Estimate Salaries and Wages (SEE ATTACHED SHEETS Professional Fees Operations Equipment Other" Total * If applicable "Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 5 BIG ISLAND RESOURCE CONSERVATION & DEVELOPMENT COUNCIL FY 2007 BUDGET BUDGET 2007 INCOME Annual Dues $ 2,050.00 Admin Fees - Projects $ 10,000.00 Other $ 500.00 Total Income $12,550.00 WAZISVI:ISK President's Fund $ 500.00 D&O; Gen Liab $ 2,200.00 PacRim Conf $ 1,000.00 Annual Filing Fees $ 5.00 CPA Compilation Fee $ 975.00 Income Tax Preparation Fee $ 600.00 Equipment Purchases & Repairs $ 200.00 Standing Committees $ 200.00 Contingencies $ 1,000.00 Web hosting $ 660.00 Internet Fees $ 540.00 Anti virus upgrades $ 100.00 Stationery & Supplies $ 200.00 Telephone $ 575.00 Meals/Refreshment $ 475.00 Annual Dues;St,Reg,Natl $ 750.00 Total Expenses $ 9,980.00 Operating Income $ 2,570.00 Begin Balance 1/1/2007 $ 5,000.00 Ending Balance 12/3112007 $ 7,570.00 By: Larry Komata, Chair Finance -Budget Committee Subject to amendment INCOME Annual Dues $2,050.00 Admin Fees -Projects $6,000.00 Other $500.00 TOTAL INCOME $$0550,00 EXPENSE President's Fund $500.00 D&O Gen Liab $1,550.00 PacRim Conf $2,000.00 Annual Filing Fees $5.00 CPA Compilation $975.00 Income Tax Preparation Fee $600.00 Bookkeeper $3,000.00 Equipment Purchases & Repairs $200.00 Contingencies $1,000.00 Internet Fees $188.00 Ant Virus Upgrades $100.00 Stationery & Supplies $200.00 Telephone $576.00 Meals/Refreshments $495.00 Annual Dues $750.00 T( i ALS xp"4"S toX1 00 ' rt� :.M1� K s�� ftpr Q BIG ISLAND RESOURCE CONSERVATION AND DEVELOPMENT COUNCIL, Inc RESOURCE CONSERVATION AND DEVELOPMENT PROGRAM Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2006-07 Actual * FY 2007-08 Budget* FY 2008-09 Estimate USDA Ag. Development Program $206,572.00 $170,000.00 County of Hawaii R&D $18,500.00 $20,000.00 $22,000.00 Hawaii State Foundation Culture and Arts $6772.00 $5000.00 NRCS Conservation Innovation Grant $70,000.00 Co. of Hi. Healing our Island $2000.00 $1000.00 $2000.00 Hi. State Coastal Zone Management $13020.00 County Council $19,000.00 $26,000.00 $26,000.00 Co of Hi .Product Enhancement $28,500.00 $74,000.00 $70,000.00 Young Brothers $500.00 $500.00 Hawaiian Electric $3000.00 $2500.00 Office of Hawaiian Affairs $11,000.00 $9000.00 Program Service Fees $5972.00 $6000.00 $6000.00 RC&D Council Annual Dues $2050.00 $2050.00 $2050.00 $373,866.00 $142,070.00 $315,050.00 Total *If applicable Note: Program Funding sources listed here are from annually received grants and are for community projects, not for RC&D council operations. Annual totals will vary based on number of grants acquired. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 6 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? Efforts will be undertaken by the BIRC&DC to move toward a greater level of independence from government support by developing and submitting capacity building grant(s). These funds will be used to sponsor board training by commissioning subject matter experts in development of capital campaigns and endowment creation. Several private foundations offer capacity building grants to non -profits for this purpose This effort can be accomplished with no expense for the council if they can initiate the proposal. An endowment is a clear and effective way to establish both a legacy and a sustainanble operational framework for the future NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 7 BIG ISLAND RESOURCE CONSERVATION AND DEVELOPMENT COUNCIL, Inc RESOURCE CONSERVATION AND DEVELOPMENT PROGRAM I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 — 2-142.2, Hawai'i County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawai'i Revised Statutes. If awarded a grant from the County of Hawaii, I (we) understand and will comply with the requirement to submit a year-end report to the Legislative auditor within 60 days after June 30 of the fiscal year. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawaii grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely, complete, an Signat re f WaV Pre nt/Chair Council does not have an Executive Director nature of Executive Director Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTEDI NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-04 Page 8 Big Island Substance Abuse Council East Hawaii Substance Abuse Program Agency Director: Contact Person: Mailing Address: Facility/Site Address Fax No.: Email Address: Dr. Stephen C. Zuniga Richard Teanio Phone No.: 969-9994 Phone No.: 935-4927 234 Waianuenue Avenue Suite 101, Hilo, HI 96720 297 Waianuenue Avenue Hilo, HI 96720 969-7570 LikekeT@bisac.com Name of AccountanVCPA (include name of firm if applicable): John Carbonaro, Carbonaro CPA's & Management Group Phone No.: 808-242-5002 Mailing Address: 1885 Main Street Suite 408, Wailuku, HI 96793 Amount of Request for County Funds: $30,000 Prior Year(s) Funding: 05-06 06-07 07-08 $30,000 $30,000 $30,000 Agency Mission Statement: The Big Island Substance Abuse Council strives to enhance the quality of care and innovative services in the areas of Substance Abuse Education, Intervention and Treatment. We are dedicated to the healing of mind, body and spirit of individuals, families and others who suffer as a result of alcohol and other substance use, abuse and addiction. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page I Big Island Substance Abuse Council East Hawaii Substance Abuse Program Program Description: The Big Island Substance Abuse Council's East Hawaii programs provide comprehensive substance abuse treatment services to adults and adolescents through research -based methods and best -practices designed for the area's target population. This population includes adolescents, adults, parents and whole families who are experiencing substance abuse or dependency and require the structure of an institution such as BISAC to begin the process of recovery or intervene with chronic relapse. BISAC recognizes the significant impact of crystal methamphetamine to the addicted individual and our communities, and has designed programs to intervene in the addictive process and build on an individual's or family's strengths to abstain from the use of drugs and alcohol and increase protective factors and relapse prevention skills to maintain their rehabilitation. The East Hawaii BISAC programs provide outpatient treatment and therapeutic living services to adults and offers separate adolescent outpatient services and school based services in twenty-three (23) schools. BISAC gives priority to pregnant women, HIV users, and those with co- occurring disorders. Several of the East Hawaii therapeutic living programs are designed to meet specific needs of the target population and include home -like settings for a variety of specialties including; mothers with children ages birth -12 years, fathers with children ages birth -12 years, women who are transitioning out of the Department of Corrections, single women, and single men. BISAC has also placed a strong emphasis on providing services to persons abusing or addicted to the drug Crystal Methamphetamine or, "Ice". The ice epidemic in East Hawaii is truly evident and requires immediate access to treatment services when the opportunity arises. BISAC is requesting funds to subsidize Outpatient and Therapeutic Living Program Treatment services to Adolescents and Adults which will improve the overall quality and accessibility of services for any client who presents themselves at BISAC and requires immediate and intensive care necessary to recover from addiction. Total Budget and Position Count Total Program Budget 3,403,558 Total Pro ram Position Count 22 Total Agency Budget 5,820,608 Total Agency Position Count 92 NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 2 Big Island Substance Abuse Council East Hawaii Substance Abuse Program Program Objectives: 1) Provide immediate access to assessment and treatment services to any individuals who are assessed and diagnosed with any substance related disorders. 2) Increase the availability of extended outpatient and therapeutic living program treatment services to addicted adults and adolescents who may have no other funding availability for treatment services. 3) Decrease the number of days between when an individual requests treatment intervention services and the date that those services are delivered, by funding treatment -on -demand services while alternative reimbursement is identified. 4) Achieve understanding of disease concept of addiction and co-occurring disorders. 5) Reducing recidivism by 30% by not incurring additional arrests 6 months post-treatment. 6) Identify clean and sober social support networks and actively participate to identify and link with support systems in preparation for discharge. 7) Identification of individualized protective factors that will significantly reduce risk factors, and has identified and implemented a minimum of six within the first 90 days of treatment. 8) Complete 80% of identified treatment goals and has developed a transition plan to prepare for discharge. Program Highlights: BISAC was able to admit approximately 624 adults into all levels of outpatient substance abuse treatment and Therapeutic Living services and 411 adolescents island -wide. Data collected from our 2006-2007 Annual Management Report disclosed the following: 46% Completed Treatment. 66% were employed, in school, vocational training or volunteering. 89% had no new arrests post treatment. 76% had no new treatment episodes. 40% were involved in self-help groups post treatment. 81 % have stable living arrangements post treatment. • 87% did not miss work or school due to drugs/alcohol. 96% had no Emergency Room admissions post treatment. 98% had no hospital admissions post treatment. 89% had no significant psychological distress within 30 days post treatment. 38% usage within in the last 30 days. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 3 Big Island Substance Abuse Council East Hawaii Substance Abuse Program Performance Measures: FY 2006-07 Actual * FY 2007-08 Budget* FY 2008-09 Estimate Substance Abuse Treatment Units 34,941 35,445 37,529 2,442,846 2,551,457 Professional Fees 65,776 49,669 137,622 Operations 1,006,377 845,986 943,152 IT Infrastructure 48,129 149,329 0 Vehicle 0 15,000 25,000 *If applicable Program Expenditures * If applicable ° Please explain in detail on separate sheet Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2006-07 Actual * FY 2007-08 Budget * FY 2008-09 Estimate Salaries and Wages 2,080,213 2,442,846 2,551,457 Professional Fees 65,776 49,669 137,622 Operations 1,006,377 845,986 943,152 IT Infrastructure 48,129 149,329 0 Vehicle 0 15,000 25,000 Total 3,200,495 3,502,830 3,657,231 * If applicable ° Please explain in detail on separate sheet Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2006-07 Actual * FY 2007-08 Budget * FY 2008-09 Estimate County 30,000 30,000 30,000 State of Hawaii 1,784,815 2,010,351 2,270,351 Federal 769,260 800,074 800,074 HIUW 29,842 20,000 20,000 Private Foundation 15,000 30,145 0 Donations/Fund raising 1,127 19,500 4,500 Private Insurance 328,249 337,448 347,571 Client Fees 140,494 143,040 147,331 Training 8,255 13,000 15,000 Total 3,107,042 3,403,558 3,634,827 *If applicable NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 4 Big Island Substance Abuse Council East Hawaii Substance Abuse Program Explain what plans, if any, your agency and/or program has to increase revenues to support this program. When do you anticipate your program to become self-sustaining? Big Island Substance Abuse Council continues efforts to diversify funding sources and expand services where appropriate throughout the State and Island of Hawaii. BISAC's treatment services increased by 10% for fiscal year 2006- 2007. Third party payors and administrative fees increased by 7%. A conservative fiscal philosophy coupled with a team of skilled and dedicated staff members has enabled BISAC to expand and retain a positive, prominent presence in the community. BISAC's sound fiscal policies are incorporated into decisions related to program expansion or to enter market niches that would expand the behavioral health continuum. Business decisions include enrolling consumers in a Quest plan when eligible and appropriately utilizing benefits to cover treatment services. Administrative staff is scheduled to participate in meetings with HMSA and other substance abuse treatment providers to evaluate ways on increasing community awareness of insurance benefits and working with physicians to appropriately identify and refer consumers who may need treatment services that would be covered by HMSA insurance. The BISAC Board understands the commitment and priority of this project. The CEO is working to obtain commitments for this project and the Board has anticipated the project costs in the approved budget. The $30,000 requested for East Hawaii under this proposal will go towards the supporting this proposal's requests. BISAC plans include exploring available funding that supports capacity building and sustainability efforts, and reduces our reliance on State and County funds. I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 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, Hawai'i County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawai'i Revised Statutes. If awarded a grant from the County of Hawaii, I (we) understand and will comply with the requirement to submit a year-end report to the Legislative auditor within 60 days after June 30 of the fiscal year, The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawaii grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely, complete, and accurate Year-end report will impact the evaluation of your program's or agency's future funding requests. ignature of Board President/Chair Patricia Engelhard Signature of Executi , it ctor Dr. Stephen C. Zuniga Date Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 6 Big Island Substance Abuse Council West Hawaii Substance Abuse Program Agency Director: Contact Person: Mailing Address Facility/Site Address Fax No.: Email Address: Dr. Stephen C. Zuniga Marilyn McIntosh Phone No.: 969-9994 Phone No.: 322-3100 234 Waianuenue Avenue Suite 101, Hilo, HI 96720 81-947 Halekii Street, Kealakekua, HI 96750 969-7570 Marilynm@bisac.com Name of Accountant/CPA (include name of firm if applicable): John Carbonaro, Carbonaro CPA's & Management Group Phone No.: 808-242-5002 Mailing Address: 1885 Main Street Suite 408, Wailuku, HI 96793 Amount of Request for County Funds: $30,000 Prior Year(s) Funding: 05-06 06-07 07-08 $30,000 $30,000 $30,000 Agency Mission Statement: The Big Island Substance Abuse Council strives to enhance the quality of care and innovative services in the areas of Substance Abuse Education, Intervention and Treatment. We are dedicated to the healing of mind, body and spirit of individuals, families and others who suffer as a result of alcohol and other substance use, abuse and addiction. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 1 Big Island Substance Abuse Council West Hawaii Substance Abuse Program Program Description: The Big Island Substance Abuse Council's West Hawaii programs provide comprehensive substance abuse treatment services to adults and adolescents through research -based methods and best -practices designed for the area's target population. This population includes adolescents, adults, parents and whole families who are experiencing substance abuse or dependency and require the structure of an institution such as BISAC to begin the process of recovery or intervene with chronic relapse. BISAC recognizes the significant impact of crystal methamphetamine to the addicted individual and our communities, and has designed programs to intervene in the addictive process and build on an individual's or family's strengths to abstain from the use of drugs and alcohol and increase protective factors and relapse prevention skills to maintain their rehabilitation. The West Hawaii BISAC programs provide outpatient treatment and therapeutic living services to adults and offers separate adolescent outpatient services and school based services in twenty-three (23) schools. BISAC gives priority to pregnant women, HIV users, and those with co- occurring disorders. BISAC committed funds in 2007 to open a therapeutic living program for males in Kona. BISAC has also placed a strong emphasis on providing services to persons abusing or addicted to the drug Crystal Methamphetamine or, "Ice". The ice epidemic in West Hawaii is truly evident and requires immediate access to treatment services when the opportunity arises. Currently, the East Hawaii therapeutic living programs are designed to meet specific needs of the target population and include home -like settings for a variety of specialties including; mothers with children ages birth -12 years, fathers with children ages birth -12 years, women who are transitioning out of the Department of Corrections, single women, and single men. Establishing a therapeutic living program in West Hawaii allows clients to transition to communities where they have chosen to live and work. BISAC has also placed a strong emphasis on providing services to persons abusing or addicted to the drug Crystal Methamphetamine or "Ice". The ice epidemic in West Hawaii is truly evident and requires immediate access to treatment services when the opportunity arises. BISAC is requesting funds to subsidize Outpatient Treatment and Therapeutic Living Program services to Adolescents and Adults which will improve the overall quality and accessibility of services for any client who presents themselves at BISAC and requires immediate and intensive care necessary to recover from addiction. Total Budget and Position Count Total Pro ram Bud et 2,089,550 Total Pro ram Position Count 21 Total Agency Budget 1 5,820,608 1 Total A eg ncy Position Count 92 NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 2 Bia Island Substance Abuse Council West Hawaii Substance Abuse Program Program Objectives: 1) Provide immediate access to assessment and treatment services to any individuals who are assessed and diagnosed with any substance related disorders. 2) Increase the availability of extended outpatient and therapeutic living program treatment services to addicted adults and adolescents who may have no other funding availability for treatment services. 3) Decrease the number of days between when an individual requests treatment intervention services and the date that those services are delivered, by funding treatment -on -demand services while alternative reimbursement is identified. 4) Achieve understanding of disease concept of addiction and co-occurring disorders. 5) Reducing recidivism by 30% by not incurring additional arrests 6 months post-treatment. 6) Identify clean and sober social support networks and actively participate to identify and link with support systems in preparation for discharge. 7) Identification of individualized protective factors that will significantly reduce risk factors, and has identified and implemented a minimum of six within the first 90 days of treatment. 8) Complete 80% of identified treatment goals and has developed a transition plan to prepare for discharge. Program Highlights: BISAC was able to admit approximately 386 adults into all levels of outpatient substance abuse treatment and Therapeutic Living services and 411 adolescents island -wide. Data collected from our 2006-2007 Annual Management Report disclosed the following: 46% Completed Treatment. • 66% were employed, in school, vocational training or volunteering. 89% had no new arrests post treatment. 76% had no new treatment episodes. 40% were involved in self-help groups post treatment. 81 % have stable living arrangements post treatment. 87% did not miss work or school due to drugs/alcohol. 96% had no Emergency Room admissions post treatment. 98% had no hospital admissions post treatment. 89% had no significant psychological distress within 30 days post treatment. • 38% usage within in the last 30 days. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 3 Big Island Substance Abuse Council West Hawaii Substance Abuse Program Performance Measures: FY 2006-07 Actual * FY 2007-08 Budget* FY 2008-09 Estimate Substance Abuse Treatment Units 17,660 18,091 18,486 Professional Fees 22,145 39,386 40,568 Operations 347,969 556,793 584,632 IT Infrastructure 14,924 101,179 0 Vehicle 0 40,000 30,000 Total 1,202,599 2,093,035 2,051,547 15,000 91,730 0 *If applicable Program Expenditures FY 2006-07 Actual * FY 2007-08 Budget * FY 2008-09 Estimate Salaries and Wages 817,561 1,355,677 1,396,347 Professional Fees 22,145 39,386 40,568 Operations 347,969 556,793 584,632 IT Infrastructure 14,924 101,179 0 Vehicle 0 40,000 30,000 Total 1,202,599 2,093,035 2,051,547 If applicable * Please explain in detail on separate sheet Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2006-07 Actual * FY 2007-08 Budget * I FY 2008-09 Estimate County 30,000 30,000 30,000 State of Hawaii 906,762 1,424,918 1,458,540 Federal 150,177 188,442 188,442 HIUW 12,658 10,000 20,000 Private Foundation 15,000 91,730 0 Donation s/Fundraising 1,340 11,000 3,000 Private Insurance 201,362 256,940 264,648 Client Fees 61,222 84,520 87,055 Total 1,378,521 2,097,550 2,051,685 *If applicable NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 4 Big Island Substance Abuse Council West Hawaii Substance Abuse Program Explain what plans, if any, your agency and/or program has to increase revenues to support this program. When do you anticipate your program to become self-sustaining? Big Island Substance Abuse Council continues efforts to diversify funding sources and expand services where appropriate throughout the State and Island of Hawaii. BISAC's treatment services increased by 10% in fiscal year 2006- 2007. Third party payors and administrative fees increased by 7%. A conservative fiscal philosophy coupled with a team of skilled and dedicated staff members has enabled BISAC to expand and retain a positive, prominent presence in the community. BISAC's sound fiscal policies are incorporated into decisions related to program expansion or to enter market niches that would expand the behavioral health continuum. Business decisions include enrolling consumers in a Quest plan when eligible and appropriately utilizing benefits to cover treatment services. Administrative staff is scheduled to participate in meetings with HMSA and other substance abuse treatment providers to evaluate ways on increasing community awareness of insurance benefits and working with physicians to appropriately identify and refer consumers who may need treatment services that would be covered by HMSA insurance. The BISAC Board understands the commitment and priority of this project. The CEO is working to obtain commitments for this project and the Board has anticipated the project costs in the approved budget. The $30,000 requested for West Hawaii under this proposal will go towards the supporting this proposal's requests. BISAC plans include exploring available funding that supports capacity building and sustainability efforts, and reduces our reliance on State and County funds. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 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, Hawai'i County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawai'i Revised Statutes. If awarded a grant from the County of Hawai'i, I (we) understand and will comply with the requirement to submit a year-end report to the Legislative auditor within 60 days after June 30 of the fiscal year. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawaii grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely, complete, and accurate year-end report will impact the evaluation of your program's or agency's future funding requests. la� Z-e�:� Signature of Boar resident/Chair Patricia Engelhard �� 4 '- " e p Signatur of Exed6ti<je Direc or Dr. Stephen C. Zuniga i--zs-oy Date /-.25-- Z nol/ Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 6 Boys & Girls Club of the Big Island Positive Youth Development Programs: Hamakua Mobile Outreach Agency Director: David (Kawika) Mattos Phone No.: 961-5536 Contact Person: Mailing Address Facility/Site Address: Fax No.: Email Address David (Kawika) Mattos Phone No.: 961-5536 100 Kamakahonu Street, Hilo, Hawaii 96720 961-5189 kawika@becbi.com Name of Accountant/CPA (include name of firm if applicable): David Chinaka - Chinaka, Sui & Co., CPAs Phone No.: Mailing Address: 3465 Waialae Avenue, Suite 250 Honolulu, Hawaii 96816 Amount of Request for County Funds: $150,000 Prior Year(s) Funding: 05-06 06-07 07-08 $0 $0 $45,000 Agency Mission Statement: To inspire and enable Big Island youth from all backgrounds, especially those from disadvantaged circumstances, to become productive and responsible citizens by offering quality programs in a safe and caring environment. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 1 /s & Girls Club of the Big Island Positive Youth Development Programs: Program Description: Mobile Outreach When opportunities are available in a community for positive participation, children are less likely to engage in substance use and other problem behaviors. The Boys and Girls Club of the Big Island — Hamakua Mobile Outreach Program, provides those opportunities on a daily basis to the young people of the Pa'auilo community, the Pa'auhau village and in the near future, the youth of Waimea. As they grow up, youth are exposed to a number of factors which may either increase their risk for, or protect them from, problems such as abusing drugs or engaging in delinquent behavior. "Risk factors" are any circumstances that may increase the likelihood of youth engaging in risky behaviors. Conversely, "protective factors' are any circumstances that promote healthy youth behaviors and decrease the chance that youth will engage in risky behaviors. The Boys and Girls Club of the Big Island (BGCBI) has been in the business of increasing the protective factors and at the same time decreasing the risk factors in our Big Island youth, ages 6 through 18, for over fifty years. Founded as the Boys Club of Hilo in 1952, the organization has served over 50,000 youth in East Hawaii. In 2002, we became BGCBI and during the last 5 years have extended our service reach to the youth in Pahoa, Kea'au, Ocean View, Pahala, and along the Hamakua coast through our unique mobile outreach program. The Hamakua Mobile Outreach Program is the most unique of all the agency's programs. In order to reach young people in some of the smallest villages along the Hamakua coast, the mobile unit has had the opportunity to bring Boys and Girls Club programming to them. This program established in February 2007 has formed a valuable partnership with the Pa'auilo County Parks and Recreation program and has been able to provide youth development activities five days a week in using a combination of park facilities and mobile unit capabilities. During the last year, this outreach program has been successful in program implementation to the youth of Pa'auhau, where the children come to the truck for activities two days a week. This coming year, the Hamakua Mobile Outreach Program will be extending its reach west to Waimea and southwest to the Hawaiian Ocean View Estate's Marshallese and Micronesian populations. Planning and development is currently underway. In the fall semester of 2007, our mobile outreach professional youth development staff implemented our SMART Moves curriculum to the 15t through 4`h grade students of Pa'auilo Elementary School. As a result of this outreach, the Boys and Girls Club membership growth in the Pa'auilo community doubled; therefore, indicating a need for the BGCBI to find permanent home in this community. The BGCBI has recently entered a leased agreement with the Pa'auilo Hongwanji to use their church hall to house our newest Boys and Girls Club. The Club sits adjacent to the Pa'auilo Elementary School and the young people attending are NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 2 Boys & Girls Club of the Big Island Positive Youth Development Programs: Hamakua Mobile Outreach able to safely walk to the club without crossing any major streets or roads. The Hongwanji hall is large enough to implement our five core programs with ease and the Hongwanji congregation expressed support and excitement to bring the Boys and Girls Club youth development program to their youth. Remaining a part of the Hamakua Mobile Outreach Program, the Pa'auilo Boys and Girls Club will provide the opportunity for youth along the Hamakua Coast to attend a safe, structured, building -centered program after school and during "out of school" hours while their parents are working. With the Pa'auilo Boys and Girls Club in place, the BGCBI will be able to reach out to the families from the following surrounding villages: 'O'okala, Pa'auhau, Kukuihaele and Honoka'a. The Hamakua Mobile Outreach Program conducts daily after-school, weekend and full day school intercession programs which include Boys & Girls Club of America's five core programs areas: • Sports, Fitness and Recreation Development: develops fitness, positive use of leisure time, skills for stress management, appreciation for the environment and social skills. Activities and programs include: game room, indoor/outdoor activities, table tournaments and inter -club leagues. • The Arts: enables youth to develop their creativity and cultural awareness through knowledge and an appreciation of the visual arts, crafts, performing arts and creative writing. Activities and programs include: arts & crafts, fine art, dance and music. • Education and Career Development: enables our youth to become proficient in basic educational disciplines, apply learning to everyday situations and embrace technology to achieve success in a career. Activities and programs include: Power Hour homework assistance, Project Learn comprehensive education based activities with high -yield learning opportunities, science based environmental programs, Club Tech computer technology program and Career Launch career preparatory program • Character & Leadership Development: empowers our youth to support and influence their Club and community, sustain meaningful relationships with others, develop a positive self-image, participate in the democratic process and respect their own and others' cultural identities. Activities and programs include: Keystone Club for 13-17 year olds, Torch Club for 10-12 year olds, Youth of the Year - local, state, regional and national youth recognition program, public speaking opportunities, community service clubs and Welcome Patrol - youth program for youth introducing the Club to guest and new members. • Health & Life Skills Development: develops our youth's capacity to engage in positive behaviors that nurture their own well-being, set personal goals and live successfully as self-sufficient adults. Activities and programs include: Skills Mastery And Resistance Training (SMART NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 3 Boys & Girls Club of the Big Island Positive Youth Development Programs: Hamakua Mobile Outreach Moves) - a nationally recognized model program for prevention of alcohol, tobacco and drug use. SMART Moves incorporates 11 age appropriate curriculum for ages 6-18 years of age as well as parents and community. Triple Play - is a fitness program that develops a connection of mind, body and soul. The Hamakua Mobile Outreach Program offers a positive, safe environment for our youth during those critical, non -school hours when youth have an increased opportunity to engage in what are known as "risky behaviors". The Hamakua Mobile Outreach Program believes that the most effective approach for improving young people's lives is to reduce risk factors while increasing protective factors in all of the areas that touch their lives. Caring, trained youth development staff provide guidance in helping boys and girls to: discover their needs, enjoy their interests, explore their talents, broaden their viewpoints, value their diversity, resolve conflicts, set goals, understand themselves and have fun! As an affiliate member of our national organization, the Boys and Girls Club of America, BGCBI strives to provide youth development programs that support the fundamental principles and beliefs of the national Boys and Girls Club Movement. Our Core Beliefs A Boys and Girls Club provides: • A safe place to learn and grow • Ongoing relationships with caring, adult professionals • Life -enhancing programs and character development experiences • Hope and opportunity Youth Development Strategy The philosophy underlying BGCBI programming is the Youth Development Strategy. All Boys and Girls Club programs and activities are designed to maximize opportunities for young people to acquire four basic "senses" which help them build self-esteem and grow into responsible and caring citizens. These four senses are: • A sense of competence — Young people feel proud and confident when they acquire new skills and know they can do something and do it well. • A sense of usefulness — Young people know the satisfaction of doing something of value for others. • A sense of belonging — Young people know they are welcome and feel that they fit in and are accepted. • A sense of power and influence — Young people know their opinions are heard and valued and that they can influence decisions. Youth development occurs in all aspects of Boys and Girls Club participation. The Hamakua Mobile Outreach Program creates a climate in which these NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 4 Boys & Girls Club of the Big Island Positive Youth Development Programs: Hamakua Mobile Outreach important "senses" are fostered in every participant, member and guest involved in program or just "hanging out". Youth Development Outcomes at age 18 The Hamakua Mobile Outreach Program strives to help all youth live full, satisfying and productive lives. The following outcomes summarize BGCBI expectations and goals for youth entering the world at age 18: a positive self identity, competencies in education and employment, social competencies enabling them to develop and sustain positive relationships, emotional competencies enabling them to appropriately express themselves, and cultural competencies enabling them to contribute in a multicultural society and demonstrate tolerance for differences among people. Other youth development outcomes include: Community and Civic Involvement: Youth have a sense of belonging to their community, family and/or group and are willing to take civic responsibility. They work closely with others to contribute to the greater good. Health and Well -Being: Youth live healthy lifestyles, take part in regular fitness activities, are able to access health care resources and engage in positive behaviors. They use sound judgment about personal safety, nutrition and avoidance of alcohol, drugs and premature sexual activity. Moral Compass: Youth have values enabling them to develop positive relationships with others. These values include honesty, a sense of justice and fairness, respect, caring and spirituality. The Hamakua Mobile Outreach Program proposes to engage youth in activities that are fun and enjoyable while supporting the development of the capacities described above. The Hamakua Mobile Outreach Program will use the Youth Development Outcome Measurement Tool Kit developed by the Boys and Girls Club of America. The goal of this measurement tool is to acquire the general well being of Club members and the degree to which they are acquiring skills, competencies and attitudes in specific areas, while assessing the impact that the Boys and Girls Club has on young people. Three internet-based surveys have been developed (elementary, middle and high school) to collect and analyze information about whether the Hamakua Mobile Outreach Program is making a difference in members' lives. The Hamakua Mobile Outreach Program will survey its members twice throughout the funding year. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 5 & Girls Club of the Big Island Positive Youth Development Programs: Hamakua Total Budget and Position Count Total Program Budget $252,298 Total Program Position Count 8 Total A enc Bud et $1,762,566 Total Agency Position Count 49 Program Objectives: 1) Increase participants' knowledge and awareness of the consequences and harmful effects of tobacco, alcohol, and other drugs on their health and well-being. 2) Increase participants' ability to identify and resist peer and media pressures to engage in risky behaviors. 3) Increase participants' involvement in positive civic and community events. 4) Increase participants' positive attitude toward school/education 5) Decrease risky behavior of youth by increasing participants' positive self esteem through participation in positive youth development programs and activities on a daily basis Program Highlights: 1) In the Fiscal Year 2006-2007 the Boys and Girls Club of the Big Island provided programs to over 1300 youth ages 6 through 18 in our Clubs located at: Hamakua Mobile Outreach in Pa'auilo and Pa'auhau, Hilo, Kea'au, Pahala, Pahoa, and Ocean View Estates. Our youth development professionals also reached out to the schools as a beginning of our outreach efforts to provide the SMART Moves Drug, Alcohol, and Pregnancy Prevention Curriculum to those youth who do not participate in our daily year-round program. The Pahala Club opened its doors on September 18, 2006 and quickly grew to 90 members by the end of Fiscal Year 2006-2007. The Hawaiian Ocean View Estates Club and the Hamakua Mobile Outreach program began on February 1, 2007 and totaled 99 youth by the end of Fiscal Year 2006-2007. These communities and villages desired youth development programs for their children and have been very supportive of the work that we do. The need is large and BGCBI responded in a large way. 2) Collaborations/partnerships increased during Fiscal Year 2006-2007. We can add the following list of agencies working in partnership with BGCBI Clubs. ➢ County Parks and Recreation (Pa'auilo, Pahala, and Ocean View) ➢ United States Tennis Association ➢ Theatre Arts Conservatory NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 6 Boys & Girls Club of the Big Island Positive Youth Development Programs: Hamakua Mobile Outreach ➢ Ocean Futures Society — Hawai'i Ambassadors to the Environment Program Hawaii State Department of Education University of Hawaii Hilo — Department of Agriculture ➢ The Rotary Club of South Hilo ➢ Coalition for a Tobacco Free Hawaii — East Hawaii ➢ Rein Teen Tours — Mainland Teens Community Service Initiative The Hawaii Big Game Fishing Club ➢ County of Hawaii Police Department 'v Hawaii Police Activities League (HI PAL) 3) Fiscal Year 2006-2007 presented BGCBI with a year of change and growth. Several key positions became available during this time including: BGCBI Finance Manager, BGCBI Director of Program Operations, Kea'au Club Director, and Hilo Teen Director. Qualified individuals were identified for all positions, each bringing their own experiences, "gifts", and visions for growth and change. BGCBI moved forward into Fiscal Year 2007-2008 with a staff dedicated to excellence and program best practices! Performance Measures: NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 7 FY 2006-07 FY 2007-08 FY 2008-09 Actual " Budget* Estimate Youth will participate in The Arts Programs. Examples: ✓ Arts and Crafts n/a 50 75 ✓ Dance ✓ Music ✓ Fine Arts Youth will participate in Character and Leadership programs. Examples: ✓ Keystone Club n/a 25 30 ✓ Torch Club ✓ Community Service Projects ✓ Club Service Projects Youth will participate in Education and Career Development Programs. Examples: ✓ Power Hour n/a 75 100 ✓ Project Learn ✓ Tutoring NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 7 Boys & Girls Club of the Big Island Positive Youth Development Programs: Hamakua Mobile Outreach ✓ Computer Technolo Youth will participate in Health and Life Skills Programs. Examples: ✓ SMART Moves n/a 75 75 ✓ Nutrition/Cooking Classes ✓ Triple Play Youth will participate in Sports, Fitness and Recreation Programs. Examples: ✓ Team/Individual Sports n/a 100 100 ✓ Games Room Activities ✓ Fitness Activities and Programs Parents will participate in FAN Club activities - Family will participate in n/a 15 4 events per activities to promote family year strengthening and unity. Youth will complete SMART Moves n/a 50 #'s included in Health and Life Skills Development Of the 50 youth completing the #'s included in SMART Moves Program, youth n/a 20 Health and Life ages 6-9 will complete the SMART Skills Development Kids Program Of the 50 youth completing the #'s included in SMART Moves Program, youth n/a 15 Health and Life ages 10-12 will complete the Start Skills Development SMART Program Of the 50 youth completing the #'s included in SMART Moves Program, youth n/a 10 Health and Life ages 13-15 will complete the Stay Skills Development SMART Program Of the 50 youth completing the #'s included in SMART Moves Program, youth n/a 5 Health and Life ages 13-17 will complete the Skills Development SMART Leaders Program Note: 2008-2009 Estimates for Skills Mastery and Resistance Training (SMART) Moves Prevention Program: This curriculum is offered to our youth within our Health and Life Skills core program area. Estimations are difficult for the actual curriculum, as our membership varies from year to year and each component has an age span. If a member is 6 years old when participating in SMART Kids, they are not able to NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 8 Boys & Girls Club of the Big Island Positive Youth Development Programs: Hamakua Mol participate in the Start SMART curriculum until age 10. BGCBI would like the County to be aware that all the youth development programming that we do includes the SMART Moves message to our youth. All five core program areas are enhanced by this curriculum sending the message to our youth that if they resist 'risky behaviors" they are able to reach their full potential as productive, caring and responsible citizens. BGCBI is committed to assisting the young people of the Big Island in developing the necessary skills to resist tobacco, drugs, early sexual activity, and other problem behaviors such as: truancy, school failure/dropout, crime, violence, family problems and suicide. Program Expenditure If applicable "Please explain in detail on separate sheet Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2006-07 Actual* bud et FY 2007-08 Budget* estimate FY 2008-09 Estimate Salaries and Wages $51,100 $139,389 $193,571 Professional Fees $130 $1,500 $1,500 Operations $38,649 $45,916 $47,627 Equipment $1,442 $9,100 $9,100 Other(Board Development) $350 $500 $500 Total $91,321 $196,405 $252,298 If applicable "Please explain in detail on separate sheet Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2006-07 Actual* (budget) FY 2007-08 Budget* estimate FY 2008-09 Estimate County of Hawaii —Non profit Grant $45,000 150,000 Boys & Girls Club of Hawaii/YMCA Rural Youth Program RYP Funds $65,324 $15,207 Office of Youth Services (OYS) $125,000 $90,000 Hawaii Community Foundation: HCF : Tobacco Fund $4,769 $9,698 $2,375 Intersession Program Fees $350 Club Fundraising Events $157 $500 $2,000 Community Donations $20,721 $1,000 $7,923 Total $91,321 $196,405 $252,298 *If applicable NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 9 & Girls Club of the Big Island Positive Youth Development Programs: Hamakua Mobile Outreach Explain what plans, if any, your agency and/or program has to increase revenues to support this program. When do you anticipate your program to become self-sustaining? The Boys and Girls Clubs of the Big Island has made a strong movement to work towards diversifying our revenues. Our goal is to be balanced between grants and unrestricted (fundraising & donation) revenues, as well as the vision to create an endowment fund for the future . We will continue to work with Federal, State, County and private agencies to enhance collaboration between all facets to help us succeed. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 10 Boys & Girls Club of the Big Island Positive Youth Development Programs: Hamakua Mobile Outreach I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 — 2-142.2, Hawaii County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawai'i Revised Statutes. If awarded a grant from the County of Hawai'i, I (we) understand and will comply with the requirement to submit a year-end report to the Legislative auditor within 60 days after June 30 of the fiscal year. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawai'i grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely, complete, and accurate year-end report will impact the evaluation of your program's or agency's future funding requests. "VW Signature of Board President/Chair ii Signature f Executive Director Date 130 D� _ Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 11 Boys & Girls Club of the Big Island Positive Youth Development Programs: Hilo Club Agency Director: David (Kawika) Mattos Phone No.: 961-5536 Contact Person Mailing Address: Facility/Site Address: Fax No.: Email Address: David (Kawika) Mattos Phone No.: 961-5536 100 Kamakahonu Street, Hilo, Hawaii 96720 100 Kamakahonu Street, Hilo, Hawaii 96720 961-5189 kawika@becbi.com Name of Accountant/CPA (include name of firm if applicable): David Chinaka - Chinaka, Sui & Co., CPAs Phone No.: Mailing Address: 3465 Waialae Avenue, Suite 250 Honolulu, Hawaii 96816 Amount of Request for County Funds Prior Year(s) Funding: 05-06 06-07 $57,000 $0 Agency Mission Statement: $150,000 07-08 $80,000 To inspire and enable Big Island youth from all backgrounds, especially those from disadvantaged circumstances, to become productive and responsible citizens by offering quality programs in a safe and caring environment. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 1 Boys & Girls Club of the Big Island Positive Youth Development Programs: Hilo Club Program Description: When opportunities are available in a community for positive participation, children are less likely to engage in substance use and other problem behaviors. The Boys and Girls Club of the Big Island — Hilo Club, provides those opportunities on a daily basis to the young people of the Hilo community. As they grow up, youth are exposed to a number of factors which may either increase their risk for, or protect them from, problems such as abusing drugs or engaging in delinquent behavior. "Risk factors" are any circumstances that may increase the likelihood of youth engaging in risky behaviors. Conversely, "protective factors' are any circumstances that promote healthy youth behaviors and decrease the chance that youth will engage in risky behaviors. The Boys and Girls Club of the Big Island (BGCBI) has been in the business of increasing the protective factors and at the same time decreasing the risk factors in our Big Island youth, ages 6 through 18, for over fifty years. Founded as the Boys Club of Hilo in 1952, the organization has served over 50,000 youth in East Hawaii. In 2002, we became BGCBI and during the last 5 years have extended our service reach to the youth in Pahoa, Kea'au, Ocean View, Pahala, and along the Hamakua coast through our unique mobile outreach program. The Hilo Club is located in downtown Hilo and sits on a 14 acre property of the Hilo Boarding School. This beautiful site includes 2 baseball fields, a small t- ball/soccer field, a full size gymnasium, a "currently under renovation" Club recreation room, art room, learning center, teen center, a computer lab, a kitchen, a patio for leisure and eating and two additional rooms for small group activities. A full size swimming pool is also part of the renovation plan to reestablish an aquatics program. The Hilo Club conducts daily after-school, evening, weekend and full-day intercession programs which include Boys & Girls Club of America's five core programs areas: • Sports, Fitness and Recreation Development: develops fitness, positive use of leisure time, skills for stress management, appreciation for the environment and social skills. Activities and programs include: game room, indoor/outdoor activities, table tournaments and inter -club leagues. • The Arts: enables youth to develop their creativity and cultural awareness through knowledge and an appreciation of the visual arts, crafts, performing arts and creative writing. Activities and programs include: arts & crafts, fine art, dance and music. • Education and Career Development: enables our youth to become proficient in basic educational disciplines, apply learning to everyday situations and embrace technology to achieve success in a career. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 2 Boys & Girls Club of the Big Island Positive Youth Development Programs: Hilo Club Activities and programs include: Power Hour homework assistance, Project Learn comprehensive education based activities with high -yield learning opportunities, science based environmental programs, Club Tech computer technology program and Career Launch career preparatory program • Character & Leadership Development: empowers our youth to support and influence their Club and community, sustain meaningful relationships with others, develop a positive self-image, participate in the democratic process and respect their own and others' cultural identities. Activities and programs include: Keystone Club for 13-17 year olds, Torch Club for 10-12 year olds, Youth of the Year - local, state, regional and national youth recognition program, public speaking opportunities, community service clubs and Welcome Patrol - youth program for youth introducing the Club to guest and new members. • Health & Life Skills Development: develops our youth's capacity to engage in positive behaviors that nurture their own well-being, set personal goals and live successfully as self-sufficient adults. Activities and programs include: Skills Mastery And Resistance Training (SMART Moves) - a nationally recognized model program for prevention of alcohol, tobacco and drug use. SMART Moves incorporates 11 age appropriate curriculum for ages 6-18 years of age as well as parents and community. Triple Play - is a fitness program that develops a connection of mind, body and soul. The Hilo Club offers a positive, safe environment for our youth during those critical, non -school hours when youth have an increased opportunity to engage in what are known as "risky behaviors". The Hilo Club believes that the most effective approach for improving young people's lives is to reduce risk factors while increasing protective factors in all of the areas that touch their lives. Caring, trained youth development staff provide guidance in helping boys and girls to: discover their needs, enjoy their interests, explore their talents, broaden their viewpoints, value their diversity, resolve conflicts, set goals, understand themselves and have fun! As an affiliate member of our national organization, the Boys and Girls Club of America, BGCBI strives to provide youth development programs that support the fundamental principles and beliefs of the national Boys and Girls Club Movement. Our Core Beliefs A Boys and Girls Club provides: • A safe place to learn and grow • Ongoing relationships with caring, adult professionals • Life -enhancing programs and character development experiences • Hope and opportunity NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 3 Boys & Girls Club of the Big Island Positive Youth Development Programs: Hilo Club Youth Development Strategy The philosophy underlying BGCBI programming is the Youth Development Strategy. All Boys and Girls Club programs and activities are designed to maximize opportunities for young people to acquire four basic "senses" which help them build self-esteem and grow into responsible and caring citizens. These four senses are: • A sense of competence — Young people feel proud and confident when they acquire new skills and know they can do something and do it well. • A sense of usefulness — Young people know the satisfaction of doing something of value for others. • A sense of belonging — Young people know they are welcome and feel that they fit in and are accepted. • A sense of power and influence — Young people know their opinions are heard and valued and that they can influence decisions. Youth development occurs in all aspects of Boys and Girls Club participation. The Hilo Club creates a climate in which these important "senses" are fostered in every participant, member and guest involved in program or just "hanging out". Youth Development Outcomes at age 18 The Hilo Club strives to help all youth live full, satisfying and productive lives. The following outcomes summarize BGCBI expectations and goals for youth entering the world at age 18: a positive self identity, competencies in education and employment, social competencies enabling them to develop and sustain positive relationships, emotional competencies enabling them to appropriately express themselves, and cultural competencies enabling them to contribute in a multicultural society and demonstrate tolerance for differences among people. Other youth development outcomes include: Community and Civic Involvement: Youth have a sense of belonging to their community, family and/or group and are willing to take civic responsibility. They work closely with others to contribute to the greater good. Health and Well -Being: Youth live healthy lifestyles, take part in regular fitness activities, are able to access health care resources and engage in positive behaviors. They use sound judgment about personal safety, nutrition and avoidance of alcohol, drugs and premature sexual activity. Moral Compass: Youth have values enabling them to develop positive relationships with others. These values include honesty, a sense of justice and fairness, respect, caring and spirituality. The Hilo Club proposes to engage youth in activities that are fun and enjoyable while supporting the development of the capacities described above. The Hilo NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 4 & Girls Club of the Bia Island Positive Youth Development Programs: Hilo Club Club will use the Youth Development Outcome Measurement Tool Kit developed by the Boys and Girls Club of America. The goal of this measurement tool is to acquire the general well being of Club members and the degree to which they are acquiring skills, competencies and attitudes in specific areas, while assessing the impact that the Boys and Girls Club has on young people. Three internet- based surveys have been developed (elementary, middle and high school) to collect and analyze information about whether the Hilo Club is making a difference in members' lives. The Hilo Club will survey its members twice throughout the funding year. Total Budget and Position Count Total Pro ram Bud et $612,955 Total Program Position Count 12 Total Agency Budget $1,762,566 Total Agency Position Count 49 Program Objectives: 1) Increase participants' knowledge and awareness of the consequences and harmful effects of tobacco, alcohol, and other drugs on their health and well-being. 2) Increase participants' ability to identify and resist peer and media pressures to engage in risky behaviors. 3) Increase participants' involvement in positive civic and community events. 4) Increase participants' positive attitude toward school/education 5) Decrease risky behavior of youth by increasing participants' positive self esteem through participation in positive youth development programs and activities on a daily basis Program Highlights: 1) In the Fiscal Year 2006-2007 the Boys and Girls Club of the Big Island provided programs to over 1300 youth ages 6 through 18 in our Clubs located at: Hamakua Mobile Outreach in Pa'auilo and Pa'auhau, Hilo, Kea'au, Pahala, Pahoa, and Ocean View Estates. Our youth development professionals also reached out to the schools as a beginning of our outreach efforts to provide the SMART Moves Drug, Alcohol, and Pregnancy Prevention Curriculum to those youth who do not participate in our daily year-round program. The Pahala Club opened its doors on September 18, 2006 and quickly grew to 90 members by the end of Fiscal Year 2006-2007. The Hawaiian Ocean View Estates Club and the Hamakua Mobile Outreach program began on February 1, 2007 and totaled 99 youth by the end of Fiscal Year 2006-2007. These communities and villages desired youth development NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 5 Boys & Girls Club of the Big Island Positive Youth Development Programs: Hilo Club programs for their children and have been very supportive of the work that we do. The need is large and BGCBI responded in a large way. 2) Collaborations/partnerships increased during Fiscal Year 2006-2007. We can add the following list of agencies working in partnership with BGCBI Clubs. ➢ County Parks and Recreation (Pa'auilo, Pahala, and Ocean View) ➢ United States Tennis Association ➢ Theatre Arts Conservatory Ocean Futures Society — Hawai'i Ambassadors to the Environment Program ➢ Hawaii State Department of Education ➢ University of Hawaii Hilo — Department of Agriculture ➢ The Rotary Club of South Hilo Coalition for a Tobacco Free Hawaii — East Hawaii ➢ Rein Teen Tours — Mainland Teens Community Service Initiative ➢ The Hawaii Big Game Fishing Club ➢ County of Hawaii Police Department ➢ Hawaii Police Activities League (HI PAL) 3) Fiscal Year 2006-2007 presented BGCBI with a year of change and growth. Several key positions became available during this time including: BGCBI Finance Manager, BGCBI Director of Program Operations, Kea'au Club Director, and Hilo Teen Director. Qualified individuals were identified for all positions, each bringing their own experiences, "gifts", and visions for growth and change. BGCBI moved forward into Fiscal Year 2007-2008 with a staff dedicated to excellence and program best practices! Performance Measures: NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 6 FY 2006-07 Actual * FY 2007-08 Budget* FY 2008-09 Estimate Youth will participate in The Arts Programs. Examples: ✓ Arts and Crafts n/a 300 300 ✓ Dance ✓ Music ✓ Fine Arts Youth will participate in Character and Leadership programs. Examples: n/a 145 150 ✓ Keystone Club _ NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 6 & Girls Club of the Bie Island Positive Youth Development Programs: Hilo Club ✓ Torch Club ✓ Community Service Projects ✓ Club Service Projects Youth will participate in Education and Career Development Programs. Examples: ✓ Power Hour n/a 370 300 ✓ Project Learn ✓ Tutoring ✓ Computer Technology Youth will participate in Health and Life Skills Programs. Examples: ✓ SMART Moves n/a 220 300 ✓ Nutrition/Cooking Classes ✓ Triple Play Youth will participate in Sports, Fitness and Recreation Programs. Examples: ✓ Team/Individual Sports n/a 485 400 ✓ Games Room Activities ✓ Fitness Activities and Programs Parents will participate in FAN Club activities - Family will participate in n/a 100 4 events per year activities to promote family strengthening and unity. Youth will complete SMART Moves n/a 537 #'s included in Health and Life Skills Development Of the 537 youth completing the #'s Included in Health SMART Moves Program: Youth 90 and Life Skills ages 6-9 will complete the SMART n/a Development Kids Program Of the 537 youth completing the #'s included in Health SMART Moves Program: Youth n/a 129 and Life Skills ages 10-12will complete the Start Development SMART Program Of the 537 youth completing the #'s included in Health SMART Moves Program: Youth n/a 229 and Life Skills ages 13-15 will complete the Stay Development SMART Program Of the 537 youth completing the #'s included in Health SMART Moves Program: Youth n/a 89 and Life Skills ages 13-17 will complete the Development SMART Leaders Program NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 7 Boys & Girls Club of the Big Island Positive Youth Development Programs: Hilo Club Note: 2008-2009 Estimates for Skills Mastery and Resistance Training (SMART) Moves Prevention Program: This curriculum is offered to our youth within our Health and Life Skills core program area. Estimations are difficult for the actual curriculum, as our membership varies from year to year and each component has an age span. If a member is 6 years old when participating in SMART Kids, they are not able to participate in the Start SMART curriculum until age 10. BGCBI would like the County to be aware that all the youth development programming that we do includes the SMART Moves message to our youth. All five core program areas are enhanced by this curriculum sending the message to our youth that if they resist 'risky behaviors" they are able to reach their full potential as productive, caring and responsible citizens. BGCBI is committed to assisting the young people of the Big Island in developing the necessary skills to resist tobacco, drugs, early sexual activity, and other problem behaviors such as: truancy, school failure/dropout, crime, violence, family problems and suicide. Program Expenditure If applicable * Please explain in detail on separate sheet Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2006-07 Actual` (budget) FY 2007-08 Budget* estimate FY 2008-09 Estimate Salaries and Wages $282,959 $326,320 $367,718 Professional Fees $4,014 $6,000 $6,000 Operations $227,216 $204,718 $229,717 Equipment $7319 $7,520 $7,520 Other(Board Development/Renovations) $200 $2,000 $2,000 Total $521,708 $546,558 $612,955 If applicable * Please explain in detail on separate sheet Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2006-07 Actual` (budget) FY 2007-08 Budget* estimate FY 2008-09 Estimate County of Hawaii —Non profit Grant $80,000 $150,000 Office of Justice Programs - Growth $35,000 Office of Justice Programs — Capacity $42,000 Office of Justice Programs — Hilo $150,000 NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 8 & Girls Club of the Bis Island Positive Youth Development Programs: Hilo Club YMCA Rural Youth Program (RYP) Grant Center Base $99,655 $45,485 Office of Youth Services (OYS) Positive Youth Development $66,577 $52,746 $40,000 Hawaii Community Foundation: HCF : Tobacco Fund $63,249 $33,605 $14,250 Hawaii Island United Way $25,600 $22,925 $25,000 Alcohol Drug Abuse Division ADAD $65,053 $50,000 Boys & Girls Club of Hawaii: Abstinence -Only Grant $8,671 Dept of Education — OHCNP $7,965 First Pics / Triple Play OJP Grant $9,000 County of Hawaii - Contingency Fund $25,000 Intersession Program Fees $23,875 $37,300 $43,705 Club Fundraising Events $49,115 $55,000 $40,000 Community Donations $24,710 $194,498 $100,000 Total $521,708 $546,558 $612,955 'If applicable Explain what plans, if any, your agency and/or program has to increase revenues to support this program. When do you anticipate your program to become self-sustaining? The Boys and Girls Clubs of the Big Island has made a strong movement to work towards diversifying our revenues. Our goal is to be balanced between grants and unrestricted (fundraising & donation) revenues, as well as the vision to create an endowment fund for the future . We will continue to work with Federal, State, County and private agencies to enhance collaboration between all facets to help us succeed. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 9 Boys & Girls Club of the Big Island Positive Youth Development Programs: Hilo Club I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 — 2-142.2, Hawai'i County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawai'i Revised Statutes. If awarded a grant from the County of Hawaii, 1 (we) understand and will comply with the requirement to submit a year-end report to the Legislative auditor within 60 days after June 30 of the fiscal year. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawaii grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely, complete, an agency's future funding requests. A" W, [k Signaturepf*ard President/Chair Signature of Executive Director Date 113 0/t9s Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 10 Boys & Girls Club of the Big Island Positive Youth Development Programs: Kea au Club Agency Director: David (Kawika) Mattos Phone No.: 961-5536 Contact Person: David (Kawika) Mattos Phone No.: 961-5536 Mailing Address: 100 Kamakahonu Street, Hilo, Hawaii 96720 Facility/Site Address: 16-0565 Pahoa Road, Kea'au, Hawaii 96749 Fax No.: 961-5189 Email Address: kawika@becbi.com Name of Accountant/CPA (include name of firm if applicable): David Chinaka - Chinaka, Sui & Co., CPAs Phone No.: Mailing Address: 3465 Waialae Avenue, Suite 250 Honolulu. Hawaii 96816 Amount of Request for County Funds Prior Year(s) Funding: 05-06 $0 06-07 $0 Agency Mission Statement: $100,000 07-08 $45,000 To inspire and enable Big Island youth from all backgrounds, especially those from disadvantaged circumstances, to become productive and responsible citizens by offering quality programs in a safe and caring environment. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 1 Boys & Girls Club of the Big Island Positive Youth Development Programs: Kea'au Club Program Description: When opportunities are available in a community for positive participation, children are less likely to engage in substance use and other problem behaviors. The Boys and Girls Club of the Big Island — Kea'au Club, provides those opportunities on a daily basis to the young people of the Kea'au community. As they grow up, youth are exposed to a number of factors which may either increase their risk for, or protect them from, problems such as abusing drugs or engaging in delinquent behavior. "Risk factors" are any circumstances that may increase the likelihood of youth engaging in risky behaviors. Conversely, "protective factors" are any circumstances that promote healthy youth behaviors and decrease the chance that youth will engage in risky behaviors. The Boys and Girls Club of the Big Island (BGCBI) has been in the business of increasing the protective factors and at the same time decreasing the risk factors in our Big Island youth, ages 6 through 18, for over fifty years. Founded as the Boys Club of Hilo in 1952, the organization has served over 50,000 youth in East Hawaii. In 2002, we became BGCBI and during the last 5 years have extended our service reach to the youth in Pahoa, Kea'au, Ocean View, Pahala, and along the Hamakua coast through our unique mobile outreach program. The Kea'au Club is located on Kea'au Middle School property on the mauka side of the old O'la'a School behind the O'la'a Community Center. The Club implements its youth development program in three connecting rooms. Sports and Fitness activities are conducted on the outdoor grassy portions of the property. The Kea'au Club conducts daily after-school, weekend and full day intercession programs which include Boys & Girls Club of America's five core programs areas: • Sports, Fitness and Recreation Development: develops fitness, positive use of leisure time, skills for stress management, appreciation for the environment and social skills. Activities and programs include: game room, indoor/outdoor activities, table tournaments and inter -club leagues. • The Arts: enables youth to develop their creativity and cultural awareness through knowledge and an appreciation of the visual arts, crafts, performing arts and creative writing. Activities and programs include: arts & crafts, creative writing, fine art, dance and music. • Education and Career Development: enables our youth to become proficient in basic educational disciplines, apply learning to everyday situations and embrace technology to achieve success in a career. Activities and programs include: Power Hour homework assistance, Project Learn comprehensive education based activities with high -yield learning opportunities, science based environmental programs, Club Tech NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 2 Boys & Girls Club of the Big Island Positive Youth Development Programs: Kea'au Club computer technology program and Career Launch career preparatory program • Character & Leadership Development: empowers our youth to support and influence their Club and community, sustain meaningful relationships with others, develop a positive self-image, participate in the democratic process and respect their own and others' cultural identities. Activities and programs include: Keystone Club for 13-17 year olds, Torch Club for 10-12 year olds, Youth of the Year - local, state, regional and national youth recognition program, public speaking opportunities, community service clubs and Welcome Patrol - youth program for youth introducing the Club to guest and new members. • Health & Life Skills Development: develops our youth's capacity to engage in positive behaviors that nurture their own well-being, set personal goals and live successfully as self-sufficient adults. Activities and programs include: Skills Mastery And Resistance Training (SMART Moves) - a nationally recognized model program for prevention of alcohol, tobacco and drug use. SMART Moves incorporates 11 age appropriate curriculum for ages 6-18 years of age as well as parents and community. Triple Play - is a fitness program that develops a connection of mind, body and soul. The Kea'au Club offers a positive, safe environment for our youth during those critical, non -school hours when youth have an increased opportunity to engage in what are known as "risky behaviors". The Kea'au Club believes that the most effective approach for improving young people's lives is to reduce risk factors while increasing protective factors in all of the areas that touch their lives. Caring, trained youth development staff provide guidance in helping boys and girls to: discover their needs, enjoy their interests, explore their talents, broaden their viewpoints, value their diversity, resolve conflicts, set goals, understand themselves and have fun! As an affiliate member of our national organization, the Boys and Girls Club of America, BGCBI strives to provide youth development programs that support the fundamental principles and beliefs of the national Boys and Girls Club Movement. Our Core Beliefs A Boys and Girls Club provides: • A safe place to learn and grow • Ongoing relationships with caring, adult professionals • Life -enhancing programs and character development experiences • Hope and opportunity NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 3 & Girls Club of the Big Island Positive Youth Development Programs: Kea'au Club Youth Development Strategy The philosophy underlying BGCBI programming is the Youth Development Strategy. All Boys and Girls Club programs and activities are designed to maximize opportunities for young people to acquire four basic "senses" which help them build self-esteem and grow into responsible and caring citizens. These four senses are: • A sense of competence — Young people feel proud and confident when they acquire new skills and know they can do something and do it well. • A sense of usefulness — Young people know the satisfaction of doing something of value for others. • A sense of belonging — Young people know they are welcome and feel that they fit in and are accepted. • A sense of power and influence — Young people know their opinions are heard and valued and that they can influence decisions. Youth development occurs in all aspects of Boys and Girls Club participation. The Kea'au Club creates a climate in which these important "senses" are fostered in every participant, member and guest involved in program or just "hanging out". Youth Development Outcomes at age 18 The Kea'au Club strives to help all youth live full, satisfying and productive lives. The following outcomes summarize BGCBI expectations and goals for youth entering the world at age 18: a positive self identity, competencies in education and employment, social competencies enabling them to develop and sustain positive relationships, emotional competencies enabling them to appropriately express themselves, and cultural competencies enabling them to contribute in a multicultural society and demonstrate tolerance for differences among people. Other youth development outcomes include: Community and Civic Involvement: Youth have a sense of belonging to their community, family and/or group and are willing to take civic responsibility. They work closely with others to contribute to the greater good. Health and Well -Being: Youth live healthy lifestyles, take part in regular fitness activities, are able to access health care resources and engage in positive behaviors. They use sound judgment about personal safety, nutrition and avoidance of alcohol, drugs and premature sexual activity. Moral Compass: Youth have values enabling them to develop positive relationships with others. These values include honesty, a sense of justice and fairness, respect, caring and spirituality. The Kea'au Club proposes to engage youth in activities that are fun and enjoyable while supporting the development of the capacities described above. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 4 Boys & Girls Club of the Big Island Positive Youth Development Programs: Kea'au Club The Kea'au Club will use the Youth Development Outcome Measurement Tool Kit developed by the Boys and Girls Club of America. The goal of this measurement tool is to acquire the general well being of Club members and the degree to which they are acquiring skills, competencies and attitudes in specific areas, while assessing the impact that the Boys and Girls Club has on young people. Three internet-based surveys have been developed (elementary, middle and high school) to collect and analyze information about whether the Kea'au Club is making a difference in members' lives. The Kea'au Club will survey its members twice throughout the funding year. Total Budget and Position Count Total Pro ram Budget $228,273 Total Program Position Count 9 Total Agency Budget $1,762,566 Total Agency Position Count 49 Program Objectives: 1) Increase participants' knowledge and awareness of the consequences and harmful effects of tobacco, alcohol, and other drugs on their health and well-being. 2) Increase participants' ability to identify and resist peer and media pressures to engage in risky behaviors. 3) Increase participants' involvement in positive civic and community events. 4) Increase participants' positive attitude toward school/education 5) Decrease risky behavior of youth by increasing participants' positive self esteem through participation in positive youth development programs and activities on a daily basis Program Highlights: 1) In the Fiscal Year 2006-2007 the Boys and Girls Club of the Big Island provided programs to over 1300 youth ages 6 through 18 in our Clubs located at: Hamakua Mobile Outreach in Pa'auilo and Pa'auhau, Hilo, Kea'au, Pahala, Pahoa, and Ocean View Estates. Our youth development professionals also reached out to the schools as a beginning of our outreach efforts the SMART Moves Drug, Alcohol, and Pregnancy Prevention Curriculum to those youth who do not participate in our daily year-round program. The Pahala Club opened its doors on September 18, 2006 and quickly grew to 90 members by the end of Fiscal Year 2006-2007. The Hawaiian Ocean View Estates Club and the Hamakua Mobile Outreach program began on February 1, 2007 and totaled 99 youth by the end of Fiscal Year 2006-2007. These communities and villages desired youth development NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 5 Boys & Girls Club of the Big Island Positive Youth Development Programs: Kea'au Club programs for their children and have been very supportive of the work that we do. The need is large and BGCBI responded in a large way. 2) Collaborations/partnerships increased during Fiscal Year 2006-2007. We can add the following list of agencies working in partnership with BGCBI Clubs. ➢ County Parks and Recreation (Pa'auilo, Pahala, and Ocean View) ➢ United States Tennis Association ➢ Theatre Arts Conservatory ➢ Ocean Futures Society — Hawai'i Ambassadors to the Environment Program ➢ Hawaii State Department of Education ➢ University of Hawaii Hilo — Department of Agriculture ➢ The Rotary Club of South Hilo ➢ Coalition for a Tobacco Free Hawaii — East Hawaii ➢ Rein Teen Tours — Mainland Teens Community Service Initiative ➢ The Hawaii Big Game Fishing Club ➢ County of Hawaii Police Department ➢ Hawaii Police Activities League (HI PAL) 3) Fiscal Year 2006-2007 presented BGCBI with a year of change and growth. Several key positions became available during this time including: BGCBI Finance Manager, BGCBI Director of Program Operations, Kea'au Club Director, and Hilo Teen Director. Qualified individuals were identified for all positions, each bringing their own experiences, "gifts", and visions for growth and change. BGCBI moved forward into Fiscal Year 2007-2008 with a staff dedicated to excellence and program best practices! Performance Measures: NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 6 FY 2006-07 Actual * FY 2007-08 Budget* FY 2008-09 Estimate Youth will participate in The Arts Programs. Examples: ✓ Arts and Crafts n/a 75 100 ✓ Dance ✓ Music ✓ Fine Arts Youth will participate in Character and Leadership programs. n/a 76 75 Examples: ✓ Keystone Club NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 6 & Girls Club of the Big Island Positive Youth Development Programs: Kea'au Club ✓ Torch Club ✓ Community Service Projects ✓ Club Service Pro ects Youth will participate in Education and Career Development Programs. Examples: ✓ Power Hour n/a 100 100 ✓ Project Learn ✓ Tutoring ✓ Computer Technology Youth will participate in Health and Life Skills Programs. Examples: ✓ SMART Moves n/a 100 125 ✓ Nutrition/Cooking Classes ✓ Triple Play Youth will participate in Sports, Fitness and Recreation Programs. Examples: ✓ Team/Individual Sports n/a 120 120 ✓ Games Room Activities ✓ Fitness Activities and Programs Parents will participate in FAN Club activities - Family will participate in n/a 40 4 events per year activities to promote family strengthening and unity. Youth will complete SMART Moves n/a 206 #'s included in Health and Life Skills Development Of the 206 youth completing the #'s included in Health SMART Moves Program, youth n/a 30 and Life Skills ages 6-9 will complete the SMART Development Kids Program Of the 206 youth completing the #'s included in Health SMART Moves Program, youth n/a 76 and Life Skills ages 10-12 will complete the Start Development SMART Program Of the 206 youth completing the #'s included in Health SMART Moves Program, youth n/a 60 and Life Skills ages 13-15 will complete the Stay Development SMART Program Of the 206 youth completing the #'s included in Health SMART Moves Program, youth n/a 40 and Life Skills ages 13-17 will complete the Development SMART Leaders Program NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 7 & Girls Club of the Bis Island Positive Youth Development Programs: Kea'au Club Note: 2008-2009 Estimates for Skills Mastery and Resistance Training (SMART) Moves Prevention Program: This curriculum is offered to our youth within our Health and Life Skills core program area. Estimations are difficult for the actual curriculum, as our membership varies from year to year and each component has an age span. If a member is 6 years old when participating in SMART Kids, they are not able to participate in the Start SMART curriculum until age 10. BGCBI would like the County to be aware that all the youth development programming that we do includes the SMART Moves message to our youth. All five core program areas are enhanced by this curriculum sending the message to our youth that if they resist `risky behaviors" they are able to reach their full potential as productive, caring and responsible citizens. BGCBI is committed to assisting the young people of the Big Island in developing the necessary skills to resist tobacco, drugs, early sexual activity, and other problem behaviors such as: truancy, school failure/dropout, crime, violence, family problems and suicide. Program Expenditure If applicable " Please explain in detail on separate sheet Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2006-07 Actual` (budget) FY 2007-08 Budget* estimate FY 2008-09 Estimate Salaries and Wages $64,442 $128,668 $183,860 Professional Fees $1,017 $2,250 $2,250 Operations $75,834 $31,003 $31,003 Equipment $2,564 $10,410 $10,410 Other (Board Development) $750 $750 Total $143,857 $173,081 $228,273 If applicable " Please explain in detail on separate sheet Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2006-07 FY 2007-08 FY 2008-09 Actual* Budget* Estimate (budget) (estimate) County of Hawaii —Non profit Grant $45,000 $100,000 Hawaii Community Foundation: $16,099 $20,401 $25,000 Hawaii Island Meth Initiative Office of Justice Programs - Growth $7,500 Office of Justice Programs — $10,500 Capacity Dept of Education - OHCNP $2,989 NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 8 Boys & Girls Club of the Big Island Positive Youth Development Programs: Kea'au Club Hawaii Community Foundation: HCF : Tobacco Fund $15,345 $27,087 $9,500 Boys & Girls Club of Hawaii/YMCA Rural Youth Program - Outreach $31,190 Boys & Girls Club of Hawaii: Abstinence -Only Grant $3,716 Alcohol Drug Abuse Division (ADAD) $11,428 $43,273 Office of Youth Services (OYS) Positive Youth Development $20,000 Hawaii Island United Way $14,400 $19,575 $12,500 County of Hawaii District - Contingency Fund $17,500 Intersession Program Fees $7,652 $6,000 Club Fundraising Events $7,969 $4,500 $3,000 Community Donations $46,259 $1,828 $15,000 Total $143,857 $173,081 $228,273 *If applicable Explain what plans, if any, your agency and/or program has to increase revenues to support this program. When do you anticipate your program to become self-sustaining? The Boys and Girls Clubs of the Big Island has made a strong movement to work towards diversifying our revenues. Our goal is to be balanced between grants and unrestricted (fundraising & donation) revenues, as well as the vision to create an endowment fund for the future . We will continue to work with Federal, State, County and private agencies to enhance collaboration between all facets to help us succeed. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 9 Boys & Girls Club of the Big Island Positive Youth Development Programs: Kea' au Club I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 — 2-142.2, Hawai'i County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawai'i Revised Statutes. If awarded a grant from the County of Hawaii, I (we) understand and will comply with the requirement to submit a year-end report to the Legislative auditor within 60 days after June 30 of the fiscal year. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawaii grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely, complete, and MU44 ((A" Signature o and President/Chair //4 Signature of Executive Director Date f 130 (v Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 10 Boys & Girls Club of the Big Island Positive Youth Development Programs: Ocean View Club Agency Director: David (Kawika) Mattos Phone No.: 961-5536 Contact Person: Mailing Address: Facility/Site Address: Fax No.: Email Address: David (Kawika) Mattos Phone No.: 961-5536 100 Kamakahonu Street, Hilo, Hawaii 96720 92-8924 Leilani Circle, Ocean View, Hawaii 96737 961-5189 kawika@becbi.com Name of Accountant/CPA (include name of firm if applicable): David Chinaka - Chinaka, Sui & Co., CPAs Phone No.: Mailing Address: 3465 Waialae Avenue, Suite 250 Honolulu, Hawaii 96816 Amount of Request for County Funds: $100,000 Prior Year(s) Funding: 05-06 06-07 07-08 $0 $0 $45,000 Agency Mission Statement: To inspire and enable Big Island youth from all backgrounds, especially those from disadvantaged circumstances, to become productive and responsible citizens by offering quality programs in a safe and caring environment. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 1 & Girls Club of the Bi¢ Island Positive Youth Development Programs: Ocean View Club Program Description: When opportunities are available in a community for positive participation, children are less likely to engage in substance use and other problem behaviors. The Boys and Girls Club of the Big Island — Ocean View Club, provides those opportunities on a daily basis to the young people of the Ocean View community. As they grow up, youth are exposed to a number of factors which may either increase their risk for, or protect them from, problems such as abusing drugs or engaging in delinquent behavior. "Risk factors" are any circumstances that may increase the likelihood of youth engaging in risky behaviors. Conversely, "protective factors" are any circumstances that promote healthy youth behaviors and decrease the chance that youth will engage in risky behaviors. The Boys and Girls Club of the Big Island (BGCBI) has been in the business of increasing the protective factors and at the same time decreasing the risk factors in our Big Island youth, ages 6 through 18, for over fifty years. Founded as the Boys Club of Hilo in 1952, the organization has served over 50,000 youth in East Hawaii. In 2002, we became BGCBI and during the last 5 years have extended our service reach to the youth in Pahoa, Kea'au, Ocean View, Pahala, and along the Hamakua coast through our unique mobile outreach program. The Ocean View Club operates out of the Hawaiian Ocean View Estates Community Center and opened its doors in February 2007. This rural complex is comprised of a full technology center with 20 computers, a library, a social recreation room and a very large multi-purpose room on the upper floor for physical and performing arts activities. The site also includes a certified kitchen for use. The Club is presently partnering with County Parks and Recreation and utilizes Kahuku Park to implement its sports and fitness programs. The Ocean View Club conducts daily after-school, weekend and full day intercession programs which include Boys & Girls Club of America's five core programs areas: • Sports, Fitness and Recreation Development: develops fitness, positive use of leisure time, skills for stress management, appreciation for the environment and social skills. Activities and programs include: game room, indoor/outdoor activities, table tournaments and inter -club leagues. • The Arts: enables youth to develop their creativity and cultural awareness through knowledge and an appreciation of the visual arts, crafts, performing arts and creative writing. Activities and programs include: arts & crafts, fine art, dance and music. • Education and Career Development: enables our youth to become proficient in basic educational disciplines, apply learning to everyday situations and embrace technology to achieve success in a career. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 2 Boys & Girls Club of the Big Island Positive Youth Development Programs: Ocean View Club Activities and programs include: Power Hour homework assistance, Project Learn comprehensive education based activities with high -yield learning opportunities, science based environmental programs, Club Tech computer technology program and Career Launch career preparatory program • Character & Leadership Development: empowers our youth to support and influence their Club and community, sustain meaningful relationships with others, develop a positive self-image, participate in the democratic process and respect their own and others' cultural identities. Activities and programs include: Keystone Club for 13-17 year olds, Torch Club for 10-12 year olds, Youth of the Year - local, state, regional and national youth recognition program, public speaking opportunities, community service clubs and Welcome Patrol - youth program for youth introducing the Club to guest and new members. • Health & Life Skills Development: develops our youth's capacity to engage in positive behaviors that nurture their own well-being, set personal goals and live successfully as self-sufficient adults. Activities and programs include: Skills Mastery And Resistance Training (SMART Moves) - a nationally recognized model program for prevention of alcohol, tobacco and drug use. SMART Moves incorporates 11 age appropriate curriculum for ages 6-18 years of age as well as parents and community. Triple Play - is a fitness program that develops a connection of mind, body and soul. The Ocean View Club offers a positive, safe environment for our youth during those critical, non -school hours when youth have an increased opportunity to engage in what are known as "risky behaviors". The Ocean View Club believes that the most effective approach for improving young people's lives is to reduce risk factors while increasing protective factors in all of the areas that touch their lives. Caring, trained youth development staff provide guidance in helping boys and girls to: discover their needs, enjoy their interests, explore their talents, broaden their viewpoints, value their diversity, resolve conflicts, set goals, understand themselves and have fun! As an affiliate member of our national organization, the Boys and Girls Club of America, BGCBI strives to provide youth development programs that support the fundamental principles and beliefs of the national Boys and Girls Club Movement. Our Core Beliefs A Boys and Girls Club provides: • A safe place to learn and grow • Ongoing relationships with caring, adult professionals • Life -enhancing programs and character development experiences • Hope and opportunity NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 3 Boys & Girls Club of the Big Island Positive Youth Development Programs: Ocean View Club Youth Development Strategy The philosophy underlying BGCBI programming is the Youth Development Strategy. All Boys and Girls Club programs and activities are designed to maximize opportunities for young people to acquire four basic "senses' which help them build self-esteem and grow into responsible and caring citizens. These four senses are: • A sense of competence — Young people feel proud and confident when they acquire new skills and know they can do something and do it well. • A sense of usefulness — Young people know the satisfaction of doing something of value for others. • A sense of belonging — Young people know they are welcome and feel that they fit in and are accepted. • A sense of power and influence — Young people know their opinions are heard and valued and that they can influence decisions. Youth development occurs in all aspects of Boys and Girls Club participation. The Ocean View Club creates a climate in which these important "senses" are fostered in every participant, member and guest involved in program or just "hanging out". Youth Development Outcomes at age 18 The Ocean View Club strives to help all youth live full, satisfying and productive lives. The following outcomes summarize BGCBI expectations and goals for youth entering the world at age 18: a positive self identity, competencies in education and employment, social competencies enabling them to develop and sustain positive relationships, emotional competencies enabling them to appropriately express themselves, and cultural competencies enabling them to contribute in a multicultural society and demonstrate tolerance for differences among people. Other youth development outcomes include: Community and Civic Involvement: Youth have a sense of belonging to their community, family and/or group and are willing to take civic responsibility. They work closely with others to contribute to the greater good. Health and Well -Being: Youth live healthy lifestyles, take part in regular fitness activities, are able to access health care resources and engage in positive behaviors. They use sound judgment about personal safety, nutrition and avoidance of alcohol, drugs and premature sexual activity. Moral Compass: Youth have values enabling them to develop positive relationships with others. These values include honesty, a sense of justice and fairness, respect, caring and spirituality. The Ocean View Club proposes to engage youth in activities that are fun and enjoyable while supporting the development of the capacities described above. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 4 & Girls Club of the Big Island Positive Youth Development Programs: Ocean View Club The Ocean View Club will use the Youth Development Outcome Measurement Tool Kit developed by the Boys and Girls Club of America. The goal of this measurement tool is to acquire the general well being of Club members and the degree to which they are acquiring skills, competencies and attitudes in specific areas, while assessing the impact that the Boys and Girls Club has on young people. Three internet-based surveys have been developed (elementary, middle and high school) to collect and analyze information about whether the Ocean View Club is making a difference in members' lives. The Ocean View Club will survey its members twice throughout the funding year. Total Budget and Position Count Total Program Budget $208,345 Total Program Position Count 6 Total Agency Budget $1,762,566 Total Agency Position Count 49 Program Objectives: 1) Increase participants' knowledge and awareness of the consequences and harmful effects of tobacco, alcohol, and other drugs on their health and well-being. 2) Increase participants' ability to identify and resist peer and media pressures to engage in risky behaviors. 3) Increase participants' involvement in positive civic and community events. 4) Increase participants' positive attitude toward school/education 5) Decrease risky behavior of youth by increasing participants' positive self esteem through participation in positive youth development programs and activities on a daily basis Program Highlights: 1) In the Fiscal Year 2006-2007 the Boys and Girls Club of the Big Island provided programs to over 1300 youth ages 6 through 18 in our Clubs located at: Hamakua Mobile Outreach in Pa'auilo and Pa'auhau, Hilo, Kea'au, Pahala, Pahoa, and Ocean View Estates. Our youth development professionals also reached out to the schools as a beginning of our outreach efforts to provide the SMART Moves Drug, Alcohol, and Pregnancy Prevention Curriculum to those youth who do not participate in our daily year-round program. The Pahala Club opened its doors on September 18, 2006 and quickly grew to 90 members by the end of Fiscal Year 2006-2007. The Hawaiian Ocean View Estates Club and the Hamakua Mobile Outreach program began on February 1, 2007 and totaled 99 youth by the end of Fiscal Year 2006-2007. These communities and villages desired youth development NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 5 Boys & Girls Club of the Big Island Positive Youth Development Programs: Ocean View Club programs for their children and have been very supportive of the work that we do. The need is large and BGCBI responded in a large way. 2) Collaborations/partnerships increased during Fiscal Year 2006-2007. We can add the following list of agencies working in partnership with BGCBI Clubs. ➢ County Parks and Recreation (Pa'auilo, Pahala, and Ocean View) ➢ United States Tennis Association ➢ Theatre Arts Conservatory ➢ Ocean Futures Society — Hawai'i Ambassadors to the Environment Program ➢ Hawaii State Department of Education ➢ University of Hawaii Hilo — Department of Agriculture ➢ The Rotary Club of South Hilo ➢ Coalition for a Tobacco Free Hawaii — East Hawaii ➢ Rein Teen Tours — Mainland Teens Community Service Initiative ➢ The Hawaii Big Game Fishing Club ➢ County of Hawaii Police Department ➢ Hawaii Police Activities League (HI PAL) 3) Fiscal Year 2006-2007 presented BGCBI with a year of change and growth. Several key positions became available during this time including: BGCBI Finance Manager, BGCBI Director of Program Operations, Kea'au Club Director, and Hilo Teen Director. Qualified individuals were identified for all positions, each bringing their own experiences, "gifts", and visions for growth and change. BGCBI moved forward into Fiscal Year 2007-2008 with a staff dedicated to excellence and program best practices! Performance Measures: NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 6 FY 2006-07 Actual * FY 2007-08 Budget' FY 2008-09 Estimate Youth will participate in The Arts Programs. Examples: ✓ Arts and Crafts n/a 50 50 ✓ Dance ✓ Music ✓ Fine Arts Youth will participate in Character and Leadership programs. n/a 35 35 Examples: ✓ Keystone Club ✓ Torch Club NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 6 Boys & Girls Club of the Big Island Positive Youth Development Programs: Ocean View Club ✓ Community Service Projects ✓ Club Service Projects Youth will participate in Education and Career Development Programs. Examples: ✓ Power Hour n/a 75 75 ✓ Project Learn ✓ Tutoring ✓ Computer Technology Youth will participate in Health and Life Skills Programs. Examples: ✓ SMART Moves n/a 75 75 ✓ Nutrition/Cooking Classes ✓ Triple Play Youth will participate in Sports, Fitness and Recreation Programs. Examples: ✓ Team/Individual Sports n/a 100 100 ✓ Games Room Activities ✓ Fitness Activities and Programs Parents will participate in FAN Club 4 events per activities - Family will participate in n/a 20 year activities to promote family strengthening and unity. Youth will complete SMART Moves n/a 50 #'s included in Health and Life Skills Development _ Of _ the 50 youth completing the #'s included in SMART Moves Program, youth n/a 20 Health and Life ages 6-9 will complete the SMART Skills Development Kids Program Of the 50 youth completing the #'s included in SMART Moves Program, youth n/a 20 Health and Life ages 10-12 will complete the Start Skills Development SMART Program Of the 50 youth completing the #'s included in SMART Moves Program, youth n/a 5 Health and Life ages 13-15 will complete the Stay Skills Development SMART Program Of the 50 youth completing the #'s included in SMART Moves Program, youth n/a 5 Health and Life ages 13-17 will complete the Skills Development SMART Leaders Program NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 7 Boys & Girls Club of the Big Island Positive Youth Development Programs: Ocean View Club Note: 2008-2009 Estimates for Skills Mastery and Resistance Training (SMART) Moves Prevention Program: This curriculum is offered to our youth within our Health and Life Skills core program area. Estimations are difficult for the actual curriculum, as our membership varies from year to year and each component has an age span. If a member is 6 years old when participating in SMART Kids, they are not able to participate in the Start SMART curriculum until age 10. BGCBI would like the County to be aware that all the youth development programming that we do includes the SMART Moves message to our youth. All five core program areas are enhanced by this curriculum sending the message to our youth that if they resist "risky behaviors' they are able to reach their full potential as productive, caring and responsible citizens. BGCBI is committed to assisting the young people of the Big Island in developing the necessary skills to resist tobacco, drugs, early sexual activity, and other problem behaviors such as: truancy, school failure/dropout, crime, violence, family problems and suicide. Program Expenditure If applicable " Please explain in detail on separate sheet Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2006-07 Actual* (budget) FY 2007-08 Budget* estimate FY 2008-09 Estimate Salaries and Wages $52,298 $114,484 $167,919 Professional Fees $130 $1,500 $1,500 Operations $40,285 $34,749 $35,937 Equipment $1,603 $2,489 $2,489 Other (Board Development) $500 $500 Total 1 $94,316 $153,7231 $208,345 If applicable " Please explain in detail on separate sheet Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2006-07 FY 2007-08 FY 2008-09 Actual* Budget* Estimate (budget) estimate County of Hawaii —Non profit Grant $45,000 $100,000 Boys & Girls Club of Hawaii/YMCA $65,324 $15,207 $50,000 Rural Youth Program - Outreach Office of Justice Programs — Ocean $2,475 $72,525 View Hawaii Community Foundation: $4,769 $4,991 $4,750 HCF : Tobacco Fund Office of Youth Services (OYS $45,000 NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 8 & Girls Club of the Big Island Positive Youth Development Programs: Ocean View Club Positive Youth Development County of Hawaii - Contingency Fund $10,000 Intersession Pro ram Fees $159 Club Fundraising Events $1,073 $1,000 $2,000 Community Donations $20,516 $5,000 $6,595 Total $94,316 $153,723 $208,345 'If applicable Explain what plans, if any, your agency and/or program has to increase revenues to support this program. When do you anticipate your program to become self-sustaining? The Boys and Girls Clubs of the Big Island has made a strong movement to work towards diversifying our revenues. Our goal is to be balanced between grants and unrestricted (fundraising & donation) revenues, as well as the vision to create an endowment fund for the future . We will continue to work with Federal, State, County and private agencies to enhance collaboration between all facets to help us succeed. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 9 Boys & Girls Club of the Big Island Positive Youth Development Programs: Ocean View Club I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 — 2-142.2, Hawai'i County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawai'i Revised Statutes. If awarded a grant from the County of Hawaii, I (we) understand and will comply with the requirement to submit a year-end report to the Legislative auditor within 60 days after June 30 of the fiscal year. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawaii grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely, complete, and 4maqL1)N Signature of Board President/Chair Signature of Executive Director Date Date J Atj1,6VK UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 10 & Girls Club of the Big Island Positive Youth Development Programs: Pahala Club Agency Director: David (Kawika) Mattos Phone No.: 961-5536 Contact Person: Mailing Address: Facility/Site Address Fax No.: Email Address: David (Kawika) Mattos Phone No.: 961-5536 100 Kamakahonu Street, Hilo, Hawaii 96720 96-2945 Paauau Street, Pahala, Hawaii 96777 961-5189 kawika@becbi.com Name of Accountant/CPA (include name of firm if applicable): David Chinaka - Chinaka, Sui & Co., CPAs Phone No.: Mailing Address: 3465 Waialae Avenue, Suite 250 Honolulu, Hawaii 96816 Amount of Request for County Funds: $100,000 Prior Year(s) Funding: 05-06 06-07 07-08 $0 $0 $45,000 Agency Mission Statement: To inspire and enable Big Island youth from all backgrounds, especially those from disadvantaged circumstances, to become productive and responsible citizens by offering quality programs in a safe and caring environment. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 1 & Girls Club of the Bit Island Positive Youth Development Programs: Pahala Club Program Description: When opportunities are available in a community for positive participation, children are less likely to engage in substance use and other problem behaviors. The Boys and Girls Club of the Big Island — Pahala Club, provides those opportunities on a daily basis to the young people of the Pahala community. As they grow up, youth are exposed to a number of factors which may either increase their risk for, or protect them from, problems such as abusing drugs or engaging in delinquent behavior. "Risk factors" are any circumstances that may increase the likelihood of youth engaging in risky behaviors. Conversely, "protective factors" are any circumstances that promote healthy youth behaviors and decrease the chance that youth will engage in risky behaviors. The Boys and Girls Club of the Big Island (BGCBI) has been in the business of increasing the protective factors and at the same time decreasing the risk factors in our Big Island youth, ages 6 through 18, for over fifty years. Founded as the Boys Club of Hilo in 1952, the organization has served over 50,000 youth in East Hawaii. In 2002, we became BGCBI and during the last 5 years have extended our service reach to the youth in Pahoa, Kea'au, Ocean View, Pahala, and along the Hamakua coast through our unique mobile outreach program. The Pahala Club conducts daily after-school, weekend and full day intercession programs which include Boys & Girls Club of America's five core programs areas: • Sports, Fitness and Recreation Development: develops fitness, positive use of leisure time, skills for stress management, appreciation for the environment and social skills. Activities and programs include: game room, indoor/outdoor activities, table tournaments and inter -club leagues. • The Arts: enables youth to develop their creativity and cultural awareness through knowledge and an appreciation of the visial arts, crafts, performing arts and creative writing. Activities and programs include: arts & crafts, fine art, dance and music. • Education and Career Development: enables our youth to become proficient in basic educational disciplines, apply learning to everyday situations and embrace technology to achieve success in a career. Activities and programs include: Power Hour homework assistance, Project Learn comprehensive education based activities with high -yield learning opportunities, science based environmental programs, Club Tech computer technology program and Career Launch career preparatory program • Character & Leadership Development: empowers our youth to support and influence their Club and community, sustain meaningful relationships with others, develop a positive self-image, participate in the democratic process and respect their own and others' cultural identities. Activities NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 2 & Girls Club of the Big Island Positive Youth Development Programs: Pahala Club and programs include: Keystone Club for 13-17 year olds, Torch Club for 10-12 year olds, Youth of the Year - local, state, regional and national youth recognition program, public speaking opportunities, community service clubs and Welcome Patrol - youth program for youth introducing the Club to guest and new members. Health & Life Skills Development: develops our youth's capacity to engage in positive behaviors that nurture their own well-being, set personal goals and live successfully as self-sufficient adults. Activities and programs include: Skills Mastery And Resistance Training (SMART Moves) - a nationally recognized model program for prevention of alcohol, tobacco and drug use. SMART Moves incorporates 11 age appropriate curriculum for ages 6-18 years of age as well as parents and community. Triple Play - is a fitness program that develops a connection of mind, body and soul. The Pahala Club offers a positive, safe environment for our youth during those critical, non -school hours when youth have an increased opportunity to engage in what are known as "risky behaviors". The Pahala Club believes that the most effective approach for improving young people's lives is to reduce risk factors while increasing protective factors in all of the areas that touch their lives. Caring, trained youth development staff provide guidance in helping boys and girls to: discover their needs, enjoy their interests, explore their talents, broaden their viewpoints, value their diversity, resolve conflicts, set goals, understand themselves and have fun! As an affiliate member of our national organization, the Boys and Girls Club of America, BGCBI strives to provide youth development programs that support the fundamental principles and beliefs of the national Boys and Girls Club Movement. Our Core Beliefs A Boys and Girls Club provides: • A safe place to learn and grow • Ongoing relationships with caring, adult professionals • Life -enhancing programs and character development experiences • Hope and opportunity Youth Development Strategy The philosophy underlying BGCBI programming is the Youth Development Strategy. All Boys and Girls Club programs and activities are designed to maximize opportunities for young people to acquire four basic "senses" which help them build self-esteem and grow into responsible and caring citizens. These four senses are: A sense of competence — Young people feel proud and confident when they acquire new skills and know they can do something and do it well. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 3 Boys & Girls Club of the Big Island Positive Youth Development Programs: Pahala Club • A sense of usefulness — Young people know the satisfaction of doing something of value for others. • A sense of belonging — Young people know they are welcome and feel that they fit in and are accepted. • A sense of power and influence — Young people know their opinions are heard and valued and that they can influence decisions. Youth development occurs in all aspects of Boys and Girls Club participation. The Pahala Club creates a climate in which these important "senses" are fostered in every participant, member and guest involved in program or just "hanging out". Youth Development Outcomes at age 18 The Pahala Club strives to help all youth live full, satisfying and productive lives. The following outcomes summarize BGCBI expectations and goals for youth entering the world at age 18: a positive self identity, competencies in education and employment, social competencies enabling them to develop and sustain positive relationships, emotional competencies enabling them to appropriately express themselves, and cultural competencies enabling them to contribute in a multicultural society and demonstrate tolerance for differences among people. Other youth development outcomes include: Community and Civic Involvement: Youth have a sense of belonging to their community, family and/or group and are willing to take civic responsibility. They work closely with others to contribute to the greater good. Health and Well -Being: Youth live healthy lifestyles, take part in regular fitness activities, are able to access health care resources and engage in positive behaviors. They use sound judgment about personal safety, nutrition and avoidance of alcohol, drugs and premature sexual activity. Moral Compass: Youth have values enabling them to develop positive relationships with others. These values include honesty, a sense of justice and fairness, respect, caring and spirituality. The Pahala Club proposes to engage youth in activities that are fun and enjoyable while supporting the development of the capacities described above. The Pahala Club will use the Youth Development Outcome Measurement Tool Kit developed by the Boys and Girls Club of America. The goal of this measurement tool is to acquire the general well being of Club members and the degree to which they are acquiring skills, competencies and attitudes in specific areas, while assessing the impact that the Boys and Girls Club has on young people. Three internet-based surveys have been developed (elementary, middle and high school) to collect and analyze information about whether the Pahala NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 4 Boys & Girls Club of the Big Island Positive Youth Development Programs: Pahala Club Club is making a difference in members' lives. The Pahala Club will survey its members twice throughout the funding year. Total Budget and Position Count Total Program Budget $226,918Totall Program Position Count 7 Total A enc Bud et 62 $1,7,566 TotaA enc Position Count 49 Program Objectives: 1) Increase participants' knowledge and awareness of the consequences and harmful effects of tobacco, alcohol, and other drugs on their health and well-being. 2) Increase participants' ability to identify and resist peer and media pressures to engage in risky behaviors. 3) Increase participants' involvement in positive civic and community events. 4) Increase participants' positive attitude toward school/education 5) Decrease risky behavior of youth by increasing participants' positive self esteem through participation in positive youth development programs and activities on a daily basis Program Highlights: 1) In the Fiscal Year 2006-2007 the Boys and Girls Club of the Big Island provided programs to over 1300 youth ages 6 through 18 in our Clubs located at: Hamakua Mobile Outreach in Pa'auilo and Pa'auhau, Hilo, Kea'au, Pahala, Pahoa, and Ocean View Estates. Our youth development professionals also reached out to the schools as a beginning of our outreach efforts to provide the SMART Moves Drug, Alcohol, and Pregnancy Prevention Curriculum to those youth who do not participate in our daily year-round program. The Pahala Club opened its doors on September 18, 2006 and quickly grew to 90 members by the end of Fiscal Year 2006-2007. The Hawaiian Ocean View Estates Club and the Hamakua Mobile Outreach program began on February 1, 2007 and totaled 99 youth by the end of Fiscal Year 2006-2007. These communities and villages desired youth development programs for their children and have been very supportive of the work that we do. The need is large and BGCBI responded in a large way. 2) Collaborations/partnerships increased during Fiscal Year 2006-2007. We can add the following list of agencies working in partnership with BGCBI Clubs. County Parks and Recreation (Pa'auilo, Pahala, and Ocean View) NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 5 Boys & Girls Club of the Big Island Positive Youth Development Programs: Pahala Club ➢ United States Tennis Association ➢ Theatre Arts Conservatory ➢ Ocean Futures Society — Hawai'i Ambassadors to the Environment Program ➢ Hawaii State Department of Education ➢ University of Hawaii Hilo — Department of Agriculture ➢ The Rotary Club of South Hilo ➢ Coalition for a Tobacco Free Hawaii — East Hawaii ➢ Rein Teen Tours — Mainland Teens Community Service Initiative ➢ The Hawaii Big Game Fishing Club ➢ County of Hawaii Police Department ➢ Hawaii Police Activities League (HI PAL) 3) Fiscal Year 2006-2007 presented BGCBI with a year of change and growth. Several key positions became available during this time including: BGCBI Finance Manager, BGCBI Director of Program Operations, Kea'au Club Director, and Hilo Teen Director. Qualified individuals were identified for all positions, each bringing their own experiences, "gifts', and visions for growth and change. BGCBI moved forward into Fiscal Year 2007-2008 with a staff dedicated to excellence and program best practices! Performance Measures: NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 6 FY 2006-07 FY 2007-08 FY 2008-09 Actual * Budget* Estimate Youth will participate in The Arts n/a 25 50 Programs. Examples: ✓ Arts and Crafts ✓ Dance ✓ Music ✓ Fine Arts Youth will participate in Character n/a 20 25 and Leadership programs. Examples: ✓ Keystone Club ✓ Torch Club ✓ Community Service Projects ✓ Club Service Pro'ects Youth will participate in Education n/a 75 75 and Career Development Programs. Examples: ✓ Power Hour ✓ Project Learn ✓ Tutoring NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 6 Boys & Girls Club of the Big Island Positive Youth Development Programs: Pahala Club ✓ Computer Technoloqy Youth will participate in Health and n/a 50 50 Life Skills Programs. Examples: ✓ SMART Moves ✓ Nutrition/Cooking Classes ✓ Triple Play Youth will participate in Sports, n/a 75 75 Fitness and Recreation Programs. Examples: ✓ Team/Individual Sports ✓ Games Room Activities ✓ Fitness Activities and Pro rams Parents will participate in FAN Club n/a 25 4 events per activities - Family will participate in year activities to promote family strengthening and unit . Youth will complete SMART Moves n/a 50 #'s included in Health and Life Skills Development Of the 50 youth completing the n/a 25 #'s included in SMART Moves Program, youth Health and Life ages 6-9 will complete the SMART Skills Development Kids Program Of the 50 youth completing the n/a 15 #'s included in SMART Moves Program, youth Health and Life ages 10-12 will complete the Start Skills Development SMART Program Of the 50 youth completing the n/a 5 #'s included in SMART Moves Program, youth Health and Life ages 13-15 will complete the Stay Skills Development SMART Program Of the 50 youth completing the n/a 5 #'s included in SMART Moves Program, youth Health and Life ages 13-17 will complete the Skills Development SMART Leaders Pro ram Note: 2008-2009 Estimates for Skills Mastery and Resistance Training (SMART) Moves Prevention Program: This curriculum is offered to our youth within our Health and Life Skills core program area. Estimations are difficult for the actual curriculum, as our membership varies from year to year and each component has an age span. If a member is 6 years old when participating in SMART Kids, they are not able to participate in the Start SMART curriculum until age 10. BGCBI would like the NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 7 Boys & Girls Club of the Big Island Positive Youth Development Programs: Pahala Club County to be aware that all the youth development programming that we do includes the SMART Moves message to our youth. All five core program areas are enhanced by this curriculum sending the message to our youth that if they resist "risky behaviors' they are able to reach their full potential as productive, caring and responsible citizens. BGCBI is committed to assisting the young people of the Big Island in developing the necessary skills to resist tobacco, drugs, early sexual activity, and other problem behaviors such as: truancy, school failure/dropout, crime, violence, family problems and suicide. Program Expenditure If applicable "Please explain in detail on separate sheet Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2006-07 Actual* (budget) FY 2007-08 Budget* estimate FY 2008-09 Estimate Salaries and Wages $65,289 $126,502 $180,297 Professional Fees (budget) $1,500 $1,500 Operations $23,479 $40,850 $42,207 Equipment $1,283 $2,414 $2,414 Other (Board Development) $500 $500 Total $90,051 $171,765 $226,918 If applicable "Please explain in detail on separate sheet Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2006-07 FY 2007-08 FY 2008-09 Actual* Budget* Estimate (budget) estimate County of Hawaii —Non profit Grant $45,000 $100,000 Hawaii Community Foundation: $57,968 Hawaii Island Meth Initiative Office of Justice Programs - Pahala $2,702 $72,298 Office of Justice Programs — $7,000 Capacity Hawaii Community Foundation: $4,467 $7,125 HCF : Tobacco Fund Boys & Girls Club of Hawaii/YMCA $15,500 $75,000 Rural Youth Program RYP Funds Alcohol Drug Abuse Division $17,560 (ADAD Office of Youth Services (OYS) $10,000 Positive Youth Development County of Hawaii - Contingency $16,000 Fund NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 8 Boys & Girls Club of the Big Island Positive Youth Development Programs: Pahala Club Intersession Program Fees $344 Club Fundraising Events $2,021 $3,500 $3,000 Community Donations $20,016 $15,000 $14,233 Total $90,051 $171,765 $226,918 *If applicable Explain what plans, if any, your agency and/or program has to increase revenues to support this program. When do you anticipate your program to become self-sustaining? The Boys and Girls Clubs of the Big Island has made a strong movement to work towards diversifying our revenues. Our goal is to be balanced between grants and unrestricted (fundraising & donation) revenues, as well as the vision to create an endowment fund for the future . We will continue to work with Federal, State, County and private agencies to enhance collaboration between all facets to help us succeed. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 9 & Girls Club of the Big Island Positive Youth Development Programs: Pahala Club I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 — 2-142.2, Hawai'i County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawai'i Revised Statutes. If awarded a grant from the County of Hawaii, I (we) understand and will comply with the requirement to submit a year-end report to the Legislative auditor within 60 days after June 30 of the fiscal year. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawaii grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely, complete, and accurate year-end report will impact the evaluation of your proaram's or agency's future fundina requests. U"u Signaturk0jf a@rd President/Chair Director �WTAJw Ibb 9 Date �j0 4S Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTEDI NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 10 Boys & Girls Club of the Big Island Positive Youth Development Programs: Pahoa Club Agency Director: David (Kawika) Mattos Phone No.: 961-5536 Contact Person Mailing Address Facility/Site Address: Fax No.: Email Address: David (Kawika) Mattos Phone No.: 961-5536 100 Kamakahonu Street, Hilo, Hawaii 96720 100 Kamakahonu Street, Hilo, Hawaii 96720 961-5189 kawika@becbi.com Name of Accountant/CPA (include name of firm if applicable): David Chinaka - Chinaka, Sui & Co., CPAs Phone No.: Mailing Address: 3465 Waialae Avenue, Suite 250 Honolulu, Hawaii 96816 Amount of Request for County Funds: $100,000 Prior Year(s) Funding: 05-06 06-07 07-08 $0 $0 $45,000 Agency Mission Statement: To inspire and enable Big Island youth from all backgrounds, especially those from disadvantaged circumstances, to become productive and responsible citizens by offering quality programs in a safe and caring environment. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 1 Boys & Girls Club of the Big Island Positive Youth Development Programs: Pahoa Club Program Description: When opportunities are available in a community for positive participation, children are less likely to engage in substance use and other problem behaviors. The Boys and Girls Club of the Big Island — Pahoa Club, provides those opportunities on a daily basis to the young people of the Pahoa community. As they grow up, youth are exposed to a number of factors which may either increase their risk for, or protect them from, problems such as abusing drugs or engaging in delinquent behavior. "Risk factors" are any circumstances that may increase the likelihood of youth engaging in risky behaviors. Conversely, "protective factors" are any circumstances that promote healthy youth behaviors and decrease the chance that youth will engage in risky behaviors. The Boys and Girls Club of the Big Island (BGCBI) has been in the business of increasing the protective factors and at the same time decreasing the risk factors in our Big Island youth, ages 6 through 18, for over fifty years. Founded as the Boys Club of Hilo in 1952, the organization has served over 50,000 youth in East Hawaii. In 2002, we became BGCBI and during the last 5 years have extended our service reach to the youth in Pahoa, Kea'au, Ocean View, Pahala, and along the Hamakua coast through our unique mobile outreach program. The Pahoa Club has been making a difference in Puna District since October 2003, initially providing services part-time 2-3 days a week at the Nanawale Subdivision's Community Center. In August 2004, the program expanded to five days a week and in June 2006 moved to their present location at Pahoa Intermediate and High School, operating Monday through Friday from 2:00 pm to 6:00 pm. On school days off and intercessions, the Club is open full-day providing care to those youth who parents are employed. The Pahoa Club has formed a strong relationship with the Pahoa DOE School Complex who supports our efforts by providing the BGCBI two large portable classrooms used for implementing BGCA core programs. We also have use of the school complex fields and outdoor facilities available for sports fitness and athletic activities. The Pahoa Club conducts daily after-school, weekend and full day intercession programs which include Boys & Girls Club of America's five core programs areas: • Sports, Fitness and Recreation Development: develops fitness, positive use of leisure time, skills for stress management, appreciation for the environment and social skills. Activities and programs include: game room, indoor/outdoor activities, table tournaments and inter -club leagues. • The Arts: enables youth to develop their creativity and cultural awareness through knowledge and an appreciation of the visual arts, crafts, NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 2 Boys & Girls Club of the Big Island Positive Youth Development Programs: Pahoa Club performing arts and creative writing. Activities and programs include: arts & crafts, fine art, dance and music. • Education and Career Development: enables our youth to become proficient in basic educational disciplines, apply learning to everyday situations and embrace technology to achieve success in a career. Activities and programs include: Power Hour homework assistance, Project Learn comprehensive education based activities with high -yield learning opportunities, science based environmental programs, Club Tech computer technology program and Career Launch career preparatory program • Character & Leadership Development: empowers our youth to support and influence their Club and community, sustain meaningful relationships with others, develop a positive self-image, participate in the democratic process and respect their own and others' cultural identities. Activities and programs include: Keystone Club for 13-17 year olds, Torch Club for 10-12 year olds, Youth of the Year - local, state, regional and national youth recognition program, public speaking opportunities, community service clubs and Welcome Patrol - youth program for youth introducing the Club to guest and new members. • Health & Life Skills Development: develops our youth's capacity to engage in positive behaviors that nurture their own well-being, set personal goals and live successfully as self-sufficient adults. Activities and programs include: Skills Mastery And Resistance Training (SMART Moves) - a nationally recognized model program for prevention of alcohol, tobacco and drug use. SMART Moves incorporates 11 age appropriate curriculum for ages 6-18 years of age as well as parents and community. Triple Play - is a fitness program that develops a connection of mind, body and soul. The Pahoa Club offers a positive, safe environment for our youth during those critical, non -school hours when youth have an increased opportunity to engage in what are known as "risky behaviors". The Pahoa Club believes that the most effective approach for improving young people's lives is to reduce risk factors while increasing protective factors in all of the areas that touch their lives. Caring, trained youth development staff provide guidance in helping boys and girls to: discover their needs, enjoy their interests, explore their talents, broaden their viewpoints, value their diversity, resolve conflicts, set goals, understand themselves and have fun! As an affiliate member of our national organization, the Boys and Girls Club of America, BGCBI strives to provide youth development programs that support the fundamental principles and beliefs of the national Boys and Girls Club Movement. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 3 Boys & Girls Club of the Big Island Positive Youth Development Programs: Pahoa Club Our Core Beliefs A Boys and Girls Club provides: • A safe place to learn and grow • Ongoing relationships with caring, adult professionals • Life -enhancing programs and character development experiences • Hope and opportunity Youth Development Strategy The philosophy underlying BGCBI programming is the Youth Development Strategy. All Boys and Girls Club programs and activities are designed to maximize opportunities for young people to acquire four basic "senses' which help them build self-esteem and grow into responsible and caring citizens. These four senses are: • A sense of competence — Young people feel proud and confident when they acquire new skills and know they can do something and do it well. • A sense of usefulness — Young people know the satisfaction of doing something of value for others. • A sense of belonging — Young people know they are welcome and feel that they fit in and are accepted. • A sense of power and influence — Young people know their opinions are heard and valued and that they can influence decisions. Youth development occurs in all aspects of Boys and Girls Club participation. The Pahoa Club creates a climate in which these important "senses" are fostered in every participant, member and guest involved in program or just "hanging out". Youth Development Outcomes at age 18 The Pahoa Club strives to help all youth live full, satisfying and productive lives. The following outcomes summarize BGCBI expectations and goals for youth entering the world at age 18: a positive self identity, competencies in education and employment, social competencies enabling them to develop and sustain positive relationships, emotional competencies enabling them to appropriately express themselves, and cultural competencies enabling them to contribute in a multicultural society and demonstrate tolerance for differences among people. Other youth development outcomes include: Community and Civic Involvement: Youth have a sense of belonging to their community, family and/or group and are willing to take civic responsibility. They work closely with others to contribute to the greater good. Health and Well -Being: Youth live healthy lifestyles, take part in regular fitness activities, are able to access health care resources and engage in positive behaviors. They use sound judgment about personal safety, nutrition and avoidance of alcohol, drugs and premature sexual activity. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 4 & Girls Club of the Bie Island Positive Youth Development Programs: Pahoa Club Moral Compass: Youth have values enabling them to develop positive relationships with others. These values include honesty, a sense of justice and fairness, respect, caring and spirituality. The Pahoa Club proposes to engage youth in activities that are fun and enjoyable while supporting the development of the capacities described above. The Pahoa Club will use the Youth Development Outcome Measurement Tool Kit developed by the Boys and Girls Club of America. The goal of this measurement tool is to acquire the general well being of Club members and the degree to which they are acquiring skills, competencies and attitudes in specific areas, while assessing the impact that the Boys and Girls Club has on young people. Three internet-based surveys have been developed (elementary, middle and high school) to collect and analyze information about whether the Pahoa Club is making a difference in members' lives. The Pahoa Club will survey its members twice throughout the funding year. Total Budget and Position Count Total Pro ram Bud et $233,777 Total Program Position Count 7 Total Agency Budget $1,762,566 Total Agency Position Count 49 Program Objectives: 1) Increase participants' knowledge and awareness of the consequences and harmful effects of tobacco, alcohol, and other drugs on their health and well-being. 2) Increase participants' ability to identify and resist peer and media pressures to engage in risky behaviors. 3) Increase participants' involvement in positive civic and community events. 4) Increase participants' positive attitude toward school/education 5) Decrease risky behavior of youth by increasing participants' positive self esteem through participation in positive youth development programs and activities on a daily basis Program Highlights: 1) In the Fiscal Year 2006-2007 the Boys and Girls Club of the Big Island provided programs to over 1300 youth ages 6 through 18 in our Clubs located at: Hamakua Mobile Outreach in Pa'auilo and Pa'auhau, Hilo, Kea'au, Pahala, Pahoa, and Ocean View Estates. Our youth development professionals also reached out to the schools as a beginning of our outreach efforts to provide the SMART Moves Drug, Alcohol, and Pregnancy Prevention Curriculum to those youth who are not able to participate in our daily year-round program. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 5 Boys & Girls Club of the Big Island Positive Youth Development Programs: Pahoa Club The Pahala Club opened its doors on September 18, 2006 and quickly grew to 90 members by the end of Fiscal Year 2006-2007. The Hawaiian Ocean View Estates Club and the Hamakua Mobile Outreach program began on February 1, 2007 and totaled 99 youth by the end of Fiscal Year 2006-2007. These communities and Big Island villages desired youth development programs for their children and have been very supportive of our mission and program. The BGCBI was given the opportunity to hear the need of these communities and with the financial assistance of various funding sources, has been able to make a difference in the lives of the young people we serve. 2) Collaborations/partnerships increased during Fiscal Year 2006-2007. We can add the following list of agencies working in partnership with BGCBI Clubs. v County Parks and Recreation (Pa'auilo, Pahala, and Ocean View) ➢ United States Tennis Association ➢ Theatre Arts Conservatory y Ocean Futures Society — Hawai'i Ambassadors to the Environment Program ➢ Hawaii State Department of Education ➢ University of Hawaii Hilo — Department of Agriculture The Rotary Club of South Hilo ➢ Coalition for a Tobacco Free Hawaii — East Hawaii ➢ Rein Teen Tours — Mainland Teens Community Service Initiative v The Hawaii Big Game Fishing Club County of Hawaii Police Department ➢ Hawaii Police Activities League (HI PAL) 3) Fiscal Year 2006-2007 presented BGCBI with a year of change and growth. Several key positions became available during this time including: BGCBI Finance Manager, BGCBI Director of Program Operations, Kea'au Club Director, and Hilo Teen Director. Qualified individuals were identified for all positions, each bringing their own experiences, "gifts", and visions for growth and change. BGCBI moved forward into Fiscal Year 2007- 2008 with a staff dedicated to excellence and program best practices! Performance Measures: NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 6 FY 2006-07 FY 2007-08 FY 2008-09 Actual * Budget * Estimate Youth will participate in The Arts Programs. Examples: n/a 75 75 ✓ Arts and Crafts ✓ Dance NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 6 Boys & Girls Club of the Big Island Positive Youth Development Programs: Pahoa Club ✓ Music ✓ Fine Arts Youth will participate in Character and Leadership programs. Examples: ✓ Keystone Club n/a 40 40 ✓ Torch Club ✓ Community Service Projects ✓ Club Service Projects Youth will participate in Education and Career Development Programs. Examples: ✓ Power Hour n/a 100 100 ✓ Project Learn ✓ Tutoring ✓ Computer Technology Youth will participate in Health and Life Skills Programs. Examples: ✓ SMART Moves n/a 100 100 ✓ Nutrition/Cooking Classes ✓ Triple Play Youth will participate in Sports, Fitness and Recreation Programs. Examples: ✓ Team/Individual Sports n/a 120 120 ✓ Games Room Activities ✓ Fitness Activities and Programs Parents will participate in FAN Club 4 events per year activities - Family will participate in n/a 25 activities to promote family strengthening and unity. Youth will complete SMART Moves n/a 206 #'s included in Health and Life Skills Development Of the 206 youth completing the #'s included in Health SMART Moves Program, youth n/a 30 and Life Skills ages 6-9 will complete the SMART Development Kids Program Of the 206 youth completing the #'s included in Health SMART Moves Program, youth n/a 76 and Life Skills ages 10-12 will complete the Start Development SMART Program Of the 206 youth completing the #'s included in Health SMART Moves Program, youth n/a 60 and Life Skills Development NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 7 Boys & Girls Club of the Big Island Positive Youth Development Programs: Pahoa Club ages 13-15 will complete the Stay FY 2006-07 Actual* (budget) FY 2007-08 Budget* estimate FY 2008-09 Estimate SMART Program $100,847 $125,666 $179,436 Of the 206 youth completing the $65 $2,250 #'s included in Health SMART Moves Program, youth n/a 40 and Life Skills ages 13-17 will complete the $3,045 $3,195 Development SMART Leaders Program $750 $750 Note: 2008-2009 Estimates for Skills Mastery and Resistance Training (SMART) Moves Prevention Program: This curriculum is offered to our youth within our Health and Life Skills core program area. Estimations are difficult for the actual curriculum, as our membership varies from year to year and each component has an age span. If a member is 6 years old when participating in SMART Kids, they are not able to participate in the Start SMART curriculum until age 10. BGCBI would like the County to be aware that all the youth development programming that we do includes the SMART Moves message to our youth. All five core program areas are enhanced by this curriculum sending the message to our youth that if they resist "risky behaviors" they are able to reach their full potential as productive, caring and responsible citizens. BGCBI is committed to assisting the young people of the Big Island in developing the necessary skills to resist tobacco, drugs, early sexual activity, and other problem behaviors such as: truancy, school failure/dropout, crime, violence, family problems and suicide. Program Expenditure " Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 8 FY 2006-07 Actual* (budget) FY 2007-08 Budget* estimate FY 2008-09 Estimate Salaries and Wages $100,847 $125,666 $179,436 Professional Fees $65 $2,250 $2,250 Operations $33,861 $46,563 $48,146 Equipment $3,045 $3,195 $3,195 Other (Board Development) $750 $750 7. 6E 1 t1'17 R 1 A 4t 17A d9d 4:9'22 777 " Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 8 Boys & Girls Club of the Big Island Positive Youth Development Programs: Pahoa Club Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2006-07 Actual* (budget FY 2007-08 Budget* (estimate) FY 2008-09 Estimate County of Hawaii —Non profit Grant $45,0001 $100,000 Hawaii Community Foundation: Hawaii Island Meth Inititative $16,099 $20,400 $25,000 Hawaii Community Foundation: HCF): Tobacco Fund $19,962 $9,500 Office of Justice Programs - Pahoa $2,938 $72,062 Office of Justice Programs - Growth $7,500 Office of Justice Programs — Capacity $10,500 Alcohol Drug Abuse Division ADAD $11,428 $48,777 Office of Youth Services (OYS) Positive Youth Development $20,000 Dept of Education - OHCNP $1,107 County of Hawaii - Contingency Fund $5,000 Hawaii Island United Way $12,500 Intersession Program Fees $3,390 Club Fundraising Events $9,749 $15,000 $3,000 Community Donations $75,107 $1,000 $15,000 Total $137,818 $178,424 $233,777 *If applicable Explain what plans, if any, your agency and/or program has to increase revenues to support this program. When do you anticipate your program to become self-sustaining? The Boys and Girls Clubs of the Big Island has made a strong movement to work towards diversifying our revenues. Our goal is to be balanced between grants and unrestricted (fundraising & donation) revenues, as well as the vision to create an endowment fund for the future . We will continue to work with Federal, State, County and private agencies to enhance collaboration between all facets to help us succeed. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 9 & Girls Club of the Bia Island Positive Youth Development Programs: Pahoa Club I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 — 2-142.2, Hawaii County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawai'i Revised Statutes. If awarded a grant from the County of Hawai'i, I (we) understand and will comply with the requirement to submit a year-end report to the Legislative auditor within 60 days after June 30 of the fiscal year. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawai'i grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely, complete, an agency's future funding requests. o���L.' Signature ojk3oard President/Chair Signature of Executive Director 'T4�/k5t E Date 30 Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 10 Brantley Center, Inc. -Agency Name mployment Rehabilitation Program - Program Name Agency Director: Cami Post Phone No.: 775-7245 Contact Person: Cami Post Phone No.: 775-7245 Mailing Address: P.O. Box 1407, Honokaa, Hawaii 96727 Facility/Site Address: 45-370 Ohelo Road, Honokaa, Hawaii 96727 Fax No.: 775-0211 Email Address: bcenter2@hawaiiantel.net Name of Accountant/CPA (include name of firm if applicable): Jennifer L. Gossert, CPA Phone No.: (808) 969-3115 Mailing Address: 688 Kinoole Street, Suite 201, Hilo, Hawaii 96720 Amount of Request for County Funds: $25,000 Prior Year(s) Funding: 06-06 06-07 07-08 $23,000 $21,000 $25,000 Agency Mission Statement: To provide quality rehabilitation services in addressing community needs for vocational training and independent living skills training to people with mental, emotional, and /or physical disabilities NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 1 Brantley Center, Inc. -Agency Name Employment Rehabilitation Program - 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 work performed. Program staff work closely with the community to provide community-based vocational training, and at the same time provide the public with an additional work force. Also included in this program are work transition services for high school students. The Center's staff work with high school counselors to transition students with disabilities from a school environment to a work environment. Total Budget and Position Count Total Program Budget 216,300 Total Program Position 5.5 Total Agency Budget 430,590 Total Agency Position Count 9.5 Program Objectives: 1) Provide vocational evaluations to 30 clients. 2) Provide individualized employment planning services to 20 clients. 3) Provide work adjustment training to 26 clients 4) Provide occupational skills training to 26 clients. 5) Provide job -readiness classes to 20 clients. 6) Provide competitive job placement and follow-up services to 12 clients 7) Provide work transition services to 14 high school students with disabilities. Program Highlights: 1) Provided vocational evaluations to 8 clients. 2) Provided individualized employment planning services to 12 clients. 3) Provided work adjustment training to 14 clients. 4) Provided occupational skills training to 16 clients. 5) Provided job -readiness classes to 10 clients. 6) Placed 8 clients in competitive employment. 7) Provided work transition services to 5 high school students with disabilities. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 2 Brantley Center, Inc. -Agency Name Employment Rehabilitation Program - Program Name Performance Measures: *If applicable Program Expenditures FY 2006-07 FY 2007-08 FY 2008-09 Salaries and Wages Actual * Budget * Estimate Number of clients who receive 21 30 30 employment rehabilitation services. 39,000 26,821 28,000 Number of clients with improved 10 20 20 scores on the Vocational Evaluation 23,383 28,973 30,000 and Training Report. 215,597 211,017 216,300 Number of clients who increased 10 20 20 their productivity percentages. Number of clients who successfully 8 18 18 completed the job -readiness classes. Number of clients placed in 8 10 10 competitive employment for a minimum of 90 days. Number of high school students who 3 10 10 received work transition services, and were placed in competitive employment. *If applicable Program Expenditures * If applicable ' Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 3 FY 2006-07 Actual * FY 2007-08 Budget * FY 2008-09 Estimate Salaries and Wages 142,214 144,223 147,100 Professional Fees 11,000 11,000 11,200 Operations 39,000 26,821 28,000 Equipment Other` Client wages 23,383 28,973 30,000 Total 215,597 211,017 216,300 * If applicable ' Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 3 Brantley Center, Inc. -Agency Name Employment Rehabilitation Program - Program Name Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2006-07 Actual * FY 2007-08 Budget* FY 2008-09 Estimate County Mass Transit 10,500 10,500 10,500 State of Hawaii 30,000 30,000 30,000 Hawaii Island United Way 26,000 26,000 30,000 County of Hawaii Nonprofit Grant 21,000 25,000 25,000 Sales & Services 128,097 119,517 120,800 Other Total 215,597 1 211,017 216,300 *If applicable Explain what plans, if any, your agency and/or program has to increase revenues to support this program. When do you anticipate your program to become self- sustaining? For fiscal year 2008-2009 Brantley Center, Inc. plans to expand the Janitorial Training Program by submitting bids for public and private contracts. We also plan to enlarge the plant nursery that was started last fiscal year. This will provide participants with additional training opportunities and at the same time increase program revenue. The Board of Directors and Administrator plan to increase fundraising activities, and large donor contributions through special invitations to the Center to show case our program services. Almost sixty percent of the total cost to provide employment rehabilitation services is funded by the Centers private funds, generated by services made available to the public. The community continues to show their support of Brantley Center through designating their donations to the Center through Hawaii Island United Way, through fundraising activities, and contributions. In order to provide employment training and supports necessary for people with disabilities to become employed, it must be a collaborative effort between Brantley Center, Inc., the State and County, and the community. The funds provided by the State and County of Hawaii are essential to provide quality rehabilitation services. Without this funding, the number of people served would decrease as well as training services. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 4 Brantley Center, Inc. - Agency Name Employment Rehabilitation Program - Program Name I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 — 2-142.2, Hawaii County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawaii Revised Statutes. If awarded a grant from the County of Hawaii, 1 (we) understand and will comply with the requirement to submit a year-end report to the Legislative auditor within 60 days after June 30 of the fiscal year. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawaii grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely, complete, and Signature of Board President/Chair Signature of Executive Director ,;;/'Date O✓ Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTEDI NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 5 Brantley Center, Inc. - Agency Name Employment Rehabilitation Program - Program Name Program Expenditures: The "Other" category is client wages. Clients get paid for the work they produce while they participate in this training program. BRIDGE HOUSE, Inc.- Agency Name Vocational Skills Building Program- Program Name Agency Director: Mark Schuster, M.A. 808-322-3305 Contact Person: Mark Schuster 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.: 808-3220809 Email Address: mark_bridgehouse@earthlink.net Phone No.: Phone No.: 808 - 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 Prior Year(s) Funding: 05-06 06-07 $00.00 $15,000 Agency Mission Statement: 07-08 $15,000 NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 1 The Bridge House mission is to assist adults who are in early recovery from drug and alcohol addiction to develop successful living skills through residential and vocational experiences in a safe, structured and supportive environment. NONPROFIT GRANT APPLICATION FISCAL YEAk 2008-09 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 the Bridge House program that provides assessment, referral and linkages, and training to program residents, that will enable graduating residents to secure and maintain successsful employment upon discharge. Total Budget and Position Count Total Program Budget 92,006.00 Total Program Position Count 1-5 Total A enc Bud et 418,093.00 Total Agency Position Count 6 Program Objectives: 1) All incoming residents to complete an "initial vocational/employment evaluation". 2) A vocational plan is developed that identifies areas of need (e.g. skills building/training, enhancement of attitude and behavior, continuing education, job coaching, resume preparation, mock interviews, job search, etc.). 3) All residents must contribute a minimum of 15 hours per week, in the manner of a practicum, of some sort of labor back to the Bridge House 'ohana. This allows for on-site staff evaluation of attitude, commitment, and general assessment of job readiness. 4) At approximately 90 days of program participation, staff and resident complete a pre-employment evaluation that assesses willingness to participate, punctuality, ability to establish and meet goals, and other items related to employment readiness. 5) Between 100-300 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, Bridge House staff will provide the resident transportation to and from the worksite. Program Highlights: NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 3 1) At the time of their admisson, 100% of the 53 admits were deemed "unemployable". 2) Twenty-two residents successfully completed the program. 3) Three months post -discharge, 83% of graduates remained in full-time employment. 4) Six months post -discharge, 79% of graduates remained in full-time employment. 5) All graduates obtained clean and sober housing, prior to discharge. 6) NONPROFIT GRANT APPJ,ICATION FISCAL YEAR 2008-09 Page 4 Bridge House, Inc. - Agency Name Vocational Skills Building Program - Program Name Performance Measures: If applicable Program Expenditures FY 2006-07 Actual * FY 2007-08 Budget * FY 2008-09 Estimate 50% of all admits will complete the program. 42% 50% 50% 70% of graduates will be employed, in school or in a job training program at 6 months post- discharge. 79% 70% 70% Operations 18,002.00 16,787.00 22,356.00 Equipment 6,036.00 2,400.00 6,350.00 Other' Total 76,930.00 69,887.00 92,006.00 If applicable Program Expenditures If applicable ° Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 5 FY 2006-07 Actual * FY 2007-08 Budget* FY 2008-09 Estimate Salaries and Wages 49,907.00 46,500.00 49,800.00 Professional Fees 2,985.00 4,200.00 13,500.00 Operations 18,002.00 16,787.00 22,356.00 Equipment 6,036.00 2,400.00 6,350.00 Other' Total 76,930.00 69,887.00 92,006.00 If applicable ° Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 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 2006-07 Actual * FY 2007-08 Budget * FY 2008-09 Estimate Hawaii Island United Way 17,000.00 24,000.00 24,000.00 State of Hawaii/ADAD 19,430.00 20,000.00 14,000.00 State of Hawaii/Judiciary 18,000.00 0.0 0.0 Program Fees 5,500.00 8,000.00 5,000.00 County 15,000.00 15,000.00 48,000.00 Donations 2,000.00 2,887.00 1,006.00 Total 76,930.00 69,887.00 92,006.00 *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 proud to report that this past year was notable for this program being able to bring our present agricultural endeavor (lychee crop) to market. And although the income was rather modest, it is anticipated that next year sales will be significantly more rewarding. There remains additional agricultural land that could be developed (and likely add to profitability), but such development is dependent upon Bridge House receiving increased funding or grants. To this end, we humbly ask the County to consider increasing our funding beyond the past year's amounts. In addition, we continue to review and apply for grants that become available and may support the program. We are beginning to realize, however, that it is unlikely that a program of this size will be entirely self- sustaining, unless or until all the agricultural land is developed and utilized. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 6 Bridge House, Inc. - Agency Name Vocational Skills Building Program - Program Name I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 — 2-142.2, Hawai'i County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawai'i Revised Statutes. If awarded a grant from the County of Hawai'i, I (we) understand and will comply with the requirement to submit a year-end report to the Legislative auditor within 60 days after June 30 of the fiscal year. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawai'i grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely, complete, an Signature of Board President/Chair Signatu of Executive Director /- Date Of /2. q Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTEDI NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 7 Child and Family Service - Agency Name Hilo Transitional Housing Program - Program Name Agency Director: Howard Garval, President and CEO Phone No.: (808) 681-3500 Contact Person: Heidemarie Koop, Director of Hawaii Island Programs Phone No.: (808) 935-8229 Mailing Address: Child and Family Service 91-1841 Fort Weaver Road Ewa Beach, Hawaii 96706 Facility/Site Address: 1266 Kamehameha, Suite A Hilo, Hawaii 96720 Fax No.: (808) 935-5589 Email Address: hkoop@cfs-hawaii.org Name of Accountant/CPA (include name of firm if applicable): Nishihama & Kishida, CPAs, Inc. Phone No.: (808) 524-2255 Mailing Address: American Savings Bank Tower, 1001 Bishop Street, Suite 1700, Honolulu, Hawaii 96813-3696 Amount of Request for County Funds: $35,000.00 Prior Year(s) Funding: 05-06 06-07 07-08 $15,000 $30,000 $35,000 NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 1 Child and Family Service - Agency Name Hilo Transitional Housing Program - Program Name Agency Mission Statement: "Strengthening families and fostering the healthy development of children" Since 1899, Child and Family Service has dedicated its efforts to its mission of "Strengthening families and fostering the healthy development of children". The spectrum of Child and Family Service programs builds on the strengths of individuals and families to address the many human challenges. The organization's comprehensive array of services has allowed Child and Family Service to develop in many areas and to offer an integrated and comprehensive human service and behavioral health care delivery system throughout the State of Hawaii. Child and Family Service continues to be known in the community for its willingness to work with hard -to -engage individuals and families facing a multitude of difficult problems. To ensure the continuation of comprehensive Domestic Violence services on the island of Hawaii, Child and Family Service agreed to a planned merger with Turning Point for Families, Inc. As of January 1, 2008, Child and Family Service oversees all of Turning Point for Families' programs in East and West Hawaii. Despite the added significant fiscal responsibilities, Child and Family Service continues to be committed to support community populations that present with increasingly complex problems and situations. Child and Family Service continues to be at the forefront of developing the skills, knowledge, and service models to address these needs. Program Description: Funds are requested to support the operation of the East Hawaii Transitional Housing program. The intention is to use Hawaii County monies to support the position of a half-time Domestic Violence Specialist position operating out of the Hilo office. Victims of Domestic Violence are faced with many challenges when making the courageous decision to finally leave their batterers. As women and men are provided services in our Domestic Abuse programs, when it comes to economic issues, it is mostly women who are confronted with financial challenges. When leaving the batterer, the victim embarks upon a path that is as fearful for her and her children as it is to stay with an abusive partner. Many of these women leave with just the clothes that they are wearing, seeking shelter, safety and most of all assurances that they made the right choice. Many lack the skills, tools and resources needed to sustain themselves and their children away from their batterer. Leaving with barely little, many women are faced with the reality of no financial resources, and inability to access resources due to marital assets retained by the perpetrator which disqualifies her from qualifying for public assistance or possibly subsidized housing. Many women turn to the Hilo or Kona Domestic Abuse shelters where they can recover and start planning a new life. Securing a safe home for the victims and their children is one of the serious NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 2 Child and Family Service - Agency Name Hilo Transitional Housing Program - Program Name challenges that the victims are facing in the county of Hawai'i due to an expensive rental market. At the end of the 90 days in a Domestic Abuse shelter, the victim must make a decision not only for herself but for her children as well. Unfortunately that decision is often to return to the batterer she sought refuge from or to become homeless. The Hilo Transitional Housing is a 12 month program designed to assist victims of domestic violence and their children rebuild their lives. The program goal is to assist victims and their children in gaining stability and independence while transitioning into a violence -free lifestyle. Victims will transition from the Domestic Abuse shelters located in West and East Hawaii and can be placed in one of 6 apartments/houses. During their 12 month stay, victims and their families receive intensive support services with the goal to guide the victims and their families towards independence which includes at discharge to move to a regular home in the community, to secure income and to be able to care for the children. Weekly home visits, case management, individual family service plans, and information and referrals to community resources are provided by the program staff. The program allows both the victims and their children the time to heal, live safely and regain their self esteem. Victims are given the opportunity to learn or enhance their life skills, including budgeting, money management and job training and in doing so, we address many of the barriers to establishing income, housing and independence. To further strengthen the program, Child and Family Service is seeking to add a half-time person to assist families of the Transitional Housing program to become independent and self-sufficient in their goal to live a domestic violence free life for themselves and their children. Total Budget and Position Count Total Pro ram Bud et $159,000.00 Total Program Position Count 1.5 Total Agency Budget 1 $6,476,615.00 1 Total Agency Position Count 94 Program Objectives: 1. 70% of the clients will reduce their level of stress as measured quarterly. 2. 70% of the clients will increase self-sufficiency as measured quarterly. 3. 90% of the clients will complete/have a Safety Plan for themselves and their children as measured quarterly. 4. 80 % of the clients will secure independent housing after 12 months of safe transitional housing. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 3 Child and Family Service - Agency Name Hilo Transitional Housing Program - Program Name Program Highlights: 1. The program is fulfilling a high need for providing housing for victims of Domestic Violence and their families. 2. Provided 11 families with transitional housing from July 2006 to June 2007. 3. Provided 10 families with transitional housing from July 2007 to December 2007. 4. The staff has developed a strong program that focuses on reintegrating victims of Domestic Abuse into independence and self-sufficiency. 5. All six units are occupied and there is a waiting list. 6. Four families have successfully transitioned into permanent housing since July 1, 2007. 7. Three families have successfully completed job training programs. 8. Two participants are currently enrolled at the University of Hawaii, one is seeking a Certified Substance Abuse Counselor (CSAC) certificate and a Bachelor's degree in Psychology, the other is working on obtaining her Associate degree in Administration of Justice. 9. Of the twelve participants who have transitioned out of program since it's beginning in 2006, eleven participants have made the decision not to re - involve themselves with their perpetrators. 10. The program has established a collaboration with the Forward March job training program. Performance Measures: *If applicable NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 4 FY 2006-07 Actual * FY 2007-08 Budget * FY 2008-09 Estimate # of families provided housing 11 14 14 # of service plans developed 11 14 14 # provided case management 11 14 14 # of safely plans developed 11 14 14 # provided aftercare services 7 8 8 # w/secured income 7 10 8 # enrolled in education program 2 4 3 # w/secure employment 5 6 6 # obtained permanent housing 7 8 8 *If applicable NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 4 Child and Family Service - Agency Name Hilo Transitional Housing Program - Program Name Program Expenditures If applicable " Please explain in detail on separate sheet Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2006-07 Actual * FY 2007-08 Budget * FY 2008-09 Estimate Salaries and Wages $3,461.00 $25,757.00 $25,860.00 Professional Fees $15,000.00 $30,000.00 $35,000.00 Operations $11,539.00 $4,243.00 $9,140.00 Equipment Other" Total $15,000.00 $30,000.00 $35,000.00 If applicable " Please explain in detail on separate sheet Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2006-07 Actual * FY 2007-08 Budget * FY 2008-09 Estimate US Department of Justice $114,887.00 $112,664.00 $116,000.00 County of Hawaii $15,000.00 $30,000.00 $35,000.00 Program Fees $8,680.00 $8,000.00 $8,000.00 Total $138,567.00 $150,664.00 $159,000.00 *If applicable NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 5 Child and Family Service - Agency Name Hilo Transitional Housing Program - Program Name Explain what plans, if any, your agency and/or program has to increase revenues to support this program. When do you anticipate your program to become self-sustaining? The Transitional Housing program has been primarily supported by the Department of Justice, Office of Violence Against Women (OVW). Due to the merger of Turning Point for Families, Inc. into Child and Family Service, the funding has been interrupted. Interim funding and new funding from the Office on Violence Against Women (OVW), Department of Justice, has been requested. Additional fundings options that primarily focus on providing Transitional Housing services will be identified. Child and Family Service will seek support from the Hawaii Community Development Corporation of Hawaii (HCDCH) homeless stipend program and the Emergency Shelter Grant Program (ESG). NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 6 Child and Family Service - Agency Name Hilo Transitional Housing Program - Program Name I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 — 2-142.2, Hawai'i County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawaii Revised Statutes. If awarded a grant from the County of Hawaii, I (we) understand and will comply with the requirement to submit a year-end report to the Legislative auditor within 60 days after June 30 of the fiscal year. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawaii grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely, complete, and accurate year-end report will impact the evaluation of your program's or agency's future funding requests. Signature o Board Presi n Cham ignature of Executive Director N -T Ay Date Id -7 aI _ D to UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 7 Child and Family Service - Agency Name Ke Ala Lokahi - Program Name Agency Director: Howard Garval, President and CEO Phone No.: (808) 681-3500 Contact Person: Heidi Koop, Director of Hawaii Island Programs Phone No.: (808) 935-8229 Mailing Address: Child and Family Service 91-1841 Fort Weaver Road Ewa Beach, Hawaii 96706 Facility/Site Address: 1266 Kamehameha Avenue, Suite A Hilo, Hawaii 96720 Fax No.: (808) 935-5589 Email Address: hkoop@cfs-hawaii.org Name of Accountant/CPA (include name of firm if applicable): Nishihama & Kishida, CPAs, Inc. Phone No.: (808) 524-2255 Mailing Address: American Savings Bank Tower, 1001 Bishop Street, Suite 1700, Honolulu, Hawaii 96813-3696 Amount of Request for County Funds: $35,000.00 Prior Year(s) Funding: 05-06 06-07 07-08 $0.00 $0.00 $0.00 NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 1 Child and Family Service - Agency Name Ke Ala Lokahi - Program Name Agency Mission Statement: "Strengthening families and fostering the healthy development of children" Since 1899, Child and Family Service has dedicated its efforts to its mission of "Strengthening families and fostering the healthy development of children". The spectrum of Child and Family Service programs builds on the strengths of individuals and families to address the many human challenges. The organization's comprehensive array of services has allowed Child and Family Service to develop in many areas and to offer an integrated and comprehensive human service and behavioral health care delivery system throughout the State of Hawaii. Child and Family Service continues to be known in the community for its willingness to work with hard -to -engage individuals and families facing a multitude of difficult problems. To ensure the continuation of comprehensive Domestic Violence services on the island of Hawaii, Child and Family Service agreed to a planned merger with Turning Point for Families, Inc. As of January 1, 2008, Child and Family Service oversees all of Turning Point for Families' programs in East and West Hawaii. Despite the added significant fiscal responsibilities, Child and Family Service continues to be committed to support community populations that present with increasingly complex problems and situations. Child and Family Service continues to be at the forefront of developing the skills, knowledge, and service models to address these needs. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 2 Child and Family Service - Agency Name Ke Ala Lokahi - Program Name Program Description: Funds are requested to support the operation of the East Hawaii Ke Ala Lokahi program. The intention is to use Hawaii County monies to hold two men's and one women's groups which will be facilitated by a Group Facilitator and a Domestic Abuse Specialist. The East Hawaii Ke Ala Lokahi (KAL) batterer's intervention program utilizes Hawaiian values, beliefs, and traditions to address intimate partner violence among native Hawaiian men and women. In addition, KAL provides legal advocacy to complete and file temporary restraining orders, court advocacy, individualized safety planning, psycho -educational and pattern changing groups, victim support groups, case management and childcare services while attending groups. The Ke Ala Lokahi program works very closely with the Alternatives -to -Violence (ATV) program in East Hawaii. In comparison to the Alternative -to -Violence program, the Ke Ala Lokahi program focuses on supporting clients with a Hawaiian Ancestry background. Upon seeking services for domestic violence services, clients with the Hawaiian Ancestry background are offered the services of the Ke Ala Lokahi program as an alternative to the ATV program. The Ke Ala Lokahi men's program consists of a 24 -week curriculum for men. Also, a significant part of the program includes visits to historical sites located on the Big Island. The purpose of these visits is to support clients to connect with their native culture. The Ke Ala Lokahi women's component consists of a 22 -week curriculum for women who have been victims of domestic and sexual violence. A significant part of the women's program, also requires visits to historical cultural sites located on the Big Island. In the core curriculum, all program activities consist of two interconnected steps. The first step is for the clients to participate in traditional Native Hawaiian physical, mental, and spiritual practices for the purpose of reinstating the integral nature of the Lokahi Triangle. The Lokahi Triangle depicts the interconnectedness between mankind, nature and god(s). With the understanding of the Lokahi Triangle, the second step is for the clients to understand how violence is used as power in intimate relationships and causes disrespect and harm that is inconsistent with the values and beliefs and conduct of traditional Native Hawaiian culture. This program philosophy and practice also incorporates the understanding of violence against women within a social, economic, and cultural analysis of gender and sex oppression. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 3 Child and Family Service - Agency Name Ke Ala Lokahi - Program Name For example in one unit of the curriculum Native Hawaiian men participate in planting, tending and harvesting taro (kalo), a food source, which is the most important symbol of the Native Hawaiian life cycle. This activity takes place at a taro farm where a Native Hawaiian cultural expert teaches the men about taro cultivation. The accompanying lesson will be an accounting for their abuse towards their partners and how the cultural meaning of kalo, as well as the practices necessary for the care of the taro are also necessary for and congruent with healthy, caring, non-violent relationships in Native Hawaiian families and communities. In one of their activities, Native Hawaiian women study with a Native Hawaiian Kumu Hula (Hula teacher). The women's program focuses on traditional representations of Native Hawaiian women in mele (song) and oli (chant), and the significance of women such as Pele (the fire goddess) and Laka (the goddess of hula) in mythology and social life. In preparation for the physical and spiritual aspects of hula, women examine how intimate violence undermines the strength and power necessary for women to engage in mele, oli, and other cultural activities. They analyze the ways in which violence reduces women's self-esteem and self-care, and how such acts are incongruent with respect for women and girls in native Hawaiian cultural, spiritual and community life. All activities of the curriculum are designed and implemented with two groups of experts: Native Hawaiian cultural specialists (for example, experts in Native Hawaiian weaving or kalo farming) and trained domestic and sexual violence counselors and advocates. The use of dual expertise teams for the program reflects the inherent design of the program curriculum. All participants are assigned a case manager to monitor their participation and performance during group, maintain contact with probation and other related services, and to provide one to one counseling and referrals. Total Budget and Position Count Total Program Budget $43,640.00 Total Program Position Count 2 Total Agency Budget $6,476,615.00 Total Agency Position Count 94 Program Objectives: 1. 60% of clients completing Ke Ala Lokahi services will demonstrate the knowledge, skill and attitudes necessary for maintenance of non -abusive behavior, which includes learning the Lokahi triangle, non-violent conflict resolution and non-aggressive communication at discharge. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 4 Child and Family Service - Agency Name Ke Ala Lokahi - Program Name 2. 100% of clients completing batterer intervention services with Ke Ala Lokahi will significantly increase their knowledge of the effects of domestic violence on children at discharge. 3. 80% of victims participating in the Ke Ala Lokahi groups will be able to identify at least 3 personal safety skills at discharge. Program Highlights: Ke Ala Lokahi men, women and children who have been affected by domestic violence (offenders, victims, witnesses,) are offered a program that is based on native Hawaiian values and traditions. The objective is to remind the men and women of their heritage and the respect for nature, for themselves and others. In Fiscal Year '07, the program provided the following: • 117 men graduated from the program after a 24 -week program. • 47 women graduated from the program after a 22 -week program. • 1533 direct contacts were made with men and women who were part of the domestic violence cycle. • 6 "24 -week" classes were held. Performance Measures: The Performance Measures for FY 2008-2009 estimates decreased based on the fact that OHA funding is not secured at this time. *If applicable NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 5 FY 2006-07 Actual * FY 2007-08 Budget * FY 2008-09 Estimate Number of men graduated from program 117 80 60 Number of women graduated from program 47 40 30 Number of (24 weeks) classes for men 4 3 2 Number of 22 -weeks classes for women 2 1 1 Number of direct contacts with men and women 1533 800 600 *If applicable NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 5 Child and Family Service - Agency Name Ke Ala Lokahi - Program Name Program Expenditures If applicable " Please explain in detail on separate sheet Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2006-07 FY 2007-08 FY 2008-09 Actual * Budget * Estimate Salaries and Wages $20,760.00 Professional Fees $55,358.00 Operations $14,240.00 Equipment $8,743.00 Other" $8,640.00 Total $0.00 $0.00 $35,000.00 If applicable " Please explain in detail on separate sheet Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2006-07 Actual * FY 2007-08 Budget * FY 2008-09 Estimate Office of Hawaiian Affairs $55,358.00 $44,537.00 $0.00 Program Fees $8,743.00 $8,640.00 $8,640.00 Hawaii County $0.00 $0.00 $35,000.00 Total $64,101.00 $53,207.00 $43,640.00 *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? NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 6 Child and Family Service - Agency Name Ke Ala Lokahi - Program Name The Ke Ala Lokahi program was funded for two years by the Office of Hawaiian Affairs (OHA). As of January 1, 2008, funding through OHA has not been secured. As Child and Family Service is in contact with OHA to request future fundings, it is also the intention to expand the program to work with adolescent boys and girls. Additionally, the plan is to strengthen the women's component. Although this program has been designed to work with native Hawaiian men and women based on the Hawaiin value system, the program will continue to serve men and women from non Hawaiian backgrounds. To strengthen and to grow the program, Child and Family Service will review national funding options. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 7 Child and Family Service - Agency Name Ke Ala Lokahi - Program Name I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 — 2-142.2, Hawaii County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawaii Revised Statutes. If awarded a grant from the County of Hawaii, I (we) understand and will comply with the requirement to submit a year-end report to the Legislative auditor within 60 days after June 30 of the fiscal year. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawai'i grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely, complete, and accurate year-end report will impact the evaluation of your program's or agency's future funding requests. Signature of B &rd Preside t it Signature of Executive Director Bto Date /'/9-'t d'd' D e UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 8 Child and Family Service - Agency Therapeutic Foster Home Program — West Hawaii — Program Agency Director: Howard Garval, President and CEO Phone No.: 681-3500 Contact Person: Heidemarie Koop Phone No.: 323-2664 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 Fax No.: (808) 323-2999 West Hawaii Email Address: hgarval@cfs-hawaii.org hkoop@cfs-hawaii.org Name of Accountant/CPA (include name of firm if applicable): Nishihama & Kishida, CPA's, Inc. Phone No.: (808) 524-2255 Mailing Address: American Savings Bank Tower, 1001 Bishop Street, Suite 1700, Honolulu, Hawaii 96813-3696 Amount of Request for County Funds: $30,000.00 Prior Year(s) Funding: Family Violence Continuum Programs 05-06 06-07 07-08 $9,000 $9,000 $9,000 NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 1 Child and Family Service - Agency Therapeutic Foster Home Program — West Hawaii — Program Agency Mission Statement "Strengthening families and fostering the healthy development of children" Since 1899, Child and Family Service has dedicated its efforts to its mission of "Strengthening families and fostering the healthy development of children". The spectrum of Child and Family Service programs builds on the strengths of individuals and families to address the many human challenges. The organization's comprehensive array of services has allowed Child and Family Service to develop in many areas and to offer an integrated and comprehensive human service and behavioral health care delivery system throughout the State of Hawaii. Child and Family Service continues to be known in the community for its willingness to work with hard -to -engage individuals and families facing a multitude of difficult problems. To ensure the continuation of comprehensive Domestic Violence services on the island of Hawaii, Child and Family Service agreed to a planned merger with Turning Point for Families, Inc. As of January 1, 2008, Child and Family Service oversees all of Turning Point for Families' programs in East and West Hawaii. Despite the added significant fiscal responsibilities, Child and Family Service continues to be committed to support community populations that present with increasingly complex problems and situations. Child and Family Service continues to be at the forefront of developing the skills, knowledge, and service models to address these needs. Program Description Funds are requested to support the Therapeutic Foster Home program in their work with children who present with severe behavioral challenges such as self - injuries, property damage, physical assaults, truancy, substance abuse and stealing. These children are in high need of professional Skills Trainers who are able to give them the one-on-one attention. Child and Family Service is requesting funding for a half-time Skills Trainer and monies to support therapeutic activities in the homes and the community. Child and Family Service Therapeutic Foster Home (TFH) program provides foster placement and clinical services for youth who have been identified as needing out -of -home placement with additional resources to accommodate their emotional, behavioral, and mental health issues. The TFH program offers a system of support, counseling and skill building services to youth as well as training and support to foster parents. The behavioral health and residential programs at Child and Family Service have seen an increase in the number of youth in their programs with neurological challenges. These youth are being referred to our programs as young as 5 years old. The majority of these youth are children whose mothers used drugs during pregnancy. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 2 Child and Family Service - Agency Therapeutic Foster Home Program — West Hawaii — Program In recent years, study after study has demonstrated the malevolent effects of substance abuse on women and their children. Deterioration in the physical, mental, and emotional health of the substance -abusing mother and her child has been well documented, with particular emphasis on the potentially devastating effects on the fetus of prenatal maternal drug abuse. In the 1996 Blind Study of Substance Abuse and Need for Treatment Among Women of Childbearing Age in Hawaii, women reported using alcohol, tobacco, marijuana, cocaine/crack, and methamphetamine in the greatest numbers. It is well documented that since the 1990s, there has been a dramatic increase in the use of methamphetamine ("ice"). It is anticipated that overtime, the number of youth referred for behavioral health services, including therapeutic foster homes, will increase as Hawaii's "ice babies" grow up. Youth with neurological impairment exhibit combined cognitive, physical and emotional difficulties. They may have learning impairments, behavioral deficits, increased motor activity, and enhanced conditioned avoidance responses. Their behaviors are difficult to understand and interventions that have been used in the past by CFS staff do not necessarily work for these youth. Parents and foster parents become frustrated and cannot cope, resulting in many placements for these youth. Multiple placements often times reinforce problem behaviors and erode the self esteem of these youth. It is cost -beneficial to learn more about this population, provide interventions as early as possible, and prevent further problems from developing. The current staffing consists of a Program Director who provides programmatic oversight of the Therapeutic Foster Home. A Master's level Mental Health Specialist provides intense clinical and case management services for the child, the therapeutic foster parents and biological family members. A Bachelor's level Mental Health Specialist focuses on therapeutic activities addressing self control, peer relationships, community safety and communication with teachers, therapeutic foster parents, family members and other adults in the community. The Support Coordinator provides daily practical support to the therapeutic foster parents in regards to transportation and appointments. Other duties include the licensing of foster homes and preparing new intakes. Child and Family Service is in the process of developing a program component that focuses on the needs of children who have neurological impairment. When these children are placed into our Therapeutic Foster Home program, there is a high need for providing one-on-one staffing to allow the child to adjust to his/her new therapeutic foster home, often a new school environment and making connections with other children in the community. Child and Family Service staff have received extensive training that focused on working with children between the ages 5 and 12 years old with these difficulties. To further support this project, an experienced Skills Trainer is needed to provide intensive services at the NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 3 Child and Family Service - Agency Therapeutic Foster Home Program — West Hawaii — Program beginning of the placement, during crisis situations and transition to a permanent placement. The Skills Trainer would be working under the direct supervision of a Program Director with guidance by the Master's level clinician. The Skills Trainer would provide groups to teach life skills that allow the children to manage their neurological challenges in a healthy way. Total Budget and Position Count Total Program Budget $580,842.00 Total Program Position Count 5.6 Total Agency Budget $6,476,615.00 Total Agency Position Count 94 Program Objectives The intermediate goal of the Therapeutic Foster Home Program is to provide a safe stable living environment to youth who experience emotional and/or behavioral problems while the children engage in therapy to address their individualized mental health and behavioral issues. The long-term goal of the program is to provide the support and skill building necessary to empower youth to engage in socially appropriate and manageable behaviors, thereby facilitating the re -unification (if appropriate) of children with their biological families or at the very least to be able to move to a less restrictive environment. Measurable objectives for the Therapeutic Foster Home program include: 1. 90% of youth show progress in the development of interpersonal relations and life skills, as measured by their participation in extra curricular, community or otherwise pro -social activities as measured quarterly. 2. 90% of youth learn how to be a positive and productive member of a family as measured by their ability to follow daily scheduling and complete household duties as measured quarterly. 3. 100% of youth work towards their identified permanency plan goals as measured quarterly. Program Highlights The Therapeutic Foster Home (TFH) Program has focused intently on developing the program's ability to provide innovative and valuable therapeutic intervention to the youth of West Hawaii. The program has also experienced an increase in census as well as an added number of quality therapeutic foster parents employed to provide services to the youth. During the last twelve months, the TFH program has evolved to become a therapeutic pioneer providing enhanced professional services that positively impact the lives of children in Kona. Some examples of our advances are listed below: NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 4 Child and Family Service - Agency Therapeutic Foster Home Program — West Hawaii — Program • The number of Therapeutic Foster Homes now available through our program has increased to twelve (12) as of December 31, 2007. • Utilization of the program has increased substantially over the last year with a total of nineteen hundred seventy (1970) bed days provided to the thirteen (13) TFH youth in West Hawaii, January through December 2007. • The program organized several statewide trainings for foster parents and program staff to reinforce established treatment approaches as well as introduced cutting edge treatment modalities with the purpose of increasing the skills and knowledge of staff/foster parents to ensure flexible, individualized treatment and evidence based interventions for youth. • A Youth Empowerment Initiative was enacted for youth in the TFH program to include an increased emphasis placed on the participation of youth in extra- curricular activities that support social and emotional growth. • Peer Therapy Sessions were initiated with youth as the latest research is showing that the most successful programs engage in peer therapy to reduce recidivism. • A Forum for Foster Youth (facilitated by TFH Therapist) is held monthly with the purpose of providing a safe place for youth in the CFS TFH program to come together to talk about issues that are important to them. • The adoption of the "Nothing About Me Without Me" philosophy, which is a best practice endorsed model for ensuring that the youth's are given the opportunity and encouraged to actively participate in their treatment planning and have their voices heard by the treatment team and other adults/professionals in their lives. Therapeutic Foster Home — West Hawaii Performance Measures *If applicable NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 5 FY 2006-07 Actual * FY 2007-08 Budget * FY 2008-09 Estimate Therapeutic Foster Home Program # of clients served 15 # of bed days utilized 2000 # of licensed foster homes 14 # of individual therapy, therapeutic activities and/or skill building 780 # family therapy sessions 780 # of discharges to a lateral or lower level of care 5 *If applicable NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 5 Child and Family Service - Agency Therapeutic Foster Home Program — West Hawaii — Program Program Expenditures FY 2006-07 Actual * FY 2007-08 FY 2008-09 Budget * Estimate Salaries and Wages $19,053.00 Professional Fees $535,002.00 Operations $10,947.00 Equipment $0.00 Other" $30,000.00 Total $30,000.00 If applicable # Please explain in detail on separate sheet Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2006-07 Actual* FY 2007-08 Budget * FY 2008-09 Estimate Department of Health (Child Adolescent Mental Health $535,002.00 $590,252.00 $649,277.00 County of Hawaii $0.00 $0.00 $30,000.00 Total $535,002.00 $590,252.00 $679,277.00 *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? Child and Family Service strives to achieve sustainability for all its programs. Yet, Child and Family Service is also committed to providing critical services in the community and pursues new treatment modalities despite their budgetary limitations. CFS is active in writing grants for supplemental funding to keep its critical programs operating. Child and Family Service has applied to other funders to ensure continuing training by for neurological impairment to further the project of working with children who are experiencing neurological challenges. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 6 Child and Family Service - Agency Therapeutic Foster Home Program — West Hawaii — Program 1 (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 — 2-142.2, Hawai'i County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawaii Revised Statutes. If awarded a grant from the County of Hawaii, I (we) understand and will comply with the requirement to submit a year-end report to the Legislative auditor within 60 days after June 30 of the fiscal year. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawaii grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely, complete, and v� Signature of &ard Presiden air ignature of Executive Director t2Alo� Date /ZIC)- 4zaldr_ D to UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 7 Child and Family Service - Agency Therapeutic Foster Home Program — West Hawaii — Program Proaram Expenditures- Other In fiscal year 2006-2007, Child and Family Service was granted $9,000 to provide monies for Kona and Hilo staff to attend best practice training seminars. These trainings are geared to further staff in being able to train other professionals in the community. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 8 Child and Family Service - Agency Name West Hawaii Dometic Abuse Shelter - Program Name Agency Director: Howard Garval, President and CEO Phone No.: (808) 681-3500 Contact Person: Heidemarie Koop, Director of Hawaii Island Programs Phone No.: (808) 323-2664 Mailing Address: Child and Family Service 91-1841 Fort Weaver Road Ewa Beach, Hawaii 96706 Facility/Site Address: 81-6587 Mamalahoa Highway, Bldg. C Kealakekua, Hawaii 96750 Fax No.: (808) 323-2999 Email Address: hkoop@cfs-hawaii.org Name of Accountant/CPA (include name of firm if applicable): Nishihama & Kishida, CPAs, Inc. Phone No.: (808) 524-2255 Mailing Address: American Savings Bank Tower, 1001 Bishop Street, Suite 1700, Honolulu, Hawaii 96813-3696 Amount of Request for County Funds: $30,000.00 Prior Year(s) Funding: 05-06 06-07 07-08 $ $17,000.00 $25,000.00 NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 1 Child and Family Service - Agency Name West Hawaii Dometic Abuse Shelter - Program Name Agency Mission Statement: "Strengthening families and fostering the healthy development of children" Since 1899, Child and Family Service has dedicated its efforts to its mission of "Strengthening families and fostering the healthy development of children". The spectrum of Child and Family Service programs builds on the strengths of individuals and families to address the many human challenges. The organization's comprehensive array of services has allowed Child and Family Service to develop in many areas and to offer an integrated and comprehensive human service and behavioral health care delivery system throughout the State of Hawaii. Child and Family Service continues to be known in the community for its willingness to work with hard -to -engage individuals and families facing a multitude of difficult problems. To ensure the continuation of comprehensive Domestic Violence services on the island of Hawaii, Child and Family Service agreed to a merger with Turning Point for Families, Inc. as of January 1, 2008, Child and Family Service oversees all of Turning Point for Families' programs in East and West Hawaii. Despite the added significant fiscal responsibilities, Child and Family Service continues to be committed to support community populations that present with increasingly complex problems and situations. Child and Family Service continues to be at the forefront of developing the skills, knowledge, and service models to address these needs. Program Description: Funds are requested to support the operation of the West Hawaii Domestic Abuse Shelter (WHDAS) program. The intention is to use Hawaii County monies to support the maintenance and repair of the facility, educational materials, and other operational needs. Child and Family Service WHDAS provides emergency shelter to single women and women with children who are victims of Domestic Violence (for a maximum of 90 days). These victims flee from the geographic areas of Ka'u all the way to Kohala. Victims from the East Hawaii side of the island are also able to access the WHDAS due to safety needs. There are no restrictions to enter the shelter as long as the circumstances of need are identified as a Domestic Violence issue. This shelter is the only shelter in West Hawaii to serve the immediate needs of the population that seeks safety due to Domestic Violence. The shelter operates 24 hours a day/365 days a year including holidays with staff members to oversee the safety and needs of the residents. This shelter has been operating and serving the West Hawaii community since 1988. The shelter also operates a 24 hour crisis hotline. The main goal of the program is to provide a safe environment with experienced advocates to help these families. In addition the shelter offers our residents NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 2 Child and Family Service - Agency Name West Hawaii Dometic Abuse Shelter - Program Name emergency food, transportation, referrals as needed, case management, individual counseling, advocacy, outreach services, safety planning, assistance with Temporary Restraining Orders, support groups, and personal planning. We are committed to raising the consciousness of our society by educating our families on a violence free lifestyle, promoting family coping and stability, and providing a place of refuge. The shelter provides three bedrooms with a total of 21 beds for families who enter into our program. In addition to the three bedrooms each room has the privacy of their own full bathroom to accommodate the residents who share the bedroom space. One bedroom is specifically geared towards housing our single women and women with disabilities. This room is ADA compliant. The facility also has an ADA ramp for easy access in/out of the shelter. In addition to the client areas, the shelter also has two offices, a playground and a children's room. These offices are used for intake and exit interviews to provide client confidentiality, case management, and individual counseling. The shelter also provides our residents with a laundry facility, full kitchen, large living and dining room area. On the shelter site a large Matson container holds furniture items, clothing and household miscellaneous items. These items are donated all year long from the West Hawaii community members who support our shelter. Total Budget and Position Count Total Program Bud et $330,833.00 Total Program Position Count 7.5 Total Agency Budget $6,476,615.00 Total Agency Position Count 94 Program Objectives: The Child and Family Service West Hawaii Domestic Abuse Shelter objective is to: 1. 75% of clients will have an increase in knowledge of community resources. 2. 90% of clients in shelter will complete a Safety Plan for themselves and their children. 3. 60% of single adults and families will move from the shelter to a non - abusive home environment. Program Highlights: During the fiscal year of 2006-2007 West Hawaii Domestic Abuse Shelter under Turning Point for Families, Inc., served 230 people; 133 adults and 97 children. The annual goal of bed days for the DHS contract was to provide 3390 bed days. The WHDAS provided 10,148 bed days which shows an alarming increase of Domestic Violence episodes in the County of Hawaii and to secure safe and affordable housing. The annual goal of the DHS contract for the hotline calls NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 3 Child and Family Service - Agency Name West Hawaii Dometic Abuse Shelter - Program Name were 210 calls. The WHDAS received 244 hotline calls that involved a crisis due to Domestic Violence. WHDAS achieved 100% of its outcomes during the fiscal year of 2006-2007 for assisting the residents with personalized safety planning, increasing awareness on the effects of children who witnessed Domestic Violence, increasing awareness of community resources, and educating the participants on healthy relationships and what equality should look like. Performance Measures: *If applicable ** Estimates are based on projection based on historical data. State projections are the same as in the FY 2007-08 column. Program Expenditures FY 2006-07 Actual * FY 2007-08 Budget * FY 2008-09 Estimate** # of Bed Das 10,148 3,647 12,000 # of Hotline Calls 244 450 500 # of Single Women 80 68 90 # of Women w/children 60 54 70 # of Children Served 128 67 140 # of requests for information and referral only 6,398 300 7,000 # of group session 341.5 260 350 # of individual session hours 3,505.75 3,700 4,000 -provided # of meals provided 10,425 9,264 12,000 # of tris (transportationprovided 350 650 700 *If applicable ** Estimates are based on projection based on historical data. State projections are the same as in the FY 2007-08 column. Program Expenditures If applicable * Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 4 FY 2006-07 Actual * FY 2007-08 Budget * FY 2008-09 Estimate Salaries and Wages $15,595.00 $20,677.00 $5,935.00 Professional Fees $1,405.00 $4,323.0 $24,045.00 -Operations -Equipment Other" Total $17,000.00 $25,000.00 $30,000.00 If applicable * Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 4 Child and Family Service - Agency Name West Hawaii Dometic Abuse Shelter - Program Name Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2006-07 Actual * FY 2007-08 Budget * FY 2008-09 Estimate of Human Servcies $312,045.00 $385,333.00 $235,333.00 -Department Fees $8,400.00 $8,000.00 $8,000.00 -Program HIUW $30,000.00 $30,000.00 $22,500.00 HPHA Emergency Shelter Grant $10,000.00 $10,000.00 $10,000.00 Prosecutor's VOCA $28,100.00 $25,000.00 $25,000.00 Hawaii County $17,000.00 $25,000.00 $30,000.00 Total $405,545.00 $483,333.00 $330,833.00 *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? Child and Family Service strives to achieve sustainability for all its programs. Yet, Child and Family Service is also committed to support critical services in the community despite their budgetary limitations. CFS is active in writing grants for supplemental funding to keep its critical programs operating. Child and Family Service relies on other funding sources such as Hawaii Island United Way (HIUW), Emergency Shelter Grant (ESG) and Victims of Crime Act from the Prosecutor's Office. In addition, the shelter also charges a modest fee for shelter to those clients with an ability to pay. Most recently, Child and Family Service also applied for Community Development Block Grant for much needed facility repairs During the last two fiscal years, the Domestic Abuse shelters in the State of Hawaii received additional monies from the Department of Human Services; these allocations were from special funds and legislative action. It is expected that funding will be reduced to the shelter's original funding in the FY2008-09 which means a decrease of revenue sources by $150,000. Child and Family NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 5 Child and Family Service - Agency Name West Hawaii Dometic Abuse Shelter - Program Name advocates for higher revenues at contract renewal as needed and will seek other sources of funding to continue the high quality of services in the community of West Hawaii. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 6 Child and Family Service - Agency Name West Hawaii Dometic Abuse Shelter - Program Name I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 — 2-142.2, Hawai'i County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawai'i Revised Statutes. If awarded a grant from the County of Hawaii, I (we) understand and will comply with the requirement to submit a year-end report to the Legislative auditor within 60 days after June 30 of the fiscal year. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawaii grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely, complete, and accurate year-end report will impact the evaluation of your program's or agency's future funding requests. Signature of oard Preside it 411���� Signature of Executive Director t Z3 C erz Date //"/,' d�' D to UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 7 QOPtd- Family Support Services of West Hawaii Ka'u and North Kohala Family Centers Agency Director: JoAnn Bishop Freed Phone No.: (808) 334-4114 Contact Person: Huellyn Whitford Phone No.: (808) 334-4110 Mailing Address: 75-127 Lunapule Road, Suite 11 Kailua-Kona, HI 96740 Facility/Site Address: Na'alehu and Hawi Fax No.: (808) 326-4063 Email Address: kids@fsswh.org Name of Accountant/CPA (include name of firm if applicable): Carbonaro CPAs & Management Group Phone No.: (808)242-5002 Mailing Address: 1885 Main Street, Suite 408 Wailuku, HI 96793 Amount of Request for County Funds: $65,000 Prior Year(s) Funding: 05-06 06-07 07-08 $51,000 $45,000 $45,000 Agency Mission Statement: Family Support Services of West Hawaii was founded in 1979 as a grassroots organization providing family support in communities throughout West Hawaii. FSSWH incorporated in 1981 as a private, non-profit organization whose mission is "to Support Families and Communities in Providing Love and Care for our Children." This mission statement was chosen carefully as the agency wanted to be sure to target support for both families and the communities in which they lived. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page I Family Support Services of West Hawaii Ka'u and North Kohala Family Centers Program Description: Neighborhoods can affect children in both positive and negative ways, according to a recent Child Trends Fact Sheet (September, 2007). For example, after-school programs in disadvantaged neighborhoods are associated with reductions in crime and violence. Several explanations underlie the association between neighborhood quality and child well-being. For instance, the supportiveness of neighbors can influence children's development through social connections, role models, trust and help. When neighbors report high levels of positive social ties, children tend to have more pro -social skills and display fewer problem behaviors. Neighborhood Family Resource Centers offer all parents what informal neighborhood networks once supplied: help in raising healthy, happy children. Family support programs offer a whole new philosophy of community service—one that builds on strengths, focuses on the entire family within its culture and community, and one that gives the family the central role in the planning, design and delivery of carefully planned and implemented services. Family supports are designed to empower parents, build communities and help prevent such problems as child abuse and neglect, low birthweight, teen pregnancy and dropping out of school. Since its inception, Family Support Services of West Hawaii (FSSWH) has been a leader in the field of family support services in the state of Hawaii. The agency opened its first Family Center in Kona in 1990 and has since become a founding member of the state-wide Family Center Alliance. As remote, rural areas of the island of Hawaii, families in both Ka'u and North Kohala faced challenges in accessing child care, health care, employment, housing, substance abuse, financial assistance, counseling and educational resources. The Ka'u and Kohala Family Centers are warm and welcoming places where any family member can go, not only in times of need, but as a regular part of day-to-day life. These Family Centers offer parent education classes, child development activities, parent -to -parent support groups, after school and academic enrichment, literacy instruction, health information, referrals and many other programs, activities and services. These services are modified and added to, depending on the needs and desires of local families. More than 3,500 individuals take advantage of the resources that they provide to children and families each year. FSSWH is seeking funding from Hawaii County to continue the work of the Ka'u and North Kohala Family Centers. Our purpose is to give parents the opportunity to reach out to one another and to learn together. The Family Centers help families prevent crises, define problems, identify strengths and become responsible for determining their own solutions. The Family Centers are the only places in each district that all parents can go to get the help and support they need in a familiar setting. FSSWH Family Center Coordinators not only respond to family needs, but also proactively create and cultivate social networks. For example, the Ka'u Family Center has partnered with the Hawaii County Department of Parks and Recreation, the Department of Health's Early Intervention Services and Good Beginnings Alliance by providing play and learn groups and parent support group opportunities for young children, including those with disabilities, and their families. The Kohala Family Center sprung into action by providing relief resources to families affected by the 6.6 earthquake in October, 2006. The Family Centers are one of the few places in each district that works with referrals from Hawaii Intake Services to help individuals meet community service requirements. The centers work with homeless families to help minimize the downward spiral that homelessness may bring in areas that lack most social service networks. The centers allow other non-profit organizations and community groups to use the facilities by providing office and meeting space. The Malama Prenatal, Healthy Start, Early Head Start, Youth after-school and summer programs have staff housed in the center and thus families are able to access these services without having to travel long distances. The Family Centers have facilitated community -wide inter -organizational partnerships and have been intimately involved in community-based NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 2 anti-drug efforts and initiatives. Our North Kohala Family Center Coordinator was one of the founding members of the Community Response to Ice (CRI), and FSSWH has since become a partner in the North Hawaii Drug -Free Coalition—co-sponsoring the "Hugs Not Drugs" Baby Basket Project and helping to bring Dr. Ira Chasnoff to the island to assist with our understanding of and assistance to substance -using prenatal women and drug -exposed infants and their birth as well as foster families. One of the hallmarks of family support is its focus on the ecological perspective—looking at the child within the context of the family within the context of the community. Programs provide child -centered developmental activities and learning opportunities for parents while simultaneously contributing to larger community -building efforts. Funding for the Ka'u and North Kohala Family Centers allows FSSWH and the County of Hawaii to impact outcomes at each of these levels: child, parent, family and community. Total Budget and Position Count Total Program Budget $ 70,000.00 Total Program Position Count 2 half- time os. Total Agency Budget $ 4,200,000.00 Total Agency Position Count 90 Program Objectives: 1) Enhance children's development and ability to attain academic and social success. 2) Promote successful transitions throughout a family's major milestones. 3) Assist families in achieving economic independence and self-sufficiency. 4) Mobilize public and private community resources to help children and families in need. 5) Decrease social isolation in rural communities Program Highlights: 1) Information and referral services were provided to 256 new 717 returning individuals during the 2006- 2007 fiscal year. There were a total of 1,126 requests for assistance of which 1,020 were able to be met over the year. 2) Emergency assistance was provided to North Kohala families through the'Ohana Quake Outreach Partnership with the Hawaii State Department of Health. 3) Provided technological support for those without access to 152 individuals over the year. 4) Coordinated Make a Difference Day in North Kohala with 20 community volunteers, including youth to provide 200 hours of service to 5 area families in dire need of home repairs such as fixing screens and windows, patching and painting and completing minor plumbing and electrical repairs. 5) Other community helping organizations were able to utilize the facility to provide services to provide 408 hours of outside service to the community. These included: Narcotics Anonymous, Alanon, Kohala Coalition Against Drugs, Teen Court, Salvation Army Family Intervention Services, Alu Like, Bay Clinic's Reach Out and Read, Na'alehu Main Street, the Ka'u Partnership and the Ka'u Community Action Team. 6) The Family Centers housed programs designed to support families at many different stages of development, such as Healthy Start, Enhanced Healthy Start, Early Head Start, the North Hawaii Child Development Program for infants and toddlers with disabilities and their families, and the Youth Development Program. 7) There were several community -wide family events in which 3,290 people participated, including a partnership with local businesses in Ka'u providing 550 people with Christmas dinner and a gift for each community keiki. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 3 The Family Centers provide a comprehensive array of family support programs, services and activities. j. • Health and developmental screenings • Immunizations • Evaluations for dev. delays • Access to pediatric care ,'110h c -u- • Access to prenatal care • Access to general medical care • Info on diet, nutrition and health riaieness rwd c!rin5<.irn� Information • Resource and referral services • Access to mental health services • Support groups • Parenting education • Financial counseling, planning, and management • Housing • After school programs • Tutorial programs • Access to GED programs • Literacy programs • After school care • Play and Learn groups • Health, medical, & nutritional services • Therapeutic services for infants and toddlers with disabilities • Child safety in and out of the home • Teenage youth councils ="r, c,e:- • Employment opportunities • Information and referral to other government and community resources NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 4 Family Support Services of West Hawaii Ka'u and North Kohala Family Centers Performance Measures: *If applicable Program Expenditures FY 2006-07 Actual * FY 2007-08 Budget* FY 2008-09 Estimate Education 37 20 25 Employment 18 15 20 Financial 33 10 25 Health 30 25 25 Parenting Information 19 25 30 Office Equip/Computer Use 152 165 150 Food 64 60 65 Substance Abuse Support/info 38 75 75 25,512.00 $ 26,900.00 Total *If applicable Program Expenditures R See Below Other Program Expenditures, con't FY 2006-07 Actual FY 2007-08 Budget FY 2008-09 Estimate Salaries and Wages $ 39,372.00 $ 39,792.00 $ 40,965.00 Professional Fees $ 4,577.00 $ 144.00 $ 5,325.00 Operations $ 651.00 $ 1.032.00 $ 1,135.00 Equipment $ 2,322.00 $ 720.00 $ 1,000.00 Other" $ 28,581.00 $ 25,512.00 $ 26,900.00 Total $ 70,926.00 $ 67,200.00 $ 70,000.00 R See Below Other Program Expenditures, con't NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 5 FY 2006-07 Actual * FY 2007-08 Budget * FY 2008-09 Estimate Employee Benefits $ 7,451.00 $ 5,304.00 $ 5,325.-00— ,325.00Pa roll Taxes Payroll $ 4,577.00 $ 4,956.00 $ 5,325.00 Occupancy $ 13,313.00 $ 13,728.00 $ 14,000.00 Supplies $ 3,018.00 $ 900.00 $ 1,500.00 Travel–mileage $ 222.00 $ 144.00 $ 250.00 Insurance $ $480.00 $ 500.00 Total Other $ 28,581.00 $ 25,512.00 $ 26,900.00 NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 5 Family Support Services of West Hawaii Ka'u and North Kohala Family Centers Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2006-07 Actual * FY 2007-08 Budget* FY 2008-09 Estimate Hawaii County $ 45,000.00 $ 50,000.00 $ 65,000.00 Private Donations $ 25,926.00 $ 17,200.00 $ 5,000.00 Total $ 70,926.00 $ 67,200.00 $ 70,000.00 *If applicable Explain what plans, if any, your agency and/or program has to increase revenues to support this program. When do you anticipate your program to become self- sustaining? Family support is about investing in the promotion of the positive things that families want for their children. In the long term, family support is a societal investment in the creation of happy, healthy, productive citizens. This investment has an impact on the families who participate in services, and on society as a whole. Research shows that by investing in positive outcomes for children and families, family support programs also, over the long term can lead to: fewer teenage pregnancies • less juvenile delinquency • improved behavior and performance of children at school • fewer incidents of child abuse and neglect • more families moving from welfare to work increased self-confidence, knowledge of child development and parenting skills among parents • greater educational attainment among parents Through these positive outcomes, family support allows us as a society to invest in the development of citizens rather than putting money into more prisons, foster homes, and public welfare. This investment has a tremendous effect on overall productivity as a society and on the ability of those receiving family support services to contribute to us as a nation. Up until this point, our state legislature has not made the investment in prevention that is necessary to carry out prevention programs such as this, thus continued support from the County is necessary, along with the powerful support given by community members. Donors continue to contribute in order to support our Ka'u and Kohala Family Centers. Collaboration has been a key to the success of the Family Center programs and is recognized as a top priority in the continued growth and service of the Centers. Collaboration among numerous agencies, student organizations, local governments, school systems, departments of health and social services, civic and religious organizations provides on-site programs, services, and activities. Representation on local Advisory Boards, scholarships and financial assistance, volunteers, and in-kind donations such as educational materials, transportation, and Center space are also contributions that will continue to support the programs. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 6 Family Support Services of West Hawaii - Agency Name Ka'u and North Kohala Family Centers (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 — 2-142.2, Hawai'i County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawai'i Revised Statutes. If awarded a grant from the County of Hawaii, I (we) understand and will comply with the requirement to submit a year-end report to the Legislative auditor within 60 days after June 30 of the fiscal year. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawaii grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely, complete, and accurate year-end report will impact the evaluation of your program's or agency's future funding requests. Signature of Board Vic re dent C' Si nature of Executive Dire /Z Dat 1 �oF, Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 7 Friends of Big Island Drug Court- Agency Name Assistance to Drug Court Clients & Program- Program Name Agency Director: None Contact Person Mailing Address: Facility/Site Address Fax No.: Email Address Phone No.: n/a Carol VanCamp, President Phone No.: PMB 126, 111 E. Puainako St., Suite #585 Hilo, HI 96720 None 969-1499 cvancamp3@hawaii.rr.com Name of Accountant/CPA (include name of firm if applicable): Brian Iwata, CPA, Taketa, Iwata, Hara & Assoc., LLC Phone No.: 935-5404 Mailing Address: 101 Aupuni St., Suite 139, Hilo, HI 96720 Amount of Request for County Funds: $10,000.00 Prior Year(s) Funding: 05-06 06-07 07-08 $0 $0 $0 Agency Mission Statement: The mission of the Big Island Drug Court is to help address societal problems related to substance abuse in order to minimize their societal and economic NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 1 costs, and to protect the Big Island community by providing timely and effective treatment for drug offenders with appropriate sanctions and incentives. Simply stated, the "Friends of Big Island Drug Court," is a 501c3 organization created to provide financial and other support to Drug Court clients and the overall program. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 2 Friends of Big Island Drug Court - Agency Name Assistance to Drug Court Clients & Program- Program Name Program Description: The Friends of Big Island Drug Court provides funding and other support for the clients and programs of Big Island Drug Court. This includes rewards and incentives to clients during their drug-free journey (such as gift certificates, movie tickets, etc.), loans or awards for tuition to further their education, and loans or awards for housing, travel or other such needs. The Friends also sponsors graduation supplies for Drug Court clients, and responds to individual requests for support.All programs and activities are conducted by volunteers, as there are no paid employees. The organization is governed by a volunteer board of directors.. Total Budget and Position Count Total Program Budget $14,000.00 Total Program Position Count 0 Total Agency Budget $14,000.00 Total Agency Position Count 0 Program Objectives: 1) The Friends is designed to integrate public support into governmental efforts directed at the rehabilitation of adult men and women, and juveniles, who are charged with or convicted of non-violent felonies and assessed as chemically dependent on alcohol and/or other drugs, by securing financial support for governmental efforts to operate Big Island Drug Court in the Third Circuit.. Program Highlights: 1) Through private donations and fundraising, we have been able to provide financial rewards and incentives to motivate Drug Court clients, and also to provide awards and loans for tuition, housing, or various other needs of Drug Court clients. The specific goal is to assist in ways that government cannot to help clients successfully complete the Drug Court program and return to society as contributing citizens. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 3 Friends of Big Island Drug Court - Agency Name Assistance to Drug Court Clients & Program - Program Name Performance Measures: *If applicable Program Expenditures FY 2006-07 FY 2007-08 FY 2008-09 Actual * Budget* Estimate Balance Sheet as of Dec. 31, 2006 $5,010.29 Budget for 2008 $14,000.00 Budget for 2009 $14,000.00 Professional Fees 0 0 0 Operations $2,687.30 $14,000.00 $14,000.00 Equipment 0 0 0 Other" 0 0 0 Total $2,687.30 *If applicable Program Expenditures * If applicable ° Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 4 FY 2006-07 Actual * FY 2007-08 Budget* FY 2008-09 Estimate Salaries and Wages 0 0 6 - Professional Fees 0 0 0 Operations $2,687.30 $14,000.00 $14,000.00 Equipment 0 0 0 Other" 0 0 0 Total $2,687.30 $14,000.00 $14,000.00 * If applicable ° Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 4 Friends of Big Island Drug Court - Agency Name Assistance to Drug Court Client & Program - Program Name Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2006-07 Actual * FY 2007-08 Budget* FY 2008-09 Estimate Donations $1,121.50 $4,000.00 $4,000.00 Grants(County of Hawaii 0 $10,000.00 $10,000.00 Total $1,121.50 $14,000.00 $14,000.00 *If applicable Explain what plans, if any, your agency and/or program has to increase revenues to support this program. When do you anticipate your program to become self-sustaining? As the number of clients accepted in the Big Island Drug Court program increases, we will continue to solicit more donations and inkind support to keep pace with the needs. It is difficult to predict sustainability due to anticipated fluctuation in client numbers. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 5 Friends of Big Island Drug Court - Agency Name Assistance to Drug Court Clients & Program - Program Name I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 - 2-142.2, Hawai'i County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawai'i Revised Statutes. If awarded a grant from the County of Hawaii, I (we) understand and will comply with the requirement to submit a year-end report to the Legislative auditor within 60 days after June 30 of the fiscal year. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawaii grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely, complete, and Signature of Board President/Chair i k /0 S, Date Signature of Executive Director Date OrC�q.•rr-uaT', I V,.es Nit H EKE4,-nvF 0;Kecrcme- UNSIGNED PROPOSALS WILL NOT BE ACCEPTEDI NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 6 Friends of Big Island Drug Court, Inc. Projected Budget 2008 Revenues: Contribution Income County of Hawaii Grant Total Revenues Expenses: Drug Court Expenses: Graduation celebrations Graduation Gifts to Graduates Incentives for participants Grants to participants Loans for Graduates Postage and Office Expenses Miscellaneous Total Expenses Revenues over Expenses $4,000 10,000 14,000 1,500 1,500 2,100 4,000 4,300 13,400 300 300 14,000 $0 Friends of the Children's Justice Center of East Hawaii - Agency Name Special Needs and Enhancement, Center Support, Prevention/Education and Training Programs - Program Name Agency Director: Marcia Prose, Board President Phone No.: 935-8755 Contact Person: Victoria Kravitsky, Program Coordinator Phone No.: 935-8755 Mailing Address: 1290 Kinoole Street, Hilo, Hawaii 96720 Facility/Site Address: 1290 Kinoole Street, Hilo, Hawaii 96720 Fax No.: 808-933-0968 Email Address: fcjceh@fcjc.org Name of Accountant/CPA (include name of firm if applicable): Jennifer Gossert, Jennifer Gossert, CPA Phone No.: 808-969-3115 Mailing Address: 688 Kinoole Street, Suite 201 Hilo Hawaii 96720 Amount of Request for County Funds: $20,000.00 Prior Year(s) Funding: 05-06 06-07 07-08 $15,000.00 $15,000.00 $12,000.00 NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 1 Agency Mission Statement: The mission of the Friends of the Children's Justice Center of East Hawaii is to help sexually, physically, emotionally abused and neglected children. We do this in partnership with the Children's Justice Center of East Hawaii, by providing funds and resources to support the needs of these children. The "Friends" offer hope, encouragement, and opportunity for victims of child abuse. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 2 Friends of the Children's Justice Center of East Hawaii - Agency Name Special Needs and Enhancement, Center Support, Prevention/Education and Training Programs - Program Name Program Description: The Friends of the Children's Justice Center of East Hawaii is a private nonprofit organization founded by concerned community members in 1990 whose primary goal was to protect and enhance the physical and psychological safety of abused or neglected children. The Friends are in a unique partnership with the Children's Justice Center (CJC), a State Judiciary Program. The CJC provides a safe, neutral homelike atmosphere where children can be interviewed regarding allegations of abuse, particularly sexual abuse. This Children's Justice Program facilitates and coordinates the system's response to victims of child abuse to reduce their trauma through a multi -disciplinary team approach which involves police, social workers, prosecutors, guardians ad litem, medical professionals, advocates, and others. The Friends support the CJC primarily by helping provide direct services and programs to child victims and their families which are not available through any other public or private source. The Friends accept referrals from state and private agencies working with child abuse victims such as Child Protective Services, Child and Family Services, Hawaii Behavioral Health, Catholic Charities, Parents Inc., etc. and facilitate requested services. The Friends serve children between the ages of 0-18, who are victims of maltreatment (sexual, physical, emotional, mental abuse or neglect) residing in East Hawaii. This includes North Hilo, South Hilo, Hamakua, Puna and parts of Ka'u. Our services are aimed at assisting children in situations of documented cases of abuse and neglect. The Special Needs and Enhnacement Program is designed to help child victims develop positive self-worth. The Friends do this by providing for needs that are not covered by any other public or private source. Funds are used to provide basic essentials (i.e. clothing, diapers, toiletries), special needs (i.e. air/ground transportation, school supplies, correspondence courses) and enhancement support (i.e. sports, music lessons, and tutoring). The Friends have a holiday gift program for children not covered by other programs. The Center Support Program was developed to reduce trauma and ensure the safety and comfort of the children that come to the Children's Justice Center for interviews. One way the Friends maintain the Center's safe, child -friendly and homelike atmosphere is with toys, games, and snacks. This is often made NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 3 possible by community donations and volunteerism. Also, the Friends maintain the Center's appearance with repairs and refurbishing when it is needed. The Prevention and Education Program is designed to educate the community on child abuse issues. This program plans and implements services and events for the public, promoting awareness and prevention of child abuse. The Training Program helps to sponsor the attendance of various professionals (i.e. social workers, police & therapists) at seminars and conferences. These professionals work with child victims and their families. Training opportunities enhance the quality of services that these victims receive and prevents them from being re -traumatized by the system's response to the allegations of abuse. Total Budget and Position Count Total Program Budget 194,925 Total Program Position Count 1 Total Agency Budget 194,925 Total Agency Position Count 1 Program Objectives: 1) Provide clothing, toiletries, bed/folding mattresses and other necessities for children in emergency or relative foster placement. 2) Cover costs of tutoring services, correspondence courses, summer school tuition to allow a child to graduate or progress on to the next grade level. 3) Pay for fees, equipment and supplies needed for the extracuricular activity (sports, music, art, drama, dancing lessons, etc.) that a child is involved in. 4) Provide gifts for a special occasion such as Christmas when a child would otherwise not receive a gift. 5) Provide gas coupons to families on a limited budget so children may be able to attend treatment programs. 6) Cover short-term costs when gaps in funding for child's treatment occur. 7) Provide formula and supplies for infants removed at birth from drug addicted mothers. 8) Pay for excursion fees, prom dresses, senior pictures, etc.to give children a chance to participate in school functions. 9) Assist police, social workers, and other professionals in keeping up to date with the latest investigative techniques, sensitivity training, forensics and knowledge of resources by helping to sponsor their attendance at training workshops and seminars. 10) Provide privacy, comfort and safety for clients who come to the Center by maintaining its warm environment. 11) Collaborate with community organizations to provide innovative prevention programs targeting schools. 12) Participate with the East Hawaii Coalition for child abuse Prevention in prevention/education activities within the community to spread awareness on issues about child abuse to the general public. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 4 Program Highlights: 1) Filled 795 appropriate special needs and enhancement requests for abused and neglected children to provide for their specific needs that would otherwise have gone unmet. Many of these requests were for a larger expenditure than average requests from previous year. 2) Spent over $3,000. for professionals to attend trainings on Oahu and the mainland (new Social Workers, police and other related professionals who interface with children who are alleged victims of abuse, to learn standard, accepted & state-of-the-art interviewing techniques). 3) Increased awareness of Abuse Prevention for the general public by carrying out prevention/education activities including: ongoing work with the Coalition and collaborating with them during April - Child Abuse Prevention Month; participate in Coalition Family Fun Day event at the Sangha Hall in Hilo; participated in the Boy Scouts annual Makahiki Festival; attend community education fairs such as the Puna Informational Fair at the Pahoa Community Center; encourage research into prevention programs for middle and high school youth, and continue to develop display items to educate public re: Friend's mission). 4) Provide approximately 150, $25 Christmas Gift cards, to teens 12-17 years old (who are not supported by other programs, as are young children with Toys for Tots). Coordinated a group of volunteers from the local school Resource Team to assist with assembling of Christmas gift cards, stuffed toy animals, pens/pencils and trading cards. 5) Held our signature fundraiser (The Phantom) by distributing over 300 invitations and raised nearly $16,000. 6) Sponsored a 4th Annual Prevent Child Abuse Golf Tournament for FCJCEH, at the Mauna Lani South Golf Course. 7) Distributed newsletters to area businesses, media, community leaders and members, donars, social workers and other associates. 8) Held a Legislative Open House, December '07, inviting approxiamtely two dozen State Legislators to visit our agency and meet our Board and volunteers. 9) Submitted two new Grant Requests, one to Hawaii Petroleum (awarded $1,000), and one to WAL MART (awaiting decision); and will continue to investigate other grant opportunities. 10) Assisted at Aid Station for runners participating in the 2007 Ironman Triathlon in Kona, as our service to the community. 11) Participated in the 2007 Annual Visitor Industry Charity Walk, a statewide event coordinated by the Hawaii Hotel & Lodging Association. 12) Recruited and trained three new volunteers to work in program, processing daily Special Needs Requests. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 5 - Agency Name - Program Name Performance Measures: *If applicable Program Expenditures FY 2006-07 Actual * FY 2007-08 Budget* FY 2008-09 Estimate Special Needs and Enhancement Requests 795 900 900 Winners' Camp 11 10 10 Christmas Gift Prqaram. 143 150 175 Equipment Other" 96,923 134,940 130,950 Total 135,682 185,640 194,925 *If applicable Program Expenditures If applicable ° Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 6 FY 2006-07 Actual * FY 2007-08 Bud et * FY 2008-09 Estimate Salaries and Wages 30,475 40,000 40,000 Professional Fees 15,200 Operations 8,284 10,700 8,775 Equipment Other" 96,923 134,940 130,950 Total 135,682 185,640 194,925 If applicable ° Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 6 - Agency Name - Program Name Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2006-07 Actual * FY 2007-08 Bud et * FY 2008-09 Estimate Donations 4,930 5,000 5,000 In -Kind Contributions 1,252 Special Event Donations (Phantom) 14,765 20,000 20,000 Hawaii Island United Way 15,000 15,000 15,000 County Funds -Prosecutor's Office 7,500 County Grant 12,250 12,000 20,000 County Restricted -One Time 15,382 4,418 Geist Foundation 40,000 42,000 45,000 Theresa Hughes Foundation 35,000 35,000 40,000 Charity Walk 6,000 6,000 IronMan 1,000 1,000 1,000 Fundraising (Net) 2,408 20,048 42,425 Interest Income 468 800 500 Carry Over Funds/Other 644 24,374 Total 1 150,599 185,640 194,925 *If applicable Explain what plans, if any, your agency and/or program has to increase revenues to support this program. When do you anticipate your program to become self-sustaining? The Friends do not collect fees for any of our services. We are continuously researching for additional grant funding, striving to increase donations for our Phantom non-event fundraiser, and expanding participation in our golf tounament fundraiser. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 7 Friends of the Children's Justice Center of East Hawaii - Agency Name Special Needs and Enhancement, Center Support, Prevention/Education and Training Programs - Program Name I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 — 2-142.2, Hawai'i County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawai'i Revised Statutes. If awarded a grant from the County of Hawaii, I (we) understand and will comply with the requirement to submit a year-end report to the Legislative auditor within 60 days after June 30 of the fiscal year. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawaii grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely, complete, and Signature of Board President/Chair Signature of Executive Date / �- a J' Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 8 FRIENDS of the CJC-WH - Agency Name Enhancement and Basic Needs Program- Program Name Agency Director: Contact Person: Mailing Address: Facility/Site Address: Fax No.: Email Address: Alice Daniel Alice Daniel 77-6403 Nalani Street Kailua-Kona, HI 96740 77-6403 Nalani Street Kailua-Kona, HI 96740 327-4988 fcjcwh@hawaii.rr.com Phone No.: 331-2425 Phone No.: 331-2425 Name of Accountant/CPA (include name of firm if applicable): Denise Hill, Vice Pres. of Finance- Hualalai Resort Phone No.: 325-8413 Mailing Address: 73-4697 Kahualani Rd., Kailua-Kona, HI 96740 Amount of Request for County Funds: $20,000.00 Prior Year(s) Funding: 05-06 06-07 07-08 $15,000 $12,000 $15,000 Agency Mission Statement: To provide assistance to children who have been traumatized by sexual assault, physical abuse or neglect, or who are witnesses to violent crime; to promote prevention of child abuse; and to support the Children's Justice Center of West Hawaii. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 1 FRIENDS of the CJC-WH - Agency Name Enhancement and Basic Needs Program- Program Name Program Description: The FRIENDS of the Children's Justice Center of West Hawaii (FCJC-WH) was formed in 1989 as the Friends of the Children's Advocacy Center of West Hawaii to provide support to child victims of abuse, neglect and sexual assault. The name changed in 2001. The program for which we seek funds from the County of Hawaii is our "enhancement and basic needs" program which provides funds for activities, services and items that the child would otherwise go without. All County of Hawaii funds are used to the direct benefit of children and teens in West Hawaii who have experienced abuse or serious neglect. No County of Hawaii funds are used for administrative expenses. Requests for funding are submitted to the FCJC-WH by a professional person working with the child, such as the social worker, therapist or counselor. To be eligible, a child must be a victim of a documented case of abuse or neglect or witness to violent crime. The requests range from $5.00 food coupons used when children are transported to court by social workers, to tuition for teens to attend Winners' Camp on Oahu, a 7 -day residential, accelerated -learning program. Our goal is to "help a victim become a child again." The FCJC-WH is able to help with basic needs and provide emergency assistance in situations where no governmental or other private agency can meet the need. The "enhancement and basic needs" program is the only program of our agency. It is not a "program" in the traditional sense, in that we are merely funding participation in other programs or supplying basic needs such as clothing and school supplies. Typical requests received are for participation in athletic, music, dance, karate, sewing lessons or attending summer programs or the Winners' Camp program on Oahu. The only exception to the statements above is that we organize "follow up" activities for the teens who return from Winners' Camp to reinforce the positive lessons and skills they have learned at camp. January 19, 2008 Winners' Camp teens from East Hawaii joined with the group from West Hawaii for a 3 -day retreat and reunion at Kalopa State Park. Nineteen teens participated. Most of these teens are from foster homes and are in need of on- going support. The FCJC-WH also assists the Children's Justice Center by helping to provide a warm, child -friendly atmosphere for the children and their siblings when they are brought to the Center for their forensic interviews. The FCJC-WH also supports training programs provided for professionals by the CJC and participates in child abuse prevention activities in West Hawaii. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 2 Total Budget and Position Count Total Pro ram Bud et 121,000.00 Total Program Position Count 1/2 Total Agency Budget 149,300.00 Total Agency Position Count 112 Program Objectives: 1) Assist 20 or more teens to attend Winners' Camp by June 30, 2009; 2) Give holiday gift stockings to 100 teenage youth by the end of December; 3) Give 25 FRIEND boxes to children entering a foster home for the first time, or being suddenly transferred to a new foster home, by June 2009; 4) Assist in planning a facilitating six follow-up activities for Winners' Camp graduates by June 2009; 5) Assess 600 enhancement or basic needs requests helping 375 individual children by June 30, 2009; 6) Support one or more training projects in West Hawaii, in collaboration with the Children's Justice Center and other agencies, to provide best practice training to professionals who work with children and families who are victims of abuse and neglect, by June 2009; 7) Participte in building community awareness of child abuse through Family Fun Day in April, attending ten Hui Laulima meetings, presenting three or more talks to community groups on issues of child abuse in West Hawaii and the work of the CJC-WH and the FCJC-WH by June 30, 2009. Program Highlights: 1) 23 trips to Winners' Camp on Oahu were sponsored during the County's FY July 2006 -June 2007. Five served as junior staff for Winners' Camp. 2) 103 holiday gift stockings were distributed to teens in December 2006. 3) 30 FRIEND boxes were distributed during the County's FY 2006-2007. 4) 8 follow up activities were held for teens who attended Winners' Camp druing the County FY 2006-2007. 5) 813 enhancement and basic needs requests were accepted and processed during the 2007 calendar year serving 357 individual children. 6) Four training projects in West Hawaii were particially supported by the FCJC-WH during the County FY 2006-2007. 7) Staff and volunteers from the FCJC-WH participated in the April Family Fun Day giving away many toys, stuffed animals, books and distributing brochures. Hui Laulima meetings are attended regularly and five talks were given to agencies regarding the work of the FCJC and CJC-WH. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 3 FRIENDS of the CJC-WH - Agency Name Enhancement and Basic Needs Program - Program Name Performance Measures: *If applicable Program Expenditures FY 2006-07 Actual * FY 2007-08 Budget * FY 2008-09 Estimate Children benefitting from CJC-WH interviews 196 215 200 Needs Requests 692 600 700 Holiday gift bas 103 120 120 FRIEND Boxes 30 25 25 Winners'Camp attendees 23 25 25 Winners'Camp follow up activities 8 6 6 Individual Children served 330 375 380 *If applicable Program Expenditures * If applicable ° Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 4 FY 2006-07 Actual * FY 2007-08 Budget* FY 2008-09 Estimate Salaries and Wages 0.00 0.00 0.00 Professional Fees 13,396.98 13,624.00 15,000.00 Operations 0.00 0.00 0.00 Equipment 0.00 0.00 0.00 Other* 110,547.17 109,450.00 106,000.00 Total 123,944.15 123,074.001 121,000.00 * If applicable ° Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 4 FRIENDS of the Children's Justice Center of West Hawaii ITEM 2006-2007 CY 2007 2006 Budget 2007 Budget 2008 Budget actual actual Athletic $ 4,093.97 $ 5,179.37 $ 5,500.00 $ 5,000.00 $ 5,500.00 Center Support* $ 12,657.13 $11,524.50 $ 13,100.00 $ 14,100.00 $ 11,400.00 Christmas Bags, Teens $ 2,813.41 $ 3,306.45 $ 3,500.00 $ 3,000.00'—$ 3,000.00 Clothing $ 4,361.36 $ 3,992.19 $ 3,000.00 $ 4,000.00 $ 4,000.00 Dental $ 5,237.51 $ 1,000.00 $ 4,000.00 $ 5,000.00 $ 2,500.00 Education $ 3,502.07 $ 3,908.20 $ 5,000.00 $ 3,500.00 $ 3,500.00 Enhancement, Basic Needs $ 2,159.39 $ 3,057.74 $ 2,900.00 $ 2,000.00 $ 3,000.00 Enhancement, Miscellaneous $ 3,142.46 $ 3,940.72 $ 4,250.00 $ 4,000.00 $ 4,000.00 Food Coupons $ 600.00 $ 525.00 $ 900.00 $ 1,000.00 $ 1,000.00 FRIEND Boxes $ 973.86 $ 1,075.24 $ 2,000.00 $ 1,000.00 $ 1,000.00 Furniture $ 1,126.03 $ 1,082.17 $ - $ 1,000.00 $ 1,000.00 Gas Coupons $ - $ - $ $ 100.00 $ 100.00 Graduation $ 973.08 $ 1,076.99 $ $ 1,000.00 $ 1,000.00 Medical $ 2,120.93 $ 2,140.68 $ 100.00 $ 1,000.00 $ 2,500.00 Music Lessons $ 495.00 $ 1,015.00 $ 750.00 $ 500.00 $ 1,000.00 Performing Arts $ 1,779.15 $ 2,163.07 $ 1,000.00 $ 2,000.00 $ 2,000.00 Prevention/Awareness $ - $ - $ 1,000.00 $ 500.00 $ 500.00 School Break Programs $ 10,316.00 $ 8,896.00 $ 2,500.00 $ 5,000.00 $ 10,000.00 School PictureslYearbook $ 399.48 $ - $ $ 500.00 $ 500.00 School Supplies/fees $ 727.00 $ 847.90 $ 2,050.00 $ 1,000.00 $ 1,000.00 Summer Camp/Fun $ 2,595.00 $ 2,440.50 $ - $ 2,500.00 $ 2,500.00 Summer School $ 941.00 $ 941.00 $ 1,750.00 $ 1,750.00 $ 1,000.00 Training & Education $ 2,325.44 $ 1,109.20 $ 4,000.00 $ 4,000.00 $ 4,000.00 Travel $ 7,972.61 $ 4,117.61 $ 10,000.00 $ 10,000.00 $ 5,000.00 Winners'Camp $ 35,883.37 $29,183.83 $ 30,000.00 $ 30,000.00 $ 30,000.00 Winners' Cam follow u $ 3,351.92 $ ,766.71 $ 6,000.00 $ 6,000.00 5,000.00 TOTALS: $ 110,547.17 $ 96,290.07 $103,300.00 $ 109,450.00 $106,000.00 FRIENDS of the CJC-WH - Agency Name Enhancement and Basic Needs Program - Program Name Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2006-07 Actual* FY 2007-08 Budget* FY 2008-09 Estimate County of Hawaii 12,000.00 13,500.00 13,500.00 Private Foundations 62,000.00 65,750.00 58,251.00 Donations 32,663.11 43,824.00 49,249.00 Total 106,663.11 123,074.00 121,000.00 *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? The FRIENDS of the Children's Justice Center of West Hawaii's "Enhancement and Basic Needs" program is essentially self-sustaining at the present time. No County of Hawaii funds are used for administrative or staff expenses. Should the County of Hawaii reduce the grant to the FCJC-WH, less money would be available to help the children eligible for services. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 5 FRIENDS of the CJC-WH - Agency Name Enhancement and Basic Needs Program - Program Name I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 — 2-142.2, Hawai'i County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawai'i Revised Statutes. If awarded a grant from the County of Hawaii, I (we) understand and will comply with the requirement to submit a year-end report to the Legislative auditor within 60 days after June 30 of the fiscal year. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawaii grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely, complete, an Ltut'o'u 2t-'& Signature of Board resident/Chair Signature of Executive Director Da e /- ::177-aY Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 6 Goodwill Industries of Hawaii, Inc — Agency Name Job Connections — Program Name Agency Director: Laura Robertson Phone No.: 808-836-0313 Contact Person: Nadia Ranne Phone No.: 808-961-0307 Mailing Address: 500 Kalanianaole Ave, Hilo, HI 96720 Facility/Site Address: 200 Kanoelehua Ave, Suite 102, Hilo, HI 96720 Fax No.: 808-969-3861 Email Address: nranne@higoodwill.org Name of Accountant/CPA (include name of firm if applicable): Catha Combs, Wikoff Combs and Co., LLC Phone No.: 808-791-1420 Mailing Address: 1001 Bishop Street, Suite 2760, Honolulu, HI 96813 Amount of Request for County Funds: $30,000 . Note: This is the second of two separate applications Goodwill submitted this year. Our top priority is the Work Experience Program. Funding for Job Connections should only be considered if the Work Experience Program is accepted. We do not want to jeopardize the Work Experience Program as the County grant serves as funding of last resort for our trainees who are people with disabilities, who have no other options. Prior Year(s) Funding: N/A 05-06 06-07 07-08 $0 $0 $0 NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 1 Goodwill Industries of Hawaii, Inc — Agency Name Job Connections — Program Name Agency Mission Statement: Our mission statement is: Goodwill Industries of Hawaii, Inc. helps people with employment barriers to reach their full potential and become self- sufficient. Goodwill Industries of Hawaii (GIH) has been in business in the State of Hawaii since 1959 providing vocational training and employment services to persons with barriers to employment, including: • Individuals with disabilities; ■ Youth who have disabilities or are economically disadvantaged; ■ Disabled veterans; • Asian and Pacific Islander immigrants; • Older individuals and dislocated workers; and • Adults who are economically disadvantaged, including Welfare -To -Work TANF/TAONF/NA-GD and Food Stamp recipients. ■ Ex -offenders transitioning from incarceration into the community With 48 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 2006 to June 2007, GIH successfully provided services to 8,222 people statewide, and placed 1,699 people into gainful employment. The East Hawaii branch of Goodwill Industries provided services to 1,672 individuals and placed 453 people into employment in 2006-2007. Over the past five years, Goodwill has successfully provided training and employment services to almost 36,000 people with barriers to employment, and placed 6,569 people into employment. These numbers reflect that Goodwill has the necessary skills and experience to perform the proposed services. It is our belief that work is a basic right that will assist people to attain other life goals. Moreover, we believe in each individual's right to self-determination, to make their own decisions regarding life choices as a means of promoting independence and self-sufficiency. In previous years, GIH has provided a menu of services to train, place and support individuals with barriers into gainful employment and assist them to overcome their barriers to both employment and job retention. Additionally, NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 2 Goodwill Industries of Hawaii, Inc — Agency Name Job Connections — Program Name Goodwill is committed to providing services to help individuals after they have obtained employment to acquire skills and resources to advance, and improve their economic self-sufficiency through training in basic literacy, computer literacy, GED, ESL, and Earned Income Tax Credit filing. Participants are also provided follow-up support after placement into employment. Examples of agencies and partners with whom we coordinate services include the Hawaii Community Correctional Center, Hawaii Paroling Authority, Adult Probation Office, Hawaii Intake Service Center, Kulani Correctional Center, Workforce Development Division, Department of Human Services, Division of Vocational Rehabilitation, Department of Health, Turning Point for Families, Office for Social Ministry, C.A.R.E. Hawaii, Big Island Substance Abuse Council, Lokahi Treatment Center, Alu Like, Chamber of Commerce, Goodwill Industries International, employers in identified industries with job opportunities corresponding to participants' career goals, and others. In addition to partnerships with other agencies, the Job Connections program has played a major role in the development of the Mayor's Task Force on Employment Solutions, "Going Home" Reintegration Initiative to support inmates and ex -offenders transitioning from incarceration to our community. The Going Home Reintegration Initiative consists of more than 70 government agencies, private agencies and concerned citizens working together to support ex - offenders re -integrating back into the community in an effort to make our community safe, reunify families, and reduce recidivism by providing services that otherwise did not exist. Employment plays a major part of successful reintegration thereby reducing recidivism. Program Description: Funding is requested to provide services to low-income individuals (at or below 150% of the Federal Poverty Guidelines), and particularly to local ex -offenders for the purpose of creating a safer community and reunifying families by reducing recidivism. The funding requested will provide services for 18 individuals that include the following three components: 1) Intake and Assessment including Individual Program Plan Developmeni 2) Job Readiness Training 3) Job Placement Upon placement into employment, the Job Connections program will continue to provide case management and support until the individual achieves employment for one year. Job Connections also provides job development and support services to employers in the community. The Job Connections program has become a leader in providing motivational and inspirational training by using a hands-on approach. First, in the process of NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 3 Goodwill Industries of Hawaii, Inc — Agency Name Job Connections — Program Name assessment, participants learn about themselves by identifying skills acquired, both inside and outside of correctional institutions. As part of assessment, participants are given skills, interests and personality assessments and corresponding choice of careers. The assessments help give participants language to describe themselves and their skills on a resume and talk about themselves to potential employers. The assessments also assist in career exploration and identifying personal career goals. Participants create their Individual Program Plan that serves as a guide to achieve their desired goals and outcomes. Second, in a 20 hour Job Readiness Training course is scheduled within one week to educate and support participants in becoming job ready. In the hands-on class, participants learn how to correctly fill out applications, write their resumes, create cover letters, learn interviewing skills, and learn innovative ways to job search. Graduation is a culmination of all the skills they have learned. They are expected to present themselves properly in appearance, body language, written material, and verbally in mock interviews. Other Goodwill Employment Counselors that participants are not familiar with conduct the mock interviews to simulate elements of a real interview. Third, the participant is assigned an Employment Counselor who helps the participant identify barriers to employment and solutions for removal of the barriers. The participant sets goals for him/herself and the Employment Counselor supports them in their achievement. Participants are invited to use the Job Connections office for their job search after graduation. They have access to: computers, internet for job searches, researching companies, and filling out applications, daily newspaper, telephone and telephone books, fax machine, and their Employment Counselor's guidance. The result is job placement, self-sufficiency and a defined direction for their lives which significantly reduces recidivism, supports the reunification of families, and creates a safer community. Job Development is an important part of the process of job placement. The Job Connections program will survey employers to gauge their frequency and attitudes on hiring ex -offenders and the services that they would like to see implemented that would assist in their hiring process. Some examples are: educating employers on how to understand criminal background checks, bonding availability, tax incentives, and understanding the process of transition from prison to parole. The program will offer support services to both the employer and employee by being a third -party entity in which either party may confide in to solve employment issues. Since 2005, the Job Connections program has served 121 participants identified as ex -offenders. All 121 participants completed assessments, 117 graduated from Job Readiness Training and 99 were placed into employment. According to a study conducted by the National Bureau of Justice Statistics, the national recidivism rate of those re -arrested within three years after release measured 67%. In Hawaii, a study conducted by the Hawaii Paroling Authority reports a 43% failure rate within two years of release. In the 3 years that the Job NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 4 Goodwill Industries of Hawaii, Inc - Agency Name Job Connections - Program Name Connections program has served ex -offenders, the program has measured a 19% re -incarceration rate - approximately 3 times less than the national rate and half of the HPA rate of re -incarceration. In FY 2006-2007 the demographics of all participants in the program were: 47% identified themselves as Hawaiian or part Hawaiian • 62% identified themselves as having a criminal background 17% identified themselves as having less than a high school education Total Budget and Position Count Total Program Budget $30,000 Total Program Position Count 3 Total Agency Budget" $2,400,000 Total Agency Position Count I 79 * Total Agency Budget denotes Hilo Branch only Program Objectives: 1) Enroll 18 participants in the Job Connections program. 2) Conduct Intake and Assessment including assessment of skills, personality, career goals, work history and barriers to employment. 3) Develop an Individual Program Plan with each participant that includes creating their goals and the steps needed to achieve them. 4) Conduct Job Readiness Training consisting of 20 hours of hands on classroom training. This may also incorporate topics related to Hawaiian Culture and Values as well as Post Incarceration Syndrome as applicable. 5) Place participants into employment of a minimum of 20 hours per week. 6) Conduct job developing activities with employers including outreach, pre- screening, job placement and follow up to ensure a smooth transition into employment. Employers will also be surveyed about their needs and concerns regarding hiring ex -offenders, educated about the benefits of hiring ex -offenders and provided with support according to the identified needs. The Job Connections will continue to support the participants and employers for one year from date of placement with a focus on successful job retention and advancement. Program Highlights: 1) Since FY 2005-06, the Job Connections program has served 121 participants identified as ex -offenders. All 121 participants completed NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 5 Goodwill Industries of Hawaii, Inc — Agency Name Job Connections — Program Name assessments, 117 graduated from Job Readiness Training and 99 were placed into employment. 2) During fiscal years 2005-06 and 2006-07 including all Job Connections participants, 170 participants completed assessments, 129 graduated from JRT, 110 were placed into initial employment and 60 were placed into subsequent employment. 3) Below are some recent success stories that illustrate the work being done: • One probationer had been through substance abuse treatment and was participating in a Hawaiian after-care program when he came into our program. With a 7 month-old baby, a new wife, and a sketchy work history, he was uninspired, scared, and did not know where to begin to pull his life together. After graduating from Job Readiness Training, we asked him to participate in the Kulani Job Fair as a way to gain interview practice. One of the interviewers offered him a job. In a follow-up phone call to our client, he was proud that he was taking his new wife to his company Christmas Party, something he never dreamed would happen. One client referred from Hale Nani's work furlough program had been in prison for 20 and years suffered from Post Incarceration Syndrome. Frightened of the "outside world" and extremely insecure in his abilities, he graduated from Job Readiness Training. With our support he secured two jobs. This client told his story to an audience of 100 people at the Going Home Reintegration Initiative Employer Forum luncheon with heartfelt gratitude. He stated that he had never filled out a job application in his life and had never held a job. Today he has been on the job for one year and is back with his family. Through participation in the Job Connections program ex -offenders experience a positive transition into the community. For Hawaii Community Correctional Center work furlough inmates, the Job Connections staff are the first people the inmates come into contact with when released to attend Job Readiness Training classes. Participants progress from fear of failure to becoming confident men and women in one week's time. The Hawaii Paroling Authority refers parolees who have been unsuccessful in obtaining employment. Our Employment Counselors work closely with parole officers to assist parolees in barrier removal and job placement. As a result, participants gain: • Empowerment • Initiative • Communication skills • Recognizing triggers for re -offending • Work Ethics • Honesty NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 6 Goodwill Industries of Hawaii, Inc — Agency Name Job Connections — Program Name Performance Measures: Goodwill's Outcome Management System evaluates program services by asking persons served, employers, and referring agencies to complete a follow-up survey used to evaluate the satisfaction and effectiveness of services. Upon program exit, each participant, employer and referring agency will be asked to complete a satisfaction survey. Parties are asked to respond to questions in several areas including the quality of services received, the service outcomes, level of satisfaction regarding the program, and suggestions for changes. Satisfaction surveys are compiled and analyzed on an annual basis. The results are shared with funding sources and Goodwill's Board of Directors. Recommendations for needed changes are analyzed. Plans for improvements are then developed and implemented as a result of this feedback. For the most recent year 2006-07, 97% of the participants were satisfied with their experience in the Job Connections Program. Participant comments included: • Everyone in the Job Connections office was kind and friendly and they really helped me out a lot by getting me a JOB!!! I really appreciate the help I received from Goodwill. • The entire Goodwill staff is great! Staff is very knowledgeable, informative, and patient in my need to research and explore my job training. I enjoyed the mock interview and was ready when I interviewed at Cost -U -Less. The Hawaii Paroling Authority response to our satisfaction survey was: Excellent communication between agencies. Prompt reply to referral noting start date for the Job Readiness program, etc. From parolee standpoint, they feel very relaxed and confident about job referrals. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 7 FY 2006-07 FY 2007-08 FY 2008-09 Actual " Budget " Estimate Job Connections Program 1 1 $30,000 Goodwill's Outcome Management System evaluates program services by asking persons served, employers, and referring agencies to complete a follow-up survey used to evaluate the satisfaction and effectiveness of services. Upon program exit, each participant, employer and referring agency will be asked to complete a satisfaction survey. Parties are asked to respond to questions in several areas including the quality of services received, the service outcomes, level of satisfaction regarding the program, and suggestions for changes. Satisfaction surveys are compiled and analyzed on an annual basis. The results are shared with funding sources and Goodwill's Board of Directors. Recommendations for needed changes are analyzed. Plans for improvements are then developed and implemented as a result of this feedback. For the most recent year 2006-07, 97% of the participants were satisfied with their experience in the Job Connections Program. Participant comments included: • Everyone in the Job Connections office was kind and friendly and they really helped me out a lot by getting me a JOB!!! I really appreciate the help I received from Goodwill. • The entire Goodwill staff is great! Staff is very knowledgeable, informative, and patient in my need to research and explore my job training. I enjoyed the mock interview and was ready when I interviewed at Cost -U -Less. The Hawaii Paroling Authority response to our satisfaction survey was: Excellent communication between agencies. Prompt reply to referral noting start date for the Job Readiness program, etc. From parolee standpoint, they feel very relaxed and confident about job referrals. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 7 Goodwill Industries of Hawaii, Inc — Agency Name Job Connections — Program Name Program Expenditures If applicable " Please explain in detail on separate sheet Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2006-07 Actual " FY 2007-08 Budget * FY 2008-09 Estimate Salaries and Wind es $30,000 Professional Fees $113,585 $138,100 $138,100 Operations Equipment $113,585 $138,100 $168,100 Other (Payroll Processing Char es)" Total 1 $30,000 If applicable " Please explain in detail on separate sheet Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2006-07 Actual * FY 2007-08 Budget * FY 2008-09 Estimate County of Hawaii Non -Profit Grant $ 30,000 State of Hawaii $113,585 $138,100 $138,100 Total $113,585 $138,100 $168,100 *if applicable Explain what plans, if any, your agency and/or program has to increase revenues to support this program. When do you anticipate your program to become self- sustaining? The funds requested in this application are for a component of an existing performance based program funded by the State of Hawaii where funds have been depleted due to our excellent outcomes. We are in year one of a two year contract that will end June 30, 2009. The money provided by the County allows us to conduct intake and assessment, conduct Job Readiness Training and place participants into employment. The remaining State of Hawaii funding will cover the case management and job retention support for the participant and employer until employment for one year is achieved. We will continue to support participants to reach job retention goals of 90 days, 180 days and 360 days on the job. We are working with our funder as well as the Going Home Reintegration Initiative to seek additional funding but currently there are no opportunities to apply for and secure funding until over a year from now. As mentioned earlier, this is the second of two separate applications Goodwill submitted this year. Our top priority is the Work Experience Program. Funding for Job Connections should only be considered if the Work Experience Program NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 8 Goodwill Industries of Hawaii, Inc — Agency Name Job Connections — Program Name is accepted by the County. We do not want to jeopardize the Work Experience Program as the County grant serves as funding of last resort for our trainees who are people with disabilities, who have no other options. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 9 Goodwill Industries of Hawaii, Inc — Agency Name Job Connections — Program Name I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 — 2-142.2, Hawaii County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawaii Revised Statutes. If awarded a grant from the County of Hawaii, I (we) understand and will comply with the requirement to submit a year-end report to the Legislative auditor within 60 days after June 30 of the fiscal year. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawal'i grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely, complete, an a enc 's future funding requests. r6 I Signature of Board President/Chair Signature of Executive Director fl!!] ;04 Date icer mt,,, 2q, _oT2 Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 10 Goodwill Industries Of Hawaii, Inc.- Agency Name Work Experience Program- Program Name Agency Director: Laura Robertson Phone No.: 808-836-0313 Contact Person: Mary Roblee 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: mroblee@higoodwill.org Name of Accountant/CPA (include name of firm if applicable): Catha Combs, Wikoff Combs and Co., LLC Phone No.: 808-791-1420 Mailing Address: 1001 Bishop Street, Suite 2760, Honolulu, Hi 96813 Amount of Request for County Funds: $29,500 Prior Year(s) Funding: 05-06 06-07 07-08 $17,000 $20,000 $28,500 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 2008-09 Page 1 Goodwill Industries Of Hawaii, Inc. - Agency Name Work Experience Program- Program Name Goodwill Industries of Hawaii (GIH) has been in business in the State of Hawaii since 1959 providing vocational training and employment services to persons with barriers to employment, including: ■ Individuals with disabilities; • Youth who have disabilities or are economically disadvantaged; ■ Disabled veterans; ■ Asian and Pacific Islander immigrants; ■ Older individuals and dislocated workers; and • Adults who are economically disadvantaged, including Welfare -To -Work TANF/TAONF and Food Stamp recipients. With over 50 years of experience operating vocational training programs as well as teaching life skills, Goodwill has developed an expertise in bringing about success to the people we serve. Goodwill Industries of Hawaii in Hilo has been serving our community since 1998. We envision a world where all individuals with disabilities and other barriers will have the opportunity to participate in a full range of life's experiences, including employment. We provide services to empower individuals to be productive and independent, based on their abilities and interests. From July 2006 to June 2007, GIH successfully provided services to 8,222 people statewide, and placed 1,699 people into gainful employment. The East Hawaii branch of Goodwill Industries provided services to 1,672 individuals and placed 453 people into employment in 2006-2007. Over the past five years, Goodwill has provided training and employment services to almost 36,000 people with barriers to employment, and placed 6,569 people into employment. These numbers reflect that Goodwill has the necessary skills and experience to perform the proposed services. It is our belief that work is a basic right that will assist people to attain other life goals. Moreover, we believe in each individual's right to self-determination, to make their own decisions regarding life choices as a means of promoting independence and self-sufficiency. In previous years, GIH has provided a menu of services to train, place and support individuals with barriers into gainful employment and assist them to overcome their barriers to both employment and job retention. Additionally, Goodwill is committed to providing services to help individuals after they have obtained employment to acquire skills and resources to advance, and improve their economic self-sufficiency through training in basic literacy, computer NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 2 Goodwill Industries Of Hawaii, Inc. - Agency Name Work Experience Program- Program Name literacy, GED, ESL, and Earned Income Tax Credit filing. Participants also receive follow-up supports and transitional services once they are employed. GIH will coordinate these services with the appropriate agencies and identified networks of support, to better serve the participant on a long-term basis. Examples of agencies and partners with whom we coordinate services include the Department of Health, Division of Vocational Rehabilitation, Workforce Development Department, Department of Human Services, YWCA, Hawaii Literacy, Department of Education, Legal Aid Society, East Hawaii Coalition for the Homeless, Chamber of Commerce, Goodwill Industries International, employers in identified industries with job opportunities corresponding to participants' career goals, and others. When possible, natural supports will be developed to enhance the individual experience in the workplace. Collaboration between employer, family, friends, and the program staff will be emphasized to increase the probability of success. Program Description: Funding is requested for a work experience program to provide wage subsidy for individuals with disabilities and other barriers to employment. The program format will allow work training opportunities for individuals that do not have work experience or who need additional supports or training to succeed in their employment goals. The training programs available are Janitorial and/or Textile/Wares processing positions. The Work Experience program will follow guidelines as set forth by the Department of Labor. Goodwill Industries has a subminimum wage certificate that requires the following: • a standard be set for each work station • community wage survey be conducted annually, and • each participant's productivity be measured every six months. Each participant will become familiar with and choose the program that is right for them. When the work experience path has been chosen, the participant will be trained on how to perform the essential job functions needed for the positions(s). The benefits of developing these work skills extend beyond the work environment. Through this program participants learn what it is like to earn a paycheck, while being provided valuable work experience and enhancing skills in a real work setting. We recognize the intrinsic value of work and understand the profound effects that meaningful, tangible employment brings to our trainees' lives. More than bringing financial self-sufficiency, work taps the spirit of the individual, provides equal opportunity, and demands commitment and dedication, values that provide the foundation for the community. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 3 Goodwill Industries Of Hawaii, Inc. - Agency Name Work Experience Program- Program Name In 2006-2007, the Work Experience Program served 18 participants that were enrolled in a Goodwill training program. The format allowed work -training opportunities for individuals to choose a position in our Janitorial program or Textile/Wares Processing program. The Work Experience Program followed guidelines as set forth by the Department of Labor. A standard was set for each workstation, a community wage survey was conducted, and each participant's productivity was measured every six months. Participants developed problem solving skills, motivational skills, an attitude for success, and increased their self- confidence in the workplace. This year Goodwill Industries of Hawaii is requesting an increase in funding to enable expanded services to high school students and other persons with employment barriers. The funding will also permit purchase of assistive devices for persons with disabilities in the program. Proposed equipment purchases include: tables with height adjustment to be used for people in wheelchairs, aprons with pockets to carry tools easily, back supports to assist when lifting, bins with springboard bottoms to raise product toward the person loading or unloading, rubber mats to ease leg fatigue when standing, adaptive chairs and low clothing racks that can be reached easily from a wheelchair. These devices will strengthen the program and increase the comfort, productivity, and success of participants. The increase in the proposed funding will allow us to serve participants that have transportation barriers. East Hawaii communities have challenging transportation needs due to the limited number of transportation resources in the Hilo area. People living in less populous areas, outside of Hilo, have difficulty finding reliable, affordable transportation. Goodwill Industries of Hawaii proposes to assist participants in meeting their transportation needs through existing transportation resources, such as the Mass Transit Shared Ride Program and using the Goodwill van to transport participants to and from the program when necessary. Total Budget and Position Count Total Program Bud et $29,500 1 Total Program Position Count 2 Total Agency Bud et $2,400,000 1 Total Agency Position Count 79 *Total Agency Budget denotes Hilo Branch only NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 4 Goodwill Industries Of Hawaii, Inc. -Agency Name Work Experience Program- Program Name Program Objectives: 1) Enroll 20 participants in the Work Experience Program. 2) Instruct proper work techniques for each workstation to be assigned, by review of the workstation development form during the first week of training. 3) Develop motivational skills and attitudes for success, self-confidence and problem solving skills throughout the training period. 4) Conduct time measurement study for participant during the first 2 weeks of entry into the program. 5) Review outcomes with the participant upon completion of the time study. 6) Continue to instruct and reinforce correct work procedures. 7) Track work hours, daily or as scheduled to work. 8) Pay each participant semi-monthly, according to hours worked. 9) Conduct time study for each participant every six months. 10) Update wages according to productivity level. The emphasis of this program is giving the participants the confidence and tools to maximize their abilities. Our philosophy is to provide an environment for people to believe they can succeed, achieve goals, develop skills and change the barriers they face every day. At Goodwill we believe in the power of work. We create hope, jobs and futures. Through our program, clients learn specific vocational skills and work environment behaviors. Individuals choose the work that matches their abilities and interests and earn wages based on productivity. Clients in the custodial services program perform a variety of cleaning duties in restrooms and offices. Clients in the retail program sort, inspect, hang, and price merchandise. Goodwill supervisors provide appropriate guidance during training that emphasizes safety, quality control, production, proper work behavior, and attendance. Program Highlights: 1) Enrolled 18 participants in the Work Experience Program in 2006/2007. 2) In a random audit of program participants we found an average 20% increase in productivity for participants since their entry into the program. 3) Instructed participants in proper work techniques for each workstation. 4) Developed motivational skills and attitudes for success, self-confidence and problem solving skills for each participant. 5) Conducted time measurement study for each participant within 2 weeks from date of entry into program. 6) Reviewed outcome of time study with each participant upon completion of study. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 5 Goodwill Industries Of Hawaii, Inc. - Agency Name Work Experience Program- Program Name 7) Instructed and reinforced correct work procedures with each participant. 8) Tracked work hours, daily or as scheduled to work. 9) Paid participants on a semi-monthly basis, according to hours worked. 10) Conducted time study of each participant every six months. 11) Updated wages according to productivity level. 12) Developed workstation for textile processing to accommodate each participant. 13) Placed four individual in competitive employment. 14) Placed four individuals in volunteer positions Through participation in the work experience program, eight participants have gained valuable job skills and have transitioned to competitive or volunteer employment. Seven additional participants volunteer serving food to the homeless one day per week during Adult Day Health Program hours. In the work experience program they learned how to take direction, follow through on their work and how to work as a team. As they progressed in the program they demonstrated strong work ethic, attention to detail and positive attitude. One trainee who started in janitorial program has transitioned to a job in the community at a produce company where he demonstrates a strong work ethic and is well liked by his fellow employees. He takes great pride in his work, has learned to budget his paycheck and to save money. Another trainee volunteers at the Foodbank, where she stocks shelves. She learned valuable related skills in the textile processing program. 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 2008-09 Page 6 Goodwill Industries Of Hawaii, Inc. - Agency Name Work Experience Program- Program Name Performance Measures: Goodwill's Outcome Management System evaluates program services by asking persons served, employers, and referring agencies to complete a follow-up survey used to evaluate the satisfaction and effectiveness of services, Upon 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 2006-07, the Work Experience Program participants that were also enrolled in the Home & Community Based Services Program indicated a participant and advocate satisfaction rate of 98% in the categories of "Very Good" to "Excellent". Participant's comments included: 1 enjoy doing janitorial work at the center and working in the store • 1 like to volunteer at the Salvation Army. Program Expenditures FY 2006-07 Actual * FY 2007-07 Budget* FY 2008-09 Estimate 1 Work Experience Program $20,000 $28,500 $29,500 Goodwill's Outcome Management System evaluates program services by asking persons served, employers, and referring agencies to complete a follow-up survey used to evaluate the satisfaction and effectiveness of services, Upon 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 2006-07, the Work Experience Program participants that were also enrolled in the Home & Community Based Services Program indicated a participant and advocate satisfaction rate of 98% in the categories of "Very Good" to "Excellent". Participant's comments included: 1 enjoy doing janitorial work at the center and working in the store • 1 like to volunteer at the Salvation Army. Program Expenditures If applicable "Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 7 FY 2006-07 Actual * FY 2007-08 Budget* FY 2008-09 Estimate Salaries and Wages $17,316 $25,500 $25,500 Professional Fees Operations Equipment $1,000 $2,000 Other (Payroll Processing Charges)* $2,684 $2,000 $2,000 Total $20,000 $28,500 $29,500 If applicable "Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 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 2006-07 FY 2007-08 Actual * Budget* FY 2008-09 Estimate County of Hawaii Non -Profit Grant $ 20,000 $ 28,500 $ 29,500 Goodwill Industries of Hawaii $200 $1,000 1,000 State of Hawaii $337,000 $340,000 $350,000 Total $357,200 $369,500 $380,500 *If applicable Explain what plans, if any, your agency and/or program has to increase revenues to support this program. When do you anticipate your program to become self- sustaining? The Work Experience Training Program is a component of a much larger service provided to persons with disabilities, through the State of Hawaii. The money provided by the county allows trainees to earn money while gaining valuable work experience in a structured learning environment. As they gain the necessary experience they transition out of the program. While this funding pays the direct salary, it does not cover overhead, supervision, and case management. We leverage the county funding to provide a full -range of services for the trainees. Although we do not have alternative funding for the program at this time, we are looking into expanding the program for trainees who possibly qualify for Federal funds and using the County grant for trainees who have no other sources of funding. County grant serves as funding of last resort for our trainees, who have no other options. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 8 Goodwill Industries Of Hawaii, Inc. - Agency Name Work Experience Program - Program Name I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 — 2-142.2, Hawai'i County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawai'i Revised Statutes. If awarded a grant from the County of Hawaii, I (we) understand and will comply with the requirement to submit a year-end report to the Legislative auditor within 60 days after June 30 of the fiscal year. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawaii grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely, complete, an Signature of Board President/Chair (AA4tt, AQ. fY,rZA' — Signature of Executive Director Dat j!tV _�j 14% Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTEDI NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 9 Grassroots Community Development Group- Agency Name Kupukupu After -School & Summer Program- Program Name Agency Director: Trina Nahm-Mijo Phone No.: Contact Person: same Phone No.: 640-5109 Mailing Address: P.O. Box 1772, Kea'au, HI 96749 Facility/Site Address: 15-0565 Kea'au-Pahoa Highway, Bdng. G Fax No.: 974-7757 Email Address: nahmmijo@hawaii.edu Name of Accountant/CPA (include name of firm if applicable): Joel Peralto/ 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: 05-06 06-07 07-08 $0 $ 42,500 $ 50,000 Agency Mission Statement: NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page I To strengthen our communities through the cooperative development of programs and services for all of Puna. To provide a quality After -School Program for area youth, family strengthening, health and wellness, cultural diversity and economic development activities. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 2 Grassroots Community Development Group - Agency Name Kupukupu After -School & Summer Program- Program Name Program Description: This free after-school program was first started through a HI Island Meth. Initiative grant in 2004 in response to the ice epidemic on the Big Island. The target population is 6th, 7th, and 8th graders from Kea'au Middle School. The program teaches drug refusal skills, pro -social and communication skills and healthy holistic development through physical activities, tutoring and homework assistance, cooking and nutrition, agricultural skills and sustainability values, and arts and crafts. Special workshops are also offered in expressive activities like music, video, circus arts, and hiphop. The program runs M -F, 1-5 p.m. and this past summer, a six-week, all day program was successfully started. Total Budget and Position Count Total Program Budget 85,000 Total Program Position Count 4 PT Total Agency Budget 160,000 Total Agency Position Count 8 PT Program Objectives: Prevent drug use and other anti -social behaviors in Kea'au area youth; 2) Increase academic performance of Kea'au Middle School youth; 3) Provide skill development in physical, social, communication, LifeSkills; 4) Provide family strengthening and community bonding activities; 5) Provide Youth Leadership opportunities through high school and college mentors Program Highlights: 1) The summer program emphasized special skill building workshops in animation, digital arts, and robotics. These activities were a great hit with the youth and seen as an enhancement for their academic growth. The addition of canoe culture also enhanced physical conditioning as well as knowledge of ocean cultura and Hawaiian cultural values. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 3 education, nutrition, and peer relationships which augmented drug prevention curriculum. 3) GCDG also was selected as a Compassion Capital Fellowship grantee which allowed the funding of Board and staff training increasing the administrative capacity of the program. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 4 Grassroots Community Development Group - Agency Name Kupukupu After -School & Summer Prog. - Program Name Performance Measures: *If applicable Program Expenditures FY 2006-07 Actual * FY 2007-08 Budget* FY 2008-09 Estimate Youth achieve pro -social and communication skills competency 64% 70% 74% Youth report being drug-free 100% 100% 100% Youth participate in community activities which teach active citizenry 30% 40% 50% Families of youth participate in family strengthening events 2001. 25% 30% Other* Total 79,644 83,000 83,000 *If applicable Program Expenditures * If applicable * Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 5 FY 2006-07 Actual * FY 2007-08 Budget * FY 2008-09 Estimate Salaries and Wages 44,100 45,000 45,000 Professional Fees 8,496 10,000 10,000 Operations 18,415 18,000 18,000 Equipment 8,633 10,000 10,000 Other* Total 79,644 83,000 83,000 * If applicable * Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 5 Grassroots Community Development Group - Agency Name Kupukupu After -School & Summer Prog. - Program Name Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2006-07 Actual* FY 2007-08 Budget * FY 2008-09 Estimate HI Island Meth Initiative Grant 8,768 10,000 Kuki o Grant 5,000 5,000 Healing Our Island Grant 2,000 County of Hawai'i 42,500 50,000 60,000 Prosecutor's Office 10,800 1,200 Donations 7,518 7,000 7,000 Fundraising 2,000 Other Grants 5,220 2,344 10,000 Total 66,006 85,144 85,200 *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? This program plans to increase revenues through the following activities: 1) Grant writing to foundations, government, and other entities; 2) Fundraising events. The goal is to be self-sustaining in four years. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 6 Grassroots Community Development Group - Agency Name Kupukupu After -School and Summer Prog. - Program Name I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 — 2-142.2, Hawai'i County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawai'i Revised Statutes. If awarded a grant from the County of Hawaii, I (we) understand and will comply with the requirement to submit a year-end report to the Legislative auditor within 60 days after June 30 of the fiscal year. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawaii grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely, complete, and accurate year-end report will impact the evaluation of your program's or agency's future funding requests. Signature of Board P esident/CI it Sidnature of Ex cutive Director Dat o� Dat UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 7 Grassroots Community Development Group- Agency Name Ohia Lehua Entrepreneurial After -School Program- Program Name Agency Director: Trina Nahm-Mijo Phone No.: Contact Person: same Phone No.: 640-5109 Mailing Address: P.O. Box 1772, Kea'au, HI 96749 Facility/Site Address: 15-0565 Kea'au-Pahoa Highway, Bdng. G Fax No.: 974-7757 Email Address: nahmmijo@hawaii.edu Name of Accountant/CPA (include name of firm if applicable): Joel Peralto/ 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: $70,000 Prior Year(s) Funding: 05-06 06-07 07-08 $0 $ 0 $ 0 Agency Mission Statement: NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page I To strengthen our communities through the cooperative development of programs and services for all of Puna. To provide a quality After -School Program for area youth, family strengthening, health and wellness, cultural diversity and economic development activities. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 2 Grassroots Community Development Group - Agency Name Ohia Lehua Entrepreneurial After -School Program- Program Name Program Description: This free or low-cost after-school program was first started through a HUD Alaskan Native/Native Hawaiian Institutions Asssisting Communities grant in 2007 in response to the ice epidemic and the low social -economic standing of the Puna community. The target population is youth, 14 - 24 year olds, predominantly from the Puna area. The program will be held at Kea'au Youth Business Center iocated in Kea au Town Center which has a state-of-the-art multimedia computer lab; the largest fully equipped sound recording studio in East Hawai'i; and a certified mobile kitchen on wheels. The After -School program M -F, 2-5 p.m. will offer skill building in digital media arts, graphic and publishing arts, music and sound recording, and culinary arts. Besides the skill building training, participants will learn business, teaming and entrepreneurial skills which will give them tools to survive and thrive in a 21' century global economy and to add to the social and economic capital of their communoities. Total Budget and Position Count Total Program Budget_ 75,000 Total Program Position Count 4 PT Total Agency Budget 160,000 1 Total Agency Position Count 8 PT Program Objectives: 1) Prevent drug use and other anti -social behaviors in Puna area youth; 2) Provide skill development in digital media arts, music and sound recording, and culinary arts; 4) Cultivate the talents and economic viability of area youth; 5) Provide Youth Leadership opportunities through community engagement, entrepreneurial training, and product and talent development. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 3 Program Highlights: The entrepreneurial skill development training program is a brand new program which was just started in August 2007, so there hasn't been enough time to develop many program highlights yet. However, the entrepreneurial skill building team "MAPS International" which was founded in 2006 by the related day program also housed at KYBC, Middle College, has participated in about 20 catering events over the past two years. These events have ranged from 50 to 300 people with an average of 6-10 youth trainees participating in each event. For example, MAPS has participated in the Taste of Hilo IX and X; cooking demonstrations with diabetes patients for the Bay Clinic, Inc. and the "Living in Paradise" public access program; the Xmas Wish Foundation Event for Homeless Children and their families; and the annual Shinenkai (New Year's) celebration for Puna Hongwanji Mission. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 4 Grassroots Community Development Group - Agency Name Ohia Lehua Entrepreneurial After -School Program - Program Name Performance Measures: *If applicable Program Expenditures FY 2006-07 Actual * FY 2007-08 Budget* FY 2008-09 Estimate 50 Youth develop video/graphic arts skills 70% 80% 50 Youth develop music/sound recording engineering skills 70% 80% 50 Youth develop culinary arts skills 70% 80% 60 Youth develop business, entrepreneurial training 70% 80% Other" Total $75,000 $163,000 *If applicable Program Expenditures If applicable # Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 5 FY 2006-07 Actual * FY 2007-08 Budget* FY 2008-09 Estimate Salaries and Wages $31,000 $75,000 Professional Fees 17,000 $20,000 Operations 11,000 $48,000 Equipment 6,000 $20,000 Other" Total $75,000 $163,000 If applicable # Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 5 Grassroots Community Development Group - Agency Name Ohia Lehua Entrepreneurial After -School Program - Program Name Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2008-07 Actual* FY 2007-08 Budget* FY 2008-09 Estimate HI Tobacco Prevention and Cessation Trust Fund $75,000 $75,000 County of Hawaii 70,000 Fundraising 10,000 Other Grants 8,000 Total $75,000 $163,000 *If applicable Explain what plans, if any, your agency and/or program has to increase revenues to support this program. When do you anticipate your program to become self-sustaining? This program plans to increase revenues through the following activities: 1) Grant writing to foundations, government agencies 2) Fundraising events 3) Entrepreneurial projects and products The goal is to be self-sustaining in five years. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 6 Grassroots Community Development Group - Agency Name Kupukupu After -School and Summer Prog. - Program Name I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 — 2-142.2, Hawai'i County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawai'i Revised Statutes. If awarded a grant from the County of Hawai'i, I (we) understand and will comply with the requirement to submit a year-end report to the Legislative auditor within 60 days after June 30 of the fiscal year. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawaii grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely, complete, and accurate year-end report will impact the evaluation of your program's or agency's future funding requests. Signature of B64rd Presid of (13110s, Dao UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 7 Habitat for Humanity West Hawaii- Agency Name General Operating Support/Staffing- Program Name Agency Director: 8010 Contact Person: 8010 Mailing Address: Facility/Site Address: Fax No.: Email Address: Vickie Bauman Vickie Bauman PO Box 4619 Kailua-Kona, HI 96745 Phone No.: 331 - Phone No.: 331 - 73-5576 Kauhola Street, Space #4 Kailua-Kona, HI 96740 331-8020 habitatkona@hialoha.net Name of Accountant/CPA (include name of firm if applicable): Alex Smith, CPA Phone No.: 877-257-6484 Mailing Address: 1403 Frank Street, Honolulu, HI 96816 Amount of Request for County Funds: $50,000 Prior Year(s) Funding: 05-06 06-07 07-08 $ 0 $ 15,000 $25,000 Agency Mission Statement: NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 1 The mission of Habitat for Humanity West Hawaii is to empower families and build community and hope through homeownership for low-income partner families. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 2 Habitat for Humanity West Hawaii - Agency Name General Operating Support/Staffing- Program Name Program Description: Habitat for Humanity West Hawaii is a nonprofit faith -based grassroots housing ministry which was founded in 2001 and granted affiliation with Habitat for Humanity International in 2002. We renovate and build houses for families earning between 40-60% of the median income for West Hawaii. Priority is placed on helping families with small children and the elderly who are in need of safe housing. Partner families are selected on the basis of four criteria: housing need, ability to pay the mortgage, willingness to partner, and access to land. We also require residency in West Hawaii for a minimum of three years. After completion, homes are sold to families on a no profit basis with a 1 % down payment, no interest loans, and a 20 year mortgage. Habitat for Humanity offers a "hand up, not a handout." Partner families will actually own the home and are expected to contribute 300 "sweat equity" hours towards building it. Last year, the County of Hawaii awarded us $25,000 to go toward our program and we were able to make siginificant strides and improvements for our affiliate's growth and therefore make an impact in our community. Our affiliate is currently in a dynamic growth stage and with the continued support and increased funding we can achieve even more of the objectives set to expand our potential. We have had several recent additions to our staff and board of directors, sucessfully opened a ReStore and have plans to significantly increase our building capacity within the next few years. We completed three homes in 2007, have four planned for 2008 and hope to increase that to five for 2009. We are requesting funding in the amount of $50,000 to support the following: -ReStore Staff ($15,000) This year, we successfully opened a Habitat ReStore in a 4,000 square foot warehouse space adjacent to our main Habitat office, which was an aggressive move for our affiliate. Once our ReStore operations becomes profitable enough to achieve overall self sustainability for Habitat, all net proceeds will be directed towards future construction funding. The ReStore customer base has been steadily increasing as word about us spreads in the community. We were able to hire a full-time ReStore manager as well as an AmeriCorps VISTA volunteer to help with daily ReStore operations and to set up systems to support its continued success. As a result, the immediate growth and success of the ReStore will require additional staff in the near future. We have also made important partnerships with local contractors and developers as well as with businesses to help generate our inventory. The ReStore has had many positive impacts on the community as it keeps reuseable items out of our landfills, provides the community with an outlet to purchase quality home improvement products at a discounted price, and the proceeds benefit our home building projects which seek to eliminate poverty housing in West Hawaii. As sales continually increase NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 3 monthly, we hope to get to the point where the ReStore generates enough income to cover overhead costs as well as provide funding to build more houses. As our ReStore continues to expand its customer base, we are finding the need to hire another person to work part-time in the store so that the office staff isn't continuously pulled to fill in. That would free up our ReStore manager to solicit more donations from local contractors, developers, and businesses as well as getting the word out to the community about the ReStore. The addition of another staff member for the ReStore would definitely have a positive impact on our daily ReStore operations. -Volunteer Coordinator ($15,000) As our affiliate contiues to grow, more and more people in the community are finding out about our projects and are interested in becoming volunteers. We currently have an AmeriCorps VISTA volunteer who is responsible for ReStore development as well as most of the volunteer coordination. Other members of the staff also assist with volunteer coordination. With the steady increase in our ReStore operations as well as our increased building capacity, we will need more volunteers to support both of those programs. The addition of a nearly full-time volunteer coordinator position would benefit our affiliate immensely to better manage our numerous volunteers and also allow our VISTA volunteer to focus much-needed attention on the growing ReStore. -Construction Site Supervisor ($20,000) We currently have a part-time Construction Site Supervisor who has been essential in helping us to fulfill our mission of building affordable homes in the West Hawaii community. As we look to the future, our building capacity will be steadily increasing which will neccesitate the Construction Site Supervisor to move to more of a full-time position to accommodate the expansion. With this significant increase, we feel it would be imperative to have a full-time Construction Site Supervisor. We would pay this position $5,000 per build and $20,000 would allow us to cover the costs for the four homes that are planned so far for 2008. Total Budget and Position Count Total Program Budget 278,474 Total Program Position Count 3 Total Agency Budget 375,000 Total Agency Position Count 6 Program Objectives: 1) Provide adequate staffing support to allow the affiliate to grow to its projected plan for the year. The core office staff currently consists of an Executive Director, an Administrative Assistant, and an AmeriCorps VISTA volunteer who is resposible for resource/donor development. They take care of the daily operations of the affiliate including maintaining the donor database, community relationship building, marketing, NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 4 fundraising/grant writing, managing financial transactions, working closely with the board of directors as well as assisting with daily operations of the Restore. We have hired a Restore Manager and another AmeriCorps VISTA volunteer who assists with Restore operations as well as recruites/coordinates the volunteers. Funding would be used to support three positions (part-time ReStore staff, Volunteer Coordinator, Construction Site Supervisor) that would help to bring us to the next level of growth and improvement. 2) Hire additional support (part-time staff position) for daily ReStore operations. This person would work with our ReStore manager and AmeriCorps VISTA volunteer to continue the ReStore's positive progress thus far. Their presence in the ReStore would allow our manager to focus on soliciting donations from local contractors, developers and businesses as well as spread the word in the community about our ReStore. 3) Ensure that our volunteers are being utilized and managed in the most productive way. This will require our Volunteer Coordinator and Construction Site Supervisor positions to be moved to more of a full-time commitment. These positions will be responsible for tracking volunteer hours, maintaining the volunteer database, recruiting volunteers, supervise volunteers and ensuring safety and positive experiences of all volunteers both in the ReStore and at the construction sites. Program Highlights: 1) County funding in the last year has helped us to accomplish the following: 2) Our Habitat ReStore is open and performing above budget expectations. We anticipate that we will break even by 2009. 3) We have hired an Executive Director, ReStore manager, two AmeriCorps VISTA volunteers, and a part-time Construction Site Supervisor to keep up with our rapidly growing affiliate's operations. 4) Over the past year, we built three homes and completed six senior home renovations. 5) We are currently working with consultants to create a strategic plan for our affiliate. Our building capacity will be increased as well as general operations streamlined to maintain our focus on the Habitat mission. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 5 Habitat for Humanity West Hawaii - Agency Name General Operating Support/Staffing - Program Name Performance Measures: "If applicable Program Expenditures FY 2006-07 Actual " FY 2007-08 Budget " FY 2008-09 Estimate Number of homes completed 2 4-5 5-7 Number of people directly benefitting from house builds/renovations 18 at least 34 at least 49 Active volunteers 175 250 350 Number of full-time HFHWH employees (" includes 1 full-time AmeriCor s VISTA volunteer 3 3" 4" ReStore Staff (" includes 1 full-time AmeriCor s VISTA volunteer 0 2" 3" Construction Site Supervisor indicates art-timeposition) 0 1"" 1 I "If applicable Program Expenditures NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 6 FY 2006-07 Actual " FY 2007-08 Budget " FY 2008-09 Estimate Salaries and Wages 45,273 90,400 95,824 Professional Fees 63,524 55,000 58,300 Operations 51,088 84,293 89,350 Equipment Other" 0 10,000 35,000` NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 6 * If applicable u Please explain in detail an separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 7 FY 2006-07 Actual * FY 2007-08 Budget * FY 2008-09 Estimate Total 159,885 239,693 278,474 (significant ' Part-time increases Restore staff occurred $15,000 and because the full-time Restore was Construction Site opened and a Supervisor full-time $20,000 Executive was hired * If applicable u Please explain in detail an separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 7 HFHWH Program Expenditures Significant increases in salaries and wages occurred between budget year 2006/2007 to 2007/2008 because a full time Executive Director was hired. The volunteer coordinator wages covered under the county grant are included in the salaries and wages. The $10,000 listed in the "other section" is for the part time construction supervisor. The Restore Staff member and the Construction site supervisor positions are listed under "other" in 2008- 2009 estimate. Significant increases in operations occurred between budget year 2006/2007 to 2007/2008 are attributed largely to rent expense. During this period, Habitat relocated its offices and opened a Restore resulting in an eleven -fold rent increase from $550/month to $6,402/month. Habitat for Humanity West Hawaii - Agency Name General Operating Support/Staffing - Program Name Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2006-07 Actual * FY 2007-08 Budget* FY 2008-09 Estimate County of Hawaii 15,000 25,000 50,000 Private Contributions 32,500 31,000 33,000 Grants 25,000 40,000 50,000 Fundraising Events 6,500 7,000 20,000 Interest Income 1,100 1,100 1,100 Hawaii Island United Way 11,000 15,000 15,900 Habitat for Humanity International 20,000 39,996 27,984 Restore 0 10,000 25,000 Total 111,100 169,096 222,984 *If applicable Explain what plans, if any, your agency and/or program has to increase revenues to support this program. When do you anticipate your program to become self-sustaining? As our organization continues to grow, we are able to become closer to achieving the goal of self -sustainability. Habitat for Humanity West Hawaii hopes to become self-sustaining by the year 2011. This will be accomplished through the growth of a combination of aspects of our organization. The first aspect of our organization which will help us to become self-sustaining is our growing "Fund for Humanity." The Habitat for Humanity model is designed so that all mortgage payments collected from our partner families go into a revolving Fund for Humanity, which is then used to build more houses. Therefore, the more houses we build, the larger our Fund for Humanity will be, allowing us more income to create affordable housing opportunities for the West Hawaii community. As our affiliate continues to grow and is able to build more houses, our income will stabilize and allow us to become more sustainable. In addition to the Fund for Humanity, our newly opened ReStore will eventually play a key role in our achieving self -sustainability. Since opening of the ReStore NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 8 operations some 5 months ago, we have been experiencing positive growth in sales volume exceeding original budget goals. We anticipate this trend to continue as we build stronger donor relationships with local building contractors and building supply retailers as well as increased customer awareness of our Restore location and product inventory availability. It's important to note that although the inventory products sold through our Restore operations are largely donated at no cost all sales proceeds are currently dedicated towards offsetting the increased rent expense. With the commitment Habitat made to open the Restore, we were faced with no other alternative but to pay prevailing high warehouse commercial lease rents. Our goal is for the Restore operations to achieve profitability by 2010 at which time all profits will be directed towards funding of future come construction. We have successfully developed a donor partnership relationship with the Kona Board of Realtors who have annually sponsored a fundraiser golf tournament which to date has raised nearly $20,000 to assist with Habitat builds. A new signature fundraiser event is currently being planned which will help both raise funding for future builds as well as build a broader community awareness of Habitat's vital role here in West Hawaii. These funding sources together with Hawaii County's continued funding support will enable Habitat to achieve its' ultimate mission and goals. Operationally, Habitat is currently having to dedicate a significant portion of it's funding resources towards rent expenses which more ideally could be redirected towards future affordable housing builds. Current commercial market rents in West Hawaii are burdensome to any nonprofit. To help address this issue we have had some recent proactive and collaborative discussions with the county which hopeful of 2011 will result in a permanent location for Habitat with reasonable long term rental rates. Again, with the help of the county through relief of rental burdens, Habitat can then become a more active participant in addressing the affordable housing needs here in West Hawaii. Please feel free to contact us at 331-8010 should you have any questions with respect to our subject grant funding request. Mahalo for your continued support for our Habitat Ohana. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 9 Habitat for Humanity West Hawaii - Agency Name General Operating Support/Staffing - Program Name I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 — 2-142.2, Hawai'i County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawai'i Revised Statutes. If awarded a grant from the County of Hawai'i, I (we) understand and will comply with the requirement to submit a year-end report to the Legislative auditor within 60 days after June 30 of the fiscal year. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawaii grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely, complete, and accurate year-end report will impact the evaluation of your program's or agency's future funding requests. Signature of Board President/Chair J% � Z'J�� Signature of Executive Director Date : . r,; Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 9 a I e pm Hawaii Advocate Program East Hawaii Janaury 31, 2008 Hie '=iia - Agency Name Hawaii Advocate Program- Program Name Agency Director: Contact Person: Mailing Address: Facility/Site Address Fax No.: Email Address Punky Pletan-Cross Steven Pavao �T 7 T -U 6I MT -10N I:Y14'] Phone No.: 969-1935 615 Pi'ikoi Street Suite 203 Honolulu, Hawaii 96814 357 Waianunue Avenue Hilo, Hawaii 96720 969-3276 spavao@halekipa.org Name of Accountant/CPA (include name of firm if applicable): Maria Gozzip, Controller Phone No.: 589-1829 Mailing Address: 615 Pi'ikoi Street, Suite 203 Amount of Request for County Funds: $80,000 Prior Year(s) Funding: 05-06 06-07 07-08 $0 $0 $50,000 Agency Mission Statement: Hale Kipa's mission is: to provide opportunities and environments that strengthen and encourage youth, their families and communities to actualize their potential and social responsibility. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 1 '" - Agency Name Hawaii Advocate Program- Program Name Program Description: The Hawaii Advocate Program is for children and families known to the child welfare and juvenile justice systems — or at -risk of becoming known to these systems. The Hawai'i Advocate Program (HAP) provides comprehensive, community-based care. This statewide program strives to prevent out -of -home placements of youth. Hale Kipa began providing the Hawaii Advocate program both on the Big Island as well as statewide in July of 2004. The major funding source for the program is the State of Hawaii's Department of Human Services. The Hawaii Advocate Program services, which are a replication of the nationally successful Youth Advocate Program model, are based on an intensive, individualized, strengths -based approach that focuses on the youth's and family's needs and goals. The Youth Advocate Program model is a scientifically proven model that prevents out -of -home placement of youth and involvement in substance abuse and other high risk behaviors. Once admitted to HAP, each family is assigned a Community Advocate. The Advocate helps the family identify and cultivate relationships with persons and associations within the community that can provide support. Families receive an average of 13 hours of advocacy service per week. Services are flexible, creative and determined by the family's needs, and are guided by a "No Reject, No Eject" policy. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 2 Agency Name Hawaii Advocate Program - Program Name SERVICES Individual and group counseling Advocacy and referrals Comprehensive assessments Individualized Service Plan Development Competency Development for Youth and Family Supports Development of Child/Family Teams Resource Development In -school Assistance Linkages to Community Resources Group Activities (recreational, skill building, cultural, tutoring, etc.) Supported Work Option 24 -Hour Staff Accessibility/Crisis/Emergency Interventions POPULATION & ADMISSION CRITERIA Youth ages 5-18 (or up to 20 if youth is on parole) who live in the East Hawaii area to include North and South Hilo and Puna. Families referred to Child Welfare Services (CWS) that have been assessed to NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 3 Kipa - Agency Name Hawaii Advocate Program - Program Name require supportive services, but not accepted for child protection services Families assessed and confirmed for child abuse or neglect by CWS that need services to prevent out -of -home placement of a child; or to support reunification of a child who has been returned home Youth in PINS status with Family Court or in DHS system Youth being diverted from placement at the Hawaii Youth Correctional Facility (HYCF) on O'ahu. YOUTH RESPONSIBILITIES Participation in the development of an individualized Service Plan and personal goals Participation in program activities, at a specified number of hours per week Attend school or maintain another appropriate educational or vocational plan DISCHARGE CRITERIA Youth/Family achieves goals of the program Youth ages out or otherwise becomes ineligible for services Placement agency removes youth from the program Prevention/Intervention Services NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 4 _4 ale €.e, Kip , - Agency Name Hawaii Advocate Program - Program Name Total Budget and Position Count Total Program Budget 1 $355,032.00 Total Pro ram Position Count 12 Total Agency Budget 1 $15,188,620.00 1 Total Agency Position Count 326 Program Objectives: 1) 95% of participant youth not placed out -of -home for safety 2) 95% of participant youth not placed out -of -home due to his/her behavior 3) 80% of youth avoided pregnancy 4) 80% of youth sought employment actively or maintained employment. 5) 90% of youth participants attend school regularly 6) 95% of youth participants remain arrest free 7) 95% of youth participants remain free from reports of abuse/neglect. Program Highlights: 1. Independently contracted research contractor, the Catalyst Group, conducted follow-up with all clients over the past two years and conducted surveys of all youth and families. 2. The above percentages were consistently attained, clearly displaying the successful impact of this program. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 5 I' �,. Kipa - Agency Name Hawaii Advocate Program - Program Name Performance Measures: *If applicable Program Expenditures FY 2006-07 Actual * FY 2007-08 FY 2008-09 Budget * Estimate Number of at -risk youth served n/a 54 62 Number of DHS referrals n/a 48 50 Number of Family Court referrals n/a 56 60 Number of advocate hours n/a 9128 9,975 Number of groups held n/a 60 70 Number of youths transported n/a 54 62 Numbers of total mileage n/a 12,248 13,575 Numbers of families financially assisted n/a 44 58 Number of referrals made for other services needed by families n/a 106 120 n/a n/a n/a n/a n/a n/a *If applicable Program Expenditures * If applicable Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 6 FY 2006-07 Actual * FY 2007-08 FY 2008-09 Budget * Estimate Salaries and Wages 203,728 256,528 Professional Fees 42214. 52,431 Operations 85635 90,775 Equipment 4455 5266 Other* 0 0 Total 336,032 405,000 * If applicable Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 6 Hn'ie Kipa -Agency Name Hawaii Advocate Program - Program Name Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2006-07 FY 2007-08 Actual * Budget* FY 2008-09 Estimate State of Hawaii/DHS 311,032 325,000 County of Hawaii 25,000* 80,000 Total 336,032 405,000 *If applicable *2007-08 County grant for $50,000 was for both East and West Hawaii. Explain what plans, if any, your agency and/or program has to increase revenues to support this program. When do you anticipate your program to become self-sustaining? Hale Kipa has a long history of being a successful fundraiser and will begin an aggressive fundraising effort statewide. The current emphasis is on a $17 million capital campaign to build its core facility on Oahu. Hale Kipa will also seek community partnerships both with the local business sector as well as with the Hawaii Island United Way. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 7 Hale Kipa - Agency Name Hawaii Advocate Program - Program Name I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 — 2-142.2, Hawaii County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawai'i Revised Statutes. If awarded a grant from the County of Hawai'i, 1(we) understand and will comply with the requirement to submit a year-end report to the Legislative auditor within 60 days after June 30 of the fiscal year. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawa!'i grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely, complete, an Signature of Board Date I -A q. OP Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 8 �4 ? p- Hawaii Advocate Program West Hawaii Janaury 31, 2008 Haie Kipa - Agency Name Hawaii Advocate Program- Program Name Agency Director: Contact Person: Mailing Address Facility/Site Address Fax No.: Email Address: Punky Pletan-Cross Steven Pavao Phone No.: 589-1829 Phone No.: 969-1935 615 Pi'ikoi Street Suite 203 Honolulu, Hawaii 96814 74-381 Kealakehe Parkway #1 Kailua-Kona, Hawaii 86740 329-6395 spavao@halekipa.org Name of Accountant/CPA (include name of firm if applicable): Maria Gozzip, Controller Phone No.: 589-1829 Mailing Address: 615 Pi'ikoi Street, Suite 203 Amount of Request for County Funds: $80,000 Prior Year(s) Funding: 05-06 06-07 07-08 $0 $0 $50,000 Agency Mission Statement: Hale Kipa's mission is: to provide opportunities and environments that strengthen and encourage youth, their families and communities to actualize their potential and social responsibility. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 1 a'e `` ipa - Agency Name Hawaii Advocate Program- Program Name Program Description: The Hawaii Advocate Program is for children and families known to the child welfare and juvenile justice systems — or at -risk of becoming known to these systems. The Hawai'i Advocate Program (HAP) provides comprehensive, community-based care. This statewide program strives to prevent out -of -home placements of youth. Hale Kipa began providing the Hawaii Advocate program both on the Big Island as well as statewide in July of 2004. The major funding source for the program is the State of Hawaii's Department of Human Services. The Hawaii Advocate Program services, which are a replication of the nationally successful Youth Advocate Program model, are based on an intensive, individualized, strengths -based approach that focuses on the youth's and family's needs and goals. The Youth Advocate Program model is a scientifically proven model that prevents out -of -home placement of youth and involvement in substance abuse and other high risk behaviors. Once admitted to HAP, each family is assigned a Community Advocate. The Advocate helps the family identify and cultivate relationships with persons and associations within the community that can provide support. Families receive an average of 13 hours of advocacy service per week. Services are flexible, creative and determined by the family's needs, and are guided by a "No Reject, No Eject" policy. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 2 *` w `pa - Aaencv Name Hawaii Advocate Program - Program Name SERVICES Individual and group counseling Advocacy and referrals Comprehensive assessments Individualized Service Plan Development Competency Development for Youth and Family Supports Development of Child/Family Teams Resource Development In -school Assistance Linkages to Community Resources Group Activities (recreational, skill building, cultural, tutoring, etc.) Supported Work Option 24 -Hour Staff Accessibility/Crisis/Emergency Interventions POPULATION & ADMISSION CRITERIA Youth ages 5-18 (or up to 20 if youth is on parole) who live in the West Hawaii area to include North and South Kohala, North and South Kona, and Kau. Families referred to Child Welfare Services (CWS) that have been assessed to NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 3 H (t9Pc4 - Agency Name Hawaii Advocate Program - Program Name require supportive services, but not accepted for child protection services Families assessed and confirmed for child abuse or neglect by CWS that need services to prevent out -of -home placement of a child; or to support reunification of a child who has been returned home Youth in PINS status with Family Court or in DHS system Youth being diverted from placement at the Hawaii Youth Correctional Facility (HYCF) on Oahu. YOUTH RESPONSIBILITIES Participation in the development of an individualized Service Plan and personal goals Participation in program activities, at a specified number of hours per week Attend school or maintain another appropriate educational or vocational plan DISCHARGE CRITERIA Youth/Family achieves goals of the program Youth ages out or otherwise becomes ineligible for services Placement agency removes youth from the program Prevention/Intervention Services NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 4 -Agency Name Hawaii Advocate Program - Program Name Total Budget and Position Count Total Program Bud et $355,032.00 Total Program Position Count 12 Total Agency Budget $15,188,620.00 Total Agency Position Count 326 Program Objectives: 1) 95% of participant youth not placed out -of -home for safety 2) 95% of participant youth not placed out -of -home due to his/her behavior 3) 80% of youth avoided pregnancy 4) 80% of youth sought employment actively or maintained employment. 5) 90% of youth participants attend school regularly 6) 95% of youth participants remain arrest free 7) 95% of youth participants remain free from reports of abuse/neglect. Program Highlights: 1. Independently contracted research contractor, the Catalyst Group, conducted follow-up with all clients over the past two years and conducted surveys of all youth and families. 2. The above percentages were consistently attained, clearly displaying the successful impact of this program. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 5 Kip -Agency Name Hawaii Advocate Program - Program Name Performance Measures: If applicable Program Expenditures FY 2006-07 Actual * FY 2006-07 Actual* FY 2007-08 Budget* FY 2008-09 Estimate Number of at -risk youth served n/a 38 44 Number of DHS referrals n/a 48 55 Number of Family Court referrals n/a 22 25 Number of advocate hours n/a 4,432 5,400 Number of groups held n/a 18 20 Number of youths transported n/a 38 44 Numbers of total mileage n/a 9,286 11,344 Numbers of families financially assisted n/a 32 40 Number of referrals made for other services needed by families n/a 66 75 n/a n/a n/a n/a n/a n/a If applicable Program Expenditures FY 2006-07 Actual * FY 2007-08 Budget* FY 2008-09 Estimate Salaries and Wages 203,728 256,528 Professional Fees 42214. 52,431 Operations 85635 90,775 Equipment 4455 5266 Other" 0 0 Total 336,032 405,000 If applicable ° Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 6 Agency Name Hawaii Advocate Program - Program Name Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2006-07 Actual * FY 2007-08 FY 2008-09 Budget* Estimate State of Hawaii/DHS 311,032 325,000 County of Hawaii 25,000* 80,000 Total 336,032 405,000 *If applicable *2007-08 County grant for $50,000 was for both East and West Hawaii. Explain what plans, if any, your agency and/or program has to increase revenues to support this program. When do you anticipate your program to become self-sustaining? Hale Kipa has a long history of being a successful fundraiser and will begin an aggressive fundraising effort statewide. The current emphasis is on a $17 million capital campaign to build its core facility on O'ahu. Hale Kipa will also seek community partnerships both with the local business sector as well as with the Hawaii Island United Way. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 7 ,0*, Hale Klpa - Agency Name g Y Hawaii Advocate Program - Program Name I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 — 2-142.2, Hawai'i County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawaii Revised Statutes. If awarded a grant from the County of Hawaii, I (we) understand and will comply with the requirement to submit a year-end report to the Legislative auditor within 60 days after June 30 of the fiscal year. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawaii grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely, complete. an Signature of Board r� SignaTure of ExecGtive Director Date /.29.0k Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 8 Hawaii Centers for Independent Living- Agency Name Indpendent Living Services- Program Name Agency Director: 5400 Contact Person: 5400 Mailing Address: Facility/Site Address: Fax No.: Email Address: Patricia Lockwood Nathan Holmes Phone No.: 522 - Phone No.: 522 - 414 Kuwili Street, Suite 102, Honolulu, HI 96817 400 Hualani Street, Suite 16D, Hilo, HI 96720 522-5427 nathanh@pacificil.org & Patl@pacificil.org Name of Accountant/CPA (include name of firm if applicable): Fred Hattori, Hattori & Co. CPA Inc. Phone No.: 949-2656 Mailing Address: 1481 S. King Street, Suite 232, Honolulu, HI 96814 Amount of Request for County Funds: $15,000 Prior Year(s) Funding: 05-06 06-07 07-08 $15,000 $15,000 $15,000 Agency Mission Statement: Hawaii Centers for Independent Living, people with disabilities, building access, indpendence, and choice. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 1 NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 2 Hawaii Centers for Independent Living - Agency Name Independent Living Services- Program Name Program Description: The Hawaii Centers for Independent Living (HCIL) is a non-profit organization operated by and for people with disabilities to ensure their rights to live independently and fully integrated in the community of their choice, outside of institutional care settings. As a non-profit, county wide resource, HCIL serves people of any age with any type of disability. HCIL was founded on the historical constitutional beliefs of civil rights and the empowerment of people with disabilities to have equal access, opportunities, and choices in life, no matter how severe their disability. To accomplish this, HCIL actively seeks systems change and promotes self - advocacy. The Philosophy That Guides HCIL Is Three -Fold: 1. HCIL's objective is to present information on a wide array of options, from full independence to other forms of community-based living, from which individuals with disabilities can make their own personal choices. 2. The needs of people with disabilities can be met effectively by comprehensive programs encompassing personal care, housing, transportation, work, recreation -- the list is almost endless. This is what drives HCIL's response to consumer requests. 3. Those who know best the needs of people with disabilities, and how to meet those needs, are people with disabilities themselves. It is the strong belief in this peer relationship that distinguishes HCIL and its services. Total Budget and Position Count Total Program Budget 327,797 Total Program Position Count 6 Total Agency Budget 1,541,772 Total Agency Position Count 30 Program Objectives: Provide landlord / tenant rights training, how to complete a housing application, how to locate housing and how to maintain their housing situation. This will reduce risk of being homeless and dependent on others. This service will be provided to 20 individuals. Timeline: 7/1/08 - 6/30/09 NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 3 2) Provide consumers with personal care attenandant regerrals whom we have screened and interviewed to assist them with their personal care, chores, etc. Provide consumer training on how to interview, hire and fire an attenent. This prevents institutionalization and dependence on family, friends, and neigbors. This service will be provided to 30 separate individuals. ( Should a person require the service more than one time in the two year period they will be counted as one individual) Timeline: 7/1/08 - 6/30/09 3) Provide one--on-one independent living skills to assist consumers in carring out their everyday living activities such as housekeeping, shopping, laundry, cooking, etc. This will reduce dependence on others. This service wll be provided to 8 individuals. Timeline 7/1/08 - 6/30/09 4) Provide consumer with information on their legal rights, how to access consumers to empower self -advocacy. This service will be provided to 30 individuals. Timeline 7/1/08 - 6/30/09 5) Provide one-on-one training with consumers to acquire problem -solving and decision-making skills. This will provide the consumer to make informed choices. This service will be provided to 20 individuals. Timeline: 7/1/08 - 6/30/09 6) Provide one -on- one training on video relay service for the deaf. Serve as the location where consumers can file complaints if they have problems with the 711 service. This service will be provided to 20 consumers. Timeline: 7/1/08 - 6/30/09 7) Provide consumers with housing referrals to acquire a place to live. This will increase their independence and decrease dependency on family and/or friends. 15 people with locate and move into housing. Timeline 7/1/08 - 6/30/09 8) Provide consumers with information and referral services to increase their options of various resources in the community. This will increase their independence. Timeline 7/1/08 - 6/30/09 Program Highlights: During the past year HCIL- Hawaii provided services to 285 persons with disabilities in the County of Hawaii. 2) HCIL- Hawaii staff attended the legislative informational briefing in Honolulu and gave testimony to the committee on the impact of the earthquake on persons with disabilities. HCIL developed an emeregency preparedness educational packet to distribute to our customers. 3) HCIL - Hawaii providing housing information and assistance to 148 person in the county and helped people get into housing in 2007. 4) HCIL - Hawaii helped 79 individuals get personal assistants in 2007. 5) HCIL-Hawaii taught 18 individuals independent livings skills in 2007. (Please note this is an unduplicated count of persons not the number of classes provided) 6) HCIL - Hawaii provided classes and technical assistance to 285 NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 4 individuals on public benefits such as Social Security Disability and how returning to work would impact not only Social Security but Medicaid, Section 8 Housing Vouchers, etc. 7) CIL-Hawaii has initiated the outreach staff working from their homes in different districts of Hawaii County. CIL-Hawaii has a staff person in the North & South Kona District, Kau District, North & South Kohala District and Puna District. The Hilo office will assist with the North & South Hilo District and Hamakua District. 8) 96 of our customer, who received services were over age 60. 9) 180 of our customer, who received services were between age 20-59 10) 9 were below age 20. 11) 7 had cognitive disabilities 12) 35 had mental emotional disabilities 13) 48 had physical disabilities 14) 24 had a hearing disability 15) 6 were blind or had low vision 16) 165 had more than one disability. 17) 0 had other kinds of disabilities such as cancer, heart problems, etc. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 5 Hawaii Centers for Independent Living - Agency Name Independent Living Services - Program Name Performance Measures: *If applicable Program Expenditures FY 2006-07 FY 2007-08 Actual * Budget* FY 2008-09 Estimate 11 Pieces of adaptive equipment 201.71 201.71 201.71 161 Housing and Shelter Services 2952.74 2952.74 2952.74 151 Independent Living Skills Srvcs 2769.34 2769.34 2769.34 227 Self-care Services 4163.18 4163.18 4163.18 36 Recreational Services 660.24 660.24 660.24 11 Vocational Services 201.74 201.74 201.74 21 Transportation Services 385.14 385.14 385.14 11 Communcation Services 201.74 201.74 201.74 50 Personal Resource Management 917.00 917.00 917.00 43 Self-Avocacy Services 788.62 788.62 788.62 21 Avocacy Serivices 385.14 385.14 385.14 75 Access the communtiy/social participation 20 1375.50 1375.50 1375.50 *If applicable Program Expenditures If applicable " Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 6 FY 2006-07 Actual * FY 2007-08 Budget* FY 2008-09 Estimate Salaries and Wages 10,059 10,500 10,500 Professional Fees 373 750 750 Operations 1,847 2,000 2,000 Equipment 60 500 500 Other" 2,854 1,250 1250 Total 15,193 15,000 15,000 If applicable " Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 6 Hawaii Centers for Independent Living - Agency Name Independent Living Services - Program Name Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2006-07 Actual * FY 2007-08 Budget* FY 2008-09 Estimate State of Hawaii 103,726 117,726 117,726 Federal Funds 176,836 175,071 175,071 Hawaii County 15,000 15,000 15,000 United Way Funds 20,000 20,000 20,000 Total 315,622 327,797 327,797 *If applicable Explain what plans, if any, your agency and/or program has to increase revenues to support this program. When do you anticipate your program to become self-sustaining? Over the past several years HCIL has worked on leveling the playing field for all of its offices in the state. We have worked on isuring that all offices have parity in terms of staff, equipment, and services. At this time HCIL is hoping to be able to increase its full program of deaf services throughout the state. For the past several years HCIL has had a deaf program which was only funded in Oahu. At this time we are seeking increased funding to take this program statewide. HCIL hopes to be self sufficient by 2010. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 7 Hawaii Centers for Independent Living - Agency Name Independent Living Services - Program Name I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 — 2-142.2, Hawai'i County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawai'i Revised Statutes. If awarded a grant from the County of Hawaii, I (we) understand and will comply with the requirement to submit a year-end report to the Legislative auditor within 60 days after June 30 of the fiscal year. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawaii grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely, complete, and accurate year-end report will impact the evaluation of your program's or agency's future funding requests. lb_g 15r� Signature of Board President/Chair Signature of Executive Director Date r 3 � Datef UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 8 Hawaii Island Adult Care, Inc. - Agency Name Hilo Adult Day Center - Program Name Agency Director: Contact Person Mailing Address Facility/Site Address: Fax No.: Email Address: Paula Uusitalo Paula Uusitalo 34 Rainbow Drive Hilo, HI 96720 same as above 961-3740 Phone No.: 961-3747 Phone No.: 961-3747 Puusitalo@hawaiiislandadultcare.org 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: $30,000.00 Prior Year(s) Funding: 05-06 06-07 07-08 $18,000.00 $16,000.00 $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 2008-09 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 care program for frail elders and mentally/physically challenged adults who are needing supervised daytime care. The center is open from Monday to Friday, 7:00 AM to 5:00 PM, and Saturdays from 8:00 AM to 4:00 PM. Total Budget and Position Count Total Program Budget 961,998.00 Total Program Position Count 22 Total Agency Budget 1,214,568.00 Total Agency Position Count 36 Program Objectives: 1) Provide a safe, caring, socially active, healthy daytime environment for frail elders and mentally/physically challenged adults including those with Alzheimer's disease; all of whom need assistance with some of their active daily living skills, many are under doctor's orders for supervised care. 2) Provide interaction/socialization with others, hands-on games and activities, singing, arts/crafts, games, bingo, excursions, entertainment and more. These individuals are generally inactive at home, having old - age depression; the day center is geared to give them enjoyment of life, something to look forward every day, and dignity at this difficult time in their lives. 3) Provide the opportunity for elders to continue living in their own homes, to be with family and to be a part of the community for the rest of their days if possible. 4) Deter pre -mature institionalization into long term care facilities, allow our elders to live at home in dignity, and also assist with taxpayer savings which would be paying for the long term care institutionalization. Ninety percent of the patients in long term care facilities in Hawaii state are paid for by Medicaid funds. 5) Provide respite for caregivers and deter "caregiver burnout", and for caregivers who work, provide the opportunity for continuing their employment while attending to their frail loved ones in the evenings and weekends. 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 2008-09 Page 2 Program Highlights: 1) Provided day care services to 130 individuals having varied physical and/or mental challenges. June 2006 had 75 participants enrolled. 2) For the fiscal year ending June 30, 2007, new participants enrolled: 50; discharged, 48, attending the full year, 53. Four clients passed away while attendees of the center and still living at home (this is the real goal for our clients, to move on from this life while still living at home). Of the 130 participants, 63% were over eighty years old. 3) Maintained professional level of client services with the state of Hawaii, Department of Human Services (DHS) Adult Day Services program and the Nursing Home w/o Walls (NHWW) program, Services for Seniors and the Hawaii County Office of Aging. The DHS Purchase of services application and renewal (occurred in 2005) for a six year term, it provides adult day services for 20 poverty level — Medicaid eligible (DHS) clients per month. 4) Continued working with numerous agencies including the Interdisciplinary team(IDT) organized by the state Department of Health to provide elder client specific case management, other agencies included are DHS Nursing Home without Walls, DHS, Services for Seniors, Kokua Nurses, Care Resources, and others. 5) Continued submitting grants and receiving private foundation support for tuition/fee assistance, received adequate support for all clients needing to attend but who could not afford full costs, no-one was limited in the days they needed to attend. Also received grant monies for tables, chairs and other equipment for the program, and for newer computers. 6) Continued the Caregiver support group, and received a second year HMSA Foundation grant to provide,caregiver training classes and hands on caregiver care sessions for the community at large, at least two classes per month including Saturdays. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 3 Hawaii Island Adult Care, Inc. - Agency Name Hilo Adult Day Center - Program Name Performance Measures: *If applicable Program Expenditures FY 2006-07 FY 2007-08 FY 2008-09 Salaries and Wages Actual * Budget* Estimate Average monthly attendance 82 85 90 All figures are totals for the year: 130 132 135 Participants enjoyment of life, 124 127 130 maintain or improve personal 170,432.00 176,000.00 180,000.00 hygiene/self-care 937,875.00 961,998.00 989,700.00 Participants continue to live in own 103 105 108 homes 12 in care homes Families/caregivers able to continue 83 85 88 employment Families/caregivers receiving 104 106 109 respite Participants continued to attend 94 96 99 after 6 months Participants continuing after 1 year 67 69 72 Participants continuing after 2 years 46 48 51 Participants continuing after 5 years 22 22 22 Medicaid monies saved on $936,000.00 780,000.00 780,000.00 participants attending day care (12 persons (10 persons) (10 versus those living in long term care were persons) institutions (based on clients discharged discharged into long term care into long during the ear) term care *If applicable Program Expenditures If applicable " Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 4 FY 2006-07 Actual * FY 2007-08 Budget * FY 2008-09 Estimate Salaries and Wages 563,826.00 584,396.00 601,000.00 Professional Fees 12,187.00 14,500.00 14,500.00 Operations 188,211.00 182,942.00 190,000.00 Equipment 3,219.00 4,160.00 4,200.00 Other" 170,432.00 176,000.00 180,000.00 Total 937,875.00 961,998.00 989,700.00 If applicable " Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 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 2006-07 Actual * FY 2007-08 Budget * FY 2008-09 I Estimate Tuition/Fees 479,605.00 516,600.00 520,000.00 State - DHS and Nursing Home without Walls 139,138.00 155,648.00 155,000.00 Federal - Nursing Home without Walls and Kupuna Care 41,126.00 35,500.00 40,000.00 County of Hawaii 16,000.00 16,000.00 30,000.00 Hawaii Island United Way 25,000.00 25,000.00 25,000.00 May Templeton Hopper Fund 67,621.00 75,000.00 75,000.00 Mclnerny/ Gwenfread Allen/HHA Charity Walk/Friends of Hawaii Charities/other grants 68,509.00 65,000.00 65,000.00 Donations 11,965.00 9,000.00 11,000.00 USDA Lunch reimbursement program 31,045.00 31,000.00 32,000.00 PIN grant management 11,000.00 8,000.00 11,000.00 Fundraising/interest/vending machines/misc. sales 29,681.00 25,250.00 25,700.00 Total 920,690.00 961,998.00 989,700.00 *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 Hilo Adult Day Center receives more than 50% of its revenue from the tuition and fees, as of Fiscal Year 2006-07, the fee rates are now adjusted annually to sustain the program. The Board of Directors held a second annual golf tournament in July, 2007, which was very successful, netting $22,000 and will assist each year with operating costs. The adult day center program can only be self-sustaining if the federal and/or state government would recognize the importance of adult day care and being able to live at home, versus long term care institutionalization and the large tax savings noted above. Government funding for those low income individuals above poverty level needs to be in place, then we would not be dependent on applying to other sources to assist with tuition costs. Some individuals have purchased long term care insurance, but this only helps those who can afford to purchase this insurance. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 5 Hawaii Island Adult Care, Inc. - Agency Name Hilo Adult Day Center - Program Name I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 — 2-142.2, Hawai'i County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawai'i Revised Statutes. If awarded a grant from the County of Hawaii, I (we) understand and will comply with the requirement to submit a year-end report to the Legislative auditor within 60 days after June 30 of the fiscal year. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawaii grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely, complete. an Qalll�' 5 n ture of Board President/Chair Signature of Executive Director M=11�6 �,WE Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 6 Hawaii Island Adult Care, Inc. County of Hawaii Nonprofit Grant Application 2008-09 Attachment Explanation Page 4: Program Expenditures Other: This is Direct Client Assistance, it is the tuition assistance to help cover tuition costs for participants can not afford full costs. Hawaii Island HIV/AIDS Foundation- Agency Name Multi -Disciplinary HIV Case Management, Hilo- Program Name Agency Director: 331-8177 Contact Person: 331-8177 Mailing Address: Facility/Sito Address: Fax Pio.: Entail Address: Georgie Kennedy Georgie Kennedy Phone No.: 808 - Phone No.: 808 - '15-240 Nani Kailua Drive #5, Kailua-Kona, 111 96740 16-204 Melekahiwa Place #1, Kea'au 111 96749 808-331-0762 or 808-982--8802 georgie@hihaf.org Plaine of Afacountant/CPA (include name of firm if applicable): James D. Jennings, CPS, Inc. Phone No.: 808-942-8813 Mailing Address: 16 )00 Kapiolani Blvd., :7uite 730, Honolulu, HI 96814 Amount of Roquest for county Funds: $20,000 Prior Year(s) Funding: 05-06 06-07 07-08 $10,000 $10,000 $15,000 Agency Mission statement: NON P12( FJT d'RANT APPL0CATION FISCAL YEAR 200€3-09 Page I The Hawaii Island HIV/AIDS Foundation is a non-profit organization dedicated to assisting those affected by HIV/AIDS to maximize their quality of life, and to ending the spread of HIV. We also utilize the lessons learned in the HIV epidernic to care and advocate for others in the fight against FIN and related diseases. Our vision is to build a healthier, stronger, and more sustainable community that supports all its members with a focus on HIV issues. It is an IPS -designated 501(c)(3) tax-exempt non-profi'r, organization which provides care and cervices for people living with HIV/AIDS (PLWHA), and we provide HIV prevention and education to 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 this proposal. HIHAF has been providing services to people at risk for, infected with, and affected by HIVIAIDS since 1986. Our Foundation is an efficient and effective systern to provide a comprehensive continuum of prevention, care, and support services with regard to HIV/AIDS for the entire Big Island. As treatment and medical care for HIV-rarfected individtials continuos to dwindle with the greatest loss of medicrl professional on our island, HIHA4 :s role in helping our clients manage I IN and AIDS becomes increasingly caucial. As reported by the Hawaii Siate Department of Health, Hawaii County has the highest number of AIDS cases outside of O'sahu at 13%. In the last year, there have been 139 new cases of All)', in the state cif Hawaii. In Hawaii County, I lawai' i Island HIVIAIDS Foundation has enrolled 7 of the 8 new AIDS eases we know of that have been identified ora this island. Additionally, we had added 20 new clierits with HIV during that same pc,r iod. The nurnir..r of people living with HIVIAIDS continues iio climb steadily with each passing year of the epidermic, and the modes of transmission are changing. HIV is no longer present prinianly in high risk populations. In fact, half of the 43,000 new annual infection,; in the United States take place, as a result of heterosexual fiansmission. Halt of these new infections also occur milong people c=aged 15-23. -this indicates to uf-." that we will continua soeing a i iso-, in clients and their needs will chancre as the;=, epidemic: continues to sh;.-,pe our client population. Presently, HIV Foundation - Hilo provides rnulti-disciplinary learn HIV case management, advocacy, information and referral, food pantry, clieni financial assistance, and other support services for rrrore thar2 1113 PI -IN to and affected persons in East Flawafi. Over the course: of the: year of 2006 through Noverriber, 2001, a. total of 158 clients haw! been cared for in Hilo. Case Managers support client independence and .self-determination by providing a range of supportive nervices. These iriclude knowledge and assistance in accessing a variety of public and private benefit programs, n-redical rand nursing services, horsing, food, emergency financial ,.assistance, transportation, employment counseling, and other loans of assistance as appropriate to help and support a client's retention rand active participation in primary rne.dical care. The services received by each Oic*rrt are roonitored regularly to determine the FINCAL YEAR 2008-09 1�2)hltbliQ)9�'I'T QtftAf�d`d' �4a�I'p�NQ_'A"fV4➢1�] Page ). effectiveness of the service plan, identity emergent needs, and measure the outcome(s) of service delivery. HIV Foundation - Hilo proposes to continue its provision of high quality multi- disciplinary team HIV case management and primary prevention services, including anonymous HIV-antibody testing and counseling services, for at least one hundred and ninety (190) people living with HIV/ AIDS during FY 2008-2009. As in past years, we continue to experience cuts in State of Hawai'i Department of Health funding allocated to HIV/AIDS case management services on all islands. 'This is reflected in our Program Expenditures and Program Funding Sources tables. Regardless, we will continue to do our very best, as always, to provide the highest quality of services to all our clients, despite the decreases iri funding available to us. Perhaps the greatesi challenge that case management has had to face ill the last year is the island -wide loss of primary HIV -treating physicians. Many doctors providing ireatrnent to HIV-positive individuals in East and West Hawaii have left Private practice in the last year, thus we have had to cobble together treatment for people with HIV. One solution we have brokered is having the physicians from the AIDS Clinical -1 rials, through John Bruns Medical School, see patients on a rnonthhiy basis in both Fast and West Hawaii. This has brought high quality treatment to many of our clients who are currently without a physician. Additionally, these clients need a primary care physician locally and with so few doctors available, and those that are beincl overwhelmed by the influx of new patients, finding a primary physician who understands the complicated nature of c:Iinically treating I IIV, often alongside other health issues, adds to the complexities of HIHAF ease managers' work. Our care team not only educates doctors on resources for the ueatrnent. of I -11V, they act as a liaison between clients and their health care providers, and advor..ates for conlprehensive treatment of the inedical and psycho -social needs of our clients. NON I'I2OFI'I' (;RANT AI'I'1,If'A'I'101'q FISCAL YEAR 2008-09 Page 3 Hawaii Island HIV/AIDS Foundation - Agency Name Multi-Disciphnary HIV Case Management, Hilo- Program Name Program Description: HIV and AIDS still carry a debilitating stigma in our society. Because of this, many of those who are infected with, affected by, and at -risk for HIV hide their challenges concerning the disease and managing it in their lives. HIHAF is one organization at which HIV-positive individuals do riot have to hide, and where all their needs can at least be addressed, if not fully resolved. A multidisciplinary team composed of two full-time (2.0 FIE) 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 t'LWHA residing in East Hawai'i. (i he housing specialist also serves the Kona side clients.) The monthly average active caseload for the East Side office of the agency this year is one hundred and twerrty (120) clients. Twenty-eight percent (30%) of the HIV Foundation - Hilo's clients are homeless, multiply diagnosed, drug misusers and/or mentally ill. Eighty-six percent (84%) fall into two or more special population categories as defined by the federal Ryan White CARE Act Title It. Addressing clients' HIV and AIDS needs often begins and ends in completely difterent arenas. HIHAPs case managers negotiate and juggle relationships with clients and their families, social service agencies and state and federal agencies and programs. They reach across Hawai'i and other states to build relationships with prior advocates, to find medical and benefits records, and to establish client histories anti needs. They are active in statewide and nationwide care coalitions to enable us to bring the latents and most up to date information and treatment to tour eaients. For example, in order to begin addressing the clinical needs of a reeently- Ietnrned Hawaiian elan, HII--IAF' advocates searched for and found his medical records and benefits in Nevada state agencies and then helped him establish his residence locally. The treatment advocates worked closely with this young man and his parents to find a doctor to treat him, although he lives in a remote part of the island. :Staff developed a strong relationship with a doctor geographically clo seri: to hire and worked proactively with his physician so he might: understanding the clients' HIV status, level of disease and other complicating factors. I -hese madtiple steps were; necessaryin order to help hien access treatrnent for his HIV as well as to begin seeking diagnosis and care for other health issues. Due to the complex nature of treating FIIV most e[fectively, HIHAF advocates will now continue to work wiih this client's doctor, guiding him as he works with one of his first HIV-positive clients. Maintaining strong relationships ON 91 RO FITGRA INT A 91 111,11 CATION FISCAL ` E'AI2 20081-09 haw-& with professionals and agencies that serve a myriad of social and other needs is only one small part of our advocates' jobs. Our case managers' holistic care for and dedication to working with all needs our clients face is motivated by HIHAF's mission of serving people who are living with HIV. For many people living with HIV, the financial and logistic difficulties of managing their disease are still complicated by fear and stigma. Several of our older, female, Hawaiian clients feel that HIHAF is the only safe place for them to let down their walls, speak of their fear for themselves and their families and discuss how this disease and their possible death will affect them. In the safety of our facility, they can show the depth of their feelings, they can find necessary, life-saving, arid disease -monitoring clinical care and drugs. They also find a shoulder to lean on, resources for themselves and their families. One example is a female client whose teenage daughter was expecting a baby The client was in shock, trying to deal with the reality of her teen daughter becoming a mother. The :strain of the client realizing that she was just making it financially herself with her two daughters and that she would probably be the sole support of her new grand0ild. Our team helped her, and her daughter, to connect with services for the minor, her soon to be born child, and created a safety net well beyond just our clientr5 HIV. Recently, phone cards and foot coupons were made: available to clients and beneficiaries of HIHAF programs through a one time grant from the Elizabeth Taylor Foundation. Advocates spent a substantial amount of time calling all clients to ensure they all received a coupon but also using the opportunity to see I ow each arid every one of them was doing and it there was anything further we could assist them with. One woman's living situation was putting tier at risk for drug abuse. HIHAF case managers discovered that, because of a previous, unrelated error, she was receiving disability benefits greatly below what she was due. HIHAF then was able to find assisted housing for her through a lottery system that went in the client's favor. Through HiHAF's efforts, this client was able to access more benefits (thereby significantly raising her monthly income), move into a safe and secure home (one she had not had previously), live in town (where she could better, access medical treatment and care for her other life needs), and begin a steady relationship with a doctor who has been able to address her medical needs. Each of theses steps conhibui:ed to her ability to stay off illegal drugs and thereby improving her health. Two challenges of this last year have greatly changed the scope of services that our case managers provide our clients. The number of physicians on the Big Island who are knowledgable about FIN and how to best treat continues to decline. The number of physicians who are willing to take patients with IIIV is even less, as the disease is particularly complex. When physicians have been found who are willing to work with HIV-positive patients and are accepting new patients, HIFIAf= case managers have continued to step in to educate and guide these physicians through proactive treaGnent of HIV. t�IDt�lq'ltd)0'I'9' f�tBiANd'Y' �Y°t`fl.l(�ia'>f'6f➢�1 FUSCAL YEAR 2008-09 Page 5 The other great challenge of this year has been for our case managers to adapt to new federal prescription drug plan legislation (Medicare D) that greatly complicates accessing necessary medicines through multiple layers of complex eligibility criteria, changes to plan structures and services covered. Our case managers are now familiar with this new program, but, as our number of clients continues to grow, the burden on our case managers to provide the excellent care they always have also continues to grow. Many of our clients face multiple health issues and need medications to suppress HIV, need other drugs to address side effects of FIN drugs, need additional drugs to treat opportunistic: infections related to HIV. Most clients who are taking medications, take from 6 to 10 drugs daily. Some of orrr clients take up to 25 medications daily or multiple times during the day. In order to enable clients to best treat these medical issues at the lowest possible cost through this new plan, ease managers must understand the client's current income and drug coverage plan, know what drugs the client needs and which plans cover it, have knowledge of the client's other medical needs, understand which pharmacies will accept which drug coverage program, and have an understanding of HIV and other pharmaceuticals to cornparc pricing. HIHAF's case managers are cot npassion cite and talented; For them, treating someone's HIV incorporates all aspects of life, as HIV affects acrd complicates all areas of the life experience. For our clients, rnany who live with fear and stigrna, who deal with other medical and social issues, and face declining access to medical services in Flawai'i, HIHAF is the only place to come for support. HIHAF's case managers are often the only people that HIV-positive individuals on this island know and trust; They are sensitive professionals who navigate the cornplications that HIV brings to the body and soul. In order to best serve the needs of our clients. a written service plan is developed cooperatively by the case manager arra the client. The service plan identifies client needs, defines the specific goals and objectives that address identified needs, and lists the action steps required to accomplish the client's stated goals and objectives- The service plan is developed and implemented within two weeks following the intake of a new client and then updated quarterly or more, frequently, if necessary, until the client is dv5charged. [between service plan updates, clients are contacted at least once a month to monitor [heir 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 tirnes per week. A minirrrum of one hundred and fifty (1 0) service plans will be developed or revised daring the upcoming I'Y.'006-2000 grant period in the Cast Hawaii office. A similar arnount will be cornpletc::d iri the West Hawaii office. Case management is ensured through schedules that make service delivery possible, consistent, and amenable to clients' needs. T he agency's doors are always open to clients, Monday through Friday, 8 00 a -m. to 4iOQ p.rrt. Staff frequently visit clients in their homes, in hospital, and outside of both horne and office, if that is what is necessary to help clients engage in their own care. The Client Service Facilitaior responsible solely for the delivery of support services, ineauding food hank, foot deliwnies, transportation, volunteers, rand clerical kJONPRO t'(,RANTAPPLICA"9I0IN V&;'tiCAL YEAR 2008-09 Pare 6 support. In 2008 the Foundation created a new position: Care Coordinator. This individual provides program administrative oversight and program supervision for care staff, quarterly reports for all funders, job counseling, staff training, and crisis intervention. This individual works directly with the care teams and is supervised by the Executive Director. Volunteers assist clients with online searches, distribution of food, clerical assistance, and helping clients shop in the food pantry. HIHAF provides invaluable support to HIV-infected individuals in keeping their loved ones free of HIV. Primary HIV prevention is based upon a culturally appropriate harm reduction methodology. When a new client begins their relationship with HIHAF, we take care to assess the relationships they have and activities they undertake that might put others at risk for HIV infection. Case managers either provide such interventions themselves or make referrals to the HIV Foundation - Hilo's prevention department. Case managers also offer anonymous HIV. -antibody counseling and testing for family members and significant others. Evaluation: Ouantitative 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 FY2008-2009 currently project that a total of twenty- six (26) separate case management services will be individually provided for 150 to 190 clients living with HIV/AIDS. Services include, but are riot limited to, intake, assessment, treatment advocacy, benefits counseling, volunteer referrals, hospital and home-, visits. medical liaison, crisis intervention, emergency financial assistance, (rousing assistance=., horne care arid transportation. Quantitative Analysis: Data collection consists of counting the number of written service plans that are developed or revised each quarter. Computer reports indicating nurnber 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 successltal. The service component is also considered successful if ninety percent (901%) of clients have a medical care provider and adhore to their ticafnuent routine-. Qualitative Analysis: A client satisfaction survey is mailed to ail 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 tederal granting organizations. Lastly, in the; last year, ! IIHAF underwent an organizational assessment arid review. Through this process, we carne to understand some of our weaknesses arid strengths, and have been able to revise some of our practices and the structure of our organization, including the Care Coordinator referred to hereinabove. The a ssessrnent process was extremely helpful in understanding NONE 'ltOtrl'I' (>IZAN'I' Al'ilI,l('A'I'ION MCAL VELAR 2008-919 Page 7 how to better Our organization and continue to be best prepared for our future and the growing number of HIV+ clients we expect to see. Total Budget and Position Count Total Proe�ram Budget 402,589 Total Program Posrtiorn Count 3 0 Total Agency Budget 1,406,512 Total Agency Positron Count 16 Program Objectives 1) Objective One: By June 30, 2008, and wither twenty-five (25) days following a determination of need, identify and secure appropriate financial resources to pay health insurance prerniums for no less than ninety percent (90%) of all PLWHA whose access to high quality primary care, ancillary health care and specialty medical care would otherwise be in jeopardy. 2) Objective Two: By June 30, 2008 and within twenty-five days following a determination of need, assist no less than ninety percent (90%) of all eligible PLWHA who request or demonstrate a need for substance misuse treatment, mental health counseling, oral health care, HIV-related medication, food and/or transportation assistance to obtain such goods and services through appropriate referrals and practical support. 3) Objective Three: By June 30, 2008 and within 'twenty-five days following a determination of need, forestall homelessness by providing financial support and/or housing relocation assistance for no less than ninety percent (90%) of all eligible PLWHA requesting or demonstrating a need for ernergency shelter, or either short-term or long-term shelter or housing assistance. 4) Objective Four. By June 30, 2008 offer HIV preventive education and/or anonymous HIV --antibody counseling and testing services to seventy --five (7;i) at -risk individuals. In addition, the HIV Foundation - Hilo shall provide the types and levels of case management related supportive :cervices for its consumers, listed below. Benefits assessment/counseling Progressive case notes Health care assessment/counseling Medical treatment referrals Housing assessments Legal document: assistance Funeral/estate coordination Housing assistance Legal advocacy assistance Nutritional assessment/counseling Mental health assessment/counseling NtDlVhI2ONT GRANT Client family counseling Crisis intervention Field /office visits Home visits Intake/assessments Financial benefits Generic assistance/counseling Fleaith care benefits Client monitoring/assessment Fisk assessment/counseling Service coordination APPLICATION FISCAL 'S FAR20118-09 Page 8 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 2008-2009. The services listed above represent baseline service projections. Client -centered Outcome(s): A mirrrimurn of one hundred fifty (150) clients and their families will access critical services including medical, financial, social, care givers, legal, nutritional, etc. through the HIV Foundation - Hilo's case management and volunteer team. At least ninety percent (90%) of clients will secure a primary care physician and remain in medical treatment. Procgrain Highlights: 1) To date during 1=Y 2006-2007, medical case management services included one hundred eighty-six (186) clients receiving medical assessment, patient education, treatment advice, nutrition, medical liaison, dental liaison. 2) As of December 2007, 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. 3) There are only 3 people on the waiting list for subsidized housing 4) The number of hospital visits during this fiscal year has dropped 15% 5) Addition of a care coordinator has created a smooth, more seamless experience: for all clients. 6) Ie ONPdgOHT GRANTAPPLICATION LICA'I ION F #SCAL YEAR 2008-09 Page 9 Hawaii Island HIV/AIDS Foundation - Agency Name Multi -Disciplinary HIV Case;: Management, Holo _ Prograrn Namo Performances Measures: Number of types of case management services provided Number of clients receiving case: management services Risk Behavior Asse ssment, Counseling and L_ducation [W Counseling and Tc j 1 `If applicable=. FY 2006.07 FY 2007.08 ActraaB Budget - 26 2.6 150 150 I 250 — j 250 FY 2008-09 Estimate __._ 27 160 1 250 - Program Expenditure 5 FY 2006-07 FY 2007-08 FY 2008-09 Actual * Budget * Estimate Salaries andWNes X140,181.00 170286.00 -$1-70-,-286 00 Professional Fees $3,500.00 ! 2,480.00 2,480.00 operations 5221,135.00 1 229 823.00 229,823.00 Equipment 0 0 Q 'Other" 0 0 0 TOW �— $304,816.00 422 589.00 402,589.00 'It appkcalbe "'Ploase erplam in detail on separate Sheet hlONPL OPI[T BdR ANT /APL"d.p4'r4"r'ION FISCAL YEAR 2008-09 )" ge 10 Hawai'i Island HIV/AIDS Foundation - Agency Name Multi -Disciplinary HIV Case Management, Hilo - Program Name Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source County of Hawaii Department of Health ('-Vve have been informed that this amount may be reduced by 5% in March 2OO8) AIDS Community Care Team (***The federal government has restricted sorne of these funds and ' we may experience a cut in these funds as well.) Medicaid Waiver United Way Housing - Special Projects of National Significance Private Foundations Donations/ Fundraising FY 2O06-07 FY 1007-Ot3 FY 2.008-09 Actual ` Budget* Estimate $15000_00 $?01000.00 $20,000.00 $201,000.00 201,000.00 $201,000.00 $63,OOO.00I $74,000.00 74,000.00 $11000.00 N/A N/A -$5000.0 - 5000.00 10 000 00 10 000.00 UWO.00 15,000.00 15,000.00 $20000.00 40,000 00 40 000.00 $48000M $50,000 00 $50,000.00 Explain wheat 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 epidermic shows no sign of ending, and indeed continues to grow. There is often a misrepresentation of facts about HIP epidermic in the media, indicating a lessening of urgency in dealing with this epidemic. The fact is, there are still a rninimum of 43,000 new cases in the US each year, and half of these new infections occur through heterosexual transmission and in the age group of 15-23 year -colds. Each newly infected individual presents with a myriad of challenges to be met and overcome. PdONI'NtQTd�'N'l' FISCAL FEAR ?08016-09 Pave t I Because the epidemic continues to grow, we do not see a specific point at which our program might become self-sustaining. We are, however, looking at development of various income producing businesses which could help to support the activities of our non-profit. We have received level or decreasing funding from our main revenue source, the State of Hawaii Department of Health, for the last 15 years. During this time, the number of people we are caring for has more than doubled, and may well double again over the next 15 years. In addition, our clients live longer now because of the availability of new drug treatments. Ihis is wonderful in that it allows those who are infected to continue as productive members of society. Simultaneously, it also raisers challenges for us as a foundation to continue to support their productivity. We are the only FIIVIAIC)S services organization in I lawai'i County providing these vital care and prevention services. We are currently still working to develop an affiliated for-profit business, whose profits would help sustain our foundation. For now, we are very grateful that we have this support from the County, and we want to thank you for this opportunity to apply to you for funding. N1bIVl'L2OItITC RA.NT APPLICATION FISCAL. YEAR 2008-09 Iage12 Hawai'i 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; gram conditions; award procedures, and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 — 2-142.2, Hawaii County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public; according to Chapter 92F, Hawai'i Revised Statutes. If awarded a grant from the County of Hawai'i, I (we) understand and will comply with the requirement to submit a year-end report to the Legislative auditor within 60 days after June 30 of the fiscal year. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawai'i grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely, complete, and accurate year-end report will impact the evaluation of your program's or agency's future funding requests. Date Dat ,-------7-- UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NON fl'1iOVIT GRAINT AV PLICATION FISCAL YEAR 20041-09 Page 13 Hawai'i Island HIV/AIDS Foundation- Agency Name Transmission Prevention for HIV+ Women in West Hawai'i County- Program Name Agency Director: 331-13177 Contact Person: 331-8177 Mailing address: Facility/:Mite Address Fax No,: Email Address: Georgie Kennedy Georgie Kennedy Phone No.: 808 - Fa TISTITWIll1: 75-240 Nani Kailua Dr., # 5, Kailua-Kona, 1-11 96740 75-240 Nani Kailua Dr., # 5, Kailua-Kona, HI 96740 331-0762 georgie@0hihaf.org Name of Accountant/CPA (include name of firm if applicable): James 1). Jennings, GPA, Inc. Phone No.: 808-942-£3813 Mailing Address: 1600 Kapiolani Blvd., Suite 730 Honolulu, 11196814 Amount of Request too, County Funds:. $20,000.00 Prior'Year(s) Funding: 05-06 06-07 07-08 $10,000 $10,000 $15,000 Agency Mission statement: NON PROFIT CRANT AIvPLICATION Fl,"WAI, YEAR 2008-09 Page I The Hawaii Island HIV/AIDS Foundation is a non-profit organization dedicated to assisting those affected by HIV/AIDS to maximize their quality of life, and to ending the spread of HIV. We also utilize the lessons learned in the HIV epidemic to care and advocate for others in the fight against related diseases. Our vision is to build a healthier, stronger, and more sustainable community that supports all its members with a focus on HIV issues. We are an IRS -designated 501(c)(3) tax-exempt non-profit organization that provides care services for People Living With HIV/AIDS (PLWHA), and provides HIV prevention and education of the residents of Hawaii County. HIHAF has been providing services to people at risk for, infected with, and affected by HIV/AIDS, since 1986. Our Foundation has an efficient and effective system to provide a comprehensive corniinuum 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 1-lawai'i State Department of Health, Hawai'i Gounty has the highest number of AIDS cases outside of Oahu, with 13% of all AIDS cases reported in the state since the beginning of the epidemic coming from the Island of Hawai' i. The number of people with HIV/AIDS climbs steadily upward every year of the epidermic. In the US alone, there are 43,000 new cases of HIV every year. Currently, we know that half of all these new infections occur through heterosexual transmission, putting wornen at a very high risk of HIV infection. As can be: assumed, the proportion of cases diagnosed in women has been increasing steadily over time, and we have little reason to believe it will decrease anytime soon. This is a distressing increase: in infection arrrong women The female population in other US and global cornrnunities continue to bear the brunt of new I-II\/ infections. Women's rights are often compromised within relationships and, due to gender imbalances within relationships, women continue to be more vulnerable to HIV infection than men. Our foundation believes in upholding a strong focus ori prevention programming, and specifically targeting wonren and populations vuInerablr_> to HIV infection. Through working with HIV-positive women and addressing their behaviors and empowering them tfuough education and prevention activities, we plan to continue contributing strongly to stopping the spread of HIV and AIDS. Women living with t IN face additional challenges, as They must prevent Uansrmitting HIV to riot only their partners, but 9x7 their infants as well. -this year, one of our HIV+ female clients began a relationship with an HIV- negative man after a decade of being single. She came to her case manager at I IIf iAF to discuss how to begin a sexual relationship and not put her partner at risk. Her partner also met with our case rnanager, who facilitated open, honest, and informative discus:.ions with the couple. -ITrey learned about safer sex skills NONPRO FIT (.RAN' AITLIC'AI'ION FiSCAI, VE AR 20013-09 Page 2 and are comfortable discussing any issues with the case manager, to ensure a happy and healthy relationship. Also this year, HIHAF was called upon to help two of our HIV-positive female clients deliver HIV-negative babies. This required significant interventions on the part of our Case Management Team. They not only found interpretors to facilitate Doctor's visits for one pregnant our non-English speaking client, but coordinated all services, from preparing for Cesaerean-section delivery to working with the hospital to ensure they would have the necessary medications available for the baby post -partum. Additionally, we continue to experience cuts in the State of Flawai'i Department of Health funding allocated to HIV/AIDS prevention services on all islands. This is reflected in our Program Expenditures and Program Funding Sources tables. We also continue to do our very hest, as ever, to provide the highest quality of services to our clients, regardless of the dec ceases in funding available to us. 1NONI'I40hI"I' (,'I3AN'�' APPLI('A'I'ION FISCAL YEAR 2008-09 Page 3 Hawai'i Island HIV/AIDS Foundation - Agency Name Transmission Prevention for HIV+ Women in West Hawaii County-. Prograrn Name Program Description: The Hawaii Island I1IV/AIDS Foundation - Kona is proposing to continue funding for tine HIV transmission prevention programs for all HIV+ women in West Hawai'i County, including individual and group protocols and counseling and testing of women at risk. This program is designed to STOP HIV at the source, with individuals who can transmit the disease to others. This program also provides early treatment for newly diagnosed HIV positive worsen, 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 recent addition to women's prevention services is the SISTA Project, "Sisters Informing Sisters about Topics on AIDS". This program is directed to local worsen at high risk for infection and transmission of HIV, and is an in-depth behavioral change program. Our Women's Outreach Specialist leads a social skills training intervention, airned at reducing IIIV sexual risk behavior among minority women who are at highest risk for HIV and other sexually transmitted dis(, ases. This includes worsen who experience poverty, drug addiction, violence; and sexual abuse. The project consists of 'rive once. -a -week two-hour sessions, and includes a sixth, "booster" session one month after the: women graduate at the fifth session. PVlc:ast of the woman participating are referred to the program from other local agencies and organizations serving community needs. To dratc, all SISTA series that have been undertaken have been extremely well received, with very positive feedback for the; program facilitator as well as Hil-IAF. 1/Ve include thaw SIS -IA Project in this application because it is inshurm,iltal in helping us reach won -ren who may already be HIV poi,itive: to get the.rn tested and into care services, as well as providing the type of behavior change training that has been accepted by the U.S. Cent( --s for I:)iscoase Control and Prevention as tfre most caffactive. .total Budget and Position Count NONPROFIT GRANT APPLICATION F1SCA L YEA14 2008-09 Page 4 Total Prorarra Budget $59,196 00 total Prog nram Position Count 3 0 - - -- — - Total Agecy Budget { $1,408 512] Total Agency Positron Count 16 Program Objectives: 1) Review each HIV+ woman's transmission prevention service plan in first month of program, and/or initiate new transmission prevention plan for newly infected women. (Estimated 28 women, 1-2 hours per client.) 2) Refer women to appropriate providers if needed, i.e. mental health providers, substance abuse providers, etc. within the first month. These providers can deal with some of the behaviors which place these women at risk of transmitting this disease. These professional counseling sessions are paid for by other funding sources, 3) Initiate transmission prevention protocol (estimated 28 clients, 1 hour each) in the first session, then quarterly, as needed when problems arise. 4) Document progress and adherence to transmission prevention protocol with input from client each quarter (28). Ei) Monthly support group for HIV+ women dealing with self-esteem, negotiation, sexual issues, transmission prevention. 6) R ferral 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 twenty (20) women during first halt of funding year 2.008-2009. 2.) Referred women to specialized care for health and/or prevention issues daring 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., rase of condorns or other protection during all sexual encounters.) ti) Twenty-five (25%) percent of participants have reported compliance 90% of the: time to (Jate, with the goal of 100% compliance by the end of the year. 7) Ninety (90%) percent of participants are documented lo have benefited from tire prograrn by maintenance of good health, increased self-esteem, and ability to interact with sexual partners in a sale mariner, thereby decreasing the probability of sexual transmission. FISCAL YEAR 2008-09 F3) As of December 2007, zero transmission of HIV by any participants ill the prograrn. No hospitalizations, stable health, and maintenance of employment. 9) A total of IIsi women of unknown HIV infection status have: participated in the SISTA Project training sessions. NON 111140 I I CRAMT PitTIR'AVV ION FISCAL YVAR'2098-09 Page, _ Hawai'i Island HIV/AIDS Foundation - Agency Name Transmission Prevention for HIVE- Women in Nest Hawai'i County .. Program Name Performance Measures: FY 2006-07 FY 2007-09 FY 2009-09 Actual * Budget * Estimate Individual transmission prevention 150 175 175 session (assessment FY 2006-07 FY 2007-08 I 1-Y 2009-09 session)_ Actual ' -i ---85 - hlealth/prcvention plan review 1 42 85 quarterly Professional Fees -0- QuarterlyIndividual transmission 41 85 85 prevention sessions (1 hr. eac i) 20196.00 20,196.00 Equipment. Review and documentation of 42 85 85 program quarterly $4,000 00 4 000.00 4,000.00 SISTA Project participation 13 60 60 `If applicable - — - Program Expenditures FY 2006-07 FY 2007-08 I 1-Y 2009-09 Actual ' Budget - Estimate Salaries and Waqes 1 $20,000.00 35,000-00 35,000.00 Professional Fees -0- Operation, - $15,19100 20196.00 20,196.00 Equipment. 0 0 0 Other'— $4,000 00 4 000.00 4,000.00 total $39,192.00 59196.00 59,196.00 If applicable " Please explain in detail oo separate sheet NONPROFIT CHANT APPLICATION FISCAL YEAR 2008-09 Page Hawai'i Island HIV/AIDS Foundation - Agency Name Transmission prevention for HIV+ Women in West Hawaii County - Program Name Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source 1 FY 20014.07 FY 2007-09 FY 2008-09 Actual n - - budget* Estimate state of Hawaii Prevention, 33% %12,500.00 11,00()l 11,000 Women only (1/2 for Kona) Hawaii Island United Way Fundraising $9,692.0O County of Hawai'I $15,000.00 Life Poundution/cD( (SISTA) 15,000 15,000 20,000 2.0,000 20,000 20,000 total 66,000 66,000 '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? Unfortunately, the HIV/AIDS epidemic shows no sign of ending, and indeed continues to grow. Often, there is a misrepresentation of tacts about the epidemic in the rnedia. The fact is, there are still people becoming infected, regardless of the rate at which that happens. And each newly infected individual presents with a myriad of challenges to be rnet and overcome. Because the epidemic continues to grow, we do not see a specific, point at which our program for prevention might becorne self-sustaining. I he more people who becorne infected, the greater the possibility of new eases of the disease. We have received level w decreasing funding from our main revenue source, the State of Hawaii Department of Health, for the: last 15 years. During this time, the number of peoples we are testing and counseling and are caring for has more than doubled, and may well double again over the next 15 years. In addition, our clients live longer now because of the availability of new drug treatments. This is NOINPROIATCHAN1 APPLICATION PI 'A'A I, V EAR 2008-09 Page 8 wonderful in that it allows those who are infected to continue as productive members of society. But it also raises additional challenges for us as a foundation to continue to support them in their productivity. We have gone through an assessment and are reorganizing our Foundation to put us into a position where we can perhaps create an "income: producing" arm of this Foundation or a for profit Foundation to help support the programs of HIHAF. 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. NON PROFFUG AZA NTAPPLICATION MCA <. YEAR 2008-09 Page °) Hawai'i 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 2.5, Sections 2-135 -- 2-142.2, Hawai'i County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shalt be rrrade public according to Chapter 92F, Hawaii Revised Statutes. If awarded a grant from the County of Hawaii, I (we) understand and will comply with the requirement to submit a year-end report to the Legislative auditor within 60 days after June 30 of the fiscal year. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawaii grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely, complete, and accurate year-end report will impact the evaluation of your program's or agency's future funding requests. 10 Sig%ature of Board Pipsjdent/C.hair t7ate i Signature of r ,utiv it ctor afe UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPI8O#q'l' 6s1�AN'll' Al'I'k.IC'A.'I'iON HSCAL YEAR e008-09 Page 10 The Island of Hawaii YMCA- Agency Name YOUTH SERVICES - Program Name Agency Director: Contact Person: 935-3721 Mailing Address: Wayne Kamitaki, CVO Phone No.: 885-5034 Facility/Site Address St. Hilo, Hawaii 96720 Kailua-Kona, Hawaii 96740 Bobby Stivers P.O. Box 7067 Kamuela, HI 96743 Phone No.: Hilo - Waiakaea Settlement YMCA 300 W. Lanikaula Kona - Kona Family YMCA 74-5605 Pawai Place, Waimea - Waimae Family YMCA P.O. Box 2998 Kamuela, Hawaii 96743 Fax No.: 887-1861 Email Address: ymca-stivers@hawaii.rr.com Name of Accountant/CPA (include name of firm if applicable): Ann Fukuhara, An Accountancy Corporation Phone No.: 961-5532 Mailing Address: 714 Kanoelehua Ave. P.O. Box 6691 Hilo, HI 96721 Amount of Request for County Funds: $60,000 Prior Year(s) Funding: NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 1 05-06 06-07 07-08 $0 $35,000 $50,000 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 practice through programs that build healthy spirit, mind and body for all." YMCA Theme: YMCA. We build strong kids, strong families, strong communities. YMCA Core Values: We teach and demonstrate caring, respect, responsibility and honesty. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 2 The Island of Hawaii YMCA - Agency Name YOUTH SERVICES - Program Name Program Description: The Island of Hawaii YMCA Youth Services program is designed to provide a spectrum of positive, safe, child centered, developmental appropriate activities in Hilo, Kona and Waimea as a basis to prevent youth from being involved in high risk behaviors sucha s drugs, alcohol, sex and violence. The YMCA since its beginning in 1844 has always developed character in its members. Today, the YMCA teaches and demonstrates its core values of caring, respect, responsibility and honesty in all its programs. Adult volunteers and staff are screened and recruited with these values in mind and serve as postive role models for the youth they serve. The YMCA will extend its services to the communities of Hilo, Kona and Waimea. Youth in these communities are at risk and providing positive experiences with adult role models will reduce the likelyhood of these youth being involved in high risk behaviors. In Hilo, the YMCA will provide services to a new youth group designed to promote cultural understanding and appreciation through polynesian dance and music. The group is composed for youth ages 6 to 17 year olds and adults. The YMCA provide support with educational and cultural supplies to advance the promotion of cultural activities. The Waimea Family YMCA and the Kona Family Family YMCAs will continue to provide servcies for children and youth through its afterschool, summer and intersession programs. YMCA programs are tools used to develop the fullest potential of each youth. Programs directed by trained, caring and nurturing adult role models will be implemented in these communities. Program activities are offered throughtout the year, including intersession breaks, summer and weekends. Leadership development including decision-making, communications, leadership skills are just some of the on-going learning experiences. Team games, youth sports, cultural music and dances , arts & crafts, field trips are just additional activities for the youth. Total Budget and Position Count Total Program Budget 1,035,615 Total Program Position Count Total Agency Budget 2-525.183 1 Total Agency Position Count NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 3 Program Objectives: 1) Develop self confidence, self worth and self esteem. 2) Develop personal skills, talents and abilities. 3) Develop social skills through group work. 4) Increase self esteem through community service. 5) Increase -making. last friendships. 6) Increase sense of empowerment. 7) Increase understanding of inter -culture and inter -national understanding. 8) Increase sense of positive values. 9) Youth asset surveys will be administered, parent satification surveys administered.. Program Highlights: 1. Community of Hilo. Establish a school year round YMCA After-school program for youth K to 6 grade, establish a Saturday morning youth sports program. During the summer, establish an summer day camp program. 2) Community of North Kona: Establish a school year youth sports after school program and Saturday morning youths sports program at Kahakai Elementary School. Integrate summer with the YMCA's summer day camp program. 3) Community of North Kohala. Establish an arts .& humanities school year afterschool and weekend program. To include drama, dance and music. YMCA facilties, supplies, equipment and van transportation will be made available. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 4 The Island of Hawai'i YMCA - Agency Name Youth Services - Program Name Performance Measures: FY 2006-07 FY 2007-08 FY 2008-09 Actual * Budget* Estimate if aoolicable Program Expenditures * If applicable ' Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 5 FY 2006-07 Actual * FY 2007-08 Budget * FY 2008-09 Estimate Salaries and Wages 648,505 665,429 733,010 Professional Fees 950 Operations 220,248 240,483 302,605 Equipment Other` Total 1 869,703 905,912 1,035,615 * If applicable ' Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 5 The Island of Hawai'i YMCA - Agency Name Youth Services - Program Name Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2006-07 Actual * FY 2007-08 Budget * FY 2008-09 Estimate County of Hawai'i 35,000 50,000 60,000 Program Fees 627,323 628,390 885,415 Donations 2,225 6,500 29,830 Total 664,548 684,890 975,245 *If applicable Explain what plans, if any, your agency and/or program has to increase revenues to support this program. When do you anticipate your program to become self-sustaining? NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 6 The Island of Hawaii YMCA - Agency Name YOUTH SERVICES - Program Name I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 — 2-142.2, Hawai'i County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that 1 (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawai'i Revised Statutes. If awarded a grant from the County of Hawai'i, I (we) understand and will comply with the requirement to submit a year-end report to the Legislative auditor within 60 days after June 30 of the fiscal year. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawai'l grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely, complete, an agency's future funding requests. U --)c tc- .-- Signature of Board President/Chair C Signature of Exec tive Director Date Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 7 Ka Hale O Na Keiki Inc.- Agency Name Families- At- Risk- Program Name Agency Director: Pua Colburn Phone No.: 775-9870 Contact Person: Kathy Oshiro Phone No.: 775-9473 Mailing Address: 45-3668 Honokaa-Waipio Rd Honokaa, HI 96727 Facility/Site Address: same Fax No.: 775-9870 Email Address: gso@kona.net Name of Accountant/CPA (include name of firm if applicable): Hoolaea Andrade; Andrade Accounting Services Phone No.: 775-1319 Mailing Address: 46-1068 Kinimaka Street Honokaa, HI 96727 Amount of Request for County Funds: $5000, Prior Year(s) Funding: 05-06 06-07 07-08 $3000 $ 3000 $ 4000 Agency Mission Statement: At Ka Hale O Na Keiki it is our mission to help children develop a lifelong love of learning through a program that encourages freedom, individualism, and creativity. Our carefully prepared environment provides children with an opportunity to explore their surroundings, challenge their thoughts, and enjoy and love the people and world around them. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 1 Through a positive interaction among the children's developmental characteristics, their school, practices, family, and community, children will be ready to have successful learning experiences that will last throughout their lifetime. Above all, our children come first. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 2 Ka Hale O Na Keiki, Inc. - Agency Name Families -At -Risk- Program Name Program Description: Ka Hale O Na Keiki is not 'just another preschool", but a community organization that serves and meets multiple needs for the people of the entire area. 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 learning, as well as provide them, and their families, with basic health and nutritional information and referrals. We promote positive social behavior and conflict resolution, as well as actively engage parents in their children's 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, and/or the inability to timely access community and human services. They are therefore at risk of being unable to take care of their basic needs and those of their nuclear family. It is 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. With no other preschool in our area, and two day-care homes closing last year, young children of the Hamakua Coast risk delayed brain development if Ka Hale 0 Na Keiki Preschool is forced to close. "Study after study has shown the benefits of a quality preschool experience. Children who attend preschool enter kindergarten ready to learn. They later have better test scores in reading and math. And, they are less likely to be involved in crime as adults and less likely to become pregnant as teenagers." (Honolulu Advertiser, 12/19/01). Additionally, over 90% of a child's brain development occurs before the age of five. 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. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 3 Our school's positive stimulation of children's brains during these critical first years lays the foundation for the child's future ability to learn, develop language skills, and interact with others. 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 Early Childhood Education (ECE) program can actually prevent illegal drug usage in the future, because we teach these children, at a very early age, how to appropriately handle conflict resolution, and we give them good self esteem, If we are to break the cycle of drug abuse in our community, we must begin taking preventative action now, and intervene at the preschool - age level. Our community, our island, and our state also benefit, as it is estimated that for every $1 invested in high-quality ECE programs the public will save $7 in costs like remedial education, welfare, and incarceration. Children who attend high-quality Early Childhood Education programs are more successful in later life and more productive than their peers who did not attend. Studies, as well, are showing that children with access to quality programs demonstrate higher I.Q.'s, high school graduation rates, and greater 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. We understand and acknowledge the scarcity of County funds, and sympathize with the Council's difficult budgetary task. We truly believe that the County's continuing investment now in the Families -At -Risk Project will save the County ten -fold in future rehabilitation costs. Total Budget and Position Count Total Program Budget 51 000.00 Total Program Position Count 6 J Total Agency Budget 281,922.65 Total Agency Position Count 8 Program Objectives: 1) Make available care and educational services to at -risk families and their children between the hours of 2:30 and 5:30 pm daily. 2) Provide high-quality care and educational services to children of at -risk families of the under -serviced Hamakua Coast. 3) Provide monthly scholarship/tuition assistance to at -risk families. 4) Pursue other funding sources for the Families -At -Risk Project, to insure that the Project, and the school, will prevail. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 4 5) Maintain a developmentally appropriate learning environment among all students, ensuring progress in social, emotional, cognitive, language, and physical development. 6) Increase the parenting skills, and the understanding of the developmental and educational needs of children of the at -risk parents we serve. 7) Recognize the need for, and provide referral services for children of at -risk families who may need treatment for known or suspected health, psychological or developmental problems. 8) Have the Families -At -Risk Program become financially self-sufficient, no longer a financial drain on the Day Program Program Highlights: 1) Remained open for the at -risk families until 5:30 pm daily, including during, monthly holidays, holiday breaks, and Summer. 2) Provided a developmentally appropriate, high-quality childcare and educational facility to the working poor of the Hamakua Coast. 3) Continued our National Accreditation standing, insuring that we are providing the best available care and education to our at -risk children, plus allowing us to obtain additional income from the State. 4) Offered scholarship/tuition assistance to families using the Families -At - Risk Project, to all who requested assistance (none were turned away). 5) Provided five jobs in our local community, in order to operate the Families - At -Risk Project. 6) Referred four at -risk children, and their families, to special services counseling, to meet their special needs, as identified by our teaching staff. 7) Succeeded in keeping our budget for the Project low, within reason, and affordable to the families we serve while being able to increase our services to them 8) Insure that all children on the Hamakua Coast were made available to them a quality preschool education and care, regardless of the family's ability to pay, and that these children in fact will be ready to learn, and ultimately ready for life by reaching his or her own full potential NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 5 Ka Hale O Na Keiki Inc. - Agency Name Families -At -Risk - Program Name Performance Measures: *If applicable Program Expenditures FY 2006-07 Actual * FY 2007-08 FY 2008-09 Budget* Estimate Total Enrollment 37 37 36 Children Enrolled 2:30-5:30 Families -At -Risk Project 27 29 30 Families receiving financial assistance from Ka Hale O Na Keiki for; the Families -At -Risk Project 27 29 30 9100 Equipment 3100 3500 4700 Other" Total 45550 45950 51000 *If applicable Program Expenditures * If applicable s Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 6 FY 2006-07 Actual * FY 2007-08 Budget * FY 2008-09 Estimate Salaries and Wages 28750 31500 34650 Professional Fees 5900 2450 2550 Operations 7800 8500 9100 Equipment 3100 3500 4700 Other" Total 45550 45950 51000 * If applicable s Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 6 Ka Hale O Na Keiki Inc. - Agency Name Families -At -Risk - Program Name Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2006-07 Actual * FY 2007-08 Budget * FY 2008-09 Estimate Payment from families for Families- At -Risk program 16200 16800 13020 Donations/Funraisers 500 500 1780 County of Hawaii Grant 3000 7800 5000 Young Bros. Grant 1000 1000 0 Friends of Hawaii Charities 1500 1500 1700 Wilcox Foundation 1000 10001 2000 Frear Trust 1500 1500 0 Mclnerny Foundation 1000 0 7500 State of Hawaii Poverty ECE Program 9000 10000 15000 Day Program payment from families' portion allocated to Families -At -Risk Project 9350 4350 3000 Hard Foundation 1500 1500 2000 Total 45550 1 45950 51000 *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? Critical to our receiving increased operations funds from the State, and from the Mclnerny Founcation, is our maintaining our National Accreditation status excellence care and educational program (even though this places great financial demands on our budget as staffing qualifications are now higher, requiring a budget for increased wages and benefits, playground safety measures, etc.) Additionally, we must continue to serve poverty families to receive increased operation funds from the State, which obviously prohibits us from charging too high of monthly rates from families. We have found it impossible to further increase parential contributions due to grave financial hardship to the poverty families we serve. Our program is one that we were told "could not be done". We were told that our isolated community did not have the economic base to afford an early childhood center, and that our area could not provide the qualified NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 7 teaching staff to run such a program. But, we have successfully done all this for eight years. With two preschools closing in Waimea, and two day care centers closing in Honokaa, all within the last year, it is an obvious indication that what we are trying to do (provide quality care and education to our youngest citizens) is not a financial windfall. But, the need, and the desire is there, and we are doing it. We are simply asking the County for their continued support for a few more years to help these children who are in desperate need. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 8 Ka Hale O Na Keiki Inc. - Agency Name Families -At -Risk - Program Name I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 — 2-142.2, Hawai'i County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawai'i Revised Statutes. If awarded a grant from the County of Hawaii, I (we) understand and will comply with the requirement to submit a year-end report to the Legislative auditor within 60 days after June 30 of the fiscal year. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawaii grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely, complete, an Signature of Board President/Chair ATU v Signature of Executive Director /1iG/2mr Date �. 116 /2© , nZ— Date' UNSIGNED PROPOSALS WILL NOT BE ACCEPTEDI NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 9 Kapi'olani Medical Center For Women & Children Kapi'olani Child Protection Center -West Hawaii Title IV -B -West HI Counseling & Supportive Living Project Agency Director: Willow Morton - KMCWC Vice President Dr. Steven Choy — KCPC Program Director Phone No.: 1-888-535-7790 Contact Person: Steven J. Choy, Ph.D. Phone No.: 1-888-535-7790 Mailing Address: Hawaii Pacific Health Research Institute Attn. Allison Lopes 55 Merchant Street — 26`h Floor Honolulu, HI 96813 Facility/Site Address: 74-5599 Luhia Street - #E7 Kailua-Kona, HI 96740 Fax No.: 329-8628 (Kona) 1-888-535-8820 (Honolulu) Email Address: stevenc@kapiolani.org Name of Accountant/CPA (include name of firm if applicable) Ernst & Young, LLP Phone No: (808) 531-2037 Mailing Address: 2400 Pauahi Tower 1001 Bishop Street Honolulu, Hawaii 96813-3429 Amount of Request for County funds: $10,000 Prior Year Funding: 05-06 06-07 07-08 $5,000 $5,000 $10,000 Agency Mission Statement: The mission of the Kapi'olani Child Protection Center is to protect children and strengthen families. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page I Kapi'olani Medical Center For Women & Children Kapi'olani Child Protection Center -West Hawaii Title IV -13 -West HI Counseling & Supportive Living Project Proaram Description: The Title IV -13 Counseling and Supportive Living Project provides assessment, counseling, service linkage and coordination, educational and supportive services to assist West Hawaii families at risk of child abuse and neglect. This program is part of the Kapi'olani Child Protection Center — a Statewide Center whose mission is to protect children and strengthen families. Priority for services is given to families at risk due to substance abuse (85% of referrals). Special priority is given to families who have or are in the process of adopting or otherwise providing a permanent home for children who have been harmed. Services are provided by KCPC-WH staff and by staff of other organizations through subcontracts with KCPC. The array of services includes, crisis intervention, individual, couple and family counseling, anger management counseling and classes, substance abuse counseling, parenting and life skills education, assistance with supportive living and other adjunct supportive services as needed by family members. The program is funded through a Federal Grant and requires matching funds from the State and from the provider. During the 2006-2007 Fiscal Year, KCPC embarked on a collaborative training program with UC -Davis Medical Center to provide the KCPC-WH Therapists with the capacity to provide Parent -Child Interactive Therapy (PCIT) to its client population. KCPC is now the only provider of this empirically -supported practice in the State of Hawaii. This form of therapy has been shown to have a dramatic, long-lasting positive effect on families struggling with changing the behaviors and relational styles that led to their neglectful and abusive parenting. Staff began providing this service to a small group of West Hawaii families in FY06-07 and continued this service in FY07-08. It will continue to make this service available to increasing numbers of families in FY08-09 provided KCPC receives adequate funding from the Hawaii County Grant, and HIUW. About 10 years ago, KCPC initiated a Foster Care Mentoring program for youth in foster care on the island of Oahu. This program provides training for older youth in the foster care system so that they can become peer mentors to younger youth who are just beginning their foster care experience. The mentors and mentees participate in monthly recreational and service activities in their community. It has been a phenomenally successful program that now serves some 19 mentor-mentee pairs. KCPC has formalized its mentor training program and initiated replication of this program for foster youth on the Big Island in FY 07-08. It will continue to provide and expand this service if there is adequate funding from the Hawaii County Grant, and HIUW. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 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 In FY07-08, KCPC began a new adult mentoring program to support individuals who have successfully completed residential treatment or an independent living program and are then ready to transition back into community life. This can be a precarious time for these clients, as their treatment demands often don't allow them to maintain stable employment and housing. As they come out of such treatment settings, they need to obtain housing, employment and still tend to their recovery and outpatient treatment goals. They can benefit greatly at such times from peer support. The mentor understands and has successfully navigated the exact challenges the mentee has to face. The mentors, in both the Transitional Living Mentoring Program and the previously mentioned Foster Care Mentoring Program, also gain a sense of enhanced self-worth as they contribute positively to others lives. This service will continue to be available provided there is adequate funding from the Hawaii County Grant and HIUW. Total Budget and Position Count Total Program Budget $375,000 Total Program Position Count 4.5 Total Agency Budget $2,526,523 Total Agency Position Count 20 "Statewide Services Program Obiectives: 1) Improve child safety by reducing child abuse/neglect risk factors 2) Improve child safety by increasing child protective factors Program Highlights: During FY2007 the following performance measures were obtained: 1) Provided services to 154 families, 240 adults and 327 children. 2) Received Permanency Planning Assistance — 4 families. 3) Completed all services - 62% of individuals served. 4) Reduced CAIN risks — 89% of caregivers who completed services. 5) Had no new CPS report within 6 months after case closure — 100% of families who completed services. 6) Had no new CPS report within 1 year after case closure — 100% of families who completed services NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 3 Kapi'olani Medical Center For Women & Children Kapi'olani Child Protection Center -West Hawaii Title IV -B -West HI Counseling & Supportive Living Project Performance Measures: *If applicable NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 4 FY 2006-07 FY 2007-08 FY 2008-09 Actual * Budget * Estimate Individuals Completing Service Plan 80% 80% 80% Individuals completing service plan who have established and implemented a 95% 95% 95% child safety plan at closure. Families completing Service Plan who have no new confirmed report of child abuse or 90% 90% 90% neglect at 6 -month follow-up Families completing Service Plan who have no new confirmed report of child abuse or 90% 90% 90% neglect at 1 year follow-up Families participating in the Parent -Child Interaction Therapy will achieve CDI N/A 75% 75% relational skill mastery. Mentor-Mentee Pairs Trained and participated in Recreational/Service NIA 90% 90% activities. *If applicable NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 4 Kapi'olani Medical Center For Women & Children Kapi'olani Child Protection Center -West Hawaii Title IV -B -West HI Counseling & Supportive Living Project Proaram Expenditures Proaram Fundina Sources Revenue Source FY 2006-07 Actual* FY 2006-07 Actual * FY 2007-08 Budget * FY 2008-09 Estimate Salaries and Wages 279,671 268,492 268,492 Professional Fees Walk $0 $3,000 $3,000 -Charity HI County Grant $5,000 87,393 109,508 109,508 -Operations -Equipment 0 0 0 Other Indirect Cost 16,000 16,000 16,000 Total 383,064 394,000 394,000 Proaram Fundina Sources Revenue Source FY 2006-07 Actual* FY 2007-08 Budget* FY 2008-09 Estimate Title IV -B Federal Grant $357,065 $360,000 $360,000 HIUW $5,000 $5,000 $5,000 Walk $0 $3,000 $3,000 -Charity HI County Grant $5,000 $10,000 $10,000 KMCWC Matching Indirect Write-off 16,000 16,000 16,000 Total $383,064 $394,000 $394,000 *If applicable Explain what plan, if any, your agency and/or program has to increase revenues to support this program. When do you anticipate your program to be self-sustaining? KCPC-West Hawaii will continue to seek donations and grants to provide the necessary matching funds to obtain the federal grant to continue to provide these very vital services for West Hawaii residents. The County grant has provided some of the matching funds that allow our program to obtain the federal funds. Without the matching funds, we will be unable to obtain the federal funds that are the major support for the program's services. KCPC-WH will need to continue to obtain matching funds and will need to continue to seek grants and donations to support this program. The IVB program can't be fully self-sustaining due to the requirements of matching funds. The KMCWC Matching Indirect write-off is In - Kind matching that doesn't actually reduce direct expenditures and thus is not real revenues but required to obtain federal funds. Donations, HIUW and the Hawaii County Grants will be needed to fund other KCPC West Hawaii Programs that did not receive full funding. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 5 Kapi'olani Medical Center For Women & Children Kapi'olani Child Protection Center -West Hawaii Title IV -B -West Hl Counseling & Supportive Living Project I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 — 2-142.2, Hawai'i County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawai'i Revised Statutes. If awarded a grant from the County of Hawai`!, I (we) understand and will comply with the requirement to submit a year-end report to the Legislative auditor within 60 days after June 30 of the fiscal year. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawal'! 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. Willow Morton KMCWC Vice President W Steven J. Choy, Ph.D. KCPC Director /%d Q �- Date 111 vY Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 6 Ke Anuenue Area Health Education Center- Agency Name Community Health Education- Program Name Agency Director: Nicole Moore Phone No.: 808.935.8658 Contact Person: Nicole Moore Phone No.: 808.935.8658 Mailing Address: 1028 Kino'ole St., #101 Hilo, HI 96720 Facility/Site Address: 1028 Kino'ole St., #101 Hilo, HI 96720 Fax No.: 808.933.1890 Email Address: nicole@keanuenue.org Name of Accountant/CPA (include name of firm if applicable): Carbonaro CPA's & Management Group Phone No.: 808.242.5002 Mailing Address: 1885 Main St., Suite 408 Wailuku, HI 96793 Amount of Request for County Funds: $54,114 Prior Year(s) Funding: 05-06 06-07 07-08 $253,530.14 $195,244.63 $110,000 Agency Mission Statement: Ke Anuenue AHEC's mission is to improve the health of the underserved through education by: supporting health profession students who participate in rural rotations on neighbor islands; visiting intermediate and high school students to introduce them to the opportunities of health careers; collaborating with community members and agencies to provide youths interested in health careers a hands-on experience in health care settings or at learning events; and providing health education for rural community members. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 1 Ke Anuenue Area Health Education Center - Agency Name Community Health Education- Program Name Program Description: A. MASH Camp: Medical Academy of Science and Health (MASH) Camp is an interactive activity that places middle to high school youth directly in a health collaborate with the health care facilities in Hawai'i County: Hilo Medical Center; Ka`u Hospital; Kona Community Hospital; Kohala Hospital; and Hale Ho`ola Hamakua, to administer 13 MASH Camps for 16 intermediate and high school students per camp, totaling 208 students who go through the program. Each medical facility develops a two day seminar/workshop schedule that includes interactive, hands-on activities related to each department that the students visit. There will be a pre- and post-test administered to see if they have developed a deeper understanding of the different health care providers. An evaluation form will also be completed by the students so that we can implement changes necessary to make the experience more meaningful. A month after the MASH Camp a smaller scaled event will take place, one day, with longer visits to the top three departments that the students indicated on their evaluation forms, which interested them. A letter will be mailed to the students inviting them to this smaller event to encourage and support them in making a choice in a future career. We will also be contacting the students throughout the year to continue to provide support and encouragement. We will also be able to track the students who are seniors in high school and note their progress in applying to college and upon their decision assist with finding a mentor in their chosen field, a nursing student or a medical student who can provide suggestions to assist in obtaining a degree in the health field. B. LifeskillsTM_ Is a diabetes self-management training class that provides the tools to make important lifestyle changes. Funding for this program was given to Ke Anuenue from the East Hawai'i Independent Physicians Association to purchase the LifeskillsTM curriculum and to hire a part-time Diabetes Education Program Coordinator, Doris Yamanoha. Lifeskills is a four class series with each class lasting two hours of instructional time. Working with the referring doctor at the beginning of the program, a baseline is established for each participant: weight, A1C and other labs, and medications at the onset of the classes. 1. Session 1: Diabetes Overview; Medications — insulin, diabetes pills, and other medications. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 2 2. Session 2: Nutrition — Dietary goals, major nutrients, food and blood sugar, meal planning, carbohydrate counting, appropriate smacks, use of alcohol, dining and special occasions. 3. Session 3: Exercise and Diabetes; blood sugar monitoring to achieve better control; hemoglobin A1C & other labs; sick day rules. 4. Session 4: High and low blood sugars; stress management; long range concerns — foot care, eye, heart, kidney, and other nerve problems; current research. Each session has a pre- and post- test for the measures to complete, this a shy ession. Fo ow up is made three months after completing the class to see if there were changes in weight, A1C and other labs, and changes in the medication types and/or dosage. A database was developed to track participant's progress as recommended by the American Diabetes Association. Currently, two classes a week, each class have eight participants and their interested family members or caregivers are being conducted. Ke Anuenue seeks reimbursement by billing insurance companies as a continued effort toward sustainability; HMSA so far, is the only participating company. Participants attending these classes without HMSA are not turned away, but are also not reimbursable. Funding levels over the next four years will be decreasing by $10,000 each year. In order to maintain this program, a charge will need to be assessed for non-HMSA participants. A similar program was initiated in Kona with a fee of $40 per class. There have been no participants. In polling the graduates from the first two classes, all were favorable to a $20 fee. The actual cost for the class is $40 per person, including instructional materials, class preparation and instructional time. Large portions of the population who have diabetes are also those who cannot afford to pay $20 or $40 a class, but they would be the ones who benefit the most from these classes. We are seeking options to assist in defraying the cost to these people without jeopardizing our program. Total Budget and Position Count Total Program Bud et 54,114 Total Program Position Count 4 Total Agency Bud et 111,000 Total Agency Position Count 4 Program Objectives: A. MASH Camp — Increase the number of activities that introduce intermediate and high school students to health careers. B. Lifeskills — Increase the number of participants unable to attend Lifeskills classes because of lack of health insurance. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 3 Program Highlights: A. MASH Camp — The two day event at the hospital where the students have the opportunity to see, do, and understand how the different areas of the health field plays a part in the over all health care of an individual and a community. Please see attached article from Hawaii Tribune -Herald. B. Lifeskills — When participants of the class become excited because they can see how their new knowledge attects their health directly, we Know that we are helping to make a difference in people's life. Here are some of the comments that we have received during the follow-up interviews with participants: "My blood sugar went down from 8.1 to 7.1 — I'm happy.!" "My A1C is down 5.8 —1 understand my diabetes better." "My A1C is doing much better— I can't wait to see my next labs!" "This class is the best — it really helped me very much. My sugars are really going down and my doctor brought down my meds and insulin. I am really happy with this class. I hope (more) people can come to this class and learn like I did to improve their diabetes. I'm very thankful for being in this class." NONPROFIT GRANT APPLICATION FISCAL YEAR 2005-09 Page 4 Ke Anuenue Area Health Education Center - Agency Name Community Health Education - Program Name Performance Measures: If applicable Program Expenditures FY 2006-07 FY 2007-08 FY 2008-09 Actual * Budget* Estimate i es i s Salaries and Wages MASH Camp 1,000 8,000 Professional Fees 0 0 Operations 24,261 30,000 -Equipment Other" Total $54,114 $75,000 If applicable Program Expenditures * If applicable ° Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 5 FY 2006-07 FY 2007-08 Actual * Budget* FY 2008-09 Estimate Salaries and Wages $29,853. $35,000 Professional Fees 0 0 Operations 24,261 30,000 -Equipment Other" Total $54,114 $75,000 * If applicable ° Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 5 Ke Anuenue Area Health Education Center - Agency Name Community Health Education - Program Name Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2006-07 FY 2007-08 FY 2008-09 Actual * Budaet * Estimate East Hawaii IPA - Lifeskills .amn _ . Arai Total *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? LifeskillsTm is a reimbursable diabetes education program and we are working to qualify for reimbursement from third party insurance companies like Medicaid, Medicare and Aloha Care. We hope to have contracts in place within a year. These reimbursements will assist with program costs. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 6 - Agency Name - Program Name I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 — 2-142.2, Hawai'i County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawai'i Revised Statutes. If awarded a grant from the County of Hawa!'i, I (we) understand and will comply with the requirement to submit a year-end report to the Legislative auditor within 60 days after June 30 of the fiscal year. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawai'i grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely, complete, and accurate year-end report will impact the evaluation of your program's or agency's future funding requests. Si ature of Boar resident/Chair Signature of Executive Director 0t13ol�g Date 0L/��� Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 5 KEAUKAHA ONE YOUTH DEVELOPMENT - Agency Name Youth Development - Program Name Agency Director: Mike Divinski Phone No. Contact Person: Mike Divinski Phone No. Mailing Address: 101 Aupuni Street, Suite 124 Hilo, Hawaii 96720 Facility/Site Address: Bayfront Hilo, Hawaii Fax No.: 935-3945 Email Address: HiloMichael@aol.com 935-5866 935-5866 Name of Accountant/CPA (include name of firm if applicable): Brian M. Iwawta Taketa, Iwata, Hara & Associates, LLC Phone No.: 935-5404 Mailing Address: 101 Aupuni Street, Suite 139 Hilo, Hawaii 96720 Amount of Request for County Funds: $ 11,500.00 Prior Year(s) Funding: 05-06 06-07 07-08 $ 0 $ 0 $ 10,000 NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page I Agency Mission Statement: General scope of the Public Charity activities for Keaukaha One Youth Development is to provide native cultural opportunities for local youth to reconnect with the historic ocean experiences here in Hawaii. The purpose of this reconnection is to provide healthy alternatives to local youth in order to steer them awayy from potential increasing drug use and other unhealthy lifestyle activites. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 2 KEAUKAHA ONE YOUTH DEVELOPMENT - Agency Name Youth Development - Program Name Program Description: The specific purpose is to reconnect children in the County of Hawaii with Hawaiian cultural heritage related to ocean activities. Total Budget and Position Count Total Program Bud et$11,500.00 Total Program Position Count 0 Total Agency Budget 1 $11,500.00 Total Agency Position Count 0 See Note below. Program Objectives: 1) The program (1) stresses physical fitness; (2) provides instructional use and maintenance of canoes; (3) strives for perfection of swimming skills; (4) provides training in physical fitness at Keaukaha Gym; and (5) provides the use of Hawaiian canoes and volunteer coaching to minor children. The charity strives to coordinate these activities with local schools. Program Highlights: 2) The date of inception of this program was August 23, 2006. Highlights to date include the acquisition of five one-man canoes which are currently being used for training/paddling by those involved with the charity and an instructional program in the refitting of a Hawaiian canoe has taken place. One year in the regatta program has also taken place. This is our second county request. We are hopeful that the request for funds is approved so that we can purchase a one-man canoe trailer, cross -training equipment for the youth in Keaukaha, and one or two additional one-man canoes, if available. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 3 KEAUKAHA ONE YOUTH DEVELOPMENT - Agency Name Youth Development - Program Name Performance Measures: FY 2006-07 FY 2007-08 FY 2008-09 Actual * Budget * Estimate See above. *If anolicable Program Expenditures FY 2006-07 FY 2007-08 Actual * Budget * FY 2008-09 Estimate Salaries and Wages Professional Fees Operations Equipment n/a $ 10,000.00 $ 11,500.00 Other" Total * If applicable "Please explain in detail on separate sheet *Equipment includes: (1) one-man canoe trailer (2) two new one-man canoes (3) Youth cross -training equipment NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 4 KEAUKAHA ONE YOUTH DEVELOPMENT - Agency Name Youth Development - Program Name Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2006-07 FY 2007-08 Actual * Budget * FY 2008-09 Estimate County of Hawaii n/a $10,000 $11,500 Total *If applicable Explain what plans, if any, your agency and/or program has to increase revenues to support this program. When do you anticipate your program to become self-sustaining? This program relies on contributions from the public and private sector in conjunction with fund-raising activity. We strive for community s upport, to spread the word of the accomplishments of the youth, to garner interest from the community at large and benefactors to subsidize our cause of cultural development and physical well being. Our aspiration is to become a self- sustaining program. 'Keaukaha One has a grant application pending for $30,000 with the County of Hawaii for youth demonstration program on a Hawaiian racing canoe restoration. There has been no disbursal to date. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 5 KEAUKAHA ONE YOUTH DEVELOPMEMT - Agency Name Youth Development - Program Name I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 — 2-142.2, Hawaii County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawai'i Revised Statutes. If awarded a grant from the County of Hawaii, I (we) understand and will comply with the requirement to submit a year-end report to the Legislative auditor within 60 days after June 30 of the fiscal year. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawaii grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely, complete, and accurate year-end report will impact the evaluation of your program's. or agency's future funding requests. Signature of Board President/Chair Signature of Executive Director Date 1-92-06 Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTED NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 6 Kokua Counseling Services — Agency Name Client Assistance Fund — Program Name Agency Director: Pat Merrill Phone No.: 935-0222 (office) Contact Name: Jerry or Pat Merrill Phone No.: 934-0940 (home) Mailing Address: P. O. Box 10397 Hilo, HI 96721 Facility/Site Address: 243 Ululani Street Hilo, HI 96720 Fax No.: 935-0222 Email Address: kcs(Shawaii.rr.com Name of Accountant/CPA (include name of firm if applicable): Janet W. Hara, CPA, MBA Taketa, Iwata, Hara & Associates, LLC Phone No.: 935-5405 Mailing Address: 101 Aupuni St., Suite 139, Hilo, HI 96720 Amount of Request for County Funds: $10,000 Prior Year(s) Funding: 05-06 06-07 07-08 00.00 00.00 $15,000 Agency Mission Statement: Kokua's primary mission is to provide confidential therapy and counseling services, which are respectful and affordable; to a broad demographic of individuals, couples and families and; to offer educational programs designed to foster positive and enriching relationships that improve the quality of life by assisting individuals in reaching their own personal mental health goals.. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 1 Kokua Counseling Services — Agency Name Client Assistance Fund — Program Name Program Description: Kokua Counseling Services provides affordable professional counseling, therapy and education for East Hawaii residents who face difficult life situations including conflicts in family and marriage life, employment and job dissatisfaction, depression, anxiety, substance abuse, financial distress, loss and grief, major life decisions and anger management. Our services integrate the insights from behavioral sciences with the wisdom of religious traditions to understand and work with persons seeking wholeness of body, mind, and spirit. All services are sensitive to the particular beliefs and cultures of clients. The Client Assistance Fund provides subsidized low-cost or no -cost counseling services to individuals, couples and families who have no health insurance, restrictive health insurance, and/or limited financial resources. The Assistance Fund enables Kokua Counseling Services (KCS) to provide low-cost, affordable counseling services for clients in need while adequately compensating its professional staff. KCS staff clinicians — two clinical social workers and one marriage and family therapist — are certified by the National Association of Social Workers and the American Association for Marriage and Family Therapy, respectively, and are licensed by the State of Hawaii. Approximately 30-40% of all clients served by KCS require "gap group' subsidized services. Total Budget and Position Count: Program Objectives: 1) Insure that no client in need of professional counseling services is turned away due to an inability to pay fees. KCS fee schedules begin as low as $25 per session, a considerable savings over standard professional rates. When clients cannot pay even reduced rates, the Client Assistance Fund is used to subsidize services. Unlike many publicly funded nonprofit agencies that require specific admission criteria for mental health services, KCS has no admission criteria. Its services are available to anyone who believes they can benefit from counseling. Its Client Assistance Fund assures that no one "falls through the cracks" due to eligibility criteria or inability to pay. 2) Provide services to clients with no health insurance to assure that successful therapeutic and life outcomes are achieved. According to the "Quality of Life' report issued by Aloha United Way, 12% of Hawaii County residents are medically uninsured. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 2 Total Program Total Program Budget $15,000 Position Count 3 Total Agency Total Agency Budget $$119,500 Position Count 4 Program Objectives: 1) Insure that no client in need of professional counseling services is turned away due to an inability to pay fees. KCS fee schedules begin as low as $25 per session, a considerable savings over standard professional rates. When clients cannot pay even reduced rates, the Client Assistance Fund is used to subsidize services. Unlike many publicly funded nonprofit agencies that require specific admission criteria for mental health services, KCS has no admission criteria. Its services are available to anyone who believes they can benefit from counseling. Its Client Assistance Fund assures that no one "falls through the cracks" due to eligibility criteria or inability to pay. 2) Provide services to clients with no health insurance to assure that successful therapeutic and life outcomes are achieved. According to the "Quality of Life' report issued by Aloha United Way, 12% of Hawaii County residents are medically uninsured. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 2 Kokua Counseling Services — Agency Name Client Assistance Fund — Program Name 3) Provide services to clients with limited or inadequate health insurance to assure that successful therapeutic and life outcomes are achieved. Where health insurance policies limit eligibility for mental health services and/or the number of sessions reimbursed by insurance is insufficient to fulfill healthy outcomes, the Client Assistance Fund is used to supplement insurance coverage. 4) Expand service delivery to clients referred by other area agencies — e.g., YMCA, Salvation Army, Care Hawaii — and expand outreach, networking and collaborative partnerships with other behavioral health agencies in Hawaii County. 5) Establish performance measures to (a) record the actual number of clients requiring assistance from the Client Assistance Fund; (b) calculate the number of financially assisted clients as a percentage of the total number of KCS clients; and (c) administer pre- and post- counseling surveys to assess the ability of clients to function well within his/her family and community. Program Highlights: 1) During its first year of operation (January -December, 2006), the Client Assistance Fund partially or fully subsidized counseling services for 34% of all KCS clients. During its second year of operation (January -December, 2007), the Client Assistance Fund partially or fully subsidized counseling services for 21% of all new KCS clients. 2) The Client Assistance Fund enabled many clients to achieve personal health goals and improve their marriage and family relationships. Performance Measures: NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 3 FY 2006-07 FY 2007-08 FY 2008-09 Actual' Bud et` Estimate` No. of uninsured Provide professional clinical and clients served by 6 10 family/marriage counseling to 10-15 Kokua's Client clients who require subsidized services Assessment Fund through the Client Assistance Fund No. of underinsured Provide professional counseling to 8 - clients served by 4 8 12 clients who lack sufficient health Kokua's Client insurance benefits to fulfill treatment Assistance Fund modalities and healthy outcomes Total no. of clients Record the number of clients needing served by Kokua's 10 18 assistance from the Client Assistance Client Assistance Fund and calculate the number of such Fund financially assisted clients as a per- centage of the total number of clients Total number of Record the number of client sessions client sessions 89 160 for which the Client Assistance Fund covered by Client was used Assistance Fund (continued) NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 3 Information applicable to all KCS clients: FY 2006-07 Actual* FY 2007-08 Bud et* (continued) Total no. of new $6,250.00 $8,000.00 Expand outreach, networking and clients served via 52 65 referral to public and nonprofit outreach and referral $4,550.00 $15,000.00 agencies to provide services to 70+ Equipment $1,000.00 $5,000.00 new clients annually Pre- and post- $15,000.00 $10,000.00 Administer pre- and post- counseling counseling surveys 74 90 surveys to assess the ability of clients (all clients) $66,350.00 $71,000.00 to function well within his/her family and community *Budget year is January 1 — December 31 Program Expenditures: *Budget year is January 1 — December 31 #Please explain in detail on separate sheet Note: 'KCS counselors are contract (not salaried) clinicians; accordingly, client services subsidized by the Client Assistance Fund are shown as "Operations" expenditures. Program Funding Sources: identify all funding sources (specific to this program only) Revenue Source FY 2006-07 Actual* FY 2007-08 Bud et* FY 2008-09 Estimate* Salaries and Wages $6,250.00 $8,000.00 $9,000.00 Professional Fees $1,650.00 $2,000.00 $2,500.00 Operations' $4,550.00 $15,000.00 $18,000.00 Equipment $1,000.00 $5,000.00 $6,000.00 Other# $15,000.00 $10,000.00 $10,000.00 Total $4,550.00 $15,000.00 $18,000.00 *Budget year is January 1 — December 31 #Please explain in detail on separate sheet Note: 'KCS counselors are contract (not salaried) clinicians; accordingly, client services subsidized by the Client Assistance Fund are shown as "Operations" expenditures. Program Funding Sources: identify all funding sources (specific to this program only) Revenue Source FY 2006-07 Actual* FY 2007-08 Budget* FY 2008-09 Estimate* Donations+ $6,250.00 $8,000.00 $9,000.00 -Corporate Church Donations+ $1,650.00 $2,000.00 $2,500.00 Jerry and Pat Merrill+ $7,500.00 $1,000.00 $1,000.00 Other Contributions+ $1,000.00 $5,000.00 $6,000.00 of Hawaii Grant++ $15,000.00 $10,000.00 $10,000.00 -County Other Grants+ $34,950.00 $45,000.00 $50,000.00 Total $66,350.00 $71,000.00 $78,500.00 *Budget year is January 2 — December 31 + A source of additional Client Assistance Funds, if needed. ++Entire amount goes into Client Assistance Fund. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 4 Kokua Counseling Services — Agency Client Assistance Fund — 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? In its first year of operation KCS successfully applied for inclusion in the Compassion Capital Fellows Program (CCFP) jointly administered by the UH Manoa Center on the Family, Hawaii Community Foundation and Hawaii Islands Ministries. Through the CCFP, KCS received two organizational "capacity -building" grants totaling $30,000. These grants provided a one-year training program for two KCS board members and funded the preparation of an "Infrastructure Assessment in Preparation for Major Gift Development' by Solid Concepts, Inc. in Honolulu on behalf of KCS. It should be noted that no funds from the CCFP grants could be applied to the KCS operating budget or Client Assistance Fund. The second CCFP grant enabled KCS to contract with a Big Island -based consultant who expanded on the work done by Solid Concepts. In 2008, KCS will implement its fund development/marketing plan to generate income streams from public and corporate donations, foundation grants, and special events. A percentage of any income received will be placed in the Client Assistance Fund. Award of a County human services grant will provide critical funding in support of our services to low-income citizens in East Hawaii while we undertake these steps to become self-sustaining. Unless action is taken at the federal or state level, there will continue to be residents of Hawaii County who do not have any health insurance or have very limited mental health coverage. Therefore, viewed as a separate entity, the Client Assistance Fund will likely never be self-sustaining. KCS is, however, working toward the establishment of an Operational Endowment Fund which will ensure ongoing revenue for the overall function of the agency. NONPROFIT GRANT APPLICATION FISCAL YEAR 2007-08 5 - Agency Name - Program Name I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 — 2-142.2, Hawai'i County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawai'i Revised Statutes. If awarded a grant from the County of Hawaii, I (we) understand and will comply with the requirement to submit a year-end report to the Legislative auditor within 60 days after June 30 of the fiscal year. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawaii grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely, complete, an Signature of Execu+ !Xr r Adolm;svravor Z3% 2 Dat 0 Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTEDI NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 5 Kokua Counseling Services — Agency Name Service Area Expansion — Program Name Agency Director: Pat Merrill Phone No.: 935-0222 (office) Contact Name: Jerry or Pat Merrill Phone No.: 934-0940 (home) Mailing Address: P. O. Box 10397 Hilo, HI 96721 Facility/Site Address: 243 Ululani Street Hilo, HI 96720 Fax No.: 935-0222 Email Address: kcs(cDhawaii.rr.com Name of Accountant/CPA (include name of firm if applicable): Janet W. Hara, CPA, MBA Taketa, Iwata, Hara & Associates, LLC Phone No.: 935-5405 Mailing Address: 101 Aupuni St., Suite 139, Hilo, HI 96720 Amount of Request for County Funds: $15,000 Prior Year(s) Funding: 05-06 $0 06-07 $0 Agency Mission Statement: 07-08 $0 Kokua's primary mission is to provide confidential therapy and counseling services, which are respectful and affordable; to a broad demographic of individuals, couples and families and; to offer educational programs designed to foster positive and enriching relationships that improve the quality of life by assisting individuals in reaching their own personal mental health goals.. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 1 Kokua Counseling Services — Agency Name Service Area Expansion — Program Name Program Description: Kokua Counseling Services provides affordable professional counseling, therapy and education for East Hawaii residents who face difficult life situations including conflicts in family and marriage life, employment and job dissatisfaction, depression, anxiety, substance abuse, financial distress, loss and grief, major life decisions and anger management. Our services integrate the insights from behavioral sciences with the wisdom of religious traditions to understand and work with persons seeking wholeness of body, mind, and spirit. All services are sensitive to the particular beliefs and cultures of clients. In its first year of operation (January 1 — December 31, 2006), KCS saw 42 clients in 210 sessions. In its second year of operation (January 1 — December 31, 2007), those numbers had increased to 74 clients in 461 clinical sessions. This dramatic rise confirms the need for affordable, professional counseling services to residents of East Hawaii. This increase in the number of clients served required a move to a larger facility in order to accommodate three therapists. All clients are currently served at the KCS office located at 342 Ululani Street in Hilo. A review of client demographic data, however, reveals a high percentage of clients residing in outlying communities, in particular the Puna District. Transportation is a major concern for many residents of outlying areas. The long-range goal of KCS is to provide services island -wide (preferably at locations convenient for the clients), however, the most pressing need is establish a satellite office in the Puna District, most likely in Keaau or Pahoa. All clients served by KCS are eligible for the KCS Client Assistance Fund which provides a financial subsidy of all or a portion of counseling fees. This enables KCS to provide services to anyone in need, even if the client has no health insurance or is underinsured. Total Budget and Position Count: Total Program Budget $25,000 Total Program Position 3 Count Total Agency Budget $119,500 Total Agency Position 4 Count Program Objectives: 1) Make counseling services more readily available to residents of the Puna District. (The Puna District ranks the lowest of any district in the state on nearly all economic and social indicators.) Puna clients would be eligible for financial support through the Client Assistance Fund whose objectives are contained in Nos. 4-6 of this section. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 2 Kokua Counseling Services — Agency Name Service Area Expansion — Program Name 2) Collect demographic data on all KCS clients to include area of residency to determine the district most in need of convenient counseling services. 3) Expand service delivery to clients referred by other area agencies — e.g., YMCA, Salvation Army, Care Hawaii — and expand outreach, networking and collaborative partnerships with other behavioral health agencies in Hawaii County. 4) Insure that no client in need of professional counseling services is turned away due to an inability to pay fees. KCS fee schedules begin as low as $25 per session, a considerable savings over standard professional rates. When clients cannot pay even reduced rates, the Client Assistance Fund is used to subsidize services. Unlike many publicly funded nonprofit agencies that require specific admission criteria for mental health services, KCS has no admission criteria. Its services are available to anyone who believes they can benefit from counseling. Its Client Assistance Fund assures that no one "falls through the cracks' due to eligibility criteria or inability to pay. 5) Provide services to clients with limited or inadequate health insurance to assure that successful therapeutic and life outcomes are achieved. Where health insurance policies limit eligibility for mental health services and/or the number of sessions reimbursed by insurance is insufficient to fulfill healthy outcomes, the Client Assistance Fund is used to supplement insurance coverage. 6) Establish performance measures to (1) record the actual number of clients requiring assistance from the Client Assistance Fund; (2) calculate the number of financially assisted clients as a percentage of the total number of KCS clients; and (3) administer pre- and post- counseling surveys to assess the ability of clients to function well within his/her family and community. Program Highlights: 1) The establishment of a Puna office will enable KCS to provide services to area residents without requiring the lengthy and expensive round-trip to Hilo. Since transportation is a major concern of those residing in outlying areas, it is anticipated that individuals in need will be more likely to seek counseling services. The need for such services is indicated by the fact that the Puna District ranks the lowest of any district in Hawaii County on nearly all economic and social indicators. 2) The present three -clinician staff of KCS location fills the present location. A continuing increase in the number of clients will require a move to a larger facility, however, the establishment of a satellite location will allow KCS additional time in which to identify and arrange such a move. 3) In partnership with another nonprofit, KCS has made arrangements for part-time use of offices in Waimea and Kona. Thus an office in the Puna area is the priority. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 3 Kokua Counseling Services — Agency Name Service Area Expansion — Program Name Performance Measures: *Budget year is January 1 — December 31 Program Expenditures: FY 2006-07 FY 2007-08 FY 2008-09 Salaries and Actual* Budget* Estimate No. of KCS clients 0.00 0.00 Track demographic information who reside in 17 25 about KCS clients to include district districts other than 0.00 0.00 of residency Hilo 0.00 $1,000.00 $6,000.00 No. of KCS clients 0.00 $5,000.00 Compile data to determine if Kea'au or who reside in Puna 17 25 Pahoa location would better serve KCS District clients Pre- and post- Administer pre- and post- counseling counseling surveys 74 90 surveys to assess the ability of clients (all clients) to function well within his/her family and community No. of hours of Expand staffing hours of marriage & operation at a 0 300 family therapist and add a Puna satellite office location to the KCS Ululani Street office where personal and family counseling sessions may be conducted *Budget year is January 1 — December 31 Program Expenditures: *Budget year is January 1 — December 31 #Please explain in detail on separate sheet Note: 'KCS counselors are contract (not salaried) clinicians; accordingly, client services are shown as "Operations" expenditures. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 4 FY 2006-07 Actual* FY 2007-08 Budget* FY 2008-09 Estimate Salaries and 0.00 0.00 0.00 -Wages Professional Fees 0.00 0.00 0.00 Operations' 0.00 $4,000.00 $14,000.00 Equipment 0.00 0.00 $5,000.00 Other# Rent 0.00 $1,000.00 $6,000.00 Total 0.00 $5,000.00 $25,000.00 *Budget year is January 1 — December 31 #Please explain in detail on separate sheet Note: 'KCS counselors are contract (not salaried) clinicians; accordingly, client services are shown as "Operations" expenditures. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 4 Kokua Counselinq Services — Agency Name Service Area Expansion — Program Name Program Funding Sources: identify all funding sources (specific to this program only) Revenue Source FY 2006-07 Actual* FY 2007-08 Budget* FY 2008-09 Estimate* Foundation Grants 0.00 $2,000.00 $2,000.00 of Hawaii 0.00 $15,000.00 -County Insurance Reimbursement $1,000.00 $8,000.00 Total $5,000.00 $25,000.00 `Budget year is January 2 - December 31 Explain what plans, if any, your agency and/or program has to increase revenues to support this program. When do you anticipate your program to become self-sustaining? In its first year of operation KCS successfully applied for inclusion in the Compassion Capital Fellows Program (CCFP) jointly administered by the UH Manoa Center on the Family, Hawaii Community Foundation and Hawaii Islands Ministries. Through the CCFP, KCS received two organizational "capacity -building" grants totaling $30,000. These grants provided a one-year training program for two KCS board members and funded the preparation of an 'Infrastructure Assessment in Preparation for Major Gift Development" by Solid Concepts, Inc. in Honolulu on behalf of KCS. It should be noted that no funds from the CCFP grants could be applied to the KCS operating budget or Client Assistance Fund. The second CCFP grant enabled KCS to contract with a Big Island -based consultant who expanded on the work done by Solid Concepts. In 2008, KCS will implement its fund development/marketing plan to generate income streams from public and corporate donations, foundation grants, and special events. In February KCS will begin a direct mail campaign as part of its effort to establish an Operational Endowment Fund large enough to insure ongoing revenue for the overall function of the agency. Creation of such a fund will require five to ten years of aggressive fund development efforts. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 5 - Agency Name - Program Name I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 — 2-142.2, Hawai'i County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawaii Revised Statutes. If awarded a grant from the County of Hawaii, I (we) understand and will comply with the requirement to submit a year-end report to the Legislative auditor within 60 days after June 30 of the fiscal year. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawaii grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely, complete, and Signature of E-xacut v l ector AIencl 4 A Voiotsird'-1 Dat / G Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 5 KONA ADULT DAY CENTER, INC. ADULT DAY CARE Agency Director: Rowena L. Tiqui Phone No.: (808) 322-7977 Contact Person: Rowena L. Tiqui Phone No.: (808) 322-7977 Mailing Address: P O Box 1360 Kealakekua HI 96750 Facility/Site Address: 81-989 Halekii Street Kealakekua HI 96750 Fax No.: (808) 322-0614 Email Address: kadcrowenaahawaii.rr.com Name of Accountant/CPA (include name of firm if applicable): Ronald G. Hawks, CPA Phone No.: Mailing Address: (808)939-7392 P O Box 2030 Kealakekua HI 96750 Amount of Request for County Funds: $30,000.00 Prior Year(s) Funding: 05-06 06-07 07-08 $15,000.00 $15,000.00 $30,000.00 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 2008-09 Page 1 KONA ADULT DAY CARE, INC. 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 sclerosis and those who are socially isolated. Day care provides a less restrictive setting and a more cost effective program than other types of care, such as home nursing or institutionalization. Total Budget and Position Count Total Pro ram Budget 305790.4§1 Total Pro ram Position Count 6 Total Agency Budget 305790.40 1 Total Agency Position Count 6 Program Objectives: 1) Program Goals for Individuals a. Avoid premature or inappropriate institutionalization. b. The client will be able to associate with a place and a group corresponding with his/her own sense of identity. C. The client's maximum level of independence will be assessed through the individual program planning. d. Mentally and physically impaired adults will be maintained at 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 disables 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 and will be ensured. h. Isolation and prejudice often associated with frail and disabled adults will be reduced. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 2 2) Program Goals for Families and Other Caregivers a. Families that desire to keep elderly members in the home will be given relief for full-time care of an impaired adult. b. Family members will be enabled to continue productive careers instead of being homebound with an elderly, disabled spouse, parent or other family member. C. Families and other caregivers will be assured that elders dependent upon them are being cared for appropriately during the day. Program Highlights: 1) 2) 3) 4) 5) Participants continue to live at home for a minimum of 6 months with adult care services. Maintained or improved socialization skills of participants. Maintained or improved hygiene/self-care of participants. Surveyed caregivers, those expressed deep satisfaction Day Center. Had intergenerational interaction activities. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 3 with Kona Adult KONA ADULT DAY CARE, INC. Adult Day Care Performance Measures: FY 2006-07 FY 2007-08 FY 2008-09 Actual * Budget* Estimate Clients Served 45 55 60 *If aDnlicable Program Expenditures * If applicable " Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 4 FY 2006-07 Actual * FY 2007-08 Budget* FY 2008-09 Estimate Salaries and Wages 162,836.95 189,192.00 200,000.00 Professional Fees 9,366.27 4,140.00 4,200.00 133,587.18 150,408.00 160,000.00 -Operations -0- -0- -0- -Equipment Other" -0- -0- -0- Total 305,790.40 343,740.00 1 364,200.00 * If applicable " Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 4 KONA ADULT DAY CENTER, INC. Adult Day Care Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2006-07 Actual * FY 2007-08 Budget* FY 2008-09 Estimate DHS Pos Program 26042.41 28800.00 30000.00 DHS NHWW 38817.00 42000.00 45000.00 HCOA Service for Seniors 6120.00 6600.00 7000.00 County of Hawaii 15000.00 30000.00 30000.00 Gwenfreid All Trust 3820.00 0.00 0.00 Templeton Hopper 13410.00 30000.00 30000.00 -May HI Island United Way 15000.00 15000.00 15000.00 Other Grants 50857.42 10500.00 10000.00 Tuition 108429.00 109200.00 114000.00 Tuition Assistance 901.00 0.00 0.00 Fees 6620.00 8040.00 9000.00 -Transportation Fees 12096.16 12000.00 13000.00 -Bathing Intake Fees 420.00 600.00 700.00 Child/Adult Food Care Pro arm 11122.67 12600.00 13000.00 Fund Raising Donations 10265.29 5000.00 5000.00 Fund Raising Membership 3485.00 5000.00 5000.00 Special Events 0.0 0.00 0.00 -Fundraising Sales 12372.12 14000.00 15000.00 -Fundraising Administration Fees 3750.00 3000.00 3000.00 Interest/Dividends Income 1552.57 1400.00 1500.00 Unrealized Gain Loss 1301.46 0.00 0.00 Medical Supplies 0.00 0.00 0.00 Total 341382.10 343740.00 346200.00 *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 plan to increase client census to maximum 60. Tuition revenue will increase but so will staffing. Rates will increase. We will continue to seek out grants. We will better promote our annual fundraising campaign and our annual membership drive. Becoming self-sustaining is a constant goal. Reaching maximum client census will help to attain that goal. We will also depend on the continued support of our community. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 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, Hawai'i County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawai'i Revised Statutes. If awarded a grant from the County of Hawaii, I (we) understand and will comply with the requirement to submit a year-end report to the Legislative auditor within 60 days after June 30 of the fiscal year. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawaii grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely, complete, an Signature of Board Estela Halverson Signaturb of Executive Rowena L. Tiqui ov `_ P- 3 a00 Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTEDI NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 6 Kona Literacy Council- Agency Name Kailua Learning Center- Program Name Agency Director: Brenda Natina Phone No.: 329-1180 Contact Person: Brenda Natina Phone No.: 329-1180 Mailing Address: Facility/Site Address: Fax No.: Email Address: Kailua Learning Center 75-5766 Kuakini Highway 106A Kailua-Kona, HI 96740 Kailua Learning Center same 329-1180 konalit@msn.com Name of Accountant/CPA (include name of firm if applicable): None Phone No.: Mailing Address: Amount of Request for County Funds: $2,000 Prior Year(s) Funding: 05-06 06-07 07-08 $1,500 $1,500 $1,500 Agency Mission Statement: NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 1 The Kona Literacy Council's trained volunteer tutors help any adult increase their basic reading, writing, math, and communication skills to enable the learners to become better family members, workers, community members and lifelong learners. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 2 KONA LITERACY COUNCIL - Agency Name KAILUA LEARNING CENTER- Program Name Program Description: The Kona Literacy Council's trained volunteer tutors provide free, one-to-one, small group, and computer-assisted literacy services at the Kailua Learning Center to any adult who wants to improve their basic reading, writing, computation skills and computer literacy. Special programs designed to meet the specific needs of the learners are offered, such as: English as a Second Language, preparation for passing the GED or Competency Based High School Diploma, Citizenship preparation, keyboarding and computer literacy. All tutoring is at no cost to the student. All of the 572 students, who have had lessons at the Kailua Learning Center since it opened in September 1992, have made remarkable progress in their basic skills; some have gained their High School Equivalency Diploma, passed the Citizenship exam, and have gotten better jobs. Reading improves the adults' self-esteem, thereby improving their lives and becoming better family members, workers and community members. Total Budget and Position Count Total Program Budget $5,600 Total Program Position Count 7 Total Agency Budget $5,600 Total Agency Position Count 7 Program Objectives: 1) Continue to provide free one-to-one, small group and computer-assisted literacy services at the Kailua Learning Center to any adult who wants to improve their basic reading, writing, computation and computer literacy skills. 2) Register, schedule, match learner with tutor, and prepare programs for 12 new students for the year. 3) Continue recruiting and training new tutors. 4) Continue networking with community agencies to provide free literacy assistance to their clients, i.e. Department of Human Services, Department of Labor & Industrial Relations, Kona Community School for Adults, various Vocational Rehabilitation Programs, Bridgehouse, Alternatiaves to Violence, court ordered participants, Family Support Services of West Hawaii, Hawaii Community College and the public libraries. 5) Offer pre-employment skills, help in filling out application forms, resume writing and interview skills to enable our learners to get and hold jobs. 6) Improve family literacy services. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 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 newsletter three times a year. 10) Hold general membership and public meetings three times a year. 11) Continue writing grants, pursuing fund raising functions, and seeking donations to keep open the doors of the Kailua Learning Center. Program Highlights: 1) 2) 3) 4) 5) 6) 7) 8) 9) Tutored 7 basic literacy students. (includes reading, math & computer literacy) Tutored 7 English as a Second Language students. Left the program and attained employment: 3 students. Retained employment: 6 students. Studying for the citizenship test: 5 students. Entered other educational programs: 1 student. Increased involvement with children's education: 3 students Met goals: 8 students. Utilized 2 volunteer tutors, 4 auxiliary personnel, plus the Program Director. 10) Tutored 385 hours of actual tutoring. 11) Contributed aproximately 400 hours by volunteers in other areas. 12) Trained 1 new tutor. 13) Passed Citizenship Test: 2. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 4 Kona Literacy Council - Agency Name Kailua Learning Center - Program Name Performance Measures: 'If applicable Program Expenditures FY 2006-07 Actual*_ FY 2007-08 Budget* FY 2008-09 Estimate Tutored Adult Basic Ed. Students 7 10 9 Tutored ESL Students 7 12 10 Citizenship Students 5 0 3 New Tutors 2 3 3 Newsletters 3 3 3 Board & General Public Meetings 3 3 3 Total Tutoring Hours 385 550 500 Total Non -Tutoring Hours 450 500 500 'If applicable Program Expenditures If applicable ° Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 5 FY 2006-07 Actual * FY 2007-08 Budget* FY 2008-09 Estimate Salaries and Wages 0 0 6 - Professional Fees 0 0 0 Operations 4,493 5,100 4,700 Equipment 264 400 400 Other' Insurance 500 500 500 Total 5,257 6,000 5,600 If applicable ° Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 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 2006-07 Actual * FY 2007-08 Budget * FY 2008-09 Estimate County Grant 1,500 1,500 2,000 Membership Dues 40 50 50 Wal-Mart 0 250 250 Donations 545 2,000 1,000 Fundraising 0 500 500 Federal Campaign 730 700 800 Young Brothers 1,000 1,000 0 Kukio 0 0 1,000 Total 3,815 6,000 5,600 *If applicable Explain what plans, if any, your agency and/or program has to increase revenues to support this program. When do you anticipate your program to become self-sustaining? The Kona Literacy Council plans to participate in more fundraising and grant proposal writing. Since we do not charge our clients for our iteracy services, we will have to continue to rely on the generosity of our community supporters. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 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, Hawai'i County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawai'i Revised Statutes. If awarded a grant from the County of Hawai'i, I (we) understand and will comply with the requirement to submit a year-end report to the Legislative auditor within 60 days after June 30 of the fiscal year. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawai'i grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely, complete, and accurate year-end report will impact the evaluation of your program's or agency's future funding requests. XXIGAa47yla,,A Signatu a of Boa d Presid&i r Signature of Ex6cutive Director Z Dat / aU'V Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTEDI NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 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 Oshiiyama Ed. D. Phone No.: 935-7844 Mailing Address: 120 Keawe Street, Suite 203 Hilo, Hawai'i 96720 Facility/Site Address: 120 Keawe Street, Suite 203 Pacific Building Fax No.: 961-9727 Email Address: kuikahi_mediation@hawaiiantel.net Name of Accountant/CPA (include name of firm if applicable): Carbonaro CPAs Phone No.: 808-242-5002 Mailing Address: 1885 Main Street, Ste 408, Wailuku , Maui HI 96793 Amount of Request for County Funds: $13,000 Prior Year(s) Funding: 05-06 06-07 07-08 $5,000 $4,000 $7,000 Agency Mission Statement: To provide a safe environment, an impartial process, and well- trained volunteer personnel for the delivery of affordable dispute resolution services (mediation, NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 1 and neutral facilitation of meetings) to the East Hawai'i community, on a non- profit basis NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 2 Ku'i kahi Mediation Center Inc. - Agency Name Ku'ikahi Mediation Center- Program Name Program Description: Ku'ikahi Mediation Center provides our East Hawai'i community with a unique service for resolving disputes in a peaceful, long-lasting manner. Through confidential mediations, and the neutral facilitation of meetings, Ku'ikahi delivers inexpensive, high quality services that can help individuals, families, and organizations. Our approach to mediation is sensitive to our multiculture community, and it's many ways of communicating, problem -solving, and co- existing. . To provide these services, Ku'ikahi develops professionally trained and dedicated volunteers who are often successful (70% reach agreement) in mediating disputes involving neighbor -neighbor, family, co -parenting, divorce, work -place, community, business, Special Education, and civil rights, and other issues. These low cost -to -free services are offered on a sliding scale according to income, which makes them available to many who are defined as as "low- income" or alienated from community resources. Ku'ikahi's skilled and respected services & solutions are sought by a broad spectrum of our community's agencies. Referrals come from the Prosecuting Attorney's Office, the County Police Department, Public Works, many local attorneys, as well as the District and the Family Courts of the 3rd Circuit. Ku'ikahi 's increasingly effective response to individuals or families who are involved in requests for restraining orders has reduced the number of calls requiring police response, as well as the threat of violence on school campuses, in the work place, and in neighborhoods. Ku'ikahi also provides Education and Outreach to the community towards preventing the development of contentious or violent events. Ku'ikahi educates the community by providing information, and holding training opportunities that promote peaceful problem -solving skills, encouraging participation in mediation, and recruiting volunteers to become mediators. Some training opportunities for the community includes mediation skills for mangers, condominium boards, community associations, DOE faculty, staff, and students, and other community agencies. To maintain a high level of competency in the 60+ members of our volunteer mediator team, we provide an intensive basic mediator training, apprenticeship training, and advanced training in specialized areas. Interested community members are encouraged apply to join our team. Ku'ikahi's outreach includes serving individuals who are without resources, live outside the mainstream, or feel culturally alienated. Some may not be prepared to express themselves or their issues in a mediation setting , and will need additional assistance in understanding the opportunities that the mediation NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 3 process provides. Ku'ikahi refers potential and existing clients to various resources in the community that will help them address some of their many needs, and also help them to understand and participate more effectively in the arena of the leagal system, and the courts. Ku'i kahi's services and training for neutral facilitation of meetings to community groups, business, and others enables us to work with large, unhappy groups . Through the facilitation of peaceful participation, people are able to be heard, important information is gathered and prioritized, and progress can be made. Ku'ikahi Mediation Center has served the Hawai'i Island community from 1983 to 2005 under the auspices of the YMCA. We are part of a network of six community-based mediation centers in the state. They were created in the 1980's to increase the opportunities for justice and peaceful problem -solving, and to reduce the tremendous load of court cases. The partial funding from the Judiciary has not kept pace with the demands on the centers so facing a serious deficit in resources, on December 22, 2005, Ku'ikahi became a 501-c-3 in order to better fulfill its mission. The center's case load, and development of services has expanded mthrough the efforts of the Board of Directors, the staff, and all the volunteer mediators. The fiscal challenges are great, as Ku'ikahi creates programs to reach the requests of our community . Total Budget and Position Count Total Program Budget $151,020 Total Program Position Count 4 pt time Total Agency Budget $151,020 Total Agency Position Count 4 pt. time Program Objectives: 1) Establish a branch office in Puna for mediations, community seminars, and recruitment of traininees for Basic Mediation Training to create a Puna -based team of mediators. 2) Offer partial training scholarships mediators who are from groups that are not well represented in our current mediation team, ie. Filipino, Hawaiian, and youth and folks under the age of 40. 3) Provide advance training for 10 new mediators in Divorce and Co - parenting, and 5 new mediators in Civil Rights Mediation. 4) Develop funding to pay the fees of participants in a "Victim -Offender Mediated Dialogue" with the Procecutors Victims Assistance Program. Such programs assist the sentencing process and reduces recividism by the offender,as well as enable the victim to gain closure. 5) Provide training for county agencies and local businesses in mediation skills, and develop "Peaceful Communications and Problem -solving" workshops for community groups and their clients. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 4 6) Acquire funding to develop and run peer mediation programs in local schools. Provide training for DOE faculty and staff. This would include developing contracts for services with the DOE. 7) Create: new part time staff positions: for Outreach and Education Coordinator, and Puna Case Worker/Coordinator. These positions are essential to the meet current service delivery as well as, the requests for increased services. 8) Collaborate with County Police Department in suggesting mediation as an option to a TRO for those disputes that are not likely to provoke violence, but are very disruptive. The outcome will reduce need for Court and Police Department responses to restraining orders. 9) Increase mediation services to Family Courts, and stimulate more self - referrals to mediation --which will be a source of additional income. 10) Secure funding for relocation in Hilo to larger office space with more confidential meeting rooms. Must be able to host 2 concurrent mediations on Mondays thru Saturdays 9:30 am to 9:30 pm. Office space in 2006-7 was 550 square feet. 11) Provide Board training in Capacity Building and Resource Development in order to engage in strategic planning to Identify other sources of support and income. Program Highlights: 1) Advanced training programs in Facilitation, and Divorce/Co-parenting , inservice-training were conducted --which developed skills and enthusiasum in our mediators. Established a Neutral Facilitation of Meetings Team of 12 mediators, added 9 new Divorce mediators. 5 mediators trained in civil rights mediation by the Hawai'i Civil Rights Commission. 2) 20% increase in TRO cases served over the previous year. Grant submitted to OHA requesting funding to support the recruitment and training of mediators, and to provide more easily accessible services to native Hawaiians, as well as the rest of the community. 3) Six mediators participated in Restorative Justice Mediation Training. Participated in planning meetings with Proscecutor's office to towards more mediation of victims and offenders. 4) Mediation Clerk hired for 12 hours a week. 5) Monthly mediator Memo sent to Mediators resulting in more mediators volunteering to support our staff work, court intakes, and training events. 6) 23% increase in self-referred mediations and facilitations 7) Divorce/co-parenting mediation documents are currently being up graded or changed. 8) Broader on-going recruitment of participants for mediation training has resulted in 5 local attorneys participating in our mediation trainings. Basic mediator training was extended to the realtors on the island, bringing in 4 new mediators. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 5 9) Ku'ikahi Kids Team created to mediate disputes involving youth, especially on school campuses. The mediators on this team all have a background in working with youth. Parents are always invited to participate in parts of the mediation so there is follow -though on agreements. The program is called "Peace it Together". 10) Thirty letters went to DOE schools to advertise the program. A presentation was made to Hilo Principals at the request of the Deputy Superintendent, and three schools have requested peer mediation training for students. 11) Hawai'i Justice Foundation grant increased from $10,000 in 2007 to $13,000 in 2008. County Public Works has used Ku'ikahi twice for neutral facilitation of community meetings. 12) 918 clients served in FY 2006-7. 13) Percent of mediations reaching agreements has increased fro 65% to 70%. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 6 Ku'ikahi Mediation Center, Inc - Agency Name - Program Name Performance Measures: *If applicable Program Expenditures FY 2006-07 Actual * FY 2006-07 Actual * FY 2007-08 Budget* FY 2008-09 Estimate Number of Cases opened 325 340 400 Number of Mediators 30 60 75 Number of Mediations held 151 215 285 Percent of Mediations reaching agreement 70% 70% 72% Number co-parenting/divorce cases 48 60 80 Number of Court referrals 299 215 370 Number self -referrals 46 50 70 Percent satisfied clients in self report 90% 90% 92% Percent clients earning less than $20,00/ r, or called "low income." 50% 55% 60% Percent native Hawaiians served 23% 25% 35% *If applicable Program Expenditures FY 2006-07 Actual * FY 2007-08 Budget * FY 2008-09 Estimate Salaries and Wages $91,557 103,220 128,145 Professional Fees $3,450 7,000 3,000 Operations $23,238 40,800 49,280 Equipment 2,000 2000 Other" Total 116,795 151,020 182,425 If applicable ° Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 7 Ku'ikahi Mediation Center - Agency Name - Program Name Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2006-07 Actual * FY 2007-08 Budget * FY 2008-09 Estimate Fees for services 19,131 26,000 34,000 County of Hawai'i 4,000 7,000 13,000 Hawai'i Justice Foundation 6,000 24,254 15,000 Atherton Found. Automation Grant 2000 2000 2000 State of Hawai'i 51,850 53,004 53,004 -Judiciary, Contributions and Fundraising 17,251 20,000 25,000 Contracts for Services 00 5000 7000 Revenue 11,618 8000 10,000 -Training Office of Hawaiian Affairs 00 5,820 23,000 Total 116,851 151,078 182,004 *If applicable Explain what plans, if any, your agency and/or program has to increase revenues to support this program. When do you anticipate your program to become self-sustaining? As our budget indicates, we are looking for additional grant including OHA. We are also intednding to develop contracts for fees for services, i.e. the DOE should pay for some , if not all of the services that are renderd directly to the school. Expanding self -referrals will bring in additional funds from businesses, and persons with higher incomes. As a non-profit we will always bee looking for funding. this coming year we are very worried about the possible reduction of funding from foundations, due to the lowering of percentage rates. We are sure that are services are also reducing costs to the county, ie. police responses to TRO's, and other issues of violence. We are so appreciative of the County's support. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 8 Ku'ikahi Mediation Center - Agency Name - Program Name . I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 — 2-142.2, Hawai'i County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawai'i Revised Statutes. If awarded a grant from the County of Hawaii, I (we) understand and will comply with the requirement to submit a year-end report to the Legislative auditor within 60 days after June 30 of the fiscal year. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawaii grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely, complete, and Sign r f Board Preside Chairk'/ r Date Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-69 Page 9 Laupahoehoe Train Museum- Agency Name Museum Education & Outreach- Program Name Agency Director: Contact Person Mailing Address: Facility/Site Address: Fax No.: Email Address Lisa Barton Lisa Barton P.O. Box 358 Laupahoehoe,H196764 Phone No.: 962-6300 Phone No.: 962-6300 36-2377 Mamalahoa Highway Laupahoehoe, HI 96764 962-6957 laupahoehoetrainmuseum@yahoo.com Name of Accountant/CPA (include name of firm if applicable): Ron Dolan Phone No.: 935-5433 Mailing Address: 16A Railroad Ave, Hilo, HI 96720 Amount of Request for County Funds: $50,000 $32,000 is for labor and $18,000 is for operational costs. Labor cost includes for 160 hours/month for 2 part time docents @ $10/hr, and 60 hours/month for a supervision/management @ $17.50/hr. Operation costs include $3,500 for accounting, $6,000 for displays, $4,000 for maintenance, $2,500 for advertising, and $2,000 for printing and postage. The $50,000 is a decrease from our 2006-07 funding request of $59,400. Prior Year(s) Funding: 05-06 06-07 07-08 $35,000 $35,000 $40,000 NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 1 Agency Mission Statement: Our purpose is to preserve, promote, and protect the historic, cultural, educational, social, civic and economic interests of the North Hilo and Hamakua districts, while highlighting the history of railroads on the island of Hawaii. Our mission is to preserve Hawaii Island's railroad history for posterity and prosperity. Through our broad purpose and in keeping with our mission, we provide many services and programs that are not funded by the community or government agencies alone. We have been working towards the sustainability of the museum since its inception by completing objectives outlined when we were established. 1) provide a quality museum experience; docents sharing information on railroads, plantations, local history as well as information on local natural attractions and points of interest as part of the Hilo/Hamakua Heritage Coast. Docent training is provided to all volunteers and staff by our experienced, seasoned management. New information acquired by donation or research, is constantly added to our collections and therefore passed on to visitors. 2) assist in the development and completion of projects in the community that enhance the area for its residents. Projects outside of the museum which were begun when the museum was established and other projects brought to the Boards attention have included Safety & First aid kids for district seniors, Kieki car seat inspection, Sports equipment for local youth sports teams, history kiosk, interpretive signage, loan program for donated sport and camp gear. 3) provide a market via our giftshop and jobs to stimulate the community's economic development. Local crafters have been able to improve their market area placing their products for sale in our gift shop. Having their products in our gift shop allows us more to offer our visitors thus improving visitor experience. We offer local youth part-time docenting positions to acquire various job skills including working with the public, retail sales restoration and repair work as well as display creation and office skills. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 2 Laupahoehoe Train Museum - Agency Name Museum Education & Outreach- Program Name Program Description: This program will focus on eduation and outreach, providing activities for youth while continuing our work towards sustainablity of the museum and its staff. The goal of this program is to make the best use of our facility as an educational resource and highlight in the community. As part of the 'Hilo-Hamakua Heritage Corridor', we preserve and protect our islands railroad, plantation and local histories and assist the community by providing social and economic stimulation in the area. This year through the Huiana program, we are partnering with DOE High Schools,Hawaii Community College, Hawaii Island Economic Development Board and Hawaii County Workforce Development to mentor Hawaii island youths to provide business experience. We will use this program to supervise , teach and encourage youth within our work environment to serve as part time docents and office staff. Funding will be used to provide supervisory services to this program. We will continue to expand the museum's interior and exterior displays to provide a quality experience to our visitors, tour groups and for those in our outreach programs. These expansion efforts include adding technology, translations and new displays as information, photos and memorabilia are donated and or researched. The use of technology will allow more photos, history and personal stories to be shared in a limited time and physical space. (i.e., videos, slide shows and power point presentations.) Maintaining our paid staff enables us to ensure; consistant business hours, updated displays, active programming and museum growth. Use of staff also provides a museum representative for outreach programs to those on limited transportation or time budgets including schools, senior centers and Hilo cruise ship visitors. Staff also assists in the expansion of our membership and gift shop, where many local crafters find a market, which assists in local economics and encourages the museums sustainability. Providing jobs within the community stimulates the community's economic development. Providing more information with new and improved displays enhances visitor experience and increases word of mouth advertising, increasing visitor count and gift shop sales, improving revenues and improving sustainability. As a young growing community endeavor these components work towards our goal of presenting a quality museum experience. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 3 Total Budget and Position Count Total Program Bud et 212,000 Total Program Position Count 3 Total Agency Budget 220,000 Total Agency Position Count 16 Program Objectives: 1) Partner with Hawaii island High Schools for Huiana Mentorship Program. 2) Provide training to local high school youth for job training and job skills. 3) Provide supervisory position for and Alu Like programs. 4) Provide tours and educational programs to Hawaii Island Youth. 5) Maintain paid staff to provide programing, tours and outreach. 6) Research to provide more displays regarding railroads, plantations and local history. 7) Maintain, update and rotate displays, memorabilia and photos in our Hiles. 8) Maintain grounds, buildings and displays. 9) Assist community in creating ne keiki park at Laupahoehoe Park. 10) Provide tours and educational programs to Cruise Ship arrivals and work towards eventually providing transportaton to and from Hilo Harbor. 11) Increase visitor count, membership recruitment, expansion of our gift shop, and creative marketing to support sustainability. 12) Research and apply for private, State and Federal funding sources to meet our operational and future expansion needs. Program Highlights: 1) Partnership with Laupahoehoe Hish School for work program. 2) Provided job training for two local high schoolers through Huiana mentorship program. 3) Provided 2 FTE jobs to Hawaii Island youth for museum operations. 4) Installation of Interpretive Signage at Laupahoehoe Scenic overlook. 5) Improvemnts to the History Kiosk at Laupahoehoe Point Park. 6) Healing Our Island Grant 2007 providing youth activities toward healthy living & creating 4 youth baseball teams as well as providing equipment for a physical education program in Waimea and Kohala. 7) Completion of the interior of our Caboose as additional display space includes seating and movie projection as well as photo displays. 8) Completion of our unique railroad locomotive 'Rusty' as our mascot and advertising icon -Feb. 2007 includes cab restoration and finish paint coat. 9) Open daily operation with the exclusion of major holidays by a mostly volunteer staff, augmented by paid staff funded by County Grant. 11 10) Museum Tours and outreach tours for school, and community groups coming from as far away as Hilo and Waimea with varying age groups. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 4 11) Laupahoehoe Walking Trail - clearing completed 2002. County reclaimed roadway in 2006 and is providing geotechnical surrey to be considered for alternative access and hiking and biking trail open to public. 12) Ookala Community Forest Stewardship grant (8th year of a 10 year program) maintaining 40 acre tropical hardwood demonstration forest including two native lowland forest restoration areas. 13) Museum Assessment Program awarded by Institute of Museums and Libraries Services 2003 reviewed our museum practices and gave positive critical review that is a guide for creating a quality museum. 14) State Incentive Grant (SIG) provide substance abuse prevention education programs to youth with four programs. (3 year program) 15) Keiki Car Seat Program provides car seat fitting station & island training. 16) Senior Safety Kits provide first aid kits, smoke detectors, emergency lights and emergeny medical cards to community seniors (500 kits). NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 5 Laupahoehoe Train Museum - (Name Museum Education & Outreach - Program Name Performance Measures: *If applicable Program Expenditures ual * FY 2006-07 Actual * FY 2007-08 Budget* FY 20 8-09 Esti ate Increase visitor count by 15% 8,050 9,100 10,0 0 Increase school and community tours by 20% 36 42 50, Expand number of displays 2 2 3 Increase paid staff FTE 1 2.5 3 Increase gift shop sales 11,000 18,000 24,000 I. *If applicable Program Expenditures ual * FY2007-08 FY 2008 Bud et * EstimaSalaries 09 and Wa e27,500 86,400 1 0,000 Professional Fees1,300 fiFY06-07 5,000 15,000 O erations25,200 46,200 46,400 E ui ment5,000 0 0 Other° 55,000 39,000 39,000 Total 114,000 177,000 212,000 If applicable ° Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 6 Laupahoehoe Train Museum - Agency Name Museum Education & Outreach - Program Name Program Funding Sources: Identify all funding sources (specific to this, program only) Revenue Source FY 2006-07 Actual* FY 2007-08 Budget * FY 20018-09 Estimate Admissions/donations 21,800 20,000 2$,000 Membership dues 3,000 8,000 k000 Sales net 13,600 30,000 40,000 Grants IMLS - federal 0 0 50,000 Docent in-kind 36,000 18,500 3,000 ,000 Management in-kind 19,000 19,000 County Appropriation 35,000 40,000 59,000 Total 131,400 137,500 212,000 *If applicable Explain what plans, if any, your agency and/or program has to it revenues to support this program. When do you anticipate your to become self-sustaining? LTM applied for a three year, $150,000 program grant through the Institute for Museum and Library Services. These are operational funds that would help's sustain the museum, while building toward self-sufficiency. These funds are to be used to increase public awareness and educational programming. Staffing the museum will allow for outreach programs to increase visitor count and revenue. With grant assistance to increase visitor awareness and extend our outreach programs, we project visitor count to be near 10,000 by 2010 and We will be near self -sustainable with a full paid staff. Explanation of Program Expenditures: In regard to the column marked "Other": in FY 2006-07 LTM recorded $55,000 for our in-kind volunteer hours . In FY 2007-08 our in-kind volunteer hours are estimated at $39,000. Paying key staff positions have been very important to the museum in terms of maintaining museum hours, researching information for new displays, display creation and maintenance of the facility. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 7 Laupahoehoe Train Museum - Agency Name Museum Education & Outreach - Program Name I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 — 2-142.2, Hawaii County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawaii Revised Statutes. If awarded a grant from the County of Hawaii, I (we) understand and will comply with the requirement to submit a year-end report to the Legislative auditor _within 60 days after June 30 of the fiscal year. The report shall. include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawaii grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely, comoletq. an Ziur f Executive 13ifeeteF Tc�4sr rzez 0 Date 112 0 /OS- Date 0 8 Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 7 Lyman Museum - Agency Name Island Heritage Gallery Design Development - Program Name Agency Director: Marie D. Strazar 5021 Contact Person: Marie D. Strazar 611104 Mailing Address: 276 Haili St. Hilo, HI 96720 Facility/Site Address: 276 Haili St. Hilo, HI 96720 Fax No.: 969-7685 Email Address: director@lymanmuseum.org Phone No.: 935 - Phone No.: 935 - Name of Accountant/CPA (include name of firm if applicable): Alex Smith, CPA Phone No.: 808.737.7761 Mailing Address: 1403 Frank Street, Honolulu, HI 96816 Amount of Request for County Funds: $200,000 Prior Year(s) Funding: 05-06 06-07 07-08 $27,500" $54,000** $31,500*** *HTA/CPEP not for this program **HTA & R&D ($35,000 for this program) *** HTA & R&D ($10,000 this program) NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 1 Agency Mission Statement: To tell the story of Hawaii, its islands and its people. It exists to: Collect, preserve, and exhibit artifacts, artwork, and memorabilia relating to the culture, art, and historical heritage of Hawai'i. Educate and encourage awareness in these areas through visually exciting as well as interpretive exhibitions, informative tours, special programs, and activities. Serve as a learning - resource center for those seeking information, entertainment, and knowledge. Fully extend itself to the public in order to instill community pride and support. Maintain a standard of excellence and professionalism, seeking to improve, progress, and realize our full potential as a Museum. The Lyman Mission House and Museum, founded in 1931, consists of the Lyman family home, first built in 1839, and a modern Museum building constructed in 1973. The restored Lyman Mission House is furnished to depict missionary life in the period 1840 to 1880. It is a reminder of a band of devoted men and women who dedicated their lives to bringing their Christian faith to the people of these islands and whose presence here exerted a profound effect on the development of these island communities. The adjacent modern Museum building houses exhibits and presents programs and activities designed to interpret the physical environment and ecology of the islands as well as the rich and varied ethnic heritage of our island people, that there may be a deeper understanding and appreciation of the on- going human process here in the fiftieth state in the heart of the Pacific Basin. The historical, cultural and contemporary artifacts are presented in the following manner: fauna. 1. Hawaiian life prior and subsequent to European discovery. 2. The Missionary period of 1840 -1880. 3. The traditional life styles of Hawai'i's major immigrant groups. 4. The natural history of Hawai'i, including its volcanos, flora and 5. Other exhibits, such as Pacific shells and worldwide minerals. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 2 Lyman Museum - Agency Name Island Heritage Gallery Design Development- Program Name Program Description: The Lyman Museum's redeveloped Island Heritage Gallery (2010-2011) will integrate the story of Hawaii's history with the growth of Hawaii's multicultural society as it came to be by the late 20th century. Beginning with an extensive section on early Hawaiian culture, moving into the historical period and the introduction of many external folkways and influences, the exhibit will have an interactive quality and a nonlinear historical perspective that highlights the emergence of a "local culture" and the diverse cultural elements contributing to it. This Program will comprise the design development stage of the Island Heritage Gallery re -do of approximately 4000 square feet of the Museum's permanent gallery space. Program elements will include content and text development, general design planning and illustration, preliminary graphic design layout, and front-end evaluation. Total Budget and Position Count 2008-09 Total Program Budget 246,600 1 Total Program Position Count 2.0 Total Agency Budget 676,140 Total A enc Position Count 17.0 Program Objectives: 1. Render in full perspective sketches of a complete new IHG exhibit. 2. Produce a full set of scaled and dimensioned exhibit plans that will include: -an Illustrative Plan, indicating layouts and look of exhibitry, with visitor flow diagrams, primary sightlines, artifact placement, and signage/graphics locations -a Floor Treatment Plan and a Wall Treatment Plan, indicating locations and extent of floor and wall materials and treatments to be used -a Reflected Ceiling Plan indicating layout and look of building elements and exhibitry impacting ceiling plane, including main exhibit labels, layout dimensions, architectural features and any major HVAC and plumbing elements NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 3 - a Lighting Plan with preliminary layout of architectural and exhibit lighting systems, including appropriate symbology, notes, legend, circuit information, and dimensions -an AN & Media Plan, indicating location and function of AN and electronic media and performance features throughout exhibit - Exhibit Elevations, i.e., illustrative views of front of each major exhibit element, including props, scenic, and graphic elements, as well as proposed exhibit cases and artifact placement -and Operation Diagrams, indicating function and operation of interactive exhibit elements. 3. Draft preliminary text to be used foi 4. Produce preliminary, fully rendered images, diagrams, and illustrations. interpretive panels and signage. layouts of graphic panels including 5. Produce preliminary draft of scripts to be used in AN, media, and interactive exhibitry. 6. Conduct front-end evaluation of the interpretive approaches planned for the exhibit to test for desired educational outcomes. Program Highlights: 1) Completed an academic analysis and interpretive plan based on the Museum's collections, outlining the themes and content for the redevelopment of the Island Heritage Gallery. 2) Concluded seven consultant reports for various sections of the proposed permanent exhibit, e.g., Hawaiian culture, working in Hawaii, local culture, etc. 3) Concluded draft of a potential curriculum piece for use in school programs tied to the proposed new exhibit on the people of Hawaii. 4) Held two programs on "Growing Up Local" to gather input from the community. 5) Completed audiences analysis and assessment study. 6) Completed draft of a concept design and walk-through description. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 4 Lyman Museum - Agency Name Island Heritage Gallery Design Development - Program Name Performance Measures: *If applicable Program Expenditures FY 2006-07 FY 2007-08 FY 2008-09 Salaries and Wages Actual * Budget * Estimate Produce interpretive plan 1 0 0 Produce consultant reports 7 0 0 Conduct "Growing Up Local' 1 1 2 sessions -program Complete audience assessment 1 0 0 report Complete concept design with 0 1 0 written walk-through Complete 15 infrastructure 0 1 0 - roof replacement -requirement Full perspective sketch rendering 0 0 _ 1 Full set of scaled and dimensioned 0 0 1 exhibit plans Draft of preliminary panel text 0 0 1 Preliminary rendering of graphic 0 0 1 -panels Preliminary draft of AV and media 0 0 2 scripts Complete Front End 0 0 1 evaluation/report *If applicable Program Expenditures If applicable ° Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 5 FY 2006-07 Actual * FY 2007-08 Budget* FY 2008-09 Estimate Salaries and Wages 60,000 60,400 50,000 Professional Fees 45,000 35,000 175,000 Operations Equipment 12,500 - p 13,000 --- 19,000 {' 2,600 i O9her" Total 0 117,500 120,000 231,000 246,600 If applicable ° Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 5 Lyman Museum — Agency Name Island Heritage Gallery Design Development— Program Name Program Expenditures Other# - Infrastructure — Roof replacement Lyman Museum - Agency Name Island Heritage Gallery Design Development - Program Name Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2006-07 Actual * FY 2007-08 Budget* FY 2008-09 Estimate Lyman Museum Operating (earned income, donations and endowment allotment 82,500 94,000 44,600 HTA & County R & D 35,000 15,000 Lyman Museum Building Fund 120,000 Atherton Foundation 2,000 2,000 County of Hawaii Non -Profit Grant (requested in this application) 200,000 Total 117,500 231,000 246,600 *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 Lyman Museum intends to apply for $400,000 from the National Endowment for the Humanities in August 2008. These funds would be for implementation of the design produced as a result of the specific design program proposed in this submission to the County of Hawaii. The developed and finalized Island Heritage Gallery design would be self-sustaining once it has gone into the implementation stage projected for 2009-2010. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 6 Lyman Museum - Agency Name Island Heritage Gallery -Program Name Design Development I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 — 2-142.2, Hawai'i County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawai'i Revised Statutes. If awarded a grant from the County of Hawaii, I (we) understand and will comply with the requirement to submit a year-end report to the Legislative auditor within 60 days after June 30 of the fiscal year. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawaii grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely, complete, and accurate year-end report will impact the evaluation of your program's or agency's future funding requests. Signature of Board President/Chair Date (Signature of E cutive Director Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 61 Malama Na Mele- Agency Name Malama Na Mele Visitor Program- Program Name Agency Director: Hugh (Buddy) Gordon Phone No.: 934-2266 Contact Person: Hugh (Buddy) Gordon Phone No.: 934-2266 Mailing Address: P.O. Box 515 Hilo, HI 96721 Facility/Site Address: 688 Kinoole St., Ste. 112 Hilo, HI 96720 Fax No.: Email Address: buddy@malamanamele.org Name of Accountant/CPA (include name of firm if applicable): Jennifer Gossert, CPA Phone No.: 969-3115 Mailing Address: 688 Kinoole St., Suite 201 Amount of Request for County Funds: $30,000.00 Prior Year(s) Funding: 05-06 06-07 07-08 $00.00 $00.00 $00.00 Agency Mission Statement: Hilo. HI 96720 Malama Na Mele is organized exclusively to collect, preserve and archive recorded historical and modern Hawaiian music for the residents of Hawaii, for NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 1 the general public and for future generations, to create a museum of Hawaiian music for the residents of Hawaii and the general public, and to educate the residents of Hawaii and the general public regarding recorded Hawaiian music, all on a non-profit basis. The goals and objectives of Malama Na Mele are: ❑ To archive, digitize, and catalogue the recorded music of Hawai'i ❑ To create a web site to access this music, and information about it ❑ To create a museum of music and hula to preserve Hawaii's music history NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 2 Malama Na Mele - Agency Name Malama Na Mele Visitor Program- Program Name Program Description: Malama Na Mele is a 501 (c) (3) organization established for the purpose of preserving Hawaiian music and education the general public about Hawaiian music, in part through establishing a process for digitizing old recordings, in part through the creation of a museum of Hawaiian music and hula. Malama Na Mele seeks to create a venue in West Hawaii aimed at informing and educating the visitor market -- as well as residents -- about Hawaiian music and its history. A retail space in the Sheraton Keauhou Bay Resort & Spa is being converted to a radio station that will be owned and operated by Parrott Broadcasting. A portion of the space will be made available to Malama Na Mele in order to showcase the history and relevance of Hawaiian music to Hawaiian culture. Malama Na Mele has engaged the services of museum designer Bob Kosturak to revamp the space where visitors and the general public can access material about Hawaiian music and its history. The Malama Na Mele Visitor Program consists of the exhibit space and the artifacts and digitized material that will be put into it. The venue will have a 12' x 8' exhibit wall that would be curved and configured to display artifacts and memorabilia related to Hawaiian music history, including album covers, letters from musicians, and photographs. The space will contain equipment to enable visitors to view video clips. Eventually, a computer with a searchable database will be added, so that visitors can research information about particular music as well as the musicians who played it. A cataloger hired by Malama Na Mele is currently working on creating discographies (i.e. thorough catalog information) for several thousand LP's and 78's currently in the archives located at KHBC Radio while funds are being sought from various funding agencies to also digitize these recordings. The objective is to make this information publicly available, in places like the visitor site at the Sheraton Keauhou, so that anyone interested in doing some quick research about Hawaiian music will have direct access to ethnographic, visual and audio material about recordings and recording artists. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 3 Total Budget and Position Count Total Program Budget 30,000.00 Total Program Position Count 0.0 Total Agency Budget $28,500.00 Total Agency Position Count 1.0 Program Objectives: 1) To educate the residents of Hawaii and the general public regarding recorded Hawaiian music by providing digitized samplings of music as well as explanations and artifacts from Hawaii's musical history: reproductions of album covers, biographical sketches of well-known Hawaiian musicians, videos and photographs on display. 2) To create a small museum of Hawaiian music for the enjoyment and education of visitors and residents alike. The recorded music of Hawaii has a rich heritage dating back to the 19th century, and most of the music from the late decades of that era and into the 20th century has not been preserved for the public good and is not readily accessible. A fraction of this music is in the archives of KHBC radio, built over the span of 40+ years, and is slowly being cataloged and will soon be digitized. This music is a critical and valuable artifact of Hawaiian culture and history and some of it will be made available to listeners via this experiential, visitor - focused venue in Keauhou that receives some 250,000 guests annually. 3) To promote the need to preserve Hawaiian music. Malama Na Mele has and is amassing the resources and the talent needed to design not only a space to experience aspects of music history of Hawaii, but also the systems and processes needed to digitize, archive (create discographies) and preserve old LP's and vinyl recordings. As this is accomplished -- and much progress has already been made -- the discographies of these recordings will be accessible to visitors and residents through this visitor program. Program Highlights: 1) The Malama Na Mele Visitor Program will create a site of interest in Keauhou, at the Sheraton Keauhou Bay Resort & Spa, where visitors and the general public may experience an audio-visual display about Hawaiian music, its history, its artists. The resorts welcomes some 250,000 guests each year. 2) To be adjacent to a live broadcasting radio station, the space is highly likely to attract the interest of visitors; and the sharing of space will help NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 4 promote the cause of preserving Hawaiian music while also limiting rental and staffing expenses for Malama Na Mele. 3) Mr. Bob Kosturak, a museum designer from Northern California, is designing the space to be eye- and ear -catching, easy to navigate and fascinating to experience. Record albums, album covers, pictorial as well as written histories of musicians, their bands and their producers will be on display. Visitors will be able to view video clips and learn more about particular artists via a flat screen display. Although admission fees will not be charged, a guest book will be set out and donations will be accepted to give visitors an opportunity to comment and contribute. 4) The purpose of the venue is to expose visitors and the general public to Hawaiian music and its history. Established in February 2006, Malama Na Mele exists exclusively to collect, preserve and archive recorded historical and modern Hawaiian music for the residents of Hawaii, for the general public and for future generations; and to educate the residents of Hawaii and the general public regarding recorded Hawaiian music. 5) Support from the County of Hawaii is an important aspect of this project: to promote the development of culturally relevant and unique visitor venues on the Big Island; to support Malama Na Mele's island -wide effort to bring historic and modern Hawaiian music to the general public; and to help perpetuate Hawaiian culture through the preservation and dissemination of information about Hawaii's music. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 5 Malama Na Mele - Agency Name Malama Na Mele Visitor Program - Program Name Performance Measures: *If applicable Program Expenditures FY 2006-07 Actual * FY 2006-07 Actual * FY 2007-08 Budget* FY 2008-09 Estimate number of visitors $5,000 Operations -app 250,000 -comments/responses in guest book $13,000# Other" 2,500 number of inquiries about Hawaiian music 2,000+ *If applicable Program Expenditures FY 2006-07 Actual * FY 2007-08 FY 2008-09 Budget* Estimate Salaries and Wages Professional Fees $5,000 Operations $12,000# Equipment $13,000# Other" Total If applicable "Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 6 Malama Na Mele - Agency Name Malama Na Mele Visitor Program - Program Name Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2006-07 Actual * FY 2007-08 Budget* FY 2008-09 Estimate Atherton Family Foundation $25,000 and Individual Sponsors $2,500 -Corporate George and Jan Handtmann Family Foundation $1,000 Total $28,500 *If applicable Explain what plans, if any, your agency and/or program has to increase revenues to support this program. When do you anticipate your program to become self-sustaining? Since it received its 501(c)(3) status in November 2006, Malama Na Mele has been applying for grants as opportunities become available. It has received several grants, the largest from the Atherton Family Foundation, as well as $2,500 in sponsorships to support the cataloging and digitizing of its collection. That work will comprise some of the content for the visitor program in Keauhou, and so this is included in the budget. As the organization grows, and a step in that direction is the new presence in West Hawaii, it will have more resources from grant funds and contributors to assist with matching large grants. Self -sustainability is a longer-term objective, and that could happen within the next five years pending funding for digitizing equipment. The intention is to generate revenue from the web -based sale of Hawaiian music that would go back into research and development of digital archiving. The ultimate goal is to support the development of a museum of Hawaiian music and hula. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 7 Mama Na Mele - Agency Name Malama Na Mele Visitor Program - Program Name I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 — 2-142.2, Hawai'i County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawai'i Revised Statutes. If awarded a grant from the County of Hawai'i, I (we) understand and will comply with the requirement to submit a year-end report to the Legislative auditor within 60 days after June 30 of the fiscal year. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawai'i grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely, complete, and accurate year-end report will impact the evaluation of your program's or agency's future funding requests. 4(/-, Signature of Board President/Chair &d' C. ", Signat re of Executive Director 6 31 ei ate 16116P Da e UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 8 MMama Na Mele Malama Na Mele Visitor Program Budget Explanation Request: $30,000 Salaries and Wages Professional Fees Design $5,000 Operations Production of materials $7,000 Creation of videos $5,000 Equipment Installation $10,000 Lighting $3,000 TOTAL $30,000 ALAMA O PUNA- Agency ame PUNA CQM UNITY ME01 AL CENTER- Frpgrarp NcIMe Agency Direc>gr; Rene Siracusa Phone No.: 965- 2pp0 Cpptact Pemgp: Dan Domizio Phgpe No.: 9F5-1801 Mji,+ing Ad4rgtts: 12-4592 Kalapana Rd, Pahoa, Hi 96778 Facilq/Site Aogrpps: 15-2660 Pahoa Village Rd, Pahoa, HI 96770 Fa4 No.: Email Address: domiziogplWshi.com N&M of Atcountant/CPA (include name of firm if applicable): N.A. (see letter below) Phone No.: N.A. Mailing A4dress: N.A. Amount of Request for County Funds: $270,315; $90,689 for site build- out, $66,900 for Equipment and Supplies, $112,725 for three months Operating Expenses Prior 11Oar(s) Funding: 05-06 06-07 07-08 $NA $NA $NA Agency Mission Statement: NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 1 Agency Mission Statement: Malama O Puna's purpose is to assure critical habitat for native species and open spaces for future generations through education, HANDS-ON PROJECTS, and the acquision of real property. Malama O Puna's overall objective is the betterment of life in and around Pahoa. "Pahoa Weed and Seed" is another of its activities. PROGRAM MISSION STATEMENT: The Puna Community Medical Center's mission is "To provide readily accessable health care to the residents of, and visitors to, Puna District. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 2 Malama O Puna - Agency Name Puna Community Medical Center- Program Name Program Description: The Puna Community Medical Center is a non-profit corporation (5010(3) which has applied (Sept, 2007) to the IRS for a tax exemption, is awaiting its letter of determination, and is utilizing Malama O Puna as its fiscal agent until we receive the letter from the IRS. - The Puna Community Medical Center (PCMC) will provide acute care for common medical problems such as infectious diseases of the Respiratory System (eg. colds, bronchitis and asthma; of The Digestive System (eg. enteritis, constipation), of the The Genito-Urinary System (bladder infections, STD's); The Skin, etc. And for common surgical problems (cuts and abrasions, sprains and strains, contusions, etc.) These services will be provided on a walk-in basis, with no appointment needed. - PCMC with do Physical Exams which are needed immediately and cannot be scheduled with the client's primary provider of care (School, Athletic, Pop Warner, PUC, etc) - PCMC will provide short -course refills of medications for chronic illness (Hypertension, Diabetes, etc.) should the client run out of these medications. - PCMC will establish an "Indigent Care Program" to cover services for the uninsured. -PCMC will have ready access to 911 Services (ambulance, fire, police) located across Rt 130, should the need arise to transfer clients to HMC's ER. - Clinical Labs and Puna Pharmacy are also in the Pahoa Market Place. Total Budget and Position Count I Total Program Budget 1 $597.700 1 Total Program Position Count 18 FTEs Total Agencv Position Count 1 -0- Program Objectives: NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 3 Program Objectives: 1) To obtain the funds (donations, grants) for start-up by mid 2008. 2)To enter into an agreement with Malama O Puna to act as PCMC's FISCAL AGENT, and to have their 5010 (3) umbrella PCMC until our Letter from the IRS arrives. 3)To employ 5 full time (at start-up), and 5 part time employees (after 1-2 months of operation. 4)To provide services from 5 days/week (to include weekends) initially, and 7 days/wk by the end of the Td month of operation. 5)To provide health services for 150 to 210 clientstweek by the end of the 3`d month of operation. 6) To establish and "Indigent Care Program" by the 6th month of operation; providing discounted or free services (including medications) to clients without insurance. 7)To generate a positive cash flow, based upon fees for services, charitable contributions, and supplemental grants sufficient to sustain operations indefinately, by the end of 6 months of operation. 8) To enter into collaborative agreements with other non-profit corporations (e.g. Makuu Farmers Assn, Malama O Puna, Puna Weed and Seed, The Bay Clinic, etc) for the purpose of creating a larger, more comprehensive health care center for Lower Puna; over the first 6 to 12 months of operation. 9) To develop a Handi-Van project to transport elderly shut-ins, disabled clients, etc. 1) Program Highlights: 1) There is not too much to describe here; we managed to organize PCMC; create By Laws and Articles of Inc, to apply for 5010(3) status with the IRS and to collect more that $3,000 in donations in 2007. 2)Working with Concept Construction; a site plan was developed in the 800sq ft space at the Pahoa Market Place. 3) Working with R. Weinstein in Honolulu, and estimate of equipment costs was developed NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 4 NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 5 Malama O Puna - Agency Name Puna Community Medical Center - Program Name Performance Measures: *If applicable Program Expenditures FY 2006-07 Actual * FY 2007-08 Budget* FY 2008-09 Estimate N.A. 350,000 See Item #4 above. 12,000 Client encounters per year (12 months 7800-10,900 Uninsured patients seen (20% of clientsper year. Includes medical &office supplies 1560-2184 Charges for services rendered $100/encounter avg. 780,000 to $1,090,000 Total 810,574 *If applicable Program Expenditures * If applicable "Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 6 FY 2006-07 Actual * FY 2007-08 Budget* FY 2008-09 Estimate Salaries and Wages 350,000 Professional Fees 12,000 102,585 -Operations Equipment Includes medical &office supplies 44,500 Other" 301,489 Total 810,574 * If applicable "Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 6 Malama O Puna -Agency Puna Community Medical Center- Program Hawaii County Non -Profit Grant Application Item #3 -TOTAL AGENCY BUDGET AND POSITION COUNT: The total Position Count for Malama O Puna is -0-; this agency is ENTIRELY VOLUNTARY, there are no paid positions. Item 7- PROGRAM EXPENDITURES: The figures here are for a full year, (our Start-up year) and include many one time expenditures. As an example; Medical Supplies and Office Supplies will have to be completely stocked before opening, but will cost less per month after operations begin. In the chart of expenditures OTHER here includes; - an estimated $35,000 for Electronic Medical Records software and license. - an estimated $3,000 for Office Management software - an estimated $172,800 to run the Indigent Care Program for a full year (for services and medications for the uninsured). Once operations are in full swing, fees for services will pay for this. - an estimated $90,689 to complete the site build -out. TOTAL "OTHER"= $301,489. Item 8- PROGRAM FUNDING SOURCES: This list includes Private Foundations to which grant requests will be submitted in 2008. At this time, we have no clear idea of what funding support, if any, will come our way from these grant requests. However, the Puna Community Medical Center's objective is to achieve financial survivability and self -sustainability during the first year of operations Malama O Puna - Agency Name Puna Community Med Center - Program Name Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2006-07 Actual * FY 2007-08 Budget* FY 2008-09 Estimate GRANTS APPLIED FOR* Weinberg Found; Build -out, start -u 182,700, or artial, or 0 -equipment; Atherton Family Found; 6 months, salaries, ops, supplies 244,150, or partial, or 0 -expenses; Atherton Family Found;lndigent care program; services and meds. 172,800, or partiaor 0 Contributions (12 months) 200,000, or partial Fees For Services (12 months) 800,000, or partial Hawaii County Non -Profit Grant 248,414, or partial Community Development Block Grant will be applied for in 2009. Total 1,848,064, or partial *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? - With the above estimated* revenues from fees for services rendered (paid primarily by 3`d party payors; private insurers, Medicaid and Medicare, and cash payments), PCMC should be self sustaining by the second half of the first year of operation. *Estimates based on current average charges and utilization rates in East Hawaii. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 7 O�C! I's 4,-, velognabon nf the wbo- bj")ahw,,4 ad MOOMPKIA XA OPV - 7t a a:r,4 /I c i,. VVnt. H,4% A- "CES` IE I Mental Health Kokua Residential Rehabilitation Services Agency Director: Greg Payton Phone No.: 737-2523 Contact Person: Gary Michell Phone No.: 331-1468 Mailing Address: 1221 Kapiolani Blvd., Ste 345, Honolulu, HI 96814 Facility/Site Address: 75-5752 & 75-5750 Alanoe PI., Kailua-Kona, HI 96740 140 Wainaku Avenue, Hilo, HI 96720 139 Amau Road, Hilo, HI 96720 Fax No.: 331-1468 Email Address: konamhk65�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: $30,000 Prior Year Funding: 05-06 06-07 07-08 $20,000 $20,000 $25,000 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 and settings, Mental Health Kokua assists people with mental illness achieve optimum recovery and functioning in the community. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 1 Mental Health Kokua Residential Rehabilitation Services Program Description: Funding is requested for our transitional residential services, including PATCH (Psychosocial and Transitional Community Housing) Place and Hale Amau in Hilo, and Hale Alanoe and Kealahou in Kailua-Kona. Mental Health Kokua will offer 24 beds in Hilo and 14 beds in Kailua-Kona, a total of 38 beds from which recovery in the community can occur. Mental Health Kokua staff provide 24-hour supervision and rehabilitation services with the goal to enable clients to move on to more independent housing. While in placement, clients are assisted in acquiring personal and social survival skills necessary for sustained community living. Staff provide training and support in daily living skills and medication management while facilitating social, educational and recreational activities in the community. Clients are also assisted in making connections to community resources including mental health centers, vocational training programs, and community housing agencies, as well as assistance with long-term community placement. These projects provide cost effective, community based alternatives to institutional care and/or homelessness. Transitional bed day costs for FY 2006 were 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 Program Budget 1,238,468 1 Total Program Position Count 22 Total Agency Budget 7,745,200 1 Total Agency Position Count 159 Program Objectives: 1) Provide residential and social rehabilitation services to 95 unduplicated persons with serious mental illness. 2) Show completion of identified treatment plan goals upon discharge by at least 80% of clients served. 3) Reduce consumer psychiatric hospitalization by at least 90% 4) Ensure 100% compliance of Commission on Accreditation of Rehabilitation Facilities (CARF) and other monitoring recommendations. 5) Show evidence of satisfaction with services received at 95% of consumers served. 6) Show improvement in daily living skill scores upon discharge in at least 90% of consumers served. 7) Place at least 70% of consumers served in more independent living settings following planned discharge. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 2 Mental Health Kokua Residential Rehabilitation Services Program Highlights: 1) Provided transitional residential rehabilitation services in FY 2007 to forty- eight (48) unduplicated clients at PATCH Place and Hale Amau in Hilo and twenty-eight (28) unduplicated clients at Hale Alanoe and Kealahou it Kailua-Kona. 2) Discharged 61% of clients to more independent living in the community. All clients (100%) showed improvement in daily living skills. 3) Provided a total of 10,641 bed days and 21,282 meals in our transitional residential programs during FY 2006. 4) In December 2007, renovation to Hale Alanoe increased the number of beds available from six (6) to eight (8), expanding the number of beds in Kona for transitional services from twelve (12) to fourteen (14). Performance Measures: *If applicable NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 3 FY 2006-07 Actual * FY 2007-08 Budget* FY 2008-09 Estimate Number of unduplicated consumers served 76 85 95 Percentage of consumers served who were discharged to more independent living settings 61% 70% 75% Number of consumers served requiring hospitalization 6 3 _ 2 Percentage of consumer satisfied with services 96% 95% 95% *If applicable NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 3 Mental Health Kokua Residential Rehabilitation Services Program Expenditures: * If applicable #Please explain in detail on separate sheet Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2006-07 Actual * FY 2007-08 Budget* FY 2008-09 Estimate Salaries and Wages 707,866 736,180 765,628 Professional Fees 16,896 17,741 18,628 Operations 514,731 540,468 567,491 Equipment 0 0 0 Other#: 0 0 0 Total 1,239,493 1,294,389 1,351,747 * If applicable #Please explain in detail on separate sheet Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2006-07 Actual* FY 2007-08 Budget* FY 2008-09 Estimate County of Hawaii 20,000 25,000 30,000 State of Hawaii - Department of Health 966,276 995,260 1,025,122 United Way 30,000 30,000 30,000 Pro ram Service Fee 136,931 140,000 142,000 CCS Fees 115,926 119,404 122,986 Donation/other 10,563 0 0 Other: MHK Support Total 1,279,696 1,309,664 1,350,108 *If applicable Explain what plans, if any, your agency and/or program has to increase revenues to support this program. When do you anticipate your program to become self-sustaining? Mental Health Kokua has demonstrated notable ability and success in obtaining funding from private sources such as trusts and foundations. We have been NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 4 Mental Health Kokua Residential Rehabilitation Services providing services to people with mental illness in Hawaii for over 30 years and have built strong relationships with many foundations and trusts. For example, in 2001 MHK started a capital campaign to raise $1.5 million to purchase properties on the Big Island and in Maui. This objective was achieved in 2003 through support from various foundations, trusts, individual donors, Board member donations, the County of Maui, and Housing and Community Development Corporation of Hawaii (HCDCH). In 2005, funding from the State of Hawaii and the U.S. Department of Housing and Urban Development (HUD) was granted to MHK for the acquisition of Hale Alanoe in Kona and the Hale Amau property in Hilo. We continue to explore ways for the agency to become fully self-sustaining. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 5 Mental Health Kokua Residential Rehabilitation Services I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 — 2-142.2, Hawai'i County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawai'i Revised Statutes. If awarded a grant from the County of Hawai'i, I (we) understand and will comply with the requirement to submit a year-end report to the Legislative auditor within 60 days after June 30 of the fiscal year. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawai'i grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely, complete, and accurate year-end report may impact the evaluation of your program's or agency's future funding requests. Signature ofBXdd Presidt!C air AIiJl8vY*4/ � Signature of Executive Director lr.z-A1oF Date Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 6 Neighborhood Place of Puna - Agency Name Home Visiting and Community Connections- Program Name Agency Director: Mary Hyslop Phone No.: 965-5550 Contact Person: Mary Hyslop Phone No.: 965-5550 Mailing Address: PO Box 2020 Pahoa Hawaii 96778 Facility/Site Address: 15-3039 Pahoa Village Rd. Pahoa HI 96778 Fax No.: 965-5109 Email Address: npp2020@hawaii.rr.com Name of Accountant/CPA (include name of firm if applicable): Alex J. Smith, CPA Phone No.: 808-737-7761 Mailing Address: 1403 Frank Street Honolulu, HI 96816 Amount of Request for County Funds: $21,625 Prior Year(s) Funding: 05-06 06-07 $0 $ 0 Agency Mission Statement: 07-08 $ 15,000 for Building Caring Community The goal of the Neighborhood Place of Puna is to prevent child abuse and neglect. The vision: "To Nurture, Strengthen and Celebrate 'Ohana". The mission: "Empowering families and communities in Puna by building strong foundations through healthy relationships that value each person's uniqueness. "E malama pono kakou". NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 1 Neighborhood Place of Puna - Agency Name Home Visiting and Community Connections- Program Name Program Description: Neighborhood Place of Puna (NPP) desires to enhance its child abuse prevention services by helping families break through their social isolation and connect with each other and their community. The prevention activities of home visiting and helping families connect to each other and the community has been documented as an effective approach in the prevention of abuse and neglect. The relationships forged between home visitors and parents can break through loneliness and isolation and serve as that first step in linking families to their communities. Just as a strong, positive community produces positive, healthy children, a lack of connection or support has a very real effect on the family's quality of life and ability to cope. Non-involvement in community can have serious social consequences — alienation, loneliness, low self-esteem, lack of motivation and may affect family functioning or impair child development. (Fegan and Bowes 1998). Programs that connect families to each other are needed because of the high rates of child abuse and neglect in the Puna district. One fourth of the County's children live in Puna. From 1998 to 2001, Puna had the most confirmed cases of child abuse and neglect. Reported cases are 11.7% compared to the County (9.5%) and State (5.9%). Unfortunately, Puna rates high on all child abuse indicators including: 45% of families with incomes under 200% poverty level (State 25.9%); 13.8% of families receiving public assistance (State 4.9%); Single parent families 30% (State 18.3%). The two most alarming statistics are the high rate of abuse of 34 children per 1000 and the rate of removal of children in East Hawaii, which is higher than any other area in the state. The geography of the Puna district also lends itself to social isolation. The district is almost 500 square miles with many undeveloped subdivisions (no water, no grated roads and many households running on generators). While some families like the isolation that Puna provides, most families want more for themselves and their children. Providing social support and promoting the development of "caring communities" are seen as important ways of preventing child maltreatment. Neighborhood Place has as its overall objective to strengthen twenty-five families by providing them opportunities to connect with other families, community resources and become active members in their communities. Families will design and help coordinate twelve activities that will bring them in contact with other families. NPP will also assist families in identifying available resources and teach them how to navigate the systems to get what they need. A family friendly directory of services in the Puna/Hilo area will be created and given to all participants. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 2 Total Budget and Position Count Total Program Budget $105,178 Total Program Position Count 1 2 FTE Total Agency Budget $225,222 Total Agency Position Count 4 FTE Program Objectives: To strengthen families by helping parents understand typical developmental stages and foster optimal growth in their children. To keep participants free of child abuse and neglect and to help families develop a support network and become more connected to their community, This will be accomplished through the following activities: 1. Provide on-going home visits that include a) education around child development and b) assessment of risk for child abuse and neglect. Twenty-five families a year will receive bi-weekly home visits for a minimum of three months. Twenty-five families will be assessed for child abuse risks. 2. Provide information and referral and advocacy to twenty-five (25) families to help them identify services and teach them how to navigate systems to get what they need. Activity tasks include helping the family assess their needs, assistance with access to entitlement programs, schools, medical care, housing, legal services, children's activities etc. Fifty referrals will be made to families and each family will receive a resource book. 3. Provide social, recreational and/or educational activities for families to connect families with each other and with their community. Twelve activities a year will be provided to 35 family members. Activities may be educational (budgeting, career assessments) or recreational. Activity tasks include - meet with families, set up activity, set up childcare and assist with transportation. 4. Develop a family friendly directory of services in the Puna/Hilo area for twenty-five (25) families. 5.. Provide opportunity for evaluation of each activity by participants. Each family will complete an evaluation after all trips/activities. Each family will complete evaluation upon cases closure. Twenty-five (25) evaluations. Program Highlights: 1) Since opening its doors in August 2002, over 250 families at risk for child abuse and neglect have received home based services, assessment of risk, advocacy and support. Ninety-nine percent (99%) of families have not been confirmed for child abuse or neglect while in the program. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 3 Ninety-five percent (95%) of families have not been confirmed for child abuse or neglect within six months of case closure. Neighborhood Place of Puna collaborates with aloha to help with the following partnerships and activities: East Hawaii Coalition for the Prevention of Child Abuse and Neglect, Puna Round Table, Ready to Learn School Supply Distribution to over 1000 children, Celebrate Your Family event, Blue Ribbon campaign and bookmarks, Trainings for families, community members and service providers, Malama A Ho'opili Pono Consortium, Pahoa Weed and Seed, Family Violence Intervention Committee, Community Alliance Partners, Neighborhood Place Partners. Additionally Neighborhood Place of Puna provides information and referrals to over 400 callers each year. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 4 Neighborhood Place of Puna - Agency Name Home Visiting and Community Connections - Program Name Performance Measures: *If applicable Program Expenditures FY 2006-07 FY 2007-08 FY 2008-09 Salaries and Wages Actual* Budget * Estimate Bi -weekly home visits n/a n/a 25 families Plan/carry out n/a n/a 12 Activities educational/recreational activities n/a n/a 0 Meet with families to provide n/a n/a 35 family childcare, transportation. n/a n/a members Provide advocacy/ information and n/a n/a 25 families referrals. 50 referrals Create a family friendly directory of n/a n/a 25 families services and give to families. Family evaluations of home visiting n/a n/a 25 families services and activities 85% Participants are free of child abuse n/a n/a 90% and neglect while enrolled Participants are free of child abuse n/a n/a 850/, and neglect six months from closure Participants provide care that n/a n/a 85% of fosters their child's optimal families development Document all services, activities n/a n/a 25 families and child abuse and neglect reports in family files *If applicable Program Expenditures * If applicable NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 5 FY 2006-07 Actual * FY 2007-08 Budget * FY 2008-09 Estimate Salaries and Wages n/a n/a $70,438 Professional Fees n/a n/a 0 Operations n/a n/a 29,540 Equipment n/a n/a 0 Other" n/a n/a 5200 Total n/a n/a $105,178 * If applicable NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 5 Neighborhood Place of Puna Home Visiting and Community Connections PROGRAM BUDGET EXPLANATION ITEM COUNTY OTHER TOTAL REQUEST FUNDING PROGRAM BUDGETB Salary and Wages $14.00 anIn. 40 (2 FTE) $14,560 $43,680 58,240 Taxes 16% 2,320 6,998 9,318 Health Insurance $120 740 2,140 2,880 mo (2) i 17,620 52,818 70,438 Total Salary/Wages: Operations: Mileage 9600 miles x 960 2,880 3,840 .40 a mile 1,400 20,700 22,100 Rent Telecommunications 700 2,900 3,600 Other: Office supplies 120 1,080 1,200 Program Supplies 825 3,175 4,000 (includes food coupons, gas certificates etc. for families) TOTAL 1 $21,625 1 83,553 1 105,178 NON PROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 6 Neighborhood Place of Puna - Agency Name Home Visiting and Community Connections - Program Name Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2006-07 Actual * FY 2007-08 Bud et * FY 2008-09 Estimate Hawaii Children's Trust Fund confirmed na na $37,215 Hawaii Island United Way confirmed na na 20,000 Blueprint for Chane confirmed na na 26,338 Count of Hawaii requested na na 21,625 Total 0 0 $105,178 *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? Neighborhood Place of Puna has constantly sought and received grants to provide family strengthening services to families at risk for child abuse and neglect. We will continue to work with other Neighborhood Places in the state to seek additional funding. Because we do not charge fees for our services this program will not be self-sustaining with out grants and other types of assistance. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 7 Neighborhood Place of Puna - Agency Name Home Visiting and Community Connections - Program Name I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 — 2-142.2, Hawaii County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawaii Revised Statutes. If awarded a grant from the County of Hawai'i, I (we) understand and will comply with the requirement to submit a year-end report to the Legislative auditor within 60 days after June 30 of the fiscal year. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawaii grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely, complete, and accurate year-end report will impact the evaluation of your program's o_r agency's future funding requests. L Signature of oard F resident/Chair Signature of -Executive Director I 1A )�Tr Date a s Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 8 Roman Catholic Church in the State of Hawaii, COPY Office for Social Ministry Beyond Shelter Agency Director: Carol R. Ignacio, Executive Director Phone No.: 808-935-3050 X 105 Contact Person: Brandee Menino, Program Administrator Phone No.: 808-935-3050 X 113 Mailing Address: 140-B Holomua Street, Hilo, HI 96720 Facility/Site Address: 110 Ululani Street, Hilo Fax No.: (808) 935-3794 Email Address: carolrigneaol.com. bmenino5rcchowaii.org Name of Accountant/CPA Nancy Kay Lee, BBA, MBA — Accountant (808) 935-3050 x 108 140-B Holomua Street, Hilo, HI 96720 Detor & Williams Phone Number: (808) 521-0002 Mailing Address: 700 Bishop Street, Suite 1040, Honolulu, HI 9681 3-41 24 Amount of Request for County Funds: Prior Year(s) Funding: 05-06 $0 06-07 $0 Agency Mission Statement: $20,000 07-08 $ 20,000 The Office for Social Ministry (hereinafter "OSM") is a multi -faceted department of the Roman Catholic Church in Hawaii, was established in 1986 to serve, with dignity, the poor and marginalized in state of Hawaii. The mission of OSM is: To meet the challenges of ever-changing community needs by utilizing spiritual, human and material resources to empower those in need to live with dignity and respect. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 1 Roman Catholic Church in the State of Hawaii, Office for Social Ministry Beyond Shelter Program Description: The Office for Social Ministry began a transitional housing program, Beyond Shelter, on June 1, 2006 at 110 Ululani Street, Hilo, HI. Private apartments for eight (8) families are available at Beyond Shelter in the form of six (6) - 2 bedroom units with 2 baths, one (1) - 1 bedroom unit with 1 bath and one (1) - studio with 1 bath. 58 beds will be available at our emergency housing. Families are expected to participate in organized program classes, pay program fees on time, be good neighbors, and commit to seeking employment or explore educational opportunities. This transitional program is based on a seamless continuum of care model as advocated by Department of Housing and Urban Development (HUD). Our target group for Beyond Shelter Transitional Housing Program consists of family units with at least one minor child experiencing homelessness, including the unsheltered homeless, those living in emergency and transitional housing programs/shelters. Families must have no record of domestic violence issues for four months or substance use for six months. Our selection criteria also depends on participants possessing personal motivation towards making positive changes in their lives and agreeing to pay program fees on time and follow House Rules. Services available to participants build on extensive linkages to agencies throughout our community as well as the experience and knowledge of our own on-site staff, and consist of: transitional housing; case management, including intake, assessment, and access to services; educational and vocational training; job placement; transportation support; a mentor program; linkages to substance abuse and mental health treatment; assistance with family unification; life skills and financial skills training; culturally appropriate activities; housing placement assistance; and one year of aftercare after placement in permanent housing. Total Budget and Position Count Total Program Budget 127,020.00.00 Total Program Position Count OR -2 PT Total Agency Budget 8,596,492.00 Total Agency Position Count 63 FT - 25 Ft Program Objectives: For FY08-09: 1. 10% of program participants will enroll in a post -secondary higher education institution. 2. 50% of unemployed program participants to enroll in higher/further educational opportunity including college courses, continuing education classes, vocational training or job- readiness/employment programs. 3. 80% of employed participants will maintain employment for at least three months. 4. 80% of participants who transition to permanent housing will remain in housing for at least six months. 5. 90% of program participants will test clean during random drug testing. 6. 75% of school age children residing at Beyond shelter will have participated in at least one extra -curricular activity throughout their program stay. 7. 75% of school age children residing at Beyond Shelter will have received tutoring and homework assistance services 8. 25% of school age children residing at Beyond Shelter for at least one year, will improve their grades (or grading marks) by at least one higher grade/mark NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 2 Roman Catholic Church in the State of Hawaii, Office for Social Ministry Beyond Shelter Program Highlights for FY 06-07: 1. OSM assumed of the Beyond Shelter transitional housing s in July 2006 at 110 Ululani Street, providing housing for up to eight (8) families; 2. Established tutorial services for homeless children in collaboration with the Department of Education — Judy Tonda; 3. Completed renovations of units — interior and exterior; 4. Secured donations from the military on Oahu to furnish units with beds, hutch, dressers, lamps and pictures; 5. Fumigation services conducted in the interior and exterior of the building and units; 6. Installed security cameras on site to be viewed by staff at Kihei Pua via internet/web- based to enhance security measures at Beyond Shelter; 7. Established community partnerships with TIFFE for parenting classes; YWCA for activities for the children and UHH Nursing Students; 8. Paid program fees and membership fees for children to participate in activities at the Boys and Girls Club after school and during school breaks; Performance Measures: *If applicable Program Expenditures FY 2006- FY 2007-08 FY 2008-09 Salaries and Wages 07Actual * Budget* Estimate Number of persons placed in emergency or 60 44 75 transitional housing $128,518.59 $108,885.00 121,010.00 Number of persons placed in permanent housing 31 3 35 Number of persons placed into drug treatment or 2 2 2 alcohol treatment $155,540.93 $132,900.00 $127,020.00 Number of persons who retained employment for a 18 9 20 minimum of six months Number of persons who participated in long-term 50 35 50 case management services Number of persons accessing mental health services 8 10 12 *If applicable Program Expenditures * If applicable R Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 3 FY 2006-07 Actual * FY 2007-08 Budget* FY 2008-09 Estimate Salaries and Wages $27,022.34 $24,015.00 $6,010.00 Professional Fees Operations $128,518.59 $108,885.00 121,010.00 Equipment Other(rent/deposit subsidies? Total $155,540.93 $132,900.00 $127,020.00 * If applicable R Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 3 Roman Catholic Church in the State of Hawaii, Office for Social Ministry Beyond Shelter Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2006-07 Actual * FY 2007-8 Budget * FY 2008-09 Estimate County of Hawaii $20,000.00 $20,000.00 HPHA—Beyond Shelter $91,320.00 $61,800.00 $61,800.00 HIUW $7,000.00 $7,000.00 Program Fees $46,463.44 $44,100.00 $38,220.00 Total $137,783.44 $132,900.00 $127,020.00 *If applicable Explain what plans, if any, your agency and/or program has to increase revenues to support this program. When do you anticipate your program to become self-sustaining? OSM's Beyond Shelter Transitional Housing program has received extensive support from State and County agencies such as the Hawaii Public Housing Authority (HPHA, formerly HCDCH); the Hawaii Island United Way; the Hawaii Community Foundation (HCF); and the County of Hawaii (CoH). We are pursuing additional grant opportunities with the Hawaii Community Foundation and the Kellogg Foundation. Program fees generated from the transitional housing program provides an additional revenue stream for operational costs once the units are fully occupied. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 4 Roman Catholic Church in the State of Hawaii, Office for Social Mini Beyond Shelter I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 — 2-142.2, Hawaii County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawai'i Revised Statutes. IF awarded a grant from the County of Hawaii, I (we) understand and will comply with the requirement to submit a year-end report to the Legislative auditor within 60 days after June 30 of the Fiscal year. The report shall include an explanation of the public benefits derived From the awarding of the grant, a complete accounting.oF all expenditures supported by County of Hawai'i grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely, complete, and accurate year-end report will impact the evaluation of your program's or agency's Future funding requests. Signature of Board President/Chair MARC R. ALEXANDER VICE PRESIDENT Signature of Executiv Cirector /nl�s Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAI, YEAR 2008-09 Page 6 COPY Roman Catholic Church in the State of Hawaii, Office for Social Ministry Care -A -Van Homeless Outreach Agency Director: Phone No.: Contact Person: Phone No.: Mailing Address: Facility/Site Address: Fax No.: Email Address: Name of Accountant/CPA Carol R. Ignacio, Executive Director 808-935-3050 X 105 Brandee Menino, Program Administrator 808-935-3050 X 113 140-B Holomua Street, Hilo, HI 96720 East HI: 479 Kinoole Street, Hilo West HI: "Friendly Place," 74-5593 Pawai Place, Kailua-Kona East HI: (808) 935-3794 West HI: (808) 329-6219 carolrign@aol.com and bmeninoCC7rcchowaii.orci Nancy Kay Lee, BBA, MBA — Accountant (808) 935-3050 x 108 140-B Holomua Street, Hilo, HI 96720 Detor & Williams Phone Number: (808) 521-0002 Mailing Address: 700 Bishop Street, Suite 1040, Honolulu, HI 96813-4124 Amount of Request for County Funds: $35,000 Prior Year(s) Funding: 05-06 06-07 07-08 $30,000 $30,000 $35,000 Agency Mission Statement: The Office for Social Ministry (hereinafter "OSM") is a multi -faceted department of Diocese of Honolulu, which exists to promote acts of charity and justice and to serve those most in need. Inviting the involvement of our parishes and community -at -large, the Office for Social Ministry strives to meet the challenges of the ever-changing communities in Hawaii by utilizing spiritual, human and material resources. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 1 Roman Catholic Church in the State of Hawaii, Office for Social Ministry Care -A -Van Homeless Outreach Program Description: For nearly 16 years, Care -A -Van (hereinafter, CAV) has served nearly 15,000 homeless persons. CAV is the only outreach program on Hawaii Island that specifically targets the unsheltered homeless population. In building a healthier community, staff members travel to where the homeless congregate and assist them ultimately into stable housing situations. Staffs drive to remote beaches, parks, woods, lava fields, emergency homeless shelters, domestic violence shelters or in and around downtown Hilo, Puna, Hamakua and Kailua- Kona. Outreach Specialists offer a cup of coffee and listen to the person's concerns as the first step in connecting him or her to housing and mainstream services. Through this type of "outreach" and engagement, trust is established with these consumers to eventually link them with needed services. Outreach Specialists will continue to provide supportive services, intervene during crises, and provide emergency items such as food, clothing, blankets, towels, hygiene products, first aid and other essentials as tools of engagement and establishing a trusting relationship. Effective engagement and initiating outreach efforts is the first step toward receiving more formal mental health services. Once a trusting relationship is established and adequate rapport is apparent, case management services may commence, as a transition into the formal system of mental health services. Interim case management services will be provided while consumer awaits eligibility determination and formally linked with a mental health case management provider. Interim case management allows a slow progression towards a more formal mental health system of care. Other support services that CAV shall provide include transportation for unsheltered homeless individuals seeking medical care, substance abuse or mental health treatment, attend court hearings, and assist with employment searches. Staff also help search for housing opportunities, prepare consumers for housing presentation and interview, and complete housing applications for Federal, State and County units. CAV owns and operates four-wheel drive vehicles to provide these mobile outreach services. Through a flexible service delivery system, tailored to each person, CAV begins with an intake process and assesses their homeless situation. CAV staff often assists people with obtaining their birth certificates enabling them to acquire a picture ID. With picture identification, they can receive social security entitlements, welfare and food stamp assistance, establish a mailing address, look for employment, and cash their checks. All of these kinds of assistance move consumers towards self-sufficiency and building a healthier community. Most importantly, CAV advocates for clients who may not be getting the services they need and they do not know how to advocate for themselves. CAV seeks to impart hope to each person and helps with the process of setting goals, no matter how small or large, that will help a client start down the path towards self-sufficiency. The goal of this program is to connect homeless consumers to more traditional program services, health care, mainstream community programs and to ultimately move them into shelter, transitional and permanent housing. Engagement and effective outreach efforts are crucial processes and a critical link to the community. Since 2004, OSM's TANF Housing Placement Program have provided services to TANF eligible families, persons and/or families with Section 8 Vouchers, or homeless families transitioning to permanent housing. OSM staff have been providing case management services which include assisting participants in securing and retaining permanent affordable rental housing; educating participants on the Hawaii Landlord -Tenant rights; strengthening families' fiscal management skills; and providing referrals for other necessary supportive services. Housing Specialists have been recruiting and educating landlords and property managers to participate in the housing placement program and to select "tenants" from our agency, who will have the support of OSM staff while transitioning to permanent housing and to guide families meet their tenancy obligations necessary to retain their housing. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 2 Roman Catholic Church in the State of Hawaii, Office for Social Ministry Care -A -Van Homeless Outreach OSM has adapted a widely recognized model for ending family homelessness to meet the pertinent issues and problems related to the TANF Housing Placement program: the "Housing First" model. OSM works from the best practices incorporated by the Los Angeles' Beyond Shelter "Housing First" Model. It is an innovative, cost- effective approach to ending and preventing family homelessness. Since its inception in 1988, the "housing first" methodology has helped thousands of homeless rebuild their lives in permanent rental housing throughout Los Angeles County. The "Housing First" Program was designed as the "next step" for homeless families in the emergency shelter system in L.A. County. The program: • helps homeless families move as quickly as possible into permanent affordable rental housing in residential neighborhoods; and • provides families with six months to one full year of individualized case management and social services to enable improved social and economic well-being In the last three years, OSM has helped over 300 TANF eligible families move into permanent affordable rental housing in residential neighborhoods throughout Hawaii County. See the projected Flow Chart below: "Housing First" Model Program - Single Point of Entry with Intake Coordinator Outreach & Drop -In Center 1 1 i 1 t 1 provision of and/or referral to crisis intervention, short-term housing/shelter and short- term management - from 1 to 6 months 1 While in temporary housing or referred by Sec 8 program, family is accepted to ... L NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 3 Emergency/Crisis/DV Transitional County Housing — DHS Shelter Housing Sec 8 Program Office 1 i 1 t 1 provision of and/or referral to crisis intervention, short-term housing/shelter and short- term management - from 1 to 6 months 1 While in temporary housing or referred by Sec 8 program, family is accepted to ... L NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 3 Roman Catholic Church in the State of Hawaii, Office for Social Ministry Care -A -Van Homeless Outreach TANF Housing Placement Program Intake and Enrollment • Screening for housing and social service needs • Individual Service Plan (Family's Action Plan) developed • Renter's Education Workshops completed • Housing search begins 1 Family moves to permanent housing 1 After family moves, provision of Case Management Support - for 6 to 12 months • Continue Tenant education Child abuse & neglect intervention & prevention • Household management • Child care resources • Money management • Child care subsidies • "Survival Skills" counseling • Referrals for medical care • Welfare advocacy • Referrals to Job readiness program • Legal advocacy • Referrals to Career counseling • Family & individual counseling • Referrals to Job training & placement • Liaison with schools • Referrals to Basic remedial education • Parenting education • Referrals to English language classes • Health/nutrition counseling • Substance abuse prevention • Address children's special needs 1 Family integrated into community, attaining improved social and economic well-being. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 4 Roman Catholic Church in the State of Hawaii, Office for Social Ministry Care -A -Van Homeless Outreach Total Budget and Position Count Total Program Budget 2,395,832.00 Total Program Positionnt 32kAu Total Agency Budget 8,596,492.00 Total Agency Position Count pt Program Objectives: For FY 08-09: 1. 50% of program participants will engage with case management services by implementing real budget planning, and seeking out community programs for which participants may be eligible. 2. 50% of program participants to enroll in higher/further educational opportunity including college courses, continuing education classes, vocational training or job -readiness employment programs. 3. 80% of participants who enrolled in shelter programs will remain there until other housing is secured. 4. 90% of eligible program participants who received monthly rental subsidies will pay their rent on time for at least 6 months. 5. 90% of AMHD-eligible participants will enroll in at least one AMHD-contracted program. 6. 80% of program participants will not violate the terms of their lease or be evicted for at least six months. Program Highlights from FY 06-07: 1. Served nearly 1,581unduplicated homeless persons in Hawaii County, including 347 unduplicated families with children (657 individuals in families); 924 unduplicated single persons; and 585 new program participants. 2. Awarded $180,000 in July 2006 through the State's Hawaii Public Housing Authority office to assist individuals and families with financial assistance to prevent homelessness, including rental deposits, rent assistance, utility costs, transportation, including major car repair, and temporary shelter. 3. 2005 was CAV's second year of implementing the Kukui Program, our local version of the U.S. Department of Housing and Urban Development's (HUD) Supportive Housing Program, Shelter Plus Care. CAV housed forty-eight (48) unsheltered homeless persons into twenty-nine (29) rental units, including thirty-eight (38) adults and ten (10) children. Participants must meet eligibility criteria including homelessness and a disability including severe mental illnesses, chronic substance abuse, dual -diagnoses, HIV/AIDS and developmental disabilities. Kukui participants pay up to 30% of their monthly income towards rent while CAV pays for the remainder of their total rent due to the landlord. A. Increased TANF funding from $500,000 to $600,000. This increase allowed an expansion of program services of housing placement, landlord cultivation and case management services. This assistance also allowed us to financially assist families with their rental deposits, rental costs, and utility deposits. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 5 Roman Catholic Church in the State of Hawaii, Office for Social Ministry Care -A -Van Homeless Outreach Performance Measures: *If applicable Program Expenditures FY 2006-07 FY 2007-08 FY 2008-09 Salaries and Wages Actual * Budget * Estimate Number of persons placed in emergency or 166 175 175 transitional housing $552,245.35 $291,379.00 $526,908.00 Number of persons placed in permanent housing 197 250 250 Number of persons placed into drug treatment or 25 45 45 alcohol treatment $1,817,637.30 $2,032,677.00 1 $2,395,832.00 Number of persons provided or referred for 445 500 500 medical or dental services (duplicated) Number of persons who participated in long-term 585 600 600 case management services Number of persons accessing mental health 545 600 600 services *If applicable Program Expenditures * If applicable NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 6 FY 2006-07 Actual * FY 2007-08 Budget * FY 2008-09 Estimate Salaries and Wages $1,092,192.14 $1,342,231.00 $1,555,158.00 Professional Fees 0 0 0 Operations $552,245.35 $291,379.00 $526,908.00 Equipment 0 0 0 Other (rent deposit subsidies) $173,199.81 $399,067.00 $313,766.00 Total $1,817,637.30 $2,032,677.00 1 $2,395,832.00 * If applicable NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 6 Roman Catholic Church in the State of Hawaii, Office for Social Ministry Care -A -Van Homeless Outreach Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2006-07 Actual * FY 2007-08 Budget * FY 2008-09 Estimate Adult Mental Health -Rep Payee $104,960.00 $172,800.00 $228,000.00 Adult Mental Health -Outreach $215,966.29 $206,244.00 $412,000.00 HPHA—Federal Shelter Plus $93,102.13 $125,832.00 $125,832.00 HPHA — Outreach $713,700.00 $750,000.00 $785,000.00 HPHA — SHEG $132,801.00 HPHA — TANF $476,926.59 $600,000.00 $800,000.00 HPHA — non TANF $22,494.53 HCF — Federal Meth CSAC Grant $7,932.51 County of Hawaii $30,000.00 $35,000.00 $35,000.00 HIUW $9,166.71 $10,000.00 $10,000.00 Donations $1,535.24 Total $1,675,784.00 $2,032,677.00 $2,395,832.00 *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? GSM's CAV program has received extensive support from State and County agencies such as the Hawaii Public Housing Authority (HPHA, formerly HCDCH); the Department of Health, Adult Mental Health Division (AMHD); the Hawaii Community Foundation (HCF); Hawaii Island United Way; the County of Hawaii (CoH), and the SuperNOFA through the U.S. Department of Housing and Urban Development (HUD), and TANF funding from the Department of Human Services. We are pursuing additional grant opportunities with the Hawaii Community Foundation and the Kellogg Foundation. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 7 Roman Catholic Church in the State of Hawaii, Office for Social Ministry Care -A -Van Homeless Outreach I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 — 2-142.2, 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 programs) pursuant to law, I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawaii Revised Statutes. If awarded a grant from the County of Hawaii, I (we) understand and will comply with the requirement to submit a year-end report to the Legislative auditor within 60 days after June 30 of the fiscal year. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawai'i grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely, complete, and accurate year-end report will impact the evaluation of your program's or agency's future funding requests. Signature of Board PresidentChair MARC R. ALEXANDER VI E PRESIDENT O Signature of Executiv ire Tor 11,410b Date lZ9� to UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL PEAR 2008-09 Page $ Roman Catholic Church in the State of Hawaii, Office for Social Ministry The Food Basket, Inc. (formerly Hawaii Island Food Bank) Agency Director: Phone No.: Contact Person: Phone No.: Mailing Address: Facility/Site Address: Fax No.: Email Address: Name of Accountant/CPA Carol R. Ignacio, President/CEO 808-935-3050 X 105 same 140-B Holomua Street, Hilo, HI 96720 same (808)935-3794 carolrign(C)aol.com Nancy Kay Lee, BBA, MBA — Accountant (808) 935-3050 x 108 140-B Holomua Street, Hilo, HI 96720 COPY Detor & Williams Ann Fukuhara, CPA Phone Number: (808) 521-0002 & (808) 961-5532 Mailing Address: 700 Bishop Street, Suite 1040 714 Kanoelehua Ave. Honolulu, HI 96813-4124 Hilo, HI 96720 Amount of Request for County Funds: $40,000 Prior Year(s) Funding: 05-06 06-07 07-08 $32,500 $35,000 $40,000 Agency Mission Statement: The Office for Social Ministry (hereinafter "OSM") is a multi -faceted department of Diocese of Honolulu, which exists to promote acts of charity and justice and to serve those most in need. Inviting the involvement of our parishes and community -at -large, the Office for Social Ministry strives to meet the challenges of the ever-changing communities in Hawaii by utilizing spiritual, human and material resources. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 1 Roman Catholic Church in the State of Hawaii, Office for Social Ministry The Food Basket, Inc. (formerly Hawaii Island Food Bank) Program Description: The mission of The Food Basket, Inc. (formerly known as the Hawaii Island Food Bank) is to feed the hungry in Hawaii county while attending to the root causes of this critical social problem. The Food Basket, Inc. will accomplish its mission by 1) preventing the waste of all edible food in Hawaii County; 2) feeding the hungry with this food; 3) educating the community about local hunger and what can be done to solve this social problem; and 4) collaborating with organizations of partnering missions to eradicate the root of hunger and other social ills: poverty. The Food Basket, Inc. (TFB) 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. The Food Basket, Inc. also receives food from the Hawaii Foodbank on Oahu for a small fee and shipping costs. USDA foods are now being shipped directly to TFB for distribution as well. On a daily basis, TFB staff members drive to donor sites to pick up these items. All goods are delivered to the warehouses, one in East Hawaii and one in West Hawaii, where TFB staff and volunteers weigh the incoming poundage and salvage usable product. Once items are salvaged, they are stocked on the warehouse shelves for distribution to nonprofit partner agencies. This past year, over 1.3 million pounds of food were distributed via our network of 106 approved nonprofit partner agencies. These agencies distribute goods directly to the public through school programs, food pantries, child and adult day programs, programs that serve the chronically ill, homeless and abuse shelters, and substance abuse recovery programs. These agencies fulfilled over 110,000 requests for food (FY06-07). Additionally, TFB operates its own Senior Brown Bag Program that provides weekly food packages to low- income housing projects throughout the island. In collaboration with the Hawaii County Office of Aging, we also participated with the USDA sponsored Senior Fresh Produce Program, distributing 90,000 pounds of locally grown fresh produce to 1,466 low-income seniors for 10 weeks this year and 208,766 pounds last year (1,858 low-income seniors for 15 weeks). Equally important to TFB is its educational component. Throughout the year TFB participates in community forums and 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. 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. The Food Basket, Inc. currently has a full-time staff of 6 and 2 part-timers. Staff members include two warehouse drivers in Kona, two warehouse drivers in Hilo, and one part-time warehouse helper in both Hilo and Kona along with one full-time Director of Agency/Food Donor Relations and one Development Specialist. The President/CEO oversees the food bank and does not receive compensation from the program. A prorated amount is charged each of OSM's programs for other supportive services, i.e. receptionist. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 2 Roman Catholic Church in the State of Hawaii, Office for Social Ministry The Food Basket, Inc. (formerly Hawaii Island Food Bank) Total Budget and Position Count Total Program Budget $3,734,737.00Total Program Position Count 8 ft — 2 pt Total Agency Budget $8,596,492.00 1 Total Agency Position Count 63 ft - 25 pt Program Objectives for FYOB-09: 1. Expand Food Supply and Distribution: • Increase core food distribution by 10% from 1.5 million pounds in FY06-07 to 1.6 million pounds of food. • Decrease the number of pounds of waste from food collected. • Apply for a minimum of $350,000 grant for Senior Fresh Produce Program that would run for approximately for 22 weeks, providing a minimum of 1850 low-income seniors with weekly locally grown, fresh fruits and vegetables. • To explore further the "mobile pantry on wheels" which work well in other parts of the country (i.e. Second Harvest Gleaners Food Bank of West Michigan, Inc. distributed over 7 million pounds through their mobile pantry in 2007 — 30% of their total distribution). 2. Support Partner Agency Development by assisting in building capacity where needed (including equipment, logistics, fund development and management): • Increase partner agency relations with the support of a full-time staff person as the Director of Agency/Food Donor Relations position. • Coordinate 3 workshops on each side of the island for partner agencies with the goal of having partner agencies optimize their resources and meet the Basic Agreement standards for: a) Optimal use of Food Bank's product offerings, etc. b) Food Safety, storage and handling of food c) Quality of service to consumers and accountability d) Promotion of the food stamp program 3. Strengthen and Manage Food Bank's Organizational Capacity; Grow and maintain The Food Basket, Inc.'s organizational, human resource and financial capacity to develop and sustain Food Bank programs to achieve strategic objectives and five-year goals in furtherance of the mission of feeding the hungry on the Big Island. • Complete transition of The Food Basket, Inc. (currently program of Catholic Diocese) to separate 501 c.3. • Create a baseline index and measurement of the Food Bank's internal organizational performance including indicators such as: o Staff development/training hours o Cost/benefit and efficiency measures o Board activity/participation and governance • 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. • To develop a pool of volunteers to assist in all volunteer opportunities (i.e. training, presentation delivery, warehousing, office/clerical work). Program Highlights FY06-07: 1. Expanding and developing the supply of more nutritious foods and distribution efforts: • Received and salvaged over 1.5 million pounds of food from Big Island donor companies, organizations that held food drives, and the Hawaii Foodbank. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 3 Roman Catholic Church in the State of Hawaii, Office for Social Ministry The Food Basket, Inc. (formerly Hawaii Island Food Bank) • Distributed over 1.3 million pounds of goods throughout Hawaii County via our island wide network of nonprofit partner agencies and via the food bank's own Senior Brown Bag Program. This food served 113,213 individual requests for food (duplicated count, individuals are counted more than once if they visit the pantry more than once a year). a) Partner Agencies (monthly average): o Food pantries -4,158 o Meal and snack programs —4,791 o Residential programs (BISAC, Women & Children Shelter, etc.) — 266 b) Senior Brown Bag Program: delivered 41,284 pounds of food island -wide to eight low income senior housing complexes twice o month at no cost to them (an increase of two new sites since last fiscal year). • Participated in a USDA -funded program titled, "Senior Farmers Market Nutrition Program" to enhance domestic consumption of locally grown produce for low-income seniors. As such, it was a nutrition program as well as an economic development program. The program ran for 10 weeks (September 17, 2007 — November 21, 2007) providing over $119,300.27 worth of produce (90,001 pounds) to 1,466 low-income seniors. • Increased distribution to Ocean View (where there are higher incidences of poverty) with two new programs — St. Jude Episcopal Church (Emergency Food Pantry), and Hawaii Ocean View Evangelical Community Church (Meal Program). • Increased food distribution in Hilo with a new food pantry —World Pentecostal Church. • Implemented a Major Giving Campaign to increase contributions annually from individual and corporate major donors. 2. Strengthening fhe movement to end hunger (education) on the Big Island (benefits the public) through the following activities: • TFB made 3 presentations to businesses, 3 to organizations and civic clubs, and 2 to churches in the community regarding hunger and related issues. • TFB made 5 presentations at schools regarding hunger and poverty on the Big Island. • TFB hosted 5 schools at the warehouse with tours of the facility and mini -educational sessions regarding hunger and how the food bank operates. • TFB published two press release4s in the local newspapers regarding Hunger Awareness Day on June 5, 2007. • TFB held two major community food drives — Fall 2006 (41,429 pounds of food/$62,913.83) and Spring 2007 (43,554 pounds of food/$38,628) — The community raised the food and money which confirms the awareness that there are hungry people in the community. Awareness is the first step to ending hunger. During the Fall Food Drive 42,500 paper bags with Hawaii's hunger statistics were inserted into local newspapers (Hawaii Tribune -Herald 8. West Hawaii Today). • TFB received over 35,000 pounds of food from the National Association of Letter Carriers Food Drive in May 2007. 3. Creating/Developing the best efficiency and effectiveness for TFB's delivery of services to the Big Island community including but not limited to governance, operations and fund development. • TFB has an established and working Founding Board of Directors that meets monthly. • Creation of a separate community based 501 c.3 not for profit transitioning smoothly. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 4 Roman Catholic Church in the State of Hawaii, Office for Social Ministry The Food Basket, Inc. (formerly Hawaii Island Food Bank) Performance Measures: *If applicable **There were delays with USDA in getting the grant approved which caused the decrease in senior participation. The lead time from when TFB found out we had the grant to the beginning of the program was very short, which did not give an adequate amount of time to advertise and inform the seniors of the program start. Once the program began, USDA stipulated a cut-off time for application acceptance, which only gave seniors two weeks to apply (whereas in previous years, they could apply at any time during the program). We are already working to resolve this problem so that more low income seniors can participate. Program Expenditures FY 2006-07 FY 2007-08 FY 2008-09 Salaries and Wages Actual* Budget* Estimate 1. Increase core food distribution to 1,276,191 lbs. 1,291,358 lbs. 1,403,810 lbs. hungry and food insecure individuals and $668,009.42 $566,630.00 $594,630.00 families in county by 10%. 2. Increase the number of low-income 1,858 seniors 1,466 seniors** 2,000 seniors seniors receiving fresh produce through $3,358,929.35 j $3,440,217.00 $3,734,737.00 USDA Fresh Produce Program. 3. Implement "Pantry Express' produce & 91,206 lbs. to 5 130,482 lbs. to 10 140,000 lbs. perishables distribution to 5 locations different agencies & different agencies & providing produce and perishables to low- organizations organizations income households (minimizing waste) 4. Decrease "pig waste" by 30% - 228,914 lbs. 73,690 lbs. 75,000 lbs. (average 30% or 250,000 lbs. 5. Coordinate a minimum of 3 capacity 1 workshop in April 2 workshops: 1 in July 3 workshops building workshops for emergency food with 56% attendance with 70% attendance pantry partner agencies with 70% & 1 scheduled for attendance. April (expecting 80%+ attendance) 6. Complete transition of organization 6/31/08 (TFB) to separate 501 c.3 with local Board of Directors increasing effectiveness and efficiency of organization *If applicable **There were delays with USDA in getting the grant approved which caused the decrease in senior participation. The lead time from when TFB found out we had the grant to the beginning of the program was very short, which did not give an adequate amount of time to advertise and inform the seniors of the program start. Once the program began, USDA stipulated a cut-off time for application acceptance, which only gave seniors two weeks to apply (whereas in previous years, they could apply at any time during the program). We are already working to resolve this problem so that more low income seniors can participate. Program Expenditures NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 5 FY 2006-07 Actual* FY 2007-08 Budget* FY 2008-09 Estimate Salaries and Wages $263,429.93 $373,587.00 $440,107.00 Professional Fees $ - $ - $ - Operations $668,009.42 $566,630.00 $594,630.00 Equipment Donated Food (value) 2,427,490.00 $2,500,000.00 $2,700,000.00 Total $3,358,929.35 j $3,440,217.00 $3,734,737.00 NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 5 Roman Catholic Church in the State of Hawaii, Office for Social Ministry The Food Basket, Inc. (formerly Hawaii Island Food Bank) Program Funding Sources *If applicable NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 6 FY 2006-07 Actual* FT -2007-08 Budget* FY 2008-09 Estimate County of Hawaii $35,000.00 $40,000.00 $40,000.00 Senior Produce Program $253,412.00 $250,000.00 $250,000.00 State of Hawaii via Hawaii Foodbank $1A,490.00 $14,490.00 $14,490.00 TEFAP $903.85 $ - $ - Hawaii Island United Way $16,170.00 $15,000.00 20,000.00 Various Small Grants $36,150.00 $24,100.00 $40,000.00 Fundraising Events $246,376.51 $100,000.00 $85,000.00 Donations $131,194.61 $365,587.00 $454,207.00 Program Service Fees $107,952.88 $121,200.00 $121,200.00 Interest Income $4,336.52 $1,000.00 $1,000.00 Patriot's Dinner $5,000.00 $5,000.00 $5,000.00 Return, Inc. $3,056.65 $3,000.00 $3,000.00 Miscellaneous $970.70 $840.00 $840.00 Donated Food (value) $2,400,000 $2,500,000.00 $2,700,000.00 Total $3,255,013.72 $3,440,217.00 $3,734,737.00 *If applicable NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 6 Roman Catholic Church in the State of Hawaii, Office for Social Minist The Food Basket, Inc. I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 — 2-142.2, Hawai'i County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the programs) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawai'i Revised Statutes. If awarded a grant from the County of Hawai'i, I (we) understand and will comply with the requirement to submit a year-end report to the Legislative auditor within 60 days after June 30 of the fiscal year. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawaii grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely, complete, and accurate year-end report will impact the evaluation of your Program's or agency's future funding requests. Signature of Board President/Chair MARC R. ALEXANDER VICE PRESIDENT Signature of Executive rJU ctor /ter/off Date Z 0 Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 7 Roman Catholic Church in the State of Hawaii, COPY Office for Social Ministry Kihei Pua Emergency Shelter Agency Director: Carol R. Ignacio, Executive Director Phone No.: 808-935-3050 X 105 Contact Person: Brandee Menino, Program Administrator Phone No.: 808-935-3050 X 1 13 Mailing Address: 140-B Holomua Street, Hilo, HI 96720 Facility/Site Address: 1 1 5 Kapioloni Street, Hilo Fax No.: (808) 935-3794 Email Address: carolriana-aol.com. bmenino(C7rcchawaii.orq Name of Accountant/CPA Nancy Kay Lee, BBA, MBA — Accountant (808) 935-3050 x 108 140-B Holomuo Street, Hilo, HI 96720 Detor & Williams Phone Number: (808) 521-0002 Mailing Address: 700 Bishop Street, Suite 1040, Honolulu, HI 96813-4124 Amount of Request for County Funds: $35,000 Prior Year(s) Funding: 05-06 06-07 07-08 $0 $20,000 $35,000 Agency Mission Statement: The Office for Social Ministry (hereinafter "OSM") is a multi -faceted department of Diocese of Honolulu, which exists to promote acts of charity and justice and to serve those most in need. Inviting the involvement of our parishes and community -at -large, the Office for Social Ministry strives to meet the challenges of the ever-changing communities in Hawaii by utilizing spiritual, human and material resources. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 1 Roman Catholic Church in the State of Hawaii, Office for Social Ministry Kihei Pua Emergency Shelter Program Description: On January 3, 2007, OSM assumed fiscal and operational responsibilities for the Kihei Pua Emergency Shelter, previously operated by the East Hawaii Coalition for the Homeless, which provides emergency shelter. This facility is located at 115 Kapiolani Street in Hilo is able to shelter 58 individuals at a time. It is currently under renovations for minor repair, maintenance and general "face lift" This site is owned by the County of Hawaii and the lease has been recently signed and executed. Our target group for the Kihei Pua Emergency Shelter Program consists of individuals and families who are experiencing homelessness, including the unsheltered homeless, those living in emergency and transitional housing programs/shelters, and those at -risk of homelessness. Families develop an accelerated six week plan with the program's Intensive Case Managers to map their road to community resources and services, employment, and government entitlements in which they are eligible for, job readiness programs, health care services and life skills building activities. This program is a vital component of our organization's ability to provide a systematic and seamless continuum of care of homeless programs, to better assist them in achieving healthier lifestyles, better life choices, and achieving greater self-determination. Services available to participants build on extensive linkages to agencies throughout our community as well as the experience and knowledge of our on-site staff. Case management and Life Skills services include: seeking transitional and permanent housing; intake, assessment of needs, educational and vocational training; job placement; transportation support; linkages to substance abuse and mental health treatment; assistance with extra -curricular activities for children, tutoring/homework assistance services; communication skill building, developing support systems, budget management; clothing, emergency supplies, food/meals, blankets and I.D assistance. Total Budget and Position Count Total Program Budget 586,610.00 Total Program Position Count 8 FT- 5 PT Total Agency Budget 8,596,492.00 Total Agency Position Count 63 FT - 25 PT Program Objectives: FY 08-09 1. 50% of unemployed program participants will enroll in continuing education classes, vocational training or job-readiness/employment programs. 2. 80% of employed participants will maintain employment for at least three months. 3. 80% of participants who transition to permanent housing will remain in housing for at least six months. 4. 90% of program participants will test clean during random drug testing. 5. 80% of participants who transition to transitional housing will complete program conditions to maintain housing. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 2 Roman Catholic Church in the State of Hawaii, Office for Social Ministry Kihei Pua Emergency Shelter Program Highlights thus far in 06-07: 1. OSM secured FY 07-08 funding through a Stipend contract with Hawaii Public Housing Authority; 2. OSM secured Hawaii Island United Way funding to help assist with operational costs for Kihei Pua; 3. OSM secured Emergency Shelter Grant funding through a contract with Hawaii Public Housing Authority (federal funds, passed through the State); 4. OSM developed and strengthened a relationship with our local Department of Public Safety through creative partnerships and job training opportunities at Kihei Pua. In the initial seven months of operation, OSM supervised a group of about five (5) Hale Nani men (inmates participating in Work Furlough) who assisted renovating and repairing the three buildings of Kihei Pua. The Hale Nani men helped paint the interior and exterior building, repaired screens and windows, built garden beds, set up new furniture and beds, laid tile throughout the residential buildings maintained the landscape of Kihei Pua and many more. What we didn't expect is the relationship OSM developed with these men and how OSM staff and administration "re-newed" their outlook and focus to helping persons reintegrating back into our community. 5. New partnerships in the community were created by operating Kihei Pua including commitments from the University of Hawaii at Hilo Nursing program students to provide health education classes on site; UHH Cooperative Extension services-EFNEP instructor to provide nutrition and budgeting classes on site; renter's education classes by TANF Housing Placement program staff; and "Forward March" employment and training program. 6. Received a donated Plymoth van for resident transportation to medical and legal appointments by request and staff availability. 7. Hired a FT Program Director, two full-time Intensive Case Managers and multiple Life Skills Specialists working 24 hrs a day, 7 days a week, 365 days a year. Performance Measures: *If applicable COMMENTS: SIX MONTHS in operation. Facility was not fully occupied due to repair and renovations. Unable to shelter families at shelter's capacity. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 3 FY 2006- FY 2007-08 FY 2008-09 07Actual * Estimate* Estimate Number of persons placed in emergency or 104 450 450 transitional housing Number of persons placed in permanent housing 45 150 150 Number of persons placed into drug treatment or 2 25 25 alcohol treatment Number of persons obtained employment 9 50 50 Number of persons who participated in long-term 104 450 450 case management services Number of persons accessing mental health 10 50 50 services *If applicable COMMENTS: SIX MONTHS in operation. Facility was not fully occupied due to repair and renovations. Unable to shelter families at shelter's capacity. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 3 Roman Catholic Church in the State of Hawaii, Office for Social Ministry Kihei Pua Emergency Shelter Program Expenditures * If applicable # Please explain in detail on separate sheet Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2006-07 Actual * FY 2007-08 FY 2008-09 Budget * Estimate Salaries and Wages $89,509.90.00 $327,812.00 $418,501.00 Professional Fees 0 0 0 Operations $130,665.72 $163,410.00 $150,109.00 Equipment 0 0 Other 0 0 Total $220,175.62 $491,222.00 $568,610.00 * If applicable # Please explain in detail on separate sheet Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2006-07 Actual * FY 2007-08 Budget* FY 2008-09 Estimate ESG-06 0 $50,100 6 - 6- Countyof Hawaii County $20,000.00 $20,000 $35,000 HIUW $3,895.85 $14,000 $14,000 Program Fees $2,905.00 $15,512 $14,600 4—HA Emergency Shelter 0 $275,000 $275,000 Other Grants & Foundations 0 $25,000 $25,000 ESG-07 $81,610 ESG-08 $81,610 Total $26,800.85 $481,222 $568,610 *If applicable Explain what plans, if any, your agency and/or program has to increase revenues to support this program. When do you anticipate your program to become self-sustaining? OSM's Kihei Pua Emergency Shelter has received extensive support from State and County agencies such as the Hawaii Public Housing Authority (HPHA, formerly HCDCH); and the County of Hawaii (CoH)). Additionally, we are applying for annual support from the Hawaii Island United Way. We are pursuing additional grant opportunities with the Kellogg Foundation, Hawaii Community Foundation and the Office of Hawaiian Affairs. Program fees generated from our emergency shelter provide an additional revenue stream for operational costs once we are operating at full capacity. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 4 Roman Catholic Church in the State of Hawaii, Office for Social Ministry Kihei Pula Emergency Shelter I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 — 2-142.2, Howai'i County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawai'i Revised Statutes. If awarded a grant from the County of Hawaii, I (we) understand and will comply with the requirement to submit a year-end report to the Legislative auditor within 60 days after June 30 of the fiscal year. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawaii grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely, complete, and accurate year-end report will impact the evaluation of your program's or agency's future funding requests. Signature of Board President/Chair MARC R. ALEXANDER VICE PRESIDENT Signature of Executi e it dor t�9o8 Date I Z- 4 Da UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 5 Office for Social Ministry COPY Mobile Care Health Project Agency Director: Carol R. Ignacio, Executive Director Phone No.: (808) 935-3050, x105 Contact Person: Kaye Lundburg, Program Director Phone No.: (808) 987-8904 Mailing Address: 140-B Holomua Street, Hilo, HI 96720 Facility/Site Address: Same Fax No.: (808) 935-3794 Email Address: Carolrign@aol.com, mikela@aloha.net Name of Accountant/CPA Detor & Williams Phone Number: (808) 531-1040 Mailing Address: 700 Bishop St., Suite 1040, Honolulu, HI 96813 Amount of Request for County funds: $30,000 Prior Year Funding: 05-06 06-07 07-08 $20,000 $20,000 $25,000 Agency Mission Statement: To meet the challenges of ever-changing community needs by utilizing spiritual, human and material resources to empower those in need to live with dignity and respect. Program Description: Funds are being requested for continuing support of the Mobile Care Health Project (hereinafter MCHP). The MCHP is a joint partnership between the Office for Social Ministry (hereinafter OSM), St. Francis Community Health Services and the community of the Big Island. The project provides primary dental care in the rural areas of West and North Hawaii and in Kona and Honokaa. Services are delivered to the low-income uninsured and underinsured people through two (2) Winnebago vans that are fully equipped for dental services. Each of the two Winnebago vans is a self-contained, fully equipped dental office including digital x-ray units and secure web -based Electronic Medical Record Systems. Additional services include oral health education in schools and at community health fairs and oral health assessments in long-term care facilities. The project partners with many different agencies to achieve the goals and objectives of meeting the dental needs of the Big Island rural poor. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 1 Office for Social Ministry Mobile Care Health Project Currently, the MCHP has established outreach sites at the following five (4) locations: West Hawaii: Ocean View, Kailua-Kona North Hawaii: Honoka'a, Kapa'au With the opening of the Keaau Family Health Center Dental Clinic in March 2003, the Mobile Care Health Project suspended services in East Hawaii. The Keaau Family Health Center Dental Clinic is now established and providing dental services for the target underserved population in East Hawaii. Mobile Care continues to advocate for the target population and provides dental services for East Hawaii patients at scheduled clinic sites. The Mobile Care Health Project focuses its efforts in North Hawaii and West Hawaii providing direct services in scheduled clinics and working collaboratively with Hawaii Healthcare Systems Corporation (HHSC) and community health centers to expand dental services. Under a Memorandum of Agreement between the Hamakua Health Center and the Mobile Care Health Project dental services are provided to the underserved population in Hamakua and North Hawaii in clinics 1 day each week. Mobile Care provides dental services at sites in Kailua, OceanView 2.5 days per week. West Hawaii Community Health Center (WHCHC) opened in Kona in January 2005 with medical services. Federal funding for the WHCHC was secured in May 2005. MobiletCare and the WHCHC have an informal agreement that includes cross - referrals.. A contract between Hawaii Hospital Systems Corporation (HHSC) and St. Francis Community Health Services enables Mobile Care to provide dental assessments for the long-term care patients in Honokaa, Kapa'au and Pahala. Total Budget and Position Count Total Program Budget 365,721.00 1 Total Program Position Count 2ft-3pt Total Agency Budget 8,596,492.00 Total Agency Position Count 63ft - 25pt Program Objectives - FY 2008-09 Mobilev Care seeks to continue to meet the project's two -fold goals: • To provide direct dental services to the low-income uninsured and Medicaid insured population of Hawaii Island. • To advocate for systemic change that will bring long-term solutions, contributing to the continuum of healthcare and access to dental care for the underserved population. The Mobile Care Health Health Project proposes to meet these goals through the following objectives: NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 2 Office for Social Ministry Mobile Care Health Project Objective #1: The MCHP will provide direct dental care and health education in at least 1,279 patient visits to people to the underserved population. This is based on a current average of 3.5 clinics per week with an average of 7 patients treated at each clinic for a period of 52 weeks. Objective #2: The MCHP will partner with Hawai'i Health Systems Corporation (HHSC) to provide annual dental assessment to all long-term care patients in HHSC facilities in Honokaa, Kapaau and Pahala. (approximately 100 patients) Objective #3: MCHP will provide dental education and preventive treatment to the community at large. • The MCHP will provide health education, fluoride treatments, and distribute health aids (ex. Toothbrushes, toothpaste, floss) and information about maintaining good oral health in at least 4 community health fairs around the island. Some fairs will be geared toward children; some will be geared specifically to adults. (Approximately 200 people served a year) Objective # 4 OSM and MobileYCare administration will continue to attend Hawaiian Island and Tri -County Oral Health Task Force monthly meetings to advocate for change in the local healthcare system, trying to secure more State funding and support for the neighbor islands. As an advocate, our primary goals have been to work within this venue to establish hospital dentistry on the island of Hawaii and to support Community Health Centers (CRCs) in North and West Hawaii to expand their services to include dental clinics.. Program Highlights — FY 2006-07: 1. Provided 224 clinic days — 18/month avg. in Honokaa, Kapa'au, Kailua, Honaunau, OceanView 2. Served patients in 1585 clinic encounters 0 7 patients/ day avg. 0 55% Acute Care 0 69% - Medicaid 0 31 % Low -Income Uninsured for Dental Services 0 4728 Clinic Dental Procedures Palliative, Restorative, Preventive 3. Provided 54 dental assessments in long-term care facilities in Honokaa, Kapa'au, and Pahala. 4. Provided 276 dental assessments and fluoride treatments in Community Health Fairs 5. Served 51 participants in Oral Health Education in local schools and transitional shelters 6. Partnered with University of Iowa Dental School, Hamakua Health Center and four Waimea Schools to provide comprehensive dental services to 96 children 7. Provided $142,508. Uncompensated Dental Services. 8. Participated as a member of the Hawaii Island Oral Health Task Force and the Tri - County (Hawaii, Maui, Kauai) Oral Health Task Force to address the oral health needs of Hawaii County as stated in the Hawaii Island Oral Health Strategic Plan and to pursue collaborative funding. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 3 Office for Social Ministry Mobile Care Health Project 9. At the end of the FY 2006-07 MC was notified of a major loss of funding for FY2007-08. All efforts to recover and replace that funding has fallen short of the budget. Coinciding with this budget deficit was the announcement of a large dental practice with offices in Kailua, Waikoloa and Hilo that they would no longer accept patients insured by Medicaid. The result is that Mobile Care became the only dental provider of Medicaid eligible adults and children in South, West and North Hawaii. At this time of increased need, Mobile Care redefined the target population to include the "most vulnerable" — children, medically fragile adults, adults in case management or residential programs. Clinics were reduced 25% from 19/month (Jan -June 2007) to 15/mon (July -Dec 2007). Further reductions it clinics have been scheduled in 2008 - January (14) and February (12). One FT Dental Assistant Position was cut. Data and challenges have been provided to state legislators, the County Council and the Mayor's Office regarding the dental crisis in North and West Hawaii with a urgent request for emergency assistance. Corporate and private donors have been contacted for support. It is critically important for the health and wellbeing of the underserved of South, West and North Hawaii that Mobile Care continue dental services until the Community Health Clinics in Hamakua and West Hawaii expand to meet the dental needs of this population. These clinics are projected to open in FY 2008. Mobile Care is working with these clinics toward a smooth transition of care. Performance Measures: Program Expenditures FY 2006-07 Actual * FY 2007-08 Budget FY 2008-09 Estimate # of people accessing services 1 1966 2000 1 1600 Program Expenditures *Please explain in detail on separate sheet (see page 6) *If applicable NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 4 FY 2006-07 Actual * FY 2007-08 Budget FY 2008-09 Estimate * Salaries and Wa es 220,243.45 225,413.00 175,767.00 Professional Fees 109,000.00 120,000.00 90,000.00 Operations 134,300.15 154,289.00 Equipment Other* Total *Please explain in detail on separate sheet (see page 6) *If applicable NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 4 Office for Social Ministry Mobile Care Health Project Program Funding Sources: Revenue Source FY2006-07 Actual* FY2007-08 Budget* FY2008-09 Estimate County of Hawaii 20,000.00 25,000.00 30,000.00 State of Hawaii 99,667.00 100,000.00 100,000.00 OHA Grant 40,000.00 90,000.00 HDS Foundation 15,000.00 50,000.00 50,000.00 Seto Grant 10,000.00 10,000.00 10,000.00 HIUW 9,166.66 10,000.00 20,000.00 HMSA 100,000.00 100,000.00 50,000.00 Thomas J. Long Foundation 10,000.00 10,000.00 Hawaii Hotel Association 5,000.00 3,000.00 3,000.00 Bank of Hawaii 10,000.00 Misc small grants 1,000.00 1,000.00 Program fees 23,225.70 20,000.00 20,000.00 Donations 21,636.00 20,702.00 21,721.00 3rd Party Payments 75,905.66 50,000.00 50,000.00 Dental fees 500.00 Miscellaneous Total 1 420,101.02 499,702.00 365,721.00 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 in FY 2008-09. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 5 Roman Catholic Church in the State of Hawaii, Office for Social Ministry Mobile Care Health Project I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 — 2-142.2, Hawai'i County Code, relating to Appropriation of Funds to Nonprofit Organizations. 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, Hawai'i Revised Statutes. if awarded a grant from the County of Hawai'i, I (we) understand and will comply with the requirement to submit a year-end report to the Legislative auditor within 60 days after June 30 of the fiscal year. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawai'i grant funds, and a lisling 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. Signe. ke)Lj�ident/Chair �MA`RC• R. ALEEX`ANDER VICE PRESIDENT (� Signature of Executiveit ctor Date I Y9 o8 Dale UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page (v Roman Catholic Church in the State of Hawaii, copy Office for Social Ministry Ponahawaiola: Community Re -integration Services Agency Director: Carol R. Ignacio, Executive Director Phone No.: 808-935-3050 X 105 Contact Person: Brandee Menino, Program Administrator Phone No.: 808-935-3050 X 113 Mailing Address: 140-B Holomua Street, Hilo, HI 96720 Facility/Site Address: 483 Kinoole Street, Hilo Fax No.: (808) 935-3794 Email Address: carolrian@aol.com. bmenino _rcchawaii.org Name of Accountant/CPA Nancy Kay Lee, BBA, MBA — Accountant (808) 935-3050 x 108 140-B Holomua Street, Hilo, HI 96720 Detor & Williams Phone Number: (808) 521-0002 Mailing Address: 700 Bishop Street, Suite 1040, Honolulu, HI 9681 3-41 24 Amount of Request for County Funds: $35,000 Prior Year(s) Funding: 05-06 06-07 07-08 $0 $0 $30,000 Agency Mission Statement: The Office for Social Ministry (hereinafter "OSM") is a multi -faceted department of Diocese of Honolulu, which exists to promote acts of charity and justice and to serve those most in need. Inviting the involvement of our parishes and community -at -large, the Office for Social Ministry strives to meet the challenges of the ever-changing communities in Hawaii by utilizing spiritual, human and material resources. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 1 Roman Catholic Church in the State of Hawaii, Office for Social Ministry Ponahawaiola: Community Re -integration Services Program Description: The mission of Ponahawaiola, a "prison -reentry" program, is to reduce barriers for men and women previously incarcerated in Hawaii County. A report published by the Hawaii Island Corrections Advisory Committee in 2003, "E Malama Kekohi I Kekahi/Taking Care of Our Own," advocates a "seamless reintegration program" as the best approach to reducing these barriers. Working from this model, OSM acts collectively with the State's correctional and judiciary agencies to identify offenders at -risk of homelessness for placement in our transitional housing program prior to the offenders' release. However, other target groups we work with include Drug Court participants, probationers, parolees, pre-trial detainees. Special needs and diagnoses are assessed during the initial application and interview process. Preparatory actions are then made to create an individualized support network for each exited man and woman, including necessary linkages to treatment facilities for those diagnosed with substance use disorders and/or mental illnesses. Private and shared rooms are available for 28 program participants in "downtown" Hilo, Hawaii. Services available to program participants are built on extensive linkages to agencies throughout our community as well as the experience and knowledge of our own on-site staff. Services include a safe, clean and supportive environment, transitional housing; case management, referrals to community programs skilled in educational and vocational training; direct job placement; transportation; mentorship services; linkages to substance abuse and mental health treatment; assistance with family unification; life skills and financial skills training; culturally appropriate activities; housing placement assistance; and one year of aftercare after placement in permanent housing. In a 2001 report commissioned by the Urban Institute, From Prison to Home, particular emphasis is given to the "moment of release" — those crucial first days and months when offenders move from a strictly controlled environment to more limited supervision or no supervision whatsoever. Offenders often report high levels of anxiety upon release, and are ill-prepared to deal with even "everyday" problems that may confront them — not to mention larger issues such as housing and substance abuse treatment. In the early moments of reentry, without a support network or any promise of stability, exited offenders may seek solace in familiar faces and habits, and relapse into substance use and/or criminal activity. It is crucial to ensure this transition progresses as smoothly as possible, to prevent relapse and recidivism — not only for the well-being of the exited offenders, but for our communities. According to a 2003 study conducted by SMS Hawaii, seven percent of the homeless surveyed in Hawaii County linked their homelessness to prison release; another 14 percent linked their current situation to alcohol or drug abuse. The majority of Hawaii County's homeless (more than 56%) are from a Hawaiian ethnic background, and according to a study conducted by Asian Americans/Pacific Islanders in Philanthropy (AAPIP), native Hawaiians have a disproportionately high representation in the Hawaii state prison system (41.2% in 2004) compared to their percentage of the general population (28%) (Asian and Pacific Islander Reentry, 2005). Once an offender has housing he/she has a better chance of staying sober and not breaking the law. Removing barriers (including cultural barriers) to housing are critical. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 2 Roman Catholic Church in the State of Hawaii, Office for Social Ministry Ponahawaiola: Community Re -integration Services Total Budget and Position Count Total Program Budget 664,180.00 Total Program Position Count 6Ft- 5 PT Total Agency Budget 8,596,492.00 Total Agency Position Count 63ft-25pt Program Objectives: For FY -07-08: 1. 80% of program participants will be referred to mainstream programs (DHS, TANF, SSA, Veteran benefits, etc.) for which they are eligible 2. 25% of program participants will enroll in higher/further educational opportunity including college courses, continuing education classes, vocational training or job-readiness/employment programs. 3. 70% of participants will participate in substance use and mental health treatment. 4. 25% of participants who transition to permanent housing with Team recommendation will remain in housing for at least six months. 5. 20% of program participants will participate in community activities. 6. 25% of program participants will increase child support and general family contact. 7. 90% of AMHD-eligible participants will enroll in at least one AMHD-contracted program. Program Highlights for FY 06-07: 1. Twelve (12) Drug Court participants placed in transitional supportive housing units. 2. 71% program participants remained drug-free since entering Ponahawaiola transitional housing program. 3. OSM strengthened partnerships with Judicial Authorities including Probation Officers, Parole Officers, Public Safety (furlough and incarcerated individuals), Drug Court, Public Defenders Office, Private Attorneys, Prosecutors Office and Hawaii Intake Service Center (pre-trial and pre -sentencing) to ensure court conditions for community release is followed. 4. OSM completed 'outreach activities" for community agencies and partners including in-service trainings to 15 agencies (170 persons), (1) one cable -TV appearance, (1) one video special, and site tours for 25 agencies and 230 persons 5. A Memorandum of Agreement with our largest property management company, Day Lum Rentals, was established to provide housing placements for this target population in the private market. This is an extreme breakthrough since housing applications generally required a credit and criminal background check. This "memorandum" will allocate ten units in its "demonstration" year, waiving the requirement for credit and background checks. Performance Measures: NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 3 FY 2006- 07Actual * FY 2007-08 Budget* FY 2008-09 Estimate Number of persons placed in transitional housing 42 48 52 Number of persons placed in permanent housing 15 12 14 Number of persons in employment 28 28 30 Number of persons placed into drug treatment or alcohol treatment 12 15 17 Number of persons receiving education/job training assistance 10 20 22 NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 3 Roman Catholic Church in the State of Hawaii, Office for Social Ministry Ponahawaiola: Community Re -integration Services Number of persons accessing health services 35 28 30 (nutrition, medical, gerontology, therapeutic $284,801.46 $367,334.00 $366,389.00 massage, aerobic) 0 0 0 Number of persons accessing mental health 20 10 20 services 0 0 0 *If applicable Program Expenditures * If applicable Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2006-07 Actual * FY 2006-07 Budget* FY 2007-08 Estimate Salaries and Wages $284,801.46 $367,334.00 $366,389.00 Professional Fees 0 0 0 Operations $197,313.97 $263,746.00 $297,791.00 Equipment 0 0 0 Other 0 0 0 Total $482,115.43 $631,080.00 $664,180.00 * If applicable Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2006-07 Actual * FY 2007-08 Budget * FY 2008-09 Estimate HCF — Federal Meth $80,620.75 0 0 HCF — Federal Living Skills 0 $75,000.00 0 County of Hawaii 0 $30,000.00 $35,000.00 HPHA — Community Re -integration services $285,000.00 $400,000.00 $500,000.00 HIUW - $10,000.00 $20,000.00 Hawaii Hotel Industry $3,000.00 $5,000.00 $3,100.00 Program Fees $80,207.14 $106,080.00 $106,080.00 Other Grants & Foundations $5,000.00 Total $448,827.89 $631,080.00 $664,180.00 *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? OSM's Ponahawai Ola program has received extensive support from State agencies and foundations such as the Hawaii Public Housing Authority (HPHA, formerly HCDCH); the Hawaii Community Foundation (HCF); and the Bank of Hawaii Charitable Foundation. Additionally, we have received support the Hawaii Visitor Industry Charity Walk. We are pursuing additional grant opportunities with funding sources including the Kellogg Foundation and Hawaii Community Foundation. Program fees generated from this program provide an additional revenue stream for operational costs. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 4 Roman Catholic Church in the State of Hawaii, Office for Social Ministry Ponahawaiola: Community Re -integration Services I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 — 2-142.2, 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 Howai'i, 1 (we) understand and will comply with the requirement to submit a year-end report to the Legislative auditor within 60 days after June 30 of the fiscal year. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawai'i grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely, complete, and accurate year-end report will impact the evaluation of your program's or agency's future funding requests. Signature of Board President/Chair MARC R. ALEXANDER VICE PRESIDENT Signature of Exe uti irector Date �Z9�$ Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 5 Agency Director: Contact Person: Mailing Address: Palekana Kai Ocean Safety, LLC. Palekana Kai Ocean Safety, LLC. Harlan Fragas Harlan Fragas Facility/Site Address: Fax No.: Email Address: Phone No.: 937-9805 Phone No.: 937-9805 980 Railroad Avenue Hilo, Hawaii 96720 980 Railroad Avenue Hilo, Hawaii 96720 Palekanakai@yahoo.com Name of Accountant/CPA (include name of firm if applicable): N/A Phone No.: Mailing Address: Amount of Request for County Funds Prior Year(s) Funding: 05-06 06-07 Agency Mission Statement: 07-0 $25,000.00 To educate community youth about ocean water safety while providing opportunities and alternative activities that build these young adults confidence, self-esteem, motivation, and a lifelong respect for the ocean and the skills needed to enjoy the ocean safely. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page I Palekana Kai Ocean Safety, LLC. Palekana Kai Ocean Safety, LLC. Program Description: Palekana Kai Ocean Safety, LLC, is a non-profit 501c (3) organization that provides ocean awareness, ocean safety, and ocean rescue training along with lifeguard and First Aid/CPR training free -of -charge for community youth between the ages of eleven and eighteen. Additionallly, the team conducts First Aid/CPR training for staff of community organizations island -wide: and provides volunteer rescue services at numerous ocean water sports events such as outrigger canoe regatta, the Richardson Rough Water Swim, long-distance races for the Big Island Racing Association, and the One Man Canoe Races. Palekana Kai's main objective is to educate and promote public safety awareness through their water safety programs that include: water safety, First Aid/CPR, and lifeguard training at public schools and at the Kamehameha Schools. The Team's five experienced lifeguards volunteer their time to conduct ocean safety classes at four public high schools located in the Hilo and Puna Districts of Hawai'i County. Activities are scheduled once each month throughout the year. Students between the ages of eleven and fifteen complete basic skills courses and earn certificates of completion that recognize their readiness for the next levels of training. The next levels of training include First Aid/CPR, Ocean Awareness and Safety, and Ocean Rescue. After completing the additional training levels, students between ages of sixteen and eighteen will have the opportunity to complete a basic Lifeguard Training course and earn a Lifeguard Certificate. This certificate is recognized by the County of Hawaii as evidence of meeting the primary requirement for an entry level paid Lifeguard position. Total Budget and Position Count Total Program Budget Total Program Position Count 7 Total Agency Budget I Total Agency Positron Count 7 J NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 2 Program Objectives: 1) Obtain equipment needed to expand the current training program and on- site activities enabling the team to continue educating community youth and building the basic skills required to respond to emergencies as they occur. It will enhance their self-esteem and prepare them for future employment. 2) Conduct informational classes on Lifeguard Training, Ocean Awareness and Safety, Ocean Rescue, and First Aid/CPR for community at -risk youth and community-based organizations. 3) Conduct at least three four-week on-site after school sessions for youth 4) Conduct at least two Life Guard certification classes 5) Expanding training staff and organization membership 6) Acquire a 1,000 square foot facility that will serve as a classroom and storage area for training equipment. Program Highlights: 1) Eight informational CPR, AED & First Aid classes were conducted- 60 Adults participated 2) Three CPR/First Aid Adult classes were conducted — 21 participants 3) Four CPR/First Aid Youth classes were conducted — 35 participants 4) Two Life guarding Adult classes were conducted —11 participants 5) One Life guarding Youth class was conducted —10 participants 6) Four Water Awareness classes were conducted 40 youth participated. As a result of participating in these classes, 10 became mentors and assisted in training other youth. 5 were able to use their certificates of completion as experience on their resumes and are currently employed. 7) Palekana Kai Rescue Team also provided rescue at 12 canoe races, the one man race, and the rough water swim at richardson's NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 3 Palekana Kai Ocean Safety, LLC. Palekana Kai Ocean Safety, LLC. Performance Measures: *If applicable Program Expenditures FY 2006-07 FY 2007-08 FY 2008-09 Professional Fees Actual*_ Budget* Estimate Eight CPR, AED&First Aid Classes 60 Other" were conducted- Adults participated Three CPR/First Aid Classes 21 conducted -Adults participated Four CPR/First Aid Classes 35 conducted -Youth participated Two Lifeguarding Classes 11 conducted -Adults participated One Lifeguarding Class conducted- 10 Youth participated Four Water Awareness Classes 40 conducted -Youth participated Youth became mentors for Water 10 Awareness Classes Youth found employment as a result 5 of experience from participating and completing Water Awareness Classes Provided Rescue at 12 Canoe 500 Races, One Man Race, and the Rough Water Swim -participants served *If applicable Program Expenditures NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 4 FY 2006-07 FY 2007-08 FY 2008-09 Actual * Budget * Estimate Salaries and Wages Professional Fees Operations 2,040.00 Equipment 6,264.00 Other" NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 4 If applicable ° Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 5 FY 2006-07 Actual * FY 2007-08 Budget* FY 2008-09 Estimate Total 8,304.00 If applicable ° Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 5 Palekana Kai Ocean Safety, LLC. Palekana Kai Ocean Safety, LLC. Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2006-07 FY 2007-08 FY 2008-09 Actual * Budget* Estimate Healing Our Island Mini Grant 2,000.00 Fund Raisers 5,000.00 Total 7,000.00 *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? Current fundraising events, primarily car washes, cover the basic program expenses sucsh as training supplies, insurance, licensing and registration fees, and annual First Aid/CPR certification fees. In June of 2006, the County of Hawai'i awarded the organization a $2000.00 "Healing Our Island" mini -grant to support the organization's efforts in mentoring the Island's young people and providing healthy, drug and alcohol -free activities. The mini -grant was used to purchase a projector, screen and instructional videos and manuals. Through its community capacity -building program the County of Hawai'i Department of Research and Development has recognized the services that Palekana Kai provides and is providing technical assistance related to non-profit board development, reporting fundraising strategies. The values of this consultation is valued at $2,800.00. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 6 Funding requests to the Hawai'i Community Foundation and other local funders including the Office of Hawaiian Affairs are being developed. The group will continue its fundraising activities, chiefly car washes which defray basic operational expenses. With a grant from the County of Hawai'i, Palekana Kai will be able to purchase equipment enabling them to provide a consistent level of program delivery and services to the community. Finally, Palekana Kai will develop an earned income stream of revenue, eventually charging nominal fees to some of the nonprofit organizations and event organizers served. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 7 Palekana Kai Ocean Safety, LLC. Palekana Kai Ocean Safety, LLC. I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 — 2-142.2, Hawai'i County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawai'i Revised Statutes. If awarded a grant from the County of Hawaii, I (we) understand and will comply with the requirement to submit a year-end report to the Legislative auditor within 60 days after June 30 of the fiscal year. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawaii grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely. complete, an agency's future fundina requests. cm 1�� . Signature of B and President/Chair Signature of Executive Director I cab Date I M Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTEDI NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 8 Puna Friends of the Parks - Agency Name Kapoho Vision Project - Program Name Agency Director: Virginia Aste Contact Person: Virginia Aste Mailing Address: 13-631 leilani —Ave.pahoa, 96778 Facility/Site Address: 13-631 leilani —Ave.pahoa, 96778 Fax No.: 965-5454 Email Address: kmkinney@hawaii.edu Phone No.: Phone No.: Name of Accountant/CPA (include name of firm if applicable): N/A Phone No.: N/a Mailing Address: N/a Amount of Request for County Funds Prior Year(s) Funding: 05-06 06-07 Agency Mission Statement: $131,040.00 07-08 $131,040.00 The purpose of the organization shall be to support planning creation development maintenance and programs at state and county parks in the Puna district county of Hawaii. To provide enhanced recreational opportunities and pleasant surroundings for resident and visitors alike NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 1 Puna Friends of the Parks - Agency Name Kapoho Vision Project - Program Name Program Description: Puna Friends of the Parks in contract with the University of Hawaii are undertaking a comprehensive survey of the Kapoho area as a first step in developing and implementing an effective conservation/management plan for the important historical and recreational area of Cape Kumukahi and Champagne Ponds. This effort aims not only to scientifically investigate and describe the condition of water quality and public health risks at Champagne Ponds, but to also examine, review and conduct an inventory of the archeological, cultural and community resources in the vicinity of Cape Kumukahi, Champagne ponds and related access points. In addition, geographic information systems technology is used to develop implement and utilize a geodatabase to conduct spatial analysis of water quality and archeological/cultural reconnaissance Total Budget and Position Count Total Pro ram Budget 200,040.00 Total Program Position Count Total Agency Budget 11,729 Total Agency Position Count 2 Program Objectives: 1) Initiate microbial water quality survey and investigate the impact of sewage by detection of human specific genetic markers at Champagne Pond for a 12 month period over the fiscal year the program is funded.1-2 sampling events /wk. 4 progress reports (1/quarter) and 1 final report will be produced. 2) Promote public and community awareness of water quality results and potential risks. During the 12 month period and/or fiscal year that the program is funded 4 community meetings will be held (1/quarter). Additional access to water quality data will be made available regularly on UH Geography website. Website will be updated (2-3/month) (6-9/quarter) for 12 month period and/or fiscal year the program is funded. 3) Inventory Archeological Cultural Resources for a 12 month period during the fiscal year that the program is funded. 4 quarterly reports and 1 final report of all data i.e. maps, literature review, field studies collected will be completed and organized for submission. Reports will be posted on UH Geography website for public access (1/quarter). 4) Develop and maintain Geo Spatial Analysis and GIS Database of water quality and archeological data during the fiscal year the program is funded. GIS technician will assist researcher's 1-2/week to model the statistical and spatial features of their data. The technician will submit 4 quarterly progress reports and 1 final report of all methodologies and maps generated for submission and posting on UH Geography website. 5) Coordinate and compile all data, results, analysis and recommendations. PI will prepare, submit, and present executive documents to the Kapoho Community, County Council, EPA, DLNR, and general public no later than 60 days from the end of the 12 month water quality study. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 2 Puna Friends of the Parks - Agency Name Kapoho Vision Project - Program Name Performance Measures: *If applicable NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 3 FY 2006-07 Actual * FY 2007-08 Budget * FY 2008-09 Estimate Professional fees for contract with 115,315.00 University of Hawaii at Hilo, Department of Geography and Environmental Studies to meet the following performance measures: Water Quality Weekly water sampling 4 reports (1/Quarter) and 1 final report will be produced. Archeological Cultural Resource Survey 7 progress reports and 1 final report of all data collected and compiled will be completed. Reports will be posted on UH Geography website for public access ( 1/month). Keaholoa STEM Interns 10 hrs/wk conducting water quality analysis. Assist in monthly and quarterly report development Field work and sampling Geo Spatial Support and Mapping GIS technician will assist researchers 1-2/week to model the statistical and spatial features of their data. The technician will submit 11 progress reports and 1 final report of all methodologies and maps generated for submission and posting on UH Geography website. Coordination and compilation of all data, results, analysis and reccomendations 22 progress reports ( 4 Water quality, 7 Archelogical, 11 GIS) 3 final report (1 Water Quality, 1 Archelogical, 1 GIS 1 Executive final report *If applicable NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 3 Puna Friends of the Parks - Agency Name Kapoho Vision Project - Program Name Program Expenditures FY 2006-07 Actual * FY 2007-08 FY 2008-09 Budget* Estimate Salaries and Wages 5,000.00 Professional Fees 115,315.00 In-kind UH Hilo EPSCoR CERE 3,225.00 -Operations 35,000.00 -Equipment Other" 7,500.00 Total 131,040.00 If applicable " Please explain in detail on separate sheet Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2006-07 Actual * FY 2007-08 FY 2008-09 Budget* Estimate Hawaii County 131,040.00 In -Kind UH Hilo Geo /Envs dept. 4,000.00 In-kind UH Hilo EPSCoR CERE 30,000.00 In -Kind UH Hilo Keaholoa STEM 35,000.00 Total 200,040.00 *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? UH -Hilo has submitted a proposal to the NOAA Oceans and Human Health Initiative to request funding ($650,000) that would support a comprehensive water quality study in the Kapoho region. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 4 Puna Friends of the Parks - Agency Name Kapoho Vision Project - Program Name I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 — 2-142.2, Hawai'i County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawai'i Revised Statutes. If awarded a grant from the County of Hawaii, I (we) understand and will comply with the requirement to submit a year-end report to the Legislative auditor within 60 days after June 30 of the fiscal year. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawaii grant funds, and a listin of other funding sources and amounts obtained during the award periodg. Failure to submit a timely, complete Signature of Board President/Chair Date Signature of Executive Director Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 5 Puna Friends of the Parks - Agency Name Kapoho Vision Project - 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, Hawai'i County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawai'i Revised Statutes. If awarded a grant from the County of Hawai'i, I (we) understand and will comply with the requirement to submit a year-end report to the Legislative auditor within 60 days after June 30 of the fiscal year. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawaii grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely, complete, an agency's future funding requests. Signat a of Board President/Chair Signatu of Executive Director Date Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 200849 Page 7 Puna Friends of the Parks - Agency Name Kapoho Vision Project - Program Name Other # Other costs of $7,500.00 include reporting and publication costs, signage, public informational meetings, and promotional materials. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 6 The Salvation A rmy Family Intervention Services Prevention Programs-Honokaa Agency Director: Pauline Pavao Contact Person Mailing Address Raymond Dangaran Facility/Site Address Fax No.: Email Address Phone No.: 935-4411 Phone No.: 935-4411 P.O. Box 5085 Hilo, HI 96720 21 W. Ohea St. Hilo, HI 96720 933-9810 pauline_pavao@usw.salvationarmy.org Name of Accountant/CPA (include name of firm if applicable): Name: Carole Nagamine(TSA-FIS)/ Donna Lum (Divisional Director of Finance) Phone: (808) 935-4411/ (808) 988-2136 Mailing: P.O. Box 5085 Hilo, HI 96720/ P.O. Box 620 Honolulu, HI 96809 Amount of Request for County funds: $37,500 Prior Year Funding: 05-06 06-07 07-08 $ 0 $28,000 $35,000 Agency Mission Statement: To provide youth with skills for a healthy life, and instill purpose, hope, and vision to youth and their families. Our agency's goals are to provide youth with a safe, caring, and nurturing environment; and provide opportunities for youth to challenge their life styles through development of appropriate social skills, academic success, and personal resiliency. Program Description: The Salvation Army Family Intervention Services -Prevention Programs provides a safe and nurturing environment along with access to opportunities, experiences, and services to support positive youth development. We utilize a prevention approach to decrease the use and abuse of alcohol, tobacco, and other illicit drugs (ICE, ecstacy, and etc.), involvement in gangs and violence, delinquent behaviors, early sexual behaviors, and to improve academic performance and school attendance. This will be NONPROFIT GRANT APPLICATION FISCAL YEAR 2003-09 Page I accomplished by implementing Outreach Services (Leadership Development Program and Positive Alternative Activities) to youth ages 7-18 years old and their families, residing in the Honokaa district. Leadership Development Program -The L.E.A.D. Team (Learning Experience in Assisting and Directing) provides development of leadership skills and training in areas of personal and social skills, teamwork, decision making, goal setting, and action planning to conduct community service and learning projects. Leadership activities will allow youth to experience leadership, group dynamics and problem solving opportunities such as youth planning committees and youth representative on community collaboration efforts. Positive Alternative Activities consist of: Recreational, Perform ingNisuaI Arts and Humanities, Educational, Cultural, and Youth Leadership Activities. Other prevention activities consist of Community Service and Learning Projects, Drug-free dances, and Excursions. These activities will provide yout with opportunities to develop an understanding of self and one's culture and a sense of identity and belonging, and promote the development of competencies (social well-being, knowledge, and social responsibility. All services will be in conjunction with the Teenage Pregnancy Prevention & Family Strengthening Program in Honokaa, currently funded by the Department of Defense. We propose to implement program services during after-school and occasionally weekend hours. The proposed funding would support and provide for 2 part-time staff: Youth Development Specialist I (Site Leader) @ 50% or 20 hours per week and a Youth Service Workers @ 19 hrs per week. Total Budget and Position Count Total Pro ram Bud et 162,500 Total Program Position Count 1.975 Total A enc Bud et 3,594,804 Total Agency Position Count 72.5 Program Objectives: 1) Of the 45 youth targeted to participate in the Prevention Programs, at least 80% will register for Outreach Services (L.E.A.D. Team, Positive Alternative Activities) and maintain participation with the program to completion or for 6 months beyond the registration date. 2) Of the 45 youth participating in the prevention activities throughout the year, at least 80% will participate in Positive Alternative Activities (Community Service and Learning Projects, Recreation, Tutoring, and Community Events), demonstrate an increase in competencies (social well-being, knowledge, and social responsibility) for the first 6 months, and continue that gain for an additional 6 months or completion of the program. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 2 Program Highlights: 2006-07 Throughout the year, we provided in school and after-school services (group facilitations, youth retreats, skill -building activities, positive alternative activities, and follow-up and monitoring services). Also, we collaborated with school personnel, community groups and associations, and community agencies and services to network, build relationships, and provide support with activities and special events. Finally, we provided family strengthening activities to increase communication, understanding, and positive relationships between youth and family. Other activities provided as follows: In -school Presentations: We are in the intermediate school with the entire seventh and eighth grade classes every M, T, W, all day. This gives us approximately 120 youth enrolled in our TPP classes. However, we targeted only 45 youth out of the 120 youth to continue services with after school. The in -school presentations included sessions in Anger Management, Decision Making and Goal Setting, Substance Use and Abuse, and Family Strengthening. Summer Program Activities: During the summer break, we provided youth with fun activities, arts and crafts projects, community services, and excursions. Fun and educational excursions included; Laupahoehoe Train Museum, Laupahoehoe Swimming Pool, Spencers Beach Park, 'Imiloa Center, Hilo Lanes -Bowling, Mauna Kea Beach Park, Tortoise Farm, Richardson Beach, Hapuna Beach, Ellison Onizuka Museum, Hilton Hawaiian Tour, Waipio valley, and Volcano National Park. End of the Year Bashes: Another major accomplishment during the program was the collaboration with Honokaa Intermediate and other community services and agencies to implement "Rewards Days". Throughout the year, we have collaborated with the schools to assist with the quarterly incentive program for the intermediate students. We participated in on -campus dances, pool days, and this final Rewards Day that was held on the Salvation Army grounds. We collaborated with Honokaa Intermediate School personnel, Hamakua YWCA Youth Center, Hamakua Health Center, Boys and Girls Club of the Big Island, and the Ohana Earthquake Outreach. The event provided closure of our TPP/FS curriculum, and an opportunity to promote and recruit for the upcoming summer program. The event activities included a dunking booth, community resource tables, recreational activities, food, and a lot of fun. Community Collaborations: Linkages with Other Agencies: At this time the agencies that we have been in contact with is the DOE and Honokaa's Power of Choice board. The support that the Honokaa high and intermediate schools have given us has been tremendous, they have invited us in to there classrooms, given us a place to provide our services and staff support. The Power of Choice board has given us a place to connect with other community organizations as well as a place to get the message out that we our here and these are the services we offer. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 3 Performance Measures: *If applicable Proaram Exaenditures FY 2006-07 Actual * FY 2007-08 FY 2008-09 Budget * Estimate Participates in L.E.A.D. Team 45 45 45 Participates in Pos. Alter. Activities 45 45 45 Participates in Comm. Srv. Projects 45 45 45 Follow up and Monitoring 45 45 45 *If applicable Proaram Exaenditures Pro ram Fundina Sources Revenue Source FY 2006-07 Actual * FY 2007-08 Budget* FY 2008-09 Estimate Salaries and Wages 112,094.16 125,694 128,284 Professional Fees 0 0 0 Operations 40,905.84 34,306 34,216 Equipment 153,000 0 0 Other* 0 0 Total 153,000 160,000 162,500 Pro ram Fundina Sources Revenue Source FY 2006-07 Actual * FY 2007-08 —Budget * FY 2008-09 Estimate Department of Defense (DOD)* 125,000 125,000 125,000 County of Hawaii 28,000 35,000 37,500 Total 153,000 160,000 162,500 *Teenage Pregnancy Prevention & Family Strengthening Program Iunded under DUL). Explain what plans, if any, your agency and/or program has to increase revenues to support this program. When do you anticipate your program to become self- sustaining? The Salvation Army -Family Intervention Services, while part of The Salvation Army, is required to seek its own funding for program services. As such, TSA -FIS relies primarily on funding from government at the federal, state and county levels to continue our prevention and intervention programs to assist at -risk youths and their families. Such funding is primarily through the purchase of service system, which we are required to submit proposals through a competitive process. Very limited funding is available through grants from trusts and foundations. We continuously explore avenues of funding to continue these programs. However, in view of the nature of our mission in developing healthy lifestyles for youths and their families, we do rely heavily on funding from all levels of government. As such, we do not anticipate being self-sufficient in providing prevention services to the youth and families residing in Hawaii County. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 4 The Salvation Army -Family Intervention Services Prevention Programs-Honokaa I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 — 2-142.2, Hawaii County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawaii Revised Statutes. If awarded a grant from the County of Hawal'i, I (we) understand and will comply with the requirement to submit a year-end report to the Legislative auditor within 60 days after June 30 of the fiscal year. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawaii grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely, complete, an !�? a� Signat irr of Board President/Chair Signature of Executive Director lolck Dat Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! t'Y'L'1°1 it tS'V ' 1 GRA -INT" '.L1'i.:-,-1L71"Y T _ h The Salvation A rmv Familv Intervention Services Prevention Programs-Pahoa Agency Director: Pauline Pavao Contact Person: Mailing Address: Raymond Dangaran Facility/Site Address Fax No.: Email Address Phone No.: 935-4411 Phone No.: 935-4411 P.O. Box 5085 Hilo, HI 96720 21 W. Ohea St. Hilo, HI 96720 933-9810 pauline_pavao@usw.salvationarmy.org Name of Accountant/CPA (include name of firm if applicable): Name: Carole Nagamine(TSA-FIS)/ Donna Lum (Divisional Director of Finance) Phone: (808) 935-4411/ (808) 988-2136 Mailing: P.O. Box 5085 Hilo, HI 967201 P.O. Box 620 Honolulu, HI 96809 Amount of Request for County funds: $35,000 Prior Year Funding: 05-06 $38,000 06-07 $32,000 07-08 $35,000 Agency Mission Statement: To provide youth with skills for a healthy life, and instill purpose, hope, and vision to youth and their families. Our agency's goals are to provide youth with a safe, caring, and nurturing environment; and provide opportunities for youth to challenge their life styles through development of appropriate social skills, academic success, and personal resiliency. Program Description: The Salvation Army Family Intervention Services -Prevention Programs provides a safe and nurturing environment along with access to opportunities, experiences, and services to support positive youth development. We utilize a prevention approach to decrease the use and abuse of alcohol, tobacco, and other illicit drugs (ICE, ecstacy, and etc.), involvement in gangs and violence, delinquent behaviors, early sexual behaviors, and to improve academic performance and school attendance. This will be NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 1 accomplished by implementing Community -Based Outreach Services and Positive Alternative Activities to youth ages 7-18 years old and their families, residing in the Pahoa district. Outreach services consist of: r Leadership Development Program -The L.E.A.D. Team (Learning Experience in Assisting and Directing) provides development of leadership skills and training in areas of personal and social skills, teamwork, decision making, goal setting, and action planning to conduct community service and learning projects. TSA -FIS has developed a program called 'Project Family" to build relationships between agency, youth, parents, and community. Project Family Activities provide parent support and family strengthening activities to promote family cohesion and positive relationships within diverse family structures. Youth and their families along with agency staff participate in regularly scheduled "Family Days" which are activity -based and fun. ➢ Positive Alternative Activities consist of: Recreational, Educational, Cultural, and Youth Leadership Activities. Other prevention activities consist of Community Service and Learning Projects, Drug-free dances, and Excursions. All services will be part of a compilation of Prevention Programs currently funded by the Office of Youth Services, Hawaii Community Foundation, and Department of Health. Program services will be provided at Pahoa School Districts and at the Nanawale Community Center. We propose to implement program services during in -school, after- school, and occasionally weekend hours. The proposed funding would support and provide for 0.30 FTE Youth Development Specialist and 0.50 FTE Youth Service Worker at 20 hours per week. Funding from the Positive Youth Development & Weed and Seed Project contracts will help support and establish a 1.00 FTE Youth Development Specialist and Youth Service Worker for Prevention Services in Pahoa. Total Rudaet and Position Count Total Pro ram Budget 110,000 Total Pro ram Position Count 1.8FTE Total Agency Budget 3,594,804 Total A enc Position Count 72.5 Program Objectives: 1) Of the 60 youth targeted to participate in the Prevention Program, at least 80% MI! register for Outreach Services (L.E.A.D. Team project Family, Positive Alternative Activities) and maintain participation with the program to completion or for 6 months beyond the registration date. 2) Of the 60 youth participating in the prevention activities throughout the year, at least 80% will participate in Positive Alternative Activities (Community Service and Learning Projects, Recreation, Tutoring, Community Events, and Family Days), demonstrate an increase in competencies (social well-being, knowledge, and social responsibility) for the first 3 months, and continue that gain for an additional 5 months or completion of the program. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 2 Program Highlights: FY 2006-07 In -school Presentations: Three in -school classes were held at Pahoa Intermediate School with 10 sessions each. These sessions were done in the Teen Health 7th grade classe, Peer Education Class, and the Alternative Learning Center. The sessions included discussions and hands-on activities regarding different topics such as: Anger Management, Goal Setting, Leadership Skills, Drug & Sexuality Awareness and Family dynamics. Holiday Events: We celebrated the holidays at the Nanawale Longhouse with the youth and their families. We assisted with Halloween, Christmas, and Easter events in collaboration with the Nanawale Community Association. We provided food, refreshments, activities, and fun with each event. We encouraged the youth and their families to participate in all activities that were offered at the Longhouse. Summer Program: A free summer program was held at the Nanawale Longhouse for youth 7-18 years old living in Nanawale. Youth participated in activities such as: Ceramics, Arts & Crafts projects, Sports and Recreational Activities, skill building groups, and Music and Dance. Youth also participated in excursions such as: Beaches (Richardson, Hapuna, Spencer Park), educational excursions ('Imiloa, Volcano National Park, Ellison Onizuka Museum), and amusement (day at the Mall, Movies, Mauna Loa Mac Nut Factory, and the Zoo). On the last day of the program, we held a "finale" where youth showcased their talents (music and dance), arts and crafts projects, and spent "quality" time with other youth and families. A mini dance was held to complete the summer program and activities. Other Program Activities: We conducted a Youth Dance (Triple D Dance -Don't Do Drugs) for 7 fnand 8 Ingraders at the Pahoa High & Intermediate Gym. Also, throughout the year, we have collaborated with several community activities such as: Participating in a resource/school supply giveaway at Pahoa Elementary with Solid Rock Ministries, also a school supply distribution at the Maku'u farmers market along with the Neighborhood Place of Puna, Helping Hands Hawaii, and other agencies. We also participated with the Salvation Army's Angel Tree held at the Prince Kuhio Plaza, where the community would donate items for the less fortunate children in the community. In collaboration with the Pahoa Weed and Seed Youth Development Committee, we assisted with the Wrestling Clinic and Tournament held at the Pahoa Gym. Finally, along with the Pahoa Weed and Seed, we participated in the Booster Seat Safety Check-up held at the Malama Parking Area. Community Agencies anrl the HPD offered information and free booster seats installed by certified personnel. Community Collaborations: TSA -FIS has worked cooperatively in coordinating services for youth and families with the following programs: Pahoa Intermediate and High School, Keonepoko Elementary, Big Island Substance Abuse Council; Workforce Investment Youth Employment Services; Hawaii County Community Policing Officers; Bay Clinic; Queen Liliuokalani Children's Center; Neighborhood Place of Puna; Boys and Girls Club of the Big Island; Alulike Inc; and Nanawale Community Center. NONPROFIT GRANT APPLICA'T'ION FISCAL YEAR 2003-09 Pagt 3 Performance Measures: Program Expenditures FY 2006-07 Actual * FY 2007-08 * FY 2008-09 Estimate Completion of L.E.A.D. Team 67 —Budget 60 60 Participates in Pos. Alter. Activities 70 60 60 Participates in Project Family 65 60 60 Follow up and Monitoring 67 60 60 Program Expenditures Program Funding Sources Revenue Source FY 2006-07 Actual * FY 2006-07 Actual * FY 2007-08 Budget* FY 2008-09 Estimate Salaries and Wages 133,408.48 76,363 75,616 Professional Fees 0 0 0 Operations 65,636.52 33,637 34,384 Equipment 0 0 Other* 0 0 Total 199,045 110,000 110,000 Program Funding Sources Revenue Source FY 2006-07 Actual * FY 2007-08 Budget* FY 2008-09 Estimate Office Of Youth Services* 167.045 75,000 75,000 County of Hawaii 32,000 35,000 35,000 Total 199,045 110,000 110,000 *Positive Youth Development services funded under Office of Youth Services. Explain what plans, if any, your agency and/or program has to increase revenues to support this program. When do you anticipate your program to become self- sustaining? The Salvation Army -Family Intervention Services, while part of The Salvation Army, is required to seek its own funding for program services. As such, TSA -FIS relies primarily on funding from government at the federal, state and county levels to continue our prevention and intervention programs to assist at -risk youths and their families. Such funding is primarily through the purchase of service system, which we are required to submit proposals through a competitive process. Very limited funding is available through grants from trusts and foundations. We continuously explore avenues of funding to continue these programs. However, in view of the nature of our mission in developing healthy lifestyles for youths and their families, we do rely heavily on funding from all levels of government. As such, we do not anticipate being self-sufficient in providing prevention services to the youth and families residing in Hawaii County. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 4 The Salvation Army -Family Intervention Services Prevention Programs-Pahoa I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 — 2-142.2, Hawai'i County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (%rje) understand that information supplied herein shall be made public according to Chapter 92F, Hawaii Revised Statutes. If awarded a grant from the County of Hawaii, I (we) understand and will comply with the requirement to submit a year-end report to the Legislative auditor within 60 days after June 30 of the fiscal year. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawai'i grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely, complete. and Signaty e, f Board President/Chair 11 Signature of Executive Director D e Z z C J'' Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! id��`:�•�vj3� i��u�!v"3 _S�FrL3�=�ila7 The Salvation Army Family Intervention Services Services to Homeless Youth "Malama Kuewa Opio" Program Agency Director: Contact Person: Mailing Address: Facility/Site Address Fax No.: Email Address `,Nest Hawaii Pauline Pavao Michael Chung 5085 POB Hilo, Hawaii 96720 Phone No.: 808-935-4411 Phone No.: 808-959-5855 Ext. 28 75-235 Kalani St. Kailua Kona, Hawaii 96740 808-933-9810 Michael Chung()usw.salvationarmy.org Name of Accountant/CPA (include name of firm if applicable): Carole Nagamine(TSA-FIS) /Donna Lum(Divisional Director of Finance) Phone No.: 808-935-4411 / 808-988-2136 Mailing Address: POB 5085 Hilo HI 96720 / POB 620 Honolulu, HI 96809 Amount of Request for County Funds: $32,000 Prior Year(s) Funding: 05-06 06-07 07-08 $32,000 $28,000 $20,000 Agency Mission Statement: To provide skills for a healthy life, and instill purpose, hope, and vision to youth and their families. The Agency's goals are to provide youth a safe, caring, and nurturing environment, and provide opportunities for youth to challenge their life styles through development of appropriate social skills, academic success, and personal resiliency. Program Description: The Federal definition of a "Homeless Youth" is a youth who is a runaway, has been abandoned by their parents, living on the streets, having no stable and safe living place of residence, and/or a youth from a homeless family. These youths are vulnerable to a host of problems including sexual exploitation, health problems, criminal behavior, and drug involvement. This is a serious problem nationally, and it has now become a growing and real concern locally here as well. According to statistics by our Hawaii County's Prosector's Office, runaways in this County is the highest juvenile arrest problem by the Police. Our own experiences in working with this population suggest NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 1 The Salvation Army Family Intervention Services Services to Homeless Youth "Malama Kuewa Opio" Program West Hawaii that many homeless and runaway youth congregate along the Alii Drive area of the Kona district. These youth are drawn into by the tourism activities of these areas, but consequently it makes them very susceptible to crime and exploitation. The Salvation Army -Family Intervention Services (TSA -FIS) provides prevention services to youth and families in various communities in our County. In an effort to help address this specific community problem in the West Hawaii region, we have begun implementing a new program, which we have appropriately named the "Malama Kuewa Opio" program. It literally means "to help our homeless youth", and it is specifically designed to target and address this particular youth population. We intend to use the und$, v✓hichvie 'u re requesting from tV�o (`n.�.ritt `n rZr. t {n Delp augmen4 and �41e ngtl�en the services of this of this particular program. Through this, we will be able to better develop staffing needs to achieve several outcomes including assisting these youth to meet their basic needs, and helping them move from their crisis situations into more stable, safe, and healthy functioning. The challenges to provide services to this target population are widespread and abound. Many of these youngsters are very distrustful of the system, and therefore, it takes time, persistence, and creative approaches to engage and develop healthy relationships with these youth. Moreover, because these youth are labeled and stigmatized, many services and opportunities are not as readily available to them. Furthermore these youth have been abandoned by their families, and do not have the necessary supports and/or financial resources to access the services that they desperately need. Through our "Malama Kuewa Opio" program, TSA -FIS seeks to provide homeless youth of the West Hawaii region with the following services. 1) Outreach services: Staff will look to engage these youngsters in areas throughout the West Hawaii region where they frequently congregate, and during times that they are frequently accessible. 2) Case Management: Our program will develop assessments and service plans for these youth, and we will also look to link youngsters to resources in the community and address other basic needs such as clothing, food, and hygiene needs. 3) Transitional services: We will look to develop youngsters with education and skills to help improve their functioning including vocational and life skill training. 4) Access to Emergency placement or family reunifications: Our program will look to connect youngsters to safe placement options including reunifying them back with their families. Tntni Rivinnf and Pnsifinn Count Total Pro ram Bud et 122,000 Total Pro ram Position Count 1.5 Total Agency Budget 1 3,594,804 Total Agency Position Count 72.5 Program Objectives: 1) 60 % of youth provided services by the program will be connected to at least one resource that can assist the youth to enhance their functioning in at least one area identified in an assessment and service plan. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 2 The Salvation Army Family intervention Services Services to Homeless Youth "Malama Kuewa Opio" Program West Hawaii 2) 60% of youth provided program services will have accessed or secured a more stable, safer living environment. Program Highlights: 1) Over the past year, our West Hawaii program has provided approximately 40 foster youth various program services. 2) Begun development of Transitional living house where youth could utilize as a potential placement option. 3) Our program services continues provide its services to the outlying areas of the %A/et Ua,°,all Alnr+h and Coty#h Kohala North and South Knn7,_t.... ,y , and parts of Hawaii Ocean View Estates. 4) Our program continues to provide its ongoing Independent Living Skills curriculum to the Konaweana and Kealakehe High schools covering the following learning components: Personal and Social Development, Budgeting and Money Management, Health and Nutrition, Employment and Career options, self care and Positive relationship building, and Daily Living skills and Community Involvement. 5) The program continues to provide various workshops and activities for youth involved in the program. They include: Community resource tours, learning to apply for financial aid, learning about Colleges and scholarships, touring the University of Hawaii and West Hawaii Campuses, resume writing skills, information and tips on Job Interviews, Job shadowing opportunities; learning first aid; nutrition and cooking workshop; and housing options workshop. 6) Our agency has planned and provided field trips designed as positive alternative activities to foster and build relationships with youth. Including visits to: Akaka falls; City of Refuge, Hapuna Beach, Mall Activity, and camping trips. 7) As part of our case management services provided to foster youth, we continue to collaborate with various community agencies and programs including: Child Welfare Services of West Hawaii; West Hawaii Community College; Konawaena High School; Kealakehe High School; Kealakehe Intermediate School; Work Force Development Division -West Hawaii, and various hotel and business in West Hawaii. Parfnrmanra MPasurPs' NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 3 FY 2006-07 Actual * FY 2007-08 Budget* FY 2008-09 Estimate # Youth identified through Outreach 50 # Provided Assessments & Service Plans 45 # Youth Provided Basic Need Services 35 # Transitional Skills training 30 # Provided Informational Services 45 # Provided Referral Services 30 NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 3 The Salvation Army Family intervention Services Services to Homeless Youth "Nialama Kuewa Opio" Program West Hawaii # Youth provided ongoing follow-up FY 2006-07 r dual FY 2007-08 I Budget 45 Services 95,414.91 61,995 85,054 # Youth Provided Placement 0 0 20 options or reunification services 37,641.93 50,995 36,946 *If applicable This a new program and therefore, there are no numbers indicated for FY 06-07 and FY 07-08 Program Expenditures If applicable Please explain in detail on separate sheet Program Funding Sources: Identify all funding sources (specific to this program oniv) Revenue Source FY 2006-07 r dual FY 2007-08 I Budget FY 2008`09 EsaiiSiate Salaries and Wages 95,414.91 61,995 85,054 Professional Fees 0 0 0 Operations 37,641.93 50,995 36,946 Equipment 0 0 0 Other" 0 0 0 Total 133,056.84 112,990 1 122,000 If applicable Please explain in detail on separate sheet Program Funding Sources: Identify all funding sources (specific to this program oniv) Revenue Source FY 2006-07 FY 2007-08 Actual * Budget* FY 2008-09 Estimate Office of Youth Services 105,057 92,990 90,000 County of Hawaii 28,000 20,000 32,000 Total 133,057 112,990 122,000 *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 (TSA -FIS), while part of the Salvation Army, is required to seek its own funding for program services. As such, TSA -FIS 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 2008-09 Page 4 The Salvation Army -Family intervention Services Services to Homeless Youth "Malama Kuewa Opio" Program West Hawaii I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 — 2-142.2, Hawai'i County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawaii Revised Statutes. If awarded a grant from the County of Hawai'!, I (we) understand and will comply with the requirement to submit a year-end report to the Legislative auditor within 60 days after June 30 of the fiscal year. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawa!'i grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely, complete, and accurate year-end report will impact the evaluation of your program's or agency's future funding requests. Sign a of Board President/Chair G' Ems. ignature of Executive Director i '2? & f' Da e Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 5 Special Olymics Hawaii- Agency Name Special Olympics Hawaii -East Hawaii - Program Name Agency Director: 943-8808 x 22 Contact Person: 935-0537 Mailing Address: Facility/Site Address Fax No.: Email Address: Nancy Bottelo Carey Uchida COPY Phone No.: (808) Phone No.: (808) P.O. Box 7265 * Hilo, HI 96720 138 Kaikuono Place * Hilo, HI 96720 808 935-1968 careyuchida@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 # 900 Honolulu, HI 96814 Amount of Request for County Funds: $15,000 Prior Year(s) Funding: 05-06 06-07 07-08 $12,000 $12,000 $12,000 Agency Mission Statement: NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 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 adults with intellectual disabilities, giving them continuing opportunities to develop physical fitness, demonstrate courage, experience joy and participate in the sharing of gifts, skills and friendship with their families, other Special Olympics athletes and the community. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 2 Special Olympics Hawaii - Agency Name Special Olympics Hawaii -East Hawaii - Program Name Program Description: Timothy Shriver, Chairman of the Special Olympics Incorporated Board of Directors, stated at the 2003 World Games in Dublin Ireland, "Somewhere near and somewhere very far away, there is a boy or a 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 life experience by a disability have little chance for the development growth and acquisition of important skills that they will need to gain employment, maintain relationships and function independently as adults. Special Olympics helps to give individuals with a intellectual disability the necessary skills to achieve that independence. We believe that all people regardless of their disability deserve to lead full , active lives, enriched with social and recreational opportunities that most of us take for granted. Unfortunately, appropriate physical education programs in the public schools and social service programs that realistically address the special needs of this population are virtually non-existent. Special Olympics 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 a vital program where these special needs individuals interact with their non -handicapped peers on a weekly basis. Unified Sports is a program that combines equal numbers of athletes with intellectual disabilities and special partners without disabilities. All participants are of similar age and athletic ability. This program dramatically increases inclusion of our athletes into the community by helping break down barriers that have historically kept people with and without disabilities apart. Special Olympics East Hawaii now has a unified softball team, many unified bowling teams and unified bocce teams that participate in our Unified Sports program. They all train and compete together here in East Hawaii and they travel to Kona, 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 self- confidence, a more positive self-image, friendships, and increased family support. Special Olympics athletes carry these benefits with them into their daily lives at home, in the classroom, on the job, and in the community. Families who participate become stronger as they learn a greater appreciation for their childs's talents. We have found that our strongest supporters and best volunteers are the family members of our Special Olympics athletes. We provide a "safe haven" for families where they know that their child is accepted for who they are and for what they can do. Community volunteers find out what good friends the athletes can be. Everyone learns more about the capabilities of people with intellectual disabilities. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 3 The need for the Special Olympics East Hawaii program to continue here on this island is extremely high. Special training is provided for our athletes and the coaching staff throughout the year. The training is essential due to the unique services that we provide. These services are not available anywhere else but with our program. We not only touch the lives of our Special Olympics athletes, but also their families and the hundreds of volunteers from our community. Our founder, Eunice Kennedy Shriver, believes sports training and competition opportunities should be available for all who qualify rather than all who could afford to participate. Therefore, our program is free of cost to all of our athletes, special partners, and coaches. We receive no money from the Kennedy Foundation or the Federal Government. All of the money raised for the East Hawaii program stays here to support our program. Due to the aspect of our program , a volunteer committee under the leadership of our Area Director must raise all the funds needed for our East Hawaii area program. Those funds will pay for all aspects of the Special Olympics progam, which includes, equipment, uniforms, transportation costs, training of the coaching staff, family activities and trainings, and 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. We have 3 athlete representatives who were selected to travel to Oahu, bi annually, where they serve on the State Athlete Congress. The Athlete Congress is a voting body that votes on issues that are affecting their program. These representatives bring their Area issues to this body and determine what all the athletes from the state want to do. When decisions are made those athletes will present their findings to the appropriate people, this could include the CEO/President of Special Olympics all the way to the Board of Directors. East Hawaii's Teresa Moore was elected by her peers throughout the State of Hawaii to serve as the Congress Chairperson for the 2007 Athlete Congress. In 2005 Teresa was selected to represent the Southwest region of the United States at the 2005 Global Athlete Congress which was held in Panama City, Panama. There 70 athletes representing 35 different countries discussed and voted on topics that would affect decisions made for Special Olympics worldwide. So there are many ways Special Olympics offers our athletes from East Hawaii the opportunity to travel, meet other athletes, expand their horizons and become a contributing member of society. Special Olympics East Hawaii's largest expense for 2008-2009 is transportation. It is an essential part of our program that Special Olympics athletes are provided an opportunity to interact and compete against people of smiliar athletic ability. Unforunately our area program is too small to be able to provide quality competition, therefore our athletes must travel to other islands to achieve that goal. The state competitions that are held on Oahu 3 times per year provide many activities that our athletes never have a chance to experience. They include; dances, Opening and Closing Ceremonies, entertainment and games, and free health exams through the Healthy Athlete Program. This Healthy Athlete program provides free dental, vision, hearing, podiatry, flexibility & nutrition screening and education for our athletes. As you know, these services NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 4 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 througout 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 transportation for athletes to get to practices and competitions. Special Olympics Hawaii -East Hawaii Area is asking for $15,000.00 from the County of Hawaii to help fund our Special Olympics East Hawaii program activities. Total Budget and Position Count Total Program Budget $113,300 Total Program Position Count 1 Total Agency Budget 1,716,950 Total Agency Position Count 18 Program Objectives: 1) To provide quality sports training and Olympic type competitions for 215 athletes and special partners within our program by June 2009. 2) To establish a new delegation at Kalanianaole Elementary & Intermediate School, therefore providing opportunities for more students with intellectual disabilities to become more physically fit through sports training and competition by June 2009. 3) To provide sports specific coaches training or recertification for 20 coaches in various Olympic type sports and at various athletic ability levels so that they may provide appropriate training to the athletes within their delegations by June 2009. 4) To provide our families, coaches, volunteers and athletes with 3 family activities throughout the year, that will be conducted by our family committee by June 2009. 5) To provide transportation to 135 athletes, coaches & special partners three times per year, so that they may travel to State competitions to compete with their peers by June 2009. 6) To provide an opportunity for three Athlete Delegates from East Hawaii to represent our area at the State Athlete Congress by July 2009. 7) To provide an opportunity for 450 community volunteers to interact with our Special Olympics athletes throughout the year, providing them the chance to " change the world." NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 5 Program Highlights: 1) We conducted 4 major area athletic competitions for our athletes and Special Partners: On October 26, 2006, we held our area singles bowling tournament. On October 27, 2006, held our area unified bowling tournament. On November 4, 2006, we held the Weinberg regional basketball tournament at UH Hilo's gym, welcoming teams from West Hawaii and Maui also. On March 31, 2007, we held our Area track & field competition at Keaau High School. 2) We provided sports training, competition and transportation to: 25 soccer athletes, 9 bocce athletes and 7 bocce special partners during the Aukake Season / 67 athletes for singles bowling and 14 special partners for unified bowling during the Winter Season/ 35 athletes who trained and competed in basketball during the Winter season / 76 track & field athletes and 50 softball athletes with 6 softball special partners during the Summer season. 3) Provided our families, coaches, volunteers and athletes 3 family events. On Aug 26, 2006 we held our annual "End of Summer Bash" picnic which was attended by 85 people/ On December 16, 2006, we held our first Christmas Party with over 75 people in attendance and on March 17, 2007, we held a St. Patrick's dance with over 80 people dressed in green attending. 4) Positions on our area management team, which helps to coordinate all activities for Special Olympics East Hawaii area program meets monthly to discuss operations for the year. 5) Mile of Quarters was added as a new fundraiser in April 2007 with $17,500 being raised at HFS Federal Credit Union and Ken's House of Pancakes during a 30 day period. 6) Athletes, coaches, volunteers and family members conducted 5 separate fundraisers, selling chili, bentos & candies throughout the year and were successful in raising a net profit of $26,125 7) We outreached to teachers at the Teachers Institute on October 10, 2007 at Keaau High School by distributing informational flyers & brochures 8) We increased the number of certified or recertified coaches in specific sports by 30 this FY 2006-2007. 9) We continued to provide our athletes, families & volunteers an opportunity to give back to the community through our annual community service project. Over 20 athletes, coaches, volunteers & family members sang Christmas carols to the residents at Hale Anuenue In December 2006. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 6 Special Olympics Hawaii - Agency Name Special Olympics Hawaii -East Hawaii - Program Name Performance Measures: *If applicable Program Expenditures FY 2006-07 FY 2007-08 FY 2008-09 Salaries and Wages Actual* Budget* Estimate Athlete & Special (Unified) Partner 186 195 215 participants $62,587 $108,085 $108,800 Volunteers from the community 417 410 425 Family members 92 80 95 Management team members 10 15 11 Community Service Projects 1 2 2 State Competitions on Oahu 3 3 3 attended Area/Regional competitions 6 7 7 attended Delegations participating within the 4 5 6 schools stem Number of family events 2 2 3 Number of volunteer hours provided 9021 9500 10,000 by volunteers for training, competition & fundraising events (note that the figures above are not dollar amounts but in number of people, events, schools or hours *If applicable Program Expenditures * If applicable ° Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 7 FY 2006-07 Actual * FY 2007-08 Budget* FY 2008-09 Estimate Salaries and Wages $2,140 $2,200 $2,200 Professional Fees 0 0 0 Operations $62,587 $108,085 $108,800 Equipment $3,989 $2,000 $2,000 Other" Total $70,8561 $112,285 $113,000 * If applicable ° Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 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 2006-07 Actual * FY 2007-08 Budget * FY 2008-09 I Estimate of Hawaii Grant $12,000 $15,000 $15,000 -County Foundations $10,000 $8,000 $9,000 Individual Contributions $6,800 $5,000 $5,000 Corporate Contributions $7,300 $6,000 $6,000 Events $23,400 $23,000 $46,000 -special HSO Co-op monies $1,500 $4,300 $4,500 Interest Income $10K$33,960 $20 Merchandise sales -East Hawaii $0 $0 Merchandise sales -Other $46,580 $27,480 New Fundraiser 0 Total $107,590 $112,285 $113,000 *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? 2008- 2009 plans to increase revenues to support our progrms: 1) We are planning to conduct our Mile of Quarters fundraising campaign in the Fall, as well as the Spring. This is an icon sale fundraiser in which we raised $17,000 during one campaign in the Spring of 2007. We will be asking two businesses to join our Fall Mile of Quarters campaign. 2) We are planning to increase our donations for Cop on Top by obtaining a great giveaway prize, to draw in more donors. 3) We are planning to look into applying for more grants that are avaiable to East Hawaii non profits. 4) We are planning to increase the number of days our Tip A Cop fundraiser is held, asking Hawaii County Police officers to once again serve our community as celebrity servers for breakfast or lunch at two restaurants in East Hawaii. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 8 Special Olympics East Hawaii is very diverse in how we raise money to support the athletes, families and volunteers. However as we continue to meet our mission of continuing to outreach to new athletes, family members and volunteers within our community, our budget continues to grow, so even as we get better at raising money, it continues to be difficult to reach our budget without the support of the County of Hawaii. Becoming self sufficient is the ultimate goal of our program, however we do know that if any of our events/grants fail to raise the expected amount of money, our program would change drastically. We would have to cut back on some services that we currently provide and/or we would have to cut back on our outreach goals. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 9 an 08 09 03:48p Carey Uchida BOB 935-1968 Sped&► 041 VA Pl'c-s 41%ufa�' - Agency Name s U�V'fo, tau - ►urtu- Program Name I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 — 2-142.2, Hawai'i County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. 1 (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawai'i Revised Statutes. If awarded a grant from the County of Hawaii, 1 (we) understand and will comply with the requirement to submit a year-end report to the Legislative auditor within 60 days after June 30 of the fiscal year. The report shall Include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawaii grant funds, and a listing of other funding sources and amounts obtained during the award period. failure to submit a timely, complete, an of `) a /71L -4U) sigrilature Viecrutive Director IMM Date /2 ce Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTEDI NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 5 Received 01-08-2008 04:23pm From -808 935 1968 To -SPECIAL OLYMPICS HAW Page 002 p.2 Special Olympics - West Hawaii- Agency Name SOWH General Funding- Program Name Agency Director: Nancy Botello Phone No.: 943 - Contact Person: David Ross Phone No.: 345-1344 Mailing Address: P.O. Box 390358, Keauhou, HI 96740 Facility/Site Address: 77-296 Kalani Way #2, Kailua-Kona, HI 96740 Fax No.: 808-943-8814 Email Address: sowhdave@yahoo.com Name of Accountant/CPA (include name of firm if applicable): Akamine, Oyadomari, and Kosaki CPA's, Inc. Phone No.: 941-0500 Mailing Address: 440-Kapiolani Blvd., Suite 900, Honolulu, HI 96814 Amount of Request for County Funds: $15,000 Prior Year(s) Funding: 05-06 06-07 07-08 $10,000 $10,000 $10,000 Agency Mission Statement: The mission of Special Olympics is to provide year-round sports training and athletic competition in a variety of Olympic -type sports for all children and adults with intellectual disabilities, giving them continuing opportunities to develop physical fitness, demonstrate courage, experience joy and participate in a NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 1 sharing of gifts, skills and friendship with their families, other Special Olympics athletes and the community. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 2 Special Olympics Hawaii - West Hawaii - Agency Name SOWN General Funding- Program Name Program Description: Special Olympics believes that people who are isolated from life experience by a disability have little chance for the development growth and acquisition of important skills that they will need to gain employment, maintain relationships and function independently as adults. Special Olympics helps to give individuals with a intellectual disability the necessary skills to achieve that independence. We believe that all people regardless of their disability deserve to lead full , active lives, enriched with social and recreational opportunities that most of us take for granted. Unfortunately, appropriate physical education programs in the public schools and social service programs that realistically address the special needs of this population are virtually non-existent. Special Olympics West Hawaii fulfills that need and provides the necessary skills for people to continue good health throughout their lives within our community. Thanks to the Hawaii County grant, Special Olympics West Hawaii is able to continue to provide many opportunities for the special needs individuals in our community. The benefits that all the athletes receive from their participation in Special Olympics include: improved physical fitness and motor skills, greater self- confidence, a more positive self-image, friendships, and increased family support. Special Olympics athletes carry these benefits with them into their daily lives at home, in the classroom, on the job, and in the community. Families who participate become stronger as they learn a greater appreciation for their childs's talents. We have found that many of our strongest supporters and best volunteers are the family members of our Special Olympics athletes. We provide a "safe haven" for families where they know that their child is not judged and is accepted for who they are and for what they can do. Community volunteers find out what good friends the athletes can be and make long lasting bonds that continue off of the sports field. Everyone learns more about the capabilities of people with intellectual disabilities, and a huge majority of our volunteers continue with the program year after year. These active volunteers are often a source of new volunteers to the program as they share their stories with friends, neighbors and co-workers. Special Olympics West Hawaii Unified Sports Program is a vital program where these special needs individuals interact with their non -handicapped peers on a weekly basis. Unified Sports is a program that combines equal numbers of athletes with intellectual disabilities and special partners without disabilities. All participants are of similar age and athletic ability. This program dramatically increases inclusion of our athletes into the community by helping break down barriers that have historically kept people with and without disabilities apart. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 3 Special Olympics West Hawaii has a unified softball team, 10 unified bowling teams and numerous unified bocce teams that participate. The need for the Special Olympics West Hawaii program to continue here on this island is extremely high. There is no other program in our Area to provide these services to our athletes. Special training is provided for our athletes and the coaching staff throughout the year. The training is essential due to the unique services that we provide. We not only touch the lives of our Special Olympics athletes, but also their families and the hundreds of volunteers from our community. Our founder, Eunice Kennedy Shriver, believes sports training and competition opportunities should be available for all who qualify rather than all who could afford to participate. Therefore, our program is free of cost to all of our athletes, special partners, and coaches. We receive no money from the Kennedy Foundation or the Federal Government. Due to the aspect of our program , a volunteer committee under the leadership of our Area Director must raise all the funds needed for our West Hawaii area program. Those funds will pay for all aspects of the Special Olympics progam. Our largest needs for 2008-2009 is to purchase new uniforms for all sports and new equipment. It has been many years since they have been replaced. As always our largest cost is airfare to get our athletes to their competitions where they compete against their peers from around the state of Hawaii. It is an essential part of our program that Special Olympics athletes are provided an opportunity to interact and compete against people of smiliar athletic ability. Unfortunately our area program is too small to be able to provide quality competition, therefore our athletes must travel to other islands to achieve that goal. The state competitions that are held on Oahu 3 times per year provide many activities that our athletes never have a chance to experience. They include; dances, Opening and Closing Ceremonies, entertainment and games, and free health exams through the Healthy Athlete Program. This Healthy Athlete program provides free dental, vision, hearing, podiatry, flexibility & nutrition screening and education for our athletes. As you know, these services are sometimes not available to individuals with disabilities due to financial difficulty or lack of professionals who are trained to treat people with disabilities. Special Olympics West Hawaii wishes to continue to provide these opportunities to all the athletes that are currently involved and be able to reach out to new special needs individuals througout our communities. In order to do this, we will need funds to maintain our services and to purchase new uniforms and equipment as well as provide transportation for athletes to get to competitions. Special Olympics Hawaii -West Hawaii Area is asking for $15,000.00 from the County of Hawaii to help fund our Special Olympics West Hawaii program activities. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 4 Total Budget and Position Count Total Program Bud et 49040.00 Total Program Position Count 1 Total Agency Budget 1 1,716,950 Total Agency Position Count 18 Program Objectives: 1) Increase participation in South Kona / Kau area and adding a delegation in the region. 2) Continue Unified Sports programs to involve more family members and general public. 3) Train new delegations on ways to maintain current and new athletes, coaches and volunteers. 4) Provide financial support for current sports. 5) Provide quality activities for families and athlete support systems. 6) Continue to provide high quality training and competition to the intillectually disabled in the West Hawaii region. 7) Expand and get more involved with local schools with the goal of beginning delegations in them. 8) Increase fund raising opportunities for Special Olympics West Hawaii. 9) Continue to provide athletes an opportunity to be involved with planning and attending social events. 10) Provide athletes with additional opportunities of learning, broadening community awareness and self sufficiency. 11) Diversify and expand our management team to include more members of our community. Program Highlights: 1) Received the Air National Guard flight for our travel to Holiday Classic saving us several thousands of dollars. 2) Developed the beginnings of a new delegation in the Waimea area. We look to continue it's growth in 2008. 3) Outreached to teachers at Teacher Institute Day. 4) Trained and competed in 9 Special Olympics official sports. 5) Extended the knowledge of what Special Olympics is all about through press releases, newspaper articles and other printed materials. 6) Continued the developmant of our Unified Partner program wth a unified softball team for the first time in years. We continued training and competeing in unified Bocce (lawn bowling) and Bowling with the largest Unified Bowling program in history with 12 teams. 7) Continued to support family specific events and booths at competitions. 8) Our basketball team medaled at the state games for the first time in 4 years. 9) Added and certified 4 new coaches NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 5 NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 6 Special Olympics Hawaii - West Hawaii - Agency Name SOWH General Funding - Program Name Performance Measures: *If applicable Program Expenditures FY 2006-07 Actual * FY 2007-08 Budget * FY 2008-09 Estimate Comminity Service Projects - Aid Stations 8 8 8 State Competitions on Oahu 3 3 3 Area / Regional Competitions 8 8 8 Regional Competitions Held in WH 3 3 3 Number of Family Events 8 8 9 Number of Athletes Within Program 38 35 38 Number of Special Partners 25 27 30 Number of Unified Bowling Teams 6 12 15 Number of Unified Softball Teams 0 1 1 Number of Families Actively Involved 40 45 48 *If applicable Program Expenditures If applicable "Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 7 FY 2006-07 Actual * FY 2007-08 Budget * FY 2008-09 Estimate Salaries and Wages 960.00 960.00 940.00 Professional Fees 0 0 0 Operations 17000.00 23299.93 29300.00 Equipment 5540.00 1164.74 9000.00 Other" 24900.00 3745.20 9810.00 Total 48400.00 29169.87 49040.00 If applicable "Please explain in detail on separate sheet NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 7 Special Olympics Hawaii- West Hawaii - Agency Name SOWN General Funding - Program Name Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2006-07 Actual * FY 2007-08 Budget * FY 2008-09 Estimate County of Hawaii Non -Profit Grant 10000.00 10000.00 15000.00 Larry Mitchell Memorial Fund 2000.00 2000.00 2000.00 Aid Stations 1500.00 1375.00 500.00 Ironman Foundation 1000.00 0.00 1000.00 Private Donations 2000.00 1 2083.88 2000.00 Merchandise Sales 1000.00 438.00 500.00 Cop on Top 28139.00 17,211.00 20000.00 Corporate Contributions 3500.00 3789.50 1350.00 Underpants Run 10000.00 5000.00 4000.00 Fueling Dreams 0 0 1500.00 Interest Income 40.00 1078.52 190.00 SOHI Co -Op Money/Weinberg 2500.00 652.50 1000.00 Total 61679.00 43628.40 49040.00 *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? 1) We are planning to increase our donations for our Cop on Top event in 2008. 2) We will plan and conduct a new event with the Law Enforcement personnel in Kona. This event is called Fueling Dreams and will be done in partnership with Tesoro. 3) We will work with the Air National Guard to hopefully receive the free airlift from Kona to Oahu for our State Games in December, saving us thousands of dollars. However as we continue to meet our mission of continuing to outreach to new athletes, family members and volunteers within our community, our budget continues to grow, so even as we get better at raising money, it continues to be difficult to reach our budget without the support of the County of Hawaii. Becoming self sufficient is the ultimate goal of our program, however we do know that if any of our events/grants fail to raise the expected amount of money, our NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 8 program would change drastically. We would have to cut back on some services that we currently provide and/or we would have to cut back on our outreach goals. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 9 unv-co-cuuo nun i.u.oa till raK�il HAWN BANK - EBD FAX N0. 808 844 3434 P. 01 01-11-2006 10:51 am Fra -SPECIAL OLYWICS NANAII 106-643.6614 T-410 P.001/001 F-264 �pecial Olymples Hawaii - West Hawaii - Agency Name SOWH General Funding - Program Name I (wp) have read and understood all of the eligibility requirements; grant conoirtlons; award procedures; and records, reporting and fiscal aountability regV�icc rementa as mandated In Article 25. Sections 2-135 — 2-142.2, Hawal'i Coonty Code, relating to Appropriation of Funds to Nonprofit Organizations. I (vie) 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 low. I (vie) understand that information supplied herein shall be made public according to Chapter 92F, Hawal'i Revised Statutes. if awarded a grant from the County of Hawal`I, I (we) understand and will co ply with the requirement to submit a year-end report to the Legislative sup or within 60 day after June 30 of the Racal year, The report:hall include an explanation of the public benefits derived from the awarding of Egrant, a complete accounting of all expenditures supported by County wai'1 grant funds, and a listing of other funding sources and amounts lned during the award period. Failure to submK a timely comelebe, gn Si Onature of Bo r Pr Identlonalr i�a�log Date r 8gn ure of Erve Director Date I WNSIGNED PRO OSALS WILL NOT BE AC= EC PIMI NONPROFIT GrRANT AprUCATION FISCAL YKAR 20011-09 Page 10 Recalved 01-28-2008 II:I Tam From -BOB 844 34a4 To -SPECIAL OLYMPICS HAW Pere 091 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, Hawai'i County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawai'i Revised Statutes. If awarded a grant from the County of Hawai'i, I (we) understand and will comply with the requirement to submit a year-end report to the Legislative auditor within 60 days after June 30 of the fiscal year. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawa!'i grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely, complete, and accurate year-end report will impact the evaluation of your program's or agency's future funding requests. Signature of Board President/Chair I k)oSign ture of Ecutive Director Date 112 dg Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 10 West Hawaii Community Health Center West Hawaii Community Health Center Children's Clinic Agency Director: Richard Taaffe Phone No.: 808-326-3884 Contact Person: Gayle Hunt Phone No.: 808-326-3894 Mailing Address: 75-5751 Kuakini Hwy., Suite 203 Kailua Kona, HI 96740 Facility/Site Address: 75-5751 Kuakini Hwy., Suite 101A Kailua Kona, HI 96740 Fax No.: 808-329-9370 Email Address: >;hunt(a2westhawaiichc.ora Name of Accountant/CPA (include name of firm if applicable): Nishihama & Kishida, CPAs, INC. Phone No.: 808-524-2255 Mailing Address: American Savings Bank Tower 1001 Bishop Street., Suite 1700 Honolulu, HI 96813-3696 Amount of Request for County Funds: $60,000 Prior Year(s) Funding: 05-06 06-07 07-08 $o $0 $0 Agency Mission Statement: The mission of the West Hawaii Community Health Center is to make quality, comprehensive, and integrated health services accessible to all who pass through our doors regardless of income. These services will be culturally sensitive and will promote community wellbeing through the practice of "malama pono ". Program Description: The Need The December 2007 Hawaii Island HealthCare Conference—" The Crisis. The Challenge. The Commitment" clearly reflected the urgency of the healthcare issues on the Big Island. If the island is experiencing health care challenges for all its inhabitants, then the crisis is understandably magnified for the uninsured and low income. For West Hawaii Community Health Center (WHCHC) with the greater Kona Coast as our service area, approximately 70% of the 4600 patients who found their way to our doors in 2007 fall in these categories. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 1 West Hawaii Community Health Center West Hawaii Community Health Center Children's Clinic Pediatrics There are few private pediatricians on the Kona Coast, even fewer who accept a limited number of Medicaid patients due to low reimbursement rates, and none who will see our uninsured keiki . Family physicians at WHCHC are the only safety net medical providers on the Kona Coast who see everyone, including children, regardless of ability to pay. However, we are located in downtown Kailua Kona, and we ]mow that the situation worsens as one travels away from town in either direction where transportation and distance issues only add to the challenge. Dental The need for dental services for children who receive Medicaid or who are uninsured is huge. In a 2006 telephone survey of private dentists, only one dentist will accept new Medicaid patients, again, because of the low reimbursement rates, leaving nearly all of our children without access to dental care. The only safety net dental provider that currently serves West Hawaii is the Office of Social Ministry (OSM) Mobile Care Health Van that offers limited services in Kailua Kona. Mental Health A similar situation exists with pediatric mental health practitioners on the Kona Coast willing to accept Medicaid and uninsured children. Currently, WHCHC mental health professionals work with their young patients as needed. Many children, however, go unserved, particularly outside Kailua Kona due to distance and transportation issues. The Proposed Solution — A Pediatric Clinic in Kealakekua (Some background It is a part of'WHCHC's strategic plan to establish additional satellites along the 80 chiles of coustline. Along with this short term proposal of a pediatric clinic in Kealakekua in 2008 is a request for federal fiends to open a satellite facility in Waikoloa to allow people of all ages in South Kohala access to medical and mental health services. This latter plan, V approved and funded by Washington, will bring quality, integrated health services in 2009 to our South Kohala residents currently unable to find affordable and convenient care.) This proposal, which requests `first year operating funds,' intends to extend WHCHC's integrated care model of health services (medical, dental, mental health) to focus on children while expanding south of Kailua Kona, thereby increasing access to health services to even more West Hawaii keiki, particularly those in the sparsely populated areas to the south, minimizing the challenges of distance and transportation. Furthermore, this plan allows for integrated, pediatric expertise to be made available to all children along our coast, regardless of income status. The children's clinic that WHCHC is establishing in Kealakekua will have 4 dental operatories, 4 exam rooms plus space for the behavioral specialists and administrative personnel. WHCHC anticipates this children's clinic will see in excess of 2000 children for medical, dental, and behavioral health services, 1400 (70%) of whom are estimated to be uninsured or receiving Medicaid. Total Budget and Position Count Total Program Budget $615,200 Total Program Position Count 6 FT; 3 PT Total Agency Budget $2,373,665 Total Agency Position Count 22FT; 2 PT NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 2 West Hawaii Community Health Center West Hawaii Community Health Center Children's Clinic Program Objectives: 1. Provide quality medical care to 2000 children by end of grant period; 2. Provide quality dental care to 900 children by end of grant period; 3. Provide quality mental health services to 200 children by end of grant period. Program Highlights: NOT APPLICABLE as this is a new program which was not in existence in the previous fiscal year. Performance Measures: *not applicable Program Expenditures: FY 2006-07 FY 2007-08 F FY 2008-09 0 Actual* Budget* Estimate Number of uninsured or Medicaid children seen — 0 0 1400 (70% of 2000) medical 0 0 $25,600 Other # Number of uninsured or Medicaid children seen — 0 0 630 (70% of 900) dental Number of uninsured or Medicaid children seen — 0 0 140 (70% of 200) mental health *not applicable Program Expenditures: *not applicable # SEE ATTACHMENT "A" FOR BUDGET DETAIL NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 3 FY 2006-07 Actual* FY 2006-07 FY 2008-09 Actual* Estimate Salaries and Wa es# 0 0 $515,400 Professional Fees# 0 0 $2,500 Operations# 0 0 $64,200 Equipment# 0 0 $25,600 Other # 0 0 $7,500 TOTAL 0 0 $615,200 *not applicable # SEE ATTACHMENT "A" FOR BUDGET DETAIL NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 3 West Hawaii Community Health Center West Hawaii Community Health Center Children's Clinic Program Funding Sources: Identify all funding sources (specific to this program only) I Revenue Source FY 2006-07 Actual* FY 2007-08 Budget* FY 2008-09 Estimate Patient Generated (self pay, private insurance, Medicaid) 0 0 **$493,000 330e grant (federal) 0 0 $60,000 Private Donors 0 0 $2,200 County of III (requested) 0 0 $60,000 TOTAL 0 0 $615,200 *not applicable ** estimated 6800 visits x $145 billed; receive estimated 50% reimbursement = S493,000 Explain what plans, if any, your agency and/or program has to increase revenues to support this program. When do you anticipate your program to become self-sustaining? While the majority of funding is patient generated and supplemented with federal funds, the need for keiki health care continues to rise within the uninsured and underinsured population. West Hawaii Community Health Center's (WHCHC) conservative fiscal philosophy as well as a team of professionals who spend prudently assists WHCHC in accepting everyone who walks through our doors, regardless of ability to pay. In 2008 and beyond, WHCHC will continue to seek funding from a variety of additional funding sources, both public and private, in order to meet the growing health needs of our community. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 4 West HI Community Health Center - Agency Name WHCHC Children's Clinic - Program Name I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures; and records, reporting and fiscal accountability requirements as mandated in Article 25, Sections 2-135 — 2-142.2, Hawaii County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawaii Revised Statutes. If awarded a grant from the County of Hawaii, I (we) understand and will comply with the requirement to submit a year-end report to the Legislative auditor within 60 days after June 30 of the fiscal year. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawaii grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely, complete, and accurate Vear-end report will impact the evaluation of your program's or agency's future funding requests. Signature of of Board President/Chai,� Signature of Ex cutiv , ector i Date Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 5 ATTACHMENT A West Hawaii Community Health Center Children's Clinic Year l (2008-2009) — Operations Budget Detail EXPENSES: Salaries and Wages Pediatrician (.6FTE) $ 80,000 Pediatric Dentist (LOFTE) $115,000 Dental Hygienist (1.OFTE) $ 64,000 Registered Nurse (.6FTE) S 30,000 Operations Manager (LOFTE) S 40,000 Dental Assistant(s) (3.OFTEs) S 85,500 Psychologist (.2FTE) $ 15,000 BENEFITS @ 20% $ 85,900 TOTAL $ $515,400 Professional Fees 2,500 (3 professionals x $500; licensing & other associated fees) Operations Rent (S2 I 00x I 2mos) $ 25,200 Electricity ($250xI2mos) $ 3,000 Water (S I 00x I 2mos) $ 1,200 Telephone/Internet ($400x I 2mos) $ 4,800 1T (EHR & Pm support;$2500x 12) $ 30,000 TOTAL $ 64,200 Equipment & Supplies $ 25,600 Medical ($2.5Ox5000visits — $12,500) Dental ($4.5Ox1800visits = $8,100) Office ($5,000) Other (CME expenses for 3 professionals) $ 7,500 TOTAL $615,200 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 Facility/Site Address: 65-1279 Kawaihae Rd., Ste. 213, Kamuela, HI 96743 Fax No.: 887-0525 Email Address: westhimed001@Whawaii.rr.com Name of Accountant/CPA: John Carbonaro Carbonaro CPA's Phone No.: 808-242-5002 Mailing Address: 1885 Main Street, Suite 408, Wailuku, HI 96793 Amount of Request for County Funds: $15,000.00 Prior Year(s) Funding: 04_05 05_06 06_07 $5000.00 $7000.00 $10,000.00 Agency Mission Statement: West Hawaii Mediation Center exists to improve the way people deal with conflict by providing mediation, facilitation, conflict resolution education and training services. Program Description: The funds are requested to support West Hawaii Mediation Center (WHMC) which serves the districts of Hamakus, North & South Kohala, North & South Kona, and Ka'u. WHMC provides community-based mediation services for both self-referred and court/legal system referred clients. These services are provided in an accessible and 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 Pro rem Budget 109,000 Total Program Position Count 1.25 Total Agency Budget 125,000 Total Agency Position Count 1.5 NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-2009 Page 1 West Hawaii Mediation Center Mediation Services Program Objectives: 1) Provide information and referral services to individuals who need services instead of, or in addition to, the mediation services offered at WHMC. 2) Recruit, train and retain high quality volunteer community mediators. 3) Provide continuing education opportunities for volunteer mediators as well as specialty trainings, i.e., condominium, special education, civil rights, and domestic mediation. 4) Provide mediation services in an affordable and accessible manner for disputes arising both in and out of the court/legal system. 5) Offer mediation services for a wide array of dispute issues including neighbor -neighbor, divorce (property division, finances, parenting plans), landlord -tenant, consumer - merchant, real estate, small claims, condominium, civil rights, special education, victim - offender, and community issues. 6) Provide adequate case management services to adequately serve all referred cases. 7) Provide community outreach and education around constructive conflict resolution practices. Program Highlights: 1) Delivered 1,665 hours of case intake services. 2) Served 238 cases (69% court/legal system referred; 41% self-referred) with 561 clients served. 3) Utilized 37 volunteer mediators in 144 mediation sessions for a total of 425.95 hours of mediation. 4) Reached full agreement in 58% of cases mediated. 5) Achieved a 91 % service satisfaction rating by respondents (post -mediation satisfaction survey). 6) Achieved a 98% rating by respondents indicating that they would recommend mediation to others in the future. 7) Provided 39% of total services to low income clients (annual income under $20,625). 8) Provided conflict resolution education and peer mediation training to over 700 elementary students in West Hawaii. Performance Measures: If applicable **3 additional trainings were offered but cancelled due to low number of participants NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-2009 Page 2 FY 2006-07 Actual* FY 2007-08 Bud FY 2008-09 Estimate* Case Management Hours 1665 1640 1665 Mediation Cases Served 248 260 280 Mediation Sessions Conducted 160 160 170 Agreements reached in mediation 63% 65% 65°6 Clients' satisfied with service 94% 95% 95% Client's willing to recommend service to others 96% 95% 95% Skills enhancement trainings offered for volunteers 3** 8 8 Affordable service to low income (%of clients considered low income 39% 45% 45% Community Awareness and Education Sessions 5 6 7 If applicable **3 additional trainings were offered but cancelled due to low number of participants NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-2009 Page 2 West Hawaii Mediation Center Mediation Services Program Expenditures: "Please explain in detail on separate sheet Program Funding Sources: Revenue Source FY 2006-07 Actual' FY 2007-08 Bud eY FY 2008-09 Estimate Salaries and Wages 73,156 75,000 80,000 Professional Fees 47,622.00 48,672.00 48,672.00 Operations 24,000.00 27,000.00 28,000.00 Equipment 2856.00 500.00 1,000.00 Other` 12,672 13,000 15000 Total 100,012 102,500 109,000 "Please explain in detail on separate sheet Program Funding Sources: Revenue Source FY 2006-7FY Actual " 2007-08 Budget " FY 2008-09 Estimate County of Hawaii 7000.00 10,000.00 15,000.00 State of Hawaii 47,622.00 48,672.00 48,672.00 Private Foundations 9,000.00 5,000.00 6,000.00 Donations 7,144.80 7500 8000 Fundraising 12,672 13,000 15000 -Service/Program Fees 3600.00 5000.00 6,000.00 Client Private fees 5596.58 5000.00 6,000.00 Total 92,635.38 1 94,172 104,172 'If applicable Future Program Support: The Center completed its first large fundraising event in April of 2007. This Wine Tasting & Silent Auction netted the Center a little over $12500.00. We are in the process of planning for this same event this coming April, and look forward to continuing this as an annual event in the years to come. in the past the Center has received grants for our school based programs. This funding was drastically decreased this year. For the first time, however, we will be receiving funding from the Hawaii Island United Way. Part of the United Way grant funding will go to support these school based programs, however, the Center has had to re -organize the program in an effort to accommodate the lack of funding in this specific area. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-2009 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, Hawai'i 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 will comply with the requirement to submit a year-end report to the Legislative auditor within 60 days after June 30 of the fiscal year. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawaii grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely. complete, and fundina reuests,.--- Sidnature of Board President/Chair Signature of Execuf a Director /7P Date i/7/6G Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTED! NONPROF17 GRANT APPLICATION FISCAL YEAR 2008-2009 Page 4 YWCA of Hawaii Island- Agency Name Empowering Alternatives Program- Program Name Agency Director: Cynthia Albers, Executive Director Phone No.: (808) 935-7141 ext. 102 Contact Person: Lorraine Davis, Quality Assurance Director Phone No.: (808) 961-3877 ext. 162 Mailing Address: 145 Ululani St. Hilo, Hawai'i 96720 Facility/Site Address: 197 Kinoole St., Hilo, Hawai'i 96720 75-5759 Kuakini Hwy., Kailua-Kona, Hawai'i 96740 Fax No.: (808) 935-5150 Email Address: calbers@ywcahawaiiisland.org or Idavis@yweahawaiii[and.org Name of AccountantlCPA (include name of firm if applicable): Carbonero and Associates Phone No.: (808) 242-5002 Mailing Address, 1885 Main Street, Suite 408, Wailuku, Hawai'i 96793 Amount of Request for County Funds: $60,000 Prior Year(s) Funding: 05-06 06-07 07-08 $50,000 $45,000 $52,000 NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page I Agency Mission Statement: The YWCA is a women's membership movement nourished by its roots in the Christian faith and sustained by the richness of many beliefs and values. Strengthened by diversity, the YWCA draws together members who strive to create opportunities for women's growth, leadership and power in order to attain a common vision: peace, justice, freedom and dignity for all people. The YWCA will thrust its collective power toward the elimination of racism wherever it exists and by any means necessary. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 2 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 Program operates the rape crisis center for the island of Hawaii. Skilled and supportive Crisis Workers provide phone support to callers on the 24-hour Sexual Assault Crisis Line, or offer face to face help in East and West Hawaii to sex assault victims who report the crime to police. Crisis Workers function as team members with police investigators and sex assault nurse examiners (SANE) in the Hawaii County Protocol for forensic examination of sex assault victims. A full time masters -prepared Therapist is employed at each Empowering Alternatives Program office (Hilo and Kailua - Kona) to provide psychotherapy, case management and legal system advocacy by appointment or walk in. Community professionals, the public and school aged groups are helped to become aware of sex assault survivor needs, available services and prevention strategies through Empowering Alternatives Program community prevention education programs. The YWCA is now in our third decade of helping sex assault survivors, who are women and men, girls and boys. Primary funding of the program is through State of Hawaii, Office of the Attorney General's through a subcontract with the Kapiolani Women's and Children Medical Center, Sex Assault Treatment Center. As a result, quality assurance, program and fiscal monitoring of services is maintained at standards. If the County of Hawaii decides favorably for continued funding of the Empowering Alternatives Program, it can do so with the knowledge that professional standards are practiced in the both service delivery and expenditure of funds. Total Budget and Position Count Total Program Budget $458,228 Total Program Position Count 15 Total Agency Budget $4,562,247 Total Agency Position Count 108 NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 3 Program Objectives: 1) Continue to operate the 24-hour Crisis Hotline receiving calls from persons seeking support, information and referral that may lead to face to face support as decribed in program objective 2. 2) Provide a Empowering Alternatives Program Crisis Worker to support each sex assault victim undergoing medical -legal examination in the period July 1, 2008 through June 30, 2009. 3) Deliver professional counseling and/or case management services to at least 100 sex assault survivors. 4) Attend and participate in monthly case tracking and interagency team coordination meetings of the East and West Hawai Children's Justice Centers throughout the fiscal year. 5) Provide sexaul assault awareness and prevention education to: 1000 school aged students, provide education to at least 35 professionals about the needs of adult/child survivors of sexual assault and methods to detect and report sexual child abuse or abuse of dependent adults. Program Highlights: 1) Candis Reinke, YWCA Program Director and LuAnn Woo O'Brien, Crisis Intervention Coordinator/Community Prevention and Education Coordinator participated in seven meetings helping to develop a new statewide training manual for sex assault Crisis Workers. The purpose of the new manual is to provide a statewide comprehensive training framework and to improve the quality of service delivery for sexual violence victim needs and services. Empowering Alternatives worked in partnership with the Sexual Assault Treatment Center (SATC) the state wide master contractor for sexual assault services) and other island service providers. 2) Eight University of Hawaii Hilo nursing students began a practicum for their senior community health seminar in January 2007 through YWCA Empowering Alternatives. During their practicum, they worked on projects specific to sexual assault. One project was to participate in a UHH event during April for the sexual assault awareness month, made and distributed "teal" ribbons and handed out brochures and pens in an attempt to provide more awareness to the community of the services that are offered for victims and survivors of sexual assault. 3) Members of the Empowering Alternatives Program staff and YWCA administrators participated in the Children's Justice Center Interagency Advisory Committee, the Hawaii Coalition Against Sexual Assault, and the Big Island Coalition Against Physical and Sexual Assault. These committees or coalitions include the involvement by staff from the following agencies: the Hawaii County Police Department, Child Welfare Services, Prosecuting Attorney, Victim Assistance Counselor, Family Court, Juvenile Probation Officers, Deputy NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 4 Attorney General, Public Health Nurses, CAMH Division of the Department of Health, Department of Human Services, Department of Education and statewide service providers. The efforts fosters consistent care throughout the County and State for sex assault services and working together as agencies to provide the best practices care for the victims. 4. The Empowering Alternatives Program Director and the YWCA of Hawai'i Island Quality Assurance Director participate in SATC state provider meetings in the review of policies, protocols and best practices throughout the State. The Quality Assurance Director is also working with the Hawai'i Sexual Response Training (HSART) through a federal grant (VAWA grant through SATC) to identify concerns and problems, upcoming trends, and establish protocols and training to address these needs. The activities of the staff, in addition to the day-to-day services that are provided through crisis intervention, advocacy, therapy and prevention education are providing healing for those who have suffered through sexual assault and all it's ramifications. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 5 YWCA of Hawaii Island - Agency Name Empowering Alternatives Program - Program Name Performance Measures: *If applicable NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 6 FY 2006-07 FY 2007-08 FY 2008-09 Actual * Budget* 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 Crisis hours/day, hours/day, hours/day, phone line. 365 days a 365 days a 365 days a year served year year 439 callers estimate estimate serving at serving at least 300 least 400 callers callers Crisis counseling, legal systems 438 victim 250 victim 300 victim advocacy, information and referral service service service are provided to each sex assault contacts contacts contacts victim undergoing medical -legal examination in East Hawaii and West Hawai Survivors of sexual assault receive 326 250 300 psychotherapy services and intensive clinical case management from SAVE masters prepared therapists in East Hawaii or West Hawaii School aged students receive 892 800 850 sexual assault prevention and awareness training Professionals receive training in 187 100 125 awareness of the needs of adults and child sexual assault survivors, how to detect and report child sexual abuse or sexual abuse of dependent adults *If applicable NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 6 Program Expenditures ' If applicable " Please explain in detail on separate sheet NONPROFrr GRANT APPLICATION FISCAL YEAR 2008-09 Page 7 FY 2006-07 Actual ' FY 2007-08 Budget ` FY 2008-09 Estimate Salaries and Wages $281,577 $327,788 $330,902 Professional Fees $9,247 $2,717 $2,500 Operations $100,994 $123,156 $124,326 Equipment $8,044 $614 $500 Other" 0 0 Total $399,8621 $454,275 $458,228 ' If applicable " Please explain in detail on separate sheet NONPROFrr GRANT APPLICATION FISCAL YEAR 2008-09 Page 7 YWCA of Hawaii Island - Agency Name Empowering Alternatives Program - Program Name Program Funding Sources: Identify all funding sources (speck to this program only) Revenue Source FY 2006-07 Actual FY 2007-08 Budget . FY 2008-09 Estimate County of Hawaii $45,000 $52,000 $60,000 State of Hawai'i DoH-KWCMC $311,603 0 0 State of Hawai'i AG - KWCMC 0 $349,175 $350,000 Federal Funding - VAWA. VOCA, VAWA-HCPD, PSEI)State of Hawaii DoH - KWCMC Rainy Da $43,576 $53,100 $25,000 State of Hawaii DoH - KWCMC Rainy Da YWCA Support 0 0 YWCA Support $85 0 Donations Total 1 $400,264 $454,272 $455,000 `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 funds received from the County allows us to enhance our services. In past years, this program has suffered through the ups and downs of the economy, legislative appropriations, and budget issues. As costs increased in expenditures, often the funding decreased. The County funds have allowed this program to stabilize financially and become fully staffed so services are more cohesive, needs are being met, and all survivors who ask for help receive help. The YWCA of Hawai'i Island is committed to this program and it's operations. The organization is looking at co -locating the Empowering Alternatives Program in buildings with other programs so programs are sharing costs of occupancy, thus controlling costs. Care in planning and monitoring program needs, along with client and community needs have become the focus of budget development and grant seeking. The use of a strategic plan with the commitment by the NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 8 YWCA of Hawai'i Islands Board of Director's has helped us to determine what we would do in the event of... and becoming sustainable. The Empowering Alternatives Program is primarily funded through a Master Contract through SATC as the master contractor for the State of Hawai'i Attorney General's office. The basic needs of the program are being met through this contract and should the County determine that funding is not available for this program, the program would continue to provide services. However, prevention education and awareness services would decrease because the master contract is primarily about "treatment" and very limited prevention. Growth opportunities for providing services to populations we traditionally don't serve would not occur and the program would become contract driven rather than survivor driven. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 9 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 Article 25, Sections 2-135 - 2-142.2, Hawaii County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawaii Revised Statutes. If awarded a grant from the County of Hawaii, I (we) understand and will comply with the requirement to submit a year-end report to the Legislative auditor within 60 days after June 30 of the fiscal year. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawai'i grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely, complete, and cpYc Cl_fir= JY nic Signature of Board President/Chair Dat / -30-06' Siggature of Executive Direcior Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTEDI NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-09 Page 10 Agency Director: Contact Person: Mailing Address: Facility/Site Address: Fax No.: Email Address: YWCA of Hawai'i Island- Agency Name Hamakua Youth Center- Program Name Cynthia Albers Phone No.: Venica Ftacek Phone No.: 145 Ululani St. Hilo, Hawai'i 96720 45-3396 Mamane St. Honoka'a, Hawai'i 96727 935-5150 calbers@ywcahawaiiisland.org 935-7141 x 102 775-0976 Name of AccountanVCPA (include name of firm if applicable): Carbonaro and Associates Phone No.: (808) 242-5002 Mailing Address: 1885 Main Street, Suite 408 Wailuku, Hawaii 96793 Amount of Request for County Funds: FY 2008-09 $65,000 Prior Year(s) Funding: 04-05 05-06 06_07 07-08 $6,000 $10,000 $30,000 45,000 Agency Mission Statement: "The YWCA of Hawaii Island is a women's membership movement nurtured by its roots in the Christian faith and sustained by the richness of many beliefs and values. Strengthened by diversity, the Association draws together members who strive to create opportunity for women's growth, leadership, and power in order to attain a common vision- Peace, justice, freedom and dignity for all people. The YWCA will thrust its collective power toward the elimination of racism wherever it exists and by any means necessary." Program Description: The YWCA Hamakua Youth Center has served the Honoka'a community since 1996 and continues to serve an important role for youth and their families by providing free, after-school and school break activities in a center dedicated to needs of youth. The YWCA Hamakua Youth Center (HYC), located at 45-3396 Mamane Street in Honoka'a, is directly across the street from Honoka'a Elementary/Middle and High Schools, making it readily accessible to students. The center is attended daily by 25-50 or more youth aged 9-18 years who flock to the center to enjoy the company of peers and access resources in a safe setting. The 900 square foot rented facility includes a social area, pool and ping-pong table, homework area and a computer lab with 6 intemet connected workstations and several printers, multimedia studio, and cultural arts workstation. Relocation of the Hamakua Youth Center to anew site within close proximity to the schools will have occurred by July 1, 2008, in response to the current premises becoming unavailable. Various options are currently under review and the YWCA welcomes input from County of Hawai'i to support our relocation. The shift in location is both positive and timely and in tandem with the need for additional space for administrative use as well as expanding youth programming. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-2009 Page 1 YWCA of Hawai'i Island - Agency Name Hamakua Youth Center- Program Name The Advisory Committee of the YWCA Hamakua Youth Center, made up of individuals dedicated to the ongoing growth and is made up of independent citizens, representatives from agencies, businesses and civic groups, as well as several youth delegates, to assure that the youths and communities perspectives guide actions, direction and decisions. Below is a quotation taken from the Department of Education website for Honoka'a Schools: "The communities of Hamakua coast are largely rural and rooted in agriculture. Sugar was the leading industry in the Hamakua Coast for at least 100 years. The closure of the Hamakua Sugar Plantation drastically altered the community. Today they are fed economically with a mixture of tourism, fanning and ranching. The largest employers are the Hotels in North Kohala and north Kona.4 A majority of households have both parents working outside the home. In addition to the standard eight hour work day commuting to North Kohala or Kona adds an additional three to four hours to the time parents are out of the hoe thus leaving children on their own in the mornings, after school and often times in the evenings. As the Hawaii State legislature states: 'The legislature finds many children are on their own in the mornings and afternoons before and after the school bell rings. Nationally, nearly two thirds of the school age children are in homes with both parents working, yet very few communities have a comprehensive system of before and after school care for children. While Hawai'i is fortunate to have A+ program for K-6, older children also need adult supervision. When older children are unsupervised in the morning, afternoon, evening, weekend and holiday hours, statistics clearly show rates of juvenile crime, drug use, and experimentation with tobacco, alcohol, and sex increase." Total Budget and Position Count FY2008-09 Total Program Budget $206,317 Total Program Position Count 5 Total Agency Budget $4,500,000 1 Total Agency Position Count 112 Program Objectives: The primary purpose of the YWCA Hamakua Youth Center is to provide youth with a safe environment during non -school hours. Both structured and unstructured activities with adult supervision reduce the risk factors and increase the protective factors influencing the behaviors of and outcomes for youth in Hamakua. The objectives are to: 1. Increase pro -social behaviors and bonding of youth with peers and adults 2. Promote participation in activities that foster healthy choices 3. Reduce reckless or risky behaviors 4. Delay the age of initiation to alcohol, tobacco and other drugs 5. Increase Cultural Awareness and Appreciation 6. Build stronger community partnerships Objectives #1-5 shall be measured by use of data from records of attendance and participation in YWCA Hamakua Youth Center programs and through a process that includes surveys, observation and interviews to assess youth participants' behaviors and attitudes. Objective #6 will be measured by the number partnerships and the number of collaborative activities achieved by the groups. Program Highlights During the 2007-08 school year, the YWCA Hamakua Youth Center continued to provide the After -School Drop - In center with structured and unstructured activities for youth at no cost. As of December 31, 2007, we have documentation showing 225 youth have participated. We are open weekdays after school from 2:00-6:00 pm, Wednesdays from 1:00-6:00 pm to accommodate the schools early dismissal and provided special evening activities twice a month. In response to the youth's persistent requests for weekend hours, in January of 2008 Saturdays hours were added from 10:00 am - 6:00 pm and include Hawaiian studies and drop-in center use. During school breaks and in the summer months open hours were modified for highest use during daytime or evening hours, based on student requests. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-2009 Page 2 YWCA of Hawai'i Island - Agency Name Hamakua Youth Center - Program Name The HYC welcomes both boys and gids who enjoy use of . Computer lab with internet access and multi- media software • Recreation programs • Multimedia studio • Hawaiian Studies • Arts and crafts • Domestic engineering education • Community service projects • Environmental Education, including recycling and consumer awareness • Community service referrals for youth in cooperation with Family Court and Teen Court. HYC also provides literature on variety of subjects of interest to youth, such as dating, domestic violence, pregnancy prevention, coping with grief, substance abuse, relationships, personal safety, higher education and life skills. As the emergent needs of youth are identified in any subject area, the director regulady provides additional opportunities for youth to become informed including casual talk story sessions, structured youth meetings, as well as presentations provided by specialists in the subject area. Some recent examples include connecting youth to healthcare upon their awakening sexuality; during a continued unexplained absence of a member of the Makahiki team, was responded to with a visit by the team who chanted the youth to come forth (he rejoined the team!); a longstanding and recognized 'location" where •pakalolo"was being used near the HYC was deemed unacceptable by the HYC staff, and subsequently resulted in monitoring efforts by the members of the community. The combined efforts of our YWCA staff, volunteers and community advisory board successfully secured multiple grants and donations that not only stabilized our program but allowed us to expand our staff, develop projects and expand cooperative projects with other service agencies. Some examples of partnerships and projects include: • Friends of the Future, who conducted "The Comic Book Project" directed by Dustin Brunelle, by artist -in - residence for Honoka'a Schools and Friends of the Future. • Kanu O Ka Aina Public Charter School, by training and participating in the second annual Makahiki games in held in Waimea • Honoka'a Hongwanji Buddhist Temple, who sponsored the United Nations Peace Parade in honor of International Day of Peace, wherein HYC youth paraded, presented a booth on sustainability and environmental education, as well as provided recycling services for the event • Honoka'a Business Association, who sponsors Western Weekend, presented a booth on sustainability and environmental education, as well as provided dean -up, rubbish removal and recycling services for the event • Merimed, a resident treatment program for at risk youth, took part in Makahiki games and several roadside clean-ups • Adopta-Highway, monthly roadside cleanup of sections of Mamane Street (formerly in collaboration the Office of the Prosecuting Attorney and adopted by HYC in January 2008). Programs and Special Activities Domestic EngineeringtUfe Skills Educational Series This educational series presented twice weekly by Activity Specialist, Susan Saunders, is comprised of four components, Introduction to Cultural Foods, Cleanliness and Sanitation, Introduction to Tools and their Practical Life Skill Application, and Pro -Social Life Skills including manners, etiquette and Cultural Protocol. Youth learn valuable lessons about the many differing cultural practices that apply to home, social and professional environments. Recreation Daily access to pool (billiards) and ping-pong recreation continues with both instruction and tournaments taking place weekly led by members of the YWCA HYC staff and volunteers. Youth learn valuable lessons through sportsmanship experiences including how to win, how to lose, play fair, support others, persevere, develop geometrical thinking skills, and take pride and ownership in the care and maintenance of recreation gear. In response to a spontaneous and increased playing of Chess we are hosting weekly chess tournaments with guest adult mentors and staff. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-2009 Page 3 YWCA of Hawai'i Island - Agency Name Hamakua Youth Center - Program Name Hawaiian Cultural Education Activity Specialist and Hawaiian Guttural Specialist, Lanakila Mangauil, a graduate of Kanu O Ka Aina Public Charter School and participant in the Ka Piko O Ka Lei Lehua Kupuna training program, directs numerous programs and activities. Youth are provided thrice -weekly traditional Hawaiian cultural classes and experiences, including oli and male, hula, olelo, kakala'au, values, and as well as traditional tool and instrument making, music and other arts. Additionally, youth take part in the tradition of the Pa ani Makahiki, training and competing in the annual Makahiki games. Multi Media Music and Videography Studio Youth Leaders identified multimedia and digital arts as a project of interest, resulting in acquisition of a videography system including a Dell computer and software for video and music production. Youth produced one informational video using the tools that was included in proposal to OYS. In February 2008, Youth Music Exchange project will be piloted, in cooperation with the Peace Posse, an organization who promotes peace through media works and new technology. Supporters and Partners The YWCA Hamakua Youth Center has nurtured many new and expanded relationships with businesses, public and private organizations who have provided support, services and collaboration. Key partners include: Alu Like HLP Hamakua Community Foundation North Hawaii Coalition for Drug Free Blane's Restaurant Honoka'a Fire Department- Hawai i Boys and Girls Club of Hilo Honoka'a Police Department North Hawaii Youth Coalition Charles Ricaido, Professional Hospice of Hilo Teen Services Power of Choice Hamakua Musician and Mentor Hula Moon Boutique Rock- N -Renew Foundation Family Court JJ's Meat Market PTSA of Hamakua High School Five Generations Foundation Kanu 0 Ka Aina Public Charter School Salvation Army Hamakua Girl's Academy Marimed, Youth Treatment Program Simply Natural Cafe Hamakua Health Center Na Pua No'eau YWCA Teen Court Hawaiian Honey Company 0nAF�nCe "ea LplMa' NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-2009 Page 4 FY 2006-07 FY 2007- 08 FY 2008-09 Actual Target and Actual as of Target 12/30/07 Average daily attendance by youth 30 Target: 35 30 30 as of 12/31/07 Total number of youth served annually 200 Target: 300 300 278 as of 12/30/07 Total number of waivers on file signed by 182 Target: 275 150 parents of youthparticipants 70 as of 12/30/07 Number youth received Orientation, Target: We including worksheets on pro -social n/a 27 as of 12/31/07 100 behaviors, and conflict resolution lessons. Survey or Interviews reflecting self-report Target: 100 of youth about responsible vs. reckless or n/a 27 as of 12/31/07 n/a irresponsible behaviors % surveys reporting an Increased or Target: 80% Target: 100 improved social bonding of youth with n/a 70% (19 of 27) students report peers and adults as of 12/31/07 and 90% improve Tracking pro -social behavior of select Target: 90 Target: 100 youth Na 27 as of 12/31/07 students report ort and 90% improve Total number of partnerships Target: 2234 25 20 as of 12/31/07 Total number of parent participants5 Target: 25 25 10 as of 12/31/07 Total number of partner projects or 240 Target: 100 150 activities presented or conducted 48 as of 12/31/07 Total number of volunteersTarget: 53 75 75 50 as of 12/31/07 NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-2009 Page 4 FY 2008-09 YWCA of Hawai'i Island - Agency Name Hamakua Youth Center - Program Name Salaries and Wages include 4FTE, taxes and benetns " Please explain in detail on separate sheet Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2006-07 FY 2007-08 Actual * Budget* FY 2008-09 Estimate Salaries and Wa es $45,145 $103,074 148,001 Professional Fees $459 $2,920 950 Operations $24,470 $43,658 53,706 Equipment $2,672 $2,280 3660 Other* 0 0 0 Total $72,746.00 $151,932.00 206,317 Salaries and Wages include 4FTE, taxes and benetns " Please explain in detail on separate sheet Program Funding Sources: Identify all funding sources (specific to this program only) Revenue Source FY 2006-07 Actual * FY 2007-08 Budget * FY 2008-09 Estimate County of Hawaii $30,000 $45,000 $65,000 State of Hawaii, Office of Youth Services 0 $84,444 $96,780 Private Foundations $2,000 $5,000 $10,000 Hawaii Island United Way' $0 $10,000 $20,000 Donations $23,218 $12,000*' $8,320 Fundraising (Special Events) 0 0 $1000 Other 3 800 $3,700 $5200 YWCA Support 16,728 0 Total $72,746.00 1 $160,144.00$206,300.00 'Donations listed for FY 2008-09 are not fully committed, therefore expenditures are budgeted at less than the full revenue amount. Private Foundation Revenue FY 2008-09 proposals to be submitted Kukio Community Fund $ 5,000 Hawai'i Tourism Authority $ 5,000 2 Proposal to Hawai'i Island United Way (HIUW) awarded at full amount of $20,000. Funding year begins January 1, 2008; therefore, $10,000 is allocated to FY2007-08, with the full award of $20,000 anticipated in FY2008-09 3Other Internal Facilities usage; wage reimbursement such as Alu Like, SEE Hawai'i Work; Other facilities rentals NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-2009 Page 5 YWCA of Hawai'i 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 seff-sustaining? The YWCA staff and board of directors is working in cooperation with the Advisory Committee to assure the continuance of the Hamakua Youth Center through fundraising/special events, facility rental, developing relationships with private donors, applications to Trusts and Foundations and endowment possibilities. We will rely upon government funding, both the State of Hawaii Office of Youth Services and Hawai'i County to support the Hamakua Youth Center. During the past year, our energy has been placed in hiring and training new staff, developing youth programs, and developing tracking systems for outcomes reporting. In order to providing no cost services to youth with age appropriate activities and caring adult supervision in safe and equipped environs will require ongoing funding from various sources. To answer to the question "When do you anticipate your program to become self-sustaining", the YWCA Hamakua Youth Center exists due to the demand and commitment of citizens in the community whose goal is to keep those services available at no cost. The YWCA will continue to seek both public and private funds in order to maintain services, and will seek a second year of funding from the Office of Youth Services, which represents 46% of budget, with the County funding requested representing 31%. We will apply for funding from the Hawai'i Tourism Authority for grants to support our Hawaiian cultural programs, and are researching grants that may support expansion of the media arts program as well. Other possible funding streams include partnerships with area businesses, and developing youth business that provide sales of merchandise, such as traditional arts and crafts, multi media art pieces, youth production studio, music CD's or videos. These will require ingenuity, expertise and seed money to develop, and we are optimistic and confident that the civic resources exist and the possibilities for these to occur are achievable. "Self - sustainability in its truest sense is neither desired nor expected, since we will always rely on the cooperation, collaboration and commitment of others. We are of course, receptive to an endowment gift that would help provide assured operational funds Cif you build it, they will come' and state this with our affirmations of growth and prosperity. As long as the need exists and cooperation prevails, we aim to provide free, youth driven, volunteer supported programming so that more opportunities for healthy choices are available for the youth in Hamakua. If the model proves overwhelmingly successful in the Honoka'a community, we will be eager to work in partnership with other agencies and communities where a similar need for youth programs after-school is needed. NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-2009 Page 6 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, Hawai'i County Code, relating to Appropriation of Funds to Nonprofit Organizations. I (we) hereby certify that information supplied herein including all supporting documents is correct and that I (we) have the authority and ability to fully administer the program(s) pursuant to law. I (we) understand that information supplied herein shall be made public according to Chapter 92F, Hawai'i Revised Statutes. If awarded a grant from the County of Hawai'i, I (we) understand and will comply with the requirement to submit a year-end report to the Legislative auditor within 60 days after June 30 of the fiscal year. The report shall include an explanation of the public benefits derived from the awarding of the grant, a complete accounting of all expenditures supported by County of Hawaii grant funds, and a listing of other funding sources and amounts obtained during the award period. Failure to submit a timely. Signature Julie Hugo, Board President Sigffature, Cynthia Albers, Executive Director Date /- 30-08 Date UNSIGNED PROPOSALS WILL NOT BE ACCEPTEDI NONPROFIT GRANT APPLICATION FISCAL YEAR 2008-2009 Page 7