HomeMy WebLinkAboutCOM 0092.003 2012-2014 William P.Kenoi '''"`. Nancy E. Crawford
Mayor Director
Deanna S. Sako
•+i'::,. ; Deputy Director
County of Hawaii
Finance Department
25 Aupuni Street, Room 2103 • Hilo,Hawaii 96720
(808)961-8234 • Fax(808)961-8569
March 19, 2013
J Yoshimoto, Council Chair and
Members of the Hawai`i County Council
Hawai`i County Council
25 Aupuni Street
Hilo, Hawai`i 96720
Re: Nonprofit Grant Applications
•
As per our discussion with Council Member Karen Eoff, Chair of the Committee on Human
Services, and in compliance with Chapter 2, Article 25 of the Hawai`i County Code, I am
submitting the County of Hawai`i Nonprofit Grant application from Special Olympics West
Hawai`i for your review and appropriation of funds for the FY2013-14 nonprofit grant program.
Should you have any questions, please feel free to call Ted Schrey at 961-8489.
6*1 C±
Nancy Crawford
Director of Finance
Enc. Application for Nonprofit Grant Funds
Comm. No. 672... 3
Ref. To:
Ref. Date_ MAR 2 ft 21113
Hawaii County is an Equal Opportunity Provider and Employer
Agency Name: SPECIAL OLYMPICS WEST HAWAII
Program Name: SOWH GENERAL FUND
Agency Director: Nancy Bottelo Phone No.: (808) 943 — 8808
Contact Person: Sandra Dela Cruz Phone No.: (808) 987 — 5057
Mailing Address: Address: PO Box 390358
Address:
City,ST,Zip Keauhou, Hawaii 96739
Facility Address: Address: 82-1015 A Kinue Road
Address:
City,sr,zip Captain Cook, HI 96704
Email Address: sowhsandie @gmail.com Fax No.: ( ) —
Accountant/CPA: Ronelle Matsunami Phone No.: (808) 833 — 1183
Firm (if applicable): Carr, Gooveia & Associates
Mailing Address: Address: 680 lwilei Road Suite 410
Address:
City,ST,Zip Honolulu, HI 96817
YOU ARE RESPONSIBLE TO KEEP THE ABOVE INFORMATION CURRENT
Amount of Request for County Nonprofit Grant Program Funds: $15,000
1. Prior Year Award of County Nonprofit Grant Program Funds:
FY 09-10 FY 10-11 FY 11-12
$12,000 $7,000 $12,000
2. 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 sharing of gifts, skills and friendship with their
families, other Special Olympics athletes and the community.
EXHIBIT A
NONPROFIT GRANT APPLICATION FY 2013-2014 Page 1 of 7
Agency Name: SPECIAL OLYMPICS WEST HAWAII
Program Name: SOWH GENERAL FUND
3. Program Description:
Special Olympics goal is to dispel negative stereotypes about people with intellectual
disabilities, to build athlete and o'hana involvement through sports, and to promote the
extraordinary gifts of people with intellectual disabilities. Special Olympics is open to every
individual with intellectual disabilities [ages 2 and up] regardless of skill level or extent of the
disability. Athletes compete with others grouped according to age, gender and records of past
performance, so that, in every event, every participant has a chance for an award.
(continue on attachment)
4. Total Budget& Position Count:
Total Program Budget: 84,050 Total Program Position Count: 1
Total Agency Budget: 1,600,000 Total Agency Position Count: 18
5. Program Funding Sources (identify all sources of funding applied to this program):
FY13-14
Revenue Source Estimate
See attached Revenue Source
TOTAL: $84,050
Attach additional pages,if needed.
6. Explain what plans your agency or program has to increase revenues to support this program:
1. Adding the 25th Annual Police Officer's Canoe Regatta to our fundraising source for
2013-2014 -we have been named as this year's receipents.
3. We will continue to make our events opened to the public to increase awareness and the
possible donation base.
4. We have added a new fund raiser- Crossfit for Special Olympics scheduled for Sat. Feb
9th. We are soliciting for sponsors and participants.
5. We will hold our 2nd Annual golf tournament. Date and time TBA.
6. Increase revenue for Cop On Top.
EXHIBIT A
NONPROFIT GRANT APPLICATION FY 2013-2014 Page 2 of 7
Agency Name: SPECIAL OLYMPICS WEST HAWAII
Program Name: SOWN GENERAL FUND
7. Program Objectives Using County Nonprofit Grant Program Funds:
1) Expand our Ka'u delegation to provide services to South Kona and Ka'u.
2) Add Unified Soccer to our Summer season to raise the caliber of competition and community
involvement.
3) Create an active delegation in the Waimea/Hawi area to provide support to Kohala.
See attachment
8. TABLE I:
What are the intended measurable outputs or outcomes that would be achieved with this funding?
PROGRAM PERFORMANCE MEASURES Applicant Projected Results
(i.e.:Number of clients served,workshops or events held,volunteer hours,etc.Describe,be specific.)
Develop a new program in Ka'u by June 2014 6 athletes 6 partners 4 coachs
Conduct 3 Regional competition and 1 local competition by June 14 152 athletes 48partners 24 co
Develop a Unified Soccer team 5 athletes 5 partners 2 coache
Train new and existing coaches 10 coaches trained, 20 total
Develop a new program in Waimea 4 athletes 2 coaches
Develop a management team 12 member team
Family member involvement 85
Attach additional pages as necessary.
9.TABLE II:
FY 12-13 FY 13-14 FY 13-14
PROGRAM EXPENDITURES
Actual* Total Budget Grant Req
Salary and Wages 15,000 15,000 0
Professional Fees 0 0 0
Operations 19,005 19,000 2,500
Supplies 12,873 12,250 2,500
Equipment 0
Other: 37,774 37,800 10,000
Other:
Other:
Other:
Other:
TOTAL 84,652 84,050 15,000
*If applicable
EXHIBIT A
NONPROFIT GRANT APPLICATION FY 2013-2014 Page 3 of 7
Agency Name: SPECIAL OLYMPICS WEST HAWAII
Program Name: SOWH GENERAL FUND
10. ORGANIZATION CONFLICT DISCLOSURE FORM
Please disclose any conflicts or potential conflicts of interest that any board member, officer, director,
or administrator of your organization may have with the County of Hawai'i. Only those listed below
need to be disclosed. One form per conflict is needed. Please duplicate as needed to fully disclose.All
disclosure forms must be signed, regardless of whether a conflict exists.
NAME:
POSITION:
May have a conflict or potential conflict of interest, including any familial relationship, with any of the
following (check all that apply):
17/1 No conflicts exist (No further information required. Please sign form at the bottom.)
I Member or members of the Council
_ Staff appointed by a member of the Council
The Mayor
ElThe Managing Director
The Director of Finance
The Corporation Counsel, the Assistant Corporation Counsel, or a Deputy Corporation
Counsel
Conflict of Interest is defined as:a substantial probability that action taken by an individual will result in measurable direct
benefits accruing to the individual as opposed to benefits accruing in general to an industry.
Please specify any and all mitigation measures to avoid, in fact or appearance, any conflicts or potential
conflicts of interest:
NA
/7 /0/.* /C) CEO / /(/ 3
Sig Lure of2uthorized Person (specify title) Date
EXHIBIT A
NONPROFIT GRANT APPLICATION FY 2013-2014 Page 4 of 7
Agency Name: SPECIAL OLYMPICS WEST HAWAII
Program Name: SOWN GENERAL FUND
11. Certification of Understanding
I (we) have read and understood all of the eligibility requirements; grant conditions; award procedures;
and records, reporting, and fiscal accountability requirements as mandated in Article 25, Sections 2-
135 —2-142.1, Hawai'i County Code, relating to Appropriation of Funds to Nonprofit Organizations.
I (we) agree to allow the County (the Legislative Auditor, the Department of Finance, designated
Council representative, or expending/oversight agency) full, free, and unrestricted access and authority
to examine and inspect any facility, equipment, property, or records pertinent to the grant, contract, or
program for which funds were used.
I (we) hereby certify that information supplied herein, including all supporting documents, is correct
and that I (we) have the authority and ability to fully administer the program(s) pursuant to law.
I (we) understand that information supplied herein shall be made public according to Chapter 92F,
Hawai'i Revised Statutes.
I (we) understand that applications will not be reviewed by County personnel receiving our County
Nonprofit Grant submittal, and that we have full responsibility to ensure that all documents are
complete and accurate prior to submittal.
I (we) understand that all documents requiring a current signature must be the ORIGINAL, SIGNED
document. Unsigned documents will be disqualified. Faxed or copied documents will not be accepted
as original documents.
If awarded a grant from the County of Hawai'i, I (we) understand and will comply with the requirement
to enroll with Hawai'i Compliance Express, and be compliant prior to final payment. To register, go
to http://vendors.ehawaii.gov, complete the easy step-by-step process, and pay the annual
registration fee online using a credit card.
If awarded a grant from the County of Hawai'i, I (we) understand and will comply with the requirement
to submit a year-end report to the County Council within 60 days after June 30 of the contractual year
for which the grant was awarded.The report shall include an explanation of the public benefits derived
from the awarding of the grant (focusing on specific, measurable outcomes), a complete accounting of
all expenditures supported by County of 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.
EXHIBIT A
NONPROFIT GRANT APPLICATION FY 2013-2014 Page 5 of 7
I (we) understand that failure to submit the final report within 60 days of June 30th shall result in loss
of all grant funds received during the grant period (must be refunded to County) and exclusion from
future grant participation for a minimum of one year or until a written report is submitted to, and
accepted by,the council.
I (we) understand there is no provision for further notification to submit the final report. Information
and instructions are available at http://www.hawaiicounty.gov/fn-nonprofit-grant-forms/on or about
May 30 of the year the final report is due.
As part of this application, you acknowledge that any funds awarded will be restricted for the purposes
stated in the application, except for a maximum ten percent (10%) for administrative and overhead
costs. Any funds unused by June 30, 2014 must be returned to the County of Hawai'i with the final
report. Failure to return these funds in a timely manner will impact the evaluation of your agency's
future funding request and may result in actions taken to recover these funds.
By signing below, you are acknowledging that you have read and understood these requirements.
yirt,cv . /c, (F0 I /l, / 3
re o uthorized Person (specify title) Date
EXHIBIT A
NONPROFIT GRANT APPLICATION FY 2013-2014 Page 6 of 7
Agency Name: SPECIAL OLYMPICS WEST HAWAII
Program Name: SOWH GENERAL FUND
12. COUNCIL AWARD WORKSHEET
TABLE I:
Applicant Council Proposed
PROGRAM PERFORMANCE MEASURES Projected Results Projected Result
TABLE II:
FY 13-14 Council
PROGRAM EXPENDITURES
Grant Request Award
Salary and Wages
Professional Fees
Operations
Supplies
Equipment
Other:
Other:
Other:
Other:
Other:
TOTAL
Additional Council directives regarding award:
EXHIBIT B
NONPROFIT GRANT APPLICATION FY 2013-2014 Page 7 of 7
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3. Program Description (con't):
Special Olympics helps bring all persons with intellectual disabilities into a larger society
under conditions whereby they are accepted, respected, and given a chance to become
productive citizens. Physical fitness training and competition is crucial for children with
intellectual disabilities; and being part of a "team" is essential to all athletes. Special
Olympics is often the only option available to the intellectually challenged population for
sports training and competition. Certainly Special Olympics is the only program that
welcomes involvement by the entire family. Our program is designed to increase
inclusion by every member of the family and the community; we believe we help them to
overcome the barriers that have historically caused children and adults with intellectual
disabilities and their `ohana to live in a world of isolation.
Benefits that our 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 child'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 make long lasting bonds that continue off of the sports field into
their daily lives. 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 recruiting 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. Special Olympics West Hawaii will have unified softball, track
relays, bocce and bowling teams and will expand and have our first unified soccer team
in FY 2013-14.
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
Agency Name: SPECIAL OLYMPICS WEST HAWAII
Program Name: SOWH GENERAL FUND
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 program is free of cost to all of our athletes, special partners, and coaches. Due to
this aspect of our program, a volunteer committee under the leadership of our Area
Director must raise all the funds needed for our West Hawaii area program. Those
funds will pay for all aspects of the Special Olympics program. Our largest needs for
2013-2014 are 1. Develop our new After School All Stars Program in Ka'u complete
with staff, coaches, uniforms, and equipment. 2. Host a neighbor island softball /t-ball
tournament. 3. Host a neighbor island Power lifting Tournament. 4. Host a neighbor
island Soccer and Bocce Ball tournament. Our largest cost, as always is airfare to get
our athletes to their competitions where they compete against their peers from around
the state of Hawaii. Hosting these three major competitions here on the West side of
the Island, as well as a local bowling competition helps us out financially by not having
to buy as many flights to off island competitions, however that aspect of our budget is
extremely large.
It is an essential part of our program that Special Olympics athletes are provided an
opportunity to interact and compete against people of similar athletic ability. We find as
many teams in the community as we can to practice and play against, but we still must
travel to Oahu three times a year to compete against similar Special Olympics
teams/athletes. The state competitions that are held on Oahu three times per year
provide many activities that our athletes never have a chance to experience. They
include: dances, Opening and Closing Ceremonies, entertainment, 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 to be able to reach out to new special needs
individuals throughout our communities. In order to do this, we will need funds to
maintain our services and to purchase new uniforms and equipment, host local
competitions 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.
5. Revenue Source:
ANTICIPATED REVENUE SOURCES AMOUNT
Kona Crossfit Fund Raiser $2,000
County Grant $15,000
Ironman Grant $6,000
Charity Walk $10,000
Fueling Dreams $5,000
SOWH Golf Tournament $5,000
Hele-On Bus Pull $3,000
Cop On Top $25,000
Police Officer's Canoe Regatta $8,000
Cosmic Bowling Fund Raiser $4,000
Corporate and Individual Donations $1,050
Total Revenue $84,050
7. Program Objectives Using county Nonprofit Grant Program Funds:
4) Establish our new Ka'u After School All Star Program.
5) Train more coaches and volutneers t continue to provide the highest skilled training
to our athletes.
6) Provide atheltes with additional opportunities: to learn, more work opportunities, and
to move towards self-sufficiency through our partnerships with The ARC of Kona and
Full Life.
7) Countine to add community service events to give back to our Kona community that
is so supportive of SOEH.
8) Expand our management team to have additional input from the local community
members and businesses.
9) Strengthen our financial contacts and expand our local fundraising opportunities.
10) Expand our outreach to younger athletes in the community to enhance the
development of our keiki.
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