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HomeMy WebLinkAbout2016-631-E Finance - Compass Center for Women and Families - Outside Agency Performance Agreement DocuSign Envelope ID: E9DE81F9-0070-4074-8F70-93DABC24ACE1 OUTSIDE AGENCY PERFORMANCE AGREEMENT THIS AGREEMENT,made and entered into the first day of July 2016, ("Effective Date")by and between the County of Orange, a political subdivision of the State of North Carolina, 200 South Cameron Street, Hillsborough, North Carolina, 27278, ("County") and Compass Center for Women and Families, a not-for- profit corporation, located at 210 Henderson St.,PO Box 1057, Chapel Hill,NC 27514 ("Provider"). WITNESSETH: WHEREAS, it is in the interests of the County that said program be assisted by the County and thereby enhance its availability to residents of the County, and said program addresses an important community human services need, as identified by the Board of Commissioners; NOW, THEREFORE, in consideration of the above and the mutual covenants and conditions hereafter set forth, the County and Compass Center for Women and Families agree as follows: 1. Term of the Agreement. The term of this Agreement shall be a program year beginning July 1, 2016 to June 30, 2017. 2. Scope of Services. a. Provider will provide services, as outlined in the attached Outside Agency Funding Application and any amendments or revision thereto which is attached as Exhibit"A" and incorporated by reference, to the residents of Orange County. The Scope of Services and the Program Budget may be different from the original application based on County appropriation; however, any revisions or amendments to this Agreement must be approved in writing by the County and attached to this Agreement as Exhibit B. b. The Provider shall be solely responsible for the means, methods, techniques, sequence, safety program and procedures necessary to properly and fully complete the work set forth in the Scope of Services. 3. Funding. a. The County agrees to appropriate for the provision of services described in Exhibit A, Scope of Services and more particularly described in the Revised Program Budget, the maximum sum of 64500. b. All funds appropriated shall be used for purposes described in Exhibit A. Any funds not used for the purposes stated shall be returned to the County. Any changes in the use of funds must be authorized in writing by the County prior to any expenditure of the funds by the Provider. If the funds are expended not in accordance with the Scope of Services, at the discretion of the County the Provider may be required to repay the funds to the County. c. The Provider shall be paid in four equal installments in the amount of$16,125. The first payment is contingent upon receipt of the agency's performance agreement; the remaining payments are contingent upon receipt of the request for reimbursement and related supporting documentation. d. The County's obligation to make the quarterly payments is contingent upon receipt of Progress Reports, which show satisfactory progress toward completion of performance measures and an accounting of expenditures as detailed in the attached Scope of Services. (Compass Center for Women and Families) Orange County Outside Agency Performance Agreement Revised 8/2016 DocuSign Envelope ID: E9DE81F9-0070-4074-8F70-93DABC24ACE1 e. Once Provider has satisfied its obligations as provided in (d) payment will be made 21 days after receipt of the Progress Report and Request for Reimbursement or 21 days after due date of Progress Report whichever is later. f. The County is not obligated to provide any other support to Provider in this or in succeeding fiscal years. 4. Agency Reporting. a. Provider will provide Orange County a Progress Report that includes a fiscal report and updates on performance measures as outlined in the Scope of Services. Progress Report dates are: July 1 —December 31; January 1 —March 31 and April 1 - June 30. Reports are due on January 13,April 14, and July 14 of the program fiscal year. b. Provider agrees to allow the County to inspect its financial books and records, which document costs of those services,upon reasonable notice during normal working hours. 5. Termination. a. In the event of any of the circumstances set forth below (hereinafter referred to as "default"), the County may immediately terminate this Agreement, in whole or in part, and from time to time. Notice of termination must be in writing, state the reason or reasons for the termination, and specify the effective date of the termination: i. In the event that Provider shall cease to exist as an organization or shall enter bankruptcy proceedings, be declared insolvent, or liquidate all or substantially all of its assets, or significantly reduce its services or accessibility to Orange County residents during the term of this Agreement; or ii. In the event that Provider shall fail to render a satisfactory accounting as provided section 4 above, the County may terminate this Agreement and Provider shall return all payments already made to it by the County for services which have not been provided or for which no satisfactory accounting has been rendered; or iii. In the event of any fraudulent representation by the Provider in an invoice or other verification required to obtain payment under this Agreement or other dishonesty on a material matter relating to the performance of services under this Agreement. iv. Nonperformance, incomplete service or performance, or failure to satisfactorily perform any part of the work identified in the Scope of Services or to comply with any provision of this Agreement, as determined by the County in its sole discretion. v. Failure to adhere to the terms of applicable county, state or federal laws, regulations, or stated public policy. b. In the event of default by the Provider, the county may elect to terminate this Agreement, in whole or in part and/or require the Provider to repay the funds within ten(10)business days from written notice of default. The County may (but shall not be required to) grant the Provider an opportunity to cure the default without termination of this Agreement. This clause shall not be interpreted to limit the County's remedies in law or in equity. (Compass Center for Women and Families) Orange County Outside Agency Performance Agreement Rev. 8/16 DocuSign Envelope ID: E9DE81F9-0070-4074-8F70-93DABC24ACE1 c. Notwithstanding the foregoing, either party may terminate the agreement at any time without penalty; provided that written notice of such termination is furnished to the other party at least 30 days prior to termination. In the event of such termination, any payment due shall be prorated to the date of termination and any unused funds shall be returned to the County within 10 days of termination. d. Any termination of this Agreement for default under this section that is later deemed to be unjustified shall be deemed a termination for convenience. 6. Insurance. a. General Requirements. The Provider shall purchase and maintain, during the period of performance of this Agreement, insurance: i. Worker's Compensation. For protection from claims under workers' or workmen's compensation acts; ii. Comprehensive General Liability Insurance covering claims arising out of or relating to bodily injury, including bodily injury, sickness, disease or death of any of the Consultant's employees or any other person and to real and personal property including loss of use resulting thereof; iii. Comprehensive Automobile Liability Insurance, including hired and non-owned vehicles, if any, covering personal injury or death, and property damage; and iv. Professional Liability Insurance, covering personal injury,bodily injury and property damage and claims arising out of or related to the performance under this Agreement by the Consultant or his agents, consultants and employees. b. Limits of Coverage: Minimum limits of insurance coverage shall be as follows: INSURANCE DESCRIPTION MINIMUM REQUIRED COVERAGE • Worker's Compensation Limits for Coverage A- Statutory State NC& Coverage B -Employers Liability $500,000 each accident, disease policy limit and disease each employee • Commercial General $1,000,000 Each Occurrence Liability $2,000,000 Aggregate • Automobile Liability $500,000 Combined Single Limit • Professional Liability $1,000,000 Each Occurrence $2,000,000 Aggregate c. All insurance policies (with the exception of Worker's Compensation and Professional Liability)required under this Agreement shall name the County as an additional insured party and as a certificate holder. Evidence of such insurance and all correspondence shall be sent to: Orange County Risk Manager Post Office Box 8181 Hillsborough,NC 27278 d. Nothing in this section is intended to affect or abrogate the County's sovereign immunity defenses. (Compass Center for Women and Families) Orange County Outside Agency Performance Agreement Rev. 8/16 DocuSign Envelope ID: E9DE81F9-0070-4074-8F70-93DABC24ACE1 7. Relationship of the Parties. Provider is an independent contractor of the County. Provider represents that they have or will secure, at his own expense, all personnel required in performing the services under this Agreement. Such personnel shall not be employees or have any contractual relationship with the County. All personnel engaged in work under this Agreement shall be fully qualified and shall be authorized and permitted under federal, state and local law to perform such services. 8. Compliance with all Laws. The Provider, at its sole expense, shall comply with all laws, ordinances, orders and regulations of the federal, state or local governments, as well as their respective departments, commissions, boards, and officers, which are in effect at the time of execution of this Agreement or are adopted at any time following execution of this agreement. 9. Subcontract. The County and Provider deem the services provided under this Agreement to be personal in nature and Provider may not subcontract any rights or duties under this Agreement to any other party without prior written consent from the County. 10. Assignment. The Provider shall not assign this Agreement, including the rights to payment, to any other party without the prior written consent of the County. 11. Indemnification. Provider agrees to defend, indemnify, and hold harmless the County, for all loss, liability, claims or expense (including reasonable attorney's fees) arising from bodily injury, including death or property damage, to any person or persons caused in whole or in part by the negligence or willful misconduct of the Provider, except to the extent same are caused by the negligence or willful misconduct of the County. It is the intent of this section to require Provider to indemnify the County to the extent permitted under North Carolina law. Nothing in this section is intended to affect or abrogate the County's sovereign immunity defenses. 12. Non-Appropriation. This Agreement is subject to the availability of funds to purchase the specified services and may be terminated at any time if such funds become unavailable. 13. Non-Discrimination. Provider agrees as part of consideration of the granting of funds by Orange County the parties hereto for themselves, their agents, officials, employees and servants agree not to discriminate in any manner of these basis of race, color, gender, national origin, age, handicap, religion, sexual orientation, familial status or veterans status with reference to any activities carried out by the grantee, no matter how remote. The parties hereto further agree in all respects to conform to the provision and intent of Orange County Civil Rights Ordinance, as amended and the Orange County Anti-discrimination Policy. This provision is enforced by action for specific performance, injunctive relief, or other remedy as by law provided; this provision shall be binding on the grantees, the successors and assigns of the parties hereto with reference to the above subject manner. 14. Living Wage. Orange County is committed to providing its employees with a living wage and encourages agencies if funds to pursue the same goal. The County's living wage is $ 13.15 per hour. To the extent possible, Orange County recommends that Compass Center for Women and Families provide a living wage to its employees. 15. Notice. The Parties hereto agree and understand that written notice, mailed or delivered, to the last known address shall constitute sufficient notice to the County and the Provider. All notices required and/or made pursuant to this Agreement to be given to the County and the Provides shall be in writing and mailed to the party addressed as follows: (Compass Center for Women and Families) Orange County Outside Agency Performance Agreement Rev. 8/16 DocuSign Envelope ID: E9DE81F9-0070-4074-8F70-93DABC24ACE1 County: Finance&Administrative Services Provider: Compass Center for Women and Orange County Families Post Office Box 8181 210 Henderson St.,PO Box 1057 Hillsborough,NC 27278 Chapel Hill,NC 27514 16. E ntire Agreement. This Agreement, including any referenced attachments, constitutes the entire Agreement between the parties and shall supersede, replace or nullify any and all prior Agreements of understandings; written or oral, relating to the matters set forth herein, and any such prior Agreements or understandings shall have no force or affect whatsoever on this Agreement. The County and Provider have read this Agreement and agree to be bound by all of its terms, and further agree that this Agreement constitutes the complete and exclusive statement of the Agreement between the County and Provider. 17. Severability. All clauses found herein shall act independently of each other. If a clause is found to be illegal or unenforceable, it shall have no effect on the other provisions of this Agreement. It is understood by the parties hereto that if any part, term or provision of this Agreement is by the Courts held to be illegal or in conflict with any laws of the State of North Carolina or the United States, the validity of the remaining portions or provisions shall not be affected, and the rights and obligations of the parties shall be construed and enforced as if the Agreement did not contain the particular part, term or provision held to be invalid. a. Governing Law. This Agreement and the duties, responsibilities, obligations and rights of respective parties hereunder shall be governed by the laws of the State of North Carolina. By executing this Agreement Provider affirms that Provider and any subcontractors of Provider are and shall remain in compliance with Article 2 of Chapter 64 of the North Carolina General Statutes. By executing this Agreement Provider certifies that Provider has not been identified, and has not utilized the services of any agent or subcontractor, on the list created by the State Treasurer pursuant to G.S. 147-86.58. 18. Signatures. This Agreement together with any amendments or modifications may be executed electronically. All electronic signatures affixed hereto evidence the intent of the Parties to comply with Article 11A and Article 40 of North Carolina General Statute Chapter 66. IN WITNESS WHEREOF,the Orange County and the Provider have signed this Agreement, effective on the last date this Agreement is signed by both parties as indicated by the dates set forth under signatures below. For an LCorIL10`h of the Provider tAt 10/31/2016 20A8CC45F3494C5... Date For and i i I,.lugectkOrange County Government botiutA,tt, hootAurst t1 11/4/2016 T a755E 7... Bonnie Hammersley, County Manager Date (Compass Center for Women and Families) Orange County Outside Agency Performance Agreement Rev. 8/16 DocuSign Envelope ID: E9DE81F9-0070-4074-8F70-93DABC24ACE1 ATTACHMENT "A" Orange County Certifications—FY 2016-17 Outside Agency Performance Agreement Chief Contact,Administrators, Chief Executive Officer and Chief Financial Officer I certify that I have provided a list of the chief contact, administrators, chief executive officer and chief financial officer for my agency with this Agreement and that I will keep it current to the County of Orange. The list should be in writing with the name, title,residential address;phone and email address and if possible, fax number. Officers and Board of Directors I certify that I have provided a current list of the Officers and Board of Directors with this Agreement and that we will continue to update the list as changes occur. The list should be in writing,with the name, physical address,mailing address and if possible,phone, fax and email address. Budget Submission I certify that I have provided a budget for the period to be covered by funding Orange County, and that any substantive changes made to this budget have been in advance authorized in writing by Orange County. Annual Financial Review I certify that I have provided a copy of the latest annual Financial Review for our agency and the budget adopted by the agency for the fiscal years encompassing this Agreement. If not,please explain on a separate sheet of paper. Alignment with Organization's Mission I certify that the programs and services for which this funding is requested align with the mission of the organization. Intended Purpose I certify that the funds provided to the agency under the terms of this Agreement will be used for a public purpose and shall only be used for the purposes intended and any money not used for those purposes will be promptly returned to Orange County. LDocuSigned by:t�,I��� 20A8CC45F3494C5 Executive Director Certified by: Title: Date: 10/31/2016 (Provider's Signature) (Compass Center for Women and Families) Orange County Outside Agency Performance Agreement Rev. 8/16 DocuSign Envelope ID E9DE81F9-0070-4074-8F70-93DABC2 4ACE1 _xhibit A Provider's Outside Agency Application APPLICATION SUBMITTAL CHECKLIST FOR OFFICE USE ONLY Received By Agency The Women's Center inc. dba Com oass Center Date/Time for Women and Families Complete Y/N Program(s) Domestic Violence Crisis Services Self-Sufficienc Proorams & Communit Education & Civic En a•ement Section S ubsection For CDBG & HOME- HUD Regulations 1. Cover Page a. ErApplicant Contact Information b. [ 'Project/pro gram Contact Information c, 4Funding Requests Identified d. Signed Application Cover Page 2. Agency a. [ Agency's Years in operation 24 CFR 570.506, Information - b. DrAgency's Purpose/Mission 570,507, 570.610; 24 C. LaAgency's Types of Services Provided CFR Parts 84 or 85 d. 4Agency's Experience e. Other Pertinent Information 3. Program/ a. 2 Type of Application and Program Identified 24 CFR 570,200(a), Project b. faSurnmary of Program 570.201570, 208, Information - C. {a Description of Identified Need 507 503 (for each cl. 4Description of Population to be Served program/ e, 2 Activity Manager and Location Description project for f. Activity Implementation which funding Timeline is requested) g. EA-Agency Collaboration h. 4Describe Impact of Reduced/No Allocation IOther Pertinent Information j. 2 Complete Target Population/Beneficiary Chart k. 2 Complete Schedule of Positions I. 4Signed Conflict of Interest Disclosure m. El Complete Work Statement iiPage DocuSign Envelope ID: E9DE81F9-0070-4074-8F70-93DABC24ACE1 L A - continued Provider's Outside Agency Application MAIN APPLICATION 24 CFR 570.200(a), 4. Financial (for Program Budget Worksheet and Detail should reflect 570.201-570. 208, each expenses for the entire program and ALL sources of 507.503 program/ funding. 24 CFR 570.506, project for 570.507, 570.601, which funding a. I 4 Program Budget Worksheet 570.602, 570.607(b), is requested) b. El/Program Budget Detail 570.611 24 CFR c. 17,Cost Per Unit 570.502-570.504, d. DI Agency Operating Budget Worksheet 570.506, 570.507, 570.610; 24 CFR Parts 84 or 85, and OMB Circulars A-87 or A 122; Treasury Circular 1075 5. Supplemental A. L Part A: CDBG & HOME Sections (as B. Er-: Part B: Construction/Rehab applicable) 6. Attachments a. 0/Audit: Organizations receiving$300,000 or more OMB Circular A-133 in Federal financial assistance, and/or organizations with more than $500,000 of receipts and expenditures in a fiscal year, must secure an audit. b. IRS Federal Form 990 c. aNC Solicitation License d. :ORS Federal Tax-Exemption Letter e. [i/Certificate of Insurance f. ,7List of Board of Directors 24 CFR Parts 84 or 85 g. 171 Articles of Incorporation/Bylaws 24 CFR 570.208, h. [2-Authorization to Request Funds 570.500(c), 570.611 i. [TA uthorized official designation j. 3-R Fee Verification Main Application 1/24/2016 2:59:42 PM Page 2 of 58 DocuSign Envelope ID: E9DE81F9-0070-4074-8F70-93DABC24ACE1 L A - continued Provider's Outside Agency Application MAIN APPLICATION 1. COVER PAGE (Each program requires a separate application.) a) Applicant Contact Information Applicant Organization's Legal Name: The Women's Center, Inc. dba Compass Center for Women and Families Applicant Organization's Physical Address: 210 Henderson St., Chapel Hill NC 27514 Applicant Organization's Mailing Address: Post Office Box 1057; Chapel Hill, NC 27514 Applicant Organization's Web Address: compassctrorg Executive Director: Cordelia Heaney Telephone Number: (919) 968-4610 E-Mail: directoracompassctr.org DUNS Number: 931214985 (Dun & Bradstreet, Inc. provides this number at no charge, and it is required for Federal funding recipients.) b) Project/Program Contact Information Project/Program Name: 1) Domestic Violence Crisis Services 2) Self Sufficiency Programs: Legal Information, Financial Education & Career Preparedness 3) Community Education & Civic Engagement Project/Program Primary Contact and Title: Ardith Burkes, Associate Director Telephone Number: (919) 968-4610 E-Mail: programsdirectoracompassctrorq c) Funding Request Identification Total Project/Program Cost: $600,385.33 Total Amount of Funds Requested: $102,200.00 Proposed Use of Funds Requested (2-3 Line Maximum): To provide domestic violence crisis services, financial education and career preparedness services, legal information services, connections to community resources, youth and adult training and education on the prevention of interpersonal violence and civic engagement related to women's and gender issues. Please check all types, sources, and amounts of funding being requested. You must submit an application package for each funding source. *The Participating Jurisdiction reserves the right to fund projects from any funding source, subject to eligibility and funding constraints. CDBG Non-Construction (CH) $ P Grant E Loan Lii CDBG Construction (CH) H Grant I- Loan Li HOME CHDO Grant P Loan HOME Other I- Grant 0 Loan Human Services: IZ] Carrboro $8,400 El Chapel Hill $29,300 Orange County $64,500 Main Application 1/24/2016 2:59:42 PM Page 3 of 5 8 El L A - continued DocuSign Envelope ID: E9DE81F9-0070-4074-8F70-93DABC24AC Provider's Outside Agency Application MAIN APPLICATION d) To the best of my knowledge and belief all information and data in this application is true and current. The document has been duly authorized by the governing board of the applicant. Signature: ecutive Dire tor, Date Signature:, -4„ „ / I "i 1 ( C oar d Chairperso Date Main Application 1/24/2016 2:59:42 PM Page 4 of 58 DocuSign Envelope ID: E9DE81F9-0070-4074-8F70-93DABC24ACE1 A - continued Provider's Outside Agency Application MAIN APPLICATION 2. AGENCY INFORMATION Please provide the following information about your agency (Limit of 2 pages total): a) Years in Operation, Date of Incorporation (Month/Year) The Women's Center, Inc. doing business as Compass Center for Women and Families was incorporated on October 19, 1979 and has operated for 36 years as a non-profit organization. During an organizational merger in 2012 the doing business as name Compass Center for Women and Families came into use. In July 2012 Family Violence Prevention Center of Orange County, Inc. (established in 2000) and The Women's Center, Inc. (established in 1979) had a successful merger. b) Agency's Purpose/Mission Compass Center for Women and Families works to promote gender equity in our community through a unique blend of empowerment resources and services. We support individuals as they navigate their personal journey to self-sufficiency, interpersonal safety, and health. Compass Center Mission Statement: Compass Center for Women and Families helps individuals and families prevent and end domestic violence and become self-sufficient. We provide domestic violence crisis services, career and financial education, assistance with legal resources, and adolescent empowerment programs. c) Types of Services the Agency Provides Our services span the continuum from financial literacy education, career exploration and preparedness, access to legal information, domestic violence crisis services (including crisis intervention, court advocacy and group support), adolescent empowerment programs including youth interpersonal violence prevention education, trainings for community members and professionals on interpersonal violence prevention and response, and a referral line to provide callers connections to community resources. Our services are available to any community member. We have a wide breadth of services under one roof to increase accessibility for community members. We find that for many community members we become a home base for services and we are able to build lasting relationships with them as their needs change. This lasting relationship means that they are more likely to engage in true change behavior towards a more stable life. d) Agency's Experience with Similar Programs as the Funding Request We have a vision of empowerment for all of our clients that includes safety, security, and economic self-sufficiency. The services for which we are applying for funding have been our core services for many years. Since maintaining high service quality and responding to community need is important to us we continue to evaluate and refine these core services. Since their inception, both pre-merger agencies served as leaders in our community. The Women's Center, Inc. has been highly regarded for improving the lives of women and girls in the Triangle through our own work and through collaborative community partnerships. Family Violence Prevention Center was known for providing comprehensive and high-quality domestic violence crisis services. The two agencies often experienced client overlap and decided that a merger would conserve resources while providing more comprehensive and efficient services. By combining agencies, Compass Center clients are able to access a larger continuum of important services under one roof. Staff trains and works with over 200 volunteers annually, some of whom have been with us more than 15 years. Our organization is a community home for not just those seeking services but for our volunteers who want to contribute meaningfully. e) Other Pertinent Agency Information Main Application 1/24/2016 2:59:42 PM Page 5 of 58 DocuSign Envelope ID: E9DE81F9-0070-4074-8F70-93DABC24ACE1 A - continued Provider's Outside Agency Application MAIN APPLICATION We are excited for the year ahead. Compass Center has a stable program staff, many of whom have been with us for a number of years, ensuring the consistency and quality of our programs. A new, permanent Executive Director joined Compass Center in August 2015. The Board of Directors is launching a new strategic planning process, with the goal of identifying strategies and setting benchmarks to help Compass Center further support our longstanding commitment to programming areas that help prevent domestic violence, promote self-sufficiency, and empower individuals. This will ensure that our work continues to reflect the needs and interests of the community we serve, and that we are working to reach traditionally underserved populations. Main Application 1/24/2016 2:59:42 PM Page 6 of 58 DocuSign Envelope ID: E9DE81F9-0070-4074-8F70-93DABC24ACE1 A - continued Provider's Outside Agency Application MAIN APPLICATION 3. PROJECT/PROGRAM INFORMATION Agency & Program Name: Compass Center for Women and Families, Domestic Violence Crisis Services As you complete your application, complete only those sections that pertain to the type of application you are submitting. The application is divided into several sections and not all sections apply to every project. Every applicant MUST complete the main application. a) Check the type of funding request for this application package submittal and complete the application and supplemental application sections as specified below: 12 Human Services (Main Application Only) • AH Non-Construction (Main Application Only) AH Construction — (Main Application AND Part B) I AHDR Non-Construction (Main Application Only) • AHDR Construction — (Main Application AND Part B) fl CDBG Non-Construction — (Main Application AND Part A) E CDBG Construction — (Main Application AND Part A AND Part B) HOME CHDO Set-aside —(Main Application AND Part A) fl HOME Other —(Main Application AND Parts A AND Part B) Indicate the type of program for which you are requesting funding: Public Housing Program Category Youth Adult Elderly (nDisabled ot elderly) Neighborhoods/Residents Education X X X X X Health and Nutrition Job Training Sports and Arts Activities Pre-School Activities After-School Activities Mentoring Transportation X X X X X Housing Other: Safety net for the vulnerable X X X X X Proaram/Project 0 scription (Label your responses as outlined below; not to exceed 3 pages.) Please provide the following information about the proposed program/project: b) Summarize the program services proposed and how the program will address the chosen Town/County priority? The Domestic Violence Crisis Services Program provides essential crisis intervention and support services to victims of domestic violence that are unavailable through any other venue in Orange County. Specifically, the community needs we will continue to address are: Main Application 1/24/2016 2:59:42 PM Page 7 of 58 DocuSign Envelope ID: E9DE81F9-0070-4074-8F70-93DABC24ACE1 t A - continued Provider's Outside Agency Application MAIN APPLICATION Immediate response to calls through operation of a dedicated 24-hour domestic violence hotline: All callers can expect to receive services from a compassionate, well-trained individual ready to offer emotional support, safety planning, resource information, and other available services. Direct crisis intervention and advocacy services: Trained staff will accompany victims to criminal and civil court, provide assistance with obtaining domestic violence protective orders, help clients file for victims' compensation through the state, and help clients find emergency shelter and other needed resources. Support Groups: We offer a variety of 8-week support groups for adults affected by domestic violence. In addition, we offer monthly art-based healing groups and workshops. Access to emergency financial support: Most domestic violence victims are unable to leave abusive relationships without financial assistance to pay for expenses during the transition period when they are moving towards self-sufficiency. We provide limited financial assistance directly to victims of domestic violence in the form of gas cards, grocery cards, and transportation payments to assist with this transition. Assistance accessing safe shelter: While we do not have a physical shelter specific to victims of domestic violence, and there is very limited emergency shelter for women with families in Orange County, we do help victims identify other shelter options. We work with victims to get placed in shelters in other counties and coordinate with local hotels to provide emergency shelter to our clients for free or low cost (paid by Compass Center), The need for a cell phone to call 911: Many victims do not have the resources to purchase a cell phone (or an abusive partner may regulate use of a phone) or theirs has been destroyed or confiscated as part of the violence they are experiencing. We pride a cell phone that can contact 911 in order to expand safety options. c) Describe the local need or problem to be addressed in relation to the Consolidated Plan or other community priorities (i.e. Council/Board Goals). Cite local data to support the need for this program and the population being served. North Carolina ranked 19th in 2012 for its high number of women murdered by men, an FBI figure typically used to count domestic violence-related homicides (Violence Policy Center 2014). In 2015 Compass Center provided services to 1,168 domestic violence clients, a 19% increase in demand for domestic violence crisis services since FY 13-14. This follows increases we have seen over the past 4 years. We are already experiencing a 9% increase in domestic violence victims seeking services this fiscal year. Since FY 13-14, 46% more Spanish-speaking victims have sought services. Compass Center's work seeks to provide prevention education in our community, assistance for victims who have experienced domestic violence, and ongoing support to help empower victims who identify as survivors. We have worked to expand services to meet the needs of victims in our community from diverse backgrounds, including victims with limited English proficiency, LGBTQ victims, and men. Compass Center will be facing unique challenges in 2016-17 when trying to help clients access shelter because the Chatham County domestic violence shelter run by Family Violence Rape Crisis Center will be closing for a year starting in March 2016 to build a new facility. This means that we will have increased costs related to placing people in hotels for safety until longer-term shelter can be found and necessitates increasing our efforts to engage local hoteliers to provide free or reduced cost hotel nights. d) Describe the population to be served or the area to benefit and indicate how you will identify beneficiaries. Domestic violence is a crime that negatively impacts people regardless of age, gender, race, socio- economic status, or religion, and is unfortunately all too common in all Orange County communities. Compass Center's Domestic Violence Crisis Services Program connects with clients via community education and outreach work, our 24-hour domestic violence hotline, word of mouth, and we receive referrals from other agencies. Anyone who has any concerns related to domestic violence can access these services. Our clients are primarily people who have directly experienced Main Application 1/24/2016 2:59:42 PM Page 8 o f 5 8 DocuSign Envelope ID: E9DE81F9-0070-4074-8F70-93DABC24ACE1 A - continued Provider's Outside Agency Application MAIN APPLICATION domestic violence in childhood or adulthood, their friends and loved ones or service providers needing assistance in addressing the needs of a victim. We refer batterers to batterers intervention programs and other services that might be helpful to them. We never have waiting lists. e) Who specifically will carry out the activities and in what location will they be carried out? The Domestic Violence Crisis Services Program is staffed by the following personnel: Associate Director, Director of Domestic Violence Crisis Services, Director of Court Advocacy and Community Response, Support Group Coordinator, Director of Latino Services, and the Client Services Specialist. They train and supervise the following volunteer positions: daytime and overnight hotline advocates, court advocates, support group facilitators, child care volunteers and interpreters. Services are provided at our offices at 210 Henderson St. in Chapel Hill, on-site at the courthouse in Hillsborough, and at other locations in the community as needed such as the hospital, medical offices, police stations, mental health clinics, etc. f) Describe specifically the period over which the activities will be carried out, the frequency with which the activities will be carried out, and the frequency with which services will be delivered. Include an implementation timeline. Dedicated 24-hour domestic violence hotline: In operation 24 hours per day 365 days per year. Court advocacy services: Trained staff will accompany victims to criminal and civil domestic violence court held weekly in Hillsborough. Clients get assistance with obtaining domestic violence protective orders, help in filing for victims' compensation through the state and are educated about legal rights and remedies daily as part of our hotline and in-person services. Support Groups: Will be offered throughout the year with staggered start times so that interested clients can quickly access group support. Generally groups start in September, October, January, February, March and June. Most last 8 weeks. Access to safe shelter: Hotline advocates help clients find emergency shelter 24-hours per day 365 days per year. Many clients are seen during in-person appointments on business days. g) Provide a bulleted list of other agencies, if any, with which your agency coordinates/collaborates to accomplish or enhance the Projected Results in the Program(s) to be funded. For each, give specific examples of the coordinated/collaborative efforts. We continue to recognize that the best response to domestic violence is a community-wide, coordinated response. Our past and ongoing collaborative relationships with numerous organizations, to ensure necessary services for our clients, include local law enforcement agencies, the District Attorney's Office, the Orange County Department of Social Services (DSS), Inter-Faith Council (IFC), Legal Aid of North Carolina, UNC Hospital's Beacon Child and Family Program, the Orange County Rape Crisis Center, Freedom House, UNC Office of the Dean of Students, UNC School of Law's Domestic Violence Advocacy Project (DVAP), El Centro Hispano, El Futuro, NC Coalition Against Domestic Violence, and domestic violence agencies in neighboring counties. Some specific examples of ongoing collaborative efforts include: • Over the past 2.5 years, Compass Center has successfully reinstituted the Orange County Domestic Violence Task Force. This is based on the effective coordinated community response model of engagement and problem solving between agencies that interact with victims of domestic violence. This includes law enforcement, Legal Aid, victim advocates, DSS, crisis unit personnel, medical personnel, batterer's intervention program staff, magistrates, school personnel, etc. The task force meets monthly. • Cross-referrals and training with Orange County Rape Crisis Center, UNC's Beacon Program, CH-TOP Early Head Start/Head Start, local schools, DSS, Durham Crisis Response Center, Family Violence and Rape Crisis Services of Chatham County and Interact of Wake County. Main Application 1/24/2016 2:59:42 PM Page 9 of 58 DocuSign Envelope ID: E9DE81F9-0070-4074-8F70-93DABC24ACE1 A - continued Provider's Outside Agency Application MAIN APPLICATION • We partner with Orange County Department of Social Services in several ways including providing training on domestic violence issues for their staff and clients in the Work First program and other departments on a regular basis. We cross-refer on a daily basis as a portion of their clients need domestic violence services and education and our clients need emergency assistance for food and shelter or need child protective services involvement. • We are also involved in the efforts to address the needs of child victims of crime through the exploration of the development of a child advocacy center and multi-disciplinary team. • Collaboration and cross-referral with seven law enforcement agencies in Orange County and interaction daily or weekly with crisis unit in the Orange County Sheriff's Office and the Chapel Hill Police Department. These agencies also assist with volunteer hotline and advocate training. Several times per year we are part of the training of Crisis Intervention Team training of select law enforcement officers. • The Orange County District Attorney's office collaborates with our court advocate and helps with hotline and advocate training. • Work with Legal Aid of North Carolina to help clients access free legal services especially as it related to protective order representation. We have a new partnership with North Carolina Coalition Against Domestic Violence to offer free legal services to Orange County residents as it relates to protective order representation when Legal Aid services are full and child custody and divorce assistance. • Continued partnerships with UNC School of Social Work as a field placement site for three MSW students, APPLES undergraduate service learning program, and UNC LGBTQ Center. • Partner with local businesses to provide pro bono services for victims such as free shelter at local hotels, pet boarding and medical supplies. • A staff member participated in the week-long Mental Health First Aid train the trainer event offered by Cardinal Innovations and UNC's Behavioral Healthcare Resource Center in order to be able to expand knowledge in our county about mental health concerns and responding to those with these issues. h) Describe what would happen if requested funding is not awarded at all or if a reduced allocation is recommended. Compass Center continues to experience an increase in demand for services and number of victims served (19% increase since FY 13-14 and 9% increase already this fiscal year). Due to the exponential increase in clients seeking domestic violence services we are trying to expand our capacity to meet these needs and are continually exploring additional funding sources to hire another domestic violence program staff member and provide additional direct assistance funds for transportation, shelter and other client needs. However, if these funds were reduced or cut, we would struggle to meet the needs of clients. Since the vast majority of the expense to run this program is personnel costs to deliver services, funding reduction from Orange County would likely result in a reduction of force. i) Include any other pertinent information. Program/Project Information j) Complete the Target Population and Program Beneficiary Demographics Chart k) Complete the Schedule of Positions Chart for Program Staff I) Disclosure of Potential Conflicts of Interested must be signed m) Complete the Work Statement Chart to describe the work to be performed, and be sure to attach copies of all data collection tools that will be used to verify achievement of program goals and objectives. Describe who will be responsible for monitoring progress. Information to Complete j.) Target Population Main Application 1/24/2016 2:59:42 PM Page 10 of 58 000 SWnsnvolopo|o: e8osB1 1 A - continued Provider's Outside Agency Application MAIN APPLICATION Complete the following tables to the best of your ability. Show numbers of participants and pe[oantageo, as applicable, in each category. Please indicate whether this project/program will serve: El Persons I | Households I | Units Program: Domestic Violence Crisis Services Program Beneficiary Demographics Actual Estimated Projected 2014-15 2015-18 2016-17 Gender Male 72 78 78 Female 1096 1195 1195 Total 1168 1273 1273 Of the females, how many are single- --------- --' ---- female Head of Households (Omit for Human Services) Ethnicity African-American 131 150 153 American Indian or Alaska Native 2 4 4 Asian 14 16 16 -----' Caucasian 241 270 270 Native Hawaiian or other Pacific Islander 0 0 0 Other 132 150 150 ------- ` Unknown 648 683 683 Total 1168 1273 1273 Of the above, how many Hispanic/Latino 121 130 130 Of the above, how many non- Hispanic/Latino 1047 1143 1143 Total 1168 1273 1273 Aoe.`!�.`�`!:�`�`.��������'�;.l�!..��'<����� 0-5 years 10 10 10 6-18 years 18 20 20 19-50 year 211 230 230 __ 51-61 years 28 30 30 62+ years 3 4 4 Unknown 898 979 979 ' Total 1168 1273 1273 Geographic Location (included in (included in (included in Durham City Durham County#) Durham Coun #) Durham County it) Durham County 90 95 95 Carrboro 86 95 95 -- --- Chapel Hill 377 410 410 Chapel Hill Public Housing Residents Unknown Unknown Unknown Main Application 1/24/2016 2:59:42 PM Page 11 Of 5 8 000 SWnsnvolopo|o: e8osB1 1 A - continued Provider's Outside Agency Application MAIN APPLICATION Orange County 157 175 175 (included in (included in (included in Raleigh Wake County if) Wake County#) Wake County if) Wake County 45 50 50 135 , 145 145 Unknown 278 303 303 Total 1168 1273 1273 Income —See following chart (Omit for HS) -- ---' ------ < 3096 Area Median Income 31'5OYf Area Median Income 51-80% Area Median Income >80%Area Median Income Total 0 0 0 Special Needs (Omit for HS) Elderly(Over 62) Disabled (not elderly) Homeless People with HIV/Aids Total 0 0 0 Main Application 1/24/2016 2:59:42 PM Page 12 of 5 8 DocuSign Envelope ID: E9DE81F9-0070-4074-8F70-93DABC24ACE1 A - continued Provider's Outside Agency Application MAIN APPLICATION CDBG & HOME ONLY- Area Benefit Activities (Infrastructure and Public Facilities) Street Census Tract Block Group Total Persons AN! Persons 2015 Area Median Family income Limits U.S. Department of Housing & Urban Development (HUD) 2015 Area Median Family Income Limits Effective March 15, 2015 Income 1 2 3 4 5 6 7 8 Level person people people people people people people people 30% AMI $14,150 $16,200 $20,090 $24,250 $28,410 $32,570 $36,730 $40,890 50% AMI $23,600 $27,000 $30,350 $33,700 $36,400 $39,100 $41,800 $44,500 80°/0 AMI $37,750 $43,150 $48,550 $53,900 $58,250 $62,550 $66,850 $71,150 100% AMI $47,188 $53,938 $60,688 $67,375 $72,813 $78,188 $83,563 $88,937 115% AMI $54,266 $62,028 $69,791 $77,481 $83,734 $89,916 $96,097 $102,278 http://www.huduser.org/portal/datasetstilfill 5/FY201 5 IL nc.pdf Main Application 1/24/2016 2:59:42 PM Page 13 of 58 DocuSign Envelope ID: E9DE81F9-0070-4074-8F70-93DABC24ACE1 A - continued Provider's Outside Agency Application MAIN APPLICATION k.) Schedule of Positions Please include program staff positions followed by volunteer positions; these financial figures should match the personnel figures in your Agency Comparative Budget Excel Form. Similar positions can be combined. (i.e., 8 Occupational Therapists can be inserted as one line item). If provided,- indicate: Position Titles FTE** Program Actual Estimated Projected 17 -Position 2014 16 2015 16 2016 Total Retirement Vacant Staff+ - Budget Plan (H) Health Plan Program 1.0 25%(1) 71,515.90 $57,636.82 $55,482.26 8.7% Dir/Assoc Dir 25%(2) 25%(3) Dir of Domestic 1.0 100%(1) 42,078.73 $40,332.16 $41,124.52 6.5% Violence Services Dir of Court 1.0 100%(1) 38,466.00 $37,740.00 $39,321.00 6,2% Advocacy& Community Response Dir of Education 1.0 100%(3) 37,219.00 $37,700.00 $38,480.52 6.0% Programs Client Services 1.0 50%(1) 19,254.25 $35,432.16 $36,238.72 5.7% H Specialist 50%(3) Dir of Latino 1.0 100%(1) 33,053.88 $34,500.00 $35,190.00 5.5% Services Dir of Teens Climb 1.0 o%(lob% 33,660.00 $34,000.08 $34,680.08 5.5% High Programs but 0%w/ OC Funds) Dir of Self- 1.0 100%(2) 43,699.43 $33,222.98 $34,680.08 5.5% Sufficiency Programs Support Group .67 80%(1) 20,230.10 $21,442.68 $20,837.80 3.3% Coordinator 20%(3) Information & .8 100%(3) N/A N/A $13000.00 2.0% Referral Coord. (Johnson Service Corps. intern) VITA Coordinator .4 100%(2) $5,684.77 $7,376.00 $7,673.99 1.2% Executive Director 1.0 15%(1) $17,129.22 $63,254.00 $66,300.00 10.4% 15%(2) 15%(3) - Development Dir 1,0 0% 0 $33,500.00 $51,000.00 8.0% Finance & HR Dir 1.0 15%(1) $48,253.80 $44,000.00 $44,880.00 7.1% 15%(2) 15%(3) Admin Manager .67 15%(1) $26,962.65 $22,685.52 $25,010.67 3.9% 15%(2) 15%(3) Communications .67 40%(3) $46,010.58 $35,979.58 $24,000.00 3.8% & Development Coord Fringe Benefits $65,392.49 $62,471.35 $68,399,35 10.7% (FICA, Insurance, Taxes, etcj Main Application 1/24/2016 2:59:42 PM Page 14 0 f 5 8 DocuSign Envelope ID: E9DE81F9-0070-4074-8F70-93DABC24ACE1 i /\ - continued Provider's Outside Agency Application MAIN APPLICATION TOTAL 15.21 548,610.80 $601,273.33 $636,299.00 10096 FTE Volunteer Hours: Volunteer B%(--� 8|FTE 8 FTE 8 FTE ---- --- MSW |nterns. FTE 33%(Z) APPLES Interns, 33%(3) Legal Intern, Board of Dipeotora, Hotline Advocates, First Response, Interpreters, Group FauiUtaborv, Community Educators, TCH Interns, Event Volunteers, etc. Project/Program Name: 1) Domestic Violence Crisis Services 2) Self Sufficiency Programs: Legal Information, Financial Education & Career Preparedness 3) Community Education & Civic Enqaqement Notes: ° Similar positions can be combined: i.e. 8 Occupational Therapists can be inserted as one line item. • °° Full Time Equivalent staff will be noted as 1.00; half time as .50; quarter time as .25, etc. • + Denotes the percentage of staff time involved with this program. • Calculate a Full Time Equivalent for all recorded volunteer hours using the following: Total Volunteer Hours = Volunteer FTE 1,960 Main Application 1/24/2016 2:59:42 PM Page 15 of 58 DocuSign Envelope ID: E9DE81F9-0070-4074-8F70-93DABC24ACE1 L A - continued Provider's Outside Agency Application MAIN APPLICATION I.) DISCLOSURE OF POTENTIAL CONFLICTS OF INTEREST Are any of the Board Members or employees of the agency which will be carrying out this project, or members of their immediate families, or their business associates: YES NO — a) Employees of or closely related to employees of the Town of Chapel Hill, Orange County, Carrboro, or Hillsborough? b) Members of or closely related to members of the governing bodies of Chapel Hill, Carrboro, Hillsborough, or Orange County? c) Current beneficiaries of the project/program for which funds are requested? Z d) Paid providers of goods or services to the program or having other financial interest in the program? If you have answered YES to any question, please provide a full explanation below. Board member Elisabeth Johnson's partner Kennard Winchester is a school bus driver for the Chapel Hill Carrboro City Schools and works as a basketball coach for the Phillips Middle School boys team. To the best of my knowledge and belief all of the above information is true and current. I acknowledge and understand that the existence of a potential conflict of interest does not necessarily make the project ineligible for funding, but the existence of an undisclosed conflict may result in the termination of any grant awarded. Signature: //2„cti/C2 Executive Director Date Signature( - t_LA (A,2 1 V ([5,1A/LA---,.., J7. L_ I Lr, oard Chairperson Date Main Application 1/24/2016 2:59:42 PM Page 1 6 of 58 DocuSign Envelope ID: E9DE81F9-0070-4074-8F70-93DABC24ACE1 A - continued Provider's Outside Agency Application MAIN APPLICATION m.) Work Statement This form is used to document program activities, program goals, performance measures, and actual results. (Add more rows as needed) If this is a new program, you will only document the projected information. • Program Activities should outline major activities the agency implements to accomplish its program goals. • Program Goal should explain what the program is trying to achieve/accomplish. Goals are statements about what the program should accomplish. SMART Goals • Performance Measures describe how you will evaluate the degree in which you achieved the stated goals. • Actual Program Results use program results to indicate the actual measureable achievement of goals. If goals were not met, please explain. Actual Estimated Projected 2014-15 2015-16 2016-17 Crisis Intervention: Crisis Intervention: Provide Crisis Intervention: Provide direct services direct services to victims of Provide direct services to to victims of domestic domestic violence victims of domestic violence including crisis including crisis violence including crisis Program Activity 1 intervention, support intervention, support intervention, support groups and advocacy in groups and advocacy in groups and advocacy in order to reduce trauma order to reduce trauma order to reduce trauma and increase clients' and increase clients' ability and increase clients' ability ability to make choices to make choices to make choices increasing their safety increasing their safety and increasing their safety and and that of their children that of their children that of their children 85% of clients who 85% of clients who meet 85% of clients who meet meet with crisis with crisis response staff with crisis response staff response staff will will develop a safety plan will develop a safety plan develop a safety plan that meets their needs and that meets their needs and Program Goal at hnadt helps st s t ht heemi r fneeeel needs a t helps them feel that they helps them feel that they they have options to have options to improve have options to improve improve their safety. At their safety. At least 800 their safety. At least 1,000 least 650 clients will be clients will be served in FY clients will be served in FY served in FY 14-15. 15-16. 16-17. All clients who meet in person with crisis All clients who meet in person All clients who meet in Performance Measures response staff or attend with crisis response staff or person with crisis response support group are asked to attend support group are staff or attend support group fill out a survey and asked to fill out a survey and are asked to fill out a survey responses are tracked. responses are tracked. and responses are tracked. Program Results 94%safety planned;88% better understood options 94% at Q2 85% Main Application 1/24/2016 2:59:42 PM Page 17 of 58 DocuSign Envelope ID: E9DE81F9-0070-4074-8F70-93DABC24ACE1 t A - continued Provider's Outside Agency Application MAIN APPLICATION Court Advocacy: Provide court services to victims of Court Advocacy: Provide Court Advocacy: Provide domestic violence to court services to victims of court services to victims of Program Activity 2 domestic violence to domestic violence to reduce the trauma and reduce the trauma and reduce the trauma and confusion that clients confusion that clients confusion that clients experience in the court experience in the court experience in the court _process. process. process. 85% of clients will report 85%of clients will report 85%of clients will report feeling supported by court feeling supported by court feeling supported by court Program Goal advocates in FY 14-15.At advocates in FY 15-16.At advocates in FY 16-17. At least 125 clients will be least 125 clients will be least 125 clients will be served. served. served. All clients receiving court All clients receiving court All clients receiving court advocacy will be asked to advocacy will be asked to fill advocacy will be asked to fill Performance Measures fill out a survey and out a survey and responses out a survey and responses responses are tracked. are tracked. are tracked. Program Results 99% 100% at Q2�_... 85% Support Group: Provide Support Group: Provide Support Group: Provide support group services to support group services to support group services to adults who have adults who have experienced adults who have experienced Program Activity 3 experienced domestic domestic violence to domestic violence to violence to decrease their decrease their trauma and decrease their trauma and trauma and increase their increase their feelings of increase their feelings of feelings of support. support. support. 85%of clients will report they feel less alone in their 85%of clients will report they 85%of clients will report experience of abuse feel less alone in their they feel less alone in their Program Goal following group experience of abuse following experience of abuse following participation in FY 14-15. group participation in FY 15- group participation in FY 16- At least 45 clients will be 16.At least 45 clients will be 17.At least 45 clients will be served. served. served. All support group All support group participants All support group participants participants will be asked will be asked to complete an will be asked to complete an Performance Measures to complete an evaluation evaluation survey at the end evaluation survey at the end survey at the end of group of group and results are of group and results are and results are tracked. tracked. tracked. Program Results 98% 97% at Q2 85% Spanish-Speaking Victim Spanish-Speaking Victim Spanish-Speaking Victim Services: Provide direct Services: Provide direct Services: Provide direct services to Spanish- services to Spanish-speaking services to Spanish-speaking speaking victims of victims of domestic violence victims of domestic violence Program Activity 4 domestic violence including crisis intervention including crisis intervention including crisis intervention and advocacy to reduce and advocacy to reduce and advocacy to reduce trauma and meet their needs trauma and meet their needs trauma and meet their as victims. as victims. needs as victims. Main Application 1/24/2016 2:59:42 PM Page 18 of 58 DocuSign Envelope ID: E9DE81F9-0070-4074-8F70-93DABC24ACE1 i /\ - continued Provider's Outside Agency Application MAIN APPLICATION 85%of clients wiU report that their needs were met 85% of clients will report that 85% of clients will report that Program Goal and they better understood their needs were met arid their needs were met and their options in FY 14-15. they better understood their they better understood their At least 50 clients will be options in FY 15-16.At least options in FY 16-17. At least served. 50 clients will be s rvod. 80 clients will be served. All Spanish-speaking All Spanish-speaking clients All Spanish-speaking clients clients who meet in-person who meet in-person with who meet in-person with with crisis response staff crisis response staff are crisis response staff are Performance Measures are asked to fill out a asked to fill out a survey and asked to fill out a survey and survey and responses are responses are tracked. responses are tracked. tracked_ Program Results 9496 96% at Q2 85q6 . Main Application 1/24/2016 2:59:42 PM Page 1 9 of 58 DocuSign Envelope ID: E9DE81F9-0070-4074-8F70-93DABC24ACE1 A - continued Provider's Outside Agency Application MAIN APPLICATION 3. PROJECT/PROGRAM INFORMATION Agency& Program Name: Compass Center for Women and Families, Self-Sufficiency Programs: Legal Information, Financial Education & Career Preparedness As you complete your application, complete only those sections that pertain to the type of application you are submitting. The application is divided into several sections and not all sections apply to every project. Every applicant MUST complete the main application. a) Check the type of funding request for this application package submittal and complete the application and supplemental application sections as specified below: • Human Services (Main Application Only) AH Non-Construction (Main Application Only) I I AH Construction — (Main Application AND Part B) E AHDR Non-Construction (Main Application Only) AHDR Construction — (Main Application AND Part B) I CDBG Non-Construction — (Main Application AND Part A) E CDBG Construction — (Main Application AND Part A AND Part B) ri HOME CHDO Set-aside —(Main Application AND Part A) fl HOME Other —(Main Application AND Parts A AND Part B) Indicate the type of program for which you are requesting funding: Disabled Public Housing Program Category Youth Adult Elderly (not elderly) Neighborhoods/Residents Education – X X X X Health and Nutrition Job Training X X X X Sports and Arts Activities Pre-School Activities After-School Activities Mentoring Transportation Housing Other: Safety net for the vulnerable X X X X Program/Project Description,(Label your responses as outlined below; not to exceed 3 pages.) Please provide the following information about the proposed program/project: b) Summarize the program services proposed and how the program will address the chosen Town/County priority? Compass Center's Self-Sufficiency programs provide access to individual support and resources that can have a direct positive impact on clients' ability to support themselves and their families financially. These programs can help them find a job or attain a better job, provide free legal advice for clients dealing with legal issues that can be financially crippling, and help clients deal with financial concerns like paying down debt or budgeting. Compass Center's Self-Sufficiency programs provide our community with easy access to important information that educates clients about their career, financial and legal options, and represent valuable safety net services. Main Application 1/24/2016 2:59:42 PM Page 2 0 o f 5 8 DocuSign Envelope ID: E9DE81F9-0070-4074-8F70-93DABC24ACE1 A - continued Provider's Outside Agency Application MAIN APPLICATION Legal Information: • Legal Information Services: 15-minute telephone consultation with a volunteer attorney to discuss issues such as divorce, child custody, consumer law, and tenants' rights. Clients are informed about what they are able to do legally on their own vs. what must be done with attorney representation in order to achieve cost savings. • Community Legal Project: University of North Carolina law students provide 30-minute in-person appointments to discuss clients' legal questions. After the initial appointment, the law student then researches the issue, composes a memo with relevant information, consults with an attorney on their information to ensure accuracy, and meets with the client for a follow-up consultation. • Our publication Family Law in North Carolina is a guide with up-to-date information on legal issues like separation, divorce, child custody, child support, and property settlement written by local attorneys in an easy to use question and answer format using lay language. • Attorney Referral Notebook: local attorney listing with information on areas of specialty and fees. Financial Literacy Education: individual financial counseling (90 min. sessions, client determines number of sessions desired), financial education workshops and free tax preparation through the Volunteer Income Tax Assistance (VITA) Program. Career Exploration and Preparedness: individual career advising (60 min. sessions, client determines number of sessions desired), career development workshops, and information about job openings. c) Describe the local need or problem to be addressed in relation to the Consolidated Plan or other community priorities (i.e. Council/Board Goals). Cite local data to support the need for this program and the population being served. Legal Information: There is significant unmet legal need in our community primarily because of the cost of representation. In North Carolina, there is only one Legal Aid attorney for every 13,170 low- income people while there is one private attorney for every 562 people in North Carolina; an estimated 80% of the civil legal needs of low-income families go unmet every year (NC Equal Access to Justice Commission). These legal needs may be related to "domestic violence, divorce, child custody, housing, consumer protection, employment, (and) health", which are all areas that have a major impact on peoples' lives and in which legal expertise is crucial (NC Equal Access to Justice Commission). Financial Literacy Education: In Orange County between 2009 and 2013, 17.8% of the population was living below the poverty line. Female-headed households with children under 18 had the highest poverty rate in Orange County at 35.6%, compared with 7.9% for married-couple households with children under 18 (US. Census Bureau Quick Facts American Community Survey). Also contributing to poverty among women is the reality of gender pay disparities that continues to be a problem in the United States. In 2010 North Carolina women earned just 82.5% of their male counterparts, and the wage gap is significantly larger for women of color. ("The Status of Women in North Carolina," Institute for Women's Policy Research). Nationally, women are also less likely to have health insurance and retirement plans (2015 White House Council of Economic Advisers Report). Because of these factors, women need to save more than their male counterparts throughout their lives. However, the federal government's Women in America report found that two out of three women say that they have little or no knowledge of financial products and services. Career Exploration and Preparedness: Women are more likely to work in industries and positions that are lower-paying than men (2015 White House Council of Economic Advisers report). In addition, women tend to hold a disproportionately high percentage of minimum-wage jobs, and North Carolina has a higher than average percentage of its workforce that are minimum-wage workers. According to the U.S. Department of Labor, North Carolina had 2.3 million workers who Main Application 1/24/2016 2:59:42 PM Page 2 1 of 58 DocuSign Envelope ID: E9DE81F9-0070-4074-8F70-93DABC24ACE1 L A - continued Provider's Outside Agency Application MAIN APPLICATION were paid by the hour in 2013. Of those, 73,000 earned the federal minimum wage of $7.25 per hour, while 57,000 earned less. Collectively, these workers made up 5.8% of all hourly-paid workers in the state (Bureau of Labor Statistics, U.S. Department of Labor, "Minimum Wage Workers in North Carolina — 2013'). As of 2012, women made up nearly two-thirds of the hourly paid workforce earning the federal minimum or less in North Carolina. They are 73% of tipped workers and 77% of restaurant servers, who earn just $2.13 per hour. (National Women's Law Center 2014). Compass Center's Career Exploration and Preparedness Programs give clients an opportunity to learn about resume and interview skills, about high-demand jobs where they have the potential for greater earnings, and about training resources they can access to strengthen their skills. Many of the individuals that our agency serves are women or men who have been absent from the workforce while they worked in their home to raise children or care for other family members. After separation from a spouse or other loss of the financial support, these individuals face a unique set of challenges as they work to achieve financial independence. Other women and men may also need assistance due to the anticipated loss of public assistance as the parent of a minor child. Cash assistance to families through the Work First Family Assistance (WFFA) program is limited to 24 months. The NC Division of Social Services estimates 230 families receiving WFFA in Orange County as of January, 2012. Our program can assist those on public benefits to become self-supporting when their benefits end by providing career and financial counseling, and referrals to other community resources. Victims of domestic violence are particularly vulnerable to economic challenges. Financial abuse is one of the most powerful and common tools abusers use to force victims to stay: research shows that it occurs in 98% of abusive relationships. This type of abuse can include control of finances, not allowing the victim to work or causing the victim to lose her job through stalking and harassment at work, forcing the victim to write bad checks or fraudulent tax returns, and charging significant debt to credit cards (National Network to End Domestic Violence, 2015). The link between financial abuse and domestic violence is of particular concern in North Carolina, which ranked 19th in 2012 for its high number of women murdered by men, an FBI figure typically used to count domestic violence-related homicides (Violence Policy Center 2014). Any services that can help domestic violence victims leave potentially lethal relationships are important. Because Compass Center also offers Domestic Violence Crisis Services, supporting financial, career and legal resources has the potential to save lives. d) Describe the population to be served or the area to benefit and indicate how you will identify beneficiaries. Compass Center's Self-Sufficiency programs are available to anyone in the Triangle region. Clients come to our services through self-referral, referrals from other organizations, and word of mouth. Additionally, Compass Center is part of two new collaborative initiatives in Orange County, the Family Success Alliance and the Comprehensive Early Childhood Initiative, to provide services to the most vulnerable families with a focus on reducing intergenerational poverty. As part of these two projects, Compass Center is providing financial education and job counseling to low-income families. By providing client-centered individual counseling and workshop services in these areas, our goal is to improve the household economic security of these families. e) Who specifically will carry out the activities and in what location will they be carried out? Compass Center's Self-Sufficiency Programs Director and Associate Director work with professional volunteers to provide high-quality workshops, individual counseling sessions, and referrals. Client sessions and workshops are primarily offered at our office at 210 Henderson St. in Chapel Hill. We also offer workshops at other community locations. As part of our new collaborative efforts we will also be offering services in community locations close to participating families such as at schools, community centers and libraries. The following volunteers work with these programs: career and financial counselors and workshop facilitators, attorneys, law students and interpreters. Main Application 1/24/2016 2:59:42 PM Page 2 2 o f 58 DocuSign Envelope ID: E9DE81F9-0070-4074-8F70-93DABC24ACE1 A - continued Provider's Outside Agency Application MAIN APPLICATION f) Describe specifically the period over which the activities will be carried out, the frequency with which the activities will be carried out, and the frequency with which services will be delivered. Include an implementation timeline. All services will be offered for the full July 2016 to June 2017 grant period. Legal workshops are offered 8-10 times a year. Legal information service attorneys hold appointments 4-8 times a month. Community Legal Project services are offered September through mid-November and February through April two Thursdays a month. June through August, weekly appointments are provided. Financial and career one-on-one counseling sessions are available during business hours; multiple appointments offered weekly. At least ten financial and career workshops will be offered this year. g) Provide a bulleted list of other agencies, if any, with which your agency coordinates/collaborates to accomplish or enhance the Projected Results in the Program(s) to be funded. For each, give specific examples of the coordinated/collaborative efforts. We collaborate with area organizations to ensure that our agency reaches a diverse client base. Current partnerships include: • UNC School of Law: Provides students seeking pro bono opportunities for our Community Legal Project and a summer extern who helps to manage the legal program. • Financial staff from Consumer Education Services, Inc. (CESI) lead financial education workshops for our clients. • Chapel Hill Carrboro Chamber of Commerce and small business owners: Assists us in promoting our services and recruiting professional volunteers for programs and board service. • Dress for Success: Accepts our referrals for clients who need to access clothing for employment purposes and we accept their referrals for Orange County community members who need self-sufficiency services. • Durham Technical Community College: provides educational opportunities for our career counseling program participants. • Orange County Job Link: have collaborated on workshops such as using social networking for job search. • Family Success Alliance: Variety of community partners delivering comprehensive services in their expertise areas in two high poverty zones in Orange County. • Orange County Comprehensive Early Childhood Initiative: Several community partners delivering services in their expertise areas with Head Start families with low-income (Partnership for Young Children, Child Care Services Assn., CH-TOP, Literacy Council, OCRCC, Freedom House, etc.). h) Describe what would happen if requested funding is not awarded at all or if a reduced allocation is recommended. We have a very long history of providing these services to the community. They were partially funded for many years by the NC Council for Women through Displaced Homemaker funds (at one point over $60,000 annually), but as of July 1, 2014 Displaced Homemaker funds no longer exist. Because these programs are so well run, using professional volunteers and achieving good outcomes, Compass Center continues to seek alternative funding and expanded collaborations in order to have them continue. We were forced to reduce our Self-Sufficiency staff last year from two to one, and a loss of funding from Orange County governments would make it difficult for us to sustain funding the staff member for these programs, even though they are an essential component to the continuum of services that we provide to our clients. I) Include any other pertinent information. Main Application 1/24/2016 2:59:42 PM Page 2 3 0 f 5 8 DocuSign Envelope ID: E9DE81F9-0070-4074-8F70-93DABC24ACE1 A - continued Provider's Outside Agency Application MAIN APPLICATION Program/Project Information j) Complete the Target Population and Program Beneficiary Demographics Chart k) Complete the Schedule of Positions Chart for Program Staff I) Disclosure of Potential Conflicts of Interested must be signed m) Complete the Work Statement Chart to describe the work to be performed, and be sure to attach copies of all data collection tools that will be used to verify achievement of program goals and objectives. Describe who will be responsible for monitoring progress. Information to Complete j.) Target Population Complete the following tables to the best of your ability. Show numbers of participants and percentages, as applicable, in each category. Please indicate whether this project/program will serve: EZ Persons Households F I Units Program: Self-Sufficiency Programs Program Beneficiary Demographics Actual Estimated Projected 2014-15 2015-16 2016-17 Gender Male 176 175 175 Female 603 645 645 Unknown 32 30 30 Total 811 850 850 Of the females, how many are single- female Head of Households (Omit for Human Services) Ethnicity • African-American 100 140 140 American Indian or Alaska Native 2 2 2 Asian 21 25 25 Caucasian 313 315 315 Native Hawaiian or other Pacific Islander 0 0 0 Other 23 25 25 Unknown 352 343 343 Total 811 850 850 Of the above, how many Hispanic/Latino 5 30 30 Of the above, how many non- Hispanic/Latino 806 820 820 Total 811 850 850 Age Main Application 1/24/2016 2:59:42 PM Page 2 4 of 58 000 SWnsnvolopo|o: e8osB1 1 A - continued Provider's Outside Agency Application MAIN APPLICATION 0-5 years 0 0 0 6-18 years 0 0 0 19-50 years 266 270 270 . 51-61 years 193 195 195 62+ years 29 30 30 Unknown 323 355 355 Total 811 850 850 Geographic Location ' ' (included in (included in (included in Durham City Durham County it) Durham County it) Durham County it) Durham County 29 _ 30 30 Carrboro 63 70 70 Chapel Hill _315 930 330 Chapel Hill Public Housing Residents Unknown Unknown Unknown Orange County 132 165 165 __ (inclja-ed (included in Wake (included in Wake Raleigh County it) County«} _- Wake County __40 _ ______50 50 , _____ Other 159 160 180 _ _ _ ___ Unknown 64 45 45 Total 811 850 850' - Income Level—See following chart (Omit for HS) < 30%Area Median Income 31-50% Area Median Income 51-8O% Area Median Income IIIIIIIIIIIIII >80%Area Median Income Total 0 0 0 Special Needs (Onn|t for HS) � ``'\�, ''`�`''`.� Elderly(Over 62) MIMIMMIII Disabled(not elderly) IIIIIIIIIIIIIIIIIIIIIIIIIII . Homeless People with HIV/Aids IIIIIIIIIIIIIIIIIIIIII Total 0 0 0 Main Application 1/24/2016 2:59:42 PM Page 25 of 58 ' DocuSign Envelope ID: E9DE81F9-0070-4074-8F70-93DABC24ACE1 A - continued Provider's Outside Agency Application MAIN APPLICATION CDBG & HOME ONLY- Area Benefit Activitielnfrastructure and Public Facilities) Street Census Tract Block Group Total Persons #LMI Persons 2015 Area Median Family income Limits U.S. Department of Housing & Urban Development (HUD) 2015 Area Median Family Income Limits Effective March 15, 2015 Income 1 2 3 4 5 6 7 8 Level person people people people people people people people 30% AM! $14,150 $16,200 $20,090 $24,250 $28,410 $32,570 $36,730 $40,890 50% AMI $23,600 $27,000 $30,350 $33,700 $36,400 $39,100 $41,800 $44,500 80% AMI $37,750 $43,150 $48,550 $53,900 $58,250 $62,550 $66,850 $71,150 100% AMI $47,188 $53,938 $60,688 $67,375 $72,813 $78,188 $83,563 $88,937 115% AM! $54,266 $62,028 $69,791 $77,481 $83,734 $89,916 $96,097 $102,278 http://www.huduser.orq/portal/datasets/i1/1115/FY2015 IL ne.pdf Main Application 1/24/2016 2:59:42 PM Page 26 of 5 8 DocuSign Envelope ID: E9DE81F9-0070-4074-8F70-93DABC24ACE1 A - continued Provider's Outside Agency Application MAIN APPLICATION k) Schedule of Positions Please include program staff positions followed by volunteer positions; these financial figures should match the personnel figures in your Agency Comparative Budget Excel Form, Similar positions can be combined. (i.e., 8 Occupational Therapists can be inserted as one line item). If provided, indicate: Position Titles Actual Estimated Projected . *= Position FTE** Program Total Retirement 2014-15 2015-16 2016-17 Vacant Staff+ Budget Plan (H) Health Plan Program 1.0 25%(1) 71,515.90 $57,636.82 $55,482.26 8.7% Dir/Assoc Dir 25%(2) 25%(3) Dir of Domestic 1.0 100%(1) 42,078.73 $40,332.16 $41,124.52 6.5% Violence Services Dir of Court 1.0 100%(1) 38,466.00 $37,740.00 $39,321.00 6.2% Advocacy& Community Response Dir of Education 1.0 100%(3) 37,219.00 $37,700.00 $38,480.52 6.0% H Programs Client Services 1.0 50%(1) 19,254.25 $35,432.16 $36,238.72 5.7% Specialist 50%(3) Dir of Latino 1.0 100%(1) 33,053.88 $34,500.00 $35,190.00 5.5% Services Dir of Teens Climb 1.0 0%(100% 33,660.00 $34,000.08 $34,680.08 5.5% High Programs but 0%w/ DC Funds) Dir of Self- 1.0 100%(2) 43,699.43 $33,222.98 $34,680.08 5.5% Sufficiency Programs Support Group .67 80%(1) 20,230.10 $21,442.68 $20,837.80 3.3% Coordinator 20%(3) -Information & .8 100%(3) N/A N/A $13000.00 2.0% Referral Coord. (Johnson Service Corps. intern) VITA Coordinator .4 100%(2) $5,684.77 $7,376.00 $7,673.99 1.2% Executive Director 1.0 15%(1) $17,129.22 $63,254.00 $66,300.00 10.4% 15%(2) 15%(3) Development Dir 1.0 0% 0 $33,500.00 $51,000.00 8.0% Finance & HR Dir 1.0 15%(1) $48,253.80 $44,000.00 $44,880.00 7.1% 15%(2) 15%(3) Admin Manager .67 15%(1) $26,962.65 $22,685.52 $25,010.67 3.9% 15%(2) 15%(3) Communications .67 40%(3) $46,010.58 $35,979.58 $24,000.00 3.8% & Development Coord Fringe Benefits $65,392.49 $62,471.35 $68,399.35 10.7% (FICA, Insurance, Taxes, etc.) Main Application 1/24/2016 2:59:42 PM Page 2 7 of 5 8 DocuSign Envelope ID: E9DE81F9-0070-4074-8F70-93DABC24ACE1 i /\ - continued Provider's Outside Agency Application MAIN APPLICATION TOTAL - ' 15.21 ---48,610'80 $602,273.33 $636,299.00 100Y6 FTE Volunteer Hours: Volunteer 33%(1) 8 FTE 8 FTE 8 FTE — MSW |nterns. FTE 33%(Z) APPLES Interns, 3]%(3) Legal Intern, Board of Oinyobzns, Hotline Advocates, First Response, Interpreters, Group Faoi|itah>ce, Community Educators, TCH Interns, Event Volunteers, etc. . Project/Program Name: 1) Domestic Violence Crisis Services 2) Self Sufficiency Programs: Legal Information, Financial Education &Career Preparedness 3) Community Education & Civic Engagement Notes: • Similar positions can be combined: i.e. 8 Occupational Therapists can be inserted as one line item. • °^ Full Time Equivalent staff will be noted as 1.00; half time as .50; quarter time as .25' etc. • + Denotes the percentage of staff time involved with this program. • Calculate a Full Time Equivalent for all recorded volunteer hours using the following: Total Volunteer Hours =Volunteer FTE 1,000 Main Application 1/24/2016 2:59:42 PM Page 2 8 of 5 8 DocuSign Envelope ID: E9DE81F9-0070-4074-8F70-93DABC24ACE1 L A - continued Provider's Outside Agency Application MAIN APPLICATION I.) DISCLOSURE OF POTENTIAL CONFLICTS OF INTEREST Are any of the Board Members or employees of the agency which will be carrying out this project, or members of their immediate families, or their business associates: YES NO ■ Lii a) Employees of or closely related to employees of the Town of Chapel Hill, Orange County, Carrboro, or Hillsborough? b) Members of or closely related to members of the governing bodies of Chapel Hill, Carrboro, Hillsborough, or Orange County? Lii c) Current beneficiaries of the project/program for which funds are requested? LI NI d) Paid providers of goods or services to the program or having other financial interest in the program? If you have answered YES to any question, please provide a full explanation below, Board member Elisabeth Johnson's partner Kennard Winchester is a school bus driver for the Chapel Hill Carrboro City Schools and works as a basketball coach for the Phillips Middle School boys team. To the best of my knowledge and belief all of the above information is true and current. I acknowledge and understand that the existence of a potential conflict of interest does not necessarily make the project ineligible for funding, but the existence of an undisclosed conflict may result in the termination of any grant awarded. Signature: - / (///4.1 Executive Director Date Signature(' -11-tj A I/714 I 1 , oard Chairperson Date Main Application 1/24/2016 2:59:42 PM Page 29 of 58 000 SWnsnvolopo|o: e8osB1 1 A - continued Provider's Outside Agency Application MAIN APPLICATION Ml.) Work Statement This form is used to document program activities, program goals, performance measures, and actual results. (Add more rows as needed) If this is a new program, you will only document the projected information. • Program Activities should outline major activities the agency implements to accomplish its program goals. • Program Goal should explain what the program is trying to achieve/accomplish. Goals are statements about what the program should accomplish. SMART Goals • Performance Measures describe how you will evaluate the degree in which you achieved the stated goals. • Actual Program Results use program results to indicate the actual measureable achievement of goals. If goals were not Ooet, please explain. Actual Estimated Projected 2014~15 2015-16 2016-17 Legal Information: Provide Legal Information: Provide Legal Information: Provide acceaaib|e, accessible, understandable, accessible, underst ndab|e, undomtamdob|o, and and respectful free legal and respectful free legal respectful free legal information to clients who information to clients who information to clients who cannot afford legal cannot afford legal Program Activity 1 cannot afford legal representation. Services representation. Services representation. Services include telephone include telephone include telephone appointments with attorneys appointments with attorneys appointments with and legal workshops. and legal workshops. attorneys and legal workshops. 85%of clients will report the information presented 85%of clients will report the 85% of clients will report the Program Goal was helpful to their information presented was information presented was situation in FY 14-15.At helpful to their situation in FY helpful to their situation in FY least 30 clients will be 15-16.At least 30 clients will 16-17.At least 30 clients will served. be served. be served. — Participants attending legal Participants attending legal Participants attending legal workshops are asked to workshops are asked to workshops are asked to Performance Measures complete an evaluation complete an evaluation and complete an evaluation and and results are tracked, results are tracked. results are tracked. Program Results 94% 95% at Q2 85% Legal Information: Provide Legal Information: Provide Legal Information: Provide aoceay|blo, accessible, understandable, accessible, understandable, understandable,and and respectful free legal and respectful free legal respectful free legal information to clients who information to clients who information to clients who cannot afford legal cannot afford legal Program Activity 2 cannot afford legal representation. Services representation.Services representation. Services include in-person include in-person include in-person appointments with UNC Law appointments with UNC Law appointments with UNC students(supervised by students(supervised by Law students(supervised attorneys). attorneys). by attorneys). Main Application 1/24/2016 2:59:42 PM Page 3 0 Of 58 000 SWnsnvolopo|o: e8osB1 1 A - continued Provider's Outside Agency Application MAIN APPLICATION 85%of clients will report that they are more 85%of clients will report that 85%of clients will report that � »���nmrm ����� knowledgeable about their they are more knowledgeable they are momknowledgeable situation in FY 14-15.At about their situation in FY15- about their situation inFY16' least 50 clients will be 18.At least 40 clients will be 17.At least 40 clients will be served. served. served. Individuals who meet with Individuals who meet with law Individuals who meet with law law students are asked to students are asked to students are asked to Performance Measures complete an evaluation complete an evaluation and complete an evaluation and and results are tnnrkod� results are tracked. results are tracked. Program Results 100% 10096 at Q2 85% ' -- --- - - — ------- -- Financial Education: Financial Education:Assists Financial Education: Assists Assists individuals and individuals and families to individuals and families to families to successfully successfully manage their successfully manage their manage their finances, finances, reduce debts,build finances, reduce debts, build Program Activity 3 reduce debts, build assets assets and meet other short- assets and meet other short- and meet other short-and- and-long-term goals in and-long-term goals in long-term goals in individual sessions and individual sessions and individual sessions and workshops. workshops. workshops. 85%of clients will report that they are leaving with 85%of clients will report that 85%of clients will report that one goal W improve their they are leaving with one goal they are leaving with one Program Goal financial situation after at to improve their financial goal to improve their financial least 200 total sessions in situation after at least 150 situation after at least 150 FY 14-15. total sessions inFY154G. total sessions in FY 16-17. — Participants are asked to Participants are asked to Participants are asked to complete an evaluation complete an evaluation after complete an evaluation after Performance Measures after each session or each session or workshop each session or workshop workshop and results are and results are tracked. and results are tracked. tracked. Program Results 98% 92% at Q2 85% Free Income Tax Free Income Tax Free Income Tax Preparation: Provide free Preparation: Provide free tax Preparation: Provide free tax tax preparation services to preparation services to low preparation services to low low and moderate income and moderate income and moderate income individuals, helping them |nd|vidum|s, helping them indiv|dua|e, helping them preserve as much income preserve as much income as preserve as much income as Program Activity 4 as possible through free possible through free possible through free preparation and full use of preparation and full use of tax preparation and full use of tax tax credits.Work with credits.Work with Dept.on credits.Work with Dept.on Dept. on Aging through our Aging through our VITA Aging through our VITA VITA program program collaborative. program collaborative. collaborative. 250 people will be served 225 people will be served in ' 225 people will be served in in the Volunteer Income the Volunteer Income Tax the Volunteer Income Tax Program Goa[ Tax Assistance(VITA) Assistance(VITA)Program in Assistance(VITA) Program in Program in FY 14-15. FY 15-16. FY 16-17. Main Application 1/24/2016 2:59:42 PM Page 3 1 of 5 8 DocuSign Envelope ID: E9DE81F9-0070-4074-8F70-93DABC24ACE1 I A - continued Provider's Outside Agency Application MAIN APPLICATION VITA staff will maintain VITA staff will maintain VITA staff will maintain appointment data in an appointment data in an appointment data in an appointment scheduler appointment scheduler and appointment scheduler and Performance Measures and track completed track completed appointments track completed appointments and taxes and taxes filed. appointments and taxes filed. filed. Program Results 170 (* see below) Tax season has not begun 225 goal Career Preparedness: Career Preparedness: Career Preparedness: Provide career counseling Provide career counseling Provide career counseling and support in individual and support in individual and support in individual advising and workshops. advising and workshops. advising and workshops. Services include help with Services include help with Services include help with Activity 5 resume writing and resume writing and resume writing and interviewing skills,job interviewing skills,job search interviewing skills,job search search skills, assessment skills, assessment of career skills, assessment of career of career and educational and educational opportunities, and educational opportunities, development development of job search opportunities, development of of job search process and process and a variety of job search process and a a variety of workshops. workshops. variety of workshops, 85%of clients will report that they are leaving with 85% of clients will report that 85% of clients will report that Program Goal at least one item to do in they are leaving with at least they are leaving with at least their career search after at one item to do in their career one item to do in their career least 125 total sessions in search after at least 100 total search after at least 125 total FY 14-15. sessions in FY 15-16. sessions in FY 16-17. Participants are asked to Participants are asked to Participants are asked to complete an evaluation complete an evaluation after complete an evaluation after Performance Measures after each session and each session and results are each session and results are results are tracked. tracked. tracked. Program Results 97% 98% at Q2 85% *Tax: Goal was not reached this fiscal year because we were not able to offer as many appointment slots due to lack of volunteer capacity. Several long-term volunteer tax preparers who serve as mandatory experienced quality reviewers were not available due to medical or family issues in FY 14-15. They are available for FY15-16 and we have increased our volunteer recruitment efforts to bring more volunteers into the system to gain experience. Main Application 1/24/2016 2:59:42 PM Page 3 2 o f 5 8 DocuSign Envelope ID: E9DE81F9-0070-4074-8F70-93DABC24ACE1 A - continued Provider's Outside Agency Application MAIN APPLICATION 3. PROJECT/PROGRAM INFORMATION Agency & Program Name: Compass Center for Women and Families, Community Education & Civic Engagement As you complete your application, complete only those sections that pertain to the type of application you are submitting. The application is divided into several sections and not all sections apply to every project. Every applicant MUST complete the main application. a) Check the type of funding request for this application package submittal and complete the application and supplemental application sections as specified below: [ZI Human Services (Main Application Only) fl AH Non-Construction (Main Application Only) AH Construction — (Main Application AND Part B) AHDR Non-Construction (Main Application Only) I AHDR Construction — (Main Application AND Part B) CDBG Non-Construction — (Main Application AND Part A) CDBG Construction — (Main Application AND Part A AND Part B) Ei HOME CHDO Set-aside — (Main Application AND Part A) fl HOME Other —(Main Application AND Parts A AND Part B) Indicate the type of program for which you are requesting funding: Disabled Public Housing Program Category Youth Adult Elderly . (not elderly) Neighborhoods/Residents Education X X X X X Health and Nutrition Job Training Sports and Arts Activities Pre-School Activities After-School Activities Mentoring Transportation Housing Other: Civic Engagement X X X X Other: Volunteerism X X X X Other: Safety net for the vulnerable X X X X Proaram/Project Descriotion,(Label your responses as outlined below; not to exceed 3 pages.) Please provide the following information about the proposed program/project: b) Summarize the program services proposed and how the program will address the chosen Town/County priority? Our Information and Referral Services program works to assess the needs of clients in-person or over the phone and connect them with a host of referrals to service providers to meet their expressed needs (most common issues: housing, low-cost mental health/medical services, legal Main Application 1/24/2016 2:59:42 PM Page 3 3 o f 5 8 DocuSign Envelope ID: E9DE81F9-0070-4074-8F70-93DABC24ACE1 L A - continued Provider's Outside Agency Application MAIN APPLICATION problems, child care, financial insecurity, etc.) in addition to Compass Center services. Being a leader in referral best practices and quality control has been of particular focus to us in the last year, and after an assessment and restructuring of these services we have created greater staff support and service consistency. Last year we served 712 individuals in this program and already in fiscal year we have served 500. In order to keep up with demand and maintain quality services we are hoping to use some of these grant funds to support a restructuring of some staff roles including having a dedicated Johnson Service Corps. intern overseeing the program as an Information and Referral Specialist. The Community Education component of our program addresses the need for youth and adult training and community education around issues of interpersonal violence prevention and response by delivering trainings and workshops to build skills and knowledge, disseminating information through various channels. Start Strong, our teen dating violence and bullying prevention program, is a two-session program delivered to 6th and 81" grade students during health class in Chapel Hill- Carrboro City Schools. We also offer professional domestic violence education events to a wide array of community members including law enforcement, attorneys, medical providers, other non- profit service providers, faith leaders, and civic organizations. Our staff and volunteers provide information at many community events and perform other outreach activities to educate our community about issues related to domestic violence, adolescent health, and employment concerns. The Civic Engagement component of our program includes coordinating community education events and activity calendars for Domestic Violence Awareness Month, Equal Pay Day, and Women's History Month. c) Describe the local need or problem to be addressed in relation to the Consolidated Plan or other community priorities (i.e. Council/Board Goals). Cite local data to support the need for this program and the population being served. In Orange County between 2009 and 2013, Female-headed households with children under 18 had the highest poverty rate in Orange County at 35.6%, compared with 7.9% for married-couple households with children under 18 (US. Census Bureau Quick Facts American Community Survey). Single, low-income women "frequently experience a lack of informational support and have difficulty connecting with others" who can provide them with knowledge and community resources (Campbell-Grossman, Hudson, Keating-Lefler & Fleck, 2005). Many of these women are not aware of the resources available in their communities, and this lack of informational, emotional, and financial support can lead to high levels of stress and feelings of depression (Campbell-Grossman et al., 2005). In addition, women in our community are more likely than men to live in poverty, be paid substandard wages, lack basic education or have the least opportunity for advancement, and be the sole caretakers of children (Orange County Commission for Women, 2012). According to the Triangle Community Foundation, civic engagement refers to "individual or collective actions designed to identify and address issues of public concern." There are many types of civic engagement, including volunteerism, community group involvement, and electoral and other political participation. There is a need for increased involvement in these activities in order to change the underlying policies, cultural beliefs, and systems that prevent women from being fully engaged in their communities as decision-makers and leaders. This is why we are committed to engaging the community during Women's History Month, Domestic Violence Awareness Month, and Equal Pay Day. As an agency that values self-sufficiency, and works with clients who are survivors of domestic violence, education is very important to us. We believe that education is the key to stopping on- Main Application 1/24/2016 2:59:42 PM Page 3 4 of 5 8 DocuSign Envelope ID: E9DE81F9-0070-4074-8F70-93DABC24ACE1 L A - continued Provider's Outside Agency Application MAIN APPLICATION going violence and, through youth education, preventing violence in the next generation. We reach thousands of adolescent and adult community members annually in our education efforts and are very proud of what we are accomplishing. Interpersonal violence prevention programs are targeted to other community professionals, youth in middle school, faith leaders, civic organizations, and the community at large. d) Describe the population to be served or the area to benefit and indicate how you will identify beneficiaries. Compass Center aims to involve a wide array of community members in our Community Education and Civic Engagement programs, to promote life-long learning and community engagement, and to ensure that our work is continuing to reflect the needs and interests of our community. Anyone is eligible to receive services as long as we have the capacity to meet the need. We do not have wait lists for any services. Inclusiveness is an important organizational value and maintaining and strengthening our commitment to diversity is a goal of our work. Based on Compass Center's mission to serve all populations regardless of ethnic origin, race, sexual orientation, gender, gender identification, religion and socioeconomic status, we strive to serve persons from all ethnic and minority groups who are in need of our services. Outreach efforts include: • Community education presentations in the past year have targeted minority groups to ensure that those communities were aware of the services that we are able to provide. • Provide domestic violence outreach sessions to Head Start families in Spanish and in Burmese dialects. • Work with staff and clients at El Centro Hispano and El Futuro to better meet the needs of the Latino community. • Routine presentations related to domestic violence for clients and staff at DSS. • Participate at local school health and service fairs for Spanish and English speaking families. • Participate in the Orange County Refugee Health Coalition. e) Who specifically will carry out the activities and in what location will they be carried out? Information and Referral services are provided by the Client Services Specialist, Information and Referral Specialist and volunteers. Services are provided at 210 Henderson St. in Chapel Hill or over the phone. Community education and civic engagement services will be carried out by our Director of Education Programs, Development and Communications Coordinator, Executive Director and Associate Director in conjunction with other staff and volunteers. This programming is offered at locations throughout the county including government and non-profit service providers, community events, places of worship, libraries, and businesses. Youth education is provided in local middle schools during health classes. The following trained volunteer positions support these programs: first response volunteers, community educators, advocacy interns, and special event volunteers. f) Describe specifically the period over which the activities will be carried out, the frequency with which the activities will be carried out, and the frequency with which services will be delivered. Include an implementation timeline. Information and Referral Line: This service is offered during business hours all year. Start Strong: Offered in school health classrooms September-November and February-May. Two sessions offered in each health classroom in 6th and 8th grade in Chapel-Hill-Carrboro City Schools. Main Application 1/24/2016 2:59:42 PM Page 3 5 of 5 8 DocuSign Envelope ID: E9DE81F9-0070-4074-8F70-93DABC24ACE1 L A - continued Provider's Outside Agency Application MAIN APPLICATION Community Education: Offered as requested throughout the year. Generally offer 6-15 presentations monthly. Professional Workshops: Offered as requested throughout the year. Generally offer 2-4 presentations monthly. Women's History Month: March is national Women's History Month. Staff, community partners and volunteers begin planning events, constructing a community calendar, and outlining marketing for the month the previous December, and then meet monthly to coordinate plans. Equal Pay Day: held on a Tuesday in April each year, created by the National Committee on Pay Equity in 1996 to raise awareness about the difference in men's and women's wages. Tuesday was selected to represent how far into the work week women must work to earn what men earned the previous week. Staff, community partners and volunteers begin planning an event and outlining marketing for the day in the previous January, and then meet monthly to coordinate plans. Domestic Violence Awareness Month: October is national Domestic Violence Awareness Month. Staff, community partners and volunteers begin planning events, constructing a community calendar, and outlining marketing for the month the previous July/August, and then meet monthly to coordinate plans. Volunteer Training: Compass Center conducts in-depth volunteer trainings for our Domestic Violence and Information and Referral volunteers. Domestic Violence Hotline trainings consist of 42 total hours and First Response volunteers for the Information and Referral Line consist of 17 hours; both occur in the fall and spring. g) Provide a bulleted list of other agencies, if any, with which your agency coordinates/collaborates to accomplish or enhance the Projected Results in the Program(s) to be funded. For each, give specific examples of the coordinated/collaborative efforts. • Chapel Hill-Carrboro City Schools: We deliver youth interpersonal violence prevention education (Start Strong) in health classes. • Orange County Rape Crisis Center: Collaborative partner in providing Start Strong curricula for 6th through 9" grade. We work with youth in 6th and 8th grade and OCRCC works with them in 7th and 9th. We created a fluid curricula and evaluate the program together. • University if North Carolina's Department of Women and Gender Studies: collaborate on Women's History Month and Domestic Violence Awareness Month events. • North Carolina Coalition Against Domestic Violence: Collaborate to offer professional trainings on interpersonal violence and provide staff training on evidence-based practices. • Johnson Service Corps: Provide infrastructure to support an Information and Referral Specialist position. • Numerous non-profit and government agencies and community groups request our professional and community education programming for their constituents to be able to better respond to their own clients or situations. h) Describe what would happen if requested funding is not awarded at all or if a reduced allocation is recommended. Since the majority of the cost of these programs is personnel expenses to deliver services and train and supervise volunteers, if this funding was reduced we would likely not restructure by adding an Johnson Service Corps. intern position and possibly be in a situation of reducing our current force. This would mean fewer clients being served and fewer youth and adult education presentations. It would inhibit us from maintaining our agreements with Chapel Hill-Carrboro City schools to deliver youth education in compliance with the Healthy Youth Act. There are few funding sources for interpersonal violence prevention work with youth and adults at this time so we rely heavily on Orange County to meet this vital need. I) Include any other pertinent information. Main Application 1/24/2016 2:59:42 PM Page 3 6 of 5 8 DocuSign Envelope ID: E9DE81F9-0070-4074-8F70-93DABC24ACE1 A - continued Provider's Outside Agency Application MAIN APPLICATION Program/Project Information j) Complete the Target Population and Program Beneficiary Demographics Chart k) Complete the Schedule of Positions Chart for Program Staff I) Disclosure of Potential Conflicts of Interested must be signed m) Complete the Work Statement Chart to describe the work to be performed, and be sure to attach copies of all data collection tools that will be used to verify achievement of program goals and objectives. Describe who will be responsible for monitoring progress. Information to Complete j.) Target Population Complete the following tables to the best of your ability. Show numbers of participants and percentages, as applicable, in each category. Please indicate whether this project/program will serve: El Persons fl Households n Units Program: Community Education and Civic Engagement Program Beneficiary Demographics Actual Estimated Projected 2014-15 2015-16 2016-17 Gender Male - Female Total 3674 3700 3700 Of the females, how many are single- female Head of Households (Omit for Human Services) Ethnicity African-American American Indian or Alaska Native Asian 1111111111111111111111 Caucasian Native Hawaiian or other Pacific IM Islander Other MIE Unknown Total 3674 3700 3700 Of the above, how many Hispanic/Latino Of the above, how many non- Hispanic/Latino Total 3674 3700 3700 Age 0-5 years 6-18 years 1369 1370 1370 Main Application 1/24/2016 2:59:42 PM Page 37 of 58 000 SWnsnvolopo|o: e8osB1 1 A - continued Provider's Outside Agency Application MAIN APPLICATION 19-50 years 51-61 years 62+ years Unknown 2305 2330 2330 Total 3674 3708 3700 Geographic Location � Durham City Durham County _77 77 77 Carrboro 38 40 40 Chapel Hill 258 260 260 Chapel Hill Public I-lousing Residents Orange County 23 30 30 Raleigh Wake County 35 35 35 Other 29 29 29 Unknown--bu(all from community edin OC, Chapel Hill and Carrboro 3214 3229 3229 Total 3674 3700 3700 Income -See following chart (Omit for'HS) < 3O96 Area Median Income 31-50% Area Median Income 51-80% Area Median Income > 80%Area Median Income Total 0 0 0 Special Needs (Omit for HS) Elderly(Over 62) Disabled (not elderly) Homeless People with HIV/Aids Total 0 0 0 DocuSign Envelope ID: E9DE81F9-0070-4074-8F70-93DABC24ACE1 A - continued Provider's Outside Agency Application MAIN APPLICATION CDBG & HOME ONLY- Area Benefit Activities (Infrastructure and Public FacilitiesL Street Census Tract Block Group Total Persons #LMI Persons 2015 Area Median Family income Limits U.S. Department of Housing & Urban Development (HUD) 2015 Area Median Family Income Limits Effective March 15, 2015 Income 1 2 3 4 5 6 7 8 Level person people People people people people people people 30% AMI $14,150 $16,200 $20,090 $24,250 $28,410 $32,570 $36,730 $40,890 50% AMI $23,600 $27,000 $30,350 $33,700 $36,400 $39,100 $41,800 $44,500 80% AMI $37,750 $43,150 $48,550 $53,900 $58,250 $62,550 $66,850 $71,150 100% AMI $47,188 $53,938 $60,688 $67,375 $72,813 $78,188 $83,563 $88,937 115% AMI $54,266 $62,028 $69,791 $77,481 $83,734 $89,916 $96,097 $102,278 http://www.huduser.org/portal/datasets/Will 51FY201 5 IL nc.pdf Main Application 1/24/2016 2:59:42 PM Page 3 9 o f 5 8 DocuSign Envelope ID: E9DE81F9-0070-4074-8F70-93DABC24ACE1 A - continued Provider's Outside Agency Application MAIN APPLICATION k.) Schedule of Positions Please include program staff positions followed by volunteer positions; these financial figures should match the personnel figures in your Agency Comparative Budget Excel Form. Similar positions can be combined. (i.e., 8 Occupational Therapists can be inserted as one line item). If provided, indicate: Position Titles FTE Program 2014 15 tim Actual Esated Projected (R) *= Position 2015-16 201617 Total Retirement Vacant Staff+ - Budget Plan (H)Health Plan Program 1.0 25%(1) 71,515.90 $57,636.82 $55,482.26 8.7% Dir/Assoc Dir 25%(2) 25%(3) Dir of Domestic 1.0 100%(1) 42,078.73 $40,332.16 $41,124.52 6.5% Violence Services - Dir of Court 1.0 100%(1) 38,466.00 $37,740.00 $39,321.00 6.2% Advocacy& Community Response Dir of Education 1.0 100%(3) 37,219.00 $37,700.00 $38,480.52 6,0% , Programs Client Services 1.0 50%(1) 19,254.25 $35,432.16 $36,238.72 5.7% Specialist 50%(3) Dir of Latino 1.0 100%(1) 33,053.88 $34,500.00 $35,190.00 5.5% Services Dir of Teens 1.0 0%(100% 33,660.00 $34,000.08 $34,680.08 5.5% Climb High Programs but 0%w/ OC Funds) Dir of Self- 1.0 100%(2) 43,699.43 $33,222.98 $34,680.08 5.5% Sufficiency Programs Support Group .67 80%(1) 20,230.10 $21,442.68 $20,837.80 3.3% Coordinator 20%(3) Information & .8 100%(3) N/A N/A $13000.00 2.0% Referral Coord. (Johnson Service Corps. intern) VITA Coordinator .4 100%(2) $5,684.77 $7,376.00 $7,673.99 1.2% Executive Director 1.0 15%(1) $17,129.22 $63,254.00 $66,300.00 10.4% 15%(2) 15%(3) Development Dir 1.0 0% 0 $33,500.00 $51,000.00 8.0% Finance & HR Dir 1.0 15%(1) $48,253.80 $44,000.00 $44,880.00 7.1% 15%(2) 15%(3) Admin Manager .67 15%(1) $26,962.65 $22,685.52 $25,010.67 3,9% 15%(2) 15%(3) Communications .67 40%(3) $46,010.58 $35,979.58 $24,000.00 3.8% & Development Coord Fringe Benefits $65,392.49 $62,471.35 $68,399.35 10.7% (FICA, Insurance, Taxes, etc.) Main Application 1/24/2016 2:59:42 PM Page 40 of 58 DocuSign Envelope ID: E9DE81F9-0070-4074-8F70-93DABC24ACE1 i /\ - continued Provider's Outside Agency Application MAIN APPLICATION TOTAL 15.2 — ----- ' ---------- ---' — — S4�,61�.8O $601,273.33 $636,299.00 100% 1 FTE Volunteer Hours: Volu 33%(1) 8 FTE 8 FTE 8 FTE MSW Interns, ntee 33m(2) APPLES Interns, r 33%(3) Legal Intern, FTE Board of Dineutorn, Hotline Advocates, First Response, Interpreters, Group Facilitators, Community Educators, TCH Interns, Event Volunteers, etc. ---- ' ---- Project/Program Name: 1) Domestic Violence Crisis Services 2) Self Sufficiency Programs: Legal Information, Financial Education & Career Preparedness 3) Community Education & Civic Enqaqement Notes: • Similar positions can be corn bned: i.e. 8 Occupational Therapists can be inserted as one line item. • °° Full Time Equivalent staff will be noted as 1.00; half time as .50; quarter time as .25, etc. • + Denotes the percentage of staff time involved with this program. • Calculate a Full Time Equivalent for all recorded volunteer hours using the following: Total Volunteer Hours =Volunteer FTE 1,960 Main Application 1/24K2016 2:59:42 PM Page 4 1 0 f 5 8 DocuSign Envelope ID: E9DE81F9-0070-4074-8F70-93DABC24ACE1 L A - continued Provider's Outside Agency Application MAIN APPLICATION I.) DISCLOSURE OF POTENTIAL CONFLICTS OF INTEREST Are any of the Board Members or employees of the agency which will be carrying out this project, or members of their immediate families, or their business associates: YES NO Ell a) Employees of or closely related to employees of the Town of Chapel Hill, Orange County, Carrboro, or Hillsborough? 1>j b) Members of or closely related to members of the governing bodies of Chapel Hill, Carrboro, Hillsborough, or Orange County? c) Current beneficiaries of the project/program for which funds are requested? -< d) Paid providers of goods or services to the program or having other financial interest in the program? If you have answered YES to any question, please provide a full explanation below. Board member Elisabeth Johnson's partner Kennard Winchester is a school bus driver for the Chapel Hill Carrboro City Schools and works as a basketball coach for the Phillips Middle School boys team. To the best of my knowledge and belief all of the above information is true and current. I acknowledge and understand that the existence of a potential conflict of interest does not necessarily make the project ineligible for funding, but the existence of an undisclosed conflict may result in the termination of any grant awarded. Signature: eitit„ )1/21//6 Executive Director ( ) Date 112,1-4 Signature:„_,A . 1 to .ard Chairperson' Date Main Application 1/24/2016 2:59:42 PM Page 4 2 of 5 8 000 SWnsnvolopo|o: e8osB1 1 A - continued Provider's Outside Agency Application MAIN APPLICATION 0M.\ Work Statement This form is used to document program activities, program goals, performance measures, and actual results. (Add more rows as needed) If this is a new program, you will only document the p jected information. * Program Activities should outline major activities the agency implements to accomplish its program goals. * Program Goal should explain what the program is trying to achieve/accomplish. Goals are statements about what the program should accomplish. SMART Goals • Performance Measures describe how you will evaluate the degree in which you achieved the stated goals. • Actual Program Results use program results to indicate the actual measureable achievement of goals. If goals were not met, please explain. Actual Estimated Projected 2014-15 2015-16 2016-17 Information and Referral Information and Referral Information and Referral Service: Connects Service: Connects community Service: Connects community members with members with local resources community members with local resources and and services after local resources and services services after assessment assessment of need. after assessment of need. of need. Resource Resource database Resource database Program Activity 1 database maintained for a maintained for a multitude of maintained for a multitude of multitude of services. services. Follow-up services. Follow-up Follow-up conducted to conducted to ensure conducted to ensure ensure connection was connection was made and connection was made and made and additional additional resources provided additional resources provided resources provided as as needed. as needed. needed. 85%of clients will report they received the 85%of clients will report they 85%of clients will report they Program Goal information or help they received the information or received the information or requested in FY 14-15.At help they requested in FY 15- help they requested in FY 16- least 750 clients will be 16. At least 650 clients will be 17.At least 800 clients will be served. served, , served. At the end of the contact, all clients are asked At the end of the contact,all At the end of the contact, all Performance Measures whether they received the clients are asked whether clients are asked whether information or help they they received the information they received the information needed.These results are or help they needed. These or help they needed.These tracked. results are tracked. results are tracked. Program Results 95% 94% at Q2 85% --- ' Youth Interpersonal Youth Interpersonal Violence Youth Interpersonal Violence Violence Prevention Prevention Education Prevention Education Education Programs: Programs: Provide age Programs: Provide age Provide age appropriate appropriate dating violence appropriate dating violence Program Activity 2 dating violence and and bullying prevention and bullying prevention bullying prevention education sessions in 6th and education sessions in 6th and education sessions in 6e 8th grade health education 8th grade health education and 8m grade health classes. classes. education classes. Main Application 1/24/2016 2:59:42 PM Page 4 3 Of 58 000 SWnsnvolopo|o: e8osB1 1 A - continued Provider's Outside Agency Application MAIN APPLICATION Out of 2000 participants, Out of 1200 participants, 85% Out of 1200 participants, 80% Program Goal 85%will report an will report an increased will report an increased increased awareness of awareness of domestic awareness of domestic domestic violence and violence and resources violence and resources resources available to available to victims in FY 15- available to victims in FY 16- victims in FY 14-15. 16.(**see below) 17. Participants will be given Participants will be given pre- Participants will be given Performance Measures pre-and-post-test surveys und'poo�bom\munmyoond pm'and'pust'tee|aun/ayo and results will be tracked. results will be tracked. and results will be tracked. Program Results _ . 89% 92%at 02 85% Professional Interpersonal Professional Interpersonal Professional Interpersonal Violence Education: Violence Education: Provide Violence Education: Provide Provide educational educational presentations to a educational presentations to presentations to a variety variety of professionals about a variety of professionals of professionals about victimization, resources and about victimization, resources victimization, resources' legal remedies available, and legal remedies available, Program Activity 3 arid legal remedies impact of domestic violence, impact of domestic violence, available, impact of reluctance of victims to reluctance of victims to domestic violence ' d|eu|oee,effect of domestic diec|oam, effect of domestic reluctance of victims to violence on children and violence on children and disclose,effect of domestic many other topics. many other topics. violence on children and many 85%of participants will report increased awareness about domestic 85% of participants will report 80%of participants will report GoaProgram Q�| violence and resources increased awamno*nabout increased awomnemeabout � available to victims in FY domestic violence and domestic violence and 14-15.At least 60 resources available to victims resources available to victims participants will be in FY 15-16.At least 60 in FY 16-17.At least 60 reached. participants will be reached. participants will be reached. Participants will be given a Participants will be given a Participants will be given a Po survey poo�0000ionova|uuUun po��'oouoionovu|uuUun Performance Measures munmyandroau|(sm/i|| be survey and results will be survey and results will be tracked. tracked. tracked. Program Results 88% 90Y6 at Q2 85% Community Interpersonal Community Interpersonal Community Interpersonal Violence Education: Violence Education: Provide Violence Education: Provide Provide community-wide community-wide education community-wide education education and information and information to groups and information to groups to groups through through presentations on a through presentations on a Program Activity 4 presentations on a variety variety of topics related to variety of topics related to of topics related to domestic violence,Will also domestic violence.Will also domestic violence.Will participate in outreach efforts participate in outreach efforts also participate in outreach to reach victims and health to reach victims and health efforts to reach victims and fairs. fairs. health fairs. Main Application 1/24/20182:59:42 PM Page 44 Of 5 8 000 SWnsnvolopo|o: e8osB1 1 A - continued Provider's Outside Agency Application MAIN APPLICATION 85%of participants will report increased 85%of participants will report 85%of participants will report awareness of domestic increased awareness of increased awareness of Program Goal violence and resources domestic violence arid domestic violence arid available in FY 14-15. At resources available in FY 15- resources available in FY 16- least 200 participants will 16.At least 200 participants 17.At least 200 participants be reached. will be reached. will be reached. Participants will be given a Participants will be given a Participants will be given a post-session evaluation post-session evaluation post-session evaluation Performance Measures survey and results will be survey and results will be survey and results will be tcuoked� tracked. tracked. Program Results 9096 8896a1C}2 85% Women's History Month: Women's History Month: Women's History Month: Civic Engagement: P|an, Civic Engagement: Plan, Civic Engagement: Plan, promote and carry-out promote and carry-out promote and carry-out activities to acknowledge activities to acknowledge activities to acknowledge Women's History Month Women's History Month Women's History Month Activity 5 based on the National based on the National based on the National Women's History Project Women's History Projec Women's History Project annual theme.We will annual theme.We will annual theme.We will highlight contributions of, highlight contributions of, or highlight contributions of,or or challenges faced by, challenges faced by,women challenges faced by,women women in our community. in our community. in our community. Educational and/or celebratory events and Educational and/or Educational and/or information to provide celebratory events and celebratory events and Program Goal community awareness will information to provide information to provide be disseminated community awareness will be community awareness will be throughout the community disseminated throughout the disseminated throughout the in March 2015. community in March 2016. community in March 2017. Data about events held, Data about events held, Data about events ho|d, activities completed and activities completed and activities completed and number of participants are number of participants are number of participants are compiled and tracked. compiled and tracked. Staff compiled and tracked. Staff Performance Measures Staff and committee and committee members and committee members members debrief and debrief and begin planning for debrief and begin planning begin planning for the next the next year based on for the next year based on year based on feedback. feedback. feedback. Information was disseminated and activities Program Results were held in March 2015. Information will be Information will be See quarterly report for full disseminated and activities disseminated and activities details. held in March 2016. held in March 2017. Domestic Violence Domestic Violence Domestic Violence Awareness Month:Civic Awareness Month: Civic Awareness Month: Civic Engagement: Plan, Engagement: Plan, promote Engagement: Plan, promote promote and carry-out and carry-out activities to and carry-out activities to Activity 6 activities to educate the educate the community and educate the community and community and raise raise awareness during raise awareness during awareness during Domestic Violence Domestic Violence Domestic Violence Awareness Month. Awareness Month. Awareness Month. Main Application 1/24/2[]16 2:59:42 PM Page 4l5 Of 5 8 DocuSign Envelope ID: E9DE81F9-0070-4074-8F70-93DABC24ACE1 i /\ - continued Provider's Outside Agency Application MAIN APPLICATION Educational events, Educational events, Educational events, community-building community-building activities community-building activities activities and information and information disseminated and information disseminated Program Goal disseminated for for community awareness and for community awareness community awareness and education in October 2015. and education in October education in October 2014. 2018. — - Data about m���� — Data about —Datamboutaventaheld. — activities completed and activities completed and activities completed and number of participants are number of participants are number of participants are compiled and tracked, compiled and tracked. Staff compiled and tracked. Staff Performance Measures Staff and committee and committee members and committee members members debrief and debrief and begin planning for debrief and begin planning begin planning for the next the next year based on for the next year based on year based on feedback. feedback. feedback. -- ----- Information was disseminated and activities Information was disseminated Program Results were held in October 2014. and activities were held in Information will be See quarterly report for full October 2015, See quarterly disseminated and activities Uetai|o._ report for full details. held in October 2818. **The number of youth reached appears reduced from FY 14-15 because historically youth were reported twice because they each participated in two presentations.We feel it is more accurate to report each youth once even though they still participate in two sessions. The number of youth reach has not actually decreased. Main Application 1/24/2016 2:59:42 PM Page 4 6 of 5 8 DocuSign Envelope ID: E9DE81F9-0070-4074-8F70-93DABC24ACE1 A - continued Provider's Outside Agency Application MAIN APPLICATION 4. FINANCIAL INFORMATION FOR SERVICE PROGRAMS a.) Program Budget - Domestic Violence Please complete a Program Budget Excel Form for each requested program. The Program Budget should reflect only figures and amounts associated with the Program(s) for which you are seeking funding and not the total agency budget. If the program's finances experienced significant changes that you would like to explain, please use the space below. It is required that your Excel budget worksheet be embedded on the next page. You must also submit an electronic copy of the MS Excel file with your application, as a separate file. Main Application 1/24/2016 2:59:42 PM Page 4 7 of 5 8 DocuSign Envelope ID: E9DE81F9-0070-4074-8F70-93DABC24ACE1 L A - continued Provider's Outside Agency Application MAIN APPLICATION Comparative Budget for Domestic Violence Program AGENCY NA h The Women's Center, Inc. dba Compass Center for Women and Families Actual Estimated Projected IlPerceul AGENCY REVENUE 2014-15 2015-16 2016-17 Change Private Donations $ 4,414.09 $ 2,747.37 $ 6,325.78 130% Agency Generated Revenue (fees) Local Government Grants: Orange County $ 21,500 $ 21,500 $ 21,500 0•/: Town of Chapel Hill $ 9,767 $ 9,767 $ 9,767 OX Town of Carrboto $ 2,800 $ 2,817 $ 2,817 Other Local: Town of Hillsborough 667 $ 667 $ -100% Other Local: 0 Other Local: 0 if more than 3 fourcef.,please provide 4 veprate Non-Local Government Grants Triangle United Way $ 14,092 $ 28,017 $ 28,569 State Government $ 190,000 $ 190,000 $ 190,000 Federal Government Other Grants Private Foundations $ 6,000 $ 2,000 $ 10,000 400X Other Grants MiscellaneousiOther Revenue $ 28,489 IIMEMIMI 10X Please 3 largest rylirxell u ano .courc : Art Show 3112015 $ 28,489 Board Initiated Events FY15 $ 10,264 Cellphone recycling FY15 $ 657 Total Agency Revenue 277 729 MI 303 450 5x AGENCY EXPENSES Compensation $ 214,850 $ 235,474 $ 249,191 Rent &Utilities $ 13,401 $ 9,634 $ 9,634 0% Supplies& Equipment $ 4,169 $ 3,133 $ 3,133 OY. Travel & Training $ 2,564 $ 2,271 $ 2,385 5X Other Expenses: $ 42,745 $ 38,340 $ 39,107 Pk ar.e list 3 largest"Other Expene.,;": Contracted Services FY15 $ 21,130 Telepone Systems FY15 $ 5,047 Art Show 32015 $ 2,467 Total Agency Expenses $277,729 $289,853 $303.450 5x SURPLUSI(OEFICIT)FOR PERIOD: - - - Main Application 1/24/2016 2:59:42 PM Page 48 of 58 DocuSign Envelope ID: E9DE81F9-0070-4074-8F70-93DABC24ACE1 A - continued Provider's Outside Agency Application MAIN APPLICATION b.) Program Budget Detail What is the cost to deliver your project/program? List each project/program element in the table below, including the cost of each element, the quantity and unit of measure, and the subtotal for each element. Where necessary, allocate costs to the use of shared space, vehicles or equipment. Example Program: Credit Counseling Class Cost Elements , Cost($) Quantity/Unit of measure Subtotal ($) Credit Counseling Teacher–in class $25 96 hours (8 hrs/mth x 12 months) $2,400 Credit Counseling Teacher—class prep $25 48 hours (4hrs/mth x 12 mths) $1,200 Credit Counselor—one-on-one $20 120 hours (10 hrs/mth x12 mths $2,400 Materials $25 120 course packets/credit reports $3,000 Total $9,000 Complete the table below for the project/program for which you are requesting funds. Attach additional rows/pages, as needed. Program: Domestic Violence Crisis Services (Projected '16-17) Cost Elements Cost($)* Quantity/Unit of measure Subtotal ($) Crisis Counseling $15.29 7600 (#clients yr. X 15 min. of $116,204 service) $15.29 Information (education, all non-crisis $15. 7100 (#clients yr. X 15 min. of $108,559 informational contacts, and follow ups) service) 29 Referral $15. 677 (#clients yr. X 15 min. of $10,351 service) Shelter referral &assistance/hotel $15.29 270 (#clients yr. X 15 min. of $4,128 placement service) $15.29 Legal information $15. 1270 (#clients yr. X 15 min. of $19,418 service) $15.29 DV Protective Order paperwork assistance 330 (#clients yr. X 15 min. of $5,046 service) 29 Advocacy(general & court) $15. 22000 (#clients yr. X 15 min. of $33,638 service) $15.29 Interpretation $15. 155 (#clients yr. X 15 min. of $2,370 service) Financial assistance (transportation, $15.29 142 (#clients yr. X 15 min. of $2,171 grocery cards, gas cards, food/toiletries) service) Main Application 1/24/2016 2:59:42 PM Page 49 of 58 DocuSign Envelope ID: E9DE81F9-0070-4074-8F70-93DABC24ACE1 A - continued Provider's Outside Agency Application MAIN APPLICATION $15.29 Additional assistance (victim $15. 90 (#clients yr. X 15 min. of $1,564 compensation, CPS reporting, 911 cell service) phones, etc. Total $303,450 *denotes a rounded average amount Define one unit of service: Each discrete separate service provided to a client is counted individually based on 15 min. increments. Most of our clients receive more than one service in each contact. Services include: crisis counseling, assistance in completing protective orders,court accompaniment and advocacy, support group screenings and attendance, assistance locating shelter, legal information, information and referrals, emergency financial or transportation assistance,911 cell phone distribution for safety, emergency child care, CPS reporting, interpretation, etc. 1 unit=up to 15 min. of time spent delivering the service to a client. c.) Cost per Unit Actual 2014-15 Estimated 2016-16 . Projected 2016-17 Total Cost of Program $277,729.00 $288,853.00 $303,450.00 Total # of Units 19,061 19,834 19,834 Cost Per Unit $14.57 $14.56 $15.29 This Cost Per Unit must reflect the total program budget and the total number of program beneficiaries (households or persons) in this application and must be consistent with report submittals from previous years (if applicable). Main Application 1/24/2016 2:59:42 PM Page 50 of 58 DocuSign Envelope ID: E9DE81F9-0070-4074-8F70-93DABC24ACE1 L A - continued Provider's Outside Agency Application MAIN APPLICATION d.) Program Budget - Self-Sufficiency Comparative Budget for Self-Sufficiency Program AGENCY NAP' The Women's Center,Inc_ dba Compass Center for Women and Families Actual Estimated Projected Percent AGENCY REVENUE 2014-15 2015-16 2016-17 Change Private Donations $ 41,296.52 $ 32,149.98 $ 32,941.90 Agency Generated Revenue(Fees) 911 $ 1,000 $ 1,002 Local Government Grants: Orange County $ 21,500 $ 21,500 $ 21,500 Town of Chapel Hill $ 9,767 $ 9,767 $ 9,767 Town of Carrboro $ 2,800 $ 2,817 $ 2,817 Other Local: Town of Hillsborough 667 $ 667 $ -100% Other Local: Other Local: If more than 3.;otirce:,plea, provide a:-,eparat‹.. Non-Local Government Grants Triangle United day $ 6,503 $ 12,928 $ 13,183 2V State Government $ 14,092 $ 19,127 $ 19,674 Federal Government Other Grants Private Foundations $ 12,034 $ 8.000 $ 8,000 Other Grants Miscellaneous/Other Revenue $ 18,583 $ 25,330 $ 31,137 23% Pleafc list 3 largeg Art Show 302015 $ 13,146 Board Initiated Events FY15 $ 4,736 Cellphone recycling FY15 $ 303 Total Agency Revenue 128 152 I 140 020 5X AGENCY EXPENSES Compensation $ 99,138 $ 108,654 $ 114,984 Rent &Utilities $ 6,184 $ 4,445 $ 4,445 0•F-: Supplies&Equipment $ 1,924 $ 1,446 $ 1,446 0% Travel& Training $ 1,183 $ 1,048 $ 1,101 Other Expenses: $ 19,724 $ 17,691 $ 18,045 2X Pk ar.e list 3 largea-t"Other Expen ": Contracted Services FY15 $ 21,130 Telepone Systems FY15 $ 5.047 Art Show 302015 $ 2,467 Total Agency Expenses $ 128,152 S 133,285 S 140,020 SURPLUSIKIEFICIT)FOR PERIOD: I - I S - - Main Application 1/24/2016 2:59:42 PM Page 5 1 of 58 DocuSign Envelope ID: E9DE81F9-0070-4074-8F70-93DABC24ACE1 A - continued Provider's Outside Agency Application MAIN APPLICATION e.) Program Budget Detail What is the cost to deliver your project/program? List each project/program element in the table below, including the cost of each element, the quantity and unit of measure, and the subtotal for each element. Where necessary, allocate costs to the use of shared space, vehicles or equipment. Example Program: Credit Counseling Class Cost Elements Cost(S) Quantity/Unit of Measure Subtotal($) Credit Counseling Teacher–in class $25 96 hours (8 hrs/mth x 12 months) $2,400 Credit Counseling Teacher—class prep $25 48 hours (4hrs/mth x 12 mths) $1,200 Credit Counselor—one-on-one $20 120 hours(10 hrs/mth x12 mths $2,400 Materials $25 120 course packets/credit reports $3,000 Total $9,000 Complete the table below for the project/program for which you are requesting funds. Attach additional rows/pages, as needed. Program: Self-Sufficiency Programs (Projected 16-17) Cost Elements Cost Quantity/Unit of measure Subtotal f$'1 Legal Information Service $26.75 190 (190 sessions/yr. X 15 min. of $5,083 service) $26.75 Community Legal Project 104 (52 sessions x 2 units at 30min.) $2,782 $26.75 Legal Workshops $26. 480 (80 participants x 6 units at 1.5 $12,840 hr.) $26.75 Individual Career Counseling $26. 600 (150 sessions x 4 units at 1 hr.) $16,050 $26.75 Career Workshop $26. 180 (45 participants x 4 units at 1 hr.) $4,815 $26.75 Individual Financial Counseling $26. 660 (110 sessions x 6 units at 1.5 $17,655 hr. $26.75 Financial Workshops $26. 260 (65 participants x4 units at 1 hr.) $6,955 $26.75 VITA 1350 (225 clients x6 units at 1.5 hr.) $36,113 $26.75 Group 1410 (235 contacts x6 units at 1.5 $37,728 hr.) Total $140,020 *denotes a rounded average amount Main Application 1/24/2016 2:59:42 PM Page 5 2 o f 5 8 DocuSign Envelope ID: E9DE81F9-0070-4074-8F70-93DABC24ACE1 A - continued Provider's Outside Agency Application MAIN APPLICATION Define one unit of service: Each discrete service provided to a client is counted in 15 min. increments to create consistency among services with varying lengths. 1 unit of service equals 15 min. for all self-sufficiency services(legal information service, community legal project, legal workshops, career counseling, career workshops, financial counseling, financial workshops,tax preparation, divorce and separation group, and self- esteem group.) f.) Cost per Unit: Estimated 2015- Actual 2014-15 Projected 2016-17 16 Total Cost of Program $128,152.00 $133,285.00 $140,020.00 Total # of Units 4761 5234 5234 Cost Per Unit $26.92 $25.46 $26.75 This Cost Per Unit must reflect the total program budget and the total number of program beneficiaries (households or persons) in this application and must be consistent with report submittals from previous years (if applicable). Main Application 1/24/2016 2:59:42 PM Page 53 of 58 DocuSign Envelope ID: E9DE81F9-0070-4074-8F70-93DABC24ACE1 L A - continued Provider's Outside Agency Application MAIN APPLICATION g.) Program Budget - Community Education and Civic Engagement Comparative Budget for Community Education &Engagement Program AGENCY NAIL The Women's Center.Inc. dba Compass Center for Women and Families Actual Estimated Projected Percent AGENCY REVENUE 2014-15 2015-16 2016-17 Change Private Donations $ 35,905.35 $ 10,691.11 $ 9,179.98 -14v. Agency Generated Revenue (fees) Local Government Grants: Orange County $ 21,500 $ 21,500 $ 21,500 OV. Town of Chapel Hill $ 9.767 $ 9,767 $ 9,767 Ox Town of Carrboro $ 2,800 $ 2,817 $ 2,817 Other Local: Town of Hillsborough 667 $ 667 $ -100v. Other Local: 0 Other Local: 0 If mare thrs 3 f.aurcer.,pke provido 4 c,t pwst I . Non-Local Government Grants Triangle United Way $ 9,948 $ 19,777 $ 20,167 State Government $ 75,000 $ 75,000 $ 75,000 ox Federal Government Other Grants Private Foundations $ 12,033 $ 8,000 $ 9,000 13% Other Grants 0 MiscellaneousiOther Revenue $ 28,128 IMEMIN 31V. Plce list 3 14rgevt .lourtc:7: Art Show 3/2015 $ 20,110 Board Initiated Events FY15 $ 7,245 Cellphone recycling FY15 $ 463 Total Agency Revenue 196 047 MN 189 063 5x AGENCY EXPENSES Compensation $ 151,661 $ 166,219 $ 175,902 674. Rent & Utilities $ 9,460 $ 6,801 $ 6,801 ox Supplies tff Equipment $ 2,943 $ 2,212 $ 2,212 Ox Travel it(Training $ 1,810 $ 1,803 $ 1,684 5% Other Expenses: $ 30,173 $ 3,133 $ 2,465 -21x PInge list 3 largQO"Othu Contracted Services FY15 $ 14,915 Telepone Systems FY15 $ 3,562 Art Show 3/2015 $ 1,741 Total Agency Expenses s 196.047 $ 179.968 $ 189.063 SURPLUS1(DEFICIT) FOR PERIOD: - 1 $ - IS Main Application 1/24/2016 2:59:42 PM Page 54 of 58 DocuSign Envelope ID: E9DE81F9-0070-4074-8F70-93DABC24ACE1 A - continued Provider's Outside Agency Application MAIN APPLICATION h.) Program Budget Detail What is the cost to deliver your project/program? List each project/program element in the table below, including the cost of each element, the quantity and unit of measure, and the subtotal for each element. Where necessary, allocate costs to the use of shared space, vehicles or equipment. Example Program: Credit Counseling Class Cost Elements Cost(S) Quantity/Unit of Measure ' Subtotal($) Credit Counseling Teacher–in class $25 96 hours(8 hrs/inth x 12 months) $2,400 Credit Counseling Teacher—class prep $25 48 hours (4hrs/mth x 12 mths) $1,200 Credit Counselor—one-on-one $20 120 hours (10 hrs/mth x12 mths $2,400 Materials $25 120 course packets/credit reports $3,000 Total $9,000 Complete the table below for the project/program for which you are requesting funds. Attach additional rows/pages, as needed. Program: Community Education and Civic Engagement (Projected '16- '17) Cost Elements , Cost($)* Quantity/Unit of measure Subtotal ($) Teens Climb High** $41.67 2400 (240 students x 10 $100,00 sessions) $13.35 Information and Referral 1500 (contacts per yr.) $20,025 35 Adult Communit Education $13. 2433 people per r. $32,481 35 Youth Community Education $13. 2740 (1370 people x 2 sessions $36,579 per yr.) Total $189,063 *denotes a rounded average amount **This program has been and will continue to be fully funded by the state's Dept. of Public Health Define one unit of service: Each Information and Referral Service contact, one attendee at an adult community education presentation (professional or community interpersonal violence education/prevention, agency services, DVAM, WHM),one session of participation in youth interpersonal violence education (Start Strong), each session of participation in adolescent evidence-based sexual health curricula (Teens Climb High). Note:we are no longer counting e-newsletter opens as part of these units of service because we don't believe there is enough educational content to justify this as a service. We are adding Teens Climb High in Main Application 1/24/2016 2:59:42 PM Page 55 of 58 DocuSign Envelope ID: E9DE81F9-0070-4074-8F70-93DABC24ACE1 A - continued Provider's Outside Agency Application MAIN APPLICATION units of service now since it is part of this array of services but Orange County funds are not used to pay for the program, state funds are. i.) Cost per Unit Estimated 2015- -- Actual 2014-15 Projected 2016-17 16 Total Cost of Program $196,047.00 $179,968.00 $189,063.00 541 TCH* 2400 TCH 2400 TCH Total # of Units 6509 remaining 6673 remaining 6673 remaining Cost Per Unit $184.85 TCH $41 .67 TCH $41 .67 TCH $14.76 remaining $11.99 remaining $13.35 remaining *We are adding Teens Climb High in units of service now since it is part of this array of services but Orange County funds are not used to pay for the program, state funds are. This Cost Per Unit must reflect the total program budget and the total number of program beneficiaries (households or persons) in this application and must be consistent with report submittals from previous years (if applicable). Main Application 1/24/2016 3:09:29 PM Page 56 of 58 DocuSign Envelope ID: E9DE81F9-0070-4074-8F70-93DABC24ACE1 A - continued Provider's Outside Agency Application MAIN APPLICATION j.) Agency Operating Budget Please show all sources and amounts of funding for your entire current fiscal year. What is your agency's fiscal year? Example: July 1, 2016 through June 30, 2017. Submit operating budget in your own format. Do not include funds that have been applied for but not yet awarded: If the total revenue is not the same amount as the budget for any fiscal year, please attach a statement explaining the deficit or surplus. It is required that your Excel budget worksheet be embedded on the next page. You must also submit an electronic copy of the MS Excel file with your application, as a separate file. Main Application 1/24/2016 2:59:42 PM Page 5 7 o f 5 8 DocuSign Envelope ID: E9DE81F9-0070-4074-8F70-93DABC24ACE1 L A - continued Provider's Outside Agency Application MAIN APPLICATION bection VI. 1-inancial Uata Comparative Budget For Entire Agency AGENCY NAIL The Women's Center. Inc. dba Compass Center for Women and Families Actual Estimated Projected Percent AGENCY REVENUE 2014-15 2015-16 2016-17 Change Private Donations $ 87,616 $ 93,500 $ 96,378 3% Agency Generated Revenue (fees) $ 911 $ 1,000 $ 1,002 0% Local Government Grants: Orange County $ 64,500 $ 64,500 $ 64,500 Town of Chapel Hill $ 29,300 $ 29,300 $ 29,300 0% Town of Carrboro $ 8,400 $ 8,450 $ 8,450 0% Other Local: Town of Hillsborough $ 2,000 $ 2,000 $ -100% Other Local: - Other Local: - 0 If more than 3 t;ourc pltc provide:a-..Ticparatt Hot. Non-Local Government Grants Triangle United'kr/ay $ 30,543 $ 60,723 $ 61,919 2% State Government $ 279,092 $ 284,127 $ 284,674 0% Federal Government 0 Other Grants Private Foundations $ 126,492 $ 75,000 $ 83,485 11% Other Grants 0 MiscellaneousiOther Revenue $ 87,282 $ 118,974 $ 146,248 23% Pkz, Ii 3 largect Niktellanour:: Art Show 312015 # 61,745.00 Board Initiated Events FY15 # 22,245.38 Cellphone recycling FY15 # 1,422.94 Total Agency Revenue 716 136 5X AGENCY EXPENSES Compensation $ 548,611 $ 601,273 $ 636,299 6% Rent a( Utilities $ 34,219 $ 24,600 $ 24,600 Supplies & Equipment $ 10,645 $ 8,000 $ 8,000 0% Travel& Training $ 6,548 $ 5,800 $ 6,090 Other Expenses: $ 109,147 $ 97,900.78 $ 99,859 2% PIcat7t Ii 3 largcgit"Dt6r Expen5c.1": Contracted Services FY15 # 53,353.63 Telepone Systems FY15 # 12,886.36 Art Show 312015 # 6,258.75 Total Agency Expenses $ 709,170 $737.574 $774,848 5x SURPLUS1(DEFICIT) FOR PERIOD: I 6,966 1 $ 1,108 Main Application 1/24/2016 2:59:42 PM Page 5 8 o 58 DocuSign Envelope ID: E9DE81F9-0070-4074-8F70-93DABC24ACE1 EXHIBIT `B" Scope of Services—FY 2016-17 Outside Agency Performance Agreement Agency Name: Compass Center for Women and Families Program 1: Domestic Violence Crisis Services Funding Award: $ 21,500 Outline how the agency will spend Orange County's funding award. Expense Description Amount Personnel Expenses—Salaries,FICA,Health Insurance Coverage 21,500 Program Services For assistance with this or the following section, please reference the Exhibit A instructions and example, located within the contract and reporting memorandum. Outline the major activities the agency will employ to attain the Anticipated Outcomes below,by June 30,2016. • Direct services to victims of domestic violence(English and Spanish) • Court advocacy for victims of domestic violence • Support group services for victims of domestic violence Anticipated Outcomes The Anticipated Results column must include quantifiable results in the form of number of persons/units served within Orange County, only (all Towns and municipalities). If you use percentages, you must also provide the total number of participants within that measure's description or for an earlier performance measure. Performance Measures Anticipated Results Out of 1,000 clients,percentage of clients who will discuss their safety and/or develop a safety 85 % plan-(Goal: 85%) Out of 150 clients,percentage of clients who will report feeling supported by court advocates- 85 % (Goal 85%) Out of 50 support group participants,percentage of clients who will report they felt increased 85 % support related to dealing with their experience of abuse because of group(Goal: 85%) Out of 90 Spanish-speaking clients,percentage who will report that they better understood their 85 % options-(Goal 85%) DocuSigned by: a�l 'I btAt.s Associate Director 11/2/2016 7458018207BE45D... E,orkLot DocuuSiggned by: t 9 Executive Director 10/31/2016 Certified by: 20A8CC45F3494C5 Title: Date: (Provider's Signature) DocuSign Envelope ID: E9DE81F9-0070-4074-8F70-93DABC24ACE1 EXHIBIT `B" Scope of Services—FY 2016-17 Outside Agency Performance Agreement Agency Name: Compass Center for Women and Families Program 2: Self-Sufficiency Programs Funding Award: $ 21,500 Outline how the agency will spend Orange County's funding award. Expense Description Amount Personnel Expenses—Salaries,FICA,Health Insurance Coverage 21,500 Program Services For assistance with this or the following section, please reference the Exhibit A instructions and example, located within the contract and reporting memorandum. Outline the major activities the agency will employ to attain the Anticipated Outcomes below,by June 30,2016. • Legal Information Service • Financial Literacy Education,Volunteer Income Tax Assistance(VITA)Program • Career Preparedness Program Anticipated Outcomes The Anticipated Results column must include quantifiable results in the form of number of persons/units served within Orange County, only (all Towns and municipalities). If you use percentages, you must also provide the total number of participants within that measure's description or for an earlier performance measure. Performance Measures Anticipated Results Out of 50 legal program participants,percentage who will report that the information presented 85 % was helpful to their situation-(Goal 85%) Out of 30 client sessions with UNC-CH law students,percentage of clients who will report they 85 % are more knowledgable about their situation-(Goal 85%) Out of 150 sessions,percentage of clients who will report that they are leaving with one goal to 85 % improve their financial situation-(Goal 85%) Number of people served in VITA program 210 Out of 75 sessions,percentage of clients who will report that they are leaving with at least one 85 % /coon.r���ditvtheir career search-(Goal 85%) arLtl, 1 +''c1-S Associ ate Di rector 11/2/2016 °'---7458018207BE45D... DocuuSigned by: Cork-tut tkt Executive Director 10/31/2016 Certified by: 2onssrnSFSaaasS._ Title: Date: (Provider's Signature) DocuSign Envelope ID: E9DE81F9-0070-4074-8F70-93DABC24ACE1 EXHIBIT `B" Scope of Services—FY 2016-17 Outside Agency Performance Agreement Agency Name: Compass Center for Women and Families Program 3: Community Education and Civic Engagement Funding Award: $ 21,500 Outline how the agency will spend Orange County's funding award. Expense Description Amount Personnel Expenses—Salaries,FICA,Health Insurance Coverage 21,500 Program Services For assistance with this or the following section, please reference the Exhibit A instructions and example, located within the contract and reporting memorandum. Outline the major activities the agency will employ to attain the Anticipated Outcomes below,by June 30,2016. • Information and Referral Services • Education: Youth Education Programming (dating violence prevention), Professional Interpersonal Violence Training, Community Interpersonal Violence Education • Civic Engagement: Women's History Month Awareness and Domestic Violence Awareness Month activities Anticipated Outcomes The Anticipated Results column must include quantifiable results in the form of number of persons/units served within Orange County, only (all Towns and municipalities). If you use percentages, you must also provide the total number of participants within that measure's description or for an earlier performance measure. Performance Measures Anticipated Results Out of 700 clients,percentage who will report that they have received the information or 80% the help they requested-(Goal: 85%) Information will be Women's History Month educational or celebratory events and information to provide disseminated and community awareness will be disseminated throughout the community activities held. Domestic Violence Awareness Month educational,community-building activities and Information will be information to provide community awareness will be disseminated disseminated and activities held. Youth Education Programs: Out of 1200 youth education participants,percentage who 75 % will report an increased awareness of domestic violence and/or resources available(Goal: 85%) Professional Interpersonal Violence Training: Out of 125 participants,percentage who 75 % will report increased awareness about domestic violence and/or resources available to victims-(Goal 85%) Community Interpersonal Violence Training: Out of 400 participants,percentage who 75 % will report increased awatensosaitibutn domestic violence and/or resources available to victims(Goal 85%) CbV'f i Lia, tkumA t.a1 `-20n8cc45F3494c5... Executive Director 10/31/2016 Certified by: Title: Date: Ek V'i.ITU, 6'144GS Associ ate Di rector 11/2/2016 7458018207BE45D... DocuSign Envelope ID: E9DE81F9-0070-4074-8F70-93DABC24ACE1 WOMECEN-02 NYOUNG AcoRL CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) `••---� 9/13/2016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Summers Thompson Lowry,Inc. PHONE 100 Europa Drive (A/C,No,Ext):(919 968-4472 FPX 919 942-4221 ) (A/C,No): ( ) Suite 571 E-MAIL info @STLinsure.COm Chapel Hill,NC 27517-2393 INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Alliance for Non-Profits for Insurance Risk Retention Group INSURED INSURER B:Standard Fire Insurance Co. The Women's Center dba/Compass Center for Women INSURER C: and Families PO Box 1057 INSURER D: Chapel Hill,NC 27514 INSURERE: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. 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