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Home My WebLink AboutBOH agenda 022416ORANGE COUNTY BOARD OF HEALTH MEETING AGENDA DATE: February 24, 2016 TIME: 7:00 P.M. PLACE: Whitted Building, 3rd Floor Meeting Rooms 300 West Tryon Street Hillsborough, NC 27278 TIME ITEM 7:00 p.m. I. Welcome New Employees 7:00 — 7:05 II. Public Comment for Items NOT on Printed Agenda Public Comment for Items ON Printed Agenda will be handled during that agenda item (Please sign up for both on sheet near the entrance to room.) Please limit your comments to 3 minutes. 7:05 — 7:10 III. Approval of February 24, 2016 Agenda 7:10 — 7:15 IV. Actions Items (Consent) A. Minutes of January 27, 2016 7:15 — 8:15 V. Educational Sessions A. Family Success Alliance Update Meredith McMonigle B. Outside Agency Review Process La Toya Strange C. Annual Report Stacy Shelp D. Debt Set -Off Program Update Rebecca Crawford E. Population Health Dashboards Colleen Bridger 8:15 — 8:45 VI. Action Items (Non Consent) A. 2016 -2017 Budget Colleen Bridger 8:45 — 8:50 VII. Reports and Discussion with Possible Action A. Health Director Report Colleen Bridger B. Media Items 8:50 — 8:55 VIII. Board Comments 8:55 IX. Adjournment BOARD MEMBERS: To ensure a quorum, SEND E -MAIL to Istrange(a)_orangecountync.gov advising her of your attendance at this meeting OR CALL 919 - 245 -2411. Compliance with the "Americans with Disabilities Act" and Title VI - Interpreter services and /or special sound equipment are available on request. Call the Immigrant and Refugee Health Program Manager at 919.245.2387 to request an interpreter or other accommodation. Conforme a la "Ley sobre Estadounidenses con Discapacidades" (ADA) y el Titulo VI — los servicios de interprete y/o equipo de sonido especial estan disponibles a solicitud. Llame a la Administradora del Programa de Salud para Inmigrantes y Refugiados al 919 - 245 -2387 para solicitar un interprete u otros arreglos o adaptaciones. MINUTES -Draft ORANGE COUNTY BOARD OF HEALTH January 27, 2015 ORANGE COUNTY HEALTH DEPARTMENT MISSION STATEMENT: To enhance the quality of life, promote the health, and preserve the environment for all people in the Orange County community. THE ORANGE COUNTY BOARD OF HEALTH MET ON January 27, 2016, at the Orange County Health Department, 300 West Tryon Street, Hillsborough, NC. BOARD OF HEALTH MEMBERS PRESENT: Liska Lackey, Vice Chair; Nick Galvez — Vice - Chair, Commissioner Mia Burroughs, Barbara Chavious, Dan Dewitya, Susan Elmore, Jessica Frega, and Reena Mehta. BOARD OF HEALTH MEMBERS ABSENT: Paul Chelminski, Sam Lasris and Timothy Smith. STAFF PRESENT: Dr. Colleen Bridger, Health Director; Carmen Alvarez, Dental Office Assistant I; Coby Austin, Senior Health Public Educator; Alan Clapp, Environmental Health Director; Rebecca Crawford, Finance & Administrative Services Division Director; Brent Davis, Communications Specialist; Robin Gasparini, Nursing Supervisor; Carla Julian, Dental Clinic Manager; Donna King, Health Promotion & Education Services Director; Pam McCall, Public Health Nursing Director; Ashley Mercer, Healthy Carolinians Coordinator; Meredith Stewart, Public Health Program Manager; Allison Young, Health Informatics Manager and La Toya Strange, Administrative Assistant II. GUESTS PRESENT: None Welcome Liska Lackey, Chair, called the meeting to order. Dr. Bridger introduced new staff members: Carmen Alvarez, Dental Office Assistant I and Micah Guidon, (shared) Management Analyst. Public Comment for Items NOT on Printed Agenda: None III. Approval of the November 18, 2015 Agenda Motion was made by Dan Dewitya to approve the agenda, seconded by Susan Elmore and carried without dissent. IV. Action Items (Consent) A. Minutes Approval of November 18, 2015 Meeting Motion to approve Consent Agenda without corrections to the November 18, 2015 minutes was made by Barbara Chavious, seconded by Susan Elmore and carried without dissent. V. Educational Sessions A. State of the Science: E- Cigarette Aerosol S: \Managers Working Files \B0H \Agenda & Abstracts \2016 Agenda & Abstracts/ February Page 1 MINUTES -Draft ORANGE COUNTY BOARD OF HEALTH January 27, 2015 Dr. Johnathan Thornburg, Director of Exposure and Aerosol Technology, Research Triangle Institute International (RTI), began with a brief overview of electronic cigarettes. Electronic cigarettes, also known as e- cigarettes, are battery- operated products designed to deliver nicotine, flavor and other chemicals. They turn chemicals into an aerosol that is inhaled by the user. E- cigarettes were created in 2007 and have become a global health issue. They have attracted the attention of the World Health Organization but there still is very little information on them due to a lack of scientific evidence. They contain a wide range of additives, some of which can be transformed into carcinogens during the process of using the product. The engineering of e- cigarettes has rapidly evolved. In spite of this, there is still a risk of overheating if they are tampered with. E- cigarettes are the most prevalent tobacco product used by teenagers. Currently, there are about 450 companies in the United States with an estimated 7,500 different liquid flavors available for purchase. E- cigarettes liquids, which are comprised of propylene glycol and /or glycerin, are available with or without nicotine and can contain flavorings. Dr. Thornburg also described the structure of an e- cigarette and noted that they generate a mixture of vapors and aerosols. He also detailed the composition of e- cigarette emissions by chemical class which included nicotine, glycerin and glycol, alkylated cyclic compounds and phenolic compounds based on their presence in the gas, aerosol or bulk liquid form. When speaking about emissions and health implications, he noted that the particle size of their emissions, which is very small, determines where the particles deposit in the lungs. He continued by stating that the concentration determines how many particles deposit in the lungs. Size and concentration determine the toxicity of the particles inhaled by the user and included in secondhand exposure. The health effects and toxicity of nicotine are well known. In addition, the toxicity of some ingredients, such as flavors with diacetyls and cinnaldehyde, is based on industrial hygiene inhalation toxicology. However, the toxicity of other ingredients, as well as the acute and chronic impacts that result from inhalation of high concentrations of many e- liquid ingredients, are still largely unknown. About 50% of what is inhaled is exhaled. Approximately 47% of inhaled emissions are deposited into the lungs. Dr. Thornburg also mentioned that exhaled e- cigarette vapors from a single user were detected indoors as far as 6 feet away; concentrations were 25 times lower than adjacent to the user. He also stated that the tertiary effects such as exposure to nicotine or other components of e- cigarette emissions that deposit on surfaces have not been investigated. Lastly, Dr. Thornburg commented that there is still much unknown as science has not kept up with technology; however, the Food and Drug Administration (FDA) is currently funding research on e- cigarettes. The BOH members had several questions that were addressed by Dr. Thornburg. B. E- Cigarettes: Trends and Policy Options Coby Austin, Senior Public Health Educator, opened her presentation by providing an overview of the trends in adult and youth use of e- cigarettes. Some of the data Ms. Austin covered included: • About 16% of cigarettes smokers are "dual users" meaning that they may smoke cigarettes as well as e- cigarettes. • About 22% of former smokers now use e- cigarettes. • The percentage of long -term former adults who currently use e- cigarettes is 2.3 %. • Younger people are using e- cigarettes more than combustible, regular cigarettes. S: \Managers Working Files \BOH \Agenda & Abstracts \2016 Agenda & Abstracts/ February Page 2 MINUTES -Draft ORANGE COUNTY BOARD OF HEALTH January 27, 2015 • Combustible cigarette use is going down among North Carolina youth; however, tobacco use is increasing. That trend is driven by both e- cigarettes and hookah use. Next, Alejandra Camargo, TRU Co- President, Carrboro High School, shared her perspective and observations on e- cigarette use among teens. Ms. Camargo stated that it is a growing fad with posts on social media including vaping memes. She continued by stating that many of her peers don't think it's harmful and consider it a better alternative than combustible cigarettes. She noted that there isn't a label on them stating their ingredients. The advertisement of the wide selection of appealing flavors such as cookies and cream and chameleon are enticing to youth. Ms. Camargo also mentioned that many youth and adults are smoking in places where they shouldn't such as while riding on the transit bus and in the classroom. She hopes that a policy on e- cigarettes is created to deter this from continuing. Ms. Austin continued the presentation by providing an overview of the current governmental regulations. Only e- cigarettes that are marketed for therapeutic purposes are currently regulated by the FDA. The FDA has issued a proposed rule that would extend the agency's tobacco authority to cover additional products that meet the legal definition of a tobacco product, such as e- cigarettes, which would include requirements such as warning labels and for manufacturers to register with the FDA and seek the agency's review of new products. There are 8 states that include e- cigarettes in their smoke -free laws which mostly cover bars, restaurants and workplaces. Ms. Austin also noted that there is no statewide policy in North Carolina restricting e- cigarette use; however, there are more than 50 counties and municipalities in NC that prohibit e- cigarette use in or on government property. Lastly, Ms. Austin reviewed the potential exposure in public places. Although there is not research on e- cigarettes use patterns, she mentioned our best indicator is to look at what the research told us about exposure to secondhand smoke before it was regulated. For example, restaurants were a primary place of exposure for adults and children, especially those from non- smoking homes. Secondhand smoke exposure experienced by servers and bartenders was also a concern as the highest concentrations of nicotine measured in public places was found in bars and lounges. Potential policy options were presented to the Board of Health. Staff recommended developing a policy to prohibit use of e- cigarettes in indoor areas of bars and restaurants. The BOH members had several questions that were addressed by Ms. Austin and Dr. Bridger. Motion to pass the resolution to develop a policy to prohibit use of e- cigarettes in indoor areas of bars and restaurants was made by Susan Elmore, seconded by Reena Mehta and carried without dissent. C. 211d Quarter Financial Reports and D. 2tl Quarter Billing Dashboard Reports Rebecca Crawford, Finance & Administrative Services Division Director, gave a report on the 2nd quarter revenue and billing accuracy. Her report is as follows: • Total Health Department Revenue: Average YTD monthly revenue in FY16 after the 2nd Quarter is $236k /month or $1.49 million YTD, representing 47.7% of our overall budgeted revenue for the year. This is an increase from an average of $218k /month in FY15. Expenses were in line with revenues at 46.41 %. S: \Managers Working Files \BOH \Agenda & Abstracts \2016 Agenda & Abstracts/ February Page 3 MINUTES -Draft ORANGE COUNTY BOARD OF HEALTH January 27, 2015 • Total Billing Accuracy: Continuing with the goal of 90% billing accuracy set in FY 14 -15, the average billing accuracy rate for medical halfway through FY 15 -16 is 86% as compared to 92% in FY 14 -15 and the average rate for dental for FY 15 -16 is 97% as compared to 94% in FY 14 -15. • Dental Earned Revenue by Source: FY 15 -16 average monthly revenue ($39k /month) is slightly below our budget projection ($45k /month) but still above our FY 14 -15 average of $36k /month. FY 15 -16 dental revenue totaled $471 k at the end of the second quarter. Dental earned revenue will most likely continue to increase each month as our new dentist adds more clients to her schedule. Medical Earned Revenue by Source: Medical earned revenue is currently below the budgeted projection for FY 15 -16. The monthly average after the second quarter ($45k /month) is lower than FY15 ($50k /y) and our budget projection ($50k /month). This is mainly due to holding Maternal Health encounters for Global Billing (billing multiple encounters at the end of the pregnancy) and holding multiple program encounters until we come to a resolution with Medicaid of an acceptable method to bill same day appointments, which we resolved in late December. FAS anticipates the monthly average will be closer to the budget projection in subsequent quarters. The BOH members had questions that were addressed by Ms. Crawford and Dr. Bridger. VI. Action Items (Non- Consent) A. Safe Syringe Initiative Meredith Stewart, Public Health Program Manager, and Robin Gasparini, Nursing Supervisor, provided an overview of the OCHD Safe Syringe Initiative (SSI) and its benefits. As a result of the BOH's Substance Abuse & Mental Health subcommittee action step to research methods to reduce infections passed through drug misuse and abuse, an educational presentation on syringe exchange programs was provided to the Board by Tessie Castillo of the NC Harm Reduction Coalition in June 2015. Ms. Stewart and Ms. Gasparini's presentation is the result of a request from the Board directing staff to investigate the practicality and design to provide Orange County residents with access to safe syringes and disposal of used syringes. Ms. Stewart stated that some of the individual and community health benefits based on research and anecdotal evidence include decreasing the transmission of hepatitis C. Another benefit would be removing potentially infectious syringes from the community. The SSI would also provide syringes to diabetics patients that reuse syringes due to the cost and availability which in turn can decrease the incidences of needle breakage, lipodystrophy and tissue micro trauma. The initiative would also assist those that wish to purchase syringes but are unable due to some pharmacists' unwillingness to sell syringes. She also stated that it is very important to have local stakeholders on board with this initiative and mentioned that formal support from the district attorney and local law enforcement has been received. Ms. Gasparini reported on the four open sessions held to allow questions and feedback from clinical staff. Below are the highlights: About 25 staff attended with 100% supporting this initiative S: \Managers Working Files \BOH \Agenda & Abstracts \2016 Agenda & Abstracts/ February Page 4 MINUTES -Draft ORANGE COUNTY BOARD OF HEALTH January 27, 2015 • Staff favored a simple hand -off process without need to collect demographic data • Staff stressed the desire to publicize the program with community partners in Orange County • Staff expressed an interest in having a refresher on sharps and biohazard procedures Ms. Stewart concluded the presentation with the SSI operating procedures including the disbursement of the SSI kits. The operating procedures would be modeled after the way that condoms are presently dispersed which involves anonymity, allowing any person who asks to receive one. The SSI kits will be available at the front desk of both clinics. A safe syringe disposal will also be available at both clinics. Ms. Stewart also expressed that, following approval by the Board, the SSI will be operational no later than April 1, 2016 which would allow time for staff training and the supply provision. The BOH members had questions that were addressed by Ms. Stewart, Ms. Gasparini and Dr. Bridger. Motion to approve the implementation of the Safe Syringe Initiative was made by Jessica Frega, seconded by Nick Galvez and carried without dissent. VII. Reports and Discussion with Possible Action A. Innovation Grant Update Each year, staff submit innovative proposals to provide better care, better health and reduced healthcare costs for Orange County residents. The Board was provided a copy of the 2015 End of Year Report and the 2016 Grant Awards. Meredith Stewart mentioned that there were 24 new submissions out of which 10 projects were funded. She briefly reviewed some of the projects. The BOH members did not have any questions. B. Health Director Report In addition to the Health Director's report, Dr. Bridger briefly spoke about the Zika virus and the suggested actions that the Centers for Disease Control and the American Congress of Obstetricians and Gynecologists are recommending in regards to pregnant women who have traveled to any of the countries during any time of their pregnancy. The BOH members had questions that were addressed by Dr. Bridger. C. RWJF Culture of Health Nomination Dr. Bridger informed the Board that Coby Austin took the lead on phase one of the application process which the OHCD successfully passed. Phase two required a 4 minute video that offers a full picture of health improvement efforts and provides a visual introduction to Orange County. The video was shown to the Board. Dr. Bridger stated that Bonnie Hammersley, County Commissioner, has been asked to share the video with the BOCC. Phase three involves a site visit from the RWJF. S: \Managers Working Files \BOH \Agenda & Abstracts \2016 Agenda & Abstracts/ February Page 5 MINUTES -Draft ORANGE COUNTY BOARD OF HEALTH January 27, 2015 The BOH members did not have any questions. D. Media Items Media items were in the packet which focused on Orange County's events and our involvement in various efforts. VIII. Board Comments Liska Lackey, Chair, commended staff for incorporating so much information within a 2 hour timeframe. IX. Adjournment A motion was made by Susan Elmore to adjourn the meeting at 8:59 p.m., was seconded by Barbara Chavious and carried without dissent. The next Board of Health Meeting will be held February 24, 2016 at the Orange County Health Department, 300 West Tryon Street, Hillsborough, NC at 7:00 p.m. Respectfully submitted, Colleen Bridger, MPH, PhD Orange County Health Director Secretary to the Board S: \Managers Working Files \B0H \Agenda & Abstracts \2016 Agenda & Abstracts/ February Page 6 Agenda Item Number: ORANGE COUNTY BOARD OF HEALTH AGENDA ITEM SUMMARY Meeting Date: February 24, 2016 Agenda Item Subject: Project updates for the Family Success Alliance Attachment(s): 2015 Gap Analysis Report Staff or Board Member Reporting: Meredith McMonigle Purpose: Action X Information only Information with possible action Summary Information: Meredith McMonigle will provide updates on progress of the Family Success Alliance (FSA). FSA was created at the initiative of the Board of County Commissioners in June 2014 in response to a growing number of children and families living in poverty in Orange County. Drawing on evidenced -based models such as the Harlem Children's Zone and Promise Neighborhoods, FSA is working collectively with schools, community partners, faith -based groups, advocates and others to build a cradle to college and career pipeline of supports for children and families in two selected "zones "; one in the New Hope area south of Hillsborough and one in the downtown Chapel Hill /Carrboro area. Now in its second year, FSA successfully piloted a k- readiness program that served 67 incoming kindergarteners and hired a zone navigator team to engage directly with families. Nine service provider partners are offering additional wrap around services including ESL and GED classes, school -based mental health services and early education programs. Meredith will highlight plans for 2016 -2017 including expansion of out of school activities, increased enrolment in FSA and additional evaluation capacity to monitor project impact and outcomes. Recommended Action: Approve Approve & forward to Board of Commissioners for action Approve & forward to X Accept as information Revise & schedule for future action Other (detail): III FAMILY SUCCESS ALLIANCE Ruilding a Pipeline of Success From Cradle to College and Career http: / /www.orangecountync.gov /departments /health /FSA.php Speaker Name & Title Orange County � 4 s ' —' A � I� Family Success Alliance ZONE 62'_ r s �1MAb to a Q; Family Success Alliance r ZONE 4 Orange County � 4 s ' —' A � I� Family Success Alliance ZONE 62'_ r k\L Children & Youth Families & Children are youth are graduate neighborhoods healthy & healthy & from high support the prepared for succeed in school & healthy school school college development of children 0 k1ft q', FAMILY SUCCESS Ar ALLIANCE A stronger pipeline... http: / /www.orangecountync.gov /departments /health /FSA.php r�� A h0N hRo 04t d r�� d 'Iie, CIO/,/) ofs ors s choo/ d oy T/� FSA Supported Programs s Services by Community Partner Collaboration Agencies S S 0 k1ft FAMILY SUCCESS Ar ALLIANCE Our partners... United Way Service Partners • Boomerang • Chapel Hill- Carrboro Public Schools Foundation • Childcare Services Assoc. • Compass Center • EI Futuro • Girl Scouts • Kidscope • Orange Literacy • Volunteers for Youth http: / /www.orangecountync.gov /departments /health /FSA.php Advisory Council • Cardinal Innovations • Chapel Hill /Carrboro City Schools • Chapel Hill Training/ Outreach Project • Compass Center • EI Futuro • Empowerment, Inc. • Interfaith Council • OC Board of Commissioners • OC Board of Health • OC Dept. of Social Services • OC Health Dept. • OC Housing & Human Rights • OC Literacy Council • OC Partnership for Young Children • OC Sheriff's Dept. • Orange Congregations in Mission • Orange County Schools • Town of Carrboro • Town of Chapel Hill • Town of Hillsborough • UNC Health Care • United Way of the Greater Triangle • Zone Representatives 1j A SUCCESS ALLIANCE �i qL IVI FAMILY SUCCESS ALLIANCE The Family Success Alliance (FSA) was formed in respo as a collaboration of leaders from local government, no and the community who envision an Orange County wi and families have the opportunity to succeed in school Our work is based on national models such as the Harle Children's Zone and the Promise Neighborhoods, the data presented in this report, and input from communil members from each zone. Photos courtesy Chapel Hill- Carrboro City 2 /� Schools and Orange County Schools. Obstacles and Opportunity In Orange County, we take pride in our community's rich history, natural beauty, and world -class education. We are a community where people choose to live and raise their families. If there is one thing families in Orange County have in common, it is the hope that they can pay their bills, put healthy food on the table, keep their children safe, and see them grow up to succeed in school and life. Yet, in Orange County, we're seeing discouraging trends in our families' ability to realize their dreams. More children are living in poverty, more babies are being born too small, fewer low- income children have health insurance, and large differences in reading and writing achievement remain. This is especiallytrue for African - American and Latino children and families. As the data and stories in this report show, Orange County is a community of great more than 4,600 prosperity but even greater economic disparities, with over 4,600 children living chiddren in poverty in 2077. When significant inequality exists, and families struggle to make ends meet, it impacts our children now, and throughout their lives. Research has proven that adverse experiences in childhood affect the way children's brains in poverty in 2011 form and will ultimately impact their future prosperity and health. in Orange County This matters not only for those children, but also their families, and the entire community if our goal is to continue as a vibrant, prosperous community that supports and provides opportunities for everyone. qL IVI FAMILY SUCCESS ALLIANCE The Family Success Alliance (FSA) was formed in respo as a collaboration of leaders from local government, no and the community who envision an Orange County wi and families have the opportunity to succeed in school Our work is based on national models such as the Harle Children's Zone and the Promise Neighborhoods, the data presented in this report, and input from communil members from each zone. Photos courtesy Chapel Hill- Carrboro City 2 /� Schools and Orange County Schools. The Pipeline from Cradle to College and Career FSA works towards four main goals for children and families along the path from cradle to college and career: • Children are healthy and prepared for school, • Children and youth are healthy and succeed in school, • Youth graduate from high school and college, • Families and neighborhoods support the healthy development of children. Family Success Alliance began our work by selecting two pilot zones (see maps) to strengthen the pipeline of high - quality, connected support systems to aid children and families in thejourney from cradle to college and career. After the selection of FSA's two pilot zones, staff and community members set to work on a gap analysis of the state of the pipeline in both zones. This report is a summary of the key findings from interviews, focus groups, and community surveys conducted as part of this process. The voices of 62 youth, parents, and service providers are represented here, along with data from 131 community surveys. More detailed reports on each piece of the gap analysis will be made available on the FSA web page. www.orangecountync.gov /departments /health /FSA.php ZONE4 Southern Hillsborough ZONE 6 Chapel Hill and Carrboro Throughout the report you'll find these symbols to describe the rating for each goal. They are a qualitative ranking of priority and need based on interviews, focus groups, and survey data. Zones voted on their priorities after seeing the qualitative and quantitative data. These final priorities are presented on page 11. a O Community Priority Availability /Accessibility Rating Rating Green Yellow Red Needs are met Needs partially met Needsarenotmet FAMILY SUCCESS ALLIANCE: 2015 GAP ANALYSIS REPORT 3 GOAL 1: Children are healthy and prepared for school. Why does this matter? Making sure children are healthy and well - prepared for school is more than packing their backpacks and lunches the first day of school. It means ensuring that children have strong, stable relationships with adult caregivers, receive recommended routine health check -ups, are screened to ensure physical and emotional development is on track, and have access to high - quality childcare and early childhood experiences. ZONE 4 The most common issues in Zone 4 related to Goal 1 were affordable, quality childcare and school readiness. Childcare Community members and service providers indicated childcare is too School readiness Readiness was a high priority for Zone 4 community members. Parents expensive and there are too few licensed childcare providers in the zone. the zone, promoting early literacy in the home, and for parent education Of the 57 survey respondents from Zone 4, over half disagreed or strongly Community Priority disagreed that, "This neighborhood has good resources for parents, like good Community Priority Rating childcare that is affordable." Quality, affordable childcare also received the Needsarenotmet second highest number of votes (23) from Zone 4 survey respondents about the top three programs that are missingfor children in the zone. QLack of childcare at programs or events was also discussed as a reason parents Availability /Accessibility do not utilize existing resources because "...by the time [a parent] gets Rating their child to preschool, and then travels an hour to a location on public Needs are not met transportation, they can't be there for the whole class because they have to spend another hour going back. So, there seems to be a lack of childcare that they could then extend their time, or to take part in some other offerings, whether it's ESL, or a parenting class." (Zone 4 Provider) School readiness Readiness was a high priority for Zone 4 community members. Parents 4 Ar C Ar expressed support for expanding pre- kindergarten (pre -k) enrollment in the zone, promoting early literacy in the home, and for parent education classes and developmental screenings. Teachers and service providers also Community Priority Rating discussed that they see children arriving at school with academic deficits and Needsarenotmet are then playing catch -up. There are existing, quality preschool programs in and around Zone 4, like NC Pre -K at New Hope Elementary and Orange County Head Start /Early Head start in Fairview, but many respondents Availability /Accessibility discussed challenges to enrolling and staying enrolled, like not knowing about Rating Needs partially met the resources, lack of reliable transportation, and childcare that is not full day or year- round. 4 Ar C Ar [Childcare is] really the issue here. The families / work with, when a parent is working, the children are usually with a relative. They're not in an enriched environment. (Zone 6 Service Provider) ZONE 6 The most talked about issues in Zone 6 related to Goal 1 were the need for affordable quality childcare and school readiness. Childcare was the most frequently raised issue related to early childhood in Zone 6. Low -cost options like the Chapel Hill- Carrboro City Schools (CHCCS) Head Start were mentioned as great resources, but many people don't meet the income requirements and cannot pay for quality childcare. Of the 34 survey respondents from Zone 6, 62% disagreed or strongly disagreed that, 'This neighborhood has good resources for parents, like good childcare that is affordable." Like Zone 4, quality, affordable childcare also received the second highest number of votes (15) from Zone 6 survey respondents about the top three programs that are missing for children in the zone. "A shift we have seen is that many families are over income to qualify for Head Start. The poverty guidelines for Head Start are very low. l think because of where we live this is not realistic. So there might be a family of 6 making $35,000. They might be just above the guidelines, but they are barely making ends meet because of where they live. They can't afford it but they don't qualify." (Zone 6 Provider) School readiness was a high priority for Zone 6 community members. At zone prioritization meetings, participants expressed the most support for expanding access to summer support programs for incoming kindergarteners, promoting early literacy in the home, and parent education classes. There are existing quality programs in and around Zone 6, but respondents discussed challenges similar to those mentioned for childcare. These include a need for transportation, knowledge of resources, childcare full day and year- round, and financial assistance. "It would make a big difference for child success if there was more involvement for kids, something structured starting at an early age. When my children were preschoolers, it was hard to find activities for them." (Zone 6 Parent) Childcare a Community Priority Rating Needs are not met O Availability /Accessibility Rating Needs partially met School readiness a Community Priority Rating Needs are not met Availability /Accessibility Rating Needs partially met EFAMILY SUCCESS ALLIANCE: 2015 GAP ANALYSIS REPORT 5 W GOAL 2: Children and youth are healthy and succeed in school. Why does this matter? If a student is on track in reading when they are in the third grade, they are four times more likely to leave school with a diploma than students not proficient by third grade in reading. Moreover, proficiency in 8th grade math skills forms a foundation for success in high school and beyond. Reading and math scores for zone schools reveal disparities based on income and race /ethnicity. Factors that contribute to increasing academic skills include school attendance, out -of- school time learning, quality teaching, healthy food and physical activity, strong family and peer relationships, and school policies that create equity, like access to advanced programs. ZONE4 The most common issues in Zone 4 related to Goal 2 were Out -of- School Support, Communication, and Transportation. Out-of-School Overall, parents and youth spoke highly of the support, resources, and teaching provided by the schools in Zone 4. Still, respondents in Zone 4 suggested a need Support for more out -of- school support, such as consistent and high quality academic support, mentoring, afterschool and summer programs, and programs to help Community Priority Rating Needs are not met parents interact with their children and strengthen skills being learned duringthe school day. Teachers reinforced the need for this support, acknowledging that: Availability /Accessibility O Rating Needs are not met 'Something that's a struggle for [middle school students] is a lack of basic skills.... It's very common for us to see sixth, seventh, and eighth grade students reading at a first second or third grade reading level. It's evident in every subject. " (Zone 4 Provider) Support for this kind of out -of- school support was also evident in survey responses, with respondents ranking mentoring opportunities, academic support and enrichment, and afterschool programs all as priorities and as missing from Zone 4. Communication School personnel and service providers discussed a need to improve communication with families. Respondents praised existing assets, like Community Priority Rating New Hope's ESL staff person, and requested increased efforts to promote Needs are not met cross - cultural understanding between school personnel and Hispanic /Latino Availability /Accessibility families. Parents expressed that sometimes schools do not send notices in a Rating timely manner to coordinate work schedules or send the information only Needs partially met in English. Transportation Parents and many other respondents said lack of transportation is a significant barrier to student participation in afterschool programs and out Community Priority Rating of school opportunities such as library programs and camps. Respondents Needsarenotmet described wantingtheir children to participate in programs, but being unable to Availability /Accessibility because of lack of transportation to and from the program and programs ending Rating O earlier than they can pick up due to work schedules. Needs are not met 6 . ZONE 6 The most talked to Uoal 2 were Uut- ot- Scnool Support and Communication. Respondents overwhelmingly expressed that Zone 6 has a strong school district with quality teachers and supportive adults. However, respondents said that "we do a goodjob of schooling but not supporting kids outside of school." Youth, parents, and service providers all pointed to adolescents' need for a place for constructive, safe activities outside of school. "What we do have is a large number of really dedicated service providers providing small bits of service all over the county, but they're isolated. If a kid wants to go to tutoring and then hang out and play basketball afterwards, there's no space for them to do both of those things. If they have to choose between basketball and tutoring, they might choose basketball, and if we could have them do both, that would be great." (Zone 6 Respondent) Parents also discussed the need for academic support, like one -on -one tutoring, especially for reading. Respondents described that poor communication from schools to parents was a problem and that high schools in particular should do a betterjob engaging parents. Also, respondents remarked on the fact that non - academic supports provided through the schools decreased as youth got older. "When [my] children were in elementary school, the school social workers were great. After that, there was a big gap, with no one to help." (Zone 6 Parent) Out- of -Schoo Support Community Priority Rating Needs are not met Availability /Accessibility Rating Needs partially met Communication Community Priority Rating Needs partially met Availability /Accessibility Rating Needs partially met . FAMILY SUCCESS ALLIANCE: 2015 GAP ANALYSIS REPORT 7 GOAL 3: Youth graduate from high school and college. Why does this matter? There is no single indicator that describes whether a young person has received an effective education. America's Promise Alliance describes nine essential components, including a positive and safe school climate, a culture of academic achievement, strong peer relationships, parent engagement, and adult guidance on higher education and careers as essential components. While having a high school diploma is no longer a guarantee of getting a well- payingjob, it is a strong predictor of success later in life and a requirement for securing the necessary post- secondary training to compete in our high tech, creative economy. ZONE4 Interview and focus group participants in Zone 4 did not focus on issues pertaining to graduation from high school or college. However, "College and Career Preparation" was the top choice by survey respondents as both a priority program and a program that is missing in Zone 4. ZONE6 The most talked about issue in Zone 6 related to Goal 3 was College /Career Preparation. College /Career Preparation Community Priority Rating Needs are not met Respondents said that high school students would benefit from more guidance on how to be successful in school and prepare for college or a career. Suggestions included expanding the AVID program, providing assistance to students and their parents on how to apply to and pay for college, and helping youth obtain work experience and "real world" skills such as completing applications and managing money. Availability /Accessibility "Having someone guide the children... high school is a whole other world. Rating Ifyou don't have a parent who went to school here or who understands it... Needs partially met you need the support [for knowing] how to apply to college or sign up for the Princeton Review. "(Zone 6 Respondent) A number of challenges to high school and college success were discussed by participants, includingfew chances for work experiences in high school and difficulty payingfor college, especiallyfor immigrant youth whose legal status means they cannot receive certain funding assistance. "Mink "Youth graduate from high school and college" is the worst [section of the pipeline]. There is a lot of attention put on [young people] to graduate but not what to do before that time... Without opportunities to work, they just sit around [playing video games]. This also affects how they view college, affecting even the purpose of going. Having more employment opportunities will fulfill some sort of self -worth and value. They can gain the independence to feel successful in college and the workplace." 8 Ar i E GOAL 4: Families and neighborhoods support the healthy development of children. Why does this matter? Children living in poverty face more adversity such as exposure to violence, food insecurity, and higher rates of mental health issues. Poverty in and of itself is considered a "toxic" stressor. In an era of growing income inequality, a wealthy, prosperous place like Orange County cannot afford to leave behind so many of its residents. Social mobility requires opportunity, and opportunity requires that the whole community work together to realize the potential for all of our children. ZONE 4 The most talked about issues in Zone 4 related to Goal 4 were Support for Families and Support for Latino Families. Several respondents ta I ked about the difficulties that low-income families Family Support and children confront including the inability to meet their basic needs, like having enough food to eat. Participants said that families struggle to pay their Community Priority Rating Needs are not met bills and do not have enough money to meet their children's basic needs. In addition to financial resources, respondents said that low- income parents O Availability /Accessibility face additional obstacles that hinder their ability to support their children Rating Needs are not met such as limited transportation, stress, and exhaustion The main desires discussed for Zone 4 were related to increased access to resources, either through transportatic zone or increased resources like a corr described ideal additions to their comr • At least one park and a pool • Affordable arts, sports, exercise, c • Transportation for activities • A resource like El Centro Hispano closer to Zone 4 Zone 4 responses continued on page • e Goal 4: Families and neighborhoods support the healthy development of children. ZONE4 The most talked about issues in Zone 4 related to Goal 4 were Support for Families and Support for Latino Families Support for Participants recognized unique challenges faced by Latino families in Zone 4. They said that Spanish- speaking parents have a difficult time helping their Latino Families children with their homework because of the language barrier. Another reported challenge was that parents sometimes rely on their children's English skills to Community Priority Rating meet their basic needs (e.g., translate a school or medical form). One respondent Needsarenotmet described that parents are working to better support their children academically Availability /Accessibility O by taking ESL classes. Rating In addition, participants described that state and federal immigration policies Needs partially met have a negative impact on families and children. Families who are undocumented do not have access to affordable health care, mental health services, adult education, and have limitedjob opportunities. It was reported that fear of deportation prevents parents from participating in school activities, for example, for fear of law enforcement checkpoints in Zone 4. ZONE6 The most talked about issues in Zone 6 related to Goal 4 were Basic Needs, Economic Disparities and the Achievement Gap, and Family Support Basic Need s Nearly every interviewee and focus group participant discussed the challenges that families in Zone 6, who live in or at risk for poverty, face in meetingtheir basic Community Priority Rating needs, including housing, transportation, financial stability, and access to medical Needsarenotmet and mental health services. Overwhelmingly, though, lack of affordable housing Availability /Accessibility 0 O was cited as a problem in the zone that affects the wellbeing of children and Rating families. Closer to downtown, development and high numbers of rentals by Needsarenotmet university students, 'brings a sense of disconnection, because there are no long lasting, caring neighbors. Disconnection is damaging for kids. Young kids feel like they are living in this vacuum, nobody is aware of who they are or what they are doing." (Zone 6 Respondent). Several mothers from Carrboro described needing to move farther from downtown due to housing costs, which in turn makes transportation more challenging. Parents and service providers outlined the ways that differences in income hinder children's academic success. One example is that schools make assignments that require computers and Internet, which not all children have access to at home. Many participants also called for more affordable afterschool options, summer enrichment, and community recreational activities for children and youth. 0 1_ 9� ZONE 6 Several participants felt that parents needed support and resources in the form of classes or mentors to help them increase their parenting skills and understanding of child development as it relates to academic success. For example, participants said that some parents do not understand the importance of reading to or engaging with (e.g., talking positively) their children. Respondents recommended more parenting classes (such as "The Incredible Years ") at a variety of times during the day and expanding mentor programs for children and parents. Family and parent support are also important when language barriers prevent parents from helping their children with school work, and inhibit communication with school and community service providers. This can create difficulties between children and parents. Zone Priorities The information discussed here was presented back to parents, service providers, and other community members at zone meetings in April 2015. Participants then completed a voting process to pick priorities to guide the Family Success Alliance to initial areas for action. I What �hallen8es are families facing in your community? Ins�a(re� r�yl ab' Nan ... Sparking Collective Action from Cradle to College and Career Family Support Community Priority Rating Needs are not met OAvailability /Accessibility Rating Needs are not met ZONE 4 Priorities Transportation Kindergarten Readiness Childcare Family Support ZONE 6 Priorities Housing Family Support Kindergarten Readiness Childcare As one participant in the gap analysis stated, "We dream big for our kids. We want them to have success in life, health, happiness, and safety, plus the ability and opportunity to live up to their full potential." We know the stakes are high for our children and we're ready to respond. Community members, service providers, schools, elected leaders, parents —we all have a role to play in dramatically increasing academic success and health for families struggling to make ends meet in Orange County. Join us in this effort as we embark on year two of the Family Success Alliance. FAMILY SUCCESS ALLIANCE: 2015 GAP ANALYSIS REPORT 1 1 . W \n. Agenda Item Number: ORANGE COUNTY BOARD OF HEALTH AGENDA ITEM SUMMARY Meeting Date: February 24, 2016 Agenda Item Subject: FY 2016 -2017 Outside Agency Funding Application Evaluation Process Attachment(s): Application Process, Advisory Board Evaluation and Scorecards Staff or Board Member Reporting: La Toya Strange Purpose: _X Action Information only Information with possible action Summary Information: A review along with a completed scoring sheet needs to be available to the Health Director for presentation to the County Manager when the departmental budget is presented for her review. The Health Department received 7 applications. We need 3 groups with 2 -3 BOH members to carefully review and score the applications. The applications, financial information, score cards, and instructions are on the Board of Health Webpage link, http:// www. orangecountVnc. qov/ V. B.% 20Outside% 20Agency %20Review %20Process.pdf The scorecards will need to be sent back to La Toya Strange by Friday, March 18, 2016. Financial Considerations: There is no immediate financial consideration with performing this task. Applicants Compass Center for Women and Families Duke Homecare & Hospice OC Disability Awareness Council OC Rape Crisis Center Piedmont Health Services, Inc. (contract with department) Planned Parenthood BOH Reviewers Liska Lackey, Nick Galvez, Susan Elmore Susan Elmore, Timothy Smith, Jessica Frega Barbara Chavious, Paul Chelminski Reena Mehta, Dan Dewitya, Nick Galvez Sam Lasris, Dan Dewitya, Barbara Chavious Liska Lackey, Timothy Smith, Reena Mehta United Way of Greater Triangle Sam Lasris, Jessica Frega, Paul Chelminski Recommended Action: _Approve _Approve & forward to Board of Commissioners for action _Approve & forward to _X Accept as information _Revise & schedule for future action _Other (detail): Recommended Action: _Approve _Approve & forward to Board of Commissioners for action _Approve & forward to _X Accept as information _Revise & schedule for future action _Other (detail): ORANGE COUNTY NORTH CAROLINA FINANCE AND ADMINISTRATIVE SERVICES 200 South Cameron Street Post Office Box 8181 Hillsborough, North Carolina 27278 To: Orange County Advisory Boards Groups From: Allen Coleman, Budget and Administrative Coordinator Date: February 12, 2016 Phone (919) 245 -2151 Fax (919) 644 -3324 Email: acoleman @orangecountync.sov Re: FY 2016 -17 Outside Agency Funding Application - Evaluation Process Thank you for your participation in this year's Outside Agency funding evaluation process. Your feedback is critical in assessing program performance, potential success and making funding recommendations. This memo provides background information and guidelines to aid Advisory Board evaluation of FY 2016 -17 funding requests. Advisory Board members should carefully review these procedures and selection criteria prior to application review. Please email application scorecards and written feedback. in MS Excel format. by Thursday. March 24, to acolemanOorangecountync.gov. I. FUNDING PROCESS OVERVIEW Application Process: On December 2, 2015, Orange County, in collaboration with the Towns of Carrboro and Chapel Hill, opened the FY 2016 -17 funding process, with a deadline of January 25, 2016. This year all three jurisdictions used the same funding application. In total, 58 agencies submitted funding requests totaling $1,532,558, an increase of $404,243 above the current year's appropriation. Advisory Board Evaluation: Seven Advisory Boards and Committees review funding applications, for program content and viability, in February and March. While funding recommendations (i.e. dollar amounts) are not provided, the groups can share whether they think a group should or should not receive funding. Finance and Administrative Services reviews the supplemental documentation and prior agency performance, for currently funded agencies. County Manager Evaluation and Recommendation: In April, the County Manager, reviews Advisory Board feedback and consults with the Department Directors. The County Manager also reviews the agencies' applications, particularly the funding request rationales. Funding recommendations are included in the Manager's Recommended Operating Budget, published in May. Board of County Commissioner's (BOCC) Decision: Two Budget Public Hearings, in May, provide direct engagement opportunities for outside agency staff and supporters. The BOCC will also discuss funding, during a June Budget Work Session. Final funding decisions will be included in the FY 2016- 17 Approved Operating Budget, adopted in late June. II. ADVISORY BOARD EVALUATION PROCESS Scorecards. Advisory Boards should review Funding Applications, only. However, agency supplementary materials are available, if they help you to understand information within the application. Advisory Boards will assess the applications using the Application Scorecard, which rates the program's mission (Section I), customer value (Section II), prior year results (Section III) and implementation plan (Section IV). The first worksheet in the Application Scorecard file explains how the scorecard should be completed. Please complete the Scorecard in MS Excel format. as it will tally the scores for you. Also. include any written feedback on this form. Written Feedback: This year we highly encourage additional feedback. Written feedback enhances the ratings, and is helpful to the County Manager. In addition, the BOCC often asks about advisory board feedback, during their deliberations. However, please note that scorecards and feedback are public record information, so be mindful in how you construct your comments. • Points Distribution: A few of the application questions and sections have changed since last year. To accommodate changes to the application, as well as the rescaled scorecard, the point distribution was altered in each section. BOCC Funding Checklist: When scoring applications and providing feedback, please also consider the BOCC Funding Checklist. The checklist identifies priority areas the BOCC deems critically important, during outside agency review. The checklist is located within the Application Scorecard file. III. FILE LOCATIONS • All files can be found on the Countywide T Drive (T Drive 4 Outside Agencies 42016 -171 unless otherwise specified by your Lead Evaluator. Applications (2016- 174Submitted Applications) Each agency has a folder; within each folder, is an Application folder that contains an agency's funding application files. The files can take various forms, but most will be in MS Word (funding application) and MS Excel (agency and program budgets) formats. Agencies must submit a single agency budget and separate program budgets for each program outlined in its funding application. Evaluation Materials (2 016-174 Evaluation Materials) In this folder, Advisory Boards can find the Evaluation Group Assignments, a funding request list and the Application Scorecards /BOCC Checklist. Miscellaneous (2016 -174 Miscellaneous) This folder contains blank copies of the application forms, application instructions and orientation materials, for your reference. FY 2016 -17 Outside Agency Funding Requests In FY 2015 -16, the Board of County Commissioners (BOCC) appropriated $1,128,315 for 46 agencies, an increase of $122,715 above the FY 2014 -15 appropriation. Outside Agency FY 2015 -16 Approved Budget FY 2016 -17 Agency Request Change from Approved Budget A Helping Hand 2,000 8,000 6,000 Behavioral Insights, Inc. - 142,760 142,760 Big Brothers Big Sisters of the Trianlge 2,000 6,000 4,000 Boys and Girls Club of Eastern Piedmont - 10,000 10,000 Bridge II Sports 2,500 8,000 5,500 Centre for Homeownership & Economic Develon 22,000 - (22,000 Chapel Hill /Carrboro Meals on Wheels 10,000 15,000 5,000 Chapel Hill/ Carrboro YMCA - Boomerang 5,000 10,000 5,000 Charles House 15,000 20,000 5,000 Child Care Services Association - 35,000 35,000 Club Nova 75,000 95,000 20,000 Communities in Schools of Orange County 78,800 78,800 - Community Empowerment Fund 7,500 7,500 - Community Home Trust 231,000 200,026 30,974 Compass Center for Women and Families 64,500 64,500 - Dispute Settlement Center 76,000 80,000 4,000 Duke Homecare & Hospice 1,000 1,000 - EI Centro Hispano 20,000 37,620 17,620 El Futuro 27,500 27,500 - EmPOWERment 20,000 25,000 5,000 Fairview Community Watch* 4,000 6,000 2,000 Farmer Foodshare 5,000 2,500 (2,500 Freedom House 29,000 30,000 1,000 Habitat for Humanity 20,000 25,000 5,000 Hillsborough Arts Council - 15,000 15,000 Historic Hillsborough Commission 7,000 8,857 1,857 Historical Foundation 6,000 6,600 600 Housing for New Hope 22,000 22,500 500 Human Rights Center 1,000 2,000 1,000 Interfaith Council 44,000 50,000 6,000 KidSCope 75,000 75,000 - FY 2016 -17 Outside Agency Funding Requests Outside Agency FY 2015 -16 Approved Budget FY 2016 -17 Agency Request Change from Approved Budget Ligo Dojo of Budo Karate 2,000 2,000 - Marian Cheek Jackson Center 8,000 10,000 2,000 Mental Health America of the Triangle - 17,000 17,000 OC Disability Awareness Council 4,000 10,000 6,000 OC Literacy Council 12,000 15,000 3,000 Orange County Living Wage - 16,750 16,750 OC Partnership for Young Children 2,000 5,000 3,000 OC Rape Crisis Center 30,000 35,000 5,000 OE Enterprises, Inc. 45,100 51,100 6,000 Orange Congregations in Mission Samaritan Rel 33,415 33,415 - Orange Congregations in Mission Meals on Whe 17,000 17,000 - Piedmont Health Services, Inc. 10,000 11,000 1,000 Piedmont Wildlife Center 2,000 5,000 3,000 Planned Parenthood 20,000 20,000 - Public Gallery of Carrboro dba WCOM -LP Radio - 1,000 1,000 Rebuilding Together of the Triangle - 30,000 30,000 Rogers Eubanks Road Neighborhd Assoc. 20,000 20,000 - Senior Care of Orange County 25,000 30,000 5,000 TABLE - 10,000 10,000 The Arc of Orange County 5,000 6,000 1,000 The ArtsCenter 7,000 10,000 3,000 The Exchange Club Child Abuse Prevention Ctr. 2,000 10,350 8,350 The Institute of Art Therapy 1,000 5,000 4,000 Triangle Bikeworks - 1,000 1,000 United Way of the Greater Triangle - 16,030 16,030 Voices Together 10,000 15,000 5,000 Volunteers for Youth - 10,000 10,000 Youth Community Project - 4,750 4,750 Total $ 1,128,315 $ 1,532,558 $ 404,243 This is a new agency that did not apply for funding in 2015 -16 This is an unfunded agency which did apply in 2015 -16 This agency has submitted two applications this year, rather the one that they submitted in the past This agency was formerly called Pre -Trial Services, not funded in FY 2015 -16. The County Manager's Office oversees the Pre -Trial Services program. FY 2016 -17 Orange County Outside Agency Funding Advisory Board Assignments Aging Advisory Board /Janice Tyler 1. A Helping Hand 2. Chapel Hill /Carrboro Meals on Wheels 3. Charles House 4. Senior Care of Orange County DEAPR Advisory Boards /Dave Stancil 1. Big Brothers Big Sisters of the Triangle 2. Boys and Girls Club of Eastern Piedmont 3. Bridge II Sports 4. Fairview Community Watch 5. Historic Hillsborough Commission 6. Historical Foundation 7. Piedmont Wildlife Center 8. Triangle Bikeworks 9. Youth Community Projects Employee Committee /Perdita Holtz 1. Communities in Schools of Orange County 2. El Centro Hispano 3. Farmer Foodshare 4. Hillsborough Arts Council 5. OC Literacy Council 6. OC Living Wage 7. Public Gallery of Carrboro dba WCOM -LP Radio 8. Rogers Road - Eubanks Neighborhood Association (RENA) 9. The ArtsCenter OPC Mental Health 1. Club Nova 2. EI Futuro 3. Freedom House 4. KicISCope 5. Mental Health America of the Triangle 6. OE Enterprises, Inc. 7. The Arc of Orange County 8. The Institute of Art Therapy 9. Voices Together Health Advisory Board /Colleen Bridger 1. Compass Center for Women and Families 2. Duke Homecare & Hospice 3. OC Disability Awareness Council 4. OC Rape Crisis Center 5. Piedmont Health Services, Inc. (Contract with Department) 6. Planned Parenthood 7. United Way of Greater Triangle Housing & Human Relations Advisory Boards /Audrey Spencer - Horsley 1. Community Empowerment Fund 2. Community Home Trust (Contract with Department) 3. EmPOWERment 4. Habitat for Humanity 5. Housing for New Hope 6. Human Rights Center (Human Relations) 7. Marian Cheek Jackson Center (Human Relations) 8. Rebuilding Together of the Triangle Social Services Advisory Board /Nancy Coston 1. Behavioral Insights, Inc. 2. Chapel Hill/ Carrboro YMCA Boomerang 3. Child Care Services Association 4. Dispute Settlement Center 5. Interfaith Council 6. Ligo Dojo of Budo Karate 7. OC Partnership for Young Children 8. Orange Congregations in Mission (OCIM) — Samaritan Relief 9. Orange Congregations in Mission (OCIM) — Meals on Wheels 10. TABLE, Inc. 11. The Exchange Club Child Abuse Prevention Center 12. Volunteers for Youth, Inc. Notes: • Applications are located on the T Drive (Outside Agencies 4 2016 -17 Folder). FY 2016 -17 Outside Agency Funding Requests In FY 2015 -16, the Board of County Commissioners (BOCC) appropriated $1,128,315 for 46 agencies, an increase of $122,715 above the FY 2014 -15 appropriation. Outside Agency FY 2015 -16 Approved Budget FY 2016 -17 Agency Request Change from Approved Budget A Helping Hand 2,000 8,000 6,000 Behavioral Insights, Inc. - 142,760 142,760 Big Brothers Big Sisters of the Trianlge 2,000 6,000 4,000 Boys and Girls Club of Eastern Piedmont - 10,000 10,000 Bridge II Sports 2,500 8,000 5,500 Centre for Homeownership & Economic Develon 22,000 - (22,000 Chapel Hill /Carrboro Meals on Wheels 10,000 15,000 5,000 Chapel Hill/ Carrboro YMCA - Boomerang 5,000 10,000 5,000 Charles House 15,000 20,000 5,000 Child Care Services Association - 35,000 35,000 Club Nova 75,000 95,000 20,000 Communities in Schools of Orange County 78,800 78,800 - Community Empowerment Fund 7,500 7,500 - Community Home Trust 231,000 200,026 30,974 Compass Center for Women and Families 64,500 64,500 - Dispute Settlement Center 76,000 80,000 4,000 Duke Homecare & Hospice 1,000 1,000 - EI Centro Hispano 20,000 37,620 17,620 El Futuro 27,500 27,500 - EmPOWERment 20,000 25,000 5,000 Fairview Community Watch* 4,000 6,000 2,000 Farmer Foodshare 5,000 2,500 (2,500 Freedom House 29,000 30,000 1,000 Habitat for Humanity 20,000 25,000 5,000 Hillsborough Arts Council - 15,000 15,000 Historic Hillsborough Commission 7,000 8,857 1,857 Historical Foundation 6,000 6,600 600 Housing for New Hope 22,000 22,500 500 Human Rights Center 1,000 2,000 1,000 Interfaith Council 44,000 50,000 6,000 KidSCope 75,000 75,000 - FY 2016 -17 Outside Agency Funding Requests Outside Agency FY 2015 -16 Approved Budget FY 2016 -17 Agency Request Change from Approved Budget Ligo Dojo of Budo Karate 2,000 2,000 - Marian Cheek Jackson Center 8,000 10,000 2,000 Mental Health America of the Triangle - 17,000 17,000 OC Disability Awareness Council 4,000 10,000 6,000 OC Literacy Council 12,000 15,000 3,000 Orange County Living Wage - 16,750 16,750 OC Partnership for Young Children 2,000 5,000 3,000 OC Rape Crisis Center 30,000 35,000 5,000 OE Enterprises, Inc. 45,100 51,100 6,000 Orange Congregations in Mission Samaritan Rel 33,415 33,415 - Orange Congregations in Mission Meals on Whe 17,000 17,000 - Piedmont Health Services, Inc. 10,000 11,000 1,000 Piedmont Wildlife Center 2,000 5,000 3,000 Planned Parenthood 20,000 20,000 - Public Gallery of Carrboro dba WCOM -LP Radio - 1,000 1,000 Rebuilding Together of the Triangle - 30,000 30,000 Rogers Eubanks Road Neighborhd Assoc. 20,000 20,000 - Senior Care of Orange County 25,000 30,000 5,000 TABLE - 10,000 10,000 The Arc of Orange County 5,000 6,000 1,000 The ArtsCenter 7,000 10,000 3,000 The Exchange Club Child Abuse Prevention Ctr. 2,000 10,350 8,350 The Institute of Art Therapy 1,000 5,000 4,000 Triangle Bikeworks - 1,000 1,000 United Way of the Greater Triangle - 16,030 16,030 Voices Together 10,000 15,000 5,000 Volunteers for Youth - 10,000 10,000 Youth Community Project - 4,750 4,750 Total $ 1,128,315 $ 1,532,558 $ 404,243 This is a new agency that did not apply for funding in 2015 -16 This is an unfunded agency which did apply in 2015 -16 This agency has submitted two applications this year, rather the one that they submitted in the past This agency was formerly called Pre -Trial Services, not funded in FY 2015 -16. The County Manager's Office oversees the Pre -Trial Services program. FY 2016 -17 Orange County Outside Agency Funding Advisory Board Assignments Aging Advisory Board /Janice Tyler 1. A Helping Hand 2. Chapel Hill /Carrboro Meals on Wheels 3. Charles House 4. Senior Care of Orange County DEAPR Advisory Boards /Dave Stancil 1. Big Brothers Big Sisters of the Triangle 2. Boys and Girls Club of Eastern Piedmont 3. Bridge II Sports 4. Fairview Community Watch 5. Historic Hillsborough Commission 6. Historical Foundation 7. Piedmont Wildlife Center 8. Triangle Bikeworks 9. Youth Community Projects Employee Committee /Perdita Holtz 1. Communities in Schools of Orange County 2. El Centro Hispano 3. Farmer Foodshare 4. Hillsborough Arts Council 5. OC Literacy Council 6. OC Living Wage 7. Public Gallery of Carrboro dba WCOM -LP Radio 8. Rogers Road - Eubanks Neighborhood Association (RENA) 9. The ArtsCenter OPC Mental Health 1. Club Nova 2. EI Futuro 3. Freedom House 4. KicISCope 5. Mental Health America of the Triangle 6. OE Enterprises, Inc. 7. The Arc of Orange County 8. The Institute of Art Therapy 9. Voices Together Health Advisory Board /Colleen Bridger 1. Compass Center for Women and Families 2. Duke Homecare & Hospice 3. OC Disability Awareness Council 4. OC Rape Crisis Center 5. Piedmont Health Services, Inc. (Contract with Department) 6. Planned Parenthood 7. United Way of Greater Triangle Housing & Human Relations Advisory Boards /Audrey Spencer - Horsley 1. Community Empowerment Fund 2. Community Home Trust (Contract with Department) 3. EmPOWERment 4. Habitat for Humanity 5. Housing for New Hope 6. Human Rights Center (Human Relations) 7. Marian Cheek Jackson Center (Human Relations) 8. Rebuilding Together of the Triangle Social Services Advisory Board /Nancy Coston 1. Behavioral Insights, Inc. 2. Chapel Hill/ Carrboro YMCA Boomerang 3. Child Care Services Association 4. Dispute Settlement Center 5. Interfaith Council 6. Ligo Dojo of Budo Karate 7. OC Partnership for Young Children 8. Orange Congregations in Mission (OCIM) — Samaritan Relief 9. Orange Congregations in Mission (OCIM) — Meals on Wheels 10. TABLE, Inc. 11. The Exchange Club Child Abuse Prevention Center 12. Volunteers for Youth, Inc. Notes: • Applications are located on the T Drive (Outside Agencies 4 2016 -17 Folder). ORANGE COUNTY NORTH CAROLINA FINANCE AND ADMINISTRATIVE SERVICES 200 South Cameron Street Post Office Box 8181 Hillsborough, North Carolina 27278 To: Orange County Advisory Boards Groups From: Allen Coleman, Budget and Administrative Coordinator Date: February 12, 2016 Phone (919) 245 -2151 Fax (919) 644 -3324 Email: acoleman @orangecountync.sov Re: FY 2016 -17 Outside Agency Funding Application - Evaluation Process Thank you for your participation in this year's Outside Agency funding evaluation process. Your feedback is critical in assessing program performance, potential success and making funding recommendations. This memo provides background information and guidelines to aid Advisory Board evaluation of FY 2016 -17 funding requests. Advisory Board members should carefully review these procedures and selection criteria prior to application review. Please email application scorecards and written feedback. in MS Excel format. by Thursday. March 24, to acolemanOorangecountync.gov. I. FUNDING PROCESS OVERVIEW Application Process: On December 2, 2015, Orange County, in collaboration with the Towns of Carrboro and Chapel Hill, opened the FY 2016 -17 funding process, with a deadline of January 25, 2016. This year all three jurisdictions used the same funding application. In total, 58 agencies submitted funding requests totaling $1,532,558, an increase of $404,243 above the current year's appropriation. Advisory Board Evaluation: Seven Advisory Boards and Committees review funding applications, for program content and viability, in February and March. While funding recommendations (i.e. dollar amounts) are not provided, the groups can share whether they think a group should or should not receive funding. Finance and Administrative Services reviews the supplemental documentation and prior agency performance, for currently funded agencies. County Manager Evaluation and Recommendation: In April, the County Manager, reviews Advisory Board feedback and consults with the Department Directors. The County Manager also reviews the agencies' applications, particularly the funding request rationales. Funding recommendations are included in the Manager's Recommended Operating Budget, published in May. Board of County Commissioner's (BOCC) Decision: Two Budget Public Hearings, in May, provide direct engagement opportunities for outside agency staff and supporters. The BOCC will also discuss funding, during a June Budget Work Session. Final funding decisions will be included in the FY 2016- 17 Approved Operating Budget, adopted in late June. II. ADVISORY BOARD EVALUATION PROCESS Scorecards. Advisory Boards should review Funding Applications, only. However, agency supplementary materials are available, if they help you to understand information within the application. Advisory Boards will assess the applications using the Application Scorecard, which rates the program's mission (Section I), customer value (Section II), prior year results (Section III) and implementation plan (Section IV). The first worksheet in the Application Scorecard file explains how the scorecard should be completed. Please complete the Scorecard in MS Excel format. as it will tally the scores for you. Also. include any written feedback on this form. Written Feedback: This year we highly encourage additional feedback. Written feedback enhances the ratings, and is helpful to the County Manager. In addition, the BOCC often asks about advisory board feedback, during their deliberations. However, please note that scorecards and feedback are public record information, so be mindful in how you construct your comments. • Points Distribution: A few of the application questions and sections have changed since last year. To accommodate changes to the application, as well as the rescaled scorecard, the point distribution was altered in each section. BOCC Funding Checklist: When scoring applications and providing feedback, please also consider the BOCC Funding Checklist. The checklist identifies priority areas the BOCC deems critically important, during outside agency review. The checklist is located within the Application Scorecard file. III. FILE LOCATIONS • All files can be found on the Countywide T Drive (T Drive 4 Outside Agencies 42016 -171 unless otherwise specified by your Lead Evaluator. Applications (2016- 174Submitted Applications) Each agency has a folder; within each folder, is an Application folder that contains an agency's funding application files. The files can take various forms, but most will be in MS Word (funding application) and MS Excel (agency and program budgets) formats. Agencies must submit a single agency budget and separate program budgets for each program outlined in its funding application. Evaluation Materials (2 016-174 Evaluation Materials) In this folder, Advisory Boards can find the Evaluation Group Assignments, a funding request list and the Application Scorecards /BOCC Checklist. Miscellaneous (2016 -174 Miscellaneous) This folder contains blank copies of the application forms, application instructions and orientation materials, for your reference. APPLICATION SUBMITTAL CHECKLIST FOR OFFICE USE ONLY Agency The Women's Center Inc. dba Com ass Center Date/Time Received By_! for Women and Families / "�r— �._�._ Programs) Domestic Violence Crisis Services Self - ►plere Y/ N Education & Civic En a omen# Sufficient P ro rams Community 1. Cover Page a• Applicant Contact Information - � i - . • b• E 'Proiect/program Contact Information c• D Funding Requests Identified d. 9 Signed Application Cover Page 2. Agency Information a• 12Agency's Years in operation - -- b• Q'Agency's Purpose/Mission 24 CFR 570.506 c- "Agency's Types of Services Provided d Agency's Experience 570.507 570.690; 24 CFR Parts 84 or 85 e. Other Pertinent Information 3. Program/ Project Information a. 9 Type of Application and Program Identified b. aSummary of program 24 CFR 570.200(a) - (for each program/ C. CfDescription of Identified Need d• 'Description 507.503 570-201-570, 208, project for of Population to be Served e. Activity Manager and Location Description which funding f. Activity Implementation is requested) Timeline g• ©"Agency Collaboration h. ['Describe Impact of Reduced /No Allocation i 'Other Pertinent Information 1 © Complete Target Population /Beneficiary Chart k• aComplete Schedule of Positions I. aftned Conflict of Interest Disclosure M. E� Complete Work Statement i I P a g e 4. Financial (for each program/ project for which fundini is requested) MAIN APPLICATION Program Budget Worksheet and Detail should reflect expenses for the entire program and ALL sources of funding. a. [Program Budget Worksheet b. [31Program Budget Detail c. aCost Per Unit d. [Z Agency Operating Budget Worksheet 5. Supplemental A. Part A: CDBG & HOME Sections (as B. ® Part 13: Construction /Rehab applicable) 24 CFR 570.200(a), 570.201 -570. 208, 507.503 24 CFR 570.506, 570.507, 570.601, 570.602, 570.607(b), 570.611 24 CFR 570.502°-570.504, 570.506, 570.507, 570.610; 24 CFR Parts 84 or 85, and OMB Circulars A -87 or A 122; Treasury Circular 1075 6. Attachments a. DAudit: Organizations receiving $300,000 or more I OMB Circular A- 133 in Federal financial assistance, and /or organizations with more than $500,000 of receipts and 71RS enditures in a fiscal year, must secure an audit. b. Federal Form 990 c. [✓]ANC Solicitation License d. [SIRS Federal Tax- Exemption Letter e. aCertificate of Insurance f. [List of Board of Directors g. [."Articles oflncorporation /Bylaws h. D'Authorization to Request Funds L YAuthorized official designation j. 0 3 -R Fee Verification 24 CFR Parts 84 or 85 24 CFR 570.208, 570.500(c), 570.611 Main Application 1/24/2016 2:59:42 PM Page 2 of 58 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: compassctr.org Executive Director: Cordelia Heaney Telephone Number: (919) 968 -4610 E -Mail: director(a)compassctr.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 c) Funding Request Identification Total Project/Program Cost: $600.385.33 E -Mail: programsdirector (aicompassctr.org Total Amount of Funds Requested: $102.200.00 Proposed Use of Funds Requested (2 -3 Line Maximum): 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) $ ❑ Grant ❑ Loan ❑ CDBG Construction (CH) $ ❑ Grant ❑ Loan ❑ HOME CHDO $ ❑ Grant ❑ Loan ❑ HOME Other $ ❑ Grant ❑ Loan ® Human Services: ® Carrboro $8_,400 ® Chapel Hill $29.300 ® Orange County $64,500 Main Application 1/24/2016 2:59:42 PM Page 3 of 58 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 f applicant. of Signature: ecutive �Djre for ZS ignature: Date oard Cho ` Z Date Main Application 1/24/2016 2:59:42 PM Page 4 of 58 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 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 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: ® Human Services (Main Application Only) ❑ AH Non - Construction (Main Application Only) ❑ AH Construction — (Main Application AND Part B) ❑ AHDR Non - Construction (Main Application Only) ❑ 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) ❑ HOME CHDO Set -aside — (Main Application AND Part A) ❑ HOME Other — (Main Application AND Parts A AND Part B) Indicate the type of program for which you are requesting funding: Program Category Youth Adult Elderly Disabled not elderly) Public Housing Neighborhoods /Residents Education X X X X X Health and Nutrition Job Trainin Sports and Arts Activities Pre - School Activities After - School Activities _ Mentorin Transportation X X X X X Housing Other: Safety net for the vulnerable X X X X X Proaram /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 Town /County priority? The Domestic Violence Crisis Services Program provides essential crisis intervention services to victims of domestic violence that are unavailable through any other vent County. Specifically, the community needs we will continue to address are: the chosen and support e in Orange Main Application 1/24/2016 2:59:42 PM Page 7 of 58 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 provide 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 19`h 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 of 58 lu /d1104 I_1»m[07_i119]0 I 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 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 1) 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 P a g e 1 0 o f 5 8 MAIN APPLICATION 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: ® Persons ❑ Households ❑ Units Program: Domestic Violence Crisis Services Gender Program Beneficiary Demographics Actual Estimated Projected 2014 -15 2015 -16 2016 -17 Male Female Total 72 78 78 1096 _ 1195 1195 1168 1273 1273 Of the females, how many are single - female Head of Households (Omit for Human Services) Ethnicity - - - - -- _._- __. -.— African - American American Indian or Alaska Native Asian Caucasian Native Hawaiian or other Pacific Islander Other Unknown Total Of the above, how many Hispanic /Latino Of the above, how many non - Hispanic /Latino Total Age 0 -5 years 6 -18 years 19 -50 years 51 -61 years 62+ years Unknown Total Geographic Location Durham City Durham County Carrboro Chapel Hill Chapel Hill Public Housing Residents 131 150 150 2 4 4 14 16 6 241 — — - -- 270 - - -- - -- 270 0 0 0 132 979 150 ------..--150 648 1683 683 1168 1 1273 1273 121 130 130 1047 1143 1143 1168 1273 1273 10 10 10 18 20 20 211 230 230 28 _ 30 30 3 4 4 898 979 1 979 1168 1 1273 1 1273 (included in Durham County (included in Durham County (included in Durham Count # 90 95 95 86 95 95 377 410 410 Unknown Unknown Unknown Main Application 1/24/2016 2:59:42 PM Page 11 of 58 Orange County Raleigh Wake County Other Unknown Total Income Level — See following chart (Omit for HS) < 30% Area Median Income 31 -50% Area Median Income 51 -80% Area Median Income > 80% Area Median Income Total Special Needs (Omit for HS) Elderly (Over 62) Disabled (not elderly) Homeless People with HIV /Aids Total MAIN APPLICATION 157 175 175 (included in Wake Count # ) (included in _LA # (included in Wake Count # 45 135 50 145 50 145 278 303 303 1168 1273 1 1273 Main Application 1/24/2016 2:59:42 PM P a g e 1 2 o f 5 8 MAIN APPLICATION " CDBG &!HOME ONLY Area Benefit Activities Infrastructure and Public Facilities Street I Census Tract I Block Group I Total Persons I #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 Level 1 person 2 people 3 - people 4 people 5 people 6 people 7 people 8 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 nttp: / /www.nucluser.org /portal /datasets /il /ill5 /FY2015 IL nc.pdt Main Application 1/24/2016 2:59:42 PM Page 13 of 58 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). Main Application 1/24/2016 2:59:42 PM P a g e 1 4 o f 5 8 If provided, indicate: Position Titles * = Position FTE ** % Program Actual Estimated Projected % Total (R) Retirement Vacant Staff + 2014 -15 2015 -16 2016 -17 Budget Plan (H) Health Plan_ Program 1.0 zsi° (1) 71,515.90 $57,636.82 $55,482.26 _ 8.7% H 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% H Violence Services Dir of Court 1.0 100%(1) 38,466.00 _ $37,740.00 $39,321.00 6.2% H Advocacy & Community Response Dir of Education 1.0 100 %(3) 37,219.00 $37,700.00 $38,480.52 6.0% _ H Pro rams Client Services 1.0 5M (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% H Services Dir of Teens Climb 1.0 o %(looi° 33,660.00 $34,000.08 $34,680.08 5.5% H 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% H 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% H 15 %(2) 15%(3) Development Dir 1.0 0% 0 $33,500.00 $51,000.00 8.0% H Finance & HR Dir 1.0 15 °%0) $48,253.80 $44,000.00 $44,880.00 7.1% H 15%(2) 15%(3) Admin Manager .67 15 %(1) $26,962.65 $22,685.52 $25,010.67 3.9% H 15%(2) 15%(3) Communications .67 40 °%13) $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, eta Main Application 1/24/2016 2:59:42 PM P a g e 1 4 o f 5 8 MAIN APPLICATION TOTAL 15.21 FTE 548,610.80 $601,273.33 $636,299.00 100% Volunteer Hours: Volunteer 33%(1 -8-FT—E 8 FTE 8 FTE MSW Interns, FTE 33%(2) APPLES Interns, 33 %(3) Legal Intern, Board of Directors, 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 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 1,960 Main Application 1/24/2016 2:59:42 PM Page 15 of 58 MAIN APPLICATION L} 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? ❑ ® 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: 6"'l, Executive Director Signature oard Chairperson ZY /A Date I i -L Date Main Application 1/24/2016 2:59:42 PM Page 16 of 58 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. Main Application 1/24/2016 2:59:42 PM P a g e 1 7 o f 5 8 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 that meets their needs helps them feel that they helps them feel that they and helps them feel that 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 are tracked. responses are tracked. and responses are tracked. Program Results -responses 94% safety planned; 88% better understood options I 94% at Q2 85% Main Application 1/24/2016 2:59:42 PM P a g e 1 7 o f 5 8 MAIN APPLICATION Main Application 1/24/2016 2:59:42 PM Page 18 of 58 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 rocess. 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. 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 MAIN APPLICATION Main Application 1/24/2016 2:59:42 PM P a g e 1 9 o f 5 8 85% of clients will 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 and 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 served. 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 Performance Measures with crisis response staff are asked to fill out a crisis response staff are asked to fill out a survey and crisis response staff are asked to fill out a survey and survey and responses are responses are tracked. responses are tracked. tracked. Program Results 94% 96% at Q2 85% Main Application 1/24/2016 2:59:42 PM P a g e 1 9 o f 5 8 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) ❑ AH Construction — (Main Application AND Part B) ❑ AHDR Non - Construction (Main Application Only) ❑ 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) ❑ HOME CHDO Set -aside — (Main Application AND Part A) ❑ HOME Other — (Main Application AND Parts A AND Part B) Indicate the type of program for which you are requesting funding: Program Category Youth Adult Elderly Disabled (not elderly) Public Housing 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 _ Mentorin Trans (jrtation Housin Other: Safety net for the vulnerable X X X X 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 20 of 58 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 QuickFacts 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 21 of 58 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 19`h 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 intergene rational 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 22 of 58 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 JobLink: 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 23 of 58 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 1) 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: ® Persons ❑ Households ❑ Units Program: Self- Sufficiency Programs Gender Male Female Unknown Total iry Demographics Actual Estimated Projected 2014 -15 1 2015 -16 2016 -17 176 175 30 603 645 _175 645 32 30 30 811 850 850 Of the females, how many are single - female Head of Households (Omit for Human Services) Ethnicity African - American American Indian or Alaska Native 30 30 806 820 100 140 140 2 2 2 Asian Caucasian Native Hawaiian or other Pacific Islander Other Unknown Total Of the above, how many Hispanic /Latino Of the above, how many non- Hispanic/Latino Total Age 5 30 30 806 820 820 21 25 25 313 315 315 0 0 0 23 25 25 352 1 343 1 343 811 1 850 1 850 5 30 30 806 820 820 811 850 850 Main Application 1/24/2016 2:59:42 PM Page 24 of 58 0 -5 years 6 -18 years 19 -50 years 51 -61 years 62+ years Unknown Total Geographic Location Durham City Durham County Carrboro Chapel Hill Chapel Hill Public Housing Residents Orange County Raleigh Wake County Other Unknown Total Income Level - See following chart (Omit for HS) < 30% Area Median Income 31 -50% Area Median Income 51 -80% Area Median Income > 80% Area Median Income Total Special Needs (Omit for HS) Elderly (Over 62) Disabled (not elderly) Homeless People with HIV /Aids Total MAIN APPLICATION 0 0 0 0 0 0 266 270 270 193 195 195 29 30 30 323 355 355 811 850 850 (included in Durham Count # ) (included in Durham County (included in Durham Count # 29 30 30 63 315 70 330 70 330 Unknown Unknown Unknown 132 165 165 (included in Wake _Counter #) (included in Wake Count # (included in Wake Count # _ 49 159 50 160 50 160 64 45 45 811 850 850 0 0 0 Main Application 1/24/2016 2:59:42 PM Page 25 of 58 0 0 0 0 0 0 Main Application 1/24/2016 2:59:42 PM Page 25 of 58 MAIN APPLICATION CDBG & HOME ONLY - Area Benefit Activities Infrastructure and Public Facilities Street I Census Tract I Block Group I 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 Level 1 person 2 people 3 people 4 people 5 people 6 people 7 people 8 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% AMI $54,266 $62,028 $69,791 $77,481 $83,734 $89,916 $963097 $102,278 nup:llwww. n Ua useLOrglportallaatasets /1 UU15 /h YZU15 IL nc.pdt Main Application 1/24/2016 2:59:42 PM Page 26 of 58 tlnw ► ' ' • 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). Main Application 1/24/2016 2:59:42 PM Page 27 of 58 If provided, indicate: Position Titles % :Actual Estimated Projected % (R) * = Position ` FTE ** Program 2014 -15 2015 -16 2016 -17 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% H 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% H Violence Services Dir of Court 1.0 100 %(1) 38,466.00 $37,740.00 $39,321.00 6.2% H Advocacy & Community Response Dir of Education 1.0 100Y. (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% H Specialist 50 %(3) Dir of Latino 1.0 100%(1) 33,053.88 $34,500.00 $35,190.00 5.5% H Services Dir of Teens Climb 1.0 oi° (100% 33,660.00 $34,000.08 $34,680.08 5.5% H 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% H 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 15i° (1) $17,129.22 $63,254.00 $66,300.00 10.4% H 15%(2) 15 %(3) Development Dir 1.0 o% 0 $33,500.00 $51,000.00 8.0% H Finance & HR Dir 1.0 15%(1) $48,253.80 $44,000.00 $44,880.00 7.1% H 15 %(2) 15%(3) Admin Manager .67 15 %(1) $26,962.65 $22,685.52 $25,010.67 3.9% H 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 27 of 58 MAIN APPLICATION TOTAL 15.21 FTE 548,610.80 $601,273.33 $636,299.00 100% Volunteer Hours: Volunteer 33%(1) 8 FTE 8 FTE 8 FTE MSW Interns, FTE 33 %(2) APPLES Interns, 33%(3) Legal Intern, Board of Directors, 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 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 1,960 Main Application 1/24/2016 2:59:42 PM Page 28 of 58 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 M ❑ a) Employees of or closely related to employees of the Town of Chapel Hill, Orange County, Carrboro, or Hillsborough? ❑ N 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? ❑ E 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: % 12-(1 Executive Director Date ol of Signature, 11-7 L4 I i oard Chairperson Date Main Application 1124/2016 2:59:42 PM Page 29 of 58 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. Main Application 1/24/2016 2:59:42 PM Page 30 of 58 Actual Estimated Projected 2014 -15 2015 -16 2016 -17 Legal Information: Provide Legal Information: Provide Legal Information: Provide accessible, 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 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 situation in FY 14 -15. At information presented was helpful to their situation in FY information presented was 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 accessible, 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 30 of 58 MAIN APPLICATION Main Application 1/24/2016 2:59:42 PM Page 31 of 58 85% of clients will report that they are more 85% of clients will report that 85% of clients will report that Program Goal knowledgeable about their they are more knowledgeable they are more knowledgeable situation in FY 14 -15. At about their situation in FY 15- about their situation in FY 16- least 50 clients will be 16. 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 tracked. results are tracked. results are tracked. Program Results 100% 100% 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 Program Goal one goal to improve their they are leaving with one goal they are leaving with one 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 in FY 15 -16. 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 individuals, helping them individuals, helping them Program Activity 4 preserve as much income preserve as much income as preserve as much income as 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 Goal 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 31 of 58 MAIN APPLICATION '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 32 of 58 VITA staff will maintain VITA staff will maintain VITA staff will maintain appointment data in an appointment data in an appointment data in an Performance Measures appointment scheduler appointment scheduler and appointment scheduler and and track completed track completed appointments P track completed appointments and taxes and taxes filed. appointments and taxes filed. filed. Program Results 170 see below Tax season has not be un 225 oal 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% 98711, at 62 8501, '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 32 of 58 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: ® Human Services (Main Application Only) ❑ AH Non - Construction (Main Application Only) ❑ AH Construction — (Main Application AND Part B) ❑ AHDR Non - Construction (Main Application Only) ❑ 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) ❑ HOME CHDO Set -aside — (Main Application AND Part A) ❑ HOME Other — (Main Application AND Parts A AND Part B) Indicate the type of program for which you are requesting funding: Program Category Youth Adult Elderly Disabled (not elderly) Public Housing Neighborhoods /Residents Education X X X X _...__._..._... - -- X Health and Nutrition Job Training Sports and Arts Activities Pre - School Activities After - School Activities Mentorin 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 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? 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 33 of 58 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 8th 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 QuickFacts 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 34 of 58 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 6`h and 8'h grade in Chapel - Hill - Carrboro City Schools. Main Application 1/24/2016 2:59:42 PM Page 35 of 58 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 6`h through 9`h grade. We work with youth in 6th and 8`h grade and OCRCC works with them in 7`h and 9`h. 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 36 of 58 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 1) 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: ® Persons ❑ Households ❑ 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 Caucasian Native Hawaiian or other Pacific Islander Other Unknown Total 3700 Of the above, how many Hispanic /Latino Of the above, how many non - Hispanic /Latino Total 3674 3700 3700 Age 0 -5 years T 6 -18 years 1369 _ 1370 1 1370 Main Application 1/24/2016 2:59:42 PM Page 37 of 58 19-50 years 51-61 years 62+ years Unknown Total Geographic Location Durham City Durham County Carrwm Chapel Hill Chapel Hill Public Housing Residents Orange County Raleigh Wake County Other Unknown—but all from community ndin (}C' Chapel Hill undCurrbnro Total Income – See following chart (Omit for HS) <80% Area Median Income 31'50% Area Median Income 51'80% Area Median Income >00% Area Median Income Total Special Needs (Omit for HS) . Elderly (Over 02) Disabled (not elderly) Homeless People with HIV/Aids Total MAIN APPLICATION 2330 1 2330 3700 1 3700 Main Application 1/24/2016 2:59:42 PM Page 38 of 58 77 77 77 38 40 40 23 30 30 35 35 35 29 29 _29 3214 3229 3229 3674 3700 3700 Main Application 1/24/2016 2:59:42 PM Page 38 of 58 MAIN APPLICATION CDBG &` HOME 'ONLY - Area Benefit Activities Infrastructure and Public Facilities Street Census Tract Block Group Total Persons #LMI Persons 6 people 7 people 8 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 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 Level 1 person 2 people 3 People 4 people 5 people 6 people 7 people 8 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 /iI /iI15/FY2015 IL nc.pdf Main Application 1/24/2016 2:59:42 PM Page 39 of 58 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). Main Application 1/24/2016 2:59:42 PM Page 40 of 58 If provided, indicate: Position Titles FTE % Actual Estimated Projected % (R) = Position , : Program 2014 -15 2015 -16 2016 -17 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% H 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% H Violence Services Dir of Court 1.0 100 %(1) 38,466.00 $37,740.00 $39,321.00 6.2% H 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% H Specialist 50 %(3) Dir of Latino 1.0 100 %(1) 33,053.88 $34,500.00 $35,190.00 5.5% H Services Dir of Teens 1.0 0 %(looi0 33,660.00 $34,000.08 $34,680.08 5.5% H Climb High Programs but 0% w/ OC Funds) Dir of Self- 1.0 loo °i° (2) 43,699.43 $33,222.98 $34,680.08 5.5% H 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% H 15%(2) 15%(3) Development Dir 1.0 0% 0 $33,500.00 $51,000.00 8.0% H Finance & HR Dir 1.0 15 %(1) $48,253.80 $44,000.00 $44,880.00 7.1% H 15 %(2) 15% (3) Admin Manager .67 15 %(1) $26,962.65 $22,685.52 $25,010.67 3.9% H 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 MAIN APPLICATION TOTAL 15.2 1 FTE 548,610.80 $601,273.33 $636299.00 100% Volunteer Hours: Volu 33 °%(1) 8 FTE 8 FTE 8 FTE MSW Interns, ntee 33%(2) APPLES Interns, r 33%(3) Legal Intern, FTE Board of Directors, Hotline Advocates, First Response, Interpreters, Group Facilitators, Community Educators, TCH Interns, Event Volunteers, etc. Project /Program Name: 1) Domestic Violet 2) Self Sufficiency 3) Community Edi 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 41 of 58 LVA rlul►, - •�r�L•��i 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? ❑ ® d) raid 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: zy Executive Director Date Signature: 1/2,L4 I and Chairperson Date Main Application 1/24/2016 2:59:42 PM Page 42 of 58 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. Main Application 1/24/2016 2:59:42 PM Page 43 of 58 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 61h and education sessions in 61" and education sessions in 61" 8th grade health education 8`" grade health education and 8`" grade health classes. classes. education classes. Main Application 1/24/2016 2:59:42 PM Page 43 of 58 MAIN APPLICATION Main Application 1/24/2016 2:59:42 PM Page 44 of 58 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 and - post -test surveys and pre- and - post -test surveys and results will be tracked. results will be tracked. and results will be tracked. Program Results 89% 92% at Q2 85% Professionallnterpersonal 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 and legal remedies impact of domestic violence, impact of domestic violence, available, impact of reluctance of victims to reluctance of victims to domestic violence, disclose, effect of domestic disclose, 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 other topics. _many 85% of participants will — _----- - - - - -- report increased awareness about domestic 85% of participants will report 80% of participants will report Program Goal violence and resources increased awareness about increased awareness about 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. artici ants will be reached. Participants will be given a Participants will be given a Participants will be given a Performance Measures post- session evaluation post- session evaluation post- session evaluation survey and results will be survey and results will be survey and results will be tracked. tracked. tracked. Program Results 88% 90% 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 1/24/2016 2:59:42 PM Page 44 of 58 MAIN APPLICATION Main Application 1/24/2016 2:59:42 PM Page 45 of 58 85% of participants will report increased 85% of participants will report 85% of participants will report Program Goal awareness of domestic increased awareness of increased awareness of violence and resources domestic violence and domestic violence and 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 Performance Measures post- session evaluation post- session evaluation post- session evaluation survey and results will be survey and results will be survey and results will be tracked. tracked. tracked. Program Results 90% 88% at Q2 85% Women's History Month: Women's History Month: Women's History Month: Civic Engagement: Plan, 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 Project 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 Program Goal g information to provide celebratory events and celebratory events and 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 held, 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 1/24/2016 2:59:42 PM Page 45 of 58 MAIN APPLICATION Program Goal Educational events, community - building activities and information disseminated for community awareness and education in October 2014. Educational events, community - building activities and information disseminated for community awareness and education in October 2015. Educational events, community - building activities and information disseminated for community awareness and education in October 2016. Data about events held, Data about events held, Data about events held, 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 details. report for full details. held in October 2016. **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 46 of 58 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 47 of 58 MAIN APPLICATION Comparative Budget for Domestic Violence Program AGENCY NAh The Women's Center, Inc. dba Compass Center for Women and Families AGENCY REVENUE Private Donations Agency Generated Revenue (fees) Local Government Grants: Orange County Town of Chapel Hill Town of Carrboro Other Local: Town of Hillsborough Other Local: Other Local: If more than 3 sources, please provide a scpante list. Non -Local Government Grants Triangle United Way State Government Federal Government Other Grants Private Foundations Other Grants MiscellaneouslOther Revenue Pleo -.e list 3 hrgect Mi:cdlanouo:ources: Art Show 3f2015 $ 28,489 Board Initiated Events FY15 $ 10,264 Cellphone recycling FY15 $ 657 Total Agency Revenue AGENCY EXPENSES Compensation Rent & Utilities Supplies & Equipment Travel & Training Other Expenses: Please liet 314rge.t "Other Expense,': Contracted Services FY15 $ 21,130 Telepone Systems FY15 $ 5,047 Art Show 312015 1 $ 2467 Total Agency Expenses SURPLUSI(DEFICIT) FOR PERIOD: Main Application 1/24/2016 2:59:42 PM Page 48 of 58 Actual 2014 -15 Estimated :2015 -16 Projected '2016 -17 :Percent. Change $ 4,414.09 $ 2,747.37 $ 6,325.78 130% $ 21500 $ 21,500 $ 21,500 0 0% $ 9,767 1 $ 9,767 $ 9,767 0% $ 2,800 $ 2,817 $ 2,817 0% $ 667 $ 667 $ - -1007. 0 $ 14,092 $ 28,017 $ 28,569 0 2i $ 190,000 $ 190,000 $ 190,000 0% 0 $ 6,000 $ 2,000 $ 10,000 400Y 0 $ tt!!t 214,850 $ 235,474 $ 249,191 6i $ 13,401 $ 9,634 $ 9,634 0% $ 4,169 $ 3,133 $ 3,133 0/ $ 2,564 1 $ 2,271 1 $ 2,385 1 5i $ 42,745 277 729 $ 38,340 288 853 $ 39,107 303 450 2i 5x Main Application 1/24/2016 2:59:42 PM Page 48 of 58 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 Referral $15.29 Total $9,000 Complete the table below for the project /program for which Vou 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) Information (education, all non - crisis $15.29 7100 (# clients yr. X 15 min. of $108,559 informational contacts, and follow ups) service) Referral $15.29 677 (# 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) Legal information $15.29 1270 (# clients yr. X 15 min. of $19,418 service) DV Protective Order paperwork assistance $15.29 330 (# clients yr. X 15 min. of $5,046 service) Advocacy (general & court) $15.29 22000 (# clients yr. X 15 min. of $33,638 service) Interpretation $15.29 155 (# 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 MAIN APPLICATION Additional assistance (victim $1529 90 (# clients yr. X 15 min. of $1,564 compensation, CPS reporting, 911 cell $277,729.00 service) $303,450.00 phones, etc. 19,061 19,834 19,834 Cost Per Unit $14.57 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 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 Actual'2014 -15 Estimated 2015 -18 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 MAIN APPLICATION d.) Program Budget - Self- Sufficiency Comparative Budget for Self- Sufficiency Program AGENCY NAE The Women's Center, Inc_ dba Compass Center for Women and Families AGENCY REVENUE Private Donations Agency Generated Revenue [fees] Local Government Grants: Orange County Town of Chapel Hill Town of Carrboro Other Local: Town of Hillsborough Other Local: Other Local: If more than 3 sources, please provide a :epwete list. Non -Local Government Grants Triangle United Way State Government Federal Government Other Grants Private Foundations Other Grants MiscellaneousfOther Revenue Please list 3luge.t Miseellanous sources: Art Show 302015 $ 13,146 Board Initiated Events FY15 $ 4,736 Cellphone recycling FY15 $ 303 Total Agency Revenue AGENCY EXPENSES Compensation Rent & Utilities Supplies 14 Equipment Travel& Training Other Expenses: Actual.. 2014 -15 Please list $ htge.t "Other Expense:": Contracted Services FY15 1 $ 21,130 Telepone Systems FY15 11 $ 5,047 Art Show 302015 1 $ 2,467 Total Agency Expenses SURPLUS7[DEFICIT] FOR PERIOD: Main Application 1/24/2016 2:59:42 PM Page 51 of 58 Actual.. 2014 -15 Estimated 2015 -16 Projected. 2016 -17 Percent_. Change $ 41.296.52 $ 32,149.98 $ 32,941.90 2/ $ $ 911 21,500 $ $ 1,000 21,500 $ $ 1,002 21,500 0/ 0/ $ 9,767 $ 9,767 $ 9,767 0/ $ 2,500 $ 2,817 $ 2,817 0/ $ 667 $ 667 $ -100/ 0 $ 6,503 $ 12,928 $ 13,163 0 2/ $ 14,092 $ 19,127 $ 19,674 3/ 0 $ 12,034 $ 8,000 $ 8,000 0/ 0 $ $ 18,583 128 152 99,138 $ 108 i084 137 20 23/ 5% 6/ $ 6,184 $ 4,445 $ 4,445 0/ $ 1,924 $ 1,446 $ 1,446 0/ $ 1,183 $ 1,048 $ 1,101 5/ 0000 Main Application 1/24/2016 2:59:42 PM Page 51 of 58 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($) + QuantitylUnit of Measure subtotal (8) 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 Legal Workshops $26.75 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 , Quantify /Unit of measure Subtotal' w= Legal Information Service $26.75 190 (190 sessions /yr. X 15 min. of $5,083 service) Community Legal Project $26.75 104 (52 sessions x 2 units at 30min.) $2,782 Legal Workshops $26.75 480 (80 participants x 6 units at 1.5 $12,840 hr.) Individual Career Counseling $26.75 600 (150 sessions x 4 units at 1 hr.) $16,050 Career Workshop $26.75 180 (45 participants x 4 units at 1 hr.) $4,815 Individual Financial Counseling $26.75 660 (110 sessions x 6 units at 1.5 $17,655 Financial Workshops $26.75 260 (65 participants x4 units at 1 hr.) $6,955 VITA $26.75 1350 (225 clients x6 units at 1.5 hr.) $36,113 Group $26,75 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 52 of 58 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: 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 MAIN APPLICATION g.) Program Budget - Community Education and Civic Engagement Comparative Budget for Community Education 8t Engagement Program AGENCY MAN The Women's Center_ Inc. dba Compass Center for Women and Families AGENCY REVENUE Private Donations Agency Generated Revenue (fees) Local Government Grants: Orange County Town of Chapel Hill Town of Carrboro Other Local: Town of Hillsborough Other Local: Other Local: If mare than 3 sourced, please provide a scpwr tc list. Non -Local Government Grants Triangle United Way State Government Federal Government Other Grants Private Foundations Other Grants MiscellaneouslOther Revenue Actual 2414 -15 Pleace list 3largest Miscdlanous sources: Contracted Services FY15 Art Show 312015 $ 20,110 Board Initiated Events FY15 10,691.11 $ Cellphone recycling FY15 I $ 463 Total Agency Revenue AGENCY EXPENSES Compensation Rent & Utilities Supplies & Equipment Travel & Training Other Espenses: Actual 2414 -15 Plcwz list 3 hrgeet "Other Expcn:cs": Projected = 2016 -17 Contracted Services FY15 $ 14,915 35,905.35 $ 10,691.11 $ TeleponeSystemsFYi5 $ 3,562 Art Show 312015 $ 1,741 Total Agency Espenses SURPLUSI(DEFICIT) FOR PERIOD: Main Application 1/24/2016 2:59:42 PM Page 54 of 58 Actual 2414 -15 Estimated - 2015 -16 Projected = 2016 -17 Percent Change $ 35,905.35 $ 10,691.11 $ 9,179.98 -14'/. $ 21,500 $ 21,500 $ 21,500 0 0% $ 9.767 $ 9,767 $ 9,767 Oi $ 2,800 $ 2,817 $ 2,817 0% $ 667 $ 667 $ - -100'. 0 $ 9,948 $ 10$20..167 0 02% $ 75,000 $ 75,000 $ 75,000 0:: 0 $ 12,033 $ 8,000 $ 9,000 13% 0 $ $ 28,428 196 047 151,661 $ $ 31,750 179 968 166,219 $ $ 41,633 189 063 175,902 31% 5% 6z $ 9,460 $ 6,801 $ 6,801 0% $ 2,943 $ 2,212 $ 2,212 0% $ 1,8101 $ 1,603 $ 1,684 5Y $ 30,173 196,047 $ 3,133 179,968 $ 9 2,465 189.0 -21% 5X Main Application 1/24/2016 2:59:42 PM Page 54 of 58 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($) Quantity /Unit of Measure Subtotal($) 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: Community Education and Civic Engagement (Projected '16- `17) Teens Climb High ** I $41.67 1 2400 (240 students x 10 1 $100,00 Information and Referral 1500 (contacts per yr.) $20,025 $13.35 ,. 9! ,. ---- '- - - -.. Ong AAA Youth Community Education 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 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. L) Cost per Unit Total Cost of Program $196,047.00 $189,063.00 Total # of Units 541 TCH* 2400 TCH 2400 TCH 6509 remaining_ 66_73 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 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 57 of 58 MAIN APPLICATION Section VI. financial Uata Comparative Budget for Entire Agency AGENCY NAP The Women's Center, Inc- dba Compass Center for Women and Families AGENCY REVENUE Private Donations Agency Generated Revenue (fees) Local Government Grants: Orange County Town of Chapel Hill Town of Carrboro Other Local: Town of Hillsborough Other Local: Other Local: If more thon 3 eouree., please provide a scpantc list. Non -Local Government Grants Triangle United Way State Government Federal Government Other Grants Private Foundations Other Grants MiscellaneouslOther Revenue Plca lit 3 hrge•.t Miecdhnous source: Art Show 312015 $ 61,745.00 Board Initiated Events FY15 3 22,245.38 Cellphone recycling FY15 $ 1,422.84 Total Agency Revenue AGENCY EXPENSES Compensation Rent & Utilities Supplies & Equipment Travel & Training Other Expenses: Please list 3largest "Other Expenoe:': Contracted Services FY15 $ 53,353.69 Telepone Systems FY15 $ 12,886.36 Art Show 3 +2015 $ 6,238.75 Total Agency Expenses -= Actual 2014 -15 Estimated. - 2015 -16 - '.Projected 2016 -17> '.Percent 1 Change $ 87,616 $ 93,500 $ 96,378 3% $ $ 911 64,500 $ $ 1,000 64,500 $ $ 1,002 64,500 0% 0% $ 29,300 $ 29,300 1 $ 29,300 01/ $ 8,400 $ 8,450 $ 8,450 0% $ 2,000 $ 2,000 $ - -100% $ 0 $ 30,5433 $ 60,723 $ $ 61,919 0 2% $ 279,092 $ 284,127 $ 284,674 G% $ 0 $ 126,492 $ 75,000 $ 83,485 11% $ - 0 $ $ 87,282 716 136 548,611 $ $ 118,974 737 574 601,273 $ $ 146,248 775 956 636,299 23% 5% 6% $ 34,219 $ 24,600 $ 24,600 0% $ 10,645 $ 8,000 $ 8,000 0% $ 6,548 1 $ 5,800 1 $ 6,090 5% 00000 SURPLUSI(DEFICIT) FOR PERIOD: I t 6.966 : 0 S 1.108 Main Application 1/24/2016 2:59:42 PM Page 58 of 58 Scorecard Instructions Using the Application Scorecard, pleases assess the four categories of each agency's application (Mission, Customer, Results, and Plan). Each category contains evaluative components (column A), with references (column B) on where to find the responses in the application. Then, determine whether the agency responded to the question and place an "X" in the appropriate box (columns C or D). If the agency did answer the question to some degree, award an appropriate number of points (column F) out of the total number of points possible for that question (column Q. Advisory Boards should use the Rescaled Scorecard for Agencies with New Programs lacking FY 2015 -16 program results (Section 3 - M Work Statement). The Rescaled Scorecard will calculate that agency's total score out of 65 rather than 100. Microsoft Excel will calculate any entries in Column E for each category, subtotal and the grand total. If completing the form by hand, please calculate the totals manually and enter amounts in the appropriate fields. Return the completed scorecards in Microsoft Excel format and comments to Allen Coleman at acoleman @orangecountync.gov, by Thursday, March 24. Submit ONLY one scorecard per outside agency. Checklist Summary of Outside Agency Applicant (Optional) This checklist identifies priorities set by the Orange County Board of County Commissioners, for nonprofit agency funding. These priorities constitute the basis, for why an Outside Agency is selected for Orange County funding, by the BOCC. Evaluators can review the checklist to determine whether an agency meets the criteria and provide additional feedback, to their Lead Evaluators. Outside Agency A Helping Hand Behavioral Insights, Inc. Big Brothers Big Sisters of the Trianlge Boys & Girls Club of Eastern Piedmont Bridge II Sports* Chapel Hill /Carrboro Meals on Wheels Chapel Hill/ Carrboro YMCA - Boomerang Charles House Child Care Services Association* Club Nova Communities in Schools of Orange County Community Empowerment Fund Community Home Trust Compass Center for Women and Families Dispute Settlement Center Duke Homecare & Hospice El Centro Hispano El Futuro EmPOWERment Fairview Community Watch Farmer Foodshare Freedom House Habitat for Humanity Hillsborough Arts Council Historic Hillsborough Commission Historical Foundation Housing for New Hope Human Rights Center Interfaith Council KidSCope Ligo Dojo of Budo Karate* Marian Cheek Jackson Center Mental Health America of the Triangle* OE Enterprises, Inc. Orange Congregations in Mission (OCIM) - Samaritan Relief Orange Congregations in Mission (OCIM) - Meals on Wheels OC Partnership for Young Children* OC Disability Awareness Council OC Literacy Council OC Living Wage OC Rape Crisis Center Piedmont Health Services, Inc. Piedmont Wildlife Center* Planned Parenthood Health Formal Services/ Programs Contract Under Contract Amounts Public Gallery of Carrboro dba WCOM -LP Radio Rebuilding Together of the Triangle* Rogers Eubanks Road Neighborhd Assoc. Senior Care of Orange County TABLE The Arc of Orange County The ArtsCenter The Exchange Club Child Abuse Prevention Ctr.* The Institute of Art Therapy Triangle Bikeworks United Way of the Greater Triangle Voices Together Volunteers for Youth, Inc. Youth Community Project Total Other Relationship Refer patients to Refer patients to Wic services they provide are located at whitted building; they provide primary care to low income as we do They provide family planning services as we do Worked with Association to conduct water and septic studv. MAIN APPLICATION 1. COVER PAGE (Each program requires a separate application.) a) Applicant Contact Information Applicant Organization's Legal Name: Duke University Health System, Inc. d /b /a Duke HomeCare & Hospice Applicant Organization's Physical Address: 4321 Medical Park Drive, Suite 101, Durham, NC 27704 Applicant Organization's Mailing Address: 4321 Medical Park Drive, Suite 101, Durham, NC 27704 Applicant Organization's Web Address: https:Hdhch.duhs.duke.edu Executive Director: Belle Starr Browning Telephone Number: 919.620.3853 E -Mail: starr.browning @duke.edu DUNS Number: (Dun & Bradstreet, Inc. provides this number at no charge, and it is required for Federal funding recipients.) b) ProiectlProuram Contact Information Project/Program Name: Duke HomeCare & Hospice Project/Program Primary Contact and Title: Dale Horton Telephone Number: 919 -479 -0318 c) Funding Request Identification E -Mail: dale. horton(a)duke.edu Total Project/Program Cost: $13,864Total Amount of Funds Requested: $7,800.00 Proposed Use of Funds Requested (2 -3 Line Maximum): Duke Hospice Bereavement Services will use the funds to offset the costs of providing care to grieving individuals in Chapel Hill, Carrboro and Orange County. We continue to offer our services at no cost to any individual in the area who requests our support. 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) $ ❑ Grant ❑ Loan ❑ CDBG Construction (CH) $ ❑ Grant ❑ Loan ❑ HOME CHDO (OC) $ ❑ Grant ❑ Loan ❑ HOME Other (OC) $ ❑ Grant ❑ Loan X Human Services: X Carrboro $3,800 X Chapel Hill $3,000 X Orange County $9 000 d) To the best of my knowledge and belief all true and current. The document has been applicant. Signature: :,� t Dire( Signature: information and data in this application is duly authorized by the governing board of the i -� -col i,-k Date 2 2- 1 t Boar Chairperson Date Main Application 1/25/2016 12:06:09 PM Page 3 of 16 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) b) Agency's Purpose /Mission c) Types of Services the Agency Provides d) Agency's Experience with Similar Programs as the Funding Request e) Other Pertinent Agency Information (a.) 37 years in operation, Incorporated in 1979 (b.)The mission of the Duke Hospice Bereavement Services (DHBS) is to facilitate a safe and healing grief process for persons who are adjusting to a loss due to death. It is a direct clinical service outreach into the community for Duke HomeCare & Hospice. (c)Duke Hospice Bereavement Services (DHBS) support to grieving people. There are two service lines provided through DHBS: hospice support and community support. The hospice benefit requires that hospice services offer grief support and education to hospice family members and operate a program through which grieving family members of hospice patients can receive counseling, information and resources to assist them in coping with the death of a loved one. In addition to the hospice level of care, DUBS extends its support to the community by offering individual grief support, access to workshops and grief groups, education and resources to help any member of the community adjust to living life after the death of a loved one. Services to both program lines: • Grief support through individual counseling and grief group support • Community education available to any civic or religious group which requests that type of support • Crisis intervention after the sudden death in the work place • School based interventions including education and workshops for administrative staff, teachers, social workers, counselors • School based interventions including training of social workers and counselors to respond to grief in the school. • School based grief support groups with an emphasis on providing training and supervision for school social workers and counselors to feel better equipped to address symptoms of grief which may occur in schools. • Annual memorial services to commemorate people lost to death. These services are open to the community. • Annual Camp ReLEAF for children kindergarten through 81h grade. An annual overnight camp to assist children in adjusting to the death of a significant person and to develop coping skills to better understand and manage their own grief responses. • Family grief support groups to provide education to parents /guardians and children to enhance communication and understanding of the impact of grief on the family system. (d) Now in its 37th year, Duke Hospice (formally Triangle Hospice) was founded by a group of volunteers in 1979. During this span, it became one of the largest and foremost providers of hospice care in North Carolina. During the early 1990's these volunteers, led by former governor, the late Terry Sanford, raised $2 million to build a 6 -bed Inpatient Care Main Application 1/25/2016 11:36:35 AM Page 4 of 16 MAIN APPLICATION Facility in the Meadowlands in Hillsborough, which provides 24 -hour care for those hospice patients in psychosocial crisis, unmanageable pain and /or need for respite care. In 1995, with a gift from G1axoWellcome, the Beard House, which is on the same 11 -acre site, was transformed into the Unicorn Bereavement Center. Staffed with two full -time bereavement counselors and one part-time bereavement counselor, the UBC serves both hospice families and those in the community who have lost a loved one. Each year, more than nine multi - week support groups and workshops arc held at the UBC. We provide medical, psychosocial, spiritual and bereavement care for terminally ill patients and families, regardless of ability to pay. Bereavement services are provided to anyone in the community, regardless of connection to hospice, through individual, family, and group sessions, as well as in the Chapel Hill - Carrboro and Orange County School Systems. 3. PROJECT /PROGRAM INFORMATION Agency & Program Name: Duke HomeCare & Hospice 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 required application and required supplemental sections (Parts) as specified below: X Human Services (Main Application Only) ❑ CDBG Non - Construction — (Main Application AND Part A) ❑ CDBG Construction — (Main Application AND Part A AND Part B) ❑ HOME CHDO Set -aside — (Main Application AND Part A) ❑ HOME Other — (Main Application AND Part A AND Part B) Indicate the type of program for which you are requesting funding: Program Category Youth Adult Elderly Disabled (not elderly) Public Housing Neighborhoods /Residents Education X X X Health and Nutrition Job Training X X X Sports and Arts Activities Pre - School Activities After - School Activities Mentoring X X X Transportation Housing Other: Please specify grief counseling X X X Main Application 1/25/2016 11:36:35 AM Page 5 of 16 wralar_1Z! Z!II.Y_Irl k1k Proaram /Project Description (Label your responses as outlined below; not to exceed 3 pages.) Please provide the following information about the proposed program /project: See attached b) Summarize the program services proposed and how the program will address the chosen Town /County priority? 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. d) Describe the population to be served or the area to benefit and indicate how you will identify beneficiaries. e) Who specifically will carry out the activities and in what location will they be carried out? 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. 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. h) Describe what would happen if requested funding is not awarded at all or if a reduced allocation is recommended. i) Include any other pertinent information. Proaram /Protect Information j) Complete the Target Population and Program Beneficiary Demographics Chart k) Complete the Schedule of Positions Chart for Program Staff 1) 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: ❑ Persons ❑ Households ❑ Units Program: 1= Proaram Beneficiary Demoaraohics I Actual I Estimated I Projected 2014 -15 1 2015 -16 1 2016 -17 Male 50 60 65 Female 63 96 103 Total 113 156 168 Of the females, how many are single - female Head of Households (Omit for Human Services) Main Application 1/25/2016 11:36:35 AM Page 6 of 16 Page 5 — Program / Project Description (b) Programs: Duke Hospice Bereavement Services has a vibrant and active children's bereavement program which emphasizes the importance of recognizing the developmental consequences of death and grief during the early years. We have developed a workshop which targeted all school personnel who may have contact with children. The goal of this workshop was to provide education and resources to assist school personnel to better understand the impact of grief and loss on the cognitive, physical and emotional well -being of children. The Bereavement Center is located in Hillsborough and serves as a primary resource for grief support and education for both the Chapel Hill /Carrboro and Orange County School system. We receive regular calls from school personnel in both districts requesting support, resources, education and intervention for the children in their districts. (c) Town/county priority: Protect and Provide for a safe community (d) Population to be served. Duke Hospice Bereavement Services has been a leader in providing grief support and education in the Triangle Area and has partnered with local school systems to address the needs of grieving students in the school setting. For over 15 years we have consulted with and responded to requests for support in the local school systems and in the communities we serve. (e) Who specifically will carry out? The Bereavement Center staff consisting of 2.6 full time staff will provide the services indicated. The staff provides training to student interns who will also be available on a limited basis to provide these services. The primary location will be the Unicorn Bereavement Center located in Hillsborough. Additional sites will include any school in the districts serving student in Orange County as well as administrative offices of those districts and other gathering places which will accommodate the provision of services requested. (f) Describe period: Camp ReLEAF is an annual event and is next scheduled for April 29, 30 & May 1, 2016. It will be held at Camp New Hope. This schedule is followed as closely as possible each year after adjusting for holidays or religious events which may interfere with those periods of time. School based grief support groups are located at the requesting school site and will run for a total of 6 weeks. The frequency will be determined by the number of requests received. Individual, group and family grief support is provided as needed and according to mutual developed goals established between the requesting person and the Duke Hospice Bereavement staff. Crisis intervention is available as requested. School consultation is available upon request. (g) Bulleted list of other agencies: • Chapel Hill - Carrboro and Orange County School System • Triangle Consortium for Suicide Prevention • Perinatal Loss Education Consortium • A Helping Hand • UNC Health System • Durham Coalition on Grief • S.O.S • Compassionate Friends • Other local non -profit organizations to meet the unmet needs of patients with limited resources. (h) Describe what would happen: Duke Hospice Bereavement Services provides the most comprehensive children's bereavement program in the area. The area likely to be most impacted by a reduction in funding would be our ability to respond to all of the requests for support services to the schools. We would continue to provide counselling and support to any child but would be challenged in our ability to take those services to the children; instead the parents /guardians would bear some of the burden of getting their children to the site where our services are offered. We would continue to seek funding from other sources to ensure our ability to reach children where they are and not increase the burden of seeking care during a time when families lives are in disarray due to the death of a significant fanuly member. African - American American Indian or Alaska Native Asian Caucasian Native Hawaiian or other Pacific Islander Other Total Of the above, how many Hispanic /Latino Of the above, how many non - Hispanic /Latino 0 -5 years 6 -18 years 19 -50 years 51 -61 years 62+ years Total Geographic Location Durham City Durham County Carrboro Chapel Hill Chapel Hill Public Housing Residents Orange County Raleigh Wake County Total Income Level — See following chart (Omit for HS) <30 %Area Median Income 31 -50% Area Median Income 51 -80% Area Median Income > 80% Area Median Income Total Special Needs (Omit for HS) Elderly (Over 62) Disabled (not elderly) Homeless People with HIV /Aids Total MAIN APPLICATI011 15 14 15 0 0 0 1 0 0 85 116 125 0 0 0 12 16 28 113 1 156 1 168 1 1 2 1 2 112 154 166 113 156 168 1 0 1 0 1 0 1 7 10 11 103 144 154 113 156 168 0 0 0 0 0 0 6 8 9 41 64 69 103 144 154 66 84 90 0 0 0 0 0 0 113 156 168 0 0 0 103 144 154 103 144 154 Main Application 1/25/2016 11:36:35 AM Page 7 of 16 MAIN APPLICATION CDBG & HOME ONLY- Area Benefit Activities (Infrastructure and Public Facilities) Street I Census Tract I 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 Level 1 person 2 people 3 people 4 people 5 people 6 people 7 people 8 people 30 %AMI $14,150 $16,200 $20,090 $24,250 $28,410 $32,570 $36,730 $40,890 50 %AM1 $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 nttp: nwww. nuduser .oraiportaudatasetsnuin5lrrzo15 it_ nc.pdt Main Application 1/25/2016 11:36:35 AM Page 8 of 16 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). Position Titles * = Position Vacant FTE* * % Program Staff + Actual Actual 5 Estimate d Estimate 6 Projecte d 2016- 17 %Total Total If provided, indicate: (R) Retiremen t Plan (H) Health Plan See attached Exhibit A 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 1/25/2016 11:36:35 AM Page 9 of 16 C O N if a� Q v � � r � W r �n c c •� Y O R v m a 00 Y O H 0 a n Y u � v � O O d N N O N Ul tD Y N E Y H W V H O N � 3 Y u Q m Y V) E t0 m O L a 0 W O ID O O O O O of 0 0 0 0 V1 O O H to LL M O O N N w > n D' Z N F- a F. Z > U w _ __ > a = Z U F- F J W w w U w w w w a ° z z w w cr cr F- Ln Q la- la- p= a N Q vwi H H O a Z V) N = Q~ W O �i u J U Z Z Z Z Z D W- -- 0 0 vii a vii a x Z vii a W J a Z F = w w w 0 H O U z d O a K K U K O K > a u U u= Q Y U z z > > > >> Z Z o Z a V s U> o a V d 0 c� 0� 0 0 w w w vi Q u z Z in J J Vl w L N cn J �n J J z F V K V U O IJ VI V1 K W N d W d U V Q d' a Z K U U V Z Z O a z a Q O a Z Z v a a a z Z Z Q Z Z a d Z Ou d u u u 0 N u u u u u S LL v= m v L 0 Y Y o ai C Y � Y w � v Q Q 4 » o � u 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 ❑ X a) Employees of or closely related to employees of the Town of Chapel Hill, Orange County, Carrboro, or Hillsborough? ❑ X b) Members of or closely related to members of the governing bodies of Chapel Hill, Carrboro, Hillsborough, or Orange County? ❑ X c) Current beneficiaries of the project/program for which funds are requested? ❑ X 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. 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 anv arant awarded. Signature: IV_;cy -1 Jl10 E ?cecutive Director Signature: FJ[l, j �, �1/✓✓�t°t<!� ` �" " `� Boar Chairperson Date Date Main Application 1/25/2016 11:36:35 AM P a g e 1 0 o f 1 6 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. (Please See Attached) Main Application 1/25/2016 11:36:35 AM P �] g is .i ; c f t b Actual 2014 -2015 Estimated 2015 -2016 Projected 2016 -2017 Program Activity 1 Program Goal Performance Measures Program Results Program Activity 2 Program Goal Performance Measures Program Results Program Activity 3 Program Goal Performance Measures Program Results Program Activity 4 Program Goal Performance Measures Program Results Program Activity 5 Program Goal Performance Measures Program Results Main Application 1/25/2016 11:36:35 AM P �] g is .i ; c f t b Work Statement (Page 11) Goals: Duke Hospice Bereavement Services (DHBS) offers bereavement support to both hospice and community clients 1) 2) 3) 4) 5) 6) Goal # 1 2 3 4 5 6 DHBS will schedule 250 community adult client encounters in FY16 DHBS will schedule 30 community child /teen clients in FY16 DHBS will schedule 330 hospice adult client encounters in FY16 DHBS will schedule 30 hospice child /teen clients in FY16 Camp ReLEAF will provide an overnight camp experience for children K -8t" grade DHBS will provide grief education and support to local educational and civic organizations as requested Actual 14 -15 277 24 446 38 10 = .334 of total 17 estimated 15 -16 175 30 440 42 10 = .334 of total 15 Projected 16 -17 150 30 450 45 10 = .334 of total 13 Performance measures for all of the listed activities will be through service evaluation requested at the time of the event or at the conclusion of a series of related events. Related events would be ongoing individual or group counseling. Goal 5 Camp ReLEAF: each camper provides feedback regarding likes and dislikes of camp activities and overall participation. Each activity scored well in different age groups. There are no numbers associated with the scoring of satisfaction. Parents provide feedback about their children's reported experience with approximately 30% of campers requesting to comeback the next year. 31 campers out of 34 total campers completed a group evaluation with 96% responding favorably to the camp experience. Predominant responses from campers indicated the importance of meeting other children their age who had experience something similar which reduces the isolation, loneliness and sense of being different. Goal # 3 98% satisfaction 97% 95% 4 [: 100 refer services 95% satisfaction 98% refer services 94% satisfaction 100% refer 100 refer services 96% satisfaction 100% refer services 95% satisfaction 100 %refer 95% refer services 95% satisfaction 95% refer services 95% satisfaction 95% refer'services MAIN APPLICATION 4. FINANCIAL INFORMATION FOR SERVICE PROGRAMS a.) Program Budget 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 1/25/2016 11:36:35 AM P a g e 1 2 o f 1 6 Program budget worksheet AGENCY NAME: PROGRAM REVENUE Private Donations Program Generated Revenue (fees) Local Government Grants: Orange County Town of Chapel Hill Town of Carrboro Other Local: Other Local: Other Local: If more than 3 sources, provide a separate list. Non -Local Government Grants Triangle United Way State Government Federal Government Other Grants: Other Grants: Miscellaneous /Other Revenue Please list 3largest Miscellanous sources: Total Program Revenue PROGRAM EXPENSES Compensation Rent & Utilities Supplies & Equipment Travel & Training Other Expenses: Please list 3largest "Other Epenses": Total Program Expenses Duke HomeCare & PF 2014 -15 1 2015 -16 j 2016 -17 Change ' $ 344,833 1 $ 467,200 1 $ 467,200 0% X $10.672.491 1 $11.483.000 1 $11.726.000 jt o .,.E r l N s� 1 4% 1,184,951 1 $ 1.208.000 1 $ 1 $ 166,535 $ 173,196 1 $ 180,124 1 4% $ 4,090,343 $ 4.170,794 1 $ 4.237,146 1 2% 478 1 $11.518.000 1 $11.881.000 $ (347,987) $ (35,000) $ (155,000) -343% ►l . ► d • ► 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 Counseling for 30 children $30 / child Total $9,000 Complete the table below for the protect /program for which you are requesting funds. Attach additional rows /pages, as needed. Program: Duke HomeCare & Hospice Cost Elements Cost $) Quantit !Unit of measure Subtotal $ School Grief Group $125 session 6 $750 Staff Supervision/Training $150/6 sessions 1 $150 Mileage 24 sessions 6 $144 Camp ReLEAF –13 students $340 /Student 13 $4420 Counseling for 30 children $30 / child 30 $900 Counseling for 250 Adults $30 / Adult 250 $7500 Total $13,864 c.) Cost per Unit 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 1/25/2016 11:36:35 AM Page 14 of 16 Actual 2014 -15 Estimated 2015 -16 Projected 2016 -17 Total Cost of Program $11,020,478 $11,518,000 $11,881,000 Total # of Units $53,931 $57,183 $58,775 Cost Per Unit $204.34 $201.42 $20214 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 1/25/2016 11:36:35 AM Page 14 of 16 MAIN APPLICATION d.) 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 1/25/2016 11:36:35 AM Page 15 of 16 AGENCY NAME: PROGRAM REVENUE Private Donations Program Generated Revenue (fees) Local Government Grants: Orange County Town of Chapel Hill Town of Carrboro Other Local: Other Local: Other Local: If more than 3 sources, provide a separate list. Non -Local Government Grants Triangle United Way State Government Federal Government Other Grants: Other Grants: Miscellaneous /Other Revenue Please list 3 largest Miscellanous sources: Total Program Revenue PROGRAM EXPENSES Compensation Rent & Utilities Supplies & Equipment Travel & Training Other Expenses: Please list 3largest "Other 6cpenses ": Total Program Expenses Operation 15udget Duke HomeCare & Hospice Actual Estimate 2014 -15 2015 -16 $ 344,833 $ 467,2 $10,319,858 $11,008,0 ,16 NO Illp $ 1.000 1 $ 1.0 467,200 1 0% 11.251.000 1 2% 1 $10.672.491 1 511.483.000 1 $11.726.000 1 1 196 1 $ 1 146 ! E 4% $ (347,987) $ (35,000) $ (155,000) -343% APPLICATION SUBMITTAL CHECKLIST FOR OFFICE USE ONU Received By Agency Orange County Disability Awareness Council Date /Time Complete Y / N Program(s) _Education /Employment, Training, and Technology Services Section 1. Cover Page Subsection a. ❑ Applicant Contact Information b. ❑ Project /Program Contact Information c. ❑ Funding Requests Identified d. ❑ Signed Application Cover Page For CDBG & • HUD Regulations 2. Agency a. ❑ Agency's Years in operation 24 CFR 570.506, Information - b. ❑ Agency's Purpose /Mission 570.507, 570.610; 24 c. ❑ Agency's Types of Services Provided CFR Parts 84 or 85 d. ❑ Agency's Experience e. ❑ Other Pertinent Information 3. Program/ a. ❑ Type of Application and Program Identified 24 CFR 570.200(a), Project b. ❑ Summary of Program 570.201 -570. 208, Information - c. ❑ Description of Identified Need 507.503 (for each d. ❑ Description of Population to be Served program/ e. F1 Activity Manager and Location Description project for which funding f. F1 Activity Implementation Timeline is requested) g F-1 Agency Collaboration h. ❑ Describe Impact of Reduced /No Allocation i. ❑ Other Pertinent Information j. ❑ Complete Target Population /Beneficiary Chart k. ❑ Complete Schedule of Positions I. ❑ Signed Conflict of Interest Disclosure m. ❑ Complete Work Statement i I P a g e MAIN APPLICATION Main Application 2/11/2016 9:12:15 AM Page 2 of 20 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. ❑ Program Budget Worksheet 570.602, 570.607(b), is requested) b. ❑ Program Budget Detail 570.611 c. ❑ Cost Per Unit 24 CFR d. El Agency Operating Budget Worksheet 570.502 - 570.504, 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. ❑ Part A: CDBG & HOME Sections (as B. ❑ Part B: Construction /Rehab applicable) 6. Attachments a. ❑ Audit: Organizations receiving $300,000 or more OMB CircularA -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. ❑ NC Solicitation License d. ❑ IRS Federal Tax - Exemption Letter e. ❑ Certificate of Insurance f. ❑ List of Board of Directors 24 CFR Parts 84 or 85 g. ❑ Articles of Incorporation /Bylaws h. ❑ Authorization to Request Funds 24 CFR 570.208, 570.500(c), 570.611 i. ❑ Authorized official designation j. ❑ Solid Waste Program Fee (SWPF) Verification Main Application 2/11/2016 9:12:15 AM Page 2 of 20 MAIN APPLICATION 1. COVER PAGE (Each program requires a separate application.) a) Applicant Contact Information Applicant Organization's Legal Name: Orange County Disability Awareness Council Applicant Organization's Physical Address: 503 West Franklin St., Chapel Hill, NC 27516 Applicant Organization's Mailing Address: 503 West Franklin St., Chapel Hill, NC 27516 Applicant Organization's Web Address: http: / /triangledac.org/ Executive Director: Timothy Miles Telephone Number: 919.245.4337 E -Mail: ocdac @orangecountync.gov DUNS Number: (Dun & Bradstreet, Inc. provides this number at no charge, and it is required for Federal funding recipients.) b) Protect /Program Contact Information Project /Program Name: Education and Training Resources for People with Disabilities Project /Program Primary Contact and Title: Timothy Miles, Director Telephone Number: 919-245-4337 c) Funding Request Identification E -Mail: ocdac(a)orangecountync.gov Total Project/Program Cost: $30000 Total Amount of Funds Requested: $30000 Proposed Use of Funds Requested (2 -3 Line Maximum): Funding for as- needed basic operating expenses, ADA related workshop employment training, human interest projects, resources, supplies, staff training, computer support, travel and printing. 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) $ ❑ Grant ❑ Loan ❑ CDBG Construction (CH) $ ❑ Grant ❑ Loan ❑ HOME CHDO (OC) $ ❑ Grant ❑ Loan ❑ HOME Other (OC) $ ❑ Grant ❑ Loan ® Human Services: ® Carrboro $10000 ® Chapel Hill $10000 ® Orange County $10000 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: Timothy L. Miles Executive Director Signature: Lynn M. Sheilds Board Chairperson January 20, 2016 Date January 20, 2016 Date Main Application 2/11/2016 9:12:15 AM Page 3 of 20 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) 17 years, 2 February 1999 b) Agency's Purpose /Mission The primary mission is to assist in the implementation of the ADA. This is would be through education, training, and other efforts to identify removal of physical, attitudinal, and other barriers to full inclusion and independence for those with disabilities c) Types of Services the Agency Provides The services that TDAC provides are career planning and placement, computer and technology education and training, and professional continuing education workshops. d) Agency's Experience with Similar Programs as the Funding Request These services are provided by trained professionals who have over 25 years of experience in vocational rehabilitation, housing and civil rights education, and the technology industry. e) Other Pertinent Agency Information OCDAC was originally organized in 1970 as a Mayor's Committee in connection with the Governor's Advocacy Council for Persons with Disabilities. Following the passage of the Americans with Disabilities Act in July, 1990, OCDAC was reorganized as a 501(3) (c) nonprofit education organization and commissioned by the Orange County Commissioners, Mayors of Chapel Hill, Carrboro and Hillsborough NC. Main Application 2/11/2016 9:12:15 AM Page 4 of 20 MAIN APPLICATION Main Application 2/11/2016 9:12:15 AM Page 5 of 20 MAIN APPLICATION 3. PROJECT /PROGRAM INFORMATION Agency & Program Name: Orange County Disability Awareness Council 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 required application and required supplemental sections (Parts) as specified below: ® Human Services (Main Application Only) ❑ CDBG Non - Construction — (Main Application AND Part A) ❑ CDBG Construction — (Main Application AND Part A AND Part B) ❑ HOME CHDO Set -aside — (Main Application AND Part A) ❑ HOME Other — (Main Application AND Part A AND Part B) Indicate the type of program for which you are requesting funding: Program Category Youth Adult Elderly Disabled (not elderly) Public Housing 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 X Mentorin Transportation X X X X Housing X X X X Other: Technology Training & Referrals X X X X Proaram /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? • Workshop(s) on disaster preparedness in association with OC EMS, The Orange Sheriff's Office and Social Services. • To some extent, collaborative efforts with NC Fair Housing Project and the Orange County Land -trust to address homeownership to cut down homelessness of people with disabilities. • Computer programs. The computer and assistive technology classes educate Main Application 2/11/2016 9:12:15 AM Page 6 of 20 MAIN APPLICATION citizens about technology which is can be used in the home and on the job • All the Triangle Disability Awareness Council (OCDAC) provides job counseling and training will require collaboration with OC NC Works partner agencies in client's job readiness development, e.g. voice over IPad, speech imput /output. • OCDAC provides volunteer opportunities for members of A Helping Hand, UNC Service Groups which offers work related and /or services learning to junior and seniors in the medical track. Many of the clients they work with who have become share the past work vocation and current disability related experiences. 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. • The concept of fostering self- sufficiency among persons with disabilities, and fullfill the County and Tri -city government priorities... e.g. affordable /accessible housing, unemployment, accessible and safe living. The Triangle Disability Awareness Council (TDAC) expects to further develop its existing programs, and that will enable more clients to get food delivered the same day delivery, technology training to find gainful employment, city /county ADA related facility assessments, etc. d) Describe the population to be served or the area to benefit and indicate how you will identify beneficiaries. • We're serving everyone in the Chapel /Carrboro /Orange County region. TDAC will identify its beneficiaries through the use of social media and our partner agency connections. e) Who specifically will carry out the activities and in what location will they be carried out? • Trained professionals with over 25 years of experience will carry out the activities of TDAC and these events and activities will be held at city /county funded sites. 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. • These activities in coordination with ongoing job education and career training are typically held over a ten month period extending from the end of January until the beginning of December. These programs and activities are held typically held two times per month. In varying degrees of capacity our services are being provided everyday whether that is through personal interaction or electronically. 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. The Orange County Disability Awareness Council training programs are being developed and implemented with the collaboration of - Teaming 4Technologies, the United Way, - NC ADA Network, - UNC Apples Interns, High School Service Learning, UNC PA Interns - Various Orange County Offices, OC Libraries, Adult Social Services, etc. - NC Central Food Bank - OC Senior Centers - S.H.I.P. - Triangle Transit, and area transit agencies Main Application 2/11/2016 9:12:15 AM Page 7 of 20 MAIN APPLICATION - Various Chapel Hill, Carrboro, offices, - Volunteer Center of Durham We invite any other social agencies that desire training or consulting concerning implementation of the ADA and customer services to people with disabilities. We publish a bi annual newsletter and post all events in print and electronic media to the OCDAC website. www.triangledac.org is a major social media source, linking us to organizations such as the NC Housing Coalition and New Hope Project, OPC Mental Health, NC Central Food Bank and Triangle Transit. We have undertaken collaborative projects in housing for persons with disabilities with Housing and Human Rights and the Center for Economic Justice in Raleigh. We have an ongoing collaborative relationship with UNC Apples, A Helping Hand and Chapel Hill High School - Service Learning and the NC Works Center. We have and plan to expand the use of volunteer UNC - Chapel Hill students and hopefully students from other area colleges. We are also continuing to work on developing a cooperative program with North Carolina Services for the Blind. h) Describe what would happen if requested funding is not awarded at all or if a reduced allocation is recommended. • Services for people will low to no income would be charged for the services that TDAC provides and many people would go without. Workload for our partner agencies would increase and general knowledge and understanding about social services would be diminished. TDAC provides necessary resources to its clients that would otherwise not be provided the assistance that they need. i) Include any other pertinent information. • It is crucial with the increase of requests for immediate housing to avoid homelessness by people with disabilities; that we are funded for paid half -time staff. Note: the cost for services and /or rental is $500.00 to 1,500 e.g. assistive listening devices, interpreters. Program /Project Information j) Complete the Target Population and Program Beneficiary Demographics Chart k) Complete the Schedule of Positions Chart for Program Staff 1) 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: ❑ Persons ❑ Households ❑ Units Main Application 2/11/2016 9:12:15 AM Page 8 of 20 Program: Gender ram Male Female Total Of the females, how many are single - female Head of Households (Omit for Human Services) Ethnicity African - American American Indian or Alaska Native Asian Caucasian Native Hawaiian or other Pacific Islander Other Total Of the above, how many Hispanic /Latino Of the above, how many non - Hispanic /Latino Total Age 0 -5 years 6 -18 years 19 -50 years 51 -61 years 62+ years Total Geographic Location Durham City Durham County Carrboro Chapel Hill Chapel Hill Public Housing Residents Orange County Raleigh Wake County Total Income Level — See following chart (Omit for HS) Main Application MAIN APPLICATION iry Demographics Actual Estimated Projected 2014 -15 2015 -16 2016 -17 175 180 180 325 335 335 500 515 515 300 300 300 50 50 50 500 500 800 195 195 195 150 150 150 5 5 5 0 0 0 5 5 5 50 50 50 500 500 800 2/11/2016 9:12:15 AM Page 9 of 20 50 50 50 325 325 325 125 125 125 150 150 150 0 0 0 2/11/2016 9:12:15 AM Page 9 of 20 250 250 250 150 150 150 50 50 50 450 450 450 2/11/2016 9:12:15 AM Page 9 of 20 < 30% Area Median Income 31 -50% Area Median Income 51 -80% Area Median Income > 80% Area Median Income Total Special Needs (Omit for HS) Elderly (Over 62) Disabled (not elderly) Homeless People with HIV /Aids Total MAIN APPLICATION 0 0 0 Main Application 2/11/2016 9:12:15 AM Page 10 of 20 MAIN APPLICATION CDBG & HOME ONLY - Area Benefit Activities (Infrastructure and Public Facilities) Street Census Tract Block Group Total Persons #LMI Persons 6 people 7 people 8 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 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 Level 1 person 2 people 3 people 4 people 5 people 6 people 7 people 8 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 /il /iII5/FY2015 IL nc.pdf Main Application 2/11/2016 9:12:15 AM Page 11 of 20 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). Position Titles * = Position Vacant FTE ** % Program Staff + Actual 2014 -15 Estimated 2015 -16 Projecte d 2016- 17 % Total Budget If provided, indicate: (R) Retirement Plan (H) Health Plan Operating Officer .5 50 1500 1500 12000 40 N/A Finance Officer .3 15 500 500 4000 13.33 N/A Technology Officer .3 15 500 500 4000 13.33 N/A Administration .3 15 500 500 4000 13.33 N/A Events Coordinator .05 5 volunteer volunteer volunteer N/A N/A 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 1960 Main Application 2/11/2016 9:12:15 AM Page 12 of 20 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? ❑ ® 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. 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: Signature: Executive Director Date Board Chairperson Date Main Application 2/11/2016 9:12:15 AM Page 13 of 20 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. Main Application 2/11/2016 9:12:15 AM Page 14 of 20 Emergency preparedness Program Goal 75 75 75 Performance Measures 75 75 Program Results 75 75 75 Affordable housing Program Goal 15 15 75 Performance Measures 15 15 Program Results 15 15 75 Computer classes Program Goal N/A 20 20 Performance Measures N/A 20 Program Results N/A 15 20 Main Application 2/11/2016 9:12:15 AM Page 14 of 20 MAIN APPLICATION 4. FINANCIAL INFORMATION FOR SERVICE PROGRAMS a.) Program Budget 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. This budget includes Salaries for the half time positions of Program Director and Administrative /Bookkeeping support. Main Application 2/11/2016 9:12:15 AM P a g e 1 5 o f 2 0 MAIN APPLICATION Budget Item Budget Amount Personnel - Salaries 24,000 Transportation (Fuel, travel, etc.) 750 Program Supplies 1,750 Outreach (Advertising, printing, etc.) 1,000 Insurance 2,200 Postage 300 Program Total $30,000 Main Application 2/11/2016 9:12:15 AM Page 16 of 20 Agency /Program: Private Donatioi Agency General Local Governmt Orange Cour Town of Chal Town of Carr Other Local: Other Local: Other Local: Non -Local GovE Triangle Unite State Goverr Federal Gove Other Grants Other Grants Miscellaneous/ Please list 3 larg Total Agency Revenue AGENCY EXPENSES Compensation Rent & Utilities Supplies & Equi Travel & Trainin Other Expenses Please list 3 larg Total Agency Expenses MAIN APPLICATION Program Budget Other Revenue 0 est Miscellanous sources: $ $ 11,050 $ 10,650 $ 30,650 188% $ 3,000 $ 3,000 $ 24,000 700% $ 2,000 $ 2,000 $ 2,000 0% pment $ 3,000 $ 3,000 $ 2,000 -33% g $ 1,500 $ 1,500 $ 1,000 -33% $ 1,500 $ 1,500 $ 1,000 -33% est "Other Expenses ": $ 11,000 $ 11,000 $ 30,000 173% SURPLUS /(DEFICIT) FOR PERIOD: I $ 50 $ (350) $ 650 286% Main Application 2/11/2016 9:12:15 AM Page 17 of 20 Actual E Estimated P Projected P Percent 2014 -15 2 2015 -16 2 2016 -17 C Change is 0 0 ed Revenue (fees) 0 0 nt Grants: ty $ $ 4 4,000 $ $ 4 4,000 $ $ 1 10,000 1 150% $ 3 3,500 $ $ 3 3,500 $ $ 1 10,000 1 186% )el Hill $ $ 2 2,500 $ $ 2 2,500 $ $ 1 10,000 3 300% )oro $ $ 4 400 $ $ - - $ $ - - 0 0 Hillsborough(discontinued) $ ADA Project $ $ 6 650 $ $ 6 650 $ $ 6 650 0 0% 0 If more than 3 sources, please provide a separate list. rnment Grants d Way 0 0 0 ment 0 0 rnment 0 0 0 SURPLUS /(DEFICIT) FOR PERIOD: I $ 50 $ (350) $ 650 286% Main Application 2/11/2016 9:12:15 AM Page 17 of 20 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 Company Insurance 2,200 Total $9,000 Complete the table below for the project /program for which you are requesting funds. Attach additional rows /pages, as needed. Program: Cost Elements Cost ($) Quantity /Unit of measure Subtotal ($) Time Program Director 12,000 12,000 '/z Time Administrative / Booking Support 12,000 12,000 Program Supplies (Paper, pens, meeting supplies, etc) 1,750 1,750 Printing brochures, flyers, program badges 1,000 1,000 Company Insurance 2,200 2,200 Postage : brochure / flyer mailings 300 300 Travel to and from meetings; Seminars 750 750 Total 30,000 c.) Cost per Unit Actual 2014 -15 Estimated 2015 -16 Projected 2016 -17 Total Cost of Program Total # of Units Cost Per Unit 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 2/11/2016 9:12:15 AM Page 18 of 20 MAIN APPLICATION d.) Agency Operating Budget Please show all sources and amounts of funding for your entire current fiscal year. What is your agency's fiscal year? July 1, 2015 through June 30, 2016. 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 2/11/2016 9:12:15 AM Page 19 of 20 MAIN APPLICATION OCDAC Operating Budget Expenses Salaries 24000 Office Supplies 1750 Printing 1000 Insurance 2200 Postage 300 Travel 750 Total Expenses 30000 Revenue Grants Orange County 3,500 Town of Chapel Hill 1,000 Town of Carrboro 2,500 Town of Hillsboro 400 ADA Project 650 Total Revenue Grants 8050 Revenue Workshops 4000 Revenue Donations 500 Total Revenue 12,550 Main Application 2/11/2016 9:12:15 AM Page 20 of 20 APPLICATION SUBMITTAL CHECKLIST Agency Orange County Rape Crisis Center Program(s) Client Services & Community Education i I P a g 1. Cover Page a. �VProjectlProgram pplicant Contact Information b. Contact Information c. © Funding Requests Identified d. [Signed Application Cover Page 2. Agency a. Agency's Years in operation 24 CFR 570.506, Information - b. Agency's Purpose /Mission 570.507, 570.610, 24 c. []Agency's Types of Services Provided CFR Parts 84 or 85 d. Agency's Experience e. Other Pertinent Information 3. Program/ a. d ype of Application and Program Identified 24 CFR 570.200(a), Project b. Summary of Program 570.201 -570. 208, Information - c. escription of Identified Need 507.503 (for each d. rVescription of Population to be Served program/ e. [� ctivity Manager and Location Description project for f. [Activity Implementation Timeline which funding g• 2"'4gency Collaboration is requested) h. Q Describe Impact of Reduced /No Allocation i. [✓Other Pertinent Information j. Complete Target Population /Beneficiary Chart k. Q Complete Schedule of Positions I. [A Signed Conflict of Interest Disclosure m. Ef Complete Work Statement i I P a g MAIN APPLICATION Main Application 1/25/2016 12:55:42 PM P a g e 2 c f 3 2 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 funding [Program Budget Worksheet 570.507, 570.601, 570.602, 570.607(b), which a. is requested) b. [Program Budget Detail 570.611 c. Cost Per Unit 24 CFR d. [` Agency Operating Budget Worksheet 570.502- 570.504, 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. ❑ Part A: CDBG & HOME Sections (as B. ❑ Part B: Construction/Rehab applicable) 6. Attachments a. [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 ex enditures in a fiscal year, must secure an audit. b. 91 RS Federal Form 990 c. VNC Solicitation License d. ZIRS Federal Tax Exemption Letter - e. [ Certificate of Insurance f. List of Board of Directors 24 CFR Parts 84 or 85 g. Articles of Incorporation /Bylaws h Authorization to Request Funds 24 CFR 570.208, 570.500(c), 570.611 i. Authorized official designation j. Solid Waste Program Fee (SWPF) Verification Main Application 1/25/2016 12:55:42 PM P a g e 2 c f 3 2 MAIN APPLICATION 1. COVER PAGE (Each program requires a separate application.) a) Applicant Contact Information Applicant Organization's Legal Name: Orange County Rape Crisis Center Applicant Organization's Physical Address: 1506 E. Franklin Street, Ste 302, Chapel Hill, NC 27514 Applicant Organization's Mailing Address: P.O. Box 4722, Chapel Hill, NC 27515 Applicant Organization's Web Address: ocrcc.org Executive Director: Alyson Culin Telephone Number: 919 - 968 -4647 E -Mail: alyson(c)-ocrcc.org DUNS Number: 835160862 b) Project/Program Contact Information (i) Project/Program Name: Client Services (ii) Project/Program Name: Community Education Project/Program Primary Contact and Title c) Funding Request Identification (i) Total Project/Program Cost: $349,572.50 (ii) Total Project/Program Cost: $349,572.50 Total Amount of Funds Requested: $74,000 n Culin. Interim Executive Director Proposed Use of Funds Requested (2 -3 Line Maximum): Provide 24 -hour crisis intervention services for survivors of sexual violence. Provide community education, training, and advocacy on sexual assault prevention and response, including programs in Chapel Hill - Carrboro City Schools, Orange County Schools, and independent schools. 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) $ ❑ Grant ❑ Loan ❑ CDBG Construction (CH) $ ❑ Grant ❑ Loan ❑ HOME CHDO (OC) $ ❑ Grant ❑ Loan ❑ HOME Other (OC) $ ❑ Grant ❑ Loan ® Human Services: ® Carrboro $12,000 ® Chapel Hill $27,000 ® Orange County $35,000 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: Z25/1 f� Exec Date Signature: � B94l tKAp'ers"on Date 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) 42 years in operation. Founded in 1974. Incorporated in December 1978. b) Agency's Purpose /Mission Our mission is to stop sexual violence and its impact through support, education, and advocacy. c) Types of Services the Agency Provides The Orange County Rape Crisis Center ( OCRCC) provides support to survivors of sexual violence (SV), their loved ones, and professionals who serve survivors in Orange County. Our expert staff and trained volunteers ( "Companions ") provide emotional support as well as resources and referrals through our 24 -Hour Help Line. Companions are available at all times to provide assistance and advocacy through active listening, safety planning, suicide intervention, and other crisis intervention techniques. They are also available to accompany survivors to the hospital, to make an official report to law enforcement, and to court appointments. For clients with financial, housing, and other concerns, we connect them with community resources and agencies. For long -term support, we provide support groups and workshops for SV survivors and their loved ones. Our innovative support group program, which has served as a model for agencies across North Carolina, offers both traditional discussion -based groups as well as activity -based groups utilizing alternative healing methods. We also provide case management for high -need survivors with multiple concerns. For example, we have connected survivors with resources for emergency and long -term housing, job training and retention, substance abuse treatment, clothing, food, and more. Additionally, the OCRCC offers educational programs for raising awareness about sexual violence and teaching prevention skills. With a 35 -year history of successful education programs, we now reach more than 13,000 youth and adults each year. Our curriculum incorporates research -based best practices utilizing both primary prevention and risk reduction strategies. The majority of our programs are delivered in elementary schools through our Safe Touch program. We are in every elementary school in both Chapel Hill - Carrboro City Schools (CHCCS) and Orange County Schools (OCS), offering annual safety education programs in every classroom. Our Start Strong program works through health education classes in middle and high schools, using primary prevention strategies to prevent perpetration of sexual violence. Our curriculum is designed to assist schools in meeting state - mandated learning objectives. We also offer prevention and response programs for parents, teachers, and professionals. The OCRCC's entire community education program is designed for continuous and comprehensive learning. For students, each year's curriculum builds on the skills and knowledge taught in previous years, offering students a clear and sustained message about safety and achieving best results for preventing violence. Furthermore, we provide take -home materials for students to share with their families, training programs for teachers and caregivers, and informational programs for parents and guardians. In this way, crucial safety messages are reinforced throughout the entire community. In 2007, the OCRCC launched our Latino Services Program with the hiring of a bilingual and bicultural Latino Services Coordinator. With this full -time position, multiple bilingual staff members, and trained Spanish- speaking volunteers, we are able to provide all our crisis services and education programs in both English and Spanish. Main Application 1/25/2016 12:55:42 PM P a c e 4 of 32 MAIN APPLICATION d) Agency's Experience with Similar Programs as the Funding Request The OCRCC has provided crisis intervention services for survivors of sexual violence for over 40 years. Our highly qualified staff members regularly attend continuing education trainings and review new research to ensure that we are providing the best level of trauma - informed care. Additionally, we have the most comprehensive volunteer training program in the state. With more than 60 hours of training, our volunteer crisis Companions — along with our staff — provide expert support and advocacy services to about 600 clients each year. Both qualitative and quantitative data show the high success level of our client services. As a leader in the field, our Client Services team regularly provides consultations for other anti - violence agencies. Among other things, we have presented at state -wide and national conferences; provided one -on -one consultations for agencies seeking advice; and offered trainings for victim service providers, healthcare professionals, and others on best practices for trauma - informed care. Additionally, we created a train - the - trainer program and accompanying manual on how to develop and expand a support group program; in collaboration with the NC Coalition Against Sexual Violence (NCCASA), our staff visited agencies across the state to offer this training. We are highly qualified to continue providing Client Services in Orange County. Launched 35 years ago, our Community Education program is one of the oldest in the country. Since the beginning, we have enjoyed a close relationship with the local school districts, delivering safety education to tens of thousands of students. Our staff members attend conferences, participate in continuing education trainings, and review new research to incorporate best practices and ensure the highest quality curriculum and pedagogy. We recently conducted a curriculum review of the Safe Touch program with input from community stakeholders, making changes to scripts and materials to improve content and delivery and to better align with new state - mandated learning objectives. Though we have already made many improvements to the Start Strong program, we plan on conducting a similar full review of that curriculum this spring. Like our Client Services program, our Community Education team also receives a large number of requests for assistance from school systems and other nonprofit groups seeking to establish or expand their safety education programs. The Community Education staff has also presented at statewide conferences and has provided consultations. Both quantitative and qualitative data prove the success of our Community Education program. We are well - positioned to continue providing sexual violence prevention and response education programs in Orange County. e) Other Pertinent Agency Information The OCRCC is the only agency in the county providing 24 -hour crisis intervention services for survivors of sexual violence (SV). Orange County residents rely on us for services and advocacy. Additionally, as the gold standard for SV victim services in North Carolina and with a solid reputation among providers and clients alike, we often provide crisis intervention and long -term support services to survivors outside of Orange County as well. Because of the unique needs of SV survivors and the specific challenges they face, it is important that our services remain free and confidential. Funding from the town and county ensures that we can continue to provide these vital services to all who need them. With regards to our education programs, more than 80 percent of our programs are provided in public schools within Orange County, but they are not paid for by the two district school systems. We rely on town and county funding to ensure this crucial safety education can be delivered to local students. Main Application 1/25/2016 12:55:42 PM Page 5 of 32 MAIN APPLICATION 3. (i) PROJECT /PROGRAM INFORMATION Agency & Program Name: Orange County Rape Crisis Center – Client 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 required application and required supplemental sections (Parts) as specified below: ® Human Services (Main Application Only) ❑ CDBG Non - Construction — (Main Application AND Part A) ❑ CDBG Construction — (Main Application AND Part A AND Part B) ❑ HOME CHDO Set -aside — (Main Application AND Part A) ❑ HOME Other — (Main Application AND Part A AND Part B) Indicate the type of program for which you are requesting funding: Education Health and Nutrition Job Training Sports and Arts Activities Pre - School Activities After - School Activities Mentorin Transportation Housing Other: Human Services X X X X X Main Application 1/25/2016 12:55:42 PM P a g e 6 of 32 MAIN APPLICATION Program /Proiect Descriation (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? As described in section one, the Client Services program will provide crisis intervention services to survivors of sexual violence, their loved ones, and professionals who support survivors. Our services include our 24 -Hour Help Line, support groups, workshops, and therapy referrals. Our program intersects with the Town /County priority for affordable healthcare as well as the priority for affordable housing. With regards to accessible healthcare, all of our services are free and confidential. As a free resource and with a strong agency commitment to accessibility for all, we provide crisis intervention and mental healthcare to people across all demographics in Orange County, including low- income residents who can't afford healthcare elsewhere. With regards to affordable housing, the connection between sexual violence and homelessness is well - documented, People with housing needs are more likely to experience violence and less likely to be able to afford healthcare. With our services being free, and with our location on a public bus line, our support is accessible for this high -risk population. 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. The 2010 National Intimate Partner Survey (NISVS) from the CDC found that 1 in 5 women in the United States are raped in their lifetime. It also found that nearly 1 in 2 women and 1 in 5 men experience some form of sexual violence other than rape, such as sexual coercion, unwanted touch, sexual harassment, and more. Although local crime statistics are difficult to obtain for any jurisdiction, our experience corroborates this finding and illustrates the need for sexual violence services. The OCRCC served 524 people last fiscal year. In that time, we had a total of 2,453 contacts, meaning that we saw each client an average of 4.7 times. The long -term effects of sexual violence can be profound and may include depression, anxiety, physical illness, substance abuse, eating disorders, suicidal thoughts and attempts, self- harming behaviors, and more. All of these factors can make it difficult for survivors to function on a daily basis, obtain and keep a job, and maintain safe housing. One study found that 50% of sexual assault victims lost their jobs or were forced to quit after being raped (Ellis, Atkeson, & Calhoun, 1993). Additionally, the abuse itself can cause a housing situation to become unsafe for individuals, such as when an intimate partner is the abuser. According to the Department of Justice, more than 50% of all sexual violence incidents occur at the victim's home or within one mile of their home. In terms of mental healthcare access, Mental Health America (MHA) reports that 2.6% of adults with mental illness and 12.3% of children with emotional /behavioral /developmental issues in North Carolina do not have consistent health insurance. But even with insurance, mental healthcare is lacking: MHA reports that 20.2% of adults with mental illness in North Carolina said they did not get the mental health services they needed and an astounding 45.7% of children who needed mental health services in North Carolina did not receive them. With affordable therapeutic resources lacking in our community and across the nation, OCRCC is committed to providing free short- and long -term services to all who need them, regardless of income level. With regards to housing access, sexual violence and homelessness are strongly connected. One study found that 92% of homeless mothers had experienced severe physical and /or sexual violence at some point in their lives; 43% of them had experienced sexual abuse as a child (Browne & Bassuk, 1997). Furthermore, if survivors are on the verge of homelessness or become homeless, their risk for experiencing additional violence increases. According to a study of homeless and marginally housed people, 32% of women, 27% of men, and 38% of transgendered people reported either physical or sexual victimization in the previous year (Kushel et al., 2003). As the local governments work toward improving housing access, our services will be needed and will increase the likelihood of success. Main Application 1/25/2016 12:55:42 PM Page 7 of 32 MAIN APPLICATION The OCRCC provides short- and long -term support, becoming a significant advocate for years throughout each survivor's healing process. Many long -term effects of sexual trauma can be mitigated if survivors receive early intervention and a supportive environment to disclose their abuse. Connecting with resources that can help survivors meet their basic needs is also crucial to healing. The OCRCC connects survivors to affordable medical care, mental health care, substance abuse treatment, housing, and financial assistance. Additionally, we provide information and support to other service providers in Orange County who are serving low- and moderate- income individuals. We can help these agencies provide trauma - informed services so that the individuals they serve receive holistic, trauma - informed care. d) Describe the population to be served or the area to benefit and indicate how you will identify beneficiaries. The OCRCC's services are available to all survivors of sexual violence, stalking, human trafficking, and domestic violence in Orange and neighboring counties. Survivors hear about our services through internet research, word of mouth, promotional materials, referrals from community partners, and more. We conduct specific outreach advertising our services to underserved populations such as the Latino /a and LGBTQ communities, to give just two examples. e) Who specifically will carry out the activities and in what location will they be carried out? Our expert staff and trained volunteer Companions will provide crisis support via our 24 -Hour Help Line as well as during business hours at the OCRCC office. Support groups will be facilitated by staff and trained facilitators; they are mostly offered at the OCRCC office, though some are offered off -site in collaboration with community partners, for example, the Freedom House Recovery Center. fl 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. Activities Timeline Program Activity 1— Crisis Support Operate a 24 -hour hotline Ongoing Provide in-person crisis counseling during business hours at the OCRCC office Provide resources and referrals to other community partners Follow up with clients as needed to ensure case management is provided Update listings of resources in crisis counseling manual Recruit and train volunteer Crisis Companions in fall training 08/2016- 11/2016 Recruit and train volunteer Crisis Companions in spring training 01/2017- 04/2017 Program Activity 2 — Support Groups Review current waitlist of clients interested in participating in groups Ongoing Schedule support group facilitators to facilitate groups and workshops Publicize support groups and workshops Review client requests for group participation Screen clients and, if appropriate, lace in group Facilitate groups and workshops Compile and review FY16 -17 support group evaluation data 07/2017 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. OC Domestic Violence Needs Assessment Planning Committee: Along with community members, service providers, and researchers, the OCRCC sits on this committee to address the need for a local shelter for violence survivors. Main Application 1/25/2016 12:55:42 PM P p g o 8 of 32 MAIN APPLICATION • Carolina Outreach: OCRCC and Carolina Outreach provide cross - referrals. Additionally, OCRCC is hosting a support group for male survivors at Carolina Outreach during FY15 -16. • NC Coalition Against Sexual Assault: In FY12 -13 and FY13 -14, the OCRCC collaborated with NCCASA to create a training program for establishing a comprehensive support group (SG) program. With our program as a model, we created a manual, guidelines, and training module, and OCRCC staff provided trainings to other anti - violence agencies on creating a SG program. We also partner on other projects, especially professional development and staff training. • University of North Carolina at Chapel Hill: • Since UNC hired the Interpersonal Violence Prevention Coordinator (IVPC) in 2009, we have maintained a strong relationship to assist their work in preventing sexual violence (SV) and relationship abuse on campus. • OCRCC staff members sit on the Sexual Assault and Relationship Violence Training and Education Task Force (SARVTAE), which provides education and resources to the UNC community. • Following national attention, UNC has worked to improve their response to SV. OCRCC staff served on the Title IX hiring committee, participated in a task forces, and provided consultations to various campus departments. • We work with the Dean of Students Office to provide services and to advocate for student survivors. • We work closely with the Carolina Women's Center in providing appropriate support for students, partnering on community events, and serving on joint committees together. • We provide education programs to UNC faculty and staff, classrooms, student groups, and Greek organizations. • We provide service- learning opportunities for students. With student volunteers and interns, the OCRCC is able to maximize our outreach and services while students gain invaluable professional experience. • Sexual Assault Response Team (SART): The Center coordinates the county -wide SART. This team brings together representatives from local law enforcement, the District Attorney's office, UNC Hospitals, UNC - Chapel Hill, and other local agencies to improve the overall community response to survivors. The goal is to collaboratively provide the best system of care for survivors needing services through a variety of local departments. Meeting monthly, SART receives training, shares experiences, and addresses issues as they arise. • The Compass Center for Women & Families: We collaborate with the Compass Center through all our services, referring clients to each other, coordinating shelter services for clients, providing mutual assistance for volunteer training, and conducting joint educational programs. Additionally, a representative from the Compass Center sits on SART. • El Centro Hispano: Our Latino Services Coordinator works closely with El Centro in order to improve services to the Latino community. In recent years, the LSC has provided client services and educational programs out of their office, allowing greater outreach to Latinos in our community. • Freedom House Recovery Center: In addition to cross - referrals, we work with Freedom House to provide support groups to survivors of sexual assault who also struggle with addiction. • Salvation Army — PROJECT FIGHT: We participate in the Rapid Response Team of the Triangle together in order to address the needs of trafficking victims in our area. The two agencies also provide cross - referrals. • Carrboro Community Clinic: In addition to cross - referrals, OCRCC provided professional training on trauma - informed care and how to connect clients with our services. • Orange Correctional Center: In this new partnership, OCRCC provides counseling in person or via phone or mail at the prison. We also provide accompaniment to the hospital if an inmate needs a forensic evidence kit ( "rape kit "). h) Describe what would happen if requested funding is not awarded at all or if a reduced allocation is recommended. Without funding from local government, we would not be able to maintain the level of comprehensive, unique service that we currently offer to our clients, including the large number of support groups and workshops. Altogether, local government grants comprise about 10% of our budget. i) Include any other pertinent information. The OCRCC measures the effectiveness of our support group services via participant evaluations. In FY2014 -2015, our data showed that OCRCC support group participants, on average, experienced a reliable decrease in PTSD symptom severity. One participant said, "Participating in this support group has made me feel less alone, made me feel like I'm actually getting somewhere in healing, made it easier for me to talk about what happened, and made me start to reach out to old friends I'd isolated myself from." Main Application 1/25/2016 12:55:42 PM Page 9 of 32 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 1) 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: ® Persons ❑ Households ❑ Units Program: Client Services Actual Estimated Projected 2014 -15 2015 -16 2016 -17 Male 69 66 72 Female 405 410 420 Other 4 6 10 Unknown* 46 108 98 Total 524 590 600 Of the females, how many are single - female N/A N/A N/A Head of Households (Omit for Human Services) iEthhicity African - American American Indian or Alaska Native Asian Caucasian Native Hawaiian or other Pacific Islander Other Unknown* Total Of the above, how many Hispanic /Latino Of the above, how many non - Hispanic /Latino Total 26 18 30 1 1 1 10 2 4 130 174 175 0 0 0 59 108 128 298 287 262 524 590 600 52 106 126 174 197 212 524 590 600 Main Application 1/25/2016 12:55:42 PM P a g e 1 0 o f 3 2 MAIN APPLICATION Age 0 -5 years 6 -18 years 19 -50 years 51 -61 years 62+ years Unknown* Total Geographic Location Durham City Durham County Carrboro Chapel Hill (incl. UNC) Chapel Hill Public Housing Residents Orange County Raleigh Wake County Homeless Other Unknown* Total 0 0 0 6 2 6 119 192 204 47 30 40 8 6 8 344 360 342 524 590 600 N/A N/A N/A 38 42 42 36 32 38 126 150 160 N/A N/A N/A 27 12 29 N/A N/A N/A 21 30 25 6 4 12 98 108 110 172 212 184 524 590 600 * A large amount of our contact with clients is over the phone on our 24 -Hour Help Line. Many clients may be experiencing a mental or physical crisis situation, in which case it may not be appropriate to ask demographic questions. Further, because of the nature of our work, many clients may be very nervous about calling us, and they greatly value anonymity. Out of respect for their confidentiality, it may not be appropriate to ask demographic questions. It is easier and more appropriate for us to collect data on clients who utilize long -term services, such as support groups. Main Application 1/25/2016 12:55:42 PM Page 1 1 of 32 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). 1) Client Services 2) Community Education 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 1/25/2016 12:55:42 PM Page 12 of 32 °Jo If pr,64,11aed, tiSitloln Tales ' . ��O Pro rim 9. ►�t,��t��naed �actea _-20� Tbta1 indleat+e: AR). Retirement * RASn7aart: St Z�1 U1 -C =d ; ' ► het Ma tto Phis 45%(1) Executive Director 1.0 55%(2) 75,929 74,235 77,673 11% R,H Client Services Director 1.0 100%(l) 58,207 55,411 56,929 8% R,H Crisis Response Coordinator 1.0 100%(l) 45,446 48,068 45,151 6.4% R,H 90%(1) Latina Services Coordinator 1.0 10%(2) 34,690 45,407 46,184 6.6% R,H Client Services Assistant .75 100%(1) 0 0 27,640 4% R,H 75% Community Education Director 1.0 100%(2) 0 52,918 54,335 7.7% R,H Prevention Coordinator 1.0 100%(2) 44,567 45,959 46,873 6.7% R,H Education & Finance 12% (1) Coordinator 1.0 88%(2) 42,701 49,314 50,116 7% R, H Education Assistant .50 100%(2) 14,524 16,227 2.3% R Development & 37%(1) Communications Director 1.0 63%(2) 53,049 58,374 62,944 9% R,H Administrative Services 65%(1) Coordinator 1.0 35%(2) 28,736 33,195 38,838 5.5% R,H Crisis Response Assistant .25 100%(l) 7,230 8,419 11,590 1.6% R 50%(1) Volunteer Hours 4.0 50%(2) n/a 1) Client Services 2) Community Education 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 1/25/2016 12:55:42 PM Page 12 of 32 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? ❑ ® 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. 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. Date Date Main Application 1/25/2016 12:49:34 PM P a g e 1 3 o f 3 2 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 -2015 2015 -2016 2016 -2017 Program Activity 1 Crisis Support: Staff and trained volunteers ( "Companions ") respond to walk -in clients and to calls on the 24 -Hour Help Line. Companions provide emotional support; give resources, information, and referrals; and accompany survivors to medical, legal, and law enforcement appointments. Staff and trained volunteers facilitate support groups and workshops for survivors. Program Goal The OCRCC will provide The OCRCC will provide The OCRCC will provide assistance to approximately assistance to approximately assistance to approximately 620 individuals. 600 individuals. 600 individuals. Performance Measures Staff and volunteers keep records of each client contact. Program Results We served a total of 524 We expect to serve about 590 We expect to serve about 600 clients. clients. clients. We estimated client numbers based on growth rates from previous years, but service numbers unexpectedly declined. Though we saw fewer clients than anticipated, we now see each client more frequently than in the past. In the past 5 years, we have seen a 62% increase in the number of contacts we have per client. 62 of the 524 clients participated in 15 support groups and/or workshops. We held more groups than the expected 8, which takes more staff time for fewer clients. Main Application 1/25/2016 12:55:42 PM P a g e 1 4 o f 3 2 MAIN APPLICATION Program Activity 2 Support Groups: Staff and trained volunteers facilitate support groups and workshops for survivors. Some are traditional discussion -based groups and others are activity- focused groups utilizing alternative healing modalities. Program Goal Clients will report that they have more information about options and resources available to them. Additionally, they will have gained emotional support as a result of their contact with the Center. We expect that more than 90% of those who complete evaluations will: (1) Report that participation in a support group helped them feel less alone in their experience of sexual violence. (2) Report that participation in a support group increased feelings of being supported in their healing process. Performance Measures Using a quantitative standardized scale for measuring post- traumatic stress disorder (PTSD), support group participants will be given a pre- and post -test for these symptoms. Participants are also asked to provide qualitative feedback about the service(s) they utilized at the OCRCC, to evaluate their service provider, and to comment on the accessibility of our programs. The Client Services Director compiles data after each support group and at the end of the fiscal year . Program Results 95% of support group participants reported that our groups helped them feel less alone in their experience. 94% of support group participants reported that our groups made them feel more supported in their healing process. Main Application 1/25/2016 12:55:42 PM Page 15 of 32 MAIN APPLICATION 3. (ii) PROJECT /PROGRAM INFORMATION Agency & Program Name: Orange County Rape Crisis Center- Community Education 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 required application and required supplemental sections (Parts) as specified below: ® Human Services (Main Application Only) ❑ CDBG Non - Construction — (Main Application AND Part A) ❑ CDBG Construction — (Main Application AND Part A AND Part B) ❑ HOME CHDO Set -aside — (Main Application AND Part A) ❑ HOME Other — (Main Application AND Part A AND Part B) Indicate the type of program for which you are requesting funding: Main Application 1/25/2016 12:55:42 PM Page 16 of 32 Diseble Pal3lc ousing Program Ceteg4ry Youth Acid# , Eiderly (nit l�isiglab ©rhaods/ Iderl Residens.. Education X X X X X Health and Nutrition Job Training Sports and Arts Activities Pre - School Activities After - School Activities Mentorin Transportation Housing Other: Human Services Main Application 1/25/2016 12:55:42 PM Page 16 of 32 MAIN APPLICATION 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? The Orange County Rape Crisis Center (OCRCC) has provided safety education programs to local youth and adults for 35 years. Our Safe Touch program was innovative and groundbreaking when first launched, and we have continued to incorporate new research and best practices into our curriculum over the years to ensure the highest quality content and delivery. Our Safe Touch program is designed for preschool through fifth grade, focusing on protective factors against sexual abuse victimization. We teach age- appropriate messages for how to identify inappropriate touches, what to do if they experience violence, and who they can talk to about violence. In fourth and fifth grade, we introduce lessons about sexual bullying, internet safety, and cyber- bullying. Our Start Strong program works in middle and high schools, focusing on risk and protective factors for perpetration of sexual violence, in accordance with primary prevention theory. In keeping with evidence -based best practices, our messages focus on positive behavior development rather than negative behavior abatement as well as on bystander empowerment rather than risk reduction for potential victims. Our programs increase protective factors for youth, including developing positive and health relationships, promoting healthy sexuality, developing media literacy skills, increasing bystander efficacy, and challenging rape myths. Our adult and parent programs utilize both primary prevention and risk reduction strategies. Our major program is Stewards of Children®, a professional training curriculum provided by the Darkness 2 Light Coalition. Relying on evidence -based methodology, we teach parents and caregivers concrete steps and practical tips for preventing, recognizing, and responding to child sexual abuse. The OCRCC's education programs address community priorities by reducing what the CDC terms Adverse Childhood Experiences (ACEs), which form the root causes of many public health issues and contribute to negative life outcomes such as substance abuse, mental and behavioral health issues, and chronic disease. In addition to their prevention focus, the programs are designed to identify children and adolescents currently experiencing violence and connect them with appropriate professional supports. Over the last five years, our staff has assisted school personnel with providing intervention services to 544 students, including making reports to the Department of Social Services in cases where mandated or recommended. 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. According to the Darkness 2 Light Coalition, about one in ten children will be sexually abused before their 18th birthday. And as this statistic includes contact -only abuse, we know that even more children will experience other forms of non - contact sexual violence, such as exposure, voyeurism, sexual harassment, and exposure to pornography. Sexual violence occurs in all communities and across all demographic groups, and research shows that children and teens are at even higher risk of victimization than adults: 70 percent of all reported sexual assaults occur to children under the age of 18. Though local data on sexual violence is difficult to assess, our experience corroborates these national findings. In addition to the alarmingly high rates of child sexual abuse, we also know that the negative impacts of abuse can be severe. Children who experience sexual violence may have mental health issues such as anxiety, depression, aggression, or suicidal thoughts; difficulty with interpersonal relationships and sexuality; self- esteem and body image issues; difficulty at school such as poor performance, poor behavior, or poor attendance; physical illness; and more. Without proper support, these difficulties may persist into adulthood, creating limitations on their health, employment, and housing outcomes. But just as with adults, these long -term consequences can be diminished if children receive early Main Application 1/25/2016 12:55:42 PM P a g e 1 < o f 3 2 MAIN APPLICATION intervention and a supportive environment to disclose their abuse and begin to heal. Further, because offenders often perpetrate in an escalating manner, recognizing inappropriate behavior and intervening early can prevent more severe abuse from occurring. It is therefore crucial that we work both to prevent initial victimization and also to identify and provide services to those who do experience violence. With the majority of our programs taking place within local schools, we are able to educate youth and adults across all demographics in Orange County, including underserved populations as well as low- and moderate - income families. d) Describe the population to be served or the area to benefit and indicate how you will identify beneficiaries. Because the program operates through the public schools, we will serve a majority of families with school -aged children in the county, with a particular emphasis on services to vulnerable and low- income families through our partnership with HeadStart/Early HeadStart and the Exceptional Children programs in both CHCCS and OCS. Every preschool and elementary student enrolled in CHCCS, OCS, or HeadStart will benefit from our programs. Older students in middle and high school in Chapel Hill and Carrboro will also benefit from our program, which will reach every 7th and 9th grader in each of the CHCCS schools. Beneficiaries in Orange County Schools will be determined based on which school personnel opt to include the program in their curriculum. While we do not collect demographic information related to housing or household income for the purposes of our educational program, we work within the public schools which maintain a commitment to serving homeless, low- income, moderate - income, and vulnerable children. We are assured that with 100% reach in the schools, we provide benefits to students from a variety of income levels and housing situations, approximately reflecting the population of the county. e) Who specifically will carry out the activities and in what location will they be carried out? Program activities will be carried out by qualified staff and trained volunteers in local schools. Safe Touch program activities at the elementary level are delivered through the regular classroom with support from classroom teachers and student support staff (i.e., counselors, social workers, nurses). Preschool classroom programs are coordinated either through the school for site -based pre -K classes, or through the Head Start/Early HeadStart program. Students enrolled in both school -based and facility -based HS /EHS receive the program in the spring when they are most developmentally prepared for the content. Start Strong program activities at the middle and high school level are delivered by staff and volunteers in the Healthful Living classes, with support from classroom teachers. Our adult education programs are delivered in a variety of settings, including during the two district Open House events and at specific schools throughout the school year. These are delivered by certified presenters on our staff. 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. Activities Timeline Program Activity 1— Safe Touch Renew Memorandum of Agreement with OCS and CHCCS 07/2016- 08/2016 Work with school personnel to coordinate program schedule 07/2016- 09/2016 Recruit and train volunteers to present Safe Touch programs 08/2016- 09/2016 Parent Open House in OCS 09/2016 Implementation of Safe Touch programs in OCS 09/2016- 11/2016 Parent Open House in CHCCS 11/2016 Implementation of Safe Touch programs in CHCCS 11/2016- 04/2017 Main Application 1/25/2016 12:55:42 PM P a g e 18 of 32 MAIN APPLICATION Implementation of Safe Touch programs in pre -K and HeadStart/Early HeadStart in OCS and CHCCS 05/2017 Schedule and implement Safe Touch programs as requested for charter schools, private schools, community groups, professional organizations, faith communities, etc. Ongoing Program Activity 2 — Start Strong Renew Memorandum of Agreement with OCS and CHCCS 07/2016- 08/2016 Work with school personnel to coordinate program schedule 07/2016- 09/2016 Recruit and train volunteers to present Start Strong programs 08/2016- 11/2016 Implementation of Start Strong 7th grade program in CHCCS & OCS middle schools 4 sessions in each participating health class 10/2016- 05/2017 Implementation of Start Strong 91h grade program in CHCCS & OCS high schools 2 sessions in each participating health class 10/2016- 05/2017 Schedule and implement Start Strong programs as requested for charter schools, private schools, community groups, professional organizations, faith communities, etc. Ongoing Program Activity 3 — Adult Education & Training Schedule and implement adult, parent, professional, and custom programs as requested for charter schools, private schools, community groups, professional organizations, faith communities, etc. Ongoing 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. Orange County Schools and Chapel Hill - Carrboro City Schools: The OCRCC maintains an annual Memorandum of Agreement (MOA) with OCS and CHCCS outlining responsibilities of both parties for program delivery, parent communication, and follow -up protocol with students who raise concerns during or immediately following a program. • Compass Center for Women & Families: The OCRCC collaborates with Compass to provide joint programming in the Start Strong program. The OCRCC provides 7th and 9th grade programs, and Compass provides 6th and 8th grade programs. We work together to ensure content and evaluation coherence. Department of Social Services: The OCRCC regularly refers families of students who raise concerns during classroom programs to DSS for follow -up services and intervention if needed. • The OCRCC also offers programming by request to a number of independent schools, community groups, professional organizations, faith communities, and others, h) Describe what would happen if requested funding is not awarded at all or if a reduced allocation is recommended. Without funding from local governments, we would not be able to provide a large number of safety education programs to our community. With only two full -time and one part-time staff members, we are already stretched beyond capacity and often have to decline program requests. In FY14 -15, the OCRCC provided a total of 898 programs to 13,614 people. More than 80% of programs were delivered to pre -K through grade 12 students. Additionally, education staff worked more closely than ever with client services staff to deliver community -wide education opportunities, bringing customized programs to faith communities, neighborhoods and families across the county. Altogether, local government grants comprise about 10% of our budget. i) Include any other pertinent information. The following comment from a parent was posted on Facebook and is shared with permission: "I wanted to let the community and the administration know HOW MUCH 1 appreciate the Safe Touch education program that the school implemented this past month. The fact that the administration and faculty made this a priority speaks volumes about putting the safety of our children first. I feel such gratitude that my children are in a safe place.... Thank you from the bottom of my heart to whomever made this happen in our school!" Main Application 1/25/2016 12:55:42 PM P a g e 1 9 of 3 2 MAIN APPLICATION Program /Project Information 0) Complete the Target Population and Program Beneficiary Demographics Chart (k) Complete the Schedule of Positions Chart for Program Staff (1) Disclosure of Potential Conflicts of Interest 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: ® Persons ❑ Households ❑ Units Program: Community Education Caucasian Native Hawaiian or other Pacific Islander Other Unknown Total N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A 1,869 1,865 1,875 10,523 10,600 10,650 1,222 1,230 1,240 13,614 13,695 13,765 Main Application 1/25/2016 12:55:42 PM P a g e 20 of 32 Geographic Location MAIN APPLICATION Durham City Durham County Carrboro Chapel Hill (incl. UNC) Chapel Hill Public Housing Residents Orange County Raleigh Wake County Chatham Other /Unknown Total 483 565 600 240 200 200 1,136 1,135 1,135 7,673 7,660 7,660 N/A N/A N/A 3,830 3,930 3,965 43 35 35 0 0 0 162 120 120 47 50 50 13,614 13,695 13,765 * We are not able to track education programs based on gender or ethnicity since they typically have mixed audiences. With the vast majority of our programs taking place in the local school districts, we can assume that our outreach numbers reflect county -wide demographic data. Main Application 1/25/2016 12:55:42 PM P a g e 21 of 32 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). 1) Client Services 2) Community Education 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 1/25/2016 12:55:42 PM P a. c I e 2 2 r f 3 2 if pr Vided, lIn lic"ate..... Titles ** program victual Est {mated ejected °10 Total t# �Posltlon ostionVacant 20 4' 0- 1 2fl1S- Budget'l etreraent .Staff plan es Health Plan 45%(1) Executive Director 1.0 55%(2) 75,929 74,235 77,673 11% R,H Client Services Director 1.0 100%(l) 58,207 55,411 56,929 8% R,H Crisis Response Coordinator 1.0 100%(l) 45,446 48,068 45,151 6.4% R,H Latina Services 90%(1) Coordinator 1.0 10%(2) 34,690 45,407 46,184 6.6% R,H Client Services Assistant .75 100%(l) 0 0 27,640 4% R,H 75% Community Education Director 1.0 100%(2) 0 52,918 54,335 7.7% R,H Prevention Coordinator 1.0 100%(2) 44,567 45,959 46,873 6.7% R,H Education & Finance 12%(1) Coordinator 1.0 88%(2) 42,701 49,314 50,116 7% R, H Education Assistant .50 100%(2) 14,524 16,227 2.3% R Development & 37%(1) Communications Director 1.0 63%(2) 53,049 58,374 62,944 9% R,H Administrative Services 65%(1) Coordinator 1.0 35%(2) 28,736 33,195 38,838 5.5% R,H Crisis Response Assistant .25 100%(l) 7,230 8,419 11,590 1.6% R 50%(1) Volunteer Hours 4.0 50%(2) n/a 1) Client Services 2) Community Education 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 1/25/2016 12:55:42 PM P a. c I e 2 2 r f 3 2 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? ❑ ® 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. 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: -- .--r25 � � �O Exec ive Di ctor Date Signature: ;5 %1 Bo r C erson Date Main Application 1/25/2016 12:49:34 PM P a g e 1,3 o f 3 2 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 -2015 2015 -2016 2016 -2017 Program Activity 1 Present educational programs to youth and adults in the community. Program Goal OCRCC will provide OCRCC will provide OCRCC will provide educational programs to educational programs to educational programs to 13,010 individuals. 13,010 individuals. 13,200 individuals. Performance Measures Program Record sheets maintained and monitored by OCRCC education staff. Program Results OCRCC provided educational programs to 13,614 individuals in the community. Program Activity 2 Present Safe Touch educational programs in elementary schools. Program Goal 90% of teachers and counselors whose classrooms receive Safe Touch programs will report an increase in student awareness of personal safety and protection against sexual violence. Performance Measures For each program within a school setting, the OCRCC provides each teacher and school counselor with an evaluation asking them to assess whether the program resulted in an increased awareness of personal safety and protection against sexual violence among students. OCRCC staff reviews evaluations periodically and compiles results biannually. Program Results 95% of teachers and counselors at schools that receive OCRCC programs reported an increase in student awareness of personal safety and protection against sexual violence. Main Application 1/25/2016 12:55:42 PM P a g e 24 of 32 MAIN APPLICATION 4. FINANCIAL INFORMATION FOR SERVICE PROGRAMS a.) Program Budget 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 1/25/2016 12:55:42 PM Page 25 of 32 MAIN APPLICATION Program Budget Agency /Program Client Services Total Agency Revenue $ $ 288,706 $ Actual Estimated Projected AGENCY REVENUE 20415. 1 $ 2015-16 201,6 -77 (1,460) Compensation 0 $ 202,540 Private Donations $ 25,000 $ 25,000 $ 25,000 Rent & Utilities Agency Generated Revenue (fees) $ - $ - $ - Local Government Grants: Supplies & Equipment Orange County $ 15,000 $ 15,000 $ 17,500 Town of Chapel Hill $ 4,000 $ 10,000 $ 13,500 Town of Carrboro $ 2,000 $ 5,000 $ 6,000 Other Local: Town of Hillsborough $ 2,500 $ 2,500 $ - Other Local: 26,679 $ 18,002 $ 16,217 Please list 3 largest "Other Expenses ": Other Local: If more than 3 sources, please $ 6,010 $ 6,627 $ provide a separate list. Professional dues, marketing, misc. $ $ 10,711 $ 7,625 Non -Local Government Grants 8,515 Client Emergency Funds, contract fees $ $ 9,958 $ Triangle United Way $ 21,412 $ 26,365 $ 22,500 State Government $ 43,784 $ 38,550 $ 35,500 Federal Government $ 134,932 $ 158,655 $ 193,655 Other Grants: Contracts (LAV) $ 14,103 $ 12,250 $ 4,000 Other Grants: Miscellaneous/Other Revenue $ ;25,975 $ 26,893 $ 31,917 Please list 3 largest Miscellanous sources: Fundraiser (annual auction) $ $ $ 24,893 $ 30,417 Miscellaneous $ $ , $ 2,000 $ 1,500 $ Total Agency Revenue $ $ 288,706 $ 320,293 $ 34v,o /L AGENCY EXPENSES SURPLUS /(DEFICIT) FOR PERIOD: 1 $ (1,460) Compensation 0 $ 202,540 $ 235,650 $ 267,250 Rent & Utilities $ 43,372 $ 45,411 $ 48,005 Supplies & Equipment $ 14,185 $ 18,150 $ 15,100 Travel & Training $ 3,390 $ 3,000 $ 3,000 Other Expenses: $ 26,679 $ 18,002 $ 16,217 Please list 3 largest "Other Expenses ": Financial: Audit, bank fees, etc. $ $ 6,010 $ 6,627 $ 6,952 Professional dues, marketing, misc. $ $ 10,711 $ 7,625 $ 8,515 Client Emergency Funds, contract fees $ $ 9,958 $ 3,750 $ 750 0% 0 17% 35% 20% -100% -8% 22% -67% 0 19% 13% 6% -17% 0% 10% Total Agency Expenses $ 290 166 $ 320,213 $ 349,572 1 22 SURPLUS /(DEFICIT) FOR PERIOD: 1 $ (1,460) $ - $ - 1 0 Main Application 1/25/2016 12:55:42 PM P a g e 26 of 32 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. Complete the table below for the project/program for which you are requesting funds. Attach additional rows /pages, as needed. Program: Client Services ±�ster»ents .. actual = Es�r�ted Cyst; Quart #1tIJnit Sulbtofal, ; Personnel staff time 5.5 FTE $290,166 $320,213 $267,250 —Supplies for volunteer training. 40 25 volunteers 2453 2773 $L000 Client Emerqency funds As many as needed $118.29 $115.47 250 Communications costs for Hel line Phone internet cell $8,120 $72,952.50 Total $349,572.50 c.) Cost per Unit 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 1/25/2016 12:55:42 PM P a e 27 of 32 actual = Es�r�ted Px+efQd IN f Total Cost of $290,166 $320,213 $349,572.50 Program Total # of 2453 2773 2820 Units Cost Per Unit $118.29 $115.47 $123.96 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 1/25/2016 12:55:42 PM P a e 27 of 32 MAIN APPLICATION a.) Program Budget 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 1/25/2016 12:55:42 PM Page 28 of 32 MAIN APPLICATION Program Budget Agency /Program: Community AGENCY REVENUE Private Donations Agency Generated Revenue (fees) Local Government Grants: Orange County Town of Chapel Hill Town of Carrboro Other Local: Town of Hillsborough Other Local: Other Local: If more than 3 sources, please provide a separate list. Non -Local Government Grants Triangle United Way State Government Federal Government Other Grants: Contracts Other Grants: Private Foundations Education 66,358 $ 54,394 ill $ 50,382 $ $ Actual 2014=^15 J, Estimated 20`1546 � Projected 20116 -J7 Percent ��#�an e" ' $ 70,387 $ 92,000 $ 92,000 0% $ 1,722 1 $ 4,800 1 $ El 015,0�00$ $ 6,000 17,500 25% 17% $ 16,000 $ 10,000 $ 13,500 35 % $ 7,000 $ 5,000 $ 6,000 20% $ 2,500 $ 2,500 $ - - 100% 0 0 1 $ 12,500 -17% $ 9,640 $ 15,016 $ 52,065 $ 42,565 $ 45,500 7% $ 59,533 $ 60,000 $ 60,000 0% $ - $ - $ 25,000 0 $ 15,500 $ 18,938 $ 21,190 12% Miscellaneous /Other Revenue Please list 3 largest Miscellanous sources: Fundraiser (annual auction) Miscellaneous Non -cash donations Total Agency Revenue AGENCY EXPENSES Compensation Rent & Utilities Supplies & Equipment Travel & Training Other Expenses: Please list 3 largest "Other Expenses ": Financial: Audit, bank fees, etc. Professional dues, marketing, misc. Client Emerqencv Funds, contract fees Total Agency Expenses SURPLUS /(DEFICIT) FOR PERIOD: 202,540 267.250 1 1 $ 66,358 $ 54,394 ill $ 50,382 $ $ 46,047 $ 44,194 $ 40,882 $ $ 1,574 $ 2,200 $ 1,500 $ $ 18,737 $ 8,000 $ 8,000 202,540 267.250 1 1 1 -14 $ (1,462)1$ - 1 $ - 1 0 Main Application 1/25/2016 12:55:42 PM Page 29 of, 31 2 $ 40,122 1 $ 41,911 $ 44,085 $ 24,861 $ 17,950 $ 20,100 $ 3,050 $ 3,500 $ 3,000 $ $ $ $ 19,594 6,010 8,008 5,576 $ $ $ $ 21,202 6,627 10,075 4,500 $ $ $ $ 15,137 6,952 7,685 500 1 -14 $ (1,462)1$ - 1 $ - 1 0 Main Application 1/25/2016 12:55:42 PM Page 29 of, 31 2 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. Complete the table below for the pro *ect /program for which you are requesting funds. Attach additional rows /pages, as needed. Program: Community Education costs c.) Cost per Unit 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 1/25/2016 12:55:42 PM P a a e 30 of 32 Total Cost of $290,166 $320,213 $349,572.50 Program Total # of Units 13,614 13,695 13,765 Cost Per Unit $21.31 $23.38 $25.40 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 1/25/2016 12:55:42 PM P a a e 30 of 32 MAIN APPLICATION d.) 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 1/25/2016 12:55:42 PM Pace 31 of, 32 MAIN APPLICATION Section M. Financial Data Operating Budget for Entire Agency AGENCY NAME: Orange County Rape Crisis Center $ 92,333 $ 81,288 $ 82,300 Amu-a,17< Estimated Projected Percent AGENCY REVENUE 2014 -15 2015 -'16 2016 -17 Change $ 3,074 $ 4,200 Private Donations $ 95,387 $ 117,000 $ 117,000 0% Agency Generated Revenue (feesfor out of 18,737 $ 8,000 $ 8,000 county community education programs) $ 1,722 $ 4,800 $ 6,000 25% Local Government Grants: Orange County $ 30,000 $ 30,000 $ 35,000 17% Town of Chapel Hill $ 20,000 $ 20,000 $ 27,000 35% Town of Carrboro $ 9,000 $ 10,000 $ 12,000 20% Other Local: Town of Hillsborough $ 5,000 $ 5,000 $ - - 100% Other Local: 0 Other Local: $ 87,322 $ 92,090 0 9 more than 3 sources, please provide a separate list. $ Non -Local Government Grants $ 36,100 $ 35,200 Triangle United Way $ 31,053 $ 41,381 $ 35,000 15% State Government $ 68,849 $ 81,115 $ 81,000 0% Federal Government $ 194,465 $ 218,655 $ 253,655 16% Other Grants: Private Foundations $ 15,500 $ 18,938 $ 21,190 12% Other Grants: contracts $ 14,103 $ 12,250 $ 29,000 137% Miscellaneous/Other Revenue Please list 3 largest Mscellanous sources: Fundraiser. annual auction miscellaneous $ Non -cash donations $ Total Agency Revenue AGENCY EXPENSES Compensation Rent & Utilities Supplies & Equipment Travel & Training Other Expenses: Please list 3 largest "Other Expenses ": Financial: Audit, bank fees, etc. $ Professional dues, marketing, rrisc. $ Client Energency Funds, contract fees $ Total Agency Expenses SURPLUS /(DEFICIT) FOR PERIOD: $ (2,918) $ $ - I 0 Main Application 1/25/2016 12:55:42 PM Page, 32 of 32 $ 92,333 $ 81,288 $ 82,300 1% $ 70,522 $ 69,088 $ 71,300 $ 3,074 $ 4,200 $ 3,000 $ 18,737 $ 8,000 $ 8,000 $ 577,412 $ 640,427 $ 699,145 9% I $ 405,079 $ 471,300 $ 534,500 13% $ 83,494 $ 87,322 $ 92,090 5% $ 39,046 $ 36,100 $ 35,200 -2% $ 6,440 $ 6,500 $ 6,000 -8% $ 46,271 $ 39,205 $ 31,355 -20% $ 12,019 $ 13,255 $ 13,905 $ 18,719 $ 17,700 $ 16,200 $ 15,534 $ 8,250 $ 1,250 $ (2,918) $ $ - I 0 Main Application 1/25/2016 12:55:42 PM Page, 32 of 32 APPLICATION SUBMITTAL CHECKLIST FOR OFFICE USE ONLY Received By Agency Piedmont Health Services, Inc. Date /Time / Complete Y / N Program(s) Carrboro Community Health Center Section 1. Cover Page Subsection a. ® Applicant Contact Information b. ® Project /Program Contact Information c. ® Funding Requests Identified d. ® Signed Application Cover Page For CDBG & • HUD Regulations 2. Agency a. ® Agency's Years in operation 24 CFR 570.506, Information - b. ® Agency's Purpose /Mission 570.507, 570.610; 24 c. ® Agency's Types of Services Provided CFR Parts 84 or 85 d. ® Agency's Experience e. ® Other Pertinent Information 3. Program/ a. ® Type of Application and Program Identified 24 CFR 570.200(a), Project b. ® Summary of Program 570.201 -570. 208, Information - c. ® Description of Identified Need 507.503 (for each d. ® Description of Population to be Served program/ e. ® Activity Manager and Location Description project for f. ® Activity Implementation Timeline which funding is requested) g• ®Agency Collaboration h. ® Describe Impact of Reduced /No Allocation i. ® Other Pertinent Information j. ® Complete Target Population /Beneficiary Chart k. ® Complete Schedule of Positions I. ® Signed Conflict of Interest Disclosure m. ® Complete Work Statement i I P a g e MAIN APPLICATION Main Application 1/25/2016 1:09:19 PM Page 2 of 22 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. ® Program Budget Worksheet 570.602, 570.607(b), is requested) b. ® Program Budget Detail 570.611 c. ®Cost Per Unit 24 CFR d. ® Agency Operating Budget Worksheet 570.502 - 570.504, 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. ❑ Part A: CDBG & HOME Sections (as B. ❑ Part B: Construction /Rehab applicable) 6. Attachments a. ® Audit: Organizations receiving $300,000 or more OMB CircularA -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. ® NC Solicitation License d. ® IRS Federal Tax - Exemption Letter e. ® Certificate of Insurance f. ® List of Board of Directors 24 CFR Parts 84 or 85 g. ® Articles of Incorporation /Bylaws h. ® Authorization to Request Funds 24 CFR 570.208, 570.500(c), 570.611 L ® Authorized official designation j. ® Solid Waste Program Fee (SWPF) Verification Main Application 1/25/2016 1:09:19 PM Page 2 of 22 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): b) Agency's Purpose /Mission: c) Types of Services the Agency Provides d) Agency's Experience with Similar Programs as the Funding Request e) Other Pertinent Agency Information Agency History, Mission and Services: Piedmont Health Services, Inc. (PHS), as Orange County's only Federally - Qualified Health Center (FQHC) organization, is a critical part of the community's health care safety net for vulnerable and /or financially- disadvantaged residents. Incorporated in May 1970 as Orange Chatham Comprehensive Health Services by a group of residents and hospital officials concerned with health care access, PHS changed its name in 1995 to better reflect its growing service area. PHS' mission statement is: "Our mission is to improve the health and well -being of the community by providing high quality, affordable and comprehensive primary health care. Our vision is a health community in which all people have timely access to quality health care." PHS is governed by a community Board of Directors, where 51% of Board members are required to be consumers of the organization's services. FQHCs are charged nationally with reducing barriers to primary health care access for low- income populations (i.e. those living below 200% of the Federal Poverty level). To meet its mission, PHS currently operates ten community health center program sites in four counties (Orange, Caswell, Chatham, Alamance) which together provide more than 42,000 people annually with sliding -fee access to comprehensive family medical care with on -site lab (all sites), family dental care (5 sites), low -cost pharmacy services available via PHS participation in the Federal 340B Drug Pricing Program (7 sites), care management (all sites), Women, Infant, Children (WIC) supplemental nutrition program (5 sites, including the Orange County Health Department) and site - specific outreach services. In addition to addressing financial barriers to care with the sliding -fee scale, PHS seeks to decrease cultural - linguistic barriers to care. All services are available in the Spanish language and additional language capacity is site - specific per need. In addition to the community health centers, PHS additionally operates Piedmont Health SeniorCare, a CMS - deemed Program of All- Inclusive Care for the Elderly (PACE) with two adult day health centers (ADHCs) in Burlington and Pittsboro. SeniorCare offers PACE - eligible individuals in five counties (including Orange County) an important community -based alternative to nursing home institutionalization. PACE eligible individuals are 55 years or older, declared nursing home eligible by the state, and capable of living safely at home with PACE supports at program entry. PACE is a full -risk, capitated model under Medicare and the state Medicaid program where PHS receives per member per month capitation from Medicare and Medicaid and is responsible for the total health care costs (i.e. primary, specialist, pharmacy hospital and nursing home care) of its now 217 PACE participants. Orange County Operations: Until 2015, PHS had only one the Carrboro Community Health Center (CCHC) in Orange County. The Center has been overwhelmed by demand for appointments in excess of supply for several years. By demonstrating this unmet need for sliding -fee health care access to HRSA, PHS was able to garner a competitive HRSA New Access Point (NAP) health center grant award in August to support the opening of two new health center program sites in Orange County. The first, IFC Community Health Center, opened in September in collaboration with the InterFaith Council for Social Service at its new IFC @SECU House Men's Shelter on Martin Luther King Jr. Boulevard. The Center is a limited -scope site that serves homeless residents in IFC's men's and women /children's emergency shelter and transitional housing programs with medical and dental care. The second site, the Chapel Hill Community Health Center, just opened in rented space in the Chapel Hill North shopping center, and like Carrboro Health Center offers care to "all comers" regardless of age or residency status. The chart below presents a summary of the services Revised November 20, 2014 Page 4 of 22 Pages MAIN APPLICATION offered by site. In addition to the New Access Point award, PHS garnered capital funds from HRSA to renovate its Carrboro Health Center to expand its dental clinic from 3 to 6 chairs and expand /enhance delivery space for its other services. This renovation is expected to be completed during the proposed funding period (2016- 2017). Piedmont Health Services Inc.: Orange Countv -Based Programs ** Services of the CCHC medical program include the Reach Out and Read early literacy program, Mobile Mammography Van and Group Diabetes Visits. To assure adequate access to services, PHS health centers use an open access scheduling system that provides scheduled appointments as well as same -day access to care for urgent needs. There is 24 -hour access to medical advice via the UNC nurse triage line, and PHS works closely with UNC and other hospitals to assure a smooth continue of care for its patients. PHS continues to be recognized for the quality of the primary care services it provides. It has been accredited by The Joint Commission since 2001, and is now recognized by the NCQA as a Level 3 Patient Centered Medical Home. FQHCs are expected to be supported by the communities they serve. PHS' Federal funder, HRSA's Bureau of Primary Health Care, expects all FQHCs to demonstrate other sources of funding besides their Federal grant dollars (which are used to partially underwrite the cost of uncompensated care), including primarily: program revenue generated through insurance billing and patient payments on the sliding fee scale, state and local grants, and donations. In funding PHS, the Towns of Carrboro and Chapel Hill and Orange County help it to demonstrate community support, support critical to garnering additional competitive funding. Other current grant funders of PHS' three Orange County -based community health center programs include: the NCDHHS Community Health Center Grant program, UNC Health Care, Susan G. Komen for the Cure NC Triangle Affiliate, and the Orange County Partnership for Children. Revised November 20, 2014 Page 5 of 22 Pages Carrboro CHC Program IFC CHC Program Chapel Hill CHC Program Founded 1970 2015 2015 IFC Shelter /Transitional Who is Served? Open to all Open to all Housing Participants Services • Family Primary Medical Care ** • Family Primary Medical • Family Medical Care with on -site Lab Care with integrated with on -site Lab • Dermatology and Cardiology Behavioral Health and subspecialist consult on -site Lab • Family Dental Care • Family Dental Care • Pharmacy (open to any PHS- • Care Management registered patient) • WIC • Care Management • Burmese Interpretation • ACA Enrollment Assistance Budgeted Staff (FTE) for FY2016 35.518 2.100 4.250 ** Services of the CCHC medical program include the Reach Out and Read early literacy program, Mobile Mammography Van and Group Diabetes Visits. To assure adequate access to services, PHS health centers use an open access scheduling system that provides scheduled appointments as well as same -day access to care for urgent needs. There is 24 -hour access to medical advice via the UNC nurse triage line, and PHS works closely with UNC and other hospitals to assure a smooth continue of care for its patients. PHS continues to be recognized for the quality of the primary care services it provides. It has been accredited by The Joint Commission since 2001, and is now recognized by the NCQA as a Level 3 Patient Centered Medical Home. FQHCs are expected to be supported by the communities they serve. PHS' Federal funder, HRSA's Bureau of Primary Health Care, expects all FQHCs to demonstrate other sources of funding besides their Federal grant dollars (which are used to partially underwrite the cost of uncompensated care), including primarily: program revenue generated through insurance billing and patient payments on the sliding fee scale, state and local grants, and donations. In funding PHS, the Towns of Carrboro and Chapel Hill and Orange County help it to demonstrate community support, support critical to garnering additional competitive funding. Other current grant funders of PHS' three Orange County -based community health center programs include: the NCDHHS Community Health Center Grant program, UNC Health Care, Susan G. Komen for the Cure NC Triangle Affiliate, and the Orange County Partnership for Children. Revised November 20, 2014 Page 5 of 22 Pages MAIN APPLICATION 3. PROJECT /PROGRAM INFORMATION Agency & Program Name: Piedmont Health Services, Inc. /Carrboro Community Health Center Program). 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 required application and required supplemental sections (Parts) as specified below: ® Human Services (Main Application Only) ❑ CDBG Non - Construction — (Main Application AND Part A) ❑ CDBG Construction — (Main Application AND Part A AND Part B) ❑ HOME CHDO Set -aside — (Main Application AND Part A) ❑ HOME Other — (Main Application AND Part A AND Part B) Indicate the type of program for which you are requesting funding: Program Category Youth Adult Elderly Disabled (not elderly) Public Housing Neighborhoods /Residents Education Health and Nutrition X X X X X Job Training Sports and Arts Activities Pre - School Activities After - School Activities Mentorin Transportation Housing Other: Please specify 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? PHS is requesting on -going support of its Carrboro Community Health Center (CCHC) Program (with human services funds generally directed to support sliding -fee primary medical services for the low- income, uninsured population at the Center (i.e those living below 200% of poverty)). As summarized in the table in Section 2, the CCHC program model provides "one -stop shop access" to comprehensive services for people Revised November 20, 2014 Page 6 of 22 Pages MAIN APPLICATION of all ages, including sliding -fee primary medical care with on -site laboratory, sliding -fee family dentistry, low -cost pharmacy, the WIC Supplemental Nutrition Program; care management, and outreach services including Health Insurance Marketplace enrollment assistance. Medical and dental visits are by individual appointment, with twice monthly group diabetes visits for those who prefer this group care option. There are two medical subspecialist clinics that occur at Carrboro CHC with contracted UNC medical specialists who see patients referred by their PHS primary care provider: a dermatology clinic on Friday afternoons and a cardiology clinic one evening monthly. All services are available in the Spanish language, with many staff bilingual in Spanish. The Center also offers full -time Burmese interpretation services to a large group of Burmese refugees. All staff receive cultural competency training as part of their orientation which includes best - practice training on creating an inclusive environment for the LGBTQ community. Please see Tables under sections a and h provide a precise picture of service delivery staff and hours of operation for all services described. In terms of additional special programming of the CCHC medical team, diabetic retinopathy screening services are provided in -kind by NC Prevent Blindness one morning monthly (same morning as Spanish group diabetes). Screening mammography is offered by the Rex Mobile Mammography which visits CCHC nearly monthly thanks to a grant from the Susan G. Komen NC Triangle Affiliate. Medical providers participate in the Reach Out and Read Program that provides new, age- appropriate books to children 0 -5 years at well child checks, and additionally distributes books provided by Book Harvest. The dental team outreaches to young children in WIC and the medical clinic to provide caregiver oral health education and fluoride varnish. 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. Pre -ACA it was estimated that 16.4% of the Orange County population age 0 -64 lacked health insurance. Low- income groups are much more likely with be uninsured than higher income groups (in NC approximately 60% of uninsured are low- income), with 34% of the Orange County population living below 200% of poverty (n= 43,668) in 2014. Despite the fact that more people have become insured since the implementation of the Affordable Care Act, there are still large numbers of low- income, uninsured people in Orange County who need access to sliding -fee medical care. Moreover, because North Carolina has elected not to expand Medicaid, many low income individuals are in fact "too poor" to qualify for insurance subsidies through the Healthcare Marketplace (i.e. they would have qualified for Medicaid under an expansion), or they are otherwise not qualified for coverage under the ACA (e.g. citizenship status). In addition to financial barriers, many individuals in the County face cultural /linguistic barriers to care, including a large Hispanic immigrant population (Orange County is now 8.4% Hispanic) and a significant growing Burmese refugee population ( >1,000 individuals) in Orange County that CCHC services seek to address. The low- income populations served by CCHC face significant documented disparities in health status (e.g. self- reported health status, cancer outcomes, chronic disease prevalence, smoking and obesity rates, low birth weight, dental caries) that can be positively impacted by a continuous relationship with a primary care home. d) Describe the population to be served or the area to benefit and indicate how you will identify beneficiaries. The Carrboro Community Health Center is open to all comers (subject to appointment availability for medical and dental visits) regardless of residency, citizenship status, or insurance status. As previously Revised November 20, 2014 Page 7 of 22 Pages MAIN APPLICATION stated, the target population for FQHC services is the low- income population living below 200% of the Federal Poverty Guideline. Most program "beneficiaries" hear of our program word -of -mouth from friends and relatives, but many are referred to our program by other health and human services programs that are aware of CCHC services. With the exception of WIC, HRSA requires all individuals receiving primary care services at CCHC to register as patients, at which time they are provided information about the CCHC program services and its sliding fee scales for medical and dental care. Those who wish to be placed on CCHCs sliding fee scales (overwhelmingly those without health insurance, although those with health insurance may also apply) submit their family size and income documentation on an annual basis to qualify for sliding fees. e) Who specifically will carry out the activities and in what location will they be carried out? The CCHC staff members carry out all program activities on site at CCHC. The Table below presents a staffing picture for the Carrboro Health Center by service. Again, Human Services funds help support medical services provided by primary care teams of family health providers (e.g. physicians, family nurse practitioners, physician assistants), nurses, medical assistants, and lab personnel. On occasion, CCHC staff members conduct community outreach, usually in concert with other agencies (e.g. health fairs). CCHC Primary Care Program Staff (35.518 FTE)* CCHC Service FTE Primary Medical Care with on -site Lab 14.118 FTE (includes 7 medical providers) Dental Care 6.375 FTE ( includes 2 dentists) Pharmacy (walk -in) 4.825 FTE (includes 5 pharmacists) WIC Nutrition Program 3.3 FTE (includes 1 dietician)* Care Management 2 FTE ACA Outreach and Enrollments Assistance 1 FTE Center Administrative Staff (i.e. front desks) 7.2 FTE (center management and front office staff) * WIC staff are considered PHS organization staff, and are part of PHS Central Administrative Office Budget, not the CCHC Program Budget. 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. Services are continuously available to the community at the times listed in table below. Medical appointments are scheduled on a standard 20- minute interval during the clinical day and are available year round (there are 9 PHS holidays /year when the health centers are closed). Carrboro Community Health Center: Hours of Operation by Service CCHC Service Total Hours Schedule Primary Medical Care with on -site Lab 55 hours /week M /Th: 8 am. -8 pm. T: 9 a -5 p W /Fri: 8a -5p; Sat: 8a -1p Cardiology (by PHS PCP referral) 3 hours /month Third Thursday of the month, 5 -8pm Dermatology (by PHS PCP referral) 4 hours /week Fridays 1 -5 pm Dental Care 49 hours /week M /T /W /Th: 8a -6p; Friday 8a -5p Pharmacy (walk -in) 48 hours /week M /Th: 8:30a -8 p. T: 9a -5p W /Fr: 8:30 a -5 p. Burmese Interpretation (contracted hourly staff)* 36 hours /week M /Th: 8:00 am — 5 pm T/W /Fri: 9a -3p Women Infant Child Nutrition Program 53.5 hrs /week Same as Medical except Thursday close is 6:30 pm. Care Management 55 hours /week Same as Primary Medical Care ACA Outreach and Enrollments Assistance 55 hours /week Same as Primary Medical Care Revised November 20, 2014 Page 8 of 22 Pages MAIN APPLICATION 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. PHS collaborates with several local agencies to enhance its impact on the target population, including but not limited to: • Orange County Health Department: PHS provides WIC services at the Orange County Health Department in Hillsborough. CCHC serves as the health department's primary referral point for refugee families needing to establish care with a PCP. The Health Department and PHS collaborate on a Susan G. Komen for the Cure grant to provide screening mammography to low- income women (PHS patients use the Rex Mobile Mammography Unit). PHS contributes to health department needs assessments and program planning as requested. The Orange County Health Department services as administrator for this funding. • UNC Health Care: PHS provides its CCHC facility for the operations of SHAC clinic at no cost to UNC. UNC provides PHS with a care access grant which helps to offset the cost of uncompensated care and funds sub - specialist outreach previously described. PHS works with UNC to identify uninsured individual in the UNC Emergency Department and in its specialty clinics to connect these individuals to care at PHS. • Inter -Faith Council for Social Service: CCHC has long provided medical care and prescriptions to homeless individuals identified by IFC. A PHS physician provided leadership for their free clinic. In September 2015, with IFC's move to their new shelter facility, PHS now provides medical and dental care to IFC emergency /transitional housing participants at the IFC shelter two half days /weekly. • Orange County Partnership for Children: The Partnership has funded Carrboro's Bilingual Children's Resource Coordination Program, a care management program focused on assisting immigrant and refugee families to access resources for their young children. h) Describe what would happen if requested funding is not awarded at all or if a reduced allocation is recommended. The PHS Carrboro Community Health Center program is budgeted to lose money in 2016 -2017 (- $144,717 total), and specifically to lose money for medical (- $144,082), and pharmacy services (- $29,488). Because of demand for care from the low- income uninsured population at CCHC, PHS cannot sustain the current CCHC program without grant support beyond that provided by HRSA. To sustain CCHC, PHS currently uses other grant funds and program revenue generated by its other health centers to help offset the CCHC operational loss for the organization. The PHS Board has a strategic goal of every health center breaking even with a 3% reserve. Thus, were the City and County not to fund PHS, it would continue to search for other sources of grant income, increase sliding fee payment expectation on patients (current nominal fee a medical visit for patient living below 100% of poverty is $25), and /or decrease available services at CCHC. i) Include any other pertinent information. The CCHC will be undergoing a capital renovation in 2016 -2017 to add dental exam rooms and improve service delivery spaces. The capital team is working to plan the renovation to minimize the number of days the Center must be closed through a phased renovation approach. In order to maintain services to CCHC patients during days when the various services are closed to appointments, PHS will move staff to the new Chapel Hill CHC space to see medical patients in need of care at this location. Revised November 20, 2014 Page 9 of 22 Pages MAIN APPLICATION Program /Proiect Information j) Complete the Target Population and Program Beneficiary Demographics Chart k) Complete the Schedule of Positions Chart for Program Staff 1) 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: ® Persons ❑ Households ❑ Units Program: Carrboro Community Health Center Program Beneficiary Demographics Actual* Estimated* Projected ** CY2014 CY2015 2016 -17 Gender Male Female Total Of the females, how many are single - female Head of Households (Omit for Human Services) Ethnicity Age African - American American Indian or Alaska Native Asian Caucasian Native Hawaiian or other Pacific Islander Other Total Of the above, how many Hispanic /Latino Of the above, how many non - Hispanic /Latino Total 0 -5 years 6 -18 years Revised November 20, 2014 2,701 (39.9 %) 2,651 (39.4 %) See notes below 4,072 60.1% 4,065 60.1% See notes below 6,773 6,716 See notes below HS App. Only HS App. Only HS App. Only 622(9.2%) 661(9.8%) See notes below 21 (0.3 %) 21 (0.3 %) See notes below 604(8.9%) 610(9.1%) See notes below 5,260 (77.7 %) 5,175 (77.1 %) See notes below 0(0.0%) 0(0.0%) See notes below 266(39%) 249(3.7%) See notes below 6,773 6,716 See notes below 4,537 (66.9 %) 4,433 (66.0 %) See notes below 2,236 (33.1%) 2,283 (34.0 %) See notes below 6,773 6,716 See notes below 1,140 (16.8 %) 987 (14.7 %) See notes below 1,817 (26.8 %) 1,898 (28.3 %) See notes below Page 10 of 22 Pages Geographic Location# 19 -50 years 51 -61 years 62+ years Total Durham City Durham County (excludes Durham city) Carrboro Chapel Hill Chapel Hill Public Housing Residents Orange County (excludes Chapel Hill and Carrboro) Raleigh Wake County (excludes Raleigh city) Other Total Income Level — See following chart (Omit for HS) < 30% Area Median Income 31 -50% Area Median Income 51 -80% Area Median Income > 80% Area Median Income Total Special Needs (Omit for HS) Elderly (Over 62) Disabled (not elderly) Homeless People with HIV /Aids Total MAIN APPLICATION 2,780 (41.1%) 2,742 (40.8 %) See notes below 607(9.0%) 646(9.6%) See notes below 429(6.3%) 443(6.6%) See notes below 6,773 6,716 See notes below 1,633 (24.1%) 1,606 (23.9 %) See notes below 10(0.1%) 9(0.1%) See notes below 1,177 (17.4 %) 1,226 (18.3 %) See notes below 2,200 (32.5 %) 2,150 (32.0 %) See notes below HS App. Only HS App. Only See notes below 380(6.0%) 394(5.9%) See notes below 71 (1.0 %) 64(1.0%) See notes below 118(1.7%) 111 (1.7 %) See notes below 1,184 (17.5 %) 1,156 (17.2 %) See notes below 6,773 6,716 See notes below HS App. Only HS App. Only HS App. Only HS App. Only HS App. Only HS App. Only HS App. Only HS App. Only HS App. Only HS App. Only HS App. Only HS App. Only HS App. Only HS App. Only FHS App. Only HS App. Only HS App. Only HS App. Only HS App. Only HS App. Only HS App. Only HS App. Only HS App. Only HS App. Only HS App. Only HS App. Only HS App. Only HS App. Only HS App. Only HS App. Only *PHS reports patient demographic characteristics on a calendar year basis to our Federal funders. * *PHS does not routinely predict patient mix by gender, race /ethnicity, age, or geographic location, instead basing our budget on predicted payer mix. FY2016 budget goal is estimated at 20,758 medical visits and 5,500 dental visits. We would anticipate similar total patient counts and demographic characteristics for patients served in CY2016 as in CY2015. #Please note: Patients from Orange County are served by all ten PHS health center locations, and in CY2015 had the following geographic distribution: Durham City: 1,901; Durham County: 32; Raleigh City: 375; Wake County: 983; Town of Chapel Hill: 2,320; Town of Carrboro: 1,282; Orange County: 1,343; Other: 26,548 Total patients served: 34,784. Final CY2015 data will be available summer 2016. Revised November 20, 2014 Page 11 of 22 Pages MAIN APPLICATION CDBG & HOME ONLY - Area Benefit Activities (Infrastructure and Public Facilities) Street Census Tract Block Group Total Persons #LMI Persons 6 people 7 people 8 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 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 Level 1 person 2 people 3 people 4 people 5 people 6 people 7 people 8 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 /il /ill5/FY2015 IL nc.pdf Revised November 20, 2014 Page 12 of 22 Pages 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). Revised November 20, 2014 Page 13 of 22 Pages If provided, Position Titles FTE ** % Program Actual Estimated Projected % Total indicate: (R) Retirement * = Position Vacant Staff + FY2014 FY2015 FY2016 Budget Plan (H ) Health Plan Medical Provider: Physicians 21.951 0.08 $3,372,038 $3,090,577 5.8% See note at bottom of (CCHC: 3.200) $3,085,713 nextpage Medical Provider: 17.013 $1,052,790 $1,499,140 2.8% See note at bottom of FNP /CNM /PA (CCHC: 2.168) $1 279 983 nextpage Nurses: RNs (CCHC: 2.000) 34.833 $1,148,725 $1,924,589 3.6% See note at bottom of $1,312,023 nextpage Enabling Services (Case See note at bottom of managers, outreach, eligibility 38.675 $853,898 $1,396,122 2.6% nextpage assistance) (CCHC: 4.000) $1,152,427 Dentist (CCHC: 1.125) 6.375 $872,146 $901,295 1.7% See note at bottom of $835,433 nextpage Dental Hygienist (CCHC: 2 .550 $150, 965 137 $227,.4% 0.4% note at bottom of 1.000) $183,068 nextpage Dental Assistants /PCCs 18.275 $637,753 $508,658 0.9% See note at bottom of (CCHC: 4.250) $524,746 nextpage WIC /Nutrition (CCHC: 3.300) 21.609 $1,024,884 $879,617 1.6% See note at bottom of $978,988 nextpage Pharmacist & Pharmacy 42.295 $1,800,520 $2,270,783 ° 4.2 /° See note at bottom of Technicians (CCHC: 4.825) $2 179,900 nextpage Other Medical Personnel (MA., 48.620 $1,519,336 $1,643,691 3.1% See note at bottom of Rehab Staff) (CCHC: 5.750) $1,497,625 nextpage Patient Support Staff (non- 36.500 $2,776,176 $3,067,627 5.7% See note at bottom of clinical) (CCHC: 5.500) $3,292,473 nextpage Center Administration & See note at bottom of Central Management (CCHC: 249.775 $3,429,175 $4,646,969 $4,882,345 9.1% nextpage 7.200) Total Personnel Salaries 436.706 $18,628,406 $20,969,348 $22,291,581 41.5% (CCHC: 35.718) Benefit Package Cost for $5,349,979 ° 10.0 /° FY2016 (24% of salary cost) Revised November 20, 2014 Page 13 of 22 Pages MAIN APPLICATION TOTAL BUDGET FOR FY2016 $53,681,642 Volunteer Hours* See Table Notes below 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 Table Notes • FTE and Salary information above reflects entire PHS organizational budget (10 CRCs and 2 SeniorCare programs). • Benefits: PHS offers employees who work more than 60% time a benefit package which includes health and retirement plan (with PHS contribution of 3% for the first 3% contributed by the employee). As of this submission, 321 PHS employees participate in the health plan and 283 are enrolled in our 403(b) retirement plan. • *Volunteers: PHS has an all- volunteer Board of Directors. PHS does not track or record volunteer hours. At clinical sites, because of the risks inherent in clinical environments, PHS generally limits unpaid staff to health professional students who are actively engaged in pursuing their education and meet our stringent employee health guidelines. Revised November 20, 2014 Page 14 of 22 Pages MAIN APPLICATION m.) Work Statement • 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. The Carrboro Community Health Center is projected to provide 20,758 medical visits in FY2016, nearly a third of which are estimated for uninsured patients. As discussed above, the requested funding will continue to be used towards salary support of a medical provider given the projected deficit of the medical department within the CCHC program budget. Piedmont Health Services estimates 4,000 medical encounters performed annually by a physician, or 3,300 medical encounters performed annually by a midlevel provider (FNP /CNM /PA), for an average of 3,650 encounters annually by a medical provider. Based on the average salary of a medical provider at Piedmont Health, the requested funding would provide 17.6% salary support for a single provider. Combining this percentage with the average number of medical encounters, an estimated 645 medical visits would be provided as a result of the requested funding. In the past, Piedmont Health Services set program goals based on the number of Carrboro /Chapel Hill /Orange County residents that would be served at CCHC with both medical and dental services. Since awarded funds have typically benefited medical services at CCHC, specifically as salary support for medical provider staff, the total number and demographics of Orange County residents were used as program performance measures to demonstrate that requested funds were benefiting a sizeable portion of the medically underserved population in the county. Piedmont Health Services proposes to use the same approach for setting program goals again this year, and will use its electronic medical records to collect all information on program activities. Data collection is the responsibility of the PHS Data Analyst Jen Cunningham. Please see table on next page. Revised November 20, 2014 Page 16 of 22 Pages MAIN APPLICATION Revised November 20, 2014 Page 17 of 22 Pages Actual Estimated Projected 2014-2015 2015 -2016 2016 -2017 Funding will be used as Funding will be used as Funding will used as provider salary support provider salary support provider salary ry support Program Activity 1 for uncompensated for uncompensated for uncompensated medical and dental care medical and dental care medical care at the CCHC at the CCHC at the CCHC Provide timely access to Provide timely access to high - quality, high- quality, Provide timely access to comprehensive primary comprehensive primary high - quality, care to over 3,400 care to over 3,400 comprehensive primary Program Goal vulnerable and /or vulnerable and /or financially financially care to over 3,400 vulnerable Orange disadvantaged Orange disadvantaged Orange County residents. County residents ( <200% County residents ( <200% FPL) FPL) PHS' electronic practice PHS' electronic practice PHS' electronic practice management system management system management system generates reports generates reports generates reports demonstrating the total demonstrating the total demonstrating the total Performance Measures number and number and number and demographics of demographics of demographics of individuals served at individuals served at individuals served at CCHC CCHC CCHC At6months: 1) 2,705 1) 3,721 Orange County Orange County residents residents were served at Electronic medical and have been served; 2) CCHC; 2) Over 90% of dental records systems Approximately 39% of medical patients were will be used to capture: medical patients were below 200% Federal 1) total number of CCHC uninsured; 4) There Poverty Level; 3) patients served; 2) total Program Results were over 3,800 medical approximately 41% of Orange County residents visits for uninsured medical patients were served at CCHC; 3) total patients. The program uninsured; 4) There number of medical visits appears to be on track to were over 7,300 for unsinred patients at serve 3,400 Orange uninsured medical visits CCHC. County residents by the at CCHC. end of the program. Revised November 20, 2014 Page 17 of 22 Pages MAIN APPLICATION 4. FINANCIAL INFORMATION FOR SERVICE PROGRAMS a.) Program Budget 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. See table next page. Revised November 20, 2014 Page 18 of 22 Pages MAIN APPLICATION Program Budget Agency /Program: Carrboro Community Health Center AGENCY REVENUE Private Donatio Agency Genera Local Governm Orange Coun Town of Chap Town of Carrt Other Local: Other Local: Other Local: Non -Local Gove Triangle Unite State Governs Federal Gove Other Grants Other Grants MiscellaneousR Rease list 3 larc Patient Manager Techinica Board I Total Agency Revenue AGENCY EXPENSES Compensation Rent & Utilities Supplies & Equl Travel & Trainh Other ExpenseE Rease list 3 larc Total Agency Expense SURPLUS /(DEFICIT) FOR PERIOD: 1 $ (636,508) $ (178,447) $ (144,716) 19°/ Revised November 20, 2014 Page 19 of 22 Pages Actual Estimated Projected Percent FY2014 FY2015 FY2016 Change n $ - $ - $ 0 ted Revenue (fees) $ 3,072,522 $ 3,876,210 $ 3,413,134 -12% ent Grants: ty $ 10,000 $ 10,000 $ 11,000 10% $ 3,000 $ 2,500 $ 3,500 40% ,el Hill $ 2,500 $ 2,500 $ 3,500 40% )Oro $ 30,000 $ 38,000 $ 28,500 -25% Orange Partnership /Smart Star 0 0 V more than 3 sources, please provide a separate list. �rnment Grants �d Way $ - $ - $ 0 $ 6,990 $ 7,908 $ - -100% 'nent mment $ 411,650 $ 441,069 $ 379,591 -14% Non -Godt grants $ 210,529 $ 175,120 $ 262,000 50 %I 0 ether Revenue $ $ 113,118 $ 77,238 -32 %I est Miscellanous sources: J44,971 nent Fees (OCNC_ $ I Assistance $ =undriaser $ $ 3 792 162 $ 4 666 425 $ 4 178 463 -10% $ 3,177,705 $ 3,349,569 $ 2,776,525 -17% I $ 70,156 $ 85,819 $ 148,539 73% ipment $ 420,562 $ 526,171 $ 382,666 -27 %I ig $ 29,667 $ 25,026 $ 17,839 -29% $ 730,580 $ 858,287 $ 997,610 16% est "Other E)<penses ": $ s $ 4,428,670 $ 4,844,872 $ 4,323,179 -11 %I SURPLUS /(DEFICIT) FOR PERIOD: 1 $ (636,508) $ (178,447) $ (144,716) 19°/ Revised November 20, 2014 Page 19 of 22 Pages 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 Cost Per Unit $162.13 Total $9,000 Complete the table below for the project/program for which you are requesting funds. Attach additional rows /pages, as needed. Program: Carrboro Community Health Center Please note that the Carrboro Community Health Center is the program for which funds are being requested. Please refer to the Program Budget table above to review the entire CCHC budget. Piedmont Health does not routinely budget expenses based on a per encounter basis, therefore the Program Budget table above is the most accurate description of how expenses are budgeted for CCHC. Cost Elements Cost ($) Quantity /Unit of measure Subtotal ($) Total Cost of Program $4,161,541 $4,929,635 $2,676,539 (medical dept.) Total # of Units 25,668 encounters 29,314 encounters 20,758 medical (medical + dental) Total encounters c.) Cost per Unit – Medical Cost per Medical Visit 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). Revised November 20, 2014 Page 20 of 22 Pages Actual 2014 -15 Estimated 2015 -16 Projected 2016 -17 Total Cost of Program $4,161,541 $4,929,635 $2,676,539 (medical dept.) Total # of Units 25,668 encounters 29,314 encounters 20,758 medical (medical + dental) (medical + dental) encounters Cost Per Unit $162.13 $168.16 $128.94 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). Revised November 20, 2014 Page 20 of 22 Pages MAIN APPLICATION d.) 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. See table next page. Revised November 20, 2014 Page 21 of 22 Pages MAIN APPLICATION Section M. Financial Data Operating Budget for Entire Agency AGENCY NAME: Piedmont Health Services. Inc. AGENCY REVENUE Private Donations Agency Generated Revenue (fees) Local Government Grants: Orange County Town of Chapel Hill Town of Carrboro Other Local: Orange Partnership /Smart Star Other Local: NC Community Grant - IFC CHI Other Local: If more than 3 sources, please provide a separate list. Non -Local Government Grants Triangle United Way State Government Federal Government Other Grants: Non -Gott grant: Other Grants: Miscellaneous/Other Revenue Please list 3 largest Miscellanous sources: atient Management Fees (CCNC $ Board Fundraiser $ Technical Assistance $ Total Agency Revenue AGENCY EXPENSES Compensation Rent & Utilities Supplies & Equipment Travel & Training Other Expenses: Please list 3 largest "Other Expenses ": Contracted Patient Care $ Repairs /Maintenance $ Contracted Admin. Services $ Total Agency Expenses Actual FY2014 Estimated FY2015 Projected FY2016 Percent Change $ 48,798 $ 59,330 $ - - 100% $ 27,557,940 $ 10,000 $ 36,946,576 $ 10,000 $ 43,091,569 $ 11,000 17% 10% $ 3,000 $ 2,500 $ 3,500 40% $ 2,500 $ 2,500 $ 3,500 40% $ 40,000 $ 38,000 $ 28,500 -25% $ 150,000 #VALUE! $ $ $ 0 0 $ 248,271 $ 74,563 $ 865,498 1061% $ 7,993,848 $ 8,781,411 $ 7,997,978 -9% $ 1,194,089 $ 1,447,365 $ 1,207,500 -17% 0 $ J571,767 $ 37 670 213 $ 23, 352,142 $ 625,445 $ 47 987 690 $ 28,148, 274 $ 322,597 $ 53 681 642 $ 39, 798,139 -48% 12% 41% $ 748,303 $ 947,484 $ 2,038,985 115% $ 3,401,725 $ 4,179,399 $ 334,075 -92% $ 394,496 $ 499,275 $ 330,108 -34% $ 10,298,990 $ 38,195,656 $ 13,437,036 $ 47,211,468 $ 18,180,335 $ 60,681,642 35% 29% SURPLUS /(DEFICIT) FOR PERIOD: 1 $ (525,443)1 $ 776,222 1 $ (7,000,000) - 1002 ° / Revised November 20, 2014 Page 22 of 22 Pages APPLICATION SUBMITTAL CHECKLIST Agency Planned Parenthood South Atlantic Program(s) Sexual Health Education and Outreach Section 1. Cover Page Subsection a. ❑ Applicant Contact Information b. ❑ Project/Program Contact Information c. ❑ Funding Requests Identified d. ❑ Signed Application Cover Page For Regulations 2. Agency a. ❑ Agency's Years in operation 24 CFR 570.506, Information - b. ❑ Agency's Purpose /Mission 570.507, 570.610; 24 C. ❑ Agency's Types of Services Provided CFR Parts 84 or 85 d. ❑ Agency's Experience e. ❑ Other Pertinent Information 3. Program/ a. ❑ Type of Application and Program Identified 24 CFR 570.200(a), Project b. ❑ Summary of Program 570.201 -570. 208, Information - C. ❑ Description of Identified Need 507.503 (for each program/ d. ❑ Description of Population to be Served project for e. ❑ Activity Manager and Location Description which funding f. ❑ Activity Implementation Timeline is requested) g, ❑ Agency Collaboration h. ❑ Describe Impact of Reduced /No Allocation i. ❑ Other Pertinent Information j. ❑ Complete Target Population /Beneficiary Chart k. ❑ Complete Schedule of Positions I. ❑ Signed Conflict of Interest Disclosure m. ❑ Complete Work Statement 1 1 Page MAIN APPLICATION Main Application 1/21/2016 18:35:26 al /p1 Page 2 of 24 24 CFR 570.200(a), 4. Financial (for Program Budget Worksheet and Detail should reflect 570.201 -570. 208, each program ) expenses for the entire program and ALL sources of 507.503 project for funding. 24 CFR 570.506, which funding 570.507, 570.601, is requested) a. ❑ Program Budget Worksheet 570.602, 570.607(b), b. ❑ Program Budget Detail 570.611 c. ❑ Cost Per Unit 24 CFR 570.502- 570.504, d. ❑ 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. ❑ Part A: CDBG & HOME NA Sections (as g ❑ part B: Construction /Rehab NA applicable) 6. Attachments a. Audit: Organizations receiving $300,000 or OMB Circular A-133 more 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. ❑ NC Solicitation License d. ❑ IRS Federal Tax - Exemption Letter e. ❑ Certificate of Insurance 24 CFR Parts 84 or 85 f. ❑ List of Board of Directors 24 CFR 570.208, g. ❑ Articles of Incorporation /Bylaws 570.500(c), 570.611 h. ❑ Authorization to Request Funds i. ❑ Authorized official designation j. ❑ Solid Waste Program Fee (SWPF) Verification Main Application 1/21/2016 18:35:26 al /p1 Page 2 of 24 MAIN APPLICATION 1. COVER PAGE (Each program requires a separate application.) a) Applicant Contact Information Applicant Organization's Legal Name: Planned Parenthood South Atlantic Applicant Organization's Physical Address: 1765 Dobbins Dr, Chapel Hill, NC 27514 Applicant Organization's Mailing Address: 1765 Dobbins Dr, Chapel Hill, NC 27514 Applicant Organization's Web Address: Executive Director: Telephone Number: 919 - 833 -7526 x6140 www.ppsat.org Jenny Black E -Mail: jenny.blackna212sat.org DUNS Number: 110314622 (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: Sexual Health Education and Outreach Project/Program Primary Contact and Title: Lisa Garland, Community Health Educator Telephone Number: 919 - 818 -7760 c) Funding Request Identification E -Mail: lisa. arg land&a 1212sat.org Total Project /Program Cost: $ 37,886Total Amount of Funds Requested: $23,500 Proposed Use of Funds Requested (2 -3 Line Maximum): Funds will be used to su1212ort the salary costs of a Community Health Educator in Orange County, who will conduct programs intended to reduce the rates of unintended pregnancy and sexually transmitted infection in the Orange County, 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) $ ❑ Grant ❑ Loan ❑ CDBG Construction (CH) $ ❑ Grant ❑ Loan ❑ HOME CHDO (OC) $ ❑ Grant ❑ Loan ❑ HOME Other (OC) $ ❑ Grant ❑ Loan 0 Human Services: ❑ Carrboro $1,000 ❑ Chapel Hill $2,500 ❑ Orange County $20,000 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: Signature: Xard Chairperson MVh Application 1/21/2016 Date 1/21/2016 Date 1/21/2016 18:35:26 a1 /p1 Page 3 of 24 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) 35 years, incorporated July 1980 b) Agency's Purpose /Mission Planned Parenthood South Atlantic ( PPSAT) proactively ensures comprehensive reproductive health care: by providing services in settings that preserve and protect the individual's right to privacy and reproductive choice; by advocating public policies that advance these rights and expand access to such services; by providing educational programming that fosters a culture of healthy sexuality; by working with and meeting the needs of diverse communities and the under - served; and by leading broad -based strategies that further these fundamental rights. c) Types of Services the Agency Provides PPSAT works to reduce the incidence of unintended pregnancy, HIV /AIDS, and other STIs, especially among teens, emerging adults (19 -29), those with limited financial resources, and uninsured clients. We operate 14 health centers throughout North Carolina, South Carolina, West Virginia, and the Blue Ridge of Virginia. Our Chapel Hill health center provides a wide range of safe, reliable health care —and the majority is preventive care, which helps reduce unintended pregnancies through contraception, reduce the spread of sexually transmitted infections through testing and treatment, and screen for cervical and other cancers. We reduce barriers to accessing care by offering same -day and by- appointment visits, evening and weekend hours, bilingual staff, and fees that are typically less than those of private providers. Our Orange County community health educator uses evidence -based curricula to equip adolescents with training and information about reproductive health and/or teen pregnancy prevention so that they can become accurate sources of information for their friends, family, and acquaintances. Our educator also provides single- session programs that serve to convey information and encourage utilization of family planning services. d) Agency's Experience with Similar Programs as the Funding Request For more than 35 years, PPSAT has provided high - quality education that reflects the needs of young people, their families, our patients, and the communities we serve. Last year, more than 25,000 young people benefited from our education programs. Programming ranges from health- center based projects like enrolling patients in health care coverage through the Affordable Care Act; to delivering model, Planned Parenthood South Atlantic- branded sex education programs; to offering professional training in the affiliate and in partnership with other nonprofit organizations; to teaching healthy living curricula in local schools. While community education is as diverse as the locations where it is offered, we place an emphasis on multi- session sex education programs that are scoped, sequenced, and proven to meet the needs of participants better than one -time presentations. Main Application 1/21/2016 18:35:26 al /p1 Page 4 of 24 MAIN APPLICATION PPSAT has offered Teen Voices and Smart Girls in the Orange County community for the past three years. e) Other Pertinent Agency Information Starting in July 2015, an opposition group calling itself the "Center for Medical Progress" released a series of deceptively edited videos intended to mislead the public and discredit Planned Parenthood. The videos have since been debunked, but they have bred an increase in hateful rhetoric from anti - women's health advocates, which culminated most recently in an attack on a Planned Parenthood health center in Colorado Springs. We have discussed these issues with Orange County education alumni. They understand that these fraudulent videos are part of a decade long campaign by extreme opposition groups to cut off access to safe and legal abortion and shut Planned Parenthood's doors. Despite the attack in Colorado Springs, teens report that they continue to feel safe in our health centers and off -site locations. Main Application 1/21/2016 18:35:26 al /p1 Page 5 of 24 MAIN APPLICATION 3. PROJECT /PROGRAM INFORMATION Agency & Program Name: Sexual Health Education and Outreach 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 required application and required supplemental sections (Parts) as specified below: Z Human Services (Main Application Only) ❑ CDBG Non - Construction — (Main Application AND Part A) ❑ CDBG Construction — (Main Application AND Part A AND Part B) ❑ HOME CHDO Set -aside — (Main Application AND Part A) ❑ HOME Other — (Main Application AND Part A AND Part B) Program Category Youth Adult Elderly Disabled (not elderly) Public Housing Neighborhoods /Residents Education X X Health and Nutrition X X Job Training Sports and Arts Activities Pre - School Activities After - School Activities X Mentorin Transportation Housing Other: Please specify Indicate the type of program for which you are requesting funding: Main Application 1/21/2016 18:35:26 a1 /p1 Page 6 of 24 MAIN APPLICATION 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? In FY 17, our education department will provide Orange County teens and young adults with medically accurate, intensive, and balanced sexuality education programs that promote positive sexuality, healthy behavior, and responsible choices — with the goal of reducing the rates of unintended pregnancy and sexually transmitted infection. In doing so, we are addressing the Town of Chapel Hill's budgeting priority to fund education, mentorship, and afterschool programming for youth facing a variety of challenges. PPSAT will provide Teen Voices, a sexual education program for teens that uses the evidence -based Becoming a Responsible Teen (BART) BART is a comprehensive curriculum specifically designed to increase many of the knowledge and skill -based protective factors about contraception use and negotiation skills. PPSAT will also offer Smart Girls, a science - based, intensive adolescent pregnancy prevention program for middle school girls. The goal of both programs is to build self - esteem and healthy decision - making to delay initiation of sex, increase condom use of sexually active teens, and reduce the number of sexual partners for those teens. We will invite graduates of our teen education programs to participate in our alumni group. Through the alumni group, we will look at the larger community to identify other needs and design and implement appropriate service projects. This service- learning component will work to increase community involvement. Parent workshops will improve parents' confidence in talking to their children about sex and will increase parent -child communication about sex and contraception. Alumni will lead workshop sessions so that parents have the opportunity to practice talking to teens about these sensitive topics. Our program will also include a series of charlas or chats aimed at young women (aged 19 — 25) who do not qualify to participate in our after - school program. These workshops will engage them in a dialogue about family planning and pregnancy prevention. 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. The Town of Chapel Hill has identified education, mentorship, and afterschool programming for youth facing a variety of challenges as a budgeting priority. The consequences of adolescent pregnancy and childbearing are serious and numerous. Teen mothers are less likely to graduate from high school and more likely to live in poverty and to rely on welfare. The children of teenage mothers are often born at low birth weight, experience health and developmental problems, and are likely to be poor, abused, and/or neglected The educational programs PPSAT offers influence specific behaviors related to sexual risk - taking and reinforce protective factors to prevent teen pregnancy. Main Application 1/21/2016 18:35:26 al /p1 Page 7 of 24 MAIN APPLICATION In 2013, the most recent year for which data is available, North Carolina's teen pregnancy rate fell 11% to 35.2 out of every 1,000 15 -19 year old girls, which is a record low in the state's history. Orange County's teen pregnancy rate dropped 35% from 2012 - from 14.8 to 9.6 in 2013. This number represents 102 teen pregnancies in 2012 down to 68 in 2013. Orange County has historically had one of the lowest rates in the state, but this large reduction year -to -year is notable and a positive step. Even with this lowest and dropping overall rate, rate disparities exist by race and ethnicity. Orange County demonstrates a greater racial and ethnic disparity when it comes to teen pregnancy rates than the state as a whole. In our community, 4.8 out of every 1,000 White teens experience teen pregnancy, whereas 21.3 out of 1,000 African American and 41.3 out of 1,000 Hispanic teens are faced with this challenge. According to the 2013 Youth Risk Behavior Survey (YRBS) for North Carolina, over 47% of high school students report having had sexual intercourse. That includes 57.5% of juniors and 63.9% of seniors. This demonstrates that many adolescents are confronted at some point during their teen years with choices about whether or not to have sex and, if they do, whether or not to use condoms and /or other contraceptives. Research shows that teens who begin having sex at an earlier age are less likely to use contraception and more likely to become pregnant and to become a parent. They are also more likely to accumulate a greater number of lifetime sexual partners. Of those that reported having had sex, only 60.8% used a condom the last time they had sex. In addition, 21.2% reported using drugs or alcohol before sex. d) Describe the population to be served or the area to benefit and indicate how you will identify beneficiaries. This project will primarily serve middle and high school aged teens living in Orange County, Chapel Hill and Carrboro. Our Community Health Educator works with social workers and counselors in the schools and community partners to promote the program and receive direct referrals. Teen Voices and Smart Girls are available to any teen that meets the age requirements for the curricula. Interested teens complete an application and interview with the educator to demonstrate their interest in the program. When there are more applicants than spaces available, the educator gives priority to older teens that many age out of the program sooner and reserves a space the following year for teens that she cannot accommodate. In addition, we will implement parent workshops to benefit parents of teens, promoting this project with our community partners and among our teen program participants. Through our charlas /workshops our community health educator reaches a variety of women of reproductive age (10 -44) e) Who specifically will carry out the activities and in what location will they be carried out? Our programs will be carried out by two part-time community health educators. Lisa Garland has seven years of work and volunteer experience with at -risk youth. She is a former Planned Parenthood peer educator, has been working at PPSAT for three years, and is fluent in English and Spanish. The other educator position is vacant, but we are recruiting now and are looking for a bilingual (English/Spanish) applicant with a degree in a related field preferred, at least one year experience working with youth, and previous experience in Public Health. Main Application 1/21/2016 18:35:26 al /p1 Page 8 of 24 MAIN APPLICATION Activities take place at community center -like locations. Past sites have included the Chapel Hill Public Library, the Unitarian Universalist Church, and the Cedar Ridge Parks Department. 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. August 2016 Begin preparation for programming (buying supplies, getting in touch with schools, writing MOAs, etc.) January 2017 Set up dates /time for spring health fair, workshops, other activities February 2017 Begin recruitment process through guidance counselors, social workers, and referrals for Smart Girls and Teen Voices March 2017 Teen Voices and Smart Girls start • Teen Voices — 12 weeks, 12 sessions • Smart Girls — 10 weeks, 10 sessions March -April 2017 Parent session in between the program dates for both Teen Voices and Smart Girls (Other parents are allowed to attend) May /June 2017 Graduation for Smart Girls and Teen Voices Throughout the year - workshops, health fairs, Teen Voices Alumni meets once a month 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. • Compass Center — participant recruitment • Orange County Library Systems — hosting workshops, sessions, and alumni meetings • Chapel Hill, Carrboro, and Orange County Schools — participant recruitment • El Centro Hispano — participant recruitment h) Describe what would happen if requested funding is not awarded at all or if a reduced allocation is recommended. PPSAT is committed to maintaining these education programs in Orange County. In addition to County and Town support, PPSAT receives funding for its educational programs from a number of private foundations. All of these foundations have a long history of supporting our programs and we anticipate their renewed support for FYI 6. If requested funding is not awarded, we will have to make a larger institutional investment in the programs - designating funds raised for general operating support. i) Include any other pertinent information. Program /Project Information Main Application 1/21/2016 18:35:26 al /p1 Page 9 of 24 MAIN APPLICATION 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: F] Persons U Households ❑ Units Program: Sexual Health Education and Outreach Program Beneficiary Demo ra hics Actual Estimated Projected 2014 -15 2015 -16 2016 -17 Gender Male Female Total Of the females, how many are single - female Head of Households (Omit for Human Services) Ethnicity African - American American Indian or Alaska Native Asian Caucasian Native Hawaiian or other Pacific Islander Other Total Of the above, how many Hispanic /Latino Of the above, how many non - Hispanic /Latino Total Age 0 -5 years 6 -18 years 19 -50 years 51 -61 years 62+ years Total Geographic Location Durham City Durham County Carrboro Chapel Hill Chapel Hill Public Housing Residents Orange County Raleigh Main Application 82 110 95 153 253 263 235 363 0 NA NA NA 44 95 95 177 263 263 235 1 363 1 363 181 187 187 10 81 81 235 363 363 58 100 100 177 263 263 235 1 363 1 363 1/21/2016 18:35:26 al/pl Pa g E_) 1 0 o" 2 151 233 233 84 130 130 152 235 235 0 363 363 1/21/2016 18:35:26 al/pl Pa g E_) 1 0 o" 2 58 90 90 152 235 235 25 38 38 1/21/2016 18:35:26 al/pl Pa g E_) 1 0 o" 2 MAIN APPLICATION Wake County Total 235 363 363 Income Level — See following chart (Omit for HS) < 30% Area Median Income 31 -50% Area Median Income 51 -80% Area Median Income > 80% Area Median Income Total Special Needs (Omit for HS) Elderly (Over 62) Disabled (not elderly) Homeless People with HIV /Aids Total NA NA NA NA NA NA CDBG & HOME ONLY - Area Benefit Activities Infrastructure and Public Facilities Street Census Tract Block Group Total Persons #LMI Persons Main Application 1/21/2016 18:35:26 a1 /p1 Page 11 of 24 MAIN APPLICATION 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 $14,15 $16,20 $20,09 $24,25 $28,41 $32,57 $36,73 $40,890 0 0 0 0 0 0 0 50 %AMI $23,60 $27,00 $30,35 $33,70 $36,40 $39,10 $41,80 $44,500 0 0 0 0 0 0 0 80 %AMI $37,75 $43,15 $48,55 $53,90 $58,25 $62,55 $66,85 $71,150 0 0 0 0 0 0 0 100% AMI $47,18 $53,93 $60,68 $67,37 $72,81 $78,18 $83,56 $88'937 8 8 8 5 3 8 3 115% AMI $54,26 $62,02 $69,79 $77,48 $83,73 $89,91 $96,09 $102,27 6 8 1 1 4 6 7 8 http: / /www.huduser.org/ portal / datasets /il /iI15 /FY2015_IL_nc.pdf Main Application 1/21/2016 18:35:26 al /p1 P a g e 1 2 c f 2 4 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). Position Titles * = Position Vacant FTE* * % Program Staff + Actual 2014 -15 Estimated 2015 -16 Projected 2016 -17 %Total Budget If provided, indicate: (R) Retirement Plan (H) Health Plan Community Health Educator 1 50 35,950 35,360 35,360 .2% Senior Director of Education 1 5 49,171 43,636 61,800 .3% H 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 1/21/2016 18:35:26 al /p1 P a g e 1 3 o f 2 4 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? ❑ ❑ 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. 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: Signature: 1/21/2016 Date 1/21/2016 Date Main Application 1/21/2016 18:35:26 a1 /p1 Page 14 of 24 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. Main Application 1/21/2016 18:35:26 a1 /p1 Page 15 of 24 Actual Estimated Projected 20142015 2015 -2016 2016 -2017 Using the Becoming a Using the Becoming a Using the Becoming a Responsible Teen Responsible Teen curriculum, Responsible Teen curriculum, curriculum, provide a diverse provide a diverse group of provide a diverse group of group of teens with training teens with training around teens with training around Program around issues of sexuality, issues of sexuality, healthy issues of sexuality, healthy Activity 1 healthy relationships, relationships, abstinence and relationships, abstinence and abstinence and contraceptive contraceptive options, contraceptive options, options, communication and communication and decision- communication and decision - decision- making skills and making skills and goal making skills and goal oal settin . setting. setting. Recruit at least 15 teens Recruit at least 15 teens (ages Recruit at least 15 teens (ages (ages 14 —18). All participants ill demonstrate 14 — 18). All participants will 14 —18). All participants will Program w at least a 10% increase demonstrate at least a demonstrate at least a Goal in knowledge about 10% increase in knowledge 10% increase in knowledge preventing pregnancy and about preventing pregnancy about preventing pregnancy STIs. and STIs. and STIs. PPSAT will measure the PPSAT will measure the PPSAT will measure the competency levels of competency levels of competency levels of participants through pre- and participants through pre- and participants through pre- and post - program tests. The pre- post - program tests. The pre- post - program tests. The pre- test will be administered at test will be administered at test will be administered at Performance the beginning of the first the beginning of the first the beginning of the first session, and the post -test will session, and the post -test will session, and the post -test will Measures be administered immediately be administered immediately be administered immediately following the conclusion of following the conclusion of following the conclusion of the program. Measurable the program. Measurable the program. Measurable outcomes include a change outcomes include a change in outcomes include a change in in knowledge, attitudes, and knowledge, attitudes, and knowledge, attitudes, and behaviors. behaviors. behaviors. Program 15 participant, 7% increase - Results students entered with a high TBD TBD baseline understanding Program Peer- educators will work Peer - educators will work Peer - educators will work Activity 2 within their schools and within their schools and within their schools and communities to disseminate communities to disseminate communities to disseminate to others the information to others the information they to others the information the Main Application 1/21/2016 18:35:26 a1 /p1 Page 15 of 24 MAIN APPLICATION Main Application 1/21/2016 18:35:26 a1 /p1 Page 16 of 24 they have learned. have learned. have learned. Program Each peer- educator will Each peer- educator will make Each peer- educator will make Goal make 20 contacts in their 20 contacts in their 20 contacts in their community. community. community. Peer - educators will maintain Peer - educators will maintain Peer - educators will maintain Performance contact logs so that the contact logs so that the contact logs so that the Community Educator can Community Educator can Community Educator can Measures review them for accuracy review them for accuracy and review them for accuracy and and completeness. completeness. completeness. 172 contacts - Many did not complete their required contacts. Community Program Educator has since TBD TBD Results incentivized by making completion of contacts mandatory to receive a full $300 gift card. Using the Smart Girls Using the Smart Girls Using the Smart Girls curriculum, provide a diverse curriculum, provide a diverse curriculum, provide a diverse group of middle school girls group of middle school girls group of middle school girls with training around issues with training around issues of with training around issues of Program of sexuality, healthy sexuality, healthy sexuality, healthy Activity 3 relationships, abstinence and relationships, abstinence and relationships, abstinence and contraceptive options, contraceptive options, contraceptive options, communication and communication and decision- communication and decision - decision- making skills and making skills and goal making skills and goal oal settin . setting. setting. PPSAT will recruit at least PPSAT will recruit at least 10 PPSAT will recruit at least 10 10 girls (ages 10 —14). All girls (ages 10 — 14). All girls (ages 10 —14). All Program participants will demonstrate participants will demonstrate participants will demonstrate Goal at least a 10% increase at least a 10% increase at least a 10% increase in knowledge about in knowledge about in knowledge about preventing pregnancy and preventing pregnancy and preventing pregnancy and STIs. STIs. STIs. PPSAT will measure the PPSAT will measure the PPSAT will measure the competency levels of competency levels of competency levels of participants through pre- and participants through pre- and participants through pre- and post - program tests. The pre- post- program tests. The pre- post - program tests. The pre- test will be administered at test will be administered at test will be administered at Performance the beginning of the first the beginning of the first the beginning of the first session, and the post -test will session, and the post -test will session, and the post -test will Measures be administered immediately be administered immediately be administered immediately following the conclusion of following the conclusion of following the conclusion of the program. Measurable the program. Measurable the program. Measurable outcomes include a change outcomes include a change in outcomes include a change in in knowledge, attitudes, and knowledge, attitudes, and knowledge, attitudes, and behaviors. behaviors. behaviors. Program 10 participants, 27% increase TBD TBD Results Create an alumni group for Program Create an alumni group for Create an alumni group for Activity 4 graduates of education graduates of education graduates of education programs who will conduct programs who will conduct programs who will conduct annual service-learning annual service-learning annual service-learning Main Application 1/21/2016 18:35:26 a1 /p1 Page 16 of 24 MAIN APPLICATION Main Application 1/21/2016 18:35:26 a1 /p1 Page 17 of 24 activities. activities. activities. At least 8 graduates will At least 8 graduates will At least 8 graduates will Program participate in the alumni participate in the alumni participate in the alumni Goal group, and conduct an annual group, and conduct an annual group, and conduct an annual student -led service- learning student -led service - learning student -led service - learning ro' ect. proj ect. proj ect. PPSAT will seek out PPSAT will seek out PPSAT will seek out feedback from the groups feedback from the groups feedback from the groups that Performance that the alumni group works that the alumni group works the alumni group works with Measures with during their service with during their service during their service learning learning activity to access learning activity to access the activity to access the value of the value of the participants' value of the participants' the participants' contribution. contribution. contribution. Program Results 8 participants TBD TBD ir Provide a series of parent Provide a series of parent Provide a series of parent workshops that will include workshops that will include workshops that will include skill building and skill building and information skill building and information information on talking with on talking with their children on talking with their children Program their children about sex. about sex. Sessions will about sex. Sessions will Activity 5 Sessions will include: role include: role play discussing include: role play discussing play discussing relationships, relationships, contraception, relationships, contraception, contraception, STIs and peer STIs and peer pressure. One STIs and peer pressure. One pressure. One session will be session will be conducted in session will be conducted in conducted in English, one English, one session in English, one session in session in Spanish. Spanish. Spanish. At least 15 parents of middle At least 15 parents of middle At least 15 parents of middle and high school students will and high school students will and high school students will participate in parent participate in parent participate in parent workshops. workshops. workshops. At least 75% of parents will At least 75% of parents will At least 75% of parents will Program report increased comfort in report increased comfort in report increased comfort in Goal talking with their kids about talking with their kids about talking with their kids about sexuality issues. sexuality issues. sexuality issues. At least 75% of parents will At least 75% of parents will At least 75% of parents will report they intend to talk to report they intend to talk to report they intend to talk to their children about sex as a their children about sex as a their children about sex as a result of the workshop. result of the workshop. result of the workshop. Participants will provide Participants will provide Participants will provide Performance feedback on the quality of feedback on the quality of the feedback on the quality of the Measures the program by completing program by completing program by completing surveys. surveys. surveys. 22 participants, 72% Program reported increase in comfort, TBD TBD Results 100% intended to talk to their children Main Application 1/21/2016 18:35:26 a1 /p1 Page 17 of 24 MAIN APPLICATION Copies of data collection tools attached. Community Health Educator Lisa Garland will be responsible for monitoring progress toward goals with the supervision of Senior Director of Education Monika Thigpen. Main Application 1/21/2016 18:35:26 a1 /p1 Page 18 of 24 Host a series of workshops Host a series of workshops Host a series of workshops Program g (charlas or chats) to help (charlas or chats) to help (charlas or chats) to help Activity 6 women of reproductive age women of reproductive age women of reproductive age assess their risk of assess their risk of pregnancy. assess their risk of pregnancy. pregnancy.. Teach at least 15 women of Teach at least 15 women of Teach at least 15 women of reproductive age about the reproductive age about the reproductive age about the benefits and availability of benefits and availability of benefits and availability of various contraceptive various contraceptive various contraceptive methods. methods. methods. Program Goal At least 75% of participants At least 75% of participants At least 75% of participants will report an increased will report an increased will report an increased understanding of their risk of understanding of their risk of understanding of their risk of pregnancy and have a plan pregnancy and have a plan pregnancy and have a plan for preventing unintended for preventing unintended for preventing unintended pregnancies. pregnancies. pregnanci es. Participants will provide Participants will provide Participants will provide Performance feedback on the quality of feedback on the quality of the feedback on the quality of the Measures the program by completing program by completing program by completing surveys. surveys. surveys. Program 37 participants, 100% Results reported increase in TBD TBD understanding. Copies of data collection tools attached. Community Health Educator Lisa Garland will be responsible for monitoring progress toward goals with the supervision of Senior Director of Education Monika Thigpen. Main Application 1/21/2016 18:35:26 a1 /p1 Page 18 of 24 MAIN APPLICATION 4. FINANCIAL INFORMATION FOR SERVICE PROGRAMS a.) Program Budget 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. • Supplies and Equipment Increase — We have depleted our supply of promotional materials (pens, lanyards, keychains) that we distribute during our events to promote Planned Parenthood. We are budgeting $600 more than last year to re- supply. Travel and Training Increase — With the hiring of a new Educator, they will need to be trained in the program curricula. Main Application 1/21/2016 18:35:26 al /p1 P a g e 1 9 c f 2 4 MAIN APPLICATION PI �xxJ�mEoL�ck�t exLul Fi5olth EcLlc�licn axi C lA Ate*! Y FEVB l_E E-Ahniatecl 201516 PC --y C— ---&--d FL— (f —4 Percent ChaiNp Lcwlal C,v�rnniert Ctaris C -try Clxrty 241 Taemol` Ch.-N Hill 0 TaroniaFCzab= 777" C& er Local: 0 Cther Local: C& er Loc .A: a elate llst F,kwA cry Q7jE r 1Lrt{#df* TriardeLVTbRd VVzV Etc-te C rn-E t Fade•A G --KdR7 rE t C&er Ct- r : 3tromd Flee C&erC#arLs: F.M. K4 rby Fc_rrclkion 0 Iwrlsraell anecxsgClh r RE%&rxje Pease II# 3largest m9>R1 sxroes 0 0 0 Total PC"x}r P4e%Amxr- 0 PGENC.Y G iyp ens3ti+ri $ 5,00D Rent &lblities 0° Skq :jAies.& EcFiiipywrt $ 101ID7 Travel &Training Cher 6g3er ses 3F%W1 $ 235448 R®arsell*1 3lax7est "Ctl'ia 5;I?3*E,5': 0 C1 FEfrES177-EtS $2 012170 Inoety $5 l©0 h+isc. $ 3mCD Trial AcpR-kcy Exper SUF11'LLEr ( MC]T) FORPER OU Ack al 2}111 -15 E-Ahniatecl 201516 Prcjet?ecl 2016-17 Percent ChaiNp 1.11-_0 241 0 $ 20, 000 777" 0 $ 2,57CI $ 1.CQJ 0 0 0 0 0 - $ 5,00D $ 5.000 0° 5J- +77 $ 101ID7 $ 9,38B $ 24616 $ 2 837' 3F%W1 $ 235448 37 $ 21.54.3 0 C1 $ $ 1,157 $ 1,1'.A 0° $ 1 2.255 $ 2.534 3[ $ 435 $ 2,487 $ 3.043 24 f4 $ 5,883 $29!616 $ 9,437 $ 38741 $ 9.210 $ 37,IBG -� ®��U Main Application 1/21/2016 18:35:26 a1 /p1 Page 20 of 24 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 $50 Total $9,000 Complete the table below for the project /program for which you are requesting funds. Attach additional rows /pages, as needed. Program: Sexual Health Education and Outreach Cost Elements Cost $ Quantity/Unit of measure Subtotal $ Refreshments — Teen Voices (TV), Smart Girls, Alumni $7 TV — 15 participants x 12 sessions Smart Girls — 10 participants x 10 sessions $2,632 Refreshments — Parents, charlas /chats $7 5 -15 participants per workshop x 2 parent workshops and 2 charlas /chats $280 Incentives — Gift Cards $300 + $2 fee TV - 15 participants $4,530 $100 +$2 fee Smart Girls —10 participants $1,020 $50 1 drawing per workshop x 2 parent workshops and 2 charlas /chats $200 Incentives — T- shirts $7.50 TV — 15 participants Smart Girls 10 participants Alumni — 8 participants $247.50 Rental Variable TV and Smart Girls - $300 each Parents and chats - $200 each Alumni - $150 $1,150 Mileage — Community Educator $0.54 175 miles per month x 12 $1,134 Training — New Educator on curriculum $995 1 participant $995 Copies $0.50 800 copies for worksheets, promotional $400 Office Supplies $40 Per month x 12 $480 Brochures $40 Per 100 x 10 topics $400 Promotional materials - swag $2 3 promotional items (keychains, pens, carbineers, etc) x 150 of each $900 Guest Trainers - TV $100 2 speakers $200 Peer Assistant - TV $100 1 assistant $100 Main Application 1/21/2016 18:35:26 a1 /p1 Page 21 of 24 MAIN APPLICATION Supplies for Child Care $40 Per workshop, 2 parent workshops and 2 charlas /chats $160 Field Trip — Bus rental for Youth Advocacy Day $420 1 day $420 APPCNC Conference $250 2 registrants $500 Education Materials - TV $20 Worksheets x 15 participants $300 Postage $0.49 50 stamps per month x 12 $294 Salary — Community Health Educator 2 educators x 50% of time each Salary — Sr. Director of Education 1 director x 5% of time Benefits — 25% of Director of Ed Salary 1 director x 5% of time Total $37,886 c.) Cost per Unit: 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 1/21/2016 18:35:26 a1 /p1 P a g e 22 of 24 Actual 2014 -15 Estimated 2015 -16 Projected 2016 -17 Total Cost of Program $29,616 $38,741 $37,886 Total # of Units 235 363 363 Cost Per Unit $126.03 $106.72 $104.37 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 1/21/2016 18:35:26 a1 /p1 P a g e 22 of 24 MAIN APPLICATION d.) 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. • Agency fiscal year is July 1, 2016 to June 30, 2017 • FYI 5 represents the first six months of Planned Parenthood South Atlantic's operations. On January 1, 2015, Planned Parenthood Health Systems (PPHS) and Planned Parenthood of Central North Carolina ( PPCNC) merged to become Planned Parenthood South Atlantic. Prior to that, PPHS and PPCNC operated as separate organizations with separate budgets. Main Application 1/21/2016 18:35:26 a1 /p1 Page 23 of 24 MAIN APPLICATION Secficq-iM- Fiialnaal []#a Q>erablCI Btck1t 6x- El,br?e- flVpixV XCERCYPAUVE Plaltx- lPar�ellhc+_ 1SxthfiHa -fic AIYF'LE Prl%. � E)cm tom Agony Govw-16 r0 F{ae11m kreee) Laval GOVEMYOrt Gta11k Ora xje &arty TmM or r31`gcl HII Tov%n cr Q:� Oti-er L oozi: 1x111_a11CX)Lrri 2r1:r76 2 Otller Leo a1: t7 —W Otl ler L coal: $ 6, S-'4 744 $ sep} ate IGt Y 2% t&MIL UM Gove fwnwd Gra*B Marge Lrn2d VGAk $14 7M+ L707 $ `St' Ae Ckvem TPl't 2% FectfA d3uerrfr2rt $ 2-500 $ Otrler cults 0% ❑trier. cults $ 1,000 005 $ MEDE11afenmmUhr FULOWL19 5% Rye 1st3 tmrget NU celaw sM. ,: $ 17.245 $ F1 ch 33.5 -h A7 F42MA ImonlE $ 31 _-OOLO 3 - Tffal AID FOArKm AlGEHV eEDVENSES conperEshm 0 FWA &LPk1tuea $ 135; 007 $ SLPP18B &EgLlpn -rt 0% TFZRM &TFZ"ng $ 1.95a 500 $ outer Erpereea 33% Rene bt3 largest" €illr_r ESKP �es': ❑epredAlon T, 379--MM Advetl *Arrg $ 3M.87i5m OOrtra.- L-d SeN cog $ 686ge1 m T&at A gmnW EMPME- U.WLLS'PEF C1T) FMPff*= k1 '15 2 2r1:r76 2 201&17 t t7 —W $ 'A 324 493 $ $ 6, S-'4 744 $ $ 6, 63� 839 2 2% k 5�01 S 888 $ $14 7M+ L707 $ $10, 647 2 2% $ 1, 2E7 $ $ 2-500 $ $ 2-500 0 0% $ sm $ $ 1,000 005 $ $ 1, 00710 5 5% $ 03, 623 $ $ 17.245 $ $ 17.245 0 07 0 0"I"Wo 0 $ 68, 0774 $ $ 135; 007 $ $ 'I 35� 0L0 0 0% $ 921, ;$7 $ $ 1.95a 500 $ $ Z 604 000 3 33% 0 [I $ 83, 296 $ $ 655145 $ $ 31, *:E�435410 $'09.400E64$11.734,650 4 4�4 $'R=M3 $-184SR3E6 7W $ msmm1 $ (32$ $ -1.= I 111 Main Application 1/21/2016 18:35:26 a1 /p1 MAIN APPLICATION 1. COVER PAGE (Each program requires a separate application.) a) Applicant Contact Information Applicant Organization's Legal Name: United Way of the Greater Triangle Applicant Organization's Physical Address: 2400 Perimeter Park Drive, Suite 150, Morrisville NC 27560 Applicant Organization's Mailing Address: 2400 Perimeter Park Drive, Suite 150 Morrisville, NC P7960 Applicant Organization's Web Address: www.unitedwaytriangle.org Executive Director: Mack Koonce Telephone Number: 919 463 -5010 E -Mail: mkoonce @unitedwaytrian Iq e_org DUNS Number: 00- 398 -6184 (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: Orange County Food Policy Council Project/Program Primary Contact and Title: Molly DeMarco Telephone Number: 919 - 966 -9563 c) Funding Request Identification Total Project/Program Cost: $32,060, E -Mail: molly_demarco @unc.edu Total Amount of Funds Requested: $32,060 Proposed Use of Funds Requested (2 -3 Line Maximum): Facilitation and development of the Orange County Food Policy Council 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. xHuman Services: x Carrboro $8,015 x Chapel Hill $9,618 x Orange County $14,427 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: Ex ee D' c vz,�., Date 1 Signature: 6 ZQ Board ChairpersoK Date Main Application 1/21/2016 1:05:37 PM Page 3 of . 7 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 ❑ x a) Employees of or closely related to employees of the Town of Chapel Hill, Orange County, Carrboro, or Hillsborough? ❑ x b) Members of or closely related to members of the governing bodies of Chapel Hill, Carrboro, Hillsborough, or Orange County? ❑ x c) Current beneficiaries of the project/program for which funds are requested? ❑ x 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. 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: Signature: Exe ive! Di r cto F1- ear Board Chairperson /Jd I Date t 125 zo Date Main Application 1/21/2016 12:57:09 PM F a g (- 12 o f 1 APPLICATION SUBMITTAL CHECKLIST FOR OFFICE USE ONU Received By Agency: United Way of the Greater Triangle Date /Time Complete Y / N Program(s): Orange County Food Council Section 1. Cover Page Subsection a. X Applicant Contact Information b. XProject /Program Contact Information c. X Funding Requests Identified d. X Signed Application Cover Page For CDBG & • HUD Regulations 2. Agency a. XAgency's Years in operation 24 CFR 570.506, Information - b. XAgency's Purpose /Mission 570.507, 570.610; 24 c. XAgency's Types of Services Provided CFR Parts 84 or 85 d. XAgency's Experience e. X Other Pertinent Information 3. Program/ a. X Type of Application and Program Identified 24 CFR 570.200(a), Project b. X Summary of Program 570.201 -570. 208, Information - c. X Description of Identified Need 507.503 (for each d. X Description of Population to be Served program/ e. XActivity Manager and Location Description project for which funding f. XActivity Implementation Timeline is requested) g . X Agency Collaboration h. X Describe Impact of Reduced /No Allocation i. X Other Pertinent Information j. X Complete Target Population /Beneficiary Chart k. X Complete Schedule of Positions I. X Signed Conflict of Interest Disclosure m. X Complete Work Statement i I P a g e MAIN APPLICATION Main Application 2/11/2016 9:25:27 AM Page 2 of 26 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. X Program Budget Worksheet 570.602, 570.607(b), is requested) b. X Program Budget Detail 570.611 c. X Cost Per Unit 24 CFR 570.502 - 570.504, d. X 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. NA Part A: CDBG & HOME Sections (as B. NA Part B: Construction /Rehab applicable) 6. Attachments a. XAudit: 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. X IRS Federal Form 990 c. X NC Solicitation License d. X IRS Federal Tax - Exemption Letter e. X Certificate of Insurance f. X List of Board of Directors 24 CFR Parts 84 or 85 g. XArticles of Incorporation /Bylaws 24 CFR 570.208, h. XAuthorization to Request Funds 570.500(c), 570.611 i. X Authorized official designation j. NA Solid Waste Program Fee (SWPF) Verification Main Application 2/11/2016 9:25:27 AM Page 2 of 26 MAIN APPLICATION 1. COVER PAGE (Each program requires a separate application.) a) Applicant Contact Information Applicant Organization's Legal Name: United Way of the Greater Triangle Applicant Organization's Physical Address: 2400 Perimeter Park Drive, Suite 150, Morrisville NC 27560 Applicant Organization's Mailing Address: 2400 Perimeter Park Drive, Suite 150 Morrisville, NC 77F, Fn Applicant Organization's Web Address: www.unitedwaytriangle.org Executive Director: Mack Koonce Telephone Number: 919 463 -5010 E -Mail: mkoonce(a)unitedwaytriangle.org DUNS Number: 00- 398 -6184 (Dun & Bradstreet, Inc. provides this number at no charge, and it is required for Federal funding recipients.) b) Protect /Program Contact Information Project /Program Name: Orange County Food Council Project /Program Primary Contact and Title: Molly De Marco Telephone Number: 919 - 966 -9563 c) Funding Request Identification E -Mail: molly_demarco @unc.edu Total Project/Program Cost: $32,060, Total Amount of Funds Requested: $32,060 Proposed Use of Funds Requested (2 -3 Line Maximum): Facilitation and development of the Orange County Food Policy Council 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. X Human Services: x Carrboro $6,412 x Chapel Hill $9,618 x Orange County $16,030 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: Executive Director Date Signature: Board Chairperson Date Main Application 2/11/2016 9:25:27 AM Page 3 of 26 MAIN APPLICATION 2. AGENCY INFORMATION Please provide the following information about your agency (Limit of 2 pages total): United Way of the Greater Triangle will be serving as the fiscal agent for the Orange County Food Policy Council through this application. All funding received will be used to support the development of the food policy council during the 2016 -2017 year. a) Years in Operation, Date of Incorporation (Month /Year) 21 years as a combined United Way between Orange, Durham and Wake United Ways. Incorporated on August 15, 1995. b) Agency's Purpose /Mission United Way of the Greater Triangle recently completed its new strategic plan with a new purpose which is: Real solutions sparked by a community united for transformative change. United Way of the Greater Triangle is a catalyst for new approaches to solve social issues. We cannot let accolades for the Triangle mask the pervasiveness of families and children facing poverty, food insecurity, and educational disparity. Therefore, our work will create awareness of the issues, ignite a call -to- action around systems change, and unite the community around sustainable, scalable solutions. United Way of the Greater Triangle (UWGT) brings together the public, private, and social sector to address the most pressing needs of low- income households in North Carolina's Durham, Johnston, Orange, and Wake counties. UWGT responds to the immediate basic needs and, through collaborative partnerships that take a two - generational approach, works with the adults and children together to build household well- being, financial stability, food security, and educational success. For the first time this year, the majority of our funding (88 %) went to: collaborative partnerships with a focus on a two - generational approach (working with children and their families together to improve the circumstances of low income households); increasing access to affordable health care; and building a food secure community. c) Types of Services the Agency Provides UWGT is a funder, convener, and catalyst for lasting social change in the region. As one of the largest philanthropic organizations in the Triangle, United Way makes a significant community investments annually into the four counties served. In 2015 -16, $7.2 million will fund 24 collaborative partnerships using a two - generational approach (child and family interventions combined) and basic needs agencies. (We raise this money from 25,000 charitable donors who contribute through workplace campaigns at over 500 companies throughout the Triangle and major gifts.) We convene a broad sector of the community to activate social change. Thought leaders across the region serve through our Board of Directors, Community Impact Committee, Community Engagement Committee, Leaders United, and Tocqueville Society. United Way mobilizes volunteers across the region, with over 2,800 people on MLK Day of Service in 2015; an extensive volunteer online resource, Get Connected; and in -house projects for corporate partners to engage both human and intellectual capital. d) Agency's Experience with Similar Programs as the Funding Request As a result of United Way of the Greater Triangle's 2014 Social Innovation Challenge that focused on ending childhood hunger, UWGT reexamined its role in hunger relief. Traditional funding in the amount of $500,000 annually focused on food distribution and senior meals. However, with a $50,000 prize at stake, UWGT found 40 new ideas /organizations who were working on ending Main Application 2/11/2016 9:25:27 AM Page 4 of 26 MAIN APPLICATION childhood hunger. UWGT realized that it was important to begin coordinating and mobilizing these new ideas. In the fall of 2014, UWGT convened its current partners and corporate volunteers, including volunteers from Bayer CropScience, Syngenta, Kellogg's, and John Deere. The volunteer group helped define priorities for future UWGT investments into hunger relief. Volunteers agreed that we must also make sure that we are providing hunger relief in the context of the entire food system. As a result, UWGT staff are participating in the three food policy councils emerging across Durham, Orange and Wake County. UWGT has provided initial funding to all three councils in the form of $12,000 from a coordinated Burt's Bees application. e) Other Pertinent Agency Information None Main Application 2/11/2016 9:25:27 AM Page 5 of 26 MAIN APPLICATION 3. PROJECT /PROGRAM INFORMATION Agency & Program Name: United Way of the Greater Triangle: Orange County Food Council 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 required application and required supplemental sections (Parts) as specified below: x Human Services (Main Application Only) ❑ CDBG Non - Construction — (Main Application AND Part A) ❑ CDBG Construction — (Main Application AND Part A AND Part B) ❑ HOME CHDO Set -aside — (Main Application AND Part A) ❑ HOME Other — (Main Application AND Part A AND Part B) Indicate the type of program for which you are requesting funding: Program Category Youth Adult Elderly Disabled (not elderly) Public Housing Neighborhoods /Residents Education Health and Nutrition X X X X X Job Training Sports and Arts Activities Pre - School Activities After - School Activities Mentorin Transportation Housing Other: Please specify Proaram /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? Since October 2014, a committed group of ten to fifteen Orange County stakeholders has convened monthly to develop the Orange County Food Council. The taskforce has formed the council with community input and county specific data collected by hosting two community forums and conducting a quantitative baseline food assessment. The result of these meetings, forums and data collection has resulted in a a Collaborative Agreement that includes a common purpose, values, and council structure, and a process for seating members of the council. The taskforce has created an application for potential members and will have a council seated by May 2016. Over the next Main Application 2/11/2016 9:25:27 AM Page 6 of 26 MAIN APPLICATION year, the Orange County Food Council proposes to launch the council and further it's development through the following activities: hire a part -time coordinator; conduct the qualitative portion of the baseline community food assessment including working directly with the Orange County Family Success Alliance to assess food insecurity in their two zones; create a community food security action plan for Orange County; and hold two large community forums to continue to build collaborations and implement the action plan to strengthen the food system in Orange County. Our proposed activities will address one of the top six priority areas (Food), identified by Chapel Hill's Human Services Advisory Board, specifically by addressing the need for affordable food and access to healthy food in Orange County. Food affordability and access will be key features of the council's action plan and the taskforce has already engaged Orange County stakeholders addressing these issues including Farmer FoodShare and the InterFaith Council for Social Services. The food council activities are well aligned with the priorities currently coming out of the Orange County Health Department's Healthy Carolinians Community Health Assessment, which is occurring through June 2016. Physical activity and nutrition will be one of their three chosen areas of focus with a specific emphasis on building /increasing community gardens, working in the zones of the Family Success Alliance to pilot activities to assist with eliminating food insecurity, providing family education around healthy foods and cooking skills, partnering with local farms to increase access to low cost healthy foods, and working to improve school - provided nutrition for school kids. The food council will collaborate with the Healthy Carolinians Partnership on these activities. The food council's proposed activities will also support key goals in Carrboro. For example, the action plan will address the following policies in Carrboro's Vision 2020 document: Policy 5.6 to preserve farmland and Policy 1.31 to look for unmet need for human services. 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. We know that increased access to healthy fruits and vegetables is an effective strategy to address food insecurity; and, when this produce is grown locally, it also supports the local economy ( "Research Based Support and Extension Outreach for Local Food Systems," Dunning, August 2013). For example, according to findings from the Robert Wood Johnson Foundation's Healthy Eating Research, consuming locally grown fruits and vegetables can both increase labor income and create new jobs locally. Bringing together community health and agriculture efforts as the Orange County Food Council proposes to do will help to mitigate poor health outcomes for Orange County citizens and address some of the challenges faced by local food producers and economic development in Orange County. The food system is complex as there are many players including producers, suppliers, and organizations and connecting consumers with local producers of healthy food is not always easy. Food councils are a solution to this problem by acting as connector to a cross - sector of individuals and organizations and by creating community partnerships that promote food access and addressing policy and programmatic barriers to a strong, local food system. Toward this end, a baseline community food assessment completed in November of 2015 analyzed all stages of the food system within Orange County, including food production, food processing and distribution, food consumption and food waste management. The purpose of the assessment was to form foundational knowledge for the food council to set priorities for action. The assessment gathered recent and historical data from established sources such as the United States Department of Agriculture and the American Community Survey, and combined it with stakeholder interviews to understand the strengths, weaknesses, threats, and opportunities facing the food system. The assessment described a strong farming culture in need of additional county support, a surprisingly high number of children needing food assistance at school, a burgeoning local food entrepreneurial environment, and a need for additional food waste management programming. More details can be found here: https:// orangecountyfoodcouncil .files.wordpress.com /2015 /11 /presentation orange - county- food - policy- council -2.pdf . Main Application 2/11/2016 9:25:27 AM Page 7 of 26 MAIN APPLICATION d) Describe the population to be served or the area to benefit and indicate how you will identify beneficiaries. The Orange County Food Council will serve all residents of Orange County through it's work to bring together parties interested in building a strong, local food system that addresses food access, farmland preservation, and a local living economy. The council brings together representatives of town and county agencies including the Orange County Departments of Economic Development, Health, and Social Services, the Orange County Schools, the Chapel Hill Carrboro City Schools, elected officials, UNC representatives, representatives of non - profits, producers, and consumers. These diverse stakeholders and agencies already serve Orange County residents and by convening together there is greater potential to strengthen the reach and impact including to vulnerable populations and the underserved. The next phase of the food assessment and community forums will help to identify the audiences most in need and will inform the council's action plan. e) Who specifically will carry out the activities and in what location will they be carried out? With this funding, we will hire a part -time food council coordinator. The coordinator will work with the seated council of 12 to 15 members to carry out all activities. Up to five working groups are also being formed to carry out the activities from the action plan. The coordinator will be an employee of the United Way of the Triangle, our fiscal agent, but will be provided work space in Orange County with one of our partners (UNC or the InterFaith Council for example). 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. Activities Frequency Jul -16 Aug -16 Sep -16 Oct -16 Nov -16 Dec -16 Jan -17 Feb -17 Mar -17 Apr -17 May -17 Jun -17 Jul -17 Hire coordinator Council meetings 1 X Monthly Engage diverse stakeholders ongoing community forums Y per year Qualitative baseline assessment with g months, FSA assessment development Development of 9 months, the action plan development 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. The following organizations have provided staff members to plan and carry out the monthly task force meetings and two community forums including agenda design, outreach, and delivering presentations over the last 16 months: • Camp Chestnut Ridge • Carrboro Farmers' Market • Orange County Department of Health • Orange County Office of Economic Development • Orange County Schools • United Way of the Triangle • UNC - Chapel Hill Center for Healthy Promotion & Disease Prevention (also provides printing /copying, Spanish translation, website maintenance, grant- writing). The following is a partial list (due to space) of organizations and businesses who have sent Main Application 2/11/2016 9:25:27 AM Page 8 of 26 MAIN APPLICATION representatives to meetings to provide input into the formation of the council and it's work: • InterFaith Council for Social Services • Farmer FoodShare • Orange County Office of Extension • Chapel Hill Farmers' Market • Vimala's Curryblossom Cafe • Seal the Seasons • Piedmont Food & Agriculture Processing Center • Orange County Solid Waste • Chapel Hill Carrboro City Schools h) Describe what would happen if requested funding is not awarded at all or if a reduced allocation is recommended. We have a number of avenues for funding should no or partial funding be awarded. We have collaborated with the United Way of the Triangle and two other food councils forming in the triangle (The Capital Area Food Council and the Durham Farm and Food Network) to seek funds through various mechanisms and will continue to do so. We have in -kind funds from UNC to provide Spanish translation, printing and copying, and limited staff time that has enabled the writing of this and other proposals and the scaffolding of the task force in developing the council. We are being provided technical assistance through the Carolina Farm Stewardship Association for facilitation that we may still be able to draw on. We have just been approved for a small grant from UNC's Food For All Academic Theme to partially support the qualitative portion of the food assessment. All of these potential resources and relationships will allow the council to continue to form, although at a slower pace. i) Include any other pertinent information. None Program /Project Information 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: X Persons ❑ Households ❑ Units Program: Orange County Food Council Gender Program Beneficiary Demographics Actual Estimated Projected 2014 -15 2015 -16 2016 -17 Male Female Total 66868 68038 69229 73065 74344 75645 139933 142382 144874 Of the females, how many are single - female Head of Households (Omit for Human Services) -- 5597 5695 Ethnicity Main Application 2/11/2016 9:25:27 AM Page 9 of 26 African - American American Indian or Alaska Native Asian Caucasian Native Hawaiian or other Pacific Islander Other Total Of the above, how many Hispanic /Latino Of the above, how many non - Hispanic /Latino Total Age 0 -5 years 6 -18 years 19 -50 years 51 -61 years 62+ years Total Geographic Location Durham City Durham County Carrboro Chapel Hill Chapel Hill Public Housing Residents Orange County Raleigh Wake County Total Income Level — See following chart (Omit for HS) < 30% Area Median Income 31 -50% Area Median Income 51 -80% Area Median Income > 80% Area Median Income Total Special Needs (Omit for HS) Elderly (Over 62) Disabled (not elderly) Homeless People with HIV /Aids Total MAIN APPLICATION 15870 16148 16430 999 1016 1034 11107 11301 11499 108352 110248 112178 22402 22794 23193 3605 3668 3732 139933 1 142382 144874 -- 18431 20429 -- 128219 129334 -- 146650 149763 7613 7746 7882 23644 24058 24479 65659 66808 67977 20166 20519 20878 22402 22794 23193 139933 142382 144874 22402 8757 8910 15459 5710 5810 108 21356 21730 313 59326 60364 -- 54288 55182 145926 148479 22402 8757 8910 15459 5710 5810 108 9266 9428 313 30500 31034 -- 54288 55182 22402 22794 23193 15459 15730 16005 108 -- -- 313 -- -- 38282 -- -- Main Application 2/11/2016 9:25:27 AM Page 10 of 26 MAIN APPLICATION 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 Level 1 person 2 people 3 people 4 people 5 people 6 people 7 people 8 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 /il /ill5 /FY2015 IL nc.pdf Main Application 2/11/2016 9:25:27 AM Page 11 of 26 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). Position Titles * = Position Vacant FTE* * % Program Staff + Actual 2014 -15 Estimated 2015 -16 Projected 2016 -17 %Total Budget If provided, indicate: (R) Retirement Plan (H) Health Plan Facilitator /consultan t for Orange County Food Policy Council .50 100 $0.0 $0.0 $19200 .60 Not applicable 8 Volunteer Task Force Members .05 8 0 0 Not applicable 15 Volunteer Food Council Members .05 0 15 0 Not applicable 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 2/11/2016 9:25:27 AM Page 12 of 26 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 ❑ x a) Employees of or closely related to employees of the Town of Chapel Hill, Orange County, Carrboro, or Hillsborough? ❑ x b) Members of or closely related to members of the governing bodies of Chapel Hill, Carrboro, Hillsborough, or Orange County? ❑ x c) Current beneficiaries of the project /program for which funds are requested? ❑ x 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. 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: Signature: Executive Director Date Board Chairperson Date Main Application 2/11/2016 9:25:27 AM Page 13 of 26 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 aoals. If aoals were not met. Dlease exDlain. Main Application 2/11/2016 9:25:27 AM P a g e 1 4 o f 2 6 Actual Estimated Projected 2014 -15 2015 -16 2016 -17 Program Activity 1 Form task force Hire coordinator Form a task force of a diverse set of food system stakeholders to Program Goal develop the Orange Hire a food council County Food Council by coordinator by January 1, 2015 that will September 30, 2016. meet monthly. Who is on the task force? Performance Measures What food system sectors do they represent? Do they meet regularly? Coordinator hired. A task force of 8 members was created representing economic development, production, food access, Program Results public health, institutions serving meals, child nutrition, and food retail. Monthly meetings to develop the council are on-going. Main Application 2/11/2016 9:25:27 AM P a g e 1 4 o f 2 6 MAIN APPLICATION Main Application 2/11/2016 9:25:27 AM P a g e 1 5 o f 2 6 Complete Phase II (qualitative) baseline Program Activity 2 community food assessment + Family Success Alliance Secure seed funding component Complete the baseline community food assessment including the component on food Program Goal insecurity within the To secure feed funding FSA zones and submit a to facilitate the work of report to the council by the task force to develop a food council. October 31, 2016. Amount of funds Number of interviews secured. conducted. Performance Measures Sources of in -kind Report submitted. support Secured $4000 in funding from the Burt's Bees Foundation; $9000 from Orange County; $750 from UNC's Food For All theme. Obtained in -kind staff support from UNC -CH Program Results (3 staff), Community Food Strategies (1 staff), Orange County (Extension (1), Public Health (2), Econ. Development (1), Schools (1)), Camp Chestnut Ridge (1), Carrboro Farmers' Market (1). Creation of a Collaborative Program Activity 3 Agreement (including a purpose and council Engage diverse structure), and council stakeholders through member application workgroups Main Application 2/11/2016 9:25:27 AM P a g e 1 5 o f 2 6 MAIN APPLICATION Main Application 2/11/2016 9:25:27 AM P a g e 1 6 o f 2 6 Recruit up to 10 members for up to 5 workgroups who are diverse in age, gender, Program Goal race, socio- To develop a demographic status, Collaborative and geographical Agreement and a residence by November membership application. 30, 2016. Number of workgroup Collaborative members recruited. Agreement created. Performance Measures Number of workgroups Membership application formed. created and disseminated. Diversity of workgroups. A Collaborative Agreement was created (see attachment) A membership Program Results application was created in both English and Spanish and is currently being widely disseminated (see attachment). Program Activity 4 Hold two community forums Adopt an action plan Develop a comprehensive food Hold two countywide systems action plan that Program Goal community forums to presents priorities for solicit input and the council and feedback on the creation workgroups by March of the food council. 31, 2016. Action plan adopted. Performance Measures Forums held. Number and nature of Number of attendees. priorities set. Main Application 2/11/2016 9:25:27 AM P a g e 1 6 o f 2 6 MAIN APPLICATION Main Application 2/11/2016 9:25:27 AM P a g e 1 7 o f 2 6 Two community forums were held, one in September 2014 and one in November 2016. 100 people attended the forum in Sept. 2014 Program Results 65 people attended the forum in Nov. 2015 with 20 people signing up to actively participant in the work of the council (by applying to be on the council or by serving on a workgroup). Complete a Activity 5 quantitative baseline community food Hold two community assessment forums Hold one community forum by November 30, 2016 and one by May 31, 2017 that engage at Program Goal Complete a quantitative least 100 Orange baseline community County residents across food assessment using a diverse range of existing data by the sectors and second community demographics. forum. Sign -in sheets that query sectors and Performance Measures Presentation of findings demographics of made at the second attendees will be used community forum. for both events. A community food assessment was carried out by two UNC graduate students (one in Public Health and one in City & Regional Program Results Planning). The results of the baseline community food assessment where presented at the community forum on November 5, 2015. Main Application 2/11/2016 9:25:27 AM P a g e 1 7 o f 2 6 MAIN APPLICATION Traditional data collection tools (pre /post tests to asses change in knowledge, attitudes, and behaviors) will not be used as we are not a service providing entity. We will use sign -in sheets to collect data on attendance and demographics of participants. The qualitative baseline community food assessment will use an interview guide that will be developed by the student team should funding be secured. They may also use the standard USDA Household Food Security Survey (http: / /www.ers. usda.gov/ topics/ food - nutrition - assistance / food - security -in- the- us /survey- tools.aspx #household, see attachment) to measure food insecurity in the two FSA zones, in collaboration with the Orange County Healthy Carolinians Partnership. Main Application 2/11/2016 9:25:27 AM Page 18 of 26 MAIN APPLICATION 4. FINANCIAL INFORMATION FOR SERVICE PROGRAMS a.) Program Budget 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 2/11/2016 9:25:27 AM P a g e 1 9 o f 2 6 MAIN APPLICATION Agency /Program Orange County Food Policy Council AGENCY REVENUE Private Donations Agency Generated Revenue (fees) Local Government Grants: Orange County Town of Chapel Hill Town of Carrboro Other Local: Other Local: Other Local: IF more than 3 sources, please provide a separate list. Non -Local Government Grants Triangle United Way State Government Federal Government Other Grants: Other Grants: Miscellaneous/Other Revenue Please list 3 largest Miscellanous sources: Total Agency Revenue AGENCY EXPENSES Compensation Rent & Utilities Supplies & Equipment Travel & Training Other Expenses: Please list 3 largest "Other Expenses ": Access related services $ Communication $ Total Agency Expenses Actual 2014 -15 Estimated 2015 -16 Projected 2016 -17 Percent Change 0 MEMEWEimi $ 9,000 $ 14,427 60% $ 9,618 0 $ 8,015 0 0 0 $ 4,000 0 -100% 0 0 0 0 iiiiiiml $ $ 13 000 $ 12,500 $ 32 060 $ 20,000 0 147% 60% 0 $ 500 $ 700 40% $ 8,800 0 $ 2,560 $ 1,360 $ 1,200 0 $ $ 13 000 $ 32 060 147% SURPLUS /(DEFICIT) FOR PERIOD: I $ - I $ - I $ - 1 0 Main Application 2/11/2016 9:25:27 AM Page 20 of 26 MAIN APPLICATION Main Application 2/11/2016 9:25:27 AM Page 21 of 26 MAIN APPLICATION Program Budget Detail Program: Orange County Food Council Cost Element Cost Quantity /Unit of Subtotal Measure Part-time Food Council Coordinator $20 20 hours /week x 4 $19,200 (Coordinator will lead the council in setting meeting weeks x 12 months agendas, facilitating meetings along with the chair, = 960 hours guiding the work of the baseline community food assessment and creation of the action plan, and coordinating the logistics for the two community forums.) Two Community Forums (We will hold two large $350 Costs include $200 $700 community forums to engage Orange County for refreshments residents in developing the actions of the council, and $150 meeting recruit participants for the working groups, and supplies including provide opportunities for sharing to facilitate flipcharts, easels, collaboration.) nametags: $350 x 2 = $700 Conduct the qualitative portion of the baseline $20 10 hours /week for $800 community food assessment including connecting 4 weeks = 40 with the Orange County Family Success Alliance hours and working directly in the two zones to assess food insecurity via stipends to graduate students. Provision of child care to facilitate wide $30 $30 for on -site $420 participation in council meetings, community forums, child care per or workgroup meetings as needed community forum and council meeting (14 total instances) Training for council members on democratic $2000 for governance $2000 +$5000 $7000 governance and consent -based decision - making training provided by and racial equity the UNC School of Government, $5000 for Racial Equity Training provided by Dismantling Racism Works or the Racial Equity Institute Translation services provided by CHICLE $55 Burmese /Karen $440 live translation services provided by CHICLE required for two meetings at the rate of $55 an hour for minimum of 2 hours. $55 /hour x 2 hours Main Application 2/11/2016 9:25:27 AM Page 22 of 26 MAIN APPLICATION b.) Cost per Unit Actual 2014 -15 x 2 meetings = Projected 2016 -17 Total Cost of Program $220 x 2 (Burmese $32,060 Total # of Units and Karen) 140,352 (population of Orange County in 2013 Cost Per Unit *Note, we have in- 22.8 cents kind funding from UNC to cover Spanish translation. Interpretation services provided by CHICLE $50 Document $500 translation for up to 5 pages of documents, $50 per page x 5= $250 x 2 (Burmese and Karen) *Note, we have in- kind funding from UNC to cover Spanish interpretation. Communication /marketing including graphic $100 $100 /month x 12 $1200 design to produce a logo and reproduction of copies, months printing of meeting materials Transportation to statewide events such as county $150 $150 /month x 12 $1800 food council convenings and to council meetings to months facilitate wide participation Total: $32,060 b.) Cost per Unit 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 2/11/2016 9:25:27 AM Page 23 of 26 Actual 2014 -15 Estimated 2015 -16 Projected 2016 -17 Total Cost of Program $32,060 Total # of Units 140,352 (population of Orange County in 2013 Cost Per Unit 22.8 cents 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 2/11/2016 9:25:27 AM Page 23 of 26 MAIN APPLICATION c.) 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. 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 2/11/2016 9:25:27 AM Page 24 of 26 MAIN APPLICATION Section Vl. Financial Data Operating Budget for Entire Agency AGENCY NAME: United Way of the Greater Triangle AGENCY REVENUE Private Donations Agency Generated Revenue (fees) Local Government Grants: Orange County Town of Chapel Hill Town of Carrboro Other Local: Other Local: Other Local: ff rnore than 3 sources, please provide a separate list. Non -Local Government Grants Triangle United Way State Government Federal GoNemment Other Grants: Premium Help Other Grants: Community Impact MiscellaneouslOther Revenue Please list 3 largest Mscellanous sources: Uncollectiblels Direc Service Events Total Agency Revenue AGENCY EXPENSES Compensation Rent & Utilities Supplies & Equipment Travel & Training Other Expenses: Please list 3 largest "Other Expenses ": Commmunity Investments $ Grant Expenses $ Contracts and Consultation $ Total Agency Expenses SURPLUS /(DEFICIT) FOR PERIOD: I $ 12,620 $ 600,536 $ 600,536 Main Application 2/11/2016 9:25:27 AM Page 25 of 26 Actual 2014 -15 Estimated 2015 -16 Projected 2016 -17 Percent Chan e $ 8,894,000 $ 9,325,000 $ 9,325,000 0% $ 436,000 $ 446,000 $ 446,000 0% 0 0 0 0 0 0 0 0 $ 704,000 $ 450,000 $ 450,000 0% $ 208,000 $ 695,000 $ 695,000 0% $ 62,000 $ 405,000 $ 405,000 0% $ (100,000)1 $ (40,000)1 $ (40,000)1 0% 356,000.00) $ (356,000.00) 187,000.00 $ 187,000.00 129,000.00 $ 129,000.00 $ :::::::I 2,897,212 1 281 000 $ 2,940,304 $ 11 281 000 $ 2,940,304 0% 0% $ 377,771 $ 396,695 $ 396,695 0% $ 54,832 $ 55,148 $ 55,148 0% $ 98,816 $ 76,720 $ 76,720 0% $ 6,762,749 $ 8,412,669 $ 8,412,669 0% $ $ $ 5,407,000 1,004,000 219,314 $ 6,695,000 $ 750,000 $ 193,197 $ 6,695,000 $ 750,000 $ 193,197 $ 10191380 $ 11,881,536 $ 11881536 0% SURPLUS /(DEFICIT) FOR PERIOD: I $ 12,620 $ 600,536 $ 600,536 Main Application 2/11/2016 9:25:27 AM Page 25 of 26 MAIN APPLICATION Main Application 2/11/2016 9:25:27 AM Page 26 of 26 Agenda Item Number: ORANGE COUNTY BOARD OF HEALTH AGENDA ITEM SUMMARY Meeting Date: February 24, 2016 Agenda Item Subject: Annual Report Attachment(s): Annual Report (http: / /www.orangecountync.gov /Annual Report 2015 FINAL.pdf) Staff or Board Member Reporting: Stacy Shelp, Communications Manager Purpose: Action X Information only Information with possible action Summary Information: Stacy will provide an overview of the 2015 Annual Report, it's success highlights and data. Recommended Action: Approve Approve & forward to Board of Commissioners for action Approve & forward to X Accept as information Revise & schedule for future action Other (detail): F1 Awards & Recognitions NCPHA Awards Tracey Langley— Environmental Health Rookie of the Year Victoria Hudson— Public Health All -Star NC City and County Communicators Award Excellence in Communications —First Place — Annual Reporl NC Association of County Commissioners Excellence in Innovation for our Naloxone Access Program First county in NC to post restaurant health inspection ratings to Yelp. Received a $4,000 Smiles for Kids grant from Delta Dental Foundation to improve services for children and provide school -based screenings. D :16I6 Nutrition Services conducted 185 outreach events to increase awareness of programs to promote healthy eating and physical activity. I F, Yid Food and Lodging made 100% of required inspections, making 1,578 inspections of 697 active establishments. At the annual Healti meeting Physical Activi Mental Health and Su and Social Determinani selected as community be addressed in 201 Yp _ C. tl 1 Y W. J'L l tl �L 100% of clients in the Diabetes Self Management Family Home Visiting completed over classes rated the program as "Excellent" or "Very 1,500 home visits to clients enrolled in Good" on their evaluations. our programs. ovided training for more than a dozen ✓ners and managers of apartments on w to develop and implement a smoke - �e policy. Walking the walk with three physical activity challenges in which more than 50% of staff participated, tracking more than 13,456 miles. P Added an additional full -time dentist, dental assistant, and office assistant in order to serve more children and adults in our dental clinic. Healthv Carolinians conducted their four year community health assessment with an unprecedented response of 1,714 surveys, 57 voices from focus groups, and 76 participants in community listening sessions. „Wai�;au �ua�W�y *V Contracted with Quitline to provide free nicotine patches, gum and lozenges to any residents who enroll in services by calling 1- 800 - QUIT -NOW. Over 17,000 riders used a Buzz Ride vehicle that was advertising Smoke - j Free Public Places and providing ' erS information to the late night, game A day, and special events crowds . Increased the number of medical encounters by 222 (44 %) compared to the previous year due to increased client follow -up. Expanded our newborn /postpartum nurse home visits to serve additional low- income women and families. Family Success Alliance -4 zone navigators hired, 66 kids participate in kindergarten readiness program, 25 families enrolled in FSA navigator support. O Tobacco Reality Unfiltered (TRU) clubs surveyed public housing communities and with input from 55% of residents, found that 80% of respondents want to live in a smoke -free building or have no preference. Naloxone -161 law enforcement offic- ers trained, 20 kits purchased for local law enforcement resulting in 4 overdose reversals.. Family Home Visiting began providing Behavioral Health Services in collaboration with our medical providers for patients with mental health care needs. '— Sheriff's Office installed two drug drop TH boxes for a total of five in the County, lol making them available in all law ____� ✓ enforcement agencies. q( �b ;ifi;iiii Finance &Multi- �w Y" Dental (Service & 70,638,1% , 427,733, RGrants), Year Grants, 5 R1 110,212,1% % Environmental Health (Fees & Grants), 460,864, 6% Personal Health i (Service & Grants), 1,543,283, 19% County Appropriation, 5,430,853, 68% Wells 306 w FY14 I a FY15 245 166 133 Permits issued New wells completed Expenses 28,750, 0.4°% nge County Health Department nections 1243 448 1 0 ITwitter ■Facebook 14 Personnel 14 Operating 1.1 Capital IRF Family Success Alliance e Connections 224 Septic Vital Records I 5,000 4,000 3,000 V FY14 -A FY15 2,000 1219 1176 1,000 Ll 0 permits — I279 Birth Certificates Death Certificates 505 IFY14 14 FY 15 Wells 306 w FY14 I a FY15 245 166 133 Permits issued New wells completed Expenses 28,750, 0.4°% nge County Health Department nections 1243 448 1 0 ITwitter ■Facebook 14 Personnel 14 Operating 1.1 Capital IRF Family Success Alliance e Connections 224 Septic 135 Systems Fa i I i ng systems repaired rry 100 awls V FY14 -A FY15 1219 1176 302 Ir , Improvement permits — I279 505 Septic system inspections 668 -- - Water samples analyzed 1651 1578 A Food & lodging inspections 190% Employee Satisfaction 80% 70% 60% 50% 40% 30°% 20%o 10% 0% Feel that they have Feel that working Have been opportunities to for0CHD sets recognized or learn and grow them apart from praised fcrgood professionally other county work in the past employees month 1431 1466 979 Interpreter Services 4 FY14 l4 i Y15 3887 3036 741 1157 —4 Staff/contract Telelangunge inte rprete r e ncounte rs & encounters 1-4 FY 14 (FY 0 239 25$ Primary Care visits Family Planning visits Nutrition Therapy Diabetes Enrolled visits Clients RZ�9 620 u-j FY14 iFY15 523 466 315 249 1 43 Reportable New STD case Rabies - related Ebola travelers Communicable investigations referrals followed Disease Investigations 6475 A FY14 5284 w FY 15 I AML 2101 2469 8�97� 939 II 1 Total visits Unique people served New patients 334 4 291 15 229 250 144 76 73 82 i� Women & At -risk women Women Women children post- received received received breast partum/ pregnancy care intensive feeding newborn pregnant/ education assessment post -partum visits counseli rig Agenda Item Number: ORANGE COUNTY BOARD OF HEALTH AGENDA ITEM SUMMARY Meeting Date: February 24, 2016 Agenda Item Subject: Debt Set -Off Program Update Attachment(s): Delinquent and Uncollectible Accounts Policy Staff or Board Member Reporting: Rebecca Crawford Purpose: Action X Information only Information with possible action Summary Information: Personal Health, Dental Health, and Environmental Health continue to participate in the NC Debt Set -Off Program, which allows the county to collect debts on delinquent accounts with a balance between $50 and $4,000 through the customer's tax refund. This has proven to be a successful way to recoup funds from overdue accounts, although FY 14 -15 total amounts are much higher than FY 15 -16 amounts as the prior year included multiple years of delinquent accounts whereas FY 15 -16 is from July 1, 2015 through January 31, 2016. The Personal Health division has also found that letters sent to delinquent accounts that warn of the potential to be sent to debt set -off have netted $1,796.40 for the period of July 1, 2015 through February 11, 2016. Division FY 14 -15 Debt Set -Off Amount FY 15 -16 Debt Set -Off (7/1/15 — 1/31/16) Personal Health $2,907.09 $71.00 Dental Health $29.807.45 $0 Environmental Health $524.05 $125 Total $33,238.59 $196 ORANGE COUNTY BOARD OF HEALTH AGENDA ITEM SUMMARY Meeting Date: Agenda Item Subject: Attachment(s): Staff /Board Member Reporting February 24, 2016 FY 2016 -17 Budget Request Budget Request & Summary Dr. Colleen Bridger Agenda Item Number: Purpose /Recommended Action: Action /Approve _X_ Action /Approve & forward to Board of Commissioners Information with possible action Accept as information Revise & schedule for future action Summary Information: The proposed FY 2016 -2017 budget for the Health Department shows an increase in expenditures of $620,561; $379,468 of which are expenditure increases related to the FY 15- 16 wage increase and increases to the medical insurance and retirement insurance rates, which are outside of the control of the department. The remaining $241,093 of the total increase is due to new and expanded services including $105,000 for the Family Success Alliance and $75,000 for Primary Care services for uninsured men. Staff projects a $328,611 increase in revenues for FY 16 -17, which will offset all of the $241,093 increase and leave a balance of revenue of $87,518. This additional revenue decreases the general fund burden of the wage increase and makes the total FY 16 -17 Health Department request for County General Funds $291,951. The proposed total budget is $10,062,417 which includes $103,536 in grant funding for the Susan G. Komen and Health Disparities projects and $705,000 (level funding) for school nurses in both Orange County school systems. New Staff Requests The Health Department requests a total of 1.4 FTE; a new 1.0 FTE Public Health Educator to serve as a community liaison and a 0.4 FTE for the Healthy Homes program, which will be added to the existing 0.6 FTE Public Health Preparedness position to total 1.0 FTE. The Health Department requires no additional funding to support these positions as they will be absorbed within the existing budget. State Funding The state has provided us with the FY 16 -17 Consolidated Agreement Addenda. Even though we will no longer receive funding for Ebola, the Maternal and Child Health Planning grant, or the Oral Health grant we received in FY 15 -16, we will receive additional funding for Prescription Drug Overdoses. Changes in funding for all other, ongoing Health Department programs equals out to the prior fiscal year. Fee Changes The FY 2016 -2017 requested budget includes fee changes for the Personal Health and Environmental Health divisions. Staff recommends multiple fee changes for Personal Health to cover the increased cost of vaccines, add a minimum lab fee for self -pay clients, and adjust the fee for 340B drugs according to changes in the state and federal policies around 340B drugs. Also, during the FY 15 -16 budget cycle, the Board of Health voted to enact Phase I of a three year phased Environmental Health fee increase in order to reach full cost recovery for Environmental Health. Staff recommends enacting Phase II of the three year fee increase by raising fees an additional 11 % over last year's increases. All proposed fee increases are described in more detail in a separate Fee Change abstract. Recommended Motion: To approve the total budget requested in the amount of $10,062,417 for 2016 -2017 as presented which includes $103,536 in grant funding for the Susan G. Komen and Health Disparities projects, and forward to the County Manager or Board of County Commissioners for action. ORANGE COUNTY HEALTH DEPARTMENT FY 16 -17 Annual Operating Budget Summary Reducing Health Disparities Grant Susan G. Komen Grant Total Granf Prnierfc FY 15 -1R Burinef FY 15 -16 Original Budget FY 16 -17 Budget Change from FY 15 -16 % Change Change from FY 15 -16 Request $ 63,708 TOTAL REVENUES $ 2,636,075 $ 2,924,858 $ 288,783 10.96% TOTAL EXPENSES $ 9,378,148 $ 9,958,881 $ 580,733 6.19% NET COUNTY $ 6,742,072 $ 7,034,023 $ 291,951 4.33% APPROPRIATION Reducing Health Disparities Grant Susan G. Komen Grant Total Granf Prnierfc FY 15 -1R Burinef Total Expenditure FY 16 -17 Grant $ 10,062,417 FY 15 -16 Original Budget Projects Budget Change from FY 15 -16 Request $ 63,708 $ 56,916 $ - $ 46,620 $ 46,61' $ 63,708 $ 103,536 1 $ 39,828 Total Expenditure $ 9,441,856 $ 10,062,417 $ 620,561 Budget Budget HighlightS Expenditure Increases Beyond The Department's Control: Personnel: Anticipated Increase in Medical Insurance Rates $ 27,014 Anticipated Increase in Retirement Rates $ 32,950 COLA Increase - Salary Line $ 252,003 COLA Increase - Benefit Line $ 67,501 Total Personnel: $ 379,468 Operatinq: Total Operatinq: Total $ 379,468 Health Department's Personnel Requests: Personnel: Public Health Educator - 1.0 FTE $ 56,765 Preparedness Coordinator - 0.4 FTE $ 29,467 Total $ 86,232 Line Item Operating Increases Above $10,000 Medical Supplies* $ 13,765 Contract Services $ 48,508 X -Ray* $ 41,236 Lab Services ** $ 14,704 Family Success Alliance $ 105,000 Total $ 223,213 *Increase related to new grant funded requests. ** Increase offset by decreases elsewhere within existing budget. Expenses SALARY &WAGES FY 15 -16 Original FY 15 -16 FY 16 -17 Budget Change from FY 15- BENEFITS & FRINGE Budget Projection Request 16 Revenue 3,660 2,500 3,660 0 FINANCIAL& ADMIN SRV REVENUE (66,385) (96,385) (201,385) (135,000) DENTAL HEALTH REVENUE (554,847) (541,644) (588,183) (33,336) HEALTH PROMOTION REVENUE (140,242) (118,035) (74,544) 65,698 ENVIRONMENTAL HEALTH REVENUE (484,880) (532,059) (592,511) (107,631) PERSONAL HEALTH REVENUE (1,453,429) (1,500,037) (1,571,771) (118,342) Total Non - County Revenue (2,699,783) (2,788,160) (3,028,394) (328,611) Expenses SALARY &WAGES 5,154,172 5,162,151 5,505,912 351,740 BENEFITS & FRINGE 1,825,562 1,780,447 1,929,927 104,365 BOARD REMUNERATION 3,660 2,500 3,660 0 TRAVEL 8,995 8,954 9,562 567 TRAINING /DEVELOPMENT 36,574 33,146 36,027 (547) CERTIFICATIONS & LICENSES 15,756 8,338 10,029 (5,727) PERSONAL MILEAGE 31,791 31,211 36,040 4,249 TELEPHONE 76,134 50,703 79,878 3,744 POSTAGE 15,957 12,314 15,402 (555) MOTOR POOL 48,807 37,367 48,807 0 EQUIPMENT REPAIRS 7,723 4,543 10,175 2,452 EQUIPMENT REP & MAINT 3,127 861 450 (2,677) EQUIPMENT RENT 1,620 819 1,200 (420) DUPLICATING 10,458 9,927 12,849 2,391 PRINTING 10,760 10,206 12,231 1,471 ADVERTISING 12,296 5,054 7,525 (4,771) DUES 5,404 5,005 5,320 (84) SUBSCRIPTIONS 1,327 2,985 1,550 223 DEPARTMENTAL SUPPLIES 41,814 20,998 38,342 (3,471) EDUCATIONAL SUPPLIES 12,175 8,193 12,811 636 OFFICE SUPPLIES 41,198 30,570 34,650 (6,549) MEDICAL SUPPLIES 146,652 150,083 160,417 13,765 BLOODBRNE PATH SUPPS 9,001 (201) 3,000 (6,001) PHARMACY SUPPLIES 239,266 218,204 228,000 (11,266) OTHER SUPPLIES 2,238 720 0 (2,238) COMP SUPP /SFTWRE 1,001 575 1,601 600 PUBLIC HEALTH COMMUNICATIONS 0 0 0 0 CONTRACT SERVICES 507,271 558,553 585,779 78,508 X -RAY 25,625 18,305 66,861 41,236 LAB SERVICES 52,502 72,669 67,206 14,704 BONDS & INSURANCE 10,602 4,507 10,347 (255) UNIFORMS 8,199 8,187 7,333 (866) COMMUNITY PROJECT SUPPORT 21,109 48,123 16,500 (4,609) EMPLOYEE WELLNESS GRANT 1,000 0 0 (1,000) INNOVATIONS PROJECT 20,000 20,000 20,000 0 ACCREDITATION PROJECT 2,750 2,750 2,750 0 WISE WOMAN PROGRAM 662 1,000 1,000 338 BT PUBLIC HEALTH PREPAREDNESS 147 0 0 (147) NICOTINE REPLACEMENT THERAPY 0 5,000 5,000 5,000 CREDIT CARD ACCEPTANCE CHARGES 10,000 11,400 10,000 0 CAPITAL UNDER $500 1,350 2,392 1,350 0 IT EQUIPMENT 3,800 4,751 2,926 (874) EQUIPMENT 3,500 4,175 0 (3,500) FURNISHINGS 0 0 0 0 CIVIL FILING FEES 0 0 0 0 ELECTRONIC MEDICAL RECORDS EXP 4,747 44,997 0 (4,747) FAMILY SUCCESS ALLIANCE 250,000 250,000 355,000 105,000 GENERAL RENOVATIONS 250 250 0 (250) LITIGATION 0 0 0 0 PROFESSIONAL SERVICES 250 250 0 (250) SCH HEALTH NURSE CONT 705,000 705,000 705,000 0 SUSAN G. KOMEN GRANT 49,624 2,883 0 (49,624) TOBACCO CONTROL GRANT 0 2,000 0 0 Total Expense 9,441,856 9,362,865 10,062,417 620,561 Total County Appropriation 6,742,072 6,574,704 7,034,023 291,951 Agenda Item Number ORANGE COUNTY BOARD OF HEALTH AGENDA ITEM SUMMARY Meeting Date: Agenda Item Subject: Attachment(s): Staff /Board Member Reporting February 24, 2016 FY 2016 -17 Fee Schedule Fee Schedule & Requested Changes Colleen Bridger, Health Director Purpose /Recommended Action: Action /Approve x Action /Approve & forward to Board of Commissioners Information with possible action Accept as information Revise & schedule for future action Summary Information: In reviewing Health Department fee schedules, which are done on an annual basis, the Department would like to make multiple fee changes in Personal Health, and continue with Phase II of the planned fee increases in the Environmental Health division. The proposed changes are detailed below: Personal Health Personal Health proposes the implementation of a minimum charge for laboratory procedures to recoup a small portion of labs performed for primary care patients. The average primary care patient requires multiple labs per visit, equating to between $24 and $185, or an average of $102 in charges. Patients pay for these labs according to where they fall on the sliding fee scale, however 0% pay patients do not pay anything for labs. The proposed minimum fee of $20 would be equal to other minimum fees within the Health Department for MNT and DSME services, which have both proven to not be cost prohibitive for clients. Personal Health also requests fee increases for multiple vaccines that are rising in cost and adjustments to our fees for 340B drugs (Family Planning drugs not including birth control pills) to make them match the county's cost to purchase them, as required by the state and federal government. This will have very little impact on both the department and patients as only 10% of self -pay patients pay more than $0 for Family Planning drugs or procedures and of that 10% we had no patients in prior years that have had to pay 100% of the cost. Personal Health Fee Changes Name of Fee 2015 -16 Rate 1 2016 -17 Proposed Anticipated Revenue from Environmental Health Board of Health voted to enact Phase I of a three year phased Environmental Health fee increase in order to reach full cost recovery for on -site and well services during the FY 15 -16 budget process. Phase I exceed our expectations and reduced the divisions general fund support by almost double the budgeted decrease ($164,000.) Phase II is projected to continue this gradual decrease in reliance on county general funds. Phase II Fee Increases (11 % over FY 15 -16 rates) Name of Fee 2015 -16 Rate Rate Fee Change Lab Minimum Fee NEW $20.00 $10,733.00 Depo Provera $40.00 $25.30 ($96.52) Mirena $745.23 $297.46 ($846.28) Nexplanon $698.99 $364.00 $1,875.94 Paragard $390.00 $233.34 ($169.19) Skyla $726.00 $488.00 Unknown, new product to clinic Liletta NEW $50.00 $150.00 Rabies Titer NEW $100.00 $1,000.00 Rabies Vaccine $269.00 $288.00 $19.00 Record of TB Screening Form Completion NEW $25.00 $1,000.00 Pap Smear with Interpretation $35.00 $26.50 ($169.00) HPV NEW $25.00 $250.00 Pap Smear with Dr. Interpretation NEW $80.00 $800.00 Environmental Health Board of Health voted to enact Phase I of a three year phased Environmental Health fee increase in order to reach full cost recovery for on -site and well services during the FY 15 -16 budget process. Phase I exceed our expectations and reduced the divisions general fund support by almost double the budgeted decrease ($164,000.) Phase II is projected to continue this gradual decrease in reliance on county general funds. Phase II Fee Increases (11 % over FY 15 -16 rates) Name of Fee 2015 -16 Rate 2016 -17 Proposed Additional Revenue from Rate Fee Change Septic -Const Authoriz $290 $325 $5,915 Septic -Est Syst Inspect $140 $155 $5,655 Septic -Mob Home Prk $140 $155 $795 Insp Septic -Mob Home Prk $195 $215 $300 Insp Septic -Mob Home Prk $250 $280 $150 Insp Septic -Site Ins /Impry Perms $390 $435 $11,115 Septic Contractor Registr Fees $225 $250 $1,850 Septic Tank Manuf Yard Insp $280 $310 $210 Contractor Education Regis Fee $30 $35 $350 Wells $480 $535 $9,350 WTMP Fees $140 $155 $8,370 Public Pool Inspections $250 $280 $3,400 Public Pools Plans Review $250 $280 $80 Tattoo Parlor Est Fees $250 $280 $330 Recommended Motion: To approve all fee changes for FY 2016 -2017 as presented and forward to the Board of County Commissioners for action. Health Director's Report February, 2016 • Just as I sat down to write this report I received an email that the contract for the software changes associated with Central Permitting for the county has just been signed! To put this into perspective for the newer members on the Board, this is a topic I first reported on in my very first Orange County Board of Health meeting over 4 years ago. At that time I reported that previous to my arrival a group had been working on this issue, but due to various challenges had abandoned the effort. A new group gathered together in 2012 and went methodically through every single issue, knocked down every single barrier and we are now ready to move forward to implement this new software /process. I never thought it would take this long and then I wondered if it would ever happen. So glad to report it has begun. Estimated implementation time is 18 months. As a result of this project, customers needing permits from the county can get the bulk of the work done on -line and transition relatively seamlessly through the process. The County will also be able to better monitor where the permit is in the approval process and identify /resolve slow spots in the system. • Related to this is an action approved by the BOCC last month to approve an addition of a .5FTE front desk person in both Environmental Health and Planning. We will combine our .5FTE with an existing .5FTE to create a full -time (time - limited to 18 months) position in Environmental Health. This will allow programmatic staff to devote time to program implementation rather than working at the front desk as they do now. • Liska gave a wonderful update to the BOCC last month covering the results of our annual report. This is the first year we won't have a joint BOH /BOCC meeting and Liska's report took the place of that. I've attached the annual report as a refresher. • We are moving forward with our pilot of Health in All Policies work with Jail Health. We'll have an update for you in a few months. • The County Manager has asked Nancy Coston (DSS Director) and me to work on a comprehensive plan for addressing mental health access issues in Orange County. She would like recommendations this time next year and I will keep you posted on our progress. • A coalition of agencies (including the Health Department) is requesting that the Orange County Board of Education change its policy and allow collection of Youth Risk Behavior Surveillance data. We all need this information to monitor health and mental health issues in our youth and design /evaluate programs and services targeting these issues. Currently the BOE requires active consent to participate in the YRBS. That meant we had 15 responses from all High School students. • We continue to monitor the Zika Virus situation with a focus on surveillance and mosquito control. This spring we'll be collaborating with our municipal partners to send out information in concert so everybody will see the same mosquito control information at multiple locations /times. So far we have no Zika Virus cases diagnosed in North Carolina. tarheel Collaboration aims to reduce high -risk drinking JANE LITTLE I PUBLISHED 17 HOURS AGO Read more: http : / /www.dailytarheel.com / article/ 2016 /02 /collaboration- aims -to- reduce - high- risk - drinking Quoted from The Daily Tar Heel The Chapel Hill Town and Gown Collaborative is looking to hire a community and campus director for alcohol and substance abuse prevention initiatives. The collaboration began in spring 2013 and works to reduce the negative effects of high -risk drinking in Chapel Hill neighborhoods, downtown and the University. The collaboration includes the town of Chapel Hill, the Orange County Health Department, UNC and the Orange County ABC Commission. Chapel Hill Downtown Partnership will employ the director and provide office space for him or her. "The position we all agreed to fund was in response to work done and a report issued by the Town and Gown Task Force to reduce alcohol misuse," Colleen Bridger, director of the Orange County Health Department, said. "The project will go into effect as soon as we hire the project manager," she said. Barbara Alvarez Martin, leader of the Town /Gown Advisory Board, said she hopes to have the project manager position filled by the end of the 2015 -16 school year. Each entity will put forward $30,000 annually to pay for the salary of the coalition director as well as the costs of the project. The total budget for the town /gown collaborative is $120,000 per year. This money will go primarily toward the director's salary, benefits and equipment. "As the director of the coalition, they would lead the coalition and implement the work the coalition wants done to address drinking and high -risk drinking," Meg McGurk, executive director of Chapel Hill Downtown Partnership, said. The director will work to initiate activities, educational opportunities and training sessions for members of the coalition, the memorandum states. Qualifications for this position include a master's degree in the social sciences, student development, public health, health education or a related field. Additionally, they must have at least five years of leadership experience in public health. "Hopefully this will make a big impact in our community," said Lisa Stuckey, chairperson of the Orange County ABC Commission, at the previous Board of Commissioners meeting on Feb. 2. At this meeting, the ABC Commission presented to the board an update on the collaboration. Bridger said while the project is primarily focused on the Chapel Hill area, she hopes it can be applied to Orange County as a whole. Alvarez Martin said UNC has been involved in the project from the beginning. "I would say the goal of UNC's project is to reduce the negative impacts of high -risk drinking through the implementation of a comprehensive set of evidenced -based and promising environmental strategies," Alvarez Martin said. Chapel Hill News February 1, 2016 Orange commissioners lay out steps for tackling 6 goals in 2016 By Tammy Grubb tgrubb @newsobserver.com CHAPEL HILL The Orange County Board of Commissioners spent Friday brainstorming and narrowing their ideas for how to best serve county residents. The goals are evolving, Commissioner Renee Price said, especially around issues with which the county has been wrestling for at least 10 years. "I think what this exercise proved is that some things are more of a priority now than the others," she said. Poverty — and how it keeps residents from having a better life — has been a common thread for many years, leading to the launch of the Family Success Alliance initiative in 2014. The alliance is envisioned as a "cradle -to- career or college pipeline" of government and community resources to better serve at -risk children. The first effort, a kindergarten prep program, started last summer, and officials are planning their next steps now. "I see the Family Success Alliance as really one of our most exciting new initiatives," Commissioner Bernadette Pelissier said, because "counties provide all these services, and a lot of them are really what we call the safety net. The safety net really just helps people, but it doesn't really solve the problem and end the cycle of poverty." Economic development holds the key, commissioners said, to addressing poverty and community values while also promoting sustainable growth and generating more tax dollars. "We've got to figure out how to pay for this other stuff, which is going to be extraordinarily expensive," Commissioners Chairman Earl McKee said. The county is doing "better, we've got more funds, but those funds are still coming out of people's pockets from their houses." He asked staff to prepare a comprehensive report about businesses that may be looking at a move to Orange County. Important decisions include the kind of businesses and jobs to attract and how to continue developing the county's three economic development districts, commissioners said. Partnerships — with the towns, UNC, residents and nonprofit groups — also are important to the county's success, they said, noting the partnerships with Chapel Hill, Carrboro and Hillsborough are positive and headed in the right direction. Other goals were: • Ensuring a community network of basic human services and infrastructure that maintains, protects and promotes well- being. Affordable housing is a big part of this goal, from mobile homes to rentals and for sale housing available to residents at all income levels. • Promoting an interactive and transparent system of governance that reflects community values. The commissioners talked specifically about better communication with the public and making the county's website more functional and easier to navigate. • Investing in quality county facilities, a diverse work force, and technology to achieve a high - performing county government. One suggestion was paying all county employees a "housing living wage" — enough so they don't pay more than 30 percent of their income on rent. • Creating, preserving and protecting a natural environment that includes clean water, clean air, wildlife, important natural lands, and sustainable energy for present and future generations. • Ensuring a high quality of life and lifelong learning that champions diversity, education at all levels, libraries, parks, recreation and animal welfare. This goal raised several suggestions, including: -More, strategically located community centers -Free community college for all high- achieving students, perhaps funded from the county's quarter -cent sales tax for education and the economy - Building public support for a $125 million November bond referendum aimed at meeting affordable housing and school repair and renovation needs Tammy Grubb: 919 - 829 -8926, @TammyGrubb Read more here: http://www.newsobserver.com / news /local /community /chapel -hill- news /article57727693.html #storylink =cpy ORANGEPOLITICS PROGRESSIVE PERSPECTIVES ON ORANGE COUNTI, NC. The Candidates Respond: Why Are People Poor? Submitted by OP Editors on February 8, 2016 - 11:00am Nine candidates are running for the Orange County Board of Commissioners in the upcoming Democratic primary election on March 15. • At Large (1 seat): Andy Cagle, Matt Hughes, Mark Marcoplos • District 1 (2 seats): Jamezetta Bedford, Mark Dorosin, Gary Kahn, Penny Rich • District 2 (1 seat): Bonnie Hauser, Renee Price OrangePolitics asked the candidates to answer five questions, and all provided responses. Today and on each of the next four Mondays, we will post the responses to one question. We begin today by posting the candidates' responses to the first question: Why are people poor? What tools or programs is the county using and /or should the county use to address poverty? The candidates cited a number of reasons for why people are poor, many naming lack of access to education and affordable housing. Some candidates acknowledged that institutional racism continues to play a role in poverty, though discussion of this issue was limited. A few candidates simply said the reasons were complex but did not provide specifics. The candidates discussed a number of tools to address poverty. The Family Success Alliance — spearheaded in 2014 by Commissioner Mark Dorosin and UNC pediatrician Michael Steiner —was named by several candidates as a key tool. We would like to see the Family Success Alliance target more systemic causes of poverty, such as racial inequity in many of our local systems, such as policing, education, the judicial system, and employment, and none of the candidates discussed this. A few candidates cited living wage policies as a tool, noting that the county's recent living wage policy moved all employees (full -time, part-time, and seasonal) to $12.76 per hour. This is an important step, and we would love to see the county move closer to what the Town of Carrboro is doing with a living wage floor closer to the cost of living in the county, which no candidate mentioned. A couple of candidates provided specific examples of other tools currently in use, such as the Social Justice Fund and the HOME Consortium (mentioned by Penny Rich) and new tools such as a "poverty ombudsman" (mentioned by Mark Marcoplos). The candidates' responses are provided below. 1= =__ = =1 AT -LARGE CANDIDATES Andy Cagle Why are people poor? Two words! Opportunities and alternatives, we must make sure that everyone has an opportunity to improve their lives. What we need is more available job training programs that are tailored to the skill set of our diverse population. We need to promote and attract light Industrials development along with other environmental friendly businesses that hire and train within the County. When the opportunity is present then the alternative is our own individual choice. Matt Hughes This is a complex question because people are poor for a variety of reasons, however, no one chooses to be poor. Despite being one of the most affluent counties in the state, and one of the few counties to see incomes above the state average, nearly a fifth of our community lives in poverty. As someone who experienced childhood poverty first -hand, I understand the struggles that these members of our community face. However, it was because I lived in a great county that provided vital programs such as Head Start, that I was ultimately able to succeed. As it relates to being an Orange County Commissioner, I see it as my job to make sure we are providing the opportunity for all of our resident to have access to education, from early childhood to adulthood. This includes providing the vocational education needed to learn new skills for jobs of the 21 st century. By the same token, creating a variety of jobs, both those requiring advanced degrees and those targeting trades, is a must. Additionally, I believe that environment, family and social services, and elder care are essential to the wellbeing of all of Orange County residents. In short, addressing poverty in Orange County is going to require a multi -level approach, including job training, the addition of jobs, the addition of affordable housing, and expanding access to public transit. The Family Success Alliance is a great tool that the county is currently using to address cradle to grave poverty in our community. By coordinating our various organizations focused on poverty, we can better serve those living in poverty and make a dent in this issue. KidScope, an organization for which I am proudly serving as a member of their Advisory Council, is a partner organization with the Family Success Alliance. KidScope provides great resources, like their Incredible Years Preschool Parenting Classes. These classes help parents understand their children's academic, social, and emotional needs and learn positive, evidence -based parenting skills. The Family Success Alliance can help break the cycle of poverty for children like me. I would like to see this program begin to expand beyond the two current pilot zones in the county. Mark Marcoplos People are poor for a variety of interconnected reasons, many of them the result of an economy that serves the ultra - wealthy at the expense of everyone else. One of the key justifications for allowing our economy to be dominated by corporate power is the shareholder value theory, which says that the sole purpose of publicly - held corporations is to maximize shareholder profit. (For more on this, see this article from 1971 by the hallowed economist Milton Friedman: hitp:/ /www.colorado.edu /studentgrogps /libertarians /issues /friedman- soc-resp- business.html) In pursuit of this over - arching goal, our economic system has a long and under- scrutinized history of exploiting minorities which continues to this day. These minorities are also often the most under - served by our educational system. Orange County may seem to many of us like an oasis in this difficult economic landscape. Yet amidst the relative affluence of our citizenry, about 20% of our population lives in poverty. We have an ethical obligation to help these people. The County is addressing poverty in a variety of ways that are helping, but we can do more. The Family Success Alliance is a relatively new project that is helping children in poverty create a better life in two communities in the County. The Orange County Schools have a free or reduced meal plan for those in need. The County has a Child care Subsidy program. The County Social Services Department administers several programs such as nutrition services, low- income health care, low income energy assistance, and more. I would like to see the County create a "Poverty Ombudsman" who would: • Manage information on the various manifestations of poverty in Orange County. • Go into communities, schools, homeless camps, trailer parks, etc. and gather first -hand knowledge. • Coordinate efforts and facilitate resource sharing among the various anti - poverty efforts. • Identify gaps in our efforts to address poverty so that we can consider different approaches. We must accelerate our affordable housing efforts. The County, Chapel Hill, & Carrboro jointly own a 169 acre parcel of land called the Greene tract which is between the Rogers Road community and Weaver dairy Extension. We should immediately begin making collaborative plans for some affordable housing projects there, since we could save on land costs which are a major source of affordable housing expense. Let's create an experimental transitional, tiny home village for homeless people. We are likely to learn what many studies have concluded — that it is less expensive for a community to house a homeless person than to use tax money for the various social services that person requires without a home. Successful transitions to an independent life for homeless people begin with having a home. We should get more bang- for - the -buck by building smaller homes and rentals with smaller units. Quick thought — instead of Orange High students building one 1700 sf affordable home per year, how about three 600 sf homes? We need to ensure that our transportation systems are serving all communities. I was glad that our work to provide better bus service to the Rogers Rd. — Eubanks neighborhood resulted in improved service for them. We should ensure that we have equal justice for all, from the streets to the courts. Reduced sentences for minor offenses will help keep families intact and minimize the interruption of young peoples' development, as well as save taxpayer money. lmmmmmml DISTRICT 1 CANDIDATES Jamezetta R. Bedford There are numerous societal conditions which contribute to poverty, including institutional racism. Often these factors weave together making it difficult for an individual to escape their circumstances. Inadequate education, employment, housing, medical care, social services and inequalities in our legal system are a few of the many factors that contribute to an individual's inability to thrive. Examples of these factors include: Education: Orange County has an alarming and persistent achievement gap between minority and white students that leads to limited earning opportunities in the future. Underpaid and understaffed teachers in deteriorating buildings only exacerbate existing problems and make it difficult to reach the students most in need. There is also a shortage of quality, affordable childcare to allow parents to work and children to be prepared for success in kindergarten. Economic/Housing: Although our unemployment rate in Orange County is relatively low, many of our citizens are "working poor" because they are not paid a living wage. We have a shortage of affordable housing in our county, which restricts the ability for low income families to provide safe and stable homes. In 2014, the hourly wage needed to afford a two bedroom apartment in Orange County was $16.21. Our state hourly minimum wage is $7.25. Taxation policies also contribute to poverty, including a decrease in unemployment benefits and length of benefit, and elimination of the state earned income credit and the pension deduction of $2,000 - $4,000 for seniors. Health and Social Services: Limited access to medical care, disease prevention and prenatal care all contribute to poverty. Mental illness, substance abuse, and disabilities also cause and sustain poverty, particularly in a political climate that will not expand medicaid. The county is using several tools and partnerships to directly and indirectly address poverty. • The county sets a living wage for county employees. • The county Family Success Alliance partners with other organizations to tackle poverty "to improve children's chances for educational and economic opportunities by serving a defined geographic area (a zone) and its children with a seamless `pipeline' of evidence -based programs, service, and supports from cradle to career." This provides a good example of the programming we need to develop and expand. • Indirectly the county approved school construction standards that allow for and fund pre -K classrooms to be included in new schools. • In October, 2015 the County made a great step by appointing its first Criminal Justice Resource Manager (for jail alternative programming such as PreTrial and Drug Court programs). On January 21, 2016 the Board approved the creation of a Criminal Case Assessment Specialist Position with clinical mental health skills to be paid for the remainder of this fiscal year. • We need to continue our public /private affordable housing partnerships with a goal towards measurable increases in affordable housing stock. The county needs to expedite economic development in the Buckhorn Economic District for clean commercial projects to bring jobs with benefits at several levels for residents, especially those who do not have college degrees. Companies can partner with Durham Tech - Orange Co to provide any technical training needed. C = =7 Mark Dorosin Poverty has myriad interrelated and inter - generational causes, including: 1) a lack of adequate educational opportunities, 2) a lack of decent paying jobs, 3) inadequate childcare, which especially burdens single parent households; 4) weakening of the safety net; 5) and the continuing impacts of race and gender discrimination. While the County has worked to expand the scope and impact of its Departments of Social Services and Health, it has struggled to stem the onslaught of adverse actions by the state legislature. The Family Success Alliance, a County led coalition of government agencies and direct service providers, has developed a wrap- around anti - poverty program specifically targeting children and families in concentrated low- wealth areas of the county. The key to the model is two -fold and represents an approach we ought to take towards all social justice advocacy: first, it recognizes the importance of an interdisciplinary approach to community challenges (here bringing schools, health department, nonprofits, and community advocates together); second, it acknowledges that making immediate impacts, even incremental ones, is vital to build support and engagement around issues that can otherwise seem too broad, intractable, or abstract. We need to expand the FSA and coordinate it with efforts to expand affordable housing and support local businesses and job opportunities. All these efforts should be focused on addressing the growing income inequality in the County, which is among the highest in the state. Gary Kahn People are poor for the following reasons, lack of a proper education, min wage jobs, family planning not planed well(i.e Too many children etc.)The county should do a better job on getting the word out of what services they need, and try to locate and reach out to them. Penny Rich One in five North Carolina families earn too little to afford life's essentials and move up the economic ladder. Orange County, which has one of the highest per capita incomes in our region, has 15.5% of people living below the poverty level (Chapel Hill 23.1 %), with our children hit hard at 13.4 %. Many factors contribute to poverty: racial discrimination in education, jobs, housing and the criminal justice system are a factor, as well as government policies that disproportionately impact the poor. Some of these policies are implemented at the county level, such as urban and housing renewal policies that result in the poor paying greater portions of their income for substandard housing. Orange County is tackling the problem of poverty head on. Some of the tools we are using are: 1. Living Wage In 2015, Orange county commissioners approved a living wage of $12.76 for all county employees regardless of job status (full time, part time and seasonal employees). I led the collaboration with the non - profit "Orange County Living Wage Project" to recognize and certify Orange County as a Living Wage Employer, and encouraged our municipalities and schools to become certified as well. OCLWP encourages local business to pay the current living wage and has certified 53 businesses that do so (http: / /www.oran eg countylivingwage.org /certified_emplo_yers). It is important that Orange County lead by example, as the county government, both school systems, local governments and the university system are the largest employers in the county. I believe we can take this one step further by implementing a "fair housing wage" for all Orange County employees, which would provide the opportunity for county employees to live in Orange County. 2. HOME Consortium This program allows local governments to partner when applying for funding for affordable housing. The 2015 -2020 plan includes strategies to expand the supply of quality housing, increase housing choices, ensure equal opportunity, and enforce the "Orange County Civil Rights Ordinance" by investigating housing discrimination cases. While discussing the 2016 Bond Referendum, I insisted that we include funding for Affordable Housing. This was an uphill battle, but I did not let up and ultimately convinced my colleagues to include a 5 million dollar allocation. Although this is a small amount compared to the size of the problem, every dollar helps. 3. Work First This program provides temporary assistance to help individuals move off welfare and into jobs. It provides employment services and support services along with some funding for families with children under the age of 18. The county works with local business and Durham Technical Community College to identify possible employment opportunities and assist applicants with the application process. 4. Family Success Alliance This program is relatively new to our county that came out a long discussion about poverty in our 2013 commissioner retreat. The goal of the program is to improve a child's chance for educational and economic success by applying evidence -based programs, services and a support systems from cradle to career, and to to end the school -to- prison pipeline. We have identified two "zones" in the county to pilot the program: Zone 4 in central Orange, and Zone 6 that covers downtown Chapel Hill to Hwy 54. A representative from each zone serves on the FSA council, taking an active decision - making role in both the education and community affairs of the children they represent. This empowers the children and families to exert some influence and control over their future. 5. Social Justice Fund This fund was resurrected by the commissioners in 2013. During the recent recession this fund had been depleted, leaving no safety net for the most needy citizens in the county. This fund is used in extreme cases where no other funding is available. For example, funding has been used to supplement state funds when the state reduced funding for childcare reimbursements, to fund The Family Success Alliance, and to support DSS General Assistance for families in crisis and not able to pay utility bills. Although this will not end poverty, it provides a hand up to pull people out of crisis status. lmmmmmml DISTRICT 2 CANDIDATES Bonnie Hauser There are countless reasons that people are poor, ranging from un/under employment, generational poverty, mental illness, sudden loss of employment, healthcare crises and more. No one wants to be poor, or worse, to stay poor. The challenge is to find ways to reduce poverty through better job and skill development and to improve affordability through better access to housing, transportation and essential services. I believe the county can do more by developing solutions for housing, transportation, and services that fit our communities. Every community is different, and solutions need to be adapted to fit. For example, good public transportation in Hillsborough looks different than Mebane or Chapel Hill. Ways that housing solutions can be adapted to our communities are discussed in Question 5. Orange County and the many not - for - profits that serve our communities have wonderful tools to help, but resources but they are not always getting where they are needed. The Family Success Alliance, Project Engage Senior Outreach, and the community center initiative that's building around Rogers Road, Efland, and Cedar Grove are helping. I'd like to foster similar initiaitves to provide tutors and to help feed low income children when school is out. A greater challenge is finding ways to serve the families of low wage contract employees that work for UNC and UNC Healthcare. I'd be interested in working with UNC and the towns to find ways to provide housing, healthcare and other services to help make life more affordable for the contractors. Cii7 Renee Price Many people are born into poverty, and have become part of a seemingly unending cycle. Others people find themselves living in poverty, unexpectedly, years after a life of comfort and security. People are of low- wealth for a variety of reasons —i.e., lack of education or skills to secure gainful employment; insufficient job opportunities paying a living wage; inability to be hired or promoted due to discrimination because of color, gender or age. Poverty, particularly persistent poverty, is indicative of the state of the local or regional economy, such as the demise of major businesses and employers. Poverty also is the consequence of a capitalistic society. Orange County, despite its charm and amenities, is home to many households living in poverty. In recent years, the County has intensified its effort to increase economic development in both the rural and urban areas in order to: bring good paying jobs to unemployed and underemployed residents; and to diversify and expand the tax base so as to decrease the tax burden on homeowners and property owners who pass the costs to renters. To assure a ready and successful workforce, we have forged a partnership with Durham Technical Community College. Our public schools also are teaching STEM and STEAM courses to prepare our young people for a competitive edge in the global economy. The Family Success Alliance teams are working with entire households to help them rise above systemic poverty—i.e., summer reading programs for pre -K youngsters and career assistance for adults While Orange County government is unable to provide jobs to all individuals in needs, it can forge forward with a campaign to attract, sustain and retain a range of businesses and employers. The County can continue to promote the living wage movement by seeking to do business with companies that offer living wages to their employees. The issue that remains to be resolved is the prejudice and discrimination that historically has put certain populations in poverty and that continues to keep certain people in an oppressed or dependent state. Certainly, cities and counties thrive when families, neighborhoods and businesses are strong— socially, financially and politically. ORANGEPOLITICS PROGRESSIVE PERSPECTIVES ON ORANGE COUNTI, NC. The Candidates Respond: Why Are People Poor? Submitted by OP Editors on February 8, 2016 - 11:00am Nine candidates are running for the Orange County Board of Commissioners in the upcoming Democratic primary election on March 15. • At Large (1 seat): Andy Cagle, Matt Hughes, Mark Marcoplos • District 1 (2 seats): Jamezetta Bedford, Mark Dorosin, Gary Kahn, Penny Rich • District 2 (1 seat): Bonnie Hauser, Renee Price OrangePolitics asked the candidates to answer five questions, and all provided responses. Today and on each of the next four Mondays, we will post the responses to one question. We begin today by posting the candidates' responses to the first question: Why are people poor? What tools or programs is the county using and /or should the county use to address poverty? The candidates cited a number of reasons for why people are poor, many naming lack of access to education and affordable housing. Some candidates acknowledged that institutional racism continues to play a role in poverty, though discussion of this issue was limited. A few candidates simply said the reasons were complex but did not provide specifics. The candidates discussed a number of tools to address poverty. The Family Success Alliance — spearheaded in 2014 by Commissioner Mark Dorosin and UNC pediatrician Michael Steiner —was named by several candidates as a key tool. We would like to see the Family Success Alliance target more systemic causes of poverty, such as racial inequity in many of our local systems, such as policing, education, the judicial system, and employment, and none of the candidates discussed this. A few candidates cited living wage policies as a tool, noting that the county's recent living wage policy moved all employees (full -time, part-time, and seasonal) to $12.76 per hour. This is an important step, and we would love to see the county move closer to what the Town of Carrboro is doing with a living wage floor closer to the cost of living in the county, which no candidate mentioned. A couple of candidates provided specific examples of other tools currently in use, such as the Social Justice Fund and the HOME Consortium (mentioned by Penny Rich) and new tools such as a "poverty ombudsman" (mentioned by Mark Marcoplos). The candidates' responses are provided below. 1= =__ = =1 AT -LARGE CANDIDATES Andy Cagle Why are people poor? Two words! Opportunities and alternatives, we must make sure that everyone has an opportunity to improve their lives. What we need is more available job training programs that are tailored to the skill set of our diverse population. We need to promote and attract light Industrials development along with other environmental friendly businesses that hire and train within the County. When the opportunity is present then the alternative is our own individual choice. Matt Hughes This is a complex question because people are poor for a variety of reasons, however, no one chooses to be poor. Despite being one of the most affluent counties in the state, and one of the few counties to see incomes above the state average, nearly a fifth of our community lives in poverty. As someone who experienced childhood poverty first -hand, I understand the struggles that these members of our community face. However, it was because I lived in a great county that provided vital programs such as Head Start, that I was ultimately able to succeed. As it relates to being an Orange County Commissioner, I see it as my job to make sure we are providing the opportunity for all of our resident to have access to education, from early childhood to adulthood. This includes providing the vocational education needed to learn new skills for jobs of the 21 st century. By the same token, creating a variety of jobs, both those requiring advanced degrees and those targeting trades, is a must. Additionally, I believe that environment, family and social services, and elder care are essential to the wellbeing of all of Orange County residents. In short, addressing poverty in Orange County is going to require a multi -level approach, including job training, the addition of jobs, the addition of affordable housing, and expanding access to public transit. The Family Success Alliance is a great tool that the county is currently using to address cradle to grave poverty in our community. By coordinating our various organizations focused on poverty, we can better serve those living in poverty and make a dent in this issue. KidScope, an organization for which I am proudly serving as a member of their Advisory Council, is a partner organization with the Family Success Alliance. KidScope provides great resources, like their Incredible Years Preschool Parenting Classes. These classes help parents understand their children's academic, social, and emotional needs and learn positive, evidence -based parenting skills. The Family Success Alliance can help break the cycle of poverty for children like me. I would like to see this program begin to expand beyond the two current pilot zones in the county. Mark Marcoplos People are poor for a variety of interconnected reasons, many of them the result of an economy that serves the ultra - wealthy at the expense of everyone else. One of the key justifications for allowing our economy to be dominated by corporate power is the shareholder value theory, which says that the sole purpose of publicly - held corporations is to maximize shareholder profit. (For more on this, see this article from 1971 by the hallowed economist Milton Friedman: hitp:/ /www.colorado.edu /studentgrogps /libertarians /issues /friedman- soc-resp- business.html) In pursuit of this over - arching goal, our economic system has a long and under- scrutinized history of exploiting minorities which continues to this day. These minorities are also often the most under - served by our educational system. Orange County may seem to many of us like an oasis in this difficult economic landscape. Yet amidst the relative affluence of our citizenry, about 20% of our population lives in poverty. We have an ethical obligation to help these people. The County is addressing poverty in a variety of ways that are helping, but we can do more. The Family Success Alliance is a relatively new project that is helping children in poverty create a better life in two communities in the County. The Orange County Schools have a free or reduced meal plan for those in need. The County has a Child care Subsidy program. The County Social Services Department administers several programs such as nutrition services, low- income health care, low income energy assistance, and more. I would like to see the County create a "Poverty Ombudsman" who would: • Manage information on the various manifestations of poverty in Orange County. • Go into communities, schools, homeless camps, trailer parks, etc. and gather first -hand knowledge. • Coordinate efforts and facilitate resource sharing among the various anti - poverty efforts. • Identify gaps in our efforts to address poverty so that we can consider different approaches. We must accelerate our affordable housing efforts. The County, Chapel Hill, & Carrboro jointly own a 169 acre parcel of land called the Greene tract which is between the Rogers Road community and Weaver dairy Extension. We should immediately begin making collaborative plans for some affordable housing projects there, since we could save on land costs which are a major source of affordable housing expense. Let's create an experimental transitional, tiny home village for homeless people. We are likely to learn what many studies have concluded — that it is less expensive for a community to house a homeless person than to use tax money for the various social services that person requires without a home. Successful transitions to an independent life for homeless people begin with having a home. We should get more bang- for - the -buck by building smaller homes and rentals with smaller units. Quick thought — instead of Orange High students building one 1700 sf affordable home per year, how about three 600 sf homes? We need to ensure that our transportation systems are serving all communities. I was glad that our work to provide better bus service to the Rogers Rd. — Eubanks neighborhood resulted in improved service for them. We should ensure that we have equal justice for all, from the streets to the courts. Reduced sentences for minor offenses will help keep families intact and minimize the interruption of young peoples' development, as well as save taxpayer money. lmmmmmml DISTRICT 1 CANDIDATES Jamezetta R. Bedford There are numerous societal conditions which contribute to poverty, including institutional racism. Often these factors weave together making it difficult for an individual to escape their circumstances. Inadequate education, employment, housing, medical care, social services and inequalities in our legal system are a few of the many factors that contribute to an individual's inability to thrive. Examples of these factors include: Education: Orange County has an alarming and persistent achievement gap between minority and white students that leads to limited earning opportunities in the future. Underpaid and understaffed teachers in deteriorating buildings only exacerbate existing problems and make it difficult to reach the students most in need. There is also a shortage of quality, affordable childcare to allow parents to work and children to be prepared for success in kindergarten. Economic/Housing: Although our unemployment rate in Orange County is relatively low, many of our citizens are "working poor" because they are not paid a living wage. We have a shortage of affordable housing in our county, which restricts the ability for low income families to provide safe and stable homes. In 2014, the hourly wage needed to afford a two bedroom apartment in Orange County was $16.21. Our state hourly minimum wage is $7.25. Taxation policies also contribute to poverty, including a decrease in unemployment benefits and length of benefit, and elimination of the state earned income credit and the pension deduction of $2,000 - $4,000 for seniors. Health and Social Services: Limited access to medical care, disease prevention and prenatal care all contribute to poverty. Mental illness, substance abuse, and disabilities also cause and sustain poverty, particularly in a political climate that will not expand medicaid. The county is using several tools and partnerships to directly and indirectly address poverty. • The county sets a living wage for county employees. • The county Family Success Alliance partners with other organizations to tackle poverty "to improve children's chances for educational and economic opportunities by serving a defined geographic area (a zone) and its children with a seamless `pipeline' of evidence -based programs, service, and supports from cradle to career." This provides a good example of the programming we need to develop and expand. • Indirectly the county approved school construction standards that allow for and fund pre -K classrooms to be included in new schools. • In October, 2015 the County made a great step by appointing its first Criminal Justice Resource Manager (for jail alternative programming such as PreTrial and Drug Court programs). On January 21, 2016 the Board approved the creation of a Criminal Case Assessment Specialist Position with clinical mental health skills to be paid for the remainder of this fiscal year. • We need to continue our public /private affordable housing partnerships with a goal towards measurable increases in affordable housing stock. The county needs to expedite economic development in the Buckhorn Economic District for clean commercial projects to bring jobs with benefits at several levels for residents, especially those who do not have college degrees. Companies can partner with Durham Tech - Orange Co to provide any technical training needed. C = =7 Mark Dorosin Poverty has myriad interrelated and inter - generational causes, including: 1) a lack of adequate educational opportunities, 2) a lack of decent paying jobs, 3) inadequate childcare, which especially burdens single parent households; 4) weakening of the safety net; 5) and the continuing impacts of race and gender discrimination. While the County has worked to expand the scope and impact of its Departments of Social Services and Health, it has struggled to stem the onslaught of adverse actions by the state legislature. The Family Success Alliance, a County led coalition of government agencies and direct service providers, has developed a wrap- around anti - poverty program specifically targeting children and families in concentrated low- wealth areas of the county. The key to the model is two -fold and represents an approach we ought to take towards all social justice advocacy: first, it recognizes the importance of an interdisciplinary approach to community challenges (here bringing schools, health department, nonprofits, and community advocates together); second, it acknowledges that making immediate impacts, even incremental ones, is vital to build support and engagement around issues that can otherwise seem too broad, intractable, or abstract. We need to expand the FSA and coordinate it with efforts to expand affordable housing and support local businesses and job opportunities. All these efforts should be focused on addressing the growing income inequality in the County, which is among the highest in the state. Gary Kahn People are poor for the following reasons, lack of a proper education, min wage jobs, family planning not planed well(i.e Too many children etc.)The county should do a better job on getting the word out of what services they need, and try to locate and reach out to them. Penny Rich One in five North Carolina families earn too little to afford life's essentials and move up the economic ladder. Orange County, which has one of the highest per capita incomes in our region, has 15.5% of people living below the poverty level (Chapel Hill 23.1 %), with our children hit hard at 13.4 %. Many factors contribute to poverty: racial discrimination in education, jobs, housing and the criminal justice system are a factor, as well as government policies that disproportionately impact the poor. Some of these policies are implemented at the county level, such as urban and housing renewal policies that result in the poor paying greater portions of their income for substandard housing. Orange County is tackling the problem of poverty head on. Some of the tools we are using are: 1. Living Wage In 2015, Orange county commissioners approved a living wage of $12.76 for all county employees regardless of job status (full time, part time and seasonal employees). I led the collaboration with the non - profit "Orange County Living Wage Project" to recognize and certify Orange County as a Living Wage Employer, and encouraged our municipalities and schools to become certified as well. OCLWP encourages local business to pay the current living wage and has certified 53 businesses that do so (http: / /www.oran eg countylivingwage.org /certified_emplo_yers). It is important that Orange County lead by example, as the county government, both school systems, local governments and the university system are the largest employers in the county. I believe we can take this one step further by implementing a "fair housing wage" for all Orange County employees, which would provide the opportunity for county employees to live in Orange County. 2. HOME Consortium This program allows local governments to partner when applying for funding for affordable housing. The 2015 -2020 plan includes strategies to expand the supply of quality housing, increase housing choices, ensure equal opportunity, and enforce the "Orange County Civil Rights Ordinance" by investigating housing discrimination cases. While discussing the 2016 Bond Referendum, I insisted that we include funding for Affordable Housing. This was an uphill battle, but I did not let up and ultimately convinced my colleagues to include a 5 million dollar allocation. Although this is a small amount compared to the size of the problem, every dollar helps. 3. Work First This program provides temporary assistance to help individuals move off welfare and into jobs. It provides employment services and support services along with some funding for families with children under the age of 18. The county works with local business and Durham Technical Community College to identify possible employment opportunities and assist applicants with the application process. 4. Family Success Alliance This program is relatively new to our county that came out a long discussion about poverty in our 2013 commissioner retreat. The goal of the program is to improve a child's chance for educational and economic success by applying evidence -based programs, services and a support systems from cradle to career, and to to end the school -to- prison pipeline. We have identified two "zones" in the county to pilot the program: Zone 4 in central Orange, and Zone 6 that covers downtown Chapel Hill to Hwy 54. A representative from each zone serves on the FSA council, taking an active decision - making role in both the education and community affairs of the children they represent. This empowers the children and families to exert some influence and control over their future. 5. Social Justice Fund This fund was resurrected by the commissioners in 2013. During the recent recession this fund had been depleted, leaving no safety net for the most needy citizens in the county. This fund is used in extreme cases where no other funding is available. For example, funding has been used to supplement state funds when the state reduced funding for childcare reimbursements, to fund The Family Success Alliance, and to support DSS General Assistance for families in crisis and not able to pay utility bills. Although this will not end poverty, it provides a hand up to pull people out of crisis status. lmmmmmml DISTRICT 2 CANDIDATES Bonnie Hauser There are countless reasons that people are poor, ranging from un/under employment, generational poverty, mental illness, sudden loss of employment, healthcare crises and more. No one wants to be poor, or worse, to stay poor. The challenge is to find ways to reduce poverty through better job and skill development and to improve affordability through better access to housing, transportation and essential services. I believe the county can do more by developing solutions for housing, transportation, and services that fit our communities. Every community is different, and solutions need to be adapted to fit. For example, good public transportation in Hillsborough looks different than Mebane or Chapel Hill. Ways that housing solutions can be adapted to our communities are discussed in Question 5. Orange County and the many not - for - profits that serve our communities have wonderful tools to help, but resources but they are not always getting where they are needed. The Family Success Alliance, Project Engage Senior Outreach, and the community center initiative that's building around Rogers Road, Efland, and Cedar Grove are helping. I'd like to foster similar initiaitves to provide tutors and to help feed low income children when school is out. A greater challenge is finding ways to serve the families of low wage contract employees that work for UNC and UNC Healthcare. I'd be interested in working with UNC and the towns to find ways to provide housing, healthcare and other services to help make life more affordable for the contractors. Cii7 Renee Price Many people are born into poverty, and have become part of a seemingly unending cycle. Others people find themselves living in poverty, unexpectedly, years after a life of comfort and security. People are of low- wealth for a variety of reasons —i.e., lack of education or skills to secure gainful employment; insufficient job opportunities paying a living wage; inability to be hired or promoted due to discrimination because of color, gender or age. Poverty, particularly persistent poverty, is indicative of the state of the local or regional economy, such as the demise of major businesses and employers. Poverty also is the consequence of a capitalistic society. Orange County, despite its charm and amenities, is home to many households living in poverty. In recent years, the County has intensified its effort to increase economic development in both the rural and urban areas in order to: bring good paying jobs to unemployed and underemployed residents; and to diversify and expand the tax base so as to decrease the tax burden on homeowners and property owners who pass the costs to renters. To assure a ready and successful workforce, we have forged a partnership with Durham Technical Community College. Our public schools also are teaching STEM and STEAM courses to prepare our young people for a competitive edge in the global economy. The Family Success Alliance teams are working with entire households to help them rise above systemic poverty—i.e., summer reading programs for pre -K youngsters and career assistance for adults While Orange County government is unable to provide jobs to all individuals in needs, it can forge forward with a campaign to attract, sustain and retain a range of businesses and employers. The County can continue to promote the living wage movement by seeking to do business with companies that offer living wages to their employees. The issue that remains to be resolved is the prejudice and discrimination that historically has put certain populations in poverty and that continues to keep certain people in an oppressed or dependent state. Certainly, cities and counties thrive when families, neighborhoods and businesses are strong— socially, financially and politically. Orange County Health Department Focuses on Public Outreach By Chris Grunert Posted February 3, 2016 at 1:29 pm The Orange County Health Department has released its annual report highlighting some of the department's successes. Spokesperson Stacy Shelp said a lot of their work relies on strong local partnerships. "The work we are doing both as a health department and a community is just so critical and we are really seeing an impact being made. We are seeing healthier individuals and a healthier culture," said Shelp. Orange County is the first health department to post their health inspection scores directly to Yelp, a popular website that evaluates restaurants on customer reviews. "Knowing the importance of technology and peoples use of applications such as Yelp to look at where am I going to go for dinner? This would be a great place to have that information at your fingertips when you're making those choices," said Shelp. There have been some trends over the past year that worry the health department. "We are also seeing more trends that are a little more frightening, like an increase in STD cases, so really needing to do more education around prevention of sexually transmitted diseases," said Shelp. Last year the health department received recognition for its opium overdose program. Police and emergency services now have access to the drug Naloxone, which can help reverse an overdose. The Health Department has also extended their anti - smoking efforts to include public housing. "Our services and our partnerships have gone in and worked on projects around teaching property managers about how they can create their own smoke free facilities in public housing, which is very exciting," said Shelp. You can view the full report here Orange County ABC pays living wage, looks to add new position Jane Little February 3, 2016 The Orange County Board of Commissioners presented arts grants to local art programs and heard an update from the Orange County ABC Commission Tuesday. The board acknowledged and presented arts grants to various Orange County arts programs, as well as individual artists. The Arts Commission awarded a total of $28,540 in county funds to 13 arts programs, which ranged from elementary schools to individual artists, Martha Shannon, staff support for Orange County Arts Commission said. "All of our grants are awarded for arts programming in Orange County and these grants help support artist workshops and in- school residencies; they help support arts programs for children in neighborhoods and in community centers, they help support public art," Shannon said. Additionally, Orange County ABC announced during its yearly update to the board that it is now a living wage employer, but it is not yet certified by the Orange County Living Wage project. "We raised the pay for our entry level, part -time folks to $12.76, we raised the pay for our full -time folks to $14.00 and we gave everyone in the organization a pay raise," said Lisa Stuckey, Orange County ABC board chair. Stuckey said the payroll would be raised by about $118,000 per year total. Commissioner Penny Rich urged the ABC to become living wage certified. "I think it's really important when people walk through those doors that they see you are certified and that you are paying your employees fairly," Rich said. "It just makes everybody feel good about it." Tony DuBois, the general manager of the Orange County ABC Board, also said an ABC store recently opened in the Chapel Hill North shopping center. "The highlight of that store is it has one of the largest local North Carolina sections in the state," he said. DuBois said the local spirits were well received by customers. "Tony touched on our mission of the ABC board and that is to return the profits that we make back into the community of Orange County," said Ron McCoy, Orange County ABC finance director. McCoy said Orange County ABC sales in 2015 amounted to $17.9 million from the sale of 1.3 million bottles. An average of $0.72 of each bottle sold was distributed locally in Orange County in 2015 and added to a total of $737,315.The funds were distributed between alcohol law enforcement, alcohol education and rehabilitation, as well as the Orange County General Fund. Stuckey also mentioned a collaboration with UNC, the town of Chapel Hill and the Orange County Health Department to address high risk drinking. She said each organization would give $30,OOO.The funds would go toward a paid position dedicated to reducing high -risk drinking in the community. The board also heard updates regarding the Cedar Grove Community Center project, as well as Phase two of the Orange County Efland Sewer to Mebane extension project. Notable: A text amendment was passed by the board, which stated the county cannot prohibit sexually - oriented businesses, but can regulate the location. Orange County Planning Supervisor Michael Harvey recommended a prohibition of the consumption of alcohol at an adult cabaret, though the county cannot ban sale of alcohol. The board passed a motion to strike this prohibition from the text amendment. Quotable: "We had some bad weather recently, which always reminds me that people gravitate toward the most important things: bread, milk, eggs and bourbon," DuBois said. "We're just as busy as a grocery store, so you've gotta get there early." @janelittle26city @dailytarheel.com Read more: http: / /www.da i lyta rheel.com /blog /town_ta I k/ 2016/02 /orange- county -abc- pays -I ivi ng- wage - and- looks- to- add - new - paid- positionQuoted from The Daily Tar Heel Read more: http:/ /www.dailytarheel.com /blog /town_talk/ 2016 /02 /orange- county -abc- pays- living- wage- and - looks -to- add - new - paid - position Quoted from The Daily Tar Heel Chapel Hill News February 1, 2016 Orange commissioners lay out steps for tackling 6 goals in 2016 By Tammy Grubb tgrubb @newsobserver.com CHAPEL HILL The Orange County Board of Commissioners spent Friday brainstorming and narrowing their ideas for how to best serve county residents. The goals are evolving, Commissioner Renee Price said, especially around issues with which the county has been wrestling for at least 10 years. "I think what this exercise proved is that some things are more of a priority now than the others," she said. Poverty — and how it keeps residents from having a better life — has been a common thread for many years, leading to the launch of the Family Success Alliance initiative in 2014. The alliance is envisioned as a "cradle -to- career or college pipeline" of government and community resources to better serve at -risk children. The first effort, a kindergarten prep program, started last summer, and officials are planning their next steps now. "I see the Family Success Alliance as really one of our most exciting new initiatives," Commissioner Bernadette Pelissier said, because "counties provide all these services, and a lot of them are really what we call the safety net. The safety net really just helps people, but it doesn't really solve the problem and end the cycle of poverty." Economic development holds the key, commissioners said, to addressing poverty and community values while also promoting sustainable growth and generating more tax dollars. "We've got to figure out how to pay for this other stuff, which is going to be extraordinarily expensive," Commissioners Chairman Earl McKee said. The county is doing "better, we've got more funds, but those funds are still coming out of people's pockets from their houses." He asked staff to prepare a comprehensive report about businesses that may be looking at a move to Orange County. Important decisions include the kind of businesses and jobs to attract and how to continue developing the county's three economic development districts, commissioners said. Partnerships — with the towns, UNC, residents and nonprofit groups — also are important to the county's success, they said, noting the partnerships with Chapel Hill, Carrboro and Hillsborough are positive and headed in the right direction. Other goals were: • Ensuring a community network of basic human services and infrastructure that maintains, protects and promotes well- being. Affordable housing is a big part of this goal, from mobile homes to rentals and for sale housing available to residents at all income levels. • Promoting an interactive and transparent system of governance that reflects community values. The commissioners talked specifically about better communication with the public and making the county's website more functional and easier to navigate. • Investing in quality county facilities, a diverse work force, and technology to achieve a high - performing county government. One suggestion was paying all county employees a "housing living wage" — enough so they don't pay more than 30 percent of their income on rent. • Creating, preserving and protecting a natural environment that includes clean water, clean air, wildlife, important natural lands, and sustainable energy for present and future generations. • Ensuring a high quality of life and lifelong learning that champions diversity, education at all levels, libraries, parks, recreation and animal welfare. This goal raised several suggestions, including: -More, strategically located community centers -Free community college for all high- achieving students, perhaps funded from the county's quarter -cent sales tax for education and the economy - Building public support for a $125 million November bond referendum aimed at meeting affordable housing and school repair and renovation needs Tammy Grubb: 919 - 829 -8926, @TammyGrubb Read more here: http://www.newsobserver.com / news /local /community /chapel -hill- news /article57727693.html #storylink =cpy Legal questions swirl around Barn of Chapel Hill • Katie Jansen • Updated Jan 23, 2016 CHAPEL HILL — In Bingham Township, signs march along the winding country roads, proclaiming "Stop the Party Barn" and "Real Farms Don't Have DJs." They're referring to the Barn of Chapel Hill, a proposed new event venue that was denied a special use permit Nov. 9 after a public hearing before the Board of Adjustment. Residents of the area, concerned about lights, traffic, noise and safety, hired an attorney to represent them at the quasi - judicial hearing. The board ruled in their favor, finding that the applicant did not prove three conditions that were required for the permit — that the project would maintain the public health, safety or general welfare of the area; that the project would maintain or enhance surrounding property values and that the project would be in harmony with the surrounding area. But neighbors say they are worried as plans for the Barn continue on property that may be legally exempt from county regulations. The Barn of Chapel Hill, slated for a 22 -acre parcel of land between Morrow Mill Road and Millikan Road, could bring 66 to 163 cars to Bingham Township every day the center holds events, civil engineer Tim Smith said at the hearing. The building could accommodate up to 250 people, according to project plans submitted to the county, and is envisioned to host retreats and weddings on the weekends and smaller events, such as corporate and university events, during the week. The property, owned by Kara and Chris Brewer, has a USDA - issued farm number, which makes it a farm recognized by state law. Under this law, first written in 1959, farms operating under farm purposes are exempt from county zoning regulations. The legislature added agritourism as an acceptable farm purpose in 2006. The Brewers present their project as an agritourism venture — a barn that brings visitors to a flower farm. This has raised red flags among some in the community, who describe the area as heavily wooded land that hasn't been farmed in generations. Brewer said she is a new farmer who was able to obtain a farm number by drafting a farm plan. She plans to begin planting this spring. Brewer's property was granted a farm number May 6, according to her special use permit application. Tina Miller, the county executive director for the FSA office in Hillsborough, said that the criteria for a property to be eligible for a farm number became more stringent as of Sept. 1. Farm numbers were originally created so that farms could participate in USDA programs, such as farm loan programs or emergency livestock assistance, Miller said. But Miller's office serves Orange and Durham counties, and she said her staff would often see several applicants a day who said they wanted a farm number to avoid permitting fees. As of Sept. 1, applicants must provide proof of their income from the farm and records of their production or harvests, in addition to the criteria that was already required, so that fewer non -farms can successfully apply for farm numbers. UNC School of Government professor David Owens said that the laws defining what constitutes as a bona fide farm have presented gray areas in many cases across the state, from event centers to bed and breakfasts to shooting ranges. Owens said that some assume that a farm property can be used for any purpose and still be exempt from county regulations. "That is clearly not the case because the statute has always said the exemption does not apply to non -farm uses," he said. If a farm is conducting agritourism as its farm use, Owens said, the activity must be related to farm production or incidental to production. Owens said that the government body responsible for administering zoning ordinances — in Orange County's case, the planning department — is also responsible for interpreting what activities in an application constitute a farm use. If either party doesn't agree with the farm use determination, the decision can be appealed, first with the Board of Adjustment and then in Superior Court, Owens said. In a letter dated Dec. 15, Pat Mallett of the Orange County planning department wrote a statement to Brewer that said agritourism was protected under state statute as a farm purpose. The statement also quoted the statute, saying that it "does not limit [zoning] regulation... with respect to the use of farm property for nonfarm purposes." Mallett said in a later interview that because the property is classified as a farm by state law, the planning department has no further involvement in the case. According to minutes of November's hearing, Michael Harvey, a supervisor in Orange County's planning department, said planning staff suggested Brewer go through the permitting process because they determined "that (planning staff) questioned whether or not there was any farm activity on the property, that warranted it being classified as such." However, he also said that the property had a farm number and that, regardless of what the Board of Adjustment decided about the permit, "it is likely the applicant has the ability to develop an agritourism operation on a farm, which can include a wedding venue, without permits from the county as same is exempt from (planning staff's) review and permit authority." It wasn't clear whether the neighbors planned to follow suit as the development moves forward. Although nothing is planted on the land yet, "we are a working farm," Brewer said of her farm plans. "We do have our orchards and our flowers and will have honey production on the farm." She said the agritourism component of the farm is important to make the farm more profitable, but she doesn't see herself booking events for the venue until 2017, after the first cycle of her crop rotation. Brewer said she is continuing forward with her plans and has submitted an application with the county inspections department for a building permit. She hopes construction can begin in the next few months, although she said her first priority is establishing her farm and her plantings. Daniel Bruce, director of permitting and inspections for Orange County, said the plan was submitted as an events center and is being reviewed. Bruce's department will ensure the structure itself, as well as the electrical, mechanical and plumbing, is up to state building codes. An environmental health review for a septic and well system will also be conducted, and the fire marshal's office will make sure the building meets fire codes. Brewer said she wanted to go through the permitting process to try to address neighbor concerns. During November's hearing, Brewer submitted a list of self- imposed conditions for the venue. All events will be required to end at 11 p.m., with no outdoor music after 8 p.m. and no fireworks allowed on the premises. The conditions also state that the Barn of Chapel Hill will work with those who rent the venue to secure shuttle service if alcohol is served. Brewer said she still plans to adhere to these conditions and has taken further action since the hearing to address concerns. For example, she has hired a sound expert to install speakers inside the barn so that sound can be controlled. She said that either she or another manager will be on site for every event. "I think I have a really sound plan to address neighbor concerns," she said, adding that she hopes the neighbors will continue to communicate and let her know what their worries are. "I know there are concerns, and I take them very seriously."