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AGENCY REQUEST FOR FUNDING FROM Indian River COUNTY <br />FISCAL YEAR 2016/2017 <br />A. Program Cover Page <br />• <br />Agency- New Horizons of the Treasure Coast, <br />Inc. Telephone: (772) 468-5600 <br />Contact Person: John Romano Fax: (772) 468-5606 <br />Title: CEO/President E -Mail: jromanoCcD_nhtcinc.orq <br />Address: 4500 W. Midway Road <br />Ft. Pierce, FL 34981 <br />Website Address: www.nhtcinc.org <br />Program Title: Mental Health and Substance Abuse <br />I certify that information contained in this application accurately reflects the activities of this agency and <br />that the expenditures or portions thereof for which County funds are being requested are not reimbursed <br />by any others urce. <br />6 <br />John Romano, CEO/President <br />Signatur 04Print name and title <br />Brief d scr' tion of the Program for which funding is requested: <br />This application secures match funding necessary to leverage funding from the Department of Children <br />and Families through their contract with Southeast Florida Behavioral Health Network (SEFBHN). The <br />funds requested will be used to provide services to Indian River County residents ranging from <br />emergency stabilization provided 24/7 to intensive community based programs. (A Program Description <br />of all services, locations, and service times is attached.) In the attached report, "Units of Service Report <br />• with State Rate" the results for 10/1/14-9/30/15 are detailed with specific services provided and number of <br />residents accessing these services. The match grant funding provided by IRBOCC in FY14/15 leveraged <br />$2,939,173 of State funded services. <br />summary Keport <br />Amount requested from Indian River County for 2016/2017: $287,172 <br />Total Proposed Program budget for 2016/2017: $4,229,819 <br />Percent of total Program budget: 7% <br />Current Funding (2015/2016) $281,541 <br />Dollar increase / (decrease) in request: $5,631 <br />Percent increase / decrease in request: 2% <br />it request increased b"/o or more briefly explain why: <br />The request includes a 2% increase based on the following budgetary challenges: <br />The cost of a benefit package for psychiatrist has increased $30,000 annually due to the demand in <br />competing with the neighboring metropolitan areas. <br />The Organization's Board of Directors has approved this application on (date): April 27, 201E <br />Garry Wilson Chair of the Board V47 <br />Name of President/Chair of the Board Signature <br />• John Romano, President/CEO <br />Name of Exec. Director/CEO ture <br />k, <br />