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• <br />• <br />AGENCY REQUEST FOR FUNDING FROM Indian River COUNTY <br />FISCAL YEAR 2019/2020 <br />A. Program Cover Page <br />Agency: New Horizons of the Treasure Coast, Inc. Telephone: (772) 468-5600 <br />Contact Person: George Shopland Fax: (772) 468-5606 <br />Title: CEO/President E -Mail: gshoplandnhtcinc.orq,., <br />Address: 4500 W Midway Rd <br />Website Address: <br />Program Title: <br />Ft Pierce, FL 34981 <br />www.nhtcinc.org <br />Mental Health and Substance Abuse <br />Sri <br />APR 1 1 20,9 <br />1 <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 other source. <br />Signature <br />George Shopland, CEO/President <br />Print name and title <br />Brief description of the Program for which funding is requested: <br />This application is to secure match funding necessary to leverage funding from the Department of <br />Children and Families through their contract with Southeast Florida Behavioral Health Network <br />(SEFBHN). The funds requested will be used to provide services to Indian River County residents <br />ranging from emergency stabilization provided 24/7 to intensive community based programs for children <br />and adults. (A Program Description of all services, locations and service time is attached.) The attached <br />report "Units of Service Report with State Rate" shows the specific services provided and number of <br />residents accessing these services for the period 10/1/2017 to 09/30/2018. The match grant funding <br />provided by IRBOCC for FY17/18 leveraged over $4,482,000 of State funded services. <br />Summary Report <br />Amount requested from Indian River County for 2019/2020: <br />Total Proposed Program budget for 2019/2020: <br />Percent of total Program budget: <br />Current Funding (2018/2019) <br />Dollar increase / (decrease) in request: <br />Percent increase / decrease in request: <br />$319,884 <br />$27,087,206 <br />1.2% <br />$310,576.00 <br />$9,308.00 <br />3% <br />If request increased 5% or more, briefly explain why: <br />The Organization's Board of Directors has approved this application on February 27, 2019: <br />Patricia Austin -Novak <br />Name of President/Chair of the Board <br />George Shopland, CEO/President <br />Name of Exec. Director/CEO <br />3 <br />Signature <br />SignatGre <br />