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Community Child Care Resorces Inc. " Psychological Service " Children 's Services Advisory Committee PROGRAM COVER PAGE • Organization Name : Communi1y Child Care Resources Inc . Executive Director: Barbara Patten Email : cccrbp(a ,aol . com Address : P . O . Box 3451 Telephone : 567 — 3202 Vero Beach, Florida 32964 Fax : 567 - 1136 Program Director: Same as above Email : Address : Telephone : Fax : Program Title : Psychological Services Priority Need Area Addressed: MENTAL WELLNESS ISSUES : 1 . Increasing programs that promote enhanced emotional-social skills . 2 . Increasing early intervention services for "border line" children- physical/emotional . Brief Description of the Program : This program provides parent counseling; (RP-450 . 650) and in-person crisis intervention (RP450 . 330) services to CCCR families and contracting centers . Families receive individual and/or family theraR from various contracting_CCCR mental health professionals . Centers receive classroom Support in the form of site visits by therapists specializingin n early childhood. • Amount Requested from Funder for 2003 /04 : $ 8 , 500 Total Proposed Program Budget for 2003 /04 : $ 49 , 258 Percent of Total Program Budget: 17 . 3 % Current Funding (2002/03 ) : $ 79000 Dollar increase/(decrease ) in request : $ 11500 Percent increase/(decrease) in request : 21 . 4 % Unduplicated Number of Families to be served Individually 25 Unduplicated Number of Adults to be served Individually , - Unduplicated Number to be served via Group settings : 75 Total Program Cost per Client : 492 . 58 Will these funds be used to match another source ? yes If yes , name the source : United Way fo I . R . C . Amount : $ 59100 . 00 The Organization 's Board of Directors has approved this application on (date). wAA -, e� � � ]--a l �S Name of President/Chair of the Board Signature • Name of Executive Director/CEO Signature 3