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HomeMy WebLinkAbout2004-229Q Y Y V / CHILDREN'S SERVICES ADVISORY COMMITTEE C/O Human Services 1840 25"' Street Vero Beach , Florida 32960-3394 Phone 561 -567-8000 (Ext. 467 or 524) Fax: 978-1798 E-Mail : Jcadson@bcc.co. indian-river.fl . us MmastersonO,bcc.co. indian-dver.fl . us To : Beth Jordan Risk Management From : Joyce Johnston-Carls Date : November 9 , 2604 Re : Contracts — Children ' s Services Advisory Committee Grant Catholic Charities of the Diocese of Palm Beach, Incd SAMARITAN CENTER Attached is the signed contract for the 2004-05 -grant year, along with the necessary insurance certificates . Please contact me if there are any changes necessary. Otherwise, please circulate . Thank you for your help . Risk Management : rt i s ti NOV 142004 4 Indian River County Grant Contract This Grant Contract ("Contract" ) entered into effective this 1 st day of October 2004 by and between Indian River County, a political subdivision of the State of Florida , 1840 25th Street , Vero Beach FL , 32960 ("County") , and Catholic Charities of the Diocese of Palm Beach , Inc ( Recipient) , of: Catholic Charities of the Diocese of Palm Beach , Inc P . O . Box 109650 Palm Beach Gardens , Florida 33410 Samaritan Center Program Background Recitals A. The County has determined that it is in the public interest to promote healthy children in a healthy community. B . The County adopted Ordinance 99- 1 on January 19 , 1999 ("Ordinance" ) and established the Children 's Services Advisory Committee to promote healthy children in a healthy community and to provide a unified system of planning and delivery within which children 's needs can be identified , targeted , evaluated and addressed . C . The Children 's Services Advisory Committee has issued a request for proposals from individuals and entities that will assist the Children 's Services Advisory Committee in fulfilling its purpose . D . The proposals submitted to the Children 's Services Advisory Committee and the recommendation of the Children 's Services Advisory Committee have been reviewed by the County. E . The Recipient , by submitting a proposal to the Children 's Services Advisory Committee , has applied for a grant of money ("Grant") for the Grant Period (as such term is hereinafter defined ) on the terms and conditions set forth herein . F . The County has agreed to provide such Grant funds to the Recipient for the Grant Period (as such term is hereinafter defined ) on the terms and conditions set forth herein . NOW THEREFORE , in consideration of the mutual covenants and promises herein contained , and other good and valuable consideration , the receipt and adequacy of which are hereby acknowledged , the parties agree as follows : 1 . Background Recitals The background recitals are true and correct and form a material part of this Contract . 2 . Purpose of Grant The Grant shall be used only for the purposes set forth in the complete proposal submitted by the Recipient attached hereto as Exhibit "A" and incorporated herein by this reference (such purposes hereinafter referenced as "Grant Purposes" ) . 3 . Term The Recipient acknowledges and agrees that the Grant is limited to the fiscal year 2004/2005 ("Grant Period") , The Grant Period commences on October 1 , 2004 and ends on September 30 , 2005 . - 1 - 4 . Grant Funds and Payment The approved Grant for the Grant Period is Fifty Thousand Dollars ($50 , 000 ) . The County agrees to reimburse the Recipient from such Grant funds for actual documented costs incurred for Grant Purposes provided in accordance with this Contract. Reimbursement requests may be made no more frequently than monthly. Each reimbursement request shall contain the information , at a minimum , that is set forth in Exhibit " B" attached hereto and incorporated herein by this reference . All reimbursement requests are subject to audit by the County. In addition , the County may require additional documentation of expenditures , as it deems appropriate . 5 . Additional Obligations of Recipient . 5 . 1 Records . The Recipient shall maintain adequate internal controls in order to safeguard the Grant. In addition , the Recipient shall maintain adequate records fully to document the use of the Grant funds for at least three (3 ) years after the expiration of the Grant Period , The County shall have access to all books , records , and documents as required in this Section for the purpose of inspection or audit during normal business hours at the County's expense , upon five (5 ) days prior written notice . 5 . 2 Compliance with Laws . The Recipient shall comply at all times with all applicable federal , state , and local laws , rules , and regulations . 5 . 3 Quarterly Performance Reports . The Recipient shall submit Quarterly Performance Reports to the Human Services Department of the County within fifteen ( 15) business days following : December 31 , March 31 , June 30 , and September 30 , 5 .4 Audit Requirements . If Recipient receives $25 , 000 or more in the aggregate from all Indian River County government funding sources , the Recipient is required to have an audit completed by an independent certified public accountant at the end of the Recipient's fiscal year. Within 120 days of the end of the Recipient's fiscal year, the Recipient shall submit the audit to the Indian River County Office of Management and Budget . The fiscal year will be as reported on the application for funding , and the Recipient agrees to notify the County prior to any change in the fiscal period of Recipient. The Recipient acknowledges that the County may deny funding to any Recipient if an audit required by this Contract for a prior fiscal year is past due and has not been submitted by May 1 , 5 .4 . 1 The Recipient further acknowledges that, promptly upon receipt of a qualified opinion from it's independent auditor, such qualified opinion shall immediately be provided to the Indian River County Office of Management and Budget. The qualified opinion shall thereupon be reported to the Board of Commissioners and funding under this Contract will cease immediately. The foregoing termination right is in addition to any other right of the County to terminate this Contract. 5 .4 .2 The Indian River County Office of Management and Budget reserves the right at any time to send a letter to the Recipient requesting clarification if there are any questions regarding a part of the financial statements , audit comments , or notes . 5 . 5 Insurance Requirements . Recipient shall , no later than September 21 , 2004 , provide to the Indian River County Risk Management Division a certificate or certificates issued by an insurer or insurers authorized to conduct business in Florida that is rated not less than category A- : VII by A . M . Best, subject to approval - 2 - by Indian River County's risk manager, of the following types and amounts of insurance : ( i ) Commercial General Liability Insurance in an amount not less than $ 1 , 000 , 000 combined single limit for bodily injury and property damage , including coverage for premises/operations , products/completed operations , contractual liability, and independent contractors ; ( ii ) Business Auto Liability Insurance in an amount not less than $ 1 , 000 , 000 per occurrence combined single limit for bodily injury and property damage , including coverage for owned autos and other vehicles , hired autos and other vehicles , non -owned autos and other vehicles ; and (iii ) Workers' Compensation and Employer's Liability (current Florida statutory limit) 5 . 6 Insurance Administration . The insurance certificates , evidencing all required insurance coverages shall be fully acceptable to County in both form and content, and shall provide and specify that the related insurance coverage shall not be cancelled without at least thirty (30 ) calendar days prior written notice having been given to the County. In addition , the County may request such other proofs and assurances as it may reasonably require that the insurance is and at all times remains in full force and effect . Recipient agrees that it is the Recipient's sole responsibility to coordinate activities among itself, the County, and the Recipient's insurer(s ) so that the insurance certificates are acceptable to and accepted by County within the time limits set forth in this Contract. The County shall be listed as an additional insured on all insurance coverage required by this Contract, except Workers ' Compensation insurance . The Recipient shall , upon ten ( 10) days ' prior written request from the County, deliver copies to the County, or make copies available for the County's inspection at Recipient's place of business , of any and all insurance policies that are required in this Contract . If the Recipient fails to deliver or make copies of the policies available to the County; fails to obtain replacement insurance or have previous insurance policies reinstated or renewed upon termination or cancellation of existing required coverages ; or fails in any other regard to obtain coverages sufficient to meet the terms and conditions of this Contract , then the County may, at its sole option , terminate this Contract . 5 . 7 Indemnification . The Recipient shall indemnify and save harmless the County, its agents , officials , and employees from and against any and all claims , liabilities , losses , damage , or causes of action which may arise from any misconduct, negligent act, or omissions of the Recipient , its agents , officers , or employees in connection with the performance of this Contract. 5 . 8 Public Records , The Recipient agrees to comply with the provisions of Chapter 119 , Florida Statutes ( Public Records Law) in connection with this Contract. 6 . Termination . This Contract may be terminated by either party, without cause , upon thirty (30 ) days prior written notice to the other party. In addition , the County may terminate this Contract for convenience upon ten ( 10 ) days prior written notice to the Recipient if the County determines that such termination is in the public interest . 7 . Availability of Funds . The obligations of the County under this Contract are subject to the availability of funds lawfully appropriated for its purpose by the Board of County Commissioners of Indian River County. - 3 - 8 . Standard Terms . This Contract is subject to the standard terms attached hereto as Exhibit C and incorporated herein in its entirety by this reference . IN WITNESS WHEREOF , County and Recipient have entered into this Contract on the date first above written . INDIAN RIVER COUNTY BOARD OF COUNTY COMMISSIONERS By: z c L Carol i ne D G1,n ` ` ' ° &. i rman , 6 BCC Approved , Attest: J . K i3arfor� , Clerk By. . r Approved : N CGVdJ��1C� Jos ph A . Baird County Administrator e s egal sufficienc is All , tant Co ttorn RECI T : By: Catholic Charities of the Diocese of Palm Beach , Inc - 4 - EXHIBIT A [Copy of complete proposal/application] - 1 - Catholic Charities of The Diocese of Palm Beach Samaritan Center PROGRAM COVER PAGE Organization Name : Error ! Not a valid link. Executive, Director: Thomas A . Bila, PhD E-mail :tbilaAdiocesepb . org Address : 9995 N. Military Trail P O Box f 09650 Telephone : 561 -775 - 9561 Palm Beach Gardens , Fl . 33410-9650 Fax : 561 -625-5906 Program Director: Joyce Wild E-mail : samaritancenterl@yahoo . com Address : 3650 41St Street Telephone : 772-770-3039 Vero Beach, Fl . 32960 _ Fax : 772-567- 0812 : Program Title:= Tlie` Samaritan Center The Priority needs that we address are : 1 ) Mental Wellness Issues and 2) Parental Support and Education. Brief Description of the Program : Homeless Shelter — BH- 180 . 850 Program that provides a temporary place to stay for people who have no permanent housing. Child Abuse Prevention — FN- 150 . 190 . 15 — Programs, often offered in the schools or in other community settings, which attempt to protect children from physical, sexual and / or emotional abuse or exploitation through a variety of educational interventions which may focus on children of various ages, parents, people who work with children and / or parents regarding ways of avoiding or handling an abusive situation and/or information about the indicators and incidence of abuse, requirements for reporting abuse and community resources that are available to children who have been abused and to their families . SUMMARY REPORT — (Enter Information In . The Black Cells Only) ` A " dqu"esfed`�.from ''Funder for2004/OS ". $ ` 66 , 836 . 41 Total Proposed Program Budget for 2004 / 05 : $ 6092354 . 23 Percent of Total Program Budget : 11 . 0 % Current Program Funding ( 2003 / 04 ) : $ 50 , 000 Dollar increase / ( decrease ) in request : $ 162836 Percent increase / ( decrease ) in request * * : 33 . 7 % Unduplicated Number of Children to be served Individually : 42 Unduplicated Number of Adults to be served Individually : 23 Unduplicated Number to be served via Group settings : _ Total Program Cost per Client : 9374 . 68 * *If request increased 5 % or more, briefly explain why : The cost of health insurance, a consultant and related payroll costs are the predominant factors for the above increase request If these funds are being used to match another source, name the source and the $ amount : The Organization 's Board of Directors has approved this applicat non (date) . ev e4 or L4 Z Name of Pr sident/Chair of the B rd Signa 17 21°li1G( �S t' G � arae of Executive Director/CEO ignature 3 Catholic Charities of The Diocese of Palm Reach Samaritan Center PROPOSAL NARRATIVE Please respond to each question in the allotted space for each section . In responding to each section of the proposal narrative, please retain the section- label and/or question that you are addressing. Type using 12 pt. font on 8 %" X 11 " paper and number each page. These directions and the graphic boxes may be deleted if space is needed . A. ORGANIZATION CAPABILITY (Entire Section A not to exceed one page) 1 . Provide the mission statement and vision of your organization . Mission Statement: Catholic Charities of the Diocese of Palm Beach, inspired by God ' s love for all , serves people of all faiths in need, advocates for justice in social structures, and collaborates with others to build just, compassionate communities . Vision , Catholic Charities provides a wide range of professional social services to those in need within the five counties comprising the Diocese of Palm Beach (Palm Beach, Martin, St. Lucie, Okeechobee and Indian. River) . We are accredited by the Council on Accreditation for Families and Children, which assures that we meet the highest standard of practice and management. Our priority is to serve the "poorest of the poor", and we attempt to develop our programs to meet the most current and pressing needs of the communities we serve. 2 . Provide a brief summary of your organization including areas of expertise, accomplishments , and population served. Catholic Charities is a multi - service agency serving the total community. We provide Adoption/Foster Care, pregnancy services, abstinence education, counseling, four out-of school programs, services to the elderly including case management and guardianship, refugee resettlement, legal immigration services , three group homes for the developmentally challenged , three HUD 202 senior housing facilities, with another scheduled to open this year, a transitional residence for homeless families, emergency assistance (FEMA) , and empowerment program for the Glades area and in - home counseling/early intervention program in Riviera Beach . The services of Catholic Charities are available to any resident of our service area who qualifies for the particular program , Catholic Charities does not discriminate based on a client ' s religion , nor on any other classification protected under applicable federal , state or local discrimination law . 4 Catholic Charities of 'I 'he Diocese of Palm Beach Samarilan Center Be PROGRAM NEED STATEMENT (Entire .Section B not to exceed one page) 1 . a) What is the unacceptable condition requiring change? b) Who has the need ? c) Where do they live ? d ) Provide local, state, or national trend data , with reference source, that corroborates that this is an area of need . a) The unacceptable condition requiring change is that of homelessness, a lack of higher education, vocational skills training and parenting skills . In addition, there are typically problems of substance abuse, physical and emotional abuse, financial problems, legal issues, transportation difficulties, mental health issues , and a general lack of adaptive life problem solving skills b) The need its realized by families that are homeless or living in unacceptable living conditions . Families must consist of at least one adult age 18 + with at least one child age 0- 17 or a pregnant female 18 years or older. c) They must be residents of Indian River County. Most are in the process of being evicted . Some have already been evicted and are living in cars, tents or on someone ' s porch for a limited time : In some cases the court mandates that a parent come into our program in order to be reunified with their child/children. d) Data : The Department of Children and Families annual report on Homeless Conditions in Florida dated June 20, 2002 states that : The profile of Florida' s homeless has shifted . Although single adult males make up 41 % of the total homeless population, families and children continue to be a growing segment of the homeless in Florida. Families now make up 37. 7% of all homeless persons . Children under 18 years of age now comprise over 27%. The causes of homelessness remain rooted in poverty and the lack of affordable housing. Complicating the situation for many individuals and families are related problems of mental health , substance abuse and the breakup of family units . While the causes of homelessness are varied and unique to each person and family, so too must be the strategies employed to help each person and family overcome their problems to attain a level of self-sufficiency needed to re-enter the housing market. Through an article in the "Facts of Life in Indian River County", the Treasure Coast Homeless Services Council reports that on any given day, the county has 457 people without permanent homes . Some live outdoors , others live in shelters, cars or are in the county jail . 2 . a) Identify similar programs that are currently serving the needs of your targeted population ; b) Explain how these existing programs are under-serving the targeted population of your program . a ) The only local program similar to ours is the Homeless Family Center. They served 17 families consisting of 40 children during the last year. In addition , they turned 23 families away. The HAC also received a grant for rental assistance for homeless families and assisted 28 Indian River County families consisting of 73 children . b) Underserving the targeted population is shown by the number of people turned away by HAC & Samaritan Center. Our records indicated that 157 families applied for residency at S . C . during the last calendar year. This consists of 180 adults . 245 children and 16 unborn children . Of these , 17 families were not I. R. C . residents and therefore not eligible for our program , 5 Catholic Charities or l 'he Diocese ol' Palm Beach Samaritan Coiter Co PROGRAM DESCRIPTION (Entire &ection C, I — 6, not to exceed two p(Wes) 1 . List Priority Needs area addressed. The priority needs that we address are : 1 ) Mental Wellness Issues and 2) Parental Support and Education . 2 . Briefly describe program activities including location of services. The program activities and services are provided through a Four Tiered Level Program that has been designed to assist residents in moving progressively forward in their life skills development . Very specific objective skills criteria are associated with each level . The goal is for the resident to complete each level before moving to the next . Adequate completion of all four levels maximizes the chances for successful independent community living after leaving our program . It is expected that most will enter the top Level IV approximately 8 months into the program . Included in each training level are such skill areas as : responsible parenting, conflict resolution , money management, organizational training, domestic skills, role modeling, shortand long goal planning . 3 . Briefly describe how your program addresses the stated need/problem. Describe how your program follows a recognized " best practice" (see definition on page 12 of the Instructions) and provide evidence that indicates proposed strategies are effective with target population . Those families that come into our program and actively participate in our four-tiered level system reduce the barriers that were described under Program Need and has become our best practice. Although many families are ready to leave the program while in Level 3 and are able to maintain independence, the families that remain in the program and graduate after completing Level 4 are the most successful when they resume independent living in the community . Level I is the period of adjustment requiring completion of admission packet/assignments, the completion of a short,term case plan with objectives, a family history and medical information, and a completion of physicals and T. B . tests . These are usually completed within the first 30 days . For those families with existing medical issues, we work with them to get immediate medical attention . Many families entering our program have neglected their health including eyes and teeth . We work with them on these issues prior to sending them out for employment search . With some families, there is habitual neglect in giving prescribed meds to children with colds, ear infections, etc . Staff oversees and monitors that all parents are requesting meds at appropriate times and actually administering them to their children . Level II requirements are regular attendance at weekly parenting classes, regular attendance at weekly counseling sessions, attendance at weekly resident meetings that include conflict resolution , and attendance at special educational opportunities, both in -house and in the community . In addition , they must actively perform P . I . P . hours (Personal Inventory Program ) , developing and progressing with long-term plans and objectives , complete a Domestic Violence evaluation, and open a savings account if receiving income & engaged in employment or enrolled in an educational program . Level III is the Development Level with the purpose of implementation of what has been taught in Level II . The requirements include the continuation of attendance at parenting classes and the weekly counseling sessions that we have recently added as a mandatory educational opportunity. In addition, there are increased P . I . P . responsibilities and privileges . The Self- Esteem Evaluation and Stress Management Evaluation are completed . Level IV is the Maintenance Level that prepares resident families toward graduation from the Center. While at this level , they are given the opportunity to maintain their own financial record keeping and banking . They have increased leadership responsibilities, positive role modeling among peers, and special project assistance to staff. They develop , with the guidance of the case manager, a plan with goals and objectives for living outside of the Center. In addition, they continue to attend all of the weekly classes, counseling and educational opportunities as mandated by the Center. In addition , 24/7 staff provides direct parenting assistance, supervision, and intervention . Age appropriate children participate in weekly programs covering "Health and Safety", "Self- Esteem ", and "Character Values". We have expanded our educational video library for toddlers through high 6 Catholic Charities ofThe Diocese ol' Palm Beach Samaritan Center school covering additional topics . This has proven to make a significant impact on grades and on the child ' s self esteem . 4 . List staffing needed for your program , including required experience and estimated hours per week in program for each staff member and/or volunteers (this section should conform with the information in the Position Listing on the Budget Narrative Worksheet). Samaritan Center Maintains a 24 hour, 7 days per week staffing pattern . While it is desired that all staff have residential experience, this is not always possible . All staff receive a comprehensive formal training at the site level and at the Diocesan level and receive ongoing staff development opportunities . Senior support staff provide 5 shifts of training to all new support employees before they begin working solo. Professional Positions Support Positions One p/t Division Director 4 . 5 hr/wk One f/t Adm . Asst./Vol . Coord . 40 hr/wk One f/t Administrator 37. 5 hr/wk One Ft Clerical Asst. 40 hr/wk One f/t Case Manager 37 . 5 hr/wk One p/t Childrens Coord. 31 hr/wk On f/t Resident Manager 37. 5 hr/wk Support Positions . Support Positions Three f/t Support Staff 40 hr/wk One p/t Support 16 hr/wk One p/t Support Staff 32 hr/wk One p/t Support 4hr/wk One /t Kitchen 25 hr/wk Substitutes As needed a rox . & 16 hrs. wk 5. How will the target population be made aware of the program ? The target group is made aware of the program through a wide variety of opportunities as follows: • Presentations to community civic and church groups • Participation/networking with other social service organizations • Presentations and bulletin announcements to Churches • Law Enforcement agencies • Current and former residents word of mouth • Annual mailings to Churches and service providers regarding services provided Media opportunities including newspaper articles, quarterly Samaritan Center Newsletter, distribution of brochures, fundraising activities , radio & TV talk shows . 6 . How will the program be accessible to target population (i. e. , location , transportation , hours of operation ) ? Samaritan Center holds an orientation/screening for those families seeking shelter. This must be completed prior to a family moving into the facility and these are done by appointment. These families are usually able to transport themselves or secure transportation through a family member, friend etc . On the rare occasion that they are unable to reach Cls on their own , we will provide transportation via the Center Van . Once a family has moved into the Center, if they do not have their own vehicle, we encourage them to be resourceful in attempts to find transportation through the community bus, or family/friends . If they are unsuccessful , we do provide transportation to their case related appointments (ex . Medical , employment, school , court, off premises educational workshops and Samaritan Center planned Social Activities) . We do not provide transport for personal outings . We are very fortunate to periodically have vehicles donated to our program . We in turn, donate the vehicle to a resident that is without transportation . This is an assurance that when they graduate from our program they will continue to have transportation to their employment, necessary appointments, .groceries, etc . 7 Catholic Charities of The Diocese of Palm Beach Samaritan Center D. MEASURABLE OUTCOMES (Entire Section D not to exceed two pages) OUTCOMES ACTIVITIES Add all (?I'/he cAlentent.c fir the kfeasurable Outcome(s) Add the !asks to acconr fish the Oulcome(s) 1 ) Resident children who are age 4 and over Age appropriate children will participate in the will increase their self-esteem by showing an weekly self-esteem module. In addition, 24 average of 5 - 10 % increase on the self-esteem hour guidance and encouragement is provided pre/post tests that are given at the end of each 8 to parents to utilize the skills that they are week session . As measured by total number of taught in the weekly parenting classes . By age related children entering the program constant reinforcement of "positive parenting during the 2004 -2005 fiscal year. Baseline : the children exhibit increased self-esteem and 2004-2005 resident children who are 4 years improved behaviors, old through 17 years. 2) Adult residents will increase their All adult residents are mandated to participate knowledge and skills in parenting by a in an 8 week parenting class conducted by minimum of 5 to 10% as evidenced through a Center Case Manager. In addition, Center parenting pre & post test given at the licensed mental health counselor holds beginning and end of the 8 week parenting parenting support groups and as the census classes. As measured by total number of changes we hold Domestic Violence parents entering the program during the 2004- workshops conducted by the Mental Health 2005 fiscal year. Baseline : Test results on total Association , number of parents entering the program during the 2004/2005 fiscal year. 3 ) Resident children who are age 4 and over Age appropriate children will participate in the will demonstrate a 5 to 10% improvement in Character Values Program . Children ' s behavior learned through the 8 week Character coordinator meets weekly with parent & child Values Program . Behaviors are charted each to share any behavioral problems and together session indicating progression. As measured by put a plan together to help child improve . total number of age related children entering the program during the 2004/2005 fiscal year. 4) 75 % of families who have completed the Former residents participate in aftercare program by achieving the minimum of Level services that include home visits, visits at the III will remain in stable housing 12 months Center, telephone contacts , invitations to after discharge date as measured by total special events or activities . These services are number of families achieving Level III or more provided through the Case Management staff a while in the Center and having moved out minimum of 2 times per month for at least 12 during fiscal year 2003 -2004 . Baseline : Total months after moving out . number of families who achieve Level III or higher and moved out of the Center during the 2003 -2004 fiscal year. 8 Catholic Charities of flee I )iocese of Palm Beach Samaritan Center E . COLLABORATION (Entire Section E not to exceed one page) 1 . List your program ' s collaborative partners and the resources thata they arc providing to the program beyond referrals and support. (See individual funder requirements for inclusion of collaborative agreement letters. Collaborative Agencp Resources provided to the program The Mental Health Association They provide an instructor who comes to our Center to present an 8 week course on Domestic Violence . I . R . C . Human Services They provide temporary housing up to 3 nights at the Citrus Motel upon referral from S . C . This process is used mostly when a family is "out on the street" and being accepted into S . C . contingent on results of background screening. Indian River Thrift Store They accept donations of furniture, household items, clothing & miscellaneous items in the name of S . C . When items are sold, a credit is placed on our account to be used by our program/clients . as needed for reasons such as clothing for employment or employment search ; furniture & household items when moving into their own housing, Indian River Health Dept. Hold meetings/workshops at S . C . as our census changes on the topics of "Pregnancy Prevention", "Aids Prevention", and general information about the prevention and treatment of sexually transmitted disease. Homeless Assistance Center Through a HUD grant, a MIS system called " Service Point" is in place to network with agencies participating in the Homeless Continuum of Care . H . A . C . & S . C . are two of the priority programs. The focus of MIS covers I&R, service coordination, case planning & assessment data. The two agencies also work closely sharing donated items such as clothing and food , along with providing referrals to each other. Habitat for Humanity A representative from Habitat comes to S . C . to present the requirements for acquiring a Habitat home . They also work with interested families on financial guidance . Boys and Girls Club They have accepted teens from S . C . as volunteers in their program when their program had no opening. They did this because they recognize the need for our teens to be involved in worthwhile activities . Gifford Community Center They provide an instructor who conducts a 12 week course on Parenting at the Samaritan Center. The Mental Health Association and The Child Witness Program , a 12 week session held at Exchange Club of I . R. C . S . C . & conducted by a M . H .A . Counselor, is designed for children having witnessed domestic violence. 9 Catholic Charities of The Diocese of Palm Beach Samaritan Center F. PROGRAM EVALUATION (Entire Section F not to exceed two pages) 1 . DEMOGRAPHICS : What information (data elements) will you need to collect in order to accurately describe your target population including demographics (age, gender, and ethnic background) required by the funder in Section H ? What are the pieces of information that qualify them for your target population ? How do you document their need for services or their " unacceptable condition requiring change" from Section Bl ? The Data elements collected for our target population are on our "Program Beneficiary Statistic form . The information collected is 1 ) Unduplicated count of program beneficiaries ; 2) Age group ; 3 ) Sex ; 4 ) Ethnic background 5 ) Program beneficiary characteristics (ex . Single parent, w/o GED or diploma, Veteran, Victim of rape/incest/domestic violence ; physically disabled) 6) Income level ; 7) Geographic residence in IRC ; 8 ) Unit of service including census days, special programs, transportation, legal & miscellaneous ; 9) Religion In addition , a monthly census form is kept by day on families that are in residence . This information is carried over to the above form at the end of each month . This information is collected and entered into the data form once they enter the program . The pieces of information that qualify them for our target population and their need is documented before entering the program . A telephone intake is the first step in assessing their need . If it appears that they qualify for our program , an appointment is scheduled to fully explain the program to them and to have them complete the following forms : 1 ) Samaritan Center Personal Inventory that is designed to obtain information about a wide range of possible problem areas ; 2) Subjective questionnaire (personal information including behaviors , mental health issues , dru (if/alcohol issues , etc. ) 3 ) A Statement regarding reason( s) or homelessness ; 4 ) Written assignment ( why they think they are a good candidate for program ; goals that they would like to accomplish and personal description of self Once this information has been completed, a determination can be made if this family tits into our target population , and depth of their need. 2 . MEASURES : What data elements will you need to collect to show that you have achieved (or made progress toward) your Measurable Outcomes in Section D ? What tools or items are you using as measures (grades, survey scores, attendance, absences , skill levels) for your program ? Are you getting baseline information from a source on your Collaboration List in Section E? Are there results from your Activities in Section D that need to be documented ? How often do you need to collect or follow- up on this data ? " Master Stats" which include : the information in the above form in addition to dates each family achieved a new Level , their Level at the time of exit, discharge information , forwarding address, phone and contact, 6 month contact information , 12 months contact information , rent/own home and whether employed . . . The tools/items used are pre-post tests, school grades , school attendance, counseling & parenting class attendance and the Level system . We have been asking our collaborative partners to administer pre and post tests but to date have been unsuccessful . We have been told that- we will receive them on future classes. 10 Catholic Charities of fhe Diocese of Palm Beach Samaritan Center All activities are documented . Information is turned into our Resident Manager who inputs the statistical information . This information is kept current and entered as clients enter a new Level and as test results are completed . 3 . REPORTING : What will you do with this information to show that change has occurred ? How will you use or present these results to the consumer, the funder, the program , and the community? How will you use this information to improve your program ? The data is collected as described in the above sections . The information becomes a permanent part of our records and is shared with those funding sources that seek that information. The "Program Beneficiary Statistical " form is the standard form that is required by Catholic Charities . This report is sent to them on a monthly basis . The outcomes are sent to Catholic . Charities for review and to evaluate how our program us doing. Some of the outcomes are shared in the community when making presentations and occasionally have been used in our newsletter that is mailed to approximately 4500 area residents and businesses . We always strive to improve our program and the outcomes are used when our treatment team meets for regular evaluation of clients and the program as a whole . 11 Catholic Charities oll 'he Diocese ol� Palm Beach Samaritan Center G . TIMETABLE (Section G not to exceed one paste) 1 . List the major action steps , activities , or cycles of events that will occur within the program year. New programs should include any start-up planning that may occur outside the funding year. In completing the timetable, review information detailed in riot sections. Month/Period Activities Ongoing year round Tuesday evening activity night — family sports, arts & crafts , music , movies, etc . — To teach families how to spend quality time w/o spending money. Quarterly Ages 4- 17 one session per week for 8 weeks of Self- Esteem Classes , Quarterly Ages 4- 17 one session per week for 8 weeks of Character Values , Quarterly Between above sessions — classes on Health & Safety are conducted by children ' s coordinator. As new age A 12 week — Child Witness Program — conducted by the Mental Health appropriate children Association , enter program Monthly Family outings that are staff supervised are held to teach and ensure quality time between parents & child (ren) . Events are held at Brevard Zoo, area recreational parks , Royal Palm Fountain , etc . Adults Quarterly 3X 8 week Parenting Classes conducted by Center Case Manager (Monday Evenings) . May , June , July 12 week Parenting Class conducted by Gifford Community Center. In between Parenting 8 week classes on Domestic Violence conducted by Mental Health Classes Association . As time allows Various classes on Budget & Financial planning, Anger Management & other educational opportunities . 12 Catholic Charities of' the Diocese of Palm Beach Samaritan Center H . PROJECTIONS FOR UNDUPLICATED CLIENTS Number of Unduplicated Clients by Location East Fiscal Year Current Fiscal Year Next Fiscal Year Location Actual 2002/2003 Budget 2003/04 Projections 2004/05 Unduplicated Clients Unduplicated Clients Unduplicated Clients N. Indian River County 10 6 8 S . Indian River County 53 54 57 Indian River Co. Total 63 60 65 Greater Stuart Hobe Sound Indiantovm _ Jensen Beach _ Palm City Martin County Total Fort Pierce Port Saint Lucie St. Lucie Co. Total Other Locations TOTAL SERVED 63 60 65 Number of Unduplicated Clients by Age Last. Fiscal Year Current Fiscal Year Next Fiscal Year Location Actual 2002/2003 Budget 2003/04 Projections 2004/05 Individuals Group Individuals Group Individuals Group '' 0 to 4 - (Pre-school ) 30 20 _ 21 5 to 10 - (Elementary) 5 14 11 to 14 - (Middle) 1 - 5 - 6 - 15 to 18 - (High School ) - Total C 'hildi•en 37 _ 37 _ 42 _ 19 to 59 - ( Adults ) 26 _ 23 _ 23 _ 60 + ( Seniors) 1 nlal Adults 26 - 23 - 23 - TOTAL SERVED New 63 - 60 _ 65 _ 13 Organization: Catholic Charities of Diocese of Palm Beach Inc. Program: Samaritan Center UNIFORM GRANT APPLICATION BUDGET NARRATIVE WORKSHEET IMPORTANT: The Budget Narrative should provide details to justify the amount requested in each line item of the budget for your program . From this worksheet, your figures will be linked to the Total Agency Budget, Total Program Budget and Funder Specific Budget Forms. AGENCY/PROGRAM NAME : Catholic . Charities of Diocese of Palm Beach Incl Samaritan Center FUNDER : Children 's Services Advisory Committee I CAUTION : Do not enter any figures where a cell is colored in dark blue - Formulas and/or links are in place. Gray.areas should j @be used for calculations and to write information only, ncEnNcr usAEs oFNOLRr Proposed Tot REVENUES (SNOW ETAIL & al P rogam - Funder Specific Total Agency CALCULATIONS) Budget Budget Budget 1 Children's Services Council-St. Lucie 196, 173.00 2 Children's Services Council-Martin 3 Advisory Committee-Indian River yrly amt 669836.41 66,836 .41 52,500.00 4 United Way-St. Lucie County52,500.00 5 United Way-Martin County 20,000.00 6 United Way-Indian River Coun�ty yrly amt 96,773,26 96,773.00 7 Department of Children & Families 8 County Funds 63,000.00 Gen. Contributions of 15, 777.62 a mo. X 12 mos. 9 Contributions-Cash 189,331 .49 189 ,331 .49 377,739. 00 Residents Fees 83 .33amox12 10 Program Fees mos =1000 1 ,000. 00 491 ,256 .00 11 Fund Raising Events-Net 100,000. 00 267,500. 00 12 Sales to Public - Net 750. 00 20,000.00 13 Membership Dues 14 Investment Income 15,000. 00 148,440 .00 15 Miscellaneous 45 , 182. 00 242,044. 00 16 Legacies & Bequests 125,000. 00 Diocese Funds 80,000. + 4000 17 Funds from Other Sources FEMD 84 ,000. 00 3, 814 , 900 .00 18 Reserve Funds Used for Operating 10,481 . 07 607 ,300. 00 19 In -Kind Donations (Not included in total) 20 TOTAL REVENUES (doesn't includelineI $609,354.23 $66, 836 . 41 $6 ,575 , 125 . 00 B C D EXPENDITURES GRAY AREAS FOR Proposed Total Program Funder Specific AGENCY USE ONLY Total Agency (SNOW caLCULAnONS) - Budget Budget Budget 21 Salaries - ( must complete chart on next page ) 288 ,070. 88 46 , 956 . 82 3 , 233 , 746 . 00 0 Salary 22 FICA - Total salaries x 0. 0765 7,65% 22 ,037.42 3 . 592 20 247, 382.00 e Yemen - Annual pension Or qua I le 23 staff . 07 x 52,494. 70 . 07 x288070.00 209164.96 3 , 286 . 97 226, 362 . 00 Life ea - e Ica enta ort-term $6 ;024 x19 :12 24 Disab . 2 . 13 FTE'S 6,024 per year. Employees 669986. 88 12 , 108 . 24 485,649.00 or ers compensation - emp oyees x 009 25 rate(. 015 x 52,494. 70 288,070.88 2 ,592.64 422 . 61 29, 104.00 5n5rzoo4 B-t • • 111 • 1 • / 1 I POSITION FunderPosition Title / Total HrsAvk Salary Program • Budget 11 (Agency) L • r Executive • . I l 111 11 l 111 / l Prograrn Admin ,/ • : • 11 43t897. 11 • • • • 1 11 24,702.0 Clerical Assistantl M . Cochran • 11 • 11 • • • • - • 11 11 t ! Support Staff/ T. Gibson • • • 11 � SupportSupport Staff/ A. Moore Rabuckup or Staff/ 1 . Woodside • 11 11 - 1 Support • : 11 t 1 / ' Support - • • 111 111 ■ 1 ' Support Staff/ M. Johnson 7,276. 001 . . • " 'Al • : : 11 11 • • : 1 • 11 1=11m, Fix WIM • . • 11 / 1 [low lwluqil�f t f t Total e•, zx �{" s �.iC� .^f'"b 'xn tt?` 1 /3w. i"-� >r o�j�£ +. Rk FRINGE BENEFITS DETAIL i� r (Funder Specific Budget Funder Pensir • • • • • Specific • • • r • . BudgetCompens. Specific Position Title I Total Hrslwk Example: Case Manager140hrs111 11 ® I1 II Ir 1 / 11 11 II II Prograrn Admin ./ J . Wild Adinin • ssist /Vol . Cord/ Clerical Assistant/ M . Cochran Support Staff/ N . • _Support ---- : Resident Manager/ K . Reece ( 331.14b .) Support Staff ll/ M - Rabuck � Supp Supporl Staff/ A. Moore ---- • Woodside! On Call Staff Support L. M Staff/ ---- 1 1 ! 1 Manager/Children 's Program Coord ' T . Craig � Support Stiff/ M . Johnson iCase P. • :Divison Director/ 4 . 5 his per-wk 120% �� 1 • • : : • 1 • • 1 .�� - -- - 1 1 t1 / 1 ry 1 P `' Organization: Catholic Charities of Diocese of Palm Beach Inc. Program: Samaritan Center B D EXPENDITURES GRAYAREAS FOR Proposed Total Program Funders Specific AGENCY USE ONLY TO p Total Agency SNOW DETAIL Budget Budget Budget 27 Travel-Daily to rave 3,069.00 miles per mo. X 90 , 382 .00 # of Staff x average # of miles/wk x 50 wks x 12mos x $ = Estimated Daily Travel/Mileage Reimb. .345= 1449 + 28 Travel/Conferences/Training Training/Semina 1 ,200.00 30, 905. 00 • National Conference (cost per staff) rs 300 • Training/Seminar (cost per staff) ydy/Conference s for 6 staff • Other Trainings (cost of travel , lodging , members- 150 x registration , food) 6=900 29 Office Supplies 4,500.00 61 ,601 . 00 • Office supplies (monthly average x 12 months = estimated cost of office supplies 375 per mo x 12 based on present history. mos=4,500 30 Telephone phone sery Is 7,500.00 109,733.00 # Phone lines x average cost per month x 547 per, mo x 12 12 months = local phone cost mos=6564 long distant is Average long distance calls x 12 months = 52 per mo x 12 Estimated cost of long distance mos=624 31 Postage/Shipping en. al ng o 4,000.00 Netus .Lefters/ 19,898. 00 • Quarterly Mailing of Newsletter Brochures 2000 • Special events, etc. per yr + Special • Bulk mailings - appeals Mailing is 32 Utilities 1 ,45ts per mo x 179500.00 72,507.00 • Electricity ($ x 12 months) in mos =17500 • Water/Sewer ($ x 12 months) garbage garbage& utility • Garbage ($ x 12 months) exp. 33 Occupancy ( Building & Grounds) 4890. 16 per 58,682.00 503,432.00 • Mortgage/Rent ($ x 12 months) Imo. Includes • Janitorial ($ x 12 months ) grounds main. , • Grounds Maint. ($ x 12 months) exterminator service.& • Real Estate Taxes building maint 34 Printing & Publications 3,750.00 22 ,801 . 00 Quarterly Newsletter ($ x 4 ) Stationary& Letterheads, Envelopes , etc. Publication, Ads Fundraising materials at 312. 50 permo. X 12 mos. Other =3750 35 Subscription/Dues/Memberships 100.00 12 ,310.00 • Membership to National Organization • Dues Membership to local • Subscriptions to Newspapers/magazines , organization etc. cost 100 per yr. 36 Insurance 41500.00 241837. 00 • Directors/Officers Liab. • Commercial/General Insurance Van insur.@ • Bond Ins. 2000 a yr. prop & liab is • Auto Insurance 2500. 37 Equipment: Rental & Maintenance 41500.00 381342 .00 • Copier lease ( $ x 12 months) • Meter lease ($ x 12 months) Copier, • Copier Maintenance ($ x 12 months) Telephone , Computer • Computer Maintenance ( $ x 12 months) maint. 375 a • Other mo. X 12 mos. 38 Advertising 1 , 500. 00 • Newspaper ads Promotional 17,644 .00 costs and Ads • Fundraising ads/promotions 125 a mo x 12 • Other (vacancies) mos. 39 Equipment Purchases : Capital Expense 29000.00 65.000.00 • Computer/monitor (# x $) • Laser Printer Sofas - 5rz512004 e-� Organization: Catholic Charities of Diocese of Palm Beach Inc. Program: Samaritan Center 40 Professional Fees (Legal, Consulting ) hrs 12.800. 00 82 ,052 .00 • Legal advice ( estimated #hrs x $) =12 ,00 1000 al • Consultant fees =services Legal services 800 ' • Other per yr. 41 Books/Educational Materials supplies for 4, 500 .00 52 , 925. 00 • Books/videos program • Materials ($ x staff) including 42 Food & Nutrition day x 365 days 10, 000. 00 73, 802 .00 • Meals ( # meals x clients x 5days x 50 wks) for approx 20 • Snacks people at a cost 43 Administrative Costs of 559,017.01 x 57,019.74 523 , 184 .00 Admin . Cost (% of total budget) 10 .2% 44 Audit Expense Agency cost 19500. 00 459000.00 Independent Audit Review 45,000 a yr. 45 Specific Assistance to Individuals Cars repairs or 7,500 .00 485 ,252 . 00 Medical assistance donated cars a Meals/Food ydy cost of 1 ,500 a yr. Rent Rent Assistance assistance 7 Other emergencies 46 OthedMiscellaneous Charges are 500.00 5, 000.00 • Background check/drug test 250 'a yr.+ • Other background 47 Other/Contract 0.00 Sub-contract for program services 48 TOTAL EXPENSES $609,354 .23 $66, 836.41 $6, 575. 125 .00 5/25/2004 B-1 O190n®IlonCWwk Ct � of D«rceae d Peen Bead, pc. Prtpran Swna°an C~ UNIFORM GRANT APPLICATION TOTAL AGENCY BUDGET AGENCY/PROGRAM NAME: FY 02103 FY 03/04 FY 04105 % INCREASE FYE FYE FYE CURRENT VS. NEXT FY BUDGET A B C D ACTUAL TOTAL PROPOSED (col. e.eol. 8ycol. 9 REVENUES BUDGETED BUDGETED 1 Children's Services Council-St Lucie 72 454.00 100P000.00 196 , 173 .00 96. 17% 2 Children's Services Council-Martin ow 0. 00 #DIV101 3 Advisory Committee-Indian River 52j500.00 52 500.00 52500. 00 0.00% 4 United Way-St. Lucie County 61000.01 2000000 52, 500. 00 162.50°!° 5 United Way-Martin County 10 000.00 12 000.00 20,000 .00 66.67% 6 United Way-Indian River County 60 000.00 63 000.00 96 773.00 53.6117a 7 Department of Children & Families 0.00 0.00 0. 00 #DIV/0 ! 8 County Funds 0.00 0.00 63 .000. 00 41]IV/O! 9 Contributions-Cash 501 493,00 377 739.00 377,739 .00 0. 00°/a 10 Program Fees 519 776.00 491 256.00 491 256 . 00 0.000/ 11 Fund Raising Events-Net 353 742.00 267 500.00 267t500. 00 0.00% 12 Sales to Public-Net 0.00 20 000.00 20.000.00 0.00% 13 Membership Dues 0.00 0.00 0.00 #DIVl0 ! 14 Investment Income 234 161 .00 150 000.00 148,440.00 -1 .04% 15 Miscellaneous 242 044.00 242 044.00 242.044.00 0. 00% 16 Legacies & Bequests 0.00 125 000.00 125.000.00 0. 00% 17 Funds from Other Sources 2,598,240.99 3111 309.00 31814.900.00 22.61 % 18 Reserve Funds Used for Operating 401 355.00 607 300.00 607, 300.00 0 00°!° 19 In-Kind Donations (Not included intota0 0.00 0.00 0.00 #DIV101 20 TOTAL 5,051 ,766,001 5 639 648.00 6.575 125.00 EXPENDITURES 21 Salaries 216179970.00 2 998 787.00 3 233,746.00 7. 84% 22 FICA 187,325,001 - 221 573.00 247 382.00 11 .65°% 23 Retirement 183 258,00 202 747.00 226.362.00 11 .65% 24 Life/Health 320 747.00 409 496.00 485,649.00 18. 60% 25 Workers Compensation 23 562.00 23 936 .00 29, 104.00 21 . 59% 26 Florida Unemployment 47688.00 0.00 16,275.00 #DIVIO ! 27 Travel-Daily 53t116.00 7807500 905382.00 15,76% 28 Travel/Conferences/Training 35 541 .00 382 30, 905 . 00 1926°/a 29 Office Supplies 50t214.00 6255000 61 ,601 .00 -1 . 52% 30 Telephone 101 310.00 116 450.00 109,733 .00 -5. 77% 31 Postage/Shipping 18 764.00 20y410.00 19,898.00 -2. 51 % 32 Utilities 71 231 .00 71 550.00 72.507.00 1 .34% 33 Occupancy (Building & Grounds 351 195.00 411 389.00 503,432 .00 22. 37% 34 Printing & Publications 25 333.00 21 850.00 22,801 .00 4. 35% 35 Subscription/Dues/Memberships 11 266.00 15 100.00 12f310.00 -18.48% 36 Insurance 22 902.00 2425500 24,837.00 2.40% 37 Eg ui ment: Rental & Maintenance 34 551 .00 2275000 38, 342.00 68 . 54% 38 Advertising 14 930.00 19 040.00 170644.00 -7. 33% 39 Equipment Purchases : Ca ital Expense 130 680.00 15,900.00 651000.00 308 . 81 % 40 Professional Fees (Legal, Consulting) 42t353.00 61t400.00 82.052.00 33. 64% 41 Books/Educational Materials 74 450.00 74 450.00 52,925 .00 -28. 9117: 42 Food & Nutrition 67 197,00 759950.00 731802.00 -2 . 83% 43 Administrative Costs 229 312.00 485,715.00 523, 184.00 7. 71 % 44 Audit Expense 41 000.00 42 000.00 45.000.00 7. 14%, 45 Specific Assistance to Individuals 195 152.00 118t750.00 485. 252. 00 308 . 63% 46 Other/Miscellaneous 18 517.00 71250.00 5 , 000, 00 -31 . 03% 47 Other/Contract 0.00 0.00 0. 00 #DIVIO ! 48 TOTAL 4;926, 564.00 563964800 6 , 575 125. 00 16. 590/a 49 REVENUES OVER/ UNDER EXPENDITURES 125720770 - 0.00 0, 00 #DIV/0! sasaon+ B.: • OrWw*Wm CMhak Chwi" of Dion of Pa" Des Inc Prow". Se km Cavin UNIFORM GRANT APPLICATION TOTAL PROGRAM BUDGET AGENCY/PROGRAM NAME : FY 02/03 FY 03/04 FY 04105 % INCREASE FYE FYE FYE CURRENTVS. NEXT FY BUDGET A B C D ACTUAL TOTAL PROPOSED (col. Ccol. Bycol. 0 REVENUES BUDGETED BUDGETED 1 Children's Services Council-St. Lucie 0. 00 #DIV/0! 2 Children's Services Council-Martin 0 .00 #DIVlO! 3 Advisory Committee-Indian River 51 000.00 52 500.00 66,836 41 27. 31 % 4 United Way-SL Lucie Coun!X 0 .00 #DIViO! 5 United Way-Martin Count 0 .00 #DIV/O! 6 United Way-Indian River County 60 000.00 63 000.00 96. 773. 26 53.61 % 7 Department of Children & Families 0.00 #DIV/01 8 County Funds 0.00 #DIV/0! 9 Contributions-Cash 162 685.78 189 331 .49 189 331 . 49 0.00% 10 Program Fees 21150.001 19000.00. 11000 .00 0.00° 11 Fund Raising Events-Net 75 405.45 100 000.00 100, 000.00 0.00% 12 Sales to Public-Net 155.00 750.00 750. 00 0.007 13 Membership Dues 0. 00 #DIV/O! 14 Investment Income 24P379.64 1500000 15.000.00 0 .00% 15 Miscellaneous 45t614.08 45 182.00 459182.00 0 .00% 16 Legacies & Bequests 0.00 #DIVlO! 17 Funds from Other Sources 97 493.95 84 000.00 84 000. 00 0.00% 18 Reserve Funds Used for Operating 51 000.00 31 500.00 10,481 .0766.73°/a 19In-Kind Donations (NocIncluded intotal) 0. 00 #DMO! 20 TOTAL 569 883.90 582 263.49 609,354. 23 4.65% EXPENDITURES 21 Salaries 277 435.80 277P272.00 288 070. 88 3.89% 22 FICA 20 552.81 21 f2l1 .00 22.037.42 3.90% 23 Retirement 18 997.76 19 409.04 209164. 96 3 .89% 24 Life/Health 49 102.42 5004900 66,986. 88 33 .84% 25 Workers Compensation 27560.091 2 495.45 23592. 64 3 .89% 26 Florida Unemployment 17215.34 0.00 2 , 880. 71 #DIVIO ! 27 Travel-Daily 17765. 19 300000 3,069.00 2.301/16 28 Travel/Conferences[ Trainin 31301 .29 11200.00 11200. 00 0.00%, 29 Office Supplies 61 .65 41500.00 450000 0 .00% 30 Telephone 7 955.55 71500.00 7 . 500. 00 0.00% 31 Postage/Shipping 41771 .90 41000.00 4,000 . 00 0 . 00% 32 Utilities 18 409.59 17 500.00 17, 500. 00 0.00% 33 Occupancy (Building & Grounds 6139839 58 682.00 58 ,68100 0.00% 34 Printing & Publications 31668.84 31750.00 31750,00 0.00% 35 Subscription/Dues/Memberships 462.50 100.00 100.00 0.00% 36 Insurance 49428.91 3J00.100 4, 500.00 21 .62% 37 E ui ment: Rental & Maintenance 41282. 17 450000 41500.00 0.00% 38 Advertising 13 957.28 11500.0 1 . 500.00 0.00% 39 Equipment Purchases : Ca ital Expense 12 958.89 12 000.00 25000 .00 -83.33% 40 Professional Fees (Legal, Consulting ) 107.75 800.00 12, 800,00 1500. 00% 41 Books/Educational Materials 21 971 .43 41500.00 4 ,500.00 0.00% 42 Food & Nutrition 16 971 .05 18 000.00 10. 000.00 -44.44% 43 Administrative Costs 59 203.61 5709500 57, 019 .74 -0. 13% 44 Audit Expense 11400.0011 1 500.00 11500.00 0,00% 45 Specific Assistance to Individuals 7 612.07 7,500.010 7 500.00 0.00% 46 Other/Miscellaneous 644.24 500.00 500 .00 0.00% 47 Other/Contract 0.00 0.00 0. 00 #DIV/01 48 TOTAL 615 196.52 582,263.49 609 354131 4, 65% 49 REVENUES OVER/ UNDER EXPENDITURES -45 312.62 0.00 0, 001 #DIV/0! vlsnoD� s3 Organization: Catholic Charities of Diocese of Palm Beach Inc. Program: Samaritan Center UNIFORM GRANT APPLICATION FUNDER SPECIFIC BUDGET PROGRAM EXPENSES AGENCY/ PROGRAM NAME . FUNDER : A B C FY 04/05 FY 04/05 % OF TOTAL FUNDER TOTAL VS, PROGRAM SPECIFIC FUNDER REQUEST BUDGET BUDGET (col. B/col. A) EXPENDITURES 21 Salaries 288 , 070 .88 46 ,956 . 82 16 . 30% 22 FICA 229037.42 3 , 592 . 20 16 . 30% 23 Retirement 20 , 164 .96 3 , 286 , 97 16 . 30% 24 Life/Health 669986 , 88 121108.24 18 , 08% 25 Workers Compensation 21592.64 422 . 61 16 . 30% 26 Florida Unemployment 21880 ,71 469 . 57 16 . 30% 27 Travel-Daily31069 ,00 0.00 0,00% 28 Travel/Conferences/Training 11200.00 0. 00 0.00% 29 Office Supplies 4, 500 , 00 0 . 00 0000% 30 Telephone 7 , 500 . 00 0 . 00 0 . 00% 31 Postage/Shipping 4 , 000 . 00 0 . 00 0. 00 % 32 Utilities 179500 . 00 0 . 00 0 , 00 % 33 Occupancy ( Building & Groundst 58 , 682 . 00 0 . 00 0 . 00% 34 Printing & Publications 37750 . 00 0 . 00 0 . 00% 35 Subscription/Dues/Memberships 100 . 00 0 . 00 0 . 00% 36 Insurance 41500 . 00 0 . 00 0 . 00% 37 E ui ment : Rental & Maintenance 41500 . 00 0 . 00 0 . 00% 38 Advertising 1 , 500 .00 0 , 00 0, 00% 39 Equipment Purchases : Ca ital Expense 29000 . 00 0 . 00 0. 00 % 40 Professional Fees ( Legal , Consulting ) 12 , 800 . 00 0 , 00 0 . 00 % 41 Books/Educational Materials 41500 . 00 0 . 00 0. 00% 42 Food 8r Nutrition 10 , 000 . 00 0 . 00 0 . 00% 43 Administrative Costs 57 , 019 . 74 0 . 00 0 . 00 % 44 Audit Expense 11500 . 00 0 . 00 0 . 00 % 45 Specific Assistance to Individuals 79500 . 00 0 . 00 0 . 00% 46 Other/Miscellaneous 500 . 00 0 . 00 0 . 00% 47 Other/Contract 0 . 00 0 . 00 # DIV/0 ! 48 TOTAL $609 , 354 . 23 $ 66, 836.41 10. 97% srz5r2W4 84 Orgawaoon Catholic Charloes of Diocese of Patin Beach Inc. Program: Samerilan Center UNIFORM GRANT APPLICATION EXPLANATION FOR VARIANCES OF 15% OR MORE TOTAL PROGRAM BUDGET AGENCYIPROGRAM NAME : FUNDER : LINE ITEM PLANATION'FOR VARIANCE #DIV/0! #DIVIO! Catholic Charities is requesting an additional $16,836.41 this fiscal year over last year actual award . The additional dollars will assist us in meeting operating expenses identified in our 2004/2005 budget request. For a number of years Catholic Charities has budget funds from its' reserve account. However, these are salty net funds and we must look for other ways to fund operating expenses. Therefore. Advisory Committee-Indian River we are asking the Advisory Commitee of Indian River to assist us in meeting our goals for 2004/2005. This amount to $46. 13 a day. #DIVIO! #DIV/0! Catholic Charities is requesting an additional $36,773 this fiscal year over last year actual award. The additional dollars will assist us in meeting operating expenses identified in our 2004/2005 budget request. For a number of years Catholic Charities has budgeted funds from its' reserve account. However, as mentioned above, these are sally net funds and we must look for other ways to fund operating United Way-Indian River Countv expenses. This request amount to an additional $ 100.75 per day. #DIV/O! #DIVIO! #DIVIO! #DIVIO! #DIVIO! Catholic Charities hearth insurance provider experience a loss last year. Which means claims paid were more than income coming in . Life/Health Our health insurance provider has informed us of a mimum increase of 15%. #DIV/0! Insurance Increase cost is anticipated due additional costs associated with transporting kids. Professional Fees ( Legal, Consulting ) A consultant will used for translations. #DIVIO! srnrtooa e s Organ¢abon: CelhOk Chwlb" of Dac'-' of Palen Beach ha; Progr": $amarftn Cwtm UNIFORM GRANT APPLICATION EXPLANATION FOR VARIANCES OF 15% OR MORE FUNDER SPECIFIC BUDGET AGENCY/PROGRAM NAME : FUNDER : LINE ITEM EXPLANATION/ FOR VARIANCE Over all this is a decrease over last year budgeted request by 3.92%. The staff of Catholic Charities did not get a salary increase last Salaries year but a salary increase is anticipate for the up coming budget year. FICA Function of salaries . Retirement Function of salaries. LifelHealth Increase costs will be experience by Catholic Charities in the up coming budget year. Workers Compensation Function of salaries. Florida Unem to ment Function of salaries. #DIVlO! W5000o B-5 EXHIBIT B [From policy adopted by Indian River County Board Of County Commissioners on February 19 , 2002] " D . Nonprofit Agency Responsibilities After Award of Funding Indian River County provides funding to all nonprofit agencies on a reimbursement basis only. All reimbursable expenses must be documented by an invoice and/or a copy of the canceled check . Any expense not documented properly to the satisfaction of the Office of Management & Budget and/or the County Administrator may not be reimbursed . If an agency repeatedly fails to provide adequate documentation , this may be reported to the Board of Commissioners . In the event an agency provides inadequate documentation on a consistent basis , funding may be discontinued immediately. Additionally, this may adversely affect future funding requests . Expenditures may only be reimbursed from the fiscal year for which funding was awarded . For example , no expenditures prior to October 1 st may be reimbursed with funds from the following year. Additionally, if any funds are unexpended at the end of a fiscal year, these funds are not carried over to the next year unless expressly authorized by the Board of Commissioners . All requests for reimbursement at fiscal year end (September 30th) must be submitted on a timely basis . Each year, the Office of Management & Budget will send a letter to all nonprofit agencies advising of the deadline for reimbursement requests for the fiscal year. This deadline is typically early to mid October, since the Finance Department does not process checks for the prior fiscal year beyond that point . Each reimbursement request must include a summary of expenses by type . These summaries should be broken down into salaries , benefits , supplies , contractual services , etc . If Indian River County is reimbursing an agency for only a portion of an expense (e . g . salary of an employee) , then the method for this portion should be disclosed on the summary. The Office of Management & Budget has summary forms available . Indian River County will not reimburse certain types of expenditures. These expenditure types are listed below . a . Travel expenses for travel outside the County including but not limited to ; mileage reimbursement , hotel rooms , meals , meal allowances , per Diem , and tolls . Mileage reimbursement for local travel (within Indian River County) is allowable . b . Sick or Vacation payments for employees . Since agencies may have various sick and vacation pay policies , these must be provided from other sources . c . Any expenses not associated with the provision of the program for which the County has awarded funding . d . Any expense not outlined in the agency's funding application . The County reserves the right to decline reimbursement for any expense as deemed necessary. " - 1 - EXHIBIT C STANDARD TERMS FOR GRANT CONTRACT 1 . Notices : Any notice , request, demand , consent, approval or other communication required or permitted by this Contract shall be given or made in writing , by any of the following methods : facsimile transmission ; hand delivery to the other party; delivery by commercial overnight courier service ; or mailed by registered or certified mail (postage prepaid ) , return receipt requested at the addresses of the parties shown below: County: Joyce Johnston-Carlson , Director Indian River County Human Services 1840 25th Street Vero Beach , Florida 32960-3365 Recipient : Catholic Charities of the Diocese of Palm Beach , Inc P . O . Box 109650 Palm Beach Gardens , Florida 33410 2 . Venue : Choice of Law: The validity, interpretation , construction , and effect of this Contract shall be in accordance with and governed by the laws of the State of Florida , only. The location for settlement of any and all claims , controversies , or disputes , arising out of or relating to any part of this Contract, or any breach hereof, as well as any litigation between the parties , shall be Indian River County, Florida for claims brought in state court, and the Southern District of Florida for those claims justifiable in federal court. 3 . Entirety of Agreement : This Contract incorporates and includes all prior and contemporaneous negotiations , correspondence , conversations , agreements , and understandings applicable to the matters contained herein and the parties agree that there are no commitments , agreements , or understandings concerning the subject matter of this Contract that are not contained herein . Accordingly, it is agreed that no deviation from the terms hereof shall be predicated upon any prior representations or agreements , whether oral or written . It is further agreed that no modification, amendment or alteration in the terms and conditions contained herein shall be effective unless contained in a written document signed by both parties . 4 . Severability: In the event any provision of this Contract is determined to be unenforceable or invalid , such unenforceability or invalidity shall not affect the remaining provisions of this Contract, and every other term and provision of this Contract shall be deemed valid and enforceable to the extent permitted by law. To that extent, this Contract is deemed severable . 5 . Captions and Interpretations : Captions in this Contract are included for convenience only and are not to be considered in any construction or interpretation of this Contract or any of its provisions . Unless the context indicates otherwise , words importing the singular number include the plural number, and vice versa . Words of any gender include the correlative words of the other genders , unless the sense indicates otherwise . 6 . Independent Contractor. The Recipient is and shall be an independent contractor for all purposes under this Contract. The Recipient is not an agent or employee of the County, and any and all persons engaged in any of the services or activities funded in whole or in part performed pursuant to this Contract shall at all times and in all places be subject to the Recipient's sole direction , supervision , and control . 7 . Assignment . This Contract may not be assigned by the Recipient without the prior written consent of the County. - 1 - -----------Client,#; g5 A R& CERTIFICATE OF L1AB [ L ► TY D10■P .AL/� , PRODUCER I N S U RAN DATE (MMmD/ryyy) ARTHUR J GALLAGHER $ CO 04/07/04 THIS CERTIFICATE tS ISSUED VAS q MATTER OF INFORMAT p 6200 NW 41St street, Ste. 200 ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Miami, Fl_ 33166 HOLDER, THIS CERTIFICATE DOES NOT AMEND 305 592-6080 ALTER THE COVERAGE AFFORDEDIB BY TT f£ PO C TEND OR INSURED INSURERS AFFORDING COVERAGE CATHOLIC CHARITIES OF INSURER A: GREAT LAKE REINSURANCE MAIC # DIOCESE OF PALM BEACH INSURER B: TNCRRG P• 0. BOX 109650 INSURER c; SAFETY NATIONAL INS. CO. WEST PALM BEACH, FL 33410-9650 wsuRER D COVERAGES 1 11111111111111 INSURER > THE POLICIES OF INSURANCE USTED BELOW HAVE BEEN t 77� 1111111 111 ANY REQUIREMENT S$( tEp TO THE INSURED NAMED ABOVE FOR THE POUCY PERIOD INDICATED. NOTWITHSTANDING MAY PERTAIN, TERM OCEAR CONDITIOED BY N OF CONTRACTOR OrHEF( DOCUMENT Wf;H RESPECT TO WHICH THIS CF�7IFICATE MAY N ISSUED TA POLICIES. AGGREGATES LIMITS H�D� WA� $ BY PAID CLAIMS. GR GED HEREIN IS $�JECTTO ALL THE TERMS, EXCLVSIONS AND CONDITIONS OFOR SUCH LTR NSR �£ � INSURANCE pO1.14'Y NY EFFE A oENERALUAwu y UMBER POLIC - 6L1DOM C E POUCYEMXPIRATI 01 UKP- X0000001 -00 04/01/04 $ X COMMERCIAL GOdUkAL UABILI 1050-05 04/01 /05 EACH OCCURRENCE 0000 00 CLAIMS MADE � OOCUR 04/01/04 04/01/05 DAhuGE TO RENTED $s11 000 0 0 ED MED EXP (Any pie pgrg�) $NIL GENL ApERSONAL & ADVINJURy S1000, 000 AGGREGATE LUT APPLIES PER GENERAL AGGREGATE POLICY PRO- SN/A +4 auro►aoBILE LIARILrrr LOC �D�M - COMP/OPAGG $1 000 000 & X ANY AUTO 01 UKEX0000001-00 04/01/04 04/01105 g 1050-05 X ALL OW11W AUTCISW01/04 0401/05 E�0Rj°e LINT DED $1 ,000 , a« Bt) s$110001000 X SCHEDULEAAU70s COLL DED $1BODILY ,N1U X "RED AUTO$ ,000 BODRy S X NON-0WNED ALITOS (PerLY J ) BODILY jN Y S GARAGE LIABILITY Pef �y DAMAGE S ANYAUIV AUTO ONLY , EA ACCIDENT S OTHER T,wN EA ACG S EXCE36/UMBRELLA LUjMIs-I• AUTO ONLY_ AGG S OCCUR EICLAIMS MADEEACH OCCURRENCE 5 AGGREGATE � $ DEDUCTIBLE S RErENnoN s A WORKERS COMPEN S SAYIOHAND 01UKEX00 S & EMPLOYERS' LIABILITY 00007 -00 04/01/44 04/01/05 ANY PROPR1ET0"ART 1050-05 X WC S BMTU- OTH C OFtICEPJMEMBFRE.XCLU 04/01/04 04/01/05 11yee. 8escnbo undw E.L. EACHACC,OENT $1 000,000 SPECIAL PROVISIONS WOW E.L DISEASE - EA OTHER EMPLOYEE 517000,000 E.L, OIB�.ASE - POLICY L,Mrr 51 , 000,000 DESCRIPTION OF OPERATIONS ! LOCAR THE VEHICLES ! EXCLUSIONS ADDED BY ENDORSEMENT I SPECUIL PROVISIONS ' RE: COUNTY FUNDING FOR THE SAMARITAN CENT INDIAN RIVER COUNTY IS NAMED AS ARITAN NAL INS 3650 RED 41 ST, VERO BEACH, FL CATHOLIC CHARITIES OF THE DIOCESE OF PALM BEACI I, D AS AGREED. P.O. BOX 109650, PALM BEACH GARDENS, FL 33410 CERTIFICATE HOLDER CANCELLATION INDIAN RIVER COUNTY FLORIDAHOULD ANV OF THE AROVE °ESCRIBED POLICIES 6E CANCELLED BePDRE THE EXPIRATION 1 $40 25TH STREET Q�DA DATE THEREOF, THE ISSUING INSURER %I ENDEAVOR TO MAI VERO BEACH, FL 32950-0365 NOT TO THE A -30 _ DAYswRrnEN KATE HOLDER NAMED TO THE LEFT, RUT FAILURE To DO SO S.4 u "O6E NO OBLIGATION OR LI wry OF ANYN IU D UPON THE WSIJRER TIS AGENTS OR R�'RESENTATfVE3_ ADTHORf$D RESE►tfATTVE ACORD 25 (2001108) 1 of #/$OWSIM65301 BRR 0 ACORD CpRpORATION 1988 @ / b 30tfd : QI ° bi02id 60 ' bi b0 - 60 - 2IdH IMPORTANT If the c®rtificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement m on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). If SUBROGATION IS WAIVED, subject to the terms and conditions of the Policy. require an endorsement. A statement on this holder in lieu of such endorsement(s), certificate does not confer rights to' thPoliciese DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(sl authorized representative or producer, and the certificate holder, nor does it afrmativelY or negativ* amend, extend or alter the coverage afforded by the policies listed thereon. ACQRD 25S (2001108) 2 of 2 >; S65456/M6S309 e / S 30t1d ; Q1 W08d 60 : bI b0 - 60 - ddtt Internal Revenue Service Department of the Treasury District Director P . 0. Box 2508 Cincinnati, OH 46201 Dates July 11 2004 Person to Contact: Myrna Huber #31 -07275 Telephone Numbers 877-829-5500 FAX Number: Ms. Deirdre Dessingue 513-253=3758 Associate General Counsel United States Conference of Catholic Bishops 3211 4 h Street, N . E . Washington , D . C . 20017- 1 194 Dear Ms. Dessingue: In a ruling dated March 25, 1946, we held that the agencies and instrumentalities and all educational , charitable and religious institutions operated , supervised, or controlled by or in connection with the Roman Catholic Church in the United States , its territories or possessions appearing in The Official Catholic Directory 1945, are entitled to exemption from federal income tax under the provisions of section 101 (6) of the Internal Revenue Code of 1939, which corresponds to section 501 (c) (3) of the 1986 Code . This ruling has been updated annually to cover the activities added to or deleted from the Directory . The Official Catholic Directory for 2004 shows the names and addresses of all agencies and Instrumentalities and all educational, charitable, and religious institutions operated by the Roman Catholic Church in the United States, its territories and possessions in existence at the time the Directory was published. it is understood that each of these is a non-profit organization, that no part of the net earnings thereof inures to the benefit of any individual , that no substantial part of their activities is for promotion of legislation , and that none are private foundations under section 509(a ) of the Code . Based on all information submitted, we conclude that the agencies and instrumentalities and educational , charitable, and religious institutions operated, supervised , or controlled by or in connection with the Roman Catholic Church in the United States , its territories or possessions appearing in The Official Catholic Directory for 2004 are exempt from federal income tax under section 501 (c) (3 ) of the Code . Donors may deduct contributions to the agencies, instrumentalities and institutions referred to above , as provided by section 170 of the Code . Bequests, legacies, devises, transfers or gifts to them or for their use are deductible for federal estate and gift tax purposes under sections 2055, 2106 , and 2522 of the Code. Ms . Deirdre Dessingue Beginning January 1 , 1984, unless specifically excepted, you and your subordinates must pay tax under the Federal Insurance Contributions Act (Social Security taxes) for each employee who is paid $ 100 or more in a calendar year. You and your subordinates are not liable for the tax under the Federal Unemployment Tax Act (FUTA) , By May 31 , 2005, please send thirteen (13) copies of The Official Catholic Directory for 2005 to IRS TE/GE in Cincinnati; one copy to the Processing Campus in Ogden , two copies each to the E© Area Managers in Newark, Brooklyn, Chicago, St. Paul, Atlanta , Los Angeles, the IRS National Headquarters and the Director, EG Examinations , Dallas. The conditions concerning the retention of your group exemption as set forth in our previous determination letter of August 17, 1983, remain in full force and effect. Sincerely, for J na Skufca, Director, TE/GE Customer Account Services VeOCOV � Office of the General Counsel 32 11 FOURTH STREET NE • WA:iHfNC,"ri7N DC 20011. 119 • 242-541 -3300 FAX 202454 t .3337 July 14, 2404 TO: Most Reverend Archbishops and Bishops , Diocesan Attorneys and State Conference Directors SUBJECT: 2004 Group Ruling FROM : Mark E . Chopko , General Counsel (Staff: Deirdre Dessingue, Associa a General Counsel ) Enclosed is a copy of the Group Ruling issued to the United States Conference of Catholic Bishops on July 1 , 2004 by the Internal Revenue Service ("IRS"), with respect to the federal tax status of Catholic organizations listed in the 2004 edition of the Official Catholic Directory (*OCD*)-V. As explained in greater detail below, this ruling is important for establishing : ( 1 ) the exemption of such organizations from: (a) federal income tax; (b) federal unemployment tax (but see 16 of "Explanation" below); and (2) the deductibility, for federal income , gift and estate tax purposes , of contributions to such organizations , The 2444 Group Ruling is the latest in a series that began with the original determination of March 25 , 1946 . in the 1946 document , the Treasury Department affirmed the exemption from federal income tax of all Catholic institutions listed In the OCD for that year. Each year since 1946 , in a separate letter, the 1946 ruling has been extended to cover the institutions listed in the current OCD?j. The language of these rulings has remained relatively unchanged , except to reflect intervening modifications in the Internal Revenue Code ("Code"). The 2004 Group Ruling is consistent with the 2003 ruling . Annual group rulings clarify important tax consequences for Catholic institutions listed in the OGD , and should be retained for ready reference. Rulings from earlier years are important to establish the tax consequences of transactions that occurred during those years . 1 A copy of the Group Ruling and this memo may be found on the USCCB website at war w, usccb. org/ogc. Catholic organizations with independent IRS exemption determination tetters are listen' in the 2004 OCD with an asterisk ( '); which is explained at page A-6 and indicates that such organizations are not covered by the Group Ruling. 2 Responsibilities under Group Ruling; Diocesan officials who compile OCD information for transmittal to the OCD publisher are responsible for the accuracy of such information . This means that they must ensure that only qualified organizations are listed , that organizations that cease to qualify are deleted promptly, and that qualified newly-created organizations are listed as soon as possible . The current legal and procedural requirements for inclusion in the Group Ruling and OCD , as well as the application form , is available at ihttp://wwwwusccboorg/bishops/dfi/exemptionruling.htm , EXPLANATION 1 . Exemption from Federal Income Tax . The latest ruling reaffirms the exemption from federal income tax under section 501 (c)(3) of the Code of "the agencies and instrumentalities and educational , charitable , and religious institutions operated , supervised or controlled by or in connection with the Roman Catholic Church in the United States, its territories or possessions appearing in the Official Catholic Directory for 2004" (with the exception of organizations designated in the OCD with an asterisk and foreign organizations). 2 . Federal Excise Taxes. Inclusion in the Group Ruling has no effect on an organization's liability for federal excise taxes. Exemption from these taxes is very limited . Please refer to your attorney any questions you may have about excise taxes. 3. StatelLocai Taxes. Inclusion in the Group Ruling does not automatically establish an organization's exemption from state or local income, sales or property taxes . Typically, separate exemptions must be obtained from the appropriate state or local tax authorities in order to qualify for any applicable exemptions. Please refer to your attorney any questions you may have about state or local tax exemptions . 4. Deductibility of Contributions . The Group Ruling assures donors that contributions to the institutions listed in the 2004 {SCD and covered by the Group Ruling are deductible for federal income, gift, and estate tax purposes. 5 . Unemployment Tax. The Group Ruling establishes exemption from federal unemployment tax only. Individual states may impose unemployment tax on organizations included in the Group Ruling , even though they are exempt from the federal tax. Please refer to your attorney any questions you may have about state unemployment tax . 6 . Social Secur t Tax. All section 501 (c)( 3 ) organizations, including churches , are required to pay taxes under the Federal Insurance Contributions Act ( FICA) for each employee who is paid $ 100 or more in a calendar year. 3° Services Section 3121 (w) of the Code permits certain church-related organizations to make an irrevocable election to avoid payment of FICA taxes, but only if such organizations are opposed for reit loos reasons to payment of social security taxes. 2 1 performed by diocesan priests in the exercise of their ministry are not considered "employment" for FICA (Social Security) purposes,.' and FICA should not be withheld from their salaries . For Social Security purposes, diocesan priests are subject to self-employment tax ("SECA" ) on their salaries as well as on the value of meats and housing or housing allowances provided to them .r' Neither FICA nor income tax withholding is required on remuneration paid to religious institutes for members who are subject to vows of poverty and obedience and are employed by organizations included in the Official Catholic Direetory.4' 7. Form 990, All organizations included in the OCD must file Form 990, Return of Organization Exempt from income Tax, unless they are eligible for a mandatory or discretionary exception . There is no automatic exemption from the Form 990 riling requirement simply because an organization is listed in the OCD. Organizations required to file Form 990 must do so by the 15th day of the fifth month after the close of their fiscal year'll Among the organizations not required to file Form 990 under section 6033 of the Code are: churches ; integrated auxiliaries of churches'; the exclusively religious activities of religious orders; schools below college level affiliated with a church or operated by a religious order; organizations vdth gross receipts normally not in excess of $25,000;2' and certain church-affiliated I. R. C. § 3121 (b)(8)(A). s LR. 0 § 1402(a)(8). See also, Compensation of Priests, at http llwww.usccb. orglblshopsldfifdualtax htm. Rev. Rul. 77490, 1977-2 C. B. 26. See also, ComDensatlon of Religious at h ttp.11www. usccb. orglbisho psldfrlreligiouscomp. h tm. ' The penalty for failure to rile the Form 990 is $20 for each day the failure continues, up to a maximum of $10, 000 or 5 percent of the organization 's gross receilits, whichever is less. However, organizations with annual gross receipts in excess of $ 1 miiilon are subject to penalties of $ 100 per day, up to a maximum of $50, 000, LR. C: § ss52(c)(1)(A). LR. C. § 6033(a)(2){A)(i); Treas. Reg. § 9 . 5033-2{h). TO qualify as an integrated auxiliary of a church, an organization must be described in section 501 (c)(3), qualify as other than a private foundation, be affiliated with a church, and qualify as internally supported. An organization will be considered internally supported unle,m it both: (1) Offers admissions, goods, services, or facilities for sale, other than on an incidental basis, to they general public (except goods, services, or facilities sold at a nominal charge or substantially below cost), and (2) normally receives more than 50 percent of its support from a combination of governmental sources; public solicitation of contributions (such as through a community fund drive); and receipts from the sale of admissions, goods, performance of services, or furnishing of facilities in activities that are not unrelated trades or businesses. Rev. Proc, 83-23, 1983- 1 C, Br 687. 3 organizations that finance, fund or manage church assets , or maintain church retirement insurance programs, and organizations controlled by religious orders that finance , fund or manage assets used for exclusively religious activities . 101 Organizations that are required to file Form 990 must upon request make a copy of the form and its schedules and attachments (other than contributor lists) available for public inspection during regular business hours at the organization 's principal office and at any regional or district offices having three or more employees. Form 990 for a particular year must be made available for a three year period beginning with the due date of the retumAV In addition , organizations that file Form 990 must comply with written or In-person requests for copies of the Form 990-. The organization may impose no charge other than a reasonable fee to cover copying and mailing costs . if requested , copies of the Form 990 for the past three years must be provided , in-person requests must be satisfied on the same day. Written requests must be satisfied within 30 days. 8 . Revenue Procedure 75-50 , Rev. Proc. 75-50'4' sets forth notice, publication, and recordkeeping requirements regarding: racially nondiscriminatory policies that must be complied with by private schools, including church-related schools, as a condition of establishing and maintaining exempt status under section 501 (c)(3) of the Code. Under Rev, Proc. 75-50 private schools are required to file an annual certification of racial nondiscrimination with the IRS . For private schools not required to file Form 990, the annual certification must be filed on Form 5578, Annual Certification of Racial Nondiscrimination for a Private School Exempt from Federal Income Tax. This form may be obtained from your local IRS office. Form 5578 must be filed by the 15th day of the fifth month following the close of the fiscal year. Form 5578 may be filed individually or by the diocese on behalf of all schools operated under diocesan auspices . The requirements of Rev. Proc. 75-50 remain in effect and must be complied with by all schools listed in the OCD . Diocesan or school officials should Insure that the requirements of Rev. Proc. 75-50 are met since failure to do so could jeopardize the exempt status of the school 1 Rev, Proc. 96- 10, 1996- 1 C. B. 577. 31 The penalty for failure to permit public inspection of the Poria 990 is 20 for each day during which such failure continues, up to a maximum of $ 10, 000. l. R. C. 5652(c)( 1)(C). 12 LR. C. § 6104(4). Generally, a copy of an organization 's exemption application and supporting documents most also be provided on the some basis. However, since Catholic organizations covered under the Group Ruling did not rile exemption applications with IRS, nor did USCCB, organizations covered under the Group Ruling should respond to requests for public inspection and written or in-person requests for copies by providing a copy of the page of the current OCD on which they are listed4 if a covered organization does not have a copy of the current UCO, it has two weeks within which to make it available for inspection and to comply with ire-person requests for copies. Written requests must be satisfied within the general time limits. 13 9975.2 C. B. 587. 4 and, in the case of a school operated by a church, the exempt status of the church itself. 9 . Lobbying Activities . Organizations included in the OCD may lobby for changes in the law, provided such lobbying is not more than an insubstantial part of their total activities . Attempts to influence legislation both directly and through grassroots lobbying are subject to this restriction . The term "lobbying" includes activities in support of or in opposition to referenda , constitutional amendments, and similar ballot initiatives. There is no distinction between lobbying activity that is related to an organization's exempt purposes and lobbying that is not . There is no fixed percentage that constitutes a safe harbor for "insubstantial" lobbying . Please refer to your attorney any questions you may have about permissible lobbying activities . 10. Political Activities . Organizations included In the Group Ruling may not participate or intervene in any political campaign on behalf of or in opposition to any candidate for public office. Violation of the prohibition against political activity can jeopardize the organization 's taxwexempt status. In addition to revoking exempt status, IRS may also impose excise taxes on an exempt organization and its managers on account of political expenditures. Where there has been a flagrant violation, IRS has authority to seek an injunction against the exempt organization and immediate assessment of taxes due. Political Campaign Activity Guidance for Catholic Organizations (March 15, 2004) available at www. usccb.orglogc, contains detailed information regarding the political activity prohibition . If you have any questions in this regard , please refer them to your attorney. 11 . Public Charity Status . The latest Group Ruling affirms that organizations included in the OCD are net private foundations under section 509(a ) of the Code . However, the Group Ruling does not identity the subsection of section 509(x) under which a particular organization is classified as a public charity . Organizations must determine for themselves whether they qualify for such status under the provisions of section 509(a)( 1 ), (a)(2) or (a )(3). Newly-created or newly- affiliated organizations must establish that they are not private foundations as a condition of inclusion in the Group Ruling and OCD . 12 , Group Exemption Number. The group exemption number assigned to USCG is 928 or 0928 . This number must be included on each Form 990, , Form 990- T, and Form 5578 required to be filed by any organization exempt under the Group Ruling. ' We recommend against using the group exemption number on Form SSA Request for Employer Identification Number, because in the past this has resulted in IRS including USCCB as part of the organization's name when it enters the organization in its database . IRS has expressed concern about organizations covered under the Group Ruling that fail to include the group exemption number, 0928, on their Form 990 filings, partkularly the initial filing, 5