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HomeMy WebLinkAbout2007-308P 7 Indian River County Grant Contract This Grant Contract ("Contract") entered into effective this A— day of October 2007 b and between Indian River County, a political subdivision of the State of Florida , 1801 27 Street, Vero Beach FL , 32960 ("County") and Childcare Resources of Indian River County, ( Recipient); of: P . O . 1801 24th Street, Vero Beach , FL . 32960 For: Psychological Services 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"). 7 Indian River County Grant Contract This Grant Contract ("Contract") entered into effective this A— day of October 2007 b and between Indian River County, a political subdivision of the State of Florida , 1801 27 Street, Vero Beach FL , 32960 ("County") and Childcare Resources of Indian River County, ( Recipient); of: P . O . 1801 24th Street, Vero Beach , FL . 32960 For: Psychological Services 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 2007/2008 ("Grant Period ") . The Grant Period commences on October 1 , 2007 and ends on September 30 , 2008 . 4 . Grant Funds and Payment The approved Grant for the Grant Period is Seven Thousand Dollars ($7 , 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, cumulative, 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 . The Recipient acknowledges and agrees that the County reserves the right to conduct random and unannounced monitoring of the program's performance throughout the Grant Period . 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. - 2 - 3 . Term . The Recipient acknowledges and agrees that the Grant is limited to the fiscal year 2007/2008 ("Grant Period ") . The Grant Period commences on October 1 , 2007 and ends on September 30 , 2008 . 4 . Grant Funds and Payment The approved Grant for the Grant Period is Seven Thousand Dollars ($7 , 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, cumulative, 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 . The Recipient acknowledges and agrees that the County reserves the right to conduct random and unannounced monitoring of the program's performance throughout the Grant Period . 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. - 2 - 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 October 21 , 2006 , 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 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 - 3 - 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. 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 Attest: J . K. Barton , Clerk BOARD OF COUNTY COMMISSIONERS By Af Deputy Clerk' By G w� Y G4/C . Wheeler, Chairman BCC Approved : q l8 .O� Approved : seph X Baird ounty Administrator Aj pj;foved as to form and legal sufficiency: Marian E . Fell , Assistant County Attorney RECIPIENT: By: CHILDCARE RESOURCES - 4 - I I 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 October 21 , 2006 , 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 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 - 3 - EXHIBIT A [Copy of complete proposal/application] Childcare Resources of Indian River, Inc. Psychological services Program. Funder: Children services Advisory Committee PROGRAM COVER PAGE y� Organization Name: Childcare Resources of Indian River Executive Director: Pam King E-mail:pking(a�,ChildcareResourcesIR org Address: 1801 2401 Street Telephone: 772-567-3202 Vero Beach, FL 32960 Fax : 772-567- 1136 Program Director: Rachael Moshman E-mail : rmoshman(a�ChildcareResourcesIR or Address : same Telephone: same Fax: same Program Title: Psychological Services Priority Need Area Addressed: Mental Health : Expand preventative remedial and support programs for students with emotional behavioral and performance problems Brief Description of the Prograrn:This program provides parent counseling (RP-450. 650) and in- person crisis intervention (RP- 150.330) services to Childcare Resources families and contracting centers. Families receive individual and/or family therapy from various contracting Childcare Resources mental health professionals Centers receive classroom support through site -visits by therapists specializing in early childhood SUMMARY REPORT — (Eater Information In The Black Celts Only) Amount Requested from Funder for 2007 / 08 : $ 75000 . 00 Total Proposed Program Budget for 2007108 : $ 46 , 500 . 00 Percent of Total Program Budget : 15 . 1 % Current Program Funding ( 2006 /07 ) : $ 7 , 000 Dollar increase / ( decrease ) in request : $ _ Percent increase /( decrease ) in request * * : 0 . 0 % n up orate um er o t ren to e serve n ivr ua y : Unduplicated Number of Adults to be served Individually : 8 Unduplicated Number to be served via Group settings : 30 Total Program Cost per Client : 1010 . 87 **If request increased 5 % or more, briefly explain why: If these funds are being used to match another source, name the source and the $ amount: United Wav of Indian River County, $4,000 The Organization 's Board of Directors has approved this application on (date). L Andrew Hartline/Chair of the Board t e Pam King/Executive Director Signature 2 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. 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 Attest: J . K. Barton , Clerk BOARD OF COUNTY COMMISSIONERS By Af Deputy Clerk' By G w� Y G4/C . Wheeler, Chairman BCC Approved : q l8 .O� Approved : seph X Baird ounty Administrator Aj pj;foved as to form and legal sufficiency: Marian E . Fell , Assistant County Attorney RECIPIENT: By: CHILDCARE RESOURCES - 4 - Childcare Resources of Indian River, Inc. Psychological Services Program. Funder: Children Services Advisory Committee ORGANIZATION: Childcare Resources of Indian River PROGRAM : Psychological Services 2007/2008 CORE APPLICATION TABLE OF CONTENTS 'X" the parts ofgrant application to indicate inclusion. Also, please put page number where the information can be located. X Section of the Proposal Page # X TABLE OF CONTENTS (check list) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 X COVER PAGE (with signatures) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 X A. ORGANIZATION CAPABILITY (one page maximum) _ 1 . Mission and Vision of organization. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 2. Summary of expertise, accomplishments, and population served. . . . . . . . . . . . . . . . . . . . . . . . . . . 3 X B. PROGRAM NEED STATEMENT (one page maximum) _ 1 . Program Need Statement. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 2. Programs that address need and gaps in service . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 X C. PROGRAM DESCRIPTION (two pages maximum) 1 . Funding priority. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 _ 2 . Description of program activities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 _ 3 . Evidence that program strategy will work . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 4. Staffmg . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 _ 5 . Awareness of program. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 6 6 . Accessibility of program . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . 6 X D. MEASURABLE OUTCOMES & ACTIVITIES MATRIX (Four outcomes maximum) . . . . . . . . . . . . . . . . . . . . . . . . . .. .... . .. X E. COLLABORATION (one page maximum) . . . . . . . . . . . . . . . .. . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 X F. UNDUPLICATED CLIENTS I . Projections by Location. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I 1 2. Projections by Age Group . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ... 1 I X G. BUDGET FORMS 1 . Financial Budget Forms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12 X H. FUNDER SPECIFIC REQUIREMENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 1 Childcare Resources of Indian River, Inc. Psychological services Program Fmder. Children Services Advisory Committee PROPOSAL NARRATIVE A. ORGANIZATION CAPABILITY (Entire Section A not to exceed one paa 1 . Provide the mission statement and vision of your organization. Mission statement: To ensure the availability and affordability of high quality early en , cl development and family support programs for children of lower income working fam - i - Indian River County. The vision of Childcare Resources is for childcare to be available and affordable for a; who qualify, and that the quality of childcare in Indian River County will be enhanced , addition, parents will be able to work secure in the knowledge their children are thrivir, i, . families will be strengthened and better able to nurture their children into responsible a Childcare Resources envisions a community that embraces the mission and recognizes community-wide support will improve the quality of life for all citizens. 2. Provide a brief summary of your organization including areas of expertise, accomplishments, and population served. Childcare Resources contracts with six local childcare centers located on eight sites to quality childcare programs for children from birth to kindergarten. Childcare Resouv r. working families who meet income eligibility guidelines and live in Indian River Cot 11 Centers must meet Childcare Resources Standards of Quality as determined by accredit the National Association for the Education of Young Children (NAEYC). Centers are on a regular basis . Staffs receive training and support, and center directors meet bi-m(I Childcare Resources staff to discuss issues that affect the delivery of a quality progra-11. criteria for contracting include: • A program which is both age and individually appropriate • Specifically trained and adequately compensated teachers • Low adult to child ratios ( 1 : 10 for preschool) (1 : 8 for 2 year olds) ( 1 : 6 for to :+ for infants) • Close ties with families and meaningful parental involvement • Access to comprehensive services Childcare Resources ' program places emphasis upon a strong family support and eduea , component, including parenting workshops, parent/child interactive programs, mentor resource and referral, and professional psychological support. The progress of the child"r monitored and documented. There is parental choice among centers. Parents sign a c committing to a sliding fee scale and mandatory participation in orientations, parent/tcc conferences and parent education programs throughout the year. Childcare Resource, fundraising and public awareness, which are vital to the support, sustainability and de' s the program. EXHIBIT A [Copy of complete proposal/application] Childcare Resources of Indian River, Inc. Psychological services Programa. Funder. Children services Advisory Committee B. 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) A percentage of all families face problems and stresses and need professional psychological intervention. Recent research indicates that more children three and under suffer from emotional stress, like adults, "but they lack the coping mechanisms years of living bring" (Florida Association for Infant Mental Health, 2003). Childcare Resources ' targeted population is more economically needy, and families historically face life challenges to a greater degree than the general population. Indian River County lacks sufficient psychological services to low-income families with mental health needs. In addition, there are challenges in identifying fandlies with such needs and encouraging them to take advantage of available resources. Childcare Resources centers lack clinical staff and the financial resources to independently contract with mental health professionals. Problems in the classroom that cannot be handled within the capabilities of the staff often result in the expulsion of the child in crisis. A child labeled a problem early on will likely arrive at kindergarten ready to live up to the label. Intervention before expulsion is far more helpful for ail concemed. b) The targeted population is families in our program who demonstrate a need for psychological services in one or more of the following areas: 1 . Children who exhibit behavioral, developmental, and/or emotional difficulties that seriously impact their chances for school and life success. 2 . Parents who deal with issues like: abuse, divorce, depression, anxiety, custody, substance abuse or significant health problems. 3 . Parents with "special needs" children in the family who need support. 4. Childcare Resources centers need the opportunity to receive on-site professional psychological/behavioral support. c) Those in need appear to be spread evenly throughout Indian River County. d) The National Mental Health Association tells us that although one in five children has a diagnosable mental health problem, nearly two-thirds of them get little or no help. Untreated mental health problems can disrupt children's functioning at home, school and in the community. Without treatment, children with mental health issues are at increased risk of school failure, contact with the criminal justice system, and dependence on social services. Professional services are only recommended after efforts by the Childcare Resources staff and center staff have been exhausted. FIdentifyfy similar programs that are currently serving the needs of your targeted on; b) Explain how these existing programs are under-serving the targeted n of your program. Resources is the only program in the county that ties psychological services, ect intervention, to the funding of childcare. In previous years the Early Learning a small amount of funding for a large population of children but even that is no longer available. 4 Childcare Resources of Indian River, Inc. Psychological Services Program. Funder: Children Services Advisory Committee C. PROGRAM DESCRIPTION (Entire Section C, 1 — 6, not to exceed two pages. 1 . List Priority Needs area addressed. Mental Health: Expand preventative, remedial, and support programs for students with emotional, behavioral, and performance problems. F describe program activities including location of services. rals start with the Childcare Resources Family & Center Resource Coordinator o conferences with the parent to assess the problem, along with the need for . Already employed strategies and resources will be reviewed and recorded. d is established, the FCRC secures authorization for the referral from the Executive D) . c) Parents select a therapist from a list of contracting providers, and give written consent for information sharing. d) Families with medical insurance use those benefits first. Families pay the therapist a $5 . 00 fee for each visit. e) The FCRC monitors the treatment plan through regular conferences with families, and consults with providers (as appropriate). f} The FCRC facilitates recommended changes in the child ' s individual school program, with the classroom teacher monitors progress. g) Services are provided at the office of the selected therapist or at the centers. Psychological SuMMOrt to Centers ' a) Contracting therapist allots 2-3 hour time blocks to our center with documented need. Purpose: work with classroom teachers on behavioral issues that may be interfering with social and/or cognitive learning in the classroom. b) A teacher completes the pre-observation form prior to therapist visit. The therapist records observations, conferences with teacher, gives written strategies and sets date for follow-up. c) The FCRC follows-up to help the classroom teacher implement and evaluate program changes. FBrieflyescribe how your program addresses the stated need/problem. Describe how gram follows a recognized "best practice" (see definition on page 12 of the ons) and provide evidence that indicates proposed strategies are effective with pulation. ources recognizes that research indicates parent support and education are vital to a sful preschool experience. A child ' s development does not end when he leaves the classroom. The child that goes home to a dysfunctional family will not thrive. The services offered in this program are often the only source of professional intervention for families. Dollars are best spent on childcare when the child is able to return home to a functional family, capable of positively reinforcing, nurturing and appreciating the child . 14 individuals sought treatment last year ( 123 individual sessions). All who had more than one session showed improvement in their Global Assessment of Functioning scores with two exceptions (those children left the program before real progress could be made) . 5 Childcare Resources of Indian River, Inc. Psychological services Program. Funder: Children services Advisory Committee PROGRAM COVER PAGE y� Organization Name: Childcare Resources of Indian River Executive Director: Pam King E-mail:pking(a�,ChildcareResourcesIR org Address: 1801 2401 Street Telephone: 772-567-3202 Vero Beach, FL 32960 Fax : 772-567- 1136 Program Director: Rachael Moshman E-mail : rmoshman(a�ChildcareResourcesIR or Address : same Telephone: same Fax: same Program Title: Psychological Services Priority Need Area Addressed: Mental Health : Expand preventative remedial and support programs for students with emotional behavioral and performance problems Brief Description of the Prograrn:This program provides parent counseling (RP-450. 650) and in- person crisis intervention (RP- 150.330) services to Childcare Resources families and contracting centers. Families receive individual and/or family therapy from various contracting Childcare Resources mental health professionals Centers receive classroom support through site -visits by therapists specializing in early childhood SUMMARY REPORT — (Eater Information In The Black Celts Only) Amount Requested from Funder for 2007 / 08 : $ 75000 . 00 Total Proposed Program Budget for 2007108 : $ 46 , 500 . 00 Percent of Total Program Budget : 15 . 1 % Current Program Funding ( 2006 /07 ) : $ 7 , 000 Dollar increase / ( decrease ) in request : $ _ Percent increase /( decrease ) in request * * : 0 . 0 % n up orate um er o t ren to e serve n ivr ua y : Unduplicated Number of Adults to be served Individually : 8 Unduplicated Number to be served via Group settings : 30 Total Program Cost per Client : 1010 . 87 **If request increased 5 % or more, briefly explain why: If these funds are being used to match another source, name the source and the $ amount: United Wav of Indian River County, $4,000 The Organization 's Board of Directors has approved this application on (date). L Andrew Hartline/Chair of the Board t e Pam King/Executive Director Signature 2 Childcare Resources of Indian River, Inc. Psychological Services Program. Funder: Children Services Advisory Committee F ing needed for your program, including required experience and estimated week in program for each staff member and/or volunteers (this section nform to the information in the Position Listing on the Budget Narrative et).ector: On average 8 hours a week are devoted to program. Experience/expertise in: istributing funding for the program, monitoring compliance regarding reporting and billing procedures, maintaining a "bank" of qualified therapists to serve families at a reduced hourly billing rate. Family & Center Resource Coordinator• On average 10 hours a week are devoted to the program. Experience/expertise in: assessing referrals, monitoring treatment plans, implementing program changes in the classroom, serving as a liaison among parents, therapists, and centers . Office Manager: On average 4 hours a week are devoted to the program. Experience/expertise in: processing invoices from providers, monitoring parent compliance regarding fee payments, checking family health insurance benefits. Center Recruitment Specialist None of the hours for this position are devoted to the Psychological Services Program, 5. How will the target population be made aware of the program? Childcare Resources families are made aware of the psychological support program during intake, at our orientation, and individually through the Family Resource Coordinator. Reminders are included in our monthly parent newsletter. We make a habit of having a contracting therapist available at orientation to introduce the program and encourage parent participation. h1 addition, center staffs are aware of the availability of the program and refer families in need. FRowll the program be accessible to target population (i.e., location, transportation, operation)? arameters of therapist specialty, there is parental choice. This enables a parent to rapist convenient to home or work. Some contracting therapists have evening and ointments available for Childcare Resources families. Some contracting therapistso hold individual therapy sessions at the child' s center. Parents unable to pay the $5 fee may have it waived through the Childcare Resources Program Committee. 6 Childcare Resources of Indian River, Inc. Psychological se[vices Program. Funder: Children Services Advisory Committee l expand as you Outcome ## 1 . 80% of those families referred for treatment will 1participate in treatment l as measured by the number of completed Mental Health Provider forms . Program Design & Task Management (Columns 1 -4) Evaluation Design & Data Collection (Columns 5-7) 3 4 Program Frequency Responsible Parties Expected Activities (how often) (who) p Indicator Data Source Time of (what) ) Outcomes/change (why) Measurements (where)) Measurement (when) (evidence) Referrals and self- As needed Teachers, parents Will participate in referrals for mental p p Patient's attendance Mental Health After initial visit and refer r Family & counseling with counselor Provider form every six month health services Center Resource Coordinator who thereafter or until refers to a thera ist sessions have stopped 7 Childcare Resources of Indian River, Inc. Psychological Services Program. Funder: Children Services Advisory Committee ORGANIZATION: Childcare Resources of Indian River PROGRAM : Psychological Services 2007/2008 CORE APPLICATION TABLE OF CONTENTS 'X" the parts ofgrant application to indicate inclusion. Also, please put page number where the information can be located. X Section of the Proposal Page # X TABLE OF CONTENTS (check list) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 X COVER PAGE (with signatures) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 X A. ORGANIZATION CAPABILITY (one page maximum) _ 1 . Mission and Vision of organization. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 2. Summary of expertise, accomplishments, and population served. . . . . . . . . . . . . . . . . . . . . . . . . . . 3 X B. PROGRAM NEED STATEMENT (one page maximum) _ 1 . Program Need Statement. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 2. Programs that address need and gaps in service . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 X C. PROGRAM DESCRIPTION (two pages maximum) 1 . Funding priority. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 _ 2 . Description of program activities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 _ 3 . Evidence that program strategy will work . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 4. Staffmg . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 _ 5 . Awareness of program. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 6 6 . Accessibility of program . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . 6 X D. MEASURABLE OUTCOMES & ACTIVITIES MATRIX (Four outcomes maximum) . . . . . . . . . . . . . . . . . . . . . . . . . .. .... . .. X E. COLLABORATION (one page maximum) . . . . . . . . . . . . . . . .. . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 X F. UNDUPLICATED CLIENTS I . Projections by Location. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I 1 2. Projections by Age Group . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ... 1 I X G. BUDGET FORMS 1 . Financial Budget Forms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12 X H. FUNDER SPECIFIC REQUIREMENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 1 Childcare Resources of Indian River, Inc. Psychological services Program Fmder. Children Services Advisory Committee PROPOSAL NARRATIVE A. ORGANIZATION CAPABILITY (Entire Section A not to exceed one paa 1 . Provide the mission statement and vision of your organization. Mission statement: To ensure the availability and affordability of high quality early en , cl development and family support programs for children of lower income working fam - i - Indian River County. The vision of Childcare Resources is for childcare to be available and affordable for a; who qualify, and that the quality of childcare in Indian River County will be enhanced , addition, parents will be able to work secure in the knowledge their children are thrivir, i, . families will be strengthened and better able to nurture their children into responsible a Childcare Resources envisions a community that embraces the mission and recognizes community-wide support will improve the quality of life for all citizens. 2. Provide a brief summary of your organization including areas of expertise, accomplishments, and population served. Childcare Resources contracts with six local childcare centers located on eight sites to quality childcare programs for children from birth to kindergarten. Childcare Resouv r. working families who meet income eligibility guidelines and live in Indian River Cot 11 Centers must meet Childcare Resources Standards of Quality as determined by accredit the National Association for the Education of Young Children (NAEYC). Centers are on a regular basis . Staffs receive training and support, and center directors meet bi-m(I Childcare Resources staff to discuss issues that affect the delivery of a quality progra-11. criteria for contracting include: • A program which is both age and individually appropriate • Specifically trained and adequately compensated teachers • Low adult to child ratios ( 1 : 10 for preschool) (1 : 8 for 2 year olds) ( 1 : 6 for to :+ for infants) • Close ties with families and meaningful parental involvement • Access to comprehensive services Childcare Resources ' program places emphasis upon a strong family support and eduea , component, including parenting workshops, parent/child interactive programs, mentor resource and referral, and professional psychological support. The progress of the child"r monitored and documented. There is parental choice among centers. Parents sign a c committing to a sliding fee scale and mandatory participation in orientations, parent/tcc conferences and parent education programs throughout the year. Childcare Resource, fundraising and public awareness, which are vital to the support, sustainability and de' s the program. Childcare Resources of Indian River, Inc. Psychological Services Proginm. Funder Children Services Advisory Comnuttee (Boxes will expand as you type.) Ebytthe ome # 2 : 85 % of individuals attending more than two therapy sessions will raise their functioning within the school year, as measured discharge score for the Global Assessment of Functioning (GAP) test or other screening devices . Baseline: Admission GAF score. Program Design & Task Management (Columns1 -4) l valuation Design & Data Collection — (Columns 5-7) Program Activities Fre uenc —r 6� I 7 what 9 y Responsible Expected Indicator Data Source (what) (huw often) Parties (who) Outcomes/change Measurements where Time of (why) (evidence) ( ) Measurement (when) Therapy with licensed As needed Parents, therapists, Adults, older mental health providers GAF scores or Mental Health GAF: At initial visit center staff siblings: improved feedback from Provider form. and every six months ability to deal with other screening Young children : after. issues that caused devices. For treatment plan self-referral; very young children, young children: feedback from improved behavioral parents and or developmental teachers. ro ress 8 Childcare Resources of Indian River, Inc. Psychological services Program. Funder: Children services Advisory Committee (Boxes will expand as you type.) Outcome #3 : To increase the level of appropriate behavior of children who have received clinical intervention during the 2007-2008 school year by an average of 10% as measured by the spring DECA and/or classroom teacher assessments. Baseline: Teacher assessments and/or fall DECA assessments. Program Design & Task Management ]Evaluation Design & Data Collection (Columns 1 -4) (Columns 5-7) Program Activities Frequency Responsible Expected 7 (what) P Indicator Data Source Time of (how often) Parties (who) Outcomes/change Measurements (where) Measurement (wily) I (evidence) (when) Behavioral and As needed Parents, therapists, Improved behavior Child's and/or DECA scores Fall and spring of developmental center staff intervention performance on school year developmental DECA progress assessments 9 Childcare Resources of Indian River, Inc. Psychological services Programa. Funder. Children services Advisory Committee B. 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) A percentage of all families face problems and stresses and need professional psychological intervention. Recent research indicates that more children three and under suffer from emotional stress, like adults, "but they lack the coping mechanisms years of living bring" (Florida Association for Infant Mental Health, 2003). Childcare Resources ' targeted population is more economically needy, and families historically face life challenges to a greater degree than the general population. Indian River County lacks sufficient psychological services to low-income families with mental health needs. In addition, there are challenges in identifying fandlies with such needs and encouraging them to take advantage of available resources. Childcare Resources centers lack clinical staff and the financial resources to independently contract with mental health professionals. Problems in the classroom that cannot be handled within the capabilities of the staff often result in the expulsion of the child in crisis. A child labeled a problem early on will likely arrive at kindergarten ready to live up to the label. Intervention before expulsion is far more helpful for ail concemed. b) The targeted population is families in our program who demonstrate a need for psychological services in one or more of the following areas: 1 . Children who exhibit behavioral, developmental, and/or emotional difficulties that seriously impact their chances for school and life success. 2 . Parents who deal with issues like: abuse, divorce, depression, anxiety, custody, substance abuse or significant health problems. 3 . Parents with "special needs" children in the family who need support. 4. Childcare Resources centers need the opportunity to receive on-site professional psychological/behavioral support. c) Those in need appear to be spread evenly throughout Indian River County. d) The National Mental Health Association tells us that although one in five children has a diagnosable mental health problem, nearly two-thirds of them get little or no help. Untreated mental health problems can disrupt children's functioning at home, school and in the community. Without treatment, children with mental health issues are at increased risk of school failure, contact with the criminal justice system, and dependence on social services. Professional services are only recommended after efforts by the Childcare Resources staff and center staff have been exhausted. FIdentifyfy similar programs that are currently serving the needs of your targeted on; b) Explain how these existing programs are under-serving the targeted n of your program. Resources is the only program in the county that ties psychological services, ect intervention, to the funding of childcare. In previous years the Early Learning a small amount of funding for a large population of children but even that is no longer available. 4 Childcare Resources of Indian River, Inc. Psychological Services Program. Funder: Children Services Advisory Committee C. PROGRAM DESCRIPTION (Entire Section C, 1 — 6, not to exceed two pages. 1 . List Priority Needs area addressed. Mental Health: Expand preventative, remedial, and support programs for students with emotional, behavioral, and performance problems. F describe program activities including location of services. rals start with the Childcare Resources Family & Center Resource Coordinator o conferences with the parent to assess the problem, along with the need for . Already employed strategies and resources will be reviewed and recorded. d is established, the FCRC secures authorization for the referral from the Executive D) . c) Parents select a therapist from a list of contracting providers, and give written consent for information sharing. d) Families with medical insurance use those benefits first. Families pay the therapist a $5 . 00 fee for each visit. e) The FCRC monitors the treatment plan through regular conferences with families, and consults with providers (as appropriate). f} The FCRC facilitates recommended changes in the child ' s individual school program, with the classroom teacher monitors progress. g) Services are provided at the office of the selected therapist or at the centers. Psychological SuMMOrt to Centers ' a) Contracting therapist allots 2-3 hour time blocks to our center with documented need. Purpose: work with classroom teachers on behavioral issues that may be interfering with social and/or cognitive learning in the classroom. b) A teacher completes the pre-observation form prior to therapist visit. The therapist records observations, conferences with teacher, gives written strategies and sets date for follow-up. c) The FCRC follows-up to help the classroom teacher implement and evaluate program changes. FBrieflyescribe how your program addresses the stated need/problem. Describe how gram follows a recognized "best practice" (see definition on page 12 of the ons) and provide evidence that indicates proposed strategies are effective with pulation. ources recognizes that research indicates parent support and education are vital to a sful preschool experience. A child ' s development does not end when he leaves the classroom. The child that goes home to a dysfunctional family will not thrive. The services offered in this program are often the only source of professional intervention for families. Dollars are best spent on childcare when the child is able to return home to a functional family, capable of positively reinforcing, nurturing and appreciating the child . 14 individuals sought treatment last year ( 123 individual sessions). All who had more than one session showed improvement in their Global Assessment of Functioning scores with two exceptions (those children left the program before real progress could be made) . 5 Childcare Resources of Indian River, Inc. Psychological Services Program. Funder: Children Services Advisory Committee E. COLLABORATION (Entire Section E not to exceed one page) 1 . List your program's collaborative partners and the resources that they are providing to the program beyond referrals and support. (See individual funder requirements for inclusion of collaborative agreement letters.) Collaborative Agency Resources provided to the program Parent/Teacher Education Partnership 1 . Parent education classes are offered to families in of Indian River County, consisting of participating agencies and to the community at large. Childcare Resources, Early Learning 2. PTEP provides a forum in which members share Coalition, FDLRS, Head Start, pertinent information regarding families moving from RCMA, IRC School District, and program to program within the partnership. Early United Way of IRC childhood research, innovative program ideas, etc. are also shared. 3 . PTEP is a liaison between the county ' s childcare t1ndhanThe iders, helping centers remain abreast of "best tices" in early childhood education. tLeamingg Schooschool district tracks Childcare Resources children ugh their database with regard to school readiness. dcare Resources provides background information e school district regarding the children from our ram. tion oFamily & Center Resource Coordinator seryes on River, Martin and Okeechobee the Indian River County Advisory Committee for the Counties Early Learning Coalition. United Way Success BySix The Executive Director serves on the Success By Six committee committee. YMCA The Executive Director works closely with the staff of the YMCA in establishing a presence in Indian River County. It is hoped that at some point the YMCA will be able to provide quality childcare here as they do elsewhere. Association of Fundraising The Executive Director serves as Vice-President of this Professionals-Indian River Chapter organization. This provides networking and educational opportunities which directly benefit Childcare Resources. Agency Executives Forum-United The Executive Director served from Sept. 2005 to Way of Indian River County December 2006 as the Moderator of this body, facilitating quarterly meetings, etc. She continues to participate in these networking and educational meetings. 10 0 0 �. y °O W IO 'PEP ` s ,WI � p O v iRLyE i i i i i i i i i i i � v� Y I� a frl f'7 ¢ IZ C 66 1 cur N PC s o q 0 t , A Fy ^ i.! CC Lhq y y 10 00 y .ti �p,i SwM"1a .r �F5 ti a" U U 5 Ca � � 4�c a 5 ra C ^�.,, Ngag � �. V O 0 0. C5 4'knM p C o m v t+" GC O U .. v y U � 'b rWi O = as p W o tiLW a cer. a a o o dH' s ` ' ❑ O ° Childcare Resources of Indian River, Inc. Psychological Services Program. Funder: Children Services Advisory Committee F ing needed for your program, including required experience and estimated week in program for each staff member and/or volunteers (this section nform to the information in the Position Listing on the Budget Narrative et).ector: On average 8 hours a week are devoted to program. Experience/expertise in: istributing funding for the program, monitoring compliance regarding reporting and billing procedures, maintaining a "bank" of qualified therapists to serve families at a reduced hourly billing rate. Family & Center Resource Coordinator• On average 10 hours a week are devoted to the program. Experience/expertise in: assessing referrals, monitoring treatment plans, implementing program changes in the classroom, serving as a liaison among parents, therapists, and centers . Office Manager: On average 4 hours a week are devoted to the program. Experience/expertise in: processing invoices from providers, monitoring parent compliance regarding fee payments, checking family health insurance benefits. Center Recruitment Specialist None of the hours for this position are devoted to the Psychological Services Program, 5. How will the target population be made aware of the program? Childcare Resources families are made aware of the psychological support program during intake, at our orientation, and individually through the Family Resource Coordinator. Reminders are included in our monthly parent newsletter. We make a habit of having a contracting therapist available at orientation to introduce the program and encourage parent participation. h1 addition, center staffs are aware of the availability of the program and refer families in need. FRowll the program be accessible to target population (i.e., location, transportation, operation)? arameters of therapist specialty, there is parental choice. This enables a parent to rapist convenient to home or work. Some contracting therapists have evening and ointments available for Childcare Resources families. Some contracting therapistso hold individual therapy sessions at the child' s center. Parents unable to pay the $5 fee may have it waived through the Childcare Resources Program Committee. 6 Childcare Resources of Indian River, Inc. Psychological se[vices Program. Funder: Children Services Advisory Committee l expand as you Outcome ## 1 . 80% of those families referred for treatment will 1participate in treatment l as measured by the number of completed Mental Health Provider forms . Program Design & Task Management (Columns 1 -4) Evaluation Design & Data Collection (Columns 5-7) 3 4 Program Frequency Responsible Parties Expected Activities (how often) (who) p Indicator Data Source Time of (what) ) Outcomes/change (why) Measurements (where)) Measurement (when) (evidence) Referrals and self- As needed Teachers, parents Will participate in referrals for mental p p Patient's attendance Mental Health After initial visit and refer r Family & counseling with counselor Provider form every six month health services Center Resource Coordinator who thereafter or until refers to a thera ist sessions have stopped 7 Chiltlrare RemurceslPsychologlcal Services 2007-2008 CORE 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 : Childcare Resources/Psychological Services FUNDER: Children 's Services Advisory Committee - . . . . . . . . . . _ • . _ • . _ • . _ • . • • . _ . • _ . . _ • . _ • • _ • - _ • . _ • • _ • • _ . . . . . . . . . . . . _ _ _ _ _ _ _ . . . . . . . . CAUTION : Do not enter any figures where a cell is colored in dark blue - Formulas and/or links are in place_ Gray areas should ybe used for providing information and calculations only. �7� .REVENUES Proposed Total Program Budget Funder Specific - Total Agency Budget . Budget 1 Children's Services Council-St Lucie 2 Children's Services Council-Martin 3 Advisory Committee-Indian ver 7,000.00 7,000.00 217,000.00 4 United Way-St Lucie CountyRi 5 United Way-Martin County 6 United Way-Indian River County 4,000.00 208,872.00 7 Department of Children & Families 8 County Funds 9 Contributions-Cash 12 , 000.00 10 Program Fees 0.00 69,000.00 2,000 .00 0.00 98,000.00 11 Fund Raising Events-Net 15,500.00 0.00 38,520.00 12 Sales to Public - Net 13 Membership Dues 5,000.00 0.00 117,500.00 141 Income 1 ,000.00 0.00 3,800.00 15Milaneous 16 ! . e�gEaHc!ie & Bequests 17 Funds from Other Sources 18 Reserve Funds Used for Operating 19 In-Kind Donations (Not included in total 2,000.00 0.00 8,000.00 20 TOTAL REVENUES (doesn't include line 19) $46,500.00 $7,000.00 $752 ,692.00 A B _ . C EXPENDITURES - proposed Total Program Budget Funder Specific Total Agency _ Budget. Bud et 21 Salaries - (must complete chart on next page 25,470. 00 0.00 150,000-00 22 FICA - Total salaries x 0.0765 1 ,948.46 0.00 11 ,475.00 e lremen - nnua pension or qua ! le 23 staff Life/Health - Medical/Dental/Short-term 24 Disab. Workers Compensation - # employees x 25 rate 600.00 0. 00 800.00 on a Hemp oyment - pro/ec e 26 employees x $7,000 x UCT-6 rate 52!2007 B-1 ChidmResources/Rsychological Services SALARIES 1 . Gross 11 N POSITION LISTING Annual Salary Portion of Salary on Proposed Ill Funder % of Gross Annual Position Trtfel Total Urs/wk (Agency) Program Specific Budget Salary Requested(c/A) Fxampfe: -. Fxecudve oireeterl40 his 70,000.00 10,000.00 5,000.00 Z14% Executive Director/40 hours 61 ,000.00 12 ,220.00 0.00 7.14% Family & Center Resource Coordinator/40 hr 41 , 000.00 10,250.00 Office Manager/40 hours 30,000.00 0.00 0.00% 3,000.00 0. 00 0,00% Center Recruitment Specialist/20 hours 18 ,000.00 0.00 0.00 0.00% #DIV/0! #DIV/0 ! #DIV/0! #DIV/0! #DIV/0! #DIV/o! #DIV/0! #D1 70- 1 #DIV/0! #DIV/Ol #DIV/0! #DIV/O ! #D i V/Ui #DIV/0 ! #DIVlO! Remaining positions throughout the agency M #DIV/O! Total Salaries $ 150,000.00 $25,470.00 ° FRINGE BENEFITS DETAIL (Funder Specific Budget I Funder ll !n IV v w vh Column C only, from line 21 to 26) Specific Budget FICA 7.65% Pension - Health Worker's Unemployrne Total Fringes Funder : (Ax %) Ins. Compens. of comperes. Specific Position Title / Total Hrs/wk Example: Case Manager/40:hm 5,000.00 382.50 200.00 500.00 . 300.00 . 200.00 1,582.50 Executive Director/40 hours 0. 00 0.00 Family & Center Resource Coordinator/40 hr 0.000.00 o.o0 0.00 Office Manager/40 hours 0. 00 0.00 Center Recruitment Specialist/20 hours 0.00 0.00 0.00 0.00 0 0. 00 0.00 0 0.00 0.00 0.0 0 0.00 0.00 0.00 0.00 0.00 0. 00 0 0. 0 0.00 0.00 .0 0 0.00 0. 00 0 0.00 0.00 0.00 0.00 o.o0 0.00 0 0.00 0.00 o.00 o.00 0 0. 00 0.00 0 0.00 o-oo 0.00 0.00 0. 00 0.00 0 0.00 0.00 0.00 o.00 o.o0a.00 0 0.00 0.00 0.00 0.00 o.00 00o o. 00 Total Funder Request Fringe Benefits $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 E7 A B C EXPENDITURES Specific Total Proposed Tota! Program Budget Funder SpAgency Budget srzrzom 9 Budget e-� Childcare Resources of Indian River, Inc. Psychological Services Proginm. Funder Children Services Advisory Comnuttee (Boxes will expand as you type.) Ebytthe ome # 2 : 85 % of individuals attending more than two therapy sessions will raise their functioning within the school year, as measured discharge score for the Global Assessment of Functioning (GAP) test or other screening devices . Baseline: Admission GAF score. Program Design & Task Management (Columns1 -4) l valuation Design & Data Collection — (Columns 5-7) Program Activities Fre uenc —r 6� I 7 what 9 y Responsible Expected Indicator Data Source (what) (huw often) Parties (who) Outcomes/change Measurements where Time of (why) (evidence) ( ) Measurement (when) Therapy with licensed As needed Parents, therapists, Adults, older mental health providers GAF scores or Mental Health GAF: At initial visit center staff siblings: improved feedback from Provider form. and every six months ability to deal with other screening Young children : after. issues that caused devices. For treatment plan self-referral; very young children, young children: feedback from improved behavioral parents and or developmental teachers. ro ress 8 Childcare Resources of Indian River, Inc. Psychological services Program. Funder: Children services Advisory Committee (Boxes will expand as you type.) Outcome #3 : To increase the level of appropriate behavior of children who have received clinical intervention during the 2007-2008 school year by an average of 10% as measured by the spring DECA and/or classroom teacher assessments. Baseline: Teacher assessments and/or fall DECA assessments. Program Design & Task Management ]Evaluation Design & Data Collection (Columns 1 -4) (Columns 5-7) Program Activities Frequency Responsible Expected 7 (what) P Indicator Data Source Time of (how often) Parties (who) Outcomes/change Measurements (where) Measurement (wily) I (evidence) (when) Behavioral and As needed Parents, therapists, Improved behavior Child's and/or DECA scores Fall and spring of developmental center staff intervention performance on school year developmental DECA progress assessments 9 Chifdc re Resou¢ slPsyc ological Sewims 27 Travel-Daily 312.801 0.001 1 ,840.00 #. of Staff x average # of miles/wk x 50 wks x $ ;= Estimated Dally Travel/Mileage ..Reimb. 28 Travel/Conferences/Training - 391 .00 ;;;00 2,300.00 * 'National Conference (cost per staff) • Training/Seminar (cost per staff) Other Trainngs (cost of travel lodging, registration, food) - - 29 Office Supplies 312 .80 0.00 1 ,840.00 ` Office supplies (monthly average x 12 months =estimated cost of office supplies based on present history. - 30 Telephone 547.00 0.00 3,220.00 - # Phone lines x average cost per month x 12 months = local phone cost Average long distance calls x 12 months = Estimated cost of long distance 31 Postage/Shipping 422.28 0 .00 2,484.00 • Quarterly Mailing of Newsletter • Special events, etc. • Bulk mailings- appeals 32 Utilities 500 .48 0.00 2 ,944.00 • Electricity ($ x 12 months) • Water/Sewer ($ x12 months) • Garbage ($ x 12 months) 33 Occupancy (Building & Grounds) 594. 32 0.00 3 ,496.00 • Mortgage/Rent ($ z 12 months) • Janitorial .($ x 12 months) • Grounds Maint. ($ x 12 months) • Real Estate Taxes 34 Printing & Publications 578.68 0.00 3,404.00 • Quarterly Newsletter IS x 4) • Letterheads, .Envelopes, etc. • Fundraisingmaterials •. Other 35 Subscription/Dues/Memberships 203.321 0.00 11196.00 • Membership to National Organization • Dues • Subscriptions to Newspapers/magazines, etc. 36 Insurance 583.44 0.00 3,432.00 • Directors/Officers Liab. • Commercial/General insurance • Auto Insurance - - 37 Equipment:Rental & Maintenance 109.481 0.00 644.00 • Copier lease' ($ x 12 months) • Meter lease ($ x 12 months) • Copier Maintenance ($ x 12 months) - Computer Maintenance ( $ x 12 months) •-Other 38 Advertising 469.20 ().001 21760.00 - •- Newspaper ads • Fundraising ads/promotions • Other (vacancies) 39 Equipment Purchases:Capital Expense 234.60 0.00 11380. 00 • Computer/monitor (# x $) • Laser Printer 40 Professional Fees (Legal, Consulting) 11 ,000.001 7,000.001 11 ,350.00 erz W7 s-i ChilO re Reswme synhologioel Services • Legal advice ( estimated #hrs x $):: • Consultant fees •. Other 41 Books/Educational Materials 187.68 '. Bookslvideos - 0.00 1 , 104.00 • Materials ($,x staff) - 42 Food & Nutrition • Meals ( # meals x clients x 5daysz 50 wks) 234.60 0. 00 1 ,380.00 . Snacks 43 Administrative Costs 0.00 0.00 3,804.00 AdminCost. (% of total budget) 44 Audit Expense _ . . 1 , 329.40 0.00 7,820.00 Independent Audits Review 45 Specific Assistance to Individuals 170. 00 • Medical assistance 0 .00 1 , 000.00 • Meals/Food • Rent Assistance • Other 46 Other/Miscellaneous 289.34 •. Background check/drugtest D.00 1 , 702 . 00 • Other 47 Other/Contract 0.00 0.00 531 ,316.00 - Sub-contract for program services 48 TOTAL EXPENSES $46A88 . 88 $7,000. 00 $752s91 .00 srzaca� e-, Childcare Resources of Indian River, Inc. Psychological Services Program. Funder: Children Services Advisory Committee E. COLLABORATION (Entire Section E not to exceed one page) 1 . List your program's collaborative partners and the resources that they are providing to the program beyond referrals and support. (See individual funder requirements for inclusion of collaborative agreement letters.) Collaborative Agency Resources provided to the program Parent/Teacher Education Partnership 1 . Parent education classes are offered to families in of Indian River County, consisting of participating agencies and to the community at large. Childcare Resources, Early Learning 2. PTEP provides a forum in which members share Coalition, FDLRS, Head Start, pertinent information regarding families moving from RCMA, IRC School District, and program to program within the partnership. Early United Way of IRC childhood research, innovative program ideas, etc. are also shared. 3 . PTEP is a liaison between the county ' s childcare t1ndhanThe iders, helping centers remain abreast of "best tices" in early childhood education. tLeamingg Schooschool district tracks Childcare Resources children ugh their database with regard to school readiness. dcare Resources provides background information e school district regarding the children from our ram. tion oFamily & Center Resource Coordinator seryes on River, Martin and Okeechobee the Indian River County Advisory Committee for the Counties Early Learning Coalition. United Way Success BySix The Executive Director serves on the Success By Six committee committee. YMCA The Executive Director works closely with the staff of the YMCA in establishing a presence in Indian River County. It is hoped that at some point the YMCA will be able to provide quality childcare here as they do elsewhere. Association of Fundraising The Executive Director serves as Vice-President of this Professionals-Indian River Chapter organization. This provides networking and educational opportunities which directly benefit Childcare Resources. Agency Executives Forum-United The Executive Director served from Sept. 2005 to Way of Indian River County December 2006 as the Moderator of this body, facilitating quarterly meetings, etc. She continues to participate in these networking and educational meetings. 10 0 0 �. y °O W IO 'PEP ` s ,WI � p O v iRLyE i i i i i i i i i i i � v� Y I� a frl f'7 ¢ IZ C 66 1 cur N PC s o q 0 t , A Fy ^ i.! CC Lhq y y 10 00 y .ti �p,i SwM"1a .r �F5 ti a" U U 5 Ca � � 4�c a 5 ra C ^�.,, Ngag � �. V O 0 0. C5 4'knM p C o m v t+" GC O U .. v y U � 'b rWi O = as p W o tiLW a cer. a a o o dH' s ` ' ❑ O ° CFN aWsw ,v➢sytivYgalSwrm' 2007-2008 CORE GRANT APPLICATION TOTAL AGENCY BUDGET AGENCY/PROGRAM NAME:Childcare Resources/Psychological Services FY 05106 FY GWY7 FY 07/08 KINCREASE FYE 6/30/06 FYE 6/30/07 FYE 6130/08 CURRENT VS. A B NEXT FY BUDGET C D ACTUAL TOTAL PROPOSED (<ai. Cco� epcm. e REVENUES BUDGETED BUDGETED 1 Children's Services Council-St Lucie 0.00 2 Children's Services Council-Martin 0.00 3 Adviso Committee-Indian River 187,234.92 197,000.00 217,000.00 10.15% 4 United We St Lucie Coun D.oD 5 Unitetl we -Martin Coun 0.00 6 Unitetl we -Indian River Coun 191 , 152.00 197, 152.00 208,872.00 5.94% 7 Department of Children & Families 0.00 8 Coun Funds 0.00 s Contributions-Cash 47,529.00 41 ,000.00 69,000.00 68.29% 10 Pro ram Fees 83,744.00 90,000.00 98,000.00 8.89 11 Fund Raisin Events-Net 7,848.03 19,800.00 38,520.00 94.55 12 Sales to Public-Net 13 Membership Dues0'00 114,950.00 119,000.00 117,500.00 -1 .26% 14 Investment Income 3,751.05 4,000.00 3,800.00 -5.00% 15 Miscellaneous 0.00 16 Le acies & 8eques[s 0-00 17 Funds from Other Sources 18 Reserve Funds Used for Operating 0.000.00 191n-Kind Donations (Not inductee m total! 8,000.00 0.00 8,000.00 20 TOTAL 636,209.00 667,952.00 752,692.00 12.69% EXPENDITURES 21 Salaries 110,61059 117,000.00 150,000.00 28.21 % 22 FICA 8,240.22 8,950.50 11 ,475.00 28.21% 23 Retirement 24 Life/Health 0.00 25 Workers Compensation 1,080.00 1,300 0.00.00 800.00 38.46% 26 Florida Unemplo ment 0.00 27 Travel-Dail 1,499.22 1,380.00 1 ,840.00 33.33% 28 TravellConferences/Trainin 1 ,269.38 11800.00 2,300.00 27.78% 29 Office Sup lies 3,587.53 1,840.00 1,840.00 30 Telephone . 3,318.42 2,944.00 3,220.00 31 Posta a/Ship in 3,803.82 3,588.00 2,484.00 32 Utilities 3,103.72 2,760.00 2,944.00 33 Occupanc (Buildin & Grounds) 7,144.46 3,680.00 3,496.00 Printin & Publications 9,409.57 6,256.00 3,404.00 45.59% 35 Subscrl tion/Dues/Memberships 2,320.00 460.00 1 ,196.00 160.00% 3 Insurance 3,856.11 4,048.00 3,432.00 37 Equipment:Rental & Maintenance 910.00 920.00 644.00 -30.00% 38 Advertisin 1 ,397.27 3,036.00 2,760.00 -9.09% 39Equi ment Purchases:Ca ital Expense 5,172.42 920.011 1,380.00 50.00% 0 Professional Fees (L al, Consultin ) 9,465.00 11,350.00 11,350.00 0.00% 41 Books/Educational Materials 504.22 1 ,380.00 1 ,104.00 -20.00% 42 Food & Nutrition 1 ,695.39 1 ,380.00 1,380.00 0.00% 4 Administrative Costs 3,500.00 3,848.00 31804.00 _1 .14% Audit Expense 7,000.00 6,900.00 7,620.00 13.33% 45 Specific Assistance to Individuals 884.00 2,000.00 1 ,000.00 - -50.00% 46 OtherfMiscellaneous 1 ,20619 4fi0.00 1,702.00 270.00% 47 Other/Contract 386,892.25 479,682.00 531,316.00 10.76% 48 TOTAL 577,869.88 667,882.50 752,691 .00 12.70% 49 REVENUES OVER/(UNDER) EXPENDITURES 58,339. 12 69.50 1.00 -98.56 szx,o� az - GFdlveFeswaLPaycMkpy S>viRg 2007-2008 CORE GRANT APPLICATION TOTAL PROGRAM BUDGET AGENCY/PROGRAM NAME:Childcare Resources/Psychological Services FY 05/06 FY06/07 FY 07/08 % INCREASE FYE 6130/06 FYE 6/30/07 FYE 6/30108 CURRENT VS. A NEXT FY BUDGET B C D ACTUAL TOTAL PROPOSED (ca. Ccnl. ellcol. s REVENUES BUDGETED BUDGETED 1 Children's Services Council-St. Lucie Children's Services Council- 0.00 Martin 3 Adviso Committee4ndian River0.00 Uni 61705.00 7,000.00 7,000.00 0.00% ted Wa SL Lucie Coun - 5 United We -Martin Coun 0.00 United We -Indian River Coun0.00 4,000.00 4,000.00 4,000.00 0,00% 7 De rtment of Children & Families 6 Coun Funds 0.00 9 Contributions-Cash 0.00 8,000.00 0.00 12,000.00 1 Pro ram Fees 3,60D.00 6,000.00 2,000.00 11 Fund Raisin Events-Net -66.67% 8,750.00 5,000.00 15,500.00 210.00% 12 Sales to Public-Net 13 Membership Dues 0.00 to Investment Income 61000.00 17,000.00 51000.00 -70.59% 15 Miscellaneous 1 ,000.00 16 Le agle6 & Bequests 0.00 17 Funds from Other Sources 0.00 7 Reserve Funds Used for Operetin 0.00 19 In-Kind Donations (Nat wduded in twe0 0.00 0.00 2,000.00 20 TOTAL 36,055.00 39,000.00 46,500.00 19.23 EXPENDITURES 21 Salaries 21 ,500.35 22,793.74 25,470.00 22 FICA 11 .74 menf 1 ,644.75 1 ,743.72 1,948.46 11 .74% 23 Retire za LifeMealth 0.00 25 Workers Com ensation 0.00 250.00 - 300.00 600.00 100.00 zs Florida Unemplo ment 27 Travel-Dail 0.00 20.00 66.00 312.80 373.94% 28 irevel/ConferenceslTraining 0.00 55.00 391.00 29 Office Sup lies 610.91 % 600.00 276.00 312.60 13.33 30 Tele hone 650.00 193.00 31 Posta efShi PPin 547.00 183.08% 500.00 221.00 422.28 91 .08% 3 Utilities 200.00 207.00 33 Occupant (Buildin & Grounds 500.48 141'78% 1 ,000.00 955.00 594.32 -37.77% Printin & Publications 500.00 442,00 3 Subscri tion/Dues/Memberships 578.68 30.92% - 0.00 50.00 203.32 306.64% 36 Insurance 0.00 276.00 583.44 37 Equi ment:Rental & Maintenance 111'39% 0.00 66.00 109.48 65.88 3 Ativertisin 0.00 55.00 01. 39 E uipment Purchases:Capi[al Expense 469.20 753.09% 0.00 83.00 234.60 182.65 Professional Fees (Le al, Consultin ) 9,115.00 11,000.00 11,000.00 41 Books/Educetional Materials 0.00% 0.00 90.00 187.68 108.53% 4 Food & Nutrition 0.00 72.00 234.60 225.83% 43 Administrative Costs 0.00 0.00 Audit Expense 0.00 0.00 0.00 1,329.40 as S ecific Assistance to Individuals 0.00 0.00 170.00 4 Other/Miscellaneous 0.00 55.00 289.34 426.07% 47 Other/Contract 48 TOTAL 0.00 0.00 0.00 35,980ALI 38,999.46 46,488.88 19.200/. 49 REVENUES OVER/(UNDER) EXPENDITURES 74.90 0.54 11. 12 srzrzod� e� Chiltlrare RemurceslPsychologlcal Services 2007-2008 CORE 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 : Childcare Resources/Psychological Services FUNDER: Children 's Services Advisory Committee - . . . . . . . . . . _ • . _ • . _ • . _ • . • • . _ . • _ . . _ • . _ • • _ • - _ • . _ • • _ • • _ . . . . . . . . . . . . _ _ _ _ _ _ _ . . . . . . . . CAUTION : Do not enter any figures where a cell is colored in dark blue - Formulas and/or links are in place_ Gray areas should ybe used for providing information and calculations only. �7� .REVENUES Proposed Total Program Budget Funder Specific - Total Agency Budget . Budget 1 Children's Services Council-St Lucie 2 Children's Services Council-Martin 3 Advisory Committee-Indian ver 7,000.00 7,000.00 217,000.00 4 United Way-St Lucie CountyRi 5 United Way-Martin County 6 United Way-Indian River County 4,000.00 208,872.00 7 Department of Children & Families 8 County Funds 9 Contributions-Cash 12 , 000.00 10 Program Fees 0.00 69,000.00 2,000 .00 0.00 98,000.00 11 Fund Raising Events-Net 15,500.00 0.00 38,520.00 12 Sales to Public - Net 13 Membership Dues 5,000.00 0.00 117,500.00 141 Income 1 ,000.00 0.00 3,800.00 15Milaneous 16 ! . e�gEaHc!ie & Bequests 17 Funds from Other Sources 18 Reserve Funds Used for Operating 19 In-Kind Donations (Not included in total 2,000.00 0.00 8,000.00 20 TOTAL REVENUES (doesn't include line 19) $46,500.00 $7,000.00 $752 ,692.00 A B _ . C EXPENDITURES - proposed Total Program Budget Funder Specific Total Agency _ Budget. Bud et 21 Salaries - (must complete chart on next page 25,470. 00 0.00 150,000-00 22 FICA - Total salaries x 0.0765 1 ,948.46 0.00 11 ,475.00 e lremen - nnua pension or qua ! le 23 staff Life/Health - Medical/Dental/Short-term 24 Disab. Workers Compensation - # employees x 25 rate 600.00 0. 00 800.00 on a Hemp oyment - pro/ec e 26 employees x $7,000 x UCT-6 rate 52!2007 B-1 ChidmResources/Rsychological Services SALARIES 1 . Gross 11 N POSITION LISTING Annual Salary Portion of Salary on Proposed Ill Funder % of Gross Annual Position Trtfel Total Urs/wk (Agency) Program Specific Budget Salary Requested(c/A) Fxampfe: -. Fxecudve oireeterl40 his 70,000.00 10,000.00 5,000.00 Z14% Executive Director/40 hours 61 ,000.00 12 ,220.00 0.00 7.14% Family & Center Resource Coordinator/40 hr 41 , 000.00 10,250.00 Office Manager/40 hours 30,000.00 0.00 0.00% 3,000.00 0. 00 0,00% Center Recruitment Specialist/20 hours 18 ,000.00 0.00 0.00 0.00% #DIV/0! #DIV/0 ! #DIV/0! #DIV/0! #DIV/0! #DIV/o! #DIV/0! #D1 70- 1 #DIV/0! #DIV/Ol #DIV/0! #DIV/O ! #D i V/Ui #DIV/0 ! #DIVlO! Remaining positions throughout the agency M #DIV/O! Total Salaries $ 150,000.00 $25,470.00 ° FRINGE BENEFITS DETAIL (Funder Specific Budget I Funder ll !n IV v w vh Column C only, from line 21 to 26) Specific Budget FICA 7.65% Pension - Health Worker's Unemployrne Total Fringes Funder : (Ax %) Ins. Compens. of comperes. Specific Position Title / Total Hrs/wk Example: Case Manager/40:hm 5,000.00 382.50 200.00 500.00 . 300.00 . 200.00 1,582.50 Executive Director/40 hours 0. 00 0.00 Family & Center Resource Coordinator/40 hr 0.000.00 o.o0 0.00 Office Manager/40 hours 0. 00 0.00 Center Recruitment Specialist/20 hours 0.00 0.00 0.00 0.00 0 0. 00 0.00 0 0.00 0.00 0.0 0 0.00 0.00 0.00 0.00 0.00 0. 00 0 0. 0 0.00 0.00 .0 0 0.00 0. 00 0 0.00 0.00 0.00 0.00 o.o0 0.00 0 0.00 0.00 o.00 o.00 0 0. 00 0.00 0 0.00 o-oo 0.00 0.00 0. 00 0.00 0 0.00 0.00 0.00 o.00 o.o0a.00 0 0.00 0.00 0.00 0.00 o.00 00o o. 00 Total Funder Request Fringe Benefits $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 E7 A B C EXPENDITURES Specific Total Proposed Tota! Program Budget Funder SpAgency Budget srzrzom 9 Budget e-� Gd]care Re;owceyPzyc�ob9icS SeMc� - AGENCY/PROGRAM NAME:Childcare F FUNDER:Children's Services Advisory Children's Services Council-SL Lucie Children's Services Council-Martin United Way-St. Lucie Coun United Way-Martin CounpL Department of Children & Families q2gqkFuqdS Contributions-Cash Fund Raisino Events-Net Sales to Public-Net Investment Income Miscellaneous Le acies & Beguests Funds from Other Sources Reserve Funds Used for Operating In-Kind Donations Not included in total Retirement - L-delHeahh Workers Compensation Florida Unem to Ment Travel-Dail Travel/Conferencesrrrainin Telephone Posta a/Shi in Utilities Printing & Publications Subscri bonlDues/Membemhi s Insurance E ui mentRental & Maintenance Advertisin Equipment Purchases:Ca ital Ex ens¢ BookslEducational Materials Food & Nutrition Administrative Costs Audit Exg2nse Specific Assistance to Individuals Other/Miscellaneous OthedContract W] 65 crew n�.�rcYmaoy�m s� AGENCYIPROGRAM NAME:Childcare F FUNDER:Children's Services Advisory #ON/O! #ONTO! #DIVIO! #DIV/0! Professional Fees Le al ConsulOn #DIVIO! #DNIO! s2TOD; e s Chifdc re Resou¢ slPsyc ological Sewims 27 Travel-Daily 312.801 0.001 1 ,840.00 #. of Staff x average # of miles/wk x 50 wks x $ ;= Estimated Dally Travel/Mileage ..Reimb. 28 Travel/Conferences/Training - 391 .00 ;;;00 2,300.00 * 'National Conference (cost per staff) • Training/Seminar (cost per staff) Other Trainngs (cost of travel lodging, registration, food) - - 29 Office Supplies 312 .80 0.00 1 ,840.00 ` Office supplies (monthly average x 12 months =estimated cost of office supplies based on present history. - 30 Telephone 547.00 0.00 3,220.00 - # Phone lines x average cost per month x 12 months = local phone cost Average long distance calls x 12 months = Estimated cost of long distance 31 Postage/Shipping 422.28 0 .00 2,484.00 • Quarterly Mailing of Newsletter • Special events, etc. • Bulk mailings- appeals 32 Utilities 500 .48 0.00 2 ,944.00 • Electricity ($ x 12 months) • Water/Sewer ($ x12 months) • Garbage ($ x 12 months) 33 Occupancy (Building & Grounds) 594. 32 0.00 3 ,496.00 • Mortgage/Rent ($ z 12 months) • Janitorial .($ x 12 months) • Grounds Maint. ($ x 12 months) • Real Estate Taxes 34 Printing & Publications 578.68 0.00 3,404.00 • Quarterly Newsletter IS x 4) • Letterheads, .Envelopes, etc. • Fundraisingmaterials •. Other 35 Subscription/Dues/Memberships 203.321 0.00 11196.00 • Membership to National Organization • Dues • Subscriptions to Newspapers/magazines, etc. 36 Insurance 583.44 0.00 3,432.00 • Directors/Officers Liab. • Commercial/General insurance • Auto Insurance - - 37 Equipment:Rental & Maintenance 109.481 0.00 644.00 • Copier lease' ($ x 12 months) • Meter lease ($ x 12 months) • Copier Maintenance ($ x 12 months) - Computer Maintenance ( $ x 12 months) •-Other 38 Advertising 469.20 ().001 21760.00 - •- Newspaper ads • Fundraising ads/promotions • Other (vacancies) 39 Equipment Purchases:Capital Expense 234.60 0.00 11380. 00 • Computer/monitor (# x $) • Laser Printer 40 Professional Fees (Legal, Consulting) 11 ,000.001 7,000.001 11 ,350.00 erz W7 s-i ChilO re Reswme synhologioel Services • Legal advice ( estimated #hrs x $):: • Consultant fees •. Other 41 Books/Educational Materials 187.68 '. Bookslvideos - 0.00 1 , 104.00 • Materials ($,x staff) - 42 Food & Nutrition • Meals ( # meals x clients x 5daysz 50 wks) 234.60 0. 00 1 ,380.00 . Snacks 43 Administrative Costs 0.00 0.00 3,804.00 AdminCost. (% of total budget) 44 Audit Expense _ . . 1 , 329.40 0.00 7,820.00 Independent Audits Review 45 Specific Assistance to Individuals 170. 00 • Medical assistance 0 .00 1 , 000.00 • Meals/Food • Rent Assistance • Other 46 Other/Miscellaneous 289.34 •. Background check/drugtest D.00 1 , 702 . 00 • Other 47 Other/Contract 0.00 0.00 531 ,316.00 - Sub-contract for program services 48 TOTAL EXPENSES $46A88 . 88 $7,000. 00 $752s91 .00 srzaca� e-, CNN , Re urm sycP 9-w SPrncrs 2007-2008 CORE GRANT APPLICATION EXPLANATION FOR VARIANCES OF 15% OR MORE TOTAL PROGRAM BUDGET Resource/Psychological Services Committee Greater proportion of these gifts will be applied to this program. Greater proportion of these funds will be applied to this program. Greater proportion of these funds will be applied to this program. Greater proportion of these gifts will be applied to this program. KReflects ealignment of program expenses. ealignment of program expenses. Reflects realignment of program expenses. Refleds realignment of program expenses. Reflects realignment of program expenses. Reflects realignment of program expenses. Reflects realignmerrl of program expenses. Reflects realignment of program expenses. Reflects realignment of program expenses. Reflects realignment of program expenses_ Reflects realignment of program expenses. Reflects realignment of program expenses. Refleds realignment of program expenses. Retieds realignment of program expenses. Reflects realignment of program expenses. Reflects realignment of program expenses. Reflects realignment of program expenses. Refleds realignment of program expenses. 5r 07 ss Ghlmre Rewwmv%ytlicYgcel S¢Mcn 2007=2008 CORE GRANT APPLICATION EXPLANATION FOR VARIANCES OF 15% OR MORE FUNDER SPECIFIC BUDGET ZesourceslPsychological Services Committee No need to write an explanation. &=007 es CFN aWsw ,v➢sytivYgalSwrm' 2007-2008 CORE GRANT APPLICATION TOTAL AGENCY BUDGET AGENCY/PROGRAM NAME:Childcare Resources/Psychological Services FY 05106 FY GWY7 FY 07/08 KINCREASE FYE 6/30/06 FYE 6/30/07 FYE 6130/08 CURRENT VS. A B NEXT FY BUDGET C D ACTUAL TOTAL PROPOSED (<ai. Cco� epcm. e REVENUES BUDGETED BUDGETED 1 Children's Services Council-St Lucie 0.00 2 Children's Services Council-Martin 0.00 3 Adviso Committee-Indian River 187,234.92 197,000.00 217,000.00 10.15% 4 United We St Lucie Coun D.oD 5 Unitetl we -Martin Coun 0.00 6 Unitetl we -Indian River Coun 191 , 152.00 197, 152.00 208,872.00 5.94% 7 Department of Children & Families 0.00 8 Coun Funds 0.00 s Contributions-Cash 47,529.00 41 ,000.00 69,000.00 68.29% 10 Pro ram Fees 83,744.00 90,000.00 98,000.00 8.89 11 Fund Raisin Events-Net 7,848.03 19,800.00 38,520.00 94.55 12 Sales to Public-Net 13 Membership Dues0'00 114,950.00 119,000.00 117,500.00 -1 .26% 14 Investment Income 3,751.05 4,000.00 3,800.00 -5.00% 15 Miscellaneous 0.00 16 Le acies & 8eques[s 0-00 17 Funds from Other Sources 18 Reserve Funds Used for Operating 0.000.00 191n-Kind Donations (Not inductee m total! 8,000.00 0.00 8,000.00 20 TOTAL 636,209.00 667,952.00 752,692.00 12.69% EXPENDITURES 21 Salaries 110,61059 117,000.00 150,000.00 28.21 % 22 FICA 8,240.22 8,950.50 11 ,475.00 28.21% 23 Retirement 24 Life/Health 0.00 25 Workers Compensation 1,080.00 1,300 0.00.00 800.00 38.46% 26 Florida Unemplo ment 0.00 27 Travel-Dail 1,499.22 1,380.00 1 ,840.00 33.33% 28 TravellConferences/Trainin 1 ,269.38 11800.00 2,300.00 27.78% 29 Office Sup lies 3,587.53 1,840.00 1,840.00 30 Telephone . 3,318.42 2,944.00 3,220.00 31 Posta a/Ship in 3,803.82 3,588.00 2,484.00 32 Utilities 3,103.72 2,760.00 2,944.00 33 Occupanc (Buildin & Grounds) 7,144.46 3,680.00 3,496.00 Printin & Publications 9,409.57 6,256.00 3,404.00 45.59% 35 Subscrl tion/Dues/Memberships 2,320.00 460.00 1 ,196.00 160.00% 3 Insurance 3,856.11 4,048.00 3,432.00 37 Equipment:Rental & Maintenance 910.00 920.00 644.00 -30.00% 38 Advertisin 1 ,397.27 3,036.00 2,760.00 -9.09% 39Equi ment Purchases:Ca ital Expense 5,172.42 920.011 1,380.00 50.00% 0 Professional Fees (L al, Consultin ) 9,465.00 11,350.00 11,350.00 0.00% 41 Books/Educational Materials 504.22 1 ,380.00 1 ,104.00 -20.00% 42 Food & Nutrition 1 ,695.39 1 ,380.00 1,380.00 0.00% 4 Administrative Costs 3,500.00 3,848.00 31804.00 _1 .14% Audit Expense 7,000.00 6,900.00 7,620.00 13.33% 45 Specific Assistance to Individuals 884.00 2,000.00 1 ,000.00 - -50.00% 46 OtherfMiscellaneous 1 ,20619 4fi0.00 1,702.00 270.00% 47 Other/Contract 386,892.25 479,682.00 531,316.00 10.76% 48 TOTAL 577,869.88 667,882.50 752,691 .00 12.70% 49 REVENUES OVER/(UNDER) EXPENDITURES 58,339. 12 69.50 1.00 -98.56 szx,o� az - GFdlveFeswaLPaycMkpy S>viRg 2007-2008 CORE GRANT APPLICATION TOTAL PROGRAM BUDGET AGENCY/PROGRAM NAME:Childcare Resources/Psychological Services FY 05/06 FY06/07 FY 07/08 % INCREASE FYE 6130/06 FYE 6/30/07 FYE 6/30108 CURRENT VS. A NEXT FY BUDGET B C D ACTUAL TOTAL PROPOSED (ca. Ccnl. ellcol. s REVENUES BUDGETED BUDGETED 1 Children's Services Council-St. Lucie Children's Services Council- 0.00 Martin 3 Adviso Committee4ndian River0.00 Uni 61705.00 7,000.00 7,000.00 0.00% ted Wa SL Lucie Coun - 5 United We -Martin Coun 0.00 United We -Indian River Coun0.00 4,000.00 4,000.00 4,000.00 0,00% 7 De rtment of Children & Families 6 Coun Funds 0.00 9 Contributions-Cash 0.00 8,000.00 0.00 12,000.00 1 Pro ram Fees 3,60D.00 6,000.00 2,000.00 11 Fund Raisin Events-Net -66.67% 8,750.00 5,000.00 15,500.00 210.00% 12 Sales to Public-Net 13 Membership Dues 0.00 to Investment Income 61000.00 17,000.00 51000.00 -70.59% 15 Miscellaneous 1 ,000.00 16 Le agle6 & Bequests 0.00 17 Funds from Other Sources 0.00 7 Reserve Funds Used for Operetin 0.00 19 In-Kind Donations (Nat wduded in twe0 0.00 0.00 2,000.00 20 TOTAL 36,055.00 39,000.00 46,500.00 19.23 EXPENDITURES 21 Salaries 21 ,500.35 22,793.74 25,470.00 22 FICA 11 .74 menf 1 ,644.75 1 ,743.72 1,948.46 11 .74% 23 Retire za LifeMealth 0.00 25 Workers Com ensation 0.00 250.00 - 300.00 600.00 100.00 zs Florida Unemplo ment 27 Travel-Dail 0.00 20.00 66.00 312.80 373.94% 28 irevel/ConferenceslTraining 0.00 55.00 391.00 29 Office Sup lies 610.91 % 600.00 276.00 312.60 13.33 30 Tele hone 650.00 193.00 31 Posta efShi PPin 547.00 183.08% 500.00 221.00 422.28 91 .08% 3 Utilities 200.00 207.00 33 Occupant (Buildin & Grounds 500.48 141'78% 1 ,000.00 955.00 594.32 -37.77% Printin & Publications 500.00 442,00 3 Subscri tion/Dues/Memberships 578.68 30.92% - 0.00 50.00 203.32 306.64% 36 Insurance 0.00 276.00 583.44 37 Equi ment:Rental & Maintenance 111'39% 0.00 66.00 109.48 65.88 3 Ativertisin 0.00 55.00 01. 39 E uipment Purchases:Capi[al Expense 469.20 753.09% 0.00 83.00 234.60 182.65 Professional Fees (Le al, Consultin ) 9,115.00 11,000.00 11,000.00 41 Books/Educetional Materials 0.00% 0.00 90.00 187.68 108.53% 4 Food & Nutrition 0.00 72.00 234.60 225.83% 43 Administrative Costs 0.00 0.00 Audit Expense 0.00 0.00 0.00 1,329.40 as S ecific Assistance to Individuals 0.00 0.00 170.00 4 Other/Miscellaneous 0.00 55.00 289.34 426.07% 47 Other/Contract 48 TOTAL 0.00 0.00 0.00 35,980ALI 38,999.46 46,488.88 19.200/. 49 REVENUES OVER/(UNDER) EXPENDITURES 74.90 0.54 11. 12 srzrzod� e� Childcare Resources of Indian River, Inc. Psychological services Program. Funder: Children Services Advisory Commiuce G. BUDGET FORMS - To open the Budget Forms, please double-click on ;` ow. In the Excel portion of this RFP you will find the following pages/tabs: 1 . Budget Narrative Worksheet (4 pages) 2. Total Agency Budget 3 . Total program Budget 4. Funder Specific Budget 5 . Explanation for Variances Make sure to print all the forms by going to each tab and selecting the Print . u ..i £ Microsoft Office Excel Worksheet Childcare Resources of Indian River, Inc. Psychological Services Program. Funder: Children Services Advisory Committee H. FUNDER SPECIFIC REQUIREMENTS MEASURABLE OUTCOMES FOR LAST YEAR. (This section not to exceed two pages) Note period outcomes/results reflect: July 1 , 2005 to June 30, 2006. OUTCOMES RESULTS List all elements of last year 's measurable outcomes. List the results of the outcomes. Cut and paste from last years application. 1 . 80% of those families referred for treatment 1 . 11 new referrals were made. 10 participated will participate in treatment as measured by the (91 %) . number of completed Mental Health Provider forms. 2. 85 % of individuals attending more than two 2 . Eight of the ten participants showed Therapy sessions will raise their functioning improvement (80%) . The other two children within the school year, as measured by the left our program before real improvement discharge score for Global Assessment of could be seen. Functioning (GAF) test or other screening devices. Baseline: Admission GAF score. 3 . Four children received clinical intervention during the 2005 -2006 school year. Two of 3 . To increase the level of appropriate behavior those children did not have inappropriate of children who have received clinical behavior in the classroom. Of the remaining intervention during the 2005-2006 school year two, both increased their levels of appropriate by an average of 10% as measured by the behavior by more than 10% as reported by the spring DECA and/or classroom teacher teachers. One improved his DECA score by assessments. Baseline: Teacher assessments 12% and the other improved by 5% (his scores and/or fall DECA assessments. where high to start with so there was less room for improvement) . Please see our quarterly reports for more current information. 13 Gd]care Re;owceyPzyc�ob9icS SeMc� - AGENCY/PROGRAM NAME:Childcare F FUNDER:Children's Services Advisory Children's Services Council-SL Lucie Children's Services Council-Martin United Way-St. Lucie Coun United Way-Martin CounpL Department of Children & Families q2gqkFuqdS Contributions-Cash Fund Raisino Events-Net Sales to Public-Net Investment Income Miscellaneous Le acies & Beguests Funds from Other Sources Reserve Funds Used for Operating In-Kind Donations Not included in total Retirement - L-delHeahh Workers Compensation Florida Unem to Ment Travel-Dail Travel/Conferencesrrrainin Telephone Posta a/Shi in Utilities Printing & Publications Subscri bonlDues/Membemhi s Insurance E ui mentRental & Maintenance Advertisin Equipment Purchases:Ca ital Ex ens¢ BookslEducational Materials Food & Nutrition Administrative Costs Audit Exg2nse Specific Assistance to Individuals Other/Miscellaneous OthedContract W] 65 crew n�.�rcYmaoy�m s� AGENCYIPROGRAM NAME:Childcare F FUNDER:Children's Services Advisory #ON/O! #ONTO! #DIVIO! #DIV/0! Professional Fees Le al ConsulOn #DIVIO! #DNIO! s2TOD; e s TAXONOMY Psychological Services Parent Counseling (RP450 . 650) In -person Crisis Intervention (RP450 .330) 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 " 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 CNN , Re urm sycP 9-w SPrncrs 2007-2008 CORE GRANT APPLICATION EXPLANATION FOR VARIANCES OF 15% OR MORE TOTAL PROGRAM BUDGET Resource/Psychological Services Committee Greater proportion of these gifts will be applied to this program. Greater proportion of these funds will be applied to this program. Greater proportion of these funds will be applied to this program. Greater proportion of these gifts will be applied to this program. KReflects ealignment of program expenses. ealignment of program expenses. Reflects realignment of program expenses. Refleds realignment of program expenses. Reflects realignment of program expenses. Reflects realignment of program expenses. Reflects realignmerrl of program expenses. Reflects realignment of program expenses. Reflects realignment of program expenses. Reflects realignment of program expenses_ Reflects realignment of program expenses. Reflects realignment of program expenses. Refleds realignment of program expenses. Retieds realignment of program expenses. Reflects realignment of program expenses. Reflects realignment of program expenses. Reflects realignment of program expenses. Refleds realignment of program expenses. 5r 07 ss Ghlmre Rewwmv%ytlicYgcel S¢Mcn 2007=2008 CORE GRANT APPLICATION EXPLANATION FOR VARIANCES OF 15% OR MORE FUNDER SPECIFIC BUDGET ZesourceslPsychological Services Committee No need to write an explanation. &=007 es 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 parry; 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: Brad E. Bernauer, Indian River County Human Services Director 1801 27'h Street, Vero Beach , Florida 32960. Recipient: Childcare Resources 1801 24th Street, Vero Beach , Fl . 32960 Attention : Pam King , Director 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. i ACUf7D CERTIFICATE OF LIABILITY INSURANCE DATE ,MtJ O^, YYYY; M lanwaua7 PRODUCER Y,v:,rc: 1772) 024MFac p721102-iwi!; THIS CERTIFICATE IS ISSUED AS A MATTER OF NF'DRAIATION HILS ROGAL & HOBBS OF FLORIDA, INC. • VERO BEACH ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 204514TH AVE. HOLDER. TNS CERTIFICATE DOES NOT AMEND, EXTEND OR P OBOX 130 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. VERO BEACH FL 32961 INSURERS AFFORDING COVERAGE MAIC 3 i MSUREG iN_SURER A: _ HARTFORD CASUALTY INSURANCE CC. - CHILD CARE RESOURCES OF INDIAN RIVER, INC. INSURER E. HART INS CO OF SOUTHEAST 027120 140124TH STREET IINSL7R£R C. `— VERO BEACH FL 32960 _ IINSURERG I- -- COVERAGES INSURER THEPOLICIES Ur MUIR " III BELOWHAVE BEEN ISSUED TO THE INSURED N ASCII FOR T:E FOLICY PERICC 'NO CA7EO, NCTVuR;i�iANO1NG ANY REONREMENT, TERM OR CONUITIC l OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT r'J WHICHTF.IS CERT9FICATE MAY BE 13,IUED OR MAY FI THE INSURANCE AFFORDED BY THE POLICIES OeSCR18E HEREIN IS 3U91ECT TO 411. THE TERMS, EXCLUSIONS ANO CONGRICNS OF .SUCH POUC19C. AGGRECATELIMTS SHOWN MAY HAVE SEEN REDU"O BY PA* CLAM , TYPE OFINSURANCE --- PoLICYEPFPLiniE oelmr ------ __ LTB 'I POLICY NUMBE4 EXm+AtIXl .]ATE OL1F N�pyyf LAIITS GENERAL L'A&Llx I 2158A FP9973 DV 10114/07 . 1011410E " EA^H pOOURRENDE % 1 .ap0,000 ' O.MNIERCIAL GENERll LABILITYI on—NacE Ie .REVTt3 - - _ I�wvRe ,E. .e,..„, 3 311ll,000 CLAMAIADE Imo . OCCUR - MEG. EYP (MY ane pa'em' L . ._ i lis 10,000 A PERSONAL &AOV INJURY 'IS 1 ,000,(100 ''... cENERALAOGRECAE Is 2,OOOAOa OEN'L AGGREIATE LIARTAPPLIEB PER . MODUCYS-COMPIOP AGI '! 2,00(1,000 PRD I POLICY JECT � LOC: : --I i ACTOMULau: LUlelurr 21 SBAFP5973 DV 16H4407 '! ANYAV'a 1 iN14106 CO-NED SINOLE ,IM,T i T ,aaa,Dan ' --I AU OWNED AUTOS -- --- A YE31 '..CHEOULEO AU TOB � iPa PIImm) %� HIRED MITOS --- -- ------ { SQDILY 'NJJRY 1 NCH-04RIE0 AUTOS i, I IPBf SCEiierU { S _I — ' � FROPERTY OAb1AGE i4 1 tPx atGdetti fiARAGE LIABILPry ! AUTO ONLY - EA OCCIDENT 18 ._ ANYAUTO -- — _. . ! OTHER THAN EA PCC iRJT00NLY AGO rrt EXCSS / MOM" LlIlkl ' i- IEACN OCCVFRENOE OCCUR a CiNMS MAllE AGGREGATE OEDUC!IBL' _ E _ 1 RtT lmgME S (WORKERS GCMPEN'SATON AND MPL :fSTu OYERS LL9EeITY 21tVEC OC8422 10114@W' 7 10/'14/(19 TCRV LMOi ! o1HER g FNY PNpPWC.IXNPARTNERRXELyTNE — _— LE`_' EACH AG;.Ic.EN* 11 500,000_ IYFlCE11rT¢ISER EICI�ID®i _, _ I . _ INYy JaFFYS, xqr '. IPL. EASEL-EACI Ia SDa,000 :ev=GAL PPOYIJSNsaew� ^-- - ilL DISEASE-PDLICuOruNrt '. 1 s00Atl0 ! OTTER: ', I ' i DESCRIPTION OF OPERATIONSfLOCATIOWLfA/CHICLESIFXCLUSIONS ADDED BY WIMORSEMENT1 SPECIAL PROVISIONS CERTIFICATE HOLDER NAMED AS ADDITIONAL INSURED WITH RESPECTS TO GENERAL LIABILITi AND BUSINESS AU70 LIASILITY AS PER POLICY FORM AND PROVISIONS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF T,-1E AEOVE DByCRSED FOUG'ES 8E CpNG°LLEC 5EORETFE WIPATION DAT[ THEREOo. "HE I3SU6NG LNSUF.ER WILL _NOEAVOR TO MAIL 10 GAYS TY-c1: ARNOTICE TC THE ,�RTO`IC,ATE HOLDER NAMIH: TO THE LEFT, E!ITFAILURE INDIAN RIVER COUNTY TSAGENI�q EP OSE NTATnIE ENC AMON OR LIABILITY OF ANYKINO VPON T.'E INSUMSR, 1000 27TH STREET ' VERO BEACH FL 329601 .,UiHORQEO REyRESENTATIVE Attent1m: Mitre AC7R0 26 (200106) C.emlR:ate 41O9023 O ACORD CORPORATION 1988 Childcare Resources of Indian River, Inc. Psychological services Program. Funder: Children Services Advisory Commiuce G. BUDGET FORMS - To open the Budget Forms, please double-click on ;` ow. In the Excel portion of this RFP you will find the following pages/tabs: 1 . Budget Narrative Worksheet (4 pages) 2. Total Agency Budget 3 . Total program Budget 4. Funder Specific Budget 5 . Explanation for Variances Make sure to print all the forms by going to each tab and selecting the Print . u ..i £ Microsoft Office Excel Worksheet Childcare Resources of Indian River, Inc. Psychological Services Program. Funder: Children Services Advisory Committee H. FUNDER SPECIFIC REQUIREMENTS MEASURABLE OUTCOMES FOR LAST YEAR. (This section not to exceed two pages) Note period outcomes/results reflect: July 1 , 2005 to June 30, 2006. OUTCOMES RESULTS List all elements of last year 's measurable outcomes. List the results of the outcomes. Cut and paste from last years application. 1 . 80% of those families referred for treatment 1 . 11 new referrals were made. 10 participated will participate in treatment as measured by the (91 %) . number of completed Mental Health Provider forms. 2. 85 % of individuals attending more than two 2 . Eight of the ten participants showed Therapy sessions will raise their functioning improvement (80%) . The other two children within the school year, as measured by the left our program before real improvement discharge score for Global Assessment of could be seen. Functioning (GAF) test or other screening devices. Baseline: Admission GAF score. 3 . Four children received clinical intervention during the 2005 -2006 school year. Two of 3 . To increase the level of appropriate behavior those children did not have inappropriate of children who have received clinical behavior in the classroom. Of the remaining intervention during the 2005-2006 school year two, both increased their levels of appropriate by an average of 10% as measured by the behavior by more than 10% as reported by the spring DECA and/or classroom teacher teachers. One improved his DECA score by assessments. Baseline: Teacher assessments 12% and the other improved by 5% (his scores and/or fall DECA assessments. where high to start with so there was less room for improvement) . Please see our quarterly reports for more current information. 13 TAXONOMY Psychological Services Parent Counseling (RP450 . 650) In -person Crisis Intervention (RP450 .330) 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 " 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 parry; 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: Brad E. Bernauer, Indian River County Human Services Director 1801 27'h Street, Vero Beach , Florida 32960. Recipient: Childcare Resources 1801 24th Street, Vero Beach , Fl . 32960 Attention : Pam King , Director 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. i ACUf7D CERTIFICATE OF LIABILITY INSURANCE DATE ,MtJ O^, YYYY; M lanwaua7 PRODUCER Y,v:,rc: 1772) 024MFac p721102-iwi!; THIS CERTIFICATE IS ISSUED AS A MATTER OF NF'DRAIATION HILS ROGAL & HOBBS OF FLORIDA, INC. • VERO BEACH ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 204514TH AVE. HOLDER. TNS CERTIFICATE DOES NOT AMEND, EXTEND OR P OBOX 130 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. VERO BEACH FL 32961 INSURERS AFFORDING COVERAGE MAIC 3 i MSUREG iN_SURER A: _ HARTFORD CASUALTY INSURANCE CC. - CHILD CARE RESOURCES OF INDIAN RIVER, INC. INSURER E. HART INS CO OF SOUTHEAST 027120 140124TH STREET IINSL7R£R C. `— VERO BEACH FL 32960 _ IINSURERG I- -- COVERAGES INSURER THEPOLICIES Ur MUIR " III BELOWHAVE BEEN ISSUED TO THE INSURED N ASCII FOR T:E FOLICY PERICC 'NO CA7EO, NCTVuR;i�iANO1NG ANY REONREMENT, TERM OR CONUITIC l OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT r'J WHICHTF.IS CERT9FICATE MAY BE 13,IUED OR MAY FI THE INSURANCE AFFORDED BY THE POLICIES OeSCR18E HEREIN IS 3U91ECT TO 411. THE TERMS, EXCLUSIONS ANO CONGRICNS OF .SUCH POUC19C. AGGRECATELIMTS SHOWN MAY HAVE SEEN REDU"O BY PA* CLAM , TYPE OFINSURANCE --- PoLICYEPFPLiniE oelmr ------ __ LTB 'I POLICY NUMBE4 EXm+AtIXl .]ATE OL1F N�pyyf LAIITS GENERAL L'A&Llx I 2158A FP9973 DV 10114/07 . 1011410E " EA^H pOOURRENDE % 1 .ap0,000 ' O.MNIERCIAL GENERll LABILITYI on—NacE Ie .REVTt3 - - _ I�wvRe ,E. .e,..„, 3 311ll,000 CLAMAIADE Imo . OCCUR - MEG. EYP (MY ane pa'em' L . ._ i lis 10,000 A PERSONAL &AOV INJURY 'IS 1 ,000,(100 ''... cENERALAOGRECAE Is 2,OOOAOa OEN'L AGGREIATE LIARTAPPLIEB PER . MODUCYS-COMPIOP AGI '! 2,00(1,000 PRD I POLICY JECT � LOC: : --I i ACTOMULau: LUlelurr 21 SBAFP5973 DV 16H4407 '! ANYAV'a 1 iN14106 CO-NED SINOLE ,IM,T i T ,aaa,Dan ' --I AU OWNED AUTOS -- --- A YE31 '..CHEOULEO AU TOB � iPa PIImm) %� HIRED MITOS --- -- ------ { SQDILY 'NJJRY 1 NCH-04RIE0 AUTOS i, I IPBf SCEiierU { S _I — ' � FROPERTY OAb1AGE i4 1 tPx atGdetti fiARAGE LIABILPry ! AUTO ONLY - EA OCCIDENT 18 ._ ANYAUTO -- — _. . ! OTHER THAN EA PCC iRJT00NLY AGO rrt EXCSS / MOM" LlIlkl ' i- IEACN OCCVFRENOE OCCUR a CiNMS MAllE AGGREGATE OEDUC!IBL' _ E _ 1 RtT lmgME S (WORKERS GCMPEN'SATON AND MPL :fSTu OYERS LL9EeITY 21tVEC OC8422 10114@W' 7 10/'14/(19 TCRV LMOi ! o1HER g FNY PNpPWC.IXNPARTNERRXELyTNE — _— LE`_' EACH AG;.Ic.EN* 11 500,000_ IYFlCE11rT¢ISER EICI�ID®i _, _ I . _ INYy JaFFYS, xqr '. IPL. EASEL-EACI Ia SDa,000 :ev=GAL PPOYIJSNsaew� ^-- - ilL DISEASE-PDLICuOruNrt '. 1 s00Atl0 ! OTTER: ', I ' i DESCRIPTION OF OPERATIONSfLOCATIOWLfA/CHICLESIFXCLUSIONS ADDED BY WIMORSEMENT1 SPECIAL PROVISIONS CERTIFICATE HOLDER NAMED AS ADDITIONAL INSURED WITH RESPECTS TO GENERAL LIABILITi AND BUSINESS AU70 LIASILITY AS PER POLICY FORM AND PROVISIONS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF T,-1E AEOVE DByCRSED FOUG'ES 8E CpNG°LLEC 5EORETFE WIPATION DAT[ THEREOo. "HE I3SU6NG LNSUF.ER WILL _NOEAVOR TO MAIL 10 GAYS TY-c1: ARNOTICE TC THE ,�RTO`IC,ATE HOLDER NAMIH: TO THE LEFT, E!ITFAILURE INDIAN RIVER COUNTY TSAGENI�q EP OSE NTATnIE ENC AMON OR LIABILITY OF ANYKINO VPON T.'E INSUMSR, 1000 27TH STREET ' VERO BEACH FL 329601 .,UiHORQEO REyRESENTATIVE Attent1m: Mitre AC7R0 26 (200106) C.emlR:ate 41O9023 O ACORD CORPORATION 1988