HomeMy WebLinkAbout2004-229B (2) Indian River County Grant Contract zozg
This Grant Contract ("Contract") entered into effective this 1st day of October 2004 by and between
Indian River County, a political subdivision of the State of Florida , 1840 25th Street, Vero Beach FL ,
32960 ("County') and Healthy Start of Indian River County ("Recipient") , of:
1603 10th Avenue
Vero Beach , Florida 32960
Background Recitals
A. The County has determined that it is in the public interest to promote healthy children in a
healthy community.
B . The County adopted Ordinance 99- 1 on January 19 , 1999 ("Ordinance") and established the
Children 's Services Advisory Committee to promote healthy children in a healthy community
and to provide a unified system of planning and delivery within which children 's needs can be
identified , targeted , evaluated and addressed .
C . The Children 's Services Advisory Committee has issued a request for proposals from
individuals and entities that will assist the Children 's Services Advisory Committee in fulfilling
its purpose .
D . The proposals submitted to the Children 's Services Advisory Committee and the
recommendation of the Children 's Services Advisory Committee have been reviewed by the
County.
E . The Recipient, by submitting a proposal to the Children 's Services Advisory Committee , has
applied for a grant of money ("Grant") for the Grant Period (as such term is hereinafter
defined ) on the terms and conditions set forth herein .
F . The County has agreed to provide such Grant funds to the Recipient for the Grant Period (as
such term is hereinafter defined ) on the terms and conditions set forth herein .
NOW THEREFORE , in consideration of the mutual covenants and promises herein contained , and
other good and valuable consideration , the receipt and adequacy of which are hereby acknowledged ,
the parties agree as follows :
1 . Background Recitals The background recitals are true and correct and form a material
part of this Contract .
2 . Purpose of Grant The Grant shall be used only for the purposes set forth in the
complete proposal submitted by the Recipient attached hereto as Exhibit "A" and
incorporated herein by this reference (such purposes hereinafter referenced as "Grant
Purposes") .
3 . Term The Recipient acknowledges and agrees that the Grant is limited to the fiscal
year 2004/2005 ("Grant Period"). The Grant Period commences on October 1 , 2004
and ends on September 30 , 2005 .
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4 . Grant Funds and Payment The approved Grant for the Grant Period is Fifteen-
Thousand Dollars ($ 15 ,000 ) . The County agrees to reimburse the Recipient from
such Grant funds for actual documented costs incurred for Grant Purposes provided in
accordance with this Contract. Reimbursement requests may be made no more
frequently than monthly. Each reimbursement request shall contain the information , at
a minimum , that is set forth in Exhibit "B" attached hereto and incorporated herein by
this reference . All reimbursement requests are subject to audit by the County. In
addition , the County may require additional documentation of expenditures , as it
deems appropriate .
5 . Additional Obligations of Recipient
5 . 1 Records . The Recipient shall maintain adequate internal controls in order to
safeguard the Grant. In addition , the Recipient shall maintain adequate records fully
to document the use of the Grant funds for at least three (3 ) years after the expiration
of the Grant Period . The County shall have access to all books , records , and
documents as required in this Section for the purpose of inspection or audit during
normal business hours at the County's expense , upon five (5) days prior written
notice .
5 .2 Compliance with Laws . The Recipient shall comply at all times with all applicable
federal , state , and local laws , rules , and regulations .
5 . 3 Quarterly Performance Reports . The Recipient shall submit Quarterly Performance
Reports to the Human Services Department of the County within fifteen ( 15) business
days following : December 31 , March 31 , June 30 , and September 30 ,
5 .4 Audit Requirements . If Recipient receives $25 , 000 or more in the aggregate from
all Indian River County government funding sources , the Recipient is required to have
an audit completed by an independent certified public accountant at the end of the
Recipient's fiscal year. Within 120 days of the end of the Recipient's fiscal year, the
Recipient shall submit the audit to the Indian River County Office of Management and
Budget. The fiscal year will be as reported on the application for funding , and the
Recipient agrees to notify the County prior to any change in the fiscal period of
Recipient . The Recipient acknowledges that the County may deny funding to any
Recipient if an audit required by this Contract for a prior fiscal year is past due and has
not been submitted by May 1 .
5 .4 . 1 The Recipient further acknowledges that, promptly upon receipt of a
qualified opinion from it's independent auditor, such qualified opinion shall
immediately be provided to the Indian River County Office of Management and
Budget. The qualified opinion shall thereupon be reported to the Board of
Commissioners and funding under this Contract will cease immediately. The
foregoing termination right is in addition to any other right of the County to
terminate this Contract .
5 .4 .2 The Indian River County Office of Management and Budget reserves the
right at any time to send a letter to the Recipient requesting clarification if there
are any questions regarding a part of the financial statements , audit comments , or
notes .
5 . 5 Insurance Requirements . Recipient shall , no later than September 21 , 2004 ,
provide to the Indian River County Risk Management Division a certificate or
certificates issued by an insurer or insurers authorized to conduct business in Florida
that is rated not less than category A-: VII by A. M . Best, subject to approval by Indian
River County's risk manager, of the following types and amounts of insurance :
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(i) Commercial General Liability Insurance in an amount not less than
$ 1 , 000 , 000 combined single limit for bodily injury and property damage ,
including coverage for premises/operations , products/completed operations ,
contractual liability, and independent contractors ;
(ii ) Business Auto Liability Insurance in an amount not less than $ 1 ,000 , 000
per occurrence combined single limit for bodily injury and property damage ,
including coverage for owned autos and other vehicles , hired autos and other
vehicles, non -owned autos and other vehicles ; and
( iii ) Workers' Compensation and Employer's Liability (current Florida statutory
limit)
5 . 6 Insurance Administration . The insurance certificates , evidencing all required
insurance coverages shall be fully acceptable to County in both form and content ,
and shall provide and specify that the related insurance coverage shall not be
cancelled without at least thirty (30 ) calendar days prior written notice having been
given to the County. In addition , the County may request such other proofs and
assurances as it may reasonably require that the insurance is and at all times
remains in full force and effect. Recipient agrees that it is the Recipient's sole
responsibility to coordinate activities among itself, the County, and the Recipient's
insurer(s ) so that the insurance certificates are acceptable to and accepted by
County within the time limits set forth in this Contract . The County shall be listed as
an additional insured on all insurance coverage required by this Contract, except
Workers ' Compensation insurance . The Recipient shall , upon ten ( 10) days' prior
written request from the County, deliver copies to the County, or make copies
available for the County's inspection at Recipient's place of business , of any and all
insurance policies that are required in this Contract . If the Recipient fails to deliver or
make copies of the policies available to the County; fails to obtain replacement
insurance or have previous insurance policies reinstated or renewed upon
termination or cancellation of existing required coverages ; or fails in any other regard
to obtain coverages sufficient to meet the terms and conditions of this Contract, then
the County may, at its sole option , terminate this Contract.
5 . 7 Indemnification , The Recipient shall indemnify and save harmless the County, its
agents , officials , and employees from and against any and all claims , liabilities ,
losses , damage , or causes of action which may arise from any misconduct, negligent
act , or omissions of the Recipient, its agents , officers , or employees in connection
with the performance of this Contract.
5 . 8 Public Records . The Recipient agrees to comply with the provisions of Chapter
119 , Florida Statutes ( Public Records Law) in connection with this Contract.
6 . Termination , This Contract may be terminated by either party, without cause , upon
thirty (30) days prior written notice to the other party. In addition , the County may
terminate this Contract for convenience upon ten ( 10) days prior written notice to the
Recipient if the County determines that such termination is in the public interest.
7 . Availability of Funds . The obligations of the County under this Contract are subject
to the availability of funds lawfully appropriated for its purpose by the Board of
County Commissioners of Indian River County,
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 .
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IN WITNESS WHEREOF , County and Recipient have entered into this Contract on the date
first above written .
INDIAN RIVER COUNTY BOARD OF COUNTY COMMISSIONERS
By: 15&
Caroline D . Ginn , Chairm �J
BCC Approved ; `
Attest .J .K. Barton , Clerk ',
By:
�0(Qy" Deputy Clerk
Approved .
Jos ph A . Baird
County Administrator
ppr v Is to orm d leg
an . Fell , ssistant Coun y Atto ney
RECIPIENT:
By:
Indian River County Healthy Start Coalition , Inc .
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EXHIBIT A
[Copy of complete proposal/application]
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7 Organization : Indian River County Healthy Start Coalition, Inc. Pro
Funder: IRC Board of County Commissioners — Children 's Services Advisory Committee 2004 Grant Newborn Application
PROGRAM COVER PAGE
Organization Name: Indian River County Healthy Start Coalition Inc
Executive Director: D. Scott Joseph M S Email * irchscQaol .com
Address : 1603 10th Avenue Telephone: (772) 563 -9118
Vero Beach FL 32960 Fax: (772) 563 -9125
i; �X . Program Director. : Nancv McClain Email: Nancy McClainQdoh state fl us
Address: IRC Health Department Telephone: (7721797534 At
196027th Street Vero Beach FL 32960 Fax: (7721794-7453
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Program Title: TLC Newborn Pro
`Y+ Priority Need Areas) Addressed : Parenting Support and Education as well as Mental Wellness
Brief Description of the Program : The TLC Program falls under two taxonomies • PH 610180
Expectant/New Parent Assistance which provides services and education for new parents to prepare
the fo"><'`emotionaiand ractical ,... . :. . : . .
D �aSDectS O p
>' an topromote bonding and nurturingof the p
n �' • = 9'F' ' Ls. , • - M`,�izi + x
U , newborPH-620. 150 = Commumcahon Trauun helm arents communicate vvrth clul health
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o er parent/u�ant mterac on slabs ocusm on positive Growth and development.
The universal TLC (Touch, Love Communicate) Newborn Promm focuses parent education infant
health care informatioIIIIIIIn, bonding advice brain development activities
Amount Requested from Funder for 2004 /05 , $ 15 , 000 . 00
Total Proposed Program Budget for 2004 /05 : $ 73 , 500 . 00
Percent of Total Program Budget : 20 .4 %
Current Funding (2003 /04 ) : $ 15 ,000
Dollar increase/( decrease ) in request :
Percent increase/(decrease )` in request ,
* * • 0 0 % 11
UnduplicatedWumber of Children to be . served . Individually: 11,217
'217
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ill "Undupl><ea ed
-1iin er of Adults * to be served Individually : i; 925It 11
s UnduplicatedNi tuber to be served viarGroup settings _
� %
' Total Program Cost per Client
34 . 31
Does not include fathers in count
* *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:
1 Yes (partial) United Way of IRC ($55 ,000000)
The Organization 'sBoard of Directors has approved this applica on (date). S/26/04
Jean Anderson
Name of President/Chair of the Board ` ' lgnatiue
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D Scott Jos hit
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Name of Executtve ctor/CEO
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Organization: Indian River County Healthy Start Coalition, Inc. Program: TLC Newborn Program
Funder: IRC Board of County Commissioners — Children's Services Advisory Committee - 2004 Grant Application
PROPOSAL NARRATIVE
Please respond to each question in the allotted space for .each section. In responding to each section of
the proposal narrative, please retain the section-label and/or question that you are addressing. Type
using 12 pt. font on 8 %2" X 11 " paper and number each page. These directions and the graphic boxes
may be deleted if space is needed.
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A. ORGANIZATION CAPABILITY (Entire Section A not to exceed one page)
tf 'I � , '� , c � 3< a r��"+k��& _ : is
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FInd
de the mission statement and vision of our oranization. .Y_ g The mission of the Indian
. County Healthy Start Coalition is to establish a system that guarantees all women have.access to services that romote no, I 3,�IkRl,
tfde the resources and mechanils le in
omes and brain development. The Vision
ent for the TLC Newborn program is althy Families — Strong Communities" . The
mission statement for TLC is "Strengthening families of newborns by providing information,
Promoting understanding and 'reassurin Parents,"
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p tsand o tilafio r organization including areas of expertise,
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rov><de a brief summa of o
�accom lishmen .;,o k z
I The Coalitions purpose is to provide coordmahon
sand r = mmni"
b plished'`b ' ` '� � ° fl al` and cluldlieattl�(MCH). ThisY� "
�accoin ,
" cstalihsl`un a ` , ♦ '` ---
g.� P , 'een theprivate and public sector, state an local
government, community alliances and maternal and child health providers to provide coordinated
community based care pregnant women; infants and families with children up to age three for
Healthy Start and age five for Healthy Families. Areas of expertise include birth and maternal
data analysis, program planning, development, implementation, and addressing gaps in MCH
If services . Once gaps in services , or poor birth outcome trends have been identified, then the
necessary "steps will betaken to improve', these gaps by building bridges; linkages or adding new
' services if they' currently do not exist to meet the. MCH needs in Indian River County.11 ,
t 'Additiona5 If
l area's"of expertise include outreach, providing educational opportunities addressing
k, ' . w�'?r#^ > d.wyes' ' ' d . ^If,q¢' i r ,y. O .
MCH issues, and ;ensuring a system` is in place for all pregnant women infants and children The
a n.,
IRCHS Coaliho level ' $ J „` ` y • i` ,
.r . , bpjed and pti in place the TLC Newborn Pro in-G1998, which serves , .
< .f approximda e : ; ants each yearas�well��asth � ' .,. - ;� x, , x
g y' Y • . t a parents of these newborns. The Coalition
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also serves as the lead a enc for Health Fama,hes IRC which provides intensive case
primary , .
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management to over 100 families each year since 1999, with the run goal of preventing child
`abuse in at-risk families: The Coalition also oversees Healthy Start Care Coordination services
in partnership with the Indian River County Healthy Department, which served over 500 families
in 2003 . The Coalition launched a child safety campaign and became a Safe Kids Chapter in
` k January 2003 The vision of Safe Kids is to "Protect the children of our community . . • through
I, education, outreach and If , involvement". The Safe Kids program focuses. on child
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safety seat instruction, infant, home and bicycle safety education and initiatives. The program ,
Chas already proven to be extremely beneficial in bringing new resources to, the community by
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.getting over 120 ,child safety seats donated from safety organizations.` To date over 300 child
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safety seat inspections have taken place by the Coalition' s Outreach/Safe Kids Coor •
dmator Safe
Kids has also. either coordinated or ` artici ated in over 20 safe events in 2003 -04
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Organization: Indian River County Healthy Start Coalition, Inc. Program: TL.0 Newborn Program
Funder. IRC Board of County Commissioners — Children's Services Advisory Committee - 2004 Grant Application
Be PROGRAM NEED STATEMENT (Entire Section B not to exceed one page)
1 . a) What is the unacceptable condition requiring change? b) Who has the need ?
c) Where ;do they live? d) Provide local, state, or national trend data, with reference
source, that corroborates that this is an area of need. What: Babies do not come with
instruction books. In today' s system of health care, the mothers of newborns are released
from the hospital within 48 hours, and in many cases less than 24 hours. Unlike past
generations, support systems; such as the newborn' s grandmother, aunts or even available
health care providers for; these mothers are in many cases non-existent, particularly in the
State`of Florida; that has 'many transplant residents leaving the mother and family to fend for
themselves:4 In irianycases " there is nowhere to turn for 'parents of newborns to help ;with
`sem y !
thehi even c 'of u>tfant care issues, such as : handling, feedm nurturing,
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,. p �� M . ... .. safety and
growth)t e e o men The TLC Newborn ro am IIs .void
anrgap of care,, ,
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e ucahon an supporWho. ' Indian River Coun had 1 ,05 ,11:6 rths m 2002. Of these
births, 62.8% wer6from' white mothers, 15 . 3 % black, 19.0% Hispanic and 2.9% "other"
mothers: In 2002, almost half, or 45 % of all births are covered under Medicaid or indigent
funding, which amounts to 475 babies being from low income families. Of all the births in
2002 (the latest year for complete birth data), 39. 6 %, or 418 babies, ,were to unwed mothers,
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with black un ed births at 76.5%. In terms of education status of the` newborn's mother,
28.3 %2 or299 0 If
mothers did not have a 12�` grade education or.GED These figures
w zF a s ` .yap ' • b,'.`< ':a � i • fir' t r
`above p 'I ess f. ffies at higher risk, but 'race income status' Lack of two anent
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domes, ca o eveaze not the,only risk factors for add' Llressor to needs `ofaii` ><nfantl `
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How to properie�are of a baby crosses' all socio. and economic boll fl undaries. Where :
The TLC prograzn serves mothers and families of newborns from the entire county. Based
I the latest year for birth data with zip code information, 20.3 % of the births were from the
Vero Beach zip code (32960), 16. 9% in the Oslo — southeast zip code (32962), 13 . 8 % in the
Gifford/Winter Beach/Wabasso zip code (32967), 12 .2% in the Sebastian zip code (32958)
and 9. 1 % mi the Fellsmere zip code (32948) . Other parts of the county encompass the
i� remaining percentage•: The information reported above is derived from birth outcome data
provided t6i'l lthy` Start from the Florida Department of Health — Vital Statistic Office•
There are no progIll, rams or services that provide "universal" support for all families of
newborns besides the TLC Newborn ro tyThe TLC Newborn
p gram m Indian River Coun ,
p�mgram h, as; 6% participation of all families of newborns over the last three ears , '
, '' }f fGe h: '3.+ • • . . .:i k, ": rk •X"R •'v>, .^F`E: . L;'ai ycy1f`eIt:: y !
whiCih
amounts WIN s M0 0 fain <hes each ear receLvinlLfr
services addressor an infant' s needs,
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2. a) Identify 'similar programs that are currently serving the needs of your targeted
population ; b) Explain how these existing programs are under-serving the targeted
population of your program. The TLC Program is totally unique not only in Indian River
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County, but in the entire state of Florida. The program is unique due to its universal nature, and
t touches almost every family of newborns in Indian River County. Healthy Start Care
Coordination and Healthy Families have similar target populations with regard to the infants and
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families of newborns," but only serve those families who are scored "at-risk" on the Healthy
,a Starf/Familits postnatal 'screen. They are primarily intensive home-based case management
s pr'o zgrams with the ma ori of services be
Ill . • � , J tY ginning prenatally. In 2003 , Healthy Start provided 91 _ .
"( infants with on=`going care coordination and Healthy Families - IRC served 145 infants.
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Organization: Indian River County Healthy Start Coalition, Inc. Program: TLC Newborn Program
Funder. IRC Board of County Commissioners — Children's Services Advisory Committee - 2004 Grant Application
Co PROGRAM DESCRIPTION ntire Section C, 1 — 6, not to exceed two a es
1 . List Priority Needs area addressed : Focus Area . Parental Support and Education : Ages
0-5 - focus on "individual" parenting programs as well as Focus Area Mental Wellness
Issues : Ages 0-5 — promoting enhanced emotional-social skills.
2. ! Briefly describe program activities including location of services. Visits to Indian River
Memorial Hospital are made six out of seven days of each week by the TLC Newborn personnel,
who'met '98% of the families last year of every newborn either the day of delivery of the baby or
thetday', er. Infants born on Sunday, the only day.TLC does not visit the hospital, are normally
contided on the second day after delivery. Follow upphone calls are made with each family of
a newbornwho is interested in participating in the TLC Newbom program, which is over 96
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p enr ofall newborn families in Indian River Couny Follow up
hone calls take lace on a
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ee asis m the�rsfmonth. =This frequencyc be increased if the family chooses, or the k
. x . ` ^R`MiI�S''`'to !d. ,a'.�g' .. t° `i#� ..,. . a1h,y �'• . .1 : -qtr .rt
= # Family Associate ><dentifies a need for greater contact< In the second month, calls are made
to the family on an every other weekly basis. From months three through six, phone contacts are
made on a monthly basis. s
Age appropriate newsletters focusing on each month of the infant's life, in terms of growth and
A ,4 11 Ilk
development, health and nutrition/feeding issues :immunizations, brain development tips and .. .
b renting ideas are mailed on a monthly basis, epend' on the age of the infant. At the
Morn offioitle' tatiYe m u do 'i Isd
TLC represen ecificed ca nal material `to each family
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} 4 accep prograiri,a In some cases, can reach the familyYs home prior * '
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to fi ly's am a1 from !41NII.
the hospital l The TW ,00rdinator assigns individual families to
rtc s . :members (including herself) . Once a �faimly is assigned to a staff member, that
connection is maintained throughout the length of the program, which assists in building trust.
Some families call the TLC Newborn office as additional assistance is needed. When referrals to
other agencies or organizations are made to the family, the TLC staff member will follow up,
regardless of the recommended call schedule.
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-The montlly newsletters also include educational}and play ideas, as well as a "Dad' s Corner",
�. which provides tips, on fatherhood issues relating to infant care. In 2003-04 a sibling newsletter
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Was' added for those, families with toddlers in the home ; This component was necessary due to
success of the Newborn program, with° niari r eaf,births from former TLC families r
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dd 1998. In 2005, the program served its S f000 ba y. Referrals to community resources,
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k. such as the Healthy Start Care Coordination team, and concerns of individual familieshare
reviewed by the TLC Newborn staff members on an as-needed basis. One of the primary
reasons for the TLC program' s success and high participation rate is its universal and non-
_ ' invasive means of education and support. Families receive TLC services in the comfort of their
home that is not intrusive or disruptive. Mothers can also contact their TLC Family Associates
. :at their convenience as questions or needs arise Keg Ing the care and well-being of their infant.
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3. Briefly_ describe how your program addresses the stated need/problem. Describe how
your program follows a recognized "best practceR (see definition on page 12 of the
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Instructions) and provide evidence that indicates proposed strategies. are effective with
target population. As 1 mentioned earlier, the major advantage of the TLC Newborn program is
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it is universal in nature' with all '
famihes ofn wbo
rns being eligible to artici ate ` With the „' y
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Organization: Indian River County Healthy Start Coalition, Inc. Program: TLC Newborn Program
Funder: IRC Board of County Commissioners — Children's Services Advisory Committee - 2004 Grant Application
ability to reach families of newborns at the hospital and in their home, there are very few barriers
to service delivery. The success of the TLC Newborn program is shown through its
participation rate of over 96 percent over the last three years. As a comparison, the acceptance
rate for the Healthy Start prenatal Screen was only 56% in 2003 and 42% for the Healthy Start
Infant/Postnatal Screen. This indicates nearly half of the pregnant women or infants in our
county are NOT being screened for risk factors and could potentially be missed in terms of
needing education and support. This is acceptable from a service delivery perspective, due to the
limited staff of Healthy Start Care Coordination not being able to serve more than a few hundred
families for ongoing case manage*went anyway. But TLC fills this gap in care and services and
p oxides a safety net for any families that were not screened for Healthy Start and might need
additional case management or nursing services. that Healthy Start or Healthy Families can offer.
One of the best indicators of the success of the TLC program, in addition to the Healthy Start and
alth"' Familie"s ro is they to
P ?s, <*, w infant mortals o ears
rate m the last two y
3 e�a anc5.7 infant deaths per ,000live births in inds�an River County which has
. .
a . ,15
., . , with postnatal
infant deaths (infant dying between 28 to 365 days of life) being extremely low and way below
the state average, which is the category that TLC services would most likely prevent. One new
component of the TLC program for 2004-OS will be a certified TLC Associate for breastfeeding
support, which accounted for 70% of the reason for mothers calling the TLC staff. This will be a
erfect compliment to the VNA home breastfeeding visitation cam onent added in 2001 -02.
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r 4 I ><sf"sfaffingneeded for yon>r program, wclndsng;regnired , ezperience and estimated
,hR A ou p r ' lin program foi�aci' si�fimembeTt d .'` � . . e ;�s �r� rw •= r4
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er v fe y r nd/or volunteers (this secti6i ' s' hould
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conior� to the llnformahon m tl><e' Position Listing ii' the Budget Narrative Worksheet).
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TL doordinator — 32 hours per-week (80% Full Time Equivalent ,,, FTE)
TLC Assistant Coordinator — 20 hours per week
Three (3) TLC Family Associates - 10 hours per week each (one Family Assoc. is bilingual)
Secretary — 10 hours per week
The TLC staff have nursing, psychology or child education backgrounds and all have college
degrees. Their, continuity and professionalism. have been cornerstones for the program's success.
5.AHow will the target population be made aware of the programs Contact is made at the
hospital with the mother and family of the newborn. TLC Newborn brochures which describe
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J-othe services, are at Indian River Mem^borial Hospital, Indian River County Department,
andobsetnc medical rovsde
p rs offices and distributed at health fairs. Hospital personnel ,.
.. t.4a R
III Aenthussastically, describe and 'endorse TLC Newborn to the mothers. Because the program is
universal in nature, much of the awareness comes from word of mouth from the 1 ,000 new
moms and families the program serves each year, as well as from the grandparents and relatives
of the newborn . ."The IRCHS Coalition also markets the program through its newsletter, public
presentations, every other month Coalition meetings, and at health fairs or other public events.
6. =TiHow-will the'program be accessible to target population (i.e., location, transportation,
d : hours of operation) ? Visits to Indian River Memorial Hospital are made six out of seven days
`A n t 'X
of each`Week bythe TLC Newborn personnel who meet the mother of every newborn either the
day of delivery of her baby or the day after. Infants born on Sunday are normallycontacted on
the second day after delivery. Follow up phone calls are made with each family, of a newborn
who w interested in artici atin ;which is over 96 percent of all newborn families in IRC. M "
1 y3�
S VA
+
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Organization: Indian River County Healthy Start Coalition, Inc. Program: TLC Newborn Program
Funder: IRC Board of County Commissioners — Children 's Services Advisory Committee - 2004 Grant Application
D. MEASURABLE OUTCOMES — PROPOSED for FY 2004-05
(Section D not to exceed two pages) .
OUTCOMES ACTIVITIES
Add all o the elements` or our Measurable Outcomes Add the tasks to accomplish the Outcome(s)
* 1 . GOAL: 70 "/0 of all families who accept 1 . During the first month telephone calls will
phone calls will be provided reassurance by be made to families. .The discussion of these
the TLC Newbofif staff during the first phone calls will be centered around care of the
month. " �. • 4 � "-dsmy •� . .
This will,be measured by ,k, , infant and development of the infant. If a
u ,< � . ; ��� �t P
documenting wha area the ;client needed parent is identified as needing reassurance
1f: s
reassIl .urance in and;what the staff did"I 0. i then the staff will provide necessaryt a'
promote' ears ran I. Y ° u informaution both . ertiI .kally an writt y order ;
$Ilk ' f � k r , to' prove a tie parer reassurance. If
'
fr o e v
rC? Y S
o. h �lS i , f . . .. fi A �• „�f; If
�, J ,
-�� _ *2. GOAL,9 80%' of families ,who accept. Yry .:; 2 . During the first month and any time there . , -
` pyi kt "'Su'z + "�r,.r �.T'.r'$4t x� , . ' •n 's � • _ • r
phone calls an need additional information after if a family is identified as needing
will receive additional mailouts/ additional information or has a need for a
information/referrals during the first referral staff will first explain the information ,
4 , y f L X erral en send ui<f r .miah the
month. and/or ref th
;mail to the ehenThefamily
g . � fi SAr 7� r#
be I Ilk
vised ><f a�n � tr
yttm ey n\ S r J. i
+_ r � � i. . explanahon� Lust " If
Ir
�
q f f, r f .Ir
af ,
*3. GOAL : 500 the families who accept" 3 . If a family is identified as having a lack of
phone calls will have a understanding understanding on any topic that TLC Newborn
during the first month through has discussed with them or if their lack of
explanations, literature, referrals and this understanding is related to a topic that TLC
under stanl' If r . ding will be measured. by , . Newborn has not discussed with them, TLC
evaluatmg, >if the'family followed through Newborn staff will take the time to go over the
with the suggesti'onZreferral aIII III -nd/or topic until parent has verbalized their ,
literature h1 z. understanding: TLCNklk
ewborn,will then follow
F r up at the t><me of the next phone call to if
0 aid a C r �i b. u• ag Y4d1yy
F .f ,� i ..yt , ,f i .fe Tyr° f kti • :; "s'x .+r✓ ,;' _ t '. ' v
Ill
p �; ; F , yAll
x , understanding had been retained by family. `. If
.j
F x ' s t en the"steps wil) d be repeated , k
r � " - T. r ' not th
14
• 1(•' k , - M o� ! s) kw n
Ilk. ' ' note: These first three5Outcoines Goals were modified from the ,
2002-03 FY based on the ri o mmendations provided at the 2003
t United Way training ongoal and objective development.. The goals
;< were altered to match the mission; statement of the TLC program and
utilize the more reliable progresess reports from the TLC Family ;,
Ilk
Associates to verify success in achieving the desired outcomes: , The
Ilk I
percentages were based `on available data from the previous year's
progress reports and have been increased for FY `0V05 based on `031a, z:
04 inid-year outcomes l t
k, ,C� e ° '' r
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I If
� �� > 1q § ted
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_ : 4_
Organization: Indian River County Healthy Start Coalition, Inc. Program: TLC Newborn Program
Funder. IRC Board of County Commissioners — Children 's Services Advisory Committee - 2004 Grant Application
PROCESS OBJECTIVES
4. GOAL : TLC Newborn staff will visit 4. Six out of seven days a week, a
98% of women who deliver at Indian River representative of TLC Newborn will visit
Memorial Hospital. Indian River Memorial Hospital and offer the
TLC Newborn program to mothers of
newborns.
ot
r
-
r " ) � krrmy rv�E' s. P� ) �Fi _ . ¢ �✓ ! ot . -
y .t. . o
t4r4 ,� . 4 r . =• x it.
_
{ b , i
V 5. GOAL#' , 93 ° o of mothers who are visited S: Continued promotion of the program
Baa i.the hospita a ,. .
accept, the invitation to through press rel aseslirochures and
• eoL ` ai1"rxwya,' . , n ..•3 x- 4Y Y'r0 "w~ ...., .k `'�t rdem't ^s . , a _ i*ya `M 'xe - '•
• :xe ... , ,+. �. .
pa :• icipat , ><n the { N wborn Program. information . to med><cal providers and health
'}�' „rti ! 4 x ysr + , jlhr` .
� . .r fairsto
. 9
to
n1�tp
r- x.
6. GOAL : 90% of familiit, es will be reached 6. Persistent It calls to follow up with
and result in 'a significant conversation with the family.
v a arent and or'.care ver two times the first .
igt.I4 0, {p
t� Lti ' month. - �` '.� 1 ` .il +7.C,� b.; o, $ " ' t" �r R'�'+". �pG � ^ `�'�'���
111 '.
It
,{2 ✓ w
,Ar Ierrals" will tie followedFamil soc><at x ' continue to (rack' k ' t
.rite . s € , .
n andconfnme a 'tawhether or not thereferrals to fam><hes and ` It on whether the
fammily,acted on`tlie'referral. Y
have followed through. ,
8. GOAL : 7.5 % of families will call 8 . Upon intake at the hospital and during
requesting additional information, conversations with families, staff will
reassurance or referrals, encourage partiCIPants to call in with questions
or concerns.
IVtyro rrts
1 its4t I 'i A11 R' f�' ya 3. 4(' � 1�' T .t• j r • } Q'¢ 11 Y' \: { . }
# Sr : 1 ? � '3,4✓f r` '1 Irl
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i< f " �' ` " �' a t ' `r �. s .xgr�d ii( J .� rt �T�I " .S�rs} '3 ' r lotr
>^s yjjj . x�^ y # "5 r + 9 e7 r x£ ir' x a 9 '
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Organization: Indian River County Healthy Start Coalition, Inc. Program: TLC Newbom Program
Funder. IRC Board of County Commissioners — Children's Services Advisory Committee - 2004 Grant Application
D. 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. (NOTE : Collaborative agreement letters
are not required by United Wayof Indian River County.)
Collaborative Agency Resources Provided to the program
to" * Free office rent * Conference room access * Access to
` Indian River County Health Dept. office equipment such as computers, copier, postage,
It
VI
axaiid telephone services. * Staff supervision
" ItSStoiage� space * Payroll services * Cleaning
yAll`these services are provided * Purchasing" services * Personnel services * clerical
} b rn:kind, ><vith no- admirastrative fee. support * outreach
F" 3 MA b r5 .. . ''.( . ' r r: ,i 't,
,
Access� fo' mothers with appropriate guidelines
ION
_ ndiaii River Memorial Hospital *, Pertinent information, especially in case of infant
V s. mortality; which is discreetly relayed to TLC Newborn
personnel when needed. As with all medical facilities, ,
confidentiality is observed throughout. * Storage space
Ira
3 . Y ' , fo { ' paperwork, manuals and references in p n „OM1
aVIA
ellechve rand Deliv ar * l
eaS ; . Positive
tie services are"provided d promo. ' onofTTI;C ro nevi mo
, ' xKr ' , = ,p thers b all
t -kc tt� aid � zx$ # # , .e _ �r , ;
n minrstrahv fee: ` o >< j Comfo communication betty"
a... T - . v
e �� vs �' �rovld'ers� .`•d Y _ o
- media `
' an TTC`"Sta
IRC IJibrary = Born to Reade * Provides two books to newborn families that are given
:....
Program to the family of the newborn by the Stork Club. The
TLC staff provides evaluation two months after birth
by asking the mother if they, have read the books to
their. children, with a follow-up of emphasizing the
dd
gortance of reading to their infant towards
ancing brain development
z� , � > ting Nurses Association of the * Provides home visitation for mothers of newborns
Nisi
IP
Treasure Coast ' ex enencm breastfeeding difficulties or in need of
ANM, °. p g . . g
-' FL t v s „ �w� grea' e> breastfeeding education.` Breastfeeding home
' t. ,7 _ _ VisitMon char g e is $50.00 er visit b the VNA.
Indian River County Healthy Start * Overall program development, integration and
Coalition
communication within all four IRCHSC programs
It (Healthy Start, Healthy Families, TLC & Safe Kids).
' (While the Coalition is the applying * Fundraising, PR and marketing of TLC program.
11111 '44agency, many in-kind collaborative * ,Tn cooperation/collaboration with the IRC Health
}e} fforts on behalf of the TLC program Department, TLC Program QA/QI, reports and
aW°w
take place.) k troubleshooting. * Provide TLC representation at
r UnitedWay. r
w yy:Way and other public events. * Presentations to
61^`. . � c ,
5 w community groups regarding theI I, TLG Program.
* .
All these services are provided m- Development and, presentation , of TLC RFP/Grant(s).
tkind, civ th no administrativefi * Fiscal oversi t and reimbursement requests,
:y 1
,�Y q� � 1r �s �eF �� au 2 . Y .:n y r icy y` " •
a.
r 'x" r:^ > 4 ';*,$ ° t M{ t e• r 3�`N, W X 5 i
a
.,. T ,; yr , �, y•' ' ` ` , ,� ! ' � a. +�#� f .N'" ff" ,v, f ',��.' s° � ,T7� ,N �
i ' Sk* � r r � tt., _
• - • .... . ,�.:,, .. . , �' T .. A .: . .?T ,. :, 3 K '' i �'Ywr V`7�+} , +• ffis It
w ,� #rp,'cGA("�:-e � • '
Organization: Indian River County Healthy Start Coalition, Inc. Program: TLC Newbom Program
Funder. IRC Board of County Commissioners — Children 's Services Advisory Committee - 2004 Grant Application
Fe PROGRAM EVALUATION (Entire Section F not to exceed two pages)
1 . DEMOGRAPHICS : What information (data elements) will you need to collect in order
to accurately describe your target population including demographics (age, gender, and
ethnic background) required by the funder in Section H? What are the pieces of
information that qualify them for your target population ? How do you document their
need for services or their "unacceptable condition requiring change" from Section Bl ?
Visits to Indian River Memorial„ITospital are made six out of seven days of each week
by the
TLC Newborn personnel who meet the mother. of every newborn either the day of delivery, of
her baby or the day after. Infants toed on Sunday, are normally contacted on the second day after
rya, Follow u hon .c
delive p p a are made with each family of a newborn who is interested in
, F
amici mill '
p pg urthe TL( ewwunty:�tl
11
ogram, chis over 95 percent of allne�born lies r
iyGg i' a! ti;rt�a�, ary •3y , T ' 1$'P. Fa �.,, ? 4 *r . ��
p seen y.TLC in Indian° RiverAll data ;. client information is gathere! at the PIItune of the
hospital visit and enrollmeiitinto tfie ro
• fip gram: :The birth of a newborn from an IRC resident is
the sole 'requirement for participation. Decreasing support, both medical, educational and
emotional, is a rim need that is filled by TLC for overall infant development and wellbeing.
2. = NMASURES : What d,att` a, elements will. you need to collect to show thaty
. ou have-
_\ g” , • ., ia`'� i�'�g «, •F'v °Lc�+ SiFgi°slrf" i ° � # ,
achieved (or made progress .toward) your Measurable Outcomes in Section D9 at tools
o>r�
Feeyon using !' measur •ales servey. scores, attendancr , absencesr.8 ;o- , ,
s �in rmahon frondsourceon our y• • • •m your Activities m Section D that
d to be documented? How often do you need to collect or follow-up on this data?
The initial intake form that is completed at the hospital provides basic reporting and baseline
information for analysis purposes and demographics. For the 2003 -04 year, the progress chart
form that the TLC Family Associates use will be modified to answer Goals One through Three.
Pi
The TLC program has a special data base designed to monitor and document the process
objectives. � ASurveys are sent out to the families during the third month of their child's birth and
at the completion of the° 12 month period. This information is tallied and results put ui the
requested reports. Goals�and objectives information is collected by each TLC staff member, and
is inputte ft a data base on a daily basis, with the number of families served, phone calls and
referrals `recorded, along withrvotherneeded information: • The Twelve Month Surve is much
shorter in length and focuses on open endedresponses addressing major benefits of th6 program
in terms of the TLC families perspective. The Three Month Survey is based on a "strongly
agree' to I strongly disagree" Liekert scale format. The survey involves ten questions and
addressesµ . ecific programissues.
Ile
3 . REPORTING: What will you do with this information to show that change has ,,
occurred . Ilow will you use or present these results to the consumer, the funder, the
programi`and the community? How will you', use this information to improve your
program?`Data'collected will be compiled in reports requested by the =and provided to
the funder°'Th'e IRC Healthy Start ,Coalition and the IlZC Health De artnient The Coalition
P. M
holds a quarterly TLC committee meeting, which is chaired by a Coalition Byoard member. The
Lill
comimtteerenewsether.r orts', as well as overall program issues and loglstics. The Coalition -'
z ,y
��'� 4 ,k . , x, �n r# 2k r . . Y •5 , w rye. . ' i �. -s
19"4. y 4.# y( ?c -'�• r iti
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1
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Organization: Indian River County Healthy Start Coalition, Inc. Program: TLC Newborn Program
Funder. IRC Board of County Commissioners — ChiIdren 's Services Advisory Committee - 2004 Grant Application
Board of Directors also receives the reports upon completion. In addition, a verbal report is
provided by the TLC Coordinator at the every other month Coalition meetings. Lastly, a
Program Managers meeting, which is also chair by the Coalition Board member, involves the
TLC Coordinator, Healthy Start Care Coordination Supervisor, and Healthy Families — IRC
Program Manger, is held each month at the Coalition office. This meeting' s purpose is to address
program issues individually, which includes updating each Program Manager on the programs
14
status, as well as ' einsuning overall communication, collaboration and integration,
� pp
. 11 ZIV
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Organization: Indian River County Healthy Start Coalition, Inc. Program: TLC Newborn Program
Funder: IRC Board of County Commissioners — Children's Services Advisory Committee - 2004 Grant Application
G. TIMETABLE (Section G not to exceed one page)
1 . List the major action steps, activities or cycles of events that will occur within the
program year. New programs should include any start-up planning that may occur
outside the funding year. In completing the timetable, review information detailed in
prior Sections.
onth/Period
4I , MActivities
All components of the TLC Newborn Pro
p {, Ile I grams aze m place, with a veteran
TLC staffproviding services., The hospital visits take place on a daily
t except Sundays
g4105. Io , { basis exc , e Ko :
>•� a
r ' , iia aL?♦ 9 1 � -
N;a •'� IS
The major programma action st s and activities of the TLC program are
the followmg. ' R
AS 2. % n
Daily*
Y' Hospital visit by TLC Associate (except on Sundays)I I .
t� * Retrieve security badge from Social Workers office,
LL t
Li { U = * Visit maternityv,yard ` 5uisesstation for,lisofnewdeliveries.
f£ * Review hst�with TLC: og for families who have been previously visited.
Y n� elf as TLC brochure. ' , x ,
* Prepare mtalte .7uesfor s
ceso
So I
*Present . �.� �♦{ � . � .�. ' . , r
p 3r proOman hL,
,{ x ° , '„ "* `Completeinake n
w. ,.d ent to services form.
pp��pppp��
* Repeat visit to all mothers of newborns not previously seen.
* Complete TLC log located at hospital.
Office:
AS
* Continue intake rocess' -includin to
p g gging information on computer
f and setting u file of family.
g p y.
x * Assign families of newborns to TLC Associate within one week.
IS
}{ * Send customized mailulgbased on family's needs,
7
> ` .. r
IS
s sc Month< *l Call famihes``of newborns e'ekly for one month `after birth of newborn '
Fust `Wee � ' ` ta ,, '
Wisdom' newsletter is mailed.
� 1 ✓ t .j. .( XYlhat�t . . : k ttF ... . :
During second month (from birth), phone calls are made every-two wks :
Ildx
From third to six month (from birth), calls are made one time per
Monthly' t- ; ", month.
ry * Age (month) a ro rI a newsletter is mailed each month,
) pp p .
On second Friday' of each month, newsletters are compiled for monthly
? wC s � `a a malhngs• � �,� i,� ' t .,i
SI
A11
( u
IAIII ' After 3rd and 121 , moth n appropriate ro evaluation surveys are
ap1
smailed, y f ' , ¢M
" A * Csn a quarterl basis ' se '
y n sibling newsletter forfamilies with children
w �� „r ages 13 months to ageour will be mailed
,
If LL
T 'ay, ,r '�, �'- �} •� ::.
•
r e�'
` i �, v 't r r r uatx 9' y _ , •s.J +Ir ,1 `, *?
C' 9 h"�'1 � xx ;� F pt ', e • ek
``#`t s ' r,�,r, •: ,;, tr ' ,. ,,g.� Tr i`` .- z t jYx°.5 � tc
hz r,♦ Cy ire '� T'R` 9' < �• : ye; }y
M Organization: Indian River County Healthy Start Coalition, Inc. Program: TLC Newborn Program
Funder. IRC Board of County Commissioners — Children 's Services Advisory Committee - 2004 Grant Application
H. PROJECTIONS FOR UNDUPLICATED CLIENTS
Number of Unduplicated Clients by Location
` Last FiscalY�ar Current Fiscal Year NettscaLYear
Location . Actual 2002/2003 , Budget 2003/04 . 13rojectons .2004/05
Unduplicated Clients Unduplicated Clients Unduplicated Clients
m 1
Mr Indian RiverCounty " 829 826 857
w
S. Indian River County 1 ,261 . 1 ,240 15285
Indian River Co. :Total { . 2
2'066 2, 14
Greater Stuart ' v
r"�^ r ,L-F gawp :l{tY: aI ilk
. y "'• ._y {• ' F .rkaab —. "(' . f. 1 -T Sc :ir' 2 �k ?
Hobe Soundr ;,_ _
3 IndiantownAll -
,. r Jensen Beach _
Palm City
9 Sri
Martin County Total
F&t Pierce
/gyp . 7777����M�_p+ g , mss'
Port Saint IMC 664 sk r < F4 t' § 3 a
x ; r St.` Lucle COr^TO'taT' Y ap 2 - � S
' t + w# �a
Z IOther Locations
TOTAL SERVED 2,090 2,066 22142
(1 ,000 families) ( 1 , 033 families) ( 1 , 025 families)
Notice: The
unduplicated client count does NOT count fathers.
i' However, it does account for multiple births.
K >: - , •tr : - " . _. : yrlk ki till
,
hlortfi Indian River Count�isAmade up of births in z p codes :, 32958, 32967, 32948, 32970 and half of
baths from 32963I Lill
. ^
�k '1`4 O
� y f >
y South Indian River County is "mbath
ss up of bs In zip "codes : 32966, 32960, 32 968, 3 962, 32961 and
, I, Lithalf of irths from 32963 F+.
91
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rl
91
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Organization: Indian River County Healthy Start Coalition, Inc. Program: TLC Newborn Program
Funder. IRC Board of County Commissioners — Children 's Services Advisory Committee - 2004 Grant Application
Number of Unduplicated Clients by Age
Lastfscal Year Current Fiscal Year Next Fjscal Year
Location
pct ial 2002/2003 Budget 2003/04 Projections 2004/05:
IndividuaIs Group Individual Group Individual Group;
0 to ` 4 - (Pre-school) 1;090 - 12033 - 19, 117 -
S to 10 `- (Elementaiy)
llao 14 ' (Middle) }
15, t618 ,=' (High School) a µ 98 100
"WA
W Total Children
1< s
� 1; 188 �.t � - ,� � �2�} ;� 1 , 133 am404t 1$,217 46 ;
19'fd-�59111'! (Adults)V,, ` �; ,:, 902 - 933 _ I � � -
r , 925
60`+ ) _
(Seniors
Total Adults 902 - 933 925 -
TOTAL SERVED 2,090 - 2,0661 - 2,142
3p � y v 4
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' IRC Healthy Start Coalition, Inc.
TLC Newbom Program FY 'OV05
UNIFORM GRANT APPLICATION
BUDGET NARRATIVE WORKSHEET
IMPORTANT: The Budget Narrative should provide details to justify the amount requested in each line item of the budget for
your program. From this worksheet, your figures will be linked to the Total Agency Budget, Total Program Budget and Funder
Specific Budget Forms.
FY 2004-05
AGENCY/PROGRAM NAME : Indian . River County Healthy Start . Coalition , Inc, - TLC Newborn
FUNDER : IRC Board of County Commissioners - Children 's Services Advisory Committee
entet
where "a
C�AUT/ON �at!`o sand fo write sformatlo 'tel/ is colored In dark blue Formulas and/or link1. s are In lace. Gra areas shout
L n only. .
P Y d
� , ; ! " ORAYAREAE FOR - '
iurEwcrusEowr Proposed Total Program vender
t q� . REVEN E ,Y. IaFawoErw . '> vender S cltic Bud t Total Agency
cucuuT Budget N , a + . Pe Budget
1 Children's Services Councii�St. Lucie
2 Children's Services Council-Martin
3 Advisoty Committee-Indian River 15,000.00 151000.0 700000.00
4 United Wa -St Lucie County
5 United Way-Martin County
6 United Waywindlarl River County 55,000.0055,000.0
7 Department of Children & Families „ ,N
8 County Fun ' cs.
1-' Yx x
W ' s ok ' a
9 Contributions=Ca's , ice ,gg@ ss ; '
1 _
10 Program Fees -*Wx vt,' xf4 , 6”r
11 Fund Raising Events-Net - , 3,500.00 8,000.
12 Sales to Public'= Net '
00
13 Membership Dues
14 Investment Income
15 Miscellaneous
16 Legacies & Bequests
DOH - FL .
17 Funds from Other Sources Ounce 967,679.00
18 Reserve Funds Used for Operating
19 1 In-Kind Donations (Not included In total) 30,000.00 939489.00
20 < ' TOTAL REVENUES
,}, - { , tom s i ' p� � °� sh` tdk� r ,.4 ` ,:1 .Y
w> doein include line 19 $73,500.00 $ 15,000.
$19100,679.00
A 4L
5 :
EE
yIXPENDITURES Proposed Total Program C TotalAgency
CN=" Budget Funder Specltic Bcfdget
Budget
00
21 Salaries - (must complete chart on next page) 55,811 .00 1590 .00 6871771 .00
\ a
k: Salary ; ='
22 FICA = Total Salaries x 0.0765 7.65°/ 4,270.00 0.00 529615.00
e remen Annualpension or qua t le 7.3% for TL
23 staff ". . F Cooed. 19954.00 0.00 319954.00
m e ea a Ica enta n-term
11
24 DISab. '' ' - ` r' y - r.
y , ♦ ,,W 9�f P s j•. . t i
o ers ompensat!on emp oyees x
0.00 68,891 .00
25 rate`
ro` 0.00 99903.0
n
oa nemp oymen - projected
ILL
26 employees x $7,000 x UCT-6 rate ? �, 0.00 19200.00
LIM
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IRC Healthy start coalition, Inc.
TLC Newbom Program Fy '04-'05
SALARIES A B D
POSITION LISTING Gross Annual portion of Salary on Proposed C % of Gross Annual
Salary Funder S cific Budget Salary
Position Title / Total Hrslwk (Agency) Program g Requested(GA)
Example: Executive Director/4ohrs 700000.00 14000.00 5,000.00 7. 14%
TLC Coordinator 32 hours per week) 26,761 .00 269761 «00 10,000«00 100.00%
TLC Assistance Coordinator (20 hours per we 12,050«00 12,050«00 50000.00 100.00%
Familly Associate (10 hours per week) 4,375.00 4,375.00 100.00°/
Famili Associate (10 hours per week 4,375.00 4,375.00 100.00%
Famili Associate (10 hours per week) 4,375.00 4,375.00 100.00°/
Secreta (10 hours per week) 3,875.00 1 39875.00 100.00%
Or
#DIV/0!
#DIV/01
#DIV/0!
Health Families - IRC , 319.054 � � u{� • �, o.00y
IRC Health Start Care Coordination 1901000 00 000%
IRC Health Start Coalition - 1221906 00 ; '
L'S, It , 1 - "..t.j 5q :^ at,> �h « S 0.0tl°/
* k #DIV/01
/ #DIV/0t
#DIV/01
#DIV/01
#DIV/0!
µ _.
#DIV/01
r r.
IV/U1
x , pppppp� 34' #DIV/ot
T ' "Notal Salaries "
$687JI11
: $552811,00 > Or
$15,000 811
Or- , Y f A . s FS t
ry� I }v. {T unit;
S ll F n` r�ntl �f r'dC .k , r ,yyav_Y' � `i�'�L �# �.v YS',�tr { y t rt rX,'
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Or
f- ... . . 5. . .
FRINGE BENEFITS DETAILIj
A ; : fOr
(Funder Speciffc� Budget Funder s c v E F G
Column C Only, from line 22 to 27 ° Pension Worker's Unemployme Total Fringes Funder
Specific FICA 7.65/ Health /ns.
Position Title / Total HtwWk ) Budget (AOr �1 Compens. nt Compens. Specific
Example: Case Manager/40 hrs 50000.00 38250 200.00 500.00 300.00 200.00 1,582,50
TLC Coordinator 32 hours r week 100000.00 0.00 0.0
TLC Assistance Coordinator 20 hours r we 5,000.00 0.00 0.0
01
Famil' Associate 10 hours per week) 0.00 • 0.00 0.0
Famili Associate 10 hours rweek .` 0.00 . u ,; 0,00 0.0
Famil' Associate . 10 hours r week 0.001 p° w r, ;r' 0.00 0.0
01
Secreta 10 hours r week 0 t; `` 0.00
0 * . ; : 0.
0 ' 0.00 0
0.001
0.
0 0. a J.< 0.00 0.0
Health Families - IRC 0.00 - 0.00 0.0
IRC Health Start Care Coordination 0.00 0.00 0.0
IRC Health Start Coalition 0.00 0.00
` 0.00 ' 0.00 0.0
0.0
0 ' 0.0 0.00 0.0
0 - 0.001 .:.
0.00 0.0
0 , 000 , 0.00 0.0
" �
% I Or„ : 0 0 0«00 0.0
0 ,
0.001n.N",
0.00 0.0
,
s, . 000 0.00
0. r ,, 0.0
# x� : 0.00 OA
> Total Funder Request Fringe Benefits $ 15,000«00 „ ; $0.0 $0.00 $0.00 $0.00 $0.00 $0.0
ION �t � a ! :'Y . ( , df
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Or
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IRC Healthy Start Coalition, Inc.
TLC Newborn Program Fy v4-'05
EXPENDITURES GPAY A EAS FOR Proo C D
AGENCY USE ONLY To posed Total Program Total Agency
Budget FunderSpecificBudget
Budget
27 Travel-0aily 706.00 0.00 190000.0
# of Staff x average # of milestwk x 50 wks x 5 staff for travel
$ = Estimated Daily Travel/Mileage Reimb.. to IRMH
28 TraveUConferenceslrraining I I500.00 0.01011 ,000.00
• National Conference (cost per staff)
• Training/Seminar (cost per staff) regi and
• Other Trainings (cost of travel, lodging, or for Coord trainingional
registration, food) And/or staff
29Office� pp
supplies (monthly average x 1 700' r 0• 10,000.00
2 �,z monthly _
months = estimated cost of office supplies average of
based on piesent history, ,-":,: °4. a 3 $66.66
30 Telephoned x
0.00 . 0,00 13 950.00
• # Pfone Imes x average , ntt�
2 months' local phone�cxist ';o
�� y �
`{ "tlPf A` .'k" FH , s: t4 •^�• • _ 1 �, yp ° 9 ;'fp { S
• Average long distance calls X-12 months = Provided in-kind by IRC County
Estimated cost of long distance ` '
Health Department (CHD) :
31 Postage/Shipping 4,884.00 0.00 8,000.00
• Quarterly Mailing of Newsletter Average of 1100
• Special events, etc. pieces Per Monthly mailing of age appropriate
month at .37 newsletter, surveys, sibling newsletters
• Bulk mailings - appeals x ; cents and first mailingthe week of birth.
32 Uttlitres + ' 0 0 79000.1
• ElednGty ($ x 12 months)
r Oxy . mx
� , is
,� • YVatedSewer ($ x 17mo � u �Nit
/. } f,,y y1 ,.t (� `_ _ n .s � d4 T.• '/1 ge ($ x •12 rrlOrrV 1� ` x
i > ra n , Nl�dnd 'O.IV iRai cK• . ri J' r "S`4r1]fF "'k ne « , i
Ficaith rtrnent (CHD) " d
.
3 bccupancjr (Building > Grounds)� � y
0. ' O'N 3461800
• Mortgage/Rent ($ x 12 months)-.l
• Janitorial ($ x 12 ax. ' A
Mo �'" `
• Grounds Maint ($ x 12 months)
• Real Estate Taxes IProvided in-kind by IRC County
Health Department (CHD)
34 Printing & Publications 2,500.00 0.00 50900.00
• Quarterly Newsletter ($ x 4) Update and re"
Letterheads, Envelopes. etc {_ c
• Fundraisin materialst 4q' f Printing of
g d monthly
• Other ; = r newsletters.
r ,u
35 Subscdption/Dues/Memberships , 0.00 ,t ,
• Membership to National Organaatio Y ,. ` 0 00 6,500.00
Dues; . . � � - `1` k { .
• Subs .; � 4 #, rK
ai tions to News ° ° `
g
P Pape magavnes, _
Y �
,4' � ♦ r .
etc. . � �, •{ � t „
36 Insurance 0.00 0,0C 49500.00
Directors/Officers Liab, y
• Commercial/General Insurance
• Bond Ins. .t
Provided in-kind by Coalition and IRC
• Auto Insurance < < : . County Health Department (CHD)
37 Equipment: Rental & Maintenance 0,00 0.00 99271 .00
• Copier lease ($ x 12 months) .
Meter lease ($ x 12 months) � r
• Copier Maintenance ($:ex 12 months) -
Computer Maintenance ( $ x 12 months)
• Provided in-kind by IRC County "
Other :a _ 'R , .
# . r 4 b Health Department (CHD)
38 Advertfsing 0.00 x "�' ' 0.00 ' 300.00
Newspaper ads a OR undraising ads/promotio � ' ��Othe vacancies) *� r~
{. r � ,
39 Equipment Purchases:Capital Expense (. ., 0.00 ' 0.00 * .
, 10
,530.00
IIV + t "
All
, �4 4.tY S - Pi i rc , 44 r' ?NQS I k'. '� • Ar" {`
ry fv
IRC Healthy Start Coalition, Inc.
TLC Newbom Program FY 'W05
• Computer/monitor (# x $)
• Laser Printer
40 Professional Fees (Legal, Consulting) 0.00 0.00 61000.00
• Legal advice ( estimated #hrs x $)
• Consultant fees Provided in-kind by Coalition and IRC
• Other County Health Department (CHD)
41 Books/Educational Materials 500.00
• Books/videos Age-approriate 0.00 2,000.0
brochure and
• Materials ($ x staff) bookliet Info.
42 Food & Nutrition 0.00 0.00 0.0
• Meals ( # meals x dients x 5days x 50 wks)
• Snacks 4 - ,
43 Administrative Costs .
0,000.00 59,
• Admin. Cost (% of total budget) Provided in-kind b 546.0
Coal, + CHD (HSCC and 546,0
44 Audit Expense x..; FARC
0.00 0,00 14.500,
Independent Audit Review off; 4 Provided in-kind by Coalition (IRCHSC & HF-IRC
45 Specific Assistance to Individuals
00,
MedlcaYassistarice s W = , 2,0
• Fa ffe _ ;z
., r ..
yok
y
< r w.
1
$�1 . . . , y', ,err .
Rent al
Assistance
• Other
46 Other/Miscellaneous Crlent Necessities
175.0 0.00 13,500.0
01
Backgroundch6ck/drug test (SI
• Other system/events/Safekid
Volunteer luncheon
47 Other/Contract , .. .., >. +4, ;tt
30 BF visits at 19500. 0.00 109100.
• Sub-contract for program services $50.00 per visit VNA and HS breastfeeding home visits
'48 `. ORAL EXP5
ENSESfi' r: x
$73,50000w,
' 515.000. $1 .1009549.
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TLC H.-tnn Rgyrn Fr D606
UNIFORM GRANT APPLICATION
TOTAL AGENCY BUDGET
FY 200ws
AGENCY/PROGRAM NAME: IRC Health Start Coalition , InC. - TLC Newborn Program
FY 02/03 FY 03/04 FY 04/05 % INCREASE
FYE.7/1/02 . 6!30/03 FYE 7/1/03 . 6/30/04 FYE 7/1/04 - 6/30105_ CURRENT VS.
NEXT FY BUDGET
A B C D
ACTUAL TOTAL PROPOSED (coL C-w, Bycoi, B
REVENUES BUDGETED BUDGETED
1 Children's Services Council-St Lucie 0.00 #DIV/O!
2 Children's Services Council-Martin 0.00 #DIV/01
3 AdvisoryCommtttee4ndian River 55 000.00 70 000.00 70 000.00 0.00%
4 United Wa �t Lucie County0.00 #DN/O!
5 United Way-Martin County0.00 #DN/01
a 6 United Wa -Indian River County45 000.00 45 000.00 55 000.00 22.22%
3, � '
7D artment of Children & Families
0.00 #DIV/01
B County Funds
k
0.00 #DIV/01
� z
a Contributions-Cash-
' " 10
Program Fees 0.00 #DN/0!
0.00 #DN/01
� * s i11 Fund Raisin Events-Net
12 500.00 8000.00 -36.00%
12 Sales to Public-Neter: ;Fb ,� �, zn �,� ws ., W 0.00 4y #DN/01f ' �?atP
`' . `' 13 MembershipDues 0.00 #DNI01
14 Investment Income
15 Miscellaneous 0.00 #DIV/01
16 Legacies & Bequests 0.00 #DIV/01
0.00 #DIV/01
17 Funds from Other Sources 804174.00 894 271 .00 967 679.00 8.21 %
`° 18 Reserve Funds Used for O eratin
19 500,00 10 000.00 0.00 100,00%
M 9 29 826,00 25 000.00 °
«' 93 489.00 273.96 /o
20TOTAL nations arinuoewMe : j � - 923674.00 ': 1031771 .00 1100679.00 6.68% '
EXPENDITURES
LL 21 �II;.A dr klirle4 r Y{ ktr ` <, 574 583.00 �i$ 660 815.00 687,771 -00 4.08•k
" „ 43 855 00 50 552 00 52 615.00 ' 4.08% ' ^ Y #f *- knit
Retirement "*- 24 048.00 "K 26 000.00 31954.00 22.90%
LifeMealth
50 957.00 64 715,00 68 891,00 6.45%
25 Workers Compensation 1400.00 2,500.00 99903,00 296.12%
26 Florida Unemployment 800.00 29000.00 120000 -40.00%
27 Travel-Dail 20 721 .00 12161 .00 19 000.00 56.24%
28 Travel/Conferences/Trainin 6156,00 1272400 11 000.00 -13. 55%
29 Office Supplies 79827.00 S 419,00 10000.00 84. 54%
30 Telephone 13'9475.00 13 958.00 13 950.00 -0.06%
31 Posta a/Shi in 4 470.00 7 384.00 8 000.00 8,34%
32 Utilities 4141.00 41500.00 700000 55. 56%
33 Occupancy Buildin & Grounds 21 720,00 30 677.00 34 618.00 12.85%
34 Printin & Publ(ca8ons 77899,00 5P919,001 51900,00 -0.32%
! � ` 35 Subsert tion/Dues/Membershi s ' 6 000.00 6,428,00 6500.00 1 . 12%
36 Insurance ° Coal, hlth ins: here in audit 169.00 160000 4 500.00 181 .25%
37 E ut ment:Rental & Maintenance 5105.00 927100 9271 .00 0.00%
38 Advertistn 10367 , 300.00 300.00 0.00%
39 Equipment Purchases:Ca itai Expense 39745.00 10 350.00 10 530.00 1 .74% ,
40 Professional Fees (Legal, Consultin 36 780mwmm� .00 5 200.00 6 000.00 15.38%
41 Books/Educational Materials 27490.001 1 418.00 2 000,00 41 .04%
42 Food & Nutrition 0.00 0,00 0.00 #DIV/01
43 Administrative Costs 26 297.00 59 546.00 59 546.00 0.00•h
44 Audit Expense 10 500.00 12 800.00 14 500.00 13.28%
45 S ecific Assistance to Individuals 2,452.00 700,00 29000.00 185,71 %
46 Other/Miscellaneous
- 14591 .00 13 500.00 13 500.00 0.00%
47 Other/Contract 21 000,00 10 900.00 10100.00 _7,34•/,
ar . 1 " - "48 TOTAL - - 923 648.00 1 031 337.00 1 100 549.00 6.71
" 49 REVENUES OVER/ UNDER EXPENDITURES 26.00 ' 434.00 130.00 -70.05%
2 '.� jr • yy
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• , •� 'fi^ _ ,ti . . x - -. . - 2
tm :., 9 '�
• • IRC W/NySw Coalkn• kt -
TLC Ner6unPW mww.os
UNIFORM GRANT APPLICATION
TOTAL PROGRAM BUDGET
FY2004-05
AGENCY/PROGRAM NAME: IRC HealthyStart Coalition. Inc. - TLC Newborn Program
FY 02/03 FY 03104 FY 04105 % INCREASE
FWL711/02-W30/03 FYE_711/01-6130/04 FYE 711/04.6/30/05 CURRENT VS.
NEXT FY BUDGET
A B C D
ACTUAL TOTAL PROPOSED � �, By�, B
REVENUES BUDGETED BUDGETED
1 Children's Services Council-St Lucie 0.00 #DN/p!
2 Children's Services Council-Martin 0.00 #DN/pl
3 Advisory Committee4ndlan River 15 000.00 1500000-S 15 000.00 0.00%
a United Wa t Lucie County t 0.00 #DNlO!
s United Way-Martin County >,> .. a• ' 0.00 #DN/01
6 United Way-Indian River County45 000.00 45 000.00 5500000 22.2270
7 Department of Children & Families 0.00 #DN/O!
8 CountyFunds 0.00 #DN/O!
Contributions-Cash ti-14-14"
0.00 #DN/01
4 ° ` 10 Program Fees" * 0.00 #DN/0!
� JFFFI, ' F11 Fund Raisin Events-Net + Alr1�a� 7 495.00 •r 3000.00
IL wk„ « 'sk j s.,• . ve 3500.00 ' # 16.6790
12 Sales to Public-Net '«
13 Membershi Dues
0.00 #DN/Oi
14 Investment Income
0.00 #DN/O!
15 Miscellaneous 0.00 #DN/O!0.00 ' " #DN/0!
16 Legacies & Bequests
0.00 #DNl01
17 Funds from Other Sources 15 000.00 0.00 -100.00%
18 Reserve Funds Used for Operating
0.00 #DN/0! '
r 19 In-Kind Donations OW kckK °d In roaq 30 000.00 30 000.00IIIIIIN
w 30 DO0.DO 0.00%
20 TOTAL v. +� yea > 6749500 78 000.00 73 500.00 ' .5.77%
ay
0.9P EXPENDITURES 4. 1
Itl
.r. . �, : >4 . a
IF
a
IV
7 s 21 Salarl � Jf, t 4 700 . :#i -° Sa 000.00 a:.
, t FICA"=` ' f 5581100 s 3.359. `
g fir : to t G "e •<' 3 2.00tf j4131.00 4270.00 "" tt ,, . - 3.36%
23 Retirement ' .-- ` I IF , 1346.00 1 750.00 1954.00 1166%
Y 24 Life/Health" ' > "
31550.00 49616.00 0.00 100.00%
25 Workers Compensation 0.00 #DN/Ol
26 Florida Unemployment 0.00 #DN/0!
27 Travel-Dail 11014,00 1 425.00 706.00
28 Travel/Conferences/Training11029.00 500.00 500.00 0.00%
29 Office on lies 595.00 800.00 700.00 -12.50%
3o Tele hone : ^ 0.00 #DN/01
31 Postage/Shipping31562.00 488400 4,884.00 0.00%
32 Utilities
0.00 #DN/0!
33 Occupancy Buildin & Grounds) , 0.00 #DN/0! ':
34 Printin &" Publications 29296.00 271900 250000 " -8.059°
'35 Subscri tion/Dues/Membersht s�uVre , I
0.00 #DN/0!
36 Insurance .. ,' 0.00 #DN/0!
37 E ui ment.Rental & Maintenance . ` - 0.00 #DN/O!
38 Advertisin 0.00 #DN/0! „
39 Equipment Purchases:Ca ital Expense 0.00 N/Ot
40 Professional Fees (Legal, Consulting) 0.00 #DN/O!
41 Books/Educational Materials 31201 .00 500.00 500.00 0.00%
42 Food & Nutrition 0.00 #DN/0l
43 Administrative Costs 0.00 #DIV/O! '
44 Audit Expense
0.00 #DIV/01
45 Specific Assistance to Individuals 0.00 #DIVlO!
46 Other/Miscellaneous 474.00 175.00 175.00 0.00%
47 Other/Contract' 1 ,400.00 29500.00 150000 -40.00%
48 TOTAL 63 946.00 78 000.60 73 500.00
49 REVENUES OVER! UNDER EXPENDITURES 31549,00 0.00 0.00 #DIV/01
S i �
r•s lf�'MS ' r Y: ').. I
'..,. ''Sf.,• t p
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,
Y ,� '� ' ' aq 9'1. f r ✓ 'S k Y
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Mt
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.,R 6xk>, .� �' � "h .•• find �: '�" >;j ' � S? I tr q in' � " � 5 i � r.z
,gw�"2y s • ' < t, v3 ft' r Y F ;� f A F .-€ d r , w .�4. a,+.2 c, " ' ,P. I� Ys
y
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IF I
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,`a" � s a x II-
IFF. ' �.
IRC Healthy Start Coalition, Inc.
TLC Newborn Program FY '04-'OS
UNIFORM GRANT APPLICATION
FUNDER SPECIFIC BUDGET
PROGRAM EXPENSES
FY 200""
AGENCY/PROGRAM NAME : IRC Healthy Start Coalition , Inc. - TLC Newborn Program
FUNDER: IRC Board of County Commissioners • A g
FY 04/05 FY 04/05 %a OF
TOTAL FUNDER TOTAL VS.
tt y a
PROGRAM SPECIFIC _ FUNDER REQUEST
c - A ,
IsI
BUDGET s " BUDGET
col. B/col. A
' EXPENDITURES a
21 Saltines d
' F k '. ` 55,81900 : °
x , �, . ;� 5,0 20 .00 /°
1 00.00
22 FICA : ' 4 270 00 ` °
0 .00
23 Retirement4 z 1 ,954.00 _ 0.00 °
24 Life/Health`.; , ,
0,00 /°
0.00 0 .00 #DIV/01
25 Workers Compensation 0 .00 0.00 #DIV/Ol
z
26 Florida Unem"Oloyment 0.00 . . _ 0.00 #DN/01
P + r as
27 Travel-dai 706.00 fY 0.00
0000%
# ` ere a rairnn 'r� ,. �„a t 'wi " 500 00 f
28 Travi 0D
0.00
office' s11 1 IF 0.00%
x ,29 UIS ffe c * � 1 3' ya ?.t#�f` t 'tfi'+""t.• rp5JkW" �r� 3.a, .,f
aa
,� . , .. ..e .1 a'1d, a� ., i x
700.00
0.00It
'' 0.00%
X30 Tele hone' . � �tw .. , 0.00 W 0.00 #DNlO !
31 Posta a/Shl ting Fr '., ' 49884.00 0 .00 0.00 %
32 Utilities 0.00 0 .00 #DIV/OI
33 Occupancy Buildin `& Grounds 0.00 0.00 #DIV/O !
&
34 Printing Publications- 2 500.00 0 . 00 0 .00%
it 35 Subscri tion/Du es/Memberships 0600 r >.j 0 .00 #DIV/O !
; ; 3s Insurance. `�. p .00 w 0,00 #DN/01
:00 r
A"IL It
37 E ui "ment: Rentaf&intenance ` � .
h e
0.00 0.00 #DN/01
38 Advert isin`. , II0.00 #DN/01
t: 0.00 .
39 Equipment Purchases : Ca ital Expense 0.00 0 .00 #DIV/01
40 Professional Fees (Legal, Consulting)
0 .00 0.00 #DIV/OI
x '41 Books/Educational Materials 500.00 0 .00 0.00 %
I IF
42 Food & Nutrition '" `
0.00 0.00 #DIV/01
43
Administrative' Costs "
0800 0.00 #DIV/01
44 Audit Event6L 0000 . :fi' 0. 00 #DIV/O1
45 S ecific Ass stance to Individuals 0.00 0.00 #DIV/O1
as
i' OtherlM,. is. c,elaneoe - 7
0 .00 0 .00 %50,
Other/Contrat
� -
{
W r : M it
f 1 ,500.00 111 91 0.00 0.00 %
i
L . Y .
r. ' 3 .ry .E f� tt�i bra 8 kap ;; e 't , •' r", ' tird* °G�}�N ''t., - JZ
tsidl+ 'k' i _
48 TOTAL r ` * , + `
$73 ,50 00 $ 15,000.00 20 .410% ' '
tI
t r a aY4N, 1 1jGR w Y k r, ?5 yh+ t ,x�t/ ¢
p 1
d1'ly '
, �r �`p W fixCn { ; ,k
y4. 3 : . ' , r. . . +Yl W. uY ^•ir h
IFIF
ILIc
IF
; y t S t It ' 22 t ..{
e
IF
IRC He&Viy Stat coaftw , k¢.
TLC Newborn PRmor m FY V4-VS
UNIFORM GRANT APPLICATION
EXPLANATION FOR VARIANCES OF 15% OR MORE
TOTAL PROGRAM BUDGET
AGENCY/PROGRAM NAME: IRC Healthy Start Coalition, Inc. - TLC Newborn Program ?FY 004-05
FUNDER: IRC Board of County Commissioners - Children's Services Advisory Committee
LINE ITEM EXPLANATIONFOR VARIANCE
#DN/01
#DN/01
#DN/01 ;
#DN/01 +_
Ri >r �}r, *x= In 2003-04. the Coalition sought 55,000.00 for fiscal year '03 04 and was awarded 5,000.00. However
ll" Prior to the panel review,
the Coalition was able to obtaina grant from the Johns Island Community Service League in the amount of s10,000.00 to be used for
the TLC Newborn program. In 2004-05, the John's Island Community Service League funds are not avaBable to be appiled m the TLC
-Indlan RNer Countyram, which creates the need for the additional S10K
#DNI01 E; rida� n r, _,. request maldn the total amount at s55.o00.00IFIFIF .
IF
Flos wvk,4awn rrttp� WNm p«,:> ,.
The Coalition will increase its fundraising efforts by 00, going from 63,000.00 to ,500.00. Unfortunatey, the Coalition ony raises r
`_
,,r a, e ' FP y S16,000.00 eacA `year WoM Ns piirnary fundraiser, the Taste of the Treasure Coast, which needs to be spread among the
S W's four Programs (Healthy Start Care Coordination, Healthy Families • IRC, TLC Newborn, Safe Kids of IRC) as wel as specific
Fun Raisin
Even et Coalition expenses,
#DN/01
#DN/0!
a
IF
_'i,4"0.' •S, k -9. . .
IF
IF
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"+saf�` fti:fa$' .y, Ax, c' yypp r �''' ' 3t ,.�n
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Yi A#"•.5`2('� Zry . Yr f.'Nr n
IF
#DNrof
#DN/01
#DN/Of
#DN/01
I IF
IF
it
ILI
#DN/01
r c , r
#DN/Of
F, F1IF It
+s
IF
sF x
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a, ' s •z .
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IF y,
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V $l L I IF IF HY I ! 4
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y t '7, a ' a � 4 pt"t 44it r t .'� }.T
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1. " .2.{ xEkfiv m e l 1 y n. _ ' t x 1 " ` r.
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r r � r � . �,�, Adl ,} xf [ y,� { x,23 W '
1y 7 ,t R. ix 6 , "� f
it
. . .
IRC NeWthySrmr Coddon. Ne.
TLC Newnan P]ogr FY '04-105
UNIFORM GRANT APPLICATION
EXPLANATION FOR VARIANCES OF 15% OR MORE
FUNDER SPECIFIC BUDGET
i
AGENCY/PROGRAM NAME: IRC Healthy Start Coalition, Inc. - TLC Newborn Program - FY 2004-05
FUNDER: IRC Board of County Commissioners - Children's Services Advisory Committee
LINE ITEM EXPLANATION FOR VARIANCE
This Is not a variance. The BOCC-CSAC funding covers a portion of the TLC Coordinators and TLC Assistant Coordinators salaries,
The funding amount allocated for salary Is similar to last years request, and actually srghtty less than the 2003-04 in terms of
Salaries percentage,
#DN/01 "
#DNrof`: .
s .
wsr e; yr r
#DNroIs,, I I. INa z . ..
N
&' w •k»c4 'ri9'���s3 ' •��A�i�Lat�v`•�t�`S�' :
#DN/O!"8�t� �3' t, ' 7 t° ��s . a �� P�. rA ' �•�7w-�ida *F � � h ) �� � �? s,. � r,°w.:�r �r . x �:�;,- ,
*,x .��r.
#DNro! '. r • r ��� t i �. .., :. , o-r.,.,.,
#DNroI
#Dlvrol
#Dnrrol
#DNroI
#DNro! < z - - ell I .Akw� , ,r rP9
#DNroI
Irl
TIG , ,e # y. aPyr
7
✓ ,.YP "C:T' t li:l�' I IN • IN > '.',
T4'• r4 sTI f
£ '
If
$ $ Y
.5^
41
IN
a y
IT
rr
Ne I
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le
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,ter A
es
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1 . v .. Zi
IIr 41 114 wr
4rNNN
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tit 7 P Y } A I I
foe
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3 z . dSt.1t& a- / ! 3
j3'Ci4x L t `. � • rf P �.Ac _ >.l )- l,re . ` �. P Yf L try . t u rpt cj� f„y fi
1C Y- N � rz � 9Kf xd i 4
k ; { .. vh w P„
I I I t
I IN
24
A t Kl 'Suf�i tr r t
_ �k _ _ . . : v. � _ .. i .:4- , . R�.� _ . .Y._ _ . f Rs is c .y. • »� .. . � u: :� vv
a ;.� �ro, � �` .
s � •
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 1St 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 -
a �
EXHIBIT C
STANDARD TERMS FOR GRANT CONTRACT
1 . Notices : Any notice , request, demand , consent , approval or other communication required or
permitted by this Contract shall be given or made in writing , by any of the following methods
:
facsimile transmission ; hand delivery to the other party; delivery by commercial overnight courier
service ; or mailed by registered or certified mail (postage prepaid ) , return receipt requested at the
addresses of the parties shown below:
County: Joyce Johnston -Carlson , Director
Indian River County Human Services
184025 th Street
Vero Beach , Florida 32960-3365
Recipient : Indian River County Healthy Start Coalition , Inc .
1603 10th Avenue
Vero Beach , Florida 32960
Attention : Scott Joseph
2 . Venue ; Choice of Law: The validity, interpretation , construction , and effect of this Contract shall
be in accordance with and governed by the laws of the State of Florida , only. The location for
settlement of any and all claims , controversies , or disputes , arising out of or relating to any part of
this Contract, or any breach hereof, as well as any litigation between the parties , shall be Indian
River County, Florida for claims brought in state court, and the Southern District of Florida for
those claims justifiable in federal court .
3 . Entirety of Agreement: This Contract incorporates and includes all prior and contemporaneous
negotiations , correspondence , conversations , agreements , and understandings applicable to the
matters contained herein and the parties agree that there are no commitments , agreements , or
understandings concerning the subject matter of this Contract that are not contained herein .
Accordingly, it is agreed that no deviation from the terms hereof shall be predicated upon any prior
representations or agreements , whether oral or written . It is further agreed that no modification ,
amendment or alteration in the terms and conditions contained herein shall be effective unless
contained in a written document signed by both parties .
4 . Severability: In the event any provision of this Contract is determined to be unenforceable or
invalid , such unenforceability or invalidity shall not affect the remaining provisions of this Contract,
and every other term and provision of this Contract shall be deemed valid and enforceable to the
extent permitted by law. To that extent, this Contract is deemed severable .
5 . Captions and Interpretations : Captions in this Contract are included for convenience only and are
not to be considered in any construction or interpretation of this Contract or any of its provisions .
Unless the context indicates otherwise , words importing the singular number include the plural
number, and vice versa . Words of any gender include the correlative words of the other genders ,
unless the sense indicates otherwise .
6 . Independent Contractor, The Recipient is and shall be an independent contractor for all purposes
under this Contract. The Recipient is not an agent or employee of the County, and any and all
persons engaged in any of the services or activities funded in whole or in part performed pursuant
to this Contract shall at all times and in all places be subject to the Recipient's sole direction
,
supervision , and control .
7 . Assignment. This Contract may not be assigned by the Recipient without the prior written consent
of the County.
- 1 -
y INTERNAL REVENUE SERVICE DEPARTMENT OF THE TREASURY
DISTRICT DIRECTOR
C — 1130
ATLANTA , GA 30501
Crate : Employer Identificatioi) Nur,iber :
APR 2 9 1993
Contact Person
ROBERTA VAiY METER
iNItIAN nI JER COUHT`: HEALTHY START Contact l e l ep ;; iDrie fiufilb = ;
COALITION 10C ( 4 041 JJ ] - 0100 f,
1900 27TH STREET
VERO BEA H s 1 3%en0
Accounting Period Ending :
June 30
Foundation Status Classification :
509 ( a ) ( 1 )
Advance Ruling Period Begins :
October 23 , 1992
Advance Ruling Period Ends :
June 30 , 1997
Addendum Applies :
Yes
Clear Appi icant :
Eased ,?n information You supplied , and assuming your operations ori i i rte a5
staled in your application for recognition �� f exemption , we have determined you
are exempt from federal income tax under section 501 ( a ) of the Internal Revenue
Code as an organization described in section 501 ( c ) ( 3 ) .
9
Because you are a newly created organization , we are not not , :Waking a
final deter ;m i nat i on of your foundation status under section C, 0 r/ ( j of th - Coade .
However , we leave determined that you can reaconab i y expect to be a pub I is i V
supported organization described in sections 509 ( a ) ( 1 ) and i70 ( b ) ( i ) ( At { vi ,i .
Accordingly , during an advance ruling period y ,:, u i•ii I l be treated as a
Publicly supported organization , and not as a private foundation . This advance
ruling period begins and ends on the dates shown above .
Xithin 90 days after the end of your advance ruling period , you must
send us the information neede- to determine whether- you have met the 1- e11uice -
ments c= f the applicable support test during the advance ruling period . If you y
establish that you have been a publicly supported organization , S-testill r. i « sci -
fY You as a section 509 ( a ) ( 1 ) or 509 ( a ) ( 2 ) organization as Ic, ;rg as you continue
to meet the requirements of the applicable support test . If you do not meet
the public support requirements during the advance ruling period , we iii Ii
classify you as a private foundation for future periods . Alst„ if we classify
you as a private foundation , we of I I treat you as a private foundat111n IrQiW
your beginning date for purposes cif .ection 507 ( d ) and 4540 .
Grantor -_ and contributors may r ,_ r ion that o are no 'c a
1y � n our determination you , -
pr' ivate foundation until 90 days after the end of your advance ruling oeri , id .
If you ; end its the regulred information i-. ithin the 90 clays : = , rant = rs and
G_, Trtrlblttc, r5 Nay Continue to rel ;/ or, -the a V - ri a '
d a . ce i, �-• teraririatic� r� eerier 1 i-: e Wial< _'
a final determination of yo =ur foundation Status .
i
ME; TAN 'tIVEh ; UUri i Y HE STr
If ete pubI ish a notice in the r4sternal Revenue! Bui letin stating that st .=
w ! I no i Ongf: r treat ': ou as a pue i i c s y 5Lipported orGan i zatt oTi : grantors and
contributors may not rely on this determination after the date we publish the
notice . In additi �� n , if you lose y ,, uw status as a publicly s.. upported organi -
zations and 4 grantor or contributor i , as responsible fors or !-las aware of , the
act or failure to act , that resulted in your loss of such status , that person
may not rely can this determination from the date of the act or failure to act .
Also , i f a grantor- or contributor learned that we had given riot i ce that you
would be removed from classification : as a publ iciy supported organization , then
that person may net rely on this determination as of the date he or she
acquired such knowledge .
If you change your sources of support , your Purp ;lses , cliaracter , or emethod
of operation , please let us know so wu can consider the effect of the change on
your exempt status and foundation status . If you amend Your ._organizational
document or bylaws , please send us a copy .• f the amended docnment or bylaw : , .
Also , let us know all changes in your name or address .
As of January 13 1951 , you are liable for social securities tares under
the Federal Insurance Contributions Act on amounts of $ 100 or more you pay to
each of your gemployees during a calendar year . You are not liable for the tax
imposed under the Federal Unemployment Tar, Act ( FUTA ) .
Organizations that are not private foundations are not subject to the pri =
vate foundation excise tares under Chapter 42 of the Internal Revenue Code .
However , you are Piot automatica ! : v exempt frig If
P rpt oth :_ r fedora 1 excise taxes .
you have any questions about excise , employment , or other- federal tares , please
let us know ,
Donors may deduct contributions to you as provided in section 170 of the
Internal Revenue Code . Bequests , legacies , devises , transfers , or gifts tc-s you
or for your tise are deductible for Federal estate and gift tai purposes if they
meet the applicable provisions of sections 20551 21061 and 25222 of the Code w
Donors may deduct contritutions to you only to the extent that their
contributions are gifts , with no consideration received . Tick: et purchases and
similar payments in conjunction with fundraising events may nOt necessarily
qualify as deductible contributions , depending on the rircurnstances , tie ;telt �! `=
Ruling 67 - 246 , published in Cumulative Bulletin 1967 - 2 , on
guidelines regarding when taxpayers page iu4 , giv
p yer- s stay deduct payments for admission to , or-
other participation in , fundraising activities for charity .
You are not required to f i le Form 9901 Return of Organ i .Zat i on Exempt From
Income Tax , if your gross receipts each year are normal iy $ 41 `, , 000 car less .
You receive Form 990 package L It
R ge in the mai 1 , simply attach the label provided ?
check the b =,< <: in the heading to indicate that your annual gross receipts are
normally $ 25 , 000 or less , and sign the return .
If you re requ i red to f i i a a rf: turnou retain. F
y t f i I � it t ;� the he _�
1th day of
._ Btl; er i : r :i _� ( t.iii ' ls �;,•
L r
F
It: i= : yrs „ :% E
th }- fifth mont-- h after the end of Your annual accounting period . Lie charge
penalty iof 110 a day when a return f i led late. , fir, i ess there i s rea , 0nab l e
Ca ;ISe fir the delay . ti !� faever the nli: iiifilUm penalty we charge � dnnot � Y, = aed
F1 , U00 or 5 ;percent of your gross receipts for the ;fear , whichever is less . 4e
may also charge this penalty if a return is not complet Soo please be sure
your return is complete before you file it .
You are not required to file federal income tax returns unless you are
subject to the tar, on unrelated business income under section F11 of the Code ,
If you are subject to this tax , you m-ust f i le an i ricome tar, return on Form
990 -T , Exempt Organization BusinessIncome Tax Return . In this letter we are
not determining rhether any of yoter Tresent or proposed activities are unre -
lated trade or business as def i reed in section 513 of the Code .
You neerl an employer i dent i f icat i on number even if you have no em I !� � - r
If an employeridentif ication number was not entered on your appl icatipn , 7j-re3 .
u i i ! ass i gn n umber to you and adv i - e you of i t . Please use that number on
all returns you fife and in all correspondence with the Internal Revenue
Service .
If we said in the heading of this letter that an addendum applies : the
addeAdum enclosed is an integral part of this letter .
• S
Because this letter could help us resolve any quAtions about yqur exempt
status and foundation status , you should keep it in your permanent records .
If you have any questions , please contact the person whose name and
telephone number are shoran in the heading of this letter .
54ycerely yours ,
Paul Williams
District Director
Enclosure ( s ) :
Addendum
Form 8872- C
` i
11 / 04 / 2004 14 : 42 7727704580 PAGE 01
e r,
DATE. (MM/DD/YYYY)
ACORD
CERTIFICATE OF LIABILITY INSURANCE I NOV 404
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
SID BANACK INSJA H11.13 ROGAL & HOBBS CO, ONLY AND TIFICATE
HOLDER. THIS NCERTIFICATE DOES NOT AMEND,FERS NO RIGHTS UPON THE EXTEND OR
204614TH AVE. ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
P 0 BOX 130
VERO BEACH FL 32961 INSURERS AFFORDING COVERAGE I NAIC #
--- •—•-- - - — '— — — ' -- - -' —' — INSURERA: AUTO-OWNERS INSURANC
I— E COMPANY_
INSURED — --
INDIAN RIVER COUNTY HEALTHY START, INC. INSURER e: HARTFORD UNDERWRITERS INSURANCE COMPANY
--- — — —
1603 10TH AVE, �--INSURER- --
VERO BEACH FL 32880 INSURER D. In. In
INSURER E;
COVERAGES
THE POLICIES OF ISURANCE LSTED BELOW 14AVE BEEN ANY REQUIRE ENTNTERM OR CIONDIT ON OF ANY CONTRACT UOR OTHER ED TO THE (DOCUMENT
WNSURED NITH RESPECT RES T To WHICH THIS AS VE FOR THE IPCERTIFICATEAMAp BE ISSUED OARNOING
MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALLTHE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
POLICY NUMBER —
• —• . . ..—. . .. • — ... . T • -" POLICY 9FFECTNe 1 POLICY EXPIRATION LIMITS
TYPE OF INSURJWCE ( p
LTR MJe EACH OCCURRENCE S 1 ,0000
0,0
GENERAL LIABILIY 93-211 -127-00 MAR 10 04 MAR 10 OS — — -- — --- r
DAMAGE TO RENTED I j 50 ,000
I rX COMMERCIAL GENERAL LIABIUT i I [EREU g.eF. .+I .. _
- — _ MED. EXP (Any Cp4VZW) S 31000
I ' - I CLAIMS MADE X I OCCUR I II . '
I I-- I I PERSONAL 3 AW INJURY , i Included
A I — - — - - In.. I I GENERAL AGGREGATE I S 1 ,0000000
_.. --- -- --• -.. :_. I I I PRODUCTS-COMP/OP AGG. ; Z 1 ,000 ,000
In
I GEN'L AGGREGATE LIMIT APPLIES PERI I I . . . . .. . - In
,. . . In
POLICY I i PR0 LOC'
AUTOMOBILE LIABILITY I 93411 -12740 MAR 10 04 I MAR 10 05 4COMBINED SINGLE LIMIT I i 11000,000
I (EP mocldera)
I I 1 ANY AUTOI . — _.
ALL OWNED AUTOS _. _.
I I BODILY INJURY
I I I I (Per persa�) I S
1 I I) SCHEOULED AUTOS
A I FX 1 HIRED AUTOS I I I I BODILY INJURY
1"X ] NON-0WNED AUTOS -•- - ' 1
PROPERTY DAMAGE is
Per Par-wert
GARAGE LIABILITY I AUTO ONLY • EA ACCIDENT 13
ANY AUTO I I I OTHER THAN EA ACC ' 3 - In
_. I AUTO ONLY: $
i
Arr
EXCESSIUMBRELLA LIABILITY I EACH OCCURRENCE S
y1 OCCUR -, CLAIMS MADE I I I AGGREGATE i5
! s
I . DEDUCT19LE I I h
! I
$
RETENTION S
WORKERS COMPENSATION AND 21WEC GD7700 MAY 3 04 MAY 3 06 _ ._I.Tt0BX MWC LTA . ; OTHER10
EMPLOYERS' LIABILITY I
1 E.L. EACH ACCIDENT 3 100, 000
ANY PROPRIETOIVPARTNERIEJIECVI'IVE . __ _ . . .__. . . . . . _ . .
B I
0FFICER4MNM91t EXCLUDED? I I I I E.L. DISEASE-EA EMPLOYEE 13 1001000
N lay, dotrlEe andel00
I i •-- ' --._ . . _ .. ... .._...
IMPCIAL PROVISIONS Wow E.L DISEASE-POLICY LIMIT is b00 ,0
( OTHER:
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS
CERTIFICATE HOLDER IS ALSO NAMED AS AN ADDITIONAL INSURED WITH REGARDS TO COMMERCIAL GENERAL LIABILITY COVERAGE,
ALSO NOTE 10 DAYS NOTICE OF CANCELLATION FOR NONPAYMENT OF PREMIUM
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF. THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 30
DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT
FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KINO UPON THE
INDIAN RIVER COUNTY BOARD OF INSURER, ITS AGENTS OR REPRESENTATIVES.
COUNTY COMMISSIONERS
1840 25TH ST AUTHORIZED REPRESENTATIVE
VERO BEACH, FL 32960 j� n Pan „ Q P
Attantlon : JOYCE JOHNSTOWCARLSON I IChele N . Poysell �✓e "
ACORD 25 (2001 /08) Certificate # 81924 0 ACORD CORPORATION 1988
NON PROFIT PROFESSIONAL LIABILITY POLICY
RENEWAL CERTIFICATE
Please attach this Renewal Certificate to your expiring Policy ,
UNITED STATES LIABILITY
INSURANCE COMPANY
WAYNE, PENNSYLVANIA
In consideration of the renewal premium stated below, expiring Policy Number ND01005544E is renewed
for the Policy Period stated below. The Company will issue a complete copy of this Policy upon receipt of
a written request from the Insured .
The New Policy Number is ND01005544F .
The Application ( if any) for this renewal , and all previous Applications made to the Company for this
insurance , including any material submitted therewith , shall be made a part of this Renewal Policy as if
physically attached hereto . PLEASE REFER TO YOUR POLICY FOR THE DEFINITION OF
"APPLICATION . "
POLICY DECLARATIONS
ITEM I . PARENT ORGANIZATION AND PRINCIPAL
Indian River County Healthy Start Coalition , Inc.
160310th Avenue
Vero Beach, FL 32960
ITEM ll . POLICY PERIOD : (MM/DD/YYYY) 12 :01 AM STANDARD TIME AT
FROM 8/8/2004 TO 8/8/2005 YOUR MAILING ADDRESS SHOWN
THIS POLICY CONSISTS OF THE FOLLOWING COVERAGE PARTS FOR WHICH LIMITS OF LIABILITY ARE INDICATED.
Coverage Part A . Non Profit Directors and Officers Liability
ITEM 111 , LIMITS OF LIABILITY: $ 1 , 000 , 000 EACH CLAIM
Not Covered FIDUCIARY LIABILITY LIMIT
$ 1 , 0000000 IN THE AGGREGATE
ITEM IV. RETENTION : $ 0 EACH CLAIM
ITEM V. PREMIUM : $ 1 , 218
Coverage Part B . Employment Practices Liability
ITEM III , LIMITS OF LIABILITY: $ 1 , 000 , 000 EACH CLAIM
$ 1 , 000 , 000 IN THE AGGREGATE
ITEM IV. RETENTION : $ 0 EACH CLAIM
ITEM V. PREMIUM : $ 343
ITEM VI . Coverage Forms Parts and Endorsements made a part of this policy at time of issue :
DNOTIC ( 12-02) Discl. Notice of Terrorism Insurance Coverage USL-DOJ (04-00) Policy Jacket
DO- 100 (04-00) Coverage . Part A
DO- 101 (04-00) Coverage Part B
DO-209 (01 -94) General Professional E & 0 Excl. Endt
DO-273 (04-02) Fair Labor Standards Act, Exclusion
DO-275 ( 11 -02) Coverage Clarification Endt
DO-FL (07-01 ) Florida State Amendatory Endt
Endorsements in bold have been added to the policy or have a new edition date and are attached with this certificate.
Agent : AGENCY MARKETING SERVICES , INC . [1004] By
Date Issued : 8/5/2004
Authorized Representativ
USL-DOD CERT (11197)
_ J ^ 1603 10th Avenue
Vero Beach , Florida 32960
Ir (772) 563 - 9118 Fax (772) 563 - 9125
z
� 2 e - mail : irchsc@aol . com
ti G0
� IVE �
Oct. 15 , 2004
IRC Board of County Commissioners —
Children ' s Services Advisory Committee
Attn : Joyce Johnson-Carlson, Director
IRC Human Services
1840 25 `}' Street
Vero Beach, Florida 32960-3365
Dear Joyce,
Enclosed is the following :
Signed contracts for ' 04- ' 05 grants
Insurance liability statement
501 C3 letter status
Letter explaining transportation of clients
The programs that are partially funded by the BOCC-CSAC for 2004-05 , which are
Healthy Families — IRC and the TLC Newborn do not transport clients in their personal
vehicles nor is their company vehicles provided for transportation of clients .
Sincerely,
all
D . Sco t Jos ,
Executive Director
The Mission of the Indian River County Healthy Start Coalition is to establish a system that guarantees all women
have access to prenatal care and that all infants have access to services that promote normal growth and development.