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2005-328t
INDIAN RIVER COUNTY GRANT CONTRACT This Grant Contract ("Contract') entered into effective this day of October 2005 , by and ate of between Indian River County, a political subdivision of the StFlorida ; 1840 25th Street, Vero Beach , Florida , 32960-3365 ; and Hibiscus Children 's Center. ( Recipient), of: Hibiscus Children ' s Center P . O . Box 305 Jensen Beach , Florida 34958 Crisis Nursery Program Background Recitals A. The County has determined that 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 proposal 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 (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 the 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 2005/2006 ("Grant Period") . The Grant Period commences on October 1 , 2005 and ends on September 30 , 2006 . - 1 - 4 . Grant Funds and Payment . The approved Grant for the Grant Period is : EIGHTEEN THOUSAND , FIFTY THREE DOLLARS ($ 18 , 053 . 00 ) . The County agrees to reimburse the fir► Recipient from such Grant funds for actual documented costs incurred for the 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 Obligation 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 to written notice . 5 . 2 . Compliance with Laws . The Recipient shall comply at all times with all applicable federal , state , and local laws and regulations . 5 . 3 . Quarterly Performance Reports . The Recipient shall submit quarterly, cumulative , Performance Reports to the Human Services Department of the County, within fifteen ( 15) business days following : December 31 , March 31 , June 30 and September 30 , 5 . 4 , Audit Requirements . If Recipient receives $25 , 000 , or more in 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 the 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 its 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 the 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 , 2005 provide to Indian River County Risk Management Division a certificate , or certificates , issued by an insurer, or insurers , authorized to conduct business in Florida that is rated not-less-than Category A- :VII by A . M . Best , subject to approval by Indian River County's Risk Manager, of the following types and amounts of insurance : ( i ) Commercial General Liability Insurance in an amount not less than $ 1 , 000 , 000 combined single limit for bodily injury and property - 2 - damage , including coverage for premises/operations , product/completed operations , contractual liability, and `W 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 ) Worker's 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 the County. In addition , the County may request such other proofs and assurances as it may reasonable 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 Worker's 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 rrr 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 . - 3 - e IN WITNESS WHEREOF , County and Recipient have entered into this Contract on the date first above written . �r INDIAN RIVER COUNTY BOARD OF COMMISSIONERS By: Thomas S . Lowther, Chairman BCC Approved : 'y — C Attest : J . K. Barton , Clerk Mr By: Deput Clerk R _1 Approved : N Jose h A . Baird County Administrator Ap vAato and legal sufficiency: By: 00M ssistant CrounWAttorney RECIPIENT : 6 , By: Hibiscus Children 's Center '�1rr► - 4 - EXHIBIT A (Copy of complete Request for Proposal ) EXHIBIT - A - Hibiscus Children Center Crisis Nursery Program Children Services Advisory Committee PROGRAM COVER PAGE Organization Name : Hibiscus Childrens Center Executive Director: Jan S . Huffert E-mail : ishuffertkhcc4kids . org Address : P . O . Box 305 Telephone : 772 -334- 9311 x 101 Jensen Beach FL 34958 Fax : 772-334- 1991 Program Director: Kathryn Garbowski E-mail : kgarbowskikhcc4kids . org_ Address : P . O . Box 305 Telephone : 772-334-9311 x 708 Jensen Beach FL 34958 Fax : 772 -334- 1991 Taxonomy BH-180. 150. 15 Program Title: Crisis Nursery ,) / Priority Need Area Addressed: Parental Support Education Brief Description of the Program : Child abuse and neglect_prevention and crisis intervention program providing voluntary in-home services to families experiencing crisis (i . e . unemployment, homelessness domestic violence mental health poverty, etc ) Services may take the form of family supportaccessing therapeutic services coordinating medical needs improving daily living skills addressing educational needs and short term respite care for children. SUMMARY REPORT — (Enter Information In The Black Cells Only) Amount Requested from Funder for 2005 / 06 : $ 00 . 00 Total Proposed Program Budget for 2005 / 06 : $ 400 , 423 . 00 Percent of Total Program Budget : 5 . 0 % Current Program Funding ( 2003 / 04 ) : $ 20 , 000 Dollar increase / ( decrease ) in request : $ - Percent increase / ( decrease ) in request * * : 0 . 0 % Unduplicated Number of Children to be served Individually : 11773 Unduplicated Number of Adults to be served Individually : 837 Unduplicated Number to be served via Group settings : - Total Program Cost per Client : 153 . 42 * *If request increased 5 % or more, briefly explain why : N/A If these funds are being used to match another source, name the source and the $ amount: N/A The Organization 's Board of Directors has approved this application on (date). 7/19/01 te Janice Norman Name of President/Chair of the Board Si Jan S . Huffert Name of Executive Director/CEO Signature 3 Hibiscus Children Center Crisis Nursery Program Children Services Advisory Committee ORGANIZATION : Hibiscus Children Center PROGRAM: Crisis Nursery TABLE OF CONTENTS Please "X" the parts of the grant application to indicate that they are included Also, please put the page number where the information can be located. g Section of the Proposal Pa e # X TABLE OF CONTENTS (check list) 1 X COVER PAGE (with signatures) . . . * " " " 111 * 11600 * 060 6 0 66 6 . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 A. ORGANIZATION CAPABILITY (one page maximum) 4 X 1 . Mission and Vision of organization . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . X 2 . Summary of expertise, accomplishments, and population served . . . . . . . . . . . . . . . . B. PROGRAM NEED STATEMENT (one page maximum) 5 X 1 . Program Need Statement. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0 . . . 0 . . . . . . . . . . . . . X 2 . Programs that address need and gaps in service . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . C. PROGRAM DESCRIPTION (two pages maximum) 6 X1 . Funding priority . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . : . . . . . . . . . . . . . . . . . . . . . . . . X 2 . Description of program activities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . X 3 . Evidence that program strategy will work . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . X4 . Staffing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 050 . 0 . . . . . 0 0 . . . . . . 0 " s . . . . . . 0 . . . . . 4 . 0 . 00 . X 5 : Awareness of program . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . X 6 . Accessibility of program . . . a a a a . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . X D. MEASURABLE OUTCOMES (two pages maximum) . . . . . . . . . . . . . . . . . . . . . . . . . 8 X E. COLLABORATION (one page maximum) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 F. PROGRAM EVALUATION (two pages maximum) 10 XL Demographics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 00 " X2 . Measures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0 . . 0 . . . . . . . . . . 0 . . 0 . . . X 3 . Reporting . , . . , . " 0016 0110 " 0 " 0 " 6 , 600 , 000 , 0110 11 * 10 * 16 * 0000 0 * 0 X G. TIMETABLE (one page maximum) . . . 12 H. UNDUPLICATED CLIENT COUNT X 1 . Projections by Location . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 X 2. Projections by Age Group . . , . , . . . . , . . , * , , * . . . . 1 Hibiscus Children Center Crisis Nursery Program Children Services Advisory Committee I. BUDGET FORMS 14 X 1 . Financial Budget Forms . . . . . . . . . . . . . . . . . . . . . . . X J. FUNDER SPECIFIC/ADDITIONAL SHEETS 22 1 . Taxonomy Description 2 . Testing Materials 3 . Not For Profit Agency Certification 4 . Authorization for Release of Information 5 . Sworn Statement Under Section 105 . 08 , IRC Code, On Disclosure of Relationships K. APPENDIX — with original only X 1 . List of current officers and directors X 2 . Latest Financial Audit Report & Management Letter X 3 . IRS Form 990 X 4 . Internal Financial Statement X 5 . Staff Organizational Chart X 6 . Annual Report X 7 . 501 (c)(3 ) IRS Exemption Letter X 8 . Articles of Incorporation X 9 . Agency' s Bylaws X 10 . Agency' s written policy regarding Affirmation Action X 11 . Nepotism Statement 2 Hibiscus Children Center Crisis Nursery Program Children Services Advisory Committee PROPOSAL NARRATIVE A. ORGANIZATION CAPABILITY (Entire Section A not to exceed one page) 1 . Provide the mission statement and vision of your organization. Hibiscus Children' s Center' s mission is to prevent and/or reduce child abuse and neglect on the Treasure Coast. Our vision centers on building capacity and developing community centered programs to ensure that a full continuum of care exists within our community to meet the needs of families and children. From prevention to intervention, the full range of services available through Hibiscus Children' s Center target family resiliency and the long-term effects of child abuse. 2. Provide a brief summary of your organization including areas of expertise, accomplishments, and population served. Hibiscus Children' s Center has six primary service programs that support its mission: Shelter - a 36-bed residential facility that provides shelter and respite care for children ages 0 - 12 . The program has provided close to 100,000 safe nights of service to children throughout the state. HOPE - a family preservation program, working with children and families in all four counties of the Treasure Coast. Families are referred by the Department of Children and Families and United For Families due to child abuse . The main goal of the program is to remove the risk in the family, not the child from the family. Crisis Nursery - a child abuse prevention program. Any family experiencing a crisis with children under the age of 18 can voluntarily seek assistance. Housing, food, budgeting, child- care, medical care, and mental health treatment are examples of some of the many reasons that families seek help from this very successful program. Lauded as a model prevention program by the National Crisis Resource Center, the program keeps nearly 100% of its clients out of the child welfare system. Foster Care - focuses on recruiting, training, licensing, re-licensing and supporting suitable families for children needing foster care . Over 80% of licensed foster families on the Treasure Coast have been licensed through this program. Clinical — provides on-site therapeutic services to children in our residential programs and community-based services to children under the age of 5 through out Infant Mental Health initiative. Village — opened in April of 2004 to provide shelter and group care services to children removed from their homes due to abuse and neglect. One of the primary focuses of this program is to ensure that siblings can stay together and to create a "home-like" environment for children that can not be safely returned to their family. Hibiscus strives to be a valuable resource for the community in the field of child abuse and neglect. We provide a continuum of family-friendly prevention and intervention services supported by over 400 volunteers who donate over 25 ,000 hours each year in support of our mission. Hibiscus actively works to remain at the forefront of best practices in child welfare through our accreditation by Council On Accreditation for Children and Family Services . 4 Hibiscus Children Center Crisis Nursery Program Children Services Advisory Committee Be PROGRAM NEED STATEMENT (Entire Section B not to exceed one page) 1 . a) What is the unacceptable condition requiring change? The abuse, neglect, or abandonment of children. Sadly, the devastating effects of child abuse go far beyond its immediate physical and emotional impact on the child. The impact permeates throughout the child' s entire life cycle . Abused children show higher rates of school delinquency and failure, drug and alcohol abuse, teen pregnancy, early entry into the criminal justice system, and domestic violence . b) Who has the need ? Families and children, birth to 18 , who are at risk of maltreatment due to a crisis and who need a wide array of intervention and support services in order to keep the family intact and the children safe. c) Where do they live? Services are provided to children and families in Martin, St. Lucie, Indian River and Okeechobee counties. The program criss-crosses socio-economic boundaries since families of every ethnicity, community, and social class can experience a crisis that places their family at risk. d) Provide local, state or national trend data, with reference source, that corroborates that this is an area of need. ❖ According to the Annie Casey Foundation, 8 out of every 1 , 000 children will at some point enter the child welfare system. ❖ Currently, there are over 1 ,763 children under the supervision of our local Department of Children & Families . ❖ Since its inception in 1994, the Crisis Nursery Program has served over 11 , 000 children and families throughout the Treasure Coast. ❖ The Kids Count Databook ranks Florida as 34th out of all of the United States in terms of children' s issues ❖ According the Florida' s Children Needs Assessment 2003/2004 , at least three out of four Treasure Coast Counties rank below the state average in the following categories : Child Death Rate ; Rate of Serious Mental Illness ; Rate of Job Growth; Percent of Students with Out-of- School Suspensions; Percent of Abused Children Removed from Parental Home ; Percent of Children on Waiting List for Subsidized Childcare ; and Percent of Two Parent Households 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. There are no other programs providing specialized family support and respite services in the four county area to children and families at risk of child maltreatment. 5 Hibiscus Children Center Crisis Nursery Program Children Services Advisory Committee C. PROGRAM DESCRIPTION (Entire Section C, 1 — 6, not to exceed M)o ages) 1 . List Priority Needs area addressed. Parental Support and Education 2. Briefly describe program activities including location of services. Crisis Nursery services are voluntary and available 24 hours a day, 7 days a week. When a family requests services, Family Advocates complete an initial intake and assessment to determine eligibility. This intake can be done at the family' s convenience - in the home, at the office, or a mutually determined location. After eligibility is established, the Program Supervisor assigns the case based on the family' s needs and case openings. A Family Support Plan, which drives all services provided, is then developed with the family served. The family clearly determines the services to be provided and when the plan is completed, unless other issues occur, the case will close. The services are short term, lasting 4 —6 weeks for most families . Clear and measurable goals and objectives establish what occurs between the family and the program. Services include identification of problematic areas and solutions, formal and informal support systems, resources available within the community, need for further services, and possibly respite services. All services are aimed at stabilizing family crisis, providing tools for family self-sufficiency, and identifying resources within the family and community to enhance and improve family functioning. This program promotes self-determination, resilience, and is built on family strengths . From assessment to case planning and family goal setting, the program is driven by consumer choice. Coordinated family support services assist families in accessing a wide variety of services including medical and mental health services, parenting education and information, substance abuse assessment and treatment, employment assistance, housing, food, clothing, and transportation. Respite services , where parents voluntarily place their children at Hibiscus Children' s Shelter for short periods of time, provide children all of their basic needs, including, but not limited to therapy and counseling, medical care, educational assessments , and a wide variety of other services as needed. Special conditions have been developed to work collaboratively with law enforcement, health care providers, schools, and a myriad of providers to serve parents in crisis . This approach works hand in hand to resolve the immediate crisis as quickly as possible in a way that is least intrusive and disruptive to the family. Helping families identify not only problems, but solutions, combine to enhance and increase family functioning, working in partnership to assist them in reaching their highest potential . In tum, families learn to resolve their own situations and are better prepared to face the future and every aspect of what it may hold. 3. Briefly describe how your program addresses the stated need/problem. Describe how your program follows a recognized "best practice" (see definition on page 12 of the Instructions) and provide evidence that indicates proposed strategies are effective with target population. The Crisis Nursery is a nationally recognized program; providing relevant child abuse prevention services in our community. National and state data, media attention, and recognition from the state and federal government support the success of its methodology. It has been cited as a best practice in child abuse prevention. Since October 1994, Hibiscus Crisis Nursery has served over 11 ,000 children and families with an average of 99% success in keeping families out of the child welfare system. Services provided within or outside of the child' s home are intended to enable the family to 6 Hibiscus Children Center Crisis Nursery Program Children Services Advisory Committee stay together and to keep the child living in the child' s home and community, reducing the risk of future crisis and abuse/neglect for children. 4. List staffing needed for your program, including required experience and estimated hours per week in program for each staff member and/or volunteers (this section should conform with the information in the Position Listing on the Budget Narrative Worksheet). The staff positions for the program consist of. • Program Director ( 1 ) oversees program functioning. A minimum of 12 hours per week is designated toward the oversight of this program. The Program Director is required to have or be working toward the completion of a master' s degree in social services or a related field and requires a minimum of 3 years related experience. • Program Manager ( 1 ) provides a high level of supervision to staff members and maintains a small caseload. This is a 40+ hours per week position requiring a degree in social services or a related field and three years of related experience. • Family Advocates (3 ) provide the bulk of direct service provision. These are para- professional positions that require a high school diploma or GED. Two years of related experience is preferred and these positions are full time (40+ hours per week) positions. • Administrative Assistant ( 1 ) provides clerical and data entry support for the program in order to maximize staffs' time spent directly with the family. 4 hours per week is spent providing support to the Crisis Nursery Program. The position requires a high school diploma or GED and 2 years of related experience is preferred. • ChildCare Workers and ChildCare Supervisors (4 .4) provide direct supervision to the children placed in the Shelter for Respite. When children are in respite, awake supervision is provided 24 hours per day. As defined in the budget narrative, we estimate that this equates to the equivalent of 4 .4 staff members working 40 hours per week throughout the year. A high school diploma or GED is required and 2 years of experience for Supervisors, 5. How will the target population be made aware of the program? In addition to enjoying statewide and national recognition, the Crisis Nursery Program is well established on the Treasure Coast and has been highlighted in the media, including newsprint and television coverage. The primary referral source for the past five years has been self- referral, which demonstrates the widespread community awareness, acceptance, and need of these valuable services . In addition, Hibiscus Children' s Center utilizes an extensive marketing plan to build awareness of all of its programs. Public Service Announcements are aired across a wide variety of local cable stations and staff participate in TV interviews, newspaper articles , and presentations to church and civic groups . Most of the clients who utilize this service hear about it from a friend or family member who has been helped by the program, 6. How will the program be accessible to target population (i.e., location, transportation, hours of operation)? This program is available 24 hours a day, seven days a week. Services are provided in the homes of families or at mutually determined locations . The program is readily available through an on- call system that puts program services in the hands of families in need around the clock. Transportation services are also provided to overcome the obstacles to services many families face due to a lack of public transportation, especially after hours and on weekends . 7 Hibiscus Childrens Center Crisis Nursery Program Children Services Advisory Committee D. MEASURABLE OUTCOMES (Entire Section D not to exceed two pages) OUTCOMES ACTIVITIES Add all o the elements or the Measurable Outcome(s) Add the tasks to accomplish the Outcome(s) 1 . To maintain at least 95 % of families served Outcomes 1 and 2 having no verified reports of abuse or neglect ❖ Maintain list of families served. during services as measured by Department of ❖ Provide list of families served to Children & Families Abuse Screening. Department of Children & Families for Baseline : Most recent DC&F monitoring 100% identification of families that had verified of families served had no verified reports of abuse or neglect reports during services and abuse or neglect during service provision. within 12 months after service provision. ❖ Receive data back from DC&F and 2 . To increase to 95 % of families served determine percentages , having no verified or indicated report of child ❖ Review families with verified abuse and abuse 1.2 months after services as measured by neglect indicators and determine strategies Department of Children & Families Abuse to prevent future occurrences . Screening. Baseline: Most recent DC&F monitoring 91 % of families served had no verified reports of abuse or neglect 12 months after services . (Services were provided to particularly challenging families during this time period and we believe that 95 % is more representative of what the program can achieve . ) 3 . To maintain 95 % of families, completing Outcome 3 services, showing improvement in one domain ❖ Administer and score AAPI as part of of their parenting abilities through the use of intake/assessment process for each family. the Adult Adolescent Parenting Inventory ❖ Administer and score an AAPI post-test for (AAPI) as a pre and post (45 + days after families who complete services (a service implementation) test. minimum of 45 days) . Baseline : Most recent analysis of data indicates ❖ Individual data to be maintained in client 100% of families demonstrated improvement files and collapsed into the quarterly Peer in at least one domain of the AAPI . Record Reports. If percentages are not achieved, a corrective action plan will be developed in response to the quarterly Peer Review and monitored through the next peer review cycle . 8 Hibiscus Children Center Crisis Nursery Program Children Services Advisory Committee E. COLLABORATION (Entire Section E not to exceed one page) 1 . List your program ' s collaborative partners and the resources that they are providing to the program beyond referrals and support. (See individual funder requirements for inclusion of collaborative agreement letters. Collaborative Agency Resources provided to the program Indian River County Human Services Referral for food, medication, travel expenses, and reciprocal services . Treasure Coast Homeless Services Matching funds for rent/mortgage and utilities. Council Collaboration on shared cases including mutual referral . Shelter for homeless families . Homeless Family Center Mutual referrals. Collaboration on open cases . Exchange Club CASTLE Mutual referral and collaboration on open cases . 211 Referrals to program and information and referral to community resources . 9 Hibiscus Childrens Center Crisis Nursery Program Children Services Advisory Committee F. PROGRAM EVALUATION (Entire Section F not to exceed two pages) 1 . DEMOGRAPHICS : What information (data elements) will you need to collect in order to accurately describe your target population including demographics (age, gender, and ethnic background) required by the funder in Section H? What are the pieces of information that qualify them for your target population? How do you document their need for services or their "unacceptable condition requiring change" from Section Bl ? The Crisis Nursery Program collects client data in many different ways, in order to meet a variety of funder requirements. Client data including age, gender, race, economic level, education level, parenting situation (i .e. single, dual, grandparents, guardian etc . ) is collected on every family served. The information is compiled on a monthly basis and put into a data spreadsheet that is used for reporting to funders . Monthly, quarterly, and year-end reports are provided upon request based on the specific requirements of each funder. All families complete an intake/assessment process to determine the level of their crisis and the ability of the Crisis Nursery Program to assist the family in meeting the need. The one universal qualification that would make a family ineligible would be abuse/neglect. The need for services is clearly documented on the intake form and incorporated into the Family Support Plan. 2. MEASURES : What data elements will you need to collect to show that you have achieved (or made progress toward) your Measurable Outcomes in Section D? What tools or items are you using as measures (grades, survey scores, attendance, absences, skill levels) for your program? Are you getting baseline information from a source on your Collaboration List in Section E? Are there results from your Activities in Section D that need to be documented ? How often do you need to collect or follow-up on this data? Outcomes (abuse histories) are measured through the Florida Department of Children & Families (DC&F), our collaborative partner, client information system. DC&F conducts an initial review of the family prior to Hibiscus accepting the family into services . Annually, DC&F or. the Community-Based Care Lead Agency monitors the Crisis Nursery Program and reports one year follow-up information on whether or not abuse occurred during services or within one year post services . In addition, the Crisis Nursery Program completes an AAPI pre-test on all families and a post- test on families who receive services for over 45 days . The results are reported to our internal Continuous Quality Improvement Plan committees . The AAPI is a valid and reliable tool that measures improvement in family functioning, in particular in parenting, empathy, corporal punishment, role reversal , and understanding development stages . 3. REPORTING: What will you do with this information to show that change has - occurred? How will you use or present these results to the consumer, the funder, the program, and the community? How will you use this information to improve your program? Data is maintained in client records, monthly Risk Management Reports , quarterly Peer Record Reviews, and MIS spreadsheets . Hibiscus utilizes a Continuous Quality Improvement Committee comprised of a broad spectrum of stakeholders (staff, board members, funders, former clients, volunteers, other agency representatives, etc .) to discuss internal and external 10 Hibiscus Childrens Center Crisis Nursery Program Children Services Advisory Committee monitoring results. This group is also instrumental in ensuring that the agency maintains a "big picture" perspective on all of its services . Hibiscus has set benchmarks for each of its programs that must be met; these benchmarks include all outcomes specified in contracts . When deficiencies are identified, a corrective action plan is developed. Follow-up takes place by comparing scores in the next review cycle to demonstrate improvement. Clients are informed in writing of our Continuous Quality Improvement processes and are allowed access to reports generated upon request. These reports are also available to funders upon request. Additionally, Hibiscus maintains an adequate MIS to comply with all funders requests for documenting and sharing data elements . Change in the family' s situation is most clearly documented through the completion of the Family Support Plan. This documentation is maintained in the individual family ' s record. The systemic change of preventing and reducing child abuse is documented through our annual monitoring by DC&F . The Department of Children & Families will report outcomes on client satisfaction, and abuse and/or neglect that occurs during services . Prior to service initiation, families are screened through the Department of Children & Families to determine if there is an open case of abuse or neglect. This information is verified by the Department and maintained in client records . At all times during services, from initiation to termination, Family Advocates are working with the families they serve to collect accurate data. Data is collected and compiled on a monthly basis by the Family Advocates and presented to the Program Director. The Program Director reviews all program data for accuracy and reporting. It is compiled by county and rolled up into a report that is provided to all funding entities based on their requirements individually and in full to the Department of Children & Families . This data is included in the agency ' s yearly annual report, is utilized in brochures and other agency materials, and is available upon request. 11 Hibiscus Childrens Center Crisis Nursery Program Children Services Advisory Committee G. TIlVIETABLE (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. Month/Period Activities Ongoing • Families are screened for eligibility for services • Families are assessed and support plans are developed with the family to meet their identified needs . • Services and interventions are provided as identified on plan • Cases are closed as needs are addressed and risk level to family and child is diminished. Weekly . Cases are staffed with supervisor to ensure appropriate level of intervention to meet the needs of the family. Monthly • Risk Management Committee reviews any significant events that occurred during the month involving the program and/or individuals served. • Records are reviewed as part of internal Peer Record Review to Quarterly ensure compliance with funder, Council On Accreditation, and "best practice" standards Annually • Monitoring occurs by Department of Children and Families to determine if any verified incidents of abuse or neglect occurred during service provision or within one year of completion of services. 12 I � 1 { 1 1I i Budget 00 ' IndianN. River Countyi 11 mm-1 pa= � 1 1 \ � • 1 . • 1 41 to 1=1 1 . ': Fort Pierce - . • 1 1 \ • rt Saint Lucie • • • � 1 ' I w• 1 1 , • • I 1 I 1 II Number of UndupUcated CHentsby Age 5.., z-m+•w -rnn &' 'TTS P. • /ayq i p:o 4,,,»«a • 1 to v . • i oOEM• • ® � � � ® � Total Adults • 1 i 1 ( � 1 Hibiscus Children's Center, Inc./Crisis Nursery UNIFORM GRANT APPLICATION BUDGET NARRATIVE WORKSHEET IMPORTANT: The Budget Narrative should provide details to justify the amount requested in each line item of the budget for your program. From this worksheet, your figures will be linked to the Total Agency Budget, Total Program Budget and Funder Specific Budget Forms. AGENCY/PROGRAM NAME : Hibiscus Children 's Center, Inc ./Crisis Nursery FUNDER : Children 's Services Advisory Committee of Indian River County 1 CAUTION : Do not enter any figures where a cell is colored in dark blue - Formulas and/or links are in place. Gray areas should 1 be used for calculations and to write information only. ; Onnv 4Rens FON '; ProposedTotal Program Funder Specific Total Ag enc REVENUES' AGENCY USE ONLY tsN y DETAIL a CALCULATIONS) Budget Budget - Budget 1 Children's Services Council-St Lucie 100, 000.00 144 ,765 .00 2 Children's Services Council-Martin 25,680.00 42,333.00 3 Advisory Committee-Indian River 20,000. 00 20,000. 00 29, 593.00 4 United Way-St Lucie County 5 ,000. 00 51000. 00 5 United Way-Martin County15, 000. 00 15, 000.00 6 United Way-Indian River Coun 7 Department of Children & Families 302 ,295. 00 8 County Funds 9 Contributions-Cash 10 Program Fees 11 Fund Raising Events-Net 12 Sales to Public - Net 225 ,000. 00 13 Membership Dues 14 Investment Income 777777741200. 00 15 Miscellaneous 16 Legacies & Bequests 17 Funds from Other Sources 2349743 .00 31702,340.00 18 Reserve Funds Used for Operating 19 In-Kind Donations (Not included In total) 36,000.00 400 ,000.00 20 TOTAL REVENUES (doesn't include line 19) $400,423.00 $20,000.00 $49470,526.00 2; AB C EXPENDITURES GRAY ARM FOR Proposed Total Program Funder;Specific Total Ao�cr use ON Lr 1 . Agency 21 SalariesSHOW cALCULAT10N3 Budget Budget . _ Budget'' - (must complete chart on next page 227 , 197.00 18, 578.73 2 ,767,057. 00 � F Salary 22 FICA - Total salaries x 0.0765 7.65% 17, 380 . 57 1 ,421 .27 206 , 782 . 33 Retirement - Annual pension for qualified 23 staff ' 0.28% 650 .00 0.00 14 ,695. 67 Life/Health - Medical/Dental/Short-term 24 Disab, 8.58% 19, 500 .43 0 .00 205 , 565 . 00 or ers Compensation - # emp oyees x 25 rate 3.52% 8 , 000. 00 0. 00 94 , 388 . 00 Honda nemp oymen - pro)ec e 26 employees x $7, 000 x UCT-6 rate Lr rr . 16 0.40'k 900.00 0 . 00 13 , 533 . 00 SALARIES A Gross s v Annual Sala Portion of Sala on Proposed C % of Gross Annual POSIT/ MUSTING C' SalaryFunder specific Budget Position Tide / Total Hrs/wk - (Agency) ` Program Salary Requested(C/A) Example - EzecutNe Director/40 hrs 70,000.(10 10,000.00 51000.00 7. 14% 5/16/2005 B-t 14 MINE 011111111111 Hibiscus Children's Center, Inc./Crisis Nursery Program Manager/40 Hours - 30% 37 , 131 . 00 11 , 139 . 00 41650.00 12 . 52 % Program Director/40 Hours - 25% 61 , 800 . 00 15 ,450 .00 0.00% Family Advocate/40 Hours - 100% 24 , 370. 00 24 , 370 . 00 29402 .73 9. 86% Program Manager/40 Hours - 100% 32 ,960 . 00 32 , 960 .00 0.00% Family Advocate/40 Hours - 100% 24 , 370 . 00 24 , 370 .00 6 ,400 . 00 26.26% Respite Care Coordinator/40 Hours - 100% 269523 . 00 26 , 523 . 00 0. 00% Family Advocate/40 Hours - 100% 24 , 370 . 00 24 , 370 . 00 2, 364 . 00 9. 70% Child Care Worker/40 Hours - 40% 16 , 004 . 00 61402 . 00 0 .00% Child Care Worker/40 Hours - 100% 16 ,604 . 00 16 ,604 . 00 0 . 00 % Child Care Worker Supervisor/40 Hours - 1001 24, 720 . 00 24 , 720.00 2,762 . 00 11 . 17% Child Care Worker/40 Hours - 100% 20, 289. 00 20 , 289 . 00 0. 00% #DIV/0 ! #DIV/0 ! #DIV/0! #DIV/0 ! #DIV/0! #DIV/0 ! #DIV/0 ! #DIV/0! #DIV/0! . Remaining positions throughout the agency 2 ,457, 916 . 00 Total Salaries I $2t767 , 057. 001 $227 , 197 .00 $ 189578.73 0.67% FRINGE BENEFITS DETAIL (Funder Spec/fic 8ualgef . A Funder B , c n E F c M a , " „ • Pension Worker's _ Unemployme Total Fringes Funder 3 C only, from 6ne 22 to 27 pecW1c Budget FICA 7.65% : Health Ins. Column (A x Yq) Compens. nt Compens. Speck �ositlon Title'/ Total Hrs/wk :; � F_ireinple CsselNaiisgerl4ohrs 5,000.00 .` 382.50 200.00 500.00 300.00 200.00 1,582.50 Program Manager/40 Hours - 30% 49650.00 355.73 355 . 7 Program Director/40 Hours - 25% 0. 00 0. 00 0 . 0 Family Advocate/40 Hours - 100% 29402.73 183.81 183 . 81 Program Manager/40 Hours - 100% 0 .00 0 . 00 0. 0 Family Advocate/40 Hours - 100% 6 ,400.00 489.60 489 . 6 Respite Care Coordinator/40 Hours - 100% 0. 00 0. 00 0 . 00 Family Advocate/40 Hours - 100% 2 , 364.00 180. 85 180. 8 Child Care Worker/40 Hours - 40% 0. 00 0. 00 0 . 0 Child Care Worker/40 Hours - 100% 0.00 0.00 0. 00 Child Care Worker Supervisor/40 Hours - 100 21762 .00 211 .29 211 .2 Child Care Worker/40 Hours - 100% 0.00 0.00 0.0 0 0 . 00 0.00 0.0 0 0.00 0. 00 0 . 0 0 0 .00 0. 00 0. 0 0 0 .00 0. 00 0 .0 0 0.00 0.00 0. 0 0 0.00 0. 00 0. 0 0 0.00 0.00 0 . 0 0 0.00 0.00 0 .0 0 0.001 0.00 0. 0 - Total Funder Reques t Fdnge Beneffts $ 18 , 578.731 $ 1 ,421 .271 $0.001 $0. 001 $0. 001 $0 . 001 $ 1 ,421 .2 AB C D EXPEND/TURES nocrosoLo Proposed Tofa/ Program Funder Specific Total Agency : . SNOW DETAIL Budget Budget Budget 27 Travel-Daily 10 ,616 . 00 0 . 00 76 , 145 . 00 # of Staff x average # of miles/wk x 50 wks x $ = Estimated Daily Travel/Mileage Reimb. 128 mileser week p @.29 for 5. 55 people 28 TraveUConferences/Training 2 , 558 . 00 0 . 001 24 , 860. 00 5/16/2005 B-1 15 Hibiscus Children's Center, Inc./Crisis Nursery • National Conference (cost per staff) • Training/Seminar (cost per staff) • Other Trainings (cost of travel , lodging , registration , food) Family Support Training for 5.55 people @ $465 per person 29 Office Supplies 37000 . 00 0 .001 28 ,240 . 00 Office supplies (monthly average x 12 months = estimated cost of office supplies based on present history. $250 per month average for 12 moths 30 Telephone 61350.00 0 .001 65 , 080 . 00 # Phone lines x average cost per month x 12 months = local phone cost Average long distance calls x 12 months = Bell South -$227.54 per month average/Cell Phones - $238. 13 per month average/Long Estimated cost of long distance Distance - $63. 50 per month average 31 Postage/Shipping 300.00 0 .00 51670 . 00 Quarterly Mailing of Newsletter • Special events, etc. • Bulk mailings - appeals Postage meter averageusage of $25 per month 32 Utilities 41400.00 0.001 55 , 745 . 00 • Electricity ($ x 12 months) • Water/Sewer ($ x 12 months) Electric - $289 .55 per month average/Water/Sewer - $32 .99 per month average/Garbage - • Garbage ($ x 12 months) $43.98 per month average 33 Occupancy (Building & Grounds) 8VO00 . 001 0.001 102 , 315 . 00 • Mortgage/Rent ($ x 12 months) • Janitorial ($ x 12 months) • Grounds Maint. ($ x 12 months) Rent '- $540 per monttWanitorial - $106,67 per month/Landscape/Lawn Maintenance $70 per • Real Estate Taxes month 34 Printing & Publications 19290. 00 0 .00 6 , 100. 00 • Quarterly Newsletter ($ x 4) • Letterheads, Envelopes , etc. • Fundraising materials • Other Letterhead, Envelopes and Misc. printing @ $ 107.50 per month average 35 Subscription/Dues/Memberships 1 , 520 .00 0. 00 17 , 760. 00 • Membership to National Organization • Dues • Subscriptions to Newspapers/magazines, PDues to Child Welfare i eague - $ 111 .47 per month/Dues for Coord. Council - $$2.53 per eta month/Subscriptions for newspapers and trade magazines - $ 12 .67. 36 Insurance 81305.00 0 .001 106 , 355 . 00 • Directors/Officers Liab. • Commercial/General Insurance • Bond Ins . Property Insurance = $75 .83 per, month/General Liability Insurance $583.75 per • Auto Insurance mo nth/Professional Liabila'ity =$32:50 per month 37 Equipment: Rental & Maintenance5,000 . 00 0. 00 111 , 715 . 00 • Copier lease ($ x 12 months) • Meter lease ($ x 12 months) • Copier Maintenance ($ x 12 months) • Computer Maintenance ( $ x 12 months) Copier Lease - $220.32 per month/Meter Lease - $40.03 per month/Copier maintenance - • Other $77.03 per;month/Software Support $79.28 per month 38 Advertising 150 .001 0. 00 32 , 730 . 00 • Newspaper ads • Fundraising ads/promotions • Other (vacancies) Newspaper ads as needed 39 Equipment Purchases : Capital Expense 0.00 0.00 72 , 000 . 00 • Computer/monitor (# x $) • Laser Printer 40 Professional Fees (Legal, Consulting) 0 .00 0. 00 17 , 960 . 00 • Legal advice ( estimated #hrs x $) • Consultant fees • Other 41 Books/Educational Materials 0 .00 0 . 00 31370 . 00 • Books/videos • Materials ($ x staff) 42 Food & Nutrition 2 ,701 . 00 0. 00 40 , 360. 00 5/16/2005 16 B-1 1 Hibiscus Children's Center, Inc./Crisis Nursery • Meals ( # meals x clients x 5days x 50 wks) • Snacks $2.89 per 3 me3als a day/week for 6 children per 52 weeks 43 Administrative Costs 36402 . 001 0. 001 299 , 355 . 00 Accountant - - 20% - Salary - $8, 580 - Fringes - $2, 145/ Coo - 20% - Salary - $ 15,000 - Fringes • Admin. Cost (% of total budget) $3 ,750/IT Manager - 15% - Salary - $6,927 44 Audit Expense 1 , 300.00 0. 00 131050. 00 • Independent Audit Review Independent audit review 45 Specific Assistance to Individuals 33v873 . 001 0. 001 71 , 530 . 00 • Medical assistance • Meals/Food • Rent Assistance Rent/Living Assistance- $2, 122 per month average/Utility Assistance - $734 per month • Other average 46 Other/Miscellaneous 1 , 030 .00 0. 001 18 , 165 . 00 • Background check/drug test • Other Background Checks/Drug Testing 47 Other/Contract 0. 00 0. 00 0 . 00 • Sub-contract for program services 48 TOTAL EXPENSES $400 ,423.00 $20, 000 .00 $41470 , 526 . 00 5/1 WO05 B-1 17 Hdn= CMdmt GNa, mJC/ Nursery UNIFORM GRANT APPLICATION TOTAL AGENCY BUDGET AGENCY/PROGRAM NAME: Hibiscus Children's Center, Inc./Crisis Nursery FY 03/04 FY 04/05 FY 05/06 % INCREASE FYE 6/30/04 FYE 6/30/05 FYE 06/30/06 CURRENT VS. NEXT FY BUDGET A B C D ACTUAL TOTAL PROPOSED (col. Ctol. Bycol. a REVENUES BUDGETED BUDGETED 1 Children's Services Council-St Lucie 96 268.60 1 "1765.00 144 765.00 0.00% 2 Children's Services Council-Martin 23p868.01 41 653.00 42 333.00 1 .63% 3 Advisory Committee-Indian River 21 437.53 2000.00 29 593.00 47.97% 4 United Way-St Lucie County 5 000.00 5 000.00 5 000.00 0.00% 6 United Way-Martin County 15 650.00 15 000.00 15q000.00 0.00% 6 United Way-Indian River County 11 533.00 11 533.00 0.00 -100.00% 7 Department of Children & Families 1 093131 .80 302 295.00 302f295.00 0.00% a County Funds 0.00 #DIV/01 9 Contributions-Cash 60 019.61 0.00 0.00 #DIV/01 10 Program Fees 0.00 #DIV/01 11 Fund Raising Events-Net 0.00 #DIV/01 12 Sales to Public-Net 272 235.76 225 000.00 225t000.001 0.00% 13 Membership Dues 0.00 #DIV/01 14 Investment Income 40145.58 4 200.004 200.00 0.00% 15 Miscellaneous 3197.86 0.00 0.00 #DIV/01 16 Legacies & Bequests 0.00 #DIV/01 17 Funds from Other Sources 11985,318.27 3 599 699.00 317027340.00 2.85% 16 Reserve Funds Used for Operating 0.00 #DIV/01 19 In-Kind Donations (Not Included In total) 606p100.00 400 000.00 400 000.00 0.00% 20 TOTAL 31591t806.02 4 369145.00 49470,526,00 2.32% EXPENDITURES 21 Salaries 2158197.30 21678,920,00 2 767 057.00 3.29% 22 FICA 151 409.21 200183.00 206 782.33 3.30% 23 Retirement 49068,65 1458000 14 695.67 0.79% 24 Life/Health 137 876.97 208 602.00 205 565.00 -1 .46% 25 Workers Compensation 123 931 .95 94t270,00 94r388.00 0. 13% 26 Florida Unemployment 12p665.00 14 500.00 13 533.00 -6.67% 27 Travel-Daily 60 084.74 76 145.00 76145.00 0.00% 28 Travel/Conferences/Training 18 624.00 24 860.00 24 860.00 0.00% 29 Office Supplies 33V456.85 28 240.00 28p240.00 0.00% 30 Telephone 55 845.00 65 080.00 651080o00 0.00% 31 Postage/Shipping 5t601 .78 51670.00 59670,00 0.00% 32 Utilities 45 559.45 55 745.00 55 745.00 0.00% 33 Occupancy (Building & Grounds 74 936.03 99 315.00 102j315.00 3.02% 34 Printing & Publications 51503.51 60100,00 610000 0.00% 35 Subscription/Dues/Memberships 17j550,04 17 760.00 17t760,00 0.00% 36 Insurance 36 343. 10 106 355.00 106 355.00 0.00% 37 E ui ment:Rental & Maintenance 73123.70 111 715.00 111 715.00 0.00% 36 Advertising 91761 .241 32 730.00 32 730.00 0.00% 39 Equipment Purchases:Ca ital Expense 122 912.25 72 000.00 72 000.00 0.00% 40 Professional Fees (Legal, Consulting) 52p242.00 17 960.00 17 960.00 0.00% 41 Books/Educational Materials 31270.49 31370.00 31370.00 0.00% 42 Food & Nutrition 23 529.02 40 360.00 40 360.00 0.00% 43 Administrative Costs 268 581 .83 289 025.00 299 355.00 3.57% 44 Audit Expense 11 t746,50 12 965.00 13 050.00 0.66% 45 Specific Assistance to Individuals 75 257.89 71 530.00 71 530.00 0.00% 46 Other/Miscellaneous 24 786.83 21 165.00 18 165.00 -14.17% 47 Other/Contract 0.00 0.00 0.00 #DIV/01 4811!jTAL 31606,865.33 4 369 145.00 414707526.00 2.32% 49 REVENUES OVER/ UNDER EXPENDITURES -15,059.31 , 0.00 0.00 #DIV/01 18 5,e0005 NlbWw Chldwn g Cwhr, hwRruk Nuewy UNIFORM GRANT APPLICATION TOTAL PROGRAM BUDGET AGENCY/PROGRAM NAME: Hibiscus Children's Center, Inc./Crisis Nurse FY 03/04 FY 04/05 FY 05/06 % INCREASE FYE 6/30/04 FYE 6/30/05 FYE 6/30/06 CURRENT VS. NEXT FY BUDGET A B C D ACTUAL TOTAL PROPOSED (col. c<ol. Bycol. B REVENUES BUDGETED BUDGETED 1 Children's Services Council-St. Lucie 63 564.00 100 000.00 100 000.00 0.00% 2 Children's Services Council-Martin 23,868,00 25 000.00 25 680.00 2.72% 3 AdvisoryCommitteedndian River 21 438.00 20 000.00 2000000 0.00% 4 United Wa St Lucie County 51000,00 500000 59000.00 0.00% 5 United Way-Martin County 15 650.00 15 000.0015 000.00 0.00% s United Way-Indian River County 11j533.00 11 ,533.00 : 0.00 100.00°h 7 Department of Children & Families 171 000.00 0.00 0.00 #DIV/01 8 County Funds 0.00 0.00 0.00 #DIV/O! 9 Contributions-Cash 14 950.00 0.00 0.00 #DIV/01 10 Program Fees 0.00 0.00 0.00 #DIV/01 11 Fund Raising Events-Net 0.00 0.00 0.00 #DIV/01 12 Sales to Public-Net 0.00 0.00 0.00 #DIVl01 13 Membership Dues 0.00 0.00 0.00 #DIV/0I 14 Investment Income 12.00 0.00 0.00 #DIV/01 15 Miscellaneous 0.00 0.00 0.00 #DIV/01 1s Legacies & Bequests 0.00 0.00 0.00 #DIV/01 17 Funds from Other Sources 75v529.00 213 240.00 234 743.00 10.08% 16 Reserve Funds Used for Operating 0.00 0.00 0.00 #DIV/01 19 In-Kind Donations (Not Included In totaq 47 652.00 32 000.00 36t000.00= 6 000.00 12.50% 20 TOTAL 402 544.00 389 773.00 400 423.00 2.73% EXPENDITURES 21 Salaries 218 141 .00215 866.00 227 197.00 5.25% 22 FICA 15 281 .00 16 290.00 17 380.57 6.69% 23 Retirement 412.00 600.00 650.00 8.33° w 24 Life/Health MO7 18 900.00 79 500.43 3. 18% 25 Workers: Compensation 7 370.00 8 000.00 8.55% 26 Florida Unemployment 850.00 900.00 5.88°k27 Travel-Dai 10 000.00 10 616.00 6. 16% 28 Travel/Conferences/Trainin 2 500.00 255800 2,32°�29 Office Su lies 2 890.00 3 000.00 3.81 % 30 Tele hone 6 350.00 6 350.00 0.00% 31 Posta a/Shl in 290.00 300.00 3.45% 32 Utilities 4174.00 4 390.00 4 3°400.00 0.2 33 Occupancy (Building & Grounds 31429,00 9 480.00 81000.00 45.61 % 34 Printing & Publications 19283.001 290.00 1 ,290.00 0.00°k 35 Subscription/Dues/Memberships 19515.00 1 520.00 1520.00 0.00% 36 Insurance 31015.00 8 305.00 8 305.00 0.00% 37 E ui ment:Rental & Maintenance 71516.00 7v940,00 500000 -37.03% 38 Advertising312.00 320.00 150.00 -53. 13°A 39 Equipment Purchases:Ca itai Expense 49410.00 0.00 0.00 #DIV/01 40 Professional Fees (Legal, Consulting) 0.00 0.00 0.00 #DIV/01 41 Books/Educational Materials 0.00 0.00 0.00 #DIV/01 42 Food & Nutrition 2j701 ,00 3 050.00 2,701 ,00 11 .44°k 43 Administrative Costs 39 122.00 38 977.0036 402.00 -6.61 % 44 Audit Expense 1 489.00 1 565.00 1 ,300.01D 76.93% 45 Specific Assistance to Individuals 44t260.00 3000000 33873.00 12.91 °A 46 Other/Miscellaneous 526.001 030.00 103000 0.00% 47 Other/Contract 0.00 0.00 0.00 #DIV/01 48 TOTALMMEMMMMM391 224.00 389 773.00 400t423.00 2.73% 49 REVENUES OVER/ UNDER EXPENDITURES 11 320.00 o.001 0.00 #DIV/01 19 shy B4 Hibiscus Children's Center, Inc./Crisis nursery UNIFORM GRANT APPLICATION FUNDER SPECIFIC BUDGET PROGRAM EXPENSES AGENCY/PROGRAM NAME : Hibiscus Children 's Center, Inc./Crisis Nursery FUNDER: Children 's Services Advisory Cot A B C FY 05106 FY 05/06 % OF TOTAL FUNDER TOTAL VS, PROGRAM SPECIFIC FUNDER REQUEST BUDGET BUDGET (col. B/col. A EXPENDITURES 21 Salaries 227 , 197 .00 18 , 578 .73 8 . 18% 22 FICA 179380 .57 19421 .27 8 . 18% 23 Retirement 650.00 0 .00 0.00% 24 Life/Health 199500 .43 0 .00 0.00% 25 Workers Compensation 81000 . 00 0. 00 0 .00% 26 Florida Unemployment 900 .00 0.00 0. 00% 27 Travel=Dally 10,616 .00 0 .00 0 .00% 28 Travel/Conferences/Training 29558 . 00 0 .00 0. 00% 29 Office Supplies 31000 . 00 0 .00 0 . 00% 30 Telephone 60350 .00 0.00 0.00% 31 Postage/Shipping 300. 00 0 .00 0. 00% 32 Utilities 49400 .00 0.00 0 .00% 33 Occupancy (Building & Grounds 8 ,000. 00 0 .00 0. 00% 34 Printina & Publications 19290 .00 0.00 0 . 00% 35 Subscription/Dues/Memberships 1 , 520 .00 0 .00 0 .00% 36 Insurance 80305 .00 0. 00 0. 00% 37 Equipment: Rental & Maintenance 55000. 00 0 .00 0 .00% 38 Advertising 150 .00 0.00 0.00% 39 Equipment Purchases : Ca ital Expense 0 .00 0.00 #DIV/0 ! 40 Professional Fees (Legal , Consulting) 0.00 0 .00 #DIV/01 41 Books/Educational Materials 0 .00 0 .00 #DIV/O ! 42 Food & Nutrition 2 ,701 .00 0.00 0. 00% 43 Administrative Costs 36140200 0 .00 0 .00% 44 Audit Expense 1 ,300 . 00 0200 0 . 00% 45 Specific Assistance to Individuals 33 , 873 .00 0 .00 E000% 46 Other/Miscellaneous 11030 . 00 0. 00 0 . 00% 47 Other/Contract 0 .00 0 .001 #DIV/01 48 TOTAL $4009423 .00 $201000 . 00 4. 99% 5/18/2006 2 0 B' HUD= CNICren's Center, InOCOft Nursery UNIFORM GRANT APPLICATION EXPLANATION FOR VARIANCES OF 15% OR MORE TOTAL PROGRAM BUDGET AGENCYIPROGRAM NAME: Hibiscus Children's Center, IncJCrisis Nursery FUNDER: Children's Services Advisory Committee of Indian RiverCounty =9DIV/01 #DN/01 #DN/01 #DN101 #DNro1 #DN/Ol ' #DN/01 #DN/01 #DN/0l #DN/01 21 Ba Wbecus Chicken's Center, Inc. CdWs Nursery UNIFORM GRANT APPLICATION EXPLANATION FOR VARIANCES OF 15% OR MORE FUNDER SPECIFIC BUDGET AGENCY/PROGRAM NAME: Hibiscus Children's Center, IncJCrisis Nursery FUNDER: Children's Services Advisory Committee of Indian RiverCounty iJNE ITEM, , .. wAfft§WgWl4h EXPLANATION FOR VARIANCE,, , s<, #DNI01 #DN/O! #DNIOI #DNl01 21 - A SM82005 BS EXHIBIT B ( From policy adopted by Indian River County Board of county Commissioners on February 19 , 2002 ) " D . Nonprofit Agency Responsibilities After Award 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 and (September 30th) must be submitted on a timely basis . Each year, the Office of Management and 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 expense by type . These summaries *taw should be broken down into salaries , benefit, 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." 'rrr� EXHIBIT - B - t EXHIBIT C STANDARD TERMS FOR GRANT CONTRACT err 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 : Hibiscus Children 's Center P . O . Box 305 Jensen Beach , FL 34958 Attention : Jan S . Huffert, Executive Director 2 . Venue ; Choice of Law. The validity, interpretation , construction , and effect of this Contract shall be in accordance with and governed by the laws of the State of Florida only . The location for settlement of any and all claims , controversies , or disputes , arising out of or relating to any part of this Contract , or any breach hereof, as well as any litigation between the parties , shall be Indian River county, Florida for claims brought in state court, and the Southern District of Florida for those claims justifiable in federal court. 3 . Entirety of Agreement . This Contract incorporates and includes all prior and contemporaneous negotiations , correspondence , conversations , agreements , and understandings applicable to the matters contained herein and the parties agree that +` there are no commitments , agreements , or understandings concerning the subject matter of this Contract that are not contained herein . Accordingly, it is agreed that no deviation from the terms hereof shall be predicated upon any prior representations or agreements , whether oral or written . It is further agreed that no modification , amendment or alteration in the terms and conditions contained herein shall be effective unless contained in a written document signed by both parties . 4 . Severability. In the event any provision of this Contract is determined to be unenforceable or invalid , such unenforceability or invalidity shall not affect the remaining provisions of this Contract, and every other provision and term 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 context indicates otherwise , words importing the singular number include the plural number, and vise 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 *ftw consent of the County . EXHIBIT - C - Internal Revenue Service Department of the Treasury P . O . Box 2508 Cincinnati , OH 45201 Date : January 16 , 2003 Person to Contact : Cassandra E . Jackson 31 -07417 Customer Service Representative Hibiscus Children ' s Center, Inc . Toll Free Telephone Number: P . O . Box 305 8 :00 a.m . to 6 : 30 p. m . EST Jensen Beach , FL 34958-0305 877-829-5500 Fax Number. 513-263-3756 Federal Identification Number : 59-2632361 Dear Sir or Madam : This is in response to the amendment to your organization ' s Articles of Incorporation filed with the state on November 30 , 1994 . We have updated our records to reflect the name change as indicated above . Our records indicate that a determination letter issued in March 1987 granted your organization exemption from federal income tax under section 501 ( c )( 3 ) of the Internal Revenue Code . That letter is still in effect . Based on information subsequently submitted , we classified your organization as one that is not a private foundation within the meaning of section 509( a ) of the Code because it is an organization described in sections 509 ( a )( 1 ) and 170( b )( 1 )(A )(vi ) . This classification was based on the assumption that your organization ' s operations would continue as stated in the application . If your organization ' s sources of support, or its character, method of operations , or purposes have changed , please let us know so we can consider the effect of the change on the exempt status and foundation status of your organization . Your organization is required to file Form 990 , Return of Organization Exempt from Income Tax , only if its gross receipts each year are normally more than $25 , 000 . If a return is required , it must be filed by the 15th day of the fifth month after the end of the organization's annual accounting period . The law imposes a penalty of $20 a day, up to a maximum of $ 10 , 000 , when a return is filed late , unless there is reasonable cause for the delay . All exempt organizations ( unless specifically excluded ) are liable for taxes under the Federal Insurance Contributions Act ( social security taxes ) on remuneration of $ 100 or more paid to each employee during a calendar year. Your organization is not liable for the tax imposed under the Federal Unemployment Tax Act ( FUTA ) . Organizations that are not private foundations are not subject to the excise taxes under Chapter 42 of the Code . However, these organizations are not automatically exempt from other federal excise taxes . Donors may deduct contributions to your organization as provided in section 170 of the Code . Bequests , legacies , devises , transfers , or gifts to your organization or for its use are deductible for federal estate and gift tax purposes if they meet the applicable provisions of sections 2055 , 2106 , and 2522 of the Code . -2- Hibiscus Children ' s Center, Inc . 59-2632361 Your organization is not required to file federal income tax returns unless it is subject to the tax on unrelated business income under section 511 of the Code . If your organization is subject to this tax, it must file an income tax return on the Form 990-T , Exempt Organization Business Income Tax Return, In this letter, we are not determining whether any of your organization ' s present or proposed activities are unrelated trade or business as defined in section 513 of the Code . The law requires you to make your organization ' s annual return available for public inspection without charge for three years after the due date of the return . If your organization had a copy of its application for recognition of exemption on July 15 , 1987 , it is also required to make available for public inspection a copy of the exemption application , any supporting documents and the exemption letter to any individual who requests such documents in person or in writing . You can charge only a reasonable fee for reproduction and actual postage costs for the copied materials . The law does not require you to provide copies of public inspection documents that are widely available , such as by posting them on the Internet (World Wide Web ) . You may be liable for a penalty of $ 20 a day for each day you do not make these documents available for public inspection ( up to a maximum of $ 10 , 000 in the case of an annual return ) . Because this letter could help resolve any questions about your organization ' s exempt status and foundation status , you should keep it with the organization' s permanent records . If you have any questions , please call us at the telephone number shown in the heading of this letter . This letter affirms your organization 's exempt status . Sincerely, Z � John E . Ricketts , Director, TE/GE Customer Account Services ACORD. CERTIFICATE OF LIABILITY INSURANCE OP ID C DATE (MM/DD/YYYY) HIBIS - 2 12 / 06 / 05 PRODUCER r THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION • ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE R . V . Johnson { GSM ) HOLDER. THIS CERTIFICATE DOES NOT AMEND , EXTEND OR 2041 E Ocean Blvd ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Stuart FL 34996 Phone : 772 - 287 - 3366 Fax : 772 - 287 - 4255 INSURERS AFFORDING COVERAGE NAIC # INSURED INSURERA: Landmark Insurance Company HibiscusINSURER B : Markel International &Hibiscu s Childress Foundation Childress Center Inc , INSURER C: Bridgefield Employers Insuranc Hibiscu P O Box 305 INSURER D: Jensen Beach FL 34958 INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. AEYDEP /DY)LTR NSR TYPE OF INSURANCE POLICY NUMBER DTMM/D /YY DATE EXPIRATION MD /YLIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1 , OOO , 000 B X X COMMERCIAL GENERAL LIABILITY 3602SS255610 - 0 07 / 12 / 05 07 / 12 / 06 PREMISES (Ea occurence) $ 200 , 000 CLAIMS MADE 1*1 OCCUR MED EXP (Any one person) $ 15000 X ABUSE /MOLES PERSONAL & ADV INJURY $ 1 , 000 , 000 $ 1 , 000 , 000 / $ 2M GENERAL AGGREGATE $ 3 , 000 , 000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 3 , 0 0 0 , 000 POLICY PROT LOC Em Ben $ 1M/ $ 3M JEC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1 B X ANY AUTO 1002SS255617 - 0 07 / 12 / 05 07 / 12 / 06 (Ea accident) i000 F000 ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per person) X HIRED AUTOS BODILY INJURY $ X NON-OWNED AUTOS ( Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE s2 , 000 , 000 B X OCCUR � CLAIMSMADE 4602SS255623 - 0 07 / 12 / 05 07 / 12 / 06 AGGREGATE $ 2 , 000 , 000 RDEDUCTIBLE $ X RETENTION $ 10F000 $ TATI 'H— WORKERS COMPENSATION AND TORY LIMITS X ER C EMPLOYERS' LIABILITY 0830 - 28580 02 / 22 / 05 02 / 22 / 06 E. L. EACH ACCIDENT $ 500000 ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBEREXCLUDED? E. L. DISEASE - EA EMPLOYEE $ 500000 If yes, describe under SPECIAL PROVISIONS below E. L. DISEASE - POLICY LIMIT $ 500000 OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS 30 days notice of cancellation for workers compensation coverage , companies have the option to cancel 10 days for non payment . Certificate holder is added as additional insured . CERTIFICATE HOLDER CANCELLATION INDIA- 1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 * DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL Indian River County IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR Marion Masterson 1840 25 Street REPRESENTATIVES. deq Vero Beach FL 32960 AUT Z PR_F,B�NT I ACORD 25 ( 2001 /08 ) © ACORD CORPORATION 1988 IMPORTANT If the certificate holder is an ADDITIONAL INSURED , the policy ( ies) must be endorsed . A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement( s ) . If SUBROGATION IS WAIVED , subject to the terms and conditions of the policy , certain policies may require an endorsement . A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s ) . DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s) , authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend , extend or alter the coverage afforded by the policies listed thereon . ACORD 25 ( 2001 /08 )