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Proposed 02 Inc/(Dec) % Change Adopted 01 Adopted 00 Middle Keys Guidance Clinic 499,558 -29,688 -5.6% 529,246 498,900 Baker Act Trans-Lower Keys 76,996 7,025 10.0% 69,971 0 Transportation 16,380 780 5.0% 15,600 13,000 Keys to Recovery 86,287 4,109 5.0% 82,178 68,482 Total Middle Keys Guidance 679,221 -17,774 -2.6% 696,995 580,382 Upper Keys Guidance Clinic 87,444 0 0.0% 87,444 87,444 Care Center 184,141 O. 0.0% 184,141 184,141 Total 950,806 -17,774 -1.8% 968,580 851,967 Mental Health Clinics Date Date We further understand that meeting the Eligibility Criteria in no way ensures that the agency will be recommended for funding by the Human Services Advisor.y Board. These recommendations are determined by service needs of the . . community, availability of funds, etc. Approval of HSAB funding rerv.mmendations is granted by the Monroe County Board of County Commissioners. - '~V -. ~V\~ (l, vL vn~ IV / A.I..A '" 7 "~J ~~ --. . ,~ , . . , [ /\ Signature Signat4re \, Chief Executive Officer by Director of Operations Lynn Mapes. Vice President....) UaVl.d 1'. lUce, 1'h.lJ. by Debbl.e Barsell, MSW,CAP Typed Name of Executive Director June 19, 2001 Typed N-ame of Board President/Chairman June 19, 2001 We understand that the agency must substantially meet the eligibility criteria to be considered for Monroe County funding and that any applicable attachments not included disqualify the agency's application. This certifies that this request for funding is consistent with our organization's Articles of Incorporation and Bylaws and has been approved by a majority of the Board of Directors. We affirm that the Agency will use Monroe County funds for the purposes as submitted in this Application for Funding. Any change will require written approval from the Monroe County Board of County Commissioners. IAGENCY PROFILE ~gency Name: Guidance Clinic of the Middle Keys, Inc. Operating Since 1973 ~gency Location(s): Marathon, FL (serving the needs of County residents throughout the Keys) Mailing Address: 3000 41st Street-ocean, Marathon, FL 33050 Contact: David P. Rice, Ph.D. Title:Chief Executive Officer !Agency Phone: 305-289-6150 Fax: 305-289-6158 Have you ever applied to Monroe County HSAB for Funding Assistance? X Yes No Will County funds be used as If yes, what is the ratio of match to match for a grant? Federal and/or State dollars? TOTAL NUMBER OF EMPLOYEES X Yes - No 15.6 % FULL 53 PART 40 TIME TIME Is funding for a AMOUNT REQUESTED AMOUNT RECEIVED AMOUNT RECEIVED new, or an FOR COUNTY FISCAL YEAR ENDING FOR FISCAL YEAR FOR FISCAL YEAR X existing, 9/30/02 ENDING 9/30/01 ENDING 9/30/00 program? $679,211 $623,413 $583,018 CERTIFICATION APPLICATION FOR FUNDING MONROE COUNTY Human Services Advisory Board October 1. 2001 - September 30. 2002 3 Client base has increased due to increased funding, particularly in the areas of substance abuse outreach, intervention, nd aftercare. x . . ~;.:-" '.:'.,c.:-:,." _.:~ ',:';h::-'-- --:::::: - "-' ':----:~----'- -:c---"':"'::,'::::,:;,r:':--::"'" - '.8sejCIi~nCD-ernographicsi '~"':'(}:0~" x x e DOC contract for outpatient substance abuse treatment was long held by GCMK. In July 2001, this contract will be ransferred by DOC to an independent contractor, reducing GCMK outpatient substance abuse services by $30K. In FY '01, DCF increased adult substance abuse intervention and outreach funding by approximately $100K to provide for the ,treet program noted above,. In January 2001, approximately $10K was added to the DCF contract to provide aftercare ervices for graduates of the KTR program. ~~;r~~1~fr81:;~':i6)bjt~~ti6~7::;:':~0:N,i)x:~~'tlR:~E_'1 r-; ---- ~ .-- x x In July 2000, GCMK fully implemented a street outreach/intervention program in Key West designed to intervene with omeless drug abusers to avoid incarceration. Two staff were hired. It is expected that this program will add another .wo staff in FY '02 and expand services from Key West to Big Pine Key. In January 2001, Mort Hall, MSW, retired from his position as KTR Director. Pat Mowery, CAP, CCJAP, assumed the osition in the same month. Ms Mowery was recruited from a 75-bed , non-secure, residential substance abuse reatment program in Ocala. In July 2001, GCMK plans to add a compliance manager to monitor and ensure overall agency compliance with Federal, IState, and County laws and regulations governing the provision of behavioral healthcare services. As regulations and ompliance issue increase the addition of this position is necessary. GCMK has relied on temporary help when necessary o support professional staff. This will be eliminated by the addition of a general office assistant who will be cross- rained for use throughout the agency. A third full-time psychiatrist is being added to the staff. This physician will allow n expansion of existing outpatient services. The substance abuse court counselor will work with Drug Court cases and rovide counseling to KTR, detox, and outpatient clients. A treatment director will be added to the inpatient unit to nsure proper treatment and discharge planning for all psychiatric and/or substance abuse clients who enter the inpatient nit. The case management and HIV coordinator position will be abolished on July 12, 2001; these duties will be ssumed by other staff. A housekeeping position was not filled and the services of a vendor were secured. AGENCY NAME: Guidance Clinic of the Middle Keys, Inc. t.j x x x S' Ithough increases are requested for some services as noted above, the overall request has decreased by 2/6% due to conomies expected in operating the Baker Act Vehicles. This request is $17,774 less than last year when co~i(iering al unding secured from the County for the services/programs notes in #2 above. How has your agency initiated any new, creative, or innovative projects to address social service needs in our community? If so, give a brief description (include a description of any innovative projects that you would like to undertake, but for which you have not yet been able to secure funding). Please include any awards or special recognition your agency may have received this past year. CMK is currently negotiating with the Key West Housing Authority to assume responsibility for the Safeport residential ubstance abuse treatment program. If this comes to fruition, GCMK will be able to broaden its array of substance abus! ervices for men, women, and children, while strengthening the continuum of behavioral healthcare. GCMK has been uccessful in renewing its HUD grant for detoxification services for the homeless. GCMK continues to receive annual "ncreases in supported housing funds for homeless persons with serious mental illness (SM!) and SMI with a co-occurring If your request is greater than last year, explain in detail what the increase is expected to fund. If the increase is due to more than one additional item, list the items in order of priority with the amount of each. 00 NOT LIST YOUR AGENCY'S BUDGET BY LrNE ITEM. Provide your agency's board-approved written mission statement. he Guidance Clinic of the Middle Keys, Inc. (GCMK), is a nonprofit, charitable organization dedicated to the provision f high-quality and cost-effective behavioral healthcare services throughout the Florida Keys. GCMK seeks to provide ervices in a timely and affordable manner for persons with or at risk of mental health and/or substance use disorders. CMK demonstrates its commitment to the community by embracing growth, expansion, and diversification of its ervices in a manner that is accountable and responsive to its stakeholders. Explain specifically how your agency plans to use the money you are requesting. e.g. rent, salaries, expansion of services or service area, or general agency operations. Baker Act Inpatient - $319,419: This request is the same as last year to provide involuntary crisis stabilization services or persons who are a danger to themselves are others. Residential Detox - $117,069: This is a 5% increase over last year's request to account for inflation (3.3% nationally) nd increased costs associated with staff recruitment and retention. Due to the national nursing shortage, costs for linpatient care have increased and will continue to increase as RNs can demand hire salaries. Residential detox is available n a voluntary and involuntary basis (Marchman Act) with an average inpatient stay of 5 days per client. Mental Health/Substance Abuse Outpatient - $63,070: This is a 10% increase over last year's request to account for nflation and increased demand. Outpatient psychiatric, counseling, and case management services for clients with or at 'sk of mental health or substance use disorder. Baker Act Vehicles - $76,996: This is a 30.6% reduction from last year's request to account for efficiencies achieved in he delivery of this service through experience. Provision of transportation for clients to Baker Act receiving facilities, IState mental hospitals, and involuntary detox units. Keys to Recovery (KTR) - $86,287: This is a 5% increase over last year's request to account for inflation and increased osts associated with staff recruitment and retention. With the retirement of the KTR Director in January 2001, it was ecessary to recruit a qualified and experienced replacement from outside Monroe County. The costs associated with Ilmporting staff from out of county is significantly higher than local recruitment. KTR provides 6 months of residential ubstance abuse treatment for felonious males. Community Transportation Coordination - $16,380: This is a 5% increase over last year's request to account for inflatior nd costs associated with staff recruitment and retention. GCMK coordinates transportation for residents of Monroe County who are transportation disadvantage. AGENCY NAME: Guidance Clinic of the Middle Keys, Inc. & Additionally, clients may initiate a grievance or complaint through the relevant licensing agency. They may file complaints .with the Human Rights Advocacy Committee (HRAC). Clients of all services are notified of their right to file grievances at admission and posters with information and telephone numbers are placed at all program locations. Persons receiving.CSU or detoxification services have direct phone access to HRAC and need not inform staff or ask staff permission to make such a call. 16. What other organizations do you network with to prevent a duplication of services? Describe any sharing of costs, referrals of clients, etc. We are looking for more detail than your membership in Interagency Council. An example of an appropriate answer is "one of XYZ's employees works out of our branch" or "we jointly fund X position with ABC Agency. GCMK is the only community mental health center in the Middle Keys area; its outpatient services are not duplicated by any other public sector funded agency in this area. It provides the only public sector psychiatric and detoxification inpatient services in Monroe County and works closely with the Care Center for Mental Health in Key West and the Guidance Center of the Upper Keys to ensure continuity of care of shared clients. We work closely with Fishermen's Hospital, providing them on-call counseling services. YES. Clients of all GCMK services have the option to seek informal redress of grievances through agency supervisors and senior man~gers or to initiate formal internal grievance procedure in accordance with written agency policies and procedures. :"X'F;t :j:#'iW;';~\;':\",:;'~<::",Y:-1:oi'::-':",';~1.:\'-+~_;"~~f:i.v; ~1~~eNC"'CQPEI:r~m!,gN 15. Does agency have a grievance procedure for clients? If yes, briefly describe. Is it a formal procedure? How are clients made aware of the procedure? 14. Briefly describe the training the volunteers receive. Same as GCMK staff. Graduate student interns also receive clinical supervision provided by a Licensed Clinical Social Worker each week during placement in GCMK. 12. 12 Volunteers contributed a total of 342 hours to our agency this past year. Board: .11Q.. hours Programs: ~ hours Committees: ~ hours 13. How do you utilize volunteers in the operation of your agency? Volunteer board of directors; graduate student intern .7. What is the authorized number of Board positions specified in your by-laws 11 8. Number of Board meetings held during past year _ 9 9. Average attendance of Board Members 86 % 10. What limits, if any. do your by-laws set on terms or years of service a board member may serve? Board memben serve staggered 3-year terms of office. There is no limit on the number of terms a Board member may serve. 11 . Complete Attachment A - Board Information Form (see attachment) ubstance use disorder. Identify any special factors that should be considered when making final funding decisions. Include comments or significant changes in revenue or expense items as compared to previous years. Also, explain any non-recurring or unusual expenditures. CMK is provides a broad array of behavioral healthcare services throughout Monroe County. GCMK operates the only ublicly funded Baker Act beds for involuntary psychiatric commitment and the only publicly funded residential etoxification beds. KTR is the only non-secure substance abuse treatment program for felonious males in the Keys. CMK is the only provider of Baker Act transportation and is the designated Community Transportation Coordinator for he county. (plus one non-voting member) Number of persons on Board of Directors 10 6. 7 . children and late adolescents with or at risk of substance abuse problems . children with an emotional handicap, serious emotional disturbance, or mental illness . children who have been abused or neglected by their families . adults with disabilities who need long-term care to remain in the community . adults and families who need assistance to become economically self-sufficient . victims of domestic violence 21. Please give a paragraph description of the program for which you are requesting funding. See page 8, #2. 22. What need or problem in this community does this program address? Include your target population. The District 118 Needs Assessment and Strategic Plan, 1997-1998 developed and distributed by the Florida Department of Children and Families the following target group priorities: 18. Is your agency receiving any in-kind services e.g. free rent, utilities, maintenance, etc. from the County or any other organization? If so, What is the fair market value? NO 19. What is the percentage of total agency revenue that goes to the following: Fundraising Expenses? 0 % Administration Expenses 14 % 20. Complete Attachment B - Agency Salary Detail Form. (see attachment) ~. . .._. '_ <.,.;..:A://' ~Y~~:f>:~ri""I;\>~ -,:~_,:,~'_>:-,))..-;^:::::';1;;:~;;:i.<~H":" '~;,~:-;<>.,; _ :""+]'-',' _ .:":t::,, 7t ~:DEFj!ll:.$aE~SPEelEICrRROG .... .,,;: "_':~!7:~.::~,;ri.~v-,..;;:.-:. -',' /~>~/ ":",~,:_,_' '~,{_;; :!i"~~'/;:!io~;*i-:.':"::';'-" oc'." ,~:~.,.. ..:.,: .>..:~':. 'c"-.;:.:'>.". .:::,;."", The State of Florida licenses and/or certifies individual clinicians by professional discipline. The CSU and the two-bed residential facility are licensed by the Agency for Health Care Administration and monitored each year. Substance abuse detoxification, residential, outpatient, outreach, intervention, aftercare, and prevention programs are monitored and licensed annually by the Florida Department of Children and Families. The Department of Corrections monitors KTR semiannuall ~aN~rAnEQ8 1,:,,- --:---~'~;~:"~/=t~~*''*::~<,t,~ei~'t-4.~~' GCMK is on the Board of Directors of SHAL, a Monroe County community coalition dedicated to serving the needs of the homeless. 17. Is your agency monitored by an outside agency? If yes, by whom and how often? If not, how does your agency document and measure its service performance and success rates? GCMK provides psychiatric services to residents of Safeport substance abuse treatment program in Key West and works closely with Safe port staff to integrate mental health services into the overall treatment plans for their residents. GCMK works closely with Prison Health Services, the contractor who provides health care to inmates in Monroe County Detention Center at Stock Island. We have a psychiatrist who see inmates each week in the jail. Department of Children and Families and MCSO share the cost of the Forensic Case Manager placed in the jail and supervised by GCMK. Keys to Recovery (KTR) and outpatient substance abuse services work closely with local law enforcement and the judiciary to provide an appropriate mix of supervision and treatment to persons whose substance abuse has led to legal problems. The Forensic Case Manager at the jail also works closely to move appropriate inmates out of the jail into KTR and other appropriate treatment or living situations. GCMK provides a Prevention Coordinator to implement a substance abuse prevention curriculum in the elementary and middle schools from Sugarloaf to Key Largo. GCMK stations two Ufe Skills Counselors in Marathon schools, enabling interventions in a familiar setting to school- age children. Funding for these positions is shared with the Monroe County School District. 'I GCMK provides some services to most of the target groups that were prioritized in this needs assessment and most services to some of the target groups. Priorities in this assessment and strategic plan were based on services not being provided in Monroe County in sufficient volume to meet established need. Reduction is current funding would effectively shift priorities by changing the levels of service availability 23. What data support this need? Attach copies of any relevant documents. See #22 immediately above. 24. Where and when is this program being offered? Ust all sites and hours of operation. II GCMK provides the full range of substance abuse and mental health services at its headquarters - 3000 41 st Street-Ocean, Marathon, FL 33050. Outpatient services: Monday-Friday, 8:30 a.m.- 5:00 p.m.; on-call counselor available 24 hours per day, 7 days per week. Inpatient and residential services: 24 hours a day, 365 days a year 25. What measurable goals do you plan to accomplish in this next funding year? GCMK continues its efforts to achieve CARF accreditation and have moved forward in this process. Once achieved accreditation will offer clients, families, payers, and taxpayers specific additional assurances of high quality services and accountability. GCMK has in place an integrated performance measurement system, which allows for quarterly adjustments in procedures when found appropriate and necessary. GCMK continues to seek new sources of revenue to maintain and enhance the services it provides. Ii '. adults with substance abuse problems . families with children in child care . families with children at risk of abuse and neglect . indigent persons who are unable to work due to age, disability, or incapacity . child victims of abuse or neglect who have become eligible for adoption . adults with mental illness . adults with disabilities and frail elderly at risk or victims of abuse, neglect, or exploitation . persons with developmental disabilities. 9 27. Please complete Attachment C - Total Unduplicated Clients Form. Sections C through F are optional; complete these sections only if you have already gathered this information. (see attachment) 6,570 6,570 189.18 $182.12 $192.40 2,920 2,920 2,555 $265.62 $262.48 $260.85 1,073 687 508 $91.15 $93.72 $88.09 3,423 2,661 . 2,149 204.22 204,22 $159.80 transport I 377 377 290 $84.88 $84.74 $78.56 4,380 4,380 4,380 $4.03 $4.86 Not availible Baker Act inpatient services Residential SA detoxification Outpatient non-medical mental health = Medical outpatient mental health Baker Act vehicle transportation Keys to Recovery residential SA TX = Community Transportation Disadvantaged Coordination = one-way tri a. Basis for cost formula: Explain how you developed the cost per unit (e.g. total cost of program divided by total units; total cost of program divided by total clients, etc.). Indicate the full cost of the unit of service. This cost should include administration, etc. The unit cost should be the same for all funding sources of the program. Total expenses within each program area divided by the total number of units within the area. b. 3 Year Unit Comparison: Provide the "cost per unit of service" for the past, current and proposed fiscal years. Provide the numbers of units of service for the past, current and the proposed fiscal years. = one day = one day one hour = one quarter hour = one-way trip one day 26. Define program unit of service (i.e. 1 unit = 1 hour counseling; 1 unit = 1 night shelter/1 meal, etc) or state why this does not apply to your operation. AGENCY NAME: Guidance Clinic of the Middle Keys, Inc. 2 Date Date fo \ l~ \ c \ Kathleen Rchr~npr Signature If ),L~~) ~ Richard Matthews, Ph.D Typed Name of Executive Director Typed Name of Board President/Chairman We understand that the agency must substantially meet the eligibility criteria to be considered for Monroe County funding and that any applica~le attachments not included disqualify the agency's application. We further understand that meeting the Eligibility Criteria in no way ensures that the agency will be recommended for funding by the Human Services Advisory Board. These recommendations are determined by service needs of the community, availability of funds, etc. Approval of HSAB funding recommendations is granted by the Monroe County - "Board of County Commissioners. This certifies that this request for funding is consistent with our organization's Articles of Incorporation and Bylaws and has been approved by a majority of the Board of Directors. We affirm that the Agency will use Monroe County funds for the purposes as submitted in this Application for Funding. Any change will require written approval from the Monroe County Board of County Commissioners. Is funding for a new, or an -X existing, program? % 36 X Yes _No If yes, what is the ratio of match to Federal and/or State dollars? Will County funds be used as match for a grant? ave you ever applied to Monroe County HSAB for Funding Assistance? X Yes No Fax: 305/853-3286 305/853-3284 ITitle: C.E.O. P.O. BOX 363 TAVERNIER, FL. 33070 Richard Matthews, Ph.D GUIDANCE CLINIC-UPPER Tavernier, Fl. APPLICATION FOR FUNDING MONROE COUNTY Human Services Advisory Board October 1, 2001 - September 30, 2002 3 x x . ,::-","l,'';::}!'';t::c,;~;-..,}-.'<,.::: :. ,_: - - __,>:i~<.'>.:<->_ ..-";--:':":"';- :: ':r-:;:-:,:' "';",: -:-::-.~,:' -'6--_'~'?";~i~0'y,:: . .ccredit!tion,; Certification;. and/or tt~ri~lI,gJ . x ?j.(< '''~<*:':::,:': ", .- :,.::,. _-'"i:-r-:}'~::.>: - :_<:.-;'"," - -'.: ::':C:->:'::::'::~--:'::'7::" ': . <.:,>::::' ' . - - - -- elatlonsflips' with:#arent~ . Naif6nal orstate;'Affiliatesi; _ '___'_"("~'_"\":_:-'-" '... ";"":'h"'~"'~:',. ,.... "" ,.. ....... ..~:':<--'--~....:...~:.,! ..,.....,.:::......'.......,..;.'" ... x . :.: _\, /tW~:;:-::,,~,:\;::< :.': ." -.''. -.;.~: :,:*,\::;: ;::~,: ,.,. _ ,:' "'.- -::-,~,-: :::'~:':- -:,-t>;:-::::::,::,-:?t-:>:$1H;,::;~::>} ,:_;,.:>_:,:-::+::::^:;,~tK},/:":::-:}/::f:'>k;i'~,{~'iJ-::t-,,-:':i::,':~.\' ':,Li]\;<(,'^ 21i":\;::-':?',,:,.;:< \,_-;- ^ . ollabaratlvei Efforts/~elatl6nshlps with: ()ttier S'ervice: Provl(f~mrP ~?1f~ c' ..... "'::::'e; ~ ~" x <:ft;}<S~~'/;>;~1:Wi;::'-':'-' <<',:_:~;-;i :_:_~;,:-(:::':,(<"'*^'fi/,-"h",:{:;'-i:,;~I lient:~Ef/CUent^Oemograpf1jcs x x x x x AGENCY NAME: 4 19. Average attendance of Board Members ~ % 10. What limits, if any, do your by-laws set on terms or years of service a board member may serve? none 11 . Complete Attachment A - Board Information Form 11 Number of Board meetings held during past year 8. 16. Number of persons on Board of Directors .-Jl 17. What is the authorized number of Board positions specified in your by-laws -WIDe IGOVERNING BOARD' Purchase meals for 100 more clients for one year (2 meals/day, total $5.00/day); will increase service levels by 3%. How has your agency initiated any new, creative, or innovative projects to address social service needs in our community? If so, give a brief description (include a description of any innovative projects that you would like to undertake, but for which you have not yet been able to secure funding). Please include any awards or special recognition your agency may have received this past year. 5. Identify any special factors that should be considered when making final funding decisions. Include comments onl significant changes in revenue or expense items as compared to previous years. Also, explain any non-recurring I or unusual expenditures. I $50,000 $25,000 $182,500 IC) Cost of living adjustment to maintain current service levels. One additional caseworker (salary & benefits) will increase service levels by 10% la) b) 1. Provide your agency's board-approved written mission statement. See Attachment !2. Explain specifically how your agency plans to use the money you are requesting. e.g. rent, salaries, expansion of services or service area, or general agency operations. INARRifnvEovERVI :,,';<>-':' ,,:::::,::~/:'''{:::'':'''~:::''''k.._ "_;"".-,;/."".,,... ..c.._;..... .-_............, -- .,,',.. ;'.,',','_ ',_._" ", '>"" AGENCY NAME: 5 DETAllSO.F:SPECIFIC., PRO.GR~NI"FOR WHI:~;~~'FuN.DING:ISiflE(].UES1'ED: 21. Please give a paragraph description of the program for which you are requesting funding. 22. What need or problem in this community does this program address? Include your target population. 23. What data support this need? Attach copies of any relevant documents. 24.. Where and when is this program being offered? List all sites and hours of operation. 25. What measurable goals do you plan to accomplish in this next funding year? What is the percentage of total agency revenue that goes to the following: Fundraising Expenses? 0 % Administration Expenses 20. Complete Attachment B - Agency Salary Detail Form. 19. 11 % 1 B. Is your agency receiving any in-kind services e.g. free rent, utilities, maintenance, etc. from the County or any other organization? If so, What is the fair market value? :FINANCIAlJNFORMA:rJON:"~: ,...... ...,' . .. . " ,. .. '-- . '-,' '.' ..' ,"" ., " ','. ,.... - ....,.. ,-_"""~,,,",\'-., 15. Does agency have a grievance procedure for clients? If yes, briefly describe. Is it a formal procedure? How are clients made aware of the procedure? 16. What other organizations do you network with to prevent a duplication of services? Describe any sharing of costs, referrals of clients, etc. We are looking for more detail than your membership in Interagency Council. An example of an appropriate answer is "one of XYZ's employees works out of our branch" or "we jointly fund X position with ABC Agency." . 17. Is your agency monitored by an outside agency? If yes, by whom and how often? If not, how does your agency document and measure its service performance and success rates? ;ip:GENc~:aPERAtJO ~"': . ".: ,<(";<,;,:::"">:";,c'~AA:,,,,:~~,,:,,:.':t,.,.,.;,.,,, . "'-<<~~""'~~:,w'>;:<e;,y, 13. How do you utilize volunteers in the operation of your agency? 14. Briefly describe the training the volunteers receive. hours Committees: hours Programs: Board: 11 hours 12. No Volunteers contributed a total of 0 hours to our agency this past year. AGENCY NAME: :tc-- In reference to me Anacr.ment CheCKlist: Since we nave rewer man i'rfty employees we are not subject to the Federal guidelines for Adults with Disabilities Act, We have a rew clients that are dlsabieo' ana we try to be sensitive to their disaDliity and accommodate them to the best of OUi ability, 25, We are going to continue to strive to be able to continue the level of services that we Have been able to provide In previous years, 21. The Guidance Clinic of the Upper Keys is an outoatient community mental health clinic oeolcateo to providing a multJ~OISClpllnary approacn to tne prooiems oT mental Illness a and substance abuse through evaluation, treatment. case management and prevention. Outpatient services include: Street Crime Alternative Treatment(SCAT); Family Services Planning Team (FSPT); Intensive Crisis Counseling Program (ICCP); the Mobile Team and the Rape Prevention program, 17, The Guidance Clinic is monitored fiscally and clinically on and annual basis by the Dept. of Children and Families. 16. The other organizations we network with to prevent a duplication of services is the Guidance Clinic of the Middie Keys and the Care Center for Mentai Heaith. 15. Yes, we 00 have a grievance proceoure for Clients. They can call tne Human Rights Comml'ttee or the Department of Children and Families. 5, With the imolementation of the Mid-Keys Mobiie team there wiii be a substantiai increase in revenues as weli as expenditures. The twO eXisting MODI I Teams nave been highly successful in their mission and there is every reason to believe that the third team will meet with the same level of success, The new therapist will help with the additional counseling required. 4. No, we do not have any new programs planned for the coming fiscal year. 2. The funaing we are reQuesting Will we useo to pay for CliniC salaries. .. t""o__ A.a.a.__I..___'" I. ,;,tItI /'\U.C1c";rlIfltlllL. ~^RRITlVE OVERVIEW OF REQUESTED FUNDING Non-direct Staff Hr. 23.79 24,02 1,230 1,318 30.87 36,21 1.902 2.331 4715 759 Outreach Cost /Unit Total Units 56,75 1,115 Prevenuon Cost /Unit Total Units Non-Direct Staff Hr. 50,17 6.523 53.07 6.535 62.80 5.376 In-Heme/On Site CostlUnit Total Units Direct staff Hour 311.54 312 278.81 312 315.68 312 Medical Servs. CostlUnit Total Units Contact Hour 100.5'1 2.541 '103.43 2.527 191,78 1,092 Outoatient CosvUnit Total Units Contact Hour 36,91 250 54.05 603 4630 1.039 Intervention CostlUnit Total Units Direct Staff Hour 53.97 3.756 50.04 3.756 55,69 3.130 Case Mangr. Cost/Unit Total Units Direct Staff Hour 35.40 1,841 31,16 1.841 110,:1 1.200 Assessment CostlUnit Total Units Contact Hour PROPOSED YEAR 2001-2002 CURRENT YEAR 2000-2001 PAST YEAR 1999-2000 26. The units of service that are used are as follows: contact hour measures face-te>-face or direct teiepnone contacts and ciient coliaterai contactS that are charted. Tne next is the direct staff hour In wTlIcn me sel'Vlce is olrectly assoclatea With a reclplern but they may not have to be pnyslcaliy presern. Non-direct sel'Vlces are In the form of group acuvlty suen as prevenuon, consultation, ana educational won< groups. These hours are categorized into cost centers. a. A contact hour is based on 1.073 A direct staff hour is based on 1.252 A non-direct staff hour is based on 1 .430 PROGRAM UNIT/COST Date Date Paul Rasmus, Chairman of the Board Cli . f C; ... t\ I Marshall Wolfe, President & Chief Executive Officer f- - /r" C1{ 9..\ G~ Signature - . y ..~ Signature This certifies that this request for funding is consistent with our organization's Artides of Incorporation and Bylaws and has beer approved by a majority of the Board of Directors. We affirm that the Agency will use Monroe County funds for the purposes as submitted in this Application for Funding. Any change wi require written approval from the Monroe County Board of County Commissioners. We understand that the agency must substantially meet the eligibility criteria to be considered for Monroe County funding and that an applicable attachments not included disqualify the agency's application, We further understand that meeting the Eligibility Criteria in no way ensures that the agency will be recommended for funding by th Human Services Advisory Board. These recommendations are determined by service needs of the community, availability of fund~ ete: Approval of HSAB funding recommendations is granted by the Monroe County Board of County Commissioners. 184,141.00 CERTIFICATION 184,141.00 184,141.00 PART I 3 TIME . AMOUNT RECENED . FOR FISCAL YEAR . ENDING 9l3OlOO . FULL nTlME AMOUNTRECElVED FORFISCALYEAR ENDING913OIOt ... AMOUNT REQUESTED FOR COUNTY FISCAL YEAR ENDING 9I30I02 Is funding for a _new, or an ...:.-existing, program? STATE IS%. WITH 25% COUNTY MATCH ",:,-Yes _No OF EMPLOYEES ,gency Phone: 305l292~ ,Fax: 3051292-6723 Have you ever applied to Monroe County HSAB for Funding Assistance? ~ Yes_ No Will County funds be used as match for a grant? If yes, what is the ratio of match to Federal and/or State dollars? ,GENCY PROFILE Operating Since 1983 ,gency Name: CARE CENTER FOR MENTAL HEALTH ,gency Location(s): 1205 FOURTH STREET KEY WEST, FL 33040 Mailing Address: 1205 FOURTH STREET KEY WEST, FL 33040 !contact: MARSH WOLFE !Title: PRESIDENT & CEO APPLICATION FOR FUNDING MONROE COUNTY Human Services Advisory Board October 1, 2001 - September 30, 2002 iOTHER: ignificant Change in Equipment and/or Facilities? * " ~'ion, Certification, and/or UC8I1$lng? * ,elationships with Parent, NatiOnal or State Affiliates? * Uaborative EffortslRelationships with. other Service Providers? * * * iSignificant Change in Service DeliveJY, Costs~ and/or Effec:tivenesSMeasures? * hange in Programs/Services (Addition.ocDeletion ofProQrains)? liOrganization MissionfStrateQic'Directi0n7 undingSOurc:es(LossarAddition Of ReVenUe)? 'oIunteer QOvernanceandlorStruClure? NO YES ...... ...,.....'.........--....-..--. 1s.igJ1~change,in.~and1or~.. Indud 'Ing..the, .'ExeaJti\'e "'Dlrector)7 .' "'.' , .'...'.'..,....... ........'...... ' . . .._...... ,......0....-'.-".---......... .. -' ... * .' -... .' .-.' UMMARYOF$IGIlIIFlCANT'QlANGE n____'" . . . ,,'-.,.--.,. .." ,...-..,.".....;....... qUeStiOns.in.tJliS..sedionpSrtalrit()~.Ci'1a 19es'tfISt~oCcuiredWithintheofganiZStiorisPast fiscal year. If there has ~change,,'~:~~fl~t:'}~~ sum~.lftherehas'~, no change, d\ed("'f<,&<)" to that.question.and proceed the.next.. ...d......' ............"............'........, ,........,.............." '. ,. . . AGENCY NAME: CARE CENTER FOR MENTAL HEALTH Number of persons on Board of Directors ~ What is the authorized number of Board positions specified in your by-laws ~ Number of Board meetings held during past year 11 Average attendance of Boatd Members ~ % 10.. What limits, if any, do your by-laws set on terms or years of service a board member may serve? NONE 11. Complete Attachment A - Board Information Form OVERHING BOARD How has your agency initiated any new, aeative, or innovative projects to address social service needs in our community? If so, give a brief desaiption (include a desaiption of any innovative projects that you would like to undertake, but for which you have not yet been able to secure funding). Please include any awards or special recognition your agency may have received this past year. The Care Center develOped and implemented a new children's mental health/substance abuse treatment program that is integratd into programs provided by the Monroe County School District and the Department of Juvenile Justice. Identify any special factors that should be considered when making final funding decisions. Include comments on significant changes in revenue or expense items as compared to previous years. Also, explain any non-recurring or unusual expenditures. Same request as last year. Provide your agency's board-approved written mission statement. Explain specifically how your agency plans to use the money you are requesting. e.g. rent, salaries, expansion of services or service area, or general agency operations. County funding ($184,141) will be used as the required match pursuant to F.S. 394 to provide Alcohol, Drug Abuse & Mental Health (ADM) outpatient mental health services which shall include assessment, crisis intervention, medical services, case management and outpatient counseling. _ . __. __........_.... . ..._". .,_........... __. '. '.:,'_'. '.,.._,..'..'_:_',': ..,..._..._.......'..... ._, '. ._,.... ._ _..'....... ......."_.'___,.... ........'.....".'...c_...__.".'........_.. ......,'..'.'...... If'you are<requestingJundinQ tor more than one program;besur8.tOsPScificaUyf.i~~isbeing purchased for each . program. Jnciudespecific,actjyjtiesthatwiD.beoanied.outbythepr1JQJ'8mlFOr'~fiffunding is fOr a new position, explain the change in staffing requirements. Specifyfullorparttime..salaIyJ,ana~!rrtanymore dientswill be served. If . funding isforadirectServicetodients,includeprogramobjectives8l'Kl:tlcr.y,'irulnj~UptiCated diems will be served. If your request is greater than last year, explain in detail what the inaease is expected to fund. If the inaease is due to more than one additional item, list the items in order of priority with the amount of each. 00 NOT LIST YOUR AGENCY'S BUDGET BY LINE ITEM. RAnvE OVERVIEWOFREQUESTED'FUNDING AGENCY NAME: CARE CENTER FOR MENTAL HEALTH 21. Please give a paragraph desaiption of the program for which you are requesting fundingCounty funding ($184,141 will be used as the required match pursuant to F.S. 394 to provide Alcohol, Drug Abuse, and Mental Health (ADM) outpatient mental health services which shall include assessment, aisis intervention, medical servies, case management and outpatient counseling. 22. What need or problem in this community does this program address? Include your target population. The Care Center is Community Mental Health Clinic for the lower Florida Keys (South of the Seven Mile Bridge). 23. What data support this need? Attach copies of any relevant documents. 24, Where and when is this program being offered? List all sites and hours of operation. Our main location is at 1205 4th Street in Key West, but we do have counselors in many off site locations including Key West High School, H.O.B. DETAILS OF SPECIFIC PROGRAM .FORWHICH.FUNDINGIS.REQUESTED Administration Expenses 8 % 18. Is your agency receiving any in-kind services e.g. free rent, utilities, maintenance, ete. from the County or any other organization? If~, What is the fair market value? NO 19. What is the percentage of totaJ agency revenue that goes to the following: Fundraising Expenses? 0 % 20. Complete Attachment 8 - /V;jercy Salary Detail Fonn. 15. Does agency have a grievance procedure for clients? If yes, briefly describe. Is it a formal procedure? How are clients made aware of the procedure? We operate under the guidelines of the Human Rights Advocacy Committee. procedures are posted. 16. What other organizations do you networ1< with to prevent a duplication of services? Desaibe any sharing of costs, referrals of clients, etc. We are looking for more detail than your membership in Interagency Council. An example of an appropriate answer is "one of XYZs employees wor1<s out of our branch" or ''we jointly fund X position with ABC Agency." The Care Center has weekly meetings with the Department of Juvenile Justice, the Depannent of Corrections, the Monroe County Detention Center and frequent meetings with the Department of Children & Families and Drug Court. 17. Is your agency monitored by an outside agency? If yes, by whom and how often? If not, how does your agency doaJrTlent and measure its service pertormance and success rates? Yes, we are monitored by several different agencies, the largest is the Florida Department of Children & Families. We also have an independent audit each year that is performed by Kemp & Green, P.A. FINANCIAL INFORMAnON AGENCY OPERAT10NS 12. 13 Volunteers contributed a total of ~ hours to our agency this past year. Board: 150 hours I Programs: 24 hours I Committees: ~hours 13. How do you utilize volunteers in the operation of your agency? BOARD MEMBERS ONLY 14, Briefly desCribe the training the volunteers receive. None. Most board members are highly visible members of our Community, and have served on numerous other boards. VOLUNTEERS (JnctudingBoarc:tMembers) AGENCY NAME: CARE CENTER FOR MENTAL HEALTH . Middle Sd1ooI, Sugarloaf Middle School, Gerald Adams ElementarY, Monroe County DetentiOn Center. & the Douglas Community Center. 25. What measurable goals do you plan to accomplish in this next funding year? THIS SPACE INTENTIONALLY LEFT BLANK 27. Please complete Attachment C - Total Unduplicated Clients Fonn. Sections C through F are optional; complete these sections only if you have already gathered this infonnation. 91.09 18300 91.09 18900 91.92 - 19200 . COST PER UNIT I Hour TOTAL,#UNITS CtlENTSSERVED 26. Define program unit of service (Le. 1 unit = 1 hour counseling; 1 unit = 1 night shelter/1 meal, atc) or state why this does not apply to your operation. 1 unit = 1 counseling hour a. Basis for cost fonnula: EXplain how you developed the cost per unit (e.g. total cost of program divided by total units; total cost of program divided by total clients. etc.). Indicate the full cost of the unit of service. This cost should include administration, etc. The unit cost should be the same for all funding sources of the program. b. 3 Year Unit Comparison: Provide the "cost per unit of service" for the past, a.uT8I'1t and proposed fiscal years. Provide the numbers of units of service for the past. current and the proposed fiscal years. tJNITlYPEl ~:~~~ 1.\~~~~;;~"i{~r,ij-'!r~:ENDING PROGRAMUNIT/COST AGENCY NAME: CARE CENTER FOR MENTAL HEALTH