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W Z ~ ~ I- (,) en en w (,) z ::J 0 ~ 0 en 0:: 0 ::::;) W Go Z ::::;) 0 0:: ~ ~ en Go w CD ~ I- g ::::;) C 0:: W W -< X 0 ::J: a: ::::;) z (,) (,) 0 Go ~ ::J: ~ 6 u. i= w - w 0 en en z (,) ~ 0:: en >- >- ::i z z ~ a: CD z w w w a.. 0 0 a: (,) w ~ ~ w a: ~ ~ ~ ~ 0:: 0:: en w 0:: ~ en ::E 0 -< 0 ~ ~ w w w 0 I- ~ ~ g -< CD (,) 0 u. u. ::J: ~ ::J: ::J: ::i "iI- S! '" ii a. a. - o ~ 8 ~ HUMAN SERVICES ADVISORY BOARD MEETING MINUTES July 11, 2000 State Building - Room 104 Monroe County Regional Service Center 10:00 A.M. Marathon, FL Board Members Present: John Rolli, Chair Lou Schwartz, Vice-Chair Alexsandra Leto Patty Schmidt Estelle I ncociati Staff present: David P. Owens Louis LaTorre ;]]rn~~u Board Member Absent: none At 10:00 a.m., Chair John Rolli called the meeting to order. Estelle Incociati made a motion to approve the minutes of the April 11, 2000 meeting, as written and Alexsandra Leto seconded the motion. Minutes were unanimously approved as written. John Rolli asked for suggestions from board members regarding how to handle applications turned in late. Estelle Incociati suggested that the Board take comments from the three agencies who turned in applications past the deadline, Samuel's House, Habitat for Humanity, and Helpline. Lou Hernandez representing Helpline, Elmira Leto representing Samuel's House, and Bert Loudenslager representing Habitat for Humanity addressed the Board concerning reasons for failing to meet the deadline. After brief discussion, Patty Schmidt moved to refuse consideration to applications turned in late and Lou Schwartz seconded. Motion carried 3-2, with Estelle Incociati and Alexsandra Leto dissenting. The board discussed the order in which to consider applications and decided to hear first from new agencies and those requesting increases in funding. Sylvia Godfrey of the Florida Keys Juvenile Center addressed the Board and outlined her need for funds to provide services and answered questions from the Board. Kathy Tuell representing Florida Keys Children's Shelter explained the need ~o fund a counselor position in the Tavernier facility which was formerly state-funded and answered questions from the Board. Joe Barker, representing Wesley House discussed the need for matching funds to secure funding to provide services for an additional forty children. Representatives of the remaining agencies addressed the Board, outlining services they provide, explaining their funding needs, and answering questions from the Board. The meeting was paused for a short break. The Board briefly discussed the directive from the Board of County Commissioners to reduce funding for each agency by ten percent at the beginning of deliberations and distribute remaining funds to new agencies and those with extraordinary needs. Estelle Incociati made a motion not to fund the Florida Keys Juvenile Services and Patty Schmidt seconded the motion. Motion carried unanimously. OMS F:\GRANTS\HSO\hsab071100.doc 08/31/00 2:45 PM Alexsandra Leto made a motion to approve $35,000.00 in funding for Wesley House and Patty 'Schmidt seconded the motion. Motion carried unanimously. Patty Schmidt made a motion to approve $30,000.00 in funding for Florida Keys Children's Shelter and Estelle Incociati seconded the motion. Motion carried unanimously. John Rolli made a motion to approve $20,000.00 in funding for Big Brothers/Big Sisters and Estelle Incociati seconded the motion. Motion carried unanimously. Alexsandra Leto made a motion to approve $20,000.00 in funding for the Pace Center for Girls and Patty Schmidt seconded the motion. Motion carried 4-1, with Lou Schwartz dissenting. Patty Schmidt made a motion to approve $40,000.00 in funding for HospiceNNA and Alexsandra Leto seconded the motion. Motion carried unanimously. Lou Schwartz made a motion to approve $10,000.00 for Caring Friends for Seniors and Estelle Incociati seconded the motion. Motion carried unanimously. Lou Schwartz made a motion to approve $30,000.00 ,for Monroe Association for Retarded Citizens and Estelle Incociati seconded the motion. Motion carried unanimously. Estelle Incociati made a motion to evenly divide the remainder of excess funds evenly between Literacy Volunteers and Florida Keys Outreach Coalition and leave the remaining agencies at the amounts which reflect the 10% reduction ordered by the County Commission: Patty Schmidt seconded the motion. Staff member David Owens agreed to allocate remaining funds in that manner. There being no further business, the meeting was adjourned at approximately 2:00 PM. OMS F:\GRANTS\HSO\hsab071100.doc 08/31/00 2:45 PM Mental Health Clinics Proposed 01 Incl(Dec) % Change Adopted 00 Adopted 99 Middle Keys Guidance Clinic 529,246 30,346 6.1% 498,900 498,900 Baker Act Trans-Lower Keys 69,971 69,971 #DIVlOI 0 0 Transportation 15,600 2,600 20.0% 13,000 0 Keys to Recovery 82,178 13,696 20.0% 68,482 0 Total Middle Keys Guidance 696,995 116,613 20.1% 580,382 498,900 Upper Keys Guidance Clinic 87,444 0 0.0% 87,444 87,444 Care Center '184,141 0 0.0% 184,141 213,616 Total 968,580 116,613 13.70/. 851,967 799,960 Office of Management & Budget 9/512000 ~ ~ 06- de ?1tiddte ~~, 'lite. Criteria for Eligibility and Attachment List x x X X X X X X X X X Monroe County Application FY 00101 2 ~ ~ ~ de "iItiadte ~t94, 'lite. . ~(;ENc:.Yo(esmIiIE9 Agency Name: Guidance Clinic of the Middle Keys (GCMK), Inc. Operating Since 1973 A ency Location: Marathon, FL Mailing Address: 3000 41 st Street-Ocean, Marathon, FL 33050 Contact: David P. Rice, Ph.D., Chief Executive Officer Agency Phone: 305/289-6150 Agency Fax: 305/289-6158 Have you ever applied with Monroe County HSAB for funding assistance? YES Will county funds What is the ratio of match to Federal '~'''' be used for and/or State $? match? YES Is funding for _New -LExisting 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 its announced purposed as submitted in its Applications for Funding. Any change will require written approval from the Monroe County Board of County Commissioners. Contact the Office of Management at 292- 4472. We understand that the agency must meet the Eligibility Criteria to be considered for Monroe County funding and that any 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 the HSAB. These recommendations are determined by service needs of the community and availability of funds. Approval for funding is granted by the Monroe County Board of County Commissioners. ~~D~ Chief Executive Officer ~~- Michael H. Puto, President Board of Directors 6~o Date ~z ~/pp ate Monroe County Application FY 00/01 3 ~ ~ ~ ~ ?1tLdd1e ~~, 'lite, '.SUMMAR~~eIiSIGNII;I€ANm[G1::IA~.G The questions in the section pertain to major changes that have occurred within the organization's past fiscal year. If there has been a change, answer the question with a brief summary. If there has been so change, check "NO" to that question and proceed to the next question. YES NO Significant change in staffing and/or management (including the Executive Director? In May 2000, GCMK reduced the availability of outpatient psychological services. Two positions (unit clerk and one mental health technician) were eliminated. One accounts receivable position was reduced and the building manager position was abolished. BoardNolunteer Governance and/or Structure? Funding Sources (loss or addition of revenue)? In FY '00, GCMK received $30,606 from Byrne Grant funding for 189 days of detoxification services for men and women. Organization Mission/Strategic Direction Change in Program/Services (addition or deletion of programs)? In October 1999, GCMK received Byrne Grant funding to add another 189 days of detoxification services for the homeless. In January 2000, DCF increased GCMK funding for HIV intervention services. Significant Change to Service Delivery, Costs. and/or Effectiveness Measures? Client Base/Client Demographics? GCMK has increased through the Byrne Grant its ability to serve substance abusing adults who are in need of residential detoxification services. Collaborative Efforts/Relationship with other Service Providers? x x x x x x x x Relationships with Parent, National, or State Affiliates, Accreditation, Certification, and/or Licensing? Significant Change in Equipment and/or Facilities Other: none x X X NARRATIVEOVERVIEW,OFHEQUES:TEDEUNDING,: 1. Provide your agency's board-approved written mission statement. The Guidance Clinic of the Middle Keys, Inc., is a nonprofit, charitable organization dedicated to the provision of high-quality and cost-effective behavioral healthcare services throughout the Florida Keys. It seeks to provide services in a timely and affordable manner. It will demonstrate its commitment by embracing growth, expansion, and diversification of its services in a manner that1s accountable and responsive to its stakeholders. Monroe County Application FY 00/01 4 ~utaHa ~ ~ tk 1Itutdle ~~, 'Jill:, 2. Explain specifically how your agency plans to use the money you are requesting; Le., rent, salaries, expansion of services or service area or general agency operations? GCMK will use County funds in six program areas: Program Area # Service Units $ Requested Substance Abuse Detoxification Services. $111,494 Mental Health Services, including assessment, outpatient services, and outpatient medical services. 57,336 Baker Act Inpatient Services: GCMK's crisis stabilization unit (CSU) is a Baker Act receiving facility and provides crisis stabilization and treatment services to adults ($18 years) who are in sufficient 319,419 emotional distress as to require acute care and continuous monitoring to assure their safety and the safety of others. Baker Act Transportation for persons throughout the County who required crisis stabilization at the GCMK's CSU or another CSU. 40,997 The amount shown represents the allocation for the program already in place. This service is required bv law. Baker Act Transportation -Lower Keys. The amount shown represents costs for expanding the services to having a vehicle and drivers in Key West to facilitate transfer of persons from the Monroe 69,971 County Jail and The Lower Keys Health Systems Hospitals to GCMK and Miami, if necessary. These monies could come from Gas Tax revenues rather than from the General Revenues. Keys to Recovery-Department of Corrections Resident Program. This is a very successful but costly program. This amount is 82,178 requested from the County Fines and Forfeitures Fund. Community Transportation Disadvantaged Coordination. This request is for General Revenues. 15,600 TOTAL $696,995 3. If your funding request is greater than last year, explain in detail, what the increase is expected to buy. Increases for Substance Abuse Detoxification Services, Mental Health Services, Baker Act Transportation (current program), Keys to Recovery and CTC Transportation are requested to cover cost increases over the past several years. The last increase granted by the county for existing programs was in 1993. In fact, allocations were decreased in FY 98-99. In the wake of increasing costs and without an increase in funding, GCMK will likely be forced to curtail and/or discontinue services. Baker Act Transportation (expanded program)- There is a crisis in the lower Keys because of the loss of Baker Act Transportation services two years ago. As it stands now, the jail is serviing as the primary Baker Act Facility. GCMK has the inpatient services so desperately needed; Monroe County Application FY 00/01 5 ~ @utie. Dj. ~ ?JtuUtte ~~, 'JHe. however, there is no mechanism now to bring the clients to us. GCMK proposes to provide that transportation as long as we can cover our costs. 4. 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 try, but have not yet been able to secure funding. Please include any awards or special recognition your agency may have received this past year. In January 2000, GCMK became the Medicaid transportation coordinator for Monroe County. It also remains the Community Transportation Coordinator for the transportation disadvantaged of this county. In January 2000, GCMK received from the Department of Children and Families (DCF) more than double the funds previously awarded to expand HIV intervention services in residential substance abuse treatment programs throughout Monroe County. In April 1998, SHAL recommended to the Local Redevelopment Authority that GCMK provide substance abuse services onsite at the Navy excessed property known as Poinciana housing. In FY '01, GCMK plans to expand its current services to provide transitional housing for special needs adults and group home services for children in the care of the DCF. In 1999, GCMK expanded detoxification services for adults through the County's Byme Grant. 5. 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. In May 1998, it was necessary to increase salaries on the stabilization/inpatient unit by $1.00 per hour for mental health technicians and to increase the differential paid to night staff from $.50 per hour to $1.00. This action was taken to remain competitive in the Marathon labor market. With businesses such as Publix and Home Depot building large facilities in Marathon, the available labor force was taxed for entry level staff and starting salaries paid by these employers was beyond that of GCMK. The net impact of stabilization unit salary increases in FY 98/99 is approximately $60,000. This expense has continued and is compounded in FY '01 with the fact that increased differentials must be paid to RNs and mental health technicians on weekends and RNs on evening shifts. Additionally, it is necessary to pay higher salaries to inpatient administrative and nursing staff to ensure to both recruit and retain qualified staff. The annual County funding for GCMK remained constant since 1993 and was reduced in fiscal year 1999 by a few thousand dollars. GCMK is requesting an increase for fiscal year 2001 due to operating cost that have continued to rise. GCMK has pursued a number of strategies to cope with the real dollar decline in funding, including aggressive pursuit of other funding, reduction in force, careful utilization management, and more efficient collections. We have now, however, fully optimized these strategies. Monroe County Application FY 0010 1 6 ~ @uue ~ tie ?1tiddte ~~, 'lite, GOVERNING:B:ErA;R 6. Number on Board of Directors? 11 currently (one non-voting member) 7. What is the authorized number of Board positions specified by your bylaws? ~ 8. Number of Board meeting held during past year? 19 9. Average attendance of Board Members: 80 percent 10. What limits, if any, does your bylaws set on terms or year of service a board member may serve? Board members 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) VOL U NTEERS":'{ includihg~Bbard:members r. '\"0.rw(~~jf~f&,,~jl~t2t:/1"; "~f~~;1~?~~~"'~'! A.~:;:,3-;_:,,- , : .^:(~ ,j;' 12. 13 volunteers contributed a total of 862 hours to our agency this past year. - Board: 220 hours Programs: 630 hours Committees: 12 hours 13. How do you utilize volunteers in the operation of your agency? Volunteer board of directors; graduate student interns to augment staff capacity on inpatient. 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 the Clinic. AGENCY 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? YES. Clients of all GCMK services have the option to seek informal redress of grievances through agency supervisors and senior managers or to initiate formal intemal grievance procedure in accordance with written agency policies and procedures. 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 locations. Persons receiving Monroe County Application FY 00101 7 ~ ~ ~ de?1tiddte ~~, 11<<" 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 organization do you network with to prevent a duplication of services: Describe any sharing of costs, referrals of clients, etc. 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. GCMK stations two Life 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. GCMK provides a Prevention Coordinator to implement a substance abuse prevention curriculum in the elementary and middle schools from Sugarfoaf to Key Largo. 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 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. GCMK provides psychiatric and psychological services to residents of the three local nursing homes and works closely with those facilities to integrate mental health services into the overall care plans for their residents. 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 who and how often. If not how does your agency document and measure its service performance and success rates? 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. Substance abuse detoxification, residential, outpatient, intervention, and prevention programs are monitored and licensed annually by the Florida Department of Children and Families. The Department of Corrections monitors KTR and the outpatient substance abuse program semiannually. Monroe County Application FY 00101 8 9<<~ ~ Df de "Htiadle ~~. 111e. 1.~EJN~NC.I~Gl1ft1ifiDi ~;<I .m.,.... .... ." ..,. ..,,~.,,~,....,.. . ...... . .. . ... . .. ... . ,. ." 18. Is your agency receiving any in-kind services, Le., free rent, utilities, maintenance, etc., from the County or any other organization? If so, what is the fair market value? GCMK receives no in-kind services. 19. What is the percentage of total agency revenue that goes to the following: Fundraising Expenses: 0 percent Administrative Expenses: 13.7 percent 20. Complete Attachment B - Agency Salary Detail Form, see attachment. li\(ElEFI(IE$()~~EGI_I;~~~~E~Wa!.~~N(3$($aa::mJES$EDIVjA't1:~41+<,1 21. Please give a one paragraph description of the agency program for which you are requesting funding. See page 5, #2. 22. What need or problem in this community does this program address? Include your target population. The District 11B Needs Assessment and Strategic Plan, 1997-1998 developed and distributed by the Florida Department of Children and Families the following target group priorities: . 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 . 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. 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 Monroe County Application FY 00/01 9 ~ ~ 05 ~?Hidd1e ~~, 'life. 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 supports this need. Attach copies of relevant documents or cite report. See #22 above. 24. Where is this program being offered: List all sites and hours of operation. 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.- 6:00 p.m.; on-call counselor available 24 hours per day, 7 days per week. Inpatient services: 24 hours a day, 365 days a year 25. What measurable changes do you plan to accomplish this next fiscal year? GCMK continues its efforts to achieve CARF accreditation, when achieved will offer patients, families, payers, and taxpayers specific additional assurances of high quality services and accountability. It is expected that GCMK will obtain a CARF survey for accreditation in calendar year 2001 GCMK continues to seek new sources of revenue as described previously herein. ;RROGRAM 26. Define program unit of service or state why this does not apply to your operation. sustance abuse detoxification = nonmedical outpatient mental health = medical outpatient mental health = Baker Act inpatient services = Baker Act transportation = one day one hour one quarter hour one day one-way trip a. Basis for cost formula: Explain how you developed the cost per unit. Total expenses within each program area divided by the total number of units within the area. Monroe County Application FY 00/01 10 tfi<<aanee @uue, D/- tk ?1tid4e ~~. 'lite. b. 3-Year Unit Comparison: Provide the "cost per unit of service" and the past, current, and proposed fiscal years. Provide the number of units of service for the past, current, and proposed units for FY 99/00. $173.00 2,920 $124.84 2,149 $244.56 6,570 $159.80 290 , ,;~''''q~WY'@a~ $182.12 2,920 $118.18 2,350 $210.18 6,570 $123.48 332 .","li'''IEN' TS::S'ER\"'Er"f!!%L.I':d!;;;";;i'~t'~~"!.~~~~i}~~W#~! . '''"'''"" '.... ~ '.~.~ .. ..'I-,! - ~_ -, _ ~i~,,:.. - ~1l'~i_!~_:~~~~;;:~J)~1~7;F;fU:t~ftl~!'JMoII.~'t~- un.r ,,'~~;.,.. ~j& . ;~,~:J~t_~~i;.t~:~?l:~;~~e~r;~;;,~ 27. Please complete Attachment C - Total Unduplicated Clients Form, see attachment. Sections C-F are optional. Complete these sections only if you have already gathered the data within your agency. Please complete Sections A-B.. Monroe County Application FY 00101 11 AGENCY NAME: HSAB BOARD & ST AF ~_,:\^'^'~O. LLt1U ,-( JiJ(J;/l Lk-L ~ YES NO COMMENTS v r -~ GREY AREA TO BE FILLED IN BY H.S.A.B. STAFF LY. Agency is a health and human service organization affecting human health and welfare. Program for which funding is requested addresses one of Monroe County's major problems as identified by the HSAB upon review of Monroe County Needs Assessments. Does Agency service all three areas of the Keys? '. Does Agency duplicate an already existing service? ! Agency's service is available regardless of race, religion, color, sex or national origin. Agency has publicized its services to residents of Monroe County via promotional activities: i.e., PSAs, a County phone book, membership in its local Interagency Council, etc. The majority of Agency's clients served are Monro,e County residents. , Agency met application deadline ATTACHMENT CHECKLIST SUBMITTED CRITERIA BELOW REQUIRE ATTACHMENTS, IF APPLICABLE. YES NO IRS Tax Exempt 501 (c) (3) Certificate X Copy of latest CPA Audit Report X Copy of IRS 990 Form X FL Consumer's Certificate of Exemption X I Federal 10 Number 59-.J...462836 X FL Dept. of Health Licenses/Permits I N/A I FL HRS License or Certification X I FL Dept. of Agriculture & Consumer Services Reg. No. N/A Current Monroe County and City Occupational License X ANY OTHER Federal & State Licenses X Front Page of Agency's EEO Policy/Plan X Front Page of Agency's ADA Transition Plan X Current Fee Schedule if fees are charges X Example A - Board-tnformation Form X Examole B - Profile of Clients Served x Examole C . Aqencv Salarv Detail X Examole 0 - Budqet Information -- X I Summary Report of most current Evaluation/Monitoring Report - I X CRITERIA FOR ELIGIBILITY AND ATTACHMENT CHECKLIST We had monitoring done In March. We are waiting on the report. AGENCY PROFILE -. .... " Agency Name: The Guidance Clinic of the Upper Kevs Agency Operat,ng Since 191.] Agency Location: 92140 U.S. HWY 1 Tavernier, Fl. 33070 Mailing Address: P.O. Box 363 Tavernier, Fl. 33070 Contact: Richard Matthews, Ph.D Title: C.E.O. Agency Phone: 305/853-3284 Fax: 853-3286 Have you ever applied with Monroe County Human Services for Funding Assistance? -x-Yes : - Will County funds be used for What is the ratio of match to Federal Match? and/or State dollars? TOTAL NUMBER OF EMPLOYEE X YES NO FEDERAL 40% STATE 60% - FULL PART TIME 24 TIME 1 Is Funding for AMOUNT REQUESTED AMOUNT RECEIVED AMOUNT RECEIVED Fe NEW FOR FOR FY 98/99 --2L- EXISTING FY 00/01 FY 99/00 Program? 87,444 87,444 87,444 CERTIFICA TION & AUTHORIZATION APPLICATION FOR FUNDING MONROE COUNTY Through Human Services Advisory Board October 1, 2000 - September 30, 2001 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 its announced purposed as submitted in its Application for Funding. Any change will require written approval from the Monroe County Board of County Commissioners. Contact the Office of Management and Budget at 292-4472. We understand that the agency must meet the Eligibility Criteria to be considered for Monroe County funding and that any 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 the Human Services Advisorv Board. These recommendations are determined by service needs of the community and availability of funds. Approval for funding is granted by the Monroe County Board of County Commissioners. or - I .- , Signature Signature , I .. Richard Matthews. Ph.D Typed Name of Executive Director Bernadette Lannon Typed Name of Board President/Chairman Date Date .,. 2 AGENCY NAME: SUMMARY OF SIGNIFICANT CHANGE The questions in this section pertain to major changes that have occurred within the organization's past fiscal year. If here has been a change, answer the question with a brief summary. If there has been no change, check "NO" to that question and proceed to the next question. YES NO Significant change in staffing and/or management (including the Executive Director)? X We have hired four new positions BoardNolunteer Governance and/or Structure? X We had nnp 1...___..::1 'r wi +-hr'l,...;:",.7 frnm t-hp h"",,...r'l Funding Sources (Loss or Addition of Revenue)? X ~~1.have rec~ived TAN~ funding for a Mid-Keys Mobile Team and a Children's nnc:;; .; nn Organization Mission/Strategic Direction? X See Mission Statement Change in Programs/Services (Addition or Deletion of Program[s])? y The Mid-Kevs Mobile Team and a Children Substance Abuse nosition. Significant Change in Service Delivery, Costs, and/or Effectiveness Measures? X Client Base/Client Demographics? X Our glient ba~; ofhchilQren and..::lf~mil~~ ~~othe middle Keys as \'Jell as r.hi 1(11 In t e Unner evs lavp ; n---- -- IllP '" T'lOt.7 ,c:: Collaborative Efforts/Relationships with other Service Providers? We are now seeing children in the Childrens' Shelter in the U-'::Iper Keys. Relationships with Parent, National or State Affiliates? I X jAccreditation, Certification, and/or Licensing? X I Significant Change in Equipment and/or Facilities? y I OTHER: 3 AGENCY NAME: NARRA TIVE OVERVIEW OF REQUESTED FU~DING 1 . Provide your agency's board-approved written mission statement. 2. Explain specifically how your agency plans to use the money you are requesting. I.E. rent, salaries, expansior services or service area or general agency operations? If you are requesting dollars for more than one program, be sure to specifically include what is being purchase for each program. Include specific activities that will be carried out by the Program. For example, if funding j, for a new position, explain change in staffing requirements. Specify full or part time, salary and how many mo clients will be served. If funding is for a direct service to clients, include program objectives and how many unduplicated clients will be served. 3. If your funding request is greater than last year, explain in detail, what the increase is expected to buy. If the increase is buying more than one additional item, list the items in order of priority with a funding amount attac to each item. DO NOT LIST YOUR AGENCY'S BUDGET BY LINE ITEM. FOR EXAMPLE: PRIORITY COST a) Cost of living adjustment to maintain current service levels. $50,000 b) One additional caseworker (salary & benefits) will increase service levels by 10% $25,000 c) Purchase meals for 100 more clients for one year (2 meals/day, total $5.00/day) will $182,500 increase service levels by 3%. 4. 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 Iik try, but have not yet been able to secure funding.) Please include any awards or special recognition your age' may have received this past year. 5. Identify any special factors that should be considered when making final funding decisions. Include comment~ significant changes in revenue or expense items as compared to previous years. Also explain any non-recurrinr unusual expenditures. GOVERNING BOARD 6. Number on Board of Directors? 9 7. What is the authorized number of Board positions specified in your By-Laws? ~e 8. Number of Board meetings held during past year? 11 9. Average Attendance of Board Members? 85 % 10. What limits, if any, does your By-Laws set on terms or years of service a board member may serve? There lS no term limits. 11 . Complete Attachment A - Board Information Form J' 4 AGENCY NAME: VOLUNTEERS (Including Board Members) 12. noneVolunteers contributed a total of hours to our agency this past year. Board: 1 0 hours I Programs: ~hours I Committees: ---L- hours 13. How do you utilize volunteers in the operation of your agency? N/A 14. Briefly describe the training the volunteers receive. II AGENCY OPERATIONS 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? See Narrative 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 joint fund X position with ABC Agency." See narrative attached. 17. Is your agency monitored by an outside agency? If yes, by who and how often? If not. how does your agency document and measure its service performance and success rates? See narrative attached. FINANCIAL INFORMATION 18. Is your agency receiving any In-Kind Services Le. 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 11 20. Complete Attachment B - Agency Salary Detail Form. DETAILS OF SPECIFIC PROGRAM FOR WHICH FUNDING IS REQUESTED 21. Please give a paragraph descripti'vn of the agency 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 supports this need. Attach copies of any relevant documents or CITE Report. 24. Where is this program being offered? List all sites and hours of operation. 25. What measurable changes do you plan to accomplish this next fiscal year? :>' 5 AGENCY NAME: EXAMPLE C - TOTAL NUMBER OF UNDUPUCA TED CLIENTS A) CLIENTS SERVED ACTUAL 98/99 PROJECTED 99/00 PROPOSED 00/01 Target POpulation Clients Served Upper Kavs 1 ?lc; .1 1 ~ 7 .1 ?nn Clients Served Middle Keys 25 55 100 Clients Served Lower "eys 110 200 300 ClientS Served Key West Total Clients Served 3,340 4,392 4,600 B) UNITS OF SERVICE ACTUAL 98/99 PROJECTED 99/00 PROPOSED 00/01 Units of Service UP".' Kevs I !=:~P- ::COS t /Uni t Units at Service Middle Keys Units of ServIce Lower "ays Units ot ServIce Key West Total Ava,lable Units ot ServIce C) GENDER TOTAL ACTUAL 98/99 PROJECTED 99/00 PROPOSED 00/01 MALE 1,942 2,296 2 400 FEMALE 1.398 2 . nqj:\ I 1 qn n D) AGE TOTAL ACTUAL 98/99 PROJECTED 99/00 PROPOSED 00101 o to 9 years 428 , 0 to , 9 years 1,075 20 to 54 years 1,600 55 to 64 years 190 65 and up 47 El ETHNICITY TOTAL ACTUAL 98/99 PROJECTED 99/00 PROPOSED 00101 White 1,825 not available at not available at Black 450 this time this time Asian 15 Hispanic 780 Other 270 F) INCOME TOTAL ACTUAL 98/99 PROJECTED 99/00 PROPOSED 0001 Below $10.000 " ..... ....... "- $10.000. $14.999 " "" $ 1 5.000. $19.999 .'-. ',,--- , , '. ~ $20.000. $29.999 ~. '" "- $30.000 and above " " ". "- "- , , Income Unknown '",- -- .,. 9 e.... . ~,~ . GREY'AREA TO~BEFlLL.ED' IN BY I:I.,S.A.B~.STAF=FONLY:;- CRITERIA FOR ELIGIBILITY AND ATTACHMENT CHECKLIST _A"~ ~'--<l:"'.".."K<' B!Ba~Rm~&TAFi ,',W.. . E1ii:~;~;~1: ',l..~.*1~~"'; ':.,'~~'):<~' ;~W,_..~::.- '~<~_..,v(:- - ;". :'..~-;-'~"-:'~: _ ':-'_,\i"-:;""-~<~.::'::"~-:-<"'_-_.' "::':"" Agency.'.iS:a:health and; human . servr~t! cirganization~I:If!!;lc:!i!"92hum health and:.welfare. "'~~-i\" "i'i:!'~'.:i7;'2:~.:';;'~1'4':;\;;:;"ij.;.z:I0:(Jf'T'i">: Programj~eWhich' funding' is requesU!d~ddress'~s onet~f:~onro~ County's:ma[or-problems as' identified. by the ,HSAB up~rr~e"iElVV'o Monroe.. County. Needs Assessments;, ':":-"'-;;;&"1'; ,.ij\i:;i'~~f~;<::':", DoesAg~I1cy.'service all three areas:iif th~, Key~l'" DoesAg~~cYduplicate an already eXii1:irig.'ssrvicc:d: Agency's-:service. is' available ,'reg.ardie'~~':CJfrac:~~: r~ligi~m~p()lor;se)(;;o,';~ national 0 n'g' in' ..,!t1?k':c".{.;'/i;;';......v:...-:'....'iY. '''(y. !il;;W;;~....:,~ii.i'.....::K1.f!J'~ N _ - . .." - ',' :"';:--;'~'~"'::--"~;':"'_ ."~'"~::,,:,:-;: ,:":1'_':,I..<~;:;~:{::.)-.t;t:~:- '~':':i~;:;. ~;.._-.._~, .,~; Agency:~;~~publicized its services~ta. fesid~l1ts:~fMoriro~~cburitVf.V promotional activities: i.e., PSAs, a, County phone' b()~.K;.,n;ernbers in its locallnteragency Council, etc. i~1-;':"'i?,::;.';;.' "';;0&#1i;P/4\;J?i:';~i, '-''-. '.-' ": ,"~ -- ~";r---<'~~'''--'''' ~',;'1- .'_';..,:....;:- ,', , ..... ' -- ..\:.':_."""':':t,.~,;,~-<.',.;.~-_--_',-..-:'-,,~ -", -,,;;ri.;;h,:;.~i:~;i;'!~;,>..;~-:-.-.-,;:- ;,;-.'.y:t~;\. The majority ofAgency'schents.served:areMonroe COuI1W- resldentStc Agency m~t;application deadline- w:" ATTACHMENrCHECKLIST'.J;~:f:~g,b,~.~;': CRITERiA BELOW REQUIRE: A1TACHMENTS~ IF APPLICABtE. -:;:> :.:_---';.,:,:,."~''''<,,:,-,, < AGENCY NAME: IRS Tax Exempt 501 (c) (3) Certificate Copy of latest CPA Audit Report Copy of IRS 990 Form v FL Consumer's Certificate of Exemption Federal 10 Number FL Dept. of Health Licenses/Permits FL HRS License or Certification FL Dept. of Agriculture & Consumer Services Reg. No. Current Monroe County and City Occupational License vi' ANY OTHER Federal & State Licenses Front Page of Agency's EEO Policy/Plan Front Page of Agency's ADA Transition Plan (),.,!~~ Current Fee Schedule if fees are charges J ,. ,.. Exam Exam Exam Exam if 1 Human Services Advisory Board Application for Funding FY 00/01 TABLE OF CONTENTS CRITERIA FOR ELIGIBILITY AND ATTACHMENT CHECKLIST ..........................................PAGE 1 AGENCY PROFILE & CERTIFiCATION...... .......... ................ ...... ........ ................. ............. PAGE 2 SUMMARY OF SIGNIFICANT CHANGE ...................................... ................. ....... ........... PAGE 3 NARRATIVE OVERVIEW OF REQUESTED FUNDING .......................................................PAGE 4 GOVERNING BOARD.... ........ ........ ................ .............. ........... ............................. ......... PAGE 5 Volunteers ........................................................................................................ P AG E 5 AGENCY OPERATIONS.. ..... ................. .............. ........ ......................................... ......... PAGE 5 Financial Information.......... ................ .......... ....... ................................ ..... .......... PAGE 5 DETAILS OF SPECIFIC PROGRAM.............. ........... ........ ........................ ................ ....... PAGE 5 Program/Unit Cost....................... ~................................................................... .. PAGE 6 Clients Served................................................................................................. .. PAGE 6 Example A - Board Information Form ....................................................................PAGE 7 Example B - Profile of Clients Served.................................................................... P AG E 8 Example C - Agency Salary Detail........................................................................PAGE 9 Example D - Program Budget Information (Expense/Income)............................. PAGE 10/11 Example E - Agency Budget Information (Expense/Income) .............................. PAGE 12/13 1 APPLlCA nON FOR FUNDING MONROE COUNTY Through Human Services Advisory Board October 1, 2000 - September 30, 2001 gency Name: Care Center for Mental Health gency Location: 1205 Fourth Street Key West, Florida Mailing Address: 1 205 Fourth Street Key West, Florida 33040 Agency Opereting Since 198:: Title: President & CEO Fax: 292-6723 gency Phone: 292-6843 Have you ever applied with Monroe County Human Services for Funding Assistance? · Yes f\ · YES NO FEDERAL STATE 75% with 25% County Match .. Will County funds be used for Match? What is the ratio of match to Federal and/or State dollars? Is Funding for NEW --.-- EXISTING Program? 11,ljr~;;il! 32 ~*~;~'illll 2 __E'JI~ $184,141 $184,141 $214,629 This certifies that this request for funding is consistent with our organization's Articles of Incorporation and Bylaws a has been approved by a majority of the Board of Directors. We affirm that the Agency will use Monroe County funds for its announced purposed as submitted in its Application 1 Funding. Any change will require written approval from the Monroe County Board of County Commissioners. Co nt, the Office of Management and Budget at 292-4472. We understand that the agency must meet the Eligibility Criteria to be considered for Monroe County funding and tt any applicable attachments not included disqualify the agency's application. We further understand that meeting the Eligibility Criteria in no way ensures that the agency will be recommended 1 fundmg by the Human ::iervlces AdVISOry Board. I hese recommendations are determmed by service needs ot t community and availability of funds. Approval for funding is granted by the Monroe County Board of Cour Commissioners. ( ~~{..~ Signature ~~~ Signature - "1--- Marshall Wolfe, President & CEO Paul Rasmus, Chairman, Board of Directors Date: June 16, 2000 Date: June 16, 2000 3 AGENCY NAME: Care Center for Mental Health FY' E.ii~t.~~~~~eri:reII1IBBIi,~IIi.i~fj~t~i!i!lli~f~lllii~~it~!{1,1:::.:.:." ........ ...:.:.:.:....:.:.:.:.:.:.:.:........:. ......:1!iili~!i:~i~:I~fl!~:r;:j:f~:::::jf:i:f;:::::::: .. in4in9}iduWP5ii~_ilml_l~il!;:~j:;:;:::;.:.:.:.:.:.:.:.::...:.::." ......... ..:::.:.:.:::::::.:.:..::.:....... .. 9t,gJnizati9b::::Miss~~lil~f.ili""i_~!lil~~:1i~ii~:ili~~fr~~f~lillif,I~;.... .. Qbang,e..in.::'p.tgg_B_;iJ.ili_:!lft.II_~tll_I1._Jl"""':.>:.:.:...:.....:.:.I!jt~~ij:l~::~i:::f~::f~~::::::::!f:i:f:::::i::::::::;::::i:..: .. ':.ib~tflca~::e.~~riQ~ilimlll_i_~ii._lt~ii!i.li_r<<_6111iil1~~~:iJl~~::::::~f~:f::::::::::::;::i:: .. .. CbJttiliOratW~;::Eff6~11I1[~~ill\I,-~i~irlil:IIJ.I~ilil!.llj_;1~~j~ijii!~lj~fliiil~::ilii[tt:~;~::::::!::::::::::::::::::}:::::::::::. .. ,e18tio"sbid$::;wiiii;::li.11i1.i:[#:~:::~I~:::lli_J.:~:ili:i~r~f~!11.ii~il;ii~iililiij~lijif~tii:::!jt:::l:j:;::J;::::t::(::: .. ...............................::::;;:::;:::::x:::::::=:::::.::.:;:;:;;:..;.;:;.;.;.;.;::::.....;.::.:.....:......:....... ..... . :.n~ti.f~[~~i$~4l~~t~ilijI~~~i~~i~~/Jti .. $goificarit;.:~~og~:ljlir~_~Jllillitl_i~_l~ji:iij[:l~~ii~f~~~jfff~lll[if; . . . :.:.:...:.:.:-:.:.:-:::ili*~:~~;:i~:;:~~:~~~:;~~$i~~$~:;~:~:~~~~~:~:~:;:~:::~:~:~:::~:~::::.:::::::::-:::::::. .:.;:::::':::~~~::~::::::~;:::::x::::~~:*:s::~:::::s:::~::::::*::::::;::::::::~:;~:::::;:;::::::.:::::.: .:: :. ::::;::~:::::;;::;:;:;:;:;:::;:::::;:::::::::~::;:::;:~::::;:;::::::::::::::.;.:.::.:;:::::;.::;::::.:.:.... ..:'. ...:. .. o.THER~: 4 AGENCY NAME: Care Center for Mental Health FY '01 1. Provide your agency's board-approved written mission statement. Attached 2. Explain specifically how your agency plans to use the money you are requesting. I.E. rent, salaries, expansion of services or service area or general agency operations? A.County funding ($184,141) will b 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, crisis intervention, medical services, case management and outpatient counseling. If your funding request is greater than last year, explain in detail, what the increase is expected to buy. the increase is buying more than one additional item, list the items in order of priority with a funding amou: attached to each item. DO NOT LIST YOUR AGENCY'S BUDGET BY LINE ITEM. Same Request as last year. 4. 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 try, but 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 integrated into programs providec by the Monroe County School District and the Department of Juvenile Justice. 5. Identify any special factors which should be considered when making final funding decisions. Include comments on significant changes in revenue or expense items as compared to previous years. Also explai any non-recurring or unusual expenditures. 6. Number on Board of Directors? 12 5 7. What is the authorized number of Board positions specified in your By-Laws? 15 8. Number of Board meetings held during past year? 11 9. Average Attendance of Board Members? 80% 10. What limits, ifany, does your By-Laws set on terms or years of service a board member may serve? NONE 11. Complete Attachment A - Board Information Form 12. 15 Volunteers contributed a total of 272 hours to our agency this past year. Board: 216 hours I Programs: 24 hours I Committees: 32 hours 13. How do you utilize volunteers m the operation of your agency? Board members. 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. 1 5. Does agency have a gnevance 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 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 m Interagency Council. An example of an appropriate answer IS "one ofXYZ's employees works out of our branch" or "we joint fund X position with ABC Agency. " The Care Center has weekly meetings with the Department of Juvenile Justice, the Department 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 who and how often? The Care Center IS annually monitored by the Department of Children & Families for program compliance and administrative compliance. In addition, each agency with whom the Care Center has a contract for semces evaluates thE center based on their own criterion. 1 8. Is your agency receiving any In-Kind Services I.e. free rent, utilities, maintenance, etc. from the County or any other organization? If so, What is the fair market value? None 6 19. What IS the percentage of total agency revenue that goes to the following: Fundraising Expenses? 0% Administration Expenses: 13cr 20. Complete Attachment B - Agency Salary Detail Form. 21. Please gtve a one-paragraph description of the agency program for which you are requesting funding. County 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, cnSlS intervention, medical servIces, case management and outpatient counseling 22. What need or problem In this community does this program address? Include your target population. The Care Center provides mental health and substance abuse treatment for all individuals west of the 7-mile bridge. 23. What data supports this need? Look around! Attach copIes of any relevant documents or CITE Report. 24. Where IS this program being offered? Our mam location IS 1205 Fourth St. We also operate a substancE abuse treatment program In the Monroe County Detention Center, and have full-time school based children's therapists at Key West High School, Horace Q'Bryant Middle School, Sugarloaf elementary/middle School and Gerald Adams elementary school. Our hours of operation are 8:30 AM to 5:00 PM Monday-Friday. Emergency/crisis services are provided 24 hours a day. 25. What measurable changes do you plan to accomplish this next fiscal year? None 7 AGENCY NAME: Care Center for Mental Health FY '01 .!IIIIII_lr::::::..::... ... . ............:..:........;~1~!~11Iiliiil~lliijlilill:!I:Ijlij~i~lil!::::!:::~j:j::~:.:::...:::.. 26. Define program unit of service (i.e. 1 unit = 1 hour counseling; 1 unit = 1 night shelter/l meal, etc) OR STATE WHY THIS DOES NOT APPLY TO YOUR OPERATION. a. Basis for cost formula: Explain how you developed the cost per unit (i.e. total cost of program divided b~ 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 funders of the program. b. 3 Year Unit Comparison: Provide the "cost per unit of service" and the past, current and proposed fiscal years. Provide the numbers of units of service for the past, current and the proposed units for FY '96-'97. "~.. ......................................... ..... ................................................... ..:I..:.!:.I.I./:I:.:.j!!!/il:i!.Ii:i:il:lllllr.:............ ;:::::::::::::::::::;:;:::::::::;:;:::::::::::::::::::;:::::::;:;:::::::::;::::::: 18900 Please complete Attachment C - Total Unduplicated Clients Form. Sections C thru F are optional. Complete these sections only if you have already gathered the data within your agency. Please complete Sections A and B. 8