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Originals 2009/2010 Agency Funding Applications Result 1, Tabs 1-7 Result 2, Tab 8 only
ORIGINALS 2009/2010 Agency Funding Applications Result 1, Tabs 1-7 Result 2, Tab 8 only Result 1 Rated by Rolf, Alicia, Adria, Elizabeth, Margie Result 2 Rated by Rolf, Alicia, Adria, Elizabeth, Margie Result 3 Rated by Rolf, Alicia, Adria, Elizabeth, Margie Result 4 Rated by Charlie, Cheryl, Tony, Robin, Sammi Result 5 Rated by Rolf, Alicia, Adria, Elizabeth, Margie Result 8 Rated by Charlie, Cheryl, Tony, Robin, Sammi Result 9 Rated by Charlie, Cheryl, Tony, Robin, Sammi r'd I 1 :1 I 1' (I • Application Cover Pages (Agency Information and Questions 1 — 7) �. N Ch ,; : enc ' nfonatio . . v, .obi : :{rt*= ,, Agency Name: Children's Home Society of Washington Applicant Name and Address: Ag ncDirect(or Children's Home Society of Washington D. haron-O'sbrheC E1 L�/R ti N e and Title PO Box 15190,3300 NE 65th Street APR 2008 Seattle,WA 98115 (2, 6)695-3200 ( ea kgc10/T tly hhop ' HUMAN S (2 T695=�LO _ RVICF E-mail address(if available) (Area Code)Fax Number --_ , -- ? Required signatures: By signing below,you certify that the information in this application is accurate to the best of your knowledge and that you have read the application, certifications, and appe ixes. (SIG Till' US /i:E IN BLUE INK 4 4 'r ... 91\1434\-- Signature IAgency10. I Pr-: dent/Date Si ture of Agency Direc or/Date ,Dan Merlino D. Sharon Osborne Printed Name of Agency Board President Printed Name of Agency President/CEO i; :?°.„St , u". : :i ,.''*'', ,: ems ; '' :,Fr r� m In 1 '1. _ ._,; 4''':' o a _ formation , a,.,,E w, x � � ' 1. Program Name Strengthening Families Contact Person(available to answer specific questions on this application) Nela Cumming (253) 854-0700 Name (Area Code)Telephone 4338 Auburn Way N Auburn,WA 98002 Address(if different than above) nelac@chs-wa.org (253) 852-3119 E-mail address(if available) (Area Code)Fax Number 2. , Program is New for our agency ❑An Ongoing Program 3. i Brief Description of Program(One sentence) The Strengthening Families project reaches low-income families with children ages birth to five with comprehensive services designed to improve the healthy development of children and increase the long-term self- sufficiency and capability of families in South King County. 4. Where are services provided? (If different from agency location) Services are provided in clients'homes and at the Green River Child Development Center located at: 31715 124th Ave SE Auburn,WA 98092 Page 1 5. Total Program Cost: Actual 2007: $1,060,530 Proposed 2009: $1,116,688• Y_ Projected 2008: $1,202,268 6. Total City Funds Requested for this Program: City Awarded 2008 Requested 2009* General Fund CDBG Total Requested** Auburn $10,000 $25,000 Federal Way $5,000 $12,500 Kent $10,000 $25,000 Renton $12,356 $12,500 City Awarded 2008 Requested 2009* General Fund General Fund Burien Covington Des Moines Enumclaw SeaTac Tukwila *Cities on a two year funding cycle will renew 2009 awards to 2010 based upon performance and availability of funds. See Part II for city specific information. **Include your total request for Auburn,Federal Way Kent and Renton. The source of funding will be determined by staff. IMMO Page 2 ( 7. Agency Contact Sheet ( Provide the following information for the agency and for the program requesting funds. Agency Contacts General Agency Name: Children's Home Society of Washington Address: 3300 NE 65th St 4338 Auburn Way N City/State/Zip: Seattle,WA 98115 Auburn,WA 98002 • Phone/Fax: (206)695-3200 (253)854-0700 Agency Web Address: www.chs-wa.org Executive Director Name: D.Sharon Osborne Title: President/CEO Direct Phone: (206)695-3209 E-Mail: sharono@chs-wa.org Development Director Name: Trish Crocker (or Grant Writer) Title: Grants Manager Direct Plionei,- (206)695-3226 E-Mail:- trishcna,chs-wa.org Finance/Accountant Name: Ana Clark ,:person preparing invoices) Title: Grant Financial Analyst Direct Phone: (206)695-3241 E-Mail: anacna,chs-wa.org Program Contact (Staff contact for contracting, reporting and program implementation.) Prog iam Name: Strengthening Families Staff Name: Nela Cumming rJ`Title: Early Head Start Program Manager :Direct Phone: (253)852-2584 E-Mail: nelac@chs-wa.org • fg Page 3 Children's Home Society of Washington Strengthening Families Application to City of Renton April 30,2008 8. ORGANIZATIONAL EXPERIENCE (2 page maximum) A. Experience. Children's Home Society of Washington(CHSW) is a private, not for profit, non-sectarian child welfare organization that was founded in 1896. The agency serves the entire State of Washington through program sites in rural, urban and suburban communities. Each year CHSW serves more than 30,000 children and family members. In it strategic planning process, CHSW identified its vision for the future—A world where all children thrive. The Society will ensure this future by working in partnership with families and communities to accomplish the mission to: develop healthy children,create strong families,build engaged communities and speak and advocate for children. This mission reflects the agency's deep commitment to supporting all families in their efforts to raise healthy children. The agency is recognized statewide and nationally for its high quality services, the stability of its programs and finances and its family support services, based on the concepts of empowerment,participant involvement and collaboration. CHSW provides services in six Core Service Areas: Early Learning; Out of Home Care (residential treatment and foster care for emotionally disturbed children); Family,Support, Adoption; Child and Family Counseling and Advocacy. CHSW has long been a pioneer in innovative children's services. In 1989, CHSW was selected as one of 24 original sites for the federally-funded Comprehensive Childhood Development Program research project,which explored the feasibility of comprehensive child development and family support services. The program gave birth to Early Head Start in 1995. CHSW has been refunded to continue its successful Strengthening Families/Early Head Start/Head Start program in South King County for the last 19 years. CHSW's Strengthening Families program, family support centers, and.many other successful collaborations demonstrate the agency's success in mobilizing communities.and diverse providers to improve services for children and families. CHSW's leadership is also involved in dozens of coalitions at the local, state and national levels. CHSW is a charter member of the Child Welfare League of America and is accredited by the Council on Accreditation(COA). Numerous CHSW.staff have served as delegates and board members-of the National and Washington Associations for the Education of Young Children(NAEYC and'WAEYC),the National Association of Social Workers,the Family Resource Coalition as well as many others. In addition,the agency maintains contractual agreements with county, city, state and federal government agencies to provide a variety of services to children and their families. In South King County, CHSW is seen as a leader in the child development and family support arenas. The agency has been the lead agency in several community initiatives to address the needs of families with infants and toddlers, including Early Head Start, Healthy Families (a home visiting program for , newborn families) and the development of Next Generation--a family support program for teen mothers. At CHSW, collaboration is viewed as a key to successful program development and implementation. The agency works through contracts, inter-agency agreements and as a.collaborative planing partner, with the majority of human service providers and larger institutions in our local communities and statewide. Page 4 Children's Home Society of Washington Strengthening Families Application to City of Renton April 30,2008 B. Operational Structure. Governing Board A Board of Trustees,with 30 representatives from across the state, governs CHSW. Each region also has a Foundation Council to oversee and implement local fund raising campaigns for the Society. In addition, the Early Head Start program has a Policy Council with representation from both South King County and Walla Walla. A list of CHSW's Board of Trustees is included in the attachments to this application. The Early Head Start Policy Council's 13 members include eight current Early Head Start parents, four representatives form local community agencies and funding partners and one representative who is the policy delegate from CHSW's Board of Trustees who serves as the principal liaison to the Trustees and ensures that community and program needs are brought forward to the governing board. The Policy Council meets at least bi-monthly. Parent members are invited at the time of enrollment to participate in a variety of volunteer opportunities within the program and are encouraged to consider Policy Council membership. Policy Council members are elected annually by the parents of the program option they represent. The Policy Council reflects the geographic and ethnic diversity of the parents and communities the program serves. A list of the Policy Council is included in the attachments to this application. The Policy Council Regional Sub-Committee meets bi-monthly(alternating with the Policy Council) and is designed to increase parent and community members participation in the Policy Council by giving members an opportunity to meet to discuss local/regional program issues and prepare recommendations for the full Policy Council. Parent Committees support the sub—regional committees by involving parents in the development, operation and evaluation of program components, evaluation of curricula, recommendations for continuous improvement, design and implementation of activities and events and election of Policy Council members. This committee also serves as a forum for families to initiate parent- ' - led activities and recommend program change ideas to the Policy Council. Staff The Board of Trustees employs the President/CEO to administer the affairs in accordance with established policies and procedures. The president works with Vice Presidents for Operations and Strategic Planning and New Business Initiatives who are responsible for the administration, development and implementation of programs. The Vice President of Operations supervises the Senior Leadership Team which is comprised of the Core Service Directors and the Community Service Managers. The Early Learning Director ensures that the program design and implementation is aligned throughout the state and is based on up to date research in these fields. The Community Service Manager for King County is responsible for supervising the program managers and working with the communities to ensure that service gaps are recognized and addressed within CHSW's resources and areas of expertise. In South King County the program is supported by a community management team which include the program manager,health coordinator, a home visiting coordinator, a family development coordinator, an early childhood mental health specialist and childcare center coordinators. The team meets at least biweekly. Supervision meetings with direct staff occur weekly in both individual and group supervision sessions. Each employee has his/her own performance plan with individualized goals and outcomes that assist them in achieving professional goals and ensuring quality services to the families. In addition, Family Resource Team members working with a family meet weekly to coordinate services. Page 5 1 Children's Home Society of Washington Strengthening Families Application to City of Renton April 30,2008 9. NEED FOR YOUR PROGRAM(2 page maximum) A. Problem Statement. Research has shown that family income levels have a negative impact on children's school readiness if not mitigated in some.way. More than half of children entering kindergarten in the State of Washington are not ready for school. The child who is not ready in kindergarten starts behind other children and tends to stay behind throughout their school years if they even stay in school. Children of poorly educated, low-income parents often don't reach the same intellectual level as children of wealthy parents because low-income families are preoccupied with daily struggles and do not have time to provide stimulating experiences that foster optimal brain development. These children may fail to fully develop the neural connections and pathways that facilitate later learning. As a result,they would be at a significant intellectual disadvantage and likely to require costly special education or other remedial services when they enter school. The population of young children in South King County is increasing in diversity. South King County has the highest proportion of families living below the federal poverty level and the highest percentage of single parent households of any region in King County. South King County also has the highest proportion of families on TANF (Temporary Assistance for Needy Families) and food stamps of all regions in the county. In Fiscal Year 2005 - 2006, there were 1,515 children and 880 adults in Renton receiving TANF benefits. Another indicator of families' economic need for services is the percentage of school aged children who are enrolled in the free or reduced lunch program. According to Office of Superintendent of Public Instruction's 2007—2008 Free and Reduced Lunch Enrollment Report(Renton School District vs King County Districts and all Washington School Districts), DSHS Client Services Report for FY 2006 and the U.S. Census Bureau 2006 American Community Survey the City of Renton/Renton School District has similar or higher proportion of residents in high risk groups than for King County. The following table compares these rates. Kent King County TANF recipients 4.2% 2.7% Free and Reduced Lunch Enrollment Rate 44% 31% Women age 15—50 with incomes below poverty and gave birth in past 12 1.0% 1.0% months Persons of color 26% 23% Latinos 7% 7% Income below poverty 10% 9% As the number of Latino families continues to increase, Strengthening Families will increase its capabilities to provide team members prepared to address the needs of these families as well as to provide resources that are appropriate to families' language, literacy, and acculturation levels. King County Developmental Disabilities Division estimates there are 1,200 children birth to four with developmental delays in South King County and less than half of them received services in 2005. Page 6 Children's Home Society of Washington Strengthening Families Application to City of Renton April 30,2008 B.Target Population. Identify and describe the population to be served by your program—both demographically and geographically. CHSW's Strengthening Families program serves pregnant women and families with children birth to five who have incomes at or below the federal poverty level or who,are eligible for public assistance and live in South King County(outside the Highline School District). The program targets its recruitment efforts to children and families with the greatest need. Based on n the recruitment/enrollment criteria approved by ' the Policy Council priority is given to: • families with a member diagnosed with a disability or developmental delay; • families transferring from another Early Head Start or Head Start program; • families who are homeless; • families referred by EHS partner organizations; • families residing in underserved geographic areas; • pregnant women or families with a newborn(prenatal to three months); • families who are English Language Learners; • • teen parent families; • and families with no medical coverage. For these families, early identification and access to comprehensive services is crucial to the promotion of healthy development and prevention of problems. In addition to these general characteristics, the program will also serve a significant number of Spanish-speaking families. The demographic profile of recruited - families will closely match that of the local low-income population, with the/added goal of recruiting a higher proportion of families of color,teen parents and families with children who have disabilities. Children's Home Society of Washington has a long history of success in reachingand recruiting low- income families that fit the Strengthening Families Early Head Start/Head Start.profile. The demographic profile of enrolled families is represented in Section 15. Children with disabilities have easy access to the ' program and currently comprise 11% of the program enrollment. • { Page 7 Children's Home Society of Washington Strengthening Families Application to City of Renton April 30,2008 W. PROPOSED PROGRAM/SERVICE A. Program Description. • (1) Type of services Strengthening Families has been serving South King County residents for nearly two decades by responding to a critical need for early childhood development services provided combined with economic development services through a coordinated support system that removes barriers to self-sufficiency. The project consistently demonstrates outstanding self-sufficiency and early childhood development outcomes for low-income families with young children. The program is family-centered and offers two options for service delivery: home based and child care center-based services. (2) Methods and locations CHSW's Strengthening Families project uses two basic strategies for helping low-income and isolated families with children age birth to five years achieve self-sufficiency and positive outcomes during early childhood: raise wages through training and education and remove barriers through an adequate support system that promotes positive early childhood development. The Strengthening Families project works one-on-one with each family to incorporate these strategies into a plan that effectively reduces the gap between what children need to thrive and the income their families can earn. • Raising Wages—Training and Education Families with inadequate educational levels or limited job skills or experience cannot achieve self- sufficiency without training and education. Strengthening Families is a comprehensive project dedicated to the economic development of families through resources that include but are not limited to: • Assess employment, education and training needs • Broker education/training referrals with voc-tech schools, community colleges and basic education programs and help with financial aid applications,registration and other barriers to enrollment • Provide job readiness training,job search skills training and employment counseling • Provide job development opportunities for job-ready families seeking employment • Work with Pacific Institute's STEPS to Excellence(a family motivational training) and Washington Women in Education and Employment job development training • Provide ongoing retention and career advancement services Removing Barriers Basic Needs Support Minimizing barriers creates the stability families need to maintain and pursue education,training and employment opportunities necessary to achieve self-sufficiency. Through`a network of on-site services, interagency agreements and referral systems,parents receive comprehensive support that responds to the needs of individual families identified through a Family Partnership Agreement. The Family Partnership Agreement is one of the cornerstones of the Strengthening Families project. The document is developed by the family with assistance from a Family Advocate and describes what the_ family and individual family members wish to accomplish within a specific time. It includes measurable goals, objectives, a timeline and a way to measure progress and goal attainment and serves as a single, coordinated plan that identifies family goals and resources needed to accomplish that plan. The Family Advocate may enlist help from a Work First caseworker, a child development specialist, a health nurse or other professional. These professionals work together as a Family Resource Team to define and ensure access to needed services, coordinate and monitor service delivery, advocate and broker for the family, and evaluate service outcomes associated with the Agreement. This approach is especially important for families with multiple challenges to achieving self-sufficiency that impact a child's healthy development. Page 8 Children's Home Society of Washington Strengthening Families Application to City of Renton April 30,2008 CHSW currently operates two child centers in South King County in Auburn and in Kent. Both centers operate from 6:30 a.m. to 5:30 p.m. and are licensed to provide child care for children birth to five. • Staffing ratios for CHSW child development centers meet or exceed federally mandated performance standards of no more than four infants or toddlers to each educator. Group,size does not exceed eight children. Both centers are accredited by the National Association for the Education of Young Children. CHSW's child development centers are located on bus lines to mitigate transportation barriers. Staff assist families needing assistance obtaining child care subsidies from the State of Washington or Green River Community College with available subsidies/scholarships to help with economic barriers. Responding to the influx of community members who do not speak English as their primary language, CHSW has staff fluent in Spanish, Russian, Chinese, and Arabic and accesses interpreters as needed in other languages. (3) Outreach Fewek than 2% of qualifying families with children age birth to three have access to Strengthening Families project services in South King County. The project maintains a waiting list among the remaining 3,000 eligible families with children ages birth to three who are seeking services. Recruitment and project awareness are conducted through a variety of strategies, including the agency's partnerships with community-based,public health and human service organizations located in South King County communities. Primary referral points are Public Health—Seattle &King County, Puget Sound Educational Service District, and response to semi-annual direct mail in partnership with DSHS. (4) How program relates to need Socio-economic factors that put children at risk for poor developmental outcomes in South King County are pervasive. These experiences are often intergenerational and they are becoming increasingly complex and severe. Recent studies, including those highlighted at the January 2006 conference convened by the , Committee for Economic Development, The Pew Charitable Trusts and PNC Financial Services Group, confirm that investments in early childhood education yield returns in economic growth and activity for years to come. The Strengthening Families project brings that research to practice by combining early childhood development and self-sufficiency strategies in a single coordinated plan in order to help families attain the resources they need to increase long-term economic stability and parenting capacity. (5) Program changes in 2009-10 and rationale CHSW has recently received a grant from the Office of Head Start to provide its SPARK(Strong Partners and Relationships for Kids)program which will be provided to parents ofEarly Head Start and Head Start eligible children. The program is based on the research of John Gottman and will provide workshops for Strengthening Families parents to learn communication and other skills that will improve their relationships with each other and thereby strengthen the family. (6) Collaboration with other programs and/or agencies The project develops and maintains partnerships with community, governmental and educational agencies that provide services or funding to assist families in attaining employment/educational goals; maintains a system to inform participants of job openings; and assures services are coordinated and unduplicated. CHSW partners with more than 30 organizations in the region and belongs to several coalitions, including the South King Council of Human Services. The organization holds multiple contracts and interagency agreements to provide the specific expertise of other agencies to the comprehensive array of services ' avail al ble to families through the Strengthening Families project. ( The project also works to collaborate and coordinate with agencies and services offering necessary supports to families as they prepare to transition out of Strengthening Families. - Page 9 Children's Home Society of Washington Strengthening Families Application to City of Renton April 30,2008 B. Performance Measures and Outcomes. Performance Measures: Children's Home Society will provide 10,800 home based child or family development visit services to low income children age birth to three in south King County with all funding sources. City of Renton requested funds would be sufficient to provide 115 home based child or family development visit services. A home based child or family development visit service is an interaction between a home visitor or family advocate with a family member(typically a mother or child) in which family development and/or child development services are provided. A center based child development day is one full day of child care plus the child and family development services that.are provided to the child and his or her caregiver. Goal 1: Improve the healthy development of children. Outcome 1A: By December 2009, 90% of children develop age appropriate motor skills. Outcome 1B: By December 2009, 85% of children develop age appropriate cognitive skills. Outcome 1C: By December 2009, 90%of children exhibit age appropriate social/emotional skills. Indicator: This goal will be measured using the Hawaii Early Learning Profile(HELP) and the Ages and Stages Questionnaire (ASQ) screening tool to determine age appropriate development skills. The appropriate tool is administered by the Home Visitor or Educator every six months to determine if the child is meeting developmental milestones. Children who are not achieving expected developmental milestones are referred to partner agencies who specialize in helping deal with development delays and/or disabilities in small children. Goal 2: Increase long-term self-sufficiency and capability of parents in South King County. Outcome 2A: By December 2009,70%of 200 parents/caregivers will demonstrate an increase - in attaining their employment and education goals. Outcome 2B: By December 2009, 40%of 200 parents/caregivers will demonstrate an increase in their income. • Indicator: This goal will be measured by client records determining starting levels at the time of enrollment and level of progress,toward employment and education goals. In addition, income at initial enrollment will be collected and will be assessed periodically to determine if family incomes increase. Data will be collected from client records. • Page 10 Children's Home Society of Washington I Strengthening Families Application to City of Renton April 30,2008 C. Staffing Plan & Evaluation. (1 page maximum) i. Staffing Plan. CHSW's Strengthening Families program is staffed by a 1.0 FTE program manager, a 1.0 FTE family services coordinator, 1.0 FTE home visiting services coordinator, 5.0 FTE family advocates, 2.0 FTE child development center coordinators, 14 FTE educators and 7.6 FTE home visitors. In addition, CHSW contracts with King County Work Training for the services of an economic development coordinator and Community Health Centers of King County for the services of a nurse health coordinator. Staff hold bachelor or master degrees in early childhood education or related field and have at least three years,experience in a child development and/or home visiting setting. Economic development and health coordinators have at least five years experience in their appropriate field. In addition, staff leadership have the following qualifications: • Nela Cumming, Program Manager, holds a MSW and has more than 20 years of experience in management and direct services in early childhood and family programs and is bilingual in Spanish. • Melanie Krevitz, Family Services Coordinator, holds a bachelor degree and has 12 years of experience supporting children and families in early childhood programs and is bilingual in Spanish. • MaryBeth Edmondson, Home Visiting Services Coordinator has 16 years experience with early childhood programs and has a master degree in early childhood education. ii. Evaluation. CHSW engages in two types of evaluation to measure success: qualitative/process and quantitative/ outcome evaluation. Ongoing process evaluation ensures that resources are targeted to those families in greatest need, analyzes barriers to program and/or client goal attainment, and ensures that the agency is able to effectively communicate measurable success to the public. Outcome evaluation is an intensive effort, including: tracking services, recording participant progress in relation to services received, and aggregating group data to measure the trends of effective programming. The Family Partnership Agreement tool measures goals and objectives over time as each family works to achieve self-sufficiency. Within 45 days of enrollment, the Hawaii Early Learning Profile (HELP), a national standardized child assessment tool, is completed on each child by the Home Visitor or Educator. The HELP is updated every three months to record the child's developmental progress. An Individualized Learning Plan(ILP) is also completed within 45 days of enrollment and updated every three months. In addition,the project utilizes another research-based tool,the Ages and Stages Questionnaire (ASQ)to screen each child at enrollment, and home visit or classroom observation forms. CHSW contracts with aPhD-level consultant who reviews, analyzes, and compiles data related to the goals and objectives of the Strengthening Families project. Data are used to inform program and strategic planning conducted by the management team and the Board of Trustees. Clients are involved in evaluation review through the governance structure described in Section I and participate in client satisfaction surveys on a regular basis. CHSW also evaluates the Strengthening Families project by conducting a self-assessment which includes: key informant interviews, group interviews, surveys, observations, and document reviews Page 11 Children's Home Society of Washington Strengthening Families Application to City of Renton April 30,2008 D. Differences in Service Delivery by City. (2 page maximum) Explain any differences in service delivery for this program among the cities that you are submitting this application to for funding. Explaimany differences in the average cost of service per client relative to funds requested by city as shown in the last column of Question 14c. There are no significant differences in the delivery of service based on geographic location of the clients served. Services are either provided in the families home or at one of the CHSW's two child development centers. Service unit costs are based on the average cost of home visits and child care days. While Children's Home Society of Washington is only requesting funds to help pay for a portion of the salary of one home visitor and one educator the services provided families include case management which is tailored to each family's strengths and needs. • Page 12 Children's Home Society of Washington Strengthening Families Application to City of Renton April 30,2008 11. LONG RANGE PLAN (1 page maximum) In this section you should describe your long range plans for this program. Discuss your plans for future service delivery, collaboration, and other sources of continued funding for the program. What funding sources do you anticipate this program will have in,the next three to five years? CHSW's dream for early learning is that every child in Washington has the opportunity from birth to reach Iiis or her full potential to be successful in school and in life. Our vision is that in a world where all children thrive, children will have the support,knowledge and skills they need to reach their full potential. Parents, educators and communities will have the support and skills they need to raise healthy children. While CHSW recognizes that high-quality early learning is critical to all children, our strategy is to focus first o1 those that are most vulnerable. We strive to engage these children,their parents, and caregivers in comprehensive early learning services—whether that be at home or in a child care setting. In South King County, CHSW plans to enhance its early learning services by adding PlayBright Learning group. These groups combine the Play and Learn group parent-child activity model with CHSW's own PlayBright Learning System curriculum. PlayBright is an early childhood curriculum based on early brain development research. This curriculum was developed to help parents, caregivers, and other early learning professionals to understand how to apply the latest early brain development research to their every day activities with children to enhance age appropriate development. Page 13 Children's Home Society of Washington Strengthening Families Application to City of Renton April 30,2008 12. BUDGET(2 page maximum) The budget section of your application pertains to the information provided in Question 17 of your application. A. Budget Request Narrative. City of Renton funds will be used to support a portion of the salary and benefits for one Family Advocate and one Home Visitor as well as a portion of the administrative cost for this program. The majority of the funding for this program comes from a federal grant which requires a 25% local match. Funding from local funding sources helps CHSW to reach this match requirement. If CHSW is not able to meet the match requirement, the federal grant is reduce by$3 for each$1 of match we are not able to.raise. B. Changes to Budget. Explain any significant changes between 2008, 2009 and 2010 expenses or revenues as noted in Question 17. Are there any known or anticipated changes to the program's 2008 Budget since adopted? Program expenses are increasing in 2009 and 2010 due to increases in personnel costs and in occupancy costs. CHSW as raised salaries for many employees in response to a market salary analysis that brings staff salaries C. Cost per Service Unit(s). You should provide an estimate of your cost per service unit provided by the program you propose. Explain how your cost per service unit was determined. These should be based on the total cost of the program and the total number of clients served,not just the funds requested. You have the option of providing a cost per service unit for each separate service provided within the program. Cost Per Service Unit: $110 per home based services $124 per center based services Explanation of how determined: . The cost per home based service unit was determined by taking the expenses for the home based portion of the budget and dividing it by the number of home based services to be provided in a year. Similarly the center based service unit was determined by taking the expenses for the center based portion of the budget and dividing it by the number of center based services to be provided in a year. Service unit costs include the additional resources provided by program staff who are not included in the request to the City of Renton. These include the direct services of the family advocate, economic development coordinator, and health care coordinator. Page 14 � I Children's Home Society of Washington Strengthening Families Application to City of Renton April 30,2008 . Data Table Requirements (Questions 13 — 18) The following documents contain all the data tables you are required to submit with your application. If you are submitting an application to continue an existing program, complete the following data tables with information pertaining only to this application. If you are submitting an application to fund a new program for your agency or forming a new agency, organization or a team of agencies and you do not have client data which is specific to your proposed program, fill out the data tables with information pertaining to what you predict your program will accomplish (projected). Explain in the applicable questions in the narrative for your program and how the numbers for each data table were determined. 13. NUMBER OF INDIVIDUALS /_HOUSEHOLDS SERVED (DATA TABLE) Provide the number of individuals or households your program serves. The columns should be an unduplicated count of clients served from all funding sources as indicated. For example, someone may have attended a group meeting in March 2007 and then received direct,personal service in October 2007. Such a person should only be counted once when they first received services in 2007. If the group meeting was for one program at your agency, and the direct personal service was offered through another program at your agency,you can count this individual once for each program. Do not double-count a ,;)erson who received the same type of service more than once. For example, a woman who received a physical exam in January and a mammogram in March would only be counted once if both medical services are part of the same program. All clients should be counted as an unduplicated user the first time they receive services in a calendar year. A client who received services from the same program on 12/31%07 and 01/02/08 would be an unduplicated user for the 01/02/08 visit. The 2007 % of column 1 clients served by city is the number of unduplicated clients served in 2007 by city, divided by the total number of unduplicated clients served in 2007. The total of this column will equal 100%. The final column represents the unduplicated number of clients that will be served with the funds requested by city in this application. You will be required to serve that number of clients if fully funded. For example, your program has a total of 900 unduplicated clients served in a city. If you are requesting $10,000 to provide services to 90 unduplicated clients with the funds requested with(the remaining 810 clients to be served with another funding source), 90 would be shown in the last column for this city. Page 15 Children's Home Society of Washington Strengthening Families Application to City of Renton April 30,2008 Agency: CHSW Program: Strengthening Families 13. NUMBER Of INDIVIDUALS/TIOUSEHOLDS SERVED BY PROGRAM ® Individuals? or ri Households? (Check which applies and use for reporting all demographics.) Unduplicated *Unduplicated Number of all Clients Served by Clients Served All Funding Sources with Funds Reguested 2007 2009 2007 %of column 1 2008 2009 (Actual) clients served (Anticipated) (Projected) (City Requested by City Funding Only) Auburn 153 28% 156 159 8 Burien 0 0% 0 0 0 Covington 9 2% 9 10 0 Des Moines 4 1% 4 4 0 Enumclaw 1 0% 1 1 0 Federal Way 43 8% 60 62 4 Kent 212 38% 219 224 8 Renton 25 5% 34 35 4 SeaTac 2 0% 2 2 0 Seattle 2 0% 2 2 0 Tukwila 14 3% 15 15 0 Ie�e�zi:I:,kC�,.�;�"�in,: ';.rtt�p��t�yr,,;.���aco- Other 84 15% 73 75 M :z r ,,rti;',;E w i,, ,r.; rt.l�A.1.�y1'1i 11��11: T;h:�51:�.1.�'L.�t ;itt%rh{I�wf ytlii' G'!'„Yl.:,f,r.IJ�hii��l''�..�it;?r r^�I!i' �..9C+I"'ru-_'u'�:k(i', 100% Total 549 (This column must 575 ' 589 24 total 100%) *Unduplicated means count each client only once per calendar year per program. This number should match the number of clients by city indicated in the top row of Question 15. Page 16 i Children's Home Society of Washington Strengthening Families Application to City of Renton April 30,2008 Agency: CHSW Program: Strengthening Families 14. Performance Measures & Average Cost of Service (Data Tables) This information will be used by each City to develop 2009-10 contracts with funded agencies. 14a. Your Performance Measures should'reflect numbers based on the funding you are requesting from each City. 14b. In the space provided, define at least one(1) and no more than three (3)performance measures the program will report with a brief explanation. Do not use Unduplicated Clients/Households as a performance measure. Provide the estimated number of clients/households served by city your program plans to provide in the corresponding column for each of the performance measures listed. Estimate the number of units to be provided for each measure annually. Provide accurate and realistic estimates. These estimates will be the basis of your contract if funded. 14c. Complete the table with the city funds requested in Question 6 and the unduplicated clients served with funds requested by City listed in the last column of Question 13. Explain any differences between the average cost of service per client between cities in Question 10.D. of your application. Example of Completed Data Tables 14a: • 14a. • Service with 2009 Requested Funds Proposed Performance Measures as listed below. A) Meals Delivered B) Case Mgmt Hrs C) Auburn 7,000 75 Burien 5,000 50 1•- .A:iii:� - -J�..air. - -- :.•1S.•a .0- . yt. i+%hA �r� 'ance=Measure_20.0�:•Pro"'osed-�,Cy :Re'>uested�Fu d 1"` Title: Brief explanation: A) Meals delivered One meal delivered counts as 1 service unit. Will include intake, assessment, planning, advocacy and evaluation --, B) Case management hours of results. Page 17 • Children's Home Society of Washington Strengthening Families Application to City of Renton April 30,2008 Agency: CHSW 14. Performance Measures (Data Table) Program: Strengthening Families 14a. Service with 2009 Requested Funds Proposed Performance Measures as defined below. A) Home Visit B) Child Care Day C) Auburn 91 81 Burien 0 0 Covington 0 0 Des Moines 0 0 Enumclaw • 0 0 Federal Way 68 60 Kent 114 101 Renton 57 50 SeaTac • Seattle Tukwila 44h1P.Nrifcillii4ifevimea,stio:00,09,4troboctiyvipoiligg,,ieoot6switylittitwoloy4.!vp,FNA Title: Brief explanation: A home visit is a meeting with the parent and child and a home A) Home visit visitor or family advocate to work on family development and child development goals B) Child Care Day A child care day is one day of comprehensive child care with licensed child care educators providing child development services C) Page 18 Children's Home Society of Washington Strengthening Families Application to City of Renton April 30,2008 Agency: 14 Performance Measures (Data Table), Cont. Program: 14c. Average Cost of Service Unduplicated Clients Served with Funds Average Cost of Service Requested 2009 Requested 2009 per Client (Same as last column of (Same as last column of Question 6) Question 13) Column 1 divided by Column 2 !Example: $5,000 45 $111.11 Auburn $25,000 8 $3,125.00 Burien Covington Des Moines :numclaw Federal Way $12;500 - • • $3,125.00 Kent $25,000 $3,125.00 Renton $12,500 $3,125.00 SeaTac Seattle Tukwila I . Page 19 Children's Home Society of Washington Strengthening Families Application to City of Renton April 30,2008 Complete Question 15 with 2007 Actual numbers reported in column 1 of Question 13. Agency: CHSW cs 15. Demographics (from all funding sources) (Data Table) Program: Strengthening Families c) .- .i:tdli6iit1Z4gideb.c 0 c,.::,Ji .O.:. ,,, aD .i cn § 43 •0 t' t -,1 i C.) Ilitcl4*-404 ' 040K4#0 . Individuals E=1:00441.4; 4:6i.ileitii'ir2ool :_;••, ;„:„„4,:,*,,,:::.:::,;:,:,,,, ,- • Aiiik(01i60i11,6eri,':',;:agf,';:;,?::;:: ::2 g-gi°?''.'t.i: :k4,,Mgliv4:24gni.'-:ii''. :i1:;N 4::t'; --fRi, 30%of Median or Below .127 0 8 4 1 37 153 21 2 , 0 14 367 50%of Median or Below 26 0 1 0 0 6 59 4 0 0 0 96 80%of Median or Below 0 0 0 0 0 0 0 0 0 0 0 0 Above 80%of Median 0 0 0 0 0 0 0 0 0 2 0 2 Unknown 0 0 0 0 0 0 0 0 0 0 0 0 TOTAL 153 0 9 4 0 43 212 25 2 2 14 464 104460N234,4deR, : ;, ; 4.a , -,, ,b ,, ,, -,,;n, Male 39 0 1 0 0 ' 8 55 4 0 2 3 112 Female 114 . 0 8 4 1 35 157 21 2 0 11 353 TOTAL 153 0 9 4 1 43 212 25 2 2 14 465 k ' !;1-416V: ''',0i:f ';;;M2 -,, :i;:....1 ':';V::!:: :'_.-.H'-i0;`,aP-itagAI:'24- ff5,:,!'11:Wi', :: '!T-gkl' i,--' ' ' t'10;ALT':'*Pi:OVA 0-4 years 64 0 5 1 1 16 80 11 1 1 6 186 5-12 years 27 0 1 0 0 6 35 5 0 0 3 77 13- 17 years 0 0 0 0 2 0 0 0 0 0 2 _ . 18-34 years 52 0 3 3 0 17 76 9 1 1 5 167 35-54 years 10 0 0 0 2 21 0 0 0 0 33 55-74 years 0 0 0 0 0 0 0 0 0 0 0 75+years 0 0 0 0 0 0 0 0 0 0 0 Unknown 0 0 0 0 0 0 0 0 0 0 0 TOTAL 153 0 9 4 , 1 ' 43 212 25 i 2 2 14 465 JWPJiMa=adtSgO4V ;MaaBM'VPTIZgrNOE125nnagNAW7 Asian 01 0 0 0 0 17 0 0 0 3 20 Black/African American 5 0 2 0 0 0 30 5 0 0 0 42 Hispanic/Latino(a) 31 0 6 4 0 5 38 11 0 0 10 105 Native 5 0 0 0 0 13 0 0 0 0 18 American/Alaskan - Pacific Islander 0 0 0_ 0 0 . 0 0 0 1 1 White/Caucasian 104 0 1 0 0 38 110 2 1 , 2 0 258 Other/Multi-Ethnic 8 0 0 1 0 4 7 1 0 0 21 TOTAL 153 0 9 4 0 43 212 25 2 2 14 464 finiiiii14606 .67 0 6 2 1 17 42 14 2 0 4 155 44:0000415 AROWNWOW 9 0 1 0 0 4 25 4 0 0 3 46 ;-- . Thi#0040.01':71:-:' ,1 67 0 2 3 0 10 60 5 0 0 5 152 NiM410.62:i'Zike;ti:i' . Page 20 Children's Home Society of Washington Strengthening Families Application to City of Renton April 30,2008 ( *Check Individual or Household,which should be the same as checked in Question 13. Unduplicated means count each client only once per calendar year. This should match the number served by City in the Actual 2007 column of Question 13. The "total"jcolumn will be different from Question 13 since the"other"column is not included due to space limitations. 16. PROGRAM STAFF (DATA TABLE) In this data table, record the number of full-time equivalent(FTE)paid staff and volunteers for this program. FTE means a 40-hour week throughout the entire year. For example, if you enter"5" in the box for Number of Volunteer FTEs, this would mean that you have, on average, five volunteers assisting your program at all times (assuming a 40-hour week). If yoi..know only the,total number of hours contributed by all volunteers for this program, simply divide that number by 2,080 to find the total FTE number. For example: 5,000 volunteer hours over the course of a yeai, divided by 2,080 equals 2.4 FTEs. 2007 2008 2009 (Actual) (Budgeted) (Projected) Total Number of Staff(FTEs) 14.13 14.2 14.2 Number of Volunteer(FTEs) 8.65 8.65 8.65 Actual Number of Volunteers _220 _220 _220 17. PROGRAM REVENUE & EXPENSE BUDGETS (DATA TABLE) Program Budget: All columns should include total program operating revenue and expenses. Complete the following data tables with figures indicating the source of program operating funds for 2007 (actual), 2008 (budgeted) and 2009 (projected). Budget amounts should match funding requested (Question 14c) and Question 5. Include an explanation of any significant differences between the revenues and expenses by year in Question 12B of your application. Page 21 I � Children's Home Society of Washington Strengthening Families Application to City of Renton April 30,2008 • Agency: CHSW 17. PROGRAM REVENUE BUDGET (DATA TABLE) Program: Strengthening Families Revenue Source 2007 2008 2009 (Actual) (Budgeted) (Projected/ Requested) , Mit-PRVIME,F12821V5MinininROPWARMR1 City Funding(General Fund & CDBG) 11,,,:,4%.,, ,14,2,40:rint zegto,w,c0.004-ife49mhavi": ,:,h; NANVEMERVMiN_WWMWVONVAAP461A4KWaLM • Auburn 10,000 10,000 25,000 • Burien 0 0 0 • Covington 0 0 0 • Des Moines 0 . 0 0 • Enumclaw 0 0 0 • Federal Way 5,000 5,000 12,500 • Kent 10,000 10,000 25,000 • Renton 12,356 12,356 12,500 • SeaTac 0 0 0 • • Seattle 0 0 0 • Tukwila 0 0 0 • Other(Specify) • • Other(Specify) . ..._. . . __ . 1, ,itpot,q,,, Other Government Funds :irquivionial 4.1140 l'!0*tjig MARIMMATA 4 • King County 0 0 0 • Washington State 0 0 0 • Federal Government(Specify) HHS,USDA 932,668 932,669 932,669 • Other(Specify) 4gglf5WWWWPWWWWIIIINOW441;141 Private Sources 4,!,;ET-4,,4:0Aiii tofiA,0410*MOIJAIlicki,40,,,w fiegimiimpa00:44 viwAli:FitattflAtionuid:vaiimmIWOOlg ;$561,03Mitital4 • t,United Way(grants &designated donors) 1,548 1,548 1,548 • Foundations and Corporations 0 0 0 • Contributions(e.g., Events, Mailings) • Program Service Fees (User Fees) 0 0 0 • Other(Specify) Board designated funds ('07) Fundraising goal (foundation, 3,898 130,696 107,472 corporate and individual combined) ('08) TOTAL PROGRAM BUDGET 975,470 1,102,269 1,116,689 Page 22 Children's Home Society of Washington Strengthening Families Application to City of Renton April 30,2008 , - 17. PROGRAM EXPENSE BUDGET, CONT. Agency: CHSW (DATA TABLE) Program: Strengthening Families , (-- Expenses 2007 2008 2009 i (Actual) (Budgeted) (Projected) Personnel Costs 1:51MV-,;,;airilift.nEtif 1,0-finuoKl!?:==n-waiNzvi:ri-fil-0 lalgt :112t54 'U A:Vi-:„4--.-'-a;,,lia:',;-,-IZit,.4-:,r4 4'.ti:Y,44: • 'Sa1aries 474,017 501,257 511,282 • benefits 113,764 120,302 122,708 • 'other i • Total Personnel 587,781 621,559 633,990 1 Operating and Supplies 11111e , :15NF 2 gin'IMIII:,,IM,I T;(:i6.7ifl;'0;1'Pla • Office/Program Supplies 16,422 17,000 17,000 • Rent and Utilities 19,059 21,031 , 21,031 • Repair and Maintenance 10,546 12,391 12,391 • Insurance 9,518 4,500 4,500 • Postage and Shipping 948 1,800 1,800 1 , • Printing and Advertising 4,060 5,700 5,700 • Telephone 15,758 13,090 13,090 • Equipment 0 0 0 1 • Conference/Travel/Training/Mileage 26,580 31,700 31,700 • Dues and Fees 791 1,821 1,821 • Professional Fees/Contracts 195,161 185,000 185,000 • Direct Asst. to Individuals 11,126 12,000 12,000 • Administrative Costs 149,926 152,037 154,026 • Other(specify) • Quality Improvement, IT, Misc 12,855 22,640 22,640 i • , • 1 TOTAL PROGRAM EXPENSES 1,060,531 1,102,269 1,116,689 - Net Profit(Loss) -85,061 0 0 I (reyenue-expenses) = Page 23 ! Children's Home Society of Washington Strengthening Families Application to City of Renton April 30,2008 Agency: CHSW 18. SUBCONTRACTS (DATA TABLE) Program: Strengthening Families List all the agencies you will be subcontracting with for this program. Provide the agency name in the first column, a description of the contract/service in the second column, and the contract amount in the third column. Do not list agencies you coordinate with on a referral only basis. Indicate not applicable if you do not subcontract for any part of this program. Subcontracting Agency Specific Subcontracted Activities Contract in the Operation of Your Program Amount Community Health Centers of King Health Coordinator services, health screenings $77,770 County King County Work Training Economic Development Specialist services,job $40,145 readiness training, Nutrition Services $14,455 Washington State University Mental Health Consultation and referral $28,000 Julie Anne Nagel coordination Page 24 • Children's Home Society of Washington Strengthening Families Application to City of Renton r' April 30,2008 19. APPLICATION CHECKLIST Applications missing one or more of the following components or not following these directions'may not bei reviewed. Sign and submit the application checklist with y.our•application. ' Contents (Your application should contain each of these items in this order.) • ® Application Cover Pages.The top three pages of your application must be a completed copy of the . Agency Information and Questions 1-7. • Application Narrative: . E.'Question 8 Organizational Experience(2 page maximum) ® Question 9 Need for Your Program(2 page maximum) ® Question 10 Proposed Program/Service(6 page maximum) ® Question 11 Long Range Plan(t page maximum) ' • ® Question 12 Budget(2 page maximum) • . Data Tables.. . - . • // Question 13 Number of Individuals/Households Served . ® Question 14a-c.Performance Measures and Average Cost.of Service ® Question 15 Demographics(from all funding sources) • ® Question 16 Program Staff ® Question 17 Program Revenue&Expense Budgets II Question 18 Subcontracts -• . ® Required documentation.Supply one copy of the following.required documents with the signed original application. See,Part II: City Specific Supplemental.Information to determine whether additional copies of the application and required documentation need to be submitted. • ® Question 19 Required Documentation, including: ■ Proof:of non-profit status • . • ■ . Organizational Chart • Agency/Organization Mission Statement . . . • .Board resolution authorizing submittal of the application(tray be submitted up to 60 days•after . application). . • . . . . • List of the current governing board and local board,if applicable;(include name,position/title,. city residence,length of time on the Board,and expiration of terms..Note any vacancies.) • Board Meeting.Minutes of last three board meetings of governing board and local board as . applicable • Annual Budget . • • ■ Financial Audit Cover Letter • Financial Audit Management Letter ■ Financial Statement•;. . • Verification of Non-Discrimination Policy ' .. . • Program Intake Form • Sliding Fee Scale ' El Application Check List:(Signed below.)' ' ® City Specific Supplemental Information.Required hi 'Name: Trish Crocker Part II for pplicable City only. • • Position: Grants'Manager• - " ' ' • . Phone#: (206)69.-3226 E-mail:trishc@,chs-wa.org Sig ature of Person Completing Checklist DOS NOT SUBMIT ANY OTHER MATERIALS WITH THIS APPLICATION Page 25 Children's Home Society of Washington Strengthening Families Application to City of Renton April 30,2008 2. Describe how the program outcomes as identified on page 9 of the application narrative will help achieve the selected Result. Outcl omes 1A- 1D as listed on page 10 were developed based on the research of Dr. McKenna. This research has helped program staff to identify individual strengths of children's developments as well as areas where children are below age appropriate ability. These assessment tools help staff identify when additional resources are needed because of a potential developmental delay. The Home Visitors and/or Family Advocate complete assessments at regular intervals using the Hawaii Early Learning Profile on infants and toddlers. Twice each year,the Home Visitors identify on a scale of 1 —7 how well each child is meeting outcomes for age appropriate development in each of seven domains: language, cognitive, social/emotional, fine motor skills, gross motor skills, self help, and emerging literacy. The Strengthening Families Early Head Start program has shown consistent success in meeting,child outcomes. Below is a comparison of assessment date from 2005, 2006 and 2007 showing the percentage of children meeting the outcome for the listed domain. Domain 2005 2006 2007 Cognitive 83% 93% ' 88% Language Acquisition 77% 75% 82% Literacy 79% 89% 86% Gros Motor 92% 93% 90% Fine Motor 89% 86% 88% Social/emotional 90% 96% 92% Self help 92% 95% 91% Page 27 JPt:Y _ 2 197373 • • -7 1740 January 11, 1973 428:RLW vtltr‘..1.4 Childress Home Society of Washingtc • 1 • c/o Elizabeth T. Bannister 3300 N.E. 65th Street Seattle, WA 981L5 • • 1 Gentlemen: This is in reply to your letter dated January 2, 1973. In accordance with your request, we have enclosed a copy of your original ! ** determination letter. This states that •you are exempt from Federal- income tax under section 101(6) of the Internal Revenue Code of 1939. This sectic corresponds to section 501(c)(3) of the 1954 Code, which is the current. According to our records, your organization has been classified as an organization which is not a private foundation under section 509 •(a)(1) • of the Internal Revenue Code because- it is an organization described in section 170(b)(1)(A)(vi) of the Code. If we can be of further assistance, please advise. Very truly yours, • • Ikkila G.A. Kirkbride . • Exempt Organizations Supervisor • Enclosure - (206) 442-4768 • • ** Date of original determination letter: September 20, 1949. Address any reply to: JlAul d4UU . pa @a a e GaE@GI3 Ofi a® T em nc • . P tiORGOGik oainel G internal Revenue Service• . Date: In reply refer to: 428 November 9; 1973 L-225, Code XIX Children's Home Society of Washingt ° 3300 Northeast 65th Street P. 0. Box 15190, Wedgewood.Station • Seattle, WA 98115 • Date of Exemption: 9-21-449 Internal Revenue Code Section: 501(c)(3) • Gentlemen: •Thank you for submitting the information shown below. We have made it a part of your file. The changes indicated do not adversely affect your exempt status and the exemption letter issued to you continues in effect. Please let us know about any future change in the character. purpose, method of operation, •name or address of your organization. - This is a requirement .for retaining your ,exempt status. Thank you for your cooperation. • • Sincerely yours, . To } IteW Changed From Name Washington Children's Children's Home So • Home Society of Washington • • . Auniotriate steps and action have been Laken to make all corrections • pertaining to your name change. - Form L-225.(Rev. CHSW - Seattle Office CHILDREN'S HOME SOCIETY April 2008 Washington Board of Trustees Executive Assistant • Bethany Gower President/ Catalyst for Kids Nancy Roberts-Brown Chief Executive Officer Sharon Osborne Communications Team Public Policy Laurie Lippold Vice President Vice President of of Marketing & Vice President of Vice President of Chief Financial Strategic Planning& New Communications Operations Development Officer Business Development Danny Howe Randy S. Perin Peg Mazen Jim Laugen Rommel Buenafe • -41 CHILDREN'S CHSW Operations HOME SOCIETY April 2008 Washington Vice President of Operations Randy S. Perin Administrative Coordinator Adam Draeger Administrative Facilities Admin/Purchasing Specialist Ron Harowicz Specialist Kathy Gill Julie Murphy I I I Community Service Core Service Director Director of Director of Director of IT Manager Administration . Human Resources Wouter Marilyn Detrick Michelle C.Langstaff Van Wageningen King County Adoption Terry Zimmerman Mike Fitzpatrick Spokane Child & Family Counseling Patt Earley Douglas Head Tacoma Early Learning Nancy Taft Cathy Garland Walla Walla OHC Richard Pankl Susan Maney Wentachee Family Support Douglas Head Mike Fitzpatrick Ts? CHILDREN'S NW Region - King County HOME SOCIETY April 2008 Washington Vice President of Operations Randy S. Perin Community Service Manager King County Terry Zimmerman I Office Services Early Childhood Cobb Center Accounting Manager Program Manager Specialist Gail Powers Nela Cumming Cottage A Michelle McInnis Program Manager Maintenance Early Head Start Cottage B Tech III (South King &Walla Program Manager Rodney Walla) Severance Head Start Child Development Cottage C Administrative Centers Program Manager Specialist II RJC & SMC Court Nicole Bates Drop-In Child Care Centers . _ . ,. _ ., . ,_," Tow, J••�.. Kin CHILDREN'S g County Early Learning HOME SOCIETY Programs Washington - Program Manager Early Head Start Nela CummingApril 2008 Policy Council Child Development South•King& Walla Coordinator Walla,Parents& Jan Wingo Community Representatives A member of PC is also a KCDC member of CHSW Board Site Supervisor of Trustees Sandy Cameron Melanie Krevitz Robin Bambaloff Data I Family Services GRCDC Center Coord Specialist Coordinator Wendy Price EHS Educator I Mary Seth Edmondson Alla Khryukina Home Based Services Yulia Beltran Center Based EHS Educator Coordinator EHS Educator Family Janie Burton I Abby Ajero Advocates Alicja Wanot • Alice Flores Cindy Morris Jennifer Hernandez Support Team: CHCKC Health Home Visitor Lisa Lamb Sarab Muhyaddin Terri Cam man Nicole Boone Asst Educator Coordinator Camp man Sharma Hanft-Rife Home Visitor Litia Leiataua Victoria Kantner Katie Westlake KCWTP Economic Erika Mitchell Debbie Still HS Educator Sandi Werner Development Bilingual Home Visitor HS-Kent Kim Moulden Coordinator Telma Dumitru Pires Educator Julie Friend Lisa Ferguson Brigid Cabellon Bilingual Home Visitor Assistant Kimberly Peterson Birth to Three Magaly Ortiz Oksana Zolina E/HS-GRCC Amanda Wendt Tara Thomas Bilingual Home Visitor HS Educator Rebekkah Gonder HS Assistant Special Needs OPEN Adell Cook Educator Coordinator Home Visitor WSU CoopExt Benaz Amin Angel Bryant Drop-In Nutritionist Dawna Gross Jon Germano Childcare Admin Specialist Gayle Alleman Pre-Natal/Family Advocate Admin. Specialist Centers Mary Deede Mental Health Lynne Van Cour Linda Spears Food Svc. Specialist - Consultant Family Advocate Food Svc. - Ginger Rang Julkie Nagel George Correa Specialist Transportation Specialist Elaine Williams Donna Jorgenson • • ADMINISTRATIVE HEADQUARTERS 3300 N.E.65th Street @_to. P.O.Box 15190 Seattle,WA 98115 • (206)695-3200 Main s DREN'S (800)456-3339 Toll Free l E SOCIETY (206)695-3201 Fax www.childrenshomesociety.org ,Washington Children's Home Society of Washington OFFICERS • CHAIR Dan Merlin() VICE-CHAIR Mission: To develop healthy children, Cliff Eric Gr elnwood ey TREASURER create strong families, build engaged SECRETARY inia RPRESIDENT/CEOoot communities, and speak and advocate Sharon Osborne for children HONORARY LIFETIME TRUSTEES ' Linda Ashlock - Lyman H.Black,Jr. Joseph C.Donoghue H.Graham Gaiser Joan Hutson Dan Merlino She,^^,borne Gail' Joh ,__.:bins Leo G.Smith Patricia Sundquist TRUSTEES Vision: A world where all children Mark Aldridge T Brett Allen thrive e Jacque Cabe Richard Corella Stephen Dennis Barbara Jirsa • • Pam Kaiser • Rod Kaseguma , Otto Klein Andrew MacDonald Ihssane Mounir Gayle Murdock • Tom Oldfield Bev Press • Joseph Wilds John Williams - 1 Unay it µ CI��IRP � CHILDREN S,ALLIANCE Childrens Home Society doe,anwwd CamMunhy Patna -- IFCW OF AMERICA Pnx�m ADMINISTRATIVE HEADQUARTERS • 3300 N.E.65th Street •; I LAP' • P.O.Box 15190 Seattle,WA 98115 (206)695-3200 Main 1, IL DREN'S (800)456-3339 Toll Free Hr 206)695-3201 Fax_, SOCIETY www.childrenshomesociety.org Washington Board Authorization OFFICERS Board Authorization will be provided following the April 25 Board of Trustee CHAIR Dan Merlino meeting VICE-CHAIR Cliff Tingley TREASURER Eric Greenwood • SECRETARY Virginia Root PRESIDENT/CEO Sharon Osborne - • HONORARY LIFETIME TRUSTEES Linda Ashlock Lyman H.Black,Jr. • Joseph C.Donoghue H.Graham Gaiser Joan Hutson Dan Merlino ; • Shr --^.-borne Gat. Joh'' :Dins • • Leo G.Smith Patricia Sundquist • • TRUSTEES Mark Aldridge Brett Allen Jacque Cabe Richard Corella - Stephen Dennis Barbara Jirsa Pam Kaiser Rod Kaseguma Otto Klein Andrew MacDonald • Ihssane Mounir Gayle Murdock Tom Oldfield Bev Press Joseph Wilds John Williams • • • • • 471 United�r ndata NALI,:$ .Way �-`ail�M�" �v Chiidren$H me Society tiAreau.<inie e GHILDREN'S ALLIANCE fumGfYM1IQ'DaMtt 1 „- IFCW OF.AMERICl1 Irogmm. • CHSW BOARD OF TRUSTEES 2007/2008 (ACTIVE) '"�y'"�\.•`��0���..,=>;�e_. ..�F�':: a-���O,��i� '�i =i�*:�a°' �. ��< •=a ate. \\\� �; c' :i:•. .s • �.. \�`�' ... :3 a:: `:•��c:, y yea,�.� \`� �.�3:,s,;. :::�,�' ������(� .. ��`�•,o```,•,� �;,;».. ;�t#S o.� T\E*.�='1���\�: ..•Y��° '�,�d', `5.;._.�a�..�'< U.��°OI�1 tt��Sw. '¢ ALDRIDGE, MARK Trustee Baseline Industrial Construction Portland, OR 2005 - 2008 Business owner; community leader ALLEN,BRETT Trustee Entrepreneur;financial planning Seattle, WA • 2005 - 2008 Business management; community leader BOT cmtes: Finance, Foundation ASHLOCK,LINDA Honorary Trustee Healthcare professional(retired) Liberty Lake, WA 1990 - lifetime Business management, community leader BOT cmtes: Executive,Volunteer Development, • CABE, JACQUE Trustee KPMG LLP,Partner(CPA) Seattle, WA 2000 - 2008 Finance professional BOT cmtes: Executive,Finance, CHSWAM CORELLA, RICHARD Trustee Business management, sales Enumclaw, WA 2006 -2009 Community leader BOT cmtes: Foundation DENNIS, STEPHEN Trustee Rosemont Partners (owner) Bellevue,WA 2005 -2008 Retired Quadrant Homes CEO; real estate BOT cmtes: Foundation DONOGHUE,JOE Honorary Trustee Real Estate professional(retired) Bellevue, WA 1979-lifetime Business management;real estate BOT cmtes: CHSWAM GAISER, GRAHAM Honorary Trustee Lawyer(retired) Bellevue, WA 1980 - lifetime Business management, financial planning • BOT cmtes: Executive,Finance, CHSWAM GREENWOOD,ERIC Treasurer(2008- Finance professional(retired) Woodinville, WA 2010) Financial planning;professional clown 2004 - 2007 BOT cmtes: Board Development,Finance JIRSA,BARBARA Trustee A La CART(owner) Sammamish, WA 1993 -2009 Marketing; advocacy BOT cmtes: Public Policy(delegate),Foundation KAISER, PAM Honorary Trustee Community Leader Bellevue, WA 1985 - lifetime BOT cmtes: Executive,Board Development(delegate) KASEGUMA,ROD Immediate Past Chair Inslee,Best-Doezie&Ryder(partner) Bellevue, WA 1993 -2008 Attorney, community leader BOT cmtes: Executive, CHSWAM 1 CHSW BOARD OF TRUSTEES 2007/2008, (ACTIVE) ,..,. .......,. . .ram.v,, : '.�i�..,,�..T•a�; \ ^. '":v o:\•� .�\.�� `;,�,.. � ��a •� : � .. .,,.�. ..,.. � KLEIN, OTTO G. Trustee • The Summit Law Group (attorney) Seattle, WA, 2005 - 2008 H.R.professional; business management BOT cmtes: Board Development,Personnel Delegate MACDONALD,ANDY Trustee ECG Management Consultants (CEO) Seattle, WA 2005 - 2008 Business management; community leader BOT cmtes: Executive,Foundation MERLINO,DAN Chair(2008-2010) ECG Management Consultants (Pres) Seattle, WA • Business management; community leader Honorary Trustee BOT cmtes: Executive 1987 - lifetime MOUNIR, IHSSANE Trustee Boeing(Country Executive) Hounslow, Middx. 2003 - 2009 International sales/commercial airplanes - BOT cmtes: Foundation OLDFIELD,TOM Trustee Sloan,Bobrick,Oldfield&Helsdon,P.S. University Place, WA 1997 -2011 Attorney; real estate; community leader BOT cmtes: Executive, CHSWAM OSBORNE, SHARON Honorary Trustee CHSW, CHSWAM(Pres/CEO) Seattle, WA 1989 - lifetime Business management; community leader BOT cmtes: Executive,Finance,Board Development, Volunteer Development,Foundation, Communication/Marketing,Public Policy,Personnel, CHSWAM PONTI, GARY Honorary Trustee McAdams,Ponti&Wernette(attorney) Walla Walla,.WA 1989 - lifetime Business management; community leader BOT cmtes: Executive PRESS,BEv Trustee Central Washington Hospital Wenatchee, WA 2004 - 2011 Healthcare professional; community leader BOT cmtes: Foundation ROBINS, JACK Honorary Trustee Retired Bellevue, WA 1970 - lifetime Adoptive parent; community leader BOT cmtes: Executive ROOT, VIRGINIA P. Secretary(03-08) Northern Trust Bank Seattle, WA 2000 - 2008 Financial planning; community leader BOT cmtes: Executive,Finance,Foundation SCHROEDER,MARY • Trustee Community leader LYNNE 2006 - 2009 BOT cmtes: Foundation Walla Walla,WA • 2 CHSW BOARD OF TRUSTEES 2007/2008 (ACTIVE) A �`".�;° ;$: .:�Z. ,'a''9'" �.1,.:r� a�':� ��. >�.ro .3".":'; :'ray,"•" �. C�.. :.;s. .�..:.e: <�:x; e is om�ni�lnit,'° gip ;. a�lt u texe a i tt 'e.. TINGLEY, CLIFF Vice Chair(2008- Mutual Materials(management) Bellevue, WA 2010) H.R.professional; community leader 1994 - 2009 BOT cmtes: Executive,HS Cannon Cmte WILDS,JOSEPH Trustee The Regence Group , Portland, Or 2006 - 2009 Insurance professional; community leader BOT cmtes: Foundation WILLIAMS, JOHN Trustee Scoville Public Relations,LLC (owner) Seattle, WA 1996 - 2009 Marketing professional; community leader BOT cmtes: Executive, Communications/Marketing (delegate) • • • • • • SINES"1 96 CHILDREN'S HOME SOCIETY Washington BOARD OF TRUSTEES OCTOBER 26,2007 MINUTES • PRESENT Trustees Joe Donoghue Dan Merlino Staff Graham Gaiser Barbara Weitemeir Doug Head Cliff Tingley Virginia Root Peg Mazen Ihssane Mounir Bev Press Danny Howe Brett Allen Tom Oldfield Bethany Gower ' Jacque Cabe Rod Kaseguma Cathy Garland Pam Kaiser Sharon Osborne Laurie Lippold John Williams Joe Wilds (phone) Jim Laugen Andy MacDonald Gary Ponti (phone) Susan Maney Otto Klein Kaaren Sidoine Eric Greenwood Guests Jack Robins Deborah, Sanjay and Linda Ashlock Asim Kapoor CALL TO ORDER Rod Kaseguma, Board Chair, called the meeting to order, requesting that attendees • introduce themselves and give a brief descriptions of their role at CHSW. Eric Greenwood moved to approve the minutes.from the previous meeting of June 29, 2007. Otto Klein seconded the,motion; the minutes were unanimously approved. EXECUTIVE COMMITTEE As recommended by the Executive and Finance Committees, the following motion was moved, seconded and unanimously approved: 1 MOTION The Board of Trustees approves the following new policies: Fraud Prevention and Reporting Supervision Practices Infection Control Tom Oldfield and Sharon Osborne gave an explanation to the trustees regarding a second proposed motion, a request for$45,000 to complete a property evaluation. CHSWAM would like to do the analysis to ensure the agency is using its capital assets for the best service to the Society. The valuations will also increase the financial base for financing projects (such as the Boarding School). The evaluation will begin with the 65th Street property. As recommended by the Executive and Finance Committees, the following motion was moved, seconded and unanimously approved: MOTION The Board of Trustees approves the CHSWAM Board of Directors' request for $45,000 from BOT restricted funds (endowment) for the purpose of completing a statewide real estate evaluation. ACORN COMMITTEE Brett Allen reported on the committee's activity. Acorn is,combination of trustee members and CHSWAM members. Pending the completion of the real estate evaluation, Acorn will then move forward with the other pieces of Boarding School project, including hiring an architect, a capital campaign, and further exploration of"plan B" along with"plan A." MARKETING REPORT John Williams introduced Danny Howe, the new Vice President of Marketing & Communications. Danny gave a presentation on branding, including what a brand is, the strengths and challenges of CHSW's brand and the steps the agency should take to refocus the brand. Danny passed out a draft message platform, which will be revised over the next couple of months and become a resource to help the agency explain its story in a simple and consistent way. Joe Donoghue and Sharon Osborne thanked Danny for his work. 2 STRATEGIC PLANNING Dan Merlino and Peg Mazen presented the second part of the Early Learning strategic plan. Dan reminded the trustees about the vision behind the plan for growth and reviewed the timeline of the current strategic planning process. Peg reviewed the continuum of Early Learning. Services are split into three categories, Prevention, Prevention/Early Intervention, and Early Intervention, depending on the different level of family need. Peg reviewed what the agency currently spends and provides, and presented the proposed priorities and strategies for 2008-10. An investment of$1.5 million will enable the agency to serve 5700 more people from communities already served and new communities. The growth will focus on the middle of the continuum and a major strategy will be to improve the quality of home and childcare environments. Some of the costs will be paid for by public or private partnerships, some by fundraising, and some by fees for service and revenue from Playbright. $800,000 of the$1.5 million is private funding. PARENTS-AS-TEACHERS REPORT Cathy Garland introduced Kaaren Sidoine, a staff member with the Parents as Teachers program and the Kapoor family, consumers of the program. Deborah Kapoor shared her , family's story. Parents-As-Teachers is an international program that works with families from pregnancy to 3 or until Kindergarten. The program increases parents' knowledge about child development,provides early awareness of developmental delays and get parents help if needed, helps prevent child abuse or neglect, and increases child readiness for school. CHSW has staff trained and ready to increase the program size,but not enough funding to do so. PUBLIC POLICY COMMITTEE Laurie Lippold gave a report on the recent activities of the committee and the priorities for the coming legislative session. Over 90 people responded to the public policy survey. The respondents' top concerns were in line with the policy priorities,for this season, including funds for home visitation and housing. The committee urged courageous advocacy for children in poverty. Strategies might include examining what other social and economic services low income families need, and looking at how to break the cycle of poverty. To prevent children from entering the child welfare system, goals will be to increase funding for home visitation, support professional development in early learning, invest in housing, increase support for kinship caregivers, and address intergenerational poverty through various supports. 3 • Laurie reported on a number of other public policy issues, such as WCAAP, the separate department, unionization bill, and initiative 960.Advocacy Day will be late January or early February 2008. The policy book will be updated and on the website soon. FINANCE COMMITTEE REPORT Jacque Cabe gave a Review of Financial Performance, year to date for 2007/08, including the Statement of Revenue and Expenses and the Variance Report by Core Service. The total agency variance was positive$66,767,which is a net deficit but a smaller deficit than was budgeted. Fundraising revenue is down but expenses are also down. EARLY HEAD START Cathy Garland gave the Early Headstart report in Mary Lynne Schroeder's absence, and noted Mary's Lynne's memo which was handed out. The Kent Childcare Center was just accredited by NAEYC,which is the gold standard of accreditation. Both childcare centers are now accredited. Extra funds at years' end were used to purchase video conferencing equipment, so the Walla Walla and Auburn council members can meet in a more productive way. FOUNDATION EXECUTIVE COMMITTEE Jim Laugen noted fundraising is up $120,000 from the same time last year. The Kiro Golf Tournament hit a new record. Street of Dreams called 2007 the best year yet. The fall will also be busy; 60% of revenue usually comes in 60-day period. Jim's goal is to have holiday campaign out by Nov 15th. The agency received$25,000 from Boeing for the re- branding effort. Jim and others are meeting with Sherwood Trust on Tuesday for a $270,000 proposal for funding to hire an Eastern Washington fundraising staff member. Andy MacDonald introduced the leadership giving campaign. The Foundation's Executive Committee's goal is 100%participation from trustees and community council members. Last year the trustees made a major increase in giving, which the committee hopes will continue. All trustees will receive a letter but can also give in the envelope included today. Andy reviewed what local community councils are planning for their campaigns. Walla Walla is still deciding; Wenatchee is taking a volunteer led/personalized approach; Spokane will do a wine tasting event; Seattle will do the Manheim classic; the Adoption • alumnae association is starting; and Vancouver is working on corporate partnerships. CEO REPORT - Sharon Osborne asked the trustees to support CWLA's effort to re-instate the White House Conference on Children and Youth. CWLA is the leading voice for children in 4 America and CHSW is one of the founding members of League. CHSA is also looking at forming an alliance with CWLA. The following motion was moved, seconded and unanimously approved: MOTION The Board of Trustees of Children's Home Society of Washington, as a founding member of the Child Welfare League of America (CWLA), supports CWLA's campaign to hold a White House Conference on Children and Youth in 2010. Sharon noted the decision made by the Finance and Executive Committees to separate the business meeting and dinner portion of the Annual Meeting into separate days. The January 2008 business meeting has an extremely full agenda. The celebration part will be special and focused on the agency's new branding. The dinner will be a great opportunity to bring guests. The venue is the Seattle Art Museum. Friday January 25th, Annual Business Meeting Saturday February 2nd, Celebration Dinner Sharon reviewed the agency's quarterly PQI report. There are no significant concerns right now. Reporting'areas include Human Resources regarding health and safety, staff activity, and external audit, legal and regulatory compliance. Administration includes facility checklists, driver authorizations, the insurance portfolio, contracts and critical incidents. Additional reporting areas include finance, fundraising, research, consumer surveys, and information security. Sharon also presented the 2006-07 outcomes report. The agency is exceeding its own outcome goals, which are already set very high. Sharon notified staff yesterday of the implementation of the salary adjustments by a memo also passed out to the trustees. 5 1001524 CHILDREN'S HOME SOCIETY BOARD OF TRUSTEES Washington JUNE 29, 2007 MINUTES PRESENT Trustees Linda Ashlock Rod Kasegama Sherilee ,WW Stephen Dennis Otto Klein Cliff Tingley Eric Greenwood Andy MacDonald Tom Oldfield Joe Donoghue Dan Merlino Joseph Wilds Barbara Jirsa Sharon Osborne John Williams Graham Gaiser Virginia Root Pam Kaiser Mary Lynne Schroeder ,- Staff Nela Cummings Jim Laugen Adam Draeger Laurie Lippold Cathy Garland Peg Mazen Billie Jundt Randy Perin CALL TO ORDER Rod Kaseguma, Board Chair, called the meeting to order,requesting that attendees introduce themselves and give a brief descriptions of their role at CHSW. The minutes from the previous meeting of April 27, 2007, were unanimously approved, as amended. EXECUTIVE COMMITTEE Rod reported that the Executive Committee has met twice since the last Board of Trustee Meeting,in April. Focus has been on advancing the Strategic Plan,mainly regarding the 2007/08 budget and including the completion of the salary survey. The CEO Evaluation Team continues its work, with a draft evaluation letter expected in the near future. More information on these and other agenda items as the meeting progresses. Board of Trustees Meeting June 29, 2007 Paget _ EARLY HEAD START PROGRAM Nela Cumming, Program Manager, gave an update on the Early Head Start Program(EHS), including most recent activities. The EHS Grant application was submitted on June 1, 2007; the award amount is $2,926,384. The grant provides service to 204 low-income pregnant women, infants and toddlers. Current Federal Poverty guidelines are $20,400 a year for a family of four. This number of families is approximately 3% of the eligible population in South King and 4% of the eligible population in Walla Walla. The new Policy Council for the August 2007—July 2008 year has been elected in both South King and Walla Walla. There are a total of eight parent representatives and four alternates. Three of the parents elected are monolingual Spanish speakers and two are bilingual English/Spanish, with Spanish as their first and most fluent language. There are six new representatives this year. We are in the process of recruiting two new community representatives in South King; Walla Walla will have the same community representatives as last year. The Policy Council Retreat is scheduled for August 24-26 in Leavenworth, Washington. A Healthy Marriage Initiative Grant, due July 20,provides for intensive couples' work around communication and managing conflict to families who are currently in EHS and those who qualify but are not in the program due to lack of space. We are working on a partnership with the Gottman Institute at the University of Washington. Gottman is nationally known for his work with couples. Nela reviewed the Summary of Child Development Outcomes assessed in January 2007, including the following highlights. Child Outcomes in the EHS Program continue to reflect significant benefits. Dr. Maggie McKenna reviewed data from 177 children in South King and Walla Walla who have received EHS interventions for at least three months. Nine of the children had significant developmental delay and are receiving Early Intervention services. A sample of the children who had been in the-program longer than 18 months had average indicator scores that were noticeable higher in the social emotional, self-help and literacy domains, than children who participated in the program less than 12 months. Copies of this summary are available to Board members upon request. • BOARD DEVELOPMENT Pam Kaiser, Chair of the Board Development Committee, introduced Mary Lynne Schroeder, as a candidate to replace Gary Ponti as the next Early Head Start representative from the CHSW Board of Trustees. Mary began as a CHSW Trustee in 2005 and has always worked in Fund Development, one way of another. She is currently a member of the Foundation Executive Committee and the Walla Walla Community Council. Board of Trustees Meeting June 29, 2007 Page 3 As recommended by the Board Development Committee, the following motion was moved, seconded and unanimously approved: MOTION The Board of Trustees approves MARYLYNNE SHROEDER as the Early Head Start (EHS) Policy Council Representative for the two-year term from August 2007 through August 2009. PUBLIC POLICY Rod Kaseguma introduced Laurie Lippold, Director of Public Policy, congratulating her on being voted an Outstanding Advocate at the Children•s Alliance Voices for Children Awards. This annual luncheon event was held at Qwest Field on June 7, 2007, with Gov. Chris Gregoire giving the keynote address. Laurie reviewed the 2008 Public Policy priority suggestions, including keeping children out of the child-welfare system and improving the well being of children in the child-welfare system. She also reviewed the BRAAM benchmarks and strategies regarding mental health, placement stability, sibling separation and services to adolescents. Additional issues include original birth certificate, services for immigrant children, affordable housing, medical/dental services for parents and school- based early intervention services. As recommended by the Public Policy Committee, the following motion was moved, seconded and unanimously approved: MOTION The Board of Trustees approves the preliminary Public Policy priorities, as documented and reviewed, for the 2008 legislative session. FOUNDATION EXECUTIVE COMMITTEE Andy MacDonald reviewed the Resource Development Plan for 2007—2008, supporting the goal to increase contributed income by$600,000 (27%) from $2,200,000 to $2,800,0-000. The CHSW Annual Fund included revenue projection goals by category and community. The CHSW Annual Giving Campaign included specific plans and rationales, strategies and timetables for each of the following: Volunteer Leadership Giving, An Integrated Approach to Individual Giving, Corporate Partners for Kids, Special Event Fundraising. New ideas include specifics regarding an Adoption Alumni Society and Agency Video and Speaker's Bureau. Board of Trustees Meeting June 29, 2007 Page4 FINANCE COMMITTEE Review of Financial Performance or May Financial Statements Eric Greenwood and Sharon Osborne reviewed the 2006/07 CHSW budget, including the Statement of Revenue and Expenses, the Variance Report by Core Service, and June 2007 Projections. Total agency variance showed a negative $107,879. Individual contributions were up $34,842. Salaries and benefits were over budget $108,000. Salary savings in administration and fund development continue to offset some of the negative variances in the core services. Specific Assistance was due to foster parent payments in the Therapeutic Foster Care Program. Proposed FY 07/08 Budget Sharon Osborne and Eric Greenwood presented the proposed 2007/08 budget of$17,897,000, representing an increase of$807,000 over last year's budget. This includes total expenses of $17,881,000 with a net positive variance of$15,000. Detailed specifics were reviewed and documented,based on the Executive Summary of 07/08 Operating Budget. Cliff Tingley reviewed the recent salary survey performed by the Human Resources Department, including the suggested salary range adjustments. Three factors were taken into consideration: length of employment;job performance; and credentials and specialized skills. As recommended by the Finance and Executive Committees; the following motion was moved, seconded and unanimously approved: MOTION The Board of Trustees approves the 2007/08 Operating Budget,with a 1% plus or minus variance,including up to $350,000 from board-designated funds for salary adjustments, as presented. CHSW ASSET MANAGEMENT(CHSWAM) Tom Oldfield reported on facility issues, including the successful removal of an oil tank from the Auburn property. 65th Street Boarding School In preparation for selecting an architect for the conceptual design phase of the 65th Street Boarding School, Rod Kaseguma and Tom Oldfield have formed a joint Trustee/CHSWAM/Staff Project Committee. It is a working group whose members bring a broad variety of real estate, finance, legal and program expertise. The committee will be chaired by CHSWAM Board Member Neal Lessenger and will include Rod Kaseguma, Sharon Osborne, Joe Donoghue, Graham Gaiser, Jacque Cabe, Brett Allen, Peg Mazen and Susan Maney. The Group will be staffed by, and work with, Karen Lane,who continues to provide overall project management. Board of Trustees Meeting June 29, 2007 Page 5 STRATEGIC PLANNING Dan Merlino introduced Peg Mazen and Cathy Garland, commending their work on Early Learning. Early Learning Plan Cathy Garland presented the Early Learning Plan for Growth for 2007-2010. She reviewed that this core service focused on young children, their parents/guardians and other caregivers. She reviewed goals for the next three to five years, including expanding home visiting and Play and Learn groups. Strategies to meet these goals include appropriate grant requests and partnering with community members to assist with plan development. Next steps include financial analysis and potential funding sources; confirming strategies with external leadership; service locations for phased-in growth. Recommendations will be presented at the Board of Trustee's next meeting. MARKETING/COMMUNICATION PlayBrightTM Peg Mazen and Mary Leighton reviewed the PlayBrightTM Learning System. Accomplishments for 2006-2007, including the completion of Guidebooks 1-3, Keys to Learning and the training manual. In addition, the trademark application was completed and filed, and the evaluation pilot was held successfully at the University of Washington. Next year, staff will be presenting PlayBright in several different venues to promote visibility and sales: Early Brain Development trainings at national, state and regional Early Learning conferences; trainings/consultation conducted locally to Early Head Start/Head Start programs, Play-and-Learn groups, community colleges, etc. Books 4 and 5 are currently in development, with additional illustrations and layout almost completed. A Train the Trainer model is being developed that will offer certification as a PlayBright Trainer to attendees. A business model being developed with consultant from Gottman Institute. The product is being translated to Spanish. Funding Partners for 2006-2007 include the Discuren Foundation, asking to remain a partner through development. The Paul G. Allen Foundation has invited us to present to Thrive by Five. 'A request has been submitted to the American Legion. Lakeshore may develop into a long-term industry partner. Business models and pricing structures will be presented at the next meeting of the Board of Trustees. Board of Trustees Meeting June 29, 2007 Page6 CEO REPORT Performance Quality Improvement (PQI) Report Sharon reviewed the Performance Quality Improvement.(PQI) Quarterly Report for January—March 2007. Reporting areas include Human Resources regarding health and safety, staff activity, and external audit, legal and regulatory compliance. Administration'includes facility checklists, driver authorizations, the insurance portfolio, contracts and critical incidents. Additional reporting areas include finance, fundraising, research, consumer surveys, and information security. i 'I°D CHILDREN'S HOME SOCIETY BOARD OF TRUSTEES Washington APRIL 27, 2007 MINUTES PRESENT Trustees Brett Allen Pam Kaiser Virginia Root Linda Ashlock Andy MacDonald Mary Lynne Schroeder Jacque Cabe Dan Merlino Cliff Tingley Rick Corella Sharon Osborne Barbara Weitemier Stephen Dennis Bev Press Joseph Wilds. Joe Donoghue Jack Robins John Williams Staff Guests: Robin Bennett Cathy Kiyomura Stacie Becker Adam Draeger Kristi Leksen Karen Lane Mike Fitzpatrick Jim Laugen Cathy Garland Peg Mazen Bethany Gower Randy Perin Robin Hing Wayne Rounseville Lupe Carlos Reese Wilson Billie Jundt BOT ORIENTATION Pam Kaiser, chair of the Board Development Committee, welcomed Trustees to the Orientation Session of the meeting, introducing it as a newly created design and welcoming suggestions and feedback. • CALL TO ORDER Dan Merlino, Vice- Chair, called the meeting to order, in Rod Kaseguma's absence. The minutes from the January 26, 2007, meeting were unanimously approved. STRATEGIC PLANNING Dan Merlino introduced Karen Lane, commending her and Peg Mazen on their work for the Therapeutic Boarding School. Board of Trustees Meeting April 27, 2007 Page 2 Boarding School Karen Lane gave an update on the progress of the boarding school. Accomplishments to date were reported, including obtaining the title report and retaining Bush Roed and Hitchings to perform ALTA and topographic survey; contracting with Heery International for construction management; identifying Hirai-Lew to carry out project cost estimating when design is complete; and, retaining Seattle Northwest Securities to undertake financial analysis. Next steps were presented, including the need for architect selection by mid-July; design and cost estimates completed by mid-December; a Capital Campaign Feasibility Study by May 2007. In addition, the CHSWAM Board and the CHSW Executive Committee of the Board of Trustees need to meet. Adoption Peg Mazen presented the Adoption Report, following the update given at(the January board meeting. She reviewed the market analysis, noting the need for domestic adoption services and the opportunity for growth. • In 2007-2008, the plan included implementing the expansion of domestic adoption services from Pierce County to King County; planning the Spokane expansion; implementing the plan for expansion of inter-country adoption; and, formalizing partnerships with other out-of-state organizations. In addition,begin expansion of inter-country home studies and inter-country post- adoption services to communities that would benefit. Conduct a market analysis to identify emerging and unmet needs.of birth parents, adopted persons, and adoptive parents, also pursuing appropriate programmatic enhancements. Early Learning, Update Cathy Garland presented on Early Learning, including explaining that it was a CHSW Core Service that focuses on young children,prenatal to kindergarten entry(birth-5 years), their parents/guardians and other caregivers; respects parents as their child(ren)'s first teacher and primary decision-maker, and involves parents in development of policies,programs and decisions that affect their child(ren) and improve family life. Cathy review the history of Early Learning at CHSW and in Washington state, the connections to national research, the desired result and the challenges. She described the quality outcomes expected, including: enhancing a child's growth and development; strengthening parents capacity as the primary nurturers of their children; and, supporting and enhancing parent-child relationships. Next steps were presented, including the need to identify additional growth strategies for the next three to five years; complete financial analysis of proposed strategies, including identification•of potential funding sources and service locations; confirm proposed strategies with Early Learning leadership statewide(internal and external); and, to present recommendations at the Board of Trustees' June meeting. Board of Trustees Meeting April 27, 2007 Page 3 FINANCE COMMITTEE Financial Update Jacque Cabe reviewed the March 2007 financial statements, noting the negative variance of $180,015. The Cobb short-term care has been doing well and may result in future planning changes. Salary savings in administration and fund development have offset some of the negative variances in the core services. Budget Update Jacque reported on the 2007/08-budget process. The management team has started going through the budget, goes to Finance Cmte . Management staff continues to work closely with the budget; several adjustments in family support and core services need to be addressed. Private dollar is expected to increase in individual contributions and special events next year. FOUNDATION EXECUTIVE COMMITTEE BOT Campaign Andy reported that giving, year-to-date, is up 10-15% from last year. Included in that, the leadership campaign has been very productive, up almost 50%. The committee co-chairs have been traveling to each CHSW community, learning fist-hand about programs. Several more locations are still on the agenda. Jim Laugen, Vice President of Development, reported on the progress of putting the Fund Development staff team together. He referenced the recommendations from the Alford Group, including strategies. He introduced new members,present at the meeting. Steve Dennis reported that the Community Councils have been asking for more direction regarding their expected role. This morning's meaning included a commitment to confirm the percent of increase requested from each as a target from events and programs. Hopefully, they will be able to accept the challenge and meet the goals. Sharon gave an update on the SweetHearts events around the state. Wenatchee, Vancouver and Walla Walla were each very successful and included many new participants. Sharon was able to attend all SweetHeart events this year. She noted how they were now all truly volunteer-driven events. In terms of broadening our circle, Joe Wild noted that there was an increase in energy than last year, including the right people in the right room. Board of Trustees Meeting April 27, 2007 Page 4 CHSW ASSET MANAGEMENT(CHSWAM) • Joe Donoghue reported on CHSWAM, in Tom Oldfield's absence. Joe encouraged real estate donations. CHSWAM has recently authorized the removal of an underground gas tank in Auburn and an upgrade to the street in front of Wenatchee office. The sale of the Tacoma office has been finalized, with the leasing of new offices completed. PUBLIC POLICY Sharon Osborne, in Barbara Jirsa's absence, commended everyone for the very successful Advocacy Day in Olympia on March 21 sc At the June Board Meeting, Laurie Lippold, Director of Public Policy, will present priority suggestions for the next session. In the interim, she will be meeting with legislators and determining CHSW priorities for board approval. Laurie reviewed the 2007 priorities, identifying what happened in each of the areas and also what did not happen. One example included extending Medicare to age 21, for kids leaving foster care. Foster care alumni have testified that visible research showed that kids who age out of foster care have very high mental health issues. The policy makers are hearing from personal-effected kids and also looking at it from an economical view. EARLY HEAD START(EHS) PROGRAM REPORT Barbara Weitemier, in Gary Ponti's absence,presented the status report for the Early Head Start (EHS) Program. There have been some changes in the makeup of the Policy Council, this year. With the resignation of a home-based parent in South King, the alternate has stepped into the full- time role. In addition, Walla Walla has elected a new representative from the Lillie Rice Center. The Policy Council has met twice since the January Board Meeting. The last meeting was in Yakima and included members from both South King and Walla Walla. The Policy Council continues to work on the community assessment, the program self-assessment, and the EHS grant application due in June. In addition, there will be an election for the EHS representative from the BOT at the June Board Meeting. Gary Ponti has completed his two-year term. CEO REPORT Sharon reminded Trustees to review the new board manual and not hesitate to call any of the presenters with questions and/or suggestions. She also reported that the Executive Committee of the Board of Trustees has decided to meet in concert with the Finance Committee, a minimum of ten times per fiscal year. Board of Trustees Meeting ' - April 27, 2007 Page 5 She attended a CHS of America-sponsored adoption meeting with Peg Mazen, focused on national- level interests and possibilities. CHSW has a good record in accessing federal money to advance this work; therefore, we are playing a key role in this iniative. ADJOURN Dan Merlino adjourned the Board Meeting, noting, "I have never seen such clarity of purpose as today. We know exactly where we're going. " • f & sd ) .) 1g-94.s p19V� i/V12 cjAAr11y( ) Children's Home Society of Washington Annual Budget 2007 -2008 Annual Budget REVENUE Individual Contributions 918,024 Foundations/Grants/Trusts 2,439,228 Use of Legacies&Bequests>$5000 - Direct Mail Contributions • 52,177 • Special Events 526,364 Product Sales 16,529 United Way Designations 69,934 United Way 986,452 Total Private Donations 5,008,708 Program Service Fees 576,815 Third Party Fees 32,000 Miscellaneous Income 484,115 Board Designated Funds 350,000 Interest&Investment Income/Endow 515,077 Interest&Investment Income/General 6,000 Total Other Private Revenue 1,964,007 Federal Grant Revenue 3,254,727 Federal Indirects 430,625 Other Federal Revenue 318,985 Total Federal Revenue 4,004,337 • Residential Treatment 1,614,384 Foster Care 1,490,575 Other State Contracts 1,164,056 County/Local/Out Of State 2,650,922 Total Non-Federal Public Revenue 6,919,937 Total Revenue $ 17,896,989 EXPENSES Salaries 10,077,057 Employee Benefits\Payroll Taxes 2,419,266 In-Kind Services Total Payroll Expenses 12,496,323 Professional Fees/Clinical 323,123 Professional Fees/Administrative 1,340,356 Supplies 239,807 Telephone 193,588 Postage&Shipping 55,447 Occupancy 950,934 Equipment Rental&Maintenance 146,712 Printing&Publications 160,834 Travel/Agency Operations 271,561 Staff Training 51,184 • Specific Assistance to Individuals 965,600 Membership&Dues 42,944 Awards&Grants 6,675 Product Sales Costs - Miscellaneous Expense 1,463 Interest&Bank Charges 51,370 Insurance Expense 177,000 Taxes Expense 8,000 Information Technology(IT) 232,156 Quality Improvements(QI) 166,546 Depreciation Expense-Capital Administrative Allocation - Total Other Expenses 5,385,300 Total Expenses $ 17,881,623 Excess(Deficit) $ 15,366 s Ceitified PublicAccouatants &Consultants . 10963 NE 4'5rreet _ SUe'�798 UM' ;1 t'r _ L Bedlt;"vueWA98094 T:4j .45kiA9T9. 8:60.01.8747 •' Independent Auditors'Report rclarkn:ubee:cnm Ckiek ube :ts Board of Directors FrctfcfiioairtServicesCgrparaidon Children's Home Society of Washington and Affiliate Seattle, Washington • We have audited the accompanying consolidated balance sheets of Children's Home Society of Washington and its Affiliate, Children's Home Society of Washington Asset Management (collectively, the "Organization") as of June 30, 2007 and 2006, and the related consolidated statements of activities -'` and changes in net assets and cash flows for the years then ended. These consolidated financial statements are the responsibility of the Organization's management. Our responsibility is to express an opinion on these consolidated financial statements based on our audit. to . ..w,, ,,... We conducted our audits in accordance with auditing standards generally accepted in the United States of America and the standards applicable to financial audits contained in the Government Auditing Standards, issued by the Comptroller General of the United States. Those standards require that we plan and perform the audits to obtain reasonable assurance about whether the fmancial statements are free of material misstatement. An audit includes examining, on a test basis, evidence supporting the amounts and { ; disclosures in the financial statements. An audit also includes assessing the accounting principles used rr " and significant estimates made by management, as well as evaluating the overall financial statement presentation. We believe that our audits provide a reasonable basis for our opinion. t£ In our opinion, the consolidated financial statements referred to above present fairly, in all material respects, the financial position of Children's Home Society of Washington and Affiliate as of June 30, 2007 and 2006, and the changes in its net assets and its cash flows for the years then ended, in conformity with accounting principles generally accepted in the United States of America. Lln In accordance with Government Auditing Standards, we have also issued our report, dated November 30, 2007 on our consideration of Children's Home Society of Washington and Affiliate's internal control Y. over financial reporting and on our tests of its compliance with certain provisions of laws, regulations, contracts, and grant agreements and other matters. The purpose of that report is to describe the scope of `.<, our testing of internal control over financial reporting and compliance and the results of that testing, and ' - not to provide an opinion on the internal control over fmancial reporting or on compliance. That report is an integral part of an audit performed in accordance with Government Auditing Standards and should be considered in assessing the results of our audit. Our audit was conducted for the purpose of forming an opinion on the basic consolidated financial •:=' statements taken as a whole. The supplemental information on pages 14 - 15 is presented for the purpose } of additional analysis and is not a required part of the basic financial statements. Such information has been subjected to the auditing procedures applied in the audit of the basic financial statements and, in our 5 opinion, is fairly stated, in all material respects, in relation to the basic consolidated financial statements taken as a whole. etta4e., P s Certified Public Accountants Bellevue, Washington November 30,2007 ADMINISTRATIVE HEADQUARTERS 3300 N.E.65th Street P.O.Box 15190 Seattle,WA 98115 (27-��LDIEN's (800)456-33396)633 Toll00 Mainr � Free 'E S©CIETY (206)695-3201 Fax www.childrenshomesociety.org Washington • Financial Statement Management Letter OFFICERS There was no management letter for the financial statements for CHSW's fiscal CHAIR Dan Merlino yearending30,June 2007. • 1 VICE-CHAIR Cliff Tingley TREASURER Eric Greenwood SECRETARY • Virginia Root PRESIDENT/CEO Sharon Osborne HONORARY LIFETIME TRUSTEES Linda Ashlock Lyman H.Black,Jr. Joseph C.Donoghu • H.Graham Gaiser Joan Hutson Dan Merlino Shp to!? borne Gain JoIi t. :;bins Leo G.Smith Patricia Sundquist • TRUSTEES Mark Aldridge Brett Allen Jacque Cabe I Richard Corella I Stephen Dennis j Barbara Jirsa Pam Kaiser j • Rod Kaseguma Otto Klein Andrew MacDonald Ihssane Mounir 1 Gayle Murdock Tom Oldfield Bev Press Joseph Wilds John Williams United t Way � � ® _ .�,.�N�;.,,., IFCW . .�(I , Communlh Partner „Y CHILDREN SAI,I,IANCE Chltdren's Home Society atu>lui�eo-,a Of AMERICA fngmim CHILDREN'S HOME SOCIETY OF WASHINGTONAND AFFILIATE Consolidated Financial Statements With Independent Auditors' Report June 30, 2007 and 2006 CHILDREN'S HOME SOCIETY OF WASHINGTONAND AFFILIATE Consolidated Balance Sheets June 30, 2007 And 2006 Society CHSWAM 2007 Total 2006 Total Current Assets: Cash and equivalents - $ 391,008 $ 613,056 $ 1,004,064 $ 791,026 Accounts receivable, net(Note 2) 1,700,717 1,700,717 1,092,315 Intercompany payable(receivable) 8,469 (8,469) Short-term investments 1,750,000 1,750,000 1,000,000 Prepaid expenses and other 103,835 103,835 56,124 Total Current Assets 3,954,029 604,587 4,558,616 2,939,465 Property and equipment, net(Note 3) 623,350 3,411,695 4,035,045 4,754,780 Investments(Note 4) 6,588,372 6,588,372 6,890,002 Beneficial interest in perpetual trusts(Note 5) 5,008,381 5,008,381 4,637,527 Total Assets $ 16,174,132 $4,016,282 $20,190,414 $19,221,774 Current Liabilities: Accounts payable $ 568,680 $ - $ 568,680 $ 459,703 Accrued liabilities 1,165,993 5,156 1,171,149 1,190,356 • Deferred revenue 74,262 74,262 132,544 Current portion of long-term debt(Note 6) 16,233 19,085 35,318 20,649 Lines of credit(Note 7), 216,678 216,678 327,334 Refundable grant(Note 8) 2,167,507 2,167,507 1,692,054 , Total Current Liabilities 4,209,353 24,241 4,233,594 3,822,640 Long-term debt(Note 6) 38,413 249,149 287,562 274,719 Total Liabilities 4,247,766 273,390 4,521,156 4,097,359 Net Assets: Unrestricted(Note 13) 5,140,338 3,742,892 8,883,230 8,845,831 Temporarily restricted (Note 14) 622,917 622,917 667,607 Permanently restricted (Note 15) 6,163,111 6,163,111 5,610,977 Total Net Assets 11,926,366 3,742,892 15,669,258 15,124,415 Total Liabilities and Net Assets $ 16,174,132 $4,016,282 $20,190,414 $19,221,774 The accompanying notes are an integral part of the financial statements. -2- l 1 ' CHILDREN'S HOME SOCIETY OF WASHINGTON AND AFFILIATE • Consolidated Statements Of Activities And Changes In Net Assets For The Years Ended June 30,2007And 2006 2007 2006 Temporarily Permanently Temporarily Permanently Unrestricted Restricted Restricted Total Unrestricted Restricted Restricted Total ' Private Support and Revenue: Direct support $ 2,136,672 $ 892,083 $ 25,000 $ 3,053,755 $ 1,972,449 $ 650,905 $ 25,000 $ 2,648,354 In-kind support 550,058 550,058 712,139 712,139' United Way 1,039,184 1,039,184 910,729 910,729 Program service fees 373,494 373,494 452,847 452,847 Investment return(Note 4) 1,089,600 51,652 1,141,252 709,586 44,419 754,005 Gain on beneficial interest in • perpetual trusts(Note 5) 527,134 527,134 182,354 182,354 Gain(loss)on disposal of fixed assets 586,770 586,770 (10,975) (10,975) Rental income and miscellaneous 124,141 124,141 114,619 114,619 • Total Private Support and Revenue 5,899,919 943,735 552,134 7,395,788 4,861,394 695,324 207;354 5,764,072 Revenue from Governmental Agencies: Federal revenue 4,745,751 4,745,751 5,643,289 5,643,289 State revenue 5,448,185 5,448,185 4,475,577 4,475,577 County and local 1,232,763 1,232,763 1,289,666 1,289,666 .Total from Governmental Agencies 11,426,699 11,426,699 11,408,532 11,408,532 17,326,618 943,735 552,134 18,822,487 16,269,926 695,324 207,354 17,172,604 Net assets released from restrictions 988,425 (988,425) 745,678 (745,678) ' Total Support and Revenue 18,315,043 (44,690) 552,134 18,822,487 17,015,604 (50,354) 207,354 17,172,604 Program Services Expenses: Out of home care .2,691,623 2,691,623 2,594,149 2,594,149 Family support 2,604,208 2,604,208 3,279,792 3,279,792 Early childhood education 5,321,264 5,321,264 4,393,580 4,393,580 Adoption 1,147,611 1,147,611 797,638 797,638 Child and family counseling 1,922,693 1,922,693 2,061,967 2,061,967 Advocacy 163,279 163,279 65,735 65,735 New business initiatives 654,507 654,507 509,200 509,200 Property services 533,524 533,524 436,568 436,568 Total Program Services 15,038,709 15,038,709 14,138,629 14,138,629 Support Services Expenses: Management and general 2,538,772 2,538,772 2,502,139 2,502,139 Fundraising 700,163 700,163 975,670 975,670 Total Support Services 3,238,935 3,238,935 3,477,809 3,477,809 Total Expenses 18,277,644 18,277,644 17,616,438 17,616,438 Total Change in Net Assets 37,399 (44,690) 552,134 544,843 (600,834) (50,354) 207,354 (443,834) Net assets at beginning of year 8,845,831 667,607 5,610,977 15,124,415 9,446,665 717,961 5,403,623 15,568,249 Net Assets at End of Year $ 8,883,230 $ 622,917 $ 6,163,111 $15,669,258 $ 8,845,831 $ 667,607 $ 5,610,977 $15,124,415 . • • • The accompanying notes are an integral part of the financial statements. - -3- CHILDREN'S HOME SOCIETY OF WASHINGTONAND AFFILIATE Consolidated Statements Of Cash Flows For The Years Ended June 30,2007 And 2006 2007 2006 Cash Flows from Operating Activities: Change in net assets $ 544,843 $ (443,834) Adjustments to reconcile change in net assets to net cash provided by operating activities: Depreciation 784,775 809,962 (Gain)Loss on asset disposal (586,770) 10,975 Net gain on long-term investments (852,914) (547,168) Gain on beneficial interest in perpetual trusts (527,134) (182,354) Contributions to endowment (25,000) (25,000) Decrease(Increase)in current assets: Receivables, net (608,402) (32,421) Prepaid expenses and other (47,711) (6,554) Increase(Decrease)in current liabilities: Accounts payable and accrued liabilities 89,770 - (13,693) Deferred revenue (58,282) 35,142 Refundable grants 475,453 (331,329) Net Cash Used by Operating Activities (811,372) (726,274) Cash Flows from Investing Activities: Purchases of investments (3,033,999) (2,666,236) Proceeds from sales of investments 3,438,543 2,799,966 Proceeds from sale of property and equipment 654,200 Purchases of property and equipment (73,109) (164,941) Net Cash Provided(Used)by Investing Activities 985,635 (31,211) Cash Flows from Financing Activities: Proceeds from long-term obligations 9,616 Principal payments on long-term obligations (31,849) (16,309) Net(payments)borrowings on line of credit agreements (110,656) 61,912 Proceeds from trust distribution 156,280 Proceeds from contributions to endowment 25,000 25,000 Net Cash Provided by Financing Activities 38,775 80,219 Net Change in Cash 213,038 (677,266) Cash balance, beginning of year 791,026 1,468,292 Cash Balance, End of Year $ 1,004,064 $ 791,026 Supplemental Disclosure: Cash paid for interest during the year $ 52,436 $ 39,635 Supplemental Disclosure of Non-Cash Financing Activities: - Purchase of fixed assets under capital lease $ 59,361 $ - The accompanying notes are an integral part of the financial statements. -4- I ' f I CHILDREN'S HOME SOCIETY OF WASHINGTON AND AFFILIATE Notes To Consolidated Financial Statements Note 1 - Organization And Significant Accounting Policies Organization - Children's Home Societyof Washington (the Society) organized for the purpose of helping g 9 is9 P P p� 9 children to thrive and become viable members of society through programs designed to provide support by strengthening families. The Society's programs are provided through regional locations in various cities in the state of Washington. Children's Home Society of Washington Asset Management (CHSWAM) was incorporated on October 16, 2002 as a non-profit affiliate organization Of the Society. CHSWAM is organized to hold and manage real property used by the Society in its programs and purposes as described above. Principles of Consolidation - These financial statements consolidate the statements of the Society and CHSWAM (collectively, the "Organization"). Inter-organization and affiliated organization accounts and - transactions have been eliminated in the consolidation: Programs - Major programs and services offered to the community include the following:, I . Out-of-home care - Working closely with the children and their families to piece together fractured childhoods and build parenting skills so that families may be reunited. Family support and parent education -Working with families early in their children's development and assisting them in securing needed services and developing support systems that enable them to prevent unmanageable crises or family dysfunction later on. Early childhood care education - Assisting parents in learning positive ways to nurture, guide, and develop their children during their first five years of life. Adoption support services - Providing information, support, therapy, and education to the adoption community, the Society maintains its historical commitment to adoption and increases the understanding of complex adoption issues. Child and family counseling - Assisting families in gaining insight into their emotions, resolving conflicts, learning more effective ways to communicate, managing parental and life stresses and being more responsive to the emotional,needs of family members. Advocacy - Advocating on behalf of those who have no voice, by educating policy makers and the public on the complex conditions that plague children and families. f -5- CHILDREN'S HOME SOCIETY OF WASHINGTON AND AFFILIATE Notes To Consolidated Financial Statements Note 1 - Continued Basis of Presentation - Net assets and revenues, expenses, gains and losses are classified based on the existence or absence of donor-imposed restrictions. Accordingly, the net assets of the Organization and changes therein are classified and reported as follows: Unrestricted net assets - Net assets that are not subject to donor-imposed restrictions. Temporarily restricted net assets - Net assets subject to donor-imposed restrictions that will be met by actions of the Society and/or the passage of time. Permanently restricted net assets - Permanently restricted net assets must be maintained by the Society in perpetuity, the income of which is expendable for operations. Permanently restricted net assets increase when the Organization receives contributions for which donor-imposed restrictions limiting the Organization's use of an asset for its economic benefits neither expire with the passage of time nor can be removed by the Organization meeting certain requirements. Revenues are reported as increases in unrestricted net assets unless use of the related assets is limited by donor-imposed restrictions. Expenses are reported as decreases in unrestricted net.assets. Gains and losses on investments and other assets or liabilities are reported as increases or decreases in unrestricted net assets unless their use is restricted by explicit donor stipulation or by law. Expirations of temporary restrictions on net assets (i.e., the donor-stipulated purpose has,been fulfilled and/or the stipulated time period has elapsed) are reported as reclassifications between the applicable classes of net assets under the caption "net assets released from restrictions." Donor-imposed restrictions that are met in the same reporting period are classified as increases in unrestricted net assets. Cash and Cash Equivalents - Cash in excess of daily requirements is generally invested in interest-bearing instruments. Interest-bearing deposits with initial maturities of three months or less are considered to be cash equivalents. However, cash and cash equivalents associated with the Organization's investment portfolio are considered investments since the intent is to reinvest them in longer-term instruments when appropriate. At times, cash deposits with banks may exceed available federally insured amounts. Receivables -Accounts and grants receivable are stated at the amount management expects to collect from outstanding balances. Management provides for probable uncollectible amounts through a charge to earnings and a credit to a valuation allowance based on its assessment of the current status of individual accounts. Balances still outstanding after management has used reasonable collection efforts are written off through a charge to the valuation allowance and a credit to trade accounts receivable. Changes in the valuation allowance have not been material to the financial statements. Short-Term Investments-Short-term investments consist of certificates of deposit and money market funds. These investments are stated at market value. Long-Term Investments - Investment securities are stated at market value. It is the Organization's policy to invest in short and intermediate term debt and equity securities, emphasizing preservation and safety of capital and diversification of risk. - 6- CHILDREN'S HOME SOCIETY OF WASHINGTONAND AFFILIATE Notes To Consolidated Financial Statements Note I - Continued Property and Equipment- Property and equipment are recorded at cost, if purchased, or at fair value at the time of donation, if donated. Property and equipment are depreciated using straight-line methods over estimated useful lives ranging from three to forty years. The Organization capitalizes all items and leasehold improvements over$5,000 to provide a future benefit. In-kind Contributions - Donated materials, property and equipment are recorded at fair market value when received. A substantial number of corporations and volunteers have donated significant amounts of time and services in the Organization's operations. Such contributed services and the related expenses are only recorded in the accounts to the extent that specific professional expertise is provided or a capitalized asset is constructed, in accordance with generally accepted accounting principles. In-kind contributions consist primarily of donated professional fees of $330,647 and $409,456 and in-kind materials/assets of$219,411 and $302,683 for the years ended June 30, 2007 and 2006, respectively. Use of Estimates -The preparation of financial statements in conformity with accounting principles generally accepted in the United States of America requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the financial statements and the reported amounts of revenues and expenses during the reporting period. Actual results could differ from those estimates. Federal Income Taxes - Both the Society and CHSWAM are nonprofit corporations as defined in Section 501(c)(3) of the Internal Revenue Code and, accordingly, the IRS has determined they are exempt from federal income taxes under the provisions of Section 501(a)of the Code. Allocation of Functional Expenses - The costs of providing various programs and other activities have been summarized on a functional basis in the statements of activities and changes in net assets.Accordingly, certain costs have been allocated among the programs and supporting services benefited. Vulnerability from Certain Concentrations - The Society receives fees and grants from federal, state, county and municipal governments. The receipt of governmental funding is generally subject to audit by various governmental agencies, the outcome of which is not-known until the audits are completed. Revenue from governmental agencies represents the following percentages of total support and revenue for the years ended June 30: . 2007 2006 Federal 25.2% 32.9% State 28.9 26.0 County and local 6.5 7.5 Total Governmental Support - 60.6% 66.4% Reclassifications -Certain reclassifications were made to the June 30, 2006 financial statements to conform to the current period presentation. The reclassifications have no effect on previously reported change in net assets or net assets.. - 7- , CHILDREN'S HOME SOCIETY OF WASHINGTON AND AFFILIATE Notes To Consolidated Financial Statements Note 2-Accounts Receivable Accounts receivable consist of the following at June 30: 2007 2006 Government agencies $ 1,468,266 $ 898,867 Pledges 143,993 127,779 United Way 85,018 75,459 Other 16,911 13,810 '1,714,188 1,115,915 Less: Provision for uncollectible accounts (13,471) (23,600) $ 1,700,717 $ 1,092,315 All pledges receivable are scheduled to be collected in less than one year. Note 3-Property And Equipment Property and equipment consists of the following at June 30: 2007 2006 Buildings and improvements $ 6,023,760. $ 6,240,938 Furniture, fixtures, and equipment 2,231,703 2,228,830 Land 1,127,506 1,150,119 9,382,969 9,619,887 Less:Accumulated depreciation (5,347,924) (4,865,107) $ 4,035,045 $ 4,754,780 Note 4-Long-Term Investments Investments are recorded at fair value using quoted market prices and consist of the following at June 30: 2007 2006 Common stocks $ 4,493,217 $ 5,325,217 Corporate bonds 506,826 195,867 Government obligations 1,588,329 1,082,729 Money market accounts 286,189 $ 6,588,372 $ 6,890,002 -8- CHILDREN'S HOME SOCIETY OF WASHINGTON AND AFFILIATE Notes To Consolidated Financial Statements Note 4- Continued Investments held in the Organization's investment fund are restricted as follows at June 30: 2007 2006 Unrestricted Board designated $ 5,433,642 $ 5,916,552 Permanently restricted 1,154,730 973,450 $ 6,588,372 $ 6,890,002 Investment return on investments and cash and cash equivalents is comprised of the following at June 30: 2007 2006 Net realized gains $ 582,544 $ 617,518 Net unrealized gains (losses) - 270,370 (70,340) Interest and dividend income 288,338 206,827. $ 1,141,252 $ 754,005 Investment return on bank accounts and the distributions from the permanently restricted perpetual trust is considered available currently for operating purposes. In addition, the Board of Trustees has directed that income generated from the Society's permanent and board designated investment fund, in.the amount of 5% -6% of the 36 month trailing average of the investment fund's value at the end of the previous three years, be made available each year to fund operations. For the year ended June 30, 2007, the Board of Trustees approved an additional amount of $550,000 to be made available to fund the Society's redesign of its operational model.All other investment income or loss is not spent currently. Note S-Beneficial Interest In Perpetual Trusts The Society is named as a beneficiary in numerous trusts held for the benefit of the Society and other local nonprofit agencies. The trusts, which are held in perpetuity, are administered by financial institutions, the majority of which provide for earnings distributions on a regular basis to the Society. One perpetual trust in which, the Society is the sole beneficiary has earnings distributions on a discretionary basis which are determined by the Trustee in response to specific requests for funds from the Society. These trusts are recognized in the financial statements of the Society at the market value of the Society's share as of the end of the reporting period.The Society received $142,323 and $172,296 in earnings distributions from the trust during the years ended June 30, 2007 and 2006, respectively. The earnings are available for general operating purposes. The Society's interest in gains in the trust value of$527,134 and $182,354 for the years ended June 30, 2007 and 2006, respectively, are recognized in the statement of activities as permanently' restricted activities. One of the perpetual trusts held by a third party bank was terminated during the year ended June 30, 2007. The Society received a distribution of $156,280 from this trust and set up a permanently restricted endowment fund of that same amount in the name of the original donor. -9- CHILDREN'S HOME SOCIETY OF WASHINGTON AND AFFILIATE Notes To Consolidated Financial Statements Note 6-Long-Term Borrowings Notes payable consisted of the following at June 30: 2007 2006 Note payable to commercial bank, monthly payments of$2,192 including interest at 7.31%, due December 2016. Secured by deed of trust on related property in Kent, WA. $ 180,448 $ 192,872 Note payable to commercial bank, monthly payments of$922 including interest at 6.5%through November 10, 2008. Final balloon payment due December 10, 2008. Secured by deed of trust on related property in Wenatchee, WA. 87,786 92,880 Capital lease payable for Tacoma telephone equipment, monthly payments of$355 including interest, due May 2009. 6,999 9,616 Capital lease payable for North Seattle Family Center telephone equipment, monthly payments of$305 including interest and tax, due November 2009. 7,097 Capital lease payable for Washougal telephone equipment, monthly payments of$287 including interest and tax, due August 2011. 12,584 Capital lease payable for Auburn telephone equipment, monthly payments of$614 including interest and tax, due June 2010. 17,635 Capital lease payable for Kent telephone equipment, monthly payments of$357 including interest and tax, due June 2010. 10,331 322,880 295,368 Less current portion 35,318 20,649 $ 287,562 $ 274,719 Principal maturities on these notes are as follows: Year Ended June 30, 2008 $ 35,317 2009 115,296 2010 30,653 2011 19,952 2012 20,095 Thereafter 101,567 $ 322,880 - 10- CHILDREN'S HOME SOCIETY OF WASHINGTON AND AFFILIATE Notes To Consolidated Financial Statements Note 6- Continued Assets under capitalized leases are included in furniture, fixtures, and equipment with a total cost of$75,087 and $15,724 at June 30, 2007 and 2006, respectively, and related accumulated amortization of $8,866 and $262 at June 30, 2007 and 2006, respectively. Amortization expense associated with assets under capital leases is included within depreciation expense. Interest rates on capitalized leases vary from 12.8% to 16% and are imputed based on the lessor's implicit rate of return. Note 7-Short-Term Borrowings The Society has aline of credit for up to $1,000,000 of which $216,678 and $327,334 was outstanding at June 30, 2007 and 2006, respectively. The line bears interest at LIBOR plus 1.25%-(LIBOR was 5.40% and 5.77% at June 30, 2007 and 2006, respectively). The outstanding balance was collateralized by certain of the Society's marketable securities. The Society has a line of credit for up to $1,200,000 of which $0 was outstanding at June 30, 2007 and 2006. The line bears interest at 1% below the bank's prime rate (prime was 8.25% at June 30, 2007 and 2006)and matures on February 1, 2008. Any outstanding balance is collateralized by certain of the Society's marketable securities. Note 8-Refundable Grant During 2005, the Society received a $2.1 million grant from the Northwest Area Foundation to provide technical and financial assistance to help reduce poverty in several areas throughout Northwest Washington. An additional $1.1 million was received during the year ended June 30, 2007 for the same purpose.The grant agreement allows for either party to terminate the grant at any time, with any unused portion refundable to the Foundation. Of the $3.2 million, the Society used $654,523 and $331,329 for the designated purpose, which _ was recognized as grant revenue in the years ended June 30, 2007 and 2006, respectively. The remaining portion of the grant is recorded as a refundable grant at June 30, 2007 and 2006. Note 9-Benefit Plan The Society sponsors a defined contribution pension plan covering all employees meeting minimum age and service requirements. Employees are fully vested in the plan immediately upon participation. The Society contributes 5% of each eligible employee's salary to the plan. The investment of such contributions is directed by each employee based on the investment options available under the plan. Total contributions for the years ended June 30, 2007 and 2006 were$370,990 and $388,498, respectively. r - 11 - CHILDREN'S HOME SOCIETY OF WASHINGTONAND AFFILIATE Notes To Consolidated Financial Statements Note 10- Commitments The Society has entered into various operating leases for facilities and equipment. Total rent expense under operating leases was approximately $258,520 and $236,354 for the years ended June 30, 2007 and 2006, respectively. Future minimum payments required under leases with initial or remaining noncancelable lease terms in excess of one year consist of the following at June 30: 2008 $ 272,352 2009 163,294 2010 86,340 2011 46,758 2012 25,759 Thereafter 4,775 Future Minimum Lease Payments $ 599,278 Note 11 -Related Party Agreements CHSWAM has an administrative services agreement with the Society. Under the agreement, the Society performs certain management, accounting, supervisory, and administrative services for CHSWAM. For services provided under this agreement, CHSWAM pays the Society a fee of$50,000 annually. At year-end, the Society forgave the annual fee due as a contribution to CHSWAM. In addition, on January 1, 2004, the Society entered into eight 10 year leases with CHSWAM for facilities used by its various programs and management. Future minimum payments under the lease agreements total $307,592 annually. Total rent expense for the years ended June 30, 2007 and 2006 was $355,012 and $403,321, respectively. At June 30, 2007 and 2006, CHSWAM forgave $317,644 and $365,951, respectively, of the annual rent due as a contribution to the Society. During consolidation, all these transactions were eliminated. Note 12 - Contingencies The Organization received block grant funds totaling $134,749 from the City of Auburn in 1993 to rehabilitate a facility owned by the Organization with the stipulation that the facility be used as a location for counseling. To ensure that the facility is used for its restricted purpose, the City has a lien against the facility which becomes enforceable should the Organization discontinue operation of the facility before the year 2008. The Organization also received block grant funds in 1996 totaling $159,000 from King County to purchase a building in Kent for the Head Start program. The City has a lien against the facility which becomes enforceable should the Organization discontinue operation of the facility before December 2021. Expenses incurred under certain grant programs are subject to audit by granting agencies. If, as a result of such audit, certain expenses incurred are determined to be nonreimbursable, the Organization may be liable for repayment of disallowed expenses'previously claimed or received. - 12- i _ - CHILDREN'S HOME SOCIETY OF WASHINGTON AND AFFILIATE Notes To Consolidated Financial Statements Note 13- Unrestricted Net Assets Unrestricted net assets are comprised of the following at June 30: 2007 2006 Investment in property and equipment $ 3,712,165 $ 4,459,412 Unrestricted and undesignated (725,938)' (862,524) Board designated investment fund 5,317,003 5,248,943 Board designated building replacement and maintenance reserve 580,000 $ 8,883,230 $ 8,845,831 CHSWAM sold its Tacoma building in December 2006. The Board of Directors has reserved $465,000 of the proceeds for replacement of a permanent Tacoma facility.- An additional $115,000 of the proceeds was reserved for a Building Reserve for agency-wide deferred maintenance. Note 14- Temporarily Restricted Net Assets N Temporarily restricted net assets are available for the following purposes at June 30: 2007 ' 2006 Out of Home Care capital projects $ 389 $ 389 Northwest region capital projects 65,373 65,373 Walla Walla building replacement and maintenance reserve 88,401 84,740 Other programs 465,772 503,002 Centennial campaign capital projects„ 2,982 14,103 $ 622,917 $ 667,607 Note 15- Permanently Restricted Net Assets Permanently restricted net assets are available for the following purposes at June 30: 2007 2006 Endowments $ 874,730 $ 718,450 Hugh Cannon staff scholarship fund 280,000 255,000 Beneficial interest in perpetual trusts 5,008,381 4,637,527 $ 6,163,111 $ 5,610,977 During the year ended June 30, 2007, one of the perpetual trusts held by a third party bank was distributed in full to the Society in the amount of$156,280. The Society has set up a permanently restricted endowment to hold these funds. - 13- SUPPLEMENTAL SCHEDULES '�7ctional Expense - \ ,% --\ , 2007 _ 2006) Program Services Supporting Services Early Child and New Out of Home Family Childhood Adoption Family Business Property Total General& Fund Care Support Education Services Counseling Advocacy Initiatives Services Programs Administrative Development Ei $ 1,505,223 $ 1,527,930 $3,038,114 $ 540,218 $ 1,326,154 $ 118,541 $ 250,760 $ - $ 8,306,940 $ 1,441,088 $ 366,232 $ 356,678 322,551 668,356 128,814 299,920 28,450 60,182 1,864,951 374,288 . 85,987 30,010 15 174,003 1,850 21,335 227,213 47,392 231,489 476,545 58,675 17,561 350 201,384 1,033,396 178,641 96,429 24,181 92,020 64,425 23,001 31,889 2,686 19,689 257,891 55,202 23,475. 23,419 39,087 77,621 15,457 34,506 1,876 8,178 200,144 75,444 3,696 1,344 5,358 5,255 3,490 2,886 256 444 19,033 12,900 16,847 68,214 131,018 137,236 15,992 76,294 14,592 443,346 424,304 6,814 :e 12,722 16,472 36;459 12,205 10,411 1,137 813 _ 90,219 44,001 10,131 13,830 22,823 25,521 12,346 10,795 2,305 56,294 - 143,914 20,961 35,767 13,871 55,556 78,371 37,653 25,423 6,002 25,579 242,455 75,386 25,769 4,315 5,700 15,352 1,442 6,565 508 3,091 36,973 8,554 3,206 533,724 125,768 144,654 276,130 10,286 5 11 1,090,578 158 1,270 401 1,623 11,092 216 30 123 17 13,502 30,610 1,569 3,479 .719 311 4,509 16,737 93 76 - 114 684 332 893 1,110 2,257 550 5,826 332 15 723 45 217 429 88 8,649 10,151 77,845 18,642 36,446 22,942 62,544 8,369 24,0'86 4,182 158,569 29,837 247 7,475 18,446 303,887 10,214 22,207 729 • 92 355,575 17,854 3,860 2,691,623 2,604,208 5,321,264 1,147,611 1,922,693 163,279 _ 654,507 14,505,185 2,891,693 700,163- _407,486 407,486 50,000 50,000 1,700 ' " 126,038 126,038 66 29 61 106 :e 129 CHILDREN'S HOME SOCIETY OF WASHINGTONAND AFFILIATE N Statements Of Unrestricted Activities For The Years Ended June 30,2007And 2006 2007 2006 Operating Activities: Private Support and Revenue: Direct support $ 2,136,672 $ 1,972,449 In-kind support 550,058 712,139 United Way - 1,039,184 910,729 Program service fees 373,494 452,847 Operating investment return 919,505 328,791 Rental income and miscellaneous 124,141 114,619 Total Private Support and Revenue 5,143,054 4,491,574 Revenue from Governmental Agencies: Federal revenue 4,745,751 5,643,289 State revenue 5,448,185 4,475,577 County and local 1,232,763 1,289,666 Total from Governmental Agencies 11,426,699 11,408,532 16,569,753 15,900,106 Net assets released from restrictions 988,425 745,678 Total Support and Revenue from Operations 17,558,178 16,645,784 Program Services Expenses: Out of home care 2,691,623 2,594,149 Family support 2,604,208 3,279,792 Early childhood education 5,321,264 4,393,580 Adoption 1,147,611 797,638 Child and family counseling 1,922,693 2,061,967 Advocacy 163,279 65,735 New business initiatives 654,507 509,200 Property services 533,524 436,568 Total Program Services 15,038,709 14,138,629 Support Services Expenses: Management and general 2,538,772 2,502,139 Fundraising 700,163 975,670 Total Support Services 3,238,935 3,477,809 Total Operating Expenses 18,277,644 17,616,438 Decrease in Unrestricted Net Assets from Operations (719,466) (970,654) Non-Operating Activities: Non-operating investment return 170,095 380,795 Gain(loss)on disposal of fixed assets 586,770 (10,975) Total Non-Operating Activity 756,865 369,820 • Increase(Decrease)in Unrestricted Net Assets $ 37,399' $ (600,834) See independent auditors'report. - 15- Children's Home Society of Washington Board Policy and Administrative Procedures Subject: Statewide Administration • Revision History: Title: NON-DISCRIMINATION 93-95-99-03-07 Page 1 of 3 GOVERNING BOARD POLICY 'It is the policy of Children's Home Society of Washington(CHSW) that no person shall be subject to discrimination by the Organization or through its contractors for any reason, including,,but not limited to: race,creed,color,religion,age,gender,national origin, sexual orientation,marital onveteran status, 'or the presence of disabilities or any other basis protected by state or federal law. CHSW is committed to equal employment opportunities. . • Procedures are therefore established to implement the provisions"of non-discrimination within every • •aspect of CHSW employment, programs,practices, and activities in accordance with federal and state laws and regulations. The intent is to eliminate artificial barriers that exclude, assuring access to both employment and program opportunities and delivery of services without discrimination. ATTACHED: LEGAL/REGULATORY REFERENCE ADMINISTRATIVE PROCEDURES CROSS REFERENCES / / � ' Approved by Date-aiittelia47 241C � air,Boa d of Trustees Children's Home Society of Washington Board Policy and Administrative Procedures Subject: Statewide Adminigtration Revision History: • Title: NON-DISCRIMINATION 93-95-99-03-07 Page 2 of 3 LEGAL/REGULATORY REFERENCE 29 CFR 1630(ADA) WAC 162-26 RCW 49.60.030 COA (HR) 1 PURPOSE CHSW endeavors to maintain the highest standards of accessibility in all matters of employment and delivery of services. Consistent with its organizational values, CHSW fully supports the rights of people to thrive and gain their full potential. It is the purpose of this policy to guard against the occurrence of any discriminatory actions within the Organization,and to ensure that all CHSW policies and practices respect individual choice and diversity. PROCEDURES 1.Children's Home Society of Washington will continually strive to:. 1.1 Promote the right of all people to request services provided within the context of its Mission. • 1.2. Strengthen referral networks within its communities to assist those people who do not qualify for services in accessing other providers who can meet their needs. 1.3. Encourage all qualified persons'in the employment process,ensuring equal treatment in recruiting,hiring,training,compensation,benefits,promotion,transfer,termination,lay- off,reduction in force,or any other terms or conditions of employment. 1.4. Dellne and enhance programs to ensure equal participation and access,never cultivating different or separate aid,benefits, or services to an individual or class of persons unless doing so is necessary to ensure the effectiveness of that person's participation. 1.5. Monitor its performance in providing equitable levels and proportionate access to CHSW's services by all potential recipients. Children's Home Society of Washington. Board Policy and Administrative Procedures Subject: Statewide Administration Revision History: Title: NON-DISCRIMINATION 93-95-99-03.07. Page 3 of 3 1.6. Support any qualified person in the opportunity to participate as a member of planning or advisory boards;or as a volunteer,consultant,or conferee. 1.7. Eliminate and.continually screen-out any criteria or methods that subject persons to discrimination or have the effect of defeating or hindering the achievements of its mission,policies and/or procedures. • 1.8. Prohibit the distribution or display of materials that harass or make derogatory comments. 1.9. Invest only in those sites,facility locations,programs, or activities that give equal l access and accommodation to all who wish to participate. 1.10. Avoid providing assistance to or doing business with any agency or organization that aids and perpetuates discrimination against any category of people. CROSS REFERENCES "Accessibility General Program Operations "Contract Management"-Department Management—Risk Management/Health&Safety "Employment Non-Discrimination and Harassment Resolution"-Department Management-HR "Employment Practices"-Department Management—HR "Facilities Characteristics and Planning"—Department Management-Facilities Affirmative Action Position Statement `D5..✓ fs t;�, Ckh--4-4.—e..-- Approved by President/CEO Date X:1Policies/Statewide Administration/Non-Discrimination Policy Eligible: Children's Home Society of Washington Yes Early Head Start i ''aggi No Application for Enrollment CHILDREN'S HOME SOCIETY Today's bate: Child's Name: bate of Birth: Parent's Name: • Phone: Address: Referral Source: Phone: Number of people in household: Household Income: Other Family Information: Source of Income: ❑ Foster Child ❑ SSI 0 Medical Coupons ❑ Food Stamps Seeking: ❑ TANF 0 Center Based: LR, KCDC, GRCC, LPA ❑ WCCC ❑ Home Based Determination of Income Points Selection Rating Scale 30=At or below Federal Poverty Level 20=$1,000 annually over Federal Poverty Level 1. Diagnosed disability 50 10=$1,000-$5,000 annually over FPL Suspected disability 30 0=more than$5,000 annually over FPL 2. Early/Head Start Transfer 50 3. Partner Agency Referral 40 Income Points: 4. Homelessness 50 5. Pre-Natal—3month old 30 6. Teen Parent 50 Next Steps towards Enrollment: 7. No Medical Coverage 50 • Explain waiting list&who will call next 8. English Language Learner 20 • If necessary, call caseworker to establish 9.Underserved geographic area 30 child care need • 10.Special concerns for child • Locate Immunization Records or family 30 • Locate proof of income for last 12 months +Income Points = TOTAL: Original: Admin Specialist/Point of Intake for HSFIS Entry Copy: Recruitment Binder Copy: Option Coordinator EHS/MK 9/07 Approved by PC 9/24/07 04/15/2008 16:33 2538500220 KENT OFFICE PAGE 03 Early Head Start Family Demographic Form SECIIOKJ jU)LT APPLIC, _ • an, e , v :^n. y rw :ntac,r �a� fin•,u.y..; ,, wti "t !I?.6, r (U f9. :11 ..b gamin, 4 "r' ,%i 4c +rl'r °HEs`; ,�T. s w Bra 1 CM/W., I hie �t� + .��; �,} avr�,: kr v. d.^•�,y� „ �J t Y`;Ss.`s, �,�: ya `c'�y'k5'K'•• 4'"�, ••��,,�� �,�Qa , , rb j �"FN �, ��^I, .;rfiya. ^d f�i�'s? G'�_� ert- c �'r�'�I� ,u � ,�p•�`"� t° 4�f i9y�'��i �� :h;S T�•.��; ,i ll ` i rr,,,J ., x orwita ,J i �P�:;`(1;. ?,., 5�,. � ,•� 7;;•�„��e'1!{k'(.e��` ,",'Ss"•�S ;ri�''�d( y�3 .4� . :.,JC,,�y 'aN';f'^•1 rt, :ter wJ�r S, ,,..a.,. ., u, }. �,.:G Yg A'§..p. .67 ti�'.i. ,.k. .y. � 1p,- .'. M �Sr�• '7Y r '\r:I a,?K�y'i+ ti;t,.J,;• , Wyk f' ..,��1, 4 ,2: b•9:�c,t.�Y . .>.s '. + is b1'+ 1 �11Y•: .f �T,,..,1 +^i i r ,. F 'L �' 'i it ! K i�,-•¢� ,cr,�X..bt"'\\di Na�,wD y��S1$td���nlh�t�v",G,��S9rt�'r74V��i�h'�1r�:�'��:��+W�,<,�5<.�:145?Y1a,1v��ia?{�'���t,�f1�'k����Fi�•(�jws i���2rJ,>r'A�.,,�t,;Fly.n✓w•� '�;L„�A.�e.,-,R�,v;(��.+,ydlb�cd,a,rkrtf�h„tf�"ll�no•remsLv_ �,yy�th5.,,. .��6� '� �:1� Applicant Name: _ _ First name MI Last name Date of Birth: SSW - Gender; CI M 0 F 0 Mother/Mother Figure El Father/Father Figure 0 None of the Above Address: Street Apt.# City State Zip Code Telephone: - , Area: (Mark all that apply) 0 Living ❑ Mailing ❑ Pick-up 0 Drop-off 0 Other:Specify Other Address: -- (if applicable) Street Apt.# City State Zip Code Telephone: Area: (Mark all that apply) ❑Living 0 Mailing CI Pick-up 0 Drop-off ❑ Other: Specify Work Phone: Work Phone Ext. Message Phone: , Race/Ethnicity,If Desired Specify Sub-Category(Mark only one): Q American Indian or Alaskan Native Ci Asian ❑ Black or African American 0 Hispanic or Latino ❑Native Hawaiian or other Pacific Islander 0 White ❑ Sub-Category • Comments; Language(s)Spoken: Primary: , Secondary: _ English Speaking Ability: 0 Very well ❑Well 0 Not Well ID Not at all Martial Status: El Single 0 Married ❑Separated 0 Divorced ❑Widowed Applicant Is Currently Pregnant: 0 Yes 0 No 0 Not applicable 04/15/2008 16:33 2538500220 KENT OFFICE PAGE 04 Early Head Start Family Demographic Form CTION I:AA I,T�dEI'Z,ICAM No .._ .......� 1 s a`rerson's Relationship to the Eligible Child(ren): Eligible Child Name: Relationship to Child: • Eligible Child Name: Relationship to Child: Primary Occupational Status(Mark only one); Date: 0 Paying job ❑In job training program O Full-time(more than 34 hours weekly) El Training program with salary O Part-time ❑Training program without salary 0 Seasonal-Non Agricultural 0 Seasonal-Agricultural El Unemployed ❑ Employed and in school 0 With past employment experience ❑With no previous employment experience ❑ In school, 0 Towards high school diploma/GED 0 Other ❑Towards trade/business qualification El Homemaker D Towards college degree 0 Retired ❑ Towards postgraduate degree 0 Unable to work due to disability El In school and employed ❑ Other 0 Not Applicable `Highest Level of Education Completed: Date Completed: , Attended Vocational Training,Trade or Business School: ❑Yes 0 No (Skip to next question) Received certificate or license: 0 Yes 0 No Participated in.Government Training Program: 0 Yes 0 No (Skip to'next question) Training program(s)attended(Mark all that apply): ❑JOBS 0 JTPA 0 Job Corps 0 Other:Specify Person is Willing to Pursue Additional Education/Job Training: A Yes El No Q Not Applicable Person Previously Enrolled in Head Start or Other Childhood Development Program: ❑Yes ❑ No If yes,specify which program(s),and date(s)of attendance: (Use date format;MMIDD/YYYY) El Early Head Start from // to / / ❑ Parent and Child Center(PCC) from . / _._/ to / / ❑ Comprehensive Child Development Program(CCDP) from / / to _/ / ❑ Head Start Family Child Care Program from / / to / / 0 Head Start Migrant Program from / / to / / © Head Start Home-based/Home visit for 3-5 yr.olds from / / to // Q Head Start Center-based for 3-5 yr. olds from / / to / / ❑ Other:Specify from / / to / / • Applicant is a Teen Mother: 0 Yes ❑No 04/15/2008 16:33 2538500220 KENT OFFICE PAGE 05 Early Head Start Family Demographic Form El Yes 0 No Applicant Currently an Elementary, Middle or High School Student: Current level of school: 0 Elementary 0 Middle or Junior high El High school School attended: Teen parent program in school attended: In Yes CI No Applicant enrolled teen parent program; CI Yes CI No • • • r. �� v":x }:` J'kk' ^:r 1 .rj- rc,:".,a •+,t•',r y,9yg. .:, ',";t. s k •R+c. .t ,'(Y ^4'fw';.0 r,,4�y,Id}';, ,;) -'yt"?'�T'Say�`:'�i:',i,'v`'.%--,,�,.r`,�'* °'}a br S L."•%• q1l, q ,. , .,j{�;,;',;.d -l{'Ji' a•:{�1.,, "S, ., {"„,„,), ;F'0k, ,4,f,,,,,, .14) ?w--,,f4. <"' •Y,•t ii?1m,m✓, ✓,..4 r,' my tic;.,r'}M.l n�tv r.,!t :F.,l .d :4F, , vi ,• ;.�qi��7`:",.'.-_.� �. 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Street Apt.# • City State Zip Code Telephone: - Area: _ (Mark all that apply) • '© Living ❑ Mailing ❑ Pick-up 0 Drop-off 0 Other; Specify • • Race/Ethnicity, If Desired Specify Sub-Category (Mark only one); . '❑ American Indian or Alaskan Native CI Asian ❑ Black or African American ❑ Hispanic or Latino ❑ Native Hawaiian or other Pacific Islander ❑White ❑ Sub-Category Comments: Language(s) Spoken: Primary:- - _ — Secondary: English Speaking Ability: 0 Very Well ❑Well ❑ Not Well ❑ Not at All • Concerns About Child's Overall Health and Development: © Yes 0 No (Skip to next question) ❑ Don't know (Skip to next question) I . Describe Concerns: Concerns expressed by: • ❑ Primary Care Provider 0 Social Service Agency • ❑ Medical Provider ❑ EHS Program Staff ❑ Family Member Cl Head Start Staff Page 1 of: 04/15/2008 16:33 2538500220 KENT OFFICE PAGE 07 Children's Home Society of Washington Early dead Start Family Demographics Form SECTION 2: ELIGIBLE CHILD ; C7 Other Person or Agency: Specify Child Previously Enrolled in Head Start or Other Childhood Development Program: C Yes Ci No (Skip to next question) If yes,specify which program(s) and date(s) of attendance: (Use the date format: MM/DD/YWY) ❑ Early Head Start from / / to __/ / ❑ Parent and Child Center(PCC) from / /,_ to / / ID Comprehensive Child Development Program (COOP) from / / to / /— ❑ Head Start Family Child Care Program from / / to / / ❑ Head Start Migrant Program from __ _/ /,_�to / / ❑ Head Start Home-based / Hornevisit for 3 -5 yr olds from / / to / / ❑ Head Start Center:-based for 3 -5 yr olds from / / to / / • 0 Other; Specify from / / to _-_/ / Child to Be Cared For By Someone Other Than the Head of Household in Addition to Participating in Head Start: ❑ Yes © No If yes, specify Day Care Provider(s) (Mark all that apply): ❑ Older sibling under age 12 ❑ Adult nonrelative in non relative's home ❑ Older sibling age 12 or older ❑ Child Care center CI Relative U Not yet arranged ❑Adult nonrelative in child's own home ❑ Other: Specify 1 • ., •�, .:, .:...,:•-, ,-:.:..•...:r...�.::,,:•.,•,:n-9•.'::•••rr..,,•n.4:do '.n:v !:Y: - '�f' - .:v'.:' gr.:^;I'w"�r;,ri>t ^.i' i.iti:`;:1;:+1"-e.`,; .,t.r..rns �p .,. -•u� �/r�,r;a,,y.Jl ,u"i,,, ,.•ep.i ,.In �,-•..5.,,.. r,• n,:�lF"i7h +!t a'r!•N:•• r�;•Jt'I' ,J4...,�,.- .,r•;,,.., r iti •.n d.,...-i:.:,. 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' i;. i •7J5 fi .1 •" ;._.;. i,8: F 3r; � i�lii., rry�.ty y, -.6,.1 ti 11,N r i, � ��• .,�.:,, ,i;%i n ,� 1 i]' ';�+� Jr,,,,t JI.�•';�,�.ter:;I:L"bcu:Aug'iti .Y�tt.i.�5'1I�'.. [r•�'w-L"�w.<J.,lf"r. ,., - vi�.: is-apOthr�:•Seify•'�ari_-��-T :>: „s:..r��- -�n:r��,:�:x,->tr,.�,..�4:' ',:'�?���•�:� ems. Parr yr2 ADMINISTRATIVE HEADQUARTERS 3300 N.E.65th Street t Cfi 896_ P.O.Box 15190 Seattle.WA 98115 (206)695-3200 Main LDREN'S (800)456-3339 Toll Free 1-kAiiE SOCIETY (206)695-3201 Fax www.childrenshomesociety.org Washington • • Sliding Fee Scale OFFICERS • CHAIR There are no program service fees for CHSW's home based EarlyHead Start Dan Merlino p g VICE-CHAIR program so there is no sliding fee scale. Cliff Tingley TREASURER Eric Greenwood SECRETARY Virginia Root PRESIDENT/CEO Sharon Osborne • • HONORARY LIFETIME TRUSTEES Linda Ashlock Lyman H.Black,Jr. Joseph C.Donoghue H.Graham Gaiser • • Joan Hutson Dan Merlino • Sh, borne Ga• , John L.Robins Leo G.Smith Patricia Sundquist TRUSTEES Mark Aldridge Brett Allen Jacque Cabe Richard Corella Stephen Dennis Barbara Jirsa Pam Kaiser Rod Kaseguma Otto Klein Andrew MacDonald lhssane Mounir • Gayle Murdock ' Tom Oldfield Bev Press Joseph Wilds John Williams W X United;7,, �• �! Way � �y, � : �.— .�n�:: . `�; Community Partner • y CHILDRENS ALLIANCE Children Home Sn�•irty ,evn,u,iwc>.r +,- IFCW OF AMERICA 1,Tram, G I 22 (, c _ I + 1 C20`G'`•i 'l gency: Communities In Schools of Renton Program: Family Liaison / (- ,/ �r� ,,11,E , Application Cover Pages (Agency Information andi5 uestions ri)0 '-' ` '' s A eio , Iiifoaat''` ' : °, ' . ' Agency Name: :ke.,4::/z.,-,Vh®A, / Applicant Name and Address: Agency Di recto S Communities In Schools of Renton Susan Richard/Exec t v Director 1055 So Grady Way Name and Title Renton WA 98057 425.430.6656 (Area Code)Telephone srichards@cisenton.wa.us 425.430.6657 E-mail address(if available) (Area Code)Fax Number Requir• • signatures: By signing below,you certify that the information in this application is accurate to the b, r.f your knowledge d that you have read the application, certifications, and appendixes. (SI C , TURE UST IN BLUE INK) 4-h.4hef /-4,,c,,_ ‘-e---e -e.J1-- 9-4_.c/ee ignature of Agency Board President/Date / Signature of Agency Director/Date Robert McBeth Susan Richards Printed Name of Agency Board President Printed Name of Agency Director _.,. ' Frog ram Information. 1. Program Name Family Liaison Program Contact Person(available to answer specific questions on this application) Susan Richards 425.430.6656 . Name (Area Code)Telephone Address(if different than above) srichards@ci.renton.wa.us 425.430.6657 E-mail address(if available) (Area Code)Fax Number 2. Program is New for our agency ❑An Ongoing Program Ell 3. Brief Description of Program(One sentence) This program provides school based family support and community resource linkage to families of children at risk of school failure in the Renton School District. 4. Where are services provided? (If different from agency location) Services are provided at high needs schools across the Renton School District identified by factors such as high free/reduced lunch,high Transiency and low WASL scores. Page 1 Agency: Communities In Schools of Renton Program: Family Liaison 5. Total Program Cost: ' Actual 2007: $338,558 Proposed 2009: , $340,846 Projected 2008: $327,736 6. Total City Funds Requested for this Program: City Awarded 2008 Requested 2009* General Fund CDBG Total Requested** Auburn Federal Way Kent Renton 12,327 13,560 City Awarded 2008 Requested 2009* General Fund General Fund Burien Covington Des Moines Enumclaw SeaTac Tukwila *Cities on a two year funding cycle will renew 2009 awards to 2010 based upon performance and availability of funds. See Part II for city specific information. **Include your total request for Auburn,Federal Way Kent and Renton. The source of funding will be determined by staff. Page 2 Agency: Communities In Schools of Renton Program: Family Liaison 7. Agency Contact Sheet Provide the following information for the agency and for the program requesting funds. Agency Contacts General Agency Name: Communities In Schools of Renton Address: 1055 So Grady Way City/State/Zip: Renton WA 98057 Phone/Fax: 425.430.6656/425.430.6657 Agency Web Address: www.renton.ciswa.org Executive Director Name: Susan Richards Title: Executive Director Direct Phone: 425.430.6656 E-Mail: srichards@ci.renton.wa.us Development Director Name: na (or Grant Writer) Title: Direct Phone: E-Mail: Finance/Accountant Name: Susan Richards (person preparing invoices) Title: Executive Director Direct Phone: 425.430.6656 E-Mail: srichards@ci.renton.wa.us Program Contact (Staff contact for contracting, reporting and program implementation.) Program Name: Family Liaison Staff Name: Susan Richards Title: Executive Director Direct Phone: 425.430.6656 E-Mail: srichards@ci.renton.wa.us Page 3 Agency: Communities In Schools of Renton Program: Family Liaison - 8. Organizational Experience A. Experience Communities In Schools of Renton is a non-profit, 501(c)(3) which was formed in 1994, from a common vision of the Renton School District, the City of Renton, and community partners to help support the success of children and youth. The mission of the agency is to champion the connection of community resources with schools to help young people learn, stay in school and prepare for life. Communities In Schools of Renton has developed and implemented collaborative programs with the School District and committed partners since 1996, providing services to children at risk of school failure and their families through the Family Liaison and Mentor Programs. The Family Liaison Program provides school based family support and resource linkage to families of students at risk of school failure. The Mentor Program matches a community volunteer with a child in need of support to meet one hour a week at the child's school. Both programs are coordinated at high needs schools and are implemented in partnership with the Renton School District. Susan Richards has been the Executive Director of the agency since 1994. She has built strong relationships with community partners and has a good understanding of human services needs in Renton. She was instrumental in the development and implementation of both the Family Liaison and Mentor programs. She has performed formal program evaluations since 1998 and continues to use data to improve services to children and their families. - Since 1996, Family Liaisons have worked with children at risk of school failure and their families providing support and access to needed community resources with the intent of addressing issues in the home environment which are impacting school performance. Last school year, 1054 children and their families were supported through this program. Demographics for those served are reported below: • 92% were on free or reduced lunch. • 75% belonged to an ethnic minority group. • 59% lived in single parent, female-headed households. • 26% were homeless. • 24% had limited English proficiency. When we compare this profile of children served against the risk characteristics that we will discuss in detail later, it confirms that we are reaching those children with the potential to be at risk for school failure based upon their demographics B. Organizational Structure Communities In Schools of Renton is governed by a board of Directors which consists of representatives from the City of Renton, the Renton School District, local businesses, church groups, service organizations, social service agencies, businesses, parents, and students from each of the District's high schools. The goal is to have a mix of gender, ethnicity and ages on the Board and focus on increasing the diversity when looking for prospective board members. Currently the board membership is 43% female - 57% male, 75% over forty- 25% under forty, and 75% white — 25% ethnic minority. Seven members (25% of the Board) are City of Renton residents. We also look at diversity in the areas of affiliations to include a mix of business, Page 4 Agency: Communities In Schools of Renton Program: Family Liaison government, school district, agency providers, churches, parents, high school students, PTSA, community service organizations, and community members. The Board meets monthly, except July and August and is responsible for establishing all policies, approving the annual budget and monthly financial reports, and authorizing all grant requests. They also authorize and monitor all contracts and partnership commitments. The Executive Committee consists of the four Board Officers, the Chairs of the Program and the Development Committees and representatives of the Renton School District and the City. They meet monthly and prepare the draft budget for Board approval, set the Board meeting agendas, oversee Board member recruitment, and supervise and evaluate the Executive Director. They also review all contracts annually to ensure that all commitments are being met. The Development Committee is responsible for overseeing and coordinating all fundraising activities. The Committee consists of the committee Chairperson and Team Leaders for the five major fundraising functions; Major Gifts, Recognition Dinner, Contributors, River Days Fun Run and the Golf Tournament. Board members volunteer to be on at least one of these fundraising Teams. The Program Committee is responsible for developing and overseeing all significant program changes and identification of school sites for the placement of program services. The Committee membership consists of the committee Chairperson, Board members and community agency representatives which allows for thoughtful analysis of programming and community needs. This Committee is also responsible for the oversight of the annual evaluation process. Program operations are overseen by Susan Richards, Executive Director of CISR. She works closely with Susan Mather, the Executive Director of Elementary Education in the School District. Susan R. keeps the programs connected with the broader community resources, program practices, emerging issues, initiatives and programs, while Susan M. keeps activities aligned with school policy and integrated into District programs and practices. This partnership allows program staff to be supported in both worlds; school and community. In order to strengthen the relationship and communication between CISR and the schools, CISR board members annually visit school sites served by our programs to assess the level of satisfaction with program services. In addition to increasing the school's awareness of the agency, it also increases Board member's awareness of the existing and emerging needs of children and their families based upon reports from the principals and staff. The agency also has an Advisory Council which meets annually and provides input and oversight to the Board. This group is made up of community leaders and is co-chaired by the Mayor and the School District Superintendent. Participants include City Council members, School Board members, Police Chief, Fire Chief, Chamber of Commerce President, presidents of local service clubs, religious leaders, executive directors of partner agencies, representatives from the Teacher's Union, the PTA Council, representatives from local parent groups, local community councils, and other prominent community leaders. Data gathered from the school site visits, discussion at the annual Advisory Council meeting, and items shared at the Board meetings from Board members, as well as reports from the Executive Director, all help to keep the Board informed of the needs in the Renton community. Page 5 Agency: Communities In Schools of Renton Program: Family Liaison 9., Need for Program A. Problem Statement In a study of Graduation and Dropout Statistics for Washington's Counties, Districts, and Schools (Class of 2003), it was noted that the dropout rate for American Indian, Black and Hispanic students along with children with limited English skills or low income is higher than White students. Disadvantaged youth (including low income and minority children) are nearly twice as likely to drop out of school (National Center for Education Statistics). Two additional factors that have been correlated with poor academic achievement include single parent homes, where children are more likely to be in poverty, and high transiency. Below is a review of local data which illustrates the prevalence of these factors in South King County and within the Renton community. Poverty • From 1979 to 2004 the percentage of the King County population living below 200% of federal poverty level increased 2.5%. While no regional data was available for 2004, data for 1979 — 1999 in the Seattle, North and East regions showed either a decline or a slight increase (.2%), while the South region had an increase of 4.3%. (Communities Count 2005) • There is a similar pattern in the percent of children age 0-17 living below 100% of poverty. For King County between 1989 —2004, this percentage increased by 3.46%. For 1989 — 1999, the Seattle and East Regions showed decreases, and the North region a slight increase (.7%). During this same time period, the South Region showed a 1.5% increase, twice that of the North region. (Communities Count 2005) • The average number of students in the Renton School District receiving free and reduced lunch has increased from 28% in 1998 to 46% in 2008. Ethnicity • 36% of the ethnic population of King County live in South County with more than 1 out of 4 residents being a person of color. (A Matter of Need, South King Council of Human Services) • The percent of King County residents who are immigrants increased overall by 6.1%, but the largest increase was in South Region which grew 8.3% (The Health of King County 2006) • Within the Renton City limits, the percentage of those who identify themselves as minority has increased by 15.3% from 1990 to 2000. (Changing Face of Renton-May 2004) • The Renton School District ethnic population has grown from 30% in 1992 to 62% in 2007. Limited English Proficiency • Over age 5 population speaking a language at home other than English rose from 10.1% to 22.6%, an increase of 123% (The Changing Face of Renton-May 2004). • 'Over age 5 population that speaks English "less than very well" increased from 3.7% in 1990 to 12% in 2000, an increase of 224% (The Changing Face of Renton-May'2004). • The percentage of students whose home language is not English has increased from 24% in 2005-6 to 30% in 2007-08 Page 6 Agency: Communities In Schools of Renton Program: Family Liaison Single Parents • More than one out of three households with children in South King County are headed by a single person. (Matter of Need, South King Council of Human Services.) • According to Census data in 2000, 23.6% of children in Renton were living with a single parent compared with 12.4% in 1990. Academic Achievement Data • The Office of Superintendent of Public Instruction's published "On Time" graduation rates show that the Renton School District dropped from 77% in 2001 to 59% in 2004 an alarming decrease of 18%, which is the second highest drop in the state with the Seattle School District having a 24% decrease. (Communities Count, 2005). • High school dropouts are almost 3 times as likely to earn at or below minimum wage than those who complete high school with no further education (National Center for Education Statistics.) • Renton School District WASL scores for 10h grade students who met the state standards in Math (39%) and in Reading (70%) were lower than the state averages of 50% and 81% respectively. B. Target Population The schools targeted for services were selected through an assessment of criteria which incorporates these demographics and provides a focus on schools where students may have a higher need for support to address barriers to education based upon the prevalence of these factors. Below are the averages of selected criteria for targeted schools. Free/ Failed Reduced Ethnic In ELL Transient WASL Lunch Minority classes Reading February October March 2006 - Spring 2008 2007 2008 2007 2007 Averages at Target Schools 58% 73% 22% 39% 41% Students at targeted schools are referred to Family Liaisons because of concerns about the impact of their home environment on their ability to be successful at school. The majority of children referred have many of these factors present in their lives. Page 7 Agency: Communities In Schools of Renton Program: Family Liaison 10. Proposed Program/Service A. Program Description Since 1996, Family Liaisons have worked with children at risk of school failure and their families providing support and access to needed community resources with the intent of addressing issues in the home environment which are impacting school performance. Last year, 1054 children and their families were served, of these students, 483 received support 3 or more times, which we consider the threshold dosage for intensive services. The request from the City is to support the delivery of intensive services to children and families. Family Liaisons are based in high needs schools as the member of the school team who work with the parents in a non-traditional way. The Liaison's job is to support parents/guardians and help them move towards self-sufficiency. Service delivery is personalized based upon the strengths and needs of the family and coordinated with other community resources. Staff receives training and professional development in areas including; family support principles and practices, developing strengths-based service plans, and Asset Development. The Family Liaisons are well trained in their role to serve, not dictate to families regarding needs and solutions. There is an established service provision process which guides their work, yet allows the flexibility to work with families based upon their receptivity and functional readiness. One parent may be in the midst of a crisis and can only think about getting food for dinner, while another may be ready to start job training. The referral process for the Family Liaison Program is primarily through school staff which includes teachers, counselors, and principals, but we have seen increasing numbers of referrals from parents and students themselves. After receiving a referral, depending upon the nature of the issue, a Family Liaison will traditionally meet the child first and then meet with the parents or guardians at a flexible time, often at their home or work; somewhere they Y are comfortable. The first meeting is usually to introduce themselves and offer general support. It may take several visits before enough trust is developed for a parent to share major issues or concerns. The Family Liaison works with parents/caregivers to identify their strengths and assets, and then helps them identify concerns they have in any of the domain areas of family, living arrangements, educational-vocational, social-recreational, psychological-emotional, medical, legal and safety. When issues are identified, the Family Liaison and the parent work jointly to develop a plan built upon the parent's assets with specific action steps to be taken by the Family Liaison and the parent. At times, if a family is in crisis, the Liaison may simply take responsibility for dealing with urgent needs, like getting food into the house. They are careful that this is not a long-term strategy and work with families who are always "in crisis" to identify and take proactive steps to help break this cycle. While dealing with families, the Family Liaison's overall objective is to build upon strengths, encourage self-sufficiency and help implement long-term solutions to address their issues. The majority of the Family Liaison's work is providing families with information and linkages to community resources to help them get assistance with things like food, clothing, emergency housing, domestic violence services, medical and mental health services, ESL/ELL classes, GED classes, and employment training and placement. For their children it may include school supplies, backpacks, warm coats, gym uniforms, eyeglasses, dental work, money to participate ( in a field trip, books to read at home and summer activities. To facilitate obtaining this assistance, the Liaisons are experts at knowing both traditional and nontraditional community resources and how to access them. Family Liaisons work in partnership with other agencies Page 8 Agency: Communities In Schools of Renton Program: Family Liaison such as Renton Area Youth and Family Services, Salvation Army, Renton Clothes Bank, Department of Social and Health Services, ECEAP/Head Start, the Seattle-King County Department of Public Health, and the YWCA to help increase access to services as well as coordinate efforts to avoid duplication and ensure needs are met comprehensively. Family Liaisons also have strong connections with local community groups including churches, service groups such as Rotary, and businesses to help address some of the individual needs which cannot be met through traditional systems. This helps in individual cases like a mom who was barely making ends meet with two children on free and reduced lunch, a car that wouldn't start and a new job that was not accessible by public transportation. She had money for the part for her car, but needed a mechanic to do the work. A minister from a local church found someone in his congregation to do the work for free. While working closely with families, the Family Liaisons develop a trusting relationship with the parent/guardian often acting as their advocate to ensure that their concerns are being heard and addressed. As a result, the families often see the Liaison as someone in the school system who cares personally about them and their children. Family Liaisons are frequently successful in encouraging and supporting disengaged families to increase attendance at school conferences and events, and to participate in classroom activities, resulting in improved support for the child. As the diversity of the School District and the Renton community continues to increase, it has become increasingly important for staff to become and remain culturally competent. While the Family Liaison's approach to children and their families may vary depending upon culture and traditions, the premise of respectful support guides their interactions. A key step in recognizing and honoring cultural beliefs, practices and traditions for families within the context of services provided, is staying knowledgeable of emerging immigrant and refugee cultures in this rapidly changing community. Currently, four out of six family liaisons are people of color and two are bi- lingual. Such a diverse staff helps maintain sensitivity of working with people of other cultures. All,Family Liaisons participate in ongoing professional development focusing on strengthening cultural competencies, including the Culture of Poverty training. Family Liaisons also attend meetings with immigrant/refugee community groups and agencies to learn more about providing support to specific cultural populations in their schools. The Executive Director of CISR continues to identify and explore partnerships with culturally diverse organizations including immigrant and refugee groups and ethnic mutual assistance agencies. She also participates in local and regional forums to develop strategies to support culturally diverse families while continuing to look for assets within the Renton community to help provide solutions. An additional need is to ensure adequate communication with families with limited English speaking abilities to help to meet their needs. With the current number of languages spoken by children in the Renton School District at 81 and growing, communication is a significant barrier, especially with the more recently emerging languages and for those cultures with no formal written language. While we have bi-lingual staff, we are not capable of assisting with communication for all languages. The Renton School District does translate some of the more common forms into the top languages spoken including Spanish, Vietnamese, Russian, Somali, Chinese and Tagalog. However with the variety of needs for the families we serve, the need for translated materials and interpreters has increased dramatically. To address this, staff utilizes formal sources like the Red Cross Language Bank and the Department of Public Health, along with informal sources including teaching assistants who speak the language and older siblings to help with communication. Page 9 Agency: Communities In Schools of Renton Program: Family Liaison B. Program Measures and Outcomes Standardized program evaluations began in 1998 and critical outcomes and indicators have been tracked since that time. Annually, staff gathers data surveys to children, parents/caregivers, mentors and teachers, as well as collects information on grades, attendance, and disciplinary actions from school records. Below we have identified the targeted indicator for outcomes under each performance measure. Performance Measure One: Number of unduplicated students living in the City of Renton whose families receive support three or more times. Outcome: Parents will increase access to community resources to meet their needs. Indicator. 70% of parents surveyed will report an increase in access to community resources. Performance Measure Two: Number of all students whose families receive support throughout the year. Outcome: Parents increase their connection to their child's school. Indicator. 70% of parents/caregivers will report an increased connection with their child's school. Page 10 Agency: Communities In Schools of Renton Program: Family Liaison C Staffing plan and evaluation Staffing plan - The plan is to have .5 FTE of Family Liaison support in each of eleven high needs elementary and middle schools in the Renton School District, resulting in 5.5 FTE's of Family Liaison services. For each of the schools, the goal is for 91 children and their families to be served with an array of supports aligned with the needs identified. Currently 45% of families served receive "intensive services" identified as 3 or more contacts with the student and/or family. As outlined above Family Liaisons provide one to one support and resource linkage to families. Family Liaisons come from a wide-range of background including counseling, social work, school intervention and youth programs. The Family Liaisons are supported by the Executive Director of CISR who allocates 40% of her time to the supervision and oversight of the Family Liaison Program. In addition to program supervision, the Executive Director is responsible identifying emerging areas of need and facilitating partnership building with additional formal and informal resource providers to bring needed services and supports to families. There is .34 FTE of administrative support to assist with data collection, and resource coordination to include the allocation and distribution of goods received from the community. Evaluation -The Executive Director is responsible for the management and facilitation of the annual evaluation process, with oversight from the Program Committee. The Executive Director oversees data management and collection over the year, culminating in the end of year assessment. Demographic data including ethnicity, economic information, English language ability, and housing status is gathered on children and families served through the program on a monthly basis which allows for a current year to date unduplicated number and composition of children and families served. Repeat child and family visits are also tracked to determine the longevity of the helping relationship while families are receiving services. In'May and June, program staff gather completed program related surveys from parents, children, and teachers along with data from school records on grades, attendance and behavior. In order to gain additional input from parents and students who participate in the programs, additional questions are included in the surveys which assess factors such as their level of satisfaction with services, the outcomes of support, and how the program could be more helpful to their situation. The Executive Director compiles the results of the evaluation and reviews the findings with the Program Committee and staff for their assessment. The Program Committee compares results with the targeted indicators and with previous years' data. After a thorough review and development of any necessary recommendations to program services or evaluation processes, the results and recommendations are taken to the Board for information and approval as necessary. The Executive Director implements necessary changes to program services and/or the evaluation process. The annual evaluation results are shared with the community through distribution of the CISR annual report, presentations to School Board and City Council and on the CISR webpage. The annual evaluation results are also reviewed with the Advisory Council for review and feedback Page 11 Agency: Communities In Schools of Renton Program: Family Liaison 11. Long Range Plan Communities in Schools of Renton staff and Board began a strategic planning process early in 2008, with support from one of our partners, Social Venture Partners. Board members convened on April 19, 2008, to identify goals or strategic priorities for the next three years. The Planning Committee has overseen the planning process, and will continue to oversee the process of converting the broad statements agreed upon at the retreat to clear goals, objectives, action plans, and resource plans. The facilitator led the whole group through brainstorming strengths, weaknesses, opportunities and threats related to the future success of CISR. Strengths and weaknesses are within the organization; opportunities and threats are in the external environment. The results are shown below. The number preceding each item reflects how it was categorized during the prioritization activity that followed the SWOT. Following the categorization, all participants "voted with dots" for the categories deemed to be the most important for the future success of CIS of Renton identifying the following four priority areas: • Marketing • Fundraising • Board development • Infrastructure The Planning Committee has the responsibility of managing the planning process through the development of goal statements, objectives, action plans, and resource plans. A final document will be presented to the Board for approval and would be available upon request. Page 12 Agency: Communities In Schools of Renton Program: Family Liaison 12. Budget A. Budget Request Narrative All requested funds will be used to support the Executive Director position and the facilitation of the'Family Liaison Program to include partnership building, training and support for family liaison staff along with the identification of additional formal and informal resources. B. Changes to Budget There have been no changes to the 2008 Budget since adopted. We anticipate no changes to the budget between 2008, 2009 and 2010. C. Cost Per Service Unit 2009 expenses for the Family Liaison Program are budgeted at $340,846. The program service goal is to support 1,000 children each school year. This number is based upon the historical data of having a .5 FTE provide quality services to a minimum of 91 children and their families at each of the eleven school sites. Based upon the target of serving 1,000 children and the budgeted expenses of$340,846, the cost to serve each child and their family will be $340. This amount covers an average of 5 home visits and/or meetings to help identify issues, to provide community resource identification and linkage, and offer ongoing support as the family moves towards self-sufficiency. Page 13 Agency: Communities In Schools of Renton Program: Family Liaison Data Table Requirements (Questions 13 — 18) The following documents contain all the data tables you are required to submit with your application. If you are submitting an application to continue an existing program, complete the following data tables with informationpertaining only to this application. If you are submitting an application to fund a new program for your agency or forming a new agency, organization or a team of agencies and you do not have client data which is specific to your proposed program, fill out the data tables with informationpertaining to what you predict your program will accomplish (projected). Explain in the applicable questions in the narrative for your program and how the numbers for each data table were determined. 13. NUMBER OF INDIVIDUALS /HOUSEHOLDS SERVED (DATA TABLE) Provide the number of individuals or households your program serves. The columns should be an unduplicated count of clients served from all funding sources as indicated For example, someone may have attended a group meeting in March 2007 and then received direct, personal service in October 2007. Such a person should only be counted once when they first received services in 2007. If the group meeting was for one program at your agency, and the direct personal service was offered through another program at your agency, you can count this individual once for each program. Do not double-count a person who received the same type of service more than once. For example, a woman who received a ( ' physical exam in January and a mammogram in March would only be counted once if both medical services are part of the same program. All clients should be counted as an unduplicated user the first time they,receive services in a calendar year. A client who received services from the same program on 12/31/07 and 01/02/08 would be an unduplicated user for the 01/02/08 visit. The 2007 % of column 1 clients served by city is the number of unduplicated clients served in 2007 by city, divided by the total number of unduplicated clients served in 2007. The total of this column will equal 100%. The final column represents the unduplicated number of clients that will be served with the funds requested by city in this application. You will be required to serve that number of clients if fully funded. For example, your program has a total of 900 unduplicated clients served in a city. If you are requesting $10,000 to provide services to 90 unduplicated clients with the funds requested with(the remaining 810 clients to be served with another funding source), 90 would be shown in the last column for this city. Page 14 Agency: Communities In Schools of Renton Program: Family Liaison 13. NUMBER Of INDIVIDUALS/HOUSEHOLDS SERVED BY PROGRAM Z Individuals? or Households? (Check which applies and use for reporting all demographics.) Unduplicated *Unduplicated Number of all Clients Served by Clients Served All Funding Sources with Funds Requested 2007 2007 %of column 1 2008 2009 2009 (City Requested (Actual) clients served (Anticipated) (Projected) Funding Only) by City Auburn Burien Covington Des Moines Enumclaw Federal Way Kent Renton 194 150 150 13,560 SeaTac Seattle Tukwila Other 289 250 250 483 100% Total (This column must 400 400 13,560 total 100%) *Unduplicated means count each client only once per calendar year per program. This number should match the number of clients by city indicated in the top row of Question 15. Page 15 Agency: Communities In Schools of Renton Program: Family Liaison 14. Performance Measures & Average Cost of Service (Data Tables) This information will be used by each City to develop 2009-10 contracts with funded agencies. 14a.Your Performance Measures should reflect numbers based on the funding you are requesting from each City. 14b. In the space provided, define at least one(1) and no more than three(3)performance measures the program will report with a brief explanation. Do not use Unduplicated Clients/Households as a performance measure. Provide the estimated number of clients/households served by city your program plans to provide in the corresponding column for each of the performance measures listed. Estimate the number of units to be provided for each measure annually. Provide accurate and realistic estimates. These estimates will be the basis of your contract if funded. 14c. Complete the table with the city funds requested in Question 6 and the unduplicated clients served with funds requested by City listed in the last column of Question 13. Explain any differences between the average cost of service per client between cities in Question 10.D. of your application. Example of Completed Data Tables 14a: 14a. Service with 2009 Requested Funds Proposed Performance Measures as listed below. A) Meals Delivered B) Case Mgmt Hrs C) Auburn 7,000 75 Burien 5,000 50 Data Table 14b: Performance Measure`2009 Proposed (City Requested Funding Only) Title: Brief explanation: A) Meals delivered One meal delivered counts as 1 service unit. Will include intake, assessment, planning, advocacy and evaluation B) Case management hours of results. Page 16 Agency: Communities In Schools of Renton Program: Family Liaison 14. Performance Measures (Data Table) 14a. Service with 2009 Requested Funds Proposed Performance Measures as defined below. A) Students Served B) Students receiving C) Intensively. services Auburn Burien Covington Des Moines Enumclaw Federal Way Kent Renton 150 1400 SeaTac Seattle Tukwila 14b: Performance Measures 2009 Proposed with funds requested City Funding Only Title: Brief explanation: A)Students served intensively Number of unduplicated students living in Renton whose families received support three or more times. B)Students receiving services Number of all students whose families receive support throughout the year. C) Page 17 Agency: Communities In Schools of Renton Program: Family Liaison 14 Performance Measures (Data Table), Cont. 14c. Average Cost of Service Unduplicated Clients Served with Funds Average Cost of Service Requested 2009 Requested 2009 per Client (Same as last column of (Same as last column of Question 6) Question 13) Column 1 divided by Column 2 Example: $5,000 45 $111.11 Auburn Burien Covington Des Moines • Enumclaw _ Federal Way • Kent Renton 13,560 150 90.40 SeaTac Seattle Tukwila Page 18 Agency: Communities In Schools of Renton Program: Family Liaison Complete Question 15 with 2007 Actual numbers reported in column 1 of Question 13. 15. i Demographics (from all funding sources) (Data Table) 0 0 3 Client Residence 3 o c, d o ce 3 PQ U A W w cc! vs E-+ E-H - , Unduplicated .. (check one) E[Individuals", rn 0 Households '--4 Served in 2007*. . Household Income Level ;: .. 30%of Median or Below 50%'of Median or Below 97 80%'Of Median or Below 78 Above 80%of Median Unknown 19 TOTAL 194 Gender: Male 93 __ _ Female 101 TOTAL 194 Age a 0-4 years 23 5- 12 years 152 13- 17years 19 18-34 years 35-54 years , 55-74 years 75+years , Unknown TOTAL 194 Lthnicity j Asian 5 Black/African American 62 Hispanic/Latino(a) 57 Native 1 American/Alaskan Pacific Islander 3 White/Caucasian 50 Other/Multi-Ethnic 16 TOTAL 194 Female Headed 104 Household Disabling;Condition Na Limited English 43 Speaking Page 19 Agency: Communities In Schools of Renton Program: Family Liaison *Check Individual or Household,which should be the same as checked in Question 13. Unduplicated means count each client only once per calendar year. This should match the number served by City in the Actual 2007 column of Question 13. The "total"column will be different from Question 13 since the"other"column is not included due to space limitations. 16. PROGRAM STAFF (DATA TABLE) In this data table,record the number of full-time equivalent(FTE)paid staff and volunteers for this program. FTE means a 40-hour week throughout the entire year. For example, if you enter"5"in the box for Number of Volunteer FTEs, this would mean that you have, on average, five volunteers assisting your program at all times (assuming a 40-hour week). If you know only the total number of hours contributed by all volunteers for this program, simply divide that number by 2,080 to find the total FTE number. For example: 5,000 volunteer hours over the course of a year, divided by 2,080 equals 2.4 FTEs. 2007 2008 2009 (Actual) (Budgeted) (Projected) Total Number of Staff(FTEs) 6.0 5.5 5.5 Number of Volunteer(FTEs) na na na Actual Number of Volunteers na na na 17. PROGRAM REVENUE & EXPENSE BUDGETS (DATA TABLE) Program Budget: All columns should include total program operating revenue and expenses. Complete the following data tables with figures indicating the source of program operating funds for 2007 (actual), 2008 (budgeted) and 2009 (projected). Budget amounts should match funding requested (Question 14c) and Question 5. Include an explanation of any significant differences between the revenues and expenses by year in Question 12B of your application. Page 20 Agency: Communities In Schools of Renton Program: Family Liaison 17. PROGRAM REVENUE BUDGET (DATA TABLE) Revenue Source Zoo? Zoos 2009 (Actual) (Budgeted) (Projected/ Requested) City Funding (General Fund& CDBG) '` • Auburn • Burien • Covington • Des Moines • Enumclaw • Federal Way • Kent • Renton 12,327 12,327 13,560 • SeaTac • Seattle • Tukwila • Other(Specify) • Other(Specify) Other Government Funds • King County • Washington State 87,300 87,300 96,030 • Federal Government(Specify) ■ Other(Renton School District) 51,000 51,000 51,000 Private Sources E `' • United Way(grants &designated donors) 28,791 29,000 30,000 ■ Foundations and Corporations 75,000 65,000 65,000 • Contributions (e.g., Events, Mailings) 84,140 83,136 85256 • Program Service Fees (User Fees) na na na • Other(Specify) TOTAL PROGRAM BUDGET 338,558 327,763 340,846 Page 21 Agency: Communities In Schools of Renton Program: Family Liaison 17. PROGRAM EXPENSE BUDGET, CONT. (DATA TABLE) Expenses 2007 2008 2009 (Actual) (Budgeted) (Projected) Personnel Costs ■ Salaries 269,333 260298 270,709 • Benefits 64,300 62172 64,660 ■' Other •, Total Personnel 333,633 322,470 335,369 Operating and Supplies "� fx ■ Office/Program Supplies 2,376 2,300 2,197 • Rent and Utilities 1,216 1,237 1,340 • , Repair and Maintenance • Insurance • Postage and Shipping ( • Printing and Advertising • Telephone 294 281 240 • Equipment • Conference/Travel/Training/Mileage 814 1,040 1,200 • Dues and Fees 225 408 500 • Professional Fees/Contracts • Direct Asst. to Individuals • Administrative Costs • Other(specify) • • • • TOTAL PROGRAM EXPENSES 338,558 327,736 340,846 Net Profit(Loss) 0 0 0 (revenue—expenses) = Page 22 Agency: Communities In Schools of Renton Program: Family Liaison 18. SUBCONTRACTS (DATA TABLE) List all the agencies you will be subcontracting with for this program. Provide the agency name in the first column, a description of the contract/service in the second column, and the contract amount in the third column. Do not list agencies you coordinate with on a referral only basis. Indicate not applicable if you do not subcontract for any part of this program. Subcontracting Agency Specific Subcontracted Activities Contract in the Operation of Your Program Amount NA Page 23 Agency: Communities In Schools of Renton Program: Family Liaison 19. APPLICATION CHECKLIST Applications missing one or more of the following components or not following these directions may not be reviewed. Sign and submit the application checklist with your application. Contents (Your application should contain each of these items in this order.) Application Cover Pages.The top three pages of your application must be a completed copy of the Agency Information and Questions 1-7. Applicatio Narrative: Question 8 Organizational Experience(2 page maximum) auestion 9 Need for Your Program(2 page maximum) uestion 10 Proposed Program/Service(6 page maximum) [✓Question 11 Long Range Plan(1 page maximum) [Question 12 Budget(2 page maximum) Data Tables VQuestion 13 Number of Individuals/Households Served [uestion 14a-c Performance Measures and Average Cost of Service Question 15 Demographics (from all funding sources) [t/Question 16 Program Staff [//Question 17 Program Revenue&Expense Budgets 2'Question 18 Subcontracts © Required documentation. Supply one copy of the following required documents with the signed original application. See Part II: City Specific Supplemental Information to determine whether additional copies of the application and required documentation need to be submitted. [Question 19 Required Documentation, including: •t/Proof of non-profit status •/ rganizational Chart • /Agency/Organization Mission Statement • Board resolution authorizing submittal of the application(may be submitted up to 60 days after application). • List of the current governing board and local board, if applicable, (include name,position/title, city residence, length of time on the Board, and expiration of terms. Note any vacancies.) • V Board Meeting Minutes of last three board meetings of governing board and local board as applicable • ✓Annual Budget ■ ("Financial Audit Cover Letter • ✓Financial Audit Management Letter • ''Financial Statement ■ ' Verification of Non-Discrimination Policy NA. Program Intake Form l Lq Sliding Fee Scale plication Check List. (Signed below.) City Specific Supplemental Information.Required in Name: Susan Richards Part II for applicable City only. Position: Executive Director_ Phone#: 425.430.6656 E-mail: srichards@ci.renton.wa.us may'' Signature of Person Completing Checklist DO NOT SUBMIT ANY OTHER MATERIALS WITH THIS APPLICATION Page 24 Agency: Communities In Schools of Renton Program: Family Liaison - Application Supplemental Questions- City of Renton 1. Results, Strategies and Activities addressed by the Family Liaison Program. The Family Liaison Program addresses the following Result included in Renton's Results, Strategies, and Activities and the Program Strategy selected was aligned with this Result. Specific program activities were identified that have proven to be successful in achieving this Result, as supported by the program outcomes below. Result 1. All children and youth are ready for educational success, work and life. Strategy B. Families and children have services and programs that support their success in schools and access to them. Activities: I. Place family liaisons in high needs schools to work with families of children at risk of school failure. 1. Help families identify barriers to their child's success and help them develop plans to address them. r. Facilitate the linkage of children and families in need with appropriate resources to meet their needs. m Provide ongoing support to the family throughout the process. These activities are selected from published guidelines from Family Support America, the national resource organization for the theory, policy, and practice of family support. Service provision adheres to the proven nine principals and the seven premises of family support practice in order to empower families to address problems by building upon their strengths. Home visiting, which is a core component of the Family Liaison Program, has been shown to be an effective vehicle for connecting families to needed services and supports, especially when combined with a range of services that are effectively integrated according to National Governor's Association Center for Best Practices. 2. Program Outcomes Performance Measure One provides the number of unduplicated students living in the City of Renton whose family receives support three or more times. This measure addresses the selected strategy by identifying the number of students who are being served intensively through the program. The associated outcome states that parents will increase access to community resources to meet their needs and the indicator is based on parent/caregiver survey responses that indicate increased access. This outcome is critical for the selected result of"All children and youth are ready for educational success, work and life" as based on the widely accepted theory known as Maslow's Hierarchy of Needs. This theory states that human beings are motivated by unsatisfied needs, and that certain lower needs must to be satisfied before higher needs can be addressed. According to the theory, needs fall into two groupings: deficiency needs (physiological, safety, and esteem) and growth needs (needing to know and understand). Once the deficiency needs such as food, housing, safety are met, then the individual can move into the higher order of needs, which is the level at which learning occurs. This theory supports our premise that by helping children and families meet their basic needs, children will become more capable of learning and benefiting from their education. The indicator will help us quantify how many parents have achieved this outcome. Performance Measure Two provides the number of all students whose families receive support of any duration throughout the year, which helps to reflect the duration of services beyond initial contact. The Outcome for this performance measure is that the parents/caregivers have increased connection to their child's school and the Indicator is based on parent/ caregiver responses that 70% of them report an increased connection with their child's school at the end of the year. Based on current research, children whose parents are engaged in school are more likely to have better academic performance. This outcome and associated indicator helps us assess the increase in parent connection which should result in improving the child's readiness for educational success. • Page 2 INTERNAL REVENUE SERVICE DEPARTMENT OF THE TREASURY P. O. BOX 2508 CINCINNATI, OH 45201 Employer Identification Number: Date: MAY 1 2 20�0 91-1689158 D9 v U 17053092817000 COMMUNITIES IN SCHOOL OF RENTON Contact Person: 1055 S GRADY WAY JEFFREY D SPROUL ID# 31182 RENTON, WA 98055 Contact Telephone Number: (877) 829-5500 Our Letter Dated: November of 1995 Addendum Applies: No Dear Applicant: _ This modifies our letter of the above date in which we stated that you would be treated as an organization that is not a private foundation until the expiration of your advance ruling period. Your exempt status under section 501(a) of the Internal Revenue Code as an organization described in section 501(c) (3) is still in effect. Based on the information you submitted, we have determined that you are not a private foundation within the meaning of section 509(a) of the Code because you are an organization of the type described in section 509(a) (1) and 170 (b) (1) (A) (vi) . Grantors and contributors may rely on this determination unless the Internal Revenue Service publishes notice to the contrary. However, if you lose your section 509(a) (1) status, a grantor or contributor may not rely on this determination if he or she was in part responsible for, or was aware of, the act or failure to act, or the substantial or material change on the part of the organization that resulted in your loss of such status, or if he or she acquired knowledge that the Internal Revenue Service had given notice that you would no longer be classified as a section 509(a) (1) organization. You are required to make your annual information return, Form 990 or Form 990-EZ, available for public inspection for three years after the later of the due date of the return or the date the return is filed. You are also required to make available for public inspection your exemption application, ' any supporting documents, and your exemption letter. Copies of these documents are also required to be provided to any individual upon written or in person request without charge other than reasonable fees for copying and postage. You may fulfill this requirement by placing these documents on the Internet. Penalties may be imposed for failure to comply with these requirements. Additional information is available in Publication 557, Tax-Exempt Status for Your Organization, or you may call our toll free number shown above. If we have indicated in the heading of this letter that an addendum applies, the addendum enclosed is an integral part of this letter. Letter 1050 (DO/CG) • -2- COMMUNITIES IN SCHOOL OF RENTON Because this letter could help resolve any questions about your private foundation status, please keep it in your permanent records. If you have any questions, please contact the person whose name and telephone number are shown above. Sincerely yours, Steven T. J[1116,. Steven T. Miller Director, Exempt Organizations l Letter 1050 (DO/CG) Communities In Schools of Renton Organizational Chart Key Responsibilities Key Responsibilities Govern the agency. Maintain awareness Advisory __ Board Of of programs and Council Directors Develop/monitor activities. a,rM policies. Provide input for Monitor financial program priorities. status. Help ensure Raise funds. organizational stability. Participate on committees. Support agency programs and Key Responsibilities Executive activities. Manage the Committee organization. Key Responsibilities Develop&monitor Executive procedures. Oversee committees. Director Implement and Develop annual oversee programs. budget. Supervise staff. Prepare Board Agenda. Support committees. Monitor contracts. Write grants Support and evaluate Executive Director. v r Program Development Committee Committee Key Responsibilities: Consists of Four Teams: Support the development Major Gifts, Community of new programs& Outreach, Benefit Dinner, River enhancement of existing Days Golf Tournament. programs. Key Responsibilities: Facilitate planning efforts. Develop and implement money Monitor program raising strategies. evaluations. Oversee fundraising events. Assist with assessing Support PR and Marketing community needs. efforts Communities In Schools of Renton Mission Statement To champion the connection of needed community resources with schools to help young people successfully learn, stay in school, and prepare for life. 10)) Communities In Schools of Renton Board of Directors 2007-2008 HELPING KIDS STAY IN SCHOOL AND PREPARE FOR LIFE Name Employer/Affiliation Job Title Entry Date End Date City Pat Auten Renton School District- Retired Community Volunteer 9/1/1994 8/31/2010 Kathleen Bailey Renton School District Executive Director:Secondary 5/4/2006 8/31/2009 Education Jeremy Cook Costco Wholesale-Tukwila Warehouse Manager 4/1/2004 8/31/2009 Jay Covington City of Renton Chief Administrative Officer 9/1/1994 8/31/2008 Deloris Gillis Employment Security Department Administrator 3/1/1999 8/31/2010 Renton Sabrina Handy Hazen High School . Student Representative 11/1/2007 8/31/2009 Renton Terry Higashiyama City of Renton Community Services-Administrator 5/4/2006 8/31/2009 Bambi Jilek Windermere Real Estate Realtor 10/1/2000 8/31/2011 Renton Freedom Johnson Renton Education Association Representative 12/6/2007 8/31/2010 Wendy Kirchner City of Renton Recreation -Senior Center 10/1/2001 8/31/2010 Nathan Kositsky Nathan Kositsky Marketing President 5/4/2006 8/31/2009 Jay Leviton Renton School District Director: Career/Life Skills 9/1/1994 8/31/2008 Susan Mather Renton School District Executive Director: Elementary 12/6/2007 8/31/2010 Education Robert McBeth Communities In Schools of Renton Board Chair 2/2/2006 8/31/2009 Diane Merrill Renton PTA Council Representative 11/7/2002 8/31/2009 Renton Toni Nelson Community Member Community Volunteer 2/1/1996 8/31/2008 Renton King Parker King & Bunny's Appliance &TV President 2/5/2004 8/31/2009 Renton Roger Paulsen Renton Ecumenical Assoc. of Representative 9/1/1994 8/31/2011 Churches PACCAR Data Analyst Jim Poff PACCAR Director 9/1/1994 8/31/2009 Keith Renfrew Renton School District-Retired Program Evaluation Consultant 9/1/1994 8/31/2010 Jerry Rerecich City of Renton Recreation Director 9/1/1994 8/31/2008 Al Talley, Sr. Alcan Building Maintenance President 4/1/2000 8/31/2010 Renton School Board President Chuck Tiernan Community Member Community Volunteer 11/1/1998 8/31/2008 James Ventris - - Renton-School District-- Retired - - Educational Consultant -_ - 4/1/2000 8/31/2010 Renton Stevie-Ray Walker Renton High School Student Representative 12/6/2007 8/31/2009 Laura W',,1-'-',sce Lakeridge/Talbot Hill Elementary Scho !-jrse 10/6/2005 8/31/2008 Communities In Schools of Renton Board of Directors 2007-2008 HELPING KIDS STAY IN SCHOOL AND PREPARE FOR LIFE Name Employer/Affiliation Job Title Entry Date End Date City Brandt Wong Lindbergh High School Student Representative 11/1/2007 8/31/2009 Ryan Wong Lindbergh High School Student Representative 11/1/2007 8/31/2009 Communities In Schools of Renton Board Meeting Minutes January 3, 2008 Board members in attendance: Kathleen Bailey, Deloris Gillis, Terry Higashiyama, Bambi Jilek, Freedom Johnson, Jay Leviton, Susan Mather, Bob McBeth, Diane Merrill, Toni Nelson, King Parker, Roger Paulsen, Jim Poff, Keith Renfrew, Jerry Rerecich, Al Talley, Jim Ventris, Brandt Wong and Ryan Wong Staff: Gail Burton, Erin Iverson, and Susan Richards Bob McBeth called the meeting to order at 5:33. Board Member Introductions Beginning Business Approval of Minutes: Keith Renfrew requested the following correction to the December 6th minutes: Dinner Discussion and Ticket Distribution section-"Bob McBeth (in place of Keith Renfrew) suggested that Board Members make donations toward the purchase of the cruise which will keep dinner expenses down". With correction noted Diane Merrill made a motion to accept the December 6th minutes and Jim Ventris seconded the motion, and was unanimously approved. Dinner Discussion and Ticket Distribution: Toni Nelson circulated signup sheets recruiting volunteers for hosting tables, set-up, and clean-up at the dinner. Toni explained the dinner committee would like the event to have a hosted feel. She asked if the student board members would help greet guests and hang their coats and then asked for table hosts to greet guests and help facilitate the collection of donations. Keith Renfrew reported the purchase of the cruise is underway, and he agreed to email cruise details to the board members. Discussion took place regarding airfare to and from the cruise boarding location. Chuck Tiernan suggested board members could donate air miles to help defray the cost of airfare for the person purchasing the cruise. Chuck and Bambi Jilek will look into this. Monthly Status Update: Susan Richards reviewed the December Monthly Status Report. Development Committee: Chuck reported the focus has been on the Benefit Dinner. Financial Reports: Jim Poff reviewed the Income and Expense Report and Balance Sheet from December. King Parker made a motion to approve the December Income and Expense Report and Balance Sheet; Chuck Tiernan seconded and was unanimously approved. Program Committee: Susan reported she had a mid-year review of our work plan with Polly Hopkins, our SVP Partner and Aaron Jacobs, SVP Senior Manager.. We will begin working with Sharon Lucus, private consultant paid through SVP to develop a strategic plan. Minutes January 3,2008 Page 2 Executive Committee: Bob McBeth reported the committee reviewed the 2007 Audit with JoAnn Kelly, CPA. There were no significant findings. The audit willbe presented at the February Board meeting for approval. Continuing Business School Visits: Cascade and Highlands will report at the February Board meeting. New Business February Board Agenda: Suggested items for next month's meeting- dinner recap and site visits. Other. Erin Iverson reported the following: January is National Mentoring Month. Proclamations will be presented at the City Council meeting on January 7th and Renton School Board on January 9th, Board members are welcome/encouraged to attend. The Mentor Program was recently featured in Renton Magazine and The Renton Reporter will present an article regarding the Benefit Dinner. The Mentor Program currently has 16 potential new mentors coming on board. A Comcast Foundation grant in partnership with the Kent CIS program is paying for public service announcements at local theaters regarding mentoring featuring Shawn Alexander along with print ads in Seattle Times SE Living Section and NW Colors. Terry Higashiyama invited Board Members to participate in the One Night Count of the Homeless, taking place January 24th at 2:00 am. This is a wonderful opportunity to help the community. Terry invited the Board to attend a reception honoring Toni Nelson and her service as a City Council member on Tuesday, January 15th at 4:00 to 6:00 at City Hall. Next meeting will be Thursday, February 7, 2008 Meeting adjourned at 6:35 p.m. Minutes Reviewed by Bob McBeth, Board Chair Communities In Schools of.Renton Board Meeting Minutes February 7, 2008 Board members in attendance: Pat Auten, Deloris Gillis, Sabrina Handy, Bambi Jilek, Wendy Kirchner, Jay Leviton, Susan Mather, Bob McBeth, Diane Merrill, Toni Nelson, King Parker, Roger Paulsen, Jim Poff, Keith Renfrew, Jerry Rerecich, Al Talley, Jim Ventris, Laura Widdice, Brandt Wong and Ryan Wong Staff: Gail Burton, Erin Iverson, and Susan Richards Bob McBeth called the meeting to order at 5:33. Board Member Introductions Beginning Business Approval of Minutes: King Parker made a motion to accept the January 3`d minutes and Jay Leviton seconded the motion, and was unanimously approved. Sharon Lucas— Review of upcoming Planning Process The Executive committee decided to move forth with strategic planning: Wendy Kirchner will chair the committee and will work with the strategic planning team to start the process. Sharon Lucas, Management Consultant, will facilitate the strategic planning process. Sharon reviewed the handout"Strategic Planning Process 2008"which includes a timeline of activities to achieve the strategic plan. The committee is aiming for Board approval of the plan in June. -- The March board meeting will start at 5:00 pm to allow more time for the process. The April 3rd Board meeting has been cancelled and will be replaced by a Retreat on Saturday, April 19th Development Committee:Teams reported. Contributors Team: Diane Merrill reported a thank you letter and annual report will be sent to donors. The committee needs help to prepare the mailing on Thursday, February 14 at 3:00 at KEC in the board room. Diane also asked for volunteers to help with monthly thank you calls to donors. Dinner Report: Bambi Jilek reported over$20,000 was received from the dinner. A great job was done by the dinner committee. Major Gifts: Keith Renfrew reported he collected a $10,000 donation from Renton Walker's Subaru and Mazda. Jay Leviton reported he has a soft commitment from First Savings. Monthly Status Update: Susan Richards reviewed the January Monthly Status Report. The Family Liaison and Mentor numbers are on target and fundraising is at 82%. Financial Reports: Jim Poff reviewed the Income and Expense Report and Balance Sheet from January. King Parker made a motion to approve the January Income and E-cpense Report and Balance Sheet; Pat Auten seconded and was unanimously approved. Executive Committee: Bob McBeth reported the committee has been discussing the Strategic planning process. Minutes February 7,2008 Page 2 Continuing Business Audit review and approval: Jim Poff reviewed the audit. He reported there were no significant findings. Pat Auten made a motion to approve the audit, Al Talley seconded and the motion was unanimously approved. School Visits: Cascade, Highlands, and Lakeridge will report at the March Board meeting. Board members requested the School Visit Information, Sign up, and Family Liaison list be resent via email. New Business March Board Agenda: Suggested items for next month's meeting- Strategic plan, permanent funding resources, and in June the Board requested the Family Liaisons be invited to share stories and for the Board to thank them for the great year. Other. Erin Iverson reported the Mentor program has 122 children being served by a Mentor. This is the highest number seen for this time of year. Laura Widdice asked "How many new kids are added to the program?", Erin will report these numbers at the next board meeting. Erin shared the Mentor program had three articles in the Renton Reporter and a short video was shot at Dimmitt, this video will air at 6:30 am on Saturday, February 9th. CIS of Washington will air the video on You-Tube. Erin extended invitations to the Board to attend the Annual Mentor/Mentee Field trip taking place on May 6th (elementary) and May 13th (middle & high) at the Museum of Flight and the Mentor Reception on May 21 st The CISR office will move to 200 Mill Avenue, on the 5th floor, on February 8th. This will be temporary for the next 3 to 6 months. There will be times when the office will be locked; deliveries may be made to the 6th floor, Renton Human Services Department. 40 Assets: Jim Ventris reported that there are plans for Kirby Unti, Denis Law, Marcie Maxwell and Jim to get together in the Spring to talk about 40 Assets. Next meeting will be Thursday, March 6, 2008 at an earlier time 5:00 pm. Meeting adjourned at 6:45 p.m. Minutes Reviewed by Pat Auten, Secretary Communities In Schools of Renton Board Meeting Minutes March 6, 2008 Board members in attendance: Kathleen Bailey, Deloris Gillis, Terry Higashiyama, Bambi Jilek, Freedom Johnson, Wendy Kirchner, Susan Mather, Diane Merrill, King Parker, Roger Paulsen, Jim Poff, Keith Renfrew, Jerry Rerecich, Al Talley, Chuck Tiernan, Stevie-Ray Walker, Laura Widdice, Brandt Wong and Ryan Wong Guests: Tameka Artison, Lynn Desmarais, Polly Hopkins, and Sharon Lucas Staff: Gail Burton, Erin Iverson, and Susan Richards Roger Paulsen, Vice Chair, called the meeting to order at 5:33. Board Member Introductions Polly Hopkins, Social Venture Partner Lead Partner, attended the Board meeting to support the strategic planning process. Tameka Artison also attended the meeting; she is interested in becoming a member of the Board. Beginning Business Approval of Minutes: King Parker made a motion to accept the February 7th minutes and Al Talley seconded the motion, and was unanimously approved. Officer Nominations and Elections: Roger Paulsen reported that it is time to acquire nominations for Executive Committee positions. The Board Chair, Vice Chair, and Treasurer are willing to continue in their positions. The Secretary has decided not to return. Roger will be looking for nominations at the May meeting and voting will take place in June. Standing Reports Monthly Status Update: No monthly status report. • Financial Reports: Jim Poff reviewed the Income and Expense Report and Balance Sheet from February. Al Talley made a motion to approve the February Income and Expense Report and Balance Sheet; Terry Higashiyama seconded and was unanimously approved. ,Sharon Lucas—Strategic Planning Process Sharon Lucas, Management Consultant, lead a discussion for the Board to develop a local purpose statement. The following handouts were reviewed and discussed: Student Needs Data; CISR Outcome and Indicators; RSD Home Languages 2007-08; CISR Mission; Healthy Youth Survey 2006; 40 Developmental Assets; Dropout Risk Factors and Exemplary Programs; and Risk Factors. The Board was reminded that the April Board meeting will be replaced by a Retreat to continue working on Strategic Plans on Saturday, April 19 at KEC. New Business May Board Agenda: Suggested items for Board meeting in June - Family Liaisons be invited to share stories and for the Board to thank them for the great year. i Minutes March 6,2008 Page 2 Other. Erin Iverson distributed the March Mentor Newsletter and a save the date bookmark reflecting upcoming Mentor Program events. Reminder—No Board meeting April 3rd Board Retreat Saturday, April 19th, 9:00 am to 2:00 at KEC in the board room. Susan Richards mentioned new mentee and mentors numbers per year have been gathered and will be shared in May. Vote - Renton School District Levy Election is March 11 there are three issues are on the ballot. Invite to the PTA Founders Day Dinner on March 10th at the Holiday Inn, Renton. Next Board meeting will be Thursday, May 1, 2008 Meeting adjourned at 7:00 p.m. Minutes Reviewed by Roger Paulsen, Vice Chair Communities In Schools of Renton Agency Budget 2007-2008 Revenues Carry Forward Operating Funds 23,594 Contributions 224,581 Fund Raising Events 27,000 Awards 45,112 Interest 3,000 Sponsors, City of Renton 41 ,000 Sponsors, Renton School District 25,000 Revenue Totals $ 389,287 Expenditures Cell Phone 625 Memberships/Dues/Events 1 ,200 Mileage, Parking 1 ,000 Miscellaneous 400 Office Lease 5,676 Payroll Service 1 ,600 PR Materials 4,000 Professional Fees 5,500 Salary/Benefits 352,786 Supplies 14,000 Training/Travel 2,500 Total Expenditures $ 389,287 Jo Ann Kelly,CPA 404 South Brandon Street Seattle,WA 98108-2236 (206)767-5403 Independent Auditor's Report To the Board of Directors Communities In Schools of Renton Renton,Washington I have audited the accompanying balance sheet of Communities In Schools of Renton (a nonprofit organization)as of August 31,2007 and 2006 and the related statements of activities, functional expenses, arid cash flows for the years then ended. These financial statements are the responsibility of the Organization's management. My responsibility is to express an opinion on these financial statements based on my audit. I conducted my audit in accordance with U.S.generally accepted auditing standards. Those standards require that I plan and perform the audit to obtain reasonable assurance about whether the financial statements are free of material misstatement. An audit includes consideration of internal control over financial reporting as a basis for designing audit procedures that are appropriate in the circumstances,but not for the purpose of expressing an opinion on the effectiveness of the Organization's internal control over financial reporting. Accordingly, I express no such opinion. An audit also includes examining, on a test basis, evidence supporting the amounts and disclosures in the financial statements, assessing the accounting principles used arid significant estimates made by management, as well as evaluating the overall financial statement presentation. I believe that my audit provides a reasonable basis for my opinion. In my opinion,the financial statements referred to above present fairly,in all material respects,the financial ,t position of Communities In Schools of Renton as of August 31,2007 and 2006, and the changes in its net assets and its cash flows for the years then ended in conformity with U.S. generally accepted accounting principles. My audit was conducted for the purpose of forming an opinion on the basic financial statements of Communities In Schools of Renton taken as a whole. The accompanying Schedule of Grants is presented for the purposes of additional analysis and is not a required part of the basic financial statements. Such information has been subjected to the auditing procedures applied in the audit of the basic financial statements and, in my opinion, is fairly stated in all material respects in relation to the basic financial statements taken as a whole. a., Seattle,Washington December 18,2007 11] f I Jo Ann Kelly, CPA 404 South Brandon Street Seattle,WA 98108-2236 ' Phone(206)767-5403 Fax(206) 767-6430 Auditor's Report on Internal Control ,-.,. - To The Board of Directors LT_ Communities In Schools of Renton -{] In planning and performing my audit of the financial statements of Communities In Schools of Renton as of and for the year ended August 31, 2007, in accordance with auditing standards generally accepted in the United States of America, I considered Communities In Schools of Renton's internal control over financial reporting (internal control) as a basis for designing my auditing procedures for the purpose of expressing my opinion on the financial statements,but not for the purpose of expressing an opinion on the effectiveness of the Organization's internal control. --11 Accordingly,I do not express an opinion on the effectiveness of the Organization's internal control. A control deficiency exists when the design or operation of a control does not allow management 1 or employees, in the normal course of performing their assigned functions, to prevent or detect misstatements on a timely basis. In addition,because of the inherent limitations in internal controls, including the possibility of management override of controls, misstatements due to error or fraud r may occur and not be detected by such controls. A significant deficiency is a control deficiency,or `. 1 a combination of control deficiencies,that adversely affects the entity's ability to initiate,authorize, record,process, or report financial data reliably in accordance with generally accepted accounting _Tiprinciples such that there is more than a remote likelihood that a misstatement of the entity's financial statements that is more than inconsequential will not be prevented or detected by the entity's internal control. I — ! A material weakness is a significant deficiency, or a combination of significant deficiencies, that results in more than a remote likelihood that a material misstatement of the financial statements will not be prevented or detected by the entity's internal control. My consideration of internal control was for the limited purpose described in the first paragraph and would not necessarily identify all deficiencies in internal control that might be significant h- deficiencies or material weaknesses. I did not identify any deficiencies in internal control that I `w,. . consider to be material weaknesses, as defined above. However, I identified the following deficiencies in internal control that I consider to be significant deficiencies. I i I i ; Board of Directors Communities In Schools of Renton F; 1 Page 2 , [ I r I I Special Events Revenue I During my testing,I noted that control and reconciliation schedules were maintained but lacked the segregation of duties and supervisory review that would help achieve the intended internal control ,-,-�; 1 objectives. Procedures that have been implemented for tracking,recording, and reconciliation of special event revenue have not been codified in writing and included in the Organization's operating manual. 1 Providing written documentation ofthese processes will also enhance oversight of financial reporting P! and internal control. Responsibilities for receipt,recording and reconciling should optimally not be concentrated in one 1 position. As noted above,a review and identification of the specific activities involved would help I identify conflicting duties and provide management with the information needed to redirect duties or implement additional supervisory review. r - - Financial Reporting and Review In conjunction with my audit procedures,I noted certain deficiencies in the recording process. The Agency has already implemented the most important step in establishing internal control using I QuickBooks accounting software: that of establishing users with different levels of access and i_ 1 providing separate passwords. Additionally, a year-end-close process was implemented the previous year, whereby a formal close date is used; however, it lacked a password protection component. I Without a password associated with the close, the protection provided by this procedure is 1 ineffective. Implementation of a unique password at the administrative level for closing purposes will help prevent inadvertent changes to financial data subsequent to releasing accounting data to I users of the financial reports. j Along with controls through options available in the accounting software, additional supervisory I control over financial recording would be achieved by establishing formal journal entry procedures. }`_; 1 Clear identification of when a journal entry is to be used versus correction of items of data input II should be established and included in the operations manual: -, I General journal entries are used to record items in the general ledger,including corrections of items 1 where actuals have already been posted(i.e., in a previous period). A journal entry form would be completed by accounting and supported by appropriate documentation. This form, with attached I documentation,would be submitted to and approved by supervisory personnel prior to its entry into 1 I the financial system. I > I I' v 1 il il Board of Directors ' Communities In Schools of Renton Page.3 ,, Authority and Responsibilities During the course of the audit in conjunction with inquiry of management, I noted certain control issues I consider to be weaknesses related to identification of authority and responsibilities as they relate to the financial process. Control could be strengthened by considering implementation of the following: . yv' [I Revise and update the existing manual to include the accounting department's operating procedures. The manual would incorporate written procedures (a how-to of job tasks), instructions,and assignment of duties. In the process of a comprehensive review of existing procedures,management might discover procedures that can be eliminated or improved upon is to make the system more efficient and effective. Since all organizations undergo change,an annual or other periodic re-assessment is recommended. } Disbursement Process - During my testing, I noted one instance where a check was released without signature. This exception indicates a deficiency in the control and review objectives. IIAlso noted were a few instances where the established procedures surrounding disbursement t_ imst ff= documentation were not complied with. To verify the authenticity of purchases, documentation supporting the actual receipt of goods ordered and invoiced should be indicated. Often,the packing . I slip is utilized,whereby the document is initialed and dated by the individual receiving the goods 1 prior to submission for invoice approval. The other deficiency noted was noncompliance with the written procedure related to "gift card -- ; acceptance." The one instance identified during my testing involved the use of gift cards as direct client support for which there was not proper documentation supporting the ultimate use of the gift �~ card. Ensuring that all personnel are familiar with the documentation process and requirements will help -17 I ' provide a strengthened control environment. --f-= " 73) ° ' '' <RA Seattle,Washington December 18, 2007 I i 1, Communities In Schools of Renton Balance Sheet to August 31, 2007 and 2006 _ Assets 2007 2006 ;q Current Assets Cash and cash equivalents $143,108 $148,279 if Accounts receivable-grants 7,419 8,551• 4 Total Current Assets 150,527 156,830 r j Investments 60,326 51,168 11 Total Assets $210,853 $207,998 ,a `f: Liabilities and Net Assets _4. y`i Current Liabilities Accrued vacation $ 12,349 $ 9,563 g. Deferred revenue — 20,000 Agency obligation-other organizations 7.985 — .y` Total Current Liabilities 20.334 29.563 Contingencies — — ' Net Assets Unrestricted Operating 44,197 63,007 Board designated-Family Liaison Program 134,322 113,081 Total Unrestricted Net Assets 178,519 176,088 .- Temporarily restricted 12,000 2.347 Total Net Assets 190,519 178,435 ' Total Liabilities and Net Assets $210,853 $207,998 r !y [ - I { - See notes to fmancial statements. -2- Ij Section: Personnel Topic: Fair Practices POLICY (Effective 12/97) The policy of Communities In Schools of Renton is to promote and afford equal opportunity to all persons regardless of race, ethnicity, national origin, gender, the presence of a non-job-related physical, sensory, or mental handicap, age, or marital status. This policy shall be based on the principles of equal employment opportunity and affirmative action guidelines as set forth in federal, state, and local laws. PROCEDURE (Revised 03/03) All activities relating to employment such as recruitment, selection, promotion, training, and termination shall be conducted in a nondiscriminatory manner. Personnel decisions will be based on individual performance and organizational staffing requirements. If an employee/potential employee believes they have been subject to unfair practice, the established Grievance Procedure should be followed. Communities In Schools of Renton Operations Manual Section: General Topic: Nondiscrimination-Program Participants POLICY (Effective 12/97) It is the policy of Communities In Schools of Renton to treat all program participants equally and without regard to age, disability, ethnic background, gender, marital status, socio-economic status, sexual preference, national origin, race or religion. Communities In Schools of Renton's programs are open to all who meet the eligibility criteria established for each program. PROCEDURE (Effective 12/97) Communities In Schools of Renton will not tolerate racial, ethnic, religious, or sexual slurs or comments by employees or program volunteers. Nor will Communities In Schools of Renton condone discriminatory actions by employees or volunteers which prove to impact program participation by eligible participants. Violations of this procedure will be cause for disciplinary action, which may include written warnings, suspension, and/or termination. Any program participant who feels he/she has been the victim of a discriminatory comment in violation of the above policy should bring this concern to the Executive Director of Communities In Schools of Renton or the Chairperson of the Board. Communities In Schools of Renton Operations Manual 3 ( C/ Gre,ixsx-41 /Age G. : Communities In Schools of Renton / Program: Mentor Application Cover Pages (Agency Informatio and Questions° ,1 / A r. 4.' ` ') ..:__._.::.�_.�...: ,., v . ...._Agency Infoi naton .�j ?,�, P i ;. Agency Name: ��4`41t e Up ,, g Y ��_ ts4: s rrye P, / 4-•'V/f Applicant Name and Address: Agency�D"i O,rectorVi /v Communities In Schools of Renton Susan Richards/Executi�ut irec or 1055 So Grady Way Name and Title Renton WA 98057 425.430.6656 (Area Code)Telephone srithards@cisenton.wa.us 425.430.6657 E-mail address (if available) (Area Code)Fax Number Requir•• signatures: By signing below,you certify that the information in this application is accurate to the b: I f your knowledge a d that you have read the application, certifications, and appendixes. (SI F. URES ST B BLUE INK) All/lAk /ii 4 79 of ,/le-c-,_-(,,,,&-zz—e-- Vd(iL ignature of Agency Board President/Date Signature of Agency Director/Date Robert McBeth Susan Richards Printed Name of Agency Board President Printed Name of Agency Director Pro am Information 1. Program Name Mentor Program Contact Person(available to answer specific questions on this application) Susan Richards 425.430.6656 Name (Area Code)Telephone Address(if different than above) srichards@ci.renton.wa.us 425.430.6657 E-mail address(if available) (Area Code)Fax Number 2. Program is New for our agency ❑An Ongoing Program El 3. Brief Description of Program(One sentence) The Mentor Program matches a caring adult community volunteer with a child in the Renton school district who is at risk of school failure and who could benefit from support to overcome life's obstacles. 4. Where are services provided? (If different from agency location) Services are provided at high needs schools across the Renton School District identified by factors such as high free/reduced lunch,high Transiency and low WASL scores. Page 1 Agency: Communities In Schools of Renton Program: Mentor 5. Total Program Cost: Actua12007: $95,142 Proposed 2009: $113,610 Projected 2008: $109,241 6. Total City Funds Requested for this Program: City Awarded 2008 Requested 2009* General Fund CDBG Total Requested** Auburn Federal Way Kent Renton 19,158 21,074 City Awarded 2008 Requested 2009* General Fund General Fund Burien Covington Des Moines Enumclaw SeaTac Tukwila *Cities on a two year funding cycle will renew 2009 awards to 2010 based upon performance and availability of funds. See Part II for city specific information. **Include your total request for Auburn,Federal Way Kent and Renton. The source of funding will be determined by staff. Page 2 Agency: Communities In Schools of Renton Program: Mentor 7. Agency Contact Sheet Provide the following information for the agency and for the program requesting funds. Agency Contacts General Agency Name: Communities In Schools of Renton Address: 1055 So Grady Way City/State/Zip: Renton WA 98057 Phone/Fax: 425.430.6656/425.430.6657 Agency Web Address: www.renton.ciswa.org Executive Director Name: Susan Richards Title: Executive Director Direct Phone: 425.430.6656 E-Mail: srichards@ci.renton.wa.us Development Director Name: na (or Grant Writer) Title: Direct Phone: E-Mail: Finance/Accountant Name: Susan Richards (person preparing invoices) Title: Executive Director Direct Phone: 425.430.6656 E-Mail: srichards@ci.renton.wa.us Program Contact (Staff contact for contracting, reporting and program implementation.) Program Name: Mentor Program Staff Name: Susan Richards Title: Executive Director Direct Phone: 425.430.6656 E-Mail: srichards@ci.renton.wa.us Page 3 Agency: Communities In Schools of Renton Program: Mentor 8. Organizational Experience . A. Experience Communities In Schools of Renton is a non-profit, 501(c)(3) which was formed in 1994, from a common vision of the Renton School District, the City of Renton and community partners to help support the success of children and youth. The mission of the agency is to champion the connection of community resources with schools to help young people learn, stay in school and prepare for life. Communities In Schools of Renton has developed and implemented collaborative programs with the School District and committed partners since 1996, providing services to children at risk of school failure and their families through the Family Liaison and the Mentor Programs. The Family Liaison Program provides school based family support and resource linkage to families of students at risk of school failure. The Mentor Program matches a community volunteer with a child in need of support to meet one hour a week at the child's school. Both programs are coordinated in high needs schools in the Renton School District and we continue to work in close partnership with the District. Susan Richards has been the Executive Director of the agency since 1994. She has strong relationships with community partners and has a good understanding of human services needs in the Renton community. She was instrumental in the development and implementation of agency programs. She has performed program evaluation since 1996 and utilized data to improve services to children and their families over the years.The Mentor Program is now in its tenth year of matching a caring community volunteer with a child in need of support. Since 1996, CISR has matched 413 community volunteers with 600 _ children. This school year we have matched 121 mentors with 138 children. B. Operational Structure Communities In Schools of Renton is governed by a board of Directors which consists of representatives from the City of Renton, the Renton School District, local businesses, church groups, service organizations, social service agencies, businesses, parents, and students from each of the District's high schools. The goal is to have a mix of gender, ethnicity and ages on the Board and focus on increasing the diversity when looking for prospective board members. Currently the board membership is 43% female - 57% male, 75% over forty- 25% under forty, and 75% white—25% ethnic minority. Seven members (25% of the Board) are City of Renton residents. We also look at diversity in the areas of affiliations to include a mix of business, government, school district, agency providers, churches, parents, high school students, PTSA, community service organizations, and community members. The Board meets monthly, except July and August and is responsible for establishing all policies, approving the annual budget and monthly financial reports, and authorizing all grant requests. They also authorize and monitor all contracts and partnership commitments. The Executive Committee consists of the four Board Officers, the Chairs of the Program and the Development Committee and representatives of the Renton School District and the City. They meet monthly and prepare the draft budget for Board approval, set the Board meeting agendas, oversee Board member recruitment, and supervise and evaluate the Executive Director. They also review all contracts annually to ensure that all commitments are being met. The Development Committee is responsible for overseeing and coordinating all fundraising activities. The Committee consists of the committee Chairperson and Team Leaders for the five Page 4 Agency: Communities In Schools of Renton Program: Mentor major fundraising functions; Major Gifts, Recognition Dinner, Contributors, River Days Fun Run and the Golf Tournament. Board members volunteer to be on at least one of these fundraising Teams. The Program Committee is responsible for developing and overseeing all significant program changes and identification of school sites for the placement of program services. The Committee membership consists of the committee Chairperson, Board members and community agency representatives which allows for thoughtful analysis of programming and community needs. This Committee is also responsible for the oversight of the annual evaluation process. Program operations are overseen by Susan Richards, Executive Director of CISR. She works closely with Susan Mather, the Executive Director of Elementary Education in the School District. Susan R. keeps the programs connected with the broader community resources, program practices, emerging issues, initiatives and programs, while Susan M. keeps activities aligned with school policy and integrated into District programs and practices. This partnership allows program staff to be supported in both worlds; school and community. In order to strengthen the relationship and communication between CISR and the schools, CISR board members annually visit school sites served by our programs to assess the level of satisfaction with program services. In addition to increasing the school's awareness of the agency, it also increases Board member's awareness of the existing and emerging needs of children and their families based upon reports from the principals and staff. The agency also has an Advisory Council which meets annually and provides input and oversight to the Board. This group is made up of community leaders and is co-chaired by the Mayor and the School District Superintendent. Participants include City Council members, School Board members, Police Chief, Fire Chief, Chamber of Commerce President, presidents of local service clubs, religious leaders, executive directors of partner agencies, representatives from the Teacher's Union, the PTA Council, representatives from local parent groups, local community councils, and other prominent community leaders. Data gathered from the school site visits, discussion at the annual Advisory Council meeting, and items shared by Board members, as well as reports from the Executive Director, all help to keep the Board informed of the needs in the Renton community. Page 5 Agency: Communities In Schools of Renton Program: Mentor 9. Need for Program A. Problem Statement In a study of Graduation and Dropout Statistics for Washington's Counties, Districts, and Schools (Class of 2003), it was noted that the dropout rate for American Indian, Black and Hispanic students along with children with limited English skills or low income is higher than White students. Disadvantaged youth (including low income and minority children) are nearly twice as likely to drop out of school (National Center for Education Statistics). Two additional factors that have been correlated with poor academic achievement include single parent homes, where children are more likely to be in poverty, and high transiency. Below is a review of local data which illustrates the prevalence of these factors in South King County and within the Renton community. Poverty • From 1979 to 2004 the percentage of the King County population living below 200% of federal poverty level increased 2.5%. While no regional data was available for 2004, data for 1979 — 1999 in the Seattle, North and East regions showed either a decline or a slight increase (.2%), while the South region had an increase of 4.3%. (Communities Count 2005) • There is a similar pattern in the percent of children age 0-17 living below 100% of poverty. For King County between 1989 —2004, this percentage increased by 3.46%. For 1989 — 1999, the Seattle and East Regions showed decreases, and the North region a slight increase (.7%). During this same time period, the South Region showed a 1.5% increase, twice that of the North region. (Communities Count 2005) • The average number of students in the Renton School District receiving free and reduced lunch has increased from 28% in 1998 to 46% in 2008. Ethnicity • '36% of the ethnic population of King County live in South County with more than 1 out of 4 residents being a person of color. (A Matter of Need, South King Council of Human Services) • The percent of King County residents who are immigrants increased overall by 6.1%, but the largest increase was in South Region which grew 8.3% (The Health of King County 2006) • Within the Renton City limits, the percentage of those who identify themselves as minority has increased by 15.3% from 1990 to 2000. (Changing Face of Renton-May 2004) • The Renton School District ethnic population has grown from 30% in 1992 to 62% in 2007. Limited English Proficiency • Over age 5 population speaking a language at home other than English rose from 10.1% to 22.6%, an increase of 123% (The Changing Face of Renton-May 2004). • Over age 5 population that speaks English "less than very well" increased from 3.7% in 1990 to 12% in 2000, an increase of 224% (The Changing Face of Renton-May 2004). • The percentage of students whose home language is not English has increased from 24% in 2005-6 to 30% in 2007-08 Page 6 Agency: Communities In Schools of Renton Program: Mentor Single Parents • More than one out of three households with children in South King County are headed by a single person. (Matter of Need, South King Council of Human Services.) • According to Census data in 2000, 23.6% of children in Renton were living with a single parent compared with 12.4% in 1990. Academic Achievement Data • The Office of Superintendent of Public Instruction's published "On Time" graduation rates show that the Renton School District dropped from 77% in 2001 to 59% in 2004 an alarming decrease of 18%, which is the second highest drop in the state with the Seattle School District having a 24% decrease. (Communities Count, 2005). • High school dropouts are almost 3 times as likely to earn at or below minimum wage than those who complete high school with no further education (National Center for Education Statistics.) • Renton School District WASL scores for 10h grade students who met the state standards in Math (39%) and in Reading (70%) were lower than the state averages of 50% and 81% respectively. B. Target Population The schools targeted for services were selected through an assessment of criteria which incorporates these demographics and provides a focus on schools where students may have a higher need for support to address barriers to education based upon the prevalence of these factors. Below are the averages of selected criteria for targeted schools. Free/ Reduced Ethnic In ELL Transient Failed WASL Lunch Minority classes Reading October Feb 2008 2007 Mar 2008 2006 - 2007 Spring 2007 Averages at Target Schools 58% 73% 22% 39% 41% Students at targeted schools are referred to Family Liaisons because of concerns about the impact of their home environment on their ability to be successful at school. The majority of children referred have many of these factors present in their lives. Page 7 Agency: Communities In Schools of Renton Program: Mentor 10. Proposed Program/Service ' A. Description The Mentor Program seeks to improve the social, emotional, and academic development of children identified at risk of school failure by fostering a personal relationship between the child and a caring community volunteer. The Program is now in its tenth year of providing children in grades K-8 with one to one support from a caring volunteer. When the Mentor Program was first developed, in keeping with the focus of avoiding duplication of services and leveraging limited resources, the agency determined that a school-based mentoring program would be best to help provide one to one support for youth, increase positive feelings about schools, and avoid duplication of community mentoring programs, like Big Brothers/Big Sisters (who at the time were not providing school based mentoring). The Mentor Program strategy was built upon a number of research based findings. Risk and Protective factor research shows that factors such as bonding with a caring adult and having high expectations have been found to alter or even reverse expected negative outcomes for youth. National studies by Public/Private Ventures, Manpower Demonstration Research, and Mathematica Policy Research have confirmed the value of mentoring programs by showing that caring adults in a young person's life can result in positive effects such as fewer unexcused absences and more positive attitudes toward school and the future. As a member of the Washington State Mentoring Partnership and the National Mentoring Partnership, we adhere to the published Elements of Effective Practice, which reflects the latest in quality mentoring research, policies, and practices. These elements provide comprehensive guidelines in the areas of program design and planning, program management, program operations and program evaluation. We also participate with a number of Mentoring initiatives in the region and across the state, including the King County Mentoring Roundtable and the Washington State Mentoring Partnership which allows us to gain information on emerging strategies and proven practices in the area of mentoring. The Mentor Program is a strong partnership between CISR and the Renton School District. The CISR Mentor Program Manager is responsible for the smooth operation of the program and reports to the CISR Executive Director. The Mentor Program Manager is responsible for recruitment, screening, training, and providing ongoing support, with assistance from the school based Family Liaisons. The Manager has been with the program since last Spring and has brought her expertise in education and child development to enhance the program. The CISR Executive Director oversees many of the risk management components of the program by reviewing all letters of reference and background checks. Volunteers go through a mandatory one-hour program orientation and two-hour training. Before being invited into the program, they are required to submit a written application, three letters of references and have a clean Washington State Patrol Background Check. In addition to the first two mandatory sessions, the Program Manager provides ongoing support sessions to address issues, provide activity ideas, and ensure program guidelines are maintained. The Family Liaisons assist in mentor orientations and trainings and are responsible for all school based functions including student selection, obtaining parent permission, and providing support for the matches. All matches are made at the elementary schools. Based upon our experience, matches between the volunteer and the child are much stronger, the participants express more satisfaction and the match continues longer if made at the elementary school, rather than at the Page 8 Agency: Communities In Schools of Renton Program: Mentor middle school. Once matched, we do encourage the pair to continue together as the child ages into the middle school as an additional support at a critical transition. Many of our matches continue on into high school. Referrals for the Mentor Program are received from school staff, most specifically principals and counselors. A referral would be made to the Mentor Program in cases when the child: • Appears shy or has low self esteem. • Has cultural/language barriers that keep them isolated. • Has minimal social skills and difficulty relating appropriately to peers. • Has few friends and tends to play alone at recess. • Exhibits excessive attention seeking behavior, sometimes in negative ways. • Has limited positive adult role models in their life. • Has had major life changes. • Exhibits a sense of failure or limited hope for the future. Once a child is referred to the Mentor Program they are placed on a waiting list. They are not notified that they have been referred until there is an appropriate match. Because there are so many more children in need of this level of support than recruited volunteers, this helps to avoid disappointment if an appropriate match is not made in a timely manner. Once an appropriate mentor matching the interests and needs of the child is recruited, screened, and trained, the Family Liaison meets with the child to assess their interest in the program. If they are interested, and they are usually thrilled, the Family Liaison contacts their parents, explains the program, answers any questions they may have and obtains written permission. For parents who are difficult to contact, the Liaison may do a home or work site visit to explain the program and obtain written permission. The'mentor.and mentee meet weekly for an hour during the day throughout the school year. Many matches continue into the next year, with some pairs having been together for over eight years. Activities during the session can include playing games, reviewing school work, reading, doing craft projects, or simply spending time together discussing issues or goals for the future. Mentors provide children with friendship, encouragement to achieve in school, opportunities to discover their talents, help in setting goals and a boost in self-confidence. By meeting at the school site, it helps the child develop positive feelings and they start seeing school as a place where they belong. Children in the Mentor Program are from a variety of cultural backgrounds, so it is critical that Mentors are well trained to understand and be sensitive to the differences. Cultural diversity is covered in the initial training for Mentors and ongoing support is offered to address cultural questions or issues that may be raised. We have also offered sessions to Mentors on the Culture of Poverty Training to help ensure a good base of understanding. Family Liaisons, through their role as school based supporters of mentors, also share information about cultural beliefs and traditions to ensure that interactions are respectful to the child. Page 9 Agency: Communities In Schools of Renton Program: Mentor B. Performance measure and outcomes Standardized program evaluations began in 1998 and critical outcomes and indicators have been tracked since that time. Annually, staff gathers data surveys to children, parents/caregivers, mentors and teachers, as well as collects information on grades, attendance, and disciplinary actions from school records. Below we have identified the targeted change for each indicator. Performance Measure One: Unduplicated number of students living in the City of Renton matched with an adult mentor. Outcome: Students will improve their attitude. Indicator. 70% of parents surveyed will report their child's attitude has improved. Performance Measure Two: Number of hours students met with their mentors. Outcome: Students will be more attached to their school. Indicator. 70% of students will report an increased connection with their school. Page 10 Agency: Communities In Schools of Renton Program: Mentor C. Staffing plan and evaluation The Mentor Program Manager is full time and oversees all functions of the program. She currently supports 122 mentors in addition to coordinating all recruitment and training activities. She receives .34 FTE of administrative support to help with database management, evaluation data collection, and with set up for trainings/orientations and major mailings. There are 6 Family Liaisons providing .5 FTE of mentor support to the 11 school sites. The majority of Family Liaison time is spent in the provision of family support services, but 15% of their time is allocated to the Mentor Program; identifying children, assisting with mentor training, and provided school based support. The average number of mentors in each building is ten. The Executive Director is responsible for the management and facilitation of the annual evaluation process, with oversight from the Program Committee. The Executive Director oversees data management and collection over the year, culminating in the end of year assessment. Demographic data including ethnicity, economic information, English language ability, and housing status is gathered on children and families served through the program on a monthly basis which allows for a current year to date unduplicated number and composition of children in the program. In May and June, program staff gather completed program related surveys from mentors, parents, children, and teachers along with data from school records on grades, attendance and behavior. In order to gain additional input from program participants, additional questions are included in the surveys which assess factors such as their level of satisfaction with the program and staff support. The Executive Director compiles the results of the evaluation and reviews the findings with the Program Committee and staff for their assessment and comments. The Program Committee compares results with the targeted indicators and with previous years' data. After a thorough review and development of any necessary recommendations to program services or evaluation processes, the results and recommendations are taken to the Board for information and approval as necessary. The Executive Director implements necessary changes to program services or the evaluation process. The annual evaluation results are shared with the community through distribution of the CISR annual report, presentations to School Board and City Council and on the CISR webpage. The annual evaluation results are also reviewed with the Advisory Council for review and feedback. Page 11 Agency: Communities In Schools of Renton Program: Mentor 11. Long Range Plan Communities in Schools of Renton staff and Board began a strategic planning process early in 2008, with support from one of our partners, Social Venture Partners. Board members convened on April 19, 2008, to identify goals or strategic priorities for the next three years. The Planning Committee has overseen the planning process, and will continue to oversee the process of converting the broad statements agreed upon at the retreat to clear goals, objectives, action plans, and resource plans. The facilitator led the whole group through brainstorming strengths, weaknesses, opportunities and threats related to the future success of CISR. Strengths and weaknesses are within the organization; opportunities and threats are in the external environment. The results are shown below. The number preceding each item reflects how it was categorized during the prioritization activity that followed the SWOT. Following the categorization, all participants "voted with dots" for the categories deemed to be the most important for the future success of CIS of Renton identifying the following four priority areas: • Marketing • Fundraising • Board development • Infrastructure The Planning Committee has the responsibility of managing the planning process through the development of goal statements, objectives, action plans, and resource plans. A final document will be presented to the Board for approval and would be available upon request. Page 12 • Agency:Communities In Schools of Renton Program: Mentor 12. Budget A. Request Narrative All requested funds will be used to help cover the salary and benefits for the Mentor Program Manager whose function it is to oversee all program efforts including mentor recruitment, training and ongoing support. B. Changes to budget There have been no changes to the 2008 Budget since adopted. There are no significant anticipated changes to the budget between 2008, 2009 and 2010. C. Cost per service unit 2009 expenses for the Family Liaison Program are budgeted at $113,610. The program service goal is to support 145 children, resulting in the cost of$784 per child. This amount covers all associated costs of recruitment, screening, training and support for the mentor. • Page 13 Agency: Communities In Schools of Renton Program: Mentor Data Table Requirements (Questions 13 — 18) The following documents contain all the data tables you are required to submit with your application. If you are submitting an application to continue an existing program, complete the following data tables with information pertaining only to this application. If you are submitting an application to fund a new program for your agency or forming a new agency, organization or a team of agencies and you do not have client data which is specific to your proposed program, fill out the data tables with information pertaining to what you predict your program will accomplish (projected). Explain in the applicable questions in the narrative for your program and how the numbers for each data table were determined. 13. NUMBER OF INDIVIDUALS /HOUSEHOLDS SERVED (DATA TABLE) Provide the number of individuals or households your program serves. The columns should be an unduplicated count of clients served from all funding sources as indicated. For example, someone may have attended a group meeting in March 2007 and then received direct,personal service in October 2007. Such a person should only be counted once when they first received services in 2007. If the group meeting was for one program at your agency, and the direct personal service was offered through another program at your agency, you can count this individual once for each program. Do not double-count a person who received the same type of service more than once. For example, a woman who received a physical exam in January and a mammogram in March would only be counted once if both medical services are part of the same program. All clients should be counted as an unduplicated user the first time they receive services in a calendar year. A client who received services from the same program on 12/31/07 and 01/02/08 would be an unduplicated user for the 01/02/08 visit. The 2007 % of column 1 clients served by city is the number of unduplicated clients served in 2007 by city, divided by the total number of unduplicated clients served in 2007. The total of this column will equal 100%. The final column represents the unduplicated number of clients that will be served with the funds requested by city in this application. You will be required to serve that number of clients if fully funded. For example, your program has a total of 900 unduplicated clients served in a city. If you are requesting $10,000 to provide services to 90 unduplicated clients with the funds requested with(the remaining 810 clients to be served with another funding source), 90 would be shown in the last column for this city. Page 14 Agency: Communities In Schools of Renton Program: Mentor 13. NUMBER Of INDIVIDUALS/110USEHOLDS SERVED BY PROGRAM [X] Individuals? or 111 Households? (Check which applies and use for reporting all demographics.) Unduplicated *Unduplicated Number of all Clients Served by Clients Served All Funding Sources with Funds Requested 2007 2009 2007 %of column 1 2008 2009 (Actual) clients served (Anticipated) (Projected) (City Requested by City Funding Only) Auburn Burien Covington Des Moines Enumclaw Federal Way Kent Renton 98 75% 105 110 21,074 SeaTac Seattle Tukwila Other 32 25% 33 35 100% Total 130 (This column must 138 145 21,074 total 100%) *Unduplicated means count each client only once per calendar year per program. This number should match the number of clients by city indicated in the top row of Question 15. Page 15 Agency: Communities In Schools of Renton Program: Mentor 14. Performance Measures & Average Cost of Service (Data Tables) This information will be used by each City to develop 2009-10 contracts with funded agencies. 14a.Your Performance Measures should reflect numbers based on the funding you are requesting from each City. 14b. In the space provided, define at least one(1) and no more than three(3)performance measures the program will report with a brief explanation. Do not use Unduplicated Clients/Households as a performance measure. Provide the estimated number of clients/households served by city your program plans to provide in the corresponding column for each of the performance measures listed. Estimate the number of units to be provided for each measure annually. Provide accurate and realistic estimates. These estimates will be the basis of your contract if funded. 14c. Complete the table with the city funds requested in Question 6 and the unduplicated clients served with funds requested by City listed in the last column of Question 13. Explain any differences between the average cost of service per client between cities in Question 10.D. of your application. Example of Completed Data Tables 14a: 14a. Service with 2009 Requested Funds Proposed Performance Measures as listed below. A) Meals Delivered B) Case Mgmt Hrs C) Auburn 7,000 75 Burien 5,000 50 Data Table 14b; Performance Measure 2009:Proposed(City Requested Funding `' Title: Brief explanation: A) Meals delivered One meal delivered counts as 1 service unit. Will include intake, assessment,planning, advocacy and evaluation B) Case management hours of results. Page 16 Agency: Communities In Schools of Renton Program: Mentor 14. Performance Measures (Data Table) 14a. Service with 2009 Requested Funds Proposed Performance Measures as defined below. A)Mentored students B)Mentor hours C) Auburn Burien Covington Des Moines Enumclaw Federal Way Kent Renton 110 1500 SeaTac Seattle Tukwila 14b::Performance Measures 2090Proposed with`funds requested City Fundingonly Title: Brief explanation: A)Mentored students Unduplicated number of students matched with a mentor. B)Mentor hours The number of hours students met with their mentors. C) Page 17 Agency: Communities In Schools of Renton Program: Mentor 14 Performance Measures (Data Table), Cont. 14c. Average Cost of Service Unduplicated Clients Served with Funds Average Cost of Service Requested 2009 Requested 2009 per Client (Same as last column of (Same as last column of Question 6) Question 13) Column 1 divided by Column 2 Example: $5,000 45 $111.11 Auburn Burien Covington Des Moines Enumclaw ' Federal Way Kent Renton 21,074 110 191.59 SeaTac Seattle Tukwila Complete Question 15 with 2007 Actual numbers reported in column 1 of Question 13. Page 18 Agency: Communities In Schools of Renton Program: Mentor 15. Demographics (from all funding sources) (Data Table) o,o —crs ce Client'Residence" a) U (� W fo � rig cis Unduplicated (check one) :Iridividuais o0 0 Households °1 • Served in 2007* *Check Individual or Household,which should be the same as checked in Question 13. Unduplicated means count each client Household.Income'Level.:,.'., 30%of Median or Below 50%of Median or Below 71 80%of Median or Below Above 80%of Median Unknown 27 TOTAL 98 Male 32 Female 66 TOTAL 98 =Age 0-4 years 81 5- 12 years 17 13- 17 years 18-34years 35-54 years • 55-74 years 75+years _ Unknown TOTAL 98 Ethnicity. Asian 7 Black/African American 1 Hispanic/Latino(a) 31 Native 12 American/Alaskan _ Pacific Islander 3 White/Caucasian 34 Other/Multi-Ethnic 10 TOTAL 98 .Female Headed 58 Household Disabling`Conditioi , -' 11 Limited English Speaking 10 only once per calendar year. This should match the number served by City in the Actual 2007 column of Question 13. The "total"column will be different from Question 13 since the"other"column is not included due to space limitations. Page 19 Agency: Communities In Schools of Renton Program: Mentor 16. PROGRAM STAFF (DATA TABLE) In this data table,record the number of full-time equivalent(FTE)paid staff and volunteers for this program. FTE means a 40-hour week throughout the entire year. For example, if you enter"5" in the box for Number of Volunteer FTEs, this would mean that you have, on average, five volunteers assisting your program at all times (assuming a 40-hour week). If you know only the total number of hours contributed by all volunteers for this program, simply divide that number by 2,080 to find the total FTE number. For example: 5,000 volunteer hours over the course of a year, divided by 2,080 equals 2.4 FTEs. 2007 2008 2009 (Actual) (Budgeted) (Projected) Total Number of Staff(FTEs) 2.5 2.25 2.25 Number of Volunteer(FTEs) 2179/2080= 2080/2080= 2080/2080= 1.05 FTE 1 FTE 1 FTE Actual Number of Volunteers 130 138 145 17. PROGRAM REVENUE & EXPENSE BUDGETS (DATA TABLE) Program Budget: All columns should include total program operating revenue and expenses. Complete the following data tables with figures indicating the source of program operating funds for 2007 (actual), 2008 (budgeted) and 2009 (projected). Budget amounts should match funding requested (Question 14c) and Question 5. Include an explanation of any significant differences between the revenues and expenses by year in Question 12B of your application. Page 20 Agency: Communities In Schools of Renton Program: Mentor -17. PROGRAM REVENUE BUDGET (DATA TABLE) Revenue Source 2007 2008 2009 (Actual) (Budgeted) (Projected/ Requested) City Funding(General Fund & CDBG) -.. . gigg•-P a:�:�>:... • Auburn • Burien • Covington • Des Moines • Enumclaw • Federal Way • Kent • Renton 19,158 19,158 21,074 • SeaTac • Seattle • Tukwila • Other(Specify) • Other(Specify) Other Government Funds • King County 5,000 5,000 . 5,000 • Washington State • Federal Government(Specify) • Other(Specify) Private Sources • United Way(grants &designated donors) 5,439 5,983 6,581 • Foundations and Corporations 34,500 35,000 35,000 • Contributions (e.g., Events, Mailings) 31,045 44,100 45,955 • Program Service Fees (User Fees) • Other(Specify) TOTAL PROGRAM BUDGET 95,142 109,241 113,610 Page 21 Agency: Communities In Schools of Renton Program: Mentor 17. PROGRAM EXPENSE BUDGET, CONT. (DATA TABLE) Expenses 2007 2008 2009 (Actual) (Budgeted) (Projected) Personnel Costs • Salaries 64765 76453 79509 • Benefits 15429 18213 18943 • Other • Total Personnel 80,194 94,666 98,452 Operating and Supplies ss ,,; , ; • • Office/Program Supplies 8,915 9,000 9,360 • Rent and Utilities 5,134 3,456 3,594 • • Repair and Maintenance • Insurance • Postage and Shipping • Printing and Advertising • Telephone 163 231 240 • Equipment • Conference/Travel/Training/Mileage 681 1,370 1,426 • Dues and Fees 55 444 461 • Professional Fees/Contracts • Direct Asst. to Individuals • Administrative Costs • Other(misc) 74 77 TOTAL PROGRAM EXPENSES 95,142 109,241 113,610 Net Profit(Loss) 0 0 0 (revenue—expenses) = Page 22 Agency: Communities In Schools of Renton Program: Mentor 18. SUBCONTRACTS (DATA TABLE) List all the agencies you will be subcontracting with for this program. Provide the agency name in the first column, a description of the contract/service in the second column, and the contract amount in the third column. Do not list agencies you coordinate with on a referral only basis. Indicate not applicable if you do not subcontract for any part of this program. Subcontracting Agency Specific Subcontracted Activities Contract in the Operation of Your Program Amount NA Page 23 Agency: Communities In Schools of Renton Program: Mentor 10. APPLICATION CHECKLIST Applications missing one or more of the following components or not following these directions may not be reviewed. Sign and submit the application checklist with your application. CO;ntents (Your application should contain each of these items in this order.) 1 E j pplication Cover Pages.The top three pages of your application must be a completed copy of the Agency Information and Questions 1-7. Applica arrative: tioQuestion 8 Organizational Experience(2 page maximum) [v] uestion 9 Need for Your Program(2 page maximum) [ Question 10 Proposed Program/Service(6 page maximum) "Question 11 Long Range Plan(1 page maximum) t[ "Question 12 Budget(2 page maximum) Data Tab s Question 13 Number of Individuals/Households Served Eli Question 14a-c Performance Measures and Average Cost of Service [►Question 15 Demographics(from all funding sources) ruestion 16 Program Staff uestion 17 Program Revenue&Expense Budgets E I' Question 18 Subcontracts �[v]�Required documentation. Supply one copy of the following required documents with the signed original application. See Part II: City Specific Supplemental Information to determine whether additional copies of the ,application and required documentation need to be submitted. [Question 19 Required Documentation, including: ■ afroof of non-profit status • LO ganizational Chart ■ gency/Organization Mission Statement • Board resolution authorizing submittal of the application(may be submitted up to 60 days after application). • A,List of the current governing board and local board, if applicable, (include name,position/title, city residence, length of time on the Board, and expiration of terms. Note any vacancies.) • ✓board Meeting Minutes of last three board meetings of governing board and local board as applicable • ✓Annual Budget • ✓Financial Audit Cover Letter ■ ✓Financial Audit Management Letter • financial Statement • verification of Non-Discrimination Policy ■Program Intake Form ■J- Tiding Fee Scale [ Application Check List. (Signed below.) ['City Specific Supplemental Information.Required in Name: Susan Richards ,Part II for applicable City only. Position: Executive Director " Phone#: 425.430.6656 E-mail: srichards@ci.renton.wa.us Signature of Person Completing Checklist DO1NOT SUBMIT ANY OTHER MATERIALS WITH THIS APPLICATION Make sure that you carefully check Part II of this application Page 24 to see what additional attachments each city requires Agency: Communities In Schools of Renton Program: Mentor • Application Supplemental Questions — City of Renton 1. Results, Strategies and Activities addressed by the Mentor Program. The Mentor Program addresses the following Result included in Renton's Results, Strategies, and Activities. The selected Program Strategy and Activities were aligned by the City of Renton as successful in achieving this Result. Result 1. All children and youth are ready for educational success, work and life. Strategy A. Increase the number of Developmental Assets for Youth Activities 0. Match caring community volunteers with children at risk of school failure to meet at the school one hour a week. p. Provide ongoing training and support to maintain successful relationships. The Mentor Program activities have been shown to be effective through a number of research based findings, including Risk and Protective factor research which shows that factors such as bonding with a caring adult and having high expectations have been found to alter or even reverse expected negative outcomes for youth. National studies by Public/Private Ventures, Manpower Demonstration Research, and Mathematica Policy Research have confirmed the value of mentoring programs by showing that { caring adults in a young person's life can result in positive effects such as fewer unexcused absences and more positive attitudes toward school and the future. 2. Program Outcomes Performance Measure One provides the number of unduplicated students living in the City who are matched with a caring adult mentor. The associated outcome states that students matched with mentors will improve their attitude and the indicator is designed to show changes in attitude based on survey responses by parents/caregivers. Research has show that overall attitude can be a key factor in academic success as students with positive attitudes tend to do better in school. Performance Measure Two provides the total number of hours students receive the school based support from caring adults. The selected outcome indicates that students will increase their connection with school as a result of the time spent with their mentor, and the indicator is based on student survey responses regarding their perception of their connection to their school at the end of the school year. Research based on the 40 Developmental Assets shows that a strong connection with school is a highly correlated indicator of school success. Students that see themselves ' as part of their school are more committed to learning and perform better academically. • I I INTERNAL REVENUE SERVICE DEPARTMENT OF THE TREASURY ' P. 0. BOX 2508 CINCINNATI, OH 45201 Employer Identification Number: Date: MAY 12 2000 D91-1689158 LN 17053092817000 COMMUNITIES IN SCHOOL OF RENTON Contact Person: 1055 S GRADY WAY JEFFREY D SPROUL ID# 31182 1RENTON, WA 98055 Contact Telephone Number: (877) 829-5500 Our Letter Dated: November of 1995 Addendum Applies: No : Dear Applicant: This modifies our letter of the above date in which we stated that you would be treated as an organization that is not a private foundation until the .. . , a expiration of your advance ruling period. Your exempt status under section 501(a) of the Internal Revenue Code as an , organization described in section 501(c) (3) is still in effect. Based on the ' information you submitted, we have determined that you are not a private ' foundation within the meaning of section 509(a) of the Code because you are an:. . .. ; organization of the type described in section 509(a) (1) and 170(b) (1) (A) (vi). . Grantors and contributors may rely on this determination unless the ' Internal Revenue Service publishes notice to the contrary. However, if you lose your section 509(a) (1) status, a grantor or contributor may not rely on - . this determination if he or she was in part responsible for, or was aware of, the'act or failure to act, or the substantial or material change on the part of ithe organization that resulted in your loss of such status, or if he or she i acquired knowledge that the Internal Revenue Service had given notice that .you ! would no longer be classified as a section 509(a) (1) organization. You are required to make your annual information return, Form 990 or Form 990-EZ, available for public inspection for three years after the later of the due date of the return or the date the return is filed. You are also required to make available for public inspection your exemption application, ' any supporting documents, and your exemption letter. Copies of these documents are also required to be provided to any individual upon written or in ' person request without charge other than reasonable fees for copying and postage. You may fulfill this requirement by placing these documents on the Internet. Penalties may be imposed for failure to comply with these ' requirements. Additional information is available in Publication 557, 1 Tax-Exempt Status for Your Organization, or you may call our toll free ' number shown above. If we have indicated in the heading of this letter that an addendum applies, the addendum enclosed is an integral part of this letter. Letter 1050 (DO/CG) ' -2- I ( COMMUNITIES IN SCHOOL OF RENTON Because this letter could help resolve any questions about your private foundation status, please keep it in your permanent records. If you have any questions, please contact the person whose name and telephone number are shown above. Sincerely yours, Steven T. J1111:e Steven T. Miller Director, Exempt Organizations • (I: Letter 1050 (DO/CG) TKesponsibIIIties: —Consists of our Teams: Support the development Major Gifts, Community development o_ Outreach, Benefit Dinner,River Communities In Schools of Renton Mission Statement To champion the connection of needed community resources with schools to help young people successfully learn, stay in school, and prepare for life. al) Communities In Schools of Renton Board of Directors 2007-2008 HELPING KIDS STAY IN SCHOOL AND PREPARE FOR LIFE Name Employer/Affiliation Job Title Entry Date End Date City Pat Auten Renton School District- Retired Community Volunteer 9/1/1994 8/31/2010 Kathleen Bailey Renton School District Executive Director: Secondary 5/4/2006 8/31/2009 Education • Jeremy Cook Costco Wholesale-Tukwila Warehouse Manager 4/1/2004 8/31/2009 Jay Covington City of Renton " Chief Administrative Officer 9/1/1994 8/31/2008 Deloris Gillis Employment Security Department Administrator 3/1/1999 8/31/2010 Renton Sabrina Handy Hazen High School Student Representative 11/1/2007 8/31/2009 Renton Terry Higashiyama City of Renton Community Services-Administrator 5/4/2006 8/31/2009 Bambi Jilek Windermere Real Estate Realtor 10/1/2000 8/31/2011 Renton Freedom Johnson Renton Education Association Representative 12/6/2007 8/31/2010 Wendy Kirchner City of Renton Recreation-Senior Center 10/1/2001 8/31/2010 Nathan Kositsky Nathan Kositsky Marketing President 5/4/2006 8/31/2009 Jay Leviton Renton School District Director: Career/Life Skills 9/1/1994 8/31/2008 Susan Mather Renton School District Executive Director: Elementary 12/6/2007 8/31/2010 Education Robert McBeth Communities In Schools of Renton Board Chair 2/2/2006 8/31/2009 Diane Merrill Renton PTA Council Representative 11/7/2002 8/31/2009 Renton Toni Nelson Community Member Community Volunteer 2/1/1996 8/31/2008 Renton King Parker King & Bunny's Appliance &TV President 2/5/2004 8/31/2009 Renton Roger Paulsen Renton Ecumenical Assoc. of Representative 9/1/1994 8/31/2011 Churches PACCAR Data Analyst Jim Poff PACCAR Director 9/1/1994 8/31/2009 Keith Renfrew Renton School District-Retired Program Evaluation Consultant 9/1/1994 8/31/2010 Jerry Rerecich City of Renton Recreation Director 9/1/1994 8/31/2008 Al Talley, Sr. Alcan Building Maintenance President 4/1/2000 8/31/2010 Renton School Board President Chuck Tiernan Community Member Community Volunteer 11/1/1998 8/31/2008 __ _lames V_entris_ - ___ ___ _ _Renton_School.District---Retired--- --- Educational Consultant - - - 4/1-/2000-- 8/31/201-0- - Renton -- ---- Stevie-Ray Walker Renton High School Student Representative 12/6/2007 8/31/2009 Laura Widdice Lakeridge/Talbot Hill Elementary School Nurse 10/6/2005 8/31/2008 Communities In Schools of Renton Board of Directors 2007-2008 HELPING KIDS STAY IN SCHOOL AND PREPARE FOR LIFE Name Employer/Affiliation Job Title Entry Date End Date City Brandt Wong Lindbergh High School Student Representative 11/1/2007 8/31/2009 Ryan Wong Lindbergh High School Student Representative 11/1/2007 8/31/2009 Communities In Schools of Renton Board Meeting Minutes January 3, 2008 Board members in attendance: Kathleen Bailey, Deloris Gillis, Terry Higashiyama, Bambi Jilek, Freedom Johnson, Jay Leviton, Susan Mather, Bob McBeth, Diane Merrill, Toni Nelson, King Parker, Roger Paulsen, Jim Poff, Keith Renfrew, Jerry Rerecich, Al Talley, Jim Ventris, Brandt Wong and Ryan Wong Staff: Gail Burton, Erin Iverson, and Susan Richards Bob McBeth called the meeting to order at 5:33. Board Member Introductions Beginning Business Approval of Minutes: Keith Renfrew requested the following correction to the December 6th minutes: Dinner Discussion and Ticket Distribution section- "Bob McBeth (in place of Keith Renfrew) suggested that Board Members make donations toward the purchase of the cruise which will keep dinner expenses down". With correction noted Diane Merrill made a motion to accept the December 6th minutes and Jim Ventris seconded the motion, and was unanimously approved. Dinner Discussion and Ticket Distribution: Toni Nelson circulated signup sheets recruiting volunteers for hosting tables, set-up, and clean-up at the dinner. Toni explained the dinner committee would like the event to have a hosted feel. She asked if the student board members would help greet guests and hang their coats and then asked for table hosts to greet guests and help facilitate the collection of donations. Keith Renfrew reported the purchase of the cruise is underway, and he agreed to email cruise details to the board members. Discussion took place regarding airfare to and from the cruise boarding location. Chuck Tiernan suggested board members could donate air miles to help defray the cost of airfare for the person purchasing the cruise. Chuck and Bambi Jilek will look into this. Monthly Status Update: Susan Richards reviewed the December Monthly Status Report. Development Committee: Chuck reported the focus has been on the Benefit Dinner. Financial Reports: Jim Poff reviewed the Income and Expense Report and Balance Sheet from December. King Parker made a motion to approve the December Income and Expense Report and Balance Sheet; Chuck Tiernan seconded and was unanimously approved. Program Committee: Susan reported she had a mid-year review of our work plan with Polly Hopkins, our SVP Partner and Aaron Jacobs, SVP Senior Manager. We will begin working with Sharon Lucus, private consultant paid through SVP to develop a strategic plan. Minutes January 3,2008 Page 2 Executive Committee: Bob McBeth reported the committee reviewed the 2007 Audit with JoAnn Kelly, CPA. There were no significant findings. The audit will be presented at the February Board meeting for approval. Continuing Business School Visits: Cascade and Highlands will report at the February Board meeting. New Business February Board Agenda: Suggested items for next month's meeting- dinner recap and site visits. Other. Erin Iverson reported the following: January is National Mentoring Month. Proclamations will be presented at the City Council meeting on January 7th and Renton School Board on January 9th, Board members are welcome/encouraged to attend. The Mentor Program was recently featured in Renton Magazine and The Renton Reporter will present an article regarding the Benefit Dinner. The Mentor Program currently has 16 potential new mentors coming on board. A Comcast Foundation grant in partnership with the Kent CIS program is paying for public service announcements at local theaters regarding mentoring featuring Shawn Alexander along with print ads in Seattle Times SE Living Section and NW Colors. Terry Higashiyama invited Board Members to participate in the One Night Count of the Homeless, taking place January 24th at 2:00 am. This is a wonderful opportunity to help the community. Terry invited the Board to attend a reception honoring Toni Nelson and her service as a City Council member on Tuesday, January 15th at 4:00 to 6:00 at City Hall. Next meeting will be Thursday, February 7, 2008 Meeting adjourned at 6:35 p.m. Minutes Reviewed by Bob McBeth, Board Chair Communities In Schools of Renton Board Meeting Minutes February 7, 2008 Board members in attendance: Pat Auten, Deloris Gillis, Sabrina Handy, Bambi Jilek, Wendy Kirchner, Jay Leviton, Susan Mather, Bob McBeth, Diane Merrill, Toni Nelson, King Parker, Roger Paulsen, Jim Poff, Keith Renfrew, Jerry Rerecich, Al Talley, Jim Ventris, Laura Widdice, Brandt Wong and Ryan Wong Staff: Gail Burton, Erin Iverson, and Susan Richards Bob McBeth called the meeting to order at 5:33. Board Member Introductions Beginning Business Approval of Minutes: King Parker made a motion to accept the January 3rd minutes and Jay Leviton seconded the motion, and was unanimously approved. Sharon Lucas— Review of upcoming Planning Process The Executive committee decided to move forth with strategic planning. Wendy Kirchner will chair the committee and will work with the strategic planning team to start the process. Sharon Lucas, Management Consultant, will facilitate the strategic planning process. Sharon reviewed the handout"Strategic Planning Process 2008"which includes a timeline of activities to achieve the strategic plan. The committee is aiming for Board approval of the plan in June. The March board meeting will start at 5:00 pm to allow more time for the process. The April 3rd Board meeting has been cancelled and will be replaced by a Retreat on Saturday, April 19th. Development Committee:Teams reported. Contributors Team: Diane Merrill reported a thank you letter and annual report will be sent to donors. The committee needs help to prepare the mailing on Thursday, February 14 at 3:00 at KEC in the board room. Diane also asked for volunteers to help with monthly thank you calls to donors. Dinner Report: Bambi Jilek reported over$20,000 was received from the dinner. A great job was done by the dinner committee. Major Gifts: Keith Renfrew reported he collected a $10,000 donation from Renton Walker's Subaru and Mazda. Jay Leviton reported he has a soft commitment from First Savings. Monthly Status Update: Susan.Richards reviewed the January Monthly Status Report. The Family Liaison and Mentor numbers are on target and fundraising is at 82%. Financial Reports: Jim Poff reviewed the Income and Expense Report and Balance Sheet from January. King Parker made a motion to approve the January Income and Expense Report and Balance Sheet; Pat Auten seconded and was unanimously approved. Executive Committee: Bob McBeth reported the committee has been discussing the Strategic planning process. Minutes February 7,2008 Page 2 Continuing Business Audit review and approval: Jim Poff reviewed the audit. He reported there were no significant findings. Pat Auten made a motion to approve the audit, Al Talley seconded and the motion was unanimously approved. School Visits: Cascade, Highlands, and Lakeridge will report at the March Board meeting. Board members requested the School Visit Information, Sign up, and Family Liaison list be resent via email. New Business March Board Agenda: Suggested items for next month's meeting- Strategic plan, permanent funding resources, and in June the Board requested the Family Liaisons be invited to share stories and for the Board to thank them for the great year. Other: Erin Iverson reported the Mentor program has 122 children being served by a Mentor. This is the highest number seen for this time of year. Laura Widdice asked "How many new kids are added to the program?", Erin will report these numbers at the next board meeting. Erin shared the Mentor program had three articles in the Renton Reporter and a short video was shot at Dimmitt, this video will air at 6:30 am on Saturday, February 9th. CIS of Washington will air the video on You-Tube. Erin extended invitations to the Board to attend the Annual Mentor/Mentee Field trip taking place on May 6th (elementary) and May 13th (middle & high) at the Museum of Flight and the Mentor Reception on May 21 st The CISR office will move to 200 Mill Avenue, on the 5th floor, on February 8th. This will be temporary for the next 3 to 6 months. There will be times when the office will be locked; deliveries may be made to the 6th floor, Renton Human Services Department. 40 Assets: Jim Ventris reported that there are plans for Kirby Unti, Denis Law, Marcie Maxwell and Jim to get together in the Spring to talk about 40 Assets. Next meeting will be Thursday, March 6, 2008 at an earlier time 5:00 pm. Meeting adjourned at 6:45 p.m. Minutes Reviewed by Pat Auten, Secretary Communities In Schools of Renton Board Meeting Minutes March 6, 2008 Board members in attendance: Kathleen Bailey, Deloris Gillis, Terry Higashiyama, Bambi Jilek, Freedom Johnson, Wendy Kirchner, Susan Mather, Diane Merrill, King Parker, Roger Paulsen, Jim Poff, Keith Renfrew, Jerry Rerecich, Al Talley, Chuck Tiernan, Stevie-Ray Walker, Laura Widdice, Brandt Wong and Ryan Wong Guests: Tameka Artison, Lynn Desmarais, Polly Hopkins, and Sharon Lucas 'Staff: Gail Burton, Erin Iverson, and Susan Richards ,Roger Paulsen, Vice Chair, called the meeting to order at 5:33. Board Member Introductions 'Polly Hopkins, Social Venture Partner Lead Partner, attended the Board meeting to support the strategic planning process. Tameka Artison also attended the meeting; she is interested in becoming a member of the Board. Beginning Business Approval of Minutes: King Parker made a motion to accept the February 7th minutes and Al Talley seconded the motion, and was unanimously approved. Officer Nominations and Elections: Roger Paulsen reported that it is time to acquire nominations for Executive Committee positions. The Board Chair, Vice Chair, and Treasurer are willing to continue in their positions. The Secretary has decided not to return. Roger will 'be looking for nominations at the May meeting and voting will take place in June. Standing Reports Monthly Status Update: No monthly status report. Financial Reports: Jim Poff reviewed the Income and Expense Report and Balance Sheet from February. Al Talley made a motion to approve the February Income and Expense Report and Balance Sheet; Terry Higashiyama seconded and was unanimously approved. Sharon Lucas—Strategic Planning Process Sharon Lucas, Management Consultant, lead a discussion for the Board to develop a local purpose statement. The following handouts were reviewed and discussed: Student Needs Data; CISR Outcome and Indicators; RSD Home Languages 2007-08; CISR Mission; Healthy Youth Survey 2006; 40 Developmental Assets; Dropout Risk Factors and Exemplary Programs; and Risk Factors. The Board was reminded that the April Board meeting will be replaced by a Retreat to continue working on Strategic Plans on.Saturday, April 19 at KEC. New Business May Board Agenda: Suggested items for Board meeting in June - Family Liaisons be invited to share stories and for the Board to thank them for the great year. Minutes March 6,2008 Page 2 Other. Erin Iverson distributed the March Mentor Newsletter and a save the date bookmark reflecting upcoming Mentor Program events. Reminder—No Board meeting April 3rd Board Retreat Saturday, April 19th, 9:00 am to 2:00 at KEC in the board room. Susan Richards mentioned new mentee and mentors numbers per year have been gathered and will be shared in May. Vote - Renton School District Levy Election is March 11 there are three issues are on the ballot. Invite to the PTA Founders Day Dinner on March 10th at the Holiday Inn, Renton. Next Board meeting will be Thursday, May 1, 2008 Meeting adjourned at 7:00 p.m. Minutes Reviewed by Roger Paulsen, Vice Chair Communities In Schools of Renton Agency Budget 2007-2008 Revenues Carry Forward Operating Funds 23,594 Contributions 224,581 Fund Raising Events 27,000 Awards 45,112 Interest 3,000 Sponsors, City of Renton 41 ,000 I Sponsors, Renton School District 25,000 Revenue Totals $ 389,287 Expenditures Cell Phone 625 Memberships/Dues/Events 1 ,200 Mileage, Parking 1 ,000 Miscellaneous 400 Office Lease 5,676 Payroll Service 1 ,600 PR Materials 4,000 Professional Fees 5,500 Salary/Benefits 352,786 Supplies 14,000 Training/Travel 2,500 Total Expenditures $ 389,287 Jo Ann Kelly,CPA 404 South Brandon Street Seattle,WA 98108-2236 (206)767-5403 Independent Auditor's Report To the Board of Directors Communities In Schools of Renton Renton,Washington • have audited the accompanying balance sheet of Communities In Schools of Renton (a nonprofit organization)as of August 31,2007 and 2006 and the related statements of activities,functional expenses, and cash flows for the years then ended. These fmancial statements are the responsibility of the Organization's management. My responsibility is to express an opinion on these fmancial statements based on my audit. I conducted my audit in accordance with U.S.generally accepted auditing standards. Those standards require that I plan and perform the audit to obtain reasonable assurance about whether the financial statements are • free of material misstatement. An audit includes consideration of internal control over fmancial reporting as a basis for designing audit procedures that are appropriate in the circumstances,but not for the purpose of expressing an opinion on the effectiveness of the Organization's internal control over financial reporting. Accordingly, I express no such opinion. An audit also includes examining, on a test basis, evidence supporting the amounts and disclosures in the financial statements, assessing the accounting principles used and significant estimates made by management, as well as evaluating the overall financial statement presentation. I believe that my audit provides a reasonable basis for my opinion. In my opinion,the financial statements referred to above present fairly,in all material respects,the fmancial position of Communities In Schools of Renton as of August 31,2007 and 2006, and the changes in its net assets and its cash flows for the years then ended in conformity with U.S.generally accepted accounting principles. My audit was conducted for the purpose of forming an opinion on the basic financial statements of Communities In Schools of Renton taken as a whole. The accompanying Schedule of Grants is presented for the purposes of additional analysis and is not a required part of the basic financial statements. Such information has been subjected to the auditing procedures applied in the audit of the basic financial statements and, in my opinion, is fairly stated in all material respects in relation to the basic fmancial statements taken as a whole. ato, CPA Seattle,Washington December 18,2007 iti I Jo Ann Kelly,CPA 1 404 South Brandon Street Seattle,WA 98108-2236 ( Phone(206)767-5403 Fax(206) 767-6430 1/11 Auditor's Report on Internal Control 1 i P To The Board of Directors ;. Communities In Schools of Renton i In planning and performing my audit of the financial statements of Communities In Schools of Renton as of and for the year ended August 31, 2007, in accordance with auditing standards generally accepted in the United States of America, I considered Communities In Schools of Renton's internal control over financial reporting (internal control) as a basis for designing my auditing procedures for the purpose of expressing my opinion on the financial statements,but not for the purpose of expressing an opinion on the effectiveness of the Organization's internal control. rI Accordingly,I do not express an opinion on the effectiveness of the Organization's internal control. A control deficiency exists when the design or operation of a control does not allow management or employees, in the normal course of performing their assigned functions, to prevent or detect misstatements on atimelybasis. In addition,because of the inherent limitations in internal controls, including the possibility of management override of controls, misstatements due to error or fraud may occur and not be detected by such controls. A significant deficiency is a control deficiency,or Q a combination of control deficiencies,that adversely affects the entity's ability to initiate,authorize, record,process, or report financial data reliably in accordance with generally accepted accounting principles such that there is more than a remote likelihood that a misstatement of the entity's _i financial statements that is more than inconsequential will not be prevented or detected by the entity's internal control. A material weakness is a significant deficiency, or a combination of significant deficiencies, tha t results in more than a remote likelihood that a material misstatement of the financial statements will I not be prevented or detected by the entity's internal control. _ . My consideration of internal control was for the limited purpose described in the first paragraph and would not necessarily identify all deficiencies in internal control that might be significant deficiencies or material weaknesses. I did not identify any deficiencies in internal control that I consider to be material weaknesses, as defined above. However, I identified the following deficiencies in internal control that I consider to be significant deficiencies. t I Board of Directors ' Communities In Schools of Renton Page 2 Special Events Revenue - During my testing,I noted that control and reconciliation schedules were maintained but lacked the segregation of duties and supervisory review that would help achieve the intended internal control objectives. rr Procedures that have been implemented for tracking,recording, and reconciliation of special event revenue have not been codified in writing and included in the Organization's operating manual. Providing written documentation of these processes will also enhance oversight of financial reporting and internal control. Responsibilities for receipt,recording and reconciling should optimally not be concentrated in one position. As noted above,a review and identification of the specific activities involved would help identify conflicting duties and provide management with the information needed to redirect duties or implement additional supervisory review. Financial Reporting and Review In conjunction with my audit procedures,I noted certain deficiencies in the recording process. The Agency has already implemented the most important step in establishing internal control using QuickBooks accounting software: that of establishing users with different levels of access and �w. providing separate passwords. Additionally, a year-end-close process was implemented the previous year, whereby a formal close date is used; however, it lacked a password protection component. Without a password associated with the close, the protection provided by this procedure is ineffective. Implementation of a unique password at the administrative level for closing purposes will help prevent inadvertent changes to financial data subsequent to releasing accounting data to users of the financial reports. Along with controls through options available in the accounting software, additional supervisory control over financial recording would be achieved by establishing formal journal entry procedures. Clear identification of when a journal entry is to be used versus correction of items of data input should be established and included in the operations manual. General journal entries are used to record items in the general ledger,including corrections of items where actuals have already been posted(i.e., in a previous period). A journal entry form would be completed by accounting and supported by appropriate documentation. This form, with attached documentation,would be submitted to and approved by supervisory personnel prior to its entry into the financial system. pI Board of Directors Communities In Schools of Renton Page.3 Authority and Responsibilities During the course of the audit in conjunction with inquiry of management, I noted certain control issues I consider to be weaknesses related to identification of authority and responsibilities as they relate to the financial process. Control could be strengthened by considering implementation of the sr following: Revise and update the existing manual to include the accounting department's operating procedures. The manual would incorporate written procedures (a how-to of job tasks), instructions,and assignment of duties. In the process of a comprehensive review of existing procedures,management might discover procedures that can be eliminated or improved upon to make the system more efficient and effective. w . Since all organizations undergo change,an annual or other periodic re-assessment is recommended. Disbursement Process During my testing, I noted one instance where a check was released without signature. This exception indicates a deficiency in the control and review objectives. Also noted were a few instances where the established procedures surrounding disbursement documentation were not complied with. To verify the authenticity of purchases, documentation supporting the actual receipt of goods ordered and invoiced should be indicated. Often,the packing slipis utilized,wherebythe document is initialed and dated bythe individual receivingthe goods { prior to submission for invoice approval. The other deficiency noted was noncompliance with the written procedure related to "gift card acceptance." The one instance identified during my testing involved the use of gift cards as direct client support for which there was not proper documentation supporting the ultimate use of the gift card. — Ensuring that all personnel are familiar with the documentation process and requirements will help provide a strengthened control environment. A 7:3 L CPA • Seattle, Washington 11111 December 18,2007 Communities In Schools of Renton Balance Sheet August 31,2007 and 2006 Assets 2007 2006 Current Assets Cash and cash equivalents $143,108 $148,279 Accounts receivable-grants 7,419, 8.551 Total Current Assets 150,527 156,830 Investments 60,326 51.168 N:. Total Assets $210,853 $207,998 Liabilities and Net Assets Current Liabilities Accrued vacation $ 12,349 $ 9,563 Deferred revenue — 20,000 Agency obligation-other organizations 7,985 Total Current Liabilities 20,334 29.563 kio Contingencies — — Net Assets Unrestricted Operating 44,197 63,007 Board designated-Family Liaison Program 134.322 113.081 Total Unrestricted Net Assets 178,519 176,088 Temporarily restricted 12,000 2,347 _ Total Net Assets 190.519 178.435 Total Liabilities and Net Assets $210,853 $207,998 See notes to financial statements. -2- Section: Personnel Topic: Fair Practices POLICY (Effective 12/97) The policy of Communities In Schools of Renton is to promote and afford equal opportunity to all persons regardless of race, ethnicity, national origin, gender, the presence of a non-job-related physical, sensory, or mental handicap, age, or marital status. This policy shall be based on the principles of equal employment opportunity and affirmative action guidelines as set forth in federal, state, and local laws. PROCEDURE (Revised 03/03) All activities relating to employment such as recruitment, selection, promotion, training, and termination shall be conducted in a nondiscriminatory manner. Personnel decisions will be based on individual performance and organizational staffing requirements. If an employee/potential employee believes they have been subject to unfair practice, the established Grievance Procedure should be followed. Communities In Schools of Renton Operations Manual Section: General Topic: Nondiscrimination-Program Participants POLICY (Effective 12/97) It is the policy of Communities In Schools of Renton to treat all program participants equally and without regard to age, disability, ethnic background, gender, marital status, socio-economic status, sexual preference, national origin, race or religion. Communities In Schools of Renton's programs are open to all who meet the eligibility criteria established for each program. PROCEDURE (Effective 12/97) Communities In Schools of Renton will not tolerate racial, ethnic, religious, or sexual slurs or comments by employees or program volunteers. Nor will Communities In Schools of Renton condone discriminatory actions by employees or volunteers which prove to impact program participation by eligible participants. Violations of this procedure will be cause for disciplinary action, which may include written warnings, suspension, and/or termination. Any program participant who feels he/she has been the victim of a discriminatory comment in violation of the above policy should bring this concern to the Executive Director of Communities In Schools of Renton or the Chairperson of the Board. Communities In Schools of Renton Operations Manual Application Cover Pages (Agency Information and Questions 1 — 7) Agency ency n ormatian Agency Name: Applicant Name and Address: Agency Director: Dynamic Family Services(Children's Therapy Center) Jon Botten,Executive Director 10811 SE Kent Kangley Road Name and Title Kent,WA 98030 (253)854-5660 (Area Code)Telephone jon@dynamicfamilies.org (253)854-7025 E-mail address(if available) (Area Code)Fax Number Required signatures: By signing below, you certify that the information in this application is accurate to the besstt of your knowledge and that you have read the application,certifications, and appendixes. (S� TURES M U§T BE IN BLUE I K) A\\CAVk (-/•/S • 0 �� Signature of Agency Board Pre ' ent/Date Sig ature of Agency Director/Date rita Schwarting Jon Botten Printed Name of Agency Board President Printed Name of Agency Director Program Information- ( ation. 1. Program Name C �cd.Cec1 (A)ti+ $ee c Q.eect5 Contact Person (available to answer specific questions on this application) Jon Botten (253)854-5660 Name (Area Code)T lep ® Same Address(if different than above) APR 02008 jon@dynamicfamilies.org 253 854-7025 °� ����®� E-mail address(if available) (Area Code)Fait Nuiriber N Cs6 v°_ 2. Program is New for our agency ❑An Ongoing Program El 3. Brief Description of Program (One sentence) Through quality pediatric therapy and support services,we help children with special needs gain skills that will help them today while decreasing their need for future services. 4. Where are services provided? (If different from agency location) Services are provided at our main location in Kent,our satellite locations in Des Moines and Auburn, and throughout the South King County community. Page 1 5. Total Program Cost: Actual 2007: $ 3,834,662 Proposed 2009: $4,759,545 �- Projected 2008: $4,345,758 6. ;Total City Funds Requested for this Program: City Awarded 2008 Requested 2009* General Fund CDBG Total Requested** Auburn $ 10,000 $0 $ 14,500 Federal Way $0 $0 $ 11,500 Kent $35,000 $0 $ 60,000 Renton $ 10,000 $0 $21,000 City Awarded 2008 Requested 2009* General Fund General Fund Burien $0 $ 8,000 Covington $7,500 $ 10,500 Des Moines $ 1,000 $ 8,500 Enumclaw $ 0 closed SeaTac $0 $9,000 Tukwila $5,000 $ 5,750 *Cities on a two year funding cycle will renew 2009 awards to 2010 based upon performance and availability of funds. See Part II for city specific information. **Include your total request for Auburn,Federal Way Kent and Renton. The source of funding will be determined by staff. Page 2 7. Agency Contact Sheet Provide the following information for the agency and for the program requesting funds. Agency Contacts General Agency Name: Dynamic Family Services(Children's Therapy Center) Address: 10811 SE Kent Kangley Road City/State/Zip: Kent,WA 98030 Phone/Fax: (253) 854-5660 Agency Web Address: www.dynamicfamilies.org Executive Director Name: Jon Botten Title: Executive Director Direct Phone: (253)854-5660 E-Mail: ion(a,dynamicfamilies.org Development Director Name: Jennifer O'Neal (or Grant Writer) Title: Communications Manager Direct Phone: (253)854-5660 x 103 E-Mail: jennifero(adynamicfamilies.org Finance/Accountant Name: Janet Meister (person preparing invoices) Title: Finance Director Direct Phone: (253)854-5660 x 309 E-Mail: janet@dynamicfamilies.org Program Contact (Staff contact for contracting, reporting and program implementation) Program Name: Children with Special Needs Staff Name: Barb Despain-Odlaug Title: Program Director Direct Phone: (253)854-5660 x 113 E-Mail: barb@ctckids.org Page 3 Application Narrative Section (Questions 8 — 12) 8. ORGANIZATIONAL EXPERIENCE A. Experience: Organizational, Program and Service Descriptions: Dynamic Family Services (Dynamic) is the umbrella agency for a nonprofit consortium that provides pediatric therapy services, early intervention, parent training, special education, custom orthotics, and compression garments for children with special needs and their families. This consortium is currently comprised of: • Children's Therapy Center(CTC): Our longest running and most well known program, CTC was founded in 1979. CTC provides medical-model, center-based physical, occupational, oral motor/feeding, and speech language therapy for children ages birth to 18. • South King Early Intervention Program(SKIP): SKIP provides Early Intervention(EI) services for families with children ages birth to three who demonstrate at least a 25% delay in one or more developmental areas, or have a medically diagnosed disability. Services are delivered in a child's natural environment- defined as a place in which children typically live, learn and play such as their home, daycare, parks or other community settings. • Dynamic Orthotic Systems (DOS): DOS provides a wide range of very flexible orthotic bracing systems for feet, ankles, arms, legs, and trunk. • SPIOTM (Stabilizing Pressure Input Orthosis): SPIO manufactures dynamic compression orthotic systems made of patented,breathable, Lycra blend material with a multi-directional stretch and high rebound factor designed to assist stability, and provide sensory feedback through deep pressure and tactile stimulation. The organizational benefits of this new structure are further discussed in the"Significant Changes" - section of the Program Description. Qualifications, Experience, and Accomplishments: The Dynamic consortium is known as a leader in pediatric therapy,not just in King County,but throughout the country and internationally. Our well- earned reputation began with the founding therapists and has been cultivated over the past three decades by hiring therapy and support staff dedicated to our mission of helping children with special needs reach their full potential. Additionally,we offer the following experience and accomplishments: • Dynamic is recognized by the State of Washington as one of only 14 Neurodevelopmental Centers in the state. • All therapists and teachers have postgraduate degrees and certification in their areas of expertise. • Multiple staff members have doctorate degrees. • Many of our staff members are considered experts in their field and are highly sought after speakers who travel the world teaching our Dynamic philosophies. • Most staff members have completed advanced specialized training. Additionally, our center conducts training seminars for therapists outside our organization. • Five of the founding therapists are still on staff each with 30+years of experience. • Dr. Stephen Glass, one of the northwest's premiere pediatric neurologists, directs the medical program at Dynamic. Major accomplishments by our organization include: • 15%+ growth in each of the last 7 years—25% growth in the last year alone! • Successfully completed 2.1 million dollar capital campaign in 2005 • Built a new 10,000 square-foot facility Page 4 • Reorganized to become part of a consortium of organizations (Dynamic Family Services) which is collaborating to more efficiently and effectively meet the needs of children and families • Opened a satellite facility in Highline to serve the communities of Burien, West Seattle, SeaTac, Des Moines, and Tukwila • Expanded hippo therapy program to a second location at Camp Berachah in Auburn • Implemented a new Fitness Center program for teens with developmental delays and disabilities • Started a new for-profit business manufacturing and distributing SPIO compression systems with any profits generated helping to fund the missions of the nonprofits participating in the consortium • Remodeled the Orthotics "house"to increase capacity • Restructured our preschool program to include more typically developing children who are serving as "peer models" for the children who are referred with special needs Although we have a long history of success, our organization's greatest accomplishments are the thousands of South King County children who are closer to reaching their full potential as a result of our services and interventions. B. Operational Structure: Board of Directors: Dynamic Family Services is governed by an eleven member,volunteer Board of Directors. Through policy and practice,the purpose of the board is clear- To ensure the Agency meets its fiduciary responsibilities and accomplishes its mission. By adhering to a highly regarded governance model called Policy Governance, the Board is able to facilitate progress without micromanaging the professional, highly capable staff. This model requires that the board connect to the community to determine Dynamic's mission, clients, and budget priorities. There is an agenda item at every board meeting called"Community Linkage". This time is devoted to presentations from individuals who are invited to educate the board and staff on trends affecting the Agency, community, and region. The information garnered during these discussions is invaluable as the Board and staff develop their strategic plans for the future. Currently the full board meets 6 times a year. Board Committees meet in timely response to issues as they present themselves. Board membership is purposefully diverse to represent the communities served. The board consists of diverse genders, sexual orientation,professions, ages, geographic locations,physical abilities, and socio-economic standing. All directors live and work in the region served. Operational Structure: Our organizational chart reveals that Dynamic has a very flat organizational structure with very little administration. The Board has appointed an Executive Director who has a diverse background in business and nonprofit management, marketing,multimedia, and education to ensure the board established mission is realized and resources are maximized. Just as the staff empowers parents to meet the needs of their children, the Executive Director empowers the staff to meet the needs of our organization. By decentralizing decision-making practices, and unleashing employee creativity, responsibility, and productivity, the staff members who work the closest to the clients are able to have the loudest voice in the decisions that impact our organization and services. Page 5 9. NEED FOR YOUR PROGRAM A. Problem Statement: In an ideal world, every child is born healthy, with the ability to learn how to walk, talk, eat, laugh and play. Unfortunately, statistics reveal that approximately 2%to 3% of new • babies are born with developmental delays and disabilities. These children need early intervention services to accomplish many of the simple daily tasks that most of us take for granted. In South King County, children with special needs find the services and support they need at the programs administered through Dynamic. Recent news stories have illuminated both the rising rates of developmental disabilities and the efficacy of early intervention services. Public awareness,medical advances, and the increased sensitivity of screening tools have led to earlier diagnosis and detection of developmental disabilities and delays. Consequently, there is a great urgency for programs that deliver quality, evidence-based therapy and related support services. In a recent publication, the United States Center for Disease Control (CDC) affirmed this by stating that"children identified with developmental or behavioral disabilities earlier have a better chance of reaching their full potential" (Dr Jose Cordero, CDC Press Release, 2007). United Way of King County conducted a Health and Human Services Community Assessment that identified several major areas of concern specific to this region, which result in increased referrals to the Dynamic consortium: • South King County is the most populated and fastest growing region in King County. • South King County has the largest percentage of children and largest percentage of children with developmental disabilities. •: The fact that a significant number of women don't receive adequate prenatal care, combined with a very large percentage of teenage mothers,results in a high number of pre-term, low-weight and special needs babies. • As pointed out in the resource A Matter of Need, "South County has 36.2 percent of the total persons of color in King County. It contains the largest number of single parent homes and the largest number of families living in poverty." The same publication illustrates that 41.4% of King County children live in the south. These statistics paint a portrait of South King County families who possess multiple risk factors and need more services from agencies than their counterparts in other areas of the county. The South King County Subregional Business Plan illustrates that"because the cost of living is lower in South King County than other parts of the county, there is a higher percentage of renters, an influx of immigrants, and other populations with high needs." Additionally, the City of Kent Housing&Human Services Master Plan 2007 -2010 reports that"18% of the South King County population is uninsured." For Dynamic,this fact results in more referrals of children who are in need of therapy and more families who are in need of scholarships, interpretation and translation services, and parent training. All of these support services are very time consuming to access and costly to provide. In spring 2007, Puget Sound Therapy Services (PSTS), a for-profit therapy service provider closed three local clinics. These closures left over 600 families displaced and frantically searching for replacement therapy services. Half of these families were residents of South King County. As the largest provider of therapy services in South King County, most of these families have turned to us for assistance. The National Center on Child Abuse and Neglect (NCCAN)research found that children with disabilities are maltreated at 1.7 times the rate of other children. Some factors leading to abuse among children with i disabilities are the same as those found in the general population, i.e., single parents, teen parents, and • various levels of stress. However, families with children with disabilities can experience additional stressors including: (1) feeling unprepared to handle the care of a disabled child, including acceptance of Page 6 that child as being "different," (2)having financial or time limits stretched as additional medical/educational activities are suggested, and (3)lacking necessary social supports or networks to work through the many concerns and situations that arise in providing care for this child and the rest of the family(Prevent Child Abuse America Fact Sheet). When you have a child with special needs you often feel desperate for information and community resources to help your child and,more importantly, to help you help your child. As one mother said recently, "I felt like a boat adrift at sea until you became the life raft for our entire family." B. Target Population: Our target population is children who possess a wide variety of disabling conditions including cerebral palsy, spina bifida, Down syndrome, cancer, muscular dystrophy,blindness, deafness, autism, strokes, traumatic brain injury, and developmental delays, some of which are caused by environmental influences such as maternal alcohol or drug abuse. Serving primarily as a"birth to three" provider for many years, community demand motivated our organization to expand our capacity a few years ago to include children up to age 18. Experience and research have revealed that one of the best ways to meet the needs of children is through empowering, training, and supporting their parents and caregivers. Therefore, we also consider parents and caregivers an important target population. Demographic Information: Through our four primary programs,we were able to serve 1,461 children during the 2007 calendar year. Sixty-nine percent of families were eligible for Medicaid based on their level of income. Twenty-two percent were Hispanic/Latino, forty-eight percent were families of color, twenty percent were non-English speaking, and twenty-two percent were from single parent households. The age of a child at the time of referral is as follows: Age at referral: 25% 0-12 months 15% 13-24 months 25% 25-36 months 12% 37-48 months 23% over 48 months A detailed itemization of demographics by city is available in data table for question 15. 10. PROPOSED PROGRAM/SERVICE A. Program Description 1) Types of Services: Dynamic Family Services provides the critical components of a comprehensive pediatric therapy program: • Medically prescribed services including comprehensive developmental assessments and evaluations;physical, occupational, and speech therapy; and specialty services such as feeding groups,hippo therapy and aquatic therapy. • Early intervention services delivered in a child's natural environment. • Inclusive playgroups and special education • Custom designed products including wheel chairs, walkers, orthotics, SPIO suits, splints, foam inserts, communication devices and other forms of adaptive equipment which offer freedom and capabilities not otherwise possible to these children. • Training, support and encouragement for parents and other caregivers. Dynamic empowers parents and caregivers by giving them the tools and techniques they need to continue to work on the child's development in between visits. Page 7 In addition to these areas of specialty, we also provide: • Interpreters for all families who speak English as a second language. • Referrals and transition to other community service agencies and schools. • Workshops,books, and videos on early intervention techniques and practices. 2)Methods to Serve Target Populations: Through child-initiated instruction, integrated interventions, and play-based therapy activities,physical, occupational, and speech language therapists improve social, emotional, communication, self-help, and motor skills; adapt environments; prevent regression; and ultimately help children achieve their highest degree of functioning. Locations: Therapy services occur in a number of locations throughout South King County including the family home; a preschool or daycare; a neighborhood school; a fitness center; a swimming pool; at a hippo therapy location; or one of our therapy centers. We will even accompany families to community settings such as grocery stores or restaurants to help solve issues. Most children receive their services in a combination of locations. 3) Outreach: Ultimately, it is our outstanding reputation in the community that makes outreach efforts so successful. Our organization works closely with physicians, Public Health Nurses, local school,districts, hospitals, and other nonprofit organizations in outreach efforts. Kids in the early education program are referred to playgroups from other agencies or the Kid Care referral service, and then qualified through the King County Division of Developmental Disabilities. "At risk" and"typically developing" children can sign up for early education and inclusive play groups through the Kent, Des Moines, and Burien Parks and Recreation Departments. The collaboration we have with the Parks Departments has also proven to be a very effective outreach vehicle to identify children who are in need of early intervention services. Dynamic also has numerous staff members who participate on a substantial number of advisory boards, make community presentations, and attend resource fairs. ' _ 4) How Program Relates to Need: Recognizing that 2%to 3% of all children born have special needs, and knowing that early intervention improves the function and long term capabilities of these children, Dynamic's program is uniquely qualified to continue to meet the needs of this vulnerable population,just as it has done for the past 29 years. "After 50 years of quantitative and qualitative research, there is clear evidence that early intervention increases the developmental and educational gains for the'child, improves the involvement of the family and reaps long-term benefits for society. Early intervention has been shown to result in the child needing fewer services later in life and being held back in school less often and in some cases,being indistinguishable from non-handicapped classmates years after intervention." (US Department of Education) Recently, organizations like United Way, Thrive by Five, SOAR, the Department of Early Learning, and the Bill &Melinda Gates Foundation have devoted a tremendous amount of effort to increasing the public's awareness of the efficacy of early intervention. With wider community recognition that early intervention programs reap long-term benefits for children, families, and society, Dynamic is getting an unprecedented number of referrals. In the absence of our services, some of the region's most vulnerable children would miss out on the services they need to reach their full potential. With these services, however, children achieve success not otherwise possible. The Infant Toddler Early Intervention Program(ITEIP), which is the lead agency for early intervention in Washington State,has reported that over 26% of the children who receive therapy and other early intervention services during their birth to three years do not need special education services by the time they are school age. This results in a substantial cost savings for schools, the medical Page 8 community, and families. A recent study from the University of Washington documented that for every dollar spent on early intervention, $8-$10 in savings were realized. 5)Language and Cultural Needs: Because parent training is so critical to the success of each child's therapy, it is imperative that language barriers be reduced. To address this, Dynamic Family Services employs the use of the use of a telephone translation service and provides translators and interpreters for therapy visits. In 2007, we spent$20,000 on translation/interpretation services and averaged over 100 calls per month using the telephone translation service. 6) Significant Changes: In support of outcome achievement,broader community impact, and capacity building, Dynamic recently become the"parent organization" for a consortium of agencies all working together to empower children, families, and community. By providing all administration, accounting, billing, development, intake, HR, and reception services for its programs, Dynamic is able to enhance the efficiency and capacity of participating agencies. One simple yet clear example of the benefits of this structure is the fact that Dynamic agencies are submitting one consolidated application to the cities of South King County instead of four. This saves time and resources for our organization, the cities, and human resource councils of South King County. 7) Collaborations: Dynamic will continue to collaborate with other organizations and agencies as described in the"Outreach" section above. The board and staff seek out mutually beneficial, strategic alliances with individuals and organizations that are committed to delivering the services and products the region needs through cost effective and efficient means. Clearly, organizations benefit, and more importantly communities benefit,when nonprofits eliminate bureaucracy and duplication of efforts. The Dynamic consortium is, in itself, a model of collaboration. Successful collaborations and outreach are also largely responsible for the fact that Dynamic has doubled caseloads, doubled the number of services being provided, doubled the size of the staff and doubled our organizational budget in the last five years. B. Performance Measures and Outcomes. Performance Measure: Our performance measure is the number of services that can be provided with the amount of funding requested from each city. Services may include physical, occupational,and speech language therapy, family resource coordination,parent training, custom orthotics, adaptive equipment, and early education services. Outcome: Children with special needs will gain skills to reach their highest potential. Indicators: After six consecutive months of service, at least 75% of the children will have made substantial progress in the developmental area(s) in which they show delay(ie Motor, Communication, Cognitive, Social/Emotional or Self Help). "Substantial progress"is determined by the child receiving either an Achieved or Emerged score on at least 50%of their individual goals as documented on their Individual Family Service Plan(IFSP). C. Staffing Plan & Evaluation: All pediatric therapy and early education services are provided by licensed physical therapists, occupational therapists, speech-language pathologists and/or certified teachers. All therapists have at least a Master's Degree, and all teachers have at least a Bachelor's Degree and hold a current certification in special education. Currently, Dynamic has 5.75 FTE Physical Therapists, 10.5 FTE Occupational Therapists, 11.5 FTE Speech/Language Pathologists, 1 FTE Teachers, 5 FTE Family Resource Coordinators, 1 FTE Program Assistants, .75 FTE Orthotists, 1.5 FTE Page 9 Development, 2.0 FTE SPIO staff, 4.25 FTE Support staff, .25 FTE Facilities, 4.0 FTE Billing, and 2 FTE Accounting/Bookkeeping staff. Activities Provided by Occupational, Physical, and Speech Language Therapists: • Evaluate infants and children in all five developmental measures. • Develop and implement Individual Family Service Plans (IFSP) as a member of an interdisciplinary team. • Design and provide group and individual therapy to develop skills. • Provide parent education as an integral part of the therapy program. • Devise and fabricate orthotics and assistive devices or adaptive equipment. Activities Provided by Teachers: • Provide educational experiences for infants and toddlers in integrated playgroups of 6-8 children. • Design and provide one on one"instruction." • Provide parent education and participation activities as an integral part of school experiences. • Provide caregiver support and training in the form of home, daycare, and/or community visits. Services Provided by Family Resource Coordinators: - - • Coordinate and perform evaluations and assessments at no charge to the family. • Facilitate the development and updates of the IFSP. • Complete and organize necessary paperwork. • Refer families to outside agencies for services not available through our programs. • . Coordinate the funding for therapy and early education services. • Facilitate transition plans to school districts. Evaluation: Our Board of Directors receives monitoring reports on the developmental progress of all children. Through these reports, and the Board's linkage activities with staff, clients, and community, board members receive ample evidence of the program's effectiveness. In fact, the board considers program monitoring to be their foremost obligation to the agency's fenders and stakeholders. Parents of kids who have been through the program also serve a very valuable role on the Board of Directors. On an annual basis, we conduct parent surveys which help drive and modify services. D. Differences in Service Delivery by City. Dynamic is not currently forecasting that there will be differences by city in the delivery of pediatric therapy services to children in South King County. As noted in the data table for question 14c,we are requesting approximately$258 per client from each city. This requested amount is only 8% of the total cost per client per year. 11. LONG RANGE PLAN Strengths: The fact that Dynamic has amazingly dedicated staff and volunteers, an outstanding reputation, and a solid infrastructure,built by 29 years of prudent management,has enabled us to grow and flourish even through difficult times. Additional strengths include: diversified funding which is largely based on earned income as opposed to government contracts and grants; good financial controls; valuable collaborations; visionary board and management; and a history of proven results with thousands of success stories. Opportunities and Goals: In order to continue to meet the needs of the community, Dynamic's goals for - the next three years include: 1. Increase child find and outreach efforts. Page 10 2. Increase our capacity to serve older children including expansion of our fitness center program. 3. Expand our aquatic therapy program now that a new collaboration with Wesley Homes has been established allowing us the use of their warm water pool. 4. Explore new satellite facilities in outlying areas and increase the number and percentage of home visits. 5. Increase the percentage of revenue we generate through the products and services we provide so we are less dependent on inconsistent government funding and fundraising. 6. Develop a state of the art training academy to help us draw more therapists. Threats: As with most nonprofits, there are issues that threaten to impact our ability to fulfill our mission. Issues currently being addressed by board and staff include decreasing caps by insurance carriers, increasing competition for grants and donations, national shortage of therapists and teachers, increasing demand for financial scholarships, transportation, and interpretation services, increased costs for home and community visits and lack of space to serve older kids. 12. BUDGET Funding: Dynamic funds pediatric therapy and parent training through a wide variety of sources. It has always been the goal of board and management to diversify funding as much as possible so we do not become overly reliant on one or two funding sources. Management also believes that strong agencies are able to raise over half of their revenue through fees for services so in times of economic downturns and government cutbacks clients do not suffer as much. For long term sustainability, in the future Dynamic expects to receive financial participation from local cities,King County, Washington State, Insurance, Medicaid, School Districts, United Way, fundraising, and private pay from clients who are financially able to contribute to the cost of their child's care. Budget Request Narrative: City funds will contribute to the cost of early intervention services for city residents, including: Physical therapy, occupational therapy, speech therapy, aquatic therapy,hippo therapy, special education, and inclusive playgroups. Specifically, funds will be applied towards the costs of therapist and teacher salaries, therapy equipment and supplies, interpreter and translator fees. Funds will be applied towards the cost of the program of the kids and families who need it most. It is the belief of the board and staff that Dynamic organizations deserve the support they receive not because we have needs,but because we meet the needs of many of the community's most vulnerable citizens- young children with developmental delays and disabilities. Changes to Budget: For 2009, we are forecasting higher salary,benefit, recruitment, interpreter, and mileage costs than in past years. Higher salary and corresponding benefit costs are expected in order to keep our compensation competitive in a tight therapy labor market. We are expecting the number of home-based therapy services to increase, which will also increase our mileage and travel expenses. Additionally, we are forecasting that our interpreter and translation costs will rise as we serve an increasing number of families who speak English as a second language. Cost per Service Unit(s): Cost Per Service Unit: $ 106.00 Explanation of Cost: The average cost for all services is $106, which does not include the thousands of trainings we offer parents. These rates were determined by taking the total program expenses for the last fiscal year and dividing it by the total number of child focused service provided during that same time frame. Page 11 On average it costs over$3,100 per child per year to offer a comprehensive early intervention program. In the last few years Dynamic has experienced a tremendous increase in the number of kids being referred for autism. Based on the research indicating that children with autism need more hours of service each week than children with other disabilities, the cost of the program for these kids can be well over$10,000. per year. Because the incidence rate of autism has risen to 1 in 150 children, we are expecting that our average cost per child will increase as well. Our staff and board feel that all children with special needs should have equal access.to the therapy services they need to reach their full potential. A child's access to services should not depend on which city they live in. Therefore, we have tried to develop a fair and logical request formula to calculate the amount of Human Services funds being requested from each city. The amount of funding requested from each city is approximately 8% of the cost of therapy services for the children of that city. For example, if Dynamic serves 39 kids from a particular city,we have used the following equations to calculate our request: $3,180 Annual cost of services x 39 Number of kids from the example city receiving services at Dynamic $124,020 Annual Dynamic cost to provide therapy services for that city's children To determine the request amount: $124,020 Annual Dynamic cost to provide therapy services for that city's children x 8% Percent of the amount requested from each city $9,921 Estimate of the amount of request(likely rounded to $10,000) To determine the annual number of services (performance measure#1): $10,000 (request amount)/$106 (average cost of services) 94 services ********LEVERAGE YOUR CONTRIBUTION TO IMPROVE OUTREACH EFFORTS******** Amazingly, Dynamic is able to get a dollar for dollar match of city funds through the Medicaid Match Program, which is administered locally by the Department of Health. Simply put, due to the nature and value of the services provided by Dynamic, Medicaid will "match" funds from cities dollar for dollar(less' a 9% administration fee). A$10,000 award to Dynamic Family Services from your City actually brings in nearly$20,000. The match money from Medicaid is designated to help Dynamic perform outreach efforts, inform clients of additional community services they are eligible for, and linkage and collaboration activities. Page 12 Agency: Dynamic Family Services Program: Children with Special Needs 13. NUMBER Of INDIVIDUALS/HOUSEHOLDS SERVED BY PROGRAM ® Individuals? or ❑ Households? (Check which applies and use for reporting all demographics.) Unduplicated *Unduplicated Number of all Clients Served by Clients Served All Funding Sources with Funds , Requested 2007 2009 2007 %of column 1 2008 2009 (Actual) clients served (Anticipated) (Projected) (City Requested by City Funding Only) Auburn _ . 51 . . . 3% _ 54 . 56 $ 14,500 Burien 28 2% 29 31 $ 8,000 Covington 37 3% 39 41 $ 10,500 Des Moines 30 2% 32 33 $ 8,500 Enumclaw 27 2% 28 30 $ 0 Federal Way 40 3% 42 44 $ 11,500 Kent 214 15% 225 236 $ 60,000 Renton 74 5% 78 82 $ 21,000 SeaTac 31 2% 33 34 $ 9,000 Seattle 126 9% 132 139 $ 0 Tukwila 20 1% 21 22 $5,750 Other 784 54% 823 864 - K .� Total 1,461 100% 1,534 1,611 *Unduplicated means count each client only once per calendar year per program. This number should match the number of clients by city indicated in the top row of Question 15. i Page 13 Agency: Dynamic Family Services 14. Performance Measures (Data Table) Program: Children with Special Needs ( 14a. Service with 2009 Requested Funds Proposed Performance Measures as defined below. A)#of Services* B) C) Auburn 137 Burien 75 Covington 99 Des Moines 80 Enumclaw - Federal Way 108 Kent 566 Renton 198 SeaTac 85 Seattle - Tukwila 52 14b., Performance Measures 2'009Proposed with funds requested City Funding Only. Title: Brief explanation: The number of services that can be provided with the amount of funding requested from each city, which may include physical, A) #of Services occupational, and speech language therapy, family resource coordination,parent training, custom orthotics, adaptive equipment, and early education services. B) C) * Service count is determined by taking amount of request and dividing it by the average cost of service. Page 14 Agency: Dynamic Family Services 14 Performance Measures (Data Table), Cont. Program: Children with Special Needs 14c. Average Cost of Service Unduplicated Clients Served with Funds Average Cost of Service Requested 2009 Requested 2009* per Client** (Same as last column of (Same as last column of Question 6) Question 13) Column 1 divided by Column 2 Auburn $14,500 56 $259 Burien $8,000 31 - $258 Covington $10,500 41 $256 Des Moines $8,500 33 $258 Enumclaw 0 30 $0 Federal Way $11,500 44 $261 Kent $60,000 236 $254 Renton $21,000 82 $256 SeaTac $9,000 34 $265 Seattle $0 139 $0 Tukwila $5,750 22 $261 *With the amount requested,each city would be paying for 8%of the service cost for each unduplicated client **Average amount contributed/subsidized by each city per client served. Total average annual cost per client is$3,180. Page 15 Complete Question 15 with 2007 Actual numbers reported in column 1 of Question 13. Agency: Dynamic Family Services 15. Demographics (from all funding sources) (Data Table) Program: Children with Special Need, • I Client Residence g -5n o 0 o . d U Q W w rz Cl) v) H E� Unduplicated. (check one) ®.Individuals N M N N M cl 0 Households ` Served,in 2007* Household Income Level - . . . . - , 30%of Median or Below 20 8 3 9 8 12 73 17 9 38 6 203 50%of Median or Below 4 6 4 6 5 8 49 21 6 25 4 135 80%of Median or Below 10 5 15 6 5 8 22 10 6 24 3 129 Above 80%of Median 4 - 9 13 9 8 12 27 16 • 10 39 4 210 Unknown * 13. . . -.-0... • 2 0 • 0 0 "43 10 • 0 0 3 0 TOTAL 51 28 37 30 27 40 214 74 31 126 20 677 Male 30 12 17 13 11 17 140 46 13 53 16 284 Female 21 16 20 17 16 23 74 28 18 73 4 393 TOTAL 51 28 37 30 27 40 214 74 31 126 20 677 0-4 years 45 22 32 23 21 31 166 61 24 97 19 521 5- 12 years 5 5 3 5 5 7 43 9 6 23 1 122 i 13- 17years 1 1 2 2 1 2 5 4 2 6 0 34 18-34 years 0 0 0 0 0 0 0 0 0 0 0 0 --- ... - 35-54years 0 0 0 0 0 0 0 0 0 0 0 0 55-74years 0 0 0 0 0 0 0 0 0 0 0 0 - • 75+years 0 0 0 0 0 0 0 0 0 0 0 0 Unknown 0 0 0 0 0 0 0 0 0 0 0 0 .TOTAL 51 28 37 30 27 40 214 74 31 126 20 677 Asian 0 3 5 3 3 4 15 10 3 14 6 74 Black/African American 3 3 1 4 3 5 29 5 4 15 2 81 Hispanic/Latino(a) 12 6 4 7 6 9 36 18 7 28 5 149 Native American/Alaskan 2 1 • 0 1 1 1 0 2 1 3 1 14 Pacific Islander 0 1 0 1 1 1 78 0 1 4 20 White/Caucasian 19 11 26 12 11 16 12 31 12 50 5 271 Other/Multi-Ethnic 15 3 1 3 3 4 44 8 3 13 1 68 TOTAL 51 28 37 30 27 40 214 74 31 126 20 677 Female Headed " 'Household. ' 10 4 0 4 4 6 30 12 4 18 3 95 Disabling Condition . 51 28 37 30 27 40 214 74 31 126 20 677 Limited English Speaking . . 12 6 4 6 5 8 43 23 6 25 7 135 *Check Individual or Household,which should be the same as checked in Question 13. Unduplicated means count each client only once per calendar year. This should match the number served by City in the Actual 2007 column of Question 13. The "total"column will be different from Question 13 since the"other"column is not included due to space limitations. Page 16 16. PROGRAM STAFF (DATA TABLE) 2007 2008 2009 (Actual) (Budgeted) (Projected) Total Number of Staff(FTEs) 49.5 52.00 54.5 Number of Volunteer(FTEs) 2.5 2.5 2.5 Actual Number of Volunteers 550 575 600 • Page 17 Agency: Dynamic Family Services 17. PROGRAM REVENUE BUDGET (DATA TABLE) Program: Children with Special Needs fie.. 2007 2008 2009 Revenue Source (Actual) (Budgeted) (Projected/ Requested) City Funding (General Fund & CDBG) • Auburn $ 10,000 $ 10,000 $ 14,500 • Burien $ 0 $ 0 $ 8,000 • Covington $ 7,500 $ 7,500 $ 10,500 • Des Moines . $ 1,000 $ 1,000 $ 8,500 • Enumclaw $ 0 $ 0 $ 0 • Federal Way $ 0 $ 0 $11,500 • Kent $ 35,000 $ 35,000 $60,000 • Renton $ 10,000 $ 10,000 $21,000 • SeaTac $ 0 $ 0 $9,000 • Seattle $ 0 $ 0 $ 0 • Tukwila $ 5,000 $ 5,000 $5,750 • Other(Specify) $ 0 $ 0 $ 0 ell • Other(Specify) $ 0 $ 0 $ 0 Other Government Funds ,i.'- --, •°i'',,p,o,,,,.:`',;t;,:-:. ''s-it • King County $ 747,578 $ 784,957 $ 824,205 • Washington State(CSHCN) $ 130,000 $ 130,000 $ 130,000 • Federal Government(Medicaid Match) $ 313,108 $ 315,000 $ 315,000 • School Districts $ 397,404 $ 417,274 $ 438,138 '?.i, f,,;:''' ,f, ',i;,'': '' '',;','•';'2' Private Sources -'.;' ' ' "" 7:,' ,,; "".-,':%!,::,y _ :,:-.. -;e, ,-,‘, ,: • , ,,,,,_ • United Way(grants &designated donors) $ 30,001 $ 30,001 $ 30,001 • Foundations and Corporations Capital Only Capital Only Capital Only • Contributions (e.g., Events, Mailings) $ 430,130 $ 451,637 $ 474,218 • Fee for Service(Insurance, Medicaid) $ 2,078,769 $ 2,182,707 $ 2,291,843 • Workshops $ 8,625 $ 8,625 $ 8,625 • Investment Income $ 142,575 $ 149,704 $ 157,189 • Net Assets Released from Restrictions $ 3,500 TOTAL PROGRAM BUDGET (.7. $ 4,350,190 $ 4,538,405 $ 4,817,969 7. Page 18 ii;:t 19. APPLICATION CHECKLIST Applications missing one or more of the following components or not following these directions may not be reviewed. Sign and submit the application checklist with your application. Contents (Your application should contain each of these items in this order.) i Application Cover Pages.The top three pages of your application must be a completed copy of the AAency Information and Questions 1-7. Applic;tion Narrative: G1 Question 8 Organizational Experience(2 page maximum) OA Question 9 Need for Your Program(2 page maximum) 2 Question 10 Proposed Program/Service(6 page maximum) ;ij Question 11 Long Range Plan(1 page maximum) Question 12 Budget(2 page maximum) Data T.bles ra Question 13 Number of Individuals/Households Served rii Question 14a-c Performance Measures and Average Cost of Service Question 15 Demographics (from all funding sources) Question 16 Program Staff -'Question 17 Program Revenue&Expense Budgets Question 18 Subcontracts 'Required documentation. Supply one copy of the following required documents with the signed original application. See Part II: City Specific Supplemental Information to determine whether additional copies of the application and required documentation need to be submitted. Question 19 Required Documentation, including: • Proof of non-profit status • Organizational Chart • Agency/Organization Mission Statement • Board resolution authorizing submittal of the application(may be submitted up to 60 days after application). • List of the current governing board and local board, if applicable, (include name,position/title, city residence, length of time on the Board, and expiration of terms. Note any vacancies.) ■ Board Meeting Minutes of last three board meetings of governing board and local board as applicable • Annual Budget • Financial Audit Cover Letter • Financial Audit Management Letter • Financial Statement • Verification of Non-Discrimination Policy • Program Intake Form ■ Sliding Fee Scale Application Check List. (Signed below.) �� � City Specific Supplemental Information.Required in Nam ,,, ,P r'�r(Gl�{/ Part II for applicable City only. Position:( n ,,,ea r'o c f2 ,'71.a,P Phone#:6 S7, &0 • (: ,..y,L7 .� C =C'� E-mail: Signature o erson Completing Checklist DO NOT SUBMIT ANY OTHER MATERIALS WITH THIS APPLICATION Make sure that you carefully check Part II of this application r to see what additional attachments each city requires. Page 21 City of Renton Supplemental Application Dynamic Family Services As a provider of pediatric therapy services, Dynamic Family Services is well aligned with several of the result priorities set forth by the City of Renton however, we are perfectly aligned with the"All children and youth are ready for educational success,work, and life"result. 1. Result Number One: All children and youth are ready for educational success, work, and life Strategy A: Through child-initiated instruction, integrated interventions, and play-based therapy activities,physical, occupational, and speech language therapists improve social, emotional, communication, self-help, and motor skills; adapt environments;prevent regression; and ultimately help children with special needs achieve their highest degree of functioning. "After nearly 50 years of research, early intervention has demonstrated results in children needing fewer special education and other services later in life, and, in some cases,being indistinguishable from non-disabled classmates" (Infant Toddler Early Intervention Program, 2006). Activities to Achieve Strategy A: • Developmental screenings, assessments, and evaluations • Physical, occupational, and speech language therapy provided by therapists with a Master's level education and accredited by the State of Washington. • Specialized therapy including hippo therapy (physical therapy on horseback) and aquatic therapy. • Playgroups that encompass typically developing peer models • Specialized early education services delivered by teachers certified in special education • Home-based early intervention services specifically designed to assist the family in understanding the child's special needs and enhancing the child's development • Provision of custom orthotics, compression garments, and assistive devices Strategy B: Through mentoring, training, education, family resource coordination, and collaboration, parents and caregivers will be empowered to recognize therapy opportunities as they occur in everyday life with the ultimate goal of preventing the need for future services. Activities to Achieve Strategy B: • Mentoring and training during therapy sessions • Parent training classes, educational workshops, and support networks • Family Resource Coordinators with an extensive referral network • Provision of interpretation and translation services • Books,videos, DVDs, and lending library As one parent said on our 2007 parent survey, "Our therapy sessions have given me techniques and insight into helping my entire family interact with our son in a positive and learning way daily." When parents and caregivers have the tools, training, and support they need to help their children reach their full potential, the community as a whole becomes stronger. The proven efficacy of early intervention,public awareness,medical advances, higher survival rates of premature babies, and increased sensitivity of screening tools have led to earlier diagnosis and detection of developmental disabilities and delays. Consequently, there is greater urgency for programs that deliver quality, evidence-based therapy and related support services like those offered by participants in the Dynamic consortium. 2. Outcome: Children with special needs will gain skills to reach their highest potential. In order to ensure that children with special needs reach their full potential,we empower not only the child but the child's family as well. By broadening our scope and integrating the family into our services, we help families build strong developmental foundations for their children. We do this by providing the critical components to a comprehensive pediatric therapy program: physical, occupational, and speech language therapy; prevention and early intervention services; and family support services. The provision of these services results in self-reliance for children, families, and communities. Prevention and Early Intervention Services: We have been providing early intervention services to families since 1979 when several pediatric therapists recognized the need in South King County. Our ultimate goal is to give children functional skills that will help them today while decreasing their need for future services. Washington State DSHS has stated that over 26% of children who receive early intervention in our state do not need special education by age three. A University of Washington study has reported $8-$10 are saved for every dollar invested in early intervention. Family Support Services: Studies prove that raising a child with special needs adds additional stressors: • Parents may be precluded from finding gainful employment due to lack of childcare for high needs children, separation anxiety, and mental/physical limitations. • Children with special needs often exhibit lower self-help skills and consequently require more assistance from parents then their typically developing peers. • Siblings of special needs children often feel jealous or neglected. • Friends and family members frequently withdraw,leaving parents of special needs children feeling isolated and without a foundation of support. Early intervention helps reduce the additional stresses and frustrations families of infants and toddlers with disabilities experience, enhancing both the child and the family. Supported families need less out of home placement. Statistics demonstrate less abuse and neglect occurs for children receiving early intervention services (Infant Toddler Early Intervention Program, 2006). At Dynamic, we mitigate these . stressors by providing families with the resources, training, tools, and techniques they need. Results - Self-Reliance: We enhance the self-reliance of three groups: 1) Children with special needs: By maximizing the development of children with developmental delays and disabilities,we improve their self-reliance by reducing or even eliminating their need for future services. We have countless stories of children who are able to walk, talk, and eat independently due to our services. 2)Parents: We improve the self-reliance of parents by empowering them to meet both their needs and their child's needs. Instead of becoming a crutch for parents to lean on, we support them in their efforts to help their children reach their full potential. Families emphasize this point: "When we left, I felt empowered to be a real advocate for my child." 3) Community: We work hard to train other service providers, childcare workers, school personnel and even local businesses, so they can best meet the needs of children with developmental delays and disabilities. As a result of these efforts, the whole community is becoming more accepting and welcoming of these special children. "We are all aware now that early intervention, appropriate to the child's delay, can make a significant difference in the child's ultimate development" (J. Cordero, S. Greenspan, et al. 2006). On behalf of the children and families we serve, we thank you for recognizing the community needs we address and for your consideration of our request. ` (.; Dep artment of the Treasury Iriterrnal Revenue Service p :, District :Director Employer Identification Number: • Date: MAR 1 4 1980 91-107$809 Accounting Period Ending: • July 31 Form 990 Required:. ® Yes 0 No a Childrens Therapy Center • Person.to Contact: • 13210 SE 240, Suite D • John Sutton Kent, WA 98031 Contact Telephone Number: (206) 442-5106 SEA:EO:$0-620 Dear Applicant: L Based on information supplied, and assuming your operations will be as stated • in your application for recognition of exemption, we have. determined you are exempt from Federal income tax' under section 501,(c) (3) of the Internal- Revenue Code. We have further determined that you are not a: private foundation within the meaning of section 509(a) of the Code, because you. are an organization described in section 509(a)(1) & 170(b)(1)(A)(iii). If your sources of support, .or your purposes, character, or method of operation. change, please let us know so we can consider the effect of the change on.your exempt status and foundation.status. Also; you should inform us of all changes in your name or address. . • Generally, you are not liable for social security. (FICA) taxes unless: you file • a waiver o.f exemption certificate as. provided in the Federal Insurance Contributions Act. If you have paid FICA taxes without filing the waiver, you should contact. us. You are not liable , for the tax'Imposed under the. Federal Unemployment Tax.Act. (FU.TA) . Since you are not a. pprivate foundation, you are. not subject to the excise taxes • under.Chapter 42 of the Code. However, you are not automatically exempt . from other Federal excise taxes. If you have any questions. about excise, . employment, scir other • . Federal taxes, please let. us know. ,. . Donors may deduct contributions to you as provided in section 170 of the• Code. • Bequests, legacies, devises, transfers, or gifts to you or for your use are deductible. for Federal estate and gift tax purposes if:they meet the.applicable • .. provisions of sections 2055;:'2106; and 2522 of the Cade• The box checked in the heading of this letter shows whether you must file • Form 990, Return of Organization Exempt from Income tax. If Yes is checked, you are required to file Form 990. only if your gross receipts each year are normally more than $10,000. If a return is required, it must be filed by .the. 15th day of of the fifth month. .after the end of your annual accounting period. The law imposes . . a penalty, of $1.0. a. day, up to a.:maximum of. $5,000, when a return is filed.;late., Unless there is,.reasonable. cause: for the delay: • . • P.O. Box 21224, Seattle, Washington. 9811 1 (over) . Letter 947(D0) (5-77) ....,, . tk---k_:Pki.1 • . • , ... .... . . • . . _ . • • • . . . •-• . ' . • . • . . . . . . • .... '.... ... . -'. '.Y.ollare-mot reqUired-to 'fiie:Pederalsincoma.ta .returne Unles.S.youare •subject • - - tiOthe: tax on unrelated business: income: under section. 511 of the 'Cbde. If you are • - subject to this tax, you must file an income tax return on Form 990-T. In this letter, we are not determining whether any of your present or proposed:. A9tivitias are unrelated trade or business as defined in section 513 of the Code. .. . i • - . • You need an employer identification number even if you have no employees. . . If an employer identification number was not entered on your application, a number will be assigned to you and you will be advised of it. Please use that number on all returns you file and. in all correspondence with the Internal Revenue Service. . Because this letter could help resolve any. questiOns about your exempt status and foundation status, you should keep it in your permanent records. ' . . . • If you have any questions, please contact the person whose name and telephone. number are shown in the heading of this letter. L• . • Sincerely yours, . • . . . . • . . . . A,L1.4.41.-- ,a, . . . . . • . . . Art .uro. A. Jacobs District Director . • . _ . . . . . • . . . .cc: Dale B. Sawyer. • . . . . . • . . • . • . . . . . . . . • . . • • . . . . . . . . . . . • • . i.. • ' . • . . _ _. _ . • _ . . . • • • . . . . . . . . . . . . • . . . . •. . _ • • . . _ . . • . . . . • . . . . . . . . . • . . • • ' . . . . . . . . . . . . . . . • . • . . . . . _ . . . . . , • . . . . . . . . . . . . • • . . , . . , • . . . . . . • .• . . . . . • • . . . . .. . . , . . . . . . . . • . . . _ • . . . . . . . • . . • • . . . . • . • . . . • • • • .. . _ . . . •.. . . . • . • . . . _ • . . . . . . ., --. . . . . , . . . . . . ' • . . . . . . . . . . . . • . . . • . . . • . . . . • •. . . " • . . .. . . . . . . . . . . . . • ' •. . . • • . • . • . • . . , ' . Letter 947(DO)(5-77) • . . . • ri b; �rf' STATE OF WASHiNGTON ARTICLES OF AMENDMENT R n SECRETARY OF STATE WASHINGTON F o $w NONPROFIT CORPORATION �' �•y (Per Cnaple(24,05 RCM a•i •Please PRINT or TYPE in black inky Q•co •Sign,date and return original AND ONE FILED FEE: $20 s •�+ ` GliETARY OF STATAN,DITBD(24•NOUR)SERVICE AVAILABLE-$20 PER ENTITY E "�' U N o CORPORATIONS DIVISION SAM REED INCLL DE FEE AND WRITE 6EXPEDITER IN BOLD LETTERS 0 § ,,►►' 801 CAPITOL WAY SOUTH•PO BOX 40234 ON OUTSIDE OF ENVELOPE v N►N OLYMPIA.WA 98504.0234 • July 3,2006 FOFRCEUSSCNLY BE SURE TO INCLUDE FILING FEE.Checks I ILED: ' t I ' should be made payable to"Secre•ary of State" STATE OF WASHINGTON IMPORTANTI Person to contact about this filing Daytime Phone Number(with area code) Janet Meister (253)854-5660 ext. 302 AMENDMENT TO ARTICLES OF INCORPORATION • NAME OF CORPORATION (As currently recorded with the Office of the Secretary of State) • Chitldren's Therapy Center of Kent UBt NUMBER CORPORATION NUMBER (If known) AMENDMENTS TO ARTICLES OF INCORPORATION WERE ADOPTED ON 600 337 984 2-292050-8 Date: 05-24-06 EFFECTIVE DATE --(Specified effective data may be up to 30 days AFTER receipt of the document by the Secretary of State) OF ARTICLES OF AMENDMENT rid Upon filing by the Secretary of State ADOPTION OF THE ARTICLES OF AMENDMENT (Reese check ONE of the following) The amendment was adopted by a meeting of members held on(specs y dale): 05-24-2006 .A quorum was present at the meeting and the amendment received at least two-thirds of the votes which members present or represented by proxy were entitled to cast 0 R ❑ The amendment was adopted by a consent in writing and signed by aH members entitled to vote. 0 F i v ❑ There are no members that have voting rights. The amendment received a majority vote of the directors at a board meeting held E on(specify date): t u • s E AMENDMENTS TO THE ARTICLES OF INCORPORATION ARE AS FOLLOWS N If necessary,attach additional amendments or information, L • ARTICLE I The name of the corporation is Dynamic Family Services • 0 R • SIGNATURE OF OFFICER F . r This document is herebyexecuted underc • penalties ofperfury,and Is,to the best of my knowledge,true and correct E qvrit.cayi ,I`' j) 9tir a/v" `MJ uJc Z�' ZIcSD�Signet J Printede Date 0 L • V 11 INFORMATION AND ASSISTANCE—360/763.7115(TOD—360/753-1486) om.00a i000) Internal Revenue Service Department of the Treasury P.O. Box 2508 Cincinnati, OH 45201 Date: September 26, 2006 Person to Contact: Sharon LeNard ID#31-07756 . DYNAMIC FAMILY SERVICES Toll Free Telephone Number: 10811 S E KENT-KANGLEY RD 877-829-5500 KENT WA 98030-7108 Employer Identification Number: 91-1078809 Dear Sir or Madam: This is in response to the amendment to your organization's Articles of Incorporation filed with the state on July 3, 2006. We have updated our records to reflect the name change as indicated above. Our records indicate that a determination letter was issued in February 1980 that recognized you as exempt from Federal income tax: Our records further indicate that you are currently exempt under section 501(c)(3) of the Internal Revenue Code. Our records also indicate you are not a private foundation within the meaning of section 509(a) of the Code because you are described in section 509(a)(1.) and 170(b)(1)(A)(iii). • Donors may deduct contributions to you as provided in section 170 of the Code. Bequests, legacies, devises, transfers, or gifts to you or for your 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. If you have any questions, please call us at the telephone number shown in the heading of this letter. Sincerely, • 14'. • Cind °nestcott Man Ter, Exempt Organizations Determinations DYNAMIC FAMIL'. ' F ORGANIZATIONS 1 Volunteer 1 1 of Directors rita Schwarting—President&Treasurer,Sue Hollinsworth—Vice President&Secretary Ryan VanQuill,Pam Mullens,Chad Homer,Mike Sharp,Karin Blakley,Jerry Bradley,Gerardo Gonzales,Steve Puryear,Randie Fockler I Jon Botten Executive Director -.. .''''.‘.°°'‘.° /... ..°° ""'.°..".°". .."... ...... I Dynamic Support Communications CTC SKIP Development Dynamic Orthotics SPIO Janet Meister Jennifer O'Neal Barb Despain-Odlaug Linda Thompson, Lois Maier Nancy Hylton Stabilizing Input Finance Director Communications Mgr Program Director, OT Program Director,PT Development Director Program Director,PT,LO Pressure Orthotics I I I I- I Wanda Rex CTC Staff CTC&SKIP Connie Leibow,PT,LO Darla Hunt Bookkeeper Sue Hudson,PT Shared Staff Marketing Manager Jeanene Laegreid,PT Gay Lloyd Pinder,SLP SKIP Staff Ruth Doane,COTA Betty Hicker,PT Jodi Van Vleet,SLP Colleen Toy,OT Angie Beaudreau Sheridan Remley,PT Meredith Shatto,SLP Christina Terbovic,SLP Kari Richardson Operations Manager Teresa English Brooke Bell,PT Becca Fenander,SLP DOS O erations Mana er Billing Manager Peggy Hobart,Teacher p g Julie Cross,SLP Tina James, SLP Cheryl Doherty,COTA Kerry Huckins,SLP Meghan Rearden,SLP Kathy Padgett,PA Teresa Braun Sarah Dempson,SLP Erin Kiggins, SLP Joli LaBissoniere,OT Melissa Mamiya,SLP Insurance Coord Cathy Muller,OT Laura Gronewald,PT Kim Schoon M'Liss Buckles,OT Karen Baker,PT Sandy Carlson Jennifer Jamieson,OT Sara Whipple,PT Family Resource AIR Specialist Nancy Hylton,PT,LO Kelli McMurtry,OT Manager Ruth Doane, COTA Erica Phelps,OT Susan Dirks Sharon Feucht,Nutrition Karen Smith,OT Family Resource Billing Specialist Elisa Shriver,OT Coordinators Vicki Kerr,COTA Elaine Ford Donna Smith Stacey Short Leslie Whitmarsh Beccy Scheuffele Laura Riddle,MSW Front Office Coord Intake Coordinator Kim Gatz Michelle Charles Receptionist Contract Coordinator Sign Interpreters Claudia Kienholz Karee Wardrop eleP g---- :PM MAIO D _S' __Sf Sp964 Dynamic Family Services Mission Statement: Enhancing the capacity of Dynamic Family organizations. Program Mission Statements: Children's Therapy Center(CTC): Maximizing the potential of children with special needs by providing individualized,family-centered therapy services. South King Early Intervention Program (SKIP): Empowering families within their community and children within their family. Dynamic Orthotic Systems (DOS): Enabling greater personal function and independence through highly flexible custom orthotic systems. SPIO (Stabilizing Pressure Input Orthosis): Enhancing the lives of individuals with special needs by manufacturing and distributing dynamic compression systems. 1'bC The DYNAMIC family of organizations Dynamic Family Services * CTC * SKIP * SPIO * DOS consortium of programs collaborating to empower children and families y C. family Services Re: Board Meeting Wednesday, May 28,2008 6:30—9:00 Location: Children's Therapy Center 10811 SE Kent Kangley Rd. Kent, WA 98030 Est.Time Allotment I. Introductions II. Review agenda and assign time allotments 2 minutes III. Approval of Minutes 2 minutes IV. Old Business and Updates > Development Report(Lois) > Program Report(s) (Barb) > Fiscal Report(Janet) > SPIO Report(Jon) > Capital Projects Update (Jon) > Rental Property Update ( V. New Business > Board Member Survey > Motion to apply for city funding VI. Policy Governance Reports > Ends &Executive Limitations (Staff) > Governance Process &Board Staff Linkage (Board) VII. Other VIII. Next Board Meeting Meeting—May 28, 2008 IX. Executive Session Adjournment DYNAMIC Family Services Board of Directors Listed in order of board seniority Name and Address Phone,Fax and email Experience&Term Profession Mullens,Pam 5623 57th NE 206-524-1743 Joined January 1993 Private Practice Seattle, WA 98105 206-524-2024(Fax) Current Term 2005-2008 Physical Therapist pmullens@u.washington.edu 5th term Horner, Chad PO Box 140 206-498-6482(H) Joined July 1998 Attorney Kent, WA 98035 253-852-2345 (W) Current Term 2005-2008 Curran Mendoza P.S. 253-859-8037 (F) Past President cvh@curranmendoza.com 3rd term Sharp,Mike 12824 SE 265th 253-630-8622 (W) Joined May 2000 Real Estate Broker Kent,WA 98031 253-630-4812 (H) Current Term 2003-2006 ReMax 253-631-4846 (F) 2nd Term sharpmt33@msn.com _ Schwarting,rita 13362 SE 232nd Pl. 253-639-3864(H) Joined January 2002 Business Owner Kent WA 98042 253-852-4116 (W) Current Term 2005-2008 A Splendid Affair 206-718-0693 (Cell) 2nd term 1splendid.day@comcast.net Vice President/Secretary VanQuill,Ryan 13210 SE 342"d 253-288-9535 (H) Joined September 2003 Sales Professional Auburn WA 98092 206-226-1535 (C) Current Term 2003-2006 rvop@aol.com 1st term President/Treasurer Hollinsworth, Sue 13210 SE 240th Street, 253-631-8286 (W) Joined February 2005 Dentist Ste.B3 253-630-3595 (H) Current Term 2005-2008 Kent, WA 98042 drsueh@comcast.net 1st term Blaldey,Karin 11811 NE First St., 425-455-4020 (W) Joined July 2006 Financial Advisor Suite 301 206-930-0551 (C) Board Term 2006-2009 Bellevue, WA 98005 kfblakely@wradvisors.com 1st term Bradley, Jerry 6648 Elizabeth Loop 253 931 5134(H) Joined November 2006 Ace Relocation SE,Auburn 98092 206 255 8761 (C) Current Term 2006-2009 jbradley@acerelocation.com 1st term Gonzalez, Gerardo E 4265 Linden Ave N 337-962-5888 (C) Joined November 2006 Boeing Engineer Unit C ggonza4@lsu.edu Current Term 2006-2009 Seattle,WA 98103 1st term Steve Puryear 19625 62nd Ave. South 253-437-4073 (W) Joined April 2007 Vice President Building C, Suite 101 206-819-7877(C) Current Term 2007-2010 Umpqua Bank Kent,WA 98032 stevepuryear@umpquabank.com 1st Term Randie Fodder 3113 N 33rd 253-752-2124(H) Joined Sept 2007 Physical Therapist Tacoma, WA 98407 253-381-2114(C) Current Term 2007-2010 fockler@comcast.net 1st Term Dates of most recent Board Meetings: , January 25, 2006, March 29, 2006, May 24, 2006, July 26, 2006, September 27, 2006, November 15, 2006, December 13, 2006, February 28, 2007, March 28, 2007,April 25, 2007, May 23, 2007, July 25, 2007, September 26, 2007, November 28, 2007, January 23, 2008,March 26, 2008 k. Meetings take place at 10811 SE Kent Kangley Rd.,Kent,WA 98030 from 6:30 to 8:30 Dynamic Family Services 10811 S.E.Kent-Kangley Road Kent,WA 98030 Board of Directors Meeting MINUTES Wednesday March 26,2008 PRESENT: BOARD MEMBERS rita Schwarting Pam Mullens Ryan VanQuill Jerry Bradley Sue Hollinsworth Steve Puryear Randie Fodder Mike Sharp Chad Homer Scott Kendall Gerardo Gonzalez ABSENT: Karin Blakley STAFF: Jon Botten Lois Maier Janet Meister Barb Despain-Odlaug Sandy Carlson Introductions: n/a II. Agenda Meeting started at 6:40pm. A quorum was present. III. Approval of the Minutes:A motion was made and carried to approve the minutes from the January 23rd 2008 meeting amended as follows: Old Business: Capital Projects Amended to read that there was follow up to be done with the city of Kent IV. Old Business: • Development Report: See attached report. Lois highlighted the Milgard match grant and provided details about the upcoming auction April 5th 2008 • Program Report: See attached. Barb recapped:New hires at both FRC and intake. NDT course to be hosted at CTC.Video presentation of IGallup therapy horse in use during therapy services • Fiscal Report: see handout. Recapped and reviewed. • SPIO Report: Staffing changes updated and sales increase discussion. SPiO is catching on! • Capital Projects Update:Tacoma progressing,framing,wiring,plumbing,,roof, HVAC all done, windows ordered,interior colors,flooring selected, etc. City of Tacoma is great to work with. Farm House project still stalled • Rental Property Update: Presentation by Mike S. Potential for development of a zoned office mixed use, 16,000 sq feet comprised of office and rental. Estimated income generation of 8000.00 per month, offset by development loan. 18 months to develop.Vacancy rates in Kent currently are 5%apartments and 15% commercial. Board members will contact engineering firms to see if we can get a pro bono land survey and initial design for pre-construction planning. DYNAMIC Family Services Board of Directors Meeting Wednesday, March 26,2008 V. New Business: • Board Member Survey: Began to Review and discuss.Board decided to have a Dynamic staff member compile a recap of the surveys to be discussed at next board meeting. VI. Policy Governance Report/Community Connectionsssss: Governance Process &Board Staff Linkage(Board) Ends and Executive Limitations Compliance reported on all policies. VII. Other: Scott Kendall is recusing himself from the board for personal reasons. Board expressed thanks for his service. VIII. Next Board Meeting: May 28,2008 at 6:00 IX. Executive Session: - N/A X. Adjournment: Meeting adjourned at 8:10pm Dynamic Family Services 10811 S.E. Kent-Kangley Road Kent,WA 98030 Board of Directors Meeting MINUTES Wednesday November 28,2007 PRESENT: BOARD MEMBERS Pam Mullens Ryan VanQuill rita Schwarting Jerry Bradley Sue Hollinsworth Scott Kendall Karin Blakley Mike Sharp Chad Homer Gerardo Gonzalez(via phone) ABSENT: Steve Puryear Randie Fockler STAFF: Jon Botten Janet Meister Barb Despain-Odlaug Gay Lloyd Pinder Linda Thompson Sandy Carlson Lois Maier GUESTS: Steve Ellison Martha Prestin Introductions: II. Agenda Meeting started at 6:30. A quorum was present. III. Auditor's Report: Financial Statements present fairly and no difficulties were experienced during the audit process. A motion was made and carried to approve the 07/01/2006—06/30/2007 audit as final. See attached. IV. Approval of the Minutes: A motion was made and carried to approve the minutes from the September 26th,2007 as written, and the October 17th 2007 (as corrected: an ad hoc committee is formed,was changed to an ad hoc committee be formed). V. New Business: • Liquid Asset Report—see handout.This document was requested at a prior board meeting. • Retained Earnings Report—see handout. • Investment Policy Discussion—see handout. Jon reminded the board that the investment policy is their policy as the Executive Limitations prohibit the Executive Director from investing in anything that risks principle. o Many board members suggested that we keep our investment policy simple so that we don't need to secure the ongoing services of a financial manager—most of whom charge DYNAMIC Family Services Board of Directors Meeting Wednesday,November 28,2007 .5% to 2% of the portfolio balance to make recommendations. Historically 80% of fund managers do not beat a standard S &P index so in the long run we'd likely be money ahead by investing in low cost,well diversified index funds. We don't plan to be active traders but wish to average better long term returns than we have historically. For discussion purposes, Scott proposed an allocation that includes 10% cash (cash/CD/money markets),50% Diversified Index Funds, and 40% Real Estate. o Some board members felt this was too heavy in real estate.A distinction was made between the real estate we purchase for program use and real estate we purchase for investment. Ryan pointed out that real estate purchased in the right area could generate revenue and appreciation in the short term and be available for program use in the future. o A motion was made and carried (6 yay's,3 nay's,and one abstention) to adopt an investment allocation for cash reserves as follows: 50% of reserve funds will be kept in cash,money markets and/or certificates of deposit and up to 50% of"reserve funds" will be invested into low cost,diversified index funds. o The investment committee of Scott, Ryan,Pam,Jerry, and Mike,with administrative support from Jon and Janet,will meet to discuss recommendations as to where the money appropriated for index funds should be invested—i.e.which funds in which amounts. The committee will also update the"draft"investment policy. o Jerry will get a couple proposals from investment brokers who have expressed a willingness to provide pro bono consultation. • Holiday Bonus Discussion—see handout. Motion made and carried to leave the decision of holiday bonuses to the Executive Director.The current Executive Limitation which states that wages and benefits shall not deviate materially from market will continue to serve as the guideline on holiday bonuses. VI. Old Business: • Year to Date Fiscal Report—see handout. • Development Report—see handout.Funders have been asking if all board members have financially contributed towards the Pierce County Capital Campaign.We do need 100% participation to demonstrate the board's commitment to this project. • Capital Projects Update &Question—see handout#8. Mike Sharp will make a presentation in January with regard to potential options for Rental house. • Board Recruitment—Funders have suggested we recruit at least one addition board member from Pierce County which again brings up the discussion of how big does the board need/want to be to appropriately govern the organization. VII. Policy Governance: Governance Process &Board Staff Linkage(Board) GP#6 Agenda Planning,see handout#10-compliance reported. Motion made and carried to maintain current agenda for the next consecutive year of operations. Ends &Executive Limitations EL#3—Financial Conditions—compliance reported. EL#4—Asset Protection—compliance reported. VIII. Other: IX. Next Board Meeting: January 23, 2008 X. Executive Session: Executive Director Evaluation XI. Adjournment: Meeting adjourned at 9:25pm Dynamic Family Services 10811 S.E. Kent-Kangley Road Kent,WA 98030 Board of Directors Meeting MINUTES Wednesday January 23,2008 PRESENT: BOARD MEMBERS Pam Mullens Ryan VanQuill rita Schwarting Jerry Bradley Sue Hollinsworth Steve Puryear Randie Fockler Mike Sharp Chad Homer Gerardo Gonzalez Scott Kendall Karin Blakley • ABSENT: STAFF: Jon Botten Janet Meister Barb Despain-Odlaug Linda Thompson Sandy Carlson F$ Gay Lloyd Pinder Introductions: II. Agenda Meeting started at 7:10. A quorum was present. III. Approval of the Minutes: A motion was made and carried to approve the minutes from the November 28,2007 as written. IV. New Business: V. Old Business: • Year to Date Fiscal Report—see handout. Recapped and reviewed. • Development Report—see handout. Recapped and reviewed. Auction will be different this year. It will be a family event as it's the 20th year anniversary of the 1st auction. Golf tournament will be in Tacoma this year. • Investment Policy Discussion—see handout, attached. Proposed policy was discussed. Also,2 investment options were offered for the board's consideration. Motion made and carried 8 to 4 (3 nay and 1 abstention) to adopt option#1 of the proposed investment portfolio.In keeping with your Policy Governance Policies,no money should be added or taken from this investment fund without prior board authorization. • Capital Projects Update—Passed out timeline and fundraising goals,see attached. Discussed board recruitment for Pierce County as funding could become an issue when we don't have many board members from Pierce County. DYNAMIC Family Services Board of Directors Meeting Wednesday,November 28,2007 • Farm House—no progress to report. Still trying to appease the city parking and building regulations. • Rental House development options report tabled to next board meeting VI. Policy Governance: Governance Process &Board Staff Linkage(Board) GP#7 Board Self Evaluation—handout passed out,please bring it back at the next board meeting or email to rita or Jon. BSL#1 Global Board Staff Linkage#10 -compliance reported. Board expressed interest in having A Step Ahead in Pierce County make a presentation to the board at a future board meeting. Ends &Executive Limitations -handouts passed out EL#1—Executive Constraint-compliance reported. EL#2—Treatment of Staff and Clients—compliance reported. VII. Other: VIII. Next Board Meeting: March 26th, 2008 IX. Executive Session: N/A X. Adjournment: Meeting adjourned at 8:25pm DYNAMIC FAMILY SERVICES July 2007-June 2008 Projected Budget REVENUES MEDICAID 1,219,234 ORTHOTICS MEDICAID 170,393 LESS MEDICAID ADJ.-W/O -671,589 MEDICAID MATCH 305,543 DDD 489,383 DDD-PART C 313,761 CSHCN 133,000 SCHOOL DISTRICTS 433,433 PLAYGROUPS-FEES 5,000 CITY OF CONTRACTS 47,224 UNITED WAY 30,084 INSURANCE 1,177,693 ORTHOTIC INSURANCE 287,361 LESS INS. W/O&ADJ. -196,432 LESS SCHOLARSHIP -175,000 LESS REFUNDS 10,000 DONATIONS 219,328 FUNDRAISING-GENERAL 300 FUNDRAISING-AUCTION 163,242 FUNDRAISING-FUN RUN 13,310 FUNDRAISING-MERCHANDISE 200 FUNDRAISING GUILD-GOLF 20,737 FUNDRAISING GUILD-WINE 40,000 WORKSHOP 3,000 INKIND DONATIONS 2,236 INVESTMENT INCOME 5,520 INTEREST&DIVIDEND INCOME 25,000 SPIO REVENUES 94,766 TOTAL REVENUES 4,166,726 COST OF SALES COST OF GOODS SOLD 24,102 INDIRECT MATERIALS 1,289 RAW MATERIAL PURCHASES 955 COST OF SALES-FREIGHT 1,374 INDIRECT LABOR COSTS 11,083 TOTAL COST OF SALES 38,802 GROSS PROFIT 4,127,924 Page 1 of 3 PROGRAM EXPENSES PAYROLL 2,500,000 EMPLOYEE BENEFITS-PROGRAM 210,000 CONSULTING 9,000 ACCOUNTING 16,000 TRAVEL/VAN 2,000 TRAVEL-STAFF 20,000 INTERPRETER EXPENSE 20,000 PRINTING 2,500 INSURANCE 18,000 DEPRECIATION 75,000 POSTAGE 10,000 POSTAGE-CASTING 3,500 RECRUITING-PROGRAM 7,500 BANK FEES 1,500 RENTAL 2,500 DUES/SUBSRPTN/MEMBERSHIPS 3,500 PROFESSIONAL FEES 3,000 REPAIRS AND MAINTENANCE 38,000 SEMINARS&EDUCATION 18,000 SUBCONTRACT EXPENS 10,000 SUPPLIES 75,000 HIPPO SUPPLIES 2,500 AQUATIC EXPENSE 1,000 CASTING 200,000 TAXES-BUSINESS 25,000 TELEPHONE 27,500 UTILITIES 17,500 UTILITIES-108TH STREET HOUSE 1,000 WORKSHOP EXPENSES 1,000 SPIO EXPENSES 168,093 TOTAL PROGRAM EXPENSES 3,488,593 FUNDRAISING PAYROLL-FUNDRAISING 64,500 EMPLOYEE BENEFITS-FUNDRAISING 6,850 ADVERTISING& PROMOTIONS 209 FUNDRAISING-GENERAL 4,554 AUTO EXPENSES/MILEAGE 773 FUNDRAISING-AUCTION 48,615 FUNDRAISING-FUN RUN 3,532 FUNDRAISING-GOLF TOURNAMENT 10,134 FUNDRAISING-WINE EVENT 32,000 FUNDRAISING-MAILERS 5,329 TOTAL FUNDRAISING EXPENSES 176,495 Page 2 of 3 ADMINISTRATIVE EXPENSES PAYROLL ADMINISTRATIVE 184,742 EMPLOYEE BENEFITS-ADMIN 24,713 ACCOUNTING EXPENSE 45,715 COMMUNITY OUTREACH/ADVERTISING 149 BANK FEES 1,101 DEPRECIATION EXPENSE 12,469 INSURANCE EXPENSE 2,785 LEGAL EXPENSE 11,149 OFFICE SUPPLIES 2,968 CONTRIBUTIONS 924 POSTAGE EXPENSE 930 RECRUTING EXPENSE 844 REPAIRS AND MAINTENANCE 8,813 RETREAT EXPENSE 1,200 SEMINARS AND EDUCATION -ADMIN 600 TAXES-BUSINESS 5,078 TELEPHONE EXPENSE 1,864 TRAVEUM EALS/LO DG I N G 1,197 UTILITIES 2,693 UTILITIES-108TH STREET HOUSE 57 TOTAL ADMINISTRATIVE EXPENSE 309,993 NET INCOME 152,843 Page 3 of 3 DYNAMIC FAMILY SERVICES . AND SUBSIDIARIES INDEPENDENT AUDITOR'S REPORT AND FINANCIAL STATEMENTS JUNE 30,2007 • • BRANTLEY JANSON YOST&ELLISON Certified Public Accountants A Professional Service Corporation 1617 South 325th Street Federal Way,Washington 98003-6009 DYNAMIC FAMILY SERVICES AND SUBSIDIARIES CONTENTS Independent Auditor's Report 1 Consolidated Statement of Financial Position 3 Consolidated Statement of Activities and Changes in Net Assets 4 Consolidated Statement of Functional Expenses 5 Consolidated Statement of Cash Flows 6 Notes to Financial Statements 7 Schedule of Expenditures of Federal Awards 15 Report on Internal Control Over Financial Reporting and on Compliance and Other Matters Based on an Audit of Financial Statements Performed in Accordance with Government Auditing Standards 16 Report on Compliance with Requirements Applicable to Each Major Program and on Internal Control Over Compliance in Accordance with OMB Circular A-133 18 Schedule of Findings and Questioned Costs 21 Consolidating Schedule of Statements of Financial Position 22 Consolidating Schedule of Statements of Activities 23 f'1' B.RANT LEY SO • • ..,E-L}4 tS, ' " "`"" INDEPENDENT AUDITOR'S REPORT • December 4,2007 To the Board of Directors of • Dynamic Family Services and Subsidiaries ,,Kent,Washington • We have audited the accompanying consolidated statement of financial position of Dynamic Family Services (a nonprofit organization) and Subsidiaries as of June 30,2007, and the related consolidated Iti statements of activities and changes in net assets,functional expenses, and cash flows for the year then • ended. These financial statements are the responsibility of the Organization's management. Our responsibility is to express an opinion on these consolidated financial statements based on our audit. We conducted our audit in accordance with auditing standards generally accepted in the United States of ,,America and the standards applicable to financial audits contained in Government Auditing Standards, issued by the Comptroller General of the United States. Those standards require that we plan and perform the audit to obtain reasonable assurance about whether the financial statements are free of material misstatement. An audit includes examining, on a test basis, evidence supporting the amounts and disclosures in the financial statements.An audit also includes assessing the accounting principles used and significant estimates made by management, as well as evaluating the overall financial statement presentation. We believe that our audit provides a reasonable basis for our opinion. In our opinion,the consolidated financial statements referred to above present fairly,in all material respects, the financial position of Dynamic Family Services and Subsidiaries as of June 30, 2007, and the changes in their net assets and their cash flows for the year then ended in conformity with accounting principles generally accepted in the United States of America. fi rr -1• • CERTIFIED PUBLIC ACCOUNTANTS AND BUSINESS ADVISORS ° 1617 South 325th Street°Federal Way,Washington 98003-6009 To the Board of Directors of Dynamic Family Services and Subsidiaries Page 2 In accordance with Government Auditing Standards, we have also issued our report dated December 4, 2007, on our consideration of Dynamic Family Services and Subsidiaries' internal control over financial reporting and on or tests of its compliance with certain provisions of laws, regulations, contracts, and grant agreements and other matters. The purpose of that report is to describe the scope of our testing of internal control over financial reporting and compliance and the results of that testing, and not to provide an opinion on the internal control over financial reporting or on compliance. That report is an integral part of an audit performed in accordance with Government Auditing Standards and should be considered in assessing the results of our audit. Our audit was performed for the purpose of forming_an opinion on.the basic financial statements taken as a whole. The accompanying schedule of expenditures of federal awards is presented for purposes of additional analysis as required by U.S. Office of Management and Budget Circular A-133, Audits of States, Local Governments, and Non Profit Organizations, and is not a required part of the basic financial statements. Such information has been subjected to the auditing procedures applied in the audit of the basic financial statements and, in our opinion, is fairly stated in all material respects, in relation to the basic financial statements taken as a whole. Our audit was conducted for the purpose of forming an opinion on the basic consolidated financial statements taken as a whole. The supplemental schedules provided on pages 22 and 23 are provided for purposes of additional analysis and are not required parts of the basic consolidated financial statements. Such information has been subjected to the auditing procedures applied in the audit of the basic consolidated financial statements and,in our opinion,is fairly stated in all material respects in relation to the basic consolidated financial statements taken as a whole. • -2- DYNAMIC FAMILY SERVICES AND SUBSIDIARIES CONSOLIDATED STATEMENT OF FINANCIAL POSITION JUNE 30,2007 ASSETS CURRENT ASSETS Cash and cash equivalents $ 1,411,016 Accounts receivable 579,757 Inventory 20,505 Prepaid expenses 17,060 Total current assets 2,028,338 FIXED ASSETS Land,building and equipment $ 4,798,032 Less accumulated depreciation (587,024) 4,211,008 OTHER ASSETS Deferred tax asset 15,000 Patents and trademark,net of amortization 37,857 52,857 TOTAL ASSETS $ 6,292,203 LIABILITIES AND NET ASSETS CURRENT LIABILITIES • Accounts payable $ 70,987 Accrued expenses 198,400 Current portion of long-team debt 8,000 Total current liabilities 277,387 LONG-TERM DEBT 1,000,000 NET ASSETS Unrestricted $ 4,992,816 Temporarily restricted 22,000 5,014,816 TOTAL LIABILITIES AND NET ASSETS $ 6,292,203 • i s The accompanying notes are an integral part of these financial'statements. -3- • DYNAMIC FAMILY SERVICES AND SUBSIDIARIES CONSOLIDATED STATEMENT OF ACTIVITIES AND CHANGES IN NET ASSETS YEAR ENDED JUNE 30,2007 UNRESTRICTED NET ASSETS Public support Fundraising $ 208,912 United Way 30,001 Donations and in-kind contributions _ 221,218 Total public support 460,131 Revenues Medicaid $ 765,259 Medicaid Match 313,108 Insurance and private payments 1,313,510 • - Department of Developmental Disabilities 946,078 School districts 397,404 Workshops 8,625 Investment income 72,496 SPiO Sales,net of cost of goods sold 70,079 3,886,559 Total public support and revenues • 4,346,690 Net assets released from restrictions 3,500 Total public support,revenues and other support 4,350,190 Expenses Program services 3,196,305 Fundraising 174,073 General and administrative 428,183 3,798,561 • Increase before income tax benefit 551,629 INCOME TAX BENEFIT • .15,000 • Increase in unrestricted net assets 566,629 TEMPORARILY RESTRICTED NET ASSETS Donations received with restrictions 22,000 Net assets released from restrictions 2,500) 18,500 INCREASE IN NET ASSETS 585,129 NET ASSETS,beginning of year 4,429,687 NET ASSETS,end of year $ 5,014,816 The accompanying notes are an integral part of these financial statements. -4- DYNAMIC FAMILY SERVICES AND SUBSIDIARIES CONSOLIDATED STATEMENT OF FUNCTIONAL EXPENSES YEAR ENDED JUNE 30,2007 Supporting Activities Total • Program General& Supporting Services Administrative Fundraising Activities Total Payroll $ 2,138,141 $ 216,797 $ 80,417 $ 297,214 $ 2,435,355 Payroll taxes 194,372 22,414 9,102 31,516 225,888 Bmployeebenefits 201,648 36,328 6,891 43,219 244,867 Accounting 32,915 25,988 25,988 58,903 Advertising 33,588 519 34,107 34,107 Automotive 97 835 932 932 Bank charges 5,134 2,553 2,553 7,687 Consulting 9,345 9,345 Dues and subscriptions 105 2,136* _ 2,612 4,748 4,853 Excise tax 22,758 5,656 5,656 28,414 Fundraising 72,810 72,810 72,810 In-kind materials and services 31,788 31,788 Insurance 13,033 2,589 2,589 15,622 Interpreter 19,450 19,450 Miscellaneous 6,038 6,038 6,038 Printing and postage 15,798 2,733 " 2,733 18,531 Professional fees 11,594 11,744 • 11,744 23,338 Recruiting 5,670 835 835 6,505 Rental expense 5,322 5,322 Repairs and maintenance 33,075 7,179 7,179 40,254 Research and development 3,416 3,416 3,416 j • Seminars and education 10,042 140 701 841 10,883 ( Subcontracting 9,375 1,930 1,930 11,305 Supplies 267,066 5,068 5,068 272,134 Telephone 29,786 3,817 3,817 33,603 Travel,meals and lodging 25,801 1,186 186 1,372 27,173 Utilities 15,020 2,776 2,776 17,796 Workshops 5,087 4,385 4,385 9,472. 3,102,325 399,393 174,073 573,466 3,675,791 • Depreciation,and amortization 93,980 28,790 • 28,790 122,770 Total expenses $ 3,196,305 $ 428,183 $ 174,073 $ 602,256 $ 3,798,561 • The accompanying notes are an integral part of these financial statements. _5- • DYNAMIC FAMILY SERVICES AND SUBSIDIARIES CONSOLIDATED STATEMENT OF CASH FLOWS YEAR ENDED DUNE 30,2007 CASH FLOWS FROM OPERATING ACTIVITIES Increase in net assets $ 585,129 Adjustments to reconcile increase in net assets • to net cash provided.by operating activities Depreciation $ 119,254 Amortization 3,517 Income tax benefit (15,000) 107,771 Changes in assets and liabilities: Accounts receivable (61,090) Grants and contracts receivable 3,500 Inventory (20,505) Prepaids 5,050 Accounts payable . - � 42,936 Accrued expenses 71,092 40,983 Changes in restricted net assets: Donations received with restrictions • 22,000 Net assets released from restrictions (3,500) , 18,500 Net cash provided by operating activities 752,383 CASH FLOWS FROM INVESTING ACTIVITIES Purchase of property and equipment (819,529) CASH FLOWS FROM FINANCING ACTIVITIES Payments on long-term debt (12,000) NET CHANGE IN CASH (79,146) CASH,beginning 1,490,162 CASH,ending $ 1,411,016 • • • • The accompanying notes are an integral part of these financial statements. -6- • f. DYNAMIC FAMILY SERVICES AND SUBSIDIARIES NOTES TO FINANCIAL STATEMENTS JUNE 30, 2007 NOTE 1 PURPOSE OF CENTER Dynamic Family Services (Dynamic) is a private nonprofit organization located in Kent, Washington. In 2007,Dynamic underwent a change in organizational structure. Prior to 2007, the Organization was structured as a single entity,known as Children's Therapy Center.Now the Organization is divided into four operating entities. Dynamic Family Services, a nonprofit organization,provides the management function for the three subsidiaries: Children's Therapy Center;South King Intervention Program, and SPiO. Children's Therapy Center(CTC), a nonprofit organization, continues to provide quality physical, occupational; speech and feeding therapies plus early education, orthotic foot braces, and critical support services for children ages birth to twenty-one with special needs. South King Intervention Program(SKIP), a nonprofit organization, provides Early Intervention services for families of children ages birth to three with a delay in their development or a diagnosed disability including Downs Syndrome, speech and language delays,motor delays, cerebral palsy, and autism speech disorders (ASD). SKIP provides services in the child's natural environment,which may include the home, daycare, and community settings. SPiO, a for-profit corporation, manufactures the SPiO (Stabilizing Pressure Input Orthosis)product. These orthotics provide deep pressure through compression to improve positional limb and body awareness, core muscle and joint stabilization, and to increase precision of muscle activation and movement in children exhibiting primary or secondary sensory deficit that impairs dynamic stability,postural activation, and movement control. SPiO sells its products in a variety of methods, including online. For over 25 years, the Organization's mission has been to maximize the potential of children with developmental delays and disabilities by providing individualized, family- centered intervention services. The ultimate goal is to give children functional skills that will help them today while decreasing their need for future services. The primary service area consists of King and Pierce Counties in the state of Washington. -7- DYNAMIC FAMILY SERVICES AND SUBSIDIARIES NOTES TO FINANCIAL STATEMENTS JUNE 30,2007 NOTE 2- • SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES Basis of Presentation The accompanying financial statements have been prepared on the accrual basis of accounting in accordance with generally accepted accounting principles. Net assets and revenues, expenses, gains, and losses are classified based on the existence of donor- imposed restrictions. Accordingly,net assets of Dynamic and changes therein are classified and reported as follows: Unrestricted net assets-Net assets that are not subject to donor-imposed stipulations. Temporarily restricted net assets-Net assets subject to donor-imposed stipulations that are met, either by actions of Dynamic and/or the passage of time.When a restriction expires,temporarily restricted net assets are reclassified to unrestricted net assets and reported in the statement of activities as net assets released from restrictions. Permanently restricted net assets-Net assets subject to donor-imposed stipulations that are maintained permanently by Dynamic. Generally,donors of these assets permit Dynamic to use all or part of the income earned on any related investments for general or specific purposes.No permanently restricted net assets were held during 2007, and accordingly, these financial statements do not reflect any activity related to this class of net assets. Principles of Consolidation The accompanying consolidated financial statements include the accounts of Dynamic and its subsidiaries (as noted above).All significant intercompany accounts and transactions have been eliminated in consolidation. Cash and Cash Equivalents For purposes of the statement of cash flows,Dynamic considers all highly liquid debt instruments purchased with a maturity of three months or less to be cash equivalents. Use of Estimates The preparation of financial statements in conformity with generally accepted accounting principles requires management to make estimates and assumptions that affect certain reported amounts and disclosures. Accordingly, actual results could differ from those estimates. -8- DYNAMIC FAMILY SERVICES AND SUBSIDIARIES NOTES TO FINANCIAL STATEMENTS JUNE 30,2007 . NOTE 2- SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES (Continued). Contributions Contributions, including unconditional promises to give, are recognized as revenue in the period received.All contributions are available for unrestricted use unless specifically restricted by the donor. Conditional promises to give are recognized.when the conditions on which they depend are substantially met. Contributions that are restricted by the donor are reported as increases in unrestricted net assets if the restrictions expire in the fiscal year in which the contributions are recognized. Unconditional promises to give due in the next year are recorded at their net realizable value.Unconditional promises to give due in subsequent years are reported at the present value of their net realizable value;using risk-free interest rates applicable to the years in which the promises are to be received. Accounts Receivable Accounts receivable consists of trade receivables due from patients, insurance companies, and granting agencies.Management reviews the collectibility of accounts receivable on a periodic basis and determines the appropriate amount of any allowance. Accounts past due more than 90 days totaled$127,368 at June 30,2007. Land,Building and Equipment Amounts recorded are based on cost or the approximate fair market value at the date of donation.Dynamic follows the practice of capitalizing all expenditures for property and equipment in excess of$1,000. Depreciation of building and equipment is computed using the straight-line method over the estimated useful lives of the assets,which are: Buildings 39 years Equipment 7 years Vehicle 5 years Reference library 5 years Advertising Advertising costs are expensed when the advertisement first appears. Advertising costs for 2007 was $34,107. -9- DYNAMIC FAMILY SERVICES AND SUBSIDIARIES NOTES.TO FINANCIAL STATEMENTS JUNE 30,2007 NOTE 2- SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES (Continued) Donated Materials and Services Donated materials or equipment,when received, are reflected as contributions in the accompanying statements at their estimated fair market values at date of receipt. Dynamic does not recognize support,revenue or expense from services contributed by volunteers, except professional services. Fair-Value of Financial Instruments - • The fair values of financial instruments approximate their carrying values at June 30, 2007. Functional Allocation of Expenses The cost of providing various programs and other activities has been summarized on a functional basis in the statement of functional expenses.Accordingly,certain costs have been allocated among the programs and supporting services benefited. Income Tax . Dynamic is exempt from federal income tax under Section 501(c)(3) of the Internal Revenue Code, and therefore,no provision for income tax is included.Dynamic has been classified as a publicly supported organization and not as a private foundation by the Internal Revenue Service. The Organization has applied for 501(c)(3) exemption for CTC and SKIP. Management expects to receive a determination letter in the near future. SPiO is taxed as a"C" Corporation. Income taxes are provided for the tax effects of transactions reported in the financial statements and consist of taxes currently due plus deferred taxes related to the differences between the basis of various assets and liabilities for financial and income tax reporting purposes.Deferred tax provisions/benefits are calculated for certain transactions and events because of differing treatments under generally accepted accounting principles'and the currently enacted tax laws. The results of these differences on a cumulative basis,known as temporary differences,result in the recognition and measurement of deferred tax assets and liabilities in the accompanying balance sheet. There was no related income tax expense for SPiO for the year ended June 30, 2007.A deferred tax benefit of$15,000 has been recorded based on SPiO's current year loss. -10- 'r. DYNAMIC FAMILY SERVICES AND SUBSIDIARIES NOTES TO FINANCIAL STATEMENTS JUNE 30, 2007 NOTE 3 - CONCENTRATION OF CREDIT RISK Dynamic maintains its cash balances at one financial institution. Balances are insured up to$100,000 by the Federal Deposit Insurance Corporation(FDIC).At June 30, 2007 Dynamic's uninsured balance totaled approximately$1,736,000. Dynamic does not anticipate any adverse effects as a result of these excess deposits. NOTE-4- ACCOUNTS RECEIVABLE Accounts receivable consist of the following at June 30,2007: Medicaid $ 227,811 Medicaid Match 148,490 Insurance and private payments 139,694 Department of Developmental Disabilities 75,451 School Districts 61,330 Washington State Depattmuent of Health 19,784 4 Cities 19,625 United Way 15,000 • Miscellaneous trade receivables 2,572 709,757 Less allowance for contractual adjustments (130,000) $ 579,757 NOTE 5- GRANTS AND CONTRIBUTIONS RECEIVABLE There were no grants and contributions receivable at June 30,2007. -11- DYNAMIC FAMILY SERVICES AND SUBSIDIARIES NOTES TO FINANCIAL STATEMENTS JUNE 30,2007 NOTE 6- FIXED ASSETS The major classes of fixed assets consist of the following at June 30,2007: Land $1,694,764 Buildings and improvements 2,554,501 Equipment 522,527 Vehicle 20,229 Reference library 6,011 4,798,032 Less accumulated depreciation (587,024) $4,211,008 Depreciation expense totaled$119,254 for the year ended June 30, 2007. The Organization received$239,000 during 2004 from a King County Block Grant as a source of funding in the purchase of the Kent facility. This grant included a stipulation that the Organization continue to provide the same services for 15 years. NOTE 7— PATENTS AND TRADEMARK In March 2006,Dynamic purchased three U.S. Patents and trademark for"The SPiO Works" a custom fitted, flexible compression and stabilizing orthotics for the neck, chest, torso, arms,hands, legs, feet; and flexible compression braces for limbs and joints. The_ intangible asset was purchased for$40,000, and will be amortized over a thirteen year period. In August 2006,Dynamic paid an additional$2,400 to perfect the trademark for the SPiO product. This additional intangible will be amortized over a thirteen year period. Accumulated amortization related to these assets was $3,517 at June 30, 2007. -12- DYNAMIC FAMILY SERVICES AND SUBSIDIARIES NOTES TO FINANCIAL STATEMENTS JUNE 30,2007 • NOTE 8- LONG TERM DEBT Long term debt consists of the following at June 30, 2007: Note payable to bank;bearing interest at 7.25%; due on demand,but if no demand is made requires interest only payments until 2010 when the note matures; secured by real property.The bank has waived the demand feature as long as the interest payments are timely made. $1,000,000 Note payable,non-interest bearing; requiring payments of$1,000 per month; maturing in 2008. 8,000 1,008,000 Less current portion (8,000) $1,000,000 NOTE 9- TEMPORARILY RESTRICTED NET ASSETS Temporarily restricted net assets consist of grants and contributions receivable for the following programs: NDT Scholarships $ 10,000 Fitness center 5,050 HIPPO program 3,000 Gross motor equipment for Pierce County 2,890 Sock Hop special event 700 Dynamic/CTC router 360 $ 22,000 -13- DYNAMIC FAMILY SERVICES AND SUBSIDIARIES NOTES TO FINANCIAL STATEMENTS JUNE 30,2007 NOTE 10- TAX DEFERRED ANNUITY PLAN Dynamic has a qualified tax deferred annuity plan covering all employees. Employees make contributions through salary reductions. Dynamic, at its discretion,may contribute a percentage of employees' elective deferrals for those employees who have completed one year of service and attainment of age twenty-one. Employer contributions to the plan totaled$36,886 for the year ended June 30,2007. NOTE 11 - NON-CASH TRANSACTIONS Dynamic entered into a long-term debt agreement in the amount of$1,000,000. • • -14- • DYNAMIC FAMILY SERVICES AND SUBSIDIARIES SCHEDULE OF EXPENDITURES OF FEDERAL AWARDS FOR THE YEAR ENDED JUNE 30,2007 Federal Federal Grantor/Pass-through CFDA Federal Grantor/Program Title Number Expenditures U.S.Department of Education King County Department of Developmental Disabilities Special Education—Grants for Infants and Families with Disabilities (IDEA Part C) 84.181 .. $325,017 U.S. Department of Health and Human Services Seattle-King County Department of Public Health Medical Assistance Program(Medicaid) 93.778 313,108 Total $638,125 -15- i B;RANTLEY . :. AI�T�S:O Ax • • REPORT ON INTERNAL CONTROL OVER FINANCIAL REPORTING AND ON COMPLIANCE AND OTHER MATTERS BASED ON AN AUDIT OF FINANCIAL STATEMENTS PERFORMED IN ACCORDANCE WITH GOVERNMENT AUDITING STANDARDS December 4, 2007 To the Board of Directors of Dynamic Family Services and Subsidiaries Kent, Washington We have audited the financial statements of Dynamic Family Services and Subsidiaries (a nonprofit organization) as of and for the year ended June 30, 2007, and have issued our report thereon dated December 4, 2007. We conducted our audit in accordance with auditing standards generally accepted in the United States of America and the standards applicable to financial audits contained in Government uditing Standards, issued by the Comptroller General of the United States. Internal Control over Financial Reporting n planning and performing our audit, we considered Dynamic Family Services and Subsidiaries' internal control over financial reporting as a basis for designing our auditing procedures for the.purpose .f expressing our opinion on the financial statements, but not for the purpose of expressing an opinion .n the effectiveness of the Dynamic Family Services and Subsidiaries' internal control over financial porting. Accordingly, we do not express an opinion on the effectiveness of the Organization's internal ontrol over financial reporting. control deficiency exists when the design or operation of a control does not allow management or -mployees, in the normal course of performing their assigned functions, to prevent or detect • isstatements on a timely basis.A significant deficiency is a control deficiency, or combination of -16- CERTIFIED PUBLIC ACCOUNTANTS AND BUSINESS ADVISORS 0 1617 South 325th Street e Federal Way,Washington 98003-6009 • To the Board of Directors of Dynamic Family Services and Subsidiaries Page 2 control deficiencies, that adversely affects the organization's ability to initiate, authorize, record, process, or report financial data reliably in accordance with generally accepted accounting principles, such that there is more than a remote likelihood that a misstatement of the organization's financial statements that is more than inconsequential will not be prevented or detected by the organization's internal control. A material weakness is a significant deficiency, or combination of significant deficiencies, that results in more than a remote likelihood that a material misstatement of the financial statements will not be prevented or detected by the organization's internal control. Our consideration of internal control over financial reporting was for the limited purpose described in the first paragraph of this section and would not necessarily identify all deficiencies in internal control that might be significant deficiencies or material weaknesses. We did not identify any deficiencies in internal control over financial reporting thatwe consider to be material weaknesses, as defined above. Compliance and Other Matters As part of obtaining reasonable assurance about whether Dynamic Family Services and Subsidiaries' financial statements are free of material misstatement, we performed tests of its compliance with certain provisions of laws, regulations, contracts, and grant agreements, noncompliance with which could have a direct and material effect on the determination of financial statement amounts. However, providing an opinion on compliance with those provisions was not an objective of our audit, and accordingly, we do not express such an opinion. The results of our tests disclosed no instances of noncompliance or other matters that are required to be reported under Government Auditing Standards. This report is intended solely for the information and use of management, the audit committee, Board of Directors, management, others within the organization, and federal awarding agencies and pass-through entities and is not intended to be and should not be used by anyone other than these specified parties. -17- , BRANTLEY ' ; t, _JSO YU •S E'r4S;- REPORT ON COMPLIANCE WITH REQUIREMENTS APPLICABLE TO EACH MAJOR PROGRAM AND ON INTERN-AL CONTROL } OVER COMPLIANCE IN ACCORDANCE WITH OMB CIRCULARA-133 • December 4,2007 • To the Board of Directors of Dynamic Family Services and Subsidiaries Kent,Washington • Compliance xi We have audited the compliance of Dynamic Family Services and Subsidiaries (a nonprofit organization) with the types of compliance requirements described in the U.S. Office of Management and Budget (OMB) Circular A-133 Compliance Supplement that are applicable to - each of its major federal programs for the year ended June 30, 2007. Dynamic Family Services and Subsidiaries' major federal programs are identified in the summary of auditor's results section of the accompanying schedule of findings and questioned costs. Compliance with the requirements of laws, regulations, contracts, and grants applicable to each of its major federal programs is the responsibility of Dynamic Family Services and Subsidiaries' management. Our responsibility is to express an opinion on Dynamic Family Services and Subsidiaries' compliance based on our audit. We conducted our audit of compliance in accordance with auditing standards generally accepted in the United States of America;the standards applicable to financial audits contained in Government Auditing Standards,issued by the Comptroller General of the United States; and OMB Circular A- 133,Audits of States, Local Governments, and Non-Profit Organizations. Those standards and -18- ' CERTIFIED PUBLIC ACCOUNTANTS AND BUSINESS ADVISORS 0 1617 South 325th Street 0 Federal Way,Washington 98003-6009 To the Board of Directors of Dynamic Family Services and Subsidiaries Paget OMB Circular A-133 require that we plan and perform the audit to obtain reasonable assurance about whether noncompliance with the types of compliance requirements referred to above that could have a direct and material effect on a major federal program occurred. An audit includes examining, on a test basis, evidence about Dynamic Family Services and Subsidiaries' compliance with those requirements and performing such other procedures as we considered necessary in the circumstances. We believe that our audit provides a reasonable basis for our opinion. Our audit does not provide a legal determination of Dynamic Family Services and Subsidiaries' compliance with those requirements. _ _ In,our opinion, Dynamic Family Services and Subsidiaries complied, in all material respects, with the requirements referred to above that are applicable to each of their major federal programs for the year ended June 30,2007. Internal Control Over Compliance The management of Dynamic Family Services and Subsidiaries is responsible for establishing and maintaining effective internal control over compliance with the requirements of laws, regulations, contracts, and grants applicable to federal programs. In planning and performing our audit, we considered Dynamic Family Services and Subsidiaries' internal control over compliance with the rrequirements that could have a direct and material effect on a major federal program in order to determine our auditing procedures for the purpose of expressing our opinion on compliance,but not for the purpose of expressing an opinion on the effectiveness of internal control over compliance. Accordingly, we do not express an opinion on the effectiveness of Dynamic Family Services and Subsidiaries' internal control over compliance. A control deficiency in an entity's internal control over compliance exists when the design or operation of a control does not allow management or employees, in the normal course of performing their assigned functions, to prevent or detect noncompliance with a type of compliance requirement of a federal program on a timely basis. A significant deficiency is a control deficiency, or combination of control deficiencies, that adversely affects the entity's ability to administer a federal program such that there is more than a remote likelihood that noncompliance with a type of compliance requirement of a federal program that is more than inconsequential will not be prevented or detected by the entity's internal control. A material weakness is a significant deficiency, or combination of significant deficiencies, that results in more than a remote likelihood that material noncompliance with a type of compliance requirement of a federal program will not be prevented or detected by the entity's internal control. Our consideration of internal control over compliance was for the limited purpose described in the first paragraph of this section and would not necessarily identify all deficiencies in internal control -19- • To the Board of Directors of Dynamic Family Services and Subsidiaries Page 3 that might be significant deficiencies or material weaknesses. We did not identify any deficiencies in internal control over compliance that we consider to be material weaknesses, as defined above. This report is intended solely for the information and use of management, the Board of Trustees, others within the entity, and federal awarding agencies and pass-through entities and is not intended to be and should not be used by anyone other than these specified parties. • -20- . q. • } DYNAMIC FAMILY SERVICES AND SUBSIDIARIES SCHEDULE OF FINDINGS AND QUESTIONED COSTS YEAR ENDED JUNE 30, 2007 SUMMARY OF AUDIT RESULTS Financial Statements Type of auditor's report issued: Unqualified Internal control over financial reporting: Material weakness identified? No Significant deficiency identified that is not considered to be material weakness? None reported Noncompliance material to financial statements noted? No Federal Awards Type of auditor's report issued on compliance for major programs Unqualified Internal control over major federal award programs: Material weakness identified? No Significant deficiency identified that is not considered to be material weakness? None reported • Any audit findings disclosed that are required to be reported in accordance with section 510(a) of Circular A-133? No • Programs Tested as Major Programs CFDA Number Name of Federal Program or Cluster 93.778 U.S.Department of Health and Human Services Seattle-King County Department of Public Health Medical Assistance Program(Medicaid) Auditee qualified as low-risk auditee? • No Program selected based on Section 520, OMB Circular A-133 risk-based approach. -21- { SUPPLEMENTAL INFORMATION • • DYNAMIC FAMILY SERVICES AND SUBSIDIARIES CONSOLIDATING SCHEDULE OF STATEMENTS OF FINANCIAL POSITION JUNE 30,2007 ' DYNAMIC CIIILDREN'S FAMILY THERAPY ELIMINATING SERVICES CENTER SKIP SPiO ENTRIES TOTAL ' ASSETS CURRENT ASSETS Cash and cash equivalents $ 1,388,304 $ 13,548 $ 5,016 $ 4,148 $ 1,411,016 Accounts receivable 577,185 2,572 579,757 Related party receivables 122,861 2,323 $ (125,184) • Inventory 20,505 20,505 Prepaid expenses 16,575 485 17,060 •- Total current assets - •2,104,925 -- 13,548 5,016 30,033 (125,184) 2,028,338 PROPERTY AND EQUIPMENT • Land 1,694,764 1,694,764 Buildings 2,554,501 . 2,554,501 Equipment,furniture and fixtures 522,527 522,527 Reference library 6,011 6,011 Vehicles 20,229 20,229 Less accumulated depreciation (587,024) (587,024) 4,211,008 4,211,008 OTHER ASSETS • Deferred tax asset 15,000 • 15,000 Patent and trademark,net 37,857 37,857 37,857 15,000 52,857 TOTAL ASSETS $ 6,353,790 $ 13,548 $ 5,016 $ 45,033 $ (125,184) $ 6,292,203 LIABILITIES AND NET ASSETS CURRENT LIABILITIES Accounts payable $ 39,756 $ 13,863 $ 14,234 $ 3,134 $ 70,987 Accrued expenses 71,637 61,786 58,186 6,791 198,400 Related party payables 2,323 122,861 $ (125,184) Current portion of long-term debt 8,000 8,000 Total current liabilities 121,716 75,649 72,420 132,786 (125,184) 277,387 LONG-TERM DEBT 1,000,000 1,000,000 • NET ASSETS Unrestricted 5,210,074 (62,101) (67,404) (87,753) 4,992,816 Temporarily restricted 22,000 22,000 5,232,074 (62,101) (67,404) (87,753) 5,014,816 TOTAL LIABILITIES AND NET ASSETS $ 6,353,790 $ 13,548 $ 5,016 $ 45,033 $ (125,184) $ 6,292,203 • • The accompanying notes are an integral part of this supplemental schedule. -22- • DYNAMIC FAMILY SERVICES AND SUBSIDIARIES CONSOLIDATING SCHEDULE OF STATEMENTS OF ACTIVITIES AND CHANGES IN NET ASSETS YEAR ENDED NNE 30,2007 DYNAMIC CHILDREN'S • FAMILY THERAPY ELIMINATING SERVICES CENTER SKIP SP1O ENTRIES TOTAL UNRESTRIC I hD NET ASSETS Public support • Fundraising $ 208,912 $ 208,912 United Way 30,001 • 30,001 Donations and in-kind contributions 219,303 $ 1,915 221,218 Total public support 458,216 1,915 466,131 Revenues Medicaid 765,259 765,259 Medicaid Match 313,108 313,108 Insurance and private payments 1,313,510 1,313,510 Department of Developmental Disabilities 946,078 946,078 Children with Special Health Care Needs School districts 397,404 397,404 • Workshops 8,625 8,625 Interest and rents-related parties 7,861 $ (7,861) Investment income 72,496 72,496 Support from related parties 885,235 $ 787,864 (1,673,099) SPIO sales,net of cost of goods sold $ 70,079 70,079 3,824,341 885,235 787,864. 70,079 (1,680,960) 3,886,559 Total public support and revenues 4,282,557 887,150 787,864 70,079 (1,680,960) 4,346,690 • Net assets released from restrictions 3,500 3,500 Total public support and revenues and net assets released from restrictions 4,286,057 887,150 787,864 '70,079 (1,680,960) 4,350,190 Expenses Program services 3,070,401 945,956 853,047 (1,673,099) 3,196,305 • Fundraising 174,058 15 174,073 General and administrative 257,711 3,280 2,221 172,832 (7,861) 428,183 3,502,170 949,251 855,268 172,832 (1,680,960) 3,798,561 Increase before income tax benefit 783,887 (62,101) (67,404) (102,753) 551,629 INCOME TAX BENEFIT 15,000 15,000 • Increase in unrestricted net assets 783,887 (62,101) (67,404) (87,753) 566,629 TEMPORARILY RESTRICTED NET ASSETS Donations received with restrictions 22,000 22,000 Net assets released from restrictions (3,500) (3,500) Increase in temporarily restricted net assets 18,500 18,500 INCREASE IN NET ASSETS 802,387 (62,101) (67,404) (87,753) 585,129 NET ASSETS,beginning of year 4,429,687 4,429,687 NET ASSETS,end of year $ 5,232,074 $ (62,101) $ (67,404) $ (87,753) $ $ 5,014,816 The accompanying notes are an integral part of this supplemental schedule. • • -23 • • - DYNAMIC FAMILY SERVICES 10811 Kent-Kangley Rd. Kent,WA 98031 NON-DISCRIMINATION PLAN A. Methods of Administration DYNAMIC FAMILY SERVICES will not, directly or through contractual or other arrangements, on the grounds of race, color, national origin, sex, age, religion, creed, marital status, disabled or Vietnam Era veteran status, sexual orientation, or the presence of any physical, mental, or sensory handicap: • Discriminate against any person in the recruitment, hiring, training, compensation, benefits,promotion, transfer, termination, lay off, reduction in force(RIF), or in any terms or conditions of employment; _ • Harass or make any comments, display, or distribute any materials that are derogatory; • Aid or perpetuate discrimination against a person by providing assistance to any agency, organization, or person that discriminates; • Deny a person any services, financial aid, or any other program benefits; • Provide access which does not afford equal participation or benefit to that afforded others; • Provide different or separate aid,benefit or services to a person or a class of persons unless such action is necessary to provide equally effective aid, benefit, or services. • Deny a person the opportunity to participate as a member of the planning or advisory boards; or as a volunteer, consultant, or conferee; • Utilize criteria or methods that have the effect of subjecting persons to discrimination; or have the effect of defeating or impairing accomplishments or objectives of this Policy and Plan; • Determine and select the site or location of facilities,programs, or activities that will have the effect of excluding or denying persons from benefits or subject persons to discrimination. Reasonable space, equipment, interpreters,printed material, or other appropriate communication will be made available as necessary in order to carry out this Policy and Plan. B. Recruitment and Employment Practices All recruiting employment,practices and activities will be conducted on a basis that does not discriminate because of race, color, national origin, sex, age, religion, creed, marital status, disabled or Vietnam Era veteran status, sexual orientation, or the presence of any physical, mental, or sensory handicap. This will be accomplished by, but not limited to: • Complying with the Center's Affirmative Action Plan; • Providing educational and training opportunities in a non-discriminatory manner; • Providing reasonable accommodations to handicapped persons; and • Providing a non-discriminatory work atmosphere, including the terms and conditions - of employment. C. Services In regards to the delivery of services, DYNAMIC FAMILY SERVICES do not discriminate on the basis of race, color, national origin, sex, age, religion, creed,marital status, disabled or Vietnam Era veteran status, sexual orientation, or the presence of any physical,mental, or sensory handicap. The staff, board and volunteers of DYNAMIC FAMILY SERVICES will not violate the civil, constitutional and/or other rights of clients. These rights include,but are not limited to: • Freedom from unnecessary medications, restraints and restrictions; • Legal protections from mental,physical and sexual abuse; • The right to associate with and communicate privately with persons of their choice; • Information concerning all rules and regulations governing conduct and responsibilities of themselves and others with whom they reside, or who provide services for them; • Information regarding services available and any related charges for these services; • The right to participate in the development of the plan for services and medical treatment, including the right to formulate Advance Directives, and to approve or reject any parts; • The right to participate in research only upon prior informed and written consent of the client and/or parent and guardian; • The right to register complaints and recommendations without interference or reprisal; • The right to participate in programs involving the use of restrictive or aversive procedures only with informed consent of the individual and/or parent or guardian; • Confidential treatment of all information contained in the individual records; • The right to participate in activities of social, religious and community groups. Any employee,board member or volunteer found to have violated a participant's fights shall be subject to immediate sanction including termination of employment. Beneficiaries,potential beneficiaries, and the general public shall be informed that all services, activities, financial aid, and other benefits are provided on a non-discriminatory manner. Referral sources, individuals that are limited-English-speaking and visually- and hearing-impaired persons will receive effective notice as well. This may be accomplished by,but not limited to: • Notice of Services Include the Organizations' Policy Statement of Non-discrimination in informational materials Display Non-discrimination Poster in prominent areas Provide information to beneficiaries and potential beneficiaries of the Non- discrimination Policy and Plan and how to file a complaint of discrimination • Delivery of Services Make adequate provisions to communicate with, and provide services to, clients and potential clients that are limited-English-speaking or have impaired vision or hearing by the appointment in service delivery positions of appropriate bilingual/bicultural staff and persons adequately trained and skilled to communicate with handicapped clients; and that pertinent materials are translated for those limited-English-speaking or made understandable for those vision or hearing-impaired individuals. Provide services in accessible locations or means of providing services if locations are inaccessible. �n-ktk.e 4 t # 1 RI:II•:ItIt \I. I\I ()K\1 \ I Il)\ \\I) L\ \I.1 .\ 1 IO\' P1..\\ ❑ CLICKTIME 1. _i CHILDREN'S THERAPY CENTER Inquiry Date: Referral Taken By: ❑ SKIP Child's Name LAST NEST MIDDLE New DOB: Age: Premature: Sex: Returning Parents/Guardian: Kent Location RELATIONSHIP TO CHILD 10811 SE Kent-Kangley Rd Household Members: Kent, WA 98030 Phone: 253.854.5660 Fax: 253.854.7025 Address: Highline Location Woodside Elementary APARTMENT COMPLEX NAME 18367 8th Ave.S. Home #: Cell #: Burien, WA 98148 Phone: 206.433.2579 Work #: Email: Auburn Location Phone call by: Phone #: @Children's Home Society Referring Source: Phone #: 4338 Auburn Ave.N Auburn,WA 98002 Pediatrician: Phone #: Other. Phone #: ;Hess Center Prescription: 26 108th Ave SE 'Kent,WA 98030 Diagnosis: Pierce County 9503 19th Ave.E. Reason for Referral/ Concerns: Tacoma,WA 98445 1(877) 854-5660 Scheduled on: DATE History of Therapy Services/ Previous Evaluations: Primary Language: Interpreter: Family Preference/Schedule Restrictions: ❑ NO ❑ YES Program needed: PT/OT Speech OM/Feeding Education Hippo Social Skills Aqua FC A 1,,;r;;tment Date: at with Date Day Time Kent Highline Fitness Center Home Visit Pierce County Other . Standardized Client Demographic Data Collection Form • for use 01 July 2007 through 30 June 200S . .-- .Agency Children's Therapy Center 0000010177 Outcome Children with developmental disabilities/delays achieve the 02409 highest possible degree of functioning. Client Instructions: Please neatly enter numbers or make an X in the appropriate boxes to answer the questions. Please note your name is not a part of this survey so that your identity is totally confidential. 1. Please fill in where you live: 6. Do you consider yourself to be disabled or have a handicap? City Name (if not in a city, write in "Unincorporated") ❑ No (1) ID Yes (2) and ZIP 0 Unknown (0) • A - 7. What is your age in years? O Homeless—formerly from ZIP and/or City ❑ ZIP Unknown 2. What is your gender? ❑ Age Unknown ❑ Female (1) 8. How many are in your household? ❑ Male (2) ❑ Transgender (3) ❑ Other 4 ( ) Total number of people in HH _r.; ❑ Unknown (0) 3. What is your race/ethnicity? Hispanics and Number of children under 18 Latinos/Latinas may be of any race. Choose all that you feel apply. ❑ Single parent (non-partnered) ❑ African (Black) or African American ❑ HH Size Unknown ❑ Asian (not Pacific Islander) ❑ Hawaiian Native or Pacific Islander 9. Using the chart on the back of this form, ID Hispanic or Latino/Latina . what is the gross yearly income category ❑ American Indian or Alaska Native for your household? El White or Caucasian- _ ❑. Other Race ❑ Race Unknown0 0 Category. gry B (1)2) 4. Are you non-English speaking or of limited .❑ Category C 3) English ability? 0 Category D (4) ❑ Unknown (0) ❑ No (1) 0 Yes (2) Thank you for your cooperation. These answers ❑ Unknown (0) will be kept completely confidential at all times 5. Are you an immigrant, refugee, or new arrival to this country? ❑ No (1 ❑ Yes (2) United Way -::) 0 Unknown (0) t , TM United Way of King County Please continue to the next column. Children's Therapy Center Sliding Fee Scale ** *** 100% 200% 225% 250% 275% 300% 325% 350% 375% 400% 425% 450% 475% 500% #of people in household 2 12,120 24,240 27,270 30,300 33,330 36,360 39,390 42,420 45,450 48,480 51,510 54,540 57,570 60,600 3 15,260 30,520 34,335 38,150 41,965 45,780 49,595 53,410 57,225 61,040 64,855 68,670 72,485 76,300 4 18,400 36,800 41,400 46,000 50,600 55,200 59,800 64,400 69,000 73,600 78,200 82,800 87,400 92,000 5 21,540 43,080 48,465 53,850 59,235 64,620 70,005 75,390 80,775 86,160 91,545 96,930 102,315 107,700 6 24,680 49,360 55,530 61,700 67,870 74,040 80,210 86,380 92,550 98,720 104,890 111,060 117,230 123,400 7 27,820 55,640 62,595 69,550 76,505 83,460 90,415 97,370 104,325 111,280 118,235 125,190 132,145 139,100 8 30,960 61,920 69,660 77,400 85,140 92,880 100,620 108,360 116,100 123,840 131,580 139,320 147,060 154,800 9 34,100 68,200 76,725 85,250 93,775 102,300 110,825 119,350 127,875 136,400 144,925 153,450 161,975 170,500 10 37,240 74,480 83,790 93,100 102,410 111,720 121,030 130,340 139,650 148,960 158,270 167,580 176,890 186,200 10+ 40,380 80,760 90,855 100,950 111,045 121,140 131,235 141,330 151,425 161,520 171,615 181,710 191,805 201,900 %of Obligation 25% 30% 35% 35% 40% 40% 45% 45% . 50% 55% .60% 65%- 70% - 75% Family Cost @ Family responsibility per service- $144 - $36 $43 $50 I $50- $58 $58 $65 '$65 $72 '`I $79- I $86 $94 - $101 $108 Amount CTC will agree to scholarship per service $108 $101 $94 $94 $86 $86 $79 $79 $72 $65 $58 $50. $43 $36 **Medicaid reimbursements allow families below 200% of the Federal Poverty Level to receive their therapy services free of charge. *** Families who make below 250% of the Federal Poverty Level could qualify for the state funded CHIP program r 5 Application Cover Pages (Agency Information and Questions 1 — 7) . .. Agency Information Agency Name:Institute for Family Development fifr4T640 Applicant Name and Address: Agenc irector: 1114 Institute for Family Development Charl tte Booth,E ecutti Director. 34004 16th Ave South, Suite 200 N e ancliViirek 2008 Federal Way,WA 98003 253 874-363 iti,c,F (Area Code)Telepho`'e'i Q,o cbooth@institutefamily.org (253)838-1670 E-mail address(if available) (Area Code)Fax Number Required signatures: By signing below,you certify that the information in this application is accurate to the best of your knowledge and that you have read the application, certifications,and appendixes. (SIGN TURES MUST BEi IN BLUE INK) Signature of Agency Board President/Date Signature of Agency Director/Date Susan Waild Charlotte Booth Printed Name of Agency Board President • Printed Name of Agency Director , w e. = *1■ orniatl on . . 1. Program Name-- g Parents&Children Together(PACT) Contact Person(available to answer specific questions on this application) Shelley Leavitt (253) 874-3630 Name (Area Code)Telephone Address(if different than above) -E-mail (253) 838-1670 E-mail address(if available) (Area Code)Fax Number 2. Program is New for our agency ❑An Ongoing Program ® • 3. Brief Description of Program(One sentence) PACT is an in-home counseling, skill building and family strengthening program designed to improve family functioning, parental capabilities and child well being to prevent/reduce child abuse and neglect, and enhance nhildren's readiness to learn and succeed in snhnnl 4. Where are services provided? (If different from agency location) Services are provided in the family's home and community(e.g. school), at times convenient to families, including evenings,weekends and holidays. aC7Z-6- 2 V 9 OslasiPage 1 Cv� r --d-e-7L(S • 5. Total Program Cost: Actual 2007: $98,707 Proposed 2009: $201,933 Projected 2008: $147,466 6. Total City Funds Requested for this Program: City Awarded 2008 Requested 2009* General Fund CDBG Total Requested** Auburn 0 0 17,496 Federal Way 3,000 13,949 18,225 Kent 0 0 23,328 Renton 0 12,798 17,496 City Awarded 2008 Requested 2009* General Fund General Fund Burien 0 0 Covington 0 0 Des Moines 0 0 Enumclaw 0 0 SeaTac 4,000 7,290 Tukwila 21,600 23,328 *Cities on a two year funding cycle will renew 2009 awards to 2010 based upon performance and availability of funds. See Part II for city specific information. **Include your total request for Auburn,Federal Way Kent and Renton. The source of funding,will be determined by staff. Page 2 7. Agency Contact Sheet Provide the following information for the agency and for the program requesting funds. Agency Contacts General Agency Name: Institute for Family Development Address: 34004 16th Ave South,Suite 200 City/State/Zip: Federal Way/WA/98003 Phone/Fax: -(253)874-3630 Agency Web Address: www.institutefamily.org Executive Director Name: Charlotte Booth Title: Executive Director Direct Phone: (253)874-3630 E-Mail: cbooth@institutefamily.org Development Director Name: Shelley Leavitt (or Grant Writer) Title: Associate Director Direct Phone: (253)874-3630 E-Mail: sleavitt@institutefamily.org Finance/Accountant Name: Paula Eronson (person preparing invoices) Title: Bookkeeper Direct Phone: (253)874-3630 E-Mail: peronson@institutefamily.org Program Contact (Staff contact for contracting, reporting and program implementation.) Program Name: Parents& Children Together(PACT) Staff Name: Janet Geissler Title: Supervisor Direct Phone: (253)874-3630 E-Mail: jgeissler@institutefamily.org • Page 3 8. Organizational Experience A. Experience: The Institute for Family Development (IFD) provides a range of in-home counseling services to families throughout Washington. We have provided in-home services to over 30,000 families since IFD was formed in 1982. All of our services are based on our nationally recognized HOMEBUILDERS® model, which was selected as a "model family strengthening program" by the U.S. Office of Juvenile Justice and Delinquency Prevention and has been recognized as an "Evidenced Based Program" in Washington State. Our programs are designed to decrease barriers to service by being highly accessible, flexible, individually tailored and by working with children and parents in their home and natural environments. The major services we provide are: HOMEBUILDERS® INTENSIVE IN-HOME SERVICES Homebuilders, is an intensive in-home counseling and skill building program designed to improve family functioning, parental capabilities, child and family safety, and prevent unnecessary family dissolution and out of home placement of children. To be eligible for the service, at least one child in the family must be at "imminent risk" of out of home placement due to abuse, neglect, family conflict/violence, or serious behavioral problems; or the child must be in out of home placement with a plan for reunification. IFD began providing Homebuilders in 1982, and now serves over 300 families each year in 22 counties. Over the past 20 years, IFD has helped more than 20 states and 8 other countries develop and implement programs that are modeled after Homebuilders. A recent "meta analyses" of the research on Homebuilders-type programs have demonstrated the cost effectiveness of the program (WSIPP, 2006). FAMILY PRESERVATION SERVICES (FPS) Based on the success of Homebuilders, in 1995, the Washington State legislature created and funded a new service called Family Preservation Services (FPS). The service model is similar to Homebuilders, but designed for a less severely troubled client population, and has a higher caseload, and fewer service hours. IFD began providing FPS in 1995 and serves nearly 250 families each year. PARENTS AND CHILDREN TOGETHER (PACT) In July 1997, IFD received a grant through the United Way of King County's "Pilot Cause Area" to develop and evaluate an in-home early intervention service, for low income, high-risk children and families. Funding from United Way and later though Social Venture Partners enabled IFD to develop the PACT program for high risk families who were not yet heavily involved with the public child welfare system, yet were experiencing serious problems related to parenting, child behavior, and/or family conflict/violence. PACT is our only in-home service that families and community agencies can access without going through the state child protection system. IFD currently offers PACT services to over 120 families each year in 4 counties. Page 4 B. Operational Structure: • The Institute for Family Development (IFD) is a private, non-profit organization, governed by,a Board of Trustees. We have 7 offices across the state. Our Federal Way office is our headquarters and houses our King county programs, training, evaluation and administrative support staff. IFD maintains an efficient management structure with an Executive Director and two Associate Directors in Federal Way. The Associate Directors provide program administration, supervise the clinical supervisors throughout the state and direct the training division. The clinical supervisors oversee service delivery and quality assurance, provide consultation and backup, hire, train, and supervise the clinical staff, and are the primary liaison with all referral sources:Supervisors are available to staff and clients 24/7 for emergency consultation, and respond to client'emergencies. Teams meet weekly for consultation, with individual consultation always available; 'Our supervisors serve on community Child Protection Teams in South King County and participate in other community advisory and advocacy groups. • The therapists' primary responsibilities are to provide in-home services to families, addressing risk factors and identified problems, and-implementing research-based interventions (e.g. cognitive/behavioral, behavioral parenting skills, etc)to help improve family functioning, and child well being. They are also actively involved with coordinating services in the community and helping children and families enhance and access other formal and informal supports. Secretaries for each site provide clerical-support and implement our client and referral worker feedback systems. Currently we have 7 women.and 5 men on our Board of Trustees. Each board member serves on at least one standing committee. The Board meets quarterly in face-to-face meetings. Telephone meetings are scheduled on an as needed basis; committees meet regularly by phone or in person. The Board's primary functions are fiscal accountability (approve the annual budget, monitor expenses and income, etc);promoting the organization and assisting in fundraising to ensure that adequate resources are available 'to achieve the agency's mission; planning; and setting and reviewing agency policies. The Board hires, evaluates and provides ongoing assistance to the Executive Director. Board members are kept informed'about our program activities, client and community needs; local, state and national trends and policy issues; funding opportunities and challenges; and other issues affecting children and families,in South King County and throughout the State, through our quarterly board meetings, written quarterly reports, and special presentations by staff and others. Board members participate in United Way and other community activities, and many are involved in related social, educational and health issues outside of their Board participation. Since our staff participates in a number of advocacy, policy and advisory groups, they keep Board members'informed about local needs and issues. Our Board members representdiverse backgrounds and'professions (e.g. pediatrician, former legislator, special'education..teacher, attorney/mediator, juvenile court administrator, child psychiatrist, business leaders, and a public policy expert). One of our members is a former consumer of our services, one member is an Asian/Pacific Islander, one is African,American and one is Asian. 1 ' Page 5 9. Need for Your Program A. Problem,Statement: Rising Child Protective Services Referrals The number of referrals to Child Protective Services continues to increase annually in our state. South King County continues to have one of the highest referral (to Child Protective Services) rates in the state. More Families with Multiple Needs and Barriers CPS social workers report working with more families with multiple needs such as mental health, substance abuse, family violence, child behavior problems and social isolation. The DSHS Facing the Future Report (2003) states that these families are at the highest risk for abuse and neglect, family conflict and violence, school problems, delinquency and other social and, behavioral problems. Research on risk factors for child abuse and neglect, school failure, and other problems have shown that interventions focusing on factors such as family conflict, poor parenting skills, and lack of social support reduce children's behavior problems and parent/child conflicts (Hawkins and Catalano, 1990). Children living in low income, multi-problem families are least likely to be prepared for entry into school and more likely to experience problems (academic, social, behavioral) in school (Papalia et. al, 2006). Many of these families face.multiple barriers to participation in services to enhance child development, school readiness and effective parenting, and to address problems at home and school. Barriers to services are greatly decreased when services to help children and parents learn and practice these vital skills are`provided in the home. Difficulty Accessing Services As funding for human services, and especially for early intervention, shrinks, access to services is becoming more difficult for families in need (United Way South King County Assessment, 2002). According to the Assessment, "transportation to services continues to be the most frequently mentioned barrier to accessing services" (pg. 196). Prevention.Pays "Early intervention of victims of child abuse and domestic violence may prevent the level of violence from escalating and thereby disruptcthe generational cycle of abuse" (Communities Count,.2002, p. 47). Youth who experienced maltreatment during childhood were significantly more,likely to display a variety of problem behaviors during adolescence, including serious violent delinquency, teen pregnancy, drug use, low academic achievement, and mental health problems (Kelly, Thomberry and Smith, 1997). A 2006 report by the Washington State Institute for Public Policy (WSIPP) on the effectiveness of our HOMEBUILDERS program showed that for every $1 spent on HOMEBUILDERS®type services, $2.54 is saved in costs for other public services (WSIPP, March 2006). - B. Target Population: The target population for the PACT program is low income families,with children/youth (age birth to 17) residing in King County(city funding is targeted to those families residing in the designated city) who are at high risk of abuse, neglect, behavioral, social and/or emotional problems, problems/difficulties related to school readiness or other school related,problems, and their parents/caregivers who are having difficulty parenting, nurturing, providing developmental opportunities and/or managing their children's behavior and who are not successfully being served by other community agencies and resources. We target families who are "falling through the cracks" of our public and community service systems, and are identified as needing in-home services by schools, public health nurses, and other community social service, health or mental health providers. Families may also "self-refer"to the program. The DSHS Facing the Future Page 6 Report (2000) states that these families are at the highest risk for abuse/ neglect, family, conflict and violence, school problems, delinquency and other social and behavioral problems. The characteristics of the clients targeted for PACT include, but are not limited to, low income children and families not engaged in or benefiting from other services and experiencing problems in the areas of: • Parenting difficulties and family and'child management problems • Children's behavioral, emotional, social, developmental and/or school related problems • Domestic violence and other family violence; • "Health and mental health • "Social isolation • Children at high.risk of delayed school readiness and school failure Through our United Way funding, families throughout King County are currently eligible for the program. Additional families in Federal Way, Tukwila, Renton and SeaTac are eligible through funding from these cities. Since the program began in 1997, we,have targeted the dissemination of the program to South King County and since we receive more than twice the number of referrals than'we can serve (due to high demand and limited funding), over the past few years we have had to greatly limit our dissemination efforts, because of the continuing escalating number of referrals. As a result, the majority of our referrals over the last year or two have been for families in the cities where we have city funding. If we were.able to expand our funding and begin disseminating information about the program to organizations in other South King County cities (e.g. ( Kent, Auburn, etc), we have no doubt that referrals to PACT for families in those cities would increase dramatically, since a large number of our IFPS and FPS clients reside in these cities. In 2006 we began,a contract with the City of Kenmore and have begun targeting families in Kenmore. The PACT program is open to families with children from birth to 17. In 2007 17% of the children served in'PACT were age birth-4 years old; 60% were 5-12 years old and.23% were 13-17 years old. Fifty percent (50%) of the clients served in 2007 were ethnic minorities/persons of color, and 56% of the families were female-headed households. ' Page 7 10. Proposed Program/Service: A. Program Description: The PACT (Parents and Children Together) program provides in-home counseling, skill building, and support to high-risk, low income families not engaged in or successfully participating in other community services, and who are experiencing multiple problems such as parenting difficulties, family violence, child abuse/neglect, and serious child behavior/emotional problems at home and/or in school. These children are at high risk of school failure and involvement with the public child welfare and/or juvenile justice systems. PACT is designed to improve family functioning, parenting skills and enhance child behavior and learning by improving the ability of children and their families to engage in positive, non-abusive behavior, and to develop effective parenting strategies and supportive and nurturing relationships at home, school and in the community. Program goals are to enhance the development and well being of children and prevent or reduce abuse, neglect and family conflict, and involvement with the public child welfare and juvenile justice systems. Program strategies and structure: PACT is designed to eliminate barriers to service, while utilizing research-based interventions. The primary strategies are: • Accessibility. PACT therapists are available to meet with families and for crisis intervention 24 hours a day, 7 days a week. Services are provided in the family's home and community, at times convenient to families, including evenings, weekends, and holidays. • Flexibility. Services are tailored to meet the needs, values, culture, language and lifestyles of each unique family. • Services provided in the natural environment. Services are provided in the family's home and natural environment where the problems occur. Helping families address problems where they occur increases the likelihood that changes will be made and maintained. • Time-limited. Services are provided to families for up to 90 days. A time-limited service decreases dependency, and helps motivate families to change. • Strengths-based. PACT therapists help clients identify and prioritize goals, needs, strengths, and values, and help them utilize and enhance strengths and resources to achieve their goals. • Skills-based. Therapists teach parents a variety of skills, including child development and behavior management, effective discipline, nurturing and other parenting skills, communication skills, problem solving skills, and mood management skills. Children are taught (via the parent and/or therapist) vital social and learning readiness skills such as: following instructions/directions, accepting "no" for an answer, taking turns, and sharing. • Developing linkages and collaborations with other community resources and supports. PACT therapists work with other community organizations, including schools, social service, mental health, health, and recreational organizations to ensure that children and families have adequate supports to maintain changes during the service, and to help address other needs. The PACT therapist completes the "North Carolina Family Assessment Scale" (NCFAS), a validated instrument for measuring changes in parental capabilities, family safety, child well being, family interactions and environment. Once completed, the therapist helps the - Page 8 family develop goals and a service plan, which is reviewed periodically with the family throughout the intervention. Services are provided for up to 90 days, with an average of 45 total service hours per family. Therapists typically meet with the family in their home once or twice per week to provide counseling, teach cognitive and behavioral skills, and a variety of life skills using a wide range of teaching strategies including demonstration and practice, worksheets, exercises, videos, etc. At service closure the therapist completes the "post" NCFAS. Scores on the NCFAS are then used to measure changes in parent and child behavior, family safety, and family'interactions and functioning. Sessions are scheduled at times convenient to the family and when problems are most likely to occur, including evenings, weekends and holidays. As a result, the services are highly accessible and there is,no need for transportation, childcare or taking time off work. Since the sessions are in the families' homes, the therapists see first hand the families' daily routines, lifestyles and challenges, and can help them implement intervention strategies that are tailored to the individual family and therefore, more likely to be effective. PACT outcome evaluations show that families served show significant improvements in child well being, parental capabilities, family interactions and family safety All services we provide involve close collaborations with a range of community supports, resources and organizations. Our PACT program works in collaboration with schools throughout South King and other parts of the County; the King County Public Health Department; Children's Hospital; the DSHS; other community social service, health and mental health agencies; and other local community organizations. These partnerships have enabled us to work closely with the referring source (e.g. school counselor, public health nurse, mental health practitioner) to develop goals and coordinate and access services for the high-risk families referred to PACT. Outreach: Until 1997, IFD's in-home services could be accessed only through Washington State's DSHS. Since developing the PACT program, we have been able to offer these in-home services to families in the community who meet eligibility criteria. Since our services occur in the clients' homes and natural environment, a significant barrier to services —the lack of transportation — is eliminated. IFD disseminates information about PACT to schools and other community organizations throughout South King County communities. Our staff participate in local/statewide advocacy and provider networks, serve on Community Protection Teams and local advisory boards. We also provide information through our web site, brochures, other written materials and an informational video. In addition, we frequently give talks to community service organizations and at United Way events. The response to our program has been overwhelming; as indicated earlier, we receive more than twice as many referrals as we have openings. Page 9 B. Performance Measures and Outcomes: Performance Measure: Provide 315 total service hours. Outcome 1: To improve child well being for the children participating in the PACT program. Outcome 1A: Increase the ability of parents to Improve child behavior. Indicator 1A: At the conclusion of the 90-day PACT program at least 75% of children will show positive behavioral changes on the North Carolina Family Assessment Scale (NCFAS). Outcome 1 B: Increase the ability of parents to improve positive parent-child interactions and relationships. Indicator 1 B: At the conclusion of the 90-day PACT program at least 75% of the families will show improvements (when needed) in parent-child interactions and relationships as measured by changes on the NCFAS. Outcome 1C: Increase the ability of parents to provide an enriched learning environment. Indicator 1 C: At the conclusion of the 90 day PACT program at least 75% of the parents will show improvements (when needed) in the home learning environment and/or the provision of developmentally enriching opportunities as measured by changes on the NCFAS. Outcome 2: To prevent and reduce child abuse and neglect and prevent entry into the public child welfare (protection) system for the high-risk families participating in the PACT program. Outcome 2A: Increase parents' ability to use positive parenting skills. Indicator 2A: At the conclusion of the 90-day PACT program at least 75% of parents will show increases (when needed) in their use of positive, non-abusive behavior as measured by changes in the NCFAS. Outcome 2B: Increase parents' ability to improve family safety Indicator 2B: At the conclusion of the 90-day PACT program at least 80% of the families will show improvements (when needed) in family safety as measured by changes in the NCFAS. Page 10 C. Staffing Plan & Evaluation: I. Staffing Plan: -- A diverse professional staff provides PACT services. Since the PACT program serves high-risk families, the Institute for Family Development has set correspondingly high standards for the qualifications and performance of staff in this program. Services are provided primarily by licensed or registered Master's and Bachelor's level counselors (degrees in fields such as social work, marriage and family counseling and psychology)who receive over 40 hours of training in the HOMEBUILDERS® model of in-home, family based services and additional training in specialized topics including: domestic violence, cultural responsiveness, and working with drug affected families. II. Evaluation: A We use the North Carolina Family Assessment Scale (NCFAS) (Kirk et al, 2000), a widely used, validated instrument designed for use by in-home service programs, to measure child and family outcomes and evaluate the PACT program. Our clinical staff have been trained in the use of the NCFAS by Dr. Ray Kirk of the University of North Carolina, one of the developers of the instrument. The therapist completes the NCFAS after the first 2-3 weeks and again at service closure. Using a six point rating scale (from "clear strength" to "serious problem"), families are assessed at the beginning of the service ("pre") and at service closure ("post") along 5 critical domains (and numerous sub domains): environment, parental capabilities, family interactions, family safety, and child well-being. Each domain measures 4-10 specific sub domains (e.g. home learning environment, child's behavior at school, parent-child interactions etc). Progress on client outcomes is determined by the changes in these ratings.. Changes in ratings of one or more points (in the positive direction) are considered (by the NCFAS developers/researchers)to be "significant" and have been demonstrated through a number of research studies to correlate with positive outcomes for children and families. At the end of the service the therapist also fills out a questionnaire regarding child safety, CPS reports and involvement in the Child Welfare or Juvenile Justice systems. In addition to the NCFAS, we ask families and referral sources to complete a program satisfaction and goal achievement questionnaire at the end of the service. We use this information to assess goal attainment from the consumers' perspective and to improve service delivery. Page 11 D. Differences in Service Delivery by City We do not anticipate any differences in service delivery for the PACT,program among the cities that we are submitting this funding application. We anticipate no differences in the average cost of services per client in each of the cities. The number of clients we are applying to serve in each city is based on the anticipated minimum number of referrals we expect to receive. • Page 12 11.Long Range Plan Since the PACT program was first developed and delivered in 1996, we have continued to evaluate and refine it, and to seek additional money. Our funding has more than doubled and we have successfully replicated the program in other counties. Our long-range plan is to .continue program development/refinement"and to seek additional funding to expand and serve more families, as well as funding to conduct more rigorous evaluation of the program ,and to develop quality assurance and enhancement processes. IFD is dedicated to the development, evaluation and dissemination of research-based programs for children and families.. Internal and follow up evaluations of the PACT program have shown very positive results. We would like to continue to evaluate the program, with the goal of disseminating throughout King County and other.counties. Over the past 2 years we have received new funding from the city of Renton and additional funding (targeting the school.readiness population)from United Way of King County. We hope to receive an additional increase in United Way funding over the next year. In addition, we continue to identify and explore other funding avenues (e.g. schools, mental health funding, tribal funding etc.) We will be exploring other funding sources (foundations, Federal government) funding for new program development and program evaluation activities. Over the next 3-5 years we hope to have a combination of funding from United Way, cities throughout King County and the state for ongoing service delivery. IFD will also continue to raise funds to support our family crisis fund, which enables therapists to provide help with"concrete needs" of families (e.g. food, clothing, school supplies, etc) in the PACT program. Our Board of Trustees and agency administrators are committed to the expansion and further dissemination of the PACT program to new geographic areas and new populations (e.g. early learning, juvenile justice; FAS children and families, adoption etc). • Page 13 12.Budget A. Budget Request Narrative: Grant funds will be used to provide PACT in-home family counseling, parenting/skill- building, and support services to: 7 families in Auburn (a minimum of 24 high-risk children and parents/caregivers) 7 families in Federal Way (a minimum of 24 high-risk children and parents/caregivers) 9 families in Kent(a minimum of 32 high-risk children and parents/caregivers) 7 families in Renton (a minimum of 24 high-risk children and parents/caregivers) 3 families in SeaTac (a minimum of 10 high-risk children and parents/caregivers) 9 families in Tukwila (a minimum of 32.high-risk children and parents/caregivers). Families will be referred by school staff, King County Public Health Department and other community social service, health and mental health organizations. Funds will allow IFD counselors to provide 40-50 total hours of service per family. Funds will be used for the salaries of in-home family therapists (2.0 FTE), supervisory(.40 FTE) and management staff(.05 FTE), and support staff(.40 FTE)for the proposed program. Other program costs include rent and office costs (e.g., supplies, telephone, postage etc.) and direct client costs (travel to clients' homes and schools). B. Changes to Budget: The changes to the budget include increases in operating expenses due to the proposed increase in the number of families served (from 60 in 2008 to 79 in 2009), increases in salaries due to annual COLA and salary changes, and anticipated increases in employer paid health insurance for the employee. C. Cost per Service Unit(s): The estimated cost of the PACT service per unit is $729 per client; the cost per hour is approximately $56.80/hour. The cost per unit was determined by dividing the total expenses - $201,933 (17. Data Table) by the estimated number of clients —277. The cost per hour was determined by dividing the total expenses ($201,933 by the total number of estimated hours (45 hours/family x 79 families= 3,555 hours)). Page 14 Agency:Institute for Family Development Program:PACT ' - _ 13. NUMBER Of INDIVIDUALS/HOUSEHOLDS SERVED BY PROGRAM M Individuals? or n Households? (Check which applies and use for reporting all demographics.) Unduplicated *Unduplicated Number of all Clients Served by Clients Served All Funding Sources with Funds ' Requested 2007 2009 2007 %of column 1 2008 2009 (Actual) clients served (Anticipated) (Projected) (City Requested by City Funding Only) Auburn 6 3 11 30 24 Burien 0 0 0 0 0 Covington 4 2 0 0 0 Des Moines 15 7 6 9 0 Enumclaw 0 0 0 0 0 Federal Way 52 25 s 46 51 25 Kent 14 7 18 37 32 Renton 31 15 35 38 24 SeaTac 11 5 14 16 10 Seattle 11 5 s5 7 0 Tukwila 33 16 45 52 32 . Kenmore 32 15 35 37 ' r ' 100% Total 209 (This column must 215 277 147 total 100%) ; *Unduplicated means count each client only once per calendar year per program. This number should match the number of clients by city indicated in the top row of Question 15. Page 15 Agency:Institute for Family Development • Program:PACT 14. Performance Measures & Average Cost of Service (Data Tables) This information will be used by each City to develop 2009-10 contracts with funded agencies. 14a.Your Performance Measures should reflect numbers based on the funding you are requesting from each City. 14b. In the space provided, define at least one(1) and no more than three(3)performance measures the program will report with a brief explanation. Do not use Unduplicated Clients/Households as a performance measure. Provide the estimated number of clients/households served by city your program plans to provide in the corresponding column for each of the performance measures listed. Estimate the number of units to be provided for each measure annually. Provide accurate and realistic estimates. These estimates will be,the basis of your contract if funded. 14c. Complete the table with the city funds requested in Question 6 and the unduplicated clients served with funds requested by City listed in the last column of Question 13. Explain any differences between the average cost of service per client between cities in Question 10.D. of your application. 1 . Example of Completed Data Tables 14a: 14a. Service with 2009 Requested Funds Proposed Performance Measures as listed below. A)Meals Delivered B) Case Mgmt Hrs C) Auburn 7,000 75 • Burien 5,000 50 }' � `�' PCs S� .t �. R,.x.,.t,.:, - � ; o..a" Z Data Table l4b 'Performance Measu're:20r09 kProposed(City RequestedXFundmg,Only '�v,. -..•*,��r..Y:,,..>2•`..: Title: Brief explanation: A)Meals delivered One meal delivered counts as 1 service unit. Will include intake,assessment,planning, advocacy and evaluation B) Case management hours of results. Page 16 Agency:Institute for Family Development 14. Performance Measures (Data Table) Program:PACT 14a. Service with 2009 Requested Funds Proposed Performance Measures as defined below. A) Service Hours B) C) Auburn 315 Burien 0 Covington 0 Des Moines 0 Enumclaw 0 Federal Way 315 Kent 405 • Renton 315 SeaTac 135 • Seattle 0 • Tukwila 405 14I Performance Measures OO9Proposed with funds requested City FundmgOnly sy;,;21',tat Title: Brief explanation: Includes direct counseling/skill building, consultation, collateral contacts, case documentation/report writing, and therapist travel A) Service Hours time. • B) C) Page 17 Agency:Institute for Family Development 14 Performance Measures (Data Table), Cont. Program:PACT 14c. Average Cost of Service Unduplicated Clients Served with Funds Average Cost of Service Requested 2009 Requested 2009 per Client (Same as last column of (Same as last column of Question 6) Question 13) Column 1 divided by Column 2 Example: $5,000 45 $111.11 Auburn 17,496 24 729.00 Burien Covington Des Moines Enumclaw Federal Way 18,225 25 729.00 Kent 23,328 32 729.00 Renton 17,496 24 . 729.00 SeaTac 7,290 10 729.00 Seattle Tukwila 23,328 32 729.00 Page 18 Complete Question 15 with 2007 Actual numbers reported in column 1 of Question 13. Agency:Institute for Family Development 15. Demographics (from all funding sources) (Data Table) Program:PACT '..!-X,T1 ---x-.•4:..- .,,,,,,::,,,, ,,,,,,.,:,,.,-,,,,, ClidnititOider10'..'; ,, g ,i o as a) o ' (c11Pc1c,P40, 'Iiial44nal :'''''-e' ' c) .:t. kt-1 ,--1 N rn N tr) 71- .—I r•-I Cn ,-I 1-1 1--4 en CS' 0 E-46SriiO4:'':',,,i 80ie'OUin, 06,1*'i:::',--,',-:-:, 044eltiildrIlleOine:feel',:.!',.;:.:5::; ?,<2.:2„ :':`21;'''::'.,,:-..<,;;11.„': 1;:,::,;:;.,: :- ..`',':.:,, .::••:'''!:,:::r-V,,' ,'.,-',,3:-V1;,'''' iz:‘..::0;f ':3,::','.•:::"'Y't::';',:::"'''::-::-:::',,, ,:'-': 30%of Median or Below 2 3 6 2 2 1 1 4 21 50%of Median or Below 1 3 3 1 4 12 80%of Median or Below 1 2 2 2 7 . . . Above 80%of Median 1 1 ) 2 2 1 1 1 9 Unknown 1 7 1 1 10 TOTAL 1 1 4 13 13 3 9 3 3 9 59 06161:"::.,::.,, - : ::: ,Y"''::;:4-', :,,i":':12,4i;' :.' 'J= ."! '',,,,:;:::;'':';*;:.;?:;;,'f:li':,*,','-::-;','-',',c,,,,W.. ;!:''01:':':"4:.•;:-', 5:;, .:3,",, ,: ki.: Male 3 3 7 13 26 8 13 4 5 9 91 Female 3 1 8 19 26 6 18 7 6 24 118 TOTAL 6 4 15 32 52 14 31 11 11 33 209 Age, :-.::::"",.:,'::: :''''.-- ',, ,:.::;, : -2 :::;-:,:;',:,,.,.,,,,,z,::::::::,, ,.:;::,,,,-,:,....::,,,Txs, ,'. :''':::::::::1,J.,::::. ','N'',-,.:';',•,;,.g:,,,:T:--:r.-,i'j:si, ,,,:,:;:,:.0,,,,,w,.;!;',7,::,',;:.:,',,,,,;;.,. ;.,,,;::',:..,,:::;":,:i::;',.?,- o-4 years 3 1 2 4 3 1 1 4 19 5-12 years 1 . 1 . 7 15 22 3 12 2 2 8 73 ' 13-17 years 2 5 7 3 2 2 7 28 18-34 years 3 6 5 3 7 3 2 5 34 35-54 years 1 2 3 6 13 3 5 3 4 4 44 55-74 years 1 1 1 3 . . 75+years . Unknown 3 1 4 8 TOTAL 6 4 , 15 32 52 14 31 11 11 33 209 E0ileitY:" :?:'''''‘ Asian 3 5 3 4 15 Black/African American 4 8 6 11 1 2 32 Hispanic/Latino(a) 5 1 3 9 Native • American/Alaskan Pacific Islander White/Caucasian 6 4 2 27 22 8 18 6 2 9 104 Other!Multi-Ethnic 1 5 17 2 5 4 15 ' 49 TOTAL 6 4 15 32 52 14 31 11 11 33 209 Female Heidid,';',; 2 7 8 6 1 2 6 32 :Houiehillit .' Disabling Condition Limited English '. 1 1 *Check Individual or Household,which should be the same as checked in Question 13. Unduplicated means count each client only once per calendar year. This should match the number served by City in the Actual 2007 column of Question 13. The "total"column will be different from Question 13 since the"other"column is not included due to space limitations. • • Page 19 16. PROGRAM STAFF (DATA TABLE) In this data table,record the number of full-time equivalent(FTE)paid staff and volunteers for this program. FTE means a 40-hour week throughout the entire year. For example, if you enter"5"in the box for Number of Volunteer FTEs, this would mean that you have, on average, five volunteers assisting your program at all times (assuming a 40-hour week). If you know only the total number of hours contributed by all volunteers for this program, simply divide that number by 2,080 to find the total FTE number. For example: 5,000 volunteer hours over the course of a year, divided by 2,080 equals 2.4 FTEs. 2007 2008 2009 (Actual) (Budgeted) (Projected) Total Number of Staff(FTEs) 2 0 2.0 2.85 Number of Volunteer(FTEs) 0 0 0 Actual Number of Volunteers 0 0 0 • 17. PROGRAM REVENUE & EXPENSE BUDGETS (DATA TABLE) Program Budget: All columns should include total program operating revenue and expenses. Complete' the following data tables with figures indicating the source of program operating funds for 2007 (actual),2008 (budgeted) and 2009 (projected). Budget amounts should match funding requested( (Question 14c) and Question 5. Include an explanation of any significant differences between the revenues and expenses by year in Question 12B of your application. Page 20 Agency:Institute for Family Development 17. PROGRAM REVENUE BUDGET (DATA TABLE) Program:PACT Revenue Source 2007 2008 2009 (Actual) (Budgeted) (Projected/ Requested) City Funding(General Fund& CDBG) • Auburn 0 0 17,496 • Burien • Covington • Des Moines • Enumclaw • Federal Way 16,949 16,949 18,225 • Kent 0 0 23,328 • Renton 10,352 10,352 17,496 • SeaTac 4,000 4,000 7,290 • Seattle • Tukwila 21,600 21,600 23,328 • Other(Specify) Kenmore 14,400 14,400 14,400 • Other(Specify) Other Government Funds ;: . .z. • King County • Washington State • Federal Government(Specify) • Other(Specify) Private Sources • United Way(grants &designated donors) 64,612 80,080 80,080 • Foundations and Corporations • Contributions (e.g., Events, Mailings) • Program Service Fees (User Fees) • Other(Specify)Family Crisis Fund 1,000 1,000 1,000 TOTAL PROGRAM BUDGET 132,913 148,381 202,643 Page 21 17: PROGRAM EXPENSE BUDGET, CONT. Agency:Institute for Family Development (DATA TABLE) Program:PACT Expenses 2007 2008 2009 (Actual) (Budgeted) (Projected) Personnel Costs ''S • Salaries 55,708 84,483 113,306 • Benefits 14,985 24,019 34,487 • Other(taxes) 5,320 8,252 11,517 • Total Personnel 76,013 116,754 159,310 Operating and Supplies : ✓ . ... ` S.N . • Office/Program Supplies 380 583 850 • Rent and Utilities 2,461 2,461 2,900 I • Repair and Maintenance 114 150 165 • Insurance(under Administrative) 0 0 0 • Postage and Shipping 136 230 275 • Printing and Advertising ' ' 32 54 125 • Telephone 627 1000 1,250 • Equipment 499 354 500 - • Conference/Travel/Training/Mileage 159 160 300 • Dues and Fees 0 75 100 • Professional Fees/Contracts(tech support) 496 550 725 • Direct Asst. to Individuals (FC Fund) 0 1,000 1,300 • Administrative Costs 12,322 19,556 26,233 • Other(specify) • Client Transportation • 5,468 7,000 7,900 • • TOTAL PROGRAM EXPENSES 98,707 149,927 201,933 Net Profit(Loss) 34,206 (1,546) (710) (revenue—expenses)= Page 22 Agency:Institute for Family Development 18. SUBCONTRACTS (DATA TABLE) Program:PACT List all the agencies you will be subcontracting with for this program. Provide the agency name in the first column, a description of the contract/service in the second column, and the contract amount in the third column. Do not list agencies you coordinate with on a referral only basis. Indicate not applicable if you do not subcontract for any part of this program. Subcontracting Agency Specific Subcontracted Activities Contract • in the Operation of Your Program, Amount Not Applicable • Page 23 19. APPLICATION CHECKLIST Applications missing one or more of the following components or not following these directions may not be reviewed. Sign and submit the application checklist with your application. , Contents (Your application should contain each of these items in this order.) Application Cover Pages.The top three pages of your application must be a completed.copy of the Agency Information and Questions 1-7. Application Narrative: Question 8 Organizational Experience(2 page maximum) Question 9 Need for Your Program(2 page maximum) • Question 10 Proposed Program/Service(6 page maximum) • Question 11 Long Range Plan(1 page maximum) Question 12 Budget(2 page maximum) Data Tables • Question 13 Number of Individuals/Households Served Question 14a-c Performance Measures and Average Cost of Service • Question 15 Demographics(from all funding sources) • Question 16 Program Staff Question 17 Program Revenue&Expense Budgets • Question 18 Subcontracts Required documentation. Supply one copy of the following required documents with the signed original application. See Part II: City Specific Supplemental Information to determine whether additional copies of the application and required documentation need to be submitted. Question 19 Required Documentation, including: • Proof of non-profit status • Organizational Chart • Agency/Organization Mission Statement • Board resolution authorizing submittal of the application(may be submitted up to 60 days after application). • List of the current governing board and local board,if applicable, (include name,position/title, city residence, length of time on the Board, and expiration of terms. Note any vacancies.) • Board Meeting Minutes of last three board meetings of governing board and local board as applicable • Annual Budget • Financial Audit Cover Letter • Financial Audit Management Letter • Financial Statement • Verification of Non-Discrimination Policy • Program Intake Form • Sliding Fee Scale • Application Check List. (Signed below.) • • City Specific Supplemental Information.Required in Part II for applicable City only. Signature of Person Completing Checklist DO NOT SUBMIT ANY OTHER MATERIALS WITH THIS APPLICATION _ Make sure that you carefully check Part II of this application to see what additional attachments each city requires. Renton Supplemental Questions 1. Please select one Result that is the best fit for the program. Identify what strategies and activities will achieve the Result. You can choose from strategies and activities that Renton has already identified or you can identify your own. If you use your own, you must cite best practices or research as to why you think they will work. The PACT program addresses the following result and strategy: Result#1: All children and youth are ready for educational success, work and life. Strategy B: Families and children have services and programs that support their success in schools and access to them. Some of the related activities include: #3 - Support other programs that are easily accessible - we provide highly accessible services that involve skill building (parenting, child and family management, child and life skills development, school interventions) and counseling to help children and youth succeed in school and life. #1 - Increase access to resources and support in a user-appropriate, understandable manner. We help families identify and access needed formal and informal supports and resources. 2. For all programs: Describe how the program outcomes as identified on page 9 of the application narrative will help achieve the selected Result. Our program outcomes: 1. Improving child well being by decreasing child behavior problems, improving parent child interactions and relationships and enhancing the home learning environment are directly related to increasing the likelihood that children and youth are ready for educational success, work and life. Research shows that children exhibiting behavioral problems are less likely to succeed in school and to experience more problems in the community. Children of parents demonstrating effective parenting skills and providing nurturing and developmentally enriching opportunities are also more likely to be successful in school (Papalia, 2007). 2. Children at risk of abuse and neglect are also at high risk of school failure, delinquency and other negative outcomes. By teaching parents non abusive parenting skills and increasing child safety, children are more likely to succeed and avoid negative outcomes. The overall goals of our PACT program are to decrease child and family risks and increase child well being and parenting skills in order to help children succeed in school and in the community. Page 1 Internal Revenue Service Department of,the Treasury P. O. Box 2508 'Cincinnati, OH 45201 Date: August 7, 2001 Person to Contact: Jeremy L. Vogelpohl 31-03888 Customer Service Representative Institute for Family Development Toll Free Telephone Number: DBA Homebuilders Family Counseling 9:00 a.m.to 9:30 p.m.EST 181 South 333`d Street, Suite 200 877-829-5500 Federal Way, WA 98003-6307 Fax Number: ' 513-263-3756 Federal Identification Number: 91-1158512 Dear Sir or Madam: This is in response to the amendment to your organization's Articles of Incorporation filed with the state.on May 8, 2001. We have updated our records to reflect the name change as indicated above., Our records indicate that a determination letter issued in May 1982 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 'oundation 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, '9gacies, devises, transfers, or gifts to your organization or for its use are deductible for federal estate and • ,ift tax purposes if they meet the applicable provisions of sections 2055, 2106, and 2522 of the Code. -2- Institute for Family Development DBA Homebuilders Family Counseling 91-1158512 Your organization is not required to file federal income tax returns unless it is subject to the tax x 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, ZPC;27.-/ -7 C., John E. Ricketts, Director, TE/GE Customer Account Services • Institute for Family Development March 2008 Board of Trustees ' Executive Director Controller Associate Director Assistant Director Associate Director • Data Manager Executive Assistant EPrcpe rtyy ManagerAssi Prope aggerer I King Yakima Training North Puget Sound FFT PierceKitsapSouth Puget Sound Spokane Vancouver (Thurston,Lewis,Mason, (Spokane,Whitman, (Clark,Skamania (Snohomish,Skagit, (King County) (Benton,Franklin,Walla King,Kitsa,Pierce (Pierce County) (Kitsap,Pierce Grays Accounting Whatcom Counties) ( a d Snohomish _ Jefferson Counties) Cowlitz,ounties)Harbor Lincoln Counties) Counties) Walla,Yakima,Kittitas, Executive Assistants HOMEBUILDERS Grant,Adams Counties) HOMEBUILDERS Counties) . HOMEBUILDERS FPS HOMEBUILDERS PACT TrainersiConsultants FPS FPS HOMEBUILDERS HOMEBUILDERS FRS FPS FPS -HOMEBUILDERS - FRS FPS State•Wide FRS FPS PCIT FRS FRS FFPSRS PACTPC King County PCIT FRS PR T PCIT PCIT PCIT ' CORE VALUES 41110 Safety The safety of' our client � _ families, staff, and. members Institute for of our community is our Family DeVelopment highest priority. Accountability Our programs and staff are MISSION STATEMENT accountable, measured by • evaluation of program Our mission is to improve the outcomes and customer lives of children and families satisfaction. through the development, provision, evaluation, and Accessibility dissemination of high-quality, It is our responsibility to engage and motivate our cost-effective, community-based client families. We do this services and supports. by providing services in the families' own homes and communities, on a'flexible schedule, in a culturally responsive manner. • GOALS Inclusion We achieve better results Provide and promote the when our decision-making process includes those most HOMEBUILDERS® model. affected by the decision. We treat our clients as Provide a range of high-quality, partners in service delivery, research-based children and . and our staff as active participants in determining family products and services that • agency policies and are consistent with our mission procedures. and values. Optimism Influence human service systems Human growth and change and public policy in order to is a natural, ongoing improve the lives of children and process. Our role is to families. influence this process to help others achieve their greatest potential. Maintain a strong, values-based organization. -. Mission Values Goals 2.0 , ) , Institute for _ Family Development Submitted By: Secretary Date • • • MINUTES OF MEETING Board of Trustees March 26, 2008 • • • , • 5:00 PM • • • Conference Call Board Members Present: Ruth Bauman, Stew Cogan, Nona Hasegawa, Board Members Absent: Gwen Glew, Carol Webster Hower Kwon, Sally Nafziger, Chris Pressey, Fred Shanafelt, Bill Smitherman, Susan Waild, Sharon Wheat Staff Present: Mary Lynn Antush, Charlotte Booth, Jack Dyer KARIMINAgiiftiVt#010;A:-W---M KG-63-IMER411'.6.4,roliWng-,;;Maii 2itomzikitimildeoteigcloyou-j 1 . Call to Order • Susan called the meeting to order at 5:05 PM. (Susan Waild) 2. Consider the election of Bryan Bryan's resume was distributed to the After discussion and a motion duly King to the board. board prior to this conference call and made and seconded, the board was discussed. Board members who unanimously elected Bryan King to the recently met with Bryan reported on board. -(Susan Waild) the meeting. • • • • Minutes 3.26.08 • • 1 of2 ' ` - rmi_ -_-'_ - -_- ��� 3. Staff COLA A summary of comparative salary After o motion duly made and data, FIB projected revenues and e seconded, the board unanimously draft of|F[)2OO8-OS budget were approved aG% increase to the salary distributed to the board prior bothis matrix. (Mary Lynn Antuoh) conference call and were discussed. ' 4. Resolution bo bid for PACT After a motion duly made and funding in the cities mfAuburn, seconded,the board unanimously Covington, Des'Moines, Federal resolved bo allow bidding for PACT in Way, Konmore, Kent, Renton, ' the listed cities. SeaToo Seattle and Tukwila through the Community Development Block Grant and/or the Human Services General -' Funds. (SunonVVoi|d) �5. Adjournment The meeting was adjourned sd5:5U PM. (SuuonVVmUd) ^ ' � ` ' 14 40 Institute for Family Development Board of Trustees Trustee Name Employment Term Length of and Title Affiliation City Expiration Time Residence Date on Board President Susan Waild King County Bothell September _ 11.6 years 2008 Secretary Sally Nafziger Presbyterian Retirement Seattle May 2009 7.9 years Communities NW; Marketing Perspectives Vice President Ruth Bauman Mercer Health & Benefits Seattle February 2011 6.2 years Treasurer Stew Cogan Private Practice Mediation Seattle April 2009 11 years and Arbitration Nona Hasegawa A.G. Edwards & Sons Mercer Island July 2008 12.6 years Gwen Glew University of Washington Kirkland April 2010 4 years Bryan King University of Washington Mercer Island March 2011 1 month and Children's Hospital and Regional Medical Center Hower Kwon Bellevue Child Behavior Bellevue - October 2010 .4 years Center • 1 Chris Pressey Self Employed Bellevue October 2009 1.5 years Bill Smitherman Retired Tacoma October 2010 .4 years Carol Webster Retired Tacoma March 2010 4.2 year Sharon Wheat Stadium High School . Tacoma January'2011 3.3 years ' '~ ~ i �� mxnsumtuom� v«mo IfDFamily Development Submitted By: Secretary Date MINUTES ��� MEETING ~�" Board of Trustees November 2" 2007 - -1:00 PM to 4:00 Pm . �TR 34004 1� Ave. S', Federal Way, WA ' Board Members Present: Ruth Bauman, Stew Cogan, Gwen Glew, Nona Board Members Absent:, HovvmrKvxon Hooe0ovva. SaUyNobigar. Chris Pramaoy, Bill 3nndhomnan, SuoanVVai|d. Conm| Webster, Sharon Wheat, Staff Present: Mary Lynn Antush, Shannon Avila, Charlotte Booth , Jack Dyer, Mary Fischer, Dale Heh±ner. Shelley Leavitt ` Q . -`��.�=^=`"~, 1. Call bw order and welcome bonew The meeting .as called to order a11:3O boordmanxber Bill 8nmdharman. p&Y. (SuaanVVaUd) Board members and staff introduced themselves to our new member, Bill ` Snnithermnn. , Minutes 112O7 1/4 . Trustee Manual,Section 1 . • � ':ib— •�� :.'k;,o- .i3 "�'a�A'£ij- 5-�.5^t'¢�,...��� _ y.�mria-•��kr u'S ..,�%'..i '"�4V::fj;,s^^s".r:Y= ^^Y-✓a.k�: •je'4a��-.� �>',• •,�t.f?: ��-'�.'%. -a�:t''!`:✓:LL. `� a'S.`-t'..•..,Y .'+6'nx S^'�=*�' 9 •[ 5!y, ^i' aST. `q's•.N�`.•N.s. L.J{'^.'•�.'•:� ii'-= 1..1.a� i'dv:^ <"Yq\ E.R:a^... - a�-tj .3;•:'i: 1+�`t-ta �,:`5iw .��. d�=Ctei»:�:,;- -�M^:3 ,= '' ;`.�� � ..t3isc�ission •�u• .���:.,:. >Decisions . �.,. ,.����v:.; ,. n_�._��.,r_w.._....._...� , :��Gr: . .._.,. _k.: 2. Approval of minutes of the July After motions duly made and seconded, • 28,2007 board meeting, and the the minutes of both meetings were • October 29, 2007 board unanimously approved as written. conference call. • • (Susan Waild) • 3. Audit Committee Report Ruth reported that the audit committee After a motion duly made and seconded, Jack will determine the met yesterday, with all members in the board unanimously resolved to accept average number of checks on attendance (members are Ops and_ . the audited financial statements. which the check signature • (Ruth Bauman) Finance members plus Ruth). . stamp is used, and assess • whether it is still needed. -Ruth distributed th'e audited financial statements. IFD received a clean audit. No management letter was sent. However,the auditors reported that use of • a signature stamp on some checks (under $500.00) is a potential vulnerability, so they will look at that each year. • Our overhead rate for the year was 15%, which is under the United Way benchmark • of 20%. • • 4'. Operations and Finance Stew reported that the committee met Committee Report yesterday, with all members in attendance. • First quarter financial Dale distributed the first quarter financial After a motion duly made and seconded Jack will change the way statements statements and investment report. IFD the board unanimously resolved to accept information is.displayed on has a surplus of$1,416 for the quarter. the financial statements. table 1 of the financials. Revenues were 12% below budget. • Revisions to the IFD Mary Lynn distributed a summary of After a motion duly made and seconded • Personnel Handbook proposed changes to the IFD Personnel . the board unanimously resolved to adopt • Handbook. Our pro bono personnel law the revisions to the personnel handbook. (Stew Cogan) attorney, Steve Peltin, already reviewed • • • • • any substantive changes. Minutes 11 2 07 2/4 Trustee Manual,Section 1 - ' / G. Board,Development Committee Carol distributed the collated results ofthe . The oomm�oemN| �v�w�o Report annual board eva|uat�n.The board board skills grid to identify ° Results of board annual discussed those items on the survey bo gaps. evaluation which one or more members answered, ' ^dioagnem^or^don'tknmw". Chris will complete the board member self-assessment form ° Board recruitment There |o one potential new member still in and discuss with his buddy. the pipa|ine--0r. Brian King,who ioo . <3vvan' ` (Carol Webster) colleague of Gwen and Hower. Gwen and Hower will continue to talk with Brian King about board membership. ` 6. ' Staff Report The Request for Proposals for ` * Q and A regarding the HOME8U|LDERS will be released next � xvam� vv�haoontnan�oto�dotaofAor quarterly report . April 08. / Charlotte expressed concern that we are Board consensus was that the payment losing o significant amount of money on system for FFTkmof concern.The the Chi|dren'o Administration Functional assumptions upon which the system was Family Therapy contract, due to the way designed seem bnba having unanticipated the payment system ia structured.VValost negative consequences. The board will $17,00Oin the first seven months ofthe review the FFT financial position again ot contract, which began last December.VVe the January meeting. have lost$1Q.O8U already in the first quarter mf this fiscal year. . ' ' next vvU �a 7. Other Business � � The nna�ongo | : ~ LonoUonand Umeof�oard } ° January 28. 8AMho meetings 1PK8ata south King County ' location Monday April 28. 12:3Ob»4PM, (SumonVVoUd) a1 Seattle area location Saturday July 26. 1 bn4PM. at Nona and Stmxv's house in ' ' Issaquah. Annual meeting party that evening. ' Monday October n7m. 12:3Obo 4PM. sdasouth King County ` location. Minute 3/4o112O7 � Trustee Manual,Section 1 � . "'ai:, ieaZi't'e: ,-:. _ c?'• :s:a+.4 . , .•sue..:. z..��3 •�:,�xw. `c' grro..;r.P�u.,. �,�.t� .:xv: cn •$' :2; .rs- y, '• W" 'e4''x,;a'3,�hk' x •,,�r. ?.:.3/► $ 'Y'<F ���"�y- 't: '.:' .��''�t$rll.. �-'�'&.' 2 �r.,a'"�'z:?���:7^:,N °`r�i.�ri,Uss\d!��.�w5.' r. s��•sx'�;.; ..�� ,r,. ... �!�- ..-e��.�-a�S^.�y,,*p� °11~J.S� �m�7�-�-'��.,.�.,.�3:.. ,.m,..A.��.�.�i ��, "°��� ...a..,..,.., K`,c$aP•s aP_.;� �a'-:r..� �. ,�?z _;....-.,...._ ...!.'ay�,=«::i#��._auw: u .�acr._...x"w:-est^,c3_`x::,.,s:$Wa��ir����s.'� •:i,wsw �'R.•u.....a.� ..,a�s',_.n....,.....�.._....`!'.!•`�,:.�:A�3Y.��,�' 8. Executive Session The board met in executive session to • Executive director annual review board and management team evaluation. evaluations of Charlotte's performance this past year. (Susan Waild) 9. Adjournment The meeting was adjourned at 4:00 PM. (Susan Waild) Minutes 11 2 07 4/4 Trustee Manual,Section 1 • - ' VV Institute for • Family Development Submitted By: Secretary Date MINUTES OF MEETING • Board of Trustees January 26, 2008 9:00 AM to 1:00 PM IFD Building . 34004 16th Ave South, Suite 104, Federal Way, WA 98003 Board Members Present: Ruth Bauman, Stew Cogan, Gwen Glew, Nona Board Members Absent: Hower Kwon Hasegawa, Sally Nafziger, Chris Pressey, Fred Shanafelt, Bill Smitherman, Susan Waild, Carol Webster, Sharon Wheat, Staff Present: Charlotte Booth, Jack Dyer, Shelley Leavitt • 1. '-'1:4):47.4141701.0;0%42'fizNil Call to order V• Susan called the meeting to order at 9:10 (Susan Waild) AM. 2. Introduction of new board Stew introduced Fred. Board members member, Fred Shanafelt welcomed Fred and introduced (Susan Waild) themselves • 3. Re-election of Trustees Ruth V VAfter a motion duly made and seconded, Bauman and Sharon Wheat V. the board resolved to re-elect Ruth and Sharon. • (Susan Waild) • • minutes 1.26.08 1/5 Trustee Manual,Section 1 ( 717-7-1 _ '4. Approval mf minutes mfthe ` After onotiondulynodma seconded, November 2,2007 board minutes of the meeting were approved as meeting � ' written. � �(SuoanyyaUd) � 5. Operations and Finance Nona reported the committee met January Committee Report 24'` Chris, Nona and Susan ooanoeo. � ° Second quarter financials Jack distributed the second quarter After discussion and o motion duly made Jack will give Gwen . financials and the schedule of cash and and seconded,the board unanimously information omthe empty suite, investments. The financials show myear approved the financial statements. am she volunteered boseek ' h»date surplus of$83,000.The bui|dihg ' advice from o nao|bor. ` has one empty suite. The balance mf cash and investments is$2'062.600 � Equity funds increased to$401,286. ° ED authority bmsign Nona explained that the current board- After discussion and a motion duly made contracts approved policyauthorizing the EOto . and seconded,the board unanimously commit the corporation bn contracts needs resolved tm amend-the policy.The updating. Jack distributed the current wording of the new policy isattached. ' policy and a draft replacement. After a motion duly made and seconded the board unanimously resolved togrant ° Pension plan investment Jack reported that staff would like bo add o the EO authority bo sign new|FpS ` addition socially responsible investment bo the list contracts in any amount. of choices for their pension dollars.The ' best time bndm this might be when/if xvm change brokerage services. ' ' Nonaand Jack pepo�edthere rn|Qhtbe /Nterdiscussion and ornotionduly nnoda Jack vviUxvorkxvith �]penaUono ° �ems��n ���m�nm������services benefitexploringono 'in �bnohmrfordhm and the board unanimously and Finance bo issue the RFP. pension funds. resolved bo empower the Operations and Finance Committee bo is-sue onRFp for o ° Staff exit interviews Charlotte distributed the last year's results new broker. mf the feedback from staff who terminated (NonoHoaegovws) employment at |FO. ' ` ' �5 m�uu� 1�s�o Trustee Manual,Section I ' - _ 6. Board Development Committee Carol that the committee has Report exnhan0edennai|o. ° Roberts Rules ofOrder . Carol distributed a handout she had The board will utilize the simplified rules. prepared and led a board discussion of Members will"call for o vote"rather than how the board will apply asimplified ^call for the quastion^. version of Roberts Rules ofOrder. ° Sharing IF0 documents with Charlotte tte reported there has been some After discussion and o motion duly made other agencies confusion regarding what |FD internal and aaoondad, the board unanimouslydocumentoonaapppoprimtetoahanevvith resolved th' t board nnamnbanaare not to ' outsiders. Charlotte distributed a list of distribute o0encymaterials without ` documents for discussion. The board permission from the executive director, � agreed that anything related bointellectual and that if the E[j feels uncomfortable she capital should not be shared at all, and will contact the president. other documents should only beshared with the intended audience. . ° Asking XF0 staff tmsupport The board discussed the awkward The board agreed that itio not appropriate other nonprofits ^ position it onombao for the EO or other staff to ask staff to support other organization when a board member asks them bn in this way. support other agencies through donations, — attendance ot fundraising events, etc. ° What kinds ofboard The board discussed the potential Communications will go through the ED. communications should 0o problems when communications with staff The exception would becommunications through the ED and what do not 0o through the ED. bebwaenboandondotoffm/hoonm-oen/ing kinds should go straight tm together ona task force or committee, or . staff a board member making o referral to an |FOprognam. / ~ Changes Xn the lFDBoard The board discussed whether bochange The board address list will remain aoitks theboondodUreaa |isttoinc|udaboand now. ' ^ rnernba�omdumoUon/daQneeo' �m�nmms'� - -' <�oro|shared odocunnent�ornanother The board agreed bo create osinni|or Board mnennberowill send obio ° ��mm'�«e�tm6�gh{��htmur nonprofit, document. (�apo|volunteered todoo and photo bm (�opo|' �m�nd ' � members are listed, along with o photo of draft. (Carol Webster) each member. ' `- 3/5.m�u�o12n�8 Trustee Manual,Section 1 • .;..t""' _ z y ^a'-%'G, r3��:'v<.' ;c-am. � �il-� :A-:�'- �"'-., aa.� �3s.` � ":'5n*:a.., .,�',=. _s iv -x. �. �4'3 .� �'�"aa'S�,::,N r-�a� `_�w,,�,-_••aF";:.,��t _ ^$_: S : ., .1 = h , ,, r Discuss O .. A ;.....� '¢ :x ' _. M f;V AssTOIi rt -. °' efida�Item �..� W. .=.r.... ..�.m.._. ...�.-.....�_�.. ... Deci�.i ris ,_. _ . _ _.. g _ �. 7. Staff Report • HOMEBUILDERS RFP The WA State Request for Proposals for • IFPS based on the HOMEBUILDERS • model came out on schedule. IFD has • applied in all sites.The results of the bidding will be announced in February. • Aggression Replacement IFD applied for and was awarded a Pierce - Training (ART) County Health Department contract to • provide ART in several Tacoma middle schools' • Functional Family Therapy Our DSHS FFT contract continues to lose After discussion and a motion duly made Charlotte will communicate the (FFT) a substantial amount of money due to an and seconded, the board unanimously board resolution to DSHS. inadequate reimbursement system and a resolved to convey to the state the • lack of enough appropriate referrals.The agency's commitment to FFT and interest losses since July are almost$40,000. in continuing to provide this important Data have been submitted to DSHS service, and to authorize the ED to showing therapist time vs. revenue continue the FFT contract.for another 30 earned at each phase in the three step days; if a acceptable contract change billing process. Similar data were does not occur within that time,the ED is submitted to the state last June, but they authorized to terminate the contract. • decided at-that time not to change the • (staff) contract. 8. Plan for the April Board Meeting The meeting will be at Stew's office in • (Susan Waild) downtown Seattle. • 9. Other Business • • •• Board recruitment With the exception of Bryan King, we will Gwen will coordinate a not pursue any additional new members meeting with Bryan King, • for a while. another board member, and • Charlotte. • Board visits to IFD sites Board members volunteered for visits to Charlotte will coordinate the IFD sites, to take place in the spring. site visits. • (Susan Waild) • • • minutes 1.26.08 4/5 Trustee Manual,Section 1 �X- -•:�:- cussion::x=.��� = �=�=� �}� ciion's�:>. ���a ::�.•.-�� si nments:�� � :� A enda-:ttem:a=r �-�- � Ass ...._.. �. .. �_-��x..-�.�. �k,�; . . _.. ., .. t..._•�,�,� _..�. ... ..�...-.,. .._.5 ._. _,�a_�.�,4tt:� .10. Executive Session • . • Executive Director Susan, Nona and Stew will meet with compensation Charlotte. (Susan Waild) 11. Adjournment The meeting was adjourned at 1:00 PM. (Susan Waild) • • • • • • • • • minutes 1.26.08 • 5/5 Trustee Manual,Section 1 maik Institute for - - Family Development Submitted By: Secretary Date • MINUTES OF MEETING Board of Trustees March 26, 2008 5:00 PM Conference Call Board Members Present: Ruth Bauman, Stew Cogan, Nona Hasegawa, Board Members Absent: Gwen Glew, Carol Webster Hower Kwon, Sally Nafziger, Chris Pressey, Fred Shanafelt, Bill Smitherman, Susan Waild, Sharon Wheat Staff Present: Mary Lynn Antush, Charlotte Booth, Jack Dyer T9i::: :igiViY.A4Vidaisitee-WEBAZPV ZWICVIRf ,0%.40:410f. <4.7* 1 • . Call to Order Susan called the meeting to order at 5:05 PM. (Susan Waild) • 2. Consider the election of Bryan Bryan's resume was distributed to the After discussion and a motion duly King to the board. " board prior to this conference call and made and seconded, the board was discussed. Board members who unanimously elected Bryan King to the recently met with Bryan reported on board. (Susan Waild) the meeting. . . Minutes 3.26.08 lof2 ^ ewi 3` Staff COLA ' A - of comparative salary After o motion duly made and data, HB projected revenues and o seconded, the board unanimously draft of|F[] 2OO8-O9buduet�mra aG96inoraaombmtheoo�n/ . approved ^ distributed to the board prior to this matrix. (Mary Lynn Antuoh) conference call and were discussed. _ ' , 4. Resolution to bid for PACT ' �. After o motion duly made and funding in the cities of Auburn, seconded, the board unanimously Covington, Des Moines, Federal ' resolved to allow bidding for PACT in VVoy, Kenmore, Kent, Renton. the listed cities. ` SeaTac. Seattle and Tukwila ' through the Community Development Block Grant and/or the Human Services General Funds. ' ' (SuoonVVoUd) ' _ 5. Adjournment ' The meeting was adjourned ot5:5O PM. (SuoonVVaUd) ' ' ` ' ^ ' � ` . . . ^ ' - ' _ . ' ' / ' K8inutaa3.26.O@ 2of2 SUMMARY Budget 2003-04 Page 1 Institute for Family Development Report Date: 10-Apr-08 Summary of Budget for Fiscal Year End 6-30-08 tAtigkOkt,YAISM,772:UTE Operations Administration TOTAL Grants/Donations $ 69,747 $ 8,100 $ 77,847 `I' Special Events $ - $ - $ - Charitable Campaigns-ICA/CCA/UWAY $ 656 $ 12,000 $ 12,656 - Charitable Org's-UWay Program$ $ 92,661 $ - $ 92,661 Clinical Services $ 3,620,738 $ - $ 3,620,738 Training/Consultation $ 621,622 $ - $ 621,622 Sales-Books/Materials $ - $ - $ _ Royalties $ - $ - $ - Interest $ - $ 84,000 $ 84,000 Rents/Sub-leases $ - $ 67,476 $ 67,476 • Rents from IFD Programs $ - $ 54,223 $ 54,223 Investment Income $ - $ 7,500 $ 7,500 Misc. $ - $ 600 $ 600 Revenues $ 4,405,424 $ 233,899 $ 4,639,323 Salaries&Wages $ 2,291,613 $ 258,400 $ 2,550,012 P/R Taxes $ 225,081 " $ 24,565 $ 249,646 • Benefits $ 362,520 $ 33,008 $ 395,528 Vacation $ 151,080 $ 18,088 - $ 169,168 Pension $ 107,914 $ 12,920 $ 120,834 Contract staff $ 45,000 $ 21,250 $ 66,250 Personnel $ 3,183,209 $ 368,231 $ 3,551,439 - Reinforcement/Hard Services $ 1,250 $ - $ 1,250 Rein/HS Reimbursed $ 182,376 $ - $ 182,376 Client Trans Clin Svcs $ 243,698 $ - $ 243,698 Client Travel-Trng $ 85,000 $ - $ 85,000 Food-Service $ 600 $ - $ 600 Cost of Good Sold $ - - • $ ' - $ - Client/Customer Expenses $ 512,924 $ - $ 512,924 • Admin Charge(internal) $ 384,476 $ (384,476) $ - Other Costs Office Supplies $ 33,458 $ 3,325 $ 36,783 Small Tools $ 15,151 $ 700• $ 15,851 Consultants $ 2,550 $ 1,000 - $ 3,550 Audit/Accounting $ - $ 14,000 $ 14,000 Legal $ 250 $ 2,500 $ 2,750 Employee Benefits Consult/Admin $ - $ 9,000 $ 9,000 Real Estate Brokerage $ - - • $ 500 ,$ 500 • Temporary Help Services $ 50 $ - $ 50 Telephone-Local $ 30,329 $ 2,725 $ 33,054 Telephone-Long Distance $ 2,436 $ - $ 2,436 Answering Service/Beepers $ 5,689 $ - $ 5,689 • • Postage/Shipping $ 11,497 $ 1,950 $ 13,447 Rent/Lease $ 47,615 $ - $ 47,615 • • Rent to FIN IFD progs. $ 33,500 $ 19,712 $ 53,212 Mortgage Int. $ - - $ 31,200 $ 31,200- •• Utilities-Gas/Electric $ 3,485 $ 15,000 $ 18,485 Utilities-Water/Sewer/Garbage $ - $ 4,200 $ 4,200 Janitorial/&Janitorial Supplies $ 455 $ 13,500 $ 13,955 . Ground Maint&Supplies $ - $ 5,000 $" 5,000 Bldg Repairs $ - $ 5,000 $ 5,000 Maintenance Agreements-Bldg $ - $ 5,500 $ 5,500 Property Taxes $ - $ 10,000 $ 10,000 Storage $ 2,285 $ 1,500 $ 3,785 Equipment Rentals $ 7,085 $ 1,800 $ 8,885 • • Room Rentals $ 1,000 $ - $ 1,000 -Maintenance Agreements $ -9,019 $ 2,825 $ 11,844 Equipment Repair $ 860 $ 120 $ 980 Travel $ 34,681 $ 4,100 $ 38,781 Printing $ 21,532 $ 1,000 $ 22,532 Publications/Periodicals $ 2,577 $ 150 $ 2,727 Business Meetings $ 3,014 $ 3,600- $ 6,614 Conference&Conventions $ 150 $ $ 150 Retreats/Awards $ 1,379 $ 500 $ 1,879 Dues/Memberships $. 2,862 $ 4,500 $ 7,362 Insurance $ - $ 15,100 $ 15,100 .• -- - Bank Charges $ 444 $ 1,500 $ 1,944 Recruitment $• 9,307 $ - - $ 9,307 Licenses&Fees $ 2,790 $ 1,010 $ 3,800 Revenue&Income Taxes $ 304 $ - $ . 304 Staff Training $ 4,532 $ 250 $ 4,782 Advertising • $ 100 $ $ 100 Website/Email Maint. $ 17,891 . $ 300 $ 18,191 Oursourced IT $ 6,215 $ 6,600 • $ 12,815 SUMMARY Budget 2003-04 Page 2 ASP's $ 8,621 $ - $ 8,621 Bad Debts - Depreciation/Amortization $ 717 $ 40,400 $ 41,117 $ $ - $ i - $ - $ - Total Other Costs $ 323,830 $ 230,067 $ 553,897 Grand total all costs $ 4,404,438 $ 213,822 $ 4,618,260 Net Revenues/(Losses) $ 986 $ 20,077 $ 21,062 • BRANTLEY r.jANSO o ST • ELLIS November 19, 2007 Mrs Keiko Chu-Yamada Team Assistant, Community Services Team United Way of King County 720 Second Avenue Seattle WA 98104 Dear Mrs Chu-Yamada: - We have audited the fmancial statements of Institute for Family Development for the year ended June 30, 2007, and have issued our report thereon dated October 5, 2007. As a result of our audit,we were not required to issue a report as to significant deficiencies or material weaknesses. Please call if you have any questions. Yours very truly, BRANTLEY JANSON YOST&ELLISON S even L.' 'son, CPA Direct Dial No.: 206-212-3129 or 253-620-3129 t Mail Address: setlison(iJbranticyjanson.com SLE:kvb cc: Institute.for Family Development • • INSTITUTE FOR FAMILY DEVELOPMENT INDEPENDENT AUDITOR'S REPORT AND FINANCIAL STATEMENTS NNE 30,2007.AND 2006 ,. • BRANTLEY JANSON'YOST&ELLISON Certified Public Accountants A Professional Service Corporation 1617 South 325t Street Federal Way, Washington 98003-6009 l CONTENTS Page Independent Auditor's Report 1 Statements of Financial Position 2 Statements of Activities and Change in Net Assets 3 Statement of Functional Expenses 4 Statements of Cash Flows 5 Notes to Financial Statements 6=11 1 . I • • • °, .'':BRANTLEY . 4-150 • 4,r Xg ,� 1' t' ��y . ' INDEPENDENT AUDITOR'S REPORT October5 2007 • Board of Directors Institute for Family Development Federal Way, Washington We have audited the accompanying statements of financial position of the Institute for Family Development;a nonprofit organization, as of June 30, 2007, and the related statements of activities and changes in net assets,functional expenses,and cash flows for the years then ended. These financial statements are the responsibility of the management of the Institute for Family Development. Our responsibility is to express an opinion on these financial statements based on our audit. We conducted our audit in accordance with auditing standards generally accepted in the United States of America. Those standards require that we plan and perform the audit to obtain reasonable • assurance about whether the financial statements are free of material misstatement. An audit includes examining on a test basis, evidence supporting the amounts and disclosures in the financial statements. An audit also includes assessing the accounting principles used and significant estimates made by management, as well as evaluating the overall financial statement presentation. We believe • that our audit provides a reasonable basis for our opinion. . In our opinion, the financial statements referred to above present fairly, in all material respects, the financial position of the Institute for Family Development as of June 30,2007, and the changes in net assets and cash flows for the year then ended in conformity with accounting principles generally •accepted in the United States of America. The financial statements of Institute for Family Development as of June 30, 2006,were audited by other auditors whose report dated August 24, 2006, expressed an unqualified opinion on those statements. • dt IT' 1race '46,0 • -1- , • CERTIFIED PUBLIC ACCOUNTANTS AND BUSINESS ADVISORS 1617 South 325th Street 0 Federal Way,Washington 98003-6009 • INSTITUTE FOR FAMILY DEVELOPMENT STATEMENTS OF FINANCIAL POSITION JUNE 30,2007 AND 2006 2007 2006 ASSETS CURRENT ASSETS Cash and cash equivalents $ 1,038,820 $ 1,260,699 Marketable securities 1,110,290 606,802 Receivables for services provided 508,311 358,470 Unbilled revenue 46,057 57,695 Prepaid expenses and other 132,157 142,036 Total current assets 2,835,635 2,425,702 PROPERTY AND EQUIPMENT,net of depreciation 1,382,349 1,398,057 TOTAL ASSETS $ 4,217,984 $ 3,823,759 LIABILITIES AND NET ASSETS CURRENT LIABILITIES Accounts payable " $ 91,423 $. 37,394 Accrued liabilities 366,982 196,544 Unearned revenue 54,403 63,009 Current portion of note payable 20,707 19,738 Total current liabilities 533,515 316,685 LONG-TERM DEBT,net of current portion 638,922 659,732 Total liabilities 1,172,437 976,417 NET ASSETS Unrestricted Designated for operating reserve 1,000,000 1,000,000 Undesignated 2,034,922 1,836,717 Total unrestricted 3,034,922 2,836,717 • Permanantly restricted 10,625 10,625 Total net assets 3,045,547 2,847,342 TOTAL LIABILITIES AND NET ASSETS $. 4,217,984 $ '3,823,759 • The accompanying notes are an integral part of these financial statements. -2- • INSTITUTE FOR FAMILY DEVELOPMENT STATEMENTS OF ACTIVITIES AND CHANGE IN NET ASSETS FOR THE YEARS ENDED JUNE 30,2007 AND 2006 2007 2006 UNRESTRICTED NET ASSETS Revenues and support State and other government Homebuilders $ 1,441,992 $ 1,449,304 Family Preservation Services 622,765 532,110 Functional Family Therapy 136,197 37,401 Family Reconciliation Services 174,236 143,683 Alternative Response,Services 126,914 20,526 Parents and Children.Together 84,327 125,585 Training - 581,405 292,070 Other 178,652 49,311 Total state and other government 3,346,488 2,649,990 Grants from United Way 82,468 89,207 Corporate and individual donations 20,821 17,419 Rental income 87,505 82,974 Interest income 83,701 58,785 • Other 53,186. , 16,224 Total revenues and support 3,674,169 2,914,599 EXPENSES Program services Clinical services 2,415,073 2,109,509 Training 442,290 232,888 • Research and evaluation 40,089 13,030 Program development 72,618 15,993 Total program services 2,970,070 2,371,420 Supporting services Administration 360,258 403,029 Building operations 139,579 132,720 Resource development 6,057 4,916 Total supporting services 505,894 540,665 Total expenses 3,475,964 2,912,085 CHANGE N NET ASSETS 198,205 2,514 • NET ASSETS,beginning of year 2,847,342 2,786,476 CORRECTION OF AN ERROR 58,352 NET ASSETS,end of year $ 3,045,547 $ 2,847,342 The accompanying notes.are an integral part of these financial statements. • -3- INST1TIITE FOR FAMILY DEVELOPMENT STATEMENT OF FUNCTIONAL EXPENSES - FOR THE YEAR ENDED JUNE 30,2007 Program Services Clinical . Research and Program Total Program Building Resource Total Supporting Total Services Training Svaluadon Dcvelooment Seradges Administration Operations Develonmenc eydp 99 Employee compensation: Salaries 1,499,377 210,459 22,922 43,781 1,776,539 154,084 6,398 3,2255 163,737 1,940,276 Payroll tams ` 143,992 19,683 2,225 3,685 169,585 14,444 583 291 15,318 - 184,903 Insurance benefits 131,283 17,121 , 2,167 3,427 153,998 19,976 276 480 20,732 174,730 Vacation 92,248 15,594 1,763 3,745 113,350 11,908 499 267 12,674 126,024 Pension 40,764 8,752 1,172 2,086 32,774 7,688 324 137 / 8,149 60,923 Contract staff 27,251 7,769 637 35.657 • 53,835 53,835 89,492 Total employee compensation 1,934,915 279,378 30,249 57,361 2,301,903 261,935 8,080 4,430 274,445• 2,576,348 • Client expenses: • Client Reinforcement 63 63 • 63 Basic needs nanreimbursed 1,780 1,780 1,780 ETS-nonreimbursed 1,199 1,199 1,199 Othernanreimbursed 1,542 59 1,601 1,601 _ Cleint hired services-reimbursed 436 436 436 Basicneeds-reimbursed _ 78,290 78,290 78,290 ETS-reimbursed _ 25,604 25,604 25,604 Other-reimbursed 48,991 ' . • ,48,991 48,991 Client related travel • 128,476 - 68 128,544 128,544 Total client expenses 286,381 59 68 286,508 286,508 Other expenses Cost of goods sold - 825 825 - 825 Office supplies 16,490 10,009 79 433 27,011 3,138 292 16 3,446 30,457 Small tools&equipment 17,204 6,413 58 9,238 32,913 - 5,126 329 253 5,708 38,621 Food service 37 • 1,019 26 1,082 16 16 1,098 Cansultanu 4,115 - 2,268 _ 6,383- 2,205 2,205 8,588 Audit/Accoundng service 16,125 16,125 16,125 Legal services 230 n 230 230 Employee benefits consultant . - 9,692 - - 9,692 9,692 Real estate brokerage 4,689 4,689 4,689 - Temporary help services 1,990 1,990 1,950 1,950 3,940 Outmurced tech support 2,697 513- 3,388 23 6,621 6,111 3 1 6,115 12,736 Clinical information management 6,679 2,000 8,679 - ' 8,679 Telephone 24,774 1,762 308 26,844 2,567 38 9 2,614 29,458 Answering service/beepers 5,761 5,761 - 119 119 5,880 Postage/shipping 4,418 4,407 - 196 9,021 , - 1,706 10 102 1,SI8 10,839 • Rent expense .- 45,354 45,354 45,354 , Mortgage interest 32,104 32,104 12,104 Utilities -3,545 2 1 3,548 4 17,955 17,959 - 21,507 Janitorial 752 752 13,270 13,270 14,022 Oround maintenance and repairs 4,455 • 4,455 4,455 Building maintenance 199 199 13,872 13,872 14,071 Real esoec taxes - 9,682 - .- 9,682 9,682 Moving&storage 718 - 718 2,765 2,765 3,483 Equipment rentals 6,927 6,927 2,088 2,088 9,015 Room morals 75 1,686 200 1,961 ' - '1,961 Maintenance agreements 5,131 842 256 6,229 2,599 31 9 2,639 8,868 . Equipment repairs 406 33 11 450 69 624 693 1,143 Travel 16,836 4,898 3,756 877 26,367 - 3,737 3 3,740 30,107 Reimbursed training travel 104,940 104,940 1,301 1,301 106,241 Printing 1,261 20,389 7 3,038 24,695 948 . 2 189 • 1,139 25,834 Publications 997 660 \ 1,657 155 156- 311 1,968 Business meetings 993 33 •250 30 1,306 - 2,941 2,941 • 4,247 Retreats/awards 928 25 953 2,073 2,073 3,026 Dues&Memberships 100 1,000 1,100 4,280 . 4,280, 5,380 Insurance 12,227 2,370 14,597 14,597 Bank charges 167 153 21 341 1,304 2,579 3,883 4,224 - Reuitmem-' - - -. 7,956 150• ' • 8,106 a . 8,106 license&fees 1,507 618 2,125 . 1,156 106 - 1,256- 3,381 Revenue&income taxes 20 275.. 295 - 72 - 72 367 Staff training 1,359 209 8 1,576 338 338 1,914 Advertising 907 - 907 1,176 1,045 2,221 3,128 Website and email maintenance 11,009 294 11,303 1,117 1,117 12,420 • Bad debt expense 1,777 25 1,802 , 50 50 1,852 Depreciation/amortization 688 688 9,174 28,932 38,106 38,794 - Total other expenses 193,777 162,853 9.772 15,237 381,659 98,323 131,499 1,627 231,449 613,108 Total 2,415,073 442,290 40,089 72,618 2,970,070 360,258 139,579 6,057 505,894 3,475,964 I The accompanying notes am an Integral part at these financial statements. -4- • INSTITUTE FOR FAMILY DEVELOPMENT STATEMENTS OF CASH FLOWS FOR THE YEARS ENDED JUNE 30,2007 AND 2006 2007 -2006 • CASH FLOWS FROM OPERATING ACTIVITIES: Changes in unrestricted net assets $ 198,205 $ 2,514 Adjustments to reconcile changes in net assets . to net cash provided by operating activities Depreciation 38,793 41,211 Loss on disposal of assets 508 _ 602 Unrealized gain on marketable securities (40,520) (5,584) .Dividends reinvested (8,030) (1,902) Changes in operating assets and liabilities: V Receivables and unbilled revenue (138,203) 44,675 Prepaid expenses and other current assets 9,879 (22,408) Accounts payable and accruals 224,467 (8,308) Unearned revenue (8,606) 2,194 Net cash provided by operating activities 276,493 52,994 CASH FLOWS FROM INVESTING ACTIVITIES: • Purchases of property and equipment (23,085) (23,870) Purchases of investments (960,800) Sales of investments 505,354 Net cash used by investing activities (478,531) (23,870) CASH FLOWS FROM FINANCING ACTIVITIES:, V Repayments of note payable V (19,841) (18,913) NET CHANGE IN CASH AND CASH EQUIVALENTS (221,879) 10,211 CASH, beginning of year 1,260,699 1,250,488 CASH, end of year $ 1,038,820 $ 1,260,699 SUPPLEMENTAL CASH FLOW INFORMATION Cash paid for interest $ 32,183 $ 33,110 The accompanying notes are an integral part of these financial statements. -5- INSTITUTE FOR FAMILY DEVELOPMENT NOTES TO FINANCIAL STATEMENTS JUNE 30,2007 AND 2006 NOTE 1 - ORGANIZATION AND SIGNIFICANT ACCOUNTING POLICIES Description of Operations Institute For Family Development(IFD) is a non-profit organization dedicated to • strengthening families and protecting children from abuse and neglect. Homebuilders/Intensive Family Preservation Services,Family Preservation Services, Family Reconciliation Services, Alternative Response Services, Functional Family Therapy and Parents and Children Together are all programs that provide in-home counseling and life-skills education for families who have children at varying levels of risk of removal to state-funded care,primarily in Washington. In addition to direct services and research to identify effective service strategies, IFD promotes - quality improvement standards and provides training and consultation for programs internationally. IFD uses the following significant accounting policies: . Basis of accounting • IFD prepares their financial statements on the accrual basis of accounting and, , S accordingly, the statements reflect all significant receivables, payables and other liabilities. - Support and revenue - Contributions received are recorded as unrestricted,temporarily restricted, or permanently restricted support, depending on the existence and/or nature of any donor restrictions. Support that is restricted by the donor is reported as an increase in unrestricted net assets if the restriction expires in the reporting period in which the support is recognized. All other donor-restricted support is reported as an increase in temporarily or permanently restricted net assets, depending on the nature of the . restriction..When a restriction expires (that is,when as stipulated time restriction ends or purpose restriction is accomplished),temporarily restricted net assets are. reclassified to unrestricted net assets and reported in the Statement of Activities as net assets released from restrictions. Grants received in exchange transactions are classified as unearned revenue until expended for the stated purpose. Other grants are recorded as temporarily restricted revenue, if applicable, as described above. Income from state and other governmental fixed-fee contracts are recognized based on the estimated percentage of completion of each case as it progresses. Training service fees are recognized at the completion of each training engagement. -6- • INSTITUTE FOR FAMILY DEVELOPMENT • . __ NOTES TO FINANCIAL STATEMENTS -JUNE 30,2007 AND 2006 _` -NOTE 1 - ORGANIZATION AND SIGNIFICANT ACCOUNTING POLICIES (Continued) Expenses • . The cost of providing program services and other activities have been summarized on a functional basis in the Statements of Activities. Certain costs have been allocated among the program and-supporting services benefited. Income tax IFD is exempt from federal income taxes under Section 501(c)(3) of the Internal = Revenue Code.Net rental income, if any,from its building is subjected to federal income tax under Section 514 relating to debt-financed property. There was no tax due for the years ended June 30,2007.and 2006. Cash and cash equivalents IFD considers all highly liquid debt instruments purchased with a maturity of three months or less to be cash equivalents. - • IFD maintains its cash in bank deposit and brokerage accounts which, at times,may exceed federally insured limits. IFD has not experienced any losses in such accounts and believes it is not exposed to any significant credit risk on.cash and cash equivalents. , Marketable securities • Marketable securities are reported at their market value as determined by quoted market prices. Unrealized gains and losses are reported as a current increase or decrease in net assets in the statement of activities. , • Accounts Receivable A reserve is established for all accounts receivables that are older than 120 days. Accounts receivable balances over 90 days were$3,835 at June 30, 2007. • Depreciation . Fixed assets are recorded at cost and IFD provides depreciation for furniture and equipment, leasehold improvements, software, and the building using the straight- line method over the estimated useful lives ranging from five to thirty years. Estimates The preparation of financial statements in conformity with accounting principles • generally accepted in the United States of America requires management to make estimates and assumptions that affect certain reported amounts and disclosures. Accordingly, actual results could differ from those estimates. -7- INSTITUTE FOR FAMILY DEVELOPMENT • NOTES TO FINANCIAL STATEMENTS JUNE 30,2007 AND 2006 NOTE 2 - CONTRACTS AND GRANTS The State of Washington Department of Social and Health Services (DSHS) contracts with IFD.to provide counseling for families to prevent long-term out-of-home placement of abused or neglected children and children in conflict with their parents through the Homebuilders, Family Preservation Services,Alternative Response Services, Functional Family Therapy,Parent Child Interaction Training and Family Reconciliation Services programs. IFD provides both short-term and long-term counseling services, ranging from 30 days to six months. The contracts extend from three to twelve months, and are obtained from various DSHS regional offices. IFD also contracts with city and county governments in the state of Washington to provide services through the Parents and Children Together and Functional Family Therapy Programs. IFD earned$2,569,000 and$2,175,000 under the DSHS contracts during the years ended June 30,2007 and 2006,respectively. DSHS owed IFD $304,000 and$257,000 at June 30,2007 and 2006,respectively. IFD periodically receives overpayments from DSHS. Unresolved overpayments totaled approximately$12,650 and $7,300 at June 30, 2007 and 2006,respectively. NOTE 3 - LEASE COMMITMENTS IFD leases office space in Olympia,Everett,Bremerton, Spokane,Vancouver and Yakima, Washington under month to month lease'agreements, except Yakima, which expires in June 2008. Rent expense was $45,354.and $44,031 during the years ended June 30, 2007 and 2006, respectively. Future minimum rental payments under the non- cancelable lease agreement at June 30, 2007 were:2008 - $14,904; and 2009 - $3,744. NOTE 4 - RETIREMENT PLAN IFD has an employer.funded 401(a)retirement plan(Plan). Regular employees who complete one year of service and work at least 1,000 hours are eligible to participate. . The amount of the employer contribution is discretionary and is determined annually by the Board of Trustees. Participants become fully vested in their accounts after six years of service. The contribution expense for the years ended June 30, 2007 and 2006 approximated$61,000 and$56,000, respectively. -8- INSTITUTE FOR FAMILY DEVELOPMENT NOTES TO FINANCIAL STATEMENTS - JUNE 30,2007 AND 2006 NOTE 5 - PERMANENTLY RESTRICTED NET ASSETS IFD has received contributions to an endowment whose investment earnings are used for program needs while the principal remains intact. These contributions are recorded in permanently restricted net assets and their earnings are included in unrestricted revenue. There are no contributions to the endowment during the years ended June 30, 2007 and 2006. NOTE 6- LINE OF CREDIT IFD has a$120,000 bank card line of credit available. At June 30,2007 and 2006, IFD had outstanding balances of$29,253 and $2,668,respectively, on the bank cards which are included in accounts payable in the accompanying financial statements. NOTE 7- NOTE PAYABLE IFD has a long-term note payable that requires monthly payments of$4,335 including interest at the bank's tax exempt fate (4.8% as of June 30,2007). The balance, if any, is due in February 2027. Principal payments in each of the next five years are as follows: year ending June 30,2008 - $20,707; 2009 - $21,723;2010 - $22,789; 2011 — $23,907 and 2012 - $25,080. The note is secured by a deed of trust on the office building. NOTE 8- PROPERTY AND EQUIPMENT Property and equipment is comprised of the following at June 30: / 2007. _ 2006 Land $ . 455, 84 $ 455,384 Building and building improvements 1,064,340 1,041,255 C Furniture and equipment 240,796 - 240,796 Software 16,655. 16,655 Total property and equipment 1,777,175 1,754,090 Less accumulated depreciation (394,826) (356,033) Net property and equipment . $ 1,382.349 ' $ 1,398,057 -9- INSTITUTE FOR FAMILY DEVELOPMENT NOTES TO FINANCIAL STATEMENTS JUNE 30,2007 AND 2006 NOTE 9 - LEASING ARRANGEMENTS During January 2002,IFD purchased a building for,$1,250,000.IIFD remodeled a portion of the building for its.own use and moved in during August 2002. The remaining office space has tenants covered under noncancellable operating leases with terms up to four years. Future minimum lease payments to be received are as follows: Years ending June 30, • 2008, $ . 59,958 2009 15,280 $ 75,238 Rental revenues from leases amounted to approximately$88,000 and$83,000 during the years ended June 30, 2007 and 2006. At June 30, 2007 and 2006,the building was 55%rented to tenants. NOTE 10 - MARKETABLE SECURITIES ; Market values and cost of marketable securities at June 30,2007 and 2006 are summarized as follows: 2007 • 2006 Cost Market . Cost - Market Municipal Bonds $ 700,000 $ 700,000 $ 500,000 $ 500,000 Stocks and equity funds 360,800 409,665 105,973 106,177 Savings Bonds 625 625 Total $ 1,060,800 $1,110,290 $ 605,973 $ 606,802 -10- • INSTITUTE FOR FAMILY DEVELOPMENT NOTES TO FINANCIAL STATEMENTS JUNE 30, 2007 AND 2006 NOTE 11—ACCRUED LIABILITIES Accrued liabilities is comprised of the following at June 30: 2007 2006' Liabilities $ 15,983 $ 10,032 Payroll 156,050 ' 91,915 Vacation 105,533 76,112 Taxes 50,382 18,029 Retirement 39.034 456 Net accrued liabilities $ 366,982 $ 196,544 NOTE 12- CORRECTION OF AN ERROR IFD makes deposits with Northwest Agencies Trust for unemployment claims. IFD had recorded the deposits as expense in prior years. During the year ended June 30, 2006, IFD determined that these deposits should have been recorded as an asset and that a liability should be recorded for estimated claims to correct this error. As a result, other current assets were increased by$74,168;accrued liabilities were increased by$16,752, and unrestricted net assets, as of the beginning of the year,were increased by $58,352. Additionally, administrative expenses were increased by$5,137 and interest income was increased by$4,201 for the year ended June 30, 2006. NOTE 13—RECLASSIFICATIONS Certain accounts in the prior-year financial statements have been reclassified for comparative purposes to conform with the presentation in the current-year financial statements. -11 • - Issue Date: November,27,2007 Supercedes Policy Dated Prior to November 27,2007 • CHAPTER 2 NON-DISCRIMINATION General Statement It is the policy of the Institute to provide services without regard to the recipient's race, color, sex, religion, national origin, citizenship, age, marital status, veteran status, disability, sexual orientation, political ideology or any other legally protected characteristics. - It is also the policy of the Institute to provide and maintain a working environment where employees are free from discrimination based upon race, color, sex, religion, national ' origin, citizenship, age, marital status, veteran status,'disability, sexual orientation, political ideology or any other legally protected characteristics. This policy applies to supervisors, managers, co-workers, clients, and any other persons. who come in contact with the organization's employees. Disciplinary Action The Institute will impose appropriate discipline up to and including termination of employment on employees engaging in discriminatory conduct Procedures for Reporting Discrimination If you believe that any employee of the Institute has subjected you or another employee to discriminatory conduct, you should promptly report the situation to the management team member responsible for human resources or the executive director (or the president of the board if the complaint is against the executive director). Use complaint procedure from harassment policy. • 5 • INTERVENTION INTAKE FORM Family Name: ,IFD ID#' General Referral Information ALL PROGRAMS Description of Reason for 4 1 Referral ii Reason for Referral-Check 0 Placement Prevention all.that apply LI Reunification o Child abuse ❑Child neglect 0 Sexual abuse LI Assessment Hard Services • O Family Conflict ❑Parent or Adult Behavior Child or Youth Behavior School Problems • At-Risk Youth petition Goals/expectations I1 regarding intervention 1 Special needs or other II concerns ii 1 Describe any safety .1 concerns not already listed above(consider gang involvement,suicide risk, criminal historyMvolvement, etc.) List any previous or current ":: counseling/services Indicate any court hearings1 0 None pending 0 At-Risk Youth O Criminal Charges-Youth t, C Criminal Charges-Parent Custody Hearing ❑Dependency Review 0 Other 0 Unknown Comments regarding i • pending court hearings • u What is the assessment of j C Very high —the potential for physical violence within the family? I C High C Moderate 0 Low C None 0 Unknown What is the assessment of = C Very high the potential for physical violence toward others? ` C High C Moderate G Low M......<:.. C.None Cl Unknown Comments regarding potential violence ij Is anyone restricted from C Yes 0 No t Unknown contact? If yes,who? 11 Is the family aware of the 11 Yes C No G Unknown referral and willing to participate? Is anyone unwilling to participate? Gross annual family income 0$10,000 and under C$10,001 -$20,000 • 0$20,001 -$30,000 C$30,001 -$40,000 • C$40,001 -$50,000 C $50,001 -$60,000 C$60,001 -$70,000 C$70,001 -$80,000 C$80,00 and over `' C Unknown Number of children identified , for services Number of other children in home Number of biological, adoptive,or step-parents in ;l home Number of other adults/ Ii 4 caretakers in home ?Total#of people in IC Y i household Safety Plan - Reunification Assessments -Transition Plan - IFPS And FPS Only DCFS Risk Factor Matrix Ratings - IFPS And FPS Only Created By: Last Modified By: ( PAYMENT CODE BAD-&- )N MONTHLY INCOME Payment Code A B C D E F G H I J Family Size 1 $658 $1,216 $1,416 $1,616 $1,816 $2,016 $2,216 $2,416 $2,616 $2,816 2 $884 $1,636 $1,836 $2,036 $2,236 $2,436 $2,636 $2,836 $3,036 $3,236 . 3 $1,111 $2,055 $2,306 $2,558 $2,809 $3,060 $3,311 $3,563 $3,814 $4,065 4 $1,338 $2,474 $2,777 $3,079 $3,382 $3,685 $3,987 $4,290 $4,592 $4,895 5 $1,564 $2,894 $3,248 $3,601 $3,955 $4,309 $4,663 $5,017 $5,370 $5,724 6 $1,791 $3,313 $3,718 $4,123 $4,528 $4,933 $5,338 $5,744 $6,149 $6,554 7 $2,018 $3,732 $4,189 $4,645 $5,101 $5,558 $6,014 $6,471 $6,927 $7,383 , 8+ $2,244 $4,152 $4,659 $5,167 $5,675 $6,182 $6,690 $7,198 $7,705 $8,213 , SLIDING FEES FOR OUTPATIENT SERVICES Payment Code A , B C D E F G H I J , Service non-MD Psych Testing/hr $0 $24 $36 $48 $60 $72 $84 $96 $108 $120 Diag. interview/intake $0 - $24 $36 $48 $60 $72 $84 $96 $108 $120 Ind ford full-- ill.. -0 $18 $27 $36 $45 $54 $63 $72 $81 $90 Ind Trtmt Brf- in ._____$0 ____$11 , $17 - $22 $2860 $3372 $3984 $4496 $$50108 $$55 Ind Trtm_ t - out _______ $0 $18- $27 $36 $45 $54 $63 $72 $81 $90, Family Svc- Brf $0 $12 $18 $24 $30 $36 $42 $48 $54 $60 Group- adult $0 $7 $11 $14 $18 $21 $25 $28 $32 $35 . Group_child $0 $8 $12 $16 $20 $24 $28 $32 $36 $40 Day Trtmt= adult $0 $7 $11 $14 $18 $21. $25 $28 $32 $35 Day-Trtmt- Child $0 $8 $12 _ $16 $20 _ $24 $28 $32 $36 $40 Med Mgt/15min__ " ' $0. __ $3 $5 $6 $8 $9 $11 $12 $14 -$15 MD Svcs Nag. interview/intake $0 $30 $45 $60 $75 $90 $105 $120 $135 $150 Ind. Therapy- full J $0 $24 $36 $48 $60 $72 $84 $96 $108 $120 Med MgUl5min $0 $8 $12 $16 $20 $24 $28 $32 $36 $40 i assesment $0 $24 $36 $48 $60 $72 $84 $96 $108 $120 6 Application Cover Pages (Agency Information and = tions 1 —7) C�� GI164 1 RPrtr-RT‘ ,_ __ Agency Information Agency Name: Renton Area Youth &Family Services APR 24 2008 Applicant Name and Address: Agen y l �C IV Renton Area Youth& Family Services(RAYS) Richar rooks�'f ��utiveiDIActi p Po Box 1510 Name and Title Renton, WA 98057 (425)271-5600 ext.30 (Area Code)Telephone richardb@rays.org (425) 227-8926 E-mail address(if available) (Area Code)Fax Number Required signatures: By signing below,you certify that the information in this application is accurate to the best of your knowledge and that you have read the application, certifications,and appendix . (SIGNATURES MUST BE IN BLUE INK) Signature of Agen Board President/Date Signature of Agency Director/Date Melinda Lawrence Richard Brooks Printed Name of Agency Board President Printed Name of Agency Director .Y'Sp7�'•i6 ;i...45 ' tniY • t' fix} y Fd- u a. r' r. y, « A , Pro ram Information �� ` ° �' f a �..• 3 .u.._. _� .. . 4,< � .;- & h0..�1: y1fi13� a�`►�-9Fub a_vwd4 1. Program Name Youth Development and Prevention Program Contact Person(available to answer specific questions on this application) Name Richard Brooks,Executive Director (Area Code)Telephone PO Box 1510 425.271.5600,ext 30 Renton,WA 98057 Address(if different than above) same 425.227.8926 E-mail address(if available)richardb@rays.org (Area Code)Fax Number _ 2. Program is New for our agency, ❑An Ongoing Program 3. Brief Description of Program(One sentence) The Youth Development and Prevention Program utilizes best practice and promising practice approaches to provide mental health services and youth development programs to children,youth and families in the city of Renton in a manner that is culturally sensitive 4. Where are services provided? (If different from agency location) These programs are provided at the agency locations, as well as school sites in the Renton School District. Page 5 5. Total Program Cost: Actual 2007: $677,520 Proposed 2009: $689,495 Projected 2008: $670,415 6. Total City Funds Requested for this Program: City Awarded 2008 Requested 2009* General Fund CDBG Total Requested** Auburn Federal Way Kent Renton 55,350 55,350. City Awarded 2008 Requested 2009* General Fund General Fund Burien Covington Des Moines Enumclaw SeaTac Tukwila 60,620 55,132 *Cities on a two year funding cycle will renew 2009 awards to 2010 based upon performance and availability of funds. See Part II for city specific information. **Include your total request for Auburn,Federal Way Kent and Renton. The source of funding will be determined by staff. Page 2 7. Agency Contact Sheet Provide the following information for the agency and for the program requesting funds. Agency Contacts General Agency Name: Renton Area Youth&Family Services(RAYS) Address: PO Box 1510 City/State/Zip: Renton,WA 98057 Phone/Fax: 425.271.5600/425.227.8926 Agency Web Address: www.rays.org Executive Director Name: Richard Brooks Title: Executive Director Direct Phone: 425.271.5600,ext 30 E-Mail: richardb@rays.org Development Director Name: Carol Sanford (or Grant Writer) Title: Director of Development Direct Phone: 425.271.5600,ext 21 E-Mail: carols(a,rays.org Finance/Accountant Name: Scott Jolley (person preparing invoices) Title: Accountant Direct Phone: 425.271.5600,ext18 E-Mail: scottj@rays.org Program Contact (Staff contact for contracting reporting and program implementation.) Program Name: Youth development and Prevention Staff Name: Richard Brooks Title: Executive Director Direct Phone: as above E-Mail: as above Page 3 8. ORGANIZATIONAL EXPERIENCE(2 page maximum) A. Experience Founded in 1-970 through a collaboration of the Renton School District, City of Renton, citizen groups, and local churches, RAYS has evolved from an agency focused on youth substance abuse into a multi-service, community-based agency serving the Renton, Tukwila, and Skyway communities. The organization's mission is to positively impact the lives of children and to strengthen families by providing family support; substance abuse treatment and mental health services in South King County. RAYS' vision is for every family to live in health and hope within a supportive community. To realize this vision, RAYS provides: • Child,Youth & Family Counseling—agency-, school-, and community-based for families with children ages birth to 18. RAYS has provided these services since 1975. • Violence Prevention—RAYS offers school-based social skills groups to help young children manage feelings and prevent bullying and the Rites of Passage program,which works with middle and high school youth involved with or at risk of involvement with the juvenile justice system. RAYS has focused on violence prevention since 1990. • Youth Substance Abuse Treatment—RAYS is a State-licensed Outpatient Substance Abuse Treatment Center providing assessment, individual and family counseling, and aftercare. RAYS has provided these services since its inception. • Parenting Education& Support—"Parenting for Success" is a free, school-based, 12- week parent education series, provided in both English and Spanish,that uses the promising practice"Strengthening Multi-Ethnic Families and Communities" curriculum. In 2005,RAYS received the Washington State Exemplary Prevention Award(from the Department of Social &Health Services and King County Alcohol and Other Drugs Prevention Program)for its quality delivery of this program. RAYS also provides a school- based parent support group and recently began offering outreach and educational services to young new parents of infants as part of the Healthy Start Collaborative. RAYS has provided parent education since 1980. 9 Family Support Services @ Skyway Family Center—Includes emergency assistance for families; a technology lab with computer/Internet access; community development; information and referral; a comprehensive holiday assistance program and a kin care group to address the needs of relatives raising kin(in collaboration with Casey Family Programs). RAYS has provided Family Support Services since 1996. RAYS has more than 35 years experience working with children, youth and families who are low-income and facing the risk factors brought on by poverty. Last year, RAYS'served approximately 750 children,youth and family members through accessible, culturally competent services. Additionally,RAYS provides information and referral services from its Skyway Family Center for 15 to 20 individuals per day. RAYS intentionally targets schools and neighborhoods with high poverty rates. As the largest, local family services organization in its service area, RAYS has unprecedented access to the schools. The organization has many staff who work onsite at public schools in Renton and Tukwila and who enjoy a high degree of collaboration with classroom teachers, site administrators, and other staff. As the area has become more ethnically diverse,the organization has prioritized making its services accessible to the changing population. RAYS initiated a rigorous cultural competency ( program in 2006 and continues this effort today, impacting all aspects of agency, including: organizational statements and documents, program policies and procedures, personnel policies and practices, skills and training of staff, organizational composition and climate, community Page 4 consultation and communication, and personal and organizational assessment. Today all staff participate in extensive cultural competency training. Approximately one-third(32%) of RAYS _ _staff are bilingual and are available to work with clients beginning_at the.critical point of program intake. RAYS also has 8 staff who are State-approved Special Populations Consultants who advise staff on cultural issues in serving individual clients and families. RAYS expects staff to make use of these resources and monitors their use. B. Operational Structure. Operationally RAYS is organized under two primary service groups: (1) Family Support Services—Includes case management, youth development,prevention, information and referral, and parent education, and (2) Clinical Services—Includes all mental health counseling and substance abuse services. RAYS staff includes 17 full-time and 15 part-time individuals who work out of RAYS' administrative offices, on-site at schools, and at the RAYS Family Center in the Skyway Neighborhood. Overall, 53% of RAYS' staff have Master's degrees in their fields. All staff have had extensive exposure to the principles of cultural competency. Management Staff include: • Richard Brooks, MA,Executive Director since 1984. He has a Masters degree in counseling from Gonzaga University and is a state-Licensed Mental Health Counselor. He has served on the boards of the Executive Alliance,the South King County Council on Human Services and the Children's Alliance. • Carol A Reich, MSW, LSW, Associate Director of Clinical Services, has over 20 years experience in mental health counseling and supervision of programs, with a specialty in treatment around child abuse issues. She is a Certified Special Populations Consultant with Native American and African American populations, and is a member of the adjunct faculty at the University of Washington,and Seattle Pacific University. • Dipti Sarnaik,MS, LMFT, Director of Clinical Programs, has 15 years of experience in direct services and program supervision. She is a Special Populations Consultant working primarily around Asian populations. • Steven Olson, Substance Abuse Program Coordinator, is a state-Certified Chemical Dependency Professional and a Licensed Mental Health Counselor. He has 25+years experience in working with youth and families in a counseling capacity, with a specialty in outpatient substance abuse treatment. • Jennifer Moore,MSW, Program Director, oversees the RAYS Family Center and Rites of Passage. She brings extensive experience working with high risk youth. Board of Directors: RAYS has a policy-making and fund raising Board of Directors that meets 10 times per year. Standing committees include: Executive, Fund Development, and Strategic Planning. The Board stays current on needs in Renton and South County through monthly staff presentations on programs and services and through the strategic planning process which requires regular examination of information and data regarding community needs. Over 89% of members reside and/or work in South County,including 78% (9 members) in Renton; 22% of board members live in Renton. The Board of Directors values diversity. Approximately 22% of board members are people of color. The board is currently recruiting to further diversify its membership. Approximately 78%of the membership is female and 22% male. The board includes adults of all ages; 22% of members are under age 35 and have young children. Page 5 9. NEED FOR YOUR PROGRAM (2 page maximum) A. Problem Statement. The Youth Development&Prevention Program provides school-based services that increase young people's successes in school, work and life. The program focuses on underlying, often interrelated factors that may undercut a student's opportunities for success in the classroom. Poverty, for example, is a significant risk factor. RAYS intentionally targets schools that serve high numbers of young people impacted by poverty. Data for the Renton School District illustrate that an increasing number of students are living in poverty, as measured by the percentage of students enrolled in'the federal free/reduced lunch program. For example, in 2000, 31.4% of students were enrolled in the program, compared to 43.3%today(May 2007). Research shows that poverty generally has an inverse relationship with school performance—a finding that holds true in Renton. For example,the only two elementary schools with 3rd grade WASL reading scores below 50%were Campbell Hill and Lakeridge (scoring 39.7% and 46.7% respectively). These schools—both sites for RAYS' counseling program—also have the highest enrollment in the federal free/reduced lunch program in the district, with 69.1%of Campbell Hill students and 75.0% of Lakeridge students in the program. School mobility is a symptom of poverty, as low-income families often change residences, leading to frequent school changes for their children. The overall mobility rate in the Renton School District has increased steadily from 18.8% in 2001-02, to 26.9% in 2004-05,to 32.02% in 2006-071—meaning that close to one out of three students changes schools within the district or leaves the district during the school year—much higher than the 15-18% average for students in the U.S. overall (2000 U.S. Census). School mobility negatively impacts the performance of individual students and schools. For example, high school students who change schools are at least twice as likely not to graduate—research indicates that only 60%will graduate.2 School mobility between the first and eighth grades increases the odds of dropping out of school during high school even after controlling for eighth-grade achievement and other factors.3 Moving also interrupts social development and the formulation of relationships with peers and teachers—both useful for cognitive and social development.4 Race also continues to be a factor in school success or failure. According to the U.S. Department of Education, the high school drop-out rate for African American and Latino students is significantly higher than their Asian or Caucasian peers. In Renton, 80% of all high school students graduate on-time. The rate is lower for Black and Hispanic students (77.6% and 67.1%) and also for Limited English Speaking students (72.4%) (OSPI data). Contributing factors are: coming from non-English speaking backgrounds, poverty, negative school climate, single parent families, alienation and decreased levels of participation in school; lack of family history of completing high school; low aspirations; and lack of support in the home for education. With increasing diversity in the Renton Public School District, more students could benefit from 1 www.renton.wednet.edu/mobility/mobility.htm 2 R.Rumberger,K.Larson,R.Ream,&G.Palardy(1999). The educational consequences of mobility for California students and schools). Berkeley,CA:Policy Analysis for CA Education. http://pace.berkeley.edu/pace mobility.html 3 R.W.Rumberger,K.A.Larson, Student Mobility and the increased risk of high school dropout. American Journal of Education, 107(1), 1-35.EJ 583 043 (1998). 4 Pribesh,S.,&Downey,D.(1999).Why are residential and school moves associated with poor school performance?Demography,36(4),521-534. Page 6 the services offered by RAYS. Need for counseling: According to a report of the Urban Institute, 21% of low-income children and youth ages 6-17 have mental health problems, nearly double that of the general population.5 Studies have linked stressful family environments to behavioral and emotional problems in children. According to the Urban Institute (June 2000) a"stressful family environment" includes situations such as inability to pay mortgage,rent or utility bills; food insecurity; challenges in accessing healthcare; and a child in poor health or with physical, learning or mental conditions.6 The same study points out that stressful family environments vary dramatically by income. For example, "Half of children living in families with income below the federal poverty level (FPL) also lived in stressful environments ... In contrast,just one child in 20 of those in families with incomes over three times the FPL lived in a stressful family environment." Need for School-based Services: According to the American Academy of Pediatrics,the advantage of basing mental health services at a school is that"students and families avoid the stigma and intimidation they may feel when they go to an unfamiliar and perhaps less culturally compatible mental health setting." School based services, such as those offered by RAYS, also are much more accessible to families. B. Target Population. The two components of the Youth Development &Prevention Program (Rites of Passage and Counseling) will reach 165 children and youth in the City of Renton next year. Rites of Passage will reach approximately 78 youth(30 in incorporated areas of Renton) at three middle schools (Dimmit,Nelson, and McKnight) and three high schools (Renton, Hazen and Lindberg). The program targets youth who are"at-risk" of dropping out of school, as determined through grades, school attendance, behavior, and involvement with the juvenile justice system. Over the past year 22% of participants were African American, 18%Asian/Pacific Islander, 22% Hispanic/Latino, 1%Native American, 17% White, 4%multi-ethnic, 3% other, and 12% unknown/declined to state. Approximately 75% come from households that are low-or very-low income, and 25% from households headed by single parents. The vast majority of students have truancy issues, and most have experimented with drugs and/or alcohol. The Mental Health Counseling Program has on-site counselors at the 4 Renton elementary schools with high enrollment in the federal free/reduced meals program (Campbell Hill, Lakeridge, Bryn Mahr, and Talbot Hill) and 3 middle schools (Dimmit,Nelson, and McKnight). The program typically serves young people with behavioral issues, emotional problems, social skills deficits, and depression due to loss. Approximately 70% of young clients have experienced trauma related to emotional,physical, or sexual abuse; an estimated 20% of the students have a parent, guardian, or sibling who is incarcerated. Most youth have witnessed high levels of violence in their homes or communities and tend to lack strong support systems in their lives. Other characteristics (based on last year's services) include: over 90% are low- or very low-income; ethnic breakdown is 33%African American; 3%Asian/Pacific Islander; 35% Caucasian; 6%Hispanic/Latino; and 22%Multi-ethnic. Nearly one-third of the young people served have a disability and/or are enrolled in special education classes; and 60% live in single- parent households. The program will serve 130 students in Renton schools in the coming year. 5 Howell, E. (2004).Access to children's mental health services under Medicaid and SCHIP.Washington, D.C.: Urban Institute. 6 Kristin Anderson Moore and Sharon Vandivere,"Stressful Family Lives: Child and Parent Well-being),In Child Trends, Urban Institute,June 2000. Page 7 10. PROPOSED PROGRAM/SERVICE A. Program Description. (2 page maximum) - 1. Type of Service: The RAYS Youth Development and Prevention Program includes two components offered at targeted schools in Renton: 1)Rites of Passage helps middle and high school youth build healthy pro-social behaviors and community attachment that will keep them in school and reduce involvement in the juvenile justice system.Rites of Passage provides weekly social/emotional skills building groups, individual mentoring, service learning opportunities, family involvement, and fun, team-building activities. 2) The Counseling Program provides individual and family counseling for families with children and youth ages birth to 18. RAYS is a Washington State- licensed mental health center. The program utilizes a family systems approach and play therapy for younger children. 2. Methods, including locations,to serve target population: Rites of Passage: In the 2008-09 year,Rites of Passage Youth Development Specialists will work on-site at three middle schools (Dimmit,Nelson and McKnight) and three high schools (Renton, Hazen and Lindberg). The central component of Rites of Passage is a social-emotional skills group utilizing a strengths-based curriculum that focuses on the power of oneself, relationships, and community. The groups meet once a week for one hour during the school day for 20 weeks throughout the school year. The program rotates meeting times to ensure that students do not always miss the same class. The program operates two gender specific groups in each of the middle schools and one or two mixed-gender groups in each of the high schools. The group work extends into the community. Approximately eight times during the school year, each group participates in community service and fun,team building activities. For example, students participated in a holiday celebration for the Skyway community by hosting a crafts table for young children. The recreational outings include hikes,movies, swimming outings and other small-group activities. During the summer months of July and August,Rites of Passage provides a structured program that meets twice a week, five hours per meeting. During the school year, each participating youth benefits from individual, bi-weekly mentoring (by the Youth Development Specialists) that focuses on goal setting, material presented in the groups, and challenges that the young person may be facing. The Youth Development Specialists connect youth to needed services and periodically"check in" with parents and guardians in order to encourage increased involvement in their youth's lives and to extend invitations to events, such as the end-of-year celebration. Counseling: RAYS provides on-site counseling services for approximately 130 K-8 students and their families at Campbell Hill, Lakeridge, Bryn Mahr, and Talbot Hill Elementary Schools and at McKnight, Dimmitt, and Nelson Middle Schools. Counselors generally work with children and their families for periods of 10 weeks to 1.5 years, with an average length of time being 20 weeks. While most counseling is one-on-one, counselors provide some group therapy around anger management and grief&loss. Families may receive additional therapy at other sites, including their homes or at RAYS' offices. The on-site counselors consult extensively with school staff and others involved in the life of the young people. 3. What outreach you will use to reach your target population Rites of Passage: RAYS Youth Development Specialists,who have offices on site at the target schools, work closely with school teachers and counselors to identify youth who are at risk of dropping out of school. The Youth Development Specialists then meet with the youth Page 8 individually to discuss the referral,to familiarize them with the program, and to ask for interested youth to bring back the authorization form signed by a parent or guardian. Participation is voluntary. Staff follow-up with youth and parents or guardians to ensure timely completion of the authorization packets and to answer any questions they may have. Counseling: School staff—including teachers,nurses, and counselors—are the primary referral sources for on-site counseling at the schools. Since RAYS counselors are on-site, they network regularly with teachers and other school staff. For example,they attend school staff meetings. Parents/guardians sign consent forms prior to treatment. 4. Discuss how your program relates to the need explained in the previous section The Youth Development&Prevention Program addresses school failure among at risk young people by strengthening the internal assets of children and youth—especially around social competencies and positive identity. Focusing on these assets strengthens youth resilience to cope with the many factors that place them at risk for school failure. Also, by delivering its services on-site at the schools, RAYS helps to transform the schools into more caring climate for children and youth. RAYS staff serve as invaluable resources to both students and teachers. 5. How the program addresses the language and/or cultural needs of clients: Rites of Passage's culturally and ethnically diverse staff are well-versed in current youth culture. The Counseling staff includes four counselors who are bilingual in English and Spanish, one who speaks Mandarin/Chinese, and one who speaks Hindi, Marathi, and French. 6. if you are making significant changes to your program or agency in 2007-08 please explain these changes and the rationale; and RAYS plans to expand Rites of Passage to Nelson Middle School. An expanded program staff will include a Resource Specialist to connect high need youth in the program (at all sites)to needed services, and to provide follow-up and mentoring for youth who leave the program. PATHS: RAYS is not requesting funds for PATHS this year, as changes in the academic day and curriculum do not allow time for this weekly, classroom-based program. RAYS is providing on-site social-emotional skills groups based on PATHS concepts for children identified by their teachers or school counselors. 7. Detail how this program will collaborate with other programs and/or agencies. RAYS has a long-term partnership agreement with the Renton Public School District and strategically places staff in schools where its services will meet the greatest need for prevention and early intervention programming. The decisions to implement Rites of Passage and the Counseling Program were made with input from teachers,parents, school staff and other . agencies from the Renton School District. RAYS has a contract with Highline Mental Health to provide psychological evaluations and medications management(and 24-hour crisis response, as needed)for the approximately 1/3 of counseling clients who require psychiatric interventions. Rites of Passage will work with the Domestic Abuse Women's Network(DAWN)to co- facilitate some of the group sessions that focus on healthy relationships. The Rites of Passage Program coordinates services with Communities in Schools of Renton for clients the two organizations have in common. Page 9 B. Performance Measures and Outcomes. (1 page maximum) List the performance measures which are.the outputs from your program (e.g. the number of home delivered_ meals) followed by the related outcome(s) of your program (e.g. increased ability of clients to obtain nutritious food) and the indicator used to measure the outcome (e.g. percent of survey respondents reporting that receiving home delivered meals makes it easier to get enough to eat). Rites of Passage A. Performance Measure: Youth Development Service Hours Outcome 1: Youth develop/strengthen resistance skills. Indicators • Youth gain awareness/understanding of the consequences of engaging in negative behavior. • Youth learn skills that enable them to make positive choices. • Youth resist/stop engaging in risk-taking, acting-out and/or criminal behavior. Outcome 2: Youth have positive relationships with adults and peers. Indicators: • The number of adult mentors for youth increases. • Youth report increased relationships with positive adults. • Youth are involved in pro-social activities with positive peers and adults. Outcome 3: Educationally at-risk students make academic progress. Indicators: • Students exhibit improved attitude towards school and learning. • Students show improved attendance. • Students show academic improvement on official school reports. Counseling B. Performance Measure: Counseling Hours Outcome: Youth/children with emotional behavioral disturbances develop/strengthen coping skills. Indicator: 75% of children and youth served will make progress in meeting their individual treatment plan goals. Page 10 C. Staffing Plan & Evaluation. (1 page maximum) i. Staffing Plan. Rites of Passage will include 3.75 FTE staff: a.half--time Program Director, 2 full-time Youth Development Specialists (YDS), a full-time YDS/Resource Specialist, and a 0.25 FTE Program Assistant. The Program Director supervises program staff while also serving as a YDS in one of the schools—a combination that ensures that the program continues to evolve in a way that is responsive to the needs of the target youth. The YDS work on-site at assigned schools, facilitating groups, providing individual mentoring for the youth, and interacting with school staff and parents/guardians. The YDS who is also a resource specialist will spend half of his/her time connecting youth to needed services, such as mental health and tutoring and in maintaining contact with youth who have left the program; this individual may also facilitate a group for parents/guardians of youth in the program; All YDS have extensive experience with youth in a variety of settings, including schools, youth groups,residential care facilities, and juvenile hall. The Program Assistant assists with data collection and recording and with family contact. During 12 years of work with RAYS, she has developed a solid reputation as a trusted advocate with the families served. The program will offer one internship position in September 2008 for a student from Seattle University. The intern will assist in co-facilitating groups at school sites and providing mentoring for some of the students. The program will have 1-2 summer interns to assist with planning and implementing the summer component. Counseling: RAYS has 7.9 FTE's who spend a part or all of their direct service time in school- based services in Renton and Tukwila. Seven staff have masters degrees and 1 has a bachelors degree. At present the non-intern staff have tenures that range from 2 to 12 years. All counselors are experienced in working within the school culture. Although RAYS employees, they are also accepted as part of the staff at their respective schools. They attend staff meetings and some in-service trainings and staff retreats. The program also benefits from 14 interns (3.5 FTE),who work on-site at the schools for 10 hours per week. Interns are enrolled in Masters degree programs at local colleges and universities. ii. Evaluation. RAYS evaluates outcomes of Rites of Passage at the beginning and end of the school year using an agency-developed tool focused on specific domains: youth involvement in pro-social activities, involvement with the juvenile justice system, relationships with adults, and attitudes toward school. The Program Assistant enters all data into an integrated system that enables RAYS to measure direct program outcomes. RAYS evaluates the Counseling Program based on behavioral-specific treatment plans with behavioral goals established by the therapists, along with parents and children. They evaluate progress.on the goals every 90 days. The Director of Clinical Programs works with line staff to gather appropriate data. A peer record review process in also in place to ensure that line,staff collect the "raw data" that is necessary for evaluation. Program Directors are responsible for ensuring that the raw data is compiled for their program area. The Director of Clinical Programs works with key staff to compile and analyze a semiannual 6-month outcome report that is reviewed by the Management Team and presented by the Executive Director to the Board of Directors. A portion of the report is an annual client satisfaction survey. The Executive Director also conducts a discussion with staff in each service area on at least an annual basis to determine program strengths and areas for improvement;together they develop action plans to address these areas needing improvement. Page 11 D. Differences in Service Delivery by City. (2 page maximum) Explain any differences in service delivery for this program among the cities that you are submitting this application to for funding. Explain any differences in the average cost of service per client.relative to funds requested by city as shown in the last column of Question 14c. This application reflects services in two cities, Renton and Tukwila. RAYS provides counseling/mental health services (a portion of the Youth Development and Prevention program) to residents in both cities. In both Renton and Tukwila, RAYS provides counseling services primarily (though not exclusively) on school sites during the school day to students identified by school staff as in need of services. The school sites are also often used as service sites after the school day for counseling services involving the families of clients. These locations promote easy and familiar service access. Clients may also be seen in their homes, or at the Agency's main office in Renton. RAYS provides a slightly different mix of school-based support and social skills groups in each city. In Renton, RAYS offers social skills groups for first and second graders as well as the Rites of Passage Program,targeting middle and high school students. In Tukwila,RAYS provides RAYS provides a Latina/teen support group as well as violence prevention groups (PATHS)for elementary school students. All of these school-based services have the intent and the outcome of positively impacting school performance as well as helping children, youth, and their families meet goals to improve interpersonal and social skills and behaviors. Service design and implementation reflect proven and best practice approaches as well as the benefits of long term integration of these programs in the communities we serve. In terms of the differences in the average cost of services per client, as indicated in Question 14c of the application,there is not a significant difference in service cost. The difference is nine dollars per client, less than 1% of the total cost. As a final note, the services described in this section are a significant portion of the total services RAYS provides in the cities of Renton and Tukwila, but do not include all of the services offered by the agency. The Agency offers a variety of parent support activities including parent education and support groups, as well as information and referral services, crisis intervention support, and emergency services. An increasing number of our clients face urgent needs for basic support services, such as assistance with housing. RAYS maintains a small fund to provide such assistance. Additionally, RAYS provides substance abuse treatment for youth in Renton. RAYS is not requesting City of Renton funding for these additional services, nor are these services included in the attached budget. However, these additional services are available to clients of the counseling and Rites of Passage programs. Page 12 11. LONG RANGE PLAN (1 page maximum) The Counseling and Rites of Passage programs are"core,"long-term programs of RAYS and have been a strong focus of the agency's current strategic planning process. This process has utilized extensive community surveys, key informant interviews, and focus groups to determine how well its programs are addressing defined and pressing community needs. The community has overwhelmingly expressed the need for expanded services in both the Rites of Passage and Counseling Programs. As a result, RAYS's long-term intent is to continue to collaborate with local school districts (Renton and Tukwila)to provide school-based services, and to continue to apply best practice principles in service delivery. The organization will continue its focus on diversifying staff to better address the needs of our changing populations and on continuing a broad range of ongoing trainings to enhance staff cultural competency. In the coming year, RAYS will expand Rites of Passage to an additional middle school. The strategic planning process has helped RAYS identify many potential collaborations, some in place, some to be initiated and developed. At present, RAYS collaborates with a group of 25 youth serving agencies in the Highline consortium for shared administrative, 24-hour crisis response, and training opportunities. RAYS also participates in a consortium of agencies that conduct outreach and education services to young families with newborns. RAYS works regularly at a line-staff level to coordinate services with Communities in Schools of Renton(for clients the two organizations have in common); staff have explored the possibility of hosting a common fund raising event. Expanded partnership development will help RAYS address growing client diversity while also offering a broader service mix to clients. The Rites of Passage partnership with Domestic Abuse Women's Network (DAWN) to deliver relationship/dating violence prevention services is an example of this type of partnership. Future funding: RAYS will seek to continue a broad mix of public and private funding sources for each program. Projected funding for the Counseling Program in the next 3-5 years (and beyond) includes: Medicaid mental health funds, cities of Renton and Tukwila, and United Way of King County (they increased RAYS' funding this year for serving high risk groups). Projected funding for Rites of Passage in 3-5 years will include: City of Renton,King County Public Health(King County Community Services Division),United Way of King County,proceeds from RAYS' annual dinner, and private sources, such as foundations, corporations, and individuals. Each of the funding sources above has worked with RAYS for a minimum of 8 years to date. While RAYS expects continued public funding, it also recognizes that funds from these sources will mostly likely remain flat or may even decline over the next 3 to 5 years. As an outcome of its strategic planning process (to be completed in June 2008)RAYS is planning a major capacity building effort to increase its donor base (individuals, foundations, corporations, and other private sources) and further the development of an effective marketing plan. The capacity building effort will include technology, staffing, marketing materials, and board development. RAYS is also developing a plan to increase volunteer resources,particularly in the Rites of Passage program over the next 3 years, and long term. Page 13 12. BUDGET (2 page maximum) A. Budget Request Narrative. In this section of the application narrative, provide a short paragraph explaining how your requested funds in Question 17 will be used. RAYS will use requested funds to support its Counseling and Rites of Passage Programs which are part of the overall Youth Development and Prevention program. Each of these long-term, successful programs addresses the needs of high risk children, youth and their families. Funding will pay for staffing costs, including salaries, benefits,payroll taxes, and other operational costs of the programs. There is a new staff position reflected in the 2008 and the 2009 budget in the Rites of Passage program, and some normal staff fluctuations anticipated over the next 2 years. B. Changes to Budget. Explain any significant changes between 2008, 2009 and 2010 expenses or revenues as noted in Question 17. Are there any known or anticipated changes to the program's 2008 Budget since adopted? There are no significant(20% or more)budget changes during the funding period. RAYS anticipates hiring an additional Rites of Passage staff person in the fall of 2008. This position will be supported by United Way funds, foundation funding, and proceeds from the Seattle Post Intelligencer Readers Care Fund, of which RAYS is a recipient agency. The budget also notes that income from King County governmental sources will decline slightly over the 2008-2010 timeframe. The intent is to offset these funds with private funds from the United Way, foundations, individuals, and other private sources. Our current strategic planning work is focused on capacity building for increased private fund development from individuals, businesses, and foundations. On chart 16 (Program Staff) there is a decline in the total number of staff FTEs between 2007 and 2008. The decline is due to the conclusion of one of RAYS' counseling programs (Functional Family Therapy) which was funded through a special contract in 2007 but not in 2008. Additionally, RAYS has a vacant counseling position in 2008 that will be left vacant for the year and filled in 2009. Renton is requesting less funding from Tukwila in 2009 than in 2008 due to the reduction in service levels in 2009 for PATHS and the Latina groups it offers in Tukwila schools. Both of these programs will be provided at a reduced level due to changes in the school curriculum structure and available space to do groups at the schools. C. Cost per Service Unit(s). You should provide an estimate of your cost per service unit provided by the program you propose. Explain how your cost per service unit was determined. These should be based on the total cost of the program and the total number of clients served, not just the funds requested. You have the option of providing a cost per service unit for each separate service provided within the program. Cost per Service Unit: $1,686, Page 14 Explanation of method of determination: The cost per unit of service for the Youth Development &Prevention Program is based upon dividing the Total Program Expenses as given in the application budget for.2009_($689,495).by the total-.number.of clients served in Renton, Tukwila, Kent, and unincorporated King County for 2009, as indicated on page 13 (409 clients total). The cost per unit(per individual served) is $1,686. This cost, when"unwrapped."reflects services delivered by a highly skilled, diverse staff to an even more diverse clientele facing a variety of challenges. Our clients are low-income, and they bring abroad variety of social and emotional issues, as well as personal assets and strengths. The unit cost involves a package of services, including an average of 20 mental health sessions per year for clients in that portion of the program. Many clients engage in many additional sessions and also benefit from other kinds of assistance included in the cost structure, including emergency services,crisis intervention,psychiatric services, and medication management. Rites of Passage clients will participate in weekly group sessions during the school year as well as individual sessions to reinforce concepts presented in the group and to engage in individual goal setting and mentoring. They will also participate in supervised community service and team building activities during the summer months and other school break periods. The service costs for each individual are indicative of a variety of services, some of which are a formal part of the program for all, some of which are individually tailored. More than 20% of children, youth, and families served will strongly exceed the average service hours. The program described is an intensive, long term intervention service that reflects the level of need presented by those requesting our assistance. The cost of providing an hour of Rites of Passage is slightly less than the cost of providing an hour of counseling due to a small salary differential (counselors receive a slightly higher salary), and the fact that much of the Rites of Passage program is group work while counseling is one- on-one. Page 15 Agency:RAYS Program:-Youth-Development & Prevention Program 13. NUMBER Of INDIVIDUALS/HOUSEHOLDS SERVED BY PROGRAM Z Individuals? or Households? (Check which applies and use for reporting all demographics.) Unduplicated *Unduplicated Number of all Clients Served by Clients Served All Funding Sources with Funds Requested 2007 2009 2007 % of column 1 2008 2009 (City Requested (Actual) clients served (Anticipated) (Projected) Funding Only) by City Auburn Burien Covington 2 0 0 0 0 Des Moines Enumclaw Federal Way Kent 2 0 2 2 0 Renton 125 27 160 165 33 SeaTac Seattle Tukwila 223 48 125 142 33 Other (KC) 110 25 100 100 100% Total 462 (This column must 387 409 66 total 100%) *Unduplicated means count each client only once per calendar year per program. This number should match the number of clients by city indicated in the top row of Question 15. Page 17 Agency:RAYS Program: Youth Dev. &Prevention 14. Performance Measures i - Average Cost of Service (Data Tables) This information will be used by each City to develop 2009-10 contracts with funded agencies. 14a. Your Performance Measures should reflect numbers based on the funding you are requesting from each City. 14b. In the space provided, define at least one (1) and no more than three (3)performance measures the program will report with a brief explanation. Do not use Unduplicated Clients/Households as a performance measure. Provide the estimated number of clients/households served by city your program plans to provide in the corresponding column for each of the performance measures listed. Estimate the number of units to be provided for each measure annually. Provide accurate and realistic estimates. These estimates will be the basis of your contract if funded. 14c. Complete the table with the city funds requested in Question 6 and the unduplicated clients served with funds requested by City listed in the last column of Question 13. Explain any differences between the average cost of service per client between cities in Question 10.D. of your application. Page 18 Agency: RAYS 14 Performance Measures (Data Table) Program: Youth Dev. &Prevention 14a. Service with 2009 Requested Funds _ Proposed Performance Measures as defined below. A) Youth Development Service Hours (Rites of B) Counseling Hours C) Passage) Auburn Burien Covington Des Moines Enumclaw Federal Way Kent Renton 750 250 SeaTac Seattle Tukwila 800 Z�z.. . x ,_: � My - it ., n _"_ ��sy,.� - ti••LL"'i�'�' la i_ p, 1- [U .__�t0 Q _��.W� 7 1� '� �` J - r J p.R o � li sa F.,.Q� Cy��� ���,1 L"�)� 9 0 u o �(:.{��'�a�tt ai�o��{ oLC�,C,�t� rI G� In 1��7ial,ni�a 0 �' �tM4 _'�;."fWV:. r,; 5�w A kfi 'tx • '�,��,Nr` rig, .: z, -7 t, '" + Title: Brief explanation: A) Youth Development Includes intake, assessment, group work, one-on-one mentoring, Service Hours (Rites of community outings, parent/guardian contact, follow-up contact, and Passage) evaluation of results. Includes include intake, assessment, counseling, case management, B) Counseling Hours family contact, and evaluation of results C) • Page 19 Agency: RAYS 14 Performance Measures (Data Table), Cont. Program: Youth Dev.&Prevention 14c. Average-Cost-of Service Unduplicated Clients Served with Funds Average Cost of Service Requested 2009 Requested 2009 per Client (Same as last column of (Same as last column of Question 6) Question 13) Column 1 divided by Column 2 Example: $5,000 45 $111.11 Auburn Sur,ien Covington Des Moines Enumclaw Federal Way Kent Renton 55,350 33 1,677 SeaTac Seattle Tukwila $55,130 33 1,671 Page 20 Complete Question 15 with 2007 Actual numbers reported in column 1 of Question 13. Agency: RAYS 15. Demographics (from all funding sources) (Data Table) Program: Youth Dev. &Prevention £ -- r� 4 0 ~ N [�v�N� r ' s` r 3"i .-fl v] "t N N cd Cd ct: CNI 1 3 0,3 outs ofU*,.,... o o N 0 0 o N � o o N cv'n } 60 i ,'Ihi I TN9�CZ 3Y ° f 4 x ,'i ,Fµ 0 P'' ,I AP* v .,7;.. .ir _.�.'124 f ....... S�aL -3 it Unknown80%of Median or Below 11 13 24 ,„•, ,l- • 1tI1t1Iiliit1iIi 4'''� 54'SSA V*.sft`` .:S'� {'- . ,t.-.r '. A �� .fit,', .=,*4 ,rF�=;.x.. 'aA • •8�b,el ,w"° a.� ��.S ... _ r'Q" ,'ems. a'<7i Y a,.._ .�:. r,,.,u3.� ,,. .. 149 228 72 11 35-54 years 55 -74 years 75+years Unlcn•wn TOTAL 2 2 125 223 352 kg' t) I y u4 , ,^r t .. ,,.... z, s' f ` .,tL r r "S i .;fit, i` 1 Asian 2 22 24 Black/African American 1 35 26 62 Hispanic/Latin• 18 90 108 Native 4 4 Pacific Islander 1 1 1 1 41 65 108 Other/Multi-Ethnic 1 28 16 45 TOTAL 2 2 125 223 352 "='I ias I�Ic `k ; 2 1 55 48 106 ' Piltidr 6V • I :411.Jo�l11HI ,,Q I IS . ;^ry 3 9 12 n u: f''i ea1{r, of ,,afrj it 1 1 12 28 42 * Check Individual or Household,which should be the same as checked in Question 13. Unduplicated means count each client only once per calendar year. This should match the number served by City in the Actual 2007 column of Question 13. The - "total"column will be different from Question 13 since the"other"column is not included due to space limitations. _ Page 21 16. PROGRAM STAFF (DATA TABLE) In this data table, record the number of full-time equivalent(FTE)paid staff and volunteers for this program. FTE means a 40-hour week throughout the entire year. For example, if you enter"5" in the box for.:Number_of_Volunteer FTEs, this would mean that you have,_on average, five volunteers assisting your program at all times (assuming a 40-hour week). If you know only the total number of hours contributed by all volunteers.for this program, simply divide that number by 2,080 to find the total FTE number. For example: 5,000 volunteer hours over the course of a year, divided by 2,080 equals 2.4 FTEs. 2007 2008 2009 (Actual) (Budgeted) (Projected) Total Number of Staff(FTEs) 12.65 10.65 11.65 Number of Volunteer(FTEs) 4.00 3.30 3.50 Actual Number of Volunteers 20 16 17 17. PROGRAM REVENUE & EXPENSE BUDGETS (DATA TABLE) Program Budget: All columns should include total program operating revenue and expenses. Complete the following data tables with figures indicating the source of program operating funds for 2007 (actual), 2008 (budgeted) and 2009 (projected). Budget amounts should match funding requested (Question 14c) and Question 5. Include an explanation of any significant differences between the revenues and expenses by year in Question 12B of your application. Page 22 Agency: RAYS 17. PROGRAM REVENUE BUDGET (DATA TABLE) Program:Youth Dev.&Prevention Revenue Source 2007_ 2008 2009 (Actual) (Budgeted) (Projected/ Requested) . City Funding(General Fund & CDBG) • Auburn • Burien • Covington • Des Moines • Enumclaw • Federal Way • Kent • Renton 55,350 55,350 55,350 • SeaTac • Seattle • Tukwila 60,620 60,620 55,132 • Other (Specify) ; • Other (Specify) Other Government Funds • King County 528,281 506,500 503,500 • Washington State • Federal Government(Specify) la Other(Specify) F Private Sources ` f _ • United Way(grants & designated donors) 10,000 20,000 30,513 • Foundations and Corporations 10,000 15,000 30,000 • Contributions (e.g., Events, Mailings) 13,269 12,945 15,000 • Program Service Fees (User Fees) • Other (Specify) TOTAL PROGRAM BUDGET 677,520 670,415 689,495 Page 23 17. PROGRAM EXPENSE tUDGET, CONT. Agency: RAYS (DATA TABLE) Program: Youth Dev. &Prevention Expenses 2007 2008 2009 (Actual) (Budgeted) (Projected) Personnel Costs 05P ';s�,,',, Pil t ,r, • Salaries 468,300 481,086 502,000 • Benefits 50,975 42,569 . 41,565 • Other/ PR Taxes 36,600 34,815 36,740 • Total Personnel 555,875 558,470 580,305 Operating and Supplies r,; ,e 1 . 1, . tr'4' • Office/Program Supplies 17,600 16,600 16,000 ei Rent and Utilities 42,000 39,240 39,240 ■ Repair and Maintenance • Insurance 10,250 10,250 10,000 . Postage and Shipping 1,725 910 1,000 • Printing and Advertising 7,750 4,065 4,000 • Telephone 5,800 6,800 6,500 • Equipment • Conference/Travel/Training/Mileage 9,050 8,610 8,000 ▪ Dues and Fees 450 450 450 6,000 4,000 4,000 • Professional Fees/Contracts • Direct Asst. to Individuals • Administrative Costs • Other (specify)/Depreciation 21,020 21,020 20,000 . TOTAL PROGRAM EXPENSES 677,520 670,415 689,495 Net Profit(Loss) -0- -0- -0- , (revenue-expenses) = Page 24 Agency: RAYS 18. SUBCONTRACTS (DATA TABLE) Program:Youth Dev. &Prevention List all the agencies you will be subcontracting with for this program. Provide the agency name in the first column,-a description of the contract/service in the second column, and the contract amount in the third column. Do not list agencies you coordinate with on a referral only basis. Indicate not applicable if you do not subcontract for any part of this program. Subcontracting Agency Specific Subcontracted Activities Contract in the Operation of Your Program Amount N/A -0- N/A • Page 25 19. APPLICATION CHECKLIST Applications missing one or more of the following components or not following these directions may not be reviewed. Sign and submit the application checklist with your application. Contents (Your application should contain each of these items in this order.) El Application Cover Pages.The top three pages of your application must be a completed copy of the Agency Information and Questions 1-7. Application Narrative: Q Question 8 Organizational Experience(2 page maximum) Q Question 9 Need for Your Program(2 page maximum) Q Question 10 Proposed Program/Service(6 page maximum) Q Question 11 Long Range Plan(1 page maximum) Q Question 12 Budget(2 page maximum) Data Tables Q Question 13 Number of Individuals/Households Served Q Question 14a-c Performance Measures and Average Cost of Service Q Question 15 Demographics(from all funding sources) Q Question 16 Program Staff Q Question 17 Program Revenue&Expense Budgets El Question 18 Subcontracts ElRequired documentation. Supply one copy of the following required documents with the signed original application. See Part II: City Specific Supplemental Information to determine whether additional copies of the application and required documentation need to be submitted. El Question 19 Required Documentation, including: • Proof of non-profit status ■ Organizational Chart ■ Agency/Organization Mission Statement ■ Board resolution authorizing submittal of the application(may be submitted up to 60 days after application). • List of the current governing board and local board, if applicable,(include name,position/title, city residence, length of time on the Board, and expiration of terms. Note any vacancies.) • Board Meeting Minutes of last three board meetings of governing board and local board as applicable • Annual Budget ■ Financial Audit Cover Letter ■ Financial Audit Management Letter • Financial Statement • Verification of Non-Discrimination Policy • Program Intake Form • Sliding Fee Scale El Application Check List. (Signed below.) OCity Specific Supplemental Information.Required in Name: Richard Brooks Part II for applicable City only. Position: Executive Director Phone#: (425)271-5600 ext.24 K-117 E-mail: richardb@rays.org Signature of Person Completing Checklist DO NOT SUBMIT ANY OTHER MATERIALS WITH THIS APPLICATION Make sure that you carefully check Part II of this application to see what additional attachments each city requires. Page 26 ADDENDUM: APPLICATION SUPPLEMENTAL QUESTIONS (1 page maximum per question) 1. Select one result that is the best fit for the program. Identify what strategies and activities will achieve the result. You can choose from the strategies and activities that Renton has already identified or you can identify your own. IF you use your own,you must cite best practices or research as to why you think they will work. Mo Za children and out i EG read, CIE e i ucational success wor . o NI Strategy A: Increase the number of Developmental Assets for Children and Youth: ACTIVITIES: 1) Increase youth opportunities to learn about community engagement through mentoring,job sharing, and leadership training. Rites of Passage involves youth in many volunteer opportunities that help build self-esteem and sense of purpose. 2) Support a variety of mentoring programs. Rites of Passage includes bi-weekly individual mentoring to assist youth in building internal assets. The program works on key skills, including anger management, non-violent conflict resolution, resistance to peer pressure, and choice making. By addressing issues that get in the way of school success,the Program opens the door to and builds a commitment to learning. 4) Expand the pool of adults who will help teens/youth get involved. RAYS Youth Development Specialists serve as caring,positive adults in the youths' lives by mentoring youth on a regular basis. Strategy B:Families and children have services and programs that support their success in school and ' access to them: ACTIVITIES: 2. Increase access to resources and support in a user-appropriate, understandable manner. RAYS provides school-based services that are easily accessible. RAYS provides all of the proposed services on-site at the schools and has culturally-competent staff who help make the services accessible to students of all backgrounds. The availability of on-site services helps transform the schools into more caring and safe climates. Page 27 2. Describe how the program outcomes as identified on page 9 of the application narrative will help achieve the selected result. Rites of Passage: The Rites of Passage Program pursues three outcomes that directly impact youths' readiness for success in education, work and life: 1) Youth develop/strengthen resistance skills; 2) Youth have positive relationships with adults and peers; and 3) Educationally at-risk students make academic progress. Some tangible ways that the program helps youth achieve these outcomes include: • Youth Development Specialists provide mentoring on a regular basis for each youth,providing a consistent,positive, adult relationship in that youth's life. The program encourages long-term follow-up so that the Youth Development Specialists can continue to provide guidance to the youth, even after they leave the program. • Youth engage in numerous positive activities—including service projects and team-building activities—with their peers. In collaboration with Domestic Abuse Women's Network(DAWN), Rites delivers a powerful relationship skills curriculum that also promotes positive relationships. • The weekly Rites of Passage groups that meet on-site at the targeted schools provide youth with opportunities to develop and practice resistance skills. The groups focus intensively on the power of oneself, relationships, and community. • The program helps youth to set and pursue individual academic goals. The Youth Development Specialists will arrange services, such as tutoring, as needed. The program encourages youth to think beyond high school by taking the youth on college visits and exposing them to career options. By virtue of being a school-based program,Rites of Passage indicates the importance of succeeding academically. Program staff have strong networking relationships with school staff. • The program specifically targets youth at risk of dropping out of school and provides support services and encouragement so the youth will be more likely to stay in school. Counseling Program: The selected outcome for this aspect of the overall program is "Youth/children with emotional behavioral disturbances develop/strengthen coping skills." This outcome will help achieve the selected result by addressing behavioral, emotional, and mental health issues that get in the way of succeeding in the school environment. For example,numerous studies have determined that children impacted by traumatic events have difficulty concentrating and learning. The Counseling Program works with these students to address the trauma and help the children learn coping skills. Examples of treatment plan goals that promote educational success are "to attend school regularly," and "to increase and maintain school performance." Page 28 -1 internal Revenue Service _Department__of-.the-Treasury District-DiretOf Date: JUL 2 1 1993 Employment Identification Number: .51-0152621 Person to Contact EOMF COORDINATOR," Ardiega Contact Telephone Number: WO (213)7?5-1235 ' RENTON AREA YOUTH AND FAMILY SERVICES Internal Revenue Code Section: so1(cx 3 1025 S 3RD ST • RENTON, WA 98055-2765 — Dear Taxpayer: • • Thank you for submitting the information shown below or on the enclosure. We have made it a part of your file. The changes indicated do not adversely affect your exempt status and the exemption letter issued to you continues in effect. Please let us know about any future change in the character, purpose, method of operation, name or address of your organization. This is a requirement for retaining your exempt status. Thank you for your cooperation. Sincerely yours, • Item Changed From To • (NAME) (SEE ABOVE) • • RENTON AREA YOUTH SERVICES • • • • • • McCASLIN INDUSTRIAL PARK 2 C U P AN I A CIRCLE' Lett®r 976(D0)(Rev. 1-87) L `MONTEREY . PARK, CA 91754-7406 Inter .._.. • District Director P. 0, Box 21224 Seattle, WA 98111 1, Date: Our getter Dated: APR 2 6 1979 August 27 . 1975 Parson to Contact: Sandra L. Burger • Contact Telephone Number: . (206) 442-5110 D. Renton Area Youth Services • 1525 North 4th Street Renton, WA 98055 • Gentlemen: • This modifies our letter of the above date in which we stated that you would be treated as an organization which is not a private foundation until the expiration of your advance ruling period. Based on the information you submitted, we have determined that you are not a private foundation within the meaning of section 509(a) of the Internal Revenue Code, because you are an organization of the type described in section *see below . Your exempt status under section 501(c) (3) of the code is still in effect. Grantors and contributors may rely on this determination until the • Internal Revenue Service publishes notice to the contrary. However, a grantor or a contributor may not rely on this determination if he or she was • in part responsible for, or was aware of, the act or failure to act that. resulted in your loss of section 509(a) (1) status, or acquired knowledge that the .Internal Revenue Service had given notice that. you would be removed from classification as a section 509(a) (1) organization. Because this letter oould help resolve any questions about your private foundation status, please keep it in your permanent records. If you have any questions, please contact the person whose name and telephone number are shown above. . Sincerely yours, Arturo A. Jacobs • District Director • *509 a 1 and 170 b 1 A vi , • • 915 Second Avenue, Seattle, Wash. 98174 Form L-399 (Rev. l-7f Renton Area Youth & Family Services Board of Directors Executive Committee Executive Director Richard Brooks Director of Family Support Program Assistant Director of Development Associate Director of Services Darlene Frank Carol Sanford Clinical Services Jennifer Moore Carol Reich I I Family Support Programs Clinical Program Substance Abuse Cynthia Green Director Program Coordinator General Counseling Billie McKibben Dipti Sarniak Steve Olson Howard Schafer Preston Credit School-Based Services School-Based Services Counselor Renton ROP Tukwila Healthy Family Prog. Jennifer Kijanka Jennifer Moore Lisa Christensen Nancy Dannemiller Gabriela Leon Daimen Crump Joanne Fromhold Jacque Rodriquez Anne Magnin Danielle Dufault Counseling interris Administrative Jason O e Parenting Prog. Keola Oka Billie McKibben I Assistant Sarah Ramstad Heidi Torres Kyle Isaacson Interns Jessica Leith Lindsey Goodman Freida Fenn Shawnda Butterfield Sarah Smith Kara Jennifer Bloomgarden Spore Lisa Tarrach Jennifer Melby Jamie Severson RAYS Organizational Chart Revised 4/16/08 , ... J . . RENTONAREA YOUTH & FAMILY SERVICES AGENCY VISION&MISSION RAYS Vision: "Every family living in health and hope within a supportive community." RAYS Mission: "To positively impact the lives of children and to strengthen families by providing family support, substance abuse and mental health services in Southeast King County." RAYS Values: RAYS values the quality of service rather than the number of clients we serve. Our service models reflect this value and are focused on individual service plans that provide the intensity level of services needed for stabilization and rehabilitation to maximize the self-sufficiency of the child and family. The majority of children and families we serve meet the categorical definition of"living in poverty"and our focus is to meet the needs of all community members during their most vulnerable times. Our services are provided on a sliding scale fee basis and no one is denied our services due to inability to pay. WE IMPLEMENT OUR VISION&MISSION THROUGH OUR COMPREHENSIVE SERVICES SUMMARIZED BELOW Child and Family Counseling/Mental Health Services Substance Abuse Counseling: We provide mental health wellness services to children and their families at our Renton office, in school locations(16 schools are staffed by RAYS), in the homes of clients and in the community. Services may include individual and family counseling, case management and referral services, advocacy,psychiatric services, group counseling and 24 hour crisis services. Family Support: Parenting for Success Project: This is an ongoing comprehensive, community-based, violence prevention,parent-education and support program. These services are provided at community schools, churches, and other locations to better reach community members. Parents are provided with on site childcare to allow them the ability to participate in program services. Family Support: Case Management Services: Community members can walk-in and access resources and information at our RAYS West Hill Family Enrichment Center. This includes monetary assistance for rent and utilities to community members in need. Technology Center: We provide community access to technology through our RAYS West Hill Family Enrichment Center Technology Lab. This is provided free to the community and is used for job search assistance and resume building.As well, it is used for activities such as school assignments for youth who do not have the financial ability to otherwise access technology. Family Support We work in partnership to provide community access and services Partnerships: through the following programs: Best Beginnings:RAYS participates in a partnership with King County Public Health to provide in home mental health services to pregnant and parenting teens. The focus is to provide the optimum home environment and parentingfor developing infants and children during their most vulnerable first five years of life. Services include individual and family counseling, case management and referral services, general support, and advocacy. This program is designed on the researched "Best Practice"olds model of intervention. Violence Prevention Project: Rites of Passage: This program focuses on prevention and rehabilitation of youth to make healthier life choices. The youth participating in this program are those identifies as "at-risk for youth violence"by the legal and/or school system. Services include group education, connecting these youth to their community through volunteer projects, and employment opportunities. This program is based on researched"risk and Protection"factors shown to be both practice focus areas. For more detailed information regarding RAYS services and how to support kids in your community through volunteerism and/or donations,please contact RAYS Development Director David Downing at(425)271-5600 ext.21.Thank you for your interest in helping children through RAYS. Board Authorization for Submittal of Application to the Cities of Renton and Tukwila for 2009-2010 General Funds 040860 Motion: That the Board of Directors authorizes the submission of the applications to the Cities of Renton and Tukwila for human service general funds by Renton Area Youth&Family Services for the 2009-2010 funding cycle. These funds support the Youth Development and Prevention Programs. O,re1 seco-nda 6—0-0 Motion passed: Action taken at the Renton Area Youth&Family Services Board meeting of April 22, 2008. .71,11;4 ?All/4441Q Melinda Lawrence President, RAYS Board of Directors 2007-09 RENTON AREA YOUTH AND FAMILY SERVICE BOARD OF DIRECTORS PRESIDENT: Melinda Lawrence V.PRESDENT PROGRAM POLICY: Mark Bratton SECRETARY: Joan Matheson TREASURER: Carolyn Parnell NAME ADDRESS PHONE AFFILIATION TERM POSITION Bonnie H-12402 SE (wk)206-382-3722 Community Rep. 2008 No email Harger160th (H)425-255-8419 Retired Bookkeeper, Served on the (Caucasian) Renton,WA. Horizon House Board for 98058 W-Retired Health 25 years Care Joan 11302127t (wk)206-283-8443x210 Associate Exec. 2009 Secretary Matheson Ave.W (H)206-283-2422 Direc. of Seattle Served on the Seattle,WA. jmatheson@washingtonea.org Education Assoc. (Caucasian) 98199 Board for 8 W-Seattle Educ. years Assoc. 720 Nob Hill H. Seattle,WA . 98109 Carolyn H-16718 133rs (H)425-254-2499 Community Rep. 2009 Treasurer Parnell P1 SE Renton, (W)425-204-2801 Valley Medical Center Served on the (African 98058 CPAR2634 a aol.com Board Board for 5 tt American) w D le Sch years Middle Sch 12320 8(1 Ave S Seattle,WA 98178 _ Suellen W-311 Morris (H)206-448-0448 Attorney/Family Law. 2008 Howard Ave.S. (W)425-228-8899 CASA/KC Court Renton,WA suellenhoward a aol.com (Caucasian) 98055 Intunan Theatre H 1942 Westlake Board Ave#1509 Seattle WA 98001 David H-11507155th (H)425-235-5076 Renton Ed. Assoc. 2008 Schneider Ave SE (W)425-204-4939 Talbot Hill Elem. Served on the Renton,WA. (Talbot Hill) Teacher PTA, Board for 6 (Caucasian) 98059 At work thurs&fri W-Talbot Hill davebschneider@yahoo.com.yahoo.com Ventures Adv. Board years Elem . 2300 Talbot Rd. S. Renton,WA 98055 Kathy H 532 Cedar Ave. (H)425-255-0936 Mayor of Renton 2008 Served on the Keolker S Renton,WA (W)425-430-6500 Board for 2 98055 (Asst.Margaret Pullar) (Caucasian) W-Renton City Kkwworld a.aol.com years Hall mpullar@ci.renton.wa.us Melinda H-2623 Aberdeen (C)425-306-6636 Renton Community 2009 President Ave NE Renton, (W)425-277-3039 Representative Lawrence WA 98056 paviawinc@msncom (Caucasian) W-The Whistle Stop Business Owner Ale House 809 S.4th St. Renton,WA 98055 Confidential— internal Use Only Mark H 5409 NE 2"`' (H)425-204-9716 Owner of Blueline 2009 Vice Preside];, Ct_Renton 98059__- (W_)425-255.5005 __ -. _-- ----Communications Program BrattOri W Blueline (Caucasian) Communications Policy • (President Elect) Sara Barbee H 20130t Ave S. (H)206-325-8500 2009 #202 Seattle,WA sabarbeel@msn.com 98144 • • Confidential— internal Use Only Board of Directors 51-0152621 990-2006 Name Term Length of Term Residence David Schneider 1/03-12/08 2 years Renton Bonnie Harger 1/04-12/08 2 years Renton Joan Matheson(secretary) 1/03-12/09 2 years Seattle Carolyn Parnell(Treasurer) 1/04-12/09 2 years Renton Suellen Howard 1/03-12/08 2 years Seattle Kathy Keolker-Wheeler 1/04-12/08 2 years .Renton Melinda Lawrence(president) 1/06-12/09 2 years Renton Mark Bratton(vrresident) 1/07-12/09 2 years Renton Sara Barbee 11/07-12/09 2 years Seattle As of March 2008 the Board of Directors has 2 vacancies. RAYS Board of Directors Meeting Minutes November 27, 2007 Members Present: Melinda Lawrence, Carolyn Parnell, Sara Barbee, Dave Schneider, Suellen Howard. Proxy:Mark Bratton Members Excused: Bonnie Harger, Joan Matheson, Kathy Keolker. Staff Present:Rich Brooks, Carol Sanford The meeting was called to order at 6:00 pm. 1. The minutes of September 25, 2007 were approved. 6-0-0. 2. Committee Reports a) Fund Development Committee—Carol Sanford. Carol provided an update of the planning for the may 31, 2008 auction, as well as the November 151 event recognizing companies who adopt families. The latter was a first time event that went exceedingly well. b) Strategic Planning—Suellen reported that the committee is working on a community input phase involving key informants, surveys, and focus groups. This phase is to be done by January 15t. 3. Board Education—Rich • Rich Discussed RAYS involvement in the Healthy Start Program. The program involves home based outreach and support for parents with children, birth to 3 years. 4. Director's Report—Rich • Rich discussed RAYS selection as an agency to participate in the Post Intelligencer Reader's Care Fund this year. This will mean a significant financial gift as well as great public relations. Rich also talked about staff departures and the hiring of new staff at the Family Center and the counseling program. 5. New Business • 2006-07 Audit. The Executive Committee recommended acceptance of the audit. • 110759 Motion: A motion was made to have the full Board accept the 2006-07 Audit as presented. The motion was passed 6-0-0. 6. Other Business • The December meeting: It was decided that the Board would not meet in December. The meeting adjourned at 7:15 pm. Submitted by Rich Brooks, Recorder. RAYS Board of Directors Meeting Minutes January 22, 2008 Members Present: Melinda Lawrence, Sara Barbee, Dave Schneider, Suellen Howard,Mark Bratton. Members Excused: Joan Matheson, Carolyn Parnell. Members Absent: Kathy Keolker Staff Present:Richard Brooks, Carol Sanford, Jennifer Moore. The meeting was called to order at 5:40 pm by Melinda Lawrence. 1. Approved minutes for January, 2007. 5-0-0. 2. Committee Reports: • Suellen Howard—Strategic Plan. The committee is doing interviews of community members for the environmental scan. A committee meeting will take place in early February. An emerging theme is the need for an increased marketing of the agency. • Carol Sanford—Fund Development. Carol reviewed the status of the fund raising event in May 2008. A press release will go out to request nominations for the RAYS 4 Dope Award. Suggestions included Rich Roodman and Don Jacobson. Nominations will be gathered by staff and presented to the Board for consideration at a future Board meeting. Carol also reported that income for general agency solicitations was up significantly 40+ gifts at an average of$140. 3. Board Education • Jennifer Moore,the Coordinator of the Rites of passage program, did a presentation on the program. 65 at risk students are served at five secondary schools in Renton. The program intent is to provide support to youth to set personal goals and work to realize them. There are increased participant volunteer activities, and early work on a Rites Alumni program. 4. Director's Report • Richard Brooks reviewed the new Healthy Start program in which RAYS is a partner with 6 agencies to provide home visitation services to parents with newborns. We will be hiring a bi-lingual Spanish speaking staff for that program. Rich also noted that we received a$1,000 grant from the Renton Community Foundation for utilities and housing support for clients. 5. Old Business • A general discussion took place re recruitment of Board members. 6. New Business • None at this meeting. 7. Adjournment The meeting was adjourned at 7:00 pm. Submitted by:Rich Brooks,Recorder - . , ......'' . ... ,.. , . . . . . . . .. . .- -. . . . . . . . . .-... .. . . . . . . . _ .. . . . . . . .. . . . . . .. '....• ' ' ... . .. . . . . . . . . . .. .. . . . . . . . . . .,. - .. . . , .. . . . . . . .. • . . . - . . .. . ... . . . . . . . , . . ,... . . • ... . . . . . , . . . . . , . . .. . . . . . . . • --".. .' . . . ,. . . . , • . ... ,.. ..... .". ,. . . . . .. . . . . . .. . . . . . . . . . . . .. . .. . . . . . . . . .. . . . . . . .. . . . . . . . . . .. .." . . . . . . . . .. . . . _ . .• .. . ., . . .. . . . . . . .. . .. . . _ . . . . . •. . . . . . — . . • .... . . . . • : . . — . . . . . . . . . . . .. .. .. . . . . . . t . . . .. . .. . . . . . . . . . . .— .. . . . . . . .. . . . • ... . .— . . . . . . .. . . . . .. . . . . • • . . . . . . . . . • .... . . . . - — . . . . • .. . .. . . . . . . . . . . . . . . .,... . . . . . •. ... . . . . . . . . — .. . . . . . .. . . - .. •. . • .. . .. . . . .. . •. . — . . . .. .... — ... e . . — . . . . . •. . —. . . . . • .,. . . . . . . . . . . :".... . . . .. . . • . ..... . . . . . .- . . . . .... - - . . . . ... . . . . e . . . . . . . . . . . .... .. . ... . —. . .. . . . .. . . . . . . . .. — . . .. — . . . . . .. . . , . o . . . . . . . .. . . . — . . . .• . . . . . .. . . . ..... • . . — . . . . . • .., .. . ,... . . . .... . .._ . . . . . . . . . . . . . . I • .. • .. .. . . . . • . —. .. . t „ . . . . • — . . . . . . .r . . . : . . . . . . . . . . • . • . — • . . . ..- . RAYS Board of Directors Meeting Minutes March 25,2008 Members Present: Mark Bratton, Carolyn Parnell, Dave Schneider, Sara Barbee, Suellen Howard, Melinda Lawrence. Members Excused: Bonnie Harger, Joan Matheson, Kathy Keolker Staff Present: Carol Sanford,Rich Brooks on vacation. Meeting called to order at 5:35. 1. The minutes of January 22, 2008 were approved 6-0-0. 2. Committee Report a) Strategic Planning—Suellen Howard. All results from the community survey, key informant interviews, and focus groups (environmental scan) have been complied resulting in no major surprises. RAYS is perceived vary favorably, work done highly praised. Lack of marketing biggest short coming. Need to do more of what we do. Next step to revise mission and values. b) Fund Development—Carol Sanford. Update on auction. Press release for RAYS 4Hope honoree did not result in generating person known in the community. Susan Richards from Communities and Schools was selected by the Board as our honoree. Carol provided list of auction items, values, possible values, she is continuing to solicit items. Discussion of contact with Bob Bridge for sponsorship. 3. Board Education—Gabriela Leon. Spoke about the Healthy Start Program which is a home visitation for families with newborns to 3 years. She explained her background, type of services she provided for her first 3 families. This program is done in collaboration with Friends of Youth and 5 other organizations. 4. Board Recruitment. Possible new candidate—Jennifer D. Hayes from City of Renton. Tyler Neal recommended her. They will follow up.Note: The Board has 2 vacant positions to fill. The meeting adjourned at 6:40 Submitted by Suellen Howard, Recorder. ANNUAL BUDGET The following Budget Report includes: The Agency Annual Budget (FY June 30, 2008) The Agency Financial Statement RENTON AREA YOUTH/FAMILY SERV. BALANCE SHEET March 31 , 200.8 ASSETS ****** 101 PETTY CASH 500.00 121 BANNER BANK 28,822.46 122 U.S. BANK 107.99 125 RENTON COMM FOUNDATN 12,698.21 150 SAVINGS ACCOUNT 3, 121 .20 222 ACCOUNTS RECEIVABLE 91 ,910.22 351 PREPAID INS 3,680.28 360 PREPAID LOAN FEE 5, 360.00 401 FIXED ASSETS 117, 723.58 410 ACCUM. DEPREC. -293,043.68 450 RAMSC BLDG 396,023.26 460 RAMSC LAND 126,368.70 490 BLDG REMODLE 25,934.73 495 F.S.C. LAND 43,873.62 496 F.S.C. BUILDING 117, 742. 10 497 F.S.C. RENOVATIONS 121 ,835.02 Total Assets 802,657.69 LIABILITIES & FUND BALANCES *************************** Liabilities 601 ACCOUNTS PAYABLE 725.00 602, LINE OF CREDIT 29,750.00 610 PR DEDUCTS / BENEFIT 10,221 .79 620 PR TAXES PAYABLE 6, 039.93 630 VAC PAYABLE 34, 135.87 665 CHILDREN'S TRUST 3,375.00 695 MORTGAGE - 1st SAVIN 485,022.55 Total liabilities 569,270. 14 800 FUND BALANCE 233, 387.55 Total Fund Balances 233,387.55 Total liabilities & Fund balance 802,657.69 Analysis of changes in Fund balance Beginning Fund balance 201 ,838.29 Add : revenues 870, 142.63 Less: expenditures -838, 593.37 ENDING FUND BALANCE 233,387.55 RENTON AREA YOUTH/FAMILY SERV. REVENUE-SUPPORT/EXPENSE SUMMARY March 31, 2008 REVENUES/SUPPORT l DESCRIPTION ORIGINAL REVISED YR TO DATE CURRENT BALANCE PERCENT BUDGET BUDGET MONTH REC/EXP 40 CONTRIBUTIONS 65,000 65,000 76,199.09 1,275.00 • -11,199.09 117.22 42 SPECIAL EVENTS 56,000 56,000 9,080.00 1,300.00 46,920.00 16.21 47 UNITED WAY 123,043 125,051 101,361.06 12,758.94 23,689.94 81.05 50 GOVERNMENTAL FEES 431,214 431,214 333,982.97 40,544.03 97,231.03 77.45 62 PROGRAM SERVICE FEES 650 650 95.00 30.00 555.00 14.61 63 HWSMH MANAGED CARE 440,000 440,000 347,465.52 35,477.71 92,534.48 78.96 65 INTEREST EARNINGS 450 450 196.54 9.12 253.46 43.67 69 MISC REVENUES 2,000 2,000 1,762.45 426.08 237.55 88.12 TOTAL REVENUES 1,118,357 1,120,365 870,142.63 91,820.88 250,222.37 77.66 x EXPENSES 70 SALARIES 770,300 770,300 578,148.48 66,112.95 192,151.52 75.05 71 EMPLOYEE BENEFITS 75,900 75,900 49,685.37 4,709.32 26,214.63 65.46 72 PAYROLL TAXES 62,000 62,000 46,962.61 6,910.18 15,037.39 75.74 73 IRS SEC 125 0 0 0.00 0.00 80 PROFESSIONAL FEES 18,000 18,000 16,657.56 280.00 1,342.44 92.54 81 SUPPLIES 53,000 53,000 37,904.71 5,796.11 15,095.29 71.51 82 TELEPHONE 14,000 14,000 10,037.63 1,101.25 3,962.37 71.69 83 POSTAGE/SHIPPING 2,600 2,600 2,356.21 33.09 243.79 90.62 84 OCCUPANCY 70,120 70,120 54,278.08 7,931.29 15,841.92 77.40 85 RENTAL/MAINT-EQUIP 500 500 1,172.20 0.00 -672.20 234.44 86 PRINTING/PUBLICATION 9,000 9,000 11,198.69 2,948.12 -2,198.69 124.42 87 TRANSPORTATION 7,500 7,500 3,694.64 684.20 3,805.36 49.26 88 TRAINING 6,000 6,000 3,271.10 381.37 2,728.90 54.51 90 AGENCY DUES 3,500 3,500 4,197.67 1,109.11 -697.67 119.93 91 MARKETING/FND RAISE 0 0 0.00 0.00 93 INSURANCE 20,500 20,500 15,689.55 .1,744.23 4,810.45 76.53 94 MISCELLANEOUS 4,000 4,000 3,338.87 391.35 661.13 83.47 95 DEPRECIATION 0 0 0.00 . 0.00 TOTAL EXP 1,116,920 1,116,920 838,593.37 100,132.57 278,326.63 75.08 EXCESS OR (DEFICIT) 3,445 31,549.26 -8,311.69 x RENTON AREA YOUTH/FAMILY SERV. REVENUE-DETAIL March 31, 2008 DESCRIPTION ORIGINAL REVISED YR TO DATE CURRENT MONTH BALANCE PERCENT BUDGET BUDGET RECVD 4001- GENL CONTRIBUTION 15,000 15,000 13,924.09 150.00 1,075.91 92.82 4050- FOUNDATION/CORPORATE 50,000 50,000 62,275.00 1,125.00 -12,275.00 124.55 4200- SOLICIATIONS 10,000 10,000 7,780.00 2,220.00 77.80 4210- FUND RAISING EVENTS 46,000 46,000 1,300.00 1,300.00 44,700.00 2.82 4701- UNITED WAY 112,043 114,051 94,052.00 11,312.00 19,999.00 82.46 4705- U/W DESG. 11,000 11,000 7,309.06 1,446.94 3,690.94 66.44 5001- KC DCHS 96,994 96,994 70,249.00 8,082.00 26,745.00 72.42 5002- KC FAMILY CENTER 76,500 76,500 57,375.00 6,375.00 19,125.00 75.00 5004- KC CHILDRENS COMM 63,500 63,500 47,625.10 5,291.66 15,874.90 75.00 5006- HEALTH START 0 0 9,994.50 4,635.25 5010- CITY OF RENTON 56,000 56,000 41,512.50 4,612.50 14,487.50 74.12 5020- CITY OF TUKWILA 60,620 60,620 42,839.94 4,176.66 17,780.06 70.66 5041- DASAS-OUTREACH 3,200 3,200 2,040.00 240.00 1,160.00 63.75 5042- DASAS-TREATMENT 20,500 20,500 15,391.19 1,546.02 5,108.81 75.07 -1043- DASAS-CASE MNGMENT 900 900 742.89 84.90 157.11 82.54 / '1050- KC PREVENTION 44,000 44,000 32,865.00 3,455.00 11,135.00 74.69 5060- TITLE XIX 9,000 9,000 13,347.85 2,045.04 -4,347.85 148.30 6200- PROGRAM SERVICE FEES 650 650 95.00 30.00 555.00 14.61 6300- HWSMH MANAGED CARE 440,000 440,000 347,465.52 35,477.71 92,534.48 78.96 6500- INTEREST INCOME 450 450 196.54 9.12 253.46 43.67 6900- MISC 2,000 2,000 1,762.45 426.08 237.55 88.12 TOTAL REVENUES 1,118,357 1,120,365 870,142.63 91,820.88 250,222.37 77.66$ RENTON AREA YOUTH/FAMILY SERV. EXPENSE-DETAIL March 31, 2008 DESCRIPTION ORIGINAL REVISED YR TO DATE CURRENT BALANCE PERCENT BUDGET BUDGET MONTH EXPNS 7001 SALARIES 770,300 770,300 578,148.48 66,112.95 192,151.52 75.05 7100 EMPLOYEE BENEFITS 75,900 75,900 49,685.37 4,709.32 26,214.63 65.46 7200 PAYROLL TAXES 62,000 62,000 46,962.61 6,910.18 15,037.39 75.74 8005 AUDIT 7,500 7,500 9,389.00 -1,889.00 125.18 8020 STAFF CONSULTANT 5,000 5,000 2,227.31 280.00 2,772.69 44.54 8030 OTHER PROF SERVICE 5,000 5,000 4,861.25 138.75 97.22 8035 FSC CONTRACT SERVS 500 500 180.00 320.00 36.00 8100 SUPPLIES 37,000 37,000 23,275.02 4,289.56 13,724.98 62.90 8150 F.S.C. SUPPLIES 16,000 16,000 14,629.69 1,506.55 1,370.31 91.43 8200 TELEPHONE 14,000 14,000 10,037.63 1,101.25 3,962.37 71.69 8300 POSTAGE/SHIPPING 2,600 2,600 2,356.21 33.09 243.79 90.62. 8405 UTILITIES 17,000 17,000 13,291.30 2,009.51 3,708.70 78.18 8409 JANITORIAL 9,000 9,000 6,675.00 875.00 2,325.00 74.16 8415 BUILDING MAINT. 5,000 5,000 4,971.96 1,786.80 28.04 99.43 8420 MORTGAGE 39,120 39,120 29,339.82 3,259.98 9,780.18 74.9^ 8500 RENTAL/MAINT-EQUIP 500 500 1,172.20 -672.20 234.4, 8600 PRINTING/PUBLICATION 9,000 9,000 11,198.69 2,948.12 -2,198.69 124.42 8707 TRAVEL 7,500 7,500 3,694.64 684.20 3,805.36 49.26 8800 TRAINING 5,000 5,000 3,271.10 381.37 1,728.90 65.42 8810 CULTURAL COMPTENCY 1,000 1,000 0.00 1,000.00 0.00 9000 AGENCY DUES 3,500 3,500 4,197.67 1,109.11 -697.67 119.93 9300 INSURANCE 20,500 20,500 15,689.55 1,744.23 4,810.45 76.53 9410 MISCELLANEOUS 4,000 4,000 3,338.87 391.35 661.13 83.47 TOTAL EXPENSES 1,116,920 1,116,920 838,593.37 100,132.57 278,326.63 75.08x Jo Ann Kelly, CPA 404 South Brandon Street Seattle, WA 98108-2236 (206) 767-5403 Independent Auditor's Report To the Board of Directors = Renton Area Youth and Family Services Renton, Washington I have audited the accompanying balance sheet of Renton Area Youth and Family Services (a nonprofit organization)as of June 30,2007 and 2006 and the related statements of activities,functional expenses,and cash flows for the years then ended. These financial statements are the responsibility of the Organization's management. My responsibility is to express an opinion on these financial statements based on my audit. I conducted my audit in accordance with U.S.generally accepted auditing standards. Those standards require that I plan and perform the audit to obtain reasonable assurance about whether the financial statements are free of material misstatement. An audit includes consideration of internal control over financial reporting as a basis for designing audit procedures that are appropriate in the circumstances,but not for the purpose of expressing an opinion on the effectiveness of the Organization's internal control over financial reporting. Accordingly, I express no such opinion. An audit also includes examining, on a test basis, evidence supporting the amounts and disclosures in the financial statements, assessing the accounting principles used and significant estimates made by management, as well as evaluating the overall financial statement presentation. I believe that my audit provides a reasonable basis for my opinion. In my opinion,the financial statements referred to above present fairly,in all material respects,the financial position of Renton Area Youth and Family Services as of June 30,2007 and 2006, and the changes in its net assets and its cash flows for the years then ended in conformity with U.S.generally accepted accounting principles. My audit was conducted for the purpose of forming an opinion on the basic financial statements of Renton Area Youth and Family Services taken as a whole. The accompanying Schedules of Contributions and Grants and Fees are presented for the purposes of additional analysis and are not a required part of the basic financial statements. Such information has been subjected to the auditing procedures applied in the audit of the basic financial statements and,in my opinion,is fairly stated in all material respects in relation to the basic financial statements taken as a whole. I vapt, GPI► Seattle,Washington October 19,2007 I Jo Ann Kelly, CPA 404 South Brandon Street - Seattle,WA 98108-2236 Phone(206) 767-5403 Fax(206) 767-6430 Auditor's Report on Internal Control To The Board of Directors Renton Area Youth and Family Services In planning and performing my audit of the financial statements of Renton Area Youth and Family Services as of and for the year ended June 30,2007,in accordance with auditing standards generally accepted in the United States of America, I considered Renton Area Youth and Family Services' internal control over financial reporting (internal control) as a basis for designing my auditing procedures for the purpose of expressing my opinion on the financial statements, but not for the purpose of expressing an opinion on the effectiveness of the Organization's internal control. Accordingly,I do not express an opinion on the effectiveness of the Organization's internal control. A.control deficiency exists when the design or operation of a control does not allow management or employees, in the normal course of performing their assigned functions, to prevent or detect misstatements on a timely basis. In addition,because of the inherent limitations in internal controls, including the possibility of management override of controls, misstatements due to error or fraud may occur and not be detected by such controls. A significant deficiency is a control deficiency, or a combination of control deficiencies,that adversely affects the entity's ability to initiate,authorize, record,process, or report financial data reliably in accordance with generally accepted accounting principles such that there is more than a remote likelihood that a misstatement of the entity's fmancial statements that is more than inconsequential will not be prevented or detected by the entity's internal control. A material weakness is a significant deficiency, or a combination or significant deficiencies, that results in more than a remote likelihood that a material misstatement of the financial statements will not be prevented or detected by the entity's internal control. My consideration of internal control was for the limited purpose described in the first paragraph and would not necessarily identify all deficiencies in internal control that might be significant deficiencies or material weaknesses. I did not identify any deficiencies in internal control that I consider to be material weaknesses, as defined above. However, I identified the following deficiencies in internal control that I consider to be significant deficiencies. During the testing of cash disbursements I noted that some payments to vendors were made from statements rather than the actual invoice as the original invoice had not been forwarded on to the accounting department. To maintain accountability for purchases and prevent payment for goods not received I recommend that either the invoice or accompanying packing slip be signed and dated when the goods are received. A centralized file should be set up in which invoices are placed until Board of Directors Renton Area Youth and Family Services Page 2 given to the accounting department. For any statements not supported by appropriate invoices, accounting or designated personnel could compensate for this weakness by contacting the appropriate vendor and obtain the necessary documentation. In the course of the audit I noted documents supporting disbursements that were not defaced in a way that would make them ineffective as support for further payments. Currently invoices paid are cancelled by using a "Paid" rubber stamp. I recommend that a stamp imprint be utilized which would provide for check number, date paid, supervisory approval, approval of footing and extensions. These documents with the appropriate approvals and other documentation would accompany the checks for signing. After the check is signed the underlying documents should be stamped"Paid" or otherwise cancelled. During my review of certain expense accounts I noted some inconsistancies in account coding of expenses. To make interim financial statements a meaningful analysis tool care should be taken to properly and consistently classify expenditures. The correct coding of all expenditures is essential for accurate and useful financial statements. The payment and recording of expenses should be closely monitored. The monitoring process could be performed in conjunction with the check signers review. The person signing the check would initial the invoice to indicate this review. Certain deficiencies were identified surrounding the payroll process. While reviewing personnel files I noted one W-4 form with a different number of exemptions from the number used in computing payroll. In discussion with accounting department personnel it was determined that the Organization sometimes makes changes in withholding on the basis of oral communication from the employee. I recommend that the Agency require revised forms to be submitted before changing withholding. As the W-4 is the basis for employee data input into the payroll database, utilized in tax reporting, such as W-2 issuance,I recommend that the W-4 be verified against the employee's social security card information. This review of information should be indicated by personnel performing the review process. In conjunction with the review of personnel files I noted that the agency performs a background check of new hires, and existing personnel on a predetermined schedule, utilizing the Washington State Patrol. One response received indicated potential duplicate results based on the information submitted. No follow up to the response was documented in the personnel file. Formal written procedures should be established to provide guidelines identifying appropriate duties and the process for resolution of inquiry issues. Payroll is the major expense of the Agency. During my audit I noted that the control procedure of written pay rate change documentation,approved by appropriate management,is utilized to authorize the accounting department to change the the rates and to update the computer and the affected employee's payroll data. I observed one instance where the employee's payrate was not in agreement with the"authorized"rate. A payroll master file should be maintained separate from the accounting departments computer database. Management should periodically review the payroll master file and compare payroll to the authorized rate. • Board of Directors • _ Renton Area Youth and Family Services Page3 • • • During the course of my testing I noted one instance that when a prenumbered check had to be voided, a check from the manual check stock was assigned the number of the voided check. This practice nullifies the control objective of prenumbered checks and should be prohibited. it The Organization has an investment of$108,000 in equipment items,and I recommend that control be strengthened in this area. Most fixed assets are never physically inventoried. Periodic physical counts of property, especially removeable equipment items, should be taken and compared to the detailed fixed asset account. In connection with this inventory,tags should be placed on each asset with numbers that are recorded in detail property records. This will help improve the tracking of assets for disposal and replacement budgeting purposes. My review of general journal entries revealed that many entries lack proper approval by a responsible employee. I recommend the adoption of a policy whereby all journal entries will be approved by a • designated member ofmanagement. All entries should be initialed by the preparer and the individual approving them. I also noted that the explanations accompanying the entries were inadequate in many instances. All journal entries should be accompanied by a full explanation and by reference 'to adequate supporting data. During the course of the audit in conjunction with inquiry of management personnel I noted certain control issues I consider to be weaknesses related to assinment of authorityand responsibilities ponsibihties as they relate to the financial process. Control could be strengthened by considering implementation of the following: Develop an organization chart with written descriptions of job responsibilities for all personnel in accounting and administrative functions. This would provide management with a basis for redistributing work loads. An organization chart is an important component in many aspects of financial and operational management. Expand the existing employee training. Training would include instruction'on performing appropriate control activities, such as accuracy and completeness check; approval and review and corrective actions that should be taken if errors are identified. The policies and procedures management develops should include routine transaction processing and recording matters as well as non routine matters such as journal entries, revenue recognition, etc.. Revise.and update the existing accounting manual to include the accounting department artment operating procedures. The manual would incorporate written procedures, instructions, y and assignments of duties. In the process of the comprehensive review of existing accounting procedures management might discover procedures that can be eliminated or improved to make the system'more efficient and effective. Board of Directors Renton Area Youth and Family Services Page 4- This communication is intended solely for the information and use of management, the Board of Directors, others within the Organization, and those funding agencies when specified in their contract documents and is not intended to be and should not be used by anyone other than these specified parties. VaS2A0, CPA Seattle, Washington November 14, 2007 I • • FINANCIAL STATEMENT The Agency Financial Statement is included in the Annual Budget submitted above for the month ending March 31, 2008. Mental Health Services Manual-Volume I Chapter 16 Section 6 -Agency Administration AA Plan Legal Reference: WAC 275-57-330 Subject Affirmative Action and Equal Employment Opportunity Policy RAYS shall maintain an Affirmative Action Program and adhere to all applicable local, state, and federal affirmative action and non-discrimination laws. 1. Non-Discriminatory Employment Practices Equal employment opportunity shall be provided in all terms,conditions,and privileges , of employment for qualified job applicants and employees without regard to race,creed, color,national origin,sexual orientation, sex,age,marital status,AIDS/HIV status, and disability. 2. AAP and Reasonable Accommodation The Affirmative Action Program shall ensure that employment and advancement opportunities are available to all qualified individuals, including women, ethnic minorities, disabled persons,and Vietnam-Era veterans. Reasonable accommodation shall be provided to applicants,employees,and clients with regard to disability and religion. 3. Affirmative Purchasing RAYS shall practice non-discrimination and affirmative action in the purchase of services and in awarding subcontracts for services. 19 New O Change ❑ RENTON AREA YOUTH AND FAMILY SERVICES CLIENT DATA FORM Case# Provider ID Medicaid# Intake Date Funding: [[City of Renton ['City of Tukwila []Medicaid ❑Private Pay []Private Insurance D Victim Comp Program ❑ Family Counseling ❑ Substance Abuse ❑ Family Support ❑ Teen Parent Client Last Name Client First Name MI Home Telephone: ( ) Cell Phone: ( ) Address: City: Zip Code: Incorporated City of Renton ❑Yes ❑ No Reopened ❑ Yes ❑ No Date of Birth Gender . ❑ M ❑F SSN# Family Size: #of Children: Household Yearly Income: Disabled Uyes ❑no Limited English Oyes Uno Interpreter Needed Oyes Ono Referred by: OClergy/Church ['District Court [Diversion ODSHS DDYS []Employer OHealth Care Prov. []Other Agency ['Parent []Police []Prosecutor [(School OSelf/Peer []Other Ethnicity: [Afro-Ethnic ['Cambodian ['Hispanic ['Thai ['Aleut []Eskimo OJapanese []Vietnamese DAmerican Indian []Filipino []Korean OWhite/Caucasian []Asian Pacific [(Guamanian ['Laotian. ['Other Race OBlack/African American DHawaiian ['Samoan ['Mixed Race ['Other Asian/Pacific Islanders Home ['Both Parents ['Father Only []Mother Only []Foster Home []Friends of Family Situation: []Mother&Partner ['Father&Partner []Relatives []Self ['Runaway/Street ['Other OHomeless Name of School School Program [Alternative Program ['Pre-School []Regular ['Special Education []Vocational School Attendance OAttending Regularly ['Completed []Irregular Attendance ['Not Attending Head of Household Name: Last First: Marital Status: []Married OSeparated/Divorced ['Partnership []Widowed ['Single []Other Relationship to client: Living Situation Ethnicity: Disabled ❑ Yes ❑ No Limited English 0 Yes ❑No Interpreter Needed ❑ Yes ❑ No Revised 4/19/07 Section IV,Attachment H ACCESS TO ROUTINE SERVICES TRACKING FORM 1. Client Name: 2. King County ID Number: 3. Date referral received:, Enter the date and time the request for services*was received. Include day, month, and year in the date. 4. Relationship of referent to client: Identify the relationship of the person who requested the services to the client, e.g., self parent, court-appointed guardian. Do not enter that person's name. 5. Date of-start of intake evaluation: An intake evaluation must be initiated with 10 working days of the request for services.* 6. Date routine services offered to occur: Enter the date on which the first routine service was offered to occur. This date should be within 28 calendar days of the request for services. 7. Documentation of reason for delay: If routine services are not offered to begin within 28 calendar days of the request for services,*a reason for the delay must be documented. * Request for Service: the point in time when a person legally authorized to sign the consent for treatment seeks or applies for mental health services through a telephone call, EPSDT referral, walk-in, or written request. King County Mental Health Plan Policies&Procedures Section IV,Attachment H Revisions Effective: January 1,2006 Page i of I Renton Area Youth & Family i,• Services Client Intake Assessment Client Name: DOB: Client#: Family History Who do you live with at this time? Relationship Are you parent's divorced or separated? Yes No N/A or Unknown If yes,who has legal custody? Is child in foster care of dependent of the state? Yes No N/A Copy of dependency order or letter of guardianship? Yes No N/A Is there any significant information about the parents' relationship or treatment toward the child which might be beneficial in counseling? Yes No If yes,describe: Client's Mother/Guardian Name: Age: Occupation: Quality of relationship between client and mother/Guardian: Good Average Poor Client's father/Guardian Name: Age: Occupation: Quality of relationship between client and father/Guardian: Good Average Poor Client's sibling and others living in the home Name Age Gender Relationship Quality of Relationship with client Good Average Poor F M Clinician notes (attach genogram): 1 Client Supports and Strengths Family support networks are extended family or friends that can help you or your family during a crisis, how would you describe your family support network? Father/male caretaker Mother/female caretakers No family support network Who in your family do you feel supports you?(Check all that apply) Father/male caretaker Mother/female caretakers _Male sibling Female sibling Grandparent Extended family No one Please list three (3) non-family members who you feel you have a positive relationship with and encourage you. Name Relationship What do you like about yourself?What are your personal strengths? What do you do for fun? Are you involved in any sports/hobbies/extracurricular activities? What do you like about your family?What are the strengths of your family? Development History Where there any concerns or complications during pregnancy and/or childbirth? Unknown No Yes,specify: Were there any areas of concern during early development(e.g.walking,talking,toilet training)? 2 Unknown No Yes,specify: Other disabilities and/or developmental concerns: Legal guardian,foster parent,social worker or client was not able to provide a developmental history. Clinician notes: Cultural History What ethnicity(s) do you identify with? Are you and your parent(s)an immigrant or refugee: yes No If yes, how long have you/they lived in the U.S? How involved are you/your family in your cultural community? How would you describe your/your family's level of comfort with the U.S culture(level of acculturation)? What sexual orientation/preference do you identify with? Heterosexual Homosexual Lesbian Bisexual Transgender Transsexual Exploring Unknown N/A Please describe you and/or your family's religious or spiritual beliefs.How involved are you or your family in that community: Clinician notes: Abuse History Check if nay of the following apply: 3 Physical Harm Sexual Assault/Inappropriate Contact Neglect Verbal/Emotional Abuse Exposure to Domestic Violence Please describe: (incidents/dates/reported investigated?CPS Open cases?) Clinician notes: Education Attending Not Attending School: Grade level; Check if any of the following are a concern: Learning disabilities IEP School Attendance Peer/Staff Interaction School Status(suspension/expulsion) Other relevant school information(i.e.academic or behavior history: Drugs/Alcohol Do you/your parents have a history of drug or alcohol use? Yes No Have you/your parents ever been in treatment for drugs or alcohol? Yes No If,yes,please describe: Are you/your parents using drugs/alcohol? Yes No Frequency of use: Alcohol: per day per week Drugs: per day per week Type of drug(s) used: Do you believe your/your parents drug/alcohol us contributes to your present concerns? Yes No If yes,explain: Legal History Not applicable/No significant legal history or issues 4 Services are court ordered Client is under the supervision of DOC/JPC Information has been disclosed to DOC/JPC Name-of diversion monitor,probation counselor,parole officer: Contact information for above: Other legal history/involvement: Clinician notes: Social Behavior Please check if any of the following are a concern: Generally age appropriate behavior Running away Eating habits Withdrawn/depressed mood Fighting or bullying Immature behavior Attention seeking behavior Relationships with friends/peers Sleeping habits Relationship with family Compulsive behavior Difficulty managing conflict Destruction of property Anxiety Lying Self Harm. Stealing Cruelty to others Cruelty to animals Mental Health Have you ever received counseling or case management services? Yes No If yes,where and when: Have you ever been hospitalized for a mental health condition? Yes No Does anyone in your family have a history of mental health issues/conditions? Yes—No Please explain: Clinician notes: Daily Life Domains Referral Made Part of TX Plan Not Identified as an Issue Food Housing - Income/Dental 5 Transportation School,work. or other age appropriate activities Social Skills/Life Psychiatric Evaluation Referral to other supportive services Others Treatment Planning Statement of concerns and goals in client/families own words Where are you here now?What brings you to this appointment today? What have you been doing to address there concerns? What helps you feel better? What do you hope to change or accomplish from participating in counseling/case management? What do you want to start working on first? Which issues are the most important to you? How strongly do you believe that there issues can be resolved/changes be made? I don't believe things can/will get better I am somewhat hopeful that things will improve I strongly believe things can change for the better Who supports your participation in counseling and/or case management? Clinician notes on treatment planning: 6 Clinical Impressions/Case summary Include symptoms,behaviors and information supporting or related to primary diagnosis: Were any intake and/or treatment planning items not completed? Yes No - Item: Reason: Item: Reason: Item: Reason: Item: Reason: I have participated in giving information for this intake process. Client Signature(13 years or over) Date Parent/Guardian Signature Date Counselor/Service Coordinator Signature Date * Intake Specialist/MHP Signature Date *Not required if counselor/Service coordinator is an MHP 7 CHILD'S MEDICAL HISTORY FORM Please complete as accurately as you can Child's general health(circle) EXCELLENT GOOD FAIR POOR Does your child have a current primary care provider? (circle) YES NO Name/number of provider When was your child's last physical exam? Were any problems noted?(circle) YES NO If yes,please explain Has your child ever been evaluated by a psychiatrist?(circle) YES NO If yes, name/phone#of psychiatrist Is your child currently taking any medication (circle) YES NO If yes, please explain: Has your child ever been hospitalized? (circle) YES NO If yes, please explain: Level of your child's physical activity(circle): HIGH MEDIUM LOW Check any of the following problems that your child has now or has had in the past: °Muscle/joint ❑Heart Problems ❑Tics °Mental Retardation UDiabetes °Bedwetting °Cerebral Palsy °Cancer/Tumors °Weight °Asthma °Hyperactivity • ❑Sleep(tao muctvtoo little) °Fatigue °Autism ❑Dizziness ❑Nightmares ❑SIeepwalking °Learning•Disability ❑Breathing °Stomach/vomiting °Headaches ❑Fainting ❑Urinary problems °Soiling ❑Constipation ❑Diarrhea °Allergies: • °Handicaps: °Other: • Do you have any concerns about your child's use of drugs,tobacco, alcohol or other chemicals such as glue,white out, or paint?(circle) YES NO if yes,please explain: DEVELOPMENTAL HISTORY How would you describe your pregnancy, labor and delivery? NORMAL COMPLICATIONS If you had any complications,please describe Child's birth weight: Age of birth mother at the time of pregnancy age of birth father • Did you drink alcohol, smoke tobacco or use drugs during pregnancy? (circle) YES NO If yes,please explain At what age did your child first begin to walk? talk Please list any previous counseling or therapeutic services your child has received and whether or not it was helpful Client# Client Name Date • • MENTAL STATUS EXAMINATION (Consider developmental stage) Client's age: • - • — .. Orientation: oriented x3 Oconfused Odisoriented Memory: immediate recent . remote ❑intact ['intact ❑intact ❑compromised Ocompromised ['compromised ❑lacking packing ❑lacking Appearance: Duriremarkable ['distressed ['bizarre flamboyant ❑physically healthy Ophysically unhealthy ['poor hygiene Ogood hygiene appears stated age Dappears younger than age ['appears older than age Activity level: ❑normal ❑hyperactivity ❑erratic ['psychomotor agitation ['psychomotor retardation Speech and language: Modality of speech: ['normal rate, tone, volume ['abnormal rate,tone, volume Quality of speech: []organized ['pressured ❑latency of response ['incoherent ['blocking Devasive ['tangential • Mood and Affect: Mood: ['Euphoric 1 elevated ❑Angry Affect: ['Appropriate 1 congruent . ❑Happy ['Anxious ❑Expansive • • ❑Euthymic ['Fearful .❑Restrictive ODysphoric ['Suspicious ['Constrictive ['Apathetic ❑Depressed • Thought content: ['organized 1 lineal ['delusions ['ideas of reference Oblocked ['flight of ideas ❑phobias\obsessive ideas Operseveration ['paranoia ['thought broadcasting\insertion 1 control Homicide ideation: ['none[How ['high Suicide ideation: ❑none ❑low ['high Perceptual disturbance: ❑none ❑hallucinations ['somatic symptoms Insight: ❑impaired ['poor ['fair ['good Judgment: ❑Impaired 1 altered ❑poor ['fair [Wood ❑impulsive Fund of Knowledge: One appropriate ❑impaired ❑unknown Abstraction: ❑age appropriate Dimpaired ['unknown Client#: Client name: Date: Revised 3/30/05 • Renton Area Youth & Family Services .RAYS Client Rights 1. Legal and Consumer Rights Materials Each of the items listed below apply to your rights as a consumer of services at RAYS. Your counselor will explain each document and give you copies of some of them.You may have a copy of all the materials if you wish. • Consent to Treatment • Resolving Client Complaints and Grievances • Mental Health Omsbuds-Service • "Counseling or Hypnotherapy(Brochure) of King County(Brochure) • Client Service Arrangements • Consent for Release of • Statement of Consumer Rights Confidential Information form Various modalities may be part of your treatment plan.These may include case management,medication management,referral for chemical dependency treatment,individual or group therapy,and family therapy.You have the right to participate in decisions regarding your care, including the right to refuse treatment.There are risks,benefits,and consequences to treatment decisions. 2. Local Rights and Advocacy Organizations These other groups may help you understand or obtain your civil and consumer rights. WAMI: Washington Advocates for the Mentally III • (206)783-9264 Washington Coalition of Citizens with Disabilities (206)545-7055 King County Office of Civil Rights • • (206)296-7592 (TTY-Hearing/Speech Impaired) (206)296-7596 Northwest Women's Law Center (206)621-7691 The Unemployment Law Project (206)441-9178 Volunteer Legal Services (206)623-0281 Washington State Human Rights Commission (206)464-6500 Long-Term Care Ombudsman(for the disabled) (206)7474832 Washington Protection and Advocacy System (206)324-1521 3. Acknowledgments My counselor has explained my rights as a client at RAYS. I understand the contents of the written materials and have received a copy of the Client Service Arrangements form, the Instruction sheet on Resolving Client Complaints and Grievances, Statement of Consumer Rights,and the Counseling or Hypnotherapy Clients brochure. Child/Youth Name(s). Signature Date Signature Date • Signature Date _ ParentlLegal Guardian Name(s) Signature Date • Signature Date Original in Client File;Copy to Client(s) Client# Client Name: Revised 3/30/05 12 Renton Area Youth & Family Services .- CLIENT GRIEVANCE FORM Renton Area Youth and Family Services has my permission to research, investigate and negotiate with me in the following complaint. I understand that I can withdraw this permission at any time. I also understand that I am to tell the Executive Director if anyone attempts to intimidate or treat me differently because I have filed this grievance. My complaint is: • • Signed Date Name(Please print) Address Phone • Please return to: ❑Carol Reich or CJ Richard Brooks RAYS, 1025 S. Third St. #B, Renton, WA 98055 Status/Plan: 06/04 clgv.doe ,rarl Renton Area Youth & Family Services /W. • Consent to Treatment Part 1- To be completed by Child/Youth I choose to receive an assessment and/or treatment without the consent of my parent or legal guardian. I am thirteen years of age or older. Client signature I grant RAYS permission to use an audio/and or visual device to record my behavior for use in therapy, consultation, or the training of RAYS staff and other professionals. I understand that I may review or edit the tape or recording or withdraw my permission to use recording devices. • Client signature • I do hereby request and agree to receive treatment by the staff of Renton Area Youth and Family Services. I understand that I will participate in developing a treatment plan suited to my unique circumstances and needs. I agree to the special circumstances I have indicated with signature above. Child/Youth Name Signature Date • Part 2- To be•Completed by Parent or Le_pel Guardian Required for treatment of a minor under age 13 I grant RAYS permission to use an audio and/or visual device to record my behavior for use in therapy, consultation, or the training of RAYS staff and other professionals. I understand that I may review or edit the tape or recording or withdraw my permission to use recording devices. Client signature UWe, the undersigned parent or legal.guardian of do hereby request and consent to the treatment of my/our said child(ren)by the staff of Renton Area Youth and Family Services. I/We understand that I/We will participate in developing a treatment plan suited to the unique circumstances and needs of my/our child(ren). I/We agree to the special circumstances I/we have indicated with signature above. Parent/Legal Guardian Name Signature Date • Client# Client name: Date: On inul in Client File Revised 3/30/05 1 Renton Area Youth & Family Services RAYS" Authorization for Use and Disclosure of Protected Health Information EPSDT Client name: DOB: Social Security#: , hereby authorizes Renton Area Youth and Family Services to: ❑ Disclose information to: ❑ Obtain information from: ❑ Exchange information with: Name: Organization: Address: Telephone: Information to be disclosed: ❑ Has Healthy Child screening been provided; if so,when? ❑ If not,when will it be provided? Specific Authorizations DRUG&ALCOHOL I understand my records may contain information,diagnosis or treatment for drug or alcohol abuse.I give my specific authorization for records to be released.(CFR 42,Part 2) STD 1 AIDS 1 HIV: I understand my records may contain Information regarding testing,diagnosis or treatment of STD 1 HIV AIDS.I give my specific authorization for these records to be released.(RCW 70.24.105) REDISCLOSURE PROHIBITED:This information has been disclosed to you from records whose confidentiality Is protected by state and federal law.These laws prohibit you from making any further disclosure of this information without the specific written consent of the person to whom it pertains or as otherwise permitted by state law.A general authorization for the release of medical or other information is NOT sufficient for this purpose. THIS AUTHORIZATION IS SUBJECT TO REVOCATION AT ANY TIME UNLESS THE AGENCY HAS ALREADY DISCLOSED THE INFORMATION. IF NOT PREVIOUSLY REVOKED,THIS CONSENT WILL TERMINATE IN NINETY(90)DAYS FROM THE SIGNATURE DATE. Signature of client ParentlLegal representative Provider Date Signature of client Parent\Legal representative Provider Date Signature of client Parent Legal representative Provider Date Client#: Client Name: IIRenton Area Youth & Family Services RAYS ' Authorization for Use and Disclosure of Protected Health Information Client name: DOB: Social Security#: ,hereby authorizes Renton Area Youth and Family Services to: ❑Disclose information to: ❑Obtain Information from: 0 Exchange information with: Name; Organization: Address: Telephone: Information to be disclosed: • ❑Attendance 1 counseling progress ❑School records 1 progress ❑Psychiatric information(If written records are disclosed,includes current prescribed medication and the most recent psychiatric evaluation as appropriate) , ❑Other mental health Information(if written records are disclosed,includes current prescribed medication and individual or group progress notes as appropriate) ❑Other(specify) . ( • For the purpose of(specify) Specific Authorizations DRUG&ALCOHOL I understand my records may contain information,diagnosis or treatment for drug or alcohol abuse.I give my specific authorization for records to be released.(CFR 42, Part 2) STD 1 AIDS 1 HIV: I understand my records may contain Information regarding testing,diagnosis or treatment of STD 1 HIV AIDS.I give my specific authorization for these records to be released.(RCW 70.24.105) REDISCLOSURE PROHIBITED:This information has been disclosed to you from records whose confidentiality is protected by state and federal law.These laws prohibit you from making any further disclosure of this information without the specific written consent of the person to whom it pertains or as otherwise permitted by state law.A general authorization for the release of medical or other information is NOT sufficient for this purpose. THIS AUTHORIZATION IS SUBJECT TO REVOCATION AT ANY TIME UNLESS THE AGENCY HAS ALREADY DISCLOSED THE INFORMATION. IF NOT PREVIOUSLY REVOKED,THIS CONSENT WILL TERMINATE IN NiNETY(90)DAYS FROM THE SIGNATURE DATE. Signature of client ParentlLegal representative Provider Date Signature of client ParentlLegai representative Provider Date ' Signature of client ParentlLegal representative Provider . Date Client#: Client Name: Renton Area Youth & 111 Family Services RAYS ' PRIMARY CARE PHYSICIAN REFERRAL LIST • Referrals: 1-800-DOCTORS Healthy Options (for Medical Coupon Holders) 1-800-562-3022 • Burien Family Medicine 14434 Ambaum Blvd. S. W. #5 206/244-6625 Dr. Janet Donovan, MD Burien 98146 . Group Health Burien Center 140 SW 146`h, Seattle 98166 206/901-2300 Odessa Brown Children's Clinic 2101 E. Yesler Way, Seattle, '.206/987-7200 Dr. Ben Danielson, MD 98122 Dr. Ken Feldman, MD • • • Dr. James Stout, MD PAC-MED, Renton Clinic 601 S. Carr Rd, #100, 425/227-3700 Dr. David Buchholz, Pediatrics Renton 98055 Dr. Mark Ensminger, MD Dr. Leslie Garland, MD Renton Community Health Center 138 South 3rd Place, Renton 98055 425/226-5536 Renton Pediatric's 4033 Talbot Rd South,#200 425/271-5437 Dr. Peyton Gaunt, MD Renton 98055 Dr. Stuart Shorr, MD ' Dr. Linda Wiseman, MD Renton Public Health 3001 NE 4`h, Renton 98056 206/296-4700 Teen Clinic/Birth Control Line 206/296.4901 King County Health Center 10821 8`h Ave SW, Seattle 98146 206/296-4620 . (White Center) Valley Family Care 3915 Talbot Road South#200 425/656-4224 Dr. Gerald Rosellini, MD Renton 98055 Dr. Lisa Britton, MD Dr. Teresa Wallace, MD C: Agency Docs 8/04 Renton Area Youth & Family Services 1025 S. Third Street, Renton, WA 98055 • • (425) 271-5600 xi FAX(425)227-8926 c TDD (425)271-3161 Notice of Privacy Practice Summary This summary discloses how medical information about you may be used by Renton Area Youth and Family Services. A full notice of your privacy rights has been provided to you. Treatment, Payment, Operations. We may use health information about you for treatment, to obtain payment for treatment,for administrative purposes, and to evaluate the quality of care that you receive. Authorization for Use and Disclosure. We win not disclose your information to others unless you tell us to do so, or unless the law authorizes or requires us to do so. Advance Directive, Appointment Reminders. We may communicate with someone designated to participate in your care in accordance with an advance directive, and we may use your information to provide appointment reminders. Public health, research, health and safety, government, workers compensation. We may disclose your information for public health activities, research, health and safety, governmental function, and in order to comply with workers compensation laws and regulations. Rights. You have a right to inspect and copy information used to make decisions about your care, to request an amendment of the information, to an accounting.of disclosures, to request communication with you by alternate means, to request restrictions on the information we use, and to revoke your authorization for release of information. Complaints. You may complain to the Executive Director, Richard Brooks at Renton Area Youth and Family Services or to the Department of Health and Human Services if you believe your privacy rights have been _ violated. You will not be retaliated against for filing a complaint. Organization duties. We must maintain the privacy of protected health information, provide you with notice of our legal duties and privacy practice with respect to your health information, abide by the terms of the notice, notify you if we are unable to agree to the requested restriction on how your information is used or disclosed, accommodate reasonable requests you may make to communicate with health information by alternative means or by alternative locations, and obtain your written authorization to use or disclose your health information for reasons other than those listed above and permitted under law. Questions. If you have any questions,please contact the Privacy Officer at(425)271-5600. "I acknowledge that I have received the Renton Area Youth and Family Services full Privacy Notice which describes how RAYS uses and discloses protected health information. I have been informed of my rights related to this information." "I acknowledge that I have received the King County Privacy Practices summary which describes how King County uses and discloses protected health information. I have been informed of my rights related to this information. " Client Name (print) Signature Date Legal Guardian Name(print) Signature Date Provider Name (print) Signature Date Client#: Client Name: Privacy Notice Summary revised 717105 Page 1 of 1 • I / Renton Area Youth & Family Services RAYS Dear RAYS Client(s), When using your medical coupon for the services you are receiving,RAYS is reimbursed by King County funds.Those services are provided under a subcontract with another agency, Highline West Seattle Mental Health Center(HWSMHC),who performs the clinical, administrative and financial services necessary to bill King County. • Our relationship with HWSMHC is for the purpose of billing services and consultation required by King County. Any client information provided by HWSMHC is strictly confidential.Both agencies are required to uphold professional and ethical confidentiality of clients services to the extent.of the law. For our records,please sign below on the line, indication you have read and understood the terms and limits of our relationship with HWSMHC.Thank you. I have read and understood the above explanation of the RAYS/HWSMHC relationship. Client Signature(13 and older) Date Parent Signature(required for children 12 and under) Date Therapist Signature Date Client# Client Name: Revised 3/30/05 Renton Area Youth & Family Services RAYS EPSDT(Early and Periodic Screening,Diagnosis,and Treatment)Rights for Children Early and Periodic Screening, Diagnosis,and Treatment(EPSDT)are a health program for children with Medicaid coverage,including foster children.With EPSDT,Children can get a regular checkup. If your child needs to get medical care for a problem that is found during the checkup,Medicaid will also pay for the follow-up care. Every child birth and up to 21.years of age has Medicaid coverage to get regular health checkups. When should children get a check up? Children should receive their first exam soon after the child is eligible for Medicaid.After the first exam, Children two to six years old should get a checkup once a year.Children age seven through 20 should get a check up every other year. For child under age two,consult with your primary care provider about how often to get a checkup. Medicaid will also cover a dental checkup for children twice a year. What if I need transportation for medical care? In many cases Medicaid will pay for transportation to health related services. If you need help finding transportation call this toll-free-number: 1-800-562-3022,http://fortress.wa.gov.dshs/maa/CHIP/ What if my child or I need a Dentist? Limited dental coverage is available to Medicaid enrollees. To find a dentist, call the local dental society in your area,it will be listed in your yellow pages under"Dentist Referral"or call the number above. Member Satisfaction Survey. Once a year,the Mental Health Division does a survey to see how you or your family member fell about the services you received.You do not have to take part in the survey, If you are contacted please take the time to respond.Your voice is the best way to improve the system. 0 • King County Department of Community and Human Services Mental Health,Chemical Abuse and Dependency Services Division Exchange Building, EXC-HS-0610 921 Second Avenue, Suite 610 • Seattle,WA 98104-1598 206 296-5213 TTy/TDD: 206.205-0569 www.metrokc.govidchs/mhd/ NOTICE OF PRIVACY PRACTICES King County Mental Health,Chemical Abuse and Dependency Services Division Mental Health Plan Effective • Date: Apri114,2003 THIS NOTICE DESCRIBES HOW MEDICAL.INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY The King County Mental Health, Chemical Abuse and Dependency Services Division (MHCADSD.) respects your privacy. We understand that your personal health information is very sensitive. We will not disclose your health information to others unless you allow-us to do so, or the law authorizes or requires us to do so. I. Your Health Information Rights We will have a health record about you. You have some rights with respect to this information • including the right to:• • Request restrictions on the health information we use or disclose about you for treatment, payment or health care operations. You must deliver this request in writing to the Privacy Officer at our office. The Privacy Officer will ask you to sign a request for restriction form, which you should complete and return to the Privacy Officer. We are not required to agree to a restriction that you request. • Cancel prior authorizations to use or disclose health information by giving us a written notice. A form is available for this purpose. Your revocation does not affect information that has already been released. It also does not affect any action taken before we have received the written revocation. - I - K.ng Canary Menial Hee;h,Chemical Abuse and Dependency Semen Di v, MHP.Notice of?mac),Pea owes • Receive a paper copy of this Notice of Privacy Practices for Protected Health Information • ("Notice") from us. • Request that you be allowed to inspect and purchase a copy of your health record. You must make this request in writing. We have a form available for this type of request. If your request is denied, you may appeal this denial (ask us to reconsider).This appeal must be in writing, • Request that we amend any of the health information used to make decisions about your care, including treatment or payment records. To do so, you must submit a written request to our Privacy Officer at 821 Second Avenue, Suite 610,Seattle, WA 98 104 and tell us why you believe the information is incorrect. We may deny your request for art amendment if it is not in writing or does not include a reason to support the request. We may also deny your request if you ask us to amend health information that: • was not created by us,unless the person or entity that created the health information is no longer available to make the amendment; • is not part of the health information we maintain to make decisions about your care; • is not part of the health information that you would be permitted to inspect or copy;or • is accurate and complete. • If we deny your request to amend your health information, we will send you a written notice of the denial stating the reason for the denial and offering you the opportunity to provide a written statement disagreeing with the denial. If you do not wish to prepare a • written statement of disagreement,you may ask that the requested amendment and our denial be attached to all future disclosures of the health information that is the subject of your request. If you choose to submit a written statement of disagreement, we have the right to prepare a written rebuttal to your statement of disagreement. In this case, we will attach the written request and the rebuttal (as well as the original request and denial) to all future disclosures of the health information that is the subject of your request. • Request that we provide you with an accounting of disclosures we have made of your health information since April 14,2003. An accounting is a list of disclosures. But this list will not include certain disclosures of your health information such as those made for the purposes of treatment, payment and health care operations or disclosures that you authorized in writing. To request an accounting of disclosures,you must submit your request in writing to the Privacy Officer at our office. For your convenience,you may submit your request on a form called a"Request For Accounting",which you may obtain • from our Privacy Officer. • Ask that we communicate with you about your health care only in a certain location or through a certain method. To request such a confidential communication,you must give us your request in writing, and sign and date it. You may submit your request on our form or in a letter containing all the information on that form. We will accommodate all reasonable requests. You do not need to give us a reason for the request; but your request must specify how or where you wish to be contacted. • gild County Mote tletlth.Cbamctl%brae mJ r)epcn3en:v Ser-.cc,U.v.uon MHP?Ohm.rl Pnvuy PrubLa • II. MHCADSD's Duties We are required by law to: • Keep your health information private except as indicated below; • Give you this Notice upon your request; • Follow the terms of the Notice of Privacy Practices currently in effect; We have the right to change our practices regarding the protected health information we maintain. If we make changes,we will update this Notice. You may receive the most recent copy of this Notice by calling and asking for it or by visiting our office to pick one up. You may also find a copy of this Notice on our web page at http;/lwww.metrokc.gov/dchs/mhd. • III. How We May Use or Disclose Medical Information About You The following categories describe the way we use and disclose health (including mental health and physical health) information. For each category of uses and disclosures,we will explain what we mean and give an example. Not every use or disclosure in a category will be listed. However.,3all of the ways that we are permitted to use and disclose information will fall within one of the categories. Examples of Use and Disclosures for Treatment, Payment and Health Care Operations Fortreatment: • Information obtained by your health care giver will be recorded in your medical record and used to decide what care is right for you. • We may also provide information to other physicians or health care professionals involved in your care. • For payment: • We request payment from the Washington State Department of Social and Health Services (DSHS). To authorize these payments, DSHS needs information such as your diagnoses, services performed or recommended care. For health care operations: • Members of our staff routinely review records to assess quality and to improve the services we provide you. • - 3 . Cal County Mcaul Hcalth.Crcm.lal lbws end lhpcndeic'y Semch D n MHP Ypioeof Pn.ee.Pnuren Other Disclosures and Uses • Notifications • We may disclose information about you to assist in disaster relief efforts. We may use and disclose your protected health information as follows: • To the extent disclosure is required by law. • For health oversight activities, • For public health and safety purposes as allowed or required by law. • To report suspected abuse or neglect. • In the course of judicial/administrative proceedings. • For law enforcement purposes as allowed or required by law. • To correctional institutions if you are in jail or prison,as necessary for your health and the health and safety of others. • For specialized government functions and workers compensation. • For approved research activities. • To a coroner, medical examiner,or funeral director. Other Uses • Uses and disclosures not described in this Notice will be made only as allowed by law or with your written authorization. IV. To Ask for Help or Complain If you have questions,want more information, or want to report a problem about the handling of your information, you may contact the Privacy Officer at 206-296-5213. If you believe your privacy rights have been violated, you may deliver a written complaint to The Privacy Officer at 821 Second Avenue, Suite 610, Seattle,WA 98104. You may also file a complaint with the United States Secretary of Health and Human Services. We respect your right to file a complaint with us or with the Secretary of Health and Human Services. If you choose to take this action, we will not retaliate against you. Website • We have a website that provides information about us. For your benefit, this Notice is on the website at this address: http://www.metrokc.gov/dchs/mhd/ - 4 - King County Mem/0Ileitth.Chemical Om ad Dependency Seroeet Du.nwe MHP Nutted ut Pm icy Pncuee. • Renton Area Youth & Family Services 1025 S.Third Street, Renton, WA 98055 (425)271-5600 u FAX (425)227-8926 TDD (425)271-3161 .. NOTICE OF PRIVACY PRACTICES Renton Area Youth and Family Services This notice describes how medical information about you may be used and disclosed and how you can get access to this information. Please review it carefully. Effective date: April 14, 2003 • If you have any questions about this Privacy Notice, please contact our Privacy Officer at(426) 271-5600. I. Introduction This Notice of Privacy Practices describes how Renton Area Youth and Family Services (RAYS) • may use and disclose your protected health information and your rights regarding that information. "Protected Health Information" includes information we have created or received regarding,your past or present physical or mental health, the provision of your health care, and payment for your health • care. It includes personal information such as your name, social security number, address, and • • phone number. • • Under the Health Insurance Portability and Accountability Act of 1996 (HIPAA), RAYS is required to maintain the privacy of your protected health information, provide you with this notice of our legal duties and privacy practices with respect to your health information, and comply with the practices and procedures set forth in this Notice. il. How we may use and disclose your health information WITHOUT your authorization. • A. Uses and Disclosures for Treatment, Payment and Operations 1. For Treatment.We may use and disclose health information without your authorization: • • ➢ To your care coordinator, therapist, psychiatrist or nurse to provide your health care and any related services. ➢ To other internal departments at RAYS in order to coordinate and manage your health care and related services. For example, we may need to disclose information in order to coordinate prescriptions, lab work, or to make recommendations such as chemical dependency treatment. > To other clinical staff who work at RAYS, such as when we consult about your care. • ➢ To another health care provider working outside of RAYS for purposes of coordinating treatment or sharing information that will help your care, such as to your primary care physician or to a laboratory. 2. For Payment. We may use or disclose health information without authorization so that the treatment and services you receive are billed to, and payment is collected from, Medicaid or Medicare, your health insurance plan, or other payers. For example, we may disclose your health information to permit your insurance company, Medicare, or the King County Mental Health Plan (which administers benefits to Medicaid individuals): > To determine your eligibility for services, • • > To review services to assure they were appropriate for your care. 3. For Health Care Operations. We may use or disclose health information without your authorization: Privacy Notice Revised 5/17/05 Page 1 of 4 > To run our organization and make sure that our consumers and patients receive quality care. Activities may include: quality assessment and improvement, reviewing the performance or qualifications of our clinicians, training students in clinical activities, licensing, accreditation, business planning and development, and general administration., >--In-combination with information about other clients to decide what additional services we _ should offer, what services are no longer needed, and whether treatments are effective. > To other health care providers, State or County funding sources, or to your health insurance plan to assist them with certain of their own health care operations.We will do so only if you have or have had a relationship with the other provider or health plan. For example, we may provide information to your health plan to assist them in their quality assurance activities. B. Other circumstances in which we may disclose your information without your consent: 4. Emergencies. To assure good care in case of emergencies. For example, we may provide • health information to a paramedic who is transporting you in an ambulance. 5. Legal Guardian. To your guardian or other fiduciary if one has been appointed by a court. 6. Research. To researchers when the research has been approved by a privacy board that has reviewed the research proposal and established protocols to protect the privacy of your health information. 7. As Required By Law. When required to do so.by other federal, state or local laws not listed here, such as the Workers' Compensation Law. 8. To Avert a Serious Threat to Health or Safety. When necessary to prevent a serious and imminent threat to the health and safety of you, the public, or another person. 9. Public Health Activities. For public health activities, to prevent or control disease, injury, or disability, or reporting to the Food and Drug Administration for investigating or tracking problems with prescription drugs. 10. Abuse or Neglect. To government entities to report abuse or neglect. 11. Health Oversight Activities. To health oversight agencies for activities such as audits, examinations, investigations, inspections and licensures. Such agencies include government agencies that oversee the health care system, government benefit programs (Medicare or Medicaid), other government programs regulating health care, and civil rights laws. 12. Disclosures in Legal Proceedings. To a court or administrative agency when a judge or administrative agency orders us to do so, or when we receive a discovery request. 13. Law Enforcement Activities. To law enforcement officials for law enforcement purposes as allowed or required by law. . 14. Department of Corrections. To a correctional institution or parole/probation officer, if you are an inmate of a correctional institution or under the custody of a State of Washington Department of Corrections parole/probation'officer. 15. Medical Examiners. To a medical examiner or coroner for investigations of deaths. 16. Military and National Security. To military authorities under certain circumstances if you are in the Armed Forces. We may disclose to authorized federal officials personal information required for lawful intelligence, counterintelligence, and other national security activities. Privacy Notice Revised 5/17/05 Page 2 of 4 all. Uses and Disclosures That May be Made Without Your Authorization, But For Whi.ch_Y_ou_Will Have an Opportunity to Object. A. Persons Involved in Your Care. We may provide health information about you: • > To a person designated to participate in your care in accordance with an advance directive validly executed under state law. B. Appointment reminders. We may provide health information to you to remind you in writing, or by phone/voice mail that you have an appointment with us, unless you specifically ask us to communicate with you through a different method. Iv. Uses and Disclosures of Your Health Information WITH Your Permission. Uses and disclosures not described above will generally only be made with your written permission called an "authorization."Authorizations are in effect for 90 days, or you may revoke them at any time. • If you revoke your authorization we will not make further uses or disclosures of your health information under that authorization, unless we have already taken an action relying upon your previous authorization. For example, we will ask for your authorization to release information: > To schools and teachers when we are coordinating care; • > To parents of minors 13 years of age or older. Minors 13 years of age or older have the right to request mental health treatment without a parent's consent. If involving your parents is necessary to your care, we will ask for your authorization to release information to them. • v. . Confidentiality of Substance Abuse Records and information related to STDs, AIDS,.HIV. For individuals who have received treatment, diagnosis or referral for treatment from drug or alcohol abuse programs, the confidentiality of drug or alcohol abuse records is protected by federal law and regulations. Information related to testing or treatment of HIV or sexually transmitted diseases is protected by state law (RCW 70.24.105). As a general rule, we may not tell a person outside the programs that you attend a drug or alcohol abuse program, disclose any information identifying.you as an alcohol or drug abuser, or disclose a diagnosis or the results of tests or . • treatment for HIV, AIDS, or sexually transmitted diseases, unless: ➢ you authorize the disclosure in writing; or > the disclosure is permitted by a court order, after(in the case of STDs, AIDS, HIV) application showing good cause, or ➢ the disclosure is made to medical personnel in a medical emergency or to qualified personnel for research, audit or program evaluation purposes; > when exchanging medical information with other health care providers (in the case of STDs, AIDS, HIV), or > for payment purposes, or > you threaten to commit a crime either at the drug abuse or alcohol program or against any person who works for our drug abuse or alcohol programs. A violation of the federal law and regulations governing drug or alcohol abuse is a crime. Suspected violations may be reported to the Unites States Attorney in the district where the violation occurs. Federal law and regulations governing confidentiality of drug or alcohol abuse permit us to report suspected child abuse or neglect under state law to appropriate state or local authorities. Please see 42 U.S.C. § 290dd-2 for federal law and 42 C.F.R., Part 2 for federal regulations governing confidentiality of alcohol and drug abuse patient records. • Privacy Notice Revised 5/17/05 Page 3 of 4 vl. Your Rights Regarding Your Health Information. You may exercise the rights described below by putting your request in writing to the Privacy Officer or by contacting the Privacy Officer. You have the right to: A. Inspect and Copy health information used to make decisions about your care, whether they are decisions about your treatment or payment for your care. Usually this would include clinical and billing records. If you request a copy, we may charge a fee for the cost of providing you with the information. We may deny your request in certain circumstances. In some cases, you will have the right to have the denial reviewed. We will inform you in writing if the denial may be reviewed. Once the review is completed, we will honor the decision made by the reviewer. B. To Request an Amendment of health information used to make decisions about your care, whether they are decisions about your treatment or payment of your care. Your request must • include why you believe the information is incorrect or inaccurate. We may deny your request if it is not in writing or does not include a reason, or if you ask us to amend health information that: ➢ was not created by us, unless the person or entity that created the health information is no longer available to make the amendment; is not part of the health information we maintain to make decisions about your care; > is not part of the health information that you would be permitted to inspect or copy; or • > is accurate and complete. • C. To an Accounting of Disclosures of when we have disclosed your health information for purposes other than treatment, payment, and health care operations. The request should state the time period of the accounting you wish to receive, should not be longer than six years and should not include dates before April 14, 2003. If you request this list more than once in a 12- month period, we may charge you a fee for additional reports. D. To Request Restrictions on the health information we use or disclose about you for,treatment, payment or health care operations. We are not required to agree to a restriction. If we do agree, we will honor your request unless the restricted information is needed to provide you with emergency treatment. E. ' To Request Confidential Communications by requesting that we communicate with you about your health care only in a certain location or through a certain method. For example, you may request that we contact you only at work or by e-mail. We will accommodate all reasonable requests. You do not need to give us a reason for the request. • F. To a Paper Copy of this Notice. VII. Complaints. If you believe your privacy rights have been violated, you may file a complaint with us or with the Secretary of the U.S. Department of Health and Human Services. To file a complaint with us, contact the QI Director at 2600 SW Holden, Seattle, WA 98126 or(206) 933-7260 (the Center) or (206) 933-7054 (the Hospital). All complaints must be submitted in writing. You may ask the Privacy Officer to assist you with writing your complaint. We will not retaliate against you for filing a complaint. VIII. Changes to this Notice. We reserve the right to change the terms of this Notice and to make the revised Notice effective for all health information we already have about you as well as any health information we receive in the future. We will post a copy of the current Notice at each site where we provide care. You may obtain a copy by calling the Privacy Officer. ix. Acknowledgement. We are required to request your acknowledgement that you received this notice. At your next appointment we will ask you to sign a form indicating you received this. Privacy Notice Revised 5/17/05 Page 4 of 4 Renton Area Youth & Family Services Dear Parent(s) or Adult Caregiver(s): The purpose of this letter is to inform you Renton Area Youth and Family Services is a subcontracting agency of Highline West Seattle Mental Health Center. As such.Renton Area Youth and Family Services is a Mental Health Center and is required to have a 24-hour on-call system for its clients. Highline West Seattle Mental Health Center has an on-call system to assist your child(ren) in the event of a crisis pertaining to your child"s issues currently being addressed by a Renton Area Youth and Family Services therapist.The on-call service is in place to respond to a crisis after the agency's normal business hours,on weekends.and during holidays. To utilize the on-call system please call(206)248-8676. Some guidelines to consider before utilizing the on-call system: • The on-call system is only accessible to deal with the immediate crisis of the child receiving services from Highline West Seattle Mental Health Center or one of its subcontracting agencies. • It is the job of the on-call system staff to work with you to reduce the immediate crisis your child is having that pertains to the issues being treated. • When you access the on-call system,the staff working on-call will determine whether your request for using the on-call system is valid. If so,the staff will work with you. If not,the staff will ask you to contact your therapist the next business day. ▪ The therapist working with your child will not be the staff working the on-call system in most cases. • The supervisor of the on-call therapists is Mary Tott, Chief Operating Officer.He can be reached during normal business hours at(206)933-7246. ▪ The on-call system is not a replacement for 911.If the crisis is a life-threatening emergency, please call 911. • The on-call system is not a message center. If you need to leave a message for your child's therapist,please call the agency and leave a message. The on-call system is responsible for approximately 2.000 children and adults. Please keep in inind the extensive responsibility of the on-call staff when you utilize the on-call system. Sincerely. CiookAta4;.-44009 Carol Reich.M.S.W. Richard Brooks Associate Director Executive Director Supervisor:CI Carol A.Reich Counselor: ient# Date, Signature:Sup tea.o''F' Signature: ervisor: Carol A.Reich Time,&Initials Signature:Init 6.brZbaswMVP I1litials� ials: toy ulw Initials Initials: 310,4 Other: Signature: Initials: CASE NOTES Must include location of service and modality of service provided Client/Client's guardian called RAYS for requesting services.Briefly talked about current issues and areas where clients need Help from counseling services. Intake interview with at .Discussed presenting concerns and history of presenting Concerns/reason for seeking services.Conducted interview re:client's social,family,and developmental history. Reviewed strengths/coping strategies and recommendations across the life domains.(See Intake Interview for Information and HIPAA/Privacy information.Reviewed confidentiality guidelines.Discussed process of Counseling and identified tentative goals.Discussed schedule for counseling.Gave parents Telesage questionnaire To complete.Gain survey's given to client. • Client# revised 9/19/06 Supervisor: Carol A.Reich Counselor: Date; Signature: - 15.1..4ke Signature: Time,&Initials Initials: slay.P Initials: Other. Signature: Initials: CASE NOTES Must include location of seavioe and modality of service provided • • • • • Client# revised 7/18/05 PAYMENT RECORD-FILE COPY Client# Fee: City of Renton City of Tukwila Medical Coupons Private Pay Private Insurance Victim Comp. Parent Full Name: Youth Full Name: Address: Telephone: (H) (W) Provider: • Date Service (Clients Time Fee/Billing Paid Balance Billing Involved Billed Source Notes • Revised 3/29/05 Individual Treatment Plan 30 day review Client name The therapist will review this case every-30 days to assess progress and appropriateness of treatment Client case(RAYS\Highline): and sign off each time in the 30 day review box below.A new form needs to be filled out every 180 days. List Client Strengths Date What is our goal? How are we going to accomplish our goal Modality(x) Target Date 30 Day Entered (recovering healthy functioning)? Frequency of completion Review Objectives(building on natural supports/strengths) Goal: Client Quote: Goal: • Client Quote: • Page of Revised 02/06/07 • Individu. ...eatment Plan Client Name: _ Client Case Number(RAYS/Highline) Authorization Dates to Summary of Services to be Provided this Treatment Plan(check only those that apply): ❑ Individual Treatment hours/week or hours/month 0 Family Treatment hours/week or hours/month — 0 Group Treatment hours/week or hours/montf i 0 Psychiatric Management hours/week or hours/month — ❑ Case Management hours/week or hours/monthi ❑ Special Population Consultation hours/year — ❑ Estimated Hours Travel Time Per Month: Life Domains to be Addressed this Treatment Plan: Basic Needs(Status of Food,Shelter,Clothing,Safety,Transportation) Needs Attention 0 Not a Concern❑ Medical Needs Attention D Not a Concern 0 Dental Needs Attention 0 Not a Concern 0 Activities of Daily Living(Physical Disabilities,etc.) Needs Attention D Not a Concern 0 Relationships with Family&Significant Others Needs Attention 0 Not a Concern 0 Educational/Vocational Needs Attention 0 Not a Concern El Social/Recreational Needs Attention D Not a Concern 0 Normalized Experiences Needs Attention 0 Not a Concern 0 Cultural(i.e.,Holidays, Spirituality,Ethnicity) Needs Attention El Not a Concern 0 Legal . Needs Attention D Not a Concern 0 Financial(Support Sources, Stressors,Assistance) Needs Attention 0 Not a Concern❑ Substance Abuse Needs Attention 0 Not a Concern 0 Flex Funds Needs Attention 0 Not a Concern 0 Other Needs Attention 0 Not a Concern 0 Referred to I have been informed of my health status,treatment options including the risks,benefits,and consequences of those options and of non-treatment.and of my right to participate in decisions regarding this healtz care,including the right to refuse treatment. I have been given information about my diagnosis and education about ways to more effectively manage accompanying symptoms and behaviors. Client's/Guardian's Signature: Date: Provider's Signature: Date: *If the provider is not an Mil'then the MII3P supervisor needs to sign off at intake only: Date: Supervisor's Signature: Date: *Treatment Plan Review(every 180 days). . Special Population Cl Yes 0 No Consultant's Signature: Date: Page of Revised 02/06/07 • REVIEW OF CLIENT RECORD (Supervisor to review client record every ninety days) (Please date and sign when PRR has been completed) Date Supervisor signature Date Supervisor signature Client#: Client name: • RAYS Signature Page For all staff who make entries into the medical record.Print your name and sign your name and title legibly. Date of initial Print Name Signature and Title Initials chart entry uk.hatoRgeti- • avx.�C�vt�i' • Client Name: Client ID: ONew Non-Medicaid Diagnosis'Justification Form CJChange Assessed by: Assessment date: DSM code Diagnosis Name (Indicate primary diagnosis with*1 Axis I Axis II Axis III Axis IV Psychosocial and Environmental problems OProblems with primary support group OProblems with social environment • ❑Educational problems ❑Occupational.problems ❑Housing,problems ❑Economic problems ❑Problems with acces's to health care • OProblems with legal system DOther problems • Axis V GAF (age> 18) CGAS (age 6-17) DC09 (age<5) Justification for Axis I or Axis II (use DSM criteria and language): MHP signature Non-MHP signature Client#: Client Name: Date: Renton Area Youth and Family Services Adult/Child Non-Medicaid Crisis Plan 1. Client Information Client Name: Date: Client ID#: Living with: Relationship: Emergency Contact/Next of Kin: • Emergency Phone: 2. Psychiatric History: Current Psych Meds: (as of date ) • Medications Prescribed by: Phone: Hospitalization (past 3) Hospital Dates Vol/invol • Current LRO: ❑Yes ❑No Start Date: End Date: • • 3. History of violence(threats/attempts, including weapons and dates): 4. History of Suicide/Self Harm (threats/attempts and dates): 5. Substance Use(describe type, frequency of etoh, nicotine, illegal/OTC/prescription drugs, caffeine): 6. Criminal Behavior/Jail History(describe behavior and date): • Page 1 of 2 Renton Area Youth & Family Services RAYS• Resolving Client Complaints and Grievances RAYS clients may use several methods to address concerns about services. These include an informal discussion with a staff person; a formal investigation by RAYS personnel; the King County Ombuds-Service; and for certain types of conduct by your therapist, the Counselor Programs section of the Washington State Department of Health. Regardless of the procedure(s) used, there will be no retaliation against you. Written documentation will be filed separately from your case record. 1. Informal Review by RAYS We will make every effort to resolve your concerns as quickly as possible through discussion with your counselor or, if you prefer, with the Director of Client Services or the Executive Director. Use your regularappointment with your counselor or arrange a .special.meeting.. If you want to see another staff person, ask the receptionist for their number or contact them in person. 2. The RAYS Client Grievance Resolution Procedure -J `��This is a more formal process through which RAYS reviews your complaint and tries to identify a mutually acceptable resolution. You may ask a staff member, family member, friend, or a Mental Health Ombuds-Service advocate (See below) to assist or represent you throughout the review. Staff persons named in your grievance do not receive, investigate, or decide on its merits. • Complete the RAYS Client Grievance form. • Mail the form to the office manager (in the self-addressed, stamped envelope) or submit it in person. • You will receive a written response to your grievance within ten (10) days. • If you disagree with the investigation findings, you may appeal the decision to the.Executive Director. • The Executive Director will review your complaint and provide a written response within ten (10) days. • If you are still unhappy, you may appeal the decision to the RAYS Board of Directors. • A sub-group of the Board of Directors will review the matter and provide you a written finding within two (2) weeks. 3. The Mental Health Ombuds-Service of King County The King County Ombuds-Service was established to-assist users of mental health services in King County. The service, consisting of fellow consumers, both advocates appropriate client services and attempts to resolve individual consumer complaints. Complaints are reviewed and resolution is attempted at the lowest possible level in the mental health hierarchy. That is, the complaint will be provided initially to your counselor. If necessary, the Director of Client Service, followed by the Executive Director will review the complaint. If a resolution does not occur at any of these levels, the complaint may be reified as a formal "grievance." • Brochures describing the Ombuds-Service are reviewed and offered to•you during your initial interview with a counselor. Brochures and_-complaint forms are also located in the reception • area. • • Complaints are accepted in-person, in writing, or by mail. Rosanne Manley (206) 205-5329 King County Ombuds-Service (800) 790-8049 506 Second Avenue, Room 501 TDD 461-3219 Seattle, WA 98104 FAX: 296-1438 •If you:use the toll-free 800 number, be'prepared to:receive:'a.call:to verify..your.address, social security number, and date of birth. • When completing the complaint form, briefly explain the problem. Include your feelings about ' • ---- the-issue-and what you-think-should-be-done-- ----- --- - • You will probably be asked to sign a written consent.permitting RAYS-to release confidential information to the Ombuds-Service advocate. 4. State of Washington Department of Health Health Professions Quality Assurance Division Counselor Programs- P.O. Box 47869 Olympia, WA 98504-7869 (360) 753-1761 Monday- Friday, 8:00 a.m. to 5:00 p.m. Your counselor is certified or registered in accordance with laws and regulations established by the state of Washington to protect public health and safety. The Client Service Arrangements form, provided to you during your first appointment with a counselor, includes information about your therapist. You may file a complaint with the Department of Health if you feel your counselor has displayed unprofessional conduct. Some examples of unprofessional conduct are listed in the brochure, "Counseling or Hypnotherapy Clients." Contact the Counselor Program section in Olympia for specific questions about what behaviors constitute a violation of law and/or to lodge a complaint. Copy to Client c:lwirrwordlformslcicomgrv.doc 06/03 • • • • Mental HitsMt Cnbuds-Service Consumer-Contact or Complaint Form of King Canty • • Exchange Bldg., 5th Floor • 821 Second Ave. • • • Seattle,WA 98104 • • • (206)205-5329 or 1-800-790-8049 • The Mental Health Ombuds-Service of King County can investigate, research, negotiate and advocate for me • regarding my Complaint or Grievance. This release will expire 90 days from date of signature. My concern or complaint is: • • • • • • • • • • • • • • • Use additional paper if more room is needed. Signature: Date: • • Printed Name: • • • dress:...SS: City: State: Zip: Phone: Social Security 4: Birthday: • ray• V.stIg%";04_ i r.„,-;t• N • r. i{L� vk9::. ...Investigation : :7�,r(I: `�.�:;. . f,. . .r .. ,,.r i" 'L ! illy `d el., �::;;�• ..i" • Y.;. ad}.. . :....• ...Research '1 �','�1 .� .• `•..ikf. , -,ti:t • ,,„::. Mental H ! th ...Negotiation } ,,�' ' t .L Gbud5_service "What Ombu.ds-Se ice Can ...Advocacy . : g Count il., o ! King y T�« .tir�ltu� f��utc�: :Do for You ,. ,:,.:: Orrrb uds-Service ` ••• 2,':. • 't•:70_ ,:teal r'; rah, t•re,�r/. •,.:,,,,,4. exists to serve primary and secondary `' Arh ,A..,' ;;Fia'*� '...,: : Listen and Record i!r,� n', ': ',..,,,,,t. , .,.. .. tnentai .health consumers (adultsAli' ;: _. ;:1,,,,.,.*4.3. '.':,`•.«,,:, • .and . Ombud ,: I.• -ksr ;�!• ;� :,;r.,�tf;t�.:«.., s-Ser,'ice staff will lie to our Sul ' ' '1;4' parents •ory . 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J committed to Alternatives affirmative e opportunity employer, P,lipnc .206,;2Q :::is information is available in accessible to action and a workplace tree from { formats discrimination5..53; �,,,t. ; ,;;,. ,• �;tll,r.. �:;,>•,1;,,;•'' bled on a '.;. �;:>;i::a;ylr !;;; pOn request at(206)�05, '� V/TDD b�• ancestry, Greed, color, disabled ,�Vi, 4 l r':' '•::,: J'i• , I' `•, rl. 5�-9 or Vietnam .1,��UU=�.).11=8U .).'�" 1;:',��';•:;�!:::: :.iii. :•''4'`: .;_�;:,;; era veteran status, ethnit;>• !1i'S ','' c- tional• origin, ,i I r;r:.:;i >ai'':;'r,, f .i; S gender, marital status, mental i ,�' :Z�G�1 , or physical ;Ix'::�UG- �135t:: ,��:•:',i,. 1. ,I;:;!�'i% race,or sexual orientation P J bility, religion, :••: '' :'!'!,.•i.`ia141:.,;tit,1,'I:,lrcr.;.,,,,;:i'a'.ti15'.f„ ?1Z,1'�" Renton Area Youth&Family Services CLIENT RIGHTS 1. Washington State Law provides certain rights to consumers,prospective consumers,and legally responsible others. Per WAC 388-865-0410,you hay --the right to:- - - -- 1. Be treated with respect and dignity. 14. Lodge a complaint with the ombuds person, regional support 2. Develop a plan of care and services which meets your unique network or provider if you believe your rights have been violated. If needs. you lodge a complaint or grievance, you must be free of any act of 3. The services of a certified language or sign language interpreter and retaliation. The ombuds may, at your request, assist you in filing'a written materials and alternate format to accommodate disability grievance. The ombuds person and the RSN phone number is: 1- consistent with Title VI of the Civil Rights Act. 800-790-8049. To contact the RSN or ombuds person via TDD call 4. Refuse-any proposed treatment, consistent with the requirements in the Crisis Clinic at 206-461-3219. See attached policy and chapter 71.05 and 71.34 RCW; procedure for resolving client grievances at the Center. 5. Receive care which does not discriminate against you,. and is 15. Change County Mental Health agency or case manager. If you wish sensitive to your gender, race, color, national origin, Vietnam era or to make a _request, please talk to your case manager about other •veteran status, religion, creed, language, age, disability, procedures and limitations. sexual orientation, marital status, ancestry, political ideology, use of 16. A second opinion by another participating staff in the enrolled guide or service dogs, use of Section 8 rent certificate, parental consumer's assigned mental health prepaid health plan: (1) When status or creed. you need more information about the medical necessity of the B. Be free of any sexual exploitation or harassment. treatment recommended by the mental health prepaid health plan; 7. Review.your clinical record and be given an opportunity to make pr'(2) if you believe the mental health prepaid health plan primary amendments or corrections. care provider is not authorizing medically necessary community 8. Receive an explanation of all medications prescribed, including mental health rehabilitation services.(WAC 388-865-0355) expected effect and possible side effects. 17. Select a County Mental Health agency or primary care provider from 9. Confidentiality, as described in 70.02, 71.05, and 71.34 RCW and the available primary care provider staff within the mental health regulations. Information may be disclosed without permission in prepaid health plan. If you do not make a choice,.the mental health certain circumstances as described in 26.44, 71.05, and 70.02 prepaid health plan or its designee must assign a primary care RCW. Instances in which disclosure is mandatory include, but are provider no later than fifteen working days after you request not limited to,the following: services; The mental health prepaid health plan or its designee must • (a).To report abuse or neglect of a child, dependent adult, or allow you to change primary care providers in the first ninety days of developmentally disabled person; enrollment with the metal health (b) To law enforcement agencies and to a person whose.health a twelve-month prepaidhealth plan and once during and safety has been threatened or who has been repeatedlyperiod for any reason; Any additional change of primary'mary care provider during•the twelvee-month period may be-made harassed, -when the identity of that person is known to the -W th'e•,documented justification e atethe -consumer's request by: a) Center,' Notifying King County MHCADSD (Mental Health Chemical Abuse (c) If it is believed that disclosure will avoid or minimize imminent and.Dependency Services Division) at 821 Second Avenue, Room -danger to your health or safety or that of anyone else; 610, Seattle, WA 98104-1598 of your request for a change and the (d) To respond to a court order. name of the new agency; and b) Identifying the reason. for the Information may be disclosed without permission in circumstances desired_change. King County MHCADSD .will review and approve related to the following: requests based. on good cause, such as geographic more, (a) in communications between qualified professional persons to irreconcilable difference-between--the-client and 'provider agency facilitate treatment; staff, andlar a need for ongoing special programming not available (b) To the extent necessary for you to make a claim, or for a claim from the current provider agency. In the case of irreconcilable to be made on your behalf for aid, insurance, or medical differences you must demonstrate you•made a good faith effort to assistance, and to contractual and financial sources for the work with the provider agency. If you wish to change case manager, purpose of determining compliance with licensure, certification, please talk to your case manager about procedures and limitations. or registration laws. (WAC 388-865-0345) 10. Al. l research concerning consumers whose cost of care is publicly 18. Request disenrollment from the mental health prepaid health plan. If • funded must be done in accordance with all applicable laws, you are requesting disenrollment you must first utilize the regional including DSHS rules on the protection of human research subjects support network grievance process (WAC 388-865-0255). On a as specified in chapter 388-04 WAC. case-by-case basis, the mental health division will disenroll a . 11. Make an advance directive, stating your choices and preferences consumer from his/her mental health prepaid health plan when the regarding your physical and mental health treatment if you are consumer has 'good cause" for disenrollment. For the purposes of unable to make informed decisions. this chapter, 'goad cause" is defined as the inability of the mental 12. Appeal any denial, termination, suspension, or reduction of services health prepaid health plan to provide medically necessary care that and to continue to receive services at least until your appeal is heard is reasonably available and accessible. A consumer will not be by a fair hearing judge; disenrolled in a mental health prepaid health plan solely due to an 13. If you are Medicaid eligible, you have the right to receive all services adverse change in the consumer's health. In determining whether which are medically necessary to meet your care needs. In the the mental health prepaid health plan provides medically necessary event that there is a disagreement, you have the right to a second care that is reasonably available and accessible, the mental health opinion from a provider within the.regional support network about division may consider, but is not limited to considering: (a) The what services are medically necessary; medically necessary services needed by the consumer; (b) Whether services are or should be available to other consumers in the mental health prepaid health plan.(WAC 388-865-0340) Be advised RAYS must legally inform appropriate authorities when there are serious threats of suicide,serious threats of harm to others,all instances of suspected child above,incest,neglect,and abuse to dependent and vulnerable adults.To express concerns regarding the services you are recieving notify yourcounselor. If you are not satisfied with the response received,notify your counselor's supervisor,Card A Reich,Associate Director of ,linical Services or Richard Brooks,Executive Director. You may file a grievance about any concerns and choose to received face to face mediation `irvices. In addition,you may file a compliant at any time with the Mental health Ombuds Services as described in Item"14"above. -.el counseling services provided are under the supervision of a Child Mental Health Specialist pursuant to the WAC 388 865 0405. Client Name: Signature Date Client ID: Copy-Chart Copy-Client 'Renton Area Youth&Family Services RESOLVING CLIENT COMPLAINTS and GRIEVANCES Policy: The Agency has an open, prompt and responsive way for responding to concerns. If you have a concern, complaint, or grievance; ever; -- reasonable effort will be made to act in an understanding way so that you and the Agency will be in agreement with the results. The complaint process may be accessed both by clients receiving services and clients applying for services. Documentation of complaints, grievances, and appeals is confidential and will be kept separate from your clinical record for six years from completion of the process. Complaint Procedures. The Complaint process is the informal process of communicating concerns. We encourage you to discuss any concerns about your treatment face-to-face with your doctor,nurse,case manager,or therapist so that resolution may occur quickly and at the lowest possible level. 1. You may make a complaint verbally or in writing about any matter 8049; TDD 206-461-3219). Include your name, birth date, regarding the services you receive. We will respond as quickly as preferred language, and a contact telephone number and/or possible. address. 2. If the matter is not resolved within 10 business days, we will give 4. You may receive written information that you may need for filing or you the-option of continuing the complaint process or accessing the resolving complaints and grievances,if you ask us for it in writing. formal Grievance process (see below): In either case, we will 5. Retaliation for filing a complaint or grievance is against the law and continue to work to resolve your concern as quickly as possible. will not be tolerated. If you feel you are being unfairly treated or 3. At any stage in the process, you may request assistance from the punished,this may be retaliation. Agency or any other person of your choice. if you are receiving King 6. If the complaint or grievance involves your case manager, there County Mental Health Plan services or applying for those services, may be times that another case manager will be assigned to work you may request assistance from King County Ombuds (1-800-790- with you during this period. Grievances—King County Mental Health Plan(KCMHP)Clients Only(or those applying for KCMHP services) 1. If you receive Medicaid,a grievance is an expression of 7. We will inform you in writing of the decision about the grievance as dissatisfaction about any mental health matter other than an Action quickly as your mental health condition requires,but no more than • (see below)that you wish to take beyond an informal complaint. 30 calendar days from the date of receipt. If you disagree, 2. if you are a non-Medicaid KCMHP client,a Grievance is an further review by King County Mental Health Plan,if requested expression of dissatisfaction about any mental health matter that you within 5 calendar days. You must then contact KCMHP Client wish to take beyond an informal complaint. Services by phone(1-800-790-8049)or mail(KCMHP,Exchange 3. We want to resolve your concerns as quickly and informally as Building,821 Second Avenue,Suite 610,Seattle,WA 98104). possible. However,you may choose to file a formal grievance at any 8. Continuation of Services During the Grievance or Appeal time. In addition,if a complaint is not resolved to your satisfaction Processes. In most cases,services will continue during the and you don't qualify for an Appeal(which occurs in response to an grievance:process according to usual eligibility criteria: If the Action),you may.file wformat Grievance. grievance or appeal involves the reduction,suspension,or 4. You may file the grievance either by phone or in writing. if you initiate termination of previously authorized Medicaid-covered services, the grievance by phone,you must send a written statement within 10 you may request to continue services during the KCMHP and/or calendar days of the phone call. If a written statement is not State-level Appeal processes under certain circumstances. received within that time,the grievance will not be continued. However,in some circumstances,if the grievance is not resolved in (However,you may file another grievance on the same matter.) The your favor,you may be asked to pay for these services. written statement must include: your name,how best to contact you, 9. Action. An Action is: the decision by the KCMHP not to authorize the Nature of the grievance,requested resolution to the grievance, covered services that meet the Access to Care Standards;the your signature(or parent or guardian). denial of a requested service,or the reduction,suspension,or 5. We will acknowledge receipt by the following working day by mailing termination of a previously authorized service;the failure to provide you a letter. If you filed the grievance by telephone,we will first talk services in a timely manner;or the failure to resolve a grievance or to you by phone to acknowledge that we received the grievance. appeal in a timely manner. Details on Actions and the Appeal of 6. You(or your representative)will be offered an opportunity to review Actions will be described in the Notice of Action that will be mailed any clinical records relevant to the grievance and to submit oral or to you when an Action occurs. written information about the grievance prior to our decision. Grievances—Other clients(those funded through private pay,insurance or Medicare only;non-King County Mental Health Plan) Before filing a formal grievance, we encourage you to discuss any concerns face-to-face with your doctor, nurse, case manager, or therapist so the concern is addressed quickly and at the lowest possible level. If you feel you can't resolve the issue informally,follow the procedures below. 1. You or your representative must put your grievance in writing, dated process. and signed. You may involve other people in the process. 4. if you are still dissatisfied, you may appeal this decision by sending 2. Grievances may be taken to supervisors or administrative staff at the a signed, dated request for appeal to the Executive Director within Center. The staff person named in your grievance will not participate 10 clays. in accepting,investigating,or deciding the grievance. 5. You may appeal the Executive Director's decision to the Board of 3. The grievance will be investigated and resolved within thirty days. Directors, through the Board President. A written report of the The timeframe may be extended by mutual written agreement but will Board decision will be made to you within thirty days. not exceed ninety days. The Associate Director of Client Services 6. Retaliation for filing a complaint or grievance is against the law and will review this report and track it to assure that your grievance is will not be tolerated. If you feel you are being unfairly treated or resolved. You will be mailed a written response at the end of the punished,this may be retaliation. Client Name: Signature Date Client ID: 220-0403 Copy-Chart . Copy—Client Rev.0404; 1204 7. Medical History Medical Problems(include allergies): Current Non-Psych Medications: Primary MD/ARNP/PA: Phone: • 8. Baseline Behavior/Mental Status (general impressions): 9. Other Relevant Information(treatment compliance): 10. Employment(Current): 11. Characterize Decompensation (client quote) 12. Effective Interventions (client quote): 13. Special Population Group: [Hard of Hearing ❑Deaf ❑Developmentally Disabled ['Sexual Minority ['Ethnic Minority ❑Child 0 Not Member of SP Therapist completing crisis plan is a specialist and recommendations for crisis plan are incorporated.above Primary Therapist(other than above)or Supervisor is a specialist and recommendations are noted below(route to supervisor for completion): Referred for consultation(complete Consultation Referral Form). Client/Guardian participated in development of this Crisis Plan. Parent/Guardian Signature Name of Person Completing Crisis Plan Signature of Person Completing Crisis Plan Client Name Case# Date Page 2 of 2 RENTON AREA YOUTH AND FAMILY SERVICES 1 . Sliding Fee Scale For Counseling As an agency,the actual cost for our counseling services is$85.00 per hour.At this hourly rate, many of our clients would be unable to afford services. Fortunately,we are able to subsidize the cost of counseling services through governmental and private funds. It is our intent to ensure access to services for all persons, regardless of income. This sliding fee schedule was developed to assure access to services for all persons regardless of their financial circumstances.Counseling fees are based on family size and income. If you have special circumstances that might make the designated fee inappropriate for you, please discuss these circumstances with your counselor. No one will be denied service due to ability to pay. If CMB is listed in the box for your family's income and size then see your counselor regarding medical coverage. You are most likely eligible for Title 19 Medicaid benefits and we can assist you in obtaining coverage. Family Income(Gross) Number of Persons in Family 1 2 3 4 5 Annual Monthly 0— 19,596 0—1,633 CMB CMB CMB CMB CMB 19,597-26,399 1,634—2,199 $70.00 'CMB CMB CMB CMB 26,400—33,203 2,200—2,766 $75.00 $70.00 CMB CMB CMB 33,204—40,007 2,767—3,333 $80.00 $75.00 $70.00 CMB CMB 40,008—46,799 3,334—3,899 $85.00 $75.00 $70.00 $60.00 CMB 46,800—53,603 3,900—4,466 $85.00 $75.00 $70.00 $65.00 $60.00 53,604—and up 4,467—and up $85.00 $85.00 $85.00 $85.00 $85.00 The fee of$85 is negotiable Clients who utilized private insurance will be billed at a rate of$85.00 CMB = Children Medical Benefit . . . . . ..,. . . . . . !. .. l , , . . . . . . . . . . .. , .„ , ,, •• ., : . . . . , . . . .. , . . . . . . . . .. . , . . . . . . • . . . • .. . . ,. . . .. . . .. . . . . ... . . . . . . . . . ,. . . . . . . . . . . . . .. . , . ..•. •• .•. . , . , . . . . . . . , , . . , • ,• . ., .. . . .. . . . .- • . . .. i . . . . . . • • . . . . , . . , . . , . . . . , . . . . . . . . . . _. . . . . . . . , . . . . . , ... . . ,. . . . . , . .. . , . . . . . . . . .. . . . . . . . . . ,. , .. . . , . . . . : .. . .. . , . . .. . . . . . . . . . . . .. , , . .. • . .. . . . . .. .. . . , . .. . .. _• , . . . . . . . • . . , . . . . . . . . . ., . . . . . . . , . . . . . . . . . , . .. . . . . . . . . . . . . . . . . . . , . ... . . .. .. . . . • . .,. . . . I. . . . .. . . . ., . . . . . . . .. . .. ... . ., .. , . . . . .. . . . . . . . . . . , . . . . ... . . ., . , . . . . . . . . . .. . . , , , , 7 , 7 Application Cover Pages (Agency Information anc,-Q-ue_stians 1_,7)� , . A �t, : , , Agency Information . : - ,lr .. I Agency Name: APR 2 5 2008 Applicant Name and Address: Agenc Director: 1 CITY OF RENTON Renton Technical College Donald Bressler p4 A Q rvp� nr°�Q 3000 NE 4th Street Name and Title - 425-204-2243 425-235-2223 (Area Code)Telephone dbressler@rtc.edu 425-235-7865 E-mail address(if available) (Area Code)Fax Number Required signatures: By signing below,you certify that the information in this application is accurate to the best of your knowled d that you have read the application, certifications,and appendixes. S G B -A BLUE INK) 23 63JI)c-11 Signature of Agency oard President/Date Signature of Agency Director ate �tcharcJ ZI,cPi kt.r Donct(d E. l3ressl r Printed Name of Agency Board President _ Printed Name of Agency Director ' . Program Information. ..,-H1: ' 1. Program Name ZV e n 5--c.`-J— Contact Person(available to answer specific questions on this application) Harriet Lefton 425-204-2243 Name (Area Code)Telephone 1800 Index Ave.NE Renton,WA 98056 Address(if different than above) hlefton@rtc.edu 425-204-2243 E-mail address(if available) (Area Code)Fax Number 2. Program is New for our agency ❑An Ongoing Program /1 3. Brief Description of Program(One sentence) Family literacy program provides GED , ESL, and parenting classes to very low income parents and simultaneously provides a quality early childhood program for their infants, toddlers, and preschoolers. 4. Where are services provided? (If different from agency location) All services are provided at Hillcrest Early Childhood Center. Hillcrest is a public school serving the preschool population of the Renton School District. t 1 5. Total Program Cost: Actual 2007: $318,969 Proposed 2009: $222,656 • Projected 2008: $297,286 6. Total City Funds Requested for this Program: City Awarded 2008 Requested 2009* General Fund • CDBG Total Requested** Auburn Federal Way Kent Renton $10,000 $20,000 City Awarded 2008 Requested 2009* General Fund General Fund Burien Covington Des Moines Enumclaw SeaTac Tukwila *Cities on a two year funding cycle will renew 2009 awards to 2010 based upon performance and availability of funds. See Part II for city specific information. **Include your total request for Auburn,Federal Way Kent and Renton. The source of funding will be determined by staff. 2 �7. Agency Contact Sheet Provide the following information for the agency and for the program requesting funds. Agency Contacts General Agency Name: Renton Technical College Address: 1800 Index Ave.NE City/State/Zip: Renton,WA 98056 Phone/Fax: 425-235-2352 Agency Web Address: www.rtc.edu Executive Director Name: Donald Bressler Title: President Direct Phone: 425-235-2235 E-Mail: dbressler@rtc.edu Development Director Name: Debbie Ranniger (or Grant Writer) Title: Foundation Director Direct Phone: 425-235-2024 E-Mail: dranniger@rtc.edu Finance/Accountant Name: Melinda Mere11 ',(person preparing invoices) Title: Director of Financial Services f" Direct Phone: 425-235-2352 ext.5509 E-Mail: mmerrell@rtc.edu Program Contact (Staff contact for contracting, reporting and program implementation.) Program Name: Renton Even Start Staff Name: Harriet Lefton Title: Director,Even Start Direct Phone: 425-204-2243 E-Mail: hleftonna,rtc.edu 3 1. Organizational Experience A. Experience The mission statement: Renton Technical College prepares a diverse student population for work, fulfilling the employment needs of individuals, business, and industry. Renton Technical College is a technical college (as state agency) recognized by the State Board for Community and Technical Colleges. For the past 13 years Renton Technical College has partnered with Renton School District in the planning, implementation and evaluation of the Even Start program. The program is one of the highest quality programs in the state of Washington as evidenced by program evaluations and reviews. Renton Technical College programs include: adult basic education and English as a second language, allied health, automotive,band instrument repair, business technology, commercial building and industrial engineering, computer science, cosmetology, culinary arts, education and human services, emergency dispatcher, engineering design technology, land surveying, machine technology,major appliance repair, robotics and industrial controls, and welding. In addition there are,a number of part time classes, including bank teller, child development associate, construction management, legal office assistant, etc. Thee organizational chain for Even Start program: Program Faculty and Staff, Even Start Director, Dean of Basic Studies, Basic Studies Advisory Committee, Vice-President for Instruction, College President Donald Bressler, and Board of Trustees. The Even Start Director and Dean for Basic Studies deliver regular report on Even Start progress to the Board of Trustees and the Basic Studies Advisory Committee. The Dean of Basic Studies supervises the Even Start Program Director and program faculty. The Dean has 25 years of experience in grant and program management. • • All staff are hired through Human Resources using a process prescribed for all Renton Technical College employees. The Human Resources Director has over 15 years experience in human resources management. Human resource has worked with Even Start for 13 years. • The Business Office oversees the processing and payment of all program costs (payroll,purchases, travel, vendor payments, etc.) The Grants Manager tracks expenditures by program issues monthly expenditure reports for review by the Program Director, Dean of Basic Studies,the Executive Vice- President for Administration and Finance, Business Office Manager, and the Board of Trustees. The Grants Manager has 5 years of grants management experience. The Business Office has been managing the financial affairs of the Even Start program for 13 years. • The Basic Studies Advisory Committee oversees the Even Start Program. The committee is comprises of representatives from the Renton Housing Authority, Department of Social and Health Services, the YWCA, King County Health Department,the Employment Security Department,King County Library System, Puget Sound ESD—Head Start,the City of Kent, and Renton School District. Advisory committee members have many years of community experience and provide valuable input to the Even Start program. B. Operational Structure j [he Renton Technical College Board of Trustees is a policy board and meets regularly the second fuesday each month except for July and August. The Board reviews and approves'all major college policies, faculty tenure, grant applications, annual budgets (monitors monthly budget reports),program 4 performance,new initiatives, financial statements,the long range strategic plan,tuition and fee increases, 'land purchases, the college president's contract, long range facilities plans, etc. Trustees are appointed by the Governor of the State of Washington. The Board of Trustees consists of three males and two females. Member racial mix includes one Pacific Islander, one Asian Indian, one African American, and two Caucasian. The Renton Technical College Board of Trustees are active in local boards and organizations such as the National Association of Social Workers, elected Fire Commissioner Fire District 40,member of the State and National Principal's Association,member of the local and state National Committee for Development of Cultural Competence Curriculum for Primary Care Physicians, and the Renton Technical College Foundation. Trustees are also active in their local community such as the North Renton Neighborhood Association, local PTA's groups as well as the King County Bar Association Pro Bono Clinics and the Indian Association of Western Washington. II. NEED FOR YOUR PROGRAM A. Problem Statement - Renton Families That Work/Even Start addresses the literacy needs of Renton families below the poverty threshold. 9.7% of individuals residing in Renton were below the poverty threshold in 2000. - Children of parents who do not speak English demonstrate significantly lower levels of achievement in school and have a far greater likelihood of not graduating from high school. Renton School District reports a steady increase in Renton's ESL population over the last 5 years. Forty'seven languages were represented in the Renton School District during the 2001-2 school year. Renton's foreign born population increased over 11% since 1990. There has been a 123%increase in Renton during the last 10 years of people who speak a language other than English in the home. The population of people reporting speaking English"less than very well"increased from 3.7% in 1990 to 12%in 20000. Children from families whose parents have not completed high school also demonstrate significantly lower levels of achievement when they enter school, and have 3.4 times the likelihood of not completing high school than children from parents of high school graduates. The 2002-3 dropout rate in Renton High Schools was 10.7%. Another indicator of need for the program is the length of our waiting list. Presently 19 qualified Renton families are waiting for places the program. English language limitations prevent Renton residents from obtaining work, integrating into the greater community,participating in city activities, and contributing to the community. English language challenges and parents who are high school drop-outs prevent the young children of these families from having an"Even Start"when they begin school in the Renton School District. B. Target Population -Renton Families That Work/Even Start serves economically and educationally disadvantaged families. 95%of the families served this year reside in the City of Renton. Parents enrolled in the program must 5 provide evidence that their family incomes fall below Federal Poverty Guidelines. Parents qualify for the ,;)rogram if they have not graduated from high school, or if they do not speak English well enough to 4., _,Obtain a job. All families served have at least one child under eight years old. The program serves the entire family: parents, infants,toddlers,preschoolers, and school age children under 8. 92% of students presently enrolled in Families That Work/Even Start speak a language other than English in their homes. Languages of present students include Spanish, Somali, Samoan, Chinese, Korean, Vietnamese, Cambodian, Ethiopian and Ukrainian. 94% of the students presently attending Even Start have very limited skills in speaking and reading English. Ages of parents in the program range from 16 to 48. Approximately 10% of the adults served are teen parents. III. PROPOSED PROGRAM/SERVICE A. Program Description Services Provided and Methods Used Adult Education Parents attend individually focused adult education classes for 22.5 hours per week to improve their basic ;kills in literacy, reading, writing, math, and GED preparation. Emphasis is placed upon improving the 'English speaking and writing skills of those who speak English as a second language (more than half of the families served). "English as a Second Language"instruction includes individual and small group work directed toward measurable advancement in ESL levels. Students are tested frequently and progress is reported to LEP Pathways (DSHS division for ESL students), from whom many of the program's ESL students are referred. Many ESL students move directly into GED preparation when their English skills reach the appropriate level. As the basic skills of the parents improve,the program assists with job search skills, often leading to job placement or entrance to further job training programs at Renton Technical College. Parenting Education Parenting Education involves parents working in small groups to learn researched best practices for helping their children toward school success. ESL students are encouraged to enrich their children's native language by asking probing questions, summarizing, comparing and contrasting, and prompting use of descriptive phrases. Current ESL research indicates that children will extend this rich native language to their English expression when they enter school. Parents receive direct instruction teaching them ways to help their children with homework, how to conference with teachers,preparing conference questions with an interpreter, alphabet and phonics games, etc. Parent and children work together on supervised, directed language activities during the school day and during regularly scheduled staff visits to each family's home. Preschool Education `:'reschool children of parents attending Families That Work/Even Start are enrolled in a state licensed ;;arty childhood program that is designed to immerse both non-English speaking children and English speaking children in a"literacy rich' environment. Vocabulary enrichment, extended conversations, 6 continuous exposure to books and written language, and dictation of children's words and stories extend ind expand language and pre-reading skills through a wide variety of developmentally appropriate ,<tctivities. Activities that enrich children's literacy are continually modeled for parents and children as they participate in their children's.classroom program. Parent Literacy Time The program provides 15 hours/month of Parent Literacy Time. Activities are planned for parents and children together, with opportunities to practice specific parent literacy skills. Parent Literacy Time includes weekly trips with parents and children to the Renton Library story hour. The program assists all parents with obtaining library cards. Parents check out age and interest appropriate books for their children each week. Mandatory homework involves reading to children each day. In addition, Parent Literacy training includes weekly supervised activities for parents and children in the program's preschool classrooms, in addition to regularly scheduled school visits to elementary school classrooms. Home Visits Staff members provide bi-monthly home visits to practice literacy games, reading with children, and parenting concepts learned in class, and to provide support services to families. Location and Program Schedule Program services are provided at a single site: Hillcrest School in the Renton Highlands. Facilities and district support services are contributed in-kind by the Renton School District. Home visits are provided in each student's home. Frequent field trips support literacy and vocabulary development, Field trips 'nclude the zoo, aquarium, children's theater, beach, camping, a fall farm trip and Renton River Days. Program intensity and duration are strengths of the Even Start program design. The program offers 22.5 hours per week of direct instruction to children and adults. Classes for adults and children are held simultaneously Monday through Friday from 9 AM to 1PM. In order to meet the needs of families with alternative work schedules,participates may attend classes at Renton Technical College in the evening and;receive other program services Outreach Recruitment is the responsibility of all staff members, administrators,partners, and current and past students. Potential families are recruited from Renton Early Head Start, Renton Head Start, Renton ECEAP, Renton Schools,Renton DSHS, Public Health, neighborhood flyer distribution and word-of mouth. Presentations by staff are done at the JFS Multi-Cultural Center, at a Renton School District Principals' meeting, and at staff meetings in every elementary school. This is the program's 15th year in the Renton community and it is well known to many community organizations providing frequent referrals. Typically, many of the students in the Even Start program are referred by Renton DSHS caseworkers. Renton Technical College has a dedicated Public Information office with full time staff. RTC materials include descriptions of the Even Start program. The RTC Bulletin is delivered to 210,000 homes. A comprehensive RTC website also includes a program description and is updated regularly. Printed materials are distributed to libraries, school, community centers, etc. Renton School District's 1-'ommunity relations office frequently informs local media about program events and generates press :;overage of the Even Start program. For example,the South King County Journal and the Renton 7 Reporter have run front page stories on the Even Start Prom. Information about Families That Work/ i I'ven Start is available in a number of languages including Russian, Spanish, and Vietnamese. Intake and selection process: 1. Referral agencies and parties are informed of eligibility criteria(Clients must show proof of income below Federal Poverty Guidelines, have a child under 8 years old, and a parent must either not have a high school diploma or speak limited English. 2. Applicants call or bring in a short application is available in their various first languages. 3. Qualifying applicants attend a program orientation, see a video of the program, and have an opportunity to ask questions about the program. Interpreters are provided. 4. After attending the orientation, clients make appointments to register. They are given a list of documentation to bring, including children's immunization forms, doctor's names,proof of income, etc. 5. Registration forms contain a list of need indicators including"single parent", "no high school diploma", "homeless", "lacks support network", "English is second language", etc. One point is assigned to each indicator and a score indicating degree of need is given to each applicant. - 6. Applicants are accepted in order of"most in need". 7. Applicants for whom there is,not room in the program are put on a waiting list according to greatest need. How Program Relates to Need 'each component of the Even Start program (parent education, early childhood education,parent-literacy Mime, home visits, and,parenting education) is directed at meeting the need for providing an"Even Start" for the children of low income, limited English and high school drop out families. Research indicates that a the primary predictor of a child's school success is the educational level of the mother. The goals of the adult education class center around improving parent literacy by helping parents improve their English, obtain a GED, and move on to further job training. Many studies have indicated that parent involvement in schools is a major factor in school success for children. Even Start guides parents in school participation by scheduling school visits, setting specific parent goals for these visits, and helping parents learn to communicate effectively with their children's teachers. Similarly,parents of preschool children are involved in their children's on-site classrooms on a daily basis. Parents are taught how to conference with teachers,how to communicate the needs and interests of their children, and how to help their children with readiness for kindergarten. Before parents can successfully help their children achieve an"Even Start"in school,they need to know and understand child development, appropriate expectations for their children, and effective ways to foster their children's skills. The parent education component of the program teaches parents successful strategies for supporting their children using research based curriculum such as "You Make a Difference". This program gives parents specific strategies for fostering literacy growth in their children, and provides opportunities to gain practice and feedback using those strategies. _ Perhaps the most significant program element in meeting the goal of giving,children of limited English Ind high school drop-out parents an even start when they begin school is.the state licensed early childhood program. Using guidelines from the National Association for Early Childhood Education's "Developmentally Appropriate Practices"and the research based"Creative Curriculum" (also used by 8 Head Start and ECEAP programs in our state),the program provides daily opportunities for children to lain the skills needed for a successful start in school. Pre-reading skills such as print knowledge and .bhonological awareness, and early phonics are taught daily and assessed frequently. Curriculum emphasizes and regularly measures vocabulary growth. Planning for the children's program is built around providing an enriched literacy environment and experience for all children. Frequent federal and state mandated assessments measure outcomes and growth and guide planning for each child's individualized curriculum. Possible Program Changes The Federal Even Start budget has been cut 20% for the 2008-9 school year. For our program this is a cut of approximately$35,000. The survival of the program and the maintenance of quality is dependent upon our other funding sources being able to compensate for this decrease. In addition, our Federal Grant is on a four year cycle ending at the end of the 08-09 school year. At present,we have no guarantee that there will be Federal funding after the 08-09 school year. In the event that Renton Even Start does not receive Federal funding, other funding sources (including a commitment from Renton Technical College to fund the adult instructors) will allow the program to continue, but modifications in intensity and duration of services will need to be made. Collaboration With Other Programs and Agencies Renton Even Start has formal, written collaborative partnerships with Renton School District, Renton Technical College, and Renton Head Start and ECEAP programs. Renton Families That Work/Even Start ias the advantage of being housed at the same site as a variety of Title 1 education programs, Renton School District's Indian Education Program, ECEAP, Special Education classes, and the district's special education preschool. As a building,the personnel from all of these programs visit one another's programs and collaborate and support one another. For example,the Indian Ed Director offers support to our program through linkages with Native American counseling and support services and resources, and through providing our staff with a better understanding of cultural influences on the behavior and learning styles of our Native American families. Even start shares families with the ECEAP and Head Start programs and has a written collaborative partnership agreement with those programs. Regular consultations are held with ECEAP, Head Start and Special Education staff member to support one another's goals for these families. Special education personnel from the school district, including speech, physical therapy, social, emotional and diagnostic services are also housed at the Even Start site, and work collaboratively to serve Even Start children. Many of the students served in the special education program at the Even Start site are serviced under the Individuals With Disabilities Act. Parents of those students frequently attend Even Start. During Parent Literacy Time,the parents of these disabled youngsters are able to participate in their disabled child's classroom. Even start staff is kept abreast of the specific learning goals for these children so that those goals can be incorporated into home visits and parent education to help provide an"Even Start"for disabled children in the Renton Schools. Even Start staff also has a collaborative relationship with DSHS caseworkers. Even Start is a part of the Renton DSHS computerized reporting system, and progress of all DSHS referrals is reported monthly through this system and through regular consultations with caseworkers. Renton Child Care Resources and Vision House Women's Shelter both have similar collaborative agreements with'Even Start. We frequently work together to provide an"Even Start" for children of homeless families. 9 B. Performance Measures and Outcomes Performance Measure#1: Growth in children's receptive language abilities Outcome IA : 85% of children enrolled in the Even Start Program for at least 60 days will demonstrate improvement in receptive language skills. Indicator: measured by the Peabody Picture Vocabulary Test administered every 6 months. Performance Measure#2 : Growth in children's social/emotional skills Outcome IB: 90% of children enrolled in the Even Start Program for at least 60 days will demonstrate improvement in emotional and social skills Indicator: "Ages and Stages Child Monitoring System" administered every two months. C. Staffing Plan Project Director: 1.0 FTE The project director works full time (40 hours/wk year round). She has a bachelor's degree (magna cum laude) in Early Childhood and Elementary Education. She has a master's degree in , Counseling and a Certificate of Advanced Study in Educational Leadership. She is certified as both a teacher and school administrator in Washington State. She has taught in, and been director of two preschools. She has 15 years of elementary and early childhood teaching experience, and 15 years experience as an elementary school principal . This is her fifth year as Even Start Director. ESL Instructor : .8 FTE-serves 20-25 adult students The adult education instructor has a bachelor's degree in Education and enrolled a masters in Adult Education from Western Washington University. As a Renton Technical College instructor, she has participated in extensive training in the teaching of GED, ESL, and Parenting Skills through intensive in-service activities and workshops provided by the college. She has fourteen years of experience teaching adults,has taught adults in Mexico, speaks-fluent Spanish as well as English, and has been an adult instructor for Renton Even Start for ten years. Adult Education(GED) Instructor 1.0 FTE-serves 20-25 adults The adult education instructor is full time senior faculty member at RTC. She holds a bachelors degree in education, and a Masters degree in Education. She has 27 years teaching experience. Preschool Teacher: .61 FTE-serves 10 preschool students (3-5 yrs old) The preschool teacher has an AA degree in Early Childhood Education from Renton Technical College. She joined our staff this fall. She has four year's experience teaching preschool. This year she completed additional trainings in parenting education,preschool curriculum, and literacy development for preschoolers. 10 Toddler Teacher: .61 FTE—(serves 7 toddlers (1-3 years old) The toddler teacher also has an AA degree in Early Childhood Education from Bellevue Community College and a bachelor's degree in Children's Studies from Eastern Washington University. This is her sixth year as the teacher of toddlers. Infant Teacher: .61 FTE—Serves 4 infants,birth to 12 months The infant teacher has a college degree in education from Viet Nam. She taught in Viet Nam for 24 years. She speaks English and fluent Vietnamese and has attended numerous training sessions and workshops about enriching the literacy environment of infants, and Washington State infant daycare regulations and procedures. This is her.8th year serving as Even Start Infant Teacher. Family Support Specialist: .5 FTE The(Family Support Specialist is a graduate of Seattle Pacific University majoring in Communications. She has worked as a caseworker for World Relief and has completed an internship in Uganda. Program Assistant:.61FTE The program assistant attended the Renton Even Start Program with her children for 1 year and obtained her GED. She then graduated from the Renton Technical College Office Assistant Program and was hired by Even Start because of her strong skills and her intimate knowledge of the program from a student point of view. This is her 3rd year as Program Assistant. Toddler Assistant Teacher: .20 FTE r" The toddler assistant teacher came to us first as a volunteer through TRAC Associates. She has 24 years teaching experience in Ukraine as well as a college degree from Ukraine. She is an especially strong asset as growing numbers of families from Ukraine enroll in Even Start. This is her second year with the program. Preschool Assistant .20 FTE The preschool assistant has an AA degree in Early Childhood from Renton Technical College. She speaks two dialects of Chinese fluently. Staff Diversity The Renton Even Start job application specifically invites and encourages minority applicants. The program is especially proud of the diversity its relatively small staff. Of ten staff members, one is Vietnamese, one is Chinese, one is from Ukraine and one is Native American. Among only eight staff members we have fluency eight languages.. Spanish,Vietnamese, Ukraine, Japanese, Russian,two Chinese dialects, and English. D. Program Evaluation The Renton Even Start Program is evaluated yearly by an outside evaluator hired by Renton School District, as well as an annual self-assessment,the data and outcomes reported in the Even Start Federal Reporting System, and through weekly written staff reviews of each component of the project. The outside evaluator works with the program throughout the year to insure accurate reporting, recording `-- land continuous improvement of all program assessments. He works with program staff to insure clarity, accuracy and reliability of assessment tools for adults and children in the program. The local evaluation is 11 an extensive analysis of the program's assessment data, and is used to formulate improvement goals for the following year. It is shared with all partners, collaborating organizations,the school district board, and the Renton Technical College board. Federal Even Start requires that each staff member, clients,board members, and partners complete an annual self-evaluation of every aspect of the program. The data from these self assessment questionnaires are assembled through a Federal Data Base and recommendations for improvement and commendations are generated from the data. Federal Even Start also requires specific outcome goals for children and adults in the program. Adult outcomes include moving ahead a level or more on the CASAS test for GED preparation or moving up a level in ESL as measured by the CASAS. Children's outcomes include improvement of children's language and vocabulary as measure by the Peabody Picture Vocabulary Test, and improvement in social and emotional skills as measured by Ages and Stages. All outcomes for every student and adult are reported through the state data base with monitoring and feedback from the state Office of the Superintendent of Public Instruction in Olympia. Students complete an evaluation of the program before they exit and each student writes an essay reflecting their experiences in the program and suggestions for improvement. D. Differences in Service Delivery by City We'are applying ONLY to the city of Renton since,morethan 95% of our clients are Renton residents. IV. LONG RANGE PLAN The Renton Even Start program is funded through grants from a variety of sources: the City of - Renton, Federal Even Start, WorkFirst, and Family Literacy. Each funding source funds a particular type of service with uniquely identifiable outcomes that are critical to offering a well rounded program that serves the whole family. Major program components include: family literacy, increasing English language skills, adult education,high school completion/attaining a GED, employment and retention,parenting education, and early childhood education and development. For the past 15 years the program has been funded through annual grants. We will continue to make applications for continued funding including seeking new sources of funding through foundations. V. BUDGET A. Budget Request Narrative Funds from the City of Renton will be used to partially fund the salaries of an infant teacher, a toddler teacher, and a preschool teacher. B. Changes in the Budget We have been notified that funding for the Federal Even Start Program and the state WorkFirst , programs will be substantially reduced at the start of the 08-09 school year—the federal grant will be reduced by 20% ($35,000) and the WorkFirst program will also be reduced by approximately$46,00. The survival of the program and the maintenance of quality is dependent upon our other funding sources being able to compensate for this decrease. 12 • Additionally,the following changes have been made to the 09-10 budget: { Equipment: Last year the program bought five new computers. Four were bought to accommodate the growth in the ESL class, since much excellent software has been developed for ESL classes. The other computer replaced a very old office computer that had broken down. With new computers all purchased, the amount budgeted for equipment was decreased significantly. Conference/Travel/Training Last year five staff members participated in a full week's training in San Diego for the"You Make the Difference"Program. This training greatly enhance the parent education component.of our program. This training was highly recommended by Federal Even Start, so we budgeted for it last year.Now that we have all been trained, we have budgeted a decrease in travel and conference funding. Professional Fees and Contracts With the funding decrease, our partners, Renton School District and Renton Technical College, have agreed to assume costs of any professional fees and contracts next year. Therefore we have eliminated this line from our budget. E. Cost per Service Unit(s)— $5946.00—cost of program per child served $297,268(total cost of program)divided by 50 children served=$5946 per child per year The primary outcome of the program is to provide the children served with an"even start". However,in order to facilitate that outcome,the parents of the children also receive ESL,GED and parenting education and therefore also benefit greatly from the program. 13 Agency:Renton Technical College Program:Even Start, 13. NUMBER Of INDIVIDUALS/HOUSEHOLDS SERVED BY PROGRAM Individuals? or n Households? (Check which applies and use for reporting all demographics.) Unduplicated *Unduplicated Number of all Clients Served by Clients Served All Funding Sources with Funds Requested 2007 ' 2009 2007 %of column 1 2008 2009 (Actual) clients served (Anticipated) (Projected) (City Requested by City Funding Only) Auburn Burien Covington Des Moines ;numclaw Federal Way 2 4% 1% 1% Kent 1% 1% Renton 45 96% 98% 98% 50 SeaTac Seattle , Tukwila Other 100% Total 47 (This column must 100% 100% 50 total 100%) *Unduplicated means count each client only once per calendar year per program. This number should match the number of clients by city indicated in the top row of Question 15. 14 Agency: Renton Technical College Program: Even Start 114. Performance Measures & Average Cost of Service (Data Tables) This information will be used by each City to develop 2009-10 contracts with funded agencies. 14a. Your Performance Measures should reflect numbers based on the funding you are requesting from each City. 14b. In the space provided, define at least one (1) and no more than three (3)performance measures the program will report with a brief explanation. Do not use Unduplicated Clients/Households as a performance measure. Provide the estimated number of clients/households served by city your program plans to provide in the corresponding column for each of the performance measures listed. Estimate the number of units to be provided for each measure annually. Provide accurate and realistic estimates. These estimates will be the basis of your contract if funded. 14c. Complete the table with the city funds requested in Question 6 and the unduplicated clients served with funds requested by City listed in the last column of Question 13. Explain any differences between the average cost of service per client between cities in Question 10.D. of your application. Example of Completed Data Tables 14a: 4a. Service with 2009 Requested Funds Proposed Performance Measures as listed below. A)Meals Delivered B) Case Mgmt Hrs C) Auburn 7,000 75 Burien 5,000 50 Data Table 14b. Performance'Measure 2009 Proposed(City Requested Funding Only);..;: :' Title: Brief explanation: A)Meals delivered One meal delivered counts as 1 service unit. Will include intake, assessment,planning, advocacy and evaluation B) Case management hours of results. 15 Agency:Renton Technical College 14. Performance Measures (Data Table) Program:Even Start -14a. Service with 2009 Requested Funds Proposed Performance Measures as defined below. A) Growth in children's B) Growth in children's receptive language social/emotional skills. C) abilities Auburn Burien Covington Des Moines Enumclaw Federal Way Kent ' enton 18 12 SeaTac Seattle Tukwila 14b. Performance Measures 2009 Proposed with funds requested City,Funding Only Title: Brief explanation: A) Growth in children's 85% of children enrolled in Even Start for at least 60 days will receptive language demonstrate improvement in receptive language skills as measured abilities by the Peabody Picture Vocabulary Test. 90% of children enrolled in Even Start for at least 60 days will B) Growth in children's demonstrate improvement in emotional and social skills as measured social/emotional skills. by the "Ages and Stages Child Monitoring System." C) 16 Agency:Renton Technical College .4 Performance Measures (Data Table), Cont. Program:Even Start 14c. Average Cost of Service Unduplicated Clients Served with Funds Average Cost of Service Requested 2009 Requested 2009 per Client (Same as last column of (Same as last column of Question 6) Question 13) Column 1 divided by Column 2 Example: $5,000 45 $111.11 Auburn Burien Covington Des Moines Enumclaw 'ederal Way Kent Renton $20,000 50 $400 SeaTac Seattle Tukwila 17 Complete Question 15 with 2007 Actual numbers reported in column 1 of Question 13. Agency: Renton Technical College 15. Demographics (from all funding sources) (Data Table) Program: Even Start 3 as Client Residence o 5 o c �, at d P1 U W r- P4 v) H E� Unduplicated. (check one) ®Individuals N in 0 Households Served in 2007* Household Income Level 30%of Median or Below 2 45 47 50%of Median or Below 80%of Median or Below Above 80%of Median Unknown _ TOTAL Gender Male 22 22 Female 2 23 25 TOTAL 47 ( Age - _ 0-4 years 2 40 42 5- 12 years 5 5 13 - 17 years 18-34 years 35-54 years 55-74 years 75+years Unknown _ TOTAL L 47 Ethnicity Asian 3 3 Black/African American 7 7 Hispanic/Latino(a) 2 31 33 Native 3 3 American/Alaskan Pacific Islander 0 White/Caucasian 1 1 Other/Multi-Ethnic TOTAL 2 45 47 Female Headed 19 Household.` Disabling Condition 2 ,.Limited English 2 18 20 ( )Speaking,. 18 * Check Individual or Household,which should be the same as checked in Question 13. Unduplicated means count each client ,- .r7)n1y once per calendar year. This should match the number served by City-in the Actual 2007 column of Question 13. The `total"column will be different from Question 13 since the"other"column is not included due to space limitations. 16. PROGRAM STAFF (DATA TABLE) In this data table, record the number of full-time equivalent(FTE)paid staff and,volunteers for this program. FTE means a 40-hour week throughout the entire year. For example, if you enter"5"in the box for Number of Volunteer FTEs,this would mean that you have, on average, five volunteers assisting your program at all times (assuming a 40-hour week). If you know only the total number of hours contributed by all volunteers for this program, simply divide that number by 2,080 to find the total FTE number. For example: 5,000 volunteer hours over the course of a year, divided by 2,080 equals 2.4 FTEs. 2007 2008 2009 (Actual) , (Budgeted) (Projected) Total Number of Staff(FTEs) 5.34 5.54 5.54 Number of Volunteer(FTEs) 1 1 Actual Number of Volunteers 1 17. PROGRAM REVENUE & EXPENSE BUDGETS (DATA TABLE) Program Budget: All columns should include total program operating revenue and expenses. Complete the following data tables with figures indicating the source of program operating funds for 2007 (actual), 2008 (budgeted) and 2009 (projected). Budget amounts should match funding requested (Question 14c) and,Question 5. Include an explanation of any significant differences between the revenues and expenses by year in Question 12B of your application. - 19 Agency:Renton Technical College 17. PROGRAM REVENUE BUDGET (DATA TABLE) Program:Even Start Revenue Source 2007 2008 2009 (Actual) (Budgeted) (Projected/ Requested) City Funding(General Fund & CDBG) - • Auburn • Burien • Covington • Des Moines • Enumclaw • Federal Way • Kent • Renton $10,000 $10,000 $20,000 • SeaTac • Seattle • Tukwila • Other(Specify) • Other(Specify) Other Government Funds • King County • Washington State $150,852 $128,376 $77,056 • Federal Government(Specify) $158,117 $158,910 $125,600 • Other(Specify) Private Sources • United Way(grants &designated donors) • Foundations and Corporations • Contributions (e.g., Events, Mailings) • Program Service Fees (User Fees) • Other(Specify) TOTAL PROGRAM BUDGET $318,969 $297,286 $222„656 20 17. PROGRAM EXPENSE BUDGET, CONT. Agency:Renton Technical College +, DATA TABLE) Program:Even Start Expenses 2007 2008 2009 (Actual) (Budgeted) (Projected) Personnel Costs • Salaries 225,719 192,359 147,439 • Benefits 79,850 79,175 62,775 • Other • . Total Personnel 305,569 271,534 210,214 Operating and Supplies • Office/Program Supplies 4,569 8,269 5,942 • Rent and Utilities • Repair and Maintenance 231 • Insurance • Postage and Shipping • Printing and Advertising 150 • Telephone • Equipment 8,860 4,500 • Conference/Travel/Training/Mileage 5,704 8,623 2,000 • --Dues and Fees • Professional Fees/Contracts 2,746 • Direct Asst. to Individuals • Administrative Costs • Other(specify) • • • • TOTAL PROGRAM EXPENSES 318,969 297,286 222,656 ]' 0 0 0 Net Profit(Loss) '1 (revenue—expenses) = 21 Program:Even Start 18. SUBCONTRACTS (DATA TABLE) Agency:,Renton Technical College .List all the agencies you will be subcontracting with for this program. Provide the agency name in the first column, a description of the contract/service in the second column, and the contract amount in the third column. Do not list agencies you coordinate with on a referral only basis. Indicate not applicable if you do not subcontract for any part of this program. Subcontracting Agency Specific Subcontracted Activities Contract in the Operation of Your Program Amount None 22 19. APPLICATION CHECKLIST ' applications missing one or more of the following components or not following these directions may not e reviewed. Sign and submit the application checklist with your application: Contents (Your application should contain each of these items in this order.) 11 Application Cover Pages.The top three pages of your application must be a completed copy of the Agency Information and Questions 1-7. Application Narrative: • Question 8 Organizational Experience(2 page maximum) Question 9 Need for Your Program(2 page maximum) ® Question 10 Proposed Program/Service(6 page maximum) © Question 11 Long Range Plan(1 page maximum) ® Question 12 Budget(2 page maximum) Data Tables O Question 13 Number of Individuals/Households Served ® Question 14a-c Performance Measures and Average Cost of Service • Question 15 Demographics(from all funding sources) • Question 16 Program Staff • Question 17 Program Revenue&Expense Budgets ® Question 18 Subcontracts at Required documentation. Supply one copy of the following required documents with the signed original application. See Part II: City Specific Supplemental Information to determine whether additional copies of the application and required documentation need to be submitted. El Question 19 Required Documentation, including: - • Proof of non-profit status • Organizational Chart' ■ Agency/Organization Mission Statement • Board resolution authorizing submittal of the application(may be submitted up to 60 days after ' application). • List of the current governing board and local board, if applicable,(include name,position/title, city residence, length of time on the Board, and expiration of terms. Note any vacancies.) • Board Meeting Minutes of last three board meetings of governing board and,local board as applicable - ■ Annual Budget ■ Financial Audit Cover Letter • Financial Audit Management Letter • Financial Statement • Verification of Non-Discrimination Policy • Program Intake Form • Sliding Fee Scale IX Application Check List. (Signed below.) RICity Specific Supplemental Information.Required in Name: _Harriet Lefton Part II for applicable City only. Position: Director,Even Start Phone#: 425-204-2243 V4 ^/ /9 / E-mail: hlefton(a,rtc.edu Signature of Person Completing Checklist DO NOT SUBMIT ANY OTHER MATERIALS WITH THIS APPLICATION Make sure that you carefully check Part II of this application 23 to see what additional attachments each city requires. Supplemental Questions n--,ton Result #1: All children and Youth are ready for educational success,work, and life. rcenton Strategy B Families and children have services and programs that support their success in schools and access to them. Renton Even Start directly addresses the above strategy and result by providing a daily program for children and their parents. The program has been designed by the U.S. Office of Education specifically for the purpose of giving children of poverty an "even start" in school and in life. Critical elements of the program are based upon extensive research in family literacy compiled by the William F. Goodling Family Literacy Foundation. The Even Start program: • Provides a state licensed, research based, early childhood curriculum to children birth to five. • Provides a literacy based program for children designed to enrich vocabulary and pre-reading skills. • Provides five hours per week of direct instruction to parents teaching specific ways to help their children succeed in school. • Exposes children and families to a wide variety of life experiences to build vocabulary and expand their worlds and life goals. • Fosters school success by providing bi-monthly visits to classrooms of school age children to encourage parents to become active partners in their children's education. Renton Strategy C: Encourage parents to read to their children This strategy is a primary goal of the Even Start program. Parents are encouraged to read to their children through the following activities: • Weekly lesson using the research based "You Make the Difference" Curriculum which teaches parents why it is important to read to children and ways to extend and enhance the reading experience. - • Mandatory homework for every parent in the program is to read with their children for 20 minutes each night. Parents keep a log of books they have read with their children. • At bi-monthly home visits, each child in the family is given a free book. Books are selected according to the ages and interests of each child. • During each home visit parents read the new books to their children and a staff member coaches them on ways to enhance comprehension and extending meaning. • Each Tuesday,the program takes all parents and children to the Renton Library for story hour. All parents in the program have library cards and select books each week to take home. • Each Friday, time is set aside for parents and children to read together. Books are pre-selected to correlate with the preschool curriculum and a cozy area is provided for reading. Supplemental Question 2 Renton Result#1 All Children and youth are ready for educational success,work, and life. Program Outcome 1A: 85%of children enrolled in the Even Start Program for at least 60 days will ' demonstrate improvement in receptive language skills as measured by the Peabody Picture Vocabulary Test. Children enrolled in the Even Start Program are severely delayed in their language development. Children in the program have multiple risk factors for language delay. They are all children of poverty, whose parents either speak a language other than English or have dropped out of school before graduating from high school. "Educational success"`for these children will be dependent upon the goal that they will begin school with vocabularies that are within the average range for their age. When children enter the program,they typically score below the 10th percentile for their age. Daily activities are planned to enhance and increase vocabulary to promote the educational success of the children. • Program Outcome 1B 90%of children enrolled in the Even Start Program for at least 60 days will demonstrate improvement in emotional and social skills as measured by"Ages and Stages Child Monitoring System". Educational,work, and life success is dependent upon adequate social and emotional skills. Children enrolled in Even Start also have multiple risk factors for social and emotional development. Many have witnessed domestic violence. Most live in homes with multiple families sharing minimal resources. All are children of extreme poverty. Many have family members or one parent living in another country, Several are homeless and living in shelters. The program provides a stable,warm, nurturing environment every day,with highly trained teachers who work daily to foster improvement in specific social and emotional skills. Daily observations are recorded for all children. Social and emotional development is measured according to specific criteria every two months. l pzzi WASHINGTON STATE BOARD FOR COMMUNITY & TECHNICAL CAROL NER RENTON TEC ICAL COLLEGE HCOLLEGESS March 19,2001 y MEMORANDUM Ref.: 01-32-06 TO: Presidents Business Officers ; FROM: Chuck Greenoug /4\ SUBJECT: COLLEGE TAX EXEMPT STATUS 0 Several colleges have been approached by potential donors who need to know any contributions they make will be tax deductible. The following was furnished by the Internal Revenue Service and is provided for your information.. As an instrumentality of a governmental unit, the community and technical colleges are not subject to Federal income tax under the provisions of Section 115(1) of the 1954 Internal Revenue Code, which states in part: "Gross income does not include income derived from the exercise of any essential governmental function and accruing to a State or any political subdivision thereof.. " Your income is not taxable as explained above, since you are an instrumentality of a governmental unit. As an instrumentality of a government, contributions to you are deductible under Section 170(c).(1) of the code.• . • If you have any questions,please feel free to contact me at(360) 753-2644 or email at cgreenough@sbctc.ctc.edu. . i Earl Hale,;Executive Director 319 7th Avenue P.O.Box 42495 Olympia,Washington 98504-2495 (360)753-2000 FAX(360)586-6440 Renton Technical College Instructional Organizational Chart FY07 ' President Dr.Donald E.Bressler Vice President Instruction Martin Heilstedt I I I I I I _ Dean Dean Dean Dean Dean Business Tech, Dean Technical Programs Director Trade&Industry and Basic Studies Trade&Industry Education&Human Allied Health CulinaryArts Apprenticeship &Distance Education Services and Heather Doug Medbury Gay Kiesling John Chadwick Karen Johnson Dante Leon General Education Stephen-Selby Peggy Moe PREPARATORY ,PREPARATORY PREPARATORY PREPARATORY PREPARATOIRY PREPARATORY PREPARATORY Commerical Bldg Engineer/ Adult Basic Education Auto Body Repair&Ref Civil CADD Accounting Clerk Cert.Ophthalmic Assist. Culinary Arts Industrial Adult Education Automotive,Ford ASSET Computer Network Tech Accounting Paraprofessional Dental Assistant Professional Baking Construction Trades Prep English as a Second Lang Automotive Gen Svc Tech Computer Science Accounting Specialist Nursing Asst Cosmetology External Diploma Program Automotive,ITEC Engineering Design Tech Administrative Assist Licensed Practical Nurse Barber GED Test Prep Automotive Tech Land Surveying Bank Teller Massage Therapy Prac Esthetician Vocational Support Custodial Training(KCRJC) Computer App/Data Entry Medical Assistant Manicurist Dispatcher Early Childhood Careers Medical Lab Tech Machine Tech/CNC Band Instrument Repair Tech Legal Sec/Legal Assist Pharmacy Tech Major Appl&Refrig Tech Medical Admin Secretary Phlebotomy Tech Welding Medical Receptionist Surgical Tech Medical Office Coder Office Support/Receptionist • Paraedu/Instru Asst • SUPPLEMENTAL ABE(KCRJC) SUPPLEMENTAL SUPPLEMENTAL SUPPLEMENTAL SUPPLEMENTAL SUPPLEMENTAL Industrial Studies Even Start(Federal) Trade&Industry Technical Business Technology Allied Health Occupations Professional Baking Trade&Industry Families That work Emergency Communications Technical Studies Parent Education Anger Management LEP Pathway Glass Blowing Real Estate Central Service Technician APPRENTICESHIPS QTTP Sewing Small Business First Aid/CPR Journey Upgrade WDC Learning Centers Education& Construction,Manufacturing, Workplace Basics Human Services and Public Utilities Supervisory& MOTOR POOL Management Programs CONTRACT TRAINING CONTRACT TRAINING CONTRACT TRAINING CONTRACT TRAINING CONTRACT TRAINING CONTRACT TRAINING WORKFIRST WORKFIRST WORKFIRST WORKFIRST WORKFIRST WORKFIRST DISTANCE EDUCATION DISTANCE EDUCATION DISTANCE EDUCATION DISTANCE EDUCATION DISTANCE EDUCATION DISTANCE EDUCATION TECH PREP/SCHOOL-TO-WORK GENERAL EDUCATION I\) O See Procedure 13010.041 for options withir - ms o N • .(I - - OOo n • • Renton Technical College Policies and Procedures Manuel RTC 2RTC 1/01 Non-Discrimination No employee of Renton Technical College shall, on the basis of race, creed, national origin, sex, age, or handicap be excluded from participation in, be denied the benefit of, or be otherwise subjected to discrimination under any program or activity in which the college participates. • As published in all quarterly Class Schedules: • Mission Statement Renton Technical'College&prepaces a diverse-student • population for,wo'rk,fulfilling the employment needs•of individuals,business, and industry , Multicultural Mission Statement, • Renton Technical College seeks to create a. . healthy;positive climate.where.the many voices. of our.students,-faculty and staff are heaid and Valued:The 11.TC cotnmuriiry will learn and • apply intercultural.skills to•encourag"e'positive 1. relationships in the world of work." Equaf Opportunity . • Renton Technical,'College is committed.to non- discrimination in'all of its educational and employment • activities,and to.'provide'equal''access.to each dim educational"programs:ar3d activities,-and.employment . opportunities:This policy:shall'applyto all students and . • applicants for•admission,as well•as all employees and' • applicants for"einployment;.without.regard to race;color; • creed;religion;national-origin;sex;setual•orientation; marital status,age;the presence•of any sensory,mental or •• physical disability;.or whether a,Vietnam-era or disabled veteran.."Questions regarding the;college affirmative action policies;harassment or discrimination•should be;`-`Ti, directed to Director of Human.Resource Development at. ', • • (425.),235=.7873,;Accommodations foe both.physical and • mental.disalilitie`s",should:lie directed to Student Services • at.(425)235=2352i'ext.5544:, • C . I . _ I Renton Technical College Board of Trustees Appointment Listing 2007-2008 Trustee Name Address Appointment Terms Ronnie Behnke 11252 SE 188th Place 10/1/06—9/30/11 (5 years) The Boeing Company Renton WA 98055 3/1/02-9/30/06(4 years 7 months) Frank Irigon 13512 SE 75th Street 10/1/07—9/30/12(5 years) Retired Newcastle WA 98059 11/1/02-9/30/07(4 years 9 months) Ira SenGupta 13514 SE 181s`Place 12/01/04-9/01/09 Executive Director Renton,WA 98058 (4 years,9 months) Cross Cultural Health Care Program Richard Zwicker 446 Pelly Avenue North 10/01/05-9/30/10(5 years) • Paralegal,Attorney Generals' Office Renton,WA 98055 One(1)open position • • • 1 I, I � 0 4E2* Renton Technical College Board of Trustees Regular Meeting • Roberts Campus Center,Board Room,Room 202 January 8,2008 - 8:00 a.m. Minutes • 1. CALL TO ORDER • The meeting was called to order at 8:06 a.m. by board chair, Mr. Zwicker. It was noted that Trustee Behnke was not present. Trustees Irigon, SenGupta and Zwicker were present and a quorum was established. Mr. Zwicker led the flag salute. 2. ADOPTION OF MINUTES Mr. Zwicker asked for corrections and/or additions to the December 11,.2007 regular board meeting minutes. • It was moved by Mr. Irigon and seconded by Ms. SenGupta to approve the December 11, 2007 regular Board of Trustees meeting minutes as presented. Motion carried. 3. COMMUNICATIONS A. Correspondence There was no correspondence for public reading. B. General Information Director Frey introduced the Renton Technical College All USA Academic Team nominees Jo Baca, Computer Science; Joy Jones, ParaEducator, Laura Lipscomb, Computer Science, and Rosario Sincioco, Computer Science. Director Frey announced that Laura Lipscomb and Rosario Sincioco were selected to represent Renton Technical College at the state and national competition. F President Bressler announced that the Ford ASSET program was named a national runner-up of the Automotive Industry Planning Council Awards of Excellence in the Post-Secondary, Manufacturer-Affiliated program category at the December 13-15, 2007 ACTE Annual Convention in Las Vegas,Nevada. President Bressler acknowledged the great work of staff as the Student Success Center celebrates supporting over 25,000 students over the past three years. President Bressler read a thank you. note from a perspective student and her parent regarding the time and effort that Karma Forbes gave to them on a recent visit to the college. C, Comments from the Audience There were no comments from the audience. • 3000 Northeast Fourth Streel - Renton,WA 98056-4195 425-235-2352 www.RTC.edu t ' BOARD OF TRUSTEES MEETING Minutes-January 8, 2008 4. TRUSTEES A. TACTC Winter Conference, January 22&23, 2008 Vice President Tiernan spoke with trustees on the development of local and state topics that would be discussed as trustees meet with legislators in Olympia during the TACTC Conference. 5. PRESIDENT A. Luther's Table Project President Bressler introduced Compass Center Development Team members Rick Friedhoff and Mark Thometz and Baylis Architect Rich Wagner. He explained that this project would provide an opportunity for the college to serve a greater community through its English as a Second Language program combined with other vocational training opportunities. Information was provided on the mission of the project,the viability of the funding,who would be served,the available services,and how Renton Technical College would serve its clients through training. B. Strategic Plan—Expand Community&Economic Development Activities Vice President Tiernan reported on the outreach activities that the college is using to educate the public about Renton Technical College. These activities include adopting the , Issaquah community relative to chamber activities, visitations to high schools, and additional outreach advertising. The foundations current house building project as well • t as using MySpace.com also puts the college into new arenas. Vice President Tiernan said that continuing to develop business partnerships continues to be successful as seen with McLendon Hardware, IKEA, and the City of Renton. The college is also highlighted when outside companies,college partners, and community events are on the campus. 6. INSTRUCTION A. Apprenticeship FTEs Dean Kiesling presented an overview of the apprenticeship growth of 127% in FTEs over the last several years and how this has affected the r - apprenticeship programs across the state. She was very pleased to report that of the 30 applications received, Renton Technical College was one of 14 proposals funded in the amount of$398,650 which was 41 percent of the total funding available. This will have a positive affect on Carpenter/Piledrivers/Scaffold, LADS-Carpenters, and Seattle Pipefitters trades. B. China Tour Report Vice President. of Instruction Marty Heilstedt presented a pictorial report on his recent trip to China. Vice President Heilstedt made this trip as part of a delegation from the City of Renton and the Renton Chamber of Commerce to the city of Linyi in Shandong province. During their two day visit to Linyi, members of the delegation toured manufacturing facilities, Linyi University, and Linyi Technical College. A highlight of the trip was the signing of a friendship city agreement by the mayors of Linyi and Renton and an economic cooperation agreement between the presidents of the'two cities' Chambers of Commerce. The delegation's trip also included ' visits to Beijing and Shanghai. 2 BOARD OF TRUSTEES MEETING Minutes—January 8,2008 7. RENTON FEDERATION OF TEACHERS . A. Faculty Report Faculty Representative Devine was pleased to report that the five technical colleges are meeting and discussing the best avenue to take in regard to developing a common salary schedule that will meet the needs of the five technical colleges. He indicated that finding a common method that meets the diversity of the technical colleges is a challenge. 8. STUDENT SERVICES/FINANCIAL AID • A Enrollment Report Vice President Pozega reported that enrollment continues to be a concern in some areas. He said that staff continue to work towards improving enrollment and that the college should meet its enrollment target. B. Opportunity Grant Director Solomon explained that the goal of the Opportunity Grant is to provide eligible students funding to cover all tuition,mandatory fees and up to $1,000 for books and supplies for 45 credits. Through the grant the college hired case manager Tern Turner who will work closely with students in every aspect of their training to ensure that students are successful in their program. Director Solomon said that Opportunity Grant students must maintain a 91 percent cumulative attendance and have at least a 2.0 grade point average. I C. Crime Statistics Elman McClain director for Public Safety and Security discussed with trustees the type of incidents on or near the college facilities as well as those incidents on the college campus. He indicated that the department is working on the development of department goals, crime reporting, and training. D. Graduation Dates Trustees were provided corrected information on the Renton Technical College's graduation dates as follows: Winter Graduation—Thursday, March 27, 2008 at the New Life Church at 7 p.m. and Summer Graduation—Thursday, August F 7, 2008 on the RTC Campus at 7 p.m. 9. ADMINISTRATION/FINANCE/OPERATIONS A. Administrative Report Vice President Werner reviewed with trustees the personnel activity for the period ending December 31, 2007. B. Source/Use of Funds As a regular report to the Board of Trustees, Executive Vice President Werner provided information on the revenues and expenditures for the period ending November 30, 2007 compared to the same period in the prior two fiscal years. Not included in this report are grants and contracts,'abatement programs,bookstore, food services, childcare, and financial aid that are all self-supporting areas. Executive Vice President Werner said that the college is expected to have less carryover than in previous years and there will be less dollars for equipment and one-time purchases. 3 • BOARD OF TRUSTEES MEETING Minutes—January 8,2008 10. INSTITUTIONAL ADVANCEMENT A. Renton Technical College Foundation Vice President Tiernan announced the following: • Spring scholarships are now available on line and the foundation awarded 29 scholarships last quarter; • The Hawaiian Luau Culinary Scholarship invitations were mailed out for the February 8th event; • The Foundation's purchase of property for the house building project has been put on hold until the housing market improves; the foundation will continue work on a marketing and solicitation plan. • A listing of Spring Quarter scholarships was provided to trustees. B. Public Information . Information was provided on recent press releases, advertising, publications, college marketing efforts,and recent community relations efforts. C. Research &Development Vice President Tiernan reported Director Chris Johnson has brought a high level of energy to the department. 12. EXECUTIVE SESSION An executive session was not held. 13. MEETINGS Due to the conflict of the ACCT National Convention in Washington DC, the next Board of Trustees meeting will be held on February 19, 2008. 14. ADJOURNMENT F .. It was moved by Mr. Irigon and seconded by Ms. Behnke to adjourn the Board of Trustees' meeting at 11:15a.m. Motion carried. RICH ZWICKE , it DR. DONALD E.BRESSLER, Secretary Board of Trustees Board of Trustees 4 . 4030 Renton Technical College Board of Trustees Regular Meeting Roberts Campus Center,Board Room,Room 202 February 19,2008 - 8:00 a.m. Minutes 1. CALL TO ORDER The meeting was called to order at 8:03 a.m. by board chair, Mr. Zwicker. It was noted that all trustees were present and a quorum was established. Mr.Zwicker led the flag salute. 2. ADOPTION OF MINUTES Mr. Zwicker asked for corrections and/or additions to the January 8, 2008 regular board meeting minutes. It was moved by Mr. Irigon and seconded by Ms. SenGupta to approve the January 8, 2008 regular Board of Trustees meeting minutes as presented. Motion carried. 3. COMMUNICATIONS A. Correspondence Letter dated February 11, 2008 from the Trustees Association of Community and Technical Colleges regarding a request for TACTC award nominations. Letters dated January 11, 2008 regarding two announcements on the search for the position of President and the position of Vice President of Student/Administrative Services at Spokane Falls Community College dated January 11,2008. B. General Information Information was provided on several upcoming college events for trustee information including the: • All-USA Academic Team Ceremony will be held on March 20, 2008 at South Puget Sound Community College at 12 noon; • Renton Technical College Winter Graduation will be held on March 27, 2008 at the New Life Church beginning at 7 p.m.; • The Renton Technical College Job Fair is scheduled on April 23, 2008 from 10:00 a.m.— 1:30 p.m. in the college cafeteria; • The CommUNITY Festival —Together in Diversity will be held the week of June 2- 5, 2008 with events being held throughout the week including the evening activities on June 5th and • On August 7, 2008 the Renton.Technical College Summer Graduation will be held at r,. 7 p.m. on the college campus. 3000 Northeast Fourth Street— Renton,WA 98056-4195 '425-23572352 -www.RTC.edu BOARD OF TRUSTEE MEETING Minutes—February 19,2008 C. Comments from the Audience There were no comments from the audience. 4. TRUSTEES A. President's Evaluation Process Subcommittee Following discussion regarding the development of the president's new evaluation process, it was moved by Trustee SenGupta and seconded by Trustee Zwicker to elect Trustee Behnke and Trustee Irigon as co-chairs of the president's evaluation subcommittee. Motion carried B. President's Evaluation Process Discussion centered on the process that would be used for the president's evaluation. Trustees determined that Trustees Behnke and Irigon would meet to develop the evaluation process and questions and would report back to the board at its March meeting. C. President and Board Goals for 2008-2009 Following discussion of the board's president's evaluation process trustees tabled the setting of the president and board goals for a date to be determined. D. ACCT National Legislative Summit President Bressler reported on his visitations to local senators and representatives at the February 11-13, 2008 Community College National Legislative Summit held in Washington D.C. President Bressler said that he focused his attention on the impact to Renton Technical College if funding was not reauthorized for the Perkins Act Career and Technical Education Programs. He explained that the college uses these funds for faculty development and in-service training for classified staff, peer tutoring, faculty outreach to industry, childcare for low income student parents and many other student/faculty/staff associated activities. E. Legislative Session Update Trustee Zwicker reviewed with trustees the current information coming out of the legislative session. F F. Trustee Travel Executive Vice President Werner discussed with trustees changes that may be necessary to the college's travel procedure that will affect board members. Trustees Irigon and Zwicker were selected to serve as the travel subcommittee. Board chair Zwicker asked for a draft policy that would be board specific and asked that it would be reviewed by the travel subcommittee by March 4th, 2008 and then submitted to the trustees for review at the March 11th board meeting with scheduled adoption at the April board meeting 5. PRESIDENT A. Strategic Plan— Overview of Strategic Plan Effectiveness President Bressler reviewed with trustees the current college Strategic Plan and made a comparison with the information coming out of the Achieving the Dream activities. He felt it was important for the trustees to provide input into the process as the college moves to a single method of analyzing data information. 2 BOARD OF TRUSTEE MEETING • Minutes—February 19,2008 • B. WACTC Board of Presidents'Report President Bressler reported on the following areas: • the,college's automotive remodel was approved by the state and has been placed on a six year funding cycle; • following the close of the legislative session President Bressler would like to invite state legislators to participate in campus tours; and • the funding short fall between cost and reimbursement for the Running Start program. 6. INSTRUCTION A. Allied Health Grants Dean Heather Stephen-Selby explained that the college is a strong grant provider in Allied Health due to the advantage of career laddering, expertise in IBEST curriculum integration, the use of the Universal Design for Learning, multidisciplinary sharing of curriculum and faculty expertise, the replication of real laboratory experiences and clinical/externship/internship learning. Dean Stephen Selby outlined-the work being completed with previous grant development such as the Youth Nursing Careers for All, the Virginia Mason Job Skills program, and the Washington Center of Nursing. Other program grants include the ongoing King County Dental grant that has provided _ !I new equipment, cabinets and simulators over the last five years; the Clinical Placement Grant in South King and Pierce counties that provides a clinical placement coordinator and administrative support; the Virginia Mason Mini Grant that provided funding for'a work based learning program for the medical assistant program for incumbent workers and the Robert Wood Johnson Grant provided money to develop work based curriculum and delivery systems for incumbent workers to become.Certified Medical Assistants. Dean Stephen-Selby was pleased that the additional technology assisted 394+ students, served 102+ individuals, which makes Renton Technical College the leader in working with industry,non-traditional and diverse students. 7. RENTON FEDERATION OF TEACHERS A. Faculty Report Faculty Representative Devine asked that the college continue to move forward on the campus safety issues. He also reported that faculty are working on preparing documents for the tenure packets and that negotiations will begin again shortly with conclusion in June. - 8. STUDENT SERVICES/FINANCIAL AID A Enrollment Report Vice President .Pozega was pleased to report that Renton Technical College is one of a few colleges who will make their FTEs. Enrollment continues to be a concern in some areas. - -- 3 BOARD OF TRUSTEE MEETING Minutes—February 19,2008 B. Security Report Providing an update on the recent developments in the college's security area, Director for Public Safety & Security Elman McClain provided trustees information on the status of the emergency notification systems as follows: BCC ALERTS —Currently being evaluated by Information Services (IS). An additional new server and new software may be need or look at hosting off campus. Some questions to consider will the full burst come through the firewall or only particle. Some colleges have had issues with other burst paging systems, the institutions firewall would only allow a certain number of messages through at once. ALERTUS — In building paging and texting system that works off of wireless paging. USA Mobility and ALERTUS will be signing an agreement shortly. Will be of benefit to the college for mass notification, centralized paging, and battery back up, can be paged from mobile devices. The college is looking at one of the alternatives as a wireless paging system which includes a telephone system upgrade with a speaker. in each building with voice and siren alarm. WEBS —Made by Talk-A-Phone would be located around campus is a new Wide-Area Emergency Broadcast System (WEBSTM) that integrates the company's emergency/information phone and wide-area broadcast capability into a single emergency/information. The legislature is moving towards funding of a campus mapping system with would be provided to first responders. The college is currently waiting to hear from the legislature to purchase one of these systems, if the legislature does not provided funding the college will need to budget from its carryover dollars for implementation next year. 9. ADMINISTRATION/FINANCE/OPERATIONS A. Administrative Report Vice President Werner reviewed with trustees the personnel F - activity for the period ending January 31,2008. B. Source/Use of Funds As a regular report to the Board of Trustees, Executive Vice President Werner provided information on the revenues and expenditures for the period ending January 31, 2008 compared to the same period in the prior two fiscal years. Not included in this report are grants and contracts, abatement programs, bookstore, food services, childcare, and financial aid that are all self-supporting areas. 10. INSTITUTIONAL ADVANCEMENT A. Renton Technical College Foundation Vice ' President Tiernan announced the following: • Spring scholarships are under review with awards to be announced shortly. • The emergency needs fund brought in $8,400 from the Luau and additionally the foundation received a $7,500 contribution for the fund from the Norcliffe 1 Foundation. 4 BOARD OF TRUSTEE MEETING Minutes—February 19,2008 • The Hawaiian Luau Culinary Scholarship Fundraiser netted close to $25,000 an increase from last year. Attendance and auction contributions were also up from the previous year. • The Foundation has met and exceeded its goal of raising dollars for scholarships for 2007-2008. B. Public Information Information was provided on recent press releases, advertising, publications, college marketing efforts, and recent community relations efforts. C. Research&Development Vice President Tiernan was pleased to report that the Research & Development Department is fully staffed with the addition of Patricia Chakravarty and Dustin Walton. He also spoke to the various activities of the team in using quantitative and qualitative data together in examining strategies while dovetailing other initiatives into this process such as Student Achievement and Universal Design for Learning. D. Achieving the Dream Report Vice President Tiernan reported on the recent Achieving the Dream Strategy Institute in Atlanta, Georgia. The team was able to gamer tremendous knowledge from other colleagues nationally. The work plan consisted of revising the communication planfor on and off campus, as well-as considering new ways to package student success work on campus. 11. EXECUTIVE SESSION An executive session was not held. 13. MEETINGS The next Board of Trustees meeting will be held on March 11,2008. 14. ADJOURNMENT It was moved by Mr. Irigon and seconded by Ms. Behnke to adjourn the Board of Trustees' meeting at 11:15 a.m. Motion carried. RICH ZWICKER, Cha' DR.DONALD E.BRESSLER, Secretary Board of Trustees Board of Trustees 5 4E31° Renton Technical College Board of Trustees Regular Meeting Roberts Campus Center,Board Room,Room 202 March 11, 2008 -8:00 a.m. Minutes 1. CALL TO ORDER The meeting was called to order at 8:06 a.m. by board chair, Trustee Zwicker. It was noted that all trustees were present and a quorum was established. Trustee Zwicker led the flag salute. 2. ADOPTION OF MINUTES Trustee Zwicker asked for corrections and/or additions to the February 19, 2008 regular board meeting minutes. It was moved by Trustee Behnke and seconded by Trustee SenGupta to approve the February 19, 2008 regular Board of Trustees meeting minutes as presented. Motion carried. 3. COMMUNICATIONS A. Correspondence There was no correspondence for public reading. B. General Information The new director for information services, Mary Kay Wegner was introduced to the Board of Trustees by Executive Vice President Werner. Ms. Wegner provided an overview of her work experience which includes working for the Port of Seattle and the cities of Bellevue and Redmond. Trustee Zwicker reminded trustees of the upcoming Winter Graduation Ceremony that will be held on March 27, 2008 at the New Life Church. C. Comments from the Audience There were no comments from the audience. 4. TRUSTEES A. Presentation of Faculty for Tenure Counselor Karma Forbes and Media Librarian Laura Staley were individually interviewed by trustees regarding their responsibilities at the college and the tenure process. Following each candidates interview trustees took the following action: After giving reasonable consideration to the recommendations of the tenure review committee and all other recommendations, it was moved by Trustee Irigon and seconded by Trustee SenGupta that Karma Forbes and Laura Staley be awarded tenure effective March 11,2008. Motion carried. • 3000 Northeast Fourth Steel — Renton,WA 98056-4195 425-235-2352 —www.RTC.edu BOAD OF TRUSTEES MEETING Minutes—March 11,2008 After giving reasonable consideration to the recommendations of the tenure review committee and all other recommendations, it was moved by Trustee Behnke and seconded by Trustee Irigon that Ted Schwarz be promoted from the first to the second year of probation effective September 15,2008. Motion carried. l B. Executive Session At 8:30 a.m. Trustee Zwicker announced that the Board of Trustees would move into executive session to discuss the performance of public employees and the executive session would last 15 minutes. At 8:45 a.m. Trustee Zwicker announced that the executive session would continue for an additional 15 minutes. At 9:00 a.m. Trustee Zwicker announced that the executive session would continue for an additional 15 minutes. At 9:15a.m., the Board of Trustees reconvened in regular session. C. Tenure Recommendations Following the executive session the Board of Trustees took the following action: After giving reasonable consideration to the recommendations of the tenure review committee and all other recommendations; it was moved by Trustee SenGupta and seconded by Trustee Behnke that Daniel Aragon,Donovan Bigelow,Martha Chamberlin, Martin Cooksey, Neil Foltz, Brian Halpern, Pamela Jeffcoat, Gerry Landes, Sheila May- Farley,Michael McEwen, Sharon Moody,Julie Morland,William Slayton, and Kimberly Smith be promoted from the second to the third year of probation effective September 15, 2008. Motion carried. D. President's Evaluation In determining how to proceed in the development of a 360 Degree Evaluation for the president, Trustees Behnke and Irigon met with John Boesenberg from the State Board to discuss the process. It was determined that this type of evaluation requires a great deal of preparation and the gathering of information over a period of time. Therefore, it was determined that Trustees Behnke and Irigon would continue to review and develop a 360 evaluation process with the assistance of the John Boesenberg which will be used for the 2008-2009 evaluation year. E. Trustee Travel Policy The Trustees discussed the current travel.policy and agreed that clarification was necessary in some areas. One specific change agreed upon by the Trustees was the Trustees would be responsible for reimbursement to the college of travel expenses and-seminar fees if the Trustee does not attend or cancels their attendance. Assistant Attorney General Alan Smith agreed to research this issue in light of the Office of Financial Management regulations. The Trustees agreed to set this over to the April meeting for additional discussion. • 2 • BOAD OF TRUSTEES MEETING Minutes—March 11, 2008 5. PRESIDENT A. Strategic Plan—Address Preparation & Transition for Students Entering and Exiting the Technical College Environment Vice President for Student Services Jon Pozega presented the characteristics and demographics for students entering Renton Technical College in Fall 2006 compared to system wide statistics. Various comparisons included purpose of attending Renton Technical College, ethnic background, students with individual learning needs, program interests, and day or evening classes. In determining how the college impacts a student's preparation and transition Vice President Pozega outlined the various funding sources available to students and the additional assistance from counselors, faculty, and Student Success Center staff. Areas that the college needs to pursue include "where each student went to work", how many students were 2006 high school graduates, and how many students were positively impacted because of the college's Universal Design for Learning Grant, the LDQI, and services for individual learning needs. B. WACTC Board of Presidents'Report President Bressler briefly outlined. the new operating budget request development process that the State Board is considering for fiscal year 2009-2011. A review of the Washington Community & Technical Colleges 2008 Supplemental Operating Budget was presented by President Bressler which included how it relates directly to students. • 6. INSTRUCTION A report was not given. 7. RENTON FEDERATION OF TEACHERS A. Faculty Report Faculty Representative Jack Devine reported on the lobbying efforts of the faculty as they visited legislators on Lobbying Day. He said that he does not see much coming out of this year's legislature with the short comings in the budget. He said that he also sees a strong effort among faculty who produce great workers who will be paying taxes. Representative Devine thanked the trustees for their work on reviewing and providing a clear process for the granting of tenure. - 3 BOAD OF TRUSTEES MEETING Minutes—March 11,2008 8. STUDENT SERVICES/FINANCIAL AID A Enrollment Report Trustees were apprised of the college's enrollment status by Vice President Pozega who reported that the college's enrollment continues to be strong and should meet requirements for additional funding. B. Security Report Director for Public Safety McClain reported that he had participated in the City of Renton's Disaster Preparedness Plan of Action meeting that included participants throughout the city including schools, churches,neighborhoods, and businesses to local police and fire departments. Director McClain presented an overview of the changes to the college's Emergency j Action Plan and discussed with trustee's additional areas of concern. 9. ADMINISTRATION/FINANCE/OPERATIONS A. Administrative Report Vice President Werner reviewed with trustees the personnel activity for the period ending March 11,2008. B. Source/Use of Funds As a regular report to the Board of Trustees, Executive Vice President Werner provided information on the revenues and expenditures for the period ending January 31, 2008 compared to the same period in the prior two fiscal years. Not included in this report are grants and contracts, abatement programs, bookstore, food services, childcare, and financial aid that are all self-supporting areas. 10. INSTITUTIONAL ADVANCEMENT A. Renton Technical College Foundation Information was provided on the following fundraising and events for the foundation as follows: • The foundation's high school scholarships have been placed at the local high schools with applications due by May 2,2008. • The foundation's Emergency Needs Fund received $8,000 from the proceeds from the Luau. • The 1st Annual Golf Tournament with the Greater Renton Kiwanis Club will be held on June 7th at the Lake Wilderness Golf Course. • The Annual Childhood Matters Conference is scheduled for April 26th with the proceeds going to fund scholarships and the Early Childhood Careers Endowment. B. Public Information Information was provided on recent press releases, media releases, advertising,marketing,publications, and community relations. C. Research &Development The Research & Development staff and core team members presented institutional statistics at the monthly Team Meeting which depicted student retention data on full-time programs. Staff will begin the initiative reporting, evaluation design, and proposals for securing next year's Achieving the Dream grant. 4 BOAD OF TRUSTEES MEETING Minutes—March 11,2008 12. EXECUTIVE SESSION At 11:30 a.m. Trustee Zwicker announced that the board would move into executive session to discuss the performance of a public employee and the executive session would last for 15 minutes. At 11:45 a.m.trustees moved back into regular session 13. MEETINGS April 8,2008 14. ADJOURNMENT It was moved by Mr. Irigon and seconded by Ms. Behnke to adjourn the Board of Trustees' meeting at-11:45 a.m. Motion carried. RICH ZWICKER, Chair DR.DONALD E.BRESSLER, Secretary Board of Trustees Board of Trustees /l • 5 } RENTON TECHNICAL COLLEGE 2004-2008 OPERATING BUDGETS "EXPENDITURES - ACTUAL ACTUAL ACTUAL BUDGET PROPOSED PROGRAM 2003-04 PERCENT 2004-05 -PERCENT 2005-06 PERCENT 2006-07 PERCENT 2007-08 PERCENT INSTRUCTIONAL VOCATIONAL $9,201,279 32.9% $8,974,806 30.8% $9,208,438 30.3% $11,221,582 36.5% $10,722,311 33.4% BASIC STUDIES/COMM ED/GEN ED $1 275 499 4.6% $1,815,524 6.2% 6.9% °$2,122,962 �- 7.0/o $2,127,991 $2,206,075 6.9/o PROJECTS** $6,810,951 24.4% $6,495 296 22.3% $7,143 034 23.5% 18.7% °, , , $5,740,034 $6,176,665 19.2/o TOTAL INSTRUCTION $17,287,729 61.8% $17,285,626 59.2% $18,474,434 60.8% $19,089,607 62.1% $19,105,051 59.5% GENERAL ADMINISTRATION $998,526 3.6% $1,010,273 3.5% $986,434 3.2% $1,037,023 3.4% $1,075,219 3.3% INSTRUCTIONAL SUPPORT SUPERVISION, $3,849,853 13.8% $3,992,594 13.7% $4,232,914 13.9% $4,073,740 13.3% $4,617,974 14.4% CLERICAL SUPP/BUSINESS ACTIVITIES - - - LIBRARY SERVICES $258,498 0.9% $283,288 1.0% $405,177 1.3% 1.5% °$460,851 $483,381 1.5/o STUDENT SERVICES $1,451,820 5.2% $1,935,629 6.6% $1,615 630 5.3% 5.8%, , $1,531,179 5.0% $1,849,398 PLANT OP(not including cap projects) $2,135,578 7.6% $2,695,256 9.2% $2,540,285 8.4% $2,366,167 7.7% $2,670,052 8.3% SUPPORT SERVICES COMPUTER SERVICES ' $1,983,982 7.1% $1,975,081 6.8% ,129 577 7.0% 7.0% 0 $2 $2,158,466 $2,313,789 7.2/o FOODS,BOOKSTORE,CHILDCARE TOTAL $27,965,986 100.0% $29,177,747 100.0% $30,384,451 .100.0% $30,717,033 100.0% $32,114,864 100.0% **INCLUDES FINANCIAL AID - IV -7- Renton Technical College Even Start The college is audited every two years. The last seven audit reports have contained no audit findings. An audit will be conducted fall of 2008 and will cover 2006-2007 and i 2007-2008. Please see page 2, "Audit History". The college does not have audited financial statements. Please see page 3, "Financial". Washington State Auditor's Office Accountability Audit Report Renton Technical College Audit Period July 1, 2004 through June 30, 2006 Report No. 6602 Issue Date °P,iN, Washington February 16, 2007 =� Cy' ` State Auditor 76'q _, � Brian Sonntag c v. o xn S`jf. 'C`3 Washington State Auditor Brian Sonntag February 16,2007 Board of Trustees Renton Technical College Report on Accountability for Public Resources Please find attached our report on Renton Technical College's accountability for public resources and compliance with state laws and regulations and its own policies and procedures. Sincerely, BRIAN SONNTAG,CGFM STATE AUDITOR • Insurance Building,P.O.Box 40021•Olympia,Washington 98504-0021•(360)902-0370•(866)902-3900•TDD Relay(800)833-6388 FAX(360)753-0646•http://www.sao.wa.gov Table of Contents State of Washington Renton Technical College Audit Summary 1 Description of the College 2 Audit Areas Examined 3 Audit Summary State of Washington Renton Technical College ABOUT THE AUDIT This report contains the results of our independent accountability audit of Renton Technical College for the period from July 1,2004,through June 30,2006. We evaluated internal controls and performed audit procedures on the financial activities of the College. We also determined whether the College complied with state`laws.and regulations and its own policies and procedures. Our work focused on specific areas that have potential for noncompliance, misappropriation or misuse of public resources. RESULTS The College's internal controls were adequate to safeguard public assets. The College complied with state laws and regulations and its own policies and procedures in the areas we examined. RELATED REPORTS Our opinion on the state. of Washington's basic financial statements is included in the state's Comprehensive Annual Financial Report. That report is issued by the Office of Financial Management in December of each year. In accordance with the Single Audit Act, we annually audit major federal programs administered by the state of Washington. Rather'than perform a single audit of each agency, we audit the state as a whole. The results of that audit are published in a report issued by the Office of Financial Management. The College is part of the state community and technical college system. All public community and technical colleges submit their financial information to the State Board for Community and Technical Colleges where the information is combined. We examine the large consolidated account balances as part of our audit of the state's financial statements. CLOSING REMARKS We thank College management and personnel for their assistance and cooperation during the audit. K Washington State Auditor's Office 1 Description of the College State of Washington Renton Technical College ABOUT THE COLLEGE Renton Technical College was founded in 1942. Located in Renton, the College is one of 34 community and technical colleges in the state. Over 19,000 students attend the College in more than 80 program areas including training programs, continuing education, community education, apprenticeships, basic studies and general education. The 2004-05 operating budget was approximately $28.8 million, of which state appropriation was approximately $14.2 million. The 2005-06 operating budget was approximately $29.4 million, of which state appropriation was approximately$14.9 million. The College has approximately 86 full-time faculty members, 162 part-time faculty members and 176 staff members (51 exempt and 125 classified). A five-member Board of Trustees, appointed by the Governor,is responsible for oversight of College operations. AUDIT HISTORY We audit the College every two years. The last seven audit reports have contained no audit findings. Washington State Auditor's Office 2 , Audit Areas Examined State of Washington Renton Technical College In keeping with general auditing practices, we do not examine every portion of Renton Technical College's financial activities during each audit. The areas examined were those representing the highest risk of noncompliance, misappropriation or misuse. Other areas are audited on a rotating basis over the course of several years. The following areas were examined during this audit period: ACCOUNTABILITY FOR PUBLIC RESOURCES We evaluated the College's accountability and compliance with certain state laws and regulations and its own policies in the following areas: • Cash receipting and revenues • Purchase and payments, (including bookstore,food services, • Open Public Meetings Act auto body program and child care • Conflict of interest center) • State grants • Safeguarding of assets • Contracts and agreements • Payroll • Agreements with K-12 schools • Accounts receivable FINANCIAL We perform an annual audit of the statewide basic financial statements as required by state law (RCW 43.09.310). These financial statements are included in the Comprehensive Annual Financial Report (CAFR) prepared by and available from the Office of Financial Management. The CAFR reflects the financial activities of all funds, organizations, institutions, agencies, departments and offices that are part of the state's reporting entity. The College had no accounts material to the state's basic financial statements. FEDERAL PROGRAMS Federal grant audit work is performed on a statewide basis, in accordance with the revised Single Audit Act. We select federal programs for audit using risk-based criteria set forth in the U.S. Office of Management and Budget Circular A-133. The College had no major federal programs. Washington State Auditor's Office 3 FINANCIAL STATEMENT N/A Renton Technical College is a State Agency. State agencies do not do financial statements. RTC 24002 1/01 Attachment 1 Public Notice AFFIRMATIVE ACTION Renton Technical College is required by law and is committed to a policy of nondiscrimination in all its education and employment activities. Concerns regarding discrimination,affirmative action,or sexual harassment should be directed to Gary Koppang,vice president for human resources,at(425)235-7874. AMERICANS WITH DISABILITIES ACT Questions or concerns relating to the Americans with Disabilities Act should be directed to Jon Pozega, vice president for student services and plant operations,at(425)235-2463. STUDENT RIGHTS AND RESPONSIBILITIES Questions or concerns arising from student rights and responsibilities issues should be directed to Mark Fristo,student rights and responsibilities officer,at(425)235-5840. PUBLIC RECORDS OFFICE Questions relating to public records should be directed to Karen DeBruyn,executive assistant for Carol Werner,vice president for finance and administration,at(425)235-2426. The above information is intended to assist students and others in directing questions, comments, or suggestions regarding the operation and programs offered by Renton Technical College. 1 Renton Families That Work/Even Start Family Eligibility Applicant: Interviewer: Date: Federal: State: Parent is ABE eligible in all languages Parent is ABE eligible in all languages Family lives within RSD • Parent has a dependent child Child is 7 years old or younger Parent is WorkFirst or 175%of poverty Child's program WorkFirst includes FTW on 1RP Family meets Federal low income guidelines —Skill (RB orJL) _Skill def. _Job ready 175% Circle all that apply. 1 point is assigned for each item: 1. Family is in need of ESL. 2. Family is homeless or temporarily dislocated. 3. Single parent family. 4. Family lacks a support network. 5. Family has a child(K-2"d grade)at a Renton Elementary School. 6. Family has no parent with a GED or high school diploma. 7. Parent reports low reading or math skills. 8. Parent is currently not employed. 9. Parent makes a commitment to attend class daily and fully participate in FTW/ES services. 10. Family has a child in HS, ECEAP, ESL, Title 1/LAP, or Special Ed. 11. Family income month/year. **Verified with(Circle all that apply): pay stub, employer letter, corroboration by case worker, or Tax Return. Keep copy in file. 12. Public assistance: Yes_ No_ _WorkFirst _TANF _Medical Coupons only BIA _SSI _Food Stamps only Name of case worker and office: For Coordinator Use: TOTAL POINTS: Accepted: Wait List: Start Date: Target Child: Child's Program: Referred To: Comments: Renton Families That Work/ Even Start Family Intake Form WA08 - - Academic year Parent social security number Intake date NAME: Last First Middle Address APT# city zip code Phone number: ( ) - Birth Date: Age: EMERGENCY CONTACT PERSON: Name: Relationship: Phone: ( ) - Please include the following information for ALL CHILDREN in the home: Name Sex Birth date Age Relationship Language at home School/ECE program Grade Teacher Name Sex Birth date Age Relationship Language at home School/ECE program Grade Teacher Name Sex Birth date Age Relationship _ _ Language at home School/ECE program Grade Teacher Name Sex Birth date Age Relationship Language at home School/ECE program Grade Teacher Name _ Sex Birth date Age Relationship Language at home School/ECE program Grade Teacher Name Sex Birth date Age Relationship Language at home School/ECE program Grade Teacher Adult Student Information 1.Gender: Female Male 2. What race do you consider yourself to be? African African/American Aleut Asian/Pacific Islander Eskimo White/Anglo Saxon American Indian Hispanic Other 3. Are you of Spanish/Hispanic heritage: yes no If"yes"please check the appropriate heritage: Mexican/Chicano Puerto Rican Cuban Other 4. What language(s)do you speak? a. 151 language b. 2nd language c. If you read to your child,what language do you use? 5. What is your family situation? Single with children Couple with children Number of people 16 or older in your home 6. What is your family income? $ per month/year Where does this income your family receives come from? (wages,alimony, child support,public assistance, SSI, L&I,other: - 7. Are you receiving public assistance? yes no If"Yes"please check all that apply: TANF/WorkFirst Food stamps Medical Coupons SSI/Disability BIA WIC 8. How long have you lived in the United States? 9. Are you a Refugee Immigrant Student/Tourist visa? 10. What is your employment status: full-time homemaker full-time employment part-time employment not employed, but seeking work not employed, not seeking work 11. Highest grade completed in school: year Country Do you have a diploma or GED? 12. How did you find out about the Families That Work/Even Start program? another student newspaper RTC Bulletin Social Worker teacher Head Start ECEAP Other: 13. Is this your first time in: ABE ESL Parenting education 14. Have you ever been told that you have a learning disability? yes no If"yes", please describe: 15. How well do you: speak English understand English read/write English (not at all, not well,very well) 16. Do you need transportation assistance(bus tickets) in order to attend school? yes no 17. How many children(15 and under)are in your home? 18. What race do you consider your child(ren)to be: African African American Asian/Pacific Islander Eskimo White/Anglo Saxon Other: 19. Is/are your child(ren)of Spanish/Hispanic heritage? yes no 20. What program does your"target"child attend? Comments: Student: Date: PARTICIPATION IN OUTSIDE SERVICES Service Previous Current Contact Person Participation Participation Public Assistance Vocational Education Vocational Rehabilitation Beginning ABE Intermediate ABE Secondary ABE/GED Beginning ESL Intermediate ESL Advanced ESL CPS Drug/Alcohol Self Self Program Other family Other family member: member: _ Legal Aid, • Self Self Other family Other family member: member: _ Court Ordered Classes Self Self (including APPLE) Other family Other family member: member: Parole Program Self Self Other family Other family member: member: Other: Student: Date: Interviewer: Survey of Needs Areas of need for information or referral: Please circle. Describe as necessary. Housing Counseling Immigration Anger management Substance abuse Library card Health Domestic violence Legal issues Driver's license Public assistance Emergency food/ clothing Early childhood education Public school Other: Areas for which parenting information is especially needed: Discipline Dental health Self esteem Family relationships Adult/child interactions Nutrition Health/safety Child development Too much TV Alternatives to Sibling rivalry Stress spanking Routines Bedtime/ sleep needs Other: Comments: Renton Families That Work/Even Start Participant Consent Form You and your child(or children) are asked to participate in a study of the Even Start program. The purpose of this study is to collect information on all Even Start Projects nationwide. As a participant in this study, you will be asked to respond to a number of interview questions. The information collecting from you and your child (or children)during this study will be used only for this study and will not be used for any other purposes without your permission. The information you provide to us will be strictly confidential. Your participation in this study is important to ensure that the Even Start program continues to provide services needed by families in your community and across the nation. I agree that my child (or children) and I will participate in the Even Start study. I understand that the information that I provide will be used for the purposes stated about and for no other purposes without my permission. I understand that this consent does not waive any civil or legal right that I may have and that I am free to withdraw my consent and end my participation in the study at any time. Signature: Date: • Renton Families That Work/Even Start Hillcrest Special Services (425)204-2243/204-2242 SUPPLEMENTAL STUDENT AGREEMENT Renton Even Start staff agrees to: > Provide classes Monday through Friday from 9am-lpm. > Provide individualized and group instruction based on student goals. > Provide a meaningful and enjoyable learning environment. > Provide an early childhood Program based on need and space availability. > Provide referrals to community organizations'an(d services when available, by appointment. , > Provide monthly home visits for parents and participating children) in the home or local library. > Provide home visits consistent with adult monthly classroom themes. > Provide weekly PACT time opportunities in your child's classroom. Teacher's signature Even Start coordinator's signature Renton Even Start student agrees to: (Noncompliance is grounds for dismissal) ➢ Attend and fully participate in class activities daily. ➢ Adhere to classrooms rules including but not limited to: respecting self, peers and staff before, during and after class, being seated and prepared for class at 9a.m. and remaining in school until 1p.m. daily. ➢ Call office if there is an EMERGENCY and you cannot attend. (Understand that more than5 emergency absences is grounds for dismissal.) • Join in class discussions and assignments. • Participate fully in all PACT time activities. > Cooperate and fully participate during all scheduled home visits. > Read with child daily. > Encourage and support child's learning. i Student's signature Program is free, so no sliding fee scale attached. 2 � j t F 8 i Application Cover Pages (Agency Information .;:n, uestions 1 — 7) `, Agency.Inforrria;on Agency Name: CATHOLIC COMMT NIFTY SERVICES / 0. �n Applicant Name and Address: i'Agilfe irector:('UO8 Catholic Community Services Joseph'ipgf am'ayQMurray-Agency Director Name anCf1/414 ea,//V 100 23"d Avenue South ck9 Seattle,WA 9R144 206-32R-5701 (Area Code)Telephone josephinetmnccsww.org 206-324-4835 E-mail address (if available) (Area Code)Fax Number Required signatures: By signing below,you certify that the information in this application is accurate to the best of your knowledge and that you have read the application, certifications, and appendixes. (SIGNATURES{MUST BE�IN BLUE INK) U� ,�%� u(�z',1_. tF/o�0,r vLI(z4I co Signature of Agency Board President/Date - of •gency Dir-Accra:ate Kenneth Haydock . o e Tamayo Murray Printed Name of Agency Board President Printed Name of Agency Director w., ._.. , �'.. ..,. .:e;r:;:..:, .. ,:. t::ii'• .Z;)., ':1; )£.i..k,.:`'.::...;i:�. ",N'".}...,"x:r4":. ✓,}3.': r....:.... ....:. .:.....,.:....:....:,...,t.:.-,�,' .:....r.•w:-.,<.<::�*L::, .�-�.> :`Y.:-,.. .a. ,rr,iz�`':r;,•` ra�n. • • • P 1. Program Name Volunteer Chore Services Contact Person (available to answer specific questions on this application) Eileen Rasnack-Program Manager 206-328-6853 Name (Area Code)Telephone Address (if different than above) eileenra,ccsw v.org 206-324-4835 E-mail address (if available) (Area Code)Fax Number 2. Program is New for our agency ❑An Ongoing Program ❑ 3. Brief Description of Program(One sentence) Volunteer Chore Services works with communities to provide free-in-home volunteer chore assistance and Transportation for low-income adults with disabilities and frail elders. 4. Where are services provided? (If different from agency location) All chore services are provided at the homes of program participants. Page 5 5. Total Program Cost: Actual 2007: $397,939 Proposed 2009: $406.292 Projected 2008: $396.164 R r 6. Total City Funds Requested for this Program: City Awarded 2008 Requested 2009* General Fund CDBG Total Requested** • Auburn 3,500 8,000 Federal Way 4,000 8,000 Kent - 8,000 Renton 5,000 8,000 Cites__ Awarded 2008 Requested 2009* General Fund General Fund Burien Covington Des Moines Enumclaw SeaTac 3,000 5,000 Tukwila *Cities on a two year funding cycle will renew 2009 awards to 2010 based upon performance and availability of funds. See Part II for city specific information. **Include your total request for Auburn,Federal Way Kent and Renton. The source of funding will be determined by staff. Page 2 7. Agency Contact Sheet Provide the following information for the agency and for the program requesting funds. Agency Contacts i General Agency Name: Catholic Community Services Address: 100—23rd Ave South City/State/Zip: Seattle, WA 98144 Phone/Fax: 206-3 23-63 3 6 Agency Web Address: www.ccsww.org Executive Director Name: JosephineTamayo Murray Title: Executive Director Direct Phone: 206-328-5701 E-Mail: JosephineTM@ccsww.org Development Director Name: Mark McKay (or Grant Writer) Title: Grants Manager Direct Phone: 206-328-5908 E-Mail: MarkM@ccsww.org Finance/Accountant Name: Eileen Rasnack (person preparing invoices) Title: Program Manager Direct Phone: 206-328-6853 E-Mail: eileenr@a,ccsww.org Program Contact (Staff contact for contracting, reporting and program implementation.) Program Name: Volunteer Chore Services Staff Name: Eileen Rasnack Title: Program Manager Direct Phone: 206-328-6853 E-Mail: eileenr@ccsww.org Page 3 Application Narrative Section (Questions 8 — 12) 8. ORGANIZATIONAL EXPERIENCE (2 page maximum) ') A. Experience. Catholic Community Services of Western Washington serves as the official social service agency outreach of the Catholic Church in Western Washington and has a 90-year history of providing services to those in need. It includes 12 family centers located throughout Western Washington, a Long Term Care System,the Family Preservation System, Chemical Dependency System Northwest, and the Archdiocesan Housing Authority. CCS/AHA annually serves tens of thousands of people through more than 80 programs that include affordable permanent housing, emergency shelter/transitional housing, counseling,home care for elders and disabled persons, senior nutrition, Volunteer Chore Services, youth services, family support, life skills/parenting education, adoption, foster care, child care,pregnancy support, Hispanic outreach,the African American Elders Program, food programs, chemical dependency services, literacy,job and care counseling, and mental health services. Through the years, CCS has demonstrated both leadership and persistence with creative responses to people in need—in its own programs,by the motivation of volunteers, and through cooperative effort with other community organizations. There are 24 programs under the umbrella of Catholic Community Services of King County serving over 11,000 individuals annually. The services are provided through three family centers strategically located in Kent to serve South King County, Bellevue to serve the Eastside, and a family center in the Central Area of Seattle, serving the greater Seattle area. The South King County Family Center, located in Kent, was established in 1986 and in 2006-2007 served 5,853 families, children, adults, and elders. Of those seeking services 34% (2,036)were experiencing homelessness, 35% (2,073)were African American and 12% (695)were Hispanic, the two largest groups of color served by the center. Single parents receiving services totaled 53% (3,090). Programs at the South King County Family Center include Family Support Services, which provides emergency assistance, information and referral services, case management and education; HOME and ARISE Shelters, two service-enriched housing programs located in Kent and Renton for men experiencing homelessness;Legal Action Center, a legal services program to prevent unnecessary evictions and prevent homelessness; Children's Treatment Program, a mental health program for low- income children; Chemical Dependency Services, providing assessments and individual outpatient treatment,most of whom are referred by the local Drug Court judicial system;Elizabeth House, a service- enriched housing program for women 18-years of age or older experiencing homelessness and who may be pregnant or parenting;Katherine's House; a service-enriched housing program targeting women experiencing homelessness who are exiting the Regional Justice Center and recovering,from drug and alcohol addiction;Project Rachel, a supportive healing program for women who have experienced abortions; Volunteer Chore Services that provides vital chore services for adults and seniors with disabilities and the Foster Grandparent Program, a tutoring and mentoring program that links elders with special needs and at risk youth. The facility also houses the CCS's Long Term Care Division. B. Operational Structure. Catholic Community Services of Western Washington has three distinct regions each with,an Agency Director: Northwest Washington, Southwest Washington, and King County, as well as several systems including Long Term Care, Family Preservation, and Chemical Dependency Services. CCS King County has three strategically located family centers to provide community based services: Randolph Carter Family and Learning Center in Seattle, the South King County Family Center in Kent, and the East King County Family Center in Bellevue. The Agency Director of CCS-King County provides administrative oversight of all operations and reports directly to the Chief Executive Officer of CCS-Western Washington. Agency Director Josephine Tarnayo Murray has a Master's Degree in Social Work from the University of Washington, Senior Page 4 Executives in State& Local Government Program certificate from Harvard University, and over thirty- five years experience in human services and administrative oversight. The supporting senior staff team includes a Regional Chief of Operations, Clinical Director, Accounting Director, Human Resources Director and a Facilities Director. Additionally, programs are managed by Program Managers who report ) to the Clinical Director and the Regional Chief of Operations. Governing Board: Catholic Community Services of Western Washington is governed by a Board of Trustees that provides organizational oversight and support and is comprised of 14 members operating in accordance with a set of bylaws and meeting five times yearly. Each member is provided a binder at the meetings with sections that include: Public Relations; Financial Issues; Housing Development; Fund Development; Operations; Quality Assurance Updates; and Reports from Agency Directors. The agenda ensures that community issues at a local level are integrated into the governance of the agency which keeps the Board informed of and able to make decisions pertaining to the operations of the organization. The Board includes representatives from the African American, Asian, and Native American communities, women, elders and adults with disabilities and represents cities throughout Western Washington. In addition, Catholic Community Services of King County is supported by a King County Advisory Council consisting of twelve representatives, three of whom are recruited from the East, South and North King County Regions respectively, and three from South Seattle. The Council members provide information to the Agency, from their respective cities, and meet quarterly. Members serve on county wide projects and committees including advocacy,parish/community relations, and fund development for the agency. In South King County a volunteer group, ConneCtionS, consists of 15 committed volunteers who help specifically on regional projects such as advocacy for the homeless, coordination of an annual golf tournament, estate planning seminars facilitation, and coordination of CCS Week fundraising and informational meetings. Page 5 9. NEED FOR YOUR PROGRAM(2 page maximum) The needs of older adults vary widely. The aging process can be a smooth transition or it can be very difficult due to a variety of circumstances that include poor health,poverty, rising health care costs, - . increased difficulty in mobility and daily living tasks, lack of transportation options, and disparities in service due to racial inequity. It is predicted that by the year 2025, 25% of the population will be over the age of 65 years in King County(Area Plan on Aging 2006-2007). South King County alone has experienced an increase of 113% in the 65+age group from 1990-2000 (City of Kent Human Services Master Plan 2007-20012). Of particular note is the anticipated growth of 85+by ethnic group from 2000-2030: African Americans 269%, American Indian 437% and Latino 706%. OFM (Provisional Projections of the Total Population by Age, Gender and Race(Including Hispanics) for the State of Washington: 2000-2030). In the city of Federal Way there are 8,925 individuals are over the age of 65 or 10.4% of the total population. The city of Auburn has 4,666 adults over the age of 65 or 11.6% of the city's population. SeaTac has 2,474 or 9.7%of its' adults over the age of 65. (U.S. Census, 2000) In 2000, the population of 65 years or older in Renton represented 10.4%of the total population. By 2010, this group is projected to increase to 11.9%. (Claritas, Inc. 2006) In the city of Kent,there are 55,200 individuals in the 65-84 age group, which is the second highest in King County only behind the city of Seattle. The 85+group is also second highest to Seattle(2006 Community Count for Age distribution by Sub-region). In Kent, 7.7% of the population is over the age of 65 years (2006 American Factfinder, US Census Bureau). At the same time that this age group is increasing, so is the average life expectancy. At age 65, the average individual in King County can expect to live another 18.8 years, although African Americans and Native Americans have seen decreases in their life expectancy(Area Plan on Aging Update 2006-2007). Income declines as people age and remains fixed regardless of the cost of living increases. This decreases the ability to access basic services necessary for independence and healthy living, including housing and food. Poverty rates for older persons increased slightly from 1990—2000 from 6.9% to 7.1% and this was during a growing economy(Area Plan on Aging 2008-2001). The current weakening of the economy will put more financial strain on older adults who are living longer and ultimately require some assistance with daily living activities. While people are living longer and staying healthy longer there is an increased need for services as people age. More self-care limitations develop for people 75 years of age and older(Area Plan on Aging 2008- 2011). This age group is more likely to experience physical disabilities or sensory limitations. Along with this there are difficulties in mobility and the ability to leave their homes for shopping, medical appointments or social events. Transportation options become more important as older adults outlive their ability to drive. The challenges of urban and rural sprawl in King County create difficulties for older adults with disabilities to remain independent. Only 3%of older adults use public transit due to concerns about safety, schedules and connections to needed destinations. (Rosenbloom, S. "The Mobility Needs of the Elderly."Transportation in an Aging Society: Improving Mobility and Safety for Older persons. Washington D.C.: U.S. Department of Transportation, 1995) Poverty, language, ethnicity, and lack of sufficient financial resources are all barriers that place a frail elder or adult with disabilities at risk of accessing services that allow them to remain in their home. Communities providing support services for older adults will help them retain their dignity,remain independent, stay connected with their community and increase their overall emotional and physical health. Page 6 All of the program participants have either a permanent or functional disability due to chronic or progressive illness. Volunteer Chore Services (VCS)provides in-home chore-assistance for adults over age 18 with disabilities and frail elders living in King County. VCS specifically works to provide services to those not qualifying for state paid services and who do not have the resources to pay for services. All services are provided at their residence and at no charge to recipients regardless of race, ethnicity,national origin, gender orientation, or religion. In 2007, 80% of program participants were over the age of 60. Eighty-two percent live alone. Eighty-one percent were females, and 19%males. Fifteen percent of the individuals receiving services were ethnic minorities: Seven percent African American, 3% Asian, 1%Native American, 2%Hispanic/Latino and 3%multi-racial. Three percent had limited English and 2% identified themselves as refugee/immigrants. Ninety-five percent of all program participants are living at 30%or less of the 2007 median income ($1362 per month). VCS specifically targets individuals who live in poverty and lack resources for support to help them to stay in their own home as long as possible. VCS does not have strict financial eligibility as its purpose is to serve as a safety net for those who do not qualify for state-paid chore and cannot afford to pay for services. The general guidelines for the program require that an individual's income is less than$1,000 a month or$1,500 a month for a couple. Other expenses such as high medical costs or living costs are also considered in determining eligibility for the program. VCS is prohibited from serving clients in nursing home settings or providing bill paying or other financial assistance. 10. PROPOSED PROGRAM/SERVICE A. Program Description. (2 page maximum) Volunteer Chore Services (VCS) is an innovative community-based service that provides direct assistance for elders and adults with disabilities with the primary goal of ensuring that they retain dignity and residence in the familiar surroundings of their home or apartment. Through the assistance of caring volunteers, these individuals receive assistance with shopping, laundry, transportation, yard work, minor _ home repair, and/or household chores. In South King County, a staff member based in.the Kent office coordinates services for South King County residents. VCS staff are also located in the Seattle and Bellevue offices of CCS. Services for South King County are coordinated by the South Volunteer Coordinator out of the CCS Kent Family Center. Requests or referrals for services can be made by calling the VCS toll-free phone number and completing an intake by phone. Staff visits each person requesting assistance to perform an in-home assessment, explain the scope of services, assure a safe placement for volunteers and answer any question the potential recipient might have. Services are provided at the recipient's residence at a time that is mutually convenient for both the volunteer and recipient. All volunteer assistance is based on volunteer availability. Most volunteers provide 1-2 hours of assistance on&weekly basis or twice monthly depending on the needs of the recipient and the availability and interests of the volunteer. On-call and group volunteers provide help with one-time and larger project requests. Volunteers are only placed once they have completed the registration process, which includes three personal references, a Washington State Patrol background check and an orientation to the program. VCS provides on-going training throughout the year and maintains regular contact with volunteers and clients. VCS staff recruit volunteers one by one through speeches, fairs,presentations, networking events, flyers and newspaper ads but the most effective method is to recruit volunteers to serve as coordinators within their communities. These coordinators can then recruit volunteers from within their sphere of influence to help people in their own neighborhoods. This is done by identifying an individual or group willing to make known the needs of elders and adults with disabilities in their church,neighborhood, Senior Center and recruit people to fill the needs. Staff time is spent recruiting and supporting coordinators who then Page 7 recruit and support their volunteers enabling the program to meet more of the needs. VCS currently has partnerships with over 30 faith communities and service organizations. Outreach activities are a key component to create awareness of the needs of frail elders and adults with ` disabilities and for successful volunteer recruitment. VCS services are publicized in many ways and mediums. The program is listed in local phone directories, internet sites, specialized service brochures, and local referring sources like the Community Information Line, Senior Services of King County, United Way and local government agencies. Flyers and brochures are updated regularly and distributed throughout the community. Staff participates in events at senior centers, community fairs and presentations to schools, churches, hospitals, service organizations and other human service providers. VCS works to provide culturally appropriate services to all program participants through targeted recruitment of volunteers who are bilingual and bicultural and working to increase community outreach, particularly in diverse communities. The program maintains a membership in the Red Cross Language Bank to assist when translation services are needed. Program materials are available in Spanish and Russian. The South Volunteer Coordinator speaks Cantonese and CCS staff are available for interpretive services in Russian, Spanish, Vietnamese, Tagalog and Chinese. Volunteer assistance ensures that elders and adults with disabilities have access to food, chore support to retain their independent living status, social support from a volunteer to decrease isolation and access to health care to ensure their physical and mental well being. Without VCS, these individuals might otherwise face making costly formal living arrangements rather than remain in their homes and familiar surroundings. Services provided by VCS volunteers help preserve independence and quality of life for seniors, as well as increase their own self-sufficiency. Volunteers also provide transportation to medical appointments and errands to the pharmacy or grocery store, thus helping them maintain their health. By recruiting community members to work as volunteers, VCS is able to draw upon the strengths of the community to help people in their own neighborhoods and provide a cost-efficient service. This gives the community the tools to meet the needs of its own residents and creates supportive relationships within neighborhoods and communities to help reduce isolation and its accompanying depression for homebound individuals. Community support not only benefits the care recipient, it can also benefit the recipients' families as they struggle with their own families,jobs and the additional role of caregiver for their loved ones. VCS actively seeks partnerships and ways to collaborate with other provider agencies in the area to ensure the needs of elders and adults with disabilities are met. VCS works closely with many providers and community organizations including AARP,Verbena, African American Elders Project, Asian Counseling and Referral Services. VCS also works with faith communities of all denominations, local schools, area businesses and service organizations to arrange services. In 2007, over 25 groups provided services for South King County residents. These groups include New Community Church, St. John the Baptist, Highland Park Nazarene, St. Stephen the Martyr, St. Anthony's School, Kent Covenant Church, Federal Way LDS, AARP, Campfire, Youth Volunteer Corps, Crossroads Community Church, Banner Bank and Life Way Church. Working agreements are in place with DSHS Region 4 Home and Community Services, Aging and Disability Services Seattle-King County AAA, and Senior Services Senior Information and Assistance, Multiple Sclerosis Association of King County and the Senior Companions program. The program works closely with case managers and social workers from all of these agencies to serve as a"safety net" for the elderly and disabled and to coordinate services for those individuals who do not qualify for paid chore services or cannot afford to pay for services. Our intake specialist provides referral and information ( service to help people access the necessary services. This past year, VCS provided over 300 callers with information and referral assistance for community resources. Page 8 VCS was honored at the National Faith in Action conference in Washington DC in May 2004 as one of 19 original chore services programs still in operation nationwide. In 2007,VCS was one of 10 programs nationally recognized for its work in transportation for seniors and persons with disabilities from the Beverly Star Foundation. \ � r B. Performance Measures and Outcomes. (1 page maximum) Performance Measure: Number of Unduplicated Clients receiving chore assistance Outcome 1: Volunteer assistance with chores will help elders and adults with disabilities remain independent in their homes as long as safely possible. Indicator: At least 80% of care recipients participating in the program for a minimum of three months will maintain housing/living arrangements reported at intake. Performance Measure: Number of chore hours provided by volunteers Outcome 2: Chore assistance helps to maintain optimal functioning relative to their condition. Indicator 1: At least 60%of care recipients report they are less fatigued with volunteer's assistance. Indicator 2: At least 60%of care recipients report that with their volunteer assistance they are better able to remain independent. I Page 9 C. Staffmg Plan & Evaluation: (1 page maximum) Volunteer Chore Service staff are located in all three Catholic Community Services offices in King County: Kent, Seattle and Bellevue. In South King County, the Volunteer Coordinator, works out of the i Kent office serving south King County.cities. This regional location allows us to be responsive to the ' needs of local communities. The VCS team has 6.8 FTE that include a Program Manager, Intake Specialist and 5 Volunteer Coordinators. Eileen Rasnack, Program Manager,has a Bachelor's Degree in Sociology and certificate in Human Services Management and Geriatric Mental Health from the University of Washington School of Social Work. She has over 20 years of volunteer management experience and has been with CCS twelve years. She is involved in advocacy with local Human Services Coalitions. The Program Manager is responsible for overall program operations including budget, contract monitoring and attainment of program goals and objectives. Volunteer Coordinators are responsible for client assessment to determine scope of project, community outreach, volunteer recruitment, orientation, training, and management, and group project coordination. The Volunteer Coordinators have Bachelor's Degrees in Social Work or a related field and at least two years work or volunteer experience in the human service field. - The Intake Specialist screens all requests for service to determine program eligibility, provides information and referral services to other community resources,processes all volunteer registration forms and provides administrative support for program staff. The Intake Specialist has a Bachelor's Degree and at least two years work or volunteer experience in the human service field. We currently have over 600 active volunteers in King County. All staff activity is directed towards supporting the volunteers who in 2007 worked with 705 clients to provide them with chore services. Last year, over 300 volunteers provided services for South County residents. Thirty-five percent of current volunteers have been with the program for 3 years or more. The goal of VCS is to help low-income elders and adults with disabilities remain independent in their own homes through a network of caring community volunteers. To this end, the program maintains a continuous quality improvement plan to evaluate the quality of services and satisfaction with partners who help make the program a success. Program recipients are surveyed for satisfaction with services twice a year and volunteers are surveyed for satisfaction with their volunteer experience. Staff utilize the feedback to make program improvements for service delivery. Intake documents, case records, anecdotal information and the recipient and volunteer surveys are all utilized to obtain data for the outcome results. VCS is highly successful in keeping elders and adults with disabilities living independently in their homes through the support of volunteers. Sixty percent of all program recipients have received services for two years or longer and 24% of program recipients have received services for 5 years or more. The attention and support of a volunteer can make a huge difference in health and safety for a homebound individual as this example illustrates. A Kent resident living alone asked for help cleaning out his freezer. During the in-home assessment,the coordinator realized that this man needed much more help than just his freezer. The coordinator arranged for a group of volunteers to clean and scrub his entire home. Learning that he did not have a bed, a volunteer arranged to have a bed donated and delivered. After removing the mat he used as his bed, the volunteers discovered rat and mouse feces covered the floor. He ( is now matched with a weekly volunteer who takes him to the grocery store and helps him keep his home in order. Page 10 C. Differences in Service Delivery by City. (2 page maximum) There are no differences in service delivery among the cities this application is being submitted to. Although the Coordinator is based in the Kent CCS office, all services are provided at the homes of those _ requesting services. The Volunteer Coordinator visits the individual requesting services in their home to , provide information on the program and answer any questions at that time. The Coordinator also schedules meetings with new volunteers in their community, meeting with them at local coffee shops, libraries or their homes to provide individual orientation meetings. Coordinators make an effort to place volunteers with someone in their neighborhoods to help. This provides more of a connection and also serves to reduce the number of requests for mileage reimbursement. The goal of the program is to engage communities in supporting their elders and persons with disabilities. This goal of engaging the community is accomplished by the coordinator being active and out in the community meeting with those who need the assistance and those who are able to provide the assistance. The average cost of service per client and service delivery costs is the same among all the cities, $545 per client in 2009. The cost of delivering services for all cities is leveraged with state, county and agency resources. 11. LONG RANGE PLAN (1 page maximum) Volunteer Chore Services (VCS) is celebrating twenty-seven years of experience in administering chore services in King County this year. VCS actively seeks to promote partnerships and to build on its' successes for the future. In the past year, VCS worked with Verbena to develop the Rainbow Assistance Project, a chore assistance program for LGBTQ elders and individuals living with a disability. In 2007, VCS received a Seattle& King County Public Health grant to participate in a Communications Network and develop an emergency preparedness plan for vulnerable adults. VCS continues to work on growing and strengthening its existing partnerships and to develop new partnerships to meet the needs of seniors and adults with disabilities in our communities. Outreach to vulnerable adults and non-English speaking groups continues to be a major focus. Preliminary discussions are underway on a collaborative falls prevention program for older adults and collaborative outreach efforts to refugee and immigrant elders. Transportation needs of older adults remains a major area of concern for the community. Over 50% of all calls to VCS include transportation requests. There simply aren't enough volunteers to meet the needs and the rising cost of gas is a barrier to volunteer drivers. VCS raised the mileage reimbursement rate by .08 per mile in an effort to provide more incentive for volunteer drivers. A group of local business leaders established GIVE, a partnership with VCS to provide transportation options when volunteers are not available. GIVE has allowed VCS to establish a taxi voucher program and increase transportation services for older adults throughout King County. A regional volunteer transportation group is forming to work on best practices and develop collaboration around transportation issues for older adults and VCS is participating in this group. VCS leverages funding from a variety of sources to ensure delivery of services throughout King County. VCS is part of a statewide chore service program administered by Catholic Community Services through a contract with the state which provides 59%of the budget. The contract is based on a reimbursement rate of$6.22 per volunteer hour up to $234,009 per current fiscal year. In addition, Volunteer Chore Services receives support from 8 cities and King County. The remainder comes from individual donors, foundations, and United Way as detailed in the budget section. It is anticipated that this diversity in funding will successfully support the program. VCS is directly linked to the mission of CCS and ensuring financial sustainability is a priority of the agency. Page 11 The agency grants manager and program staff review funding proposals for alignment with agency goals to determine opportunities for growth and project funding. This includes private, local government and federal funding. Improvements are underway for the agency website to make the site more interactive for the user, enhance donor relationships and giving, and feature program accomplishments in the community. Volunteer Chore Services is working with the E-website manager to feature stories of program participants,publicize volunteer opportunities and streamline the registration process for prospective volunteers. Volunteer Coordinators encourage volunteers to check with their employers on matching grants or time off for volunteering to build support for the program 12. BUDGET(2 page maximum) A. Budget Request Narrative. City funds will be used to cover personnel costs of the Volunteer Coordinator. The Volunteer Coordinator provides volunteer management and coordination of chore services. The Coordinator serves as a resource both for volunteers providing services and those receiving services. It takes a strong staff knowledgeable in older adult issues and volunteer management to coordinate the necessary services for seniors and adults with disabilities. B. Changes to Budget. Reduced funding from cities and United Way has had an impact on the program. In response to the $15,500 reduction in funding that the program faced in 2006, the program consolidated staff in King County moving 2 staff from the eastside CCS office to the Seattle CCS office. This has helped to reduce expenses for rent and utilities for 2008-09. The budget has been adjusted for 2009 to plan for a potential reduction of 30%in King County funding as a result of the announced shortfall the County is facing. More significant reductions to existing funding from either the cities or the county will result in staffing reductions and consequently reduced ability to deliver chore services. C. Cost per Service Unit(s). You should provide an estimate of your cost per service unit provided by the program you propose. Explain how your cost per service unit was determined. These should be based on the total cost of the program and the total number of clients served, not just the funds requested. You have the option of providing a cost per service unit for each separate service provided within the program. Cost Per Service Unit: $ 545_per client Explanation of how determined: The unit cost is based on the total projected program budget($406,292) and total projected service hours (37,300) contracted to provide in the coming year. Total budget: $406,292/ 37,300 =$10.90 per service hour. The projected service hours are divided by the total number of projected clients for 2009 to get the average number of hours for each client: 37,300/749 (projected total clients)= average of 50 hours per client per year Actual clients served by city funding are based on this average of 50 hours per client per year. The total number of clients served and total number of service hours in all areas will be higher as seen in previous year reports of services. These additional clients and service hours will continue to be leveraged by other funding sources. $10.90 service hour cost X 50 avg. service hours per client=$545 per client for 2009 Page 12 Agency:Catholic Comm Services Program:Volunteer Chore Services 13. NUMBER of INDIVIDUALS/HOUSEHOLDS SERVED BY PROGRAM `�-) Individuals? or ri Households? (Check which applies and use for reporting all demographics.) Unduplicated *Unduplicated Number of all Clients Served by Clients Served All Funding Sources with Funds Requested 2007 2009 2007 %of column 1 2008 2009 (Actual) clients served (Anticipated) (Projected) (City Requested by City Funding Only) Auburn 31 4% 35 35 8,000 Burien 13 2% 15 20 Covington 6 1% 10 10 _ Des Moines 3 .05% 5 5 Enumclaw 2 .05% 2 2 Federal Way 30 4% 35 35 8,000 t Kent 43 6% 45 45 8,000 Renton 40 6% 40 40 8,000 SeaTac 14 2% 15 20 5,000 Seattle 207 30% 225 225 Tukwila 6 1% 10 12 Other 310 44% 300 4 Q,> : :',f `t '`.+;v; 100% Total 705 (This column must 737 749 37,000 total 100%) Page 13 Agency:Catholic Comm Services 14. Performance Measures (Data Table) Program:Volunteer Chore Services 14a. Service with 2009 Requested Funds Proposed Performance Measures as defined below. A)#Clients Served B)#Volunteer Hours C) Auburn 15 750 Burien Covington Des Moines Enumclaw • Federal Way 15 750 Kent 15 750 Renton 15 750 SeaTac 9 450 Seattle Tukwila �1. li: a anc IVleas res:'2409�Pro Deed-with.fwiids-:re;'ue'st+e}'C'Y �Fun 'ui P 4.. d xty dinga0 .,Y, Title: Brief explanation: A)#of Clients served Unduplicated number of clients receiving chore assistance B)#of Volunteer Hours Number of hours volunteers provided in chore assistance C) Page 14 Agency:Catholic Comm Services 14 Performance Measures (Data Table), Cont. Program:Volunteer Chore Services 14c. Average Cost of Service Unduplicated Clients Served with Funds Average Cost of Service Requested 2009 Requested 2009 per Client (Same as last column of (Same as last column of Question 6) Question 13) Column 1 divided by Column 2 Example: $5,000 45 $111.11 Auburn 8,000 15 533.00 Burien Covington Des Moines Enumclaw Federal Way 8,000 15 533.00 Kent 8,000 15 533.0u Renton 8,000 15 533.00 SeaTac 5,000 9 555.00 Seattle Tukwila Page 15 Complete Question 15 with 2007 Actual numbers reported in column 1 of Question 13. Agency: CCS 15. Demographics (from all funding sources) (Data Table) Program:VCS en es -Client'RRidence - o o -6 '' w Q a C.) A W 4-4 cis H :;00,101cated` ':: ; check one , .1">Y.cF may • _ =®Irnciividiials en en N o en o V o �o o, =�DHat seI tilde M M N r' Seared.iii-26o1*; °.<% N` �H6iisehoidYInco ine:L•exel=, :.� • g>`, -4..-;- - s;, g 30%of Median or Below 31 12 5 3 2 27 41 35 12 192 6 366 50%of Median or Below 1 1 3 2 5 2 15 29 80%of Median or Below Above 80%of Median Unknown TOTAL 31 13 6 3 2 30 43 40 14 207 6 395 s.;Ge,=, e Male 9 2 2 0 2 16 8 20 8 47 3 117 Female 22 11 4 3 0 14 35 20 6 160 3 278 TOTAL 31 13 6 3 2 30 43 40 14 207 6 395 'x. L> 0-4 years 5- 12 years 13- 17years 18-34 years 3 1 4 35-54 years 4 1 5 9 3 1 28 2 53 55-74 years 11 4 2 9 16 17 5 77 2 143 75+years 16 8 4 3 2 16 38 20 _ 5 98 1 211 Unknown 3 1 4 TOTAL 31 13 6 3 2 30 43 40 14 207 6 395 Ethnici Asian 1 1 8 10 Black/African American 1 2 4 2 25 2 36 Hispanic/Latino(a) 1 2 1 4 Native 1 2 2 5 American/Alaskan Pacific Islander White/Caucasian 31 11 6 3 2 22 38 34 12 172 2 333 Other/Multi-Ethnic 4 1 2 1 12 1 21 TOTAL 31 13 6 3 30 43 40 14 6 395 Feinaie Headed ' litiuitii014:':.j '_ 2 2 4 1 9 'D• isabling hind tiori',Y- 31 13 6 3 2 30 43 40 14 207 6 395 Ilitiiited;English.-''''.:'::: 1 1 `Speakin > ,> 8 10 *Check Individual or Household,which should be the same as checked in Question 13. Unduplicated means count each client only once per calendar year. This should match the number served by City in the Actual 2007 column of Question 13. The "total"column will be different from Question 13 since the"other"column is not included due to space limitations. Page 16 16. PROGRAM STAFF (DATA TABLE) In this data table,record the number of full-time equivalent (FTE)paid staff and volunteers for this program. FTE means a 40-hour week throughout the entire year. For example, if you enter"5"in the box ) for Number of Volunteer FTEs, this would mean that you have, on average, five volunteers assisting your program at all times (assuming a 40-hour week). If you know only the total number of hours contributed by all volunteers for this program, simply divide that number by 2,080 to find the total FTE number. For example: 5,000 volunteer hours over the course of a year, divided by 2,080 equals 2.4 FTEs. 2007 2008 2009 (Actual) (Budgeted) (Projected) Total Number of Staff(FTEs) 6.8 6.8 6.8 Number of Volunteer(FTEs) 17 18 19 Actual Number of Volunteers 2,200 2,200 2,500 Page 17 Agency:Catholic Comm Services 17. PROGRAM REVENUE BUDGET (DATA TABLE) Program:Volunteer Chore Services Revenue Source 2007 2008 2009 `------- (Actual) (Budgeted) (Projected/ Requested) City Funding (General Fund & CDBG) ' ':; ':::::,.1' : ''..;:',',; ':: :',''":,,:-.' ''',*:•;::::: :i:7,''.:';':.0:1*"; 4f';'i,:',- '. :''':';i,: q''Pr'i:',• Auburn 1,500 3,500 8,000 • Burien - - - • Covington - - - • Des Moines - - - • Enumclaw - - - • Federal Way 4,000 4,000 8,000 • Kent - - - • Renton 5,000 5,000 8,000 • SeaTac 3,000 3,000 5,000 • Seattle - - - • Tukwila - - - • Other( Specify) Bothell 2,000 2,000 3,000 • Other(Specify) Redmond 5,000 5,000 5,000 • Other(Specify)Shoreline 3,728 3,278 5,000 • Other(Specify)Bellevue 6,890 6,992 10,000 Other Government Funds ,, .,...-:,.,?---;?;,--.:-, .,•i.,-, ,:, , ,,,,-;,,,,i.:, -1:*,,-x::,--,',:; :4.•-‘,,v• :",,, ' ;,‘ '‘,ef"14', ,:*, '1,:'3't-::',':4,,:•1 -: : !<.?_.,,.!.': .,-T,' '''?.:'-' 4"::,,A;;':•::'1 ''': 4.',-;;''':'''= '': • King County 26,228 26,228 18360 • Washington State 216,393 234,009 234,009 • Federal Government(Specify) - _ • Other(Specify) _ Private Sources A:4;,-,,,4•Xft,-/: ,;''"":',t'::1:' :`,,Y,Rfs.c::;;72 ",i;:,'::?:-',,';';',,'::',','n ,i:fsi?: !.,.':::-,''',` :'': '''', : • United Way(grants & designated donors) 17,093 16,244 16,244 • Foundations and Corporations 17,582 16,688 15,000 • Contributions (e.g., Events, Mailings) 5,714 3,600 4,500 • Program Service Fees (User Fees) • Other(Specify) 79,800 62,675 54,429 TOTAL PROGRAM BUDGET 397,933 396,164 406,292 Page 18 17. PROGRAM EXPENSE BUDGET, CONT. Agency:Catholic Comm Services (DATA TABLE) Program:Volunteer Chore Services +.,_j Expenses 2007 2008 2009 c (Actual) (Budgeted) (Projected) Personnel Costs >,_ ,ba , ;,,,pf - i • Salaries 203,392 212,039 218,400 • Benefits 28,809 35,490 36,555 • Other • Total Personnel 232,201 247,529 254,955 Operating and Supplies '-�' . ,':: . , ;, ,': 3r.- ,t.:1:'' -:.,. ,, :":': 4; • Office/Program Supplies 4,614 5,109 5,212 ■ Rent and Utilities 66,852 51,185 52,209 • Repair and Maintenance 5,248 6;080 6,202 • Insurance • Postage and Shipping 3,342 2,937 2,995 • Printing and Advertising 5,267 5,218 5,322 • Telephone 1,222 1,162 1,197 • Equipment • Conference/Travel/Training/Mileage 6,356 5,419 6,000 ■ Dues and Fees 105 158 200 • Professional Fees/Contracts 3,296 4,944 4,000 • Direct Asst. to Individuals 915 968 1,000 • Administrative Costs 57,268 5,6710 57,000 • Other(specify) Volunteer Expense 11,523 8,745 10,000 • • • • ' TOTAL PROGRAM EXPENSES 397,939 396,164 406,292 Net Profit(Loss) (6) -0- -0- (revenue-expenses)= Page 19 Agency:Catholic Comm Services 18. SUBCONTRACTS (DATA TABLE) Program:Volunteer Chore Services List all the agencies you will be subcontracting with for this program. Provide the agency name in the first column, a description of the contract/service in the second column, and the contract amount in the third column. Do not list agencies you coordinate with on a referral only basis. Indicate not applicable if you do not subcontract for any part of this program. Subcontracting Agency Specific Subcontracted-Activities Contract in the Operation of Your Program Amount N/A Page 20 19. APPLICATION CHECKLIST Applications missing one or more of the following components or not following these directions may not be reviewed. Sign and submit the application checklist with your application. Contents (Your application should contain each of these items in this order.) U. Application Cover Pages.The top three pages of your application must be a completed copy of the Agency Information and Questions 1-7. Applica ion Narrative: Question 8 Organizational Experience(2 page maximum) Question 9 Need for Your Program(2 page maximum) Question 10 Proposed Program/Service(6 page maximum) Question 11 Long Range Plan(1 page maximum) Question 12 Budget(2 page maximum) Data T bles Question 13 Number of Individuals/Households Served Question 14a-c Performance Measures and Average Cost of Service Question 15 Demographics(from all funding sources) Question 16 Program Staff Question 17 Program Revenue&Expense Budgets 1 Question 18 Subcontracts Required documentation. Supply one copy of the following required documents with the signed original pplication. See Part II: City Specific Supplemental Information to determine whether additional copies of the application and required documentation need to be submitted. [ Question 19 Required Documentation, including: • Proof of non-profit status • Organizational Chart • Agency/Organization Mission Statement • Board resolution authorizing submittal of the application(may be submitted up to 60 days after application). • List of the current governing board and local board,if applicable, (include name,position/title, city residence, length of time on the Board, and expiration of terms. Note any vacancies.) • Board Meeting Minutes of last three board meetings of governing board and local board as applicable • Annual Budget • Financial Audit Cover Letter • Financial Audit Management Letter • Financial Statement • Verification of Non-Discrimination Policy • Program Intake Form ATM Application Check List. (Signed below.) lalltkity Specific Supplemental Information.Required in Name: Eileen Rasnack PaII for applicable City only. Position: Program Manager _ Phone#: 206-328-6853 E-mail: eileenr a,ccsww.org Signature of Person Completing Checklist DO NOT SUBMIT ANY OTHER MATERIALS WITH THIS APPLICATION Make sure that you carefully check Part II of this application to see what additional attachments each city requires. Page 21 Catholic Community Services Volunteer Chore Services Supplemental Questions—City of Renton 1. Volunteer Chore Services (VCS) matches Result#2 that individuals have adequate food, housing and healthcare. The VCS strategy is to serve as an essential safety net for those individuals who are not eligible for state paid services and lack the resources to pay for services— volunteer assistance provides one of the few options for many of these individuals. Volunteer services help these individuals remain in their homes by providing help with the chores they can no longer do themselves. These chores include housework, laundry, shopping, transportation to medical appointments and errands, yard work, minor home repair and respite. Help with these chores ensures that adults and elders with disabilities have access to food, retain their independent living status, receive social support from a volunteer, and access to health care/doctor's appointments to ensure their physical and mental well-being. The program is preventative through its efforts to help to maintain the quality of life,health, and well-being of the recipients, relieve caregiver burden and stress, and create an infrastructure that supports homebound individuals. VCS directly works with the community to build a strong network of support for elders and persons with disabilities to support their self-sufficiency. VCS' strategy of promoting volunteer assistance ensures that individuals have access to the services that they require. Volunteers maintain regular contact through their visits. This helps protect seniors and adults with disabilities from neglect. The volunteers serve as gatekeepers by observing potential changes or deterioration in the physical and mental well being of the individuals they assist. This allows them to report concerns to VCS staff who can connect them with other community resources or report concerns to the appropriate authorities. The ability to mobilize the community to respond to the needs of elders and adults with disabilities is a unique strength of Volunteer Chore Services. In the past year, volunteers have provided 1,267 hours of service for Renton residents. This project will help develop the necessary infrastructure to deliver services that meet these increasing needs in our community. More and more in today's society, neighborhoods and communities are becoming detached from each other. This community-based project provides an opportunity,for neighbors to meet one another again and support those in need. Families are provided the opportunity to reconnect to elders and increase their awareness of people living with disabilities. The program is an amazingly positive experience for everyone involved, offering intergenerational opportunities for youth and seniors alike. 2. Outcomes Outcome 1: Volunteer assistance with chores will help elders and adults with disabilities remain independent in their homes as long as safely possible. Volunteer assistance with housework, transportation, yard work and minor home repair provided through Volunteer Chore Services will help achieve Outcome 1 that elders and adults with disabilities remain independent in their homes as long as safely possible. Recruiting and providing volunteers is the main activity that VCS uses to accomplish this outcome. The program's outreach activities create awareness of the needs of elders and adults with disabilities. Community members are invited to help meet these needs as volunteers in the program. Volunteers are matched with seniors and adults with disabilities to provide weekly help with household chores and transportation. Other volunteers and volunteer groups provide assistance with one time service requests such as minor home repair, yard work or on-call transportation needs. The program works with communities to develop supportive connections to ensure seniors and adults with disabilities obtain the support and services they need to remain in their homes. The program builds on the strengths of the community, engaging local organizations, faith communities and businesses in all sectors to provide volunteer assistance. To accomplish this VCS establishes collaborations at all levels. In Renton, VCS has worked with faith communities, local businesses, code compliance officers, County programs and city of Renton staff to identify resources and provide services for Renton residents. Outcome 2: chore assistance helps clients to maintain optimal functioning relative to their condition. The assistance of a volunteer provides the seniors and adults with disabilities with help for chores they are no longer able to perform or would be at risk for injury in attempting to still do. Many `•" older adults can no longer reach, lift or bend over to complete household chores, repairs and yard work. As a consequence,many of these chores are not accomplished and the house and yard fall into disrepair. The inability to complete these chores can create unhealthy living conditions, which jeopardize their health and safety,potentially putting them violation of city codes and at risk for eviction from subsidized housing. Sixty percent of program participants have received services for 2 years or longer; of these, 24% have been receiving volunteer services for 5 years or more. Seventy-four percent of clients responding in the 2007 client survey reported that they were less fatigued because of the assistance of their volunteer. Sixty-nine percent felt they were better able to deal with their changing health status. These results highlight the success of providing free in-home services and involving the community to support elders and adults with disabilities. Internal Revenue Service Department of the Treasury District Director P. O.Box 2508 Cincinnati, OH 45201 Date: July 1, 2007 Person to Contact: James Blair iD#31-07578 Telephone Number: 877-829-5500 FAX Number: Ms. Deirdre Dessingue 513-263-4330 Associate General Counsel United States Conference of Catholic Bishops 3211 4th Street, N.B. Washington, D.C. 20017-1194 Dear Ms. Dessingue: ' in a ruling dated March 25, 1946, we held that the agencies and instrumentalities and all educational, charitable and religious institutions operated, supervised, or controlled by or in connection with the Roman Catholic Church in the United States, its territories or possessions appearing in The Official Catholic Directory 1946, are entitled to exemption from federal income tax under the provisions of section 101(6)of the Internal Revenue Code of 1939, which corresponds to section 501(c)(3)of the 1986 Code. This ruling has been updated annually to'cover the activities added to or deleted from the Directory. The Official Catholic Directory for 2007 shows the names and addresses of all agencies and instrumentalities and all educational, charitable, and religious institutions operated by the Roman Catholic Church in the United States, its territories and possessions in existence at the time the Directory was published. It is understood that each of these is a non-profit organization, that no part of the net earnings thereof Inures to the benefit of any individual, that no substantial part of their activities is for promotion of legislation, and that none are private foundations under section 509(a)of the Code. Based on all information submitted, we conclude that the agencies and instrumentalities and educational, charitable, and religious institutions operated,supervised, or controlled by or in connection with the Roman Catholic Church in the United States, its territories or possessions appearing.in The Official Catholic Directory for 2007 are exempt from federal income tax under section'501(c)(3)of the Code. Donors may deduct contributions to the agencies, instrumentalities and institutions referred to above, as provided by section 170 of the Code. Bequests, legacies, devises, transfers or . gifts to them or for their use are deductible for federal estate and gift tax purposes under sections 2055, 2106, and 2522 of the Code. z Ms. Deirdre Dessingue Beginning January 1, 1984, unless specifically excepted, you and your subordinates must pay tax under the Federal Insurance Contributions.Act(Social Security taxes)for each employee who is paid $100 or more in a calendar year, as indexed for inflation. You and your subordinates are not liable for the tax under the Federal Unemployment Tax Act (FUTA). By May 31, 2008, please send three (3)copies of The Official Catholic Directory for 2008 to IRS TE/GE in Cincinnati; one copy to the Processing Campus in Ogden;two copies each to the EQ Area Managers in Newark, Brooklyn, Chicago, St. Paul, Atlanta, Los Angeles, the IRS National Headquarters and the Director, EQ Examinations, Dallas. The conditions concerning the retention of your group exemption as set forth in our previous determination letter of August 17, 1983, remain in full force and effect. Sincerely, for Robert Choi, Director, Exempt Organizations Rulings &Agreements Catholic Community Services and the Archdiocesan Housing Authority Mission Statement Rooted in Catholic social teaching and the Gospel imperative, Catholic Community Services and the Archdiocesan Housing Authority are outreaches of the Catholic Church in Western Washington, under the leadership of the Archbishop of Seattle and the Boards of Trustees. CCS and AHA answer the Gospel call to loving and compassionate service with particular concern for the sanctity of human life from conception to natural death and the dignity of the human person. Our employees and volunteers come from many faith traditions to serve and support poor and vulnerable people through the provision of quality, integrated services and housing. Our focus is on those individuals, children, families, and communities struggling with poverty and the effects of intolerance and racism. We actively join with others to work for justice. Vision Statement Catholic Community Services of Western Washington and the Archdiocesan Housing Authority are prophetic voices for justice, recognizing the sacredness and dignity of every human person. Rooted in the Gospel message of hope, we will continue to be leaders, advocates,providers and partners serving poor and vulnerable people. Core Values Compassion—Providing care,understanding and concern for those we serve in order to honor the God-given life and sacredness of each person at every stage and condition of life. Diversity—Welcoming the differences of race, culture, faith, and thought with a strong commitment to naming and combating institutional racism and discrimination. Excellence—Providing high quality,professionally competent services with integrity, using best practices. Justice—Defending and advocating for the rights of poor and vulnerable people while working toward the common good. Stewardship—Prudently developing and using the gifts and talents of employees and volunteers and the financial resources needed to live out our mission. Belief Statement We believe... ...in every child growing up in a safe, loving and nurturing environment. ...in elders living in security and dignity. ...in healthy family life being affirmed and supported in our communities. ...in every person having the right to a safe, affordable place to call home. ...in compassion, love and respect for all people, especially those who are poor and vulnerable. ...in joining with others to change the systems which oppress, discriminate or otherwise cause human suffering. ...in employees and volunteers working in an environment which offers respect, teamwork and excellence. ...in all these things for all people, whatever their color, whatever language they speak or however they worship. Catholic Community Services and Archdiocesan Housing Authority Board of Trustees Very Reverend Kenneth Haydock Pat Sursely(Treasurer) Michael Reichert(ex-officio) (Chair) Dir. of Administration and Finance President,CCS/AHA Pastor,Holy Rosary Parish Archdiocese of Seattle 100- 23`d Avenue South 760 Aloha Street 710-9th Avenue Seattle,WA 98144 PO Box 206 Seattle,WA 98104 206-328-5696 (work) Edmonds, WA 98020 206-382-4588, e-mail: michaelr(aiccsww.org 425-778-3122 x224 fax 206-382-4297 Permanent e-mail: email:PatS(a�seattlearch.org khaydock(a�holyrosaryedmonds.org Permanent Permanent John Cunningham John Stoner James Hilger 4951 NE Laurel Crest Ln. 2600 W.Viewmont Way W. 901 N. Yakima Ave. Seattle,WA 98105 Seattle,WA 98199 Tacoma,WA 98403 Cell: 206-276-3796 cell: 206-623-0089 Work: 253-382-1919 Home: 206-517-5282 Home:206-285-2391 Home: 253-302-3570 j ohn(c iclearfir.com Work: 206-623-8880 jkhilgerAearthlink.net October,2010 john a,paragonrea.com October,2010 October,2010 Dennis O'Leary(Vice Chair) Sr.Barbara Schamber,SP Elizabeth Thomas Archdiocese of Seattle Sisters of Providence 715—20th Avenue East 710-9th Avenue 913 Lilly Road NE,Apt. A-13 Seattle, WA 98112 Seattle,WA 98104 Olympia,WA 98506 206-324-7024 206-382-4834(direct) (360)459-0313 e-mail: liz72(&juno.com fax 206-382-4840 email: schambersp a,aol.com October,2010 e-mail: denniso@seattlearch.org seattlearch.org October,2010 October,2010 Diane Christie Dora Alcorta Diana Bader,O.P. 1402 NE 151st Avenue PO Box 3184 6619 Larch Way G-304 Vancouver,WA 98684-3614 Everett,WA. 98213 Lynnwood,WA 98037 Business: (360) 695-7658 x311 Business: (425)353-1211 Phone: (425)741-6617 Home: (360) 892-0601 Home: (425)353-7248 E-mail: sdbaderop(aiaol.com E-mail: execdir(isharevancouver.org E-mail: ddalcorta(aicomcast.net September,2009 September,2009 September,2009 Ron Cook 2211 38th Place East Seattle,WA 98112 Business: (425)580-6671 Mobile: (206)669-9572 E-mail:RC6796@ att.com February 2011 Updated January 2008 Catholic Community Services of Western Washington Board of Trustees Meeting September 24,2007 Trustees Present Excused Staff Present Guests Fr. Kenneth Haydock, Chair Dora Alcorta Peter Bernauer Evelyn Allen Sr. Diana Bader, O.P. Diane Christie Bill Hallerman Peter Nazzal John Cunningham Pat Sursely John Hickman Denny Hunthausen James Hilger Kay Lagreid Jose Uriarte Dennis O'Leary, Vice Chair Colleen Oglesby Susie Hofstedt Michael Reichert Annette Quayle Helen Meyer John Stoner Rob Van Tassell Helen Vajgert Elizabeth Thomas Irene Ward Jim Anderson Sr.Barbara Schamber, S.P. Therese O'Brien CATHOLIC COMMUNITY SERVICES OF WESTERN WASHINGTON BOARD OF TRUSTEES MEETING WAS CONVENED NOTE: This meeting was held in Tacoma at Catholic Community Services' Tahoma Center. NOTE: This marks the first of the new longer board meetings which are now scheduled to last four hours instead of three. Convening Very Rev.Kenneth Haydock convened the meeting at 10:00 a.m. and made special mention of the upcoming feast day of St.Vincent de Paul,the saint who became the champion of the poor and for which the St. Vincent DePaul Society was named. Opening Prayer and Reflection Annette Quayle offered an interactive Reflection pledging commitment to serve the poor and vulnerable. After reading a selection from the new"Sacred Stories"booklet, she then handed out a personal copy to each Board Member as a thank-you for the way each member lives out the mission of CCS/AHA. Previous Meeting Minutes It was recommended that the CCS Board of Trustees minutes from the June 25,2007 meeting be changed to reflect that Sr.Barbara Schamber's name be removed as the person who seconded the motion to approve the minutes. In addition,it was agreed that the words"final"should be removed from the approval of the resolution for the provisional budget noted on page seven. Dennis O'Leary motioned to accept the minutes for the June 25,2007 CCS Board Meeting with the stipulated changes noted above. The motion was seconded and the minutes were approved unanimously. 1 Catholic Community Services of Western Washington Board of Trustees Meeting September 24,2007 Planning Process Update CCS is coming to the conclusion of the planning process and although Insights and Implications are continuing to come in from staff throughout the organization,it is hoped that the fmal product will be placed before the Board for approval at the December meeting. At this meeting though,the goal is to finalize the Vision,Belief,Mission and Core Values Statements. Dennis O'Leary referred to pages 8 through12 of the Board book which listed three proposed versions of the next generation of Vision,Mission, Belief and Core Values Statements for the Board to review and approve at this meeting. Discussion ensued as to which of the three choices in statements were most appropriate as well as the placement of certain words within the statements. A motion to accept the following Vision Statement was made and seconded. The motion was unanimously approved by the Board: VISION STATEMENT As prophetic voices for justice addressing human suffering, Catholic Community Services of Western Washington and the Archdiocesan Housing Authority will continue to be leading,faith-based advocates,providers and partners serving poor and vulnerable people. A motion to accept the following Mission Statement was made and seconded. The motion was unanimously approved by the Board: MISSION STATEMENT Catholic Community Services and the Archdiocesan Housing Authority answer the Gospel call to loving and compassionate service with particular concern for the sanctity of human life from conception to natural death and the dignity of the human person. Our employees and volunteers come from many faith traditions to serve and support poor and vulnerable people through the provision of quality, integrated services and housing. Our focus is on those individuals, children,families, and communities struggling with poverty and the effects of intolerance and racism. We actively join with others to work for justice. CCS and the AHA are faith-based outreaches of the Catholic Church in Western Washington, under the leadership of the Archbishop and the Boards of Trustees. A motion to accept the following Core Values Statement was made and seconded. The motion was unanimously approved by the Board: CORE VALUES Compassion—Providing care, understanding and concern for those we serve in order to honor the God-given life and value of each person at every stage and condition of life. Diversity— Welcoming the differences of race, culture,faith, and thought with a strong commitment to naming and combating institutional racism and discrimination. 2 Catholic Community Services of Western Washington Board of Trustees Meeting September 24,2007 Excellence—Providing high quality,professionally competent services with integrity, using best practices. Justice—Defending and advocating,for the rights of poor and vulnerable people while working toward the common good. Stewardship—Prudently developing and using the gifts and talents of employees and volunteers and the financial resources needed to live out our mission. A motion to accept the following Belief Statement was made and seconded. The motion was unanimously approved by the Board: BELIEF STATEMENT We believe... ...in every child growing up in a safe, loving and nurturing environment. ...in the elderly living in security and dignity. ...in healthy family life being affirmed and supported in our communities. ...in every person having the right to a safe, affordable place to call home. ...in compassion, love and respect for all people, especially those who are poor and vulnerable. ...in joining with others to change the systems which oppress, discriminate or otherwise cause human suffering. ...in employees and volunteers working in an environment which offers respect, teamwork and excellence. ...in all these things for all people, whatever their color, whatever language they speak or however they worship. Discussion ensued regarding the proper sequencing of the statements. It was agreed that the Vision Statement should come first followed by the Mission Statement.The Core Values should be third and followed by the Belief Statement. A motion to approve the proper sequencing of the statements was made and seconded. The motion passed unanimously. Introductions of Guests After break,the meeting continued with the introduction of Board Members and CCS Southwest Staff. Denny Hunthausen, Southwest Agency Director, Peter Nazzal,Long Tenn Care System Director; Jose Uriarte,Regional Finance Director; Susie Hofstedt,Tahoma Family Center Director; Helen Vajgert, 3 Catholic Community Services of Western Washington Board of Trustees Meeting September 24,2007 Human Resources Director; Helen Meyer, IT Director; and Jim Anderson, Director of Hospitality Kitchen and Achieve.A brief history of the Tahoma Center was given along with an overview of the services delivered in the Southwest region. The Board thanked the staff on the work they do and then toured the Hospitality Kitchen. Corporate Office Budget Peter Bernauer referred to the discussion at the June Board Meeting about the Board approval of the entire system budget versus just the corporate office budget. After checking with the Bylaws Peter noted that there is a requirement that the Corporate Member approve the corporate budget. So,there are two budgets attached;the corporate office budget requiring a Resolution and a Certificate of Action and a separate system budget requiring an affirmation by the Board. The corporate office budget,the system wide budget and the financial summaries were presented to the finance committee prior to this meeting. Discussions at the Finance Committee Meeting centered on line items that changed since the approval of the provisional budget in June. Jim Hilger added that the Finance Committee went over this budget in great detail. There wasn't anything that came out of the Finance Committee review that warranted any further change. Revenue Revenue is projected$60,000 higher on the final budget as compared to the provisional budget. Increases in Convio online giving and other changes including agency fees. Personnel Page 19 lists the FTE's and the changes from the provisional budget. In the governance office we added a business developer position that would be for%of the year.We did not replace the Operations CoordinatoraIMINM although we did increase professional fees in case we needed to hire a temp over the period of the year.In the fund development arena,we added a 1.0 FTE for the Convio Implementation Process.The end result in all this was an increase in 1.17 FTE's. Operating Costs Page 17 contains the operating costs for the agency. These were modified from the original budget based on year end totals plus CPI,unless there was some other information which warranted an additional change. Pass Through Funds Page 18 deals with the pass through of funds that have either been received or collected on behalf of the agency and then distributed out to the regional offices. There were 2 changes from the provisional budget; one to the NW region reducing the allocation by$28,000 due to the restriction of pass-through dollars in 2007-2008; and the elimination of the allocation of$35,000 to Long Term Care because they will be receiving the appeal dollars directly this year. One of the issues that the board needs to take a look at is the actual allocation of the Catholic Charities Foundation.Peter noted that there is a section on the bottom where he put last year's allocation and then staff's recommendation for the 2007-2008 fiscal year. 4 Catholic Community Services of Western Washington • Board of Trustees Meeting September 24,2007 RESOLUTION CCS-0907-12-R: A motion was made by Dennis O'Leary and seconded by Sr.Barbara Schamber to approve the Corporate Office Budget for the 2007—2008 Fiscal Year. The Resolution passed unanimously. Entire Organization Budget An explanation of the entire organization's budget was available for review in the Board Book and projected approximately$7 million growth over the 2007-2008 fiscal year. The question was asked if CCS needs a larger line of credit. Peter said that we have$1.5 million line of credit with Bank of American,$1 million line with the foundation and approximately$700,000 in cash reserves for the organization. Peter.commented that he felt the available credit would be adequate for the cash flow needs of the organization, and suggested we look at the status again in December. RESOLUTION: Father Haydock called for a Resolution to Accept the Assumption of the System-wide Budget.Sr.Diana Bader made the motion to accept the Resolution.The resolution was seconded and passed unanimously. The board congratulated Peter Bernauer on an excellent breakdown and presentation of the budgets. Housing Development The Spruce Street Resolution under consideration was explained to the Board. This Resolution would allow CCS to proceed with the acquisition and development of the Village Spirit Center Housing at Spruce Street. ' RESOLUTION CCS-0907-11R: Father Haydock called for a motion to accept the Village Spirit Center Housing at Spruce Street Resolution requesting a Certificate of Action by the Corporate Member to proceed with the development of the project. John Cunningham made the motion to accept the Resolution.The resolution was seconded and passed unanimously. Peter added that financing of the Spruce Street project requires a$300,000 loan from the Catholic Charities Foundation and therefore a Unanimous Consent Resolution for the loan to CCS will need to be signed by the Foundation Board. Fund Development Report: The goal this year is to have 100%participation by the parishes as well as by board members, committee members and advisory council members. Speakers are always needed. Another goal is to streamline CCS Week as well as do a better job of reachin out to the pastors to acquire more speaking and mailing list permissions. To that end, was hired. She is a retired school principle who will work approximately 20 hours per week contacting parishes about CCS Week. Materials this year will be printed and mailed by the same company used by the Annual Appeal of the Archdiocese for the past three years. One reason for this is so pastors will have something that looks very familiar to them. 5 Catholic Community Services of Western Washington Board of Trustees Meeting September 24,2007 Both CCS Week materials and our on-line presence will utilize the new CCS/AHA outcomes - Safety, Stability and Connections-and our new Belief Statement. We have signed a contract with Convio which is a national provider of online fundraising and web constituent management software. They have 1,200 plus clients across the United States including, The American Red Cross, Catholic Relief Services, and the Susan G. Komen Foundation. Our partnership with Convio will strengthen our community ties (volunteer, employees,donors,business and government),and allow us to dramatically communicate our story about the work that we do and the outcomes we provide which we believe will substantially increase the dollars raised online. John Cunningham added that the goal for the first year of operation to get 25,000 e-mail addresses of folks who have given us permission to communicate via e-mail with them. Hunthausen Awards: Kay handed out the Hunthausen Award packets to each Board Member.Five recommendations were received this year. Packets include supporting materials for each candidate and a ranking sheet. The deadline for submitting ranking sheets is Friday, October 19th. The award will be presented on Thursday, February 21st at the Mission Day gathering in Edmonds at Holy Rosary Parish. This is the first time in the history of the award that it will be given at any other time than in the fall. All the nominees and the winner will be notified of the new date that the award will be presented. Father Haydock and Diane Christie will absent themselves from ranking the nominees as Father Haydock has a family member nominated and Diane Christie has a board member nominated. Board Member Recruitment Six board members should have received a letter from the Archbishop confirming the renewal of their terms on the Board. Currently we have seven Board Members not including Michael. We are trying to recruit two others. One of those is 1.1111111111.11who works for the Providence system and has a wonderful understanding of the needs of Snohomish County. Sister Barbara is going to help recruit him. The other person,Ron Cook is a CPA that works for AT&T purchasing land and would make a great addition to the I-Iousing Development Committee. President's Report Michael thanked Fr. Haydock and the Archbishop for the quick response and approval of the executive compensation increase which has now been implemented. Michael handed out the final version of the housing checkerboard for the board to review. The goal of building 150-175 housing units(approximately 3 projects per year) over the next ten years was discussed as part of our overall planning process. Michael handed out a document that showed the history of allocations and donor designated gifts from United Way of King County to CCS, and indicated that CCS King County will receive an allocation this year that will be$300,000 short of the previous year. Although our United Way allocations have been steadily declining over the years, this shortfall has caused CCS King County to have to close the 6 Catholic Community Services of Western Washington Board of Trustees Meeting September 24,2007 counseling program and downsize the emergency assistance program. These reductions resulted in the elimination of between 6—7 FTE's. Futures II Michael reported on the insights and implications portion of the Futures II process, and referenced the first Futures process which we are using as a model for the Futures II. We are asking our Directors Group to help in the development of the key insights and implications for the future. These will form the basis of our Futures II planning document and provide the foundation for our new initiatives over the next several years. In December,we will present draft insights and implications for Board approval. Council on Accreditation Update: We were invited by the Council on'Accreditation to have a conversation with them—to address concerns they had regarding the outcome of our audit in June. This gave us an opportunity to tell them how we felt about the way the reaccredidation process was conducted. We expressed our concerns that the audit team was very out of sync with many of the things CCS is doing as an agency and the fact that we felt their audit team didn't have the experience to judge some of the services we provide. We will be working with an auditor/consultant,assigned by COA on the initial report we received, and will be correcting any deficiencies confirmed by the auditor/consultant. We will have an additional report at the December Board Meeting. Adjourn The motion to adjourn was made and seconded. The motion passed unanimously. The meeting ended at 1:45 p.m. 7 Catholic Community Services of Western Washington Board of Trustees Meeting o- December 10,2007 Trustees Present Excused Staff Present Guests Fr. Kenneth Haydock, Chair Dora Alcorta Irene Ward Ron Cook Sr. Diana Bader, O.P. Jim Hilger John Hickman Gloria Burton Pat Sursely Bill Hallezman Richard Klarberg John Cunningham Colleen Oglesby Dennis O'Leary, Vice Chair Kay Lagreid Michael Reichert Annette Quayle John Stoner Rob Van Tassell Elizabeth Thomas Therese O'Brien Sr. Barbara Schamber, S.P. Diane Christie •CATHOLIC COMMUNITY SERVICES OF WESTERN WASHINGTON BOARD OF TRUSTEES MEETING WAS CONVENED Opening Prayer and Reflection: Annette Quayle offered an interactive Advent Prayer by Annabel Shilson-Thomas. Convening: After the Archdiocesan Housing Authority meeting adjourned,Very Rev. Kenneth Haydock convened the Catholic Community Services meeting at 10:58 a.m. Previous Meeting Minutes: A motion to accept the minutes from the September 24, 2007 Board Meeting was made by Sr. Diana Bader and seconded by Elizabeth Thomas. The minutes were unanimously approved as written. Planning Process Update: Irene reported on the final stages of the Planning Process which CCS hopes to roll out on Mission Day, February 21,2008. Irene noted that there are two issues at this Board meeting for discussion.Those issues are the final draft version of the Vision,Mission, Core Values and Belief Statements, and the doelunent outlining the Insights,Implications and Key Action Steps. Each issue requires separate consideration from the Board as there will be separate resolutions for each as well as a Certificate of Action by the Corporate Member for the Mission,Vision, Core Values and Belief Statement. Vision Statement: The Board referred to page 12 and 13 of the Board book. It was explained that the first approved Vision Statement read clumsily after it was changed from the singular to plural. With the slight change noted below,it read more smoothly. Motion: After review and discussion, a motion to accept the following Vision Statement as written was made by Dennis O'Leary and seconded by Elizabeth Thomas. The motion to accept the following Vision Statement was unanimously approved by the Board: ti Catholic Community Services of Western Washington Board of Trustees Meeting j' December 10,2007 \ VISION STATEMENT As prophetic voices for justice addressing human suffering, Catholic Community Services of Western Washington and the Archdiocesan Housing Authority will continue to be faith-based leaders, advocates,providers and partners serving poor and vulnerable people. Belief Statement: It was requested by the Board that the second sentence of the Belief Statement be changed from"...in the elderly living in security and dignity."to"...in elders living in security and dignity." RESOLUTION CCS-1210-18-R: A motion was made by Sr.Barbara Schamber and seconded by Sr.Diana Bader to approve the resolution recommending to the Corporate Member the approval of the CCS Mission, Vision, Core Values and Belief Statement.The motion passed unanimously. The Board thanked CCS for all the hard work involved in developing the new Mission,Vision, Core Values and Belief Statement as well as the Insights and Implications. Insights and Implications: Insights, Implications and Key Action Steps for the future were reviewed by line item. Suggested changes to the document were written down during discussion and will be made to the final document prior to implementation. Due to the length of the document, it was suggested that _ changes to the document be redlined to allow a quicker review at a later date. RESOLUTION CCS-1210-17-R: A motion was made by Dennis O'Leary to approve the Insights and Implications for Futures II after incorporating suggested changes made by the Board.The motion was seconded by Sr.Diana Bader.The motion passed unanimously. A special thanks was given to Irene Ward and Annette Quayle for all the time and effort put forth in the creation of Insights and Implications. Lunch: The Board broke for Christmas Lunch at noon and gifts were distributed to Board Members as appreciation for their hard work and dedication throughout the year. Introduction of Gloria Burton: Gloria Burton,Farmworker Housing Developer for CCS/AHA was introduced to the Board and announced that CCS/AHA was recently awarded$1.5 million for the Farmworker Housing project in Centralia. Congratulations from the Board were given to Gloria. It was added that CCS/AHA is the largest owner/operator of Farmworker Housing in Washington State. Samaritan Magazine: Congratulations were given to Kay Lagreid for another very fine edition of the Samaritan Magazine. a Catholic Community Services of Western Washington Board of Trustees Meeting December 10,2007 Hunthausen Award: The person receiving the most votes for the Hunthausen Award was John Morford. Fr. Haydock asked if the Board was in agreement to forwarding the nominees' slate to the Archbishop. The Board agreed. The process for selecting a finalist for the Hunthausen Award was discussed. It was suggested that for 2008,perhaps the protocol for choosing the winner could be changed to reflect a better,more clearly understood selection process. Board Member Recruitment:, , a potential candidate for the Board of Trustees who works for the Providence Health System,is not able to attend Monday Board Meetings. The Board would still like to contact him for ideas and suggestions in areas of his expertise. Should his schedule change to allow him to attend Monday meetings,CCS/AHA would again approach him for Board membership. The other candidate, Ron Cook was in attendance at this Board meeting to become acclimated to the process and procedures. Financial Summary: The Financial Summary for the first quarter of 2007 ending September 30,2007 was reviewed. Due to the illness of Peter Bernauer,a summary of the financial statement was available to aid in the Board's review of the financial statement. It was noted that this is the best first quarter,financial report CCS has had in recent years; although there will probably be a drop off as the winter months approach. This drop off will partly be due to the wage increases which would not have taken effect yet for this report. Another positive aspect is the anticipated CCS Week income. The CCS line of credit is adequate at this time. If the organization continues to grow, it may have a , need for more money. In addition to growth,the Regional Support Network(RSN)is changing the way they reimburse Family Preservation Services,and CCS does not know how the change in the RSN reimbursement procedure will affect reimbursement to the agency. Josephinum Update: CCS/AHA now has complete ownership of the Josephinum. The next issue is the re-development of the Josephinum and how it will be structured in the future. The archdiocese is looking at creating a parish that seats 300 at the Josephinum, and conversations around this topic begin this month with re- development possibly beginning a year from now. Executive Session At this time, an Executive Session was requested. Housing Development: It was reported that currently only one project is under construction and that is Monica's Village. A status sheet on the project was provided for review. Catholic Community Services of Western Washington Board of Trustees Meeting December 10,2007 In addition,the purchase and sale agreement on the VFW building in Everett was signed. By way of review,the VFW building is a great opportunity as it can be built upward to a maximum of eight stories and can be used for housing for veterans,women veterans with children, and families. Rob added that the Holden and Westlake II projects may need a unanimous consent resolution prior to the next board meeting. Fund Development Report: An update on CCS Week was handed out for review as well as copies of CCS Week collateral materials. This year's mailing was the largest CCS Week mailing ever. In addition,there are 115 speakers presenting at parishes. It was announced that we have 100%of our Board Trustees donating to CCS Week. A special note of thanks was given to Board Members who are giving CCS Week presentations at parishes. To date CCS Week has generated 860 gifts,producing a total so far of$82,386. An e-mail was sent by Michael Reichert to parishes letting them know that if a pastor chose to do so,he could request his 25%Parish Partner Return be expedited so it could then be forwarded to a parish in Lewis County or.Grays Harbor,County directly affected by the December, 2007 storm. A special paragraph was also inserted into the parish presentations telling about the CCS/AHA Early Response Tearn.dispatched to assess the flood damage in the southwest region, and sharing how CCS and AHA are helping victims of the flooding. Materials which depicted the look and style of the new Convio powered CCS/AHA website were handed out for review. The continuing theme of Safety, Stability, and Connections is evident throughout. Special acknowledgement was given by John Cunningham to the Fund Development staff for their hard work and dedication to developing and implementing the new website. President's Report The Board was reminded to complete their Annual Conflict of Interest Forms and return them to CCS as soon as possible. The Archdiocesan Workers Comp Program(that covers all Archdiocesan employees)which had been administered by CCSWW staff,has been moved to a new third party administrator. Denny Hunthausen,Agency Director for CCS Southwest has been assessing the damages and is prepared to set up an operations center through which direct assistance can be provided for the victims. There are several parishes that Denny has been in contact with that are willing to set up operations, coordinate volunteers and provide housing to the volunteers in a similar manner to what was done in Biloxi after Hurricane Katrina. ,. r-' Catholic Community Services of Western Washington Board of Trustees Meeting December 10,2007 A figure of$300,000 was suggested as a final financial commitment from CCS for flood relief with the stipulation that it be allocated in three waves of$100,000 each. A clarification was made that any monies collected by the archdiocese would be included in this $300,000. Motion: John Cunningham made a motion that$300,000 be distributed to flood victims through the staff of CCS with the approval of the Executive Committee of the Board and that those funds be made available in$100,000 increments. Sr. Diana Bader seconded the motion. The motion passed unanimously. Council on Accreditation Update: Michael Reichert introduced guest Richard Klarberg,President and CEO of the Council on Accreditation. Richard spoke to the Board about the Final Pre-Commission Report for Catholic Community Services' re-accreditation audit and the erroneous results reported by the first site auditors. He explained that he wanted to come to CCS to personally apologize for the poor job COA did on our reaccreditation process. He admitted that the process was an embarrassment to COA. Mr.Klarberg confirmed that he thought something had gone seriously wrong when he read the original report and saw that CCS was deficient in 117 areas. It didn't make sense to him that CCS,which had a reputation as an excellent organization, could have done so poorly on an audit.As a result,COA authorized a very experienced and highly skilled independent COA auditor to re-audit the findings of the first audit. That individual Was Don Mertic who held interviews with CCS staff and re-reviewed CCS documentation. �A Based on that analysis,the pre-commission report was re-written,and CCS was found to be out of complianceTor only 8 standards compared to the original 117 standards cited in the original report. Mr. Klarberg indicated that he thought the new report is excellent for an agency as large and diverse as CCSWW. After reviewing the results of both audits,it was clear that the original auditors were clearly not experienced enough to visit an organization as large and complex as CCS. In addition,Mr. Klarberg formally and sincerely apologized on behalf of his staff and himself for the embarrassment,pain and humiliation brought upon the staff and leadership of CCS. He added that the costs incurred by CCS to host the independent auditor would be paid by COA. Board members asked if there was a way that members of the CCS Board could have a conversation with members of the COA Board. Mr. Klarberg indicated that is certainly possible. Adjourn The motion to adjourn was made and seconded. The motion passed unanimously. The meeting adjourned at 2:10 p.m. Catholic Community Services of Western Washington Board of Trustees Meeting March 10,2008 Trustees Present Excused Staff Present Guests Fr. Kenneth Haydock, Chair Jim Hilger Irene Ward Mary Hatch,Director Sr. Diana Bader, O.P. John Cunningham John Hickman of Human Resources Pat Sursely John Stoner Bill Hallerman for CCS and AHA Ron Cook Colleen Oglesby Dennis O'Leary, Vice Chair Kay Lagreid Michael Reichert Annette Quayle Dora Alcorta Rob Van Tassell Elizabeth Thomas Therese O'Brien Sr. Barbara Schamber, S.P. Peter Bernauer Diane Christie CATHOLIC COMMUNITY SERVICES OF WESTERN WASHINGTON BOARD OF TRUSTEES MEETING WAS CONVENED Convening: Very Rev. Kenneth Haydock convened the Catholic Community Services Board meeting at 10:03 a.m. Opening Prayer and Reflection: Annette Quayle offered the interactive Justice Prayer by Jann Kajatin. Previous Meeting Minutes: A motion to accept the minutes from the December 10, 2007 Board meeting was made by Sr. Barbara Schamber and seconded by Diane Christie. The minutes were unanimously approved as written. Financial Issues Peter referred the Board to the Financial Report from July through December, 2007 in the Board book. All regions and systems reported to be in a positive position for the first six months of the year. From operations,the systems and Family Centers reported a combined excess of$1,005,000. The Corporate Office reported an excess of$177,000. Peter explained there is some concern that the Family Preservation System may experience some losses during the second half of the year as the contracts move from a capitated reimbursement rate to a fee for service rate. In addition to the operating excess,the system reported non-operating excesses of$1,805,000 consisting of restricted contributions and accrued interest income from notes receivable. Overall, CCS is showing an excess of$2,989,000 from operating and non-operating activities for the first 6 months of FY 07-08. As a result of the excesses,the cash flow concerns raised during the budget process have not materialized. Mike Reichert thanked Peter and Irene for their work in helping the NW agency transition to a more P efficient family center model. He explained that the new, successful NW model will continue to evolve into other areas of the organization including King County. Page 1 of 5 )41 Proposed Revision of Allocation of Catholic Charities Foundation Grant The Catholic Charities Foundation does a distribution each year to CCS; and this year,the distribution is $450,000. When that money is received,it becomes a part of the budget and it is listed in that budget how those funds will be allocated. The Board then approves the budget. The proposal before the Board at this time is to request that the Catholic Charities Foundation distribution be revised as follows: 1. To support capital expansion of the Long Term Care System, in particular for the Lakewood facility. 2. To support expansion of the Mental Health System in the Northwest Region rather than just Snohomish County, as was previously proposed. 3. To support disaster relief efforts in Southwest Washington in the amount of$110,000. This request eliminates the previous allocation for support for program expansion in Western Washington and contingent needs of the agencies, the sum of which was$110,000. At the December 10,2007 Board meeting,the Board authorized$300,000 for flood expenses in SW. To date, CCS has received contributions in the amount of$146,000 in restricted funds for flood relief. With the additional$110,000 from the Catholic Charities distribution added to the$146,000 already raised, CCS would only need to use an additional$44,000 to reach the $300,000 approved by the Board at the December 10, 2007 meeting. It was noted that money from the 25%rebate from CCS Week that parishes donated back to CCS for flood relief is counted in the$146,000. It was asked if a certificate of action would be needed and it was clarified that,per the Bylaws, since the reallocation was less than 5% of the agency budget, the requested change could be made by a motion rather than by resolution and certificate. MOTION: A motion was made by Pat Sursely to approve the reallocation of the Catholic Charities 2007-2008 distribution as requested. Sr. Barbara Schamber seconded the motion and the motion passed unanimously. Internal Audit Sister Diana raised a question for consideration regarding internal auditing, and handed out an article from the December 07 issue of"Tone at the Top", a newsletter published by the Institute of Internal Auditors. Non-profit organizations are now required to undergo internal audits as well as external audits. This process is not conducted because of any suspicious behavior in the organization or fear that something is amiss in the organization. It is simply a matter of being in control over the organization's processes, operations and procedures. Discussion ensued as to the pros and cons of CCS engaging in the practice of internal auditing. The suggestion was made that a committee of staff and Board should be formed to take a look at the scope of what should be included in an audit. Sr. Barbara volunteered to check with the person that performs her organization's audits to see if they could be of help to CCS. Fr. Haydock volunteered to chair an Ad Hock Committee of the Board to define the scope of the audit. Other members of that committee include: Sr. Barbara Schamber, Sr. Diana Bader and Ron Cook. This committee will meet and report at the May Board meeting. Page 2 of 5 ^;OC I t Josephinum Report from Finance Committee As requested at the previous Board meeting, the results of the Josephinum discussion from the Finance Committee meeting were reported on. Now that CCS/AHA owns the Josephinum, the plan for the building is to continue to provide affordable housing. The building currently has contracts with the city and state for up to 10 years. In addition to housing,the Josephinum also hosts service programs such as the Women's Wellness Program and SHARE/WHEEL. Going forward, the Archdiocese is in the process of creating a parish on the property, and an architect is currently in the process of designing the retail space into office space as well as an alternative entrance and lobby area. The question was asked if the architect could further maximize the space;but, since the building's exterior is registered as an historic landmark, the structure is preserved from adding additional floors. US Bank 403(b)Plan Resolution Mary Hatch explained that the old 403(b)plan through US Bank has had to remain operational for staff, both current and terminated because those people have not taken the necessary steps to close out their accounts. Human Resources has sent numerous correspondence to those folks requesting that they either roll over their funds into another retirement plan or request a distribution;however,response to that correspondence has not achieved the required results, leaving the balance as of 12/31/07 at just under$300,000. This amount reflects the investment of the 15-20 participants remaining in the plan that have not requested distribution. Of particular concern to CCS is the volatility in the stock market today and the potential of those funds to decline. Just in the month of January, 2008, the valuation declined by 10%. Of additional concern is that the organization is continuing to pay an administrative fee for this now obsolete 403(b)plan. It has been suggested that CCS look at a different methodology in the distribution of the plan which would entail looking at the percentage of ownership as of 12/31/07 and use that as a basis for future distributions based on the daily market value of the account, thus imposing a more fair and equitable means of distribution. This is what prompts the resolution brought before the Board this day. RESOLUTION CCS-0208-22R After review and discussion Pat Sursely motioned to accept the resolution approving the change in how distributions or transfers from the US Bank 403(b) Plan are made. Those transactions will be based on the daily valuation and on percentage of"ownership"basis. The percentage of "ownership"will be calculated based on the most recent semi-annual valuation as a percentage of the entire plan asset base.The motion was seconded by Sr. Diana Bader and passed unanimously. Father Haydock asked that the Board leave the decision up to CCS as to how best to implement the distributions. Page 3 of 5 \s\f',,,,,,..,,,io.:ii 1„: Housing Development: Rob Van Tassel reported that CCS received tax credit awards for St. Leo family housing which is planned for 50 units of family housing. It is hoped that groundbreaking will occur in October or November of this year. The name for this project as approved by the Archbishop is Guadalupe Vista. Planning Process Update: The proposed agenda for the upcoming Mission Day was passed out for review. The major focus of the day is the rollout of Futures II. This is the day when staff will be introduced to the changes being implemented in the organization and will also have the chance to absorb them. At that time, we will also be asking for volunteers for the newly organized task forces. The Board's role in the Diversity module of Futures II was discussed, and Michael distributed a paper published by Catholic Charities USA entitled"Poverty and Racism in America, Overlapping Threats to the Common Good" for review and insight into understanding why the issue of diversity is such a key element in the rollout of Futures II. It was agreed that it will take a considerable commitment by the Board and CCS to fully implement Insight#4 from the Futures II process. Elizabeth suggested that the workshop"Undo Racism"presented by the People's Institute NW would be a good starting point for top level leadership and suggested that she would like to talk more about this with Michael and Chanin Rae, the CCS Diversity Manager. Father Haydock suggested that a task force of the Board be empowered with this issue and be prepared to discuss diversity at the next Board meeting. Volunteers from the Board include: Elizabeth Thomas, Michael Reichert,Dennis O'Leary, and Dora Alcorta. December Storm Report Michael talked about what a tremendous job CCS staff has done for SW flood relief and added that Irene would pass out a list of folks who volunteered in Lewis County to help flood victims. Michael asked that the Board officially recognize the people on the list. Fr. Haydock thanked staff for the tremendous work they did in Lewis County and added that Fr. David Mullholland, Pastor of St. Joseph Parish in Chehalis and Dean of the South Sound Deanery, continues to praise CCS for their help and their presence in Lewis County. Fr. Haydock also suggested that CCS use some of Fr. Mullholland's quotes in future correspondence regarding CCS Week or other upcoming fundraisers. Hunthausen Award: After discussion, it was decided that a policy should be developed for determining the way in which the Hunthausen Award winner is chosen. The Board would like to see a weighted vote implemented; i.e. 5 for first place,4 for second place, 3 for third place, etc. Fr. Haydock cautioned that the final selection would still be determined by the archbishop. Fr. Haydock offered to work with Kay Lagreid in developing this policy for review at the next Board meeting. Fund Development Report: An update on CCS Week was handed out for review. One goal of the CCS Week team was to increase the size of the mailing; and, this year's mailing was the largest CCS Week mailing ever. In addition, 169 parishes participated this year(in some way) compared to 152 participating last year.Those that did not participate had very specific reasons for not doing so. Page 4 of 5 P4(3 Another goal of the CCS Week team was to increase the number of parish permissions for use of their mailing lists. This goal was met quite successfully as is evidenced by the total mailing of 88,000 which, compared with 68,000 the previous year reflects an increase of 20,000 households. In the future, the practice of accepting oral permission from the parish will be changed, and we will have to implement a system whereby we receive written permission. Colleen asked that each Board member send an e-mail through the CCS website to 5 of their friends encouraging them to sign on to the website to receive e-newsletters, etc. This action will help build e- mail house files. Instructions on how to do this will be sent to the Board. Another exciting aspect of what Fund Development will be doing is the impact tours to some of the CCS/AHA sites. Suggestions on who to invite to these tours are welcome from the Board. It was announced that CCS has purchased the url"Catholic Charities Foundation.org"which will become the official website address of the Catholic Charities Foundation of Western Washington. President's Report • Michael Reichert gave an update on the Legislative session, focusing his remarks specifically on the housing reform agenda. • As CCS begins to set up endowments, it was suggested that one of them be named for Archbishop Brunett in honor of his 50 years as a priest(which he will be celebrating in July), as well as honoring the way in which he has always been a dedicated supporter of CCS and AHA. • Michael referred to an updated list of future Board meeting dates which was available in the Board books. There was a conflict with the May date which was changed from May 19th to May 12�h. Adjourn The motion to adjourn was made by Dennis O'Leary and seconded by Dora Alcorta. The motion passed unanimously. The meeting adjourned at 12:35 p.m. Page 5 of 5 Tpea Catholic COMMUNITY services OF KING COUNTY King County Agency Advisory Council Josephine Tamayo Murray,MSW Amsale Mengistu 100 23rd Avenue South 2615 SE 16th Street Seattle,WA 98144 Renton,WA 98058 206-328-5701 425-235-8769 (h),206-696-3476© josephinetm@ccsww.org amsalem@msn.com, amsale.mengistu@gatesfoundation.org Vern Endres Mary"Lee"Gowell 15020 81st Ave NE 9140 NE 21st P1 Kenmore,WA 98028 Clyde Hill,WA 98044 425-488-1734 425-454-6223 vlsj@comcast.net mlgowell@msn.com Dr.Robert Gary Marion C. Krueger 5751 Wilson Ave S. 21907 NE 4th St Seattle,WA 98118 Sammamish,WA 98074 206-723-3298 206-999-7229 mckrbk@aol.com Regina Melonson Mark Flynn 1526 34th Ave P.O.Box 322 Seattle,WA 98122 Sea Hurst,WA 98062 (h)206-325-3496(w)206-577-2245(cell)206-371-9190 206-243-5734(h),206-683-7192(cell) reginamelonson@msn.com Markflynn45@comcast.net Leslie Kae Hamada Michael Burke 28026 189th Ave SE Mercer Island Kent,WA 98042 206-655-9189,206-306-1473(cell) 253-631-3895 Bburke021@comcast.net Leslieglenhamada1@prodigy.net Carolyn Lewis-Carter Dr.Joe Drake 140 23rd Ave.E.Unit A 13476 SE 242nd St. Seattle,WA 98112 Kent,WA 98042 206-324-1757(h),206-621-9211 (w) 253-631-3989 (h),206-252-4700 carolynlc@sprucestreetschool.org jdrake@seattleschools.org Last Updated April2007 1,4t�° Catholic COMMUNITY Services OF KING COUNTY King County Agency Advisory Council Josephine Tamayo Murray,MSW Amsale Mengistu Affiliation: Agency Director Affiliation: The Gates Foundation Catholic Community Services of King County Region: South County Term Expires: Staff Term Expires: August 2009 Number of Years Served: 15 Number of Years Served: 1 Vern Endres Mary"Lee" Gowell Affiliation: Construction/Project Management Affiliation: Seattle Archdiocese Advisory Region: East King County (Faith Development) Term Expires: Region: East King County Number of Years Served: 1 Term Expires: May 2009 Number of Years Served: 1 Dr.Robert Gary Marion C. Krueger Affiliation: Seattle Public Schools,Retired Affiliation: National Association of Region: South Seattle Retired Federal Employees Term Expires: May 2009 Region: East King County Number of Years Served: 1 Term Expires: May 2007 Number of Years Served: 4 Regina Melonson Mark Flynn Affiliation: Education1526 34th Ave Affiliation: Real Estate Development and Region: Seattle(Central) Management Term Expires: May 2009 Region: South King County Number of Years Served: 1 Term Expires: May 2009) Number of Years Served: 1 Leslie Kae Hamada Michael Burke Affiliation: Kent United Methodist Church Affiliation: The Boeing Corporation Kent Ecumenical Board Region: Seattle(South) Region: South King County Term Expires: May 2009 Term Expires: May 2009 Number of Years Served: 1 Number of Years Served: 1 Carolyn Lewis-Carter Dr.Joe Drake Affiliation: Educator,Spruce Street School Affiliation: Principal,John Marshall School Region: Seattle(North) Region: South County Term Expires: May 2009 Term Expires: Number of Years Served: 1 Number of Years Served: 1 Last Updated April2007 Catholic COMMUNITY Services OF KING COUNTY King County Agency Advisory Council Board History: Current Board was assembled in May of 2006. Length of Terms: Terms will normally be 3 years with the exception of the establishment of the Council to assure rotation of terms. Frequency of Meetings: The Agency Advisory Council typically meets on a,quarterly basis. Last Updated April2007 Catholic Community Services of King County Advisory Council Meeting September 11,2007 Meeting Summary ' Council Members Present Staff Present Michael Burke Eileen Rasnack Amsale Mengistu Josephine Tamayo Murray Regina Melonson Schelia Ward Dr.Robert Gary I. Welcome&Reflection Mike Burke convened the meeting at 6:15PM with a reflection from Stephen Covey's 8th Habit. He welcomed the group. II. Issue Presentation on Volunteer Chore Services/Foster Grandparents Program—Eileen Rasnack Eileen gave history of the VCS and FG program,program statistics, and the issue of recruiting volunteers. Word of mouth is the best referral. Council members participated in suggesting recruitment strategies. VCS could encourage a business to adopt a senior housing building and have a contact person. Churches and community events could be identified for volunteer recruitment presentations, including placing an ad in the church bulletin. FG needs Council help with event planning,marketing and recruiting volunteers in South King County and seeking interpreters in Korean, Cantonese and Mandarin languages. III. Old Business Youth Ad-Hoc Committee Report The Council discussed the Ad-Hoc Youth Council Committee applications. The next step is for the Committee to reconvene to discuss and decide the feasibility of the Youth Council member concept. Schelia Ward will coordinate a Committee meeting the first couple of weeks in October. Both Mike Burke and Regina Melonson requested youth application packets. IV. Summary of Council Member Commitments Michael Burke: Advisory Council President; assist St.Monica Parish with VCS volunteer recruitment Carolyn Carter: former Advisory Council President,Youth Ad-Hoc Committee; backpack project Dr.Joe Drake: Promote MLK Day Home and YTP; Youth Ad-Hoc Committee Vern Edres: EKC Family Center Parish Staff Lunch; CCS Week St. Brendan Parish Coordinator/Speaker; Avondale Meals Mark Flynn: CCS Week St Francis of Assisi Parish Permission and Coordinator/Speaker; Post SKC Family Center Flyers &Volunteer Flyers at parish Dr.Robert Gary: Coordinate with Greg Alex of the Matt Talbot Center CCS presentation of services to African American Ministers Group,Youth Ad-Hoc Committee; CCS Week speaker Lee Gowell: EKC Family Center Parish Staff Lunch Coordinator; Recruit Volunteers for Foster Grandparent Program and Housing Services Program Leslie Hamada: Registration volunteer for South King County Golf Tournament; CCS Week Sunday speaker at South County parish; Youth Ad-Hoc Committee alternate Marion Krueger: EKC Family Center Parish Staff Lunch; Harrington House Fund Raising Luncheon Coordinator Amsale Mengistu: YTP New Holly&Rainier Vista,Bring Speaker from Mayors Office; SKC Family Center,Attend Summer Community Fairs and promote programs. Youth Ad-Hoc Committee Regina Melonson: CCS Week Speaker; Youth Ad-Hoc Committee V. Calendar of Upcoming Events Members present decided that the next Advisory Council meeting will be November 20, 6:00PM at the Randolph Carter Family&Learning Center with a presentation on the Youth Tutoring Program and volunteer recruitment strategies. CCS Week Parish Presentations: November 24-25,December 1-2,December 8-9,December 15- 16,December 22-23,December 29-30 VI.Adjourn The meeting of the Catholic Community Services King County Advisory Council was adjourned at 7:30PM. Catholic COMMUNITY services OF KING COUNTY Catholic Community Services of King County Advisory Council Meeting November 20,2007 Meeting Summary Council Members Present Staff Present Michael Burke Bob Fortner Carolyn Carter Josephine Tamayo Murray Mark Flynn Dr.Robert Gary Lee Gowell Marion Kruger Council Members Excused Regina Melonson Vern Endres Amsale Megistu Leslie Hamada I. Welcome&Reflection Mike Burke convened the meeting at 6:30 p.m. asking each person present that since we will be celebrating Thanksgiving on Thursday to offer what they were thankful for. II.Issue Presentation on Youth Tutoring Program—Bob Fortner Bob talked about history of the Youth Tutoring Program,program statistics, and the issue of recruiting volunteers. He provided statistics where YTP wants to improve in recruiting volunteers, especially with African,African American and Latino communities. Council members participated in suggesting recruitment strategies. Public employees, AARP, WEA and STA were suggested. African American fraternities and sororities should be on a recruitment list. The Breakfast Club and Tabor 100 were also recommended. The Seattle School District ESL program was recommended for recruitment contact. Tutor cross training was also suggested. Two YTP graduates give back as work study students. Council members agreed to provide Bob via Josephine the contact information for the public employees group,African American fraternities and sororities, and the School District ESL program. Bob agreed to follow- up with the contacts and send Council members invitations for YTP's Dream Big Breakfast. HI. Old Business Youth Ad-Hoc Committee Report Josephine informed the Council that Committee members were continuing to recruit Youth Council members with a December 31 deadline. The next step is for the Committee to reconvene to review the submitted applications, discuss the feasibility of Youth Council members and make a recommendation to the Council. Schelia Ward will coordinate the Committee meeting January 29. Both Carolyn Carter and Regina Melonson requested youth application packets with the Randolph Carter Family&Learning Center flyer. IV. CCS Week Activities Josephine announced the success of CCS Week parish permissions(172 out of 175) and requested Council members' assistance as a Speaker. Marion Kruger volunteered to speak at Holy Innocents in Duvall. Instead of using the meeting time,Josephine will email out to Council members the parishes, dates and times requesting their help. Catholic COMMUNITY services OF KING COUNTY V. Calendar of Upcoming Events Members present decided that the next Advisory Council meeting will be March 4, 6:00PM at the Randolph Carter Family&Learning Center with a presentation on the Legal Action Center and the issues the program faces. CCS Week Parish Presentations: November 24-25,December 1-2,December 8-9,December 15- 16,December 22-23, December 29-30. Marion Kruger announced the Harrington House Luncheon May 10 featuring Jeff Renner as Keynote Speaker. VI.Adjourn The meeting of the Catholic Community Services King County Advisory Council was adjourned at 7:45PM. Catholic COMMUNITY services OF KWG COUNTY Catholic Community Services of King County Advisory Council Meeting March 18,2008 Meeting Summary Council Members Present Staff Present Michael Burke Rick King Carolyn Carter Josephine Tamayo Murray Dr. Robert Gary Lee Gowell Marion Kruger Council Members Excused Regina Melonson Mark Flynn Amsale Mengistu Leslie Hamada I. Welcome&Reflection Mike Burke convened the meeting at 6:30 p.m. sharing thoughts and life lesson learned after a trip to Granada. Mike Burke asked each person present to introduce themselves to Rick King. II.Issue Presentation on University District Youth Center Program—Rick King Rick talked about history of the University District Youth Center Program,program statistics, and the barriers to public housing. He provided data and information regarding the United Way Wrap Around Program pilot project. Council members participated in question and answer session. Josephine shared that the one night count was 15%higher than last year and included and increase in the population that the UDYC serves. Rick agreed to follow-up with information regarding the program implementation. III. Old Business Youth Ad-Hoc Committee Report Josephine informed the Council that Committee members were continuing to recruit Youth Council members with a May 3rd deadline. The next step is for the Committee to reconvene to review the submitted applications, discuss the feasibility of Youth Council members and make a recommendation to the Council. Schelia Ward will coordinate the Committee meeting April 15th. Carolyn Carter and Regina Melonson suggested further discussion about transporting the youth to and from meetings.Lee Gowell suggested we contact the Youth Ministries at the Parishes. IV.Follow-up Council Member Commitments Lee Gowell-CCS Week success over$1 million raised.Parish Secretaries luncheon completed. Recommitted to same activities as last year Catholic COMMUNITY services OF KING COUNTY Marion Kruger—Harrington House Luncheon cancelled. Speaking engagement at Holy Innocents in Duvall a success. Volunteered to approach Father Dugan at Mary Queen of Peace. Amsale Mengistu—Recommitted to same activities as last year: Mike Burke—Speaking engagements at parishes a success. Participating in recruitment for Volunteer Chore Services. Recommitted to same activities as last year. Dr. Gary—Talking to ministers. Shifted focus to young kids.Meeting with Administration from S.C.C.C., S.V.I. & Superintendant of Public Schools-Seattle to consider expanding tutoring and include CCS as partner. Recommitted to same activities as last year. Carolyn L.C.—Recruiting for Ad-Hoc Youth Council. Looking forward to back pack event this year. Recommitted to same activities as last year. Regina M.—Recruiting for Ad-Hoc Youth Council. Recommitted to same activities as last year. V.Directors Report for Q4 2007/Q12008 Josephine discussed the agencies successful transition due to funding cuts by United Way. Members participated in Q&A regarding future plans for Elizabeth House and Harrington House. VI.Adjourn - Members present decided that the next Advisory Council meeting will be June 17, 6:00PM at the Randolph Carter Family&Learning Center with a presentation on the Legal Action Center and the issues the program faces. The meeting of the Catholic Community Services King County Advisory Council was adjourned at 7:45PM. CATHOLIC COMMUNITY SERVICES OF KING CO FISCAL 2008 BUDGET REVENUES CORPORATIONS,FOUNDATIONS, &TRUSTS 648,392 INDIVIDUAL DONORS 323,339 ASSOCIATED ORGANIZATION 657,954 UNITED WAY 917,679 GOVERNMENT FEDERAL 1,770,713 STATE 2,390,865 ------------------- -- - -------- ----- --------------------- COUNTY 569,928 CITY 694,487 PROGRAM SERVICE FEES 660,397 OTHER REVENUE 489,408 SPECIAL EVENTS _ 119,095 DISCRETIONARY BASE DEFICIT REDUCTION ALLOCATION _ IN KIND 205,350 NET ASSETS RELEASED FROM RESTRICTION 41,822 TOTAL REVENUE 9,489,429 Less : -------------- - ---- ----- In-Kind 205,350 Provider Payments(Pass through) 2,175,382_ TOTAL PASS THRU REVENUE 2,380,732 NET REVENUE 7,108,697 ----- -- ---- ------ ----------- EXPENSES 5 SALARIES 4,112,650 BENEFITS 661,960 TAXES ---------- -----__ 483,707 TOTAL SALARIES AND RELATED EXPENSES 5,258,317 PROFESSIONAL FEES 313,465 SUPPLIES 123,812 TELEPHONE 95,625 POSTAGE _ 24,076 OCCUPANCY _ 412,709 EQUIPMENT 25,150 PRINTING _ 50,479 ADVERTISING 30,501 TRAVEL 89,022 CONFERENCES AND MEETINGS 48,763 SPECIFIC ASSISANTANCE 299,334 DUES AND FEES 10,968 AWARDS AND GRANTS 15,750 MISCELLANEOUS 39,552 TAXES 3,438 INTEREST AND BANK CHARGES 50,807 IN KIND 205,350 OTHER OPERATING EXPENSES 1,838,801 DEPRECIATION 216,929 NON-OPERATING EXPENSES 216,929 TOTAL EXPENSES 7,108,697 EXCESS(DEFICIT) FROM OPERATIONS 0 WATSON & McDONELL, PLLC CERTIFIED PUBLIC ACCOUNTANTS 600 UNIVERSITY STREET,SUITE 2828 SEATTLE,WASHINGTON 98101-330.1 April 10,2008 Board of Directors Catholic Community Services of Western Washington Seattle,Washington In planning and performing our audit of the financial statements of Catholic Community Services of Western Washington as of and for the year ended December 31, 2007,in accordance with auditing standards generally accepted in the United States of America,we considered Catholic Community Services of Western Washington's internal control over financial reporting(internal control)as a basis for designing our auditing procedures for the purpose of expressing our opinion on the financial statements,but not for the purpose of expressing an opinion on the effectiveness of the Organization's internal control. Accordingly,we do not express an opinion on the effectiveness of the Organization's internal control. A control deficiency exists when the design or operation of a control does not allow management or employees,in the normal course of performing their assigned functions, to prevent or detect misstatements on a timely basis. A significant deficiency is a control deficiency,or combination of control deficiencies,that adversely affects the entity's ability to initiate,authorize,record,process, or report financial data reliably in accordance with generally accepted accounting principles such that there is more than a remote likelihood that a misstatement of the entity's financial statements that is more than inconsequential will not be prevented or detected by the entity's internal control. A material weakness is a significant deficiency,or combination of significant deficiencies,that results in more than a remote likelihood that a material misstatement of the financial statements will not be prevented or detected by the entity's internal control. Our consideration of internal control was for the limited purpose described in the first paragraph and would not necessarily identify all deficiencies in internal control that might be significant deficiencies or material weaknesses. We did not identify any deficiencies in internal control that we consider to be material weaknesses,as defined above. This communication is intended solely for the information and use of management,the board of directors, others within the organization,private and public lenders and grantors,and is not intended to be and should not be used by anyone other than these specified parties. Sincerely, 1 WATSON&McDONELL,PLLC fJI ' 1 Lillian McDonell, CPA Managing Member TELEPHONE:(206)624-2380 FACSIMILE:(206)382-3558 MEMBER AMERICAN INSTITUTE OF CERTIFIED PUBLIC ACCOUNTANTS AND WASHINGTON SOCIETY OF CERTIFIED PUBLIC ACCOUNTANTS EI CATHOLIC COMMUNITY SERVICES OF WESTERN WASHINGTON Financial Statements for the Year Ended June 30,2007 (With Comparative Totals for 2006) and Independent Auditors' Reports CATHOLIC COMMUNITY SERVICES OF WESTERN WASHINGTON Table of Contents Independent Auditors' Report 1 Financial Statements: Statements of Financial Position 3 Statements of Activities 5 Statements of Functional Expenses 7 Statements of Cash Flows 8 Notes to Financial Statements 10 Supplementary Information: Schedule of Expenditures of Federal Awards 26 Notes to Schedules of Expenditures of Federal Awards 32 Schedules of Functional Expenses By Division: Governance Office 33 King County 34 Southwest 35 Long-Term Care 36 Northwest 37 Independent Auditors' Report on Internal Control Over Financial Reporting and on Compliance and Other Matters Based on an Audit of Financial Statements Performed in Accordance With Government Auditing Standards 38 Independent Auditors' Report on Compliance With Requirements Applicable to Each Major Program and on Internal Control Over Compliance in Accordance With OMB Circular A-133 40 Schedule of Findings and Questioned Costs 42 WATSON & McDONELL, PLLC CERTIFIED PUBLIC ACCOUNTANTS 600 UNIVERSITY STREET,SUITE 2828 SEATTLE,WASHINGTON 98101-3301 INDEPENDENT AUDITORS' REPORT To the Trustees Catholic Community Services of Western Washington Seattle,Washington We have audited the accompanying statement of financial position of Catholic Community Services of Western Washington(a Washington nonprofit corporation)as of June 30,2007, and the related statements of activities,functional expenses and cash flows for the year then ended. These financial statements are the responsibility of Catholic Community Services of Western Washington's management. Our responsibility is to express an opinion on these financial statements based on our audit. The financial statements of Catholic Community Services of Western Washington as of June 30,2006,were audited by other auditors whose report dated March 20,2007,expressed an unqualified opinion on those financial statements. We conducted our audit in accordance with auditing standards generally accepted in the United States of America and the standards applicable to financial audits contained in Government Auditing Standards,issued by the Comptroller General of the United States. Those standards require that we plan and perform an audit to obtain reasonable assurance about whether the financial statements are free of material misstatement. An audit includes examining, on a test basis, evidence supporting the amounts and disclosures in the financial statements. An audit also includes assessing the accounting principles used and significant estimates made by management, as well as evaluating the overall financial statement presentation. We believe that our audit provides a reasonable basis for our opinion. In our opinion, the financial statements referred to above present fairly,in all material respects,the financial position of Catholic Community Services of Western Washington as of June 30,2007, and the changes in its net assets and its cash flows for the year then ended in conformity with accounting principles generally accepted in the United States of America. In accordance with Government Auditing Standards,we also have issued our report,dated March 31, 2008 on our consideration of Catholic Community Services of Western Washington's internal control over financial reporting and our tests of its compliance with certain provisions of laws,regulations, contracts, and grant agreements and other matters. The purpose of that report is to describe the scope of our testing of internal control over financial reporting and compliance and the results of that testing,and not to provide an opinion on the internal control over financial reporting or on compliance. That report is an integral part of an audit performed in accordance with Government Auditing Standards and should be considered in assessing the results of our audit. TELEPHONE:(206)624-2380 FACSIMILE: (206)382-3558 MEMBER AMERICAN INSTITUTE OF CERTIFIED PUBLIC ACCOUNTANTS AND WASHINGTON SOCIETY OF CERTIFIED PUBLIC ACCOUNTANTS Independent Auditors' Report, Page 2 Our audit was performed for the purpose of forming an opinion on the basic financial statements of Catholic Community Seivices of Western Washington taken as a whole. The accompanying schedule of expenditures of federal awards is presented for purposes of additional analysis as required by U. S. Office of Management and Budget Circular A-133,Audits of States,Local Governments, and Non Profit Organizations, and the schedules of functional expenses by division are presented for purposes of additional analysis,and are not a required part of the basic financial statements. Such information has been subjected to the auditing procedures applied in the audit of the basic financial statements and,in our opinion,is fairly stated,in all material respects in relation to the basic financial statements taken as a whole. Wt M`D 'ef, P1-1-c March 31,2008 2 CATHOLIC COMMUNITY SERVICES OF WESTERN WASHINGTON Statements of Financial Position June 30,2007 (With Comparative Totals for 2006) . SERVICE AND AREA DIVISIONS GOVERNANCE KING LONG-TERM TOTAL • OFFICE COUNTY SOUTHWEST CARE NORTHWEST ELIMINATIONS 2007 2006 CURRENT ASSETS Cash and cash equivalents $ 2,798,711 $ 828,406 $ 725,631 $ 190,671 $ 4,543,419 $ 2,042,890 Accounts receivable-net of allowance for doubtful accounts of$396,005 19,487 884,601 2,047,730 3,490,207 880,576 7,322,601 6,643,172 Accounts receivable-related parties 2,164,954 79,530 194,518 1,729 309,541 (2,538,584) 211,688 389,963 Notes receivable-current portion . 13,033 13,033 310,538 Prepaid expenses 61,016 29,028 24,764 11,187 36,654 162,649 421,432 Inventory-food 68,273 68,273 - 71,337 Funds held in trust 309 5,275 5,584 6,685 TOTAL CURRENT ASSETS 5,057,201 1,821,874 3,060,916 3,693,794 1,232,046 (2,538,584) 12,327,247 9,886,017 PROPERTY AND EQUIPMENT Land 2,214,500 857,072 791,349 179,523 312,794 4,355,238 4,355,238 Buildings and building improvements 159,000 6,821,251 4,690,874 315,785 2,577,361 14,564,271 12,536,124 Furniture and equipment 1,342,302 523,442 1,168,338 575,458 488,471 4,098,011 4,246,475 Leasehold improvements 654,632 654,632 687,350 Construction in progress 256,558 448,145 704,703 628,937 3,972,360 8,201,765 7,305,193 1,518,911 3,378,626 24,376,855 22,454,124 Less:accumulated depreciation 1,267,447 3,124,479 1,697,726 572,021 1,841,691 8,503,364 8,011,211 TOTAL PROPERTY AND EQUIPMENT 2,704,913 5,077,286 5,607,467 946,890 1,536,935 15,873,491 14,442,913 OTHER ASSETS Notes receivable-net of current portion 9,643,604 474,448 202,808 10,320,860 11,513,180 Lease receivable-net of allowance for doubtful accounts of$1,225,745 436,856 436,856 374,412 Cash-maintenance reserve account 112,794 112,794 112,282 Due from related party 202,912 Cash-endowment fund 142,129 14,825 156,954 133,298 Investments 90,000 100,000 25,335 215,335 115,335 TOTAL OTHER ASSETS 10,170,460 142,129 574,448 355,762 11,242,799 12,451,419 TOTAL ASSETS $ 17,932,574 $ 7,041,289 $ 9,242,831 $ 4,640,684 $ 3,124,743 $ (2,538,584) $ 39,443,537 $ 36,780,349 The accompanying notes should be read with these financial statements 3 CATHOLIC COMMUNITY SERVICES OF WESTERN WASHINGTON Statements of Financial Position,Continued June 30,2007 (With Comparative Totals for 2006) ' SERVICE AND AREA DIVISIONS GOVERNANCE KING LONG-TERM TOTAL OFFICE COUNTY SOUTHWEST CARE NORTHWEST ELIMINATIONS 2007 2006 CURRENT LIABILITIES Accounts payable $ 153,641 $ 260,202 $ 486,034 $ 114,338 $ 105,689 $ 1,119,904 $ 1,285,870 Accounts payable-related parties 10,733 87,604 178,286 937,401 2,011,537 (2,538,584) 686,977 691,244 Accrued payroll and related expenses 162,060 310,165 980,060 2,163,494 254,128 3,869,907 3,477,557 Current portion of notes and mortgages payable 55,922 24,164 45,315 120,160 245,561 292,388 Refundable deposits 611,566 611,566 584,894 Accrued liabilities 21,025 540,691 35,283 596,999 204,579 Deferred revenue 91,783 92,607 184,390 204,001 Funds held in trust 309 14,040 14,349 6,685 TOTAL CURRENT LIABILITIES 326,434 827,010 2,301,842 3,907,397 2,505,554 (2,538,584) 7,329,653 6,747,218 LONG-TERM LIABILITIES Notes and mortgages payable-net of . current portion 1,629,159 2,966,635 485,119 944,475 6,025,388 6,956,170 Accrued liabilities-long-term 83,342 83,342 124,935 . TOTAL LONG-TERM LIABILITIES 83,342 1,629,159 2,966,635 485,119 944,475 6,108,730 7,081,105 TOTAL LIABILITIES 409,776 2,456,169 5,268,477 4,392,516 3,450,029 (2,538,584) 13,438,383 13,828,323 NET ASSETS Unrestricted net assets 15,720,789 4,243,241 3,974,354 248,168 (491,794) 23,694,758 21,443,734 Temporarily restricted net assets 1,796,009 199,750 154,508 2,150,267 1,371,752 Permanently restricted net assets 6,000 142,129 12,000 160,129 136,540 TOTAL NET ASSETS 17,522,798 4,585,120 3,974,354 248,168 (325,286) 26,005,154 22,952,026 TOTAL LIABILITIES AND NET ASSETS $ 17,932,574 $ 7,041,289 $ 9,242,831 $ 4,640,684 $ 3,124,743 $ (2,538,584) $ 39,443,537 $ 36,780,349 The accompanying notes should be read with these financial statements 4 CATHOLIC COMMUNITY SERVICES OF WESTERN WASHINGTON Statements of Activities For the Year Ended June 30,2007 (With Comparative Totals for 2006) SERVICE AND AREA DIVISIONS GOVERNANCE KING LONG-TERM TOTAL OFFICE COUNTY SOUTHWEST CARE NORTHWEST ELIMINATIONS 2007 2006 CHANGES IN UNRESTRICTED NET ASSETS Revenues and gains: Contributions-received directly $ 101,979 $ 947,613 $ 820,318 $ 145,854 $ 312,857 $ 2,328,621 $ 2,488,431 Contributions-received indirectly 18,670 1,800 20,470 12,823 Contributions-United Way allocations 734,443 476,341 14,991 255,073 1,481,048 1,470,843 Contributions-United Way donor designated 391,265 52,519 443,784 470,620 Contributions-associated organizations 1,113,180 698,020 603,394 150,066 209,028 $ (1,250,026) 1,523,662 1,652,786 Contributions-in-kind-Note(10) 238,641 1,228,527 1,467,168 1,452,100 Legacies and bequests 946,539 49,573 47,683 200,000 1,243,795 115,731 Special events revenue 844,022 152,701 102,547 10,747 13,690 1,123,707 1,097,952 Special events expenses (189,224) (51,776) (9,166) (10,838) (1,803) (262,807) (272,105) Fees and grants from governmental agencies 5,204,852 18,054,680 27,586,066 6,358,465 (705,939) 56,498,124 50,905,458 Revenue: Management fees 3,443,273 (2,632,443) 810,830 1,196,595 Private program service fees 713,458 997,890 7,527,055 1,043,699 10,282,102 9,446,908 Investment income 819,712 64,127 580 884,419 839,434 Gain on sale of assets 6,750 Miscellaneous revenue 54 475,261 160,843 288,554 113,721 (164,685) 873,748 465,994 Net assets released from restrictions 178,064 93,260 28,254 _ 165,680 465,258 614,000 TOTAL UNRESTRICTED REVENUES, GAINS AND SUPPORT 7,276,269 9,647,311 22,575,638 35,712,495 8,725,309 (4,753,093) 79,183,929 71,964,320 Expenses and losses: Program services 2,137,795 8,260,110 20,164,510 34,540,155 8,078,310 (3,190,117) 69,990,763 63,819,097 Supporting services: Management and general 2,981,160 1,079,271 1,472,478 1,405,102 807,731 (1,556,834) 6,188,908 6,466,978 Fundraising 375,090 189,579 116,832 77,875 (6,142) 753,234 707,505 TOTAL EXPENSES 5,494,045 9,528,960 21,753,820 35,945,257 8,963,916 (4,753,093) 76,932,905 70,993,580 INCREASE IN UNRESTRICTED NET ASSETS BEFORE TRANSFER OF UNRESTRICTED NET ASSETS 1,782,224 118,351 821,818 (232,762) (238,607) 2,251,024 970,740 TRANSFER OF UNRESTRICTED NET ASSETS FROM GOVERNANCE TO LONG TERM CARE (57,131) 57,131 INCREASE(DECREASE)IN UNRESTRICTED NET ASSET! $ 1,725,093 $ 118,351 $ 821,818 $ (175,631) $ (238,607) $ 2,251,024 $ 970,740 The accompanying notes should be read with these financial statements 5 CATHOLIC COMMUNITY SERVICES OF WESTERN WASHINGTON Statement of Activities,Continued For the Year Ended June 30,2007 (With Comparative Totals for 2006) SERVICE AND AREA DIVISIONS GOVERNANCE KING LONG-TERM TOTAL OFFICE COUNTY SOUTHWEST CARE NORTHWEST ELIMINATIONS 2007 2006 CHANGES IN TEMPORARILY RESTRICTED NET ASSETS Contributions-received directly $ 1,077,735 $ 99,143 $ 66,895 $ 1,243,773 $ 413,938 Contributions-associated organizations 229,873 Net assets released from restrictions (178,064) (93,260) (28,254) (165,680) _ (465,258) (614,000) INCREASE(DECREASE)IN TEMPORARILY RESTRICTED NET ASSETS 899,671 5,883 (28,254) (98,785) 778;515 29,811 CHANGES IN PERMANENTLY RESTRICTED NET ASSETS Contributions-received directly 15,000 15,000 20,757 Investment income 8,589 8,589 INCREASE IN PERMANENTLY RESTRICTED NET ASSETS 23,589 23,589 20,757 INCREASE IN NET ASSETS 2,624,764 147,823 793,564 (175,631) (337,392) 3,053,128 1,021,308 NET ASSETS AT BEGINNING OF YEAR 14,898,034 4,437,297 3,180,790 423,799 12,106 22,952,026 21,930,718 NET ASSETS AT END OF YEAR $ 17,522,798 $ 4,585,120 $ 3,974,354 $ 248,168 $ (325,286) $ 26,005,154 $ 22,952,026 The accompanying notes should be read with these financial statements 6 CATHOLIC COMMUNITY SERVICES OF WESTERN WASHINGTON Schedules of Functional Expenses For the Year Ended June 30,2007 (With Comparative Totals for 2006) PROGRAM MANAGEMENT TOTAL SERVICES AND GENERAL FUNDRAISING ELIMINATIONS 2007 2006 Salaries and related payroll expenses $ 55,714,601 $ 5,152,464 $ 541,792 $ (1,786,341) $ 59,622,516 $ 54,907,597 Professional fees and contract service payments 1,268,861 1,374,003 9,495 (940,477) 1,711,882 1,133,524 Supplies 1,201,405 122,080 17,827 (920) 1,340,392 1,325,842 Telephone 613,373 76,358 3,948 (771) 692,908 671,369 Postage 123,330 30,982 11,603 (254) 165,661 176,905 Occupancy 1,811,478 295,737 42,252 (168,124) 1,981,343 1,753,258 Equipment rental and maintenance 274,945 113,265 21,721 409,931 303,283 Printing and advertisement 290,797 62,885 87,716 441,398 358,372 Travel 602,669 50,831 2,392 (2,012) 653,880 529,758 Conferences 120,346 9,410 3,627 (784) 132,599 148,265 Contributions,grants and specific assistance/foster care payments 8,445,006 (1,850,115) 6,594,891 6,645,056 Dues and fees 30,234 121,276 2,273 153,783 138,571 Taxes and insurance 65,714 124,339 1,085 191,138 161,941 Interest and bank charges 279,767 98,137 2,215 380,119 374,876 Bad debts 313,124 313,124 181,359 In-kind expenses 1,467,168 1,467,168 1,407,100 Miscellaneous 96,398 34,679 6,741 (3,295) 134,523 208,572 Total expenses before depreciation 72,719,216 7,666,446 754,687 (4,753,093) 76,387,256 70,425,648 Depreciation 461,664 79,296 4,689 - 545,649 567,932 TOTAL EXPENSES $ 73,180,880 $ 7,745,742 $ 759,376 $ (4,753,093) $ 76,932,905 $ 70,993,580 The accompanying notes should be read with these financial statements 7 CATHOLIC COMMUNITY SERVICES OF WESTERN WASHINGTON Statements of Cash Flow For the Year Ended June 30,2007 (With Comparative Totals for 2006) SERVICE AND AREA DIVISIONS GOVERNANCE KING LONG-TERM TOTAL CASH FLOWS FROM OPERATING ACTIVITIES OFFICE COUNTY SOUTHWEST CARE NORTHWEST ELIMINATIONS 2007 2006 Increase(decrease)in net assets $ 2,624,764 $ 147,823 $ 793,564 $ (175,631) $ (337,392) $ 3,053,128 $ 1,021,308 Adjustments to reconcile increase(decrease)in net assets to net cash provided by operating activities: Depreciation 31,632 223,545 172,912 13,124 104,436 545;649 567,930 Increase in accrued interest on notes receivable (417,901) (417,901) (743,584) Increase in lease receivable (47,444) (47,444) (28,673) Write off of notes receivable 2,320 Value of donated property and equipment (45,000) (Gain)loss on disposal of equipment (17,479) 1,631 (1,631) (5,380) (22,859) (6,750) (Increase)decrease in remaining current assets (216,568) 399,204 (424,176) 150,633 (97,592) (49,708) (238,207) (449,285) Increase(decrease)in current liabilities (98,124) (81,056) 82,876 285,839 343,192 49,708 582,435 941,013 Increase(decrease)in long-term accrued liabilities (41,593) (41,593) (16,703) NET CASH PROVIDED(USED)BY OPERATING ACTIVITIES 1,817,287 689,516 626,807 272,334 7,264 - 3,413,208 1,242,576 CASH FLOWS FROM INVESTING ACTIVITIES Purchases of property and equipment $ (12,128) $ (11,479) $ (1,349,075) $ (25,008) $ (1,397,690) $ (2,138,681) Additions to construction in progress (256,558) $ (299,119) (555,677) (386,941) Additions to notes receivable 280,263 Deposits to cash-endowment fund (23,589) (67) (23,656) (20,867) Deposits to cash-maintenance reserve account (512) (512) (9,497) Investment in limited partnership (100,000) (100,000) Principal payments received on notes receivable 2,095,534 104 2,095,638 17,388 Proceeds from sale of property and equipment 156,750 NET CASH PROVIDED(USED)BY INVESTING ACTIVITIES $ 1,826,848 $ (35,068) $ (1,449,075) $ (299,119) $ (25,483) $ 18,103 $ (2,101,585) The accompanying notes should be read with these financial statements 8 CATHOLIC COMMUNITY SERVICES OF WESTERN WASHINGTON Statements of Cash Flows,Continued For the Year Ended June 30,2007 (With Comparative Totals for 2006) SERVICE AND AREA DIVISIONS GOVERNANCE KING LONG-TERM TOTAL CASH FLOWS FROM FINANCING ACTIVITIES OFFICE COUNTY SOUTHWEST CARE NORTHWEST ELIMINATIONS 2007 2006 Advances on forgiveable loans $ 452,197 $ 452,197 $ 1,461,815 Principal payments on notes payable $ (1,138,806) $ (55,922) (19,198) $ (49,288) $ (119,765) (1,382,979) (219,601) Repayments of line of credit (200,000) NET CASH PROVIDED(USED)BY FINANCING ACTIVITIES (1,138,806) (55,922) 432,999 (49,288) (119,765) (930,782) 1,042,214 INCREASE IN CASH AND CASH EQUIVALENTS 2,505,329 598,526 (389,269) (76,073) (137,984) 2,500,529 183,205 CASH AND CASH EQUIVALENTS AT BEGINNING OF YEAR 293,382 229,880 1,114,900 266,744 137,984 2,042,890 1,859,685 CASH AND CASH EQUIVALENTS AT END OF YEAR $ 2,798,711 $ 828,406 $ 725,631 $ 190,671 $ - $ 4,543,419 $ 2,042,890 SUPPLEMENTAL DISCLOSURES Interest paid $ 20,226 $ 54,514 $ 83,183 $ 44,661 $ 102,530 $ 305,114 $ 318,188 Non-cash investing activity Land and building valued at$45,000 were received as a contribution during 2006 $ 45,000 The accompanying notes should be read with these financial statements 9 CATHOLIC COMMUNITY SERVICES OF WESTERN WASHINGTON Notes to Financial Statements For the Year Ended June 30,2007 NOTE 1 -PURPOSE AND ORGANIZATION OF THE AGENCY Catholic Community Services of Western Washington(CCSWW)was incorporated as a Washington nonprofit corporation during 1988. The following diagram sets forth the relationship of the various divisions of CCSWW and other organizations: MOST REVEREND ALEXANDER J.BRUNETT, ARCHBISHOP OF SEATTLE I I CATHOLIC COMMUNITY SERVICES THE CATHOLIC CHARITIES OF WESTERN WASHINGTON FOUNDATION OF ARCHDIOCESAN HOUSING AUTHORITY WESTERN WASHINGTON Service and Redmond Area Divisions Josephinum LIMITED PARTNERSHIPS Housing Elderly 308 West Champion Associates Institute* — Housing CCS/Bellingham CCSWW HI Association CCS/Bremerton Housing ' Governance CCS/Mount Vernon Housing Office Josephinum Halcyon CCS/Pacific Square Associates Foundation CCS/Renton Housing CCS Northwest Limited Continental Place Partnership Hilltop Housing (Bellingham/ AHA-Plerce ML King Family Housing Everett) County Monte Cristo Partners Association Sumner Commons CCS King County Township Family Housing (Seattle) Kincaid Traugott Terrace Housing Women's Westlake Woodland Family Housing CCS Long-Term Care System Pioneer LIMITED LIABILITY COMPANIES Court Centralia Family Housing Housing Chestnut Street Housing CCS Southwest College Way Family Housing (Tacoma) Holden Street Family Housing Sunrise Kelso Family Housing Court Westlake II Housing Housing Woodland II Family Housing Tahoma Center Pierce County Devoe Housing Wintonia Association Affordable Housing LLC Community (Nonprofit) Associa(Nonprofit)* Housing _ 1431 Minor Limited Partnership (Nonprofit) — Association* ' Unrelated but affiliated 10 CATHOLIC COMMUNITY SERVICES OF WESTERN WASHINGTON Notes to Financial Statements For the Year Ended June 30,2007 NOTE 1 -PURPOSE AND ORGANIZATION OF THE AGENCY, CONTINUED Catholic Community Services of Western Washington(CCSWW),The Catholic Charities Foundation of Western Washington(CCF)and Archdiocesan Housing Authority(AHA)are related organizations,as the Archbishop of Seattle is the only member of the separately incorporated entities. As the only member, the Archbishop of Seattle has the power to appoint or remove any member of the Boards of Trustees, In addition,certain transactions require the approval of the Archbishop of Seattle. The purpose of CCSWW is to minister to the needs of individuals,families, and groups in western Washington who are poor,troubled or otherwise in need,with a broad range of interrelated services. Through CCSWW,the Roman Catholic Church seeks to demonstrate its caring and compassion by serving those in need. Such needs are met by professionals,trained volunteers, and lay helpers working in partnership to provide direct social services, advocacy in behalf of individuals, and empowerment of local community groups. To accomplish this objective, special purpose programs have been designed to meet the physical,emotional, and spiritual needs of the community. Service and Area Divisions operate social service programs at a number of locations under various names. NOTE 2-SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES The financial statements include the activity of the Governance Office and the following Service and Area Divisions of CCSWW: Catholic Community Services King County(King County), Catholic Community Services Southwest(Southwest), the Long-Term Care System(Long-Term Care)and Catholic Community Services Northwest(Northwest). All material interdivision transactions have been eliminated. Estimates and assumptions The preparation of financial statements in conformity with accounting principles generally accepted in the United States of America requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the financial statements and the reported amounts of revenues and expenses during the reporting period. Actual results could differ from those estimates. Cash and cash equivalents Cash and cash equivalents includes cash in banks,money market accounts,and investments that are traded on a daily basis in certain mutual funds that invest in various securities. 11 CATHOLIC COMMUNITY SERVICES OF WESTERN WASHINGTON Notes to Financial Statements For the Year Ended June 30,2007 NOTE 2-SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES, CONTINUED Accounts Receivable Accounts receivable consists primarily of fees to be collected from third party payors and private- pay payers under various sliding fee schedules. Accounts receivable from third-party payers are adjusted to the amount expected to be collected from the third-party payer. The allowance for doubtful accounts is calculated based on collection experience of prior periods. Pledges Receivable Pledges receivable are reported net of estimated uncollectible pledges. Pledges from corporations, family trusts, and certain individuals are considered to be totally collectible. Other pledges are considered to be offset by an uncollectible amount equal to the amount of these pledges. Property and Equipment. Land,building and equipment is recorded at cost for items purchased and at estimated fair market value for items donated. The cost of land with existing buildings is allocated between land and buildings based on the relative assessed values for real estate tax purposes. In accordance with the capitalization policy, acquisitions of individual items costing$1,500 or less are expensed in the year of acquisition. Depreciation is calculated on the straight-line basis over the following estimated useful lives: Buildings 30-40 years Building improvements 5 -30 years Furniture and equipment 3 - 10 years Leasehold improvements 3 - 10 years Because of CCSWW's relationship with the Corporation of the Catholic Archbishop of Seattle (CCAS), it is CCSWW's policy to capitalize and depreciate any building or additions to buildings acquired at CCSWW's expense but owned by CCAS. Cash- endowment fund CCSWW has received donations that are permanently restricted. Some of those funds are maintained in separate accounts. Investments Investments in equity securities with a readily determinable fair value are reported at their fair value and changes in the unrealized gain or loss are recognized in the current period. 12 CATHOLIC COMMUNITY SERVICES OF WESTERN WASHINGTON Notes to Financial Statements For the Year Ended June 30,2007 NOTE 2-SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES, CONTINUED Deferred Revenue Amounts received in advance for services to be provided in the future are recorded as deferred revenue.Amounts deferred are recognized as earned revenue as services are provided. Public support CCSWW receives contributions from associated organizations,local parish units and the general public as well as indirectly through United Way annual allocations. These revenues are recognized when received. All contributions are considered available for unrestricted use unless specifically restricted by the donor. Donor restricted contributions CCSWW receives contributions from associated organizations,local parish units, and the general public. Contributions received are recorded by division as unrestricted, temporarily restricted, or permanently restricted net assets, depending on the existence and/or nature of any donor restriction. Contributions are considered available for unrestricted use unless specifically restricted by the donor. When a donor's restriction expires, that is,when a stipulated time restriction ends or purpose restriction is accomplished on a first-in,first-out basis, temporarily restricted net assets are reclassified to unrestricted net assets and reported in the statement of activities as net assets released from restrictions. Contributions subject to donor-imposed restrictions that are met in the same year as the year the contribution is received are reported as an increase in unrestricted net assets. Contributions having or implying a time restriction for acquisition of long-lived assets are recognized as released from restrictions and reclassified to unrestricted net assets at the time the long-lived asset is acquired. Contributions-associated organizations Contributions-associated organizations include funds received from the CCAS and its local parish units, as well as CCF. Donated services,materials and facilities Assets donated that have a significant value are recorded at fair market value as determined by an independent third party at the time of donation. Donated facilities are recognized at their fair market rental. Donated materials and services have not been recognized in the accompanying financial statements since no objective basis is available to measure the value of such materials and services. However, a substantial number of volunteers have donated significant amounts of their time to CCSWW's programs. Cost reimbursement grants Revenues under cost-reimbursement type contracts are recognized at the time the related costs are recognized. 13 CATHOLIC COMMUNITY SERVICES OF WESTERN WASHINGTON Notes to Financial Statements For the Year Ended June 30,2007 NOTE 2-SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES, CONTINUED Allocation of expenses Certain costs are allocated on various bases depending on the nature of the expense. Reclassifications Certain prior year amounts have been reclassified for consistency with current year presentation. Prior-year summarized information The financial statements include certain prior-year summarized comparative information. Such information does not include sufficient detail to constitute a presentation in conformity with generally accepted accounting principles. Accordingly,such information should be read in conjunction with the organization's financial statements for the year ended June 30,2006,from which the summarized information was derived. NOTE 3 -FEDERAL INCOME TAX CCSWW is exempt from federal income taxes as a division of an organization described in Section 501(c)(3)of the Internal Revenue Code. The exemption under Section 501(c)(3)is granted according to the United States Catholic Conference group ruling by the Internal Revenue Service. CCSWW is included under the ruling by virtue of its listing in the Official Catholic Directory by the Archdiocese of Seattle. CCSWW is not a private foundation as defined in Internal Revenue Code Section 509(a). NO i'L 4-RELATED PARTY TRANSACTIONS Corporation of the Catholic Archbishop of Seattle CCSWW received$673,550 from CCAS during 2007 and is included in contributions-associated organizations. CCSWW also administered CCAS' self-insurance plan for workers compensation. A fee of$252,000 was received from CCAS for those administrative services during 2007. In addition, CCSWW had transactions with CCAS that are described in Notes 7 and 13. Catholic Charities Foundation CCSWW received$445,000 from CCF during 2007 and is included in contributions-associated organizations. The operations of CCF are managed by CCSWW. CCF paid CCSWW$63,641 in management fees. 14 CATHOLIC COMMUNITY SERVICES OF WESTERN WASHINGTON Notes to Financial Statements For the Year Ended June 30,2007 NOTE 4-RELA LED PARTY TRANSACTIONS,CONTINUED Archdiocesan Housing Authority CCSWW made grants and allocations to AHA of$236,018 during 2007. AHA owes Northwest$202,808. The amount is receivable upon demand. Management does not expect to collect this amount within one year. CCSWW received reimbursement from AHA of the following costs during 2007: $198,102 for the CCSWW unemployment insurance program and$300,423 for shared personnel. King County receives the use of facilities free of charge from associated organizations and other organizations for various programs. Total estimated value of donated space from CCAS and AHA for 2007 was$38,400,and is included in contributions—in-kind. King County has sublet space to AHA. Rent income from this lease for 2007 is$94,176, and is included in miscellaneous revenue. King County charges AHA for certain overhead costs. Reimbursement of these costs for 2007 is$110,258,and is included in miscellaneous revenue. Tahoma Center Association Southwest manages the Tahoma Center property at no cost to Tahoma Center Association(TCA). Office space is leased by Southwest from TCA at a cost of$169,489 for 2007. Long-Term Care also uses space at Tahoma Center under an oral agreement at a cost of$27,342.TCA owes Southwest$447,448 on a note receivable that is described in Note 8. Pierce County Affordable Housing Association Southwest provides services to Pierce County Affordable Housing Association(PCAHA)and its residents. Southwest billed service fees during 2007 of$31,623. Southwest made a contribution of $8,397 to the PCAHA. The following amounts are due from or to entities that are related parties, as described in Note 1 at June 30,2007: Amounts due from related entities Archdiocesan Housing Authority $ 121,377 Others 2,164 Devoe Housing LLC 72,479 Pierce County Affordable Housing Association 15,668 TOTAL $ 211,688 15 CATHOLIC COMMUNITY SERVICES OF WESTERN WASHINGTON Notes to Financial Statements For the Year Ended June 30,2007 NOTE 4 -RELATED PARTY TRANSACTIONS, CONTINUED Amounts due to related entities Corporation of the Catholic Archbishop of Seattle $ 670,814 AHA 15,070 Others 1,093 TOTAL $ 686,977 NOTE 5 -FUNDS HELD IN TRUST Funds held in trust by CCSWW consist primarily of client deposits held until the funds can be disbursed as required. NOTE 6 -RESTRICTIONS ON USE OF LAND AND BUILDINGS Funding for the purchase of some land and buildings was provided under grants and contracts that restrict the future use or sale of the assets. The following schedule summarizes the restrictions currently in effect: RESTRICTION LOCATION CONTRACTOR/GRANTOR RESTRICTION EXPIRES South Regional HUD Community Development Change in use requires July 1,2016 Office Block Grant("CDBG")passed notice through King County Katherine House Department of Community, Residential units must be December 2051 Trade and Economic rented to tenants with Development,State of household incomes at or Washington below 30%of the local area median income Katherine House Department of Housing and Six units must be used June 2036 Community Development, by tenants whose King County income is at or below 30% of median income in King County 16 CATHOLIC COMMUNITY SERVICES OF WESTERN WASHINGTON Notes to Financial Statements For the Year Ended June 30,2007 NOTE 6-RESTRICTIONS ON USE OF LAND AND BUILDINGS, CONTINUED RESTRICTION LOCATION CONTRACTOR/GRANTOR RESTRICTION EXPIRES Benedict House Department of Community, Residential units must be December 2045 Trade and Economic rented to tenants with Development, State of household income at or Washington below 30%of the local area median income Sale, transfer or changes in use of the facilities at the above locations may result in repayment of some or all of the restricted funding or reversion of the property to the funding source,depending on the contract. NOTE 7 -NOTES AND MORTGAGES PAYABLE Notes and mortgages payable at June 30,2007, are summarized as follows: t,.. Installment notes payable $ 2,289,012 Notes payable to or on behalf of CCAS 1,392,722 Forgivable notes and loans 2,589,215 TOTAL NOTES AND MORTGAGES PAYABLE 6,270,949 Less current portion 245,561 LONG-TERM LIABILITY $ 6,025,388 Line of credit CCSWW has a$1,500,000 line-of-credit agreement with a bank. The credit line is available until the loan is paid in full or the parties agree in writing to terminate the agreement. The interest rate, which varies with the bank's prime rate,was 8.25 percent at June 30,2007. The line-of-credit is shared by all divisions of CCSWW. Receivables and bank accounts are pledged as collateral. The agreement requires financial reporting,the maintenance of current assets in excess of current liabilities of at least$2,000,000, and at least$14,000,000 of net assets. There was no outstanding balance at June 30,2007. 1 ` 17 CATHOLIC COMMUNITY SERVICES OF WESTERN WASHINGTON Notes to Financial Statements For the Year Ended June 30,2007 NOTE 7 -NOTES AND MORTGAGES PAYABLE, CONTINUED Installment notes payable Installment notes payable are collateralized by deeds of trust on the listed properties. INTEREST RATE AT MATURITY BALANCE PROPERTY JUNE 30,2007 MONTHLY PAYMENT DATE JUNE 30,2007 Randolph Carter Center and Kent Family Center 6.74 % $4,660 plus interest 12/01/2011 $ 810,866 Everett office 4.96 % $1,163 plus interest 12/01/2011 202,347 Oak View Place, Vancouver,Washington 7.26 % $9,660 including interest 8/01/2011 1,275,799 $ 2,289,012 The Randolph Carter Center and Kent Family Center, and the Everett office loans require variable monthly payments that include a fixed principal amount plus interest. Interest rates are adjusted every 12 months. Notes payable to or on behalf of CCAS Notes payable to or on behalf of CCAS at June 30,2007,were as follows: INTEREST RATE AT MATURITY BALANCE PROPERTY JUNE 30,2007 MONTHLY PAYMENT DATE JUNE 30,2007 Northwest Martin Center and School buildings 7 % 13,600 2/01/2015 $ 862,288 Lakewood Property, Lakewood,Washington 6.75 % 6,645 10/31/2020 530,434 $ 1,392,722 CCAS holds title to the Northwest Martin Center and School buildings. CCAS requires a maintenance reserve account for Martin Center. CCAS allows withdrawals for properly documented maintenance costs. The balance of the maintenance reserve account at June 30,2007, was$112,794., 18 CATHOLIC COMMUNITY SERVICES OF WESTERN WASHINGTON Notes to Financial Statements For the Year Ended June 30,2007 NOTE 7 -NOTES AND MORTGAGES PAYABLE, CONTINUED Forgivable notes and loans Forgivable notes and loans payable at June 30,2007,were as follows: INTEREST RATE AT MATURITY BALANCE PROPERTY JUNE 30,2007 MONTHLY PAYMENT DATE JUNE 30,2007 State of Washington Zero None-forgiven at maturity 12/31/2051 $ 285,000 King County Zero None-forgiven at maturity 6/01/2036 334,215 The City of Seattle Zero None-forgiven at maturity 11/30/2018 255,000 State of Washington Zero None -forgiven at maturity 12/31/2045 835,000 State of Washington Zero None -forgiven at maturity 12/31/2046 530,000 City of Olympia Zero None—forgiven at maturity 7/31/2009 350,000 $ 2,589,215 The State of Washington provided$285,000 to finance the construction of a seven-bed transitional housing facility to be operated by King County. The loan dated January 1,2001,will be forgiven on the maturity date if all conditions of the agreement are complied with for the 50-year period. The Department of Housing and Community Development,King County,Washington loaned King County$334,215 for the construction of a seven-bed transitional housing facility. The loan dated October 27,2000,will be forgiven on the maturity date if all conditions of the loans are complied with for the 35-year period. A note payable fox up to $255,000 to The City of Seattle was signed November 30,2003, that bears interest at zero percent,unless contingent interest becomes due. The note,which matures November 30,2018,will be forgiven if the terms and conditions of the loan agreement have been met continuously as defined in the loan documents. The funds were provided for the acquisition and improvement of the ML King Day Home Center property. The State of Washington,Department of Community Trade and Economic Development provided $835,000 for the construction of Benedict House. The loan dated February 16,2005,will be forgiven on the maturity date if all conditions of the loan are complied with for the 40-year period. 19 CATHOLIC COMMUNITY SERVICES OF WESTERN WASHINGTON Notes to Financial Statements For the Year Ended June 30,2007 NOTE 7-NOTES AND MORTGAGES PAYABLE, CONTINUED The State of Washington,Department of Community,Trade and Economic Development provided $530,000 for the construction of the Drexel/Devoe Housing project. The loan,dated April 20, 2006,will be forgiven at maturity if all the conditions of the agreement are complied with for the 40-year period. The City of Olympia provided$350,000 for the construction of the Drexel/Devoe Housing project. The loan, dated July 30,2004,will be forgiven at maturity if all the conditions of the agreement are complied with for the 5-year period. Summary of Notes Payable Debt agreements require the following principal payments for each of the next five years and thereafter: NOTES FORGIVABLE PAYABLE NOTES TOTAL 2008 $ 245,561 $ 245,561 2009 263,722 $ 350,000 613,722 2010 277,898 277,898 2011 293,050 293,050 2012 309,246 309,246 Thereafter 2,292,257 2,239,215 4,531,472 TOTAL $ 3,681,734 $ 2,589,215 $ 6,270,949 Interest expense was$305,114 for 2007. NOTE 8 -NOTES AND LEASE RECEIVABLE Notes and lease receivable at June 30,2007, are summarized as follows: Notes receivable Tahoma Center Association $ 474,448 Archdiocesan Housing Authority 202,808 DUE FROM RELATED PARTIES 677,256 CCS/Bremerton Housing Limited Partnership 33,272 308 West Champion Associates Limited Partnership 54,265 Various limited partnerships 2,041,750 Josephinum Associates Limited Partnership 7,527,350 TOTAL 10,333,893 Less -current portion 13,033 TOTAL $ 10,320,860 20 CATHOLIC COMMUNITY SERVICES OF WESTERN WASHINGTON Notes to Financial Statements For the Year Ended June 30,2007 NOTE 8 -NO t'ES AND LEASE RECEIVABLE,CONTINUED CCSWW is the holder of a note receivable for$2,361,398, dated December 29, 1989 from the Josephinum Associates Limited Partnership. The note bears interest at 8.09 percent and annual payments are made from the partnership's surplus cash, as defined in the note. If surplus cash is less than the payment amount due under the note for any year,the difference shall accrue with the interest and shall be paid when surplus cash becomes available, except that interest is due 10 years after it was accrued and all unpaid interest and principal is due by November 30, 2008. Accrued interest receivable is $5,165,953. Payments of$282,064 of accrued interest were made in 2007. The note is collateralized by a fifth deed of trust on the building and ground lease. Tahoma Center Association owes Southwest$474,448 on a note receivable,revised January 27, 2006. Monthly payments are interest only at seven percent,with monthly payments of$3,511, including interest beginning October 2008. The note matures December 31,2019. Interest income for 2007 was$33,211. CCS/Bremerton Housing Limited Partnership owes CCSWW$33,271 on a note receivable dated October 1, 1996. Monthly payments under the note are$716,including interest at eight percent with the final payment due October 1,2011. 308 West Champion Associates Limited Partnership owes CCSWW$54,265 on a note dated September 1,2000 and amended June 15,2001. Monthly payments are$843, including interest at 6.33 percen,with the final payment due August 1,2013. The following notes receivable are also due to CCSWW from limited partnerships: DATE OF MATURITY INTEREST ORIGINAL BALANCE DUE JUNE 30,2007 NOTE DATE RATE AMOUNT PRINCIPAL INTEREST TOTAL 3/10/1998 3/31/2018 6 % $ 206,924 $ 180,686 $ 63,903 $ 244,589 7/7/1998 4/30/2023 6 % 164,169 171,143 75,035 246,178 10/15/1998 4/30/2019 6 % 296,643 296,643 195,696 492,339 9/1/1998 4/30/2040 6 % 300,000 218,495 99,228 317,723 4/2/1998 4/30/2023 6 % 440,849 440,849 245,799 686,648 8/20/2004 8/30/2034 5 % 51,000 51,000 3,273 54,273 $1,358,816 $ 682,934 $2,041,750 The notes receivable are collateralized by subordinated deeds of trust. Annual payments of principal and interest are due in an amount equal to available net cash flow calculated at the end of each calendar year. Payments on interest of$552 were received during 2007. 21 CATHOLIC COMMUNITY SERVICES OF WESTERN WASHINGTON Notes to Financial Statements For the Year Ended June 30,2007 NO l'h 8-NOTES AND LEASE RECEIVABLE, CONTINUED Western Washington leases the land on which the Josephinum Apartments are located to The Josephinum Associates Limited Partnership under a 40-year ground lease effective December 29, 1989. The lease has a 10-year renewal option. The annual rent is$15,000 through 2016 and $250,000 thereafter. Rent is payable to the extent of 10 percent of the Partnership's surplus cash on December 31 of each year. Unpaid rents accrue interest at 8.09 percent. Accrued rents are due in full not later than the 10th anniversary of the date it was accrued. The lease provides that at the termination of the lease, the title to the improvements on the land will transfer to Western Washington. In accordance with Financial Accounting Standard No. 13,Accounting,for Leases, CCS has recorded the lease on a straight-line basis. The deferred lease receivable at June 30,2007 was$1,662,601 including accrued interest of$174,274. An allowance for uncollectible amounts of $1,225,745 was recorded in 2007,leaving rent and interest receivable of$436,856 at June 30,2007. A lease payment of$15,000 was received in 2006. Payments to be received, as required by the lease,excluding escalations and accrued interest on amounts due, are due each February 1,as follows: 1993-2016 (annual payments of$15,000) $ 315,000 2017 250,000 f 2018-2029 (annual payments of$250,000) 3,000,000 2030 247,945 TOTAL, $ 3,812,945 NOTE 9-INVESTMENTS Southwest invested$100,000 in Devoe Housing,LLC,which owns a 26-unit housing project to provide affordable housing to individuals in Olympia. Northwest entered into an agreement with other social service providers to form a Washington limited liability company,Associated Provider Network,LLC(APN),for the purpose of contracting with managed care organizations to provide comprehensive behavioral healthcare services in and around the five-county North Sound region of the State of Washington. All items of income,gain,loss and deduction are to be allocated among members in their respective capital account percentage as defined by the agreement. Northwest's capital account percentage is 16.5 percent. Northwest, as a member of the company,has entered into a provider agreement with APN. Northwest is not required to make any additional capital contributions. Initial investment $ 64,569 Losses recognized through June 30,2007 (39,234) TOTAL $ 25,335 22 CATHOLIC COMMUNITY SERVICES OF WESTERN WASHINGTON Notes to Financial Statements For the Year Ended June 30,2007 NOTE 9 -INVESTMENTS,CONTINUED Western Washington invested$90,000 in the Josephinum Housing Institute(JHI)to enable JHI to meet its financial obligations as the general partner in The Josephinum Associates Limited Partnership. The market value of the investment is not determinable. NOTE 10-CONTRIBUTIONS -IN-KIND CCSWW receives the use of facilities free of charge from associated organizations and other organizations for various programs. Total estimated value of donated space included in in-kind contributions was$80,028 for 2007. CCSWW operates three feeding programs-Hospitality Kitchen in Tacoma,Feed the Hungry in Aberdeen and Community Kitchen in Olympia. The value of food received as in-kind donations for these programs is estimated at$1,228,527. In-kind services valued at$158,613 were recognized in connection with the Foster Grandparent program. NOTE 11 -PENSION PLAN CCSWW adopted a money purchase pension plan effective July 1, 1991. All divisions participate. All employees,except hourly home care and care aide employees and highly compensated employees,who have completed one year of service and 1,000 hours are eligible. Contributions to the plan are six percent of the employee's compensation. Pension expense for the year was $1,020,244. Transactions of the retirement plan are not included in the financial statements. Contributions are made directly to a bank that maintains the retirement plan's invested funds. NO lb 12- LEASED AND RENTED FACILITIES AND EQUIPMENT Some buildings and equipment used by CCSWW for its offices and community services programs are leased under operating leases. Under some of the operating leases,CCSWW pays a portion of property taxes,insurance,maintenance, and expenses related to the leased property. Total rent expense for leased facilities and equipment and those rented on a month-to-month basis was $1,137,835. 23 CATHOLIC COMMUNITY SERVICES OF WESTERN WASHINGTON Notes to Financial Statements For the Year Ended June 30,2007 NOTE 12- LEASED AND RENTED FACILITIES AND EQUIPMENT, CONTINUED Minimum future obligations on noncancellable operating leases in effect at June 30,2007, are: 2008 $ 648,257 2009 258,151 2010 174,294 2011 126,524 2012 47,257 Thereafter 26,076 TOTAL $ 1,280,559 NOTE. 13 - INSURANCE Insurance is provided by a program for protected self-insurance by CCAS. Premiums are remitted to the Archdiocese of Seattle to pay for the losses incurred,to purchase the necessary administrative services and to provide insurance to limit the self-insured outlay. The protected self-insurance program covers all buildings,contents,general and automobile liability, directors and officers, money,securities and employee fidelity. Insurance premiums paid were$173,867 for 2007. 2 CCSWW also participates in an Archdiocesan self-insurance program for workers compensation. Premiums are remitted to CCAS and are used to pay the claims for industrial accidents and for the cost of administering the program. Premiums for workers compensation are computed at a rate established by job classification times the number of hours worked with a discount available for prompt payment. Insurance premiums expensed were$2,675,977 for 2007. NOTE 14-CONCENTRATIONS Credit risk Assets for which CCSWW has a risk of loss consist of amounts on deposit with financial institutions in excess of amounts insured by Federal Deposit Insurance Corporation, and those not secured by any other collateral. CCSWW's management does not anticipate any material adverse effect on its financial position from these credit risks. Collective bargaining agreements Sixty-three percent of the employees are covered under the following collective bargaining agreements: The Long-Tenn Care System's home care workers,expiring June 30,2009 King County's hourly paid employees at child care facilities,expiring August 30,2008 Nonmanagement employees at Northwest, expiring June 30,2009 24 CATHOLIC COMMUNITY SERVICES OF WESTERN WASHINGTON Notes to Financial Statements For the Year Ended June 30,2007 NOTE 15 - CONTINGENCIES AND COMMITMENTS CCSWW receives funds under numerous contracts,grants and agreements with federal, state and local governmental agencies. CCSWW may be subject to repayment of funds received under contracts, grants and agreements with governmental agencies that provide for payments to CCSWW based on cost or statistical data. Most contracts,grants and agreements are subject to audit by the funding sources. CCSWW and Josephinum Housing Institute(JHI)are mutually liable to the limited partner of the Partnership under an indemnification agreement dated June 18, 1991,for such portion of the deficiency amount, as defined in the agreement, attributable to negligence,acts or failure to act or misrepresentation of JHI, CCSWW or AHA with respect to losses or related to the low income housing credits or the historic tax credits. The amount of the possible future liability cannot be reasonably estimated. The agreement remains in effect until the earlier of the date of the Partnership's sale of the project or the end of the compliance period under Section 42 of the Internal Revenue Service Code. No payments have been required under the agreement through June 30, 2007. CCSWW has agreed to advance funds to Devoe Housing LLC when the operations of Devoe ,, Housing LLC result in an operating deficit, as defined in the agreement. CCSWW's obligation under the agreement is unlimited. Repayment of the operating deficit loans are without interest and as provided in the agreement. No payments have been required under the agreement through June 30,2007. CCSWW has signed agreements with vendors regarding projects in development. These contracts are expected to be paid within the next year. CCSWW has signed a purchase and sale agreement in the amount of$600,000 for property in Tacoma,Washington for the purpose of development. As of the date of this report, title to this property has not been acquired. CCSWW has signed a purchase and sale agreement in the amount of$2,500,000 for property in Tacoma, Washington for the purpose of development. As of the date of this report, title to this property has not been acquired. NO'1'h 16 -SUBSEQUENT EVENTS CCSWW purchased land and building for development of a project in September 2007 in the amount of$850,000. CCSWW also obtained a loan from CCF in the amount of$300,000 for this purchase and the remaining$550,000 was paid from CCSWW funds. 25 CATHOLIC COMMUNITY SERVICES OF WESTERN WASHINGTON Schedule of Expenditures of Federal Awards For the Year Ended June 30,2007 PASS-THROUGH FEDERAL ENTITY FEDERAL GRANTOR/PASS-THROUGH GRANTOR/ CFDA IDENTIFYING FEDERAL PROGRAM OR CLUSTER TITLE NUMBER NUMBER EXPENDITURES U. S.DEPARTMENT OF AGRICULTURE Child and Adult Care Food Program: Passed through State of Washington, Office of Superintendent of Public Instruction Child Adult Care Food Program (Caring Place) 10.558 06-27-01-0498 $ 10,594 Child Adult Care Food Program (Kid's Place) 10.558 06-27-01-0498 777 Child Adult Care Food Program (St.Mike's Tikes) 10.558 06-27-01-0498 18,322 Child Adult Care Food Program (St. Olaf s) 10.558 06-27-01-0498 7,526 Martin Luther King Daycare and Our Place Daycare 10.558 02-17-240 12,606 TOTAL CHILD AND ADULT CARE FOOD PROGRAM $ 49,825 TOTAL U.S.DEPARTMENT OF AGRICULTURE $ 49,825 U. S.DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT Community Development Block Grants/Entitlement Grants: Passed through City of Auburn,Department of Planning and Community Development Emergency Assistance 14.218 BG0603 $ 5,895 Passed through City of Bremerton CDBG City of Bremerton 14.218 63416 77,056 CDBG City of Bremerton 14.218 63604 5,978 CDBG City of Bremerton 14.218 63704 4,125 Passed through City of Everett CDBG 006 Program Year 14.218 None 5,000 Passed through City of Seattle Eviction Prevention Program-CDBG 14.218 DA06-1138 50,158 Eviction Prevention Program-CDBG 14.218 DA07-1138 53,630 MLK Dayhome Center-Note D 14.218 DL03-7674 255,000 University District Youth Center 14.218 DA2006-1002 31,289 Passed through City of Tacoma PHN- CDBG 14.218 None 35,000 26 CATHOLIC COMMUNITY SERVICES OF WESTERN WASHINGTON Schedule of Expenditures of Federal Awards For the Year Ended June 30, 2007 PASS-THROUGH FEDERAL ENTITY FEDERAL GRANTOR/PASS-THROUGH GRANTOR/ CFDA IDENTIFYING FEDERAL PROGRAM OR CLUSTER TITLE NUMBER NUMBER EXPENDITURES U. S.DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT-CONTINUED Community Development Block Grants/Entitlement Grants- Continued: Passed through King County Emergency Assistance—Burien Clients 14.218 D35904D $ 5,600 Katherine House: Transitional Housing-Note D 14.218 D26556D&F 106,435 Emergency Assistance—South 14.218 D37182D 6,002 HOME 14.218 D37184D 7,186 HOME Emergency Shelter 14.218 D37184D 10,897 Passed through Kitsap County Kitsap CDBG 14.218 KC-194-06 6,323 Kitsap CDBG 14.218 KC-210-07 10,018 Passed through Pierce County-Department of Community Service CDBG/ESGP 14.218 52464 5,975 Suited for Success 14.218 15,000 Passed through Snohomish County Human Services Volunteer Chore Services CDBG 14.218 CDBG-S 2005#3 3,696 `y: •Volunteer Chore Services CDBG 14.218 CDBG-S 2006#01 17,493 Passed through Solid Ground of Washington k'... KC Housing Stability Project CDBG 14.218 None 5,523 KC Housing Stability Project CDBG 14.218 None 7,350 KC Housing Stability Project CDBG 14.218 None 18,572 KC Housing Stability Project CDBG 14.218 None 24,816 TOTAL COMMUNITY DEVELOPMENT BLOCK GRANTS/ENTITLEMENT GRANTS $ 774,017 Community Development Block Grants/State's Program Passed through Thurston County Thurston County CDBG—Drexel House 14.228 $ 433,280 TOTAL COMMUNITY DEVELOPMENT BLOCK GRANTS/STATE'S PROGRAM $ 433,280 Emergency Shelter Grants Program: Passed through City of Tacoma PHN-Emergency Shelter Grant 14.231 None $ 18,000 Passed through King County Planning and Community Development Division HOME-ESG 14.231 D35860D 11,360 Legal Action Center-ESG 14.231 D35861D 6,334 Legal Action Center-ESG 14.231 D37185D 7,500 Passed through Kitsap Community Resources ESG 14.231 07-46106-18 1,353 27 CATHOLIC COMMUNITY SERVICES OF WESTERN WASHINGTON Schedule of Expenditures of Federal Awards For the Year Ended June 30, 2007 PASS-THROUGH FEDERAL ENTITY FEDERAL GRANTOR/PASS-THROUGH GRANTOR/ CFDA IDENTIFYING FEDERAL PROGRAM OR CLUSTER TITLE NUMBER NUMBER EXPENDITURES U. S.DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT-CONTINUED Emergency Shelter Grants Program,Continued: Passed through Pierce County Department of Community Services CDBG/ESGP 14.231 52464 $ 12,536 Passed through State of Washington Department of Social and Health Services CTED ESG 14.231 06-46106-12 12,000 CTED ESG 14.231 07-46106-41 1,802 TOTAL EMERGENCY SHELTER GRANTS PROGRAM $ 70,885 Supportive Housing Program: Direct Funding Transitional Housing/Elizabeth House 14.235 WAO1B40005119 $ 20,672 Transitional Housing/Elizabeth House 14.235 WA01B600058 122,807 SHP McKinney-Drexel Capital 14.235 None 182,076 SHP McKinney-Drexel Operating&Maintenance 14.235 None 10,600 TOTAL DIRECT FUNDING $ 336,155 i Passed through Child Care Resources OPDC Child Care 14.235 None $ 416 Passed through City of Seattle Pro Youth 14.235 DA2004-7155 33,222 Pro Youth 14.235 DA2005-7155 32,491 Passed through Pierce County-Department of Community Services PHN Transitional Housing-TCC 14.235 WA01B403004 71,640 Transitional Housing 14.235 WA01B303006(WA60115) 37,253 Transitional Housing 14.235 WA01B603007(WA60115) 14,134 Passed through Snohomish County Human Services HUD Supportive Housing 14.235 HCD-60-50-0502-007 31,429 Meadowdale 14.235 HCD-06-50-0401-007 13,625 SHP—Autumn Leaf 14.235 WAO1B30-4013 (1) 22,447 SHP—Autumn Leaf 14.235 WAO1B30-4013 (2) 39,117 TOTAL INDIRECT FUNDING 295,774 TOTAL SUPPORTIVE HOUSING PROGRAM $ 631,929 HOME Investment Partnership Program: Passed through State of Washington,Department of Community,Trade and Economic Development Drexel House-Note D 14.239 $ 530,000 TOTAL HOME INVESTMENT PARTNERSHIP PROGRAM $ 530,000 28 CATHOLIC COMMUNITY SERVICES OF WES 1'hRN WASHINGTON Schedule of Expenditures of Federal Awards For the Year Ended June 30, 2007 PASS-THROUGII FEDERAL ENTITY FEDERAL GRANTOR/PASS-THROUGH GRANTOR/ CFDA IDENTIFYING FEDERAL PROGRAM OR CLUSTER TITLE NUMBER NUMBER EXPENDITURES U. S.DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT-CONTINUED Housing Opportunities for Persons with AIDS: Passed through City of Seattle HUD/Seattle/Housing Opport.For People w/AIDS 14.241 DA06-1056 $ 66,104 HUD/Seattle/Housing Opport.For People w/AIDS 14.241 DA07-1056 54,633 TOTAL HOUSING OPPORTUNITIES FOR PERSONS WITH AIDS $ 120,737 Public and Indian Housing: Passed through Seattle Housing Authority Youth Tutoring Program 14.850 3299 $ 218,485 Youth Tutoring Program 14.850 3630 37,756 TOTAL PUBLIC AND INDIAN HOUSING 256,241 '{' TOTAL U.S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT $ 2,817,089 U. S. DEPARTMENT OF JUSTICE :,.Edward Byrne Memorial State and Local Law Enforcement Assistance Discretionary Grants Program: Passed through the City of Seattle Yesler Terrace Youth Tutoring Program 16.580 DA2006-1390 $ 3,784 TOTAL EDWARD BYRNE MEMORIAL STALE,AND LOCAL LAW ENFORCEMENT ASSISTANCE DISCRETIONARY GRANTS PROGRAM 3,784 TOTAL U.S.DEPARTMENT OF JUSTICE $ 3,784 U. S. DEPARTMENT OF LABOR WIA Youth Activities: Passed through Snohomish County Workforce Development Council Youthworks 17.259 04-CC-0-01-WY-2 $ 61,636 TOTAL WIA YOUTH ACTIVITIES 61,636 TOTAL U.S.DEPARTMENT OF LABOR $ 61,636 U. S.DEPARTMENT OF EDUCATION Federal Work-Study Program: Passed through Seattle University Federal Community Work Study Program 84.033 None $ 9,660 Passed through University of Washington Federal Community Work Study Program 84.033 None 15,350 TOTAL FEDERAL WORK-STUDY PROGRAM 25,010 TOTAL U.S.DEPARTMENT OF EDUCATION $ 25,010 29 CATHOLIC COMMUNITY SERVICES OF WESTERN WASHINGTON Schedule of Expenditures of Federal Awards For the Year Ended June 30, 2007 PASS-THROUGH , FEDERAL ENTITY FEDERAL GRANTOR/PASS-THROUGH GRANTOR/ CFDA IDENTIFYING FEDERAL PROGRAM OR CLUSTER TITLE NUMBER NUMBER EXPENDITURES U. S.DEPARTMENT OF HEALTH AND HUMAN SERVICES Special Program for the Aging-Title III,Part B-Grants for Supportive Services and Senior Centers: Passed through Human Services Council Senior Transportation 93.044 06-07-TSB-03 $ 19,000 Senior Transportation 93.044 06-07-TSB-03 87,831 Passed through Senior Services of South Sound LMT Volunteer Transportation 93.044 06-1120-0041-08(a-3) 1,527 LMT Volunteer Transportation 93.044 06-1120-0041-08(2) 1,787 TOTAL SPECIAL PROGRAM FOR THE AGING-TITLE III,PART B- GRANTS FOR SUPPORTIVE SERVICES AND SENIOR CENTERS $ 110,145 Promoting Safe and Stable Families: Passed through Tacoma-Pierce County Health Department Hilltop/Eastside Family Support Center 93.556 2006-451-4 $ 14,729 Hilltop/Eastside Family Support Centers 93.556 2007-451-5 23,387 TOTAL PROMOTING SAFE AND STABLE FAMILIES $ 38,116 Unaccompanied Alien Children Program: Passed through U. S. Conference of Catholic Bishops Alien Unaccompanied Minors 93.676 None $ 39,669 Alien Unaccompanied Minors 93.676 None 183,278 Transitional Foster Care 93.676 None 252,633 Transitional Foster Care 93.676 None 88,603 TOTAL UNACCOMPANIED ALIEN CHILDREN PROGRAM 564,183 TOTAL U.S.DEPARTMENT OF HEALTH AND HUMAN SERVICES $ 712,444 CORPORATION FOR NATIONAL AND COMMUNITY SERVICES Retired and Senior Volunteer Program: Direct Funding Retired Senior Volunteer Program(RSVP) 94.002 06SR059774 $ 19,045 Retired Senior Volunteer Program(RSVP) 94.002 07SR073474 76,634 TOTAL DIRECT FUNDING 95,679 TOTAL RETIRED AND SENIOR VOLUNTEER PROGRAM $ 95,679 AMERICORPS: Passed through State of Washington,Employment Security Department Washington Reading Corp-AmeriCorp 94.006 06-008-G $ 7,837 Washington Reading Corp-AmeriCorp 94.006 07-024-G(1) 36,647 TOTAL AMERICORPS $ 44,484 30 . CATHOLIC COMMUNITY SERVICES OF WESTERN WASHINGTON Schedule of Expenditures of Federal Awards For the Year Ended June 30, 2007 PASS-THROUGH FEDERAL ENTITY FEDERAL GRANTOR/PASS-THROUGH GRANTOR/ CFDA IDENTIFYING FEDERAL PROGRAM OR CLUSTER TITLE NUMBER NUMBER EXPENDITURES AMERICORPS, CONTINUED: Foster Grandparent Program: Direct Funding Foster Grandparent 94.011 06SFPWA002 $ 965,147 TOTAL DIRECT FUNDING 965,147 TOTAL FOSTER GRANDPARENT PROGRAM $ 965,147 Volunteers in Service to America: Passed through United Way of Snohomish County Washington Reading Corp-VISTA 94.013 06-008-G $ 2,137 Washington Reading Corp-VISTA 94.013 07-024-G(1) 12,163 TOTAL VOLUNTEERS IN SERVICE TO AMERICA 14,300 TOTAL CORPORATION FOR NATIONAL AND COMMUNITY SERVICE $ 1,119,610 U.S.DEPARTMENT OF HOMELAND SECURITY Emergency Food and Shelter National Board Program: eh Passed through Archdiocesan Housing Authority . FEMA-PHASE 24 97.024 LRO ID#891400-038 $ 9,391 Passed through United Way of King County FEMA-LRO 08 CCS 97.024 24-889000-008 262 FEMA-LRO 08 CCS 97.024 25-889000-008 304 FEMA-LRO 08 CCS 97.024 24-8890-00 2,126 FEMA-LRO 08 CCS 97.024 25-8890-00 2,250 FEMA-LRO 08 CCS 97.024 24-889000-008 5,525 FEMA-LRO 08 CCS 97.024 25-889000-008 4,206 FEMA-LRO 08 CCS 97.024 23-889000-008 2,537 FEMA-LRO 08 CCS 97.024 24-889000-008 2,991 Passed through United Way Kitsap County Kitsap County FEMA Board Chair 97.024LRO ID#889600-019 Phase 24 6,810 Kitsap County FEMA Board Chair 97.024LRO ID#889600-019 Phase 25 22,072 Passed through United Way of Pierce County PHN-FEMA 97.024LRO ID#891400-019 Phase 24 28,351 PHN-FEMA 97.024LRO ID#891400-019 Phase 25 24,000 Passed through United Way of Thurston County Emergency Food&Shelter Program(FEMA) 97.024LRO ID#893400-015 Phase 24 2,650 Emergency Food&Shelter Program(FEMA) 97.024LRO ID#893400-015 Phase 25 2,500 Passed through Young Men's Christian Association FNMA 97.024 24-8924-00008 2,961 FEMA 97.024 25-8924-00008 3,465 TOTAL EMERGENCY FOOD AND SHELTER NATIONAL BOARD PROGRAM 122,401 TOTAL U.S.DEPARTMENT OF HOMELAND SECURITY $ 122,401 TOTAL FEDERAL AWARDS $ 4,911,799 31 CATHOLIC COMMUNITY SERVICES OF WESTERN WASHINGTON Notes to Schedule of Expenditures of Federal Awards For the Year Ended June 30,2007 NOTE A-BASIS OF PRESENTATION The accompanying schedule of expenditures of federal awards presents the federal grant activity of Catholic Community Services of Western Washington and is presented on the accrual basis of accounting. The information in this schedule is presented in accordance with the requirements of OMB Circular A-133,Audits of States,Local Governments, and Non Profit Organizations. Therefore,some amounts presented in this schedule may differ from amounts presented in,or used in the preparation of,the basic financial statements. NOTE B -FEDERAL AND NONFEDERAL DOLLARS When awards include both federal and nonfederal dollars, and the federal dollars are not separately identified in the contract,it is assumed that federal dollars are expended first. NOTE C-FEE FOR SERVICE CONTRACTS Expenditures related to certain fee-for-service contracts are not accumulated by individual contracts. NOTE D -LOANS AND GRANTS WITH CONTINUING COMPLIANCE REQUIREMENTS Catholic Community Services of Western Washington received the following funding through loans. Loan documents require compliance with program regulations until the maturity date of the loan. The loans are forgivable on their maturity dates provided that Catholic Community Services of Western Washington remains in compliance with the loan documents. The loan balances outstanding at June 30,2007, are included in the accompanying schedule of expenditures of federal awards and are as follows: Outstanding Loan Balance U.S.DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT Community Development Block Grants/Entitlement Grants: Passed through City of Seattle ML King Day Home Center 14.218 DL03-7674 $ 255,000 Passed through King County Katherine House 14.218 D26556D&F 106,435 HOME Investment Partnership Program: Passed through State of Washington,Department of Community,Trade and Economic Development Drexel House 14.239 530,000 TOTAL $ 891,435 32 CATHOLIC COMMUNITY SERVICES OF WESTERN WASHINGTON Schedule of Funcation Expenses-Governance Office For the Year Ended June 30,2007 (With Comparative Totals for 2006) PROGRAM MANAGEMENT TOTAL SERVICES AND GENERAL FUNDRAISING ELIMINATIONS 2007 2006 Salaries and related payroll expenses $ 259,293 $ 2,115,718 $ 236,067 $ 2,611,078 $ 2,393,868 Professional fees and contract service payments 237,132 2,420 239,552 181,445 Supplies 522 42,076 12,136 54,734 33,185 Telephone 26,966 1,271 28,237 27,543 Postage 13,410 7,001 20,411 15,211 Occupancy 67,838 14,329 $ (79,608) 2,559 (176) Equipment rental and maintenance 69,447 13,949 83,396 76,473 Printing and advertisement 3,980 41,042 77,322 122,344 65,722 Travel 17,534 44 17,578 21,596 Conferences 4,321 3,149 7,470 19,740 Contributions,grants and specific assistance/foster care payments 1,874,000 (1,250,026) 623,974 859,625 Dues and fees 103,354 1,827 - 105,181 85,577 Taxes and insurance 121,783 700 122,483 67,564 Interest and bank charges 67,657 67,657 84,009 Bad debts 2,320 In-kind expenses Miscellaneous 21,250 4,875 26,125 69,583 Impairment loss - - -- Total expenses before depreciation $ 2,137,795 $ 2,949,528 $ 375,090 (1,329,634) $ 4,132,779 $ 4,003,285 Depreciation - 31,632 - - 31,632 68,210 TOTAL EXPENSES. $ 2,137,795 $ 2,981,160 $ 375,090 $ (1,329,634) $ 4,164,411 $ 4,071,495 33 CATHOLIC COMMUNITY SERVICES OF WESTERN WASHINGTON Schedule of Functional Expenses-King County For the Year Ended June 30,2007 (With Comparative Totals for 2006) PROGRAM MANAGEMENT TOTAL SERVICES AND GENERAL FUNDRAISING ELIMINATIONS 2007 2006 Salaries and related payroll expenses $ 4,121,613 $ 754,576 $ 149,587 $ (226,082) $ 4,799,694 $ 4,925,277 Professional fees and contract . service payments 207,066 129,380 2,222 (183,177) 155,491 33,056 Supplies 115,644 6,521 2,076 (920) 123,321 126,864 Telephone 96,493 3,952 454 (771) 100,128 123,149 Postage 21,050 6,143 2,194 (254) 29,133 54,527 Occupancy 358,868 87,981 13,653 (3,439) 457,063 386,651 Equipment rental and maintenance 23,646 10,713 3,703 38,062 (61,877) Printing and advertisement 63,505 16,996 9,079 89,580 62,002 Travel 89,729 5,478 671 (2,012) 93,866 67,478 Conferences 56,389 3,762 458 (784) 59,825 48,045 Contributions,grants and specific assistance/foster care payments 2,587,475 (600,089) 1,987,386 1,967,561 Dues and fees 3,729 8,255 225 12,209 10,565 . Taxes and insurance 8,403 90 5 8,498 15,788 Interest and bank charges 33,467 19,444 1,604 54,515 51,559 Bad debts In-kind expenses 238,641 238,641 210,158 Miscellaneous 31,295 8,748 432 (3,295) 37,180 55,480 Total expenses before depreciation $ 8,057,013 $ 1,062,039 $ 186,363 (1,020,823) $ 8,284,592 $ 8,076,283 Depreciation 203,097 17,232 3,216 - 223,545 231,571 TOTAL EXPENSES $ 8,260,110 $ 1,079,271 $ 189,579 $ (1,020,823) $ 8,508,137 $ 8,307,854 34 i y CATHOLIC COMMUNITY SERVICES OF WESTERN WASHINGTON Schedule of Functional Expenses-Southwest For the Year Ended June 30,2007 (With Comparative Totals for 2006) PROGRAM MANAGEMENT TOTAL SERVICES AND GENERAL FUNDRAISING ELIMINATIONS 2007 2006 Salaries and related payroll expenses $ 13,072,999 $ 1,377,355. $ 100,036 $ (534,099) $ 14,016,291 $ 12,722,665 Professional fees and contract service payments 413,965 (187,534) (252,864) (26,433) (182,989) Supplies 444,878 59,407 2,021 506,306 492,990 Telephone 336,105 31,859 831 368,795 311,736 Postage 37,670 6,219 1,337 45,226 39,008 Occupancy 632,469 119,622 8,949 761,040 650,692 Equipment rental and maintenance 109,012 23,064 2,419 134,495 152,386 Printing 109,275 2,813 497 112,585 98,066 Travel 227,183 13,112 663 240,958 175,627 Conferences 45,656 1,327 20 47,003 49,455 Contributions,grants and specific assistance/foster care payments 3,211,528 3,211,528 3,029,699 Dues and fees 4,764 2,100 6,864 5,775 Taxes and insurance 5,884 24 5,908 6,439 Interest and bank charges 93,620 1,884 95,504 80,810 Bad debts 29,400 29,400 23,217 In-kind expenses 1,228,527 1,228,527 1,196,942. Miscellaneous 9,822 126 9,948 31,515 Total expenses before depreciation $ 20,012,757 $ 1,451,378 $ 116,773 (786,963) $ 20,793,945 $ 18,884,033 Depreciation 151,753 21,100 59 - 172,912 155,735 TOTAL EXPENSES $ 20,164,510 $ 1,472,478 $ 116,832 $ (786,963) $ 20,966,857 $ 19,039,768 • 35 CATHOLIC COMMUNITY SERVICES OF WESTERN WASHINGTON Schedule of Functional Expenses-Long-Term Care For the Year Ended June 30,2007 (With Comparative Totals for 2006) PROGRAM MANAGEMENT TOTAL SERVICES AND GENERAL ELIMINATIONS 2007 2006 Salaries and related payroll expenses $ 32,745,187 $ 209,898 $ (773,329) $ 32,181,756 $ 28,215,088 Professional fees and contract service payments 379,164 1,156,065 (408,632) 1,126,597 958,732 Supplies 528,113 5,057 533,170 542,064 Telephone 78,292 7,971 86,263 82,083 Postage 47,442 3,057 50,499 45,770 Occupancy 344,220 2,978 (85,077) 262,121 223,670 Equipment rental and maintenance 53,172 4,618 57,790 50,369 Printing and advertisement 103,412 372 103,784 109,755 Travel 97,626 6,510 104,136 84,453 Conferences 18,301 18,301 31,025 Contributions,grants and specific assistance/foster care payments Dues and fees 10,090 10,090 10,345 Taxes and insurance 157 Interest and bank charges 44,661 8,293 52,954 35,180 Bad debts 59,380 59,380 34,850 In-kind expenses Miscellaneous 18,151 103 18,254 11,543 Total expenses before depreciation $ 34,527,211 $ 1,404,922 (1,267,038) $ 34,665,095 $ 30,435,084 Depreciation 12,944 180 - 13,124 10,361 TOTAL EXPENSES $ 34,540,155 $ 1,405,102 $ (1,267,038) $ 34,678,219 $ 30,445,445 36 • CATHOLIC COMMUNITY SERVICES OF WESTERN WASHINGTON Schedule of Functional Expenses-Northwest For the Year Ended June 30,2007 (With Comparative Totals for 2006) PROGRAM MANAGEMENT TOTAL SERVICES AND GENERAL FUNDRAISING ELIMINATIONS _ 2007 2006 Salaries and related payroll expenses $ 5,515,509 $ 694,917 $ 56,102 $ (252,831) $ 6,013,697 $ 6,650,699 Professional fees and contract service payments 268,666 38,960 4,853 (95,804) 216,675 143,280 Supplies 112,248 9,019 1,594 122,861 130,739 Telephone 102,483 5,610 1,392 109,485 126,858 Postage -17,168 2,153 1,071 20,392 22,389 Occupancy 475,921 17,318 5,321 498,560 492,421 Equipment rental and maintenance 89,115 5,423 1,650 96,188 85,932 Printing and advertisement 10,625 1,662 818 13,105 22,827 Travel 188,131 8,197 1,014 197,342 180,604 Conferences Contributions,grants and specific assistance/foster care payments 772,003 772,003 788,171 Dues and fees 11,651 7,567 221 19,439 26,309 Taxes and insurance 51,427 2,442 380 54,249 71,993 Interest and bank charges 108,019 859 611 109,489 123,318 Bad debts 224,344 224,344 120,972 In-kind expenses Miscellaneous 37,130 4,452 1,434 43,016 40,451 Total expenses before depreciation $ 7,984,440 $ 798,579 $ 76,461 (348,635) $ 8,510,845 $ 9,026,963 Depreciation 93,870 9,152 1,414 - 104,436 102,055 TOTAL EXPENSES $ 8,078,310 $ 807,731 $ 77,875 $ (348,635) $ 8,615,281 $ 9,129,018 37 WATSON & McDONELL, PLLC CERTIFIED PUBLIC ACCOUNTANTS 600 UNIVERSITY STREET,SUITE 2828 SEATTLE,WASHINGTON 98101-3301 INDEPENDENT AUDITORS' REPORT ON INTERNAL CONTROL OVER FINANCIAL REPORTING AND ON COMPLIANCE AND OTHER MATTERS BASED ON AN AUDIT OF FINANCIAL STATEMENTS PERFORMED IN ACCORDANCE WITH GOVERNMENT AUDITING STANDARDS To the Trustees Catholic Community Services of Western Washington Seattle,Washington We have audited the financial statements of Catholic Community Services of Western Washington (a Washington nonprofit corporation)as of and for the year ended June 30,2007, and have issued our report thereon dated March 31,2008. We conducted our audit in accordance with auditing standards generally accepted in the United States of America and the standards applicable to financial audits contained in Government Auditing Standards,issued by the Comptroller General of the United States. Internal control over financial reporting In planning and performing our audit,we considered Catholic Community Services of Western Washington's internal control over financial reporting in order to determine our auditing procedures for the purpose of expressing our opinion on the financial statements and not to provide an opinion on the internal control over financial reporting. Accordingly,we do not express an opinion on the effectiveness of the Organizations' internal control over financial reporting. A control deficiency exists when the design or operation of a control does not allow management or employees,in the normal course of performing their assigned functions,to prevent or detect misstatements on a timely basis. A significant deficiency is a control deficiency, or combination of control deficiencies,that adversely affects the Organization's ability to initiate,authorize,record, process,or report financial data reliably in accordance with generally accepted accounting principals such that there is more than a remote likelihood that a misstatement of the Organization's financial statements that is more than inconsequential will not be prevented or detected by the entity's internal control. A material weakness is a significant deficiency,or combination of significant deficiencies,that results in more than a remote likelihood that a material misstatement of the financial statements will not be prevented or detected by the Organization's internal control. ( II if TELEPHONE: (206)624-2380 FACSIMILE:(206)382-3558 MEMBER AMERICAN INSTITUTE OF CERTIFIED PUBLIC ACCOUNTANTS AND WASHINGTON SOCIETY OF CERTIFIED PUBLIC ACCOUNTANTS { Independent Auditors' Reports on Internal Control Over Financial Reporting and on Compliance and Other Matters Based on an Audit of Financial Statements Performed in Accordance with Government Auditing Standards, Page 2 Our consideration of the internal control over financial reporting was for the limited purpose described in the first paragraph of this section and would not necessarily identify all deficiencies in internal control that might be significant deficiencies or material weaknesses. We did not identify any deficiencies in internal control over financial reporting that we consider to be material weaknesses as defined above. Compliance and other matters As part of obtaining reasonable assurance about whether Catholic Community Services of Western Washington's financial statements are free of material misstatement,we performed tests of its compliance with certain provisions of laws,regulations, contracts,and grant agreements, noncompliance with which could have a direct and material effect on the determination of financial statement amounts. However,providing an opinion on compliance with those provisions was not an objective of our audit and,accordingly,we do not express such an opinion. The results.of our tests disclosed no instances of noncompliance or other matters that are required to be reported under Government Auditing Standards. This report is intended solely for the information and use of the Board of Trustees, management, federal awarding agencies and pass-through entities and is not intended to be and should not be used by anyone other than these specified parties. )4/4413421,1 M4-aoe& ?L`� March 31,2008 39 WATSON & MCDONELL, PLLC CERTIFIED PUBLIC ACCOUNTANTS 600 UNIVERSITY STREET,SUITE 2828 SEATTLE,WASHINGTON 98101-3301 INDEPENDENT AUDITORS'REPORT ON COMPLIANCE WITH REQUIREMENTS APPLICABLE TO EACH MAJOR PROGRAM AND ON INTERNAL CONTROL OVER COMPLIANCE IN ACCORDANCE WITH OMB CIRCULAR A-133 To the Trustees Catholic Community Services of Western Washington Seattle,Washington Compliance We have audited the compliance of Catholic Community Services of Western Washington(a Washington nonprofit corporation)with the types of compliance requirements described in the U.S. Office of Management and Budget(OMB) CircularA-133 Compliance Supplement that are applicable to each of its major federal programs for the year ended June 30,2007. Catholic Community Services of Western Washington's major federal programs are identified in the summary of auditors' results section of the accompanying schedule of findings and questioned costs. Compliance with the requirements of laws,regulations,contracts,and grants applicable to each of its major federal programs is the responsibility of Catholic Community Services of Western Washington's management. Our responsibility is to express an opinion on Catholic Community Services of Western Washington's compliance based on our audit. We conducted our audit of compliance in accordance with auditing standards generally accepted in the United States of America;the standards applicable to financial audits contained in Government Auditing Standards,issued by the Comptroller General of the United States;and OMB Circular A-133,Audits of States,Local Governments, and Non Profit Organizations. Those standards and OMB Circular A-133 require that we plan and perform the audit to obtain reasonable assurance about whether noncompliance with the types of compliance requirements referred to above that could have a direct and material effect on a major federal program occurred. An audit includes examining, on a test basis,evidence about Catholic Community Services of Western Washington's compliance with those requirements and performing such other procedures as we considered necessary in the circumstances. We believe that our audit provides a reasonable basis for our opinion. Our audit does not provide a legal determination of Catholic Community Services of Western Washington's compliance with those requirements. In our opinion, Catholic Community Services of Western Washington complied,in all material respects,with the requirements referred to above that are applicable to each of its major federal programs for the year ended June 30,2007. TELEPHONE:(206)624-2380 FACSIMILE: (206)382-3558 MEMBER AMERICAN INSTITUTE OF CERTIFIED PUBLIC ACCOUNTANTS AND WASHINGTON SOCIETY OF CERTIFIED PUBLIC ACCOUNTANTS Independent Auditors'Report on Compliance With Requirements Applicable to Each Major Program and on Infernal Control Over Compliance in Accordance With OMB Circular A-133, Page 2 Internal control over compliance The management of Catholic Community Services of Western Washington is responsible for establishing and maintaining effective internal control over compliance with the requirements of laws,regulations,contracts and grants applicable to federal programs. In planning and performing our audit,we considered Catholic Community Services of Western Washington's internal control over compliance with requirements that could have a direct and material effect on a major federal program in order to determine our auditing procedures for the purpose of expressing our opinion on compliance,but not for the purpose of expressing an opinion on the effectiveness of internal control over compliance. Accordingly,we do not express an opinion on the effectiveness of Catholic Community Services of Western Washington's internal control over compliance. A control deficiency in an entity's internal control over compliance exists when the design or operation of a control does not allow management or employees,in the normal course of performing their assigned functions,to prevent or detect noncompliance with a type of compliance requirement of a federal program on a timely basis. A significant deficiency is a control deficiency, or combination of control deficiencies,that adversely affects the Organization's ability to administer a federal program such that there is more than a remote likelihood that noncompliance ,LJ with a type of compliance requirement of a federal program that is more than inconsequential will not be prevented or detected by the entity's internal control. .19 :, A material weakness is a significant deficiency,or combination of significant deficiencies,that results in more than a remote likelihood that material noncompliance with a type of compliance requirement of a federal program will not be prevented or detected by the Organization's internal control. Our consideration of the internal control over compliance was for the limited purpose described in the first paragraph of this section and would not necessarily identify all deficiencies in internal control that might be significant deficiencies or material weaknesses. We did not identify any deficiencies in internal control over compliance that we consider to be material weaknesses,as defined above. This report is intended solely for the information and use of the Trustees,management,federal awarding agencies and pass-through entities and is not intended to be and should not be used by anyone other than these specified parties. Wet, £ 69014 Pc-L C March 31,2008 41 CATHOLIC COMMUNITY SERVICES OF WESTERN WASHINGTON Schedule of Findings and Questioned Costs For the Year Ended June 30,2007 Section I - Summary of Auditors' Results Financial statements Type of auditors' report issued: Unqualified Internal control over financial reporting: • Material weaknesses identified? No • Significant deficiencies identified that are not considered to be material weaknesses? None reported Noncompliance material to financial statements noted? No Federal awards Internal control over major programs: • Material weaknesses identified? No • Significant deficiencies identified that are not considered to be material weaknesses? None reported Type of auditors' report issued on compliance for major programs: Unqualified Any audit findings disclosed that are required to be reported in accordance with Section 510(a) of Circular A-133? No Identification of major programs: CFDA Number Name of Federal Program or Cluster 14.218 Community Development Block Grants/Entitlement 14.228 Community Development Block Grants/State's Programs 14.235 Supportive Housing Program 14.239 HOME Investment Partnership Program 93.676 Unaccompanied Alien Children Program Dollar threshold used to distinguish between Type A and Type B programs $300,000 Auditee qualified as low-risk auditee? No 42 CATHOLIC COMMUNITY SERVICES OF WESTERN WASHINGTON Schedule of Findings and Questioned Costs For the Year Ended June 30,2007 Section II - Financial Statement Findings None reported. Section III - Federal Award Findings and Questioned Costs None reported. 43 CATHOLIC COMMUNITY SERVICES OF WESTERN WASHINGTON EQUAL OPPORTUNITY STATEMENT AND EMPLOYEE PLEDGE EQUAL OPPORTUNITY STATEMENT It is the policy of Catholic Community Services of Western Washington to provide equal employment opportunity for employees and applicants for employment without regard to race, color,sex,sexual orientation, marital status, political ideology, age, creed, religion [except where religion is a bona fide occupational qualification for the position],ancestry, national origin,status as a Vietnam era veteran, the presence of a medical condition or disability or the use of a trained dog guide or service animal by a disabled person. This policy applies to all areas of employment, including recruitment, hiring,training and development, promotion, transfer, disciplinary action,termination, reduction in force,compensation and benefits, and all other conditions and privileges of employment. It is the responsibility of all CCSWW employees,supervisory and non-supervisory,to adhere to this policy and to use all efforts to further its goals and spirit. It is the policy of Catholic Community Services to provide access to and information about opportunities for advancement and to administer relevant personnel policies/procedures on an equitable basis to all employees. It is the policy of Catholic Community Services to create a workplace and enact employment policies and procedures which respect,cultivate and enhance a diverse and inclusive work force. Catholic Community Services acknowledges the pervasiveness of racism in American society, institutions, and communities. Catholic Community Services is committed to making our services, our agencies and our communities free of the divisive and dehumanizing ravages of racism. EMPLOYEE PLEDGE We will not tolerate attitudes, behaviors, or statements that alienate, offend,or injure any person associated with CCSWW because of their racial or ethnic origin. We will enable and support all efforts to become aware of and eliminate racism and racist behaviors within CCSWW and the broader community. We will take exceptional steps to identify and root out such biases, especially where there appear to be long-standing, institutional patterns of unacceptable behavior or lack of performance. CCS VOLUNTEER CHORE SERVICES Intake Phone: 206-328-5787 / 888-649-6850 CLIENT INTAKE FORM FAX #: 206-324-4835 :,eferral Date: Referring Agency Name: Referred By: Referents Title: Referents Phone Number: FAX#: - - (Last, First) Client Name: _ Monthly Income: Street Address: City: Zip Code: Building Name: ❑ Homeless ❑ Unincorporated Email: Phone Number: - - Mailing Address: City:: Zip Code: Date of Birth: Age: Gender ❑ Ltd. English ❑ Ltd. Communication ❑ Immigrant ❑ Emergency Contact:: Relationship: Phone Number: ETHNICITY ❑ Caucasian ❑ American Indian/Alaskan Native ❑ Hispanic ❑ Unknown ❑ African American ❑ Asian/Pacific Islander ❑ Multi-Ethnic Living Situation: Number in Household: Pets: ❑ Smoker ':Children under 18: Single Parent ❑ Veteran Status: Self ❑ Immediate Family Member❑ Active Duty❑ DSHS Assistance Disability: ( difficulty walking, vision, hearing, mental health) Health Situation: Requested Tasks: ❑ Transportation ❑ Moving Assistance ❑Yard Care ❑ Communication ❑ Other ❑ Shopping ❑ Laundry ❑ Cooking ❑ Monitoring ❑ Household Repairs ❑ Housework ❑ Wood Provision ❑ Respite Specific Request: How Soon Is Volunteer Needed? How Often? Also Referred To: Additional Information: