CANCER SUPPORT COMMUNITY AZ APPLICATION GRIC 2017.PDF

Last updated: 02/07/2017
General information
Organization Cancer Support Community AZ
Contact First name Dora
Contact Last name Vasquez
Contact e-mail dvasquez@cscaz.org
Contact phone number 602-712-1006
Address
Street 360 East Palm Lane
City Phoenix
State AZ
ZIP Code 85004
From what tribe is the organization requesting the grant?
Gila River Indian Community
Total grant amount request
225,000
The Gila River Indian Community offers multi-year awards. If your organization is
requesting a multi-year grant for this project or program from the Gila River Indian
Community, enter the amount to be requested each year.
Amount
Year 1 (Gila River Indian Community Grants Only) 75,000
Year 2 (Gila River Indian Community Grants Only) 75,000
Year 3 (Gila River Indian Community Grants Only) 75,000
Year 4 (Gila River Indian Community Grants Only)
Year 5 (Gila River Indian Community Grants Only)
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Gila River Indian Community Grant Application
Grant Cycle 2017
Cover Sheet
Municipality Information
1. Date of Application: 2/27/2017 (NOTE: Click or use up/down arrow keys to move among fields)
2. Name of City, Town or County: Maricopa County
3. Mayor (City or Town) or Board of Supervisor’s Chairman (County): Denny Barney, Chairman Board of Supervisors
4. Mailing Address: 301 West Jefferson, 10th Floor
5. City: Phoenix State: Arizona Zip Code: 85003
6. Acknowledgement of Submission by Authorized Municipality Representative:
Typed Name/Title: Melody Henderson Signature:
Applicant Information
7. Department/Organization Name: Cancer Support Community Arizona
8. Is this a 501c non-profit Organization? No Yes If yes, attach IRS Determination Letter
9. Application Contact Person: Dora Vasquez Title: Director of Grants and Partnerships
10. Phone Number: 602.712.1006
11. Mailing Address: 360 East Palm Lane
12. City: Phoenix State: Arizona Zip Code: 85004
13. Email Address: dvasquez@cscaz.org Website Address: www.cscaz.org
Project Information
14. Project Name: Cancer Support Community Arizona: Building Wellness
15. Purpose of Grant: To provide programs free of cost, where all whose lives are touched by cancer can be
surrounded by an atmosphere of healing and support.
16. Priority Funding Area Healthcare
17. Annual amount requested $75,000
18. Number of years that funding is requested 3
19. Total amount requested (annual amount x $225,000
number of years)
20. Has your organization received past No
funding from GRIC? If yes, list each year and
amount
21. Geographic area served Maricopa County
For Office Use Only:
Data Entry Receipt Evaluation
Outcome  Approval Recommended/Amount $  Denial

Gila River Indian Community Grant Application
Grant Cycle 2017
Narrative
Please structure your proposal to provide the following information in the order indicated. Provide the narrative in
paragraph form in the text field provided. Please be thorough but strive for brevity.
1. Briefly describe the organization’s history, mission and goals.
Founded in 1999, the mission of the Cancer Support Community Arizona is to ensure that all people impacted by cancer
are empowered by knowledge, strengthened by action and sustained by the community. The Cancer Support Community
Arizona is the only comprehensive program in Arizona providing psychosocial support and services to people, of any age,
diagnosed with cancer. Annually, Cancer Support Community Arizona serves 2,000 adults, teens and children through
programs provided free of cost, in a home-like setting where all whose lives are touched by cancer can be surrounded by
an atmosphere of healing and support. Every day, Cancer Support Community Arizona provides professionally led support
groups, educational workshops, and mind/body programs so that people affected by cancer can learn vital skills to regain
control, reduces feelings of isolation and restore hope.
2. If the applying organization is non-municipal or a non-profit 501c, please describe your relationship with Arizona
municipalities including past and present support, whether it be through partnerships, collaborations, in-kind
contributions, grants, tax-based funding or other. Describe the supporting municipality’s role in this project. If
the applying organization is a municipality governmental sub-division please enter the text “Not applicable.”
Maricopa County provides the local government entity to submit application to the State-Shared
Revenue Program. Cancer Support Community Arizona does not receive in-kind contributions, tax-based
funding or any other funds from Maricopa County.
3. Describe the proposed project and planned goals and activities.
Through funding from the Gila River Indian Community critically needed resources and support will be provided annually
to 2,000 children, youth, adults diagnosed with cancer through professionally led support groups, educational
workshops and mind/body programs so that people affected by cancer can learn vital skills to regain control, reduce
feelings of isolation and restore hope. At Cancer Support Community Arizona, anyone diagnosed with cancer and their
family can participate, free of charge, in the following programs:
The Youth and Family Program ensures that children, teens and their families, friends and caregivers have access to
information, support and health and wellness resources that will help them feel more in control of the diagnosis,
improve the chance of survival and decrease the risk for recurrence. Programs deliver evidence-based psychosocial
support services via certified social workers and or/or licensed therapists. The program services help individuals navigate
the cancer continuum, including diagnosis, treatment, post-treatment, long-term survivorship, end-of-life and
bereavement.
Kid Support™, a six session program for youth ages 5 to 12, offered as summer workshops at our campus. The nationally
recognized curriculum teaches children age appropriate information about cancer, coping skills to de-stigmatize the
diagnosis, dispels myths, discusses treatment effects and how to be a good friend to someone with cancer while
promoting healthy communication and expression of feelings.

Gila River Indian Community Grant Application
Grant Cycle 2017
Monthly healthy lifestyle programs such as nutrition and exercise classes, expressive arts and music are available to
anyone 13 and older.
Social connections, especially activities such as Teen Prom help celebrate milestones, monthly gatherings help reduce
isolation and build peer relations, and the Family Day of Hope inspires interaction, play and humor.
Family Connect, features monthly support groups for families where children ages 5-12, teens ages 13-18, and parents
each have their own professionally facilitated groups at the same time. Support groups help families process how to live
with and beyond cancer, its treatment and relevant life issues.
Cancer Support Navigation provides resource navigation for all ages, regarding programs and community resources,
performs assessment and education and uses counseling intervention with the intention to help patients, caregivers and
family members establish and achieve reachable goals to make diagnosis and treatment more tolerable and to maintain
the best quality of life possible.
4. Describe how the proposed project satisfies one or more of the priority funding areas identified by the Gila River
Indian Community.
The proposed project aligns with the Gila River Community healthcare funding priority area as it
promotes wellness activities, provides recreational activities that encourage physical fitness, health
education and programs that provide psychosocial support for persons impacted by cancer.
5. Identify the needs/problems to be addressed, target population and number of people to be served by the
project.
Each year in Arizona, approximately 32,000 people are diagnosed with Cancer and few opportunities
exist for these individuals to receive the support services they need and deserve. In fact, while some
health centers may offer some educational and social opportunities for those diagnosed, Cancer Support
Community Arizona is the only organization in Arizona that provides psychosocial support to meet the
needs of the whole person, at any stage of their cancer journey, and Cancer Support Community Arizona
is the only organization to provide year-round support specific for teens with cancer. The National
Institute of Medicine states that it is impossible to deliver quality cancer care without addressing the
psychological needs of each patient. Cancer Support Community Arizona uses the Patient Active
Concept Model® in all aspects of programming. Research from several sources, including the National
Institute of Health and the National Cancer Institute, shows that this approach reduces pain and trauma
symptoms, improves coping and immune response and may increase the potential for long-term
survival. For our youth, support services are especially important as youth, diagnosed with cancer, are
vulnerable to depression, anxiety, and fear, and face pressures and emotions that can isolate them from
their peers and take a long-term toll on their development. In addition, because a youth’s body is still
growing and developing; cancer and its treatment is more likely to affect developing organs and side

Gila River Indian Community Grant Application
Grant Cycle 2017
effects may happen years after treatment with potential late effects including growth development,
fertility issues, second cancers, joint replacement, hearing loss and congestive heart failure. Fortunately,
Cancer Support Community Arizona offers a full range of age-appropriate support services for all ages,
at no cost to ensure we do not increase the financial burden during a stressful time in a cancer patient’s
life. Funding from the Gila River Indian Community will support 2,000 children, youth, adults and their
families in their journey toward healing.
6. Define the project as a new or continuing program.
The program is continuing and the Cancer Support Community Arizona has been providing programs for
nearly 20 years.
7. Provide a brief timeline including start and finish dates. Indicate if the timeline is flexible.
The timeline is flexible with plans to implement programming as follows: Year 1: October 1, 2017 to
September 30, 2018: Year 2 October 1, 2018 to September 30, 2019 and Year 3: October 1, 2019 to
September 30, 2020.
8. Identify other organizations, partners or funders participating in the project and their roles.
Cancer Support Community Arizona has an expansive list of partners including;
Banner University Medical Center, contracted hospital partner to collaborate on program services.
Dignity Health: St. Joseph’s Hospital and Medical Center, contracted hospital partner to fund the
position of a Cancer Resource Navigator.
Arizona State University, University of Arizona, Grand Canyon University and Midwestern University
provide student interns. In addition, Arizona State University provides guidance and support regarding
program evaluation.
A variety of medical providers, hospitals and community clinics, including Phoenix Children’s Hospital
and the Maricopa Integrated Health System serve as referral sources, guiding patients and their families
to the support they need through programming at Cancer Support Community.
Community members offer their time and talent to lead discussion groups, book clubs and more.
9. Would you be able to implement the proposed plan if your organization received partial funding for this project?
Yes
10. Describe your plan for project sustainability beyond the grant period. If this is a program/project previously
funded by the Gila River Indian Community describe efforts made towards the previously described
sustainability plan.

Gila River Indian Community Grant Application
Grant Cycle 2017
Foundation and hospital partnerships are the catalyst that contribute to the sustainability of the
program; additional fundraising and donor support promote the continuation of services.
11. Describe your plan to document progress and results.
Success is determined through Individual and family survey for each program offered. Data collection
memorializes results with the gathering of individual stories further documenting the success of the
program.
12. Indicate any application to and/or awards made by a tribe other than the Gila River Indian Community for state
shared revenues for this and any other project for the past five (5) years. If this information is included in a
separate attachment, please indicate that here.
Cancer Support Community Arizona has not received, nor applied for state-shared revenue in the past
five years.

Gila River Indian Community Grant Application
Grant Cycle 2017
Project Budget
Budget Period: October 1, 2017 to September 30, 2018
For each budget item listed here please provide a narrative description on the following Project Budget Detail page.
Proposed Budget Expense Amount Amount In Kind Total Budget
(list each budget item) requested from requested or contributions
GRIC secured from
other funders
1. Salaries and ERE $10,000 $680,000 $0 $690,000
2. Contracted Direct Services $20,000 $70,000 $0 $90,000
3. Program Supplies & Expenses $25,000 $25,000 $0 $50,000
4. Equipment Rental $5,000 $8,500 $0 $13,500
5. Program Meals and snacks $10,000 $2,500 $0 $12,500
6. Transportation Mileage $5,000 $3,000 $0 $8,000
7. Training $0 $2,500 $0 $2,500
8. Printing and Delivery Costs $0 $26,500 $0 $26,500
9. Postage and Shipping $0 $3,000 $0 $3,000
10. Insurance $0 $19,500 $0 $19,500
11. Telephone/Internet $0 4,500 $0 $4,500
12. Occupancy Costs $0 $32,500 $0 $32,500
13. Public Awareness $0 $10,000 $0 $10,000
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15. Click here to enter text. $0 $0 $0 $0
16. Click here to enter text. $0 $0 $0 $0
17. Click here to enter text. $0 $0 $0 $0
Total Budget $75,000 $887,500 $0 $962,500

Gila River Indian Community Grant Application
Grant Cycle 2017
Project Budget Detail
Please provide a narrative description for each of the project budget items listed on the previous page. Include the
dollar figure and how it was derived.
1. Salaries and Employee Related Expenses (ERE): $690,000 includes all staff directly supporting the daily operations of
Cancer Support Community Arizona.
2. Contracted Direct Services: $90,000 includes costs associated with contracting licensed professionals in the areas of
social work, counseling, nutruition and exercise. Individuals hired under this line item provide evidence-based
pychosocial support services.
3. Program Supplies and Expenses: $50,000 provides supplies and costs to support daily/weekly activities such as
expressive art, nutrition and wellness activities; monthly gatherings and community outings that help to reduce isolation
and yearly events such as Teen Prom, a milestone often missed by a youth diagnosed with cancer.
4. Equipment Rental: $13,500 includes costs associated with the rental of tables and chairs, lighting, etc. for special
family gatherings and community events.
5. Program Meals and Snacks: $12,500 includes costs associated with nutrition classes and snacks/light meals for
evening program participates attending workshops and peer support groups.
6. Transportation/Mileage: $8,000 includes $5,000 for costs to provide transportation for participants who are not able
to drive to the program as a result of their illness and recovery. Items to be reimbursed include metro light rail and bus
fare, gas cards, as well as, taxi and Lyft or Uber services. In addition, mileage provides reimbursement to staff traveling
to program locations in western and southern Maricopa County.
7. Training: $2,500 provides training as needed for staff development.
8. Printing and Delivery Costs: $26,500 includes all agency costs associated with printing
9. Postage and Shipping: $3,000 includes costs to mail quarterly calendars, newsletters and individual correspondence to
Cancer Support Community Arizona participants.
10. Insurance: $19,500 includes property and liability insurance.
11. Telephone/Internet: $4,500 includes direct costs for telephone and internet services.
12. Occupancy Costs: $32,500 includes costs associated with utilities, building and ground maintenance.

Gila River Indian Community Grant Application
Grant Cycle 2017
13. Public Awareness: $10,000 includes costs associated with marketing, public relations and social media.
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Other explanation: Click here to enter text.