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Created: 02/01/2016 Last updated: 04/01/2016 Page 1 General information Organization North County Fire & Medical District Contact First name Tim Contact Last name Van Scoter Contact e-mail tvanscoter@ncfmd.az.gov Contact phone number 602-881-2733 Address Street 18818 N. Spanish Garden Drive City Sun City West State AZ ZIP Code 85375 From what tribe is the organization requesting the grant? Fort McDowell Yavapai Nation Total grant amount request 18,300 1 of 1 NORTH COUNTY FIRE & MEDICAL DISTRICT Internationally Accredited ~ ISO Class 1 Designated Agency 18818 N. Spanish Garden Drive ⦁ Sun City West, Arizona 85375 ⦁ (623) 544-5400 ⦁ Fax (623) 544-5455 ⦁ www.ncfmd.az.gov March 22, 2016 Ms. Selena Castaneda The District proudly Fort McDowell Yavapai Nation Tribal Council Secretary serves the P.O. Box 17779 communities of: Fountain Hills, AZ 85269 Sun City West RE: North County Fire & Medical District – Local Government Agency Status Coldwater Ranch Corte Bella Ms. Castaneda: Cross River The North County Fire & Medical District (formally the Fire District of Sun City West) is a local government “Special District” under the Arizona Revised Statues 48-805 and is a not for profit Dos Rios government entity with an Internal Revenue Service issued Employer Identification Number of Marisol Ranch 86-0503076. IRS verification letter is attached to this letter. Pinnacle Peak County Island Respectfully, Rancho Cabrillo Rancho Silverado Tim Van Scoter Assistant Chief Rio Sierra Sun City West Fire District Sundero and other unincorporated portions of Maricopa County NORTH COUNTY FIRE & MEDICAL DISTRICT Internationally Accredited - ISO Class 1 Designated Agency .•I11I1I•1 18818 N. Spanish Garden Drive • Sun City West, Arizona 85375 • (623) 544-5400 • Fax (623) 544-5455 • www.ncfmd.az.gov March 22, 2016 Ms. Selena Castaneda Fort McDowell Yavapai Nation Tribal Council Secretary P.O. Box 17779 Fountain Hills, AZ 85269 The District proudly serves the RE: Prop. 202 Grant Application communities of Sun City • West Dear Ms. Castaneda: Coldwater Ranch • North County Fire & Medical District is pleased to present this application for the Fort Corte Bella McDowell Yavapai Nation Prop. 202 Grant Program. This is the first time that North County Fire & Medical District has applied for your grant program for this project. Cross River North County Fire & Medical District is committed to providing public safety services to Sun Dos Rios City West and the surrounding communities in the northwest valley. This grant program request will greatly enhance our ability to provide critical services and continue our Marisol Ranch commitment to serving the citizens of not only our community, but anyone needing assistance Pinnacle Peak in the surrounding area. County Island • The requested funding will be used to purchase a lifesaving Cardio Pulmonary Resuscitation Rancho Cabrillo (CPR) compression device (Lucas Device). This device is a vital component used by our paramedics for treating critically ill and injured patients who are suffering from cardiac arrest. Rancho Silverado • Our hope is that, with your assistance, we will be able to complete this project for the Rio Sierra community we serve. Sundero • We look fcivkard to working with you on this project. and other unincorporated Thank y portions of Maricopa County Robert Filiscoe Fire Chief RB:tvs NORTH COUNTY FIRE & MEDICAL DISTRICT Internationally Accredited - ISO Class 1 Designated Agency Fort McDowell Yavapai Nation Prop. 202 Grant Application 2016 Organization Information: North County Fire & Medical District 18818 North Spanish Garden Drive Sun City West, AZ 85375 Primary Contact: Tim Van Scoter, Assistant Chief 18818 North Spanish Garden Drive Sun City West, AZ 85375 tvanscoterasicfmd.az.00v 623-544-5400 Narrative Introduction North County Fire & Medical District serves the Northwest Phoenix metropolitan area with 140 uniformed, civilian, and volunteer employees. The District was formed in 1981 and has grown to protect roughly 50,000 residents within an approximately 45 square mile area. The District provides fire protection, medical service, public assistance/non-emergency response, and other services to the retirement community of Sun City West and surrounding areas. The District is a unique entity which has a history of using an innovative approach to delivering excellent quality and highly efficient services to its residents. In 2015, the District's paramedics and firefighters responded to almost 10,000 calls for assistance, with an average response time for emergency calls of 3 minutes and 39 seconds. This continues to be one of the best average response times in the Phoenix Metropolitan area. District services are provided from five facilities strategically positioned throughout the District. Description of the Proposed Project for Funding The proposed project involves purchasing and equipping a paramedic engine with a lifesaving CPR compression device (Lucas Device). The District opened a new fire station in January 2016 that serves newly annexed areas of the District. This lifesaving device will be used by our crews at this new fire station to provide emergency medical services (EMS) to the community. The proposed project will directly benefit the citizens of North County Fire & Medical District, neighboring communities, and anyone suffering from cardiac arrest. The Lucas Device is an automatic chest compression device which is a safe and efficient tool that standardizes chest compressions and gives patients the best possible chance for survival. In addition, automated chest compression devices allow for greater safety of EMS personnel in the back of ambulances during transport to the hospital. Paramedics do not have to stand over a patient and try to provide adequate CPR in the back of a moving ambulance. They can remain seat-belted and provide other lifesaving measures to treat the patient while the Lucas Device provides continuous and consistent chest compressions for the patient. Currently, the District has one of these devices at each of the other three District fire stations and has seen great success with their use. This is not a new project, but the requested funding will outfit our new fire station with the same lifesaving device. The other devices were obtained through a private grant from the Sun Health Foundation, but the funding provided was limited and we could not purchase a device for our new fire station due to lack of funds. Project purpose and description of how the proposed project meets Fort McDowell's funding priorities. As a public safety organization, this proposed project requested by North County Fire & Medical District directly satisfies the priority funding area focus on Public Safety as outlined. The purpose of this request is to ensure that all of our first responders have this lifesaving device available for use on any cardiac arrest victim; no matter where they are in the District. Studies have shown that this device is able to sustain a higher blood flow NORTH COUNTY FIRE & MEDICAL DISTRICT Internationally Accredited — ISO Class 1 Designated Agency to the heart and brain of a cardiac arrest victim compared to manual compressions. This device gives the cardiac arrest victim the best chance for survival and saves lives. Identification of the need grant will address, target population and number of people to be served by the project. The District protects a 45 square mile area in the Northwest Phoenix Metropolitan area. This area includes approximately 20 square miles of newly annexed area that this new station serves and would greatly enhance our ability to serve the 50,000 residents of our District and residents of surrounding communities. The Lucas Devices currently in use provide our paramedics with the latest technology to deliver the best care possible for cardiac arrest patients. Capital funding is limited and has been dedicated to building the new station and the purchase of new fire trucks and ambulances to be utilized by crews. The District's current budget lacks the funds for this project without diverting funds from other critical programs. North County Fire & Medical District is primarily funded by property taxes. Recent legislative changes make it very difficult for fire districts to increase revenue. Your funding assistance with the purchase of this Lucas Device will ensure our crews have the tools necessary to serve the public and provide the best patient care possible. Description of partners in the project; other entities providing funding and support. Applications or awards granted by other tribes/nations. There are no other organizations, partners, or funders directly participating in this project or request. As stated, funds were secured in 2014 for three other Lucas Devices; but those funds have been exhausted and do not impact this request. North County Fire & Medical District has developed this project to meet the needs of the District. However, as stated, this project will greatly benefit many people outside of our District through our EMS service provided to surrounding communities through an automatic aid agreement. The District has never received funding from any tribal/state shared revenue grant programs. The Fort McDowell and other tribal gaming facilities are well supported by the citizens of the Sun City West retirement community and we look forward to working with you on this project. Timetable for implementation of the project. The proposed timeline set for this project would include a start date of July 1, 2016 or the date the project is funded by your grant program. The finish date would be on or before June 30, 2017 (the end of our fiscal year). The timeline is flexible and the District would be open to any timeline or other changes necessary to meet your program funding guidelines. Due to the fact that this equipment would be used to equip a paramedic engine, the District's current budget will be able to provide funding for maintenance and operation. The sustainability of this project would be for the entire life of the equipment, which is expected to be over 10 years. BUDGET DETAILS - QUANTITY _ ITEM DESCRIPTION PRICE 1 each Lucas 2.2 Chest Compression System 15,220.00 1 each Lucas 2 Power Supply Cord 358.80 1 each Lucas 2 12V Vehicle Cable 137.00 1 each Lucas 2 Rechargeable Lithium Polymer Battery 712.20 1 each Zone5 (151 to 200Mi) or (243 to 322Km) 420.00 1 each Lucas Service — 1 Yr. Ship in Comprehensive Coverage 1,295.00 Sub Total 18,220.00 Estimated Shipping 157.00 (Grant Amount Request) Grand Total 18,300.00 NORTH COUNTY FIRE & MEDICAL DISTRICT Internationally Accredited - ISO Class 1 Designated Agency Welcome to Lucas CPR • LUCAS CPR • LUCASTM CPR Page 1 of 2 Your Partner LUCAS' PHYS10 in Life Support CONTROL About us I Cardiac Arrest I LUCAS CPR I For users I News & Media I Contact I English LUCAS TM CPR LUCAS'' CPR Keeping the flow up LUCAS T" clinical overview In order to be able to save the lives of sudden cardiac arrest patients and avoid neurological damage, a steady supply of oxygen to the heart and brain is LUCAS publication references necessitated. Life-sustaining circulation can be created through effective and uninterrupted chest compressions. Performing manual chest compressions of Technical info and instructions for use high quality Is both difficult and tiring, and impossible in certain situations. Accessories The quality varies depending on who provides CPR and deteriorates quickly after Latest news only one, two minutes. Product literature Large, randomized trial: LUCAS Films Chest Compression System is effective and reliable in pre- LUCAS T" Web hospital cardiac arrest training center More Automatic CPR devices saves life of woman who was clinically dead for 42 minutes More Train on LUCAS ."' 40b TrefPi * *0 v • • • 2 ; LUCAS 2 4.4 )cae-cbt LUCAS TN - standardising the quality of chest compressions The LUCAS TM Chest Compression System is a safe and efficient tool that standardises chest compressions In accordance with the latest scientific guidelines. It provides the same quality for all patients and over time, independent of transport conditions, rescuer fatigue, or variability in the experience level of the caregiver. By doing this, it frees up rescuers to focus on other life-saving tasks and creates new rescue opportunities. Safe and effective Experimental studies show that the mechanically controlled LUCAS"' compressions are able to sustain a higher blood flow to the brain and heart compared to manual compressions. The side-effects are similar as for manual compressions. LUCAS T" does compressions according to guidelines - on the middle of the chest, not more, not less. Emil, and quick The LUCAS device is easy to carry and handle, and can be applied to the patient with interruptions of manual compressions of less than 20 seconds. ""— Cypress Creek EMS applies LUCAS LUCASTn2 Now electrically powered, the life-saving medical device offers the most compact, lightweight and portable solution to maintain circulation in cardiac arrest patients. httu://www.lucas-cur.com/en/lucas cur/lucas cur 3/22/2016 Physio-Control, Inc 11811 Willows Road NE PHYSIC' P.O. Box 97006 CONTROL Redmond, WA 98073-9706 U.S.A. www.physio-control.com tel 800.442.1142 fax 800.732.0956 To EMS Coordinator Rebecca Hero Quote Number 00007584 NORTH COUNTY FIRE/MEDICAL Revision # 1 18818 N SPANISH GARDEN DR SUN CITY WEST,AZ 85375 Created Date 8/19/2015 6235445400 Sales Consultant Gary Guntman rharoftscw _fireq FOB Redmond, WA Terms All quotes subject to credit approval and the following terms and conditions NET Terms NET 30 Expiration Date 03/19/2016 Unit Unit Total Product Description Quantity List Puce Sales Discount Price Price LUCAS 2.2 Chest Compression System INCLUDES BASE UNIT WITH BACK PLATE, CARRYING BAG, 99576-000024 TWO (2) PATIENT STRAPS, STABILIZATION STRAP, 3 1 15,220.00 15,220.00 SUCTION CUPS, 1 RECHARGEABLE BATTERY, AND INSTRUCTIONS FOR USE WITH EACH DEVICE. 11576-000055 LUCAS 2 Power Supply Cord 1.00 358.80 358.80 11576-000048 LUCAS 2 12V Car Cable 1.00 137.00 137.00 11576-000039 LUCAS 2 Battery - Rechargeable Lithium Polymer (LiPo) 1.00 712.20 712 20 50999-000121 Zone5: (151 to 200M1) or (243 to 322Km) 1.00 420.00 420.00 LUCAS Service - 1 YEAR. 1,295.00 LUCAS-SICOMP-1 1.00 1,295.00 Ship In Comprehensive Coverage. Subtotal USD 18,143.00 Estimated Tax Estimated Shipping & Handling USD 157.00 Grand Total USD 18,300.00 Quote Number: 00007584 Last updated: 02/02/2016 Page 1 General information Organization Maricopa County Education Service Agency Contact First name Valerie Contact Last name Keim Contact e-mail valerie.keim@mcesa.maricopa.gov Contact phone number 6023727289 Address Street 4041 N Central Ave City Phoenix State Arizona ZIP Code 85012 From what tribe is the organization requesting the grant? Fort McDowell Yavapai Nation Total grant amount request 9,000 1 of 1 This page intentionally left blank. March 28, 2016 Contact Information: Ms. Laurie King, Director of Communication and Learning Systems Maricopa County Education Service Agency 4041 N. Central Ave, Suite 1200 Phoenix, AZ 85012 (602) 372-3704 Dear Mrs. Selena Castaneda, Description of the proposed program- New or Continuing Students that are exposed to role models in science, technology, engineering, and mathematics (STEM) fields are more likely to pursue those professions themselves. Unfortunately, many students residing in rural or underserved areas of Maricopa County do not have access to such role models. This lack of access decreases the likelihood that these kids will pursue careers in these high-tech, high-paying fields. STEM Pro Live! is an award-winning, continuing program that leverages technology to connect STEM role models to students, regardless of their physical location. Maricopa County Education Service Agency (MCESA) has developed relationships with STEM professionals that are eager to connect with students in order to inspire them to pursue STEM careers. MCESA has also created a partnership with Arizona Public Broadcast System (PBS) to live stream these professionals over the internet. Students watch a live broadcast of a STEM professional at her/his place of work, and then use a secure chat room to ask questions that are immediately answered “on air.” Description of how the proposed program or project meets one or more of Fort McDowell’s funding priorities. Education Providing STEM role models to students that otherwise may not have them has shown to increase students’ persistence in STEM subject areas. The research shows that when students understand how subject matter applies to their own experiences, they are more likely to become engaged in that subject. That engagement transfers to increased academic success in math and science. STEM Pro Live! connects the coursework they are taking to a “cool” job that really exists in close proximity to their community and creates educational motivation for students. Economic Development Arizona is struggling with finding enough high-tech workers to fill positions in STEM fields. This is especially true in underserved areas of the state. By providing students with a “picture” of what they can become, we are increasing the likelihood that they will take the necessary coursework and pursue a STEM career. This will expand our local STEM talent pool and increase our ability to attract high-tech, high-paying industries. 4041 N. Central Avenue, Ste. 1200, Phoenix AZ 85012 • Phone 602-506-3866 • Fax 602-506-3753 www.maricopa.gov/mcesa Twitter: #mcesaaz Facebook: mcesaaz Fort McDowell Yavapai Nation Grant Application March 28, 2016 Page 2 Identification of the need your grant will address, target population and number of people who will be served. Need Identified Hispanic, Native American and black youth are entering STEM professions at a disproportionately low rates. However, when youth interact positively with STEM role models, their likelihood of entering and persisting in STEM fields increases. MCESA knows in order to truly inspire students, we must feature role models that represent the populations we are trying to reach. Using technology, we can amplify the impact of underrepresented STEM professionals to reach large numbers of youth. Funding from Fort McDowell can help us make those connections. MCESA has a need to fund the technology and human capital investment it takes to produce a STEM Pro Live! Although STEM professional role models volunteer their time, the video production and communication equipment and staff are contracted. Target Population Although STEM Pro Live! has a reach well outside of Arizona (we have connected with students as far away as Hawaii, Germany, and England), our target population is rural middle school students. The content of the programming is selected to best engage underrepresented STEM field populations (Native American, Black, Hispanic, and female). Number of People Served STEM Pro Live! reaches an average of about 1,000 students an episode. However, the number increases or decreases depending on the topic and timing of school schedules. MCESA is asking Fort McDowell to fund four episodes with a projection of serving 3,500-4,000 students. Partners in the program STEM Pro Live! has been broadcasting monthly since November 2014. The streaming service for each episode has been provided through a partnership with PBS. The video production and communication equipment and staff have been supported by different partners depending on the episode. Past partners have been Intel and the U.S. Department of Education. MCESA is hopeful that Fort McDowell will chose to partner on four upcoming episodes. Timeline for implementation STEM Pro Live! has monthly broadcasts, as funding is available. The funding from this request would guarantee four months of STEM Pro Live! between October 1, 2016, and September 30, 2017. It takes two weeks on average to schedule, coordinate, and broadcast each STEM Pro Live! episode. MCESA prepares the STEM professional for the broadcast in advance. How quickly an episode is produced is heavily dependent on the STEM professional’s and MCESA staff’s schedules. Budget to Broadcast 4 STEM Pro Live! Events MCESA will coordinate, produce, and broadcast four STEM Pro Live events at a total cost of $9,000. The $2,250 cost for each broadcast consists of the following: Recruitment and training of STEM Professionals $990 / broadcast Live streaming service $500 / broadcast Rental of video equipment $400 / broadcast Development of teacher and student resources $300 /broadcast Videographer services to coordinate and produce the broadcast $60 / broadcast Per Broadcast Total= $2,250 Grand Total for 4 broadcasts = $9,000 Each STEM Pro Live! Broadcast requires coordination, scheduling, and training. MCESA staff will be used to recruit and train the STEM professionals for the live broadcast. Training includes what will be expected during the broadcast and how to relate to K-12 students. MCESA staff travel to each STEM professional's work site to record an overview video to show the professional's day-to-day experience and returns to broadcast the question and answer session live. MCESA has a partnership with the local PBS affiliate to stream the live broadcast, and needs to rent video equipment for each broadcast. Created: 02/08/2016 Last updated: 04/01/2016 Page 1 General information Organization National Kidney Foundation of Arizona Contact First name James Contact Last name Ivie Contact e-mail jivie@azkidney.org Contact phone number (602) 840-1644 Address Street 360 E. Coronado Rd., Suite 180 City Phoenix State Arizona ZIP Code 85004 From what tribe is the organization requesting the grant? Fort McDowell Yavapai Nation Total grant amount request 19,740 1 of 1 e:'qjiI, ri) DeDartmenz of Treasv ur 12A,ji L!,.[6 Int'erwa Revenue Servici; P.O. Box 2508, Room 4010 In reply refer to: 4077550277 Cincinnati OH 45201 July 06, 2010 LTR 4168C 0 86-6052343 000000 00 00032602 BODC: TE NATIONAL KIDNEY FOUNDATION OF ARIZONA 4203 E INDIAN SCHOOL RD STE 140 PHOENIX AZ 85018-5341 124930 Employer Identification Number: 86-6052343 Person to Contact: Ms Benjamin Toll Free Telephone Number: 1-877-829-5500 Dear Taxpayer: This is in response to your Apr. 22, 2010, request for information regarding your tax-exempt status. Our records indicate that your organization was recognized as exempt under section 501(c)(3) of the Internal Revenue Code in a determination letter issued in July 1964. Our records also indicate that you are not a private foundation within the meaning of section 509(a) of the Code because you are described in section 509(a)(2). 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. Beginning with the organization's sixth taxable year and all succeeding years, it must meet one of the public support tests under section 170(b)(1)(A)(vi) or section 509(a)(2) as reported on Schedule A of the Form 990. If your organization does not meet the public support test for two consecutive years, it is required to file Form 990-PF, Return of Private Foundation, for the second tax year that the organization failed to meet the support test and will be reclassified as a private foundation. If you have any questions, please call us at the telephone number shown in the heading of this letter. Sincerely yours, Cindy Thomas Manager, ED Determinations 360 E. Coronado Road Suite 180 Phoenix, AZ 85004 National Kidney Tel 602.840.1644 of Fax 602.840.2360 FoundationTM Arizona www.azkidney.org Ms. Selena Castaneda May 1, 2016 OFFICERS Tribal Secretary Chairman Fort McDowell Yavapai Nation Tribal Council John F. Rausch, MD P.O. Box 17779 Secretary Fountain Hills, Arizona, 85269 Isaac Kahn Re: Prop 202 Grant Application: Requesting $19,740 Treasurer Pamela A. Paul Local Government Entity Contact: Organization applying for funding: BOARD OF DIRECTORS National Kidney Foundation of Arizona Brian K. Altman Amanda Nash James lvie, PhD, LCSW Victoria A. Bellomo, Esq. Maricopa County Government Relations Director of Patient Services Betsy Born beck Shari Bombeck 301 W. Jefferson, 10th Floor 360 E. Coronado Rd., Suite 180 Lynn A. Boschee Phoenix, AZ 85003 Phoenix, AZ 85004 Robert S. Cohen, MD (602) 506-4485 (602) 840-1644 Keith Killough nasha001@mail.maricopa.gov jivie@azkidney.org Michael Krassner Leonard J. McDonald Sen. Robert Meza Dear Ms. Castaneda, Bruce Z. Morgenstern, MD Adrian Ruiz Karny Stefan, Mpa, CFRE Path to Wellness (PTW) is a continuing program that promotes health education, Kathleen A. Taddie screening, and self-management skill development in order to strengthen the Charlie Thomas, LCSW prevention, early detection and successful management of diabetes, heart and Daniel F. Walton, MD Andre F. Wilson kidney disease in at-risk communities. The PTW program cycles through three recurring phases of 1) outreach to target populations; 2) free comprehensive MEDICAL ADVISORY BOARD screenings for chronic disease; and 3) follow-up services that facilitate application Chairman Bruce Z. Morgenstern, MD for insurance coverage, connection to a medical home, and enrollment in workshops that teach chronic disease self-management skills. IN MEMORIAM Carol G. Bombeck Erma Bombeck Ultimately, early identification of people who are at risk is associated with the Melvin L. Cohen, MD implementation of healthy lifestyle changes; more timely referral into the health Kenneth E. Johnson, Sr., MD care system for treatment; and a reduction in the burden of disease and health Daniel J. Potter, MD Glenna Jones Shapiro care costs, undiagnosed conditions, and associated complications. PTW seeks to remove barriers that tend to isolate ethnically, linguistically and culturally diverse CHIEF EXECUTIVE OFFICER communities from participation. One way to do this is by translating educational Jeffrey D. Neff materials, promotional messaging, and screening forms into the languages of minority populations that are at higher risk for "triple threat" chronic diseases. Despite increased access to health insurance through the Affordable Care Act, Arizona has a higher rate of uninsured people (13.6%) than the national uninsured rate of 10.4%. The population that will benefit from this proposal are those who are most at-risk for chronic disease with limited access to healthcare and/or who are not proficient in English. The PTW model of recurring cycles of outreach, screening and follow-up is designed to offer multiple opportunities to engage with minority groups who are more likely to delay care and refuse recommended services due to mistrust and misunderstanding. The translation of materials into languages other than English and the use of multilingual helpers intends to build trust and mutual understanding. PTW program materials have already been translated into Spanish and bilingual volunteers help with all phases of the program cycle. Our goal now is to translate PTW into three additional languages, produce educational videos about "triple threat" chronic diseases (in English, Spanish and three more languages), and engage with interpreter services to facilitate the participation of minority groups that remain underserved due to a language barrier. Heart disease, diabetes and kidney disease are among the leading killers of chronic disease patients in Arizona, and Centers for Disease Control and Prevention data show that American Indians, African Americans, Hispanics and Asians are disproportionately impacted by these diseases. This "triple threat" is of particular concern in poor, ethnic minority, uninsured and underserved populations, with higher incidence rates and prevalence of advanced stages of these chronic conditions. Most patients do not learn about the relationships between these conditions until their most advanced stages, which underscores the need to concentrate resources in communities disproportionately impacted by these diseases. Underserved populations often contend with more barriers to health care resources than the mainstream population due to language differences and cultural traits that constrain communication, trust and understanding. An important goal is to reach the most vulnerable, underserved and underinsured segments of the population, in their own languages, in order to engage them with enduring access to health resources. PTW is currently delivered in English and Spanish. Our goal for the next year is to translate and deliver the program in three additional languages. This proposal requests funding from the Fort McDowell Yavapai Nation to cover the costs involved for two of those languages. Our current model has established quarterly cycles of outreach, screenings, and follow-up. Multi-media outreach efforts touch thousands of people and the screenings are designed to accommodate up to 200 people per event. Over the span of a year, up to 800 people could be screened and tens of thousands reached through public education and promotional efforts. The National Kidney Foundation of Arizona (NKF AZ) partners with the Cardio Renal Society of America (CRSA) to deliver the PTW program on a quarterly basis. CRSA has secured funding to deliver quarterly screenings throughout the year from Sanofi Pharmaceuticals, which includes limited funding for materials in Spanish. No funding has been secured for translation or interpreter services in other languages. NKF AZ is currently applying to the Gila River Indian Community for support of our transportation assistance program for dialysis patients. Quarterly cycles of outreach, screening, and follow-up have already begun in 2016 and are currently planned through the summer of 2017. Projected Budget for Path to Wellness Program from 7/1/2016 to 6/30/2017 Expenditure Category Total Budget Amount Requested From Ft. McDowell Yavapai Nation Translation Services $8,500 $5,100 Video Production Services 4,300 2,580 Printing and Signage 1,900 1,140 Outreach to Target Populations 7,700 4,620 Interpreter Services 10,500 6,300 Totals: $32,900 $19,740 Thank you for considering this application. / / 7/ 4-James !vie, PhD, LCSW Director of Patient Services Last updated: 03/07/2016 Page 1 General information Organization New Pathways for Youth Contact First name Jeremiah Contact Last name Smith Contact e-mail jeremiah.smith@everyonesagrantwriter.org Contact phone number 6024055330 Address Street 1001 E Pierce St City Phoenix State AZ ZIP Code 85006 From what tribe is the organization requesting the grant? Fort McDowell Yavapai Nation Total grant amount request 25000 1 of 1 CO IRS Dopartment Internal Revenue of the Treasury Service In reply refer to: 0423291515 OGDEN UT 84201-0046 Nov. 15, 2012 LTR 3910C 0 86-0615007 000000 00 00033789 BODC: TE NEW PATHWAYS FOR YOUTH INC 1001 E PIERCE ST PHOENIX AZ 85006-3342 011627 Dear Taxpayer: Thank you for the inquiry dated Oct. 03, 2012, Your employer identification number is 86-0615007. Please keep this number in your permanent records. You should enter your name and EIN, exactly as shown above, on all federal tax forms that require its use, and on any related correspondence or documents. Our records indicate that your organization is exempt under Section 501(c) 3 of the Internal Revenue Code. If you have any questions, please call us toll free at 1-877-829-5500. If you prefer, you may write to us at the address shown at the top of the first page of this letter. If you write, please include a copy of this letter and indicate your telephone number and the hours you can be reached in the spaces below. You should keep a copy of this letter for your records. Telephone Number Hours Sincerely yours, Sheila Bronson Dept. Manager, Code & Edit/Entity 5 Enclosure(s): Copy of this letter local government to accept/disburse funds non-profit organization Maricopa County New Pathways for Youth 301 W. Jefferson St., 10th Floor 1001 E Pierce St. Phoenix, AZ 85003 Phoenix, AZ 85006 Amanda Nash Christy McClendon Legislative Analyst, Government Relations President, CEO (602) 506-4485 (602) 422-9268 03/24/2016 Mrs. Selena Castaneda Fort McDowell Yavapai Nation Tribal Council Secretary P.O. Box 17779 Fountain Hills, AZ 85269 Dear Mrs. Castaneda, Description of proposed program (is this a new or continuing program): New Pathways for Youth's mission is to empower youth to fulfill their potential through mentoring and life skill development. At NPFY, youth transform their lives, participating in 1:1 transformative mentoring programs, evidence-based life skills curriculum, service learning projects, and college/career readiness support. Since 1989, mentors and staff have inspired over 5,500 at-risk and homeless youth throughout the Phoenix metro area to see beyond their current circumstances and break the vicious cycles of poverty, homelessness, and violence. New Pathways for Youth began as a grassroots organization in the Garfield neighborhood, one of the most impoverished and dangerous neighborhoods in the United States. The Garfield neighborhood reports 355 crimes per square mile, compared to an average of 34 statewide, and 40 nationally. The per capita income of $7,800 is one of the lowest in the country, typically ranking in the poorest ten neighborhoods in America. Today the Transformative Mentoring Program, serves over 500 youth each year (throughout the year); matching screened and trained volunteer adult mentors with youth in need of the skills to build healthy relationships, succeed in school, and develop a vision of their own future broader than what they see in their neighborhood. Every youth who participates in our Transformative Mentoring Program receives: • One-on-one mentoring with a well-trained, caring volunteer adult; • Evidence-based life skill development workshops; • Enrichment activities that expand learning through interactive projects and experiences; • Service learning projects that foster civic responsibility and build academic resumes; • Age-appropriate, intensive 4-day retreats and camps; • College application and scholarship support; and • Family and parenting programs that change the cycle of violence in the community. Purpose of program and how it meets one or more of Fort McDowell’s funding priorities: Fort McDowell Yavapai Nation’s priorities include health, education, public safety, and economic and community development. By focusing on continued education and healthy relationships, New Pathways combats cycles of poverty, chronic health issues, and destructive behavior (drugs, alcohol, crime, violence) in the families and neighborhoods we partner. Youth participating in the Transformative Mentoring Program graduate high school, pursue post-secondary, and enter the workforce at higher rates than youth with similar backgrounds who do not participate in transformative mentoring. Need addressed by proposed program, target population, and number of people served: We believe all children can make a positive impact on their community. Unfortunately, an estimated 247,140 children in Maricopa County living in low-income homes, including 30,000 homeless youth, never receive an opportunity to reach their potential. Youth living in low-income households are five times more likely to drop out of school. Research shows that students without a high school diploma suffer a multitude of lifelong consequences including lower earning potential and higher risk for incarceration. New Pathways' Transformative Mentoring Program addresses the major social and psychological factors that promote high-risk behaviors. The Transformative Mentoring Program's primary emphasis, supported by research, is on the development of important personal and social skills. Central to these skills is an adult mentor, whose role goes far beyond companionship and guidance. Last year, 525 youth (151 homeless youth) actively participated in a transformative mentoring relationship and regularly attended life-altering workshops. Each year nearly 500 volunteer adult mentors commit over 80,000 hours of service, working directly with youth. The rate of high school completion and college enrollment for youth in the Transformative Mentoring Program is nearly twice the rate of similar students who do not receive the care and support of a trusted adult in their life. Partners in the program (including other tribes/nations): New Pathways for Youth is a model of and thought leader in transformative mentoring. The frequency and intensity of the interventions is much greater than the service of traditional (assistive) mentoring programs. We are the only provider of such transformative mentoring to youth living in homeless shelters and transitional housing. In order to work with such vulnerable youth, especially in places as sensitive as shelters, our relationships with partners like UMOM, Homeward Bound, and Save the Family, and nearby school districts, are much more than an agreement on paper. We work closely with all of our partners to create a collaborative plan of service to best position each youth for success. Integrated in that plan are the volunteer mentors and NPFY staff members who create relationships with youth and their families that last for years, sometimes decades. There is, quite frankly, no other organization doing what we do. Timetable for implementation of proposed program: The Transformative Mentoring Program is a year-round, on-going program. Services and projects are scheduled and executed throughout the school year and summer to best serve the youth. An investment of $25,000 from the Fort McDowell Yavapai Nation, will assist New Pathways to serve youth in the highest need communities build the skills and relationships necessary to succeed in the classroom and in life. Gratefully, Christy McClendon Transformative College/Career Social/Emotional Expense Description Subtotal Mentoring Readiness Workshops Salaries and ERE $759,508 $658,797 $64,836 $35,875 Salaries and Wages Salaries and Wages $600,388 $520,578 $51,253 $28,557 Employee Benefits unemployment $53,558 $46,523 $4,572 $2,463 Workers compensation workers comp $14,796 $12,874 $1,263 $659 Federal Payroll taxes ERE-FICA and Medicare $45,994 $39,934 $3,926 $2,134 state payroll taxes $0 $0 $0 $0 Group Insurnance $37,933 $32,957 $3,238 $1,738 Cell Phone Reimbursement Phone Reimburse $6,839 $5,931 $584 $324 Contract Service Expenses $66,519 $57,737 $5,678 $3,103 Payroll Service Contract-Payroll $3,542 $3,052 $302 $188 Audit and Accounting Contract-Audit.Accounting $0 $0 Legal Contract-Legal $0 $0 $0 $0 Evaluation Contract-Evaluation $12,300 $10,575 $1,050 $675 Program Contract-Program $0 $0 $0 $0 Fund Development/Marketing Contract-FD.Marketing $50,676 $44,110 $4,326 $2,240 Donated Professional Services (in-kind) DonatedProfessionalSvcs $0 $0 $0 $0 NonPersonnel Expenses $59,287 $51,057 $4,545 $3,684 Office Supplies OfficeSupplies $5,740 $4,970 $490 $280 Program Supplies ProgramSupplies $13,784 $11,865 $1,177 $743 Telephone, Internet TelephoneInternet $8,315 $7,201 $710 $404 Program Achievement/Recognition Awards ProgramAchievementRecog $275 -$350 $275 $350 Snack/Food Snack.Food $14,850 $13,250 $500 $1,100 Postage and Shipping Postage $3,403 $2,964 $291 $149 Printing and Copying Printing $12,919 $11,158 $1,103 $658 Facility/Camp Rental Facility.CampRental $0 $0 $0 $0 Donated Materials and Supplies (In-kind) Doanted Materials.Supplies $0 $0 $0 $0 Facility and Equipment Expenses $23,711 $20,632 $2,024 $1,054 Licenses and Permits Licenses.Permits $0 $0 $0 $0 Security Fees Security $295 $256 $25 $14 Software and Equipment Software $1,468 $1,268 $125 $75 Maintenance and Repair Maintenance.Repair $8,143 $7,108 $695 $340 Utilities Utilities $12,066 $10,493 $1,030 $543 Depreciation Depreciation $0 $0 $0 $0 Property taxes Property Taxes $1,738 $1,508 $148 $82 Donated Equipment (in-kind) DonatedEquipment $0 $0 $0 $0 Travel and Meetings $14,965 $13,018 $1,278 $670 Travel Expenses TravelExpenses $3,321 $2,890 $284 $148 Bus/Rental Bus.AutoRental $0 $0 $0 $0 Mileage and automobile Mileage&AutoExpense $7,626 $6,653 $651 $322 Conferences/Conventions, meetings Conference.Meetings $4,018 $3,475 $343 $200 Donated Training Services (In-kind) DonatedTraining $0 $0 $0 $0 Other $65,737 $58,405 $4,734 $2,597 Fingerprinting Fingerprinting $10,276 $10,276 $0 $0 Insurance Insurance $12,760 $11,086 $1,089 $585 Membership Dues & Subscriptions MemberDues.Subscriptions $3,041 $2,623 $260 $159 Staff and volunteer development Staff.VolDevelopment $15,539 $13,491 $1,327 $722 Outside computer/technology services ComputerTechServices $9,523 $8,306 $813 $405 Advertising Advertising $3,362 $2,886 $287 $189 Fundraising Fundraising $0 $0 $0 $0 Community/Volunteer Relations Community.VolRelations $6,601 $5,726 $564 $312 Bank Fees BankFees $4,633 $4,013 $396 $225 Merchant Fees Merchant Fees $0 $0 $0 $0 Other Donated Materials/Services (In-kind) DonatedOther $0 $0 $0 $0 Total Expense $989,727 $859,645 $83,095 $46,983 Last updated: 03/11/2016 Page 1 General information Organization Maricopa Community Colleges Foundat Contact First name Mary Contact Last name O'Connor Contact e-mail mary.oconnor@domail.maricopa.edu Contact phone number 4807318403 Address Street 2419 W. 14th Street City Tempe State Arizona ZIP Code 85281 From what tribe is the organization requesting the grant? Fort McDowell Yavapai Nation Total grant amount request 300,000.00 1 of 1 Internal Revenue Service Department of the Treasury P. 0 Box 2508 Cincinnati, OH 45201 Person to Contact: Date August 6, 2003 Cassandra Jackson 31-07417 Customer Service Representative Mancopa County Community College District Foundation Toil Free Telephone Number: 2419 West 14 th Street 800 a rn to 6:30 p Tri EST Tempe, AZ 85281-6941 877-829.5500 Fax Number: 513-283-3756 Federal Identification Number: 86-0327449 Dear Sir or Madam: This is in response to your request of July 7, 2003 regarding your organization's tax-exempt status In April 1977 we issued a determination letter that recognized your organization as exempt from federal income tax Our records Indicate that your organization is currently exempt under section 501(c)(3) of the Internal Revenue Code Based on information subsequently submitted, we classified your organization as one that Is not a private Inundation within the meaning of section 509(a) of the Code because it is an organization described in section(s) 509(a)(1) and 170(b)(1)(A)(vi) This classification was based on the assumption that your organization's operations would continue as stated in the application if your organization's sources of support, or its character, method of operations, or purposes have changed, please let us know so we can consider the effect of the change on the exempt status and foundation status of your organization Your organization is required to file Form 990, Return of Organization exempt from Income Tax, only if its gross receipts each year are normally more than $25,000 If a return is required, it must be filed by the 15th day of the fifth month after the end of the organization's annual accounting period, The law Imposes a penalty of $20 a day, up to a maximum of $10,000, when a return Is filed late, unless there Is reaSonable cause for the delay All exempt organizations (unless specifically excluded) are liable for taxes under the Federal Insurance Contributions Act (social security taxes) on remuneration of $100 or more paid to each employee during a calendar year Your organization is not liable for the tax imposed under the Federal Unemployment Tax Act (FUTA) Organizations that are not private foundations are not subject to the excise taxes under Chapter 42 of the Code. However, these organizations are not automatically exempt from other federal excise taxes. Donors may deduct contributions to your organization as -provided In section 170 of the Code Bequests, legacies, devises, transfers, or gifts to your organizatien or for its use are deductible for federal estate and gift tax purposes if they meet the applicable provisions of sections 2055, 2106, and 2522 of the Code -2- Maricopa County Community Collage District Foundation 86-0327449 Your organization is not required to the federal Income tax returns unless it is subject to the tax on unrelated business income under section 511 of the Code If your organization is subject to this lax, it must file an income tax return on the Form 990-T, Exempt Organization gusinese 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 613 of the Code Section 8104 of the Internal Revenue Code 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 -The law also requires organizations that received recognition of exemption on July 15, 1987, or later, 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 Organizations that received recognition of exemption before July 16, 1987, and had a copy of their exemption application on July 15, 1987, are 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 For additional information on disclosure requirements, please refer to Internal Revenue Bulletin 1999 - 17 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, John E RickettS, Director, TEJGE Customer Account Services The Maricopa Community Colleges Foundation is a 501C3 non-profit organization whose mission is to support the students and programs of all of the colleges in the Maricopa Community Colleges District through fundraising in the private sector. Governmental Relationship and Contacts The Foundation has had a relationship with Maricopa County for several years. The County supports the Foundation by being the fiduciaiy for any 12% tribal funding the Foundation receives. The primary contact for this grant is Mary O'Connor, Interim President & CEO for the Maricopa Community Colleges Foundation, 2419 W. 14" Street, Tempe, AZ 85281-6942. (480) 731-8403 or (480) 543-8643. Mary.oeonnor@domail maricopa.edu The contact at Marieopa County is Melody Henderson, Maricopa County Government Relations, 301 W. Jefferson, 10th Floor, Phoenix, AZ 85003. (602) 506-2798. Proposed Project There are multiple projects and goals within the proposal because we have multiple colleges and each college was allowed to submit a project. The final proposal contains 3 main projects — a central American Indian student success project, a Health Care Clinic including a mobile clinic and dental assistant internships, The first two projects are existing and the third is new. The total request for funding from Yavapai is $300,000. The proposed project satisfies one or more of the priority funding areas identified by the Yavapai Indian Community: Education-the programs in this area recognize that it is imperative that we work collectively and responsibly to meet the life-long learning needs of our culturally diverse students and communities. The Healthcare Clinic serves as training ground for more than 200 of Gateway Community College's allied health students and the mobile clinic will double this number. Community Education-dental internships are designed to augment graduates' learning. Healthcare- the healthcare clinic offers specialized services that community health clinics do not offer, such as physical therapy, respiratory therapy and diagnostic sonography. Needs/problems The healthcare clinic, mobile clinic and dental internships address two critical community needs- qualified, well-trained healthcare works and specialty healthcare for those who cannot afford it. The Education programs will be conducted on all ten Maricopa Community College campuses, which serve over 250,000 students annually. Many of our activities will be available and attended by community stakeholders and residents. Partners Tribal Education Officers, surrounding school districts, American Indian agencies, Mountain Park Health Center, Wellness Center at UMOM New Day Center, BEACH Clinic at Educare Arizona, ASU, NAU, Marieopa Integrated Health System, American Heart Association, MS Society, American Diabetes Association, American Lung Association, Cancer Treatment Centers of America. Timeline Timelines are flexible, but ideally would start in January 2017 and be completed by December 2017. Additional information regarding the programs applied for in this grant proposal: GateWay Community College (GWCC) is seeking a gift to expand its successful state licensed, pro bono Healthcare United at Gate Way (HUG) Clinic using a mobile model. This Mobile HUG expansion will enable the HUG Clinic to double both the number of patients treated, and the number of student healthcare workers receive hands-on patient care experience in the Physical Therapist Assisting (PTA), Diagnostic Medical Sonography (DMS) and Respiratory Therapy programs. The HUG Clinic was created on the campus of Gate Way Community College in 2013 as an innovative and much needed response to two different but symbiotic community needs: providing allied health students with hands-on patient care experience, and delivering pro-bono specialty healthcare services to uninsured and low income community members. With assistance of faculty, who are also licensed professionals in their fields, GWCC students provide services including diagnostic ultrasound, physical therapy and respiratory care. The goals of the clinic are to: 1. Integrate classroom material with practical application 2. Provide students with additional clinical training opportunities 3. Enhance the ready-to-work skill set of students, reducing on-the-job training needed. 4. Provide pro-bono specialty health care services to the community Traditionally, students have received their "hands-on" training by using human simulators and role playing with other students. Many do not have human patient interaction until they are placed in a clinical rotation toward the end of their education. At the same time students are faced with increased pressure to be workforce ready upon graduation as budgetary constraints and limited staffing in hospitals and clinics reduce the opportunity for on-the-job training. The HUG Clinic also provides students with the rare experience of practicing workplace soft skills such as communication, time management, problem solving, flexibility and adaptability. These skills are often overlooked by the education system but are critical to successful patient interaction and career success. Meanwhile, although many free, community clinics offer basic healthcare services, GateWay's community partners, including the Multiple Sclerosis Society, American Lung Association and Cancer Treatment Centers of America, reported that many of their patients are unable to afford follow-up care for chronic diseases and injuries. The HUG Clinic is able to efficiently and capably fill this unique niche, providing ongoing treatment for patients who require physical therapy and those with COPD, multiple sclerosis, asthma, lymphedema, and diabetes. In fact, the HUG Clinic is the only pro bono clinic in the country that provides this unique combination of services. The Mobile Model Since HUG opened in 2013 more than 1,800 patient appointments have been logged and 200 students have received clinical experience. By the end of HUG's first year in operation the Clinic was already operating at full capacity and it became apparent that space constraints within the small clinic would prohibit any expansion of services within those walls. The idea for a Mobile HUG Clinic began to take shape. Although GateWay's central location and proximity to the light rail make it a convenient location for patients to seek treatment, HUG staff found that transportation can be a barrier to health care, particularly for chronically ill and injured patients. In addition, most hourly wage earners are unable to miss work to attend appointments. Mobile HUG's flexible hours of operation and travelling physical presence is designed to help eliminate these healthcare barriers. The on-site HUG Clinic will continue to operate, but Mobile HUG will allow HUG to serve the community in these additional ways: • The mobile model will enable HUG to expand the scope of its services by partnering with our sister colleges within the Maricopa Community Colleges District who offer different, but complimentary patient care services, including Therapeutic Massage (Phoenix College), Exercise Science (Scottsdale Community College) and Behavioral Health (Glendale Community College). Our first mobile MCCD partnership is with Chandler Gilbert Community College's Dietetic Technician, Registered (DTR) program. The importance of diet in relation to health cannot be underestimated, and by incorporating a portable kitchen into our Mobile HUG Clinic, Chandler-Gilbert students can add another layer of support and care to our existing services. DRT students will also contribute to an online patient portal that can he accessed by all HUG patients and the public. The portal will contain nutrition information specific to patients' medical needs as well as general nutrition tips and recipes of interest to the special patient populations receiving HUG's services. • In collaboration with our community partner organizations and sister colleges Mobile HUG will provide special population care days. These single-topic sessions will offer cross-disciplinary care for patients with diabetes, obesity, multiple sclerosis, COPD, etc, Patient needs, including nutrition, exercise & physical therapy and diagnostic ultrasound will be addressed in one session. In addition, Mobile HUG will conduct several general education sessions on topics such as staying healthy during flu season, pre-natal needs & exercise & nutrition for seniors. In the summer of 2015 GWCC launched a two-hour pilot Mobile HUG Clinic. GateWay nursing students administered flu shots to the public in partnership with Chandler Regional Hospital. This two hour Mobile HUG Clinic was extremely successful and more than 100 community members received their vaccinations. Some of the lessons learned from this pilot project include: • The response was far greater than we expected. We could easily have provided vaccines to twice the number of people. • There is a great need for holistic family care. Many parents brought their children to the Mobile HUG Flu Shot Clinic hoping to have them vaccinated. Because HUG had a limited number of doses for adults only, many children had to be turned away. • GateWay's Mobile HUG Clinic project satisfies both the Gila River Indian Community's priority areas of Education and Healthcare. • Education • The Clinic currently serves as an onsite training ground for more than 200 of Gate Way's PTA, DMS and Respiratory Therapy students. We expect the Mobile HUG Clinic to double the opportunities for students to train in this critically needed environment. Increased competition in the marketplace, combined with budgetary constraints and limited staffing in hospitals, medical centers, and doctors' offices, has made clinical placements required for appropriate training and likens= certification harder and harder to come by. • Another educational benefit of the HUG Clinic is the opportunity for students to interact with others in an inter-professional education (IPE) environment, An inter-professional environment allows students with expertise in different modalities the chance to work together in an actual healthcare setting. This approach to health care delivery has gained much more attention in recent years for its effectiveness in improving patient care, hospital processes, working relationships between health care professionals, and recruitment and retention. There is a growing body of literature suggesting that inter- professional collaboration improves patient and worker satisfaction, improves coordinated access to appropriate clinicians and resources, and reduces costs associated with redundant medical testing and clinical errors. There is also mounting evidence that IPE allows healthcare workers to feel more confident in their roles and abilities, to be more aware and respectful of the roles and responsibilities of others, and to better collaborate in clinical decision making. The collaborative process is now seen as a way to optimize patient care outcomes while simultaneously reducing costs. (The Impact of Structured Interprofessional Education, on Health Care Professional Students' Perceptions of Collaboration in a Clinical. Setting, Pinto et al., 2012). • GateWay, the University of Arizona College of Medicine/Phoenix. (UA), Northern Arizona University (NAU) and Arizona State University (ASU) are also HUG Clinic collaborators. UA Medical Residents and Fellows do rotations through the Clinic as do Physician Assistant and • Physical Therapy students from NAU. Students from the ASU Biomedical Informatics Department are building an online patient portal for the HUG Clinic. Students studying wellness and kinesiology at Arizona State University also work hands-on with HUG Clinic patients. These partnerships provide another critical level of patient service and provide students with opportunities to learn from each other. The HUG Clinic is the only pro bono community health center in the Valley simultaneously treating patients while training technical level through graduate level medical education students in the same clinical setting. • Healthcare • Currently, in the neighborhood surrounding Gate Way, there are four community health clinics that provide primary care services, The HUG Clinic partners with these entities to maximize resources and ensure that efforts are not duplicated. The existing clinics are Mountain Park Health. Center, the Wellness Center at UMOM New Day Center, the BEACH Clinic at Educare Arizona, and Wesley Health Center. These clinics do not offer specialized services such as Physical Therapy Assisting, Respiratory Therapy, and Diagnostic Medical Sonography that are offered through GateWay's HUG Clinic. Likewise, GateWay's HUG Clinic does not offer a full array of primary care services. Patients of FIUG's partner community clinics are referred to the HUG Clinic for needed services, providing a continuum of care. • According to the 2012 Maricopa County Community Health Assessment Public Health Strategic Priorities report, 1 in 6 Maricopa County residents are uninsured, delaying or not receiving health care due to cost. Partnerships between GateWay, UMOM, MIHS, Mountain Park Health Center, Wesley Clinic and Educare Arizona, provide an avenue for residents to receive ongoing specialty care services outside of an emergency room setting. The Mobile HUG project will address two critical community needs: 1) qualified, well trained healthcare workers and, 2) specialty healthcare services for those who cannot otherwise afford it. Data from the most recent US Census (2010) shows the following in GateWay's direct service area of 85034: • Median household income significantly below state average ($14,547 compared to $46,709) • 55.8% of residents had an income below the federal poverty level • Median house value below state average ($121,300 compared to $153,800) • Black race population percentage significantly above state average • Hispanic race population percentage above state average • 51,9% of residents speak Spanish at home HUG Clinic services are available to the general public but the majority of patients are referred by our partner organizations. The Clinic is licensed by the Arizona Department of Health Services and, since its opening in 2013, nearly 2000 patient visits have been conducted, which is equivalent to more than $200,000 in pro bono care. We estimated that, with the addition of the Mobile HUG Clinic and other modalities through partnerships with other M:CCD healthcare programs, the HUG Clinic will conduct more than 4,000 patient appointments per year, saving the healthcare system hundreds of thousands of dollars annually. Mobile HUG will also provide additional inter-professional clinical training opportunities for 200 additional students per year. Gate Way is well positioned to take on this challenge. It is part of GateWay's mission to offer responsive educational services to support student success, and the HUG Clinic is a perfect example of the college's ability to be flexible and responsive to the changing environment so that students can achieve their educational goals for the benefit of all Arizonans. The HUG Clinic at GateWay is a continuing program. The Clinic was licensed by the Arizona Department of Health Services in 2013 and since its inception, more than 750 patients have been treated in the Clinic. Because of the nature of the illnesses HUG treats, most of these patients return for multiple treatment sessions. Mobile HUG will be ready to launch within 45 days of funding. Planning for Mobile HUG special population days during 2017 has already begun as follows: 1) Prenatal Day: Partners: UMOM, UofA, ASU, NAU, Chandler-Gilbert Nutrition 2) Autism Day: Partners: UofA, ASU, NAU, Chandler-Gilbert Nutrition, Gateway Childcare Center, Hope Street Group School for Autism. 3) MUltiple Sclerosis Day: MS Society, tjoa, A.SU, Chandler-Gilbert 'Nutrition, NAU 4) Stroke Day: American Heart Association, UofA., ASU, Chandler-Gilbert Nutrition, NAU 5) Diabetes Day: American Diabetes Association, UofA, ASU, Chandler-Gilbert Nutrition, NAU 6) Holistic Family Health Day: Mountain Park Health Center, MIHS, UofA, ASU, Chandler-Gilbert Nutrition, NAU 7) Cardiac Health Day: American Heart Association, UofA, ASU, Chandler-Gilbert Nutrition, NAU 8) Oncology Day: Cancer Treatment Centers of America, UofA, ASU, Chandler-Gilbert Nutrition, NAU 9) COPD Day: American Lung Association, UoiA, ASU, Chandler-Gilbert Nutrition, NAU 10) Developmental Day: Phoenix Children's Hospital, UMOM, UofA, ASU, Chandler- Gilbert Nutrition, NAU 11) Obesity Day: Gila River, MIHS, CTofA, ASU, Chandler-Gilbert Nutrition, NAU 12) Parkinson's Day: Parkinson's Foundation, UofA, ASU, Chandler-Gilbert Nutrition, NAU The success of the Mobile HUG Clinic will be determined by: • Number of GateWay students who are able to obtain clinical training hours through the HUG Clinic instead of in an external setting • Number of allied health and nursing students from other Maricopa Community Colleges who receive training through the HUG Clinic • Number of clinical hours students are able to obtain at the Clinic based on hours of operation and staffing capacity • Number of patients served • Number of uninsured and underinsured patients served • Amount of pro bono care provided to the community on an annual basis, saving the local health care system time and money Patient data is collected during the intake process. These metrics will establish benchmarks for Mobile HUG Clinic operations. Data will be collected at the end of each semester over the grant period to measure outcomes and make adjustments as needed in areas such as location, program topics, accessibility of services as dictated by patient needs, allied health and nursing program enrollment, and needs of partner organizations. Rio Salado Dental Internships: Rio Salado College (RSC) proposes piloting a paid internship program for students who graduate from the Clinical Dental Assisting certificate program. This pilot project, administered post- program, would provide RSC dental assisting graduates an additional opportunity for a clinical experience in order to hone the skills they have learned through the program and apply them in a hands-on setting under the expertise of a licensed professional. This experience would immensely benefit graduates because it reinforces their learning before fully entering the workforce, ultimately enabling them to feel more confident in their skills. By completing this additional internship, graduates will have earned up to 500 hours of hands-on, clinical practice. Goal: Increase participants' confidence in their knowledge, skills, and abilities. Interns will be paired with a mentor who will support them through the internship, offering encouragement, addressing common questions and concerns, and overall, helping to boost the intern's confidence in their skills. A key role of the mentor will be to provide guidance and coach interns as they prepare for the Dental Assisting National Board (DANB) Certified Dental Assistant (CDAO) exam. These exams can be difficult to pass; according to latest DANB figures, the national passing rate is 72%. The pilot will be administered over two years and will serve up to 10 participants (students who have graduated from the RSC Clinical Dental Assisting certificate program). RSC will develop an internship application process and share this with program graduates. An individual with a dental background will serve as the mentor. Each internship will cover 200 hours (approximately five weeks) of clinical practice, in addition to the 300 hour requirement of the program. RSC plans to build internship partnerships with dental practices across the state, but in particular, is interested in placing graduates at a Community Health Center (CHC). A CHC would be an ideal host for an internship program because it would provide interns with a broad array of dental experience and exposure to procedures that they might not otherwise receive. Often. times, students are not aware of internship opportunities at CHCs, or opt to take their internship at a dental practice near their residence. In addition, this internship pilot will cover the costs for the Dental Assisting National Board (DANB) Certified Dental Assistant (CDAO) exam. In order to earn the national CDA® credential, dental assistants must pass the CDA® exam, made up of three component exams. While not a requirement of R.SC's program or employment, successfully completing the exams leads to a national certification which increases graduates' employability and wages. Finally, a key component of this pilot project is the mentor role. As previously described, the mentor will offer guidance and coach interns through both the internship and the DANB CDA1) exam. Some responsibilities of the mentor include coaching the interns on the transition to the workfbrce, sharing effective study habit strategies and skills (that can be used for the exams), and supporting interns by providing feedback that encourages them to have a successful experience during their internships. American Indian Support Programs: The goal of the following projects and activities are to support American Indian students, as well as other special populations, in achieving their academic and personal goals. All proposed projects and planned goals will be overseen by the District American Indian Outreach (AIO) office but the projects will be conducted at the 10 colleges within MCCCD. Mesa Community College's American Indian Institute and Scottsdale Community College's American Indian Program will support their colleges as they have a specific program on campus to oversee their projects. The proposed projects/activities are as follows: I. Increase college readiness by partnering with local high schools and tribal conununitites to improve opportunities for exposure to higher education prior to high school graduation. 2. Create a college education bridge that will: (a) focus on encouraging American Indian high school students to pursue a college education; (b) help parents learn about the benefits of a college education; and (c) assist American Indian college students to connect to student support services. The program will also guide them to participate in new student orientations, tutoring, mentoring, counseling, student clubs, workshops, and special events 3. Create a summer bridge program for youth in 6 th through 8th grade in an effort to familiarize them to a college campus and provide them with a college experience at a younger age. 4. Offer activities that integrate culture and diversity to increase opportunities to learn about different cultures at the campus. 5. Fund American Indian students, as well as faculty and staff that work with American Indian populations, to attend conferences and leadership opportunities. 6. Support current students attending college by focusing on retention activities that will increase their connection to their campus, faculty, and staff for degree completion and transfer. 7. Incorporate more programmatic efforts to support academic success through club involvement, campus activities, new-to-college support services, and to specifically work with Maricopa Community College's Male and Female Minority Success Initiatives. Internal Revenue Service Department of the Treasury P.O Box 2508 Cincinnati, 011 45201 Person to Contact: Date: August 6, 2003 Cassandra Jackson 31.07417 Maneopa County Community College District loundation Customer Service Representative 2419 West 14th Sheet Toll Free Telephone Number: Tempe, AZ 85281-6941 8:00 tn to 6:30p in EST 877.829-5500 Fax Number: 513-203-3758 Federal Identification Number: 86-0327949 Dear Sir or Madam: "this Is in response to your request of July 7, 2003 regarding your organization's tax-exempt status In April 1977 we issued a determination letter that recognized your organization as exempt from federal income tax Our records indicate that your organization is currently exempt under section 501(c)(3) of the Internal Revenue Code Based on information subsequently submitted, we classified your organization as one that is not a private foundation within the meaning of section 509(a) of the Code because it Is an organization described in section(s) 509(a)(1) and 170(b)(1)(A)(v1) 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 end 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 flied by the 15th day of the fifth month after the end of the organization's annual accounting period The taw 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 forthe 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, 1-1014,ever, these organizations are not automatically exempt from other federal excise taxes Donors may deduct contributions to your organization as provided In section 170 of the Code. Bequests, legacies, devises, transfers, or gifts to your organization or for its Use are deductible for federal estate and gift tax purposes if they meet the applicable provisions of sections 2055, 2106, and 2522 of the Code -2- Maricopa County Community Collage District Foundation 88-0327449 Your organization is not required to file federal Income tax returns unless It is subject fo the tax on unrelated business income under section 511 of the Code if your organization is subject to this tax, it must file an Income tax return on the Form 990-T, Exempt Organization Business income Tax Return In this letter we are not determining whether any of your organization's present or proposed activities are unrelated trade or business as defined in section 513 of the Code Section 6104 of the internal Revenue Code 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 The law also requires organizations that received recognition of exemption on July 15, 1987, or later, 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 Organizations that received recognition of exemption before July 15, 1987, and had a copy of their exemption application on July 15, 1987, are also required to make available for public Inspection a copy of the exemption application, any supporting documents and the exemption fetter to any individual who requests such documents in person or in writing For additional Information on disclosure requirements, please refer to Internal Revenue Bulletin 1099 - 17 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, John E RickettS, Director, TE/GE Customer Account Services Last updated: 03/28/2016 Page 1 General information Organization Marc Community Resources, Inc. Contact First name John Contact Last name Moore Contact e-mail john.moore@marccr.com Contact phone number 480-969-3800 Address Street 924 N Country Club Drive City Mesa State Arizona ZIP Code 85201 From what tribe is the organization requesting the grant? Fort McDowell Yavapai Nation Total grant amount request 100,000.00 1 of 1 la IRS Department of the Treasury Internal Revenue Service P.O. Box 2508 In reply refer to: 0248464840 Cincinnati OH 45201 Dec. 14, 2012 LTR 4168C E0 86-0137109 000000 00 00017132 BODC: TE MARC COMMUNITY RESOURCES INC % RANDY GRAY 924 N CNTRY CLB DR MESA AZ 85201-4108 037242 Employer Identification Number: 86-0137109 Person to Contact: Mrs. Dudley Toll Free Telephone Number: 1-877-829-5500 Dear Taxpayer: This is in response to your Dec. 05, 2012, request for information regarding your tax-exempt status. Our records indicate that you were recognized as exempt under section 501(c)(03) of the Internal Revenue Code in a determination letter issued in MARCH 1965. Our records also indicate that you are not a private foundation within the meaning of section 509(a) of the Code because you are described in section(s) 509(a)(1) and 170(b)(1)(A)(vi). 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. Please refer to our website www.irs.gov/eo for information regarding filing requirements. Specifically, section 6033(j) of the Code provides that failure to file an annual information return for three consecutive years results in revocation of tax-exempt status as of the filing due date of the third return for organizations required to file. We will publish a list of organizations whose tax-exempt status was revoked under section 6033(j) of the Code on our website beginning in early 2011. 0248464840 Dec. 14, 2012 LTR 4168C E0 86-0137109 000000 00 00017133 MARC COMMUNITY RESOURCES INC % RANDY GRAY 924 N CNTRY CLB DR MESA AZ 85201-4108 If you have any questions, please call us at the telephone number shown in the heading of this letter. Sincerely yours, A4404,1e "14014.-, Richard McKee, Department Manager Accounts Management Operations 114 11"cnriul Community Resources Inc. Enriching Lives Since 1957 March 28, 2016 Amanda Nash Maricopa County 301 W Jefferson Street Phoenix, AZ 85003 Dear Ms. Nash: This letter serves as an intent to apply for the 2016 Arizona Benefits Fund Grant from the Fort McDowell Yavapai Nation. Please find below information regarding the grant. DATE OF APPLICATION: 3/28/2016 NAME OF PROGRAM: Applied Behavioral Analysis (ABA) Program for Adults with Disabilities REQUESTED GRANT AMOUNT: $100,000 NAME AND CONTACT INFORMATION FOR GOVERNMENT ENTITY/ORGANIZATION: APPLYING FOR GRANT FUNDS: Organization: Marc Community Resources, Inc. Primary Contact: John Moore, President & CEO Address: 924 North Country Club Drive Mesa, AZ 85201 Email: john.mooreQmarccr.com Phone: 480-969-3800, ext. 277 MUNICIPALITY INFORMATION: Name of County: Maricopa County Board of Supervisor's Chairman: Clint L. Hickman Mailing Address: 301 W Jefferson Street, 10th Floor Phoenix, AZ 85003 Following this intent to apply is the narrative for this grant request. Attached is the budget along with other relevant attachments that will provide a fuller understanding of the program. Thank you for your consideration of this grant. Sincerely, (56 ohn Moore President & CEO Authorized Signature Date Maricopa County som 4.4 rarr 924 North Country Club Drive • Mesa, Arizona 85201 • 480.969.3800 • F 480.644.1557 • MarcCR.com Fort McDowell Yavapai Nation Grant Narrative for Applied Behavior Analysis (ABA) The Organization and Collaboration Marc is a not-for-profit organization that has been providing a comprehensive continuum of educational, vocational, day activity, community living, affordable housing, outpatient clinic services, psychiatric intervention, in-home supports and other related programs for people with developmental disabilities and behavioral health challenges since 1957. Today we assist approximately 9,000 individuals and their families in pursuing the highest level of independence, based upon principles of choice, inclusion and community integration. Over the past five years, Marc has served approximately 100 Native Americans each year. All the individuals we serve are low income and have been medically determined to be at risk for institutionalization, including assisted living, nursing care, hospitals and jails. Our services, including supported housing, employment, health and wellness, day programs, counseling and family support, help keep the family unit intact and help individuals with severe medical and behavioral challenges to pursue a meaningful life and the greatest level of self-sufficiency possible. Marc was just named the “nonprofit of the year” by the Mesa Chamber of Commerce. Marc has a long history of collaboration and support with the City of Mesa where it was founded and maintains its headquarters. Marc employees serve on the City of Mesa Human Relations committee and are actively involved on the City’s Housing our Heroes initiative to provide supporting services to homeless veterans. Marc has a contract with the City of Mesa to employ individuals with disabilities to make sandwiches for police detainees. Marc receives funding each year from Mesa United Way. For the past ten years, Marc has received City of Mesa Human Services funding to support its employment program and received Community Development Block Grant (CDBG) funding for several capital campaigns. The City of Mesa used Neighborhood Stabilization Program (NSP) funding to purchase and rehabilitate four different bankrupt housing units in blighted neighborhoods and then deeded the homes to Marc to use in its programs and rent to low income citizens. The campus that Marc calls its headquarters was deeded to Marc by the City of Mesa. It is also noteworthy that Maricopa County has also supported Marc, deeding a five acre park to our agency and providing revenue sharing funding and CDBG grant support over the last 35 years. A core element of all Marc’s programs is to work directly with families and connect them to the entire behavioral health system for additional issues that need to be addressed. Faith-based communities regularly donate time, services and items essential for community living, as well as providing opportunities for our service recipients to participate in meaningful volunteer activities. In 2014, the Salt River Pima Maricopa Indian Community approved a $100,000 grant to help build a senior center and day program for individuals with developmental disabilities in Mesa. This construction project has been successfully completed. The Program ABA targets the Fort McDowell Yavapai Nation priority funding for healthcare, specifically behavioral healthcare. We know that 10% of individuals in the Maricopa County public Medicaid system consume 80% of the available funding. According to system of care leaders at the Division of Developmental Disabilities and Regional Behavioral Health Authority (MMIC), one common characteristic of this high cost, high need Medicaid population is intense, aggressive and socially unacceptable behaviors that prevent stable housing, employment, social networks and positive family relationships. ABA is an evidence-based intervention shown to be effective at replacing maladaptive behaviors with positive behaviors. Currently, the ABA services provided by board certified behavior analysts in Arizona are almost exclusively focused on children with Autism. There is a severe shortage of ABA practitioners who provide these services in home environments. Parents have great difficulty accessing these essential services and experience significant stress in dealing with these types of behavior problems. For the first time in Arizona, with the funding support of Fort McDowell Yavapai Nation, Marc will expand its ABA program to be accessible to adults in the public developmental disability system (DD) in Maricopa County. To be in the DD system, individuals must be poor, have minimal assets and be medically determined to be at risk for institutionalization. We will serve 70 individuals in the first full year of this new program. The program will document progress by tracking a number of outcomes, including the number of people served and the behavior change goals attained due to the ABA interventions. Current Funding and Sustainability The Federal government, through HUD, the Centers for Medicare/Medicaid Services (CMS), the Substance Abuse and Mental Health Service Administration (SAMHSA) and state/county public disability service agencies are all focused on innovative services to address this high cost, high need population, especially through the deployment of effective evidence-based practices. Marc started a small ABA program in 2014 and used the positive outcome results to convince Mercy Maricopa Integrated Care, Maricopa County’s Regional Behavioral Health Authority to fund the majority of a $450,000 ABA program for individuals with serious mental illness enrolled in the public RBHA system, starting in 2016. With the help of funding from the Fort McDowell Yavapai Nation, Marc will expand its program to serve individuals in the public developmental disability system and use positive life-altering outcomes to obtain permanent contracts with the Division of Developmental Disabilities, AHCCCS, health plans and other health insurance agencies. See also the narrative in the Project Budget Detail attached. The timeline for the program is flexible. Our ideal goal is to start the program no later than October 1, 2016, and serve 70 individuals through September 30, 2017. A sense of urgency stems from the fact that Marc gets calls from desperate families that hear about our program only to find out that the Division of Developmental Disabilities or their AHCCCS medical plan does not pay for such services at this time. We will start earlier if funding is secured prior to October 1. Fort McDowell Yavapai Nation Grant Application Grant Cycle 2016 Project Budget Budget Period: October 1, 2016 to September 30, 2017 Amount requested from Fort Amount requested Proposed Budget Expense (list each budget McDowell Yavapai or secured from In Kind # item) Nation other funders Contributions Total Budget 1 Two Board Certified Behavior Analysts $65,000 $260,000 $0 $325,000 2 Positive Behavior Support Specialist $15,000 $109,000 $0 $124,000 3 Quality and Data Support Specialist $0 $27,000 $0 $27,000 ERE Expenses (employer taxes, employee 4 benefits) $20,000 $99,000 $0 $119,000 5 Computers and Phones $0 $15,000 $0 $15,000 6 Mileage $0 $18,000 $0 $18,000 7 Occupancy $0 $25,000 $0 $25,000 8 $0 9 $0 10 $0 11 $0 12 $0 13 $0 14 $0 15 $0 16 $0 17 $0 Total Budget $100,000 $553,000 $0 $653,000 Notes: 1 Marc has used over $200,000 of its own funding to-date to create a pilot ABA program for individuals with serious mental illness and now, primarily due to the recent permanent funding from MMIC, the Regional Behavioral Health Authority in Maricopa County, Marc has secured total funding of about $450,000 or about 69% of the total need. Marc seeks another $200,000 from other funding sources, including Fort McDowell Yavapai Nation, to offset the cost of all additional positions needed to serve individuals with severe disabilities served by the Division of Developmental Disabilities. Once funded, the total program budget will be about $650,000. 2 Board Certified Applied Behavior Analysts command a salary of $65,000, minimally. Five staff total $325,000. 3 The Positive Behavior Support Specialist is a person training in ABA principles that can support and train families to implement a behavior plan. A trained PBSS staff costs $31,000 per year and four staff, as required by this program, cost $124,000. 4 The Quality and Data Support Analyst provides critical data analysis, outcome reporting, compliance and administrative support. 5 ERE costs include FICA taxes, employee benefits, workers’ compensation and state unemployment. It generally runs about 25% of total wages. 6 New staff require computer clinical record system licensing and cell phones. We assume $750 per direct care staff for annual licensing costs and cell phone costs per person, with all functionality, including Internet access, totalling $880. Total cost per person is $1,630 and for nine employees costs about $15,000. 7 For Mileage, we assume each of the three employees will travel 100 miles per week for 45 weeks in a year and be reimbursed at 45 cents per mile. This totals $2,025 per direct care staff or about $18,000 in total mileage reimbursement per year. 8 Space costs per person is about $2,500, including rent, utilities, property taxes, common area manintence expenses, property insurance and janitorial. The total cost for ten staff is, therefore, about $25,000. What is ABA? Applied Behavior Analysis (ABA) is a scientific discipline that utilizes behavioral principles to help individuals make meaningful and socially significant behavior changes. The ABA approach involves studying the relation- ship between the individual and their environment to determine what occasions and maintains problem be- havior. ABA practice utilizes data to make important clinical decisions that help guide services and help lead the individual to achieve meaningful outcomes. ABA has been proven successful in the treatment of individu- al’s with serious mental illness, developmental disabilities, addiction recovery, dementia care, traumatic brain injuries, eating disorders, and the list goes on! What is a BCBA? A Board Certified Behavior Analyst (BCBA) is the appropriate title and credential for a professional qualified to engage in the design and implementation activities of ABA. BCBA’s are certified by the Behavior Analyst Certification Board and must meet specific standards that include the completion of graduate level education and coursework related ABA as well as 1500 hours of supervision prior to sitting for the board’s BCBA examination. In the state of Arizona, in addition to the BCBA credential, one must go through the process of being licensed through the Arizona Board of Psychology Examiners. Individuals who com- plete this process are then referred to as Licensed Behavior Analysts (LBA). So what does the Marc ABA Department do? The Marc ABA Department conducts Functional Behavioral Assessments (FBAs) to determine the function of target behaviors and develop plans for reducing problem behaviors and increasing positive behaviors. Once the BCBA has conducted the FBA, a behavior support guide is developed. The BCBA then trains the staff, family, or primary caregivers on how to implement the plan to facilitate the behavior change. The presence of staff, family, or primary caregivers who are willing and able to imple- ment the plan are vital in the process of behavior change. The BCBA’s utilize positive reinforcement strategies in addition to a variety of proactive measures to motivate individuals during the behavior change process. The BCBA’s support, training, and consultation are on-going throughout the process to aid service providers and family members with maintaining improved behavioral gains. Common Abbreviations: ABA– Applied Behavior Analysis BCBA—Board Certified Behavior Analyst DBI—Direct Behavior Interventionist LBA—Licensed Behavior Analyst FBA—Functional Behavioral Assessment BSG—Behavior Support Guide ABA Services Fast Facts ABA is not Counseling. While behavior analysts do spend time communicating with individuals receiving services, their role isn’t to process situations as one would with a counselor. A BCBA does not meet with a client for an hour once a week and “talk” about their issues. BCBAs are not Behavior Coaches. The role of the BCBA is to assess, develop, and train on the behavior support guide. The BCBA may model intervention strategies, but they are not the actual individuals who will carry out the plan with the individ- ual on a day to day basis. This role is met by staff at the individual’s placement, family members, primary caregivers, and in some cases, staff that are put in place by Marc Community Resources. Marc’s Direct Behavior Interventionists (DBI): During the assessment process, the BCBA will determine if the current staff to client ratio is appropriate to successfully implement the behavior support guide. If the BCBA determines that the individ- ual would benefit from additional staff support, Marc will provide a Direct Behavior Interventionist (DBI) to assist the BCBA in implementing the behavior support guide. The FBA will outline the number of hours needed from the DBI and will be discussed with the service provider, family/caregiver and team. ABA is a time Limited Service. When referring individuals for ABA services it is important to understand that the services are time limited. The BCBA will work with the clinical team to determine goals for appropriate discharge criteria early in the process. Once criteria are met, the case will transition into maintenance status and the discharge process will begin. ABA is Evidence Based. ABA is not a new approach. There are decades of research supporting the value and application of ABA in many environments. ABA is Data Driven. The BCBAs make decisions based on the data collected, not feelings or clinical instincts. Data is contin- uously collected and analyzed while receiving ABA services. Any statement of progress is supported by data, reflecting a reduction in behaviors or an increase in the desired positive behaviors. A word about the FBA. It is important to understand that conducting an FBA is a process rather than a single procedure or test. This is markedly different from taking an individual to a psychologist or counselor to be assessed. In other disciplines, the assessment results may be achieved in 1-2 visits to the behavioral health professional. A main part of the FBA process involves the BCBA going to observe the individual referred for treatment in their natural environment. The process of col- lecting data for an FBA also involves review of documentation and conducting interviews. The coordination and time for this process, as well as the time to compile all of the information into a formal report can take up to a month or two. Who implements the BSG? It is important to be aware of the BCBA’s role with the BSG. The BSG will outline how to imple- ment the intervention techniques to facilitate positive behavior change for the individual. The responsible party for carry- ing out the BSG is not the BCBA. The BCBA’s role is to train and model the BSG for others to implement. Examples of indi- viduals who may be responsible parties are direct support staff, family members, caregivers, clinical team members, or DBI, etc. Let’s make recovery happen together! We want to talk to you! Schedule the ABA Department to come out and present to your staff to educate them about ABA, determining appropriate cases for ABA services, and all about our referral and treatment process. For more information please contact: Erin Juarez, M.A., BCBA, LBA Director of Behavior Analytic Services Nikki Gates, MA, RBT Marc Community Resources, Inc. ABA Support Specialist Behavioral Health Services Office: (480) 969-3800 x363 Office: (480) 969-3800 x1330 /Mobile: (480) 267-6697 Mobile: (480) 433-8296 nichole.gates@marccr.com Erin.Juarez@marccr.com Story To provide a real example, imagine a family who had exhausted all options for their loved one. Imagine reaching a point of helplessness and feeling like the only hope for your loved one to survive would be to institutionalize them for the rest of their lives. This is what everyone, including the psychiatrist and case managers, thought would be the plight of K. K was diagnosed with two of the most debilitating psychiatric conditions, paranoid schizophrenia and polydipsia. After six psychiatric inpatient stays, placement at a facility specifically designed for her diagnosis of polydipsia, and failed results on the strongest anti-psychotic medication on the market, everyone was sure the only option for K was to place her into the Arizona State Hospital. The clinical team put in a request for 24 hour one-to-one support in a transitional assistance program (TAP) through Marc Community Resources. The TAP management right away observed the potential for the ABA Department at Marc to help K. The ABA Department conducted a functional behavioral assessment and developed a behavior support guide for K. They trained staff on the plan to ensure consistency and clinical integrity. The family was included in the plan from inception and was very supportive of all that has been requested of them. The direct support staff has been exceptional in their consistency of following the plan, as observed by the department regularly monitoring all of the components of the treatment. We are elated to report through evidence of data and staff and family reports that K has much improved in the occurrence and severity of her symptoms for both diagnoses. The family reports that they have never seen K this happy. K is not only engaging in more independent care now, but will soon be moving toward social activities in the community. A life spared from being institutionalized is the gift that ABA has supported. The ABA Department of Marc Community Resources is indeed proud of K’s progress.