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Created: 02/20/2015 Last updated: 05/18/2015 Page 1 General information Organization Leukemia & Lymphoma Society Contact First name Naomi Contact Last name Martinez Contact e-mail naomi.martinez@lls.org Contact phone number 6025677612 Address Street 3877 N 7th St Ste 300 City phoenix State az ZIP Code 85014 From what tribe is the organization requesting the grant? Tohono O’odham Nation Total grant amount request 25000 The Gila River Indian Community offers multi-year awards. If your organization is requesting a multi-year grant for this project or program, enter the amount to be requested each year. Amount Year 1 Year 2 Year 3 Year 4 Year 5 1 of 1 Proposal to Tohono O’odham Nation A) Explain the perceived need and how the proposal will address that need. The Arizona Chapter of The Leukemia & Lymphoma Society provides financial and educational services to persons in Arizona with leukemia, lymphoma, myeloma, and Hodgkin’s disease. There are approximately 3,000 new cases in Arizona each year, 76% of which are children. LLS recognizes that finding cures is not enough; we need to ensure that patients have access to the treatments they need to live longer, better, healthier lives. LLS is dedicated to removing barriers to care and is the voice for blood cancer patients, working with regulatory bodies (i.e., FDA) and state and federal legislatures to drive policies that accelerate the development and approval of innovative treatments. We ensure patients have access to quality, affordable, coordinated care and is the leading source of free blood cancer information, education and support for patients, families and healthcare professionals. Services include national and community-based programs including travel assistance, co-pay assistance, clinical-trial search and peer- to-peer support. The Arizona Chapter of the Leukemia & Lymphoma Society (LLS) provides services to blood cancer patients living in the 15 counties of Arizona. LLS's Patient Travel Assistance Program, provides financial assistance to people diagnosed with a blood cancer who struggle to pay for treatment-related transportation and/or lodging costs (e.g., parking, tolls, gasoline, plane or train tickets, temporary housing). Qualified patients receive an annual stipend of $500 to help cover these expenses. Applicants to the program must meet the following eligibility criteria: • Applicants (patients) must be US citizens or permanent residents; and • Applicants must have a confirmed blood cancer diagnosis; and • Applicants must meet financial eligibility criteria defined as an annual household income at or below 500% of the Federal Poverty Level. This grant will be 100% restricted to LLS’s Patient Travel Assistance Program and will aid blood cancer patients with financial need in the state of Arizona by helping to cover treatment-related travel and lodging expenses. LLS has recognized this as an area of unmet patient need and a significant barrier to access for many patients. The Tohono O’odham Nation’s support will help LLS break down this financial barrier and allow more patients to access the care they need. B) Describe the population who will benefit fro the proposal if approved The Travel Assistance Program (TAP) will serve blood cancer patients residing within the 15 counties in the state of Arizona. We have initiated the program because patient feedback consistently identified financial assistance as an area of unmet need. Often a lack of financial resources represents a significant barrier to access to necessary care. Patients often express fear and concern over the immense financial burden that comes with a cancer diagnosis. While LLS does offer co-pay assistance to help with insurance 1 co-pay obligations and premiums, the expenses of traveling to and from treatments can be quite substantial and these expenses are not covered under the co-pay program. LLS will target this assistance to those who need it most by requiring an attestation of financial need. LLS regularly receives calls from patients in crisis who cannot move forward with potentially life-saving treatments because they cannot afford to pay for transportation to get to their providers, e.g., doctors, hospitals, transplant centers, and research or clinical trial centers. As patients increasingly need to travel to see a specialist for treatment, follow-up, or special tests to make the most of their chance to fight for life, these costs and burdens are only increasing. Some patients have no transplant center in their state or surrounding area and they are faced with the challenges of flying to a treatment center and residing far from home for an extended period of time. Other patients who are immuno-compromised cannot take public transportation. Taxi fares or the cost of gas, tolls and parking fees to get to numerous appointments over weeks, months or years is a great burden. Regardless of geography, the out-of-pocket costs associated with traveling for care are prohibitive for many patients and reduces the funds available for basic needs such as food, shelter and utilities. This is especially true of patients in Arizona’s rural communities. Oncologists and practice managers rely heavily on advocacy organizations like LLS to provide reimbursement for treatment-related expenses like transportation to assist patients’ access to care (2012 Kantar Health Oncologist and Practice Manager Surveys). LLS is viewed by healthcare professionals as a crucial resource that provides education and support to patients. Addressing the logistics of getting to and from doctors’ appointments and securing temporary housing when appropriate for certain treatment protocols is a crucial piece of the treatment planning process. If transportation/lodging needs are not met, issues with compliance and adherence to 2 treatment regimens arise, which can affect survival outcomes for blood cancer patients. Further, travel obstacles can have a direct impact on clinical trial enrollment. LLS has received numerous reports from our LLS-funded investigators stating that transportation challenges prevented appropriate candidates from enrolling in clinical trials. All of these factors affirm the value and necessity of LLS’s Patient Travel Assistance Program to help patients better manage a life-threatening blood cancer diagnosis. Our experience with the Travel Assistance Program confirms this—LLS has already distributed nearly $300,000 in Travel Assistance to patients nationwide this year and receives an average of 75 applications for assistance per day. C) Include a budget of requested funds with the total amount clearly notated Patient Travel Assistance Program Proposed Budget Budget Expense Amount From Amount from Total Budget Tohono O’odham Other Sources Patient Financial $25,000 $175,000 $200,000 Tranportation Aid Total Budget $25,000 $175,000 $200,000 We are requesting $25,000 in grant funding from the Tohono O’odham Nation. D) List any funding requests that have been made for this or substantially related proposals and provide the status of those requests. Grant Total Amount Status Ft. Mc Dowell Grant $25,000 pending status Gila River Grant $25,000 pending status E) Indicate whether the entity has already received a 12% distribution from the Tohono O’odham Nation or other AZ tribes along with amount and date awarded. Gila River Casino Light the Night Sponsorship-$25,000 (6/2014) Gila River Casino Light the Night Sponsorship-$25,000 (04/2015) Yavapai Prescott Indian Tribe $3,100 (2011) Yavapai Prescott Indian Tribe $300 (2011) F) Identify a designated contact person and alternate contact person for follow- up, including e-mail address, phone number, mailing address, and fax number for these persons Contact Person: Naomi Martinez, Development Assistant, Leukemia & Lymphoma Society 3877 N. 7th Street #300 Phoenix, AZ 85014 602-567-7612 phone, 602-567-7601 fax naomi.martinez@lls.org (email) Alternate: Jim Brewer, Executive Director, Leukemia & Lymphoma Society 3 3877 N. 7th Street #300 Phoenix AZ 85014 602-567-7260 phone, 602-567-7601 fax jim.brewer@lls.org (email) G) Indicate which priority area (from the above list) the proposal falls under. The proposal to Tohono O’odham fall under the priority of (b) healthcare. H) If the proposal is from a non-profit organization, include the name of the city, town, or county an agreement will be made if funds are granted. Phoenix, Arizona Maricopa County- Amanda Nash, Legislative Analyst 4 Last updated: 05/18/2015 Page 1 General information Organization Sun City West Fire District Contact First name Tim Contact Last name Van Scoter Contact e-mail tvanscoter@scwfire.org 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? Tohono O’odham Nation Total grant amount request 149,589 The Gila River Indian Community offers multi-year awards. If your organization is requesting a multi-year grant for this project or program, enter the amount to be requested each year. Amount Year 1 Year 2 Year 3 Year 4 Year 5 1 of 1 Internationally Accredited ~ Class 1 Fire Department SUN CITY WEST FIRE DISTRICT 18818 N. Spanish Garden Drive, Sun City West, Arizona 85375 Business: (623) 544-5400 Fax: (623) 544-5455 – www.scwfire.org May 18, 2015 Chairman Ned Norris Jr. Tohono O’odham Nation P.O. Box 837 Sells, Arizona 85634 Attention: Lanez Valisto RE: 12% Gaming Distribution Proposal Chairman Norris: The Sun City West Fire District is pleased to present this application (proposal) for the Tohono O’odham Nation 12% Gaming Distribution Program. This is the first time that Sun City West has applied for your distribution program. The Sun City West Fire District is committed to providing public safety services to Sun City West and the surrounding communities. This request will greatly enhance our ability to provide critical services and continue our commitment to serving the citizens of not just our community, but the entire state. With recent changes to our service area, through annexations of rural areas outside of the community of Sun City West, it has become critically important to replace an aging Type 6 Brush Truck/Wildland Engine to enhance our ability to fight wildland fires and also to gain access to remote/rugged locations within the District. Our hope is that with your assistance, we will be able to complete this project for the community we serve. We look forward to working with you on this project. Sincerely, Robert Biscoe Fire Chief The SCWFD was formed in 1981 and has grown to protect roughly 45,000 residents within an approximate 45 square mile area including the communities of Sun City West, Corte Bella, Cross River, Dos Rios, Rancho Cabrillo, Rio Sierra, Pinnacle Peak County Island and many other unincorporated portions of Maricopa County. Tohono O’odham Nation 12% Gaming Distribution - Grant Proposal/Application Submitted By: Sun City West Fire District The Sun City West Fire District serves the northwest Phoenix metropolitan area with 142 uniformed, civilian and volunteer employees. The District was formed in 1981 and has grown to protect roughly 50,000 residents within an approximate 45 square mile area. The Fire District provides fire protection, medical service, hazardous materials response, technical rescue, disaster preparedness, public assistance/non-emergency response, public education, and other supportive services to the community and surrounding areas from five facilities strategically positioned throughout the District. The District’s Mission Statement states “As a team of highly trained and dedicated professionals, it is our mission to provide the highest standard of emergency and non-emergency services to all those who may seek our help. We are a service provider and will faithfully provide these vital services, promptly and safely.” The Sun City West Fire 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 2014, the Fire District responded to approximately 8,500 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. The District has five fundamental strategic goals which include: Community Outreach & Partnerships, Financial Sustainability, Resource Development & Deployment, Personnel Development and Infrastructure. This proposed grant will directly contribute to these goals and will greatly enhance the District’s ability to serve and protect our community. a) Explain the perceived need and explain how the proposal will address that need. The goals of the grant proposal include purchasing and equipping a new Type 6 Brush Truck/Wildland Engine to replace an aging brush truck that the District has operated for more than a decade. The current brush truck is the only truck of its type that the District currently owns and operates. The Fire District protects a 45 square mile area northwest of Phoenix. This response area includes approximately 20 square miles that is more rural in nature with large areas of desert and mountainous terrain containing hundreds of private homes and structures. Many of these areas have unimproved roads and are not well suited for emergency response by the District’s larger fire apparatus. The District’s ability to respond in these areas is limited by our current lack of smaller brush trucks such as the one proposed in this project. Continued slow economic growth, high foreclosure rates, and significant increases in mandated expenses (pensions, health insurance, etc.) have rendered the District incapable of providing funding for this vital piece of apparatus. To add to these financial issues, the Arizona Legislature has now restricted fire district funding with a tax rate cap, levy increase cap, reduced commercial tax rates and most recently, a constitutional amendment limiting all annual property value increases. Also, as you have likely been impacted by as well, Phoenix metro was one of the areas of the nation that was hardest hit by the housing market collapse. Today, 92% of the District’s value is comprised of residential properties. Residential 1 property values within the District suffered a 44% decline amounting to a $1.5 billion total loss in value to the District over the past 5 years. b) Describe the population who will benefit from the proposal if approved. The District serves a diverse geographic area. A portion of the District is rural county with lower income families. However, 35,000 or 77% of the District’s residents are senior citizens with an average age of 76 with 88% of these residents on a fixed income per 2010 Census. In addition to their elevated demand for emergency medical assistance, these seniors are very vulnerable to fires or other disasters due to limited mobility and hearing and visual impairments. These traits place them in a high-risk category per the U.S. Fire Administration. The requested funding will greatly enhance the District’s ability to serve all of our 50,000 residents. The cost-benefit for the District’s mostly senior population is that the grant funds will allow us to provide the necessary apparatus to provide adequate fire protection thereby reducing risks. The proposed brush truck would also be available for response to assist all fire departments in the greater Phoenix Metropolitan area through our existing Automatic and Mutual aid agreements (the District responded to assist our neighboring fire departments over 600 times last year). In addition, the new brush truck would be placed on the state-wide wildland resource list and would be available for fire response to other areas within the state to assist other agencies including the Tohono O’odham Nation. The proposed project will directly benefit Sun City West residents, neighboring communities, state/federal/tribal partners and all the potential communities served when this new brush truck is deployed on large Wildland fire emergencies. Overall, the new brush truck will increase the level of safety and protection for our residents and our firefighters. c) Include a budget for the requested funds, with the total amount requested clearly notated. Proposed Budget Expense Amount Type 6 Brush Truck/Wildland Engine $149,589 Equipment, Hose, Training $8,655 Total Project Costs $158,244 Total Amount Requested from $149,589 Tohono O’odham Nation This proposal is for the purchase of a Type 6 Brush Truck/Wildland Engine and equipment. Any and all costs of maintaining and operating the truck will be the responsibility of the Sun City West Fire District and will be programed into our annual operating budget. Due to the fact that this new brush truck would be replacing an existing brush truck that is more than 10 years old and that would be removed from frontline service; the District’s current budget for maintaining and operating the existing brush truck will be reallocated to the new brush truck. The sustainability of this proposal would be for the entire life of the vehicle. 2 d) List any other funding requests that have been made for this or substantially related proposals and provide the status of those requests. The Sun City West Fire District currently has no other funding requests for any projects related to this proposal. e) Indicate whether the entity has already received a 12% distribution from the Tohono O’odham Nation or other Arizona tribes, along with the amount and date awarded. This is the first time that the Sun City West Fire District has applied for the Tohono O’odham Nation 12% Gaming Distribution. The District has never received funding from any tribal/state grant programs. The 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. f) Designated contact person and alternative contact person: Designated Contact: Alternative Contact: Tim Van Scoter, Assistant Chief Mary Dalton, Assistant Chief 18818 N. Spanish Garden Drive 18818 N. Spanish Garden Drive Sun City West, Arizona 85375 Sun City West, Arizona 85375 Email: tvanscoter@scwfire.org Email: mdalton@scwfire.org Office: (623) 544-5400 Office: (623) 544-5400 Mobile: (602) 881-2733 Mobile: (928) 713-4581 Facsimile: (623) 544-5455 Facsimile: (623) 544-5455 g) Indicate which priority area the proposal falls under: As a public safety organization, this proposal directly relates to Distribution Priority Area C - Public Safety. As stated in our mission statement, public safety is the District’s number one priority. h) If the proposal is from a non-profit organization, include the name of the city, town, or county an agreement will be made with if funds are granted. A letter from the governmental entity acknowledging its agreement to work with the non-profit is necessary for the initial proposal. However, it is necessary for those non-profits selected to receive grant funding. As an Arizona fire district, the Sun City West Fire District is working through the Maricopa County Government Relations Office Grant Application Process. If funded, an agreement will be initiated with Maricopa County to pass the awarded funds to the District. 3 Last updated: 05/18/2015 Page 1 General information Organization Heard Museum Contact First name Dianne Contact Last name Baker Contact e-mail dbaker@heard.org Contact phone number 602-251-0203 Address Street 2301 N. Central Ave. City Phoenix State AZ ZIP Code 85004 From what tribe is the organization requesting the grant? Tohono O’odham Nation Total grant amount request 25,000.00 The Gila River Indian Community offers multi-year awards. If your organization is requesting a multi-year grant for this project or program, enter the amount to be requested each year. Amount Gila River Indian Community Year 1 25,000.00 Gila River Indian Community Year 2 Gila River Indian Community Year 3 Gila River Indian Community Year 4 Gila River Indian Community Year 5 1 of 1