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Created Monday, February 09, 2015 Updated Monday, March 09, 2015 Page 1 General information General information | Organization NABI Foundation General information | Contact First name ELANA General information | Contact Last name PAYTON General information | Contact e-mail epayton@nabifoundation.org General information | Contact phone number 480-446-7052 Address Address | Street PO Box 25606 Address | City Phoenix Address | State AZ Address | ZIP Code 8 5 002 From what tribe is the organization requesting the grant? Gila River Indian Community Total grant amount request $375,000 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 $75000 Year 2 $75000 Year 3 $75000 Year 4 $75000 Year 5 $75000 Page 1 INTERNAL REVENUE SERVICE DEPARTMENT OF THE TREASURY P. 0. BOX 2508 CINCINNATI, OH 45201 Employer Identification Number: Date: MAY 2 7 2010 43-1967299 DLN: 17053313333039 NABI FOUNDADATION Contact Person: 6125 N CENTRAL AVE STE 16 ZENIA LUK ID# 31522 PHOENIX, AZ 85012 Contact Telephone Number: (877) 829-5500 Accounting Period Ending: December 31 Public Charity Status: 170(b)(1)(A)(vi) Form 990 Required: Yes Effective Date of Exemption: November 4, 2009 Contribution Deductibility: Yes Addendum Applies: No Dear Applicant: We are pleased to inform you that upon review of your application for tax exempt status we have determined that you are exempt from Federal income tax under section 501(c) (3) of the Internal Revenue Code. Contributions to you are deductible under section 170 of the Code. You are also qualified to receive tax deductible bequests, devises, transfers or gifts under section 2055, 2106 or 2522 of the Code. Because this letter could help resolve any questions regarding your exempt status, you should keep it in your permanent records. Organizations exempt under section 501(c)(3) of the Code are further classified as either public charities or private foundations. We determined that you are a public charity under the Code section(s) listed in the heading of this letter. Please see enclosed Publication 4221-PC, Compliance Guide for 501(c)(3) Public Charities, for some helpful information about your responsibilities as an exempt organization. Letter 947 (DO/CG) -2- NADI FOUNDADATION We have sent a copy of this letter to your representative as indicated in your power of attorney. Sincerely, Director s Exempt Organizations Rulings and Agreements Enclosure: Publication 4221-PC Letter 947 (DO/CG) Gila River Indian Community Grant Application Cover Sheet Municipality Information Date of Application: 2/13/2015 Name of City, Town or County: Maricopa County Mayor (City or Town) or Board of Supervisor’s Chairman (County): Steve Chucri Mailing Address: 301 W. Jefferson City: Phoenix State: Arizona Zip Code: 85003 Acknowledgement of Submission by Municipality Representative: Typed Name: Amanda Nash Signature: Applicant Information Department/Organization Name: NABI Foundation Application Contact Person: Elana Payotn Title: COO Phone Number: 480-446-7052 Mailing Address: PO Box 25606 City: Phoenix State: Arizona Zip Code: 85002 Email Address: epayton@nabifoundation.org Project Information Project Name: NABI Youth Education Summit Purpose of Grant: The primary purpose of this grant is to provide an opportunity for Native youth to engage in education workshops and activities that will enhance their high school academic experience in preparation for college, career and life long goals. Priority Funding Area Education Annual amount requested $75000.00 Number of years that funding is requested (1- 5 5) Total amount requested (annual amount x # of $375,000.00 years) Has your organization received funding from The NABI Foundation received funds in Partnership with the City of Gila River Indian Community in the Past? If yes, Phoenix Neighborhood Services TILT program in 2012. $50k please list each year and amount Geographic area served Maricopa County For Office Use Only: Data Entry Receipt Evaluation Gila River Indian Community Grant Application Narrative Please structure your proposal to provide the following information in the order indicated. List the heading first and then provide the narrative in paragraph form. Please be thorough but strive for brevity. 1. Briefly describe the organization’s mission, history and goals. 2. Describe the goals and activities of the proposed project. 3. Describe how the proposed project satisfies one or more of the priority funding areas identified by the Gila River Indian Community. 4. Identify the needs/problems to be addressed, target population and number of people to be served by the project. 5. Define the project as a new or continuing program. 6. Provide a brief timeline including start and finish dates. Indicate if the timeline is flexible. 7. Identify other organizations, partners or funders participating in the project and their roles. 8. Would you be able to implement the proposed plan if your organization received partial funding for this project? 9. Describe your plan for project sustainability beyond the grant period. 10. Describe your plan to document progress and results. 11. Indicate any application to and/or awards made by a tribe other than the Gila River Indian Community for state shared revenues for this and any other project. Gila River Indian Community Grant Application Project Budget Budget Period: January 1 thru September 30, 2015 Proposed Budget Expense Amount Amount In Kind Total Budget (list each budget item) requested from requested or contributions GRIC secured from other funders 1. Advertising $1,100.00 $1,200.00 $0 $2,300.00 2. Catering & Workshop Food Costs $11,000.00 $11,00.00 $0 $22,000.00 3. Contractor Expenses & Related $22,500.00 $15,000.00 $0 $37,500.00 Costs 4. Equipment Rental (Copier) $400.00 $0 $400.00 $800.00 5. Facility Rentals $10,000.00 $800.00 $0 $18,000.00 6. Staff Salaries & Benefits (2) $17,000.00 $14,000.00 $0 $31,000.00 7. Marketing: brochures, promotional $8,000.00 $6,000.00 $1,000.00 $15,000.00 items i.e. t-shirts, bags, water bottles, etc. 8. Program Supplies & Printing $5,000.00 $2,000.00 $0 $7,000.00 9. Postage $0 $500.00 $0 $500.00 10. Click here to enter text. $0 $0 $0 $0 11. Click here to enter text. $0 $0 $0 $0 12. Click here to enter text. $0 $0 $0 $0 13. Click here to enter text. $0 $0 $0 $0 14. Click here to enter text. $0 $0 $0 $0 15. Click here to enter text. $0 $0 $0 $0 16. Click here to enter text. $0 $0 $0 $0 17. Click here to enter text. $0 $0 $0 $0 Total Budget $75,000.00 $50,500.00 $1,400.00 $134,100.00 Gila River Indian Community Grant Application Project Budget Detail Please provide a narrative description for each of the project budget items. 1. Advertising – Promotion of the Summit, College, Career and Health Fair through local agencies, media, and partner organizations. 2. Catering & Wrokshop Food Costs – Meet and greet reception on June 30, 2015 and lunch will be provided to participants (3 days). Water and snacks will also be provided for participants and workshop speakers during the scheduled summit days. 3. Contractor Expenses & Related Costs – Speaker fees, materials, meals, and transportation if traveling from outside of the state. 4. Copier Rental – Onsite copier utilized to make copies of materials as needed. 5. Facility Rentals – Meeting rooms to conduct workshops. 6. Staff Salaries & Benefits – Salaries and benefits for two staff throughout the budget period. 7. Marketing Mateirals – Brochures, pamphlets, t-shirts, giveaways, handouts, and related workshop materials for participants and workshop speakers. 8. Program Supplies & Printing – Paper, pens, pencils and related materials needed for workshop participants and guest speakers. Surveys, reports, and documentation (sign-in sheets, etc.). 9. Postage - Mailings 10. Click here to enter text. 11. Click here to enter text. 12. Click here to enter text. 13. Click here to enter text. 14. Click here to enter text. 15. Click here to enter text. 16. Click here to enter text. Gila River Indian Community Grant Application 17. Click here to enter text. Other explanation: Click here to enter text. Gila River Indian Community Grant Application Narrative I. Organization’s History, Mission and Goals The NABI Foundation is committed to supporting Native American youth by implementing programs that encourage higher education, sports, health & wellness and community building. Our mission is to create, encourage and support Native American youth now and through their journey as they discover who they are, what they want to be and how they can impact future generations. In 2002, Mark West Vice President Players Programs /Phoenix Suns, Scott Podleski/Arizona Rattlers, and GinaMarie Scarpa/Former Executive Director/AC Green Youth Foundation, created and organized NABI. Since its inception, NABI has delivered programs to youth nationwide with a vision to raise a generation of leaders by creating the spark that ignites youth to set their sights higher, make the most of their potential and reach their dreams. The NABI Foundation specializes in working with urban and reservation American Indian youth. The Native American Basketball Invitational (NABI) was formed in 2003 to host a twenty-four team tournament and create college scholarship opportunities for Phoenix area Native American high school athletes. In the first year, NABI ended up with a national tournament and with major national sponsors NIKE and Phoenix Suns. The NABI basketball tournament is the largest Native American basketball tournament in the world and the only all Native American National College Athletic Association (NCAA) sanctioned event resulting in over 50 athletes scouted and granted athletic scholarships, with two promising Native American NABI Athletes being picked up by Division 1 college teams. Furthermore, the NABI College Scholarship Fund has awarded Native American college students and national Native American youth non-profits over $250,000. NABI launched the first annual Native American Baseball & Softball Invitational in partnership with the Arizona Diamondbacks in 2008 and is also the largest all Native American tournaments in the country. NABI Chasing the Sun 10K & Pow Wow were first held in 2009; and in 2010 the NABI Foundation, a 501 (c) (3) youth organization, was launched with all programs now organized under the newly formed non-profit. In 2011, the NABI Youth Physical Education Program (ages 8-14) and the NABI UpRise Youth Motivational Presentations (ages 8-18) were launched to provide on and off reservation services. The NABI Physical Education Program focuses on diabetes, cardio vascular, obesity and other health issues while the NABI UpRise Youth Motivational Presentations targets suicide, substance abuse, school drop-out, gangs, and other youth related concerns. Both programs focus on building on individual strengths, family, community and cultural support systems. II. Goals and Activities of the Proposed Project Because NABI draws the attention of thousands of Native American youth to our annual basketball tournament, we have implemented educational components that will encourage our participants to explore higher education. Some of those components are a College & Career Fair where every participant must attend. The College & Career Fair features colleges and universities from all of the US. Their representatives are available to discuss the many opportunities that await our youth. We also host Educational Seminars. The seminars host guest speakers, who represent leaders in their fields, to inspire our youth to keep their options open and explore different career choices. With the success of NABI Basketball, our College & Career Fair and Education Seminars the NABI Foundation desires is to expand opportunities to our Native Youth by developing an the NABI Youth Educational Summit. The summit will be open to “any” Native American high school student. The summit is designed to introduce opportunities for youth and will be aimed at exploring career and higher education goals. Workshop presentations will include topics related to: education goal setting, career options, financial resources, identifying community mentors, test preparation topics, college and career programs, four year academic plan development, healthy and positive life choices and service / volunteer opportunities. The summit will also include a night of cultural celebration. Goal 1: By August 1, 2015, 2500 youth ages 13-19 will attend the College & Career fair. Youth will be exposed to education information and opportunities. Goal 2: By August 1, 2015, 2500 youth ages 13-19 will attend the Youth Educational Summit to include workshops on suicide prevention, college/career preparedness, building positive character traits, developing leadership skills and life skills, and the importance of volunteerism. Goal 3: By August 1, 2015, 1800 youth ages 13-19 will engage in activities that promote tradition, pride, respect and a greater appreciation for their culture. NABI Youth Educational Summit Objectives • Increase prevention and awareness of high risk behaviors that impede academic success. • Introduce education topics that will increase knowledge of high school and higher education or career technical education goals. • Challenge youth to pursue academic rigor and excellence. • Increase awareness of global economic, social, and political issues that impact their education. • Educate youth on college preparation requirements and entrance assessments, job application skills, and resume development. • Inspire Native American high school athletes and youth to develop compassion by engaging in service activities in their communities. III. Describe how the proposed project satisfies on or more of the priority funding areas identified. The Gila River State Shared Revenue Program will help support three of five priority funding areas: Education, Healthcare, and Public Safety. This grant request will essentially target Arizona reservation and inner city Native youth as noted: A. Education Priority NABI prides itself in serving Native youth through community partnerships, sports, and education and prevention programs NABI implements. This is accomplished by making cultural global awareness at the NABI tournament meet and greet reception wherein all team players and their coaches are invited to participate in a wide variety of ice breaking activities. Educational seminars are presented throughout the week for all youth and coaches. Addressing topics related to college, career and life. Guest speakers range from community leaders to professional athletes. The focus of speaking topics include: suicide prevention, college and career preparedness, building positive character traits, developing leadership skills and life skills, and the importance of volunteerism and giving back. B. Healthcare Priority Social, emotional, and physical health are critical areas of concerns impacting the target population. The summit will address health prevention topics related to suicide, substance use, and nutrition. NABI seeks to combat Type II Diabetes and promote healthy choices education with the intent to increase awareness of high risk behaviors that impede academic success and healthy living. C. Public Safety Priority The education summit will address leadership and civic responsibility skill sets as key components through volunteerism and the importance of community engagement with local grass roots organizations and schools encouraging community involvement. The summit will provided uniquely designed education topics motivating youth the be actively involved in their communities by promoting individual and public safety through healthy living, life style choices, and staying positively active in their neighborhoods and surrounding communities. The Center for Social development defines civic engagement as “social action that makes a difference at a local, national, or international level”. Youth are more inclined to engage in the communities they are connected to and therefore are committed to making positive decisions, participate in extracurricular activities, perform better in school and less likely to choose risk behaviors (Corporation for National and Community Service, 2005). IV. Identify the needs / problems to be addressed, target population, and number of people served by the project. Native American athletes are among the most talented in the world but with some reservations being desolate and isolated, Native youth are unable to showcase their talent to secure college athletic scholarships. According to the National Center for Education Statistics graduation rates are crucially low for Native students. In 2010, 51% of Native students received a high school diploma with dropout rates double the national average. As a subset of the overall population, American Indian youth face immense health, mental health, education attainment, economic, social, and countless other challenges at staggering rates when compared to the general population. The Center for Disease Control (2012) reports that young adults ages 15-24, approximately 100-200 attempts. In 2011, a national sample of youth grades 9-12 16% of youth reported considering attempting suicide; furthermore, Native youth rates indicate: • Suicide as the 2nd leading cause of death between the ages of 15-34. • Violence including intentional injuries, homicide and suicide make up 75% of deaths among Native youth. • Death rates are 2 to 5 times greater than any other cultural age group. Comprising less than 1% of students in the public school system, the Native youth graduation demographic is dismal wherein more youth engage in high risk behaviors related to use of substances at an alarming rate (National Center for Education Statistics)(SAMHSA). In addition, a high prevalence of risk factors, Type II Diabetes effects Native youth ages 10-19 and continues to grow at an alarming rate. The CDC reports one of the highest rates of diabetes in the world is among the Pima of Arizona. Furthermore, binge alcohol use is higher among American Indian and Alaskan Native adults than the national average (30.6 percent vs. 24.5 percent) wherein one 1 in 8 seeks treatment to combat drug or alcohol use. According to recent census data, American Indians make up approximately 5.3% percent of the 6.7 million people in Arizona. The NABI Foundation hosts a multitude of tribes and indigenous populations from Arizona, the continental US, Alaska, Canada and New Zealand. The Native youth that attend NABI programs represent a combined total of 125 tribes and communities wherein these unique challenges impact their daily lives. Over 1800 Native youth currently attend the NABI Basketball tournament and are required to attend at least two education seminars offered during the week of the tournament. With the addition of a youth educational summit, NABI would provide an opportunity all Native youth (athletes and non-athletes), to attend the workshops and engage with Native and Indigenous high school athletes from all over North America. By opening up our summit to non-athletic students, NABI would be increasing education, prevention and life skills topics for an additional 700 youth participants, ages 13 to 19. Many of the youth participants live in communities typically underserved with youth leadership development, civic engagement opportunities, and lack educational and financial resources to enhance their future. According to the US Census, one-third of American Indians reside on reservations and remote rural areas limiting access to higher education. Although enrollment in colleges has doubled among American Indian / Alaskan Native students, they are still less likely to complete their education program to earn a bachelor’s degree or higher in comparison to non- Native students and account for less than 1% of those who have earned a bachelor’s degree (71.8% of whites, 9.8% of African Americans, 7.9% of Hispanics, and 7% of Asian/Pacific Islanders – National Center for Education Statistics, Status and Trends in Education of American Indians and Alas Natives, 2008; National Congress of American Indians, 2006; National Center for Education Statistics, 2005; U.S. Department of Education, Institute of Education Sciences, National Center for Education Statistics, and 2005 National Indian Education Study. Over the span of a lifetime, college graduates earn 60% more than high school graduates resulting in opportunities to increase earning potential, healthcare, and overall livelihood (National Center for Education Statistics; College Board study). V. Define the project as a new or continuing program. The NABI Youth Educational Summit is an expansion of education workshops conducted during the week long basketball tournament and is categorized as a continuing program. Educational Seminar presentations have been conducted since the inception of the NABI Basketball tournament entering into its 13th year this summer, 2015. NABI tournament participants and non-NABI tournament high school students will be invited to attend the education summit. The summit will provide an opportunity to educate youth on the importance of pursuing higher education or career technical education. The education summits will address the underlying issues and risk factors that impede academic success by introducing the importance of making sound education decisions and positive lifestyle choices. The summit workshops are designed to incorporate a holistic approach that includes parent/family information and topics, community support topics, and health related topics. The three main components of the summit include: 1) Youth reception; 2) College/Career and Health Fair; 3) Education Workshops; 4) Cultural Night; 5) Access to Tournament Games; and 6) Closing Ceremonies. NABI’s greatest desire is to channel avenues of opportunities to Native youth living on reservations. By cultivating awareness and prevention, NABI seeks to support youth leadership development by encouraging Native youth to choose healthy living and seek education through activities and sports. Through educational and leadership development workshops, a new generation of youth leaders will develop skills to needed to thrive and develop into healthy adults. The summit is a holistic approach to combating the harsh realities of reservation life while celebrating the traditions of their culture is a measure of success that NABI hopes others will embrace and support. VI. Timeline of start and finish dates The proposed project will run from January 1, 2015 to August 2015. Participants playing in tournament games and their coaches will be required to participate in summit workshops and seminars. Summit workshops dates are not flexible as the summit is set to occur during the week of the NABI Basketball tournament to ensure that all participants have the opportunity to attend workshops. Description Start Date Finish Date Development of marketing materials, outreach January 1 July 4 activities and program schedules. Announcement of the grant via verbal, website, and social and professional network. Secure facilities January 1 February 28 Attain and secure guest speakers March 1 July 3 Youth Summit Recruitment and Applications March 1 June 30 Prepare writing materials, videos, and resources March 1 June 30 Secure college, career and health fair entities March 1 June 30 Recruit Volunteers April 1 June 30 Team Check In and Summit Registration & June 30 June 30 Orientation College, Career and Health Fair June 30 June 30 Meet and Greet Reception June 30 June 30 Tournament Games and Cultural Night July 1 July 1 Summit Workshops and Seminars July 1 July 3 Summit closing ceremony July 3 July 3 Tournament Games and Silver Division July 3 July 3 Championship Tournament Gold Division Championship games July 4 July 4 @ Talking Stick Resort Arena Program Closeout and Reports July 5 August 1 Final Program Reports August 1 September 30 VII. Identify other organization, partners or funders participating in the project and their roles. At this time the NABI Foundation is the sole entity involved in this grant request. It is anticipated that NIKE N7, Yavapai Prescott Indian Tribe, Seminole Tribe, MHA Nation, Beard and Native Nations will participate as they have been involved in supporting past NABI activities. NABI exists as result of multiple resources and support through its partnerships relationships with area Tribal Communities. It is anticipated that other similar funding sources will be pursued to achieve the goal of serving the total number of youth targeted. VIII. Would you be able to implement the proposed plan if your organization received partial funding for this project? The NABI Foundation is committed to creating a rewarding educational experience for the targeted population and will efficiently utilize any funds received through the grant. Partial funding for this project may limit resources required to fully implement the proposed plan; however, the NABI Foundation will make appropriate adjustments as needed while keeping the integrity of the program. IX. Plan for project sustainability beyond grant period. NABI will continue to seek in-kind resources in addition to identifying and applying for funds and sponsorships from other resources. This will be accomplished by establishing new partnerships with other organizations and continuing partnerships with organizations such as: NIKE N7, Yavapai Prescott Indian Tribe, Seminole Tribe, Beard and Native Nations. The NABI Foundation is a 501 (c) (3) non-profit organization which seeks grant, foundation, and other funding to secure resources for the provision of services. Additionally, tournaments and other events that generate funding for the organization will be used to conduct business. Historically, NIKE and NIKE N7, individual sponsors, donors and partners have contributed financially to the NABI Foundation. These sources of funding are considered long-term resources. X. Describe your plan to document progress and results. NABI evaluates program effectiveness through formal and informal feedback via survey from participants and maintaining demographic information of all youth and adults participating in program activities. This includes tribal affiliation, gender, DOB, school GPA, and college attendance. Records are maintained for a minimum of 5 years and stored in a lock storage unit by year. Marketing, recruitment and outreach will be recorded and reported in respect to the number of contacts, and outcomes. This documentation will be gathered from Summit and Tournament Participant Applications. Documentation of attendance will recorded via sign-in sheets. Participants will be required to sign-in every time they attend a workshop presentation. Reports will be generated monthly for internal purposes to track progress and quarterly reports will be submitted to the Office of Special Funding. Furthermore, a yearend report will be generated describing program challenges, success, and overall demographics and feedback from participants. K. Indicate any application to and/or awards made by a tribe other than the Gila River Indian Community for state shared revenues for this and any other project. The NABI Foundation will apply for state shared revenues from Tohono O’odham Tribe and Fort McDowell for this project. 12/8/2014 Native American youth in 'national crisis' White House — RT USA Keep up with the news by installing RT’s extension for Chrome. Never miss a story with this clean and simple app that delivers the latest headlines to you. ﺔﻴﺑﺮﻌﻟﺍ ESP РУС DE Freevideo ИНОТВ RTД RUPTLY Applications RSS LIV E 00:46 GMT, Dec 9, 2014 News USA UK Russian politics Business Op‐Edge In vision In motion Shows Bulletin board More Home / USA / Where to watch Schedule Native American youth in 'national crisis' - White House Published time: December 06, 2014 03:24 Get short URL Recommended Humans on Mars One Reuters/Rick Wilking mission would start… 2.8K 605 'No way! ': Pentagon A White House report on Native American Tags trashes Iranian replica … students said they face educational, Accident, Ecology, Education, socioeconomic, and health barriers that are Global warming, History, Human rights, USA “nothing short of a national crisis." Russia at the gates? US State Dept, Pentagon Based on information gathered during the Annual Cannonball Flag Day grilled over NATO… Powwow at the Standing Rock Sioux Tribe reservation in une, the ‘2014 Native outh Report’ is intended to expand opportunities for young by Taboola Native Americans. Back over the summer, President Barack Obama and First Lady Michelle Obama met with Lakota young adults privately. What they heard http://rt.com/usa/211955obamanativeamericancrisis/ 1/10 12/8/2014 Native American youth in 'national crisis' White House — RT USA troubled and upset them enough that back at the White House, Obama ordered his cabinet to come up with a plan for new avenues of opportunity for Native American youth. READ MORE: Native Americans unite to fight pipelines, including Keystone X At the Tribal Nations Conference on Wednesday in Washington, DC – when the report was released – President Obama made reference to his past meeting. “And these young people could not have been more poised and they could not have been more thoughtful. And they talked about their families, and their friends, and their dreams for the future,” he said. “But they also talked about the pain in their hearts, and the obstacles they had had to overcome, and the problems they had seen with loved ones who had been brought down by drugs or alcohol or violence or poverty.” Maggie Dunne ollow @mhope13 I see @K_MaN7! #NativeYouth @WhiteHouse TribalNations Conference bit.ly/1vw1x1M @Lakota_Children @BarackObama 8:32 AM ‐ 5 Dec 2014 4 RETWEETS 6 FAVORITES Thirty‐nine percent of the Native American and Alaskan Native http://rt.com/usa/211955obamanativeamericancrisis/ 2/10 12/8/2014 Native American youth in 'national crisis' White House — RT USA population is under 24 years of age, the report states, compared to 33 percent of the total population in the United States. Additionally, 15‐ 19‐year‐olds make up 42 percent of the Native American population, compared to 34 percent for in the US. More than one in three American Indian and Alaskan Native children lives in poverty. Their school graduation rate is 67 percent – the lowest of any racial/ethnic demographic group across all schools. And suicide is the second leading cause of death – 2.5 times the national rate – for Native youth in the 15 to 24 old age group. “One young man was raising his four little brothers by himself,” Obama recalled. “All of them knew somebody that they loved who had attempted suicide, committed suicide, died in a car accident before their time. Some of them had spent time living in a bus. And there were tears in that room pretty much the entire conversation, and the sense that schools weren’t always preparing them properly and that they weren’t sure about the possibilities of a better future.” http://rt.com/usa/211955obamanativeamericancrisis/ 3/10 12/8/2014 Native American youth in 'national crisis' White House — RT USA Arne Duncan ollow @arneduncan Both the hope, and the heartbreak in the lives of Native American youth compels us to act #TribalNations wapo.st/1CJMF4H 1:33 PM ‐ 4 Dec 2014 How the stories of Native American youths made Obama cry in the Oval... By Katie Zezima @katiezez Obama met in North Dakota with young people who spoke of lives affected by suicide, poverty and homelessness. Washington Post @washingtonpost 26 RETWEETS 18 FAVORITES The report authors acknowledge the United States “owes a trust responsibility” – based on treaties, agreements, statutes, court decisions and executive orders ‐ to Native American tribes. They also acknowledge the country’s deeply troubling and destructive federal policies and actions that hurt Native communities, exacerbated inequality and accelerated the loss of tribal cultural traditions, particularly through federal policies regarding the education of Native American children which continue to have effects on their communities. READ MORE: Leonard Peltier in solitary confinement http://rt.com/usa/211955obamanativeamericancrisis/ 4/10 12/8/2014 Native American youth in 'national crisis' White House — RT USA The education of Native American children meant sending them to boarding schools to “Kill the Indian, Save the Man,” where their hair was cut, they were forced to wear school uniforms and change their names to common Euro‐American names, and were punished for speaking their native tongue. These schools were also meant to teach them “English, Christianize them, inculcate within them the values and beliefs of possessive individualism, and ultimately prepare them for American citizenship.” The report’s other findings included the fact that 92 percent of Native American youth attend regular public schools, but the schools lacked “culturally relevant curriculum and culturally competent staff that understand how to reach Native youth.” Other schools, meanwhile, are in need of repair and renovation. READ MORE: Native Americans ‘slaughtered, sacrificed, fenced in reservations’ in US Ahniwake Rose, executive director for the National Indian Education Association, told the Huffington Post the report and its recommendations are "unprecedented," and “is the first time that a sitting president has talked about Indian education since Kennedy.” Still, she said it was just an important first step and that significant progress needed to be made. Reuters/Jonathan Ernst The report makes several recommendations. Obama’s entire cabinet is going to meet with Native young people and hear firsthand about their lives. The Department of Education is working on a new initiative – Nation Youth Community Projects – which will give support for http://rt.com/usa/211955obamanativeamericancrisis/ 5/10 12/8/2014 Native American youth in 'national crisis' White House — RT USA nutrition programs, mental health needs and creating a culturally relevant curriculum. The report recommends that schools and colleges work to revitalize Native American history and languages in school curriculum. “We know that learning about the history and language and traditions of one’s people can make a huge difference in a child’s education,” said Obama. READ MORE: Seattle to recognize Indigenous Peoples’ day on Columbus Day indianz.com ollow @indianz President Obama makes Native youth a priority in remaining years of administration indianz.com/News/2014/0158… 12:16 PM ‐ 4 Dec 2014 9 RETWEETS 3 FAVORITES Through a program called Generation Indigenous, a National Tribal Youth Network will connect and support talented young people in Tribal Nations. A Tribal Youth Gathering will take place in the White House next year. READ MORE: Native American tribes denied easy access to polls Obama will also present to Congress in February a request for investment in connecting tribal schools to high‐speed internet, and http://rt.com/usa/211955obamanativeamericancrisis/ 6/10 12/8/2014 Native American youth in 'national crisis' White House — RT USA reauthorize the Native American Housing Assistance and Self‐ Determination Act, which guarantees housing. 2.8K 605 More From The Web Sponsored Links A Love Letter to America's Wilderness The Atlantic American Homeowners Are in for an Extremely Big Surprise... Bills.com The Answer to Paying Off High Credit Card Debt Freedom Debt Relief CIA Insider Reveals Government "Day After" Plan Money Morning 23 Discontinued Cars That Should Be Brought Back RantCars The Sexiest Shots in Golf ‐ Blair O'Neal: How to Hit a Flop Shot Golf Digest by Taboola More from rt.com Humans on Mars One mission would start dying off in 68 days ‐ MIT study 'No way!': Pentagon trashes Iranian replica of US drone Russia at the gates? US State Dept, Pentagon grilled over NATO expansion by Taboola 21 comments Login http://rt.com/usa/211955obamanativeamericancrisis/ 7/10 12/8/2014 Native American youth in 'national crisis' White House — RT USA Leave your comment... Dan Duke 0 They did the same thing to Native Americans in Canada. They both got the same result...unbelievably unbelievable that people could be treated this way... Well not so much ... people are cutting off heads elsewhere in the world. People are just f'd. day ago 23:11 Reply Tess Hellene Butler 0 Why dont he try to make treaties a priority. He just stole more land from the Apache. day ago 22:51 Reply Hoopdog 0 Actually good on Obama fro taking an interest lets hope this translates into some positive action for first Nations people. I cant believe they still have to go to boarding schools I thought that was just the 50s. day ago 19:40 Reply Sasa +3 We can see that USA is teaching all the world about human rights. America bombs other nations just for "human rights". Well, I do not see respect for human rights in America right now. My sympathies to native Americans (especially for Indians). They are like us. Greetings from Serbia. 2 days ago 15:17 Reply megastiffrod 0 Their High Schools must be pretty bad because if they make it to college their tuition is entirely paid for in most cases. 2 days ago 09:44 Reply http://rt.com/usa/211955obamanativeamericancrisis/ 8/10 12/8/2014 Native American youth in 'national crisis' White House — RT USA Don't read my comments. 0 Do you have any evidence of this? about 10 hours ago Reply yankee phil +1 We were all wounded.......at wounded knee.................An old song for an old problem. They been shoot'n Indians longer than colored folks,thats a fact. 2 days ago 09:34 Reply Phildazz +1 Let's hope that they actually do something about it. 2 days ago 09:18 Reply god +1 Remember the Zionist Bankers involvement in all of this Genocidal Shame. 2 days ago 09:05 Reply Mikhas +6 A hapless gayclown and a drag queen leading a settler state built upon the bones of 50 million genocided native Americans. 3 days ago 02:27 Reply Next comments News In vision Live ﺍﻟﻌﺮﺑﻴﺔ USA In motion Where to watch Español UK Shows Schedule Русский Applications RSS Russian politics Bulletin board Legal disclaimer Deutsch http://rt.com/usa/211955obamanativeamericancrisis/ 9/10 12/8/2014 Native American youth in 'national crisis' White House — RT USA Business More Privacy policy Freevideo Op‐Edge Feedback НОТВ About us RTД Contact info RUPTLY RT NEWS ENGLISH APPS Applications Android RSS iOS Legal disclaimer Windows phone Privacy policy Windows 8 Feedback About us Contact info © Autonomous Nonprofit Organization “TV ‐Novosti”, 2005–2014. All rights reserved. http://rt.com/usa/211955obamanativeamericancrisis/ 10/10 Created Thursday, February 19, 2015 Page 1 General information General information | Organization Maricopa County Community College District Foundation General information | Contact First name Mary General information | Contact Last name O'Connor General information | Contact e-mail mary.oconnor@domail.maricopa.edu General information | Contact phone number 4807318403 Address Address | Street 2419 West 14th Street Address | City Tempe Address | State AZ Address | ZIP Code 85281-6942 From what tribe is the organization requesting the grant? Gila River Indian Community Total grant amount request $749,000.00 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 Year 1 $424,500.00 Year 2 $324,500.00 Year 3 $ Year 4 $ Year 5 $ Page 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 Toll Free Telephone Number: 2419 West 14th Street BM rn to MO p rn EST Tempe, AZ 85281-6941 877-829-5500 Fax Number: 513-263-3756 Federal Identification Number: 86-0327449 Dear Sir or Madam: This is in response to your request of July 7, 2003 regarding your organization's taxiexempt 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 1700)(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 (RITA) Organizations that are not private foundations are not subject to the excise taxes under Chapter 42 of the Code However, these organizations are not autematicaliy 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 86-0327449 Your organization is not required to file 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 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 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 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 T his letter affirms your organization's exempt status Sincerely, John E RickettS, Director, TE/GE Customer Account Services Gila River Indian Community Grant Application Cover Sheet Municipality Information Date of Application: 2/27/2015 Name of City, Town or County: Maricopa County Mayor (City or Town) or Board of Supervisor's Chairman (County): Steve Chucri Mailing Address: 301 W. Jefferson Street City: Phoenix State: Arizona Zip Code: 85003 Acknowledgement of Submission by Municipality Representative: Typed Name: Amanda Nash Signature: Applicant Information Department/Organization Name: Maricopa Community Colleges Foundation Application Contact Person: Mary O'Connor Title: Executive Vice-President & Chief Operating Officer Phone Number: (480) 731-8403 Mailing Address: 2419 W. 14th Street City: Temp State: Arizona Zip Code: 85281 Email Address: mary.oconnor@domail.maricopa.edu Project Information Project Name: Maricopa Community Colleges Programs and Scholarships Purpose of Grant: To support various programs and scholarships at 7 of the 10 Maricopa Community Colleges Priority Funding Area Education Annual amount requested $349,500.00 Number of years that funding is requested (1-5) 2 Total amount requested (annual amount x # of $599,000.00 years) Has your organization received funding from no Gila River Indian Community in the Past? If yes, please list each year and amount Geographic area served Maricopa County For Office Use Only: Data Entry Receipt Evaluation Briefly describe the organization's mission, history and goals. The Maricopa Colleges Foundation, with its donors and partners, supports the Maricopa County Community Colleges District, its students, faculty and staff, through scholarships, programs, equipment, and financial and human capital. The Foundation was founded in 1977 to serve as the 501C3 non-profit entity to solicit and receive private gifts and grants on behalf of all Maricopa County Community Colleges. The Foundation has built its assets to over $38 million as of 2014. It is in the process of a campaign to raise $50 million over five years to support the colleges. Describe the goals and activities of the proposed project The goals and activities in the proposed projects include serving special and underserved student populations in early outreach programs through scholarships and program funding, equipping a healthcare clinic, purchase of a video conferencing system, and expanding tutoring programs. Describe how the proposed project satisfies one or more of the priority funding areas identified by the Gila River Indian Community. Our projects fit in several categories- education-our programs assist students in achieving success in the classroom by providing tutoring, scholarships and other student support services that enhance the general knowledge of participants and promotes life-long continuous learning. Healthcare- our HUG clinic, and "exercise is medicine" projects in the proposal meet the goals of GRIC by promoting health, wellness, nutrition, direct patient care and improve the overall health of the participants and the community. Identify the needs/problems to be addressed, target population and number of people to be served by the project. The projects are from six of the ten colleges in our system. The projects address education success for under-served populations, including disabled and minority students starting in 9 th grade. The colleges serve over 200,000 students. The general population will be served by the HUG clinic. Define the project as new or continuing The projects are all continuing accept the South Mountain video conferencing program which is new. Provide a brief timeline including start and finish dates. Include if the timeline is flexible. The projects are proposed for fiscal year starting July 1, 2015. The budgets are for two years so the finish date would be June 30, 2017. The timeline is flexible. Identify other organizations, partners or funders participating in the project and their roles. High schools in each college area are partners in our ACE and Hoop programs. Various medical providers and clinics are partners with our HUG clinic. Would you be able to implement the proposed plan if your organization received partial funding for this project? Yes, each line item in the budget is a separate project. We could implement any or all of the projects with partial funding. Describe your plan for sustainability beyond the grant period The projects in the proposal will be steadily incorporated into the operations budgets of the colleges and continual funding will be sought from various sources. Describe your plan to document progress and results. We have operational plans and metrics in place that will be used to document success of the clinics and public programs. Standard student public records will be used to track student progress. Indicate any application to and/or awards made by a tribe other than Gila River Indian Community for state shared revenues for this and any other projects. Salt River Pima Maricopa Indian Community funds other projects at Scottsdale Community College, Mesa Community Colleges and the District office of Maricopa Community Colleges (serving all ten colleges). For the 2014-15 year, the total funded was $212,000. This is the only tribal funding that comes through the Maricopa Community Colleges Foundation. Gila River Indian Community Grant Application Project Budget Budget Period: July 1, 2015 —June 30, 2016 Proposed Budget Expense Amount Amount In Kind Total Budget (list each budget item) requested from requested or contributions GRIC secured from other funders 1. Achieving a College Education early $65,000.00 $0 $0 $0 outreach program 2. Hoop of Learning Early Outreach $52,500.00 $0 $0 $0 programs 3. Sustainable Food System Ceritifcate $27,000.00 $0 $0 $0 Scholarships 4. Healthcare United Clinic $75,000.00 $0 $0 $0 5. Video Conference System 100,000.00 $0 $0 $0 6. Tutoring for students with 20,000.00 $0 $o $o disabilities 7. Exercise is medicine $10,000.00 $o $o $0 8. $0 $o $0 9. $0 $o $o 10. $o $o $o 11. $o $o $o 12. $o $o $o $o 13. $o $o $o $0 14. $0 $o $o 15. $0 $0 $0 $0 16. $o $o $o $o 17. $0 $0 $0 Total Budget $349,500 $0 $0 $o Gila River Indian Community Grant Application Project Budget Detail Please provide a narrative description for each of the project budget items. 1. The Achieving a College Education (ACE) is an early outreach program at all ten Maricopa Community Colleges. The program is designed to reduce dropouts among "at-risk" students and transition them to Community College and university studies. Phoenix College, Paradise Valley Community College and Rio Salado College are requesting program and scholarship funds to support the students in this program. Scholarships for 50 students as well as some materials for workshops (7 Habits of Highly Effective Teens). 2. Hoop of Learning is similar to the ACE program, but is limited to Native American students. It provides academic support to students in grades 9-12 to transition them to Community College and university studies. Phoenix College, Paradise Valley Community College and Rio Salado College are requesting program and scholarship funds to support the 50 students in this program. 3. Rio Salado is requesting program and scholarship funding for a cohort of students in the Sustainable Food Systems Certificate program. The funding will provide tuition, fees, books, a knife kit and chef jackets for 10 students. 4. Gateway Community College operates a Healthcare United Clinic (HUG) at which students get real-life practical experience in health care settings. They seek to make the clinic "mobile" and are requesting fund for supplies ($7,170), a mobile ultrasound machine ($44,230), EPIC Licensure ($14,000),Clinic faculty director ($9,600). 5. South Mountain Community College(SMCC) is requesting funds to purchase a video conferencing system to teach interative classes at either SMCC or Gila River Indian Community and they can be viewed at either end, so teach at Sacaton, for example but main campus students can participate or vice versa. $67,000 of the funding will be used to purchase Vidyo IDVP-Plus intermediate Virutal Room Solution. A mobile unit will reside at each campus and will connect to the IDVP-Plus virtual rooms. Each room will support up to 100 participants, SD gateway, and the VidyoRoom mobile units. Included is the VidyoReplay which will enable recording and streaming functionality for live or on-demand viewing of courses. The streaming solution will enable for more students to be able to view a course as needed. The other $33,000 of this line item will be used for student scholarships. 6. Glendale Community College is requesting funding for tutoring services for students with disabilities. This program has seen a significant increase in enrollment in recent years and needs expanded funding. This direct 1-1 tutoring instruction promotes increased academic skills leading to college course success. The $20,000 in this line item budget will be used to pay the tutors for fall, spring and sumer sessions. 7. Glendale Community College is requesting funding for its "Exercise is Medicine" program. Exercise is Medicine (EIM) is a global health initiative managed by the American College of Sports Medicine (ACSM). Working in collaboration with the American Medical Association (AMA), EIM is committed to the belief that physical activity is integral in the prevention and treatments of diseases. The goal is to include exercise participation as a vital sign at every doctor visit and to link patients with community resources. Glendale Community College (GCC) is an excellent resource to support health promotion and disease prevention in the community. GCC boasts an array of degreed and certified exercise professionals who currently promote physical activity and guide clients/participants through fitness programming and promote physical fitness GCC has state-of-the-art facilities and can accommodate a diverse population to improve the overall health of participants in the community GCC prepares fitness professionals for the workforce in Exercise Science, Personal Training and Nutrition degrees and certificate. The $10,000 budget in this line item will be used for staffing for the sports performance lab and ambassadors of programs. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. Other explanation: Created Thursday, February 19, 2015 Page 1 General information General information | Organization Hope & A Future General information | Contact First name Michael General information | Contact Last name Brewer General information | Contact e-mail michael@azhope.com General information | Contact phone number 602-258-5860 Address Address | Street PO Box 61172 Address | City Phoenix Address | State AZ Address | ZIP Code 8 5 0 82 From what tribe is the organization requesting the grant? Gila River Indian Community Total grant amount request $500,000 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 $100,000 Year 2 $100,000 Year 3 $100,000 Year 4 $100,000 Year 5 $100,000 Page 1 IRS Internal Department Revenue of the Treasury Service P.O. Box 2508, Room 4010 In reply refer to: 0441637415 Cincinnati OH 45201 May 08, 2009 LTR 4168C EO 42-1651164 000000 00 000 00027342 BODC: TE HOPE AND A FUTURE INC % MICHAEL BREWER 1802 E WINTER DR PHOENIX AZ 85020-4412 007323 Employer Identification Number: 42-1651764 Person to Contact: N Putnam Toll Free Telephone Number: 1-877 829 5500 Dear Taxpayer: This is in response to your request of Apr. 29, 2009, regarding your tax-exempt status. Our records indicate that a determination letter was issued in August 2005, that recognized you as exempt from Federal income tax, and discloses that you are currently exempt under section 501(c)(3) of the Internal Revenue Code. Our records also indicate you are not a private foundation within the meaning of section 509(a) of the Code because you are described in section(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. If you have any questions, please call us at the telephone number shown in the heading of this letter. Sincerely yours, Rtkua_,Atbz.„, Rita A. Leete Accounts Management II Gila River Indian Community Grant Application Cover Sheet Municipality Information Date of Application: 3/1/2015 Name of City, Town or County: Maricopa County Mayor (City or Town) or Board of Supervisor's Chairman (County): Steve Chucri Mailing Address: 301 W. Jefferson, 10th Floor City: Phoenix State: Arizona Zip Code: 85003 Acknowledgement of Submission by Municipality Representative: Typed Name: Amanda Nash Signature: Applicant Information Department/Organization Name: Hope and A Future Application Contact Person: Michael Brewer Title: President Phone Number: 602 -258 -5860 Mailing Address: PO Box 61172 City: Phoenix State: Arizona Zip Code: 85082 Email Address: Michael@azhope.com Project Information Project Name: Life Skills Center for Arizona Foster Children Purpose of Grant: Provide educational resources and training to foster children between 12 to 21 years of age. Priority Funding Area Education Annual amount requested $100,000 Number of years that funding is requested (1-5) 5 Total amount requested (annual amount x # of $500,000 years) Has your organization received funding from No Gila River Indian Community in the Past? If yes, please list each year and amount Geographic area served Maricopa County For Office Use Only: Data Entry Receipt Evaluation Narrative 1. Briefly describe the organization's mission, history and goals. Hope and A Future was specifically formed in 2004 to invest in the lives of foster children, especially as they become teenagers. Although there are many programs serving younger foster children, our founders recognized that there was a community need to help serve the foster children, especially as they become teenagers and young adults. Therefore, Hope and A Future was formed specifically for that purpose to serve these children who have been physically, sexually and emotionally abused in their lives and help them become productive adults. Our vision is that one day all children in the Arizona foster care system will have a hope for their future. The mission of Hope & A Future is to serve abused and neglected children in the Arizona foster care system by helping them reach their potential and achieve their dreams. Our organization provides two distinct summer camp opportunities for Arizona foster children: Royal Family Kids' Camp for foster children who are 7 to 11 years old, and Teen Reach Adventure Camp for foster children who are 12 to 15 years old. Since 2006, our week-long overnight summer camps have served over 1200 Arizona foster children with over 700 volunteers participating. The purpose of the overnight summer camps is to provide positive childhood memories for the abused and neglected foster child. The goal is to spend quality time with each child, encouraging them to respect themselves and others, work hard, work as a team, have fun and make a difference in the community. Specifically, the teenage camp includes several activities that stress the importance of teamwork and communication. In the fall of 2011, Hope & A Future launched a new program for foster children who are 14 to 21 years old. This program is a life skills mentoring program for the children who are "aging out" of the foster care system and includes a separate weekend retreat for these children and a monthly mentoring activity. This program provides a bridge to the children we have served since they were 7 years of age and are now aging out of the foster care system. Our organization also has a college scholarship program for foster children. In 2011, we partnered with Grand Canyon University who is annually providing full tuition scholarship to four foster children in our programs. To date, we have provided college scholarships to 25 foster children in our programs. One recipient graduated from the University of Arizona, two are seniors at Arizona State University, four attend Grand Canyon University and several are enrolled at community colleges in Maricopa County. Finally, each year we host an annual Christmas celebration for Arizona foster children. For many children facing challenges, the holidays can be especially difficult. For the over 16,300 foster children living away from their parents in Arizona, they can be a time of profound sadness. In 2014, we hosted the annual Christmas celebration at Rawhide with over 500 foster children, their foster families and volunteers in attendance. Based on the differences our organization was making in the community, a local community partner, E.B. Lane, donated their services and re-designed our nonprofit website (www.azhope.com ) in 2009. In 2010, our website was awarded the best non profit website by American Marketing Association (AMA). In 2011, I was a recipient of a "40 under Forty" award by the Phoenix Business Journal for my efforts in co-founding Hope & A Future and positively impacting the lives of Arizona foster children. In 2013, our organization was recognized by Magellan as an "Outstanding Community Partner" for the difference we have made in the lives of foster children in Maricopa County. 2. Describe the goals and activities of the proposed project. Specifically, Hope & A Future is requesting assistance for our Life Skills program with funding directly related to a Life Skills Center for Arizona foster children. At this time, the organization does not have a permanent location to conduct our life skills program. However, the organization has secured funding for several other aspects of our Life Skills program, including salaries for a life-skills coordinator, tutoring services, mentoring program, a computer lab, and transportation costs and other costs for the life skills program. Having funding for a permanent location to conduct the program will make a tremendous impact on the lives of Arizona foster children that we serve. There are three main goals under the Life Skills program: 1. Provide tools and resources to foster youth who are 14 years old or older to help them graduate from high school. This goal is achieved by stressing the importance of goal setting, being proactive, and helping students map out life decisions so they will have a better understanding of their future. Struggling in school seems to be a common ailment that hinders foster teens. By providing guidance and tutoring students in course work, Hope and A Future hopes to establish successful students. Many foster youth struggle with registering, studying, and finding possible funds to prepare for college entrance exams such as the ACT and SAT. With guidance and resources such as laptops which will help in the registration and studying for postsecondary entrance exams, tutors who can determine gaps in a student's education, and providing guidance with FASFA forms foster teens will hopefully feel supported to succeed in high school. 2. Foster and encourage a strong desire for Arizona foster youth who participate in our program to pursue a postsecondary education. Through consistent participation in our life skill program, the youth are introduced to new ideas, schools, and career options that most foster teens are unaware of Though college campus visits, students are able to witness the excitement and opportunities a university has to offer. Through these visits, foster youth recognize the numerous career options and degrees offered across Arizona State Colleges, and find a passion. Hope and A Future will also partner with local schools and/or organizations to create a "College Night" event where students have the ability to visit different colleges, universities, and trade schools located in the state of Arizona. While preparing for college students will also be given the opportunity to apply for scholarships online with assistance of Hope and A Future staff During this step, the foster teens will be given the opportunity to apply for the John S. Brewer Memorial Scholarship Fund. 3. Through our life skills mentoring program, match foster youth with caring adults who can encourage and support the foster youth as they finish high school and age out of the system at 18. A large number of foster teens after aging out of the system find themselves homeless, in prison, or uneducated without much hope of a successful future. Matching these teens with a caring, responsible, and giving adult early in the teen years will help create a support system that is reliable and able to direct wise decision making. Having the ability to train caring adults in proper ways to facilitate a mentoring relationship will change the lives of each foster teen, one at a time. Youth that find themselves aging out of the foster care system often desire to have one person they know will encourage them, assist in a crisis, or simply care about their future. Highly trained mentors can be the one important individual. 3. Describe how the proposed project satisfies one or more of the priority funding areas identified by Gila River Indian Community. Our Life Skills program directly satisfies the education priority established by the Gila River Indian Community. Funding for a permanent Life Skills center that allows us to effectively carry out our life skills program (tutoring, mentoring and scholarships) will help Arizona foster children succeed in high school, expose them to post-secondary education opportunities and provide college scholarships. 4. Identify the needs/problems to be addressed, target population and number of people to be served by the project. Arizona has a record number of foster children in foster homes and group home settings today with over 16,900 foster children. Each year over 725 children "age out" of the system when they turn 18. 1 out of 5 will become homeless. 25% of these youth will be incarcerated. Only 58% of foster children will graduate from high school and of those only 3% will ever graduate from college. These statistics represent the dire situation that these foster youth face in our state. The outcomes for Arizona foster youth in the foster care system must be improved by creating or growing mentoring programs that encourages both high school and college graduation and entrance into the workforce. 5. Define the project as a new or continuing program. Hope & A Future's Life Skills program has existed since 2010. However, funding directly related to a Life Skills Center would be considered a new aspect of the program. 6. Provide a brief timeline including start and finish dates. Indicate if the timeline if flexible. Our Life Skills program operates year round and the timeline is flexible. However, we would prefer to open a permanent Life Skills Center in 2015 and secure funding of the operations of the center for 5 years. 7. Identify other organizations, partners or funders participating in the project and their roles. Funding for our Life Skills program has been secured, but that does not include funding for a Life Skills Center. As demonstrated on the Project Budget, over $210,000 has been secured through other partners for program operations, computers, tutoring services, supplies and other items. This funding is through grants provided by the Governor's Office of Workforce Development, Union Pacific, Phoenix Suns Charities and Coyote Charities. 8. Would you be able to implement the proposed plan if your organization received partial funding for this project? If we received partial funding, we would be able to continue to operate our Life Skills program, however, we would be limited in our ability to open and operate a life skills center. 9. Describe your plan for project sustainability beyond the grant period. A Life Skills Center would allow the organization to leverage our status as a Qualifying Foster Care Charitable Organization in the State of Arizona with potential donors who can receive a tax credit for donating to the organization. Also, we would continue to apply for grants through other grant making entities such as the Virginia Piper Foundation, Nina Mason Pulliam Trust and others. 10. Describe your plan to document progress and results. A Life Skills Center would help us to achieve our three mains goals of the life skills program, with the following results: • Have 50 students participating in monthly events that stress the importance of academic success and postsecondary education or workforce entrance. • Each year, identify 20 foster youth who express an interest to attend college or trade school. • Each year, match 20 foster youth with trained mentors that encourage success through high school, postsecondary education, and in life. 11. Indicate any application to and/or awards made by a tribe other than the Gila River Indian Community for state shared revenues for this and any other project. Not Applicable Gila River Indian Community Grant Application Project Budget Budget Period: Click here to enter text. Proposed Budget Expense Amount Amount In Kind Total Budget (list each budget item) requested from requested or contributions GRIC secured from other funders 1. Life Skills Coordinator $0 $55,000 $0 $55,000 2. Life Skills Assistant Coordinator $0 $35,000 $0 $35,000 3. Workers' Comp, Taxes, Insurance $0 $12,500 $0 $12,500 4. Contract Services $0 $11,000 $0 $11,000 5. Transportation $0 $10,000 $0 $10,000 6. Life Skills Supplies $0 $31,000 $0 $31,000 7. Computer Lab $0 $8,500 $0 $8,500 8. Cell Phones & Annual Service $0 $2,800 $0 $2,800 9. College Scholarships / year $0 $25,000 $0 $25,000 10. Life Skills Center Loan $24,000 $0 $0 $24,000 11. Life Skills Center Insurance, $24,000 $0 $0 $24,000 Maintenance, Utilities, Furniture 12. Life-Skills Center Receptionist $35,000 $0 $0 $35,000 13. Workers' Comp, Taxes, Insurance $6,000 $0 $0 $6,000 14. Education Liaison $11,000 $22,000 $0 $33,000 15. Click here to enter text. $0 $0 $0 $0 16. Click here to enter text. $0 $0 $0 $0 17. Click here to enter text. $0 $0 $0 $0 Total Budget $100,000 $210,800 $0 $310,800 Gila River Indian Community Grant Application Project Budget Detail Please provide a narrative description for each of the project budget items. 1. $55,000 is an annual salary amount for our Life-Skills Coordinator. This amount is already secured through the organization's fundraising and other grants. 2. $30,000 is an annual salary for the Life Skills Assistant Coordinator. This amount is already secured through the organizations's fundraising and other grants. 3. $12,500 represents various employee expenses for the Life Skills employees, such as workers' compensastion, payroll taxes and insurance. This amount is already secured through the organizations's fundraising and other grants. 4. $11 ,000 represents 200 hours of paid tutoring for foster children through a contracted provider, Tutor Doctor. This amount is already secured through the organizations's fundraising and other grants. 5. $10,000 represents travel costs to transport foster children to monthly activities, including collge visits. This amount is already secured through the organizations's fundraising and other grants. 6. $31,000 represents supplies for the life skills program, including a mentoring program, volunteer training, background checks, curriculum, recruitment and marketing. This amount is already secured through the organizations's fundraising and other grants. 7. $8,500 represents the expense to purchase a compuer lab for foster children. This amount is already secured through the organizations's fundraising and other grants. 8. $2,800 represents cell phone purchase and annual service costs for life skills employees. This amount is already secured through the organizations's fundraising and other grants. 9. $25,000 represents the annual amount of college scholarships that are given to Arizona foster children through the John S. Brewer Memorial Scholarship program. This amount is already secured through the organizations's fundraising and other grants. 10. $24,000 is the annual cost on the loan for our life skills center, or $2,000/mo. This amount IS NOT currently funded. 11. $24,000 is the annual cost of insurance, maintenance, utitilies and furniture and supplies for the life skills center. This amount IS NOT currently funded. Gila River Indian Community Grant Application 12. $35,000 represents the cost for a full-time life-skills receptionist and administrative assistant for the life skills center. This amout IS NOT currently funded. 13. $6,000 represents the represents various employee expenses for the Life Skills receptionist/administrative assistant, such as workers' compensastion, payroll taxes and insurance. This amount IS NOT currently funded. 14. $11,000 represents partial funding for an educational liaison for foster children who receive a scholarhisp and enroll into college. This liaison keeps contact with the student, creates accountability by reviewing academic progress and grades, and provides support to the student. This amount IS NOT funded. 15. Click here to enter text. 16. Click here to enter text. 17. Click here to enter text. Other explanation: Click here to enter text. IRS Internal Department Revenue of the Treasury Service P.O. Box 2508, Room 4010 In reply refer to: 0441637415 Cincinnati OH 45201 May 08, 2009 LTR 4168C EO 42-1651164 000000 00 000 00027342 BODC: TE HOPE AND A FUTURE INC % MICHAEL BREWER 1802 E WINTER DR PHOENIX AZ 85020-4412 007323 Employer Identification Number: 42-1651764 Person to Contact: N Putnam Toll Free Telephone Number: 1-877 829 5500 Dear Taxpayer: This is in response to your request of Apr. 29, 2009, regarding your tax-exempt status. Our records indicate that a determination letter was issued in August 2005, that recognized you as exempt from Federal income tax, and discloses that you are currently exempt under section 501(c)(3) of the Internal Revenue Code. Our records also indicate you are not a private foundation within the meaning of section 509(a) of the Code because you are described in section(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. If you have any questions, please call us at the telephone number shown in the heading of this letter. Sincerely yours, Rtkua_,Atbz.„, Rita A. Leete Accounts Management II Created Thursday, February 19, 2015 Page 1 General information General information | Organization Public Health General information | Contact First name Anna General information | Contact Last name David General information | Contact e-mail annadavid@mail.maricopa.gov General information | Contact phone number (602)526-0220 Address Address | Street 4041 N Central Avenue, Suite 1400 Address | City Phoenix Address | State AZ Address | ZIP Code 8 523 3 From what tribe is the organization requesting the grant? Gila River Indian Community Total grant amount request $77,500 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 $77,500 Year 2 $ Year 3 $ Year 4 $ Year 5 $ Page 1 This page left blank intentionally Gila River Indian Community Grant Application Cover Sheet Municipality Information Date of Application: 3/2/2015 Name of City, Town or County: Phoenix – Maricopa County Mayor (City or Town) or Board of Supervisor’s Chairman (County): Steve Chucri Mailing Address: 4041 N. Central Ave. Suite 1400 City: Phoenix State: Arizona Zip Code: 85012 Acknowledgement of Submission by Municipality Representative: Typed Name: Amanda Nash Signature: Applicant Information Department/Organization Name: Maricopa County Department of Public Health, Office of Tobacco and Chronic Disease Prevention Application Contact Person: Lilliana D. Cardenas, MSW Title: Prevention Program Education Supervisor Phone Number: 602-639-0278 Mailing Address: 301 W. Jefferson, 10th Fl. Phoenix, AZ 85003 City: Phoenix State: Arizona Zip Code: 85012 Email Address: lillianacardenas@mail.maricopa.gov Project Information Project Name: Maricopa County Teacher Wellness Initiative Purpose of Grant: The Maricopa Teacher Wellness Initiative seeks to conduct comprehensive assessments using the Center for Disease Control’s School Health Index (SHI) and work closely with schools to develop a School Health Improvement Plan (SHIP). These efforts will focus on schools that identify a deficiency in staff health and wellness promotion. This partnership would explore and guide the expansion and modification of wellness trainings such as the Healthy Arizona Worksites Program (HAWP) and the development of a tool kit that will speak to the specific needs of individual schools and their staff. Priority Funding Area Education Annual amount requested $Year One $62,500; Year Two $51,000 Number of years that funding is requested (1-5) 2 Total amount requested (annual amount x # of $113,500 years) Has your organization received funding from Yes, Gila River Indian Community in the Past? If yes, 2014 for Parent Ambassador program $50,000 please list each year and amount 2011 for Mobile STD Services $150,000 For Office Use Only: Data Entry Receipt Evaluation Gila River Indian Community Grant Application Geographic area served Maricopa County Gila River Indian Community Grant Application Narrative Please structure your proposal to provide the following information in the order indicated. List the heading first and then provide the narrative in paragraph form. Please be thorough but strive for brevity. 1. Briefly describe the organization’s mission, history and goals. 2. Describe the goals and activities of the proposed project. 3. Describe how the proposed project satisfies one or more of the priority funding areas identified by the Gila River Indian Community. 4. Identify the needs/problems to be addressed, target population and number of people to be served by the project. 5. Define the project as a new or continuing program. 6. Provide a brief timeline including start and finish dates. Indicate if the timeline is flexible. 7. Identify other organizations, partners or funders participating in the project and their roles. 8. Would you be able to implement the proposed plan if your organization received partial funding for this project? 9. Describe your plan for project sustainability beyond the grant period. 10. Describe your plan to document progress and results. 11. Indicate any application to and/or awards made by a tribe other than the Gila River Indian Community for state shared revenues for this and any other project. Gila River Indian Community Grant Application Project Budget Budget Period: August 2015 – July 2017 Proposed Budget Expense Amount Amount In Kind Total Budget (list each budget item) requested from requested or contributions GRIC secured from other funders 1. Mini-grants to schools Year One $45000 $0 $0 $0 2. Mini-grants to schools Year Two $30000 $0 $0 $0 3. Stipened for school coordinators $7500 $0 $0 $0 Year One 4. Stipened for school coordinators $7500 $0 $0 $0 Year Two 5. Creation of toolkits and $9,000 $0 $0 $0 modifications to curriculum Year One 6. Development and implementation $9,000 $0 $0 $0 of professional development Year One 7. Meetings, trainings and $3500 $0 $2000 $0 presentations Year Two 8. Printing of material and distribution $2,000 $0 $2500 $ 9. MCDPH Staff working with schools $0 $0 $17,400 $0 10. MCDPH Staff working with schools $0 $0 $22,880 $0 11. MCDPH Staff working with Schools $0 $0 $22,880 $0 12. Data collection and evaluation $0 $0 $10,000 $0 13. Click here to enter text. $0 $0 $0 $0 14. Click here to enter text. $0 $0 $0 $0 15. Click here to enter text. $0 $0 $0 $0 16. Click here to enter text. $0 $0 $0 $0 17. Click here to enter text. $0 $0 $0 $0 Total Budget $113,500 $0 $77,660 $0 Gila River Indian Community Grant Application Project Budget Detail Please provide a narrative description for each of the project budget items. 1. All 15 schools who participate in the pilot project will receive a mini-grant of $3,000 the first year. These funds will be awarded after the school has successfully completed the SHI and developed their SHIP as outlined in the proposal. 2. All 15 schools who continue onto Year Two of the pilot project will receive an additional mini-grant of $2,000 once all Year One data, surveys and SHIP have been complete. They will need to re-visit and re-evaluate SHIP and develop a plan for Year Two to enhance the work of Year One. 3. School Champions/Coordinators will be provided a $500 stipened each year. The coordinator will be tasked with organizing school staff, leading the SHI, SHIP and implementation of goals. 4. School Champions/Coordinators will be provided a $500 stipened each year. The coordinator will be tasked with organizing school staff, leading the SHI, SHIP and implementation of goals. 5. Toolkits will be developed in collaboration with listed partners. Extensive research will be completed to account for best practices, current trends and models of program development. Toolkits will be distributed to all participating schools and made available for all school districts in Maricopa County. 6. Professional development and capacity bulding will be developed and provided to all participating schools and districts. Trainings such as the modified Health Arizona Worksites Program will be available to schools statewide. This modification and resource development will not only benefit Maricopa County schools, but statewide schools and districts. 7. Countywide trainings and presentations will be held to present findings and recommendations to push for policy and systems change and improvements. 8. Toolkits and other training/education resources will be printed and provided to schools. These materials will be made available during and after trainings to ensure compliance with pilot project. 9. MCDPH will provide in-kind staff support. These staff currently work to support several schools countywide with the SHI/SHIP and various others health and wellness prevetion and promotion programs. 10. Data will be collected at various points during the pilot study. We will work with our Epidemology department to analyze the data and create the report. 11. Click here to enter text. Gila River Indian Community Grant Application 12. Click here to enter text. 13. Click here to enter text. 14. Click here to enter text. 15. Click here to enter text. 16. Click here to enter text. 17. Click here to enter text. Other explanation: Click here to enter text. Organizations Mission, History and Goals: The Maricopa County Department of Public Health (MCDPH) serves the third largest local public health jurisdiction in the U.S., with more than 3.8 million residents according to the 2010 census. Maricopa County encompasses over 9,200 square miles, roughly the size of the state of Massachusetts, composed of a mix of urban, suburban, and rural areas including the whole or parts of five sovereign American Indian Reservations. Home to the city of Phoenix, the nation’s sixth largest city (population 1,445,632), Maricopa County serves as the state’s major geopolitical and economic center. The mission of MCDPH is “to protect and promote the health and well-being of Maricopa County residents and visitors.” Staffing at the department is complicated. As of the end of fiscal year 2013, MCDPH has the capacity for 687 positions (659.075 FTEs) of which 613 employees are employed (585.075 FTE positions), 74 positions are vacant. The fiscal year 2013 operating budget was $55,803,560, of which 72% was grant funded ($40,041,018). The health department reports to a local Board of Health, but is governed by the Maricopa County Board of Supervisors. This grant is requested on behalf of the Office of Tobacco and Chronic Disease Prevention (OTCDP), a program of the Community Transformation Division within the MCDPH. OTCDP provides leadership, educational programing and preventative outreach in and around tobacco prevention and cessation as well as chronic disease prevention and management. Services are offered throughout Maricopa County in collaboration with schools, hospitals, community organizations and academic institutions. Goals and Activities of Proposed Project Maricopa County’s Department of Public Health, Office of Tobacco and Chronic Disease respectfully submits this request for consideration for funding to the Gila River Indian Community for $113,500 over a two year period. These funds will directly support the Maricopa County Teachers Wellness Initiative which will be piloted at 15 schools throughout Maricopa County. Goal 1: Create opportunities for school staff health and wellness promotion through assessment, health planning, professional development, and school policy. Activities: Use the Centers for Disease Control (CDC) School Health Index (SHI) to assess staff health and wellness promotion. The SHI is an evidence based assessment of environmental, physical and systematic health and wellbeing status of schools, staff, students and parent engagement. Select 15 schools throughout Maricopa County who have identified staff health and wellness promotion deficiencies at their school through previous School Health Index assessments. Identify a school wellness champion who will be the school-level contact and coordinator for the SHI and School Health Improvement Plan (SHIP). This champion will receive a $500 annual stipend. The SHIP is a plan developed once the SHI has been completed and has specific improvement goals that align with deficiencies founds within the assessment. Develop a School Health Improvement Plan that specifically addresses staff health and wellness promotion. Conduct staff surveys and focus groups to gather information on current health and wellness practices at schools and their impact on staff satisfaction, retention, absenteeism, and morale. Evaluate Data and provide recommendations to local and state agencies on policy and system improvements around staff health and wellness. Use staff survey and focus group results to inform the development and modifications of professional development and tools to enhance staff health and wellness promotion. Schools will receive a Staff Health and Wellness Toolkit with practical approaches to planning and implementation of school based health initiatives. Participating schools will receive a mini-grant of $3,000 in year one and $2,000 in year two. These mini-grants will be awarded to each school to purchase educational material, supplies, equipment, and incentives that will directly support the School Health Improvement Plan. Goal 2: Create awareness of the importance of staff health and wellness and its impact on school culture and academic success. Provide technical assistance, guidance and an opportunity for school staff to voice their concerns and recommendations to improve current educational policies and systems. Collaborate and inform partners and projects that seek to work with schools and improve academic outcomes and teacher retention. Develop presentations on findings and recommendations to be shared at the state and national level via conferences, publications, and webinars. Provide schools with technical assistance and professional development opportunities on their School Health Improvement Plan, staff self-care, chronic disease management, tobacco prevention, stress management, and others areas as they are identified. Provide key school staff with a school-based modified version of the Healthly Arizona Worksite Program through the Arizona Department of Health Services and the Maricopa County Department of Public Health. Funding Priority: This proposal’s work aligns with the Gila River Indian’s Education Priority. This pilot program will assist students and/or educators in achieving success in the classroom. Purpose of Grant 1. Describe the proposed program/project Teachers are the backbone of the education system. They enter the profession for love and purpose, but all too often sacrifice a great deal to remain invested long term. In Arizona we are facing a grim reality, a recent report prepared by the Arizona Department of Education highlighted that 53% of district and charter schools reported between one and five educators broke their contract or resigned midyear during the 2013-2014 school year. This abrupt leave impacts administrators, fellow teachers, students and parents. It continues to have a ripple effect that begins to impact the entire education system and the culture of the teaching profession. The Maricopa Teacher Wellness Initiative seeks to conduct comprehensive assessments using the Center for Disease Control’s School Health Index (SHI) and work closely with schools to develop a School Health Improvement Plan (SHIP). These efforts will focus on schools that identify a deficiency in staff health and wellness promotion. Various studies have shown that by creating a culture of health by increasing healthy behaviors and providing healthy eating, physical activity, stress reduction, and chronic disease management wellness programs there will be an increase in employees’ ability to focus, reduce absenteeism, and improve employee’s morale1. In the past three years of conducting the SHI with schools throughout the county, more than 30 schools have identified a lack of staff health promotion and support as an area of improvement at their schools. A growing need and limited resources has kept MCDPH from expanding its reach and opportunities to address this with schools. The Gila River Indian Tribe funds would go directly into increasing the opportunity for MCDPH to design and develop toolkits, trainings, and supports by working in collaboration with the Arizona Department of Education and the Arizona Department of Health Services. This partnership would explore and guide the expansion and modification of wellness trainings such as the Healthy Arizona Worksites Program (HAWP) and the development of a tool kit that will speak to the specific needs of individual schools and their staff. Resources will be allocated to the Maricopa Teacher Wellness Initiative pilot project, which will work closely with these identified schools and partners. We plan to provide assessment, technical assistance, and planning guidance to 15 schools throughout the county over a two- year period. Data will be collected using the SHI, SHIP, staff satisfaction surveys, focus groups, and end of year program evaluations. Schools will have an opportunity to participate in free professional development and wellness programs that will be developed as part of this grant. The data collected over the two-year pilot will inform our work with local and state agencies that can further influence policy and develop additional supports and resources to increase staff health and wellness promotion at schools which will have long-term positive impacts on retention, morale, and school culture. Project Status: The Maricopa County Teacher Wellness Initiative is a pilot project that incorporates current practices of working with schools throughout the county and administering the SHI. This specific project is New due to the nature and focus specifically on staff health and wellness. Timetable for Implementation: The timing is flexible as long as it is conducting during the school year. Year 1 (August 2015 – July 2016) 1 Chapman, Larry S. “Meta-Evaluation of Worksite Health Promotion Economic Return Studies: 2012 Update”. The American Journal of Health Promotion 26.4 (2012): 1-12. Recruitment of 15 schools: meeting with district August 2015 and school administrators Identify school wellness champion at each school August – September 2015 Begin planning and developing training August 2015 opportunities for staff Host orientation meetings for participating schools September – November 2015 Conduct baseline staff health/wellness and October – November 2015 satisfaction survey Begin School Health Index/Module 7, after November – December 2015 completion of baseline survey Schools conduct School Health Index/Module 7 December 2015 – February 2016 and develop School Health Implementation Plan Schools begin work on School Health February – April 2016 Implementation Plan (SHIP) Conduct mid-point staff health/wellness and April – May 2016 satisfaction survey SHIP end-of-year evaluation May 2016 Data evaluation and analysis for Year One June 2016 Year One report and information sharing July 2016 Year 2 (August 2016 – July 2017) Continue work with 15 schools: meeting with August 2015 school administrators and school wellness champions Host orientation meetings for participating schools September – November 2015 and revisit SHIP to determine next steps for year two completion Conduct Year two staff health/wellness and October – November 2015 satisfaction survey Provide professional development and resources November – December 2015 to continue work on SHIP Spring SHIP check-in and status update with all February – April 2016 schools Conduct mid-point staff health/wellness and April – May 2016 satisfaction survey SHIP end-of-year evaluation May 2016 Data evaluation and analysis for Year Two June 2016 Pilot project comprehensive report and July 2016 information sharing Identified Partners: Arizona Department of Education Arizona Department of Health Services Maricopa Education Service Agency Various Local Education Agencies (LEAs) as identified through the grant Healthy Arizona Worksites Program Funding Status: The Maricopa County Teacher Wellness Initiative is in its early stages and is an innovative approach to gathering data and working with schools to create a culture of wellness. MCDPH staff already has a well-developed relationship with schools and administration and expertise in capacity building. Even if we are only able to receive partial funding, much of this work would still continue, but at a drastically reduced rate. The project would be limited to a very small group of schools with minimal financial incentives. The incentives are necessary to gain buy-in and to provide the necessary means for the schools to purchase supplies that they need to make their School Health Improvement Plans a reality. A smaller pilot also means less credible data and a much harder time making the case for teacher health and wellness promotion in Maricopa County. Sustainability: Various partners are interested in the movement of staff health and wellness promotion and its impact on retention and academic achievement. The desire to gather strong evidence that will inform policy and system change is an overarching goal of this project. This pilot will add to the current work that both county and state entities are looking to accomplish in the next couple of years. This project will be the beginning of something much larger and because of that it becomes even more important to fund. Documenting Progress and Results: All data points from the SHI, SHIP, surveys, and evaluations will be collected by MCDPH. Data will be analyzed by our epidemiology department and reports will be provided to partners and funder outlining findings, trends, and recommendations. A traditional report will be developed in addition to a PowerPoint presentation that will be shared at various opportunities with partners and school districts in Maricopa County. We will even apply to present at local and national conferences and seek to publish findings at the end of the two year pilot in public health and academic journals. Maricopa County Teacher Wellness Initiative GRIC portion Item Basis Year 1 Year 2 TOTAL School Based Svcs. Mini-grants 15 schools x $3,000 $45,000 $45,000 School Champion/Coordinator 15 coordinators x $500 $7,500 $7,500 Mini-grants 15 schools x $2,000 $30,000 $30,000 School Champion/Coordinator 15 coordinators x $500 $7,500 $7,500 Materials and Supplies Toolkit development and curriculum modifications $9,000 $9,000 Development and Implemenation of Professional Development $9,000 $9,000 Printing (toolkits 15 @ $2,000 $2,000 Meetings/trainings/presentations $3,500 $3,500 Total Requested to GRIC $72,500 $41,000 $113,500 In-Kind Costs (MCDPH/OTCDP) 15% Program Supervisor $8,700 $8,700 $17,400 25% Specialist $11,440 $11,440 $22,880 25% Specialist $11,440 $11,440 $22,880 Printing (additional material) $1,250 $1,250 $2,500 Data collection and evaluation $3,000 $7,000 $10,000 Meetings/trainings/presentations $2,000 $2,000 Total In-Kind Costs $35,830 $41,830 $77,660 Total project cost $108,330 $82,830 $191,160 Created Thursday, February 19, 2015 Updated Monday, March 09, 2015 Page 1 General information General information | Organization Leukemia & Lymphoma Society General information | Contact First name Naomi General information | Contact Last name Martinez General information | Contact e-mail naomi.martinez@lls.org General information | Contact phone number 6025677612 Address Address | Street 3877 N 7th St Ste 300 Address | City Phoenix Address | State AZ Address | ZIP Code 8 50 1 4 From what tribe is the organization requesting the grant? Gila River Indian Community 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 $ Page 1 IRS Department of the Treasury Internal Revenue Service In reply refer to: 0248121964 CINCINNATI OH 45999-0038 Feb. 10, 2015 LTR 4168C 0 13-5644916 000000 00 00020385 BODC: TE LEUKEMIA & LYMPHOMA SOCIETY INC 1311 MAMARONECK AVE STE 310 WHITE PLAINS NY 10605-5223 009717 Employer Identification Number: 13-5644916 Person to Contact: Ms.Mitchell Toll Free Telephone Number: 1-877-829-5500 Dear Taxpayer: This is in response to your Jan. 30, 2015, request for information regarding your tax-exempt status. Our records indicate that you were recognized as exempt under section 501(c)(3) of the Internal Revenue Code in a determination letter issued in January 2001. 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. 0248121964 Feb. 10, 2015 LTR 4168C 0 13-5644916 000000 00 00020386 LEUKEMIA & LYMPHOMA SOCIETY INC 1311 MAMARONECK AVE STE 310 WHITE PLAINS NY 10605-5223 If you have any questions, please call us at the telephone number shown in the heading of this letter. Sincerely yours, /96, "1 4-itz-44t Doris Kenwright, Operation Mgr. Accounts Management Operations 1 Gila River Indian Community Grant Application Cover Sheet Municipality Information Date of Application: 3/2/2015 Name of City, Town or County: Phoenix Mayor (City or Town) or Board of Supervisor’s Chairman (County): Steve Chucri Mailing Address: 301 W. Jefferson St City: Phoenix State: Arizona Zip Code: 8500. Acknowledgement of Submission by Municipality Representative: Typed Name: Amanda Nash Signature: Applicant Information Department/Organization Name: Leukemia & Lymphoma Society AZ Chapter Application Contact Person: Naomi Martinez Title: Assistant Development Coordinator Phone Number: 6025677612 Mailing Address: 3877 N 7th St Ste 300 City: Phoenix State: Arizona Zip Code: 85014 Email Address: Naomi.Martinez@lls.org Project Information Project Name: ReducingCancer Health Disparities Through Education and Outreach, and Providing Financial Aid for Transportation for Blood Cancer Patients in AZ Purpose of Grant: Provide transportation to patients for treatments, doctor appointments and support groups Priority Funding Area Healthcare Annual amount requested $25,000.00 Number of years that funding is requested (1-5) 1 Total amount requested (annual amount x # of $25000 years) Has your organization received funding from Gila 2012, 2006, River Indian Community in the Past? If yes, 2010---------------------------------------------------------------- please list each year and amount ----------------------------------------------------------------------- ----------------------------------------------------------------------- For Office Use Only: Data Entry Receipt Evaluation Gila River Indian Community Grant Application ----------------------------------------------------------------------- ----------------------------------------------------------------------- ----------------------------------------------------------------------- ----------------------------------------------------------------------- ----------------------------------------------------------------------- ----------------------------------------------------------------------- ----------------------------------------------------------------------- ----- Geographic area served Phoenix and surrounding cities (state of Arizona) Gila River Indian Community Grant Application Narrative Please structure your proposal to provide the following information in the order indicated. List the heading first and then provide the narrative in paragraph form. Please be thorough but strive for brevity. 1. Briefly describe the organization’s mission, history and goals. 2. Describe the goals and activities of the proposed project. 3. Describe how the proposed project satisfies one or more of the priority funding areas identified by the Gila River Indian Community. 4. Identify the needs/problems to be addressed, target population and number of people to be served by the project. 5. Define the project as a new or continuing program. 6. Provide a brief timeline including start and finish dates. Indicate if the timeline is flexible. 7. Identify other organizations, partners or funders participating in the project and their roles. 8. Would you be able to implement the proposed plan if your organization received partial funding for this project? 9. Describe your plan for project sustainability beyond the grant period. 10. Describe your plan to document progress and results. 11. Indicate any application to and/or awards made by a tribe other than the Gila River Indian Community for state shared revenues for this and any other project. Gila River Indian Community Grant Application Project Budget Budget Period: 2014-2015 Proposed Budget Expense Amount Amount In Kind Total Budget requested from requested or contributions (list each budget item) GRIC secured from other funders 1. Patient Financial Aid for 25,000 $0 $0 $25000 Transportation 2. Click here to enter text. $0 $0 $0 $0 3. Click here to enter text. $0 $0 $0 $0 4. Click here to enter text. $0 $0 $0 $0 5. Click here to enter text. $0 $0 $0 $0 6. Click here to enter text. $0 $0 $0 $0 7. Click here to enter text. $0 $0 $0 $0 8. Click here to enter text. $0 $0 $0 $0 9. Click here to enter text. $0 $0 $0 $0 10. Click here to enter text. $0 $0 $0 $0 11. Click here to enter text. $0 $0 $0 $0 12. Click here to enter text. $0 $0 $0 $0 13. Click here to enter text. $0 $0 $0 $0 14. Click here to enter text. $0 $0 $0 $0 15. Click here to enter text. $0 $0 $0 $0 16. Click here to enter text. $0 $0 $0 $0 17. Click here to enter text. $0 $0 $0 $0 Total Budget $0 $0 $0 $0 Gila River Indian Community Grant Application Project Budget Detail Please provide a narrative description for each of the project budget items. 1. Financial aid for patients requiring assistance with transportation to and from appointments and treatments for care. 2. Click here to enter text. 3. Click here to enter text. 4. Click here to enter text. 5. Click here to enter text. 6. Click here to enter text. 7. Click here to enter text. 8. Click here to enter text. 9. Click here to enter text. 10. Click here to enter text. 11. Click here to enter text. 12. Click here to enter text. 13. Click here to enter text. 14. Click here to enter text. 15. Click here to enter text. 16. Click here to enter text. 17. Click here to enter text. Other explanation: Click here to enter text. 1. Briefly describe the organization’s history and goals. Mission Statement, Purpose or Strategic Plan of Organization The mission of The Leukemia & Lymphoma Society (LLS) is: Cure leukemia, lymphoma, Hodgkin's disease and myeloma, and improve the quality of life of patients and their families. Research • Advance the diagnosis and treatment of blood cancers • Proactively establish a research agenda and direct a portion of research spending to specific areas of unmet medical need Patient Services • Develop a services agenda for patients and their families to address their information and support needs • Inform blood cancer patients and improve access to the latest individual therapy options and clinical trials • LLS is the key source of information and services for patients throughout their cancer journey Public Policy • Increase funding from nonLLS sources to accelerate discovery and development of therapies • Encourage an effective, sciencedriven regulatory system for efficient review of new therapies • Ensure patients have insurance coverage and wellcoordinated, high quality cancer care 2. Describe the goals and activities of the proposed project The Travel Assistance Program (TAP) serves blood cancer patients residing in Arizona. We have initiated the program because patient feedback consistently identified financial assistance as an area of unmet need. Often times a lack of financial resources represent a significant barrier to access to care. Patients often express fear and concern over the immense financial burden that comes with a cancer diagnosis. LLS regularly fields calls from patients who cannot move forward with their treatments because they cannot afford the transportation to get to their providers. While LLS does offer copay assistance to help with insurance copay obligations and premiums, the expenses of traveling to and from treatments can be quite substantial and these expenses are not covered under the copay program. LLS will target this assistance to those who need it most by requiring an attestation of financial need. 3. Describe how the proposed project satisfies one or more of the priority funding areas identified by the Gila River Communities. There will be an estimated________new cases of blood cancer in Arizona this year. We anticipate an increase in need as the incidence of blood cancer continues to increase. Blood cancers occur in people of all ages. There are very few known causes of blood cancers and no opportunities for prevention or early detection. TAP provides qualified patients a stipend. To be eligible, a patient’s household income must be at or below ______% of the Federal Poverty Level as adjusted by the Cost of Living Index. 4. Identify other organizations, partners, or funders participating in the project and their roles Many families faced with a cancer diagnosis are faced with difficult decisions regarding budgets, family needs, and treatment. In many cases, having a family member undergoing treatment for leukemia or lymphoma requires a parent, spouse or partner to miss many days of work, creating even more economic stress. Some patients have to travel great distances to reach the right treatment center or specialist or to participate in a clinical trial. While some patients are fortunate to receive treatment closer to home, their families may incur substantial expenses in gas, parking fees, and/or public transportation costs, particularly when treatment extends over months or years. The Travel Assistance Program alleviates some of this financial burden by providing financial assistance to help cover costs incurred in traveling to and from treatments. The program helps to reduce a financial barrier to care and allows patients access to the treatments that they need. 5. Define the project as a new or continuing program The Travel Assistance Program is a brand new program for LLS, launched in spring of 2014. Thus far, $150,000 in grants have been secured (nationwide). Those funds have been depleted. Our national office continues to seek funding that will benefit patients in all of its chapters, but because money raised in Arizona will stay in the community and help local residents, we’ve expanded our efforts to raise money from local companies, foundations and individuals. These funds are completely restricted for this specific use in Arizona. Anecdotally, over 90% of the calls to LLS’ Information Resource Center are for financial need. The program is critical and is often the entry point into other services provided by LLS. 6. Provide a brief timeline including start and finish dates January 2016 - July 2016: Develop fundraising and program plan for upcoming fiscal year. Start to submit letters of inquiry. July 2016 - December 2016: Begin Phase 1 of the program at medical hematology/oncology offices, as a continuation of previous pilot program. September 2016 - November- 2016: Speak with hospitals to increase the number of locations where transportation is needed. Hospitals interested in the program will be included in Phase 2. November 2016: Preparation for Phase 2 begins December 2016: Evaluation of phase 1 begins. Evaluations will provide feedback for Phase 2 and any suggestions/improvements/changes that need to be made to the program. January 2017: Most funds will have been secured for program January 2017 – June 2017: Phase 2 begins with new locations as needed June 30, 2017: Fiscal year 2014 ends. Program is evaluated extensively. July 1, 2017: Program continues, with evaluation results being applied to program throughout year. *dates dependent on grant funding stipulations and implementation LLS will keep records of the number of patients log served by the Travel Assistance Program beginning 2016, including age and geographic location, and will assess its success at the end of the year by determining how many Arizona blood cancer patients were reached through this program. A survey end of fiscal year will be taken of all recipients, asking specific questions on how the patients/families have been helped by the funds. The success of the program will be reflected in the survey results which undoubtedly will show that patients were better able to afford the costs associated with travel to and from treatment. 7. Identify other organizations, partners, or funders participating in the project and their roles. LLS Arizona chapter will work with local community parties to develop various routes based on location and need. 8. Would you be able to implement the proposed plan if your organization received partial funding for this project? Although it may be a bare projects without all the funding, it would be a great start for patients and allowing them to tend to appointments without the stress of finding a ride. Also in extreme cases, not attending appointments or treatments due to nit having transportation. 9. Describe your plan for project sustainability beyond the grant period. The annual $250 grants will be used to assist Arizona residents with any and all travel costs related to their blood cancer diagnosis, including active treatment, lab work and follow up appointments. Residents may apply for these grants on an annual basis since treatments and follow up for blood cancers often stretch over several months. The Patient Access Manager for the Arizona Chapter will provide an application directly to those patients who potentially qualify for the funds. The Travel Assistance Program Application form must be fully completed by the patient and health care providers and submitted to the Regional Mission Operations Manager, who will be responsible for reviewing and approving the request. Once approved, a check request will be generated and sent to the National Office Patient Access Project Manager for fulfillment. Checks will be sent directly to awardees as long as funds are available. 10. Describe your plan to document progress and results. LLS will work closely with the patient services coordinator to develop a tracking form for all patients including the reason for transportation services with date and time services are rendered. Tracking will assist in deciding on location factors, patient needs, as well as assistance implementation for future needs. 11. Indicate any application to and/or awards made by a tribe other than the Gila River Indian Community for state shared revenues for this and any other project We have also applied for with the intent to Ft. McDowell Community and Tohono O’odham communities for the 12% shared grant. As well, we are partnering with the Ft. McDowell community for our “Man/Woman of the Year” campaign for 2015 (Talking Stick Resort) .