Youngtown Community Fund Medical Equipment Application

El Mirage Community Partnership Grant Program
Application
Program Overview 
The City of El Mirage Community Partnership Grant supports nonprofit organizations that provide essential
health and human services directly to El Mirage residents, including low-income families, seniors, youth,
and other individuals who may benefit from additional support.  
Health and human services refer to programs, projects, or activities that improve the general health,
including physical, mental, emotional, or social well-being, of individuals and families. These services
address basic needs, promote safety and stability, and enhance residents' overall quality of life.  
The program offers one-time funding of up to $10,000 per application annually from July 1 to June 30.
Eligible nonprofits and other qualified charitable organizations with 501(c)(3) status or IRS letter of
determination recognizing nonprofit status under A.R.S. §42-11154 may submit multiple applications for
funding, provided each application represents a distinct program or project.  
Applicants are limited to one application per program or project. Each application must specify the
minimum funding required. Applications are evaluated based on an evaluation scoring rubric approved by
the City Council. The ultimate funding decisions are made by the El Mirage City Council. 
Applicant Eligibility Criteria   

The applicant must be a 501(c)(3) nonprofit corporation or other qualified charitable or nonprofit
organization as provided for in A.R.S. §42-11154. 

The applicant must provide direct health and human services to El Mirage residents and
demonstrate how the program or project improves resident well-being. 

The applicant must demonstrate the ability to generate revenue from sources other than the City of
El Mirage. 

The applicant must submit the five following required documents:
    1) Proof of 501(c)(3) status or IRS determination letter under A.R.S. §42-11154. 
    2) Organizational mission statement. 
    3) Board of directors list, including roles and affiliations. 
    4) Last two years of IRS Form 990 filings (or explanation if not available or required to file). 
    5) Completed application signed by an authorized representative. 

If awarded, the applicant must register with the City of El Mirage as a vendor and provide an IRS

Form W-9 to receive funds. 

If awarded, the applicant must demonstrate satisfactory progress toward stated goals and
objectives and provide timely and accurate reports as required by the city. 
Application Directions 
Please answer the following questions in narrative form. Applicants will receive up to five points for a
complete and accurate application.  
Submission Directions 

One electronic copy of the application and required attachments must be submitted no later than
the date and time identified in the notice to apply. 

Late applications will not be accepted. 

Please save a copy of this application for your records.

Awarded applicants are required to report completed program or project goal measurements by a
date and time specified in the notice of award, before the end of the fiscal year of the award,
or sooner as may be required by the city.  
More Program Information
Visit www.ElMirageAZ.gov/Grants for more information about the program, including evaluation scoring
rubric.
Program-Related Inquiries  
For program questions or to update contact information, please contact Regan Jepson at
communityservices@elmirageaz.gov. 
Part 1: Agency and Program or Project
Section A: Agency Information 
Agency Name
Youngtown Community Fund (YCF) Medical
Equipment Lending Center
Tax Number
86-6056167
Executive Director / CEO
N/A
Website
https://ytcommunityfund.wixsite.com/ytcommuni
tyfund
Address
11215 A W Nevada Ave, Suite A, Youngtown, Arizona 85363

Phone
(623) 977-4661
Section B: Agency Overview  
Briefly describe your organization, the services it provides, mission, goals, and population served. 
The Youngtown Community Fund is a 60-year-old, community-based 501(c)(3) charitable organization
located in Youngtown, Arizona.
Mission Statement: "To provide temporary use of durable medical equipment at no cost for up to 4 months,
to area residents with disabilities, mobility challenges or recovering from surgery, illness or an accident
fostering independence, dignity, and well-being in our community."
Service Provided: YCF loans a wide array of the most needed durable medical equipment including
wheelchairs, walkers, crutches, canes, shower and bath aids, commode equipment, and mobility assistive
devices. We currently have a staff of 2 part-time employees and a 5-person volunteer board of directors.
Our program operates through a structured intake, inventory, sanitation, and tracking process that ensures
equipment is safe, functional, and available when needed. Requests are received through direct walk-ins,
phone inquiries, referrals from social service agencies, healthcare providers, and family caregivers.
Equipment is assessed for appropriateness, fitted when needed, and tracked to ensure accountability and
timely return for reuse.
Goals and Objectives
The goals of the YCF are pragmatic and community-focused rather than large-scale or policy-driven. It's
our primary goal to meet the ever-increasing durable medical equipment needs of our aging communities.
Annually, we service over 1700 individual clients. It is our goal to reach 2500 clients by the end of 2026
demonstrating both the scale of need and our organization’s operational impact.
Specifically, in the city of El Mirage, we served 221 clients during our fiscal 2024/2025 year. So far in
2025/2026 we have helped 210 individual clients. It is our main goal to assist 300+ residents of El Mirage
in 2026/2027.
We will only be able to meet this need with increased inventory, expanded maintenance and greater
promotion of our service to the community. This way we can ensure everyone in need, in the city of El
Mirage, can obtain essential assistive devices quickly and cost-free.
Population Served: The YCF serves a broad but locally concentrated population in the West Valley of the
Phoenix metropolitan area. This includes the town of Youngtown and our neighbor El Mirage as well as the
cities of Surprise, Peoria, Glendale, Wittmann, Waddell and surrounding unincorporated areas.
The city of El Mirage, like most of the NW Valley, has a large senior population. 30% of the population is
over the age of 55. For these 11,000 residents, mobility issues are common, and access to our equipment
helps them remain independent and stay in their homes longer. Many community members live on fixed
incomes or Social Security. Insurance often won’t cover items, has long waiting times, and/or requires co-
pays people can’t manage. However, services are not limited by age and are available to anyone in need
within the service area.
We loan our equipment free of charge. Our program ensures that financial hardship doesn’t prevent
anyone from getting needed support. After surgery, accident, or illness, people often need equipment
temporarily. Buying it outright doesn’t make sense. The center allows people to borrow rather than buy.
Also, reusing equipment prevents unnecessary purchases, landfill waste and storage of unused items in
homes and garages.
The demographics of clients who borrow equipment from YCF reflect a broad range of individuals with

varying needs. Key demographic groups include:
-Seniors: A significant portion of borrowers are elderly individuals experiencing age-related mobility issues
or chronic conditions who need walkers, wheelchairs, and scooters to maintain mobility and independence.
-Individuals with physical disabilities or chronic health conditions who rely on DME to manage their daily
activities. This group may include both children and adults with temporary disabilities.
-Low-income households that may not have the financial means to purchase or rent expensive medical
equipment.
-Patients Recovering from Surgery or Injury who only need assistance on a short-term basis.
-Family member or professional caregivers borrow equipment to assist elderly or disabled loved ones with
rehabilitation or daily care.
-Veterans who who require DME due to injuries sustained during military service or age-related health
issues.
Please upload the following required documents: 
1.
Proof of Section 501(c)(3) Tax Exemption - IRS determination letter verifying nonprofit status under
A.R.S. §42-11154 from the Internal Revenue Service. Please upload. 
2.
Organizational mission statement. Please upload. 
3.
Board of Directors list including a current list of board members with roles and affiliations. Please
upload.  
Upload Files Here
501 3C.pdf
Mission Statement 2026.pdf
BOARD MEMBER LIST 2026 with Affiliations.pdf
Section C: Program or Project Information 
Program or Project Name
Growing Services and Exposure of YCF Medical
Equipment Lending Center in El Mirage
Program or Project Contact Person
Jay Lickus
Email 
jaypatfan@hotmail.com
Phone
(623) 734-5438
Does the program or project directly serve residents of the City of El Mirage?
Yes
Please select one health & human services category that best aligns with the need met by the
program.
Senior / Aging Services and Support
If you selected "Other" above, please specify:
Part 2: Program Description

Section A: Narrative Description 
Please provide a detailed description of the program or project that these grant funds will support,
if awarded.
Aggressively grow the lending of essential durable medical equipment to El Mirage residents free of charge
for up to four months and ensure the agency is in a strong financial position going into 2027 to expand
services even further.
Although El Mirage is the 2nd smallest city by population we serve it has the highest percentage of
residents served vs. the population with over 200 transactions in last 12 months. Approximately 20% of the
population is over the age of 55 and 10% are over 65 years old with many experiencing some sort of need
for DME. 12.5% are below the poverty line. Our goal is to increase visibility in El Mirage so more of the
aging population are aware of our services and improve our lending capabilities to meet the increased
demand.
Funds will be targeted for:
1.Marketing and Advertising:
a.
Website improvement – Our website is currently hosted on Wix and needs to be moved to a new,
more robust hosting site and updated.
b.
Brochures – Our current bifold brochure is several years old and also needs to be updated. It will
be used by the Board and volunteers for outreach to local senior-oriented businesses, government
agencies, hospitals and healthcare facilities in the Surprise area.
c.
Hyper-local magazine/online ads in local age restricted communities in the El Mirage area like
Pueblo El Mirage, Coppersun, and Rosewood Estates.
d.
Hosting of informational tables at City of El Mirage community events.
2.
Maintenance of existing equipment including purchasing replacement parts.
3.
Purchase of new equipment including need-specific items such as “Sit to Stand” lifts and Hoyer
lifts.
4.
Purchase of new equipment to replace items not returned. Approximately 12% of our loaned
equipment is never returned.
5.
Utilities and property maintenance.
6.
Office supplies and mailings.
Describe how this program or project will benefit El Mirage residents directly and the need or gap
in service that it meets. Please include data to support your response.
The City of El Mirage does not have a durable medical equipment lending center. Other organizations in
the area provide the same or similar services but not to the City of El Mirage. Sunshine Service – Sun City
only, Helping Hands – Sun City West only, Helping Neighbors – Sun City Festival only, Southwest Lending
Closet - Avondale, Buckeye, Goodyear, Litchfield Park and Tolleson.
While there is no single publicly reported statistic that captures the exact number of durable medical
equipment (DME) users at the city level, available demographic and health data strongly demonstrate
significant need within the El Mirage community. Our internal data indicates YCF helped 201 El Mirage
clients in 2023/24, 221 El Mirage clients in 2024/25 and expect to service 280 El Mirage clients in 2025/26.
But the need is much greater than the services we are currently providing mainly due to the lack of
exposure of Youngtown Community Fund in El Mirage.
El Mirage has an estimated population of approximately 36,700 residents, of whom nearly 20% are age 55
or older—the population most likely to rely on mobility aids, fall-prevention equipment, and other medical
devices that support independent living. 37.8% of El Mirage residents over the age of 65 report having a

disability. In addition, 12% of residents under age 65 have a disability. These groups frequently depend on
durable medical equipment due to chronic illness, injury, or functional limitations.
A 2024 U.S. Department of Health & Human Services survey estimates more than 1.2 million Medicare
recipients in Maricopa County are at risk and may require DME. A refined estimate of the Medicare
recipients likely to need DME (25% to 40%) by the 3 zip codes in El Mirage shows:
Zip Code
Medicare Population
Likely to Need DME
85351
19,000 to 24,000
4,800 to 9,600
85335
3,500 to 5,300
900 to 1,200
85307
500 to 850
125 to 340
Over a typical 20-year retirement period (ages 65–85), an Arizona senior might expect to spend between
$5,000 and $25,000 out-of-pocket on DME. This estimate accounts for basic equipment like walkers,
canes, shower chairs, power wheelchairs, as well as hospital beds. The clients who borrow durable
medical equipment from YCF are typically in dire need of affordable solutions for mobility, independence,
and daily living, often due to limited fixed incomes, financial constraints, age-related health issues, or
temporary recovery needs.
Is this a new or continuing program?
Continuing
If you selected "Other" above, please specify:
Section B: Scope & Timeline 
What are the program or project dates? 
If funds are received July 1, 2026 the program will run to June 30, 2027.
Total number of persons expected to be served by this program or project during the funded year.
2,600
Total number of El Mirage residents you expect to be served by this program or project during the
funded year.
300
How soon will the program or project be implemented after funds are received, if awarded? (If not
applicable, write “N/A.”) 
Immediately
Section C: Accessibility and Resource Needs 
Does your program or project take place in the City of El Mirage? * 
Yes
Where will your project or program be located, and how does this location support your ability to
serve El Mirage residents effectively?
Our services are offered to anyone living in the City of El Mirage and surrounding areas. Our project and
the use of the grant money will be focused on increasing visibility and services within the City of El Mirage
so more of the citizens are aware of and will utilize our services. The program/activity will be based out of
our office/warehouse at 11215 W Nevada Ave, Suite A, Youngtown, AZ 85363, which is 1,845 ft from the
closest border of El Mirage and only 1.6 miles from the population center of El Mirage.

Describe how your program or project will be open to the public and ensure accessibility for
persons with disabilities, including specific accommodations.
The Youngtown Community Fund is fully open to the public without restrictions and operates in accordance
with ADA principles by ensuring physical, programmatic, and communication accessibility. Through
accessible facilities and individualized assistance, the organization removes barriers to essential medical
equipment and support services. Its model prioritizes equitable access for seniors and individuals with
disabilities, ensuring that all community members can participate fully and safely in its programs.
YCF ensures that services remain accessible even when physical or logistical barriers exist by allowing
caregivers or family members to pick up equipment on behalf of clients, offering flexible scheduling and
assistance with equipment selection and providing alternative service methods (e.g., coordination by
phone or community partners.)
As a charitable organization, it provides free access to durable medical equipment and related support
services, ensuring that individuals—particularly seniors, individuals with disabilities, and caregivers—can
obtain essential DME regardless of income or insurance status.
Our programs and services are structured to be non-discriminatory and inclusive, available through walk-in
access, scheduled appointments, and community referrals and designed to remove barriers for individuals
with mobility, health, or transportation challenges.
Will the implementation of this activity require space, staffing, grants management, or in-kind
contributions from another agency, a school, or another jurisdiction?
No
If you selected "Other" above, please specify (If not applicable, write “N/A.”):
N/A
Section D: Collaboration and Outreach 
Are you currently partnered with, or have you ever partnered with, the City of El Mirage?
No
Describe how you will collaborate with the City of El Mirage to coordinate outreach promoting the
program or project to the residents of El Mirage.
In order to increase visibility, knowledge and ease of use of the agency’s services in the City of El Mirage
we will:
1.
Distribute agency brochures to all appropriate city departments and offices.
2.
Participate in as many city-hosted health fairs and resource expos and seasonal community events
we can.
We will start by engaging the departments that already reach our target population including Community
Services / Parks & Recreation, Senior programming staff, Fire Department (community paramedicine / fall
prevention), City Manager’s office (for cross-department coordination).
If you like we can propose a simple Memorandum of Understanding (MOU) outlining referral pathways, co-
branded outreach commitments and shared goals (e.g., reduce falls, improve post-discharge recovery).
If possible we would leverage city communication channels. We would coordinate placement in the city
newsletters, utility bill inserts, official website resource pages and social media.

How will you work with other local partners to maximize impact and ensure residents are aware of
and engaged with your services?
1.
Distribute agency brochures to local senior oriented businesses, hospitals, senior living and
healthcare facilities aiming for at least 50 inquiries or service applications within 12 months.
2.
Implement a referral partnership program with at least 3 El Mirage-based senior support agencies
to generate 25 new client referrals within 12 months.
3.
Place hyper-local magazine/online ads in local age restricted communities in the El Mirage area
like Pueblo El Mirage, Coppersun, and Rosewood Estates.
Part 3: Program or Project Goals and Outcomes
Please provide up to three goals of the program or project and describe how progress will be
measured to ensure success in providing health and human services to the residents of El
Mirage. It is important to ensure that your goals correspond with the proposed number of residents to
be served within the program year. Explain how you will collect and report data and measure the
impact for each stated goal. 
Example Goal: Of the 80 persons served by the project, 40% (32 persons) will find employment within
three months of entering the program. This will be measured by follow-up contact with each program
participant. 
Measurable Goal No. 1
Our goal is to increase agency visibility in El Mirage so more of the population is aware of our services thus
increasing service transactions and improving our lending capabilities to meet the increased demand. The
goal advances 3 key priorities.
First, to increase City of El Mirage residents service transactions to 300. To ensure success we will track
the number of individual transactional requests fulfilled by city and in order to gauge where our biggest
geographic impact is we will track client usage by zip code. Having this information, we will be able to
estimate the cost savings we have created for the citizens of the city.
Measurable Goal No. 2
Second, to improve digital marketing and advertising in the City of El Mirage. We will grow online visibility
and service accessibility by improving website logistics and exposure in turn increasing website
interactions and social media followers from El Mirage zip codes by 25% within 12 months. These figures
will be measured monthly by online analytics and measured on a month-to-month basis vs. prior year.
Measurable Goal No. 3
Third, to increase visibility and ease of use of the agency’s services in El Mirage.
1. Distribute 250 agency brochures to local senior oriented businesses, hospitals, senior living and
healthcare facilities aiming for at least 50 inquiries/service applications within 12 months and
2. Implement a referral partnership program with 3 El Mirage-based senior support agencies to generate
25 new client referrals within 12 months.
To ensure success of these actions, we will track the number of individual transactional requests fulfilled by
city and in order to gauge where our biggest geographic impact is we will track client usage by zip code.

Part 4: Funding Request
Total Community Partnership Grant Funding Requested
10,000.00
Minimum Community Partnership Grant Funding Requested
5,000.00
Is program or project implementation contingent upon receiving the full award?
No. Youngtown Community Fund is committed to growing our services and exposure and serving more
residents of El Mirage regardless of the full award amount. Core program operations—including equipment
lending, social media expansion, community outreach, and referral intake—will proceed using existing
inventory, volunteer support, and organizational resources.
If full funding is not secured, the program will be implemented at a reduced scale, prioritizing our highest-
need goals. Receipt of the full award will allow for expanded inventory, increased outreach in El Mirage,
and the ability to serve a significantly greater number of individuals.
If approved for an amount less than 100% of your request, how will you address the shortfall?  
We will continue to leverage partnerships with other groups and organizations. We have secured financial
support from the Town of Youngtown, the West Valley Lutheran Thrift Shop, Desert Diamond Casino,
Sunflower Resort Worship Service and St. Clement of Rome Men’s Club. We are also working on grants
with the City of Peoria, Credit Union West, Sam’s Club and several other nonprofit agencies. We are also
focusing on marketing efforts with senior support agencies like the Salvation Army, Area Agency on Aging
and St. Vincent de Paul as well as retirement communities, in home care companies, churches and
volunteer groups.
Part 5: Program or Project Budget
Section A: Total Program or Project Budget 
Total Cost of the Program or Project Operations
17,800.00
Total Program or Project Funding from Other Funding Sources
7,800.00
What other funding sources presently support this program or project? 
We have secured financial support from the City of Surprise, the Town of Youngtown, the West Valley
Lutheran Thrift Shop, Desert Diamond Casino, Sunflower Resort Worship Service and St. Clement of
Rome Men’s Club. We are also working on securing grants with the City of Peoria, Credit Union West,
Sam’s Club and several other nonprofit agencies.
Section B: Total Budget for Program or Project – Grant Award
Only 
Grant Award Budget Narrative 
Wages/Salaries
Employee-Related Expenses (ERE)

Professional Services & Outside Services
Training
500.00
Materials & Supplies
1,800
General Office Supplies
500.00
Administrative Cost (not to exceed $1,000 or
10% of grant request)
Program/Project Incentives (gift cards, food,
certificates of achievement)
Marketing/Outreach
7,200.00
Other
If you selected "Other" to the previous question,
please explain.
N/A
Explain how grant funds will be utilized to support administrative costs for your project.
Grant funds will not directly support administrative costs.
Section C: Program or Project Funding Sustainability 
How will your organization generate or secure additional funding to sustain services for the
continued operation of this program or project? 
The board will continue to sustain the YCF Medical Equipment Lending Center through existing and
ongoing revenue sources that support current operations. These include individual donations, community-
based fundraising efforts, and in-kind contributions of durable medical equipment, which significantly
reduce program costs.
The organization is actively pursuing volunteer support to assist with intake, equipment processing,
maintenance, and outreach which helps maintain low operating expenses. In addition, we will continue
applying for grant funding from foundations and community partners aligned with senior services and
healthcare access.
Established relationships with referral partners and local entities, including the City of El Mirage, support
ongoing program visibility and utilization, which in turn strengthens fundraising and sustainability efforts.
Through this combination of contributed revenue, in-kind support, and cost-efficient operations, the
Youngtown Community Fund is positioned to sustain program services beyond the grant period.
If the program receives less than the requested amount of funding, what adjustments, if any, would
be made to the program and services provided to El Mirage residents?
YCF will continue implementing the marketing and services expansion serving El Mirage residents, with
adjustments focused on scale rather than service quality. Core services—including equipment lending,
client intake, and referral coordination—will be maintained.
We will contract for a more streamlined upgrade to our website and a focused social media plan,
prioritizing core functionality and high-impact outreach. Additional enhancements and expanded
campaigns will be implemented as funding permits.
Modifications would include a reduced volume of equipment purchases, prioritization of high-need cases,
and a more targeted outreach approach within El Mirage. Program growth would be phased over a longer
timeline, with expansion occurring as additional resources are secured.

The organization will also increase reliance on in-kind equipment donations and volunteer support to help
offset resource constraints and maintain service continuity. These adjustments ensure that essential
services remain available to El Mirage residents while aligning program capacity with available funding.
Part 6: Operational and Financial Status
Please upload the following required attachments: 
Applicant organization's last two IRS Form 990 filings.   
If your organization is not required to file a 990, upload a brief explanation. 
Please upload attachment (1). 
990-N filed in 2025 for 2024 fiscal year.pdf
Please upload attachment (2). 
990-N filed in 2024 for 2023 fiscal year.pdf
If your organization does not have either document available, please explain below.
Authorized Representative Signature