HomeMy WebLinkAbout20070493.tiff RESOLUTION
RE: APPROVE VALE GRANT APPLICATION FOR LONG TERM CARE OMBUDSMAN
ADVOCATE/FRIENDLY VISITOR PROGRAM AND AUTHORIZE CHAIR TO SIGN
WHEREAS, the Board of County Commissioners of Weld County, Colorado, pursuant to
Colorado statute and the Weld County Home Rule Charter, is vested with the authority of
administering the affairs of Weld County, Colorado, and
WHEREAS, the Board has been presented with a VALE Grant Application for the Long
Term Care Ombudsman Advocate/Friendly Visitor Program between the County of Weld, State of
Colorado, by and through the Board of County Commissioners of Weld County, on behalf of the
Department of Human Services, Area Agency on Aging, and the Victims Assistance and Law
Enforcement Board, commencing July 1, 2007, and ending June 30, 2008, with further terms and
conditions being as stated in said application, and
WHEREAS, after review, the Board deems it advisable to approve said application, a copy
of which is attached hereto and incorporated herein by reference.
NOW, THEREFORE, BE IT RESOLVED by the Board of County Commissioners of Weld
County, Colorado, that the VALE Grant Application for the Long Term Care Ombudsman
Advocate/Friendly Visitor Program between the County of Weld,State of Colorado, by and through
the Board of County Commissioners of Weld County, on behalf of the Department of Human
Services,Area Agency on Aging,and the Victim's Assistance and Law Enforcement Board,be,and
hereby is, approved.
BE IT FURTHER RESOLVED by the Board that the Chair be, and hereby is, authorized to
sign said application.
The above and foregoing Resolution was,on motion duly made and seconded, adopted by
the following vote on the 26th day of February, A.D., 2007.
BOARD OF COUNTY COMMISSIONERS
WE i,iOIJI\ATY, COLORADO
ATTEST: Y ;" /7`� i G j
�-77
' , David E. Long, Chair
Weld County Clerk to the Bga(d
y�� /-• °• William H. Jerk ro-Tem
G
BY: "-n� 7 - 'k.,t
Deputy Clerk to the Board_ °� (4.1/7(
Wil • m F. Garcia
APPROVED S -19,1 : 91' V
L '' Robert D. Masd
2 -aunty Attorney
�/ / 7 o la ademac er
Date of signature:
2007-0493
HR0078
NI / fsc� 693- olti_/7
Monday, February 26th, 2007
RE: "V.A.L.E.," Victim Assistance Law Enforcement Application
To Whom It May Concern:
Please contact Raegan Maldonado at extension 3324 when the Signature
Pages are ready.
I would like to pick them up in person.
Thank you,
_
agit+Cl ► t er CA �'
Raegan L. Maldonado
MEMORANDUM
4401 a
TO: David E. Long, Chair, Weld County Board of
Commissioners
FROM: Walter Speckman, Executive Director, (i
Department of Human Services 1/t}
COLORADO DATE: Monday, February 2dh, 2007
SUBJECT: Weld County Area Agency cn Aging's Long
Term Care Ombudsman Advocate/Friendly
Visitor Program VALE grant approval
Enclosed for Board approval and signature is the grant application for VALE (Victims Assistance
and Law Enforcement)assistance. The Ombudsman Program has received this grant for the past
9 years. The amount being requested for the July 2007-June 2008 funding cycle is $10,000.This
grant will allow the Ombudsman program to provide elder abuse prevention programs to long term
care staff; continue the long term care friendly visitor program, and maintain and strengthen the
Volunteer Ombudsman program.
If you have additional questions, please contact Eva Jewell at 3533800, extension 3331.
2007-0493
VALE Grant Application
Signature Page
Applicant Agency: WELD COUNTY AREA AGENCY ON AGING
Street Address: 1551 North 17th Avenue
Mailing Address(if different): Post Office Box 1805
Phone: (970)353-3800 ext 3324 Fax: (970) 304-6442 Email: rmaldonado@co.weld.co.us
Project Title: Weld County Long Term Care Ombudsman Advocate/Friendly Visitor
Grant Period: July 1, 2007 to June 30, 2008
The following signatories,understand and agree that any grant received as a result of this application shall
incorporate and be subject to the statements made within the above described VALE Grant Application(The
Application). Furthermore,the signatories certify that they have each read The Application and are fully cognizant of
their duties and responsibilities for this project.
(Original signatures of each party to this application (i.e., Project Director, Financial Officer and Authorized Official)
are required. Please use BLUE INK to distinguish the original documents from copies).
Project Director:
Name: Eva Jewell Position/Title: Weld County Area Agency on Aging Director
Agency (including Division or Unit): Weld County Area Agency on Aging, Division of Human Services
Mailing Address: 1551 North 17th Avenue, Post Office Box 1805 Greeley, CO 80632
Phone: (970)353-3800 ext 3331 Fax: (970)304-6442 E-Mail: ejewell@co.weld.co.us
Signature:CA%ct i eC Date: ;C. - Zi; ,: 1
Financial Officer:
Name: Dennis Bogott Position/Title: Financial Officer
Agency (including Division or Unit): Division of Human Services
Mailing Address: 1551 North 17th Avenue, Post Office Box 1805 Greeley, CO 80632
Phone: (970) 353-3800 ext 3350 Fax: (970) 304-6442 E-Mail: dbogott(@,co.weld.co.us
Signature:; c6r),,-O' Date: ,4/7
Authorized Official ��V/
Name: David E. Long Position/Title: Chair
Agency(including Division or Unit): Weld County Board of Commissioners
Mailing Address: 915 10th Street, Greeley, CO 80631 Post Office Box 758, Greeley, CO 80632
Phone: 970 3 6- 100 e - 4208 Fax: (970)352-0242 E-Mail: dlong@co.weld.co.us
Signature: er e� - Date: FEB 2 6 2007
In accordance with the Colorado Revised Statutes 24-72-202.6,information supplied in this application is considered a public record.
a'2-0V23
2007-2008 VALE ASSISTANCE FUNDS
19th Judicial District, Weld County
Application page 1
SECTION A-AGENCY INFORMATION
1. APPLICANT AGENCY:
Program Name: Weld County Area Agency on Aging
Division of Human Services
Street Address: 1551 North l7`h Avenue
Greeley, Colorado 80632
Mailing Address: Post Office Box 1805
Greeley, Colorado 80632
Phone: (970) 353-3800 extension 3324
Fax: (970) 304-6442
E-Mail: rmaldonado@co.weld.co.us
2. CONTACT PERSON: Eva Jewell
Title: Weld Area Agency on Aging Director
Phone: (970) 353-3800 extension 3331
Fax: (970) 304-6442
E-Mail: ejewell@co.weld.co.us
3. AGENCY STATUS: Governmental
Tax ID Number: 14-02101
4. PROJECT TITLE: Weld County Long Term Care Ombudsman/
Friendly Visitor Program
5. PROBLEM STATEMENT:
The VALE funds will allow the Ombudsman Program to have a consistent presence in Weld County long
term care settings. Also, the funds will enable the LTC Ombudsmen to maintain an abuse prevention and
awareness program. In addition, the Assistant Ombudsman will be able to continue recruitment and
training for the Ombudsman Volunteer Program.
6. FUNDS REQUESTED: $10,000
SECTION B - NARRATIVE SUMMARY:
7. AGENCY DESCRIPTION: The Weld County Long Term Care Ombudsman Program is housed under the
umbrella of the Weld County Area Agency on Aging. The Long Term Care Ombudsman Program has been a
consumer voice for the elderly residing in nursing homes and assisted living facilities for more than twenty (20)
years. The authority of the local Ombudsman Program comes from the Older American's Act, Colorado
Revised Statutes 25-11.5 and the Nursing Home Reform Law of 1987. The Weld County Ombudsman acts as a
consumer voice for the concerns of the elderly living in institutions, who may have no one else to speak for
them. The Ombudsman also receives and resolves questions, issues, problems and complaints made by, for, or
on behalf of residents of long term care facilities.
The purpose of the Weld County Long Term Care Ombudsman Program is to assist and empower consumers of
long term care services by providing information about those services and furnish support in complaint
resolution. These issues or complaints may include, but are not limited to access to long term care services,
redress of neglectful or abusive care, and information and assistance with civil and human rights. The Long
Term Care Ombudsman program is a resident/patient/consumer-centered advocacy program.
Long Term Care Ombudsmen have statutory status under the Older Americans Act of 1965 as amended and are
required by federal and state law to visit every nursing home monthly and every assisted living facility
quarterly. They also receive, investigate and resolve complaints, identify needs of long term care residents and
help establish programs to meet those needs. The Ombudsmen also document and report problems of long term
care and help to stimulate and promote improvement of the system.
8. BRIEF PROJECT DESCRIPTION: The V.A.L.E. grant has allowed the Ombudsman Program to
increase staff time to keep up with the increasing demand for advocacy on behalf of this very vulnerable
population. The funds have also enabled the program to maintain an abuse prevention and awareness program
aimed at educating Certified Nurse Assistants (C.N.A.'s) and other long term care staff. This has allowed the
Assistant Ombudsman to educate residents and staff about the Ombudsman Program, abuse issues and resident
rights, as well as investigation of complaints of abuse and neglect.
The Ombudsman's role through observation and a frequent presence in the facilities; is to insure that resident
rights are being respected, that quality care is administered, and that abuses do not occur. Continued funding of
the Assistant Ombudsman will make it possible for the Weld County Area Agency on Aging Ombudsman
Program to serve the increasing number of vulnerable long term care residents and their families. We believe
that our request for a continuation of funding relates to the mandate of early crisis intervention and to provide
assistance and support to victims and their families.
9. MANAGEMENT PROJECT: The Director of the Weld County Area Agency on Aging will supervise the
Lead Long Term Care Ombudsman during the duration of this project. The Lead Long Term Care Ombudsman
will be responsible for providing reports to the V.A.L.E. Board. The Director and the Lead Ombudsman will be
responsible for the day-to-day management of this project. The Lead and Assistant Ombudsmen will carry out
the duties outlined in this project.
10. Who will provide the proposed services? Will volunteers be utilized?
The Assistant Ombudsman will recruit and train Volunteers for the Friendly Visitor Program. The Lead and
the Assistant Ombudsmen will facilitate the Abuse Free Prevention Training.
•
SECTION C - GOALS AND OBJECTIVES:
(Goal 1, objectives 1 and 2, are mandatory for all applicants.)
11. GOAL 1 (standard): This project will provide direct services that assist crime victims with
emotional and physical needs to stabilize their lives, provide a measure of safety and security, and/or
enhance victims' experience with the criminal justice system.
• OBJECTIVE 1 (standard): To provide services to the following estimated unduplicated number of
crime victims during the 12-month grant period. (Note: Count each victim only once based upon
predominant crime type.)
EST. NO. EST. NO.
VICTIMS TYPE OF CRIME VICTIMS TYPE OF CRIME
Child Physical Abuse Assault
Child Sexual Abuse Adults Molested as Children
Domestic Violence 54 Elder Abuse (including economic
exploitation and fraud crimes)
6 Adult Sexual Assault Robbery
Victims of vehicular assault, homicide, Other violent crimes such as hate and
DUI/DWI crashes or careless driving bias crime, gang violence (specify).
resulting in death.
Survivors of Homicide Victims
TOTAL UNDUPLICATED VICTIMS ESTIMATED TO BE SERVED DURING THE 12-MONTH PERIOD 60
• OBJECTIVE 2 (standard): To provide the following types of services to the following estimated
number of victims during the 12-month grant period.
EST. NO. EST. NO.
VICTIMS SERVICES VICTIMS SERVICES
Crisis Counseling Emergency Financial Assistance
50 Follow-up Emergency Legal Advocacy
Therapy 40 Victim Compensation Assistance
(required)
Group Treatment/Support 50 Personal Advocacy
Shelter/Safehouse 50 Telephone Contact(information/referral)
40 Information/ Referral (in person) Crisis Hotline Counseling
Criminal Justice Support/Advocacy Other(specify):
TOTAL 230
•
12. PROJECT-SPECIFIC GOALS AND OBJECTIVES:
GOAL 2: Provide Abuse Free Training to Direct Caregivers who work in Long Term Care settings.
Objective 1: Educate each NHA/manager on the importance of an Abuse Free Environment.
Objective 2: Coordinate efforts with Alzheimer's Assoc to provide education on behaviors.
Objective 3: Organize and facilitate 4 Trainings for Certified Nursing Assistants.
GOAL 3: Recruit and Train Ombudsman Volunteers for Friendly Visitor Program.
Objective 1: Sustain the current 3 Volunteer Ombudsmen and continue educating them.
Objective 2: Ongoing marketing, recruit 6 potential Volunteer Ombudsmen.
Objective 3: Train 1 Volunteer Ombudsman to assist with Abuse Free Training.
GOAL 4: Educate students enrolled in the Certified Nursing Assistant Program about the importance of
Elder Abuse Prevention and the Ombudsman Program.
Objective 1: Meet with the coordinator of the C.N.A. Program at AIMS.
Objective 2: Educate 60 students on Ombudsman Program and Abuse Prevention.
Objective 3: Make adjustments to current evaluation used.
GOAL 5: Sexual Assault Training for all staff who work in long term care settings.
Objective 1: Research for potential educators on the topic.
Objective 2: Develop curriculum that Ombudsman Program can provide to staff.
Objective 3: Begin efforts to coordinate a conference for all long term care staff in Weld.
13. What problems do you anticipate in implementing your program's goals and
objectives, if any?
Currently, the program has three active volunteers, and the Assistant Ombudsman continues to
progressively recruit potential dedicated volunteers. Unfortunately, the program has an ongoing challenge
of recruiting appropriate and reliable volunteers. Volunteer Ombudsmen cannot have any current
connection to a Weld County long term care facility, as this would be considered a conflict of interest for
the Ombudsman Program. The Assistant Ombudsman will continue to recruit and screen potential
volunteers for appropriateness.
Staffing issues continue to be a major crisis in long term care facilities. For this reason, the Assistant
Ombudsman continues to be flexible and open to suggestions from long term care facilities regarding
training programs. If necessary, the developed programs can be modified to meet the needs and schedules
of those working in long term care facilities. We do not anticipate any problems of reaching the new
goals and objectives for July 2007-June 2008. The Assistant Ombudsman will be able to fulfill the
original goals and objectives while enhancing the Volunteer, C.N.A. training, Sexual Assault training and
CARIE programs.
14.How does the project address the victims and witnesses services need outlined in the
V.A.L.E. statute? Refer to C.R.S. 24-4.2-105 (4) (a — m).
This program continuation request most relates to 24-4.2-105, Section 2, part a and part b. Part a
addresses provision of service for early crisis intervention. As mentioned earlier, there is evidence that
when there is constant and continuing community presence in long term care facilities the potential to
improve the quality of life and prevent abuse and exploitation is reduced for the residents. We intend to
continue advocate contacts with long term care residents as a preventive move. We know that there may
be many barriers to the elderly, particularly those in long term care facilities, to express their individual
needs without assistance from others. Some of these barriers are physical due to loss of sight, speech, or
hearing. Some barriers are psychological due to a sense of isolation, fear of retaliation, or disorientation.
Barriers to self-advocacy can also be related to the lack of information about rights, alternatives, and legal
remedies.
Part b addresses assistance programs for victims and their families. A key role of the longterm care
Ombudsman is complaint investigation and complaint resolution. Long term care residents must be
assured that the Ombudsman will be able to follow up on their complaints in a timely and professional
manner. With the continued increase in long term care beds, the ability of the present Ombudsman to
respond appropriately to complaints will be jeopardized. The extension of the friendly visitor/advocate
under this proposal will continue our Ombudsman hours, insuring that the Lead Ombudsman and the
Assistant Ombudsman will be able to respond to residents and their families in a timely and appropriate
manner.
SECTION D - SERVICE INFORMATION:
15. What is the population and geographic area targeted for service through this
project?
Populations targeted are 60 plus elderly residing in nursing homes, assisted living facilities and personal
care boarding homes located in Weld County.
a) How many people are in need of these services?
Approximately, 1,400 Weld County residents live in long term care facilities. All of these residents
receive services through the Ombudsman program, either directly with visitations and complaint
resolution or indirectly through training and technical assistance provided to staff to improve the quality
of care. By extension, the program also may represent the concerns of relatives and/or friends of long
term care residents as long as the concern reflects the concerns of the resident. Continuation of support
will make it possible for the Area Agency on Aging Ombudsman Program to continue to serve all of the
long term care residents and their families with the same type and degree of services that we currently are
providing.
b) How many people are presently being served?
Same as above.
16. Are there other community agencies currently providing like services to the targeted
population? If yes, explain how this project is not a duplication of services.
There are no other programs which provide services equivalent to the Ombudsman Program.
•
17. Document community support, coordination and networking by providing the
following information:
a) List the agencies with whom your agency has an active memorandum of
understanding or an agreement regarding the coordination and provision of services.
See SECTION I. ATTACHMENTS
We have formal agreements with agencies that we fund directly to provide a variety of services to seniors
such as: Eldergarden Adult Day Program; Senior Peer Counseling through North Range Behavioral Health
and in-home personal care through RVNA. We also work in collaboration with Adult Protective Services,
the Alzheimer's Association, local skilled nursing facilities and local assisted living facilities. We have
established a Coordinating Committee for Victims of Crime coordination agreement with the following
agencies: The 19th Judicial District Attorney's Office; the Probation Department; C.A.R.E.; Colorado
Legal Services; Weld County Law Enforcement; SASI; the Greeley Police Department; A Woman's
Place; Partners; UNC's Assault Survivors Advocacy Program and A Kid's Place.
b) Is your agency an active participant in Weld County's Coordinating Committee for
Victims of Crime (CCVC)? If "yes," provide the name and position(s) of the CCVC
participant(s) and their level of involvement in that group and attach the most current
Coordinating Agreement. See SECTION I. ATTACHMENTS
The Weld County Area Agency on Aging is an active participant in Weld County's Coordinating
Committee for Victims of Crime (CCVC), and also a participant in the CCVC Coordination Agreement.
Currently, the active member is Raegan L. Maldonado, Lead Long Term Care Ombudsman.The Lead
Long Term Care Ombudsman anticipates further involvement with future subcommittees, as assigned and
needed in the CCVC meetings. It is pertinent for Assistant Ombudsman to be involved in this committee
and she has been attending CCVC meetings. The Assistant Ombudsman will offer to share information
from our "Ensuring an Abuse Free Environment" training with the members of CCVC. In addition, the
Lead Ombudsman routinely presents information to the CCVC committee about other networking groups
available in the community that focus on aging and adult services.
c) Briefly describe any other agency actions that demonstrate its high priority for
developing community support, coordination, networking, and cooperation.
Weld County Senior Service Network,Northern Colorado Culture Change Coalition, Bioethics
Committee, and Adult Protection Network.
d) List the agency name(s) and person(s) who provided letter(s) of support (no more than
three) applicable to this specific grant funding request. See SECTION I. ATTACHMENTS
Agency Names
AIMS Community College Tess Masters
Centennial Health Care Center Dayna Acosta
Rocky Mountain Alzheimer's Association Bonnie Wacker
SECTION E -VICTIM COMPENSATION
Provide the following information concerning your agency's involvement with the Crime Victim
Compensation Program:
18. a) Does your agency regularly inform victims about Victim Compensation and help them to
apply when appropriate?Yes
How? The Weld County Area Agency on Aging regularly informs victims about Victim Compensation.
For example, during a sexual assault case involving an at-risk adult, the Ombudsman's office assisted the
victim's family in applying for services. The victim's family and the Ombudsman used resources
available through Victim Compensation during the time of the trial. Such resources include the Victim
Assistance area set up for victims and families at the Weld County courthouse.
b) Explain any major issues that hinder your agency in helpingcrime victims to understand
Victim Compensation eligibility requirements and to apply for benefits.
The Weld County Area Agency on Aging and the Ombudsman program do not foresee any issues that
would prevent informing crime victims of the Victim Compensation eligibility requirements and
information regarding victims' rights. We would also be able to provide assistance to those individuals
who are unable to apply for assistance independently.
c) Does your agency regularly conduct/receive Victim Compensation training for direct
services staff and volunteers?
Yes, we require that our Volunteer Ombudsmen attend this training as a fulfillment for their continuing
education.
If"yes," what was the date of the last training and who provided it?
Our agency receives Victim Compensation training for direct services staff and volunteers on a regular
basis. The last training was provided by Karol Patch from the District Attorney's office on April 3rd,
2006, which took place at the Weld County Training Center. We are scheduled to attend the 2007
training on July 12tt', 2007. This training session will be provided by Karol Patch. In addition, The
Ombudsman Program participated in the Victim Awareness Luncheon on April 21st, 2006 and plans to
attend the luncheon in 2007.
•
SECTION F - VICTIM RIGHTS ACT:
19. Has your agency taken steps to assure that all staff and volunteers have read and
understand the rights afforded to crime victims in 24-4.1-302.5 CRS and the services
delineated in sections 24-4.1-303 and 24-4.1-304 CRS (i.e., the Victim Rights Act (VRA)
and enabling legislation)? Yes
If "yes",
a) Does your agency have a statutory mandate to notify victims about their rights under
VRA?
No
b) Briefly describe how your agency assures that all staff and volunteers are trained on
VRA.
The Weld County Ombudsman Program requires that each volunteer attend the training provided by the
Karol Patch and the Victim Witness Program. If a volunteer is activated when a training opportunity is
not available, the Assistant Ombudsman educates the volunteer(s) using information from the training that
we have attended.
c) Provide the date of your last VRA training and who provided that training.
April 3rd, 2006
d) How does your agency notify victims of their rights under VRA?
When appropriate, the Area Agency on Aging notifies victims of their rights under VRA by referring
individuals to the District Attorney's Office Victim Assistance Program. As mentioned above, the Area
Agency on Aging referred the victim of the sexual assault case and her family to the District Attorney's
Office. The Ombudsman Program also educates residents, families, and facility staff on residents' rights
and provides them with resources.
e) Does your agency have a brochure describing VRA? If "yes", list the languages in
which your brochure is available. See SECTION I. ATTACHMENTS Yes
We distribute Ombudsman brochures that include information about Residents' Rights. The brochures
are provided in both English and Spanish.
f) If your agency does not have a brochure describing VRA, please indicate if your
agency utilizes brochures from other agencies. See SECTION I ATTACHMENTS
When appropriate, we hand out brochures provided by the District Attorney's Office.
SECTION G — EVALUATION:
How will you evaluate the effectiveness of this project?
To evaluate the effectiveness of the CARTE program, the Assistant Ombudsman will continue to collect
data from evaluations that are distributed at the end of each training session. This data continues to be
utilized to determine if the goals and objectives of the program are being met. This information will also
be used to enhance and modify the program as needed. The success of the Ombudsman Volunteer
Program will be measured by monitoring the number of additional visits, educational sessions and
volunteer satisfaction surveys will be evaluated. In addition to previous years, the results of this year's
evaluations highlight how valuable the CARTE training is for staff working in long term care facilities.
The Ombudsman Program maintains files that generate monthly,quarterly,and annual reports. Data is kept
on numbers of visits, complaints,referrals and technical assistance contacts. Data is broken down further to
reflect types of interventions,types of complaints,types of facilities,and actions taken. This data is analyzed
by the state Ombudsman office to assist in determining the efficiency of the program.
In addition, the Ombudsman Program has developed and utilizes a client satisfaction survey. It is
anticipated that these questions will assist with measuring the quality of Ombudsman services provided to
residents, families and community individuals. Overall, the 2005-06 survey response was positive. At the
conclusion of the current grant period, the Ombudsman Program will have provided CARTE training for
CNA staff representing all nursing homes and the majority of Assisted Living Residences in Weld
County.
20. If this is an application for continuing funding, how successful has this project been
in the past in accomplishing its proposed goals and objectives?
We have been very successful in accomplishing past goals.
21. What is the projected cost per client served (cost/benefit ratio)?
Cost Savings: When an advocate visits a long term care facility and discovers issues that affect the direct
health of a resident, the advocate can facilitate and coordinate care with the facility to enhance the
resident's plan of care to help reduce the problem from escalating. There are considerable medical
savings to the taxpayer (most nursing home residents are on Medicaid) when extreme medical procedures
can be avoided. When long term care patients are restrained, not only is it a violation of individual rights,
but an opportunity is missed to administer therapies, which can help the patient become more
independent. The ombudsman, again, can identify these situations and work with the staff to develop
alternate interventions which will respect individual rights and give the patient care that may increase
his/her potential to be independent. Dependence costs society.
Elder abuse education is invaluable to reduce incidences that occur. When a resident is exposed to an
abusive situation the experience can cause not only physical, but also emotional, psychological, and social
damage. The resources used to investigate and monitor these incidences are costly and limited, the
Ombudsmen become a valuable resource to assist and prevent abuse in long term care facilities.
Repercussions from abuse result in expensive and time consuming therapies and utilize valuable resources
allocated for the community. The abuse education provided by the funds from this grant help to raise
awareness and allow intervention before abuse situations occur.
Cost/ benefit ratio:Due to the complexity and uniqueness of the program, the current cost benefit ratio is
difficult to determine as we provide a combination of training, technical assistance and direct service to an
unlimited number of residents and family members. However, we do know that early intervention by the
Ombudsman can prevent costly medical costs that may have resulted due to poor quality of care.
SECTION H - BUDGETARY INFORMATION:
22. All Budget pages MUST be completed.
SECTION I - ATTACHMENTS:
Attach any active memorandum of understanding or an agreement regarding the
coordination and provision of services.
_Attach CCVC Coordinating Agreement, if applicable.
_Attach letters of support
_Attach your agency's VRA brochure, if applicable.
Attach VRA brochures from other agencies your agency utilizes, if applicable.
Attach a signed copy of the attached Grant Applicant Memorandum of
Understanding Concerning the Rights Afforded to Crime Victims.
_Attach a list of your agency's Board of Directors, if applicable.
Include a copy of agency's most recent audit report or financial review. If agency is
not subject to audit, explain how proper management and disbursement of funds is
monitored. (Only one copy of the audit or financial review is required.)
BUDGET INFORMATION
TOTAL AGENCY VICTIM SERVICES
Please indicate the sources for ALL funding your agency receives for victim services.
FUNDING START DATE END DATE
AMOUNT Month / Day / Year
Month / Day / Year
VALE Grant (if applicable) $ 8,500 07 / 01 / 06 06 / 30 / 07
VAWA Grant / / / /
VOCA Grant / / / /
Other-Federal Funds $56,605 07 / 01 / 06 06 / 30 / 07
Other-State Funds $22,235 07 / 01 / 06 06 / 30 / 07
Other / / / /
Other / / / /
Please specific the source of "Other funds" ( other grants, government funds, city funds,
donations, fund-raising, etc.)
HOW WILL FUTURE FUNDING NEEDS BE MET?
Future funding needs will be met through the Older American's Act funds and State General funds that
support the Long Term Care Ombudsman Program.
VALE PROJECT BUDGET INFORMATION
PROJECT FUNDS REQUESTED BUDGET:
Continuation Applicants fill out Columns 1,2, and 3.
New Applicants fill out Column 2 only.
Continuation Applicants ALL APPLICANTS Continuation
(Column 1) (Column 2) Applicants
(Column 3)
Current Grant Award Requested Budget Increase or
Decrease
PERSONNEL PERSONNEL (+/-)
Job Position Job Position/NAME
Kathleen Alvarado Kathleen Alvarado
Assistant Ombudsman $5,430 Assistant Ombudsman $ 6,731 $1,301
Reagan, Maldonado $ 717 Reagan, Maldonado
Lead Ombudsman Lead Ombudsman $ 720 $ 3
Fringe Benefits $1,090 Fringe Benefits $ 1,639 $ 549
Subtotal $7,237 Subtotal $ 9,090 $1,853
SUPPLIES AND OPERATING SUPPLIES & OPERATING EXPENSES (copying, (+/-)
EXPENSES rent, phone,tuition, registration fees& other items under
$5,000)
Training Materials $ 360 Training Materials $ ($360)
Subtotal $ 360 Subtotal I ($360)
IN-STATE TRAVEL IN-STATE TRAVEL(itemize transportation/per diem, (+/-)
etc)
Mileage $ 903 Mileage $ 910 $ 7
Subtotal $ 903 Subtotal $ 910 $ 7
EQUIPMENT EQUIPMENT (+/-)
Subtotal Subtotal
PROFESSIONAL SERVICES PROFESSIONAL SERVICES (+/-)
Subtotal $8,500 Subtotal $10,000 $1,500
TOTAL FUNDS: TOTAL FUNDS REQUESTED:
VALE PROJECT
BUDGET DETAIL AND JUSTIFICATION
A.PERSONNEL:
List each job position, include the name of the employee, if available.
If two individuals have the same job title, list it twice.
Indicate FTE of individual (EX: 1 FTE; .5 FTE; .75 FTE)
TOTAL COST- Show the total amount of salary and fringe benefits of the position
(SALARY and FRINGE BENEFITS are to be show separately.)
VALE% - Show the VALE percent requested for the total cost of the position
VALE Funding- Calculate the VALE funding request based on the TOTAL COST and VALE%.
Other Funding Source(s)- Indicate how the position is paid for other than VALE funding. If the position cannot be
funded(because 100%VALE Funding) indicate this.
Title of Job Position\Name FTE Total VALE VALE If THIS grant funding will not pay for the
Cost % Funding entire position,what other SOURCE will
Requested Requested be used to pay for the rest of the position
Raegan Maldonado-Lead 1 43,913 2% $ 878 Older Americans' Act-Federal
Kathleen Alvarado-Assist 1 35,703 23% $8,212 Older Americans' Act-Federal
Narrative Justification: Explain and justify the project's budget and relate the item(s)budgeted to project activities.
Position: Raegan Maldonado, Lead Ombudsman
VALE Cost: $878
Duties to be performed\project activities:
Supervise Assistant Ombudsman.
Carry out role and duties of the Long Term Care Ombudsman Program.
Assist with the C.N.A. Training Program and the "Ensuring an Abuse Free Environment" program.
Conduct visitations with residents who live in long term care facilities.
Position: Kathleen Alvarado, Assistant Ombudsman
VALE Cost: $8,212
Duties to be performed\project activities:
Recruit and coordinate training for Long Term Care Volunteer Friendly Visitors.
Carry out role and duties of the Long Term Care Ombudsman Program
Facilitate the C.N.A. Training Program and the "Ensuring an Abuse Free Environment: program.
Conduct visitations with residents who live in long term care facilities.
B. SUPPLIES AND OPERATING REQUEST: All supplies and operating requests must be specific, itemized
costs related to victim services.
Training materials for Ensuring an Abuse Free Environment Training.
C. IN-STATE TRAVEL REQUEST: Itemize travel expenses of project personnel by purpose(e.g.,to attend
training sessions,to transport clients, etc.).
Itemize these categories: mileage, lodging, meals,registration fees. ONLY IN-STATE TRAVEL IS ELIGIBLE.
Mileage reimbursement for travel to and from long term care facilities in Weld County.
D. EQUIPMENT REQUEST Direct benefits to crime victims or witnesses must be shown for the purchase of
equipment to facilitate smoother operation of law enforcement activities.
E. PROFESSIONAL SERVICES REQUEST: List consultants or independent contractors who will provide
victim services under the grant.
F. DIFFERENCES FROM LAST YEAR'S REQUEST (Continuation Applicants only): If this is an application
for continuing funding, explain any changes in proposed funding.
Increased request from $8,500 to $10,000. The Weld County Area Agency on Aging has not requested an increase
within an 8 year timeframe. The additional amount will cover the approximate yearly 3% cost of living increase.
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