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HomeMy WebLinkAbout20170542.tiffRESOLUTION RE: APPROVE VICTIM ASSISTANCE AND LAW ENFORCEMENT (VALE) GRANT APPLICATION FOR LONG TERM CARE OMBUDSMAN 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 Victim's Assistance and Law Enforcement (VALE) Grant Application for the Long Term Care Ombudsman Friendly Visitor Program from 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, to the Victim's Assistance and Law Enforcement Board, commencing July 1, 2017, and ending June 30, 2018, 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 Victim's Assistance and Law Enforcement (VALE) Grant Application for the Long Term Care Ombudsman Friendly Visitor Program from 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, to 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 22nd day of February, A.D., 2017. BOARD OF COUNTY COMMISSIONERS WELD COUNTY, COLO ' DO ATTEST:da o;ok, Weld County Clerk to the Board BY: APP 02,_c. uty Clerk to the Board ounty orney Date of signature:3/co/ I1 Steve Moreno, Pro-Tem Sean P. Conway ike Freeman cct H3OCRrnicmIse/J'(,) arbara Kirkmeyer 2017-0542 HR0088 MEMORANDUM DA'L'E: January 31, 2017 '1O: Board of County Commissioners — Pass -Around FR: Judy A. Griego, Director, Human Services RE: Department of Human Services' Area Agency on Aging (AAA) 2017-2018 Victim Assistance Law Enforcement (VALE) Grant Application Please review and indicate if you would like a work session prior to placing this item on the Board's agenda. Request Board Approval of the Department's Area Agency on Aging (AAA) 2017-2018 Victim Assistance Law Enforcement (VALE) Grant Application. The AAA Ombudsman Program has received the VALE grant since 1997. AAA would like to submit the grant application requesting $10,000 for the July 2017 through June 2018 funding cycle. Through the years, the VALE 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 enabled the Program to maintain an abuse education and awareness program aimed at educating direct caregivers who work in long term care settings. The grant has also allowed the opportunity for the Ombudsman Program to educate residents and staff about the Ombudsman Program, abuse issues and resident rights. Continued funding will make it possible for the Ombudsman Program to serve the increasing number of vulnerable long term care residents. Continuation of funding relates to the mandate of early crisis intervention and to provide assistance and support to victims and their families. I do not recommend a Work Session. I recommend approval of the Application Submission. Sean P. Conway Julie A. Cozad, Chair Mike Freeman Barbara Kirkmeyer Steve Moreno, Pro-Tem Approve Schedule Recommendation Work Session Other/Comments: Pass -Around Memorandum; January 31, 2017 — (Not in CMS) Pagel 2017-0542 VALE Grant Application Signature Page Applicant Agency: Weld County Department of Human Services, Area Agency on Aging Project Title: Weld County Long Term Care Ombudsman/Friendly Visitor Program Grant Period: July 1, 2017 to June 30, 2018 We hereby certify that the information contained herein is true and correct to the best of our knowledge and belief. 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. Refer to Application Instructions for definitions for the signing authorities. Protect Director: Name: Eva M. Jewell Position/Title: AAA Division Head Agency (including Division or Unit): Weld County Department of Human Services, Area Agency on Aging Mailing Address: Post Office Box 1805, Greeley, CO 80632 Phone: (970) 400-610 Signature Financial Officer: Name: Leonard L. Bottorff (970) 346-6951 E -Mail: ejewell@weldgov.com Date: Position/Title: Fiscal and Budget Manager Agency (including Division or Unit): Weld County Department of Human Services Mailing Address: Post Office Box A, Greeley, CO 80632 Phone: (970) 400-6537 Fax: 70) 346-7691 E -Mail: lbottorff@weldgov.com Signatur Date: /I / 17 Authorized Official: Name: Julie Cozad Position/Title: Chair Agency (including Division or Unit): Weld County Board of Commissioners Mailing Address: Post Office Box 758, Greeley, CO 80632 Phone: (970) 400-4209 Fax: (970336-7233 E -Mail: jcozad@weldgov.com Signatu 21 Date: FEB 2 2 2017 In accordance with the Colorado Revised St•Stutes 24-72-202.6, information supplied in this application is considered a public record. oZon- osvz �i) 2017-2018 VALE ASSISTANCE FUNDS 19th Judicial District, Weld County Application REFER TO APPLICATION INSTRUCTIONS TO COMPLETE THIS APPLICATION CORRECTLY. SECTION A - AGENCY INFORMATION: 1. APPLICANT AGENCY: Weld County Department of Human Services Area Agency on Aging Program Name: Weld County Long Term Care Ombudsman Program Street Address (if not confidential): 315 C. North 11th Avenue Greeley, Colorado 80631 Mailing Address (if different): Post Office Box 1805 Greeley, Colorado 80632 Phone: (970) 400-6128 Fax: (970) 346-6951 E -Mail: rmaldonado(c�weldgov.com 2. CONTACT PERSON: Raegan Maldonado Title: Ombudsman Supervisor Phone: (970) 400-6128 Fax: (970) 346-6951 E -Mail: rmaldonado(a�weldgov.com VALE USE ONLY Grant #: Amount Requested: Amount Funded: 3. Agency Status ® governmental nprivate-non-profit n private -for-profit 84-6000813 Non -Profit agencies include their TAX ID Number here. NOTE: If you are claiming non-profit status and if you have not previously provided documentation supporting this claim to the VALE Board, then you must provide sufficient documentation concerning your agency's non-profit status with this application. 4. PROJECT TITLE: Weld County Long Term Care Ombudsman/Friendly Visitor Program 5. Give a problem statement that is specific to the community the project will serve: The at -risk adult population is growing rapidly. The funding will allow the Ombudsman Program to have a consistent presence in Weld County long term care settings, allowing for advocacy and education. The funding will enable the Long Term Care Ombudsmen to maintain a friendly visitor and awareness program. 6. FUNDS REQUESTED TOTAL: $10,000 ITEMS 1 - 6 MUST REMAIN ON THIS PAGE 1 SECTION B - NARRATIVE SUMMARY 7. Agency description: The Weld County Long Term Care Ombudsman Program is housed within the Weld County Area Agency on Aging, and is funded by Federal and State grants. The authority of the local Ombudsman Program comes from the Older American's Act, Colorado Revised Statutes 25- 11.5, and the Federal Nursing Home Reform Law/OBRA. 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 on a quarterly basis. There are currently 8 Long Term Care Facilities and 25 Assisted Living Facilities in Weld County. The Long Term Care Ombudsman Program is a resident/patient/consumer-centered advocacy program. 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 these services and furnish support in complaint resolution. The Weld County Ombudsman acts as a consumer voice for the concerns of the at -risk adults living in institutions, who may have no one else to speak for them. The Ombudsman also investigates and resolves questions, issues, problems and complaints made by, for, or on behalf of residents of long term care facilities. 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. In addition, the Ombudsman documents and reports problems of long term care, helps establish programs to meet residents' needs, and stimulates and promotes improvement of the system. 8. Project Description for which the funds are being requested. The V.A.L.E. Assistance Funds have allowed the Ombudsman Program to maintain 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 educational program aimed at educating residents, Certified Nursing Assistants (C.N.A.'s), other long term care staff, and family members. Education material includes, but is not limited to: information about the Long Term Care Ombudsman Program, Resident Rights, Elder Abuse and Neglect, and Victim Compensation. The Ombudsman's role, through observation and a frequent presence in facilities, is to insure that resident rights are being respected and that quality care is being administered. In addition, our program focuses on the importance of recognition and appropriate response to signs and symptoms of elder abuse and neglect. Continued V.A.L.E. funding 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. The Long Term Care Ombudsman Program has been very fortunate to have this partnership with Victim Services. Being involved with CCVC and other networking groups involving Victim Services, has strengthened and enhanced our ability to address the needs of at -risk adults in Weld County. 2 SECTION C - GOALS AND OBJECTIVES: (Goal 1, objectives 1 and 2, are mandatory for all applicants.) 9. 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. Although a person may be a victim of multiple crimes in one criminal episode, they can be counted only once using the predominant crime. Definitions: Victims: primary and secondary victims Primary victim: The person against whom the crime was committed, except in the case of homicide, and DUI/DWI deaths where the primary victims are the survivors of the victim. In domestic violence crimes, children of the primary victims (who are receiving services) are also considered to be primary victims. Secondary Victims: Persons other than primary victims receiving services because of their own reaction or needs resulting from a crime. Unduplicated Count: New and continuing victims served by the project . Continuing victim is a person served in the prior grant year who is continuing to receive services in the new grant year. EST. NO. VICTIMS TYPE OF CRIME EST. NO. VICTIMS TYPE OF CRIME Child Physical Abuse Adults Molested as Children Child Sexual Abuse Survivors of Homicide DUI/DWI - Victims of vehicular assault or vehicular homicide, DUI/DWI crashes or careless driving resulting in death. Robbery Domestic Violence Assault 10 Adult Sexual Assault Other violent crimes such as hate and bias crime, gang violence (specify). 80 Elder Abuse (including economic exploitation and fraud crimes) Other, please specify TOTAL UNDUPLICATED VICTIMS ESTIMATED TO BE SERVED DURING THE 12 -MONTH PERIOD 90 3 OBJECTIVE 2 (standard): To provide the following types of services to the following estimated number of unduplicated victims during the 12 -month grant period. Number of Victims Receiving Each Type of Service: Estimate the number of victims who will receive each type of service during the grant period. A victim may receive the same type of service more than once (i.e. counseling), but the type of service can be counted only once during the grant period. An individual service category cannot exceed the total number of victims listed in table A. EST. NO. VICTIMS SERVICES EST. NO. VICTIMS SERVICES 50 Crisis/Counseling Intervention (in person) 90 Victim Compensation Assistance (required) 40 Follow-up (includes crisis intervention by phone) 70 Personal Advocacy Therapy 40 Telephone contact Group Treatment / Support Civil Legal Advocacy/Court Accompaniment Shelter / Safehouse Forensic Exam 50 Information / Referral (in person) Hospital/Clinic Response Criminal Justice Support / Advocacy/Court Accompaniment Language Services (interpretation) Emergency Financial Assistance Transportation Emergency Civil Legal Attorney Assistance Transitional Housing Victim Rights Act Services 4 PROJECT -SPECIFIC GOALS AND OBJECTIVES: Add at least one more goal with objectives but no more than three additional goals with no more than three objectives per goal. Refer to Application Instructions, use format provided below. GOAL 2: The Weld County Long Term Care Ombudsman Program will educate long term care residents and their families about their rights and crimes committed especially against at -risk adults. This education will include information regarding Victim Rights and Victim Compensation. Objective (list title of person responsible) Intended Outcome/Impact Data Collection Timeframe 1 The LTC Ombudsman and Ombudsman Supervisor will provide 1:1 education to 20 long term care residents per quarter. Residents in facilities will have knowledge of their rights, crimes targeting at -risk adults, and victim rights and victim compensation. Staff documentation in database. During the 12 -month grant period. 2 The LTC Ombudsman and Ombudsman Supervisor will provide group education during 2 Resident Council meetings per month. Residents will have an opportunity to discuss victim information in a group setting. Involve facility staff in the discussion. Staff documentation in database. During the 12 -month grant period. GOAL 3: The Weld County Long Term Care Ombudsman Program will provide group education about resident rights, and elder abuse detection and response topics. This education will include information regarding Victim Rights and Victim Compensation. Objective (list title of person responsible) Intended Outcome/Impact Data Collection Timeframe 1 The LTC Ombudsman and Ombudsman Supervisor will provide education to 100-150 nurse aide students. Nurse aide students will be knowledgeable about elder abuse and victims services before they begin their employment at facilities. Staff documentation in database. Training evaluations. During the 12 month grant period. 2 The LTC Ombudsman and Ombudsman Supervisor will provide education to 50-100 direct care staff. Direct care staff will be informed about abuse detection and how to respond, including victim services. Staff documentation in database. Training evaluations. During the 12 month grant period. 3 The LTC Ombudsman and Ombudsman Supervisor will provide victim rights and compensation information during 5-10 committee meetings. Agencies in the Ombudsman network will be made aware of victim rights and victim compensation. Staff documentation in database. During the 12 month grant period. 5 GOAL 4: The Weld County Long Term Care Ombudsman Program will collaborate with Adult Protective Services when applicable. Objective (list title of person responsible) Intended Outcome/Impact Data Collection Timeframe 1 The LTC Ombudsman and Ombudsman Supervisor will attend 10-12 Adult Protection Networking Group Meetings. Networking with other entities involved with at- risk adult cases. Include information about victim rights and victim compensation. Number of cases addressed during the meetings. During the 12 month grant period. 2 The LTC Ombudsman and Ombudsman Supervisor will refer cases to APS, and receive cases from APS. Referrals to appropriate program. Number of case referrals. During the 12 month grant period. 3 The LTC Ombudsman and Ombudsman Supervisor will combine efforts with APS when appropriate. Combined investigations will allow for gathering necessary data at the same time. Number of collaborated case investigations. During the 12 month grant period. 6 10. QUALITY ASSURANCE PLAN: Describe the approach for evaluating the project in response to the stated objectives, intended outcomes/impact and data collection. We will track the type of meeting attended, education provided, and the number of individuals present. We will also distribute training evaluations when appropriate. The evaluations will include questions regarding knowledge of victim rights and victim compensation. We will document cases in our database in order to keep track of our collaboration with Adult Protective Services. All pertinent information will be documented in our quarterly VALE reports. The long term care community is a population that no other entity has access to like the Ombudsman Program. We intend to ensure that this population is made aware of victim rights and victim compensation. 7 11a. Services as defined in the V.A.L.E. statute, 24-4.2-105 (4) (a — m) C.R.S. Indicate YES for services which are indicated in the Goals and Objectives of this application, and NO for services NOT indicated in the Goals and Objectives of this application. YES NO Services: C.R.S. 24-4.2-105 (4) (a — m) J (a) Provision of services for early crisis intervention; x (b) Provision of telephone lines for victims and witnesses assistance; J (c) Referral of victims to appropriate social service and victim compensation programs and assistance in filling out forms for compensation; J (c.5) Assistance programs for victims and their families; x (d) Education of victims and witnesses about the operation of the criminal justice system; x (e) Assistance in prompt return of the victims' property; x (f) Notification to the victim of the progress of the investigation, the defendant's arrest, subsequent bail determinations, and the status of the case; x (g) Intercession with the employers or creditors of victims or witnesses; x (h) Assistance to the elderly and to persons with disabilities in arranging transportation to and from court; x (i) Provision of translator services; x (j) Coordination of efforts to assure that victims have a secure place to wait before testifying; x k) Provision of counseling or assistance during court appearances when appropriate; x (1) Protection from threats of harm and other forms of intimidation; x (m) Special advocate services (7) (b) "Special advocate services" means the services offered to aid victims who are children, including, but not limited to, court -appointed special advocate (CASA) programs, sexual assault treatment and prevention programs, community -based youth and family servicing programs, gang alternative programs, school -based intervention and prevention programs, big brother and big sister programs offering aid to children who are victims, restitution programs, partners programs offering aid to children who are victims, and child abuse treatment programs. Only grants submitted by the Court Administrator's Office would check (2.5) (a) (I) below. (2.5) (a) (I) The court administrator of each judicial district may apply for grants of moneys for the purpose of collecting all moneys assessed by the courts, including moneys owed pursuant to this article, and collecting and disbursing restitution owed to victims of crime; Only grants submitted by the local Probation Department would check (2.5) (a) (II) below. (2.5) (a) (I) The local probation department may apply for grants of moneys for the purpose of implementing the right of victims. 8 11b. For each YES listed in 13a), reference the Goal and Objective that relates to the service rovided with a brief explanation. DO NOT RESTATE THE GOAL OR OBJECTIVE. a Goal 2 and Objectives 1 and 2 Goal 3 and Objectives 1, 2 and 3 Goal 4 and Objectives 1, 2 and 3 Explanation: All of these goals and objectives focus on early crisis intervention through education and collaboration of services. c Goal 2 and Objectives 1 and 2 Explanation: We will provide residents and family members with information regarding social services contacts and Ombudsman contacts in case they are in need of assistance with filling out forms for compensation. Goal 3 and Objectives 1, 2 and 3 Explanation: We will refer victims to APS, and collaborate with APS, when appropriate. We will provide individuals with information regarding the Victim Compensation Program and assist them as needed. Goal 4 and Objectives 1, 2 and 3 Explanation: We will provide information regarding the Victim Compensation Program during our trainings. c.5 Goal 2 and Objectives 1 and 2 Explanation: We will educate residents and their families about assistance programs. Goal 3 and Objectives 1, 2 and 3 , Explanation: We will provide education about assistance programs for victims and their families. 12. Will this project utilize volunteers and or interns? n Yes ® No If yes, please answer the following: Number of volunteers/interns which were utilized for last six months, July 1, 2016 through December 31, 2016. In 2016, the total number of volunteers/interns was who provided hours to the agency. 9 SECTION D - SERVICE INFORMATION: for service through this project? and will you serve? 13. What is the population and geographic area targeted a) How many crime victims have you served VICTIMS SERVED 1 YEAR July 1, 2014 Through June 30, 2015 VICTIMS SERVED 1 YEAR July 1, 2015 Through June 30, 2016 PROJECTED VICTIMS SERVED July 1, 20156 Through June 30, 2017 PROJECTION OF VICTIMS TO SERVE July 1, 2017 Through June 30, 2018 70 90 90 90 b) What is the number c) Are there other community There are no other community If yes, explain how this 14. Document community a) List the top five of victims served July 1, 2016 through December 31, 2016? 46 agencies currently providing like services to the targeted population? agencies that provide such services to long-term care residents. project is not a duplication of services. support, coordination and networking by providing the following information: agencies who your agency works most closely with in coordination and victim services and indicate how you work with them. provision of crime AGENCY HOW YOU COORDINATE 1 Home and Community Based Services SEP quarterly meeting, collaborate efforts if working with the same resident/client. Information and referral regarding Weld County long term care facilities. 2 Adult Protective Services APS monthly meeting, APS case staffing meeting, collaborate efforts if working the same resident/client, together facilitate trainings to groups. Referral of abuse and neglect cases that occur in Weld County. 3 Disability Law Colorado Information, consultation and referral with State Ombudsman's office. 4 Medicaid Technicians Refer residents and families when they are in need of applying for Medicaid. 5 Weld skilled nursing and assisted living facilities Advocating, consultation, and education. 10 b) Is your agency an active participant in Weld County's Coordinating Committee for Victims of Crime (CCVC)? If "yes," provide the name(s) and position(s) of the CCVC participant(s) and their level of involvement in that group. Yes NAME OF MEMBER HOW THEY PARTICIPATE Raegan Maldonado Ombudsman Supervisor Quarterly Meetings, Victim Rights Day, Subcommittee as needed, Trainings Teresa Hill Long Term Care Ombudsman Quarterly Meetings, Victim Rights Day, Subcommittee as needed, Trainings c) Briefly describe any other agency actions that demonstrate its high priority for developing community support, coordination, networking, and cooperation. COMMITTEE HOW WE PARTICIPATE Adult Protective Services Networking Meeting Monthly meetings, present Ombudsman perspective during case review, provide group with information regarding LTC, the Ombudsman Program and Victim Services. The Weld County Bio-Ethics Committee Quarterly meetings and emergency meetings. Develop case studies for review. Provide education regarding LTC, the Ombudsman Program and Victim Services. ADRC (Aging and Disability Resources for Colorado) Six meetings per year. Provide education regarding LTC, the Ombudsman Program and Victim Services. Weld County Senior Support Network Attendance at meetings. Provide education regarding LTC, the Ombudsman Program and Victim Services. 11 SECTION E - VICTIM COMPENSATION: Provide the following information concerning your agency's involvement with the Crime Victim Compensation Program: 15. a) Does your agency regularly inform victims about Victim Compensation and help them to apply when appropriate? M Yes n No How? We meet with residents, victims, family members and staff members 1:1 to provide them with information regarding Victim Compensation and their rights. In addition, we inform people about Victim Compensation during Ombudsman trainings and meetings. We also educate individuals via telephone and email, when appropriate. We also inform them that we can assist them with the application process if they would like us to do so. d) Explain any major issues that hinder your agency in helping crime victims to understand Victim Compensation eligibility requirements and to apply for benefits. We have no major issues that hinder our agency in helping crime victims to understand Victim Compensation eligibility requirements and to apply for benefits. c) Date of the last Crime Victim Compensation training: Tuesday, April 5th, 2016 d) Person who conducted the training: Fawn Harmon 2 Number of Staff and Volunteers in your agency providing services to crime victims. 2 Number of Staff and Volunteers who attended the last Victim Compensation Training. DO NOT INCLUDE VICTIM COMPENSATION BROCHURES WITH YOUR APPLICATION. 12 SECTION F- VICTIM RIGHTS ACT: 16. Has your agency taken steps to assure that all staff and volunteers have read and understand the GUIDELINES FOR ASSURING THE RIGHTS OF VICTIMS OF AND WITNESSES TO CRIMES: Rights afforded to crime victims - C.R.S. 24-4.1-302.5; Procedures for assuring rights of victims of crimes; C.R.S. 24-4.1-303; and Child victim or witness — rights and services — C.R.S. 24-4.1-304 ®Yes 0 N a) Briefly describe how your agency assures that all staff and volunteers are trained on VRA. We require that the Ombudsman staff read, "Crime Victims Have Rights," on the DCJ website: www.dcj.ovp.state.co.us, on a yearly basis. If we are able to recruit appropriate volunteers, we will require that they review this information as part of their training. b) Does your agency have a statutory mandate to notify victims about their rights under VRA? ❑ Yes ® No c) Date of last VRA Training: June 28th, 2016 d) Person who conducted the training: Ami Gerstner, COVA 2 Number of Staff and Volunteers in your agency providing services to crime victims. 2 Number of Staff and Volunteers who attended the VRA Training. e) How does your agency notify victims of their rights under VRA? We provide residents, family members and facility staff members with information from, "Crime Victims Have Rights," from the DCJ website: http://dcj.ovp.state.co.us/home/victim-rights, when appropriate. We provide the large print brochures to individuals who have visual impairments. We also have Ombudsman brochures that we distribute that specifically explain Resident Rights when they live in an assisted living facility or nursing home. f) Does your agency have a brochure describing VRA? ❑ Yes ® No If "yes", list the languages in which your brochure is available. See SECTION I. ATTACHMENTS g) If you agency does not have a brochure describing VRA, please indicate if your agency utilizes brochures from other agencies. See SECTION I ATTACHMENTS VRA brochures SHOULD be included in the application (all languages). DO NOT INCLUDE VICTIM COMPENSATION BROCHURES TO YOUR APPLICATION. "Crime Victims Have Rights," from DCJ website: http://dcj.ovp.state.co.us/home/victim-rights. 13 SECTION G - BUDGETARY INFORMATION: All Budget pages MUST be completed. All figures should be rounded to the nearest dollar. 17. Have you received 19th JD VALE Funding for this project? ® Yes ❑ No GRANT YEAR AMOUNT AWARDED AMOUNT OF FUNDS RETURNED ( not used during grant cycle) 2016-2017 $10,000 0 2015-2016 $9,000 0 2014-2015 $9,639 0 2013-2014 $12,000 0 18. What is the projected cost per client served (cost/benefit ratio)? Funds requested divided by number of victims projected to serve = cost per client $12,000 divided by 90 = $133.33 cost per client. 19. RESPONSIBLE PARTIES: a) List the two individuals who are responsible for ensuring the grant is administrated as proposed by the organization and approved by the VALE Board. NAME TITLE PHONE EMAIL Eva Jewell AAA Division Head (970) 400-6101 ejewell@weldgov.com Raegan Maldonado Ombudsman Supervisor (970) 400-6128 rmaldonado@weldgov.com b) Who (give name and title) in your agency is responsible for reviewing agency bank statements against agency financial reports for accuracy of financial information? Chris D'Ovidio County Accounting 20. What controls and processes does your agency have in place for writing checks? The answer should include information including: who in the agency is authorized to request a check, who is authorized to write a check, who is authorized to sign a check, whether or not dual signatures are required on any checks, and whether or not a person authorized to write a check could sign a check to themselves. Weld County has separate processes in place to order goods and services, authorize payment, approve payment and write checks. Program personnel order goods and services with the assistance of the county purchasing office. After the order is received, an invoice is sent to the department fiscal office where the accounts payable staff verify the delivery of the item, obtain authorization for payment and code the payment in the accounting system. Approval of the payment is completed by a departmental accounting supervisor and the central county accounting office verifies the approval and writes the check. The system of internal control ensures that authorization, approval and disbursement are done by different offices; no checks are authorized and written by the same individual. 21. What process does your agency have in place to reconcile financial information with the quarterly VALE Financial Report? The Ombudsman Supervisor submits a request to the Weld County Human Services fiscal department, requesting that the fiscal department complete the required information/paperwork. The completed information is then reviewed by the Ombudsman Supervisor, the AAA Department Head, and the Financial Officer. The AAA Department Head and the Financial Officer sign the quarterly VALE financial reports. 14 Hello