Loading...
Res 68-80 RESOLUTION NO. 68-80 ~ A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF DELRAY BEACH, FLORIDA, AUTHORIZING AND DIRECTING THE MAYOR TO EXECUTE AN AGREEME~T WITH THE STATE OF FLORIDA DEPARTMENT OF COMMUNITY AFFAIRS UNDER THE FLORIDA FINANCIAL ASSIST- ANCE FOR COMMUNITY SERVICES ACT; PROVIDING THAT THE CITY OF DELRAY BEACH WILL BE RESPONSIBLE FOR THE LOCAL MATCH REQUIRED UNDER PROVISIONS OF SAID ACT. i NOW, THEREFORE, BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF DELRAY BEACH, FLORIDA, AS FOLLOWS: Section 1. That the City hereby authorizes, confirms and ap- proves the filing of the application of Planned Parenthood, Palm Beach Area, Inc. for grant funds under the Florida Financial Assistance and Community Services Act. The application being for the fiscal year October 1, 1980 through September 30, 1981 requesting state grant ~funds in the amount of $50,000. Section 2. That the Mayor is hereby authorized and directed to sign in the name and on behalf of the City an Agreement between the Florida Department of Community Affairs and the City of Delray Beach, Florida, under the Florida Financial Assistance for Community Services Act, endorsing the program of Planned Parenthood - Palm Beach Area, Inc. A copy of the Agreement is attached hereto and made a part hereof. Section 3. That Planned Parenthood, Palm Beach Area, Inc. will be the delegate agency and subcontractor of the City of Delray Beach in connection with this grant. Section 4. That the City will be financially responsible for the local share of the grant as required pursuant to the provisions of Florida Statute Chapter 409, notwithstanding the fact that all or part of the local share is to be met or contributed by other source, i.e., contribu- tions, other agencies or organization funds. PASSED AND ADOPTED in regular session on this the 12th day of August, 1980. MAYOR ~ LEON M. WEEKES ATTEST: City Clerk FLORIDA FINANCIAL ASSISTANCE FOR COMe, UNITY SERVICES ACT OF 1974 (CO~NITY SERVICES TRUST FUND) GRANT APPLICATION Page 1 of 7 REPLY TO: * SUBMIT FOUR (4) COPIES DEPARTMENT OF CO:.LMUNITY AFFAIRS (ONE MUST BE ORIGINAL) OFFICE OF CO~hMUNITY SERVICES 2571 EXECUTIVE CENTER CIRCLE, EAST * PLEASE TYPE - ANS~,'.~R ALL TALLAHASSEE, FLORIDA 32301 QUESTIONS 1. Local Governmental Unit Applying for Grant: N~e: City of D~I~v B.e~h. VI~H~ Telephone: ~5) 77~-?~4] '(name of ~town, 'city or county) Address: 100 N%~ 1st Ave., Delray Beach, Fla. zip: 33z:~:4 County: Palm B~ach County 2. Delegate Agency (s): Planned Parenthood of South Palm Beach and Broward Counties, Inc 3. Person with over-all responsibility of grant: (Our Department will contact this person should questions arise) Name: Sbir] ev M~r~ Telephone: (30~ 368-1023 Address: Planned Parenthood-160 NW 4th Street, Boca Raton, Fla. 33432 Signature: 4. Name and address of person authorized to receive funds. If this ap- plication is funded, checks will be mailed to this person. All checks will be made payable to the local government. N~e: Thomas Weber Address: Finance Department. City_ of Delrav Beach. 100 ~ 1st Ave. Delr~y Beach. Florida zip: "CC~.:PLETE A SEPARATE PAGE 2 FCR EACH PRSGRA?.i. Use attachment if necessary. :lame of Pro,ram 1. Give a brief overview of the proposed program. 2. Identify the problem this prcgram will address. 3. Specify the target population in your program service area af- fected by this problem. How large is the target population? Provide quantifiable n~mbers. 4. What is the severity of the problem among the target'population. Provide quantifiable numbers/percentages, etc. 5. How will this program address the problem? 6. How many and what percentage of the target population will be served? Is this amouht an increase over the existing services? 7. Will this program provide direct access or availability of other services? If yes', identify them. 8. Is the program operating now? If yes, explain what changes this grant will provide for if any. 9. will the grant funds be used as match to obtain other funds? If yes, what other funds? 10. What funds will sustain the program after this grant expires? 11. Who will do the audit of the program? 1. GIVE A BRI~O\,~aRVItP,.7OF~ PROPOSED PPfKTP,~h The proposed program would give Planned Parenthood of South Palm Beach and Broward Counties, Inc. located in Boca Raton, the opportunity to establish a Planned Parenthood family planning center in the counseling area of the Jean Cobb's Sickle Cell Center in Delray, expand outreach in the Delray-Boynton area and continue to provide increased family planning medical, counseling, and referral services at the existing Planned Parenthood medical clinic in Boca Raton. Last year as a result of a Planned Parenthood sponsored sickle cell project completed by a Florida Atlantic University student, the Planned Parenthood and the Jean Cobbs Sickle Cell Boards of Directors explored the possibilities of: 1). offering sickle cell screening as part of the medical health check received by contraceptive clients at Planned Parenthood. This.program was initiated with the financial help of Community Affairs Trust Fund Grant, 1979-1980, and is operating successfully. 2). opening a Planned Parenthood counseling center in the space donated at the Cobbs Center to reach teens and marginal income women and families living in West Delray and Boynton with additional access to family planning services. The proposed Planned Parenthood counseling and referral center in Delra¥ would offer services free of charge- as are all Planned Parenthood counseling and referral services. Planned Parenthood and the Cobbs Sickle Cell Center are both committed to freedom of choice in dealing with Sickle Cell Trait and reproductive capacity. Sickle Cell counseling is provided at the Cobbs Center by an R.N. trained in genetic counseling and includes fertility control as one option. By having a Planned Parenthood counseling center in the same facility, sickle cell clients and other persons in the community who wish further information on fertility control and services could receive this specialized counseling within their own community. The Plan~ed Parenthood Center in Boca Raton will increase its provision of contraceptive services, counseling and education to all persons without regard to age, sex, background or ability to pay. Low-income reSidents of South County will continue to reveive services at no cost under Title XX or with funding from other sources. (Fifty-five percent of South County clients have NO income or incomes less than $4,000 per year). Contraceptive services are provided at the Boca Raton Planned Parenthood clinic: a free-standing, 1800 square feet modern building located in the civic center area. The clinic is in a "downtown" location readily accessible by car and public trans- portation. Clinic sessions are staffed by local OB-GYN's, nurse practitioners, R.N.'s and trained counselors, many of them volunteers. Medical services include social and medical history, weight, height, blood pressure, hemoglobin, VDRL, sickle cell testing when requested, urine, albumin and sugar, pregnancy testing, information (written and group instruction) on birth control methods (pill,' IUD, diaphragm, foam, condom, natural family planning), breast check, heart, lung, and thyroid check, and pelvic examinations including pap smear and GC culture. Birth control methods are prescribed and supplied by the clinic. Clients are followed for contraceptive and medical problems and notified of annual exam. Counseling services include birth control, VD, sterilization and problem pregnancy counseling. The agency has a wide variety of referral resources in both Palm Beach and Broward Counties. Birth control counseling and sterilization counseling involve education about methods, risk-benefits, cost, resources, etc. Problem pregnancy counseling involves examination of all options open to a woman with an unplanned pregnancy: resources for assistance if the pregnancy is to be full-term, adoption, foster care, abortion. Planned Parenthood is the ONLY AGENCY providing pregnancy testing and problem pregnancy counseling in Palm Beach County where all options are given, where birth control methods are explained, contraceptive problems are dealt with and follow- up appointments for contraceptive services are made as a part of the counseling service. Planned Parenthood is the ONLY SOUTH COUNTY CLINIC offering morning and evening clinics. The Health Department in Delray Beach offers afternoon family planning clinics only. Educational services are provided both on and off site. Education and decision making about sexuality, health care, family life and responsibility are an integral part of on site clinic and counseling services. A board-certified sex educator (AASECT) is involved in the sex education programs in both public and private schools. Youth and church groups and local agencies also use the educational services of Planned Parenthood. Nursing and counseling students from local colleges and universities are trained in family planning at Planned Parenthood. Workshops for professionals such as public health nurses, school counselors, HRS employees and ministers are offered at Planned Parenthood. The proposed program would continue medical services at an increased rate with the addition of trained medical and counseling staff. 2. IDENTIFY THE PROBLEM THIS PROGRAM WILL ADDRESS. The primary problems to be addressed by this program are the problems of the high rate of teenage pregnancy and illegitimacy, and the need for sickle cell trait persons to be identified and completely informed as to their options. Unplanned teenage pregnancy, resulting in an unplanned birth or an abortion, contributes to the emotional, financial, medical and social problems seen in the unprotected sexually active teenager. Illegitimacy among non-whites has remained at a high level over the past four years; illegitimacy among whites has increased during the same period.~ One in ten black Americans and a significant number of other~ whose ancestors come from the Mediterranean area, the Carribean and parts of South, Central and North America, the Middle East and parts of?India, may have Sickle Cell trait or other hemoglo- binopathies.~ Ail persons deserve the opportunity to avail themselves of free screening for these genetic diseases so they can plan for a healthy family. 1Bureau of Vital Statistics, Tallahassee, Florida. 2Cobb Sickle Cell Center, Delray Beach, Florida. Additionally, this program will aid in the detection of venereal disease and cancer. Venereal disease is a significant health problem in the State of Florida, since only Georgia has a higher syphilis rate and only seven states have higher gonorrhea rates. Cancer detection--breast and cervical--remain of primary importance in female health care. Breast cancer remains at a high rate, affecting one in thirteen American women. The inci- dence of cervical cancer is increasing due to the increase of the Herpes II virus, increased sexual activity at an early age among adolescents and the ~ffect of DES in millions of American women and their daughters.~ Both VD and cancer cures depend on early detection and treatment. While these problems are present in all segments of society, low-income persons (increasing in number because of inflation) are more often the victims of lack of medical care. Planned Parenthood will continue to see marginal and low income persons, regardless of ability to pay. 3. SPECIFY THE TARGET POPULATION IN YOUR PROGRAM SERVICE AREA AFFECTED BY THIS PROBLEM. The South County Center sees any person, regardless'of age, sex or residence. (A small, but significant number of our clients are teens and young adults who are without a true permanent residence.) However, these itinerant teens plus the Palm Beach and nearby Broward County pre-teens and teenagers are the persons most at risk of unplanned pregnancies and the high incidence of venereal disease. Teenagers in general are more fearful of and less able to pay for medical services within traditional settings. HOW LARGE IS THE TARGET POPULATION? (Provide quantitative numbers.) A population explosion has occurred in both Palm Beach and Broward Counties with a mass migration of individuals and families from northern cities to the "Sun Belt." Since 1970 Palm Beach County has experienced a 46.9% population increase compared with a 28.5% increase for the total State of Florida. There were 505,605 Palm Beach County residents in 1977: 10,233 were 0-14 years and 73,880 ~ere 15-24 years old. It was estimated at a United Way planning meeting last year that the population of West Boca Raton, now over 17,000 will number 55,000 by 1980. Broward County has grown from a population of 620,000 in 1970 to 902,543 residents in 197~: 176,551 were 0-14 years old and 126,342 were 15-24 years old.~ The Boca Raton Center is primarily concerned with population growth in nearby Broward communities such as Deerfield, Pompano and Coral Springs whose population has more than doubled in the last seven years. ~ Approximately 10% of Broward and Palm Beach County residents are non-white. No information is available as to the ancestral make-up of the white population. It is not known how many persons in the areas of Palm Beach and Broward communities near South County Center are candidates for the sickle cell screeing program now in operation. 3American Cancer Society publications. 4Florida Statistical Abstracts, 1977. 4. I.~U\T IS THE SEVERITY OF THE PROBLEM k~.[0NG THE TARGET POPULATION? Palm Beach and Broward Counties both have high rates of teenage pregnancy, consistent with high rates found in the rest of the United States. In Palm Beach County births to non-white women under 16 years of age was considered to be one of the major health problems of the county. J ~ In Palm Beach County 26% of non-white births and in Broward County 27% of non-white births were to teenagers. Although exact abortion statistic~ are not available, The Alan Guttmacher Institute reports 1/3 of the 1.3 million abortions in 1978 were to teenagers. Illegitimate birth rates in both Broward and Palm Beach Counties remains high, at approximately 64% of all births for non-whites and 11% for whites. Although teen-age pregnancy is medically high-risk by definition, nearly half of pregnant teenagers receive no prenatal care in their first trimester. The death rate from complications of pregnancy and childbirth is 13% greater for 15-19 year olds and 60% greater for teenagers 14 or younger compared with women in their early 20's. Early childbearing poses serious social and economic consequences for teenage mothers and their children. Teenage mothers are often forced"to leave school and to forgo job training and other opportunities for economic advancement. Unmarried mothers may face social disapproval, financial hardship and difficulty in finding work and child care facilities. They may be forced to turn to welfare for support. A New York City survey, for example, reports 72% of mothers who first gave birth between 15 and 17 were on welfare. A life begun in poverty often continues in poverty and perpetuates a cruel cycle. If they marry, teenage mothers are more likely to have unstable marriages and financial problems than others of same age and socio-economic status. Women who have their first child in their teen years tend to have more children in quicker succession than their peers. The suicid~ rate of teen mothers is seven times that of other teenage girls.~ The health risk to babies born to teenagers is enormous. They are two to three times more likely to die in their first year than babies born to women in their early 20's. Babies born to teenagers are often born too small, or premature, with the associated problems of mental retardation and congenital malformations.7 Nine percent (9%) of total live births in 1976 were infants weighing less than 2,500 grams. According'to the Florida Inventory of Services for Adolescents HRS, the percentage of females aged 15-19 at risk of unintended pregnancy who are living in families below 200% of the federal poverty index are 45% in Palm Beach County and 37% in Broward County. In Palm Beach County 55% of females at risk aged 15-19 are not served by organized family planning programs; in Broward the number exceeds 76% (one of the highest in the State of Florida). Sexually transmitted diseases--syphilis, gonorrhea and herpes simplex II--continue to plague persons of all ages, and economic strata. Teenagers tend to be the most frequent victims and young persons under 25 are usually half the reported cases. Broward County reports syphilis to be the third leading communicable disease in that County, with a 59% increase between 1973 and 1975. The Health Planning and Development Council for Broward County reports the total United States incidence rate for gonorrhea increased by 57.7% from 1970 to 1975. During the same time period the total rate in Florida increased 117%. Palm Beach County Health Department reports 265 cases of syphilis and 2680 cases of gonorrhea in 1978. 5Health Planning Council 6"Teenage Parenthood"-Florida Cooperative Extension, 1979. 7March of Dimes No-statistics on sickle cell screening are available for either Palm Beach County or Broward Counties. The ~.Iarch of Dimes in Palm Beach County provided genetic counseling to 83 persons in 1978. Sickle cell, a genetically inherited disease, is prevalent among Blacks; it has been estimated that it affects one in every ten Black Americans (2~ million persons) in the trait form and one in every 400 Black Americans as the severe or actual sickle cell disease. '~ 5. HOW WILL THIS PROGR3uM ADDRESS THE PROBLEM? The objective of all Planned Parenthood Affiliates is to achieve the virtual elimination of unwanted pregnancies and abortions through voluntary fertility control. At the same time Planned Parent%hood provides broad-based general health screening for anemia, hypertension, diabetes, disease of kidney and bladder, cancer, venereal disease and sickle cell. 1. By restructuring contraceptive clinics, no client will have to wait longer than two weeks for an appointment or longer than two hours to see the doctor or nurse practitioner. The number of clinic sessions will be increased from four to five per week, and will include an"additional morning clinic to accomodate the large influx of population in the Boca-Delray area. 2. Increase the number of clients able to receive gynecological services and information by hiring an additional R.N.-counselor and increasing the-hours of an already-employed Florida State Certified Family Planning Nurse Practitioner. 3. Increase the number of women able to receive preg- nancy testing and counseling services by training additional volunteer counselors. The training will be conducted by an AASECT (American Association of Sex Educators, Counselors, and Therapists) member, the Family Planning Nurse Practitioner, and an M.Ed. counselor with expertise in family planning and human sexuality. 4. Increase the number of educational contacts to 5,000 yearly by training additional volunteer outreach workers. Educational contacts include group instruction in sex education in public and private schools, clinics, civic groups and teen organizations. ,. 5. Increase the number of informational ourtreach through TV, radio, and newspapers by working to coordinate media presentations with other local Planned Parenthoods in Dade and Broward Counties and in West Palm Beach. 6. Continue the successful Boca Raton Center Lamaze Program, involving young pregnant mothers and their husbands in preparation for natural childbirth-- encouraging men to feel comfortable at the Planned Parenthood center. 7. Continue Sickle Cell screening when requested as part of the clinic visit--encouraging non-whites to feel comfortable at the Planned Parenthood clinic and providing a needed medical service in the community. 8. Developing a satellite counseling center and out- reahh program in West Delray to make family planning information more readily accessible to a high-risk population by organizing FAU Delta Sorority members or other civic groups in West Delray to actively participate in Planned Parenthood activities. 6. HOW ~.t~NY AND I.,~IAT PERCENTAGE OF THE TARGET POPULATION WILL BE SERVED? The current number of medical and counseling clients served at the Boca Raton Center is approximately 350 per month. The proposed pro~ram will allow for an increase of 50 monthly for a total of 4,800 yearly. At present, off-site encounters, which include sex education programs, TV, radio, newspapers, number approximately 35,000. The addition of trained volunteers in this position will allow 53,000 such contacts to be made. IS THIS ~MOUNT AN INCREASE OVER THE EXISTING SERVICES? Yes. It is more than a 15% increase. 7. WILL THIS PROGRA!~ PROVIDE DIRECT ACCESS OR AVAILABILITY OF OTHER SERVICES? IF YES, IDENTIFY THEM. The program will provide access to the following services: 1. Contraceptive medical services. 2.'~ Counseling services. 3. Referrals, including medical. 4. Educational services. 5. Student training services~ 6. VD and cancer testing, education and follow-up. 7. Broad-based health screening for diabetes, hyper- tension, anemia, kidney and bladder disease, diseases of heart, lung and thyroid. 8. Lamaze instruction for prepared childbirth. 9. Sickle cell screening. 8. IS THE PROGRAM OPERATING NOW? Yes--Planned Parenthood of South Palm Beach and Broward Counties, Inc. began as a counseling and referral agency using volunteers only in one room of the local Unitarian Universalist Church in June 1975. By December 1976 clinic services began using the Sunday School rooms of the Church. In January 1978, with 2~ employees and 25 volunteers, a local building was selected, purchased and renovated into a family planning clinic (CBS 1800 square feet). In the 2~ years of services in the South County center, the building has been completely paid for by private contributions and the case load has tripled. The South County Center now has seven employees including a part-time Family Planning Nurse Practitioner, forty volunteers, three contracted local OB-GYN's helping provide clinic services and almost 5,000 clients. A new branch clinic in Ft. Lauderdale, under a separate budget and utilizing Title X funds, has been opened July !, 1980 as part of Planned Parenthood of South Palm Beach and Broward Counties, Inc. EXPLAIN ~tAT CHANGES THIS GRANT WILL PROVIDE FOR. By increasing the staff at the Boca Raton Center, the waiting time for clinic and counseling appointments can be reduced, an important factor when dealing with a young, transient population. Increasing clinics will allow for a greater number of clients to receive family planning services--a projected 15% increase in the next year. The addition of one more clinic in the morning will allow teens and working mothers (many who work evenings as waitresses, etc.) to be able to use the clinic facilities at a time when they are free to do so. In a recent client survey  al numbers of clients said they could use the clinic mornings, ~-~noons and evenings. The sickle cell screening and satellite counseling center in West Delray will encourage involvement of the Black community in family planning activities. The addition of these services will allow for the participation of Black churches, civic groups and organizations in Planned Parenthood functions. The long range projection of Planned Parenthood working together with the Cobbs Sickle Cell Center can include the planning for other broad-based screening and counseling services in the areas of Tay-Sachs and other genetic diseases. (Cobbs Sickle Cell Center projects testing and counseling for other genetic diseases in the future). Additionally, the area of health education in local schools and colleges will be reinforced. In the past three years significant changes have occurred in local acceptance of the need for these programs. Planned Parenthood has been able to provide materials, teacher and counselor education, and professional speakers for the classroom. This grant will allow for the continuation and expansion of this in the South County. 9. WILL THE G~A~NT FUNDS BE USED TO OBTAIN OTHER FUNDS? No. South' County currently receives funding from Title XX from Palm Beach and Broward Counties, and from United Way of Greater Boca Raton. Other funds anticipated are generated from private foundations, contributions, and patient fees. 10. WHAT FUNDS WILL SUSTAIN PROGRAMAFTER THIS GRANT EXPIRES? Individual contributions 63,500. Special events 1~500. United Way-Boca Raton 12,000. Title XX-Palm Beach and Broward 20,000. Medicaid 1,000. Patient fees 30,000. Contraceptive sales 15,000. Other income 5,000. Investment income 1,000. Presentations (training workshops) 1,000. 150,000. 11. WHO WILL DO THE AUDIT OF THE PROGRAM? ~ Patricia Rowe, C.P.A. West Palm Beach, Florida 0 ~ 0~-~ ~ ~ ~ ~ ~ O~ ~ O o ~ ~ E ~0~ ~ ~ o ~0© 0 ~ ~ ~ - ~ · I ~ · o =.~ ~ g =.~= ~ ~o=.~o ~ ~ 0 ~ ~ - ~'~ ~'~ D 0 0 ~ 0  ~0 ~0 U -~ -~ 0 ~ O~ ~ o ~0 0 ~'~ ~ ~0 · 0-~ ~ 0~ ~ -00~ · ~ ~' 0 ~ 0 ~ ~ ~ '~ I ~ I I I I I Ii , i O~ ~ > ~ ~ o ~ ~.~ ~ 0 ~ ~ 0 ~ ~ ~ -n 0 0 ~ 0 ~ 0 ~ ~ ~ ~ ~ ~ 0 ~ 0 ~ ~ ~ ~ 0 ~ 0 0 ~ ~ ~ ~ 0 ~ 0 0 ~ ~ ~ ~ O = · 0 0 0 · %0 0 · = ) 0 ~, · ~ GRAf{2 APPLICATION PAGE 4 of 7 N,~,.e of Applicant: Planned Parenthood of Sou~h Palm Beach and Br~.vard Counties, Inc. (City or County) TOTAL BUDGET A. Include figures from all delegate agency budgets. B. Explain by attachment all expenditures over $500 per line item. C. Cash match must be at least one half of state grant requested. D. The cash and in-kind match combined must equal the state grant. REVENUE 1. State Grant 50,000. 2. C~h M~zh (nD £mJDr~l fBD~ c=cDp~ rDMDD~ sh~riDg~ allQw~d)25,000. '3. In-Kind Match 25,000. 4. TOTAL Bg~E~uE 100,000. GRANTEE ADMINISTRATIVE EXPENSE CASH IN-KIND 5. Salaries 6. Rental S~ace 7. Travel 8. Supplies 9. Other (specify on attachment) 10. TOTAL (lines' 5 through 9 ) DELEGATE ADMINISTRATIVE EXPENSE 11. Salaries 3,750.00 12. Rental Space 13. Travel 310.00 14. Supplies 15. Other (specify on attachment) 16. TOTAL (lines 11 through 16) 310.00 3,7~0~00 '17. TOTAL ADMINISTRATIVE EXPENSES (line 10 and 16) *Line 17 must not exceed 15% of two times line 1. GRANTEE PROGRA~M EXPENSE 18. Salaries 19. Rental Space 20. Travel 21. Equipment 22. Other (specify on attachment) 23. TOTAL (lines 18 through 22) DELEGATE PROGR~24 EXPENSE 24. Salaries 41,800.00 6,850.00 25. Rental Space 14,400.00 26. Travel 1,340.00 27. Equipment 9,000'.00 28. Other (specify on attachment) 22,550.00 29. TOTAL (lines 24 through 28) 30. TOTAL PROGRA24 EXPENSES (lines 23 and 74,690.00 29) 31. TOTAL EXPENDITURES (line 17 and 30) 75,000.00 25,000.00 32. TOTAL COMBINED EXPENDITURES (Cash and in-Kind) . 100,000.00 (line 32 should equal line 4) G~ANT APPLICATION Page 6 of 7 Local Governmental Unit Applying: City of Delray Beach, Florida (County or City) Delegate Agency Budget - Complete one for each Delegate' Agency Program Name: Family Planning Name of Delegate Agency: Planned Parenthood of So. Palm Beach and Br~ard Co., Inc Address: 160 ~.~ 4th Street, Boca Raton, Fla. Zip: 33432 Contact Person: Shirley Mir~, Executive Director Telephone: (30) ) 368-1023 06-01086-0060 Tax Exempt Number: (if none, attach a copy of the certificate of incorporation) ADMINI STRAT/VE EXPENSES CASH IN-KIND 1. Salaries '~ 3,750. 2. Rental 3. Travel 310. ~ ' 'Supplies 5. Other (specify on attachment). 6. TOTAL (lines 1 through 5) 310. 3,750. PROGk~4 EXPENSES 7. Salaries 41,800. 6,850. 8. Rental Space 14,400. 9. Travel 1,340. 10. Equipment 9,000. · 11. Other (specify on attachment) 22,550. 12. TOTAL (lines 7 through 11) 74.690. 13. TOTAL EXPENSES (line 6 and line 12) 75,000. 25,000. Explain by attachment all Line items over $500~ TOTAL BUDGET 100,000. THE DELEGATE AGENCY HEREBY APPROVES THIS AP~CATION AN~--WJJ~ COMPLY WITH ALL RuLEs, REGUlaTIONS AND CONTRACTS~-~R~LA~ING THER~_~ ,/~J APPROVED BY: The Rev. R~_bert W. Switz . , ~cl~-V · President of Board . /(Signature) ATTESTED BY: Shirley ~[ircx~ j/~ ,~ '(, ~ . Name (Slgnsture~f Executive Director Title G~'-_'~7 ;FPLiCAITION Page 7 of 7 Local Governmental Unit Applying: City of Delrav Beach, Florida ( N~ViE OF CITY OR COUNTY ) 14. THE ~OPLiCANT CERTIFIES THAT THE DATA IN THIS APPLICATIOM ~D ITS VARIOUS SECTIONS INCLUDING BUDGET DATA, ARE TRUE AND CORRECT TO THE BEST OF HIS OR HER KNOWLEDGE AND THAT THE FILING OF THIS APPLICATION HAS BEEN DULY AUTHORIZED AND UNDERSTANDS THAT IT WILL BECOME PART OF THE CONTRACT BETWEEN THE DEPARTMENT AND THE APPLICANT. THE BOARD OF COUNTY COmmISSIONERS OR THE CITY COUNCIL HAS PASSED AN APPROPRIATE RESOLUTION WHICH AUTHORIZES THE EXPENDITURE OF FUNDS FOR THE SPECIFIED PROGRA~MS. IF FEES OR CONTRIBUTIONS ARE TO BE UTILIZED AS MATCHING FOR THIS GRANT, OR IF A DELEGATE AGENCY IS TO PROVIDE THE MATCHING S~\RE, ~MD'THESE FUNDS ARE NOT FORTHCOMING, THIS RESOLUTION ALSO SPECIFIES THAT THE CITY OR COUNTY WILL PROVIDE THE NECES- SARY ~TCH. THIS APPL!C~N~ FURTHER CERTIFIES, DUE TO THE LEGISLATIVE INTENT NOT TO DUPLICATE SERVICES AND THAT THESE PARTICULAR SERVICES ARE NOT BEING PROVIDED NOR ARE THEY AVAILABLE FROM ~NY OTHER STATE AGENCY. ALTHOUGH SIMILAR SERVICES MAY BE AVAILABLE, THE APPLICANT CERTIFIES THAT NO OTHER RESOURCE EXISTS TO PROVIDE THESE PARTI- CULAR SERVICES TO THESE CLIENTS WITHOUT THE USE OF THIS MONEY. Leon M. Weekes Name (typed) Signature 100 N.W. !st Avenue~ Delra.y Beach~ Florida Address (305) 278-2841 Telephone Date ATTESTED BY: Name (typed) Signature Title In Kind Delegate Am~aimistrative Expenses Line 11 Salaries F. xecutive Director' s Administrative Supervision @ $10.00 per hour x 375 hours (based on annual salary of 20,000.00) 3,750.00 Delegate Program Expenses Line 24 Salaries Executive Director's Program Involvement @ $10.00 per hour x 375 hours (based on annual salary of 20,000.00) 3,750.00 10 volunteer nurses and counselors worlcing 620 hours @ $5.00 per hour 3,100.00 6,850.00 Line 25 Rental Space 1800 s~m~re feet CBS free-standing building owned by Planned Parenthood. Located in Civic Center area of Boca Raton. Completely furnished as a family planning clinic @ $8.00 per sq. ft. 14,400.00 Cash Delegate Administrative Expense Line 13 Travel ~xecutive Director's Travel to Delray Beach 130miles per n~nthx 12months x .20 per mile 310.00 Delegate Program Ex~ense Line 24 Salaries Family Planning Nurse Practitioner half time 7,000.00 Registered ~horse full tim~ 13,000.00 Counselor (M.Ed.) full time 12,000.00 Office Coordinator full timm 9,800.00 41,800.00 Line 26 Travel Executive Director and/or conformity educator's travel to schools, churches, youth groups, etc. 220miles per month x 12r~nths x .20 per mile 540.00 Workshop and conference travel: $35.00 per diem x 3 105.00 265.00 round trip airfare 265.00 Parking, tolls, limo. 30.00 400.00 Timas 2 persons 800.00 1,340.00 Line 27 Equipment Satellite counseling center in Delray (space contributed by Cobb Sickle Cell Center) 2 desks @ $250.00 500.00 2 steno chairs @ $60.00 120.00 ~ 1 typewriter 780.00 2 file cabinets @ $100.00 200.00 1 typing stand 60.00 4 office chairs ~ $50.00 200.00 2 bookcases @ $150.00 300.00 2,160.00 2,160.00 South County Center in Boca Raton 1.filing "bookcase" 280.00 1 large refrigerator 600.00 1 typewriter (I5~ Selectric) 960.00 1 bond copier 5,000.00 6,8~0.00 6,840.00 9,000.00 Line 28 Other Physician' s Fees $500.00 month x 12 months = 6,000.00 Telephone 3,550.00 Medical Supplies (green soap, drape sheets, disposable gloves, autoclave paper and tape, ~xam table covers, swabs, prescription pads) 3,000.00 Contraceptive Supplies (Pills, IUD's, Diaphragms, Foam, Condoms) 3,000.00 Laboratory F~x~penses (pregymncy tests, Biomedical lab work, cancer screening tests, VDRL tubes, needles, syringes, cotton balls, alcohol) 3,000.00 Educational Supplies (brochures, books, films, filmstrips, for schools, and patient education). 2,000.00 Office Supplies (file folders, calen~d~rs, envelopes, stationery, pencils, pens) 2,000.00 22,550.00