The URL can be used to link to this page

Home My WebLink AboutGrant Request - NeighborImpactEconomic Development Fund Discretionary Grant Program Organization: NeighborImpact Organization Description: NeighborImpact is an organization established to serve and speak out on behalf of economically disadvantaged people in Central Oregon. This organization works to break the cycle of poverty by removing barriers that prevent people from achieving economic self-sufficiency. Project Name: Head Start Mobile Dental Van Collaboration Project Description: Neighborlmpact's Head Start program is collaborating with Northwest Medical Teams Mobile Dental Program to provide exams and treatment for uninsured or under -insured Head Start children ages three to five. These visits will occur at Head Start center locations using a volunteer Pediatric Dentist. Project Period: September 22, 2008 — June 30, 2009 Amount of Request: $3,000+ Previous Grants: • FY 2009 Community Grant: $25,000 - salary and operating costs for the Food Recovery Program (66%) and purchase food for distribution to Deschutes County Emergency Food Box agencies (33%). Deschutes County Board of Commissioners 1300 NW Wall St., Bend, OR 97701-1960 (541) 388-6570 - Fax (541) 385-3202 - www.deschutes.org DESCHUTES COUNTY ECONOMIC DEVELOPMENT FUND DISCRETIONARY GRANT PROGRAM APPLICATION Direct Application to: Commissioner Tammy Baney Commissioner Dennis R. Luke Date: L� ` 22.08 Project Name: Project Beginning Date: Commissioner Michael M. Daly All Three Commissioners thd 5114 "I obi,. ted41 ((Uri (` i!tl d /Oh 2 on Amount of Request: 13 f more, Applicant/Organization: Address: Contact Name(s): Fax: Project End Date: Date Funds Needed: 1i fir,." , cyr,ialist 3� 1504 57'25 Alternate Phone: Tax ID #• City & Zip: Telephone: 141, 5C.238C Email: x 105 fur 0,7200(1 p -b') h r' 1.) 2G'e ,1309/549,R9 cpm cnd q 7751 11•x 8 2 Cx124' atKi ii11 C eol On a separate sheet, please briefly answer the following questions: 1. Describe the applicant organization, including its purpose, leadership structure, and activities. 2. Describe the proposed project or activity. 3. Provide a timeline for completing the proposed project or activity. 4. Explain how the proposed project or activity will impact the community's economic health. 5. Identify the specific communities or groups that will benefit. 6. Itemize anticipated expenditures*. Describe how grant finds will be used and include the source and amounts of matching funds or in-kind contributions, if any. If the grant will support an ongoing activity, explain how it will be funded in the future. Attach: Proof of the applicant organization's non-profit status. * Applicant may be contacted during the review process and asked to provide a complete line item budget. Amount Approved: By: Date: Declined: By: Date: Neighborlmpact Critical Needs. Diverse Services. Empowering Change. z3o3 SW First Street, Redmond, OR 97756 1el 541 548 2,38o (ar 541 548 6o13 www. neighbo rimy act. o rg Jill Rowe Wellness Specialist Neighborlmpact Head Start 2303 SW 1st Street Redmond, Oregon 97756 541-548-2380x126 Dear Commissioner Baney, Enclosed is the Neighorlmpact Head Start program grant application. I will be out of the office the first few weeks of July but available the rest of the summer. Please feel free to contact me with any questions you may have about this grant application. Thank you for your consideration of this application. EBUr UN 1 ' 2008 i �� I BOARO OF COMMISSIONERS -RA TiON 1.) Describe the applicant organization, including its purpose, leadership structure, and activities: Founded in 1985, Neighborlmpact is a private nonprofit organization established to serve and speak out for economically disadvantaged people in Central Oregon. Our mission is to break the cycle of poverty by helping remove the barriers that prevent people from achieving economic self-sufficiency. Neighborlmpact is governed by a tripartite board of directors consisting of elected officials, representatives of low income residence, and community representatives. The agency has two program management divisions, the Early Care and Education division and the Housing and Emergency Services division. The Head Start program is part of the Early Care and Education division which offers comprehensive early childhood education with family education and health prevention to increase children's readiness and success in school. Neighborlmpact provides administrative services, including an executive director, business services, and development. 2.) Describe the proposed project or activity: Neighborlmpact's Head Start program is collaborating with Northwest Medical Teams Mobile Dental Program to provide exams and treatment for uninsured or under -insured Head Start children ages three to five. These visits will occur at Head Start center locations using a volunteer Pediatric Dentist. 3.) Provide a timeline for completing the proposed project or activity: Starting near or after mid- September, the van will visit Head Start centers to provide dental exams through December. Head Start Federal Performance Standards requires that every child must have a dental exam within 90 days of being enrolled in the Head Start program. December through June, services will be provided by the van, for completing treatment plans created from exams occurring in the earlier months. 4.) Explain how the proposed project or activity will impact the community's economic health: Support for early evaluation and treatment of young children's dental needs will result in fewer hospitalizations for treatment, fewer requests for free or reduced fee services from local dentists, and fewer dentists left with unpaid bills by families in crisis. Additionally, the communities' economic health will be supported by families requiring less missed days of work to care for children in dental pain or crisis. 5.) Identify the specific communities or groups that will benefit: The Head Start program serves both the Deschutes and Crook County communities, with classrooms in Prineville, LaPine, Bend, Redmond, and Sisters. The ages of children served are three to five years old. The goal for the 2008-2009 school year is to provide dental services for the uninsured or under- insured children in the Deschutes County communities that participate in the Head Start program. 6.) Itemize anticipated expenditures. Describe how grant funds will be used and include the source and amounts of matching funds or in-kind contributions, if any. If the grant will support an ongoing activity, explain how it will be funded in the future: Grant funds will be used to cover project development expenses for critical and essential expenses to ensure the project's success. Please see Itemized Anticipated Expenditures sheet. Itemized Anticipated Expenditures Costs are based on the van visiting the Head Start program every other month for a total of five visits. Cost of bringing the van: $4,000 Pediatric Dentist time: $10,000 Two days per month coordination by Wellness Specialist: $1,445 Education supplies/materials/equipment: $700 Electrical set up plus labor: $900 Discretionary funds to fill fluoride prescriptions: $200 Misc. dental supplies for the van: $200 Donated time and materials: Reduced rate for bringing van: $2,500 Volunteer Pediatric Dentist time: $10,000 Private and Business donation: $1,200 *Any costs not covered will be absorbed by using appropriated Head Start funds. *The Northwest Medical Teams Mobile Dental Program suggested cost for bringing the van is $800.00. They have been willing to partner with the Head Start program to provide reduced costs. Our goal is to collaborate with our community partners to create corporate sponsorships and donations to sustain growth and longevity of the dental program. Head Start's Wellness Specialist will identify local grant writing opportunities to bring in funds to support this collaboration. 48/20/2004 17:24 FAX 513 263 3756 1E/GI CJN11 internal Revenue Service Date: August 20, 2004 Central Oregon Network Inc. 2303 SW 1ST S Redmond, OR Community Agency 97756-9608 Dear Sir or Madam: tjVV6/VVG Department of the Treasury P. O. Box 2508 Cincinnati, OH 45201 Person to Contact: Sylvia A. Williams 31-0817 Customer Service Representative Toll Free Telephone Number: 8:00 a.m. to 6:30 p.m. EST 877-829-5500 Fax Number: 513-2613-3756 Federal Identification Number: 93-0884929 This is in response to your request of August 20, 2004, regarding your organization's tax- exempt status. In March 1987 we issued a determination letter that recognized your organization as exempt from federal income tax. Our records indicate that your organization is currently exempt under section 501(c)(3) of the Internal Revenue Code. Our records indicatethat your organization is also classified as a public charity under sections 509(ax1) and 170(b)(1)(AXvi) of the Internal Revenue Code. Our records indicate that contributions to your organization are deductible under section 170 of the Code, and that you are qualified 10 receive tax deductible bequests, devises, transfers or gifts under section 2055, 2106 or 2522 of the Internal Revenue Code. If you have any questions, please call us at the telephone number shown in the heading of this letter. Sincerely, iLIA:A'AdicA) Janna K. Skufca, Director, TE/GE Customer Account Services Internal Revenue Service Department of the Treasury 'District Director Date: MAR. 2, 1987 CENTRAL OREGON COMMUNITY ACTION AGENCY NETWORK INC 1345 NW WALL BEND, OR 97701 Dear Applicant: Employer Identification Number: 93-0903720 Case Number: 95702.3016 Contact Person: JEANNIE BARBA_ Contact Telephone Number: ' (206) 442-8465 Caveat Applies: yes Based on the information you recently submitted, He have classified your organization as one that is not a private foundation Hithin the meaning of section 509(a) of the Internal Revenue Code because you are an organization described in section 509(a)(1)#. Your exempt status under section 501(c)(3) of the Code is still in effect. This classification is based on the assumption that your operations Hill continue as you have stated. If your sources of support, or your purposes, character, or method of operation change, please let us knoH so He can "consider the effect of'the change on your exempt status and foundation status. This supersedes our letter dated Oct. 14, 1986. Because this letter could help resolve any questions about your foundation status, you should keep it in your permanent records. If the heading of this letter indicates that a caveat applies, the caveat beloH or on the enclosure is an integral part of this letter. "If you have any questions, please contact the person Hhose name and telephone number are shorn above. Sincerely yours, r �e Frederick C. Nielsen District Director Letter" 1078(CG) _2 - CENTRAL OREGON COMMUNITY ACTION :0,509 (a) (1) and 170(6) (1) (A) (vi) f Letter 1078(CG)