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HomeMy WebLinkAboutCommunity Counseling Center HSG 2024-25 ApplicationsHuman Services Grant Application 2024-25 Application Questions Part 1 Basic Information 1. Organization Name * Community Counseling Center (CCC) of San Luis Obispo County 2. Fiscal Agent (if different than above)* Same as above. 3. Project/Program Name * Sharing the Therapeutic Space: Professional and Affordable Psychotherapy Options for Underprivileged Populations in the City of San Luis Obispo 4. Requested Amount * $5,000.00 5. Name of Person Completing Application * James Statler, Executive Director 6. Name of Person for Grant Communication and Contract for Grant Cycle (if different from above)* Same as above. 7. Organization Mailing Address * 676 Pismo Street, San Luis Obispo, Ca. 93401 8. Phone * 8055437969 9. Email * james@cccslo.com Part 2 Organizational Information 1. Purpose/Mission Statement * The agency’s mission is "to build and support emotionally strong individuals, families and community through confidential, affordable, and transformative counseling, education, and advocacy." 2. Briefly describe your organization’s purpose, vision, primary activities, and operating structures * The Community Counseling Center (CCC)’s purpose and vision support our mission, as stated above. Our vision is for a Central Coast community where all members have access to qualified counseling, therapists are nurtured across their professional development and society is united in the effort to promote positive mental health. CCC is a mental health care safety net for the economically disadvantaged and uninsured residents of San Luis Obispo County with mild to moderate conditions. We support community members who fall through the cracks of public human services organizations due to income eligibility and/or severity of diagnosis. Our licensed and pre-licensed marriage family therapists, clinical social workers and psychologists provide our clients with high quality professional psychotherapy at affordable rates. CCC provides these therapists support through continuing education and training opportunities. Our Sliding Scale Program is the foundation on which all other programs are built. This Program provides onsite and online counseling for youth and adults regardless of ability to pay. Our onsite counseling service model is solution-focused cognitive behavioral therapy. Clients are provided with the tools necessary to help them through their current challenges as well as those in the future. This approach results in a high success rate of client improvement within as few as six sessions. In 1970, we added a training component that both increased the pipeline of mental healthcare professionals in the County and enhanced our ability to serve more clients. Our training program has now grown to become one of the premier training sites in California. We have expanded our continuing education opportunities for our therapists and opened those opportunities to all therapists in the area. CCC’s Executive Director, with the guidance and approval of our Board of Directors, manages all activities of the Center in its central clinic location in San Luis Obispo and in our satellite locations in Paso Robles and Oceano. The ED oversees the administrative staff and works closely with the Clinical Director, who oversees all clinical activity. 3. Name of Executive Director * James Statler 4. Name of Board President or Chair * Gil Stork 5. Number of paid staff (full or part-time)* 47 6. Number of volunteers * 33 7. Describe the community(ies) your organization supports * CCC provides services throughout San Luis Obispo County. Our primary clinic is located near downtown San Luis Obispo, where we serve the lion’s share of our clients, both in person and online. Thanks to a grant from the Harold J. Miossi Charitable Trust, our clinic has created two teletherapy hubs in this building that allow our therapists the technology they need to provide high quality video interactions with their clients. 8. Approximate Annual Budget * $1,100,000.00 9. Major Sources of Funding * Public and private grants, CenCal reimbursement, contracts with local school districts, full/partial payment from clients, private donations, and endowment fund investments. Part 3 Project/Program Information 14. In the table below include a minimum of four (4) metrics or performance outcomes that relate to the implementation/success of the project. Examples include: # of SLO City residents served, # of referrals provided to individuals seeking social services. Methods of Evaluation Indicators of Success / Measurable Outcomes Number of clients served Growth trends over time Number of monolingual Spanish speaking clients served Growth trends over time Number of referrals from other agencies Growth trends over time Clinical treatment improvement Therapist evaluation at end of treatment 1. Please provide an executive summary of proposed project/program * The proposed program is in fact not proposed at all, but rather a continuation of 56 years of success providing low-cost and no-cost therapy to residents of San Luis Obispo. CCC has evolved from a small collective of volunteer therapists and coordinators to a flourishing organization that serves thousands of low-income residents, students, and unhoused individuals and provides training opportunities to current and future mental health professionals. We refer and receive referrals from a broad variety of local organizations and government departments in order to provide non-duplicative services that support the mental well-being of our residents. Funding from this grant will support continued growth of our services. 2. Total Project Cost?* $232,794.00 3. Requested Project Amount * $5,000.00 4. Please provide a detailed description of proposed project/program * The funds requested will support the pursuit of our core mission and allow us to continue to expand the breadth and depth of our services. In addition to our reimbursement from CenCal, school district contracts, client payments, and private contributions, our program relies heavily on public and private grant funding to operate. Staff salaries and benefits, therapist support, outreach activities, technology hardware, software, and support, and facilities rent/maintenance all require continuous funding. CCC uses well-established protocols for outreach, client intake, provision of counseling services, and both clinical and client satisfaction outcomes measurement. Our training program continues to sophisticate and funding that allows us to compensate our therapists has strengthened our provider base. For approximately two decades we have pursued avenues to better serve our Latinx community and have made great strides recently by enhancing our administrative and counseling staff with bilingual/bicultural colleagues. Although the threat of COVID 19 is no longer at an urgent level nationally, families and individuals who were hit the hardest by the financial, emotional, and, in the case of children, developmental effects of the pandemic continue to struggle. Food and housing insecurity are both at pandemic-level highs. The inability of families to meet those basic needs can lead to depression, anxiety, and violent acting out at home and in school. The need for low/no-cost counseling will remain high for the foreseeable future. Funding from this grant will help CCC better meet those needs. 5. Describe the community/population the project/program will support.* CCC’s mission and program activities focus on three specific populations: low-income community members with mild to moderate mental health conditions, K-12 students at all income levels and mental health status, and mental health care professionals, both licensed and pre- licenced. The average net household monthly income for the majority of CCC’s clientele is below the Federal Poverty Level. Within that population are monolingual and Limited English Proficiency Spanish speakers, individuals struggling with grief, pre- and perinatal mothers, LGBTQ youth, women and children fleeing unsafe home environments, and unhoused individuals. The counseling we provide can prevent mild to moderate conditions from escalating to domestic violence, drug abuse, and suicide ideation. Of the 2,000 clients served annually 1,400 are adults and 600 are youth. 1,100 adults are between the ages of 25 and 75, and 300 are transitional aged adults 18 to 24. Since 2015, we have negotiated contracts with several school districts in the county to provide on-campus support to K-12 students. Our on- campus therapists coordinate with educators and school support staff to integrate mental health education into curricula and school programs with one-on-one and group support for students. Funding above and beyond our contracted amounts would allow us to deepen our support of monolingual and Limited English Proficiency students and their families. Clinical counselors in training and post licensure grow and thrive through their partnership and affiliation with the agency. CCC is a professional development hub and premiere training ground for pre-licensed therapists who are enrolled in a Master’s or Doctoral degree program at an accredited university. MFT, ASW, PCC, PhD and PsyD trainees and practicum students receive professional supervision, mentoring, and opportunities to accrue hours while working with clients with diverse backgrounds and presenting concerns. All of our pre- and post-licensed therapists have access to free or reduced cost agency Continuing Education workshops and didactic seminars. Additional funding will allow us to extend our outreach and training opportunities. 6. The HRC has identified homeless prevention including affordable and alternative housing, supportive services, and transitional housing as the main funding priority. Does your grant request meet this funding priority?* Yes No 7. Which other priority of the non-ranked HRC funding priorities does your request support? Please check the appropriate boxes:* Hunger and malnutrition prevention Supportive physical and mental health services for those in need Services for seniors and/or people with disabilities in need Supportive and developmental services for children and youth in need Services encouraging diversity, equity, and inclusivity in marginalized communities 8. Provide timeline for project * August 1, 2024 - July 31, 2025 9. Identify any partnerships/collaborations that are supporting this project/program and their roles * We collaborate with agencies throughout the county, both giving and receiving referrals and we frequently partner with other local agencies on new expansions and special projects. Those partners include CAPSLO (40 Prado), K-12 School Districts, CenCal, Hospice of SLO County, a pending partnership with Lumina Alliance (formerly Stand Strong/Rise), and a collaboration with Transitions Mental Health Association in San Luis Obispo. Other partnerships include the Center for Family Strengthening, Dignity Health, and Pregnancy and Parenting Support (PPS). New partnerships include BLOOM private practice and the Alzheimer ’s Association and Hospice of SLO County. 10. Describe your plan for sustainability beyond the City’s one-year award funding * CCC has a track record of successful grant awards and fundraising. These successes have kept the organization offering our invaluable services to the community for 56 years. In addition to fundraising, we maintain moderate program costs by using volunteer professional therapists and limited paid administrative staff. Increases in client and therapist numbers mean that there are also increases in total clinical revenue from Medi-Cal for CCC New partnerships and paid contracts with CenCal, K-12 School Districts, SAMSHA/40Prado, Lumina Alliance and the First5 Resilient Families program diversify funding streams for the future. 11. Describe the plan for promoting this project, program, or service within the City of San Luis Obispo * CCC will promote the proposed project through distribution of a press release, publishing through social media posting across multiple platforms, website listing on Grant funder recognition page/s, and inclusion in seasonal newsletters. 12. Est. Number of people served through this project/program * 2,000 13. Est. Number of SLO City Residents served through this project/program * 600 Attachments Copy of Organization’s most recent complete fiscal year financial statement (for the previous year because it is the middle of the current fiscal year) including a statement of financial position/balance sheet, statement of revenue & expenses/income statement, profit & loss. Financial Statement * ME 12 Dec 2023 CCC P&L Balance Sheet.xlsx 28.91KB 1-page Organization Chart * CCC 2024 Org Chart.pdf 119.65KB Document Certifying Federal Tax-Exempt Status * CCC IRS Determination Letter-Federal Tax ID 8.28.15.pdf 405.65KB 1-page detailed budget for the program including how the total requested amount of grant would be spent.   Budget * CCC-SLO City HRC-GIA Budget Proposal-FY 24-25.pdf 112.23KB 1-page DEI statement that includes: Applicants’ understanding and application of DEI Affirming language that creates access and a sense of belonging in our community apart from grant Explain how this project will advance DEI in the City of SLO DEI Statement * CCC DEI Statement.pdf 120.69KB Board of Directors Executive Director Administrative Staff: -CenCal Case Manager/Coordinator ( FT) -Sliding Scale Case Manager (FT) -Reception and Operations Spec. (FT) -Latino Outreach and Engagement Specialist 1 (FT ) -Latino Outreach and Engagement Specialist 2 (FT) *Contracted Bookkeeping MOSAIC Business Services Clinical Director Clinical Committee Board Committees Volunteer Clinicians 80+ Paid Clinicians 40+ Fundraising Committee Executive Committee Organizational Chart School Program Coordinators Finance Committee Capital Campaign Committee Grants & Contracts Committee Legend *Direct Report: *Informal Report: Licensed therapists Licensed Clinical Supervisors Pre-Licensed Interns/Trainees Community Counseling Center Profit & Loss Budget Performance F Dec 2023 Dec 2022 MTD Budget July 2023 - Dec 2023 July 2022 - Dec 2022 YTD Budget Ordinary Income/Expense Income 40000 ꞏ Sliding Scale Revenues 5,802.83 3,910.00 5,000.00 31,505.94 30,449.00 30,000.00 44000 ꞏ Grants 42,900.10 15,824.04 35,505.83 188,628.06 116,133.63 213,034.98 41000 ꞏ Donations and Fundraising 21,769.54 49,055.57 12,916.67 42,473.48 82,872.81 77,500.02 42000 ꞏ Contracts 32,527.14 37,453.32 44,333.67 225,356.59 182,898.86 261,002.02 43000 ꞏ Other Revenues 4.97 14.72 158.33 36.22 72.36 949.98 Total Income 103,004.58 106,257.65 97,914.50 488,000.29 412,426.66 582,487.00 Gross Profit 103,004.58 106,257.65 97,914.50 488,000.29 412,426.66 582,487.00 Expense 50000 ꞏ Staffing 50010 ꞏ Administrative 32,632.99 33,648.98 34,390.83 200,155.22 182,080.85 206,344.98 50030 ꞏ CenCal wages 7,500.00 9,925.00 13,301.67 67,665.83 50,357.50 79,810.02 50040 ꞏ School wages 4,978.50 2,057.50 6,000.00 21,169.75 7,390.00 24,000.00 50060 ꞏ 40 Prado wages 1,280.00 0.00 1,750.00 8,065.00 9,091.25 10,500.00 50085 ꞏ PMAD / First 5 Wages 1,905.00 0.00 0.00 6,452.50 0.00 0.00 50080 ꞏ Sliding Scale Wages 2,607.00 2,631.50 2,702.50 18,200.00 18,397.50 16,215.00 50100 ꞏ Payroll taxes 4,965.39 4,461.27 5,510.34 27,151.30 21,984.85 32,630.04 50200 ꞏ Workers Comp 426.00 161.75 75.00 2,298.33 970.50 450.00 50300 ꞏ Health insurance benefits 2,565.67 2,049.78 2,083.33 12,791.02 11,502.72 12,499.98 50300 ꞏ Restricted Grant Wages 0.00 0.00 50400 ꞏ Payroll fee 782.90 771.63 716.67 4,161.91 4,160.02 4,300.02 54045 ꞏ Prof. Dev. / License 0.00 41.67 220.00 0.00 250.02 Total 50000 ꞏ Staffing 59,643.45 55,707.41 66,572.01 368,330.86 305,935.19 387,000.06 60000 ꞏ Independent Contractors 16,881.03 7,497.33 12,345.25 102,085.61 42,699.78 73,271.50 70000 ꞏ Community Fundraising 687.08 250.00 283.34 8,758.32 9,095.82 5,700.04 80000 ꞏ Facilities 4,742.83 4,345.16 5,317.09 28,768.82 27,422.74 31,902.54 81000 ꞏ Legal and Accounting 2,878.00 8,574.00 4,291.66 23,258.00 31,492.00 25,749.96 82000 ꞏ Insurance Expense 788.80 788.80 833.33 4,732.80 4,534.71 4,999.98 83000 ꞏ Technolgical Services 6,387.11 5,929.27 6,351.84 36,571.45 39,032.67 38,111.04 80410 ꞏ Advertising 0.00 350.00 125.00 158.00 3,600.00 750.00 84000 ꞏ Operating Expense 1,695.21 1,570.01 1,818.74 10,222.11 11,274.30 10,912.44 Total Expense 93,703.51 85,011.98 97,938.26 582,885.97 475,087.21 578,397.56 Net Ordinary Income 9,301.07 21,245.67 -23.76 -94,885.68 -62,660.55 4,089.44 Other Income/Expense Other Income 91010 ꞏ Misc Income 0.00 0.00 90200 ꞏ Capital campaign income 0.00 0.00 90300 ꞏ Dividends and interest 109.85 0.00 109.85 0.00 90400 ꞏ Donation restricted 0.00 0.00 90500 ꞏ Gain or loss disposal of assets 0.00 0.00 90600 ꞏ Realized gain / loss investment -100.63 41.67 -100.63 250.02 90700 ꞏ Unrealized gain / loss investment 80.84 0.00 559.01 0.00 91000 ꞏ Allocation of Restricted Funds 0.00 0.00 Total Other Income 0.00 90.06 41.67 0.00 568.23 250.02 Other Expense 91100 ꞏ Capital campaign expenses 0.00 0.00 90010 ꞏ Offsite parking / capital repairs 0.00 0.00 0.00 6,575.64 1,785.00 0.00 91200 ꞏ Depreciation 4,324.60 4,272.33 4,298.50 25,947.60 25,633.98 25,791.00 91300 ꞏ Endowment administrative fee 65.38 8.33 65.38 49.98 91305 ꞏ Net earn & fees on agency endowment 0.00 0.00 91500 ꞏ Interest on loans 938.11 989.56 987.42 5,693.78 6,000.22 5,924.52 Write Off 0.00 0.00 1,953.18 6,354.88 0.00 Total Other Expense 5,262.71 5,327.27 5,294.25 40,170.20 39,839.46 31,765.50 Net Other Income -5,262.71 -5,237.21 -5,252.58 -40,170.20 -39,271.23 -31,515.48 Net Income 4,038.36 16,008.46 -5,276.34 -135,055.88 -101,931.78 -27,426.04 Page 1 of 4 Community Counseling Center Profit & Loss Budget Performance F Dec 2023 Dec 2022 MTD Budget July 2023 - Dec 2023 July 2022 - Dec 2022 YTD Budget CCC Balance Sheet-December 2023 ASSETS Current Assets Checking/Savings 10200 ꞏ Pacific Premier checking 9034 102,675.38 10300 ꞏ Petty cash 100.00 11100 ꞏ Pacific Prem. MM cap outlay 9352 830.34 11200 ꞏ Pacific Prem. MM reserves 9131 120,411.34 11400 ꞏ CCC SLO Endowment Fund 12,899.57 Total Checking/Savings 236,916.63 Accounts Receivable 12100 ꞏ Accounts receivable 91,735.10 12200 ꞏ Allowance for doubtful accounts -11,033.03 Total Accounts Receivable 80,702.07 Other Current Assets 0 12001 ꞏ Undeposited Funds 0.00 14100 ꞏ Grants / donations receivable 26,951.00 14400 ꞏ Rent deposit 2,750.00 14500 ꞏ Prepaid expenses 6,803.94 14600 ꞏ Other Asset 4,915.68 Total Other Current Assets 41,420.62 Total Current Assets 359,039.32 Fixed Assets 15100 ꞏ Computers 9,263.61 15300 ꞏ Furniture and equipment 9,781.74 15800 ꞏ Building 1,134,903.44 15700 ꞏ Land 308,361.00 Total Fixed Assets 1,462,309.79 TOTAL ASSETS 1,821,349.11 LIABILITIES & EQUITY Liabilities Current Liabilities Accounts Payable 20000 ꞏ *Accounts payable 15,798.21 Total Accounts Payable 15,798.21 Other Current Liabilities 21000 ꞏ Payroll liabilities 910.31 21100 ꞏ Accured expenses 17,516.00 21200 ꞏ Accrued payroll 40,132.56 21400 ꞏ Vacation payable 18,239.86 21600 ꞏ CalSavers Payable 583.48 25200 ꞏ Current of long term debt 18,001.72 Total Other Current Liabilities 95,383.93 Total Current Liabilities 111,182.14 Long Term Liabilities 26000 ꞏ Notes Payable 302,140.21 Total Long Term Liabilities 302,140.21 Total Liabilities 413,322.35 Equity 31500 ꞏ Net assets w/donor restrictions 243,834.29 32000 ꞏ Unrestricted net assets 1,299,248.35 Net Income -135,055.88 Total Equity 1,408,026.76 TOTAL LIABILITIES & EQUITY 1,821,349.11 Page 2 of 4 Community Counseling Center Profit & Loss Budget Performance Ordinary Income/Expense Income 40000 ꞏ Sliding Scale Revenues 44000 ꞏ Grants 41000 ꞏ Donations and Fundraising 42000 ꞏ Contracts 43000 ꞏ Other Revenues Total Income Gross Profit Expense 50000 ꞏ Staffing 50010 ꞏ Administrative 50030 ꞏ CenCal wages 50040 ꞏ School wages 50060 ꞏ 40 Prado wages 50085 ꞏ PMAD / First 5 Wages 50080 ꞏ Sliding Scale Wages 50100 ꞏ Payroll taxes 50200 ꞏ Workers Comp 50300 ꞏ Health insurance benefits 50300 ꞏ Restricted Grant Wages 50400 ꞏ Payroll fee 54045 ꞏ Prof. Dev. / License Total 50000 ꞏ Staffing 60000 ꞏ Independent Contractors 70000 ꞏ Community Fundraising 80000 ꞏ Facilities 81000 ꞏ Legal and Accounting 82000 ꞏ Insurance Expense 83000 ꞏ Technolgical Services 80410 ꞏ Advertising 84000 ꞏ Operating Expense Total Expense Net Ordinary Income Other Income/Expense Other Income 91010 ꞏ Misc Income 90200 ꞏ Capital campaign income 90300 ꞏ Dividends and interest 90400 ꞏ Donation restricted 90500 ꞏ Gain or loss disposal of assets 90600 ꞏ Realized gain / loss investment 90700 ꞏ Unrealized gain / loss investment 91000 ꞏ Allocation of Restricted Funds Total Other Income Other Expense 91100 ꞏ Capital campaign expenses 90010 ꞏ Offsite parking / capital repairs 91200 ꞏ Depreciation 91300 ꞏ Endowment administrative fee 91305 ꞏ Net earn & fees on agency endowment 91500 ꞏ Interest on loans Write Off Total Other Expense Net Other Income Net Income Annual Budget % Completed vs Yearly Budget 60,000.00 53% 426,070.00 44% 155,000.00 27% 527,000.00 43% 1,900.00 2% 1,169,970.00 42% 1,169,970.00 42% 412,690.00 49% 159,620.00 42% 60,000.00 35% 21,000.00 38% 0.00 #DIV/0! 32,430.00 56% 65,692.00 41% 900.00 255% 25,000.00 51% 0.00 #DIV/0! 8,600.00 48% 500.00 44% 786,432.00 47% 147,343.00 69% 8,400.00 104% 63,805.00 45% 51,500.00 45% 10,000.00 47% 76,222.00 48% 1,500.00 11% 21,825.00 47% 1,167,027.00 50% 2,943.00 0.00 0.00 #DIV/0! 0.00 #DIV/0! 0.00 0.00 500.00 0% 0.00 #DIV/0! 500.00 0% 0.00 #DIV/0! 51,582.00 50% 100.00 0% 11,849.00 48% 0.00 63,531.00 63% -63,031.00 64% -60,088.00 Page 3 of 4 Community Counseling Center Profit & Loss Budget Performance CCC Balance Sheet-December 2023 ASSETS Current Assets Checking/Savings 10200 ꞏ Pacific Premier checking 9034 102,675.38 10300 ꞏ Petty cash 100.00 11100 ꞏ Pacific Prem. MM cap outlay 9352 830.34 11200 ꞏ Pacific Prem. MM reserves 9131 120,411.34 11400 ꞏ CCC SLO Endowment Fund 12,899.57 Total Checking/Savings 236,916.63 Accounts Receivable 12100 ꞏ Accounts receivable 91,735.10 12200 ꞏ Allowance for doubtful accounts -11,033.03 Total Accounts Receivable 80,702.07 Other Current Assets 0 12001 ꞏ Undeposited Funds 0.00 14100 ꞏ Grants / donations receivable 26,951.00 14400 ꞏ Rent deposit 2,750.00 14500 ꞏ Prepaid expenses 6,803.94 14600 ꞏ Other Asset 4,915.68 Total Other Current Assets 41,420.62 Total Current Assets 359,039.32 Fixed Assets 15100 ꞏ Computers 9,263.61 15300 ꞏ Furniture and equipment 9,781.74 15800 ꞏ Building 1,134,903.44 15700 ꞏ Land 308,361.00 Total Fixed Assets 1,462,309.79 TOTAL ASSETS 1,821,349.11 LIABILITIES & EQUITY Liabilities Current Liabilities Accounts Payable 20000 ꞏ *Accounts payable 15,798.21 Total Accounts Payable 15,798.21 Other Current Liabilities 21000 ꞏ Payroll liabilities 910.31 21100 ꞏ Accured expenses 17,516.00 21200 ꞏ Accrued payroll 40,132.56 21400 ꞏ Vacation payable 18,239.86 21600 ꞏ CalSavers Payable 583.48 25200 ꞏ Current of long term debt 18,001.72 Total Other Current Liabilities 95,383.93 Total Current Liabilities 111,182.14 Long Term Liabilities 26000 ꞏ Notes Payable 302,140.21 Total Long Term Liabilities 302,140.21 Total Liabilities 413,322.35 Equity 31500 ꞏ Net assets w/donor restrictions 243,834.29 32000 ꞏ Unrestricted net assets 1,299,248.35 Net Income -135,055.88 Total Equity 1,408,026.76 TOTAL LIABILITIES & EQUITY 1,821,349.11 Annual Budget % Completed vs Yearly Budget Page 4 of 4 COMMUNITY COUNSELING CENTER PROGRAM BUDGET REQUEST FORM SLO CITY GIA FY 2024-25 Project Expense Grant Budget Requested Other Funding Available* Amount & source I. PERSONNEL EXPENSES (associated with the proposed project) Director of Clinical Training 16 hrs week/50weeks @ $60 per hour EHRS/requisite telehealth/virtual services Clinical Program Manager 12 hrs week/50 weeks @ $32 per hour Bilingual Admin. Specialist. 20 hrs week/50 weeks @ $17 per hour Bilingual Mental Health Clinical Counselor 30 hrs per week/50 weeks @ $20.00 per hour $48,000 $19,200 $12,750 $30,000 $1,000 $750 $1,500 $10,000 (Medi- Cal) $4,000 (MHSA- PEI Grant; Medi-Cal) $2,500 (MHSA- PEI Grant) $2,000 (Medi-Cal) Subtotal – Personnel Expenses $109,950 $3,250 $18,500 II. OPERATING EXPENSES (associated with the proposed project) Subsidized Counseling fees – 50 Homeless individuals, couples or families (25 clients covered by HRC-GIA) $40 per hour/400 hours Telehealth Platform Annual Subscription Personal Protective Equipment (PPE) Rent/Mortgage Insurance Teletherapy Hubs/Tech/Equipment $16,000 $46,300 $750 $28,934 $24,660 $6,200 $1,250 $500 In-kind of 200 hours $20,000 & SLO Hub Grant $4,500 Subtotal – Operating Expenses $122,844 $1,750 $24,500 Total Grant Project Expenses $232,794 $5,000 $43,000 *List in this column all agency funds available to support the project. Indicate with a “@” next to the amount that are in-kind and a “NS” for those not yet secured. Diversity, Equity, and Inclusion Statement 1. DEI statement CCC is firmly committed to diversity, equity, and inclusion. As stated in our employee Handbook, Section 1.1: “we provide employment and access to care opportunities without discrimination in regard to race, ethnicity, religious belief, color, sex, sex stereotype, pregnancy, childbirth or related medical conditions (including breastfeeding), age, national origin, ancestry, sexual orientation, gender identification and expression, transgender status, physical or mental disability, medical condition, genetic characteristics, genetic information, family care, marital status, enrollment in any public assistance program, status as military, veteran, or qualified disabled veteran, status as an unpaid intern or volunteer, or any other classification protected by law.” Toward this end, CCC works to embed DEI values into all program elements, which includes cultural competency training opportunities for staff and adopting affirmative and non-alienating language in and outside of CCC clinics and host sites.