Loading...
HomeMy WebLinkAbout2026.03.09 HHSC Special Agenda 04 �,?ACHf� City of Apache Junction, Arizona Meeting location: +� City Council Chambers Z 300 E.Superstition Blvd. Special Meeting Agenda Apache Junction,AZ \RizaNr 85119 Health and Human Services apachejunctionaz.gov Commission P:(480)982-8002 Doors are open to the public at least 15 minutes prior to the posted meeting start time. Monday, March 9,2026 3:00 PM City Council Chambers A. Call to Order B. Pledge of Allegiance C. Roll Call D. Consent Agenda 1. 26-83 Consideration of approval of agenda. 2. 26-84 Consideration of approval of special meeting minutes of February 23, 2026. Attachments: 2026.02.23 HHSC Minutes- DRAFT E. Old Business F. New Business The Commission shall consider any business not yet considered.Arizona Open Meeting Law prohibits public comments at this time. 3. 26-85 Interview of applicants for Health and Human Services funding for Fiscal Year 2026-2027: A New Leaf,Apache Junction CDC,Azura VITA, Black and Gold Youth Football League, Boys and Girls Club, Kiwanis, NAZCARE Inc., and Superstition Food Bank. Attachments: A New Leaf Application AJ CDC Application Azura VITA Application BGYFL Application Boys and Girls Club Application Kiwanis Application NAZCARE Inc Application Superstition Community Food Bank Application Commissioner Scoring Sheet City of Apache Junction,Arizona Page 1 Printed on 311812026 Health and Human Services Special Meeting Agenda March 9,2026 Commission G. Information and Reports The chair at this time may announce information regarding activities involving Health and Human Services matters, such as, but not limited to attendance of commission members at community meetings or events, seminars or conferences, or upcoming events or conferences. H. Staff Liaison's Report The City Clerk, members of City staff or those individuals designated by the Manager, may present information pertinent to items under consideration or information related to the operation of the City. I. Selection of Meeting Dates, Times, Location and Purpose J. Adjournment Copies of this agenda and additional information regarding any of the items listed above may be reviewed from 7:00 a.m. to 6:00 p.m., Monday through Thursday, except holidays, at the City Clerk's Office located at 300 East Superstition Boulevard in Apache Junction,Arizona, 85119, telephone number is(480) 982-8002. The City of Apache Junction invites and welcomes people of all abilities to use our programs, sites and facilities. Specific requests may be made by contacting the Human Resources Office at(480)474-2617 or TDD(480) 983-0095. City of Apache Junction,Arizona Page 2 Printed on 311812026 ►P�"E�c�, City of Apache Junction, Arizona 300 E Superstition Boulevard o Agenda Item Cover Sheet Apache Junction,AZ U =i 85119 Agenda Item No. 1. �Piz oN* File ID: 26-83 Sponsor: Agenda Date: 3/9/2026 Index: In Control: Health and Human Services Commiss Consideration of approval of agenda. City of Apache Junction,Arizona Pagel Printed on 311812026 ►P�"E�c�, City of Apache Junction, Arizona 300 E Superstition Boulevard o Agenda Item Cover Sheet Apache Junction,AZ U =i 85119 Agenda Item No.2. �Piz oN* File ID: 26-84 Sponsor: Agenda Date: 3/9/2026 Index: In Control: Health and Human Services Commiss Consideration of approval of special meeting minutes of February 23, 2026. City of Apache Junction,Arizona Pagel Printed on 311812026 City of Apache Junction, Arizona Meeting location: U z Executive Session Special Meeting Minutes Conference Room 300 E.Superstition Blvd. Health and Human Services Apache Juncctiti Building E, Floor on,AZ Commission 85119 apacheju nctionaz.gov P:(480)982-8002 Doors are open to the public at least 15 minutes prior to the posted meeting start time. Monday,February 23,2026 5:00 PM Executive Session Conference Room A. Call to Order Chair Brennan called the meeting to order at 5:00 p.m. B. Pledge of Allegiance Chair Brennan led the Pledge of Allegiance. C. Roll Call Present 6- Chairperson Brennan Commissioner Smithson Commissioner Mykland Commissioner Montgomery Commissioner Krcilek Vice Chair Danford Excused 1- Commissioner Wood Staff in Attendance: Deputy City Clerk,Amy Greening Administrative Assistant,Naomi Funk D. Consent Agenda Vice Chair Danford moved,seconded by Commissioner Krcilek to approve the Consent Agenda as presented. Yes: 5- Chairperson Brennan,Commissioner Mykland,Commissioner Montgomery, Commissioner Krcilek and Vice Chair Danford No: 0 Excused: 2- Commissioner Smithson and Commissioner Wood Commissioner Smithson arrived to the meeting after the Consent Agenda motion was made. 1. 26-60 Consideration of approval of agenda. 2. 26-61 Consideration of approval of special meeting minutes of January 26,2026. City of Apache Junction,Arizona Pagel Health and Human Services Special Meeting Minutes February 23,2026 Commission E. Old Business F. New Business 3. 26-62 Presentation and discussion on the applications submitted for Fiscal Year 2026-2027 funding. Deputy City Clerk Amy Greening announced Board Liaison Evie McKinney will not be attending the meeting this evening. She also informed the Commission that Commissioner Wood has a conflict of interest with one of the applicants and will not be participating in the process. Commission members discussed the 8 applications that were submitted for funding for Fiscal Year 2026-2027.The concerns they had included: 1.A New Leaf being a large non-profit,receiving funding from other sources and if granted any funding,will it go to Apache Junction residents. 2.Apache Junction Community Development Corporation- costs listed on application, specifically the amount to Parks and Recreation. 3.Azura VITA-confusion on the what the proposed project is,their total amount of projected grants,and the percentage of clients that are Apache Junction residents. 4.Black and Gold Youth Football League(BGYFL)-how they determine who will get the scholarships,want to be sure the recipients are Apache Junction residents,and how they split up the age groups for the teams. 5.Boys and Girls Club-fundraising events and other grants received,retention of students,and that the funding will go to employees working with Apache Junction residents. 6.Kiwanis-confusion on what the funding will go to/proposed project. 7.NAZCARE Inc-requesting funds for capital improvements and Commission members feel like the funding should not be used for this purpose. 8.Superstition Community Food Bank-funding from other cities,qualification process,seniors on the waiting list,size of food boxes per family,community partnerships and success of the holiday meal boxes. G. Information and Reports H. Staff Liaison's Report I. Selection of Meeting Dates,Times, Location and Purpose J. Adjournment Chair Brennan adjourned the meeting at 6:30 p.m. City of Apache Junction,Arizona Page 2 Health and Human Services Special Meeting Minutes February 23,2026 Commission Michael Brennan Chair City of Apache Junction,Arizona Page 3 ►P�"E�c�, City of Apache Junction, Arizona 300 E Superstition Boulevard o Agenda Item Cover Sheet Apache Junction,AZ U =i 85119 Agenda Item No. 3. �Piz oN* File ID: 26-85 Sponsor: Agenda Date: 3/9/2026 Index: In Control: Health and Human Services Commiss Interview of applicants for Health and Human Services funding for Fiscal Year 2026-2027: A New Leaf, Apache Junction CDC, Azura VITA, Black and Gold Youth Football League, Boys and Girls Club, Kiwanis, NAZCARE Inc., and Superstition Food Bank. City of Apache Junction,Arizona Pagel Printed on 311812026 O� PpPICHE�Gy� City of Apache Junction Fw�= HEALTH & HUMAN SERVICES COMMISSION gRIZOIA Request for Financial Assistance Application Cover Sheet Name of Agency: A New Leaf, Inc. Mailing Address: 868 E. University Drive, Mesa, AZ 85203 Street Address: 2066 W. Apache Trail, Suite 101 , Apache Junction, AZ 85120 Phone: 480.969.4024 Agency Director: Michael Hughes, CEO Email Address: contracts@turnanewleaf.org Direct Line: 480.969.4024 x. 4021 Project Manager: Dana Martinez, Director of DV and SV Services Email Address: dmartinez@turnanewleaf.org Direct Line: 602.768.8192 Project: A New Leaf's CAAFA DV Outreach Total Amount requested: $20,000 Population and number of people to be served: 50 Apache Junction Domestic and Sexual Violence Survivors Agency Description: Please provide a brief description of your organization's history, experience, and services provided. Please address the following: 1. Has your agency received funding from Apache Junction in the past? If yes: a. What was the year b. Amount, c. Project/Service d. How your agency met the expectations of the funding agreement. A New Leaf most recently received Apache Junction funding in FY25. The agency received $6,750 from Apache Junction to provide services for domestic violence survivors through the agency's Community Alliance Against Family Abuse (CAAFA) shelter and outreach programs. Services included hotel stays, emergency food, provision of basic needs and essentials, and transportation. A New Leaf's CAAFA programs were able to serve 40 Apache Junction households (72 individuals), including 1 household in CAAFA shelter, hotel stays for 8 Apache Junction households, food cards for 9 households, gift cards for essential items for 10 households, and Lyft transportation for 12 households. A New Leaf exceeded the proposed expectations of the contract. 2. Purpose of the agency A New Leaf was established in 1971 as PREHAB of AZ, with a focus on providing residential and outpatient behavioral health services for youth experiencing mental health challenges and navigating substance use concerns. In 2006, the organization adopted the name A New Leaf to reflect a broader spectrum of community services and commitment to offering individuals and families the opportunity to make meaningful, positive change in their lives. Over the years, the organization has grown through collaboration with local leaders, organizations, and community members to address critical needs and fill service gaps. This growth has also been driven by the integration of smaller agencies that provided vital services but faced sustainability challenges. A New Leaf is committed to transforming lives by empowering individuals and families through tailored support services, ensuring every person can achieve long-term stability and well-being. In July 2021 , A New Leaf merged with the Community Alliance Against Family Abuse (CAAFA), located in Apache Junction. Community Alliance Against Family Abuse (CAAFA) was founded in 1998 by community members who were confronted by the tragic reality that local survivors of domestic violence and their children were living in their cars and out in the desert because they had nowhere to go. The agency has grown substantially since then, now serving survivors of domestic and sexual violence from Pinal and eastern Maricopa Counties (i.e. the East Valley). CAAFA provides a 16-bed emergency shelter, legal advocacy, case management, victim advocacy, community outreach services, and more. A New Leaf requests funding to support essential services for residents of Apache Junction. 3. Type of agency A New Leaf is a 501 (c) 3 non-profit organization. 4. Services provided Last year, 18,825 community members experiencing economic disadvantages and systemic barriers to stability were positively impacted by services including: ■ 4,004 individuals accessed emergency shelter and supportive housing ■ 2,587 survivors of domestic or sexual violence received essential support services ■ 9,001 individuals benefited from financial assistance, employment and career support, and financial empowerment ■ 1 ,691 adults and children received behavioral health services ■ 1 ,304 children and their parents/caregivers benefited from family support services ■ 238 children received educational opportunities that supported their development Services provided by A New Leaf's CAAFA include: ■ CAAFA DV Shelter ■ CAAFA DV Outreach 5. Provide target population and demographic information on your current clientele to include percentage located within the City of Apache Junction A New Leaf's CAAFA serves under-served families, children, and adults experiencing domestic violence and other crisis situations. Of 466 individuals served in FY25, 72 (15%) were Apache Junction residents. Demographics of Apache Junction residents served include: Race/Ethnicity: - African American: 1 - Asian: 1 - Caucasian: 54 - Hawaiian/Pacific Islander: 1 - Hispanic: 11 - Multi-racial: 1 - Native American: 2 - Other/Unknown: 12 Age: - Under 18: 3 - 18-24: 5 - 25-59: 48 - 60+: 7 - Unknown: 10 Gender: - Male: 7 - Female: 62 - Transgender/non-binary: 2 - Other/Unknown: 1 The U.S. Census bureau cites the median household income in the agency's service area ranges from $77,588 in Pinal Co. to $85,518 in Maricopa Co. (U.S. Census Bureau, 2023). Median household income in Apache Junction was $58,619. During the last fiscal year, 65% of emergency shelter adults earned less than $15,650 per year. Many of the survivors CAAFA serves in shelter are considered under-served: Rural/geo- graphic isolation (approximately 10% of our shelter residents each year), men/boys (10%), ethnic/racial minorities (45%), victims with mental/physical/cognitive disabilities (13%) and low income (99%). 6. Explain how your agency will have adequate capacity to complete the project/service being requested. Programmatic Capacity A New Leaf's CAAFA adheres to the Arizona Service Standards for Domestic Violence Service Providers, the Arizona Service Standards for Sexual Violence Service Providers, and the Recommended Guidelines for a Coordinated Community Response to Adult Sexual Assault set forth by the Governor's Office of Youth, Faith, and Families. Services are designed with an empowerment philosophy, an anti-oppression framework that is healing centered, trauma informed, culturally sensitive, and strengths based. Services are provided in a sensitive, respectful, and nonjudgmental manner, where survivors are listened to and believed. Advocates empower survivors by prioritizing their safety, rights, needs, and wishes, and ensure that survivors have access to appropriate, accessible and quality services. Dana Martinez, Director of DV and SV Services, provides oversight of s programs in the DV/SV Division, including CAAFA Shelter and CAAFA Outreach.. An employee of A New Leaf since 1996, Ms. Martinez has experience working with victims of sexual and domestic abuse, as well as homelessness. Under Ms. Martinez's supervision, Cynthia Rodriguez, Associate Director of DV Outreach Services, manages CAAFA DV Outreach Services. Staff include a Community Engagement Coordinator, Program Manager, Administrative Support, two Lay Legal Advocates, and two Outreach Advocates. Financial Capacity Since the inception of its Domestic Violence (DV) services, A New Leaf has been able to provide quality, uninterrupted services to men, women, and children through grant funding, valuable partnerships, dedicated volunteers, and the generosity of local businesses and individuals. By leveraging such resources, DV Services has been able to maintain and expand facilities and services as the needs have changed over the years. A New Leaf operates with diverse funding streams that include federal, state, and local funders along with various foundations and corporations. The agency also receives private and in-kind donations that aid in A New Leaf's commitment to its clients. A New Leaf is currently operating with an approximate 60-day cash reserves for all programs to ensure the sustainability of services in the case of shortfalls in funding. The Government Grants and Contracts team maintains a schedule for applying for and renewing grants and contracts, as well as for meeting requirements for compliance. A New Leaf's Philanthropy team conducts fundraising activities to engage individual donors and corporate and foundation support to fill gaps in funding and to enhance services. Financial oversight of the project will fall to John Moore, Chief Financial Officer. John holds an MBA in Finance from UCLA's Anderson School and a BA in Accounting from Cal Poly San Luis Obispo. He also completed an executive certification at Stanford Graduate School of Business and is a CPA (inactive). Known for his data-driven decision-making and cross-functional leadership, John has successfully secured multimillion-dollar grants, negotiated favorable contracts, and influenced state-level funding policies to benefit underserved communities. Other Resources Partnerships: A New Leaf/ CAAFA has established collaborative relationships with a variety of community partners to ensure a full continuum of care for the DV and SV survivors served through this project. Apache Junction Police Dept - AJPD refers survivors to CAAFA; CAAFA offers training to AJPD officers on DV/SV dynamics and CAAFA services. A New Leaf offers a dedicated phone number for the AJPD to call to immediately assist survivors of DV/SV when safety is at risk. Superstition Food Bank - to help supply necessary food and supplies to the families served. Horizon Health: A New Leaf collaborates with Horizon Health to assist survivors by making referrals and by supporting survivors who are clientele of Horizon Health. Empowerment Systems: Empowerment Systems offer support with employment, housing and nutrition assistance. Gilbert PD - GPD refers survivors to CAAFA, and CAAFA assists survivors with needs they may have with their civil or criminal court processes. Local motels —A New Leaf's staff work with a third-party booking site specifically designated for victim service providers to quickly book emergency hotel stays. These hotels are vetted by the booking site and ensure the hotels' responsibility in maintaining survivors' confidentiality. Volunteers: A New Leaf's volunteers play a vital role throughout the agency. Individuals, businesses, churches, civic and community groups take an active role in the success of A New Leaf's programs. Volunteer hours are consistently provided in the areas of tutoring, recreational activities, sorting donations, gardening, landscaping, office assistance, and other projects that help to improve the lives of shelter residents. In FY25, A New Leaf engaged 91 individual community volunteers and 47 volunteer groups comprised of 573 people, contributing over 17,500 hours of valuable time to the operations of A New Leaf's programs. Donations: Clients benefit from generous donations made by businesses, foundations, and individual community members. Annual drives for specific needs, including water, food and hygiene products for residents, are conducted on a regular basis by volunteer groups and individuals such as Eagle Scouts. Once the drive is complete, donations are brought to the agency's Basic Needs area for storage and distribution to individuals and families. Additional donations include new clothing, bicycles, household goods, cleaning items, homemade quilts, holiday gifts, and more. 7. Provide a list of your annual fundraisers and average amount raised. A New Leaf hosts two annual fundraisers. The amounts are the averages of the last three years. With One Voice: $158,670 Camaraderie Gala: $817,258 8. Are you listed on the www.2llArizona.org website? Yes, A New Leaf is listed on the 211Arizona.org website. 9. Have you participated in the following: a Project Connect event, a Health and Wellness Expo or the Apache Junction Community Resource Center in the past? A New Leaf strives to be a valued community partner. Staff have participated in Project Connect, a Health and Wellness Expo, and the Apache Junction Community Resource Center in the past and will continue to participate in events to provide outreach materials and other resources to the community. Project/Service Description: Please describe the proposed project/service to be funded. Please address the following: 1. Who will be served? CAAFA serves under-served families, children, and adults experiencing domestic violence and other crisis situations. In FY25, 466 individuals served through A New Leaf's CAAFA programs, including 72 Apache Junction residents. 2. How will this project serve Apache Junction proper residents? Located in Apache Junction, A New Leaf's CAAFA provides easy access to services for survivors of domestic and sexual abuse. Outreach advocates provide crisis intervention, resources and referral to assist survivors in obtaining the support needed to meet their specific needs. When needed, overflow shelter through hotel stays are provided. Outreach advocates also offer support groups and education classes for survivors. In addition to direct services, A New Leaf staff participate in Apache Junction community events to provide education and outreach for those who may be seeking assistance. 3. What services will be provided? The mission of A New Leaf's CAAFA DV Outreach is to empower individuals, families, and communities to be free from abuse through collaboration, prevention, awareness, and support. The program, based in Apache Junction, is a key provider of domestic and sexual violence services in Pinal County, where there are limited services available and a high need. According to the Arizona Department of Economic Security, 14,942 adults and children received services from mobile DV outreach, which was nearly triple the number of individuals who received shelter-5,588. As many survivors of Domestic Violence do not receive shelter services, the advocacy services provided by programs like A New Leaf's DV Outreach is crucial in filling this gap. (Arizona Department of Economic Security DOMESTIC VIOLENCE SERVICES REPORT, FY2024). While emergency shelter is important to secure immediate safety, focusing responses solely on shelter services fails to address the diverse needs of victims and survivors. While many people who have been victimized may not be in immediate need of safety, the trauma of domestic violence may impact their ability to stabilize after they have left. By expanding these resources to those who do not seek shelter, A New Leaf is able to fill crucial community needs. A New Leaf's services help individuals through every step of their journey, whether that is helping individuals navigate the process of leaving, helping those in current crisis, or providing resources to those who are struggling after they have left a dangerous situation. Overall, this program helps individuals who have been victimized overcome barriers to independence and self-sufficiency. Through its DV Outreach Program, A New Leaf offers individual advocacy, safety, basic needs, and support to vulnerable individuals and families in our community who are experiencing domestic or sexual violence and other crisis situations. Services include crisis stabilization, safety planning, basic needs, advocacy, and emergency hotel placement when safety is compromised. Services are personalized and delivered with consideration and understanding of the trauma victims have endured to support them in rebuilding their lives. A New Leaf's trained advocates accept referrals from community partners to provide survivors with information and connection to needed shelter, support, and community- based services. This program applies best practices that incorporate an understanding of the unique dynamics of domestic violence and its many co-occurring issues to achieve positive outcomes. This approach assists clients in rebuilding their lives by strengthening their capacity to deal with the complex issues they face while obtaining long-term safety and recovering from the impacts of domestic violence and other abuse. Healing centered and trauma-informed services are offered in an environment that is inclusive, welcoming, destigmatizing, and non-retraumatizing. Advocacy and support services are client-directed and empowerment-focused to support clients in reaching self-identified goals, obtaining needed community resources, and gaining long-term stability. The DV Outreach Team's experienced staff offer: - Crisis stabilization - Immediate and long-term safety planning - One-on-one advocacy and support - Basic needs assistance - Support groups - Lay legal advocacy for protective orders and/or family court navigation - Assistance with securing safe long-term housing resource - Referrals to partnering organizations In FY27, A New Leaf expects to serve 450 people (50 Apache Junction residents) through its outreach program. 4. What are the benefits? A New Leaf's DV Outreach services provide crucial support to survivors of crimes that need help that a traditional DV shelter cannot provide. The following testimony illustrates how these services can be life-changing for Arizona residents: Frank was referred to A New Leaf by law enforcement; the mother of his child was physically abusive, and he needed an Order of Protection. When arriving at A New Leaf, Frank was not aware that what he had experienced was in fact domestic violence. He had a stable place to stay, and did not need shelter, but was in need of other services. Frank needed an order of protection for his child from his wife who was physically abusive. Lay Legal Advocates from A New Leaf's DV Outreach Team helped him obtain the Order of Protection for Frank and his child and then accompanied him to court when the child's mother contested it. With guidance from A New Leaf's DV Lay Legal Advocates, his Order was upheld and Frank successfully negotiated visitation rights with his child. With help and education from A New Leaf's DV Lay Legal Advocates, Frank has a better understanding of his rights, and how to identify controlling behaviors and red flags in his relationships. He was also able to participate in counseling services and peer support groups to assist him in achieving stability for himself and his child. As demonstrated by Frank's story, many people are lost in a labyrinth of confusing options when they seek help from a domestic violence situation. And while the stereotypical victim of domestic violence is a romantic partner escaping a threat, there are many other individuals who benefit from these services who might be in danger. A New Leaf's services assist survivors in regaining safety and well-being. 5. Provide a timeline and who is responsible. Services are ongoing, and the DV Outreach Team is prepared to serve clients from Day One of contract execution. Under the oversight of Dana Martinez and Cynthia Rodriguez, direct service activities include: Outreach Advocates: - meet with clients and help them to gain access to resources. - provide crisis intervention, resources, and referrals. - help clients access emergency overflow shelter through hotel nights. - coordinate support groups and educational classes. Lay Legal Advocates: - assist clients with navigating court processes such as filing for orders of protection, and emergency custody orders and visitation - provide clients with safety planning, assistance with reporting violations of protective orders, information on victim rights, as well as gathering information and evidence - Accompany or provide transportation assistance (e.g. bus passes, taxi, etc.) to court or other important appointments related to legal issues resulting from victimization. - provide referrals to Community Legal Resources and support with safely exploring alternative options for legal remedies Administrative Support: - delivers assistance to clients and callers through crisis intervention, safety planning, providing information and referrals, education on DV and offering emotional support. - provides basic needs to clients as appropriate while they are receiving services. - conducts intakes for clients who walk-in to the outreach office. In addition to direct service activities, the Administrative Support also runs data quality reports, submits monthly, quarterly, and annual reports, assists with distribution of program information, and other administrative tasks. 6. Where will the services be provided? A New Leaf has an office site within the Apache Junction location. Services are provided at that site or other locations that are more convenient for clients. The goal is making services easily accessible for all clients, even for rural clients throughout Pinal County. Outreach events take place in Apache Junction, Mesa, and other locales. 7. How will you provide the services? A New Leaf uses a healing centered, trauma-informed approach to serving survivors of domestic and sexual abuse. Services are provided with focus on three intentional goals: JUSTICE: The program assists DV and SV victims to understand and participate in the criminal justice system. Advocates partner closely with victims to help them navigate the civil court system and educate them along the way. A New Leaf's DV Outreach staff advocate for survivors within the system, offer court accompaniment, and provide ongoing moral support and encouragement as they face the difficult task of asserting their rights. It is also important to note that "justice" may mean something different to each victim, and many choose not to get involved in the criminal justice system. DV Outreach staff are available to help participants safely explore alternatives. SAFETY: This program improves victims' immediate safety by helping to secure orders of protection and supporting victims as they participate in prosecutions of their abusers. DV Outreach Staff help improve victims' long-term safety by ensuring that through safety planning, understanding the dynamics of DV and SV, establishing abuse-free lives, accessing concrete supports, and achieving stability, they are equipped to maintain their safety in the community. Another important note is that DV and SV victims often struggle with emotional and mental safety as well. Whether or not their physical safety continues to be at risk, A New Leaf DV Advocates can help them safety plan to cope with and respond to emotional and psychological triggers in a safe and healthy way, and to stabilize their mental health. HEALING: The program responds to helping clients heal in a number of ways. A New Leaf's DV Advocates provide case management, which often results in direct financial assistance to ensure that victims' basic needs (food, clothes, transportation, etc.) are met. These basic needs can be a tremendous barrier as survivors seek to get their lives back. This program helps victims access medical care, as appropriate, to address injuries, comorbidities related to neglected health, and other physical needs that may have been caused by or overlooked during their experiences with DV and SV. The project responds to victims' emotional needs through trauma-informed services, including supportive listening, support groups, personal advocacy, and referrals to mental health providers. 8. Are there any community partners in this project? If so, please list. DV Outreach Team participates in several activities with the Town of Apache Junction's Parks and Recreation Department. Some of these activities are focused on bringing awareness to the community of our resources and services. Other activities are geared towards creating safe spaces for survivors. For the second summer in a row, we will be hosting workshops for teens and parents separately to discuss Teen Dating Violence and Healthy Relationships. This summer sessions are held at the Multi- Gen Center in Apache Junction. The DV Outreach Leadership Team meets with the Apache Junction Police Department on a monthly basis to ensure that the services we are offering to the community are helpful and relevant. In response to their feedback during these meetings, we were able to create a hotline number specific for law enforcement officers to access an emergency response protocol that helps them place DV/SV Survivors in a hotel when there is an immediate safety risk. Our Community Engagement Coordinator has also provided training to AJPD officers. A New Leaf also participates in collaborations, designed to identify barriers and challenges and develop new strategies for efficient service delivery, as well as improve systemic response to DV. Collaborations include Arizona Coalition to End Sexual and Domestic Violence and the domestic Violence Fatality Review Team. A New Leaf partners with multiple community agencies, including additional Family Advocacy Centers, government agencies, county attorney's offices, mental health and substance use service providers, Apache Junction Police Department, Superstition food Bank, Horizon Health, and local motels. 9. What is the project/service and agency goals? With 55 years of service to local communities, A New Leaf recognizes the resilience, resourcefulness, and potential within every family. Lasting change is achieved by building on these strengths and offering personalized support that honors each person's goals and supports their progress toward stability. Specific to the DV Outreach program, the primary objective is to meet people where they're at, meet basic needs, and assist with achieving safety and wellness. Goals include: Meeting Clients' Basic Needs • To achieve this goal, A New Leaf will ensure accessibility to services through outreach and flexible services. Clients will receive basic needs, transportation, and flexible funding when needed. • 450 clients (50 Apache Junction residents) will receive access to basic needs. • Outcome: Within the 12-month contract period, 450 clients will have access to basic needs. 95% will report having an increased knowledge of community resources. Ensure Client Safety • To achieve this goal, staff will assist clients in assessing their safety and creating safety plans. Staff will also assist with obtaining Orders of Protection when necessary. • 300 domestic violence and sexual survivors (30 Apache Junction residents) will be assisted with creating a safety plan. • Outcome: Within the 12-month contract period, 85% of program participants will report knowledge of how to plan for their continued safety. Improved Feelings of Well-Being • To achieve this goal, staff will provide individual and group support, as well as connection to other services and resources necessary to achieve well-being. • 300 domestic and sexual violence survivors (30 Apache Junction residents) will participate in case management, counseling, and group support activities. • Outcome: Within the 12-month contract period, 85% of program participants will report feelings of safety and well-being. Services are evaluated through the following methods: - Intake and Assessment: basic client information is collected to provide an initial assessment and a baseline from which to measure progress - Individual Service Plan: identifies client goals and objectives, strengths, and challenges - Program Discharge Report: information about discharge destination, financial situation, ongoing goals, and social support networks is collected - Satisfaction Surveys: used in determining effectiveness of services and to gauge the level of client confidence, knowledge, and skill development in a variety of areas 10.How and will you sustain this project after the agreement has ended? Since the inception of its DV services, A New Leaf has been able to provide quality, uninterrupted services to men, women, and children through grant funding, valuable partnerships, dedicated volunteers, and the generosity of local businesses and individuals. A New Leaf benefits from diverse funding streams that include federal, state, and local funders along with various foundations and corporations. The agency also receives private and in-kind donations that aid in A New Leaf's commitment to its clients. A New Leaf is currently operating with an approximate 60-day cash reserves for all programs to ensure the sustainability of services in the case of shortfalls in funding. The Government Grants and Contracts team maintains a schedule for applying for and renewing grants and contracts, as well as for meeting requirements for compliance. A New Leaf's Philanthropy team conducts fundraising activities to engage individual donors and corporate and foundation support to fill gaps in funding and to enhance services. Project/Service Budget: Provide a detailed project budget and narrative based on activities indicated above including: 1. Amount being requested: $20,000 2. Amount of funding provided by your agency (include source) A New Leaf receives private grant funding, individual donations, and in-kind donations to support services. For this program, $82,524 in private funding will assist in providing services to DV and SV survivors. 3. Amount of funding provided by partners (include source) A New Leaf's DV Outreach program is funded by the following partners- - AZ Department of Public Safety (VOCA Funding)- $285,804 - AZ Department of Economic Security- $227,464 4. A detailed narrative of the costs - Salaries -A New Leaf requests funding to pay for .2 FTE of the Administrative Support position. This position provides both direct care and administrative activities necessary for providing services to DV and SV survivors. ($44,754 annual salary x .2 = $8,951). - Employee-Related Expenses (ERE)- ERE includes payroll taxes, health and life insurance, and retirement benefits. Providing benefits assists in obtaining and retaining quality staff. ERE are calculated at 22.5% of salaries ($8,951 x .225 = $2,104). - Flexible Housing Stability Funds- These funds help vulnerable households remain housed by helping with utilities, food, transportation, or other vital needs ($615.83/mo. x 12 months = $7,390). - Indirect Costs- Indirect expenses cover accounting, contract management, IT, and other activities necessary for providing services at CAAFA. This is calculated at the federally-approved 15% de minimis rate of modified total direct costs (MTDC); for this request, the MDTC is $10,965 ($10,965 x .15 = $1 ,645). The total request is $20,000. 5. What percentage of your agency's total annual budget is this funding request? The total DV Outreach project budget is $615,792. The $20,000 requested from Apache Junction represents 3% of the project budget. A New Leaf projects that 11% of program participants will be Apache Junction residents. The agency's total annual budget is $43,552,126; the Apache Junction request is less than .5% of the total budget. 6. Indicate if you would accept partial funding and if so, provide the minimum amount and how your project will change. Each funder is a valuable partner to A New Leaf. Uniting with various municipalities strengthens our ability to serve, as we collaborate to achieve a common goal of improving the lives of underserved, vulnerable populations. A New Leaf is willing to accept partial funding in order to maintain our valued partnership with Apache Junction. A New Leaf would accept $13,500 for the DV Outreach project. This would impact the flexible funding available for client needs. If funded, A New Leaf wishes to leverage Apache Junction funding for salaries and ERE as match toward A New Leaf's AZ DPS (VOCA) contract. �0 PQ^�"f✓Gyp City of Apache Junction �= HEALTH & HUMAN SERVICES COMMISSION Aa,zoNP, Request for Financial Assistance Application Cover Sheet Name of Agency: Apache Junction Community Development Corporation Mailing Address: 300 E Superstition Blvd. Street Address: 300 E Superstition Blvd. Phone: (480)431-0831 Agency Director: Gail Evans, Chair Email Address: gdcevans@gmail.com Direct Line: 480-818-2840 Project Manager: Thomas Kelly Email Address: tnbkelly@gmail.com Direct Line: 480-797-1786 Project: Operating Expenses, Code Compliance & Residents Cleanup Needs Total Amount requested: $7,500 Population and number of people to be served: Residents of Apache Junction (2024 pop. reported as 42,000) who are elderly (34%), disabled (15%), veterans (14%), or living below the poverty line (12%). Page 4 of 12 Agency Description: Please provide a brief description of your organization's history, experience,and services provided. Please address the following: 1. Has your agency received funding from Apache Junction in the past?If yes: a.What was the year b.Amount, c. Project/Service d. How your agency met the expectations of the funding agreement. Apache Junction Community Development Corporation (AJCDC) has been in operation for over 20 years and has received funding from the City of Apache Junction for FY22, FY23, FY24($5,010); FY25($5,010)and FY 26($3,937.52). This funding has been used primarily to provide operating expenses such as insurance;web page and applicable software such as the Give application,WP Forms; shared cloud document storage; and cell phone service to allow citizens to contact the AJCDC directly. The funding is also used to provide needed services(such as dumpster service) as well as a variety of tools, supplies and safety items to include first aid kits and high-visibility shirts for our volunteers to use and safety. Thus far in FY 26,AJCDC has completed cleanup projects at E.4th Ave, S. Lawson,2 on Foothill, assisted Pinal County on N. Canyon (please see quarterly reports for more detail).We have also provided additional assistance with transporting material to the Hazardous Waste Event in Apache Junction. 2. Purpose of the agency The AJCDC was established in November 2002 as a 501(c)3 nonprofit. Our purpose is to support and improve the health and quality of life of residents of Apache Junction by combatting community deterioration through redevelopment.We work in neighborhoods to help those less fortunate to maintain their yards and property.AJCDC is committed to helping our community by focusing on initiatives that create positive change and strong neighborhoods.Through community outreach and partnerships within Apache Junction, including Pinal County islands within the city, AJCDC works to create a neighborhood friendly atmosphere, helping local businesses thrive and pride in community. Page 5 of 12 Mission:Working together to maintain and create safe affordable housing, support economic opportunities, instill a sense of community pride and commitment, and enhance the physical image of Apache Junction. Vision:Through community involvement, having a common and unified purpose to"Make a Difference"while providing conduits and assistance that enable a strong and sustainable community. 3.Type of agency AJCDC is a Community Development Corporation,a 501(c)3 nonprofit organization.The purpose of community development corporations is to revitalize their neighborhoods and/or towns through community redevelopment, economic development, and social services. 4. Services provided The AJCDC offers cleanup assistance to qualified homeowner/residents who have Code Compliance cases,through removal of excess, dry or dead vegetation and weeds, removal of compiled trash and refuse.This assistance is offered to any citizen who meets the criteria: elderly, disabled,veteran, and those living below the poverty line. AJCDC also hosts the annual Community Action Day event in Apache Junction,which includes engaged neighborhood-scale cleanup opportunities as well as roadway and trail improvements in local city parks such as Silly Mountain and Flatiron parks. AJCDC works with the City of AJ to transport Household Hazardous Waste(HHW)for those residents who are unable to transport it themselves(due to physical limitations or lack of financial ability),this being accomplished during the City's two HHW annual events. "Make A Difference Day" is a nationally recognized day in early October to help beautify America. Due to heat considerations here,the AJCDC holds Community Action Day in conjunction with the city of Apache Junction. We have adopted Baseline from Ironwood to Tomahawk for street clean up (about a 2-mile stretch)and performs this event at least twice per year. Page 6 of 12 5. Provide target population and demographic information on your current clientele to include percentage located within the City of Apache Junction Population and number of people to be served: Residents of Apache Junction(2025 est.) pop. reported as 44,529)who are elderly(34%of AJ population), disabled (15%of AJ population), veterans (14%of AJ population), or living below the poverty line(12%of AJ population). 6. Explain how your agency will have adequate capacity to complete the project/service being requested. Over the past 12 months,AJCDC has added new Board members who have shown needed skills and experience with both community development, management of volunteers and other expertise needed.This offsets Board losses over the past two years due to health concerns,terms of service and other reasons.The AJCDC's ability to recruit volunteers and complete projects has been greatly enhanced.The Board continues to seek out new members who show a commitment to serve the community. 7. Provide a list of your annual fundraisers and average amount raised. The AJCDC has not held any fundraising events. Our web page has a Donations section,which has been utilized by the public. 8.Are you listed on the www.211Arizona.org website? Not at this time as we are awaiting the process of getting listed on this site; an application for listing has been submitted. 9. Have you participated in the following:a Project Connect event,a Health and Wellness Expo or the Apache Junction Community Resource Center in the past? No Project/Service Description: Please describe the proposed project/service to be funded. Please address the following: 1.Who will be served? Page 7 of 12 Population and number of people to be served: Residents of Apache Junction(2025 est.) pop. reported as 44,529)who are elderly(34%of AJ population), disabled (15%of AJ population), veterans (14%of AJ population), or living below the poverty line(12%of AJ population).2. How will this project serve Apache Junction proper residents? The efforts made by AJCDC benefit many Apache Junction residents beyond those directly served. This is done bythe removal of unsightlytrash and debris. In this the neighboring properties find, property values are improved; neighborhood relations improve; regional neighborhood esthetics benefit;the quality of life in the neighborhood increases; and there is reduction of fire threat and again, better quality of life for the entire community and neighborhood. 3.What services will be provided? Cleanup assistance.Again, as previously noted the AJCDC aids those homeowners/residents facing Code Compliance cases,through the removal of identified excesses of dry or dead vegetation and weeds, removal of accumulated trash and refuse.This assistance is offered to any citizen who meets the criteria:elderly, disabled,veteran, and those financially unable and or living below the poverty line. Community Action Day.AJCDC also hosts the annual Community Action Day(formerly Make a Difference Day) in Apache Junction,which includes neighborhood-scale cleanup activities in identified areas working with the city, as well as quality of life improvements in local city parks such as Silly Mountain and Flatiron parks. Household Hazardous Waste assistance.AJCDC works in concert with the city to transport Household Hazardous Waste (HHW)for those qualified and unfortunate residents who are unable to transport it themselves during the City's two HHW annual events and as needed.With the use of the cell phone and internet services CDC is available 24/7. (Note: Make-A-Difference Day is a national event held the first Saturday in October and the AJCDC participates in this program when it's possible but has created a local Community Action Day in support of the national initiative. This was done due to the excessive heat in October which limited the number of volunteers we got for the event.We continue to support and participate in any city clean-up activities. 4.What are the benefits? Due to the removal of debris,trash, and sometimes hazardous waste neighboring properties experience a healthier safer environment. Property values are improved; neighborhood relations improve; neighborhood esthetics improve; and,there is a reduction of fire exposure/risks for the entire neighborhood. Page 8 of 12 5. Provide a timeline and who is responsible. From the time a candidate property and owner resident has been identified and accepted for assistance,AJCDC projects average 2-weeks start to finish.A board member is responsible to oversee this process. 6.Where will the services be provided? AJCDC provides services primarily within the city limits, including county Islands within this perimeter. We also assist Pinal County as needed in the spirit of cooperation. 7. How will you provide the services? AJCDC goes out to the identified location,with additionalvolunteers if appropriate, and performs a variety of services to remediate the identified issue as needed. 8.Are there any community partners in this project?If so, please list. AJCDC is proud and happy to list many valued community partners: Ace Hardware Genesis Project ADR Hardware True Value Handlebar Pub and Grill AJI Sporting Goods Ironhorse Seating AJ Mounted Rangers Hitching Post Saloon Austin Devel. &Construction Hardknox Rox&Excavating Bank of America Jayrey Graphics City of Apache Junction Kulvert King Clear Title Agency of Arizona Linx Auto Body Dilly Dog Modern Woodman Insurance Dutson Law Firm, Ltd. Mountain View Lutheran Church Edward Jones—Magie Berizzi Planet Fitness Electric Panel Specialist Safeway Evans Family VFW Post 9399 Friends of Apache Junction Walmart Page 9 of 12 9.What is the project/service and agency goals? AJCDC has continued the goal of providing AJ Code Compliance with as much assistance as possible to remediate those properties in distress by city code authorities. AJCDC also accepts requests for assistance from resident owners who meet the criteria (elderly,disabled,veterans, living below poverty level).We provide the same assistance to self-identified owner residents for property cleanup and household hazardous materials transport as possible.The AJ Code Compliance group have hundreds of open cases they work on a regular basis, only a few will meet the requirements to receive help from the AJCDC. Code will make a referral to the AJCDC and the AJCDC will make an in person or telephonic contact with the resident, determine eligibility and do an evaluation of the dept of the project. 10. How and will you sustain this project after the agreement has ended? AJCDC will continue to provide assistance to AJ residents who are in need, utilizing resources as available. Project/Service Budget: Provide a detailed project budget and narrative based on activities indicated above including: 1.Amount being requested: $7,500 2.Amount of funding provided by your agency(include source): All funding for AJCDC activities is provided by external grants and donations. 3.Amount of funding provided by partners(include source): For the previous 12 months, a total of$2000 has been provided by partners: $2,000 from Republic Services (in-kind donation) $500 AJ Mounted Rangers 4.A detailed narrative of the costs Q1 FY25 Zoom $159.90 Give WP Software App $99.00 Sparkles Screen Print $1,502.34 Republic Services $343.13 Page 10 of 12 Q2 FY25 Word Press Forms $399.00 Kabat's Ace Hardware $833.45 Philadelphia Insurance $1,217.00 TracFone $22.13 Republic Services $69.28 AJ Chamber of Commerce $195.00 Q3 FY25 None Q4 FY25 Republic Services $11.93 AJ Parks & Rec $6,419.98 Blue Host $324.73 5.What percentage of your agency's total annual budget is this funding request? The requested $7,500 represents the total AJCDC annual budget for FY 27 and would enable the agency to complete projects without additional funding. Since the AJCDC works with AJ residents only. 6. Indicate if you would accept partial funding and if so, provide the minimum amount and how your project will change. AJCDC would of course accept any partial funding and would then prioritize the number of projects and support we could offer Code Compliance and the City.As an example, if funded to 3/a of the Page 11 of 12 request, or$5,625,AJCDC may have to adjust be able to complete 3/4 of the planned Neighborhood, Community Action Day, Household Hazardous Waste assistance projects for the fiscal year. As we do not always know ahead of time what the needs of the community could be we would have to find a way to render the unknown services requested. Page 12 of 12 PpPICHf� City of Apache Junction O C�� �Z HEALTH & HUMAN SERVICES COMMISSION gQ,ZoNP` Request for Financial Assistance ',. Application Cover Sheet Name of Agency: Azura VITA Mailing Address: 137 E University Dr Mesa AZ 85201 Street Address: 137 E University Dr Mesa AZ 85201 Phone: 480-834-2122 Agency Director: Kymbrlee Hsu & Heather Cavitt Email Address: vita@azuracares.org Direct Line: 480-834-2126 Project Manager: Kymbrlee Hsu Email Address: KHsu@azuracares.org Direct Line: 480-304-1092 Project: Volunteer Income Tax Assistance for low to moderate income individuals and families Total Amount requested: Population and number of people to be served: Agency Description: Please provide a brief description of your organization's history, experience, and services provided. Please address the following: 1. Has your agency received funding from Apache Junction in the past? If yes: a. What was the year b. Amount, c. Project/Service d. How your agency met the expectations of the funding agreement. 2. Purpose of the agency 3. Type of agency 4. Services provided 5. Provide target population and demographic information on your current clientele to include percentage located within the City of Apache Junction 6. Explain how your agency will have adequate capacity to complete the project/service being requested. 7. Provide a list of your annual fundraisers and average amount raised. 8. Are you listed on the www.2llArizona.org website? 9. Have you participated in the following: a Project Connect event, a Health and Wellness Expo or the Apache Junction Community Resource Center in the past? Mesa United Way's mission is to fight for the health, education, and financial stability of every person in our community. We have operated in Mesa and the greater Phoenix area for 100 years, creating solutions and innovative programming to find gaps in service in our community and solve unresolved problems. In conjunction with Azura, a new nonprofit launched by Mesa United Way leadership, we successfully deliver meaningful services to our clients by implementing programs under 4 distinct initiative areas: (1) poverty alleviation as the area's local VITA provider for tax assistance for low-income people; (2) foster children and the needs of youth aging out of the foster system, (3) literacy programs, and (4) supporting veterans through holistic case management. To ensure success, we employ more than 20 staff and leverage thousands of hours of volunteer service to exceed our impact goals year-on-year. We also collaborate with state, city, and local organizations to fulfill our mutual goals and ensure that services are not duplicated. We began our VITA (Volunteer Income Tax Assistance) program in July 2009 when the City of Mesa asked Mesa United Way (MUW) to assume responsibility and administration of the city's VITA work. Subsequently, in 2018, the City of Chandler requested that MUW oversee the 5 sites the city had been operating. In 2023 MUW VITA became Azura VITA. We are a 501(c)3 organization. The Azura VITA program has grown to become the primary provider of VITA services in Chandler and Mesa, as well as the East Valley communities of Gilbert, San Tan, Queen Creek, Apache Junction, and Gold Canyon. Our program has 11 VITA sites (5 within the City of Chandler, 5 Within Mesa,1 in Gilbert) — 11 sites operate during the tax season, and 1 VITA site provides year-round services to clients Over the last 15 years, we have prepared more than 67,000 tax returns in total across all our sites, which have resulted in over $76 million in refunds for low- income tax filers and their families. Our target population has an income limit of $69,000 (2025 guidelines). Furthermore, we partner with 134 volunteers annually who donate 10,300 hours to help us complete tax returns for the people we serve. For the 25-26 fiscal year, we adjusted our calendar by adding additional opening hours and days at our sites so we can serve more clients in need year-over-year. Due to the increased need we are also actively seeking more host partnerships with cities that we see using our VITA sites because they do not have a site closer to them. In 2025, we began hosting mini financial literacy sessions that will lead to better employment opportunities for our clients. We will continue these courses throughout 2026. As we head into the next fiscal year, our plan is to work with financial institutions to provide no-fee banking. In addition, we are cultivating a network of partners to develop resources and tools to help individuals and families get out of payday and title loan debt. We have not received funding in the past from Apache Junction. We are not listed on www.211Arizona.org We have not participated in Project Connect event, a Health and Wellness Expo or the Apache Junction Community Resource Center in the past. Simply, our proposed service is to provide free tax preparation services to low- and medium-income individuals and families in the City of Apache Junction; our focus is on serving taxpayers whose maximum income is $69,000, which is the maximum income for which a family of four can receive the EITC (Earned Income Tax Credit). Enhancing our clients' financial stability, the VITA program ensures that tax returns are prepared accurately and that clients receive all the tax benefits to which they are entitled. This is accomplished with a professional level of service, in a safe and secure environment, for those members of the community who need it the most. The average cost of professional tax preparation is approximately $500 per return, and this cost continues to rise over time. For low- and moderate- income families, this represents a significant financial burden and often becomes a barrier to filing taxes and claiming the refunds they are entitled to. The upfront, out-of-pocket expense for professional tax preparation can make a critical difference—impacting immediate needs such as food or rent and leading to a long-term loss of economic opportunity. Without receiving all eligible tax return adjustments, families miss out on essential resources that could help cover everyday living expenses or be invested for future growth. For example, if 1,000 tax returns were filed for Apache Junction residents, the collective cost of professional tax preparation would total approximately $500,000. without factoring in the refunds those taxpayers would receive. The average federal refund for our VITA clients during last year's tax season was 1,500, meaning we help clients save or recover around $750,000. each year by providing free tax preparation services. Unfortunately, many low-income families do not file their taxes, leading to significant negative consequences. For example, when their children apply for college or vocational programs, they must submit FAFSA applications to be eligible for financial aid. FAFSA requires the filing of tax returns, often for the two previous years. Throughout the year, we receive numerous calls from students referred to us by their financial aid offices, urgently needing prior- year tax returns for themselves or their parents, which we provide on an expedited basis. By offering free tax preparation services, we generate immediate and long-term economic benefits that extend across generations. These services likely result in millions of dollars in additional income and tax revenue that would otherwise be lost. Notably, 83% of our clients in Apache Junction have incomes below 80% of the AMI (Area Medium Income), a common measure of low and medium income. In total, our VITA program helped clients receive more than $6.1 million in refunds during the last tax season. To determine eligibility, Azura VITA follows the standard intake and screening protocols established by the national VITA program. Upon arrival, clients complete an IRS-approved intake form (Form 13614-C), which captures critical information such as household income, filing status, and sources of income. Trained volunteers then review this information to verify that total household income does not exceed our upper threshold (currently set at an annual income of$69,000 for a family of four, aligned with the maximum for EITC eligibility). Income limitation exceptions are made for those who have limited mental faculties or could be exploited. Volunteers also assess the complexity of each return to ensure it falls within VITA's scope of service— simple to advanced filings are acceptable, but highly complex returns may be referred to a professional tax preparer. As part of this process, clients must present valid photo identification and Social Security or Individual Taxpayer Identification documents for all individuals listed on the return. This combination of intake screening, identification verification, and an assessment of return complexity ensures that only those who meet the appropriate income and service scope requirements receive assistance through the VITA program. We ensure appropriate staff-to-client ratios at the sites by carefully coordinating volunteer schedules based on anticipated client volume and site capacity. Our staff/volunteer-to client ratios are 1:45. The Co-Executive Directors oversee all scheduling logistics, ensuring each site has an adequate number of certified volunteers to handle client flow effectively. Volunteers are assigned to shifts according to client demand—peak days and hours receive additional volunteer support, while lower- volume times require fewer personnel. This approach helps maintain manageable waiting times, provides each client with individualized attention, and supports a thorough quality review process. By partnering closely with community organizations, the program gains insight into projected attendance and can adjust volunteer levels in real time. As a result, Azura VITA sites remain consistently well-staffed, guaranteeing that each client receives timely, high-quality tax assistance. Azura considers our VITA program to be one of our key primary programs. One of its most important characteristics is that it is a service we deliver directly to the public, rather than as a pass-through funding mechanism to support service delivery via sub-award contracts with other organizations. As such, it is a core component of our overall business plan. Funding & Sustainability-Azura has actively sought multiple sources of funding in addition to the City of Apache Junction. These include the IRS, Wells Fargo, City of Chandler, City of Gilbert and individual donors. Our partnerships are expected to continue long-term as it is based on the success and continued growth of the program. To ensure we are expanding the reach, impact, and sustainability of the VITA program, we will continue to seek a diversified pool of funding resources to enhance funding we receive from the City of Apache Junction and other funders currently included in our donor portfolio. Facilities -All the organizations that host VITA sites provide access to their facilities, and often computer equipment, at no charge to Azura. They include the Red Mountain Library (City of Mesa), Mesa Community College (2 sites), AZCEND (Gilbert), Hamilton and Sunset Libraries (City of Chandler) Chandler-Gilbert Community College (3 sites), and Chandler Care Center. Streamlining open, free access to shared infrastructure adds measurable value to the program while also creating service utilization efficiencies that translate to sustainability of the program in the long-term. Community Partners - Our community partner organizations actively promote the VITA program to their clients and through their community partner networks and contacts. This includes not only outreach to potential VITA clients but also volunteer recruitment. Their efforts are critical to getting awareness of the VITA program to as many members of the community as possible. Volunteers-The most important component of the Azura VITA program is the volunteers that are the heartbeat of our work. It is these individuals, who willingly volunteer their time to serve their fellow members of the community, who make the program possible. They are both reliable, always showing up on time at their agreed sites, and loyal, returning year after year to learn the new tax laws and serve with the program. Over 85% of the volunteers in the Azura program return to serve year after year. During the 2024-2025 fiscal year, 134 volunteers contributed more than 10,300 hours of their time to complete 5,856 tax returns. With $35.52/hour being the value of volunteer time (per Independent Sector), the commercial value of VITA's volunteer service last year was nearly $366,000! Staffing -Our VITA program has two experienced full-time managers and one full-time admin, in addition to support staff within Azura. Project/Service Description: Please describe the proposed project/service to be funded. Please address the following: 1. Who will be served? 2. How will this project serve Apache Junction proper residents? 3. What services will be provided? 4. What are the benefits? 5. Provide a timeline and who is responsible. 6. Where will the services be provided? 7. How will you provide the services? 8. Are there any community partners in this project? If so, please list. 9. What is the project/service and agency goals? 10.How and will you sustain this project after the agreement has ended? The Azura VITA program addresses a critical, yet often overlooked, financial need within the community by serving residents across the economic spectrum who are burdened by the high cost of tax preparation. Azura VITA actively serves Apache Junction residents through our surrounding East Valley locations. We provide these residents with the same high-quality, free tax preparation and financial coaching that has returned millions of dollars to our regional community. For many in Apache Junction, our service is the key to accessing vital federal and state refunds without incurring prohibitive filing fees. The Azura VITA program proposes to utilize funding to expand the outreach, promotion, and service capacity of our established free tax preparation program, with a dedicated focus on ensuring residents of Apache Junction can fully access these vital services. We will serve low- to moderate-income individuals and families across the East Valley, specifically targeting Apache Junction residents for whom the average $500 cost of professional tax preparation is a prohibitive barrier to filing. This includes seniors, veterans, and individuals with disabilities. Currently, Apache Junction residents must travel to our existing sites in neighboring cities; this project will actively bridge that gap by directing resources to ensure these residents are aware of, and can readily utilize, our services at these accessible locations, securing refunds and credits that would otherwise be lost. The services provided are comprehensive and designed for both immediate impact and long-term financial empowerment. Our core offering is free, high- quality tax preparation and e-filing conducted by IRS-certified "Advanced" volunteers, ensuring clients claim all eligible credits like the Earned Income Tax Credit. This transactional service is integrated with immediate financial coaching during the appointment, where clients receive personalized guidance on allocating refunds towards debt, savings, or essential needs. Furthermore, we provide structured financial literacy education through mini-courses and referrals to monthly workshops in partnership with the YWCA, covering topics from budgeting to safe banking. All services are accessible, with bilingual interviews (English/Spanish) and accommodations for other languages and ASL interpretation. The benefits of this project are multi-layered and significant. The direct financial benefit saves each client approximately $500 in preparation fees while injecting their full refunds—often totaling thousands of dollars—directly into household budgets and the local Apache Junction economy. This addresses immediate economic needs and fosters long-term stability. Beyond dollars, the program delivers economic justice by removing a systemic barrier, reduces the profound stress associated with tax season through a trusted, judgment-free service, and unlocks future opportunities by helping clients resolve prior-year filings necessary for processes like FAFSA applications. The program operates on a clear, annual timeline managed by our three full- time staff. Volunteer recruitment and training occur from August through December. The peak service season runs from January to April at our network of 11 seasonal VITA sites across Mesa, Chandler, and Gilbert. Year-round services, including for complex prior-year returns, continue from May through October at our permanent Mesa site. Services are delivered directly at these trusted community locations—including public libraries, community colleges, and nonprofit centers—through our corps of dedicated volunteers, who benefit from a high retention rate exceeding 85% due to robust training, support, and recognition. This project is inherently collaborative, built upon strong community partnerships. Our host site partners, including AZCEND, Chandler Care Center, City of Chandler libraries, Chandler-Gilbert Community College, Mesa Community College, and the City of Mesa library, provide essential in-kind support through space and equipment and actively promote our services. We also partner with the YWCA and other financial institutions to deliver financial literacy workshops and we are an active member of the Central Arizona VITA Network (CAVN), collaborating with five other regional VITA programs on training and best practices. The overarching project goal is to significantly increase the number of Apache Junction residents served, ensuring they retain more of their income and gain critical financial knowledge. This aligns directly with our agency's mission to strengthen financial stability through free tax preparation as a gateway to wellness. Sustainability after the grant period is assured as the VITA program is a permanent, core service of our agency. It is supported by a diversified funding model including ongoing support from the IRS, other municipalities, corporate partners, and individual donors. Our cost-effective volunteer delivery model and long-standing in-kind partnerships with host sites ensure the program's continued operation and ability to serve Apache Junction residents as part of our enduring commitment to the East Valley community. This year's current locations are as follows: Azura VITA 137 E University Dr Mesa AZ 85201 Chandler Gilbert Community College Sun Lakes 25105 S Alma School Rd 85248 Chandler Gilbert Community College Williams campus 5915 S Kent St. Mesa 85212 Chandler Gilbert Community College Peco 2626 E Peco Rd Chandler 85225 Chandler Care Center 777 E Galveston t Chandler 85225 Gilbert Heritage AZCEND 132 W Bruce Ave Gilbert 85233 Hamilton Library 3700 S Arizona Ave Chandler 85248 Mesa Community College Main Campus 1833 W Southern Ave Mesa 85202 Mesa Community College Red Mt. Acacia Village 2305 N Power Rd Mesa 85215 Red Mt Library 635 N Power Rd. Mesa 85205 Sunset Library 4930 W Ray Rd Chandler 85226 Some key elements in our management of this program: 1. We maintain consistency in the operation of all sites and services to taxpayers. 2. Our site coordinators are trained and follow all IRS rules in their operations. 3. All volunteers are certified as "advanced" tax preparers to provide a higher level of knowledge and service to clients. 4. Additional reference materials (beyond that required/produced by the IRS) are prepared by Azura and provided to all sites. 5. We start training new, and recurring, volunteers well in advance to ensure all preparers are certified and able to serve clients effectively. We even provide additional training for recurring volunteers who want to expand their tax preparation knowledge. 6. Volunteers are the cornerstone of our programming, and we make sure they know it! Over 85% of our volunteers return to the program every year. We host end-of-year thank-you events for them, provide training and make sure to supply food/drinks every time they help us. 7. We maintain good relationships with host sites and other community partners resulting in long-term partnerships to support our program every year. 8. We have very experienced staff, with tenure, who maintain consistency in the program year-over-year. Azura's marketing team deploys the following tactics to communicate our services: 1. Social media posts through Facebook, Twitter, and ourwebsite. Our partners provide links to the Azura & VITAwebsite and social media accounts. 2. Printing and distribution of bilingual flyers are widely distributed to potential clients. 3. Networking with other service organizations—we have an active/current distribution list of non-profit contacts throughout the Valley to promote the VITA program. 4. Targeted flyer distribution—We provide flyers to food box distribution sites and put them in each food box that is passed out to people in need. 5. Posters are placed at each tax preparation site by the end of December to alert the public to the services and hours at each site. 6. The IRS provides many referrals to our VITA program throughout the year. The Mesa VITA Flyers are handed out by the Mesa IRS office. 7. We partner with large employers to provide information on our services to their staff. Our Proven Impact: Over the past 16 years, we have prepared more than 73,000 tax returns, securing over $82 million in refunds for our community's most vulnerable members. This vital infusion of capital helps families meet essential needs, reduce debt, and build savings. There is also an emotional impact. For many, tax season is daunting—especially for those facing challenges with language, education, or technology. VITA offers a judgment-free, personalized experience that helps ease anxiety and fosters trust and dignity. Clients leave with more than a filed return—they leave with peace of mind and a renewed sense of control over their finances. Our program's continuing mission: Our program directly addresses the priority need for financial education and literacy by transforming a critical annual event—tax preparation—into a sustained, accessible, and actionable gateway to financial learning and empowerment. We fulfill this specific community need through a structured, two-tiered approach: 1. Immediate, Integrated Education at the Tax Moment: Tax time is a teachable moment when individuals are most engaged with their financial data. Our VITA service is not merely transactional; it is an educational intervention. Our IRS-certified volunteers and coaches provide: • Credit Claiming Education: We explain the purpose and impact of key tax credits (EITC, Child Tax Credit), turning a complex form into a lesson on public benefits and income supplementation. • Financial Product Literacy: We educate clients on the differences between high-cost check-cashing services and low- or no-cost banking products, often facilitating direct access to safe accounts. • One-on-One Coaching: Clients receive immediate, personalized coaching on their specific tax outcome—whether discussing how to allocate a refund toward debt reduction, emergency savings, or other financial goals. 2. Planned Expansion to Address Systemic Educational Gaps: Recognizing that brief annual interactions are insufficient to change long-term financial trajectories, our 5-year expansion plan is specifically designed to fill identified educational gaps in our community: • FAFSA Guidance: Addresses the profound need for post-secondary education access education. Many low-income families are intimidated by the FAFSA's complexity, leaving critical financial aid untapped. We will provide step-by-step education to demystify the process. • IRS Debt Forgiveness Guidance: Addresses the need for navigating complex public systems. We will educate eligible clients on programs like Offer in Compromise, providing knowledge to resolve debilitating tax debt. • Dedicated Financial Education Workshops: Moves us from sporadic coaching to structured curriculum-based learning on core topics like credit building, budgeting, and debt management. • Payday/Title Loan Debt Pathway: Provides crisis-specific financial education. This program will educate clients on the true cost of predatory loans, strategies for alternative short-term financing, and structured debt exit plans. Project/Service Budget: Provide a detailed project budget and narrative based on activities indicated above including: 1. We are requesting $15,800.00 2. In the 2025-26 Fiscal year we received $259,550 in funding from government grants, city grants, and private grants. We will be applying for all these funding sources for the 2026-27 fiscal year. Here is a summary of our current projections. 2026-27 Grant Projections IRS Grant $ 210,000.00 City of Mesa Grant $ 50,000.00 City of Chandler Grant $ 20,000.00 Flagstar Grant $ 20,000.00 Wells Fargo Grant $ 23,550.00 Total $254,750 3. Amount of funding provided by partners (including source): See number 2 of attached required documents. 4. Our primary expenses are wages for those who direct and coordinate the program, office supplies, volunteer recognition, new equipment, and IT services. We also have software, training, printing, and marketing expenses. We strive to keep our indirect costs as low as possible and maximize the funding used for direct services. 5. The requested amount is 5% of our project budget for 2026-27 fiscal year. 6. As we are a non-profit and funding is always tight, we would appreciate any assistance to help the residents of Apache Junction. City of Apache Junction HEALTH & HUMAN SERVICES COMMISSION d�Fi Request for Financial Assistance ; Application Cover Sheet Name of Agency: r L Mailing Address: I ` ( Ci Pa��e SvL� � n rl t - �S)20 Street Address: r-�] Phone: �5 z-- + ✓ Z g 5 3 Agency Director: ar ke Earley Email Address: �y���� . wlrt,+ar _01S�k ' Direct Line: (� 2 3 -?� Project Manager: Todd RX0 15h b �� . Pvn 50r-COO r� Email Address: � y Direct Line: P-9 y Project: 16,tl &too Total Amount requested: A �) 0 0 Population and number of people to be served: 26 �f 1 Q rg L4 � 5'ed �00 U,54/ zq Agency Description: Please provide a brief description of your organization's history, experience, and services provided. Please address the following: 1. Has your agency received funding from Apache Junction in the past? If yes.. a. What was the year b. Amount, c. Project/Service d. How your agency met the expectations of the funding agreement. 2. Purpose of the agency 3. Type of agency 4. Services provided 5. Provide target population and demographic information on your current clientele to include percentage located within the City of Apache Junction 6. Explain how your agency will have adequate capacity to complete the project/service being requested. 7. Provide a list of your annual fundraisers and average amount raised. 8. Are you listed on the www.2llArizona.org website? 9. Have you participated in the following: a Project Connect event, a Health and Wellness Expo or the Apache Junction Community Resource Center in the past? Project/Service Description: Please describe the proposed project/service to be funded. Please address the following: 1 . Who will be served? 2. How will this project serve Apache Junction proper residents? 3. What services will be provided? 4. What are the benefits? 5. Provide a timeline and who is responsible. 6. Where will the services be provided? 7. How will you provide the services? 8. Are there any community partners in this project? If so, please list. 9. What is the project/service and agency goals? 10. How and will you sustain this project after the agreement has ended? Project/Service Budget: Provide a detailed project budget and narrative based on activities indicated above including: 1. Amount being requested 2. Amount of funding provided by your agency (include source) 3. Amount of funding provided by partners (include source) 4. A detailed narrative of the costs 5. What percentage of your agency's total annual budget is this funding request? St-SINESS LICENSE EEP,3 '2S pmIT-13 1 6. Indicate if you would accept partial funding and if so, provide the minimum amount and how your project will change. a op t A a-0 vJ SQ���y ���� W a 4- 00 Lor, , _ ( 1 p V �VN 5 r�n5 1 I� 2 D x k L �-V for .��,ob° , T►�' � 13P� t a{5 �("kCt a Pro sP �bK-'� �1 W1 o 6 /Tniuf an � �5 lS , 150 �a� P" �e C 1^C�� veer ` pf\ok�� ° a ur c1 N4\�- b ,Owq Vi }xr) i 5 �r Via +� �r c�5 a ') �o >�� UJ o� "( � W04 ��kr� a �� y � x 2.D� Y I yo LU LOB° =Li- m p4 PePICHf�G'Yn City of Apache Junction '^ = HEALTH & HUMAN SERVICES COMMISSIONS=, � gR,o�A Request for Financial Assistance Application Cover Sheet Name of Agency- Boys & Girls Clubs of the Valley (BGCAZ) Mailing Address- 4309 E. Belleview Street, Building 14, Phoenix, AZ 85008-5409 Street Address- 4309 E. Belleview Street, Building 14, Phoenix, AZ 85008-5409 Phone- 602-954-8182 Agency Director: Marcia Mintz, President & CEO Email Address: marcia.mintz@becaz.org Direct Line: 602-954-8182 Project Manager: Heather Budzien, Vice President of Programs & Branches Email Address: heather.budzien@becaz.org Direct Line: 602-954-8182 Project: Out of School Time Programs for Apache Junction Youth Total Amount requested: $30,000 Population and number of people to be served: The Superstition Mountain Branch of Boys & Girls Clubs will serve 250 youth, ages 5- 18. 45% of members at this Branch live at or below 100% of the Federal Poverty Level and 54% live with a single parent or adults other than biological parents, including grandparents and foster guardians. 60% of members served at this Club are Apache Junction residents. Agency Description: Please provide a brief description of your organization's history, experience, and services provided. Please address the following: 1. Has your agency received funding from Apache Junction in the past? If yes: a. What was the year b. Amount, c. Project/Service d. How your agency met the expectations of the funding agreement. Yes. Boys & Girls Clubs of the Valley is grateful to be a consistent recipient of funding from Apache Junction. Our most recent award is FY25-26, for $9,000 to support youth mentorship programming and financial assistance for low-income families. As of 12/31/25, we have provided $5,040 in financial assistance for Apache Junction families (of the $3,000 in our agreement) and have allocated $4,163 towards direct service staff salaries for youth mentorship (of the $6,000 allocated in our agreement). To date, we have served 179 youth at the Superstition Mountain Branch in Apache Junction, with 109 being Apache Junction residents. 2. Purpose of the agency Boys & Girls Clubs of the Valley offers affordable after-school and summer programs for over 20,000 young people in grades K-12. In 31 Clubs across Arizona, BGCAZ provides award-winning programs designed to change the lives of young people. For 80 years, BGCAZ has been creating equity and opportunity for youth through academic, social, and workforce opportunities. We help young people make healthy decisions and focus on social development to build resilient young adults. Most importantly, we work to develop strong character and leadership skills by creating positive connections to caring adults and their community. Boys & Girls Clubs employs a Formula for Impact for how the organization impacts the life of a child. Our programs are organized around four Priority Outcomes: Health & Well-Being; Academic Success; Character & Leadership; and Life & Workforce Readiness. 3. Type of agency Boy & Girls Clubs of the Valley is recognized by the Internal Revenue Services as a 501(c)(3) nonprofit organization. 4. Services provided Superstition Mountain Boys & Girls Club, located at 2805 S. Ironwood Drive, Apache Junction, AZ 85120, is open Monday through Friday from 2:00 p.m. to 7:00 p.m. during the school year, with adjusted hours for early release days. When school is not in session, the Club operates full-day hours from 7:00 a.m. to 6:00 p.m., providing a safe, enriching environment for youth. All members receive nutritious meals and snacks daily. As of FY2026, the Superstition Mountain Branch is also a designated 21st Century Community Learning Center (21st CCLC) site (partnered with Cactus Canyon Junior High). This designation enhances the Club's ability to offer structured, standards- aligned academic programming and deeper community partnerships to support student success. Youth are grouped by age and rotate through daily activities that align with BGCAZ's four Priority Outcome Areas: 1. Academic Success The day begins with academic support, including homework help and tutoring, to reinforce learning from the school day. Youth also participate in STEAM-focused modules (Science, Technology, Engineering, Arts, and Math) that foster curiosity and build skills for future careers. In fact, 50% of the Club's program time and budget is dedicated to Academic Success activities. 2. Health & Wellness Clubs promote physical and mental health through individual and team sports, cooking clubs, and wellness activities that help members build lifelong habits. Youth also learn how to manage stress, recognize emotions, and make healthy decisions, aligning with BGCAZ's Whole Child Approach and FY26 Health & 3. Character & Leadership Youth are mentored by trained staff who model positive behavior and support members in building respect, empathy, and citizenship. Older members are encouraged to take on leadership roles within the Club and participate in service projects that benefit the community. 4. Life & Workforce Readiness As youth progress toward high school, they engage in programs that help them explore interests, learn job-readiness skills, and prepare for future employment. This includes resume writing, mock interviews, and opportunities for job shadowing and paid internships, helping them develop confidence and career direction. In all these areas, programming is intentionally designed to close equity gaps for youth from low-income households, many of whom face barriers to accessing high-quality enrichment, tutoring, or mentoring elsewhere. BGCAZ's presence in Apache Junction ensures that all children, regardless of background, have the opportunity to thrive academically, socially, and emotionally. 5. Provide target population and demographic information on your current clientele to include percentage located within the City of Apache Junction The Superstition Mountain Club, for FY26-27, will serve 250 youth members. Those served are between the ages of 5 and 18. 46% of members at this Club identify as persons of color (44%); 45% come from families living at or below 100% of the Federal Poverty Level; and 54% live with a single parent or adults other than biological parents, including members of the child welfare system. Of the 250 members who served at the Superstition Mountain Club, 60% are residents of Apache Junction, with the balance coming from nearby communities. 6. Explain how your agency will have adequate capacity to complete the project/service being requested. Boys & Girls Clubs of the Valley (BGCAZ) has been serving youth in Arizona since 1946. Our Superstition Mountain Branch in Apache Junction is a well-established part of the community and has strong relationships with local schools and the Apache Junction Unified School District. As of FY2026, this site is also a 21st Century Community Learning Center (21st CCLC), which allows us to expand our academic and enrichment programming even further. Each year, BGCAZ serves more than 20,000 youth across 31 Club locations, including the Superstition Mountain Branch. We have the staff, systems, and experience needed to keep programs running smoothly and safely. Our trained youth development professionals are supported by a strong operations team that ensures quality across all sites. Our Clubs also play a key role in helping families stay employed. In fact, 93% of BGCAZ families say the Club helps them keep their jobs by giving their kids a safe, reliable place to go after school. We're proud to provide a space where youth are supported and parents have peace of mind 7. Provide a list of your annual fundraisers and average amount raised. Boys & Girls Clubs of the Valley hosts several annual fundraising events that support all of our Clubs, including Apache Junction. These events help us cover administrative costs and expand programs that serve youth across the Valley. STARS Gala — $2,000,000 Avondale Cup — $100,000 Connect Brunch — $100,000 In addition, Yesteryear is a local event that directly supports our Superstition Mountain Branch in Apache Junction, raising an average of $40,000 each year. Funds from Yesteryear stay in the community and help us offer affordable, high-quality programs for local youth and families. 8. Are you listed on the www.211Arizona.org website? Yes. Boys & Girls Clubs of the Valley is listed on ;ww.211Arizona.orq. 9. Have you participated in the following: a Project Connect event, a Health and Wellness Expo or the Apache Junction Community Resource Center in the past? Yes, BGCAZ has participated in the past. We recently added two positions to our agency — a Vice President of Regional Impact, and Director of External Affairs. Both of these positions are designed to support our agency and individual Clubs in engaging in more community events and community partnerships. Project/Service Description: Please describe the proposed project/service to be funded. Please address the following: 1 . Who will be served? BGCAZ provides services to any youth, ages 5 to 18, and their families. 2. How will this project serve Apache Junction proper residents? Youth in Apache Junction benefit directly from high-quality programs at our Superstition Mountain Branch that help them stay on track in school, graduate on time, and plan for life after high school, whether that means college, trade school, or entering the workforce. Just as important, they have a safe place to go during out-of-school hours, which helps reduce the risks that come with unsupervised time and lowers the potential strain on law enforcement and other community resources. BGCAZ keeps program fees as low as possible so families can access care. For those who still cannot afford it, we offer fee waivers thanks to generous donor support. No child is ever turned away due to a family's financial situation. The benefits of BGCAZ programs extend beyond the individual youth we serve. A 2025 independent study by ASU's Seidman Institute found that every $1 invested in BGCAZ results in $14.79 in social and economic value returned to the community. Supporting Apache Junction youth helps build stronger families and a stronger community overall. 3. What services will be provided? Boys & Girls Clubs of the Valley provides high-quality, out-of-school-time programs for youth ages 5 to 18. These services are offered after school during the academic year, including on early release days, and full-day during school breaks and summer. Programming is designed to meet the needs of working families while helping youth build the skills and confidence they need to succeed. All activities align with BGCAZ's four Priority Outcomes: 1. Academic Success — Helping youth become self-directed learners who succeed in school through homework help, tutoring, STEAM activities, and academic enrichment. 2. Health & Wellness — Supporting young people in making informed, healthy decisions that strengthen their physical, mental, and emotional well-being. 3. Character & Leadership — Encouraging youth to stay true to their values, show good citizenship, and create positive change in their Club and community. 4. Life & Workforce Readiness — Preparing young people to navigate adulthood and explore career pathways with programs that build confidence, time management, and financial literacy skills. Programs are led by trained staff in a safe, supportive environment, giving youth the tools they need to thrive today and into the future. 4. What are the benefits? Boys & Girls Clubs of the Valley helps youth in Apache Junction build confidence, develop life skills, and stay on a positive path. When young people are supported after school and during school breaks, they are more likely to succeed in school, avoid risky behaviors, and build strong relationships with peers and mentors. Families benefit from having access to consistent, affordable care. This allows parents and guardians to work or pursue education, knowing their children are safe and engaged in meaningful activities. The broader impact goes even further. An independent study by ASU's Seidman Institute found that our programs contribute to higher high school graduation rates, reduced food insecurity, and better job retention for working parents. These outcomes not only benefit individual families but also strengthen the entire Apache Junction community. (Economic Impact Summary attached in this packet) 5. Provide a timeline and who is responsible. Boys & Girls Clubs of the Valley offers programming year-round. Our schedule generally follows the school calendar, with after-school programs running from August through May and full-day programs offered during school breaks and summer. Club members renew their membership each July before the new school year begins, but new members can register at any time. At the organizational level, BGCAZ is led by an experienced leadership team: • Marcia Mintz, President & CEO, has led BGCAZ since 2016. She brings more than 20 years of experience in both the nonprofit and corporate sectors and holds a Master's in Business Administration. • Swati Webb, Chief Financial Officer and Vice President of Business Operations, oversees all financial, HR, facilities, and technology operations. She has been with BGCAZ since 2005. • Heather Budzien, Vice President of Programs and Branches, is responsible for the design and delivery of programs across all Club locations. She has held leadership roles within BGCAZ since 2008 and holds a Master's in Management. • Liz Byrne, Vice President of Regional Impact, helps ensure that Clubs remain responsive to local community needs and partnerships. At the Superstition Mountain Branch, Angela Davis serves as Branch Director. She oversees daily operations, leads the on-site staff team, and maintains strong relationships with members, families, and community partners. Ms. Davis has led the Apache Junction Club since 2013. 6. Where will the services be provided? Services are provided at the Superstition Mountain Boys & Girls Club, 2805 South Ironwood Drive, Apache Junction, Arizona, 85120. 7. How will you provide the services? Services are delivered in person at the Superstition Mountain Branch by trained and caring staff who are experienced in working with youth. Programming takes place in a safe, welcoming Club environment designed to support academic growth, healthy habits, and positive relationships. Transportation is provided by local elementary schools in most cases, making it easier for younger members to get to the Club each day. Middle and high school students typically walk, since their campuses are located nearby. Once at the Club, youth follow a structured daily schedule that includes homework help, enrichment activities, recreation, and more. All staff receive ongoing training to ensure consistent, trauma-informed, high-quality experiences for members at every age and stage. 8. Are there any community partners in this project? If so, please list. Yes. BGCAZ is deeply connected to the communities we serve, and our Superstition Mountain Branch is no exception. We work closely with local elementary, middle, and high schools in Apache Junction to coordinate transportation for students, share Club information with families, and support youth during distance learning or school-based activities. We also partner with the Apache Junction Police and Fire Departments, as well as the Parks and Recreation Department, to offer safety workshops and community engagement opportunities for our members. The Club frequently hosts guest speakers, local sports teams, and city leaders to help connect youth with their community. In addition, we are proud to partner with the Apache Junction Mounted Rangers and a group of dedicated local residents led by Connie Van Driel, who organize fundraisers and advocate on behalf of the Superstition Mountain Branch. Their support plays a vital role in helping us keep services accessible for Apache Junction families. 9. What is the project/service and agency goals? As a newly designated 21st Century Community Learning Center (21st CCLC) site, the Superstition Mountain Branch is committed to specific program goals that align with state and federal standards for academic and youth development outcomes. These goals guide our daily programming and ensure measurable progress for youth and families in Apache Junction. Academic Objectives • By the end of each program year, at least 40% of all regular attendees will improve their reading scores by 4 percentage points, based on pre- and post- assessments provided by the school district. • By the end of each program year, at least 40% of all regular attendees will improve their math scores by 3 percentage points, as measured by the same method. Youth Development Objectives • At least 70% of regular attendees will show growth in one or more youth development indicators, such as perseverance, growth mindset, or social awareness, as measured through a program-created pre- and post-survey. • At least 70% of regular attendees will demonstrate improved skills in managing peer conflict and problem-solving, based on a student check-in tool developed by the program team. Family Engagement Objective • At least 30% of family members of regular attendees will participate in one or more literacy or education-focused engagement opportunities, as tracked through attendance records. In addition to these site-specific goals, BGCAZ has established broader outcome targets across all Club locations to be reached by June 30, 2026: • 85% of K-12 members will participate in homework help or academic enrichment. • 65% of participating members will report improved learning mindsets and academic identity. • 65% will report building healthy habits related to physical activity, decision- making, and resisting peer pressure. • 65% of teens will report stronger confidence in time management, financial literacy, and post-secondary planning. These goals are measured through tools like the National Youth Outcomes Initiative (NYOI) survey and site-based evaluations. Results guide continuous improvement and help ensure we deliver effective, high-impact programs to Apache Junction youth and families. 10.How and will you sustain this project after the agreement has ended? BGCAZ has a strong, diversified fund development strategy in place to sustain this project and all of our Club operations. We raise funds through a mix of individual donors, corporate and foundation grants, government service contracts, and well- established fundraising events. This balanced approach helps ensure long-term stability and reduces reliance on any single funding source. We also invest in ongoing community engagement and digital media efforts to share our impact and attract continued support. BGCAZ is fiscally sound, with a proven track record of not only maintaining but growing services across our network of Clubs. With your support, we are confident that we can continue offering high-quality programs at the Superstition Mountain Branch well beyond the end of this agreement. Project/Service Budget: Provide a detailed project budget and narrative based on activities indicated above including: 1. Amount being requested BGCAZ respectfully requests an award of $30,000 to support services for Apache Junction youth at the Superstition Mountain Branch. This funding would help cover salaries and benefits for the trained youth development professionals who deliver mentorship, academic support, and enrichment programming every day. While financial assistance does not appear as a direct expense in our budget, it is reflected as reduced revenue from program fees. By investing in staff salaries, this award directly supports our ability to provide high-quality programs and make them accessible to all families, regardless of income. 2. Amount of funding provided by your agency (include source) 3. Amount of funding provided by partners include source Line Item Apache Other Sources Sources of Junction Funds REVENUE Special Events (net $119,262 Organizational expenses) Fundraisers Contributions $145,924 Corporate & Foundation Grants, Individual Donations Govt. Funding $30,000 $139,667 Food Program, AZ Dept. of Education, Pinal Count In-Kind $10,000 Community Donations Club Revenues (net $47,723 Membership fees, financial assistance) monthly fees less financial TOTAL $30,000 $462,576 $492,576 EXPENSES Salaries $26,000 $342,038 ERE (Benefits & Payroll $4,000 $37,475 Taxes Contracted Services $1 ,620 Communications $4,490 Program Supplies $53,750 Occupancy (Rent, Utilities $87,850 Building & Grounds Transportation $3,025 Travel/Meetings/Conferences $400 Membership Dues/Support to $4,136 Affiliate Organizations Non-Payroll Insurance $19,330 TOTAL $30,000 $462,576 $492,576 4. A detailed narrative of the costs The total club budget is $492,576 covering the following: Salaries: Direct program staff salaries who provide daily enrichment activities and mentorship to youth ERE: Includes taxes and other Employee Related Expenses for direct service staff. Contracted Services: Covers contracted staff through Terros Health for Behavioral Health Technicians embedded in Clubs to facilitate our Whole Child Approach focusing on mental and emotional wellness. Communications (phone, fax, modem, postage): Phone, internet, and copying. Program Supplies: Direct service program supplies, including foods for healthy meals and snacks. Occupancy: Building occupancy including utilities and facility maintenance. Travel/Meetings/Conferences: Costs for staff training. Transportation: Reflects transportation costs for staff to attend agency training events, field trip transportation, etc. Membership Dues: Allocation of costs to remain affiliated with Boys & Girls Clubs of America Non-Payroll Insurance: Includes liability and other non-payroll insurance. 5. What percentage of your agency's total annual budget is this funding request? With an annual operating budget of$28,261,720, this request represents less than 1% of our total budget, and 6% of the Superstition Mountain Club Budget. 6. Indicate if you would accept partial funding and if so, provide the minimum amount and how your project will change. Yes, Boys & Girls Clubs of the Valley would accept partial funding. While the request reflects the true cost of delivering high-quality programs at the Superstition Mountain Branch, we are committed to ensuring that Apache Junction youth continue receiving safe, supportive, and enriching services regardless of the funding level. We recognize that your investment represents a meaningful commitment to this community, and we value the partnership. Your support helps us keep program fees low, provide scholarships to families in need, and enhance the quality of experiences we offer to local youth. Should partial funding be awarded, BGCAZ would not reduce services, but we would need to adjust internal resources or seek additional funding to close the gap. TQ:ZW'3 9& City of Apache Junction HEALTH & HUMAN SERVICES COMMISSION 0�+� Request for Financial Assistance Application Cover Sheet Name of Agency: G" °F "fac" TkKC+-i°N Mailing Address: '(). pac p � Tt� �,,A2 $S('o!0 Street Address: 35( N � '��' Lof133 �TtL-h� �2 SS faZa Phone: (00) ag4-9a04 Agency Director: J Email Address: Direct Line: C30) da9-9a()4 Project Manager: Lm�e,YAtiwvl Email Address: "MtX Q J*\xk(,CVM Direct Line: `(q) -3ya-;431 Project: YW, Sarou Total Amount requested: a�poo W Popu lation an d n u mber of people to be served: U �.Dd �; 60"J- �,,, Ouw VcLho.� ?roa)rtLP"- a Ca to vat ke- e,Qh'waly. Aft JU ww4C ww do 1 Wpm prpo4�4 Tiw bal veii�su TO:ZHJ oz;sZ NUf 301ijo S:M]1 0 hil Agency Description: Please provide a brief description of your organization's history, experience, and services provided. Please address the following: 1. Has your agency received funding from Apache Junction in the past? If yes: Weuco-k e4wLEh a. What was the year K/A. b. Amount, c. Project/Service d. How your agency met the expectations of the funding agreement. 2. Purpose of the agency- $Q.�,;,no�t1;&W(&rev 1- c%,-- {y, 3. Type of agency - S4";Ce"cin,LAM/o)uA P0bf4+ 4. Services provided- L''UJe&on T1 a U,%&*5vAMes/swill} A.-it, 5. Provide target population and demographic information on your current clientele to include percentage located within the City of Apache Junction - Lilt c N CINAt Sofia, a 6. Explain how your agency will have adequate capacity tp complete the project/service being requested.-txJ Ho►ti %I deA- Me.k64-3 ib c,"pi tt c, .r P",n t;, 7. Provide a list of your annual fundraisers and average amount raised.-L,S Q tU FAah�*R 8. Are you listed on the www.211Arizona.org website? 1J* �+q 9. Have you participated in the following: a Project Connect event, a Health and Wellness Expo or the Apache Junction Community Resource Center in the past? N/d, P VAN 6AAAea -� WIXk A AC^\y (dos E,6►. L.Af1U.) Project/Service Description: Please describe the proposed project/service to be funded. Please address the following: 1. Who will be served? Spec;m\ S"e-\h-6 U:14 .k Q..';"s WA aft MO. NJ 2. How will this project serve Apache Junction proper residents?- Au P aL&%c are 3. What services will be provided?-snarl'Q -q-MZS proi mm, Sk.•+d4aT, UBnjrs�G+�cC4b+fa( 4. What are the benefits?--7,� � eayo,ojsw�t+lacc. M.wSwt1.1(�� 5. Provide a timeline and who is responsible.- 6VgoIN-*d) "*At; "t 0&Y40, t c4,•6 Lem 6. Where will the services be provided?-jpac4Q 31-nd-b-,,v"-,%*-s 1-c-%t7a%X. 7. How will you provide the services?-C1,,,.(.bl:+.,4r.,,,3* Gl....l. AA&*%kw s -WMt41+AMy 8. Are there any community partners in this project? If so, please list. � 4*u; D7 9. What is the project/service and agency goals?-1 AM a�trls � 10.H�eQw and will you sustain this project after the agreement has ended? Gold vS FVnV LM 4 0AY pwri OC c►s. o 6Jlet,IJt will 61P 4s�t(f la olo MOM ?n r1a ca►+tNtwr� 61-ta w w�jk•* 11QT Q-: .�., Project/Service Budget: Provide a detailed project budget and narrative based on activities indicated above including: 1. Amount being requested fa,oal& 2. Amount of funding provided by your agency (include source)h4i000(C. ral I..dmr ws) 3. Amount of funding provided by partners (include source) WA 4. A detailed narrative of the costs - „� „�o," Fa( $wdq-4 5. What percentage of your agency's total annual budget is this funding request? 3390 TO:zHd sz,sZ NUf 3a1JJ0 s: d3]a Al" r� 6. Indicate if you would accept partial funding and if so, provide the minimum amount and how your project will change. ,a W-r"e"► ' SaKe dC- rl*- Gr.4, 6-Lt Ko al( o� t1V ve�L'ejt' d 91,6003 c.-e k",u e tv sla�Q b or, t1w bit a."cl/or cut sew:c". �0 Pe01 ✓G1 City of Apache Junction �Z HEALTH & HUMAN SERVICES COMMISSION gA/ZONp' Request for Financial Assistance M M Application Cover Sheet Name of Agency: NAZCARE Inc Mailing Address: 8128 E State Route 69 Prescott Valley AZ 86314 Street Address: 879 N Plaza Dr Suite E101 Apache Junction AZ 85120 Phone: 928-442-9205 Agency Director: CEO Greg Billi Email Address: gbilli@nazcare.org Direct Line: 928-830-6116 Project Manager: Ashley Leiker Email Address: aleiker@nazcare.org Direct Line: 928-273-3310 Project: Rising Star Wellness Center Renovations Total Amount requested: $62400 Population and number of people to be served: - 50 Agency Description: Please provide a brief description of your organization's history, experience, and services provided. Please address the following: 1. Has your agency received funding from Apache Junction in the past? If yes: a. What was the year b. Amount, c. Project/Service d. How your agency met the expectations of the funding agreement. Our organization has not yet received funds from the city of Apache Junction. 2. Purpose of the agency: NAZCARE provides mental health, transportation, counseling, and housing services to Apache Junction residents in need. Repairing our building would ensure it can continue to be a safe space to live and receive services in for years to come, as we continue to empower Apache Junction's low-income and critically disabled population. 3. Type of agency: Mental Health Services, 501(C)(3) non-profit 4. Services provided NAZCARE offers: • One-on-one Peer Support • Education on Monitoring Skills • Wellness Planning/Whole Health Management • Recreational Activities • Employment Readiness • Arts/C rafts • Exercise • Diet/Nutrition • Socialization • Life Skills • Support Services • Integrated Wellness • Community Integration • Peer Whole Health/Wellness Checks • SMART (all substance abuse) Recovery 5. Provide target population and demographic information on your current clientele to include percentage located within the City of Apache Junction At Rising Star 100% of current clientele are located within the city. The demographic group is LMI and critically disabled SMI persons, and the goal is rehabilitation through socialization and community integration. 6. Explain how your agency will have adequate capacity to complete the project/service being requested. Repairs to the building in Rising Star will be completed by our contractor James Talavera. 7. Provide a list of your annual fundraisers and average amount raised. NAZCARE does not hold fundraisers but rather maintains regular income through insurance billing for mental health services performed. 8. Are you listed on the www.2llArizona.org website? Yes. 9. Have you participated in the following: a Project Connect event, a Health and Wellness Expo or the Apache Junction Community Resource Center in the past? No. Project/Service Description: Please describe the proposed project/service to be funded. Please address the following: 1. Who will be served? Clienteles who attend the Rising Star Wellness Center in the heart of Apache Junction. 2. How will this project serve Apache Junction proper residents? By ensuring safe facilities for services to be delivered in. 3. What services will be provided? One-on-one Peer Support Education on Monitoring Skills Wellness Planning/Whole Health Management Recreational Activities Employment Readiness Arts/Crafts Exercise Diet/Nutrition Socialization Life Skills Support Services Integrated Wellness Community Integration Peer Whole Health/Wellness Checks SMART (all substance abuse) Recovery 4. What are the benefits? Community re-integration of SMI persons, stability and recovery of former substance users, improvement of Apache Junction Community through addition of upstanding citizens who have received treatment at Rising Star. 5. Provide a timeline and who is responsible. 6. James Talavera will be responsible for building renovations that will improve environmental issues that affect clientele's attending the center. The timeline of renovations is that the project will be performed within the year that grant money is received. 7. Where will the services be provided? On location at 879 N Plaza Dr Suite E101 Apache Junction AZ 85120 8. How will you provide the services? Services are provided weekdays at the center from 9AM to 4PM. 9. Are there any community partners in this project? If so, please list. No. 10.What is the project/service and agency goals? NAZCARE's mission is to provide quality, evidence-based behavioral health, peer-support, and housing services to individuals and families with mental, co- occurring, and substance use disorders, promoting recovery, wellness, and empowerment. They focus on offering consumer-operated services across rural Arizona. 11.How and will you sustain this project after the agreement has ended? Renovations to our building will further our mission of providing a safe, stable place for our peers to receive treatment. Project/Service Budget: Provide a detailed project budget and narrative based on activities indicated above including: 1. Amount being requested $62400 2. Amount of funding provided by your agency (include source) If the project were to cost more, we would meet those costs. 3. Amount of funding provided by partners (include source) There is no other source of funding for this project. 4. A detailed narrative of the costs See attached. 5. What percentage of your agency's total annual budget is this funding request? n/a 6. Indicate if you would accept partial funding and if so, provide the minimum amount and how your project will change. We would accept partial funding, ideally $3000 for fixing the window trims, which would improve insolation — especially important the hot, A/C heavy summer months. City of Apache Junction IUi 00 HEALTH & HUMAN SERVICES COMMISSION !'J� N� Request for Financial Assistance Application Cover Sheet Name of Agency: Superstition Community Food Bank Mailing Address: 575 N Idaho Road, Ste 701, Apache Junction, AZ 85119 Street Address: 575 N Idaho Road, Ste 701, Apache Junction, AZ 85119 Phone: 480-983-2995 Agency Director: Erik Arriola Email Address: erik.arriola@superstitionfoodbank.org Direct Line: 480-233-6680 Project Manager: Erik Arriola Email Address: erik.arriola@superstitionfoodbank.org Direct Line: 480-233-6680 Project: The Superstition Community Food Bank is requesting funding to purchase food to support our overall programming, including: • Emergency Food Program • Holiday Box Program • Student Backpack Food Program Total Amount requested: $75,000 Population and number of people to be served: Total overall served in 2025: 45,790 Total population served (Apache Junction Proper) in 2025: 26,890 Agency Description: Please provide a brief description of your organization's history, experience, and services provided. Since 1983, the Superstition Community Food Bank has served thousands of people in East Valley communities. We are a community food bank that aids individuals and families facing food insecurities in Apache Junction, Gold Canyon, Northwest Pinal County, and East Mesa. Driven by a small, but passionate staff, supported by an engaged, committed Board and a team of enthusiastic, energetic volunteers, everyone involved with Superstition Community Food Bank works together to provide food to feed the hungry in our community. Please address the following: 1. Has your agency received funding from Apache Junction in the past? If yes: a. What was the year b. Amount, c. Project/Service d. How your agency met the expectations of the funding agreement. We are grateful for the continued support we have received from the City of Apache Junction. Most recently, the Superstition Community Food Bank was awarded $70,000 for the 2025-2026 fiscal year. These funds were allocated to purchase food for three core programs: • Emergency Food Program & Holiday Food Boxes: $50,000 • Student Backpack Food Program: $20,000 Because all awarded funds are used exclusively for food purchases, we have consistently met—and often exceeded—the expectations outlined in our funding agreement with the City. This support directly strengthens our ability to provide reliable, nutritious food to individuals and families in need throughout Apache Junction. Past Funding 2025-2026: $70,000 2024-2025: $56,250 2023-2024. $351000 2022-2023: $30,000 2021-2022: $26,000 2. Purpose of the agency The purpose of the Superstition Community Food Bank is to ensure that individuals and families facing food insecurity have reliable access to nutritious food. We exist to support those who are struggling to put meals on the table, offering essential assistance during times of financial hardship. Our Mission Together with our volunteers and community partners, the Superstition Community Food Bank provides food services to qualified individuals and families in East Valley communities with kindness, respect, and dignity. Our mission reflects our commitment not only to feeding people, but to doing so in a way that honors their humanity and strengthens our community. 3. Type of agency The Superstition Community Food Bank is a 501 c3 nonprofit community food bank, founded in 1981 and incorporated in 1983. We are dedicated to providing reliable food assistance to individuals and families facing food insecurity throughout the East Valley. 4. Services provided The Superstition Community Food Bank provides a range of programs designed to meet the diverse needs of individuals and families experiencing food insecurity. Our services include: Emergency Food Assistance This program provides immediate food support to individuals and families facing hardship. Qualified clients may visit twice per month to receive a variety of groceries, including meat, bread, canned goods, non-perishable items, and fresh fruits and vegetables. When available, clients may also receive milk, cheese, and eggs. This program helps households avoid choosing between essential needs such as rent, utilities, medication, or medical care and putting food on the table. In 2025, it was our largest program, serving 45,790 individuals. Commodity Supplemental Food Program (CSFP) CSFP improves the health of low-income adults aged 60 and older by supplementing their diets with nutritious USDA foods. Seniors enrolled in this program receive a monthly box filled with high-protein, high-fiber, and nutrient-dense items. Due to high demand, we currently serve 140 seniors with an additional 40+ individuals on the waiting list. Holiday Food Boxes Holidays can be especially difficult for families experiencing food insecurity. To help lift spirits and reduce financial strain, we provide Holiday Food Boxes for Easter, Fourth of July, Thanksgiving, and Christmas. Each box includes a main dish—such as hot dogs, a turkey, or a ham—along with festive sides and fixings. Our goal is to serve 300 families for each holiday. Student Backpack Food Program In partnership with the Apache Junction Unified School District (AJUSD), we provide weekend food "backpacks" to students who may not have reliable access to meals outside of school. Students may self-enroll, be enrolled by a parent, or be referred by school staff. Many participants rely on school meals as their primary source of nutrition, making this program essential for their well-being. Special Partnerships Our partnerships help us reach vulnerable individuals who may not be able to visit the Food Bank directly: • A New Leaf (CAAFA) o Provides Holiday Meal Boxes (turkey for Thanksgiving, ham for Christmas) to families in crisis. • Apache Junction Parks & Recreation o Distributes Emergency Food (EFB) and CSFP boxes to seniors who ride the shuttle van to the Multigenerational Center. o Receives food backpacks for students participating in summer programs. • Apache Junction Police Department o Coordinates with us to provide Holiday Meal Boxes (with ham) to families participating in the "Shop with a Cop" Christmas program. • Apache Junction Unified School District (AJUSD) o Partners with us to sponsor families for the holidays, including distributing Thanksgiving Meal Boxes to elementary school families. o Collaborates to support hourly district employees who experience reduced hours during school breaks and may need food assistance. • Boys & Girls Club — Superstition Mountain Branch o Receives food backpacks for students enrolled in summer programs. 5. Provide target population and demographic information on your current clientele to include percentage located within the City of Apache Junction The Superstition Community Food Bank primarily serves individuals and families living in Apache Junction and surrounding East Valley communities. In 2025, 59% of all clients served were Apache Junction residents, demonstrating the significant local need for food assistance. 2025 Apache Junction Service Area Statistics (covering ZIP codes 85117, 85118, 85119, 85120, and 85178) • 26,890 individuals served • 11,725 households served • 29% were seniors (ages 60+) • 28% of those served were children (ages 0-18) These demographics reflect the diverse and vulnerable populations who rely on our services, including families with young children, older adults on fixed incomes, and individuals facing financial hardship. 6. Explain how your agency will have adequate capacity to complete the project/service being requested. The Superstition Community Food Bank has the full capacity to carry out the project as requested. The funding we are seeking will support programs that are already fully established, staffed, and operating successfully within our organization. Because these services are part of our ongoing, year-round operations, we have the systems, personnel, volunteers, and infrastructure in place to continue delivering them effectively. We are confident in our ability to fulfill all project requirements and ensure that the funding directly benefits the individuals and families we serve. 7. Provide a list of your annual fundraisers and average amount raised. For many years, the Superstition Community Food Bank hosted an Annual Charity Golf Tournament as our primary fundraising event. However, revenue from this event has steadily declined due to increased competition from other tournaments and the rising cost of participation for players. Net revenue over the past four years reflects this downward trend: • 2022: $31,556.81 • 2023: $21,586.96 • 2024: $18,589.81 2025: $14,124.40 Given the significant decrease in proceeds and the economic challenges affecting participant giving, we have made the strategic decision to pause the golf tournament for 2026. In 2025, we partnered with the Superstition Mountain Rotary Club to launch a new fundraising initiative—our inaugural Casino Night, which successfully netted $5,500 for the Food Bank. We are exploring opportunities to continue and expand this event in partnership with the Rotary Club as a more sustainable and community-engaging fundraiser. 8. Are you listed on the www.211Arizona.org website? The Superstition Community Food Bank is listed on the 211Arizona website, and we update our information annually to ensure accuracy for those seeking assistance. We are also listed on the Arizona Food Bank Network website, further expanding access to our services for individuals and families in need. 9. Have you participated in the following: a Project Connect event, a Health and Wellness Expo or the Apache Junction Community Resource Center in the past? The Superstition Community Food Bank is an active participant in the annual Project Connect event sponsored by the Apache Junction Homeless Coalition. We also take part in various City-hosted events to increase community awareness of our services and ensure residents know how to access food assistance. In addition, we partner with American Legion Post 27 and VFW Post 7968 during their Veteran Stand Down events. These partnerships help us reach local veterans—an important population we strive to support by ensuring they know the Food Bank is a resource available to them. Project/Service Description: Please describe the proposed project/service to be funded. Please address the following: The Superstition Community Food Bank is requesting funding to purchase food that directly supports three of our core programs. These programs operate year-round and provide essential nutrition to individuals and families experiencing food insecurity in Apache Junction and surrounding communities. The funding requested will be used to sustain and strengthen the following programs: • Emergency Food Program • Holiday Box Program • Student Backpack Food Program These programs form the foundation of our services and ensure that children, families, and seniors have reliable access to nutritious food during times of need. 1. Who will be served? The Superstition Community Food Bank will continue to serve individuals and families living in Apache Junction, Gold Canyon, Northwest Pinal County, and East Mesa. These communities represent our core service area, and the requested funding will directly support residents who rely on our programs for consistent access to nutritious food. 2. How will this project serve Apache Junction proper residents? This project will directly benefit Apache Junction residents, who make up the majority of the individuals and families we serve. In 2025, 59% of our total clientele were Apache Junction residents, demonstrating the significant local need for food assistance. 2025 Apache Junction Service Area Statistics (Covering ZIP codes 85117, 85118, 85119, 85120, and 85178) • 26,890 individuals served • 11,725 households served These numbers reflect the substantial impact our programs have within Apache Junction and underscore the importance of continued support to meet the community's growing needs. 3. What services will be provided? The Superstition Community Food Bank provides a range of programs designed to meet the diverse needs of individuals and families experiencing food insecurity. Our services include: Emergency Food Assistance This program provides immediate food support to individuals and families facing hardship. Qualified clients may visit twice per month to receive a variety of groceries, including meat, bread, canned goods, non-perishable items, and fresh fruits and vegetables. When available, clients may also receive milk, cheese, and eggs. This program helps households avoid choosing between essential needs such as rent, utilities, medication, or medical care and putting food on the table. In 2025, it was our largest program, serving 45,790 individuals. Commodity Supplemental Food Program (CSFP) CSFP improves the health of low-income adults aged 60 and older by supplementing their diets with nutritious USDA foods. Seniors enrolled in this program receive a monthly box filled with high-protein, high-fiber, and nutrient-dense items. Due to high demand, we currently serve 140 seniors with an additional 40+ individuals on the waiting list. Holiday Food Boxes Holidays can be especially difficult for families experiencing food insecurity. To help lift spirits and reduce financial strain, we provide Holiday Food Boxes for Easter, Fourth of July, Thanksgiving, and Christmas. Each box includes a main dish—such as hot dogs, a turkey, or a ham—along with festive sides and fixings. Our goal is to serve 300 families for each holiday. Student Backpack Food Program In partnership with the Apache Junction Unified School District (AJUSD), we provide weekend food "backpacks" to students who may not have reliable access to meals outside of school. Students may self-enroll, be enrolled by a parent, or be referred by school staff. Many participants rely on school meals as their primary source of nutrition, making this program essential for their well-being. Special Partnerships Our partnerships help us reach vulnerable individuals who may not be able to visit the Food Bank directly: • A New Leaf (CAAFA) o Provides Holiday Meal Boxes (turkey for Thanksgiving, ham for Christmas) to families in crisis. • Apache Junction Parks & Recreation o Distributes Emergency Food (EFB) and CSFP boxes to seniors who ride the shuttle van to the Multigenerational Center. o Receives food backpacks for students participating in summer programs. • Apache Junction Police Department o Coordinates with us to provide Holiday Meal Boxes (with ham) to families participating in the "Shop with a Cop" Christmas program. • Apache Junction Unified School District (AJUSD) o Partners with us to sponsor families for the holidays, including distributing Thanksgiving Meal Boxes to elementary school families. o Collaborates to support hourly district employees who experience reduced hours during school breaks and may need food assistance. • Boys & Girls Club — Superstition Mountain Branch o Receives food backpacks for students enrolled in summer programs. 4. What are the benefits? These programs directly support individuals and families experiencing food insecurity by ensuring they have consistent access to nutritious food. The most immediate benefit is simple but essential: people have food to eat. A secondary and equally important benefit is financial relief. By reducing the amount households must spend on groceries, families can redirect limited resources toward rent, utilities, medical needs, transportation, and other critical expenses that help them remain stable, housed, employed and healthy. 5. Provide a timeline and who is responsible. Funding for the Student Backpack Food Program is typically utilized at the start of the school year, with the majority of purchases occurring in August or September. The remaining funds are spent strategically throughout the fiscal year to support our Emergency Food Program and Holiday Box Program. Erik Arriola, the Executive Director, is responsible for overseeing all Food Bank programming, including food purchasing, program implementation, and ensuring that all services are delivered efficiently and in alignment with grant requirements. 6. Where will the services be provided? Most services will be provided directly at the Superstition Community Food Bank. However, several programs include off-site distribution to ensure accessibility for individuals who cannot travel to the Food Bank. Exceptions include: • Apache Junction Parks & Recreation: Staff pick up food boxes for senior participants who ride the shuttle van to the Multigenerational Center. • Student Backpack Food Program: Food filled backpacks are delivered directly to Apache Junction Unified School District elementary schools on a weekly basis. • "Shop with a Cop" Program: Holiday Food Boxes are delivered to participating families at the Apache Junction Multigenerational Center using our refrigerated box truck. • A New Leaf (CAAFA): Social workers pick up Holiday Food Boxes from the Food Bank and deliver them directly to their clients • AJUSD: The school district picks up food boxes for hourly employees of the school district and distributes them directly to their employees. These distribution methods ensure that vulnerable residents—especially seniors, students, and families in crisis—receive the food assistance they need, regardless of transportation barriers. 7. How will you provide the services? The Food Bank will continue to provide our services as normal. Emergency Food Distribution (daily): Monday: 2:00pm-4:00pm Tuesday: 2:OOpm-4:00pm Thursday: 2:00pm-4:00pm Friday: 2:00pm-4:OOpm Commodity Supplemental Food Program—CSFP (Seniors 60+): 31d Thursday of the Month Holiday Box Distribution: (must have voucher to participate): Easter: 03/28/2026 4th of July: 06/26, 6/29, 6/30 & 7/2 (normal distribution, no voucher needed) Thanksgiving: 11/21/2026 Christmas: 12/19/2026 Student Backpack Food Program "Weekly during the school year. (August—May) 8. Are there any community partners in this project? If so, please list. The Superstition Community Food Bank will continue to collaborate with key community partners to ensure broad access to food assistance and to reach individuals who may not be able to visit the Food Bank directly. Our partners include: • A New Leaf (CAAFA) • Apache Junction Parks & Recreation • Apache Junction Police Department • Apache Junction Unified School District • Boys & Girls Club — Superstition Mountain Branch These partnerships strengthen our ability to serve vulnerable populations, expand outreach, and ensure that food reaches those who need it most. 9. What is the project/service and agency goals? The Superstition Community Food Bank is requesting funding to purchase food that supports three essential programs serving individuals and families experiencing food insecurity: • Emergency Food Program • Holiday Box Program • Student Backpack Food Program These programs ensure that children, families, and seniors have consistent access to nutritious food throughout the year. Our overarching agency goal is to assist as many individuals and families as possible within our service area by providing reliable, dignified food assistance. As part of this commitment, we maintain a specific annual goal of distributing 300 Holiday Food Boxes to families for Easter, Fourth of July, Thanksgiving, and Christmas. These holiday distributions help families celebrate important occasions without the added financial burden of purchasing special meals. 10.How and will you sustain this project after the agreement has ended? The Superstition Community Food Bank is committed to sustaining these programs long after the funding agreement concludes. We will continue to seek support through additional grants, community organizations, service clubs, and private donors to ensure ongoing food purchases for our core programs. As a long-standing nonprofit serving this community, we have no plans to reduce or discontinue services. Our mission remains to provide consistent, reliable food assistance to individuals and families in need, and we will continue pursuing diverse funding sources to maintain and strengthen these essential programs. Project/Service Budget: Provide a detailed project budget and narrative based on activities indicated above including: 1. Amount being requested The Superstition Community Food Bank is requesting $75,000 to purchase food that supports our core year-round programming, including: • Emergency Food Program • Holiday Box Program • Student Backpack Food Program These funds will be used exclusively for food purchases to ensure that children, families, and seniors in our service area have consistent access to nutritious food throughout the year. 2. Amount of funding provided by your agency (include source) The Superstition Community Food Bank operates with an annual budget of$2,640,801. This total includes funding from a diverse range of sources, including grants, community organizations, churches, schools, and private donors. The budget also reflects significant in-kind contributions, including food received through our Food Rescue Program, community food drives, and the in-kind donation of our facility rent provided by Pinal County. These combined resources help sustain our core programs and ensure continued service to individuals and families experiencing food insecurity. 3. Amount of funding provided by partners (include source) The Superstition Community Food Bank does not receive financial support from its partnering agencies, including A New Leaf (CAAFA), Apache Junction Parks & Recreation, the Apache Junction Police Department, the Apache Junction Unified School District, or the Boys & Girls Club — Superstition Mountain Branch. These partnerships are collaborative in nature and focus on outreach rather than funding. Each partner helps us reach vulnerable individuals who may be unable to visit the Food Bank on their own. We will continue working with community partners and exploring new collaborations to expand our reach and ensure that more individuals in need can access our services. 4. A detailed narrative of the costs The cost of food purchases varies throughout the year based on community donations, the success of food drives, and fluctuations in client demand. Because the Food Bank receives a significant amount of donated food, our purchasing needs shift depending on which items are donated and which essential staples must be supplemented through direct purchase. For example, during the 2025 federal government shutdown, the number of households seeking assistance increased dramatically due to delays in SNAP benefits. In response, we needed to quickly purchase large quantities of basic food items to ensure we could meet the sudden surge in demand. Situations like this highlight the importance of flexible funding that allows us to respond rapidly to community needs. When purchasing food, we consistently seek the best possible prices by comparing vendors, buying in bulk when appropriate, and prioritizing cost-effective options without compromising nutritional value. A detailed record of how past grant funding has been utilized is included in the attached AJ City HHS Grant 2025-2026 Usage Report, which demonstrates our responsible and transparent use of funds. 5. What percentage of your agency's total annual budget is this funding request? The amount requested—$75,000—represents 2.85% of the Superstition Community Food Bank's 2025 annual budget. 6. Indicate if you would accept partial funding and if so, provide the minimum amount and how your project will change. The Superstition Community Food Bank is open to accepting partial funding. However, receiving less than the requested amount would limit our ability to expand services and reach additional families in need. Specifically, partial funding may prevent us from adding The Classical Academy at Superstition Mountain and Avalon Elementary School to the Student Backpack Food Program. Even so, we remain deeply grateful for any level of support provided by the City of Apache Junction. Your investment directly strengthens our capacity to serve the community. Thank you for your time and consideration. With gratitude, 2 Erik Arriola Executive Director 480-983-2995 (w) 1480-233-6680 (c) erik.arriola@superstitionfoodbank.org 1,741110 M Superstition Community Food Bank 575 N Idaho Road, Ste 701 Apache Junction, AZ 85119 Superstitionfoodbank.org Health and Human Services Funding Applications 2026 Identified Compliant with Demonstrated Detailed Proposal Performance Is a Community previous HHSC Recommended Funding request Project Problem Identified Community Need Provided Measures Partner funding Funding Amount Provide services for domestic A New Leaf $ 20,000.00 violence survivors Apache Junction Community Development Operating Corporation $ 7,500.00 Expenses Expand outreach of free tax preparation Azura VITA $ 15,800.00 program Black and Gold Youth Football Football and cheer League $ 6,000.00 scholarships Boys and Girls Club of the East Youth Program Valley $ 30,000.00 Staff Kiwanis $ 2,000.00 Youth Services Rising Star Wellness Center NAZCARE Inc $ 62,400.00 Renovations Superstition Food Bank $ 75,000.00 Purchase food $ 218,700.00 0 Commissioner: HEALTH AND HUMAN SERVICES MEETING ROLL CALL Date: Regular S: .3 •01PI401E: S is COMMISSION: Present Absent/Excused CHAIR BRENNAN VICE CHAIR DANFORD COMMISSIONER MONTGOMERY COMMISSIONER KRCILEK COMMISSIONER SMITHSON COMMISSIONER MYKLAND COMMISSIONER WOOD TOTAL CITY STAFF: Present Absent/Excused City Clerk Evie McKinney Deputy City Clerk Amy Greening 5:�,rsoar,:s and �.ommissions\rieaith and f,unian Strvice5 Lommission\'emplatesWoh C,oi Attendance.docx HEALTH AND HUMAN SERVICES COMMISSION VOTE — Roll Call Q ITEM �G �$ MEETING DATE 3'% ZPZk�' MOTION: SECOND: > COMMISSION MEMBERS Yes No Excused COMMISSIONER MONTGOMERY VICE CHAIRMAN DANFORD COMMISSIONER KRCILEK COMMISSIONER SMITHSON COMMISSIONER WOOD COMMISSIONER MYKLAND CHAIRMAN BRENNAN 1p I ITEM MOTION: SECOND: COMMISSION MEMBERS Yes No Excused VICE CHAIRMAN DANFORD COMMISSIONER KRCILEK COMMISSIONER MONTGOMERY COMMISSIONER SMITHSON COMMISSIONER WOOD COMMISSIONER MYKLAND CHAIRMAN BRENNAN Pg1of3 S:\Boards and Commissions\Health and Human Services Commission\Templates\Roll Call Vote and Attendance.doc City of Apache Junction, Arizona Meeting location. - City Council Chambers 300 E.SuperslRion Blvd Special Meeting Agenda Apache Junction,AZ 85119 Health and Human Services apachejunctionaz.gov Commission P:(480)982-8002 Doors are open to the public at least 15 minutes prior to the posted meeting start time. Monday,March 9, 2026 3:00 PM City Council Chambers A. Call to Order B. Pledge of Allegiance C. Roll Call D. Consent Agenda 1. 26-83 Consideration of approval of agenda. 2. 26-84 Consideration of approval of special meeting minutes of February 23, 2026. Attachments: 2026.02.23 HHSC Minutes-DRAFT E. Old Business F. New Business The Commission shall consider any business not yet considered. Arizona Open Meeting Law prohibits public comments at this time. 3. 26-85 Interview of applicants for Health and Human Services funding for Fiscal Year 2026 -2027:A New Leaf, Apache Junction CDC, Azura VITA, Black and Gold Youth Football League, Boys and Girls Club, Kiwanis, NAZCARE Inc., and Superstition Food Bank. Attachments: A New Leaf Application AJ CDC Application Azura VITA Application BGYFL Application Boys and Girls Club ApylicatiOn Kiwanis Application NAZCARE Inc Application Superstition Community Food Bank Applicat on Commissioner Scoring Sheet City otApache Junction,Arizona Page J Printed on 3/5/2026 Health and Human Services Special Meeting Agenda March 9,2026 Commission G. Information and Reports The chair at this time may announce information regarding activities involving Health and Human Services matters, such as, but not limited to attendance of commission members at community meetings or events, seminars or conferences, or upcoming events or conferences. H. Staff Liaison's Report The City Clerk, members of City staff or those individuals designated by the Manager, may present information pertinent to items under consideration or information related to the operation of the City. I. Selection of Meeting Dates, Times, Location and Purpose J. Adjournment Copies of this agenda and additional information regarding any of the items listed above may be reviewed from 7:00 a.m. to 6:00 p.m., Monday through Thursday, except holidays, at the City Clerk's Office located at 300 East Superstition Boulevard in Apache Junction, Arizona, 85119, telephone number is(480) 982-8002. The City of Apache Junction invites and welcomes people of all abilities to use our programs, sites and facilities. Specific requests may be made by contacting the Human Resources Office at(480) 474-2617 or TOD(480)983-0095. City of Apache Junction,Arizona Page 2 Printed on 3/5/2026 3.9.2026 Health and Human Services Commission Meeting Consent Agenda Items No. 1 and 2 1 move that the Health and Human Services Commission accept the consent agenda as presented. City of Apache Junction Health & Human Services Commission 2026 Grant Application / Questions from Commission working session Student Backpack Food Program Commissioner Danford asked: Q: Did the Food Bank extend the backpack program to all schools? A: Not yet. We added one additional school this year— Peralta Trails Elementary School. We are now serving: Desert Vista Elementary School—63 students Four Peaks Elementary School—127 students Peralta Trails Elementary School—57 students The Food Bank was not notified in time that AJUSD was opening The Classical Academy at Superstition Mountain, but a teacher has already reached out expressing that students there would benefit from the program. I strongly believe we can expand to include this school. Avalon Elementary School (Excalibur Charter School) experienced administrative changes last year, so we were unable to add them to this cycle. We plan to try again to launch the program on their campus in the upcoming school year. Q: What do we need to make the backpack program available on every campus? A:The two primary needs are: Funding — this is the biggest requirement. School participation — each campus must agree to coordinate and distribute the backpacks. Our goal is to eventually serve all five local elementary schools: • Avalon Elementary School (Excalibur Schools) • Desert Vista Elementary School (AJUSD) • Four Peaks Elementary School (AJUSD) • Peralta Trails Elementary School (AJUSD) • The Classical Academy at Superstition Mountain (AJUSD) Q: Does increased giving to the Student Backpack Food Program free up funds for other programming? A: No. Because we are actively expanding the program to include more schools and more students, the overall cost continues to rise. However, I am constantly seeking additional grant opportunities to help offset expenses for this and other Food Bank programs. 1 Q: How do we determine who receives a backpack? A: Students can be enrolled in the program in several ways: • They may self-enroll • A parent or guardian may enroll them • A teacher or school staff member may enroll them if they identify a need Commission Montgomery asked: Q: How do we educate parents about how to get additional food from the Food Bank? A: We participate in numerous community events to raise awareness, including: • Stand-Up AJ's Back-to-School event • Back-to-school events at each elementary school For families already enrolled in the Backpack Program, our registration form includes our website, and we collect email addresses from those who want more information. We then send details on how to access additional Food Sank services. Emergency Food Program Q: How do we determine who receives food assistance? A:Clients must complete the registration process: • Fill out the Arizona Department of Economic Security form (HRP-1028A). • Meet income guidelines — household income at or below 185%of the Federal Poverty Level (HRP-1023A). If a household is receiving SNAP (food stamps), it automatically qualifies for this program. Clients may visit the Superstition Community Food Bank twice per calendar month, with a required 72-hour waiting period between visits to us or any other food agency. Q: What impact have federal cuts had on our clientele? (AHCCCS&SNAP) A: After the government shutdown and the announcement on October 23, 2025, that SNAP benefits would not be funded, we immediately saw a 30% increase in families and individuals seeking assistance.That increase has not subsided. Q:What federal cuts have been made to our food supply? (USDA) A: In March 2025, the Trump administration canceled $500 million in food aid deliveries through the Emergency Food Assistance Program (TEFAP). More than 4,000 deliveries were canceled nationwide, reducing supplies of meat, dairy, eggs, and produce during a period of rising food insecurity. Arizona alone lost nearly 2 million pounds of food. Commissioner Montgomery asked: Community Partnerships Q: How do our community partnerships work? How is food delivered or distributed? 2 A New Leaf(CAAFA) We provide Holiday Meal Boxes.Agency social workers act as proxies and deliver the boxes to families. We have also donated bulk items for the shelter to cook and provide a holiday meal to all domestic violence victims living at their shelter. Apache Junction Parks & Recreation Homebound Seniors: We prepare emergency food boxes for seniors who ride the shuttle to the Multi-Generational Center on the second Monday of each month. Summer Program: We deliver Student Backpacks filled with food to their summer camps for distribution to all participating students. Apache Junction Police Department We partner with AJPD's "Shop with a Cop" program and provide each family with a Christmas Meal Box. Apache Junction Unifier!School District Student Backpack Food Program: We deliver backpacks every Wednesday during the school year, and the schools distribute them to enrolled students. Food Boxes for Staff: AJUSD picks up food boxes for hourly employees who experience reduced hours during school breaks. Boys&Girls Club (Superstition Mountain Branch) We deliver Student Backpacks for their Summer Program, and the Club distributes them to participating children. In summary, both the Student Backpack Food Program and the Emergency Food Program continue to play a critical role in supporting families, children, and individuals across our community. While we have made meaningful progress in expanding services to additional schools and strengthening partnerships, the need continues to grow— especially in light of federal benefit reductions and cuts to food assistance programs. Our ability to serve every child and every household in need depends on two things: sustainable funding and strong collaboration with our local schools, agencies, and community partners. With continued support, we are confident that we can reach all five elementary schools, maintain essential emergency food services, and ensure that no child or family in Apache Junction goes without access to nutritious food. We remain committed to transparency, partnership, and proactive outreach, and we will continue seeking grants, building relationships, and adapting to the evolving needs of our community.Together, we can ensure that every student nd every family has the resources they need to thrive. rik Arriola Executive Director, Superstition Community Food Bank 3 SUPERSTITION FOOD OD ` 1 What is the Student Backpack Food Program? Backpack food programs offer students free groceries for weekends. Food backpacks include healthy, easy-to-prepare food for kid-friendly meals. Food banks partner with schools to distribute backpacks to students. What comes in the backpacks? Every Backpack Program is unique. Most backpacks include enough food to make a few healthy meals while the student is home over the weekend.That way, kids return to school on Monday, ready to learn. Backpacks may include: • Breakfast items like cereal, oatmeal, or granola bars • Easy to prepare meals like mac and cheese, peanut butter and jelly sandwiches, Ramen or canned soups • Bread • Milk or juice • Fresh or canned fruit • Fresh or canned vegetables • Snacks How often can I get a food backpack? Depending on enrollment, we will distribute backpacks at least once a month. Most programs give out backpacks every week on Fridays or the day before a school break. Programs usually take a break during summer. How can I help? There are many ways you can help your local BackPack Program. • Volunteer. Many BackPack programs rely on regular volunteers. Volunteers pack backpacks, set up distributions, and pass out backpacks to students. • Donate. In 2022, network BackPack programs served over 54 million meals. You can donate to the Superstition Community Food Bank directly at: Superstition Food Ban k.org; Student Backpack Food Program 2025-2026 Enrollment Form *All fields are required - Please print nicely so we can read your writingl no _YES, I would like my child to participate in the Student Backpack Food Program_ _NO, at this time we DO NOT wish to participate. *This form is being completed by: ,The student —The student's parent/guardian _The student's teacher _Other school personnel Other: *Student's First Name: *Student's Last Name: *Student's Date of Birth: (mm/dd/yy) *Grade: *Teacher: *1 would like more information on local food resources: _YES, my email address is: NO *Parent/Guardian Signature: *Parent/Guardian Printed Name: *Date: SUPERSTITION FOOD it 575 N Idaho Road,#701 Apache Junction,AZ 85119 480-983-2995 For information about receiving additional food assistance, please visit: SuperstitionFoodBank.org ARIZONA DEPARTMENT . ECONOMIC SECURITY Child MCI COMMUllity Services Division (CCSD) Coordinated - 7 The Emergency Food Assistance Program The Emergency Food Assistance Program (TEFAP) is a federal program that helps supplement the diets of people with low- Your household income by providing them with emergency food assistance at qualifies for TEFAP no cost. This assistance is available to families, single people, if you meet the seniors, and people who are experiencing homelessness. following two requirements: If your household is receiving SNAP(food stamps), it automatically qualifies for TEFAP. 0 The household income is at or Household Annual Monthly Weekly below 185% of the Size I Federal Poverty 1 $28,953 $2,413 $557 Level. (See chart 2 $39,128 $3,261 $753 to the right.) 3 $49,303 $4,109 $949 Q You live in the 4 $59,478 $4,957 $1,144 geographic area 5 $69,653 $5,805 $1,340 where a TEFAP 6 $79,828 $6,653 $1,536 distribution is being held. 7 $90,003 $7,501 $1,731 8 $100,178 $8,349 $1,927 For each Add $10,175 Add $848 Add $196 additional person: (Federal Poverty Guidelines 185%, effective March 2025) ■ . ■ Scan for more information, and to get TEFAP in your area: MW �■ visit des.az.aov/emergengy-food This institution is an equal opportunity provider. Equal Opportunity Employer/Program • Under Titles VI and VI of the Civil Rights Act of 1964 (Title VI & VII), and the Americans with Disabilities Act of 1990 (ADA), Section 504 of the Rehabilitation Act of 1973, the Age Discrimination Act of 1975, and Title II of the Genetic Information Nondiscrimination Act(GINA) of 2008; the Department prohibits discrimination in admissions, programs, services, activities, or employment based on race, color, religion, sex (including gender identity and sexual orientation), national origin, age, disability, genetics and retaliation. To request this document in alternative format or for further information about this policy, contact your local office; TTY/TDD Services: 7-1-1. • Free language assistance for DES services is available upon request. • Espanol al reverso HRP-1023A FLYBIL(03/25) HRP-1028A FORFF(12/24) Arizona Department of Economic Security Page 1 of 3 Division of Community Assistance and Development (DCAD) For DS Use Only: Coordinated Hunger Relief Program Application for Benefits Date: O TEFAP O CSFP Client ID#: DS: Applicant . • Last Name: First Name: Date of Birth: Number of People in the Household: Gender (Optional): ❑ Male ❑ Female ❑ Undisclosed Marital Status (Optional): ❑ Single ❑ Married ❑ Divorced ❑ Separated ❑ Widowed ❑ Undisclosed ❑ Common-Law Address (No., Street): City: County: State: ZIP Code: Phone Number: Email: Housing Type (Optional): ❑ Emergency Shelter/Mission/Transitional ❑ Evacuee ❑ Unhoused ❑ Own Home ❑ Private Rental ❑ Public (Social) housing ❑ With Family/Friends ❑ Youth Home/Shelter ❑ Undisclosed ❑ Other ❑ No Fixed Address/Undisclosed Language (Optional): Ethnicity (Required for CSFP): ❑ White/Anglo ❑ Black/African American ❑ Hispanic/Latino ❑ Pacific Islander ❑ Asian ❑ American Indian/Native American ❑ Alaska Native/Aleut/Eskimo ❑ Middle Eastern/North African ❑ Other Self-identified as (Optional): ❑ Disability ❑ Undisclosed ❑ Veteran ❑ Mental Illness ❑ N/A ❑ Pregnant ❑ Postpartum ❑ Breastfeeding ❑ Other Authorization for Proxy I understand that I must pick up my food regularly and that I may be terminated from CSFP if I fail to pick up my food. In the event that I am unable to pick up my food, please release it to: Proxy's Printed Name(s): This application is being completed in connection with the receipt of Federal assistance. Program officials may verify information on this form. I am aware that deliberate misrepresentation may subject me to prosecution under applicable State and Federal statutes. CSFP Clients: I am aware that the information provided may be shared with other organizations to detect and prevent dual participation. I have been advised of my rights and obligations under the program. I certify that the information I have provided for my eligibility determination is correct to the best of my knowledge. authorize the release of information provided on this application form to other organizations administering assistance programs for use in determining my eligibility for participation in other public assistance programs and for program outreach purposes. (Please indicate decision by placing a checkmark in the appropriate box.) ❑ Yes ❑ No certify that my gross household income is equal to or below the federal poverty level acceptable for the program I am applying for. I have reviewed the current income eligibility chart and received an explanation of countable and non- countable income. Applicant's Name (Please Print): Applicant's Signature: Date: See page 3 for USDA/EOE/ADA disclosures HRP-1028A FORFF(12124) Page 2 of 3 Household Member-Information Last Name: First Name: Date of Birth: Relationship: ❑ Spouse ❑ Child ❑ Parent ❑ Sibling ❑ Grandparent ❑ Other Relative ❑ Boyfriend/Gidfdend ❑ Friend ❑ Undisclosed Gender (Optional): ❑ Male ❑ Female ❑ Undisclosed Household Member Information 2 Name: First Name: Date of Birth: Relationship: ❑ Spouse ❑ Child ❑ Parent ❑ Sibling ❑ Grandparent ❑ Other Relative ❑ Boyfriend/Girlfriend ❑ Fdend ❑ Undisclosed Gender(Optional): ❑ Male ❑ Female ❑ Undisclosed Houselhold Member Last Name: First Name: Date of Birth: Relationship: ❑ Spouse ❑ Child ❑ Parent ❑ Sibling ❑ Grandparent ❑ Other Relative ❑ Boyfriend/Girlfriend ❑ Friend ❑ Undisclosed Gender(Optional): ❑ Male ❑ Female ❑ Undisclosed Please send this completed application to Email: coordinatedhungerreliefprogram@azdes.gov Mail: Arizona Department of Economic Security Child and Community Services Division Coordinated Hunger Relief Program (Mail Drop 4382) 1789 W. Jefferson Street Phoenix, AZ 85007 For more information about DES food assistance programs, please visit.- https://des.az.gov/services/basic-needs/food-assistance HRP-1028A FORFF(12/24) Page 3 of 3 In accordance with federal civil rights law and U.S. Department of Agriculture (USDA) civil rights regulations and policies, this institution is prohibited from discriminating on the basis of race, color, national origin, sex (including gender identity and sexual orientation), disability, age, or reprisal or retaliation for prior civil rights activity. Program information may be made available in languages other than English. Persons with disabilities who require alternative means of communication to obtain program information (e.g., Braille, large print, audiotape, American Sign Language), should contact the responsible state or local agency that administers the program or USDA's TARGET Center at (202) 720-2600 (voice and TTY) or contact USDA through the Federal Relay Service at (800) 877-8339. To file a program discrimination complaint, a Complainant should complete a Form AD-3027, USDA Program Discrimination Complaint Form which can be obtained online at: https://www.usda.gov/sites/default/files/documents/ad-3027.pdf, from any USDA office, by calling (866) 632-9992, or by writing a letter addressed to USDA. The letter must contain the complainant's name, address, telephone number, and a written description of the alleged discriminatory action in sufficient detail to inform the Assistant Secretary for Civil Rights (ASCR) about the nature and date of an alleged civil rights violation. The completed AD-3027 form or letter must be submitted to USDA by: 1. mail: U.S. Department of Agriculture Office of the Assistant Secretary for Civil Rights 1400 Independence Avenue, SW Washington, D.C. 20250-9410; or 2. fax: (833) 256-1665 or (202) 690-7442; or 3. email: program.intake(aD_usda.gov This institution is an equal opportunity provider. To request this document in alternative format or for further information about this policy, contact your local office; TTY/TDD Services: 7-1-1. • Free language assistance for DES services is available upon request. - Disponible en espahol en linea o en la oficina local