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APPLICATION FORM
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2017
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04. April
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2017-04-04 10:00 AM - Commissioners' Agenda
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APPLICATION FORM
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Last modified
1/16/2018 2:45:30 PM
Creation date
1/16/2018 11:43:22 AM
Metadata
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Meeting
Date
4/4/2017
Meeting title
Commissioners' Agenda
Location
Commissioners' Auditorium
Address
205 West 5th Room 109 - Ellensburg
Meeting type
Regular
Meeting document type
Supporting documentation
Supplemental fields
Alpha Order
f
Item
Request to Approve the 2017 Kittitas County Developmental Disabilities Request for Proposals for Information and Education Funds
Order
6
Placement
Consent Agenda
Row ID
35739
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3. Partnerships: List your key community partnerships for the proposed project and <br />describe what their role will be. (max. 250 words) <br /> <br />4. Gaps and Duplication in Services: Describe how your proposed project fills a gap in <br />services that wouldn’t otherwise exist in Kittitas County. Include a description of how <br />the project is or isn’t a duplication of current services. (max. 250 words) <br /> <br />5. Funding Utilization: Describe how the funds will be used to support the proposed <br />activities. For example, will the funds be used for staff time, supplies, consultants, <br />travel, training, direct customer services, etc.? (max. 250 words) <br /> <br />6. Partial Funding: If this project were to receive only partial funding from this source, <br />how would the proposal be impacted? How would the proposal be adjusted for less <br />than the requested amount of funds? (max. 250 words) <br /> <br />7. Goals & Objectives: Use the Goals and Objectives Form below to fill in the following <br />table with your project’s goals, measures, strategies, and objectives. See the examples <br />below for guidance and use as many forms as necessary. <br /> <br />Example #1: <br />GOAL: Increase number of people enrolled in health insurance by 25% by December 31, 2017. <br /> Measures (How will you know you are making progress toward your goal?) Data Source <br />Number of new enrollees in health insurance Internal tracking <br />sheet <br /> Strategy #1 <br />(What will you do to achieve your goal?) <br />Create promotional materials to distribute to local partners <br />advertising health insurance enrollment assistance. <br />Measurable Objectives: <br /> Promote the service with at least 5 community <br />partners each quarter through December 2017. <br /> Distribute at least 100 flyers around the community by <br />December 2017. <br />Strategy #2 <br />(What will you do to achieve your goal?) <br />Offer health insurance enrollment assistance at local <br />community events. <br />Measurable Objectives: <br /> Attend at least 2 community events per quarter in both <br />Upper Kittitas County and Lower Kittitas County <br />through December 2017. <br />Strategy #3 <br />(What will you do to achieve your goal?) <br />Offer health insurance enrollment assistance appointments in <br />the office. <br />Measurable Objectives: <br /> Schedule at least 40 hours per month of open walk-in <br />assistance through December 2017. <br /> Ensure staff availability for at least 25 scheduled <br />appointments each month through December 2017. <br /> <br />Example #2: <br />GOAL: Increase the number of trail systems available to the general public within the City of Ellensburg from 5 <br />to 7 by December 2019. <br /> Measures (How will you know you are making progress toward your goal?) Data Source
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