CONSUMER CONFERENCE ATTENDANCE SUBSIDY APPLICATION

Transcription

1 CONSUMER CONFERENCE ATTENDANCE SUBSIDY APPLICATION 2014 National Health Care for the Homeless Conference & Policy Symposium New Orleans Marriott May 28 30, 2014 Applications are due February 14, 2014 Late or incomplete applications will NOT be considered Eligible Applicants Through a Cooperative Agreement with the Health Resources and Services Administration (HRSA), the National Health Care for the Homeless Council (Council) will provide a limited number of Consumer Conference Subsidies to support consumer participation in the National HCH Conference & Policy Symposium occurring May 28-30, 2014, in New Orleans. This Consumer Conference Subsidy will be offered only to HCH grantees to support the travel of consumers who are: members of HCH grantees Board of Directors, or members of Consumer Advisory Boards of HCH grantees, or employees of HCH grantees. Consumers are defined as people who have experienced homelessness and have received services from the HCH grantee. HCH grantees, for this purpose, are agencies that receive HCH grants from HRSA under Section 330(h) of the Public Health Service Act, or their subcontractors or sub-grantees (as listed at Available Funding A maximum travel subsidy of $1, will be provided for each HCH grantee (not each consumer) whose application is accepted. This funding will support consumer participation in the National HCH Conference and Policy Symposium only. In order to maximize consumer participation in the Conference, we are not supporting participation in this year s Pre-Conference Institutes on May 27, This funding will be allocated as follows:

2 Lodging: The National HCH Council will prepare a rooming list of consumers approved for travel subsidies, will make hotel reservations, and will deduct the charges from the amounts awarded to each project. The cost of a hotel room, arriving Tuesday, 5/27 and departing Friday 5/30 and at the discounted Conference rate, plus tax, amounts to $ ($ per night) deducted from the maximum subsidy amount. HCH grantees interested in maximizing use of the conference subsidy and/or sending more than one consumer to the conference may wish to use a double occupancy room. The cost of a double occupancy room is the same rate - $ per night or $ for three nights. You may use the form below if you would like to send more than one consumer to the conference If you are interested in spreading the subsidy further by sharing a room with another consumer, not associated with your HCH project, please contact Brian Zralek (bzralek@nhchc.org or , ext. 239) and we will try to make arrangements. Incidentals such as pay-per-view TV, room service, or telephone calls from the room will not be available for rooming list rooms without a separate payment guarantee (a credit card) at check-in. Per diem: The National HCH Council will provide a cash per diem payment to each approved consumer upon arrival at the conference hotel. This amount is calculated according to federal travel guidelines, to include meals on travel days and meals not provided by the Conference, plus daily incidentals. For each approved consumer, the Council will provide $188.50, deducted from the maximum subsidy amount. Transportation and any other costs: Grantees are responsible for arranging and paying for all ground or air transportation to and from the conference, including airfare, bus or train fare, and taxis or shuttles. The National HCH Council will reimburse grantees for transportation costs up to the amount of the maximum travel subsidy remaining after lodging and per diem costs are deducted. See worksheet on application form below. A reimbursement claim form including receipts for these transportation costs will be required by June 20, 2014, and reimbursements will be paid promptly. Travel planning should provide for arrival at the hotel in New Orleans, LA in time for beginning of the conference, the morning of Wednesday, May 28 (for most people this will mean arriving on Tuesday, May 27 and departure after 2 pm on Friday, May 30). Grantees are encouraged to apply for subsidies as early as possible to find the most costeffective travel arrangements. Conference Registration: Upon notification that a travel subsidy has been awarded, grantees will be expected to register the consumer for the Conference on the conference website. A special code to indicate consumer registration will be included in the notification. The cost of registration ($450) will be covered by the subsidy.

3 Pre-Conference Institutes: No subsidy is available for the May 27 Pre-Conference Institutes, however, if possible, HCH grantees are encouraged to register consumers for their participation in Pre-Conference Institutes. HCH grantees are responsible for paying registration fees for consumer participation in the Pre-Conference Institutes and accommodations for the night of Monday May 26. Hotel reservations for the night of Monday, May 26 may be made directly with the Hotel via the conference website. Additional Consumer Participants: Grantees are encouraged to apply the consumer travel subsidy to support more than one consumer s attendance at the Conference. Because there is a maximum allotment per project, any costs above the maximum are the responsibility of the grantee or the consumer personally. Events for Consumer Conference Subsidy Recipients National Consumer Advisory Board (NCAB) Orientation Meeting Wednesday, May 28, from 5 pm 6 pm: This meeting is to orient all consumer attendees to NCAB and the National Conference. Attendees will meet and discuss activities of local Consumer Advisory Boards, Conference workshops, the rally, and the Conference Mentor program among other agenda items. This meeting is mandatory for Consumer Conference Subsidy recipients. NCAB Membership Meeting Wednesday, May 28, 6 pm 7pm: The purpose of this meeting is to elect NCAB leadership and confirm revisions to NCAB Operating Guidelines. This session is mandatory for all Consumer Conference Subsidy recipients. Conference Workshops: It is expected that Consumer Conference Subsidy recipients will participate in workshops and sessions throughout the conference. Several conference workshops will directly address issues of consumer involvement. Here is a sample of workshops that are relevant and may be of interest to consumers: Wednesday, May 28 You Don t Need a Home to Vote Housing the Whole Person: Lessons Learned, What Worked, What Didn t Forming and Maintaining a Consumer Advisory Board Improving Healthcare Outcomes through Outreach, Engagement and Linkage to Care Housing First: Consumers and Providers Speak Out on Strategies to Support Housing Stability and Recovery Thursday, May 29 House Calls: Multidisciplinary Team Visits to Chronic Rough Sleepers Placed in Low Threshold Supportive Housing, Getting Away from Grants: Developing Sustainable Funding Streams

4 Protecting the Civil Rights of People Experiencing Homelessness and Promoting Alternatives to Criminalization Employment for People Experiencing Homelessness: Evidence, Principles and Guidance for Implementation Homelessness, Racism and Social Justice Friday, May 30 Bringing Providers Together in the Field: Developing a Homeless Healthcare Alliance Reducing the Need and the Cost of Health Care for the Homeless Breaking Boundaries: An Innovative Cross-System Collaboration among Police, Prosecutors and Social Workers Advocating for Ourselves: Creating a Client Speakers Bureau Building an Effective Advocacy Campaign Please visit the NHCHC Conference Webpage for more information on workshops. Consumer Support A large national conference in an unfamiliar setting is potentially overwhelming for any conference participant. To help assure a positive experience for all consumers, NCAB has developed a mentoring program pairing experienced NCAB leaders with new consumerattendees to provide orientation and on-going support for each new consumer throughout the conference for any needs that may arise. All NCAB Steering Committee members, Regional Representatives, and the staff of the Council will be available to assist during the conference, as well. There will be 12 Step meetings each morning and evening for those who are in recovery and wish to participate. Selection Criteria A limited amount of Consumer Conference Subsidies will be available. In the event that there are more applications than available funds will support, priority in selection will be given in the following order: 1. Consumers who are presenting at the 2014 conference 2. Consumers who have not attended a previous conference 3. Consumers who have been nominated by a Consumer Advisory Board or Board of Directors of which they are a part 4. Consumers who have participated in the Consumer Participation Outreach process described at 5. Consumers representing projects that have not received support for prior conferences 6. Consumers who are formally involved in HCH project governance 7. Consumers who are employed by HCH projects

5 Application & Reimbursement Schedule To be considered, the Council must receive signed applications using the form below no later than Friday, February 28, Applications may be mailed to PO Box 60427, Nashville TN , faxed to 615/ , or scanned and ed to The signature of an official of the HCH grantee denotes that the grantee understands and accepts the terms above. Decisions regarding consumer travel subsidy applications will be communicated to applicants and consumers via by Friday, March 7, A reimbursement claim form will be provided with the notification of award. Reimbursement claim forms must be submitted to the Council no later than June 20, Late submissions cannot be paid. Copies of receipts of all claims will be required for reimbursement. Questions? Please contact Brian Zralek, Consumer Advocate, at the National Health Care for the Homeless Council, (615) , ext. 239 or bzralek@nhchc.org. See application below.

6 CONSUMER CONFERENCE SUBSIDY APPLICATION FORM 2014 National Health Care for the Homeless Conference & Policy Symposium Please Print or Type Incomplete applications will not be considered. Agency and consumer signatures are required at the bottom. Name of Organization: City and State: This organization is a: 330(h) Grantee 330(h) Subrecipient 330(h) Subcontractor This organization requests Consumer Conference Subsidy as follows: Subsidy Worksheet Maximum travel subsidy available per grantee: $ Deductions, please mark as applicable: Single occupancy hotel room x three nights Registration Per diem (total- three days) for first consumer Per diem (total- three days) for second consumer TOTAL DEDUCTIONS $ $450 $ $ MINUS $. DIFFERENCE (subtracted from $1,600), available to reimburse for transportation costs $.

7 Consumer #1 Consumer Name: Consumer Mailing address: Consumer Telephone: Consumer This consumer: was nominated by Consumer Advisory Board was nominated by agency Board of Directors has participated in a Consumer Participation Outreach effort is member of HCH Project s Board of Directors is member of Advisory Committee or Consumer Advisory Board is staff member of HCH project is currently homeless is formerly homeless attended previous National HCH Conference will attend an NCAB orientation meeting at 5:00 on Wednesday May 28, from 5 pm 6 pm (mandatory) will attend the NCAB Membership Meeting, immediately following the Orientation, on Wednesday May 28, from 6 pm 7 pm (mandatory) will participate in the National HCH Conference May (mandatory) is a member of NCAB (mandatory; join on-line for free at

8 Consumer #2 (if applicable) Consumer Name: Consumer Mailing address: Consumer Telephone: Consumer This consumer: was nominated by Consumer Advisory Board was nominated by agency Board of Directors has participated in a Consumer Participation Outreach effort is member of HCH Project s Board of Directors is member of Advisory Committee or Consumer Advisory Board is staff member of HCH project is currently homeless is formerly homeless attended previous National HCH Conference will attend an NCAB orientation meeting at 5:00 on Wednesday May 28, from 5 pm 6 pm (mandatory) will attend the NCAB Membership Meeting, immediately following the Orientation, on Wednesday May 28, from 6 pm 7 pm (mandatory) will participate in the National HCH Conference May (mandatory) is a member of NCAB (mandatory; join on-line for free at Applications must be received no later than Friday, February 14, Please send to National Health Care for the Homeless Council, PO Box 60427, Nashville TN ; fax to 615/ ; or bzralek@nhchc.org.

9 Agreement As a part of this application for a Consumer Conference Subsidy for the National Health Care for the Homeless Council National Conference May in New Orleans, LA, I agree to the following: HCH Organization Representative: 1. I agree to be responsible for all reservations related to airfare including baggage fees, shuttles, and transfers. 2. I will file a reimbursement request including original receipts no later than June 20, I understand that any submissions after this date will not be reimbursed by the Council. 3. I will ensure that the consumer(s) have the necessary funds to pay out-of-pocket travel expenses. (To the extent possible, these will be prepaid such as shuttles and baggage fees.) More information on ground transportation will be provided with acceptance letter. 4. I have taken meeting times into account when booking travel. 5. To the best of my knowledge, the consumer I am recommending can represent my organization and its CAB well and fully participate in all conference activities. 6. I have read and fully understand the Consumer Conference Subsidy application and consumer requirements (below) Consumer Utilizing Consumer Conference Subsidy: 1. I agree that there are certain expectations that come with this Consumer Conference Subsidy. These include, but are not limited to: full participation in the conference, sobriety during meetings, respectful physical appearance, and participation in all required meetings. 2. If any part of the conference is a challenge for me at any time, I agree to contact my mentor, a member of the NCAB Steering Committee, NCAB Regional Representative, or a Council staff person to seek assistance. 3. I understand that I must be a member of NCAB to be eligible for the Consumer Conference Subsidy. The membership application is available at: National HCH Council staff are available by phone at to assist if needed. 4. I understand that I am responsible for spending per diem funds appropriately and that I will not be provided with additional Council funds.

10 Agency representative signature & Date Agency representative name & title printed, , and phone Consumer Applicant #1 signature & Date Consumer Applicant #1 name printed Consumer Applicant #2 signature & Date Consumer Applicant #2 name printed