Episcopal Presbyterian Health Trust Responsive Grants

New Grant Request: August 21, 2019

St. Louis Children’s Hospital – Victims of Violence EPHT Board Report- August 21, 2019

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Organization St. Louis Children’s Hospital Foundation Grant Request $20,000 Purpose of Grant Victims of Violence Use of Funds Salary Persons Served 75 – 100 Grant Period 01/01/2020 – 12/31/2020

Report Summary St. Louis Children’s Hospital Foundation is the philanthropic funding arm of St. Louis Children’s Hospital (SLCH). SLCH is recognizes for their ability to deliver essential health care services, conduct breakthrough research that leads to improved treatments for pediatric conditions, and provide community outreach for better childhood wellness. Violence in St. Louis City is a critical health problem, with 85% of youth living in neighborhoods where challenges compromise their well-being and contribute to violent behaviors. The Victims of Violence (VOV) program decreases acts of violence and saves lives of youth who visit the St. Louis Children’s Hospital Emergency Room for gunshot, stabbing, assault, and human trafficking. The VOV program provides 12 months of non-cost counseling and mentoring services from a Licensed Clinical Social Worker (LCSW) to youthful victims (ages 8 – 19) to transform their lives and curtail subsequent ER visits due to violence. Since 2014, 91 youth have completed VOV services, with only one returning to the ER - for mental healthcare. Of the 637 youth who did not receive VOV service, 207 visited the ER again for violence, with seven dying (6 from gunshot wounds and 1 in a vehicle incident). The VOV program serves a largely urban population that is primarily African-American and all of whom are living in poverty and most of whom live in North St. Louis City. Delivery of the VOV program is entirely reliant on building a rapport with the clients served and, in an effort to connect better with the teens in the program, VOV employs Licensed Clinical Social Workers (LCSWs) with experience and expertise working with this population. Outcomes. The goal of Victims of Violence (VOV) is to change the life trajectory of youth ages 8-19 seen in the ER due to violence-related incidents by providing trauma-related behavioral counseling and supports to decrease the chance that these youth will return to the ER due to repeated involvement in violence. Specifically, at least 83% of those completing the program will:

• Increase use of anger management skills and solution focused decision-making; • Eliminate involvement in interpersonal violence; • Diminish disrespectful and challenging behaviors toward police; • Decrease risk-taking behaviors such as unprotected sex, drug use, use of firearms, and gang

related associations. • Less than 5% of youth who participate in VOV will re-visit the St. Louis Children’s Hospital ER

due to violence. Financial Summary The VOV program is a $350,000 program in an organization that raises $30,000,000 per year for St. Louis Children’s Hospital, or approximately 1% of the budget. Financials provided are for the St. Louis Children’s

Episcopal Presbyterian Health Trust Responsive Grants

New Grant Request: August 21, 2019

St. Louis Children’s Hospital – Victims of Violence EPHT Board Report- August 21, 2019

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Hospital Foundation which did show a decrease in revenues in 2018 from 2017. Overall, however, the organization appears solid with close to $300,000,000 in net assets.

Funding Rationale The VOV program provides lifesaving support to the teens who join the program; however, with the Trustees 2018 decision not to include gun violence in its priorities, the program falls outside EPHT’s parameters.

Staff Recommendations At $430,000 in grants -0- At $270,000 in grants -0- At $195,000 in grants -0-

Previous Funding 2018 - $20,000 for Victims of Violence 2012 - $30,000 for Healthy Kids Express Dental Van Total Program Budget: $ 353,195 Trust Requested Grant: $ 20,000 Trust allocation: 5.6% Cost per person (EPHT): $ 267

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NARRATIVE SECTION A: ORGANIZATION INFORMATION 1. Brief summary of organization’s history. St. Louis Children’s Hospital Foundation is the philanthropic funding arm of St. Louis Children’s Hospital (SLCH.) Our mission supports theirs—“to do what’s right for kids.” Charitable donations made through our Foundation make it possible for our hospital to provide world-class medical, emotional, and social health support that can’t be found anywhere else. This is an important part of caring for the whole child. Founded in 1879 and the oldest children’s hospital west of the Mississippi, SLCH is a leader in pediatric medicine. For more than a century, SLCH has set new standards in care, breakthrough research leading to improved disease treatments, and community outreach for better childhood wellness in our region. We have an unbroken, 140-year tradition of serving every child in need, without regard for ability to pay (in 2018 we provided care free of charge to more than 9,700 children in need.) SLCH makes a positive difference in childhood wellness in St. Louis and impacts more than 100,000 children and families each year. For more than a dozen consecutive years, US News & World Report has ranked us among the nation’s top children’s hospitals and we achieved national rank in all of ten pediatric specialties measured. We are recognized as a hub of collaborative medical training and our Emergency Room (ER) is the only American College of Surgeons-verified Level 1 Pediatric Trauma Center in Missouri. Staffed by top medical professionals from Washington University School of Medicine and with investments from community partners, SLCH delivers highly specialized treatments for childhood illnesses. Children and families come to us for the latest therapeutic advances to treat the most complex medical diagnoses. 2. Brief description of the organization’s current programs, activities, number served annually, and recent accomplishments. Due to our urban location, St. Louis Children’s Hospital (SLCH) is on the front lines of treating pediatric conditions that could often be avoided if patients had access to preventative care and medications through insurance. SLCH, as a nonprofit institution, generates most earned revenue by providing medical care to children who come to the hospital for treatment. SLCH serves a highly diverse population and is the medical safety net for many children in low-income urban communities in the St. Louis area and surrounding medically underserved rural areas. Of note is that St. Louis has close to 100,000 refugees and immigrants making the greater metropolitan region their home. At our hospital, a multicultural team of interpreters is available 24 hours a day to provide culturally sensitive communication assistance in 42 different languages and dialects for patients and family members. Steadily increasing numbers of immigrant and refugee populations seek treatment and medical services from SLCH and its cross-cultural health screenings and education outreach programs. Over 35% of our patients come from low-income families and qualify for Medicaid, the public health insurance program for poor children, and an additional 25% live just above poverty level and their families can be considered “working poor.” The medical bills of patients that qualify for Medicaid are paid by the government at a rate that is much lower than the hospital’s actual cost for service. Regrettably, the state of Missouri has not expanded Medicaid coverage, so many families still live entirely without health insurance. With budget cuts to Medicaid and Children’s Health Insurance Program, our imperative to provide equitable access to health care for disadvantaged populations has never been more crucial. Our foundation strives to diversify and continually increase our base of support so that SLCH make a positive difference for the neediest children and families in our community. We also work to ensure SLCH can remain keenly focused on one of the biggest challenges facing our region—eliminating local disparities in pediatric disease prevention, diagnosis, and treatment. One approach is to provide quality health care outreach for our most vulnerable children, centered on their particular physical, emotional, social, and cognitive needs. This targeted outreach includes: free, community-based mobile health care through Healthy Kids Express Asthma, Dental, and Screening; a Family Resource Center that offers free, unlimited access to child safety education training and information on medical conditions and parenting a sick child (to decrease incidents of abuse or neglect); and a car seat installation station and safety store that provides free items as necessary.

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One of our most notable programs for youth, for which we are seeking $20,000 in philanthropic investment from the EPHT, is Victims of Violence: A Behavioral Health Program to Transform the Lives of Children and Youth. Our program literally saves lives of at-risk youth, one at a time, by offering counseling and behavioral treatment services to those who have been involved in violent interactions—providing them with an opportunity to heal themselves emotionally, physically, and spiritually in order to turn their lives around. For each young victim of violence who is not helped by our program, we lose an entire lifetime of contributions to families, potential employers, and communities. VOV fulfills our mission to “do what’s right for kids,” especially those youth with limited access to health care, by taking hospital services to them through outreach in the community and meeting them where they are. By fostering safe, stable and nurturing connections with young people, our program builds social-emotional learning, discourages risky and violent behaviors while building healthy behaviors, and encourages youth to have a powerful vision for their future. VOV also directly influences wellbeing and economic security for young people in our region. In fact, the global Campaign for Violence Prevention estimates that, for each $1 invested in reducing violent delinquency, $3 is saved in direct medical, possible incarnation, and lost-productivity costs associated with violence. We have developed the knowledge, experience, and best-practice strategies to make real and lasting differences in our community—but we need your partnership to continue this life altering work.

SECTION B: DIVERSITY, EQUITY, & INCLUSION Your answers will provide a valuable perspective on our potential grantees’ capacity to address the issues of diversity, equity, and inclusion (DEI). See User Guide for more information and examples. 3. List any internal or external efforts your organization is currently undertaking to incorporate diversity, equity, and/or

inclusion (DEI) into its policies and practices. Are there DEI initiatives your organization hopes to undertake? SLCH is committed to diversity and inclusion, both outside and inside the hospital. “Embracing Diversity” is one of the six core values for our hospital. SLCH has a suite of community-based programs under the umbrella of Child Health Advocacy and Outreach (CHAO). CHAO programs include: free, community-based mobile health care through Healthy Kids Express Asthma, Dental, and Screening; a Family Resource Center that offers free, unlimited access to child safety education training and information on medical conditions and parenting a sick child (to decrease incidents of abuse or neglect); and a car seat installation station and safety store that provides free items as necessary. Sadly, St. Louis’ excellent health care is utterly inaccessible for many families due to lack of insurance, funds, and transportation to get kids to doctors and dentists. Many, because of bad past experiences, don’t trust healthcare providers. Asthma and dental problems are leading causes of school absences, increasing academic disparities for poor children; the scarcity of healthcare providers, especially dentists, who accept Medicaid makes it even harder for these children to get a positive start. CHAO programs provide critical services to 40,000 children annually. It is not coincidental that CHAO programs are housed within SLCH’s office of Diversity, Inclusion, and Community Affairs, led by Greta Todd. Ms. Todd heads a diverse team of more than 70; her department includes our Language Services for patients and provides comprehensive diversity and inclusion training for all hospital staff, both administrative and clinical. New employee orientation includes an introduction to diversity training, and departments can engage Diversity, Inclusion, and Community Affairs for ongoing training programs. SLCH has been named a “Leader in LGBT Healthcare Equality” by the Human Rights Campaign Foundation, and we work hard to ensure that we provide the best possible experience for LGBT patients and families. This level of recognition is awarded to facilities that can demonstrate patient and employee nondiscrimination policies that specifically address sexual orientation and gender identity, and provide LGBT health education for key staff members. In addition, SLCH’s workforce of more than 3,000 is racially and culturally diverse; the hospital makes resources available, including tuition assistance, childcare subsidies, and other benefits, that ensure all employees can take advantage of advancement opportunities. We have recently added to staffing in Diversity, Inclusion, and Community Affairs, including another diversity training specialist, and anticipate that we will continue to improve our policies and training.

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4. How are the demographics of the community/clients your organization serves reflected in the composition of your staff, board, and/or volunteers? Are there ways that your organization strives to incorporate the perspective of the community/clients your organization serves? (Examples of demographics that may apply to your work include age, ability, national origin, religion, sexual orientation, socio-economic level, veteran status, or personal experience with issue (e.g., previous client of your organization)).

SLCH strives to maintain a staff that is diverse in terms of race, culture, national origin, religion, age, disability, sexual orientation, and gender identity. Our large workforce of more than 3,000 includes distributions across these categories that broadly reflect distributions throughout our region. The VOV program, serving a largely urban population that is primarily African American, employs Licensed Clinical Social Workers (LCSW) of diverse background and with expertise specifically in working with this population. At present, all of these LCSWs are African American women. Throughout the history of the program, we have found that the majority of program participants are much more likely to speak openly with African American women—most live in households headed by women, and are likely to distrust men because of negative past experiences. Delivery of the VOV program is entirely reliant on building a rapport with the clients served and, when possible, their families. The program’s mentoring model is rooted in: ensuring that clients’ perspectives are heard and respected, and building a treatment plan based on clients’ specific circumstances, needs, and views. SECTION C: DESCRIPTION OF COMMUNITY/CLIENT NEEDS & STRENGTHS 5. What are the community/client needs or problems that will be addressed by this project? Why is this issue important? Violence—and youth violence in particular—is a major problem for St. Louis City. According to the St. Louis Regional Youth Violence Prevention Task Force, more than 85% of youth in St. Louis City live in communities where they are confronted by numerous challenges that compromise their safety and well-being and contribute to violent behaviors. In St. Louis City— with 50 youth gunshot deaths for every 100,000 people—almost half of all violence victims are under age 25 and more than half of suspects are under the age of 25. In a recent study comprised of 90,118 US students aged 12 to 18 (The Contagious Spread of Violence Among U.S. Adolescents Through Social Networks) researchers found that adolescents are more likely to engage in violent behavior if their friends do the same. Moreover, this effect of violence extends beyond immediate friends to friends of friends. Study participants were 48% more likely to have been involved in a serious fight, 183% more likely to hurt someone badly, and 140% more likely to pull a weapon on someone if a friend engaged in the same behavior. Our program, focused on changing violent behaviors in individual children, has the potential to extend its reach into future generations and promote overall societal change in order to counteract these statistics. Through our hospital’s 2016 Community Health Needs Assessment process (repeated every three years), stakeholders determined that one of the top pediatric health issues in our city is Public Safety and Violence among and toward children. This finding mirrors a trend in which firearm-associated homicide and suicide are leading causes of death among American youths (aged 10 to 24 years,) with rates among African American youths being disproportionately high. And, with St. Louis’ violence rate being 3X the national rate, resulting in 50 youth gunshot deaths for every 100,000 people, interpersonal violence among—and toward—children is among the largest public health issues in our city. Unsurprisingly, the Emergency Room (ER) at St. Louis Children’s Hospital (SLCH), located in an urban environment and serving a predominantly high-risk, low-income population is witness to escalating interpersonal violence against adolescent victims in St. Louis. Almost once per day a child victim of gunshot, stabbing, or physical/sexual assault is brought to our ER for trauma care. The summer of 2019, though only half over, has seen a terrible toll—10 children have been killed by gun violence in St. Louis City, the youngest only 3 years old. As young people living in violent neighborhoods—and having been involved in an aggressive incident—youth who present at our ER for trauma suffer from its debilitating health and mental health effects and live each day with the constant fear of being shot, stabbed, or killed. It is also widely understood that victims of crime, especially violent crime, can experience enduring deterioration in their emotional health, with symptoms of anxiety, depression, hostility, and fear. Almost all return to the same home and neighborhood where they were hurt—facing the same dangers, and often targeted as potential “snitches” to police. To cope, many try to isolate themselves or engage in delinquent behavior such as using drugs, fighting, and joining or assisting local gangs to survive. They have few options for seeking out safer circumstances or positive role models. Lacking resources and opportunities that could support long-term, positive life changes, these youngsters are much more vulnerable to poor outcomes as adults.

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In 2013, Margie Batek, MSW, with the ER at SLCH, realized that behavioral interventions offered in ER’s were historically only used to facilitate reduction in domestic violence among adults and suicide attempts in adolescents—and that very little systematic programming had focused on pediatric ER’s as a means to prevent future violence and victimization among youth. In addition, while various St. Louis agencies are available for referral of families whose youth are involved in violence, SLCH staff found after years of referring youth out to other organizations for follow-up behavioral health and counseling services that few—if any—followed up. These young victims were discharged back to their homes and neighborhoods to face high risk for recurrent violent incidents—with no further SLCH intervention. The way we usually discovered the poor outcome was when a child died in our ER. As a result SLCH alone, among local hospitals, took it upon ourselves to design and begin delivering a comprehensive model of health care specifically aimed at addressing the rampant problem of preventing reoccurrences of interpersonal violence among—and towards—underserved youth in St. Louis City. Through this imperative our Victims of Violence: A Behavioral Health Program to Transform the Lives of Children and Youth was developed. Victims of Violence (VOV) provides 12 months of no-cost counseling and mentoring services from a Licensed Clinical Social Worker (LCSW) to youthful victims to transform their lives and curtail subsequent ER visits for violence. 6. Identify 3-5 strengths of the community/clients that your organization serves AND explain how those strengths might

contribute to the success of this project. The youth who take part in the VOV program are true survivors. Their strengths include:

1) Resilience – While suffering the effects of violence can take a terrible emotional toll, these children are remarkable at adapting to their circumstances and continuing to move forward with their lives. With the help of our LCSWs, they can find positive coping strategies to help them make more positive choices that they can couple with that tenacity to build better lives for themselves and avoid violence.

2) Resourcefulness – VOV participants live in very challenging circumstances, often experiencing temporary homelessness or lacking basic amenities such as beds or winter clothing, yet they find creative ways to solve problems and get through day-to-day life. These children display creative thinking that, with guidance, can help them envision and act to create a different life.

3) Commitment – Only a small percentage of those eligible for VOV opt to participate (though we hope to grow that number gradually). Those who join are overcoming significant social pressures and fears even to speak with a counselor. They demonstrate a strong commitment to make a change in their lives. Over the lifetime of the program only about 36% of those who have begun the program have subsequently dropped out. Once these youth overcome initial hesitation and commit to change, they are overwhelmingly successful in avoiding violence.

SECTION D: PROJECT INFORMATION 7. Describe who will be served by this grant? Please include what percentage of those served live in poverty and how you define poverty. Through the Victims of Violence (VOV) program, youth (ages 8-19) visiting our Emergency Room (ER) for gunshot, stabbing, assaults, mental health issues, domestic violence, and fear of being trafficked are encouraged to develop empathy and emotional intelligence to decrease future acts of interpersonal violence. Currently there is no other St. Louis provider utilizing immediate youth violence intervention through a hospital ER, although studies indicate that initiating these services immediately is critical to preventing re-victimized of at-risk youth. Moreover, while it may be impossible to place a price on saving just one life, it is important to note that VOV program costs approximately $3,500 per participant per year, which is quite an impressive return on investment. Youth to be served through this request will be similar to the 652 youth (99.9% African-American) offered VOV services from July 2014-May, 2019 when presenting in our ER for physical trauma treatment due to interpersonal violence. Most youth reside in North St. Louis city and are from highly disadvantaged neighborhoods—those characterized by low-income and high poverty, unemployment, and crime. 100% of program participants live in poverty. We base this number on a combination of indices: the demographics of the neighborhood, along with specific personal/household information (such as income, employment, household size, insurance status) gathered via hospital admissions and a program Data Sheet. These youth are at greater risk for several negative outcomes associated with being raised in low-income circumstances, such as: poor academic achievement/school dropout; being a victim of or perpetuating abuse and neglect; gang-related behavior; and chronic physical, socio-emotional, and behavioral health problems.

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Of these young people, 194 (23%) accepted VOV services and were enrolled into the program between 2014 and 2019. The majority of participating youth endured gunshot (27%) or assault (57%), with the rest suffering from stabbing, domestic violence, or mental health concerns. Two had fallen victim to human trafficking. Two-thirds were male, with over 70% being 14-18 years old. Sadly, 27% were children under the age of 14. Many teen participants are homeless or couch-surfing with friends/distant relations (due to family conflict) or have been involved with the juvenile or criminal justice systems—factors which greatly increase their risk for being further victimized, abused, trafficked, or suffering from additional physical health problems. Living in fear and poverty may have devastating effects upon these kids, but providing alternatives to delinquent behavior, such as VOV services—can alleviate the negative long term emotional and physical health consequences of urban violence—as evidenced by our outstanding outcomes. As of May, 2019, 91 youth had successfully completed VOV through meeting treatment goals (not being lost-to-follow-up/not progressing towards goals) only 1 has returned to the SLCH ER (for mental health issues, not interpersonal violence.) Most importantly, all are either in school (with two in college) or have their GED and are employed. As of May, we had 34 youth still working towards their goals. During this same time period, of 637 youth who declined VOV service, or who began VOV and did not complete goals/were lost-to-follow-up (less than 10% of all participants—207 presented again in our ER for other violent incidents, with 7 dying (6 from gunshot wounds and 1 in a motor vehicle accident.) We realize that our acceptance rate for VOV services may not seem impressive but it is not always easy to convince these youth to accept VOV services—even though they are introduced to VOV while they are in our ER for active trauma treatment. They are a hard to reach population, often distrustful of adults and with legacies of mistrust among institutions. Our experience in recruiting willing participants mirrors those experienced by others, such as Reverend Marc D. Smith, Bishop’s Deputy for Gun Violence Prevention, who struggles to reach and enroll adult participants in services for victims of violence. It is also important to note that until January of 2017, when we secured emergency gap funding to add two additional LCSW/Mentors to the VOV staff that we could only serve 50 youth at any point in time—so we often had a waiting list. Even now, with 4 LCSWs we can only serve 100 total at any point in time. A future goal of the VOV program is to secure funding for a VOV staff position who would work as an ambassador with youth and families who decline services in an attempt to change their mind. It is envisioned that this person would be a past participant in VOV, or a close family member like a mother, who would do work similar to that of a community health worker. It is our belief that this “lay” position may be able to encourage even higher participation rates. In the meantime, we continue to work hard to provide LCSWs who mirror the community in which they work. This allows them to better connect with these young men and women (and their families, who must consent to services) and to assure them that by enrolling to participate that they will not be expected to “snitch” on anyone involved with the violence (we leave that to law enforcement.) Our LCSWs also need to dispel any perception by families that–beyond what must be reported if observed, such as physical or sexual abuse—our staff would not keep client confidentiality. The challenge now facing our VOV program is securing funding to retain full staffing of 4 LCSWs in order to be able to serve up to 100 youngsters at any point. Your support of this proposal will help to leverage additional donations from private foundations, corporations, and individuals throughout the St. Louis community in the short term, while positioning us to seek state and federal sources of health and violence-prevention funding. 8. How many will be served with funding from this grant? We anticipate that approximately 75-100 children will participate in the VOV program during the grant year. Of these, approximately 32 will be new admissions to the program, while the rest will be at some stage of their one-year course of Mentoring. A gift of $20,000 will support services across the program, and will be devoted entirely to staffing costs which represent the core of the program.

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9. What are your project goals? (Operating or capital requests: what are your agency’s major goals?) The goal of Victims of Violence (VOV) is to change the life trajectory of youth (ages 8-19) seen in the ER due to violence-related incidents by providing trauma-related behavioral counseling and supports to decrease the chance that these youth will return to the ER due to repeated involvement in violence.

• At least 83% of those completing the program will:

o Increase use of anger management skills and solution focused decision-making; o Eliminate involvement in interpersonal violence; o Diminish disrespectful and challenging behaviors toward police; o Decrease risk-taking behaviors such as unprotected sex, drug use, use of firearms, and gang related

associations. We meet these objectives by employing Licensed Clinical Social Workers (LCSW’s) who provide 12-months of free, personalized, evidence-based health care, trauma counseling, instruction in anger management and conflict resolution, assistance with health concerns and medication compliance, as well as and overall mentoring. 10. What activities do you intend to engage in or provide to achieve the aforementioned goals? Please provide an in-depth

description of the activities/services, including: 1) how much, 2) how often, 3) how long activities/services will be provided. For expanded project requests, distinguish between current and expanded activities/services.

Victims of Violence (VOV) program activities utilize behavioral health interventions—all of which are best practices in the field of trauma treatment and have the highest potential for reducing a child’s chances of delinquency and further instances of violence. Youth participating in VOV have generally experienced numerous traumas in their lives; before you can treat the symptoms, you must treat the trauma. To combat this these youth receive 12-months of free health trauma-based healthcare and counseling from Licensed Clinical Social Workers (LCSWs) to build resiliency, teach positive social skills, and impart tactics to avoid peer pressure, gangs, violence, human trafficking, and drugs. LCSWs providing VOV services to youth also understand that they must work within the “no-snitch” rule that prevents young African-Americans from seeking support out of fear of appearing powerless or weak. To combat this, we purposely refer to VOV as a Mentorship program, which is critical to gaining confidentiality and loyalty of potential program participants. With each LCSW Mentor, we can expertly provide VOV intervention to 25 underserved youth (at any given point.) Licensed Clinical Social Workers (LCSWs) who are African-American and skilled in working with highly stressed, urban families provide services to youth. In addition, VOV LCSWs participate in the National Network of Hospital Based Violence Intervention Programs to share ideas and methods to better serve our VOV youth. An initial Psychosocial Assessment of Youth—including screening for Post-Traumatic Stress Disorder—allows LCSWs to identify poor coping skills, mental health/ substance abuse needs, sexual-exploitation (asking specifically if youth “Have ever traded sex for drugs, food, or a place to stay?”), and lingering effects of past traumas to pinpoint strengths that can help youth develop resilience. Awareness of factors discovered during this assessment shapes initial intervention and lays a foundation for further assistance. It is vital that LCSW mentors know enough about these youth so they can help reveal the beliefs behind their actions, perceive their ability to resolve crises to move past the issues that may potentially lead to acts of violence, and to live healthy, productive lives. Following the Psychosocial Assessment, LCSWs empower youth and/or parents to develop individual trauma-informed treatment intervention and counseling goals to be addressed through VOV intervention services during the period of service (generally 9-12 months) to improve patterns of behavior and promote a sense of accomplishment. Evidence-based strategies include behavioral therapy to process painful emotions; cognitive processing therapy to treat posttraumatic stress; and motivational interviewing and crisis management communication, which teaches ways to interrupt harmful situations by changing their behavior. Trust is enhanced by transparency, which includes acknowledging and respecting different agendas. Youth participate in weekly, individual counseling/treatment sessions with their LCSW for approximately 6-7 months. At that point they move to bi-weekly meetings for 2-3 months, and then to monthly meetings for 1-2 months. Since these youth have generally experienced multiple traumas in their lives, most treatment goals cannot be achieved in less than 9 months (29-30 hours of counseling.) Youth completing 12 months of service receive roughly 32-36 hours of treatment.)

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Areas explored during VOV health intervention include creative problem solving and overcoming irrational beliefs; self-assertiveness, self-regulation, anger management and communication training; dealing with substance abuse and grief/loss; and, psycho-educational interventions, which empower children and families to develop collaborative goals and problem solving to protect themselves. By focusing on the emotional well-being of youth, these interventions have the highest potential for reducing a child’s chances of delinquency, academic failure, and further instances of violence. In addition to providing formal counseling and intervention, LCSWs spend time with and mentor the youth they serve by attending Individual Education Plan meetings, meetings with Department of Justice officers, school conferences, celebrating children’s accomplishments (such as school awards and graduation), and arrange family group therapies. Further, they accompany children to medical visits and take other important and necessary steps to ensure child wellbeing. Likewise, they take each youth out to dinner on their birthday and invite their youth to attend a holiday party and an annual retreat, where youth interact with other individuals being served through VOV, or recent “graduates” from VOV services. Once goals are met, youth are considered to have successfully completed VOV, although LCSWs are available for past participants as a source for character references, referral to additional services, or to celebrate future successes.

11. What are the anticipated short-term and long-term measurable outcomes that would be achieved by this grant? Outputs for 2020:

• Of approximately 200 youth visiting our ER, 160 will qualify for and be offered VOV intervention services within 24 hours of a violence-related ER visit and immediately be able to enroll for services.

• At least 32 of these youth will receive an Initial Psychosocial Assessment. • At least 32 youth will discuss with LCSW Mentors factors discovered during Psychosocial Assessment and determine

counseling intervention activities/personal goals to prevent recidivism. • At least 27 youth will enroll into VOV services and receive receiving evidenced-based counseling from an LCSW

Mentor to address stated objectives in their individual VOV participation plan. • Approximately 50 youth who begin receiving VOV services will complete the stated objectives in their individual VOV

participation plan. • A minimum of 32 youth will remain enrolled in VOV and still working toward completion of stated objectives in their

individual VOV participation plan. Outcomes for 2020:

• A minimum of 20% of all youth who visit St. Louis Children’s Hospital (SLCH) Emergency Room (ER) for a violence-related incident will agree to see a Victims of Violence (VOV) Licensed Clinical Social Worker (LCSW) Mentor for an Initial Psychosocial Assessment.

• At least 89% of youth who have an Initial Psychosocial Assessment will begin to see a LCSW Mentor for VOV services. • Over 60% of youth leaving VOV will have successfully completed 100% of stated objectives in their individual VOV

participation plans. • Less than 5% of youth receiving VOV services who participate in VOV will re-visit the SLCH ER due to violence.

12. What is the timeline for implementing this grant? This funding will be used in its entirety between January 1, 2020-December 31, 2020

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13. What are the organization’s most significant interactions with other organizations and initiatives? For project requests, address this question with respect to that project only. (e.g., who are the other partners, what is your past experience collaborating with each organization, what is their role in this project, and what is their expertise, etc.?)

Our Victims of Violence (VOV) Licensed Clinical Social Worker (LCSW) Mentors consistently leverage community partnerships to enhance the trauma-informed intervention counseling and services they provide to ensure that youth have a spectrum of supports in place when intervention services through VOV are completed or when there is a need to coordinate care for current VOV participants. As appropriate, our LCSW Mentors coordinate with community partners to provide services beyond our reach, including GED test preparation, job placement, college application assistance, and connecting with primary medical and psychological service providers. LCSW’s work with youth/families to determine necessary connections and then visit agencies in-person to vet quality and scope of services offered before handing off VOV participants. Hand-offs of participants are always done in person to ease the transition for youth who may be distrustful of adults and/or authority figures. Concurrently, VOV staff continue to disseminate VOV of program effectiveness findings through submitting article for publication (Journal of Public Health in 2017) as well as sharing outcomes with the National Network of Hospital Based Violence Intervention Programs. Moreover, VOV staff are participating in a citywide violence prevention initiative (being coordinated by WUSTL Institute for Public Health and Dr. Kristen Mueller) that includes the Emergency Rooms of Barnes Jewish, Cardinal Glennon, and St. Louis University Hospitals. This alliance will allow comprehensive, long-term data collection and monitoring of youth who are enrolled in/have completed SLCH VOV service and who age out of of—or present at—a different ER than ours. 14. What other agencies or projects are doing similar work in the region and how are you different? Currently there is no other St. Louis provider utilizing youth violence intervention through a hospital ER, although studies indicate that initiating services like these—without delay—is critical to preventing re-victimization and ending the cycle of violence. Victims of Violence (VOV) is consistently recognized as the only program of its kind in the state and one of two in the entire Midwestern Region to utilize this unique opportunity. Our program, in its current incarnation, is not modeled from another program. There are a few programs across the U.S. who do short term case management with 2-4 encounters—but none that provide the intensive, 12 months support and intervention of our VOV program. We are unique in the duration of time, educational level of the clinicians as Licensed Clinical Social Workers (LCSW) and the fact that our services are free and no incentives are used to recruit families. VOV staff did consult assessment tools from many types of programs to develop our initial Psychosocial Assessment of Youth tool, allowing us to best identify substance abuse issues, mental health diagnoses, domestic violence incidence, risk-taking behaviors such as unsafe sex, gang activity, etc. No one assessment she reviewed from any other program incorporated all the questions and concerns that our highly stressed, urban youth population may need to have addressed to help them heal emotionally and developmentally. Our “proof of concept” period for VOV (2012- 2014) was based on a 2-4 visit model and outcomes indicated that this short service span did not result in truly changing the trajectory of the children’s lives. The timeframe was too short to develop rapport and the behaviors were too entrenched to change with minimal contact with the LCSW Mentor. Moreover, there was only one LCSW Mentor, a male. During this time period (July-December 2014) the program could not adequately serve girls or children, as those populations were not comfortable interacting with an adult male for trauma counseling (very few girls on younger children opted-in to his services.) We designate this period as the “proof of concept” phase of the program, since only one subset of the whole was served. Realizing the program was missing a critical component—the ability to provide services to girls and younger children—we worked to secure additional funding to add a female LCSW Mentor. During this “pilot” program (2015-2016), the VOV team incorporated changes to the program based on what didn’t work during proof of concept—including a longer length of service and adding an additional LCSW Mentor. The “pilot” period in which we had both a male and female LCSW allowed Margie and her team to set benchmarks for the VOV program using service data for boys and girls—including preteen children.

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The entirety of our VOV program development to-date has helped highlight which of our intervention techniques work best—and which do not—with low-income, at-risk urban youth. Now that our program is standardized, and has produced such notable outcomes, we will share it with other local hospital Emergency Rooms that are part of a citywide violence prevention collaboration, in collaboration with Washington University, to ensure program viability in other pediatric medical environments and to see if the same level of service can work with adult populations. Program founder Margie Batek co-published research with WUSTL concerning outcomes of VOV during its proof of concept phase (2012-2014), and we hope to see additional publications on results of the pilot phase of VOV (2015-2016). 15. Who are the key staff members, board members, and/or volunteers who will ensure the success of the

project/organization and what are their qualifications?

Margie Batek, MSW, LCSW, who was with the SLCH ER Trauma Team for 20+ years and founded the Victims of Violence (VOV) program, retired at the end of June, 2019. All LCSW staff remain, and service is continuous under the supervision of Mary Alice Scherrer, Manager, Social Work/Chaplaincy. SLCH will seek a full-time program manager for VOV. Since VOV Mentors provide trauma intervention that empowers urban youth, addresses the realities of their unique struggles, and focuses on their mental health needs to prevent re-victimization or exploitation, she hires Licensed Clinical Social Workers (LCSW) armed with experience in culturally relevant intervention and who understand the unique challenges of providing crisis counseling. These LCSWs understand the unique challenges working with highly stressed, urban youth who have limited access to mental health care. These unique individuals have backgrounds that include mentoring fathers, providing counseling to the homeless, working with children in foster care, and adults with behavioral health issues. Mentors provide evidence-based counseling interventions, provide instruction in anger management and conflict resolution, and can assist with medication compliance. These interventions have the highest potential for reducing a child’s chances of delinquency, academic failure, and further instances of violence. Mentors also attend school functions/conferences, celebrate noble accomplishments, and arrange family group therapies. 16. What staff, board, or volunteer training and professional development needs are required to implement this project, if

any? Please be specific (e.g. trainings on cultural competency, effective use of social media, or fundraising techniques). As described above, the LCSWs selected for the program are very carefully vetted for their expertise in working with the target population. We encourage these staff members to participate in ongoing coursework and professional development experiences relevant to their field and important to maintenance of their licenses; this includes attendance at an annual conference.

17. How does this request fit within your organization’s long-term goals? (We define long-term as the time-period beyond this grant). How does this project support your organization’s implementation of its strategic plan?

Every three years St. Louis Children’s Hospital (SLCH) undertakes a regional Community Health Needs Assessment (CHNA) survey and focus group process. This initiative utilizes input from parents and those who have special knowledge and expertise in the area of public health—to help us identify which childhood health concerns, from infancy to adolescence, community stakeholders consider most important in the St. Louis bi-state region. In 2016, CHNA stakeholders determined that one of the top pediatric health issue in our city was Public Safety and Violence among—and toward children. SLCH staff reviewed primary and secondary CHNA data and have developed an Implementation Plan that prioritizes and details what interventions our hospital will undertake to address community health needs. It includes rationale for why a need was selected, measurable goals and objectives, annual action plan, stated outcomes, and an outcome evaluation process to determine success. The Plan is updated as community needs and priorities change. The Victims of Violence program is one way in which our hospital is committed to combating violence as a public health issue in our region. We employ epidemiologists to ensure we target services identified in the CHNA to those most in need of our care, as well as data experts who compile weekly and monthly analysis reports to help us better serve our community. Interventions are considered successful if they meet or exceed our set objectives defined annually and successfully provide services to the targeted/intended populations. By regularly assessing and responding to the needs of our stakeholders, SLCH has built a level of community trust which allows program providers to provide the greatest impact, while remaining nimble enough to respond directly to the greatest needs. Community impact and important findings are shared with our Foundation at the end of each program year we, in turn, share these with donors.

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18. What is your long-term funding plan once funding from this funder ends? (For project requests, address this question with respect to that project only). A bold program like Victims of Violence (VOV)—which has proven short-term success in preventing interpersonal violence among at-risk youth and has potential for long-term, systemic change—is provided free-of-charge in order to encourage participation from youth who often have no access to counseling care. Sadly, VOV expenses are not presently reimbursable through Medicaid or insurance billing and cannot be absorbed into SLCH’s operating budget. In 2016, VOV staff explored the possibility of billing insurance for clinical counseling services, for which a case could be made for medical necessity. We realized at that point that in addition to not having the capacity to conquer the processing of claim paperwork that the anticipated amount of insurance reimbursement—approximately 46.7%, according to Missouri Foundation for Health—would not offset the cost to create this infrastructure to track billing and provide staff to do so. Long-term plans for a more sustainable VOV model include utilizing 5 years of VOV program effectiveness data collected between 2014-2019 to prove its ability for replication within other urban areas across the U.S., which will allow us to develop a fee-based “train-the-trainer” component and prepare us to seek secure federal funding for the prevention of interpersonal violence. The challenge now facing the VOV program is to secure funding to preserve continuity of care for up to 100 at-risk youth. In the near-term, St. Louis Children’s Hospital Foundation will continue to solicit donations from forward-thinking corporate and foundation sources with health-centered missions—similar to that of EPHT—as well as from interested individuals throughout the St. Louis community. 19. Describe the extent to which your project/organization is based on evidence-based, best, or promising practices. Victims of Violence (VOV) services align with recommendations made in For The Sake Of All, which shows the need for our region’s youth to receive behavioral health services that build resiliency, teach positive social skills, and impart skills on how to avoid peer pressure, gangs, violence, and drugs—which are key in curtailing involvement in subsequent victimization. Our approach is also supported through other studies that have shown the effectiveness of programs like VOV that recognize and address violence as a complex preventable health problem. A study published in the 2017 Annals of Internal Medicine, which examined the potential effect of exposure to violence on the associations between gun carrying and psychological distress among 1,170 vulnerable male adolescents. These youngsters, aged 14 to 19 years had committed a serious violent act (The Relationships Among Exposure to Violence, Psychological Distress, and Gun Carrying Among Male Adolescents Found Guilty of Serious Legal Offenses: A Longitudinal Cohort Study.) This research found that exposure to violence (as either a victim or a witness) was significantly related to gun carrying, with increased incidences of gun carrying corresponding with each additional report of involvement in violent incidents. This study also noted, “When strategies to reduce gun violence among vulnerable male youths are being considered, intervention efforts that focus on dealing with psychological distress after victimization and that are rooted in trauma-informed care may be most effective in combating gun violence among high-risk, vulnerable adolescents.” Before and After the Trauma Bay: The Prevention of Violent Injury Among Youth, a study published in 2008 states: “High rates of health care recidivism for violent injury, along with increasing research that demonstrates the effectiveness of violence prevention strategies in other arenas, dictate that physicians recognize violence as a complex preventable health problem and implement violence prevention activities into current practice rather than relegating violence prevention to the criminal justice arena.” They elaborate, “The emergency department (ED) and trauma center settings in many ways are uniquely positioned for this role. Exposure to firearm violence doubles the probability that a youth will commit violence within 2 years, and research shows that retaliatory injury risk among violent youth victims is 88 times higher than among those who were never exposed to violence. Assessment and intervention with violently injured youths to prevent reinjury is a logical extension of violence interventions already occurring in the ED and can build on protocols that are already in place.” And the Office of the Surgeon General, in the report Youth Violence: A Report of the Surgeon General, indicates: “Effective programs for young people who have already demonstrated violent or seriously delinquent behavior produce long-term changes in individual competencies, environmental conditions, and patterns of behavior. The best information on general strategies that are effective or ineffective in reducing the risk of further violence among these youths comes frequently cited meta-analyses of violence prevention programs are those conducted by M.W. Lipsey and colleagues.

Missouri CGA V.2.0: Page 14 of 16

Two major conclusions come from Lipsey's research. The first is that “effective treatment can divert a significant proportion of delinquent and violent youths from future violence and crime.” Additionally, results from the Lipsey studies also indicate, “multimodal, behavioral, and skills-oriented interventions are more effective than other less-structured approaches for non-institutionalized individual counseling emerged as one of the most effective intervention approaches for seriously delinquent youths.” SECTION E: EVALUATION 20. What tools and processes does your organization use to measure whether or not your program is achieving its goals and

outcomes? Describe the measurement tools (e.g., intake sheets, participation checklists, pre/post surveys, client questionnaires follow-up surveys, co-design evaluation tools/co-collect data with your clients/community members, etc.).

St. Louis Children’s Hospital (SLCH) staff are well versed in the need for stringent program analysis and review to set new standards in care, cure, and community outreach that improve life in St. Louis. Primary changes in knowledge, attitude, and behaviors that LCSW’s observe as indicators of VOV program success for youth are: no recidivism of interpersonal violence; improved personal stress management; achievement of personal goals the youth/family developed; enhanced decision-making and better conflict resolution skills; and, successful academic achievements or employment. Our Licensed Clinical Social Workers (LCSW) are also made aware of household hardship indicators, including: unemployment; inability to meet essential expenses; non-payment of rent or mortgage/eviction; failure to pay utility bills/utilities being cut off; foregoing needed medical/dental care or extreme medical bills; mental instability, depression, or drug/alcohol abuse; and not enough food to eat. In addition to tracking demographics, meeting attendance, and program compliance, data tracked and reviewed to determine progress towards intended project outcomes are:

• Periodic review of interventions by LCSW and child/family to determine progress toward completing clinical counseling and personal goals and to identify plan obstacles.

• Monitor report cards/teacher notes, court hearing outcomes, special education plans, and work collaboratively with other individuals/agencies in each child’s life.

• Document all services delivered and attempts to re-engage lost-to-follow-up cases. • Monitor Emergency Room (ER) visits made by youth who have completed VOV services.

The program supervisor, who like all of our LCSWs holds a Masters of Social Work, obtains, enters and monitors demographic data on youth/families, ER records, case notes and data from LCSWs, and participant self-report surveys. This cumulative data is compiled into VOV data analysis reports that are discussed in weekly team meeting case reviews to measure and evaluate program effectiveness. VOV results are also reviewed annually, which allows LCSWs and supervisor to recognize successes and challenges and to identify necessary program modifications to better serve enrollees and their families. 21. How will the evaluation results be used to inform/strengthen future programming and organizational operations? Program evaluation allows LCSWs and their supervisor to recognize successes and challenges to identify necessary program modifications, which will better serve enrollees and their families. Program impact and important findings are shared with our Foundation at the end of each program year we, in turn, share these with donors. VOV is now in a capacity-building phase (2017-2019) which will help us amass 5 years’ effectiveness data to further demonstrate program success in helping our target population and better position us to seek state and federal sources of support, such as Victims of Crime Act (VOCA) funding.

Missouri CGA V.2.0: Page 15 of 16

SECTION F: BUDGET NARRATIVE JUSTIFICATION 22. After completing the CGA budget template (NOTE: check both tabs of the spreadsheet), please provide a description of

each expense and revenue line item listed on the program/project budget. Indicate whether this is a new expense for your project or if funding is being requested to cover a current/existing expense. For example, if you list personnel expenses, please state whether these funds will be used for new or existing staff positions. Explain how the numbers are being calculated.

A $20,000 grant from EPHT will be used between 1/1/20 and 12/31/20 to help with continuation and growth of Victims of Violence (VOV) program service delivery and assessment:

Salary and benefit expenses associated with LCSW VOV Delivery Staff, of which 100% of their time is dedicated to direct program delivery of VOV services providing direct behavioral and mental health counseling and support for at-risk youth in challenging neighborhoods. LCSWs plan/deliver services to 25 youth each at any given point over 12 months.

Management oversight/training of LCSW VOV Delivery Staff by the VOV Program Supervisor Direct delivery project expenses including $10,000 for incidentals for positive reinforcement, Holiday; and mobile

business phones for LCSW/Mentors, who are available to youth 24/7. The Total Budget for 1/1/20-12/31/20 is as follows. 1. Salaries+Benefits: $310,806

Program Supervisor: 60% of Salary+Benefits =$54,540/yr. Manage LCSW mentors; evaluate program effectiveness; train VOV LCSWs. LCSW: 100% VOV = Salary+Benefits ($64,066.5/yr. AVG x 4 LCSW) LCSWs deliver services to 25 youth at any point.

2. Training & Professional Development: $4,000. Trauma Informed Care Conference (4 LCSW) LCSW remain current in best practice. 3. Travel: $10,109. Local program travel (4 LCSW x 90 mile/wk. avg. x 52 weeks x .54/mile.) LCSW's meet with youth/family at home or school. 4. Program Supplies: $5,000. Intervention/Counseling Tools used with youth/families. 5. Conferences/Meetings: $2,000. Annual retreat for youth/mentors to bring together youth for peer exposure. 6. Other: $21,280.

Assistance for youth served: $10,000 ($100/youth per year x 100 youth.) Incidentals for positive reinforcement. Holiday Party for all current/past participants: $6,000 (80 youth x $75.) Acknowledge program participation. Business cell phones/wireless internet for mentors: $5,280 ($110/mo. x 4 LCSW x 12 mo.) LCSW's on-call 24/7 for youth served.

7. In-Kind from SLCH or SLCH Foundation: Salary and Benefits: ER VOV Intake staff; Contract Services - Fundraising; Occupancy (rent, utilities, maintenance); Insurance; Equipment; Printing, Copying & Postage; Evaluation; Marketing; and Administration.

Missouri CGA V.2.0: Page 16 of 16

REQUIRED ATTACHMENTS 1. Copy of the current IRS Letter of Determination indicating tax-exempt status.

2. List of current board of directors. Include the following information for each board member:

• Professional affiliations (name of organization of employment and title) • ZIP code of residence (e.g. 63105, 63135)

3. If applicable: Letter of support from each collaborating organization that explains their role and is signed by the top

executive(s) of that organization.

4. If applicable: Memorandum of Understanding or contract between the organization and the fiscal agent/fiscal sponsor.

5. Financials NOTE: financial statements are to be prepared according to generally accepted accounting procedures (GAAP)

• Project budget (must use Excel CGA Project Budget template included as part of this application) • Internally prepared income statement for current fiscal year. (You may use Excel CGA Organizational Budget

template included in this application or your own personal template). AND

i. Complete copy of organization’s audited/reviewed/compiled financial statements for the last fiscal year (which should include two (2) years of financial information). OR

ii. Organization’s most recently filed Form 990, plus internally prepared financial statements for the past two (2) years. Must include: * Statement of activities (income statement) * Statement of financial position (balance sheet) * Statement of cash flow

6. Additional Attachments: Individual grantmakers may choose to request additional attachments. Please check with the individual grantmaker.

Please read the following statements and check both the boxes certifying that this application is complete according to the requirements set forth by the grantmaker.

JC I have reviewed the website or spoken with the grantmaker to whom I am submitting this application and have reviewed their mission, funding interests, process, and requirements to determine if my request is a funding fit.

JC I have included in this application any additional materials and attachments required by this funder.

Name Board Position Business Affiliation ZIPBaur, Richard D. (Todd) Principal, Conway Investment Research LLC 63124Buck, Joseph F. (Joe) Community Volunteer 63124Button Bell, Katherine (Kathy) Vice President, Chief Marketing Officer, Emerson 63124Cammon, Dale L. Chairman and Co-Chief Executive Officer, Bryant Group, Inc. 63124Fusz Jr., Louis J. (Lou) Emeritus President, Lou Fusz Automotive Network 63124Glanvill, Derek W. Community Volunteer 63011Harbison, Keith S. Managing Partner, Alitus Partners 63124Hermann Jr., Robert R. (Bob) President and Chief Executive Officer, Hermann Companies 63124Hogan, Brian J. President, Hogan Truck Motor Leasing, Inc. 63131Johnson III, James L. (Jim) Partner, Johnson Bender Asset Management 63124Kreienkamp, Ray Ex-Officio, Legacy Advisor Chair Husch Blackwell, LLP 63131Ledbetter, Rich President, Castle Contracting 63105Lewis, Christopher N. (Chris) Edward Jones 63119Lilly, Julie J. Woodmark Group Liaison The St. Louis Trust Company 63124Lintz, Katherine (Kathy) Finance Chair Founder and PartnerMatter Family Office 63105Magruder, Joan BJC Group President 63017Maher, Kevin A. Nominating/Governance Chair President, St. Charles Automotive 63124McClure, Richard (Rich) Ex-Officio, Hospital Board Chair Community Volunteer 63122McDonnell III, James S. (Jim) Vice Chair Community Volunteer 63124McKee III, Paul Joseph (Joe) Chief Executive Officer, Paric Corporation 63131Miller, Roger Chairman, Gateway Packaging Company 63105Myers, Karen D. Gift Planning Chair Senior Vice President, U.S. Bank 63105O'Connell, John T. Community Volunteer 63131Oliver, Timothy C. (Tim) CHAIR Community Volunteer 63131Oliver, Kim Ex-Officio, Friends Board Chair Community Volunteer 63131Packnett, Gwendolyn Community Volunteer 63032Parker, Craig M. President, Center Oil Company 63131Pope, Kathy RAC Chair Washington University School of Medicine 63124Schenck, Sandy Ex-Officio, Development Board ChaDirector of Buisness Development and Product Strategy, ACAP 63130Silverman, Gary Ex-Offiicio Chairman, Department of Pediatrics, Washington University Sc 63110Sivewright, Joseph R. (Joe) President, Nestle Purina 63124Stapleton, John L. (Jack) Donor Care Chair & CMN Liaison Commerce Trust Company 63122Theiss, James M. (Jim) President and CEO, TKC Holdings, Inc. 63105Van de Riet Jr., Raymond R. (Ray) President, Aero Charter, Inc. 63141Windsor Jr., Charles E. (Charlie) CEO/Chairman , Oakwood systems Group, Inc. 63124Irwin, Hale S. Honorary Community Volunteer 85253

2019 St. Louis Children's Hospital FoundationBoard of Directors

Episcopal Presbyterian Health Trust

Salary and Benefits - 4 LCSW Program Delivery Staff (100% for VOV Program; 1 VOV Program Supervisor (60% for VOV Program) 310,806$ 20,000$ Salary and Benefits - 24 hrs/wk as needed ER VOV intake In-Kind donation from St. Louis Children's Hospital -$ -$ Contract Services (fundraising) In-Kind donation, St. Louis Children's Hospital Foundation -$ -$ Occupancy (rent, utilities, maintenance) In-Kind, St. Louis Children's Hospital -$ -$

Training & Professional Development - Annual Trauma Informed Care Conference (4 LCSW) 4,000$ -$ Insurance In-Kind, St. Louis Children's Hospital -$ -$ Travel - 4 LCSW x 90 mile/wk avg. x 52 weeks x .54/mile 10,109$ -$ Equipment In-Kind, St. Louis Children's Hospital -$ -$ Supplies - Intervention and Counseling Tools 5,000$ -$ Printing, Copying & Postage In-Kind, St. Louis Children's Hospital -$ -$ Evaluation In-Kind, St. Louis Children's Hospital -$ -$ Marketing In-Kind, St. Louis Children's Hospital -$ -$ Conferences, meetings, etc. - Annual retreat for youth/mentors 2,000$ -$ Administration In-Kind, St. Louis Children's Hospital -$ -$ *Other - Incidental assistance for youth being served ($100/youth per year x 100 youth) 10,000$ -$ *Other -Annual holiday party/gifts for current & past participants 6,000$ -$ *Other - Business cell phones & wireless internet for LCSW mentors off-site program delivery ($110/mo x 4 x 12 mo) $ 5,280 $ -

TOTAL EXPENSES 353,195$ 20,000$

Contributions, Gifts, Grants, & Earned RevenueLocal Government -$ -$ State Government -$ -$

Federal Government -$ -$ Individuals -$ -$

*Foundation - Episcopal Presbyterian Health Trust -$ 20,000$ *Foundation - Anonymous Foundation, Vollintine Fdn 100,000$ 102,000$

*Foundation - Bernice Priger Charitable Trust, Roblee Fdn 10,000$ 15,000$ *Foundation -TBD -$ 26,000$ *Corporation-TBD -$ 25,000$

*Corporation-______________ -$ -$ *Corporation-______________ -$ -$ *Federation-_______________ -$ -$ *Other -__________________ -$ -$

Membership Income -$ -$ Program Service Fees -$ -$

Products -$ -$ Fundraising Events (net) 55,200$ -$

Investment Income -$ -$ In-Kind Support -$ -$

*Other -__________________ -$ -$

TOTAL REVENUES 165,200.00$ 188,000.00$

*Please specify for contributions over $1,000.

Amount Requested from FunderTotal Project Expenses

Missouri CGA - Project Budget (Required)

Committed PendingRevenues

Expenses

St. Louis Children's Hospital Foundation on behalf of the Victims of Violence Program

Episcopal Presbyterian Health Trust St. Louis Children's Hospital Foundation

ExpensesSalary & Benefits 4,501,104$ Contract Services (consulting, professional, fundraising) 1,697,725$ Occupancy (rent, utilities, & maintenance) 335,809$ Training & Professional Development 3,340$ Insurance 2,417$ Travel 65,925$ Equipment 22,097$ Supplies 217,008$ Printing, Copying & Postage 494,766$ Evaluation -$ Marketing 1,329,493$ Conferences, meetings, etc. 139,615$ Depreciation 141,907$ Administration 182,348$ *Other -_______________ 23,900,000$ *Other -_______________ -$

TOTAL EXPENSES: 33,033,554.00$

Revenues Committed PendingContributions, Gifts, Grants, & Earned Revenue

Local Government -$ -$ State Government -$ -$

Federal Government -$ -$ Individuals 8,177,805$ 13,172,408$

*Foundation - Dana Brown 400,000$ -$ *Foundation - Butler Family 250,000$ -$

*Foundation -Anonymous 250,000$ -$ *Foundation - Blues for Kids 150,000$ -$

25 Other Foundations 405,920$ Other Foundations 2,064,434$

*Corporation-Hyundai 250,000$ -$ *Corporation-Edward Jones 198,142$ -$

*Corporation-Emerson 150,000$ -$ Children's Miracle Network 614,000$

134 Other Companies and Organizations 1,227,557$ Othe Companies and Organizations 3,554,418$

*Federation-_______________ -$ *Other -__________________ -$

Membership Income -$ Program Service Fees -$

Products -$ -$ Fundraising Events (net) 1,394,436$ 140,314$

Investment Income -$ 23,512,650$ In-Kind Support -$ -$

*Other -__________________ -$ -$ TOTAL REVENUES: 13,467,860.00$ 42,444,224.00$

*Please specify for contributions over $1,000.

Missouri CGA - Organizational Budget (Optional)