city of sanibel resolution 16-079 a resolution amending resolution ...
CITY OF SANIBEL RESOLUTION 16-079 A RESOLUTION AMENDING RESOLUTION 12-040 RELATING TO THE SANIBEL RECREATION FINANCIAL COMMITTEE; PROVIDING FOR AN AMENDMENT TO SECTION I OF SUCH RESOLUTION IN ORDER TO AMEND AND UPDATE ADDITIONAL RECREATION RELATED PROGRAMS TO BE CONSIDERED BY THE COMMITTEE; SETTING FORTH THE CURRENT "SLIDING SCALE" FEE SCHEDULE; AND PROVIDING AN EFFECTIVE DATE. WHEREAS, the City Council has established a financial assistance program for the Recreation Department's after-school program, summer camp program, holiday program and similar recreation programs conducted during and after the school year; and WHEREAS, the purpose of such financial assistance program is to provide financial assistance for recreation programs to individuals, children and families in need; and WHEREAS, it has been proposed and recommended to the City Council that the programs to be considered and included within the scope of financial assistance by the Committee specifically include basketball league, babysitter training camp, volleyball camp and zuni camp out; and WHEREAS, the City Council finds it appropriate to include such programs within the scope of authority in review procedures of the Committee; NOW THEREFORE, BE IT RESOLVED, by the City Council, City of Sanibel, Florida, that City of Sanibel Resolution No. 12-040, is hereby amended as follows with underlined language indicating additions and strike tfiraugh language indicating deletions: SECTION 1. This resolution sets forth the purpose of the Recreation Financial Assistance Committee and establishes the membership appointment criteria for the Committee, the functions and duties of the Committee and an annual attendance requirement for the Committee membership. This Resolution also sets forth the financial assistance policy and procedures for the Recreation Department's Summer Camp Program, After-School Program, (which include Holiday Programs and Fun Days Programs). Basketball League, Babysitter Training Camp, Volleyball Camp and Zuni Camp Out conducted during and after the school year. SECTION 2. There shall be a review board, which shall henceforth be known as the Recreation Financial Assistance Committee, which shall consider and approve financial assistance applications based on the guidelines established herein. A. Such Recreation Financial Assistance Committee shall be composed of up to seven (7) citizens appointed by the Sanibel City Council. Four (4) members of the Recreation Financial Assistance Committee shall constitute a quorum for purposes of conducting Committee business. Res. 16-079
All current committee members shall be authorized to serve in their positions H1r the remainder of their terms and thereafter all appointments of members to the Recreation Financial Assistance Committee shall be made by City Council in accordance with this section. B. The function and duties of the Recreation Financial Assistance Committee shall be to review, consider and, where appropriate, grant financial assistance based upon the policies and guidelines established in this Resolution and/or developed by the Recreation Financial Assistance Committee pursuant to the authority of this Resolution. C. There is hereby established an annual attendance requirement for the Recreation Financial Assistance Committee which shall be a minimum attendance requirement of 75% of all scheduled meetings during each calendar year commencing January 1, 2012. "Attendance" shall mean physically present at a meeting. Emergency meetings, if called, shall not constitute a scheduled meeting for purposes of this provision. In the event that a member fails to meet the minimum attendance requirement, such failure shall constitute an automatic and immediate tender of resignation. Such vacancy shall be filled through appointment by the City Council as soon as it is practical.
SECTION 3. An individual or family seeking financial assistance for the recreation programs must complete a Recreation Financial Assistance Application Form, a copy of which is attached hereto and incorporated herein as Exhibit "A", which shall be developed and issued by the Recreation Financial Assistance Committee. Such application shall, at a minimum, require proof of eligibility for the free or reduced school lunch program, and require a copy of the most recent tax return, excluding the social security number(s) of the individuals listed on the tax retum for security purposes, arul W2, a recent pay stub, proof of filing tor child support (if applicable) and a valid Florida Driver's License/Florida ID Card or Florida Voter's Registration Card. SECTION 4. Approval of financial assistance for me Sammer Camp Pregram ·.viii be based on the "sliding f'ee" selledt!le attaehed hereto and ineol)'lorated herein as Eithibit "B", and fiaaneial assistanee for the After Selloel Pro!,'fam, will be based ea the "sliding fee" selledt!le attaehed hereto and ineol)'lerated herein as Elthibit "C". all of the programs and activities set forth in Section I of this Resolution will be based on the "sliding fee" schedule attached hereto and incornorated herein as Exhibit "B". SECTION 5. This Resolution shall amend and supersede Resolutions I 0-076, 12-004 and 12-040, as amended. SECTION 6. Effective date. This resolution shall take effect immediately upon adoption.
DULY PASSED AND ENACTED by the Council of the City of Sanibel, Florida, this 4th day of October, 2016. Re-s. 16-079
AUTHENTICATION:
Kevin Rua e, Mayor
Clerk
Vote of Council Members: Ruane Denham Congress Harrity Jennings
yea yea yea yea yea
Date filed with City Clerk: October 4, 2 0 1 6
Res. 16-079
® .
.
aTY OF.~IBEL
RECREATION FINANCIAl- A:SSJSTANCf Af?P1.ICA•1TO!V
'Tb~City of Snnihel hllS Rnlintllllll~~!S't.:lllce 'llV4!1abl~ 1~11' R~treutlon Prugr>mls, The llmount or thedinandnl ::tij.Jstancc j¥lll bll lloter.JDin'Qd l{ilng ~stilling f~.i! scllll! und Is bu~d on 11nn11~l jnq>me and other l1mme~inl $UP,porl 1Ceillycl,l. To :a~~~~t: jn our revi~IY, pi~1Ue prnvldl.' the Mlowi11g: l. Proof of cllgillility tor tile frc~ «r redu~!!d llmdt pl'l)gram (If Jlpplkalllt)
'Z. Cop}\ of'tllnst.<et;; nppllcatlon r-urivell: - - - - - - Applicant Stat11s;
0 Bcpcat
-t\lf Sod at Security nunibersfnnm~slphon" iliimlierlladilre5s.~s urc biDdled out:
0
YeS>
0
Asslsf:llll'\! umounlllus.bcefl determined nnd '\Vttttcn on uppliGalillnt
0 0
Vts
0 'N(I·
-~1!0:
0 .N8.500 55% 50% 45% 70% 60% 40% 35% 30% 20% 344.25 $ 382.50 $ 420.75 $ 306.00 $ 459.00 497.25 s 229.50 $ 535.50 61~:, 472.50 $ 425.25 $ 519.75 $ $ 28.3.50 $ 378.00 $ 567.00 $ 614.25 $ 661.50 $ 756.
3 or more Financial Assistance % Remaining Balance (Member) Remaining Balance (Non-Member)
0-$28.500 $28.501- $33,500 $33,501 - $38.500 $38.501 - $43,500 $43,501- $48,500 $48.501 - $53,500 $53.501 -$58,500 $58,501 - $63.500 $63.501 - $08,500 70% 65% 60% 55% 50% 80% 45% 40% 30% 267.75 $ 306.00 $ 344.25 $ $ 153.00 $ 229.50 $ 382.50 $ 420.75 $ 459.00 $ 535.50 378.00 $ $ 189.00 $ 330.75 $ 425.25 s 472.50 $ 519.75 $ 283.50 $ 567.00 $ 661.50
Summer Camp Program Fees Member Non-Member
s
s
Per Week 85.00 105.00
s s
#Weeks 9 9
$
s
s
Total 765.00 945.00
EXHIBIT "B" C: \Documents and Settings \jkg \Local Settings\ Temporary Internet Files\ OLK2E \ Finasstslidescale
$63,501 - S68,500 10% $ 688.50 s 850.50
s
~1
•
olctllc:hn·ln~
1 Financial Assistance % Remaining Balance (Member) Remai'ling Balance (NOI'l'Member)
0-$28,500 $28.501 - $33,500 $33,501 - $38,500 $38.501 - $43,500 $43,501 - $48.500 $48.501 - $53,500 $53,501 - $58,500 $58.501 - $63,500 $63.501 - S68.500 4()'1; 50% 45% 35% 30% 60% 25% 20% 10% 3I6.00 s 344.50• 265.00 s 291.00 371.00 s 212.00 $ 397.50 424.00 s A77.00 j79.80 $ 3A8.15 $ 411.45 4A3.TO s s 253.20 s 316.50 s 474.75 s 506.40 569.70
2 Financial Assistance % Remoinlng Bolaoee (Member) Remaining Balance (Non-Member)
0-$28.500 $28.001 - $33.500 $33,501 - $38.500 $38.001 - $43,500 $43,501 - $48.500 $48.001 - $53,500 $53,001 - $58,500 $58.001 - $63,500 $63,001 - S68.500 «)% 60% 55% 50% 45% 35'.1> 70% 30% 20'1. 159.()) :~ 291.00: s 212.00 $ 265.00 s 318.00 s 238.00 3A4.50 s '371.00 424.00 s $ 284.85 31650 348.15 189.90 s 253.20 s 379.80 s 411.45 443.10 506.40
3armare Fnanclol Assistance % Remaining Balance (Member) Remaining Balance (Non-Member)
0-$28.500
s
s s
s
s s
s
$
s
s
s
s s
$28.501 - $33,500 $33,501 - $38.500 $38,501 - 543,500 $43.001 - $48.500 $48.501 - $53.500 $53.001 - $58,500 $58,001 - $63.500 $63.501 - $68,500 ff:fl, 55% 65% 50% 70% 45% 40% 30% 185.50 s 212.00 238.50 s 159.00 s 265.00 s 106.00 s 291.50 s 318.00 s 37100 126.60 s 189.90 221.55 253.20 s 284.85 s 316.50 s 348.15 s 379.80 s 44310
80%
s
s
s
s
s
Atterschool Program Fees Member Non-Member
EXHIBIT "C"
CITY OF SANIBEL RESOLUTION NO. 10-076 A RESOLUTION AMENDING RESOLUTION 09-085 WHICH RELATES TO THE CITY'S RECREATION FINANCIAL ASSISTANCE PROGRAM POLICIES AND PROCEDURES FOR THE RECREATION DEPARTMENT'S SUMMER CAMP PROGRAM AND AFTER-SCHOOL PROGRAM (WHICH INCLUDE HOLIDAY PROGRAMS AND FUN DAYS PROGRAMS) CONDUCTED DURING AND AFTER THE SCHOOL YEAR; AMENDING THE "SLIDING FEE" SCHEDULES FOR SUCH SUMMER CAMP PROGRAM AND AFTER-SCHOOL PROGRAM; AND PROVIDING AN EFFECTIVE DATE. WHEREAS, the City Council originally established a financial assistance program for certain Recreation Department Programs through Resolution 04-080 on October 19, 2004 and such financial assistance program has been updated and improved from time to time, with the latest update being set forth in City of Sanibel Resolution No. 09-085; and WHEREAS, the purpose of such financial assistance program is to provide financial assistance to individuals, children and families in need; and WHEREAS, due to the current economic times, the City Council determines it appropriate to update and revise the "sliding fee" schedules for the Summer Camp Program and the After-School Program to reflect a higher and more appropriate percentage of assistance to eligible applicants; NOW THEREFORE, BE IT RESOLVED, by the City Council, City of Sanibel, Florida, that City of Sanibel Resolution No. 09-085, is hereby amended as follows with underlined language indicating additions and strike throHgh language indicating deletions: SECTION 1. This Resolution sets forth the financial assistance policy and procedures for the Recreation Department's Summer Camp Program sessions, and Holiday Program, After-School Program, and similar recreation programs (which include Holiday Programs and Fun Days Programs) conducted during and after the school year. SECTION 2. There shall be a review board, which shall henceforth be known as the Recreation Financial Assistance Committee, which shall consider and approve financial assistance applications based on the guidelines established herein. Such Recreation Financial Assistance Committee shall be composed of the following:
(a) City of Sanibel Recreation Director or their designee; (b) Director of Community Housing & Resources (CHR) or their designee; (c) A member of the Parks and Recreation Committee;
Res. 10-076
(d) The Director of Friends In Service Here (FISH) or their designee; and (e) A citizen at-large appointed by City Council. The function and duties of the Recreation Financial Assistance Committee shall be to review, consider and, where appropriate, grant financial assistance based upon the policies and guidelines established in this Resolution and/or developed by the Recreation Financial Assistance Committee pursuant to the authority of this Resolution.
SECTION 3. An individual or family seeking financial assistance for the recreation programs must complete a Recreation Financial Assistance Application Form, a copy of which is attached hereto and incorporated herein as Exhibit "A", which shall be developed and issued by the Recreation Financial Assistance Committee. Such application shall, at a minimum, require proof of eligibility for the free or reduced school lunch program, eF and require a copy of the most recent tax return, excluding the social security number(s) of the individuals listed on the tax return for security purposes, and a recent pay stub. SECTION 4. (a) A:pproval of financial assistance application requests \.vill be based on a "sliding fee" schedule, a copy of which is attached hereto and incorporated herein as Exhibit "A". Approval of financial assistance for the Summer Camp Program will be based on the "sliding fee" schedule attached hereto and incorporated herein as Exhibit "B", and financial assistance for the After-School Program, will be based on the "sliding fee" schedule attached hereto and incorporated herein as Exhibit "C".
SECTION 5. This Resolution shall amend and supersede Resolution 09-085. SECTION 6. Effective date. This resolution shall take effect immediately upon passage.
DULY PASSED AND ENACTED by the Council of the City of Sanibel, Florida, this 20th day of July, 2010.
AUTHENTICATION:
2
Res. 10-076
Vote of Council Members: Ruane Denham Harrity Jennings Pappas
yea yea ~
¥-ea. y.e.a...
Date filed with City Clerk:
July 2 0,
2 01 0
3
Res. 10-076
CITY OF SANIBEL
RECREATION FINANCIAL ASSISTANCE APPLICATION The City of Sanibel has financial assistance available for Recreation Programs. The amount of the financial assistance will be determined using a sliding fee scale and is based on annual income and other financial support being received. To assist in our review, please provide: I. Proof of eligibility letter for the free or reduced lunch program (if applicable) AND 2. A copy of your most recent tax return (remove social security numberls) AND most recent pay stub
FINANCIAL ASSISTANCE APPLICATIONS ARE ACCEPTED AT TIME OF PROGRAM REGISTRATION APPLICATIONS MUST BE SUBMITTED WITH ALL REQUIRED DOCUMENTS ATTACHED. Name of ParentJGuardian: - - - - - - - - - - - - - - Email Address: _ _ _ _ _ _ _ __ Street address: _ _ _ _ _ _ _ _ _ _ _ _ City:. _ _ _ _ _ _ State: _ _ _ _ Zip:. _ _ _ __ Home Phone: _ _ _ _ _ _ _ _ Work P h o n e : - - - - - - - - Cell Phone: _ _ _ _ _ _ __ Number of Adults Living in Household: _ _ __
Number of Children Living in Household: _ _ __
Ages of Children Living in Household: - - - - - - - - - - - -
ADDITIONAL QUESTIONS TO BE COMPLETED FOR THIS APPLICATION: Are you an annual or monthly client ofF.I.S.H? 0 Yes 0 No. If yes, amount received$ _ _ _ __ Are you an annual or monthly client of CHR? 0 Yes 0 No Have you or anyone on your behalf filed an action in court against the biological parent? 0 Yes 0 No If yes, what is the case number? # State: County: _ _ __ Do you receive child support? 0 Yes 0 No. If yes how much? $._ _ _ __ If you do not receive support, is there a court order for you to receive child support? 0 Yes 0 No. If yes, what is the case#? State: County: Monthly Amount$_ _ __ Do you receive Social Security Benefits? 0 Yes 0 No. If yes, how much monthly? $_ _ _ __ Do you receive Social Security Benefits for your children? 0 Yes 0 No. If yes, how much monthly? $_ _ _ __ Do you receive a pension? 0 Yes 0 No. If yes, how much monthly? $_ _ _ __ Do you receive alimony? 0 Yes 0 No. If yes, how much monthly? $_ _ _ __ Do you receive Foster Care payments? 0 Yes 0 No. If yes, how much monthly? $_ _ _ __ Do you receive Workers Compensation? 0 Yes 0 No. If yes, how much weekly? $_ _ _ __ Do you receive Unemployment Compensation? DYes 0 No. If yes, how much weekly?$ _ _ _ __ Do you receive daily, weekly, monthly, quarterly or annually, a financial gift from anyone? 0 Yes 0 No. If yes, state the amount. $_ _ _ __ Do you receive an in kind benefit, such as someone paying your rent, mortgage, groceries, $_ _ _ __ utilities, automobile gasoline, room and board? 0 Yes 0 No. If yes, amount. Do you receive any other monies or has anyone on you or your children's behalf How much? $_ _ _ __ provided you with additional monies? If so, from whom? Did you receive a Federal Income Tax Refund? 0 Yes 0 No If yes, how much? $._ _ _ __
Total Household Annual Income: $_ _ _ _ _ _ _ _ __ Updated 7/12/2010- Approved by Committee 6/21/10
EXHIBIT "A"
Page 2
Please Check Program(s) for Financial Assistance Requested:
0
After-School Program
Holiday Program: 0 Winter 0 Spring 0 FunDays
Number of Children _ _
Total: $ _ _ __
Number of Children _ _ Total:$ _ _ __ Total: $ _ _ __ Number of Children _ _
Total $ _ _ _ __
Total Financial Assistance requested for programs
Total $ _ _ _ __
NOTE: Reminder, only sign up for programs after registration begins.
0
Summer Program Number of Children _ _ Number of weeks for each child. _ _ _ _ __
Total $ _ _ _ __
Total Financial Assistance requested for Summer Program: Total$ _ _ __ Total of Financial Assistance requested for all Programs:
Total$ _ _ __
Other than what is listed in the above application, list any special circumstances to be considered. (If more space is needed, please attach additional information). NOTE: I swear and affirm under penalties of perjury that the foregoing representations are true and correct to the best of my knowledge. Signature of Parent/Guardian: - - - - - - - - - - - - Date: _ _ _ _ _ __ STATE OF FLORIDA COUNTY OF LEE The foregoing instrument was acknowledged before me this _ _day of _ _ _ _ _, 20_, by _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _(name of person acknowledging).
Signature of Notary Public (NOTARY SEAL)
Typed/Printed Name of Notary Typed Personally Known OR Produced Identification _ __ Type of Identification P r o d u c e d - - - - - - - - - - - - - - - - - - - - - - (You can get this application notarized at the Recreation Center, City Hall, Bank of the Islands and Sanibel/Captiva Community Bank at no charge)
This application will be reviewed by the Recreation Financial Assistance Committee in a public meeting which is held at McKenzie Hall. The Committee will review this application and determine if assistance can be granted. The Recreation Department will contact you and let you know of the Committee's decision. Updated 7/12/2010- Approved by Committee 6/21/10
Page 3
STAFF USE ONLY Date application received by staff: _ _ _ _ _ __ Is appJication complete and reviewed by staff:
StaffSignature: - - - - - - - - -
DYes
0
No Staff initial: _ _ _ __
All Social Security numbers/names/phone numbers/addresses are blacked out:
0
Yes
D
No
Assistance amount has been determined and written on application:
0
Yes
0
No
Applicant is aware that they may participate in activity they applied for:
0
Yes
D
No
D
No
Applicant is aware that a sliding scale based on income is used to determine assistance: D Yes
Applicant has been told that the fee for programs are due at the time the program has began, or the committee has made a decision on the Financial Assistance: Staff Initials: _ _ __ Date applicant was contacted about committee decision: _ _ _ _ _ __ Is F.I.S.H. providing assistance: D Yes
D
Does the applicant have an outstanding balance?
(If yes) Amount: $_ _ _ _ _ __
No
0
Staff Initials: _ _ __
Yes
D
No (If yes) Amount: $._ _ _ __
Staff must record status here, any outstanding balance and time and date of calls made to patrons:
Staff must keep track of approved applicant attendance in programs. (NOTE: Responsibility of Program Director and Front Desk designated Staff).
Staff Initials: _ _ __
Date data entered into RecTrac:
Staff Initials: _ _ _ __
STAFF/PANEL NOTES:
For Panel Review Committee and Staff Use Onl :
0
Application Approved
Signature of Approving Authority:
D Application Denied Date:
Assistance amount for After School type programs: $._ _ _ _ _ _ __ Assistance amount of Summer Program:$ Total Assistance Granted: $ _ _ _ _ __
Updated 7112/2010- Approved by Committee 6/21/10
(
(
Summer Camp Program Sliding Fee Scale Annual Housshold lnCOitiS Rangfl
#of ChRdTen in Household 1 Financial Assistance % Remaining Balance (Member) Remaining Balance (Non-Member) 2 Financial Assistance % Remaining Balance (Member)
s
$33,501 - $38.500 45% 420.75 519.75
s s
$38,501 - $43.500 40%
$43,501 - $48,500
$48,501 - $53,500
$53,501 - $58,500
s s
s
35% 49725 61LI.25
30% 535.50 661.50
25% 573.75 708.75
459.00 567.00
$
$
s
$
s
$58,501 - $63,500 20%
$63,501 - S68,500
s s
s s
612.00 756.00
10% 688.50 850.50
0-$28.500 $28.501 - $33,500 $33,501 - $38,500 $38,501 - $L13,500 $43,501 - $48,500 $48,501 - $53,500 $53,501 - $58,500 $58,501 - $63,500 $63,501 - $:'>8,500 45% 40o/o 300,{, 55% 50% 60% 35% 70% 20% 382.50 420.75 $ 344.25 306.00 459.00 229.50 497.25 535.50 612.00 472.50 519.75 425.25 567.00 $ 378.00 614.25 283.50 661.50 756.00
s
s s
153.00 189.00
Per Week 85.00
s s
105.00
$33,501 - $38,500
7001,
80%
s s
s s
s
s s
s
0-$28,500 $28,501 - $33,500
3ormore Financial Assistance % Remaining Balance (Member) Remaining Balance (Non-Member)
Member Non-Member
s s
s
Remaining Balance (Non-Member)
Summer Camp Program Fees
0-$28,500 $28,501 - $33,500 60% 50% $ 30600 382.50 472.50 378.00
#Weeks 9 9
s s
267.75 330.75
$
Total 765.00 9LI!inn
s
s
s
s
s s
s
$38,501 -$43,500
$43,501 - $48,500
$48,501 - $53,500
$53,501 - $58,500
$58,501 - $63,500
60% 306.00 378.00
55% 344.25 425.25
50% 382.50 472.50
45% 420.75
$
40% 459.00
519.75
$
567.00
65% 229.50 283.50
s s
s $
$
s
s s
s s
EXHIBIT "B" C:\Documents and Settings\jkg\Local Settings\ Temporary Internet Files\OLK2E\Finasstslidescale
$63,501 - $~8.500
30%
s s
535.50 661.50
(
(
(
Alterschool Program Sliding Fee Scale t# of Ctliklt9n in Household 1
0-$28,500
Financial Assistance % Remaining Balance (Member) Remaining Balance (Non-Member)
60%
2 Financial Assistance %
s
s
212.00 253.20
0-$28,500
Remaining Balance (Member)
s
70% 159.00
Remaining Balance (Non-Member)
s
189.90
3ormore
$28,501 - $33,500 $33,501 - $38,500 $38,501 - $43,500 $43,501 - $48,500 $48,501 - $53,500 $53,501 - $58,500 $58,501 - $63,500 $63,501 - $68,500 40",.; 35% 45% 30% 25% 20".6 50% 10% 344.50 318.00 s 371.00 291.50 397.50 424.00 $ 265.00 477.00 348.15 s 379.80 411.45 s 316.50 s 443.10 474.75 s 506.
All current committee members shall be authorized to serve in their positions H1r the remainder of their terms and thereafter all appointments of members to the Recreation Financial Assistance Committee shall be made by City Council in accordance with this section. B. The function and duties of the Recreation Financial Assistance Committee shall be to review, consider and, where appropriate, grant financial assistance based upon the policies and guidelines established in this Resolution and/or developed by the Recreation Financial Assistance Committee pursuant to the authority of this Resolution. C. There is hereby established an annual attendance requirement for the Recreation Financial Assistance Committee which shall be a minimum attendance requirement of 75% of all scheduled meetings during each calendar year commencing January 1, 2012. "Attendance" shall mean physically present at a meeting. Emergency meetings, if called, shall not constitute a scheduled meeting for purposes of this provision. In the event that a member fails to meet the minimum attendance requirement, such failure shall constitute an automatic and immediate tender of resignation. Such vacancy shall be filled through appointment by the City Council as soon as it is practical.
SECTION 3. An individual or family seeking financial assistance for the recreation programs must complete a Recreation Financial Assistance Application Form, a copy of which is attached hereto and incorporated herein as Exhibit "A", which shall be developed and issued by the Recreation Financial Assistance Committee. Such application shall, at a minimum, require proof of eligibility for the free or reduced school lunch program, and require a copy of the most recent tax return, excluding the social security number(s) of the individuals listed on the tax retum for security purposes, arul W2, a recent pay stub, proof of filing tor child support (if applicable) and a valid Florida Driver's License/Florida ID Card or Florida Voter's Registration Card. SECTION 4. Approval of financial assistance for me Sammer Camp Pregram ·.viii be based on the "sliding f'ee" selledt!le attaehed hereto and ineol)'lorated herein as Eithibit "B", and fiaaneial assistanee for the After Selloel Pro!,'fam, will be based ea the "sliding fee" selledt!le attaehed hereto and ineol)'lerated herein as Elthibit "C". all of the programs and activities set forth in Section I of this Resolution will be based on the "sliding fee" schedule attached hereto and incornorated herein as Exhibit "B". SECTION 5. This Resolution shall amend and supersede Resolutions I 0-076, 12-004 and 12-040, as amended. SECTION 6. Effective date. This resolution shall take effect immediately upon adoption.
DULY PASSED AND ENACTED by the Council of the City of Sanibel, Florida, this 4th day of October, 2016. Re-s. 16-079
AUTHENTICATION:
Kevin Rua e, Mayor
Clerk
Vote of Council Members: Ruane Denham Congress Harrity Jennings
yea yea yea yea yea
Date filed with City Clerk: October 4, 2 0 1 6
Res. 16-079
® .
.
aTY OF.~IBEL
RECREATION FINANCIAl- A:SSJSTANCf Af?P1.ICA•1TO!V
'Tb~City of Snnihel hllS Rnlintllllll~~!S't.:lllce 'llV4!1abl~ 1~11' R~treutlon Prugr>mls, The llmount or thedinandnl ::tij.Jstancc j¥lll bll lloter.JDin'Qd l{ilng ~stilling f~.i! scllll! und Is bu~d on 11nn11~l jnq>me and other l1mme~inl $UP,porl 1Ceillycl,l. To :a~~~~t: jn our revi~IY, pi~1Ue prnvldl.' the Mlowi11g: l. Proof of cllgillility tor tile frc~ «r redu~!!d llmdt pl'l)gram (If Jlpplkalllt)
'Z. Cop}\ of'tllnst.<et;; nppllcatlon r-urivell: - - - - - - Applicant Stat11s;
0 Bcpcat
-t\lf Sod at Security nunibersfnnm~slphon" iliimlierlladilre5s.~s urc biDdled out:
0
YeS>
0
Asslsf:llll'\! umounlllus.bcefl determined nnd '\Vttttcn on uppliGalillnt
0 0
Vts
0 'N(I·
-~1!0:
0 .N8.500 55% 50% 45% 70% 60% 40% 35% 30% 20% 344.25 $ 382.50 $ 420.75 $ 306.00 $ 459.00 497.25 s 229.50 $ 535.50 61~:, 472.50 $ 425.25 $ 519.75 $ $ 28.3.50 $ 378.00 $ 567.00 $ 614.25 $ 661.50 $ 756.
3 or more Financial Assistance % Remaining Balance (Member) Remaining Balance (Non-Member)
0-$28.500 $28.501- $33,500 $33,501 - $38.500 $38.501 - $43,500 $43,501- $48,500 $48.501 - $53,500 $53.501 -$58,500 $58,501 - $63.500 $63.501 - $08,500 70% 65% 60% 55% 50% 80% 45% 40% 30% 267.75 $ 306.00 $ 344.25 $ $ 153.00 $ 229.50 $ 382.50 $ 420.75 $ 459.00 $ 535.50 378.00 $ $ 189.00 $ 330.75 $ 425.25 s 472.50 $ 519.75 $ 283.50 $ 567.00 $ 661.50
Summer Camp Program Fees Member Non-Member
s
s
Per Week 85.00 105.00
s s
#Weeks 9 9
$
s
s
Total 765.00 945.00
EXHIBIT "B" C: \Documents and Settings \jkg \Local Settings\ Temporary Internet Files\ OLK2E \ Finasstslidescale
$63,501 - S68,500 10% $ 688.50 s 850.50
s
~1
•
olctllc:hn·ln~
1 Financial Assistance % Remaining Balance (Member) Remai'ling Balance (NOI'l'Member)
0-$28,500 $28.501 - $33,500 $33,501 - $38,500 $38.501 - $43,500 $43,501 - $48.500 $48.501 - $53,500 $53,501 - $58,500 $58.501 - $63,500 $63.501 - S68.500 4()'1; 50% 45% 35% 30% 60% 25% 20% 10% 3I6.00 s 344.50• 265.00 s 291.00 371.00 s 212.00 $ 397.50 424.00 s A77.00 j79.80 $ 3A8.15 $ 411.45 4A3.TO s s 253.20 s 316.50 s 474.75 s 506.40 569.70
2 Financial Assistance % Remoinlng Bolaoee (Member) Remaining Balance (Non-Member)
0-$28.500 $28.001 - $33.500 $33,501 - $38.500 $38.001 - $43,500 $43,501 - $48.500 $48.001 - $53,500 $53,001 - $58,500 $58.001 - $63,500 $63,001 - S68.500 «)% 60% 55% 50% 45% 35'.1> 70% 30% 20'1. 159.()) :~ 291.00: s 212.00 $ 265.00 s 318.00 s 238.00 3A4.50 s '371.00 424.00 s $ 284.85 31650 348.15 189.90 s 253.20 s 379.80 s 411.45 443.10 506.40
3armare Fnanclol Assistance % Remaining Balance (Member) Remaining Balance (Non-Member)
0-$28.500
s
s s
s
s s
s
$
s
s
s
s s
$28.501 - $33,500 $33,501 - $38.500 $38,501 - 543,500 $43.001 - $48.500 $48.501 - $53.500 $53.001 - $58,500 $58,001 - $63.500 $63.501 - $68,500 ff:fl, 55% 65% 50% 70% 45% 40% 30% 185.50 s 212.00 238.50 s 159.00 s 265.00 s 106.00 s 291.50 s 318.00 s 37100 126.60 s 189.90 221.55 253.20 s 284.85 s 316.50 s 348.15 s 379.80 s 44310
80%
s
s
s
s
s
Atterschool Program Fees Member Non-Member
EXHIBIT "C"
CITY OF SANIBEL RESOLUTION NO. 10-076 A RESOLUTION AMENDING RESOLUTION 09-085 WHICH RELATES TO THE CITY'S RECREATION FINANCIAL ASSISTANCE PROGRAM POLICIES AND PROCEDURES FOR THE RECREATION DEPARTMENT'S SUMMER CAMP PROGRAM AND AFTER-SCHOOL PROGRAM (WHICH INCLUDE HOLIDAY PROGRAMS AND FUN DAYS PROGRAMS) CONDUCTED DURING AND AFTER THE SCHOOL YEAR; AMENDING THE "SLIDING FEE" SCHEDULES FOR SUCH SUMMER CAMP PROGRAM AND AFTER-SCHOOL PROGRAM; AND PROVIDING AN EFFECTIVE DATE. WHEREAS, the City Council originally established a financial assistance program for certain Recreation Department Programs through Resolution 04-080 on October 19, 2004 and such financial assistance program has been updated and improved from time to time, with the latest update being set forth in City of Sanibel Resolution No. 09-085; and WHEREAS, the purpose of such financial assistance program is to provide financial assistance to individuals, children and families in need; and WHEREAS, due to the current economic times, the City Council determines it appropriate to update and revise the "sliding fee" schedules for the Summer Camp Program and the After-School Program to reflect a higher and more appropriate percentage of assistance to eligible applicants; NOW THEREFORE, BE IT RESOLVED, by the City Council, City of Sanibel, Florida, that City of Sanibel Resolution No. 09-085, is hereby amended as follows with underlined language indicating additions and strike throHgh language indicating deletions: SECTION 1. This Resolution sets forth the financial assistance policy and procedures for the Recreation Department's Summer Camp Program sessions, and Holiday Program, After-School Program, and similar recreation programs (which include Holiday Programs and Fun Days Programs) conducted during and after the school year. SECTION 2. There shall be a review board, which shall henceforth be known as the Recreation Financial Assistance Committee, which shall consider and approve financial assistance applications based on the guidelines established herein. Such Recreation Financial Assistance Committee shall be composed of the following:
(a) City of Sanibel Recreation Director or their designee; (b) Director of Community Housing & Resources (CHR) or their designee; (c) A member of the Parks and Recreation Committee;
Res. 10-076
(d) The Director of Friends In Service Here (FISH) or their designee; and (e) A citizen at-large appointed by City Council. The function and duties of the Recreation Financial Assistance Committee shall be to review, consider and, where appropriate, grant financial assistance based upon the policies and guidelines established in this Resolution and/or developed by the Recreation Financial Assistance Committee pursuant to the authority of this Resolution.
SECTION 3. An individual or family seeking financial assistance for the recreation programs must complete a Recreation Financial Assistance Application Form, a copy of which is attached hereto and incorporated herein as Exhibit "A", which shall be developed and issued by the Recreation Financial Assistance Committee. Such application shall, at a minimum, require proof of eligibility for the free or reduced school lunch program, eF and require a copy of the most recent tax return, excluding the social security number(s) of the individuals listed on the tax return for security purposes, and a recent pay stub. SECTION 4. (a) A:pproval of financial assistance application requests \.vill be based on a "sliding fee" schedule, a copy of which is attached hereto and incorporated herein as Exhibit "A". Approval of financial assistance for the Summer Camp Program will be based on the "sliding fee" schedule attached hereto and incorporated herein as Exhibit "B", and financial assistance for the After-School Program, will be based on the "sliding fee" schedule attached hereto and incorporated herein as Exhibit "C".
SECTION 5. This Resolution shall amend and supersede Resolution 09-085. SECTION 6. Effective date. This resolution shall take effect immediately upon passage.
DULY PASSED AND ENACTED by the Council of the City of Sanibel, Florida, this 20th day of July, 2010.
AUTHENTICATION:
2
Res. 10-076
Vote of Council Members: Ruane Denham Harrity Jennings Pappas
yea yea ~
¥-ea. y.e.a...
Date filed with City Clerk:
July 2 0,
2 01 0
3
Res. 10-076
CITY OF SANIBEL
RECREATION FINANCIAL ASSISTANCE APPLICATION The City of Sanibel has financial assistance available for Recreation Programs. The amount of the financial assistance will be determined using a sliding fee scale and is based on annual income and other financial support being received. To assist in our review, please provide: I. Proof of eligibility letter for the free or reduced lunch program (if applicable) AND 2. A copy of your most recent tax return (remove social security numberls) AND most recent pay stub
FINANCIAL ASSISTANCE APPLICATIONS ARE ACCEPTED AT TIME OF PROGRAM REGISTRATION APPLICATIONS MUST BE SUBMITTED WITH ALL REQUIRED DOCUMENTS ATTACHED. Name of ParentJGuardian: - - - - - - - - - - - - - - Email Address: _ _ _ _ _ _ _ __ Street address: _ _ _ _ _ _ _ _ _ _ _ _ City:. _ _ _ _ _ _ State: _ _ _ _ Zip:. _ _ _ __ Home Phone: _ _ _ _ _ _ _ _ Work P h o n e : - - - - - - - - Cell Phone: _ _ _ _ _ _ __ Number of Adults Living in Household: _ _ __
Number of Children Living in Household: _ _ __
Ages of Children Living in Household: - - - - - - - - - - - -
ADDITIONAL QUESTIONS TO BE COMPLETED FOR THIS APPLICATION: Are you an annual or monthly client ofF.I.S.H? 0 Yes 0 No. If yes, amount received$ _ _ _ __ Are you an annual or monthly client of CHR? 0 Yes 0 No Have you or anyone on your behalf filed an action in court against the biological parent? 0 Yes 0 No If yes, what is the case number? # State: County: _ _ __ Do you receive child support? 0 Yes 0 No. If yes how much? $._ _ _ __ If you do not receive support, is there a court order for you to receive child support? 0 Yes 0 No. If yes, what is the case#? State: County: Monthly Amount$_ _ __ Do you receive Social Security Benefits? 0 Yes 0 No. If yes, how much monthly? $_ _ _ __ Do you receive Social Security Benefits for your children? 0 Yes 0 No. If yes, how much monthly? $_ _ _ __ Do you receive a pension? 0 Yes 0 No. If yes, how much monthly? $_ _ _ __ Do you receive alimony? 0 Yes 0 No. If yes, how much monthly? $_ _ _ __ Do you receive Foster Care payments? 0 Yes 0 No. If yes, how much monthly? $_ _ _ __ Do you receive Workers Compensation? 0 Yes 0 No. If yes, how much weekly? $_ _ _ __ Do you receive Unemployment Compensation? DYes 0 No. If yes, how much weekly?$ _ _ _ __ Do you receive daily, weekly, monthly, quarterly or annually, a financial gift from anyone? 0 Yes 0 No. If yes, state the amount. $_ _ _ __ Do you receive an in kind benefit, such as someone paying your rent, mortgage, groceries, $_ _ _ __ utilities, automobile gasoline, room and board? 0 Yes 0 No. If yes, amount. Do you receive any other monies or has anyone on you or your children's behalf How much? $_ _ _ __ provided you with additional monies? If so, from whom? Did you receive a Federal Income Tax Refund? 0 Yes 0 No If yes, how much? $._ _ _ __
Total Household Annual Income: $_ _ _ _ _ _ _ _ __ Updated 7/12/2010- Approved by Committee 6/21/10
EXHIBIT "A"
Page 2
Please Check Program(s) for Financial Assistance Requested:
0
After-School Program
Holiday Program: 0 Winter 0 Spring 0 FunDays
Number of Children _ _
Total: $ _ _ __
Number of Children _ _ Total:$ _ _ __ Total: $ _ _ __ Number of Children _ _
Total $ _ _ _ __
Total Financial Assistance requested for programs
Total $ _ _ _ __
NOTE: Reminder, only sign up for programs after registration begins.
0
Summer Program Number of Children _ _ Number of weeks for each child. _ _ _ _ __
Total $ _ _ _ __
Total Financial Assistance requested for Summer Program: Total$ _ _ __ Total of Financial Assistance requested for all Programs:
Total$ _ _ __
Other than what is listed in the above application, list any special circumstances to be considered. (If more space is needed, please attach additional information). NOTE: I swear and affirm under penalties of perjury that the foregoing representations are true and correct to the best of my knowledge. Signature of Parent/Guardian: - - - - - - - - - - - - Date: _ _ _ _ _ __ STATE OF FLORIDA COUNTY OF LEE The foregoing instrument was acknowledged before me this _ _day of _ _ _ _ _, 20_, by _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _(name of person acknowledging).
Signature of Notary Public (NOTARY SEAL)
Typed/Printed Name of Notary Typed Personally Known OR Produced Identification _ __ Type of Identification P r o d u c e d - - - - - - - - - - - - - - - - - - - - - - (You can get this application notarized at the Recreation Center, City Hall, Bank of the Islands and Sanibel/Captiva Community Bank at no charge)
This application will be reviewed by the Recreation Financial Assistance Committee in a public meeting which is held at McKenzie Hall. The Committee will review this application and determine if assistance can be granted. The Recreation Department will contact you and let you know of the Committee's decision. Updated 7/12/2010- Approved by Committee 6/21/10
Page 3
STAFF USE ONLY Date application received by staff: _ _ _ _ _ __ Is appJication complete and reviewed by staff:
StaffSignature: - - - - - - - - -
DYes
0
No Staff initial: _ _ _ __
All Social Security numbers/names/phone numbers/addresses are blacked out:
0
Yes
D
No
Assistance amount has been determined and written on application:
0
Yes
0
No
Applicant is aware that they may participate in activity they applied for:
0
Yes
D
No
D
No
Applicant is aware that a sliding scale based on income is used to determine assistance: D Yes
Applicant has been told that the fee for programs are due at the time the program has began, or the committee has made a decision on the Financial Assistance: Staff Initials: _ _ __ Date applicant was contacted about committee decision: _ _ _ _ _ __ Is F.I.S.H. providing assistance: D Yes
D
Does the applicant have an outstanding balance?
(If yes) Amount: $_ _ _ _ _ __
No
0
Staff Initials: _ _ __
Yes
D
No (If yes) Amount: $._ _ _ __
Staff must record status here, any outstanding balance and time and date of calls made to patrons:
Staff must keep track of approved applicant attendance in programs. (NOTE: Responsibility of Program Director and Front Desk designated Staff).
Staff Initials: _ _ __
Date data entered into RecTrac:
Staff Initials: _ _ _ __
STAFF/PANEL NOTES:
For Panel Review Committee and Staff Use Onl :
0
Application Approved
Signature of Approving Authority:
D Application Denied Date:
Assistance amount for After School type programs: $._ _ _ _ _ _ __ Assistance amount of Summer Program:$ Total Assistance Granted: $ _ _ _ _ __
Updated 7112/2010- Approved by Committee 6/21/10
(
(
Summer Camp Program Sliding Fee Scale Annual Housshold lnCOitiS Rangfl
#of ChRdTen in Household 1 Financial Assistance % Remaining Balance (Member) Remaining Balance (Non-Member) 2 Financial Assistance % Remaining Balance (Member)
s
$33,501 - $38.500 45% 420.75 519.75
s s
$38,501 - $43.500 40%
$43,501 - $48,500
$48,501 - $53,500
$53,501 - $58,500
s s
s
35% 49725 61LI.25
30% 535.50 661.50
25% 573.75 708.75
459.00 567.00
$
$
s
$
s
$58,501 - $63,500 20%
$63,501 - S68,500
s s
s s
612.00 756.00
10% 688.50 850.50
0-$28.500 $28.501 - $33,500 $33,501 - $38,500 $38,501 - $L13,500 $43,501 - $48,500 $48,501 - $53,500 $53,501 - $58,500 $58,501 - $63,500 $63,501 - $:'>8,500 45% 40o/o 300,{, 55% 50% 60% 35% 70% 20% 382.50 420.75 $ 344.25 306.00 459.00 229.50 497.25 535.50 612.00 472.50 519.75 425.25 567.00 $ 378.00 614.25 283.50 661.50 756.00
s
s s
153.00 189.00
Per Week 85.00
s s
105.00
$33,501 - $38,500
7001,
80%
s s
s s
s
s s
s
0-$28,500 $28,501 - $33,500
3ormore Financial Assistance % Remaining Balance (Member) Remaining Balance (Non-Member)
Member Non-Member
s s
s
Remaining Balance (Non-Member)
Summer Camp Program Fees
0-$28,500 $28,501 - $33,500 60% 50% $ 30600 382.50 472.50 378.00
#Weeks 9 9
s s
267.75 330.75
$
Total 765.00 9LI!inn
s
s
s
s
s s
s
$38,501 -$43,500
$43,501 - $48,500
$48,501 - $53,500
$53,501 - $58,500
$58,501 - $63,500
60% 306.00 378.00
55% 344.25 425.25
50% 382.50 472.50
45% 420.75
$
40% 459.00
519.75
$
567.00
65% 229.50 283.50
s s
s $
$
s
s s
s s
EXHIBIT "B" C:\Documents and Settings\jkg\Local Settings\ Temporary Internet Files\OLK2E\Finasstslidescale
$63,501 - $~8.500
30%
s s
535.50 661.50
(
(
(
Alterschool Program Sliding Fee Scale t# of Ctliklt9n in Household 1
0-$28,500
Financial Assistance % Remaining Balance (Member) Remaining Balance (Non-Member)
60%
2 Financial Assistance %
s
s
212.00 253.20
0-$28,500
Remaining Balance (Member)
s
70% 159.00
Remaining Balance (Non-Member)
s
189.90
3ormore
$28,501 - $33,500 $33,501 - $38,500 $38,501 - $43,500 $43,501 - $48,500 $48,501 - $53,500 $53,501 - $58,500 $58,501 - $63,500 $63,501 - $68,500 40",.; 35% 45% 30% 25% 20".6 50% 10% 344.50 318.00 s 371.00 291.50 397.50 424.00 $ 265.00 477.00 348.15 s 379.80 411.45 s 316.50 s 443.10 474.75 s 506.
