Evergreen Respite and Caregiver Support Center

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Executive Summary

Evergreen Respite and Caregiver Support Center is a nonprofit in Wisconsin that gives families who care for a person with dementia a safe place for their loved one to spend the day, and gives the caregiver rest, training and support. We run an adult day respite program with trained aides, activities, meals and transportation, and we offer caregiver education classes, support groups and one-on-one care consultations. Fees are on a sliding scale, and no family is turned away because they cannot pay.

Caring for someone with dementia is a full-time job that the caregiver usually does alone, often while working and raising a family. Many caregivers go years without a break, and their own health suffers. Paid care is costly, waiting lists are long and many programs do not take people with advanced memory loss. Families tell us the same thing: they do not need advice as much as they need a few hours, a few days a week, when they know the person they love is safe and cared for.

With this grant we will serve about 1,300 participant-days in Year 1 with a capacity of 12 participants a day, hold 4 caregiver education series and 12 monthly support group meetings, and complete about 120 care consultations. Our goals are that at least 85% of caregivers tell us the program gives them meaningful relief, that at least 80% of participants attend regularly for at least 3 months and that no family is turned away because of ability to pay. We do not promise to slow the disease or to delay a move to a care home. We measure what we can and report it honestly.

Our Year 1 budget: about $574,000, growing to about $818,000 by Year 5. Each year's budget is planned to balance, with a small surplus. We have 9 paid staff in Year 1 and 13 by Year 5. Area Agency on Aging contracts, participant fees, Medicaid waiver payments and gifts add steady support, so grants fall from about 63% of our income in Year 1 to about 35% in Year 5.

We are asking the Aging in Place Foundation for $110,000 for one Caregiver Support Coordinator, one Respite Care Aide and a respite scholarship fund that reduces fees for families who cannot pay. Contracts, fees, other grants and gifts cover the rest, so this grant is one part of a shared funding plan.

I am Beverly Hartmann, the Executive Director, a licensed social worker with 18 years in aging services, and a former family caregiver for my own mother. The numbers in this proposal are estimates based on the assumptions listed at the end, not promises.

Company Description

Evergreen Respite and Caregiver Support Center is a nonprofit organization in Wisconsin. We are a 501(c)(3) public charity (or a program of one, through a fiscal sponsor), governed by a volunteer board of directors. We will provide our IRS determination letter, board list and most recent financial statements with this proposal.

Our mission. To give families who care for a person with dementia rest, skills and support, and to give people living with dementia a day that is safe, active and kind.

What we believe. A person with dementia is still a person, with a history, preferences and dignity. A caregiver who is rested, trained and connected to others is better able to keep a loved one at home safely and longer. Respite is not a luxury. It is part of care. We serve people of every race, faith, income and background, and we make reasonable accommodations for disability.

How we started. Evergreen began when a group of former caregivers met in a church basement to share what had helped them. They invited a social worker and an occupational therapist to a few meetings, and the group grew from 6 to 40. A volunteer-run Tuesday respite morning for 6 people had a waiting list within a month. This proposal asks for support to turn that volunteer effort into a staffed program.

What we offer:
- Adult day respite. A structured day, with meals, music, exercise, gardening and cognitive activities, led by trained aides at a ratio of at least one aide for every four participants, in a safe, secure room, with a nurse or social worker on the team.
- Transportation. Door-to-door rides in our wheelchair-accessible van for participants who cannot get there otherwise.
- Caregiver education. Evidence-based classes for caregivers, such as Powerful Tools for Caregivers and similar programs, delivered by trained facilitators.
- Support groups and care consultation. Monthly support groups, and one-on-one consultations with a licensed social worker to plan care, find services and prepare for what is next.
- Respite scholarships. A fund that reduces fees for families who cannot pay, applied directly to the family's account at the center.

Who we serve. Adults living with Alzheimer's disease and other dementias, and their family caregivers, in our county and nearby communities. Fees are on a sliding scale, and we help families apply for the Medicaid waiver programs and other benefits that can pay for adult day services.

What we do not do. We do not provide skilled nursing, overnight care or care for people who need a higher level of supervision than a day program can provide, and we help those families find the right place. We do not promise to slow the disease. We do not use physical restraints. We are not a replacement for a doctor or for emergency care.

How we are run. A nine-member volunteer board of directors oversees the organization and approves the budget each year. The board includes two former caregivers, a geriatrician, a nurse, an elder law attorney, a faith community leader, a banker, a social worker and a certified public accountant. The Executive Director manages the organization, the Program Director runs daily care and an outside accountant reviews our books every year.

Where things stand today. We have letters of support from the county aging unit, two churches, a hospital social worker and an elder law attorney, and a letter of intent for space in a community center. Before we begin, our attorney will review our participant agreements and consent forms, and we will confirm what Wisconsin requires for adult day services.

Problem & Opportunity

Dementia affects millions of older adults and their families. Most people with dementia live at home, and most of their care is provided by family members, who are often spouses or adult children with jobs and children of their own. Research from public health agencies and universities consistently finds that dementia caregivers have more stress, depression and health problems than other caregivers, and that a lack of breaks is one of the main reasons families move a loved one to a care facility sooner than they wanted.

Respite is hard to find. Adult day programs are scarce in many communities, and many do not accept people with moderate to advanced dementia, people who wander or people who need help with toileting. Paid in-home care is costly by the hour. Many families do not know what help exists and learn about it after a crisis.

Cost is a barrier. Medicaid waiver programs can pay for adult day services, but eligibility is limited, and the rates are often below the real cost of care. Families who earn too much for Medicaid and too little to pay for care privately are stuck in the middle.

For a small nonprofit, the economics are hard. A good adult day program needs a ratio of one aide for about every four participants, a safe space, meals, a van and trained staff, whether the room has 6 participants or 12. Costs are fixed while attendance builds, and fees alone do not cover the cost for families who cannot pay.

We want to be clear about what we know and do not know. We know that caregiver relief is a real need and that families say respite helps. We do not know that any single program will delay a nursing home move for any one family, and we will not claim it. We will use the most recent numbers from the Alzheimer's Association, the Census Bureau and the state for our county in our final application and will not overstate them. Our own pilot served 6 people one morning a week and had a waiting list of 19.

Products & Services

Evergreen will run a staffed adult day respite program, teach and support caregivers, and keep fees affordable through a sliding scale and a scholarship fund.

How it works, step by step:
1. First call and visit. A caregiver calls, and our care coordinator visits the home or the center, listens and explains what we offer and what it costs. There is no charge.
2. Assessment. A nurse or social worker meets the person and the family to learn about the person's history, abilities, medicines, preferences and what a good day looks like, and to decide whether we can care for the person safely.
3. Agreement and fees. We sign a participant agreement, set a sliding-scale fee and help the family apply for Medicaid waiver programs, veterans' benefits and other help.
4. Care plan. Each participant has a written plan that lists the activities, supports and warning signs that matter for that person, and we review it every few months.
5. A typical day. The van picks up participants in the morning. Aides greet each person, lead music, exercise, crafts, gardening and reminiscing, serve a hot lunch and snacks, help with toileting and rest, and keep records. A nurse or social worker is on site.
6. Caregiver support. During the day, caregivers can attend a class, a support group or a one-on-one consultation, or simply rest.
7. Family communication. We send a short note home each day and call about any change.
8. Safety. The room has a secure door, trained aides count participants throughout the day, and staff are trained to call 911 in any emergency and the family right after.
9. Quality. We track attendance, falls, incidents, caregiver relief and satisfaction, and review each one.

What this grant will pay for. One Caregiver Support Coordinator, one of the Respite Care Aides, and the respite scholarship fund. The rest of the budget comes from Area Agency on Aging and state caregiver support contracts, participant fees and Medicaid waiver payments, other grants and gifts.

Market Analysis

Who benefits: people living with dementia, their family caregivers, and the health system and community, which depend on families who can keep caring safely.

Our primary group is adults with Alzheimer's disease and related dementias in our county who live at home with a family caregiver. We will use the most recent numbers from the Alzheimer's Association, the Census Bureau and the state in our final application. Our secondary group is caregivers who need training and support, whether or not their loved one attends the day program.

Referral sources are doctors and memory clinics, the county aging and disability resource center, hospital discharge planners, home health agencies, faith communities and elder law attorneys.

How we sized our plan. We plan for 1,300 participant-days in Year 1 (about 5.2 participants a day on average, with room for 12), 1,900 in Year 2, 2,500 in Year 3 (capacity 16), 3,000 in Year 4 and 3,300 in Year 5 (capacity 20). Fees are billed at a blended rate of about $88 a participant-day in Year 1 (private fees and lower Medicaid waiver rates together), rising about 3% a year. We also plan for about 120 care consultations and 4 education series in Year 1.

Demand data. Our volunteer morning served 6 people and had a waiting list of 19 within two months. We expect demand to exceed capacity.

We do not take everyone. People who need more supervision than a day program can safely give are helped to find another option.

Competitive Landscape

Other choices for families, and what makes us different.

- In-home care agencies. They provide one-on-one care at home. They can be costly by the hour, and they do not offer the social setting or the caregiver education of a day program. We refer families to them for evenings and overnights.
- Other adult day centers. Some are excellent, and many have waiting lists or do not accept people with advanced dementia. We focus on dementia and keep a high staffing ratio.
- Memory care and assisted living. They provide residential care and are the right choice for many families. We help families delay or plan for that step, and we help them choose one.
- Nursing homes. They provide skilled care and are costly. We are not a substitute.
- Volunteer and faith-based respite. Some congregations offer a few hours a week. We work with them and offer training.
- The Alzheimer's Association and county aging programs. They provide education, helplines and referrals. We are a partner, and we offer direct respite and long-term support.

What makes us different.
- A program built for dementia, with trained aides and a nurse or social worker on site.
- Caregiver education, support groups and respite in one place.
- A sliding fee scale and a scholarship fund.
- Rides to and from the center.
- Honest outcomes: we report what caregivers tell us and what we count, whether the results are good or not.

What we do not claim. We are new. Our pilot was small, and established programs have longer histories. We plan to earn trust one family at a time.

Marketing & Sales Strategy

How we will reach families and referral partners.

Families. We will work through doctors and memory clinics, the county aging and disability resource center, hospital social workers, home health agencies, faith communities, elder law attorneys and caregiver support groups. We will keep a simple website with clear prices, a phone line that is answered and printed guides at libraries and clinics.

Referral partners. We will visit memory clinics, geriatricians and social workers, bring a one-page guide, offer a tour and ask what slows them down. We do not pay for referrals.

Caregivers. We will hold open houses and short talks at churches, senior centers and libraries, and ask each family to introduce a friend.

County and state partners. We will meet the county aging unit and the Area Agency on Aging each quarter, share our data and apply for the contracts and grants that fund caregiver support.

Funders and donors. We will report results as totals twice a year and in a short annual report, invite funders to visit and to see a typical day, and invite faith communities, businesses and individuals to sponsor a participant day, a van ride or a scholarship. We will not use stories or photographs of participants or families without clear, written permission.

Pricing. Our blended fee in Year 1 is about $88 a participant-day, on a sliding scale, with scholarships for families who cannot pay. We publish our fees and terms in writing.

Operations Plan

How the program will be carried out.

Timeline for Year 1:
- Months 1 to 2: Attorney review of participant agreements, hire the Program Director, the Caregiver Support Coordinator and the first three aides, buy the van and set up the room, train staff, and apply for any state approval.
- Month 3: Open the day program to the first 6 participants and add caregivers each week as staffing allows.
- Months 4 to 8: Fill the program to its capacity of 12, begin the first caregiver education series and a monthly support group, begin care consultations.
- Months 9 to 12: Fall and winter series, a family event, year-end data collection, report to funders and planning for Year 2.

The room and the schedule. We lease a ground-floor room of about 1,500 square feet in a community center, with a kitchen, an accessible bathroom, a secure entrance and an outdoor space, open five days a week from 8 a.m. to 4 p.m. Rent and utilities are $30,000 a year in Year 1.

Staffing. At least one aide for every four participants is on duty at all times. In Year 1 we have three Respite Care Aides, a Program Director who is a registered nurse or licensed social worker, a Caregiver Support Coordinator who is a licensed social worker, an Activities Coordinator, a Transportation Aide and Driver and a part-time Program Assistant. We add aides, an Activities Coordinator and a second driver as the program grows to 16 and then 20 participants a day.

Hiring and training. Every employee passes a criminal background check and a caregiver registry check, completes dementia care training, first aid and CPR before working alone and receives ongoing training. We pay aides about $36,000 a year in the plan.

Fees and scholarships. We bill at a blended rate of about $88 a participant-day in Year 1, rising about 3% a year. Families pay on a sliding scale, and Medicaid waiver programs pay a set rate for eligible participants. A scholarship fund of about $28,000 in Year 1 reduces fees for families who cannot pay. Scholarships are applied directly to the family's account at the center and never paid as cash. The Program Director and Executive Director approve each scholarship, and the board reviews a summary each quarter.

Safety and emergencies. The room has a secure door, a head count every hour and an emergency plan. Staff are trained in wandering prevention, fall prevention and de-escalation. We keep an incident log and review each incident.

Privacy. Participant records are kept in a locked cabinet and a secure system and shared only with the family's permission, except where the law requires. We report results to funders only as totals.

Insurance. We carry general and professional liability, abuse and molestation, commercial auto, workers' compensation and volunteer accident insurance. Insurance is about $14,000 a year in Year 1.

Management & Organization

The people who will carry out the program.

Beverly Hartmann, Executive Director. A licensed social worker with 18 years in aging services, including nine years running a county caregiver support program, and a former family caregiver. She leads fundraising, partnerships, finance and hiring, reports to the board and is the main contact for funders and the county. (Replace this paragraph with your own background.)

Program Director (registered nurse or licensed social worker). Runs daily care, supervises aides, completes assessments and reviews incidents.

Caregiver Support Coordinator (licensed social worker). Leads caregiver education and support groups and meets with families for care consultations.

Respite Care Aides. Provide daily care and activities and keep records, at a ratio of at least one aide for every four participants.

Activities Coordinator. Plans music, exercise, gardening and cognitive activities.

Transportation Aide and Driver. Drives and helps participants on and off the van.

Program Assistant (part-time). Keeps records and handles scheduling and billing.

Board of directors. Nine volunteers who meet quarterly: two former caregivers, a geriatrician, a nurse, an elder law attorney, a faith community leader, a banker, a social worker and a certified public accountant. The board approves the budget and policies, reviews scholarship and outcome summaries each quarter and does not receive pay.

Caregiver advisory group. Current and former caregivers meet twice a year and tell us what is working and what is not.

Staff pay in this plan includes payroll taxes and workers' compensation. Salaries are Executive Director $66,000, Program Director $62,000, Caregiver Support Coordinator $54,000, Respite Care Aide $36,000 each, Activities Coordinator $40,000, Transportation Aide and Driver $34,000 and part-time Program Assistant $26,000. Replace them with the pay you can offer where you live.

Milestones Narrative

Our goals for each year and how we will measure them.

- Before opening: meet at least 10 doctors, social workers and faith leaders and get at least 3 letters of support, confirm the lease and any state requirements, get insurance quotes and open a bank account. Do not take a participant until staff are trained and the room is inspected.
- Year 1: Serve about 1,300 participant-days with capacity for 12, and hold 4 caregiver education series and about 120 care consultations. A balanced budget of about $574,000, with a small surplus of about $14,700. 9 paid staff.
- Year 2: Serve about 1,900 participant-days and add a second van route. A balanced budget of about $592,000, with a small surplus of about $14,610. 9 paid staff.
- Year 3: Expand to a capacity of 16 and serve about 2,500 participant-days. A balanced budget of about $650,000, with a small surplus of about $15,214. 10 paid staff.
- Year 4: Expand to a capacity of 20 and serve about 3,000 participant-days. A balanced budget of about $787,000, with a small surplus of about $16,675. 13 paid staff.
- Year 5: Serve about 3,300 participant-days at a capacity of 20. A balanced budget of about $818,000, with a small surplus of about $16,921. 13 paid staff.

What we measure:
- Participants and participant-days, by month and by payer.
- Attendance regularity: the share of participants who attend at least 3 months.
- Caregiver relief and well-being, measured by a short survey at enrollment and every 6 months.
- Care consultations, education series completed and support group attendance.
- Falls, incidents and emergency calls.
- Scholarships awarded, and families who left because of cost.
- Cost per participant-day and cost per caregiver served.

How we review results. The Program Director reviews attendance and incidents every week, and the full team reviews outcomes monthly. Each season, staff, caregivers and our partners review results together and we change what is not working. Twice a year the board reviews results and we share them with funders as totals. Every number in this plan is a goal, and we will report what really happens, including when we fall short.

Funding Request

What we are asking for, and how the money will be used. Our request: $110,000 from the Aging in Place Foundation for one Caregiver Support Coordinator, one Respite Care Aide and a respite scholarship fund, for July 2027 through June 2028.

The request is spread across these budget lines:
- Personnel: Caregiver Support Coordinator salary (licensed social worker), $54,000 (other funds add $0).
- Personnel: Respite Care Aide salary (one of three aides), $36,000 (other funds add $72,000).
- Other: Respite scholarship fund: program fees reduced for families who cannot pay, applied directly to the family's account at the center, never as cash to a family, $20,000 (other funds add $8,000).

Other money in the program. Other grants, contracts, earned income and gifts pay the other $452,100 of Year 1 costs, including the matching amounts above. All Year 1 costs are listed below.

Year 1 budget: about $574,000, planned to balance with a small surplus (about $14,700 after spreading startup and equipment costs over five years). Year 1 money coming in: grants $362,000 (this request plus other grants we are applying for), area Agency on Aging and State Caregiver Support Contracts $70,000, participant Fees and Medicaid Waiver Payments (before scholarships) $114,000, donations and Faith Community Gifts $28,000. Year 1 costs: executive Director $66,000; program Director (RN or licensed social worker) $62,000; caregiver Support Coordinator (licensed social worker) $54,000; respite Care Aide (3 positions) $108,000; activities Coordinator $40,000; transportation Aide and Driver $34,000; program Assistant (part-time) $26,000; respite Scholarships (fees waived for families who cannot pay) $28,000; space Rent and Utilities $30,000; meals and Snacks $16,000; insurance $14,000; activity Supplies and Incontinence Care Supplies $8,000; van Operations and Maintenance $12,000; dementia Care Training and Staff Credentials $9,000; records System and Technology $6,000; outreach and Caregiver Education Materials $8,000; evaluation and Reporting $8,000; administration and Accounting $12,000; and about $21,100 a year for spreading startup and equipment costs over five years. These add up to $562,100.

How we planned participant fees and scholarships. We plan for about 1,300 participant-days in Year 1 at a blended rate of about $88 a day, or $114,000 billed, rising to about 3,300 participant-days and $327,000 by Year 5. We budget about $28,000 in Year 1 for fee reductions for families who cannot pay, growing as attendance grows. Staffing is the largest cost, and we keep one aide for every four participants.

About government funding. Area Agencies on Aging receive federal and state funds under the Older Americans Act, including funds for family caregiver support, and contract with local organizations. Medicaid waiver programs can pay for adult day services for eligible participants. These funds are competitive or limited, awarded for set periods and subject to appropriations and agency rules. The amounts in this plan are our planning estimates, not promises, and agencies can change their budgets, rules and awards.

One-time startup costs. Startup costs of $91,500 are paid once from startup money and are listed item by item in the Startup Costs section.

How we got our startup number. The Funding Need Calculator in this plan adds the startup costs ($91,500), the cash the budget uses before it levels out (about $7,180) and a cash cushion of about $135,250, which is three months of Year 1 operating costs. That comes to about $233,930, rounded up to the nearest $500: $234,000. We start with $20,000 of our own savings and $215,000 in startup support from a community foundation, a faith community fund and our board, $235,000 in all, which covers that amount.

The next five years. Our budget grows from about $574,000 in Year 1 to about $818,000 in Year 5. Grants are planned at $362,000, $291,000, $262,000, $317,000, $289,000 in Years 1 to 5, and area Agency on Aging and State Caregiver Support Contracts grow from $70,000 to $150,000; participant Fees and Medicaid Waiver Payments (before scholarships) grow from $114,000 to $327,000; donations and Faith Community Gifts grow from $28,000 to $52,000. Grants fall from about 63% of our income in Year 1 to about 35% in Year 5.

Savings. We plan to keep several months of costs in savings. The lowest year-end balance in the plan is about $136,300, at the end of Year 1. Contract and grant payments often arrive after we bill or after we submit reports, and a month or two of costs is held in cash. We plan for about $40,180 owed to us at the end of Year 1.

After the grant. Our plan is to grow Area Agency on Aging and state contracts as our data accumulates, to serve more Medicaid waiver participants and to invite faith communities, businesses and families to give. Because a good day program gives caregivers real relief, success strengthens our case for public funding.

Risks and how we will handle them:
- Attendance builds more slowly than planned. We keep staffing flexible, begin with part-time aide hours and watch the daily count, and we keep a cash cushion for the early months.
- A participant is injured or leaves the building. We keep a high staffing ratio, a secure door, hourly head counts and a written wandering plan, and we carry liability insurance.
- A caregiver cannot pay. We use the scholarship fund and help families apply for benefits, and we do not turn families away for ability to pay.
- Medicaid waiver rates or rules change. We track rates, plan conservatively and keep other funding sources.
- A key staff member leaves. We cross-train staff and keep written procedures for every part of the day.
- A grant ends. We keep savings, grow fees and Area Agency contracts, and keep our cost per participant-day low.

If you are just starting. A new organization can begin before it has its own 501(c)(3) status through a fiscal sponsor: an established nonprofit that receives grants for you and passes them to your program, usually for a fee (commonly around 5% to 10% of the grant, sometimes more; ask before you agree). Another way is to start smaller: one morning a week for six participants run by a trained volunteer team and a social worker, tracked carefully for six months. A waiting list and a few caregiver stories are the best evidence you can bring to your first grant application.

Appendix Notes

Documents to attach with this proposal:

- Your IRS 501(c)(3) determination letter, or your fiscal sponsor agreement.
- Your most recent financial statements and your current year budget.
- A list of your board members and what each one does.
- Resumes for your Executive Director and Program Director, and job descriptions for the Caregiver Support Coordinator and aides.
- Letters of support from the county aging unit, a memory clinic, a hospital social worker, faith communities and an elder law attorney.
- Your participant agreement, consent forms, sliding fee schedule and scholarship policy.
- Your dementia care and staff training plan, including wandering and fall prevention.
- Your plan for measuring results, including caregiver surveys.
- Results from your volunteer pilot, shown as totals.
- Proof of general and professional liability, workers' compensation and commercial auto insurance, or quotes.
If you don't have any of this yet, no worries - let's continue.

The assumptions behind our numbers (change them in the Financials section to match your own):
- Income: Grant Revenue: $362,000 in Year 1, growing to $289,000 by Year 5; Area Agency on Aging and State Caregiver Support Contracts: $70,000 in Year 1, growing to $150,000 by Year 5; Participant Fees and Medicaid Waiver Payments (before scholarships): $114,000 in Year 1, growing to $327,000 by Year 5; Donations and Faith Community Gifts: $28,000 in Year 1, growing to $52,000 by Year 5.
- Participant-days: 1,300 in Year 1, then 1,900, 2,500, 3,000 and 3,300, at a blended rate of about $88 a day, rising 3% a year; capacity of 12, 12, 16, 20 and 20 participants a day.
- Respite aides: at least one for every four participants (3, 3, 4, 5 and 5 aides).
- Respite scholarships: about 25% of fees billed in Year 1 ($28,000), growing about 30% a year.
- Pay (a full year, per person, including payroll taxes and workers' compensation): executive director $66,000; program director (rn or licensed social worker) $62,000; caregiver support coordinator (licensed social worker) $54,000; respite care aide $36,000; activities coordinator $40,000; transportation aide and driver $34,000; program assistant (part-time) $26,000.
- Other yearly costs in Year 1: respite Scholarships (fees waived for families who cannot pay) $28,000, space Rent and Utilities $30,000, meals and Snacks $16,000, insurance $14,000, activity Supplies and Incontinence Care Supplies $8,000, van Operations and Maintenance $12,000, dementia Care Training and Staff Credentials $9,000, records System and Technology $6,000, outreach and Caregiver Education Materials $8,000, evaluation and Reporting $8,000, administration and Accounting $12,000. These grow between 4% and 30% a year, and negative growth means a cost that is highest in Year 1.
- Startup costs ($91,500) and later equipment are spread evenly over five years in the plan's books, about $21,100 a year.
- About 7% of each year's income is still owed to us at year end.
- Tax: none, as a nonprofit.
- Every dollar amount is an estimate. Replace them with your own quotes and real budget.

Startup Costs