Forms

By signing in or creating an account, some fields will auto-populate with your information and your submitted forms will be saved and accessible to you.

Mental Health and Disability Service Surplus Application

Steps

  1. 1. Requirements & Criteria
  2. 2. Application Cover
  3. 3. Application Content
  4. 4. Required Attachments
  • Requirements & Criteria

      • Grant funding must be used for the project described in the application.
      • Grantees shall have offices located in Linn County and provide mental health and disability services to Linn County residents.
      • Organizations designated as non-profits must provide proof of non-profit status.
      • Municipalities within the jurisdictional boundaries of Linn County may submit an application but must demonstrate how funding would be used to help people with mental health and/or disabilities.
      • Due to legal restrictions, Iowa Code Section 331.901(5), organizations under ecclesiastical or sectarian management or control are not eligible for Linn County funds..
      • The Board of Supervisors may request a representative from your organization to attend a public meeting to relate progress towards the completion of your project.

    1. Applications are available on Linn County’s homepage (www.linncounty.org) starting on Monday January 15th. Applications must be submitted no later than 5:00 p.m. on Thursday February 15th.

    2. Applications for funding will be scored based on how well they meet the following objectives:

      • Has potential for long-term impact
      • Serves those with mental health and disability needs in Linn County
      • Addresses an emerging need, or provides a solution to an existing community need within mental health and disability services
      • Clearly describes project goals
      • Demonstrates sound financial plans for future funding of the project/program

      • Organization name
      • Project name
      • Address
      • Contact person and title
      • Phone
      • Email
      • Dollar amount requested
      • Total project cost
      • Summary of request (500 characters)

      • Brief description of your organization and mission
      • Is your organization designated as a non-profit (Yes or No)
      • If yes, please provide documentation proving non-profit status

      • Define and document the problem or need addressed by this program or project

      • Describe the project and what will be accomplished.
      • Describe the target population, how many will be served and for how long?
      • Evidence Based Practice. (Yes or No)
      • Will program/project serve residents outside the jurisdictional boundaries of Linn County?

    3. List the project goals and objectives

      • Applicant must indicate if their funding request is for one time dollars or for ongoing expenditures.
      • If approved, how would program/project be sustained into the future without future Linn County fund balance dollars?

    4. For questions, please contact Linn County Supervisor Ben Rogers at 319-892-5106 or ben.rogers@linncounty.org.

    5. Requirements & Criteria Verification*