The recipient entity's physical address:
           2600 Johnston St.
Lafayette, LA 70503

The recipient entity's mailing address (if different):
           2600 Johnston St.
Lafayette, LA 70503

Type of Entity (for instance, a nonprofit corporation):  Non-Profit Corporation

If the entity is a corporation, list the names of the incorporators:
          Jewell P. Lowe; Nancy Whittington, RN; Dr. Evelyn Redding; Joan M. Ables, RN; Janice Coggins, ASCW; Dr. Donald Williams; Dr. James Oliver; Dr. R. Fred Marceau; Dr. Jerome Romagosa; Dr. Aline Garrett; Bernell Fontenot; Reverend Wayne Evans; Reverend Louis Richard; Maureen Goldware; Wanda McDonald; Dr. Louis Buettner; Nez Pate

The last four digits of the entity's taxpayer ID number:  6231

What is the dollar amount of the request?  $165,000

What type of request is this?  General Appropriation

Is this entity in good standing with the Secretary of State?  Yes

Provide the name of each member of the recipient entity's governing board and officers:
           Judith Kennedy
207 Louie Dr.
Lafayette, LA 70503

Michael Odinet, MD
344 Lippi Blvd
Lafayette, LA 70508

Mike Hebert
711 W. Congress St.
Lafayette, LA 70501

Nancy Mounce Cochrane
317 Thibodeaux Dr.
Lafayette, LA 70503

Tom Pears
700 Robert Lee Cr.
Lafayette, LA 70506

Camille Claibourne, RN, PhD
320 Deerpark Trail
Lafayette, LA 70508

Louis Bernard
713 Omega Dr.
Lafayette, LA 70506

Rev. Louis Richard
P.O. Box 1507
Abbeville, LA 70511

Rev. Thomas James, SVD
232 St. DePorres St.
Broussard, LA 70518

Jules Edwards, III
P.O. Drawer 3568
Lafayette, LA 70502

Kevin Berken
P.O. Box 29
Jennings, LA 70546

Janice Beyt
403 Myrtle Place
Lafayette, LA 70506

Ryan Breaux
333 Waterford Place
Breaux Bridge, LA 70517

Burton Cestia, Jr.
2826 Teal Dr.
New Iberia, LA 70560

Larry Baker, MD
116 Canterbury Rd.
Lafayette, LA 70503

Molly Kallenberger
407 Oakleaf Dr.
Lafayette, LA 70503

Steve P. Landry, PhD
325 Lippi Blvd
Lafayette, LA 70508

Melinda Oberleitner, RN, PhD
482 1/2 Nona St.
Breaux Bridge, LA 70517

Karl Brousssard, CEO
484 Nona St.
Breaux Bridge, LA 70517

Provide a summary of the project or program:
           Hospice of Acadiana, Inc. is requesting funding for ongoing palliative care services for seriously ill individuals and those with chronic disease. These individuals are at high risk for disease exacerbation, or new illness onset, given their comorbidities which are further heightened by our current pandemic. Palliative medicine services will be provided by a nurse practitioner or physician in a clinical setting, or in the patient's home setting (i.e. individual residence, Assisted Living Facility, nursing home, etc.) to reduce public exposure and mitigate the risk of communicable disease and/or symptoms complications. Palliative care includes patient assessment and intervention, including, but not limited to medications, supplies/equipment needs, psycho-social support, and social determinant support, as appropriate, for disease processes. Treatment increases patients' quality of life, reduces/slows disease trajectory, and reduces and/or eliminates recurrent hospitalizations.

What is the budget relative to the project for which funding is requested?:
          Salaries. . . . . . . . . . . . . $0
          Professional Services. . . $165,000
          Contracts . . . . . . . . . . . $0
          Acquisitions . . . . . . . . . $0
          Major Repairs . . . . . . . $0
          Operating Services. . . . $0
          Other Charges. . . . . . . $0

Does your organization have any outstanding audit issues or findings?  No

If 'Yes' is your organization working with the appropriate governmental agencies to resolve those issues or findings?
          Not Applicable

What is the entity's public purpose, sought to be achieved through the use of state monies?
          Palliative services offered by Hospice of Acadiana will promote the overall health and well being of seriously ill, high-risk individuals while reducing the ever-increasing burden on our current healthcare system. The palliative care services are focused on meeting the needs of this gap population - those that are chronically ill but not yet imminently terminal. These services address a need that currently exists in our community and costs our taxpayers and systems considerable time and dollars. As a nonprofit, the palliative services are provided to all chronically individuals regardless of their ability to pay for service.

What are the goals and objectives for achieving such purpose?
          The goal of the program is to prevent the health decline, and lessen the burden on other healthcare providers, while improving the patient's quality of life. Our objective is to treat patients safely, and timely, in order to slow condition decline and promote optimal health and well being. Education, advanced care planning, and social determinant counseling (i.e. nutrition, financial, medication, shelter, caregiving, etc.) encourage these high-risk individuals to be proactive in the handling and management of their conditions, which will ultimately lessen the strain on them, their families, and the healthcare system.

What is the proposed length of time estimated by the entity to accomplish the purpose?
           12 months

If any elected or appointed state official or an immediate family member of such an official is an officer, director, trustee, or employee of the recipient entity who receives compensation or holds any ownership interest therein:
     (a) If an elected or appointed state official, the name and address of the official and the office held by such person:
                 NA
    
     (b) If an immediate family member of an elected or appointed state official, the name and address of such person; the name, address, and office of the official to whom the person is related; and the nature of the relationship:
                 NA

     (c) The percentage of the official's or immediate family member's ownership interest in the recipient entity, if any:
                 NA

     (d) The position, if any, held by the official or immediate family member in the recipient entity:
                  NA

If the recipient entity has a contract with any elected or appointed state official or an immediate family member of such an official or with the state or any political subdivision of the state:
(a) If the contract is with an elected or appointed state official, provide the name and address of the official and the office held by such person: 
               NA

(b) If the contract is with an immediate family member of an elected or appointed state official:
          Provide the name and address of such person:
               NA

          Provide the name, address, and office of the official to whom the person is related:
                NA

          What is the nature of the relationship?  NA

(c) If the contract is with the state or a political subdivision of the state, provide the name and address of the state entity or political subdivision of the state:
                 NA

(d) The nature of the contract, including a description of the goods or services provided or to be provided pursuant to the contract:
               NA


Contact Information
name:  Karl Broussard 
                                       address:  2600 Johnston St.
Lafayette, LA 70503
                                       phone:  3372321234
                                       fax:  3372320477
                                       e-mail:  karl@hospiceacadiana.com
                                       relationship to entity:  Chief Executive Officer