Emergency Solutions Grant Program

Transcription

1 PY2018 APPLICATION Cobb County CDBG Program Office 192 Anderson Street, Suite 150 Marietta, GA 30060

2 FUNDING AVAILABILITY 2018 Instructions This program is funded and regulated at the federal level by the U.S. Department of Housing and Urban Development (HUD) and administered locally by the Cobb County CDBG Program Office. It is authorized under Homeless Emergency Assistance and Rapid Transition to Housing Act of 2009 (HEARTH Act). Annually, the Cobb County CDBG Program Office requests proposals from local non-profit organizations and government entities to carry out eligible activities in the County. This funding application is for the period beginning January 1, 2018 through December 31, A Selection Committee will review all applications for compliance with requirements and make funding recommendations to the Chairman and Cobb County Board of Commissioners (BOC). Recommendations for grant awards will be provided to the Chairman and BOC on or before Tuesday, November 7, ESG PROGRAM GOALS: Reduce the number of unsheltered individual and families. Prevent individuals and families from becoming homeless. Increase the percentage of individuals and families remaining in permanent housing. ESG ELIGIBLE ACTIVITES: Street Outreach Emergency Shelter Homelessness Prevention Rapid Re-housing Homeless Management Information System (HMIS) ELIGIBILITY REQUIREMENTS: The must be submitted by or on behalf of a non-profit organization or governmental entity. Proposed activities must benefit low and moderate income residents or communities within Cobb County (See Attachment A). There must be no adverse impacts to the environment in proposed activities; to be determined through an Environmental Review. SUBMITTAL INSTRUCTIONS: Please provide 1 ORIGINAL AND 1 COPY of your completed application with attachments. Please submit 1 COPY of your organization s single audit. Note: For those organizations whose operational budget is less than $25,000 annually, please submit 1 COPY of your audited financial statements. s must be submitted to the CDBG Program Office no later than 5:00 p. m. on Friday, April 7, Office/Mailing Address CDBG Program Office 192 Anderson Street, Suite 150 Marietta, GA Attn: PY2018 ESG for Funding Please note: Incomplete s will NOT be considered for funding. Please be sure to complete all sections of the applications and provide all requested documentation. 1

3 APPLICATION WORKSHOPS: Please plan to attend one of the following PY2018 Funding Cycle workshops below: Thursday, February 9, :00 a. m. Cobb County Board of Commissioners Room 100 Cherokee St., Marietta Thursday, February 16, :00 p. m. Vinings Public Library 4290 Paces Ferry Rd., Atlanta Thursday. March 2, :00 p. m. Mountain View Regional Library 3320 Sandy Plains Rd., Marietta Tuesday, March 14, :00 p. m. South Cobb Regional Library 805 Clay Rd., Mableton Thursday, March 30, :00 p. m. Charles D. Switzer Public Library 266 Roswell St., Marietta Questions regarding the application process should be directed to the Cobb County CDBG Program Office Staff at 192 Anderson Street, Suite 150, Marietta, GA or

4 SUBMISSION REQUIREMENTS 1. The applicant must a. have nonprofit status for at least one (1) full year, or b. have two (2) full years of operating experience under another nonprofit entity, or c. be a local governmental entity or agency (governmental agencies can skip to line 5) 2. The applicant must be registered to conduct business in the State of Georgia at the time of application. (Not applicable to governmental agencies) 3. The applicant must have an audit or audited financial statements (if budget is less than $25,000 annually) prepared by a qualified accountant or accounting service, covering the last two most recent reporting periods of operation. Copies of each audited financial statement must be submitted with the application. Reviews and Compilations will not be accepted. Audit findings will make the applicant ineligible to receive assistance. (Not applicable to governmental agencies) DOCUMENTATION Provide a copy of a 501(c) (3) designation letter from the Internal Revenue Service if a nonprofit applicant Provide a copy of current certification from the GA Secretary of State. For assistance, please visit: Provide one copy each of the last two most recent audited financial statements that meet the criteria described. Include management letters if applicable. 4. Non-profit organizations must have an active Board of Directors within the last 12 months. (Not applicable to governmental agencies) Provide list of board members and a copy of board meeting minutes authorizing the submittal of this application. Please also include a copy of Conflict of Interest Statement. 5. The applicant must have at least twelve (12) months experience directly related to the proposed project or program. 6. The applicant must submit a written copy of its financial management procedures, including staff responsibilities and required procedures. 7. The applicant must agree to abide by all policies, regulations, ordinances, or statutes as required by HUD or Cobb County. Provide funding commitments displayed on letterhead, resumes of principal staff and personnel directly working on the project, and include descriptions of the applicant s previous related program activities. Provide a copy of the agency s written financial management procedures, and a current organization chart. Provide a signed statement that the organization acknowledges its responsibilities in the Certification. 8. Each applicant must submit one original and one copy of their application unbound. Provide an original and one copy unbound. 9. Each applicant must submit proof of insurance for the following types of insurance: General Liability, Auto Liability, and Worker s Compensation Provide a copy of Certificate of Insurance 10. Each applicant must submit proof that the organization has registered with the U.S. System for Award Management. Visit Provide proof of registration with the U.S. System for Award Management. 3

5 EXECUTIVE SUMMARY APPLICANT: PROJECT TITLE: If PY2017 funds were available, would you want to be considered for these funds? YES NO If yes, please let us know how soon after signing an agreement could your project start? Immediately (within first 30 days) 2-4 months 5-7 months Anticipated completion date: Please select funding request type: New Project Existing Project Please select project type: Street Outreach Emergency Shelter Homeless Prevention Rapid Re-housing Homeless Management Information System (HMIS) Summary: Summarize your grant request. This includes a brief description of the project, the need or problem to be addressed, the program goals and objectives for meeting those needs, and the funding request for the project. Please also discuss the total budget for this project and how much funding is already secured. Please include additional pages as needed and label accordingly. Response: 4

6 I. ORGANIZATION INFORMATION Organization Name: Mailing Address: Telephone Number: Contact Person: DUNS Number: Dun & Bradstreet, Inc. provides this number at no charge. Title: Tax ID #: II. PROJECT INFORMATION Project Title: Project Location: Project Priority of If your organizations submits more than one application, please rank priority. III. REQUESTED FUNDING BY ELIGIBLE COMPONENT Component Amount Requested Component Amount Requested Street Outreach Emergency Shelter Case Management $ Essential Services $ Transportation $ Shelter Operations $ Special Service Needs $ Renovations $ Homelessness Prevention Rapid Rehousing Financial Assistance $ Financial Assistance $ Homelessness Prevention Services $ Rapid Re-housing Services $ HMIS Coordination Data Management $ IV. LEVERAGING & COLLABORATION [FUNDING SUPPORT ] Total Project Cost: Total ESG Amount Request: Percentage of ESG Investment (Total Amount/Total Project Cost): Please list all funding secured for this Project currently and additional funding awarded in the past three years. Do not include other ESG funding received from Cobb County CDBG Program Office. Year Awarded Agency Funding Type Amount 5

7 V. AGENCY INFORMATION 1. What is your organization s mission statement? 2. How long has the Organization existed in its current form? 3. How long has the Organization had its 501 (c) (3) status? If your organization is a government entity, enter N/A? 4. How many years has the Organization conducted the project/program for which it is requesting funding? 5. A Homeless Management Information System (HMIS) must be used to track program participants. Does your organization use Pathways or a compatible HMIS? VI. ORGANIZATION CAPACITY 1. What percentage of the Organization s budget is grant funded? 2. How many program staff persons are dedicated to this project (i.e. Case Managers, Intake Coordinators)? 3. Does the organization have administrative staff (i.e. Accountants, Executive Director) dedicated to this grant? 4. Has the organization secured funding for the administrative staff for this project? VII. NARRATIVE Please provide a detailed description in a separate attachment to address the following questions: Yes No Yes No 1. Description a. Project Goals: What are the goals of the program and how will funds be used to assist households in maintaining stability? (A comprehensive and detailed one year project budget MUST be submitted). b. Encouraging Partnership: How will the proposed activity encourage new partnerships or use existing partnerships to complete the activity? c. Organization s Experience: Does the organization have experience working with projects similar to the one proposed? If the organization has received federal entitlement funds in the past, has it demonstrated an ability to meet all program requirements? d. Resources: Does the organization have the staffing in place and the financial resources necessary to successfully operate the proposed program? Where applicable, indicate how these funds will be used to leverage additional resources and whether these resources are committed or pending. e. Match: ESG funds are subject to a dollar for dollar match. The match can be in the form of cash or noncash contributions (i.e. donated material/property, rate of volunteerism). How does your organization intend to comply with ESG Match Requirement? 6

8 2. Evaluating Accomplishments a. Discuss how your organization will evaluate project accomplishments and outcomes. b. Please indicate proposed performance goals and outcomes on the chart below: Proposed Performance Goals Ex. To assist 20 families with prevention or re-housing services Outcomes Ex. 10 families in housing by 2 nd Qtr 10 families in housing by 4 th Qtr 3. Performance: Reporting, Monitoring, Record-Keeping ESG requires HMIS reporting of client-level data, such as the number of persons served and their demographic information. Additionally, the CDBG Program Office will require organizations to provide data and information for the submission of monthly, quarterly and annual reports pertaining to expenditure of ESG-funded activities. (Therefore projects funded are required to use Pathways to report ESG activities. a. Describe and discuss your organization s experience with utilizing the HMIS/Pathways and/or other reporting systems. b. Discuss your organization s current record keeping process to ensure protection of client s sensitive information. VIII. PERFORMANCE MEASUREMENT METRICS Please outline the total number of persons your organization plans on serving by this proposed project for the next five (5) years. These numbers are merely projections, but attempt to be realistic in your assessment What performance measurement outcome does your project best exemplify? What performance measurement objective does your project best exemplify? Improving Availability / Accessibility Suitable Living Environment Improving Affordability Decent Housing Improving Sustainability Creating Economic Opportunity 7

9 IX. PROPOSED SERVICES Please list the services you propose to provide using the grant funds requested. If multiple funding sources will be used to provide services (as will be the case for many organizations) please show the number of persons to be served and units of service to be provided with only the ESG funds being requested. For reporting purposes only, this may require that you determine the per unit cost for the service and divide the funds requested by the per unit cost. Persons to be served should reflect an unduplicated count (if you serve someone more than once, count them only once). Please indicate under the "Proposed Service Units" both the number and type of service unit you will provide (i.e., 1,000 nights of shelter, 25 utility bills to be paid, etc.). Service Description Number of Persons to be Served Service Units Dollar Amount Requested Street Outreach Emergency Shelter Homelessness Prevention Rapid Re-Housing HMIS Coordination Total X. PROPOSED MATCH & SOURCES List sources and amounts of proposed match (project requires a 100% match): Match may be cash or in-kind, but it must be documented during program operations, reported monthly with each request for reimbursement, and is subject to review during monitoring. Matching must be used in providing the same or closely related services. s should list sources and uses of proposed match. Attach additional sheets if necessary. Check here if additional pages attached. Agency/ Organization/Grantee/Donor Source (Federal, non-federal, In-Kind, etc.) Amount of Match (For 100% of ESG Funds Requested) 8

10 XI. CURRENT SERVICES PROVIDED Services currently provided to at-risk and homeless population in Cobb County on an annual basis: Please list the services that your organization currently provides to the relevant population groups. This should include all services that are provided to homeless families and individuals, as well as to at-risk persons in danger of becoming homeless without assistance (for example, delinquent rent or utility payments). You may use estimated numbers of persons served, units of service (nights of shelter, meals, trips provided, counseling visits, etc.), and dollars spent for these services. The purpose of this section is to help us understand how this grant request will relate to your current activities. Click here if additional pages attached. Services Description Number of Persons Served (Unduplicated) Number of Service Units Approximate Expenditures 9

11 CONFLICT OF INTEREST ACKNOWLEDGEMENT Do any family relationships (by blood or marriage) exist between staff in your organization and/or Agency Board members? Yes No If yes, please explain in detail and document the staff person s involvement with these grant funds. Do any family relationships (by blood or marriage) exist between staff in your organization and/or Cobb County Board of Commissioners? Yes No If yes, please explain in detail and document the staff person s involvement with these grant funds. CERTIFICATION: The application should be signed by the individual who has been authorized by the Board of Directors. The person who prepares the application cannot sign as the Authorized Representative. I certify that the applicant meets the conditions specified in the application instructions and will be able to carry out the proposed services in concert with these conditions. I also certify that the organization is a certified IRS 501(c) (3) non-profit organization. Preparer Authorized Representative Printed Name Printed Name Signature Signature Date Date 10

12 Proposals should include an itemized Proposal Budget as shown in Exhibit 1 below. Exhibit 1: PY2018 Proposal Budget for ESG Funding EMERGENCY SHELTER COMPONENT Essential Services 1. Case Management $ 2. Childcare $ 3. Education Services $ 4. Employment Assistance/Job Training $ 5. Outpatient Health Services $ 6. Legal Services $ 7. Life Skills Training $ 8. Mental Health Services $ 9. Substance Abuse Treatment Services $ 10. Transportation $ Shelter Operations 1. Minor or Routine Repairs $ 2. Rent/Lease Payments $ 3. Security $ 4. Fuel $ 5. Equipment $ 6. Insurance $ 7. Utilities $ 8. Food $ 9. Furnishings/Bedding $ 10.Custodial Supplies $ 11. Office Supplies and Printing $ 12. Shelter Staff $ Renovations 1. Labor $ 2. Materials/Tools $ 3. Major Rehabilitation $ 4. Conversion $ 5. Total $ Total Emergency Shelter $ HOMELESSNESS AND RAPID RE-HOUSING COMPONENT Financial Assistance 1. Rental Fees $ 2. Security Deposit $ 3. Last Month's Rent $ 4. Utility Deposit / Payments $ 5. Moving Costs $ Service Costs 1. Housing Search/ Placement $ 2. Housing Stability Case Management $ 3. Mediation and legal service $ 4. Credit Repair/Budgeting $ Rental Assistance 1. Short Term Rental Assistance (up to 3 Months) $ 2. Medium Term Rental Assistance (4-24 Months) $ Total Homelessness and Rapid Re-housing Component $ HMIS COORDINATION 1. Computer hardware, software, or software licenses $ 2. Equipment $ 3. Participation Fees charged by HMIS Lead $ Total HMIS Coordination $ TOTAL GRANT REQUEST $ 11