1 Wisconsin Balance of State Continuum of Care State Transitional Housing (TH) pplication Explanation of the grant and process: State Transitional Housing dollars are designed to support transitional housing and appropriate supportive services to assist individuals and families experiencing homelessness as they transition from homelessness and to enable them to live as independently as possible. The WI Balance of State Board of Directors will apply for the Transitional Housing Grant from the WI Division of Housing. If funded, the Balance of State will sub-contract with successful applications for the awarded TH dollars in each region (Balance of State and Other Metro) in conjunction with the current COC-funded THP programs. The estimated grant funds available are: Other Metro $67,500 less admin Total vailable for Other Metro $60,800 Balance of State $100,000 less admin Total vailable for Balance of State $89,950 Total $167,500 less 10% admin ($16,750) Total vailable $150,750 **The final amount available will not be known until the WI Balance of State receives an official grant award from the WI Division of Housing. The amounts listed in this application are subject to change. gencies eligible to apply for funding in each region are (in alphabetical order): Balance of State Maximum ward mount (Total $89,950) DVOCP Fond du Lac Transitional Housing Program $11,232 CCSCW Jefferson County Transitional Housing $16,816 CI Rock/Walworth Transitional Living Program $25,000 CP Services Transitional Living Program $10,703 Couleecap Couleecap Transitional Housing $25,000 CWCC Project Chance Transitional Housing $25,000 Forward Service Corp New Homeless Continuum $25,000 NCCP The Big Ten $18,054 NWCS BC Transitional Housing $11,585 West CP Families in Transition Supportive Housing $25,000 Other Metro Maximum ward mount (Total $60,800) City of ppleton Fox Cities Housing Coalition THP $18,115 Family Services of NE WI Brown County Transitional $16,284 Housing KHDS Homeless Youth Project $14,324 KHDS KYF Supportive Housing Program $12,906 NWCS Transitional Housing $9,438 Richard s Place I SHP TH $11,470 West CP Chippewa County Transitional Housing Program $13,400 Women & Children Horizons Transitional Living Program $22,477 YWC of the Coulee Region Transitional Housing $7,472 These charts are based on a maximum award of $25,000 or 10% of COC grant award whichever is higher.
Requirements To be eligible to receive financial assistance, an applicant must be: 1. Be a non-profit corporation in good standing, qualified for tax exemption under 501(c)(3) of the internal revenue code or a municipal corporation; 2. Have the administrative and financial management capacity necessary to administer and to account for the use of a grant in accordance with the funding requirements; 3. Not engage in any inherently religious activities, such as worship, religious instruction, or proselytization, as part of the activities and services funded with any grant for activities or services covered by this rule; and if religious activities are offered, they must be offered at a separate time or location from the activities and services funded under this program; and participation in those religious activities must be voluntary for persons receiving assistance under this program; 4. Be a drug free work-place in accordance with federal statute; 5. Operate its programs free from discrimination on the basis of age, race, color, religion, national origin, physical or mental disability, sexual orientation, or gender in accordance with applicable federal and state fair housing laws; 6. Regularly participate in all local area continuum of care meeting and planning functions for at least one-year; 7. There was no finding that may result in the forfeiture of funds or unresolved questioned costs in a financial audit; 8. ctively participate in the WI Balance of State CoC defined as volunteering for the board of directors or a member of a WI BOS committee; 9. In good standing with WI Balance of State CoC, WI Division of Housing, and HUD; 10. CoC-funded Transitional Housing Programs must be in compliance with the COC Interim Rule including by not limited to: HQS, leasing/occupancy agreements, Match requirements, supportive service requirements, program fees, termination, etc. 11. Participation and compliance with the State of WI HMIS Policies & Procedures for Data Collection unless program is prohibited from utilizing HMIS, then a comparable database. Once the Grant is awarded, the agency is required to: 1. Document services provided with TH dollars in HMIS. If the COC-funded Transitional Housing Program is victimbased, the agency will be required to track services in a comparable manner to HMIS. 2. Provide TH funded services only to those clients enrolled in the COC-funded Transitional Housing Program. To apply: gency applicants must submit one (1) electronic copy of the completed application by March 21, 2014 at 4:30pm CST to Carrie Poser (VP of BOS Board of Directors) at: wiboscoc@gmail.com. Either WORD or PDF is acceptable. ny request received after the deadlines above will not be considered. Grant wards for each region will be determined as follows: The applications will be reviewed and scored by the Balance of State Board of Directors. Each project will be ranked, highest point total to lowest within each group (Other Metro vs. Balance of State). Each grant will be awarded from the top down until the funds are depleted. The exact dollar amount will not be determined until and unless the Balance of State is awarded the state-thp grant from the WI Division of Housing. TH Scoring Tool What makes one application better than another? High Risk Pool Score (chronic homeless, mental health/od, coming from street or Emergency Shelter, no income) Rank in the Board Scoring Tool 2013 Recidivism scores: percentage of clients that leave transitional housing and return to shelter within 6 months nswers to the application questions (assurances and narrative) 2
3 THP Sub-recipient pplication gency Name COC-Funded TH Program Name Project Contact Name Email ddress Phone Number Mailing ddress Local Continuum of Care Name Local Continuum of Care Lead Contact Name Primary cities or counties served by COC-funded TH program Region for THP Funding Balance of State Other Metro Milwaukee COC-funded program facility type Scattered Site Dedicated Site 1. Request for Funding Eligible activities under these grant funds include: Services: (via actual services provided by the agency or vouchers) Case-Management, Child Care, Education Services, Employment ssistance, Outpatient Health Services, Life Skills Training, Mental Health Services, Substance buse Treatment, and Transportation Operations: Maintenance, Rent, Security, Fuel, Insurance, Utilities, Food, Furnishings, Equipment, Supplies Fill out the chart below with the total request for the CoC-funded Transitional Housing Program. It is your responsibility to make sure the Overall Total matches the programs maximum award amount listed on page 1 of this application. Services Funding Request Operations Funding Request Case Management Maintenance Child Care Rent Education Services Security Employment ssistance Fuel Outpatient Health Services Insurance Life Skills Training Utilities Mental Health Services Food Substance buse Treatment Furnishings Transportation Equipment Supplies Subtotal for Services Subtotal for Operations Overall Total (Services + Operations)
2. Program Description Describe the COC-funded Transitional Housing program for which funding is being requested. The description should include who the program services, describe populations targeted, and how your agency outreaches to these populations. Describe the geographic area for the program. Note any issues with capacity. Explain what funds the COC-funded Transitional Housing currently receives (leasing, supportive service, operations, HMIS) and what those funds are used for. Brief description of the COC-funded Transitional Housing Program 4 3. Funds within Program Description Describe how the funds requested will be used to support the COC-funded Transitional Housing Program. The description should include an explanation that addresses how the funding for each of the specific eligible activities (services and/or operation) will be used and why it is beneficial to the population served by the COC-funded Transitional Housing Program. Brief description of how funds will be used to support the COC-funded Transitional Housing Program 4. Budget, Staffing, and Referrals Indicate the agency s current and previous fiscal year total agency budget, total COC Program budget, and total HUD COC award. Please indicate the COC-funded Transitional Housing s current operating year:. Total HUD COC Program Budget Total HUD COC ward Total gency Budget Previous Operating Year (ctual) Current Operating Year (Projected) Indicate the number of staff and/or volunteers utilized during the previous operating year for the COC-funded Transitional Housing Program. Staff # of individuals Volunteers (# of individuals) Full-Time Equivalent # of individuals (total hours / 2080 hours) Full-Time Paid Staff Part-Time Volunteers Indicate where the most common referrals come from for your program. Include the agency name and the number or percentage of clients who actually are enrolled from those locations. Name of gency/organization Percentage of Clients Enrolled from this Org.
5 5. HMIS (or comparable database) Report For COC-funded TH programs that are required to use HMIS, provide the following numbers from your HMIS-run PR for the date range: 1/1/13 12/31/13. Use report: 0625 HUD CoC PR v21 Number of Clients Served Q7: Total # of Clients Served Q8: Total # dults Q8: Total # Children Q9: Total # people in HH with children Q9: Total # people in HH without children Q10: Total # of households with children Q10: Total # of household without children Gender Totals dd adult and children Q15a: Total # of adults who are male # of Males Q15a: Total # of adults who are female # of Females Q15a: Total # of adults who are transgender # of Transgender Q15b: Total # of children who are male Total # of People Q15b: Total # of children who are female Q15b: Total # of children who are transgender ge Q16: Total # of 0-17 year olds (dd up under 5, 5-12, and 13-17) Q16: Total # of 18-24 year olds Q16: Total # of 25-61 year olds (dd up 25-34, 35-44, 45-54, and 55-61) Q16: Total # of 62+ year olds (elderly) Total # of People Subpopulations - Disability Q18a. Total # of persons with Mental Illness Q18a. Total # of persons with lcohol buse Q18a. Total # of persons with Drug buse Q18a. Total # of persons with Chronic Health Problem Q18a. Total # of persons with HIV/IDS Q18a. Total # of persons with Develop. Disability Q18a. Total # of persons with Physical Disability Totals # of people with no conditions: # of people with 1 condition: # of people with 2 conditions: # of people with 3+ conditions: Total # of People Subpopulations - Other Q19a. Total # of victims of domestic violence Q21. Total # of veterans # of Chronically Homeless *To get this number, run the Entry/Exit (EE) ETH report for the same time frame as listed above
6 Residence the Night Before Entering the Program Q20a1: Total # adults from Emergency Shelters Q20a1: Total # adults from Transitional Housing Q20a1: Total # adults from Places not meant for human habitation Q20a1: Total # adults from Safe Havens Q20a2: Total # adults from all Institutions (total) Q20a3: Total # adults from Owned home (with or without sub.) Q20a3: Total # adults from Rental (with or without sub.) Q20a3: Total # adults from Hotel/Motel (client paid) Q20a3: Total # adults from Friends Q20a3: Total # adults from Family Q20a3: Total # adults from other ***For COC-funded TH programs that do not use HMIS or a portion of your project does not use HMIS, provide the same information listed above separately from your HMIS data (if applicable). 6. Information and ssurances Enter information about the agency. Write YES if the agency performs the function described and NO if it does not. Please note, that some functions listed in the agency information section are required for funding by the WI Division of Housing and as such are required by the. Financial Management Do the accounting records for the organization (agency) identify the source and use of all funds, including information on: ll grant awards received uthorizations or obligations of awards received. Un-obligated balances ssets & Liabilities Program Income Total actual outlays or expenditures to date re the accounting records of the agency supported by adequate source documentation such that the combination of source documentation and accounting records provides a complete audit trail? complete audit trail includes documenting the following: When a purchase was requested? B. Who requested the purchase? How the purchase was formally approved? What funds were used to pay for the purchase? When was it paid? How much was paid? Does the agency use employee timesheets that allow employees to track grant funded time spent on THP C. related activities separately from time spent and funded from other resources? Does the agency have a system in place for maintaining its financial resources for four (4) years or until D. any litigation, claim, audit, or other action involving the records has been resolved, whichever comes later? Does the agency have a current financial policy and procedure manual that covers basic accounting E. procedures such as those for recording financial transactions, for maintaining accounting records, and for approving grant funded expenditures? Consumer Participation Does the agency have representation of a person who is homeless or formerly homeless on the board of directors or a policymaking entity directly responsible for making policy for the project(s) for which funding is being requested?
7 B Does the agency, to the maximum extent practicable, require the participation of individuals and families who are homeless in maintaining, and operating the facilities and programs for which funding is requested? Client Rights Does the agency have published and accessible grievance and termination procedures that meet the requirements of 576.402 - Terminating assistance? Does the agency release client-specific data only insofar as it is required for the client s case plan or in the B. course of business and with the client s permission? Client HMIS Data Does the agency fully participate in HMIS, or if the agency is a victim service's agency, an HMIS comparable database specifically LICE? Point-in-Time Count Does the agency actively participate in the overnight street count during the semi-annual Point-in-Time Count held on the last Wednesday in January and July? Discrimination Is the agency is an equal opportunity employer in accordance with all federal regulations? When an agency turns down a client because that client does not meet appropriate demographic criteria, is B there a system in place to refer that client to appropriate services? The agency does not engage in inherently religious activities, such as worship, religious instruction, or C proselytization as part of the programs or services funded under THP. Good Standing Is the lead agency (for the COC-funded Transitional Housing program) qualified for tax exemption under 501(c)(3) of the internal revenue code or a unit of government? B The agency is an equal opportunity employer in accordance with all federal regulations. In the last two prior years, if applicable, a financial audit was conducted in compliance with OMB -133 C standards and submitted to the WI Department of dministration. In the last two prior years, in that audit, there was no finding or unresolved question cost in the financial D audit in which funds were requested to be returned because of misappropriation or ineligible expenses. In the last two prior years, there were no fines or liens levied again the agency (paid or unpaid). Example: E a fine for not paying payroll taxes. In the last two prior years, no funds from other grants that serve individual or families experiencing F homelessness form any other funder were required to be returned. The following are specific assurances: Continuum of Care Does the agency actively participate in local Continuum of Care meetings? This includes attending meetings regularly, participating in local continua planning, etc. B Does the agency regularly attend WI Balance of State quarterly meetings? C Is a member of the agency on the Board of Directors or a Balance of State committee? If yes, name the person(s) and committee(s) or board in the space below: D E The agency participates in the operation or development of the Coordinated ssessment system. Continuum of Care Interim Rule Does the agency have program participants enter into occupancy agreements (or sub-leases) for a term of at least one month, automatically renewable upon expiration, except on prior notice by either party, for up to 24 month? Does the agency ensure that all housing leased with COC program funds or where rental assistance B payments are made with COC Program funds meet Housing Quality Standards (HQS) by physically
8 inspecting each unit? C Does the agency ensure that the staff physical inspecting each unit is HQS certified? Does the agency inspect all units at least annually during the grant period to ensure that the units continue D to meet HQS? E Does the agency charge program fees to program participants? Does the agency require program participants to take part in supportive services through the project as a F condition of continued program participation? G. re those supportive service requirements disability-related? Does the agency ensure that the termination of program participants is limited to only the most severe H. cases? 6. Program Experience & Design nswer the following questions specifically as it relates to the funding requested. These responses should pertain directly to the COC-funded Transitional Housing Program and requested TH funds for that program. Experience and Capacity: Provide a brief description of the program. Describe staff that will be assigned to this program including knowledge, capacity, and availability. Funding/Match: Provide a brief description of in-kind and cash match & leverage used for the COC-funded Transitional Housing Program. Funding, Fundraising, & Volunteers: Describe fundraising and volunteer support specifically as it relates to homeless services. Describe efforts to ensure diverse and stable funding for homeless programs and how successful these efforts have been. Case Management and Mainstream Resources: Describe how case management works in the COC-funded Transitional Housing Program. Discuss location of visits (on or off-site), other agencies involved, frequency, duration, and items covered during visit/mtg. Describe how case managers access an individual/family mainstream service/non-cash benefit status, identify needs, and make referrals. HUD defined Performance Measures: Describe how the COC-funded Transitional Housing Program increases housing stability and self-sufficiency for program participants (non-employment income, earned income, and housing stability). Include goals established for this program, as reflected in COC Project pplication. Rapid Re-Housing: Explain why individuals/families served in your COC-funded Transitional Housing Program were not diverted into your local continua s Rapid Re-housing program(s).