FY 2018 CONSOLIDATED HOMELESS FUND

EMERENCY SHELTER OPERATIONS

AND

ESSENTIAL SERVICES APPLICATION

Subject to the provisions in 576.100 (b) and the Consolidated Homeless Fund Policies and Procedures, Emergency Shelter funds may be used for costs of providing essential services to families and individuals in emergency shelters, renovating buildings to be used as emergency shelter for homeless families and individuals, and operating emergency shelters.
Individuals and families who meet HUD’s definition of Homeless (as defined by HUD Homelessness Categories 1-4, see Appendix 1) are eligible to receive services through CHF. Generally, these include individuals and families who are:
  1. Literally Homeless (living on the street or in emergency shelter)
  2. Imminently Homeless (within14 days)
  3. Unaccompanied youth/families who meet other Federal homeless definition (must also meet additional criteria for HUD, similar to 2)
  4. Fleeing/attempting to flee Domestic Violence
Household composition includes an individual living alone, family with or without children, or a group of individuals who are living together as one economic unit. In all cases a household must lack sufficient resources and support networks necessary to obtain or retain housing without the provision of CHF assistance in order to be program eligible.
PROJECT INFORMATION AND BACKGROUND
Applicant (Agency) Legal Name
Project/Program Name
Project Address
HMIS Bin Number
Contact Person (person responsible for day to day management of program)
Contact Person Phone
Contact Person Email
*Please note that project name and HMIS Bin number will be used by CHF in all future correspondence. If this is a new project please indicate by entering “new” for the HMIS Bin Number. If this is a domestic violence shelter please indicate by entering “DV” for the HMIS Bin number.
  1. Project Type: Please specify below the type of funding this project is requesting (check one that best describes your request for funding::

Emergency Shelter Operations and Essential Services Support
Emergency Shelter Operations Support Only
Essential Services Only
  1. Bed and Unit Capacity for Emergency Shelter
/ Beds / Units
How many beds/units does this project have TOTAL?
How many beds/units does this project have for households without children?
How many beds/units does this project have for households with children?
Notes on Capacity (including information regarding number of overflow beds/units available):
  1. Total PROJECTED Served Annually 7/1/2017 through 6/30/2018(Please note: If funded, this number will be referenced later to determine project progress.)
/ Number / Percent
Individuals
Number of families
Average family size
Number of persons in families
Total unduplicated persons (12 months) assisted
Total households assisted*
*Generally, households assisted = individuals + number of families. However, multiple individuals can be assisted in a single households (unrelated roommates.
  1. Proposed Outcomes for Emergency Shelter
/ Persons / Households
# / % / # / %
Number of persons/households exiting to permanent housing
Number of persons/households exiting to non-permanent destinations
Number of persons/households whose income increases from entry to exit
  1. Proposed Outcomes for Essential Services
/ Persons / Households
# / % / # / %
Referred to Permanent Housing
Referred to Emergency Health Services
Referred to Mental Health Services
Provided with Transportation Assistance
Assisted with SSI/SSDI application assistance
Assisted with Food Stamp application
Assisted with other benefits, please specify
Assisted with other benefits, please specify
Assisted with other benefits, please specify
Assisted with other benefits, please specify
Assisted with other benefits, please specify
Assisted with other benefits, please specify
COMPLIANCE WITH ESG REQUIREMENTS
  1. Coordinated Intake/Placement, ESG Part 576.400: All CHFP grant recipients are required to use the common assessment as designated by the Continuum of Care and to participate in the coordinated intake/placement.

Please describe your level of readiness to utilize the common assessment tool and to participate in the coordinated entry system.
  1. Prohibition Against Involuntary Family Separation 24 CFR Part 576.102 (b):

Programs that receive CHF funding that serve families with children under age 18 may not deny admission to any family based on the age of the child.
N/A, this project does not serve families with children.
Yes, applicant assures that its projects are in compliance with this HEARTH Act provision.
If Yes, describe arrangements to be provided in order to accommodate all families with children, particularly those with teenage boys.
  1. Any group of people that present together for assistance and identify themselves as a family, regardless of age or relationship or other factors, are considered to be a family and must be served together as such.

N/A, this project does not serve families.
Yes, applicant assures that its projects are in compliance with this HEARTH Act provision.
If Yes, describe arrangements made in the project in order to accommodate families regardless of composition.
  1. McKinney Vento Compliance

If your program services families, please describe how you will ensure all children are connected with McKinney services within the school.
  1. Non Discrimination/Equal Opportunity & Affirmative Outreach ESG 576.407: All CHFP grant recipients are required to make known that use of the facilities, assistance and services are available to all on a non-discriminatory basis.

a.Please describe the steps your program/project takes to “affirmatively market” your program/project to all individuals/families in need of the facilities/services on a non-discriminatory basis regardless of race, ethnicity, sex, age, gender, gender identity, national origin, familial status, or disability who may qualify for those services/facilities.
  1. What steps does your program/project take, if any, to ensure meaningful access to programs and activities for Limited English Proficiency (LEP) persons?

  1. Describe access for persons with disabilities and list any reasonable accommodations your program/project provides to ensure that prospective clients with a wide range of needs can be served.

  1. CHF subrecipients/contractors are required to follow HUD’s “Equal Access to Housing in HUD Programs, Regardless of Sexual Orientation or Gender Identity” final rule published on February 3, 2015. Please describe how your program/project complies with this rule or your plans to assure compliance.

  1. Please describe your program/projects policy to ensure the promotion of fair housing laws?
Policy should include where client can file a complaint
PROGRAM/PROJECT DESIGN
  1. Homeless Need

Describe HOMELESS need in your area. Please describe what local needs and service gaps this program seeks to fill or currently fills. Be sure to note any supporting evidence or this need (reference reports, statistical data etc.)
  1. Targeted Populations

Individuals
Families
Describe populations targeted, how your organization will reach these populations and verify homelessness for all households. Describe how this project will reduce the number of unsheltered homeless in the proposed service area.
  1. Subpopulations (Indicate the approximate percentages of the following homeless sub-populations served by the activity.

Subpopulation / % to be served
Chronically Homeless (meets HUD definition of Chronically Homeless)
Long Term Homeless Families
Chronic Substance Abusers
Veterans
Victims of Domestic Violence
  1. Cities/Geographic Areas Served (Indicate the approximate percentages of the number of homeless individuals to be served in these areas).

City of Providence
City of Pawtucket
City of Woonsocket
Other Geographic Area, please specify:
Other Geographic Area, please specify
  1. Length of Stay/Participation

  1. What is the average length of stay/participation for this program/project?

  1. What is the maximum length of stay/participation for this program/project?

  1. Explain rationale for maximum lengths of stay/participation.

  1. Typically, how much time passes from initial assessment to permanent housing referral?

  1. Explain how your program/project will shorten the length of time that households are homeless?

  1. Describe any services/activities offered by your program that will promote housing stability, movement toward permanent housing and increased self-sufficiency?

  1. Entry/Eligibility Requirements

Briefly discuss eligibility requirements including intake processes and requirements for clients upon entering program/project, etc. Describe how you will verify homelessness.
  1. Site Information (applicants applying for essential services only do not have to answer this question).

Briefly discuss layout, conditions, and hours of operation, if 24-hour staff available on site or on call.Please attach shelter inspection report.
  1. Project Requirements

Briefly discuss fees, house rules, requirements of participants during enrollment,reasonsfor dismissal, termination/eviction processes, appeal procedures,etc.
CASE MANAGEMENT, SERVICES AND MOVEMENT TOWARD STABLE HOUSING
  1. Case Management and Individualized Service Plan

  1. Does your program develop an individualized service plan, including a path to permanent housing stability for each client/household? If yes, please describe how this plan is designed to help clients achieve the ultimate goals of permanent housing? How is program participant progress toward achieving permanent housing monitored and evaluated? If your program does not currently develop an individualized service plan, describe how your program will do this moving forward?
.
  1. Mainstream Benefits

Describe the efforts your project makes to connect participants with mainstream benefits. If benefits support is provided by a 3rd party, please describe. Include a formal Memorandum of Agreement (MOA) in application upload if a 3rd party is used.
This project does not provide mainstream benefits
List the mainstream benefits projects with which participants in this project receive application assistance (TANF, SSI/SSDI, etc.).
What percentage of eligible participants will complete applications for benefits while in project? What percentage of eligible applicants will receive benefits while in project?
  1. Summary of Supportive Services REQUESTED in this application - Please indicate services requested as a part of application.

Applied for in this / Service Type
(Note that for ESG eligibility, services must be “related to emergency shelter or street / Name the key staff person or outside organization / Provider of Service
application? / outreach.” All services provided by applicant or partners are not expected to be ESG-eligible!) / responsible for providing
each service / Applicant or staff member / Outside Agency
a / Yes / LIFE SKILLS
If yes, describe:
b / Yes / ONGOING CASE MANAGEMENT
If yes, describe:
c / Yes / EMPLOYMENT ASSISTANCE / JOB TRAINING
If yes, describe:
d / Yes / SUBSTANCE ABUSE SERVICES
If yes, describe
e / Yes / EDUCATION SERVICES / /
If yes, describe
Applied for in this application? / Service Type
(Note that for ESG eligibility, services must be “related to emergency shelter or street outreach.” All services provided by applicant or partners are not expected to be ESG-eligible!) / Name the key staff person or outside organization responsible for providing each service / Provider of Service
Applicant or staff member / Outside Agency
f. / Yes / OUTPATIENT HEALTH SERVICES
If yes, describe:
g / Yes / CHILD CARE
If yes, describe:
h / Yes / MENTAL HEALTH SERVICES
If yes, describe:
i. / Yes / LEGAL SERVICES
If yes, describe:
j. / Yes / TRANSPORTATION FOR HOUSING SEARCH, EMPLOYMENT, HEALTH CARE
If yes, describe:
MEASURING PROGRAM SUCCESS/EFFICIENCY
  1. DV Comparable Database (DOMESTIC VIOLENCE PROJECTS ONLY)

Are you currently using a DV comparable database to track participants served by this project?
YesNo
  1. Homeless Management Information System (HMIS) (NON-DOMESTIC VIOLENCE AGENCIES)

Does your agency currently use HMIS?
YesNoN/A
If your program uses HMIS to measure performance, please describe what data elements are used and how the program uses the data to inform its services. If your program does not use HMIS, please explain why not?
MEASURING PROGRAM SUCCESS/EFFICIENCY (Continued)
  1. Please describe your YTD (7/1/2016-March 31, 2017) program outcomes (attach a copy of your HUD CoC APR for this time period.

MEASURING PROGRAM SUCCESS/EFFICIENCY (Continued)
  1. Is your program on track to achieve its CHFP performance objectives for the year? Of not, please explain why not?
  1. What lessons and strategies will your program apply from the operation of your current program to the new/improved program design? What program modifications or changes will you implement in this program, if funded?

BUDGET/FUNDING REQUEST
  1. Funding Request

Describe the specific request for funding, include:
a)The reasons why funding for some activities is requested.
b)Note any issues with capacity the project may have.
c)If your program/project does not receive the full amount of funding request, is it still financially viable?
d)Describe fundraising and volunteer support specifically as it relates to the program for which funding is being requested. Describe efforts the agency is making to ensure diverse and stable funding for the program and how successful these efforts have been.
BUDGET/FUNDING REQUEST

Please attach program/ projectbudget. Include all sources of financial support, including the amounts provided by other sources of funding.

Budget Guidance

Emergency Shelter - ESG funds may be used for costs of providing essential services to homeless families and individuals in emergency shelters and operating emergency shelters. Further note that the age, of a child under age 18 must not be used as a basis for denying any family’s admission to an emergency shelter or services to families with children under age 18.

a.Case management. The cost of assessing, arranging, coordinating, and monitoring the delivery of individualized services to meet the needs of the project participant is eligible. Component services and activities consist of: (A) Using the centralized or coordinated assessment system as required under § 576.400(d); (B) Conducting the initial evaluation required under § 576.401(a), including verifying and documenting eligibility; (C) Counseling; (D) Developing, securing, and coordinating services and obtaining Federal, State, and local benefits; (E) Monitoring and evaluating project participant progress; (F) Providing information and referrals to other providers; (G) Providing ongoing risk assessment and safety planning with victims of domestic violence, dating violence, sexual assault, and stalking; and (H) Developing an individualized housing and service plan, including planning a path to permanent housingstability.

b.Child care. The costs of child care for project participants, including providing meals and snacks, and comprehensive and coordinated sets of appropriate developmental activities, are eligible. The children must be under the age of 13, unless they are disabled. Disabled children must be under the age of 18. The child-care center must be licensed by the jurisdiction in which it operates in order for its costs to beeligible.

c.Education services. When necessary for the project participant to obtain and maintain housing, the costs of improving knowledge and basic educational skills are eligible. Services include instruction or training in consumer education, health education, substance abuse prevention, literacy, English as a Second Language, and General Educational Development (GED). Component services or activities are screening, assessment and testing; individual or group instruction; tutoring; provision of books, supplies and instructional material; counseling; and referral to communityresources.

d.Employment assistance and job training. The costs of employment assistance and job training projects are eligible, including classroom, online, and/or computer instruction; on-the-job instruction; and services that assist individuals in securing employment, acquiring learning skills, and/or increasing earning potential. Learning skills include those skills that can be used to secure and retain a job. Services that assist individuals in securing employment consist of employment screening, assessment, or testing; structured job skills and job-seeking skills; special training and tutoring, including literacy training and prevocational training; books and instructional material; counseling or job coaching; and referral to communityresources.

e.Outpatient health services. Eligible costs are for the direct outpatient treatment of medical conditions and are provided by licensed medical professionals. Emergency Solutions Grant (ESG) funds may be used only for these services to the extent that other appropriate health services are unavailable within the community. Eligible treatment consists of assessing a project participant’s health problems and developing a treatment plan; assisting project participants to understand their health needs; providing directly or assisting project participants to obtain appropriate medical treatment, preventive medical care, and health maintenance services, including emergency medical services; providing medication and follow- up services; and providing preventive and non-cosmetic dentalcare.

f.Legal services. (A) Eligible costs are the hourly fees for legal advice and representation by attorneys licensed and in good standing with the bar association of the State in which the services are provided, and by person(s) under the supervision of the licensed attorney, regarding matters that interfere with the project participant’s ability to obtain and retain housing. (B) Emergency Solutions Grant (ESG) funds may be used only for these services to the extent that other appropriate legal services are unavailable or inaccessible within the community. (C) Eligible subject matters are child support, guardianship, paternity, emancipation, and legal separation, orders of protection and other civil remedies for victims of domestic violence, dating violence, sexual assault, and stalking, and appeal of veterans and public benefit claim denials. (D) Component services or activities may include client intake, preparation of cases fortrial,

provision of legal advice, representation at hearings, and counseling. (E) Fees based on the actual service performed (i.e., fee for service) are also eligible, but only if the cost would be less than the cost of hourly fees. Filing fees and other necessary court costs are also eligible. If the subrecipient is a legal services provider and performs the services itself, the eligible costs are the subrecipient’s employees’ salaries and other costs necessary to perform the services. (F) Legal services for immigration and citizenship matters and issues relating to mortgages are ineligible costs. Retainer fee arrangements and contingency fee arrangements are ineligible costs.