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CITY OF ANAHEIM FY 2015-2016 EMERGENCY SOLUTIONS GRANT PROGRAM SUBRECIPIENT FUNDING APPLICATION Application Deadline: February 12, 2015, 4:00 p.m. Return Location: City of Anaheim Community Development Dept. 201 S. Anaheim Boulevard, Suite 1003 Anaheim, CA 92805 Contact: Stephen Stoewer - (714) 765-4338 OVERVIEW The City of Anaheim expects to receive approximately $300,000 in Fiscal Year (FY) 2015-2016 Emergency Solutions Grant (ESG) funds from the U.S. Department of Housing and Urban Development (HUD). The City’s ESG Program makes funds available to organizations that provide homelessness prevention and rapid rehousing services and operate emergency shelters and transitional housing facilities for various homeless populations. The City invites eligible organizations to apply for FY 2015-2016 ESG funding. The attached application provides an opportunity for organizations to propose their homeless assistance and/or homelessness prevention services. While applicant organizations may offer services throughout Orange County, the City’s ESG funds must be used to provide homeless assistance and/or homelessness prevention within the Anaheim community (see 24.CFR.576 for complete ESG Program regulations). The FY 2015-2016 minimum grant amount will be $20,000. SCREENING CRITERIA The following criteria will be used to screen applicant eligibility for the City’s ESG Program: • Proposal to implement ESG eligible activities • Ability to meet a dollar-for-dollar funding match of the total grant award (see Attachment II, Definitions) • Funding request conforms to HUD’s categorical spending caps (Emergency Shelter/Street Outreach cannot exceed 30%) • Participation in the Client Management Information System (CMIS) • Ability to meet the City’s Insurance requirements • Possession of a City of Anaheim Business License EVALUATION CRITERIA The City will evaluate applications based on various factors to determine the organization’s suitability for the City’s ESG Program. These factors may include: • Prior experience implementing an ESG program ---PAGE BREAK--- • Performance history with the City’s ESG Program • A proposed funding request that conforms to HUD’s categorical spending caps • The ability to leverage other homeless assistance funds • Provision of robust supportive services and a demonstrated record of helping homeless families (or individuals) achieve stability APPLICATION REVIEW PROCESS 1. City staff reviews applications and proposed activities for ESG eligibility 2. Applicants make brief presentations about their proposals and funding requests to the Anaheim Housing and Community Development Commission’s (HCDC’s) ESG Funding Subcommittee. Please be advised that this presentation is mandatory. The presentation is tentatively scheduled for Wednesday March 18, 2015 (specific information will be sent to applicants). 3. ESG Funding Subcommittee and City staff review applications and develop funding recommendations. 4. ESG Funding Subcommittee presents funding recommendations to the HCDC. 5. HCDC submits funding recommendations to the Community Development Advisory Committee (CDAC) for final recommendations. 6. City Council considers the FY 2015-2016 Annual Action Plan, which will include the recommended ESG Program budget and subrecipient grant amounts to be forwarded to HUD for review and approval. THIS APPLICATION PACKAGE INCLUDES THE FOLLOWING: • Application Certification • FY 2015-2016 ESG Subrecipient Funding Application • Attachments I. Application Checklist II. Definitions III. Insurance Requirements GENERAL INSTRUCTIONS 1. Submit five copies of the ESG Subrecipient Funding Application, including the signed certification and the required attachments (refer to Attachment I, Application Checklist). Please do not include any other attachments. 2. Submit applications to the City’s Community Development Department at 201 S. Anaheim Blvd., Suite 1003, Anaheim, CA 92805, no later than February 12, 2015 4:00 p.m. Late or incomplete applications will not be considered for ESG funding. ---PAGE BREAK--- CITY OF ANAHEIM FY 2012-2013 EMERGENCY SOLUTIONS GRANT PROGRAM APPLICATION CERTIFICATION Legal Name of Applicant Organization: Address: Authorized Representative*: Contact Person: Phone Title: Email Address: FAX Federal Employer No.: State Employer Tax No.: City Business License No.: DUNS No.: *Note: If awarded ESG funding, applicant must provide documentation Board Resolution or equivalent) authorizing the person named above to execute agreements on behalf of the organization. Grant Amount Requested: ESG Program Summary: This application and the information contained herein are true, correct and complete, to the best of my knowledge. I further certify that the applicant possesses legal authority to carry out ESG activities in accordance with all applicable federal laws and regulations. Print Name Title Signature of Authorized Representative Date 1 SIGN ---PAGE BREAK--- FY 2015-2016 ESG Subrecipient Funding Application City of Anaheim FY 2015-2016 EMERGENCY SOLUTIONS GRANT PROGRAM SUBRECIPIENT FUNDING APPLICATION PROGRAM SUMMARY 1. Describe the proposed ESG services and activities and how they will benefit the homeless or at risk of homelessness population of Anaheim. From July 1, 2015 to June 30, 2016, how many unduplicated Anaheim homeless (or at-risk) individuals are expected to be served: From July 1, 2013 to June 30, 2014, how many unduplicated Anaheim homeless (or at-risk) individuals were served: PROGRAM STAFFING 2. Total number of organization employees: full-time part-time A. Will Anaheim ESG funds be utilized to pay for staff salaries and benefits? No: Yes: If yes, number of staff: B. Will ESG funds be utilized to pay for outside services (i.e. counselors, etc.)? No: Yes: If yes, types of services: 1 ---PAGE BREAK--- FY 2015-2016 ESG Subrecipient Funding Application City of Anaheim ORGANIZATION INFORMATION 3. Briefly describe your organization's experience in assisting homeless individuals and families. How does this experience specifically serve and/or benefit Anaheim? 4. Specify the individuals and families your organization serves by checking the appropriate categories below. Also, please attach a copy of the client intake form(s) (see attached Application checklist). POPULATION CATEGORY YES NO Unaccompanied Males (18+ years of age) Unaccompanied Females (18+ years of age) Unaccompanied Male Youths (under 18) Unaccompanied Female Youths (under 18) Single-Parent Families Two-Parent Families Adult Couples without Children Unable to Specify 5. How do your organization’s services/activities differ from those provided by other homeless assistance organizations serving Anaheim? 2 ---PAGE BREAK--- FY 2015-2016 ESG Subrecipient Funding Application City of Anaheim PROPOSED ACTIVITIES 6. A. Describe the services/activities to be funded by ESG that will benefit the Anaheim homeless population and the expected outcomes. SERVICE/ACTIVITY EXPECTED OUTCOME B. How does your organization measure the number of people served, services provided, etc.? Check all that apply: Transitional Housing Emergency Shelter Motel/Hotel Voucher Counseling Outreach Skill Development / Job Training Referrals Childcare Treatment Transportation Other (list): 7. How will ESG funds be used to accomplish the proposed services/activities? Specify the funds requested for individual ESG activity categories Homeless Prevention, Rapid Rehousing, Street Outreach, Emergency Shelter, or HMIS). 3 ---PAGE BREAK--- FY 2015-2016 ESG Subrecipient Funding Application City of Anaheim 8. If your organization is recommended to receive a lower amount of Anaheim ESG funds than requested, how would your organization prioritize its ESG activity categories? 9. Does your organization operate a facility in Anaheim? No Yes A. If yes, provide the address and the type of services provided at this location: B. If yes, describe the capacity to provide the proposed services described in Section 9A: 4 ---PAGE BREAK--- FY 2015-2016 ESG Subrecipient Funding Application City of Anaheim C. If no, describe your organization’s ability to serve the homeless population of Anaheim. Specify the types of outreach efforts that will direct assistance towards BUDGET 10. Provide a breakdown of the grant amount requested. Please note that requests must fit within the caps noted for each category. FUNDING CATEGORY FUNDING AMOUNT REQUEST Homeless Prevention Activities $ Rapid Rehousing Activities $ Emergency Shelter / Street Outreach (30% Cap) $ Moderate Rehabilitation $ Major Rehabilitation or Conversion $ HMIS/CMIS $ Total: $ 5 ---PAGE BREAK--- FY 2015-2016 ESG Subrecipient Funding Application City of Anaheim 11. Please provide an overview of your organization’s budget, using the format below: 12. A. Does your organization charge a fee to stay at your shelter? N/A No Yes If yes, answer questions below; B. What is the rate? C. Are there other fees charged? No Yes If yes, describe the types of expenses they cover: D. Are fees mandatory or voluntary? REVENUE ACTUAL FY 2012/2013 ACTUAL FY 2013/2014 BUDGET FY 2014/2015 PROJECTED FY 2015/2016 County State Other Governmental City of Anaheim ESG Fund Raising/Donations Service Fees Paid by Clients/Participants (describe purpose in question #12) Other (Please specify): TOTAL REVENUE EXPENDITURES ACTUAL FY 2012/2013 ACTUAL FY 2013/2014 BUDGET FY 2014/2015 PROJECTED FY 2015/2016 Personnel Costs Operating Expenses Services and Assistance (Please specify major categories): Capital Improvements Other (Please specify): TOTAL EXPENDITURES 6 ---PAGE BREAK--- FY 2015-2016 ESG Subrecipient Funding Application City of Anaheim 13. Please list all NON-ESG funds received from the City of Anaheim within the last three years. PROGRAM/PURPOSE FUNDING SOURCE YEAR FUNDED FUNDING RECEIVED $ $ $ $ $ $ 14. Describe the fundraising efforts that support your organization’s homeless assistance activities and services. 15. All ESG-funded activities must meet a dollar-for-dollar match. Please list the proposed source(s) of matching funds. Indicate which funds are confirmed, pending, etc. If available, provide documentation of confirmed 2015-2016 matching funds. 7 ---PAGE BREAK--- FY 2015-2016 ESG Subrecipient Funding Application City of Anaheim PERFORMANCE EVALUATION 16. How does your organization evaluate the success of services provided? Specify the type of information collected and tracked when determining the amount of people “served.” Please include a copy of your evaluation instruments (see checklist). 17. Does your organization participate in the Client Management Information System (CMIS)? Yes No If no, answer question below; Does your organization have the capacity to participate in CMIS? Please describe. 18. Has your organization ever been investigated for breach of contract and/or misuse of funds? If yes, please specify the reason for the investigation and the status or outcome of each investigation. 19. Can your organization meet the insurance requirements set forth in Attachment III? Yes No 8 ---PAGE BREAK--- FY 2015-2016 ESG Subrecipient Funding Application City of Anaheim ATTACHMENT I: APPLICATION CHECKLIST Interested applicants must submit five complete ESG applications and one set of the required attachments listed below. Please do not include any other documents beyond those required for this application packet. Late or incomplete applications will not be considered for ESG funding. Applicants must submit the following attachments in conjunction with the application packet: 1. Client Intake Form(s) 2. Evaluation Instrument(s) 3. Completed Application Certification 4. Organization Chart 5. List of Board of Directors 6. Copy of most recent financial audit 7. Articles of Incorporation 8. Bylaws 9. IRS Letter of Tax-exempt Status 10. Program Policy and Procedure Manual 11. Affirmative Action Plan 1 ---PAGE BREAK--- FY 2015-2016 ESG Subrecipient Funding Application City of Anaheim ATTACHMENT II: DEFINITIONS At risk of homelessness means: 1) An individual or family who: i) Has an annual income below 30 percent of median family income for the area, as determined by HUD; ii) Does not have sufficient resources or support networks, e.g., family, friends, faith- based or other social networks, immediately available to prevent them from moving to an emergency shelter or another place described in paragraph of the ‘‘homeless’’ definition in this section; and iii) Meets one of the following conditions: Has moved because of economic reasons two or more times during the 60 days immediately preceding the application for homelessness prevention assistance; Is living in the home of another because of economic hardship; Has been notified in writing that their right to occupy their current housing or living situation will be terminated within 21 days after the date of application for assistance; Lives in a hotel or motel and the cost of the hotel or motel stay is not paid by charitable organizations or by Federal, State, or local government programs for low-income individuals; Lives in a single-room occupancy or efficiency apartment unit in which there reside more than two persons or lives in a larger housing unit in which there reside more than 1.5 persons reside per room, as defined by the U.S. Census Bureau; Is exiting a publicly funded institution, or system of care (such as a health-care facility, a mental health facility, foster care or other youth facility, or correction program or institution); or Otherwise lives in housing that has characteristics associated with instability and an increased risk of homelessness, as identified in the recipient’s approved consolidated plan; 2) A child or youth who does not qualify as ‘‘homeless’’ under this section, but qualifies as ‘‘homeless’’ under section 387(3) of the Runaway and Homeless Youth Act (42 U.S.C. 5732 section 637(11) of the Head Start Act (42 U.S.C. 9832(11)), section 41403(6) of the Violence Against Women Act of 1994 (42 U.S.C. 14043 section 330(h)(5)(A) of the Public Health Service Act (42 U.S.C. 254 section 3(m) of the Food and Nutrition Act of 2008 (7 U.S.C. 2012(m)), or section 17(b)(15) of the Child Nutrition Act of 1966 (42 U.S.C. 1786(b)(15)); or 3) A child or youth who does not qualify as ‘‘homeless’’ under this section, but qualifies as ‘‘homeless’’ under section 725(2) of the McKinney-Vento Homeless Assistance Act (42 U.S.C. 11434 and the parent(s) or guardian(s) of that child or youth if living with her or him. Consolidated plan means a plan prepared in accordance with 24 CFR part 91. An approved consolidated plan means a consolidated plan that has been approved by HUD in accordance with 24 CFR part 91. 2 ---PAGE BREAK--- FY 2015-2016 ESG Subrecipient Funding Application City of Anaheim Continuum of Care means: the group composed of representatives of relevant organizations, which generally includes nonprofit homeless providers; victim service providers; faith-based organizations; governments; businesses; advocates; public housing agencies; school districts; social service providers; mental health agencies; hospitals; universities; affordable housing developers; law enforcement; organizations that serve homeless and formerly homeless veterans, and homeless and formerly homeless persons that are organized to plan for and provide, as necessary, a system of outreach, engagement, and assessment; emergency shelter; rapid re-housing; transitional housing; permanent housing; and prevention strategies to address the various needs of homeless persons and persons at risk of homelessness for a specific geographic area. Emergency shelter means any facility, the primary purpose of which is to provide a temporary shelter for the homeless in general or for specific populations of the homeless and which does not require occupants to sign leases or occupancy agreements. Any project funded as an emergency shelter under a Fiscal Year 2010 Emergency Solutions grant may continue to be funded under ESG. Homeless means: 1) An individual or family who lacks a fixed, regular, and adequate nighttime residence, meaning: i) An individual or family with a primary nighttime residence that is a public or private place not designed for or ordinarily used as a regular sleeping accommodation for human beings, including a car, park, abandoned building, bus or train station, airport, or camping ground; ii) An individual or family living in a supervised publicly or privately operated shelter designated to provide temporary living arrangements (including congregate shelters, transitional housing, and hotels and motels paid for by charitable organizations or by federal, state, or local government programs for low-income individuals); or (iii) An individual who is exiting an institution where he or she resided for 90 days or less and who resided in an emergency shelter or place not meant for human habitation immediately before entering that institution; 2) An individual or family who will imminently lose their primary nighttime residence, provided that: i) The primary nighttime residence will be lost within 14 days of the date of application for homeless assistance; ii) No subsequent residence has been identified; and iii) The individual or family lacks the resources or support networks, e.g., family, friends, faith-based or other social networks, needed to obtain other permanent housing; 3) Unaccompanied youth under 25 years of age, or families with children and youth, who do not otherwise qualify as homeless under this definition, but who: i) Are defined as homeless under section 387 of the Runaway and Homeless Youth Act (42 U.S.C. 5732a), section 637 of the Head Start Act (42 U.S.C. 9832), section 41403 of the Violence Against Women Act of 1994 (42 U.S.C. 14043e–2), section 330(h) of the Public Health Service Act (42 U.S.C. 254b(h)), section 3 of the Food and Nutrition Act of 2008 (7 U.S.C. 2012), section 17(b) of the Child Nutrition Act of 1966 (42 3 ---PAGE BREAK--- FY 2015-2016 ESG Subrecipient Funding Application City of Anaheim U.S.C. 1786(b)) or section 725 of the McKinney-Vento Homeless Assistance Act (42 U.S.C.11434a); ii) Have not had a lease, ownership interest, or occupancy agreement in permanent housing at any time during the 60 days immediately preceding the date of application for homeless assistance; iii) Have experienced persistent instability as measured by two moves or more during the 60-day period immediately preceding the date of applying for homeless assistance; and iv) Can be expected to continue in such status for an extended period of time because of chronic disabilities, chronic physical health or mental health conditions, substance addiction, histories of domestic violence or childhood abuse (including neglect), the presence of a child or youth with a disability, or two or more barriers to employment, which include the lack of a high school degree or General Education Development (GED), illiteracy, low English proficiency, a history of incarceration or detention for criminal activity, and a history of unstable employment; or 4) Any individual or family who: i) Is fleeing, or is attempting to flee, domestic violence, dating violence, sexual assault, stalking, or other dangerous or life-threatening conditions that relate to violence against the individual or a family member, including a child, that has either taken place within the individual’s or family’s primary nighttime residence or has made the individual or family afraid to return to their primary nighttime residence; ii) Has no other residence; and iii) Lacks the resources or support networks, e.g., family, friends, faithbased or other social networks, to obtain other permanent housing. Homeless Management Information System (HMIS) means the information system designated by the Continuum of Care to comply with the HUD’s data collection, management, and reporting standards and used to collect client level data and data on the provision of housing and services to homeless individuals and families and persons at risk of homelessness. Program income shall have the meaning provided in 24 CFR 85.25. Program income includes any amount of a security or utility deposit returned to the recipient or subrecipient. Program participant means an individual or family who is assisted under ESG program. Program year means the consolidated program year established by the recipient under 24 CFR part 91. Victim service provider means a private nonprofit organization whose primary mission is to provide services to victims of domestic violence, dating violence, sexual assault, or stalking. This term includes rape crisis centers, battered women’s shelters, domestic violence transitional housing programs, and other programs. 4 ---PAGE BREAK--- FY 2015-2016 ESG Subrecipient Funding Application City of Anaheim ATTACHMENT III: INSURANCE AND INDEMNIFICATION. Insurance. Without limiting City's right to indemnification, it is agreed that Subrecipient shall secure prior to commencing any activities under this Agreement, and maintain during the Term of this Agreement. Required Insurance Coverage. Subrecipient shall secure and maintain the following insurance coverage: Workers' Compensation Insurance as required by California statutes; Comprehensive General Liability Insurance, or Commercial General Liability Insurance, including coverage for Premises and Operations, Contractual Liability, Personal Injury Liability, Products/Completed Operations Liability, Broad-Form Property Damage, Independent Contractor's Liability and Fire Damage Legal Liability, in an amount of not less than One Million Dollars ($1,000,000.00) per occurrence, combined single limit, written on an occurrence form; and Comprehensive Automobile Liability coverage, including - as applicable - owned, non-owned and hired autos, in an amount of not less than One Million Dollars ($1,000,000.00) per occurrence, combined single limit, written on an occurrence form. The City’s Representative, with the consent of the City’s Risk Manager, is hereby authorized to reduce the requirements set forth above in the event they determine that such reduction is in City’s best interest. Required Clauses in Policies. Each policy of general liability and automobile insurance required by this Agreement shall contain the following clauses: “This insurance shall not be canceled or allowed to lapse without at least ten (10) days' prior written notice to the City Clerk of the City of Anaheim, 200 S. Anaheim Boulevard, Anaheim, CA 92805.” “It is agreed that any insurance maintained by the City of Anaheim shall apply in excess of and not contribute with insurance provided by this policy.” “The City of Anaheim, its officials, agents, employees, representative, and volunteers are added as additional insureds as respects operations and activities of, or on behalf of the named insured, performed under contract with the City of Anaheim.” Vendor hereby agrees to waive subrogation which any insurer of the Vendor may acquire from the Vendor by virtue of the payment of any loss. Vendor agrees to obtain any endorsement that may be necessary to effect this waiver of subrogation. 5 ---PAGE BREAK--- FY 2015-2016 ESG Subrecipient Funding Application City of Anaheim The Workers’ Compensation policy shall be endorsed with a waiver of subrogation in favor of the City for all work performed by the vendor, its employees and subcontractors. Required Certificates and Endorsements. Prior to commencement of any work under this Agreement, the Subrecipient shall deliver to City insurance certificates confirming the existence of the insurance required by this Agreement, and including the applicable clauses referenced above and (ii) endorsements to the above-required policies, which add to these policies the applicable clauses referenced above. Such endorsements shall be signed by an authorized representative of the insurance company and shall include the signator’s company affiliation and title. Should it be deemed necessary by City, it shall be the Subrecipient’s responsibility to see that City receives documentation, acceptable to City, which sustains that the individual signing such endorsements is indeed authorized to do so by the insurance company. Also, City reserves the right at any time to demand, and to receive within a reasonable time period, certified copies of any insurance policies required under this Agreement, including endorsements effecting the coverage required by these specifications. 6