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ATTACHMENT ACity Council Districts

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Position NameAt-Large Position 1 Mike KnoxAt-Large Position 2 David W. RobinsonAt-Large Position 3 Michael KuboshAt-Large Position 4 Letitia PlummerAt-Large Position 5 Sallie AlcornDistrict A Amy PeckDistrict B Jerry DavisDistrict C Abbie KaminDistrict D Carolyn Evans-ShabazzDistrict E Dave MartinDistrict F Tiffany ThomasDistrict G Greg TravisDistrict H Karla CisnerosDistrict I Robert GallegosDistrict J Edward PollardDistrict K Martha Castex-Tatum

ATTACHMENT BHCAAA Boundaries of Eight (8) Service Areas & Five (5) Municipalities

for Harris County Area Agency on Aging (HCAAA)

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Boundaries of Service Areas

Area 1 Area 2North – Harris County line North – Harris County lineEast – U.S. 59 (Eastex Freeway to East – Harris County lineWest/South – I-45 (North Freeway) South – I-10 (East Freeway)

West – U.S. 59 (Eastex Freeway)

Area 3 Area 4North – I-10 (East Freeway) North/East – I-45 (Gulf Freeway)East – Harris County line East – Harris County line South – I-45 (Gulf Freeway) West/South – State Route 288 (South West – U.S. 59 (Eastex Freeway Freeway)

Area 5 Area 6North/West – U.S. 59 (Southwest Freeway) North – I-10 (Katy Freeway)East – Harris County line East – I-45 West/South – State Route 288 (South Freeway) South – U.S. 59 (Southwest Freeway)

West – Harris County line

Area 7North – U.S. 290 (Northwest Freeway); I-610 (North Loop)East – Shepherd Drive South – I-10 (Katy Freeway)West – Harris County line

Area 8North – Harris County LineEast – I-45 (North Freeway) South – I-10 (Katy Freeway); Shepherd Drive; I-610 (North Loop)West – Harris County line

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ATTACHMENT C

Senior Services ProgramFocal Point Checklist

Reporting Period: ___FY 2021____

Contractor Name: _______________________________________________

Place an X where applicable.Activity Site Name: Site Name: Site Name:

Outreach

Volunteer Recruitment and Training

Inter-agency service coordination

Field trips

Retraining/Re-employment workshops classes and support groups

Health Education

Availability of support groups

Special transportation activities

Recruitment and training

Health Screening

Information and Referral

Recreational and Social Activities

Exercise/Physical Fitness

Volunteer Opportunities

Intergenerational Programs

Nutrition Education

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ATTACHMENT D

List of Congregate Sites

SENIOR CENTER ADDRESS SERVICE AREA

Acres Home 6719 W Montgomery Rd., 77091 8

Bellerive 7225 Bellerive, 77036 6

City of Jacinto City 1025 Oates Jacinto City, 77029 3

City of La Porte 1322 S. Broadway St., 77571 3

City of South Houston 1018 Dallas South Houston, 77587 3

Goldberg Towers 10909 Fondren, 77096 5

Clear Lake Presbyterian Church 1511 El Dorado Blvd., 77062 4

Denver Harbor Multi-Service Ctr. 6402 Market St., 77020 3

Gateway Center 6309 Martin Luther King, 77021 4

Golden Age Hobby House 2805 Winbern, 77004 4

Harbach-Ripley 6225 Northdale, 77087 4

Hiram Clarke Multi-Service Ctr. 3810 West Fuqua, 77045 5

Indochinese Cultural Center 3333 Fannin St., 77004 5

JW Peavy Senior Ctr. 3814 Market, 77020 2

Kashmere Multi-Service Ctr. 4802 Lockwood, 77026 2

Lakeview 8950 Hammerly Blvd., 77080 7

Lagacy Center for Senior Life 4640 Main St., 77002 6

Longhorn 1414 Longhorn, 77080 7

Lyerly Senior Center 75 Lyerly, 77022 1

Magnolia Multi-Service Ctr. 7037 Capitol, 77011 1

Montrose Counseling Center 401 Branard, 2nd floor, 77006 6

New Life 4828 Almeda Genoa Rd, 77048 4

Northeast Community Center 10918 Bentley, 77093 1

Northeast Multi-Service Ctr. 9720 Spaulding, 77016 2

Northwest Assistance Ministries 15555 Kuykendahl Rd., 77090 8

Oak Tree 14603 Fonmeadow, 77035 5

Ripley House 4410 Navigation, 77011 3

Salvation Army 2732 Cherrybrook Ln., 77502 3

Southwest Multi-Service Ctr. 6400 High Star, 77074 5

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Sunnyside Multi-Service Ctr. 9314 Cullen, 77051 4

Telephone Road Apt - Senior Center

6000 Telephone Rd., 77087 4

Third Ward Multi-Service Ctr. 3611 Ennis, Suite 118, 77004 4

Wesley Community Center 1410 Lee, 77009 1

West End Multi-Service Ctr. 170 Heights, 77007 6

West Office 10303 West Office, 77042 6

The current congregate meal sites in Harris County are listed above. Proposers may choose to continue services at these locations or propose services at alternative sites. (State law requires congregate sites to be open for a minimum of four hours per day.)

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ATTACHMENT EHarris County Zip Codes for Congregate and Home Delivered Meals

Identified Zip Code Total Population Total No. of 60+ Seniors by Zip Code

Percentage of 60+ Seniors by Zip Code

77002 12,370 1,018 8%77003 9,646 1,135 12%77004 37,642 4,789 13%77005 28,233 5,296 19%77006 21,945 3,175 14%77007 35,822 3,950 11%77008 34,491 5,321 15%77009 37,751 6,124 16%77010 915 187 20%77011 18,598 2,992 16%77012 20,085 2,835 14%77013 20,790 2,365 11%77014 35,729 3,410 10%77015 57,258 6,418 11%77016 29,597 6,844 23%77017 32,556 4,917 15%77018 28,073 5,166 18%77019 21,572 4,752 22%77020 25,898 4,033 16%77021 26,654 4,993 19%77022 27,364 4,801 18%77023 28,528 4,032 14%77024 38,110 9,536 25%77025 28,922 5,359 19%77026 22,799 4,257 19%77027 16,012 3,058 19%77028 15,725 3,301 21%77029 17,894 3,047 17%77030 10,813 1,687 16%77031 18,052 2,784 15%77032 14,443 1,572 11%77033 29,692 5,862 20%77034 40,183 3,862 10%77035 38,324 5,619 15%77036 76,605 8,056 11%77037 20,038 2,133 11%77038 30,653 2,937 10%77039 27,972 3,018 11%77040 48,273 7,094 15%77041 35,372 5,423 15%77042 42,098 5,040 12%77043 25,838 4,347 17%

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77044 42,665 4,065 10%77045 36,270 5,712 16%77046 1,029 306 30%77047 29,410 3,480 12%77048 17,143 2,889 17%77049 33,749 3,282 10%77050 5,031 928 18%77051 16,661 3,591 22%77053 31,868 3,479 11%77054 22,517 2,248 10%77055 45,003 6,218 14%77056 21,732 5,335 25%77057 40,130 6,564 16%77058 16,669 2,603 16%77059 17,374 4,035 23%77060 44,549 3,548 8%77061 26,276 3,209 12%77062 26,583 5,735 22%77063 38,931 5,502 14%77064 49,578 8,107 16%77065 38,820 5,752 15%77066 33,796 4,869 14%77067 33,489 2,998 9%77068 10,897 2,386 22%77069 18,238 5,320 29%77070 51,080 8,640 17%77071 27,981 5,630 20%77072 62,162 8,141 13%77073 42,780 3,551 8%77074 39,915 5,268 13%77075 43,586 4,327 10%77076 35,144 3,735 11%77077 57,757 10,242 18%77078 15,820 2,514 16%77079 33,577 6,468 19%77080 45,665 6,401 14%77081 49,059 2,855 6%77082 56,641 8,950 16%77083 79,408 10,736 14%77084 104,582 12,234 12%77085 17,981 2,445 14%77086 29,506 3,597 12%77087 37,200 5,532 15%77088 56,716 8,540 15%77089 52,699 7,841 15%

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77090 38,361 4,232 11%77091 25,277 4,445 18%77092 38,476 4,902 13%77093 44,428 5,343 12%77094 9,439 1,778 19%77095 72,081 10,234 14%77096 35,465 7,204 20%77098 13,444 2,527 19%77099 51,905 6,913 13%

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ATTACHMENT E (Cont.)

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Congregate and Home Delivered Meals

ATTACHMENT E (Cont.)

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Transportation Direct Response Summary[Statistics from October 1, 2018 to September 30, 2019]

Residence Zip Code

# of Consumers

Units (# of trips)

Unknown 1 17877002 1 44177003 5 92377004 29 4,91777007 5 37277008 7 30277009 26 6,39877011 12 2,24477012 6 78677014 13 1,20577016 11 2,04077017 13 3,04277018 1 43277020 15 2,94277021 24 3,72577022 5 1,74677023 14 3,36177024 3 1,38477026 22 4,62277028 9 2,74377029 3 32877032 1 7777033 11 2,51877034 7 1,66677036 1 40077039 4 38677041 2 65277043 2 60577044 1 177045 5 1,00277047 1 42577048 10 1,48377050 1 2277051 11 1,86877057 1 32277058 3 21277059 2 46177062 8 1,96277065 1 677066 2 22477069 2 16577070 1 9877072 5 1,64877074 3 786

77075 1 15077078 2 21277079 1 21877080 17 7,32277081 2 52477083 3 40477087 10 2,06077088 7 2,12577089 1 2277090 1 28777091 5 78877092 7 2,39477093 13 71477099 35 9,14877338 1 2877373 1 1477379 2 39977388 1 18177389 1 477396 1 11377502 20 2,96677503 10 1,90877504 6 1,34877505 1 44277506 18 1,93477587 6 79877598 1 213

Total 484 97,666

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ATTACHMENT F

Percentage of Population Over 60 Map

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ATTACHMENT G

Percentage of Population in Poverty Map

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ATTACHMENT H

Nutrition Service Delivery Form

The Proposer may use as much space as needed for each category.

Additional pages may be used as necessary.

Proposed Routes and Delivery Schedule

Frozen Meal Justification (if applicable)

___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

List of Congregate Sites

Nutrition Education Plan for Congregate and/or Home Delivered Meals: (frequency, source(s), dissemination method)

___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

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ATTACHMENT I

Detailed Description of Waiting List Procedures for Congregate and/or Home Delivered Meals: _________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Emergency Preparedness Plan for Congregate and/or Home Delivered Meals: _________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

List of Home Deliver Meal Distribution Sites:

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ATTACHMENT J

Transportation Staffing Profile

Organization: __________________________________ Service:___________________________

List your organization’s staffing profile. It is not necessary to list each driver; only the total number of drivers and backup drivers.

Position Salaried/Volunteer

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ATTACHMENT K

Transportation Vehicle List

Organization: __________________________________ Service:___________________________

List the vehicles your organization plans to use in providing transportation services to the nutrition sites.

Type of Vehicle (Car, Van, etc.) Number of Vehicles Regular Service/Backup

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ATTACHMENT L

In-Kind Match Contributions

Provider: ____________________

In-Kind Contribution(s):____________________________ __________________________________

All items listed below must be accompanied with support documentation.

ITEM DATE OF RECEIPT VALUATION

Note: All contributions must meet the requirements of IRS Publication 561 (http://ftpfedworld.gov/pub/irs-pdf/p561.pdf)

Examples of Documentation may include:

Rent: 1. Letter of Agreement with Owner.

2. Adequate Valuation of Property on a Current Basis (this should be reviewed at least very two years if the Senior

Center is based on property value and center participation).

Labor: 1. Minimum wage.2. Documented Prevailing Rate in area.

All in-kind labor must be required for the service to be provided. If you would not hire someone to perform the labor if it were not in-kind, then you cannot count it as in-kind.

Utilities: 1. Copy of Bill.

2. Agreement of Amount Paid if Partial.

_________________________________________ ___________________________________________________________________ ______________________________Name of Contracted Provider Printed/Typed Name of Signer

___________________________________ ______________________________Date Signature

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ATTACHMENT M

Budget Worksheet Instructions

Functions and Worksheet Calculations:

Costs are entered into the Provider Total Budget by Service worksheet under the “Cost Area”.

Provider Total Budget by Service Worksheet:

Example: Enter Costs/dollar amounts for the line item “Salaries” Add sum of in the “Total Salaries” area.

Cost Area Provide ALL requested information in each Cost Area in the worksheet. Refer to the Cost Area and Cost

Categories document for instructions on completing the line items. Enter the total amount of the costs for each line item in the Cost Area in the “Total Agency Budget”

column

Example: the line item “Salaries”, includes the job titles with the salaries. Additional rows can be added, if needed.

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#1

#2

#1

#2

Example: Additional Line Items have been included to further delineate costs. Purchased Meals and the types of meals are included.

Columns for Allocation of Costs

Additional columns have been included in the worksheet. These added columns allow for other programs and costs not allowable for the Home Delivered and Congregate Meal Programs.

Use “Agency Budget not Applicable to Programs” column for cost that cannot be allocated to federally funded programs.

“If applicable, replace with title or other agency” columns are optional columns for other funding

sources.

Example: Program columns for allocating costs

Balance Not Budgeted Column

“Balance Not Budgeted” column, reconciles the cost allocated across the programs or funding sources to the “Total Agency Budget”

o If the amount in this column is not zero, the total budget was not allocated. This is the amount that has not been allocated to a program or the amount allocated was entered incorrectly.

o This column must equal zero (0). If not, make corrections/explain.

Example: “Total Agency Budget” column, $25,000 is allocated in the total budget for the “Director”. The “Balance not Budgeted” column indicates $10,450 is not allocated to a program or another

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funding source. If the costs allocated do not equal the “Total Agency Budget,” the “Balance not Budgeted” column will not be “zero”.

Percentage of Total Cost and Total Budgeted Meals

Calculate the total cost of each program at the bottom of each worksheet.

At the bottom of the worksheet enter the number of meals by “TYPE” for each program.

Nutrition Education

Nutrition Education costs are required to be included in the meal cost. Therefore, proposers must enter the budget amount for Nutrition Education under the “Nutrition Education AAA Clients” column only.

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ATTACHMENT N

Cost Areas and Cost Categories

This is additional guidance on what to include or not include in specific cost categories within specific cost areas in the rate setting budget worksheets. Some cost categories (examples: depreciation or interest) may be included in more than one cost area. Use detailed line items in the cost areas to prevent duplication and ensure the nutrition provider accounts for all necessary costs. For example: list the specific items depreciated such as a steam table to ensure it is included only once (under equipment), and not another category of depreciation such as building/occupancy.

PERSONNEL

Salaries: This category includes salaries and wages only. Expenses listed for salaries and wages, whether treated as direct costs or indirect costs, must be based on documented payrolls approved by a responsible official(s) of the organization. The distribution of salaries and wages to programs must be supported by personnel activity reports.

The cost for each employee must be listed separately identified by job title.

Payroll Taxes and Benefits:This category includes employer payment of what are commonly called fringe benefits:

Unemployment insurance, Workers compensation, Health insurance, Retirement/pension contributions, and Federal Insurance Compensation Act contributions.

Each type of benefit should be listed separately.

The list of benefits above is not all-inclusive. If the employer pays premiums for a type of benefit (for example-dental insurance) the type of benefit must be listed on a separate row within this cost category.

Ensure the employee portion deducted or withheld from the employee’s salary or wages gross income is not reported in this category and the “Salaries” category. This category is for taxes and benefits paid by the EMPLOYER.

Housing and personal living expenses for/of the organization’s officers are unallowable as fringe benefit or indirect costs regardless of whether the cost is reported as taxable income to the employees.

Contract Staff:The provider must maintain documentation of the contract staff scope of work and be able to demonstrate the relationship between the contracted work and the operation of the program(s) to which the cost is allocated.

PROFESSIONAL DEVELOPMENT

Conference:

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The costs of attending meetings and conferences, including the cost of conference registration, transportation, meals and other cost related to attending the meeting or conference should be listed here. The conference must be associated with the program to which it is charged.

List each conference and identify those that occur out-of-state, including necessity of out-of state travel to secure the covered information.

The cost of conferences on fund raising, political action or other topics not necessary to delivery of services/enhancement of services cannot be allocated to the Home Delivered Meals or Congregate Meals program.

If a portion of the conference registration cost includes social or entertainment activities; that portion of the cost is unallowable and should not be included as a cost of program delivery.

Dues:Dues included here must be limited to those necessary for membership in business, professional, and technical organizations related to the provision of program services. If the membership organization is not related to a program, then none of the costs of the dues would be allocated to that program.

Costs of membership in civic or community organizations are allowable if there is a relationship to the program(s) to which the dues are allocated.

Costs of membership in any country club or social or dining club or organization are unallowable for funding as part of meal program rates.

List each organization to which dues are paid.

Materials:The cost of recorded media presentations, course books or other items used for professional development may be included in this cost category.

List the items

MEALS / FOOD

Raw FoodThis category includes cost of menu items and ingredients to prepare the meals on the menu.

If the provider is preparing meals and freezing them for later delivery or consumption, the associated costs are recorded in this category, not as the purchase of frozen meals.

Do not include the cost of any items that are not on the menus approved by the dietician/nutritionist.

Do not include the cost of food items for other purposes, such as volunteer recognition events, or snacks for drivers.

Purchased MealsThis category is used to record the cost of purchasing frozen, chilled, shelf stable or hot prepared meals purchased from external suppliers.

This category does not include the cost of preparing meals at one location operated by the provider, then packaging them for further distribution at other provider operated locations. The cost of ingredients for meals prepared and frozen by the provider is recorded under raw food.

List each type of meal purchased and the costs of each on a separate row.

Do not include the cost of any items that are not on the menus approved by the dietician/nutritionist.

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Do not include the cost of any food items for other purposes, such as volunteer recognition events, or snacks for drivers.

Freight:Charges for shipment/delivery of raw food or supplies to the nutrition provider.

Storage Cost:Storage costs include the costs associated with the rental of both refrigerated and non-refrigerated space used to hold food or supplies until prepared or used.

Do not include the cost of insulated carriers used to transport meals to consumers, or the cost of meal packaging in this category.

Consumables:This is the category in which to list equipment costing less than $5,000 per item.

The cost of paper and plastic goods (including meal packaging) should be shown here.

The cost of pots, pans and cooking utensils should be included in this category.

The same pots and pans or equipment purchased in a prior year should not be listed on a current year budget, even if still in use. The cost is incurred in the year purchased.

This consumable cost area and cost category is for items related to food/meals only. Consumable supplies of other types such as janitorial supplies (including those used to prepare food preparation surfaces) or office supplies are recorded in other cost areas.

Other:List only items not covered in Raw Food, Purchased Meals, Freight, Storage or Consumables that are necessary to the purchase of food and meal items.

List individually all items that cost more than $100 per item.

EQUIPMENT

Depreciation:This category (Depreciation as a cost category in the Equipment cost area) includes the depreciation expense associated with major equipment purchases (those costing more than $5000).

Depreciation may not be claimed on an item if the purchase was fully funded through a state or federal funding source.

Depreciation cannot be claimed on rented or leased equipment.

Item, year purchased and item cost must be shown.

InterestThis category includes interest or financing costs paid or incurred on equipment assets used in the provision of the funded meal programs.

Mortgage interest is shown in the Building/Occupancy cost area, not in this category.

Costs incurred for interest on borrowed capital are unallowable.

List the item purchased, year of the purchase and purchase cost.

Leasing

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Enter the lease cost of equipment used in program provision.

List each item, and the year leased.

MaintenanceInclude costs incurred for necessary maintenance, repair, or upkeep of equipment. Allowable costs are those which keep equipment in efficient operating condition.

Costs incurred for improvements which add to the permanent value of the equipment or appreciably prolong the intended life of the equipment must not be included in this category but are treated as capital expenditures.OCCUPANCY/BUILDING

RentOnly include the rental fees paid for buildings used in the provision of services, not rental of equipment or vehicles.

UtilitiesThis cost category includes items such as natural gas or propane used for heating and cooking, water or electricity.

DepreciationThis category includes the depreciation expense associated with the purchase of property, including capital improvements to land and buildings.

Depreciation may not be claimed on an item if the purchase was funded through a state or federal funding source.

Depreciation cannot be claimed on rental property or land acquisitions.

Item, year purchased and item cost must be shown.

Mortgage InterestThis category includes interest or financing costs paid or incurred on building assets used in the provision of the funded programs.

InsuranceThis cost category specifically refers to insurance related to space occupancy (for example fire, theft or flood insurance on the building housing the meal preparation site), not to the cost of insurance benefits paid for employees, automobile insurance or other types of insurance costs.

Identify each type of Building/Occupancy related insurance if there is more than one type purchased.

SecurityInclude the cost of alarm system monitoring fees or private security staff/patrols if applicable.

JanitorialIf a contracted building maintenance or janitorial contract is utilized, list the cost here.

Include costs incurred for necessary maintenance or upkeep of the building(s). Allowable costs are those which keep buildings in efficient operating condition.

This is the category where janitorial supplies, including consumable items should be listed.

Costs incurred for improvements which add to the permanent value of the building or appreciably prolong the intended life of the building must not be included in this category but are treated as capital expenditures.

RepairInclude costs incurred for necessary repair or upkeep of the building(s). Allowable costs are those which keep buildings in efficient operating condition.

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Costs incurred for improvements which add to the permanent value of the building or appreciably prolong the intended life of the building must not be included in this category but are treated as capital expenditures.

Taxes Identify the type and amount of taxes paid on building(s).

TRANSPORTATION/TRAVEL

Mileage ReimbursementMileage logs must be maintained showing number of miles reimbursed and rate of reimbursement.

Mileage reimbursement to volunteers who deliver meals is allowable.

DeliveryIndicate delivery charges if this service component is subcontracted.

Do not duplicate expenses of the freight cost category.

Gas & OilIf staff/volunteers that utilize their own vehicles are directly reimbursed for gas and oil charges, indicate that cost here.

Gas & Oil expenses for operation of provider owned/leased vehicles used in program operations are shown here.

Repairs (identify item and year purchased)Repair expense of provider owned/leased vehicles used in program operations are shown here.

InsuranceThis category only includes automobile/van insurance.

Depreciation/LeaseList vehicles separately and identify whether lease cost or depreciation.

If the charge is for depreciation, show the year purchased and cost.

Depreciation cannot be claimed on leased vehicles.

Depreciation cannot be claimed on vehicles funded with state/federal dollars.

InterestThis category includes interest paid on vehicle financing.

Tags & LicensesInclude the cost of tags and licenses for provider owned/leased vehicles used in service provision.

ADMINISTRATIVE & GENERAL

AdvertisingAllowable advertising costs are those which are solely for:

Recruitment of personnel Procurement of goods and services Other specific purposes necessary to meet meal program requirements.

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Unallowable advertising and public relations costs include: Salaries and wages of employees engaged in setting up and displaying exhibits, making demonstrations, and

providing briefings; Costs of promotional items and memorabilia, including models, gifts, and souvenirs; Costs of advertising and public relations designed solely to promote the provider.

Allocate the following based on program utilization:o Printing o Copyingo Office supplieso Postageo Telecommunications

Contractual Agreements and Consulting FeesItems or services secured through contractual agreement or consultancy are only allowable if they are of a type that would be allowable if included in salaries or operating expenses.

Example: a contract with a media consultant to develop fund-raising appeals would not be allowable as fund-raising is not an allowable cost of the HDM or Congregate meal programs.

Other Fees Other Misc.

The cost/expense must be described in sufficient detail to support inclusion in the budget.

Note: Interest-Working - CapitalCosts incurred for interest on borrowed capital, temporary use of endowment funds, or the use of the non-profit organization’s own funds, however represented, are unallowable.

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