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CITY OF POMONA

EMERGENCY SOLUTIONS GRANTS (ESG) PROGRAM

HOMELESS ASSISTANCE PROGRAMS

REQUEST FOR PROPOSALS (RFP)PROGRAM YEAR 2013-2014

APPLICATION PACKET

Mark Lazzaretto, Director Community Development Department505 South Garey AvenueBox 660, Pomona, Ca 91769

COMMUNITY DEVELOPMENT DEPARTMENTCITY OF POMONAFY 2013-2014 ESG REQUEST FOR PROPOSAL (RFP) FULL APPLICATION FOR FUNDING

TABLE OF CONTENTS

SECTION 1 – APPLICATION INTRODUCTION.......................................................................3

A. ESTIMATED AVAILABLE FUNDING..................................................................................4

B. ELIGIBILITY FOR APPLICATION......................................................................................4

C. MANDATORY MATCH REQUIREMENTS..........................................................................5

D. MANDATORY TRAINING REQUIREMENTS......................................................................6

SECTION 2 - ESG PROGRAM OVERVIEW............................................................................7A. AUTHORITY........................................................................................................................7

B. DEFINITION OF HOMELESS..............................................................................................7

C. ELIGIBLE ACTIVITIES........................................................................................................9

D. ESTIMATED FUNDING CAPS FOR EMERGENCY SOLUTIONS GRANTS (ESG)........10

PROGRAM.............................................................................................................................10

E. INELIGIBLE ACTIVITIES.................................................................................................10

SECTION 3 - RFP APPLICATION AND SELECTION CRITERIA.........................................11A. RFP GENERAL APPLICATION REQUIREMENTS........................................................11

B. RFP EVALUATION - SELECTION CRITERIA...............................................................14

C. RFP REVIEW AND APPEALS PROCESS.....................................................................14

D. BASIC INSTRUCTIONS FOR SUBMITTING A REQUEST FOR FUNDING..................15

E. WORKSHOP ANNOUNCEMENT...................................................................................16

SECTION 4 - RFP APPLICATION PACKAGE......................................................................17A. APPLICATION COVER SHEET......................................................................................18

B. APPLICATION CHECKLIST...........................................................................................19

C. APPLICATION................................................................................................................20

D. PROGRAM BUDGET......................................................................................................23

E. BUDGET PROTOCAL....................................................................................................35

F. MATCHING SHARE:......................................................................................................38

G. PERFORMANCE MEASUREMENT SYSTEM AND OUTCOMES STATEMENT..........42

ATTACHMENT A: BOARD OF DIRECTORS AFFIDAVIT....................................................43

ATTACHMENT B: STATEMENT OF CERTIFICATIONS......................................................44

ATTACHMENT C: OTHER FEDERAL REQUIREMENTS.....................................................47

APPLICANT AGENCY _________________________________ 2


ATTACHMENT D: STATEMENT OF CONFIDENTIALITY....................................................50

ATTACHMENT E: CERTIFICATION OF RELIGIOUS COMPLIANCE..................................51

ATTACHMENT F: APPEALS PROCESS FOR CLIENT TERMINATIONS...........................52



I.SECTION 1 – APPLICATION INTRODUCTION

INVITATION TO APPLYWEDNESDAY, JANUARY 23, 2013

NOTICE OF FUNDING AVAILABILITY FOR

THE EMERGENCY SOLUTIONS GRANTS (ESG) PROGRAM PROGRAM YEAR 2013-2014

The City of Pomona is seeking proposals from organizations with specific skills in providing street outreach, emergency shelter, homeless prevention, or rapid re-housing to implement the Emergency Solutions Grants components of the City's Continuum of Care System. Only homeless provider organizations that meet the "Minimum Requirements" and "General Program Requirements" (see Section 3 of application) will be considered at this time.

RFP AVAILABILITY:The Request for Proposal (RFP) Application Packet will be available at 12:00 noon, January 23, 2013 at the following location:

PURCHASING DIVISION (basement)505 SOUTH GAREY AVENUE

POMONA, CA 91766City Hall hours of operation are: Monday – Thursday, 7:30 a.m. – 6:00 p.m.

City Hall is closed every Friday.RFP WEB INFORMATION: Visit our website at www.ci.pomona.ca.us and click on any one of the following links to access and download the RFPS in word format:

www.ci.pomona.ca.us/index.php/businesses/current-bids-and-rfpswww.ci.pomona.ca.us/index.php/community-development-home/housing-divisionwww.ci.pomona.ca.us/index.php/government/city-departments/community-developmentwww.ci.pomona.ca.us/index.php/housing-division-home/homeless-services

The Purchasing Division must receive all completed submissions no later than:4:00 p.m., Thursday, February 21, 2013

POMONA CITY HALL HOURS:City Hall is open Monday – Thursday, 7:30 AM-6:00 PM. City Hall is closed every Friday.


http://www.ci.pomona.ca.us/


A. ESTIMATED AVAILABLE FUNDING The total amount of ESG funds anticipated to be awarded to the City for Program Year 2013-2014 is $220,994. This amount is estimated and dependent on the amount ultimately awarded by the Federal government. Eligible activities that have established funding limits or caps will be adjusted in accordance with final awarded amount.

B. ELIGIBILITY FOR APPLICATIONThe following eligibility criteria will be used in considering ESG applications for funding in Program Year 2013-2014:

1. Only eligible project activities that meet the following will be considered:

a) Must meet City of Pomona’s strategic goals to end homelessness as outlined in the City’s Consolidated Plan

b) Must be eligible under the definitions of the Homeless Emergency Assistance and Rapid Transition to Housing (HEARTH) Act.

c) Under the HEARTH Act, must coordinate activities with the Continuum of Care process to carry out ESG eligible activities.

d) Must demonstrate the capacity to participate in/and meet the performance and reporting requirements under the Homeless Management Information System (HMIS).

e) Strengthening the City's Continuum of Care by addressing gaps in residential

and non-residential services and/or ;

f) Developing and implementing a plan of homeless prevention that emphasizes “housing stabilization”;

g) Goals and actions that specifically target chronic homeless, veterans, families with children and unaccompanied youth;

h) Cultivate collaboration between the recipient agency and the Continuum of Care process;

2. Projects that show collaborative effort with at least one other agency to provide stated services.



3. Projects from service providers that have at least two years experience in successfully providing at least one of the following eligible Emergency Solutions Grant (ESG) components:

a) Street Outreach serves unsheltered homeless persons.

Essential Services included in street outreach include: Engagement, Case Management, Emergency health and mental health services, transportation and services for special populations including homeless youth, homeless persons with HIV/AIDS, and Homeless Victims of Domestic Violence, Sexual Violence and Stalking.

b) Emergency Shelter serves people staying in emergency shelters.

Essential Services include case management, childcare, education, employment and life skills services, legal services, health, mental health and substance abuse services, transportation, and services for special populations. Operations include maintenance, utilities, furniture, and food. Renovations include major rehab or conversions.

c) Homeless Prevention activities are available to persons below 30% Area Median Income (AMI) and are homeless or at risk of becoming homeless.

Homeless prevention assistance, including (but not limited to): can be used to prevent and eligible individual or family from becoming homeless or to help and individual or family regain stability in current housing or other permanent housing. Eligible activities include housing relocation and stabilization services as well as short and medium-term rental assistance.

d) Rapid Re-Housing is available to help those who are literally homeless move into permanent housing and achieve housing stability. Activities include housing relocation and stabilization services as well as short and medium term rental assistance.

C. MANDATORY MATCH REQUIREMENTSThe Emergency Solutions Grants (ESG) Program requires a 100% matching grant equal to the amount of the requested funds. All Applicants must provide documentation of the cash or in-kind match with the RFP:

Funding Match: A 100% percent (100%) funding match is required. A nonprofit recipient selected through this RFP process must provide this match, equal to the grant award.



In calculating the amount of matching funds, a subrecipient may include the documented value of any donated material or building, and the time and services contributed by volunteers and staff to carry out a homeless services program or shelter, determined at the rate of $5.00 per hour. The City’s Homeless Services Coordinator will determine the value of any donated material or building, or any lease, using any method reasonably calculated to establish a fair market value.

D. MANDATORY TRAINING REQUIREMENTSAn Applicant Technical Assistance Workshop will be held to provide an opportunity for all potential applicants to ask questions about the overall Emergency Solutions Grant program, evaluation criteria, Continuum of Care (CoC) strategies and ESG proposal process.

The workshop is mandatory for all agencies applying for funding, regardless of current of past ESG funding.

TECHINICAL ASSISTANCE WORKSHOP:A mandatory RFP Workshop will be held on Thursday, February 7, 2013, 11:00 a.m. – 1:00 p.m., at the City Council Chambers, 505 South Garey Avenue, Pomona, CA.

Please note: An Agency representative must be present at the workshop for the application to qualify. One person cannot represent multiple agencies. RFP’s submitted by agencies that do not attend the workshop will not be considered for funding and will be returned unopened

TECHNICAL ASSISTANCEPlease contact the City’s Homeless Services Coordinator, Jan Cicco at (909) 620-2571 if you have any additional questions.

RFP SUBMISSIONSSubmit one (1) original plus two (2) copies (one with original signature and corporate seal) in a sealed envelope with the words “ESG PROJECT 2013-2014” written on the envelope. Proposals must not be bound or stapled; secure proposals with a binder clip. Number pages and label each section with identifying tabs utilizing RFP section and paragraph titles.

THE CITY RESERVES THE RIGHT TO THE FOLLOWING:

1. Waive defects or irregularities in the presentation of an application.2. Incomplete applications will not be processed unless the City grants a waiver, in

writing.3. Proposals that are disqualified will not be reviewed or evaluated by the RFP review

team.

OTHER:Questions regarding this notice may be directed to Jan Cicco at (909) 620-2571. Questions regarding the City’s purchasing procedures should be referred to the Purchasing Division, Kennie Nicomedie at (909) 620-2039.



SECTION 2 - ESG PROGRAM OVERVIEW

A. AUTHORITYThe ESG Program was established by the McKinney – Vento Homeless Assistance Amendments Act of 1987 (Public Law 100-628) and Section 832 of the 1990 Affordable Housing Act (Public Law 101-625). This Program is governed by Title 24, Code of Federal Regulations (CFR), Part 576. The Pomona City Council, in its capacity as a metropolitan City eligible for a formula grant under the ESG regulations, has authorized participation as described in the City's Comprehensive Housing Affordability Strategy.

HOMELESS ASSISTANCE REAUTHORIZATION

On May 20, 2009, Congress adopted S.896, The Homeless Emergency Assistance and Rapid Transition to Housing (HEARTH) Act of 2009. The HEARTH Act amends and reauthorizes the McKinney – Vento Homeless Assistance Act of 1987. On November 15, 2011, HUD released the interim regulation for the new Emergency Solutions Grants (ESG) program and the corresponding amendments to the Consolidated Plan regulations and published the final rule on the definition of homelessness, which changed as legally defined in Public Law 100-628.

The HEARTH Act also consolidates HUD’s homeless assistance programs, created a Rural Housing Stability Program; simplified match requirement; increased prevention resources; and, increased the emphasis on performance by requiring participation in HMIS.

PREVENTION AND REHOUSING ASSISTANCE: The New Emergency Solutions Grant

ESG, formerly known as the “Emergency Shelter Grant” is renamed the “Emergency Solutions Grant”, signifying a shift to funding homelessness prevention and re-housing, as well as emergency shelter.

B. DEFINITION OF HOMELESS

On November 15, 2011, HUD published the final rule on the definition of homelessness, which integrates the regulation for the definition of "homeless," and the corresponding recordkeeping requirements, for the Emergency Solutions Grants program, the Shelter Plus Care program, and the Supportive Housing Program.

The proposed rule was released and provided necessary clarification on terms within the statutory definitions of "homeless," "homeless individual," "homeless person," and "homeless individual with a disability" and contained proposed recordkeeping requirements designed to assist communities appropriately document an individual or family's homeless status in the case file.


http://www.hudhre.info/index.cfm?do=viewResource&ResourceID=4519

http://www.hudhre.info/esg

http://www.hudhre.info/esg


Only programs serving homeless persons or families as defined under HUD's Federal regulation will be considered. A homeless person is defined under Federal regulations as:

1. Individuals and families who lack a fixed, regular, and adequate nighttime residence and includes a subset for an individual who resided in an emergency shelter or a place not meant for human habitation and who is living in an institution where he or she temporarily resided;

2. Individuals and families who will imminently lose their primary nighttime residence;

3. Unaccompanied youth and families with children and youth who are defined as homeless under other federal statutes who do not otherwise qualify as homeless under this definition; and

4. Individuals and families who are fleeing, or are 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.

BACKGROUND AND FINAL RULES

The City is making available $220,994 in federal ESG funds to one or more providers of homeless services in the City. The ESG exists under the Homeless Emergency Assistance and Rapid Transition to Housing (HEARTH ACT) of 2009, which consolidated three of the separate homeless assistance programs, administered by HUD under the McKinney-Vento Homeless Assistance Act into a single grant program, and revised the Emergency Shelter Grants program and renamed it as the Emergency Solutions Grant program. The City is soliciting proposals from nonprofit providers of homeless services that will effectively utilize all or part of the funds as subrecipients.

Once funds are awarded by the City, professional service agreements with homeless agencies may be renewed for a second year, depending on future HUD funding levels and satisfactory compliance with program regulations.

Major priorities for program year 2013-2014 are Homeless Prevention, Eviction Prevention and Rapid Re-housing. The federal government has taken a very proactive stance in keeping families housed, and also in trying to reduce the incidences of family homelessness.

Agencies participating in ESG or other HEARTH Act, McKinney Vento funding are encouraged to seek ongoing education and guidance through www.HUDHRE.info and the HUD Help Desk located on this site.


http://www.HUDHRE.info/


CONTINUATION OF FUNDING

Pursuant to the terms of the grant agreement between the Department of Housing and Urban Development (HUD) and the City of Pomona, implementation of the City's Continuum of Care Plan will take place over a five-year period, with regular performance evaluations by HUD. Continuation of funding for each year is contingent upon the satisfactory fulfillment of the stated goals of the grant agreement with HUD and between the City and the subrecipients. Organizations must expect to make a significant difference in breaking the cycle of homelessness and hold to high standards of effort and accomplishment. Failure to achieve contracted goals and comply with contract provisions will lead to potential de-obligation and termination of funds to homeless providers unable to meet goals.

C. ELIGIBLE ACTIVITIESa. Street Outreach

Essential Services related to reaching out to unsheltered homeless individuals and families, connecting them with emergency shelter, housing, or critical services, and providing them with urgent, non-facility-based care. Eligible costs include engagement, case management, emergency health and mental health services, and transportation.

b. Emergency Shelter Major Rehabilitation, Conversion, or Renovation of a building to serve as a homeless shelter. Site must serve homeless persons for at least 3 or 10 years, depending on the cost. Note: Property acquisition and new construction are ineligible ESG activities.

Essential Services such as case management, childcare, education services, employment assistance and job training, outpatient health services, legal services, life skills training, mental health services, substance abuse treatment services, transportation, and services for special populations.

Shelter Operations, including maintenance, rent, repair, security, fuel, equipment, insurance, utilities, relocation, and furnishings.

c. Prevention Housing relocation and stabilization services and short-and/or medium-term rental assistance as necessary to prevent the individual or family from becoming homeless if:

Annual income of the individual or family is below 30 percent of median family income.

Assistance is necessary to help program participants regain stability in their current permanent housing or move into other permanent housing and achieve stability in that housing.



Eligible costs include utilities, rental application fees, security deposits, last month's rent, utility deposits and payments, moving costs, housing search and placement, housing stability case management, landlord-tenant mediation, tenant legal services, and credit repair.

d. Rapid Re-Housing Housing relocation and stabilization services and short-and/or medium-term rental assistance as necessary to help individuals or families living in shelters or in places not meant for human habitation move as quickly as possible into permanent housing and achieve stability in that housing. Eligible costs also include utilities, rental application fees, security deposits, last month's rent, utility deposits and payments, moving costs, housing search and placement, housing stability case management, landlord-tenant mediation, tenant legal services, and credit repair.

e. Data Collection (HMIS) Grant funds may be used for the costs of participating in an existing HMIS of the Continuum of Care where the project is located. HMIS is available for staff travel for training and program participant intake and participation fees that may be charged by the HMIS Lead agency, the Los Angeles Homeless Services Authority (LAHSA). At the time of release of this request for proposals, LAHSA does not charge participation fees.

D. ESTIMATED FUNDING CAPS FOR EMERGENCY SOLUTIONS GRANTS (ESG) PROGRAM

At the time of the release of this request for proposals, funding amounts have not been published. All funding is projected and awards may be modified to reflect actual awards made by the Department of Housing and Urban Development.

The total estimated amount of ESG funds anticipated to be awarded to the City for Program Year 2013-2014 is $220,994. This amount is estimated and dependent on the amount ultimately awarded by the Federal government. Eligible activities that have established funding limits or caps will be adjusted in accordance with final awarded amount.

E. INELIGIBLE ACTIVITIESThe following activities are prohibited:

Acquisition of a facility for use as an emergency shelter for the homeless. Rehabilitation services such as preparation of work specifications, loan processing, or

inspections. Renovation or conversion of buildings owned by primarily religious organizations or

entities. All services must be free from religious influences.



CONTINUED SHELTER USE REQUIREMENTS

A shelter assisted with ESG funds must be maintained as a shelter for the homeless for a specific minimum time period. The time period begins on the date of initial use as an emergency shelter for the homeless or the date that grant amounts are first obligated by the grantee for the shelter, whichever is later. The specific time frames, according to the specific activity assisted, are as follows:

1. Conversion or Major Rehabilitation: 10 Years2. Renovation: 3 Years3. Homeless Prevention: No continued use requirement4. All Other Activities: The period during which ESG assistance is provided, up to 2

years.

PROGRAM FEE POLICY

The Federal regulations do not address the issues of fee payment by Shelter clients.

1. Requirements regarding payment of fees by clients may be established by subrecipients subject to the grantee's concurrence, so long as any fees charged do not exceed 30% of the client's documented monthly income from all sources. If the family unit consists of more than one (1) person, income of all family members 18 years of age and older can be considered in making the 30% calculation.

2. Assisted clients must provide an appropriate budget management/savings plan to enable an independent living transition.

SECTION 3 - RFP APPLICATION AND SELECTION CRITERIA

A. RFP GENERAL APPLICATION REQUIREMENTSThe following criteria must be included in the RFP application to be considered a qualified application:

1. The scope of Program Services must be City-based.

2. Proposed program and activities must be of direct benefit to homeless persons as defined by HUD in Federal regulations. Homeless prevention programs must benefit homeless persons or those at risk of becoming homeless.



3. All applications must include a performance measurement system to track productivity and program impact clearly reflecting the extent to which the activities produce the desired outcomes in the community or in the lives of persons assisted. All goals must be linked with outcomes.

4. Evidence of a 100% match must be submitted. Match may be cash or in-kind and must be used or counted towards eligible ESG activities.

5. All submitted projects must be considered eligible activities under ESG as required by HUD regulations and should be planned for a maximum of 12 months.

6. Agency must be a legally incorporated non-profit organization or government entity and operational before submission.

7. Must provide 501 (c) (3) tax-exempt IRS status.

8. Must provide current IRS Determination Letter.

9. Must provide Articles of Incorporation and Organization By-laws.

10.Must provide current Dun and Bradstreet Number

11.Applicant must provide current documentation that it possesses adequate fiscal and management systems and legal certifications to implement the proposed project: Must provide current 990’s Must provide copy of Annual Report with Financial Data. Must provide copy of last Independent Audit, results and copy of management

letter. Must provide copy of current business license, local and/or State permits. Must provide copy of Affirmative Action Plan.

12.Applicant must submit verification of Insurance Coverage. Minimum certifications are: Commercial General Liability, minimum limit $1,000,000 per occurrence,

$2,000,000 aggregate. Automobile Liability (hired and non-owned vehicles), minimum limit $1,000,000 per

occurrence. Additional Insured Endorsements, regardless of form, must be signed by an

authorized representative of the insurance carrier or its broker.

Fidelity Bond (Employee Dishonesty Coverage)

Employee Benefits Liability – Worker’s Compensation (statutory) Insurance

The City (Grantee) must be named as an additional insured, and must include the endorsement page and the following language:

1) The additional insured is, “The City of Pomona including elected or appointed officials, directors, officers, agents, employees, volunteers, or contractors.”



2) “This insurance provided by this policy shall be primary as respects any claims related to the (name and dates of program). Any insurance, pooled coverage or self-insurance maintained by the City of Pomona, its elected or appointed officials, directors, officers, agents, employees, volunteers, or contractors shall not contribute to it.”

Additional Insured Endorsements, regardless of form, must be signed by an authorized representative of either the insurance carrier or its broker. A signature of the insured is not considered an authorized signature.

13.Must demonstrate a minimum of twenty-four (24) months previous experience as of the application deadline of Wednesday, February 8, 2012.

14.A qualified Fiscal Officer/Bookkeeper, preferably certified by AICPA, must be listed in the proposed budget and a resume included as part of the application.

15.Agencies that have not submitted performance reports and those with past compliance and performance problems may not be considered for funding.

16.Program activities must be available to serve all religious, race and ethnic groups, in accordance with Title VI of the Civil Rights Act of 1964, and Section 109 of Title I, of the Housing and Community Development Act of 1974.

17.Program activities must comply with Section 504 of the Rehabilitation Act of 1973, which states: “No qualified individual with handicaps can be excluded from participation in or denied the benefits of any activity receiving Federal financial assistance.

18.Board and/or advisory board should be representative of the community, your organization's service population, and homeless or formerly homeless persons. Homeless persons must be involved in planning and/or operation of project.

19.Awarded agencies must be represented at the Pomona Continuum of Care Coalition (PCOCC) monthly meetings on a regular and consistent basis.

20.Agency must be able to demonstrate bilingual capacity through paid or volunteer staff on-site or on-call.

GENERAL PROGRAM REQUIREMENTS

Providers funded with ESG program funds will be expected to adhere to the following to be considered in good program standing:

Make themselves familiar with and adhere to all program requirements of the EMERGENCY SOLUTIONS GRANTS, as stated in Title 24 of the Code of Federal Regulations, Part 576;



Work with City staff in developing and implementing the City's Continuum of Care Plan;

Collaborate with other homeless providers in the operation of the project;

Adhere to Pomona's reporting and monitoring requirements;

Use common reporting software as specified by the City of Pomona;

Participate in training and coordination meetings;

Cooperate with related research and evaluation activities;

Prioritize referrals from homeless service providers within the City's Continuum of

Care System;

Meet high standards of professionalism in implementing the project;

Conform to all fiscal accountability standards required by the City of Pomona and by the Federal government (see attached 24 CFR, Part 84);

B. RFP EVALUATION - SELECTION CRITERIA

The following scoring system will be applied in evaluating the proposals:

Program design .......................................................12Program experience and qualifications .....................5Performance Measurement Tool ............................17Documentation and Recordkeeping.........................17Collaborative Effort ...................................................5Community and Service Population Representation 17Fiscal capacity ........................................................17Budget and source of matching funds . . ..................10

Total Points Available: 100

C. RFP REVIEW AND APPEALS PROCESSThe City’s review process entails four levels of review prior to final authorization of a federally assisted project:

1) Staff Evaluation Team reviews applications for responsiveness to RFP requirements2) Determine ESG Eligibility of proposed activities3) Eligible activities are reviewed and evaluated by the City’s Budget Ad Hoc Committee

and Staff Evaluation Team.4) Funding is approved by the City Council

An organization that has sought funding may appeal to the City Council at any of the Public Hearings held to obtain citizen comments. Written appeals may also be submitted to the Community Development Department prior to adoption of the final budget in May 2013.

Public hearings will be noticed in local newspapers in the Legal Notice section.



D. BASIC INSTRUCTIONS FOR SUBMITTING A REQUEST FOR FUNDING

The following tips provide basic technical guidance for preparation and final submittal of an ESG RFP application to the City for funding a proposed project:

1) The RFP application forms should be typewritten or printed for clarity of information and numbered to ensure RFP evaluators and reviewers do not misread information.

2) Only one RFP application is submitted for each proposed project or program proposed in an application (1 project for 1 application). This will ensure compliance with federal requirements and also ensures that the project budget and staffing is adequate to carryout a project.

3) The RFP Application Checklist of requested documents is provided to help the applicants organize the application properly.

4) Completion of the RFP Application in the order requested will make the proposal more competitive for the funding grant you are seeking. Utilize the headings in the RFP for your proposal in order to assist the reviewers in evaluating your application. Tab key headings and sections for easy reference. The original and copies must be secured with a large binder clip only. Do not staple, mechanically bind, or use notebook binders. Provide index tabs for each section and major paragraph section using the RFP titles.

5) Proposed program activities should have a clearly written scope of services that links goals with program outcomes: “Need” + “Design” + “Performance Measures” = Proposed Outcomes. Be sure to indicate the number of individuals and families to be served.

6) If you are not sure about any section of the RFP Application, contact Jan Cicco at (909) 620-2571 early in the application process to obtain a clear understanding of what is required to properly complete the contents of the application.

7) Verify that all items listed with the application checklist have been answered to ensure that the proposal can be properly evaluated and understood by its readers.

INCOMPLETE APPLICATIONS OR NON-RESPONSIVENESSIncomplete applications will not be evaluated and will be returned to applicant. In order to be considered complete and responsive to RFP requirements, your application must include all items listed in the “Application Checklist”, regardless of whether or not any of these items have been submitted in prior years.



E. WORKSHOP ANNOUNCEMENT

A Request for Proposal Application Workshop is offered to guide the approach to and answer questions regarding the ESG application. Because of significant changes in the rules and regulations governing the Emergency Solutions Grants, attendance at this workshop is absolutely mandatory for all agencies wishing to submit an ESG application.

REGISTER NOW!

DATE: THRUSDAY, FEBRUARY 7, 2013

LOCATION: CITY OF POMONA, COUNCIL CHAMBERS 505 S. GAREY AVENUE

POMONA, CA 91769

To register, contact Cecilia Munoz at (909) 620-2198 or by e-mail at [email protected].

Please indicate that you are interested in the ESG Application.

WORKSHOP SESSION WILL BE HELD:

TIME WORKSHOP TOPIC

11:15 a.m. – 12:15 p.m. ESG Applications

THE WORKSHOP WILL COVER:

Review of Application Minimum Eligibility Requirements HUD’s Eligibility Requirements Technical Assistance

Visit our website at www.ci.pomona.ca.us and click on “download forms and docs” to download the RFP in word format.


http://www.ci.pomona.ca.us/

mailto:[email protected]


SECTION 4 - RFP APPLICATION PACKAGE

The City of Pomona ESG Program Year 2013-2014 request for proposals consists of the following elements:

⌂ APPLICATION CHECKLIST⌂ APPLICATION with cover sheet⌂ ATTACHMENTS⌂ REQUIRED DOCUMENTATION⌂ INSURANCE COVERAGE⌂ OVER-ARCHING FEDERAL REQUIREMENTS⌂ AGENCY CERTIFICATIONS

APPLICATION PACKAGES ARE DUE BY:

4:00 p.m., Thursday, February 21, 2013

APPLICATIONS MUST BE SUBMITTED TO:

CITY OF POMONAATTENTION: PURCHASING DEPARTMENT (basement)

505 SOUTH GAREY AVENUEP.O. BOX 660

POMONA, CA 91766

Please submit one (1) ORIGINAL AND two (2) unbound copies.

LATE, FAXED, E-MAILED OR APPLICATIONS HANDWRITTEN IN SCRIPTwill not be accepted.


A. APPLICATION COVER SHEETCITY OF POMONA

COMMUNITY DEVELOPMENT DEPARTMENTEMERGENCY SOLUTIONS GRANTS (ESG)

FY 2013 - 2014

SUBMIT TO: CITY OF POMONA (909) 620-2361Purchasing DivisionP.O. Box 660Pomona, California 91766

DEADLINE: SUBMIT ONE (1) ORIGINAL, SIGNED WITH CORPORATE SEAL and TWO (2) UNBOUND COPIES BEFORE 4:00 P.M. Thursday, February 21, 2013

______________________________________ __________________________Legal Name of Agency Project Name

_______________________________________ _______________________Federal Identification Number (9- Digit #) DUNS # (Dunn & Bradstreet)

________________________________________________________________________ Agency Address City Zip Code

TYPE OF ACTIVITIES

AMOUNT

HOMELESS PREVENTION $______________

STREET OUTREACH (May not exceed 60% of total award) $ _____________

EMERGENCY SHELTER (May not exceed 60% of total award) $______________

RAPID RE-HOUSING $ _____________

HMIS $ _____________

TOTAL REQUESTED $ _____________

A separate proposal must be submitted for each activity with the exception of HMIS.

Grant Contact Person and Title: _____________________________Phone No: _________________________ Fax No: _________________________ E-mail: ____________________________

Designated Representative responsible for job performance, negotiations, contractual matters, and coordination with the City:

Name & Title: ________________________Mailing Address: ______________________Email Address: ______________________ Telephone No: ____________________

____________________________________ _______________________________ Legally Authorized Signatory Typed or Printed Name

B. APPLICATION CHECKLISTThe Application Checklist must be completed to verify that all required documents are completed for submission. Incomplete applications will be rejected with a written justification of items missing. No opportunity will be given to provide additional information after the Submittal Deadline. If further assistance is needed, contact Jan Cicco, Homeless Services at (909) 620-2571.

CHECK WHEN COMPLETEDProgram Experience and QualificationProgram DesignPerformance Measurement – Program Goals with OutcomesCollaborative Effort Fiscal Administration Proposed Budget Summary

Personnel Budget FormDetailed Breakdown of Costs Form(s) (use applicable form(s))

Match Requirements Shelter Facility Information (if applicable)

ATTACHMENTSA: Board of Directors AffidavitB: Statement of CertificationC: ESG Compliance RequirementsD: Statement of Confidentiality (if applicable)E: Certification of Religious Compliance (if applicable)F: Appeals Process for Termination

REQUIRED DOCUMENTATION501 (c) (3) Tax-exempt statusCurrent 990’sCopy of Audited Financial Data with Statement of OpinionCopy of Articles of Incorporation and By-lawsBusiness LicenseDun and Bradstreet (DUNS) Number

INSURANCE COVERAGE – City must be named as co-insuredCurrent General LiabilityAutomobile LiabilityFidelity Bond Employee Benefit Liability (Worker’s Compensation) Additional Insured Endorsement (signed)

OTHERAffirmative Action PlanAttach resume of fiscal officerOrganization By-LawsArticles of IncorporationMemorandum(s) of Understanding for collaborative services

C. APPLICATION1. PROGRAM DESIGN

a. ESG Activity Type and Number of Clients to be served. b. Purpose of the proposed project.c. Need for the project and how was the need for the proposed activity identified?d. Target Population: Identify any unique characteristics of the population that

you propose to serve. Be specific (e.g. families with children, males with substance abuse problems, chronic mentally ill).

e. Provide information on the types of services that will be offered and how they will be provided.

f. Outreach Plan: Describe the methods to be used to ensure that the target population and community residents will find out about the services provided by the project. What are the possible referral sources for this project? How will they be used?

2. ORGANIZATION AND STAFF QUALIFICATIONS AND EXPERIENCE

a. Provide a summary of the qualifications of your organization to carry out the proposed project.

b. Provide a summary of the experience of your organization. Include any program that your agency has administered that is most similar to the proposed activity.

c. Describe your agency’s bi-lingual capacity. List all languages in which your agency has capability.

3. PERFORMANCE MEASUREMENT

a. List the measurable goals of the proposed project. Include the number of individuals and families to be served.

b. List the proposed outcomes for each goal.c. Evaluation Plan: The evaluation process is designed as a planning and

measurement tool. Evaluation is the analysis of data for the purpose of determining if and how the planned activities were carried out, if objectives/goals were achieved.

i. What data will be collected to identify the events that take place, when, with whom? Include who will be responsible for collecting the information and at what intervals it will be collected.

ii. Outcome Evaluation: Describe your process for evaluating outcomes? How will outcomes be measured? How will you build objective analysis into your outcome evaluation process?

4. PROGRAMMATIC DOCUMENTATION AND RECORDKEEPING a. Does the agency current record client information in the Los Angeles

Continuum of Care HMIS? If yes, how long has the agency utilized the system.b. If no, does the agency intend to implement HMIS during the 2013 – 2014 fiscal

year?i. Describe the status of HMIS implementation:

1. not yet started, 2. status of obtaining equipment and software3. status of training4. status of installing HMIS and obtaining passwords

ii. Describe the process for documenting client intake, goals, progress, success and exit. Include responsible parties and time allocated for documentation.

5. COLLABORATIVE EFFORT

a. Please list any coalitions, consortiums, or any other community meetings that your agency participates in on a regular and consistent basis.

b. Is this project conducted in collaboration with other agencies? Please describe.c. Attach Memorandum of Understandings, Letter of Support, and any other

documentations showing collaboration between the applicant agency and other local agencies.

6. COMMUNITY AND SERVICE POPULATION REPRESENTATION

a. Board and/or advisory board should be representative of the community, your organization's service population, and homeless or formerly homeless persons. Homeless persons must be involved in planning and/or operation of project.

i. All organizations funded by this RFP must ensure the maximum feasible participation of the homeless persons in project planning, implementation and evaluation processes. Specify the methods used for recruitment and hiring, if appropriate. Indicate whether those involved are paid staff or volunteers.

ii. Describe the membership on your Board of Directors, Advisory Board or other advisory and decision-making bodies within the applicant agency the includes representation of community members and member, or former members, of the population served.

iii. If your organization does not currently have a Board of Directors or Advisory Board whose membership includes a reasonable percentage of service recipients and/or homeless individuals, what steps will be taken, and when, to ensure representation of the poor and very low income persons on the Board of Directors or Advisory Board?

7. FISCAL ADMINISTRATION a. Name of Financial Management System. Describe your organization's

accounting and financial reporting system. Does the agency use accrual or cash accounting basis? Does the accounting system accounting system provide for the control of revenues as well as expenditures. Please discuss briefly.

b. Identify Finance Staff positions. Describe roles of staff positions discussing the internal controls used to ensure the safeguarding of funds and proper classification of expenditures to ensure that a thorough record of expenditures can be provided for purposes of monthly billing, providing reports and of an annual audit.

c. Identify the agencies three most recent federal grants by grant title and dollar amount. If fewer than three, identify non-federal grants. If Does the applicant agency have any past due obligations with any other funding source? Did the applicant agency fully expend the three most recent grants that have closed out terms? If not, why not and how much was not expended?

d. Does the agency have an unearned grant from a previous contract, which has not been returned to the funding source?

i. If you answered yes to any of the above please submit the following information:

a. Name of funding source and program title:b. Reason for past due obligations, and the amount of such

obligation:e. In the past three years, has the agency had an Internal Revenue Service (IRS)

or State levy? If so, is the agency on a repayment schedule? How was the matter resolved?

D. PROGRAM BUDGETThe Emergency Solutions Grant will cover a portion of the eligible expenses for funded programs. ESG requires 100% match and this must be calculated into the budget. Match can be cash or in-kind and must be applied to eligible activities.

Staff working all, or in part, providing direct client services for eligible activities must be included in the budget. The administration has the flexibility to determine what portion, if any, of the eligible salary will be billed to ESG.

Example: A case manager provides services to ESG Street Outreach Program clients 50% of the time that she works. The program budget may treat this in the following fashions:

1) Split cost between ESG and other source to go toward match requirement. In this case, the administrator decided to split 50/50.

2) Case manager $100 salary .5 to program = $50 to program. The program may split this salary $25 ESG, $25 other source for match.

3) The program may full expense $100 to ESG. The other percentage of time that the case manager works with other programs or clients may not be allocated to match. No match is credited.

4) Because the case manager’s time is shown in the budget and is an eligible expense, the entire $100 could be allocated toward meeting the match requirement, with none of this expense billed to ESG in the billing period.

Expenses for services, equipment, etc. required to implement the program should be included in the budget. Applicant may determine what portion will be billed to ESG and what portion will be billed to other funding sources and applied to match. If the equipment, space, or service is shared by other programs, the amount must be pro-rated and only the portion utilized by the ESG funded program may be billed to ESG and/or allocated towards match.

Adequate management and administration is also required for the program, but is not funded by ESG. The Executive Director and Accountant must be shown in the initial Personnel Budget form, demonstrating capacity to implement the program. The job descriptions must be included with the proposal.

Expenditure Limits placed upon the City of Pomona for the total ESG awardCombined street outreach and emergency shelter combined awards to all programs from each fiscal year's ESG grant cannot exceed the greater of:

1. 60% of that federal fiscal year's total ESG grant award2. The amount of FY 2013-2014 grants funds committed to homeless assistance

activities.

INDIRECT COSTSESG grant funds may only be used to pay indirect costs in accordance with OMB Circular A-87 (2 CFR part 225), or A-122 (2 CFR part 230), as applicable. Indirect costs may be applied to each eligible activity using the direct cost base specified in the approved cost allocation plan.

Indirect costs charged to an activity with an expenditure limitIndirect Costs + Direct Costs = Total Costs

Total Costs are then compared to the Expenditure Limit

Applicants wishing to include indirect costs in the proposal budget must attach a copy of the HUD approved cost allocation plan with the application.

The Eligible Costs for each of the ESG Components are provided below. Utilize this detailed information to properly formulate the program budget for the proposal.

Eligible Costs Category#1: Street Outreach

Engagement; Activities to locate, identify and build relationships with unsheltered homeless Case management, Emergency Health Services, Emergency Mental Health Services, transportation, services to special populations. Staff salaries related to carrying out street outreach activities is also eligible.

Activities to locate, identify and build relationships with unsheltered homeless people for the purpose of providing immediate support, intervention, and connections with homeless assistance programs and/or mainstream Eligible Initial assessment of needs and eligibilitysocial services and housing programs. Providing crisis counseling, Addressing urgent physical needs, actively connecting and providing info and referral, Cell phone costs of outreach workers.

Emergency Health ServicesOutpatient treatment of urgent medical conditions by licensed medical professionals in community-based settings (e.g., streets, parks, and campgrounds) to those eligible participants unwilling or unable to access emergency shelter or an appropriate healthcare facility.

Assessing participants' health problems and developing treatment plans Assisting participants to understand their health needs Providing or helping participants obtain appropriate emergency medical treatment Providing medication and follow-up services

Case ManagementAssessing housing service needs, arranging /coordinating/ monitoring the delivery of individualized services. Using the or centralized coordinated assessment system, Initial evaluation / verifying and documenting eligibility, Counseling, Developing / securing / coordinating services, Helping obtain Federal, state, and local benefits; Monitoring / evaluating participant progress; Providing information and referral to other providers; Developing an individualized housing / service plan.

Emergency Mental Health ServicesOutpatient treatment of urgent mental health conditions by licensed professionals in community-based settings (e.g., streets, parks, and campgrounds) to those eligible participants unable or unwilling to access emergency shelter or an appropriate healthcare facility. Crisis interventions Prescription of psychotropic medications Explain the use and management of medications Combinations of therapeutic approaches to address multiple problems

TransportationTravel by outreach workers, social workers, medical professionals or other service providers during the provision of eligible street outreach services.

Transporting unsheltered people to emergency shelters or other service facilities Cost of a participant’s travel on public transit Mileage allowance for outreach workers to visit participants Purchasing or leasing a vehicle for use in conducting outreach activities, including the cost of gas, insurance, taxes and maintenance for the vehicle Costs of staff to accompany or assist participants to use public transportation

Services to Special Populations Otherwise eligible Essential Services that have been tailored to address the special needs of homeless youth, victims of domestic violence and related crimes/threats, and/or people living with HIV/AIDS who are literally homeless. Engagement Case Management Emergency Health Services Emergency Mental Health Services Transportation

Eligible Costs Category #2: Emergency Shelter

Overarching Principles

⌂ Eligible Program Participants: Individuals and families who are homeless.⌂ Overview of Eligible Activities: Essential services to Individuals and families who are

persons in emergency shelters*, renovating buildings to be used as emergency shelters, and operating emergency shelters. Staff costs related to carrying out emergency shelter activities are also eligible.

Essential ServicesServices provided to individuals and families who are inan emergency shelter. Case Management Life Skills Child Care Education Services Mental Health Services Substance Abuse Treatment Services Employment Assistance and Job Training Outpatient Health Services Transportation Services for Special Populations Legal Services

Case Management

Assessing, arranging, coordinating, monitoring individualized services. Using the centralized or coordinated assessment system Initial evaluation including verifying and documenting eligibility Counseling Developing, securing and coordinating services including Federal, state, and local benefits Monitoring and evaluating program participant progress Providing information and referrals to other providers Providing ongoing risk assessment and safety planning with victims of domestic violence, dating violence, sexual assault, and stalking Developing an individualized housing and service plan

Child CareLicensed child care for program participants with children under the age of 13, or disabled children under the age of 18: Child care costs Meals and snacks Comprehensive and coordinated sets of appropriate developmental activities

Education ServicesInstruction or training to enhance participants' ability to obtain and maintain housing: literacy, English literacy, GED, consumer education, health education, and substance abuse prevention. Educational services / skill-building Screening, assessment and testing Individual or group instruction Tutoring Provision of books, supplies and instructional material Counseling Referral to community resources

Employment Assistance and Job TrainingServices assisting participants secure employment and job training programs. Classroom online and/or computer instruction: Employment screening, assessment, or testing On the-job instruction Job finding, skill-building Structured job-seeking support Reasonable stipends in employment assistance and job training programs Books and instructional material Special training and tutoring, including literacy training and pre-vocational training Counseling or job coaching Referral to community resources

Outpatient Health Services

Direct outpatient treatment of medical conditions provided by licensed medical professionals: Assessing health problems and developing a treatment plan Assisting program participants to understand their health needs Providing or helping participants obtain appropriate medical treatment, preventive medical care, and health maintenance services, including emergency medical services Providing medication and follow-up services Providing preventive and non-cosmetic dental care

Legal ServicesNecessary legal services regarding matters that interfere with the program participant’s ability to obtain and retain housing. Hourly fees for legal advice and representation by licensed attorneys and certain other fees-for-service Client intake, preparation of cases for trial, provision of legal advice, representation at hearings, and counseling Filing fees and other necessary court costs

Legal representation and advice to resolve legal problems that prevent participants from obtaining or retaining permanent housing: Child support Guardianship Appeal of veterans and public benefit claim denials Paternity Emancipation Orders of protection and other civil remedies for victims of domestic violence, dating violence, sexual assault, and stalking Legal separation Resolution of outstanding criminal warrants

Life Skills TrainingCritical life management skills necessary to assist the program participant to function independently in the community. Budgeting resources Managing money Managing a household Resolving conflict Shopping for food and needed items Improving nutrition Using public transportation Parenting

Mental Health ServicesDirect outpatient treatment of mental health conditions by licensed professionals.

Crisis interventions Individual, family or group therapy sessions Prescription of psychotropic medications or explanations about the use and management of medications Combinations of therapeutic approaches to address multiple problems

Substance Abuse Treatment ServicesSubstance abuse treatment services provided by licensed or certified professionals, designed to prevent, reduce, eliminate or deter relapse of substance abuse or addictive behaviors. Client intake and assessment Outpatient treatment for up to thirty days Group and individual counseling Drug testing

TransportationCosts of travel by program participants to and from medical care, employment, child care, or other facilities that provide eligible essential services; and cost of staff travel to support provision of essential services. Cost of a program participant’s travel on public transportation Mileage allowance for service workers to visit participants Purchasing or leasing a vehicle used for transport of participants and/or staff serving participants, including the cost gas insurance 34 of gas, insurance, taxes and maintenance for the vehicle Travel costs of staff to accompany or assist program participants to use public transportation

Services for Special PopulationsOtherwise eligible essential services tailored to address the special needs of homeless youth, victims of domestic violence and related crimes/threats, and people living with HIV/AIDS in emergency shelters. Case Management Legal Services Child Care Education Services Employment Assistance and Job Training Life Skills Training Mental Health Services Substance Abuse Treatment Services Outpatient Health Services Transportation

Rehabilitation and Renovation

Renovating buildings to be used as emergency shelter for homeless families and individuals. Minimum use periods apply for buildings that are rehabilitated, converted or renovated. Labor Materials Tools Other costs for renovation, including soft costs Major rehabilitation of an emergency shelter Conversion of a building into an emergency shelter

Shelter OperationsCosts to operate and maintain emergency shelters and also provide other emergency lodging when appropriate. *Hotel or motel vouchers are only eligible when no appropriate emergency shelter is available. Maintenance ( including minor or routine repairs) Food Rent Security Furnishings Equipment Supplies necessary for the operation of the emergency shelter Fuel Insurance Utilities Hotel or motel voucher for family or individual*

Eligible Costs Category #3: Homeless Prevention &

Eligible Costs Category #4: Rapid Re-Housing

Overarching Principles

Eligible Program Participants:

Rapid Re-housing: Individuals and families who are literally homeless, meaning those who qualify under paragraph (1) of the definition of homeless.

Homelessness Prevention: Individuals and families who are at imminent risk, or at risk, of homelessness, meaning those who qualify under paragraph (2) and (3) of the homeless definition or those who qualify as at risk of homelessness. Individuals and families must have an income at, or below, 30% of AMI.

Overview of Eligible Activities: Short- and medium-term rental assistance and housing relocation and stabilization services. Staff salaries related to carrying out rapid re-housing and homelessness prevention activities are also eligible.

Housing Relocation and Stabilization Services

Financial Assistance Moving costs –such as truck rental, hiring a moving company, certain temporary storage fees Rent application fees - as charged by the owner to all applicants Security deposit – no more than 2 months rent Last month's rent – paid to owner at time of security deposit and first months rent are paid Utility deposit – as required by utility company for all customers Utility payments – up to 24 months per participant per service including up to 6 months or arrearages, per service

Services Housing search & placement Housing Stability Case Management Mediation Legal Services Credit repair

Housing Search and Placement

Assessment of housing barriers, needs and preferences Development of an action plan for locating housingHousing search and outreach to and negotiation with owner Assistance with submitting rental applications and understanding leases Assessment of housing for compliance with ESG requirements for habitability, lead based paint, and rent reasonableness Assistance with obtaining utilities and making moving arrangements Tenant counseling

Housing Stability Case ManagementAssessing, arranging, coordinating, and monitoring the delivery of individualized services to facilitate housing stability. Using the centralized or coordinated assessment system, conduct the initial evaluation and re-evaluation Counseling Developing, securing and coordinating services including Federal, state, and local benefits Monitoring and evaluating program participant progressProviding information and referrals to other providers Developing an individualized housing and service plan

MediationMediation between the program participant and the owner or person(s) with whom the program participant is living, to prevent the program participant from losing permanent housing in which they currently reside.

Time and/or services associated with mediation activities

Legal ServicesLegal services that are necessary to resolve a legal problem that prohibits the program participant from obtaining or maintaining permanent housing. Hourly fees for legal advice and representation Fees based on the actual service performed (i.e., fee for service), but only if the cost would be less than the cost of hourly fees Client intake, preparation of cases for trial, provision of legal advice, representation at hearings, and counseling Filing fees and other necessary court costs Subrecipient’s employees’ salaries and other costs necessary to perform the services, if the subrecipient is a legal services provider and performs the services itself

Legal representation and advice may be provided for: Landlord/tenant matters Orders of protection and other civil remedies for victims ofdomestic violence, dating violence, sexual assault, and stalking Child support Guardianship Paternity Emancipation Legal separation Resolution of outstanding criminal warrants

Appeal of veterans and public benefit claim denialsThe services must be necessary to resolve a legal problem that prevents a participant from obtaining or maintaining permanent housing.

Credit RepairServices necessary to assist program participants with critical skills related to household budgeting, managing money, accessing a free personal credit report, , and resolving personal credit problems. **Assistance cannot include the payment or modification of a debt. Credit Counseling Other related services

Short- and Medium-Term Rental Assistance Short term up to 3 months, Medium term 4 – 24 months Rental arrearages may be a one-time payment of up to 6 months, including any late fees on those arrearages Any combination of the three types of rental assistance listed above, not to exceed 24 months during any 3-year period, including any payment for last month’s rent.

Tenant Based Rental Assistance – program participants select a housing unit in which to live (may be within a specified service area) and receive rental assistance

Project Based Rental Assistance – recipients or subrecipients identify permanent housingunits that meet ESG requirements and enter into a rental assistance agreement with the owner to reserve the unit and subsidize its rent so that eligible program participants have access to the units.

Discretion to Set CapThe applicant agency may set a maximum dollar amount and maximum period for which a program participant may receive any of the types of assistance or services described within the regulatory maximums.

Eligible Costs Category #5: HMISOverarching Principles

• Recipients and subrecipients: All recipients and subrecipients may pay the costs of contributing data to the CoC’s HMIS.• Recipients and subrecipients that use comparable databases: Victim service providers and legal service providers may use ESG funds to pay the costs of establishing and operating a comparable database.

Participation Requirement - The HEARTH Act makes HMIS participation a statutory requirement for ESG recipients and subrecipients. Victim service providers cannot, and Legal Services Organizations may choose to not, participate in HMIS. These providers must use a comparable database that produces unduplicated, aggregate reports, instead.

Hardware, Equipment and Software Costs- Purchasing or leasing computer hardware- Purchasing software or software licenses- Purchasing or leasing equipment, including telephones,faxes and furnitureStaffing: Paying salaries for operating HMIS, including:- Data collection- Completing data entry- Monitoring and reviewing data quality- Completing data analysis- Reporting to the HMIS Lead- Training staff on using the HMIS or comparable database- Implementing and complying with HMIS requirementsTraining and Overhead- Obtaining technical support- Leasing office space- Paying charges for electricity, gas, water, phone service and high-speed data transmission necessary to operate or contribute data to the HMIS- Paying costs of staff to travel to and attend HUD-sponsored and HUD-approved training on HMIS and programs authorized by Title IV of the McKinney-Vento Homeless Assistance Act- Paying staff travel costs to conduct intake- Paying participation fees charged by the HMIS Lead, if the recipient or subrecipient is not the HMIS Lead.

Comparable Database Costs for Victim Services Providers or Legal Services ProvidersIf the subrecipient is a victim services or a legal services provider that use a comparable database, it may use ESG funds to establish and operate a comparable database that collects client-level data over time and generates unduplicated aggregate reports based on the data.* Activities already defined under this component that allow for the establishment and operation of a comparable database

E. BUDGET PROTOCAL

Provide detail to clearly identify expenses. Categories may be changed or eliminated to

properly address the program budget. Identify the ESG Component for which funding is requested at the top of the budget: (i.e. - Street Outreach, Emergency Shelter, Homeless Prevention or Rapid Re-Housing. Applicant may only submit for one component plus HMIS per application).

Categories of Expense: Utilize the Category Headers and detail language in the Eligible Expense Section for the ESG Component to be implemented (Subtotal Categories (personnel, operations, services, capital costs, etc.) highlight subtotal lines

Example: (Eligible Activity/Component: Street Outreach)Expense Categories: Engagement, Case Management, Emergency Health Services, Emergency Mental Health Services, Transportation, Services to Special Populations

Detail provided under each category will be the specific expense items to carry out that function.

Personnel Costs – Must be the first line items of your budget (Regardless of Category)Identify full or part-time, % of time to program: Example 1FTE Case Manager .5. Provide fringe benefits at the bottom of personnel as a separate line item.

Other expenses – Specifically identify expense type i.e.: Utilities define by type: gas, electricity. Telephone break out equipment, service, cell phones, etc.

Administration Expenses – Include administration expenses on the separate Personnel Budget form to demonstrate capacity. Administration expenses are not an eligible cost under this RFP.

PERSONNEL BUDGET FORMStaff providing direct client service for the ESG eligible activity proposed must be included on this form. The Executive Director and Lead Accountant, are not eligible for ESG funding as administrative positions, but must be included on this budget table, demonstrating agency capacity to implement the program.Cost Category: Personnel CostsNOTE: Job Descriptions for Must Be Attached To Budget Detail Form

Agency Name:____________________________________________ Project Name:__________________________________________

A B C D E F G H

# OFPOSITIONS

POSITION TITLE MONTHLY SALARY

ANNUAL SALARY

% OF TIME TO PROGRAM

AMOUNT OF SALARY

FOR PROGRAM

IMPLEMENTATION (DxE)

AMOUNT OF

PROGRAM IMPLEMENT

ATION SALARY

BILLED TO ESG

AMOUNT OF PROGRAM

IMPLEMENTATION SALARY ALLOCATED

TO MATCH(IF ANY)

Executive Director

Accountant

TOTALS

Funding sources for Executive Director ______________________________________________________________________________________

Funding sources for Accountant / Bookkeeper ________________________________________________________________________________

Administrative and organizational staff time not eligible match. Use additional sheets as needed.

Name of Program _________________________________________________________________________PROGRAM BUDGET

Fiscal Year – Twelve Month BudgetESG Eligible Component _________________________________________

ESG Eligible Expense ESG Expense Other Funding Source

Total Cost

PERSONNEL

Fringe

Personnel subtotal

Eligible ESG Component Expenses

TOTALS (Sum each column)Use additional sheets if required. Column 3, ESG Expense, must total the entire amount requested. Utilize a separate sheet HMIS budget, if also requesting HMIS funding.

F. MATCHING SHARE:

Identify any non-McKinney-Vento Act funds and in-kind funds for matching share to be contributed in support of the proposed project.

Matching Funds: Identify an amount equal to or the requested amount of ESG funds. The amount of these supplemental funds may include the value of any donated material or building; the value of any lease on a building; any salary paid to staff in carrying out the emergency shelter program; and the time and services contributed by volunteers to carry out the program based upon a $5 per hour rate, in-kind donations, Shelter Partnership or Food Bank contributions to the program. Funds must be contributed to and used by the ESG funded program for ESG eligible activities between July 1, 2012 and June 30, 2013.

Source Match Amount Period Available

Cash or In-Kind From To

TOTAL MATCH, SUM of Column 2 (must be equal to the amount of ESG funds requested.)

SITE CONTROL

(1) Site currently occupied by Applicant? ___Yes ___ No

(2) Does the applicant/shelter: Own, Rent, Lease, Lease with option?

$____________Per month

If Lease, Term of Lease: From _______ To _________

If Lease, are any of the items below included in the Lease?

Electricity ___Yes __No $_______________________Gas ___Yes __No $_______________________Water ___Yes __No $_______________________Garbage ___Yes __No $_______________________

Total Rent/Lease/Utility $_______________________

(3) Project Zoning:

Zoning Designation: General Plan Designation: Designation Permit Shelter Use: __Yes __No If not, Entitlement Requirement:

__ Zoning Variance__ Conditional Use Permit Waiver, granted

by:________________________ Standard "R" Zoning

___________Number of persons

Certificate of Occupancy

OBJECTIVES, OUTCOMES AND OUTPUTS

HUD has prescribed a specific menu of objectives and outcomes to be used for all funded projects to standardize achievements reporting on a local, state and national level. Please evaluate your proposed projects according to the following definitions. Identify which objectives your project will address; then identify the proposed outcome your project will achieve. Please choose 1 objective and 1 outcome per project. Place a check mark indicating your choice. Keep in mind, if your project is funded, this information will be utilized in preparation the FY2013-2014 Annual Plan and in reporting your accomplishments in the year-end Consolidated Annual Performance and Evaluation Report (CAPER).

Objectives:

Suitable Living Environment . Includes activities that benefit communities, families, or individuals by addressing issues in their living environment such as public services, emergency essential services, capital improvements, neighborhood revitalization, etc.

Decent Affordable Housing. Includes the wide range of housing programs possible under HOME, CDBG or ESG where the purpose of the program is to meet individual family or community needs and not programs where housing is an element of a larger effort (such as would be captured above in Suitable Living Environment).

Creating Economic Opportunities: Includes activities related to economic development, commercial revitalization, or job creation.

Outcomes:

Availability/Accessibility. Activities that make services, infrastructure, housing or shelter availability or accessible to low-income people, including persons with disabilities. Accessibility includes making the affordable basics of daily living available and accessible to low-income people.

Affordability. Activities that provide affordability in a variety of ways in the lives of low-income people. Includes the creation or maintenance of affordable housing, basic infrastructure, or services such as transportation or day care.

Sustainability: Promoting Livable or Viable Communities. Projects where the activity or activities are aimed at improving communities or neighborhoods, helping to make them livable or viable by providing benefit to low-income people or by removing or eliminating slums or blighted areas, through multiple activities or services that sustain communities or neighborhoods

Objective and Outcomes: Check one box in each table below that best reflects your projects and outcomes. If your agency was funded for more than one project, please submit a separate form for each project that indicates the objectives and outcomes for that project. See sections above for projects applicable to each objective and outcome.

Objective Check One Outcome Check OneSuitable Living Environment

Availability/Accessibility

Decent Affordable Housing

Affordability

Creative Economic Opportunities

Sustainability: PromotingLivable or Viable

Communities

G. PERFORMANCE MEASUREMENT SYSTEM AND OUTCOMES STATEMENT

Agency Name: Program Name:Benchmarks Indicate benchmarks with numerical values

OutcomesIndicate outcomes with percentages

Eligible Category: Essential Services, Operations or Homeless Prevention

Service or Activity to fill Need

Output Goal (units of service)

Achievement Outcome goal (difference to the community)

Measurement Reporting Tools

Evaluation Process

Short Term

Intermediate

Long Term

Eligible Category – show which ESG eligible component the project will implementService or Activity- name the ESG eligible service or activity that will be delivered (e.g. life skills workshops, employment placement assistance, utility bill payment)Output Goal – Set specific, quantifiable goals, including time frames. This will allow the City to monitor program progress.Achievement Outcome – State the proposed outcome for the actual impact you hope to achieve (i.e. 30% are able to renew and maintain positive family relationships, 10% achieve employment, 72% achieve housing stability)Measurement Reporting Tools- list the tools you will use to track output and/or outcome information (e.g. case reports, pre- and post-tests, etc.)Evaluation Process- identify the methodology you will use to assess success in meeting outputs goals and outcomes.

ATTACHMENT A (1 OF 1)

ATTACHMENT A: BOARD OF DIRECTORS AFFIDAVIT

All applicant agencies must complete this affidavit listing the members of the Board of Directors. If there are changes in the Board Membership after the proposal is submitted, the Grants Administration Division of the City of Pomona must be notified in writing of the changes. Note with an asterisk (*) any Board members that are City of Pomona residents, or consumers or previous consumers of homeless, at-risk of homelessness or low income services.

I, ___________________________________________________________ (please print), depose and say

that

I am_______________________________________________, (President, Vice President, etc.) of

_____________________________________________________________, (Name and address of

organization), which submits this proposal. The only other members of the Board of Directors and other

officers of this organization are:

Board Member Name Address

Use an additional sheet if necessary. Deposer must sign all Director’s Affidavit pages.

Signature of Deposer and date _______________________________________________________________

Name of deposer (print or type) ______________________________________________________________

ATTACHMENT B (1 OF 3)

ATTACHMENT B: STATEMENT OF CERTIFICATIONS

(a) It possesses the legal authority to apply for the grant, and to execute the proposed program;

(b) Its governing body has duly adopted or passes as an official act or resolution, motion, or similar action authorizing the fining of the application, including all understandings and assurances contained therein, and authorizing the applicant's chief executive officer or other designee to act in connection with the application and to provide such additional information as may be required;

(c) It will comply with the policies, guidelines and requirements of OMB Circular A-87 and A-102 as they relate to the acceptance and use of EMERGENCY SOLUTIONS GRANTS amounts by local governments, and A-110 and A-122 as they relate to the acceptance and use of EMERGENCY SOLUTIONS GRANTS amounts by private non-profit organizations.

(d) It will comply with the following regarding non-discrimination:

(1) Title VIII of the Civil Rights Act of 1968 and implementing regulations;(2) Executive Order 11063 and implementing regulations;(3) Title VI of the Civil Rights Act of 1964 and implementing regulations;(4) The Age Discrimination Act of 1975 and Section 5043 of the Rehabilitation Act

of 1973;(5) Executive Order 11246 and implementing regulations;(6) Section 3 of the Housing and Urban Development Act of 1968;(7) Executive Orders 11625, 12432, and 12138 regarding encouragement of

minority and women's business participation;(8) The prospective contractor's signature affixed hereon and dated shall constitute

a certification under penalty of perjury under the laws of the State of California that the bidder has, unless exempted , complied with the non-discrimination program requirements of Government Code Section 12990 and Title 2, California Administrative Code, Section 8103;

(e) For major rehabilitation or conversion, it will comply with the Uniform Federal Accessibility Standards (24 CFR Part 40, Appendix A);

(f) No person who is an employee, agent, consultant, officer, or elected or appointed official of the non-profit recipient that receives EMERGENCY SOLUTIONS GRANTS amounts and who exercises or has exercised any functions or responsibilities with respect to assisted activities or who is in a position to participate in a decision-making process or gain inside information with regard to such activities, may obtain a personal or financial interest or benefit from the activity, or have an interest in any contract, subcontract, or agreement


with respect hereto, or the proceeds there under, either for him or herself or those with whom he or she has family or business ties, during his or her tenure or for one (1) year thereafter;

(g) It will comply with the applicable requirements of the Lead Based Paint Poisoning Prevention Act and implementing regulations;

(h) It will not comply, award contracts to, or otherwise engage the services of any contractor while that contractor is in a period of debarment, suspension, or placement in ineligibility status under the provision of 24 CFR Part 24;

(i) It will maintain records necessary to document compliance with applicable requirements and will give HUD, the City of Pomona, or any of their authorized representatives access to and the right to examine all records related to the grant;

(j) It will supplement its grant amount with an equal amount of funds from sources other that this grant after the date of grant award;

(k) Reports required by the City or HUD shall be submitted in a timely manner and contain all required information as can reasonably be made available;

(l) The requirements of 24 CFR 576.21(a)(4)(ii) providing that the funding of homeless prevention activities for families that have received eviction notices or notices of termination of utility services will not supplant funding for pre-existing homeless prevention activities from any other source;

(m) The requirements of 24 CFR 576.51(b)(2)(iii) concerning the submission by non-profit organizations applying for funding of a certification of approval of the proposed project(s) from the unit of local government in which the proposed project is located;

(n) The requirements of 24 CFR 576.51(b)(2)(v) concerning the funding of emergency shelter in hotels or motels or commercial facilities providing transient housing;

(o) The requirements of 24 CFR 576.73 concerning the continued use of buildings for which EMERGENCY SOLUTIONS GRANTSs or used for rehabilitation or conversion of buildings for use as emergency shelters for the homeless; or when funds are used solely for operating costs or essential services, concerning the population to be served;

(p) The building standard requirements of 24 CFR 576.75;


(q) The requirements of 24 CFR 576.77, concerning assistance to the homeless;

(r) The requirements of 24 CFR 576.79, other appropriate provision of 24 CFR Part 576, and other applicable Federal laws concerning non-discrimination and equal opportunity;

(s) The requirements of 24 CFR 576.80 concerning the Uniform Relocation Assistance and Real Property Acquisition Policies Act of 1970; and,

(t) The requirement of 24 CFR 576.80 concerning minimizing the displacement of persons as a result of a project assisted with these funds.

This certification is made under penalty of perjury.

CERTIFYING OFFICIAL:

____________________________________(Print Name)

____________________________________(Signature)

____________________________________(Date)

ATTACHMENT C (1 OF 3)

ATTACHMENT C: OTHER FEDERAL REQUIREMENTS

Use of the EMERGENCY SOLUTIONS GRANTS Program requires compliance with the following additional requirements:

(a) Non-discrimination and Equal Opportunity .

(1) The requirements of Title VIII of the Civil Rights Act of 1968, 42 U.S.C. 3601-19 and implementing regulations; Executive Order 11063 and implementing regulations at 24 CFR Part 107; and Title VI of the Civil Rights Act of 1964 (42 U.S.C. 2002d-1) and implementing regulations issued at 24 CFR Part 1.

(2) The prohibitions against discrimination on the basis of age under the Age Discrimination Act of 1975 (42 U.S.C. 6101-7) and the prohibitions against discrimination against handicapped individuals under Section 504 of the Rehabilitation Act of 1973 (29 U.S.C. 794);

(3) The requirements of Executive Order 11246 and the regulations issued under the Order at 41 CFR Chapter 60; and,

(4) The requirements of Section 3 of the Housing and Urban Development Act of 1968, 12 U.S.C. 1801u (see 570.607 (b) of this Chapter); and,

(5) The requirements of Executive Orders 11625, 12432, and 12138. Consistent with HUD's responsibilities under these Orders, the grantee must make efforts to encourage the use of minority and women's business enterprises in connection with activities funded under this part.

(b) Applicability of OMB Circulars . The policies, guidelines, and requirements of OMB Circulars Nos. A-87 and A-102, as they relate to the acceptance and use of EMERGENCY SOLUTIONS GRANTS amounts by States and units of general local government, and nos. A-110 and A-122 as they relate to the acceptance and use of EMERGENCY SOLUTIONS GRANTS amounts by private non-profit organizations.

(c) Uniform Federal Accessibility Standards . For major rehabilitation or conversion, the Uniform Federal Accessibility Standards at 24 CFR Part 40, Appendix A.

(d) Lead-Based Paint . The requirements, as applicable, of the Lead-Based Paint Poisoning Prevention Act (42 U.S.C. 570.611(d) and (e) of this chapter).


(e) Conflicts of Interest . In addition to conflict of interest requirements in OMB Circulars A-102 and A-110, no person who is an employee, agent, recipient, officer, or elected or appointed official of the grantee, State recipient, or non-profit recipient (or of any designated public agency) that receives EMERGENCY SOLUTIONS GRANTS amounts and who exercises or has exercised any functions or responsibilities with respect to assisted activities or who is in a position to participate in a decision making process or gain inside information with regard to such activities, may obtain a personal or financial interest or benefit from the activity, or have an interest in any contract, subcontract or agreement with respect thereto, those with who he or she has family or business ties, during his or her tenure or for one year thereafter. HUD may grant an exception to this exclusion as provided in 570.611(d) and (e) of this chapter.

(f) Use of debarred, suspended, or ineligible contractors . The provisions of 24 CFR Part 24 relating to the employment, engagement of services, awarding of contract, or funding of any contractors or subcontractors funding any period of debarment, suspension, or placement in ineligibility status.

(g) Flood Insurance . No site proposed on which renovation, major rehabilitation, or conversion of a building is to be assisted under this part, other than by grant amounts allocated to State, may be located in an area that has been identified by the Federal Emergency Management Agency (FEMA) as having special flood hazards, unless the community in which the area is situated is participating in the National Flood Insurance Program and the regulations there under (44 CFR Parts 59-79 or less than a year has passed since FEMA notification regarding such hazards), and the grantee will ensure that flood insurance on the structure is obtained in compliance with section 102(a) of the Flood Disaster Protection Act of 1973 (42 U.S.C. 4001 et seq.

(h) Audit . The financial management system used by a State or unit of local government that is a grantee or State recipient shall provide for audits in accordance with 24 CFR Part 44. A private non-profit organization is subject to the audit requirements of OMB Circular A-110.

In addition to, and not in substitution for, other provisions of this agreement, the Recipient:

1. Represents that if it is, or may be deemed to be a religious or denominational institution or organization or an organization operated for religious purposes which is supervised or controlled by or in connection with a religious or denominational institutional or organization; and,


2. Agrees that, in connection with such essential services and operational costs

a. it will not discriminate against any employee or applicant for employment on the basis of religion and will not limit employment or give preference in employment to persons on the basis of religion;

b. it will not discriminate against any persons seeking emergency shelter and related services on the basis of religion and will not limit such services or give preference to persons on the basis of religion;

c. it will provide no religious instruction or counseling, conduct no religious worship or services, engage in no religious proselytizing, and exert no other religious influence in the provision of housing or emergency services; and,

d. the portion of the facility used as an emergency shelter assisted in whole or part under this agreement shall contain no sectarian or religious symbols or decorations.

(i). Building Standards (subpart 576.75) Any building for which EMERGENCY SOLUTIONS GRANTS amounts are used for renovation, conversion, or major rehabilitation must meet local government safety and sanitation standards.

(j). Relocation and Acquisition (subpart 576.80) Minimizing displacement - Consistent with other goals and objectives of this Part, grantees and recipients must assure that they have taken all reasonable steps to minimize the displacement of persons (families, individuals, businesses, non-profit organizations, and farms) as a result of a project assisted under this part.

(k). Drug-Free Workplace Act of 1988. The sub-recipient will comply with maintaining a drug-free work site by enforcing the requirements of 24 CFR Part 24, subpart F.

CERTIFYING OFFICIAL:

____________________________________ (Print Name)

____________________________________(Signature)

____________________________________(Date)

ATTACHMENT D: STATEMENT OF CONFIDENTIALITYFOR

VICTIMS OF FAMILY VIOLENCE

____________________________________________(Agency Name)Assures that it will adopt policies which meet at least the minimal standards for protecting the confidentiality of information as set forth in the State Information Practices Act (Civil Code 1798, et. seq.).

__________________________________________(President, Board of Directors

__________________________________________(Date)

__________________________________________(Executive Director)

__________________________________________(Date)

ATTACHMENT E: CERTIFICATION OF RELIGIOUS COMPLIANCE

________________________________________, agrees to provide all eligible activities under this program in a manner that is free from religious influences and in accordance with the following principles:

A. It will not discriminate against any employee or applicant for employment on the basis of religion and will not limit employment or give preference in employment to person on the basis of religion.

B. It will not discriminate against any person applying for shelter or any of the eligible activities under this program on the basis of religion and will not limit such housing or other eligible activities or give preference to person on the basis of religion; and

C. It will provide no religious instruction or counseling, conduct no religious worship or services, engage in no religious proselytizing, and exert no other religious influence in the provision of shelter and other eligible activities under this program.

_________________________________________(Signature of Executive Director)

____________________________ (Date)

ATTACHMENT F: APPEALS PROCESS FOR CLIENT TERMINATIONS

An organization requesting funds under the EMERGENCY SOLUTIONS GRANTS Program must state its formal appeal process for the termination of any homeless families or individuals assisted, who may violate established program requirements of the project. This process must recognize the rights of the affected individuals and may include a hearing. The formal process must be stated below or attached.

________________________________________________________________________

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