prince william area continuum of care · william area continuum of care ranking ... fy 2017 coc...

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FY 2017 CoC Grant Application

Continuum of

Care Program

Grant Application

Application must be e-mailed to

[email protected] by 5pm

Monday, August 4, 2017

Prince William Area

Continuum of Care

Name:

Agency Score:

______ / ______

Total points possible: 100

Bonus points possible: 5 points

mailto:[email protected]

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FY 2017 Continuum of Care Program Scoring Criteria

Each project applicant will be ranked using Scoring Tool developed by the Program and

Analysis Ranking (PAR) Committee. The scoring criteria is based on performance and

completion. Each applicant project is evaluated and ranked in accordance with the Prince

William Area Continuum of Care Ranking Procedures to decipher all funding allocations.

Section 1: Agency Component

Fiscal Capacity 8 points 8%

Governance 2 points 2%

Staff Training 1 point 1%

Section 2: Project Component

Housing First Narrative 20 points 20%

Benchmarks Narrative 10 points 10%

Budget and Financial Management 31 points 30%

Additional Applicant Attachments 2 points 2%

Homeless Management Information

System (HMIS)

5 points 5%

Service Delivery 21 points 21%

Total Points Possible: 100

Section 3: Bonus Section

SOAR Staff Training 2 points 2%

Continuum of Care Attendance 3 points 3%

Total Bonus Points: 5

All of the following attachments must be included with the application for both physical

and electronic copies. Failure to submit the following attachments will void your

application.

Attachment Scoring Criteria

Required Attachments Agency Component

Agency’s latest IRS Form 941 – Employer’s

Quarterly Federal Tax Return (Not necessary

for Governmental Agencies)

Submitted with application

Agency Organizational Chart Submitted with application

Agency’s most recent Annual Performance

Report (APR)

Submitted with application. The Program and

Ranking committee will look at agency

APR’s for reported percentage of permanent

housing exit destinations and increases in

income.

Audit management letter, Independent

Auditors report, or other written certification

from the CPA


Board Resolution Requesting Funds Submitted with application

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Financial/Accounting Policy and Procedure or

Explanation


First two pages of latest submitted IRS Form

990


List of Board of Directors Submitted with application

Management Response to Audit Submitted with application

Match Tracking System for cash and/or in-

kind


Required Attachments for Project Component

25% Match Verification Submitted with application

Housing Inspection form Submitted with application

If a DV provider and applicable, a copy of a

database report covering your last grant year


If applicable, applicant response to PWC DSS

monitoring report


If applicable, PWC DSS monitoring report Submitted with application

Project Budget Submitted with application

Additional required attachments

Conflict of Interest Policy (Staff) Submitted with application

Drug Free Workplace (Staff) Submitted with application

Non-discrimination Policy (Staff) Submitted with application

Position Descriptions and Responsibilities

(Staff)


Sexual Harassment Policy (Staff) Submitted with application

Standards of Professional Conduct (Staff) Submitted with application

Confidentiality Policy (Client) Submitted with application

Grievance Policy (Client) Submitted with application

Non-discrimination Policy (Client) Submitted with application

Formatting and Presentation Requirements

Applicants must provide six complete printed applications and attachments to the

Homeless Services division of Prince William County Department of Social Services at

14716 Potomac Mills Rd., Woodbridge, VA, 22192 on August 4, 2017 by 5pm.

The six physical applications must be displayed in a binder or spiral bound. If the

applicant does not meet this requirement, the application will be voided.

An electronic copy of the complete application and attachments must be submitted to

[email protected] on August 4, 2017 by 5pm.

All application questions must be answered in 12 pt. Times New Roman font or the

application will be voided.

Applications must include coversheets to separate each individual section. These

coversheets are included in the application itself.

Failure to meet one or all of the formatting and presentation requirements will void your

application.

mailto:[email protected]

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Agency and Project Information

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Agency and Project Information

Agency Name:

Project Name:

Name and Grant Number of all Current U.S. Department of Housing and Urban

Development (HUD) Projects:

1.

2.

3.

4.

Project Type:

Select one project type per

application

Rapid

Re-Housing

(RRH)

Permanent Supportive

Housing (PSH)

Transitional Housing (TH) and Permanent Housing-Rapid Re-

Housing (RRH) - Permanent Housing Bonus

Project Service Delivery: Total number of Beds project

will provide:

Total number of Households

project will serve:

Permanent Supportive Housing: Select all

that apply $143,940

$143,194

$8,137

Rapid Rehousing: $195,656

Amount of Funding Available for TH

Permanent Housing-RRH bonus project:

Select one project type per application

$97,450

CoC Competition Year: 2017

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Secondary Contact Information

Name: Title:

Address: Phone:

E-mail:

Primary Contact Information

Name: Title:

Address: Phone:

E-mail:

E-SNAPS

Application

Will the primary or secondary contacts be available August

16th to September 5th for immediate response to questions

for e-snaps submission?

Yes No

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Agency Component

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Fiscal Capacity: 8 points

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Fiscal Capacity: 8 points 1. What are the dates of your agency’s

fiscal year? (Sample 7/1 – 6/30) 1 point for completion

2. a. Does the agency have an

independent financial audit

completed within 6 months of the end

of the most recent fiscal year?

1 point with attachment

Yes No

If no, applicant is not eligible for HUD CoC

funding.

If yes: Attach most recent Management letter.

b. Did the agency have finding(s) for

the independent financial audit

completed within 6 months of the end

of the fiscal year?

2 points with attachments

Yes No

If yes: Attach management letter and management

response letter.

3. Does the agency have the fiscal

capacity to operate all of its HUD

CoC grants?

2 points with attachments

Yes No Attach:

First two pages of latest submitted IRS

Form 990/990EZ.

Latest IRS Form 941.

4. Does agency have specific

accounting procedures for tracking

grants expenditures that align with

budgets and comply with grants

requirements?


Yes No

If yes: Attach accounting procedure manual or

explanation.

5. Does agency have a system to track

matching funds, both cash and in-

kind?


Yes No

If yes: Attach match of tracking system for both

cash and in-kind

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Governance: 2 points

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Governance: 2 points 1. Does your agency have a homeless or

formerly homeless representative on

your Board of Directors?

Yes No

2. Attach a list of your Board of Directors. 1 point for attachment

3. Please attached current organizational chart. 1 point for attachment

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Staff Training: 1 point

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Staff Training: 1 point 1. Does your agency provide or have staff participate in training about best practices in

services for persons who are homeless? Yes No

If Yes, list trainings that were provided and number of staff who attended for the past

year: 1 point for at least two listed.

Please limit response to 500 characters (including spaces).

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Project Component: 30 points

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Housing First Narrative: 20 points

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Narrative: All projects must complete this question to be considered for funding. Failure to

complete this section will void your application. 20 points

Provide a complete and concise description of the proposed project and how it utilizes the

housing first service model. It must include a clear picture of the community/target

population(s) to be served, the plan for addressing the identified needs/issues of the CoC

community/target population(s), projected outcome measure(s), any coordination with other

source(s)/partner(s), data sources/data usage for project evaluation, strategies and expected

outcomes used to quickly move participants into permanent housing, benchmarks and data

used to meet the expected outcomes and that assurances are in places to remove barriers from

program eligibility.

Please limit response to 3,000 characters (including spaces).

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Performance Measures Narrative: 10 points

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Narrative: All projects must complete this question to be considered for funding. Failure to

complete this section will void your application. 10 points

Provide a complete and concise description of how the proposed project addresses the three

Performance Measure Benchmarks. Include data measurement(s) used for project evaluation,

strategies and projected outcomes for how the project will perform on performance

benchmarks in the future.

Performance Benchmark #1: Reduce the Length of Time Program Participants Spend

Homeless.

Performance Benchmark #2: Permanent Housing Success Rates.

Performance Benchmark #3: Returns to Homelessness.


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Budget and Financial Management: 31 points

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Budget and Financial Management – 31 points 1. Please provide the proposed budget for this project. 25 points

Rental Assistance

$ % of total

Leasing

$ % of total

Operations

$ % of total

Supportive Services

$ % of total

Administration

$ % of total

Questions 2-8: Current Renewal provider applicant only – GSHF

Questions 5-6: All other applicants 2. Renewal projects: Does this project

submit invoices to PWC DSS to

draw down funds from HUD’s Line

of Credit Control System (LOCCS)

at least quarterly?

Yes No

3. Have all HUD funds been drawn

down for the last two grant years?

Yes No If no, how much was unspent each

year?

If no, provide an explanation


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4. What is the total amount of your

current grant?

5. What is the total amount of

financial match your agency

supplied for the last two CoC grant

years or other grant-funded project?

1 point with attachment showing 25% or

more for both grant years.

6. What is the total amount of your documented leveraging for the grant you are

applying for? (Leverage is over and above match. An amount that is listed as

leverage in the project application may not also be listed as match on the project

budget. Any financial assistance that comes from public or private resources can be

counted as cash leverage. Services (counseling, legal advocacy, etc.) and physical

goods (food, furniture, clothing, etc.) can be counted as in-kind leverage. The funds,

goods, or services would need to come directly from the source to your

organization.)

5 points if 100% or more of grant

7. Does the project have any

outstanding obligation to federal,

state, or local government that is in

arrears or has unspent funds?

Yes No

If yes, please provide explanation below. Please limit response to 2,000 characters (including spaces).

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8. Does the project have any evidence

of untimely expenditures on prior

award?

Yes No

If yes, please provide explanation below.


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Other Attachments: 2 points

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Other Applicant Information:

2 points for attachments

9. Please explain any unresolved monitoring or audit findings for any HUD grants

(including ESG) operated by the applicant?


10. Please indicate the last time the applicant was monitored by PWC DSS? If not

applicable, move to question #11.

Please attach monitoring report.

Please attach response to monitoring report.

1 point for each report

*If monitoring report and response are not attached provide explanation below


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11. Does this project conduct Housing

Inspections that coincides with the

Housing Habitability Standards

review annually?

Yes No

If Yes, please attach a blank Housing Inspection

form that is used.

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HMIS: 5 points

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HMIS: up to 5 points

1. Attach the HMIS policies and procedures that cover data quality, confidentiality,

and staff training. 5 points

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Service Delivery and Evaluation: 21 points

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Service Delivery and Evaluation:

Up to 21 points 12. a. Is there a systematic process for

ensuring that clients apply for and

receive all mainstream resources to

which they are entitled? This

includes, but is not limited to

TANF; SSI/SSDI, SNAPS;

Medicaid; Medicare; CHIP; local

behavioral, mental and physical

health care.

Yes No

b. Describe process and include staff training requirements. Up to 5 points.


13. Is there a systematic process for

clients to obtain and maintain

employment?

Yes No

2 points if Yes. 0 points if No

14. Please give an example of how you have used data to evaluate a program to improve

its efficiency and effectiveness. 2 points


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15. Does the agency participate in the

current Coordinated Entry Process? Yes No

16. Please describe your procedure for determining homeless status and chronically

homeless status for the participants in this project and attach any form utilized.

*2 points possible: for description and attachments


17. Following the “Housing First” Model, does the project ensure that participants are

not screened out based on the following items? Select all that apply. By checking all

of the first four Boxes, this project will be considered low barrier. 4 points possible

a. Active or history of substance abuse Yes No b. Criminal history Yes No c. History of domestic violence (e.g. lack

of a protective order, period of

separation from abuser)

Yes No

d. Having little to no income Yes No 18. Please identify the target populations. (Select all that apply).

Please note: TH programs must serve DV or unaccompanied youth and PSH

projects must serve the chronically homeless population or the application will be

void.

Chronically Homeless Yes No Veterans Yes No Unaccompanied Youth (18-24) Yes No Families Yes No Domestic Violence Yes No Substance Abuse Yes No HIV/AIDS Yes No Disabling Condition Yes No Mental Health Yes No

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19. Does this project exclusively serve victims of domestic violence? (Transitional

Housing for DV) Yes No If No, skip to #21, if Yes answer below:

a. What is the comparable database to

Service Point that you are using for

client data

b. Please attach a report from the database for your last complete grant year. 1 point

c. Are there policies and procedures in

place for the comparable database that

covers data quality, confidentiality,

and staff training?

Yes No

d. Does the program adhere to all

confidentiality and safety

requirements of the Violence Against

Women Act (VAWA)?

Yes No

20. Does the project ensure that participants are not terminated from this program for

the following reasons? Select all that apply. 4 points total

Failure to participate in supportive services Yes No

Failure to make progress on a service plan Yes No Loss of income or failure to improve income Yes No Being a victim of domestic violence Yes No

21. For All Supportive Services noted below, indicate providers by checking all

applicable columns. 1 point

Supportive Service Applicant Partner Non-Partner

Assessment of

Service Needs

Assistance with

Moving Cost

Child Care

Education Services

Employment

Assistance and Job

Training

Substance Abuse

Treatment

Housing Search and

Counseling Services

Transportation

Utility Deposit

Outreach Services

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Outpatient Health

Services (physical or

mental health)

Life Skills Training

Legal Services

Food

22. Does the organization have any

history of serving ineligible

program participants, expending

funds on ineligible costs, or failing

to expend funds within statutorily

established timeframes?

Yes No If Yes, please provide an explanation

below.


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Bonus Section: 5 points

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Please note any staff with SOAR Certification to receive 2 bonus points Please limit response to 500 characters (including spaces).

Did your agency meet the attendance

requirement of 80% for the Prince William

Area Continuum of Care? 3 bonus points

Yes No

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Agency and Client Policies and Procedures

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Attach the following agency policies/procedures that cover the following items. Failure

to provide below policies will void your application.

a. Non-discrimination policy

b. Sexual harassment

c. Standards of professional conduct

d. Descriptions and responsibilities for positions that are funded through HUD Funding

e. Drug Free Workplace

f. Conflict of interest policy

Attach the following client policies/procedures that cover the following items.

Failure to provide below policies will void your application.

a. Grievance policy

b. Non-discrimination policy

c. Confidentiality Policy

Truth Statement: By checking this box and entering the Authorized Representative name

in the space below, I certify that all statements and information throughout the agency and

project forms are true, complete and accurate to the best of my knowledge.

Type name and title of Authorized Representative:

Signature:

Date:

Lobbying Statement: By checking this box and entering the Authorized Representative

name in the space below, I certify that I, or any representative from my Agency will not lobby

any member of the Review Panelist in an attempt to influence their decision regarding an

applicant or project during the competition.

Type name and title of Authorized Representative:

Signature:

Date:

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Required Attachments Checklist

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Required attachments for Agency Component:

☐ Agency’s latest IRS Form 941 – Employer’s Quarterly Federal Tax Return (Not necessary for

Governmental Agencies)

☐ Agency Organizational Chart

☐ Agency’s most recent Annual Performance Report

☐ Audit management letter, Independent Auditors report, or other written certification from the

CPA

☐ Board Resolution Requesting Funds

☐ Financial/Accounting Policy and Procedure or Explanation

☐ First two pages of latest submitted IRS Form 990

☐ List of Board of Directors

☐ Management Response to audit

☐ Match Tracking System for cash and/or in-kind

Required attachments for Project Component:

☐ 25% Match Verification

☐ Housing Inspection form.

☐ If a DV provider and applicable, a copy of a database report covering your last grant year

☐ If applicable, applicant response to PWC DSS monitoring report.

☐ If applicable, PWC DSS monitoring report.

☐ Project Budget

Additional required attachments:

☐ Conflict of Interest Policy (Staff)

☐ Drug Free Workplace (Staff)

☐ Non-discrimination Policy (Staff)

☐ Position descriptions and responsibilities (Staff)

☐ Sexual Harassment Policy (Staff)

☐ Standards of Professional Conduct (Staff)

☐ Confidentiality Policy (Client)

☐ Grievance Policy (Client)

☐ Non-discrimination Policy (Client)

prince william area continuum of care · william area continuum of care ranking ... fy 2017 coc...

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