Fill - Free fillable Cherokee Nation Education Services is submitting an application (Cherokee Nation) PDF form

Cherokee Nation Education Services is submitting an application to the Office of Community Services for

supplemental funding through the Community Services Block Grant (CSBG) Coronavirus Aid, Relief and

Economic Security (CARES) Act.

The purpose of the CARES Act is to address and mitigate the spread of COVID-19 by providing critically

needed resources to meet community needs.

The Cherokee Nation CARES Act plan will focus on assisting low income families and individuals in

attaining adequate literacy and education by offering additional funding to public schools that serve 60-

95% low income students. The plan in its entirety can be reviewed during the period of Tuesday,

September 8 to Monday, September 21, 2020. The Cherokee Nation invites citizens and other interested

parties to review and comment on the CSBG CARES Act plan. Comments may be sent via one of these

methods by 5:00pm Tuesday, September 21, 2020.

Email: nancy-scott@cherokee.org

Telephone: 918-506-8777

Mail: Cherokee Nation

Attn: Chrissy Marsh

PO Box 948

Tahlequah, OK 74465

Lux Consulting Group, Inc. is proud to serve Native American communities as the Community Services Block Grant

(CSBG) Tribal Training & Technical Assistance Program provider. This publication was created by Lux Consulting

Group, Inc. in the performance of the U.S. Department of Health and Human Services, Administration for Children and

Families, Office of Community Services, Grant Number #GS-10F-0328T/75P00119F80215. Any opinion, findings, and

conclusions, or recommendations expressed in this material are those of the author(s) and do not necessarily reflect

the views of the U.S. Department of Health and Human Services, Administration for Children and Families.

FY20 CSBG Tribal CARES Act Plan

Fillable-PDF Tool

for Tribes & Tribal Organizations

FY20 CSBG Tribal CARES Act Plan Fillable-PDF Tool

Instructions

The CSBG Tribal CARES Act Plan Fillable-PDF Tool is provided as a technical

assistance tool to assist grantees in producing the CSBG Tribal CARES Act Plan as

required in the Coronavirus Aid, Relief, and Economic Security Act, 2020, Public

Law 116-36.

For more information about the CSBG CARES Act Supplemental Administrative

Guidance, see Information Memorandum (IM) 2020-158.

For more information about the CSBG Immediate Guidance on COVID-19

Response, see Information Memorandum (IM) 2020-157.

As you work through the application, remember that help is available anytime from

the CSBG Tribal T/TA team at tribalta@luxcg.com or (301) 244-3557.

A few important notes:

1. Download this Fillable-PDF Tool onto your computer and save it before

you open it in Adobe Acrobat to begin working on it. Loss of data will

occur if the tool is not downloaded, saved, and opened in the Adobe

Acrobat program prior to entering data.

2. Grantees who submitted a one- or two-year CSBG Tribal Plan in FY20 received

CSBG CARES Act supplemental funding and are required to submit a CSBG

Tribal CARES Act Plan with information specific to CSBG CARES Act

supplemental funding by September 30.

3. Where signatures are required, wait until the entire application is fully complete

before adding signatures.

4. All boxes on the form require data entry or the form will not be saved properly. If

there is a box that is not applicable to your organization, please indicate “N/A”

for not applicable in the box.

FY20 CSBG Tribal CARES Act Plan Fillable-PDF Tool

OLDC Access

Current CSBG Grant Administrators: Login to the OLDC System and confirm that

CSBG is listed as one of your programs. If you are unable to log in or do not have

CSBG listed as one of your programs, complete an OLDC Access Form and submit

to Niki Frazier, OCS Senior Records Specialist/Project Lead, at

nikita.frazier@acf.hhs.gov.

New CSBG Grant Administrators: To gain access to the OLDC System, new

administrators of current CSBG grantees must complete an OLDC Access Form and

email it to Niki Frazier, OCS Senior Records Specialist/Project Lead, at

nikita.frazier@acf.hhs.gov.

For more information on accessing the OLDC System, please review our Guide to the

OLDC System webinar and materials.

FY20 CSBG Tribal CARES Act Plan Fillable-PDF Tool

CSBG Tribal CARES Act Plan

SF-424M Form

All grantees must complete an updated SF-424M Form with their CSBG Tribal

CARES Act Plan submission.

☐ The Tribe or Tribal Organization will complete the electronic SF-424M form in

the OLDC system.

Section 1 - CSBG Tribal Administrative Information/Transmittal Letter

Provide the following information in relation to the Tribe or Tribal Organization

designated to administer CSBG.

The following information should mirror the information provided on the Application

for Federal Assistance, SF-424M.

1.1 Name of Tribe or Tribal Organization:

1.2 Authorized Tribal Official to receive the CSBG Grant Award: Contact

information for the Authorized Tribal Official (Chairperson/Chief/CEO) who is to

receive the CSBG Grant Award is as follows:

1.2.a Authorized Tribal Official Name:

1.2.b Authorized Tribal Official Title:

✔

Cherokee Nation

Tralynna Sherrill Scott

Treasurer

FY20 CSBG Tribal CARES Act Plan Fillable-PDF Tool

1.2.c Street Address:

1.2.d City, State, Zip Code:

1.2.e Telephone:

1.2.f Fax:

1.2.g Email:

1.2.h Website:

1.3 Tribal CSBG Program Contact Person: Individual designated within the Tribe

or Tribal Organization to take the lead in administering the Community Services

Block Grant and serve as the primary contact on all programmatic activities. The

Tribal Program Contact Person information is as follows:

1.3.a CSBG Program Contact Person Name:

1.3.b CSBG Program Contact Person Title:

P O Box 1669

Tahlequah, OK 74465-1669

918-453-5052

918-458-6157

grants@cherokee.org

www.cherokee.org

Tanya Johnson

Director, Grant Services

FY20 CSBG Tribal CARES Act Plan Fillable-PDF Tool

1.3.c Street Address:

1.3.d City, State, Zip Code:

1.3.e Telephone:

1.3.f Fax:

1.3.g Email:

1.4 Delegation of Authority: Is this Tribe or Tribal Organization’s Authorized Tribal

Official (Chairperson/Chief/CEO) delegating signature authority to any other

individual to sign assurances, certifications, and other required CSBG

documents on their behalf?

☐ No, Chairperson/Chief/CEO does not delegate authority to another

individual.

☐ Yes, Chairperson/Chief/CEO does delegate authority to another individual.

If yes, signature authority is delegated to the following additional

Authorized Tribal Official:

1.4.a Name of Authorized Official:

1.4.b Title of Authorized Official:

P O Box 1669

Tahlequah, OK 74465-1669

918-453-5303

918-458-6157

grantdevelopment@cherokee.org

✔

Tralynna Sherrill Scott

Treasurer

FY20 CSBG Tribal CARES Act Plan Fillable-PDF Tool

1.4.c Telephone Number:

1.4.d Email:

1.5 Statement of Assurance Regarding Tribal & Administrative Status:

I hereby affirm that the following remain the same as those documented in our

approved FY2020 CSBG Tribal Plan:

1.5.a ☐ Federal or State recognition status

1.5.b ☐ Tribal CSBG administrative structure

1.5.c ☐ Tribal resolutions endorsing the Tribe or Tribal Organization to apply

for CSBG funding on their behalf (for applicants representing more than one

Tribe.)

1.6 Statement Regarding Certifications, Programmatic, Administrative and

Fiscal Assurances, and Assurance on Limitations:

All CSBG CARES Act supplemental funding is subject to the signed

certifications; programmatic, administrative, and fiscal assurances; and

assurance on limitations included in the FY20 CSBG Tribal Plan:

1.6.a ☐ Yes, the Tribe or Tribal Organization affirms that the certifications;

programmatic, administrative, fiscal assurances, and assurance on

limitations will be followed and adhered to.

1.7 Chairperson/Chief/CEO Signature for CSBG Tribal Administrative

Information/Transmittal Letter:

1.7.a Name of Tribe or Tribal Organization:

918-453-5052

grants@cherokee.org

✔

Cherokee Nation

FY20 CSBG Tribal CARES Act Plan Fillable-PDF Tool

1.7.b Chairperson / Chief / CEO Name:

1.7.c Chairperson / Chief / CEO Title:

1.7.d Chairperson / Chief / CEO Signature:

Reminder:

➢ Wait until the entire CSBG Tribal CARES Act Plan is fully complete

before adding signature.

Section 2 - CSBG Tribal CARES Act Plan Public Review

2.1 CSBG Tribal CARES Act Plan Public Review:

Notes:

➢ Evidence must be provided that the CSBG Tribal CARES Act Plan was made

publicly available for review and comment (e.g. via the Tribe or Tribal

Organization’s website) for a reasonable timeframe. (OCS recommends a

minimum of 10 business days.)

➢ Evidence must also be provided that the Tribe or Tribal Organization specifically

notified stakeholders that the CSBG Tribal CARES Act Plan was available for

public review and comment.

2.1.a ☐ Yes, the Tribe or Tribal Organization made the CSBG

Tribal CARES Act Plan publicly available for review and comment for a minimum

of 10 business days.

Chuck Hoskin, Jr.

Principal Chief

✔

click to sign

signature

click to edit

FY20 CSBG Tribal CARES Act Plan Fillable-PDF Tool

2.1.b Public Review Details:

Method of Public Review

Describe the means by which the CSBG Tribal CARES Act

Plan was made available for public review and comment.

Dates

Enter a range of dates.

(mm/dd/yyyy to mm/dd/yyyy)

2.1.c Notification to Stakeholders:

Notification Method

Describe the means by which stakeholders were notified that

the CSBG Tribal CARES Act Plan was available for public

review and comment.

Dates

Enter dates.

(mm/dd/yyyy)

Section 3 - Individual and Community Income Eligibility Requirements

Notes:

➢ CSBG CARES Act requires that services be provided to those who meet

specific CSBG income guidelines (not to exceed 200% of the FPL).

➢ Information Memorandum (IM) 2020-157: Immediate Guidance on COVID-19

Response clarified that Tribes and Tribal organizations have substantial

discretion in defining the procedures for determining if an individual or family

meets the eligibility requirements for CSBG, including the timeframes for review

and necessary documentation appropriate to the services or strategies being

implemented. CSBG grantees were encouraged to review existing procedures

and establish emergency procedures, if appropriate, to streamline the eligibility

determination process for the duration of the national public health emergency.

Notice posted on Cherokee Nation website under Public

Notices page and Education Services page

09/08/2020 to 09/21/2020

Email sent to Superintendents of the 60 schools written in the

plan.

09/08/2020

FY20 CSBG Tribal CARES Act Plan Fillable-PDF Tool

3.1 Describe policies and/or procedures for determining eligibility.

The entities targeted for the CARES Act funds will be public schools that serve

60-95% low income students. The sixty schools deemed eligible are located within

the fourteen county area of the Cherokee Nation reservation. The low income status

of the schools were determined using the 2020 low income report submitted by the

schools to the Oklahoma State Department of Education Nutrition Program. The

information provided in the report is used to calculate the percentage of students

eligible for the free and reduced lunch program.

FY20 CSBG Tribal CARES Act Plan Fillable-PDF Tool

3.2 Describe policies and/or procedures when individual income verification is not

possible or practical.

With the public schools that serve a high number of low income students being the

primary focus of this plan, individual applications of students, parents or households

will not be necessary. The low income report mentioned in 3.1 above considers all

children in a household with at least one household member receiving benefits from

an assistance program as automatically qualified for free meals. Examples of

assistance programs cited are: Supplemental Nutrition Assistance Program (SNAP),

Temporary Assistance for Needy Families (TANF), and Food Distribution Program

for Indian Reservations (FDPIR). These assistance programs use a designated

percentage above the Federal Poverty Guideline (FPG) as a qualifier for income but

is below the 200% of FPG designated for the CARES Act funds for income eligibility.

Other programs or situations viewed as automatic qualifiers for the free lunch

program are households with a child or children enrolled in Head Start, homeless

children, migrant children, runaways receiving assistance and children in foster care.

FY20 CSBG Tribal CARES Act Plan Fillable-PDF Tool

3.3 Describe how the Tribe or Tribal Organization ensures that services target and

benefit low-income communities, for those services that provide a community-wide

benefit.

Section 4 - Purpose of Funds

Note: This section is optional. If you are not providing this description, indicate “N/A” for

not applicable.)

4.1 Provide a description of the activities supported with CARES Act supplemental

funds, including activities that will address at least one of the following three areas

(4.1.a, 4.1.b, and 4.1.c, as applicable):

The Cherokee Nation service area consists of eight full counties (Adair, Cherokee,

Craig, Mayes, Nowata, Rogers, Sequoyah, Washington) and six partial counties

(Delaware, McIntosh, Muskogee, Ottawa, Tulsa, Wagoner) in northeastern

Oklahoma. The highest percentage of low income individuals live in Adair,

Cherokee, Delaware, Sequoyah and Mayes County. Forty five, or 75%, of the

schools under this plan are located in these five counties. With the exception of

McIntosh and Tulsa counties, there is at least one low income school located in each

of the remaining seven counties that will benefit from this program.

FY20 CSBG Tribal CARES Act Plan Fillable-PDF Tool

4.1.a

1) Assisting low-income families and individuals in: (i.) removing obstacles

that block the achievement of self-sufficiency; (ii.) secure and retain

meaningful employment; (iii.) attain adequate literacy and education; (iv.)

make better use of available income; (v.) obtain and maintain adequate

housing; (vi.) obtain emergency assistance; and/or (vii.) achieve greater

participation in the affairs of the communities.

Provide a description of activities that assist low-income families/individuals in

removing obstacles. (If you are not providing this service or this description, indicate

“N/A” for not applicable.)

A survey of the public schools in the Cherokee Nation service area was conducted in

July of this year to determine the most pressing issues the schools were facing due

to COVID-19. The survey revealed the greatest needs were: (1) providing enough

devices for the students; (2) connectivity issues; (3) maintaining licensing of

software; (4) personal protective equipment (PPE); (5) staff development on distance

learning. Through COVID-19 relief funds from various funding sources, the

Cherokee Nation was able to provide supplemental funding to the public schools to

help address these needs. However, it is anticipated some or all of these issues will

be continuous throughout the school year. The CARES Act funds will serve as

additional funding for low-income schools to help address any lingering issues

previously identified or any new issues brought about by COVID-19.

FY20 CSBG Tribal CARES Act Plan Fillable-PDF Tool

4.1.b

2) Addressing the needs of youth in low-income communities through youth

development programs.

Provide a description of activities that address the needs of youth in low-income

communities. (If you are not providing this service or this description, indicate “N/A”

for not applicable.)

N/A

FY20 CSBG Tribal CARES Act Plan Fillable-PDF Tool

4.1.c

3) Making more effective use of, and coordinating with, other programs

related to the purposes of the CSBG Act.

Provide a description of activities that coordinate with other programs communities

related to the purpose of the CSBG Act. (If you are not providing this service or this

description, indicate “N/A” for not applicable.)

N/A

FY20 CSBG Tribal CARES Act Plan Fillable-PDF Tool

4.2 Linkages to Fill Service Gaps: Provide a description of how funds were utilized

to develop linkages to fill identified gaps in services. For example, through the

provision of information, referrals, case management, and follow up consultations. (If

you are not providing this description, indicate “N/A” for not applicable.)

Using different funding sources, the Cherokee Nation was able to provide an

opportunity for children, 5 to 18 years old, to apply for an educational stipend of

$400. The stipend was intended to help ease the impact of COVID-19 for Cherokee

families and could be used for Wi-Fi connectivity, specialized software or

technological equipment for distance learning. Applicants had to be Cherokee

citizens with no requirements of income or residency. Even with this opportunity, the

public schools that serve a high number of low income students will have students

with unmet technological needs. Cherokee students who are not enrolled in the

Cherokee Nation were not eligible to apply for the stipend nor were students who are

members of a different tribe. The low income students that are not Cherokee tribal

members were also not able to take advantage of the stipend. The CARES Act funds

will be made available to the sixty schools with emphasis placed on helping fill gaps,

such as technological devices, that exist in the services provided for low income

students.

FY20 CSBG Tribal CARES Act Plan Fillable-PDF Tool

4.3 Public-Private Resource Coordination: Provide a description of how funds will

be coordinated with other public and private resources. (If you are not providing this

description, indicate “N/A” for not applicable.)

The CARES Act funds will be coordinated through sixty public schools located in the

Cherokee Nation service area that serve 60-95% low income students. The

Superintendents of the schools will be notified of available funding to be directed

toward any lingering or new burden placed on the school due to COVID-19. The

schools will be awarded funds through an application process coordinated through

the Education Services Department.

FY20 CSBG Tribal CARES Act Plan Fillable-PDF Tool

4.4 Innovative Community and Neighborhood-based Initiatives: Provide a

description of how funds will be used to support innovative and neighborhood-based

initiatives. (If you are not providing this description, indicate “N/A” for not applicable.)

N/A

FY20 CSBG Tribal CARES Act Plan Fillable-PDF Tool

Signature

Review and confirm that you have provided all of the necessary information. It is also

helpful to save your PDF again. Once all answers are complete, the signature of the

Tribe or Tribal Organization’s Authorized Official can be added to the following

section:

➢ Section 1, Item 1.7.d

End of Form

Once the signature has been added, save your final signed PDF file. It is ready to be

uploaded to the OLDC System as part of your official CSBG Tribal CARES Act Plan

submission.

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