Fillable ESG COVID 2- Application 91020 Final Draft.ashx (Fulton County Government)

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ESG COVID 2- Application 91020 Final Draft.ashx (Fulton County Government)

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ESG COVID-19 1
Fulto
n County Department of Community Development
Homeless Division
Emergency Solutions Grant COVID-19 (2) Application
Release Date: September 11, 2020
Due Date: 11:59 p.m., September 27, 2020
ESG COVID-19 2
I. OVERVIEW & ELIGIBILITY
1. Fulton
County is making available funds awarded through the Department of Housing and Urban Development
(HUD) and the Coronavirus Aid, Relief, and Economic Security Act (CARES Act) to Fulton County municipalities with
the exception of Atlanta, and nonprofit agencies providing eligible services in Fulton County, outside of the city of
Atlanta to support their response to local needs related to the homeless activities and the COVID-19 pandemic.
Please note that grant funds are reimbursable; your agency must have the capacity and cash flow to incur eligible
costs. The County encourages collaborative submissions which define a strategic approach to addressing critical
needs in our community.
2. The primary objective of the ESG-CV Program is to prevent, prepare for, and respond to the coronavirus, among
Individuals, and families who are homeless or receiving homeless assistance and to support additional homeless
assistance and homelessness prevention activities to mitigate the impacts created by coronavirus.
3. Funds may be used to cover or reimburse allowable costs to eligible ESG CV homeless activities included in
“Attachment A” of this document.
4. This program is funded and regulated at the federal level by the U.S. Department of Housing and Urban
Development (HUD) and administered locally by the Fulton County Department of Community Development. It is
authorized under the Coronavirus Aid, Relief, and Economic Security Act (CARES Act).
5. This funding application is for the period beginning September 1, 2020.
6. A Selection Committee will review all applications for compliance with requirements and make funding
recommendations to the Fulton County Board of Commissioners (BOC).
7. Client Income Limits
• For Homelessness Prevention and Rapid Rehousing assistance, households must have an income at or below
50% AMI to receive homelessness prevention, or to continue receiving rapid re-housing assistance.
FY 2020
ESG-CV Extremely Low Income Limits (50% AMI)
Area
1-person
2-person
3-person
4-person
5-person
6-person
7-person
8-person
Atlanta-Sandy Springs-
Roswell, GA HUD Metro
FMR Area
$28,950
$33,100
$37,250
$41,350
$44,700
$48,000
$51,300
$54,600
Click Here for an
Explanation
8. All
ESG-CV funded agencies are required to participate in the Homeless Management Information System (HMIS)
ClientTrack.
9. Funding Cycle: This application is for the ESG-CV 19 federal allocation.
• ESG-CV 19: Grant agreement will be from September 1, 2020 for a 12 month or 18 month period.
• Estimated Funds Available: $1,609,778.00.
• Grant Allocation: $50,000.00 minimum and $150,000.00 maximum.
ESG COVID-19 3
II. IMPLEMENTATION TIMELINE
1. Phase One
• Application public release, on September 11, 2020.
• Application is due by 11:59 p.m., on September 27, 2020.
o Submit questions and applications to: HomelessInfo@fultoncountyga.gov
o Technical Assistance Zoom call: 2 to 3:30 p.m., on September 17, 2020.
o Meeting ID: https://zoom.us/j/96262640130?pwd=UW5zRTJ4NkpEQUJ1UUZtL2xrREdkZz09
o Meeting ID: 962 6264 0130
o Passcode: 241011
• Selected Agency/Municipality and program summary will be submitted to the Fulton County Board of
Commissioners for a final approval.
2. Phase Two
• Applicant notifications will be released per the approval of the Fulton County Board of Commissioners.
• Selected Agency’s MOU execution process will commence per the approval of the Fulton County Board
of Commissioners.
III. APPLICATION CHECKLIST
Submission Requirements
Check if
Enclosed
1. The applicant must
a. have nonprofit status for at least one (1) full
year, or
b. have two (2) full years of operating experience
under another nonprofit entity, or
c. be a local governmental entity or agency
(governmental agencies can skip to line 5)
2. The applicant must be registered to conduct
business in the State of Georgia at the time of
application. (Not applicable to governmental
agencies)
3. The applicant must have an audit or audited
financial statements (if budget is less than
$25,000 annually) prepared by a qualified
accountant or accounting service, covering the
last two most recent reporting periods of
operation. Copies of each audited financial
statement must be submitted with the
application. Reviews and Compilations will not
be accepted. Audit findings will make the
applicant ineligible to receive assistance. (Not
applicable to governmental agencies)
4. Non-profit organizations must have an active
Board of Directors within the last 12 months. (Not
applicable to governmental agencies)
ESG COVID-19 4
Submission Requirements
Check if
Enclosed
5. The applicant must have at least twelve (12)
months experience directly related to the
proposed project or program.
6. The applicant must submit a written copy of its
financial management procedures, including staff
responsibilities and required procedures.
7. Each applicant must submit proof of insurance for
the following types of insurance: General Liability,
Auto Liability, and Worker’s Compensation
8. Each applicant must submit proof that the
organization has registered with the U.S. System
for Award Management. Visit www.sam.gov
9. The contract period for the project, if approved,
will begin:
ESG COVID-19: 12 to 18 month contract.
10. Resolution that authorizes the submission of the
application.
All submitted materials will be used in determining the organization’s eligibility for funding.
IV. AGENCY INFORMATION
Agency Name:
Mailing Address:
Telephone Number:
Email:
Contact Person:
Title:
DUNS Number:
Tax ID #:
PROGRAM INFORMATION
Program Title:
Program Location:
If prior years funding is
available, would you
want to be considered
for these funds?
☐ YES
☐ NO
If yes, please let us know how soon after signing an agreement could your project start?
☐ Immediately (within first 30 days), ☐ 2-4 months, or ☐ ☐5-7 months
Anticipated completion date: ______________________________________________
ESG COVID-19 5
Have you received
CDBG CV, Fulton
County CV, State, or
Federal Funding?
☐ YES
☐ NO
If Yes, provide the following:
Award Source and Amount(s): ________________________________________________
Award(s) Period: ___________________________________________________________
Award Activity (s): __________________________________________________________
V. PROGRAM COST AND REQUESED FUNDING
Category
Request
Street Outreach/Shelter
Homelessness Prevention/Rapid Rehousing
Total ESG-CV Request
Total Program Cost
VI. DISTRICT SERVICE AREA
Service Area
1
2
3
5
6
Street Outreach
Emergency Shelter
Homelessness Prevention/Rapid Re-Housing
VII. EVALUATION CRITERIA
1. Appli
cations are evaluated using the following criteria
•
Organization Capacity (40 points); Budget (20 points); Financial Capacity (20 points); Target Population (10
points) and Sustainability (10 points)
VIII. TARGET POPULATION
1. Brief
ly describe the target population/category of persons to be served in Fulton County
(i.e. seniors 62+,
homeless, abused children or women, or persons with disabilities). (300 words maximum)
___________________________________________________________________________________________
All clients served must certify as Homeless per 24 CFR 576.2. Please select the following hyperlink for more
information: 24 CFR 576.2. (300 Words Maximum)
IX. PERFORMANCE OBJECTIVES & OUTCOMES
Select two objectives that best describes your project
□
Provide affordable housing to people experiencing or most at risk of homelessness.
□
Upgrade Housing Condition.
□
Provide permanent supportive housing to end chronic homelessness.
ESG COVID-19 6
□
Advance housing stability for vulnerable populations, including youth aging out of the foster care and juvenile
justice systems, Veterans, and persons who are being discharged from hospitals and criminal justice
institution.
□
Increase meaningful and sustainable employment for people experiencing or most at risk of homelessness.
□
Improve access to mainstream programs and services to reduce people’s financial vulnerability to
homelessness.
□
Integrate primary and behavioral health care services with homeless assistance programs and housing to
reduce people’s vulnerability to and the impacts of homelessness.
X. PROPOSED SERVICES
Please list the proposed number of persons to be served in each applicable service activity.
Service Description
Number of Persons Served
Street Outreach
Emergency Shelter
Homeless Prevention/Rapid Re-Housing
Total Persons to be Served
XI. ORGANIZATIONAL CAPACITY
1. Brief
ly describe the program/project
accomplishments by outlining the objectives and outcomes of the previous
two (2) years. (300 words maximum). __________________________________________________________
2.
Provide a description of the proposed project for funding. Include supporting data used to identify the need(s) for
the proposed program (i.e. community input, surveys, and input from other agencies) in your response. (300
words maximum). ___________________________________________________________________________
3.
Describe and discuss your organization’s experience with utilizing an HMIS database or other comparable
reporting system. (100 words maximum). _______________________________________________________
4. What is your organization’s current intake and recordkeeping process… include
measures taken to ensure the
protection of sensitive client information. (300 words maximum) _____________________________________
5. What percentage of the Organization’s budget is grant funded? (N/A for municipalities) ___________________
6. How many program staff persons are dedicated to this project? _______________________________________
(i.e., Case Managers, Intake Coordinators)?
XII. BUDGET
Street Outreach
Line Items
ESG CV Funds
Other Funds
Total Funds
1. Engagement
$
$
2. Case Management
$
$
3. Emergency Health Services
$
$
4. Emergency Mental Health Services
$
$
5.Transportation
$
$
6. Services for Special Populations
$
$
Total Street Outreach
$
$
ESG COVID-19 7
Emergency Shelter
Essential Services
Line Items
ESG CV Funds
Other Funds
Total Funds
1. Case Management
$
$
2. Childcare
$
$
3. Education Services
$
$
4. Employment Assistance
$
$
5. Outpatient Health Services
$
$
6. Legal Services
$
$
7. Life Skills Training
$
$
8. Mental Health Services
$
$
9. Substance Abuse Treatment Services
$
$
10. Transportation
$
$
Shelter Operations
1. Minor or Routine Repairs
$
$
2. Rent/Lease Payments
$
$
3. Security
$
$
4. Fuel
$
$
5. Equipment
$
$
6. Insurance
$
$
7. Utilities
$
$
8. Food
$
$
9. Furnishings/Bedding
$
$
10.Custodial Supplies
$
$
11. Office Supplies and Printing
$
$
Renovations
1. Labor
$
$
2. Materials/Tools
$
$
3. Major Rehabilitation
$
$
4. Conversion
$
$
5. Total
$
$
Total Emergency Shelter
$
ESG COVID-19 8
Homelessness Prevention & Rapid Re-Housing
Financial Assistance
Line Items
ESG CV Funds
Other Funds
Total Funds
1. Rental Application Fees
$
$
2. Security Deposit
$
$
3. Last Month’s Rent
$
$
4. Utility Deposit / Payments
$
$
5. Moving Costs
$
$
Service Costs
1. Housing Search/ Placement
$
$
2. Housing Stability Case
Management
$
$
3. Mediation and legal service
$
$
4. Credit Repair/Budgeting
$
$
Rental Assistance
1. Short Term Rental
Assistance (up to 3)
$
$
2. Medium Term Rental
Assistance (4-24)
$
$
Total Homelessness Prevention
& Rapid
Re-housing Component
$
$
XIII. BUDGET NARRATIVE
1.
Provide a budget narrative for each line item that is listed in your budget, provide a detailed description of how
ESG-CV funds will be used to support your program. (300 words maximum) _______________________________
XIV. SUSTAINABILITY
1. Wha
t is your organization’s mission statement? (100 words maximum)
If your organization is a government entity,
enter N/A. ____________________________________________________________________________
2. How long has the Organization existed in its current form? ___________________________________________
3. How long has the Organization had its 501 (c) (3) status? If your organization is a government entity, enter N/A.
___________________________________________________________________________________________
4. How many years has the Organization conducted the project/program for which it is requesting funding? _____
5. Provide the source and amount of funding commitments, as well as, additional funding awarded in the past three
years for this project. ____________________________________________________________________
Attach additional page(s) documents, if needed.
ESG COVID-19 9
XVI. APPLICATION EVALUATION
• Upo
n receiving each application, the Homeless Division will verify that the application is complete, including required
attachments. Incomplete proposals will be considered non-responsive and will be issued a declination notice.
• Complete proposals will be evaluated and scored by the Homeless Division.
XVII. EXPECTATIONS
• Agen
cy/Municipality will engage in direct or modified, per local COVID-19 standards, client contact to conduct
client/household assessment.
• Agency/Municipality will engage in client contact, per local COVID-19 standards, (in person or via telephone) and
provide appropriate supportive services to clients
• The agency/municipality will engage in direct client contact, per local COVID-19 standards, to identify household’s
needs and appropriate interventions.
• Agency/Municipality will utilize HMIS.
• Agency/Municipality must be accessible to households experiencing homelessness, including the offering of flexible
hours (evenings/weekends) and methods, e.g. phone screening.
• Agency /Municipality will make client records and HMIS data available for system performance and monitoring
purposes by Fulton County.
• Agency/Municipality should ensure services provided are accessible to clients i.e. via phone or in person.
• Agency/Municipality will provide service delivery and appointment times that meet the needs of clients including early
mornings, evenings, and weekends.
• Agency/Municipality will provide case plans, as appropriate, that identify objectives and delineation of responsibilities.
XVIII. OPERATIONAL SPECIFICATIONS
The
awardee will be required to submit a current Certificate of Declaration of Insurance, with Fulton County Government
added as an “Additional Insured”. Language reflecting “Fulton County Government as an “Additional Insured” must be
stated on the certificate.
All applicants are required to submit FORM F: Georgia Security and Immigration Contractor Affidavit and Agreement
and as applicable FORM G: Georgia Security and Immigration Subcontractor Affidavit.
XIX. SIGNATURE PAGE
Letter from an Authorized Certifying Official is attached with the following resolution that authorizes the submission of
the application.
ESG COVID-19 10
Name of Applicant: _____________________________________________________________________________
Be it resolved that the Board of Directors or Council of the above-referenced Applicant resolved at its meeting date
referenced below, to authorize the Applicant to submit an application to the Fulton County Department of Community
Development, Homeless Division office for grant funding. The individual referenced below is authorized to execute any
documents necessary for application submission and funding.
Meeting Date: ________________________________________________________________________________________
Amount Requested: ___________________________________________________________________________________
Executor: ___________________________________________________________________________________________
I hereby certify that the foregoing resolution was approved by our Board of Directors of Council.
____________________________________________________ __________________________
Certifying Official (Signature, Name & Title) Date
I certify that I have completed the application for Fulton County ESG-CV Act funding. All information contained in this
submission has been completed as thoroughly and as accurately as possible, and a governing body resolution or letter
from an authorized certifying official approving the submission has been attached. Through this submission, I have
defined other funding sources received confirming that if selected for funding, these funds will not supplant or duplicate
current sources.
Prepared by (Signature & Date): __________________________________________________________________________
Prepared by (Printed Name & Title): ______________________________________________________________________
Approved by (Signature & Date): __________________________________________________________________________
Approved by (Printed Name & Date):_______________________________________________________________________
ESG COVID-19 11
ATTACHMENT A
I. ELIGIBLE EXPENSES
A. Emergency Shelter Services
• Shelter Operations (Infectious Disease Preparedness)
o Transportation (Train or bus tokens, taxi or rideshare for program participant to travel to and from
medical care
o Equipment: washers, dryers, portable handwashing
o Furnishings: cots, room dividers
o Supplies
▪ Cleaning supplies such as bleach, disinfectant wipes, scrubbers, mops
▪ Program participant needs such as bed lines, towel, hand sanitizer, soap and tissue packets
▪ Projective equipment such as masks, disposable gloves
• Hotel/Motel Vouchers
• Case Management
• Childcare
• Education services
• Employment assistance and job training
• Legal services
• Mental health services
• Life skills training
• Outpatient health services
• Substance abuse treatment services
• Transporation
B. Provision of temporary shelters (through leasing of existing property, temporary structures, or other means) to
prevent, prepare for, and respond to the coronavirus.
C. Homelessness Prevention/Rapid Re-Housing Services
• Financial Services
o Moving costs
o Rental application fees
o Security deposit
o Last month’s rent
o Utility deposit
o Utility payments
• Housing Relocation and Stabilization Services
o Housing Search & Placement
o Housing Stability Case Management
o Mediation
o Legal Services
o Credit Repair
• Rental Assistance
o Short-term (up to 3 months)
o Medium-term (up to 24 months)
o Rental arrears (one-time payment for up to 6 months of arrears)
• Street Outreach
o Engagement – (Urgent Physical needs) Hand Sanitizer, soap, tissue packets, masks
o Engagement (Equipping Staff) Masks, disposable gloves, hand sanitizer, other personal protective
equipment
o Case Management – Coordinating medical care
o Emergency Health Services
o Emergency Mental Health Services
ESG COVID-19 12
o Transportation: Train, or bus tokens, taxi or rideshare for program participants to travel to and from
medical care.
o Services for Special Populations
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Completed 13 February 2021

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