Emergency Solutions Grant Operations Manual

Oregon Housing and Community Services Emergency Solutions Grant Operations Manual Prepared by: Oregon Housing and Community Services Department Marga...
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Oregon Housing and Community Services

Emergency Solutions Grant Operations Manual Prepared by: Oregon Housing and Community Services Department Margaret VanVliet, Director

Funding Years 2011 (2nd Allocation) and Forward v. Oct. 24, 2012

725 Summer St NE, Salem, OR 97301 (503) 986-2000, FAX (503) 986-2020, TTY (503) 986-2100 www.ohcs.oregon.gov

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Table of Contents 1. Program Development ..................................................................................... 5 A. Intent....................................................................................................... 5 B. Program Standards .................................................................................. 5 C. Key Program Requirements ..................................................................... 6 D. HUD Priorities .......................................................................................... 6 E. Continuum of Care Coordination ............................................................. 7 2. Acronyms ......................................................................................................... 9 3. Definitions ...................................................................................................... 11 4. Contacts ......................................................................................................... 15 5. Eligible Activities ............................................................................................ 17 A. Street Outreach ..................................................................................... 17 B. Emergency Shelter Services ................................................................... 19 C. Homeless Prevention Services ............................................................... 21 D. Rapid Re-Housing Assistance ................................................................. 22 E. Prevention & Rapid Re-Housing Activities ............................................. 22 F. Homeless Management Information System (HMIS) ............................. 24 G. Administration....................................................................................... 25 H. Ineligible Activities/Assistance............................................................... 25 6. Citizenship Requirements and Verification ..................................................... 29 7. Eligibility ......................................................................................................... 31 A. General .................................................................................................. 31 B. Homeless Prevention Income Eligibility (only) ....................................... 31 C. Homeless Prevention Housing Status .................................................... 32 D. Rapid Re-Housing Housing Status .......................................................... 32 E. Street Outreach Housing Status............................................................. 33 F. Emergency Shelter Housing Status ........................................................ 34 G. Eligibility Re-certification ....................................................................... 34 H. Treatment of Assets .............................................................................. 35 I. Rent Assistance Models ......................................................................... 35 8. File/Verification Requirements....................................................................... 37 9. Case Management ......................................................................................... 41 10. Lease Agreements .......................................................................................... 43 11. Habitability Standards and Lead-Based Paint Inspections .............................. 45 12. Rent Reasonableness ..................................................................................... 47 13. Termination, Appeals, and Grievances ........................................................... 49 14. Financial Management ................................................................................... 51 A. Support of Salaries and Wages .............................................................. 51 Emergency Solutions Grant Program Manual

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15. 16. 17. 18. 19. 20. 21. 22. 23. 24. 25. 26. 27. 28. 29. 30.

B. Percentage of Program Components ..................................................... 52 C. Match Requirements ............................................................................. 52 D. Indirect Costs:........................................................................................ 53 E. Certification of Local Government Approval:......................................... 53 HMIS and Reporting Requirements ................................................................ 55 Monitoring ..................................................................................................... 59 Resources ....................................................................................................... 61 Appendix A: Criteria for Defining Homelessness ............................................ 63 Appendix B: Eligibility by Component ............................................................. 65 Appendix C: Income Eligibility Guidelines ....................................................... 67 Appendix D: Income Inclusion ........................................................................ 69 Appendix E: Income Exclusion ........................................................................ 70 Appendix F: Income Documentation Requirements ....................................... 75 Appendix G: Homeless/At-Risk Acceptable Documentation ........................... 81 Appendix H: Housing Options/Resources Documentation (for all ESG applicants) ...................................................................................................... 83 Appendix I: Rapid Re-Housing Eligibility Documentation for Homeless Persons .... 85 Appendix J: Homelessness Prevention Eligibility Documentation for Persons At-Risk of Homelessness ................................................................................ 91 Appendix K: Habitability Standards for ESG .................................................... 95 Appendix L: Notice on Limitation on use of Funds.......................................... 97 Appendix M: Forms ...................................................................................... 103 A. B. C. D. E. F. G. H. I.

Emergency Solutions Grant (ESG): VERIFICATION OF INCOME ................................ 105 Emergency Solutions Grant (ESG): SELF-DECLARATION OF INCOME ....................... 107 Emergency Solutions Grant (ESG: HOMELESS CERTIFICATION................................. 109 Emergency Solutions Grant (ESG): SELF-DECLARATION OF HOUSING STATUS ........ 111 Emergency Solutions Grant (ESG): RENT REASONABLENESS ................................... 113 Emergency Solutions Grant (ESG): PARTICIPANT SERVICE PLAN ............................. 115 Emergency Solutions Grant (ESG): STAFF AFFIDAVIT ............................................... 119 Emergency Solutions Grant (ESG): HABITABILITY STANDARDS ................................ 121 Emergency Solutions Grant (ESG): CERTIFICATION OF LOCAL GOVERNMENT APPROVAL ................................................................................................................. 125

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1.

Program Development A. Intent Emergency Solutions Grant (ESG) funds are intended to help individuals and families who would be homeless, but for this assistance. ESG assistance should be “needsbased,” meaning that programs should determine the amount of assistance based on the minimum amounts needed to prevent the program participant from becoming homeless or returning to homelessness in the near-term.

B. Program Standards The following program standards are required for delivering the ESG program: a. No one should be on the street for more than 30 days (this standard and performance measurement is already problematic for many of the rural communities with extreme economic hardship and will require consistent communication and flexibility to adapt on case-by-case basis). b. The Housing First approach is the housing model of choice. o NO first-come, first-served approach to housing services. o Focus will be on housing before anything else. o Individualized service plans will be developed after housing is secured o Concerns about individuals and families being able to sustain their housing should be addressed through program design rather than by screening out of assistance. o Centralized intake or standardized local process across local community will be encouraged. o Presenting issues will be measured using various tools to facilitate access to the right permanent housing program to meet immediate needs (e.g. Vulnerability Assessment Tool, Vulnerability Index and Service Prioritization Decision Assistance Tool). Shelter diversion to housing will be a key component. c. Rapid Re-Housing in 30 days or less is the overarching, statewide priority. d. Homeless prevention should only be used if the individual or household meets riskassessment and diversion criteria. o Encourage shelter diversion with prevention, which could include staying in current housing, referral to mediation services, doubling up with family/friends. o The characteristics of people who receive prevention assistance should logically mirror those of families who are actually in shelter. e. Development of a community-wide system to prevent and end homelessness will be encouraged (and conversations and tools for this work will be on-going across multiple jurisdictions). o Funds must be able to sustain the system. Emergency Solutions Grant Program Manual

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o

o

Participating Recipient/Subrecipient must demonstrate capacity to provide housing and services in accordance with funding requirements or in coordination with other community agencies. Community-wide collaboration will be necessary among all partners that provide housing and services to the homeless.

f. HMIS Data collection and reporting. g. Required Policies and Procedures: o For coordination among homeless housing and assistance providers and mainstream service providers in their service area; o For determining and prioritizing which households will receive Rapid ReHousing and Prevention Assistance; o Standards for determining amount of rent assistance, length of assistance and if there will be any adjustments over time; o Standards for determining type, amount, and duration of housing relocation and stabilization services; o Termination of participation, denial, and grievance procedures; o Confidentiality of client records.

C. Key Program Requirements The Key Program Requirements will: o Require use of centralized/coordinated intake in coordination with CoC o Coordinate with CoC on allocation of funds and performance measures o Have written standards to ensure consistent Program administration o Connect program participants with mainstream resources o Regularly re-evaluate participant eligibility o Include a Housing Stability Plan for program recipients o Require monthly meetings between program recipient and case manager D. HUD Priorities Priorities developed by HUD for ESG funding include the following: o Broaden existing emergency shelter and homelessness prevention activities o Emphasize Rapid Re-Housing o Help people quickly regain stability in permanent housing after experiencing a housing crisis and/or homelessness o Enhance alignment of ESG regulations with other HUD programs, such as CDBG, HOME, and Housing Choice Voucher program o Support more coordinated and effective data collection, performance measurement, and program evaluation HUD identifies important considerations for ESG recipients in designing local programs and setting priorities which include: o Target funds carefully Emergency Solutions Grant Program Manual

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o o o o o o

Think strategically about limited resources Invest more funds in Rapid Re-Housing Focus on results Collect quality data in HMIS Collaborate with CoCs Implement changes as needed at a community-wide level

HUD strongly encourages jurisdictions to target new funds toward assisting individuals and families living on the streets or in emergency shelter. Effective Rapid re-Housing can transition people out of homelessness quickly and decrease the overall number of people that are homeless in the community. Homelessness prevention is difficult to strategically target and potentially inefficient in reducing homelessness. Rapid reHousing should be given highest priority under ESG to ensure that existing resources – within and outside the homeless assistance system – are used as efficiently as possible.

E. Continuum of Care Coordination HUD promotes greater collaboration between ESG recipients/subrecipients and Continuums of Care in planning, funding, implementing and evaluating homeless assistance and homelessness prevention programs locally. In particular, ESG recipients/subrecipients are required to consult with the Continuum(s) of Care within their geographic area regarding: o determining how to allocate ESG funds for eligible activities; o developing the performance standards for activities funded under ESG; and o developing funding, policies, and procedures for the operation and administration of the HMIS. Examples of possible consultation process include meetings with CoC leadership and members, and joint workgroups or committees. Recipients/Subrecipients must coordinate and integrate, to the maximum extent practicable, ESG-funded activities with other programs targeted to homeless people in the area covered by the continuum of Care or area over which the services are coordinated to provide a strategic, community-wide system to prevent and end homelessness for that area. These programs include: o Shelter Plus Care Program o Supportive Housing Program o Section 8 Moderate Rehabilitation Program for SRO Program for Homeless Individuals o Veterans Affairs Supportive Housing o Education for Homeless Children and Youth Grants for State and Local Activities o Grants for the Benefit of Homeless Individuals o Healthcare for the Homeless o Programs for Runaway and Homeless Youth o Projects for Assistance in Transition from Homelessness o Services in Supportive Housing Grants Emergency Solutions Grant Program Manual

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Emergency Food and Shelter Program Transitional Housing Assistance Grants for Victims of Sexual Assault, Domestic Violence, Dating Violence, and Stalking Program o Homeless Veterans Reintegration Program o Domiciliary Care for Homeless Veterans Program o VA Homeless Providers Grant and Per Diem Program o Health Care for Homeless Veterans Program o Homeless Veterans Dental Program o Supportive Services for Veteran Families Program o Veteran Justice Outreach initiative o As well as mainstream housing, health, social services, employment, education, and youth programs for which families and individuals at risk of homelessness and homeless individuals and families may be eligible, such as:  Public housing programs  Housing programs receiving tenant-based or project-based assistance  Supportive Housing for Persons with Disabilities  HOME Investment Partnerships Program  Temporary Assistance for Needy Families  Health Center program  State Children’s Health Insurance Program  Head Start  Mental Health and Substance Abuse Block Grants  Services funded under the Workforce Investment Act Further guidance at 24 CFR 576.400 and 24 CFR 91.100(d)(e) o o

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2.

Acronyms Acronyms commonly used in this programs are: CAA

Community Action Agency

CFR

Code of Federal Regulations

COC

Continuum of Care

DHS

Department of Human Services, Oregon

ESG

Emergency Solutions Grant

FMR

Fair Market Rent

HH

Household

HMIS

Homeless Management Information System

HPRP

Homeless Prevention and Rapid Re-Housing Program

HQS

Housing Quality Standards

HUD

United States Department of Housing and Urban Development

IDIS

Integrated Disbursement and Information System

SRO

Single Room Occupancy

TTA/T &TA

Training and Technical Assistance

VA

Veteran’s Administration

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3.

Definitions At-Risk of Homelessness: Individuals and Families who: a. Have an annual income below 30% of median family income for the area; AND b. Do not have sufficient resources or support networks immediately available to prevent them from moving to an emergency shelter or another place defined in Category 1 of the “homeless” definition; AND c. Meets one of the following conditions: o Has moved because of economic reasons 2 or more times during the 60 days immediately preceding the application for assistance; OR o Is living in the home of another because of economic hardship; OR o Has been notified that their right to occupy their current housing or living situation will be terminated within 21 days after the date of application for assistance; OR o Lives in a hotel or motel and the cost is not paid for by charitable organizations or by Federal, State, or local government programs for low-income individuals; OR o Lives in an SRO or efficiency apartment unit in which there resides more than 2 persons or lives in a larger housing unit in which there resides more than one and a half persons per room; OR o Is exiting a publicly funded institution or system of care; OR o Otherwise lives in housing that has characteristics associated with instability and an increased risk of homelessness, as identified in the recipient’s (State) approved Consolidated Plan Criteria for Defining Homeless: Appendix A has a convenient chart that will help identify the definition for homeless and at-risk of homelessness. This appendix can also be found at the following link: http://www.hudhre.info/documents/HomelessDefinition_RecordkeepingRequirementsand Criteria.pdf Documentation: a. Homeless Status: Third-party documentation, whenever available, is the preferable documentation of homeless status. The exception to this is for provision of emergency assistance, including emergency shelters that provide a bed for one-night and victim service are provided. If third-party documentation is not available, utilizing other forms of already available documentation is acceptable evidence of an individual or family’s status. b.

Institutional Stay: Acceptable evidence of an institutional stay could include an oral statement made by a social worker, case manager, or other appropriate official at an institution. If an oral or written statement is not available, the intake worker must document in the case file his or her due diligence in attempting to obtain the official information.

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c.

Imminent Loss of Housing: Documentation will include a court order resulting from an eviction action, or the equivalent notice under applicable state law, AND a formal eviction notice, a Notice to Quit, or a Notice to Terminate, that require the individual or family to leave their residence within 14 days after the date of their application for homeless assistance.

d.

Unaccompanied Youth or a Family with Children and Youth Who Qualify as Homeless under ‘Other Federal Statutes’: Documentation for this status of homelessness must be included in the case file and be certified by the local non-profit, state or local government that administers the assistance under other federal statutes.

e.

Individuals and Families Fleeing, or Attempting to Flee, Domestic or Dating Violence, Sexual Assault, and Stalking (not being served by a victim service provider): The individual or head of household must certify that he/she has not identified a subsequent residence and lacks the resources or support networks, (e.g. family, friends, faith-based, or other social networks), needed to obtain housing and where the safety of the individual or family would not be jeopardized. Additionally, the status must be verified by written observation of the intake worker or by written referral from housing or service provider, social worker, health-care provider, law enforcement, legal assistance, pastoral counselor, or any other organization from which the individual or family has sought similar assistance. The information only needs to be sufficient to document the status, but does not include specific details of circumstances.

Emergency Shelter: Any facility, the primary purpose of which is to provide a temporary shelter for the homeless in general or for specific populations of the homeless and which does not require occupants to sign leases or occupancy agreements. Any project funded as an Emergency Shelter under a Fiscal Year 2010 Emergency Solutions Grant may continue to be funded under ESG. If this should change, recipients/subrecipients will be notified with 24 business hours of HUD’s notification to OHCS. Homeless: The interim ESG rule (and final rule on the Federal definition of homelessness) identifies four categories of people who are “at risk of homelessness” and therefore eligible for assistance through the ESG program: a. Literally homeless: an individual or family who lacks a fixed, regular, and adequate nighttime residence, meaning: o Has a primary nighttime residence that is a public or private place not meant for human habitation; o Is living in a publicly or privately operated shelter designated to provide temporary living arrangements (including congregate shelters, transitional housing, and hotels and motels paid for by charitable organizations or by federal, state and local government programs); or

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o

Is exiting an institution where (s)he has resided for 90 days or less and who resided in an emergency shelter or place not meant for human habitation immediately before entering that institution

b.

Imminent risk of homelessness: an individual or family who will imminently lose their primary nighttime residence, provided that: o Residence will be lost within 14 days of the date of application for homeless assistance; o No subsequent residence has been identified; AND o The individual or family lacks the resources or support networks needed to obtain other permanent housing.

c.

Homeless under other Federal statutes: unaccompanied youth under 25 years of age, or families with children and youth, who do not otherwise qualify as homeless under the definition, but who: o Are defined as homeless under the other federal statutes; o Have not had a lease, ownership interest, or occupancy agreement in permanent housing during the 60 days prior to the homeless assistance application; o Have experienced persistent instability as measured by two moves or more in the preceding 60 days; AND o Can be expected to continue in such status for an extended period of time due to special needs or barriers. Note: This definition is only allowable on Continuum of Care projects and its use must be pre-approved by HUD and follow very strict guidelines. The following link goes to the HUD Notice for this category; a copy of the Notice is also included in Appendix B: http://portal.hud.gov//huddoc/12-01cpdn.doc

d.

Fleeing, or attempting to flee, domestic violence: an individual or family who: o Is fleeing, or is attempting to flee, domestic violence; o Has no other residence; AND o Lacks the resources or support networks to obtain other permanent housing.

Project-Based Rental Assistance: Recipients or subrecipients identify permanent housing units 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 unit. Watch out for conflicts of interest. Rental Assistance: Short-term assistance is up to 3 months and Medium-term assistance is from 4 to 24 months. Duration of Rental Assistance is up to 24 months during any 3-year period, including one-time payment for up to 6 months of rent arrears on the tenant’s portion of the rent, including late fees. This assistance can be on tenant-based or project-based programs. Recipients may set a maximum dollar amount and maximum period for which a program participant may receive Emergency Solutions Grant Program Manual

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any rental assistance within the regulatory maximums. The recipient may also require program participants to share in the costs of 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. Youth: With the inclusion of youth in the new Federal definition of homeless, children (and youth) are defined as less than 25 years of age. The age definition was altered so that transition-aged youth (including those exiting foster care systems) might be adequately served in the ESG program. “Long-term period” and “frequent moves” are defined as 60 days and two moves, respectively.

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4.

Contacts Oregon Housing and Community Services Program Delivery Division Community Services Ann Brown 725 Summer St. NE, Ste. B Salem, OR 97301 Email: [email protected] Ph: 503-986-2122

Fax: 503-986-2020

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5.

Eligible Activities Appendix B is a table of eligibilities both by definition of homelessness category and program activity category. This can also be found at the following link: http://www.hudhre.info/documents/HomelessDefEligibility%20_SHP_SPC_ESG.pdf A. Street Outreach Individuals defined as Category 1, literally homeless, or Category 4, fleeing/attempting to flee DV (where the individual or family also meets the criteria for category 1) are eligible for assistance in street outreach with the following limitations: o Individuals and families must be living on the streets (or other places not meant for human habitation); AND o Be unwilling or unable to access services in emergency shelter. Eligible uses for funds within this category include engagement services, case management services, emergency health services, emergency mental health services, transportation, and services for special populations. Note: Referrals can be provided; however, direct case management for employment, health, substance abuse and other related services cannot be provided with these funds. ESG funds may be used for costs of providing essential services necessary to reach out to unsheltered homeless people; connect them with emergency shelter, housing, or critical services; and provide urgent, non-facility-based care to unsheltered homeless people. 1) Engagement Services The costs of activities to locate, identify, and build relationships with unsheltered homeless people and engage them for the purpose of providing immediate support, intervention, and connections with homeless assistance programs and/or mainstream social services and other housing programs. Engagement services must be provided to homeless individuals and families for at least the funding year for such services. Engagement Services include: making an initial assessment of needs and eligibility; providing crisis counseling; addressing urgent physical needs, such as providing meals, blankets, clothes, or toiletries; and actively connecting and providing information and referrals.

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Cell phone costs of outreach workers during the performance of engagement activities is also an eligible cost. 2) Case Management activities consist of: a) Using centralized or coordinated assessment systems; b) Conducting initial evaluations including, verifying and documenting eligibility; c) Counseling; d) Developing, securing and coordinating services and obtaining Federal, State, and local benefits; e) Monitoring and evaluating program participant progress; f) Providing information and referrals to other providers; g) Developing an individualized housing and service plan, including planning a path to permanent housing stability. Emergency Health services and Mental Health services are eligible activities to the extent that other appropriate services and treatment are unavailable or inaccessible within the community. 3) Emergency Health services include: assessing health problems; developing treatment plans; assistance in understanding health needs; providing directly or assisting to obtain appropriate emergency medical treatment; and providing medication and follow-up services. 4) Emergency Mental Health services include: crisis intervention; the prescription of psychotropic medications; explanation about the use and management of medications; and combinations of therapeutic approaches to address multiple problems. 5) Transportation costs include: public transportation for participants, mileage allowance for service workers using their own vehicles to visit program participants; the cost of gas, insurance, taxes, and maintenance for purchased or leased vehicles in which staff transport program participants and/or staff; and travel costs of staff to accompany or assist program participants to use public transportation. 6) Services for Special Populations means services that assist program participants who are victims of domestic violence, dating violence, sexual assault, or stalking, including services offered by rape crisis centers and domestic violence shelters, and other organizations with a documented history of effective work concerning domestic violence, dating violence, sexual assault, or stalking.

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B. Emergency Shelter Services ESG funds may be used for costs of providing essential services to homeless families and individuals in emergency shelters; renovating a building to be used as emergency shelter for homeless families and individuals; and operating emergency shelters. Those meeting the definition of homeless in Categories 1, 2, 3, and 4 are eligible for emergency shelter services. Essential services include: case management, child care, education services, employment assistance and job training, outpatient health services, legal services, life skills training, mental health services, substance abuse treatment, transportation, and services for special populations, (homeless youth, victim services, and services for people living with HIV/AIDS (so long as the costs of providing these services are eligible as previously listed). 1) Essential Services a) Case management activities consist of: • Using centralized or coordinated assessment systems; • Conducting initial evaluations including, verifying and documenting eligibility; • Counseling; • Developing, securing and coordinating services and obtaining 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; and • Developing an individualized housing and service plan, including planning a path to permanent housing stability b)

Child Care services are for children under the age of 13, or disabled children under the age of 18. The child-care center must be licensed by the jurisdiction in which it operates. Services include providing meals and snacks, and comprehensive and coordinated sets of appropriate developmental activities.

c)

Education services include instruction or training in consumer education, health education, substance abuse prevention, literacy, ESL and GED, including screening, assessment, testing, individual/group instruction, tutoring, books, supplies, and instructional materials, counseling, and referral to community resources.

d)

Employment assistance and job training include: classroom, online, and/or computer instruction; on the job instruction; reasonable stipends to

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program participants in employment assistance and job training programs; employment screening; assessment or testing; structured job skills and jobseeking skills; special training and tutoring; literacy training; pre-vocational training; books and instruction materials; counseling or job coaching; and referral to community resources. Outpatient Health services, Legal services, Mental Health services and Substance Abuse Treatment are eligible activities to the extent that other appropriate services and treatment are unavailable or inaccessible within the community. e)

Outpatient Health services include: assessing health problems; developing treatment plans; assistance in understanding health needs; providing directly or assisting to obtain appropriate medical treatment; preventive medical care; health maintenance services; emergency medical services; medication and follow-up services; and providing preventive and noncosmetic dental care.

f) Legal services include: child support; guardianship; paternity; emancipation; legal separation; orders of protection and other civil remedies for victims of domestic violence, dating violence, sexual assault, and stalking; appeal of veterans and public benefit claim denials; and resolution of outstanding criminal warrants. Legal services for immigration and citizenship matters and issues relating to mortgages, retainer fee arrangements, and contingency fee arrangement are ineligible costs. g) Mental Health services include: crisis intervention; individual, family, or group therapy sessions; the prescription of psychotropic medications; explanation about the use and management of medications; and combinations of therapeutic approaches to address multiple problems. h) Substance Abuse Treatment include: client intake and assessment; outpatient treatment for up to 30 days; group and individual counseling; and drug testing. Inpatient detoxification and other inpatient drug or alcohol treatment are not eligible costs. i) Transportation costs include: public transportation for participants, mileage allowance for service workers using their own vehicles to visit program participants; the cost of gas, insurance, taxes, and maintenance for purchased or leased vehicles in which staff transport program participants and/or staff; and travel costs of staff to accompany or assist program participants to use public transportation. j) Services for Special Populations means services that assist program participants who are victims of domestic violence, dating violence, sexual

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assault, or stalking, including services offered by rape crisis centers and domestic violence shelters, and other organization with a documented history of effective work concerning domestic violence, dating violence, sexual assault, or stalking. 2) Rehabilitation and Renovation costs include labor: materials; tools; and other costs for major rehabilitation of an emergency shelter or conversion of a building into an emergency shelter owned by a government entity or private non-profit organization. Buildings renovated with ESG funds must be maintained as a shelter for homeless individuals and families for not less than a period of 3 or 10 years, depending on the type of renovation and the value of the building. 3) Shelter Operation costs include: minor or routine maintenance; rent; security; fuel; equipment; insurance; utilities; food; furnishings; and supplies necessary for the operation of the emergency shelters. Where no emergency shelter is available, eligible costs may also include a hotel or motel voucher. 4) Uniform Relocation Assistance and Real Property Acquisition Policies Act of 1970 assistance include: relocation payments and other assistance to persons displaced by a project assisted with ESG funds. Persons that receive URA are not considered “program participants” for the purposes of this part, and relocation payments and other URA assistance are not considered “rental assistance” or “housing relocation and stabilization services” for the purpose of this part.

C. Homeless Prevention Services Homeless Prevention Services are housing relocation and stabilization services and short- and/or medium-term rental assistance necessary to prevent an individual or family from moving into an emergency shelter. Homeless prevention must be provided in accordance with housing relocation/stabilization requirements, shortand/or medium-term rental assistance requirements, and written standards and procedures established under 24 CFR 576.400. Individuals or families defined as Category 2, imminent risk of homeless, Category 3, homeless under other federal statutes, or Category 4, fleeing/attempting to flee DV (where the individual or family also meets the criteria for category 1) AND with an individual and family annual income not exceeding 30% of AMI are eligible for homeless prevention assistance.

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D. Rapid Re-Housing Assistance Rapid Re-Housing Assistance is housing relocation and stabilization services and short- and/or medium-term rental assistance necessary to help an individual or family move as quickly as possible into permanent housing and achieve stability in that housing. Rapid re-housing must be provided in accordance with housing relocation/stabilization requirements, short- and/or medium-term rental assistance requirements, and written standards and procedures established under 24 CFR 576.400. Individuals or families defined as Category 1, literally homeless, or Category 4, fleeing/attempting to flee DV (where the individual or family also meets the criteria for category 1) are eligible for assistance in rapid re-housing.

E. Prevention & Rapid Re-Housing Activities Eligible activities for both Homeless Prevention and Rapid Re-Housing assistance includes: Housing Relocation & Stabilization services [financial assistance costs, housing search and placement services; housing stability case management, mediation, legal services, credit repair], and short-term and medium-term housing either tenant or project based. 1) Housing Relocation & Stabilization services include: a) Financial Costs include: rental application fees; security deposits of not more than 2 month’s rent; last month’s month (which will be included in the participant’s total rental assistance, that does not exceed 24 months during any 3-year period); standard utility deposit (gas, electric, water, sewer); utility payments (per service), including up to 6 months of arrears, with the total utility payments not exceeding 24 months within any 3-year period; moving costs, which may include truck rental, moving company, and up to 3 month’s temporary storage fees, providing that costs are not incurred until after program participation begins and before move-in. Moving costs may not include arrearage temporary storage fees. b) Housing Search and Placement include: assessment of housing barriers, needs, and preferences; development of an action plan for locating housing; housing search; outreach to and negotiation with owners; assistance with submitting rental applications and understanding leases; assessment of housing for compliance with ESG requirements of habitability, lead-based paint, and rent reasonableness; assistance with obtaining utilities and making moving arrangements; and tenant counseling. c) Housing Stability Case Management include: assessing, arranging, coordinating, and monitoring the delivery of individualized services to

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facilitate housing stability for a program participant who is already in permanent housing (not to exceed 24 months), or to assist a program participant to overcoming immediate barriers to obtaining housing (not to exceed 30 days). Services include: • Using centralized or coordinated assessment systems; • Conducting initial evaluations including, verifying and documenting eligibility; • Counseling; • Developing, securing and coordinating services and obtaining Federal, State, and local benefits; • Monitoring and evaluating program participant progress; • Providing information and referrals to other providers; • Developing an individualized housing and service plan, including planning a path to permanent housing stability; and • Conducting re-evaluations. d) Mediation, providing that mediation is necessary to prevent the participant from losing their housing. e) Legal services must be necessary to resolve legal problems that prohibits the participant from obtaining or keeping housing. Legal services include: landlord/tenant matters, child support; guardianship; paternity; emancipation; legal separation; orders of protection and other civil remedies for victims of domestic violence, dating violence, sexual assault, and stalking; appeal of veterans and public benefit claim denials; and resolution of outstanding criminal warrants. Legal services for immigration and citizenship matters and issues relating to mortgages, retainer fee arrangements, and contingency fee arrangement are ineligible costs. f) Credit Repair include: credit counseling and other services related to household budgeting, managing money, accessing a free personal credit report, and resolving personal credit problems. This does not include the payment or modification of debt. Subgrantees can set a maximum dollar amount that a participant may receive financial assistance for each service listed and also set a maximum period of time for which a participant may receive these types of assistance; however, the time may not exceed 24 months during any 3-year period. Fund limits for this section will apply to the total assistance an individual receives, either as an individual or as part of a family. This assistance may not be provided to a participant who is receiving the same type of assistance through other public sources or those receiving replacement housing payments under the URA during the period of time covered by the URA payments.

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2) Short- and Medium-Term Rental Assistance provide a participant with up to 24 months of rental assistance during any 3-year period and may include arrears, or any combination of rental assistance payments. a) Short-Term Assistance is for up to 3 months rent b) Medium-Term Assistance is more than 3 months, no more than 24 months. c) Payment of Arrears must be a one-time payment of up to 6 months rent, including late fees. Rental assistance may be tenant or project based. Rental assistance payment will comply with 24 CFR 576.106.

F. Homeless Management Information System (HMIS) Whether utilized by the recipient or sub-recipients, costs for administering and working within the HMIS system are eligible uses and could include any of the following: 1) Cost of Contributing Data and Operating HMIS a) Purchasing or Leasing Computer Hardware; b) Purchasing Software or Software Licenses; c) Purchasing or Leasing Equipment including telephones, fax machines and furniture; d) Obtaining Technical Support ; e) Leasing Office Space; f) Payments for electricity, gas, water, phone service and high speed data transmission necessary to operate or contribute data to HMIS; g) Paying Salaries for operating HMIS, including: o Completing data entry o Monitoring and reviewing data quality o Completing data analysis o Reporting to the HMIS lead o Training staff on using HMIS or comparable database o Implementing and complying with HMIS requirements h) Paying costs of staff to travel to and attend HUD-sponsored and HUDapproved training on HMIS (including programs authorized by Title IV of the McKinney-Vento Homeless Assistance Act); Emergency Solutions Grant Program Manual

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i) Paying Staff travel costs to conduct intake; j) Paying participation fees charged by HMIS Lead, if the recipient or subrecipient is not the HMIS Lead. 2) Comparable Database Victim services providers or legal services providers: may use ESG funds to establish and operate a comparable database (one which includes all required HUD data elements) that collects client-level data over time (i.e., longitudinal data) and generates subsequent unduplicated aggregate reports on the data.

G. Administration Expenses are limited to 7.5% of the total ESG award (5% for recipient and 2.5% for sub-recipient) [Sub-recipient distribution of administrative fees must be negotiated locally] and could include any of the following activities: 1) General management, oversight, and coordination: a) Salaries, wages, and related costs of the recipient’s staff, sub-recipient’s staff, other staff engaged in program administration; b) Travel costs incurred for monitoring of sub-recipients; c) Administrative services performed under 3rd party contracts/agreements (General legal services, accounting, auditing); d) Other costs for goods & services (rental/purchase of equipment, insurance utilities, office supplies, and maintenance of office space). 2) Training on ESG requirements, including cost of attending training on ESG requirement, and HUD-sponsored ESG trainings. 3) Environmental Reviews, including costs of carrying out the environmental review responsibilities.

H. Ineligible Activities/Assistance Among the ineligible activities associated with ESG funding of any category are the following (not an inclusive list): 1) Funds cannot be used to expand the number of shelter beds in an existing shelter or supplant existing mainstream resources;

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2) Payments can only be made to third parties such as landlords or utility companies; payments cannot under any circumstance be made to program participants; 3) An assisted property must not be owned by the sub-grantee, sub-recipient, or the parent subsidiary or affiliated organization of the sub-grantee or subrecipient; 4) Mortgage assistance (including land contracts); 5) Hotel/motel vouchers, except as previously identified; 6) Purchase of agency vehicles, except as previously identified; 7) Rental assistance payments on behalf of eligible individuals or families for the same period of time and for the same cost types as are being provided through any other Federal, state, or local housing subsidy program; 8) Moving expenses, except as previously identified; 9) Furniture (sub-recipients are encouraged to use existing community sources); 10) Pet care and/or pet deposits; 11) Credit card bills or other consumer debt (including child support and any garnishments); 12) Car repair; 13) Medical or dental care and medicines, except as previously identified; 14) Clothing and grooming; 15) Entertainment activities; 16) Work- or education-related materials including literacy classes, except as previously identified; 17) Cash assistance; 18) Payment of licenses, certifications, and general classes; 19) Development of discharge planning programs in mainstream institutions such as hospitals, nursing homes, jails, or prisons.

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Note: Persons whose discharge from public-funded institutions is imminent are eligible to receive financial assistance through ESG

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6.

Citizenship Requirements and Verification Title IV of the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (PRWORA, also known as the Welfare Reform Act) prohibits the provision of non-exempted "federal public benefits" to an alien, who is not a "qualified alien" ESG funds may only be used to assist qualified aliens ESG is considered a Federal public benefit under PRWORA, which generally prohibits unqualified aliens from receiving Federal public benefits. However, a nonprofit charitable organization is not required by the Act to seek an applicant’s confirmation that he or she is a qualified alien, or to have a separate entity verify the applicant’s status before providing benefits. To be eligible for this exemption, an organization must be both ‘‘nonprofit’’ AND ‘‘charitable.’’ For purposes of this Guidance, an organization is ‘‘nonprofit’’ if it is organized and operated for purposes other than making gains or profits for the organization, its members or its shareholders, and is precluded from distributing any gains or profits to its members or shareholders. An organization is ‘‘charitable’’ if it is organized and operated for charitable purposes. The term ‘‘charitable’’ should be interpreted in its generally accepted legal sense as developed by judicial decisions. It includes organizations dedicated to relief of the poor and distressed or the underprivileged, as well as religiously-affiliated organizations and educational organizations. If your organization chooses to verify, even though it is a nonprofit charitable organization that is not required to do so under the Act, you should comply with the procedures set forth in this Guidance and provide benefits only to those whom you verify to be U.S. citizens, U.S. non-citizen nationals or qualified aliens. Any verification request to INS by a nonprofit charitable organization must be accompanied by the written consent of the individual whose status is to be verified to the release of information about the individual to a nongovernmental entity. The consent must be notarized or executed under penalty of perjury. (INS Form G–639 may be used for this purpose.) Question: We are a Private Non-profit. Is this different? Answer: A “private” non-profit means that the agency is not a publicly held agency and the profits go back into the organization and are not disbursed among shareholders, etc. If your agency is a 501(c)(3), there shouldn’t be any problem because we know your agency fits the “charitable organization” as defined. If you have different answers here as to what “private” means to you, then please contact our office to discuss this further. QUALIFIED ALIEN.—For purposes of this title, the term ‘‘qualified alien’’ means an alien who, at the time the alien applies for, receives, or attempts to receive a Federal public benefit, is:

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(1) (2) (3) (4) (5) (6)

an alien who is lawfully admitted for permanent residence under the Immigration and Nationality Act; an alien who is granted asylum under section 208 of such Act; a refugee who is admitted to the United States under section 207 of such Act; an alien who is paroled into the United States under section 212(d)(5) of such Act for a period of at least 1 year; an alien whose deportation is being withheld under section 243(h) of such Act; or an alien who is granted conditional entry pursuant to section 203(a)(7) of such Act as in effect prior to April 1, 1980.

The Personal Responsibility and Work Opportunity Reconciliation Act of 1996 may be found at: http://www.gpo.gov/fdsys/pkg/PLAW-104publ193/content-detail.html

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7.

Eligibility A. General  Individuals or households with children who are homeless or would be homeless, but for the assistance. There is no age restriction on persons receiving assistance; 

No appropriate subsequent housing options have been identified;



Individuals or household who lack financial resources and support networks needed to obtain immediate housing or remain in existing housing; AND



Households must develop and work within a case plan to increase housing stability and self-sufficiency (including attendance at financial fitness and/or tenant education classes, among others).

B. Homeless Prevention Income Eligibility (only) To be eligible for rental assistance or other assistance utilizing ESG funding, an applicant household’s gross annual income must be below 30% of the Area Median Income (AMI), which is considered very low income by HUD standards and is dependent on the size of the household (i.e., number of household members). The AMI for each state and community can be found at: http://www.huduser.org/portal/datasets/il/il12/index.html). Income is money that goes to, or on behalf of, the family head of household or spouse (even if temporary or absent) or to any other adult family member. Annual income includes the current gross income of all adult household members. A representative list of income types is included in Appendix D. Gross Income: The amount of income earned before any deductions (such as taxes and health insurance premiums). Current Income: Income the household is receiving at the time of application for assistance. The calculation of current income at the three-month review period (for households receiving on-going assistance such as the medium-term rental assistance) is also based on total household income at the time of review. Adult Household Members: Income earned by minors is excluded, as is income of adult full-time students who are not recognized heads of household. Annualizing Wages and Periodic Payments: When calculating income based on hourly, weekly, or monthly payment information, add the gross amount earned in each payment period that is documented and divide by the number of payment periods. This provides an average wage per payment period. Depending on pay periods used by the Emergency Solutions Grant Program Manual

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employer or the schedule of periodic payments, the following calculations convert the average wage into annual income:     

Hourly Wage multiplied by Hours Worked per Week multiplied by 52 weeks Weekly Wage multiplied by 52 weeks Bi-Weekly (every other week) Wage multiplied by 26 bi-weekly periods Semi-Monthly Wage (twice a month) multiplied by 24 semi-monthly periods Monthly Wage multiplied by 12 months

Income eligibility requirements can be found in Appendix C, Appendix D, and Appendix E. C. Homeless Prevention Housing Status An applicant’s household housing status must be one of the following to be eligible for Homeless Prevention: I. Imminent Risk (at-risk) of Homelessness a. Individual or family who will imminently lose their primary nighttime residence, provided that: i. Residence will be lost within 14 days of the date of application for homeless assistance; ii. No subsequent residence has been identified; and iii. The individual or family lacks the resources or support networks needed to obtain other permanent housing. II. Homeless under other Federal statutes a. Unaccompanied youth under 25 years of age, or families with children and youth, who do not otherwise qualify as homeless under this definition, but who: i. Are defined as homeless under the other listed federal statutes; ii. Have not had a lese, ownership interest, or occupancy agreement in permanent housing during the 60 days prior to the homeless assistance application; iii. Have experienced persistent instability as measured by two moves or more in the preceding 60 days; and iv. Can be expected to continue in such status for an extended period of time due to special needs or barriers. III. Fleeing/Attempting to Flee Domestic Violence a. Any individual or family who: i. Is fleeing, or is attempting to flee, domestic violence; ii. Has no other residence, and iii. Lacks the resources or support networks to obtain other permanent housing. D. Rapid Re-Housing Housing Status An applicant’s household housing status must be one of the following to be eligible for Rapid Re-Housing:

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I.

Literally Homeless a. Individual or family who lacks a fixed, regular, and adequate nighttime residence, meaning: i. Has a primary nighttime residence that is a public or private place not meant for human habitation; ii. Is living in a publicly or privately operated shelter designated to provide temporary living arrangements (including congregate shelters, transitional housing, and hotels and motels paid for by charitable organizations or by federal,, state and local government programs); or iii. Is exiting an institution where (s)he has resided for 90 days or less and who resided in an emergency shelter or place not meant for human habitation immediately before entering that institution. II. Fleeing/Attempting to Flee Domestic Violence (where the individual or family also meets the criteria for Literally Homeless) a. Any individual or family who: i. Is fleeing, or is attempting to flee, domestic violence; ii. Has no other residence, and iii. Lacks the resources or support networks to obtain other permanent housing. E. Street Outreach Housing Status I. Literally Homeless a. Individual or family who lacks a fixed, regular, and adequate nighttime residence, meaning: i. Has a primary nighttime residence that is a public or private place not meant for human habitation; ii. Is living in a publicly or privately operated shelter designated to provide temporary living arrangements (including congregate shelters, transitional housing, and hotels and motels paid for by charitable organizations or by federal,, state and local government programs); or iii. Is exiting an institution where (s)he has resided for 90 days or less and who resided in an emergency shelter or place not meant for human habitation immediately before entering that institution. II. Additional Limitation a. Within Literally Homeless definition above, individuals and families must be living on the streets (or other places not meant for human habitation) and be unwilling or unable to access services in emergency shelter. III. Fleeing/Attempting to Flee Domestic Violence (where the individual or family also meets the criteria for Literally Homeless) b. Any individual or family who: i. Is fleeing, or is attempting to flee, domestic violence; ii. Has no other residence, and iii. Lacks the resources or support networks to obtain other permanent housing. Emergency Solutions Grant Program Manual

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F. Emergency Shelter Housing Status I. Literally Homeless a. Individual or family who lacks a fixed, regular, and adequate nighttime residence, meaning: i. Has a primary nighttime residence that is a public or private place not meant for human habitation; ii. Is living in a publicly or privately operated shelter designated to provide temporary living arrangements (including congregate shelters, transitional housing, and hotels and motels paid for by charitable organizations or by federal,, state and local government programs); or iii. Is exiting an institution where (s)he has resided for 90 days or less and who resided in an emergency shelter or place not meant for human habitation immediately before entering that institution. II. Imminent Risk (at-risk) of Homelessness b. Individual or family who will imminently lose their primary nighttime residence, provided that: i. Residence will be lost within 14 days of the date of application for homeless assistance; ii. No subsequent residence has been identified; and iii. The individual or family lacks the resources or support networks needed to obtain other permanent housing. III. Homeless under other Federal statutes c. Unaccompanied youth under 25 years of age, or families with children and youth, who do not otherwise qualify as homeless under this definition, but who: i. Are defined as homeless under the other listed federal statutes; ii. Have not had a lese, ownership interest, or occupancy agreement in permanent housing during the 60 days prior to the homeless assistance application; iii. Have experienced persistent instability as measured by two moves or more in the preceding 60 days; and iv. Can be expected to continue in such status for an extended period of time due to special needs or barriers. IV. Fleeing/Attempting to Flee Domestic Violence d. Any individual or family who: i. Is fleeing, or is attempting to flee, domestic violence; ii. Has no other residence, and iii. Lacks the resources or support networks to obtain other permanent housing. G. Eligibility Re-certification Households must be re-evaluated for eligibility, appropriateness of services and assistance. Re-assessments may be conducted by telephone in cases where distance Emergency Solutions Grant Program Manual

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prohibits a face-to-face assessment; though HUD encourages face-to-face assessments whenever possible, (telephone assessment is limited to once per household receiving assistance). For Homeless Prevention, re-assessments must occur once every three months and assistance cannot last longer than 24 months within a 3-year period. If a household income is determined to be at 31% of AMI at the time of re-assessment, the household is no longer be eligible for assistance. If unrelated individuals are joint parties to a lease, income for all adults in the household must be included when determining eligibility. For Rapid Re-Housing, re-assessment must occur at a minimum of once a year and assistance cannot last longer than 24 months within a 3-year period. H. Treatment of Assets Household assets are generally not counted as income with the exception of interest and dividend income. However, household assets are taken into account when determining whether financial resources are sufficient to obtain or maintain housing. Programs must assess and document that the individual or household would become homeless, but for the ESG assistance. In other words, without ESG assistance a household would require emergency shelter or would otherwise be literally homeless. When determining if a household would be homeless, but for the assistance, programs must consider a household’s assets. An asset is cash or items that could be converted to cash quickly, including assets that are owned by more than one person, but allow unrestricted access to the applicant. An applicant household is required to spend down the following assets to an amount equivalent to twice the FMR (FMR x 2) before becoming eligible for ESG assistance:  Amounts in checking and saving bank accounts; 

Stocks, bonds, savings certificates, money market funds, and other investment accounts;



The cash value of trusts that may be withdrawn by the household; AND



Lump sum receipts of cash received and accessible by household, such as inheritances, capital gains, lottery winnings, insurance settlements, income tax refunds, and other claims.

I. Rent Assistance Models ESG rent assistance may be applied to tenant-based, project-based, or master leasing arrangements. The rent assistance model must be consistent for all households within each individual program. Each program (defined by program type and location designated a unique row on the housing inventory chart) is allowed only one model, and rent assistance calculations must be documented in the client file. Emergency Solutions Grant Program Manual

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The Models: 1. Flat Rate: The subsidy is a set amount each month for all households (e.g., all households get a maximum of $200 each month). 2. Household income: Household rent share is based on a specific percentage of household income (e.g., 30 percent, 40 percent, 50 percent). ESG does NOT mandate any specific tenant contribution. 3. Percentage of the rent: Household rent share is a pre-set percentage of the rent (e.g., all households must pay 75% of their rent). 4. Graduated subsidy: Whether income-based or fixed, the subsidy declines in “steps” based upon a fixed timeline or when the individual has reached specific goals, until the household assumes full responsibility for monthly housing costs. The steps are known (and documented) in advance and act as deadlines for increasing income. Grantee ESG policies and/or procedures for rent assistance must include, at a minimum: 1. A clear description of the model, rent subsidy/household’s share of rent and utilities and how it is calculated; 2. Any minimum lease periods (e.g., a year’s lease) that may be required; 3. Provisions for handling returned deposits made on behalf of clients; and 4. An explanation of any tenant escrow accounts that may be established for clients. When rent assistance is based on a household’s income, the following ESG policies and/or procedures must include, at a minimum: 1. Minimum tenant payments (if any); 2. How utilities impact a household’s subsidy; and 3. Any requirement for households to report changes in income prior to recertification and how changes in income will impact tenant rent share.

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8.

File/Verification Requirements A. Rention: Programs are responsible for verifying and documenting eligibility of all ESG applicants prior to providing assistance. Once an ESG participant is approved for assistance, programs are responsible for maintaining this documentation in the ESG participant case file. All records pertaining to each fiscal year of ESG funds must be retained for the greater of 5 years or the period specified below. Copies made by microfilming, photocopying, or similar methods may be substituted for the original records. Where ESG funds are used for the renovation of an emergency shelter and the costs charged to the ESG grant for renovation exceed 75 percent of the value of the building before renovation, records must be retained until 10 years after the date that ESG funds are first obligated for the renovation. Where ESG funds are used to convert a building into an emergency shelter and the costs charged to the ESG grant for the conversion exceed 75 percent of the value of the building after conversion, records must be retained until 10 years after the date that ESG funds are first obligated for the conversion. B. Access: HUD, the HUD Office of the Inspector General, and the Comptroller General of the United States, or any of their authorized representative, and Oregon Housing and Community Services are allowed access to program/financial records. Rights of access are not limited to the required retention period, but last as long as the records are retained. The recipient must provide citizens, public agencies, and other interested parties with reasonable access (consistent with state and local laws regarding privacy and obligation of confidentiality) to records regarding any uses of ESG funds the recipient received during the preceding 5 years. C. Confidentiality: All records containing personally identifying information of any individual or family who applies for and/or received ESG assistance will be kept secure and confidential. The address or location of any domestic violence, dating violence, sexual assault, or stalking shelter project assisted under the ESG will not be made public, except with written authorization of the person responsible for the operation of the project. The address or location of any housing of a program participant will not be made public, except as provided under a pre-existing privacy policy of the recipient or subrecipient and consistent with state and local laws regarding privacy and obligations of confidentiality. D. Documentation: ESG programs will be monitored to ensure appropriate documentation is obtained and included in participant household files. For purposes of ESG, HUD permits various types of documentation, ranging from third-party verification to applicant self-declaration.

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Documentation standards, in order of preference, are as follows: 1) Written Third Party: Verification in writing from a third party (e.g. individual employer, Social Security Administration, welfare office, etc.) either directly to ESG staff or through print out provided by the applicant. ESG staff should document third-party verification and retain documentation in the ESG participant file. 2) Oral Third Party: Verification from a third party (e.g. individual employer, Social Security Administration, welfare office, etc.) provided by the third party over the telephone or in-person directly to ESG staff. ESG staff should document oral thirdparty verification and retain in the ESG participant file. 3) Applicant Self–Declaration: An affidavit of income as reported by the household. ESG staff should document an applicant’s self-declaration and retain documentation in the ESG participant file. HUD expects a conscientious and reasonable effort be made by programs to use the highest documentation standard possible. Documentation that is dated within 30 days prior to the time of application is acceptable. In addition to file documentation provided by, or on behalf of, applicant households, a Staff Affidavit is also required to document that the household meets all eligibility criteria, certifies that true and complete information was used to determine eligibility, and certifies that no conflict of interest exists related to the provision of ESG assistance. See Appendix G for Homeless/At-Risk acceptable documentation requirements. See Appendix H for Housing Options/Resources eligibility documentation requirements. See Appendix I for Rapid Re-Housing Eligibility Documentation for Homeless Persons. See Appendix J for Homelessness Prevention Eligibility documentation for Persons atRisk of Homelessness. ESG Reporting Requirements state that we are to keep a record of all clients that were screened, but found ineligible. Each individual and family determined ineligible to receive ESG assistance, must include documentation of the reason for this determination; however, the data does not need to be included in HMIS, although HMIS may be used if a recipient/subrecipient wishes to do so. E. Verification Requirements: 1) Request and consent for services; 2) Participant rights and responsibilities including grounds for termination; 3) Grievance and appeals procedures; 4) Client confidentiality;

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5) Household information sheet; 6) Intake and assessment of household needs; 7) Verification of income form (for 3rd party), self-declaration of income form or appropriate documentation showing lack of financial resources and support networks needed to obtain or retain housing; 8) Homeless certification form, self-declaration of housing status form documenting homelessness or at risk of homelessness; 9) Staff affidavit form; 10) File notes by case manager of risk factors for participants receiving medium-term rental assistance; 11) Participant service plan including the plan for obtaining or maintaining housing; 12) Habitability standards/lead-based paint inspection form (documentation if/why not required); 13) Rent reasonableness documentation (current and arrears payments); 14) Lease agreement documenting amount of monthly rent and verification that program participant is on the lease agreement; 15) Recertification and reassessment of participant eligibility every three months (to be conducted in person when possible).

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9.

Case Management A. Case Management: All short- and medium-term rental assistance participants must be case managed as defined by the following services: 1) Using a centralized, coordinated assessment system; 2) Conducting initial evaluation, including verification & documentation of eligibility; 3) Counseling; 4) Developing, securing & coordinating services, and obtaining Federal, State, and local benefits; 5) Monitoring an evaluating program participant progress; 6) Developing an individualized housing and service plan; AND 7) Assuring program participants’ rights are protected. B. Intake Every participant receives a comprehensive assessment (intake) with a case manager who assists the applicant in developing a case plan that prioritizes needs based on the severity of their housing crisis and targets the most appropriate response with the situation presented. The intent is to discern primary need and the urgency of the need. Programs should have a clear process for determining the type, level, and duration of assistance for each program participant. C. Housing Assessments Depending on the urgency and priority identified in the intake, the ESG program will conduct a comprehensive assessment with the household. The assessment, at a minimum, will identify the housing needs of the household. The assessment will function as the basis for creating a housing plan and placement, which serves as the foundation for resource coordination and resolution of the housing crisis. It will require staffing familiar with housing resources, with the local housing market, and with services. D. Housing Plan and Placement A housing plan and placement must be completed for all individuals that receive a housing assessment. The plan is intended to be a guide for both the household and the service programs. It must focus on obtaining or maintaining housing with defined goals, outcomes and timelines. The plan should also identify needed community resources, referrals to partnering agencies especially for mainstream benefits, budget education and tenant education.

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E. Risk Factors for Determining ‘At Risk of Homelessness’ For an individual or family to qualify as ‘‘at risk of homelessness’’ under the first category of the definition, the individual or family must meet two threshold criteria and must exhibit one or more specified risk factors. The two threshold criteria, as provided in the statute, are: 1) The individual or family has income below 30 percent of median income for the geographic area, AND 2) The individual or family has insufficient resources immediately available to attain housing stability. To further ensure consistency of interpretation, the interim rule also clarifies several of the risk factors that pertain to the first category of individuals and families who qualify as ‘‘at risk of homelessness.’’ As provided under the statute, the pertinent risk factors are as follows: 1) Has moved frequently because of economic reasons; 2) Is living in the home of another because of economic hardship; 3) Has been notified that their right to occupy their current housing or living situation will be terminated; 4) Lives in a hotel or motel; 5) Lives in severely overcrowded housing; 6) Is exiting an institution; or 7) Otherwise lives in housing that has characteristics associated with instability and an increased risk of homelessness.

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10.

Lease Agreements A Lease Agreement is a legally binding, written lease between tenant and landlord and is required to receive ongoing rental assistance. “Master-leasing” is not allowed whereby the recipient/subrecipient signs the lease and sub-leases it to the program participant. The rental assistance agreement between landlord and recipient/subrecipient can be between property manager or owner and recipient/subrecipient, or sub-subrecipient. A lease must be in place and the program participant must be on the lease in order to use ESG funds for the rent or security deposit. Therefore, assistance could not be provided to an individual renting from a friend or relative if a legal lease is not in place. In cases where an individual is renting a unit from a friend or relative and a legal lease is in place, programs providing assistance must ensure that the arrangement is not in violation of the conflict of interest provisions outlined in the ESG Notice (e.g., the rent charged and the terms of the lease must be the same for the participant as they are for other tenants renting comparable units).

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11.

Habitability Standards and Lead-Based Paint Inspections Habitability standard inspections and lead-based paint inspections do not have to be performed by a third party. ESG project staff can conduct the inspections. If a program participant is moving into a unit and using another subsidy program that requires an inspection, staff from the other program may conduct the inspection, as long as they follow the minimum habitability standards required by ESG. Inspections must be conducted upon initial occupancy and then on an annual basis for the term of ESG assistance. A. Habitability Standards Habitability Standards inspections are required for any household receiving financial assistance for rental assistance (whether for prevention or rapid rehousing, new unit or existing unit). Inspections must be conducted upon initial occupancy, on an annual basis for the term of ESG assistance, and upon a change of tenancy. Habitability Standards are different from the Housing Quality Standards (HQS) used for other HUD programs. Because the HQS criteria are more stringent than the Habitability Standards - programs could use either standard. Units also need to be compliant with local housing codes relating to occupant, health, and safety standards. If there are local housing codes, the program must comply with the more stringent of the two. See Appendix K for full list of Habitability Standards for ESG. B. Lead-Based Paint Inspections Lead-based paint requirements of the Lead-Based Paint Poisoning Prevention Act apply to housing and common areas of a unit occupied by all households receiving any rental assistance. A lead-based paint inspection is required if all three of the following criteria exist: 1) Household is served with Homeless Prevention or Rapid Re-housing funds, and 2) Housing is occupied by families with children under the age of 6 or a pregnant woman, and 3) Housing was constructed before 1978. Lead-based paint inspections are not required if the property has had all lead-based paint identified and removed in accordance with HUD regulations. If peeling/deteriorated paint is detected during the visual assessment, costs associated with testing and repair/cleanup are not eligible expenses under ESG. However, once the deteriorated paint has been repaired, the cost of a clearance exam may be charged against the grant under the financial assistance category.

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Programs must present evidence that appropriately trained individuals are performing visual assessments. While lead-based paint certification is necessary to conduct leadbased paint inspections, a self-directed online ‘visual assessment’ training is accessible by this link: http://www.hud.gov/offices/lead/training/visualassessment/h00100.cfm. You might also check with your local community action agency, as all weatherization programs are now required to have at least one certified lead renovator on staff who is certified to conduct a swab test for lead-based paint. Basic info regarding the date a dwelling was constructed can be found through the Oregon Assessor and Property Tax Records located at: http://publicrecords.onlinesearches.com/Oregon-Assessor-and-Property-TaxRecords.htm. More information provided by HUD about Lead-Based Paint Poisoning Prevention is available. See 24 CFR Part 35, at this site: http://ecfr.gpoaccess.gov/cgi/t/text/textidx?c=ecfr&tpl=/ecfrbrowse/Title24/24cfr35_main_02.tpl

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12.

Rent Reasonableness Rent reasonableness must be considered when determining if a unit is eligible for ESG assistance. See Appendix M for the rent reasonableness form. Rent reasonableness is determined case-by-case and should be determined by considering the following: A. The reasonableness in relation to rents being charged for comparable unassisted units, taking into account the location, size, type, quality, amenities, management, and maintenance of each unit; AND B. The rent should not be in excess of rents currently being charged by the same owner for comparable unassisted units. Comparison can include units advertised for rent as well as documenting actual rent charged. Per the ESG Rule, rental assistance cannot be provided if the rent exceeds the Fair Market Rent (FMR) established by HUD, as provided under 24 CFR part 888, and complies with HUD’s standard of rent reasonableness, as established under 24 CFR 982.507. Rent reasonableness for all units for which ESG rental assistance (including arrears) and/or security deposit assistance is being provided must be determined and documented. The requirement applies whether homelessness prevention assistance or rapid re-housing assistance is provided. For purposes of calculating rent under this section, the rent shall equal the sum of the total monthly rent for the unit, any fees required for occupancy under the lease (other than late fees and pet fees) and, if the tenant pays separately for utilities, the monthly allowance for utilities (excluding telephone) established by the public housing authority for the area in which the housing is located. CFRs can be found electronically at: http://ecfr.gpoaccess.gov/cgi/t/text/text-idx?c=ecfr&tpl=%2Findex.tpl

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Termination, Appeals, and Grievances Grantees must have written termination, denial, and grievance policies and/or procedures. The policies and/or procedures should be readily available to households either in written information or by posting the policy in a public place. It is important to effectively communicate these policies and/or procedures to households and ensure that they are fully understood. A. Termination If a program participant violates program requirements, the recipient/sub-recipient may terminate the assistance in accordance with a formal process established by the recipient/subrecipient that recognizes the right of individuals affected. Judgment must be exercised and all extenuating circumstances must be examined in determining when violations warrant termination so that a program participant’s assistance is terminated ONLY in the most severe cases. To terminate ESG program services to a program participant, a formal process is required and must consist of: 1) Written notice to the program participant containing a clear statement of the reasons for termination; 2) A review of the decision, in which the program participant is given the opportunity present written or oral objections before a person other than the person (or subordinate of that person) who originally made or approved the termination decision; AND 3) Prompt written notice of the final decision to the program participant. Termination does not bar the recipient or subrecipient from providing further assistance, at a later date, to the same family or individual. B. Appeals and Grievances ESG does not have a prescribed appeal process. Programs should use their approved, internal processes for handling participant grievances and appeals from households which are denied services. A right to appeal must be posted in a common client access area and a copy of the procedure presented to the participant at intake.

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Financial Management Programs will maintain an accounting system which segregates each major funding category (Street Outreach, Homeless Prevention Financial Assistance, Homeless Prevention Stabilization Services, Rapid Rehousing Financial Assistance, Rapid Re-Housing Stabilization Services, Admin., etc.). Please note the following:  Program must not make payments directly to program participants but only to third parties such as landlords and utility companies;  Property receiving ESG financial assistance funds may not be owned by the grantee, sub-grantee, or the parent, subsidiary or affiliated organization of the sub-grantee;  Rental assistance paid by program cannot exceed the actual rent cost;  Programs may not charge program fees to participants;  Bookkeeping costs may be charged under administration, financial assistance, or housing relocation and stabilization services depending on the type of activity being conducted by the bookkeeper.

A. Support of Salaries and Wages OMB Circular A-122 directs non-profit agencies on the required methods for supporting personnel expenses charged to federal grants. Timecards must indicate, after-the-fact, total time worked indicating the percentage of actual time worked on ESG. Timecards must be signed by the employee and supervisor and generated at least monthly. OMB Circulars can be found electronically at: http://www.whitehouse.gov/omb/circulars_default OMB Circular A-122 Attachment B, #8m reads: Reports reflecting the distribution of activity of each employee (professionals and nonprofessionals) must be maintained for all staff members whose compensation is charged, in whole or in part, directly to ESG funding. In addition, in order to support the allocation of indirect costs, such reports must also be maintained for other employees whose work involves two or more functions or activities if a distribution of their compensation between such functions or activities is needed in the determination of the organization's indirect cost rate(s) (e.g., an employee engaged part-time in indirect cost activities and part-time in a direct function). Reports maintained by non-profit organizations to satisfy these requirements must meet the following standards:

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 The reports must reflect an after-the-fact determination of the actual activity of each employee. Budget estimates (i.e. estimates determined before the services are performed) do not qualify as support for charges to ESG funds;  Each report must account for the total activity for which employees are compensated and which is required in fulfillment of their obligations to the organization;  The reports must be signed by the individual employee or by a responsible supervisory official having first-hand knowledge of the activities performed by the employee and attest that the distribution of activity represents a reasonable estimate of the actual work performed by the employee during the periods covered by the reports;  The reports must be prepared at least monthly and must coincide with one or more pay periods.

B. Percentage of Program Components The total amount of the recipient’s fiscal year grant that may be used for street outreach and emergency shelter activities cannot exceed the greater of (1) 60% of the recipient’s fiscal year grant; or (2) The amount of Fiscal Year 2010 grant funds committed for homeless assistance activities. Any change to (2) will be given to recipients within 24 business hours of HUD notification to OHCS.

C. Match Requirements In general, federal, state, local, or private funds may be used to satisfy the dollar for dollar match requirement for ESG, so long as the following conditions are met:  The matching funds are contributed to the ESG program and expended for the recipient or subrecipient’s allowable ESG costs;  The matching funds must be used in accordance with all requirements that apply to ESG grant funds, except for the expenditure limits in 24 CFR 576.100, AND if the matching funds are from another federal program, they must ALSO be used in accordance with that program’s requirements;  The matching funds are contributed after the date HUD signs the grant agreement for the ESG funds being matched;  The matching funds are expended by the expenditure deadline that applies to the ESG funds being matched;  The matching funds have not been and will not be used to match any other federal program’s funds, nor any other ESG grant;  The recipient does not use ESG funds to meet the other program’s matching requirements; AND Emergency Solutions Grant Program Manual

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 The recipient keeps records of the source and use of the matching funds, including the particular fiscal year ESG grant for which the matching contribution is counted.  Eligible sources of match may be federal, state, local, and private sources, within the limits above. Match may be either cash contributions or non-cash contributions. To calculate non-cash contributions you may (1) determine the value of any donated material or building, or of any lease, using a method reasonably calculated to establish the fair market value; and (2) value the rate of services consistently with those ordinarily paid for similar work in your organization. If the recipient does not have employees performing similar work, the rates must be consistent with those ordinarily paid by other employers for similar work in the same labor market. For more guidance on matching requirements see 24 CFR 576.201.

D. Indirect Costs: In general, ESG grant funds may 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 allocated to each eligible activity so long as that allocation is consistent with an indirect cost rate proposal developed in accordance with the OMB Circulars previously listed. Expenses such as office rent, photocopier, office supplies, etc., may be charged either directly or indirectly to a program component. You would charge the costs to the activity for which the funds are being used: For example, office rent for an organization that only does rapid re-housing activities would be charged to the rapid re-housing line item. If an activity is not a direct cost of delivering services or financial assistance, and it IS a cost required for administering the program: For example, an executive director’s salary, could be charged to the administrative activity line item.

E. Certification of Local Government Approval: Each recipient must submit new ESG certifications in accordance with the requirements in 24 CFR 91.225(c) for local governments and territories. The Certification Form can be found in the “Forms” section of this manual.

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HMIS and Reporting Requirements A. HMIS: ESG requires participation in HMIS, and the designated system for use by ESG-funded Recipients/Subrecipients is ServicePoint (Bowman Systems, Copyright 2012, All Rights Reserved). Each grantee must follow all state and federal laws governing HMIS, including collecting informed written consent from program participants, not denying service based solely on program participant refusal to provide data to an HMIS, protecting program participant confidentiality, not collecting personally identifying information from program participants that are victims of domestic violence, and other requirements defined in RCW 43.185C.030, 43.185C.180, and VAWA Reauthorization Section 605. Please note that households should remain in the program(s) for which they were initially enrolled, (Homeless Prevention or Rapid Rehousing) throughout their term of service. “Income and Source” is a Program-Specific data element listed in the Standards because this data is needed to complete APRs for both ESG and CoC programs. The HMIS standards require that grantees enter income sources and amounts and noncash benefits received in the past 30 days during three points in time - at entry into program, at exit from the program and at least once annually if the household is in the program over a year. The amount documented through this calculation should NOT be used to determine eligibility, but rather can be used to show that the household does lack resources to maintain housing. B. Reporting Requirements: Sub-grantees will compile data for ESG reporting using ServicePoint HMIS. Data should be entered at the time of service, within 72 hours, as data completeness and integrity is key. Programs should prioritize data quality and reporting. DV Shelters contact: Ann Brown at [email protected], (503) 986-2122. 1) Regular Reports ESG Provider Reports are required half-way through the funding year and again within 30 days of the funding year’s end within 20 days of the end of the reporting period. Recipients/subrecipients must use the OHCS Provider Report Form for this purpose. 2) Annual Performance Report Oregon Housing and Community Services is required to submit an Annual Performance Report at the end of each fiscal year. Annual Performance Reports will

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report the number of individuals and households served, demographic data and outcomes related to housing stability. For other HMIS-Related issues, contact: Robin Buchholz at [email protected], (503) 986-0978. C. Personal Identifying Data: Individually identifying information for or about an individual including information likely to disclose the location of a victim of domestic violence, dating violence, sexual assault, or stalking, could include: o A first and last name; o A home or other physical address; o Contact information (including a postal, e-mail or Internet protocol address, or telephone or facsimile number); o A social security number; and o Any other information, including date of birth, racial or ethnic background, or religious affiliation that, in combination with any other non-personally identifying information, would serve to identify any individual collecting “non-identified” client records. D. Data Entry for “Non-identified” Client Records o Leave the “Name” fields NULL (blank). Do not write in names such as “Anonymous” or “Refused” as that will compromise data quality at the state level. o If there are no personal identifiers for a client record, there needs to be an “Agency Unique ID” of some sort created and stored in the system that can be used by the recipient/subrecipient to access the record at a later time (and should not be an algorithm of elements that can lead to the client’s identification). o Enter an approximate year of birth – subtract or add one to three years to the actual year of birth. o Enter “Refused” for gender, race, and ethnicity when the real answers to those questions, in combination with other data, can potentially lead to identification of the client. o Enter any additional answer to the universal, program-specific and optional data elements (from the March 2010 HMIS Data Standards) only if the answers to those questions, in combination with other data, will not lead to the identification of the client. Emergency Solutions Grant Program Manual

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Program Entry Date, Program Exit Date and Service Date are generally required unless those elements can be used in combination with other elements to identify the client. If this is the case, please enter an approximate Program Entry Date, Program Exit Date and Service Date by adding one to three months to the actual dates and keeping the “Length of Stay” (the number of days between program entry and program exit) consistent with reality. Keeping the approximate service date, if used, within the actual service date’s reporting period is also recommended.

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16. Monitoring Performance reviews OHCS and/or its assigns, will review the performance of each recipient in carrying out its responsibilities whenever determined necessary, but at least annually. In conducting performance reviews, OHCS will obtain from the records and reports from the recipient and, when appropriate, its subrecipients, as well as information from onsite monitoring, audit reports, and information from electronic data sources. Where applicable, OHCS may also consider relevant information pertaining to the recipient's performance gained from other sources, including citizen comments, complaint determinations, and litigation. Reviews to determine compliance with specific requirements of ESG will be conducted as necessary, with or without prior notice to the recipient. If OHCS determines preliminarily that the recipient or one of its subrecipients has not complied with an ESG program requirement, OHCS will give the recipient notice of this determination and an opportunity to demonstrate, within the time prescribed by OHCS and on the basis of substantial facts and data, that the recipient has complied with Emergency Solutions Grant (ESG) requirements. Recipient draws downs for Emergency Solutions Grant (ESG) funds occur through the electronic system as required by OHCS. To obtain prior approval, the recipient may be required to manually submit its payment requests and supporting documentation to OHCS in order to show that the funds to be drawn down will be expended on eligible activities in accordance with all ESG program requirements. If the recipient fails to demonstrate to OHCS' satisfaction that the activities were carried out in compliance with ESG program requirements, OHCS will take one or more of the remedial actions or sanctions. Remedial actions and sanctions Remedial actions and sanctions for a failure to meet an ESG program requirement will be designed to prevent a continuation of the deficiency; mitigate, to the extent possible, its adverse effects or consequences; and prevent its recurrence. OHCS may instruct the recipient to submit and comply with proposals for action to correct, mitigate, and prevent noncompliance with ESG requirements, including: a.

Preparing and following a schedule of actions for carrying out activities affected by the noncompliance, including schedules, timetables, and milestones necessary to implement the affected activities;

b.

Establishing and following a management plan that assigns responsibilities for carrying out the remedial actions;

c.

Canceling or revising activities likely to be affected by the noncompliance, before expending ESG funds for the activities;

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d.

Reprogramming ESG funds that have not yet been expended from affected activities to other eligible activities;

e.

Suspending disbursement of ESG funds for some or all activities;

f.

Reducing or terminating the remaining grant of a subrecipient and reallocating those funds to other subrecipients; and

g.

Making matching contributions before or as draws are made from the recipient's ESG grant.

OHCS may suspend payments to the extent OHCS deems it necessary to preclude the further expenditure of funds for affected activities. OHCS may remove the recipient from participation in reallocations of funds. OHCS may deny matching credit for all or part of the cost of the affected activities and require the recipient to make further matching contributions to make up for the contribution determined to be ineligible. OHCS may reduce or terminate the remaining grant of a recipient and reallocate those funds to other recipients. OHCS may condition a future grant. OHCS may take other remedies that are legally available. Reallocated or reprogrammed funds must be used by the expenditure deadline. Subrecipient sanctions If the recipient determines that a subrecipient is not complying with an ESG program requirement or its subgrant agreement, the recipient must take appropriate actions, as prescribed for OHCS in this section of the manual. Reallocated or reprogrammed funds must be used by the expenditure deadline.

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17. Resources HUD Resource Exchange site can be found at: http://www.hudhre.info/esg/index.cfm The HUD Resource Exchange site includes: • ESG Program Guidance; • Regulations and Allocations; • Tools and TA Resources; • Webinars; • Listserv opportunities; and • Frequently asked questions. Substantial Amendment Process for the Second Allocation of the FY 2011 ESG Funds Webinar: http://www.hudhre.info/index.cfm?do=viewSubstantialAmendProcFor2ndAlloc2011ESGFu nds_Webinar Homelessness Prevention and Rapid Re-Housing Assistance - A Comparison of HPRP and ESG Requirements http://www.hudhre.info/documents/HPRP_ESG_Comparison.pdf Consultation with Continuums of Care: http://www.hudhre.info/documents/ESGStateRecipientConsultationWithCoC.pdf

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Appendix A: Criteria for Defining Homelessness

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Appendix B: Eligibility by Component

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Appendix C: Income Eligibility Guidelines

To find the Area Medium Income by County in Oregon, go to the link below and then choose the fiscal year, and then choose Oregon from the map: http://www.huduser.org/portal/datasets/il.html

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Appendix D: Income Inclusion The Part 5 definition of annual income is the gross amount of income of all adult household members that is anticipated to be received during the coming 12-month period. This definition sounds straightforward, but there are several specific issues related to the calculation of Part 5 annual income. • Background on Using Part 5 •

Whose Income to Count



Types of Income to Count



Treatment of Assets

The following link will take you directly to the HUD Website that explains Part 5. http://www.hud.gov/offices/cpd/affordablehousing/training/web/calculator/definitions/par t5.cfm The following link will take you to HUD’s Occupancy Handbook, Chapter 5: Determining Income and Calculating Rent. http://portal.hud.gov/hudportal/documents/huddoc?id=DOC_35649.pdf

Appendix D:

Income Inclusion Table

This table presents the ESG income inclusions. The following types of income must be counted when calculating gross income: General Category 1. Earned Income

2. Business Income

3. Interest and Dividend Income 4. Pension/Retirement Income

Description The full amount of gross income earned before taxes and deductions. The net income earned from the operation of a business, i.e., total revenue minus business operating expenses. This also includes any withdrawals of cash from the business or profession for your personal use. Monthly interest and dividend income credited to an applicant’s bank account and available for use by the household (not just the applicant). The monthly payment amount received from Social Security, annuities, retirement funds, pensions, disability, and other similar types of periodic payments.

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5. Unemployment and Disability Income

Any monthly payments in lieu of earnings, such as unemployment, disability compensation, SSI, SSDI, and worker's compensation.

6. TANF/Public Assistance

Monthly income from government agencies excluding amounts designated for shelter (rent assistance, and utilities, WIC, SNAP/food stamps, and child care).

7. Alimony, Child Support and Foster Care Income

Alimony, child support, and foster care payments received from organizations or from persons not residing in the dwelling.

8. Armed Forces Income

All basic pay, special pay and allowances of a member of the Armed Forces excluding special pay for exposure to hostile fire (hazard pay).

22.

Appendix E: Income Exclusion

This table presents the ESG income exclusions. The following types of income are not counted when calculating gross income: General Category 1. Income of Children 2. Inheritance and Insurance Income

Description Income from employment of children (including foster children) under the age of 18 years. Lump-sum additions to family assets, such as inheritances, insurance payments (including payments under health and accident insurance and worker's compensation), capital gains, and settlement for personal or property losses (except as provided in number 5 of Income Inclusions).

3. Medical Expense Amounts received by the household that are specifically for, or in Reimbursements reimbursement of, the cost of medical expenses for any household member. 4. Income of Live-in Income of a live-in aide (as defined in 24 CFR 5.403). Aides 5. Disabled Persons Certain increases in income of a disabled member of a qualified household (24 CFR 5.671(a)). 6. Student Financial Aid 7. Armed Forces Hostile Fire Pay 8. Self-Sufficiency Program Income

The full amount of student financial assistance paid directly to the student or to the educational institution. The special pay to a family member serving in the Armed Forces who is exposed to hostile fire. a. Amounts received under training programs funded by HUD. b. Amounts received by a person with a disability that are disregarded for a

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General Category

9. Gifts 10. Reparations

11. Income from Full-Time Students 12. Adoption Assistance Payments 13. Social Security and SSI Income 14. Property-Tax Refunds 15. Home Care Assistance

Description limited time for purposes of SSI eligibility and benefits because they are set aside for use under a Plan to Attain Self-Sufficiency (PASS). c. Amounts received by a participant in other publicly assisted programs that are specifically for, or in reimbursement of, out-of-pocket expenses incurred (special equipment, clothing, transportation, child care, etc.) and which are made solely to allow participation in a specific program. d. Amounts received under a resident service stipend. A resident service stipend is a modest amount (not to exceed $200 per month) received by a resident for performing a service for the public housing authority (PHA) or property owner, on a part-time basis, that enhances the quality of life in the development. Such services may include, but are not limited to, fire patrol, hall monitoring, lawn maintenance, resident initiatives coordination, and serving as a member of the PHA's governing board. No resident may receive more than one such stipend during the same period of time. e. Incremental earnings and benefits resulting to any household member from participation in qualifying state or local employment training programs (including training not affiliated with a local government) and training of a household member as resident management staff. Amounts excluded by this provision must be received under employment training programs with clearly defined goals and objectives, and are excluded only for the period during which the family member participates in the employment training program. Temporary, nonrecurring, or sporadic income (including gifts). Reparation payments paid by a foreign government pursuant to claims filed under the laws of that government by persons who were persecuted during the Nazi era. Earnings in excess of $480 for each full-time student 18 years old or older (excluding the head of household or spouse). Adoption assistance payments in excess of $480 per adopted child. Deferred periodic amounts from SSI and Social Security benefits that are received in a lump-sum amount or in prospective monthly amounts. Amounts received by the family in the form of refunds or rebates under State or local law for property taxes paid on the dwelling unit. Amounts paid by a recipient/subrecipient to a family with a member who has a developmental disability and is living at home to offset the cost of services and equipment needed to keep this family member at home.

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General Category 16. Other Federal Exclusions

Description Amounts specifically excluded by any other Federal statute from consideration as income for purposes of determining eligibility or benefits under a category of assistance programs that includes assistance under any program to which the exclusions of 24 CFR 5.609(c) apply, including:  The value of the allotment made under the Food Stamp Act of 1977.  Payments received under the Domestic Volunteer Service Act of 1973 (employment through VISTA, Retired Senior Volunteer Program, Foster Grandparents Program, youthful offender incarceration alternatives, senior companions).  Payments received under the Alaskan Native Claims Settlement Act.  Income derived from the disposition of funds to the Grand River Band of Ottawa Indians;  Income derived from certain sub-marginal land of the United States that is held in trust for certain Indian tribes;  Payments or allowances made under the Department of Health and Human Services' Low-Income Home Energy Assistance Program.  Payments received under the Maine Indian Claims Settlement Act of 1980 (25 U.S.C. 1721).  The first $2,000 of per capita shares received from judgment funds awarded by the Indian Claims Commission or the U.S. Claims Court and the interests of individual Indians in trust or restricted lands, including the first $2,000 per year of income received by individual Indians from funds derived from interests held in such trust or restricted lands.  Amounts of scholarships funded under Title IV of the Higher Education Act of 1965, including awards under the Federal work-study program or under the Bureau of Indian Affairs’ student assistance programs.  Payments received from programs funded under Title V of the Older Americans Act of 1985 (Green Thumb, Senior Aides, Older American Community Service Employment Program).  Payments received on or after January 1, 1989, from the Agent Orange Settlement Fund or any other fund established pursuant to the settlement in the In Re Agent Orange product liability litigation, M.D.L. No. 381 (E.D.N.Y.).  Earned income tax credit refund payments received on or after January 1, 1991, including advanced earned income credit payments.  The value of any child care provided or arranged (or any amount received as payment for such care or reimbursement for costs incurred for such care) under the Child Care and Development Block Grant Act of 1990.  Payments received under programs funded in whole or in part under the Job Training Partnership Act (employment and training programs for Native Americans and migrant and seasonal farm workers, Job Corps, State job training programs and career intern programs, AmeriCorps).  Payments by the Indian Claims Commission to the Confederated Tribes

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General Category

  



Description and Bands of Yakima Indian Nation or the Apache Tribe of Mescalero Reservation. Allowances, earnings, and payments to AmeriCorps participants under the National and Community Service Act of 1990. Any allowance paid under the provisions of 38 U.S.C. 1805 to a child suffering from spina bifida who is the child of a Vietnam veteran. Any amount of crime victim compensation (under the Victims of Crime Act) received through crime victim assistance (or payment or reimbursement of the cost of such assistance) as determined under the Victims of Crime Act because of the commission of a crime against the applicant under the Victims of Crime Act. Allowances, earnings, and payments to individuals participating in programs under the Workforce Investment Act of 1998.

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Appendix F: Income Documentation Requirements

Type of Income Wages, salary, etc.

Business income1

Include in Income Calculation? Yes

Yes

Acceptable Types of Documentation Copy of most recent paystub(s)

Documentation Requirements and Process  Obtain copy(ies) of most recent pay

stub(s) from applicant.  Include copy(ies) in participant file. OR Written verification of  Mail, fax, email written verification of income. See ESG Verification income request directly to of Income template employer(s). (HUDHRE.info/ESG)  Obtain signed and dated verification of income from employer(s).  Include verification of income in file. OR (if written third-party documentation cannot be obtained) Oral verification of income.  Contact employer(s) by phone or in See ESG Verification of person to obtain oral verification. Income template  Document oral verification of (HUDHRE.info/ESG/) income.  Include verification of Income in file. OR (if written documentation or oral third-party verification is not obtained) Self-declaration of income.  Obtain signed and dated original selfSee ESG Self-Declaration of declaration of income from applicant.  ESG worker must document attempt Income template to obtain third-party verification (HUDHRE.info/ESG/) (written or oral) and sign selfdeclaration of income.  Include self-declaration of income in file. Copy of most recent federal  Obtain copy of most recent federal or state tax return showing or state tax return from applicant. net business income  Include copy in file. OR (if written documentation cannot be obtained) Self-declaration of income.  Obtain signed and dated original selfSee ESG Self-Declaration of declaration of income from applicant. Income (HUDHRE.info/ESG/)  ESG worker must document attempt to obtain third-party verification (written or oral) and sign self-declaration of

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Type of Income

Include in Income Calculation?

Acceptable Types of Documentation

Documentation Requirements and Process

income.  Include self-declaration of income in file. 1 It can be a challenge for grantees and sub-grantees to obtain third-party verification of selfemployment income. When third-party verification is not available, sub-grantee should always request a notarized tenant declaration that includes a perjury statement. Copy of most recent interest  Obtain copy(ies) of most recent Interest and interest or dividend income statement or dividend income dividend from applicant. Yes statement income  Include copy(ies) in file.

Copy of most recent federal or state tax return showing interest, dividend or other net income

Pension and/or retirement income

Yes

OR  Obtain copy of most recent federal or state tax return from applicant.  Include copy in file.

OR (if written documentation cannot be obtained) Self-declaration of income.  Obtain signed and dated original selfSee ESG Self-Declaration of declaration of income from applicant. Income (HUDHRE.info/ESG/)  ESG worker must document attempt to obtain third-party verification (written or oral) and sign self-declaration of income.  Include self-declaration of income in file. Copy of recent statement or  Obtain copy(ies) of most recent benefit benefit notice from Social notice, pension statement or other Security Administration payment statement from applicant. (SSA), pension provider, or  Include copy(ies) in file. other source OR Written verification of  Mail, fax, email verification of income income. See ESG Verification request directly to Social Security, of Income pension provider or other source. (HUDHRE.info/ESG/)  Obtain signed and dated verification of income from income source.  Include Verification of Income in file. OR (if written third party documentation cannot be obtained)

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Type of Income

Include in Income Calculation?

Acceptable Types of Documentation Oral verification of income. See ESG Verification of Income (HUDHRE.info/ESG/)

Unemploymen t and disability income

Yes

Documentation Requirements and Process  Contact source(s) by phone or in

person to obtain oral verification of income.  Document oral verification of income.  Include Verification of Income in file. OR (if written documentation or oral third-party verification cannot be obtained) Self-declaration of income.  Obtain signed and dated original selfSee ESG Self-Declaration of declaration of income from applicant. Income (HUDHRE.info/ESG/)  ESG worker must document attempt to obtain third-party verification (written or oral) and sign self-declaration of income.  Include self-declaration of income in file. Copy of most recent  Obtain copy(ies) of most recent unemployment, payment statement(s) and/or benefit worker’s compensation, SSI, notice(s) from applicant. SSDI, or  Include copy(ies) in file. severance payment statement or benefit notice OR Written verification of  Mail, fax, email verification of income request directly to unemployment income. See ESG Verification administrator, worker’s compensation of Income (HUDHRE.info/ESG/) administrator, or former employer.  Obtain signed and dated verification of income from income source.  Include verification of income in file. OR (if written third party documentation cannot be obtained) Oral verification of income.  Contact source(s) by phone or in person to obtain oral verification of See ESG Verification of Income (HUDHRE.info/ESG/) income.  Document oral verification of income.  Include Verification of Income in file. OR (if written documentation or oral third-party verification cannot be obtained) Self-declaration of income.  Obtain signed and dated original self-

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Type of Income

Include in Income Calculation?

Acceptable Types of Documentation

Documentation Requirements and Process

See ESG Self-Declaration of Income (HUDHRE.info/ESG/)

TANF/public assistance

Yes

Armed Forces income

Yes

declaration of income from applicant.  ESG worker must document attempt to obtain third-party verification (written or oral) and sign self-declaration of income.  Include self-declaration of income in file. Copy of most recent TANF  Obtain copy(ies) of most recent benefit payment statement or notice(s) or payment statement(s) benefit notice from applicant.  Include copy(ies) in file. OR Written verification of  Mail, fax, email verification of income income. See ESG Verification request directly to TANF administrator. of Income  Obtain signed and dated verification of (HUDHRE.info/ESG/) income from income source.  Include verification of income in file. OR (if written third party documentation cannot be obtained) Oral verification of income.  Contact source(s) by phone or in See ESG Verification of person to obtain oral verification of Income (HUDHRE.info/ESG/) income.  Document oral verification of income.  Include Verification of Income in file. OR (if written documentation or oral third-party verification cannot be obtained) Self-declaration of income.  Obtain signed and dated original selfSee ESG Self-Declaration of declaration of income from applicant. Income (HUDHRE.info/ESG/)  ESG worker must document attempt to obtain third-party verification (written or oral) and sign self-declaration of income.  Include self-declaration of income in file. Copy of pay stubs, payment  Obtain copy(ies) of most recent statement, or other payment stubs(s), statements, or other government-issued government-issued statement from statement indicating income applicant. amount  Include copy(ies) in file. OR

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Type of Income

Include in Income Calculation?

Acceptable Types of Documentation Written verification of income. See ESG Verification of Income (HUDHRE.info/ESG/)

No Income Reported

N/A

Documentation Requirements and Process  Mail, fax, email verification of income

request directly to appropriate armed services representative.  Obtain signed and dated verification of income from income source.  Include Verification of Income in file. OR (if written third-party documentation cannot be obtained) Oral verification of income.  Contact source(s) by phone or in See ESG Verification of person to obtain oral verification of Income (HUDHRE.info/ESG/) income.  Document oral verification of income.  Include Verification of Income in file. OR (if written documentation or oral-third party verification cannot be obtained) Self-declaration of income.  Obtain signed and dated original selfSee ESG Self-Declaration of declaration of income from applicant. Income (HUDHRE.info/ESG/)  ESG worker must document attempt to obtain third-party verification (written or oral) and sign self-declaration of income.  Include self-declaration of income in file. Self-declaration of income.  Obtain signed and dated original selfdeclaration of income from applicant. See ESG Self-Declaration of Income (HUDHRE.info/ESG/)  ESG worker must document attempt to obtain third-party verification (written or oral) and sign self-declaration of income.  Include self-declaration of income in file.

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24.

Appendix G: Homeless/At-Risk Acceptable Documentation

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25.

Appendix H: Housing Options/Resources Documentation (for all ESG applicants)

Housing Options and Resources Other Subsequent Housing Options

Meets ESG Requirements? Yes, if no appropriate subsequent housing options have been identified

Acceptable Types of Documentation Assessment of housing options by ESG case manager or other authorized ESG staff

Documentation Requirements and Process  Assess with applicant all other

appropriate (i.e., safe, affordable, available) subsequent housing options.  Verify that no other appropriate subsequent housing options are available.  Assessment Must: o Be documented by ESG case manager or other authorized staff o Include assessment summary or other statement indicating that applicant has no other appropriate housing options o Be signed and dated by ESG case manager or other authorized staff  Include assessment and verification of no other subsequent housing options in file.

AND

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Housing Options and Resources Financial Resources and Support Networks

Meets ESG Requirements? Yes, if participant lacks the financial resources and support networks needed to obtain immediate housing or remain in existing housing

Acceptable Types of Documentation Assessment of financial resources and support networks by ESG case manager or other authorized ESG staff

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Documentation Requirements and Process  Assess with applicant all financial

resources and support networks (i.e., friends, family or other personal sources of financial or material support).  Verify that applicant lacks financial resources and support networks to obtain other appropriate subsequent housing or remain in existing housing.  Assessment Must o Be documented by ESG case manager or other authorized staff o Include review of current account balances in checking and savings accounts held by applicant household o Include assessment summary or other statement indicating that applicant lacks financial resources and support networks to obtain other appropriate subsequent housing or remain in existing housing o Be singed and dated by ESG case manager or other authorized staff  Include assessment and verification of insufficient financial resources and support networks in file.

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26.

Appendix I: Rapid Re-Housing Eligibility Documentation for Homeless Persons

Note: This only includes Emergency Shelter programs identified in the Continuum of Care’s (CoC) most recent Housing Inventory Chart submitted to HUD or otherwise recognized by the CoC as part of the CoC inventory (e.g. newly established Emergency Shelters)

Place Not Meant for Human Habitation (e.g., cars, parks, abandoned buildings, streets/sidewalks)

Sleeping in an Emergency Shelter

Living Situation

Homeless per ESG Criteria? Yes

Acceptable Types of Documentation (in order of preference)

Documentation Requirements and Process

HMIS record of shelter stay.  Obtain HMIS record showing shelter stay concurrent with ESG program entry date.  Include HMIS record in ESG participant file. OR (if HMIS record cannot be obtained) Written homeless certification. See ESG Homeless Certification template (located at www.HUDHRE.info/ESG/).

 Obtain signed and dated original Homeless

Certification from shelter provider.  Include Homeless Certification in ESG

participant file.

OR (if HMIS record and ESG Homeless Certification cannot be obtained)

Yes

Emergency shelter provider letter.

 Obtain letter from emergency shelter

Written homeless certification. See ESG Homeless Certification template (located at www.HUDHRE.info/ESG/).

 Obtain signed and dated original Homeless

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provider.  Letter Must: o Be on shelter provider letterhead o Identify shelter program o Include statement verifying current shelter occupancy of ESG participant, including most recent entry and exit (if applicable) dates. o Be signed and dated by shelter provider  Include emergency shelter provider letter in participant file. Certification from homeless street outreach provider.  Include Homeless Certification in ESG participant file.

OR (if ESG Homeless Certification cannot be obtained)

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Living Situation

Homeless per ESG Criteria?

Acceptable Types of Documentation (in order of preference) Homeless street outreach provider letter.

Documentation Requirements and Process  Obtain letter from homeless street

outreach provider. The letter may be from the ESG-funded rapid re-housing provider if the provider also provides outreach to persons on the street as part of engagement and admission activities.  Letter Must o Be on outreach provider letterhead o Identify outreach program o Include statement verifying current homeless status of ESG participant o Be signed and dated by outreach provider  Include outreach provider letter in participant file.

OR (if ESG Homeless Certification and provider letter cannot be obtained)

Hospital or Other Institution

Self-declaration of  Obtain signed and dated original selfhomelessness. See ESG Selfdeclaration from applicant. Declaration of Housing  ESG worker must document attempt to Status template (located at obtain written third party verification and www.HUDHRE.info/ESG/). sign self-declaration form.  Include self-declaration in participant file. Yes, if also meet the following two conditions:

Letter from hospital or other  Obtain letter from hospital or other institution institution.  Letter Must: o Be on hospital or other institution letterhead o Include statement verifying current 1. stay in a hospital/institution stay of ESG hospital or participant other o Include hospital/institution admission and discharge dates verifying that stay institution has been has been for 180 days or less for 180 o Be signed and dated by days or hospital/institution representative less  Include hospital/institution letter in participant file.

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Living Situation

Homeless per ESG Criteria? AND

Acceptable Types of Documentation (in order of preference)

Documentation Requirements and Process

AND (to verify homeless status prior to hospital or other institution admission)

2. was sleeping in HMIS record of shelter stay  Obtain HMIS record showing shelter stay an (if previously sleeping in concurrent with ESG program entry date. emergenc emergency shelter).  HMIS record must indicate shelter stay y shelter immediately prior to (i.e. the day before or or other same day as) hospital/institution place not admission date. meant for  Include HMIS record in ESG participant file. human OR habitation (if HMIS record cannot be obtained) (cars, Written homeless  Obtain signed and dated original Homeless certification. See ESG Certification from shelter provider or Homeless Certification homeless street outreach provider. template (located at  Certification must verify homelessness www.HUDHRE.info/ESG/) (if (residing in shelter or place not meant for previously sleeping in human habitation) immediately prior to emergency shelter or place (i.e. the day before or same day as) not meant for human hospital/institution admission date. habitation).  Include Homeless Certification in ESG participant file. OR (if HMIS record and ESG Homeless Certification cannot be obtained) Emergency shelter provider  Obtain emergency shelter provider letter. or  Letter Must: Homeless street outreach o Be on shelter provider letterhead provider letter. (if previously o Identify shelter program o Include statement verifying shelter stay sleeping in emergency shelter or place not meant immediately prior to (i.e. the day before for human habitation). or same day as) hospital/institution admission date. o Be signed and dated by shelter provider  Include documentation in ESG participant file. OR (if HMIS record, ESG Homeless Certification, or provider letter cannot be obtained)

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Living Situation

Homeless per ESG Criteria?

Acceptable Types of Documentation (in order of preference)

Documentation Requirements and Process

Note: This only includes Transitional Housing programs serving homeless persons (per HUD’s definition) and listed in the Continuum of Care’s (CoC) most recent Housing Inventory Chart submitted to HUD or otherwise recognized by the CoC as part of the CoC inventory (e.g. newly established Transitional Housing programs).

Transitional Housing

Self-declaration of  Obtain signed and dated original selfhomelessness. See ESG Selfdeclaration from applicant. Declaration of Housing  Self-declaration must verify homelessness Status template (located at (residing in shelter or place not meant for www.HUDHRE.info/ESG/) human habitation) immediately prior to (ONLY if previously sleeping (i.e. the day before or same day as) in place not meant for hospital/institution admission date. human habitation).  ESG worker must document attempt to obtain written third party verification and sign ESG Self-Declaration form.  Include self-declaration in participant file. Yes, if graduating or timing out from Transitional

Written homeless certification. See ESG Homeless Certification template (located at www.HUDHRE.info/ESG/).

 Obtain signed and dated original Homeless

Certification from transitional housing provider.  Include Homeless Certification in ESG participant file. OR

(if ESG Homeless Certification cannot be obtained) Transitional housing provider letter.

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 Obtain letter from transitional housing

provider.  Letter Must:

o Be on transitional housing provider letterhead. o Identify transitional housing program. o Include statement verifying current transitional housing occupancy and of ESG participant. o Include statement verifying that ESG applicant is graduating from or timing out of transitional housing program. o Include statement verifying ESG applicant was residing in emergency shelter or place not meant for human habitation immediately prior to transitional housing admission. o Be signed and dated by transitional housing provider.  Include transitional housing provider letter in participant file.

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Living Situation

Homeless per ESG Criteria?

Domestic Violence

Yes, if ESG assistance is needed to leave domestic violence situation

Acceptable Types of Documentation (in order of preference)

Documentation Requirements and Process

Self-declaration of  Obtain signed and dated original selfhomelessness. See ESG Selfdeclaration from applicant. Declaration of Housing  ESG worker must document attempt to Status template (located at obtain written third party verification and www.HUDHRE.info/ESG/). sign self-declaration form.  Include self-declaration in participant file.

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27.

Appendix J: Homelessness Prevention Eligibility Documentation for Persons At-Risk of Homelessness

Living Situation Current living situation including:  Rented by Applicant  Owned by Applicant  Other Housing Occupied by Applicant without Paying Rent (including housing shared with friends or family)

At Risk of Homelessness per ESG Criteria? Yes, but only if without ESG assistance household will lose housing and become homeless (i.e., require emergency shelter or sleep in a place not meant for human habitation)

Acceptable Types of Documentation1 Copy of eviction notice from landlord/property manager of unit or court order based on eviction action that notifies the applicant that they must leave

Documentation Requirements and Process  Obtain copy of eviction notice (typed or



AND Copy of lease naming applicant as leaseholder. Copy of notice indicating building in which applicant is renting or otherwise residing is being foreclosed on



AND





Copy of lease naming applicant as leaseholder.

 Hospital or other institution  Hotels or Motels not paid for by

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handwritten) or court order AND copy of lease. Eviction Notice/Court Order Must: o Identify the ESG applicant and unit where ESG applicant is the leaseholder o Indicate that applicant must leave their housing o Be signed and dated by owner/landlord or court Include eviction notice or court order and copy of lease in participant file. Obtain copy of foreclosure notice (may including notice from landlord/property manager, court, published in local newspaper or other print or on-line public record documentation) AND copy of lease. Foreclosure Notice Must: o Identify the building or unit where ESG applicant is the leaseholder or is otherwise residing o Indicate that housing is being foreclosed on o If written notice to applicant, be signed and dated by the landlord or property manager. Include notice and copy of lease in participant file.

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Living Situation Federal, State or local government or charitable programs

Current living situation including:  Rented by Applicant  Owned by Applicant  Other Housing Occupied by Applicant without Paying Rent

At Risk of Homelessness per ESG Criteria?

Acceptable Types of Documentation1 Copy of eviction letter from host family or friend who owns or rents the housing that notifies the applicant that they must leave

Documentation Requirements and Process  Obtain copy of eviction letter (typed or

handwritten) AND copy of lease.  Eviction Letter Must:

o Identify the ESG applicant and unit where ESG applicant is residing o Indicate that applicant must leave owner’s/renter’s housing AND o Be signed and dated by the host owner/renter Copy of lease naming host  Include eviction letter and copy of lease in family/friend as participant file. leaseholder Copy of utility shut-off  Obtain copy of utility shut-off notice. notice from utility  Shut-Off Notice Must: company. o Identify the ESG applicant and unit where ESG applicant is the leaseholder o Indicate that utility shut off/disconnection is imminent (e.g. within XX days) will be shut-off o Be signed and dated by utility company representative and/or include utility company contact information  Include utility shut-off notice in participant file. Yes, but only if Copy of notice from  Obtain copy of notice (may include notice without ESG landlord/property published in local newspaper or manager, public health, assistance government jurisdiction’s website) AND household will code enforcement, fire copy of lease. lose their marshal, child welfare or  Notice Must: housing and other government entity o Identify the building or unit where ESG become that housing is applicant is the leaseholder or is homeless (i.e., condemned otherwise residing require o Indicate that housing is condemned emergency AND (i.e., unfit for human habitation) shelter or sleep o If written notice, be signed and dated in a place not Copy of lease naming by the landlord property manager, meant for applicant as leaseholder public health, code enforcement, fire human marshal, child welfare, or other habitation) government entity.  Include notice and copy of lease in

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Living Situation

At Risk of Homelessness per ESG Criteria?

Acceptable Types of Documentation1

(including housing shared with friends or family)  Hospital or other institution  Hotels or Motels not paid for by Federal, State or local government or charitable programs

Documentation Requirements and Process participant file

Copy of foreclosure notice  Obtain copy of foreclosure notice. from lending institution  Foreclosure Notice Must: o Be on financial institution letterhead o Identify the ESG applicant and residence where ESG applicant is the homeowner o Indicate that applicant must leave their housing o Be signed and dated by financial institution  Include foreclosure notice in participant file Written statement from  Obtain letter from hospital or other hospital or other institution institution  Letter Must: o Be on hospital or other institution letterhead o Include statement verifying current hospital/institution stay of ESG applicant o Indicate the individual has no housing (other than emergency shelter) to return to upon discharge o Indicate the institution has followed all appropriate discharge procedures and cannot find housing for the individual. o Be signed and dated by hospital/institution representative  Include hospital/institution letter in participant file

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Living Situation

At Risk of Homelessness per ESG Criteria?

Acceptable Types of Documentation1

Documentation Requirements and Process

Self-declaration. See ESG  Obtain signed and dated original selfSelf-Declaration of declaration from applicant Housing Status template  ESG worker must document attempt to (located at obtain third party documentation and www.HUDHRE.info/ESG/). sign self-declaration form  Include self-declaration in participant file NOTE: Self-Declaration is only acceptable if third party documentation cannot be obtained. Acceptable documentation depends on what factors grantees and sub-grantees select to determine whether an applicant will lose their housing but for ESG assistance. The list is not all inclusive.

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28.

Appendix K: Habitability Standards for ESG Organizations providing rental assistance with ESG funds will be required to conduct initial and any appropriate follow-up inspections of housing units into which a program participant will be moving. Following are the habitability standards that grantees must enforce: A. State and local requirements: Each grantee or sub-grantee under this Notice must ensure that housing occupied by a family or individual receiving ESG assistance is in compliance with all applicable state and local housing codes, licensing requirements, and any other requirements in the jurisdiction in which the housing is located regarding the condition of the structure and the operation of the housing or services. B. Habitability standards: Except for less stringent variations as are proposed by the grantee or sub-grantee and approved by HUD, housing occupied by a family or individual receiving ESG assistance must meet the following minimum requirements: 1)

Structure and materials: The structures must be structurally sound so as not to pose any threat to the health and safety of the occupants and so as to protect the residents from the elements.

2)

Access: The housing must be accessible and capable of being utilized without unauthorized use of other private properties. Structures must provide alternate means of egress in case of fire.

3)

Space and security: Each resident must be afforded adequate space and security for themselves and their belongings. Each resident must be provided an acceptable place to sleep.

4)

Interior air quality: Every room or space must be provided with natural or mechanical ventilation. Structures must be free of pollutants in the air at levels that threaten the health of residents.

5)

Water supply: The water supply must be free from contamination.

6)

Sanitary facilities: Residents must have access to sufficient sanitary facilities that are in proper operating condition, may be used in privacy, and are adequate for personal cleanliness and the disposal of human waste.

7)

Thermal environment: The housing must have adequate heating and/or cooling facilities in proper operating condition.

8)

Illumination and electricity: The housing must have adequate natural or artificial illumination to permit normal indoor activities and to support the health and safety

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of residents. Sufficient electrical sources must be provided to permit use of essential electrical appliances while assuring safety from fire. 9)

Food preparation and refuse disposal: All food preparation areas must contain suitable space and equipment to store, prepare, and serve food in a sanitary manner.

10) Sanitary condition: The housing and any equipment must be maintained in sanitary condition. 11) Fire safety: a) Each unit must include at least one battery-operated or hard-wired smoke detector, in proper working condition, on each occupied level of the unit. Smoke detectors must be located, to the extent practicable, in a hallway adjacent to a bedroom. If the unit is occupied by hearing impaired persons, smoke detectors must have an alarm system designed for hearing-impaired persons in each bedroom occupied by a hearing-impaired person. b)

The public areas of all housing must be equipped with a sufficient number, but not less than one for each area, of battery-operated or hard-wired smoke detectors. Public areas include, but are not limited to, laundry rooms, community rooms, day care centers, hallways, stairwells, and other common areas.

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29.

Appendix L: Notice on Limitation on use of Funds

Special Attention of: Notice: CPD- 12-001 Issued: January 17, 2012 Expires: This Notice is effective until amended, superseded, or rescinded.

All Secretary's Representatives All Regional Directors for CPD All CPD Division Directors Continuums of Care Grantees of the Supportive Housing Program Grantees of the Shelter Plus Care Program

Cross Reference: 24 CFR Parts 582 and 583 and 42 U.S.C. 11371 et seq.

Subject: Notice on Limitation on Use of Funds to Serve Persons Defined as Homeless Under Other Federal Laws Table of Contents I.

Purpose A. Background

II.

Limitation on Use of Funds to Serve Persons Defined as Homeless under Other Federal Laws A. Statutory Basis B. Final Rule on the Definition of Homeless C. Applicability of Limitation on FY2011 SHP New and Renewal Projects

III.

Demonstrating Priority for this Population A. Requesting Permission to Use Funds for this Purpose B. HUD Approval

IV.

Recordkeeping A. General Recordkeeping Requirements B. Additional Recordkeeping Requirements for Limitation on Use of Funds

I.

Purpose This Notice provides guidance to Continuums of Care (CoC) and recipients of Supportive Housing Program (SHP) FY2011 grant funds for Transitional Housing (TH) or Supportive Services Only (SSO) projects, regarding the limitations imposed in Section 422(j) of the McKinney-Vento Act, as amended by the Homeless Emergency Assistance and Rapid Transition to Housing (HEARTH) Act (Public Law 111-22). This Notice provides further

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clarification on information in the Notice of Funding Availability (NOFA) Questions and Answers: A Supplement to the FY2011 CoC Homeless Assistance NOFA and Application. The subject Notice is only applicable to those recipients of eligible projects whose approved FY2011 applications (new or renewal) proposed to serve families with children and/or unaccompanied youth. Please note, as stated in the FY2011 CoC Homeless Assistance Grants NOFA, the only persons eligible for permanent supportive housing, including Shelter Plus Care (S+C) and SHP-PH projects, are persons coming from the streets, emergency shelters, safe havens, or transitional housing projects if they originally came from streets or shelters. Therefore, this Notice is not applicable to these project types as they are not permitted to serve the population described herein. A. Background The HEARTH Act, substantially amended and reauthorized the McKinney-Vento Act. HUD is in the process of issuing regulations and developing requirements for the implementation and administration of the CoC program and all other programs amended or authorized by the HEARTH Act. The regulations are being issued and implemented in phases. On December 5, 2011, HUD published the final rule on the definition of homelessness. This rule integrates the regulation for the definition of “homeless” and the corresponding recordkeeping requirements, and is applicable to the Emergency Solutions Grants program, the S+C program, and the SHP. The final rule provides four categories under which individuals and families may qualify as homeless. These categories are: 1. individuals and families who lack a fixed, regular, and adequate nighttime residence and includes a subset for individuals who resided in an emergency shelter or a place not meant for human habitation, or who is exiting 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 who are defined as homeless under other federal statutes and 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. II.

Limitation on Use of Funds to Serve Persons Defined as Homeless under Other Federal Laws

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A. Statutory Basis Section 422(j) of the HEARTH Act provides the statutory basis for the limitation on use of CoC funds to serve persons defined as homeless under other federal laws. The statute states that a collaborative applicant may use not more than 10 percent of funds awarded under the CoC program for any of the types of eligible activities specified in paragraphs (1) through (7) of Section 423(a) to serve families with children and youth defined as homeless under other federal statutes, or homeless families with children and youth defined as homeless under Section 103(a)(6), but only if the applicant demonstrates that the use of such funds is of an equal or greater priority or is equally or more cost effective in meeting the overall goals and objectives of the plan submitted under Section 427(b)(1)(B), especially with respect to children and unaccompanied youth. The 10 percent limitation shall not apply to CoCs in which the rate of homelessness, as calculated in the most recent Point-in-Time (PIT) count, is less than one-tenth of 1 percent of its total population. B. Final Rule on the Definition of Homeless The final rule on the Definition of Homeless refers to the population described in Section 103(a)(6) as Category 3 of the homeless definition. Per the final rule, persons considered homeless under this category are unaccompanied youth under 25 years of age, or families with children and youth, who do not otherwise qualify as homeless under this definition, but who do meet all of the following criteria: 1. Are defined as homeless under Section 387 of the Runaway and Homeless Youth Act (42 U.S.C. 5732a), Section 637 of the Head Start Act (42 U.S.C. 9832), Section 41403 of the Violence Against Women Act of 1994 (42 U.S.C. 14043e-2), Section 330(h) of the Public Health Service Act (42 U.S.C. 254b(h)), Section 3 of the Food and Nutrition Act of 2008 (7 U.S.C. 2012), Section 17(b) of the Child Nutrition Act of 1966 (42 U.S.C. 1786(b)), or Section 725 of the McKinney-Vento Homeless Assistance Act (42 U.S.C. 11434a); 2. Have not had a lease, ownership interest, or occupancy agreement in permanent housing at any time during the 60 days immediately preceding the date of application for homeless assistance; 3. Have experienced persistent instability as measured by two or more moves during the 60-day period immediately preceding the date of applying for homeless assistance; and 4. Can be expected to continue in such status for an extended period of time because of chronic disabilities, chronic physical health or mental health conditions, substance addiction, histories of domestic violence or childhood abuse (including neglect), the presence of a child or youth with a disability, or two or more barriers to employment, which include the lack of a high school degree or General Education Development

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(GED), illiteracy, low English proficiency, a history of incarceration or detention for criminal activity, and a history of unstable employment. C. Applicability of Limitation on FY2011 SHP New and Renewal Projects The limitation on use of funds to serve persons defined as homeless under other federal laws will be incorporated in the final rule on the CoC program, when published. However, the final rule on the homeless definition is effective as of January 4, 2012, and therefore the limitation on use of funds affects new and renewal SHP TH and SSO projects that were awarded in FY2011. It does not apply to existing projects that did not receive renewal funding in FY2011. Further, it only applies to projects that proposed to serve families with children and/or unaccompanied youth in their FY2011 application for funding. The target population of a project cannot be changed in order to accommodate this newly eligible group. The new definition will apply to projects at the beginning of the project’s operating year. The 10 percent cap will apply to any CoC where the rate of homelessness, as calculated in the most recent Point-in-Time count, is more than one-tenth of 1 percent of the total population. Furthermore, after consultation with the designated project grantee(s), CoCs must request permission from HUD to use up to 10 percent of the total funds awarded to a CoC for projects in FY2011 for this purpose. The 10 percent is measured as a percentage of the CoCs total award amount, and not at the individual project level. This limitation does not apply to CoCs where the rate of homelessness, as calculated in the most recent PIT count, is less than one-tenth of 1 percent of the total population. III.

Demonstrating Priority for this Population A. Requesting Approval to Use Funds for this Purpose In order for one or more of a CoC’s FY2011 projects to be permitted to use funds to serve persons eligible under Category 3 of the homeless definition in §583.5, the CoC must be able to demonstrate to HUD that the use of such funds is of an equal or greater priority or is equally or more cost effective in meeting the overall goals and objectives identified in the CoC’s FY2011 Exhibit 1 application in regards to children and unaccompanied youth. CoCs must make a formal written request to the local HUD field office for approval to use any portion of their funds for this purpose. This also applies to those communities whose homeless population is less than one-tenth of 1 percent. No SHP TH or SSO project is permitted to use any of its FY2011 funds to serve Category 3 homeless persons until the CoC has received written permission from HUD. The request must contain the following information to be considered: 1. Section 3A, Objective 5 in the FY2011 Exhibit 1 application asked CoCs to provide short- and long-term planning strategies to decrease the number of homeless households with children. Explain how using funds to serve Category 3 homeless

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persons will be more cost effective at accomplishing the goals described in this section; and, 2. Section 3C, question 8, asked CoCs to describe the CoCs efforts to address youth homelessness. Explain how using funds to serve Category 3 homeless persons will be more cost effective at accomplishing the goals described in this section; or 3. Describe how and why serving this population is of greater or equal priority for the CoC than serving homeless families with children or unaccompanied youth that are homeless under categories 1, 2, and 4. The CoC must be able to demonstrate this as a priority in the Consolidated Plan(s) and its CoC strategic plan goals. For 1 and 2 above, in addition to the narrative requested, CoCs must attach a copy of these relevant sections from their FY2011 Exhibit 1. For 3, CoCs must provide the applicable portions of the Consolidated Plan and specifically identify the CoC strategic plan goals. CoCs are also required to identify which project(s) they are proposing be permitted to serve this population. The FY2011 Exhibit 2 application for the applicable project(s) must also be attached as well as a written statement from the grantee(s). The CoC must also indicate the amount of funds that will be set-aside for this population from each project so that HUD may ensure that the total does not exceed 10 percent. A single project may use more than 10 percent of its funding to serve this population, however the amount may not exceed 10 percent of the CoC’s total funding. For example, a CoC was awarded 10 projects in FY2011 for a combined amount of $1 million. No more than $100,000 of project funds may be used for this purpose. The CoC may identify a single TH or SSO project or may identify multiple TH and/or SSO projects; however, in either circumstance, the total combined amount set-aside by all projects may not exceed $100,000. The CoC may not identify any SHP-PH or S+C projects, as these projects may not serve this population per the FY2011 NOFA. Only projects identified in the written request will be authorized to use funds to serve this population. B. HUD Approval Requests to use FY2011 grant funds to serve persons defined as homeless under Category 3 of the homeless definition will be reviewed by HUD. In addition to the information provided by the CoC in its request, HUD may also consider other factors such as past performance of the grantees and/or project sponsors with carrying out program requirements. IV.

Recordkeeping A. General Recordkeeping Requirements

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Section 583.301 of the final rule on the definition of homeless, requires that grantees develop, maintain, and follow written intake procedures to ensure compliance with the homeless definition in §583.5. The procedures must require documentation at intake, of the evidence relied upon to establish and verify homeless status. For Category 3 of the homeless definition, grantees will be required to follow the recordkeeping requirements outlined at §583.301(b)(4). B. Recordkeeping Requirements for Limitation of Use of Funds Grantees that have received approval to use some or all of their FY2011 grant funds to serve persons defined as homeless under Category 3 of the homeless definition will be required to maintain financial records to show that the amount(s) used to serve persons defined as homeless under Category 3 does not exceed the amount HUD approved in the CoC’s request for the individual project.

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30.

Appendix M: Forms

Recipients/Subrecipients may develop their own forms; however, the minimum information on such forms must include all fields as identified in the following set of forms: Verification Of Income (1 page) Self-Declaration Of Income (1 page) Homeless Certification (1 page) Self-Declaration Of Housing Status (1 page) Rent Reasonableness (example)(1 page) Participant Service Plan (example) (1 page) Staff Affidavit (1 page) Habitability Standards (2 pages) I

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A. Emergency Solutions Grant (ESG): VERIFICATION OF INCOME ESG Applicant Name:

Instructions for Employer/Payment Source Representative: This document certifies the income received by the above-named individual (representing all adult members of the applicant household) for purposes of participating in the ESG program and determination of household status and benefit eligibility. Complete only the selected section below that includes an authorization to release information. Please return this form to: Name and Title: Phone:

Fax:

Address: Email:

Employment Income ESG Applicant Release: I hereby authorize release of the following employment information. ESG Applicant Signature:

Date:

Employer representative to complete this section The person named above is employed by . He/she is paid $

on a

since

basis and works an average of

hours a

____________. Please specify any additional compensation and for what purpose: Probability of continued employment: Authorized Employer Representative Signature: Name and Title:

Date:

Address and Phone:

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Payments and/or Benefit Income (complete one form for each distinct source of income for person named above) CIRCLE ONE: Social Security/SSI Public Assistance Alimony Payments Armed Forces Income

Pension/Retirement Unemployment Compensation Foster Care Payments Other (please specify):

TANF Workers Compensation Child Support Payments

ESG Applicant Release: I hereby authorize release of the following payment and/or benefit information. ESG Applicant Signature:

Date:

Payment source representative to complete this section Payments or benefits in the amount of $ expected duration of the payments or benefits is

are paid on a

basis. The

Authorized Payment Source Representative Signature: Name and Title:

Date:

Address and Phone:

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B. Emergency Solutions Grant (ESG): SELF-DECLARATION OF

INCOME ESG Applicant Name: This is to certify income status for the above-named individual. Income includes, but is not limited to:  The full amount of gross income earned before taxes and deductions.  The net income earned from the operation of a business, i.e., total revenue minus business operating expenses. This also includes any withdrawals of cash from the business or profession for personal use (available to the household).  Monthly interest and dividend income credited to an applicant’s bank account (available for household use).  The monthly payment amount received from Social Security, annuities, retirement funds, pensions, disability, and other similar types of periodic payments.  Any monthly payments in lieu of earnings such as unemployment, disability compensation, SSI, SSDI, and worker's compensation.  Monthly income from government agencies, excluding amounts designated for shelter, utilities, WIC, food stamps, and childcare.  Alimony, child support, and foster care payments received from organizations or from persons not residing in the dwelling.  All basic pay, special pay and allowances of a member of the Armed Forces excluding special pay for exposure to hostile fire. Check only one box and complete only that section I certify, under penalty of perjury, that the household currently receives income from the following sources: Source:

Amount:

Frequency:

Source:

Amount:

Frequency:

Source:

Amount:

Frequency:

Source:

Amount:

Frequency:

Source:

Amount:

Frequency:

Source:

Amount:

Frequency:

Source:

Amount:

Frequency:

ESG Applicant Signature:

Date:

I certify, under penalty of perjury, that the household currently receives no from any sources: ESG Applicant Signature:

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ESG Staff Verification I understand that third-party verification is the preferred method of certifying income for ESG assistance, and I also understand that self-declaration of income is only permitted when I have attempted, but cannot obtain, third-party verification. Documentation of attempt made for third-party verification:

ESG Staff Signature:

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C. Emergency Solutions Grant (ESG: HOMELESS CERTIFICATION

ESG Applicant Name: Household without dependent children (complete one form for each adult in the household) Household with dependent children (complete one form for household) Total number of persons in the household: This is to certify that the above-named individual(s) or household is currently homeless based on self-declaration, other indicated information, and signature indicating current living situation.

Check only one box and complete only that section Living Situation: place not meant for human habitation (e.g. cars, parks, abandoned buildings, streets/sidewalks). If currently in hospital or other public institution, include living situation prior to hospitalization. . The individual(s) or household described above is/are currently living in a public or private place not designed for, or ordinarily used as, a regular sleeping accommodation for human beings, including a car, park, abandoned building, bus station, airport, or camp ground. Description of current living situation:

Homeless Street Outreach Program Name:

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This certifying agency must be recognized by the local Continuum of Care (CoC) as an agency operating a program designed to serve persons living on the street or other places not meant for human habitation. Examples include street outreach workers/centers, day shelters, soup kitchens, health care for the homeless sites, etc. Authorized Agency/Program Representative Signature: Name and Title:

Date:

Living Situation: Emergency Shelter. If currently in hospital or other public institution, include living situation prior to hospitalization. The individual(s) or household described above is/are currently living in a supervised publicly or privately operated shelter. Emergency Shelter Program Name: This emergency shelter must appear on the CoC’s Housing Inventory Chart submitted as part of the most recent CoC homeless assistance application to HUD or be otherwise recognized by the CoC as part of the CoC inventory (e.g. newly established Emergency Shelter). Authorized Agency/Program Representative Signature: Name and Title:

Date:

Living Situation: Transitional Housing The individual(s) or household described above is/are currently living in a transitional housing program for those who are homeless. The individual(s)/household described above is/are graduating from or timing out of the transitional housing program: Transitional Housing Program Name: This transitional housing program must appear on the CoC’s Housing Inventory Chart submitted as part of the most recent CoC homeless assistance application to HUD or be otherwise recognized by the CoC as part of the CoC inventory (e.g. newly established Transitional Housing program). Immediately prior to entering transitional housing, the individual(s) or household described above was/were residing in: emergency shelter OR

a place unfit for human habitation

Authorized Agency/Program Representative Signature: Name and Title:

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D. Emergency Solutions Grant (ESG): SELF-DECLARATION OF

HOUSING STATUS ESG Applicant Name: Household without dependent children (complete one form for each adult in the household) Household with dependent children (complete one form for household) Total number of persons in the household: This is to certify that the above-named individual(s) or household is currently homeless or atrisk of homelessness based on the following information and signed declaration by the applicant.

Check only one: I (and my children) am/are currently homeless and living on the street (i.e. a car, park, abandoned building, bus station, airport, or camp ground). I (and my children) am/are the victim(s) of domestic violence and am/are fleeing from abuse. I [and my children] am/are being evicted from current housing and must exit/vacate within the next days. I certify that the information specified above and other relevant information I’ve provided to determine my (household) eligibility for ESG assistance is true, accurate and complete. ESG Applicant Signature: __________________________________

Date: ________________

ESG Staff Certification I understand that third-party verification is the preferred method of certifying homelessness or risk for homelessness for an individual who is applying for ESG assistance. I understand self declaration is only permitted when I have attempted to but cannot obtain third party verification. Documentation of attempt made for third-party verification:

ESG Staff Signature:

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E. Emergency Solutions Grant (ESG): RENT REASONABLENESS Proposed

Comparable

Comparable

Comparable

Unit

Unit #1

Unit #2

Unit #3

Address Number of Bedrooms Square Feet Type of Unit/Construction Housing Condition Location/Accessibility Amenities – Unit Amenities – Site Amenities - Neighborhood Age of Unit (in years) Utilities (types) Unit Rent Utility Allowance Gross Rent Handicap Accessible?

Based upon the above-listed rent comparison, the proposed rent for the unit: is

is not

eligible for rental assistance through the ESG program.

ESG Staff Signature:

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F. Emergency Solutions Grant (ESG): PARTICIPANT SERVICE

PLAN ESG Applicant Name: ESG Case Manager:

Service Plan Goals

To Obtain this goal, I will:

Target Date

Achievement Date

1. My Housing Goal: 1.

2.

3.

4.

5.

2. My Second Goal: 1.

2.

3.

4.

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3. My Third Goal: 1.

2.

3.

4.

5.

4. My Fourth Goal: 1.

2.

3.

4.

5.

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5. My fifth goal: 1.

2.

3.

4.

5.

Additional Comments:

I agree that I developed the above-listed goals, they are appropriate and relate to my current situation, and that I will participate in the identified steps to achieve these goals. I have received a copy of these goals for my use. I also understand that the Participant Service Plan represents a general plan of services and activities, that it is not an entitlement to services, nor is it a legal contract that guarantees delivery of services described.

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G. Emergency Solutions Grant (ESG): STAFF AFFIDAVIT Instructions: This Staff Affidavit serves as documentation that the applicant individual(s) and/or household named below meets all eligibility criteria for ESG assistance, certifies that true and complete information was used to determine eligibility, and also certifies that no conflict of interest exists related to the provision of ESG assistance. Each staff person determining ESG eligibility must complete this Staff Affidavit document for every applicant individual(s) and/or household once eligibility is verified. The completed Staff Affidavit document remains valid until or unless a different staff person re‐determines ESG eligibility at regular three-month intervals. ESG Staff Affidavits must be signed and dated by ESG staff and supervisors for each household approved for ESG assistance and kept in the applicant individual(s) and/or household’s case file. Head of Household Name: Names of All Household Members:

Each person signing below certifies that the individual(s) and/or household named above meets all requirements to receive assistance under the Emergency Solutions Grant program (ESG) and that all of the information provided to determine eligibility is true and complete, to the best knowledge possible. It is further certified that the provision of ESG assistance to the individual(s) and/or household named above has not resulted, nor will result, in a personal or financial interest or benefit, either for the undersigned or for anyone with whom there are personal family or business ties. Fraud is investigated by the Department of Housing and Urban Development, Office of Inspector General, and may be punishable under Federal laws to include, but not limited to, 18 U.S.C. 1001 and 18 U.S.C. 641. If either of the Federal certifications is found to be false, the undersigned staff (and supervisor) will be subject to criminal, civil, and administrative penalties and sanctions. ESG Staff Signature:

Date:

ESG Staff Signature:

Date:

ESG Staff Signature:

Date:

ESG Supervisor Signature:

Date:

ESG Supervisor Signature:

Date:

ESG Supervisor Signature:

Date:

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H. Emergency Solutions Grant (ESG): HABITABILITY STANDARDS

All housing assisted with HUD funding (SHP or ESG) must provide safe and sanitary housing that is in compliance with the habitability standards outlined below and any additional and applicable state or local requirements. Mark each statement as A for approved or D for deficient. Property must meet all standards in order to be approved. ESG Applicant Name: Approved or Deficient

Standard Number

Standard Requirement

1.

Structure and materials: The housing unit must be structurally sound so as to not pose any threat to the health and safety of the occupants and so as to protect the residents from the elements.

2.

Access: The housing unit must be accessible and capable of being utilized without unauthorized use of other private properties. Structures must provide alternate means of egress in case of fire.

3.

Space and Security: Each resident must be afforded adequate space and security for themselves and their belongings. Each resident must be provided an acceptable place to sleep.

4.

Interior air quality: Every room or space must be provided with natural or mechanical ventilation. Structures must be free of pollutants in the air at levels that threaten the health of residents.

5.

Water Supply: The water supply must be free from contamination.

6.

Thermal environment: The housing must have adequate heating and/or cooling facilities in proper operating condition.

7.

Illumination and electricity: The housing must have adequate natural or artificial illumination to permit normal indoor activities and to support the health and safety of residents. Sufficient electrical sources must be provided to permit use of essential electrical appliances while assuring safety from fire.

8.

Food preparation and refuse disposal: All food preparation areas must contain suitable space

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Approved or Deficient

Standard Number

Standard Requirement and equipment to store, prepare, and serve food in a sanitary manner.

9.

Sanitary Conditions: The housing and any equipment must be maintained in sanitary condition.

10.

Sanitary Facilities: Residents must have access to sufficient sanitary facilities that are in proper operating condition, may be used in privacy, and are adequate for personal cleanliness and the disposal of human waste.

11.

Lead-based paint: If the structure was built prior to 1978, and a child under the age of six or a pregnant woman will reside in the property, and the property has a defective paint surface inside or outside the structure, the property cannot be approved until the defective surface is repaired by at least scraping and painting the surface with two coats of non-lead based paint. Defective paint surface means: applicable surface on which paint is cracking, scaling, chipping, peeling or loose. If a child under age six, residing in the assisted property, has an Elevated Blood Level, paint surfaces must be tested for lead-based paint. If lead is found present, the surface must be abated in accordance with 24 CFR Part 35. Note the following information to assist in determining if unit can be approved or is deficient: Date built/rehabbed ______________; Children under 6 present

12.

Pregnant woman

Smoke detectors: Each unit must include at least one batteryoperated or hard –wired smoke detector, in proper working condition, on each occupied level of the unit. Smoke detectors must be located, to the extent practicable, in a hallway adjacent to a bedroom. If the unit is occupied by hearingimpaired persons, smoke detectors must have an alarm system designed for hearing-impaired persons in each bedroom occupied by the hearingimpaired person. The public areas of all housing must be equipped with a sufficient number, but not less than one for each area, of battery-operated or hard wired smoke detectors. Public areas include,

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Approved or Deficient

Standard Number

Standard Requirement but are not limited to, laundry rooms, community rooms, day care centers, hallways, stairwells, and other common areas.

ESG Staff Signature:

Date:

I certify that I am not a HUD certified inspector and I have only visually evaluated the property located at the following address to the best of my ability and find the following: The property meets all of the above standards

The property does not meet all of the above standards

The property is Rent Reasonable

The property is not Rent Reasonable

Lead-Based Paint Inspection only

Therefore, the following determination is made: The property is approved.

The property is not approved.

ESG Applicant Name:

Address:

Evaluator Signature:

Evaluator Phone:

Email:

Name and Title:

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I. Emergency Solutions Grant (ESG): CERTIFICATION OF LOCAL

GOVERNMENT APPROVAL

CERTIFICATION OF LOCAL GOVERNMENT APPROVAL FOR NONPROFIT ORGANIZATIONS RECEIVING ESG FUNDS FROM STATE SUBRECIPIENTS

I, _______________________________________________ (name and title), duly authorized to act on behalf of the _____________________________ (name of jurisdiction), hereby approve the following emergency shelter activities proposed by _______________________________ (name of nonprofit organization), which are to be located in _________________________________ (name(s) of jurisdiction(s)):

By:

_____________________________________________ Signature and Date

______________________________________________ Typed or Written Name of Signatory Local Official

______________________________________________ Title

Note: This certification does NOT need to be completed annually for the same emergency shelter activities funded the previous year. The State only needs to document that it has offered the local government the opportunity to withdraw its previous approval.

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