Pierce County Continuum of Care by lifemate


									                                    Pierce County

                 Transitional Housing Operating and Rent
                           Funding Application

                          State Fiscal Years: 09 and 10

                   January 1, 2010 through June 30, 2011

Applications are due no later than 4:00 p.m., November 30, 2009 and will not be accepted if
late. Please hand deliver application to Pierce County Department of Community Services,
Housing Programs, 3602 Pacific Avenue, Tacoma, WA. to ensure it is received on time.
                                         Pierce County


                     Transitional Housing Operating and Rent (THOR)
                                   Funding Application

This application contains the information and forms needed to prepare an application for funding
for the Transitional Housing, Operating, and Rent (THOR) Expansion Program. Pierce County
Department of Community Services administers this program on behalf of the State of
Washington Department of Commerce.

This is a competitive application process to award $502,941 to be used to serve homeless
households who reside in Pierce County. Applicants will be rated based upon need, readiness,
capacity, leverage, and ability to work collaboratively to reduce homelessness in Pierce County
consistent with the 10 Year Plan to Reduce Homelessness. Funding will be provided to eligible
agencies who submit a complete application that is awarded funding. Pierce County reserves the
right to negotiate contract terms and reduce award amounts based upon activities proposed. The
contract award period is January 1, 2010 through June 30, 2011. Preparation of an application
does not guarantee that applicants will receive funds. Applicants are encouraged to read and
understand the THOR Program Guidelines for both eligible activities, Operating Subsidies and
Rental Assistance.

There will be an application workshop Tuesday, November 17, 2009 starting at 10:30 a.m in
Conference Room A. All applicants are encouraged to attend the workshop to be held at Pierce
County Department of Community Services, 3602 Pacific Avenue in Tacoma.

Applications are due no later than 4:00 p.m. November 30, 2009 and should be delivered to
Pierce County Department of Community Services, 3602 Pacific Avenue, Suite 200, Tacoma.
Applications should be hand delivered to ensure they are received on time. Any application not
received by the deadline will not be considered for funding.

There will be an outcome measurement tool (Logic Model) that will be required to be submitted
that will be made available at a later date.

If you need further information please contact Jeff Rodgers, Community Services Planner II, by
email at jrodger@co.pierce.wa.us or by phone at (253) 798-6908.

Assembling the application packet:

       Submit 1 original and five copies of each complete application in the following order

              1.    Application Cover Page,
              2.    Application (Form D through Form J),
              3.    Community Support Letters
              4.    Additional attachments (including a copy of the Agencies most recent audit
                   report and evidence of non-profit status).
                                         Pierce County
                        Transitional Housing Operating and Rent (THOR)


                                      Project Application

Agency Name

Project Name

Agency Contact Person

Contact Phone Number
Subgrantee Summary Information (submit a separate form for each subgrantee)

Organization/Agency Name:                                                Tax Identification Number (TIN):

Mailing Address:                                                         City:             State:           Zip:

Telephone:                                                               Website:

Type of Agency
Check one agency type. Nonprofit community or neighborhood-based organizations and regional or statewide nonprofit
housing assistance organizations must submit a copy of the Secretary of State registration with the application.
      Local government
      Housing authority
      Regional Support Network established under chapter 71.24 RCW
      Nonprofit community or neighborhood-based organization
      Federally recognized Indian tribe in the state of Washington
     Regional or statewide nonprofit housing assistance organization

Audit Information
Date of last audit:                                               Type of audit:
Name of company performing the audit:
Audit findings or management letter:  No                     Yes, please detail:

If required by local government, do you have the necessary license to operate this proposed housing
    Yes       N/A        No, please explain:

                             Executive Director   Program Contact            Client Data            Finance Contact
(if different from mailing
FORM D continued
Subgrantee Summary Information (submit a separate form for each subgrantee)
Indicate the direct services you will provide by checking the appropriate box(es) below. Complete property name/address
and unit information only for properties receiving operating subsidies (add rows as necessary). For each property identified
below, a Pro Forma will need to be completed in Excel, see Form G.

   Rental Assistance             Case Management               Operating Subsidy

Property Name/Address                                                                 # of THOR Units       Total # of Units

I attest that all information, including program responsibilities and associated budget, described herein for our agency as a
subgrantee for the THOR program has been reviewed, and is true and accurate.

Submitted by Executive Director or other Authorizing Official (for the subgrantee)

 Name (typed or printed)                                      Title

 Authorized Signature                                         Date
Subgrantee Application Narrative (submit a separate form for each subgrantee)
Program Design
Complete the following (A through F as applicable) for each subgrantee providing services.

A. Briefly describe who you intend to serve including any preferences/priorities and the program design including case
management model, staffing level (case manager to client household), and collaboration and partnership efforts, etc.

B. Describe the rental assistance/housing experience, staff credentials, etc. that uniquely qualifies the grantee/subgrantee to
offer THOR services to the population(s) specified in your performance measures (Excel, Form F).

If you intend to serve individuals or families with an adult member who has a mental health or chemical dependency
disorder, or who was previously incarcerated, respond to the following:
C. Agency Coordination
Explain how you will coordinate with the following, as applicable: DOC and local law enforcement, RSN, DASA and/or
other agencies (please specify).

D. Unit Safety
Describe your plan to address safety within the housing unit(s) in the event of a significant problem (e.g. a program
participant becomes aggressive or violates terms of their supervision).

E. Location
Explain how your project will avoid overconcentration of harder-to-serve populations in any one neighborhood, housing
project or building.

F. Community/Neighborhood Concerns
Do you anticipate community opposition to the project?
    No       Yes. If yes, describe how you will coordinate with community/neighborhood organizations to address any
concerns (safety, etc.) in providing housing and services to program participants.
The following listed Forms must be completed and submitted. These Forms are accessible
through the Excel Software Program.

FORM F          Performance Measures

FORM G          Operating Pro Forma

FORM H          Proposed Budget

FORM I. Households and Beds (Please complete for both Operating and Rental Assistance

         Households              Projected Level    Projected Level             Total
                                     Year 1             Year 2           Number Projected
                                   01/01/10 –         07/01/10 –            To be Served
                                    06/30/10           06/30/11          01/01/10 – 06/30/11
  Families with children
  Individual and/or families
  without children
  Families with children who
  are receiving services under
  RCW Chapter 13.34
  Individuals or families with
  an adult member who has a
  mental health or chemical
  dependency disorder
  Individuals or families with
  an adult member who is an
  offender released from
  confinement within the past
  eighteen months

                       Project Level        Projected Level             Total
        Beds               Year 1                Year 2          Number Projected
                     01/01/10 - 06/30/10   07/01/10 – 06/30/11      To be Served
                                                                 01/01/10 – 06/30/11
    Number of
    Number of
    Number of
FORM J. Need Statement and Project Description

Need Statement: (Limit response to one page)

Describe the need or problem to be addressed by the proposed project in terms of your project’s
ability to continue and/or expand to provide services/housing to homeless households. (It is
unnecessary to describe the extent and nature of homelessness as the Continuum of Care has a
plan in place outlining those issues.)

Project Description: (Please limit your response to two (2) pages)
1. Describe the proposed project including its purpose, methods utilized to effectively move
   families toward permanent/stable housing, expected results, average length of assistance to
   each family.

2. Describe how project design relates to the 10 Year Plan to Reduce Homelessness goals.

To top