Pierce County Transitional Housing Operating and Rent (THOR) Expansion 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 2009-2010 Transitional Housing Operating and Rent (THOR) Expansion 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 firstname.lastname@example.org 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) Expansion Project Application Agency Name Project Name Agency Contact Person Contact Phone Number FORM D 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: License(s) If required by local government, do you have the necessary license to operate this proposed housing program? Yes N/A No, please explain: Contacts Executive Director Program Contact Client Data Finance Contact Contact Name: Title: Address: (if different from mailing address) Phone: Fax: E-Mail: 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 FORM E 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 Projects) 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 Housing Units Number of Bedrooms Number of Beds 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.
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