Michigan State Housing Developme by fjwuxn


									 Michigan State Housing Development Authority
    2001 Emergency Shelter Grant Program

                     (Exhibit 2)

                         Due Date:
  All Submissions Must Be Postmarked by February 15, 2001

For Further Information, Contact Your Community Development Specialist
                           (See List Attached)
                       Michigan State Housing Development Authority
                      2001 EMERGENCY SHELTER GRANT PROGRAM



     All projects must be part of a local Continuum of Care strategy in order to be eligible to apply.

     Funds requested through this Program Application must be specifically recommended in the ESG
      Funding Strategy submitted by your local Continuum of Care Coordinating Body. If there is a
      discrepancy between funding amounts recommended in the area’s 2001 Continuum of Care
      Planning Document and this Program Application, MSHDA will utilize the figure identified in the
      Continuum of Care document.

     Please pay close attention to the 2001 ESG NOFA as you prepare your application.


     Please use a simple 8 1/2 “ x11” manila folder or pocket folder as a cover for your application
      materials. Materials may simply be clipped or stapled together and inserted into this labeled folder.

     Print or type the legal name of the applicant agency on the upper right-hand corner of the front of the
      folder. Be sure to include your MSHDA Organization Number (4-digit number) on this label, and
      please indicate which folder contains the original.

     Please provide all information and/or materials that are requested. Keep your answers brief and to
      the point. Failure to provide complete information or providing inaccurate information may result in
      denial of the application.

     Each program applicant must submit one ORIGINAL (with ink signatures) and one copy of the
      program application. We require only one copy of attachments and associated materials (e.g.
      Certification of Local Approval, Shelter Standards Certification, Partnership Profile, etc.). These
      materials should be included with the ORIGINAL, only.

     Applications must be postmarked by February 15, 2001. MSHDA will not accept any application that
      does not meet this deadline.

     Submit application materials to:

                             Michigan State Housing Development Authority
                                  Emergency Shelter Grants Program
                             401 S. Washington Square - P.O. Box 30044
                                          Lansing, MI 48909


Operating Expenses (for Emergency Shelter and/or Transitional Housing Operations)

       Expenses associated with the operation of a shelter, transitional housing, or related service facility,
       including (but not limited to) insurance, rent, food, utilities, telephone/cell phone service, internet
       expense, furnishings, agency vehicles, staff transportation, and maintenance and repair of facilities.
       Costs of program and/or grants administration (including accounting and audit-related expenses) are
       also allowable in this category -- up to ten percent of the total MSHDA grant amount.

Essential Services (for Emergency Shelter and/or Transitional Housing Services)

       Expenses for staffing and other related costs associated with provision of homeless prevention
       services, supportive services in shelter and transitional housing, or other housing-related activities
       and services. Eligible expenses include (but are not limited to) both program and direct assistance
       costs which support case management, follow-up, housing skills, child care, parenting education,
       budgeting, employment, health care, substance abuse, education, children’s services, and client
       transportation activities.

Homelessness Prevention

       Direct financial assistance to prevent the occurrence of homelessness, including (but not limited to)
       short-term subsidies to help defray rent and utility arrearage for families that have received eviction or
       utility termination notices; security deposits and/or first month’s rent to permit a homeless family to
       move into their own dwelling; payments to prevent a home from falling into foreclosure; and mediation
       programs for landlord/tenant disputes. Please note: Expenses for staffing for Homeless Prevention
       activities are allowable under the ESG Program, but must be requested under the Essential Services
       category, above.

Continuum of Care Coordinating Expenses

       In the 2001 ESG funding cycle, MSHDA allows a its state-based ESG funding to be used for
       expenses associated with Continuum coordinating activities. These might include costs of printing
       and postage, expenses that enable more active consumer participation in the Continuum process,
       and other related travel, meeting, planning, or coordinating costs. Costs for time and fringes of a
       coordinating staff role will also continue to be eligible. Only one such request per Continuum of
       Care body will be considered. The applicant can be any public or private non-profit agency
       participating in the Continuum of Care planning process and designated by the Continuum as the
       applicant for these purposes.


No matching funds will be required in this submission for 2001 MSHDA ESG support.

                                      OFFICE OF COMMUNITY DEVELOPMENT
                                                   CONTACT LIST
                                       Director: Marjorie Green 517-373-6001
                                       Secretary: Sharon Michael 517-373-3712

Program Managers
Planning Coordinator:      Julie Hales           517-373-6026
Homeless Coordinator:      Chuck Kieffer         517-335-4473
HOME/CDBG Coordinator:     Bill Parker           517-373-1462
Lender Relations:          Howard Miles          517-373-6666
Student Assistant:         Jodi Pulido           517-335-0099

Internal Operations
Operations Manager:        Richard Ballard       517-373-2409
Systems Specialist:        Mary Cook             517-335-7868
Departmental Technician:   Sue Hull              517-335-2002
Financial Analyst:         Jeff Knoll            517-373-3726
Financial Analyst:         Charisse Sanders      517-335-2308
Data Coding Operator       Jean Degenhardt       517-241-4655

Technical Assistance
Secretary:                       Judy Barrett             517-373-8568
Manager:                   Jess Sobel            517-241-0453
Financial Specialist:      Angela Huntoon        517-241-0718
TA Admin- Assistant:       Ann Grambau           517-373-8870

Regions 1 & 3
Secretary:                        Vacant                  517-373-6208
Regional Manager:          Christine Cummins     517-373-3309
Student Assistant:         Tracey McDowell       517-241-2588
CD Specialists:            Darcy Carpenter       517-335-2307      Baraga, Dickinson, Gogebic, Houghton, Iron, Keweenaw,
                                                                   Ontonagon, Ottawa
                           Debbie Irwin          517-241-1157      Allegan, Chippewa, Luce, Mackinac
                           Julie Kanouse         517-241-4656      Branch, Calhoun, Cass, St- Joseph, VanBuren
                           Kathy Koryba          517-241-1158      Alger, Delta, Marquette, Menominee, Muskegon, Schoolcraft
                           Lisa Lehman           517-241-4474      Berrien, Kalamazoo
                           Sandy Pearson         517-335-7291      Newaygo, Oceana
                           J-T- Johnston         517-335-5317      Barry, Kent
Regions 2 & 4
Secretary:                       Julie Barron             517-373-9015
Regional Manager:          Bonnie Rennirt        517-373-3499
Student Assistant:         Cort Roose                     517-241-4350
CD Specialists:            Mary Jo Dean          517-335-3081      Antrim, Benzie, Clare, Grand Traverse, Kalkaska, Leelanau,
                                                                   Missaukee, Wexford
                           James Espinoza        517-335-3078      Bay, Midland, Saginaw
                           Jerrie Lynn Gibbs     517-241-1156      Alcona, Alpena, Cheboygan, Iosco, Manistee, Montmorency,
                                                                   Otsego, Presque Isle
                           Stephen Lathom        517-373-8853      Charlevoix, Emmet, Ingham, Lake, Mason
                           Jodie Sparks          517-335-0615      Crawford, Hillsdale, Isabella, Jackson, Mecosta, Ogemaw,
                                                                   Osceola, Oscoda, Roscommon
                           Vacant                                  Arenac, Clinton, Eaton, Gladwin, Gratiot, Ionia, Montcalm,
Region 5
Secretary:                      Carrie Trover                517-241-4659
Regional Manager:          Jacquelyn Williams-
                             Armstrong           517-373-3383
TA Liaison, Marketing,
  & Outreach Specialist:   Tiffany King          517-241-1155
Student Assistant:         Jenelle Ferance       517-241-2150
Detroit Office:            Joseph Davis          313-256-2861
CD Specialists:            Renee Conklin         517-373-8544        Downtown Detroit, Counties of Lenawee, Livingston, Monroe,
                                                                     Cities of Wayne, Westland
                           Carolyn Cunningham    517-335-4661        Northern Detroit, Genesee County, Cities of Hamtramck,
                                                                     Highland Park, Inkster, Livonia
                           Lisa Edmonds          517-335-3091        Northwest Detroit, Oakland County, Cities of Dearborn,
                                                                     Ecorse, Melvindale, Redford Twp-, Taylor
                           Shulawn Scott         517-241-1106        Southwest Detroit, Detroit Eastside (North of I-94), Counties of

                                                                      Huron, Lapeer, Macomb, St- Clair, Sanilac, Tuscola
                            Connie Zatsick       517-373-1851         Detroit Eastside (South of I-94), City of Belleville, Washtenaw
                      2001 EMERGENCY SHELTER GRANT PROGRAM

                                       PROGRAM APPLICATION

            (Each Program Applicant must submit this form directly to MSHDA, following review and
                      recommendation by the local Continuum of Care planning body.)

1.        Applicant/Agency Identification

 Name of Applicant Agency:


 City:                                 State:                                      Zip:

 County(ies) Served:                   Continuum of Care:                         MSHDA Organization #:

 Federal Employer ID#:

 Contact Person:                                            E-mail:

 Title:                                             Phone:                                Fax:

 Signature:                                                                               Date:

Number of years your agency has provided shelter or services for homeless populations: _____ Years

2.        Budget Request Summary

 Activity                                                   Amount Requested from MSHDA


 Homeless Prevention

 Essential Services

 Continuum of Care Coordination Expenses


        This should be equal to the amount recommended by your Continuum for funding in its ESG Funding Strategy.

3.       Program Summary

         Summarize in one brief paragraph the program and activities for which you are requesting funds.
         This summary should include response to the following:

          a.     Briefly describe your target population.
          b.     Briefly describe the need(s) and gap(s) in your community’s Continuum of Care plan that
                 this program will address.
          c.     Briefly describe the specific activities and services that MSHDA funds will help to support.

4.       Estimate of Number of Persons To Be Served

         a. Point-in-Time Capacity: If proposed MSHDA ESG funds will be used to support any portion of
            your agency’s emergency shelter or transitional housing operations, please indicate the number
            of persons and households your full program can serve on a daily basis.

                                  Programs Serving                       Programs Serving Families
                                  Single Adults and

                                                               Number of Families         Total Number of Persons
                                 Number of Individuals
                                                                 (Households)                    in Families

 Emergency Shelter

 Transitional Housing

         b. Annual Capacity: If proposed MSDHDA ESG funds will be used to support any portion of your
            agency’s activities in the eligible categories listed below, please estimate the total number of
            persons and households that will be served by your full program during the year in each activity
            category (unduplicated annual count).

                                  Programs Serving                       Programs Serving Families
                                  Single Adults and

                                                               Number of Families         Total Number of Persons
                                 Number of Individuals
                                                                 (Households)                    in Families

 Emergency Shelter

 Transitional Housing

 Homeless Prevention

 Essential Services

5.        Use of Funds

          A.        Operating Funds (Fill in only those categories that apply)

                Operations                       Amount                   Brief Explanation of Expense
               Sub-Category                     Requested
                                               From MSHDA


 Services & Costs





 Telephone/Internet Access


 Office Supplies




 Operation Staff (e.g.,
 administration, accounting,
 clerical support)

     o   Transfer total amount to Budget Request Summary on page 5.

     2 This amount cannot exceed 10% of your total MSHDA grant award.

B.        Homeless Prevention Activities (Fill in only those categories that apply)

          Briefly respond to the following questions:

          1.        How often can families/individuals receive homeless prevention assistance?

          2.        What is the cap on the amount that any one family/individual can receive in one year?

          3.        How are your homeless prevention services coordinated with resources of other agencies in
                    your community providing similar supports?

           Homeless Prevention                           Amount Requested            Estimated
                Sub-Category                               From MSHDA            # of Households 2
                                                                                 to be Served with
                                                                                   These Funds

 Utilities Arrearage

 Rent/Mortgage Arrearage

 Security Deposit/
 First Month’s Rent

 Mediation Services



     o   Transfer total amount to Budget Request Summary on page 5.

C.         Essential Services (Fill in only those categories that apply)

        Essential Services                            Amount Requested                                Amount Dedicated to
           Sub-Category                                 from MSHDA                               Fulfilling HUD/SHP Supportive
                                                                                                          Services Match 2

 Case Management/
 Follow-Up Services

 Counseling Services

 Job Training/Education

 Child Care/Children’s

 Housing Placement/ Housing

 Transportation Services/
 Transportation Assistance



In narrative form, briefly describe (for each sub-category) how these funds will be used.

Example: Counseling Services: $12,000 will be used for a .50 FTE drug/alcohol rehab counselor to work with clients
at the shelter. Of the $12,000 amount, $1,500 will be used for benefits.

     2 Single adults should be considered a “household” for these purposes.

     oTransfer total amount to Budget Request Summary on page 5.
     2 Fill out this column only if agency is using funds in conjunction with a current HUD/SHP project.

D.       Continuum of Care Coordination (if applicable)

         Answer the following briefly and succinctly:

         1. Briefly describe the applicant agency and its role/relationship in the structure of the local
            Continuum of Care planning process.

         2. Describe how decisions regarding expenditure of these coordinating funds will be managed and
            monitored at the local level.

     Continuum Coordination            Amount
         Sub-Category                 Requested                 Brief Description of Expense
                                    from MSHDA

 Meeting Supplies




 Office Supplies

 Consumer Involvement

 Travel-Related Expense

 Contractual Staff

 Coordinator Salary/Fringes


     TOTAL: 1

                                                        ATTACHMENT II-A

                                Michigan State Housing Development Authority
                         Certification of Local Approval for Non-Profit Organizations

I,                                                                , (name and title of the highest elected official duly

authorized to act on behalf of the                                                               (name of the jurisdiction)

hereby approve the attached proposal submitted to the Michigan State Housing Development Authority by

                                                                            (name of non-profit) which is located in

                                                                       (name of jurisdiction).

Brief Project Description (optional):




By:           _
              Name and Title



     Transfer total amount to Budget Request Summary on page 5.


                                         ATTACHMENT II-B

                                  CERTIFICATION OF

The following checklist outlines the minimum requirements for shelters requesting Emergency Shelter Grant
(ESG) funds under MSHDA Homeless Programs.

Yes     No


[   ]   [    ]   1.   The agency assures non-discrimination on the basis of race, religion, gender,
                      national origin, age of children or family size, except where limited by the facility.

[   ]   [   ]    2.   Client records are secured in a locked area or locked filing cabinet.

[   ]   [   ]    3.   There are written policies for intake procedures and criteria for shelter admission.

[   ]   [   ]    4.   Alcohol, drugs, and weapons are prohibited in and around the premises. Persons
                      who refuse to relinquish any of these are refused admittance to the shelter.

[   ]   [   ]    5.   Clients are allowed to use the shelter as a legal residence for the purpose of voter
                      registration and the receipt of public benefits.

[   ]   [    ]   1.   There is adequate on-site staff coverage during all hours the shelter is open. (During
                      awake hours, there should be 1 staff person to 30 residents for an adults-only facility,
                      and 1 staff person to 20 residents for a facility housing children.)

                 2.   All shelter staff, including volunteers, have received, at a minimum, training and
                      orientation regarding:
[   ]   [   ]         a.      Fire and emergency evacuation procedures for the facility;
[   ]   [   ]         b.      Emergency procedures for medical, psychiatric, or other crisis situations;
[   ]   [   ]         c.      Special needs of homeless persons;
[   ]   [   ]         d.      Client confidentiality requirements;
[   ]   [   ]         e.      Appropriate chains of authority or command within the shelter.

[   ]   [   ]    3.   There is a written position description for each type of position which includes, at a
                      minimum, job responsibilities, qualifications and salary range.

[   ]   [   ]    4.   There are written personnel policies in effect which also include a Code of

                     Ethics for all shelter personnel.
Yes     No


[   ]   [   ]   1.   The agency complies with all state and local zoning, health, safety, and fire codes
                     and regulations which apply to the safe operation of the shelter.

[   ]   [   ]   2.   Cooking or heating appliances in any room used for sleeping are prohibited.

[   ]   [   ]   3.   The physical plant, premises and equipment, are maintained in a clean and sanitary
                     condition, free of hazards and in good repair. Corrections are made within 30 days of
                     notification of a problem.

[   ]   [   ]   4.   A bed or crib is provided for each guest except in extenuating overflow conditions.
                     Provisions for clean linen for each tenant are made. Procedures to provide for the
                     sanitizing of all linens and sleeping surfaces are in place.

[   ]   [   ]   5.   Sufficient showers/baths, wash basins and toilets are provided for personal hygiene
                     and are in proper operating condition. Towels, soap and toilet tissue are available to
                     each client.

                6.   There is a fire safety plan which includes at least the following:
[   ]   [   ]        a.     A posted evacuation plan;
[   ]   [   ]        b.     Fire drills, conducted as least quarterly;
[   ]   [   ]        c.     Operating fire detection systems which are tested at least quarterly;
[   ]   [   ]        d.     Battery operated alarms which are functional at all times; and
[   ]   [   ]        e.     Adequate fire exits.

                7.   Provisions have been made for the following services:
[   ]   [   ]        a.      Pest control services;
[   ]   [   ]        b.      Removal of garbage from interior premises;
[   ]   [   ]        c.      Properly functioning ventilation and heating systems; and
[   ]   [   ]        d.      Heat, electricity and water 24-hours a day.

[   ]   [   ]   8.   Entrances, exits, steps, and walkways are kept clear of garbage, debris, and other
                     hazards such as ice and snow.

[   ]   [   ]   9.   Adequate natural or artificial illumination is provided to permit normal indoor activities
                     and to support the health and safety of occupants.

Yes     No

FOOD SERVICES         (For shelters providing prepared meals for residents)

[   ]   [    ]   1.   Adequate provisions for the sanitary storage and preparation of food are made.
                      Meals are nutritionally balanced.

[   ]   [    ]   2.   Requirements of a licensed food service establishment under Public Health Code
                      MCL 333.12901 et. seq. are met.


[   ]   [   ]    1.   First aid equipment and emergency medical supplies are available at all times.

[   ]   [   ]    2.   Staff have access to a telephone while on duty. Emergency telephone numbers are
                      posted conspicuously near the telephone.


[   ]   [   ]    1.   Daily attendance logs are maintained and include, at a minimum, the name, age, sex,
                      social security number (if known by the client) and signature of each person residing
                      in the shelter.

[   ]   [   ]    2.   Residents are furnished information about available services in the community.

[   ]   [   ]    3.   The shelter holds money or food stamps, if requested, by a resident and also keeps
                      adequate records of the residents’ money and stamps. The money and stamps are
                      available to the residents on request without unreasonable delay.

                 4.   The following are posted and distributed to residents in appropriate language:
[   ]   [   ]         a.      Rules of the shelter;
[   ]   [   ]         b.      Shelter residents’ rights and responsibilities;
[   ]   [   ]         c.      A list of standards for conditions in shelters; and
[   ]   [   ]         d.      The shelter’s internal grievance procedures.

If you have answered ‘No’ to any of the above questions, please explain what actions you are taking in
order to meet these shelter standards.

My signature below certifies that our emergency shelter and/or transitional housing facilities meet all
of the applicable Basic Standards enumerated in this checklist.

________________________________________                                    ______________________
Executive Director                                                          Date
                                         ATTACHMENT II-C


        New Partnership Profile (first submission by this organization)
        Updated Partnership Profile



CITY:                               COUNTY:                 STATE:            ZIP:

MICHIGAN NONPROFIT #:                          FEDERAL EMPLOYER ID#:

MSHDA ORG. #:                                  MSHDA REGION:


PHONE:                                                      FAX:

CONTACT PERSON:                                              TITLE:

PHONE:                                                       FAX:

FINANCIAL OFFICER:                                             TITLE:

PHONE:                                                        FAX:

FISCAL YEAR BEGINNING DATE:                             ENDING DATE:

GOVERNING BOARD CHAIR:                                      TITLE:


CITY:                               COUNTY:                        STATE:            ZIP:

PHONE:                                                               FAX:

Form Completed By                                                                    Date

NOTE: If the applicant is a local unit of government, a different Partnership Profile is required. Please contact your CD
Specialist for copies of this form.
                                      PARTNERSHIP PROFILE NARRATIVE

1.      Briefly describe the target or service area:

2.      The organization’s primary targeted population(s) (check all that apply):

           Low-income                   Homeowners                        Families
           Very low-income              First-time homebuyers             Single person household
        __ Homeless                     Renters

3.      The organization’s primary services to the community:

          New construction                     Housing rehabilitation             Homeless Programs
          Rental                               Economic development               Social/human services
        _ Other (please describe)

4.      Is the organization an active participant in your local Continuum of Care body?

                 Yes                   No                N/A _________

5.      Organizational planning status: (Not Applicable for Homeless Programs Applicants)

        Is there an organizational development plan?                Yes            No            N/A

                 Date adopted or updated

                 In process?                   Expected completion date

        Is there a strategic community housing plan?                 Yes            No           N/A

                 Date adopted or updated

                 In process?                   Expected completion date

Is the organization part of a City/County/Regional plan? Yes   No   N/A

       Date adopted or updated

       In process?               Expected completion date

                                          REQUIRED ATTACHMENTS
                                (Check boxes and attach documents as appropriate)

                                                           Document Attached              Document Previously
                                                                                          Submitted Still Current

1.      Most Recent IRS - 990 (Corporate Tax Return) 1                                            N/A

2.      Current Fiscal Year Operating Budget 1                                            N/A

3.      Certificate of Good Standing,
        dated within last 12 months 1                                                             N/A

4.      IRS - 501(c)3 Designation 1

5.      Articles of Incorporation 1

6.      Organizational Bylaws 1

7.      List of Board of Directors & Their Titles 1

8.      Current Organizational Chart

9.      CHDO Authorization Letter (if applicable) 2
                   Local PJ

10.     Employee status (Indicate the number
        of paid personnel who work 35 hours or more per
        week and how many paid personnel work less
        than 35 hours per week) 2

11.     Housing employee roster (all full and/or part-
        time positions/FTE’s whose duties include direct
        housing and/or homeless services 1

12.     Target or Service Area Map 2

13.     Planning Documents (any planning documents
        referenced by Question 5 on Page 2) 2

14.     Most recent available fiscal year audit 1

     Include one with original submission only. If current document is already on file, please do NOT include.

    These documents are NOT required for ESG submission .


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