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Home My WebLink About20100287.tiff RESOLUTION RE: APPROVE 2010-2011 COMMUNITY SERVICES BLOCK GRANT(CSBG)APPLICATION AND PLAN AND AUTHORIZE CHAIR TO SIGN WHEREAS, the Board of County Commissioners of Weld County, Colorado, pursuant to Colorado statute and the Weld County Home Rule Charter, is vested with the authority of administering the affairs of Weld County, Colorado, and WHEREAS,the Board has been presented with the 2010-2011 Community Services Block Grant(CSBG)Application and Plan from the County of Weld, State of Colorado, by and through the Board of County Commissioners of Weld County, on behalf of the Department of Human Services, to the Colorado Department of Local Affairs, commencing March 1, 2010, and ending February 28, 2011, with further terms and conditions being as stated in said application and plan, and WHEREAS,after review,the Board deems it advisable to approve said application and plan, a copy of which is attached hereto and incorporated herein by reference. NOW, THEREFORE, BE IT RESOLVED by the Board of County Commissioners of Weld County, Colorado, that the 2010-2011 Community Services Block Grant (CSBG) Application and Plan from the County of Weld, State of Colorado, by and through the Board of County Commissioners of Weld County, on behalf of the Department of Human Services, to the Colorado Department of Local Affairs be, and hereby is, approved. BE IT FURTHER RESOLVED by the Board that the Chair be, and hereby is, authorized to sign said application. The above and foregoing Resolution was, on motion duly made and seconded, adopted by the following vote on the 8th day of February, A.D., 2010. �\ %'OARD OF COUNTY COMMISSIONERS � � '�1� ELD COUNTY, COLORADO ATTEST: • '.. !'rife�452 gl._ 'adem.cher, Chair Wel• ounty Clerk to the Bo.%O ,OuNor CUSED n Barbara Kirkmeyer, Pro-Tem BY: /1 'I , 11 ' Depu lerk t• the =oard Sean if n ay/ C APPR S • ( "1 � 4m . Garcia nttiS orney David E. Long Date of signature: Ii0 2010-0287 00 . flsClcKl -) ,/-2 /� HR0081 MEMORANDUM f lit Avg' DATE: February 4, 2010 (7 TO: Douglas Rademacher, Chair, Board of County Commissioners WIlD C.FROM Judy A Griego, Director, Human Services De rt COLORADO 4(4 u RE: Community Services Block Grant10-20111 b tween(the Weld County Department of H , n Services and e Colorado Department of Local Affairs Enclosed for Board approval is the Community Services Block Grant for Program Year 2010- 2011 between the Weld County Department of Human Services and the Colorado Department of Local Affairs. This Grant was presented at the Board's February 3, 2010, Work Session. Weld County will provide services to the low-income citizens of the County through partnerships between the Weld County Department of Human Services and WELDCO. Weld County has identified a number of areas where low-income citizens can and will be served. Eligible expenses include prorated share of the administration cost pool of expenses that comply with the CSBG Act, including administrative staff time to prepare and monitor the CSBG grant. A. AAA Volunteer and Senior Coordinator Services will direct the 21 senior nutrition sites and provide training to volunteers who run the nutrition program. B. Pre- and post-employment services, including job-seeking activities, providing supplies for employment, including uniforms, transportation vouchers and educational supplies for job training. C. WELDCO provides door-to-door transportation to Weld County senior citizens. Eligible expenses for WELDCO include volunteer and coordinator mileage, supplemental car insurance and staff time to prepare the county-wide senior volunteer banquet. D. Department of Human Services provides emergency assistance. The term of this request will be March 1, 2010 through February 28, 2011. The total of the request is for $279,267.00. If you have any questions, give me a call at extension 6510. 2010-0287 2008-09 Community Services Block Grant (CSBG) Application and Plan PROGRAM PERIOD: March 1, 2010 To February 28, 2011 GRANTEE: Weld County Department of Human Services FEDERAL 0B /E Ideh ,JE a a,' k 1 . Employment X 2. Education 3. Income Management 4. Housing 5. Emergency Services 6. Nutrition 7. Linkages with Other X Programs 8. Self-Sufficiency 9. Health TOTAL CSBG ALLOCATION REQUESTED $ 279,267 LIST OF SUBGRANTEES AND AMOUNT AWARDED: Use additional sheets if necessary. WELDCO $4,500 SUBGRANTEE NAME AMOUNT AWARDED Department of Human Services (Social Services Fund) $110,297 SUBGRANTEE NAME AMOUNT AWARDED SUBGRANTEE NAME AMOUNT AWARDED SUBGRANTEE NAME AMOUNT AWARDED SUBGRANTEE NAME AMOUNT AWARDED 2010-11 Community Services Block Grant (CSBG) Application and Plan NAME OF ELIGIBLE ENTITY: Weld County Department of Human Services ADDRESS OF ELIGIBLE ENTITY: all_MatbjjkAyentanU3Sa A Street address and mailing address if different from street address Greeley C9lorado 80632 City/Town State Zip Code CONTACT PERSONS INFORMATION: PRIMARY Contact Person for Eligible Entity: Judy A. Grieao Phone Number for Primary Contact Person: 970-352-151 ext. 6510 Use direct line number and/or extension Fax Number for Primary Contact Person: 970-353-5215 Email Address for Primary Contact Person: arieaoiaaco.weld.co.us PROGRAM Contact Person: Judv A. Grieao Phone Number for Program Contract Person: $70-352-1551 ext. 651D Use direct line number and/or extension Fax Number for Program Contact Person: 970-353-5215 Email Address for Program Contact Person: grieaoiala'co.weld.co.us FINANCIAL Contact Person: _Dennis Boaott Phone Number for Financial Contract Person: 970-352-1551 Use direct line number and/or extension Fax Number for Financial Contact Person: $70-353-5215 Email Address for Financial Contact Person: Not Available vet Page 2 of 35 CSBG Grant Year 2010-11 Names, Phone Numbers, and Emails of County Commissioners for Eligible Entity: If a multi county entity list the names and phone numbers of all county commissioners in each of the counties for the multi county area. Use additional sheet if necessary Douglas Rademacher, Chair (970)-356-4000 ext.4200 drademacher@co.weld.co.us Commissioner Name Phone Number Email Barbara Kirkmeyer, Pro-Tern (970)-356-4000 ext.4200 bkirkmeyer@co.weld.co.us Commissioner Name Phone Number Email William F. Garcia (970)-356-4000 ext.4200 wgarcia@co.weld.co.us Commissioner Name Phone Number Email David E. Long (970)-356-4000 ext.4200 dlong@co.weld.co.us Commissioner Name Phone Number Email Sean P. Conway (970)-356-4000 ext.4200 sconway@co.weld.co.us Commissioner Name Phone Number Email Commissioner Name Phone Number Email Commissioner Name Phone Number Email Commissioner Name Phone Number Email Page 3 of 35 CSBG Grant Year 2010-11 CERTIFICATIONS: The grantee assures that activities implemented with CSBG funds will be: o used to accomplish the State CSBG Goal and Objective stated in the State Plan; and o within the requirements set forth in the Community Services Block Grant Act, Title IV of the Civil Rights Act, the Age Discrimination Act of 1975, the Rehabilitation Act of 1973, Public Law 103- 227, Part C, Environmental Tobacco Smoke, also known as the Pro-Children Act of 1994 (Act), Certification Regarding Drug-Free Workplace Requirements, Certification Regarding Lobbying, Certification Regarding Debarment, Suspension, and Other Responsibility Matters - Primary Covered Transactions, Office of Management and Budget (OMB Circular A110 and A122), and the current State of Colorado CSBG Plan. The grantee also assures that it will: o specifically consider, in a public meeting the designation of any local public or private entity to carry out the county community service activities under contract with the county, any local community action agency (CAA) which received federal fiscal 1981-82 funding; o consider, on the same basis as other non-governmental organizations, religious organizations to provide the CSBG services, so long as the program is implemented in a manner consistent with the Establishment Clause of the first amendment to the Constitution. Grantees shall not discriminate against an organization that provides assistance under, or applies to provide assistance, on the basis that the organization has a religious character. (Please review Sec.679 Operational Rule in the CSBG Act); o provide for coordination between community anti-poverty programs and ensure, where appropriate, that emergency energy crisis intervention programs under Title XXVI (relating to low- income home energy assistance) are conducted in such community; o provide, on an emergency basis, for the provision of such supplies and services, nutritious foods, and related services, as may be necessary to counteract conditions of starvation and malnutrition among low-income individuals; o coordinate, to the extent possible, programs with and form partnerships with other organizations serving low-income residents of the community and members of groups served, including religious organizations, charitable groups, and community organizations; o establish procedures under which a low-income individual, community organization, or religious organization, or representative of low-income individuals that considers its organization, or low- income individuals, to be inadequately represented on the CSBG board (or other mechanism) to petition for adequate representation; o in the case of public organizations, have a tripartite advisory board which shall have members selected by the organization and shall be composed so as to assure that not fewer than 1/3 of the members are persons chosen in accordance with democratic selection procedures adequate to assure that these members (a) are representative of low-income individuals and families in the neighborhood served, (b) reside in the neighborhood, and (c) are able to participate actively in the development, planning, implementation, and evaluation of program funded. o in the case of private non-profit entities, have a tripartite board that participates in the development, planning, implementation, and evaluation of the program to serve low-income communities. The board shall be composed so as to assure that (a) 1/3 of the members are Page 4 of 35 CSBG Grant Year 2010-11 elected officials, holding office on the date of selection, or their representatives, except that if the number of such elected officials reasonably available and willing to serve on the board is less than 1/3 of the membership of the board, membership on the board of appointive public officials or their representatives may be counted in meeting such 1/3 requirement; (b) not fewer than 1/3 of the members are person chosen in accordance with democratic selection procedures adequate to assure that these members are representative of low-income individuals and families in the neighborhood served, and each representative of low-income individuals and families selected to represent a specific neighborhood within a community resides in the neighborhood represented; and (c) the remainder of the members are officials or members of business, industry, labor, religious, law enforcement, education, or other major groups and interest in the community served; o prohibit the purchase or improvement of land, or the purchase, construction, or permanent improvement (other than low-cost residential weatherization or other energy-related home repairs) of any building or facility with CSBG funds; o prohibit, including subcontractors, (a) any partisan or nonpartisan political activity or any political activity associated with a candidate, or contending faction or group, in an election for public or party office, (b) any activity to provide voters or prospective voters with transportation to the polls or similar assistance in connection with any such election, or (c) any voter registration activity. o prohibit that persons shall, on the basis of race, color, national origin or sex, be excluded from participation in, be denied the benefits of, or be subjected to discrimination under, any program or activity funded in whole or in part with CSBG. Any prohibition against discrimination on the basis of age under the Age Discrimination Act or 1975 (42 U.S.C 6101 et seq.) or with respect to an otherwise qualified individual with a disability as provided in Section 504 of the Rehabilitation Act of 1973 (29 U.S.C. 12131 et seq.) shall also apply to any such program or activity. o participate in the Results-Oriented Management and Accountability (ROMA) System, and describe outcome measure to be used to measure performance in promoting self-sufficiency, family stability, and/or community revitalization; o make available for public inspection each plan prepared as part of the program planning process. The grantee may, at its initiative, revise any plan prepared for CSBG funding and shall furnish the revised plan to the Director of the Community Services Block Grant under the Department of Local Affairs. Each plan prepared for submission shall be made available for public inspection within the county and/or service area in such a manner as will facilitate review of, and comments on, the plan; o cooperate with the State, to determine whether grantee performance goals, administrative standards, financial management requirements, and other requirements of the State, in conducting monitoring reviews including (1) a full on-site review for each grantee at least once during each 3-year period, (2) on-site review for each newly designated grantee immediately after the completion of the first year in which funds were received, (3) follow-up reviews with grantees that fail to meet the goals, standards, and requirement established by the State, and (4) other reviews as appropriate, including reviews of grantees with other programs that have had other federal, State, or local grants terminated for cause. o make available appropriate books, documents, papers, and records for inspection, examination, copying, or mechanical reproduction on or off the premises upon reasonable request by the U.S. Controller General, the State, or their authorized representatives should an investigation of the uses of CSBG funds be undertaken; Page 5 of 35 CSBG Grant Year 2010-11 o in the case of county governments or subgrantees which receive a CSBG award in excess of $100,000, comply with the following three certifications related to the "Limitation on use of appropriated funds to influence certain Federal Contracting and financial transactions (P.L. 101- 121, Section 319 and USC Title 31 Section 1352)": 1. No Federal appropriated funds have been paid or will be paid by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract, continuation, renewal, amendment, or modification of any Federal contract, grant, loan, or cooperative agreement. 2. If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or any employee of a Member of Congress in connection with this Federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form LLL, "Disclosure Form to Report Lobbying," in accordance with its instruction. 3. The undersigned shall require that the language of this certification be included in the award document for subawards at all tiers (including subcontracts, subgrants, and contracts under grants, loans, and cooperative agreements) and that all subrecipients shall certify and disclose accordingly. The grantee certifies to the best of its knowledge and belief, that it and its principals: a) are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from covered transactions by any Federal department or agency; b) have not within a three-year period preceding this proposal been convicted or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public transaction; violation of Federal or State antitrust statues or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property; c) are not presently indicted for otherwise criminally or civilly charged by a governmental entity (Federal, State or local) with commission of any of the offenses enumerated in paragraph (b) of this certification; and d) have not within a three-year period preceding this application had one or more public transactions (Federal, State or local) terminated for cause or default. (If you are unable to certify to any of the statements in this certification, please attach an explanation to this application , CONTRACTOR bc),13r))te-t> If County Gfantee: Cha' man of the Board of County Commissioners must sign If Multi-County Service Agency: Chairman of the Board of Directors with delegated contracting authority must sign. Douglas Rademacher, Chair FEB 0 8 2010 POSITION TITLE: Weld County Board of Commissioners DATE: Page 6 of 35 CSBG Grant Year 2010-11 ao/o-O 7 TRIPARTITE BOARD For each eligible entity that receives Community Services Block Grant dollars there must be a tripartite board in place. The responsibilities of the tripartite board are very clear in the CSBG Act of 1998, Section 676B: "The eligible entity shall administer the community services block grant program through a tripartite board that fully participates in the development, planning, implementation, and evaluation of the program to serve low-income communities." The CSBG Act includes the Composition of the board which is to be determined using a democratic process: 1/3 elected public officials or their representatives 1/3 low-income individuals or their representative 1/3 members business, industry, labor, religious, law enforcement, education or other major group of interest in the community served. The following page(s) must be filled out completely and returned with the application and plan. Include the date of most current by-laws: April 2009 TRIPARTITE BOARD MINUTES: Attach a copy of the CSBG Tripartite Board minutes of the meeting when the CSBG application was reviewed and approved by your CSBG Tripartite board. These minutes are not the minutes from the Board of County Commissioners. A QUORUM MUST BE PRESENT FOR THE APPROVAL OF THE APPLICATION AND PLAN BY THE TRIPARTITE BOARD. PROOF OF PUBLIC HEARING: Attach a copy of the public notice, including the listing in the local newspaper for each county served, calling for public review and comment on your CSBG Application and Plan. MINUTES OF PUBLIC HEARING: Attach a copy of the minutes of the Public Meeting when the CSBG Application was reviewed and approved by the Board of County Commissioners or Agency Executive Board. Page 7 of 35 CSBG Grant Year 2010-11 co I, r O M r Q Y N F— 'Si W = Q � o cq CO N O O N N N c`lN a >- N N N N CO O r rr N 15 -O M M M M a W N r 0 N LL — c0 ,_ O N O cn to O N C O O O N Q' 1.D. �' N N M r M E O ° O (00 r r r o L c N y To w rj. a _ c Cl) EE O c > m • 4.9 O O 2 a} -4-• C C N or N a (a Nr. CO N@ Y . O w OS N U O O a C co O c Q 'O C -2 U N C7 N "o j d ix o .- O1 w a) y O N O N N N ` co ,O 0n N O 2g O li c rn N to O� > m O O p_.) O N z E C m• cp Q. f a N C a> N a c C a O N N .T.. N N O f6 w E a o rn m o •_ 0- Z � >. m 2 S u> Ce UCC a a it rp re Q .0 in C Q -i-a N O N - 'N •o N — F- O Z ->' > LL C d CO N 0 I- N N E C7CE ca w O o O 1a2 Q J c O it o Z CO 0 .. Q N U) W• 0 `0„ > x X > -c co m Cl) 4 N Y c U N N U) 00 N u X TN.c 03° 3 X :w D C U > d E O 3 O CE U N C 2 o O a U -o m 6 Cl) ai c co 3 v v Q E O M M M c0 C 0 (O N Z co O Q .y NOor O Mao 0_ CMn _N N 3.. _O N2 OOo i NON Npcf rU) C EN N N Q N O N U O oE. Q U .cv O O W E v co >7,LO CO T C c a R t r _N fO N _ (0 a) c? Q. Q NM ~ M NM +05 �_ Z E C M N � -o O N p C N N p N W 0 o 7 O � Nn ° N Nr Nv N � .NN El- CO JZU U` °' CO 09. Y r O . LT NJ- LID r M � O 6 01O N N a1 a } c a1 C`O C7 CO U U X X 0 E O O m co o co J U $2 • O 3 a > U z 0- a a) a a) 0i C7 z z z This page intentionally left blank. Page 10 of 35 CSBG Grant Year 2010-11 COMMUNITY ACTION PLAN: As required in the reauthorized CSBG Act, please answer all 5 questions using additional sheets as needed. SUBCONTRACTORS are NOT required to submit an Action Plan. 1. COMMUNITY NEEDS ASSESSMENT: Our State office must secure from each CSBG eligible entity, as a condition to receipt of funding, a community action plan that includes a community-needs assessment for the community served. This community-needs assessment may be coordinated with community- needs assessments conducted for other programs. The Community Needs Assessment must address the needs of those in the community who are at or below 125% of poverty. A first step for a Community Action Plan is a survey of clients served to determine where the gaps may be in assisting individuals to become self-sufficient and to move out of poverty. The Community Action Plan includes the results of the community needs assessment, the service delivery system, how coordination occurs with other public and private resources, and information on the innovative community and neighborhood-based initiatives. 2. SERVICE DELIVERY SYSTEM: Describe the service delivery system for services provided or coordinated with CSBG funds that target low-income individuals and families within your service area. 3. LINKAGES: A. Describe how linkages will be developed to fill identified gaps in services, through the provision of information, referrals, case management, and follow up consultations. B. Describe how linkages will be established between government and other social service programs to assure effective delivery of service to low-income individuals and to avoid duplication of such services 4. COORDINATION WITH OTHER PUBLIC AND PRIVATE RESOURCES: Describe how CSBG funds will be coordinated with other public and private resources, which would include any resources beyond financial. 5. INNOVATIVE COMMUNITY AND NEIGHBORHOOD-BASED INITIATIVES: Describe how CSBG funds will be used to support innovative community and neighborhood-based initiatives related to the purposes of CSBG, which may include fatherhood initiatives and other initiatives with the goal of strengthening families and encouraging effective parenting. The following language is a quote from the CSBG Act to fulfill the requirements of the above listed information: (3) information provided by eligible entities in the State, containing-- (A) a description of the service delivery system, for services provided or coordinated with funds made available through grants made under section 675C (a) (Grants to Eligible Entities and Other Organizations. ) , targeted to low-income individuals and families in communities within the State; " (B) a description of how linkages will be developed to fill identified gaps in the services, through the provision of information, referrals, case management, and followup consultations; Page 11 of 35 CSBG Grant Year 2010-11 (C) a description of how funds made available through grants made under section 675C(a) will be coordinated with other public and private resources; and " (D) a description of how the local entity will use the funds to support innovative community and neighborhood-based initiatives related to the purposes of this subtitle, which may include fatherhood initiatives and other initiatives with the goal of strengthening families and encouraging effective parenting; " (4) an assurance that eligible entities in the State will provide, on an emergency basis, for the provision of such supplies and services, nutritious foods, and related services, as may be necessary to counteract conditions of starvation and malnutrition among low-income individuals; " (5) an assurance that the State and the eligible entities in the State will coordinate, and establish linkages between, governmental and other social services programs to assure the effective delivery of such services to low-income individuals and to avoid duplication of such services, and a description of how the State and the eligible entities will coordinate the provision of employment and training activities, as defined in section 101 of such Act, in the State and in communities with entities providing activities through statewide and local workforce investment systems under the Workforce Investment Act of 1998; (6) an assurance that the State will ensure coordination between antipoverty programs in each community in the State, and ensure, where appropriate, that emergency energy crisis intervention programs under title XXVI (relating to low-income home energy assistance) are conducted in such community; " (7) an assurance that the State will permit and cooperate with Federal investigations undertaken in accordance with section 678D; (8) an assurance that any eligible entity in the State that received funding in the previous fiscal year through a community services block grant made under this subtitle will not have its funding terminated under this subtitle, or reduced below the proportional share of funding the entity received in the previous fiscal year unless, after providing notice and an opportunity for a hearing on the record, the State determines that cause exists for such termination or such reduction, subject to review by the Secretary as provided in section 678C(b) ; " (9) an assurance that the State and eligible entities in the State will, to the maximum extent possible, coordinate programs with and form partnerships with other organizations serving low-income residents of the communities and members of the groups served by the State, including religious organizations, charitable groups, and community organizations; " (10) an assurance that the State will require each eligible entity in the State to establish procedures under which a low-income individual, community organization, or religious organization, or representative of low-income individuals that considers its organization, or low-income individuals, to be inadequately represented on the board (or other mechanism) of the eligible entity to petition for adequate representation; " (11) an assurance that the State will secure from each eligible entity in the State, as a condition to receipt of funding by the entity through a community services block grant Page 12 of 35 CSBG Grant Year 2010-11 made under this subtitle for a program, a community action plan (which shall be submitted to the Secretary, at the request of the Secretary, with the State plan) that includes a community- needs assessment for the community served, which may be coordinated with community-needs assessments conducted for other programs; " (12) an assurance that the State and all eligible entities in the State will, not later than fiscal year 2001, participate in the Results Oriented Management and Accountability System, another performance measure system for which the Secretary facilitated development pursuant to section 678E(b) , or an alternative system for measuring performance and results that meets the requirements of that section, and a description of outcome measures to be used to measure eligible entity performance in promoting self-sufficiency, family stability, and community revitalization; and " (13) information describing how the State will carry out the assurances described in this subsection. Page 13 of 35 CSBG Grant Year 2010-11 BUDGET-Use only the attached forms. Complete your budget in as much detail as possible utilizing the provided format. This information will be used for monitoring and performance evaluation. It is critical to include any and all costs that will be associated with the CSBG Program. PERSONNEL COSTS Indicate the CSBG dollar amount allocated to each position(s) funded including fringe benefits. Indicate the percentage (%) of the person's time paid with CSBG funds on timesheets, unless actual timekeeping is tracked. Each employee paid with CSBG must have a signed timesheet indicating the time spent on CSBG activities. DIRECT OPERATING COSTS Direct program costs can be identified with delivery of a particular project, service, or activity undertaken to achieve an objective of the grant program. For CSBG, these purposes and eligible activities are specified in the reauthorizing statute and reflected in the national ROMA performance measures. Direct program costs are incurred for the service delivery and management components within a particular program or project. Therefore, direct costs include expenditures on some activities with administrative qualities, equipment, training, conferences, travel, and contracts, as long as those expenses relate specifically to a particular program or activity, not to the general administration of the organization. ADMINISTRATIVE COSTS also referred to as INDIRECTIOVERHEAD Administrative costs are equivalent to typical indirect costs or overhead. As distinguished from administration or management expenditures that qualify as direct costs, administrative costs refer to central executive functions that do not directly support a specific project or service. Incurred for common objectives that benefit multiple programs administered by the grantee organization, or the organization as a whole, administrative costs are not readily assignable to a particular program funding stream. Rather, administrative costs relate to the general management of the grantee organization, such as strategic direction, board development, executive director functions, accounting, budgeting, personnel, and procurement. If your indirect costs are based on a percentage that figure must be consistent throughout the grant year. SUBCONTRACT COSTS Those dollars allocated out to subcontractors to provide CSBG related services. This information needs to be as detailed as the information provided by the eligible grantee in order for the grantee to monitor the subcontractor for compliance in both program and financial operations in accordance with all applicable laws for CSBG. This would include the application and plan, CSBG Act, and OMB circulars. Page 14 of 35 CSBG Grant Year 2010-11 This page intentionally left blank. Page 15 of 35 CSBG Grant Year 2010-11 M 2 m O 3 le oel I) Ca •. 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Z � (0 U C C U U W U ZW Ncm « a inc"' _0 -= "— coccooccc) O .O T.o 000m@ _ _C' H 2 — .— u 8o � 11) Nc m, 20 NCT) � aa) N •O ay9 € � co) "-) aJ O 0 CI c m C C .- U .0 C C "O - COW E O Oz "Eo -0 O O.0 C O .O O) a) 00 El C C N O = 1.. O = 000 "O jD dal o O Q - ¢ = a mw ` omo `ma rnow ma V) 0. •+ H aS5 o N m to oo g on OO k u § 2 \ \ // ,... � } 0 � Q d \ \ S _ .o ® CD 2 � / 0 m { \ 2 -- / e ao. \ C)a { ++ cd I & \ •-0 ) \ a ® E & k /., ) j 1) j § / /\.{ \ ( / D Ca 0 ) \ I,-,) 0 2 .(\ ® •; o » ; l- } ( i ) \ 0c - az @ 5 CO5 22 , ] ® 23 / oj ' # \ \ - E ° • `2 / § s E - fy 0io * > I - 2 � t7 a / » •` � \ \ v ■ • § § »9G ( O.-Oe 0 � [ 32 § ) \ j \ \ & 2 & 0 O § 0 0 0 LO r CO N- O 6 W O N N N N N ar c m O m w U Y C co II a) a) CO C O :`+ C a, ++ C a) C, CO a m - I— Colorado CSBG ROMA Instructions by Section Headings: FOR EACH PROGRAM FUNDED BY CSBG USE ONE(1) FORM. Summary Sheet Instruction Form Implementing Agency: Complete Name of the Organization applying for CSBG funding. Select National Indicators: These are provided as an attachment with the application and plan. Select Federal Objective: Applicants must mark ONE Federal Objective. See Federal Objectives descriptions to determine the Federal Objective that should be identified. Select National Goal(s): GOAL 1 Low-income people become more self-sufficient. FAMILY GOAL 2 The conditions in which low-income people live are improved. COMMUNITY GOAL 3 Low-income people own a stake in their community. COMMUNITY GOAL 4 Partnerships among supporters and providers of services to low-income people are achieved. AGENCY GOAL 5 Agencies increase their capacity to achieve results. AGENCY GOAL 6 Low-income people, especially vulnerable populations, achieve their potential by strengthening family and other supportive systems. FAMILY Low income Target Population: Indicate the specific population of whom you provide services. The purpose of this documentation is to track programs that are specific to youth or specific to seniors. If the population is not either youth or seniors do not check either box, it will be assumed that you provide services to all populations. Page 20 of 35 CSBG Grant Year 2010-11 COLORADO CSBG ROMA SUMMARY SHEET CONTRACTOR/SUBCONTRACTOR County/Multi County: Weld County Implementing Agency Weld County Department of Human Services (Each agency/subcontractor receiving CSBG dollars must complete this form) Implementing Agency Contact Person: Judy A. Grieco Complete Mailing Address, including zip: P.O. Box A, Greeley, CO 80632 Phone Number(970) 352-1551 ext. 6510 Fax: (970) 353-5215 Email Address: griegoja@co.weld.co.us Program Period: March 1, 2010 to February 28, 2011 Select National Indicators: 6.1a (see CSBG National Indicators sheet) (i.e. 1.2, 2.1,6.2, etc.) SELECT ONE FEDERAL OBJECTIVE O Employment O Nutrition ✓ Linkages with Other Programs O Income Management O Self-Sufficiency O Housing O Emergency Services O Education O Health The National Goal and National Indicator should match. (i.e. National Indicator 1.2, National Goal 1) O Goal 1 Low-income people become more self-sufficient. (Family) O Goal 2 The conditions in which low-income people live are improved. (Community) O Goal 3 Low-income people own a stake in their community. (Community) O Goal 4 Partnerships among supporters and providers of services to low-income people are achieved. (Agency) O Goal 5 Agencies increase their capacity to achieve results. (Agency) ✓ Goal 6 Low-income people, especially vulnerable populations, achieve their potential by strengthening family and other supportive systems. (Family) LOw INCOME TARGET POPULATION: ONLY CHECK IF YOUR PROGRAM THAT IS FUNDED WITH CSBG DOLLARS SERVES ONLY SENIORS OR YOUTH. X SENIORS \ YOUTH Program Director Signature: l f/ 't a I Date: 4/ t> C I C Name and Title: Judy A. Grieq(Director-Veld County Departmd t of Human Services Page 21 of 35 CSBG Grant Year 2010-11 Page Two Instruction Form Program Description: Provide a description of the program in two sentences or less. CSBG Program Mission Statement: Give the mission statement of the program that the CSBG funds are being used in; not the Agency mission statement. MISSION STATEMENT SHOULD ADDRESS THE FOLLOWING: • Uses language that identifies the population being served. • Describes the type of services/intervention. • Explains the results/outcomes or impact that the organization/program is trying to achieve. • Includes language identifies the area to be served (city, region, area). • Clear and concise. (EXAMPLE - Create a practical and useful reporting ROMA system for Colorado CSBG fund recipients and implement training to achieve an improved quality of standard reporting.) Problem, Need or Situation: State the identified problems in your community determined by the needs assessment related to this application. This is directly related to your mission statement. Service, Activity or Intervention: State the specific service, activity or intervention provided to address the problem, need or situation. Include the estimated total number of people (target population) who receive the services provided. Target population: household, family, partnerships, etc. Helpful Hint: Your agency will have to identify when a client becomes a client—is it at the time of the initial phone call, or is at another time? Outcome: Your Outcome is the Ultimate Goal of why your program exists; it is the impact your service, activity or intervention has on your family, agency or community. You may have more than one outcome per program. You may elect to outline short term, intermediate and long term outcomes. Helpful Hint: An outcome does NOT indicate number of clients receiving services. Indicator: Using the data from past years identify the number of clients that are proposed to be served, identifying the percentage of those clients who will complete the program identified to use CSBG funds. Helpful Hint: This information is from a historical viewpoint. For an emergency shelter that does not turn anyone away the formula would be 250 or 100% of homeless individuals are provided shelter. THE FOLLOWING INFORMATION IS LOCATED IN THE FAR RIGHT COLUMN. Measurement Tool: Tools used to track your outcomes: surveys, attendance log, case record and pre- and post-test, in-take forms, etc. Data Source and Collection Procedures: Describe how data as related to your outcome is collected. Describe where information is located and be specific. Helpful Hint: Central Database, individual case records, another agency, etc. Frequency of Data Collection and Reporting: State how often data is required by the agency to be collected and reported, e.g., daily, weekly, monthly, yearly, etc. Page 22 of 35 CSBG Grant Year 2010-11 _ as m . ¢ L ° aui �° Ha U. 0a N N J.NQ N2 -0 E ZW CO 0-0.- - mDcc (0m¢ � E- N fL6 cal W (gOQ: C ILIWZILI aJ JiO.: mt ¢ my pQ 2 Mr O1 Fm - n•• c - �- C C Nu) Z. 0) y d"OUO Wp.a .o o ° °o m '- ° og E o0 C O 0 = y WW " DUbrk rw >,.' p_v >. ¢ V mo co 0 Q 4. m C Q F J c W F 0::,. p_ E N N N a N c c � N (� C ._ O W.40G' re = p rn� m c rn ,.c c rn � d ' C 'Op =, :o- d >- l6 ' LL 12 O C W O ° ° _ "� d ca ew a ° gym m aa,,, d 0mO ° � 1cmo CO N C N Q2�E _ " a, a N n- co t) nvi CD 0 O c5 -``qt aO z } "' ' N U N a E -- �, ° 2L 'o .., OFx 'yaZi L E '> 3 C O - U ,__ vf< c 'c oic2 a) 45 w rn45 c ciao d a . ` c � Jo2Lu � x 4ss o o az:a° o aci oo E m O > C - Ea 0zW c a) p (p was N FNW a) c c ° E 0 f. z u- to U1 L U N O 0 d Wa.0O a, - ° 3 - rn 02 � L 1Wrapu) ock rnc > - a) o U D. my., ,0mZIZi. CD ous oY - mr 0 C w x f .z a ° ° °0 c Nw ° C - 0 C . ...022x ~ e= E cc o o N to o U) -0 a mOwxt. a ° a; = 23s C 3diI- ^ OC1M1- N3'v- F- Z 3 w o .0 F co a L. H 0 $ ' ,1 J a p, o � � Y W sel3 L 7 � - wG } x5.. me -03 o . o C W O ..:.x • Q cciW ¢ v o ° eE o.1C'). U y O 0 •• E `U, o z ,y.,,. o o0 o n °cop a) m N N N .4 -° re .� '� 'n � . c c N a7 J a c U r cal U in 2 Q rm 2 'y vsazcmz ¢ o o a) n 2 Q W L y >' 00 ° � n o ° � v v ZO F •+ °' _,,,a1:00'. y 0c P_ � Zdcornw c - cis .n Co O C . s W W c .c c c 2n E LU U {$,5 _ La) - ° m ° o - c ° as m d � 00 2 0 < 2 ~ m FV) > cby U3mdn a, EN O d ` 3 m Co• t6 fn 0 o 4 CO W N N W 0 O 0 2 o p n Q 3 X •O `40 OZZO ' ' . o c0 a F (e 0 (c L vi rt O I- E a '3 "2 O O - Q a p a rn O C O d d .; x o o - 3 aad MCA ar E3 COLORADO CSBG ROMA SUMMARY SHEET CONTRACTOR/SUBCONTRACTOR County/Multi County: Weld County Implementing Agency Weld County Department of Human Services (Each agency/subcontractor receiving CSBG dollars must complete this form) Implementing Agency Contact Person: Judy A. Griego Complete Mailing Address, including zip: P.O. Box A, Greeley, CO 80632 Phone Number(970) 352-1551 ext. 6510 Fax: (970) 353-5215 Email Address: griegoja@co.weld.co.us Program Period: March 1, 2010 to February 28, 2011 Select National Indicators: 1.1a (see CSBG National Indicators sheet) (i.e. 1.2, 2.1,6.2, etc.) SELECT ONE FEDERAL OBJECTIVE ✓ Employment O Nutrition O Linkages with Other Programs O Income Management D Self-Sufficiency O Housing D Emergency Services O Education O Health The National Goal and National Indicator should match. (i.e. National Indicator 1.2, National Goal 1) O Goal 1 Low-income people become more self-sufficient. (Family) O Goal 2 The conditions in which low-income people live are improved. (Community) O Goal 3 Low-income people own a stake in their community. (Community) O Goal 4 Partnerships among supporters and providers of services to low-income people are achieved. (Agency) O Goal 5 Agencies increase their capacity to achieve results. (Agency) O Goal 6 Low-income people, especially vulnerable populations, achieve their potential by strengthening family and other supportive systems. (Family) Low INCOME TARGET POPULATION: ONLY CHECK IF YOUR PROGRAM THAT IS FUNDED WITH CSBG DOLLARS SERVES ONLY SENIORS OR YOUTH. SENIORS YOUTH Program Director Signature: L" - Date: y��C C Name and Title: Judy A. Griea/ALL\ irector-W Lid Co v Departm nt of Human Services T �. Page 24 of 35 CSBG Grant Year 2010-11 Page Two Instruction Form Program Description: Provide a description of the program in two sentences or less. CSBG Program Mission Statement: Give the mission statement of the program that the CSBG funds are being used in; not the Agency mission statement. MISSION STATEMENT SHOULD ADDRESS THE FOLLOWING: • Uses language that identifies the population being served. • Describes the type of services/intervention. • Explains the results/outcomes or impact that the organization/program is trying to achieve. • Includes language identifies the area to be served (city, region, area). • Clear and concise. (EXAMPLE — Create a practical and useful reporting ROMA system for Colorado CSBG fund recipients and implement training to achieve an improved quality of standard reporting.) Problem, Need or Situation: State the identified problems in your community determined by the needs assessment related to this application. This is directly related to your mission statement. Service, Activity or Intervention: State the specific service, activity or intervention provided to address the problem, need or situation. Include the estimated total number of people (target population) who receive the services provided. Target population: household, family, partnerships, etc. Helpful Hint: Your agency will have to identify when a client becomes a client—is it at the time of the initial phone call, or is at another time? Outcome: Your Outcome is the Ultimate Goal of why your program exists; it is the impact your service, activity or intervention has on your family, agency or community. You may have more than one outcome per program. You may elect to outline short term, intermediate and long term outcomes. Helpful Hint: An outcome does NOT indicate number of clients receiving services. Indicator: Using the data from past years identify the number of clients that are proposed to be served, identifying the percentage of those clients who will complete the program identified to use CSBG funds. Helpful Hint: This information is from a historical viewpoint. For an emergency shelter that does not turn anyone away the formula would be 250 or 100% of homeless individuals are provided shelter. THE FOLLOWING INFORMATION IS LOCATED IN THE FAR RIGHT COLUMN. Measurement Tool: Tools used to track your outcomes: surveys, attendance log, case record and pre- and post-test, in-take forms, etc. Data Source and Collection Procedures: Describe how data as related to your outcome is collected. Describe where information is located and be specific. Helpful Hint: Central Database, individual case records, another agency, etc. Frequency of Data Collection and Reporting: State how often data is required by the agency to be collected and reported, e.g., daily, weekly, monthly, yearly, etc. Page 25 of 35 CSBG Grant Year 2010-11 E LO .- a) M w O O W b C 3 O N N i _c a) rnN -o -oo 6 `o ar i O C W C O Z U) R) aN _ o O N J. p- m C a) O E 0 E a ° o i T E T _O a) C O O. i 7 C a) E O 0 V T U) O v to a) N O a 9 O >' c C t i N o 3 O W U o_ _o •>` vL fin C i N i a.)v coC 'V w 4- CO C t 0 03 7 a o E ,+LYn a T— a) O) p O Wi a) 7 N E --O �N O O. r CD 7 4) Cm.�« 5 iC va 2 O_16 E .a) d n N 0 C I O - C -7 (1) fl 'T W O i i 3 - Uv E O i J 7 T — W L CD C a « E I— � - ° $ W C a) n _0 i E o N E al «' F12 >- Otzfa ce Q - 'c W 0 E W i a W o m Ty N Z 'c EQ E 2 I a cn a) O a a2Z ._E Ce Roma - m Cl)C 0 yNw 0 W T O N U O o W a 3 O c E o c C ct O 0 Oc0C9C J i OYToO m O m x i m x m o a a. a a a 0 •o . sz � , _ - OOY':., c .. o roc o c � " o FQ p �c o g 3 t v c F 7LL F.. � Ecc � nEwm -°c tir a � ai nooc' N co co ZW . y :OUZ -oo• wpmO m ° om a) m c ' Qq° m gUR' p ?>- Wi= d °- aOiaoidoddo -o oacC. co me @aoai n DOU;G 3WOW' EWiywoovoiodd = 3wc -o° --pa LmYvoi S.Et ,_ o0 O < wW al Et armm .E ?.2od ` Owm o trnNaE E no Q 1-',•"4O' .. O W cm cv F• O .@. E > E a' c �° m c N N N S N O Y U c m .m. O O N N WC'Ca LL <$4 O ° in ° 02 o m e n U@ o am v m° E ° °o o n @ } a foga LL' ,>e ? N y E=_ a' m N N m O 0 O c = _ 3 g m E et � ` U m N O co E≥ ° w U ° D1 m" a� £ Z N uy a U v Y a c o 3 a ON > w C gh _ a) 2 p a� E OFrt O43 ' c i21- a) am E Ie a ° ( i. pc .C _ O I'D c _ F- wi- W a) to woa) m Ed c3 W m O 0J 0cx o U z o N m Q E Da c -° .O U C N z,aUVJr.:; a ° o � .� ° ¢ 3 doom t I- 1@c a c v d m Z LL�i ,,, ,, M o 'm Bo •,WCO ° � Emm --3 FAO .k l w u- 3 '9 '"4OO f1 U ... C O W,"X µVAII a) m Y p taw , 9-. OiE .EOw O,m`& W O a o c LL'y•y'4LL , .d ,F� I— Z �W � y cm F. 2W O ' 9Ua an ii0P (-4F ow r � 3 aE di dg — J a) m c C (a CO N F'{� > 0) 3 = .0 N w L V w w 0 w 'p -5 j C -g p (n w m ow ) c� �.. y � � Yc � co � m uo d -Owg , Uaorn� o '-i_ CAW, u w w N-o tii O L a) 2 E- 'Z W o casi O N 'L" r j cw? T C a) p C V O C L O W . :� W Z � w w oawiro c Ste 2 ''n, c c — !P�• a) ' F w3 , .= U FOZ. ,, v' > OawaW ma « LE o ca o w cop, � " a w 3 � oawi w wd1° , E 5 Z Dec c -≥ u E. c w> a u'i m �' m c ' w a O ` o c al w w» caw ` a' to >. 3 - ''.OWJ m 'c c%) >, to ):° Etna) , � 0 c = a) oa1 .. L « ≥ wo N yO.c,~t C—s •• E d C E.� O a L W T w O > O U o N C C2 L-' w L C N N C C p C E tat.9W > �fz ca) ddEvo we aOv _ owmwmmE . > E8 . m $ ma' W 'aa a Eca ao � wocacw .. Ern3a °a_ a or aEL � octiEwom `�' WE y ' 2oo °) 0 ` uvc = 0m oLwooaEvEma' s `� E cc a 'omda OQ.`Zm F• ryf�'' 0. Eta E .. wt� w — o aHtndmwW co « « 3w Nww � ta > a$ o s . . E. m u, co To co o = c mEdaw' E m movmFEr. � $) O W , x+ Q U .> m E Z r c -O-00030 O. J m C a p.m m 0.C w Lm a) na 0 uj °a a� ° ,. LOG`O ik -°. a°i ca. .(0 0 3o m aci «-' c o m ° `° aci >,0 N 2 ,.'-,;(g-0F �.F,x E >. c2Ea > 3 0) = E = 0 ,0 .-.. — E >, > 0- 5a) Ec0Ow ° 0E0 °- dc 'ex0. < kr #; N EO m U OTw8 �O -p ≥ N c N O'o p tmj °» E o m pap a) -"-1.'0--,Et � `Mru4 p ° > a) a Y a ≥ m m@ p °' a Y a '_' a) C °- m` e = D ice-, umcE ° s "° oa Eaoox � mEo - E ° M. ZN t,yr-s dm .comis wS rno dmo oa� madc o COLORADO CSBG ROMA SUMMARY SHEET CONTRACTOR/SUBCONTRACTOR County/Multi County: Weld County Implementing Agency Weld County Department of Human Services (Each agency/subcontractor receiving CSBG dollars must complete this form) Implementing Agency Contact Person: Judy A. Griego Complete Mailing Address, including zip: P.O. Box A, Greeley, CO 80632 Phone Number(970) 352-1551 ext. 6510 Fax: (970) 353-5215 Email Address: griegoja@co.weld.co.us Program Period: March 1, 2010 to February 28, 2011 Select National Indicators: 6.1a (see CSBG National Indicators sheet) (i.e. 1.2, 2.1,6.2, etc.) SELECT ONE FEDERAL OBJECTIVE O Employment O Nutrition ✓ Linkages with Other Programs O Income Management O Self-Sufficiency O Housing O Emergency Services O Education O Health The National Goal and National Indicator should match. (i.e. National Indicator 1.2, National Goal 1) O Goal 1 Low-income people become more self-sufficient. (Family) O Goal 2 The conditions in which low-income people live are improved. (Community) O Goal 3 Low-income people own a stake in their community. (Community) O Goal 4 Partnerships among supporters and providers of services to low-income people are achieved. (Agency) O Goal 5 Agencies increase their capacity to achieve results. (Agency) O Goal 6 Low-income people, especially vulnerable populations, achieve their potential by strengthening family and other supportive systems. (Family) Low INCOME TARGET POPULATION: ONLY CHECK IF YOUR PROGRAM THAT IS FUNDED WITH CSBG DOLLARS SERVES ONLY SENIORS OR YOUTH. X SENIORS / YOUTH �i JJJ�� Program Director Signature: / a L,, ) Date: / I /<1 U I O Name and Title: Judy A. Griego Di ector-Wel County De artment of Human Services Ir Page 28 of 35 CSBG Grant Year 2010-11 Page Two Instruction Form Program Description: Provide a description of the program in two sentences or less. CSBG Program Mission Statement: Give the mission statement of the program that the CSBG funds are being used in; not the Agency mission statement. MISSION STATEMENT SHOULD ADDRESS THE FOLLOWING: • Uses language that identifies the population being served. • Describes the type of services/intervention. • Explains the results/outcomes or impact that the organization/program is trying to achieve. • Includes language identifies the area to be served (city, region, area). • Clear and concise. (EXAMPLE — Create a practical and useful reporting ROMA system for Colorado CSBG fund recipients and implement training to achieve an improved quality of standard reporting.) Problem, Need or Situation: State the identified problems in your community determined by the needs assessment related to this application. This is directly related to your mission statement. Service, Activity or Intervention: State the specific service, activity or intervention provided to address the problem, need or situation. Include the estimated total number of people (target population) who receive the services provided. Target population: household, family, partnerships, etc. Helpful Hint: Your agency will have to identify when a client becomes a client—is it at the time of the initial phone call, or is at another time? Outcome: Your Outcome is the Ultimate Goal of why your program exists; it is the impact your service, activity or intervention has on your family, agency or community. You may have more than one outcome per program. You may elect to outline short term, intermediate and long term outcomes. Helpful Hint: An outcome does NOT indicate number of clients receiving services. Indicator: Using the data from past years identify the number of clients that are proposed to be served, identifying the percentage of those clients who will complete the program identified to use CSBG funds. Helpful Hint: This information is from a historical viewpoint. For an emergency shelter that does not turn anyone away the formula would be 250 or 100% of homeless individuals are provided shelter. THE FOLLOWING INFORMATION IS LOCATED IN THE FAR RIGHT COLUMN. Measurement Tool: Tools used to track your outcomes: surveys, attendance log, case record and pre- and post-test, in-take forms, etc. Data Source and Collection Procedures: Describe how data as related to your outcome is collected. Describe where information is located and be specific. Helpful Hint: Central Database, individual case records, another agency, etc. Frequency of Data Collection and Reporting: State how often data is required by the agency to be collected and reported, e.g., daily, weekly, monthly, yearly, etc. Page 29 of 35 CSBG Grant Year 2010-11 , = m c Z y0)0 2C000m C0 Q 2 WJox,....4.#6 V�J 0. 2 .2 < a3 -00 < -P- LI,CO r y SOU © WOp a0oo c - o � o y VIa0 CO JU ra ILI caZ, m ac m _- 00E Mo d y m CV IA) 0 W < OOZ `044Z no rn� m c m ;, 0) m g N E a u o.` LL c as a o Q .E O_ o Q co co d ov a > m Ew t f2 To �y. „ C roO0w as co 0 g p 4L" 2 N N N o c V C " (15,= .L.+ U jo U` L a?W•LL: r• U m Y a) nU 2 — Q .,- -8 m m a7cp. ca ,,". y;.. O V _ 'OcL ° UC f0 u) c ` Oca) (4 a+ z O a O c la o E a) .L. O ik 0 E O rn y m o a) CO 't.CC z o dw ° � uav) ocmoc = 3c A')00 I's N 1-) L - m '- mv nmta Z ° 0 •-c 3:"FU:FN do aai ~ Evo � amimcymm � � 'E. 2 is atu2V o c v m am w c .am m N a� . oc VOWV mN mo a) aoo3LSo. cm0CV C2 r t•_o,.a V N O` N —1O o `O N o O J o L = a) o o w N ? din 6. .- ahem Nv000 c > a N RI O 2 V d � vO`�-W c N ".ZLLrLa '0 is co WOQp ` N 15 t mull- a w ` m C la 0„ WnW Z c w C 'O !NO N I- 0 s 43 v N COC - .L+ S m.O W{".� _ .c N •E C LL = O L .— _ W rZ.W Z 0 k4, 3 ° E O CU 0...C 0.7 U W I- was E2 — a c0 o d V > p.. O a a) CO Oy O.OW2 k, N CC i N 00MI- a) „', CU c C a> .- E � . W O a) t 'Js 0 o) N ) Lit S 0 Ott '�a W 0 c O I— .. W c rn c.) o c o U ' FOZ»", o um, oo o f & c ZO0A > .,z g" ,-a , c›i � � � m a J W �R �' W gr .a - N m c 0 t Wag 0— LIJ?O.0 m N -O .c 0 7 O H c O 1745 yet O. Q `� 1a > a0 fn O H a EU _ Q > a Oc I-- Es OW <L) mE '� cw d CJZWS.. L w m 0 ar Zap O < _ mr° F- � Eu � � y. Fe O O > O .v. 'at{ 0 0 0 o O O (� a) CO CO v m c o. ' . t-).r w a) > o C 0 o — N to W o mar : o 3oc U 0 L 22 Y ,,- , , ;. - C O v O cs O oQv < E I" COJ Z . ', -1 E _ CD cc pF � � (7 `md mop . m >, acm -°o2 ,_ O > Oca oO o � Eo Omd' o gym = 0ujI- ° nmo00aa)) r C) aaa a a.. zo ...: 0_ m ..... .- ._ c co .. COLORADO CSBG ROMA SUMMARY SHEET CONTRACTOR/SUBCONTRACTOR County/Multi County: Weld County Implementing Agency Weld County Department of Human Services (Each agency/subcontractor receiving CSBG dollars must complete this form) Implementing Agency Contact Person: Judy A. Griego Complete Mailing Address, including zip: P.O. Box A, Greeley, CO 80632 Phone Number(970) 352-1551 ext. 6510 Fax: (970) 353-5215 Email Address: griegoja@co.weld.co.us Program Period: March 1, 2010 to February 28, 2011 Select National Indicators: 6_2 (see CSBG National Indicators sheet) (i.e. 1.2, 2.1,6.2, etc.) SELECT ONE FEDERAL OBJECTIVE O Employment O Nutrition / Linkages with Other Programs O Income Management O Self-Sufficiency O Housing O Emergency Services O Education O Health The National Goal and National Indicator should match. (i.e. National Indicator 1.2, National Goal 1) O Goal 1 Low-income people become more self-sufficient. (Family) O Goal 2 The conditions in which low-income people live are improved. (Community) O Goal 3 Low-income people own a stake in their community. (Community) O Goal 4 Partnerships among supporters and providers of services to low-income people are achieved. (Agency) O Goal 5 Agencies increase their capacity to achieve results. (Agency) ]✓ Goal 6 Low-income people, especially vulnerable populations, achieve their potential by strengthening family and other supportive systems. (Family) Low INCOME TARGET POPULATION: ONLY CHECK IF YOUR PROGRAM THAT IS FUNDED WITH CSBG DOLLARS SERVES ONLY SENIORS OR YOUTH. SENIORS ( YOUTH L/ (j) Program Director Signature: \ , () Date: cC/ I O Name and Title: Judy A. Griego, Dir ctor-Wel County D artmentlof Human Services Page 31 of 35 CSBG Grant Year 2010-11 Page Two Instruction Form Program Description: Provide a description of the program in two sentences or less. CSBG Program Mission Statement: Give the mission statement of the program that the CSBG funds are being used in; not the Agency mission statement. MISSION STATEMENT SHOULD ADDRESS THE FOLLOWING: • Uses language that identifies the population being served. • Describes the type of services/intervention. • Explains the results/outcomes or impact that the organization/program is trying to achieve. • Includes language identifies the area to be served (city, region, area). • Clear and concise. (EXAMPLE — Create a practical and useful reporting ROMA system for Colorado CSBG fund recipients and implement training to achieve an improved quality of standard reporting.) Problem, Need or Situation: State the identified problems in your community determined by the needs assessment related to this application. This is directly related to your mission statement. Service, Activity or Intervention: State the specific service, activity or intervention provided to address the problem, need or situation. Include the estimated total number of people (target population) who receive the services provided. Target population: household, family, partnerships, etc. Helpful Hint: Your agency will have to identify when a client becomes a client—is it at the time of the initial phone call, or is at another time? Outcome: Your Outcome is the Ultimate Goal of why your program exists; it is the impact your service, activity or intervention has on your family, agency or community. You may have more than one outcome per program. You may elect to outline short term, intermediate and long term outcomes. Helpful Hint: An outcome does NOT indicate number of clients receiving services. Indicator: Using the data from past years identify the number of clients that are proposed to be served, identifying the percentage of those clients who will complete the program identified to use CSBG funds. Helpful Hint: This information is from a historical viewpoint. For an emergency shelter that does not turn anyone away the formula would be 250 or 100% of homeless individuals are provided shelter. THE FOLLOWING INFORMATION IS LOCATED IN THE FAR RIGHT COLUMN. Measurement Tool: Tools used to track your outcomes: surveys, attendance log, case record and pre- and post-test, in-take forms, etc. Data Source and Collection Procedures: Describe how data as related to your outcome is collected. Describe where information is located and be specific. Helpful Hint: Central Database, individual case records, another agency, etc. Frequency of Data Collection and Reporting: State how often data is required by the agency to be collected and reported, e.g., daily, weekly, monthly, yearly, etc. Page 32 of 35 CSBG Grant Year 2010-11 i \ \ \csJ a) @Q - � � o _ � k \ • § d « _ 2 ■ ] ) ) co to - e — - 0O 8 < b § $ cn of � \ } \ � e - � } [ ( - o / E k � - t ° ` E kf k $ % 2 §— ® § \ •• > c k ti E tf _ [ � 0w - § 2 § ) E / f I / t + - S ® f & f@ LU 11.1 Co � = e 4482 \ C \ CD E § k \ 2 © � 2 � k )■ : co El � 0 / 0 % IDCO S j \ \ cc mfg g = as o 0 } 15 2 /\ S § 8 ) Stm k / -. § % < Cc « E > « § 5 CCoc k \ 0 ) \ o0 . -I = o , a o7z RZ E / § I * E Oo T V) � o O Z '8 O ''' oa -00 0 mo mo - oV; ZW. y �0 (,) — 000)c oocEv 50 c ao W VrZW 'Y:WF 0oaci0 a = mcoi 0 .0) 00 _ >' ▪ CC, c.) -Iii-Oli o •m 0 E Co u 3 n �'Z o m c m 3 o m CLIOV+C -"WOO. 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V) j >. >. 0 0 0 p_ Z o E- o a U a a7 '5 N U m x Y OI- m= W 0o '- - W0 ) `nc co) ,?almo W O0Sr:. c N 0 c o o m ni o 0 c 0 c a c a) 0 O g F > Q: K a= a o c m d w `O 'al °) °) a-o) o m a) o o m o b- rnw c Za W d E E o c .= m = E a) 0 O -O 0 o h o 0 y 3 can) a) o W a �)� 0 m 0x m = 0 0 m E E O 0 E Er.) L W - 0 O Ili_ mF fA.;. F a o E 0 S .E o o a E o W S a E = o w E '4 E PD O W ra z.S . U d a 0 a) •#w C 'O IA:,.;z # �k a) .- � a W 1.: E o a) a) r W C 0 O _ xvi. 0E ° m I— UlM" 5 j d tlt y =° Ev = W 2 O c J Z f7 v-,,, '� :; Z mot m U This page intentionally left blank. Page 35 of 35 CSBG Grant Year 2010-11 COMMUNITY ACTION PLAN: 1. Community Needs Assessment(including food needs): For the program year (March 1, 2010 through February 28, 2011), Weld County is using the Weld County Area Agency on Aging Strengths and Needs Assessment of Weld County, 2004. In addition, we have evaluated historical population trends for the County's seniors, using 2006 Colorado State demographer's census estimates. Together these sources have shown a continuing need for transportation services, especially for rural seniors and low-income individuals. The current needs assessment for the employment segment of the CSBG grant request was derived from the 2007-2008 reporting period for Weld County local Workforce Center applicant demographics. The data revealed these statistics: 79% of Registrants were unemployed at time of registration 46% of Registrants lacked a high school diploma or G.E.D 48% of Registrants considered one of the minority ethnic groups Staff of the Weld County segment of Employment First Food Stamp Job Search has already worked with over 3,000 mandatory cases during the first seven months of the current year's program. Although obtaining employment for these Food Stamp recipients was the overall goal, there was a lack of supportive services available to help transition individuals to employment. Currently, the local workforce center and program such as Employment First are seeing inordinate increases in enrollments. Ultimately, we foresee the possibility of placing low income individuals with limited financial resources into the labor force without pre or post employment support services that can improve their self-sufficiency status. 2. & 4. Service Delivery System and Coordination with other Public and Private Resources: Weld County Division of Human Services is a one-stop service center for various Federal and State programs; all targeted to low-income, at-risk individuals. The Area Agency on Aging umbrellas several senior programs including Older American Act Programs and Options for Long-Term Care and the Single Entry Point program for Weld County. The Employment Service Area has WIA Adult and Youth programs, Dislocated Workers, Employment First, TANF, Job Service, Americorp and an Educational Computer Lab. The Child Support Enforcement(CSE) Division of the Weld County Department of Human Services provides help to parents and anyone caring for a child. CSE can help locate parents, establish paternity, establish a child support order and enforce child support obligations. We understand that families need support on a regular basis to remain self- sufficient. Child Welfare is a family focused, and community-based system, that promotes the safety, permanency and well-being for children, youth and their families in Weld County through efficient interventions and service delivery. Assistance Payments determines eligibility for public assistance programs. All programs are targeted to low- income, at-risk individuals. CSBG funding fills the gaps in integrated services we currently provide. 3. Linkages: Since we are a Human Services agency serving a low-income, in-need population in various ways, we have developed many partnerships with other county agencies that are pursuing the same goals. With these linkages, our case managers can refer qualifying clients to our programs as well as refer them to other agencies. In addition, other agencies can refer their clients to Human Services. With this partnership, clients will not have gaps in-between services. Our case managers always do follow-up consultations with our clients. We currently work with primary and secondary educational systems, as well as a host of non-profits in Weld County, aimed at self-sufficiency for the citizens of our area. Since we track all of our clients, we are able to avoid any duplication of services. 5. Innovative Community and Neighborhood-based Initiatives: Since Weld County Division of Human Services is a one-stop service center for various Federal and State programs, this provides initiatives for community members to address all needs. With CSBG funding, this program's goal of strengthening families with employment and educational opportunities can be achieved, which will help participants become self-sufficient. Weld County Department of Human Services Human Services Committee Meeting Minutes 1/29/2010 Committee Members Present Brad Patterson Cornelia Dietz Kevin Thompson I. Committee Updates a. Tom Denning resigned from the Committee as he got a job at the Colorado Department of Education doing the 21st century grant at the state level. b. Jodi Hartmann from the Greeley Transitional House and Elizabeth Ortiz from Sunrise should be joining the Committee at the next Committee meeting c. C.J. Archibeque from the City of Greeley and Elizabeth Barber from Weld School District 6 has shown interest in joining the Committee and will hopefully be on board at the next meeting d. The Committee will assist in identifying other potential Committee members to fill the vacant slots II. Department Updates a. Katie Hall is no longer with the Weld County Department of Human Services (Department). She went to work for a company doing tax accounting. b. Fiscal office has lost three key staff members in the past seven months. c. The Department is looking at hiring a full-time staff member that part of his or her duties will be working on the Community Services Block Grant (CSBG). III. CSBG expenditures The Department will e-mail out the most current CSBG and CSBG ARRA expenditures in the next week or two. IV. 2010-2011 CSBG Plan The Committee approved the 2010-2011 CSBG plan. V. Survey The Committee was tasked with identifying customer satisfaction surveys that could be used by the Assistance Payments Division. VI. Other a. There was discussion on having divisions within the Department come to the Committee and present what each division does, staffing levels and budget so the Committee can have a better knowledge of the Department b. There was discussion on transportation, Weld County Transportation and what the changes in funding could mean to the community. c. The Committee wanted to explore having technologically savvy adolescents and young adults help seniors with computer set-up, training, etc. There was further discussion on what is available in the community now. d. The Committee wanted to explore having young adults learn the bus routes to train the community on how use the bus. With the hope that the young adults would someday be bus drivers. VII. Next Meeting April 16, 2010 at 8:00 at Weld County Department of Human Service, Building C Hello