The URL can be used to link to this page

Browse Search

Home My WebLink About20050659.tiff RESOLUTION RE: APPROVE 2005-2006 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 2005-2006 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 1,2005,and ending February 28, 2006, 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 are attached hereto and incorporated herein by reference. NOW,THEREFORE, BE IT RESOLVED by the Board of County Commissioners of Weld County, Colorado, that the 2005-2006 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 are, approved. BE IT FURTHER RESOLVED by the Board that the Chair be, and hereby is, authorized to sign said Application and Plan. The above and foregoing Resolution was,on motion duly made and seconded, adopted by the following vote on the 28th day of February, A.D., 2005. ,I. ELa` BOARD OF COUNTY COMMISSIONERS WELD COUNTY, COLORADO 1861 "'L Sf �lij William H. J e, Chair .1n .sf Jerk to the Board °Ili HI Deputy Cle, to a Board Da dl r1\q` Cc APPR ED AS FORM: ve lit- v� Robert D. Masd aunty Att ney /OA Glenn Vaadh--- Date of signature: `5!/!/05 2005-0659 �'C' :643.- 9 ) D HR007oJ MEMORANDUM DATE: February 24, 2003 TO: William Jerke Board of County Commissioners FROM: Walter J. Speckman, Executive Director, Human Services SUBJECT: Community Services Block Grant for PY 2003 - 2004 To be placed on Agenda for February 28, 2005 Enclosed for Board approval is the Community Services Block Grant for Program Year 2005-2006 to the Colorado Department of Local Affairs from the Weld County Division of Human Services. The total of the request is for $274,230. The focus of the grant is linkage of services and access to transportation for the in-need rural elderly of Weld County. The funding will allow for staff time to set up,coordinate,and train the Senior Aide volunteer pools at rural senior sites. The grant also funds the operating costs of Senior Minibus Transportation for the rural elderly from the rural senior sites and also subcontracts Weldco's Senior volunteer pool to transport seniors in volunteer vehicles for one-time needs that Minibus cannot address, and reimburses the volunteer at $.385/mile. We have also added two new services, one is a Case Manager for the Medicaid clients and the other is a service for clients in our triage program to help them succeed in their new employment. The term of this request will be March 1, 2005 through February 28, 2006 If you have any questions, please telephone me at 353-3800, extension 3317. 2005-0659 Public Notice The Weld County Division of Human Services plans to sub- mit a Community Services Block Grant(CSBG) application to the State of Colorado,Department of Local Affairs. CSBG funds are intended to fill gaps in services that impact the low income population of Weld County projects. The application being considered focuses on transportation for the low income rural elderly. A public hearing will be held at 9:00 a.m. on Monday, February 28, 2005 at Weld County Commissioners Public Meeting Room at 915 10th Street, Greeley, Colorado to obtain citizen input and questions. We are dEo alno O porminat Ethe basyer.We e,not ion,comate on �C O L O R A D 0 tha age, stionat origin or dialogsex, • national origin or disability WO R Ii FORCE Ofrecemos asistencia para encon- tear empleo y entremaniento.Para CEN T E R mas infarmacion hable al 353-3800 extension 3399,3379,3378 Public Notice The Weld County Division of Human Services plans to submit a Community Services Block Grant (CSBG) application to the State of Colorado, Department of Local Affairs. CSBG funds are intended to fill gaps in services that impact the low income population of Weld County projects. The application being considered focuses on transportation for the low income rural elderly. A public hearing will be held at 9:00 a.m. on Monday, February 28, 2005 at Weld County Commissioners Public Meeting Room at 915 10`h Street, Greeley, Colorado to obtain citizen input and questions. 2005-06 CSBG APPLICATION and PLAN GRANTEE: Weld County Division of Human Services ADDRESS: P.O. Box 1805 Greeley, CO 80632 CONTACT PERSON: Walter J. Speckman TITLE: Executive Director PHONE: (970) 353-3800 E-MAIL: FAX: (970) 356-3975 COUNTIES INCLUDED IN THIS PLAN: Weld TOTAL CSBG ALLOCATION $ 274,230.00 PROGRAM PERIOD: March 1, 2005 To February 28, 2006 attach additional pages if more space is needed. "*.t.�I FEDERAL OBJECTIVE ',; Total ' Total ' Total 1 ₹ „1 Direct Program , r 5 ��g ',Administrative CSBG Funds' I- Costs , 1.'' ' _ w , X e" See Pa -o Rde sett See Page rd2 eta' , ,g r r tit ea uman by H.S.&NalHe , ...Human Services P , 4`t";g .' 1. Employment $ 20,435.00 $ $ 20,435.00 2. Education $ $ $ 3. Income Management $ $ $ 4. Housing $ $ $ 5. Emergency Services $ $ $ 6. Nutrition $ $ $ 7. Linkages with Other Programs $ 253,795.00 $ $ 253,795.00 8. Self-Sufficiency $ $ $ 9. Health $ $ $ 10.Other(define): $ $ $ TOTAL $ 274,230.00 $ $ 274,230.00 I. The "Other" category should only be used for services that are not covered under Federal Objectives 1-9. It should not be used to reflect administrative/indirect costs. CSBG APPLICATION DIRECTIONS I. GRANTEE INFORMATION AND FEDERAL OBJECTIVES: Check the Federal Objective(s)your agency activity(ies)will be addressing. For each activity, LIST ONLY ONE Federal Objective. II. BUDGET FORMAT: Complete your budget in as much detail as possible utilizing the provided format. This information will be used for monitoring and performance evaluation. A. 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. B. 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, including salaries and benefits of program staff and managers, 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. C. ADMINISTRATIVE COSTS also referred to as INDIRECT/OVERHEAD 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, procurement, and legal services. D. CAPITAL EXPENDITURES Please itemize the equipment you intend to purchase. For any Capitol Equipment costs, you are required to submit a narrative to describe equipment needed and your procurement process. The State requires that bids and final equipment invoices be submitted to the State. E. SUBCONTRACT COSTS Those dollars allocated out to subcontractors to provide CSBG related services. F. TOTAL CSBG FUNDS BUDGETED II. BUDGET Cost Category Employment Education Income Housing Emergency Nutrition Linkages Self- Health Other:(define) TO TAL Management Services Sufficiency A. Personnel $8,435 $86,261 $ 94,696 %of time paid with CSBG • B. Direct $ 12,000 $135,611 $ 147,611 Operating C. Indirect/ $27,423 $ 27,423 Overhead (administrative) D. Capital $ Equipment • E. Subcontract $ 4,500 $ 4,500 F. TOTAL $20,435 $253,795 $274,230 List all agencies and funding you plan to subcontract with to provide CSBG services: (Please add additional sheets if necessary) * See Narrative for WELDCO'S $ 4,500.00 5 � S $ II. BUDGET NARRATIVE Cost Category Explain each CSBG cost as related to the proposed CSBG plan. Please add additional sheets if necessary A. Personnel Employment: $ 7,502.00 Employment Services Technician at .20FTE, $7,502.00 Upon a client exiting the Employment First Grant, an Employment Services Technician will look at each client's characteristics and essentials. At that time, it will be determined if they are eligible for the CSBG Grant Supportive services. If eligible the services will be provided. Linkages: $ 86,261 Community Services Director at .40FTE, $21,448 Volunteer Support Community Services Technician at .40FTE, $18,541 Volunteer Support SEP Case Manager at 1.0 FTE, $46,272 Single Entry Support These CSBG funds will pay for Service Directors and Service Technicians time for training of Volunteers at all rural senior sites. This helps Volunteers and Coordinators provide access to services and programs for rural low-income seniors. The Senior Case Manager staff member will work with about 60 HCBS/Medicaid recipients who will qualify to be assessed for medical and life care needs. B. Direct Operating EMPLOYMENT: $12,000 Supportive Services: $12,000 Employment First Food Stamp Job Search and Triage Targeted Population Programs- Pays for client supplies and services not allowed by EF grant, i.e. eyeglasses or repairs, physicals, uniforms or special clothing to start job, immunizations needed for job, Drivers License or State ID, Background checks,transportation vouchers, hygiene kits, ELS\GED books, education, training and job search supplies, to get and maintain employment$ 12,000. LINKAGES: $ 136,544 Transportation: $ 121,229 Pays for general operating costs of providing rural senior minibus services. This program increases the availability of transportation to our rural low-income seniors for essential services that would be otherwise be missed due to no transportation. This in turn improves the life conditions of the low-income rural elderly. Volunteer Support: $ 8,892 Senior Volunteer mileage-Pays for mileage incurred for Coordinators for service to senior sites, $ 2,800.00 Volunteer Insurance- Pays for the under 55 volunteers supplemental car insurance, $300.00 ( See WELDCO'S subcontract) Volunteer Recognition Banquet- Pays DHS portion of countywide senior volunteer banquet, $1,400.00 General Operating for Volunteer Support(457.53*12*0.8FTE)=$4,392. Single Entry Support: $6,423.00 General Operating for Case Management(457.53*12*1.OFTE)=$5,490. General Operating for Employment Services Technician( 388.78*12*.20FTE)=$933.00 C. Indirect/Overhead Administration: $27,423.00 Administration Staff Personnel Costs $ 20,567.00 Administration Operating Costs $ 6,856.00 Pays for administrative time to administer, budget, track and report on grant. D. Capital Equipment Describe equipment needed and your procurement process. The State requires that bids and equipment final invoices are submitted to the State. E. Subcontract WELDCO'S Contract: $ 4,500.00. Pays WELDCO'S for Volunteer Mileage.This service is coordinated through the senior sites. Volunteers use their own vehicles to provide transportation services to rural low-income seniors to doctor appointments, grocery store, meal sites, and other needed services, that are not meet by the minibus service. These Volunteers are only reimbursed their mileage expenditures. 4 III. 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 (including food needs): 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. 2. Service Delivery System: Please 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: Please describe how CSBG funds will be coordinated with other public and private resources. 5. Innovative Community and Neighborhood-based Initiatives: Please 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. VII. CERTIFICATIONS: The grantee assures that activities implemented with CSBG funds will be: used to accomplish the State CSBG Goal and Objective stated in the State Plan; and 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 Al 10 and A122), and the current State of Colorado CSBG Plan. The grantee also assures that it will: 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; 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); 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; 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; 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; 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; 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. 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 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; 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; 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. 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. 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; 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; 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. 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; 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 certibi to any of the statements in this certification,please attach an explanation to this application.) CONTRACTOR: If County Grantee: Chairman 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. POSITION TITLE: William H. Jerke, Chair, Board of DATE: 2/28/2005 Weld County Commissioners • Moos-ors 9 V. CSBG BOARD LIST: Representatives of Private Sector: Name: Cornelia Dietz (United Way Representative) Name: Mary Fox (Community at Large) Address: 1713 Glen Meadows Drive Greeley,CO 80631 Address: 415 1°`Street Kersey,CO 80644 Phone: (970)352-8313 H Phone: (970)356-6277 H (970)352-8394 B Name: Robert Masden (County Commissioner) Name: Address: 915 10th Street Greeley.CO 80631 Address: Phone: (970)353-3800 ex.4200 B Phone: Representatives of Public Sector: Name: Bonnie Veik(Disabled Comm Rep) Name: John Lee (City of Greeley)) Address: 14801 WRC 100 Nunn,Colorado Address: 1000 10`h Street Greeley,CO 80631 Phone: Phone: (970)350-9731 B Name: Name: Address: Address: Phone: Phone: Low-Income Persons or their Representatives: Name:Yvonne Benevides(FENWC Parent Policy Representative) Name: Address: 136 E.24th Street#9 Greeley,CO 80631 Address: Phone: (970)395-0429 H 9970)352-1551 B Phone: Name: Torn Denning (FENWC Parent Policy Representative) Name: Address: Address: Phone: Phone: ATTACHMENTS TO APPLICATION VI. BOARD MINUTES Please attach a copy of your CSBG Board minutes of the meeting when the CSBG application was reviewed and approved by your CSBG board. VII. PROOF OF PUBLIC HEARING: Please 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. VIII. MINUTES OF PUBLIC HEARING Please attach a copy of the minutes of the Public Meeting when the CSBG Application was reviewed and approved. IX. OUTCOME PLAN(S) Please attach an outcome plan for each activity funded. If funds are subcontracted, an outcome plan for each subcontract should also be included. COLORADO CSBG APPLICATION SUMMARY SHEET County: Weld Implementing Agency: Weld County Human Services (Each agency/subcontractor receiving CSBG dollars must complete this form) Implementing Agency Contact Person: Walt Speckman Complete Mailing Address, including zip: 1551 N. 17th Ave, Greeely CO 80634 Phone Number: (970)352-3740 Fax: (970)356-3975 Email Address: Program Period: 03/01/05 to 02/28/06 CSBG Award: $48,881.00 Select ONE Federal Objective O Employment O Nutrition O Education X Linkages with Other Programs O Income Management O Self-Sufficiency O Housing O Health O Emergency Services O Other: Select ONE National Goal/Outcome: OGoal 1 Low-income people become more self-sufficient. (Family) X Goal 2 The conditions in which low-income people live are improved.(Community) OGoal 3 Low-income people own a stake in their community. (Community) OGoal 4 Partnerships among supporters and providers of services to low-income people are achieved. (Agency) OGoal 5 Agencies increase their capacity to achieve results. (Agency) OGoal 6 Low-income people, especially vulnerable populations,achieve their potential by strengthening family and other supportive systems. (Family) Select ONE National Direct Measure/Indicator (see CSBG National Goals and Outcome Measures sheet) 2D Low income Target Population: Increase in access to community services&resources by low-income people. Official Signature: //"v+2' Date: 2/28/2005 Official's Name and Title: William H. Jerke, Chair &cos-d6s9 • COLORADO CSBG APPLICATION(ROMA Logic Model) AGENCY: Weld County Human Services PROGRAM: AAA Volunteer& Senior Coordinator Services PROGRAM MISSION STATEMENT: To help Weld County's seniors' maintain their individual independence and dignity in their home as well as in their community by partnership with the 22 meal site programs. National Goal#: 2 Circle ONE Outcome Goal: Family Community Agency Problem, Service, Activity or Outcome Indicator(#and %) Measurement Data Source Frequency of Need or Intervention Tool(s) and Data Situation Collection Collection Procedures Lack of The Area Agency on The Area Agency on Aging 100 of the 200 or 50% of The Area The Area Data is access to Aging Senior Senior Nutrition Coordinator Seniors will continue to Agency Intake Agency on entered services for Coordinator will direct and the interaction of the key participate in the Senior tool. Aging's regular basis the low- our 22 senior nutrition Senior Volunteers, will facilita Nutrition program over the SAMS data by the Senior income senior sites and provide access to these meal service next 12 month period. base. Nutrition staff population. training to volunteers and other programs. and who run the nutrition Volunteers. program. Coordination of this program will provide access to these and other services for the estimated 200 senior participants in Weld County. EXPLANATIONS/DISCUSSION: Form Adapted by the Colorado Community Action Association and the Colorado Department of Local Affairs. Created by Virtual Outcomes College;©FY 2001, 2002, The Center for Applied Management Practices,Harrisburg, PA. COLORADO CSBG CONTRACTOR/SUBCONTRACTOR SUMMARY SHEET County: Weld Implementing Agency: Weld County Human Services (Each agency/subcontractor receiving CSBG dollars must complete this form) Implementing Agency Contact Person: Walt Speckman Complete Mailing Address, including zip: 1551 N. 17`h Ave, Greeely CO 80634 Phone Number: (970)352-3740 Fax: (970) 356-3975 Email Address: Program Period: 03/01/05 to 02/28/06 CSBG Award: $20,435.00 Select ONE Federal Objective x Employment O Nutrition O Education O Linkages with Other Programs O Income Management O Self-Sufficiency O Housing O Health O Emergency Services O Other: Select ONE National Goal/Outcome: OGoal 1 Low-income people become more self-sufficient. (Family) X Goal 2 The conditions in which low-income people live are improved.(Community) OGoal 3 Low-income people own a stake in their community. (Community) OGoal 4 Partnerships among supporters and providers of services to low-income people are achieved. (Agency) OGoal 5 Agencies increase their capacity to achieve results. (Agency) OGoal 6 Low-income people,especially vulnerable populations, achieve their potential by strengthening family and other supportive systems. (Family) Select ONE National Direct Measure/Indicator (see CSBG National Goals and Outcome Measures sheet) 2F Low income Target Population: Increase in availability& afford ability of essential services. Official Signature: Date: 2/28/2005 Official's Name and Title: William H. Jerke, Chair aces-61 ,59 COLORADO CSBG APPLICATION(ROMA Logic Modell AGENCY: Weld County Human Services PROGRAM: Employment Services PROGRAM MISSION STATEMENT: Conform the workforce system, to be responsive to the low-income, unskilled job seekers,and help clients obtain full time employment for self-sufficiency, in partnership with Weld County employers. National Goal#: 2 Circle ONE Outcome Goal: Family community Agency Problem, Service, Activity or Outcome Indicator(#and %) Measurement Data Source Frequency of Need or Intervention Tool(s) and Data Situation Collection Collection Procedures Lack of The Employment The discharging client from 144 of 240 or 60% of the Employment Centralized Data is supportive First, Food Stamp, Employment First, will recipients will exit their Services data base of entered daily services from Job Search Programs be able to maintain their programs and be provided client intake client in the system various and Triage employment through these their one-time supportive forms. registration in as the clients programs, to Population Programs supportive services and services from the CSBG Employment come in to obtain needed clients' are not remain self sufficient. Grant. Of the 144 participants Services. register. supplies for allowed supportive exiting the programs, 72 or full-time services by the 30%will maintain their employment. Employment First employment and self Grant. The CSBG sufficient. funds provide items such as eyeglasses, physicals, uniforms and transportation vouchers, ELS\GED books and supplies needed. Employment Services estimated that the number of client intakes will be 240. EXPLANATIONS/DISCUSSION: COLORADO CSBG CONTRACTOR/SUBCONTRACTOR SUMMARY SHEET County: Weld Implementing Agency: Weld County Human Services (Each agency/subcontractor receiving CSBG dollars must complete this form) Implementing Agency Contact Person: Walt Speckman Complete Mailing Address, including zip: 1551 N. 17'h Ave, Greeely CO 80634 Phone Number: (970)352-3740 Fax: f970) 356-3975 Email Address: Program Period: 03/01/05 to 02/28/06 CSBG Award: $ 121,229.00 Select ONE Federal Objective O Employment O Nutrition O Education X Linkages with Other Programs O Income Management O Self-Sufficiency O Housing O Health O Emergency Services O Other: Select ONE National Goal/Outcome: OGoal 1 Low-income people become more self-sufficient. (Family) X Goal 2 The conditions in which low-income people live are improved. (Community) OGoal 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) OGoal 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) Select ONE National Direct Measure/Indicator (see CSBG National Goals and Outcome Measures sheet) 2F Low income Target Population: Increase in availability and afford ability of essential services,e.g.transportation medical care,child care. v / Official Signature: I //i— Date: 2/28/2005 Official's Name and Title: William H. Jerke, Chair o7co5 e≤S9 COLORADO CSBG APPLICATION(ROMA Logic Model) AGENCY: Weld County Human Services PROGRAM: Transportation Department PROGRAM MISSION STATEMENT: To help Weld County seniors' maintain their individual independence and dignity in their home home as well as in their community by identifying and advocating for their special needs. National Goal#: 2 Circle ONE Outcome Goal: Family Community Agency Problem, Service, Activity or Outcome Indicator(#and %) Measurement Data Source Frequency of Need or Intervention Tool(s) and Collection Data Situation Procedures Collection Lack of The Transportation These seniors will maintain 300 of the 450 or 67% of the The The Data is transportation Department will their independence and self clients served will continue to Transportation Transportation entered daily access to the coordinate with sufficiency through their remain in their own rural Departments' Logs as the client's frail and rural clients to provide transportation needs. community. tracking coordinate elderly and transportation for system. their needs. convenient services such as and affordable health care facilities, transportation Weld County internal to the low- programs, Social income. Services, shopping and recreation for the residences of Weld County. Weld County's Transportation Department estimates that 450 clients will be served. EXPLANATIONS/DISCUSSION: Form Adapted by the Colorado Community Action Association and the Colorado Department of Local Affairs. Created by Virtual Outcomes College;O FY 2001, 2002, The Center for Applied Management Practices, Harrisburg, PA. COLORADO CSBG CONTRACTOR/SUBCONTRACTOR SUMMARY SHEET County: Weld Implementing Agency: Weld County Human Services (Each agency/subcontractor receiving CSBG dollars must complete this form) Implementing Agency Contact Person: Walt Speckman Complete Mailing Address, including zip: 1551 N. 17th Ave, Greeely CO 80634 Phone Number: (970)352-3740 Fax: (970) 356-3975 Email Address: Program Period: 03/01/05 to 02/28/06 CSBG Award: $27,423.00 Select ONE Federal Objective O Employment O Nutrition O Education X Linkages with Other Programs O Income Management O Self-Sufficiency O Housing O Health O Emergency Services O Other: Select ONE National Goal/Outcome: OGoal 1 Low-income people become more self-sufficient. (Family) OGoal 2 The conditions in which low-income people live are improved.(Community) OGoal 3 Low-income people own a stake in their community. (Community) OGoal 4 Partnerships among supporters and providers of services to low-income people are achieved. (Agency) XGoal 5 Agencies increase their capacity to achieve results. (Agency) OGoal 6 Low-income people,especially vulnerable populations, achieve their potential by strengthening family and other supportive systems. (Family) Select ONE National Direct Measure/Indicator (see CSBG National Goals and Outcome Measures sheet) 4A Low income Target Population: Increase in the availability and afford ability of essential services,e.g.transportation medical care,and child care. Official Signature: "L f /// - Date: 2/28/2005 Official's Name and Title: William H. Jerke, Chair COLORADO CSBG APPLICATION(ROMA Logic Modell AGENCY: Weld County Human Services PROGRAM: Administration PROGRAM MISSION STATEMENT: To provide financial disbursements to clients or vendors for services rendered for clients who meet the qualifications for the CSBG Grant. National Goal#: 5 Circle ONE Outcome Goal: Family Community Agency Problem, Service, Activity or Outcome Indicator(#and %) Measurement Data Source Frequency of Need or Intervention Tool(s) and Data Situation Collection Collection Procedures Lack of Senior or low-income Giving financial services to The number of activities for Weld County's General Data is administrative individuals my clients for maintaining their clients posted on Weld General Ledger. collected services to contact Weld County quality of life and self County's General Ledger. Ledger. daily on assure the Government sufficiency. General activities regarding services Ledger implemented implemented by with CSBG CSBG funds. funds are in accordance with the CSBG regulations, goals and objectives. EXPLANATIONS/DISCUSSION: Form Adapted by the Colorado Community Action Association and the Colorado Department of Local Affairs. Created by Virtual Outcomes College;©FY 2001, 2002, The Center for Applied Management Practices,Harrisburg, PA. COLORADO CSBG CONTRACTOR/SUBCONTRACTOR SUMMARY SHEET County: Weld Implementing Agency: Weld County Human Services (Each agency/subcontractor receiving CSBG dollars must complete this form) Implementing Agency Contact Person: Walt Speckman Complete Mailing Address, including zip: 1551 N. 17th Ave, Greeely CO 80634 Phone Number: (970)352-3740 Fax: (970) 356-3975 Email Address: Program Period: 03/01/05 to 02/28/06 CSBG Award: $ 51,762.00 Select ONE Federal Objective O Employment O Nutrition O Education X Linkages with Other Programs O Income Management O Self-Sufficiency O Housing O Health O Emergency Services O Other: Select ONE National Goal/Outcome: OGoal I Low-income people become more self-sufficient. (Family) OGoal 2 The conditions in which low-income people live are improved. (Community) OGoal 3 Low-income people own a stake in their community. (Community) OGoal 4 Partnerships among supporters and providers of services to low-income people are achieved. (A) OGoal 5 Agencies increase their capacity to achieve results. (Agency) X Goal 6 Low-income people, especially vulnerable populations,achieve their potential by strengthening family and other supportive systems. (Family) Select ONE National Direct Measure/Indicator (see CSBG National Goals and Outcome Measures sheet) 68 Low income Target Population: Number of medically challenged participants maintaining an independent living situation. Official Signature: t 1 / L Date: 2/28/2005 Official's Name and Title: William H. Jerke, Chair COLORADO CSBG APPLICATION(ROMA Louie Model) AGENCY: Weld County Human Services PROGRAM: Area Agency on Aging PROGRAM MISSION STATEMENT: To help Weld County Seniors and Disabled Adults maintain their individual independence and dignity in their home as well as in their community by identifying and advocating for their special needs. National Goal #: 6 Circle ONE Outcome Goal: Family Community Agency Problem, Service, Activity or Outcome Indicator(#and %) Measurement Data Source Frequency of Need or Intervention Tool(s) and Data Situation Collection Collection Procedures Lack of help The Options for Long Clients will maintain 40 of 80 or 50% of the The Options The Options Data is accessing Term Care Case independence and self recipients will remain in their for Long Term for Long entered on medical and Manager will track sufficiency. home or in the least Care Client Term Care an ongoing supportive and serve Medicaid restrictive living arrangement Intake form. Case basis as community recipients of Weld possible. Manager will clients are based County to make sure maintain all identified. services by that their medical and clients' low income at essential needs are intakes and risk adults. being met. case records. Weld County Human Services estimates that the number of client intakes will be 80. EXPLANATIONS/DISCUSSION: Form Adapted by the Colorado Community Action Association and the Colorado Department of Local Affairs.Created by Virtual Outcomes College;©FY 2001, 2002, The Center for Applied Management Practices,Harrisburg,PA. COLORADO CSBG CONTRACTOR/SUBCONTRACTOR SUMMARY SHEET County: Weld Implementing Agency: Weld County Human Services (Each agency/subcontractor receiving CSBG dollars must complete this form) Implementing Agency Contact Person: Walt Speckman Complete Mailing Address, including zip: 1551 N. 17th Ave, Greeely CO 80634 Phone Number: (970)352-3740 Fax: (970) 356-3975 Email Address: Program Period: 03/01/05 to 02/28/06 CSBG Award: $4,500.00 Select ONE Federal Objective O Employment O Nutrition O Education X Linkages with Other Programs O Income Management O Self-Sufficiency O Housing O Health O Emergency Services O Other: Select ONE National Goal/Outcome: OGoal 1 Low-income people become more self-sufficient.(Family) X Goal 2 The conditions in which low-income people live are improved. (Community) OGoal 3 Low-income people own a stake in their community. (Community) OGoal 4 Partnerships among supporters and providers of services to low-income people are achieved. (Agency) OGoal 5 Agencies increase their capacity to achieve results. (Agency) OGoal 6 Low-income people,especially vulnerable populations, achieve their potential by strengthening family and other supportive systems. (Family) Select ONE National Direct Measure/Indicator (see CSBG National Goals and Outcome Measures sheet) 2F Low income Target Population: Increase in the availability and afford ability of essential services,e.g.transportation medical care,and child care. Official Signature: Date: 2/28/2005 Official's Name and Title: William H. Jerke, Chair c3(219Ds—e',65-2 I COLORADO CSBG APPLICATION(ROMA Logic Model) AGENCY: Weld County Human Services PROGRAM: WELDCO'S PROGRAM MISSION STATEMENT: To provide information and referral services, recruit, train, and utilize volunteer partnership to provide transportation, home visits, telephone reassurance, recreation and other personalized services to the senior citizens of Weld County. National Goal #: 2 Circle ONE Outcome Goal: Family community Agency Problem, Service, Activity or Outcome Indicator(#and %) Measurement Data Source Frequency of Need or Intervention Tool(s) and Data Situation Collection Collection Procedures Lack of The Area on Aging Senior's will maintain their 20 of the 40 or 50% of the Area Agency WELDCO'S/ Data is transportation estimates that 40 independence and self clients served will continue to on Aging Area on collected needs for the seniors will receive sufficiency in the community. remain in their own rural intake tool. Aging trip monthly basis frail, rural, low- door to door community. and mileage from the trip income transportation by the logs. and mileage seniors who WELDCO'S program. logs. need door to door services in getting to their destinations. EXPLANATIONS/DISCUSSION: Form Adapted by the Colorado Community Action Association and the Colorado Department of Local Affairs. Created by Virtual Outcomes College;©FY 2001, 2002, The Center for Applied Management Practices, Harrisburg, PA. Hello