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COD WrittenStandards ESGCV Emergency Solutions Grant Program (ESG-CV) Program Written Standards l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l Community Development Division 601 E. Hickory, Suite B Denton, TX 76205 version: October, 2020 Emergency Solutions Grants Program Manual – Denton County Revised: October x, 2020 Page 2 CONTENTS TOPIC ESG Rule Ref: Page Background & Information 3 Overview 4 Resources 4 Quick Reference 24 C.F.R. §576.100 5 Program Components & Eligible Activities 6-15 101. Street Outreach (SO) Eligible Activities & Costs 24 C.F.R. §576.101 6-7 102. Emergency Shelter (ES) Eligible Activities & Costs 24 C.F.R. §576.102 7-10 103. Homelessness Prevention (HP) 24 C.F.R. §576.103 10 104. Rapid Re-Housing (RRH) 24 C.F.R. §576.104 11 105. Housing Relocation and Stabilization Services 24 C.F.R. §576.105 11-13 106. Short- and Medium-Term Rental Assistance 24 C.F.R. §576.106 13 107. HMIS 24 C.F.R. §576.107 13-14 108. Administrative Activities 24 C.F.R. §576.108 14-15 109. Indirect Costs 24 C.F.R. §576.108 15 Match 24 C.F.R. §576.201 15 400 – Area-Wide Systems Coordination Requirements 24 C.F.R. §576.400 16 HCRS ESG-CV Program Requirements 24 C.F.R. §576.400 17-30 Record Keeping and Reporting Requirements 24 C.F.R. §576.500 30 Attachments A-Q 31-72 Emergency Solutions Grants Program Manual – Denton County Revised: October x, 2020 Page 3 BACKGROUND & INFORMATION Emergency Solutions Grants (ESG) The ESG program is authorized through the Homeless Emergency Assistance and Rapid Transition to Housing Act of 2009 (HEARTH Act) amended the McKinney-Vento Homeless Assistance Act of 1987 Title IV, as amended (U.S. Code: 42 USC 11371 et seq.) and funded by the Department of Housing and Urban Development (HUD). These funds will be used for emergency shelter (operation, maintenance and essential services with homeless prevention component), rapid re- housing assistance, Homeless Management Information System (HMIS) and necessary administrative costs. HUD allocates funds by formula grant to eligible states and units of general purpose local government for the administration of ESG. The City of Denton does not meet the population threshold to be a direct recipient of ESG funding. In the state of Texas, ESG state funds are administered by the Texas Department of Housing and Community Affairs (TDHCA). In the state program, ESG is a competitive grant that awards funds to private nonprofit organizations, cities, and counties in the State of Texas to provide the services necessary to help persons that are at- risk of homelessness or homeless quickly regain stability in permanent housing. The City of Denton is an eligible grantee of funds through the state. In the past the City has administered the award as lead agency in a collaborative with area nonprofits. The collaborative supports a comprehensive delivery of ESG eligible activities and in support of the City’s Housing Crisis Response System. Coronavirus Aid, Relief and Economic Security Act (CARES Act) On March 27, 2020, the Federal government enacted the third stimulus package for COVID-19, known as the Coronavirus Aid, Relief and Economic Security Act (CARES Act). The CARES Act included $4 billion for a supplemental appropriation of Homeless Assistance Grants under the Emergency Solutions Grants (ESG) as authorized by McKinney-Vento Homeless Assistance Act of 1987 (P.L. 100-77), as amended by the Homeless Emergency Assistance and Rapid Transition to Housing (HEARTH) Act of 2009 (P.L.111-22) (42 U.S.C.S.§11371 et. seq.). The funding supports additional homeless assistance and homelessness prevention activities to mitigate the impacts created by coronavirus. The first allocation of ESG CARES Act funding (ESG-CV) released by HUD allocated $33,254,679 to the Texas Department of Housing and Community Affairs (TDHCA), the State ESG Recipient. On April 23, 2020, the TDHCA Board approved that Continuum of Care (CoC) Lead Agencies perform the role of an ESG Coordinator for their geography. The Texas Homeless Network (THN), the CoC Lead Agency for the Texas Balance of State Continuum of Care (TX BoS CoC), has applied and is the only application for the Role of ESG Coordinator for the 215 counties within the TX BoS CoC. THN has $7,020,131 in ESG CARES funds to distribute. On May 25, 2020, the CoC released the ESG CV-19 application for agencies in the TX BoS CoC. The City of Denton is included and participates in the TX BoS CoC. The City made application to the TX BoS CoC for $1.425 million in ESG-CV program funds. Based on the application requirements, the City of Denton intends to procure and contract with local social service agencies to provide eligible services through the ESG-CV Program. These CARES Act ESG coronavirus program written standards as required by 24 CFR Part 576.400 (e)(2) assist the City of Denton with administration of the funding for The City’s Housing Crisis Response System, ESG (HCRS ESG-CV) project. Rather than duplicate information these standards may refer to other laws, regulations, guidelines, or written standards where appropriate. Emergency Solutions Grants Program Manual – Denton County Revised: October x, 2020 Page 4 OVERVIEW Subrecipients (City of Denton) must comply with all applicable laws and guidance. Contractors are also required to follow all relevant ESG guidelines as issued by the Department of Housing and Urban Development as set forth in the Interim Regulations for Homeless Emergency Assistance and Rapid Transition to Housing 24 CFR Part §91 and 24 CFR Part §576 (Consolidated Plan Conforming Amendments and Emergency Solutions Grants Program) and 2 CFR 200 Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards where applicable. Additional ESG guidelines are also provided from the Texas Department of Housing and Community Affairs in the Texas Administrative Code (T.A.C) Title 10, Chapter 7. An overview of program components & eligible activities along with the policies & procedures selected for Denton’s HCRS ESG-CV project are provided. The CARES Act ESG (ESG-CV) provided some waivers. These will be highlighted where applicable. RESOURCES: APPLICABLE LAWS AND GUIDANCE  Department of Housing and Urban Development (HUD) - https://www.hud.gov/  The McKinney-Vento Homeless Assistance Act as amended by S. 896 The Homeless Emergency Assistance and Rapid Transition to Housing (HEARTH) Act of 2009 https://files.hudexchange.info/resources/documents/S896_HEARTHAct.pdf  ESG Law, Regulations, and Notices: o https://www.hudexchange.info/programs/esg/ o https://www.hudexchange.info/programs/esg/esg-law-regulations-and- notices/  The McKinney-Vento Homeless Assistance Act  ESG Interim Regulations and Consolidated Plan Conforming Amendments  "Homeless" Definition Final Rule  2 CFR part 200: Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards https://tinyurl.com/yb3qm98w  Texas Department of Housing and Community Affairs (TDHCA) /ESG - http://www.tdhca.state.tx.us/home-division/esgp/guidance-solutions.htm o Texas Administrative Code Title 10: https://tinyurl.com/TDHCAT10  Title 10, Chapter 1 Administration: https://tinyurl.com/TDHCAT10C1  Title 10, Chapter 7 Homeless Programs: https://tinyurl.com/TDHCAT10C7  CARES Act ESG (ESG-CV) https://www.hud.gov/program_offices/comm_planning/homeless_esg_covid-19 Emergency Solutions Grants Program Manual – Denton County Revised: October x, 2020 Page 5 QUICK REFERENCE PROGRAMS & ELIGIBLE ACTIVITIES (§576.100) ESG funds may be used for eligible activities in five programs and for administrative activities. Street Outreach (§576.101)  Outreach & Engagement  General Case Management  Emergency Health Services  Emergency Mental Health Services  Transportation  Services for Special Populations Emergency Shelter (§576.102) Essential Services Shelter Operations  General Case Management  Child Care  Education Services  Employment Assistance and Job Training  Outpatient Health Services  Legal Services  Life Skills Training  Mental Health Services  Substance Abuse Treatment Services  Equipment  Food  Fuel  Furnishings  Hotel/Motel Vouchers  Insurance  Maintenance  Operating Supplies  Rent  Security  Utilities Homelessness Prevention Activities (§576.103) & Rapid Re-housing Activities (§576.104) Direct Financial Assistance Housing Relocation and Stabilization (§576.105)  Rental Application Fees  Security Deposits  Last Month’s Rent  Utility Deposits  Utility Payments  Moving Costs  Housing Stability Case Management  Housing Search and Placement  Mediation  Legal Services  Credit Repair Short-term rental assistance* (§576.106)  Short-Term Rental Subsidies  Medium-Term Rental Subsidies  Rent Arrearages *Rental assistance can be project-based, or tenant-based. HMIS (§576.107) HMIS Lead  Hosting/Maintaining  Backing up, recovering or repairing  System Upgrades  Integrating/Storing Data  Administering the system  Reporting to CoC and HUD  Conducting training  Establish a comparable database  Computer Purchasing/Leasing  Purchasing Software  Equipment Purchasing/Leasing  Obtaining Technical Support  Office Space Leasing  Paying Utilities  Salaries  Travel to Training  Staff Travel to Conduct Intake  Fees to HMIS Lead Agency ADMINISTRATIVE (§576.108)  Salaries Admin Staff  Travel to monitoring sub recipients  Administrative services  Rental/Purchase of equipment  Training from HUD sponsored trainings  Preparing/Amending Consolidated Plan  Environmental Review Emergency Solutions Grants Program Manual – Denton County Revised: October x, 2020 Page 6 101. Street Outreach (SO) Eligible Activities & Costs 24 C.F.R. §576.101 Subject to the expenditure limit in §576.100(b)[WAIVED], ESG funds may be used for costs of providing essential services necessary to reach out to unsheltered homeless people; connect them with emergency shelter, housing, or critical services; and provide urgent, non-facility based care to unsheltered homeless people who are unable to access emergency shelter, housing, or an appropriate health facility. (Homelessness Defined: ATTACHMENT O) 1) Outreach & Engagement 24 C.F.R. §576.101(a)(1): Activities to locate, identify, and build relationships with unsheltered homeless people and engage them for providing immediate support, intervention, and connections with homeless assistance programs and/or mainstream social services and housing programs. Eligible activities include:  Assessment of needs and eligibility  Crisis Counseling  Addressing urgent physical need – meals, blankets, clothes, toiletries  Providing information and referral to other programs Eligible costs include:  Cell phone cost of outreach workers during the performance of these activities  Salaries of staff Conducting engagement work 2) Case Management 24 C.F.R. §576.101(a)(2): Assessing housing and service needs, arranging, coordinating, and monitoring the delivery of individualized services. Eligible activities include:  Using centralized or coordinated assessment system (in §576.400)  Initial evaluation; verifying and documenting eligibility (in §576.401)  Counseling  Developing/securing/coordinating services  Obtaining federal, state, and local benefits  Monitoring/evaluating participant progress  Providing information and referral to other providers  Developing an individualized housing/service plan Eligible costs include:  Salaries of staff conducting engagement work 3) Emergency Health Services 24 C.F.R. §576.101(a)(3): Direct outpatient treatment of medical conditions provided by licensed medical professionals operating in community- based settings (e.g. streets, parks, and campgrounds) to those eligible participants for whom other appropriate health care services are inaccessible or unavailable within the area. Eligible activities include:  Assessing health problems and developing a treatment plan  Assistance in helping participants understand their health need  Providing or directly assisting in obtaining emergency medical treatment  Providing medication and follow-up services Eligible costs include:  Direct outpatient treatment of medical conditions Emergency Solutions Grants Program Manual – Denton County Revised: October x, 2020 Page 7 4) Emergency Mental Health Services 24 C.F.R. §576.101(a)(4): Direct outpatient treatment of urgent mental health conditions by licensed mental health professionals in community- based settings (e.g. streets, parks, and campgrounds) to those eligible participants for whom other appropriate mental health care services are inaccessible or unavailable in the area. Eligible activities include:  Crisis Intervention  Prescription of psychotropic medications  Explanation about the use and management of medications and combinations of therapeutic approaches to address multiple problems. Eligible costs include:  Direct outpatient treatment of medical conditions 5) Transportation 24 C.F.R. §576.101(a)(5): Travel by outreach workers, social workers, medical professionals, or other service providers during the provision of eligible street outreach services. Eligible costs include:  Cost of transporting unsheltered people to emergency shelters or other service facilities  Cost of a program participant’s travel on public transit  Mileage allowance for service workers to visit participants  Purchasing or leasing a vehicle for staff use in conducting outreach, including the cost of gas, insurance, taxes, and maintenance for the vehicle  Costs of staff to accompany or assist participants to use public transportation 6) Services for Special Populations 24 C.F.R. §576.101(a)(6): Provide essential services for special needs of homeless youth, victims of domestic violence, and services for people living with HIV/AIDS who are experiencing literal homelessness. Eligible costs include:  All five categories of Street Outreach essential services. 102. Emergency Shelter (ES) Eligible Activities & Costs 24 C.F.R. §576.102 Subject to the expenditure limit in §576.100(b). [WAIVED], Essential services delivered to persons who are experiencing homelessness in temporary shelter including rehabilitation of that Shelter, and for Shelter operations. 1) Essential Services: Case Management 24 C.F.R. §576.102(a)(1)(i): Assessing housing and service needs and arranging, coordinating, or monitoring the delivery of individualized services. Eligible costs include:  Using centralized or coordinated assessment system  Initial evaluation; verifying and documenting eligibility  Counseling  Developing/securing/coordinating services  Helping to obtain federal, state, and local benefits  Monitoring/evaluating participants’ progress  Providing info and referral to other providers  Developing an individualized housing/service plan Eligible costs include:  Salaries of staff conducting engagement work Emergency Solutions Grants Program Manual – Denton County Revised: October x, 2020 Page 8 2) Child care 24 C.F.R. §576.102(a)(1)(ii): Licensed child care for program participants with children under the age of 13, or disabled children under the age of 18. Eligible costs include:  Child Care  Meals and snacks  Comprehensive and coordinated sets of appropriate developmental activity 3) Education Services 24 C.F.R. §576.102(a)(1)(iii): Instruction or training to enhance participants’ ability to obtain and maintain housing, including literacy, English as a second language, GED, consumer education, health education, and substance abuse prevention. Eligible costs include:  Screening, assessment and testing  Individual or group instruction  Tutoring  Provision of books, supplies, and instructional material  Counseling  Referral to community resources 4) Employment Assistance and Job Training 24 C.F.R. §576.102(a)(1)(iv): Job training programs and services assisting participants to secure employment. Eligible costs include:  Classroom, online and/or computer instruction  On-the-job instruction  Services that assist individuals in securing employment, acquiring learning skills, and/or increasing earning potential  Job-finding, skill-building  Reasonable stipends for employment assistance and job training programs  Acquisition of vocational licenses and/or certificates  Books and instructional material  Counseling or job coaching  Employment screening, assessment, or testing  Structured job-skills and job seeking skills  Special training and tutoring, including literacy training and pre-vocational training  Referral to community resources 5) Outpatient Health Services 24 C.F.R. §576.102(a)(1)(v): Direct outpatient treatment of medical conditions to the extent that other appropriate health services are unavailable within the community. These services must be provided by licensed medical professionals provided by licensed medical professionals. Eligible costs include:  Assessing health problems and developing a treatment plan  Assisting program participants to understand their health needs  Providing or helping participants obtain appropriate medical treatment, preventive medical care, and health maintenance services, including emergency medical services  Providing medication and follow-up services  Providing preventive and non-cosmetic dental care Emergency Solutions Grants Program Manual – Denton County Revised: October x, 2020 Page 9 6) Legal Services 24 C.F.R. §576.102(a)(1)(vi): Necessary legal services regarding matters that interfere with the program participant’s ability to obtain and retain housing. Eligible activities include:  Eligible subject matters include child support; guardianship; paternity; emancipation; legal separation; resolution of outstanding criminal warrants; appeal of veterans and public benefit claim denials; and orders of protection and other civil remedies for victims of domestic violence, dating violence, sexual assault, and stalking. Eligible costs include:  Hourly fees for legal advice and representation by licensed attorneys (or persons under the supervision of the licensed attorney)  Client intake, preparation of cases for trial, provision of legal advice, representation at hearings, and counseling  Filing Fees and other court costs  Fees based on actual service performed i.e., fees-for-service but only if the cost would be less than the hourly fees  Subrecipient’s employee’s salaries and other costs necessary to perform the services if the subrecipient is a legal service provider and performs the service itself. 7) Life Skills Training 24 C.F.R. §576.102(a)(1)(vii): Critical life skills necessary to assist the program participant to function independently in the community. Eligible costs include:  Budgeting resources  Managing money  Managing a household  Resolving conflict  Shopping for food and needed items  Improving nutrition  Using public transportation  Parenting 8) Mental Health Services 24 C.F.R. §576.102(a)(1)(viii): Direct outpatient treatment of mental health conditions by licensed professionals, provided that other appropriate mental health services are unavailable or inaccessible within the community. Eligible costs include:  Crisis interventions  Individual, family, or group therapy sessions  Prescription of psychotropic medications or  Explanations about the use and management of medications  Combinations of therapeutic approaches to address multiple problems 9) Substance Abuse Treatment Services 24 C.F.R. §576.102(a)(1)(ix): Treatment services provided by licensed or certified professionals that are designed to prevent, reduce, eliminate or deter relapse of substance abuse or addictive behaviors. Services are eligible only if other appropriate substance abuse treatment is unavailable or inaccessible within the community. Eligible costs include:  Client intake and assessment  Outpatient treatment for up to 30 days  Group and individual counseling  Drug testing Emergency Solutions Grants Program Manual – Denton County Revised: October x, 2020 Page 10 10) Transportation 24 C.F.R. §576.102(a)(1)(x): Costs of travel by program participants to and from medical care, employment, child care, or other facilities that provide eligible essential services, and the cost of staff travel to support provision of essential services. Eligible costs include:  Cost of a program participant’s travel on public transportation  Mileage allowance for service workers to visit participants  Purchasing or leasing a vehicle used for transport of participants and/or staff serving participants, including the cost of gas, insurance, taxes, and maintenance for the vehicle  Travel costs of staff to accompany or assist program participants to use public transportation 11) Services for Special Populations 24 C.F.R. §576.102(a)(1)(xi): Otherwise eligible essential services that have been tailored to address the special needs of homeless youth; victims of domestic violence and related crimes/threats; and/or people living with HIV/AIDS who are in emergency shelters. Eligible costs include:  All ten categories of Emergency Shelter essential services. 12) Shelter Operations 24 C.F.R. §576.102(a)(3): Costs to operate and maintain emergency shelters (or provide hotel/motel vouchers if no appropriate emergency shelter is available). Eligible costs include:  Maintenance (including minor or routine repairs)  Rent  Security  Fuel  Insurance  Utilities  Food  Furnishings  Equipment  Supplies necessary for the operation of the emergency shelter  Hotel/motel voucher for an individual or family 103. Homelessness Prevention (HP) 24 C.F.R. §576.103 ESG funds may be used to provide housing relocation and stabilization services and short- and/or medium-term rental assistance necessary to prevent an individual or family from being evicted or moving into an emergency shelter. This assistance, referred to as homelessness prevention, may be provided to individuals and families who meet the criteria:  under the ‘‘at risk of homelessness’’ definition, or  in paragraph (2), (3), or (4) of the ‘‘homeless’’ definition in §576.2 and have an annual income below 30 percent of median family income for the area, as determined by HUD. Homelessness prevention be provided in accordance with the housing relocation and stabilization services requirements in §576.105, the short- and medium-term rental assistance requirements in §576.106, and the written standards and procedures established under §576.400. Emergency Solutions Grants Program Manual – Denton County Revised: October x, 2020 Page 11 104. Rapid Re-Housing (RRH) 24 C.F.R. §576.104 ESG funds may be used to provide housing relocation and stabilization services and short- and/or medium-term rental assistance as necessary to help a homeless individual or family move as quickly as possible into permanent housing and achieve stability in that housing. This assistance, referred to as rapid re-housing, may be provided to individuals and families who meet the criteria:  in paragraph (1) of the ‘‘homeless’’ definition in §576.2 or  in paragraph (4) of the ‘‘homeless’’ definition in §576.2 and live in an emergency shelter or other place or another place as described in paragraph (1) of the ‘‘homeless’’ definition in §576.2 Rapid re-housing assistance must be provided in accordance with the housing relocation and stabilization services requirements in §576.105, the short- and medium-term rental assistance requirements in §576.106, and the written standards and procedures under §576.400. 105. Housing Relocation and Stabilization Services FOR BOTH HP AND RRH 24 C.F.R. § 576.105 Subject to the general conditions under §576.103 and §576.104. ESG funds can be used to cover costs associated with providing homeless or at-risk homeless clients with housing relocation and stabilization services. Eligible costs include:  Staff and overhead costs directly related to carrying out eligible Homeless Prevention and Rapid-Re-Housing activities 1) Financial Assistance 24 C.F.R. §576.105(a): ESG funds may be used to pay housing owners, utility companies, and other third parties. Does not include rental assistance. Eligible costs include:  Rent Application Fees: Application fee that is charged by the owner to all applicants  Security Deposit: Equal to no more than 2 months’ rent  Last month’s rent: Paid to the owner of housing at the time security deposit and fist month’s rent are paid (Is counted toward the 24 months of assistance in 3 years.)  Utility deposit: Standard utility deposit required by the utility company for all customers (i.e. gas, electric, water/sewage)  Utility payment: Up to 24 months per participant per service; including up to 6 months of arrearages, per service (i.e. gas, electric, water/sewage).  Moving Costs: Funds may be used for reasonable moving costs such as truck rental or hiring a moving company, or temporary storage fees up to 3 months but before moving into permanent housing. (Arrearages not eligible) 2) Services 24 C.F.R. §576.105(b): Housing Search & Placement 24 C.F.R. §576.105(b)(1): Eligible costs include:  Assessment of housing barriers, needs and preferences  Development of an action plan for locating housing  Housing search and outreach to and negotiation with owner  Assistance with submitting rental applications and understanding leases  Assessment of housing for compliance with ESG requirements for habitability, lead based paint, and rent reasonableness  Assistance with obtaining utilities and making moving arrangements  Tenant counseling Emergency Solutions Grants Program Manual – Denton County Revised: October x, 2020 Page 12 Housing Stability Case Management 24 C.F.R. §576.105(b)(2): Assessing, arranging, coordinating, and monitoring the delivery of individualized services to facilitate housing stability. Assistance cannot exceed 30 days during the period the program participant is seeking permanent housing and cannot exceed 24 months during the period the program participant is living in permanent housing. Eligible costs include:  Using the centralized or coordinated assessment system to conduct the initial evaluation and re-evaluation  Counseling  Developing, securing and coordinating services including Federal, state, and local benefits  Monitoring and evaluating program participant progress  Providing information and referrals to other providers  Developing an individualized housing and stability plan Mediation 24 C.F.R. §576.105(b)(3): Mediation between the program participant and the owner or person(s) with whom the program participant is living, to prevent the program participant from losing permanent housing in which they currently reside. Eligible costs include:  Time and/or services associated with mediation services Legal Services 24 C.F.R. §576.105(b)(4): Legal services necessary to resolve a legal problem that prohibits the program participant from obtaining or maintaining permanent housing. Eligible activities include:  Legal representation and advice pertaining to the following subjects: landlord/tenant matters, child support, guardianship, paternity, emancipation, legal separation, resolution of outstanding criminal warrants, orders of protection and other civil remedies for victims of domestic violence, dating violence, sexual assault, and stalking, appeal of veterans and public benefit claim disputes Eligible costs include:  Hourly fees for legal advice and representation  Fees based on the actual service performed (i.e. fee for service), but only if the cost would be less than the cost of hourly fees  Client intake, preparation of cases for trial, provision of legal advice, representation at hearings, and counseling  Filing fees and other necessary court costs  Program employees’ salaries and other costs necessary to perform the services, if the program is a legal services provider and performs the services itself Credit Repair 24 C.F.R. §576.105(b)(5): Services necessary to assist program participants with critical skills related to household budgeting, managing money, accessing a free personal credit report, and resolving personal credit problems (assistance cannot include the payment or modification of debt). Eligible costs include:  Credit counseling  Other related services Emergency Solutions Grants Program Manual – Denton County Revised: October x, 2020 Page 13 Requirements and Restrictions Participants must meet with a case manager at least once a month* for the duration of assistance, except where funding under the Violence Against Women Act (VAWA) or Family Violence Prevention and Services Act (FVSP) prohibits the recipient or subrecipient from making shelter of housing conditional upon receipt of services. ● Participants must be assisted as needed, in obtaining:  Appropriate supportive services like medical or mental health treatment or services essential for independent living.  Mainstream benefits like Medicaid, SSI, or TANF *Subject to waivers published by HUD on 4/1/2020, as amended. 106. Short- and Medium-Term Rental Assistance 24 C.F.R. §576.106 Subject to the general conditions under §576.103 and §576.104, participant may be provided with up to 24 months of rental assistance during any 3-year period. Tenant Based Rental Assistance: Program participants select a housing unit in which to live (may be within a specified service area) and receive rental assistance. Project Based Rental Assistance: Program identifies permanent housing units that meet ESG requirements and enters into a rental assistance agreement with the owner to reserve the unit and subsidize its rent so that eligible program participants have access to the units. Eligible costs include:  Short-term rental assistance: Up to 3 months  Medium-term rental assistance: 4 to 24 months  Payment of rental arrears: One-time payment of up to 6 months, including any late fees on those arrears  Any combination of the Three Types of rental assistance: Total cannot exceed 24 months during any 3-year period, including any payment for last month’s rent (§576.106(b) Requirements and Restrictions  Compliance with Fair Market Rents (FMR) limits and Rent Reasonableness  Compliance with Minimum Habitability Standards  Rental Assistance Agreement and Lease Standards: - The rental assistance agreement must set forth the terms under which rental assistance will be provided - Each participant receiving rental assistance must have a legally binding, written lease (between the owner and participant) for the rental unit, unless the assistance is solely for rental arrears. - Project-based rental assistance leases must have an initial term of one year.  Cannot Use with Other Subsidies - No rental assistance can be provided to a household receiving rental assistance from another public source for the same period (except 6 months of arrears) - Rental assistance may not be provided to a participant who is currently receiving replacement housing payments under the Uniform Relocation Assistance (URA).  Late Payments - The rental assistance agreement must contain the same payment due date, grace period, and late payment penalty requirements as the program participant’s lease. - The recipient or subrecipient must make timely payments to owners in accordance with the rental assistance agreement. - The recipient or subrecipient is solely responsible for paying (with non-ESG funds) late payment penalties that it incurs. Emergency Solutions Grants Program Manual – Denton County Revised: October x, 2020 Page 14 107. Homeless Management Information S ystem (HMIS) 24 C.F.R. §576.107 The HEARTH Act makes HMIS participation a statutory requirement for ESG recipients and third- party contractors except as prohibited by law. Domestic Violence service provider will utilize an approved comparable database. All agencies must comply with HUD data standards on participation, data collection and reporting as described by HMIS Lead (Texas Balance of State CoC, the Texas Homeless Network). 1) Contributing Data to the HMIS: to the HMIS designated by the CoC Eligible costs include: Hardware 24 C.F.R. §576.107(a)(1)  Purchasing or leasing computer hardware  Purchasing software or software licenses  Purchasing or leasing equipment including telephones, fax machines, and furniture Staffing 24 C.F.R. §576.107(a)(1)  Data Collection  Completing data entry  Monitoring and reviewing data quality  Completing data analysis  Reporting to the HMIS Lead  Training staff on using the HMIS or comparable database Training and Overhead Costs 24 C.F.R. §576.107(a)(1)  Obtaining technical support  Leasing office space  Paying charges for electricity, gas, water, phone service, high-speed data transmission  Paying costs of staff to travel to attend HUD Sponsored and HUD approved HMIS training  Staff travel costs to conduct intake  Fees to pay HMIS Lead 108. Administrative Activities 24 C.F.R. §576.108 Recipients may use up to 6% of ESG grant for the payment of administrative costs related to planning and execution of ESG activities. 1) General management, oversight and coordination 24 C.F.R. §576.108 (a)(1): Costs of overall program management, coordination, monitoring and evaluation. ie. Budgets, developing systems for assuring compliance, developing agreements, monitoring program activities, preparing reports, coordinate the resolution of audit or monitoring findings, evaluating program results, managing staff. Eligible costs include:  Salaries, wages and related costs of staff engaged in program administration  Travel costs for monitoring sub recipients  Administrative services under contracts or agreements ie legal, accounting and audit.  Other costs for goods and services required for the administration of the program. Rental or purchase of equipment, insurance, utilities, office supplies, rental (not purchase) and maintenance of office space 2) Training 24 C.F.R. §576.108 (a)(2): Eligible costs include:  Training on ESG requirements from HUD sponsored trainings Emergency Solutions Grants Program Manual – Denton County Revised: October x, 2020 Page 15 3) Consolidated Plan 24 C.F.R. §576.108 (a)(3): Eligible costs include:  Preparing, amending the ESG and homeless section of the Consolidated Plan 4) Environmental review 24 C.F.R. §576.108 (a)(4): Eligible costs include:  Costs of carrying out an environmental review 109. Indirect Costs 24 C.F.R. §576.109 ESG funds may be used to pay indirect costs in accordance with 2 CFR part 200: Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards, as applicable. Eligible costs include:  Indirect costs may be applied to each eligible activity using the direct cost base specified in the approved cost allocation plan. Limitations:  Allocation must be consistent with an indirect cost rate proposal developed in accordance with 2 CFR part 200: Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards, as applicable  Must be added to direct costs charged for an activity when determining the total costs subject to expenditure limits. 201. MATCH* 24 C.F.R. §576.201 The CARES Act has waived the match requirements for the ESG-CV appropriation, therefore the City of Denton requires NO match for the use of these funds. ESG Subrecipients, except ESG-CV, must match dollar-for-dollar the ESG funding provided by HUD with funds from other public or private sources. Documentation of match will be provided monthly along with reimbursement requests. Subrecipient match funding can be generated by:  Cash Contributions are cash expended for allowable costs, as defined in 2 CFR part 200: Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards. Examples of sources of cash contributions include: private donations, or grants from foundations, nonprofits, or local, state, and federal sources. o Non-Cash Contributions are the value of any real property, equipment, goods, or services contributed to the subrecipient’s ESG program provided if the subrecipient had to pay for them would be allowable. o Match used for ESG may not be used as a match for any other program grant. o Match must be utilized during the contract period. *Subject to waivers published by HUD on 4/1/2020, as amended. POLICIES AND PROCEDURES Emergency Solutions Grants Program Manual – Denton County Revised: October x, 2020 Page 16 400 – Area-Wide Systems Coordination Requirements 24 C.F.R. §576.400 To meet federal, state, to end/prevent homelessness, and local goals for making homelessness rare, brief, and nonrecurring, an effective homeless response system is required. The City of Denton’s planning and program implementation are also coordinated with the Continuum of Care (CoC) through the Texas Balance of State, the Denton County Homeless Coalition, and other targeted homeless services. Because of this consultation and coordination Denton County has adopted Housing Crisis Response System (HCRS). Community partners are an integral part of this response system. The HCRS is made up of the services and projects that are currently working with people experiencing and at-risk of homelessness. The HCRS provides the framework for coordination among the various partners. The coordination processes is delivered through our HCRS partners using vital community tools such as HMIS, the Coordinated Entry (CE) system and the Housing Priority List (HPL). City funded partners and service contractors are required to coordinated under the HCRS and utilize CE/HPL. These processes are designed to ensure that people experiencing a housing crisis are prioritized for and matched with the most appropriate housing intervention as quickly as possible. It aims to standardize the access, assessment, and assistance process across all housing and homelessness services. COLLABORATION REQUIREMENTS HCRS effectively ensures ESG projects will serve the most vulnerable and that services and processes work together to provide seamless and effective permanent housing interventions. Because this HCRS ESG-CV will be a collaborative project all contractors regardless of service provided will be required to link with other SO, ES, HP and RRH projects as a part of the HCRS’s coordinated housing focused strategy. To improve outcomes related to moving people from unsheltered to sheltered and on to permanent housing, the HCRS ESG-CV will have collaborative case management (from outreach engagement, to housing transition, to housing stability) which will improve housing outcomes for this population and slow the spread of COVID-19 across Denton County. With the HCRS tools such as HMIS, Coordinated Entry (CE), and the Housing Priority List (HPL) we are able prioritize people at high risk of developing severe illness because of COVID-19. By integrating SO, ES, HP, and RRH services in this HCRS ESG-CV collaboration, we will prioritize people at high risk of developing severe COVID-19 symptoms and integrate that priority throughout the HCRS ESG-CV collaborative project. To achieve system goals, all ESG contractors will be required to coordinate and collaborate with the CoC, its lead agency, and member providers, and with Coordinated Entry (CE) in accordance with 24 CFR 576.400(d), as well as to meet individual client housing and service needs in a coordinated manner. This includes, but is not limited to, the following:  Participate in Coordinated Entry (CE) in accordance with 24 CFR 576.400(d)  Ensuring that at least one program staff member regularly attends bi-monthly Case Conferencing.  To have at least one representative attend all meetings local Denton County Homelessness Leadership Team Denton County Homeless Coalition workgroup meetings, the Balance of State CoC general membership meetings.  To have at least one program staff member participate in the planning and implementation of the annual Homeless Point in Time (PIT) Count in January of each year. POLICIES AND PROCEDURES Emergency Solutions Grants Program Manual – Denton County Revised: October x, 2020 Page 17 ESG PROGRAM REQUIREMENTS The intent of this document is to standardize the quality and type of services individuals and families can expect to receive from the Housing Crisis Response System, ESG -CV (HCRS ESG-CV) activities. All efforts were made to ensure these Written Standards align with the Standards put forth in with the TX BoS CoC Written Standards. With funding needs supported by the data, investment in ESG eligible activities such as SO, ES, HP, RRH and HMIS is a part of the HCRS coordinated housing-focused strategy that aims to reduce the number of people who become homeless, shorten the length of time people experience homelessness, and increase the number of people experiencing homelessness who are transitioned from unsheltered living situations to emergency/transitional housing and/or to permanent housing. Those who are already experiencing homeless are especially vulnerable to COVID-19. Due to the extraordinary nature of the pandemic-induced economic crisis, low-income housed families are faced with financial uncertainties ahead that also put them at an increased risk of becoming homeless. Those who do not have a safe place to stay at home are challenged with appropriate social distancing to prevent the spread of diseases such as COVID-19. The pandemic reinforces the critical role that housing plays in protecting health, safety, and well-being. Housing represents a place to work and stay protected from COVID-19 and this response is now also a vital part of the healthcare system as a place to stay healthy and prevent others from becoming infected. Moreover, many direct service providers have had to limit services due to a lack of protective equipment. This reduction in services has made it especially difficult for individuals experiencing and at-risk of homelessness to access resources. The HCRS ESG-CV funding will allow the City to fund programs and services in our Housing Crisis Response System (HCRS) as a part of a continuum of resources that help people experiencing homelessness who are disproportionately affected by the virus obtain safe, stable housing and assist people at-risk of homelessness to maintain stable housing through housing-focused programs and services. POLICIES AND PROCEDURES Emergency Solutions Grants Program Manual – Denton County Revised: October x, 2020 Page 18 400.101 – STREET OUTREACH (SO) The purpose of SO is to provide services to unsheltered homeless persons. The Homeless Outreach Team (H.O.T)., a cross-sector collaborative team with representatives led by Denton Police Homeless Outreach Officers and nonprofit agencies along with a Denton Fire paramedic, locates, identifies, and builds relationships with unsheltered people experiencing homelessness and engage them. H.OT. provides immediate support, intervention, and connection with the Housing Crisis Response System (HCRS) homeless assistance projects, mainstream social services and/or housing programs. Engagement takes place outdoors or apart from a homeless services building. HCRS ESG-CV funding for SO will allow H.O.T. to expand outreach efforts to people who are living unsheltered especially those in encampments. An increase in outreach is needed to sustain efforts to protect the health and safety of people experiencing homelessness and slow the spread of COVID-19 across Denton County. HCRS ESG-CV funding will incorporate support for outreach to those staying in encampments, including:  Encouraging them to set up their tents/sleeping quarters with adequate space per individual,  Providing guidance and safeguards to protect the health and safety of outreach staff and people experiencing homelessness to minimize the spread of COVID-19,  Connecting clients to medical care and facilitating access to non-urgent medical care as needed. The funding will further support improving standard outreach procedures around clients in need of immediate medical attention. ELIGIBILTY REQUREMENTS To be eligible for SO, the client(s) must meet the criteria for category 1, 3, or 4 of the HUD definition of homelessness in 24 CFR 576.2. All clients must be entered, and eligibility tracked through HMIS (or comparable database). Procedure is described in section 401. Eligible activities are described in Section 101. Additional detail for eligible uses with HCRS ESG-CV funds including:  QUARANTINE HOUSING Clients who are positive for COVID-19 need to have access to services and a safe place to stay, separated from others who are not infected. To facilitate a continuation of services, the HCRS ESG-CV collaboration will include resources to connect people living unsheltered to emergency and temporary housing, including access to individual private rooms with the provision of appropriate services, supplies, and staffing. 400.102 – EMERGENCY SHELTER (ES) The purpose of ES is to provide essential services to sheltered homeless persons. Emergency shelter and temporary housing provides a safe option for people experiencing a housing crisis or fleeing an unsafe situation. Emergency Shelter (ES) services as part of a continuum of resources in our Housing Crisis Response System (HCRS) that help people experiencing homelessness to obtain stable permanent housing. HCRS ESG-CV funding for ES services will provide vital resources to improve the layout of shelter facilities, offer guidance and safeguards to protect the health and safety of all stakeholders, and reduce the number of people living in overcrowded shelters by providing alternative individual spaces, such as hotel rooms, for isolation and self-quarantine. HCRS ESG-CV funds will also allow POLICIES AND PROCEDURES Emergency Solutions Grants Program Manual – Denton County Revised: October x, 2020 Page 19 our community to fill gaps in service provision by increasing the number of staff who work with clients on pandemic-related care plans, especially those with medical and/or behavioral health issues who are at a higher risk of severe illness. HCRS ESG-CV ES programs will support a person’s medical condition(s) through awareness and education, connect clients to healthcare providers, and oversee medications, daily routines, and activities and offer behavioral health case management services to assist people with developmental and/or behavioral health conditions who may have difficulties accessing resources, understanding or practicing preventative measures, and communicating symptoms of illness. Additional Program Requirements are provided below. (1) DIVERSION – Diversion should be attempted with all potential participant households before or within the first seven days enrollment into ES. (2) LOW BARRIER – HCRS ESG-CV ES must be low barrier by reducing all preconditions for entry to shelter and services. (3) ENHANCE SHELTER MODEL – In addition to coordination of mainstream and other services, housing focused case management is a priority throughout the HCRS. a. Housing Focused Case Management - Every client in shelter should be on a path to permanent housing. Housing focused case management can be provided by partnering with Rapid Re-housing and Permanent Supportive Housing providers so that shelter clients have access to housing and supportive services that can quickly re-stabilize their housing situation. Prioritized clients should have the option for extended shelter stay while the client and the HCRS ESG-CV RRH or PSH provider work together to secure affordable and available housing. b. Right of Return - Have the right of return with a guaranteed bed each night, and therefore do not have to line-up each day for shelter access; c. Pets - Can bring their pets with them into the shelter; and d. Possessions - Are provided with a locked storage unit so that they can protect their personal possessions when they leave for work, one-on-one case management appointments, employment interviews, medical visits, and more. (4) PRIORITIZATION – Clients with high vulnerability scores identified through CE and included on the Housing Priority List (HPL) should be prioritized for enrollment in ES and should be those who are Chronic homeless, Veterans, or DV and living unsheltered (SO). ELIGIBILTY To be eligible for ES, the client(s) must meet the criteria for category 1, 3 or 4, of the HUD definition of homelessness in 24 CFR 576.2. All clients must be entered, and eligibility tracked through HMIS (or comparable database). Procedure is described in section 401. Eligible activities are described in Section 102. Additional detail for eligible uses with HCRS ESG-CV funds including:  PERSONAL PROTECTION EQUIPMENT – Adequate personal protection equipment, cleaning supplies and enhance cleaning services.  FACILITY LAYOUT – Improvements to the layout of shelter facilities to create separation and isolation, including temporary barriers for separation of sleeping units. POLICIES AND PROCEDURES Emergency Solutions Grants Program Manual – Denton County Revised: October x, 2020 Page 20  QUARANTINE HOUSING – Clients who are positive for COVID-19 need to have access to services and a safe place to stay, separated from others who are not infected. To facilitate a continuation of services, the HCRS ESG-CV collaboration will include resources to connect people living unsheltered to emergency and temporary housing, including access to individual private rooms with the provision of appropriate services, supplies, and staffing.  ADEQUATE STAFFING – Facilitate a surge of staff support (i.e., medical, mental, behavioral health, substance use counseling, medication assisted treatment, janitorial, and security).  HOUSING REFERRAL – To moving people from unsheltered to sheltered and on to permanent housing, the HCRS ESG-CV will have collaborative case management (from outreach engagement, to housing transition, to housing stability) which will improve housing outcomes for this population and slow the spread of COVID-19 400.103 – HOMELESS PREVENTION (HP) The purpose of HP is to prevent homelessness from occurring by providing short-term rental assistance, utility assistance, or relocation to housing that is affordable for the household. Providers also ensure the client remains stable through the provision of housing focused case management that offers support services and connections to mainstream services as needed for housing stability. With the City of Denton having the only overnight shelters there are limited emergency housing options in Denton County and extremely limited available, accessible, and affordable housing in Denton County. Homeless prevention is a vital resource for keeping families in crisis in their home and preventing them from entering homelessness. Preventing homelessness is by far the most efficient and cost-effective component in the HCRS. It is critical that clients with reduced income or job loss due to the COVID-19 pandemic can stay in their homes and remain safe. HCRS ESG-CV will provide emergency rental assistance for people who are struggling to afford the rent and are at serious risk of eviction because of the COVID-19 outbreak. ELIGIBILTY To be eligible for HP, the client(s) must the criteria for category 2 or At-Risk of the HUD definition of homelessness in 24 CFR 576.2. All clients must be entered, and eligibility tracked through HMIS (or comparable database). Procedure is described in section 401. Eligible activities are described in Section 103, Section 105 and Section 106. Additional detail for eligible uses with HCRS ESG-CV funds including:  ADEQUATE STAFFING – Facilitate a surge of staff support (i.e., medical, mental, behavioral health, substance use counseling, medication assisted treatment, janitorial, and security). 400.104 – RAPID RE‐HOUSING (RRH) The purpose of RRH is to assist eligible program participants to quickly obtain safe stable permanent housing. It is a permanent housing solution and is a valuable component in our HCRS. RRH provides housing relocation, stabilization services, and other assistance as necessary to help POLICIES AND PROCEDURES Emergency Solutions Grants Program Manual – Denton County Revised: October x, 2020 Page 21 a person experiencing homelessness move as quickly as possible into permanent housing and achieve stability in that housing. Permanent housing is the best option to protect the health and safety of people experiencing homelessness and slow the spread of COVID-19. Through HCRS ESG-CV expanded funding for housing assistance programs, we can reduce the number of people living in congregate shelters by providing them with permanent housing and personal spaces for isolation. ELIGIBILTY To be eligible for RRH, the client(s) must meet the criteria of category 1 or 4, of the HUD definition of homelessness in 24 CFR 576.2. All clients must be entered, and eligibility tracked through HMIS (or comparable database). Procedure is described in section 401. Eligible activities are described in Section 104, Section 105, and Section 106. Additional detail for eligible uses with HCRS ESG-CV funds including:  PERSONAL PROTECTION EQUIPMENT – Adequate personal protection equipment, cleaning supplies and enhance cleaning services.  ADEQUATE STAFFING – Facilitate a surge of staff support (i.e., medical, mental, behavioral health, substance use counseling, medication assisted treatment, janitorial, and security). 400.105 – HOUSING RELOCATION AND STABILIZATION SERVICES Additional Program Requirements are provided below.  Direct coordination with HCRS ESG-CV SO and ES - Coordination with the SO, ES and other services providers is required. Referral will occur through CE and the prioritization of the client will be in the Housing Priority List.  Prioritization - Priority will be given to individuals in HCRS ESG-CV funded SO and ES services.  Case Conferencing  While providing HP and RRH, CM will meet with clients not less than once per month [24 C.F.R. 576.401 (e), (i)] to assist the client in achieving long-term housing stability and ensure the client retains permanent housing once the HCRS ESG-CV assistance ends. WAIVER 400.106 – SHORT‐ AND MEDIUM‐TERM RENTAL ASSISTANCE 400.6a – Cost-Sharing HCRS ESG-CV HP or RRH assistance providers may include cost-sharing or cost-sharing adjusted over a scheduled time in the housing assistance program as a part of a housing stability case management plan but clients will not be required to pay any portion of rent and utilities while receiving HCRS ESG-CV HP or RRH assistance nor will any cost-sharing ever be more than 30% of the client’s income. Clients must not be required to pay any fee while receiving HCRS ESG- CV SO or ES assistance. 400.6b - Length of Rental Assistance The types, amount, and duration of housing stabilization and relocation services eligible under 24 C.F.R. §576.105 (p.12-13) and Short- and Medium-Term Rental Assistance 24 C.F.R. §576.106 (p 14) will be determined on a case-by-case basis. The Collaborative will be POLICIES AND PROCEDURES Emergency Solutions Grants Program Manual – Denton County Revised: October x, 2020 Page 22 focused on providing the least amount of assistance during the shortest time period with the goal of stabilizing households as quickly as possible. While up to 24 months is eligible under ESG. The standard duration that a household may receive housing search, placement, financial assistance and short-term rental assistance will be 3-6 months with option to extend to a maximum of 12 months of medium-term rental assistance. Additional extensions may be requested but the review and approval must be of unanimous consent of City of Denton and Case Conferencing Partners. In addition, in 10 TAC §7.8(d) it is now required by TDHCA that with the exception for clients served under Violence Against Women Act or Family Violence Prevention and Services Act, prior to clients being assisted with the seventh month of rental assistance, the client must have documentation of application for rental assistance benefits through other eligible programs as applicable including the Housing Choice Voucher Program (section 8), Section 811 for persons with disabilities or Section 202 for the elderly. Additional Considerations: Reassessment of eligibility will occur every 3 months for Homelessness Prevention, and every 12 months for Rapid Re-housing. 1. Program Income: Program income includes any amount of security or utility deposit returned to the Contractor. Contractors providing security or utility deposits, must return these funds to the City when clients assisted with HCRS ESG-CV funding move from the rental property or utility services are discontinued. HMIS The City requires the use of the Homeless Management Information System (HMIS) by any Contractor that receives funding from the City for people experiencing or at-risk of homelessness. This funding will require the Contractor to utilize HMIS to allow for tracking progress in our Housing Crisis Response System (HCRS). The data on all persons served and all activities assisted under ESG must be entered into the applicable community-wide HMIS in the area in which those persons and activities are located, or a comparable database, in accordance with HUD’s standards on participation, data collection, and reporting under a local HMIS. For Monitoring (See City of Denton Human Services Guide – Service Agreements, Funding Implementation and Monitoring) Policy and Procedure Manuals All contractors are responsible for developing policies and procedures regarding the applicable HCRS ESG-CV funded activities delivered by the subrecipient. The policy applicable to clients must be readily available to the client either in written information or by posting the policy in a public place. At a minimum these written standards must include required items in accordance with:  24 C.F.R. 576.400 – (e) Written Standards;  24 C.F.R. 576.401 – Evaluation of Program Eligibility and Needs;  24 C.F.R. 576.402 – Terminating Assistance;  24 C.F.R. 576.403 – Shelter and Housing Standards; POLICIES AND PROCEDURES Emergency Solutions Grants Program Manual – Denton County Revised: October x, 2020 Page 23  24 C.F.R. 576.404 – Conflicts of interest;  24 C.F.R. 576.405 – Homeless participation; and  24 C.F.R. 576.406 – Faith-based Activities. These written policies and procedures must be submitted to the City prior to expending funds. POLICIES AND PROCEDURES Emergency Solutions Grants Program Manual – Denton County Revised: October x, 2020 Page 24 401 – Evaluation of Program Participant Eligibility and Needs 24 C.F.R. 576.401 401.1 Process for evaluation Eligibility and Need The following minimum eligibility criteria must be met in order for an individual or family to be provided with HCRS ESG-CV assistance. Documentation in HMIS (or comparable) and in print case file is required. Additional DV guidelines are provided in Attachment I. 1) Intake, Eligibility & Case Management: All households must have at least an initial consultation with intake in HMIS at the time of assessment with a determination of homeless or at-risk status. Coordinated Entry (CE) must be used when client is determined to be experiencing homeless and include referral to an HCRS ESG-CV program.  Intake: collects demographic information in the client and household members.  Verification of Homeless/At-Risk Status: The household’s housing status must be determined at the time of intake. All program participants funded under the ESG must meet the HUD definition of homelessness and at-risk of homelessness in 24 CFR 576.2.  If Homeless, the CE workflow must be completed to document prioritization, determine appropriate housing need, and make referral to applicable program. Referral Contractor will accept the referral and assess eligibility for HCRS ESG-CV program and determining the program type, amount, and the length of assistance.  If At-Risk (housed but at eminent risk of eviction), the assessment for eligibility must document that the household would become homeless but for the HCRS ESG-CV assistance. In other words, a household would require emergency shelter or would otherwise become literally homeless in the absence of ESG assistance. Before providing assistance through ESG, the Contractor must determine and document if the household has any other available options or resources that may prevent them from becoming literally homeless. 2) Income guidelines:  If Homeless, Initial income eligibility is NOT required for Street Outreach, Emergency Shelter, and Rapid Re-housing for homeless in Categories 1-4.  If At-Risk, income eligibility must be determined for those eligible for HP Clients who are at-risk of homelessness must have an annual income* below 30% of the area medium income (AMI)* to qualify for ESG assistance. 3) Screening:  When determining eligibility, participants may not be screened out of the program based on the following criteria. o Having too little or no income o Active or history of substance use o Having a criminal record with exceptions for state-mandated restrictions o History of victimization, e.g., domestic violence, sexual assault, child abuse, human trafficking *Annual income: Annual income includes the total current gross income of all adult household members. When determining the annual income of an individual or family, the must use the standard for calculating annual income under 24 CFR 5.609. HUD Area Median Income Limits: http://www.huduser.org/DATASETS/il.html POLICIES AND PROCEDURES Emergency Solutions Grants Program Manual – Denton County Revised: October x, 2020 Page 25 4) Case management: CM’s will employ housing focused case management. CM will meet with clients not less than once per month [24 C.F.R. 576.401 (e), (i)] to ensure long-term housing stability that includes but is not limited to connecting clients to mainstream and other resources as needed; developing plans to secure affordable, available housing; housing stability to retain housing after ESG assistance ends; and improving earned income and non-cash benefits. 5) Recertification of eligibility: Agencies must evaluate and re-certify the housing status and income eligibility of ESG program participants based on program guidelines in each component. Homelessness Prevention funds recipients must be recertified at 3-months and Rapid Re-housing funds recipients at 12 months. 6) Residency: The individual or family must be homeless or reside in Denton County, be enrolled in a Denton County homeless shelter, or have been relocated from an outside shelter to Denton prior to intake. *Except ESG-CARES Act funding which increases AMI eligibility to 50% 401.2 Explanation of Documentation Standards For purposes of ESG, HUD allows various types of documentation, ranging from third party verification to applicant self-declaration. Minimum acceptable types of documentation vary depending on the particular housing status and circumstance being documented. These are explained here. Staff must clearly and briefly describe in case file anytime written third party documentation is not used. This may be done as part of the documented client assessment or as part of other case file documentation (e.g., in case notes, on the income verification form). General documentation standards, in order of preference, are as follows: Housing Documentation: 1. Written Third Party—Verification in writing from a third party (e.g. emergency shelter provider, landlord, etc.) either directly to ESG staff or via the applicant is most preferred. Written third party documentation may include completion of a standardized form, such as “ESG Homeless Certification” (Attachment G or HUD templates1). 2. Oral Third Party—Verification from a third party provided by the third party over the telephone or in-person directly to ESG staff. Oral third-party verification is acceptable only if written third party verification cannot be obtained. ESG staff must document reasons why third party written verification could not be obtained in the ESG participant file. See “ESG Homeless Certification” (Attachment G or HUD templates1). 3. Applicant Self-Declaration—An affidavit of housing status as reported by the household is allowable but is only acceptable if written or verbal third party verification cannot be obtained. Self-declaration of housing status (e.g., eviction) should be rare. ESG staff must document reasons why third party written, or oral verification could not be obtained in the ESG participant file. “ESG Self-Declaration of Housing Status” (Attachment H or HUD templates1). POLICIES AND PROCEDURES Emergency Solutions Grants Program Manual – Denton County Revised: October x, 2020 Page 26 Income Documentation: 1. Written Third Party—Verification in writing from a third party (e.g. individual employer, Social Security Administration, welfare office) is preferred. Written third party documentation may include completion of a standardized form, such as a verification of income statement. See “ESG Income Screening Tool” (Attachment I or HUD templates1). 2. Oral Third Party—Verification from a third party (e.g. individual employer, Social Security Administration, welfare office, etc.) provided by the third party over the telephone or in- person directly to ESG staff. Oral third-party verification is acceptable only if written third party verification cannot be obtained. ESG staff must document reasons why third party written verification could not be obtained in the ESG case file. The Contractor may use the “Income Screening Tool” form to document oral third-party income verification. 3. Applicant Self-Declaration—an affidavit of income status as reported by the household is allowable but is only acceptable if written or verbal third party verification cannot be obtained. ESG staff must document reasons why third party written, or oral verification could not be obtained in the ESG case file. See “ESG Self-Declaration of Income” (Attachment J or HUD templates1). At a minimum, self-declaration documentation must include, source, amount, frequency, applicant’s signature, and date. 1See “FORM” templates at www.HUDHRE.info. 401.3 Timeliness of Documentation Documentation that is dated within 30 days prior to the time of application is acceptable for purposes of ESG. However, a statement received any time within the twelve months prior to the time of application and reflecting current benefits received by an applicant household is allowed. All documentation must be dated prior to any payment for program services. 402 – Terminating Assistance 24 C.F.R. §576.402 Providers may terminate assistance to a household who does not meet program requirements. In terminating assistance to a household, the Contractor must provide a formal process in writing that recognizes the rights of individuals receiving assistance to due process of law. The policy must be readily available to households either in written information or by posting the policy in a public place. This process, at a minimum, must consist of: 1. Written notice to the program participant containing a clear statement of the reasons for termination; 2. A review of the decision, in which the program participant is given the opportunity to present written or oral objections before a person other than the person (or a subordinate of that person) who made or approved the termination decision; and 3. Prompt written notice of the final decision to the program participant. POLICIES AND PROCEDURES Emergency Solutions Grants Program Manual – Denton County Revised: October x, 2020 Page 27 4. Participants must be notified in writing at the time of enrollment that they may not be terminated for: a. Failure to participate in supportive services. b. Failure to make progress on service plan. c. Loss of income or failure to improve income. d. Any other activity not covered in the lease agreement typically found for unassisted persons in the project’s geographic area. 403 – Shelter and Housing Standards 24 C.F.R. §576.403 Emergency Shelters and Housing providers in the collaborative are required to develop written standards. The following in part (a) are minimum requirements in emergency where applicable. Part (b) covers all other minimum housing habitability requirements for inspection and the minimum standards for permanent housing. a) Emergency Shelters are required to establish Policies and Procedures and Shelter Standards. At a minimum these must include: 1. Structure and materials must be structurally sound so as not to pose any health and safety threat to occupants and to protect occupants from the elements. 2. Access must be accessible to occupants without being accessible to unauthorized persons and must provide an alternate means of egress in case of fire. 3. Space and security must afford adequate space and security for occupants and belongings including an acceptable place to sleep. 4. Interior air quality each room or space must be provided with natural or mechanical ventilation and must be free of air pollutants at levels that threaten the health of the occupants. 5. Water supply must be free from contamination. 6. Sanitary facilities Residents must have access to sufficient sanitary facilities that are in proper operating condition, may be used in privacy, and are adequate for personal cleanliness and the disposal of human waste. 7. Thermal environment must have adequate heating and or cooling facilities in proper working condition. 8. Illumination and electricity must have adequate natural or artificial illumination to permit normal indoor activities and to support the health and safety of occupants. Sufficient electrical sources must be provided to permit use of essential electrical appliances while assuring safety from fire. 9. Food preparation and refuse disposal all food preparation areas must contain suitable space and equipment to store, prepare, and serve food in a sanitary manner. 10. Sanitary condition housing and any equipment must be maintained in a sanitary condition. 11. Fire safety o Each dwelling must include at least one working smoke detector, in each occupied unit of the shelter. Where possible Smoke detectors must be located, POLICIES AND PROCEDURES Emergency Solutions Grants Program Manual – Denton County Revised: October x, 2020 Page 28 near sleeping areas. The fire alarm system must be designed for the hearing- impaired persons. All public areas of the shelter must have at least one working smoke detector. There must also be a second means of exiting the building in the event of a fire or other emergency. b) Permanent Housing - An on-site inspection is required anytime a program participant is receiving ESG financial assistance and moving into a new unit. (Financial assistance includes rental assistance, security deposit assistance, utility assistance, etc.) A housing unit inspection is not required for a program participant served with ESG prevention assistance in a unit in which the participant was already residing. i. Habitability - The unit must be in compliance with all applicable state and local housing codes and licensing requirements. Habitability inspections are also not required for persons receiving services only. ii. Lead Based Paint Inspection 1. Structure and materials must be structurally sound so as not to pose any health and safety threat to occupants and to protect occupants from the elements. 2. Space and security must afford adequate space and security for occupants and belongings including an acceptable place to sleep. 3. Interior air quality each room or space must be provided with natural or mechanical ventilation and must be free of air pollutants at levels that threaten the health of the occupants. 4. Water supply must be free from contamination. 5. Sanitary facilities Residents must have access to sufficient sanitary facilities that are in proper operating condition, may be used in privacy, and are adequate for personal cleanliness and the disposal of human waste. 6. Thermal environment must have adequate heating and or cooling facilities in proper working condition. 7. Illumination and electricity must have adequate natural or artificial illumination to permit normal indoor activities and to support the health and safety of occupants. Sufficient electrical sources must be provided to permit use of essential electrical appliances while assuring safety from fire. 8. Food preparation and refuse disposal all food preparation areas must contain suitable space and equipment to store, prepare, and serve food in a sanitary manner. 9. Sanitary condition housing and any equipment must be maintained in a sanitary condition. 10. Fire safety There must be a secondary means of exiting the building in the event of fire or other emergency. o Each dwelling must include at least on battery-operated or hard-wired smoke detector, in proper working condition, on each occupied level of the unit. Smoke detectors must be located, to the extent practicable, in a hallway adjacent to a bedroom. If the unit is occupied by hearing-impaired persons, smoke detectors must have an alarm system designed for the hearing-impaired in each bedroom occupied by a hearing-impaired person. o Public areas of all housing must be equipped with a sufficient number, but not less than one for each area, of battery-operated or hard-wired detectors. Public POLICIES AND PROCEDURES Emergency Solutions Grants Program Manual – Denton County Revised: October x, 2020 Page 29 areas include, but are not limited to, laundry rooms, community rooms, day care centers, hallways, stairwell, and common areas. NOTES:  The Housing Quality Standards (HQS) used for other HUD programs are more stringent than the habitability standards outlined in the ESG Notice. Agencies are not required to use HQS, but may do so if they choose.  Habitability standards do not require a certified inspector to conduct on-site inspections.  Agencies should use the “ESG Habitability Standards Checklist” Attachment M (templates also available on HUD’s Homelessness Resource Exchange at http://hudhre.info) as a guide to conduct the on-site inspection. This checklist should be completed upon initial occupancy and on an annual basis for the term of ESG assistance. Copies of the completed checklists should be included in the case files for documentation purposes. 404 – Conflicts of Interest 24 C.F.R. §576.404 There are two situations that are often referred to as a “conflict of interest.” 1) The first is when ESG program participants are to be assisted in a property that is owned by the Contractor or affiliated organization of the Contractor. In this instance: The waiver must: a. Cannot force the client to use the Contractor’s property or b. Owner of the housing cannot conduct FMR, rent reasonableness, or initial habitability inspection. 2) The second type of conflict of interest that can occur is at the individual level (as opposed to the Contractor level). The ESG Notice states: “No person who is an employee, agent, consultant, officer, or elected or appointed official of the grantee and who exercises or has exercised any functions or responsibilities with respect to assisted activities, or who is in a position to participate in a decision-making process or gain inside information with regard to such activities, may obtain a personal or financial interest or benefit from the activity, or have an interest in any contract, subcontract, or agreement with respect thereto, or the proceeds there under, either for himself or herself or for those with whom he or she has family or business ties, during his or her tenure or for one year thereafter.” NOTE: Employees of an Contractor and their families are not automatically disqualified from receiving ESG assistance, as long as they meet the qualifications of the above paragraph (i.e., they are not in a position to exercise any responsibilities, make decisions about, gain inside information into, or obtain a personal benefit from ESG). This situation would be more likely in a large agency than it would in a very small agency. When a conflict of interest exists, the grantee may seek an exception by writing to the local HUD Field Office, including the following information: • For states and other governmental entities, a disclosure of the nature of the conflict, accompanied by an assurance that there has been public disclosure of the conflict and a description of how the public disclosure was made; and • For all grantees, an opinion of the grantee’s attorney that the interest for which the exception is sought would not violate state or local law. POLICIES AND PROCEDURES Emergency Solutions Grants Program Manual – Denton County Revised: October x, 2020 Page 30 If there is a question or the appearance of a conflict of interest of any type, the Contractor should contact the local HUD field office to determine if an exception or waiver is needed. 405 – Homeless Participation 24 C.F.R. §576.405 All funded agencies in this collaborative must have a written plan that details how people experiencing homelessness and/or formerly experienced homelessness will have input into the agency’s planning, policies, and its direct services offered to the homeless population. This shall be submitted before the Service Agreement between the City and the Agency is executed. 406 – Faith-Based Activities 24 C.F.R. §576.406  Organizations that are religious or faith-based are eligible, on the same basis as any other organization, to receive ESG funds. Neither the Federal Government nor a State or local government receiving funds under ESG shall discriminate against an organization on the basis of the organization’s religious character or affiliation.  Organizations that are directly funded under the ESG program may not engage in inherently religious activities, such as worship, religious instruction, or proselytization as part of the programs or services funded under ESG. If an organization conducts these activities, the activities must be offered separately, in time or location, from the programs or services funded under ESG, and participation must be voluntary for program participants.  Any religious organization that receives ESG funds retains its independence from Federal, State, and local governments, and may continue to carry out its mission, including the definition, practice, and expression of its religious beliefs, provided that the religious organization does not use direct ESG funds to support any inherently religious activities, such as worship, religious instruction, or proselytization. Among other things, faith-based organizations may use space in their facilities to provide ESG-funded services, without removing religious art, icons, scriptures, or other religious symbols. In addition, an ESG- funded religious organization retains its authority over its internal governance, and the organization may retain religious terms in its organization’s name select its board members on a religious basis and include religious references in its organization’s mission statements and other governing documents.  An organization that receives ESG funds shall not, in providing ESG assistance, discriminate against a program participant or prospective program participant on the basis of religion or religious belief.  ESG funds may not be used for the rehabilitation of structures to the extent that those structures are used for inherently religious activities. ESG funds may be used for the rehabilitation of structures only to the extent that those structures are used for conducting eligible activities under the ESG program. Where a structure is used for both eligible and inherently religious activities, ESG funds may not exceed the cost of those portions of the rehabilitation that are attributable to eligible activities in accordance with the cost accounting requirements applicable to ESG funds. Sanctuaries, chapels, or other rooms that an ESG-funded religious congregation uses as its principal place of worship, however, are ineligible for funded improvements under the program. Disposition of real property after the term of the grant, or any change in use of the property during the term of the POLICIES AND PROCEDURES Emergency Solutions Grants Program Manual – Denton County Revised: October x, 2020 Page 31 grant, is subject to government-wide regulations governing real property disposition (see 24 CFR parts 84 and 85).  ESG Subrecipients that are faith-based organizations must provide the "Written Notice of Beneficiary Rights" described in 24 CFR §5.109(g) to applicants or program participants. Attachment O  If the subrecipient that is a local government voluntarily contributes its own funds to supplement federally funded activities, the subrecipient has the option to segregate the Federal funds or commingle them. However, if the funds are commingled, this section applies to all of the commingled funds. 407 – Other Federal Requirements 24 C.F.R. §576.407 ESG rental assistance and services are available to all on a nondiscriminatory basis and all citizens have equal access to information about ESG with equal access to the financial assistance and services provided under this program. Each Contractor must take reasonable steps to ensure meaningful access to programs. If the procedures that are utilized to make known the availability of the rental assistance and services are unlikely to reach persons of any particular race, color, religion, sex, age, national origin, familial status, or disability who may qualify for such rental assistance and services, additional procedures must be established that will ensure that such persons are made aware of the rental assistance and services. For persons with limited English proficiency (LEP), pursuant to Title VI of the Civil Rights Act of 1964 agencies should be providing language assistance or ensuring that program information is available in the appropriate languages so that limited English proficient persons have meaningful access to ESG assistance. “Final Guidance to Federal Financial Assistance Recipients Regarding Title VI Prohibition Against National Origin Discrimination Affecting Limited English Proficient Persons” (72 42 Federal Register 2732; January 22, 2007). In addition, all notices and communications shall be provided in a manner that is effective for persons with hearing, visual, and other communication-related disabilities consistent with section 504 of the Rehabilitation Act of 1973 and implementing regulations at 24 CFR 8.6. Recipients and subrecipients must comply with the following other Federal Requirements:  24 CFR part 5, including nondiscrimination and equal opportunity requirements at 24 CFR 5.105(a)  Section 3 of the Housing and Urban Development Act of 1968 (except homeless individual have priority over other Section 3 residents)  Environmental Review under 24 CFR part 50  2 CFR part 200: Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards  HUD Eligibility Determination and Documentation Guidance  Any Waivers or Special Condition Notices issues by HUD during the grant term. Recipients and subrecipients must also comply with the following other Federal Requirements:  Fair Housing Act  Uniform Administrative Requirements  Equal Employment Opportunity Programs POLICIES AND PROCEDURES Emergency Solutions Grants Program Manual – Denton County Revised: October x, 2020 Page 32  Minority Business Enterprises  Nondiscrimination in Federally Assisted Programs  Age Discrimination Act of 1975  Women’s Business Enterprise  Drug Free Workplace Act  Debarred Suspended  Section 504 of the Rehabilitation Act  Americans with Debarred, Suspended, Ineligible Contractors  Affirmative Outreach Disabilities Act  Section 6002 of the Solid Waste Disposal Act, as amended by the Resource Conservation and Recovery Act  Uniform Relocation Act applies but is extremely rare for ESG. See §576.408 for details. Equal Access Rule In February 2012, the U.S. Department of Housing and Urban Development ("HUD") issued the Equal Access to Housing in HUD Programs Regardless of Sexual Orientation or Gender Identity Rule ("Equal Access Rule"). The rule, which applies to the Emergency Solutions Grants ("ESG") program, creates a new regulatory provision that generally prohibits providers from considering a person's marital status, sexual orientation, or gender identity (a person's internal sense of being male or female) in making assistance available. https://www.hudexchange.info/resource/1991/equal-access-to-housing-final-rule/ The following notes are added to address the Equal Access Rule.  Note on eligibility: A shelter or housing program may limit assistance to households with children but it may not limit assistance to only women with children. To be in compliance with the Equal Access rule the shelter/program must also serve 1) single male head of household with minor child(ren); and 2) any household made up of two or more adults, regardless of sexual orientation, marital status, or gender identity, presenting with minor child(ren). https://www.hudexchange.info/faqs/1529/how-is-the-definition-of-family-that-was-included  Note on Eligibility: TDHCA also clarified that shelters/programs should allow individuals to self-identify gender at the time of application intake to avoid screening out otherwise eligible transgendered applicants. 408 - Displacement, Relocation, and Acquisition 24 C.F.R. §576.408 All reasonable steps must be taken to minimize the displacement of households. If ESG funds will be utilized for the acquisition, rehabilitation or demolition, persons should qualify as displaced. Therefore, relocation, temporary or otherwise, is not permitted when using ESG funds on existing shelter and housing facilities. POLICIES AND PROCEDURES Emergency Solutions Grants Program Manual – Denton County Revised: October x, 2020 Page 33 500 - RECORDKEEPING AND REPORTING REQUIREMENTS 24 C.F.R. §576.500 Provided throughout this manual are information sources and tools necessary for understanding recordkeeping and reporting requirements for this grant. This includes checklists and standard forms needed for documenting client eligibility and all other program elements that require specific documentation. The attachments found in the next section include many standardized forms. Forms provided are required where stated. Attachment A: Documentation of Collaborative Agencies Attachment B: Client Checklist Attachment C: Certification and Recordkeeping Requirements Checklist Attachment D: Income Screening Tool – HP Only Attachment E: HMIS Consent Form Attachment F: Rental Assistance Agreement Attachment G: Homeless Certification Attachment H: Self-Declaration of Homeless/Domestic Violence/At Risk Attachment I: Domestic Violence Guidance Attachment J: Self Declaration of Income Attachment K: Re-Certification of Eligibility Attachment L: Fair Market Rent/Rent Reasonableness Inspection Checklist Attachment M: Habitability Standards Inspection Checklist Attachment N: Lead Screening Worksheet Attachment O: Written Notice of Beneficiary Rights – Religious Organizations Attachment P: HUD Homeless Definition POLICIES AND PROCEDURES Emergency Solutions Grants Program Manual – Denton County Revised: October x, 2020 Page 34 [This Page Left Intentionally Blank] Emergency Solutions Grant Program (ESG) Program Manual – ATTACHMENTS A-P l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l Community Development Division 601 E. Hickory, Suite B Denton, TX 76205 version: June 5, 2020 2020 Emergency Solutions Grant Program (ESG) Page | 2 TABLE OF CONTENTS - Program Manual – ATTACHMENTS A-P # Description Document Size, #Pages A Denton County ESG Collaborative List 1 B Client File Checklist 1 C Certification And Recordkeeping Requirements Checklist 5 D Income Screening Tool 1 PROGRAMA PARA DETERMINAR INGRESOS 1 E HMIS Consent Form & Privacy Policy 6 Spanish 6 F Rental Assistance Agreement 6 Spanish 6 G Homeless Certification 1 H Self‐Declaration Of Homeless/Domestic Violence/At Risk 1 Declaración Sin Hogar/Violencia Doméstica/En Riesgo 1 I Domestic Violence Program Guidance TBD J Self‐Declaration Of Income 1 Declaración De Ingresos 1 K Re‐Certification Of Eligibility 1 L Fair Market Rent/Rent Reasonableness Inspection Checklist 1 M Housing Habitability Standards Inspection Checklist 2 N Lead–Based Paint Hazards Disclosure 1 O Written Notice of Beneficiary Rights – Religious Organizations 1 P Homeless Definitions – HUD Rule 2 PROGRAM NOTE: The City of Denton reserves the right to update attachments as needed for program improvement. 2020 Emergency Solutions Grant Program (ESG) 1 Page | 1 DENTON COUNTY ESG COLLABORATIVE  City of Denton (COD) will serve as sub-recipients for grant and lead agency procuring programs and services under the ESG grant. The City will maintain compliance, fulfilling required reporting requirements and acting as fiduciary agent. Community Development 601 E. Hickory Suite B Denton, TX 76206 http://cityofdenton.com *This page will be updated at the time partners are procured  PROCURED PARTNER Services Description Street City, St Zip Phone Website  PROCURED PARTNER Services Description Street City, St Zip Phone Website  PROCURED PARTNER Services Description Street City, St Zip Phone Website  PROCURED PARTNER Services Description Street City, St Zip Phone Website CoC Balance of State administered through the Texas Homeless Network COMMUNITY COALITION Denton County Homeless Coalition 2020 Emergency Solutions Grant Program (ESG) 2 Page | 2 [Blank] 2020 Emergency Solutions Grant Program (ESG) 1 Page | 1 CLIENT FILE CHECKLIST Applicant Name: Client ID: The following checklist and applicable forms are provided for City of Denton ESG Collaborative. Form Street Outreach Emergency Shelter Rapid Re‐Housing Homeless Prevention  All Households (Services / Rental /Financial Assistance) Client Intake Form/Application 1    Certification and Recordkeeping Requirements Checklist (Pages 1‐5 as applicable)     Homelessness Certification, OR Self Declaration of Homelessness     HMIS Consent Form2     Case Management Form(s) 1      Households Receiving Rental Assistance (Short‐Term/Medium‐Term/Rental Arrears) prohibited from use with other subsidies except one‐time payment of rental arrears Income Verification  FMR/Rent Reasonableness/Utility Calculation Form and Attachments   Housing Habitability Inspection   Lead‐Based Paint Inspection 3   Rental Assistance Agreement4 (between agency and landlord)   Lease5 (between tenant and landlord)   Re‐certification of Eligibility 6    Households Receiving Financial Assistance/Services (Application Fees/Security Deposit/Last Month’s Rent/Utility Deposits/Utility Payments/Moving Costs) Housing Habitability Inspection   Lead‐Based Hazards Disclosure3   Staff Signature: Date: 1 Can vary by ESG Collaborative Agency, can be in HMIS of comparable Db 2 or comparable Database for DV Agency 3 Does not apply when only services are provided but does apply when rental or financial assistance is provided. 4 ESG TDHCA requires HUD approved form 5 Varies by Leasing Provider 6 Re‐certification of eligibility required for Homeless Prevention every 3 months and Rapid Re‐housing every 12 months. 2020 Emergency Solutions Grant Program (ESG) 2020 ESG Collaborative Forms Attachment B: Client File Checklist Page | 1 [Blank] 2020 Emergency Solutions Grant Program (ESG) 2020 ESG Collaborative Forms Attachment C: Certification and Recordkeeping Requirements Checklist Page | 1 CERTIFICATION AND RECORDKEEPING REQUIREMENTS CHECKLIST Applicant Name: Client ID: CRITERIA FOR DEFINING HOMELESSNESS Category 1  Literally Homeless Individual or family who lacks a fixed, regular, and adequate nighttime residence, meaning:  Has a primary nighttime residence that is a public or private place not meant for human habitation;  Is living in a publicly or privately operated shelter designated to provide temporary living arrangements (including congregate shelters, transitional housing, and hotels and motels paid for by charitable organizations or by federal, state and local government programs); or  Is exiting an institution where (s)he has resided for 90 days or less and who resided in an emergency shelter or place not meant for human habitation immediately before entering that institution RECORDKEEPING REQUIREMENTS ELIGIBILITY Street Outreach2 Emergency Shelter Rapid Re‐Housing 2Individual/Families must be living on the streets (or other place not meant for human habitation) and be unwilling or unable to access services in emergency shelter  Written observation by the outreach worker; or  Written referral by another housing or service provider; or  Certification by the individual or head of household seeking assistance stating that (s)he was living on the streets or in a shelter;  For individual exiting an institution – one of the forms of evidence above and;  discharge paperwork or written/oral referral, or  written record of intake worker’s due diligence to obtain above evidence and certification by individual that they exited institution REF: Homeless Definitions ‐ 24 C.F.R. § 576.2. Staff Signature: Date: 2020 Emergency Solutions Grant Program (ESG) 2020 ESG Collaborative Forms Attachment C: Certification and Recordkeeping Requirements Checklist Page | 2 CERTIFICATION AND RECORDKEEPING REQUIREMENTS CHECKLIST Applicant Name: Client ID: CRITERIA FOR DEFINING HOMELESSNESS Category 2  Imminent Risk Of Homelessness Individual or family who will imminently lose their primary nighttime residence, provided that:  Residence will be lost within 14 days of the date of application for homeless assistance;  No subsequent residence has been identified; and  The individual or family lacks the resources or support networks needed to obtain other permanent housing RECORDKEEPING REQUIREMENTS ELIGIBILITY Emergency Shelter Homelessness Prevention3 3Individual/Families must have annual income below 30% of AMI  A court order resulting from an eviction action notifying the individual or family that they must leave; or  For individual and families leaving a hotel or motel – evidence that they lack the financial resources to stay; or  A documented and verified oral statement; and  Certification that no subsequent residence has been indentified; and  Self‐Certification or other written documentation that the individual lacks the financial resources and support necessary to obtain permanent housing REF: Homeless Definitions ‐ 24 C.F.R. § 576.2. Staff Signature: Date: 2020 Emergency Solutions Grant Program (ESG) 2020 ESG Collaborative Forms Attachment C: Certification and Recordkeeping Requirements Checklist Page | 3 CERTIFICATION AND RECORDKEEPING REQUIREMENTS CHECKLIST Applicant Name: Client ID: CRITERIA FOR DEFINING HOMELESSNESS Category 3  Homeless under other Federal Statutes Unaccompanied youth under 25 years of age, or families with children and youth, who do not otherwise qualify as homeless under this definition, but who:  Are defined as homeless under the other listed federal statutes;  Have not had a lease, ownership interest, or occupancy agreement in permanent housing during the 60 days prior to the homeless assistance application;  Have experienced persistent instability as measured by two moves or more during in the preceding 60 days; and  Can be expected to continue in such status for an extended period of time due to special needs or barriers RECORDKEEPING REQUIREMENTS ELIGIBILITY Street Outreach Emergency Shelter Homelessness Prevention3 2Individual/Families must be living on the streets (or other place not meant for human habitation) and be unwilling or unable to access services in emergency shelter 3Individual/Families must have annual income below 30% of AMI  Certification by nonprofit or state or local government that the individual or head of household seeking assistance met the criteria of homelessness under another federal statute; and   Certification of no PH in the last 60 days; and  Certification by the individual or head of household, and any available supporting documentation, that (s)he has moved two or more times in the past 60 days; and   Documentation of special needs or 2 or more barriers REF: Homeless Definitions ‐ 24 C.F.R. § 576.2 Staff Signature: Date: 2020 Emergency Solutions Grant Program (ESG) 2020 ESG Collaborative Forms Attachment C: Certification and Recordkeeping Requirements Checklist Page | 4 CERTIFICATION AND RECORDKEEPING REQUIREMENTS CHECKLIST Applicant Name: Client ID: CRITERIA FOR DEFINING HOMELESSNESS Category 4  Fleeing/ Attempting to Flee DV Any individual or family who:  Is fleeing or attempting to flee domestic violence;  Has no other residence; and  Lacks the resources or support networks to obtain other permanent housing RECORDKEEPING REQUIREMENTS ELIGIBILITY Street Outreach1/2 Emergency Shelter Rapid Re‐Housing1 Homelessness Prevention3 1Must also meet criteria for Category 1 2Individual/Families must be living on the streets (or other place not meant for human habitation) and be unwilling or unable to access services in emergency shelter 3Individual/Families must have annual income below 30% of AMI For domestic violence providers:  An oral statement by the individual or head of household seeking assistance which state: they are fleeing; they have no subsequent residence; and they lack resources. Statement must be documented For non‐victim providers:  Oral statement by the individual or head of household seeking assistance that they are fleeing. This statement is documented by self‐certification or by the caseworker. Where the safety of the individual or family is not jeopardized, the oral statement must be verified; and  Certification by the individual or head of household that no subsequent residence has been identified; and  Self‐certification or other written documentation, that the individual or head of household lacks the financial resources and support networks to obtain other permanent housing. REF: Homeless Definitions ‐ 24 C.F.R. § 576.2. Staff Signature: Date: 2020 Emergency Solutions Grant Program (ESG) 2020 ESG Collaborative Forms Attachment C: Certification and Recordkeeping Requirements Checklist Page | 5 CERTIFICATION AND RECORDKEEPING REQUIREMENTS CHECKLIST Applicant Name: Client ID: Address where Applicant is being evicted: CRITERIA FOR DEFINING AT RISK OF HOMELESSNESS  Individuals & Families  Unaccompanied Children and Youth A child or youth who does not qualify as “homeless” under this definition, but qualifies as “homeless” under another Federal statue  Families with Children and Youth A unaccompanied youth who does not qualify as “homeless” under the homeless definition, but qualifies as “homeless” under section 725(2) of the McKinney‐Vento Homeless Assistance Act and the parent(s) or guardian(s) of that child or youth if living with her or him. An individual or family who:  Has an annual income below 30% of the AMI; and  Lacks sufficient resources or support networks immediately available to prevent them from moving to an emergency shelter or another place described in Category 1 of the “homeless” definition; and EVIDENCE OF THE SECOND ELIGIBILITY CRITERIA FOR ABOVE ATTACH DOCUMENTATION OF (A), (B), or (C) TO FORM  (A) Source Documents (e.g. notice of termination from employment, unemployment compensation statement, bank statement, health‐care bill showing arrears, utility bill showing arrears).  (B)To the extent that source documents are unobtainable, a written statement by the relevant third party (e.g., former employer, public administrator, relative) or written certification by the intake staff of the oral verification by the relevant third party that the applicant meets one or both of the criteria of the definition of “at risk of homelessness” or  (C) If source documents and third‐party verification are unobtainable, a written statement by intake staff describing the efforts taken to obtain the required evidence. Meets one or more of the following conditions:  Has moved because of economic reasons 2 or more times during the 60 days immediately preceding the application for assistance; or  Is living in the home of another because of economic hardship; or  Has been notified in writing that their right to occupy their current housing or living situation will be terminated within 21 days after the date of application for assistance; or  Lives in a hotel or motel and the cost is not paid by charitable organizations or by Federal, State, or local government programs for low‐income individuals; or  Lives in a single‐room occupancy (SRO) or efficiency apartment unit in which there reside more than 2 persons or lives in a larger housing unit in which there reside more than 1.5 persons reside per room; or  Is exiting a publicly funded institution, or system of care (such as a health‐care facility, a mental health facility, foster care or other youth facility, or correction program or institution); or  Otherwise lives in housing that has characteristics associated with instability and an increased risk of homelessness, as identified in the recipient's approved consolidated plan REF: Homeless Definitions ‐ 24 C.F.R. § 576.2. Staff Signature: Date: 2020 Emergency Solutions Grant Program (ESG) 2020 ESG Collaborative Forms Attachment C: Certification and Recordkeeping Requirements Checklist Page | 6 [Blank] 2020 Emergency Solutions Grant Program (ESG) 2020 ESG Collaborative Forms Attachment D: Income Screening Tool Page | 1 Income Screening and Income Certification for Homelessness Prevention and Rapid Re‐Housing programs. INCOME SCREENING TOOL  Initial Certification  Recertification Annual Income of all members of household (exclude earned income from employment by persons under the age of 18) Identify all income by source, including periodic payments: Head of Household Co‐Head/ Spouse Other Adult Child or Dependent Total Salary  Yes  No Overtime Pay  Yes  No Commissions/Fees  Yes  No Tips and Bonuses  Yes  No Salary from 2nd Job  Yes  No Temporary Income  Yes  No Income from Military  Yes  No Interests/Dividends  Yes  No Business Net Income  Yes  No Net Rental Income  Yes  No Social Security  Yes  No Supplemental Security Income  Yes  No Pension  Yes  No Retirement Funds  Yes  No Familial Support  Yes  No Unemployment Benefits  Yes  No Workers Compensation  Yes  No Alimony  Yes  No Child Support  Yes  No Anticipated, Voluntary, Court Ordered‐regardless if pd. AFDC/TANF  Yes  No Educational Scholarship/Grant  Yes  No Other (explain):  Yes  No NON‐CASH BENEFITS SNAP  Yes  No Medicare Health Insurance  Yes  No Medicaid Health Insurance  Yes  No State Children’s Health Insurance  Yes  No VA Medical Services  Yes  No Special Supplemental Nutrition for Women, Infants  Yes  No Section 8, public housing, other temporary rental assistance  Yes  No TANF Child Care/Other Services  Yes  No Other (explain):  Yes  No APPLICANT NAME/CLIENT ID: 2020 Emergency Solutions Grant Program (ESG) 2020 ESG Collaborative Forms Attachment D: Income Screening Tool Page | 2 HOUSEHOLD ASSETS (identify if anyone has any of the following type of assets, including dependents under the age of 18) Identify All Asset Sources Cash Value Asset Income (Interest/Dividends) Name of Financial Institution Account Number Checking Account  Yes  No Additional Checking Account(s)  Yes  No Savings Account  Yes  No Additional Savings Account(s)  Yes  No Credit Union Account(s)  Yes  No Stocks, Bonds, Mutual Funds*  Yes  No Real Estate or Home  Yes  No IRA/Keogh Account(s)*  Yes  No Retirement/Pension Fund(s)*  Yes  No Trust Fund(s)  Yes  No Mortgage Note Held  Yes  No Whole Life Insurance Cash Value*  Yes  No Real Estate/Land*  Yes  No Other (explain):  Yes  No *When listing the “cash value” of any asset with an asterisk*, indicate the amount you would have if you were to convert it to cash. The amount would have deducted any penalties for withdrawal, amounts used to pay off a balance, or any fees which may be assessed for the conversion. HOUSING ASSISTANCE (List any assistance provided to or received by any member of the household) Source Amount Date Received Reason FEMA  Yes  No (Federal Emergency Management Agency) SBA  Yes  No (Small Business Administration) Section 8  Yes  No (Housing and Urban Development HUD) TBRA  Yes  No (Tenant Based Rental Assistance) Insurance  Yes  No (Homeowner) Other (explain):  Yes  No APPLICANT CERTIFICATION RELEASE: My/Our Signature here authorizes the release and verification of my employment information. Applicant/Resident Printed Name: Signature: Date: Co‐Applicant/Resident Printed Name: Signature: Date: Adult Member Printed Name: Signature: Date: Adult Member Printed Name: Signature: Date: 2020 Emergency Solutions Grant Program (ESG) 2020 ESG Collaborative Forms Attachment D: Income Screening Tool Page | 3 Uun programa para determinar ingresos para reubicación y prevención del desamparo a familias y personas. PROGRAMA PARA DETERMINAR INGRESOS  Certificación inicial  Recertificación Ingresos anuales de todos los miembros del hogar (excluir ganado ingresos procedentes del empleo de las personas menores de 18 años) Identificar todos los ingresos por fuente, incluidos los pagos periódicos: Cabeza de familia Codirector / Cónyuge Otro adulto Niño o Dependiente Total Salario Sí No Pago de horas extras Sí No Comisiones y tarifas Sí No Consejos y bonificaciones Sí No Salario de 2nd trabajo Sí No Renta temporal Sí No Ingreso de militares Sí No Intereses/dividendos Sí No Ingresos netos de negocio Sí No Renta neta Sí No Seguro social Sí No Seguro de ingreso suplementario Sí No Pensión Sí No Fondos de jubilación Sí No Apoyo familiar Sí No Prestaciones por desempleo Sí No Compensación de trabajadores Sí No Pensión alimenticia Sí No Manutención de menores Sí No Voluntaria, Ordenado por la corte – a pesar si se paga. AFDC/TANF Sí No Beca educativo Sí No Otro (explique): Sí No BENEFICIOS NO‐LÍQUIDAS SNAP Sí No Seguro de Salud Medicare Sí No Seguro de Salud Medicaid Sí No Seguro de Salud infantil del Estado Sí No Servicios Médicos VA Sí No Nutrición Suplementaria para mujeres y bebés Sí No Sección 8, vivienda pública, otra asistencia de alquiler temporario Sí No Guardería TANF / otros servicios Sí No Otro (explique): Sí No 2020 Emergency Solutions Grant Program (ESG) 2020 ESG Collaborative Forms Attachment D: Income Screening Tool Page | 4 Activos domésticos (identificar si alguien tiene alguno de los siguientes tipos de activos, incluyendo dependientes menores de 18 años) Identificar todas las fuentes de activos Valor en efectivo Ingresos activos (Intereses/dividendos) Nombre de la institución financiera Número de cuenta Cuenta de Cheques Sí No Cuenta de Cheque(s) adicional Sí No Cuenta de Ahorros Sí No Cuenta de Ahorro(s) adicional Sí No Cuentas de Cooperativas de Ahorro y Crédito Sí No Acciones, bonos, fondos de inversión* Sí No Propiedad/Casa Sí No Cuenta de IRA/Keogh (s) * Sí No Plan de Retiro /Pensión * Sí No Fondos fiduciario Sí No Nota de hipoteca Sí No Valor Efectivo de Seguro de vida * Sí No Propiedad/Terreno Sí No Otro (explique): Si No * Cuando determinado el valor de cualquier activo con un asterisco *, índice las cantidad si fueras convertirlo en efectivo. La cantidad habría deducido todas las penalizaciones para el retiro, cantidades utilizadas para pagar un saldo o cargos que pueden ser evaluados para la conversión. Asistencia para la vivienda (Lista de asistencia proporcionada o recibida por cualquier miembro del hogar) Fuente Cantidad Fecha de recepción Razón FEMA Sí No (Agencia Federal para el Manejo de Emergencias) SBA Sí No (Administración de Empresas) Sección 8 Sí No (Departamento de Vivienda y Desarrollo Urbano de EE.UU.) TBRA Sí No (Asistencia para la Renta al Arrendatario) Seguros Sí No (Propietario) Otro (explique): Sí No CERTIFICACIÓN COMUNICADO: Mi/nuestra firma aquí autoriza la liberación y la verificación de la información de mi empleo. Nombre del solicitante/residente: Firma: Fecha: Nombre del solicitante/residente: Firma: Fecha: Nombre del miembro adulto: Firma: Fecha: Nombre del miembro adulto: Firma: Fecha: 2020 Emergency Solutions Grant Program (ESG) 2020 ESG Collaborative Forms Attachment E: HMIS Consent Form & Privacy Policy Page | 1 ATTACHMENT E HMIS CLIENT RELEASE OF INFORMATION FORM The ESG collaborative is a part of the Texas Balance of State CoC operated by the Texas Homeless Network (THN). THN serves as HMIS lead and provides all HMIS required documentation. Agency should download the current form as need from the THN website. The client release of information Form is available at: https://www.thn.org/texas-balance-state-continuum-care/hmis/hmis-start-kit/ Direct link: English-https://www.thn.org/wp-content/uploads/2020/04/ROI_English.pdf Spanish-https://www.thn.org/wp-content/uploads/2020/04/ROI_Spanish_V2.pdf HMIS PRIVACY POLICY The ESG collaborative is a part of the Texas Balance of State CoC operated by the Texas Homeless Network (THN). THN serves as HMIS lead and provides all HMIS required documentation. Agency should download the current form as need from the THN website. The HMIS Privacy Policy Form is available at: https://www.thn.org/texas-balance-state-continuum-care/hmis/hmis-start-kit/ Direct link: https://www.thn.org/wp-content/uploads/2020/03/HMIS-Privacy-Policy-Final.pdf 2020 Emergency Solutions Grant Program (ESG) 2020 ESG Collaborative Forms Attachment E: HMIS Consent Form & Privacy Policy Page | 2 2020 Emergency Solutions Grant Program (ESG) 2020 ESG Collaborative Forms Attachment F: Rental Assistance Agreement PAGE 1 Page | 1 ATTACHMENT F RENTAL ASSISTANCE AGREEMENT – ENGLISH/SPANISH 2020 Emergency Solutions Grant Program (ESG) 2020 ESG Collaborative Forms Attachment F: Rental Assistance Agreement PAGE 2 Page | 2 2020 Emergency Solutions Grant Program (ESG) 2020 ESG Collaborative Forms Attachment G: Homeless Certification Page | 1 HOMELESS CERTIFICATION Applicant Name:  Household without dependent children (complete one form for each adult in the household)  Household with dependent children (complete one form for household) Number of persons in the household: This is to certify that the above named individual or household is currently homeless based on the check mark, other indicated information, and signature indicating current living situation. Check one ONE BOX and ONLY complete that section. *IMPORTANT: THIRD PARTY EVIDENCE MUST BE ATTACHED TO THIS FORM IN ORDER TO CERTIFY HOMELESSNESS Living Situation: place not meant for human habitation (e.g. cars, parks, abandoned building, streets)  The person(s) named above is/are currently living in (or, if currently in hospital or other institution, was living in immediately prior to hospital/institution admission) a public or private place not designed for, or ordinarily used as a regular sleeping accommodation for human beings, including car, park, abandoned building, bus station, airport, campground. Description of current living situation: Homeless Street Outreach Program Name: This certifying agency must be recognized by the local Continuum of Care (CoC) as an agency that has a program designed to serve persons living on the street or other places not meant for human habitation. (Examples may be Street Outreach workers, day shelters, soup kitchens, Health Care for Homeless sites, etc. Living Situations: Emergency Shelter  DV? (check if “yes”)  The person(s) named above is/are currently living in (or, if currently in hospital or other institution, was living in immediately prior to hospital/institution admission) a supervised publicly or privately operated shelter: Emergency Shelter Program Name: This emergency shelter must appear on the CoC’s Housing Inventory Chart submitted as apart of the most recent CoC Homeless assistance application to HUD of otherwise be recognized by the CoC as part of the CoC inventory (e.g. newly established Emergency Shelter). Living Situations: Other Housing  DV TH? (check if “yes”)  The person(s) named above is/are currently living in a transitional housing program for persons who are homeless, has just exited and institution or is receiving other temporary housing support. The person(s) named above is/are graduating from or timing out of the housing program services: Housing Program Name: Immediately prior to entering the housing the person(s) named above was/were residing in:  Emergency shelter OR  a place unfit for human habitation Authorized Referral Outreach/Shelter/Transitional Housing Agency Representative Signature: Date: 2020 Emergency Solutions Grant Program (ESG) 2020 ESG Collaborative Forms Attachment G: Homeless Certification Page | 2 [Blank] 2020 Emergency Solutions Grant Program (ESG) 2020 ESG Collaborative Forms Attachment H: Self‐Declaration of Homeless/Domestic Violence/At Risk Page | 1 SELF‐DECLARATION OF HOMELESS/DOMESTIC VIOLENCE/AT RISK Applicant Name:  Household without dependent children (complete one form for each adult in the household)  Household with dependent children (complete one form for household) Number of persons in the household: This is to certify that the above named individual or household is currently homeless or at‐risk of homelessness, based on the following and other indicated information and the signed declaration by the applicant. Check only one:  I [and my children] currently qualify as “homeless” as spelled out in the definition.  I [and my children] am/are the victims(s) of domestic violence and am/are fleeing from abuse, have not identified a subsequent residence, and lack the resources or support networks, e.g. family, friends, faith‐based, or other social networks, needed to obtain housing where my/our safety would not be jeopardized..  I [and my children] am/are being evicted from the housing we are presently staying in and must leave this housing within the next ______ days. I certify that I have insufficient financial resources and support networks; e.g., family, friends, faith‐based or other social networks, immediately available to obtain housing or to attain housing stability without ESG assistance. I certify that the information above and any other information I have provided in applying for ESG assistance is true, accurate and complete. Applicant Signature: Date: Staff Verification **MUST BE COMPLETED I understand that third‐party verification is the preferred method of certifying homelessness or risk for homelessness for an individual who is applying for ESG assistance. I understand self declaration is only permitted when I have attempted to but cannot obtain third party verification. Documentation of attempt made for third party verification: Staff Signature: Date: 2020 Emergency Solutions Grant Program (ESG) 2020 ESG Collaborative Forms Attachment H: Self‐Declaration of Homeless/Domestic Violence/At Risk Page | 2 DECLARACIÓN SIN HOGAR/VIOLENCIA DOMÉSTICA/EN RIESGO Nombre de Solicitante:  Hogar sin niños dependientes (complete una forma para cada adulto en el hogar)  Hogar con niños dependientes (completa una forma por hogar) Número de personas en el hogar: Esto es para certificar que los miembros del hogar se encuentran sin hogar o en riesgo de perder su hogar, basado a los siguientes y otra información indicada y la declaración firmada por el solicitante. Marque sólo uno:  Yo [y mis niños] actualmente calificamos como "sin hogar" como en el definición.  Yo [y mi niños] soy/somos víctimas de violencia doméstica y estoy/están huyendo del abusos, no hemos identificado otro lugar para residencia y no tenemos los recursos o soporte de familia, amigos, o otras redes sociales, necesarios para obtener vivienda donde yo/nuestra seguridad no esté en peligro.  Yo [y mi niños] estoy/estamos siendo desalojados de la vivienda que actualmente alojamos y debemos abandonar esta vivienda en los próximos ____días. Certifico que no tengo suficientes recursos financieros y redes de apoyo; por ejemplo, familia, amigos, o otro social redes, disponible de inmediato para obtener vivienda o para lograr la estabilidad de la vivienda sin ayuda de ESG. Certifico que la información sobre y cualquier otros información me han proporcionado en aplicando de ESG asistencia es verdadera, precisa y completa. Firma del solicitante: Fecha: Verificación Personal ** DEBE SER COMPLETADO Entiendo que una verificación de tercera persona es preferido para certificar sin hogar o en riesgo de perder su hogar para una persona que está solicitando la asistencia de ESG. Comprendo que una Verificación Personal sólo está permitida cuando he intentado pero no puede obtener verificación de tercera persona. Documentación de los intentos hechos para la verificación de tercera persona: Firma personal: Fecha: 2020 Emergency Solutions Grant Program (ESG) 2017 ESG Collaborative Forms Attachment I: Domestic Violence Program Guidance Page | 1 DOMESTIC VIOLENCE PROGRAM GUIDANCE [Place holder for DV Guidance Tools] 2020 Emergency Solutions Grant Program (ESG) 2017 ESG Collaborative Forms Attachment I: Domestic Violence Program Guidance Page | 1 SELF‐DECLARATION OF INCOME Applicant Name: This is to certify the income status for the above named individual. Income includes but is not limited to:  The full amount of gross income earned before taxes and deductions.  The net income earned from the operation of a business, i.e., total revenue minus business operating expenses. This also includes any withdrawals of cash from the business or profession for your personal use.  Monthly interest and dividend income credited to an applicant’s bank account and available for use.  The monthly payment amount received from Social Security, annuities, retirement funds, pensions, disability and other similar types of periodic payments.  Any monthly payments in lieu of earnings, such as unemployment, disability compensation, SSI, SSDI, and worker's compensation.  Monthly income from government agencies excluding amounts designated for shelter, and utilities, WIC, food stamps, and childcare.  Alimony, child support and foster care payments received from organizations or from persons not residing in the dwelling.  All basic pay, special day and allowances of a member of the Armed Forces excluding special pay for exposure to hostile fire. Check only one box and complete only that section  I certify, under penalty of perjury, that I currently receive the following income: Source: Amount: Frequency: Source: Amount: Frequency: Source: Amount: Frequency: Applicant Signature: Date:  I certify, under penalty of perjury, that I do not have any income from any source at this time. Applicant Signature: Date: Staff Verification **MUST BE COMPLETED I understand that third‐party verification is the preferred method of certifying income for ESG assistance. I understand self declaration is only permitted when I have attempted to but cannot obtain third party verification. Documentation of attempt made for third party verification: Staff Signature: Date: 2020 Emergency Solutions Grant Program (ESG) 2017 ESG Collaborative Forms Attachment I: Domestic Violence Program Guidance Page | 2 DECLARACIÓN DE INGRESOS Nombre de Solicitante: Esto es para declara el estado de ingreso sobre el solicitante mencionado arriba. El ingreso incluyen pero no es limitada a:  La cantidad completa de ingresos brutos antes de impuestos y deducciones.  El neto ingresos ganado de la operación de un negocio, es decir, ingresos totales menos gastos. Esto también incluye cualquier retiro de dinero del negocio o profesión para su uso personal.  Intereses mensuales e ingresos de dividendo creídos a la cuenta bancaria del solicitante y disponible para uso.  El pago recibió mensualmente de Seguro Social, anualidades, fondos de retiro fondos, pensiones, Beneficios de incapacidad y otros tipos de pagos.  Cualquier pago mensuales en lugar de ganancias como desempleo, compensación de discapacidad, SSI, SSDI, y la compensación del trabajadores.  Ingresos mensuales de agencias del gobierno excluyendo cantidades designadas para refugio, y servicios públicos, WIC, asistencia para la comida, y el cuidado de niños.  Pensión alimenticia, manutención de menores y pagos para el cuidado de crianza temporal recibidos de organizaciones o de personas que no residen en la vivienda.  Todo el sueldo básico, día especial y concesiones de un miembro de las Fuerzas Armadas excluyendo paga especial para exposición a fuego hostil. Solamente marque un caja y completa esa sección  Yo certifico, bajo pena de perjurio, que yo recibo actualmente los siguientes ingresos: Fuente: Cantidad: Frecuencia: Fuente: Cantidad: Frecuencia: Fuente: Cantidad: Frecuencia: Firma del solicitante: Fecha:  Yo certifico, bajo pena de perjurio, que yo no tengo cualquier ingreso de cualquier fuente en este tiempo. Firma del solicitante: Fecha: Verificación Personal ** Debe ser completado Entiendo que una verificación de tercera persona es preferido para certificar sin hogar o en riesgo de perder su hogar para una persona que está solicitando la asistencia de ESG. Comprendo que una Verificación Personal sólo está permitida cuando he intentado pero no puede obtener verificación de tercera persona. Documentación de los intentos hechos para la verificación de tercera persona: Firma personal: Fecha: 2020 Emergency Solutions Grant Program (ESG) 2020 ESG Collaborative Forms Attachment K: Re‐Certification of Eligibility Page | 1 RE‐CERTIFICATION OF ELIGIBILITY Client Name: Date: How many total months of service has the client received to date? Note: Required for Homeless Prevention Clients every three months and Rapid rehousing clients every twelve months. HOUSEHOLD INFORMATION Has any of the client’s contact information changed in the past three months?  Yes  No (If yes, please provide updated information below.) CURRENT STREET ADDRESS: _APT. #: CITY: STATE:_ ZIP CODE: PHONE: EMAIL: Has the Client’s household composition changed since program entry?  Yes  No (If yes, please provide updated information below.) TOTAL # OF PEOPLE IN THE HOUSEHOLD: # OF ADULTS IN THE HOUSEHOLD:_ # OF CHILDREN UNDER THE AGE OF 18 CURRENTLY RESIDING IN THE HOUSEHOLD: HOMELESSNESS STATUS INFORMATION Have there been any changes to the client’s homelessness status in the past three months?  Yes  No (If yes, please complete a new & updated ESG Self Declaration of Homeless Status Form and attach.) INCOME INFORMATION Have there been any changes to the client’s income in the past three months?  Yes  No (If yes, please complete a new & updated ESG Income Screening Tool and attach.) OTHER CHANGES TO CLIENT STATUS THAT RELATE TO ESG ELIGIBILITY Please use the space below to discuss any additional changes to the client’s status that have occurred over the past three months as it relates to eligibility for ESG services: Staff Verification **MUST BE COMPLETED I understand that third‐party verification is the preferred method of certifying eligibility for ESG assistance. I understand self declaration is only permitted when I have attempted to but cannot obtain third party verification. To the best of my knowledge, all of the above information is true. Staff Signature: Date: 2020 Emergency Solutions Grant Program (ESG) 2020 ESG Collaborative Forms Attachment K: Re‐Certification of Eligibility Page | 2 [Blank] 2020 Emergency Solutions Grant Program (ESG) 2020 ESG Collaborative Forms Attachment L: FMR/Rent Reasonableness Inspection Checklist Page | 1 FAIR MARKET RENT/RENT REASONABLENESS INSPECTION CHECKLIST Applicant Name: CERTIFICATION #1 – Fair Market Rent (FMR): Checklist/Certification Published FMR for this type of unit is $ Zip Code: FMR LOOKUP: http://www.huduser.org/portal/datasets/fmr.html CERTIFICATION #2 – Rent Reasonableness: Proposed Unit UNIT #1 UNIT #2 ADDRESS: YEAR BUILT: SQUARE FEET: NUMBER OF BEDROOMS TYPE OF UNIT/CONSTRUCTION:  Apt: 1‐4 Floors  Apt: 5+  Duplex/Townhouse  Single Family  Manufactured Home  Other:  Apt: 1‐4 Floors  Apt: 5+  Duplex/Townhouse  Single Family  Manufactured Home  Other:  Apt: 1‐4 Floors  Apt: 5+  Duplex/Townhouse  Single Family  Manufactured Home  Other: AMENITIES:  Balcony  Carport  Dishwasher  Garbage Disposal  Recreational Facilities  Washer/Dryer  Other:  Balcony  Carport  Dishwasher  Garbage Disposal  Recreational Facilities  Washer/Dryer  Other:  Balcony  Carport  Dishwasher  Garbage Disposal  Recreational Facilities  Washer/Dryer  Other: UTILITIES INCLUDED (TYPE): UTILITY ALLOWANCE*RATE: MONTHLY RENTAL RATE: GROSS RENT: *To verify amount, must complete: Utility Chart – 2013 Denton.xls or Utility Chart – 2013 Lewisville.xls and attach to this form. Is this contract rent less than Fair Market Rent?  Yes  No If YES continue, if NO the unit is not eligible. Based upon a comparison with rents for comparable units, I have determined that the proposed rent for the unit [ ] is / [ ] is not reasonable. NAME: SIGNATURE: DATE: 2020 Emergency Solutions Grant Program (ESG) 2020 ESG Collaborative Forms Attachment L: FMR/Rent Reasonableness Inspection Checklist Page | 2 Insert completed applicable Utility Chart from pages 1‐3 (Denton) or Utility Chart from pages 1‐3 (Lewisville) 2020 Emergency Solutions Grant Program (ESG) 2020 ESG Collaborative Forms Attachment M: Housing Habitability Standards Inspection Checklist Page | 1 HOUSING HABITABILITY STANDARDS INSPECTION CHECKLIST About this Tool These standards apply only when a program participant is receiving financial assistance and moving into a new (different) unit. Inspections must be conducted upon initial occupancy and then on an annual basis for the term of ESG assistance. The recipient or subrecipient cannot use ESG funds to help a program participant remain in or move into housing that does not meet the minimum habitability standards under §576.403(c). This restriction applies to all activities under the Homelessness Prevention and Rapid Re‐housing components. ESG Client Name: ESG Agency Name: HOUSING INFORMATION: Street Address: _APT. #: City: State:_ Zip: CERTIFICATION: Evaluator’s Signature: Date: Evaluator’s Name: If Applicable: Approving Officials’ Signature: Date: Approving Officials’ Name: Instructions: Place a check mark in the correct column to indicate whether the property is approved or deficient with respect to each standard. The property must meet all standards in order to be approved. A copy of this checklist should be placed in the client file. 2020 Emergency Solutions Grant Program (ESG) 2020 ESG Collaborative Forms Attachment M: Housing Habitability Standards Inspection Checklist Page | 2 Approved Deficient Element 1. Structure and materials: The structure is structurally sound to protect the residents from the elements and not pose any threat to the health and safety of the residents. 2. Space and security: Each resident is provided adequate space and security for themselves and their belongings. Each resident is provided an acceptable place to sleep. 3. Interior air quality: Each room or space has a natural or mechanical means of ventilation. The interior air is free of pollutants at a level that might threaten or harm the health of residents. 4. Water Supply: The water supply is free from contamination. 5. Sanitary Facilities: Residents have access to sufficient sanitary facilities that are in proper operating condition, are private, and are adequate for personal cleanliness and the disposal of human waste. 6. Thermal environment: The housing has any necessary heating/cooling facilities in proper operating condition. 7. Illumination and electricity: The structure has adequate natural or artificial illumination to permit normal indoor activities and support health and safety. There are sufficient electrical sources to permit the safe use of electrical appliances in the structure. 8. Food preparation: All food preparation areas contain suitable space and equipment to store, prepare, and serve food in a safe and sanitary manner. 9. Sanitary condition: The housing is maintained in sanitary condition. 10. Fire safety: a. There is a second means of exiting the building in the event of fire or other emergency. b. The unit includes at least one battery‐operated or hard‐wired smoke detector, in proper working condition, on each occupied level of the unit. Smoke detectors are located, to the extent practicable, in a hallway adjacent to a bedroom. c. If the unit is occupied by hearing‐impaired persons, smoke detectors have an alarm system designed for hearing‐impaired persons in each bedroom occupied by a hearing‐ impaired person. d. The public areas are equipped with a sufficient number, but not less than one for each area, of battery‐operated or hard‐wired smoke detectors. Public areas include, but are not limited to, laundry rooms, day care centers, hallways, stairwells, and other common areas. N/A N/A 11. Meets additional recipient/subrecipient standards (if any). N/A CERTIFICATION STATEMENT I certify that I am not a HUD certified inspector and I have evaluated the property located at the address below to the best of my ability and find the following:  Property meets all of the above standards.  Property does not meet all of the above standards. 2020 Emergency Solutions Grant Program (ESG) 2020 ESG Collaborative Forms Attachment M: Housing Habitability Standards Inspection Checklist Page | 1 ATTACHMENT N LEAD‐BASED PAINT HAZARDS DISCLOSURE Additional Resources: https://www.epa.gov/lead/protect‐your‐family‐lead‐your‐home 2020 Emergency Solutions Grant Program (ESG) 2020 ESG Collaborative Forms Attachment N: Lead‐Based Paint Hazards Disclosure PAGE 2 Page | 2 [Blank] 2020 Emergency Solutions Grant Program (ESG) 2020 ESG Collaborative Forms Attachment O: Written Notice of Beneficiary Rights – Religious Organizations Page | 1 WRITTEN NOTICE OF BENEFICIARY RIGHTS For religiously affiliated organizations Name of the Organization: Name of the Program: Because this program is supported in part by funds made available through the Federal government, this organizations is certifying to potential beneficiaries of the Emergency Solutions Grant (ESG) through this written notice of beneficiary rights. This written notice states that: a) This organization may not discriminate against you on the basis of religion or religious belief, a refusal to hold a religious belief, or a refusal to attend or participate in a religious practice; b) This organization may not require you to attend or participate in any explicitly religious activities that are offered by the organization, and any participation by me in such activities must be purely voluntary; c) This organization must separate in time or location any privately funded explicitly religious activities from activities supported by the direct financial assistance you might receive; d) If you objects to the religious character of the organization, the organization will undertake reasonable efforts to identify and refer you to an alternate provider to which you have no objection; the organization may not be able to guarantee, however, that in every instance, an alternate provider will be available; and e) You may report violations of these protections (including denials of services or benefits) by the organization to the Texas Department of Housing and Community Affairs. CLIENT I certify that this written notice of beneficiary rights was provided to me prior to the time I enrolled in the program or received services from the program: Client Signature: Date: ORGANIZATION REPRESENTATIVE I certify that this written notice of beneficiary rights was provided to the client prior to the time they enrolled in the program or received services from the program: Staff Signature: Date: 2020 Emergency Solutions Grant Program (ESG) 2020 ESG Collaborative Forms Attachment O: Written Notice of Beneficiary Rights – Religious Organizations Page | 2 [Blank] 2020 Emergency Solutions Grant Program (ESG) 2020 ESG Collaborative Forms Attachment O: Homeless Definitions 24 C.F.R. § 576.2. Page | 1 HOMELESS DEFINITIONS (1) An individual or family who lacks a fixed, regular, and adequate nighttime residence, meaning: i) An individual or family with a primary nighttime residence that is a public or private place not designed for or ordinarily used as a regular sleeping accommodation for human beings, including a car, park, abandoned building, bus or train station, airport, or camping ground; ii) An individual or family living in a supervised publicly or privately operated shelter designated to provide temporary living arrangements (including congregate shelters, transitional housing, and hotels and motels paid for by charitable organizations or by federal, state, or local government programs for low‐income individuals); <or> iii) An individual who is exiting an institution where he or she resided for 90 days or less and who resided in an emergency shelter or place not meant for human habitation immediately before entering that institution; <or> (2) An individual or family who will imminently lose their primary nighttime residence, provided that: (i) The primary nighttime residence will be lost within 14 days of the date of application for homeless ii) assistance; (i) No subsequent residence has been identified; <and> (ii) The individual or family lacks the resources or support networks, e.g., family, friends, faith‐based or other social networks, needed to obtain other permanent housing; <or> (3) Unaccompanied youth under 25 years of age, or families with children and youth, who do not otherwise qualify as homeless under this definition, but who: (i) Are defined as homeless under section 387 of the Runaway and Homeless Youth Act (42 U.S.C. 5732a), section 637 of the Head Start Act (42 U.S.C. 9832), section 41403 of the Violence Against Women Act of 1994 (42 U.S.C. 14043e–2), section 330(h) of the Public Health Service Act (42 U.S.C. 254b(h)), section 3 of the Food and Nutrition Act of 2008 (7 U.S.C. 2012), section 17(b) of the Child Nutrition Act of 1966 (42 U.S.C. 1786(b)) or section 725 of the McKinney‐Vento Homeless Assistance Act (42 U.S.C. 11434a); (ii) Have not had a lease, ownership interest, or occupancy agreement in permanent housing at any time during the 60 days immediately preceding the date of application for homeless assistance; (iii) Have experienced persistent instability as measured by two moves or more during the 60‐day period immediately preceding the date of applying for homeless assistance; <and> (iv) Can be expected to continue in such status for an extended period of time because of chronic disabilities, chronic physical health or mental health conditions, substance addiction, histories of domestic violence or childhood abuse (including neglect), the presence of a child or youth with a disability, or two or more barriers to employment, which include the lack of a high school degree or General Education Development (GED), illiteracy, low English proficiency, a history of incarceration or detention for criminal activity, and a history of unstable employment; <or> (4) Any individual or family who: (i) Is fleeing, or is attempting to flee, domestic violence, dating violence, sexual assault, stalking, or other dangerous or life‐threatening conditions that relate to violence against the individual or a family member, including a child, that has either taken place within the individual's or family's primary nighttime residence or has made the individual or family afraid to return to their primary nighttime residence; (ii) Has no other residence; <and> (iii) Lacks the resources or support networks, e.g., family, friends, faith‐based or other social networks, to obtain other permanent housing. REF: Homeless Definitions ‐ 24 C.F.R. § 576.2. 2020 Emergency Solutions Grant Program (ESG) 2020 ESG Collaborative Forms Attachment O: Homeless Definitions 24 C.F.R. § 576.2. Page | 2 HOMELESS DEFINITIONS At risk of homelessness means: (1) An individual or family who: (i) Has an annual income below 30 percent of median family income for the area, as determined by HUD; <and> (ii) Does not have sufficient resources or support networks, e.g., family, friends, faith‐based or other social networks, immediately available to prevent them from moving to an emergency shelter or another place described in paragraph (1) of the “homeless” definition in this section; <and> (iii) Meets one of the following conditions: A) Has moved because of economic reasons two or more times during the 60 days immediately preceding the application for homelessness prevention assistance; B) Is living in the home of another because of economic hardship; C) Has been notified in writing that their right to occupy their current housing or living situation will be terminated within 21 days after the date of application for assistance; D) Lives in a hotel or motel and the cost of the hotel or motel stay is not paid by charitable organizations or by Federal, State, or local government programs for low‐income individuals; E) Lives in a single‐room occupancy or efficiency apartment unit in which there reside more than two persons or lives in a larger housing unit in which there reside more than 1.5 persons reside per room, as defined by the U.S. Census Bureau; F) Is exiting a publicly funded institution, or system of care (such as a health‐care facility, a mental health facility, foster care or other youth facility, or correction program or institution); <or> G) Otherwise lives in housing that has characteristics associated with instability and an increased risk of homelessness, as identified in the recipient's approved consolidated plan; <or> (2) A child or youth who does not qualify as “homeless” under this section, but qualifies as “homeless” under section 387(3) of the Runaway and Homeless Youth Act (42 U.S.C. 5732a(3)), section 637(11) of the Head Start Act (42 U.S.C. 9832(11)), section 41403(6) of the Violence Against Women Act of 1994 (42 U.S.C. 14043e–2(6)), section 330(h)(5)(A) of the Public Health Service Act (42 U.S.C. 254b(h)(5)(A)), section 3(m) of the Food and Nutrition Act of 2008 (7 U.S.C. 2012(m)), or section 17(b)(15) of the Child Nutrition Act of 1966 (42 U.S.C. 1786(b)(15)); <or> (3) A child or youth who does not qualify as “homeless” under this section, but qualifies as “homeless” under section 725(2) of the McKinney‐Vento Homeless Assistance Act (42 U.S.C. 11434a(2)), and the parent(s) or guardian(s) of that child or youth if living with her or him. REF: Homeless Definitions ‐ 24 C.F.R. § 576.2.