Sonoma County Community Development Commission

FUNDING APPLICATION

Sonoma County Community Development Commission

Santa Rosa/Petaluma (Balance of State) ESGProgram, FY 2016-17

Application Summary Sheet

Legal Name of Organization Applying:

ProjectName:

ProjectAlternate Name:

Primary Physical Location of Activities (if more than one location, please provide only primary):

Total ProjectedAnnual ProjectBudget: $

Total 2016-17Amount Requested This Application: $

Minimum request: $50,000

We request consideration for a 2-year award Yes No

The Community Development Committee may recommend some awards for a two-year duration. If selected, funding for years two is contingent upon adequate funding and full substantive compliance with the funding agreement for the prior year. Please refer to the FY 2016-2017 State ESG Funding Policies, page(s) 5 and 10.

ORGANIZATION CONTACT INFORMATION

Organization Mailing Address, City State & Zip:

General Phone: Organization Web URL:Agency DUNS Number:

______

Executive Directoror CEO

Name:

Email: Phone:

Contract Manager (or other secondary contact)

Name:

Title:

Email: Phone:

CDC Receipt Use Only

Received By: ______Ref: ______

PART I

SummaryProject Information

1. Summary Project Description:

Limit this section to no more than 125 words

1. Project Component:

Check the ESG-eligible component that this project will address:(Check no more than one.)

Street Outreach Emergency Shelter

Homelessness PreventionRapid Re-Housing

1. Executive Summary:

Provide a summary of the project, being sure to cover the following areas: the community need that these services will address, the target population and core services delivered, the average number of core services a participant will receive, average length of time the participant will receive services and length of time the project has been in operation.

Limit this section to no more than 700 words

1. Project History:

Has this project as it is titled in the application been funded by the Community Development Commission (CDC) or the State Department of Housing and Community Development before?

CDC State HCD Neither

If the project identified in this application waspreviously funded by the CDC or HCD, what was themost recent fiscal year and funding amount received?

Has this project been funded by the CDC using a different project name? Yes No

If Yes, please briefly explain the reasons for the change and when it occurred.

PART I (cont’d)

1. Project Services Provided:

Check additionally related services this project directly provides. Please select any that apply:

Homelessness
Short- to Medium-Term Rental Assistance / Case Management
Financial Literacy/Assistance / Tenancy Education
Provision of Meals, Transportation or Personal Items / Housing Location services
Other Services Not Listed:

1. Project Subpopulations:

Check all subpopulations this projectdirectly serves:

Families with children / Single Adults 25+ / Children <18
Runaway & Homeless Youth (12-17) / Transitional Youth (18-24) / Seniors/Elderly
Veterans / Physical Health Disabilities / Mental Health Disabilities
Substance Abuse Disabilities / Other Disability:
Racial/Ethnic Groups / Farm workers / Other:

PART II

Project Detail

1. Barriers to Service: Describe how this project overcomes barriers to service access for participants for each of the categories listed below:

Language and cultural differences:

Disabilities:

Geography:

Transportation Limitations:

Intake Processes:

Service Hours:

b. Project Model:Briefly describe how each of the following components is designed:

Length of average project enrollment:

What is a successful project exit?What will the participant be expected to achieve by being delivered the services you propose?

Follow up (if any) of project exited participants (if no follow up is provided please indicate)

c. Project Outreach:

Describe the target population for this project:

What outreach strategies are used to reach the target population?

How are participants referred into the program?

d. Project History and Readiness:

1. If this project has been operating one year or less, please discuss its stage of project growth or readiness (limit to 250 words):

2. If this project has been operating longer than one year, describe any material changes that have affected the projectalong with associated impact(s) that have taken place over the past two years due to any of the following conditions (limit each response to 250 words):

a)Funding reductionsor increases that have impacted the total project budget by 10% or more

b)Turnover in key projectand top administrative staff

c)Incorporation of new/improved project design as informed by HMIS or other data (for projects not participating in the HMIS please describe any project design changes resulting from the evaluation of your internally collected data)

d)Influences by other external funders such as new or changed regulatory requirements

e)Other changes to the project not reflected in questions a. – d.

3. If the project is anticipated to materially expand or contract in size during FY 2016-17 please describe changes to service levels and number of unduplicated participants to be served.

e. Project Outcomes:

Two outcomes are required: a housing outcome appropriate to the service component (street outreach, emergency shelter, homelessness prevention, or rapid re-housing), AND one outcome related to increasing client incomes. Using the table below,select the appropriate housing outcome that that your project will provide to participating households. NOTE: Please state the number of HOUSEHOLDS served and the number of households that will achieve the outcome rather than unique persons.

Housing Indicator
Please choose the appropriate housing indicator for your project / Project Goal
Briefly describe how your project will work towards achievement the specified Housing Indicator / Quantitative Measure
Identify a numerical accomplishment for the specified Housing Indicator
Street Outreach
Placement in safe housing (shelter, transitional, or permanent housing) / Click here to enter text. / _____% or
_____ of _____
Emergency Shelter
Exit to a permanent housing destination / Click here to enter text. / _____% or
_____ of _____
Homelessness Prevention
Improved Housing Status from project entry to project exit / Click here to enter text. / _____% or
_____ of _____
Rapid Re-Housing
Permanently housed at 12 months or contract year end / Click here to enter text. / _____% or
_____ of _____
Income Indicator / Project Goal
Briefly describe how your project will work towards achievement the specified Income Indicator / Quantitative Measure
Identify a numerical accomplishment for the specified Income Indicator
Change in income from project entry to project exit or contract year-end / Click here to enter text. / _____% or
_____ of _____

Please describe all outcomes in terms of Households, not Individuals.

1)Describe the history your agency has in achieving the outcomes identified above.

2)Project Evaluation Framework:

Describe how your agency will evaluate this project’s performance and make needed adjustments to service delivery. Be sure to note any participant involvement that is included in evaluating the services (limit to 250 words):

PART III

Participant Information

a. Who will this project serve? (Check all that apply.)

Single Adults 25+ Families with Children Unaccompanied Youth <25

b. Number of UnduplicatedHouseholdsprojected to be served by the project during the twelve month period July 1, 2016 to June 30, 2017 Also indicate the number historically served by this projectfor a recent one-year period with an end date between June 30 and December 31, 2015. Please attach an HMIS report for this period as documentation.

Projected Number of Households To Be Served
July 1, 2016 – June 30, 2017 / Historical Time Period
(Enter month/year below) / Historical Number of Households Served
_____Households of Single Adults 25+ / From _____ to ______/ _____ Households of Single Adults 25+
_____Families with Children / From _____ to ______/ _____ Families with Children
_____Households of Unaccompanied Youth <25 / From _____ to ______/ _____HH’s Unaccompanied Youth HHs <25
______Total Households / ______Total Households

PART IV

Sonoma County and Federal Requirements

1. Program Requirements – These activities are required by federal and State rules.

Does your agency participate in Coordinated Entry (including making referrals to and accepting referrals from Coordinated Entry)? Please describe how.

Does your agency contribute data to the HMIS (Homeless Management Information System)?

Does the agency or project utilize a Housing First Approach? Please describe how.

Does the agency participate in the relevant program standards working groups?

Yes No

Compliance with the local program standards for your project component, and participation in program standards working groups, will be a requirement of all funding agreements.

1. Sonoma County Upstream Investment Initiative:

Is this project or components of it represented in the Upstream Portfolio? Yes No

If Yes, which Upstream Tier is this project participating in?

Tier 1 – Evidence Based Practice (EBP) Tier 2 – Promising Practice Tier 3 – Emerging Practice

If this project is not on the portfolio, how does your Organization incorporate Evidence Based Practice (EBP) theory into the service delivery of the project being applied for with this funding? (Check all that apply)

Organization has or is seeking a Resolution of Alignment with the Upstream Initiative

Agency Board of Directors have received information or training about the Upstream Initiative or EBP

EBP research is currently being conducted for incorporation into this project’s service delivery (List samples of the applicable research being reviewed for potential incorporation into project service) ______

Organization is discussing the incorporation of EBP’s into future project delivery.Our anticipated timeframe is: ______

This projectutilizesEBP’s or practices and principles similar to those of Evidence Based Practice theory which include:

______

PART V

PROJECT FINANCING AND BUDGET

1. According to the project budget accompanying this application, what is the calculated Cost per Household $ . Explain the primary cost componentsmaking up this calculation(e.g.,total hours ofcase management,facility costs, or other services provided such as education, food, transportation services, etc.).

1. In accordance withCDC Funding Policies, fundsmay generally not be used for general administration.If you have requestedindirect or administrative costs in the project budgetplease attach a copy of your agency’s most current Indirect Cost Rate Plan. (Please see Attachment 1, Indirect Cost Rate Memo. All requests for charging indirect/administrative costs will be subject to prior approval by CDC staff).

1. Describe how the project will be affected if it receives less than the amount requested for FY 2016-17 CDC funding. Describe the aspects of the project design that are scalable and indicate how many fewer participants will be served, if applicable.

1. Describe the plan for long-term financial sustainability for this project.

NOTE 1: Projects funded with State ESG funds shall comply with audit requirements of the Office of Management and Budget, 2 CFR 200. Private nonprofit organizations must submit annual financial audits to the CDC for review and approval. These audits must comply with all applicable federal laws, See 2 C.F.R. 200

NOTE 2: Please attach a copy of your most recent financial audit, including all “management letters” and related documents. Additional financial information may be requested by CDC Staff as deemed appropriate.

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Sonoma County Community Development Commission

Application Santa Rosa/Petaluma (Balance of State) ESG Funding

FY 2016-18