SECTION (3): PROPOSED PROGRAM POPULATIONS Max Section Points: 40 Single women Chronically homeless Infants Single men Persons with mental health Children Couples w/out children Persons with substance abuse Adolescents Single-parent families Persons with HIV/AIDS GLBTQ Youth Two-parent families Domestic violence survivors Other: (Please list) Unaccompanied Youth Veterans Renewal Projects Planning to Serve: 100% Chronic- (10) Points 50%-99%-(5) Points Total Chronic Served (please highlight one) 100% Chronic Served 50-99% Chronic Served YES NO Is this % different than what the project typically serves? If the project applicant to serve one of the (4) HUD priority populations, the project must receive 100% of its referrals from a local Coordinated Entry Process or from a Community managed by-name list. 100% Households with Family (prioritized by need) 50%-99%- 10 Points 5 Points YES NO Is this % different than what the project typically serves? 100% Unaccompanied Youth 50%-99% 10 Points 5 Points YES NO Is this % different than what the project typically serves? 100 % Veteran (all types of discharges) 50%-100% 10 Points 5 Points YES NO Is this % different than what the project typically serves? SECTION (4): PROPOSED PRIOR LIVING SITUATIONS Max Section Points: 5 Homeless Participants Projected Percentages (%) Priority I: On the Street, Safe Havens or Emergency Shelters
(attach) HUD or *HUD monitoring letter-Any Related correspondence Board body (attach) YES NO § 578.75-CoC Interim Rule Each recipient must have homeless or formerly homeless representation on a policy-making entity Copy of Membership and last (3) Agendas noting attendance or homeless or formerly homeless board member. Program Participants Informed of Rights (attach) YES NO § 578.91-CoC Interim Rule Participant informed of eligibility criteria, discharge policies, rights to appeal. Agency's written standards including program rules, termination process, written notice of termination and appeals process. Expenditure of Grant (attach) YES NO § 578.107-CoC Interim Rule/§ 578.87 If less than 100% expended during program year, the leftover funding be de-obligated by HUD.-Draw down requirements: Maintained Quarterly Draw-downs. of last quarter. Total Left Unspent (enter amount below) APR Submission Deadlines (attach) YES NO Overview of the Application and Grant Award Process-CoC Interim Rule Recipients have (90) days to submit the Annual Performance Report (APR) in HUD's designated reporting vehicle, eSnaps. *Please note that if you have ever had trouble submitting an APR-please provide documentation explaining this delayed submission. Screenshot of last (2) submitted APRs submission screens in eSnaps for projects. Submission years needed: 2012 2013 HMIS Participation and Data Quality YES NO Project Data Quality the 95% threshold requirement. “Data Not Collected” less than 2% for any category and on average. HMIS DQ for APR SECTION (6): FY2015 PROJECT PERFORMANCE Max Section Points: 70 Categories Response Total Points Possible
2. Active or history of substance abuse (can test positive on drug screen) YES NO 2 3. Having a criminal record with exceptions for state-mandated restrictions YES NO 2 4. History of domestic violence (either perpetrator or victim) YES NO 2 Question Number: “Does the project ensure that participants are not terminated from the program for the following reasons?” FY2015 Project Renewal Applications. If yes to all questions, the project will be considered Housing First. If yes to questions 1-4, project is considered low barrier. 5. Failure to participate in supportive services YES NO 2 6. Failure to make progress on service YES NO 2 7. Loss of income or failure to improve income YES NO 2 8. Being a victim of domestic violence YES NO 2 9. Any other activity not covered in a lease agreement typically found in the project’s geographic area YES NO 2
Reduce length of time persons are homeless YES NO Increase income and connection to benefits YES NO Move homeless persons into permanent housing, and assure high rate of housing retention YES NO End homelessness among chronic homeless persons, veterans, families with children and unaccompanied youth YES NO Our agency understands our CoC-funded projects can only accept persons meeting the HUD definition of literally homeless. YES NO Our agency understands the requirements of data collection and the priority on data-driven planning using the continuums local HMIS YES NO Signed: Executive Director: Agency Staff Designated to Attend CoC meetings/workshops: Date Signed: FY2016 Fund Availability: Approximately 93% of TN-504 Threshold or $3,025,832.00 PSH/RRH Current Funding $2,789,711 TH Current Funding $301,326 SSO Current Funding $34,500 HMIS Current Funding $53,508 Total Current Funding $3,253,583 Instructions for completing each section: Note: The following terms are defined as: (as defined in HUD’s regulations and on the FY2016 Renewal Application released by HUD on 07.18.2016.) Chronic Homelessness: HUD: 24 CFR 578.3 Veterans: Include all persons who served in the military, regardless of discharge status. RRH-PH Projects: Cannot accept any new clients or new families coming from Transitional Housing. RRH projects can only accept new individuals or new families identified in the FY2016 Renewal Application released by HUD on 07.18.2016.