6.6 KS Emergency Shelter Grant
CITY OF SALINA
REQUEST FOR CITY COMMISSION ACTION
DATE
04/05/03
TIME
4:00 P.M.
AGENDA SECTION:
NO.
6
ORIGINATING DEPARTMENT:
DEAN ANDREW
PLANNING & COMMUNITY
DEVELOPM ENT
APPROVED FOR
AGENDA:
ITEM
NO.
6
BY:
BY:
Item
Consider applications for the 2004 Kansas Emergency Shelter Grant Program.
Background
The Kansas Housing Resources Corporation (formerly Kansas Department of Commerce and
Housing) is accepting applications for the 2004 Emergency Shelter Grant (ESG) Program. This
program provides funding to assist homeless individuals and families. As in previous years,
applications from local agencies must be submitted through units of local government. Five eligible
Salina agencies serving the homeless have submitted applications as follows:
Orqanization
Ashby House
Domestic Violence Association
of Central Kansas
$ 6,500
$15,000
Service
(Shelter renovation & utilities,
Client transportation, Staff salaries)
(Staff salaries, Rent/Utility assistance)
Req uest
$21,300
Catholic Charities
Emergency Aid /Food Bank
$12,000
(Shelter renovation & utilities, Staff
salaries, Rent/utility assistance)
(Dental care, Client transportation,
Nutritional Counseling, Rent/utility
assistance)
TOTAL Requests
$ 8,000
$62,800
(Rent/utility assistance)
Salvation Army
If funding is approved and accepted by an agency, a grant agreement will be signed between the
agency and the City. A combined grant agreement will also be signed between the City and the
State. Funding will be supplied by the City as requested by the agency and reimbursed to the City
by the State. In the event the full amount requested is not approved, some reallocation may be
necessary.
Recommended Action
If the City Commission wishes to sponsor the grant applications by these local agencies, a motion
should be passed authorizing the Mayor to sign the application and related documents.
Encl: Copy of Applications
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Kansas
Emergency Shelter Grant
Application
FFY 2004
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City of
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Salina
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Emergency Shelter Grant Application
APPLICA TION FOR
2004 KANSAS EMERGENCY SHELTER GRANT
Instructions: Please complete all eight sections of the Emergency Shelter Grant (ESG)
application.
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SECTION I: APPLICANT INFORMATION (Local Units of Government Only)
A. Applicant Information
Local
Government
Authorized
Representati ve
City of Salina, Kansas
Alan E. Jilka
Title Mayor
City Salina
67402- Federal J.D.
0736 Number #48-6017228
Address
P.o. Box 736
State Kansas Zip
Contact to whom questions about
thi~; application should be directed:
Judy Brengman
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Telephone
(785) 309-5760
Fax
(785) 309-5761
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r.~mail Address
judy. brengman@salina.org
B. Purpose of Request (Check all that apply.)
D Bring building up to health and safety codes.
D Make or improve facilities accessibility.
D Increase beds for homeless people by - (number).
~ Expand or maintain the number of homeless individuals or families served.
~ Increase or maintain essential services.
~ Provide homeless prevention services.
~ Other (Specify):
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Certification: To the best of my knowledge and belief, the data in this application are true and
correct. This document h~s been duly authorized by the governing body of the applicant. The
applicant will comply with federal and state regulations if assistance is approved.
_{jJa~ ¿. ~4
Signature
4-/2-lbOY
Date
Alan E. Jilka
Mayor
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PROPOSED PROJECT BUDGET
FFY 2004 KANSAS EMERGENCY SHELTER GRANT PROGRAM
GRANTEE NAME
City of Salina, Department of Development Services
Neighborhood Services Division
GRANTEE ADDRESS
300 West Ash
Salina, Kansas
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SUB-GRANTEE NAMES
Ashby House
Catholic Charities
Domestic Violence Association of Central Kansas
Emergency Aid Food Bank
Salvation Army
SUB-GRANTEE ADDRESS
150 S. 8th
425 West Iron
203 S. Santa Fe
255 S. Chicago
1137 N. Santa Fe
PROJECT BUDGET
FUNDS REQUESTED
Shelter Rehabilitation
Operations
Essential Services
Homeless Prevention
$ 7,744
12,400
13,500
18,000
Subtotal
$62,800
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Local GovernmentAdministration @2.5% $ 1.570
TOTAL FUNDS REQUEST
$64,370
MATCIDNG FUNDS
A. Cash
B. Non-cash, including leases
C. Staff Salaries
D. Volunteer Labor*
$33,0010
10
23,000
12,00'Q
TOTAL Grant Funds Match (at least 1 :1)
$68,0010
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GRAND TOTAL (Request + Match)
$132,370
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*Time and services estimated at $5.00 per hour
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KANSAS EMERGENCY SHELTER GRANT
SECTION II: PROVIDER INFORMATION
Ashby House
Project Funds Requested
Shelter Rchabilitation
Operations
Essential Services
Homeless Prevention
Total Request
Matching Funds
Cash
Staff Salaries
Non-cash (volunteer labor *)
Total Match
*Time and services estimated at $5 per hour
$ 2,300
$ 9,000
$10,000
$ 0.00
$21,300
$ 8,000
$ 8,000
$ 6,000
$22,000
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Emergency Shelter Grant Application
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SECTION II: PROVIDER IN FORl\tlA TION
Section II asks for information on each of the homeless service providers. Section II
needs to be completed on each sub-grantee in order to receive funding. If more space
is needed, please make copies of page 2 and 3 and attach them to the completed
application.
A. Provider Information
Emergency Shelter or
Service Provider Ashby House, Ltd.
Address
150 S. 8th, P. O. Box 3482
City
Salina
Federal I.D. Number
48-1099925
Fax
(785) 825-6924
ashbv{@,alltel.net
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Saiine, McPherson, Eilsworth, Lincoln, Ottawa & Dickinson
counties, as well as most of northwest Kansas.
Saline-Dist.24; McPherson-Dist.35; Ellsworth-
Dist36; Lincoln-Dist.36; Ottawa-Dist24;
Dickinson-Dist.24 & pulls in 35.
Saline-Dist.67,69,71; McPherson-Dist. 70, 73, 74;
Ellsworth-Dist67,69,71 and pulls in 119;
Lincoln-DistI19; ûttawa-Dist1O7; Dickinson-
Dist.ó7,69,71 and pulis in 64,68,107.
E-mail Address
Counties served by shelter
State Senate Districts of all counties served
State House Districts of aU counties served
Contact Person Bryan Anderson
Telephone (785) 826-4935
State KS Zip 67401
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Emergency Shelter Grant Application
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SECTION IV: ACTIVITY DESCRIPTION
A.
Activities
1. Briefly describe the purpose and capacity of the agency providing services to the
homeless.
The mission of Ashby House is to provide homeless and destitute families with the
resources and skills necessary to become productive members of the community.
Ashby House is the only full-time emergency and transitional shelter for homeless
families in Salina and Saline County. Since opening in 1992, 1021 families have
been sheltered. In 1995, Ashby House opened a Life Skills Center to serve families
that are homeless and families that are on the verge ofhomelessness. Clients
receive instruction in basic life skills such as: nutrition, parenting, job readiness,
personal hygiene, money management, healthlwellness, and goal setting. In 1998,
Ashby House added transitional shelter (90 day) to its program through the purchase
of a 12 unit apartment building (Bridge House) at 153 South 8t.'1. Ashby House can
provide services for up to 16 families at a time (4 families in Ashby House
Homeless Shelter and 12 families in Bridge House Transitional Shelter).
2. Describe how ESG funds for each category requested in this applicatilon wili be used,
(be specific, add more pages if needed):
Rehabilitation: Amount Requested: $2,300.00
Renovate exterior brick work on Bridge House Transitional Shelter. Water damage
caused the brick surtàce and mortar to deteriorate.
Operations:
Amount Requested: :£9,000.00
Gas, electricity and water for Ashby House Homeless Shelter and Bridge House
Transitional Shelter.
Essential Services:
Amount Requested: $10,000.00
($2,000) Clienllransportalion for employment, medical, substance abuse
counseling, mental evaluation and counseling.
($8,000) Life Skills and advocacy for homeless individuals living at Ashby House.
Expenses include staff salaries, materials, and translation services necessary for
homeless clieI)ts to gain self-sufficiency. These services are:
i. Employment preparation
2. Assistance in obtaining permanent housing through public programs and
private landlords.
3. Health and nutrition education, decision making, parenting, budgeting.
4. Assistance in improving levels of education, including GED, diploma, and
job training programs.
Homeless Prevention:
N/A
Amount Requested: $
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Emergency Shelter Grant Application
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B.
Assistance
Specifically describe how the following assistance, if applicable, will be provided to
persons served by your agency:
1.
Permanent Housing Referral Services
Referrals are primarily made to the Salina Housing Authbrity for Section 8 and
Public Housing. Clients who are ineligible for assisted housing work with
Ashby House staff to determine cost limits for housing based on income and
other expenses.
2.
Overnight Shelter
Ashby House provides overnight shelter to homeless families, couples, and
unaccompanied women. Clients also receive meals, personal hygiene items and
clothing free of charge. Each family stays in a private room with a common
living room, dinning room, and kitchen.
3.
Medical Services
Medical services are received through referrals to the Salina Cares Clinic, Saline
County Health Department, Salina Regional Health Center, and Central Kansas
Mental Health. The clients provide medical and dental services to low income
O' .. 0
cnents at a mtnnnal cost.
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Children's Services
Children participate in a life skills program, a reading program staffed by
volunteers, and structured play activities while their parents are in life skills
classes. Families also participate in parenting classes (Child Abuse Prevention
Services) and are referred to Family Preservation, Parents as Teachers, and the
Heartland Programs for additional support.
5.
Mental Health and/or Drug Abuse and/or Counseling Services
Counseling services are provided by referral to Central Kansas Mental Health,
Providian, and Central Kansas Foundation. These agencies work in-house to aid
in the referral process. CKMH teaches a class in stress management and CKF
assists with intervention for substance treatment.
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Emergency Shelter Grant Application
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6.
Employment Services
Ashby House staff meets with clients daily for a job club. During that time staff
help clients make job contacts and also gives instruction in job æadiness and
maintenance. The Job Service Center and The Salina Chamber of Commerce
collaborate with Ashby House to provide job placement through the One Step
Career Center.
7.
Transportation
Transportation is provided through a taxi voucher system. Clients also receive
assistance with fuel if they own a car. Occupational Center of Central Kansas
offers some public transportation at a minimal cost to clients. However, the
OCCK program has restricted hours and requires 24 hour advanced notice for a
ride.
8.
Other Available Federal, State, and Private Assistance
Clients are referred to Social Rehabilitation Services for assistance, particularly
in the area of food stamps, child care, and financial assistance. Clients are also
referred to Social Security for issues concerning disability.
9.
Other
Clients in need of education are referred to Little House Learning Center,
Smoky Hill Learning Center, and the Salina Area Technical School for Adult
Education.
c.
Confidentiaiity
Section 832 of the Cranston-Gonzalez National Affordable Housing Act changes to the
ESG Program require grantees to develop procedures to ensure confidentiality of victims
of family violence. Indicate how this requirement will be met to protect victims offamily
violence in your Shelter or service provider organization. Note: If this application
includes funding to II domestic violence shelter, the shelter must provide their
confidentiality policy in order to be considered for funding.
The staff of Ashby House is extensively trained on confidentiality and family security.
While Ashby House is not considered a "safe house", every precaution is taken to
provide a safe environment. Visitors are not allowed into the shelter without client
approval. The shelter is locked at night and no one is allowed in after curfew. The
shelter is staffed 24 hours per day.
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KANSAS EMERGENCY SHELTER GRANT
SECTION II: PROVIDER INFORMATION
Catholic Charities
Project Funds Requested
Shelter Rehabilitation
Operations
Essential Services
Homeless Prevention
Total Request
Matching Funds
Cash
Non-cash (lease & prop. Value)
Staff Salaries
Volunteer Labor *
Total Match
*Time and services estimated at $5 per hour
$ 0
$ 0
$ 2,500
$ 4,000
$ 6,500
$ 11,000
$ 0
$ 0
$ 0
$11,000
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Emergency Shelter Grant Application
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SECTION II: PROVIDER INFORMATION
Section II asks for information on each of the homeless service providers. Section II
needs to be completed on each sub-grantee in order to receive funding. If more space
is needed, please make copies of page 2 and 3 and attach them to the completed
application.
A. Provider Information
Emergency Shelter or Catholic Charities of Salina,
Service Provider Inc. Contact Person Karen Hauser
Address
425 W. Iron Ave.
Telephone
(785) 825-0208
City
Salina
State
Kansas
Zip 6740]
(785)826-9708
Federal J.D. Number
48-0676263
Fax
E-mail Address
ccharsal@alhelp.org
Counties served by shelter
State Senate Districts of all counties served
State House Districts of all counties served
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67,69,71
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Emergency Shelter Grant Application
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SECTION III: Matching Funds
Note: Matching funds must be provided after the date of the grant award to the grantee. Funds
used to match a previous ESG grant may not be used to match a subsequent grant award.
Please describe in detail matching funds to be used for this grant.
A.
Cash Funds
Describe the source of the cash funds.
We have $7,000.00 cash funds, provided to Catholic Charities by the Knights of
Columbus, for emergency assistance (ie. Rent, utility assistance), for families with
children. We have an additional $4,000.00 in the Catholic Charities Assistance account
for rent and utility assistance.
B.
Non-Cash Resources
Describe the source and value of any non-cash resources, including materials, salaries
paid by local agency, volunteer labor ($5.00 per hour allowed; Volunteer providing
professional services, such as medical or legal services are valued at the reasonable and
customary rate in the community), the appraised value of any donated building, or other
match.
We provide an office to meet with clients, phone, office supplies, and MAACLink
connection for case management.
C.
Other State/Federal Agency Grant Funds
Describe the source of the funds and precisely how the funds are to be used. A letter of
commitment from the relevant state/federal agency must be attached to the application if
other state/federal funds are to be used to meet matching fund requirements.
D.
\lV' aiver
Section 832 of the Cranston-Gonzalez National Affordable Housing Act makes
substantial changes to the ESG regulations. One change is the elimination of the first
$100,000 of the Kansas ESG match requirements. Kansas Housing Resources
Corporation intends to pass this benefit to units of local government in behalf of the
emergency shelter/service providers who demonstrate inability or hardship in meeting the
match requirement. Applicants wishing to be considered for a waiver of the match
requirement must furnish an explanation of need. Indicate the amount of the match
requested to be waived and the reason why a waiver is needed (attach waiver request to
the back of this application).
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WORK CONDITIONS
CONFIDENTIALITY
Agency personnel will strive to maintain the confidentiality of the employee/client
relationship. The Agency places responsibility for maintaining of client confidentiality
with each employee. Information may be disclosed to sources outside the agency on a
need-to-know only basis under the following circumstances: to prevent hann to self or
others; by court order, as required by law; upon the presentation of a signed release of
information request by the client.
Within the Agency, information may be released to other members of staff when
necessary to further the delivery of services, to include information for billing purposes,
information shared with other staff clinicians in the transfer of cases and all
accompanying records, and for the purposes of conducting quality assurance reviews. In
such cases information transferred from one Catholic Charities office to another within
the Diocese of Salina will be treated in the same manner as transfer of information within
a single office location. All Catholic Charities employees are bound by the same
confidentiality agreement and will not violate that trust.
Client confidentiality procedures, including security of files, handling of materials related
to cases, release of information~ billing records, etc., should be discussed at the monthly
Continuous Quality Improvement (CQI) meetings.
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Approved
1/21/2002
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,';l¡elter Grant Application
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SECTION IV: ACTIVITY DESCRIPTION
A.
Activities
1. Briefly describe the purpose and capacity of the agency providing services to the
homeless.
Catholic Charities is a multi-service agency providing homeless prevention services
to the poor in our 31 county area. A part of this effort is to þrovide emergency
assistance for homeless prevention, to advocate with landlords on behalf of our
clients, to provide interpretation services to residents with limited English-speaking
abilities, and to provide screening and referral to clients to alleviate problems of
domestic violence, drug and alcohol problems, crises pregnancy services and
problems of daily living.
2. Describe how ESG funds for each category requested in this application will be used,
(be specific, add more pages ifneeded):
Rehabilitation: Amount Requested: $
Operations:
Amount Requested: $
Essential Services: Amount Requested: ~OO.OO
We are requesting $2,500.00 for essential services. This will be used for case
management services to review emergency assistance requests and to provide
language translation and interpretation where needed. Additional salary will be
covered by Catholic Charities.
Homeless Prevention:
Amount Requested: $4,000.00
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We are requesting $4,000.00 for rent and utility assistance for persons on the verge
ofhomelessness. This will be matched by Catholic Charities.
3. Kansas Housing Resources Corporation is permitted to use five percent of the state's
2002 ESG award for administrative purposes. The state sub grants two-and-a-half
percent of the award to local governments who receive ESG grants for costs
associated with accounting for the use of grant funds, preparing program-related
reports, obtaining program audits, and similar costs related to administering the grant
after the award. Provide a description of the expected use for this request, (to be
completed by local unit of government).
This will be used for clerical and reporting purposes.
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Emergency Shelter Grant Application
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B.
Assistance
Specifically describe how the following assistance, if applicable, will be provided to
persons served by your agency:
1.
Permanent Housing Referral Services
We provide rent and utility assistance to persons on the verge of eviction or for
persons transitioning from a shelter to permanent housing. The case manager
does an assessment of need and works with utility companies and local
landlords and, in some case, works out a payment plan.
2.
Overnight Shelter
We make referrals to the men's shelter and to Ashby House, or occasionally pay
for motel lodging.
3.
lv1edical Services
Catholic Charities has a special fund to provide assistance for unmet medical
needs which are evaluated by a case manager. We also provide accompaniment
and interpretation services for Doctor's appointments for Iimited-English-
speaking clients.
4.
Children's Services
We provide counseling services for children and adolescents and a
tutoringlmentoring program for Hispanic children, six and under. This is an in-
kind service, funded by other sources.
5.
Mental Health and/or Drug Abuse and/or Counseling Services
These services are funded by other sources of Catholic Charities.
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KANSAS EMERGENCY SHELTER GRANT
SECTION II: PROVIDER INFORMATION
Domestic Violence Association of Central Kansas
Project Funds Requested
Shelter Rehabilitation
Operations
Essential Services
Homeless Prevention
Total Request
Matching Funds
Cash
Non-cash (lease & prop. Value)
Staff Salaries
Volunteer Labor *
Total Match
*Time and services estimated at $5 per hour
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$ 6,000
$ 6,000
$ 3,000
$ 0.00
$15,000
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$ 0
$ 0
$15,000
$ 0
$15,000
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Emergency Shelter Grant Application
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SECTION II: PROVIDER INFORMATION
Section II asks for information on each of the homeless service providers. Section II
needs to be completed on each sub-grantee in order to receive funding. If more space
is needed, please make copies of page 2 and 3 and attach them to the completed
application.
A. Provider Information
Domestic Violence
Emergency Shelter or Association of Central
Service Provider Kansas
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Federal I.D. Number
48-0903329
Contact Person Heather Soper
Telephone 785-827 - 5862
State Kansas Zip 67401
Fax 785-827-2410
Address
203 S. Santa Fe
City
Salina
E-mail Address
heathers@salhelp.org
Saline, Washington, Dickinson, Ellsworth, Ottawa, Republic,
Counties served by shelter Mitchell, Cloud, Jewell, and Lincoln
State Senate Districts of all counties served 24,36
State House Districts of all counties served 67,69,71,106,107
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D.
tcmergency Shelter Grant Application
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SECTION III: Matching Funds
Note: Matching funds must be provided after the date of the grant award to the grantee. Funds
used to match a previous ESG grant may not be used to match a subsequent grant award.
Please describe in detail matching funds to be used for this grant.
A.
Cash Funds
Describe the source of the cash funds.
The Executive Assistant's Salary will serve as the cash match for the funds that we are
requesting. This position makes $29,000 a year and we will use $15,000 of this salary
for our cash match.
B.
Non-Cash Resources
Describe the source and value of any non-cash resources, including materials, salaries
paid by local agency, volunteer labor ($5.00 per hour allowed; Volunteer providing
professional services, such as medical or legal services are valued at the reasonable and
customary rate in the community), the appraised value of any donated building, or other
match.
c.
Other State/Federal A2encv Grant Funds
Describe the source of the funds and precisely how the funds are to be used. A letter of
commitment from the relevant state/federal agency must be attached to the application if
other state/federal funds are to be used to meet matching fund requirements.
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Waiver
Section 832 of the Cranston-Gonzalez National Affordable Housing Act makes
substantial changes to the ESG regulations. One change is the elimination of the first
$100,000 of the Kansas ESG match requirements. Kansas Housing Resources
Corporation intends to pass this benefit to units of local government in behalf of the
emergency shelter/service providers who demonstrate inability or hardship in meeting the
match requirement. Applicants wishing to be considered for a waiver of the match
requirement must furnish an explanation of need. Indicate the amount of the match
requested to be waived and the reason why a waiver is needed (attach waiver request to
the back of this application).
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Emergency Shelter Grant Application
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SECTION IV: ACTIVITY DESCRIPTION
A.
Activities
1. Briefly describe the purpose and capacity of the agency providing services to the
homeless.
The Domestic Violence Association of Central Kansas (DV ACK) was incorporated
in 1980. Our agency provides specialized services to victims of domestic violence
and sexual assault. We cover a ten county area in North Central Kansas providing
our specialized services to a population of 122,000. One ofthe ways that DV ACK
serves this population is through our emergency shelter. The clients that are in
shelter go through a program that is called our "21-day program" and they complete
this during their stay. This program includes components of education on domestic
violence and sexual assault. This program also includes information on other area
agencies in the area that may be able to assist them in their current situation. Our
main goal here at DV ACK is to assist women and children in developing a safe and
healthier home/lifestyle while they are receiving our services.
2. Describe how ESG funds for each category requested in this application will be used,
(be specific, add more pages if needed):
Rehabilitation:
Amount Requested: $2,000
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Rehabilitation is an ongoing process when you have a shelter facility that sees many
people come through the door. One of the toughest areas to maintain upkeep on is
our shelter facility. We need some minor renovations done in our shelter. Weare
requesting funds for new carpet, minor shelter repairs, renovation costs of our toy
room, and replacement costs of appliances that are outdated and worn out.
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Operations:
Amount Requested: $6,000
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DV ACK is requesting funds to help operate the shelter. Since we are a non-profit
agency, the majority of our funds that we receive from our grants go to pay for the
shelter staff that assists the clients. This in turn leaves us with limited funding for
operations in the shelter. We would like to ask for $6,000 to assist in shelter
maintenance, operations, utilities, security, and insurance for the building.
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Essential Services:
Amount Requested: $3,000
DV ACK is seeking funding in this category to better serve our clients. We are
requesting $3,000 in funds to assist our clients in receiving health benefits,
employment assistance, travel vouchers, rent and utility assistance, and other
emergency services that are essential when they need assistance from our agency.
We would also ask for funds to be able to provide child care when it is necessary.
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Emergency Shelter Grant Application
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Homeless Prevention:
Amount Requested: $
3. Kansas Housing Resources Corporation is permitted to use five percent of the state's
2002 ESG award for administrative purposes. The state sub grants two-and..a-half
percent of the award to local governments who receive ESG grants for costs
associated with accounting for the use of grant funds, preparing program-related
reports, obtaining program audits, and similar costs related to administering the grant
after the award. Provide a description of the expected use for this request, (to be
completed by local unit of government).
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Emc(;~¡;w;y Shelter Grant Application
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B.
Assistance
Specifically describe how the following assistance, if applicable, will be provided to
persons served by your agency:
1.
Permanent Housing Referral Services
DV ACK has always had a very positive working relationship with the Housing
Authority. When the clients come to DV ACK one of the first things we want to
help them accomplish is to get them on the housing list. We work very closely
with the housing manager to ensure that domestic violence victims are a top
priority.
2.
Overnight Shelter
Emergency overnight shelter is one ofDV ACK's main programs. Although when
we say overnight shelter, we typically hope they will stay and complete the
program which is at least 30 days if not closer to 60 days. DV ACK is committed to
providing emergency services to victims of domestic violence and sexual assault.
More often than not, our services are usually sought in emergency type situations.
3.
Medical Services
DV ACK is first and foremost concerned with a client's medical status. TIús is one
of the first things we do to ensure their safety, is to make sure we have met all their
medical needs. This is vital to the women and children that we serve that have
been isolated from any type of medical care. We have a very good working
relationship with the local hospital, the health departments, and local non-.profit
clinics.
4.
Children's Services
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DV ACK is able to assist the children that we have come into shelter. We work
very closely with SRS and Child Abuse Prevention Services. We feel that we meet
the children's needs by providing support groups for them as well as for their
mothers, by providing support services, and also by referring them to counseling if
needed.
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5.
Mental Health and/or Drug Abuse and/or Counseling Services
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Through referrals to local service agencies such as Counseling and Growth,
Central Kansas Mental Health, and Central Kansas Foundation for drug and
alcohol, we do what we can to refer our clients to these agencies as needed.
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Emergency Shelter Grant Application
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6.
Employment Services
Some of the ways that DV ACK provides assistance with employment services is
through job services agencies, SRS, and adult education life skills classes.
DV ACK also helps with employment by providing the local newspaper, a
computer for internet job search, and by assisting in filling out applications and
assistance with resumes.
7.
Transportation
DV ACK is asking for funds to be able to help provide transportation for the
clientele that we serve. Currently we collaborate with OCCK and the Hotline to
help provide affordable low cost transportation but unfortunately that is often
not enough. We have to utilize area cab companies because Salina does not have
much in the way of public transportation.
8.
Other Available Federal, State, and Private Assistance
DV ACK will assist in anyway possible to ensure that our clients have access to
any services that may be available to them through the Federal, State, or local
government.
9.
Other
c.
Confidentiality
Section 832 of the Cranston-Gonzalez National Affordable Housing Act changes to the
ESG Program require grantees to develop procedures to ensure confidentiality of victims
of family violence. Indicate how this requirement will be met to protect victims of family
violence in your Shelter or service provider organization. Note: If this application
includes funding to a domestic violence shelter, the shelter must provide their
confidentiality policy in order to be considered for funding.
All information received on intake forms are placed in a locked file cabinet. Only staff
that is privy to that information can obtain those files. Confidentiality agreements are
signed by all clients and staff that work with clients. Information release forms must be
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Emergency Shelter Grant Application
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signed by the client before any information can be released to another agency or case
worker.
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KANSAS EMERGENCY SHELTER GRANT
I
SECTION II: PROVIDER INFORMATION
Emergency Aid / Food Bank
Project Funds Requested
Shelter Rehabilitation
Operations
Essential Services
Homeless Prevention
Total Request
Matching Funds
Cash
Non-cash (lease & prop. Value)
Staff Salaries
Volunteer Labor *
Total Match
*Time and services estimated at $5 per hour
$ 0
$ 0
$ 6,000
$ 6.000
$12,000
$ 6,000
$ 0
$ 0
$ 6.000
$12,000
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Emergency Shelter Grant Application
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SECTION II: PROVIDER INFORMATION
Section II asks for information on each of the homeless service providers. Section II
needs to be completed on each sub-grantee in order to receive funding. If more space
is needed, please make copies of page 2 and 3 and attach them to the completed
application.
Á. Provider Information
Emergency Shelter or Salina Emergency Aid!
Service Provider Foodbank
Contact Person Kathleen Jackson
Address
255 South Chicago
Telephone
785-827-7111
City
Salina
State
KS
Zip 67401
Federal J.D. Number
237425890
Fax
785-452-9851
E-mail Address
F oodbank@salhelp.org
Counties served by shelter
Saline
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State Senate Districts of all counties served
State House Districts of all counties served
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Emergency Shelter Grant Application
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SECTION III: Matching Funds
Note: Matching funds must be provided after the date of the grant award to the grantee. Funds
used to match a previous ESG grant may not be used to match a subsequent grant award.
Please describe in detail matching funds to be used for this grant.
A.
B.
~
Cash Funds
Describe the source of the cash funds.
Cash funds used to match the grant will come from donors, private, churches, and
business.
Non-Cash Resources
Describe the source and value of any non-cash resources, including materials,. salaries
paid by local agency, volunteer labor ($5.00 per hour allowed; Volunteer providing
professional services, such as medical or legal services are valued at the reasonable and
customary rate in the community), the appraised value of any donated building, or other
match.
We have a volunteer of about 50 people. We will be using their labor and the salaries
that are paid to the staff.
C.
Other State/Federal Agency Grant Funds
Describe the source of the funds and precisely how the funds are to be used. A letter of
commitment from the relevant state/federal agency must be attached to the application if
other state/federal funds are to be used to meet matching fund requirements.
D.
Waiver
Section 832 of the Cranston-Gonzalez National Affordable Housing Act makes
substantial changes to the ESG regulations. One change is the elimination of the first
$100,000 of the Kansas ESG match requirements. Kansas Housing Resources
Corporation intends to pass this benefit to units of local government in behalf of the
emergency shelter/service providers who demonstrate inability or hardship in meeting the
match requirement. Applicants wishing to be considered for a waiver of the match
requirement must furnish an explanation of need. Indicate the amount of the match
requested to be waived and the reason why a waiver is needed (attach waiver request to
the back of this application).
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Emergency Shelter Grant Application
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SECTION IV: ACTIVITY DESCRIPTION
A.
Activities
1. Briefly describe the purpose and capacity of the agency providing services to the
homeless.
Salina Emergency Aid! Foodbank have been at the fÌont line of preventing
homelessness for thirty two years. We provide cash assistahce, budgeting, cooking
classes, referrals to Housing, Social Security, representative payee program,
Foodbank. This is our third year for a garden which provides volunteer time for our
clients and a purpose of self worth. The purpose ofthe agency is to help those in
need, with dignity.
2. Describe how ESG funds for each category requested in this application will be used,
(be specific, add more pages if needed):
Rehabilitation: Amount Requested: $
Operations:
Amount Requested: $
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Essential Services: Amount Requested: $6000.00
The funds in essential services will be used in three different categories. Dental we
see people needing a tooth pulled every week. Currently we have no dental program
in Salina, and the dentist want the money up front if you do not have insurance. The
grant will be to help with e-x-ray initial visit and extraction ofthe tooth or teeth.
Our goal is to help people continuing to work. With the loss of work comes less
pay and that leads to homelessness. Transportation this will allow our clients a ride
to and fÌom receiving our services. Salina is too small for a transportation system
yet too big to walk to most places. We will work we a transportation service
already set up and have them do the transportation and then we will pay them for
the rides. We have used this method in the past and it works. Many clients do not
come because they have no ride. Staff salaries: Because staff works on the fÌont
live this grant will be used to help pay for staff. We recently started using a data
base program that is HUD approved as far as getting number of people served and
the % of ethnicity.
It will not increase the staffs salary it will allow us to continue to see clients and
help in a small way.
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Emefp}~JlCY Shelter Grant Application
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Homeless Prevention: Amount Requested: $6000.00
Salina Emergency Aid! Foodbank are a leader in prevention ofhomelessness. We
currently have 81 persons that we handle their money every month because of their
mental illness. Salina has seen a lot of job loss in the past year. Everyday we see
people who have lost jobs because of being laid off or hurt on the job or illness.
Rent in Salina continues to go up and with the price of gas to heat people's homes
we are seeing people have to make a decision. Do I pay fdr heat or a place to live?
We recently saW a gas (heating) bill for $348.00 for one month. The money will go
to help with rent evictions, and to help pay up to one month electric/heating bill or
rent payment. More and more people are working, however they are working part
time jobs, jobs paying low wages,
3. Kansas Housing Resources Corporation is permitted to use five percent of the state's
2002 ESG award for administrative purposes. The state subgrants two-and-a-half
percent ofthe award to local governments who receive ESG grants for costs
associated with accounting for the use of grant funds, preparing program-related
reports, obtaining program audits, and similar costs related to administering the grant
after the award. Provide a description ofthe expected use for this request, (to be
completed by local unit of government).
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Erncrgcnçy Shelter Grant Application
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SECTION III: Matching Funds
Note: Matching funds must be provided after the date of the grant award to the grantee. Funds
used to match a previous ESG grant may not be used to match a subsequent grant award.
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Please describe in detail matching funds to be used for this grant.
A.
Cash Funds
Describe the source of the cash funds.
Cash funds used to match the grant will come from donors, private, churches, and
business.
B.
Non-Cash Resources
Describe the source and value of any non-cash resources, including materials, salaries
paid by local agency, volunteer labor ($5.00 per hour allowed; Volunteer providing
professional services, such as medical or legal services are valued at the reasonable and
customary rate in the community), the appraised value of any donated building, or other
match.
We have a volunteer of about 50 people. We will be using their labor and the salaries
that are paid to the staff.
c.
Other State/Federal Agency Grant Funds
Describe the source of the funds and precisely how the funds are to be used. A letter of
commitment from the relevant state/federal agency must be attached to the application if
other state/federal funds are to be used to meet matching fund requirements.
D.
Waiver
Section 832 of the Cranston-Gonzalez National Affordable Housing Act makes
substantial changes to the ESG regulations. One change is the elimination of the first
$100,000 of the Kansas ESG match requirements. Kansas Housing Resources
Corporation intends to pass this benefit to units of local government in behalf of the
emergency shelter/service providers who demonstrate inability or hardship in meeting the
match requirement. Applicants wishing to be considered for a waiver of the match
requirement must furnish an explanation of need. Indicate the amount of the match
requested to be waived and the reason why a waiver is needed (attach waiver request to
the back of this application).
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Emergem;y Shelter Grant Application
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SECTION IV: ACTIVITY DESCRIPTION
A.
Activities
1. Briefly describe the purpose and capacity of the agency providing services to the
homeless.
Salina Emergency Aid! Foodbank have been at the front line of preventing
homelessness for thirty two years. We provide cash assistance, budgeting, cooking
classes, referrals to Housing, Social Security, representative payee program,
Foodbank. This is our third year for a garden which provides volunteer time for our
clients and a purpose of self worth. The purpose ofthe agency is to help those in
need, with dignity.
2. Describe how ESG funds for each category requested in this application will be used,
(be specific, add more pages if needed):
Rehabilitation: Amount Requested: $
Operatons:
Amount Requested: $
Essential Services: Amount Requested: $6000.00
The funds in essential services will be used in three different categories. Dental we
see people needing a tooth pulled every week. Currently we have no dental program
in Salina, and the dentist want the money up front if you do not have insurance. The
grant will be to help with e-x-ray initial visit and extraction of the tooth or teeth.
Our goal is to help people continuing to work. With the loss of work comes less
pay and that leads to homelessness. Transportation this will allow our clients a ride
to and from receiving our services. Salina is too small for a transportation system
yet too big to walk to most places. We will work we a transportation service
already set up and have them do the transportation and then we will pay them for
the rides. We have used this method in the past and it works. Many cJients do not
come because they have no ride. Staff salaries: Because staff works on the front
live this grant will be used to help pay for staff. We recently started usiing a data
base program that is HUD approved as far as getting number of people served and
the % of ethnicity.
It will not increase the staffs salary it will allow us to continue to see clients and
help in a small way.
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Emergency Shelter Grant Application
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Homeless Prevention: Amount Requested: $6000.00
Salina Emergency Aid! Foodbank are a leader in prevention ofhomelessness. We
currently have 81 persons that we handle their money every month because of their
mental illness. Salina has seen a lot of job loss in the past year. Everyday we see
people who have lost jobs because of being laid off or hurt on the job or illness.
Rent in Salina continues to go up and with the price of gas to heat people's homes
we are seeing people have to make a decision. Do I pay fori heat or a place to live?
We recently saw a gas (heating) bill for $348.00 for one month. The money will go
to help with rent evictions, and to help pay up to one month electric/heating bill or
rent payment. More and more people are working, however they are working part
time jobs, jobs paying low wages,
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3. Kansas Housing Resources Corporation is permitted to use five percent of the state's
2002 ESG award for administrative purposes. The state subgrants two-and-a-half
percent ofthe award to local governments who receive ESG grants for costs
associated with accounting for the use of grant funds, preparing program-related
reports, obtaining program audits, and similar costs related to administerlng the grant
after the award. Provide a description of the expected use for this request, (to be
completed by local unit of government).
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Emergency Shelter Grant Application
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B.
Assistance
Specifically describe how the following assistance, if applicable, will be provided to
persons served by your agency:
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1.
Permanent Housing Referral Services
Salina Emergency Aid/ Foodbank refers clients to the Salina Housing Authority,
We also contact landlords to see if they have affordable rentals available.
We encourage each person to sign up for housing and to keep checking back
until they get on.
2.
Overnight Shelter
Overnight shelter is referred to Ashby House or the Rescue Mission. If no
shelter is found we put people up for one night in a motel
3.
Medical Services
Salina Cares Clinic takes care of the indigent population. During an interview
when we hear that a person does not have medical insurance we refer them to
Salina Cares.
4.
Children's Services
We provide help with food and rent evictions, utility disconnects.
5.
Mental Health and/or Drug Abuse and/or Counseling Services
We work closely with Mental Health. Of the 81 clients we have in our payee
program the majority have a connection with the Mental Health Center. Our job
is to help create as normal a life style as possible and keep them from becoming
homeless. We can say with certainly that because of us 81 individuals and
family members are not homeless each night in Salina.
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Emergency Shelter Grant Application
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6.
Employment Services
We provide a paper in our waiting area with local jobs. We also tell people
about the library and the use of the internet which lists local jobs.
7.
Transportation
Salina Emergency Aid! Foodbank works with the agencies that already has
transportation in place. That way we are not duplicating services.
8.
Other Available Federal, State, and Private Assistance
9.
Other
We write grants to help with assistance for prevention ofhomelessness. The
cost of gas this winter and the higher rents are forcing people out in the street,
because they can not afford both.
C.
Confidentiality
Section 832 of the Cranston-Gonzalez National Affordable Housing Act changes to the
ESG Program require grantees to develop procedures to ensure confidentiality of victims
of family violence. Indicate how this requirement will be met to protect victims of family
violence in your Shelter or service provider organization. Note: If this appUcation
includes funding to' a domestic violence shelter, the shelter must provide their
confidentiality policy in order to be considered for funding.
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KANSAS EMERGENCY SHELTER GRANT
SECTION II: PROVIDER INFORMA nON
The Salvation Army
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Project Funds Requested
Shelter Rehabilitation
Operations
Essential Services
Homeless Prevention
Total Request
Matching Funds
Cash
Non-cash (lease & prop. Value)
Staff Salaries
Volunteer Labor *
Total Match
*Time and services estimated at $5 per hour
$ 0
$ 0
$ 0
$8,000
$8,000
$8,000
$ 0
$ 0
$ 0
$8,000
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Shelter Grant Application
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SECTION II: PROVIDER INFORMATION
Section II asks for information on each of the homeless service providers. Section II
needs to be completed on each sub-grantee in order to receive funding. If more space
is needed, please make copies of page 2 and 3 and attach them to the completed
application.
A. Provider Information
Emergency Shelter or
Service Provider The Salvation Army
440-545-998
Contact PerSon Roxanne Matous
Telephone (785) 823-2251
State KS Zip 67401
Fax 785-823- 7766
Address
1137 N. Santa Fe
City
Salina
Federal I.D. Number
E-mail Address
Counties served by shelter
Saline
SÜÙe Senate Districts of all counties served
State House Districts of all counties served
24
67,69, 71
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SECTION III: Matching Funds
Note: Matching funds must be provided after the date of the grant award to the grantee. Funds
used to match a previous ESG grant may not be used to match a subsequent grant award.
Please describe in detail matching funds to be used for this grant.
A.
Cash Funds
Describe the source of the cash funds.
Our matching funds of$8000.00 will come from current Salvation Army fund raising
efforts.
B.
Non-Cash Resources
Describe the source and vqlue of any non-cash resources, including materials, salaries
paid by local agency, volu~teer labor ($5.00 per hour allowed; Volunteer providing
professional services, such as medical or legal services are valued at the reasonable and
customary rate in the community), the appraised value of any donated building, or other
match.
N/A
C.
Other StatelFederal A~ency Grant Funds
Describe the source of the funds and precisely how the funds are to be used. A letter of
commitment from the relevant state/federal agency must be attached to the application if
other state/federal funds are to be used to meet matching fund requirements.
D.
Waiver
Section 832 of the Cranston-Gonzalez National Affordable Housing Act makes
substantial changes to the ESG regulations. One change is the elimination of the first
$100,000 of the Kansas ESG match requirements. Kansas Housing Resources
Corporation intends to pass this benefit to units of local government in behalf of the
emergency shelter/service providers who demonstrate inability or hardship in meeting the
match requirement. Applicants wishing to be considered for a waiver of the match
requirement must furnish an explanation of need. Indicate the amount of the match
requested to be waived and the reason why a waiver is needed (attach waiver request to
the back of this application).
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Emergmcy Shelter Grant Application
4
SECTION IV: ACTIVITY DESCRIPTION
A.
Activities
1. Briefly describe the purpose and capacity of the agency providing services to the
homeless.
The Salvation Army, an international movement, is an evangelical part of the
universal Christian church. It's message is based on the Bible. It's mission is to
preach the gospel of Jesus Christ and to meet human needs 'in His name without
discrimination. The Salvation Army offers year round services to homeless families
and individuals by assisting with utility disconnects, prescriptions, food, clothing,
eye exams, household furnishings and other emergency needs.
2. Describe how ESG funds for each category requested in this application will be used,
(be specific, add more pages if needed):
Rehabilitation: Amount Requested: $
Operations:
Amount Requested: $
Essential Services:
Amount Requested: $
Homeless Prevention: Amount Requested: $8000.00
The Salvation Army will request $8000.00 to assist with utility assistance.
3. Kansas Housing Resources Corporation is permitted to use five percent ofthe state's
2002 ESG awa'rd for administrative purposes. The state subgrants two.-and-a-half
percent of the award to local governments who receive ESG grants for costs
associated with accounting for the use of grant funds, preparing program-related
reports, obtaining program audits, and similar costs related to administering the grant
after the award. Provide a description ofthe expected use for this request, (to be
completed by local unit of government).
N/A
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Shelter Gran1 Application
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B.
Assistance
Specifically describe how the following assistance, if applicable, will be provided to
persons served by your agency:
1.
Permanent Housing Referral Services
In addition to providing direct assistance, The Salvation Army will make
referrals to other agencies as needed. I
2.
Overnight Shelter
The Salvation Army, in Salina, does not provide overnight shelter and refers to
proper agencIes. . "
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Mcd¡ca~ Services
The Salvation .Army will assist with prescriptions and eye exams, we will refer
to other agencies if needed.
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4.
Children's Services
N/A
5.
Mental Health and/or Drug Abuse and/or Counseling Services
N/A
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Emergency Shelter Grant Application
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6.
Employment Services
The Salvation Army makes referrals as needed.
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7.
Transportation
The Salvation Army, in Salina, does not assist with transportation and will refer
those with this need to the proper agencies.
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8.
Other Available Federal, State, and Private Assistance
N/A
-.
9.
Other
The Salvation Army will provide assistance for homeless prevention for those
providing necessary documentation including disconnect notices.
c.
Confidentiality
Section 832 of the Cranston-Gonzalez National Affordable Housing Act changes to the
ESG Program require grantees to develop procedures to ensure confidentiality of victims
of family violence. Indicate how this requirement will be met to protect victims offamily
violence in your Shelter or service provider organization. Note: If this application
includes funding to a domestic violence shelter, the shelter must provide their
confidentiality policy in order to be considered for funding.
The Salvation Army client records are confidentiaL They are kept in lockt.~d files and /
or password-protected computer programs, accessible only by designated persons.
Client information is not shared with other agencies unless an Authorization Release
of Information is signed by the client, or there is a valid court order.
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SECTION V: HOMELESS DEFINITION
AND COMMUNITY RESOURCES
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SECTION VI : CONTINUUM OF CARE
SECTION VII : PERFORMANCE MEASURES
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SECTION V:
HOMELESS DEFINITION AND COMMUNITY RESOURCES
Homeless means as the term is defined in 42 U.S.c. 11302. "(a) IN GENERAL-For purposes of
this Act, the term "homeless" or "homeless individual or homeless person" includes--{l) an
individual who lacks a fixed, regular, and adequate nighttime residence; and (2) an individual
who has a primary nighttime residence that is: A) supervised publicly or privately operated
shelter designed to provide temporary living accommodations (including welfare hotels,
congregate shelters, and transitional housing for the mentally ill); B) ~ institution that provides a
temporary residence for individuals intended to be institutionalized; or C) a public or private
place not designed for, or ordinarily used as, a regular sleeping accommodations 1ür human
beings. EXCLUSION.- For purposes of this Act, the term "homeless" or "homeless individuals"
does not include any individual imprisoned or otherwise detained under an Act of the Congress
or a State law." (42 U.S.C. 11302) There is a statutory requirement that ESG funds must benefit
either homeless persons, or persons at imminent risk of becoming homeless in the case of
homeless prevention activities.
A. Estimate an unduplicated count of homeless persons in your city/county, including the
homeless population who do not access services. Explain how you estimated the
homeless population. Has your community implemented, or is planning on
implementing, an HMIS (Homeless Management Information System)? If so, what
software is your community utilizing?
(1) Homeless population living in a shelter:
(point in time shelter count)
(2) Homeless population who do not access services: 3
(count determined by physical count at random times during the year)
(3) HMIS: no funding for a community-wide system at this time, but Catholic Charities
is using MAACLink with good success. HMIS has been identified as crucial
for effective collaboration among local Continuum of Care agencies.
95
f
B. List all existing emergency shelter(s), domestic violence shelter(s), transitional housing,
and social services that assist the homeless in your city/county area. If the agency listed
below provides shelter include capacity and characteristics of the population served; if
the agency provides only services provide characteristics of population served. (If the
agency listed below only serves a sub population of the homeless, i.e. mentally ill,
veteran, victims of domestic abuse please note this in population served).
Shelter Capacity Population Served
Families/
unaccompanied
women
Families/
unaccompanied
women
1. Ashby House Homeless Shelter
14
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f
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2. Bridge House Transitional Shelter
3. Domestic Violence Association of
Central Kansas (DV.A.C.K.)
48
18
Women/children
Unaccompanied
men
4. Salina Rescue Mission
TOTAL
62
142
(Add pages, if necessary)
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Emergency Shelter Grant Application
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SECTION VII: PERFORMANCE MEASURES
The local government and recipient nonprofit organizations must keep unduplicated counts of the
number of homeless individuals and families assisted and report them quarterly to the state. For
FFY 2003, this will continue to be done by Performance Reports that need to be submitted to the
state on a quarterly bases. The Performance Reports are available on our web site at
www.kshousingcoro.org (Web site instructions: Click on "Programs", Click on Emergency
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Shelter Grant Program", Click on "ESG Program Forms", Click on "ESG 2004 Application".
Further, the local organizations involved in the proposed project should develop standardized
performance measures for significant outcomes, (keeping in mind that the stated goal of ESG
funded programs is too increase permanent housing, stability and self-sufficiency in the
homeless population). Submitting this application implies understanding and agreement of the
required data collection for this grant.
Note: This year the Annual Report will be required under the technical submission stage of
funding. The data used to submit this document will be projections based on previous year
performance reports. This change is so that the state can meet federal IDIS reporting
These requirements were emphasized in a January 29, 2004, meeting with subgrantee-
applicants.
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CERTIFICATION OF LOCAL APPROVAL
FOR NONPROFIT ORGANIZATIONS
LOCAL UNIT OF GOVERNMENT
EMERGENCY SHELTER GRANT PROGRAM
FY 2004 CERTIFICATIONS
Emergency Shelter Grant Application
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SECTION VIII: STATEMENT OF ASSURANCES AND CERTIFICATIONS (Following
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pages)
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Emergency Shelter Grant Application
II
KANSAS HOUSING
RESOURCES CORPORATION
CERTIFICATION OF LOCAL APPROVAL
FOR NONPROFIT ORGANIZATIONS
I, Alan E. Jilka, Mayor
, duly authorized to act on behalf
of the
City of Salina, Kansas
hereby approve the following project(s) proposed by
the City of Salina, Kansas.
By:
lJt; M) L. c¡}Jk
Alan E. Jilka "-
Signature
4-12~2LO4-
Date
Mayor
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¡ ';mcrgency Shelter Grant Application
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KANSAS HOUSING
RESOURCES CORPORATION
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LOCAL UNIT OF GOVERNMENT
EMERGENCY SHELTER GRANT PROGRAM
FY2004 CERTIFICATIONS
I, Alan E. Jilka, Mayor
, authorized to act on
I
behalf of The City of Salina, Kansas , certify that
the City of Salina will ensure compliance by the Neighborhood Services Division and nonprofit
organizations to which it distributes funds under the Emergency Shelter Grant Program with:
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(4)
(5)
(6)
(7)
(8)
(9)
(I)
The requirements of24 CFR 576.2 I (a)(4), which provide that the funding of homeless
prevention activities for families that have received eviction notices or notices oftennination
of utility services meet the following standards: (A) that the inability of the family to make
the required payments must be the result of a sudden reduction in income; (B) that the
assistance must be necessary to avoid eviction of the family or tennination of the services to
the family; (C) that there must be a reasonable prospect that the family will be able to resume
payments within a reasonable period of time; and (D) that the assistance must not supplant
funding for pre-existing homeless prevention activities trom any other source.
(2)
The requirements of24 CFR 576,25(b)(2) concerning the submission by nonprofit
organizations applying for funding ofa certification of approval of the proposed project(s)
from the unit of local government in which the proposed project is located.
(3)
The requirements of24 CFR 576.53 concerning the continued use of buildings for which
Emergency Shelter Grant funds are used for rehabilitation or conversion of buildings for use
as emergency shelters for the homeless; or when funds are used solely for operating costs or
essential services, concerning the population to be served.
The building standards requirement of24 CFR 576.55.
The requirements of24 CFR 576.56, concerning assistance to the homeless.
The requirements of24 CFR 576.57, other appropriate provisions of24 CFR Part 576, and
other applicable Federal law concerning nondiscrimination and equal opportunity.
The requirements of24 CFR 576.59(b) concerning the Unifonn Relocation Assistance and
Real Property Acquisition Policies Act of 1970.
The requirements of24 CFR 576,59 concerning minimizing the displacement of persons as a
result of a project assisted with these funds.
The requirements of24 CFR 576.65(a) and 576.65(b) that grantees develop and implement
procedures to ensure the confidentiality of records pertaining to any individual provided
family violence prevention or treatment services under any project assisted under the
Emergency Shelter Grant Program and that the address or location of any family violence
shelter project assisted with ESG funds will not be made public, except with written
authorization of the person or persons responsible for the operation of the shelter.
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Emergency Shelter Grant Application
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(10)
The requirement that recipients involve, to the maximum extent practicable, homeless
individuals and families in constructing, renovating, maintaining, and operating facilities
assisted under the ESG program, and in providing services for occupants of these facilities as
provided by 24 CFR 576.56(b)(2).
(11 )
The new requirement of the McKinney Act (42 USC 11362) to develop and implement, to the
maximum extent practicable and where appropriate, policies an<f protocols for the discharge
of persons from publicly funded institutions or systems of care (such as health care facilities,
foster care or other youth facilities, or correction programs and institutions) in order to
prevent such discharge from immediately resulting in homelessness for such persons. I
further understand that State and local governments are primarily responsible for the care of
these individuals, and that ESG funds are not to be used to assist such persons in place of
State and local resources.
I certify that the local unit of government will comply with the requirements of24 CFR Part 24
concerning the Drug-Free Workplace Act of 1988.
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I certify that the local unit of government will comply with the provisions of, and regulations and
procedures applicable under 24 CFR 576.57(e) with respect to the environmental review responsibilities
under the National Environmental Policy Act of 1969 and related authorities as specified in 24 CFR Part
58 as ap¡!icablc to activities of nonprofit organizations funded directly by the State. The local unit of
government also agrees to assume the Department's responsibility and authority as set forth in 24 CFR
576.57(e) for acting on the environmental certifications and requests for the release of funds submitted to
the State by local government recipients.
I certify that the local unit of government will ensure the provision of the matching funds required
by 24 CFR 576.51 and 42 USC 113 75, including a description ofthe sources and amounts of such
supplemental funds, as provided by the State, units of general local government or nonprofit
organ izations.
Name and Title:
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SIgn re
Lt-J2 -lDY1
Date
Alan E. Jilka, Mayor
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