[PPT] - 2019 Emergency Solutions Grant Program Finance and Compliance PowerPoint Presentation

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2019 Emergency Solutions Grant Program Finance and Compliance Training Webinar

Denise Hoss – Community Initiatives Compliance Officer Brooke Anderson – ESG Administrator Thursday, March 14, 2019

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EMERGENCY SOLUTIONS GRANT 2019 FINANCIAL PROCESSES

THURSDAY, MARCH 14, 2019 WEBINAR BROOKE ANDERSON – EMERGENCY SOLUTIONS GRANT ADMINISTRATOR

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Payment Request Process Timeline

Submit Payment Request Packet to MHDC by

email

ci.accounting@mhdc.com
Request may be discarded if incomplete or

incorrect and must be resubmitted

Agency’s program contact and financial contact

will be notified by email of discard

All payment requests are submitted monthly to

DSS (by MHDC)

Reimbursements are typically deposited to

grantee’s bank account in 4‐6 weeks

1. MHDC

Payment Request review

2. Aggregate

Invoice to DSS

3. Agency

Reimbursement deposit

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ESG funds are provided solely for reimbursement of:

Actual, eligible expenses incurred and paid by grantee
Within awarded funding components (Admin, RRH, etc.)
Expenses incurred during the 2019 funding period
January 1, 2019 – March 31, 2020

Grantee must document that all ESG funds are expended within these requirements.

Eligible Expenses

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Eligible expenses are detailed in:
2019 ESG Desk Guide‐http://mhdc.com/ci/esg/fad/documents.htm
24 CFR 576 Subpart B – Federal regulations on ESG Program
Reach out to MHDC ESG Administrator with specific questions
Grant Award Amounts by funding component are detailed in:
2019 ESG Grant Agreement, Section 3
Required documentation for the incurred, eligible expenses
ESG 2019 Desk Guide – Table 4

Eligible Expenses

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Quarterly Draw Deadlines

Must submit at least one

Payment Request leading to a disbursement of ESG funds per quarter

Discarded payment request

submissions do not meet this requirement

Spending Deadlines

Must spend at least 25% of

grant award amount by end

f Q2.
Must spend at least 50% of

grant award amount by end

f Q4.

Spending Requirements

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ESG Financial Timeline

2019 Emergency Solutions Grant Program : Quarterly Deadlines

Quarter 1 Q1 Payment Request Deadline January 01, 2019 – March 31, 2019 April 01, 2019, 5:00 p.m. Quarter 2 Q2 Payment Request Deadline 25% Spending Deadline April 1, 2019 – June 30, 2019 July 01, 2019, 5:00 p.m. June 30, 2019, 5:00 p.m. Quarter 3 Q3 Payment Request Deadline July 01, 2019 – September 30, 2019 October 01, 2019, 5:00 p.m. Quarter 4 Q4 Payment Request Deadline 50% Spending Deadline October 01, 2019 – December 31, 2019 January 02, 2020, 5:00 p.m. December 31, 2019, 5:00 p.m. Quarter 5 Final Payment Request Deadline January 01, 2020 – March 31, 2020 April 01, 2020, 5:00 p.m.

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Payment Request Packet

Payment of ESG funds requires the submission and approval of a complete Payment Request packet ESG Payment Request Packet:

ESG‐211 Payment Request
ESG‐212 Expense Detail Report for each funding component
Salaries ‐ with last 4 of SSN in expense description
HMIS/Comparable Database Reports for each funding component

Forms:

ESG‐211, ESG‐212: http://mhdc.com/ci/esg/fad/documents.htm
HMIS Reports: Generated from grantee’s HMIS/comparable Database

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Emergency Solutions Grant Program Payment Request ESG‐211

CERTIFICATION By signing this report, I certify to the best of my knowledge and belief that the report is true, complete, and accurate, and the expenditures, disbursements and cash receipts are for the purposes and objectives set forth in the terms and conditions of the Federal award. I am aware that any false, fictitious, or fraudulent information, or the omission of any material fact, may subject me to criminal, civil or administrative penalties for fraud, false statements, false claims or otherwise. (U.S. Code Title 18, Section 1 0 0 1 and T itle 3 1 , Sect io ns 3 7 2 9 –3 7 3 0 and 3 8 0 1 –3 8 1 2 ).

Authorized Signature Printed Name

MHDC Personnel Use Only

Notes:

Approval Date Grant Number Agency Name Total Requested Amount $0.00 Funding Component Request Amount Administration HMIS Street Outreach Emergency Shelter Essential Services Operations Emergency Shelter Total $0.00 Homelessness Prevention Financial Assistance Housing Services Rental Assistance Homelessness Prevention Total $0.00 Rapid Re‐housing Financial Assistance Housing Services Rental Assistance Rapid Re‐Housing Total $0.00 Total Requested Amount $0.00

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Payment Request Packet

ESG‐211: Payment Request Form

Reflects the funding component requested amounts and total

payment request amount

Each Payment Request requires one signature from Authorized

Signature Card (Form CI‐101)

Each payment request must be accompanied by ESG‐212: Expense

Detail Report for the funding component(s) and HMIS/Comparable Databased Report(s)

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Emergency Solutions Grant Program Administration Expense Detail Form ESG‐212

Paid Date Check Number Vendor Total Amount ESG % Paid by ESG Amount Detail Description

‐ Page 2 Total $

12

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Payment Request Packet

ESG‐212: Expense Detail Form

Reflects expenditures by funding component
Separate sheet for each funding component:
Administration, HMIS, Street Outreach, Emergency Shelter,

Homelessness Prevention, and Rapid Re‐housing

Reporting Range of the incurred date(s) must reflect the reporting

range of the HMIS/Comparable Database Reports

The total expense amount must reflect the payment request (ESG‐211)

amount for each funding component

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Payment Request Packet

HMIS/Comparable Database Reports

Reports are created by each grantee’s HMIS/Comparable Database

administrator

Street Outreach & Emergency Shelter
Bed night report
Program roster
Homelessness Prevention & Rapid Re‐housing
Client detail report
Reflects direct financial assistance to program participants within

report

Contact your CoC’s HMIS Lead Agency if reports are not functioning properly
Non‐HMIS report use requires prior approval from ESG Administrator

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Payment Request Summary

Payment Requests must be submitted to: ci.accounting@mhdc.com

MHDC will not accept Requests submitted via mail or to a

different email address

Complete submissions include one PDF file with the full Payment Request Packet:

Payment Request Form (ESG‐211)
Expense Detail Form (ESG‐212)
HMIS/Comparable Database Report(s)

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Budget Amendment Process

Grantees may submit a budget amendment request to transfer funds between funding components Budget Amendment Requests are submitted in writing to the ESG Administrator for approval After review, a budget amendment request form (ESG‐213) may be provided

Funding Components:

Administration
HMIS
Street Outreach
Emergency Shelter
Homelessness

Prevention

Rapid Re‐Housing

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Emergency Solutions Grant Program Budget Amendment Request ESG‐213 Instructions

ESG grantees may request one budget amendment per grant quarter. To request a budget amendment, complete the Budget Detail box below, detailing the current grant budget and the proposed budget adjustment. To show the proposed budget adjustment, complete the Budget Change column below to show the increase or decrease in funding for each budget category. The total Budget Change should remain at zero. The final total for the New Budget must be the same as the final total of the Original Budget.

Reason for Budget Amendment Request Budget Detail Budget Categories Original Budget Budget Change New Budget Street Outreach ‐ $ ‐ $ ‐ Emergency Shelter ‐ $ ‐ $ ‐ Homelessness Prevention ‐ $ ‐ $ ‐ Rapid Re‐housing ‐ $ ‐ $ ‐ Homeless Management ‐ $ ‐ $ ‐ Administration ‐ $ ‐ $ ‐ Total ‐ $ ‐ $ ‐ Grantee Information Grantee Name: Grant Number: Grant Award: $ ‐ Executive Director or Authorized Official Signature Date Printed Name Title

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Budget Amendment Process

Form ESG‐213: Budget Amendment Request details:
Original budget
Proposed change
New budget
Explanation why the amendment is needed
If ESG‐213 is approved, a budget amendment agreement is

drafted and executed by the grantee and MHDC

The agreement must be fully executed prior to utilizing the revised

budget

One budget amendment request is allowed per grant quarter

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Budget Issues

Amendments made without MHDC

approval

Amendments utilized before

budget amendment letter is fully executed

Other Issues

Funds spent outside of approved

CoC

Ineligible expenses
Funds spent outside of funding

period

Payment Request Issues

Missing HMIS/comparable database

report(s)

Duplicate submission
Expired Certificate of Insurance
Inconsistent Amounts between

ESG‐211, ESG‐212, and HMIS/comparable database report

Submission to an email address
ther than:

ci.accounting@mhdc.com

Common Issues

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Contact Information

TBD ‐ Grants Administrator Brooke Anderson

Emergency Solutions Grant Administrator Phone: (816) 759‐6632 Email: brooke.anderson@mhdc.com Payment Request Submission: Community Initiatives Department Accounting ci.accounting@mhdc.com Information and Forms for MHDC ESG Program: http://www.mhdc.com/ci/esg/index.htm

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Questions?

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EMERGENCY SOLUTIONS GRANT COMPLIANCE WEBINAR

THURSDAY, MARCH 14, 2019 WEBINAR DENISE HOSS – COMMUNITY INITIATIVES COMPLIANCE OFFICER

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Compliance Site Visit Basics

The Compliance Officer will need to examine client files, financial assistance,

administrative / operating expenses, along with written policies and procedures to verify compliance with program rules and regulations

All required documentation should be assembled in an orderly fashion, in paper

form, and available for review within 15 minutes of request in a private workspace

Agency staff directly involved with program operations should be available for

questions

Agency staff will be expected to present an HMIS or comparable data base client

report for the clients served from beginning of grant period to date of visit

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Client File Documentation

Case management / housing stability goal plan
Case Management should be documented with emphasis on making this the responsibility of the case

managers rather than a requirement of clients. Case Managers should attempt to meet with the client at least once a month and document all attempts.

Verification of homeless status, (CI‐104, 105)
HUD definitions of literal homelessness, at risk of homelessness, fleeing or attempting to flee

domestic violence, other.

Proper household identification or documentation of attempts to collect items, i.e. Housing First Principles

apply.

Program consent form
Intake application
Verification of income &/or assets – Income received within 30‐days of assistance.
Types of verification in order from best: Written from source, oral or telephone, (must document

attempts made to verify), self‐certification.

Proof of need
Rent, deposits, rental arrears – Lease or letter from landlord which clearly lists the amounts.
Utilities including arrears – Copy of bill or print out from source with amount(s) and time frame(s) due

clearly documented

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Emergency Solutions Grant

Emergency Solutions Grant Program intended to serve extremely low income individuals and families

Assistance based on each components eligibility for homeless and at‐risk of

homelessness individuals and families

ESG Desk Guide FY2019
Homelessness Prevention participants must have household income below 30%

AMI

Must determine that the applicant’s total household income is below 30

percent of the AMI at the initial evaluation and any subsequent 3 month re‐ revaluation for Homelessness Prevention component

Rapid Re‐Housing
No income requirement at in‐take, income cannot exceed 30% AMI at annual

re‐evaluation

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EMERGENCY SOLUTIONS GRANT PROGRAM Income Eligibility Calculation Worksheet ESG‐201

To be eligible for ESG Homelessness Prevention assistance, households must have an income BELOW 30% AMI at initial evaluation, and have no other housing options, financial resources, or support networks. At re‐evaluation (not less than every three months) the participant must have an annual income LESS THAN OR EQUAL TO 30 % AMI. For ESG Rapid Re‐Housing assistance, an income assessment is not required at initial evaluation. However, at annual re‐evaluation, income must be LESS THAN OR EQUAL TO 30% AMI (and meet

ther ESG eligibility requirements). Grantees should use this worksheet to determine whether an applicant household meets the ESG income eligibility threshold.

A copy of this worksheet should be kept in the ESG participant case file. For further reference surrounding participant eligibility and income requirements: 24 CFR 576.401 and 24 CFR 576.500(e).

Date: Type of Evaluation:

Household Member Number Household Member Name Age of Household Member 1 2 3 4 5 6 7 8 9 10 11 Total Household Members (Household size) 30% of Area Median Income (AMI) for Household Size Household Member Number/Name Sources of Household Income Currently Documented Gross Income Amount Frequency of Income Number of Payments per Year Annual Gross Income Zero Income (signed form in file) $ ‐ Earned Income (for ADULT household members only) $ ‐ $ ‐ Earned Income (for ADULT household members only) $ ‐ $ ‐ Earned Income (for ADULT household members only) $ ‐ $ ‐ Self‐employment/business income $ ‐ $ ‐ Self‐employment/business income $ ‐ $ ‐ Interest & Dividend Income $ ‐ $ ‐ Interest & Dividend Income $ ‐ $ ‐ Pension/Retirement Income $ ‐ $ ‐ Pension/Retirement Income $ ‐ $ ‐ Unemployment & Disability Income $ ‐ $ ‐ Unemployment & Disability Income $ ‐ $ ‐ TANF/Public Assistance $ ‐ $ ‐ TANF/Public Assistance $ ‐ $ ‐ Alimony, Child Support and Foster Care Income $ ‐ $ ‐ Alimony, Child Support and Foster Care Income $ ‐ $ ‐ Armed Forces Income $ $ ‐

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Calculating Income

Determine all Sources of Income

Inclusions
Exclusions

Methods of Calculating Income

Annualize income by calculating the gross annual income based on current

circumstances.

Income that may not last for 12 months should be calculated assuming that

circumstances will last 12 months (seasonal work, etc.)

Use verifications of all income received within the past 30 days of assistance and

calculate the average of the gross amount . Annualize based on the frequency of pay.

Calculate the annual income based on anticipated changes through the year
Information that is available on changes throughout the year should be used to

calculate anticipated income from all known sources

Changes will be reflected at recertification period as required for each program

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Calculating Income

Homelessness Prevention / Rapid Rehousing programs will

utilize HUD Chapter 5: Determining Income and Calculating Rent

Must calculate income for an individual or family for all

programs with income eligibility requirements

HUD specifies the types and amounts of income and deductions

to be included in the calculation

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Calculating Income (continued)

Frequency of Pay

Hourly wages by the number of hours worked per year (2,080 hours

for full‐time employment with a 40‐hour work week and no

vertime)
Weekly wages by 52
Bi‐weekly wages (paid every other week) by 26
Semi‐monthly wages (paid twice each month) by 24
Monthly wages by 12
T
annualize other than full‐time income, multiply the wages by the

actual number of hours or weeks the person is expected to work

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Calculating Income: Example

Client A works an average of 32 hours per week and is paid every two weeks.

He/she has presented two check stubs to verify his income which are within 30 days of the assistance date (4/1/19)

Check Stub 1: payment date 3/3/19 for $329.50 (gross wages)
Check Stub 2: payment date 3/17/19 for $445.00 (gross wages)
Calculate by dividing the total of the gross pay ($329.50 + $445.00 = $774.50)

by the number of check stubs (2) and multiply by the frequency of pay (26) to annualize the income

T
tal: $774.50/2= $387.25 x 26= $10,068.50

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MHDC Community Initiatives: SELF‐DECLARATION OF INCOME

Form: CI 103

Staff Signature:

1 of 1 Effective: January 1, 2019

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

ther 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 I understand that third‐party verification is the preferred method of certifying income for

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: Date:

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Calculating Assets

What is an asset?

Items of value that may be turned into cash
Some clients have assets that are not earning interest
Necessary personal property is not an asset

Asset Inclusions and Exclusions Considerations

Must determine whether the total “cash value” of family assets exceeds $5,000
Market value less reasonable expenses incurred selling or converting the asset to cash
Note: a family is NOT required to convert the asset to cash. Determining the cash value

is done as a calculation in the process of determining the value of all assets

If assets are owned by more than one person, prorate based on percentage of
wnership, if there is no percentage specified or provided by law

, prorate evenly

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Calculating Assets: Example

Client B has a checking account with a six month average balance of $500.00

which earns no interest. He/she has a savings account with a current balance

f $500.00 which currently earns 1.5 percent interest
Savings account interest ($500 x .015 = $7.50)
Client C owns his/her house valued at $50,000. He/she currently has an
utstanding mortgage balance of $34,000. The reasonable selling costs of a

realtor , taxes, insurance, etc. would be $3,400

The cash value of their home would be $12,600 ($50,000 ‐ $34,000 =

$16,000 ‐ $3,400 = $12,600)

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Form: CI‐104

MHDC Community Initiatives: HOUSING STATUS CERTIFICATION

ApplicantName: Client referral received from: ☐ Coordinated Entry ☐ Walk‐in ☐ Other

Individual without dependent children (complete one form for each household) Household with dependentchildren (completeone form for each head of household) Numberof 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 their current living situation. Check only ONE BOX and ONLY complete that section. *IMPORTANT: THIRD PARTYEVIDENCEMUST BEATTACHED TO THISFORMINORDER TO CERTIFY HOMELESSNESS.

LITERALLY HOMELESS

Living Situation: place not meant for human habitation (e.g., cars, parks, abandoned buildings, streets/sidewalks)

The person(s) named above is/are currently livingin (or, if currently in hospitalor other institution,was living in immediately prior to hospital/institution admission) a public or private placenot designed for, or ordinarily used as a regular sleeping accommodation for humanbeings,includinga car, park, abandonedbuilding,busstation, airport, or campground. Descriptionofcurrent livingsituation: HomelessStreet Outreach/Other Program(ifapplicable): 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 forhuman habitation. (Examples may be street outreach workers, day shelters, soup kitchens, Health Care for the Homeless sites, etc.)

Living Situation: Emergency Shelter

The person(s) named above is/are currently livingin (or, if currently in hospitalor other institution,was living in immediately prior to hospital/institutionadmission) a supervised publiclyor privately operated shelter as follows: EmergencyShelterProgramName: This emergency shelter must appear on the CoC’s Housing Inventory Chart submitted as part of the most recent CoC Homeless Assistance application to HUD or otherwise be recognized by the CoC as part of the CoC inventory (e.g. newly established Emergency Shelter).

Living Situation: Transitional Housing

The person(s) named above is/are currently livingin a transitional housing programfor persons who are

homeless. The persons(s) named above is/are graduatingfrom or timingout of thetransitional housingprogram:

TransitionalHousingProgramName: Immediately prior to entering transitional housing the person(s) named above was/were residing in: □ Emergency Shelter OR ☐ A place not meant for human habitation

Effective: January 1, 2019 35 of 3

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Form: CI‐104

Living Situation: Market Housing

The person(s)named above was/were evicted from or otherwise lost housingobtained through the private market.

AT RISK OF HOMELESSNESS

LivingSituation: FacingEviction

The person/household named above is currently living in rental housing from which he/she/they is/are being evicted. assistance provided will not overlap with other federal funding sources.

The individual or family:

1. Has income that is at or below the area median income eligibility requirement (ESG 30%/MHTF & MoHIP 50%) for the

geographic area(see income documentation form);

AND

2. Lacks sufficient resources to attain housing stability. [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 Category 1

f the homeless definition.

The person(s) listed above meet one or more of the following risk factors: (1)Has moved frequently because of economic reasons (2) Is living in the home of another because of economic hardship (3)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

(4)Lives in a hotel or motel; “and the cost of the hotel or motel is not paid for by federal, state, or

local government programs for low‐income individuals or by charitable organizations’’

(5) Lives in severely overcrowded housing; (in a single‐room occupancy or efficiency apartment unit in

which more than two persons, on average, reside or another type of housing in which there reside more than 1.5 persons per room, as defined by the U.S. Census Bureau.)

(6)Is exiting a publicly funded institution; or system of care, (such as a health‐care facility, mental

health facility, foster care or other youth facility, or correction program or institution)

(7)Otherwise lives in housing that has characteristics associated with instability and an increased risk of

homelessness.

Evidence of risk factors for this Applicant is:

(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 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.

36 of 3 Effective: January 1, 2019

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Form: CI‐104

Oral Third Party Verification

Applicant Name: Date of Third Party Verification: Name of Third Party Representative: Verification of homeless status was provided: □ Over the phone ☐ In person I understand that obtaining third party verification of eligibility or risk factors is the preferred method of certifying eligibility for an individual who is applying for assistance, but cannot meet this standard. Below I am providing details of

ral third party verification of eligibility or risk factors and certifying all statements to be true, accurate and complete.

I made the following efforts to obtain third party verification:

StaffObservationVerification

I have observed the following conditions which serve as evidence related to the applicant’s housing status and available

resources. Due to the following factors I certify this applicant’s eligibility for

assistance: I understand that obtaining third party verification of eligibility or risk factors is the preferred method of certifying eligibility for an individual who is applying for assistance, but cannot meet this standard. I made the following efforts to

btain third party verification:

Staff Certification

I certify that I have provided verification as indicated above that the Applicant meets eligibility criteria and/or risk factors for being: □ Literally Homeless OR ☐ At Risk of Homelessness

Staff Signature: Date: 3 of 3 Effective: January 1, 2019

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MHDC Community Initiatives: SELF‐DECLARATION OF HOUSING STATUS

Form: CI‐105

Staff Signature:

1 of 1

Date:

Effective: January 1, 2019

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

n the following and other indicated information and the signed declaration by the applicant.

Check only one: □I [and my children] am/are currently homeless and living on the street (i.e., a car, park, abandoned building, bus station, airport, or camp ground). □I [and my children] am/are the victim(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, 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 14 days. I certify that I have insufficient financial resources and support networks, e.g., family, friends, faith‐based,

ther social networks, immediately available to obtain housing or to attain housing stability without ESG,

MHTF, or MoHIP assistance. I certify that the information above and any other information I have provided in applying for ESG, MHTF, or MoHIP assistance is true, accurate and complete. Applicant Signature: Date: Staff Certification 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, MHTF, or MOHIP 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:

☐ ☐

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Form: CI‐110

Identification CertificationMHDC Community Initiatives

PLEASE NOTE: Prior approval must be obtained by agency/organization for use of this form. PROGRAM TYPE: Missouri Housing Trust Fund ☐Emergency Solutions Grant ☐Missouri Housing Innovation Program Household Identifier: Total Number of Persons in Household: Number of Adults: Number of Children: ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ 1 Household Member Unique Identifier The above household member is: 18 years of age or older Under 18 years of age Identification verified: Photo Identification Social Security Number 2 Household Member Unique Identifier The above household member is: 18 years of age or older Under 18 years of age Identification verified: Photo Identification Social Security Number 3 Household Member Unique Identifier The above household member is: 18 years of age or older Under 18 years of age Identification verified: Photo Identification Social Security Number 4 Household Member Unique Identifier The above household member is: 18 years of age or older Under 18 years of age Identification verified: Photo Identification Social Security Number 5 Household Member Unique Identifier The above household member is: 18 years of age or older Under 18 years of age Identification verified: Photo Identification Social Security Number ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐

Effective: January 1, 2019

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Form: CI‐110

Identification CertificationMHDC Community Initiatives

6 Household Member Unique Identifier The above household member is: 18 years of age or older Under 18 years of age Identification verified: Photo Identification Social Security Number 7 Household Member Unique Identifier The above household member is: 18 years of age or older Under 18 years of age Identification verified: Photo Identification Social Security Number 8 Household Member Unique Identifier The above household member is: 18 years of age or older Under 18 years of age Identification verified: Photo Identification Social Security Number The undersigned individuals do, by their respective oaths solemnly swear and affirm as follows:  That the Staff Member completing this Identification Certification has verified the identification of the individual(s) to whom this certification relates;  That the Staff Member has been presented with a valid government issued photo ID (or other acceptable form of identification) by the individual(s) to whom this certification relates evidencing that such individual(s) are U.S. citizens

r otherwise lawfully presented in the U.S.;

 That the Staff Member has collected and reviewed valid documentation of income for the individual(s) to whom this certification relates and have verified that such individual(s) income is within the appropriate income limits to qualify for assistance from any funding sources being used to provide services to such individual(s); and,  That the Executive Director has reviewed the file for the individual(s) to which this Identification Certification relates, and has verified that all the representations made by the Staff Member in this Identification Certification are true and correct. The undersigned individuals affirm, by penalty of perjury, that all the statements made herein are true and correct.

Staff Signature Date Staff Print Name

☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐

Executive Director Signature Date Executive Director Print Name

Effective: January 1, 2019

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Emergency Solutions Grant

Rent Reasonableness and FMR
Utility Allowance documentation
Comparable rent documentation
Rental Assistance Agreement
VAWA Lease Addendum– We will post the HUD VAWA Lease Addendum
n our website for agencies to use in correlation with the Rental

Assistance Agreement. The form requires the signature of both the landlord and client. This will accomplish the requirement of notification to the client of his/her rights and to the landlord of this regulation.

Equal Access Rule
Housing Stability Standards Inspection
Lead‐based Paint inspection

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EMERGENCY SOLUTIONS GRANT PROGRAM Rent Reasonableness and Fair Market Rent Certification ESG‐206

Fair Market Rent Verification Contract Rent + Utility Allowance = Proposed Gross Rent Applicable Fair Market Rent Rate: Proposed Unit does not exceed applicable FMR: Certification Based upon a comparison with rents for comparable units, the proposed rent for the unit: Is reasonable Is not reasonable

Name: Date: Signature:

Yes $0.00 Rent Reasonableness Verification

The rent charged for a unit must be reasonable in relation to rents currently being charged for comparable units in the private unassisted market and must not be in excess of rents currently being charged by the owner for comparable unassisted units. Date: Household Name:

Proposed Unit Unit #1 Unit #2 Unit #3 Address # of Bedrooms Total Square Feet Ty pe of Unit/Con struction Housing Condition Location/Accessibility Amenities Age in Years Type of Utilities Monthly Unit Rent Handicap Accessible?

SLIDE 43

Allowances for Tenant-Furnished Utilities and Other Services

OMB Approval No. 2577-0169 (exp. 04/30/2018) U.S. Department of Housing and Urban Development Office of Public and Indian Housing

Form HUD‐52667 (04/15)

ref. Handbook 7420.8

The Nelrod Company 8/2017 Update

Locality: Housing Authority of Kansas City,

MO

Unit Type: High-

Rise/ Apartment

Date (mm/dd/yyyy)

January 1, 2018

Utility or Service:

Monthly Dollar Allowances

0 BR 1 BR 2 BR 3 BR 4 BR 5 BR Heating

a. Natural Gas

$14.0 $17.0 $20.0 $22.0 $25.0 $27.0

b. Bottle Gas/Propane
c. Electric

$24.0 $28.0 $38.0 $47.0 $57.0 $66.0

d. Electric Heat Pump

$21.0 $25.0 $29.0 $33.0 $37.0 $40.0

e. Oil / Other

Cooking

a. Natural Gas

$2.0 $2.0 $3.0 $4.0 $5.0 $6.0

b. Bottle Gas/Propane
c. Electric

$7.0 $8.0 $12.0 $15.0 $19.0 $23.0

Other Electric (Lights & Appliances)

$26.0 $31.0 $42.0 $54.0 $66.0 $78.0

Air Conditioning

$12.0 $13.0 $19.0 $24.0 $29.0 $34.0

Water Heating

a. Natural Gas

$5.0 $5.0 $7.0 $10.0 $12.0 $14.0

b. Bottle Gas/Propane
c. Electric

$17.0 $20.0 $26.0 $31.0 $37.0 $43.0

d. Oil / Other

Water

$36.0 $37.0 $47.0 $57.0 $68.0 $78.0

Sewer

$60.0 $61.0 $77.0 $93.0 $108.0 $124.0

Trash Collection (avg)

$18.0 $18.0 $18.0 $18.0 $18.0 $18.0

Range / Microwave Tenant-supplied

$12.0 $12.0 $12.0 $12.0 $12.0 $12.0

Refrigerator Tenant-supplied

$13.0 $13.0 $13.0 $13.0 $13.0 $13.0 Other

speci

fy:

Monthly Electric Fee $13.14

$13.0 $13.0 $13.0 $13.0 $13.0 $13.0

Monthly Gas Fee $26.93

$27.0 $27.0 $27.0 $27.0 $27.0 $27.0 Actual Family Allowances

To be used by the family to compute allowance. Complete below for the actual unit rented.

Utility or Service per month cost Heating $ Cooking $

Name of Family

Other Electric $ Air Conditioning $ Water Heating $

Address of Unit

Water $ Sewer $ Trash Collection $ Range / Microwave $ Refrigerator $ Other $

Form can be found at: http://www.hakc.org/s ites/www/Uploads/HC V(Section%208)/2018‐ Utilities‐HCV.pdf

SLIDE 44

GRANT RECIPIENT’S CONSENT TO RELEASE OF INFORMATION I, understand and acknowledge that (the “Agency”), in exchange for receiving certain funds from the Missouri Housing Development Commission (“MHDC”), is required to share certain un‐identifying information about me with MHDC in order to ensure the Agency’s compliance with all rules and requirements associated with the funds from MHDC. I have been informed that the Agency will not release any information about me, my children, or my abuser to any group or individual unless a written release of information is signed by me. I understand that I may revoke a release of information at any time. The funding received by the Agency and administered by MHDC may actually be from other state and federal agencies, such as Department of Social Services (collectively the "Auditors"). Together with MHDC, the Auditors are entitled to examine records in performing audit and review functions. In these cases, MHDC and the Auditors may see the client information sheet located in my file. I understand that neither MHDC nor the Auditors will leave the premises with any identifying information about me, and will not disclose any identifying information to any third party. By my signature below, I hereby authorize the Agency to share un‐identifying information with MHDC and its Auditors for the limited purposes of proving that I qualify to receive the assistance administered by MHDC and ensuring that the Agency is in compliance with the rules and requirements associated with the funds from MHDC. Applicant’s Signature (initials): Printed Unique Identifier: Date: Among the stated goals of programs administered by MHDC is the provision of safe, decent and sanitary

housing. In order to assist MHDC in furthering this goal, please indicate which of the following statements

below is most accurate as it pertains to your current housing: I believe my current housing, for which I am seeking MHDC assistance, IS safe, decent and sanitary. I believe my current housing, for which I am seeking MHDC assistance IS NOT safe, decent and sanitary. NOTE – If, at any time while you are receiving assistance through programs administered by MHDC you believe your current housing ceases to be safe, decent and sanitary, please report this to the Agency; and, the Agency will assist you in locating housing that is safe, decent and sanitary. Effective:January1,2019 CI‐108 DV

SLIDE 45

GRANT RECIPIENT’S CONSENT TO RELEASE OF INFORMATION I, understand and acknowledge that (the “Agency”), in exchange for receiving funds from the Missouri Housing Development Commission (“MHDC”) is required to share certain information about me with MHDC in order to ensure the Agency’s compliance with all rules and requirements associated with the funds from MHDC. By my signature below, I hereby authorize the Agency to share all of my personal information with MHDC for the limited purposes of proving that I qualify to receive assistance administered by MHDC and ensuring that the Agency is in compliance with the rules and requirements associated with the funds from MHDC. I further authorize MHDC to contact me directly to discuss any matters related to my receipt of MHDC funds and agree to provide any additional information that MHDC may deem necessary in order to fully determine my eligibility for MHDC funds and/or to determine whether the Agency is in compliance with all rules and requirements of associated with the funds from MHDC. I understand that the funding received by Agency and administered by MHDC may actually be from other state and federal agencies, such as the Department Social Services, and I hereby authorize MHDC to share my information with such funding sources for the limited purposes of proving that I qualify to receive such assistance and ensuring that all program rules and requirements are complied with by Agency and MHDC. I further authorize such other funding sources to contact me directly to discuss any matters related to my receipt of the funds administered by MHDC and agree to provide any additional information that such funding sources may deem necessary in order to fully determine my eligibility and/or to determine whether all program rules are complied with by Agency and MHDC. Applicant’s Signature: Printed Name: Date: Among the stated goals of programs administered by MHDC is the provision of safe, decent and sanitary

housing. In order to assist in furthering this goal, please indicate which of the following statements below is

most accurate as it pertains to your current housing: I believe my current housing, for which I am seeking MHDC assistance, IS safe, decent and sanitary. I believe my current housing, for which I am seeking MHDC assistance IS NOT safe, decent and sanitary. NOTE – If, at any time while you are receiving assistance through programs administered by MHDC, you believe your current housing ceases to be safe, decent and sanitary, please report this to the Agency; and, the Agency will assist you in locating housing that is safe, decent and sanitary.

1 of 1 Effective: January 1, 2019

CI-108

SLIDE 46

E ME R GE N C Y SOLUTIONS GRANT PROGRAM

ESG-204

CERT/FICATION OF RECEIPT OF ESGASSISTANCE

By signing this form, I state that I am aware that it is unlawful to receive Emergency Solutions Grant (ESG} services or assistance for more than twenty-four (24) months in any three (3) year

period. I do hereby certify that:

D

Neither I, nor any member of my household, either individually or as part of another household have received Emergency Solutions Grant services or assistance within the three (3) years prior to this application.

D

Signature of Applicant Date of Application Address City State

I, or someone in mv,...household, received E S G services or assistance within the three (3) years prior to this application.

D

I have received E S Gservices or assistance within the three (3) years prior to this application. Type of services or assistance received:- - - - - - - - - - - - - - Length of time services or assistance was received: _ Location of services or assistance received: - - - - - - - - - - - -

D

A member of my household received E S Gservices or assistance within the three (3) years prior to this application. Name of person(s) that received services or assistance: _ Type of services or assistance received:- - - - - - - - - - - - - Length of time services or assistance was received:- - - - - - - - - Location

f services or assistance received: - - - - - - - - - - - -

SLIDE 47

EMERGENCY SOLUTIONS GRANT PROGRAM ESG-205

. . . .. " Instructions: Place a check mark in the correct column to indicate whether the property is

M : X) U;t.! hc1JSJNG

approved or deficient with respect to each standard. A copy of this checklist should be placed in thP c;h<>lt<> 'c; filpc; Approved Deficient Standard (24 CFR part 576.403(b))

1. Structure and materials:

a. The shelter building is structurally sound to protect the residents from the elements and not pose any threat to the health and safety of the residents. b. Any renovation (including major rehabilitation and conversion) carried out with ESG assistance uses Energy Star and WaterSense products and appliances.

2. Access. Where applicable, the shelter is accessible in accordance with:

a. Section 504 of the Rehabilitation Act (29 U.S.C. 794) and implementing regulations at 24 CFR part 8; b. The Fair Housing Act (42 U.S.C. 3601et seq.) and implementing regulations at 24 CFR part 1 00; and c. Title IIof the Americans with Disabil i ties Act (42 U.S.C. 1 2131et seq.) and 28 CFR part 35.

3. Space and security: Except where the shelter i

s i ntended for day use only, the shelter provides each program participant in the shelter with an acceptable place to sleep and adequate space and security for themselves and their belongings.

4. Interior air quality: Each room or space within the shelter 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.

5. Water Supply: The shelter's water supply is free of contamination.
6. Sanitary Facilities: Each program participant inthe shelter has access to sanitary

facilities that are i n proper operatingcondition, are private, and are adequate for personal cleanliness and the disposal of human waste.

7. Thermal environment: The shelter has any necessary heating/cooling facilities in

proper operating condition. 8. Illumination and electricity: a. The shelter has adequate natural or artificial illumination to permit normal indoor activities and support health and safety. b. There are sufficient electrical sources to permit the safe use of electrical appliances i n the shelter.

9. Food preparation: Food preparation areas, if any, contain suitable space and

equipment to store, prepare,and serve food i n a safe and sanitary manner.

10. Sanitary conditions: The shelter is maintained in a sanitary condition.

11. Fire sa fety:

a. There is at least one workingsmoke detector in each occupied unit of the
shelter. Where possible, smoke detectors are located near sleeping

areas. b. All public areas of the shelter have at least one working smoke detector. c. The fire alarm system is designed for hearing-impaired residents. d. There is a second means of exiting the building in the event offire or other emergency. 1

2. I

f ESG funds were used for renovation or conversion, the shelter meets state or l

cal government safety and sanitation standards, as appli

cable.

13. Meets additional recipient/subrecipient standards (if any).

Minimum Standards for Emergency Shelter

SLIDE 48

ESG-205

CERTIFICATION STATEMENT

I certify that I have evaluated the property located at the address below to the best of my ability and find the following:

D Property meets fill of the above standards. D Property does not meet all of the above standards.

COMMENTS:

ESG Recipient Name: -

ESGSubrecipient Name (if applicable): -
Emergency Shelter Name:

Street Address: - - - - - - - - - - - - - - - - - - - - - - - - - -

City: -
State:
-
- -

Zip: _ Evaluator Signature: -

Date of review:

_ Evaluator Name: Approving Official Signature (if applicable): -

Date:

_ Approving Official Name (if applicable): _

SLIDE 49

Emergency Solutions Grant Program ESG-205 Minimum Standards for Permanent Housing

; :..·· f11 SSDC )RJ HOU51t.G

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. Approved Deficient Standard (24 CFRpart 576.403(c))

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
f 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.

I

I 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 offire or

ther 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.

11. Meets additional recipient/subrecipient standards (if any).

Page 1

e-;:;

ESG Minimum Habitability Standards Checklist

SLIDE 50

ESG-205 CERTIFICATION STATEMENT I certify that I have evaluated the property located at the address below to the best of my ability and find the foilowing:

D Property meets ill!of the above standards.

D Property does not meet all of the above standards.

COMMENTS:

ESG Recipient Name: - - - - - - - - - - - - - - - - ESG Subrecipient Name: - - - - - - - - - - - - - - - - Program Participant Name: Street Address: - - - - - - - - - - - - - - - - Apartment : _ _ _

City: _ _

State: _ _ _ Zip: _ Evaluator Signature:- - - - - - - - - - - - - - - Eva luator Name: Date of review: _ Approving Official Signature (if applica ble):- - - - - - - - - - - Date: _ Approving OfficialName (if applicable):- - - - - - - - - - - - - - -

ESG Minimum Habitability Standards Checklist

Page 2

SLIDE 51

Emergency Solutions Grant Program

51

ESG-207

ESG Lead Screening Worksheet

About this Tool The ESG Lead Screening Worksheet is intended to guide grantees through the lead-based paint inspection process to ensure compliance with the rule. ESGstaff can use this worksheet to document any exemptions that may apply, whether any potential hazards have been identified, and if safe work practices and clearance are required and used. A copy of the completed worksheet along with any additional documentation should be kept in each program participant's case file.

INSTRUCTIONS

To prevent lead-poisoning in young children, ESG grantees must comply with the Lead-Based Paint Poisoning Prevention Act of 1973 and its applicable regulations found at 24 CFR 35, Parts A, B, M, and R. Under certain circumstances, a visual assessment of the unit is not required. This screening worksheet will help program staff determine whether a unit is subject to a visual assessment, and if so, how to

proceed. A copy of the completed worksheet along with any related documentation should be kept in

each grantee or program participant's file. Note: ALL pre-1978 properties are subject to the disclosure requirements outlined in 24 CFR 35, Part A, regardless of whether they are exempt from the visual assessment requirements .

BASIC INFORMATION

Name of Participant Address City ESG Program Staff

PART 1: DETERMINE WHETHER THEUNIT IS SUBJECTTOAVISUAL ASSESSMENT

If the answer to one or both of the following questions is 'no,' a visual assessment is not triggered for this unit and no further action is required at this time . Place this screening worksheet and related documentation in the program participant's file. If the answer to both of these questions is 'yes,' then a visual assessment is triggered for th i$ unit 3nd program staff should continue to Part 2. 1. Was the leased property constructed before 1978?

O ves

0 N o 2. Will a child under the age of six be living in the unit occupied by the household receiving ES G assistance?

O ves

0 N o Unit Number State Zip

SLIDE 52

ESG-207

PART 2: DOCUMENT ADDITIONAL EXEMPTIONS If the answer to any of the following questions is 'yes,' the property is exempt from the visual assessment requirement and no further action is needed at this point. Place this screening sheet and supporting documentation for each exemption in the program participant's file. If the answer to all of these questions is 'no,' then continue to Part 3 to determine whether deteriorated paint is present.

1. Is it a zero-bedroom or SRO-sized unit?

O ves

0 N

2.

Has X-ray or laboratory testing of all painted surfaces by certified personnel been conducted in accordance with HUD regulations and the unit is officially certified to not contain lead-based paint? O ves

0 N

3.

Has this property had all lead-based paint identified and removed in accordance with HUD regulations? O v es

0No

4. Is the client receiving federal assistance from another program, where the unit has already undergone (and passed) a visual assessment within the past 12 months (e.g., if the client has a Section 8 voucher and is receiving ESGassistance for a security deposit or arrears)?

0 Yes (Obtain documentation for the case file.)

0 N

5.

Does the property meet any of the other exemptions described in 24 CFR Part 35.115(a). O ves

0No

Please describe the exemption and provide appropriate documentation of the exemption.

52

PART 3: DETERMINE THE PRESENCE OF DETERIORATED PAINT To determine whether there are any identified problems with paint surfaces,.program staff should conduct a visual assessment prior to providing HPRPfinancial assistance to the unit as outlined in the following train ing on HUD's website at: http://www.hud.gov/office s/lead/training/visualassessment/h001 01.htm. If no problems with paint surfaces are identified during the visual assessment, then no further action is required at this time. Place this screening sheet and certification form (Attachment A) in the program participant's file. If any problems with paint surfaces are identified during the visual assessment, then continue to Part 4 to determine whether safe work practices and clearance are required.

SLIDE 53

ESG-207

1. Has a visual assessment of the unit been conducted?

Yes 0 N o

2. Were any problems with paint surfaces identified in the unit during the visual assessment?

0 Y e s

0 No (Complete Attachment A - Lead-Based Paint Visual Assessment Certification Form)

PART 4: DOCUMENT THE LEVELOF IDENTIFIED PROBLEMS

All deteriorated paint identified during the visual assessment must be repaired prior to clearing the unit for assistance. However, if the area of paint to be stabilized exceeds the de minimus levels (defined below), the use of lead safe work practices and clearance is required. If deteriorating paint exists but the area of paint to be stabilized does not exceed these levels, then the paint must be repaired prior to clearing the unit for assistance, but safe work practices and clearance are not required. 1. Does the area of paint to be stabilized exceed any of the de minimus levels below?

20 square feet on exterior surfaces 0 Yes 0 No
2 square feet in any one interior room or space 0 Yes D No
10 percent of the total surface area on an interior or exterior component with a small

surface area, like window sills, baseboards, and trim D Yes 0 No If any of the above are 'yes,' then safe work practices and clearance are required prior to clearing the unit for assistance.

PART 5: CONFIRM ALL IDENTIFIED DETERIORATED PAINT HAS BEEN STABILIZED

Program staff should work with property owners/managers to ensure that all deteriorated paint identified during the visual assessment has been stabilized. If the area of paint to be stabilized does not exceed the de minimus level, safe work practices and a clearance exam are not required (though safe work practices are always recommended). In these cases, the ESGprogram staff should confirm that the identified deteriorated paint has been repaired by conducting a follow-up assessment. If the area of paint to be stabilized exceeds the de minimus level, program staff should ensure that the clearance inspection is conducted by an independent certified lead professional. A certified lead professional may go by various titles, including a certified paint inspector, risk assessor, or sampling/clearance technician. Note, the clearance inspection cannot be conducted by the same firm that is repairing the deteriorated paint. 1. Has a follow-up visual assessment of the unit been conducted? 0 Y e s 0 N o 2. Have all identified problems with the paint surfaces been repaired? 0 Y e s 0 N o

53

SLIDE 54

ESG-207

3. Were all identified problems with paint surfaces repaired using safe work practices?

O ves

0 N o

D Not Applicable -The area of paint to be stabilized did not exceed the de minimus levels.

4. Was a clearance exam conducted by an independent, certified lead professional?

Oves

0 N o

D Not Applicable - The area of paint to be stabilized did not exceed the de minimus levels.

5.

Did the unit pass the clearance exam?

D ves

No

D Not Applicable - The area of paint to be stabilized did not exceed the de minimus levels.

Note: A copy of the clearance report should be placed in the program participant's file.

54

SLIDE 55

ESG-207

ATTACHMENT 1: LEAD-BASED PAINT VISUAL ASSESSMENT CERTIFICATION TEMPLATE

55

I, _ , certify the following:

(Print name)

I have completed HUD's online visual assessment training and am a HUD-certified visual

assessor.

I conducted a visual assessment at -
(Property address and unit number)
n

(Date of Assessment)

No problems with paint surfaces were identified in the unit or in the building's common areas.

(Signature) (Date) Client Name: -

Case Number: -

SLIDE 56

Emergency Solutions Grant Program

56

ESG-208 ESG Lead-Based Paint Property Owner Certification Form

About this Tool The ESG Lead-Based Paint Property Owner Certification Form is a tool program staff can use to have property owners/managers certify that all paint stabilization activities have been completed in accordance with guidelines when formal clearance is not required (or as additional documentation when formal clearance is required). A copy of the completed form along with any additional documentation {i.e., a copy of the clearance report) should be kept in each program participant's file. INSTRUCTIONS To prevent lead-poisoning in young children, the ESG program must comply with the Lead-Based Paint Poisoning Prevention Act of 1973 and its applicable regulations found at 24 CFR 35, Parts A, B, M, and R. If a visual assessment reveals problems with paint surfaces, property owners/managers must repair all identified problems with paint surfaces in accordance with the guidelines of 24 CFR 35, Parts A, B, M, and R, prior to a unit receiving ESG assistance. Property owners/managers should complete this form to certify that all identified problems with paint surfaces have been repaired/stabilized in accordance with the guidelines.

1. Have all identified problems with the paint surfaces been repaired? O v e s 0 N o 2. Have all identified problems with paint surfaces been repaired using safe work practices? O v e s 0 N o

0 Not Applicable - The area of paint to be stabilized did not exceed the de minim us levels.

3. Was a clearance exam conducted by an independent, certified lead professional? D ves No D Not Applicable - The area of paint to be stabilized did not exceed the de minim us levels. 4. Did the unit pass the clearance exam? O ves No

D Not Applicable - The area of paint to be stabilized did not exceed the de minim us levels.

SLIDE 57

ESG-208

57

Name of Property Owner/Manager Property Owner/Manager Signature -

Date

Name of ESG Program Staff ESG Program Staff Signature Date Name of Tenant Address City State Unit Number Zip

SLIDE 58

VIOLENCE, DATING VIOLENCE OR STALKING U.S. Department of Housing and Urban Development Office of Housing

OMB Approval No. 2502-0204

Exp. 6/30/2017

LEASE ADDENDUM

VIOLENCE AGAINST WOMEN AND JUSTICE DEPARTMENT REAUTHORIZATION ACT OF 2005

This lease addendum adds the following paragraphs to the Lease between the above referenced Tenant and Landlord. Purpose of the Addendum The lease for the above referenced unit is being amended to include the provisions of the Violence Against Women and Justice Department Reauthorization Act of 2005 (VAWA). Conflicts with Other Provisions of the Lease In case of any conflict between the provisions of this Addendum and other sections of the Lease, the provisions of this Addendum shall prevail. Term of the Lease Addendum The effective date of this Lease Addendum is- . This Lease Addendum shall

--- -

TENANT LANDLORD UNIT NO. &ADDRESS continue to be in effect until the Lease is terminated. VAWA Protections

1. The Landlord may not consider incidents of domestic violence, dating violence or stalking as

serious or repeated violations of the lease or other "good cause" for termination of assistance, tenancy or occupancy rights of the victim of abuse.

2. The Landlord may not consider criminal activity directly relating to abuse, engaged in by a

member of a tenant's household or any guest or other person under the tenant's control, cause for termination of assistance, tenancy, or occupancy rights if the tenant or an immediate member of the tenant's family is the victim or threatened victim of that abuse.

3. The Landlord may request in writing that the victim, or a family member on the victim's

behalf, certify that the individual is a victim of abuse and that the Certification of Domestic Violence, Dating Violence or Stalking, Form HUD-91066, or other documentation as noted

n the certification form, be completed and submitted within 14 business days, or an agreed

upon extension date, to receive protection under the VAWA. Failure to provide the certification or other supporting documentation within the specified timeframe may result in eviction. Tenant Date

Form HUD-91067

(9/2008)

Landlord Date

SLIDE 59

Coordinated Entry/Housing First

Agency participation in the Coordinated Entry process must follow the Housing First model. This should include:

Completion of an exit survey and keeping records of all

completed surveys

Posting a notice in a high traffic area about the exit survey,

referrals, and reasons for exit

Tracking the number of referral agencies and types of services

provided

SLIDE 60

Housing First Model

Follow HUD’s model of Housing First Principles by looking for violations in screening packets or written standards.

Requiring as a condition of services: (these can be offered but not

required)

Employment, or income
Being sober

, or participation in drug or alcohol treatment programs

No criminal history (agencies can screen for sex offender status)
Non‐participation in service and treatment plans cannot be a reason

for eviction or exit

SLIDE 61

Financial Documentation

Proof of need, i.e. invoice,

receipt, payroll

If a service or utility bill; it must

list physical address of service (DV shelters can be exempt)

Receipts must list eligible item(s)

purchased, services performed, amount(s), and date(s)

Assemble receipts, bills in order

(preferably by payment date with corresponding CI invoice)

Proof of cleared payment
Copy of cleared payment or bank

statement clearly showing check number , date, and amount

Payroll debits on bank statements must

match payroll report total of net amount or copy of paystub

Timesheets
Last 4 digits of employees’ SSN
Employee benefits (insurance, taxes,

work comp., etc.)

SLIDE 62

Non‐Compliance

Common Errors

Missing required forms
Participants failing to disclose income information / inadequate

intake application

Missing household eligibility documentation, i.e. income and

homelessness

Missing documentation of case management and housing

stability goals

Utilizing net vs. gross income amounts &/or frequency of pay
Fair Market Rent and Utility Allowance calculations

SLIDE 63

Replacement back up

If ineligible expenses are found during a site visit, replacement back up must be submitted Items required in the back up are:

Replacement Backup form

http://www.mhdc.com/ci/documents/CI_Replacement%20Back‐ Up%20Form.pdf

Copies of eligible expenses incurred within the grant period

which have not previously been submitted for payment

Bill, invoice or other proof of expense
Proof of cleared payment
Household eligibility documentation, i.e. income and

homelessness, program consent form, and intake application.

Corrected HMIS or comparable database report

SLIDE 64

Replacement Back-Up Form - Community Initiatives

Instructions: This form should be completed in order to replace ineligible expenses previously billed to a Missouri Housing Development (MHDC) Community Initiatives grant (i.e., Emergency Solutions Grant, Missouri Housing Innovation Program, Missouri Housing Trust Fund).

Agency Date Grant Number Community Initiatives Program Total Amount of Direct Financial Assistance Total Administrative/Operating Expenses Total Amount of Replacement Expenses The following supporting documentation should be submitted with this form in order for MHDC to determine eligibility of replacement expenses: Revised HMIS report Proof of household(s) income eligibility Consent form(s) Proof of need Proof of cost(s) incurred Proof of cleared payment(s) I hereby certify that all information on this form is true, that I have collected and reviewed all required records to maintain, and that all expenses are authorized and meet the eligibility of the grant. Authorized Signature #1 Date Authorized Signature #2 Date

SLIDE 65

Resources

HUD Chapter 5: http://portal.hud.gov/hudportal/documents/huddoc?id=DOC_356 49.pdf ESG Desk Guide: http://www.mhdc.com/ci/esg/documents/2018/a/FY2018%20ESG %20Desk%20Guide.pdf Compliance Resources: http://www.mhdc.com/ci/compliance/index.htm

SLIDE 66

SLIDE 67

QUESTIONS

SLIDE 68

Contact Information

Denise Hoss Community Initiatives Compliance Officer Phone: (816) 759‐6642 Email: dhoss@mhdc.com Brooke Anderson Emergency Solutions Grant Administrator Phone: (816) 759‐6632 Email: brooke.anderson@mhdc.com Steve Whitson Community Initiatives Assistant Manager Phone: (816) 759‐6890 Email: steve.whitson@mhdc.com