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Home My WebLink AboutJanuary 16, 20139r~o Treasure.. Goast Community Action Agency 0 Martin 1U\'ItiORY RL),112U p14:1i1SF.12ti C Lnirnron Ilat 6xrx \I1uw-C;vdiner Rcptcu nhni; SI Lue)r (umily 1 nc-6.hun otan ISxrhxra I~cIUm Ri prCFfnlptg SI I uclc Count) ~i et chirp Yxc~ptl Uxrrcll Druu)nunui fit. Lncic County At)mn II. t.alpeppor t)krecltuDcc Cmmi}' '>, 1Vnxlln Klcsper Qltcechohec C:mutlp lila(nc Pawl dlnriLi Cuunl}' Rabnnalcl \'. Ilarnrm;e-nnll 1lartin C nunry~ len'e (ore, Sr. \hu1ht(bupty wf ttf Item cicnt t8res 1lctanic \lycrs Sh Cucic County tiheiix Siiragc ¢iteechuticc Cmuny lnipt C:ucaves dlxriiii (!uunh• ~~e~ ~~.~~ ADVISi7RY BOARp MEETING Wednesday, April 24, 2013 -- 2:00 P.M. Classroom - SLC Community Service Office ' ~~ ~M AGENpA /. Coil to Order _ __ (yV~~2 Welcome and Introduction of new board members ~~~ 3. Approval and Ratification of {'Minutes: July 18, 201F~~(} 1 ~ ~, ~ "' f~ ~ v_:c~VVK~ January 16, 2013 4. I,Aeceptance and Ratification of Financial Reports: , j`1/1b~207v July 18, 2012 ~+p'.~;{ C~.~=tnf;~Lt~ ~~0 October 17, 2012 ,~F.«.eX ~ ~ ~judGtt • January 10, 2013 /J J (j fY~d-GWc~~ClT4 0.1,~ (.1f~dtY~. Okeechobee -Sheila Savage 1- i`~`""n`~" Martin -Anita Cocoves ~~"~?"°`" St. Lucie -Stefanie Myers ~ t? 5. Oid Business Low-income Sector election results for all Counties ~~ v~' ~ Appointment Letters Y ~ Officla acceptance of new boar members 6. Neyr Business /• Review of Quarterly Report --~• Acceptance of Contract Modificaton(,(/~j~ f= / • Monitoring Report v Findings. 1/" • Response ` 7. Announcements • May is National Community Action Month - St. Lucie County Pr°clamation May 7, 2013 (a}t 6 pm ~~,~ : 8. Public comments ~pr~c~'W 9. Adjournment ~~ I ~ }'~ ~: /~ ~ Q4~, - ~'~ju.166~'i?- nlAxt maatinn U1ilI be Jufv 17 2013 -Please mark your calendars The Treasure Coast Community Action Agency's mission is fo partner with other human services organizations, the private sector and citizens to offer programs and services fhatbuild self reliant individuals, families and communities. }, Ed.PV~ ,-ltf:d2s~ t~i~ 1~`V L~i~L'CG~t.L,9 r [? ' ~ U '~ ~~ Cu;.~~,~•~ ~d-tlh.Ctn c~{ ~b~v(1474~1.e~ ~v l.~cb- ~ ~ ~t~ks~r~.~ n~vuti.~ :fix ~~~~: ~t_:ls~ -~ to-~-~c ~-E`~Y~~~ s _,. U -f__` --t-~ ~ „ ~_- j'-~ C~-~,~'' `'~-~v~~ct~~~- ~~~-~~ Lu ~~ ~€~C L~ ,~ (~ ~7 l,N„ !k~,lt,i u ~LU~.~, -f~:e,u.,,, ~~ -z~ x ~r~ /~ ~--/-? 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Sahtibanez St. Luce; Barbara Mason-Gardiner, Barbara Feiton, Darrell Drummond Members Absent; Martin: Elaine Penn, Claudius Taylor, Jr. Okeechobee: Linda Wilson, Bryant Culpepper St Lucie: ' None Staff present: Martin: Anita Cocoves, Albert Hill .Okeechobee: Sheila Savage 'St Lucie: 'Stefanie Myers, Sandra Gilfillan Others irtiAttendancet David Hall I. CALL TO ORDER - Ltuorum not presenf Barbara Mason-Gardiner called the meeting to order at 2:10 PM. A quorum was not present. 11. APPROVAL OF MINU7@S The minutes of October 17, 2012 were approved with the fiollowing correction to Section VI - second sentence: remove word uniform and insert "use of the TGCCAA logo rather than as individual counties," Darrell Drummond made a motion to accept the minutes subjecf to ratification by the full board at the next meeting: Motion was seconded by Barbara Feltoh. Motion carried 4-0. Introduction of guest €~avid Hall represehting the ihterests of the Northwest section of St. Lucie County:. III. FINANCIAL REPORT Financial reports were presented to the.Board. A. Martin County: Anita .:Cocoves Most of the CSBG #uhds are being used for salaries, Staff 1s working on several projects such as FBL .Care to'Share, Shelter Pius Care, .employment for,people in drug court, These programs do not have funding for staff costs.. Reorganization of -job responsibilities is being explored and'it is hoped that other resources may become available for`alaries so That CSBG funds can be designated for directservices. Ocean Breeze is going into foreclosure and it ls-expected #hat many seniors will need shelter/housing assistance. Stefanie Myers asked about outcome tracking far all programs. There was discussion ,~" about the ability to,report these outcomes as the programs are not overseen by the TCGAA Board, CAA Minutes January 16, 2Q13 ' i would calif "his. outcomes and characteristics. At this point, ali outcomes are tracked as CSBG funds are utilized to maintain the staff to provide the service. Confirmation was requested from DE©. B. dkeechobee County: Sheila Savage. ..Okeechobee is on target for full expenditure of their funds and continues to provide home support services to seniors, C. St. i~ucie: Stefanie Myers St. Lucie is using much of their funding for staff and utilizing other resources for direct service expenditures. Donatedlocal funds are used to assist seniors overcome barriers to self-sufficiency and independent living, including housing stabilization, prescrip#ions and medical care. St Lucie collaborates with other agencies to support employment, work search and medical transportation, childcare subsidies in support of parent employment/education, obtaining vital records and other identification so applicahts can receive medical care and obtain employment, support for. completing GED or post secondary education, and others, There is a new partnership in development to address. the growing number of homeless high school students who wish to finish their education. Christina Santibanez made a motion to accept the financial, reports subject #oxatifioation by , the full board at the. next meeting. Motion. was seconded by Barbara Felton and was approved 4-0. IV. OLD BUSINESS The Information System Survey from the National Association for State Community Services Programs was completed. The federal government uses this uniform nationwide report to document the successful outcomes generated through the CSBG funding. The IS survey report is completed using the final fourth quarker report with some minor adjustments to match the federal format. V. NEW BUSINESS A. QUARTERkY REPORT Each report is tabulated separately by county and then compiled into one, report for the CAA. The combined report was reviewed. The last page of the report contains explanations for deviance of outcomes from the plan. It was noted that the work plan goals are set the previous fiscal year-and. area 'best estimate' of what is expected: There are times when the actual outcomes differ from the arignal work plan. Adjustments can be made to the. plan goals at ahe mid-year modification. The modification historically includes an increase in funding comprised of the balance carry-forward from the prior year and an increase in funding; if available. ~*~. I Darrell Drummond made the motion to accept the quarterly reports, seconded by Barbara Felton. Motion carried 4-l). CAA Minutes January 16, 2013 ~u,rwwu,w al~[a,T delays. in being .monitored, this year's assessmenc,woi oe cgmp~er~u ui~uoi ~„G newest version of the guide. Based on the new manual, it is expected that some changes may be needed to the procedures and by-laws. Once the monitoring has been completed,' suggested revisions will be provided to the board. The new monitoring date is'stili pending. C. ELECTION OF LOW-INCOME BOARD MEMBERS Terms for current board members representing the lbw-income population in each of the three :counties expire this month. Each County must complete fhe democratic election process for, the position for athree-year term as deVineated in the by-laws D. PUBLIC SECTOR Appointment letters are needed from St. Lucie and Okeechobee Counties s#ating the person selected to represent the Public Sector. E. COMMUNITY ACTION AGENCY MONTH May is National Community Action Month. It is strongly suggested that each County. issue a Proclamation tb this effect. The-Chairman, Barbara Gardiner, and other members of the board should a#tend to accept the proclamation and provide information that would educate elected officials and the community on the contributions #hat the CAA makes for its citizens. 1t was stggested that an annual report of the CAA be prepared .that could be presented to the various BQCC meetings, VI. ANNOUNCEMENTS Sheila Savage announced her retirement in July from Okeechobee County.. Mer replacement will be Karyne Brass. Karen. is the fiscal specialist for Okeechobee Senior Services. VII. PUBLIC COMMENTS -None JIII. NEXT MEETING -The next meeting will be held. on April 17, 2013. IX. ADJOURNMENT -The meeting-was adjaurned at 3:10 pm. Submitted by: ~~~ `~ Stefanie My Approved by: J~~cn~ 122-(~tn~~,c~~.~v Barbara Mason-Gardiner, Vice-Chairman Linda Wilson, Secretary Note: Due to quorum related concerns, the meeting was rescheduled to April 24, 2013: RELEASE y Community Services :' FOR MORE INFORMATION, CONTACT: St Lucie Couaty Gunnnm~ity Services Department 772-462-1777 Faz:772-462-1703 FOR IMMEDIATE RELEASE Fort Pierce, FL, April t0, 2013 Community ActiotrAgenay Mestinn Announcement The quarterly meeting of the Treasure Coast Comrnuuity ActionAge»gy Advisory Board will be field Wednesday, April 24, 2013 at 2:00 pm in the Classroom of the Gotnmunity Services office located at 437 North 7°' Street (Corner of 7°i St and Ave D) Fort Pierce, Florida 3495t) - (772) 462-1777. Anyone with a disability rcquirhtg aoconnnodation to attend this tneeting shpuld contact the Safely and Risk Manager at (772) 462-] 546 or TDD (772) 462-1.42$ al least fo~~ty-eight (48) hours prior to the meeting. Cc: Fleather Young, Assistant Attorney, St: T,acie County Sheila Savage -Okeechobee Camty Anita Cocoves -Martin County YesDesk nscriuns.corn f" Sandv Gilfillan From .Anita Cocoves tacocoveslalmartin fl Ilea.. en : Thursday, Aprilll; 2013 3:58 PM _._ Ta: _ Renee Scott _ __ __ Cc: Sandy Gilfillan; Stefanie Myers Subject: FW: Please post the attached press Releaso for the CAAmeeting April 24, 2013 -Thank you. FYI Anita From: Donna Gordon Sent: Thursday, April 11, 2013 3:04 PM To: Anita Cocoves Subject: I2E; Please post the attached .Press Release for the CAA meeting April 24, 2013 -Thank you. ~~-ilrNuBOwLiq 1U'nis Gxb:rt W~6)w.fr~l~arlnr CmrurylW,r>U pl trNglY Cunuufainurr MONiixlS afnlr~virS qNY• 2d~AVFY1119H4aacmc[uw G4dUmm~y AUpni A4rrmyAM1y:v~ry Yana put wxra Mrernq _ u.,,. r. ~ .,1 nl?417 '1r. e:.n ,.e«ri~; si,c..r. ~~~a nno~:~ s ronl rl sl. t„~.,!„'IY< o., .,;y .. rrr .:i„rur s'-i 'o3e tr I 41 1 + li= i t t 91t E!1 x~l prc.nt~ N f nt.5• a¢1•n 4.<~r1ei of nj t 1 I iSRrei l /Yi t I l tf C? ;U..qa,{ {t 14h5p: t)JJI t(J~iTii A v. eL.v .ubhr nl 1 x nnu~a.r .l uvcs.d lnv 1 r ouN rl l~.e . lr nJ n.kN t+r er {; 7t: •to! 1 1 ~d lClii ri;,'I 1i+t IAe r~"c.[lee r, gar pl R)4Jnat .",Lr It's on the web under Events: "" """ Plus I will post tha Notice in our display case: tomorrow morning Donna From: Anita Coc_ovos Sent: Thursday, April 11, 2013.2:41 PM To: Donna-Gordon Subject: FW: Please post the attached Press Release for tfie CAA meeting April 24, 2013 -Thank you. Hi Donna! Can you. post the attached press release, thanks! Anita From: Sandy Gilfillan [mailto•oilfillansCa~stlucieco oraj Sent: Thursday, April 11, 2013 10:07 AM 70: Sharon McPeak; Anita Cocoves; Heather Young;. YesDeskcascrioos.com Ccs Stefanie Myers; Renee Scott; Cammy Treahor; Melinda Aviles; Suzanne Antonetti Subject: Please post the attached press Release for the CAA meeting April 24, 2013 -Thank you; 1 went Treasure Coast Community. Action Agency Advisory Board Meeting Page 1 of l Treasure Gaast community Action Agency. Advisory Board Meeting. _. bate:. Wednesday, April 24, 2013 Start Time: 2:00 pm End Time: 4:00 pm (Tme Zone: Us/Eastern) - Location: Community Services Office Conference Room Category; Meeting J 1Norkshop bescription The Treasure Coast Community Action Advisory Board (CAA) meets quarterly to' oversee the programs and budget for Community Services Black Grant funds for the tri-county area served. The CAA collaborates with human services organizations; the private sector and citizens o offer programs and services that build'selP-reliant Individuals, families and communities. The Advisory Board consists of representatives from each County (Okeechobee, Markin and St. Lucie) along vdith staff members and the public, Three representatives, one from each of the following categories are required. * One elected official, currently holding office or a designated representative thak musk be appointed annually by each County, * One representative from each County of the low-ineome population chosen by a democratic selection rcedure adequate to .assure thak they are representative cf khe poor in the areas served. * One representative From each County of business, industry, labor, religious, welfare or education interests in the county. The Florida Department of Economic Opportunity receives. aranuaily allocated funds. from the federal government, which are then distributed to Community Action Agencies throughout the state. CSBG funds are designed to provide a range of services to assist tow-income people in attaining the skills knowledge and the motivation necessary to achieve self sufficiency. * Financial education, including budgeting, credit repair, future planning, etc; * Identifying and accessing educational opportunities * Reducing expenses by utilizing available resources, such as food pantries, community gardens, and lost saving programs. * Asset development * Accessing local resources to help with job searches and improve job search skills such as interviewing. The public is welcome to attend. .Contact: Sandy Gdfilian .Email: comet infot_lastlucieco.orq Phone: 772-462-1777 Mare Info; http:d/wwwstlucieco.govlcommuniky/community action agency.htm' ,cation Details Community Services Office Conference' Room 437 North 7th Street Fort Pierce FL 34950 4/16J20i3 Sandy Giifilian To: Sandy Gilfillan Subject: FVJ: Please post the attached Press Release'for the CAA meeting Apri124, 2013 -Thank you: Fram: Anita Cocoves [t»ailto:acocovesC~martin.fl.usj Sent: Thursday, April 11, 2013 3:58 PM To: Renee Scott Cc: Sandy Gilfillan; Stefanie Myers Subject: FW: Please past the attached PressReleasE for the CAA meeting April 24, 2013 -Thank you.. FYI Anita ...From: DonnaGordon.•,. _ __._ Senk: Thursday, April 11, 2013 3:04 PM To: Anlta Cecoves Subjeet:RE: Please post the attached Press Release far the CAA meeting April 29, 2013 -7hankyou. ` Ihn l4XowBrp ilr;msGstid lxAUW AM HuI'n1 i:.lbntY lM)tltll 6l t:4unry Cairoidtiskiw~i MpuUnUs ur~d tvtuLx aNy. ' 2d•AIMtOU13£#GtA6u/!!Sads{Cnmit.rndtY MYkwt Aye-cy Mfrdvrry 9e9U Vni lNianl NW;tGrq ..y~Dr:o Cleew.am rzl to"f r ~'f :!„~'A U14q-13/+iSgh. AG i:.:?bK:' Si thin Cahn{y Gv.vfimnly SCrvt'.q i)Zd62.t) / f C ne.pBitn ilggtd`InrF'rtirvc ,tingfq? Gmf Camr,ap )nr nya+.o..rn n a~ ~ 1v;,+t~, luo ryeu rc< me It's on the web under Events: Plus I will post the Notice in our display case tomorrovr morning. Donna __ - - __ From. Anita Cacoves Sent: Thursday, April 11, 2013 2141 PM To: Donna Gordon Subjects F1N: Please post the attached Press Release for the CAA meeting April 24, 2013 -Thank you. Hi Donna! Can you post the attached press release,thanksl Anita i St Lucie County Florida Otiline ~~ Home I waNT TD: AAd9 FOr I. a"t Gmnmmem Censil Eonalpttiwrs Fads and Slats (dads COdo Ct iiip4uocd ~~ ~~"_ .L..,__... ..._-.. ~~~~irylb4cntlons NEWS: Page 1 of 1 ' oP 5 t 'ti B "Il dose al the '---"-- --'-'-'- -^ Find ~~ ~ • end c/business an Fdda p., y, April28 and vAll rro =n Pay far ""° 'V'' r ~ < on Wptlnosdny, Juna 5, e5 cielvs remove Iheold .... ..... .... TaQecTlll 5 `". s caryel a0d mslall new Ooodng. Libraryusers aro Rebate ~~~~ ~~~~~~~~ ~~ Business ez eteip ~ eatoumged to utilize the MOrningslde Branch Get HaIP `h5(h TduristD ~.Y~i~f~~n~fl~2410 Mmningsitlo Blvd. Port St. LUde) as well as the Pmfll Campus Library .....:. ........ _... _ Va'atd , . Aiarmpe T `(~'o ~ifV Calilornia Blvd, 5l. LUUe Wes!) ,'_~2ead More Hunting&Fishing ABGUT US: Real Estate &ProVady - .- .. ~aAUNTV CALENDAR -Ghlid Su LEARN WHY TEENS KILL MAY 2 ? ps p . -.--F -_,... -:. .. TfaNlo Cllalbns Phil Chalmers,Amodcas Ap I201a Tw6y aJ Ald To wU. Th N' se dJ 1 E t i Q 4 Z t s 14 _ 1t ':u- L }~ 15 16 i Ia. g gp u ~ ~ u ~ z u i ai gs ~ a ~ ? 4 t 'E: 14 ll leading mdhonty anrLvenlle homlUtle and plvonpb mass moNer, will be providing o IYAe pdbsdpfase0lehon,"Wny Teens Klil,' en Thursday, May 2 a10 p.m aUhe Haved L. Fenn Canlof, 2000 Virginia Avo., Fotl Pie2o. Storm lntormmton ~_}taad Mare ReCOlds ROgUOSlS .-- ....... ........ ..y1aVl lha Full6alandaf Press Reiaases FROM THECOMMiSSI ERS .. . SLCTV PROGRAMMING A~ a ai B tigds ;!{ 3 Daar Resltlelt 8 Visitors: Click below ror the latest prograins:. SL YV bn behalf of yo. SI Ldde BDGC Mdoling "°° "" "'""' a count Cammis5 ers,l iota Aipdm a Ggvainnahl Links Y PffiT Maegng -~~~^~~~ ~-•~-~-- ~~~--~- am pleased to Wal ayou BCCC Calendar Cotlo Matting -.___._ ....,,--- Io SL LUda County Onilna!Thla WOb is ---- Insida SL LUUa Ail Al naiOS Arb Agentltls ,,,,,,,,,,,,,,_,_-. _,;': _. youf source fonlelVS antl udonnaYOn LacWre Hall Curren) IIGCG Ayanda rela11n01o S6 Lucie Gdanly,... • Cglfee wlih the Chairman - Ppslcards /rum Home _Raaed More -:;jdora Vitlaoa on Remand Wad, Apol?4 2013 _. Home) Contact Ua I Sita Map I Lhdt Raqueet Policy Idvr on.Mawaa,m I Ge/imwydq knyA r.awa : I Q 20t3 St. Lu4o Cpunt~~lOride, ~tl risghls rosarved and other copy) i apply. 6 AI~ .OOP W venoms PeiR aM Campplwik- Nata ifndar FlarMalSW, efilmi addrB=SOS art Ba bliar~rovvrrcpir s. e~es~~~nM1dO0 ~~~IievraaltYl Your tCLefdv m deSl do fl d eb lL l9 llO 1 1P1~~ y a mdtl atldl li l0aed in reaponae loepubllo j - h dii t , g p 00 c Q n a S entit lnst2aG, tonta O I M G p tt i s p far or. rl vr ng. B O AM~ 2NP Q51. LU a County GMry. fivifklca b,arcJl 6NNO1 PtluVMM s3o AM -- TuawmCeaal Community Action Apancy Advbayaovd Poedly fraMY YWrs Heeling 10]OpJA-11:00 AM®eL UMM Wunly pqualW m l-0alornq ~ no-enbatl Ematl RamIM Ore SlrviAaonlen yAOrlm EaM1iM ~....__ ,-- 1 mra:wra. ap xd. zora - I ' Tmc 200 PAI.9Op PM Lacalien:CO,nmunay Salvkps PHke COn(moree Foam calagpry; MaeanOt WaYtaMy besulplian Thb Ttea(we Gaul Carvrvvuly Klan AJriury OoatE (LMI iweu Am lblryleevoraealM pw•wia eM WigelW Canvnunlry SerukpfaKKM deMMwAe MlM hiceunry alas e eivW. _ iM f.Ai rN M _ w,i, F,m. ,. •_.. hitp:/lwwwsthtcieco,gov/ 4!23/2013 Treasure Coast Community Action Agency Advisory Board Meeting Pa e 1 of 1 g Treasury Coast Community Action Agency Advlsyry Boerd Mooting •>~~ Dote; Wed, Apr 24, 20t3 A~~ .. _.. _t ....,..._.._, .e. ~.e .... _...,_,. _,a ,a__w._ __ Lacafign: CommunityBervicesDfficeConlerenceRdom ---.- -- -- -- --- --- -- Category; Mewing / Workshop. bescflPtioh Tne Treasure Coast Community Acgon Advisory Board (CAA) meets gpageriy to oversee the pfogralns and budget for Community Services Block Grbnt /ands for the td-county area served. The CAA collaborates with human services organizations, the pmale sector and cigiens to otter programs and services that build self-reliant individuals,(amilies and commun(Qes. The Advisory Board csnslsis of represenlatves Irom each County (Okeechobee,Marlin end SL Lucie) along vnih stag members aetl the public, Tbreerepresentalives, one from each of the following calegones areregmretl. 'One sleeted ogidal, currently holding ot5ce or a designated represehtahvo Ihat mustbe appointed annually by each County. "One representative tmm each County of iha IoW-Income population ghosan by a democralm selection procedure atlequata to assure that they ere representative of trio paorin the areas served ' Ono represenfativyJrom each County of business, industry,labor, religious, welfare or education interests in the county: The Florida Departmen(st Economic Opportunity recelyes anrualiy allocated funds from the federal gdvemmeni wh(ch are Then+iis(ributed to Community Action Agenciasahroughoul the slate CSRG fuetls are designed to provide a tango of services to asslsllow-Income people in attaining the skills knawledga and the motivation necessary fo achieve self suMdency. '. ' Financial education, including budgeting, credit repair, future planning; etc ' IdenUrytng and acaess(ng educaflonal oppodunitiss 'Reducing expenses by ugiiiing available resources, such as toad pantries, community gardens, and cost saving programs, 'Asset development 'Accessing local resources to help with job searches and Improve job search skills sucfi as interviewing. The public Is welcome to spend. Contact: Sandy Gilhllan Bmail: wmm Info/~sgcciew o Phyna; 772-462-7777 More Info; hba~IM1w,w siluc' ov/communitvleomm '1 t on a enev M a Location DeWlls G 5 Community Services Olfice Conference Room 437 Notlh 7th Sireal Fort Pierce FC34850 about:blank 4/2312013 St Lucie County Florida Online ~~ Home Page 1 of 1 IwANrT° ~ .= PSL Library Closes -' Krn3""' '" "'~-' and of business air rnday, April 26 anQ 1NIl reopen ----- --~---.-~~ ~ ~ •-- Pny {or -~ car Wednesday Juno 5, na wows Nmdva the old ..-:- .-- ..... .. .. .. ... - carpal sari hlstailnoyi lroonng. UbrBiy usersare encouraged to ul hzC the MomingsidC Drench Gel Help Nair+ ...... ............. .... s . Linrary DlanGl CF4Itl MdmhiOSide Dlvd, Pen 5l. LUae}ns well as the Pmlli Campus Linmry .- .. ylatoh 1500NW Caftomra Dlvtl, 51. Lune NMsry [,jtead Mnre' neburus: - -~ _,-,_ ,,, , , COUNTY CALENDAR LEARN WHY TEENS KILL MAY2 rno Phil Chalm4rs, Amenaa's _. _ Agilzsu leading atdhonly On }uvenile , CVmM'tJlla a1014[ef6 Tadx/ ~` homiade and luvenilo mass •.,•... '--.- - hasis rrd Fm6s 6u TAO iu Yto m ry. sa nwrnef yrllt be pmvidng a ..... .. )1 1 5. 7 0 ~ ¢ , ' Lmrs P. Coda fonip!iantd T a, T. 3 ~ LJ !? hoc puuijc pre:enla(ion,'Wny Teens Klll," Puopwlmns 1 4 iA }g 14 ?o Cn Thursday, tytay2alGPm al the leaven ~ ~ i ~ ~ ~ L. Fenn CCnlrz(. 2000 Virginia Ave„ Fon - NEWti: L ~ ~ _.. ~. . d. ..Pierce - - Sla'nr m[crmdean Qtcdd Mmq Recnras Re}ae~wx , ...._..._...._..-._-._ - .-~hw tiro FUll Garet ar Hess Re:eases pR(7M 7HE COM `STONERS SICTV PROGRAMMING Fan dD ~gPis "" U?ar `dw}LS&Ursdats: Cdsk Wotan foe W4lalesl ptanrams' St Civ ~ ~~~ - ~~~ ~ Orr bah far your 5l Lurie DOCC Meoiing ~~~"Lxal Meal Gomnun nLrYx-~~- ~ County nmrsstwlgrs.t P&Z Me®ung °~~--~~~--°~---"~--~~-~~--~- 80CC Calendar - am ~4a IP weimnW you - Coda Mooting '•' ...-_-.... ..... ......... 3. r . I45L Lnfaa (.'9nnly Llnl ITh1a VlCbSi1@IS h151da $f,LUbIB Ad f.I nYl4Saw AgendJY ._ ., ___.,_._„ ", . . year sauea (or news alx nfamalidn lecthto Hall ' - Cwrnnl P,bC.C Ag=iota mlaung l0 54. Lu44 Com - , CoILW YAIh 1119 ChAlnnan - ___ -~_2ostcards from MOmB - _._ W+I APIe sn. atria ;. Home } Cennl4t US I Sita Map } Llnk ftequeai[ Policy , ca„m nE 2013 5E Ludv Cou et~+ I Nole: Under FiPdea Caw, a-nwil addtesses~re ~u~N records request rid nw send ~lecfroni e,wrti P(4 Yld}+,ds an Demand BOe,d OrAd;usNYenl B as NA Fvedrq F cur i _- _ -_ - __ tOMAIA t10a AII~SLLw L MMvarun lealuma Ne SrNms iM hx6IrA1 mcoaslc vnny acuon ggcicy Advisory amrd B [bn(bsd Era Remy care: W<d Ap 24. ]ale e's) Tlma:~ad PM.l ae PM i Locanan:cwmaMry Senl~xNfw GS,renrce RoaP =t1 Gte9ory: MeaW.d NlaluuP '.4~ wztripwn j E~ nw i ruxvo Coazl Car++wn:ry heal Abnxxy Bdvd ICMt mopes quedary b aTmra+Iln papmrp a+.i pu6Ae1 is CNm,etirySMu}n el kUraMfuMStp+ta iduonry uca sonm +'>d ~rvbM.o,acwne. M.man ~ui.m.srcmrvnrw.• m ~ httpi//wwwstlucieco:gov/ 4/2 312 0 1 3 ~''~'- ~ 2401 S E -MONTERE April 2, 2013.. oouc srAlH ~Gmm~5l~GPei gi91(tCl ED FIELDING Camntssloner b~sincl? ANNE SCO7T Cgmmisfongr brsled 8 SARAN NEARb CG~Tmi59a~e+. UKi+~CI 4 :tnHN nnnogx Ca(nnk5$Piier D~s4cct 5. IARYN HRYGPA. CP1A Caunly Atlmin~sUalN) 1ELEPHONE /ti•TEG-5tU0 V/E6 APPRESS nits n• , wr magn L ~_. ~. y. J141"T IiVAVI1V112f51U1V 77itt7 ROAD • STUAR7 FL 34986 Telephone. 7TL,221,1352 1''ax~ 771.288:5432 EmniC dggrdonCN'mnrtin.fl:us ,,R~{{ cabondel ~`. Hargrove-Hall tf C' )SE;L,ethaCircle trt FL 34994 ear Ms Hargrove-Hall: TlTe Board of Goimty Coinmissioncrs, at thew April `L, 2013 meeting, approved your appointment to serve. as a representative on the 'IYeasure Coast Community Actipn Agency Advisory Board. Your term on I.he $oard will begin April 1S; 2013 and expire on April 17, 201G; The iVia>ain County Board of County Commissioners retains the ;right toremove, at will; any. appointeo tD a Board or Committee with or without cause. The Staff Liaison to the Treasure Coast Comcuunity .Action Agency Advisory.. Board will contact you regarding meeting dates and times. Enclosed for your review is information regarding Florida's Government-u•the-Sunshine Law. The Board wishes to extead its appreciation for your interest and willnxgneas to serve in this capapity. Sincerely,. ~. ~~~ j~~¢~~ Sarah-I-Ieard, Chair Board of County Commsyionary SI-Tldg c Anita Cocoves, Ph,D„ Health 8c Human Services. IVlauager & Staff Liaison adn52013L25Zdocx BOAR17 OF CQtIivTY CC)Tv1M15S10NERS g4nt S.E. MdNrEREY ROAa • STUART. FL 3A996 Apri12, 2013 Telephone: 7T2.2L1.1352 Fax: 772.288.G~l32 Fmeil: dgrn•don~?martin.fl,us oouc 3MItN Cammr95roner DrsPoel t F.0 FIELbIN(i Lanmss~oner. i151rkr 2 ANNE SCOTT Ccmrms5ronsr D51bc1 ] SARAH HEARO Ccrnmias~aner D!sb21 d ~oHN IIADOOx COf11m15910PFr Dr514G15 7ARYN KR Y7DA, CvM Caonty pdm~msvaiw TELF.PMONf: n7 lbb-`aa{~ WE9 ADpftESS is . Jerry (rare, Sr: ntecostal Church of Crod ~ Sli Lake Stieet zait, FL 34994 ar Mr. Gare~ e Board of County Commissioners, at theix-s~pril 2 2013 meeting, proved. your appointment tp serve ae a represerttative on the Treasure ast Community Action Agency Advisory Board. Your term on the Board tl begin April X6; 2013 and expire on April 17, 2016:' The i4lartin County aid of County Commissioners retains the right to remove, at will, any pointeo to a Board or Committee with or without cause. Ie Staff l,iaisan to the Treasure Coast Community Action Agen.c:g• 1ldviso%y yard will contact you regarding moeting dates and times. );nclosed for your view is infoiuiation regarding Flozda s Government-in•the-Sunshine Law. ie Board wishes to axtend its appreciation for your intoreat ani3 willingness serve in this capacity. Sarah Heard, Ghair Board of County Coramiasioners 5Hldg Enclosure c Anita Cocoves, Ph.ll., Health & Human Services Manager & Staff Liaison ndrn20I9[257.decv .~. DOnG SMITH Cummsnrope~ DlLUlil I [D GIELDIN6 Comm~ss~oner Gis(r~n 2 ANNE SCOTT Gammisslonuh Disinci ;t 5ARAH.HEARD GUIQn1R]1On$i I1i511R1 A JOHN NADppX. CnnmgsioiiY.r -0islncl ~. TARYN KRYTOA, CBM CuwIIy AUnlirvsnaml reLCvNONe 77?~?AlG54D0 YJEa ADOfjE55 '+Ilp!: • nv mail ^ 0 os ovr~nvs~r ~.vurv'1 z vVD7M1~>S~1VNL1t5 3dD7 S.E. MON7BREY ROAR + 57UAR7, F4 96998 April 2, 2013 Telephane~ 772.221.1362 FRx: 772.288.6432 Email: dgordon~martin.R.us Ms. Charlepe tlakowsky 613 Sh; Ashley Oaks Way Stuart, FL 31997 Dear Ms, Oalcowslcy~ SH/dg IOn behalf of Martin County, please aocopt the Board of County. Commissioners' sincere alTpreciation for your service as a member of the' 1Yeasure Coast Community Action Agency Advisaxy Board. you have done an exceptional job for the County, Ind we do not want 3~our dedicationand efforts to ga unrecognized, Community minded people sucl>< ae you ars indeed an asset. Please accept the enclosed Certificate as a gesture° of our tribute for your time and hard ti~vork. ' Sincerely, Sarah IIeard, Chair Board of County Commissioners (Enclosure c .lnita Cocoves, Ph.D., Health & Human Services Manager & Staff Liaison ndm2013 L257:docx s !Martin County Bor~rrCof county Commissioners 1 Irz reco~nr'tion of your outstandzng service to the citizens ow f ~Ylartin County t(zroztgn your~~nCurztctry efforts in su~lport of tFe ?reasure Coast ~ommunityActionA~ency .1~cf~sory hoard 1'resented~ tlxis 2nd day of ftpriC2o13 Sarah Jfear~! Chair B0AR1J OR C0LIN`1'Y COMMIS 2401S,E~ MONT€REY ROAD • STUART Fl ,l~ iprIl 2, 2013 DGDG SMITH /.0IOrT15$140EI, Dlsipcl 1 EU rIELDING Cartim~ssmrwc:DSlnif2 r.Cy,,~~laudius Taglor, Jr: ANNE SCOTT r1O L&St. lOttr Street fmnmss dne![52[r c13. tuart, FL J~9~J4 SARAH HEARD [:arrtnnsz~ur+ei...U,elrcin .ear 1~4r. `1'aylOr~ >IVl•;xs Telephone ^+72.221.1352 Fax. 772:288.5982' ~mail~ dgordonCTnartin.fl.uy JDHN HADDGX cnmmiac~nner n~sir~ls n behalf of Martin County, please accept the Board of Crntnty CCommissioners' sincere appreciation for your seTVice as a member of tha (freaeure Coast Community Action Agency Advisory Board. 7ARYN KRY2PA, CPM co~„elp namavsaaidr ou have done an exceptignal job for the County, and we do not want your dedication and efforts to ~o unrecognized. Community minded people Ruch as 1 you are indeed att asset. Please accept the enclosed Certificate as a gesture of our tribute for yotu• time, and hard .work. ~ fLC -~~ ' , Sarah Heard, Ghaix Board of County Coinmissinners c Anita CocoveR, Ph.D„ Health & 1•iuman Services IVlanager & Staff Liaison' WEB ADDRESS 'nlp ~.v',w-alarm-l)s adm20131252ducn hone: 772.221.136`) l+ax 772.288.6432 mail: dgordonQmartin:fl.us ceept the Board of County se>tvice as an alternate member cy Advisory Board: nty, and we do qpt want your munity><ninded people such as closed Certificate as a gestuto L=,~===U vA vv u.v~ r vuNiM1551UNF.RS 240i S.E, MONTEREYROAO. BTUART p~ 349@S Aprt12, 2019 Telep OGUG 9h11TH - I Carom ss(unN DISInUI i ED EiEtpING Co nm sz:o~+el Dau[t2 Mr, llennis Killla commase ei usin~ra 792 SW Shady Lake Terrace alm City, N'L 34990 SAq AH HEAftO Lon•,imesibnlr.. D.,Inq ^.. ear IVIr: Ifilliia: JOHN HAeOGX c°`"`"ss°'~` °i~I"`I~ n hehalY of Martin t'.ounty; please a Gommiasioners' sitieere appreciation for your fthe Treasure Coast Community Action Agen TAp YN KRY20A, CPM Couory Adm nsl.dtw 'ouhave done an eXCeptlpnal jeh £Or the COU dedicatimi and efforts to go unrecognised. Coro you are indeed an asset. Please accept the en of our tribute for your time and. hard wor&. Sincerely, ~~~~~~ Sarah ?`Ieard, Chair. Board of County Cvmmissianers ISH/dg Enclosure c )nits Cocoves, Ph.D:, Health 8z Human Services Manager & StaffLiaison TELEPHONE ~t2~25g54W WEB Agt)RE55 ~e~~ M1IIp i1Y, 'AM /OSt(iq 11 ~' li '. ndm2U13L257.doax "'^. ,9~i'artin bounty ~]3oariCof'~ounty ~ontnissioners In,,~ppreciatian 2'resented to Dennis ~iCCzCa In recognition ~f your outstanding service to tFe citizens of ~2artin County throug(z yoaar vo~antary efforts in support of the Treasure Coast Community Action Agency ,Advisory ~oarcC ~'r'~sented tfiu ~~~~~day ofApnC2nr9 SarahJCeard, Chair ~- ~._~~_--s-_-___-_ ---_ _ ----------- -_----------- - _. What Gvety Beard Member Needs To Know About Outcomes by Positive OutcomesT"' Eleanor Hunnemann and Frederick Riohmond, partners Introdua#ion: America's public policy oycles are nearly a0 years long, and as a society we are nearing the peak of discussions in this cycle about how we treat the poor. Deoisions we make in the nexttwo years will affect flaw our society delivers services to low-income people for the next three decades. '['herefore, whafyou do in your role as a member of the Board of Directors of a Community Action Agency will have historical impact. Our current naHohal discussion about the responsibility society has to low-income peaple coincides with the new emphasis on Results-Oriented Aceoanfability Systems, more familiarly known as Outcome-Based Management. This focus on results began in the early t970's, but agencies needed new tools and new understandings to implement the emphasis, Now, 25 years of experimentation has produced modals and knowledge which overcome many barriers to using the new techniques. As a board member, you have a unique opportunity to support and preside aver potentially 'T fundamental changes in how your organization delivers services, manages staff; collects and stores information, and most importantly, uses its new information to advocate on behalf oflow-income people. The reaLpower of the results-oriented techniques emerges when you use your data to convince funding sources, lawmakers, and policy makers about improvements that can be made in the way`our society uses the dollars it allocates o assist low-incorrie people. Correct application of the techniques will'empower your agency in its mission to stimulate, focus, and coordinate available resources to eliminate barriers to self-suffteiency' Bastes for Board Members; CAAs may tre effective...butcen we prove it? Resuhs-Oriented Accountability shifts an agency's focus frotm the actual delivery ofa service to. wlfat hirpperrs to the client as a result of the service, Instead pf asking questions about how fast or how nftan we deliver a service, w8 now need to knew haw effective the'serviee is. And we must be able2o prove that the desired result occurred. For agencies whose mission is to help low- income people get out of poverty, this shift in faces has tremendous consequences, The road out The Management and Technal Assulancc Publication Series is supptxlcd by a gram from the Pennsylvania Depanmem of Cummwmy and [catwmic aerelnpmene, aurcau afCommuniry F.mpowetmrnt. Petmissionis grained muse this ankle viii ilie ralka~mgeujiian Ifunnemann E. 4Y , aRd Richnpnd, E; K., Irhn! Ereq~ Banrd AfemberNceda To Xno1v,16out Oirtca!lles. Community gclidn Assaiatian 61 Pennsylvania Manag<mcm and Technl®I Asnscancc Publication Serea ~imiber 7, Ilatrisbuig, PA: ®Cumrnunily Acljon Assaiatwn of Pennsylsania. i y')G- Community Aetinn Association of Pennsylvania 4 4_ of poverty takes many years for most ofthe families we help, but our agencies depend on one-year grants to operate, How can we prove that someone gets out of poverty in just one year? Our one-year grants also harry additional restrictions regarding income ceilings for people receiving our services. For manyof our programs, the limit is 125°!0 of the rederal Poverty Line ($1,625 per .month for a family of four), How'can we accomplish our mission of helping people get out of .poverty if we can't even assist people until they are ful-y_stable7 Many community action agencies. provide volunteers and staff to support community organizing activities and community coalitions to foster institutional change. Community-level changes oecor over many years, as a result of a variety of influences: How do we prove that our agency's strategy helped achieve the desired change? Our staffs previously counted the units of service they provided, such as how many meals we served, how many homes we weatherized, or how many'people attended our training classes. Now the staff will be required to count the results of our services. In other words: how many people ware no longer hungry because of our meals, hoW much did a familysave on their energy bills after we weatherized the house, and how many people got jabs after their education or training was completed. 'What burden will the additional record keeping have on our staffl. How do we tell if that effort is worthwhile? When viewed from the perspective of results cost-analysis, our services, on face, appear more expensive. Properly tracked, the casts of our results will either be defendable or will point out areas where we should establish priorities for program revisions. Staff ale accustomed to counting and reporting large numbers of peoplo served, but the number of positive outcomes achieved during a report period may be re]atively low, while the unit cost For the positive outcomes willbe comparatively high. It is important not to panic. when we first see these numbers, but Team instead to assess and interpret this information in the way it is intended, We must calculate the savings these outcomes produce for our community and our tax base. We must took at performance rates for.. other providers. We must look at t}te relationship of our programs to otherservices provided in our community, and we must demonstrate the effectiveness of these connections. The transition to rasdlts-oriented accountability forces us to explore the context in which our. agency delivers services. Community Action Association of Pennsyivania 4 d` J~ Changes a Board Member Should Expect: The transition to results-based accountability will affect every aspect of the organization, and may ultimately raise queskions about the agency's mission and services. T7reinost important Community Aotioa question of all is "f-Iotiv many low-income people became self-sufficient because of the activities of our agency?" A healthyagency can withstand tfiis introspastion, meebthese challenges head on, and be firther strengthened by the process. The first area where you mig service. Because staff will o they will need to create an er staff and provide necessary f outcome information. They many need to shift the hours personnel involved with the and holiday parties as ways t ffduringkhetransifron. Some staff new paperwork is an unfair burden on the clients, while still odrers will think the new system promotes "creaming" by targeting resources on the clients most likely.. to succeed: 'Perhaps the shongest resistance will come from staff who derive their personal ttiotivation from the Focus on their own efforts to help the client by solving the client's problems forthem. These enablers lose essential. motivation when attention shifts to what the client does a$er the service is provided. Finally, the kind of reports you will recalve from the staff will change as the staff members undergo a major change in how they collect and report information: When we shift from counting units of servieg to counting outcomes; we must"shift our defrnition ofsuccess and failure during the> intcrpretation of our data. If staff feeCpressured fo produce high numbers of positive outcomes,' they may choose immediate or short-term outcomes wish little community impact and small returns on investments. This short-sighted approach will compromise the value of the outcome information in your advocacyefforts. of Bible change in the agency is the way the agency daiivers measure what happens fo the clienEas a result of the service, Went in wfrich the client is motivated to keep in contact with the k. Staff may use different intake forms to collect baseline .e survuys to monitor clients' progress towards goals. They ;ncy is open, the locations at which services are offered, and the Some agencies encpurage support groups; Workshops, picnics, ad the communal feel of.-their nartnershins: Another thing you might notice is strong di will resist the changes in the way services a measures are a ploy to evaluate their on-the Communty`Action Association of Pennsylvania 4 What Board Members Can Do: A supportive board member realizes that major changes-are oecumng in the organization. Change isn't easy for our clients or our community, and it certainly isn't easy for our staff 'Your senior staffwill need your help,in providing an adequate timeframe for the ransiti6n and'an appropriate training program to help staff overcome these obstacles, Dependingon the number ofprograms your agency operates, your timeframe for transition can span several years. All members of the staff will need some orientation to the basic concepts, and your program, frscal, and data management staff may need on-going technical assistance to help them over the tough spots: Thu sooner your senior management can'make the transition into the new way of thinking, the sooner they'll be able to respond appropriatoly when funding sources put pressure on the agency. But remember, a realistic timetable is more. valuable than one based solely on ambition. :ri Theburden of maintaining service while changing perspective and techniques will be immense for stall :You can provide requ{red lead@rship during the difficuh period ahead by staying informed on the state and national trends pushing your agency in this direction. You can reinforce the agency's strengths, and you can provide support for the. staff as they form new collaborative efforts with other service providers. You can help your funding sources understand the road to transition that your agency is taking, and you can advocate'in new ways with your-new information, As a CAA board member, you can shape your agency's course,'supportend guide your staff as they adopt results-oriented accountability kechnques, and provide the resources that will permit people to move out of poverty. You'll soon realize that agency procedures covering confidentiality and data management will need to be updated to include new processes that produce outapme information. Job descriptions will mast likely change, especially as managers and supervisors are delegated new responsibilities for tracking and protecting the new data, ,And, with an ironic twist, you'll notice that your newly trained staff will have gained skills'that make them more competitive in the marketplacebf non- profits and local governments thatseek people who understand and can implement results-based technology.- Your agency may have to adjust its pay scale to keep'your shining scars. The Yfanagement and Tce{inical Asstslanc< Publieatlon Senea is supported by a gran! hum the Pennsylvania Departmentof Community and Ecorioynic Develrymem~nureau orCoimnunity Pmpoxromtem. 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Sj O. w p o pOi ~i.. m~Y `gym '~ ~ ~ ~ m ~ ~ ° ~ ~ 2~ ~~ ~ ~ ~ S ~f4 ~ ~' 3 ~ ~. , qp ~... N 10 (S(~~ f9Q O •' m N ~ N ~ ~ ~ C ~' ~ ~ ~ - a ~ ~ ~ ~ NN N ~ -m. ,'3.2 ~.~ 2 m -~' . -~ ~ ~ f0 ~ m -. N ~ !0 ~ c ~ ~, a o ~ 1 ~ ~ ~ ~ u' ~ n 3 ~. nC,w m ° N ~ ~.. ~ ~ d O '~ @@ # P~ ~ ~ ~ N Zt N ~ ~ N ~ 3 ~ 3 ~ ' `" 8 J ~ ~~ c g ~ ~ m ~ ~ ~ o ~io n~ n ~ ~ ~ ~ ~ o c ~ ~ ~ m ~ ~ ~ Flick Scott GOVERNOR Jassy Panuccio EXECUTIVE'nIRECTOR OMIC``OPPORTUNITY' RECEIVEDBY __ MEMORANDUM FEB112013 &t. tude County i` FROM: an Amison, Planning Manager mmunry Assistance Section DATE: February 5, 2013 Sl1BJECT: FY 2012-2013 Community Services Block Grant Matlificafinns Holulnp 6 Community TO. CnmmuoityServicesBlockGrantReclplents < $arvlces The Department of Economic Opportunity (DEO) is actepting madif(catlons to current 2012- 203 Community Services Black Grant (C58G} contracts. Tfiis modfflcatlon incorporates atlditional Fy 2012-2013CS8G funding and carry-forward funds from recipients' FY 2D111-2012 C58G ton[racts, if any. Please take this opportunity to review your current fiscal and program status and revise your budget and work plan in light ofyear-to•date fiscal expenditures and program accomplishments. Please note the following budget summary riiodlfication requirements: The Amended Attachment GScope ofWork/Work Plan requires explanations for line item changes that result in a decrease from the9rlginal expected outcome. Modifications received without these explanations will not be accepted and will delay receipt of any additional funding allocated to your agenry, The Instructions and forms for modifications to Rmended Attachment C, Scope of Work/Work Plan have been emalled to you along with the electronic Excel forms far Attachments B-1, 82, 8.3 and B-4. Please submit the modrflcation to the Department as soon as possible: The modification will be effective when bath parties havesigned it. Mail two modiflcatian packages With otiginal signatures to: Florida nepartmnnt of ECOr 998.FI.A2815 a5a.216.7t05 An equal opportunity employorlr lelephona numbefs on Ihts d nic OOportumly Tne Caldwell 8ulidin9 107 E. Madison Street Tallahasaea, FL 32399-1129 859.92La22a Fax www FloAdaJobs.dra www.Iwiner.comIFL0E0 www,(acebdoa.com/FLOEO gram. Auxitary altla and servlcea are evallahle upon request 1d IndNiduala wtlh dleabilibea. All vdca ument may be reached by persona using TTYROD equipment via Na Florida Rairy Service ap751. -; ~_m Page2of2 Ms: Jean Amison, Planning Manager Department of Economic Opportunity Dlyision of Community Development Office of Nousing and Community Development Community Assistance Section 107. East Madison Street MSC-400 Tallahassee, Florida 32399.2100 In addition to the two hard copies of the modification package, send the Excel forms to ROn.IynnCa~deo.myflorida.com as an attachment to an email, If you have any questions or if you have not received the electrohic forms by email, please contact your CSBG contract manager at X850) 717.8450, by fax at ~$SO) Q88.2A88, or by email JA/sI 4 Recipient") to modi#y UEU Contract Number I.iJt3-kL-It-uu-U[-ut~ (°[ne ngreemem"`). .WHEREAS; the Department and the Recipient have entered into the Agreement, pursuant to which the Dopartment has provided asub-grant of $201,92( to the Recipient; and WHEREAS, FY 2012 carryover funds are available to increase the amount ofthe funding granted tothe Recipient; and WHER)iAS, additional funds have became available to increase the amount of the funding granted to the Recipient; and WHEREAS, the modified sub-grant is now $ 29 60 NOW, THEREFORE, in consideration bf the mutual premises of the parties contained herein, the parties agree as follows; 1. Paragraph (17)(a) Funding Consideration, is hereby modified to Bead as follows: {a) This is a cost-reimbursement Agreement. The Recipientshall be reimbursed for costs incurred in the satisfac[orv performance of work hereunder in an amount not to exceed $329.607, subject to the budget authority are available, changes to the costs the Recipient may incur will be accomplished" notice from the Department to the`RecipienYs contact person identified in Attachment A, Recipe( Information. The terms _of the Agreement shall be considered to have been modified to allow the Recipient to incur additional costs upon the Recipient's.-receipt of the written notice from the Department. This revised contract amount includes; 2. A. X201,921 Current CSBG Allocation (FY 2012-2013) )}, $ 3g,41 S Carryover from FX 2012 G; $ 89,268 Base Increase (FX 2012-2013) D. $329,6Q7 Total` (Amended GSBG Allocation) If applicably, Attachment. A, Recipient Information, Attachment B-1, Budget Sum 2~ Sub-Recipient Inforrnatian, Attachment 13-3, Budget Detail, Attachment B-4, Se Administration and Attachment C, Scope of Work/Wockplan are hereby deleted in replaced with Amended Attachment A, Recipient Information, Amended Attaehmg Summary, Amended Attachment B-2, Sub-Recipient Information; Amended Attac! Detail, Amended Attachment B-4, Secondary Administration and Amended Attach Work/Workplan are attached hereto and incorporated herein by reference. Attachment B- ry ~; 3. All provisions of the. Agreement being modified and any attachments thereto in conflict with this Modification shall be and aze hereby changed to conform with this Modification, effective as of the date `"of the las6exeeution of this Modification by both parties. 4. -All provisions not in conflict with this Modification remain in full force and effect, and are to be perforated at the level specified`in the Agreement. REMAINDER OF PAGE INTENTIONALLY LEFT BLANK -,: f. v~ li IN WITNESS WHEREOF, the parties hereto have executed this document as ofthe dates set out herein, RECIPIENT STATE OF FLORIDA DEPARTMENT OF ECONOMIC OPPORTU1VITy' (Type Legal Name of Recipient) ]3y: Bys Ken Reecy, Assistant Director (Type Name and Title Here) Division of Community Development Date: Date: FederatIdentification Numbei` DUNS* Number ~'~'` *Data Universal Numbering System Approved as to farm and legal Sufficiency, subject only to full and -- _ Pro r execution b the.. arties Qttice ofthe General Counsel Department of Economic 4pportuniry By: Approved -Date: rr 2p7z-z013 CSBG MODiFICA7lON --. evcunen_arr~. - -`-BUDGET-SUMMARY---- KECIPIENT. Troasum Coaet Camrounlty Acllan Atlency-9LC CONTRACR 13S&-FZ-12-0n-ol.riDa - REVENUE SOURCES 1 MppIF1ED CSBG.Grant Funds _.. o -.p~RCENT ':C MATCH D TOTAL NOTE 2 Cash Match .329,897 -nound ail Peuraa,VE to lha ndarast daieu _ 0 E 17,838 . •PraVWe cm7nlmymo(2%Cesn Alal{lf and 20%TAIei 3 In KIndMaich Malch. - 0 § !17,988 '9A nol pealer makh. 7999(. CASK hlAlchb 4 TOTAL MATCH (LIne2+3) 0 anecceaiabk : M _ E 85,022 - alcN emAWltsmWia9rea tNN Ow amended mNts 5 TOTAL FUNDS (LIne 1+Llno 4) rafleclAdon dw Mod~fcatlAA CAVat Pa9A. . A '. E 395,529 CSBG FUNDS pNLY BUDGET CATEGORY B Lasl C Proposed D.. CarrydYet E - F... 'TOTAL . Approved Budgol" trdm' CSBG FUND5 Cash and BUdgal pnaWdo BAao lncreesa) 29N-2012 (Gal C r D) fo-KhiJ Match e RECIPIENT EXPENSES (Salaries+Fnn9e RenlWNlles Other). 57,500 §26,188 80 525,188 $34 829 SUB-RECIPIENT EXPENSES -~•-_ - _._--_._ -.__ _- __. --..__ _ .___ __ _ , 7 (Salades+Fringa, Rent Wll9as, Olhet),, EO . $1,790 _ $~ _ _ _ _ -$1,740 _ §27,951---- 8 TO7ALAOMINISTRATIVE EXPENSES - LIne 6+ Llna 7 ' ' - 57,500 528,806 Ep 528,806 382.771 9 ADMINISTRATIVE EXPENSE-PERCENT ((Cell BC dlvlded by dell 18C} x 100) 10.OOYe VALUE iN 8C MAY NOT EXCEED 15% OF CELL 19C 10 RECIPIENT DIRECT CI.IEN7 ! ' ~ ~ _. ASSISTANCE EXPENSES -,..~-__ 9.__.- _ .~ S 97,438 § 127,530 $ 18,315 $ .145,845 $ . ---__^_--.__..__, 11 RECIPIPNT OTHER PROGRAM EXPENSE - - - -"•---- '"- '~'"---- -- •------ (Selades+FdnBe. Rent, UOIIOes, Other) $ 3,090 $ 3,090 $ _ S 3,090 12 SUBTOTAL RECIPIENT PROGRAM - -' EXPENSE Ltna l0+Lfna 11 E 100,528 E 130,820 $ 18,315 E 148,935 - 6 135UBRECIPIENTDIRECTCLIENT - ASSISTANCEEXPENSES - S 93,893 $ 131,103 $ 20.193 $ .951,268 § 3 151 14 SU&RECIPIENT OTHER PROGRAM ` "-"_'-" "- ---•'---.-• -- ------ ----:-_.__. , - EXPENSE.(Salanaa+Fnn9o,KentuunuAa,omar) § $ 2,500 $ - S 2,509 E 13 SUBTOTAL SUB-RECIPIENT PROGRAM EXPENSE LIne 13+LIne 14 E - 93,893 S 133,683 E 20,103 S Yb3,78B $ 3,161 18 TOTAL PROGRAM - - - Llne 12+LIne 15. 5 `194,421 S 284,283 $ 38,418 E 302,701 S'- 3,151 17 SECONDARYApMINISTRATIVE - -EXPENSES S - S - $ _ E 18 GRAND TOTAL EXPENSE Uno B+Llno l6+Llne 17) _... __. $201,921 5281,189 538,418 5328;807 ;85,922 'TNO amounle In Calla 90 and tt0 cnuunr aveaon a...,..:____,~ '. .. :: --°--• -•~•e•••. waauvv vmance srom your eT 2071.2012 COntraat olocoduL "Meko doelrotl adiuetmonta to feel approved 0986 budtlel anA Inelutla baea IheraaeA amount In Column C. - .._. ..__. _ ___~ » ~ ~ _.-.~ '- .... . __ ~'~ ~ e ~~ ._ ~ ~ ~ ... ~ _ _ _ MggIFIED ATTACHMENT-B•3 - BUDDET CEfAIL • FY 21112.1073 Redplenl; Treasure coon Canmumly Acdpn Agency SLC - Contract: f3S8-F2-12-00-0t-023 - - - - DUDOEr NATIONAL'. EXP D O A B D - _ aUMMggV PERFORMANCE : E%PENO(rU - RE9 LINE INDICATORS Rcund UPime ham lcWSto ddlars. CSBG CASH' IN-KIND ~ ~Ht:T frEM.. (Direct Glenj Po NOT use cen4 and dadmels In Weis. FUND9 MATCH MATCH CtiyN ~ NUMaEN Assisterwa Onl - • ~ ' 6. RecigientAdminl9tradve ~Xp9t1999 Salary-Community Services Manager.E $31,338 -1'893. All Salary and BaneNS paid by St. LucldCounty BOCC. • 100% a" 'i .3. 45%CSBG 50%Trarispodatlon 5%Shelter plus Cere 2080 houra~ $38 =:74,880' 41 %- 31;336 ~ salary ~ bireator $10,266 -';4028$. Majority of salary and bene6ls are paid with SL LudeCaunty BOCC funds, 2080 hopia Q 47= $97.,043' 10.5%a= ;. AtlvaNls(ng $300 -t.` 360% Newspaper advertising Ulllilias-437N71hStreet $3,452 `5:732) Matefi Source (s SL Liicle County BOCC " E9UIPment: - - - - 3 Computers to be used by volunteers far the Volunteer Income Asalstanca $3,049 ~ `~3 ~~ Sllea and by staff for outreach, mobile aitakas, date entry,. benaNs , ~ enfollment end ease management. Suppilea and printing ` $600 ~+ - TralNng & Regiairatlun $753 3 ~ = p183~; Travel $1,000 One boardlsta0 memberwiil partic(pateto FACq or other appropriate - trainingin accordance with the comma gu(delines. Software maintenance.fees-Calabase annual feesfar streamilning reporting and client tracking as Well as elfglbllily determinallon. follow up, gg 500 . referrals, and other long tans case management daialle. This figure also ~ Includes tAe user licenses for Iha year. ! - Adminiatmtlva Subtotals 515,168 ig RaciDient Dlract Client Sarvlces' -NPI 1.8 Satariea 6 1.20 - Community Services Coordinator - - = 1040 hours X $20.3 (50°(0 of salary} $21,112 - Fringe 6enatlta FICA, FICA Mand, Retirement, Group Health Insurance, workoYsCOmpansatlon,UnemploymanfCOmpensatioa=50%ofFdage $10,b58 Bane0ls Batance Is paid. by St. Lucie County BOCC •Balance is palrlby SL Lucie County BOCC ` NPI i-8 Program Spealeliat (Case Manager} - =2080`$17`40%= ;$14,144 '. ' Fringe Benefits -FICA, FICA Mand, Relimmenl, Gmup Health Insurance, ~- workefsCompensation, Unempiaymenl Compensa(lori Balance Is paid by S6 Lucie County BOCC 100°k df Fdnge = 60%of salary. $7,072 NPI1fi Program.Spacfaliat (Case Menage) =20$0"$17.OB' 90%= $31,974 Fringe Benaflta-FICA, FICA Mand,ReOrement; Group Health Insurance, Workers Compensallon, Onemploymant Compensailon Balance is paid by S6 Lucte.County BOCC 100°k bf Fdnge=50%of salary.. $15,887 J ~~i its to tldlers. C594 CASN' - '-IN~xINn'-. dmels in totals. FU bS MAC MATC achieving self-auPoctency. Assistarce n education, employment health, medical, 1.1,.25 othora; depending upon the unique ta+Yilly 1.3 1.1, 2'- • Based upandhe family needs;: 2.1. suPocieacy could tall in these categbfies:' astlmatos as results Will be vadablebase 1.3 • Beneflls enrollmept to manage pud4 2.1 • Posi Secondary educ forihoseaaell~, Apprpzimateiy 6 adult students will ba es expenses of approximately $300 toivarA { t 2A B (the goal of becoming eggible for othok flm 211 certificate or degree programs to obtain t ~ortof lousing, are'or x fartllly self $4,000 sdan lal aid, bobk tlori wlUl ~leilag aL $1,600 1.2A,BEmploymeh(SUpporls 2.11 ladrease Eduaatlon placement Approximately 260 people wtll be assisted With appoximately $20 for 1.2F; 2,1N, 6.21 iransporiatlon foroampleting education, seeking employment, and $5,000. oblalnirg medical care. i 2H; 2AI Approximatoly 10 people will be assisted with the registration cost of $50 $500 . per semeslerto complete their GEDiraining and/or to complete lha exam: 7.1, 1.2, Os, 6.4 Approximately l4 households wdll beasslatad wllhachildcare subsidy for :'$12,000 chgtlren from birth to 13 yo in support of edupauoh and employment. Youth-.Approximately6young addiis who era homeless and onrdllad in ~ 2, school will receive appmxfmately $3,b00 in support of achieving salt- sumciancy. Assistance may be in th_e form of housing, case managmant, $21 000 2.1t gscel education, post=sacondarylhighschocl education, employment, , . ;: - health, medical, tmncponagon, Childcare or otherabasad oRideriti4ad needs . Approximately 20 people wlq fie essle(ed with approximately $50 tq obtain L2F,M, ideatificatlon, healtieara, toad, housing atabiUly; etc. in support of -. $1,000 employment, education, medical care, obtaining bene4(s, etc. - - - - - -- DGaak SorvicasSUbtotal ]$145,945 S4 ii other Praararn EzD4n3e9 -. - Community Garden • These funds will fie used to sustain and further develop the Food Parity Bucket Gartlon, includinpexpansfon of the 2,2C, 6.SA axisllag garden, proylsion of bucketgardons to tow Income families io elan $2,500 Ihoir own gaMens, as well as implamenWtion of community education in the areas of nutdllen and toad preparation. - Budget and Flacatgducation Matorlats -Resources for dlsldbuGon to 1.38, 6.3C eel{-suf9ctenoy ckenieand to thosepanlcipaling is general budgeting $65 slassee. This includes Byers to educate the communltyabout the availability of 6sdal educatloh. 1.3A1 Volunteer Income Tax Assistance Inlemet Access; Flyers; sUppllsa $52b Other Pregram Expenao 9ublotal $3,494 $4 - TOTAL 5174,d01 $3,4i ^. Expleln ai laWrcesaCash end In -Wnd Mehh is SO g 531,338 me - - - "SU (Complet PIENT: IPIENT NAME: :STREET P CONT~ TELEP (IF. pIFFER~NT) ,GT PERS6N'S. NAME AND TITLE: HONE: (8631462-5150 : 'Y 2012 ,2013 CS~G. _ _ 8-2 2EClI~1~N~ INFORMATION tiffs page for each ub-recipient). Treasure Coast Community Action Agency - SLC SUB-RECIPIENT INFORMATION Okeechobee.Senior5ervices 1019 WS PerkStreet Okeechobee FL ZIP,CODE 34974 - FL:.ZIpCODE : :GI: JfICOlallal CSBG __ CASH IN•KIND (D) 'EXPENSECATEGORY'. FUNDS MATCH MATCH ,TOTAL 9i1~.ft~Glt?t~NT.ADIifIP1~STiiATIVE,~XpENS~$,. za ` > ,<. , '; ~ ; ~`i. ess x i ,., ~,"~.. F, ~~~~ 7. SUB.•RECIPIENT~.EXPENSES - - (Salaries+Frnge, Rerrl, Utlligas, Tiave; O)har) $0.00 $9,453.00 $0.00 !$9 453.00 B; E P__ ;P,R. RAM, ~_._E ~eirirsn r ,€_ 13. SUB-RECIPIENT DIRECT CLI@NT ASSISTANC€ EXPENSES $63,016.00 $3,t51.p0 i$O.Op $66,167.00 14. SUB RECIPIENT OTHER PROGRAM EXPENSES (Salaries+Fringe, Rent, UtillOes, TraV9l, etc) $0.00 .$0.00 $OAO $OAO i5. SUBTOTAL SUB-RECIPIENT PROGRAM EXPENSES (Line 13+(,1ne14) .$63016.00 $3151;00 . $0.00 t$661b7.00 T07AL EXPENSES; (Line 7+Lins f5) 543,036;04 X1$ 500 00 50 0 " 8'p S75,d34 , , _„ , ,- , , ummary:° `ali sub The Recipient must have a written agreement with all subcontractors. The agreement musi meet the requirements of Sectioh 14 of this agreement. A copy of the. ungigned agreement with the subcontractor must be fohvarded to the Department for review and approval alohg With this agreement. See OMB Circular A-133.210; Sub-recipient Vendor Determination, for further clarification. 4~' ,~ ~; MQBIFIE@AIfALflMeIVl n•+ - BUDGET NATIONAL E FJ(PFNOITURE DETAIL - '~'^`° EXPEND °~°'-'~° RURES SUMMARY LINE RFORMANCE P INDICATORS . 'Round UPllre Hem laiols la ddlara. CBBG OAaN' MATCH IN KIND + i~E7 NANIIE ~~' MATCH O ITEM (Direct ClkM Do NOT USe ceMaand decimals i0 teals. FUNDS ,. , ~ ~~~ NUMBER -Assisience Od F ~ ~ 7 ADMINISTRATIVE EXPENSES - {; ` A . ~ - Sub-Recipient AdminlsUative ~rpanses _ Salades: ~~ Program Manager '' - BOCC-15%jCCE=6%~ OAA=25%; GSBG=15%; MW=5%; AbI=6%; HCE~5°k; ' -- t NSIP=S%; EHEAP-20% ~' -`'~` - ' 1313 H@li(s Q $241Hr. _. $27,800 ` 15%? $4,727 4,727 ~"-` 687 ' Fiscal Specialist: BOCC=20%; GCE-t5°/; OAA=20%; CSBG=20°!0; MW = 5%; ADI=5%IHCE-5°1°I NSIP=5%,EHEAP=S°lo ~ `' ' " 1312.75 HetIfsQ$18/Hr..=$20,700'20%=$4,728 4,728 ri 687.. Total SubReoipient AdminlsUaifve Exp@hses 0 0,453 I a:. 1 174 .5„ . " 13 PROGRAM EXPENSES -' ~~,~ ," Sub-Recipient Dlrecl ClienlAssistenca ' " r s i Approximately 35 clients Will receive assistance in theGhomes, thcluding pars@nal ` y ' 2.2p,E homemaking and respi(@ care (for care9lYerS of elleMS requiring 24•hour care). ~ " . A. 8 8.1:6;9. B.I Approximately 4,288,84 oohs (a) $15.50 ea. will be provided. 83,018 3,151 ~-.w,r ~?A77 ~ . Total SUbrecipianl bltecl Client Assistance Expenses -- 83,018 3,161 '.: 779 Y.~ Y 3 °: ~3?i- GRAND 70TALS 83,O1B-- 12,$04 ^: 0 f '?2605.. 1 ~t -.. - /~.ad;l ACRONYMS: - '` ' ' " ~ ` BOCC = e@erd of CcunlyCommissbners - - ~ ~ CCE~= community Oare JoT the Eldery _ `~ " "~" ` OAA-'Older Amedcans Acts ~'"'~ a, -'` CSBG = Gommunity services Block Grant I?, '_' " MW=Mad-Waiver -° ~~~ ADI=Alzheimer's Olsease7niga6ve` ~~ ?' HCE-Health Care for7heElderly '~ ~` r,<t NSIp ° fJUlditon Servings tncontiva Program - ~ ~ '~ EHEAP =Emergency Hgme Enefgy Assistance for the Elderly Program Y` ~ ~~ • Cash Match is provided by Okeechobee 8000 (General Revenue Fund}. s a?,~ *. _ y ~ ' ,. ~, ~~ ,1 (Comb aient) :RECIPIENT: St. _Luole Gourity Board of County Commissioners SUB-RECIPIENT INFORMATION .SUB-RECIPIENT NAIVE: Martin County Board of County Commissioners ' MAILING ADDRESS. 2401 S.E. Monterey Road ' ' Stuart FL TIPCdDE 34996 ' STREET ADDR~St's (IF DIFFERENT} FL ZIPCODE CONTACt PERSON'S NAMS AND TITLE: Anika Cocovos Ph.D., LMHC CAP I .:TELEPHONE; (772) 419-6932 FAX; {772) 223.4829. "',NOTE: The following line items (7, 13, 14 and 15) musi correspond to Attachment 13x1, Budget Summary. 'lf there ismore than one sub-recipient, it is the Recipient's responsibility to ensure that the total of all sub- recipient -budgets add correctly. 1=xpenditures must be detailed in Attachment B-3, Budget Detail CSBC, FUNDED PROGRAMS ONLY {A) {a) (C} CSBG CASH IN-KINb t4) EXPENSE GATEOORY TOTAL FUNDS MATCH :MATCH rr. `~. _ - ,,,« 1 7. Sy6•RECIPIEN7 EXPENSES (Seleriss+Fringe, Bent, Ufilities,:Travel, Other) SU$rREGIPI$NT pR~GRAM EXPEN3ES;,: ~= ,,.~ W~~ ' 13. SUB-RECIPIENT-0IRECTCLIENT ASSISTANCE '` EXPENSES ' 14. 5UB~RECIPIENTOTHER PROGRAM EXPENSES (Salaries +.Fringe, Rent,Utllltles, Travel, etc) :- 16. SUBTOTAL SUB•RECIPIENT PROGRAM ' EXPENSES (Une 3+Ltna14) TOTAL EXPENSES; (L7ne7+Llne 15) a $2,500,01 $0.00 $0,00 $90,`750;00 `~=~`ItS5if90 ~'~~~~b;~$ A = ~~ t 0 98$:0 :ontractors. fihe;agreemer}t must meef`1 he unsigned agreement with the subconl wal along with this agreement. See OM r clarification. - afar :.: -.CSBG '. BUDGETDETAI4 - FY 20i2-2013 Recipient: utarlin County Board of County Commissioner -. f. DontracU 13SB-FZ-12-00-01.023 (mod) ~ ~ BUDGET NATIONAL EXPENDITURE DETAIL TOTAL BUDGETED ' ; SUMMARY PERFORMANCE EXPENDITURES -. ~' LINE INDICATORS Round UP Ilne Item totals to dollars CSBG CASH` IN-KIND" -~ T , ITEM -NUM9ER (P6reot Gllenl Assistance:Onl Do NOT use cants and decimals in totals. - FUNDS MATCH MATCH GNAt~G~ ~lin'ar.Mlnd•'` 7 HHS Manager salary 333 hours x, $50ihr. ~y 16,64$ j, 7188 Remaining balance paid through Ad Valorem t~ ;_ `: funding and 1l2 Justice Assistance Granfftinding ' ` Utilities - 435 S.E. Flagler Avenue (match source 'i is Martin County BOCC) 1,850 ~~ j;$5p Supplies and printing 250 53 ~~~ Training and. registration `° ' One Board member/staff person will participate in ` FAOA training atthe annual conference.:This will 690 z S9d cover the expense of registration. It is also planned ' N for at least one staff person to , '" x participate in necessary webinars.. "` ? ~, ;. Travel One Boartl rnemberlstaff member will participate in _ ' FAOA training at the atinual 9p0 ,• `. , - ~.,$ , „ , ` conference to ensure clear understanding of ROMA: : ~s`; ~`~ ' These funds will be used for , : W; ~ ~,~ housing and food. The county will cover the ' mileageezpenses. ~ ,, „_. „ ...%~ 1,740 1:860 .'1.6,848 ` ,». 't Sub recloient Direct Olient Services =>`s ._ 13 NPl 1 - 6 Case Manager - 2080 hours x $22.15/hr, = 46,080 46;080 ` ~ 6'f120 - , Approximately 39 clientslfamilies will be assisted ' ~ 13 1.'1 - 8, 2.1 ,,kith approximately $680 In support of achieving 26620 ~ ~~ ,~~ self sufficiency (ass(stance may be in the form of housing, etlucation, employment, health, medical, transportation, childcare, utilities, "3- depending on the unique heeds of ' , ~ -- the tndtviduai/family. 93 6.1A,B, 8.4E Al homeless disabled ind(vidualswiil receive case 0 _ to participate in `value added' progiamrnigg. c.;~ ,~ x 6.4D Family Supports: Low income Individuals who are 9,000 _ adults with disabitltles obtain health Caro for ,.... _ • .. ...- homeless disabled individuals who have been ' drug testing services ' '-= E .~ -~ ' - Emergency Legal Assistance: Individuals placed in ... .., ~~ ~ 6.2H court diversion ro rarhsihatenable 3,700 , ;, aiao P 9 !',: 14 "Explain e ~EXPENDI7URE DETAIL l _._...~ o....wn no ....,.:...., r.,,,.,.s.,_aa,~ .... .rscr_: r_, Do NOT use centa'and decimals intotals. FUNDS M~ tnem to nave tnelr cnarges aroppea,_mus enaonng ' federal school them to receive loans and empioymenk that requires Iicetsure(background checks cart achieve self sufficiency. Approximately 37 individuals will be assisted withlhelr fees @ approx. $100 each. 2 1 Approximately 44 Individuals will be assisted with; 1,100 . H approximately $25 for transpottation 6.2 I for completing education, seeking employment, obtaining medical care,: meeting legal heeds. Approx. 10 individuals will be assisted with the 1.26 2.11 registration cost of $30 persemestecto complete 850 their GED iralning and $55 for the oxam, 6,3 B 5 Juveniles @ $200wk for summer camp 1;000 Direct 88;250 44her Program Expanses- 2,2C 6.5A Community Gartlen 2,500 Other Pro ram 2,500 92,490 1;850. 18,648' mrces of Cash and Iri-Kind Match ,z~, r o `w~ r ~ ~ ~ ~ , • -- -- ' (1 N N c- N N N ' ~ •1 ,' M ~• [~ O ~ I~ 'w N Q •U Q C~1v. :r ,QI ~~ N V M O h. r O~~~~ to N O O N N ~ 'QxQ ~ !1 O W v • .~. 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O ~ O ~ $ o o Y ~ m O W ° :E o c o w ~ " ~ ~ z W gym ~ o E o »-. • i m a , . o ° ~ c ~ ~ c v _ c ~ ~ ;c m ~ '. m ~ ~ ~ o o c ,~ .~ ~ m ro N CC ~ N ~ ~ U ~ rail tU E U ~' ~ C ~ ~O ~ E . i a ~ c~tlq y ~ N ~ 'O O L 'q C u i ltl C N U C N G /6 ~ `.+ .~ ' o E ~ o : ~ Z a L ~ ~ ,~ t t o W ~+ ~ '~ ~ ~? ~ N ~ N > m O 'fl N ~ ~ ~ O ti. ~ O _ •d ~ ~ ~ d N d L d C d C d '' a ~ ~° a a a ~ n a ~ W { ¢ N N vyN ~~ , N N ~ ryry to { ~ V3 t ~ ¢ c ~ 4 c ~ ¢ ~ S OD C7 0 pl lL C~ = = N 0 N MI V Z e c d Q c 0 E t~ N __ -.._. _ _ _ ___ r i '~ O OOpO~ ~~ ~+'~ M M „„' c =`'~ O - - _ _ - _ __ _--_ - _ ~ ' • ~ p } R o N N r • ~ ~ ' V ~ 5 ~~ ~~ ~ r ~ c o z ,$ :~ o o ° in in F ~~ ., . . ~ ~i N N Q ~ "; ~ J o , • O ~~' O 4 p y _: ~ '% ' ( t? O O O O d O b O ~ O d N p O O ~ . I L _ Y # ~ C O ~ pF, t, ~-~ y N !~ pp O 4 - N a ~ ~ ro ~ ~ ~ U 7 ~ N A .c ' lj C # w `?7 ~' ~ v v N ~ 1. ~ t ~q - V ~ 'C W $+ ~ r c w e > o ~r ~ ro ,~ ,. o 2 U c o + . c r z~ N ~ 4 . 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G C NN ,p ,N N N ~ N j O `A b ~ W m N .'~- .~ ~ b b v O $ ~ r ~ a ~ O U O C ~ d ~ +~- E d fU .. ~ 3 ~y ° ' - • ° °F .~ G' v C [~ C ~ ~{ ~ ~ ~ Q; O W a ~ o '~ O ~ m ~. am j -:o W 'v 1 ~ . ~ ~ ~ Vj "~ ~ ~ 0 . N N V , 4 ~ d L ~ ,~ .0 Ew ~ y U ' c E~.~m --~ ~ pp V.Q-QFL".~ ~ ~ 1 U E ~ ~~'~ ~ `~ L~° ' L° ~ ~u ' a ' , Q ~ ~ o 0 w0. a Q _ Q Apri112, 2913 Jesse<Panuccio R~GEIVED BY APR 18 2013 St. Woe County ' iv1s. Beth RydY?, Couununity Settirices I7ixectoe Nouslnp ~ Cemmunlty St. Lucie County Board of County Gonmiissioncrs Services 437 North Th Street Pt. Preece, Florida X4950 Re: Corntnunit}r Services Block Grant Contract No. 12SliAY-i?-00 01-023 (CSBG) Dear Hiss Ryaex. Doting the period of Janiaarp 2$-January 31, ?013, Susan Lawrence: and Jennie Leigh Copps fcorn the Department of Economic C?pportunity visited your agent}' to monitor the Community Sen~ces Block Grant cpntxact you admirxister• I appreciate the cooperation you and }roux staff extended to them during theft visit. 'I1ie accompanying monitoring report reflects d\e tevte~v of tree areas: Administrative. Qperatinns, Racal Operations, and Pxogtam Admirtistxation for the most recent cantxact reporting pe>;od. please nnte that our report is based only oma sample of activities and is aot intended to relieve the recipient of its obligation to manage the contracts in accordance with applicable rules and sound management practices A "fording" relates to issues of noneampliance n~ith a specific federal, state of contractual requirement. Each finding includes corrective acd~rts that must be taken to resolve the'pxobletn. i1 "concern" relates to a potential problem d\at may result in noncompliance, questioned costs, ox other management issues. Each area of concern is followed by a course a£ .recommended acnon that may be considered in working rowaxd the resolution of the issue. In adilidon, please see Attachment A fox issues that i\~ete correcxed during the monitoring, and Attacluncnt B for Tecluiical Assistance that is being provided for your information. After your review, please share this report with your acltrnitistxation, board, and staff members )vidence that this report has been tet~iewed ur its entirety b}` your' Board is required. A copy of the minutes from the meeting at which the report was reviewed, or a letter from the Board Chair will satisfy this requirement.... A Nrirten response is clue to the Department of Economic Opportunity within 35 days from the date of this letter. In the response, address and reference each finding and concern by numbeL, such as Concern #4. Please address your response to Ms. Jennie Copps at die address below nrrd email a copy in MS Word format to jennie.copps(n~deo•myflorda.com. I'lurid+ Ucpnrturcnt ni i•.cnuomic Uppuriun~tj C,tldricII t3wklurfi 10: li. \t rdiauii Svcct 1 ollnh:is'+'~, 1'L 32399 3661Ir\'345 8y0.245.71G5 6509~t.32~3Ins fl, hi t-.,,re ~.m/I+1 t)1~O f-rch k c tm11•IARU ' itiiS, B)/'i f-1 RIDER " _~ rlpxil 12, 2013 'i Page 2 of 2 _ _.~__ _ __~ _ v, .____ _. ~~ _. ~ __ ot~ng report ox an}' o ex contract-related issue, please contact ' - Ms. Copps-by phone at (fi5Q)717<$462 or email. _ __ ,, , April 12, 2013 GItA.NTEE: St. Lucie County IIoaxd of County Commission d/U/a Treasure Coast Cotmnwuty <~ction Agency (PCCAA) CONTRACTS: Cammututy Sen7ces Block Grant Program (CSBG) ConreackNumbex:I2SB-9Y-12-00-C11-(I?~ DATES OF MONITOJ.LING: Januar3~ ?8-31, 013 EXIT CONFERENCE ATTENDED BY: e: - ector ~f I lousing and Comtnunit}> Sen=ices, St. Lucic CouutS~ ices Manager, St l~ucie Goutity >s Coozdinator `St Lucie Cotinry Assistant, St l Aicic County> anager;(?keechoUee Setuar Sen~ices* tecialist, ()Iceecbobec Senior Senrices' t and human Senhces Manager, C5BG Program Managc>•; I~lartitt Count}t lttuerc r liu, ~..,~ ....b__, Barbarn Mason Gardiner, Board Chair, Treasure Gast Community Action gency t Attendance br`telephone `' Representing the Department:. Susan Laivxence, Planner It/ Jemue Leigh Copps, Gt~nts Manctgcr RESULTS OF TI-IE MONITORING VISIT I. ADMINISTRATIVE OPERATIONS Tbc packages;134-taws; ~c re rep*iewed: "I'reasw~e Coask Convnututy Action i) n?eedng minutes January, April and Jul} 2012: hxaugh October 2012; current roster; board tuectitg Is and policies and otgnluzational chart. fanee Pollcv are established in Arkicle 3.1 of the TCGAA he attendance requirements identified in Article Cornmuni;y Action Advisory Board Bylaws. '] 3.1(A} 5 states in part: `' Flnri~/u -ipart»>eri/ o(Leonaruie Opportruril)4 SL-Iaraa`e Gotrnly Bonrrl a% Camtiy Canut~irriunerr AfaruJOrf7r~v Rrppr? April 12 013 Page I The TCC_AAAdvisoty Board meeting policies ate identified iu Article 5.1 of the TCCAA Bylaws. At a minitnnm, quarterly meetings ate to be held each calendar year. The 2012 Baatdmeetng riiuutes and attcudance records indicate one member did not attend four meeting. The absent baatd mezuber has aot resigned. Therefore, theAdvisory Board is not in compliance with its Bylaws. Corrective Actioni 'I1te Grantee mustabide by rht4 ac}opted attendance policy to 6e in compliance its Bylaws. The absent Board member is deemed resigned as required by ,\rtlcle 3.1(x1) 5. Documentation must be provided avlrich deti5onstrates the board tueniber lias resittied. Additionally, the agency is requited to fill the c%acaucy in the low-income sectt?i wiriiin 90 days of d,e vacancy. Concern hlo.1: Coordination-of Service Delivery The CSBG_ program is curreutly being implemented in St. x.ucie, Martin and dkeechobee Counties upder au inter-local agreement that was executed in 1997: ' Following the review of operations and eflent files at each of the three county in-take locatioits, the ftiliowing issues were identified: A. Program procedures, client file documentation and operations were not consistent hehveen' thc'tlttee counties. 11~lartin and Okeechobee Counties were using program procedures and forms from FY 2007 and FY 2010. However, St. Lucie was using PY 2012 procedures and "°' farina. B. The current agreement does not clearly identify one specific county as the lead entity responsible for the oversight and contract compliance of the CSBG program. ALL /vlvs-1 p~`oui~cl~~ Overrs~~e., ItecommendedAction: It is recommended that St, Lucie Count} consider implementing sub- recipient agreements with !\~Inrtin aid Okeechobee Counties. This would require increased oversight and ou-site mgrutoring from St. Lucie Cotttt¢ staff to insure that services arc beittg provided ht ace- °rdance~vich--tli~-C-SB~eli ' and procedures: n t to Agency's response to this rep- orG, documentation which demonstrates that this. {. c u•as discussed at a TCCt1A Advisory Board meetirrg must be provided. 1/ Coacefn No. 2: Board Participation A'.;quorum is defined as a simyle majority {fifty-otie percent) in Advisory Board Bylaw policies j Article 4.1{e) anti 5.1(b). The membership policies in Artit:le 3.1(A} ~, 2 &3 establish that the Advisory Board has dine members. A minimnm of five members is needed to achieve a quorum. The TCCAA Advisory Board held five meetings ueriveen January 2012 and January-2013. A quorum was not achieved at October 11 2012 and. January l6, 2013 meetings. The Board cannot fitlly participate in the del>elopment, planning, implementation and. evaluation of the programs ntithout greater participation. An active board serves as a key community leader. Itserves as as advocate for the presen~ation and expansion of opportunities to assist low-income individuals and neighborhoods move out of poverty. When members Florzda DcyiviYnieril njEcorroxnzn Oppor/nrtify::S 1. Lrriie G'omdy Bo~t'd of C'otutt~~ G`aiitr!/+rrio>tert A-forritorrtg Repor7 :~1pri11?; s013 Rage 2 .. •. i f .1 • • . _ • ~ • 1. ~~ Recommended Action: roi~ this concern, board ti~auung is required anti it is recommended that the board conduct aself- assessment: Docameotation that board paining has been provided itr scheduled is to be subnuttecl as 5 response to this concern, Sec .lttachment 13, Technical rlssictance, far a list of available tranuttg resources. II. FISCAL I~PERATIONS "['he follocvutg lrcas of fiscal operations were reviewed Fns the CSIIG program: revenue and expense statements; cost allocation methodology; ledger trial balances and spreadsheets; persotutel expenses; rrtnsacrioo analysis; check requisitirus and nccompany~in~ documents; financial trends. There were no Gndings'or concerns related to fiscal operations: III. PROGRAM OPERA't'TQNS 4, 'I'Ite followittg areas of program optr:rdons fqr the C513C program were reviewed: procedures; client files; salt-recipient program activities; ~iragrain icports; client re intake policies sad procedures; client eligiullity determinations; Outreach activities; Performance'Uidicators aitd goal setting. Find%xtg No. 2: Disallowed Costs A review of the GSBG client files in Martin County noted the folIotving disa Client Ex enditare Assistance Reason N. Freeman ' $ 203.54 Bns Not an approved expense in the current budget Ticket L; Bohanan $ 177.00 Utility Not an approved expense in the current budget ` -Asst. M, Shcllenberer $1,050.00 Rent No income documentation, no self declaration form or food stem documentation M. Meyerin $1,OQ0.00 Reat No CSBG application, income documentation or identification'in file.' Deloach $ 700.00 'Rent $193.94 over income thteshald Corrective Action: r1s a response to this concern, dte rlgencr is required to Submit a 12eviscd Close-but for DEO Conaact No: l°SB 9Y-Z2-00-O1-023. A checl: in the ataount of X3,130,50 trust be returned to'tbe CSBG program. The source of the fuads trust come fiam unrestricted, non-federal CSBG resources. Plnrrdn 17rrnr/ii+•u1 u%E~airiruie a~fiarfniriryc SL Lrrie Coiirtty )#aarr! ofCanu_ly Courrnicrianrrrr llorrilaing ICepwi .~prll i?, 24i3 Page 3 progrnm 1toLctes and portitg systems; clicnE_ GSBG National Vowed costs. .. __ .w._ ....,_, _ _. • ..:. ~. _ . ell tt,_~._...;_._... _... __.,..: _ ..___. .._____ _.:._. During a review of client Fdes, no statements wnt_en o , identified We reasons income documentation could not he provided. This-regtiixextitent is , identified Attachment D, Scanom.H(1) of the Agency's 2b12 CSBG eontu<ct which states in part: ,..In the event that the applicant cannot protdde income documentation, tlae Recipient sltall kequire the applicant to protlde a siam+ed certification ofeligibillty to attest to the applicant's verbal declaration of total household r'ncome. Tlus certification must specify' the reasons that no current tiocumentadon can be supplied b}' tha applicant and a statement ofhom the;applicaniis protdding for /// lus/hat basic needs; COirecttt_ "_ e~ A___C ---t/On7 As a response xa this fui¢ing, rite Agency must provide the Depnrtntuit tivith docrunctitadou wliieh indicates ho~i' clients with nn income ore s•eri6ed to be eligible. iii addtuon, the rlgetac}' must update its program policies and procedures ro include tt palicy on ha~v die rlgencp ~viil t exify a client declaring no income. Sclt-declaratiaii srntetuent forms. Eram utldtiple Florida c:otawtutilt}~ action agencies were pro~rided to the tlgency. It is at ilae discretion of the Agency to develop flu format ~vliich best meets the needs of the Agency's (~rogratn pravided it coti7plies wilt the stah+torV requirements of the GSBC; ptot~*ram. ~o~~~.,G~CancemNo 3• Praerltn~ otatiatts Martin Coc p. Ti?e review of Martin County's C5BG Program p Wr intake farms using poverty incotne guidelines frt ~~ n J not match the contract year reviewed (FY2012). I _ application's client characteristics page was attar which qualiFted clients fox services based upon 2 t, ~yt income guideline requirements are identified in ~'' -1 1 >~vaM~. C:S,BG contact which states in patt-that: procedures dad client files found years (PY2007 ~attd 2010) that did a Martin County CSBG ogtam handout (Lend a Hand) income guidelines. The poverty D, Section 1-I(1) of the `1ati~tir" ,,, 7'Gr total household:income cannot eiceed 125 percent ofthe current Oflice of Management and Budget Poverty Guidelines. A r'7iousehold"is aft indit7dual or group ofindir~duals iii'ng together as one economic t+nir Community Services Block Grant income guidelines ate: revised annually. The income guidelines must match the contract year in order to accurately tietetmine an app~cant'a eligibilityforservices. Recommended Action: The It4artin Count}' CSBG Program is required to update the povecn' incatue guidclutes annually when provided by dte Deparnneat. Eligibiiity for programs listed in Nlarrin County's program manual, including die CSBG program, should be clearly identified. For CSBG the -policy should clearly state that eligibility is based upon 125% poverty incame guidelines and reference the income guidelines provided annually by the Department, r~s a response to this concern, proi~ide,documetuanon that the Tt4athiit County CSBG Progratn Manual has been revised. F/onrlrt Depnttmest of ~rnaarnii OjrpoNrruit}:' Si. Lneie Cmrnly Borrrr! o/•Carnr~~ Cotvrrri,;tiarrers A9wri(artrg TZcpnri April t?,'Zt113 Page ~, r. __. Forms were not from the current contract year, seu ucu.a,..u.... a W«---~--•° • .- nthe files; and income eligibility k~as not reassessed for FSSP clients that continue to sistance unde/~~t~h~e~n~e~w contract. 1 1^lnddr~ DepnrJinenJ oj•Emrrornn' Opporlrurilp: St. l~r~r Carrl~~ Bnarrd gl Gortrrlp CGIIIJnLr[L+llCrS 1 '-t3fonilorfiig Repofl April 12; ?1113 Page 5 Reco amended Action: Tlie Qkceclaobee Cow~t}' CSBG program is,~cquired t ulidateits Coiittnutvt}• Services Bloclc uttotne gtudelutes to tn~ttch the cun~ent eonkiact year iij order to accurately leternvne an appli~ eligibility for strt'ices, A self declaration statement must be completed for all files in \yhich zer ~- irant rot's is teporteci, Tee t,oztecnve »ctlntt, t'inautg Na..sl. nucuuouauy; uuaern new contract, a cturent t'~~t' client's income must be rccaleulated using the 125% poverty htcome guidelines to deternune if the}' will coiitinue'to qualify for ervices. I~ocumentetion that these issues are addressed must ~e provided in the Agenc)?s xespnnse to this report: Concern No 5: Income Calculauott The method used to calculate income is identified in the Agency's procedures at Policy G. Determination, and'states in part: C~Iculnte Income received from aC/house/rold meaxrbers for the prerdous 30 days, The CSBG;Program requites that itrcotne be projected based t}pon annual income not monthly, Tte policy does not Provide specific guidelines ozi how the income received ftpm ltouseliold' membersis to be calculated to arrive ~t an attnualized income. In atldition, tliepolicies are not clear on ~v~at types of income will be used and which types: will be excluded. The Department' provides a listing of included and excluded income which the Agency should ise in its policies. The calculation of income and what is countcd'as income must be consistent across the prograw and across the three counties, regardless of the type of services provided under the program. Recommended Action: The method identified in Policy U, Determination should be redrsed to cleanly state how the Agency will calculate income and bow the agency will determine if certavt types of income are to be counted and hazy. ,1s a response to this cUnccrtt, provide the rec7scd policy. ISSUE NUMBER Ai`1D TI'PE OF FINDII~IGS AI*TD,COhICI/RNS Administrative Fiscal Pro ram Total rindin 0 D' D 0 C6ncerns 0 t). 0. 0.,.. 1~laiihi Depnt9~uent o% Einiioihlc O~poiliurily S!. L.treie Coiuilj~ Board ojConu~~ Conrbiirrronerr tl'lotd/ai3n3 R ~pii ~1Pii1 Y? ?013 Page 6 on- omplance Cottecied Dutinb hxanitating Visit None ', tom"` hlarirla Dc~giiinerrl of F.iarraili~ npJ;orlunit~c SY. Lrzi~ C~lrtily 13orn~d of Cargl~~ Coili/nirriorerr illouiloriug ~porl .4prii 12, 2013 Page 7 i; ATTACHMENT.B ~, Technical Assistance ..__ __ ...'Technic 1 Assistance No.1' TCCAA Adviso Board B laws Tlae Bylaws should be rertsed to iuclttde a piocess for vetting prospective board members. i 'fhe flutding ~ceme rip vith Martit> and UI.~Ceclxabee Cc urines Thesel pace t ges are bused on an annual into-loco gl cotu'act allocation that changes Exam year to year. Such utfavnatipn should not be itxcluded in documents thht are not >evised ainiuall}'• Techn____. ical A~s!stanr ~ 2 CSBG Pro ram olicics The following revisions to the CSBG Ptagtam Manual Chec4dist should be considered: Cntcr~ et~stsCance: `Che t}'pe of emergency assistance lvvits amounts that will be liravided should be i addcessedui the natrat~'e; flit ibtlity: CSBG is riot an assets based pcogratn: The statement `<asset 1'aiuts maybe eonsidcecd on a case at case basis" should be deleted 1:ducatibual Asistance: The ry>pes of assistance rvhich will he provided should be addressed in tltc uacr~tive: client )aiie Documentarii>n Reaulremeuts; `I1te volume of docuinentadan currently requited Enx cousideratian oFCSBG assistance is extensive. '1'ltree matiths of rent ieceipes Three months. of utility bills 7ltree months'~f tvorlt bistorq Such dncuiiientation is not neccssat'}' for sUott terns rSSP (non case inat7aged elients) s~ch- as bus passes, obeaiuiiig identification or ~itth certifxc~tes of sitnilax assistance- Retuoving this requitement would enable staff #o reduect tesi>urces to the more tune cotisunung requirements the CSt3G program. ]t a=ould also reduce the golnme of paperwork that is maintained fot one client. lticomeyation' Section G. Bank statements should not be used as income dpcumentatiou because posted deposits m1y not reflect the client's gross income amomtt. ~ crier staff and boned members 1s anolicants A stipulation should be added that rlic npplicatians of sill staff or 1?oard members a=iA be-approved. b}= die progrnm director or the board chair. Technical Assistance No 3. Board Ttaiuin Resources Board uauiing resources are provided by State and National Commutut}~ Action ilgency tlssociations: 3'he hlarida tlssocittion of Cotnmuniq= =lction ~;d11 host a board txauwig session it its annual conference in 1`4ay, 2Q13. National association resources include the Conimunit}'tlction Parmexslup (CAP svtvw,conmunih':ictioimartnetshie corn) the National Associltton fax State Comutumt}' Sen`ices ' NlazAt~ Dtprrt~~uetit a(EeauoJnic (7ppot9unifje SI. Lxrie Ganul}~ Bonril of Corrttt~~ L'onrnricriarets AlouilnCing Report April t2, ?013 Page 8 ~C,AP-i Ai The CAP site (rt~r1~•.rirrual Board Self-,1ss~ssment Tool. 'the scl£-as l~ttlrll~~'«r<v.virtualcalt.or~ do~rnlo ~3s t~ L' .sment tool can be obtgAied at JIN-C4~-Board Self-Aa~essnimlt.lidF).` F(a~da DcJrmiiirn! of ~ronnnrir Of~/~oi~nuil}~• Sl. Urtir Corrttl}~ Board of Corrufy Conrnu.crinnrrx it tonitarr~g Rej~oi/ r1Pril l2, 2013 Page 9 '9i 77~is boaro' assessment leas prepared by IN CAA, Results Unlimited, and Cartier Surrus, ! LC CIJMMUNITYAC`i TON AGENCY B©AR[>} SELF-ASSESSMENT ~ - Thls publication was created by the ladiana Community Aatlon Associatfon in-the performance of the U.S. Dapartmenf of Health and Numan Services, Adminfstration for Children and Families, Off+ca of Community Services, Grant Number 9oEQ229, Any opinion, findings, and conclustons, or recommendations expressed in this maten'al era fhose of the authorjs) and do not necessarily reflect the views oftha U, S, t7epartment of Health and Numan Services, Administration for Children and Families, ~y a~ i INTRODUCTION •• (Volunteer board members desire to have engaging and rewarding volunteer experiences. Non-profits seek ~ leadersh(p and support of a board that brings their very best to every meeting and to the organization. The ' jboard self-assessment process is a way to see whether the board and;organization are meeting these mutual ;goals. a i ': I .practice and stimulates conversation of how to strengthen the board's performance, This board self-assessment is f `' a measurement tool that facilitates a greater understanding of how the board thinks it is doing at a particular point and time and to identify priorities for enhancing governance and 6cganizational effectiveness. 's ;Remember, Chat this is just the starting point, and that this journey should proceed to a steady pace with every skep leading to a stronger board and organization. i ;INSTRUCTIONS Assessment is one of the most powerfal interventions available for turning a good board into a great i board. This self-study is comprised of 11 sections. Sections 1-9 address your perception of the board's performance. Section to addresses your perception of your PERSONAI, performance on the board. i Section 11 of the self-study requires demographicinformation khat is important for board recruitment and j evaluation. 1 'E hash of these sections consists of statements that you will rate using a numerical ratino of aoreement or {~° 3 1 1 1 S 'i $ c t. hat you-take the time to rate each stakement lio questions that require your comments; It'Is stly based on your personal knowledge and t" w~*f y R .~ '"~' ' ~ { `~ ~~ $,~ ~^}fl;~ ~~~ ~,t ,- ~SPfJIV ~ TING ~aa ; w, ~ 4 ~ . 1.,r .. „ ~ 1 2 3 4 DK Strongly Agree Agree with Disagree wikh Strongly Disagree , Don t Know :with Statement Statement 5tatemenk with Statement ~ Y ~ ~ , V A ~,ES ~ L sL .r, T{~ i~.Slat? Fts Ga ~ ~~.:d_ . 5' t l l x l to the self-study in its entirety. Remember individual responses of the self-study _are Na board member's name will be identified with speciFlc responses. All responses will be tabulate >ercentage bf members that gave an item a particular rating and arraverage rating for each be calculated. All ~esponses'to open-ended questions will be recorded as wrikten and included ih t not identified with any individual Thank you in advance for your willingness to his self-study it is greatly appreciated! 1IPaye " rhls board assessment was prepared bylN-CAA; :Results Unl/mitetl, and Cddiei Burrus, LLC +. z 4.~, = S.'k =f w;~ ti a ,kYp ~. i . s h.~~!", ~_ -. ~... .a ..,v.1 ;' .f C r ~) ._ }:.; :. ~ 3 2 4 DK Strongly Agree ` Agree with Disagree with Strongly Disagree , Don t Know witfi Statement- Statement Statement with Statement ~ j v^; r.. ~k ':3 'S ' ~ ~Y ~" ' ~ f C to iF 1 3 ~n Fi +. t.:~) `~_~~hY $ Ar C~S' t/a~S 'fi~~x~vn}y~}i ev yy(nr r-ir d. Y F~ Y. i. Ila.~"''. i+R) L t'LM{td ] b. j 'I ~ At ~~ 1~ ~i +S ~' ^+'v' f yL) i~t `i } f ~ ~ t j Y .a~ TS ; °.'kTt ~ ~ G $ ~f ~ ~ ~ l? ~ l ~ J ~5 ~ y SS3} t ~ S4'1 {L V ~ i YS, .. A ~d=~ ~Y(e ~ ~~~iRY b l f'r I Hv 'rN~3vlie~t $~ .J'~ 3•it b~~a V$ + ~ . - ... < 4 , ~ ~ 5 ,. , .. . ., , , s x i RATING 1. The organization has clearly stated vision and mission statements. 2. The organization's vision and mission have specific goals. 3. The organization's mission is clearly understoodand aecepked by the poard, 4. The board considers tiow all programs, activities, and pollcy decisions Flt witK the organization's mission. 5. There is consensus among the board khat the vision ah8 mission accurately reflect where khe organization is headed In the next two to three years. &. What are your suggestions for how the board can do a better job in this area? 7. What resources and/or organizatiohs does the board obtain information from when working oh issues in this area? 8. What resources or training would be helpful to your board and .help them improve their performance in this area? 21 Page ,,, x;, ~z ~, Th/s board assessment was prepared by IN-CAA„Results Unlimited; and Cartier Burrus, LGC __ ._. =1~ - S~CTI~N 2; STRATEGIC .PtANNI _ _ _ 1- _ - r F ~ ~y ~{ ~ i~ -,.a > n n ~ ~ ' C -l cir y z ~ ~ ' ~i` i i. ~N[? -4r'k F ~~ ~, ??i nS~. ,~ R xt X5,51 i ,_, ~$ ~,~~r r,, s 5~ ~t '~„ y RESPONS~ RAT~~.. ~,.,.,,. ~, 1 ~ 2 3 h DK . ANSWER THESE QUESTIONS BASEp ON YOUR PRECEPTION OF BOARD'S PERFORMANCE RATING 9. The board engages in a strategic planning process that lays outthe organization's goals over the next two to three years: 10.The board demonstrates a strong abiUty to promote Improvement and . manage change in the organization. 11.The 6dard takes primary responsibility for establishing and regularly reviewing the organlzatiods polides and procedures, 12.The board operates using clearly written policies apdby-laws that enhance `. the governing body. 13.The board has and follows the conFlict of interest policy when making offidal program and policy dedslons for the organization. 14. What are your suggestions for how the board can do a better job in this area? iS. What resources andJor organizations-does the board obtain information €rom when working on issues in this area? i6. What resources or training,wQuid be helpful to your board and help them improve their performance in this area? 3~Page v ~: Ex~cu 1 2 tingly Agree: Agree with ` n Statement Statement Y ^Ll ~~ ~~~ n('. srt t 5:; PK pERFORMAi RAT1l 17.The executive director demonstrates the abil(ty to maintain a positive, constructive relationship with the board that maximizes o~ganizationai performance. 18.The executive director ensures the board has access to relevant information and data Eo facilitate informed decislommaking regarding the organization and Its programs, actlviEles, and services. 19. The executive director-.and board chair are viewed as working cooperatively as a "team. "' 20. The executive director ensures that the organization has Clearly defined and implemented board approved policies and procedures that are used for oversight of operations,. 21.The executive director's'performance and compensation is formally assessed annually based on objectives established by the boartl at the beginning of the organization's fiscal year: 22. What are your suggestions for how the board can do a better job in this area? •GG 23. What resources andJor organizations does the board obtain information from when working on - issues in this area? 24. What resources or training would be helpful to your board and help them improve their performance in this area? ,: 4~page 4 7ttls board assessment.was prepared by IN-CA9, Resu/ts;Unl/m/ted„and Cartrer BUrrus, LLC , S .~ Y ° ~ ~Riw i r --~ ~ 3,. ~.(.3 r~ .~. pt fN St~,...~.6'.~.d3 .U. t• pp/~ ~i. ~ ~ ba t f.r ~ 4 ' it Ai. ~ is 2hiifL~S~C~.~~1~~~-~ti~ ati~~i P ^i?.er; ~a1 X'S~~fC ^~~.+~nt~~.'l~ ;'~!'! ~, _. 2 $ 4 DK Strongly Agroe Agree with `pisagree with Strongly Disagree ' Don t Know ;with Statement . Statement Statement , : :with Statement ~ :. 4-~ n 1 11t : .~ ~`~ ~ ~rT d1t° ~{ kR)K~` t 9 1i ~ 4f Y3 ~L ,~,. ~ " q ~ t ti` k £ f~ Cx 1~.,,.A' t + ~,'bl~R rYA ~k ~ 3` .> 4y ~ }y~ T 4 K~ F~l jl '$ ~ ~ $~ ~ 1 T .;,?~~;P 2~z f2y~.R ..~f 4 ~W.+. ~.ftl~il~ S 1;J~`:. 7~ ,~iSn•~; T'4.f' . k 1~1, +Ui.S~~~r ?ylt „!'1-:ft_ . -l 1~2~ ~~tt ~J~. .~i', ANSWER THESE QUESTIONS BASEO ON YOU#2 ~RECEPTIdN OF t30AR0'S PERFORMANCE RATING ~5, Beard members are clear ahouk expectations for their personal fundraising'. responsltillity (Le.;`Indlvidtial gNing, voluhteering at'fundraising events); 26.The board works to diversify and maximize sustainable revenue sources beyond CSBG funding to ensure the health of the organization: 27.The board supports efforts to seek public and private funding to implement new programs and. services to address the Identified needs of the community. 2;3. A clearly written fund development plan is in place with specific. implementation strategies and goals. 29. What are your suggestions for how the-board can do a better job in this area? 30. Whatresources and/or organizations does the board obtain information from when working on issues in this area? 31s What rosources or training would tae helpful to your b©ard and help them improve their performancein this area? 5~Paye ~~Y>?~~i~~+~~~~€~~`~34jy s~ti:{+~1 n~ ; ~'., a :,7 ~.1 .d~~;SE ~~~~iq',%~~}iJ`r ,~'i,.~'~`rYf tr ,•5Yy 3 i,~.~a ~,~,Nyi".,~.„ ~,Y ~ .. i z 3 a oK Strongly Agree Agree with Dlsagree with Strongly Disagree ' . with StatemenE Statement Statement Don t Know with Statement 4 rU 4~ ~aA 7i ~ ~ s ~ ~ V~ `'a~Tt',~= 6t`}~}gy~. E~ tii 5`~~n'}} r,~-"~"o- L-t~t' ~ ~ F t ~ ' t""!~ ~j~a~ ~ ,, ~~`}~.a~'S~. ~'f~ ~r~+k~~~'~ ~' ~ i h t{UJ ,[ .. )v).+ _ t l .PL~`.}~.'l A C~. .~3'E` ..-e~"I)L 14.taY41 max./ F ~Y~~'?P ..`+ . a~, 4 S~~~q°~~9. ~. ANSWER THESE QUESTIONS BASED ON YOUR PREC~PTION OF B opportunities to serve on board committees, RATIO 32.The organization collaborates with other agencies and groups thatprovide assistance to low°Income families in the community. 33.The board and staff engage commuhity members to skrengthen the ; organization's advocacy efforts. 34. The organization can readily mobilize z network of community allies and advocates who can fie Influential at neighborhood, city, town, and state levels. __.._ 35. The board actively promotes the organization and Its activities to enhance its repukation in the community. 3b.The board and organization Invite policymakers and elected officials to agency events, such as the annual meeting. 37. The organization has an effective publ(c relations and communicatfari plan in plate, keeping the community informed about the organization's acklvities and accomplisftments. __ 38.COmmunity members and other partners that are not on the board have 39. What are your suggestions for how the board can do a better job in this area? J 40. What resources and/or organizations does the board obtain inforrrtatiori from when working on Issues in this area? 41. What resources or training would be helpful to your board and help them Improve their performance in khis areal 6~paye /(eSO1lD tAtmun ~ --- fiis board assessment was prepare y, ~ ;, SECTTON 6: PROVTDING EFFECTI MANAGEMENT 3 to ,~,~ .. mss' vj ,y t ~l4'~ 4SS ~ R S 9r~ ~.'b +~~; ~'s .a`sYe~_Se~' a t eR:h~w+ +` ~y pnpp~c+ x,. Yt.+k..a.+~~ _ s ~r t l.t;~~ +;~ ~ >, s.J~fArt' i ' ,a,: 3rA~Y.~h.~ru..!"rY_PQ~ ~~ „e„-t 'u, ~ ~ 4 1 2 3 =3 Strongly Agree Agree with. Disagree with Strangiy Disagree pon't Know wikh Statement Statement Statement with Statement w,~ `~ ~ ~s ' ~' i - ~ rc Yiw'Jr ~ ~f ~3 ~t° ~3 ~'. ,`~ ~i•~t~4e7 ~, ~ t aF.re. „JF~T ~ e. L ANSWER THESE QUESTIONS RASE[? ON YOUR PRECEPTION OF BOARD'S pER~FORN ANGE 42. The organization's annual budget is fully discussed and understood by board. t members prior to Its approval. 53' 43.The fiscal status of the organization is regularly reviewed and necessary i board action is taken In a timely manner, ____ ~ 44.Organizakionai funding needs ate reviewed annually and priorities are established. 45rThe Chief Financial Officer provides relevant Flnanda) statements and 'documents to the board at least one week before every board meeting for , review by board members. i 46.The organization's audit report is reviewed `by the full board and :necessary ~. actions are taken in a timely manner. , 47. What are your suggestions for how the board can do a betterjob in this aCea? ,;; ' 48. What resources and/or organizations does the board obtain information from when working on ` issues in thisarea? 49. What resdurces or training would be helpful to your board and help them improve their performance In this area? 7 ~ Page:.. vlts Un!!mlted, and Carder 8urrus, LLC a 50. Data is used to Inform decisions regardi services targeted to reduce Inequality in and famllles. 51.The organization staff demonstrates khe diverse populations, 52.The board uses the results of activity p~ strategic plan,, 53.The board annually engages in a thorot organization's programs and servites. 54.The board uses evaluation and activity aide decisions about program modiflca I~--{?ER~RMANCE } td. ,~SE ~~YNi7"f-a•J"'~S ,~°~-3~1~~'Ir.?;e r~{~~, ~~ r'r~'" °f~.,;; ~:_ ,. 3~ 4 DK rgree with' Strongly Disagree Don't Know' atement with Statement ~ ~' ~~~i~';~~ s'5~~6' dt'~~3~3at 1,~y4ir~~,i 'd4+ 5~d: IUR PRM=CEPTION OF BOARD'S PERFORMANCE '. RATING dementation of programs and ~~-^~ ability to work effectively with :rformahce reviews to update the igh review of performance of the nnrfnrmance review information to g _ 55.The board evaluates program performance against the organization's mission oh a regular basis. 56. Written organizational procedures are in place _to ensure equikable access to program services and facilities. 57. What are your suggestions for how the board can do a bettor job in this areal 58. What resources and/or organizations does the board obtain information from when Working on Issues in this area? 59. What resources or training would be helpful to your board and help them improve their performance in this area? 8~Fage a 77E/s board assessment was prepared by IN GA.4, Results Unl/mrted, and Cartier Burrus, LLC _._ __ _. `t, SECTION_8~ BQARD ~. ___ _.. _~_ ~ ~~__ _~ . ~~ y Y '{~h t ( ~Y ~~1 ~p [[~~ tCY'i.'..~ i.. rt,1~j~~... 94Y S?~~tf ~~t ~1 ~$t ~ ~.1? •z~ t`4-\ i a.Ji X~, ~, EVIFM~O~i1~71~Vtt ~~i ~~}~S V~b'x~`a~~~t ~ , .u .~. ..~ ... . ~-~- bp:_~ ~Y'f 9}t'+i ~hl-it ~'Fn ., i - ~ 2 3 4 DK Strongly Agree Agree with Disagree with Strongly Disagree. , Dpn t Know with Statement Statement- Statement with Statement xe)3' ~ y~p{A~+~i~ ."s . ~,~L iE~,:,.v~l.'~1 i~`f 't'ry#xik~ia ~ dt n i ~ -~'t Yy.~r~a }t }ry'Ny! t+.~ ~} l~g'+u{~'~{~t l~'Y~Nv,:st^~l~,t YJ,.x~~. Zn~'~` ,~?~,~.?S.#L~~i+~; %t3 b 4:~5`k~~r ~ a *ta °' rt~t~;e,t S-Zfr .t4~`r ii~ns,.vj lt~G52b d ~';},~g'~'~'/n+, iiY ~r? t~ i r w[~`~kS~i~V{2~aYlN, _. 'r3~q ANSWER THESE QUESTIONS BASED ON YOUR PREGEP7ION OF BOARD'S PERFORMANCE RATING 60. Line of responsibility for board and organizatlonai Staff are clearly defined and differentiated, 81.Tfie board delegates to the executive director sufficient authority to lead the staffand carry out the orgahizatian's mission. 82rBoard and staff have a shared understanding of the organization's strategic: '.goals and work cooperatively to achieve those goais~ '' 83 What are your suggestions for'how the board can do a better job in this'area? l G4. What resources and/ar organizations does khe board obtain information from when working oh issues in this area? &5. What resources or training would be helpful to your board and help them improve their performance an this area? This board assessment was prepared by IN-CAA, Results Unlimited, and Cartier Burrus, LLG l~l IV 9.-DC~JRRh t'TI71 I(`7'11D~-I~R17Yi~iV~ t E ~. .3 { L f V f t 4 3 {. h I'a t+ p. y y I a .u ry }~~c j/~ c_ ~t Y d~ r 1'~Y~.x~"i .> S.. e4t{2;,. {Iq~ Y(tF4 ~'~z'i~.i`C~, i~~~ }.T,ESPO~7~?E T1S~Qst~~~.~~1'? >i:I a,n~i ~~f t~.IF.+~'4~t..L~Ff~.. 3.,.. .t 1 2 3 4 DK Strongly Agree'' Agree with disagree with Strongly Disagree Don't Know with Statement Statement. statement wi#h Statement s.a a k i vt«: t )~ ,~.. k ... { e t° ~ Y~ p2k r .t3 r , t „KY as .~'S«uvf~d .Y-~irid-~Fa'tL ~t~?r=~~ ~ Fb~SAr;~~siix~YtF:G !";~"".fi(_ 0~~5'~.t~J.^4',~.h3~. iY eyf ..tk9`11~`,~}4liti4~.?;`zf~' ~~~"~..g'.Ar....~.1, ~ ._T1 ~. 4NSWER THESE QUESTIONS BA5E0 ON YOUR pREGEPTION Op BOARD'S PERFORMANCE RA7SNG 66.The roles, responsibll(ties, and expectation of board members are clearly understood. 67.The board s(ze Is adequate. 68. The areas of expertise, skills, and other factors needed to be an effective board for the organization are adequately represented among current board members, 69. Board members are actively recruited based on the organization's needs. _. __ - 7t).Board members are provided a comprehensive orientation that includes the history of community action, community action promise and code of ethics, and the organization's mission, vision, by-laws, policies, programs, and roles and responsibilities agboard members. 71. The board has a written succession. plan in place for board leadership to provide guidance wheh there is an anticipated or unanticipated change. _ _:_ 72.The board thoroughly examines the pros and cons of a0 major Issues before dedslans are f(nalized. 73.The board's committee structure Is effective, the number of comm(ttees is appropriate, and their objectives are well-defined; __ 74. Each board member serves on at least one board committee. 75.The organization's conflict of Interest policy is clear and all board members adhere to it. 76. The format of the board meetingsls the right balance of information sharing and strategic thinking about majorissues and concerns. 77. The board's meeting schedule has the right number and length of meetings, 78. Board meeting are generally well-run and make goad use of members' time. 79. What ate your suggestions fat how the hoard can do a better job in this area? 10(Page '° i~l;,- _.. Thic hnar(/acc6ccmPnt was9 1 Skrongly Agree ANSWER THESE QUESTIONS PERPORMA' Don't Knnw se` ~~ti~ Y n' ~`~ i it1 ~ ~ ~~:' V THE gOARl7 RATING 82.I get excited about the mission of the organization and support where we are headed In two to three years, 83.i look for news and trends that impact our organization: 84.I am knowledgeable about and can describe the organization's program and services: 85.I have a clear understanding of my role and responsibilities as a Community Action board member. 86.I thoughtfully prepare for board and committee meetings. 87.I actively participate In board meetings and feel very engaged fn he governing process._ 88. T actively participate on at least one board committee. _.. _. 89.I actively partidpate in board and committee work, 90.I recommend people for the board and board committees. 91.I respect the other members of the board and have a strong work{ng relationship with them..,: 92.I actively participate in he development or the organization's strategic plan. 93.I actively participate In the annual review of the organization's executive '.director. 9Aa am knowledgeable enough about the organization's. budgek to make Informed funding decisions about the organization and the programs and services iEoffers. _ 95.I-.make an annual f(nancial gift to the organization. 96.I share information about the mission and programs of-the organization with people in the tommunity. 97.I actively participate in at least one organization activityor evenfa year. 98.I am a advocate for Community Action rn my community. 99.I believe that being a member of this board is meaningful and a productive commitment of my time. 100. What resources or training would be helpful to you as a board member and that you. help you improve your performance as a board member? 'eel would 12~Page =ssmenf ~ 1 11. This derno~rg please select N _... :litelitditd eVdllldtlDii~ How long have you served an the board? ^ 1 year or less ^ 1-3 yeas ^ 46 years i ^ 7-9 years ` ^ More than 10 years .: , : : _,.. - ,., .. ... r ... :; .- .. ,..,~. .. . .. . .. . . . ..~ .,: 1 € Gender i '• i CJ Male ^ Female ~ ' ~, ., Ethnicity # ^ African American American Indian/Alaska Native Asian/Pacific Islander 1 J Caucasian(White (non-Hispanic) € ^ HlspanicJLatino Multi-Ethnicity Age ^ 18-21 ^ 22-30 31-40 ^ 41-50 ~ ^ 51-60 i ^ over 60 { '~'SG,(:PvR3s~l-.ug3lPilhJL ... a.r~N::;.yS. ~ _Y. 2S..9r!(it i.I. id~x u-I::i:r...n~A. I3EL~.r ..a..-~.~.-.e£-.-S.a.~1:2(.4LC;urSti~IfZ:Nfea'ti'yS~2`~'.ty';h._=..L.~.z~ v. ~K'~~Z's i t Are you a board officer? t7 Yes. ^ No { , .......~5aa 3L44~c`3n'.• J ~ i C... e+.w~~ra`9. ;YS -0.Y'. r.Y'_1s r :1~_._..t~-P_ 'a ~:i'. ?:~-~:-ll ..uVGi~~k#±f3«~.=c1 y.~..i.4a N..~..:Y.53xkl:Z.a 2. ...a What board position do you occupy? ~ ^ Public (elected official, policymaker, council person) ^ Private (lawyer, CPA, business) t ^ Low-Income (low-Income person or representative from the community) 1~~Page <, TCCAA Community Services Block Grant Policy & Procedures S;\PtoCedufes\CSBG Pagel of 13 L Program Overview ..... ................................... ....................... ......3 A. Rental/mortgage assistance :...:..:. .:....:..:.:....:.........:......,... ........:....3 B. Educational Assistance..: ......:: . ....................... ......::. ..::....:....3 C. Emergency Assistance :... .....::.: ,..,..i ,.......:........,.. ...:....:.•.4 il. Eligibility. .... z. ...... .......... ....4 #. .,:.~ . .......:.....:...... ,....5 Screening A ... v R . C. Confidentialftp. .., . `~~~, ....... ...... Y .5 t D. Social Security Numbers. .. .5 E. Release of Information'and Applicant Statement .: :.... :....:.,.6 Determination: : „ F ,~ . .. . ; ~ : ~: Denial `of Services.. ......::. ......: ::.. .:..:.: .......:. ...:.......6` III: Family Self Sufficiency r ... ............... ... .....:..: .......:.....7 IV Payment Processing . ........ ....... .r ,................,..... ...::..,.....:.... ., ..7 . V. Right to Appeal ......... ...... ........ ..: _,8 VI. Quality Review........... ............:. ..,..~ .:....... ......:. :..:,.::....:8 .VII. AgQncy Staff and Board. Members pplicants ......: .... ....::..: .:.....:.::..8 .VIII. C' `ility-Income5ources,:. ...:.................. ...::.................... ..9 IX r Shork Term Assistance ....:.... ........: ....:.... ..:......,. q ireme 10 . ~ r X. irements ~ ong Term Assistance:......... .,...:.... - :..:..:.................. 11 XL Deaf , otter ...,.. ..... 12 XII, Applic tatemen , .. . 13 J.k I Trea .Coast Community Action Agency Community Servioes Block Grant Mission The Treasure Coast Community Action Agency's mission is to partner with other human services ,. organizations, the private sector and citizens to offer programs and services that build self-reliant "individuals, families and communities, TCGAA Community Services Block Grant Policy& Procedures S:\Procodures\CSBG Page 2 of 13 '' support of employm~ Ths` al of the educational assistance program is to provide. funding for students in ordert4 ~ to their financial a(d. This program also provides funding for credit hour programs tha ire not financial aid eligible. Applicants who are in temporary housing situations (such as with a relative or friend) may'provide a signed statement indicating the living arrangements. Applicant must provide proof that their household is maintained separately. Ex. Food stamps, Medicaid, separate (lying expenses, etc. Community Services provides services geared toward helping individuals and families become self-sufficient, including but not limited tc~ • Education related expenses, Childcare assistance to in support of education oremployment. Nutrition assistance to ensure ongoing self-sufficiency. • DisasterRelief. • Transportation assistance for employment, educatio_ ~ ource access, medical appointments. employment supports: tools, uniforms,testing~~~s • Asset Development ~ • Referral Services ~ • Evictionlforeclpsure prevention. ~ _ . • Utility assistance for deposits or disconnect prevention. ~' Emergency prescription medication. Other services maybe provided ' ~ rdatlce with the Department rnissi n, Applicants enter the program via direct telephone o t 'a ., requests and;referrals from other community organizations. ~_ ~ , a ~~ ~~; ,~ A. Rentallmortgage assistance Applicants seeking :emergency rental/mortg~. assistance may not have a history of multiple prior evictit~ sx~r gust be current on property es. This will be verified by accessing the public ray; , ~~fi~l~erk of the Circuit Cou ~; r other means as deemed appropriate.l ~~ B. '~' ,. eational;As§~ce poi 7x Education I' „ istance is pi` : dad to applicants for certificate and degree programs at the State College 3 .. ri-coon ` ~ rec. Assistance is provided for those seeking a first degree. Assistance is also: vided f ~ ~ hose seeking certificate courses, testing and licensing in TGCAA Community Services Block Grant Policy & Procedures S:IPfocedures\CSBG papa 9 of 13 _ _ _ __ The majority of the CSBG funds are dedicated to assisting residents toward long term self- sufficiency. A small portion'is set aside far emergency situations, including but not limited to: • Disaster recovery • LZental or Mortgage assistance • Utility assstahce • Medical assistance Food assistance • Transportation needs ~. • Clothing. ~ €~''~ • Childcare r ~ ; • Shelter k~~ , Legal r;' Protection from Violence F Emergency assistance is limited to $1000 per applicant without ~f~'t•,approval. The program manager may approve additional amounts depending on the severi the situatioh: ~~~ `~ ~'<;~ II. Eli ibilit ~ ~'~` 9~ Y ~. ~,. • Applicants seeking assistance tit" ~ ugh t ;i N am must show that`they fall at or below 125°/a of poverty level. Eligibility~~ b ~ ~ } e ~'~ '~ : number' of household members, gross monthly income, and other! r ~ ants. `i~itributians from any other source to the family unit are considered incom per DEO guidelines, • Appjj~ea ,must be a County resident . x= t least six months, For educational ~ ~~~f~ ~§ ~ r icants must meet the re 1~ncy requirements of the State University in ~ ucie Cou,~ , ~r~~ mergency a s~ tance, applicants must demonstrate a need for services based up©t~' one-time crr~including: loss of wages, illness, divorce/separation; disaster; etc. ~~ ~~ The agency wilh~ exclude ~licants from program participation or deny program benefits or otherwise discrim rt again'"' ny person ar class of persons by reason of race, creed, color, national origin, sex,; ~ o nh bllity. Applicants for education ssistance are approved on a first come, first complete, first served basis. Family self-sufficiency clients are identified from incoming applications or referral sources. These applicants must show a commitment to becoming self- sufficient and a willingness to work closely with a case manager to address barriers to independence. TCCAA Community Services Block Grant Policy & Procedures SaPr6oetlUrBatCSBG page 4 of 13 : +nanage~-an-a~pNc-aptly-be~fet~ied~+rfviees; Appifeantsare~nformed ofthi~ consequence at time of application, A: Screening A prescreening is completed at time of initial inquiry for assistance:Based on the initial screening, the applicant maybe, Asked to gather verifying documents then contact the office for an appointment. • Referred to other agencies in the community for'assistance, • Assisted with case management to identify barriers and potential resources. B. Intake __~ An appointment will be scheduled once eligibAity can be determined at the timer I. All applications must be signe 2. All files will be reviewed and it compliance with grant guidelir C. Confidenti Ali documentation` Ames collected from appl will disclosed without the ~ kr defined in State or Fedora-~- utilized strictly to verify apps assistance. D. Social Security Numbers Social Security Numbers are required for eligibility and are kept in a locked and secured Iocatlon. These numbers are used for the purpose of verification of identity and will not be disclosed without the prior know-edge or consent from the individual or legal representative, as defined in State or Federal Law, code, rules or regulations. Other Identifying information may also be redacted in the case of record requests, except when required by State er Federal Law. .. has all the required documentation, Final it. t a~" the case manager. n+isor or designee to ensure .YTS l time of application. However, all information ate and confidential. information will not be it from the individual or legal representative, as egulations. The release of information is ~ allow forreferral to other programs for _w TCCAA Community Services Block Grant Policy & Procedures SilPtocetlUres\CSBG page 6 of 19 Applicants must sigh the application indicating that they are responsible for the accuracy of the ihformation and that any falsification or misrepresentatioh of the ihformation is just cause for denial of servicest F. Determination The income received. by all members of the household mu t be totaled and measured against the Income limit for the household's size. The follov income: • Calculate gross income received from a .days. Use current CSBG allowable sou include. Annualize income by multiplyir Compare income to current CSBG pove ..eligibility.' ~g met~od will be used to calculate iousetjd members for the previous 3D es of inco, to determine the income to total receivers~~,n previous 30 days by 12. / income qui`deltt~es to determine • df self-employed, detep~*ine income by subtracting from gross receipts. • Ifi income is from a roor~"i •" er, the countable income is the total income. ,~, received less expenses i s o~ • Benefit check,. verification~i~ onfirm award notice or written letters from: ^ Social Security Adminis#rat a n ^ Department of Children and flies ^ Assiskance from. other agencies ~t~ .. ..~ nc ~ r of is unattainable, a seifeclaration of low income status may be '~ accepted: ~ certification. must specify the reasons that the applicant oan supply ;~~;ro current doh entation. An additional explanation of how the applicant is 3 iding for hi ',, `r basic needs must be attached. 6 }mod,` j~Y ~"" F2' ti{ ~ w.~ G. Denial of Serve }T If an applicant is deemed=neliglble for services, a denial letter indicating the cause for denial will be mailed or delivered tothe applicaht. This letter includes the righf to appeal process, including time frames. Reasans for denial may include, but are not limited to the following:. Household income exceeds that allowed by the program. ~"'` Supporting documentation for your application was not provided and/or verifications could hot be obtaihed. TCGAA Community Services Block Grant'olicy &:Procedures S;1ProcedureslQSBG Page 8 of 13 uya.,,uy. Multiple prior evictions are documented. III. Family Self- Sufficiency Program The FSS program delivers a case management comp~ei,~sive and coordinated plan of activities for low income households to achieve familQ -sufficiency. The objective is to provide a community based approach to the delive~cjf`~gial services in order to help eligible families become self reliant and independent of alb"~orms'o~ lic assistance. The emphasis of the program is focused on client accountability and resporisjt~ty for their life, and moving forward on an established plan for the future. "~ The following activities are established in an effort to assist participax : ~overcomhg obstacles to self sufficiency; • Provide a comprehensive c ,,t n ~~ et of services adequate for participants to ~,,, become self sufficient. • Mobilize resources and mainte = etwo ~ ~ essary for empowering participants to become self-sufficient. ~, • Provide transitional support service sure p~; ipant's achievement of self sufficiency is sustained= • Encourage participants to commit to ndividual's plan for attaining self sufficiency: • Inform and solicit the support of the ger~:~ I community for the basic objectives of the. FSS program. Scale matrices may be used to evaluate progress in a variety of categories, including employment, health, education, housing, transportation; nutrition,'and others, These matrices will use a ladder scale from In-Crisis up to Thriving to illustrateprogress toward goals and eventual successful exit from the program. Additional details on the Family Self Sufficiency program will be addressed in a separate policy. IV. Payment Processing A. Once eligibiltyis determined, the case manager will provide file for reviev~: B. The supervisor checks the File for quality and verifies fund availability. C. Once approved, the case manager will generate check requests and confirmation letters. '? TCCAA Community Services Block Grant Policy & Procedures S:1ProceduraslCSBG Page 7 or 13 '- . Finance Department Policies and P_rocedures.-.Fiscal Specialist will also ensure #hat -- =-- dh t da t z V. VI Vii. Area s ee expen I ure racking is updated . Expenditure spreadsheet will be maintained on network drive for easy access by all. program. staff. The spreadsheet will be updated by the fiscal specialist as funds are expended.. Right to Appeal Ifthe applicant is dissatisfied with the disposition of hislher application, helshe has the right to appeal. All applicants are notified of this right during the initial intake. Appeals must be submitted in writing or postmarked within 30 calendar days of the disposi#ion of hislher application, ,~, If the appeal is not roceived within a 30 cal'` ar day period, the right to appeal is waived and the prior disposition is final. All appeals s~1'~a,{~e addressed to the agencythat processed the appQcatlon: ~.. ~ ~ The applicant mus# present additional substantiate the request at the: time of All applicants will be (Appendix III). Quality Review All #iles go through a rev ahd clearly illustrate the determihed, the goals dF or verification, Jn writing, to with their rights to appeal. e notes and outcomes must be clear and concise pplicant, how eligibility and sustainability were as outcomes. ' Agency Staff and Board Membets as Applicants Eligible agency staff, board members and their family mem'~ they meet established eligibility criteria. No preference or pi regard to the application process orthe disbursement of fur a family member or any other persons with whom a cohflict situation the client should be processed byanother case m. individuals will be referred for assistance to other organizati for agency staff or board members must be approved byth~ Chairman. may apply for assistance if l vvill be given to them with Agency staff should not assist rterest may arise;' In this rer. Where possible, these as available. Ali applications >gram Director or Board ''"2 Note that: checks issued through this program require at least 10 business days for processing and no checks will be made outdirectly to clients. of any denial of service antl TCCAA Community Services Block Grant Policy & Procedures S:IProceduies1C38G Page 8 bF 13 VIII, CSBG eligibility-Income Sources CSBG income guidelines are revised annually.. The income guidelines and the allowable sources of income must match the contract year in order to accurately determine an applicant's eligibility. ss~s ~~ iySy~~~ 1~ { aE-1:... ~ 6 Y ~~§n 5 E"...- ~; TCCAA Community Services Block Grant Policy & Procedures S:1Prooeduresl~SeG Page 9 of 13 Picture ID for all adults ih the household 18 years of age. or older Social Security Cards for all family members Birth Certificates for all children in fhe household under the age of18 Proof of all household income for prior 30 days- if unable to provide proof of income, aself- declaration of income must be completed and signed. r.~ Current rent receipt or a letter from the landlord stat fn~g~t amount and date of last payment OR monthly martgage stater»ent(Copy of lease if a,i~sg with rental payment. Current utility bill showing address °•~~ Mnst recent bank statement for all accounts held by the housel~~lt ~~, Sc ' ~~ ?.";.. Telephone: (7' i St[eet, Avonue R) :'349b0 Fax: (772) 462-2094 TCCAA Community Services Block Grant Policy & Procedures S:\Prooedures\CSBG Page 1D ot73 ,., X. Requirements for bong Term Assistance: ,+v,wv ,v ,v,un vv v,w q, aw , vu,,uw ,v ru ,v uyv va u,. Social Security Cards for ali family members Birth Certificates for all children in the household under the age of 18. 3 months paid rent receipts or a letter from the landlord stating the amounts and dates of last 3 payments OR 3 months paid mortgage statements. Copy of lease/rental agreement or mortgage documentation 3 months of previously paid utility bill showing current address. 3 months of bank statements far all accoun~~eld by the household. x ~`_ 3 months of documentation showing prid`~~~+ork history and income for ail adults in the household who are 18 years of age or ol~aT. A certification. of income from the employerwil) also qualify. ~ `~ ~~~ y+ ~ Eviction notice for rent shut off notice for utilitie~t5`~~ ast due mortgage note. Copies of official documentation showing ANY other $ ome, such as: child support, Social Security Disc y~lit Retirement {SS), SSI, TANF, alz~ ny, unemployment, t ~ =~ worker's comp~~,¢~ on,'t~c~rstamps, eta: Copies of all the ~ thly hog `hold bills Other financial docu~; frf~ta#ta~t: u~ng but not limited tc arrest records, divorce ~, decrees, custod docum ion, no~io`~, f.,eviction, past dueldisconnect notices, Y ~~ mohthly bills, notarized state't`iiiC..ts, employmehtverfications, financial aid verification, ~~.-. or others. ~_. Please note that all applicants will be required to participate in free financial and budgeting education in order to receive services. 437 North 7th Street, (Corner of 7th & Avenue D) Ft; Pierce, Ft. 34950 Telephone; (772) 462-1777; Fax: (772) 462-2094 TCCAA Community Services Block Grant Applicant S:lPtocedUres\CSBG Page 11 p(13 XI. Denial.Latter pate Applicant Name Address City, State,Zlp -~~ Y~ K ~~ Dear Applicant, ~' 4tf~~3 ~~ It is with regret that we notify you that you are not eligit~~le for s~~4 es through our program for the following reason indicated: ~~~ - ~X ~~.. Household income exceeds that allowed by the program `-~~~, .Supporting documentation #or•your application was not provided. ^ Verification could not be obtglfi~,d~for income home owners uflllt .bill efc: ^ Landlord refuses to sign WJ9 # ~`~,~ ~; ^ Landlord is unwilling to work wit ` ien~~ our agency... Prior evictions documented C] Other: `t~. Please be aware that you have the right to app writing and postmarked within 30 calendar day If your app '~ reno "te d within a 30 calm the decisi~dicated is i, ,,~. All appeals shoe indicated be`~r, and must be'. ~ ompanied by in writing, to s t~. rtthe appeal quest. t~~~ ~: is decision.. Appeals must be submitted in ie date of this letter. ~y period, the right to appeal is Waived and addressed to the director at the atldress mal documents, information or verification; if you have any quo~~ ~ s, you m~ cohtactthe office at 772-462-1777. ~~~ ~; Sincerely ~~~~- Name Case Manager TCCAA Community Services Block Graht Applicant S:1ProeedureslCSBG Page 12 of 13 Treasure Coast Community Action Agency I swear/affirm that 1 have read/had read to me, the information on this application for assistance and that the information that I have provided has been properlyrecorded: I understand that 1 am responsible for the accuracy of the information as recorded and it is my statement in support of my eligibilityfior services I also und~T~ and that falsification or misrepresentation of the information recorded is lust cau~~f~enial of services and prosecution for fraud. hereby grant permissionand authorized disclosure o"~any an lx; l information to Treasure Coast Community Action Agency concerning my past, present, Vii; future financial accounts. furthermore, I au#horize Treasure Coast Gommunit Action A enc to~~~c~uest and/or release Y g Y any and all information with respect to my household income or househdfi pense, and medical or psychological information as may be pertinent to my applrcatlonfi~service provision and caserecord. I understand that my persona! information (such as; Social Security Numbers and benefits information) will be held cptf~ ential as required by StateJFederal Law. ~~"', mar= `il •s~ _ G, ~~~ Applicant Signature; ~~ ~~ ,„ ~ Date: / / --~ Co-Applicant Signature: Date: _/`/ Case Manager Signature: ~ `- Date: / / TCCAA Community Services Block Grant Applicant SaProcedureslCSBG Paga 13 of 13 __ '_ acv :. ~~~~' M~tio• ~~~~ CO~IIMUNITX SERVICES $LOCK GRANT ___ __ INTAKE/APPLICATION Name: pOl3: SS#: Address: City: Zip: Phone: Work: Cell: Email: Sex (Circle one)? Male Ft=,male Are you a veteran? Yes 'No \tond~„ Household MemberslRelatives Soclal Security# Relationship. Sex - Pisabted Veteran p08 Age Income Income source M19rent worker: M F Y N Y N -- - Y N' fV1 F Y N Y N Y N M F Y N Y N Y' N M F Y N 'Y N Y N M R Y N I'Y N I Y N M F` Y N Y N Y N Annual Household Income: Number of people in household:. If applicant has children: Filed for child Support? Yes No (it No, assistwlth process! folipwupwithin 30 days to identify the amouhUoutcome) Office Use ONIy • Receivip9 food stamps? Yes No Medlcatd? -Yes No ' TANF? YE3 NO (If no, assist applicant in registering and count in outcome date] -. - • Registered with Lifeline/Llnk up pr Safelink7 Yes No (If rio ahdare oligibte; please register during appointment and add to quaHarly outcome repotting data with amount saved] bo you file taXesfi Yes No Know about Free 7az Ptep Sites? Yes No (If yes, are they familiar antl eligible for Eametl Income Tax Credit?j - Yea No r °Page 1 of 9 Rev(sed 4/73 Cod1Q1UH//v e. , f 4 ~*-' jt \..: 3 . ~b~ ,~~ . Q~ `Earned In~ame (Use additional page(s) for more family members) Employment Information: Household Member Name: Employer Name: Pdsition: Address: Length of time empioyetl: Hourly Wage: Hours worked per week:: Paid: ^ Weekly ^ Bi-weekly ^ Monthly Gross Annual Income: $ Self Employed: ,^ Yes ^ No _ Gross Monthly Income: $ Phone Number; Supervisor's. Name: employment Information: Household Member Name: Employer Namo: Position: Address: Length of time employed: Hourly Wage: Hours worked per week: Paid; ^ Weekly ^ Bi-weekly ^ Monthly Gross Annual Income: $ Self Employed; ^ Yes ^ No _ Gross Monthly Income: $ Phone Number. Supervisor's Nama: °' .Page 2 of 9 Revised 4113 ~_ . ~' ~r~ .~._ , , . ~~ ~. ~ p~~ Household Member Name: ross earned income per year $ + Unearned Jncome per year $ Grand total $ Page $ of 9 Revisea ana SOURGE GROSS MONTHLY ` SOURCE GROSSMONTHLY AMOUNT AM©UNT Soclal Security Retirement Whop $ TANF, Who? $ Railroad RetiremenE $ Training Stipend or Grant Who? $ Who? UIt3, Who? $ Alimony, Who? $ Strika i3erefits, Who? $ MIIltaryAllotment, Whop $ :Worker's Compensation $ Support from someone not living in $ -Who? household Who? Veterans Administration $ Child Support, Who? $ WhG? S5bl, Who? $ $ SSI, Who? $ Other.. $ Who; What TOTAL $ z°~Co~~~~~0~ ,, , _~ ~ - ___- ~ ~: ,, ~~c. ~~ . p~~~~ Applicant Name: Nlonthl Bill? iHOUSEHC}LD EXPENS ES dent/Nlort $ Life Ins ` $ Electric $ Furniture Water $ Cable... $ _ Phone $ pia ers $ Garbs e' $ Personal Faod $ Other Meds $ Qther 2 $ Car Ins $ Other 3 $ Car $ Other A~ $ Other 5 $ Total Ex' eases: I understand that I am responsible #or the accuracy of the household income/expense and related information and that giving ar misrepresenting information will cause m~ to be found ineligible for assistance. Applicant. Signature: Date: Agency: Case. Manager Signature: Date: ` Page 4 of 9 ReWSed 4/13 Sacllan 0 Program Participant tWaraciedetlw i. Name bfAgoncy ltOparttng _ a. Able __. a. One ^ -. . _.... 4 Feirele b.TWO ^ ,. -TOTAL g c. Three ^ - __ d, Four ^ g. Ago Number of Perso na' a, FHe ^ ' b. 8.91 9. haven ^ c. 12.17 h. tighten more a. 78-4d TOTAL"' 0.24 -.44 14. Please chock all incomeaourcas for lhle lamiy. L46~54 a. TAkp A g 65.68 b. S$I h. 70i t. Sochi Securay ^ TOTAL' _ 0 d. Panakn ^ e, General ASaalante ^ 9, BhnkilyltaaCO Number olPersone' 1. Lhet4goyrrem hsurance ^ -.-.. er S ^ 1. ehniclty - ouris g. Fmploymanlr0lh e Hspank, Latino or Spanish qgh h. 6rybyirent Prty ^ b. FbIlBpand, Le0ro; or Spanish(Mgm ~ I. gher ^ TOTAL' 0 Nse onlymrere cases. xhen appropriate: M1b hta~(+Rponed ^. lLDSCe Oats not coaecled ^ a. Vrhae b. Sleek or pfrkan Armrkan c. Amar>cen hd'anand AWSka MdLva ib. Levol of Family intama 'tCheck Deny t) - d.Aaan f'AOlHHS OU7delfne) - eNaiNaHawa~nandOtherPatdicBlantlH e.'.WW50%: f. gher b. 5f%ta 75% ^ g FUW-Data (any hvo a more of the ebova) c.. 7890 M 100%. - TOTAP O tl. 701%io 1Y5% ^ e. i26%Ni60% ^ 1g. FEUCeIIOn I.aVaib of Aduilsk. 'f. i51%1o 175% ^ (qFw AdulM2f years Or Olaer Only) Number o/Persons" g. 176%to 400% ^ a. 0~8 h. 2n7%and over ^ b. 8d4lWn;Graduale'. c. Fegh School GradualalG® a 12t Some Post Sepandary e. 2w d years Oagege CYaduala TOTAL' I11. ghar CAaraclerlatico }IOW MANY IN FIONSEf7Oi.D; - e. FiaveFkakh heurance b. Arm IXsebled c. Ara $aaabnal Farmxorker d. Ara Mgranl Farmvorker 72. FamilyTyDe (dheck Doty 1M a. Smgb i~rent Feirele b. Single Fgrent Aige t. Two ParentfbU40haM tl Snp'a Porson o. TwoAdolbNO cnidran r. oirkr Revised A/13 ig. tloueing tChepk onlyl) a. Dan g b.Renl^ :: Number o7 Parsona• -d.'Oihar ',.^ Vee PIo TOTAL'. U ,g g L~ n Page 5 of 9" ~aS~LQ~uwuY//~ z -~' ~~ . :g l !' ~, ~~o ~Iattin - Q~ Applicant Name: SELF DECLARATION DF INCOME I~ata• This is`to certify the income status for the above named individual Incame 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., xotal revenue minus businoss operating expenses. This also includes any withdrawals of cash from the business or profession for your Personal use. • Monthly interest and dividend income credited to an applicant's bank account and available for use: • The monthly payment amount received from Social Security,`annuities retirement funds, pensions, disability and other similar types: of periodic payments. • Any monthlypayments in lieu of earnings, such as unemployment, disability compensation, SSI, SSRI, and worker's compensation. '• Monthly income from governmenkagencies excluding amounts designafed forshelter, and utilities, WIG, food stamps, and childcare. • Alimony, child support and foster care payments received from organisations 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 of perjury, Source: Amount:..... Source: Amount: Sourcei _ Amount: Signature: following. income: .Frequency:. Frequency`, ....Frequency: Date: certify, under penalty of perjury, that I do not have any income from any source at this time. Applicant Signature:... Date: '' Gass Manager Signature: Date: Page 6 of 9 Revlsetl 4113 I swearlaffirm that I have read/had read to me, the information on this application for assistance and' that the-Information that I have provided has been.. properly recorded. I understand that 1 am responsible for the accuracy of the Information as recorded and it is my statement in support of my, eligibility for services. I also understand that falsification or misrepresentation of the. information cecordad is just cause for denial of services and prosecution for fraud: I hereby ,grant permission !and authorize disclosure ,of any and ail information to Treasure Coast Community Action Agency'concerning my past, present, and future financial accounts: Furthermore, I authorize Treasure Coast Community Action .Agency to request and/or release any and all information with respect to my household income or household expense, and medical or psychological information `as may be pertinent #o my application for service,provision and case .records. I understand that my personal identifying Information, such as Social Security Numbers, wilt be-held confidential, as required by State/Federal Law. Applicant Sighature: Mato: _/ / Case Manager Signature; '' Date: !_! ~~}-p~,1,1V1 Please provide emergency contact/ NOK information: Name: Phone: ,, Name:.:.. Phone: Page 7 of 9 Revised 4/13 - ;- i ~ C s m z "". "~ r s 0 3 c 7 v° m ~~ m ~ ~' 'i Z m ~ ~ r x o o ~ z; -~~ ~, z cs a A v i o m a z m ryH VI G ~ C rn m D Z r, z m ~~ ' ~~ v 0 Z , ~ . . tn_ t1 m rn ~ z °o 0 C7 ~' d m G7 Z -^I ~ / J ~ / / ~ ~~y ~ / 11~ ' V I I I I I I( ICI m m o ~ nz w z n rn O Qr Do rn c v C n rn z v C~~LaQUUUZUl~,~~/o s dfh71 ti February 20, 2013 Ms, Jane,Smith, Intake Sp~ciTlisk 707 North 7"' Street Fort Pierce, FL 34950 Dear Ms' Smithi This is to notify you that Treasure Coast Commufiity Action Ageney,is adzninistering a Comm 131o~k Grant which will pay $180.OU reiztal assistance for James Jones, 100 North 7"'Street Foz Florida 34950. Our check will be forthcoming as spon as it can he processed through our accounting system, takes about ten working days for the check to be processed.. If you should have any questions, please call Name pf intake worker at 772-XXX-XXXX Sincerely, Namebf intake worker Title ec' James Jones ~,'; Treasure Coasf ~o~~~,o>~ut~lty~~6~ Community Action Agency:. ~, : . <' ~, ~. ~~' Catlin p~~~© This contract of participation. for the Family Self-Sufficiency (FSS) Program is between the Family, Treasure Coast Community Action Agency and _ - s ,head of the, C=SS household. This agreement establishes the goals for my household and case manager support. The a#tachments ko this contract are also Included in my agreement. Qualification for this program will be determined on an annual basis. I understand it is mygoal to become self- sufficient and I agree tc#ully participate and make the stepstoward that goal a priority. I also understand that this program ma_y be a long-term commitment, potentially-more than a year. My failure to actively participate In this program will7esult in my forfeiting the ability to obtain assistance and will lead to termination from the program. With this understanding, Lagree to the following requirementsi far active participation: --- Provide only true, correct, and compete answers to all questions about my family, finances and other requests. Treat members of my support teatn with. respect, courtesy, and dignity at all times. -Attend all scheduled meetings. ~. Arrive on time for all appointments:. Actively contribute to the development of goals and goal steps. Rbide by agreed upon goal steps and perform al( activities listed in the self-sufficiency plan. _ -Look for and accept a job. - Not quit a job unless I determine with my case manager that there is just cause. - Report all work, Income and family changes within 10 days of the change, - Cooperate in a kimely manner wikh applications and enrollment in programs that may benefit reaching my goals, inciutling child support, I'rfelinelsafelink, food stamps, eta - Participate diligently in retraining, if it is an identified goal step. - Discuss my self-sufficiency plan with my case manager whenever a concern arises. The program agrees to: - Provide support in identifying barriers, goals and the steps needed to achieve those goals to develop a realistic plan for achieving self-sufficiency: Assist with the identification and referral to programs that may help me in reaching my goals. - Assist with the identification of resources in support of independence. - Treat members of my household with respect, courtesy, and dignity at all times. - Provide financial education in support of long term success. -Provide guidance in the areas of employment, education, fiealthcare, and more. 'Completion of this contract occurs when, the family achieves its goals andlor when the family income Is greater than 125% of the poverty level upon annual evaluation. ' -Case manager please indicate those that fit with thegoal and have the participant initial indicating theft agreement. Signature Page (Participant)' (Case Manager signature) (Date) (Date Signed) TERMINATION The case manager and supervisor have determined that the above contract criteria have not been met and the. participant is terminated from the program. The specific reasons are: I understand that I am being terminated from the Family Self Sufficiency program and have the following comments. Ifiave been given a copy of my right to appeal, Right to Appeal If any applicant is dissatisfied with the decision of eligibility, termination or other staff determinations, he/she has the right to appeal. Appeals must be submitted in writing or postmarked within 30 calendar days of the notification and will be reviewed by the program manager. An appointment may be set up with the applicaht, case manager, sup. ervisor and program manager.. If the appeal is not received within a 30 calendar day period, the right to appeal. is waived and the prior dispasitlan is final. All appeals should be addressed to the agency that processed the application. To be considered for an appeal, the applicant must present additiohal written documehts, information or verification; to substantiate the request. Applicants will be notified in writing of the outcome of the appeal. r~~~ Y TSPr]4GP!lC LC~CG!!1Q!!L _. swear/affirm that I have read/had read to me, the information on this application for assistance and that the information that I have provided has been properly recorded, I '' understand that I am responsible for the accuraoy of the information as recorded and it is my statement in support of my eligibility for services. I also understand that providing invalid or misrepresented information is just cause for denial of services and prosecution for fraud. hereby grant permission and authorized disclosure of any and all information to Treasure : Coast Community Action Agency concerning my past, present, and future financial accounts. Furthermore, I authorize Treasure Coast Community Action Agency to request and/or , release any and all information with respect to my household income, as well as household :expenses, :educational, employment, medical or psychological, or other related information as may be pertinent to my application for service provision and case record. I understand that my personal information (such as; $ocialSecurity Numbers and benefits information} will be held confidential as required by StatelFederal Law. Applicant Signature: Date: _I / Co-Applicant Signature: Date: _/_/ Case Manager Signature: Date: _!_/ PEt~PLE IN THE HOUSEHOLD 125%:. ~; 1 ~ , $ ,14;363 2 $ ~ 9,383 ' 3 $ 24;413. 4- $ 2943.$..> 5 $ 3A~463' 6 $ 39;488, . 7 $ 4.4;513 , 8 $49;538 , Add this amount for each addifionai ..person in the household with more than $5;025 :: '' 8 eople. ""The above figures are based on the 2013 US. Deparkment of Health and Human Services '(HH5) poverty guidelines pubUshed in fhe Federal Registekon January 2q, 2013. Ems' '. COMMUNITY SERVICES BLOCK GRANT (CSBG) ALLOWABLE50URCESOFINCOME - EFFECTIVE APRIL 1, 2011 -INCLUDED -' Includes total annugi cash`recei to befpreYaxes from all sources) - SOURCES OF IIJCOD1E 1 : Money wagesand salaries before any deductions LCAPITAL GAINS 2 . Nek receipts from non farm em to meat revel is from a P y , ( p ' ' Any Assets drown dawn as withdrawals from a bank, the sale of properly, a houso or a car ..person s own .unincorpotated businass, professional . enterprise,orp;utncrship, after deductions For business 2.;'fuzRefimds expenses) 3. Gifts 3. Net rexeipts from faun self-em to eat rceei tsfrom u p ym ( P 4. Loads. 5. Lumpsum inheritaricds farm which one operates asap owner, renter, or sharecropper oiler dedactio f f e 6. Onedimo insurance payments , ns or arm op rating expenses) 7. Foster Care Paymeri{s* $. Compensation for injury 4. REGULAR PAYMENT PROM 9, Cmnbat tone pay to the military Social Security Rerlroad retirement Ip: NON-CAShLBENEPITS Unemployment compensation (n) Employer-paid iir unimt paid portion of health Strikebenefltsfromuniontunds iusiimnce orotlier employee benefits Worker's compensation ' Veteran's paynrcnts (b) Food ar housing received in lieu of wages Public Assistance or Temporary Assistance for Nccdy Fatirilies (c) Tttd value of food and fitcl produced and (TANF}, Supplcmtenfal Security Income, and non-tedcrahy consmned on farms fimded General Assistance or General RelicFmoney payments. . 5. Payments to fester childrenage l8 or older received through rho (d) Thaimputedvalueofrentfromowner-occupied non-farm or farm housing: (ndepandcnt Living Program 6. Training stipends (e) Federal non-cash bencfitpmgrants such as Medicare, 7. Alimony Medicaid, FoodSlamps, school Iunehe<;, and housing 8. Child Support assistance. 9. Social Security Benetit Garnishes far Non-Payment of School Loans. {'fire tarot mnount of the Social Security Retirement 11. Supplemental Security Income (SS>) benefits cannot he benefit Including the gamtshed deduction muskbe used when gushed for any reason unless a recipient received an calculating theapplieant's income.) overpayment of benefits. The total amount of(he SSI benefit minus the gamislred lQ, Military family nllonnent m• other regular support from deduction for recoupmentmust be used when calculating . a family member or someone not living in the the appli cant s income. household 11. Private pensions *Persons whose cost of residence is paid through a foster care or residential program a<hninistcmd by the stale 12. Govemmcnt employee pensiats (indudrig military cannot be counted as household mmnbors: retirement pay) 13. 2egular insut~ancu or tmnu(ty paytnen[s 14. Educational Assistance: Grants, Pellotivships, Assistantships, College or University Scholarships-'Only eomrt es Income those funds specifically allotted, for Iivli~g ¢x eases - _ 15, t3ividends 16, Interest 17. Net rental incmno IS. Net royalties l9. Periodic rccoipts from estates or trusts 20, Net gambling or lottery winnings Red Tab Picture IDs for adults. Social Security Cards for atl family members Birth Certificates for all children under the age of 18 Blue Tab Lease/rental agreement or mortgage documentation Rant recaipts/.letter from landlord/ mortgage statements A Utility bill can also be use as proof of address Green Tab Work Documentation Child Support, Alimony' Social Security DisabiltylRatirement ASS), SSI, TANF, Unemployment, Worker's Compehsation, etc Food Stamps.. Bank Statements Pink-Tab Tax Documents Financial Aid Documents __ Hospital Discharge Police Reports D(vorce Decrees, Custody Documentatlon Other ~yy~~o ~~ ~~~~ p .0 S Q ~. 9 id ~ 0 „ y X $$ ' '.SC.~~SR:~~ g 882 S F ~L 9~ ~ ~ g~ ~ ~n~~~ ~~ ~; h @. s 8 ygp ~~ r ~ k' r W w S~ ~ ~ ~Q~ ~ F~z~ ~ `~~8 c a ~ s m g s .- k ma$ 4 p5~ ~v ~ ,~. 9 ~~'~ 5~~~ --. sgF ~ ~.~~ ~-ke ~ ~4 fr3`~? L ~~ '~.i~ t "~ ~ ~S,B~Ala415' r e1~~ @hlelS algQaau~nA g ~ ~ ~ ~p b 4 . - ••7,. - pPe. ~ zT __1. cage _ __.. Mengger LOBBY WALK-UP COMPUTER/.PHONE USAGE 2013 NAME (PLEASE PRINT TIME ARRIVED ~Ew_ow IF YOU ARE MALE BELow IF YOU AFtE FEMALE ot~PUT~w~HaN~sE-D~o EXAMPLE: FOOD STAMPSI UNEMPLOYMENTIJOB SEARCH '' (PLEASE.PRINT) TIME LEFT MALE FEMALE MALE FEMALE MAtE fEMA4E` MALE FEMALE MALE FEMALE MALE FEMALE MALE FENIACE MALE FEMALE MALE FEMALE MALE FEMALE - MALE FEMALE MALE FEMALE _ MALE FEMALE _ MALE FEMALE MALE FEMALE MALE FEMALE MALE FEMALE MALE FEMALE 5