esg financial and compliance presentation 1.14mhdc.com/ci/esg/documents/2020/2020 finance...

2020 Emergency Solutions Grant Program

Finance and Compliance Training Webinar

Denise Hoss – Community In it iat ives Compliance Off icer

Cass ie Wilson– Grants Administrator

Tuesday, January 14, 2020

EMERGENCY SOLUTIONS GRANT2020 FINANCIAL PROCESSES

Tuesday, January 14, 2020

WEBINAR

Cassie Wilson – GRANTS ADMINISTRATOR

Payment RequestProcess

Timeline

◦ Submit Payment Request Packet to MHDC by email

◦ [email protected]

◦ Request may be discarded if incomplete or incorrect and must be resubmitted

◦ Agency’s program contact and financial contact will be notified by email of discard

◦ All payment requests are submitted monthly to DSS (by MHDC)

◦ Reimbursements are typically deposited to grantee’s bank account in 4‐6 weeks

1. MHDC Payment Request review2. Aggregate Invoice to DSS3. Agency Reimbursement deposit

ESG funds are provided solely for reimbursement of: Actual, eligible expenses incurred and paid by grantee

Within awarded funding components (Admin, RRH, etc.)

Expenses incurred during the 2020 funding period November 1, 2019 – November 30, 2020

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

Eligible Expenses

Eligible expenses are detailed in: 2020 ESG Desk Guide‐

http://www.mhdc.com/ci/esg/fad/FY2020%20ESG%20Desk%20Guide.pdf 24 CFR 576 Subpart B – Federal regulations on ESG Program Reach out to MHDC ESG Administrator with specific questions

Grant Award Amounts by funding component are detailed in: 2020 ESG Grant Agreement, Section 3

Required documentation for the incurred, eligible expenses ESG 2020 Desk Guide – Table 4

Eligible Expenses

Quarterly Draw Deadlines• Must submit at least one

Payment Request leading to a disbursement of ESG funds per quarter

• Discarded payment request submissions do not meet this requirement

Spending Deadlines• Must spend at least 25% of

grant award amount by end of Q2.

• Must spend at least 50% of grant award amount by end of Q3.

Spending Requirements

ESG Financial Timeline2020 Emergency Solutions Grant Program : Quarterly Deadlines

Quarter 1Q1 Payment Request Deadline

November 01, 2019 – January 31, 2020February 03, 2020, 5:00 p.m.

Quarter 2 Q2 Payment Request Deadline

25% Spending Deadline

February 01, 2020 – April 30, 2020May 01, 2020, 5:00 p.m.May 01, 2020, 5:00 p.m.

Quarter 3Q3 Payment Request Deadline

50% Spending Deadline

May 01, 2020 – July 31, 2020August 01, 2020, 5:00 p.m.August 01, 2020, 5:00 p.m.

Quarter 4 Q4 Payment Request DeadlineFinal Payment Request Deadline

August 01, 2020 – November 30, 2020December 01, 2020, 5:00 p.m.December 01, 2020, 5:00 p.m.

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

ESG Payment Request Packet: ESG‐211 Payment Request ESG‐212 Expense Detail Report for each funding component

Salaries ‐ with last 4 of SSN in expense description HMIS/Comparable Database Reports for each funding component

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

Emergency Solutions Grant Program

Payment Request

ESG-211

CERTIFICATIONBy signing this report, I certify to the best of my knowledge and belief that the report is true, complete,and accurate, and the expenditures, disbursements and cash receipts are for the purposes and objectives set forth in the terms and conditions of the Federal award. I am aware that any false, fictitious, or fraudulent information, or the omission of any material fact, may subject me to criminal, civil or administrative penalties for fraud, false statements, false claims or otherwise. (U.S. Code Title 18, Section1 0 0 1 and T itle 3 1 , Sect io ns 3 7 2 9 –3 7 3 0 and 3 8 0 1 –3 8 1 2 ).

Authorized SignaturePrinted Name

MHDC Personnel Use Only

Notes: Approval

DateGrant NumberAgency Name

Total Requested Amount $0.00

Funding Component Request AmountAdministrationHMISStreet OutreachEmergency Shelter

Essential ServicesOperations

Emergency Shelter Total $0.00Homelessness Prevention

Financial AssistanceHousing Services

Rental AssistanceHomelessness Prevention Total $0.00

Rapid Re-housingFinancial Assistance

Housing ServicesRental Assistance

Rapid Re-Housing Total $0.00Total Requested Amount $0.00

Payment Request PacketESG‐211: Payment Request Form

Reflects the funding component requested amounts and total payment request amount

Each Payment Request requires one signature from Authorized Signature Card (Form CI‐101)

Each payment request must be accompanied by ESG‐212: Expense Detail Report (if billing for expenses that are NOT direct assistance) and HMIS/Comparable Databased Report(s).

Emergency Solutions Grant Program Administration Expense Detail Form

ESG-212

Paid DateCheck

Number VendorTotal

Amount ESG % Paid by ESGAmount

Detail Description

‐Page 2 Total $

12

Payment Request PacketESG‐212: Expense Detail Form Reflects expenditures by funding component

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

Homelessness Prevention, and Rapid Re‐housing

Reporting Range of the incurred date(s) must reflect the reporting range of the HMIS/Comparable Database Reports

The total expense amount must reflect the payment request (ESG‐211) amount for each funding component

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

administrator Street Outreach & Emergency Shelter

Bed night report Program roster

Homelessness Prevention & Rapid Re‐housing Client detail report Reflects direct financial assistance to program participants within

report

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

Payment Request SummaryPayment Requests must be submitted to:[email protected]

MHDC will not accept Requests submitted via mail or to adifferent email address

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

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

Budget Amendment ProcessGrantees may submit a budgetamendment request to transfer funds between funding components

Budget Amendment Requests are submitted in writing to the Grants Administrator for approval

After review, a budget amendmentrequest form (ESG‐213) may be provided

Funding Components:

Administration HMIS Street Outreach Emergency Shelter Homelessness

Prevention Rapid Re‐Housing

Emergency Solutions Grant Program Budget Amendment Request

ESG-213

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

Reason for Budget Amendment Request

Budget DetailBudget Categories Original

BudgetBudget Change New Budget

Street Outreach - $ - $ -Emergency Shelter - $ - $ -

Homelessness Prevention - $ - $ -Rapid Re-housing - $ - $ -

Homeless Management - $ - $ -Administration - $ - $ -

Total - $ - $ -

Grantee InformationGrantee Name:Grant Number:

Grant Award:

$ ‐

Executive Director or Authorized Official

Signature Date

Printed Name Title

Budget Amendment Process Form ESG‐213: Budget Amendment Request details:

Original budget Proposed change New budget Explanation why the amendment is needed

If ESG‐213 is approved, a budget amendment agreement is drafted and executed by the grantee and MHDC The agreement must be fully executed prior to utilizing the revised

budget

One budget amendment request is allowed per grant quarter

Budget Issues Amendments made without MHDC

approval Amendments utilized before

budget amendment letter is fully executed

Other Issues Funds spent outside of approved

CoC Ineligible expenses Funds spent outside of funding

period

Payment Request Issues Missing HMIS/comparable database

report(s) Duplicate submission Expired Certificate of Insurance Inconsistent Amounts between

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

Submission to an email addressother than: [email protected]

Common Issues

Contact InformationCassie WilsonGrants AdministratorPhone: (816) 759‐7236Email: [email protected]

Cassie Sipos-HaasEmergency Solutions Grant AdministratorPhone: (816) 759‐6630Email: cassie.sipos‐[email protected]

Payment Request Submission:Community Initiatives Department [email protected]

Information and Forms for MHDC ESG Program:http://www.mhdc.com/ci/esg/index.htm

Questions?

EMERGENCY SOLUTIONS GRANTCOMPLIANCE WEBINAR

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

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

All required documentation should be assembled in an orderly fashion, in paper form, and available for review within 15 minutes of request in a private workspace

Agency staff directly involved with program operations should be available forquestions

Agency staff will be expected to present an HMIS or comparable data base client report for the clients served from beginning of grant period to date of visit

Client File Documentation Case management / housing stability goal plan

Case Management should be documented with emphasis on making this the responsibility of the casemanagers rather than a requirement of clients. Case Managers should attempt to meet with the clientat least once a month and document all attempts.

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

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

apply. Program consent form Intake application Verification of income &/or assets – Income received within 30‐days of assistance.

Types of verification in order from best: Written from source, oral or telephone, (must document attempts made to verify), self‐certification.

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

clearly documented

Emergency Solutions Grant Emergency Solutions Grant Program intended to serve extremely lowincome individuals and families Assistance based on each component's eligibility for homeless and at‐risk of

homelessness individuals and families ESG Desk Guide FY2020 Homelessness Prevention participants must have household income below 30%

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

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

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

re‐evaluation

EMERGENCY SOLUTIONS GRANT PROGRAM

Income Eligibility Calculation Worksheet

ESG-201

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

For ESG Rapid Re‐Housing assistance, an income assessment is not required at initial evaluation. However, at annual re‐evaluation, income must be LESS THAN OR EQUAL TO 30% AMI (and meetother ESG eligibility requirements). Grantees should use this worksheet to determine whether an applicant household meets the ESG income eligibility threshold.

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

Date: Type of Evaluation:

Household Member Number

Household Member Name Age of Household Member

1

2

3

4

5

6

7

8

9

10

11

Total Household Members (Household size) 0

30% of Area Median Income(AMI) for Household Size

Household Member Number/Name

Sources of Household Income Currently Documented Gross Income Amount

Frequency of Income

Number of Payments per

Year

Annual Gross Income

Zero Income (signed form in file) $ -

Earned Income (for ADULT household members only) $

‐

$ -


‐

$ -


‐

$ -

Self‐employment/business income $

‐

$ -

Self‐employment/business income $

‐

$ -

Interest & Dividend Income $

‐

$ -

Interest & Dividend Income $

‐

$ -

Pension/Retirement Income $

‐

$ -

Pension/Retirement Income $

‐

$ -

Unemployment & Disability Income $

‐

$ -

Unemployment & Disability Income $

‐

$ -

TANF/Public Assistance $

‐

$ -

TANF/Public Assistance $

‐

$ -

Alimony, Child Support and Foster Care Income $

‐

$ -

Alimony, Child Support and Foster Care Income $

‐

$ -

Armed Forces Income $ $ -

Calculating Income

Determine all Sources of Income Inclusions Exclusions

Methods of Calculating Income Annualize income by calculating the gross annual income based on current

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

circumstances will last 12 months (seasonal work, etc.) Use verifications of all income received within the past 30 days of assistance and

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

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

calculate anticipated income from all known sources Changes will be reflected at recertification period as required for each program

Calculating Income Homelessness Prevention / Rapid Rehousing programs will

utilize HUD Chapter 5: Determining Income and CalculatingRent

Must calculate income for an individual or family for allprograms with income eligibility requirements

HUD specifies the types and amounts of income and deductionsto be included in the calculation

Calculating Income (continued)Frequency of Pay

Hourly wages by the number of hours worked per year (2,080 hours for full‐time employment with a 40‐hour work week and noovertime)

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

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

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

He/she has presented two check stubs to verify his income which are within30 days of the assistance date (4/1/19) Check Stub 1: payment date 3/3/19 for $329.50 (gross wages) Check Stub 2: payment date 3/17/19 for $445.00 (gross wages)

Calculate by dividing the total of the gross pay ($329.50 + $445.00 = $774.50)by the number of check stubs (2) and multiply by the frequency of pay (26) toannualize the income

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

MHDC Community Initiatives: SELF-DECLARATION OF INCOME Form: CI 103

Staff Signature:1 of 1

Effective: January 1, 2019

Applicant Name:

This is to certify the income status for the above named individual. Income includes but is not limited to: The full amount of gross income earned before taxes and deductions. The net income earned from the operation of a business, i.e., total revenue minus business operating expenses.

This also includes any withdrawals of cash from the business or profession for your personal use. Monthly interest and dividend income credited to an applicant’s bank account and available for use. The monthly payment amount received from Social Security, annuities, retirement funds, pensions, disability and

other similar types of periodic payments. Any monthly payments in lieu of earnings, such as unemployment, disability compensation, SSI, SSDI, and worker's

compensation. Monthly income from government agencies excluding amounts designated for shelter, and utilities, WIC, food

stamps, and childcare. Alimony, child support and foster care payments received from organizations or from persons not residing in the

dwelling. All basic pay, special day and allowances of a member of the Armed Forces excluding special pay for exposure to

hostile fire.Check only one box and complete only that section

I certify, under penalty of perjury, that I currently receive the following income:

Source: Amount: Frequency:Source: Amount: Frequency:Source: Amount: Frequency:

Applicant Signature: Date:

I certify, under penalty of perjury, that I do not have any income from any source at this time.


Staff VerificationI understand that third‐party verification is the preferred method of certifying income forassistance. I understand self declaration is only permitted when I have attempted to but cannot obtain thirdparty verification.

Documentation of attempt made for third‐party verification:

Date:

Calculating Assets What is an asset?

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

Asset Inclusions and Exclusions

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

is done as a calculation in the process of determining the value of all assets If assets are owned by more than one person, prorate based on percentage of

ownership, if there is no percentage specified or provided by law, prorate evenly

Calculating Assets: Example Client B has a checking account with a six month average balance of $500.00

which earns no interest. He/she has a savings account with a current balanceof $500.00 which currently earns 1.5 percent interest Savings account interest ($500 x .015 = $7.50)

Client C owns his/her house valued at $50,000. He/she currently has anoutstanding mortgage balance of $34,000. The reasonable selling costs of arealtor, taxes, insurance, etc. would be $3,400 The cash value of their home would be $12,600 ($50,000 ‐ $34,000 =

$16,000 ‐ $3,400 = $12,600)

Form: CI‐104

MHDC Community Initiatives: HOUSING STATUS CERTIFICATION

ApplicantName:

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

Individual without dependent children (complete one form for each household) Household with dependent children (complete one form for each head of household) Number of persons in the household:

This is to certify that the above named individual or household is currently homeless based on the check mark, other indicatedinformation, and signature indicating their current living situation. Check only ONE BOX and ONLY complete that section.*IMPORTANT: THIRD PARTY EVIDENCE MUST BE ATTACHED TO THIS FORM IN ORDER TO CERTIFY HOMELESSNESS.

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

The person(s) named above is/are currently living in (or, if currently in hospital or other institution, was living in immediately prior to hospital/institution admission) a public or private place not designed for, or ordinarily used as a regular sleeping accommodation for human beings, including a car, park, abandoned building, busstation, airport, or camp ground. Description of current living situation:

Homeless Street Outreach/Other Program (if applicable):

This certifying agency must be recognized by the local Continuum of Care (CoC) as an agency that has a program designed to serve persons living on the street or other places not meant for human habitation. (Examples may be street outreach workers, day shelters, soup kitchens, Health Care for the Homeless sites, etc.)

Living Situation: Emergency Shelter

The person(s) named above is/are currently living in (or, if currently in hospital or other institution, was living in immediately prior to hospital/institution admission) a supervised publiclyor privately operated shelter as follows:

Emergency Shelter Program Name:This emergency shelter must appear on the CoC’s Housing Inventory Chart submitted as part of the most recent CoC Homeless Assistance application to HUD or otherwise be recognized by the CoC as part of the CoC inventory (e.g. newly established Emergency Shelter).

Living Situation: Transitional HousingThe person(s) named above is/are currently living in a transitional housing program for persons who are

homeless. The persons(s) named above is/are graduating from or timing out of the transitional housing program:

Transitional Housing Program Name:

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

Effective: January 1, 2019 35 of 3

Form: CI‐104Living Situation: Market Housing

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

AT RISK OF HOMELESSNESSLiving Situation: Facing Eviction

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

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

geographic area(see income documentation form);

AND

2. Lacks sufficient resources to attain housing stability. [e.g., family, friends, faith‐based or other social networks immediately available] to prevent them from moving to an emergency shelter or another place described in Category 1 of the homeless definition.

The person(s) listed above meet one or more of the following risk factors:(1)Has moved frequently because of economic reasons(2) Is living in the home of another because of economic hardship(3)Has been notified in writing that their right to occupy their current housing or living situation will be terminated within 21 days after the date of application(4)Lives in a hotel or motel; “and the cost of the hotel or motel is not paid for by federal, state, or local government programs for low‐income individuals or by charitable organizations’’(5) Lives in severely overcrowded housing; (in a single‐room occupancy or efficiency apartment unit inwhich more than two persons, on average, reside or another type of housing in which there reside more than 1.5 persons per room, as defined by the U.S. Census Bureau.)(6)Is exiting a publicly funded institution; or system of care, (such as a health‐care facility, mental health facility, foster care or other youth facility, or correction program or institution)(7)Otherwise lives in housing that has characteristics associated with instability and an increased risk of homelessness.

Evidence of risk factors for this Applicant is:(A) Source documents (e.g., notice of termination from employment, unemployment compensation statement, bank statement,

health‐care bill showing arrears, utility bill showing arrears).(B) To the extent that source documents are unobtainable, a written statement by the relevant third party (e.g.,

former employer, public administrator, relative) or written certification by the intake staff of the oral verification by the relevant third party

OR(C) If source documents and third‐party verification are unobtainable, a written statement by intake staff describing the efforts

taken to obtain the required evidence.

36 of 3Effective: January 1, 2019

Form: CI‐104

Oral Third Party Verification

Applicant Name:Date of Third Party Verification:Name of Third Party Representative: Verification of homeless status was provided: □Over the phone ☐ In person

I understand that obtaining third party verification of eligibility or risk factors is the preferred method of certifying eligibility for anindividual who is applying for assistance, but cannot meet this standard. Below I am providing details oforal third party verification of eligibility or risk factors and certifying all statements to be true, accurate and complete.I made the following efforts to obtain third party verification:

Staff Observation Verification

I have observed the following conditions which serve as evidence related to the applicant’s housing status and available resources. Due to the following factors I certify this applicant’s eligibility for assistance:

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

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

Staff Signature: Date:

3 of 3 Effective: January 1, 2019

MHDC Community Initiatives: SELF-DECLARATION OF HOUSING STATUS Form: CI‐105

Staff Signature:

1 of 1

Date:


Applicant Name:

Household without dependent children (complete one form for each adult in the household) Household with dependent children (complete one form for household)

Number of persons in the household:

This is to certify that the above named individual or household is currently homeless or at-risk of homelessness, basedon the following and other indicated information and the signed declaration by the applicant.

Check only one:

□I [and my children] am/are currently homeless and living on the street (i.e., a car, park, abandonedbuilding, bus station, airport, or camp ground).

□I [and my children] am/are the victim(s) of domestic violence and am/are fleeing from abuse, have notidentified a subsequent residence, and lack the resources or support networks, e.g., family, friends, faith‐ based, other social networks, needed to obtain housing where my/our safety would not be jeopardized.

□I [and my children] am/are being evicted from the housing we are presently staying in and must leave this housing within the next 14 days.

I certify that I have insufficient financial resources and support networks, e.g., family, friends, faith-based,other social networks, immediately available to obtain housing or to attain housing stability without ESG, MHTF, or MoHIP assistance. I certify that the information above and any other information I have providedin applying for ESG, MHTF, or MoHIP assistance is true, accurate and complete.


Staff CertificationI understand that third‐party verification is the preferred method of certifying homelessness or risk forhomelessness for an individual who is applying for ESG, MHTF, or MOHIP assistance. I understand self declaration is only permitted when I have attempted to but cannot obtain third party verification.

Documentation of attempt made for third‐party verification:

☐

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Form: CI‐110

Identification CertificationMHDC Community Initiatives

PLEASE NOTE: Prior approval must be obtained by agency/organization for use of this form.PROGRAM TYPE: Missouri Housing Trust Fund ☐Emergency Solutions Grant ☐Missouri Housing Innovation Program

Household Identifier:Total Number of Persons in Household: Number of Adults:Number of Children:

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1 Household Member Unique Identifier The above household member is:

18 years of age or older Under 18 years of age

Identification verified:Photo Identification Social Security Number













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Form: CI‐110

Identification CertificationMHDC Community Initiatives










The undersigned individuals do, by their respective oaths solemnly swear and affirm as follows: That the Staff Member completing this Identification Certification has verified the identification of the individual(s) to

whom this certification relates; That the Staff Member has been presented with a valid government issued photo ID (or other acceptable form of

identification) by the individual(s) to whom this certification relates evidencing that such individual(s) are U.S. citizens or otherwise lawfully presented in the U.S.;

That the Staff Member has collected and reviewed valid documentation of income for the individual(s) to whom this certification relates and have verified that such individual(s) income is within the appropriate income limits to qualify for assistance from any funding sources being used to provide services to such individual(s); and,

That the Executive Director has reviewed the file for the individual(s) to which this Identification Certification relates,and has verified that all the representations made by the Staff Member in this Identification Certification are true andcorrect.

The undersigned individuals affirm, by penalty of perjury, that all the statements made herein are true and correct.

Staff Signature Date

Staff Print Name

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Executive Director Signature Date

Executive Director Print Name


Emergency Solutions Grant Rent Reasonableness and FMR

Utility Allowance documentation Comparable rent documentation

Rental Assistance Agreement VAWA Lease Addendum– We will post the HUD VAWA Lease Addendum

on our website for agencies to use in correlation with the RentalAssistance Agreement. The form requires the signature of both thelandlord and client. This will accomplish the requirement of notificationto the client of his/her rights and to the landlord of this regulation.

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

EMERGENCY SOLUTIONS GRANT PROGRAM

Rent Reasonableness and Fair Market Rent Certification

ESG-206

Fair Market Rent Verification

Contract Rent + Utility Allowance

= Proposed Gross Rent

Applicable Fair Market Rent Rate:

Proposed Unit does not exceed applicable FMR:

Certification

Based upon a comparison with rents for comparable units, the proposed rent for the unit:

Is reasonable Is not reasonable

Name: Date:

Signature:

Yes

$0.00

Rent Reasonableness Verification

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

Date: Household Name:

Proposed Unit Unit #1 Unit #2 Unit #3Address

# of Bedrooms

Total Square Feet

Type of Unit/ConstructionHousing Condition

Location/Accessibility

Amenities

Age in Years

Type of Utilities

Monthly Unit Rent

Handicap Accessible?

Allowances for Tenant-Furnished Utilities and Other Services

OMB Approval No. 2577-0169(exp. 04/30/2018)

U.S. Department of Housing and Urban Development

Office of Public and Indian Housing

Form HUD‐52667 (04/15)ref. Handbook 7420.8

THE NELROD COMPANY 8/2017 UPDATE

Locality: Housing Authority of Kansas City, MO

Unit Type: High-Rise/ Apartment

Date (mm/dd/yyyy)

January 1, 2018

Utility or Service: Monthly Dollar Allowances

0 BR 1 BR 2 BR 3 BR 4 BR 5 BRHeating a. Natural Gas $14.0

0$17.00

$20.00

$22.00

$25.00

$27.00

b. Bottle Gas/Propane

c. Electric $24.00

$28.00

$38.00

$47.00

$57.00

$66.00

d. Electric Heat Pump $21.00

$25.00

$29.00

$33.00

$37.00

$40.00

e. Oil / Other

Cooking a. Natural Gas $2.00

$2.00

$3.00

$4.00

$5.00

$6.00


c. Electric $7.00

$8.00

$12.00

$15.00

$19.00

$23.00

Other Electric (Lights & Appliances) $26.00

$31.00

$42.00

$54.00

$66.00

$78.00

Air Conditioning $12.00

$13.00

$19.00

$24.00

$29.00

$34.00

Water Heating a. Natural Gas $5.00

$5.00

$7.00

$10.00

$12.00

$14.00


c. Electric $17.00

$20.00

$26.00

$31.00

$37.00

$43.00

d. Oil / Other

Water $36.00

$37.00

$47.00

$57.00

$68.00

$78.00

Sewer $60.00

$61.00

$77.00

$93.00

$108.00

$124.00

Trash Collection (avg) $18.00

$18.00

$18.00

$18.00

$18.00

$18.00

Range / Microwave Tenant-supplied $12.00

$12.00

$12.00

$12.00

$12.00

$12.00

Refrigerator Tenant-supplied $13.00

$13.00

$13.00

$13.00

$13.00

$13.00

Other--specify:

Monthly Electric Fee $13.14 $13.00

$13.00

$13.00

$13.00

$13.00

$13.00

Monthly Gas Fee $26.93 $27.00

$27.00

$27.00

$27.00

$27.00

$27.00

Actual Family AllowancesTo be used by the family to compute allowance. Complete below for the actual unit rented.

Utility or Service per month cost

Heating $

Cooking $Name of Family Other Electric $

Air Conditioning $

Water Heating $Address of Unit Water $

Sewer $

Trash Collection $

Range / Microwave $

Refrigerator $

Other $Number of Bedrooms Other $

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

Rent Reasonableness and Fair Market Rent Under the Emergency Solutions Grants Program

44JUNE 5, 2013

ABOUT THIS RESOURCE

Providing rental assistance through the Emergency Solutions Grants (ESG) program requires understanding and adherence to both Fair Market Rents (FMRs) and rent reasonableness standards, to determine whether a specific unit can be assisted with short- or medium-term rental assistance. This resource provides an explanation of both concepts and describes how to determine and document compliance with each. In addition, it briefly describes some of thedifferences and similarities between rental assistance provided under the Homelessness Prevention and Rapid Re-Housing Program (HPRP) and ESG. ESG recipients and their subrecipients can use this resource to develop policies, procedures, and documentationrequirements to comply with HUD rules.

OVERVIEW

The ESG program Interim Rule allows short- and medium-term rental assistance to beprovided to eligible program participants only when the rent, including utilities (gross rent1), for the housing unit:

1. Does not exceed the Fair Market Rent (FMR) established by HUD for eachgeographic area, as provided under 24 CFR 888 and 24 CFR 982.503; and

2. Complies with HUD’s standard of rent reasonableness, as established under 24 CFR 982.507.2

This requirement is in the ESG program Interim Rule at 24 CFR 576.106(d).

HPRP & ESG: Key Difference

HPRP: Rent must meet rent reasonableness standards.

ESG: Rent must meet rent reasonableness standards and cannot exceed HUD’s published FMRs for the area.

In some communities, the reasonable rent for a specific unit may belower than the FMR that has been established for the community.

Bottom line: The rent for the unit assisted with ESG funds must not exceed the lesser of the FMR or the rent reasonableness standard.

1Gross rent is the sum of the rent paid to the owner plus, if the tenant pays separately for utilities, the monthly allowance for utilities established by the public housing authority for the area in which the housing is located. For purposes of calculating the FMR, utilities include electricity, gas, water and sewer, and trash removal services but not cable or satellite television service, or internet service. If the owner pays for all utilities, then gross rent equals the rent paid to the owner.

2The rent must be reasonable when compared to other units of similar location, type, size, and amenities within the community.

DETERMINING IF RENT IS ACCEPTABLE FOR ESG RENTAL ASSISTANCE

Whether a household is seeking to maintain its current housing or relocate to another unit to avoid homelessness (Homelessness Prevention), or exiting homelessness into newhousing (Rapid Re-Housing), the process for determining acceptable rent amounts is thesame:

The recipient or subrecipient first compares the gross rent (see box below) forthe current or new unit with current FMR limits, which are updated annually.

If the unit’s gross rent is at or below FMR, the recipient/subrecipient next uses current data to determine rent reasonableness (more information is provided belowon how to determine and document this).

If the gross rent is at or below both the FMR and the rent reasonableness standard for a unitof comparable size, type, location, amenities, etc., ESG funds may be used to pay the rentamount for the unit.

If the gross rent for the unit exceeds either the rent reasonableness standard or FMR, ESG recipients are prohibited from using ESG funds for any portion of the rent, even if thehousehold is willing and/or able to pay the difference. However, because the FMR and rent reasonableness requirements apply only to rental assistance, ESG funds may be used:

1. to pay for financial assistance and services to help the eligible program participant stayin the unit, or

2. to pay for financial assistance and services to locate and move to a different unit that meets the rent reasonableness standard and is at or below FMR and pay rental assistance in that unit.

Rent reasonableness and FMR requirements do not apply when a program participant receives only financial assistance or services under Housing Stabilization and Relocation Services. This includes rental application fees, security deposits, an initial payment of “last month’s rent,” utility payments/deposits, and/or moving costs, housing search and placement, housingstability case management, landlord-tenant mediation, legal services, and credit repair. (Note: “Last month’s rent” may not exceed the rent charged for any other month; security deposits may not exceed 2 months’ rent.)

Calculating the GROSS RENT AMOUNT

To calculate the gross rent of a unit that is being tested by the FMR standard:

Total contract rent amount of the unit

+Any fees required for occupancy under the lease (excluding late fees and pet fees)

+Monthly utility allowance* (excluding telephone) established by local PHA

=Gross Rent Amount

*Note: The monthly utility allowance is added only for those utilities that the tenant pays for separately (for more information on utility allowances established by the local public housing agency (PHA), see 24 CFR § 982.517). The utility allowance does not includetelephone, cable or satellite television service, and internet service. If all utilities are included in the rent, there is no utility allowance.

45JUNE 5, 2013

WHAT IS THE FMR REQUIREMENT?

HUD establishes FMRs to determine payment standards or rent ceilings for HUD-funded programs that provide rental assistance, which it publishes annually for 530 metropolitan areas and 2,045 non-metropolitan county areas. Federal law requires that HUD publish final FMRs for use in any fiscal year on October 1—the first day of the fiscal year (FY). FMRs for eachfiscal year can be found by visiting HUD’s website at www.huduser.org/portal/datasets/fmr.htmland clicking on the current “Individual Area Final FY20 FMR Documentation” link. This site allows recipients/subrecipients to search for FMRs by selecting their state and county from the provided list. The site also provides detailed information on how the FMR was calculated for each area.

Recipients/subrecipients must consult the most current FMR published for their geographicarea and document FMR for all units for which ESG funds are used for rental assistance.

46JUNE 5, 2013

To calculate the gross rent for purposes of determining whether it meets the FMR, consider the entire housing cost: rent plus the cost of utilities that must, according to the lease, be the responsibility of the tenant. Utility costs may include gas, electric, water, sewer, and trash. However, telephone, cable or satellite television service, and internet service are not included in FMRs, and are not allowable costs under ESG. The FMR also does not include pet fees or late fees that the program participant may accrue for failing to pay the rent by thedue date established in the lease.

Example:

A case manager is looking to rapidly re-house a mother and son, and has identified a 2-bedroom unit at a rent of$1,200 per month, not including utilities (the tenant’s responsibility). The utility allowance established by the PHA is

$150. Therefore, the gross rent is$1,350. A check of three similar units inthe neighborhood reveals that the reasonable rent is $1,400 for that area ofthe city. However, the FMR for thejurisdiction is $1,300. This means the family cannot be assisted with ESG inthis unit because the gross rent exceeds the FMR.

HUD sets FMRs to ensure that a reasonable supply of modest but adequate rental housing is available to HUD program participants. To accomplish this objective, FMRs must be both high enough to permit a selection of units and neighborhoods and low enough to serve as many low-income families as possible.

Note: Once a unit is determined to meet the FMR and rent reasonableness requirements, ESG funds may be used to pay for the actual utility costs. The utility allowance calculation is only used to determine whether the unit meets the FMR standard.

Determining and Documenting FMR

Recipients/subrecipients must ensure that the rent for units assisted under the ESG Program does not exceed current HUD-published FMRs for their particular geographic region.

Determining FMR standards is straight forward; no geographic area has more than one FMR standard. However, if a recipient/subrecipient covers multiple cities or counties, they must use the appropriate FMR for the geographic area in which the assisted rental unit is located. Recipients/subrecipients should print and place in case files a copy of the applicable FMR datato document the FMR for that participant’s unit size and geographic area.

WHAT IS THE RENT REASONABLENESS REQUIREMENT?HUD’s rent reasonableness standard is designed to ensure that rents being paid are reasonable in relation to rents being charged for comparable unassisted units in the same market. Methods of determining and documenting rent reasonableness are described in the section below. For units within the FMR limit, if a rent reasonableness determination supports a lower rent than the advertised rent, then ESG funds may not be used to rent the unit (unless the landlord is willingto lower the rent). However, as with FMR, ESG funds could be used to assist the program participant to move to a different unit that meets both the FMR and rent reasonableness standards. If the rent reasonableness determination supports the advertised rent (and is within the FMR limit), rental assistance with ESG funds may be provided for the unit, as long as all other program requirements are met.

47JUNE 5, 2013

Determining and Documenting Rent Reasonableness

Recipients are responsible for determining what documentation is required in order to ensurethe rent reasonableness standard is met. Recipients and subrecipients should determine rent reasonableness by considering the location, quality, size, type, and age of the unit, and any amenities, maintenance, and utilities to be provided by the owner. Comparable rents can be checked by using a market study of rents charged for units

Caution

Comparable rents vary over time with market changes, so it is important to ensure that the comparison you are using is up-to-date and appropriate

for each prospective unit.

of different sizes in different locations or by reviewing advertisements for comparable rental units. For example, a participant’s case file might include the unit’s rent and description, a printout of three comparable units’ rents, and evidence that these comparison units shared the same features (location, size, amenities, quality, etc.). Another acceptable method of documentation is written verificationsigned by the property owner or management company, on letterhead, affirming that the rent for a unit assisted with ESG funds is comparable to current rents charged for similar unassisted units managed by the same owner.

Recipients must establish their own written policies and procedures for documenting comparable rents and ensure that they are followed when documenting rent reasonableness in the case file. A recipient may require all subrecipients to use a specific form or a particular data source. Useof a single form to collect data on rents for units of different sizes and locations will make thedata collection process uniform. A sample “Rent Reasonableness Checklist and Certification”form is available at: www.hud.gov/offices/cpd/affordablehousing/library/forms/rentreasonablechecklist.doc

Note: This sample form is used across different housing programs.

Before conducting its own study of rent levels in its community, a recipient/subrecipient should consult existing sources of rental housing data that can be used to establish comparablerents. The section below describes some different sources of information on rental units to help recipients and subrecipients meet rent reasonableness requirements. Each recipient must determine which approach is appropriate for its jurisdiction, given the size of its program, other housing programs it administers, local staff capacity, and other resources availablewithin the community.

Rental Housing Data Sources

Public sources of data: There may be organizations within the recipient’s jurisdiction that collect and aggregate data on the rental housing stock, such as a state or local PublicHousing Agency (PHA) or the local Chamber of Commerce.

Real estate advertisements and contacts: Ads in newspapers or online are simple ways to identify comparable rents. The following are potential sources of information:

Newspaper ads (including internet versions of newspaper ads); Weekly or monthly neighborhood or “shopper”

48JUNE 5, 2013

Tip: Real estate ads and contacts might not provide all the information the recipient requires to determine rent reasonableness. In such instances, a follow-up call to obtain the missing information may be required. Newspaper and internet listings often contain either the lowest rent or the range of rents when there is variation among units with the same number of bedrooms. The recipient should follow up to determine what causes the rents to vary (e.g., unit size, location within the development, number of bathrooms, amenities), and then document these factors.

newspapers with rental listings; “For Rent” signs in windows or on lawns; Bulletin boards in community locations, such

as grocery stores, laundromats, churches, and social service offices;

Real estate agents; Property management companies that

handle rental property; and Rental Listing websites like:

www.apartmentguide.comwww.apartments.comwww.forrentmag.comwww.move.com/apartments/main.aspxRental market study: A rental market study is an in-depth analysis of a particular rental

market that is often prepared by independent organizations for specific communities. Commercial firms will frequently conduct these studies before developing rental housing in aparticular location. They can provide a good source of data to use as the basis of a rent reasonableness policy. However, some rental market studies may be narrowlyfocused on a particular type of rental housing (such as housing for seniors or rental condominiums) and might be useful only for certain housing units assisted with ESG funds.

Rental market survey: A rental market survey provides a comparison of various landlords and property management companies in the area. Some local governments conduct surveys to assist with planning activities. Additionally, local associations of

Tip: When using either a market study or a market survey, it is very important to understand what is and is not included in the rent reported. For example, surveys/studies may report rents with all, some, or no utilities included. When comparing unassisted market units with ESG-assisted units, it is important to consider whether utilities and other amenities are included in the rent.

rental owners and managers may survey their members periodically and publish the results. Many of these surveys report average rents and/or rent ranges by the number of bedrooms and submarket location. However, such surveys frequently do not contain the detailed information required for rent reasonableness comparisons, such as amenities (free parking, laundry, etc.) or additional fees that must be paid. Rental market surveys are designed to show the overall picture of the rental market and may not be useful in evaluating the rent for a particular unit type.

Rental database: For HPRP, some grantees found it useful to build their own rental databasein order to perform more efficient searches for comparable rents. Building a rental databaseallows the majority of work to be completed on the front end, which increases the efficiency ofmaking

49JUNE 5, 2013

rent reasonableness determinations and allows assistance to be provided more quickly.However, there are serious resource issues to consider for this option, including updating thedata and maintaining the database, which can be labor-intensive and costly. If choosing this option, ESG recipients in close proximity to one another may choose to collaborate on a regional database.

Rural Housing Data Sources

While there may be fewer rental units in rural areas than in urban and suburban areas, it is possible to find comparable rents for different unit types located in these areas using various data sources, including:

U.S. Department of Agriculture’s Rural Development Agency (USDA): USDA provides direct and guaranteed loans for single and multi-family housing development in rural areas and for farm laborers. Contact information for Rural Development State and Local Offices or USDA Service Centers is available at www.rurdev.usda.gov/recd_map.html. Each Rural Development Office, if it has a Rural Housing component, should provide information on the types of rental housing availablein communities throughout the state, and include unit sizes and rental rates.

PHAs: If a rural community is also under the jurisdiction of a PHA, the PHA may bea source of comparable rent data.

Real estate agents: Local real estate agents are not only knowledgeable about real estate prices but often are a source of information on rental housing in the area. They may be able to extrapolate rent estimates based on the general cost of housing in the area. To find real estate agents active in particular communities, recipients can consult theNational Association of Realtors on the web at www.realtor.org. For demographicinformation on the housing stock, market trends, etc., recipients should access www.realtor.org/research.

COMPONENTS OF AN EFFECTIVE POLICY

For monitoring purposes, HUD will determine whether the recipient/subrecipient developed a written policy and followed that policy to determine and document that:

1. The rent was reasonable; and

2. The rent was within the established FMR limit.

The basis for the determination must be supported by the evidence documented in the casefile. Therefore, adequate documentation will enable a supervisor or other entity charged with monitoring the program to readily identify the factors and process that resulted in the determination that each unit met HUD requirements.

Recipients’/subrecipients’ policies and procedures must be transparent and consistentlyapplied across their program, and result in decisions that comply with HUD requirements. At a minimum, an effective policy includes a methodology, documentation requirements, staffing assignments, and strategies for addressing special circumstances.

This means that policies and procedures should provide step-by-step guidance on making comparisons between the program participant’s rent, the FMR, and the rentreasonableness standards for comparable units in that community. This includes thedocumentation to be included in each case file, such as forms and/or case notes from thestaff making the

50JUNE 5, 2013

determination. For example, a recipient could create a policy where a provider must considerthe rents of three comparable units and allow as “reasonable” only rents that fall within $50 ofthe average of the three comparable rents. In this example, a rent could be paid that is slightly higher than some of the individual comparable units. That rent would still be considered “reasonable” under the recipient’s policy–but rent could only be paid if it is also at or below the FMR.

STAFF ROLES AND RESPONSIBILITIES

Recipients/subrecipients should have a procedure in place to ensure that compliance with rent reasonableness and FMR are documented prior to a check for rent being approved and/or prepared. The responsibility of determining and documenting each unit’s compliance with these standards may be assigned to one or more program staff, such as the case manager,clerical support staff, or a staff member who is assigned to conduct habitability inspections. One staff person may perform all the checks, or the tasks may be divided among more than onestaff. For example, for rent reasonableness, one staff member could conduct a telephone surveyof the property owner/landlords, while another searches rental databases for comparableproperties.

GRANT RECIPIENT’S CONSENT TO RELEASE OF INFORMATION

I, understand and acknowledge that(the “Agency”), in exchange for receiving certain funds from the Missouri Housing Development Commission (“MHDC”), is required to share certain un‐identifying information about me with MHDC in order to ensure theAgency’s compliance with all rules and requirements associated with the funds from MHDC.

I have been informed that the Agency will not release any information about me, my children, or my abuser toany group or individual unless a written release of information is signed by me. I understand that I may revokea release of information at any time.

The funding received by the Agency and administered by MHDC may actually be from other state and federal agencies, such as Department of Social Services (collectively the "Auditors"). Together with MHDC, theAuditors are entitled to examine records in performing audit and review functions. In these cases, MHDC and the Auditors may see the client information sheet located in my file. I understand that neither MHDC nor theAuditors will leave the premises with any identifying information about me, and will not disclose anyidentifying information to any third party.

By my signature below, I hereby authorize the Agency to share un‐identifying information with MHDC and its Auditors for the limited purposes of proving that I qualify to receive the assistance administered by MHDC and ensuring that the Agency is in compliance with the rules and requirements associated with the funds fromMHDC.

Applicant’s Signature (initials):

Printed Unique Identifier:

Date:

Among the stated goals of programs administered by MHDC is the provision of safe, decent and sanitary housing. In order to assist MHDC in furthering this goal, please indicate which of the following statements below is most accurate as it pertains to your current housing:

I believe my current housing, for which I am seeking MHDC assistance, IS safe, decent and sanitary.

I believe my current housing, for which I am seeking MHDC assistance IS NOT safe, decent and sanitary.

NOTE – If, at any time while you are receiving assistance through programs administered by MHDC you believe your current housing ceases to be safe, decent and sanitary, please report this to the Agency; and, theAgency will assist you in locating housing that is safe, decent and sanitary.

Effective: January 1,2019

CI‐108 DV

GRANT RECIPIENT’S CONSENT TO RELEASE OF INFORMATION

I, understand and acknowledge that(the “Agency”), in exchange for receiving funds from the Missouri Housing Development Commission (“MHDC”) is required to share certain information about me with MHDC in order to ensure the Agency’s compliance with all rules and requirements associated with the funds from MHDC.

By my signature below, I hereby authorize the Agency to share all of my personal information with MHDC for the limited purposes of proving that I qualify to receive assistance administered by MHDC and ensuring that the Agency is in compliance with the rules and requirements associated with the funds from MHDC. I further authorize MHDC to contact me directly to discuss any matters related to my receipt of MHDC funds and agreeto provide any additional information that MHDC may deem necessary in order to fully determine myeligibility for MHDC funds and/or to determine whether the Agency is in compliance with all rules and requirements of associated with the funds from MHDC. I understand that the funding received by Agency and administered by MHDC may actually be from other state and federal agencies, such as the Department Social Services, and I hereby authorize MHDC to share my information with such funding sources for the limited purposes of proving that I qualify to receive such assistance and ensuring that all program rules and requirements are complied with by Agency and MHDC. I further authorize such other funding sources to contact me directly to discuss any matters related to my receipt of the funds administered by MHDC and agreeto provide any additional information that such funding sources may deem necessary in order to fullydetermine my eligibility and/or to determine whether all program rules are complied with by Agency and MHDC.

Applicant’s Signature:

Printed Name:

Date:

Among the stated goals of programs administered by MHDC is the provision of safe, decent and sanitaryhousing. In order to assist in furthering this goal, please indicate which of the following statements below ismost accurate as it pertains to your current housing:

I believe my current housing, for which I am seeking MHDC assistance, IS safe, decent and sanitary.

I believe my current housing, for which I am seeking MHDC assistance IS NOT safe, decent and sanitary.

NOTE – If, at any time while you are receiving assistance through programs administered by MHDC, you believe your current housing ceases to be safe, decent and sanitary, please report this to the Agency; and, the Agency will assist you in locating housing that is safe, decent and sanitary.

1 of 1 Effective: January 1, 2019

CI-108

EMERGENCY SOLUTIONS GRANT PROGRAM ESG-204

CERT/FICATION OF RECEIPT OF ESGASSISTANCE

By signing this form, I state that I am aware that it is unlawful to receive Emergency SolutionsGrant (ESG} services or assistance for more than twenty-four (24) months in any three (3) yearperiod. I do hereby certify that:

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

D

Signature of Applicant Date of Application

Address City State

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

D I have received ESGservices or assistance within the three (3) yearsprior to this application.

Type of services or assista nce received: - - - - - - - - - - - - - -Length of time services or assista nce was received: _

Location of services or assista nce received: -- - - - - - - - - - -

D A member of my household received ESGservices or assistance withinthe three (3) years prior to this application.

Name of person(s) that received services or assistance: _Type of services or assista nce received: - - - - - - - - - - - - -

Length of time services or assista nce was received:- - - - - - - - - Locationof services or assista nce received: -- - - - - - - - - - -

EMERGENCY SOLUTIONS GRANT PROGRAMESG-205

. .. . . " Instructions : Place a check mark in the correct column to indicate whether the property isM :X) U;t.!hc1JSJNG approved or deficient with respect to each standard. A copy of this checklist should be placed in

thP c;h<>lt<> 'c; filpc;

Approved Deficient Standard

(24 CFR part 576.403(b))

1. Structure and materials:a. The shelter building is structurally sound to protect the residents from the

elements and not pose any threat to the health and safety of the residents .b. Any renovation (including major rehabilitation and conversion) carried out

with ESG assistance uses Energy Star and WaterSense products and appliances.

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

a. Section 504 of the Rehabilitation Act (29 U.S.C. 794) and

implementing regulations at 24 CFR part 8;

b. The Fair Housing Act (42 U.S.C. 3601et seq.) and implementing regulations at24 CFR part 100; and

c. Title II of the Americans with Disabilities Act (42 U.S.C. 12131et seq.) and 28

CFR part 35.

3. Space and security: Except where the shelter is intended for day use only, the shelter provides each program participant in the shelter with an acceptable place to sleep and adequate space and security for themselves and their belongings.

4. Interior air quality: Each room or space within the shelter has a natural or mechanical means of ventilation. The interior air is free of pollutants at a level that might threaten or harm the health of residents.

5. Water Supply: The shelter's water supply is free of contamination.

6. Sanitary Facilities : Each program participant in the shelter has access to sanitary facilities that are in proper operating condition, are private, and are adequate for personal cleanliness and the disposal of human waste.

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

8. Illumination and electricity:

a. The shelter has adequate natural or artificial illumination to permit normal

indoor activities and support health and safety.

b. There are sufficient electrical sources to permit the safe use of

electrical appliances in the shelter .

9. Food preparation: Food preparation areas, if any, contain suitable space and equipment to store, prepare,and serve food in a safe and sanitary manner.

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

11. Fire safety:a. There is at least one working smoke detector in each occupied unit of the

shelter. Where possible, smoke detectors are located near sleepingareas.

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

emergency.

12. If ESG funds were used for renovation or conversion, the shelter meets state or local government safety and sanitation standards, as applicable.

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

Minimum Standards for Emergency Shelter

ESG-205

CERTIFICATION STATEMENT

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

D Property meets fill of the above standards.

D Property does not meet all of the above standards.

COMMENTS:

ESG Recipient Name: - - - - - - - - - - - - - - -

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

Emergency Shelter Name:

Street Address: - - - - - - - - - - - - - - - - - - - - - - - - - --City: - - - - - - - - - - - - - - - - - State:

- -- - - Zip:

_

Evaluator Signature: - - - - - - - - - - - - - - - Date of review:

_Evaluator Name:

Approving Official Signature (if applicable): - - - - - - - - - - - Date:

_Approving Official Name (if applicable):

_

Emergency Solutions Grant Program ESG-205

Minimum Standards for Permanent Housing;:.. ··

f11SSDC)RJ HOU51t.GInstructions: Place a check mark in the correct column to indicate whether the property isapproved or deficient with respect to each standard. The property must meet all standards

in order to be approved. A copy of this checklist should be placed in the client file.

Approved DeficientStandard

(24 CFRpart 576.403(c))

1. Structure and materials: The structure is structurally sound to protect theresidents from the elements and not pose any threat to the health and

safety of the residents.

2. Space and security: Each resident is provided adequate space and security

for themselves and their belongings. Each resident is provided an

acceptable place to sleep.

3. Interior air quality: Each room or space has a natural or mechanical means

of ventilation. The interior air is free of pollutants at a level that might

threaten or harm the health of residents.

4. Water Supply: The water supply is free from contamination.

5. Sanitary Facilities: Residents have access to sufficient sanitary facilities that are in proper operating condition, are private, and are adequate forpersonal cleanliness and the disposal of human waste.

6. Thermal environment : The housing has any necessary heating/cooling

facilities in proper operating condition.II

7. Illumination and electricity : The structure has adequate natural or artificialillumination to permit normal indoor activities and support health andsafety. There are sufficient electrical sources to permit the safe use ofelectrical appliances in the structure .

8. Food preparation : All food preparation areas contain suitable space and

equipment to store, prepare, and serve food in a safe and sanitary

manner.9. Sanitary condition : The housing is maintained in sanitary condition.

10. Fire safety:a. There is a second means of exiting the building in the event off i re or

other emergency.

b. The unit includes at least one battery-operated or hard-wired smoke

detector, in proper working condition, on each occupied level of the

unit. Smoke detectors are located, to the extent practicable, in a

hallway adjacent to a bedroom.c. If the unit is occupied by hearing-impaired persons, smoke detectors

have an alarm system designed for hearing-impaired persons in each

bedroom occupied by a hearing-impaired person.d. The public areas are equipped with a sufficient number, but not less

than one for each area, of battery-operated or hard-wired smoke

detectors. Public areas include, but are not limited to, laundry rooms,

day care centers, hallways, stairwells, and other common areas.

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

Page 1e - ; : ;

ESG Minimum Habitability Standards Checklist- -

ESG-205

CERTIFICATION STATEMENT

I certify that I have eva luated the property located at the address below to the best of my ability andfind the foilowi ng:

D Property meets ill! of the above standa rds.

D Property does not meet all of t he above standa rds.

COMMENTS:

ESG Recipient Name: - - - - - - - - - - - - - - - -

ESG Subrecipient Name: - - - - - - - - - - - - - - - -

Progra m Participant Name:

Street Add ress: - - - - - - - - - - - - - - - -

Apartment : _ _ _

City: _ _ State: _ _ _ Zip: _

Evaluator Signatu re:- - - - - - - - - - - - - - - Eva

luator Name:

Date of review :_

Approvi ng Officia l Signatu re (if applica ble): - - - - - - - - - - - Date:_

Approving OfficialName (if applica ble): - - - - - - - - - - - - - - -

--•ESG Minimum Habita bility Standa rds Checklist Page 2


58

ESG-207

ESG Lead Screening Worksheet

About this Tool

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

INSTRUCTIONS

To prevent lead-poisoning in young children, ESGgrantees must comply with the Lead-Based Paint

Poisoning Prevention Act of 1973 and its applicable regulations found at 24 CFR 35, Parts A, B, M, and R. Under certain circumstances, a visual assessment of the unit is not required. This screening worksheet will help program staff determine whether a unit is subject to a visual assessment, and if so, how toproceed. A copy of the completed worksheet along with any related documentation should be kept ineach grantee or program participant's file .

Note: ALL pre-1978 properties are subject to the disclosure requirements outlined in 24 CFR 35, Part A, regardless of whether they are exempt from the visual assessment requirements .

BASIC INFORMATION

Name of Participant

Address

City

ESGProgram Staff

PART 1: DETERMINE WHETHER THE UNIT IS SUBJECTTOA VISUAL ASSESSMENT

If the answer to one or both of the following questions is 'no,' a visual assessment is not triggered forthis unit and no further action is required at this time . Place this screening worksheet and relateddocumentation in the program participant's file.

If the answer to both of these questions is 'yes,' then a visual assessment is triggered for th i$ unit 3ndprogram staff should continue to Part 2.

1. Was the leased property constructed before 1978?

O ves0 N o

2. Will a child under the age of six be living in the unit occupied by the household receiving ESGassistance?

O ves0 N o

Unit Number

State Zip

ESG-207

PART 2: DOCUMENT ADDITIONAL EXEMPTIONS

If the answer to any of the following questions is 'yes,' the property is exempt from the visual assessment requirement and no further action is needed at this point. Place this screening sheet andsupporting documentation for each exemption in the program participant's file .

If the answer to all of these questions is 'no,' then continue to Part 3 to determine whether deterioratedpaint is present.

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

O ves

0 No2. Has X-ray or laboratory testing of all painted surfaces by certified personnel been conducted in

accordance with HUD regulations and the unit is officially certified to not contain lead-based paint?

O ves

0 No3. Has this property had all lead-based paint identified and removed in accordance with HUD

regulations?

O v es

0No4. Is the client receiving federal assistance from another program, where the unit has already

undergone (and passed) a visual assessment within the past 12 months (e.g., if the client has aSection 8 voucher and is receiving ESGassistance for a security deposit or arrears)?

0 Yes (Obtain documentation for the case file .)

0 No5. Does the property meet any of the other exemptions described in 24 CFR Part 35.115(a).

O ves

0NoPlease describe the exemption and provide appropriate documentation of the exemption .

59PART 3: DETERMINE THE PRESENCE OF DETERIORATED PAINT

To determine whether there are any identified problems with paint surfaces,. program staff should

conduct a visual assessment prior to providing HPRPfinancial assistance to the unit as outlined in the

following train ing on HUD's website at :

http://www.hud.gov/office s/lead/training/visualassessment/h001 01.htm.

If no problems with paint surfaces are identified during the visual assessment, then no further action isrequired at this time. Place this screening sheet and certification form (Attachment A) in the programparticipant's file.

If any problems with paint surfaces are identified during the visual assessment, then continue to Part 4to determine whether safe work practices and clearance are required.

ESG-207

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

0 Yes

0 N o

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

0 Y e s

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

PART 4: DOCUMENT THE LEVEL OF IDENTIFIED PROBLEMS

All deteriorated paint identified during the visual assessment must be repaired prior to clearing the unitfor assistance. However, if the area of paint to be stabilized exceeds the de minimus levels (definedbelow), the use of lead safe work practices and clearance is required.

If deteriorating paint exists but the area of paint to be stabilized does not exceed these levels, then thepaint must be repaired prior to clearing the unit for assistance, but safe work practices and clearance are not required.

1. Does the area of paint to be stabilized exceed any of the de minimus levels below?

• 20 square feet on exterior surfaces 0 Yes 0 No

• 2 square feet in any one interior room or space 0 Yes D No

• 10 percent of the total surface area on an interior or exterior component with a small surface area, like window sills, baseboards, and trim D Yes 0 No

If any of the above are 'yes,' then safe work practices and clearance are required prior to clearing theunit for assistance.

PART 5: CONFIRM ALL IDENTIFIED DETERIORATED PAINT HAS BEEN STABILIZED

Program staff should work with property owners/managers to ensure that all deteriorated paint identifiedduring the visual assessment has been stabilized. If the area of paint to be stabilized does not exceed thede minimus level, safe work practices and a clearance exam are not required (though safe work practicesare always recommended). In these cases, the ESGprogram staff should confirm that the identifieddeteriorated paint has been repaired by conducting a follow-up assessment.

If the area of paint to be stabilized exceeds the de minimus level, program staff should ensure that theclearance inspection is conducted by an independent certified lead professional. A certified leadprofessional may go by various titles, including a certified paint inspector, risk assessor, or

sampling/clearance technician. Note, the clearance inspection cannot be conducted by the same firmthat is repairing the deteriorated paint.

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

0 Y e s

0 N o

2. Have all identified problems with the paint surfaces been repaired?

0 Y e s

0 N o

60

ESG-207

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

O ves0 N o

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

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

Oves0 N o

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

5. Did the unit pass the clearance exam?

D ves0 No

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

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

61

ESG-207

ATTACHMENT 1: LEAD-BASED PAINT VISUAL ASSESSMENT CERTIFICATION TEMPLATE

62

I, _ , certify the following:

(Print name)

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

• I conducted a visual assessment at - - - - - - - - - - - - - - -

(Property address and unit number)

-on

(Date of Assessment)

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

(Signature)

(Date)

Client Name: - - - - - - - - - - -

Case Number: - - - - - - - - - - -


63

ESG-208

ESG Lead-Based Paint Property Owner Certification Form

About this Tool

The ESG Lead-Based Paint Property Owner Certification Form is a toolprogram staff can use to have property owners/managers certify that all paintstabilization activities have been completed in accordance with guidelineswhen formal clearance is not required (or as additional documentation whenformal clearance is required). A copy of the completed form along with any additional documentation {i.e., a copy of the clearance report) should be keptin each program participant's file.

INSTRUCTIONS

To prevent lead-poisoning in young children, the ESG program must comply with the Lead-Based Paint

Poisoning Prevention Act of 1973 and its applicable regulations found at 24 CFR 35, Parts A, B, M, and R. If

a visual assessment reveals problems with paint surfaces, property owners/managers must repair all

identified problems with paint surfaces in accordance with the guidelines of 24 CFR 35, Parts A, B, M, and

R, prior to a unit receiving ESGassistance. Property owners/managers should complete this form to

certify that all identified problems with paint surfaces have been repaired/stabilized in accordance with

the guidelines.

1. Have all identified problems with the paint surfaces been repaired?

O v e s

0 N o

2. Have all identified problems with paint surfaces been repaired using safe work practices?

O v e s

0 N o

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

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

D ves

0 No

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

4. Did the unit pass the clearance exam?

O ves

0 No

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

ESG-208

64

Name of Property Owner/Manager

Property Owner/Manager Signature - - - - - - - - Date

Name of ESG Program Staff

ESG Program Staff Signature Date

Name of Tenant

Address

City State

Unit Number

Zip

VIOLENCE, DATING VIOLENCEOR STALKING

U.S. Department of Housingand Urban Development

Office of Housing

OMB Approval No. 2502-0204

Exp. 6/30/2017

LEASE ADDENDUMVIOLENCE AGAINST WOMEN AND JUSTICE DEPARTMENT REAUTHORIZATION ACT OF 2005

This lease addendum adds the following paragraphs to the Lease between the above referenced Tenant and Landlord.

Purpose of the Addendum

The lease for the above referenced unit is being amended to include the provisions of the Violence Against Women and Justice Department Reauthorization Act of 2005 (VAWA).

Conflicts with Other Provisions of the Lease

In case of any conflict between the provisions of this Addendum and other sections of the Lease, the provisions of this Addendum shall prevail.

Term of the Lease Addendum

The effective date of this Lease Addendum is- . This Lease Addendum shall---- -

TENANT LANDLORD UNIT NO. &ADDRESS

continue to be in effect until the Lease is terminated.

VAWA Protections

1. The Landlord may not consider incidents of domestic violence, dating violence or stalking asserious or repeated violations of the lease or other "good cause" for termination of assistance,tenancy or occupancy rights of the victim of abuse.

2. The Landlord may not consider criminal activity directly relating to abuse, engaged in by a member of a tenant's household or any guest or other person under the tenant's control, causefor termination of assistance, tenancy, or occupancy rights if the tenant or an immediatemember of the tenant ' s family is the victim or threatened victim of that abuse.

3. The Landlord may request in writing that the victim, or a family member on the victim'sbehalf, certify that the individual is a victim of abuse and that the Certification of DomesticViolence, Dating Violence or Stalking, Form HUD-91066, or other documentation as notedon the certification form, be completed and submitted within 14 business days, or an agreedupon extension date, to receive protection under the VAWA. Failure to provide the certification or other supporting documentation within the specified timeframe may result ineviction .

Tenant Date

Form HUD-91067(9/2008)

Landlord Date

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

Completion of an exit survey and keeping records of allcompleted surveys

Posting a notice in a high traffic area about the exit survey, referrals, and reasons for exit

Tracking the number of referral agencies and types of services provided

Housing First Model Follow HUD’s model of Housing First Principles by looking for violations inscreening packets or written standards. Requiring as a condition of services: (these can be offered but not

required) Employment, or income Being sober, or participation in drug or alcohol treatment programs No criminal history (agencies can screen for sex offender status) Non‐participation in service and treatment plans cannot be a reason

for eviction or exit

Financial Documentation Proof of need, i.e. invoice,

receipt, payroll If a service or utility bill; it must

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

Receipts must list eligible item(s)purchased, services performed,amount(s), and date(s)

Assemble receipts, bills in order (preferably by payment date withcorresponding CI invoice)

Proof of cleared payment Copy of cleared payment or bank

statement clearly showing checknumber, date, and amount

Payroll debits on bank statements must match payroll report total of netamount or copy of paystub Timesheets Last 4 digits of employees’ SSN

Employee benefits (insurance, taxes, work comp., etc.)

Non-Compliance Common Errors Missing required forms Participants failing to disclose income information / inadequate

intake application Missing household eligibility documentation, i.e. income and

homelessness Missing documentation of case management and housing

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

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

Replacement Backup formhttp://www.mhdc.com/ci/documents/CI_Replacement%20Back‐Up%20Form.pdf Copies of eligible expenses incurred within the grant period

which have not previously been submitted for payment Bill, invoice or other proof of expense Proof of cleared payment Household eligibility documentation, i.e. income and

homelessness, program consent form, and intake application. Corrected HMIS or comparable database report

Replacement Back-Up Form - Community Initiatives

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

Agency Date

Grant Number Community Initiatives Program

Total Amount of Direct Financial Assistance Total Administrative/Operating Expenses

Total Amount of Replacement Expenses

The following supporting documentation should be submitted with this form in order for MHDC to determine eligibility of replacement expenses:

Revised HMIS report

Proof of household(s) income eligibility

Consent form(s)

Proof of need

Proof of cost(s) incurred

Proof of cleared payment(s)

I hereby certify that all information on this form is true, that I have collected and reviewed all required records to maintain, and that all expenses are authorized and meet the eligibility of the grant.

Authorized Signature #1 Date

Authorized Signature #2 Date

ResourcesHUD Chapter 5:http://portal.hud.gov/hudportal/documents/huddoc?id=DOC_35649.pdf

ESG Desk Guide:http://www.mhdc.com/ci/esg/documents/2018/a/FY2018%20ESG%20Desk%20Guide.pdf

Compliance Resources:http://www.mhdc.com/ci/compliance/index.htm

QUESTIONS

Contact InformationDenise HossCommunity Initiatives Compliance OfficerPhone: (816) 759‐6642Email: [email protected]

Cassie Sipos‐HaasEmergency Solutions Grant AdministratorPhone: (816) 759‐6630Email: cassie.sipos‐[email protected]

Steve WhitsonCommunity Initiatives Assistant ManagerPhone: (816) 759‐6890Email: [email protected]

Cassie Wilson Grants AdministratorPhone: (816)759‐7236Email: [email protected]

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