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Home My WebLink AboutC04-044 CSBG Application and Plan c.. 0 tf- 4'1-- z...<=- 2004-05 CSBG APPLICATION and PLAN GRANTEE: Eae:le County Health & Human Services - Eae:le County Government ADDRESS: PO Box 660 Eae:le. Colorado 81631 CONTACT PERSON: Kathleen Forinash TITLE: Health & Human Services Director PHONE: 970-328-8858 E-MAIL: kathleen.forinash(tlleae:lecountv.us FAX: 970-328-8829 COUNTIES INCLUDED IN THIS PLAN: Eae:le TOTAL CSBGALLOCATION: $40.362 PROGRAM PERIOD: March 1.2004 To Februarv 28. 2005 1. Employment $ $ $ 2. Education $ $ $ 3. Income Management $ $ $ 4. Housing $ $ $ 5. Emergency Services $ $ $ 6. Nutrition $ $ $ 7. Linkages with Other Programs $ 40,362 $ $ 40,362 8. Self-Sufficiency $ $ $ 9. Health $ $ $ TOTAL $ 40,362 $ $ 40,362 E-t riiIi:l ~ ~ = ~ N N ~ \0 \0 l""l l""l 0 0 -.:t -.:t fA GI; fA fA GI; GI; '#. ~ :I: ~ '#. <o!. Ii u.u rn~ rn N '#. N ~ \0 <:> \0 \C> l""l l""l ~ 0" 0 ;.J -.:t -.:t 6 '#. '+:1 'g Z ~ '#. Ii g 2:,0'- e ~ I1lrn tlJl '#. .5 ~ 0 :I: '#. 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"$ ;[ ~ (\,) t; Q) ~ ~ ~ 0 ,.c --,.c ,.c ~ 0 t:S .~ 3~ .~ ,.c U t> ~ 0 .~ rIl 0 U ~ u e ~ .= ~ <<I .g "'C (\,) ~ ~ l:l.. .... ~ ~ ~ 0 ..s s:l u 00 ~ 0 0 0 Z Z Z 0 E-< Z < co u ci ~ COLORADO CSBG CONTRACTOR/SUBCONTRACTOR SUMMARY SHEET County: Eagle Implementing Agency: Eagle County Health & Human Services (Each agency/subcontractor receiving CSBG dollars must complete this form) Implementing Agency Contact Person: Kathleen Forinash Complete Mailing Address, including zip: PO Box 660. Eae:le Colorado 81631 Phone Number: 970-328-8858 Fax: 970-328-8829 Email Address:kathleen.forinash@eaglecounty.us Program Period: March 1. 2004 to February 28.2005 CSBG Award: $40.362 Select ONE Federal Objective C Employment C Income Management C Emergency Services C Nutrition C Self-Sufficiency C Education C Linkages with Other Programs CHousing C Health Select ONE National Goal/Outcome: CGoall Low-income people become more self-sufficient. (Family) CGoal2 The conditions in which low-income people live are improved. (Community) CGoal3 Low-income people own a stake in their community. (Community) CGoal4 Partnerships among supporters and providers of services to.low-income people are achieved. (Agency) CGoal 5 Agencies increase their capacity to achieve results. (Agency) CGoal 6 Low-income people, especially vulnerable populations, achieve their potential by strengthening family and other supportive systems. (Family) Select ONE National Direct MeasurelIndicator (see CSBG National Goals and Outcome Measures sheet): 6.i.7 (i.e. 6.a, 1.n, 2.b, etc.) Low income Target Population: Pregnant women and children birth to five (i.e. Seniors, Youth, etc.) ~ Date: 9-a~C2 ~ ZOO <( Health & Human Services Name and Title: Kathleen Forin VII. CERTIFICATIONS: The grantee assures that activities implemented with CSBG funds wiD be: used to accomplish the State CSBG Goal and Objective stated in the State Plan; and within the requirements set forth in the Community Services Block Grant Act, Title N of the Civil Rights Act, the Age Discrimination Act of 1975, the Rehabilitation Act of 1973, Public Law 103-227, Part C, Environmental Tobacco Smoke, also known as the Pro-Children Act of 1994 (Act), Certification Regarding Drug-Free Workplace Requirements, Certification Regarding Lobbying, Certification Regarding Debannent, Suspension, and Other Responsibility Matters _ Primaty Covered Transactions, Office of Management and Budget (OMB Circular Alto and AI22), and the current State of Colorado CSBG Plan. The grantee also assures that it wiD: specifically consider, 'in a public meeting the designation of any local public or private entity to carry out the county community service activities under contract with the county, any local community action agency (CAA) which received federal fiscal 1981-82 funding; consider,on the same basis as other non-governmental organizations, religious organizations to provide the CSBG services, so long as the program is implemented in a manner consistent with the Establishment Clause of the first amendment to the Constitution. Grantees shall not discriminate against an organization that provides assistance under, or applies to provide assistance, on the basis that the organization has a religious character. (Please review Sec.679 Operational Rule in the CSBG Act); provide for coordination between community anti-poverty programs and ensure, where appropriate, that emergency energy crisis intervention programs under Title XXVI (relating to low-income home energy assistance) are conducted in such community; provide, on an emergency basis, for the provision of such supplies and services, nutritious foods, and related services, as may be necessary to counteract conditions of starvation and malnutrition among low-income individuals; coordinate, to the extent possible, programs with and fOIm partnerships with other organizations serving low-income residents of the conununity and members of groups served, including religious organizations, charitable groups, and community organizations; establish procedures under which a low-income individual, community organization, or religious organization, or representative of low-income individuals that considers its organization, or low-income individuals, to be inadequately represented on the CSBG board (or other mechanism) to petition for adequate representation; in the case of public organizations, have a tripartite advisory board which shall have members selected by the organization and shall be composed so as to assure that not fewer than 1/3 of the members are persons chosen in accordance with democratic selection procedures adequate to assure that these members (a) are representative of low-income individuals and families in the neighborhood served, (b) reside in the neighborhood, and (c) are able to participate actively in the development, planning, implementation, and evaluation of program funded. in the case of private non-profit entities, have a tripartite board that participates in the development, planning, implementation, and evaluation of the program to serve low-income communities. The board shall be composed so as to assure that ( a) 1/3 of the members are elected officials, holding office on the date of selection, or their representatives, except that if the number of such elected officials reasonably available and willing to serve on the board is less than 1/3 of the membership of the board, membership on the board of appointive public officials or their representatives may be counted in meeting such 1/3 requirement; (b) not fewer than 1/3 of the members are person chosen in accordance with democratic selection procedures adequate to assure that these members are representative of low-income individuals and families in the neighborhood served, and each representative of low-income individuals and families selected to represent a specific neighborhood within a community resides in the neighborhood represented; and (c) the remainder of the members are officials or members of business, industry, labor, religious, law enforcement, education, or other major groups and interest in the community served; prohibit the purchase or improvement of land, or the plirchase, construction, or pennanent improvement (other than low-cost residential weatherization or other energy-related home repairs) of any building or facility with CSBG funds; prohibit, including subcontractors, (a) any partisan or nonpartisan political activity or any political activity associated with a candidate, or contending faction or group, in an election for public or party office, (b) any activity to. provide voters or prospective voters with transportation to the polls or similar assistance in connection with an~ such election. or (c) any voter registration activity. prohibit that persons shall, on the basis of race, color, national origin or sex, be excluded from participation in, be denied the benefits of, or be subjected to discrimination under, any program or activity funded in whole or in part with CSBG. Any prohibition against discrimination on the basis ofage under the Age Discrimination Act or 1975 (42 U.S.C 6101 et seq.) or with respect to an otherwise qualified individual with a disability as provided in Section 504 of the Rehabilitation Act of 1973 (29 U.S.C. 12131 et seq.) shall also apply to any such program or activity. participate in the Results-Oriented Management and Accountability (ROMA) System, and describe outcome measure to be used to measure performance in promoting self-sufficiency, family stability, and/or connnunity revitalization; make available for public inspection each plan prepared as part of the program planning process. The grantee may, at its initiative, revise any plan prepared for CSBG funding and shall furnish the revised plan to the Director of the Community Services Block Grant under the Department of Local Affairs. Each plan prepared for submission shall be made avai1able for public inspection within the COWlty and/or service area in such a manner as will facilitate review of, and comments on, the plan; cooperate with the State, to detennine whether grantee perfonnance goals, administrative standards, financial management requirements, and other requirements of the State, in conducting monitoring reviews including (1) a full on-site review for each grantee at least once during each 3-year period, (2) on-site review for each newly designated grantee immediately after the completion of the first year in which funds were received, (3) follow-up reviews with grantees that fail to meet the goals, standards, and requirement established by the State, and (4) other reviews as appropriate, including reviews of grantees with other programs that have had other federal, State, or local grants temrinated for cause. make available appropriate books, documents, papers, and records for inspection, examination, copying, or mechanical reproduction on or off the premises upon reasonable request by the U.S. Controller General, the State, or their authorized representatives should an investigation of the uses of CSBG funds be undertaken; in the case of county governments or subgrantees which receive a CSBG award in excess oUI00,000, comply with the following three certifications related to the "Limitation on use of appropriated funds to influence certain Federal Contracting and financial transactions (p.L. 101-121, Section 319 and USC Title 31 Section 1352)": 1. No Federal appropriated funds have been paid or will be paid by or on behalf of the Wldersigned, to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract, continuation, renewal, amendment, or modification of any Federal contract, grant, loan, or cooperative agreement 2. If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or any employee of a Member of Congress in connection with this Federal contract, grant, loan, or cooperative agreement, the Wldersigned shall complete and submit Standard Form LLL, "Disclosure Form to Report Lobbying," in accordance with its instruction. 3. The undersigned shall require that the language of this certification be included in the award document for subawards at all tiers (including subcontracts, subgrants, and contracts under grants, loans, and cooperative agreements) and that all subrecipients shall certify and disclose accordingly. The grantee certifies to the best of its knowledge and belief, that it and its principals: a) are not presently debarred, suspended, proposed for debarment, declared ineligtble, or voluntarily excluded from covered transactions by any Federal deparbnent or agency; . . a b) have not within a three-year period preceding this proposal been convicted or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or perfonning a public transaction; violation of Federal or State antitrust statues or commission of embezzlement, theft, forgery, bribery, . falsification or destruction of records, making false statements, or receiving stolen property; c) are not presently indicted for otherwise criminally or civilly charged by a governmental entity (Federal, State or local) with commission of any of the offenses enumerated in paragraph (b) of this certification; and d) have not within a three-year period preceding this application had one or more public transactions (Federal, State or local) terminated for cause or default. (If you are unable to certify to any of the statements in this certification. please attach an explanation to this application.) CONTRACTOR: ~.~ If COllnty Grantee: Chairman of the Board of County Commissioners must sign If Multi-County Service Agency: Chairman of the Board of Directors with delegated contracting authority must sign. PosmON TITLE: Chairman, Eagle County Board of Commissioner~ATE: January 27, 2004 . .