Uniform Application for State Grant Assistance SCSEP... · 2019. 6. 12. · SCSEP FY 2020/PY 2019...

Illinois Department on Aging

Title V/Senior Community Service Employment Program (SCSEP)

SCSEP FY 2020/PY 2019 Application

Uniform Application for State Grant Assistance

Agency Completed Section Agency Information

1. Type of Submission

□ Pre-application Application □ Changed / Corrected Application

2. Type of Application

New □ Continuation (i.e. multiple year grant) □ Revision (modification to initial application)

3. Date / Time Received by State

(Office Use Only)

4. Name of the Awarding State Agency


5. Catalog of State Financial Assistance (CSFA) Number

402-01-0023

6. CSFA Title

Senior Community Service Employment Program

Catalog of Federal Domestic Assistance (CFDA) □ Not applicable (No federal funding)

7. CFDA Number 17.325

8. CFDA Title Senior Community Service Employment Program (SCSEP)

9. CFDA Number

10. CFDA Title

Funding Opportunity Information

11. Funding Opportunity Number

12. Funding Opportunity Title

13. Funding Opportunity Program Field

Competition Identification

14. Competition Identification Number

15. Competition Identification Title




Applicant Completed Section

Applicant Information Use same Legal Name as used for DUNS registration and grantee pre-qualification.

16. Legal Name

17. Common Name (DBA)

18. Employer / Taxpayer Identification Number (EIN, TIN)

19. Organizational DUNS number

20. SAM Cage Code

21. Business Address Street address City, State County, Zip + 4

Applicant’s Organizational Unit

22. Department Name

23. Division Name

Applicant’s Name and Contact Information for Person to be Contacted for Program Matters involving this Application

24. First Name

25. Last Name

26. Suffix

27. Title

28. Organizational Affiliation

29. Telephone Number

30. Fax Number

31. Email address

Applicant’s Name and Contact Information for Person to be Contacted for Business/Administrative Office Matters involving this Application

32. First Name

33. Last Name

34. Suffix

35. Title

36. Organizational Affiliation


38. Fax Number

39. Email address

Areas Affected

40. Areas Affected by the Project (cities, counties, state-wide)

List the Planning and Service Areas (PSAs) and counties you propose to serve with this grant application. You can submit the information as an attachment.




*Reference the attached Statewide Provider Service Area (PSA) Map that was included as part of the grant application packet.

41. Legislative and Congressional Districts of Applicant

List your applicable Legislative and Congressional Districts per https://www.elections.il.gov/votinginformation/CongRepDist.aspx

42. Legislative and Congressional Districts of Program / Project

List your applicable Legislative and Congressional Districts per https://www.elections.il.gov/votinginformation/CongRepDist.aspx

Applicant’s Project

43. Description Title of Applicant’s Project

Title V/Senior Community Service Employment Program Grant

44. Proposed Project Term Start Date: October 1, 2019 End Date: June 30, 2020

45. Estimated Funding (include all that apply)

Amount Requested from the State: □ Applicant Contribution (e.g., in kind, matching): □ Local Contribution: □ Other Source of Contribution: □ Program Income: Total Amount: $_________

Applicant Certification: By signing this application, I certify (1) to the statements contained in the list of certifications* and (2) that the statements herein are true, complete and accurate to the best of my knowledge. I also provide the required assurances* and agree to comply with any resulting terms if I accept an award. I am aware that any false, fictitious, or fraudulent statements or claims may subject me to criminal, civil or administrative penalties. (U.S. Code, Title 18, Section 1001) (*) The list of certification and assurances, or an internet site where you may obtain this list is contained in the Notice of Funding Opportunity. If a NOFO was not required for the award, the state agency will specify required assurances and certifications as an addendum to the application.

□ I agree

Authorized Representative

46. First Name

47. Last Name

48. Suffix

49. Title


51. Fax Number

52. Email Address

53. Signature of Authorized Representative

54. Date Signed

https://www.elections.il.gov/votinginformation/CongRepDist.aspx

https://www.elections.il.gov/votinginformation/CongRepDist.aspx


Section I.: Uniform Budget and Financial Plan

Refer to the attached State of Illinois – Uniform Budget Section A. and B. Budget Summary

and Excel Spreadsheets for Exhibit I. (Budget Worksheet and Narrative)

Exhibit II.A


Section II.: SCSEP Program Plan

The following Section includes all data relevant to the Narrative portion

of the applicant’s submission of the FY 2020/PY 2019 SCSEP Application

(be sure to submit the questions in the order they are presented).

Exhibit II.A


ORGANIZATIONAL, ADMINISTRATIVE & FISCAL CAPACITY

(See additional detailed information in the Instructions)

Describe in detail your organization’s ability to administer SCSEP in the areas where you are requesting authority to

provide service. Describe how your organizational, administrative, and fiscal capacity will support the SCSEP project

by addressing the organizational, administrative and fiscal components listed below. For each component, include

a comprehensive description of what you have done in the past and what outcomes you have achieved. Include data

on your prior experience wherever applicable.

Use additional sheets if needed. _________________________________________________________________________________________

Capacity to Manage Core Organizational Functions and Program Operations

Capacity to Manage Data

Financial Stability and Ability to Adjust to Changes in Funding

Reporting and Audits

Exhibits II.B


STATEMENT OF NEED

Describe, in both quantitative and qualitative terms, the need for assistance for the TitleV/SCSEP-eligible

population in the counties in your chosen Planning and Service Areas (PSAs) area and incorporate demographic

information whenever possible. Refer to Instructions for detailed guidance on how to respond to this section.

Use additional sheets if needed.

__________________________________________________________________________________

Exhibits II.B


PROJECT DESIGN

Provide a comprehensive plan of action that outlines the scope and detail of your Title V/SCSEP project and how

you will accomplish the proposed employment and training activities. Describe how you will implement Title

V/SCSEP by addressing the three program factors listed below. For each component, if you have had experience

providing these or similar services, include a discussion of what you have done, what outcomes you have

achieved, and what changes to your current program design(s), if any, you will make if awarded a grant under

this competition. Describe your partnerships with One-Stop Centers, employers, host agencies, and other

organizations and detail the specific roles played by each wherever possible. Include data on your prior

experience wherever possible.


Working with Employers & Employer Associations

Recruiting & Managing Host Agencies

Providing Quality Service to Participants

Exhibits II.B


PARTNERSHIPS

Describe the relationships you have developed with key partners (e.g. employers, educational institutions, Area

Agencies on Aging and others) to support Title V/SCSEP or similar programs and how this coordination of

services supports the participants. Detail the specific roles played by each organization and tie them to your

program activities and timeline. Include data on your prior experience where applicable. Do not include activities

under the Workforce Innovation and Opportunity Act since this information is required on the following page of

the program narrative.


Description of Collaboration with Key Partners

Description of Types of Agreements & Contributions

List of Current & Future Key Partners

Exhibits II.B


ACTIVITIES UNDER THE WORKFORCE INNOVATION AND OPPORTUNITY ACT

Applicants must include a detailed description of their efforts to partner with the Local Workforce Investment

Areas (LWIAs) and One-Stop Centers where the applicant proposes to administer the Title V/SCSEP program.


Description of Efforts to Partner & Collaborate with LWIAs & One-Stop Centers

Experience in Developing & Implementing Memorandums of Understanding

Exhibit II.C


PAST PERFORMANCE & PROGRAMMATIC CAPABILITY

Use the following format for each performance measure.

Service Level

PY 2015 PY 2016 PY 2017

Performance Goal for each PY

YTD Rate from the final SPARQ report for the PY

Exhibit II.D


PROPOSED JOB INVENTORY

SERVICES TO THE GENERAL COMMUNITY NO.

JOBS

SERVICES TO THE ELDERLY COMMUNITY NO.

JOBS

1. Education

11. Project Administration

2. Health and Hospitals

12. Health and Home Care

3. Housing/Home Rehabilitation

13. Housing/Home Rehabilitation

4. Employment Assistance

14. Employment Assistance

5. Recreation, Parks, and Forests

15. Recreation/Senior Centers

6. Environmental Quality

16. Nutrition Programs

7. Public Works and Transportation

17. Transportation

8. Social Services

18. Ombudsman

9. Other (Specify)

19. Other (Specify)

10. TOTAL JOBS IN GENERAL COMMUNITY

21. TOTAL JOBS IN ELDERLY COMMUNITY


Section III.

SCSEP Program Assurances


PROGRAMMATIC ASSURANCES FOR PY 2019 FUNDS

You must certify that you will conform to these assurances throughout the period of the grant by

checking each of the assurances below. These assurances apply fully to any sub-recipient, local

project, or grantee staff involved in the delivery of services.

You agree to:

Recruitment and Selection of Participants Develop and implement methods to recruit and select eligible participants to assure

maximum participation in the program.

Use income definitions and income inclusions and exclusions for SCSEP eligibility as described in TEGL No. 12-06 https://wdr.doleta. gov/directives/corr doc.cfm?DOCN=2291), to determine and document participant eligibility.

Develop and implement methods to recruit minority populations to ensure at least proportional representation in your assigned service area as listed in the latest Minority Report.

Develop and implement strategies to recruit applicants who have priority of service as defined in OAA section 518(b) (1)-(2) and by the Jobs for Veterans Act (NA).

Individuals with priority are those who:

Are covered persons in accordance with the JVA (covered persons who are SCSEP-eligible must receive services instead of or before all non-covered persons);

Are 65 years or older;

Have a disability;

Have limited English proficiency;

Have low literacy skills;

Reside in a rural area;

Have low employment prospects;

Have failed to find employment after utilizing services provided through the American Job Center (previously referred to as the One-Stop Center);

Are homeless or are at risk for homelessness.

Assessment

Assess participants at least twice per 12-month period, and more frequently if appropriate

Use assessment information to determine the most appropriate community service

assignments (CSAs) for participants.

Individual Employment Plan (IEP)

Establish an initial goal of unsubsidized employment for all participants.

Update the IEP at least as frequently as assessments occur (at least twice per 12-month

period).

Modify the IEP as necessary to reflect other approaches to self-sufficiency, if it becomes clear that unsubsidized employment is not feasible.

For participants who will reach the individual durational limit or would not otherwise

achieve unsubsidized employment, include a provision in the IEP to reflect other

approaches to self-sufficiency, transition to other services or programs.


Rotate participants to a new host agency (or a different assignment within the host

agency) based on a rotation policy approved by DOL in the grant agreement but only when an individualized determination determines that the rotation is in the best interest of the participant. Such rotation must further the acquisition of skills listed in the IEP.

Community Service Assignment (CSA)

Base the initial CSA on the assessment done at enrollment.

Select only designated 501(c)(3) organizations or public agencies as host agencies.

Put in place procedures to ensure adequate supervision of participants at host agencies.

Ensure safe and healthy working conditions at the CSA through annual monitoring of the host agency site and annual safety consultation with the participant at the host agency site.

Recertification of Participants

Recertify the income eligibility of each participant at least once every 12 months, or more

frequently if circumstances warrant.

Physical Examinations

Offer physical examinations to participants upon program entry, and each year thereafter, as a benefit of enrollment.

Obtain a written waiver from each participant who declines a physical examination.

Not obtain a copy or use the results of the physical examination to establish eligibility or

for any other purpose.

Host Agencies

Develop and implement methods for recruiting new host agencies to provide a variety of

training options that enable participants to increase their skill level and transition to unsubsidized employment.

Comply with maintenance of effort: Ensure that CSAs do not reduce the number of employment opportunities or vacancies that would otherwise be available to individuals who are not SCSEP participants. You must specifically ensure that CSAs do not:

Displace currently-employed workers (including partial displacement, such as a

reduction in non-overtime work, wages, or employment benefits).

Impair existing contracts or result in the substitution of Federal funds for other

funds in connection with work that would otherwise be performed.

Assign or continue to assign a participant to perform the same work, or

substantially the same work, as that performed by an individual who is on layoff.

Orientation

Provide orientations for its participants and host agencies, including information on:

Project goals and objectives

Participant rights and responsibilities

Community Service Assignments

Opportunities for paid training outside the CSA

Available supportive services

Availability of free physical examinations


Local staff must address the topics listed above and provide additional orientation to

participants on:

SCSEP goals and objectives

Grantee and local project roles, policies, and procedures

Holiday and sick leave

Assessment process

Development and implementation of IEPs

Evaluation of participant progress

Health and safety issues related to each participant 's assignment

Role of supervisors and host agencies

Maximum individual duration policy, including the possibility of an extension, if

applicable, and the documentation required to support an extension

Termination policy

Grievance procedure

Wages

Provide participants with the highest applicable required wage (highest of federal, state,

or local minimum wage) for time spent in orientation, training, and community service assignments.

Participant Benefits

Provide workers' compensation, other benefits required by state or Federal law (such as unemployment insurance), and the costs of physical examinations.

Establish written policies relating to compensation for scheduled work hours during which the participant's host agency is closed for Federal holidays.

Establish written policies relating to approved breaks in participation and any necessary sick leave that is not part of an accumulated sick leave program.

Not use grant funds to pay the cost of pension benefits, annual leave, accumulated sick

leave, or bonuses.

Procedures for Payroll and Workers' Compensation

Make all required payments for participant payroll and pay workers' compensation premiums on a timely basis.

Ensure that host agencies do not pay workers' compensation costs for participants.

Durational Limits Maximum Average Project Duration - 27 Months

Maintain average project duration of 27 months or less

Maximum Individual Participant Duration - 48 Months

Allow participants to participate in the program no longer than 48 months (whether or not

consecutively)


Notify participants of your policy pertaining to the maximum duration requirement, including the

possibility of an extension if applicable, at the time of enrollment and each year thereafter, and whenever ETA has approved a change of policy.

Provide 30-day written notice to participants prior to durational limit exit from the

program.

Transition Services

Develop a system to transition participants to unsubsidized employment or other

assistance before each participant's maximum enrollment duration has expired.

Begin transition planning for participants who will exit for durational limit at least 3-6 months prior to their exit date.

Termination Policies

Provide a 30-day written notice for all involuntary terminations that states the reason for termination and informs the participants of grievance procedures and right to appeal.

Maintain written termination policies in effect and provide to participants at enrollment

for:

Provision of false eligibility information by the participant

Incorrect initial eligibility determination at enrollment

Income ineligibility determined at recertification

Participant has reached individual durational limit

Participant has become employed while enrolled

IEP-related termination

Cause (must be approved by ETA prior to implementation)

Equitable Distribution (ED)

Comply with the equitable distribution plan for each state in which the grantee operates and

only make changes in the location of authorized positions within a state in accordance with the state ED plan

and with prior ETA approval.

Comply with the authorized position allocations/ED listed in www.scseped.org.

Collaborate with all grantees authorized to serve in a state in which you operate to achieve compliance with

authorized positions while minimizing disruption to the participants.

Over-Enrollment

Manage over-enrollment to minimize impact on participants and avoid layoffs.

Collaboration and Leveraged Resources

Collaborate with other organizations to maximize opportunities for participants to obtain

workforce development, education, and supportive services to help them move into unsubsidized

employment. These organizations may include but are not limited to: workforce investment boards,

American Job Centers (previously known as One-Stop Centers), vocational rehabilitation providers,

disability networks, basic education and literacy providers, and community colleges.

Supportive Services

Provide supportive services, as needed, to help participants participate in their community service assignment and to obtain and retain unsubsidized employment.

Establish criteria to assess the need for supportive services and to determine when

participants will receive supportive services, including after obtaining unsubsidized employment.

http://www.scseped.org/


Complaint Resolution

Establish and use written grievance procedures for complaint resolution for applicants, employees, and participants.

Provide applicants, employees, and participants with a copy of the

grievance policy and procedures.

Maintenance of Files and Privacy Information Maintain participant files for three program years after the program year in which the participant received

his/her final follow-up activity.

Ensure that all participant records are securely stored by grantee or sub-recipient and access is limited to appropriate staff in order to safeguard personal identifying information.

Ensure that all participant medical records are securely stored by grantee or sub-recipient separately from all other participant records and access is limited to authorized staff for authorized purposes.

Establish safeguards to preclude tampering with electronic media, e.g., personal identification numbers (PINs) and SPARQ or other data system logins.

Ensure that the ETA/SCSEP national office is immediately notified by grantee in the event of any potential security breach of personal identifying information, whether

electronic files, paper files, or equipment are involved. cc: State program manager Comply with and ensure that authorized users under its grant comply with all SPARQ and other data system

access and security rules.

Documentation

Maintain all documentation required for compliance with record retention rule set forth in the first bullet of the prior

section, Maintenance of Files and Privacy Information

Maintain documentation of waivers of physical examinations by participant.

Maintain documentation of the provision of complaint procedures to participants.

Maintain documentation of eligibility determinations and re-certifications.

Maintain documentations of terminations and reasons for termination.

Maintain records of grievances and outcomes.

Maintain records required for data validation.

Maintain documentation of evaluation activities conducted on host agencies.

Data Collection and Reporting Ensure the collection and reporting of all SCSEP required data according to specified

time schedules. Ensure the use of the OMB-approved SCSEP data collection forms and the SCSEP

Internet data collection and evaluation system, SPARQ, or the successor data system as designated by DOL.

Ensure at the Title V/SCSEP staff and other staff that those capturing and recording data are familiar with the latest instructions for data collection, including ETA administrative issuances, e.g., TEGLs, Data Collection and Data Validation Handbooks, and the Older Worker Community of Practice.

Ensure data are entered directly into the WDCS/SPARQ, or the successor data system as designated by DOL.


If the grantee is not in compliance with any of the assurances above, the grantee must provide information on a

separate attachment indicating what specific steps the grantee is taking to conform to these standard grant

requirement(s).

By signing below, I certify that my organization will comply with each of the listed requirements and will

remain in compliance for the program year for which we are submitting this application.

Signature of Authorized Representative Date


ASSURANCE OF COMPLIANCE WITH THE DEPARTMENT OF

HEALTH AND HUMAN SERVICES UNDER

TITLE VI OF THE CIVIL RIGHTS ACT OF 1964

.

(Name of SCSEP sub-grantee of Name Secondary Recipient)

(herein after called the "Sub-grantee") HEREBY AGREES THAT it will comply with Title VI of the Civil Rights Act of 1964 (P.L. 88-

352) and all requirements imposed by or pursuant to the Regulation of the Department of Health and Human Services (45 CFR

Part 80) issued pursuant to that title, to the end that, in accordance with Title VI of that Act and the Regulation, no person in the

United States shall, on the ground of race, color, or national origin, be excluded from participation in, be denied the benefits of, or

be otherwise subjected to discrimination under any program or activity for which the Sub-grantee receives Federal financial

assistance from the Illinois Department on Aging, a recipient of Federal financial assistance from the Department (hereinafter

called "Grantor"); and HEREBY GIVES ASSURANCE THAT it will immediately take any measures necessary to effectuate this

agreement.

If any real property or structure thereon is provided or improved with the aid of Federal financial assistance extended to the sub-

grantee by the Grantor, this assurance shall obligate the Sub-grantee, or in the case of any transfer of such property, any

transferee, for the period during which the real property or structure is used for a purpose for which the Federal financial assistance

is extended or for another purpose involving the provision of similar services or benefits. If any personal property is so provided,

this assurance shall obligate the Sub-grantee for the period during which it retains ownership or possession of the property. In all

other cases, this assurance shall obligate the Sub-grantee for the period during which the Federal financial assistance is extended

to it by the Grantor.

THIS ASSURANCE is given in consideration of and for the purpose of obtaining any and all Federal grants, loans, contracts,

property, discounts or other Federal financial assistance extended after the date hereof to the Sub-grantee by the Grantor,

including installment payments after such date on account of applications for Federal financial assistance which were approved

before such date. The Sub-grantee recognized and agrees that such Federal financial assistance will be extended in reliance on

the representations and agreements made in this assurance, and that the Grantor or the United States or both shall have the right

to seek judicial enforcement of this assurance.

1This assurance is binding on the Sub-grantee, its successors, transferees, and assignees, and the person or persons whose

signature(s) appear below is/are authorized to sign this assurance on behalf of the Sub-grantee.

______________________________________________________________

(Applicant) (Date)

______________________________________________________________

(President, Chairman of Board or comparable Authorized Official)

______________________________________________________________

(Recipient’s Street Address)

_____________________________________________________________

(City, State & Zip Code +4)

______________________________________________________________

Typed Name and Title of Recipient)


Section IV.

Attachments


Attachment A

PARTICIPANT WAGE WAIVER REQUEST


Attachment B.

On-the-Job Experience (OJE)


Attachment C.

REQUIRED ATTACHMENTS TO BE SUBMITTED BY ALL APPLICANTS

All applicants must submit the following attachments with their submitted grant applications.

▪ Most recent audited financial statements and, if applicable, the accompanying management letter with any audit finding.

▪ Memorandums of Understanding that describe services and referrals; Memorandums of Agreement that describe the relationship and obligations of each party; and Signed letters of commitment (not simply letters of support) described on the Partnership Project Narrative page

▪ Memorandums of Understanding with LWIA organizations described on the WIOA Project Narrative page


Attachment D.

OTHER ATTACHMENTS SUBMITTED BY APPLICANT

All applicants should outline below the other attachments (not required) submitted with the grant application, and

include a brief explanation of each attachment.

Uniform Application for State Grant Assistance SCSEP... · 2019. 6. 12. · SCSEP FY 2020/PY 2019...

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