HUD 40119 Substantial Amendment to the Consolidate Plan for the HP

Substantial Amendment to the Consolidated Plan 2008 Annual Action Plan for the Homelessness Prevention and Rapid Re-Housing Program (HPRP)

Substantial Amendment to the Consolidated Plan 2008 Annual Action Plan for the Homelessness Prevention and Rapid Re-Housing Program (HPRP)

In order to receive HPRP funds, grantees eligible to receive funds under the Homelessness Prevention and Rapid Re-Housing Program (HPRP) are required to complete a substantial amendment Consolidated Plan 2008 Annual Action Plan. This form sets forth the required format for this substantial amendment. A completed form is due to HUD within 60 days of the publication of the HUD HPRP notice.

To aid grantees in meeting this submission deadline, the HPRP Notice amends the requirement for a 30-day public comment period to no less than 15 calendar days for this substantial amendment. With this exception, HPRP grantees are required to follow their Consolidated Plan’s citizen participation process, including consultation with the Continuum of Care (CoC) in the appropriate jurisdiction(s). Grantees are also required to coordinate HPRP activities with the CoC’s strategies for homeless prevention and ending homelessness. To maximize transparency, HUD strongly recommends that each grantee post its substantial amendment materials on the grantee’s official website as the materials are developed.

A complete submission contains the following three documents:

1. A completed form HUD-40119 (this form),

2. Signed and dated Consolidated Plan and HPRP certifications, and

3. A signed and dated SF-424.

For additional information regarding the HPRP program, visit the HUD Homelessness Resource Exchange (www.hudhre.info).  This site will be regularly updated to include HPRP resources developed by HUD and its technical assistance providers.

The information collection requirements contained in this application have been submitted to the Office of Management and Budget (OMB) for review under the Paperwork Reduction Act of 1995 (44 U.S.C. 3501-3520).  This agency may not collect this information, and you are not required to complete this form, unless it displays a currently valid OMB control number.

Information is submitted in accordance with the regulatory authority contained in each program rule.  The information will be used to rate applications, determine eligibility, and establish grant amounts.

Public reporting burden for this collection of information is estimated to be 16 hours, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information.  This information is required to obtain benefits. To the extent that any information collected is of a confidential nature, there will be compliance with Privacy Act requirements.  However, the substantial amendment to the Consolidated Plan 2008 Action Plan does not request the submission of such information.

Warning:  HUD will prosecute false claims and statements.  Conviction may result in criminal and/or civil penalties. (18 U.S.C. 1001, 1010, 1012; 31 U.S.C. 3729, 3802)

A. General Information

Joint Agreement. Check this box if multiple eligible grantees, as defined in the Notice, are joining together to apply for HPRP funds and submitting a single substantial amendment. Part A must be completed for each eligible grantee, and an authorized official from each jurisdiction must sign Part F of this form and the HPRP certifications.

Grantee Name
Name of Entity or Department Administering Funds
HPRP Contact Person (person to answer questions about this amendment and HPRP)
Title
Address Line 1
Address Line 2
City, State, Zip Code
Telephone
Fax
Email Address
Authorized Official (if different from Contact Person)
Title
Address Line 1
Address Line 2
City, State, Zip Code
Telephone
Fax
Email Address
Web Address where this Form is Posted

Amount Grantee is Eligible to Receive*	$
Amount Grantee is Requesting	$

*Amounts are available at http://www.hud.gov/recovery/homelesspreventrecov.xls

B. Citizen Participation and Public Comment

1. Briefly describe how the grantee followed its citizen participation plan regarding this proposed substantial amendment (limit 250 words).

Response:

2. Provide the appropriate response regarding this substantial amendment by checking one of the following options:

Grantee did not receive public comments.

Grantee received and accepted all public comments.

Grantee received public comments and did not accept one or more of the comments.

3. Provide a summary of the public comments regarding this substantial amendment. Include a summary of any comments or views not accepted and the reasons for non-acceptance.

Response:

C. Distribution and Administration of Funds

Reminder: The HPRP grant will be made by means of a grant agreement executed by HUD and the grantee. The three-year deadline to expend funds begins when HUD signs the grant agreement. Grantees should ensure that sufficient planning is in place to begin to expend funds shortly after grant agreement.

1. Check the process(es) that the grantee plans to use to select sub-grantees. Note that a subgrantee is defined as the organization to which the grantee provides HPRP funds.

Competitive Process

Formula Allocation

Other (Specify: ___________________________________________)

2. Briefly describe the process(es) indicated in question 1 above (limit 250 words).

Response:

3. Briefly describe the process the grantee plans to use, once HUD signs the grant agreement, to allocate funds available to sub-grantees by September 30, 2009, as required by the HPRP Notice (limit 250 words).

Response:

3. Describe the grantee’s plan for ensuring the effective and timely use of HPRP grant funds on eligible activities, as outlined in the HPRP Notice.  Include a description of how the grantee plans to oversee and monitor the administration and use of its own HPRP funds, as well as those used by its sub-grantees (limit 500 words).

Response:

D. Collaboration

1. Briefly describe how the grantee plans to collaborate with the local agencies that can serve similar target populations, which received funds under the American Recovery and Reinvestment Act of 2009 from other Federal agencies, including the U.S. Departments of Education, Health and Human Services, HohOMHomeland Security, and Labor (limit 250 words).

Response:

2. Briefly describe how the grantee plans to collaborate with appropriate Continuum(s) of Care and mainstream resources regarding HPRP activities (limit 250 words).

Response:

3. Briefly describe how HPRP grant funds for financial assistance and housing relocation/stabilization services will be used in a manner that is consistent with the grantee’s Consolidated Plan (limit 250 words).

Response:

E. Estimated Budget Summary

HUD requires the grantee to complete the following table so that participants in the citizen participation process may see the grantee’s preliminary estimated amounts for various HPRP activities. Enter the estimated budget amounts for each activity in the appropriate column and row. The grantee will be required to report actual amounts in subsequent reporting.

HPRP Estimated Budget Summary
	Homelessness Prevention	Rapid Re-housing	Total Amount Budgeted
Financial Assistance1	$	$	$
Housing Relocation and Stabilization Services2	$	$	$
Subtotal (add previous two rows)	$	$	$

Data Collection and Evaluation3	$
Administration (up to 5% of allocation)	$
Total HPRP Amount Budgeted4	$

¹Financial assistance includes the following activities as detailed in the HPRP Notice: short-term rental assistance, medium-term rental assistance, security deposits, utility deposits, utility payments, and moving cost assistance.

²Housing relocation and stabilization services include the following activities as detailed in the HPRP Notice: case management, outreach, housing search and placement, legal services, mediation, and credit repair.

³Data collection and evaluation includes costs associated with operating HUD-approved homeless management information systems for purposes of collecting unduplicated counts of homeless persons and analyzing patterns of use of HPRP funds.

⁴This amount must match the amount entered in the cell on table near the end of Section A titled “Amount the Grantee is Requesting.”

F. Authorized Signature

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 218, Section 1001)

___________________________________________________ ___________________ Signature/Authorized Official Date

__________________________________________________

Title

7 HUD-40119