HUD-52798 Community and Supportive Services Plan

HOPE VI Application

52798 HOPE VI CSS PLAN TEMPLATE

HOPE VI Application

OMB: 2577-0208

⚠️ Notice: This form may be outdated. More recent filings and information on OMB 2577-0208 can be found here:

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ADD NAME OF THE HOUSING AUTHORITY HERE

DATE / VERSION

HOPE VI COMMUNITY AND SUPPORTIVE SERVICES PLAN

ADD PHA NAME HERE

ADD DEVELOPMENT NAME HERE

ADD DATE SUBMITTED HERE

ADD DRAFT / VERSION HERE

HOUSING AUTHORITY POC:

ADD POINT OF CONTACT NAME HERE

HUD HOPE VI CSS MANAGER:

ADD NAME HERE

1^st review: DATE

2^ndreview: DATE

3^rd review: DATE

Approved: DATE

Public reporting burden for this collection of information is estimated to average 15 hours per response, 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 agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless that collection displays a valid OMB control number. This collection of information requires that each Grantee submit information to enable HUD to review their community and supportive services plan. The information will be used by HUD to determine whether the proposed community and supportive services plan is approvable. The information is essential for grant management. Responses to the collection are required by the HOPE VI Grant Agreement. The information requested does not lend itself to confidentiality.

SIGNATURES AND ASSURANCES

I certify that, to the best of my knowledge and belief, all of the information in and attached to this plan is true, correct, complete and made in good faith.

______________________________ __________

Executive Director Date

______________________________ __________

HOPE VI Coordinator Date

______________________________ __________

HOPE VI CSS Coordinator Date

______________________________ __________

Resident Representative Date

AN ORIGINAL SIGNED HARDCOPY OF THIS PAGE SHOULD BE SUBMITTED TO HUD UNDER SEPARATE COVER.

CONTACT INFORMATION

Figure 1: Contact information

Executive Director
Phone # & extension
Email
HOPE VI Coordinator
Phone # & extension
Email
HOPE VI CSS Coordinator
Phone # & extension
Email
Resident Council President
Phone # & extension
Email
Housing Authority
Street
City, state, zip-code
Fax #
Phone # (main line)
HOPE VI office
Street
City, state, zip-code
Fax #
Phone # (main line)
HUD HOPE VI CSS Grant Manager
Street
City, state, zip-code
Fax #
Phone # & extension
Email

EXECUTIVE SUMMARY

Figure 2: Executive Summary matrix

Total units to be developed
Public housing units
Homeownership units
Current number of HOPE VI CSS eligible households
Current number of HOPE VI CSS eligible individuals
Current number of individuals ages 19-64 (who are not disabled)
Total number of households to be relocated (or who were relocated)
Total number of individuals to be relocated (or who were relocated)
Date that relocation will begin (or when it began)
Date that relocation will be completed (or when it was completed)

MILESTONES TRACKED BY HUD

Figure 3: HOPE VI CSS Plan Milestones Matrix

MILESTONE	PLANNED COMPLETION	DATE COMPLETED
Complete 100% of all case management intakes with the current number of HOPE VI CSS eligible individuals.
Complete 50% of all individual development plans (IDP) established for adults (ages 19 or older) who are eligible for HOPE VI CSS and agree to participate (including elderly and the disabled) in the HOPE VI CSS program.
Fully implement all MOUs, partnership agreements, contracts and sub-grant agreements listed in the HOPE VI CSS Partner and Service Matrix that have service start dates during the first year of the CSS Plan.
Conduct four meetings with the Community Task Force.

Figure 4: Additional HOPE VI CSS Plan Milestones Matrix

MILESTONE	PLANNED COMPLETION	DATE COMPLETED
TO BE COMPLETED BY HUD STAFF
TO BE COMPLETED BY HUD STAFF
TO BE COMPLETED BY HUD STAFF
TO BE COMPLETED BY HUD STAFF
TO BE COMPLETED BY HUD STAFF
TO BE COMPLETED BY HUD STAFF

SECTION 1 ELIGIBLE FAMILIES AND SERVICE NEEDS #

1.1 HOPE VI CSS eligible residents # 1.2 Needs assessment process #

1.3 Resident needs #

SECTION 2 CSS GOALS #

2.1 HOPE VI Quarterly Progress Report CSS goals #

2.2 Additional CSS goals #

SECTION 3 PARTNERS AND SERVICES #

3.1 Partners and services #

3.2 Changes in leverage since grant application #

3.3 Monitoring service providers #

3.4 Service coordination across HOPE VI sites #

SECTION 4 CASE MANAGEMENT #

4.1 Case management staffing #

4.2 Caseload management, outreach and resident status #

4.3 Coordinating case management services and caseloads across partners #

4.4 Service facilities and locations #

SECTION 5 RELOCATION #

5.1 Relocation timing and processes #

5.2 Reoccupancy criteria, timing and processes #

SECTION 6 PROGRAM MANAGEMENT #

6.1 Management structure #

6.2 Section 3 strategy #

6.3 Community Task Force #

6.4 Resident, service provider and community participation #

SECTION 7 EVALUATION #

Evaluation partner #

7.2 Indicators #

7.3 Process and timeline #

SECTION 8 SUSTAINABILITY AND POST-OCCUPANCY FACILITIES #

SECTION 9 BUDGET NARRATIVE #

SECTION 1: ELIGIBLE FAMILIES AND SERVICE NEEDS

1.1 HOPE VI CSS eligible residents

Figure 5: Eligible residents and planned CSS caseload

Caseload Metrics	Total
Total number of original residents (individuals)
Number of original residents (individuals) who lost HOPE VI CSS eligibility since grant award
Current number of HOPE VI CSS eligible households
Current number of HOPE VI CSS eligible individuals
Current number of HOPE VI CSS eligible individuals ages 19-64 (who are not disabled)
Age distribution (all HOPE VI CSS eligible individuals)
0 to 5
6 to 12
13 to 18
19 to 64
65 +

Figure 6: Education

Education Metrics	Total
Education levels
College degree
Some college
HS diploma or GED
Less than HS diploma or GED
Number of residents who speak English as a second language (ESL)

Figure 7: Employment and income

Employment Metrics	Total
Number of residents currently employed (all residents)
Median household income	$
Primary sources of income
Employment
TANF
SSI
Disability
Other:
Other:
Income categories
0% to 30% of AMI
31% to 60% of AMI
61% to 80% of AMI
81% + of AMI

1.2 Needs assessment process

1.3 Resident needs

Figure 8: Summary of needs for all adults (ages 19-64) who are not disabled

Need

Data source

Description

Total

10.

11.

12.

13.

14.

15.

Figure 9: Summary of needs for all youth (ages 0-18)

Need

Data source

Description

Total

Figure 10: Summary of needs for disabled and elderly (65+) residents

Need

Data source

Description

Total

SECTION 2: CSS GOALS

2.1 HOPE VI Quarterly Progress Report CSS goals

Figure 11: HOPE VI Quarterly Progress Report CSS Goals Matrix (by year)

METRIC	Year 1	Year 2	Year 3	Year 4	Year 5	Total
Employment preparation and placement enrollments
Job skill training program enrollments
High school or equivalent education enrollments
Child care enrollments
Transportation assistance enrollments
Counseling program enrollments
Substance abuse program enrollments
Job skills training program completions
Number of residents currently employed
Number of residents currently employed 6 months or more
Entrepreneurship training program enrollments
Entrepreneurship training program completions
Resident owned businesses started
Resident employment in resident owned businesses
Resident owned businesses receiving no PHA funds
Section 3 contract dollars
Section 3 employees transferred to non-PHA jobs
Number enrolled in homeownership counseling programs
Number of homeownership counseling completions
ESL service enrollments

Figure 12: HOPE VI Quarterly Progress Report CSS Goals Matrix (by quarter and year)

METRIC

YEAR 1

YEAR 2

YEAR 3

YEAR 4

YEAR 5

TOTAL

Resident jobs resulting from Section 3

ANNUAL GOAL

High school or equivalent education completions

ANNUAL GOAL

New job placements

ANNUAL GOAL

Number of residents purchasing a home

ANNUAL GOAL

2.2 Additional CSS goals

Figure 13: Additional CSS Goals Matrix

METRIC	Year 1	Year 2	Year 3	Year 4	Year 5	Totals

SECTION 3: PARTNERS AND SERVICES

Partners and services