2019 Emergency Solutions Grant Program. Finance and Compliance Training Webinar

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2 2019 Emergency Solutions Grant Program Finance and Compliance Training Webinar Denise Hoss Community Initiatives Compliance Officer Brooke Anderson ESG Administrator Thursday, March 14, 2019

3 EMERGENCY SOLUTIONS GRANT 2019 FINANCIAL PROCESSES THURSDAY, MARCH 14, 2019 WEBINAR BROOKE ANDERSON EMERGENCY SOLUTIONS GRANT ADMINISTRATOR

4 Payment Request Process Timeline 1. MHDC Payment Request review 2. Aggregate Invoice to DSS 3. Agency Reimbursement deposit Submit Payment Request Packet to MHDC by Request may be discarded if incomplete or incorrect and must be resubmitted Agency s program contact and financial contact will be notified by 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

5 Eligible Expenses 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 2019 funding period January 1, 2019 March 31, 2020 Grantee must document that all ESG funds are expended within these requirements.

6 Eligible Expenses Eligible expenses are detailed in: 2019 ESG Desk Guide 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: 2019 ESG Grant Agreement, Section 3 Required documentation for the incurred, eligible expenses ESG 2019 Desk Guide Table 4

7 Spending Requirements 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 Q4.

8 ESG Financial Timeline 2019 Emergency Solutions Grant Program : Quarterly Deadlines Quarter 1 Q1 Payment Request Deadline January 01, 2019 March 31, 2019 April 01, 2019, 5:00 p.m. Quarter 2 Q2 Payment Request Deadline 25% Spending Deadline April 1, 2019 June 30, 2019 July 01, 2019, 5:00 p.m. June 30, 2019, 5:00 p.m. Quarter 3 Quarter 4 Q3 Payment Request Deadline Q4 Payment Request Deadline 50% Spending Deadline July 01, 2019 September 30, 2019 October 01, 2019, 5:00 p.m. October 01, 2019 December 31, 2019 January 02, 2020, 5:00 p.m. December 31, 2019, 5:00 p.m. Quarter 5 Final Payment Request Deadline January 01, 2020 March 31, 2020 April 01, 2020, 5:00 p.m.

9 Payment Request Packet Payment 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: HMIS Reports: Generated from grantee s HMIS/comparable Database

10 Emergency Solutions Grant Program ESG 211 Payment Request Date Grant Number Agency Name Total Requested Amount $0.00 Funding Component Request Amount Administration HMIS Street Outreach Emergency Shelter Essential Services Operations Emergency Shelter Total $0.00 Homelessness Prevention Financial Assistance Housing Services Rental Assistance Homelessness Prevention Total $0.00 Rapid Re housing Financial Assistance Housing Services Rental Assistance Rapid Re Housing Total $0.00 Total Requested Amount $0.00 CERTIFICATION By 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, Section and T itle 31, Sect io ns and ). Authorized Signature Printed Name Notes: MHDC Personnel UseOnly Approval

11 Payment Request Packet ESG 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 for the funding component(s) and HMIS/Comparable Databased Report(s)

12 Emergency Solutions Grant Program Administration Expense Detail Form ESG 212 Paid Date Check Number Vendor Total Amount Amount ESG % Paid by ESG Detail Description Page 2 Total $ 12

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14 Payment Request Packet ESG 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

15 Payment Request Packet HMIS/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

16 Payment Request Summary Payment Requests must be submitted to: MHDC will not accept Requests submitted via mail or to a different 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)

17 Budget Amendment Process Grantees may submit a budget amendment request to transfer funds between funding components Budget Amendment Requests are submitted in writing to the ESG Administrator for approval After review, a budget amendment request form (ESG 213) may be provided Funding Components: Administration HMIS Street Outreach Emergency Shelter Homelessness Prevention Rapid Re Housing

18 Emergency Solutions Grant Program Budget Amendment Request ESG 213 Grantee Information Grantee Name: Grant Number: Grant Award: $ Instructions ESG 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. Budget Detail Budget Categories Original Budget Change New Budget Budget Street Outreach $ $ Emergency Shelter $ $ Homelessness Prevention $ $ Rapid Re housing $ $ Homeless Management $ $ Administration $ $ Total $ $ Reason for Budget Amendment Request Executive Director or Authorized Official Signature Printed Name Date Title

19 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

20 Common Issues 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 address other than: 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

21 Contact Information TBD Grants Administrator Brooke Anderson Emergency Solutions Grant Administrator Phone: (816) Payment Request Submission: Community Initiatives Department Accounting Information and Forms for MHDC ESG Program:

22 Questions?

23 EMERGENCY SOLUTIONS GRANT COMPLIANCE WEBINAR THURSDAY, MARCH 14, 2019 WEBINAR DENISE HOSS COMMUNITY INITIATIVES COMPLIANCE OFFICER

24 Compliance Site Visit Basics The Compliance Officer will need to examine client files, financial assistance, administrative / operating expenses, along with written policies and procedures to verify 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 for questions 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

25 Client File Documentation Case management / housing stability goal plan Case Management should be documented with emphasis on making this the responsibility of the case managers rather than a requirement of clients. Case Managers should attempt to meet with the client at 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

26 Emergency Solutions Grant Emergency Solutions Grant Program intended to serve extremely low income individuals and families Assistance based on each components eligibility for homeless and at risk of homelessness individuals and families ESG Desk Guide FY2019 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 rerevaluation for Homelessness Prevention component Rapid Re Housing No income requirement at in take, income cannot exceed 30% AMI at annual re evaluation

27 EMERGENCY SOLUTIONS GRANT PROGRAM ESG 201 Income Eligibility Calculation Worksheet 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, or support 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 meet other 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 participanteligibility andincome requirements: 24CFR and24 CFR (e). Household Member Number 1 Date: Household Member Name Type of Evaluation: Age of Household Member Total Household Members (Household size) 0 Household Member Number/Name Sources of Household Income Currently Documented Gross Income Amount 30% of Area Median Income (AMI) for Household Size Frequency of Income Number of Payments per Year Annual Gross Income Zero Income (signed form in file) $ Earned Income (for ADULT household members only) $ Earned Income (for ADULT household members only) $ 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 $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $

28 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

29 Calculating Income Homelessness Prevention / Rapid Rehousing programs will utilize HUD Chapter 5: Determining Income and Calculating Rent Must calculate income for an individual or family for all programs with income eligibility requirements HUD specifies the types and amounts of income and deductions to be included in the calculation

30 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 no overtime) 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

31 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 within 30 days of the assistance date (4/1/19) Check Stub 1: payment date 3/3/19 for $ (gross wages) Check Stub 2: payment date 3/17/19 for $ (gross wages) Calculate by dividing the total of the gross pay ($ $ = $774.50) by the number of check stubs (2) and multiply by the frequency of pay (26) to annualize the income Total: $774.50/2= $ x 26= $10,068.50

32 MHDC Community Initiatives: SELF DECLARATION OF INCOME Form: CI 103 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 amember 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. Applicant Signature: Date: Staff Verification I understand that third party verification is the preferred method of certifying income for 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: Staff Signature: 1 of 1 Date: Effective: January 1, 2019

33 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

34 Calculating Assets: Example Client B has a checking account with a six month average balance of $ which earns no interest. He/she has a savings account with a current balance of $ 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 an outstanding mortgage balance of $34,000. The reasonable selling costs of a realtor, 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)

35 Form: CI 104 Applicant Name: MHDC Community Initiatives: HOUSING STATUS CERTIFICATION 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 indicated information, 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 HOMELESS Living 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, bus station, airport, or camp ground. Description of current living situation: HomelessStreet Outreach/Other Program (ifapplicable): 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 publicly or privately operated shelter as follows: EmergencyShelter 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 Housing The 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: TransitionalHousingProgram 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, of 3

36 Living Situation: Market Housing The person(s) named above was/were evicted from or otherwise lost housing obtained through the private market. Form: CI 104 AT RISK OF HOMELESSNESS Living 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 in which 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. Effective: January 1, of 3

37 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 an individual who is applying for assistance, but cannot meet this standard. Below I am providing details of oral 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 Certification I certify that I have provided verification as indicated above that the Applicant meets eligibility criteria and/or risk factors for being: Literally Homeless OR At Risk of Homelessness Staff Signature: Date: 3 of 3 Effective: January 1, 2019

38 MHDC Community Initiatives: SELF DECLARATION OF HOUSING STATUS Form: CI 105 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, based on 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, abandoned building, 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 not identified a subsequent residence, and lack the resources or support networks, e.g., family, friends, faithbased, other social networks, needed to obtain housing where my/our safety would not be jeopardized. I [and my children] am/are being evicted fromthehousingwearepresently 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 provided in applying for ESG, MHTF, or MoHIP assistance is true, accurate and complete. Applicant Signature: Date: Staff Certification I understand that third party verification is the preferred method of certifying homelessness or risk for homelessness 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: Staff Signature: 1of1 Date: Effective: January 1, 2019

39 Form: CI 110 Identification Certification MHDC 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: 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 2 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 3 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 4 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 5 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 Effective: January 1, 2019

40 Form: CI 110 Identification Certification MHDC Community Initiatives 6 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 7 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 8 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 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 and correct. The undersigned individuals affirm, by penalty of perjury, that all the statements made herein are true and correct. Staff Signature Date Staff Print Name Executive Director Signature Date Executive Director Print Name Effective: January 1, 2019

41 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 Rental Assistance Agreement. The form requires the signature of both the landlord and client. This will accomplish the requirement of notification to the client of his/her rights and to the landlord of this regulation. Equal Access Rule Housing Stability Standards Inspection Lead based Paint inspection

42 EMERGENCY SOLUTIONS GRANT PROGRAM ESG 206 Rent Reasonableness and Fair Market Rent Certification Date: Household Name: 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. Address Proposed Unit Unit #1 Unit #2 Unit #3 # of Bedrooms Total Square Feet Ty pe of Unit/Con struction Housing Condition Location/Accessibility Amenities Age in Years Type of Utilities Monthly Unit Rent Handicap Accessible? Fair Market Rent Verification Contract Rent + Utility Allowance = Proposed Gross Rent Applicable Fair Market Rent Rate: Proposed Unit does not exceed applicable FMR: $0.00 Yes Certification Based upon a comparison with rents for comparable units, the proposed rent for the unit: Is reasonable Is not reasonable Name: Date: Signature:

43 Allowances for Tenant-Furnished Utilities and Other Services Locality: Housing Authority of Kansas City, MO U.S. Department of Housing and Urban Development Office of Public and Indian Housing Unit Type: High- Rise/ Apartment OMB Approval No (exp. 04/30/2018) Date (mm/dd/yyyy) January 1, 2018 Utility or Service: Monthly Dollar Allowances 0 BR 1 BR 2 BR 3 BR 4 BR 5 BR Heating a. Natural Gas $14.0 $17.0 $20.0 $22.0 $25.0 $ b. Bottle Gas/Propane c. Electric $24.0 $28.0 $38.0 $47.0 $57.0 $ d. Electric Heat Pump $21.0 $25.0 $29.0 $33.0 $37.0 $ e. Oil / Other Cooking a. Natural Gas $2.0 $2.0 $3.0 $4.0 $5.0 $ b. Bottle Gas/Propane c. Electric $7.0 $8.0 $12.0 $15.0 $19.0 $ Other Electric (Lights & Appliances) $26.0 $31.0 $42.0 $54.0 $66.0 $ Air Conditioning $12.0 $13.0 $19.0 $24.0 $29.0 $ Water Heating a. Natural Gas $5.0 $5.0 $7.0 $10.0 $12.0 $ b. Bottle Gas/Propane c. Electric $17.0 $20.0 $26.0 $31.0 $37.0 $ d. Oil / Other Water $36.0 $37.0 $47.0 $57.0 $68.0 $ Sewer $60.0 $61.0 $77.0 $93.0 $108.0 $ Trash Collection (avg) $18.0 $18.0 $18.0 $18.0 $18.0 $ Range / Microwave Tenant-supplied $12.0 $12.0 $12.0 $12.0 $12.0 $ Refrigerator Tenant-supplied $13.0 $13.0 $13.0 $13.0 $13.0 $13.0 Other Monthly Electric Fee $ $13.0 The Nelrod $13.0 $13.0 Company $13.0 $13.0 $ speci Monthly Gas Fee $26.93 $27.0 $27.0 $27.0 $27.0 $27.0 $27.0 8/2017 Update fy: Actual Family Allowances To be used by the family to compute allowance. Complete below for the actual unit rented. Utility or Service Heating $ Cooking $ Name of Family Other Electric $ Air Conditioning $ Water Heating $ Address of Unit Water $ Sewer $ Trash Collection $ Range / Microwave $ Refrigerator $ Other $ per month cost Form HUD (04/15) ref. Handbook Form can be found at: ites/www/uploads/hc V(Section%208)/2018 Utilities HCV.pdf

44 CI 108 DV 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 the Agency 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 to any group or individual unless a written release of informationissignedbyme. IunderstandthatImayrevoke a 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, the Auditors 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 the Auditors will leave the premises with any identifying information about me, and will not disclose any identifying 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 from MHDC. 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, the Agency will assist you in locating housing that is safe, decent and sanitary. Effective: January 1, 2019

45 CI-108 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. Ifurther authorize MHDC to contact me directly to discuss any matters related to my receipt of MHDC funds and agree to provide any additional information that MHDC may deem necessary in order to fully determine my eligibility 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 agree to provide any additional information that such funding sources may deem necessary in order to fully determine 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 sanitary housing. In order to assist 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, the Agency will assist you in locating housing that is safe, decent and sanitary. 1of 1 Effective: January 1, 2019

46 EMERGENCY SOLUTIONS GRANT PROGRAM ESG-204 CERT/FICA TION OF RECEIPT OF ESGASSISTANCE By signing this form, I state that I am aware that it is unlawful to receive Emergency Solutions Grant (ESG} services or assistance for more than twenty-four (24) months in any three (3) year period. I do hereby certify that: D D Neither I, nor any member of my household, either individually or as part of another household have received Emergency Solutions Grant services or assistance within the three (3) years prior to this application. I, or someone in mv,...household, received ESG services or assistance within the three (3) years prior to this application. D I have received ESG services or assistance within the three (3) years prior to this application. Type of services or assista nce received: Length of time services or assistance was received: _ Location of services or assista nce received: D A member of my household received ESG services or assistance within the 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: of services or assista nce received: _ Location Signature of Applicant Date of Application Address City State

47 EMERGENCY SOLUTIONS GRANT PROGRAM Minimum Standards for Emergency Shelter ESG " Instructions: Place a check mark in the correct column to indicate whether the property is M :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 (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 at 24 CFR part 100; and c. Title IIof the Americans with Disabilities Act (42 U.S.C et seq.) and 28 CFR part 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 inthe 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 sleeping areas. 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).

48 ESG-205 CERTIFICATION STATEMENT I certify that I have evaluated the property located at the address below to the best of my ability and find the following: D Property meets fill of the above standards. D Property does not meet all of the above standards. COMMENTS: ESG Recipient Name: ESG Subrecipient 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):

49 Emergency Solutions Grant Program ESG-205 ;:.. f11ssd C)RJ HOU51t.G Minimum Standards for Permanent Housing Instructions: Place a check mark in the correct column to indicate whether the property is approved 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. I Approved Deficient Standard (24 CFRpart (c)) 1. Structure and materials: The structure is structurally sound to protect the residents 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 for personal cleanliness and the disposal of human waste. 6. Thermal environment : The housing has any necessary heating/cooling facilities in proper operating condition. 7. Illumination and electricity : The structure has adequate natural or artificial illumination to permit normal indoor activities and support health and safety. There are sufficient electrical sources to permit the safe use of electrical 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 offire 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). I e-;:; ESG Minimum Habitability Standards Checklist - - Page 1

50 ESG-205 CERTIFICATION STATEMENT I certify that I have evaluated t he property located at the add ress below to the best of my ability and find the foilowing: D Property meets ill!of the above standa rds. D Property does not meet all of the above standards. COMMENTS: ESG Recipient Name: ESG Subrecipient Name: Program Participant Name: Street Address: Apartment : _ City: State: _ Zip: _ Evaluator Signature: luator Name: Eva Date of review: _ Approving Officia l Signature (if applica ble): Approving OfficialName (if applicable): Date: _ ESG Minimum Habita bility Standards Checklist Page 2 -

51 Emergency Solutions Grant Program ESG-207 ESG Lead Screening Worksheet About this Tool The ESG Lead Screening Worksheet is intended to guide grantees through the lead-based paint inspection process to ensure compliance with the rule. ESGstaff can use this worksheet to document 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 completed worksheet along with any additional documentation should be kept in each program participant's case file. INSTRUCTIONS To prevent lead-poisoning in young children, ESG grantees 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 to proceed. A copy of the completed worksheet along with any related documentation should be kept in each 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 ESG Program Staff State Unit Number Zip PART 1: DETERMINE WHETHER THE UNIT IS SUBJECTTO A VISUAL ASSESSMENT If the answer to one or both of the following questions is 'no,' a visual assessment is not triggered for this unit and no further action is required at this time. Place this screening worksheet and related documentation 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 3nd program staff should continue to Part Was the leased property constructed before 1978? Oves 51 0No 2. Will a child under the age of six be living in the unit occupied by the household receiving ESG assistance? Oves 0No

52 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 and supporting 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 deteriorated paint is present. 1. Is it a zero-bedroom or SRO-sized unit? O ves 0 No 2. 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 No 3. Has this property had all lead-based paint identified and removed in accordance with HUD regulations? O v es 0No 4. 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 a Section 8 voucher and is receiving ESGassistance for a security deposit or arrears)? 0 Yes (Obtain documentation for the case file.) 0 No 5. Does the property meet any of the other exemptions described in 24 CFR Part (a). O ves 0No Please describe the exemption and provide appropriate documentation of the exemption. PART 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 HPRP financial assistance to the unit as outlined in the following training on HUD's website at: s/lead/training/visualassessment/h htm. If no problems with paint surfaces are identified during the visual assessment, then no further action is required at this time. Place this screening sheet and certification form (Attachment A) in the program participant's file. If any problems with paint surfaces are identified during the visual assessment, then continue to Part 4 to determine whether safe work practices and clearance are required. 52

53 1. Has a visual assessment of the unit been conducted? 0 Yes ESG-207 0No 2. Were any problems with paint surfaces identified in the unit during the visual assessment? 0Yes 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 unit for assistance. However, if the area of paint to be stabilized exceeds the de minimus levels (defined below), 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 the paint 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 the unit 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 identified during the visual assessment has been stabilized. If the area of paint to be stabilized does not exceed the de minimus level, safe work practices and a clearance exam are not required (though safe work practices are always recommended). In these cases, the ESGprogram staff should confirm that the identified deteriorated 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 the clearance inspection is conducted by an independent certified lead professional. A certified lead professional 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 firm that is repairing the deteriorated paint. 1. Has a follow-up visual assessment of the unit been conducted? 0Yes 53 0No 2. Have all identified problems with the paint surfaces been repaired? 0Yes 0No

54 3. Were all identified problems with paint surfaces repaired using safe work practices? Oves 0No D Not Applicable -The 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? Oves 0No D Not Applicable - The area of paint to be stabilized did not exceed the de minimus levels. 5. Did the unit pass the clearance exam? D ves 0 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. ESG

55 ESG-207 ATTACHMENT 1: LEAD-BASED PAINT VISUAL ASSESSMENT CERTIFICATION TEMPLATE 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) 55 Client Name: Case Number:

56 Emergency Solutions Grant Program ESG-208 ESG Lead-Based Paint Property Owner Certification Form About this Tool The ESG Lead-Based Paint Property Owner Certification Form is a tool program staff can use to have property owners/managers certify that all paint stabilization activities have been completed in accordance with guidelines when formal clearance is not required (or as additional documentation when formal clearance is required). A copy of the completed form along with any additional documentation {i.e., a copy of the clearance report) should be kept in 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 ESG assistance. 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? Oves 0No 2. Have all identified problems with paint surfaces been repaired using safe work practices? Oves 0No 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 56 0 No D Not Applicable - The area of paint to be stabilized did not exceed the de minim us levels.

57 ESG-208 Name of Tenant Address Unit Number Zip City State Name of Property Owner/Manager Property Owner/Manager Signature Date Name of ESG Program Staff ESG Program Staff Signature Date 57

58 VIOLENCE, DATING VIOLENCE OR STALKING U.S. Department of Housing and Urban Development Office of Housing OMB Approval No Exp. 6/30/2017 LEASE ADDENDUM VIOLENCE AGAINST WOMEN AND JUSTICE DEPARTMENT REAUTHORIZATION ACT OF 2005 TENANT LANDLORD UNIT NO. & ADDRESS 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 continue to be in effect until the Lease is terminated.. This Lease Addendum shall VAWA Protections 1. The Landlord may not consider incidents of domestic violence, dating violence or stalking as serious 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, cause for termination of assistance, tenancy, or occupancy rights if the tenant or an immediate member 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's behalf, certify that the individual is a victim of abuse and that the Certification of Domestic Violence, Dating Violence or Stalking, Form HUD-91066, or other documentation as noted on the certification form, be completed and submitted within 14 business days, or an agreed upon extension date, to receive protection under the VAWA. Failure to provide the certification or other supporting documentation within the specified timeframe may result in eviction. Tenant Date Landlord Date Form HUD (9/2008)

59 Coordinated Entry/Housing First Agency participation in the Coordinated Entry process must follow the Housing First model. This should include: Completion of an exit survey and keeping records of all completed 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

60 Housing First Model Follow HUD s model of Housing First Principles by looking for violations in screening 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

61 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 with corresponding CI invoice) Proof of cleared payment Copy of cleared payment or bank statement clearly showing check number, date, and amount Payroll debits on bank statements must match payroll report total of net amount or copy of paystub Timesheets Last 4 digits of employees SSN Employee benefits (insurance, taxes, work comp., etc.)

62 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

63 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 form 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

64 Replacement Back-Up Form - Community Initiatives Instructions: This form should be completed in order to replace ineligible expenses previously billed to a Missouri Housing Development (MHDC) Community Initiatives grant (i.e., Emergency Solutions Grant, 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

65 Resources HUD Chapter 5: 49.pdf ESG Desk Guide: %20Desk%20Guide.pdf Compliance Resources:

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