APPLICATION FOR
EMERGENCY FOOD
AND SHELTER FUNDS
New Hanover County
PHASE 32 (2014)
Please return this COMPLETED application by 5:00pm
Monday, April 21st, 2014 to:
Emergency Food and Shelter Program
New Hanover County Board
Due by E-mail ONLY to: Mallory.broomfield@uwcfa.org
EFSP GRANT APPLICATION GUIDELINES:
The Emergency Food and Shelter Program (EFSP) was created in 1983 to supplement and expand
the work of local social service agencies, both nonprofit and governmental, in an effort to help
people with economic (NOT disaster-related [i.e. fire victims, floods, tornadoes, etc.]) emergencies.
The EFSP funding is open to all organizations helping hungry and homeless people. EFSP funds
MUST BE USED to supplement feeding, sheltering (including transitional sheltering) and
rent/mortgage and utility payment assistance efforts only. EFSP is governed by a National Board
that selects jurisdictions for funding. Local Boards are convened in those qualifying jurisdictions
(New Hanover County) to determine the highest need and best use of funds and to select Local
Recipient Organizations (LROs) that will provide emergency food and shelter services. Each year,
New Hanover County’s needs are to be assessed in an effort to adapt funding allocations to
particular community needs.
EFSP GRANT ALLOCATION INFORMATION:
On January 28th, 2013 the New Hanover County EFSP Board adopted the following application and
allocation procedure information for Phase 32 (2014) EFSP Program funds:
Application Information:
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A legal notice will be published in the Wilmington Star-News to announce the Phase 32
(2014) EFSP Allocations application, criteria for submission, contact information and
deadline for submission.
The Phase 32 (2014) EFSP Allocation application will be distributed VIA E-MAIL to
CURRENT – Phase 31 (2013) funded programs.
A completed application (ALL APPLICATION QUESTIONS ANSWERED), including
required supplemental documents, MUST BE RECEIVED VIA EMAIL by 5:00pm on
Monday, APRIL 21st, 2014 to Mallory.broomfield@uwcfa.org.
Application Review Process:
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United Way of the Cape Fear Area liaison and the New Hanover County EFSP Board Chair
will review, after the submission deadline, each application and its accompanying
attachments to ensure completeness. All applicants should consider submitting their
application by April 7th. Applications received by this early deadline will be reviewed for
completeness. Applicants will be notified immediately if their applications are incomplete
and provided the opportunity to provide any missing information by the final deadline of
April 28th, 2014. INCOMPLETE APPLICATIONS WILL NOT BE CONSIDERED FOR
FUNDING.
United Way of the Cape Fear Area and the New Hanover County EFSP Board Chair will
then determine whether previously-funded agencies, submitting complete Phase 32 (2014)
applications, are in compliance with EFSP requirements for allowable activities, use of
funds, and Generally Accepted Accounting Principles. Any previously-funded EFSP
agencies NOT IN COMPLIANCE will be brought before the full New Hanover County
EFSP Board, at the next scheduled meeting, to determine, by majority vote of quorum
present, whether said agency will be considered for Phase 32 (2014) EFSP Allocations.
An advertisement will be published in the Wilmington Star-News listing the QUALIFIED
EFSP Phase 32 (2014) Allocations Applicants to afford public comment and/or concerns on
respective agencies, for a period of 5 days prior to New Hanover County EFSP Final Phase
32 (2014) Allocations Meeting.
Each qualified EFSP Phase 32 (2014) application will be distributed via email to all EFSP
Board Members for review, at least one week prior to the final EFSP Board Meeting for
Phase 31 (2013) Allocations. United Way of the Cape Fear Area staff will distribute
qualified applications via email to all EFSP Board Members, along with any received public
comments, concerns or non-compliance issues, for review. NO EFSP BOARD MEMBERS
WILL BE PERMITTED TO REVIEW THEIR OWN AGENCY’S APPLICATION. Every
EFSP Board Member will have an opportunity during the Phase 32 (2014) Allocations
Meeting to voice concerns or ask any questions regarding each agency’s application, after
which the Board will make a recommendation for Phase 32 (2014) funding. NO EFSP
BOARD MEMBERS WILL BE PERMITTED TO MAKE A RECOMMENDATION OF
THEIR OWN AGENCY.
EFSP Phase 32 (2014) Funding Allocation Process:
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All EFSP Phase 32 (2014) funding is contingent upon the amount awarded to New Hanover
County by the National EFSP Board. EFSP fund allocations for New Hanover County are
determined by the National EFSP Board on a year-to-year basis, with no guarantee of a set
funding amount.
Previously-funded EFSP Phase 31 (2013) agencies, in good standing, will receive
preference in the EFSP Phase 32 (2014) process. New EFSP applicant agencies will be
considered based on the following criteria, adopted by New Hanover County EFSP Board
on Monday November 16th, 2009: Unique services for the hungry and homeless, and based
on funding availability. New Hanover County EFSP Board, based on a majority vote of a
quorum of members present, reserves final determination for funding of any new EFSP
Phase 32 (2014) Applicants.
EFSP Phase 32 (2014) funding determinations are based on amounts awarded in EFSP
Phase 31 (2013) and recommendations for funding from New Hanover County EFSP Board
members. Each agency’s final allocation for Phase 32 (2014) amounts are awarded by a
majority vote of a quorum of New Hanover County EFSP Board Members present. New
Hanover County EFSP Board members MUST ABSTAIN from Phase 32 (2014) allocation
votes called for their respective agency’s application.
EFSP Phase 32 (2014) FUNDED Agency Information:
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All EFSP Phase 32 (2014) FUNDED Agencies will become default members of the overall
New Hanover County EFSP Local Board.
New Hanover County EFSP Local Board Meetings are held quarterly, usually on a Monday,
from 9:30am-11:30am at 5919 Oleander Dr. Suite 115—offices of United Way of the Cape
Fear Area.
All EFSP Phase 32 (2014) FUNDED Agencies are REQUIRED to send a representative to
at least three (3) of the four (4) quarterly meetings. If an EFSP Phase 32 (2014) agency does
not attend a scheduled quarterly board meeting, they will be contacted by a United Way of
the Cape Fear Area staff to be alerted their agency’s absence has been noted. An EFSP
Phase 32 (2014) FUNDED Agency that FAILS to attend three (3) out of four (4) quarterly
meetings WILL BE TREATED AS A NEW EFSP AGENCY APPLICANT IN THE
FOLLOWING PHASE’S FUNDING PROCESS.
GENERAL INFORMATION
Name of Organization: ________________________________________________
Agency’s Physical Address:
_________________________________________________________________________
Agency’s Mailing Address:
________________________________________________________________
Phone Number : ______________________________________
Taxpayer I.D.# : ______________________________________
Executive Director: ____________________________
_________________________________
NAME
Phone Number: ___________________________
Board President: ____________________________
SIGNATURE
Email Address: ___________________________________
_________________________________
NAME
Phone Number: ___________________________
Approved by Board on:
SIGNATURE
Email Address: ___________________________________
_________________________ (date)
Contact Person:
___________________________________
If different than Executive Director
NAME
Phone Number: __________________________
Email: _________________________________
Requested EFSP GRANT Amount: $______________________
Attachments:
A. IRS Letter of tax-exempt 501(c)(3) Status (or other exempt status)
B. Current List of Volunteer Board Officers & Directors
C. Copy of highest level of BOARD APPROVED financial statements (audit, financial review, compilation report)
D. Copy of agency’s disaster recovery plan
AGENCY ELIGIBILITY
1.
Is the agency a nonprofit or an agency of government? ____YES ____NO
(If No, STOP HERE, the agency does not qualify to receive EFSP funds)
2.
Is the agency debarred or suspended from receiving funds or doing business with the federal
government? ___YES ____NO
3.
Does the agency have an accounting system? _____YES _____ NO
If yes, what accounting software does your agency utilize?
4.
Describe target populations that will be served by this FEMA EFSP grant:
5.
Does your program deny services to a particular population? If so, why? (*see disclaimer
below)
6.
What is the eligibility criterion for serving a client?
7.
What is your geographic service area? Describe how your agency will assure these FEMA
ESFP funds will be utilized in New Hanover County:
8.
Does the agency practice nondiscrimination? ____ YES ____ NO
If yes, does your agency have a Board-approved, written Non-Discrimination Policy?
9.
Is your agency a faith-based organization? ____YES ____NO
If yes, does your agency agree not to refuse services to an applicant based on religion or
require attendance at religious services as a condition of assistance, nor will such groups
engage in any religious proselytizing in any program receiving Emergency Food and Shelter
Program fund.
*The Local EFSP Board reserves the right to make a final determination on whether your agency’s policies
are in line with FEMA-EFSP Local Board guidelines. For more information regarding the FAIR
HOUSING ACT, visit:
http://portal.hud.gov/hudportal/HUD?src=/program_offices/fair_housing_equal_opp/FHLaws.
APPLICANT AGENCY INFORMATION
1.
Describe the organization's mission and purpose; include information on current programs
and services. (500 words or less)
2.
If awarded, explain exactly how the organization will use EFSP funds in 2014. Describe in
detail, including target population and number of people to be served. (2 pages or less)
3.
If applying for “Shelter” funding, are you currently entering your client data into CHIN? If
no, please explain why and when you expect to do so?
REQUEST WORKSHEET
Instructions:
Agencies that received EFSP funds in 2013 (Phase 31), please answer all questions. Agencies that
did not request or receive funds in 2013, please answer questions 3, 5, and 6.
1a) If you received EFSP funds for 2013 (Phase 31), what dollar amount did your agency actually receive in
each category? Please include units of service, and calculate based on a twelve month period.
Column 1
Column 2
Column 3
Other Funded*
EFSP
(Other funding
for EFSP eligible
activities, like ESG)
Column 4
Column 5
Other Unfunded
Total EFSP
(EFSP eligible ac& Unfunded
Column 6
Total #
units served
tivities paid with
unrestricted funds)
(Total of columns
3 & 5)
(Total of columns
2 & 4)
Served Meals
Other Food
meals
meals
meals
meals
meals
meals
meals
meals
Mass Shelter
nights
nights
nights
nights
Other Shelter
nights
nights
nights
nights
Rent/Mortgage Payments
Total $s / Total Units
Utility payments
Total $s / Total Units
$
/
$
/
$
/
$
/
$
/
$
/
$
/
$
/
EFSP eligible services are those provided to residents of New Hanover County who paid no fees
of any kind for the services. Only list EFSP eligible services in the table above.
* Other Funded is any units of service that received restricted funding for that purpose. It does not
include units of service funded through an agency’s own unrestricted funds.
Agencies that provided shelter and received funds from the ESG program must put these “nights” in
the “Other Funded” column, calculated as the total amount of the ESG grant divided by $12.50.
(For example, if you received $12,500 from the ESG program that is EFSP eligible, you must place
at least 1,000 nights in the “Other funded” column.)**For more information on ESG (Emergency
Shelter Grants), please visit, http://www.hudhre.info/index.cfm?do=viewEsgProgram or
http://www.dhhs.state.nc.us/oeo/ESG/esg.htm
1b) Please describe how your agency tracks the information listed in the table above. If your
agency provides some services for a fee, explain how recipients of paid services (not EFSP
eligible) are tracked separately from those who pay no fees (EFSP eligible). If you provide
services to residents of other counties (not EFSP eligible), explain how they are tracked
separately from residents of New Hanover County (EFSP eligible).
2.
If your agency returned any awarded EFSP funds in Phase 31 (2013) or Phase 30 (2012) by writing a
check to United Way of America, please put the dollar amount here and the reason why you returned the
funds.
2013 amount returned: $__________________
Reason:_______________________________________________________________________________
______________________________________________________________________________________
________________________________________________________________________________
2012 amount returned: $ __________________
Reason:_______________________________________________________________________________
______________________________________________________________________________________
3.
What is your request for EFSP funds for Phase 32 (2014)
(Notes: In the Mass shelter category, $12.50 per diem. In the Served Meals category, you may elect to use $2.00 as per Diem.)
**NOTE: On 9/16/08-EFSP Local Board approved a $12.50 per diem amount for Mass Shelter documentation.
4.
Expenditure Category
Amount
Served meals
Other food
Mass shelter
Other shelter
Rent/Mortgage payments
Utility payments
__________
__________
__________
__________
__________
__________
Est. % of
Total Budget
_________
_________
_________
_________
_________
_________
Units of Service
______ meals
______ meals
______ nights
______ nights
______ bills
______ bills
Anticipated #
People Served
__________
__________
__________
__________
__________
__________
If you are requesting an amount that is greater than the amount you received last year, how many
additional units of service will you be able to provide?
Served meals:
Other food:
Mass shelter:
______ meals
______ meals
______ nights
Other shelter:
Rent/mortgage payments:
Utility payments:
5.
How did you arrive at the above units of service?
6.
What tools does your agency use to determine the units of service above?
______ nights
______ bills
______ bills
7.
Comments (This space is provided for any additional information you may wish to include. Please keep
to fifty words or less. (Optional):