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HomeMy WebLinkAbout010614a Agenda PackageHARNETT COUNTY BOARD OF COMMISSIONERS County Administration Building 102 East Front Street Lillington, North Carolina Regular Meeting January 6, 2014 9:00am 1. Call to order-Chairman Joe Miller 2. Pledge of Allegiance and Invocation -Commissioner Jim Burgin 3. Consider additions and deletions to the published agenda 4. Consent Agenda A. Minutes B. Budget Amendments C. Tax refunds, rebates and release D. Sheriff's Office requests adoption of resolution authorizing disposition of four surplus motor vehicles previously used by the Harnett County Sheriffs Department to the Central Carolina Emergency Services Training Center. E. CCCC requests $25,000 this fiscal year and $25,000 next fiscal year to help fund the College's Central Carolina Works program. F. Emergency Services, on behalf of Lillington Fire Department, requests approval to spend $22,374 to install8 fire hydrants in the newly contracted Flatwoods Fire District. G. Emergency Services requests approval to apply for the 2014 Emergency Management Performance Grant administered by North Carolina's Public Safety Division of Emergency Management. H. IT Department, E-911 Division, requests permission to contract with Fred R. Burgess for sign blade maintenance. I. Human Resources, on behalf of General Services, requests approval of a salary increase for the vacant position of Transit Services Manager. J. Health Director requests approval to submit a grant application to North Carolina Triangle to the Coast Affiliate of Susan G. Komen grant funds. No matching funds are required. 5. Period of up to 30 minutes for informal comments allowing 3 minutes for each presentation 6. Appointments 7. County Manager's report-Tommy Burns, County Manager -Veterans Affairs Activities Report-December 2013 -Johnston-Lee-Harnett Community Action Inc. Fiscal Year 2014-2015 Application for Funding Page 1 8. New Business 9. Closed Session 10. Adjourn Page2 BUDGET ORDINANCE AMENDMENT BE IT ORDAINED by the Governing Board of the County of Harnett, North Carolina, that the following amendment be made to the annual budget ordinance for the fiscal year ending June 30,2013: Section 1. To amend the General Fund , EDC/Education the appropriations are to be changed as follows: EXPENDITURE AMOUNT AMOUNT CODE NUMBER DESCRIPTION OF CODE INCREASE DECREASE l l 0-8600-480.35-86 Education-Central Carolina Works $ 25,000.00 l l 0-71 00-465.54-26 Advertising 5,000.00 l l 0-7100-465.30-04 Profressional Services 20,000.00 REVENUE AMOUNT AMOUNT CODE NUMBER DESCRIPTION OF CODE INCREASE DECREASE EXPLANATION: Contribution to CCCC -Central Carolina Works Program APPROVALS: n~~ Finance Officer (date) County Manager (date) ( d./31 (t 3 Section 2. Copies of this budget amendment shall be furnished to the Clerk to the Board, and to the Budget Officer and the Finance Officer for their direction. Adopted __________________________________ __ Margaret Regina Wheeler, Clerk to the Board Joe Miller, Chairman Harnett County Board of Comm BUDGET ORDINANCE AMENDMENT BE IT ORDAINED by the Governing Board of the County of Harnett, North Carolina, that the following amendment be made to the annual budget ordinance for the fiscal year ending June 30, 2014; Section 1. To amend the General Fund, Health Department, the appropriations are to be changed as follows: EXPENDITURE AMOUNT AMOUNT CODE NUMBER DESCRIPTION OF CODE INCREASE DECREASE 110-7600-441.11-00 Salaries & Wages $ 2,600.00 110-7600-441.21-00 Group Insurance $ 500.00 110-7600-441.22-00 FICA $ 250.00 110-7600-441.23-00 Retirement $ 200.00 110-7600-441.26-08 Worker's Compensation $ 39.00 110-7600-441.54-26 Advertising $ 600.00 110-7600-441.58-14 Travel $ 600.00 110-7600-441.64-25 Books & Publications $ 2,000.00 REVENUE AMOUNT AMOUNT CODE NUMBER DESCRIPTION OF CODE INCREASE DECREASE 11 0-0000-334.76-23 Healthy Communities $ 6,789.00 EXPLANATION: To budget additional State funds received for the Healthy Communities program. ,.., APPROVALS: ~ 9)fJw(j)(0~ Department Head (date} ger (Date} t~{J-7fJ3 Section 2. Copies of this budget amendment shall be furnished to the Clerk of the Board, and to the Budget Officer and the Finance Officer for their direction. Adopted this Margaret Regina Wheeler, Clerk to the Board day of Joe Miller, Chairman Harnett County Board of Commissioners IGG, b BUDGET ORDINANCE AMENDMENT BE IT ORDAINED by the Governing Board of the County of Harnett, North Carolina that the following amendment be made to the annual budget ordinance for the fiscal year ending June 30, 2014: Section 1. To amend the General Fund, Social Services Department, the appropriations are to be changed as follows: EXPENDITURE AMOUNT AMOUNT CODE NUMBER DESCRIPTION OF CODE INCREASE DECREASE 110-7710-441.80-60 Day Care Smart Start 650,000 110-7710-441.80-50 Day Care Subsidy 597,104 110-7710-441.88-20 Work First Transportation 28,605 110-7710-441.80-92 LIEAP 964 110-7710-441.89-30 Fuel Fund Donation 392 110-7710-441.89-40 General Agency Donation 314 110-7710-441.89-50 Elderly Assistance Donation 1,520 110-7710-441.89-60 Foster Care Donation 250 110-7710-441.89-70 Christmas Cheer 322 110-7710-441.88-15 SpedaiNeedsAdopt~ns 38,165 REVENUE AMOUNT AMOUNT CODE NUMBER DESCRIPTION OF CODE INCREASE DECREASE 110-0000-330.77-05 Day Care-Smart Start 650,000 110-0000-330.77-04 Day Care-Subsidy 597,104 110-0000-334.77-04 Work First Transportation 28,605 110-0000-330.77-01 Social Services Administration 964 110-0000-399.00-00 Fund Balance Appropriated 40,963 EXPLANATION: To budget funding allocated by the State for Day Care services, Low Income Home Energy Assistance and Work First Transportation services. To budget and roll forward donations and adoption funding received in the prior year to assist the elderly, disabled and foster children of Harnett County. Adopted this_ day of _____ 2 __ Margaret Regina Wheeler, Clerk to the Board Joe Miller, Chairman Harnett County Board of Commissioners BUDGET ORDINANCE AMENDMENT BE IT ORDAINED by the Governing Board of the County of Harnett, North Carolina, that the following amendment be made to the annual budget ordinance for the fiscal year ending June 30, 2013; Section 1. To amend the General Fund, Health Department, the appropriations are to be changed as follows: EXPENDITURE AMOUNT AMOUNT CODE NUMBER DESCRIPTION OF CODE INCREASE DECREASE 110-7501-441.41-11 Telephone and Postage $ 339.00 110-7501-441.58-14 Travel $ 700.00 110-7501-441.60-33 Materials & Supplies $ 700.00 REVENUE AMOUNT AMOUNT CODE NUMBER DESCRIPTION OF CODE INCREASE DECREASE 110-0000-334.75-03 Medicare Counseling SHIIP $ 1,739.00 EXPLANATION: Budget Amendment to budget additional funds received from the Medicare Counseling SHIIP Grant. APPROVALS: , \ <7 c;tnwvz~;~~ Department Head (date) nager (Date) J;)../17(;3 Finance Officer ate) Section 2. Copies ofthis budget amendment shall be furnished to the Clerk ofthe Board, and to the Budget Officer and the Fin a nee Officer for their direction. Adopted this Margaret Regina Wheeler, Clerk to the Board day of ,2012 Joe Miller, Chairman Harnett County Board of Commissioners BUDGET ORDINANCE AMENDMENT BE IT ORDAINED by the Governing Board of the County of Harnett, North Carolina, that the following amendment qe made to the annual budget ordinance for the fiscal year ending June 30, 2014: Section 1. To amend the Public Utilities Department, 531 account, the appropriations are to be changed as follows: EXPENDITURE AMOUNT AMOUNT CODE NUMBER DESCRIPTION OF CODE INCREASE DECREASE 531-9000-431--New> West Central Transmission $183_..845.00 '1 -">:;,; REVENUE AMOUNT AMOUNT CODE NUMBER DESCRIPTION OF CODE INCREASE DECREASE 531-0000-399-00.00 Fund Balance Appropriated $183..,84:5.00 .., ~'l ')' EXPlANATION: To fund West Central Transmission Project. The Project Ordinance was approved by the BOC on May 6, 2013. Adopted this day of Margaret Regina Wheeler, Clerk to the Board ,2013. Joe Miller, Chairman Harnett County Board of Commissioners BUDGET ORDINANCE AMENDMENT BE IT ORDAINED by the Governing Board of the County of Harnett, North Carolina, that the following amendment be made to the annual budget ordinance for the fiscal year ending June 30, 2014: Section 1. To amend the General Fund, Cooperative Extension, the appropriations are to be changed as follows: (lC [2-12---J.~ { lli (1 '-6 ~'-/ EXPENDITURE CODE NUMBER DESCRIPTION OF CODE 110-7306-465-41-11 Telecommunications & Postage 110-7306-465-55-12 , Printing & Binding 110-7306-465-58-14 Travel REVENUE CODE NUMBER DESCRIPTION OF CODE 110-0000-399-0000 Fund Balance Appropriated Adopted this day of Margaret Regina Wheeler Clerk to the Board AMOUNT AMOUNT INCREASE DECREASE 302 300 1,500 AMOUNT AMOUNT INCREASE DECREASE 2,102 Joe Miller, Chairman Harnett County Board of Commissioners ll8b Cooperative Extension Program Bal a n c e s To: From: Date: Fee Based Programs Prior Year funds Fund Balance Aooroor i a t e d Aariculture Revenue Received 110-0000-344-12- 0 0 Expense 110-7300-465-32-29 Current Year Balance Prior Year funds Fund Balance Appropr i a t e d CCR&R United Wav Revenue Received 110-0000-353-17-00 Revenue Received 110-0000-353-73-06 Expenses 11 0-7306-465-XX-XX T. Fi s h e r , W Ha r d i s o n , S. Wi l l i a m s , A. Wi l l f o r d Ca t h y Ry a l s 10 / 2 1 / 1 3 3: 2 7 P M FY 2 0 1 2 - 2 0 1 3 Ac t u a l $1 , 8 2 0 Pr i o r Ye a r fu n d s $0 Fu n d Ba l a n c e Ap p r o p r i a t e d $1 , 8 2 0 FC S $4 , 1 4 8 Re v e n u e Re c e i v e d 11 0 - 0 0 0 0 - 3 4 4 - 1 1 - 0 0 $3 , 5 2 1 Ex p e n s e 11 0- 7 3 0 0 - 4 6 5 - 3 2 - 3 0 $2 , 4 4 8 Cu r r e n t Ye a r Ba l a n c e $1 , 6 4 9 $0 $1 , 6 4 9 $5 , 6 5 8 $4 , 6 0 4 $2 , 7 0 3 $2 , 9 2 7 Fu n d Ba l a n c e Ap p r o p r i a t e d Ye a r En d i n g FY 2 0 1 3 $0 Ag r i c u l t u r e $2 44 7 . 6 9 $2 , 9 2 7 ' FC S $2 , 7 0 3 . 2 6 $8 4 4 4- H $5 , 7 6 5 . 6 2 $1 , 0 0 0 CC R & R Un i t e d Wa y $4 , 7 7 1 . 0 0 $0 _ Th r u 6- 3 0 - 2 0 1 3 Pr i o r Ye a r fu n d s $7 , 9 1 8 Fu n d Ba l a n c e Ap p r o p r i a t e d $9 9 5 4- H $6 , 9 2 3 Re v e n u e Re c e i v e d 11 0 - 0 0 0 0 - 3 4 4 - 1 4 - 0 0 $1 4 , 7 1 9 Ex p e n s e 11 0 - 7 3 0 0 - 4 6 5 - 3 2 - 3 1 $1 5 , 8 7 6 Cu r r e n t Ye a r Ba l a n c e $5 , 7 6 6 BUDGET ORDINANCE AMENDMENT BE IT ORDAINED by the Governing Board of the County of Harnett, North Carolina, that the following amendment be made to the annual budget ordinance for the fiscal year ending June 30, 2014: Section 1. To amend the Finance Department, the appropriations are to be changed as follows: EXPENDITURE AMOUNT AMOUNT CODE NUMBER DESCRIPTION OF CODE INCREASE DECREASE 110-4400-410.74-74 Capital Outlay $9J49 110-4400-410.11-00 Salaries & Wages $9J49 REVENUE AMOUNT AMOUNT CODE NUMBER DESCRIPTION OF CODE INCREASE DECREASE EXPLANATION: To move lapsed salaries to purchase a new machine to fold, insert and seal EMS bills, accounts payable checks and other correspondence. The current machine, which was given to the Finance office and is over ten years old, is not under a maintenance contract and continues to jam and destroy the documents. APPROVALS: Department Head (date) Manager (datet ~ ;.2._,( t s \ ~ 3 Section 2. Copies of this budget amendment shall be furnished to the Clerk to the Board, and to the Budget Officer and the Finance Officer for their direction. Adopted this Margaret Regina Wheeler Clerk to the Board day of Joe Miller, Chairman Harnett County Board of Commissioners Agenda Item 4.{'"" C Date: 01/06/2014 Approved By : TO : HARNETT COUNTY BOARD OF COMMISSIONERS RE: CONSIDERATION OF REFUND FOR TAXES, INTEREST AND PENALTIES FOR ALL MUNICIPAliTIES 1 BRYANT, JAMES RAY JR City 0.00 Property in 0000031005-2013-2013-000000 382.70 Refund Land Use County 382.70 2 CASPER, CHRISTOPHER PAUL City 0.00 Military 0001580304-2011-2011-000000 31.59 Refund Exemption County 31.59 3 COVINGTON, ZACHEUS City 0.00 Veterans 0000012533-2013-2013-000000 300.00 Refund Exemption County 300.00 4 CURRIN, NELSON T City 0.00 Value 0000013367-2009-2009-000000 261.14 Refund Decrease County 261.14 5 EASON, JERRY LEE City 0.00 Double-Billed 0002108524-2013-2012-000000 123.45 Refund County 123.45 6 FARMER LP GAS & OIL CO City 0.00 Double-Billed 0000017399-2010-2010-000000 459. 17 Refund County 459.17 7 GOLDSTEIN, SHAUN TAIYO City 0.00 Military GOLDSTEIN, SARAH ASHLEY 0002106649-2013-2013-000000 222.62 Refund Exemption County 222.62 8 HONDA LEASE TRUST City 0.00 Double-Billed 0002107912-2013-2012-000000 217.10 Refund County 217.10 9 JERNIGAN, JIMMY R Only 1 JERNIGAN, NANCYW Dwelling on City 0.00 Property; 0000026745-2008-2008-000000 45.00 Refund Refund 1 Solid Waste Fee County 45.00 10 JERNIGAN, JIMMY R Only 1 JERNIGAN, NANCY W Dwelling on City 0.00 Property; 0000026745-2009-2009-000000 45.00 Refund Refund 1 Solid Waste Fee County 45.00 11 JERNIGAN, JIMMY R Only 1 JERNIGAN, NANCY W Dwelling on City 0.00 Property; 0000026745-2010-2010-000000 45.00 Refund Refund 1 Solid Waste Fee County 45.00 12 KNIGHT, GARLAND WADE JR Land Use City 0.00 Granted 0000029562-2013-2013-000000 44.59 Refund County 44.59 13 NEAL, ERICA LYNNE City 0.00 Military NEAL, JOSHUA DUANE 0002081624-2012-2012-000000 152.54 Refund Exemption County 152.54 14 STONE, LEWIS ALGER JR City 0.00 Double-Billed 0000051344-2008-2008-000000 153.60 Refund County 153.60 15 STONE, LEWISALGERJR City 0.00 Double-Billed 0000051344-2009-2009-000000 40.85 Refund County 40.85 16 STONE, LEWIS ALGER JR City 0.00 Double-Billed 0000051344-2010-2010-000000 88.97 Refund County 88.97 17 STONE, LEWIS ALGER JR City 0.00 Double-Billed 0000051344-2011-2011-000000 80.83 Refund County 80.83 18 STONE, LEWIS ALGER JR City 0.00 Double-Billed 0000051344-2012-2012-000000 81.85 Refund County 81.85 19 WHITE, ALICE Dwellings WHITE, LEWIS JERRY Removed from City 0.00 Property; Refund Two 0000058923-2012-2012-000000 140.00 Refund Solid Waste Fees County 140.00 WM. A. TONY WILDER City Total 0.00 Revenue Administrator County Total 2,916.00 Total to be 2,916.00 Refunded CC: WM. A. TONY WILDER Date: 01/06/2014 Approved By:. ________ _ TO : HARNETT COUNTY BOARD OF COMMISSIONERS RE: CONSIDERATION OF REFUND FOR TAXES, INTEREST AND PENALTIES FOR ALL MUNICIPALITIES FARM & HOME GAS INC City() 3,719.07 Value C/0 DIVERSIFIED ENERGY, LLC 0000017381-2013-2011-000000 3,719.07 Refund Decrease County 0.00 2 FARM & HOME GAS INC City() 3,542.85 Value C/0 DIVERSIFIED ENERGY LLC 0000017381-2013-2012-000000 3,542.85 Refund Decrease County 0.00 3 JUDD, LONNIE City(CI02) 344.69 Veterans 0000022403-2013-2013-000000 985.58 Refund Exemption County 640.89 4 KNIGHT, MAVIS S City 0.00 Double- 0001581523-2013-2013-000000 691.71 Refund Listed County 691.71 5 MAYNARD, DELTON City 0.00 Elderly 0000034048-2013-2013-000000 727.62 Refund Exemption County 727.62 6 WATKINS, CAREY JR City 0.00 Elderly M, WATKINS 0000056999-2013-2013-000000 822.33 Refund Exemption County 822.33 WM. A. TONY WILDER City Total 7,606.61 Revenue Administrator County Total 2,882.55 Total to be 10,489.16 Refunded CC: WM. A. TONY WILDER Board Meeting Agenda Item Agenda Item 4 -D MEETING DATE: .January 6, 2014 TO: HARNETT COUNTY BOARD OF COMMISSIONERS SUBJECT: Disposition of Personal Property REQUESTED BY: Sheriff Larry Rollins REQUEST: Adoption of the attached resolution authorizing disposition of four surplus motor vehicles previously used by the Harnett County Sheriffs Department to the Central Carolina Emergency Services Training Center. Please see attached documentation supporting the Sheriffs request for disposition. COUNTY MANAGER'S RECOMMENDATION: p C:\Users\islusser\Desktop\14.0 1.06.Agenda Request Disposition. doc 1 of 1 Page STATE OF NORTH CAROLINA COUNTY OF HARNETT RESOLUTION AUTHORIZING DISPOSITION OF PERSONAL PROPERTY WHEREAS, County of Harnett (the "County") owns the following motor vehicles, utilized by the Harnett County Sheriffs Department in connection with its public safety function: YEAR 2005 2007 2007 2004 MAKE Ford Ford Ford Ford VIN 2FAFP71 W:X5X158331 2FAFP71 W57Xl 05927 2FAFP71 W07X105933 2F AFP71 W 14 X 1 06228 WHEREAS, such vehicles are now obsolete and surplus to the needs of the County; WHEREAS, said vehicles have little, if any, value on the open and public market; WHEREAS, Central Carolina Community College ("CCCC"), located in Lee County, could utilize such vehicles for training purposes at its Emergency Services Training Center, said Center is often used by the various local government jurisdictions within Harnett County for training purposes; WHEREAS, the transfer of such vehicles to CCCC would provide for and promote the safety and welfare of the citizens of Harnett County by affording County law enforcement personnel and other local government jurisdiction law enforcement personnel equipment to be used for training purposes. NOW, THEREFORE, BE IT RESOLVED BY THE HARNETT COUNTY BOARD OF COMMISSIONERS, that the Harnett County Sheriff shall be and is hereby authorized and directed to take any such action as might be necessary and advisable to transfer the above-referenced vehicles to Central Carolina Community College, without consideration, pursuant to the provisions ofNorth Carolina General Statute§ 153-176. Duly adopted this the 6th day of January, 2014. County of Harnett By: _______________ _ Joe Miller, Chairman Harnett County Board of Commissioners ATTEST: (SEAL) Margaret Regina Wheeler, Clerk STATE OF NORTH CAROLINA COUNTY OF HARNETT :NOTICE PROPOSED RESOLUTION AUTHORIZ G 0 EC 31 20l3 ; DISPOSITION OF PERSONAL PROPER Y _ "ft?~ . _ _j)_ i. TO BE ADOPTED BY HARNETT COUN liT_<><;_ (!,r~ 1 BOARD OF COMMISSIONERS ON JA~-~~~~:·_;~'\1]§U'RT- WHEREAS, County of Harnett (the "County") owns the following motor vehicles, utilized by the Harnett County Sheriff's Department in connection with its public safety function: YEAR 2005 2007 2007 2004 MAKE Ford Ford Ford Ford VIN 2F AFP71 WX5X 15 83 31 2F AFP71 W57X 105927 2FAFP71W07X105933 2FAFP71Wl4X106228 WHEREAS, such vehicles are now obsolete and surplus to the needs of the County; WHEREAS, said vehicles have little, if any, value on the open and public market; WHEREAS, Central Carolina Community College ("CCCC"), located in Lee County, could utilize such vehicles for training purposes at its Emergency Services Training Center, said Center is often used by the various local government jurisdictions within Harnett County for training purposes; WHEREAS, the transfer of such vehicles to CCCC would provide for and promote the safety and welfare of the citizens of Harnett County by affording County law enforcement personnel and other local government jurisdiction law enforcement personnel equipment to be used for training purposes. NOW, THEREFORE, BE IT RESOLVED BY THE HARNETT COUNTY BOARD OF COMMISSIONERS, that the Harnett County Sheriff shall be and is hereby authorized and directed to take any such action as might be necessary and advisable to transfer the above-referenced vehicles to Central Carolina Community College, without consideration, pursuant to the provisions of North Carolina General Statute § 153-176. Duly adopted this the 6th day of January, 2014. County of Harnett By:. _______________ _ Joe Miller, Chairman Harnett County Board of Commissioners ATTEST: (SEAL) Margaret Regina Wheeler, Clerk December 6, 2013 Overview Office of the Sheriff of Harnett County Sheriff Larry Rollins www.harnettsheriff.com PO Box 399 175 Bain Street, Lillington, NC 27546 Phone: 910-893-9111; Fax: 910-893-6450 Over the past 18 Months the harnett County Sheriff's Office has replaced 46 patrol vehicles from it's aged fleet. During the period of 2010 to 2012, only two vehicles were purchased through the GHSP. As a result, many vehicles have accumulated high milegage. Further, the age and the technology of the equipment does not permit us to re-use it into the newer vehicles coming into the fleet. Some of the patrol vehicles have had a "partition" (See below) that was placed between the operator and the rear passenger for the safety of transporting offienders . These partitions are too large for the smaller Dodge Chargers and do not fit any law enforcement vehicle to this day. The manufacturer will not entertain a credit, nor selling them outright will gain any significant income. Emergency lights and sirens available from 2007 to 2011 were installed with two separate control boxes and used a Strobe/type system. Now, our vehicles use a dual control box with LED system. In short, the equipment removed from the emergency vehicles for sale is not re-usable AND can not be sold to the consumer UNLESS they are Law Enforcement Agencies. Law Enforcement Agencies do not want to risk using old technology and will not purchase our surplace. We have been steadily accumulating Siren Boxes, Light Boxes and Light bars from 2010 to present. Storing these items for no foresee-able profit is a waste of space and time. Solution. Office of the Sheriff of Harnett County Sheriff Larry Rollins www.harnettsheriff.com PO Box 399 175 Bain Street, Lillington, NC 27546 Phone: 910-893-9111; Fax: 910-893-6450 Central Carolina Community College has been training young men and women for employment as sworn officer for several years now. They serve as feeder schools for our employees. They NEED equipment during certain phases of instruction in order to be completely certified as Sworn Officers. Proposal: Donate the following vehicles complete with emergency Equipment installed along with the accumulated light bars and siren control boxes. Any equipment we need for repairs of existing emergency equipment we will maintain on hand in order to prevent purchasing new replacement parts. Miles ~IN \¥ear 165798 2FAFP71WX5X158331 2005 179333 2FAFP71VV57X105927 2007 154966 2FAFP71VV07X1 05933 2007 176641 2FAFP71VV14X1 06228 2004 Approximate ~alue: 18 Partitions@ $27.75 each 18 strobe/blue lights @ $98.88 each 18 Federal control boxes @ 16.00 each Make ford ford ford ford lliMpe crown victoria crown victoria crown victoria crown victoria $499.50 $1779.84 $288.00 Blue book Equip Total $2320.00 141.75 $2461.75 $2798.00 141.75 $2939.75 $3161.00 141.75 $3302.75 $1870.00 141.75 $2011.75 $10,716.00 Total value $13,283.34 Any questions concerning the above information, contact the undersigned at 910 893-0118. Agenda Item L/-.... £ CENTRAl CAROliNA -- coMMUNITY COLLEGE November 15,2013 Commissioner Jim Burgin, Chairman Harnett County Board of Commissioners P 0 Box 759 Lillington, NC 27546 Dear Commissioner Burgin: Harnett County 46 a> ph. 910.893.9101 We are grateful for the overwhelming private support that the College's Central Carolina Works project has generated in recent months. As you will recall from our many discussions, Central Carolina Works will benefit students by helping them to earn a year or more of tuition-free college credit by the time they graduate from high school. In achieving this goal, the project will enhance individuals' career and earnings potential, while ensuring that our area's workforce possesses the knowledge and skills it needs to be competitive in the 21st-century global economy. Central Carolina Works is poised to begin training Career and College Advisors in early 2014 for their work in our area high schools; but in order to move forward, the project needs your support. In order to achieve our overall budget goal of $750,000, we are asking that Harnett County make a onetime contribution of$50,000 ($25,000 for each of the next two budget cycles). We are confident that our community will see abundant returns on this investment, and we invite you to contact any of us if you have questions or would like more details about the project. Thank you for all that you do .... Sincerely, Dr. T. Eston Marchant President Central Carolina Community College Thomas S. Frye Superintendent Harnett County Schools Kirk J. Bradley Chairman Central Carolina Works Committee Agenda Item L/ "" E Board Meeting Agenda Item MEETING DATE: January 6, 2014 TO: HARNETT COUNTY BOARD OF COMMISSIONERS SUBJECT: Lillington Fire Department requests approval to spend$ 22,374.00 to install 8 fire hydrants in the newly contracted Flatwoods Fire District. REQUESTED BY: Gary Pope, Emergency Services Director REQUEST: We would like to request approval for Lillington Fire Department to spend funds in the amount of$ 22,374.00 to install 8 new fire hydrants in the newly contracted Flatwoods Fire District. In cooperation with the N.C. Office ofthe State Fire Marshal they have agreed to extend the cities class 4 insurance rating to the newly contracted Flatwoods Fire District. This agreement with the state would lower each homeowners insurance within this district. There are no county funds requested for this project. This would complete the first phase of hydrant coverage needed to meet these goals. COUNTY MANAGER'S RECOMMENDATION: C:\Users\jriddle\Documents\agendaform20 14 Lillington Flatwoods. doc I of2 THIS INSTRUMENT HAS BEEN REVIEWED THE FINANCE OFFICER ~. n ~3TRIIfvifNT HAS BEEN D:~:·AUDil t_~ THE MA,'>JNE>l REOUif\o·c :: (The: LCCAL VERNMENT BUDGET AND FI~C:AL -NTROL ACT Page December 18,2013 Mr. Jimmy Riddle Harnett County Fire Marshal Jimmy, Lillington Fire Department Flatwoods Fire District P.O. Box 296 Lillington, North Carolina 27546 Tel: 910-893-9342 Fax: 910-814-1770 .John]>, ncn'i!ln~ Fire Chief I would like to be put on the next available County Board of Commissioners meeting agenda. As you are aware we are attempting to obtain a district wide insurance rating of "4" for the entire Flatwoods Fire District. We will need to install 8 fire hydrants which Flatwoods will purchase and Metro Water will install labor free. The cost of the hydrants and associated valves and fittings is $22,374.40. This is the first phase of the project. We will also be installing 3 water lines and 3 more hydrants at a later date to get complete coverage. I will let you know when the cost estimate of this next phase is complete so we can ask for permission to complete this also. I appreciate your assistance in this matter. John Bethune .~- zreChief John here your quote 6-fire hydrant-3' 6" bury$ 1385 x 6 = $ 8310 2-fire hydrant-4' bury $ 1425 x 2 = $ 2850 8-6 x 6 tapping sleeve $ 545 x 8 = $ 4360 8-6" valve $ 625 x 8 = 16-6" grip rings $ 46.85 x 16 = 8-valve boxes$ 51.00 x 8 = 160' 6" pipe$ 3.68 x 160 = 8-concrete collar$ 13.50 x 8 = Total $5000 $ 749.60 $ 408 $ 588.80 $ 108 $ 22374.40 Agenda Item LJ-G: Board Meeting Agenda Item MEETING DATE: ~bet%,'2013 TO: HARNETT COUNTY BOARD OF COMMISSIONERS SUBJECT: Request permission to apply for 2014 Emergency Management Performance Grant administered by North Carolina Public Safety Division of Emergency Management REQUESTED BY: Gary Pope, Emergency Services Director REQUEST: We would like to request permission to apply for the 2014 Emergency Management Performance Grant. This is a federal grant administered by the State that is available to local governments to assist in the cost of developing and maintaining a comprehensive emergency management program. These are funds that are received annually and are included as part of our operating budget. COUNTY MANAGER'S RECOMMENDATION: THIS INSTRUMENT HAS BEEN REVIEWED U:\agendaform2013.doc Page 1 of2 NO R T H CA R O L I N A LO C A L GO V E R N M E N T AP P L I C A T I O N F O R FF Y 20 1 4 EM P G FU N D I N G G r a n t Pe r i o d : Oc t o b e r 1, 2 0 1 3 - Se D t e m b e r 30 , 20 1 5 1. 1 E M Ag e n c y N ar n e Ha r n e t t Co u n t y Em e r g e n c y Ma n a g e m e n t 1. 2 St r e e t Ad d r e s s , Ci t y , Zi p Co d e P. O . Bo x 37 0 10 0 5 Ed w a r d s Br o t h e r s Dr i v e , Li l l i n g t o n , NC 27 5 4 6 1. 3 Ap p l i c a t i o n Co m p l e t i o n Da t e No v e m b e r 25 , 2 0 1 3 L O C A L E M E R G E N C Y M A N A G E M E N T P R O G R A M Fo r 1. 5 in d i c a t e ac t u a l pe r c e n t a g e o f ti m e Em e r g e n c y 1. 5 * 1. 6 1.7 Ma n a g e m e n t di r e c t o r de v o t e s to wo r k on on l y E M ac t i v i t i e s . Pl e a s e do no t in c l u d e wo r k ti m e (o r EM S , 91 1 , Fi r e Ma r s h a l , T i m e ( % ) C u r r e n t Da t e of Employment Sa f e t y ac t i v i t i e s , et c . (e . g . SO % , 75 % , Sa l a r y in C u r r e n t Position 1. 4 E M Pr o g r a m M a n a g e r (P r i n t / T y p e in Na m e Be l o w ) 10 0 % ) Be v e r l y Wi l l i a m s 10 0 % $5 4 , 3 3 0 10 - 0 1 - 2 0 0 5 I 1. 8 Pe r s o n n e l Da t a : Co m p l e t e fo r pe r s o n n e l su p p o r t e d wi t h FF Y 20 1 4 E M P G P r o g r a m fu n d s a. Al l EM P G Pr o g r a m fu n d s (F e d e r a l an d ma t c h ) al l o c a t e d to w a r d s Lo c a l em e r g e n c y ma n a g e m e n t pe r s o n n e l $48,241 b. Fu n d s al l o c a t e d to w a r d s Lo c a l co n t r a c t o r s ? -0- c. No n - E M P G Pr o g r a m fu n d s al l o c a t e d to w a r d s Lo c a l em e r g e n c y ma n a g e m e n t pe r s o n n e l (o t h e r so u r c e s o f -0- fu n d i n g al l o c a t e d fo r Lo c a l EM A pe r s o n n e l ) ? d. To t a l Nu m b e r o f Lo c a l em e r g e n c y ma n a g e m e n t fu l l - t i m e eq u i v a l e n t (F T E ) pe r s o n n e l (i n c l u d i n g th o s e 2 su p p o r t e d an d no t su p p o r t e d by th e EM P G Pr o g r a m ) ? e. Nu m b e r o f Lo c a l em e r g e n c y ma n a g e m e n t fu l l - t i m e eq u i v a l e n t (F T E ) pe r s o n n e l su p p o r t e d by EM P G 2 Pr o g r a m ? f. Co s t Sh a r e or In - K i n d Ma t c h ex p l a n a t i o n in de t a i l ? Th e Co u n t y wi l l ma t c h 50 % in ki n d ma t c h wi t h Co u n t y Em e r g e n c y Ma n a g e m e n t Co o r d i n a t o r ' s sa l a r y an d be n e f i t s . *A r e a Co o r d i n a t o r mu s t ve r i f y th e pe r c e n t a g e o f ti m e de v o t e d to Em e r g e n c y Ma n a g e m e n t ac t i v i t i e s . B.P v J i 1 L 0, ! Jl z ~ 0 J v Lo c a l Pr o g r a m Ma n a g e r Si g n a t u r e Ar e a Co o r d i n a t o r Si g n a t u r e Br a n c h Ma n a g e r Si g n a t u r e EM Ap p l i c a t i o n Fo r m 66 (R e v . 9/ 1 8 ) Pa g e 3 STATE/LOCAL FFY 2014 EMPG AGENCY: Harnett County Emergency Management This is to certify that the above named agency agrees to successfully complete the activities below in full partnership with North Carolina Emergency Management and the U.S. Department of Homeland Security. The appropriate Branch Manager and/or Area Coordinator will review the progress of this agreement quarterly with the local Emergency Management Director. This report will also be the basis for continued funding during this fiscal year. Please report quarterly the Emergency Management activities you completed during this agreement period that ends September 30, 2014. Your Quarterly Reports should include the progress from all previous quarterly reports as well. All Universal and Optional activities with deliverables are to be completed by the September 30, 2014 deadline. Deliverables are to be submitted to your Branch Office by their deadline. Certify completion of the following activities for EMPG Universal activities by September 30, 2014 unless otherwise noted below: 2014.01 Update the new 2014 THIRA/SPRINIMS reporting tool by November 15, 2013; 2014.02 Review/Update County Emergency Operation/Response plan; 2014.03 Participate in a minimum 24 hours EM training; 2014.04 Conduct three exercises per year; 2014.05 Complete all NIMS training requirements as outlined in NIMS Five-Year Plan; 2014.06 Update Resources in Web EOC Resource Manager; 2014.07 Attend Statewide EM Conference NOTE: As listed above to be eligible to receive FFY 2014 EMPG funding, applicants must meet NIMS compliance requirements. The N!MS, formally NIMSCAST, is the required means to report FY 2014 NIMS compliance for FFY 2014 funds. FFY 2014 Compliance Requirements 111 NIMS Training: IS 1 00; IS 200; IS 700; and IS 800; rm FEMA Professional Development Series: IS 139; IS 230b; IS 235b; IS 240a; IS 241 a; IS 242a; and IS 244a EMPG Program funds used for training should support the nationwide implementation of NIMS. Grantees are encouraged to place emphasis on the core competencies as defined in the NIMS Training Program. The NIMS Training Program can be found at http://www.fema.gov/pdflemergency/nimslnims_training_program.pdf The NIMS Guideline for Credentialing of Personnel provides guidance on the national credentialing standards. The NIMS Guidelines for Credentialing can be found at http://www. fema. govlpdflemergencylnims/nims_ cred_guidelines_report.pdf. EM Application Form 66A (Rev. 9 /18) PageS This Agreement will become effective upon execution of all parties to the Agreement. The date of execution shall be the date of the last signature. EXECUTED THIS THE __ DAY OF ____ , 201 Beverly Williams (Print) Name of Local EM Program Manager Signature of Local Chief Executive Officer Counzyof __ ~H~a=r~ne~t=t ________________________ __ EM Application Form 66A (Rev. 9/18) d·.),.)-13_ Date Date Page 6 PROGRAM EMERGENCY AGENCY I DO HEREBY CERTIFY THAT THE EM PROGRAM MANAGER POSITION* IS NOT VACANT OR IS CURRENTLY BEING LLED BY AN ACTING COUNTY EMPLOYEE. Signature: ~ + ?t/u.j~ EM PROGRAM MANAGER Date: 11-25-2013 * AS PART OF GRANT APPLICATION DEUVERABLES, A CURRENT POSITION DESCRIPTION AND ORGANIZATION CHART THAT MEETS U.S. DEPARTMENT OF HOMELAND SECURITY PROGRAM AND STA REQUIREMENTS IS ESSENTIAL. EMPG Application Form (Rev. 9 /18) Page? - HARNETT COUNTY EMERGENCYMANAGEMENTAGENCY FUNCTIONAL STATEMENTS EMERGENCY PROGRAM DIRECTOR/COORDINATOR The Emergency Program Director/Coordinator is responsible for the planning, coordinating and operation of the Emergency Management activities in Harnett County. Under general supervision performs coordinative, consultative and administrative work in preparedness, response, :recovery and mitigation plans for emergency or disaster situations and for SARA Title III Hazardous Materials Program and for Harris Nuclear Program. The Manager shall maintain liaison with the State and Federal authorities and the authorities of nearby political subdivisions so as to insure the most effective operation of the emergency management plans. EM E R G E N C Y SE R V I C E S OR G A N I Z A T I O N Em e r g e n c y Se r v i c e s Di r e c t o r Se n i o r ... Ad m i n i s t r a t i v e Su p p o r t Sp e c i a l i s t I I B Fi r e Ma r s h a l Em e r g e n c y Em e r g e n c y Ma n a g e m e n t Me d i c a l Se r v i c e s I Co o r d i n a t o r Di v i s i o n Ch i e f I Ch i e f De p u t y Fi r e Da y Tr a n s p o r t 1 Op e r a t i o n s Tr a n s p o r t a t i o n Training Ma r s h a l ... . !" ' As s i s t a n t Di s p a t c h e r Officer I As s i s t a n t I Em e r g e n c y Wh e e l Ch a i r De p u t y Fi r e Ma n a g e m e n t Tr a n s p o r t ... . Co o r d i n a t o r Ma r s h a l I A Sh i f t Su p e r v i s o r 1- - 1 B Sh i f t C Shift Supervisor De p u t y Fi r e Su p e r v i s o r ... . Ma r s h a l I I I I ... . Se n i o r Me d i c ... . Se n i o r Me d i c -Senior Medic - De p u t y Fi r e Ma r s h a l L L L I EM S Fi e l d St a f f EM S Fi e l d St a f f EMS Field Staff 15 pe r s o n n e l 15 pe r s o n n e l 15 personnel De p u t y Fi r e "'" ' Ma r s h a l Pa r t Ti m e 4 Pa r t Ti m e 4 Pa r t Ti m e 4 Part Time l x 2 - · · · · - - ~ DEPARTMENT OF HOMELAND SECURITY FEDERAL EMERGENCY MANAGEMENT AGENCY O.MB. No. 1660-0o25 Expires November 30, 2013 CERTIFICATIONS REGARDING LOBBYING; DEBARMENT, SUSPENSION AND OTHER RESPONSIBILITY MATTERS; AND DRUG·f'REE WORKPLACE REQUIREMENTS PAPERWORK BURDEN E Public reporting burden for this data collection is estimated to average 1. 7 hours per response. The burden estimate includes the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and submitting this form. This collection of information is required to obtain or retain benefits. You are not required to respond to this collection of information unless a valid OMB control number is displayed on this form. Send comments regarding the accuracy of the burden estimate and any suggestions for reducing the burden to: Information Collections Management, Department of Homeland Security, Federal Emergency Management Agency, 1800 South Bell Street, Arlington, VA 20598-3005 Paperwork Reduction Project (1660-0025). NOTE: Do not send your completed form to this address. Applicants should refer to the regulations cited below to determine the certification to which they are required to attest. Applicants should also review the instructions for certification included in the regulations before completing this form. Signature of this form provides for compliance with certification requirements under 44 CFR Part 18, "New Restrictions on Lobbying" and 28 CFR Part 17, "Government-wide Debarment and Suspension (Nonprocurement) and Government-wide Requirements for Drug-Free Workplace (Grants)." The certifications shall be treated as a material representation of fact upon which reliance will be placed when the Federal Emergency Management Agency (FEMA) determines to award the transaction, grant, or cooperative agreement 1. LOBBYING As required by section 1352, Title 31 of the U.S. Code, and implemented at 44 CFR Part 18, for persons entering into a grant or cooperating agreement over$ 100,000, as defined at 44 CFR Part 18, the applicant certifies that: (a) No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the making of any Federal grant, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any Federal grant or cooperative agreement. (b) If any other funds than Federal appropriated funds have been paid or will be paid to any other person for influencing or attempting to influence an officer or employee of any agency, a member of Congress, an officer or an employee of Congress, or employee of a member of Congress in connection with this Federal Grant or cooperative agreement, the undersigned shall complete and submit Stand Form-LLL, "Disclosure of Lobbying Activities," in accordance with its instructions. c) The undersigned shall require that the language of this certification be included in the award documents for all subawards at all tiers (including subgrants, contracts under grants and cooperative agreements, and subcontracts) and that all subrecipients shall certify and disclose accordingly. I Standard Form-LLL "Disclosure of Lobbying Activities" attached (This form must be attached to certification if nonappropriated funds are to be used to influence activities) 2. DEBARMENT,SUSPENSION, AND OTHER RESPONSIBILITY MATTERS (DIRECT RECIPIENT) As required by Executive Order 12549, Debarment and Suspension, and implemented at 44 CFR Part 67, for prospective participants in primary covered transactions, as defined at 44 CFR Part 17, Section 17.510-A A. The applicant certifies that it and its principals: (a) Are not presently debarred, suspended, proposed for debarment, declared ineligible, sentenced to a denial of Federal benefits by a State or Federal court, or voluntarily excluded from covered transactions by any Federal department or agency; (b) Have not within a three-year period preceding this application been convicted of a or had a civilian judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or perform a public a public (Federal ,State, or local) transaction or contract under a public transaction; violation of Federal or State antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property; (c) Are not presently indicted for otherwise criminally or civilly charged by a governmental entity (Federal, State, or local) with commission of any of the offenses enumerated in paragraph (1) (b) of this certification; and (d) Have not within a three-year period preceding this application had one or more public transactions (Federal, State, or local) terminated for cause of default; and B. Where the applicant is unable to certify to any of the statements in this certification, he or she shall attach an explanation to this application. 3. DRUG-FREE WORKPLACE (GRANTEE OTHER THAN INDIVIDUALS) As required by the Drug-Free Workplace Act of 1988, and implemented at 44 CFR Part 17, Subpart F, for grantees, as defined at 44 CFR Part 17.615 and 17.620- A The applicant certifies that it will continue to provide a drug-free workplace by; (a) Publishing a statement notifying employees that the unlawful manufacture, distribution, dispensing, possession, or use of a controlled substance is prohibited in the grantee's workplace and specifying the actions that will be taken against employees for violation of such prohibition; (b) Establishing an on-going drug free awareness program to inform employees about- (1) The dangers of drug abuse in the workplace; (2) The grantee's policy of maintaining a drug-free workplace; (3) Any available drug counseling, rehabilitation, and employee assistance programs; and (4) The penalties that may be imposed upon employees for drug abuse violations occurring in the workplace; (c) Making it a requirement that each employee to be engaged in the performance of the grant to be given a copy of the statement required by paragraph (a); (d) Notifying the employee in the statement required by paragraph (a) that, as a condition of employment under the grant. the employee will- ( 1) Abide by the term of the statement; and (2) Notify the employee in writing of his or her conviction for a violation of a criminal drug statute occurring ion the workplace no later than five calendar days after such convictions; FEMA Form 112-0-3C (11/2010) PREVIOUS EDITION OBSOLETE (e) Notifying the agency, in writing, within 10 calendar days after receiving notice under subparagraph (d)(2) from an employee or otherwise receiving actual notice of such conviction. Employers of convicted employees must provide notice, including position, title, to the applicable FEMA awarding office, i.e., regional office or FEMA office. (f) Taking one of the following actions, within 30 calendar days of receiving notice under subparagraph (d)(2), with respect to any employee who is convicted- (1) Taking appropriate personnel action against such an employee, up to and including temnination, consistent with the requirements of the Rehabilitation act of 1973, as amended; or (2) Requiring such an employee to participate satisfactorily in a drug abuse assistance or rehabilitation program approved for such purposes by a Federal, State, or local health, Jaw enforcement, or other appropriate agency; (g) Making a good faith effort to continue to maintain a drug free workplace through implementation of paragraphs (a), (b), (c), (d), (e) and (f). B. The grantee may insert in the space provided below the site(s) for the performance of work done in connection with the specific grant: Place of Perfomnance (Street address, City, County, State, Zip code) 1 005 Edwards Brothers Drive Lillington Harnett County, NC 27546 j There are workplaces on file that are not identified Sections 17.630 of the regulations provide that a grantee that is a State may elect to make one certification in each Federal fiscal year. A copy of which should be included with each application for FEMA funding. States and State agencies may elect to use a state wide certification. OMB Number: 404o-0007 Expiration Date: 06/30/2014 ASSURANCES • NON-CONSTRUCTION PROGRAMS Public reporting burden for this collection of information is estimated to average 15 minutes per response, including time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the Office of Management and Budget, Paperwork Reduction Project (0348-0040), Washington, DC 20503. PlEASE DO NOT RETURN YOUR COMPLETED FORM TO THE OFFICE OF MANAGEMENT AND BUDGET. SEND IT TO THE ADDRESS PROVIDED BY THE SPONSORING AGENCY. NOTE: Certain of these assurances may not be applicable to your project or program. If you have questions, please contact the awarding agency. Further, certain Federal awarding agencies may require applicants to certify to additional assurances. If such is the case, you will be notified. As the duly authorized representative of the applicant, I certify that the applicant 1. Has the legal authority to apply for Federal assistance and the institutional, managerial and financial capability (including funds sufficient to pay the non-Federal share of project cost) to ensure proper planning, management and completion of the project described in this application. 2. Will give the awarding agency, the Comptroller General of the United States and, if appropriate, the State, through any authorized representative, access to and the right to examine all records, books, papers, or documents related to the award; and will establish a proper accounting system in accordance with generally accepted accounting standards or agency directives. 3. Will establish safeguards to prohibit employees from using their positions for a purpose that constitutes or presents the appearance of personal or organizational conflict of interest, or personal gain. 4. Will initiate and complete the work within the applicable time frame after receipt of approval of the awarding agency. 5. Will comply with the Intergovernmental Personnel Act of 1970 (42 U.S.C. §§4728-4763) relating to prescribed standards for merit systems for programs funded under one of the 19 statutes or regulations specified in Appendix A of OPM's Standards for a Merit System of Personnel Administration (5 C.F.R. 900, Subpart F). 6. Will comply with all Federal statutes relating to nondiscrimination. These include but are not limited to: (a) Title VI of the Civil Rights Act of 1964 (P.L. 88-352) which prohibits discrimination on the basis of race, color or national origin; (b) Title IX of the Education Amendments of 1972, as amended (20 U.S.C.§§1681- 1683, and 1685-1686), which prohibits discrimination on the basis of sex; (c) Section 504 of the Rehabilitation Previous Edition Usable Act of 1973, as amended (29 U.S.C. §794), which prohibits discrimination on the basis of handicaps; (d) the Age Discrimination Act of 1975, as amended (42 U. S.C. §§6101-6107), which prohibits discrimination on the basis of age; (e) the Drug Abuse Office and Treatment Act of 1972 (P.L 92-255), as amended, relating to nondiscrimination on the basis of drug abuse; (f) the Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment and Rehabilitation Act of 1970 (P.L. 91-616), as amended, relating to nondiscrimination on the basis of alcohol abuse or alcoholism; (g) §§523 and 527 of the Public Health Service Act of 1912 (42 U.S.C. §§290 dd-3 and 290 ee-3), as amended, relating to confidentiality of alcohol and drug abuse patient records; (h) Title VIII of the Civil Rights Act of 1968 (42 U.S.C. §§3601 et seq.), as amended, relating to nondiscrimination in the sale, rental or financing of housing; (i) any other nondiscrimination provisions in the specific statute(s) under which application for Federal assistance is being made; and, 0) the requirements of any other nondiscrimination statute(s) which may apply to the application. 7. Will comply, or has already complied, with the requirements of Titles II and Ill of the Uniform Relocation Assistance and Real Property Acquisition Policies Act of 1970 (P.L. 91-646) which provide for fair and equitable treatment of persons displaced or whose property is acquired as a result of Federal or federally-assisted programs. These requirements apply to all interests in real property acquired for project purposes regardless of Federal participation in purchases. 8. Will comply, as applicable, with provisions of the Hatch Act (5 U.S.C. §§1501-1508 and 7324-7328) which limit the political activities of employees whose principal employment activities are funded in whole or in part with Federal funds. Authorized for Local Reproduction Standard Form 4248 (Rev. 7-97) Prescribed by OMB Circular A-102 9. Will comply, as applicable, with the provisions of the Davis- Bacon Act (40 U.S.C. §§276a to 276a-7), the Copeland Act (40 U.S.C. §276c and 18 U.S.C. §874), and the Contract Work Hours and Safety Standards Act {40 U.S. C. §§327- 333), regarding labor standards for federally-assisted construction subagreements. 10. Will comply, if applicable, with flood insurance purchase requirements of Section 1 02{a) of the Flood Disaster Protection Act of 1973 (P.L. 93-234) which requires recipients in a special flood hazard area to participate in the program and to purchase flood insurance if the total cost of insurable construction and acquisition is $10,000 or more. 11. Will comply with environmental standards which may be prescribed pursuant to the following: (a) institution of environmental quality control measures under the National Environmental Policy Act of 1969 (P.L. 91-190) and Executive Order (EO) 11514; (b) notification of violating facilities pursuant to EO 11738; (c) protection of wetlands pursuant to EO 11 990; (d) evaluation of flood hazards in floodplains in accordance with EO 11988; (e) assurance of project consistency with the approved State management program developed under the Coastal Zone Management Act of 1972 (16 U.S.C. §§1451 et seq.); (f) conformity of Federal actions to State (Clean Air) Implementation Plans under Section 176(c} of the Clean Air Act of 1955, as amended (42 U.S.C. §§7401 et seq.); (g) protection of underground sources of drinking water under the Safe Drinking Water Act of 1974, as amended (P.L. 93-523); and, {h) protection of endangered species under the Endangered Species Act of 1973, as amended (P.L. 93- 205). • SIGNATURE OF AUTHORIZED CERTIFYING OFFICIAL 12. Will comply with the Wild and Scenic Rivers Act of 1968 (16 U.S.C. §§1271 et seq.} related to protecting components or potential components of the national wild and scenic rivers system. 13. Will assist the awarding agency in assuring compliance with Section 106 of the National Historic Preservation Act of 1966, as amended (16 U.S.C. §470), EO 11593 (identification and protection of historic properties), and the Archaeological and Historic Preservation Act of 1974 (16 U.S.C. §§469a-1 et seq.). 14. Will comply with P.L. 93-348 regarding the protection of human subjects involved in research, development, and related activities supported by this award of assistance. 15. Will comply with the Laboratory Animal Welfare Act of 1966 (P.L 89-544, as amended, 7 U.S.C. §§2131 et seq.) pertaining to the care, handling, and treatment of warm blooded animals held for research, teaching, or other activities supported by this award of assistance. 16. Will comply with the Lead-Based Paint Poisoning Prevention Act (42 U.S.C. §§4801 et seq.} which prohibits the use of lead-based paint in construction or rehabilitation of residence structures. 17. Will cause to be performed the required financial and compliance audits in accordance with the Single Audit Act Amendments of 1996 and OMB Circular No. A-133, "Audits of States, Local Governments, and Non-Profit Organizations." 18. Will comply with all applicable requirements of all other Federal laws, executive orders, regulations, and policies governing this program. *TITLE Harnett County Emerge~cy Managemen): I Standard Form 4248 (Rev. 7-97) Back lOBBYING ACTIVITIES Complete this form to disclose lobbying activities pursuant to 31 U.S.C.1352 Approved by OMB 0348-0046 1. * Type of Federal Action: 2. * Status of Federal Action: 3. * Report Type: 0 a contract 0 a. bid/offer/application (g) a. initial filing §"""" I.BJ b. initial award 0 b. materia! change c. cooperative agreement 0 c. post-award d_loan 0 e. loan guarantee 0 f. loan insurance 4. Name and Address of Reporting Entity: I.B]Pnme OsubAwardee *Name !Harnett County: Emerg.Mg:mt. I "Streett leI Q I Box 370 I Street 2 11 O O 5 Edwards Bros. Drive I "City (Lillington I State I NC I Zip !27 5461 Congressional Districl, if known: l_ I :5. If ~er;o;tinu Enti!y in No.4 is 3ubawmdeC>, Ente1 Name ;:Jncl ,c\cidress o>' Prime: 6. * Federal Department/Agency: 1. *Federal Program Name/Description: I N/A I I CFDA Number, if applicable: I I 8. Federal Action Number, if known: 9. Award Amount, if known: I I $I I 10. a. Name and Address of lobbying Registrant: Prefix 1 I "First Name J N /A Middle Name I I •Last Name I N/A I Sufflx I I •street! I I Street2 I I • City I State I I Zip I I b. Individual Performing Services (indudingaddressiFdifferentfromNa 10a) Prefix I ,. Arst Name j 1\T / 11. Middle Name I I •Last Name j _N /11 I Suffix I I • Street 1 I I Street2 1 I • City I J State L I Zip I I 11. Information requested through this form is authorized by tiUe 31 U.S.C. section 1352. This disclosure of lobbying activities is a material representation of fact upon which reliance was placed by the tier above when the transaction was made or entered into. This disclosure is required pursuant to 31 U.S.C. 1352. This information wJII be reported to the Congress semi-annually and will be available for public inspection. Any person who fails to file the required disclosure shalf be subject to a civil penafty of not Jess than $10,000 and not more than $100,000 for each such failure. r • Signature: ft -1:5Pt/J1 }t-1._ fA/..r_/JL.-/.A, J. A I *Name: I I l3everly I Middle Name I I "LEsiName I Wi 11 i ~me::: I Sufflx I I Title: !Eme;r;:g: • Mg:mt • Coordina to~ Telephone No.:~ 1 0 893-7580 I Data: m 1 1 -2 5 -1 3_ ! Federal Use Only: l Authorizsd fo< Looal Reproduction Standan::l Form -LU (Rev. 7 -97} Board Meeting Agenda Item Agenda Item 4-H MEETING DATE: January 6, 2014 TO: HARNETT COUNTY BOARD OF COMMISSIONERS SUBJECT: Sign Blade Maintenance Contract REQUESTED BY: IT Department (E-911 Division) REQUEST: Permission to contract with Fred R. Burgess for sign blade maintenance. Contract will be paid out of account 110-5900-420.33-45. COUNTY MANAGER'S RECOMMENDATION: C:\U sers\bblinson \AppData\Local\Microsoft\ Windows\ Temporary Internet Files\Content. Outlook\ 1 EAS44 IB\agendaform20 14-01 06-Sign-Blade-Maintenance.doc 1 of 1 Page -BOOGET ORDINANCE AMENDMENT BE IT ORDAINED by the Governing Board of the County of Harnett, North Carolrna, that the following amendment be made to the annual budget ordinance for the fiscal year ending June 30, 2014: Section 1. To amend the Emergency Telephone System Fund, the appropriations are to be changed as follows: EXPENDITURE AMOUNT AMOUNT CODE NUMBER DESCRIPTION Of CODE INCREASE DECREASE llG-5900-420.33-45 Contracted Services $5,000 llG-5900-420.60-61 Road Signs/Materials $5,000 RMNUE AMOUNT AMOUNT CODE NUMBER DESCRIPTION OF CODE INCREASE DECREASE EXPI.ANA110N: Funds are needed to cover the new Sign Blade Maintenance Contract, due to the early retirement of the county employee that was making the sign blades. APPROVALS: Finance Officer (date) County Manager (date} Section 2. Copies of this budget amendment shall be furnished to the Clerk to the Board, and to the Budget Officer and the Rna nee Officer for their direction. Adopted this day of Margaret Regina Wheeler, Acting Clerk to the Board ,2013. Jim Burgin, Chairman Harnett County Board of Commissioners NORTH CAROLINA HARNETT COUNTY CONTRACT FOR SIGN BLADE MAINTENANCE THIS CONTRACT FOR SIGN BLADE MAINTENANCE ("Contract") is made and entered into as of this 6th day of January, 2014, by and between the County of Harnett, a body politic, organized and existing under the laws of the State of North Carolina (hereinafter referred to as "County"), and Fred R. Burgess, Sr., a resident of Lillington, North Carolina, (hereinafter referred to as "Contractor"); WHEREAS, County desires sign blade maintenance services, as described herein, for the County; WHEREAS, Contractor desires to provide sign blade maintenance services; WHEREAS, County and Contractor have reached an agreement for the sign blade maintenance services described herein and the parties desire to set forth the terms and conditions of this agreement in this Contract; and NOW, THEREFORE, in consideration of the mutual benefits, representations, and agreements contained herein and for good and valuable consideration, the receipt and sufficiency of which are hereby acknowledged, the parties agree, each with the other, as follows: 1. Purpose. The purpose of this Contract is to set forth the understandings and agreements of the parties regarding the sign blade maintenance services to be performed by Contractor for the County. 2. Contract Term. This is a five month contract beginning on February 1, 2014 and ending on June 30,2014, subject to appropriation by the Harnett County Board of Commissioners. Should the funds for this Contract not be appropriated by the Harnett County Board of Commissioners, this Contract shall be terminated by the County upon ten ( 1 0) days written notice to Contractor. 3. Contract Price. Contractor shall perform the services described herein pursuant to the fee schedule set forth in Exhibit A, attached hereto and hereby incorporated herein. 4. Contract Extension. County reserves the right to renew this Contract after the initial contract term expires subject to the same terms and conditions, upon agreement of both parties, provided that funds have been appropriated by the governing board and performance under this Contract by Contractor has been satisfactory. Any price increase requested by Contractor shall be considered at contract renewal time, and may be cause for non-renewal. 5. Compliance with Laws. Contractor shall obtain and maintain all licenses, permits, liability insurance, worker's compensation insurance and comply with any and all other standards or regulations required by Federal, State, or County statute, ordinances and rules during the performance of any contract between Contractor and the County. 6. Guarantee. Unless otherwise specified by the County, Contractor will unconditionally guarantee the service and workmanship of all services. Any defects occurring that are due to faulty services shall be repaired and/or replaced by Contractor at its sole expense, to the complete satisfaction of the County. These repairs, replacements, or adjustments shall be made only at such time designated by the County to be the least detrimental to the operation of County business. 7. Indemnity & Insurance. To the extent permitted by law, Contractor will indemnify and hold harmless the County, its officers, agents, and employees from and against all loss, cost, damage, expense and liability caused by accident or other occurrence resulting in bodily injury, including death and disease to any person, or damage or destruction to property, real or personal, arising directly or indirectly from operations, products, or services rendered or purchased under this Contract. Contractor, at its sole expense, will purchase and maintain automobile bodily injury and property damage liability insurance; commercial general liability to include bodily injury and property damage liability as will protect the Contractor from claims of bodily injury or property damages which arise from operations of this contract; and workers' compensation and employers' liability meeting the statutory requirements of the State ofNorth Carolina. Contractor shall provide the County with a certificate of such insurance naming County as an additional insured and containing the provision that the County will be given thirty (30) days written notice of any intent to amend or terminate said policy by either the insured or the insuring company. However, a ten (10) day notice is sufficient for cancellation by the insuring company due to non-payment of premium. 8. Default Provision. Failure to satisfactorily perform the services required by this Contract will be grounds for the County to declare Contractor in default. Upon default by Contractor, County shall provide thirty (30) days written notice to Contractor of its default, if said default is not corrected by Contractor within this thirty (3 0) day period, this Contract may be canceled or annulled, in whole or in part, by the County for nonperformance or violation of this Contract's terms. Upon cancellation of the services of Contractor by the County, an award may be made to another vendor and Contractor shall be liable to County for costs to the County in excess of the defaulted contract prices. Contractor shall continue the performance of this Contract to the extent that any part is not terminated under the provisions of this clause. 9. Equipment and Supplies. The sign blades, a computer with sign making software, a plotter/printer, and all sign blade materials/products/equipment needed to complete a sign blade will be provided in a climate controlled work area. 10. Services to be Performed by Contractor. The Contractor shall be allowed to use County facilities and equipment during regular County operating hours. The Contractor shall contact a member of the County Addressing Staff in person or by telephone a minimum of once a week for a sign blade request update. If a sign blade is needed ASAP, and the County notifies the Contractor of such, the Contractor shall make the needed sign blade within 2 working days. Sign blades shall be made according to the directions and instructions on the Road Sign Installation Request Form prepared by the County. Sign blades shall be made in the order requested by the County. If a sign blade is incorrectly made, at the fault of the Contractor, the Contractor shall remake the sign blade with no additional labor cost to the County. 11. Personnel Qualifications. The Contractor warrants and agrees that all of its personnel performing service and maintenance upon the County sign blades pursuant to this proposal shall be trained for the services they are to perform. 12. Payments. The Contractor shall invoice the County a minimum of once a month or a maximum of once a week. The invoice shall have all completed Road Sign Installation Request Forms attached to it. Each Road Sign Installation Request Form shall show itemized cost and the date the sign blades were made. The payment terms shall be Net 10 days. 13. Transfer, Assignment or Subcontract. The covenants and agreements contained in this Contract are specifically binding upon the parties hereto. Contractor may not transfer, assign or subcontract any rights or obligations under this Contract to any other party or parties without the express written consent of the County. In the event that the County consents to Contractor's assignment, Contractor shall continue to remain liable notwithstanding such assignment for the future performance of all of the terms, covenants and conditions of this Contract. 14. Mediation. Any claim, dispute or other matter in question arising out of or related to this Contract shall be subject to mediation as a condition precedent to the institution of legal or equitable proceedings by either party. The Parties agree that the mediation will be conducted and governed by the North Carolina Rules Implementing Statewide Mediated Settlement Conferences in Superior Court Civil Actions, and N.G. Gen. Stat. §7A-38.1(c), except as specifically provided otherwise herein. The parties shall share the mediator's fee and any filing fees equally. The mediation shall be held in Harnett County, unless another location is mutually agreed upon. Agreements reached in mediation shall be enforceable as settlement agreements in any court having jurisdiction thereof. 15. Governing Law and Venue. This Contract shall be governed by the laws of the State of North Carolina. Any action or proceeding brought under this Contract shall be filed and heard in the Superior Court of Harnett County. 16. Entire Agreement. This Contract represents the entire and integrated agreement between County and Contractor and supersedes all prior negotiations, representations or agreements, either written or oral. This Contract may only be amended by written instrument signed by County and Contractor. 17. No Third Party Beneficiaries. Nothing contained in this Contract shall create a contractual relationship with, or cause of action in favor of, a third party against Contractor or County. 18. Severance Clause. In the event any provision of this Agreement is adjudged to be not enforceable or found invalid, such provision shall be stricken and the remaining provisions shall be valid and enforceable. 19. Notices. All notices or other communications which shall be made pursuant hereto shall be in writing and shall be deemed to be given and received (a) when hand delivered to the address stated below, (b) three (3) days after being mailed to the address stated below, postage prepaid by certified or registered mail of the United States, return receipt requested to the address set forth below: TO CONTRACTOR: Fred R. Burgess, Sr. 8198 McDougald Rd Lillington, North Carolina 27546 TO COUNTY: With copy to: County of Harnett: Attn: E911 Operations Administrator 305 W. Cornelius Harnett Blvd, Suite 100 Lillington, North Carolina 27546 County of Harnett Attn: County Staff Attorney Post Office Box 238 (mail) 102 E. Front Street (physical) Lillington, North Carolina 27546 Either party to this Contract may change its designated person or designated address at any time and from time to time by giving notice of such change to the other party in the manner set forth above. 20. Equal Opportunity Employer. Harnett County is an equal employment opportunity employer. The County is a federal contractor, and therefore the provisions and affirmative action obligations of41 CFR § 60-1.4(a), 41 CFR 60-741.4, and 41 CFR 60-250.4 are incorporated herein by reference, where applicable. IN WITNESS WHEREOF, the parties hereto, through their duly authorized representatives or officers have executed this Contract as to the date and year first above written. CONTRACTOR: Fred R. Burgess, Sr. Zl (SEAL) COUNTY OF HARNETT: By: ------------------------------Name: Tommy Burns Title: County Manager This instrument has been preaudited in the manner required by the Local Government Budget and Fiscal Control Act. By: -----------------------------Name: Kimberly Honeycutt Title: County Finance Officer Sign Blade Price List Exhibit A 9" Single Sided Sign Blade Without Ranges $8.50 9" Single Sided Sign Blade With Ranges $15.30 6" Single Sided Sign Blade Without Ranges $6.80 6" Double Sided Sign Blade (for Anderson Creek Club) $8.50 Double Sided Address Sign Blade $7.14 Single Sided Address Sign Blade $4.76 STATE OF NORTH CAROLINA AFFIDAVIT COUNTY OF HARNETT ************************** I, ___ Fred R. Burgess _____ (the individual attesting below), being duly authorized by and on behalf of_County ofHamett. _____________ (Contractor "Employer") after first being duly sworn hereby swears or affirms as follows: 1. Employer understands that E-Verify is the federal E-Verify program operated by the United States Department of Homeland Security and other federal agencies, or any successor or equivalent program used to verify the work authorization of newly hired employees pursuant to federal law in accordance with NCGS §64-25(5). 2. Employer is a person, business entity, or other organization that transacts business in this State and that employs 25 or more employees in this State. (mark Yes or No) a. YESL, or b. NO 3. Employer understands that Employers Must Use E-Verify. Each employer, after hiring an employee to work in the United States, shall verify the work authorization of the employee through E-Verify in accordance with NCGS§64-26(a). 4. Employer's subcontractors comply withE-Verify pursuant to federal law, and Employer will ensure compliance with E-Verify by any subcontractors subsequently hired by Employer. This _13_ day of_ December _____ __, 2013 Print or Type Name: Fred R. Burgess. __________ _ State ofNorth Carolina County of f}-o.v fl..ef-J-- Signed and sworn to (or affirmed) before me, this the /1 ~ My Commission Expires: "7-. ,201 ~ IT: Fred R. Burgess, Sr LS 14-3 1 0 Board Meeting Agenda Item Agenda Item L/-T MEETING DATE: January 6, 2014 TO: HARNETT COUNTY BOARD OF COMMISSIONERS SUBJECT: HARTS Transit Services Manager Salary Adjustment REQUESTED BY: Human Resources, on behalf of General Services REQUEST: Human Resources, on behalf of General Services, requests the Board of Commissioners consider and approve a salary increase for the vacant position of Transit Services Manager (Class code 91). Salary increase will be absorbed through current budget. The over-riding reason for the increase request is two-fold. This position requires a professional managing transportation planner and/or business administrator with a 4-year degree or like experience to oversee the operations of a $1.0 million O&M budget, 4 full-time and 32 part-time employees, 20+ vehicles amassing 800,000+ miles annually and the know-how to guide this organization through operational transition. In addition, the Director requests this increase to solicit and attract solid, experienced professionals to help direct the organization through strategic change. Finally, NCDOT/Public Transportation Division Mobility Project specialist for Harnett County indicates a salary increase could be re-couped on the FY15 (July 14- June 15) 5011 Administration grant salary expenditures line and be identified for future grant opportunities reimbursments. IfBOC approved, hiring salary range will be $40,100- $42,500. COUNTY MANAGER'S RECOMMENDATION: C:\Users\gwheeler\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\Z5TP9EAN\agenda request Transit Sys Mgr increase January 2014 (2).doc Page 1 of 1 Agenda Item Board Meeting Agenda Item -. \:.J~uk~~-'i C, ZOiLf MEETING DATE:~~~ TO: HARNETT COUNTY BOARD OF COMMISSIONERS SUBJECT: Grant Request -!us~. Komen REQUESTED BY: Joh(Jull REQUEST: The Harnett County Board of Health at its meeting on November 21, 2013, approved to submit grant application as follows: The Harnett County Health Department is requesting to submit a grant application to North Carolina Triangle to the Coast Affiliate of Susan G. Komen grant funds which will become available 2014. The grant seeks innovative projects in the areas of breast health and breast cancer education, outreach, screening, etc., targeting services not otherwise available to the medically underserved populations: The Health Department is requesting to apply for this grant to support program expansion by making available additional educational programs within the community and providing additional mobile mammography screening dates through a partnership with Rex Mobile Mammography. • For 2012, a total of 12 mobile mammography screenings were offered, with approximately 257 women receiving screenings and 68% or 176 of these women were uninsured. • YTD: January to November 2013, currently we have screened 214 women, with 71% or 153 ofthese women were uninsured. Two additional screenings are scheduled for December 5 and 1 0, 2013. We anticipate surpassing the last year's number which supports the need for additional screening dates to meet the need within Harnett County. No matching funds are required. Thank you for your consideration for giving us the opportunity to apply for this grant. THIS INSTRUMENT HAS BEEN REVIEWED ~THE FINANCE OFFICER HARNE~*~ U:\my documents\1-Winword\BOC Mtg Request\Susan G Komen Grant Request 12-2013.doc 1 of2 Page Agenda Item 6 January 6, 2014 APPOINTMENTS NEEDED ADULT CARE HOME COMMUNITY ADVISORY COMMITTEE We need members on this committee. Members receive mileage reimbursement as claimed. AGRICULTURAL ADVISORY BOARD We have a vacancy for on this board for District 4. BOARD OF ADJUSTMENT We have a vacancy for an alternate member on this board for District 1. TOWN OF ERWIN PLANNING BOARD-ETJ MEMBER Town of Erwin Board of Commissioners recommends the appointment of Gary B. Blackmon to serve as an ETJ member of their Planning Board. BOARD OF HEALTH Health Director John Rouse respectfully requests appointment of Dr. Mike Soderling to serve on this Board. HARNETT NURSING HOME COMMUNITY ADVISORY COMMITTEE We need members on this committee. Members receive mileage reimbursement as claimed. HISTORIC PROPERTIES COMMISSION We currently have a vacancy for a regular member in District 3. Bryan Avery recently resigned recently. We currently have a vacancy for a regular member in District 5. MID-CAROLINA AGING ADVISORY COMMITTEE We need members on this committee. Members receive mileage reimbursement as claimed. Page 1 -Appointments Gina Wheeler From: Sent: To: Subject: Attachments: Hello Gina, Cynthia Patterson <cpatterson@erwin-nc.org> Thursday, December 12, 2013 3:13 PM Gina Wheeler Out of Town Planning Board Alternate Gary Blackmon.pdf Please see the attached recommendation for the Erwin Planning Board (Out of Town). The Board of Commissioner's approved this at the December sth meeting. Thank you, Cynthia B. Patterson, CMCINCCMC Town Clerk/Accts. Payable Town of Erwin P.O. Box459 Erwin, NC. 28339 910-897-5140 (Ext. 224) 910-897-5543 (Fax) 1 'Ih~ T:1'Viirt ~/~ ili:W''/.~~!ll. 2:1r-:crr·'=:.~i.n:r:0 ~~~~~ ~:n.t.£t'ef:1 ftn ;F.'!f'\~ilL..,:i o~1 ~ 15f!l:}I'cl.sn1:lt ~~~r11 [rr,z.:;:ts t~~a1 vvt: j-.. "' .._ ~ .. :1"f~mr J:~t·.~· t~ .. -~ ftL~L~!.P-;v:ltr .. ~ ~1f'ZJl]it1~t~{]il£ 'Jrn~s "1fjt]~~:~m\ti1lfi Ii'\Pri 1~ l:§~~ ~~ ;::H;::a ,{ ;lpF.?,~"4"Jj~~;.t~<~lf! ba~~-~!.~ Vl£ ;"'l'JJ:JJ.: ::u:~.e'"' ;;;~"!-1:rn ;:p!:2y3n§ ~{]'"':' "' Jt:p·~r,;t fu tlb:: 'K'~':YJG! oif .E;r·.-~;1!. i\!JD1icai1i 1 :a1.1c: -· 0.B.!.':..c:f----~-· . .8JB:t;,._~-~-y __ Date .:' ;,;.;;pl'cation: .§.t...J.J..'f.j --~(3 Hom" ;-;_ddn .. ss: ____ 'k>._ .. .BEE .. 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Yes __ No v-- Ir yes, plea:~; explain _______ -----·---····---·----------····---·-·--···-·-----·· _______________ ---·---- Any e•.':dcnce found to be incorrect on t:te apnlirr,:hn P'":\Y result in disqualib~~.t<1 · _ DJeq<)e write a bri~,· state;::ent :•s to ,_v;1~' you are iilt..::;·esterl ;,1 s~rv:·;g r'<1 one o-:: the:::e B('<~nl·;. ____ z__}J_~-~--"?. ... f.r __ fi._~J ..... t~ .£r~--~ ~--·· !.'::::-?~--!J:!..'f---~! .. f..t!!:-. ..; ... ~l!...~!:-1 __ ~J.l"F!:~ ... a ______ _ b (' q_ ;2rlll! I' -q-e .{J-rt-. (/ c iJ efb P......t" ,._"/ 8 -fJ-MI.( t:b~Y. '10..,; 4.-) ~ r , I :~~<: ?§.i; :L·.u:L.:,~ ~~ ~~ ~f!li ~; i 2 .~~~nr~J 1 1If2~ a~~~T ~:rm:; IF 1~Ef:4r-.!iit .!:~ IB :P~i!: i! t~./ ~.\:·.DTI~: ~:·:~!1/, ':'---,; ./:Cil·c·;~ .rrc .. ::'~ j J. :..1 /lu~TI :r. -..:t :l-... ~ !.l~J~e ··!(r) .... z:~r·~,,;-; o .. _. taKT>~1J;·~;l, T~-:;;~~ '·~~o 15 ar COUNTY NORTH CAROLDlA December 16, 2013 TO: FROM: SUBJECT: Tommy Burns County Manager BOH Members Department of Public Health www.harnett.org Harnett County Go, ernment Complex 307 W Cornelius Harnett Boulevard Lillington, NC 27546 ph 910-893-7550 fax: 910-893-9429 I am submitting a Board of Health application for Dr. Mike Soderling to replace a member who has served 9 years on the Board. Dr. Soderling works as a Professor at Campbell University. He currently resides in Harnett County. Please let me know if you have any questions. strong roots· new growth APPLICATION TO SERVE ON A BOARD APPOINTED BY THE HARNETT COUNTY BOARD OF COMMISSIONERS BOARD: _ ____,A"'+'.d!.,_··, L-J.'f;e__,.-'/=~:::::.:::__¥A_--'---:~~--=----------- U c:::-n _ - NAME: ----il-m-'---'---,ri/!-Y0""-'es:;;,... _ _._dJ52X-f'~~o_:r~{~;}Lg~,___.-~-, ______ _ ADDRESS: _ _Lj_~___,~~~~_::_Fm~e___s..c::lJ~r __ L:.:_::__:_r!._.!_#t_I~-J--L/6>1 _______ _ VOTING DISTRICT: (Please check district number in which you live): D District 1, Commissioner Hill's D District 4, Commissioner Springle's D District 2, Commissioner House's D District 5, Commissioner Miller's D District 3, Commissioner Burgin's TELEPHONE: (HOME) 9/ {) _. r;;q J ,, ) Sf? 5-(WORK) PRESENT OCCUPATION: ---ll~-"r--'~"-(,___,(~~,---~,C=--I--=-{1~§L..l7f11"'----'------------ L,L-f- YEARSOFFORMALEDUCATION: ----~--~~----------------------------------- CIVIC AND FRATERNAL ORGANIZATIONS IN WHICH YOU HAVE PARTICIPATED: PLEASE TELL WHY YOU WOULD LIKE TO SERVE ON THE ABOVE LISTED BOARD: DATE: ~~;; &1 l FOR OFFICE USE ONLY: ~0' r N~~~ ~a! ;£t.~ ,/" . I ~ SIGNATURE:(~:~~ **************************************** DATERECEIVED: ------------------------------------------------------ DATE FORWARDED TO COUNTY COMMISSIONERS: ---------------- NO R T H CA R O L I N A DI V I S I O N OF VE T E R A N S AF F A I R S 7 AC T I V I T I E S RE P O R T I N G FO R M Agenda Item _ __._~.--- NC D V A - 2 Re v . De c . 2 0 0 7 C o u n t y / D i s t r i c t : _ Ha r n e t t Mo n t h / Y e a r : ] ) t e e m ac dVI3 Co r r e s p o n d e n c e Re q u e s t fo r Se r v i c e Ou t (T e l e p h o n e an d In - P e r s o n ) Wr i t t e n Ac t i o n Ta k e n (c l a i m s & development) In - P e r s o n 0> 3l ..l!3 Q. ) E It= 0 E " 0 c: (J) - c: ... . ~ c: CiS i= tU 0 c: (J) "0 IJ . . (J) 0 'E 0 c: 0 co c: ... . . 0 'i i i 0 m - ~ Q. ) (! ) ( 0 "( i j E c: c: 'i i i " 0 0 m f/) (/) G) ... . . .. c 0 0 (J ) c: .. . . . . c: f/ ) .£: :::J m 0 . ~ c: E c ~ - :; : : : . z a. . ~ m .9 - -e 0 0 u. ... . . Q. ) ~ 0 m c: (!) I 0 ~ E 0. . Q j f / ) I f/ ) I c: . . c : (J) :;:::. c: ~ c: .c 0 > o . c: .! ! l . -c : ( / ) .. - - 0 f/ ) E m ~f/) m m 'i : : : N . . ff i ~ (.) Q. ) ... . . Q . m " 0 (! ) :: : 1 (J ) m ~ -§ 't= c:Cl 8 en u: c: 0 '9 ~ a . I Be (J) c: !: ! Q. ) G) ~ 'i : : Q. ) (J ) m ..c: Q) ~ - - " 0 E ~ ~ :0 t: f/)~ .. . . . .. c " i w Q. ) ~ .s : : co 0 ( . ) c. ~ :: : J . . c : a. (/) m ~ - :: J 0 - ~ ( Y ) _ 8 ~ ~ " 0 0 (J) (J) 0 ~ ·- 0 Na m e ~ 0 I - 0 ( ! ) 5 ~ 0 : ; a 0 we n 0 ~ z a....O ~ 28 7 6 12 35 7 10 11 38 4 5 2 10 9 24 3 5 5 1 48 ~ - ; ~ /[? 7 ~ b:/" 1-. 1 ( / . . - ( . A . . . 7 ' ~ P D ~ Er i c Tr u e s d a l e Ha r n e t t Co u n t y Ve t e r a n s Of f i c e r £ ~ ~ 1 ) / t V-. 7 i' J . f I rtt - I .. ; I ; - / f t r7 rn bn ~ ve ' _ j ~!Is i To t a l 28 7 6 12 35 7 10 11 38 4 5 2 10 9 24 3 5 5_11..-48 INCORPORATED MAIN OFFICE Phone 919-934-2145 Fax 919-934-6231 Post Office Drawer 711 11 02 Massey Street Smithfield, NC 27577 Ms. Margaret R. Wheeler, Clerk Harnett County Commissioners 107 E. Front St. Lillington, N.C. 27546 Dear Ms. Wheeler: LEE COUNTY OFFICE Phone 919-776-0746 Fax 919-774-1867 Post Office Box 1061 225 S. Steele Street Sanford, NC 27330 December 17, 2013 Agenda Item __ 7_.._ __ HARNETT COUNTY OFFICE Phone 910-814-8360 Fax 910-814-8362 Post Office Box 40 745 Shawtown Rd., Suite A Lillington, NC 27546-0040 Pursuant to Instruction 20 of the August 5, 1982 OEO Letter of Instruction and State Administrative Code entitled "Review of Local Agencies Program Year and Community Service Block Grant Anti-Poverty Plan by Public and County Commissioner's, we are pleased to submit this plan for your review. We would appreciate you signing and notarizing the attached form, that you have received the grant to go to the Commissioners and if there are comments please provide them to be included in the grant. lfyou need additional information, please don't hesitate to let us know. EMW/ Enclosure: Sincerely, E. Marie Watson Executive Director AN EQUAL OPPORTUNITY EMPLOYER UNITED WAY AGENCY North Carolina Department of Health and Human Services Division of Social Services/Economic and Family Services Agency: Federal J.D. DUNS Number: . ~ OFFICE of~ ECONOMIC OPPORTUNITY Community Services Block Grant Program Fiscal Year 2014-15 Application for Funding Project Period July 1, 2014-June 30,2015 Application Due Date: January 31,2014 Applicant Information Johnston-Lee-Harnett Community Action, Inc 560859623 153233663 Administrative Office Address: 1102 Massey Street, Smithfield. NC 27577 Mailing Address: Post Office Drawer 711, Smithfield, NC 27577 Telephone Number: 919.934.2145 Fax Number: 919.934-6231 Board Chairperson: Mr. Robert W. Atkinson Board Chairperson's Address: 4212 Massey-Holt Road, Princeton, NC 27569 (where communications should be sent) Board Chairperson's Term of Office: 10/13/2012-10/13/13 Executive Director: Mrs./ E. Marie Watson Executive Director Email Address: jlhca@jlhcommunityaction.org Agency Fiscal Officer: Mrs. Lakisha Nichols Fiscal Officer Email Address: lanichols@jlhcommunityaction.org CSBG Program Director: Ms. Tina Ray CSBG Program Director Email Address: tinarray@jlhcommunityaction.org Counties Served with CSBG funds: Johnston, Lee and Harnett North Carolina Department of Health and Human Services Office of Economic Opportunity-Verna P. Best, Director 2420 Mail Service Center I Raleigh, North Carolina 27699-2420 http://www.ncdhhs.gov/oeo/ JLHCA, Inc Checklist to Submit a Complete Community Services Block Grant (CSBG) Application Please put a check mark in the appropriate box to show that you have included the completed document 'th r r All d t · d ·th th r f th th t "'f r bl " WI your app rca 1on. acumen s are requ1re WI e excep 1on o ose a say 1 app 1ca e. Item Signed Application Certification (blue ink only) Signed Board Membership Roster (blue ink only) Board of Directors Officers and Committees Planning Process Narrative Form 210-Agency Strategy for Eliminating Poverty Form 212 -One-Year Work Program Monitoring, Assessment and Evaluation Plan Form 212A-CSBG Administrative Support Worksheet (if applicable) Form 225-Agency Budget Information Form 225N-Budget Narrative A1212endices (to be attached by the Ar;1121icant}: • Organizational Chart • Job Description and Resume for the Agency's Executive Director • Job Description and Resume for the Agency's Chief Financial Officer • Job Descriptions for all CSBG employees (do not include names) • Affirmative Action Plan • Documentation of Public Hearings for Initial Planning Process: Copy of Public Notice(s) from Newspaper(s) Agenda of Public Meeting(s) Copy of Attendance Sheet(s) Minutes of Public Meeting(s) Ill Documentation for Notice of Intent to Apply: Copy of advertisement(s) • Documentation of Submission to County Commissioners: Certified document from county clerk Commissioners' comments or minutes (if applicable) • Cognizant-Approved Indirect Cost Agreement • Cost Allocation Plan (if applicable) • IRS State Exempt Letter • Contracts and Leases Forms to be comgleted by the AQ[;!Iicant. The forms are included: • • • • • • • • Verification of 501 (C)(3) Status (Annual) Notarized Conflict of Interest Policy/Acknowledgement Conflict of Interest Verification (Annual) State Grant Certification-No Overdue Tax Debts State Certification -Contractor Certifications Required by N.C. Law Federal Certifications Federal Funding Accountability and Transparency Act (FFATA) Attach evidence of Central Contractor Registration (CCR) Vehicle Registrations Fiscal Year 2014-15 Community Services Block Grant Application Page2 of 54 Included (.../) ./ ./ ./ ./ ./ ./ ./ ./ ./ ./ ./ ./ ./ ./ ./ ./ ./ ./ ./ ./ ./ ./ ./ ./ ./ ./ ./ ./ ./ ./ N/A Community Services Block Grant Program Fiscal Year 2014-15 Application for Funding Certification and Assurances Public Hearing on the Initial Plan JLHCA,Inc We herein certify that a public hearing as required by 1 OA NCAC 97B .0402 Citizen Participation in the Application Process occurred on January 17th, 19th and 191h 2012 for the initial planning process for the agency's current project plan and the agency has maintained documentation to confirm the process of the public hearing. For multi-county providers, indicate the date and the county the hearing was held. Date County Date County 1/19/2012 Johnston 1/17/2012 Lee 1/19/2012 Harnett County Commissioners' Review We herein certify that the application for this project period was submitted to the Board of County Commissioners for review and comment on --.:D::.!e~c.::::em~b~e~r-!..:13=20~1:.:::3 ___________ _ as required by 1 OA NCAC 97C .0111 (A). For multi-county providers, indicate the county and date the application for funding was presented to the Board of County Commissioners as required by 10A NCAC 97C .0111 (B). Date County Date County December 13, 2013 Johnston December 13, 2013 Lee December 13, 2013 Harnett Board of Directors Approval of the Application I hereby certify that the information contained in the attached application is true and the Board of Directors has reviewed and approved this application for the Community Services Block Grant Program. Date of Board Approval: December 12, 2013 Board Chairperson: (Signature) Finance Committee Chairperson: (Signature) Fiscal Year 2014-15 Community Services Block Grant Application Page 3 of 54 (Date) (Date) I Total Seats Per Agency Bylaws I 18 I I To t a l Cu r r e n t Va c a n t I 0 Se a t s Bo a r d of Di r e c t o r s ' Me m b e r s h i p Ro s t e r Total Number of Seats Reserved fo r Ea c h Po o r 8 Pu b l i c 6 Pr i v a t e 4 Sector Total Number of Vacant Seats Pe r Ea c h Po o r 0 Pu b l i c 0 Pr i v a t e 0 Sector Name Em a i l Ad d r e s s Co u n t y of Co m m u n i t y Gr o u p / Da t e In i t i a l l y Nu m b e r of Cu r r e n t Te r m Re s i d e n c e Ar e a Re p r e s e n t e d Se a t e d Te r m s Se r v e d Ex p i r a t i o n [m o n t h / y e a r ] [c o m p l e t e d ] [m o n t h / y e a r ] .... ;=r ---.. ·. _.· ; IL /- .. -.. -.-- · . - · .. _ .· ·· - - · · - · •·-- - - .... _ -·· · •.. _ ___ ···~ --· - - - · - - • ·.• : ·~R e p t e s e n t i t i ~ ~ , ; o f j t b e Bo o r : . · • · · - .. > > / • .• . . . . , ... • .• .. ·· . . :_ 1. Jackie McMillian Sa n f o r d CC C C / J o b l i n k 06 / 1 9 9 3 10 08 / 2 0 1 5 2. Pamela Thombs Jo h n s t o n NC C U , Co n s u m e r Fi n a n c i a l 09 / 2 0 0 8 3 02 / 2 0 1 5 3. David Barber Jo h n s t o n CS B G Po l i c y Ad v i s o r y Co u n c i l 11 4. Karen Wall Jo h n s t o n Pa r t n e r s h i p fo r Ch i l d r e n 10 / 2 0 0 6 3 01 / 2 0 1 5 5. Roger Pope Jo h n s t o n CS B G Po l i c y Ad v i s o r y Co u n c i l 09 / 2 0 0 9 2 06 / 2 0 1 5 6.Rev. Frank Taylor Ha r n e t t CS B G Po l i c y Ad v i s o r y Co u n c i l 04 / 2 0 0 7 3 06 / 2 0 1 5 7. Kayla McDougald Ha r n e t t He a d St a r t Po l i c y _ Co u n c i l 09 / 2 0 1 3 0 09 / 2 0 1 4 8. Latasha Sessoms Jo h n s t o n He a d St a r t Po l i c J _ Co u n c i l 11 / 2 0 1 3 0 11 / 2 0 1 4 ·_. : .. · . . ·. _. · Pu b l i c i E l l i c f i \ ! ' C i i o f f i c i i : i l s · . .. . . . . . _ 1.Robert W. Atkinson Jo h n s t o n Jo h n s t o n Co u n t y 02 / 2 0 0 6 3 02 / 2 0 1 4 Co m m i s s i o n e r s 2. C. Gordon Springle Ha r n e t t Ha r n e t t Co u n t y 01 / 2 0 1 3 0 01 / 2 0 1 6 Co m m i s s i o n e r s 3. Amy Dalrymple Le e Le e Co u n t y Co m m i s s i o n e r s 01 / 2 0 1 3 0 01 / 2 0 1 6 4. Ursela Mclean Ha r n e t t Ha r n e t t Co u n t y 04 / 2 0 0 6 3 02 / 2 0 1 5 Co m m i s s i o n e r s 5. Dawn Winn-Burdo Jo h n s t o n Jo h n s t o n Co u n t y 06 / 2 0 0 9 2 08 / 2 0 1 5 Co m m i s s i o n e r s 6. Rev. Dr. Ricky Frazier Le e Le e Co u n t y Co m m i s s i o n e r s 01 / 2 0 1 3 0 01 / 2 0 1 6 z ·•c. _:..·. .:. ; • : · ~~ · · . ;_ - . · •. _ .. · ·-_ - - · -- · · • . Re p ( e s e r i t a t i V e s : d t P r i v a t a i 0 t 9 a n i z a t i o n s -'- • · - - .·. f . ·· · - - ·-.. . . _.-.. · ·- : · ; •. _ .· 1.Louise Sewell Jo h n s t o n Jo h n s t o n Co u n t y Ci t i z e n s 08 / 1 9 9 8 7 00 9 / 2 0 1 4 As s o c i a t i o n 2.Joyce Holloman Jo h n s t o n Co m m u n i t y & Se n i o r Se r v i c e s 04 / 2 0 0 6 3 01 / 2 0 1 4 3. Jerry Lemmond Le e En r i c h m e n t Ce n t e r 02 / 2 0 0 1 6 01 / 2 0 1 4 4. Jim Currin Ha r n e t t Ru r i t a n Clu b 10 / 2 0 0 6 3 08 / 2 0 1 3 ~--··-···· - - - - · - - - The signature of the Board of Di r e c t o r s Ch a i r p e r s o n ce r t i f i e s th a t th e pe r s o n s re p r e s e n t i n g th e po o r we r e se l e c t e d by a de m o c r a t i c pr o c e s s an d th a t th e r e is do c u m e n t a t i o n on fi l e that confirms the selection of al l bo a r d me m b e r s . In ad d i t i o n , by si g n i n g be l o w , th e Bo a r d of Di r e c t o r s Ch a i r p e r s o n co n f i r m s th a t th e se l e c t i o n of al l bo a r d me m b e r s co i n c i d e s wi t h the directives outlined in the ag e n c y ' s by l a w s an d th a t a cu r r e n t Bo a r d of Di r e c t o r s Me m b e r Pr o f i l e is on fi l e fo r ea c h me m b e r . Bo a r d of Di r e c t o r s Ch a i r p e r s o n Board of Directors' Officers and Committees Note: All committees of the board should fairly reflect the composition of the board (10A NCAC 97C .01 09). Be sure to identify the chairperson and other committee positions. *To be completed by agencies serving multiple counties. Community Services Block Grant Program Fiscal Year 2014-15 Application for Funding Planning Process Narrative ROMA Goals 1, 3 and 5 Low income People Become More Self-Sufficient; Low income People Own a Stake in their Community; Agencies increase their capacity to achieve results DHHS Excels-Goal 2 Expand understanding and use of information to enhance the health and safety of North Carolinians 1. Explain in detail how each of the following was involved in the planning and development of this strategic plan. a. The Poor: * The CSBG STARS Program will have Policy Advisory Council in all three counties according to the following design: * Five low-income participants either participants or persons in the community that can represent low-income people because of their involvement with them and their understanding of their problems. * Six representatives selected from the following agencies: Department of Social Services, NC Cooperative Extension Program, Community College, Public Library, Legal Services, Division of Employment Services and Job Link. etc. * The STARS (Successfully Transitioning to Achieve Real Self-Sufficiency Policy Advisory Council's) in each county will meet at least once per quarter in conjunction with the agency's preparation of OEO Form 240 Report to review program performance to date and to propose modifications (if needed) in the program geared at achieving more effective services. They also share pertinent information from their agency and/or area that could be beneficial to the STARS participants as well as the program. * The Policy Advisory Council will review and recommend funding proposals and other prospective changes to the STARS program to the Board of Directors. * Representatives from the low-income community complete need survey and distribute surveys to residents in their own communities or in their workplace. * Representatives from the low-income serve as a Policy Advisory Council representative to the Board of Directors. * The Policy Advisory Council will review any proposed changes in the STARS program and submit them to the Board of Directors for approval, ex. Procedures manuals, etc .. b. The Staff: * Staff members played a crucial role in the planning and developmental process of the strategic plan. A number of strategic planning sessions was held with the S.T.A.R.S. staff to re-evaluate the strategies from the previous program year. This helped to determine the effectiveness of the plan and if the needs expressed on the Needs Assessments were addressed. * Working with staff, activities was planned for the next program year that would best meet the needs listed by the program participants and the survey contributors using the most efficient method possible. Staff members distributed, collected and quantified the survey data during the strategic planning stage. The CSBG Director and other staff members contacted other agencies and organizations in our service areas to collect data. The CSBG Director compiled the data to develop a demographical profile of all three counties. c. The Board: * The Board will meet bi-monthly to: * Receive administration's assessment of project operation and process. ROMA Goal5 JLHCA, Inc Planning Process Narrative (Continued) * On its own they will review the bi-monthly computer generated printouts that are mailed to them prior to the board meeting showing progress made toward the timely fulfillment of Performance Measures. * Receive the report, advice and recommendations of the Board Planning and Evaluation Committee with respect to suggestions made by the STARS Policy Advisory Councils for program enhancement, as well as with respect to their own suggestions. * Participate and/or conduct public relation activities designed to highlight the agency's accomplishments. DHHS Excels-Goals 1 and 2 Agencies increase their capacity to achieve results Manage resources that provide an elevated level of effective and efficient delivery of services and programs to North Carolinians; Expand understanding and use of information to enhance the health and safety of North Carolinians 2. Describe your agency's method and criteria for identifying poverty causes and list the identified causes. Also describe the methods and criteria used to determine priority and selection of strategies to be implemented that will address the poverty causes. This is the third year of a three-year plan and services were prioritized based on the results of the Family Needs Survey that was conducted in Johnston, Lee and Harnett County during the planning process in October 2012. The respondents listed the following areas of needs: Affordable Housing- Education-Employment and Transportation. There have been several plant closings in our service areas that have played a major role in creating the negative situations many of our participants are encountering. The STARS Counselors use a "Tell me About Yourself' questionnaire to help determine the participants' needs and to provide guidance in making lifestyle changes. Using a all- inclusive approach in helping the participants' achieve self-sufficiency has proven to be the best practice for our program. The economy though classified as recovering has yet to find its way to our service areas continues to have a devastating impact on low-income people. Temporary employment agencies are having problems finding jobs for the unemployed no matter how qualified they are, which creates another problem for many participants who have a GED/ high school diploma or less. It is truly an employer's market and those with limited skills are still having a hard time finding gainful employment. ROMA Goal1, 2, 3 and 6 Low income People Become More Self-Sufficient; The conditions in which low income people live are improved; Low- income people own a stake in their community; Low-income people, especially vulnerable populations, achieve their potential by strenotheninQ family and other support systems DHHS Excels-Goal 4 Provide services to individuals and families identified as being at risk of compromised health and safety. 3. Describe activities that your agency has undertaken to advocate for and empower low-income individuals and families to achieve economic independence and security. The goal of the agency is to design and implement programming with the express purpose of meeting the needs of low-income individuals and families in Johnston, Lee and Harnett Counties. We will seek funding to increase the scope and efficiency of our agency, whether it's affordable housing, employment opportunities, educational advancement, affordable daycare issues, financial literacy, homeownership, Fiscal Year 2014-15 Community Services Block Grant Application Page 7 of 54 JLHCA, Inc Planning Process Narrative (continued) early childhood education, etc. As other funding opportunities and/or partnerships present themselves, we will make an effort to meet needs that can potentially empower the participants or help them avoid adverse situations that could derail their journey to success. The Individual Development Account (IDA) Program is available to our clients who are ready to become homeowners. The problem of sustaining high rent becomes a bigger problem for many low-income clients when it's combined with high utility bills. Involvement in the IDA Program help participants become more skillful at the basics of saving money and to get into the practice of making their scheduled payments in a timely manner. Credit and Pre-purchase Counseling are vital components of the IDA Program and enables participants to meet the criteria for low interest rates and assistance from other funding streams. This also affords IDA participants the chance to obtain low payments and to own a stake in their community. Twenty-one (21) hours of Financial Literacy Training and eight (8) Homeownership Education are mandatory for all IDA participants. The STARS Counselors provide workshops on a wide-range of topics that are critical to the issues that our participants are facing. Topics such as: Income Tax Preparation, Energy Conservation, Credit Counseling, Financial Literacy, Home Ownership/Renters Insurance, Nutrition, Job-Readiness Skill Building, Renter's Rights, Consumer Credit Education and other topics that will help participants become advocates for themselves and their families. Intense one-on-one case management is one of the fundamental tools used in helping participants reach the goal of self-sufficiency. Getting participants to own the problem plays an important role in finding the solution. Participants working with the counselors set both short and long range goals, and then prioritize them in order to achieve quantifiable successes. Networking and collaborations with other human services agencies, organizations, private sectors and faith-based programs are all vital elements of reaching and affecting positive changes in the lives of as many low-income families/individuals as possible. By working together with other entities, our resources (manpower, financial, etc.) are able to assist a greater number of low-income people. ROMA Goals 1, 2 4, 5 and 6 Low income People Become More Self-Sufficient; The conditions in which low income people live are improved; Agencies increase their capacity to achieve results; Partnerships among supporters and providers of services to low-income people are achieved; Low-income people, especially vulnerable populations, achieve their potential by strengthening family and supJJort systems DHHS Excels-Goals 1 and 2 Manage resources that provide an elevated level of effective and efficient delivery of services and programs to North Carolinians; Expand understanding and use of information to enhance the health and safety of North Carolinians 4. Describe how your agency plans to make more effective use of, coordinate and form partnerships with other organizations and programs including: State welfare reform efforts; public and private resources; religious organizations, charitable groups, and community organizations. JLHCA is a charter member of the Job Link Centers in both Johnston and Lee Counties and the agency provides four (4) hours of staffing once a week at sites in all three counties. We will coordinate with other programs in our areas in an effort to pool resources and provide services to more low-income people. Collaborative efforts will involve joint workshops conducted or through the sharing of information that would benefit our participants. We hold seats on each other's boards or committees to ensure that representatives from the public, private and poor sectors are aware of services. The Executive Director is a member of the Human Services Council, Job Link Managing Partners Board for Johnston County, Capital Area Workforce Development Board of Directors, Bank of Four Oaks Advisory Board, BRAG Board member, Weatherization Policy Advisory Council, Johnston County Board of Elections, Smithfield-Selma Chamber of Commerce Public Policy Committee, a lifetime member of the North Carolina Community Action Association Board, South Eastern Fiscal Year 2014-15 Community Services Block Grant Application Page 8 of 54 JLHCA, Inc Planning Process Narrative (continued) Association of Community Action Agencies, Johnston County Citizens' Association Assistant Secretary and Tribute to Excellence Committee chair, Johnston County Jury Commission, Neuse Charter School Board member, Living Well Partnership of Johnston County/Healthy Carolinians Board member, Johnston County Area Transportation System Advisory Board, the Johnston County Emergency Food and Shelter Board, Chairman of the Lee County Emergency Food and Shelter Program Board, Southeastern Rural Assistance Community Project, and Legal Services Advisory Council, United Way of the Greater Triangle Executive Directors Council and United Triangle Resource Investment Cabinet and the Johnston County Continuum of Care and the Balance of State Committee. The CSBG Director is a lifetime member of the North Carolina Head Start Association and the North Carolina Community Action Association, Johnston County Family Preservation Team, Johnston County Child Fatality Task Force, Johnston County Community Child Protection Team, 2nd Vice-President of the North Carolina Community Action Association, Johnston County Human Services Council, Princeton Area Ministerial Association, Smithfield-Selma Chamber of Commerce Public Policy Committee, Living Well Partnership of Johnston County /Healthy Carolinians Task Force, Johnston County Citizen's Association Chairperson and Tribute to Excellence Committee Banquet (funds are awarded annually for scholarships for six (6) local high school seniors), Johnston County Continuum of Care and the Balance of State Committee. Program staff in the agency work very closely with other local human service organizations to guarantee that the low-income families obtain services. A coordination of services through information and referrals and follow-up also play an important role in this initiative. We partner with local community resources in order to increase the number of low-income people that can be served. We partner with public and private resources using a variety of methods such as in the area of cross training. As members and the founder of the Human Services Council, we meet bi-monthly to discuss any concerns or opportunities that may have become available since the last meeting. We also provide training for each other's clients and staff to make sure that areas of needs/concerns are identified and addressed. The agency is diligent in keeping private citizens informed about programs and other initiatives with goals that help stamp out the causes of poverty. This is accomplished by issuing information through year-in-reviews, news releases, announcements to churches and other community groups/organizations. Staff attends faith-based, civic organizations and other community groups' functions to keep them abreast of services that our agency offers. Our agency is dedicated to eliminating the core issues that threaten to destroy the low-income; therefore it is crucial that we work together as a team. The private and public sectors in our service areas are involved in almost every phase of this process. Individuals from both populations sit on our Tri-parte Board of Directors, assisting in the planning process, serving on the Successfully Transitioning to Achieve Real Self-Sufficiency (STARS) Policy Advisory Council in each county to help ensure that we are apprised of any changes that could have a negative or a positive impact on our target population. We serve on each other's boards and stay in contact to help guarantee a seamless delivery of services. They donate both time and money to help us meet the needs of the participants that we serve. Representatives from these two groups help distribute and collect CSBG client surveys each year to help gauge the needs of low income people in our target area. Other methods the agency use to involve the private and public sector in our efforts to eliminate the causal factors of poverty are: * The agency participates in Drug Action Meetings in Johnston and Lee Counties. Fiscal Year 2014-15 Community Services Block Grant Application Page 9 of 54 JLHCA, Inc Planning Process Narrative (continued) * The Executive Director is a member of the Capital Area Work Force Development Board. The CSBG staff works very closely with local business and industry in an effort to gain employment for the clients. The Counselors in all three counties provide their time and expertise to people four (4) hours weekly at the Joblink centers * Staff members serve on boards and committees that work with low-income residents and other entities that can have a positive effect the lives of the poor in the target area. * The agency works very closely with the Area Ministries, Faith-based organizations, local churches and Food Closets in all three counties which affords us an opportunity to enlighten laypersons about the struggles faced by low-income residents in the community. * The Executive Director serves on the Low-Income Initiative for the Bank of Four Oaks and on the Board of Directors of the Southeast Rural Community Assistance Project. * The Board of Directors of Johnston-Lee-Harnett Community Action, Inc. has a tri-parte representation. The members represent the public, private and poor sector of the community. * Partnerships have been developed with local banks in providing funding for housing counseling. Housing counseling assist individuals/families who want to purchase a home and help others having trouble paying their mortgage. Bank staff also conducts Financial Literacy Classes. * The Executive Director and the CSBG Director serve on the Public Policy Committee of the Smithfield-Selma Chamber of Commerce. Serving on committees in the chambers afford us the opportunity to network and get the Community Action story and mission out to both the public and private sector. We are Chamber members in the three-county service areas. * The Executive Director, CSBG Director, Human Resources Director and the STARS Senior Counselors in Johnston, Lee and Harnett County are (FDIC) Federal Deposit Insurance Corporation Certified Money Smart Trainers. The STARS Senior Counselors in Johnston and Lee are SOARS Specialists. * The STARS Senior Counselor in Johnston County serves on the New Choices Advisory Board with the local Domestic Violence Shelter. The Lee County Senior Counselor serves on the Lee County Community Child Protection Team and Child Fatality Task Force, The Senior Counselors attend the Lee-Harnett Housing Collaborative in their respective counties. The Harnett County STARS Senior Counselor attend the Job Link Partners meeting, the Harnett County Community Food Pantry, The Hispanic Task Force, North Carolina Latino Foundation and the Belhaven Fire Dept., * The agency use data from our intake systems as a tool in verifying the validity of clients seeking services from our partners/lay people in the community. This process help determine if the needs presented by the participants are legitimate and to reduce the frequency of duplication and/or abuse of services. * The Head Start Director serves on the Partnership for Children of Johnston County Executive Committee, Lee County Partnership for Children Early care and Education Committee, Harnett County Partnership for Children Outreach Committee, Fatherhood Advisory Committee, NC Pre-K Committee in Johnston, Lee and Harnett Counties, Safe Kids, North Carolina Head Start Association (Budget, Conference and Executive Committee), Johnston County Ready Schools Committee, Johnston Community College Early Childhood Advisory Committee. Other Head Start staff serves on the Committee for Exceptional Children, Johnston and Harnett County Local Fiscal Year 2014-15 Community Services Block Grant Application Page 10 of 54 JLHCA, Inc Planning Process Narrative (continued) Interagency Coordinating Council, NC Head Start Cluster 8, Special Olympics and the Consumer and Family Advocacy Committee and the Coastal Girl Scouts Council. * Our agency work with banks and other lending institutions such as Rural Economic Development and North Carolina Housing Finance to assist with low-interest mortgage loans to help low-income individuals buy a home In some instances, the applicant will not have to pay a down payment. We provide reverse mortgage counseling when the banks and/or mortgage companies refer families to the agency. Our agency provides pre-purchase, foreclosure prevention, default; reverse mortgage and delinquent mortgage counseling, * Through the Presbytery of New Hope's Outreach Ministry and partnering with the local Presbyterian Church, we received funds to provide rental deposits for low-income families. Our counselors inspect these homes using the same criteria set forth by HUD Section VIII. A delegate from the local church and a CSBG staff member have the option to makes a home visit to indoctrinate the family into the community each time these funds are used to assist needy families with a rental deposit. The deposit is returned to our agency if a client moves and doesn't owe any money for rent or damages * Some of the local churches include the STARS Crisis fund in their annual budget, and/or have special initiatives to assist us in meeting the needs of local low-income residents. * Our agency is also a CHDO, which is designated as Community Housing Development Organization. * The agency is a charter member of the Job Link Program in Johnston and Lee Counties. Counselors in all three counties; man the Joblink centers in their perspective area one day a week. * Area Ministries and local churches provide food and monetary support for our participants to help supplement our funds in order to provide quality services and allow us to serve more low-income people. We received a grant for food from Food Lion that will help alleviate the plight of the hungry in our three county service area. * We participate in and help coordinate Resource Fairs, Health Fairs, workshops and other activities with other partners that keep the public informed about resources/ services in the community. * The agency partners with local churches and other organizations to perform repairs on the homes of low-income people. Our agency provided the names and completed intakes on potential participants. By collaborating with the local churches, more individuals living in substandard housing received housing services that they could not ordinarily afford. * As a member and founder of the Human Services Council, we meet bi-monthly with individuals from community, public sector, private sector, charitable groups and other group representative who have an interest in the welfare of the low-income. Discussions relevant to the needs and concerns or the availability of new opportunities are shared with the partners who then share with their participants. We provide training for each other's clients and staff members to ensure that issues affecting low- income people were being addressed. * The Counselors refer families to Head Start. Participants are referred to (HRD) Human Resources Development classes and (ESL) English as a Second Language at Johnston Community College, Fiscal Year 2014-15 Community Services Block Grant Application Page 11 of 54 JLHCA, Inc Planning Process Narrative (continued) Central Carolina Community College and to other agencies offering classes. Participants are mandated to enroll in and attend Career Readiness Certification classes at the community colleges to increase their job-readiness skills. * Budgeting and Computer classes are taught by staff from the community college both on campus and the agency to enhance job-readiness skills of our participants. Clients are referred to any programs that can help them work toward achieving their goals whether the service provider is internal or external. 5. Describe how your agency will establish linkages between governmental and other social services programs to assure the effective delivery of such services to low-income individuals, to avoid the duplication of such services and to fill identified gaps in services, through the provision of information, referrals, case management and follow-up consultations. Staff composition in Johnston County consist of a STARS Senior Counselor/Supervisor and two (2 STARS Counselors. Because of budget constraints in Lee County a STARS Counselor work in the Harnett and Lee County offices. Harnett County has a STARS Senior Counselor/Supervisor, one (1) full time STARS Counselor and one ( 1) shared Counselor while Lee County has a STARS Senior Counselor/Supervisor and a shared Counselor. The CSBG Director monitors the total CSBG Program program (see organizational chart). When a participant enters the STARS office, a counselor will interview them to assess their conditions. The participant completes a 'Tell Me About Yourself' questionnaire so the counselor can determine the next course of action and get a sense of what the participant is doing to correct their situation. The counselor completes an intake and that information is assessed to see if the participant is eligible for enrollment into the STARS Program. The file is given to the Senior Counselor who will review it to determine if meets the eligibility guidelines and to assign the participant to a STARS Counselor If the needs are for emergency food, a voucher is issued on-site and they are then referred to the Department of Social Services to apply for food stamps. If the need is for emergency shelter, etc. the counselor will refer them to the appropriate resource in order to link needs with services. When needed the counselor will facilitate the process through direct communication, coordination of services to help strengthen the link between the participant and service provider. When there's a crisis, an intake is completed by a counselor and if eligible, the client is referred to the STARS Senior Counselor who reviews all applications for emergency assistance. The crisis is corroborated by contacting the service providers who can authenticate the information given by the applicant. The senior counselor then searches for community resources or generates a voucher (if funds are available) to meet the need. The agency has received grants from the Presbyteria of New Hope to assist with rental deposits for eligible participants. The Emergency Food and Shelter Program provided grants in Johnston, Lee and Harnett Counties to assist participants with utility bills and rental and/or mortgage payments. United Way of the Greater Triangle provides funds to assist low-income people in crisis who live in Johnston County, while the United Way of Harnett County help resolve emergency situations in Harnett County. The United Way of Lee County provided funds earmarked for emergency assistance. Partnering with other groups has been the focus of Johnston-Lee-Harnett Community Action, Inc. to help build bridges and break down barriers being the cornerstone. The goal of the agency is to provide a ladder of opportunity for needy individuals and /or families to pull themselves up and out of the stranglehold of poverty. The STARS Senior Counselors meet with the counselors on a weekly basis to discuss concerns, client progress, celebrate successes and any other issues that may affect the successful attainment of the goals set by their self-sufficiency participants. During this meeting, potential candidates for case management are discussed and the senior counselor then assigns a counselor to the client. Fiscal Year 2014-15 Community Services Block Grant Application Page 12 of 54 JLHCA,Inc Planning Process Narrative (continued) Some participants were enrolled into the STARS program after the resolution of a crisis and it had been determined that they would benefit from case management intervention. Some participants come to the agency seeking case management and others are referred from other organizations/agencies. The STARS Counselors' meet with their case management participants at least once a month to evaluate and re-examine their goals. They work with participants as they work toward realizing their dreams using strategies crafted to help them rise above the poverty level. Workshops are offered to participants on topics that can help affect positive changes in their life. Some workshops offered are Job-Readiness, Money Smart, Income Tax Preparation, Energy Conservation and Insurance (all types), etc. Following up on their accomplishments and/or their concerns is a basic but integral part of casemanagement. One major goal of casemanagement is getting clients to take a more proactive approach in making life choices rather than reactive. ROMA Goal 2, 4 and 6 Low income People Become More Self-Sufficient; Partnerships among supporters and providers of services to low-income people are achieved; Low-income people, especially vulnerable populations, achieve their potential by strengthening family and other support systems DHHS Excels-Goals 1 and 3 Manage resources that provide an elevated level of effective and efficient delivery of services and programs to North Carolinians; Offer outreach and services to individuals and families identified as being at risk of compromised health and safety. 6. Provide a description of how your agency will support innovative community and neighborhood-based initiatives related to the purposes of the Community Services Block Grant (fatherhood initiatives and other initiatives with the goal of strengthening families and encouraging effective parenting). Participants enrolled in the STARS Program with children enrolled in the Johnston-Lee-Harnett Head Start Program may participate in a variety of initiatives that can enhance the self-sufficiency experience. They are encouraged to take advantage of programs being offered by other community or Human Services agencies, as they are made available. Johnston-Lee-Harnett Head Start offers the I am moving ..... I am learning Initiative which is a proactive approach to addressing childhood obesity in Head Start children. The program teaches Head Start children and their families a variety of methods on how to become more physically active and use these four basic components: Moving With the Brain in Mind, Body language, Nutrition Building Blocks and Resources for Family Meals to help them achieve and maintain a healthier lifestyle. Head Start's Male Involvement Program (Men for Tots) is designed to enhance the lives of the primary males in the children's lives as well as the entire family. The program targets initiatives that would strengthen the emotional and financial well-being of the family. Key elements that the program focuses on are effective parenting, building leadership skills and entrepreneurship and other critical issues facing males in today's society. Staff work with the men to foster self-sufficiency. The males do not have to be the child's biological father; they can be stepfathers, grandfathers, uncles, and friends of the family or other relatives. The only prerequisite for participation in this program is that they have never been convicted of a felony (especially involving a child) and that they have a genuine interest in the welfare of children. The workshops provided by this initiative are open to the public. When there are other programs that offer parenting programs, we encourage our parents to participate fully in them in order to gain the maximum benefit in the parenting experience. The STARS Program coordinates supports and provides assistance in organizing Area Ministries and other and nontraditional partners are key elements in closing the gap between needs and services. Fiscal Year 2014-15 Community Services Block Grant Application Page 13 of 54 JLHCA, Inc Planning Process Narrative (continued) For participants of the STARS Program, strategies are designed that will identify barriers to achieving self-sufficiency. Goal setting activities are then designed in such a manner that the problem they are experiencing can be curtailed. The service plan may include several groups working together with the clients to come up with a plan of action that can help move the family/individual above the poverty guidelines. Participants are mandated to attend Financial Literacy (budgeting) classes designed to help them create and maintain a budget. Incorporating this strategy into the program can assist them as they work to attain the goal of self-sufficiency. The Individual Development Accounts Program (IDA) is designed to help low-income people establish the habit of saving in order to become a first time homebuyer. The program incorporates financial literacy training, one-on-one counseling, training sessions with potential lenders and real estate agents to make sure that participants are well versed in the area of home ownership. When the participants reach their savings goal and have completed the Financial Literacy Training, they are then entitled to a two to one match that will help toward the purchase of a home. Children who are enrolled in the Head Start Program and have been diagnosed with asthma can also participate in the Head Start Asthma Outreach Program. This program was designed to minimize the number of asthmatic episodes that Head Start children were experiencing. A Respiratory Therapist from Down East Respiratory Services was assigned to work with the children who have asthma three days a week at the center that they attend. It is not mandatory and parent/guardians have the option to enroll their children in the program. Doctors and the insurance carriers have to agree that the child can be enrolled in the program. The respiratory therapist makes home visits to the children during the holidays and is available to provide services year round. This ensures continuity of services and care and treatment for the child and to answer questions and address concerns that the family may have. Since the inception of the program about 30% of the 717 children who are enrolled in the program have benefitted through education, knowledge, management of the disease and a decreased number of asthma attacks. Enrollment in the program has decreased the number of absentees due to Asthma related illness. The HUD Emergency Solutions Grant (ESG) Rapid Re-Housing Program affords us the opportunity to help move homeless families/individuals out of cars, parks and other dangerous living conditions and get them into standard housing. Clients enrolled in the program may receive utility and rent deposits up to 3-months assistance. A counselor will work them to help them find employment and/or link them with services they may be eligible to receive. The counselor helps them assess their situation, help determine what circumstances got them to this place and what they could do to avoid becoming homeless again. The CSBG Director is a National Certified Grant Specialist and continually looks for funding to support programs that are beneficial to low-income people in Johnston, Lee and Harnett Counties such as Foundation Grants, Emergency Food and Shelter Program, United Way Support, Presbyteria of New Hope and other as opportunities arise. We will continue to apply for funding to develop programs that will help our participants rise above the poverty level. The Head Start (BMI) Body Mass Index Program was initiated due to the high number of head start children who were overweight. The initiative is a collaborative effort between Head Start, primary care physicians, local Health Departments, Women, Infant and Children's (W. I. C) offices. During the bi- annual height and weight checks, if a child's body mass index percentage indicates that a child's is high, at risk, or underweight a computer generated graph is sent a copy of the information and then have to take the child to a medical provider for follow-up. The nutrition coordinator then tracks the progress or lack of progress and follows up with the parent/guardian. If the BMI percentage is high, the curriculum in Fiscal Year 2014-15 Community Services Block Grant Application Page 14 of 54 JLHCA, Inc Planning Process Narrative (continued) the classroom will be amended to help rectify the situation. Healthy snacks are encouraged and parents receive educational information, such as monthly newsletters, etc. to help introduce a healthier lifestyle for the entire family. The Housing Urban Development Housing Counseling Program provides multiple services which specifically target both homeowners and potential homeowners. Reverse Mortgage for senior citizens who own their homes are afforded the opportunity to stay in the homes and receive funds to help meet their needs. The Housing Counselor is one of a very few counselors who is nationally certified to coordinate reverse mortgages. The Counselor also offers Homeowners Training, Default and Pre- Purchase Counseling. The Financial Literacy Training is incorporated into the other elements of the this program and is conducted by the Senior STARS Counselors who are Certified Money Smart Trainers. The Executive Director, CSBG Director and the Human Resources Director are also Certified Money Smart Trainers. ROMA Goal 5 and 6 Agencies increase their capacity to achieve results; Low-income people, especially vulnerable populations, achieve their potential by strengthening family and other support systems DHHS Excels-Goals 1 and 5 Manage resources that provide an elevated level of effective and efficient delivery of services and programs to North Carolinians; Provide services and protection to individuals and families experiencing serious health and safety needs who are not, at least temporarily, able to assist themselves. 7. Describe activities that your agency has undertaken or plans to undertake, on an emergency basis, for the provision of such supplies and services, nutritious foods and related services, as may be necessary to counteract conditions of starvation and malnutrition among low-income individuals. The agency participates in the Area Ministries and encourages churches to provide crisis assistance when resources are available. We sought and received funding from Food Lion Foundation to provide food for low-income people. Food Vouchers will be issued to eligible applicants in Johnston, Lee and Harnett Counties. We will pursue additional funds from other sources to help meet the needs of low- income people in crisis. Funding from the Presbyteria of New Hope through a grant request from the agency also assists in this venture. United Way and the Emergency Food and Shelter Program (EFSP) assist the agency in Johnston, Lee and Harnett Counties providing for emergency needs. Food closets are organized within each area ministry and are supported by volunteers and private donations from churches, schools and food drives conducted by the community. In Johnston County, the Senior Counselor mails the Food Closet volunteers a schedule, so that each volunteer knows when they are scheduled to work. Some low-income people in crisis benefited when some private donors personally contributed funds for the sole purpose of providing emergency assistance .. Private donors can help the needy in this way without having to screen them to see whether or not there is real crisis. Local churches in all three counties also provide funds to assist participants who are experiencing a crisis. The program partners with churches, food banks and other organizations whose primary mission is to distribute food to those in need. Some people receive food vouchers, bags of groceries or hot nutritious meals from area soup kitchens that are referred from our agency. We maintain a close relationship with these groups to make sure that no one goes hungry and to keep abreast of any new services that may become available. There are no set agency wide methods used to operate the emergency food programs. Each food distribution program dictates the process that it will use according to their policies and procedures and/or mandates from the funding source. Intakes are completed on all of the clients who come into the agency Fiscal Year 2014-15 Community Services Block Grant Application Page 15 of 54 JLHCA, Inc Planning Process Narrative (continued) seeking any kind of assistance including food assistance. Completing these intakes is another method that we use to track the activities of the participants to see how often they come into the agency seeking services. The only restriction placed on the recipients of food vouchers is that they cannot receive a voucher more than once per quarter. Since crisis counseling is an essential component of the crisis program; it is important that we investigate to the fullest extent as to why the client would be coming on such a regular basis. The STARS staff in Johnston County issues food vouchers which are returned to our office after they have been redeemed. This process help track the number receiving vouchers in order to try to minimize the possibility of duplications. When a person comes in requesting a food voucher, staff will determine whether or not the person is eligible to receive food stamps, if so a referral is made. The Senior Counselor sends a monthly report to the Smithfield Area Ministries that tracks the location of bags issued, the number of people served and the number of bags filled. In Harnett County some food resources require written referrals from our agency while others have their own forms to be used expressly for clients we refer to their organization. These forms are given to clients after an intake has been completed and they are ready to go to the resource. In Lee County, two methods are used in helping people get emergency food. One program requires a program designed food voucher and the other program require a telephone call from the counselors. The Senior Counselor who also serves as the Crisis Counselor also keeps copies of the forms. 8. Describe how your agency will coordinate the provision of employment and training activities with entities providing activities through statewide and local workforce investment systems under the Workforce Investment Act of 1998. The Executive Director is a member of the Capital Area Workforce Development Board. Our agency is a Charter Member of the Job Link Centers in both Johnston and Lee Counties: we also staff the Harnett County Job Link Center. Currently we provide four (4) hours staffing time each week at the Job Link sites in all three counties. Referrals are made to agencies in our service area for employment and training programs. We also offer Job-Readiness training to our casemanagement participants. We also work with Triangle South Workforce Development in Lee and Harnett County. Staff from our agency as well as from other Human Services agencies serves on each other's Boards and Policy Advisory Councils to ensure that our counselors are well-informed on the availability of services that are beneficial to our clients. We use referral forms to speed-up the delivery of service and to avoid duplication of services. The Executive Director and the CSBG Director serve on the Public Policy Committee of the Smithfield-Selma Chamber of Commerce. This affords the agency an opportunity to be in on the planning stage of any business prospects that may be coming to or leaving our area that could have a positive or potentially negative impact on low-income people. The sharing of information at our Board of Directors and Policy Advisory Council meetings plays a vital role in coordinating, and establishing linkages between governmental and other social services programs in the delivery of services to low-income individuals. As the Board of Directors is a Tri-parte board, its members include county commissioners, bankers, realtors, representatives from legal services, Department of social services, faith based organizations, local health department, senior citizens councils, teachers, division of employment services, head start policy council, partnerships for children, civic groups, etc., Programming concerning the availability, delivery and quality of services are always of the utmost importance and at the forefront of discussions. Fiscal Year 2014-15 Community Services Block Grant Application Page 16 of 54 JLHCA, Inc Planning Process Narrative (continued) ROMA Goal 4 and 6 Partnerships among supporters and providers of services to low-income people are achieved; Low-income people, especially vulnerable populations, achieve their potential by strengthening family and other support systems DHHS Excels-Goal 5 Provide services and protection to individuals and families experiencing serious health and safety needs who are not, at least temporarily, able to assist themselves. 9. Describe how your agency will ensure coordination with the emergency energy crisis intervention program under title XXVI (relating to low-income home energy assistance). The Emergency Assistance at the Department of Social Services refers low-income people to our agency for emergency assistance. These service requests include utility payment assistance and other crisis aid for needy persons outside LIEAP/CIP when they no longer have funds available. Social Services' Emergency Assistance/Crisis Programs have fairly restrictive guidelines. Their emergency assistance programs are structured to meet crisis needs within a 24 hour time frame and for a certain household type; therefore their available funds are depleted very quickly and many households are left without services because they don't meet the guidelines. We coordinate our resources to try to ensure that those individuals who are in crisis receive needed help, if when are available. By using this strategy, we can assist more low-income people as they fight to keep the most basic of needs, ex. utility payments, rental assistance, medicine, food, etc. The agency continues to seek private donations of cash, goods, and volunteer services, that is then made available to low-income people in the area. The Harnett County Department of Social Services' LIEAP and CIP programs are being contracted out to our agency and have staff placed in our office to meet emergency utility needs. The program is a heating/cooling program and funds are disbursed only when weather conditions become extreme. The determination to release funds is made by the Department of Social Services Director. The agency operate a Weatherization Program and a HARRP (Heating Assistance Repair Replacement Program) to assist families with their energy needs. One goal of this program is to create a safe, healthy environment in which low income people live and to save on energy bills by maximizing their heating and air appliances capabilities. They provide home and heating system repairs, air sealing using new method to make the best use of energy conservation, rehabilitate substandard houses, replace heating systems when needed and offering educational classes in small home repairs and energy conservation. Urgent repairs are made when funds are available. The Executive Director is a member of the Weatherization Policy Advisory Council for the state Weatherization Program. ROMA Goals 4 and 5 Partnerships among supporters and providers of services to low-income people are achieved; Agencies increase their capacity to achieve results DHHS Excels-Goals 1 and 2 Manage resources that provide an elevated level of effective and efficient delivery of services and programs to North Carolinians; Expand understanding and use of information to enhance the health and safety of North Carolinians 10. Describe the needs of low-income youth and your agency's efforts to promote increased community coordination and collaboration in meeting the needs of low-income youth. Low-income youth in our service area are finding it harder to find employment due to the economy and the availability of jobs. The dropout rate dropped slightly but has had very little impact on lessening their financial, social and emotional problems and their chances of finding a good job. Low-income youth are competing with adults who have more education, experience and emotional stability even in jobs that were traditionally held by our youth. There are few programs and/or activities that focus on low-income youth. Many youth in the areas that we serve have criminal records and that has only worsened their situation. Because of the high incidences of substance abuse (the youth themselves or their parents) Fiscal Year 2014-15 Community Services Block Grant Application Page 17 of 54 JLHCA, Inc Planning Process Narrative (continued) and drug related crimes in our area, parents no longer feel that the parks and play areas are safe; therefore the youth are not allowed to run and play in their own neighborhood. Low-income youth need an access to a legal source of income, recreational programs and other activities designed to foster self-esteem and create a sense of purpose. Most of the youth-focused programs in the area are geared toward youth who already have a juvenile record or who have medical problems (mental/social/physical). Staff and some Board members serve on committees who offer services to youth between the ages of 0 to 21. We work closely with the Department of Social Services, Community Colleges, Health Departments, Partnerships for Children, National Fatherhood Practitioners, Johnston County Neuse Charter School Board, Johnston County Citizens' Association, N.C. Coastal Pines Girl Scouts, Harnett Productions, Kiwanis Club of Lee County, Kappa Alpha Phi Fraternity, Omega Psi Phi Fraternity, YMCA, Safe Kids Coalition, NAACP, Johnston County Chapter of the Delta Sigma Theta Sorority, Project Task Force, Johnston County Schools, First in Families Johnston County Industries, Family Promise, Psi Sigma Omega Chapter of the AKA Sorority, Sisters Informing Sisters about Topics on Aids Project, Johnston County Girls and Boys Club, Base Realignment and Closure (BRA C), local churches and other groups that work with youth identifying problems and seeking solutions. The Executive Director is a member of the Capital Area Work Force Development Board and is a member of the Youth Council for Johnston and Wake Counties. They have determined the following design for programs to meet the needs of youth: * Provide preparation for post-secondary educational opportunities; * Provide linkages between academic and occupational learning; * Provide preparation for employment experiences; and * Provide effective connections to intermediary organizations that provide strong links to the * Job market and employers. ROMA Goals 1 and 5 Low-income People Become More Self-Sufficient; Agencies increase their capacity to achieve results DHHS Excels-Goal1 Manage resources that provide an elevated level of effective and efficient delivery of services and programs to North Carolinians. 11. Describe activities that your agency has undertaken or plans to undertake to establish a pool of unrestricted funds to further the agency's mission and reduce dependency on government funding. a. Funds to support services for low-income persons: We seek funds from every sector of the population to support services for low-income people. Some private citizens donate funds to help low-income persons in need of emergency assistance. Grants from the Emergency Food and Shelter Programs, Foundations, United Way, local churches, area ministries have also been used to provide funds to meet the needs of low- income persons. These funds are used to prevent utility disconnections, evictions, rental deposits, purchase medications; provide housing assistance to homeless persons and other needs that low- income people are experiencing. b. Funds to support the overall agency: Some activities our agency has undertaken to build a pool of unrestricted fund are the building and renovating of homes through the agency's Economic Development Program. We also bid on jobs across the state that allow the agency to establish a pool of unrestricted funds in order to guarantee the agency can stay true to its mission without being wholly dependent on government funds. We seek other funding streams from private foundations as a way to secure unrestricted funds. Fiscal Year 2014-15 Community Services Block Grant Application Page 18 of 54 JLHCA, Inc Planning Process Narrative (continued) ROMA Goal 2, 4 and 6 Low income People Become More Self-Sufficient; Partnerships among supporters and providers of services to low-income people are achieved; Low-income people, especially vulnerable populations, achieve their potential by strengthening family and other support systems DHHS Excels-Goals 1 and 3 Manage resources that provide an elevated level of effective and efficient delivery of services and programs to North Carolinians; Offer outreach and services to individuals and families identified as being at risk of compromised health and safety. 12. Describe your agency's method for informing custodial parents in single-parent families that participate in CSBG programming about the availability of child support services. In addition, describe your method for referring eligible parents to the child support office[s]. * All participants including custodial parents in single-parent households are asked whether or not they are receiving child support. They are told about the availability and advisability of seeking assistance through the child support office. They are informed about any services they may be eligible for and contact information during the intake process. When eligible participants come into the agency seeking services, they are given a referral form by the Successful Transitioning to Achieve Real Self-Sufficiency (STARS) Counselor that can be used for any purpose at any organization/agency. If they are not receiving child support and express an interest, they are referred to the local child support agency, . If they have made arrangement with the non-custodial parent and is not interested in pursuing court- ordered child support or do not wish to involve the local child-support office, we do not try to intervene. In some instances, they receive more assistance directly from the non-custodial parent than they would if they involved the local child support agency. 13. Does your agency calculate return on investment for your CSBG program? If so, please explain and give the calculation. Our agency does not currently calculate return on investment for the CSBG program. Fiscal Year 2014-15 Community Services Block Grant Application Page 19 of 54 Planning Period: Community Services Block Grant Program Fiscal Year 2014-15 Application for Funding OEO Form 210 Agency Strategy for Eliminating Poverty July 01, 2014-.hme 30, 2015 Section 1: Identification of the Problem (use additional sheets if necessary) JLHCA, Inc 1. Give the Poverty Cause name, rank the poverty cause(s) and identify which one(s) the agency will address. Poverty Cause Name :Employment/Affordable Housing/Education/Financial Literacy The poverty causes were ranked in the following order based on the results of the Family Needs Survey which was conducted during the initial planning process in October and November of 2011 : 1. Affordable Housing 2).Education 3) Financial Literacy 4). Employment. But the poverty causes that the STARS Program will address during the 2014-15 program year will be: Employment Affordable Housing, Education and Financial Literacy. i. The STARS Program will address the employment issue as its number one priority for the 2014-15 program year to assist STARS participants in finding employment that will enable them to meet their financial obligations such as paying their rent. When possible, participants who have a marketable skill will be encouraged to consider entrepreneurship. Working in conjunction with the Community Colleges Small business Centers, Private Industries and Workforce Development Centers, emphasis will be placed on job development and building skills designed for the successful creation of small business. ii. Housing will now be ranked as the second priority the STARS Program will address. It was surprising that Affordable Housing was ranked number one from the survey but upon closer reflection, it became very clear why respondents chose this issue. If jobs are hard to find and the average rental property list for over $400.00 a month, it was a very wise choice. Affordable housing also comes with some very harsh and oftentimes restrictive requirements such as good credit and a criminal check. These requirements have proven to be a barrier to securing affordable housing. iii. Education will now be the third priority the program will address as it will best increase the likelihood of obtaining a good job or creating a market for the skills they possess. iv. Financial Literacy/Money Management is the fourth priority we will undertake during the 2014-15 program year. The FDIC Money Smart module will be incorporated into the participants' journey as they embark on the path to self-sufficiency. Creating and maintaining a budget and paying their bills on time will help build their credit. This will help minimize the need for low-income housing or any type of outside assistance. Purchasing a home through the Individual Development Accounts Program (IDA) will be a great by-product of building your credit through incorporating sound financial practices into their daily lives. Fiscal Year 2014-15 Community Services Block Grant Application Page 20 of 54 Agency Strategy for Eliminating Poverty (Continued) JLHCA, Inc 2. Describe the poverty cause(s) in detail in the community with appropriate statistical data (Include data sources). Explain why the problem exists. Identify the segment of the population and give the number of people experiencing the problem. Explain how the persons are adversely affected. * Approximately 26,241 people of the 17 4,938 (NC Census Johnston Co. Quick Facts) in Johnston County lives below the poverty guidelines. These figures are reflective of the total households. * Approximately 10,052 people of the 59715 people (NC Census-Lee County Quick Facts) in Lee County live below the poverty guidelines. These figures are reflective of the total households. * Approximately 20,640 people of the 122,135 people (NC Census-Harnett County Quick Facts) in Harnett County live below the poverty guidelines. These figures are reflective of the total households * The current percentages of people living below the poverty level are listed as follows: Lee-17%, Harnett- 16.9% and Johnston-15.2 %. * According to the N.C State Data Center, the average number of people in a household per county is: Johnston County-2.72, Lee County-2.66 and Harnett County-2.69 * The figures in the chart below reflect the number ofTANF, Medicaid and Food Stamps recipients. The working poor continue to make up a large percentage of families living below the poverty level. They also receive little if any benefits on their jobs. As of November 2013, these are the following numbers receiving assistance from the Department of Social Services: Service: Food Stamps (households): Work First/TANF Medicaid: a) Explain why the problem exists. 1) Employment: Johnston 14,020 246 33,777 Lee Harnett 5772 9,896 105 not available 11,866 130,073 Even though there are signs that the economy is in a recovery mode, there has not been a surge of new hires and/or rehires in Johnston, Lee or Harnett Counties. Therefore, it's not surprising that employment was one of the top priorities for persons completing the surveys. Jobs in our service area are still scarce for the clients that we serve for a variety of reasons; such as lack of education both academic and vocational. People with degrees are finding it hard to find a job and even harder to find one with benefits. Competition is fierce and jobs are few or require specific skill sets. Many of the participants only have a high school diploma or a GED, which makes their prospect for employment bleak. Participants without a diploma are finding it very hard to find a job. Employers are increasingly concerned with the skill level of both their current employees and of any potential employees. Employers have to be cognizant of the type of skills necessary for their businesses to thrive in today's workplace. According to the North Carolina Career Readiness Certificate Consortium, more than 80% of all jobs were projected to require skills beyond those earned in high school. The CRC is an assessment- based credential that gives employers and career seekers a uniform measure of key workplace shills. As a result, both job seekers and incumbent workers are increasingly called upon to Fiscal Year 2014-15 Community Services Block Grant Application Page 21 of 54 JLHCA, Inc Agency Strategy for Eliminating Poverty (Continued) demonstrate a more advanced set of skills or at least the ability to develop those skills through on-the-job training. North Carolina's Career Readiness Certification (CRC) is designed to meet the needs of both employers and job seekers in this transitioning economy. For employers, the CRC offers a reliable means of determining whether a potential employee has the necessary literacy, numeracy and problem solving skills to be "job ready .. To countermand these barriers, the STARS program will place more emphasis on programming which incorporate activities that will enhance job/skills development, coaching participants on job-readiness endeavors which include the Career Readiness Certification. It is imperative that STARS participants are equipped with this certificate because for job seekers, the CRC serves as a portable credential that can be more meaningful to employers than a high school degree or a resume citing experience in a different job setting. Unemployment figures reflect those persons still unemployed and drawing benefits, so the actual figures are usually higher than reported. Some people don't have any reserve of time to draw down from. The latest unemployment figures for 2013 are as follows: Johnston County-8.4% , Lee County- 13.6% and Harnett County 9.5% 2). Affordable Housing Affordable housing was listed as a top priority, it was not one of the issues that we addressed during the first year of our three-year plan. Income based housing is very prohibitive due to the eligibility criteria such as good credit, no criminal record and some even ask for character references. Even if the records' check reveal a misdemeanor, if there is a judgment or a file reflecting an action by a past landlord, they are deemed ineligible. Many potential renters have to pay a non-refundable deposit to complete an application and credit report. Some private landlords can charge an exorbitant amount for rent even if the house is substandard. Affordable Housing: is a premium with waiting lists up to 4 years and more. In Johnston County alone, the Housing Assistance payment program has a waiting list that has climbed to 7 years. There are more and more layers of restrictions than ever before on renters. Many Landlords are requiring excellent credit, criminal checks and the potential renter has to pay a non-refundable deposit fee to fill out an application and for the credit report. As the renters' market increases, the chances of our clients finding affordable housing decreases. Becoming a homeowner is a dream deferred .The sense of pride and achievement that comes with homeownership continues to elude them as they struggle just to pay their rent. Many low-income families are no longer looking to purchase a home with one of the primary reasons being that it is cost prohibitive. The average cost for mid-size homes according to the local homebuyers' association range from $187,000 to $217,890. Johnston County is listed as one of the fastest growing counties in the state which is good for the sector of the population but is causing serious problems for the low-income citizens. Add that with extremely high utility bills and high tax rates and the burden on the poor gets heavier. The cost of living has escalated in Johnston, Lee and Harnett County with little or no relief in sight. This rise can be attributed to the large influx of people moving into our counties from the triangle area. Some landlords have taken advantage of the situation by increasing the cost of rental properties. The average cost of housing has risen so high that our clients cannot find safe, affordable housing. As Wake, Durham and Orange Counties experience a housing explosion, they are migrating to our target counties. More and more clients are finding themselves and their families living in expensive but substandard housing that eventually lead to evictions and an even worse credit score. Another group of people we're encountering are those who because of the economy have lost their homes or are being threatened with foreclosures. This group of "new poor" are now finding themselves in the strange predicament ... having to seek emergency assistance. Therefore, the poverty causes that the STARS Program will address will increase the possibility of participants purchasing a home through the Individual Development Accounts (IDA) Program. Participation in this program includes the completion of twenty-one (21) of the FDIC Money Smart Training and eight (8) hours of Homebuyers Education. Credit Counseling and Repair are also an integral part of this program. With this intervention, the credit scores will rise making the participant more attractive to the landlord or mortgage lenders. Fiscal Year 2014-15 Community Services Block Grant Application Page22 of 54 3). Education: Agency Strategy for Eliminating Poverty (Continued) JLHCA, Inc As the economic forecast bounces from one end of the spectrum to the other and jobs are becoming even more competitive; our participants have to go to school in order to level the playing field. In today's current job market, it is becoming increasingly more difficult for even individuals with a Bachelors' Degree to find a job. It is even more difficult for some of the low-income people coming into the agency, as many don't even have a high school diploma. This is borne out by the numbers of individuals coming into the agency who are classified as illiterate. Adult Literacy is defined as individuals over the age of twenty-five (25) who do not have a high school diploma and/or aGED. The following percentages reflect the individuals who do not have high school diplomas or aGED: Harnett-16%, Johnston-17.7% and Lee County-19%. Many low-income individuals are not returning to school because they cannot afford to take the time off from work, they don't have adequate childcare, and reliable transportation or they don't think that they have the knowledge required to succeed in school. Because the job market has changed, the demand for a more formal or skilled-based education has increased. 4). Financial Literacy: The number of people coming to the agency seeking financial assistance is increasing even as funds are diminishing. During the 2012-13 program year over 2764 low-income persons came into the agency in the three service areas seeking emergency assistance. One programmatic criteria that has been incorporated into the program is a mandate that requires any participant approved for assistance must attend at least 3 financial literacy workshops Of the persons attending the sessions, over 75% had little or no idea how to manage their money. During the budgeting section of the intake process, it was very evident by some of the bills listed that managing money, creating or following a budget had not played a role in their purchases. Furthermore the mismanagement of a bank account or the lack of one had helped create the crisis situation. b. Identify the segment of the population experiencing the problem. The segment of the population that is experiencing the problems outlined above includes low-income unemployed and uneducated persons,. We have seen an increasing number of people who were not low-income until the economic recession created a negative impact on their finances mainly due to the loss of employment. c) Quantify the number of persons experiencing the problem. Currently these percentage reflect the number of people living below the poverty level in Johnston, Lee and Harnett County: Lee-17%, Harnett-16.9% and Johnston-15.2 %. d.). Clarify how the persons are adversely affected. Low-income persons in Johnston, Lee and Harnett Counties are negatively affected because most of them don't have the money or the resources to meet their most basic needs. With unemployment benefits as the main source of income (which has been reduced and shortened), trying to maintain a household, put food on the table and keep utility services active is almost impossible. Many low-income persons seeking services are living on SSI benefits for their child(ren) or child support from absentee dads or moms. Foreclosures are on the rise as well as the number of Reverse Mortgages request that the agency is receiving which is an indicator of the scope of the problem. It has affected all age groups as the Reverse Mortgage Program requires that the homeowner must be 62 years of age or older Fiscal Year 2014-15 Community Services Block Grant Application Page23 of 54 AGENCY STRATEGY FOR ELIMINATING POVERTY-FORM 210 (Continuation Page) Section II: Resource Analysis (use additional sheets if necessary) 3. Resources Available: a. Agency Resources: JLHCA, Inc Johnston-Lee-Harnett Community Action's current programs implemented to enhance this grant: * Head Start program serves 3 and 4-year old children and their families-$4,250,149 * Early Head Start (prenatal to 3 years of age -$1,238,856 * Weatherization-$64,355 * LIHEAP Housing Assistance Repair/Replacement Program-$643,072 * Six (6) food closets operated by local area ministries are working closely with JLHCA to provide emergency food and volunteers operate ali facilities. * North Carolina Pre-K-$295,000 * Presbytery of New Hope provides funds for rental deposits. $2000 * Emergency Food and Shelter Programs-(3 counties) $52,593 * Head Start Community Food & Nutrition-$525,698 * USDA Food Programs-$500,000 * ESG Housing Grant $90,692 * United Way (3-counties)-$76.284 * Early Childhood Program-$256,170 Fiscal Year 2014-15 Community Services Block Grant Application Page 24 of 54 AGENCY STRATEGY FOR ELIMINATING POVERTY-FORM 210 (Continuation Page) b. Community Resources :Per households: I Average per Month Johnston County Lee County I Food Stamps 37,170 5772 I Cost per month $3,640,326 $1,839,857 I Medicaid 24,698 11,866 I Cost per month $15, 919,259 no county share I Work First 246 105 I Cost per Month $53,932 no county share I Emergency Assistance Funds $35201 $0 I General Assistance $36,126 N/A ILIHEAP $396,300 $160,054 I Wake Electric $0. N/A I Progress Energy/Energy Neighbor-H $12,960 $7,838 jc1P $919,108 $362,346 Number of Regulated daycares 73 52 Cost per month $537,666 $153,882 JLHCA, Inc Harnett County 9896 $2,736,633 10,089 $10,522,576 not available not available $662,420 $0 $292,602 N/A $6,134 $662,420 72 $355,000 * Social Security Payments: Johnston $25,434,000; Harnett-$13, 003,642; Lee County: $20,487,800 * HUD: Section VIII Housing: 610 units in Johnston County; 464 in Lee County and 277 in Harnett County Public Housing: Johnston County-561 units, Lee County-447, and Harnett County-143 * Harbor in Johnston County is a battered women's shelter that has 16 beds available for women and children at an annual budget of $600,000. * Haven of Lee County has a total of 29 beds for battered women, 109 for children with an annual budget of $655,251 * Safe Harnett County is a battered women's shelter that has 13 beds with an annual budget of $305.306 * Division of Employment Services annual report of 2013 unemployment expenditures reported the following figures: Johnston-$29,744,630, Lee-$703,733, Harnett-$22,886,009. * Rural Housing Development Project Units-Loans were broken down in the three-county target area in this manner: 2012 fi Johnston County Lee County Harnett County 502 Loans Low: (4) $485,888 502 Loans -Low: (4) $427,215 502 Loans-Low: (1) $17,000 502 Loans Very Low: (6) $7,285,300 502 Loans Very low:(5)$478,045 504 Loans: Very Low (2) $70,933 Loans: 3 $19,499 504 Loans:O 504 Loans®1) $7000 504 Loan & Grant: (2) $ 14,999 504 Loans & Grant:O 504 Loan & Grant: (1) $14,999 Guaranteed: 493 $74,593,960 502 Guaranteed: 61 $8,022,389 502 Guaranteed; 130$17,330,648 Fiscal Year 2014-15 Community Services Block Grant Application Page 25 of 54 AGENCY STRATEGY FOR ELIMINATING POVERTY-FORM 210 (Continuation Page) 4. Resources Needed:$12,825,000 c. Agency Resources: JLHCA, Inc Some of the resources listed below are needed, but we are unable to place a monetary value on them. Some of these services are not available or accessible to our participants at the present, but could be obtained by networking with existing resources and by obtaining additional funding. (a) Job development/apprenticeships assistance, career planning program-$950,000. (b) Additional support staff for Head Start child care positions-$350,000. (c) County-wide before and after school programs--$1 ,500,000 (d) Homeownership assistance programs-$1,750,000. (e) Build/operate Homeless Shelters for women & children, families and men-$3,000,000: (f) Funding for standard weatherization-$500,000. (g) Creation of a microenterprise-$875,000 (h) Additional resources to meet the needs of the homeless/w disabilities-$1 ,500,000. (I) One-stop agency wide intake system $250,000 U) Affordable housing Counseling assistance-$750,000. (k) Provide linkages between participants and affordable, reliable transportation. (I ) Five (5) Bus monitors for Head Start-$90,000 (h) Four (4) school buses for Head Start-$400,000 c. Community Resources: (a) More Job Training opportunities. (b. Services for ex-offenders. (c. County wide affordable transportation (d. Shelters for women, families and single men (e. More affordable housing. (f) Lower cost and accessibility of medical care. (g. Substance abuse prevention/intervention for our families. (h. Homeless intervention programs Section Ill: Goal and Strategy 1. Long-Range Goal: To move 361ow-income households above the poverty guidelines by June 30, 2015 Strategies for Achieving Long-Range Goal: • Develop and provide supportive services to low-income people that break down barriers to self- sufficiency. • Locate and network with employers, community colleges and other resources that can assist the agency in its quest to help implement self-improvement behavior. • Secure additional funding streams and collaborate with community resources in order to assist participants/families experiencing a crisis in order to stabilize the situation. • Collaborate with Work Force Development Boards to work through employment issues and help • participants develop and build job-readiness skills that will increase their marketability to potential and/or current employers. Cultivate partnerships in the public and private sector that will help secure job training and placement opportunities for STARS participants. • Provide intensive educational guidance to help persons enrolled in the Self-Sufficiency Program, identify and plan strategies to attain a diploma, degree or certification. • Enroll participants in the FDIC Money Smart Curriculum to help them become financially literate. to encourage them to open a bank account, create and maintain a budget . Fiscal Year 2014-15 Community Services Block Grant Application Page26 of 54 1. Project Name: 2. Poverty Cause Name: Community Services Block Grant Program Fiscal Year 2014-15 Application for Funding One· Year Work Program OEO Form 212 Section 1: Project Identification STARS (Successfully Transitioning to Achieve Real Self-Sufficiency Employment/Education/Money Management/Affordable Housing JLHCA, Inc 3. Long-Range Goal: To move 52 low-income households above the poverty guidelines by June 30, 2015. 4. Selected Strategy: Develop and provide supportive services to low-income people that break down barriers to self-sufficiency. Locate and network with employers, community colleges and other resources that can assist the agency in its quest to help implement self-improvement behavior. Utilize Work Force Development Boards to work through employment issues. Secure additional funding streams and collaborate with community resources in order to assist participants /families when in crisis in order to stabilize the situation. 5. Project Period: July 1, 2014 1 To June 30, 2015 I Plan Year I I ot I 6. CSBG Funds Requested for this Project: 788,476 7. Total Number Expected to Be Served: 110 a. Expected Number of New Clients 100 b. Expected Number of Carryover Clients 10 8. Number expected to be moved above Federal Poverty Guidelines this year (Self-Sufficiency 50 Projects): 9. Percent of Long-Range Goal Expected to be Met this Year (For projects other than Self- Sufficiency): Section II: One-Year CSBG Program Objective and Activities Objective: Provide comprehensive services designed to remove them from poverty to 110 low-income households by June 30, 2015. Implementation Schedule •··· .. • .'' .··· . ·· ... · First 'A6flvfties .. 'Pp§itionTi~le@J .· Quarter . : .···:. ; ;:,:;> . . ••..•. ; \'',:',··>· "&: ','' ·:::···:· ·: .. ·. ·. . •·. .· ... Objective: CSBG Director 35 Provide comprehensive services designed to remove STARS Senior them from poverty to 110 low-income households by Counselors (SSCS) S.T.A.R.S. Counselors June 30, 2014. (SC) Activities: CSBG Director 09/14 1. Monitor and direct CSBG Program in all three counties. 2. Supervise Senior STARS Counselors/Supervisors CSBG Director 09/14 3. Find additional funding streams to augment services CSBG Director 09/14 provided by the CSBG STARS Program Fiscal Year 2014-15 Community Services Block Grant Application Page 27 of 54 Second Third Fourth Quarter Quarter Quarter 75 95 110 (40) (25) (10) 12/14 03/15 06/15 12/14 03/15 06/15 12/14 03/15 06/15 Community Services Block Grant Program Fiscal Year 2014-15 Application for Funding One-Year Work Program OEO Form 212 (continued) JLHCA, Inc Section II: One-Year CSBG Program Objective and Activities (continued) Objective: Provide comprehensive services designed to remove them from poverty to 110 low-income households by June 30, 2015. ' First A.dtivlhes PQsition l'itiJ(s) Quarter ' :: '', ;, :,/ '', 4. Identify and enroll self-sufficiency participants into sscs 35 Program. STARS Counselors 5 Provide supervisory oversight for STARS Self-STARS Senior 09/14 Sufficiency staff. Counselors/Supervisors 6. Conduct outreach and recruitment using strategies such CSBG Director, SSCS, 09/14 as media, referrals, flyers, brochures and advertisement sc tools. ?.Make home visits to stay abreast of participants SSCS,SC 35 accomplishments and provide continuous follow-up and support 8. Provide budget counseling and develop long-range plans SSCS,SC 35 with the family. Su~~ortive and Transition Services ~ Counseling ~ FDIC Money Smart Curriculum ~ Information and Referrals ~ Work clothes and tools ~ Transportation >-Educational supplies, books, tuition, etc. 9. Work with participants as needed to obtain affordable SSCS,SSSC 35 Housing 10. Establish and develop comprehensive services that CSBG Director, SSCS, 35 involve the total family to achieve self-sufficiency sc ~ Orientation ~ Develop plans ~ Assessment/reassessment ~ Facilitate problem-solving sessions );>-Employment Counseling 11. Encourage participants to establish and maintain SSCS,SC 35 savings account. 12. Maintain updated records of all activities and SSCS, SC 35 Accomplishments. 13. Provide staffing at Joblink Centers in each county. sc 09/14 Fiscal Year 2014-15 Community Services Block Grant Application Page 28 of 54 Implementation Schedule Second Third Fourth Quarter Quarter Quarter 75 95 110 (40) (25) (10) 12/14 03/15 06/15 12/14 03/15 06/15 75 95 110 (40) (25) (10) 75 95 110 (40) (25) (10) 75 95 110 (40) (25) (10) 75 95 110 (40) (25) (10) 75 95 110 (40) (25) (1 0) 75 95 110 (40) (25) (1 0) 12/14 03/15 06/15 14. Stabilization Services CSBG Director, SSCS, 09/14 }> Contact partners in the event emergency sc assistance is needed }> Conduct mandatory crisis prevention/budgeting workshops }> Advocate with service providers on participants behalf to avoid evictions, disconnects, etc. }> Crisis interventions. 15. Administer EFSP, United Way and other funds in the CSBG Director, SSCS 09/14 agency's service areas. 16. Conduct needs assessment to identify and prioritize the SSCS, SC 09/14 needs expressed by low-income people in our service area. 17. Operations & Accountability CSBG Director 09/14 }> Report on outcome measures }> Provide staff development & training }> Monitor AR4CA reports }> Complete and submit CSBGIS Report to OEO }> Complete and submit end of the year report to OEO }> Submit Profile report to OEO in the 286 report }> Provide report to the agency's Board of Directors on a bi-monthly basis }> Provide report to STARS Policy Advisory Council on a quarterly basis Fiscal Year 2014-15 Community Services Block Grant Application Page 29 of 54 JLHCA, Inc 12/14 03/15 06/15 12/14 03/15 06/15 12/114 03/15 06/15 12/14 03/15 06/15 Community Services Block Grant Program Fiscal Year 2014-15 Application for Funding One-Year Work Program OEO Form 212 (continued) JLHCA, Inc 10. Use the tables below to enter your agency's projected outcome results (targets). The outcome measures will be included in the agency's CSBG contract. All CSBG grantees operating self-sufficiency projects are required to complete Table 1. All CSBG grantees operating non self-sufficiency projects are required to enter applicable outcomes in the Table 2. If your agency operates more than one non self-sufficiency project, please add tables as needed. There should be one table of outcome measures per project. Table 1 Outcome Measures for Self-Sufficiency Projects Project Name: Expected to Achieve the Outcome Measures Outcome in Reporting Period (Target) Number of persons served 110 The number of low-income families rising above the poverty level 50 The average change in annual income per participant family $8,750 (in whole #'s) The number of participants obtaining employment 35 The number of participants obtaining jobs with medical benefits 9 The participant average wage rate $8.30 The number of participants completing education/training programs 15 The number of participants securing standard housing 18 The number of participants provided emergency assistance 55 Table 2 Outcome Measures for Non Self·Sufficienc 1 Projects Project Name: STARS Emergency Assistance Program Expected to Achieve the Outcome Measures Outcome in Reporting Period (Target) Number of persons served 290 Rental Assistance to prevent evictions 100 Utility assistance to prevent disconnections 150 Miscellaneous (medications, food, etc. 40 Fiscal Year 2014-15 Community Services Block Grant Application Page30 of 54 Co m m u n i t y Se r v i c e s Bl o c k Gr a n t Pr o g r a m Fi s c a l Ye a r 20 1 4 · 1 5 Ap p l i c a t i o n fo r Fu n d i n g On e · Ye a r Wo r k Pr o g r a m OE O Fo r m 21 2 (c o n t i n u e d ) 11. For Community Action Ag e n c i e s th a t se r v e mu l t i p l e co u n t i e s , pr o v i d e a br e a k d o w n of th e ex p e c t e d nu m b e r of pe r s o n s se r v e d in ea c h de s i g n a t e d county in the table belo w . Sh o w th e to t a l nu m b e r of pe r s o n s se r v e d in th e ta b l e . Nu m b e r of Fa m i l i e s to be Se r v e d Pe r Co u n t y Agency Name: Johnston-Lee-H a r n e t t Co m m u n i t y Ac t i o n , In c . Project Name: S.T.A.R.S. (Suc c e s s f u l l y Tr a n s i t i o n i n g to Ac h i e v e Re a l Se l f - S u f f i c i e n c y ) County Johnston I To t a l Total Planned 47 I Project Name: .T.A.R.S. (Succ e s s f u l l y Tr a n s i t i o n i n g to Ac h i e v e Re a l Se l f - S u f f i c i e n c y ) County Lee I To t a l Total Planned 18 I Project Name: .T.A.R.S. (Succ e s s f u l l y Tr a n s i t i o n i n g to Ac h i e v e Re a l Se l f - S u f f i c i e n c y ) County Harnett Total Planned 45 Nu m b e r of Fa m i l i e s to be Se r v e d Pe r Co u n t y Agency Name: Johnston-Lee-H a r n e t t Co m m u n i t y Ac t i o n , In c . Project Name: S.T.A.R.S. Eme r g e n c y As s i s t a n c e County Johnsto n Total Planned 150 Project Name: .T.A.R.S. Emer g e n c y As s i s t a n c e County Lee Total Planned 40 Project Name: .T.A.R.S. (Eme r g e n c y As s i s t a n c e County Harnett Total Planned ~ .. j _ I I I I I I I I I I : i Community Services Block Grant Program Fiscal Year 2014·15 Application for Funding Monitoring, Assessment and Evaluation Plan 1. Describe the role and responsibilities of the following in the assessment and evaluation of agency programs. Board of Directors: The Board will meet bi-monthly to: * Receive administration's assessment of project operation and process. * On its own they will review the monthly computer generated printouts showing progress made toward the timely fulfillment of Performance Measures. * Receive the advice and recommendations of the Board Planning and Evaluation Committee with respect to the disposition of the Project Policy Advisory Councils suggestions for program refinement, as well as with respect to their own suggestions. * Participate in public relation activities designed to highlight the agency's accomplishments. Low-Income Community: * The CSBG STARS Program will have Policy Advisory Council in all three counties according to the following design: * Five low-income participants either participants or persons in the community that can represent low-income people because of their involvement with them and their understanding of their problems. * Six representatives selected from the following agencies: Department of Social Services. * NC Cooperative Extension Program, Community College, Legal Services, Employment Security Commission and Job Link .. * The Successfully Transitioning to Achieve Real Self-Sufficiency (STARS) Policy Advisory Council's in each county will meet at least once per quarter in conjunction with the agency's preparation of OEO Form 240 Report to review program performance to date and to suggest adjustments in the program geared at achieving more effective services. They also share pertinent information from their agency and/or area that could be beneficial to the STARS participants as well as the program. * Representatives from the low-income community complete need survey and distribute surveys to residents in their own communities or in their workplace. * Representatives from the low-income serve as a PAC representative to the Board of Directors. Program Participants: * STARS participants complete need/interest surveys. * Work with their counselors to achieve self-sufficiency by following through on short and long- range plans. * Participants and family members when relevant attend workshops that can benefit them * STARS Counselors advise participants to approach their individual circumstances from a proactive standpoint rather a reactive stance. * Identify and develop strategies to achieve realistic goals designed to help lift themselves and the family out of poverty. a. Others: Community Services Block Grant Program Fiscal Year 2014-15 Application for Funding Monitoring, Assessment and Evaluation Plan JLHCA,Inc * Staff will assess the needs of low-income person during the initial intake, home visits, subsequent office visits and while administering the Holland Self-Esteem Test when they sign up for casemanagement and at the end of the year to determine progress made. * Staff evaluate the program by tracking the participants' progress toward reaching theirgoals, participation in group learning sessions and on job retention abilities, rate their income increases and whether or not they have risen above the poverty level. Staff attends and provides technical support at the PAC meetings. Staff acts as an advocate for the participant while working with them to help them become knowledgeable enough to advocate for themselves. * Representatives from other human service agencies serve on the Board, The Policy Advisory Councils in each county and network with the agency to foster a seamless delivery of services. * Members from the faith-based community work with the agency to assist in resolving crisis situations. They rely on the staffs relationship with community partners and their ability to both assess and authenticate the situation. The program's intake system is used to either used to either substantiate and/or negate information received by the applicant and to reduce the possibility of services being duplicated. Representatives from this group also serve on Policy Advisory Councils 2. Describe how administrative policies and procedures are monitored by the Board of Directors. The Board of Director monitors administrative policies and procedures through a review of financial records and reports, affirmative action goals, personnel action, etc. The Executive Director takes action as necessary to ensure that agency policies and procedures are not violated and recommend needed policy changes to the Board of Directors for approval. The Board examine, analyze, evaluate and discuses policies in effect during the program year. The Board reviews the annual audit with the agency's auditor to make sure that the agency is fiscally sound. The Board reviews program reports at each bi-monthly meeting. The Board's committee structure allows for all aspects of the agency's programs to be reviewed on a monthly or bi-monthly basis with committees reporting to the full board. The Board conduct an annual evaluation of the Executive Director's performance in order to determine if the agency's goals and objectives are being met. 3. Describe how the Board acts on monitoring, assessment and evaluation reports. * The Policy Advisory Council will meet each quarter to review, approve the ar4ca report, the crisis report, and the non-quantifiable, suggest if relevant program adjustments and share relevant information from their individual program that may be beneficial to low-income people. * Members of the Board of Directors' Planning and Evaluation Committee meet each quarter with the Policy Advisory Councils to review program progress and make recommendations if warranted o the full board on any proposed programmatic changes Fiscal Year 2014-15 Community Services Block Grant Application Page 33 of 54 Monitoring, Assessment and Evaluation Plan (Continuation Page) JLHCA, Inc * Each proposed project in last year's plan contained performance measures against which progress in the program was measured on a quarterly basis. All goals were accomplished 100%. For the program year ending June 30, 2013, we planned to provide comprehensive casemanagement for 75 CSBG families and we actually provided comprehensive casemanagement to 80 families. This fiscal year's project evaluation will begin July 01, 2014 and end June 30, 2015. 4. Describe the Board's procedure for conducting the agency self-evaluation. Board members participate on a team composed of staff, participants and community representatives to review records, interview staff and participants to ascertain whether the agency is in compliance with the rules and regulations that govern the agency. Board members complete a survey, distribute and collect surveys in their respective communities in order to rate the agency's services and to determine the type of services low-income persons need based on those responses 5. Summarize the results of the Board's most recent self-evaluation. Describe how the information has been or will be used to develop the agency's next Strategy for Eliminating Poverty. Indicate the timeframe and planned activities for the next evaluation. The Board of Directors met on October 18, .2013 for an orientation/training retreat. The results of a self- evaluation survey were reviewed and each item was discussed to determine strengths and weakness. A course of action and corrective strategies were addressed. During the board training member revisited the original benchmarks from a prior Strategic Planning Session. They assessed their strengths and weaknesses during the session as well as the duties and roles that each member would undertake for the coming year. Another self- evaluation will be conducted in October 2014. Fiscal Year 2014-15 Community Services Block Grant Application Page 34 of 54 Community Services Block Grant Program Fiscal Year 2014-15 Application for Funding CSBG Administrative Support Worksheet OEO Form 212A 1. Administrative Support requested for (Name of Grant): N/A 2. Total amount of Administrative Support requested: $ 3. Brief description of grant including the name of the funding source: 4. Total Grant Amount: 1$ 5. Give the reason for requesting Administrative Support from CSBG and describe how the funds will be used: (Attach supporting documentation in the Appendices) 6. How will the agency track the CSBG funds used for Administrative Support? 7. Basis for determining amount of Administrative Support needed. (Please select either Indirect Costs or Cost Allocation, not both.) Indirect Costs Indirect Cost Base: Indirect Cost Rate %: % Indirect cost base amount for this grant: $ Percent indirect allowed by funding source for this % grant: Dollar amount indirect allowed by funding source for $ this grant: Cost Allocation Percent of administrative costs allowed by funding % source for this grant%: Dollar amount of administrative costs allowed by $ funding source for this grant: 8. Actual numerical calculation used to determine Administrative Support needed: 9. Administrative Support to be applied: Monthly (choose one) Quarterly Annually Fiscal Year 2014-15 Community Services Block Grant Application Page35 of 54 JLHCA, Inc OEO Form 225N· The Budget Narrative Space Costs: Travel: All calculations are provided in OEO 225. Supplies/Materials:AII explanations are provided in OEO Form 225 Other: Fiscal Year 2014-15 Community Services Block Grant Application Page 16 of 32 Agency Name VERIFICATION OF 501 (C) (3) STATUS We, the undersigned entity, hereby testify that the undersigned entity's 501 (c) (3) status is on file with the North Carolina Department of Health and Human Services, Division of Social Services is still in effect. Johnston-Lee-Harnett Community Action, Inc. Name of Agency xecutive Director, or other Authorized Official Sworn to and subscribed before me, This is the ___ day of _______ , 20 . Notary Public My Commission expires: _______ _ NOTARIZED CONFLICT OF INTEREST POLICY State of North Carolina County of Johnston I, , Notary Public for said County and State, certify that ---------------------personally appeared before me this day and acknowledged thatheffiheis_~~~~------------------of ___________________ ___ [enter name of entity] and by that authority duly given and as the act of the Organization, affirmed that the foregoing Conflict of Interest Policy was adopted by the Board of Directors/Trustees or other governing body in a meeting held on the _________ day of Sworn to and subscribed before me this _____ day of----------' __ . (Official Seal) Notary Public My Commission expires--------------' 20 ••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••• Instruction for Organization: Sign and attach the following pages after adopted by the Board of Directors/Trustees or other governing body OR replace the following with the current adopted conflict of interest policy. Johnston-Lee-Harnett Community Action, Inc. Name of Organization Signature of Organization Official Conflict of Interest Policy Instructions: This document is intended as an aid to assist non-State entities in establishing a conflict of interest policy. It is not intended to be used verbatim, but rather to serve as a template for nongovernmental organizations as they craft their individual conflict of interest policy. This example includes definitions of what is considered unacceptable, and the consequences of any breaches thereof. Each organization that chooses to use this template should take care to make changes that reflect the individual organization. The Board of Directors/Trustees or other governing persons, officers, employees or agents are to avoid any conflict of interest, even the appearance of a conflict of interest. The Organization's Board of Directors/Trustees or other governing body, officers, staff and agents are obligated to always act in the best interest of the organization. This obligation requires that any Board member or other governing person, officer, employee or agent, in the performance of Organization duties, seek only the furtherance of the Organization mission. At all times, Board members or other governing persons, officers, employees or agents, are prohibited from using their job title, the Organization's name or property, for private profit or benefit. A The Board members or other governing persons, officers, employees, or agents of the Organization should neither solicit nor accept gratuities, favors, or anything of monetary value from current or potential contractors/vendors, persons receiving benefits from the Organization or persons who may benefit from the actions of any Board member or other governing person, officer, employee or agent. This is not intended to preclude bona-fide Organization fund raising- activities. B. A Board or other governing body member may, with the approval of Board or other governing body, receive honoraria for lectures and other such activities while not acting in any official capacity for the Organization. Officers may, with the approval of the Board or other governing body, receive honoraria for lectures and other such activities while on personal days, compensatory time, annual leave, or leave without pay. Employees may, with the prior written approval of their supervisor, receive honoraria for lectures and other such activities while on personal days, compensatory time, annual leave, or leave without pay. If a Board or other governing body member, officer, employee or agent is acting in any official capacity, honoraria received in connection with activities relating to the Organization are to be paid to the Organization. C. No Board member or other governing person, officer, employee, or agent of the Organization shall participate in the selection, award, or administration of a purchase or contract with a vendor where, to his knowledge, any of the following has a financial interest in that purchase or contract: 1. The Board member or other governing person, officer, employee, or agent; 2. Any member of their family by whole or half blood, step or personal relationship or relative-in-law; 3. An organization in which any of the above is an officer, director, or employee; 4. A person or organization with whom any of the above individuals is negotiating or has any arrangement concerning prospective employment or contracts. D. Duty to Disclosure --Any conflict of interest, potential conflict of interest, or the appearance of a conflict of interest is to be reported to the Board or other governing body or one's supervisor immediately. E. Board Action --When a conflict of interest is relevant to a matter requiring action by the Board of Directors/Trustees or other governing body, the Board member or other governing person, officer, employee, or agent (person(s)) must disclose the existence of the conflict of interest and be given the opportunity to disclose all material facts to the Board and members of committees with governing board delegated powers considering the possible conflict of interest. After disclosure of all material facts, and after any discussion with the person, he/she shall leave the governing board or committee meeting while the determination of a conflict of interest is discussed and voted upon. The remaining board or committee members shall decide if a conflict of interest exists. In addition, the person(s) shall not participate in the final deliberation or decision regarding the matter under consideration and shall leave the meeting during the discussion of and vote of the Board of Directors/Trustees or other governing body. F. Violations of the Conflicts of Interest Policy --If the Board of Directors/Trustees or other governing body has reasonable cause to believe a member, officer, employee or agent has failed to disclose actual or possible conflicts of interest, it shall inform the person of the basis for such belief and afford the person an opportunity to explain the alleged failure to disclose. If, after hearing the person's response and after making further investigation as warranted by the circumstances, the Board of Directors/Trustees or other governing body determines the member, officer, employee or agent has failed to disclose an actual or possible conflict of interest, it shall take appropriate disciplinary and corrective action. G. Record of Conflict --The minutes of the governing board and all committees with board delegated powers shall contain: 1. The names of the persons who disclosed or otherwise were found to have an actual or possible conflict of interest, the nature of the conflict of interest, any action taken to determine whether a conflict of interest was present, and the governing board's or committee's decision as to whether a conflict of interest in fact existed. 2. The names of the persons who were present for discussions and votes relating to the transaction or arrangement that presents a possible conflict of interest, the content of the discussion, including any alternatives to the transaction or arrangement, and a record of any votes taken in connection with the proceedings. Approved by: Johnston-Lee-Harnett Community Action, Inc. Name of Organization Signature of Organization Official Date Conflict of Interest Verification (Annual) We, the undersigned entity, hereby testify that our Organization's Conflict of Interest Acknowledgement and Policy adopted by the Board of Directors/Trustees or other governing body, is on file with the North Carolina Department of Health and Human Services (DHHS). If any changes are made to the Conflict of Interest Policy, we will submit a new Conflict of Interest Acknowledgment and Policy to the Department (DHHS). Johnston-Lee-Harnett Community Action, Inc. Name of Organization Chairman, Executive Director, or other Authorized Official Date INCORPORATED MAIN OFFICE Phone 919-934-2145 Fax 919-934-6231 Post Office Drawer 711 11 02 Massey Street Smithfield, NC 27577 LEE COUNTY OFFICE Phone 919-776-0746 Fax 919-774-1867 Post Office Box 1061 225 S. Steele Street Sanford, NC 27330 To: State Agency Head and Chief Fiscal Officer Certification: HARNETT COUNTY OFFICE Phone 910-814-8360 Fax 910-814-8362 Post Office Box 40 745 Shawtown Rd., Suite A Lillington, NC 27546-0040 We certifY that the Johnston-Lee-Barnett Community Action, Inc. does not have any overdue tax debts, as defmed by N.C.G.S. 105-243.1, at the federal, State, or local level. We further understand that any person who makes a false statement in violation ofN.C.G.S. 143C-6-23(c) is guilty of a criminal offense punishable as · provided byN.C.G.S. 143-34(b). Sworn Statement: Robert W. Atkinson and E. Marie Watson being duly sworn, say that we are the Board Chair and, Executive Director respectively, of Johnston-Lee-Barnett Community Action, Inc ... of Smithfield in the State ofN orth Carolina; and that the foregoing certification is true, accurate and complete to the best of our knowledge and was made and subscribed by us. We also acknowledge and understand that any misuse of State funds will be reported to the appropriate authorities for further action. B~ard Chair } C. '1'Y'\ A.A.-&v (A_~ Executive Director Sworn to and subscribed before me on the day of the date of said certification. My Commission Expires: ____ _ (Notary Signature and Seal) Ifthere are any questions, please contact the state agency that provided your grant. If needed, you may contact the North Carolina Office of State Budget and Management: NCGrants@osbm.nc.gov-(919)807-4795 1 G.S. 105-243.1 defines: Overdue tax debt. -Any part of a tax debt that remains unpaid 90 days or more after the notice of final assessment was mailed to the taxpayer. The term does not include a tax debt, however, if the taxpayer entered into an installment agreement for the tax debt under G.S. 105-237 within 90 days after the notice of final assessment was mailed and has not failed to make any payments due under the installment agreement." MS&NCD Form 0008 Eff. July 1, 2005 Revised July 18, 2006, 7107, 8109, 9/11 Page 1 of2 AN EQUAL OPPORTUNITY EMPLOYER UNITED WAY AGENCY MS&NCD Form 0008 Eff. July 1, 2005 Revised July 18, 2006, 7/07, 8/09, 9/11 Page 46 of 54 State Certification Contractor Certifications Required by North Carolina Law Instructions The person who signs this document should read the text of the statutes cited herein and consult with counsel and other knowledgeable persons before signing. The text of G.S. 143-59.1 can be found online at: http://www.ncga.state.nc. us/EnactedLegislation/Statutes/PD F /BySection/Chapter 143/GS 143-59 .l.pdf The text ofG.S. 143-59.2 can be found online at: http://www.ncga.state.nc. us/EnactedLegislation/Statutes/PDF /BySection/Chapter 143/GS 143-59 .2.pdf The text ofG.S. 105-164.8(b) can be found online at: http://www.ncga.state.nc.us/EnactedLegislation/Statutes/PDF/BySection/Chapter 1 05/GS 1 05-164.8.pdf Certifications (1) Pursuant to G.S. 143-59.1(b), the undersigned hereby certifies that the Contractor named below is not an "ineligible Contractor" as set forth in G.S. 143- 59.1(a) because: (a) Neither the Contractor nor any of its affiliates has refused to collect the use tax levied under Article 5 of Chapter 105 of the General Statutes on its sales delivered to North Carolina when the sales met one or more of the conditions ofG.S. 105-164.8(b); and (b) [check one of the following boxes] I:8J Neither the Contractor nor any of its affiliates has incorporated or reincorporated in a "tax haven country" as set forth in G.S. 143- 59.1(c)(2) after December 31, 2001; or D The Contractor or one of its affiliates has incorporated or reincorporated in a "tax haven country" as set forth in G.S. 143- 59.1 ( c )(2) after December 31, 2001 but the United States is not the principal market for the public trading of the stock of the corporation incorporated in the tax haven country. (2) Pursuant to G.S. 143-59.2(b), the undersigned hereby certifies that none of the Contractor's officers, directors, or owners (ifthe Contractor is an unincorporated (3) The Contractor shall require its subcontractors, if any, to make the same certifications before they perform any work under the contract. (4) The undersigned hereby certifies further that: 1. He or she is a duly authorized representative of the Contractor named below; 2. He or she is authorized to make, and does hereby make, the foregoing certifications on behalf of the Contractor; and 3. He or she understands that any person who knowingly submits a false certification shall be guilty of a Class I felony. Johnston-Lee-Barnett Community Action, Inc. Contractor's Name Signature of Contractor's Authorized Agent Printed N arne of Contractor's Authorized Agent Signature of Witness Printed Name of Witness Date Title Title Date The witness should be present when the Contractor's Authorized Agent signs this certification and should sign and date this document immediately thereafter. FEDERAL CERTIFICATIONS The undersigned states that: 1. He or she is the duly authorized representative of the Vendor named below; 2. He or she is authorized to make, and does hereby make, the following certifications on behalf of the Vendor, as set out herein: a. The Certification Regarding Nondiscrimination; b. The Certification Regarding Drug-Free Workplace Requirements; c. The Certification Regarding Environmental Tobacco Smoke; d. The Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion Lower Tier Covered Transactions; and e. The Certification Regarding Lobbying; 3. He or she has completed the Certification Regarding Drug-Free Workplace Requirements by providing the addresses at which the contract work will be performed; 4. [Check the applicable statement] D He or she has completed the attached Disclosure Of Lobbying Activities because the Vendor has made, or has an agreement to make, a payment to a lobbying entity for influencing or attempting to influence an officer or employee of an agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with a covered Federal action; OR D He or she has not completed the attached Disclosure Of Lobbying Activities because the Vendor has not made, and has no agreement to make, any payment to any lobbying entity for influencing or attempting to influence any officer or employee of any agency, any Member of Congress, any officer or employee of Congress, or any employee of a Member of Congress in connection with a covered Federal action. 5. The Vendor shall require its subcontractors, if any, to make the same certifications and disclosure. Board Chairman Signature Title Johnston-Lee-Hamett Community Action, Inc. Vendor Date [This Certification Must Be Signed By the Same Individual Who Signed the Proposal Execution Page] ********************************************************************************************************** I. Certification Regarding Nondiscrimination The Vendor certifies that it will comply with all Federal statutes relating to nondiscrimination. These include but are not limited to: (a) Title VI of the Civil Rights Act of 1964 (P.L. 88-352) which prohibits discrimination on the basis of race, color or national origin; (b) Title IX of the Education Amendments of 1972, as amended (20 U.S.C. §§1681-1683, and 1685-1686), which prohibits discrimination on the basis of sex; (c) Section 504 of the Rehabilitation Act of 1973, as amended (29 U.S.C. §794), which prohibits discrimination on the basis of handicaps; (d) the Age Discrimination Act of 1975, as amended (42 U.S.C. §§6101-6107), which prohibits discrimination on the basis of age; (e) the Drug Abuse Office and Treatment Act of 1972 (P.L. 92-255), as amended, relating to nondiscrimination on the basis of drug abuse; (f) the Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment and Rehabilitation Act of 1970 (P.L. 91-616), as amended, relating to nondiscrimination on the basis of alcohol abuse or alcoholism; (g) Title VIII of the Civil Rights Act of 1968 (42 U.S.C. §§3601 et seq.), as amended, relating to nondiscrimination in the sale, rental or financing of housing; (h) the Food Stamp Act and USDA policy, which prohibit discrimination on the basis of religion and political beliefs; and (i) the requirements of any other nondiscrimination statutes which may apply to this Agreement. ********************************************************************************************************** H. Certification Regarding Drug-Free Workplace Requirements 1. The Vendor certifies that it will provide a drug-free workplace by: (a) Publishing a statement notifYing employees that the unlawful manufacture, distribution, dispensing, possession or use of a controlled substance is prohibited in the Vendor's workplace and specifYing the actions that will be taken against employees for violation of such prohibition; (b) Establishing a drug-free awareness program to inform employees about: (1) The dangers of drug abuse in the workplace; (2) The Vendor's policy of maintaining a drug-free workplace; (3) Any available drug counseling, rehabilitation, and employee assistance programs; and (4) The penalties that may be imposed upon employees for drug abuse violations occurring in the workplace; (c) Making it a requirement that each employee be engaged in the performance of the agreement be given a copy of the statement required by paragraph (a); (d) NotifYing the employee in the statement required by paragraph (a) that, as a condition of employment under the agreement, the employee will: (1) Abide by the terms of the statement; and (2) NotifY the employer of any criminal drug statute conviction for a violation occurring in the workplace no later than five days after such conviction; (e) NotifYing the Department within ten days after receiving notice under subparagraph (d)(2) from an employee or otherwise receiving actual notice of such conviction; (f) Taking one of the following actions, within 30 days of receiving notice under subparagraph (d)(2), with respect to any employee who is so convicted: (I) taking appropriate personnel action against such an employee, up to and including termination; or (2) Requiring such employee to participate satisfactorily in a drug abuse assistance or rehabilitation program approved for such purposes by a Federal, State, or local health, law enforcement, or other appropriate agency; and (g) Making a good faith effort to continue to maintain a drug-free workplace through implementation of paragraphs (a), (b), (c), (d), (e), and (f). 2. The sites for the performance of work done in connection with the specific agreement are listed below (list all sites; add additional pages if necessary): StreetAdmessNo.l:~ll~0~2~M~as~s~ey~S~tr~ee~t~--------------------------------------~------------- City, State, Zip Code: Smithfield NC 27577 StreetAdmessNo.2:~2~2~5~S~·~S~t~ee~Ie~Str~ee~t ____________________ ~------------~----------------- City, State, Zip Code: _;::.:San=fo,_,r'""'d"'-'N'-'-""C--"2'-'-7~33~0'------------------------------- 3. Vendor will inform the Department of any additional sites for performance of work under this agreement. 4. False certification or violation of the certification may be grounds for suspension of payment, suspension or termination of grants, or government-wide Federal suspension or debarment. 45 C.F.R. 82.510. ****************************************************************************************** III. Certification Regarding Environmental Tobacco Smoke Public Law 103-227, Part C-Environrnental Tobacco Smoke, also known as the Pro-Children Act of 1994 (Act), requires that smoking not be permitted in any portion of any indoor facility owned or leased or contracted for by an entity and used routinely or regularly for the provision of health, day care, education, or library services to children under the age of 18, if the services are funded by Federal programs either directly or through State or local governments, by Federal grant, contract, loan, or loan guarantee. The law does not apply to children's services provided in private residences, facilities funded solely by Medicare or Medicaid funds, and portions of facilities used for inpatient drug or alcohol treatment. Failure to comply with the provisions of the law may result in the imposition of a civil monetary penalty of up to $1,000.00 per day and/ or the imposition of an administrative compliance order on the responsible entity. The Vendor certifies that it will comply with the requirements of the Act. The Vendor further agrees that it will require the language of this certification be included in any subawards that contain provisions for children's services and that all sub-grantees shall certify accordingly. ************************************************************************************************************ IV. Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion Lower Tier Covered Transactions Instructions [The phrase "prospective lower tier participant" means the Vendor.] I. By signing and submitting this document, the prospective lower tier participant is providing the certification set out below. 2. The certification in this clause is a material representation of the fact upon which reliance was placed when this transaction was entered into. If it is later determined that the prospective lower tier participant knowingly rendered an erroneous certification, in addition to other remedies available to the Federal Government, the department or agency with which this transaction originate may pursue available remedies, including suspension and/or debarment. 3. The prospective lower tier participant will provide immediate written notice to the person to whom this proposal is submitted if at any time the prospective lower tier participant learns that its certification was erroneous when submitted or has become erroneous by reason of changed circumstances. 4. The terms "covered transaction," "debarred," "suspended," "ineligible," "lower tier covered transaction," "participant," "person," "primary covered transaction," "principal," "proposal," and "voluntarily excluded," as used in this clause, have the meanings set out in the Defmitions and Coverage sections of rules implementing Executive Order 12549, 45 CFR Part 76. You may contact the person to whom this proposal is submitted for assistance in obtaining a copy ofthose regulations. 5. The prospective lower tier participant agrees by submitting this proposal that, should the proposed covered transaction be entered into, it shall not knowingly enter any lower tier covered transaction with a person who is debarred, suspended, determined ineligible or voluntarily excluded from participation in this covered transaction unless authorized by the department or agency with which this transaction originated. 6. The prospective lower tier participant further agrees by submitting this document that it will include the clause titled "Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion--Lower Tier Covered Transaction," without modification, in all lower tier covered transactions and in all solicitations for lower tier covered transactions. 7. A participant in a covered transaction may rely upon a certification of a prospective participant in a lower tier covered transaction that it is not debarred, suspended, ineligible, or voluntarily excluded from covered transaction, unless it knows that the certification is erroneous. A participant may decide the method and frequency by which it determines the eligibility of its principals. Each participant may, but is not required to, check the Nonprocurement List. 8. Nothing contained in the foregoing shall be construed to require establishment of a system of records in order to render in good faith the certification required by this clause. The knowledge and information of a participant is not required to exceed that which is normally possessed by a prudent person in the ordinary course of business dealings. 9. Except for transactions authorized in paragraph 5 of these instructions, if a participant in a covered transaction knowingly enters into a lower tier covered transaction with a person who is suspended, debarred, ineligible, or voluntarily excluded from participation in this transaction, in addition to other remedies available to the Federal Government, the department or agency with which this transaction originated may pursue available remedies, including suspension, and/or debarment. Certification a. The prospective lower tier participant certifies, by submission of this document, that neither it nor its principals is presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in this transaction by any Federal department or agency. b. Where the prospective lower tier participant is unable to certify to any of the statements in this certification, such prospective participant shall attach an explanation to this proposal. ************************************************************************************************************ V. Certification Regarding Lobbying The Vendor certifies, to the best ofhis or her knowledge and belief, that: 1. No Federal appropriated funds have been paid or will be paid by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any Federal, state, or local government agency, a Member of Congress, a Member of the General Assembly, an officer or employee of Congress, an officer or employee of the General Assembly, an employee of a Member of Congress, or an employee of a Member of the General Assembly in connection with the awarding of any Federal contract, continuation, renewal, amendment, or modification of any Federal contract, grant, loan, or cooperative agreement. 2. If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any Federal, state or local government agency, a Member of Congress, a Member of the General Assembly, an officer or employee of Congress, an officer or employee of the General Assembly, an employee of a Member of Congress or an employee of a Member of the General Assembly in connection with this Federally funded contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form SF-LLL, "Disclosure of Lobbying Activities," in accordance with its instructions. 3. The undersigned shall require that the language of this certification be included in the award document for subawards at all tiers (including subcontracts, subgrants, and contracts under grants, loans, and cooperative agreements) who receive federal funds of$100,000.00 or more and that all subrecipients shall certify and disclose accordingly. 4. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission ofthis certification is a prerequisite for making or entering into this transaction imposed by Section 1352, Title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000.00 and not more than $100,000.00 for each such failure. ************************************************************************************************************ VI. Disclosure of Lobbying Activities Instructions This disclosure form shall be completed by the reporting entity, whether subawardee or prime Federal recipient, at the initiation or receipt of a covered Federal action, or a material change to a previous filing, pursuant to title 31 U.S.C. section 1352. The filing of a form is required for each payment or agreement to make payment to any lobbying entity for influencing or attempting to influence an officer or employee of any Federal or state or local agency, a Member of Congress, a Member of the General assembly, an officer or employee of Congress, an officer or employee of the General Assembly, an employee of a Member of Congress or an employee of a Member of the General Assembly in connection with a covered Federal action. Use the SF-LLL-A Continuation Sheet for additional information if the space on the form is inadequate. Complete all items that apply for both the initial filing and material change report. Refer to the implementing guidance published by the Office of Management and Budget for additional information. I. Identify the type of covered Federal action for which lobbying activity is and/or has been secured to influence the outcome of a covered Federal action. 2. Identify the status of the covered Federal action. 3. Identify the appropriate classification of this report. If this is a follow-up report caused by a material change to the information previously reported, enter the year and quarter in which the change occurred. Enter the date of the last previously submitted report by this reporting entity for this covered Federal action. 4. Enter the full name, address, city, state and zip code of the reporting entity. Include Congressional District, if known. Check the appropriate classification of the reporting entity that designates if it is, or expects to be, a prime or sub-award recipient. Identify the tier of the subawardee, e.g., the first subawardee of the prime is the 1st tier. Subawards include but are not limited to subcontracts, subgrants and contract awards under grants. 5. If the organization filing the report in Item 4 checks "Subawardee", then enter the full name, address, city, state and zip code of the prime Federal recipient. Include Congressional District, ifknown. 6. Enter the name of the Federal agency making the award or loan commitment. Include at least one organizational level below agency name, ifknown. For example, Department of Transportation, United States Coast Guard. 7. Enter the Federal program name or description for the covered Federal action (Item 1). If known, enter the full Catalog of Federal Domestic Assistance (CFDA) number for grants, cooperative agreements, loans, and loan commitments. 8. Enter the most appropriate Federal IdentifYing number available for the Federal action identified in Item 1 (e.g., Request for Proposal (RFP) number, Invitation for Bid (IFB) number, grant announcement number, the contract grant, or loan award number, the application/proposal control number assigned by the Federal agency). Include prefixes, e.g., "RFP-DE-90-001." 9. For a covered Federal action where there has been an award or loan commitment by the Federal agency, enter the Federal amount of the award/loan commitment for the prime entity identified in Item 4 or 5. 10. (a) Enter the full name, address, city, state and zip code of the lobbying entity engaged by the reporting entity identified in Item 4 to influence the covered Federal action. (b) Enter the full names of the individual(s) performing services, and include full address if different from 10(a). Enter Last Name, First Name and Middle Initial (MI). 11. Enter the amount of compensation paid or reasonably expected to be paid by the reporting entity (Item 4) to the lobbying entity (Item 10). Indicate whether the payment has been made (actual) or will be made (planned). Check all boxes that apply. If this is a material change report, enter the cumulative amount of payment made or planned to be made. 12. Check the appropriate boxes. Check all boxes that apply. If payment is made through an in-kind contribution, specifY the nature and value of the in-kind payment. 13. Check the appropriate boxes. Check all boxes that apply. If other, specifY nature. 14. Provide a specific and detailed description of the services that the lobbyist has performed, or will be expected to perform, and the date(s) of any services rendered. Include all preparatory and related activity, not just time spent in actual contact with Federal officials. IdentifY the Federal official(s) or employee(s) contacted or the officer(s), employee(s), or Member(s) of Congress that were contacted. 15. Check whether or not a SF-LLL-A Continuation Sheet(s) is attached. 16. The certifYing official shall sign and date the form, print his/her name, title, and telephone number. Public reporting burden for this collection of information is estimated to average 30 minutes per response, including time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the Office of Management and Budget, Paperwork Reduction Project (0348- 0046), Washington, D. C. 20503 Disclosure of Lobbying Activities (Approved by OMB 0344-0046) this form to disclose activities uant to 31 U.S.C.1352 1. Type of Federal Action: 2. 3. Report Type: D a. contract D a. Bid/offer/application D a. initial filing D b. grant D b. Initial A ward D c. cooperative agreement D c. Post-Award D d. loan D e. loan guarantee D f. loan insurance 4. Name and Address of Reporting Entity: D Prime D Subawardee Tier (ifknown) _________ _ Congressional District (if known) __________ _ 6. Federal Department/Agency: 8. Federal Action Number (if known) 10. a. Name and Address of Lobbying Entity (if individual, last name, first name, MI): (attach Continuation Sheet(s) SF-LLL-A, if necessary) 11. Amount of Payment (check all that apply): $ ______________ D actual D planned 12. Form of Payment (check all that apply): D a. D b. cash In-kind; specify: Nature ________ _ Value _________ _ 5. D b. material change For Material Change Only: Year Quarter Date Of Last Report: ______ _ If Reporting Entity in No.4 is Subawardee, Enter Name and Address ofPrime: Congressional District (if known) __________ _ 7. Federal Program Name/Description: CFDA Number (if applicable) _________ _ 9. Award Amount (if known) b. Individuals Performing Services (including address if different from No. 1 Oa.) (last name, first name, MI): (attach Continuation Sheet(s) SF-LLL-A, if necessary) 13. Type of Payment (check all that apply): D a. retainer D b. one-time fee D c. commission D d. contingent fee D e. deferred D f. other; specify: 14. Brief Description of Services Performed or to be Performed and Date(s) of Services, including officer(s), employee(s), or Member(s) contacted, for Payment Indicated in Item !!(attach Continuation Sheet(s} SF-LLL-A, if necessary): 15. Continuation Sheet(s) SF-LLL-A attached: D Yes D No 16. Information requested through this form is authorized by title 31 Signature:-------------------- U. S.C. section 1352. This disclosure of lobbying activities is a material representation of fact upon which reliance was placed by Print Name:-------------------- the tier above when this transaction was made or entered into. This disclosure is required pursuant to 31 U.S. C. 1352. This Title:-------------------- information will be reported to the Congress semi-annually and will be available for public inspection. Any person who fails to Telephone No: ________ Date: _______ _ file the required disclosure shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. Authorized for Local Reproduction Standard Form-LLL FFATA REPORTING SECTION FOR PRIOR FISCAL YEAR Entities Required to Provide FFATA Data: All entities which receive federal funding are required to provide the following information per the reporting requirements of the Federal Funding Accountability and Transparency Act (FFATA). [J Attach evidence of your registration with the Central Contractor Registration (CCR) (i.e., a printout of the results page from a CCR search on your entity's name or DUNS number). Entity's Legal Name: DUNS Number of Entity Location of Entity: Street Address: City/State/Zip: Johnston-Lee-Hamett Community Action, Inc. 153233663 DUNS Number of Entity's ------------Parent (if applicable) 11 02 Massey Street Smithfield, N. C. 27577 Congressional District/ County: Contract Number Associated with Performance Locations Locations ofPerformance Under the Award (add additional pages if necessary) address city I state I zip congressional district I county address city I state I zip congressional district I county address city I state I zip congressional district I county 11 02 Massey Street address Smithfield, NC. 27577 city I state I zip ----------~---------------congressional district I county ------------~-------------225 S. Steele Street address ----------------Sanford, NC 275330 city I state/ zip -----~------------congressional district I county -------------------745 Shawtown Rd., Suite A address Lillington, NC 27546-0040 city I state I zip ----~--~------------congressional district I county Entities Required to Provide Executive Compensation Data List Executive Compensation for the five most highly compensated Officers: 1. 2. 3. 4. 5. Provide signature below of person completing the above information. Entity: Johnston-Lee-Harnett Community Action, Inc. Total Compensation Name: E. Marie Watson Title: Executive Director Signature c.~ Wa...bn Date: December 16, 2013 Questions and Submission -Please Contact: (FFATA) Rev: I 1/19/12 Glenda Pearce, NC Grants Manager DHHS-Social Services 2401 Mail Service, Center, Raleigh, NC 27699-2401 Telephone Number: 919-527-6425 Email: glenda.pearce@dhhs.nc.gov Federal Funding Accountability and transparency Act Subaward Data reporting Requirements OEOForm 225 Revised: 8/8/2013 AG E N C Y BU D G E T IN F O R M A T I O N Bu d g e t Ty p e : An n u a l Ap p l i c a t i o n : X Am e n d m e n t : Bu d g e t Ch a n g e : Section 1. IDENTIFICATION Agency Name: Jo h n s t o n - L e e - H a r n e t t Co m m u n i t : t Ac t i o n , In c . Co n t r a c t Pe r i o d : Ju l : t 1, 20 1 4 -J u n e 30 , 20 1 5 SECTION II. CONTRACT SUMMARY CSBG To t a l Di r e c t Co s t s To t a l In d i r e c t Co s t s Ad m i n . Su p p o r t (C S B G On l y ) To t a l Co n t r a c t Am o u n t _1 $7 2 5 , 2 0 9 $6 3 , 2 7 0 $7 8 8 , 4 7 9 TO T A L OE O CO N T R A C T AM O U N T $7 8 8 , 4 7 9 CSBG ADMINISTRATIVE SUPPORT: Ins e r t na m e of pr o g r a m su p p o r t e d by CS B G an d th e am o u n t of su p p o r t in d i c a t e d on th e Ad m i n i s t r a t i v e Su p p o r t Wo r k s h e e t (O E O Fo r m 21 2 A ) . !(Insert Program Name) (I n s e r t Pr o g r a m Na m e ) SECTION Ill. BUDGET SUMMARY OBJECT CATEGORIES ST A R S (I n s e r t Pr o g r a m Na m e ) PR O G R A M TO T A L S CO U N T Y TO T A L S Salaries & Wages $3 7 4 , 3 7 6 $3 7 4 , 3 7 6 $3 7 4 , 3 7 6 Fringe Benefits $1 1 3 , 1 5 1 $1 1 3 , 1 5 1 $1 1 3 , 1 5 1 Equipment Communication $1 1 , 9 8 8 $1 1 , 9 8 8 $1 1 , 9 8 8 Space Cost $3 , 0 0 0 $3 , 0 0 0 $3 , 0 0 0 Travel $1 4 , 1 3 9 $1 4 , 1 3 9 $1 4 , 1 3 9 Supplies/Materials $8 , 4 0 0 $8 , 4 0 0 $8 , 4 0 0 Contractual $6 , 5 0 0 $6 , 5 0 0 $6 , 5 0 0 Client Services $1 4 8 , 1 8 0 $1 4 8 , 1 8 0 $1 4 8 , 1 8 0 Other $4 5 , 8 5 0 $4 5 , 8 5 0 $4 5 , 8 5 0 Total Direct Costs $7 2 5 , 5 8 4 $7 2 5 , 5 8 4 $7 2 5 , 5 8 4 Indirect Costs Approved Rate: 16.8% $6 2 , 8 9 5 $6 2 , 8 9 5 $6 2 , 8 9 5 Base: $374.376 x 16.8% TOTALS $7 8 8 , 4 7 9 $7 8 8 , 4 7 9 $7 8 8 , 4 7 9 - OEOForm 225 Revised: 8/8/2013 Johnston-Lee-Harnett Community Action, In c . SECTION IV. -SALARIES AND FRINGE BE N E F I T S Annual % C S B G Fr i n g e Ty p e Fr i n g e Be n e f i t Co m p u t a t i o n (I n s e r t (I n s e r t Position Title Salary & No . o f CS B G Sa l a r y Sh a r e (I t e m i z e ) eg . Be n e f i t Am o u n t x No . of Mo n t h s ST A R S ST A R S Pr o g r a m Pr o g r a m Wages Mon t h s Na m e ) Na m e l FT E ' s eQ . Sa l a r y x be n e f i t Am o u n t ! % Fr i n q e s Sa l a r v Fr i n g e s Sa l a r y CSBG Director $58,896 12 $5 8 , 8 9 6 10 0 . 0 0 % FI C A $5 8 , 8 9 6 X 7. 6 5 % $4 , 5 0 6 $5 8 , 8 9 6 He a l t h In s u r a n c e $5 0 1 . 0 5 x 12 mo s $6 , 0 1 3 Wo r k e r s Ca m p $5 8 , 8 9 6 X 3. 2 % $1 , 8 8 5 Un e m p $2 1 , 4 0 0 X 1. 6 8 0 % $3 6 0 Li f e & Sa l Pr o t e c t i o n $5 8 , 8 9 6 X 1. 4 % $8 2 5 Re t i r e m e n t $5 8 , 8 9 6 X 5% $2 , 9 4 5 J. C.STARS Senior Cslr $50,280 12 $5 0 , 2 8 0 10 0 . 0 0 % FI C A $5 0 , 2 8 0 X 7. 6 5 % $3 , 8 4 6 $5 0 , 2 8 0 He a l t h In s u r a n c e $5 0 1 . 0 5 x 12 mo s $6 , 0 1 3 Wo r k e r s Co m p $5 0 , 2 8 0 X 3. 2 % $1 , 6 0 9 Un e m p $2 1 ,4 0 0 X 1. 6 8 0 % $3 6 0 Li f e & Sa l Pr o t e c t i o n $5 0 , 2 8 0 X 1. 4 % $7 0 4 Re t i r e m e n t $5 0 , 2 8 0 x5 % $2 , 5 1 4 LC STARS Senior Cslr $50,280 12 $5 0 , 2 8 0 10 0 . 0 0 % FI C A $5 0 , 2 8 0 X 7. 6 5 % $3 , 8 4 6 $5 0 , 2 8 0 He a l t h In s u r a n c e $5 0 1 . 0 5 x 12 mo s $6 , 0 1 3 Wo r k e r s Co m p $5 0 , 2 8 0 X 3. 2 % $1 , 6 0 9 Un e m p $2 1 ,4 0 0 X 1. 6 8 0 % $3 6 0 Li f e & Sa l Pr o t e c t i o n $5 0 , 2 8 0 X 1. 4 % $7 0 4 Re t i r e m e n t $5 0 , 2 8 0 X 5% $2 , 5 1 4 H.C. STARS Senior Cslr $50,280 12 $5 0 , 2 8 0 10 0 . 0 0 % FI C A $5 0 , 2 8 0 X 7. 6 5 % $3 , 8 4 6 $5 0 , 2 8 0 He a l t h In s u r a n c e $5 0 1 . 0 5 x 12 mo s $6 , 0 1 3 Wo r k e r s Co m p $5 0 , 2 8 0 X 3. 2 % $1 , 6 0 9 Un e m p $2 1 ,4 0 0 X 1. 6 8 0 % $3 6 0 Li f e & Sa l Pr o t e c t i o n $5 0 , 2 8 0 X 1. 4 % $7 0 4 Re t i r e m e n t $5 0 , 2 8 0 X 5% $2 , 5 1 4 J.C. STARS Cslr $41,160 12 $4 1 '1 6 0 10 0 . 0 0 % FI C A $4 1 , 1 6 0 X 7. 6 5 % $3 , 1 4 9 $4 1 '1 6 0 He a l t h In s u r a n c e $3 0 0 x 12 mo s $3 , 6 0 0 Wo r k e r s Ca m p $4 1 , 1 6 0 X 3. 2 % $1 , 3 1 7 Un e m p $2 1 ,4 0 0 X 1. 6 8 0 % $3 6 0 Li f e & Sa l Pr o t e c t i o n $4 1 . 1 6 0 x 1 . 4 % $5 7 6 Re t i r e m e n t $4 1 , 1 6 0 X 5% $2 , 0 5 8 J. C. STARS Cslr $41 '160 12 $4 1 '1 6 0 10 0 . 0 0 % FI C A $4 1 , 1 6 0 x 7 . 6 5 % $3 , 1 4 9 $4 1 '1 6 0 He a l t h In s u r a n c e $5 0 1 . 0 5 x 12 mo s $6 , 0 1 3 Wo r k e r s Co m p $4 1 , 1 6 0 X 3. 2 % $1 , 3 1 7 Un e m p $2 1 , 4 0 0 X 1. 6 8 0 % $3 6 0 Li f e & Sa l Pr o t e c t i o n $4 1 . 1 6 0 x 1 . 4 % $5 7 6 Re t i r e m e n t $4 1 , 1 6 0 X 5% $2 , 0 5 8 TOTAL FRINGE S $8 6 , 2 0 5 $8 6 , 2 0 5 TOTAL SALAR I E S $2 9 2 , 0 5 6 $2 9 2 , 0 5 6 TOT A L FT E ' s 6. 0 0 !OEO Form 225 Revised: 81812013 Johnston-Lee-Harnett Community Action, In c . SECTION IV.-SALARIES AND FRINGE BE N E F I T S Annual %C S B G Fr i n g e Ty p e Fr i n g e Be n e f i t Co m p u t a t i o n (I n s e r t (I n s e r t !Position Title No. o f ST A R S ST A R S Pr o g r a m Pr o g r a m Salary & CS B G Sa l a r y Sh a r e (I t e m i z e ) eg . Be n e f i t Am o u n t x No . of Mo n t h s Mont h s Na m e \ Na m e \ l Wages FT E ' s eg . Sa l a r y x be n e f i t Am o u n t / % Fr i n g e s Sa l a r y Fr i n g e s Sa l a r y iL. C. STARS Cslr $41,160 12 $4 1 , 1 6 0 10 0 . 0 0 % FI C A $4 1 , 1 6 0 x 7 . 6 5 % $3 , 1 4 9 $4 1 , 1 6 0 He a l t h In s u r a n c e $5 0 1 . 0 5 x 12 mo s $6 , 0 1 3 Wo r k e r s Ca m p $4 1 , 1 6 0 x 3 . 2 % $1 , 3 1 7 Un e m p $2 1 ,4 0 0 X 1. 6 8 0 % $3 6 0 Li f e & Sa l Pr o t e c t i o n $4 1 . 1 6 0 x 1 . 4 % $5 7 6 Re t i r e m e n t $4 1 , 1 6 0 X 5% $2 , 0 5 8 H. C. STARS Cslr $41 '160 12 $4 1 '1 6 0 10 0 . 0 0 % FI C A $4 1 , 1 6 0 X 7. 6 5 % $3 , 1 4 9 41 1 6 0 ' He a l t h In s u r a n c e $5 0 1 . 0 5 x 12 ma s $6 , 0 1 3 ' Wo r k e r s Ca m p $4 1 , 1 6 0 X 3. 2 % $1 , 3 1 7 Un e m p $2 1 , 4 0 0 X 1. 6 8 0 % $3 6 0 Li f e & Sa l Pr o t e c t i o n $4 1 . 1 6 0 x 1 . 4 % $5 7 6 Re t i r e m e n t $4 1 , 1 6 0 X 5% $2 , 0 5 8 TOTAL FRINGES $2 6 , 9 4 6 $2 6 , 9 4 6 TOTAL SALARIE S $8 2 , 3 2 0 $8 2 , 3 2 0 TOTA L FT E ' s 2. 0 0 --------------- OEO Form 225 !Revised: 8/8/2013 Johnston-Lee-Harnett Community Actio n , In c . SECTION IVa. -BUDGET SUPPORT DA T A COST CATEGORY ST A R S (I n s e r t Pr o g r a m TO T A L Na m e ) EQUIPMENT Desc r i p t i o n Qu a n t i t y Un i t Pr i c e TOTAL EQUIPMENT COMMUNICATIONS Telephone/Fax-$914 x 12 mos $1 0 , 9 6 8 $1 0 , 9 6 8 Postage -$85 x 12 mos $1 , 0 2 0 $1 , 0 2 0 TOTALCOI\Ir( '!CATIONS $1 1 , 9 8 8 ~ 88 OEO Form 225 !Revised: 8/8/2013 iJohnston-Lee-Harnett Communi t y A c t i o n , In c . SECTION IVb-BUDGET SUPP O R T DA T A I ST A R S (I n s e r t Pr o g r a m TO T A L COST CATEGORY Na m e ) I SPACE COST , Utilities -$250 x 12 mos $3 , 0 0 0 $3 , 0 0 0 TOTAL SPACE COSTS $3 , 0 0 0 $3 , o o o l TRAVEL Local Travel -840 miles x .50 mi l e x 12 ma s $5 , 0 4 0 $5 , 0 4 0 Johnston 375 miles x .50 x 12 ma s ; Le e 14 1 mi l e s x .5 0 x 12 mo s ; H a r n e t t 32 4 x .5 0 x 12 mos. NCCAA Conference-8 staff x 3 da y s x $1 3 5 ni g h t x 56 pe r di e m ; 60 mi l e s x .5 0 $9 , 0 9 9 $9 , 0 9 9 SEACAA Conference-2 saff me m b e r s x 3 da y s x $1 3 5 ni g h t x 56 pe r di e m ; 60 0 m i x .5 0 National Conference -1 staff x 3 dy s x $1 9 0 ni g h t x $7 5 pe r di e m ; Ai r f a r e - $4 5 0 Contractor's Training-8 staff x 3 da y s x 56 ; 60 mi l e s x .5 0 TOTAL TRAVEL $1 4 , 1 3 9 $1 4 , 1 3 9 SUPPLIES/MATERIALS Materials -$700 x12 months $8 , 4 0 0 $8 , 4 0 0 Paper products, office supplies (p e n s , sa l e s , et c ) TOTAL SUPPLIES/MATERIAL S L _ _ _ _ - - - - - - - - ~ - - - - ~ - - - - - - - - - - $8 , 4 Q Q - - - - - - - - ~ - - - - - - - - - - - $8 , 4 0 0 - - - - - - - - ~ - OEO Form 225 Revised: 8/8/2013 Johnston-Lee-Harnett Community Actio n , In c . SECTION IVc.-BUDGET SUPPORT DA T A COST CATEGORY ST A R S (I n s e r t Pr o g r a m TO T A L Na m e ) CONTRACTUAL Audit (Per Cost Allocation Plan) Other (specify) Community Action Opportunities $2 , 5 0 0 $2 , 5 0 0 Data Entry CMA Technologies $4 , 0 0 0 $4 , 0 0 0 Voucher Data Entry I $6 , 5 0 0 $6 , 5 n n OEO Form 225 Revised: 8/8/2013 Johnston-Lee-Harnett Commun i t y Ac t i o n , In c . SECTION IVd.-BUDGET SUP P O R T DA T A COST CATEGORY ST A R S (I n s e r t Pr o g r a m TO T A L Na m e ) CLIENT SERVICES Case Management Clients -Av e r a g e $3 7 0 . 4 5 x 11 0 $4 0 , 7 5 0 $4 0 , 7 5 0 families for school, supplies, re n t ut i l i t i e s , de p o s i t s , cl o t h i n g , pa s t du e bi l l s , education, fuel, physicals, job dr u g te s t i n g an d wo r k s h o p s (f o o d , su p p l i e s an d sp a c e ) Crisis Assistance -$370.45 x 29 0 cl i e n t s $1 0 7 , 4 3 0 $1 0 7 , 4 3 0 families for school, supplies, re n t ut i l i t i e s , de p o s i t s , cl o t h i n g , pa s t du e bi l l s , education, fuel, physicals, job dr u g te s t i n g an d wo r k s h o p s (f o o d , su p p l i e s an d sp a c e ) . I TOTAL CLIENT SERVICES $1 4 8 , 1 8 0 $1 4 8 , 1 8 0 OTHER (specify) Insurance -annual general liab i l i t y $2 5 , 6 0 0 $2 5 , 6 0 0 Maint & Repairs-Garbage pi c k u p - bu i l d i n g re p a i r s . - $1 7 5 mo s x 12 mo s $2 , 1 0 0 $2 , 1 0 0 Meetings & Conferences -staf f re g i s t r a t i o n s - $3 5 0 x 11 st a f f $3 , 8 5 0 $3 , 8 5 0 Memberships & Subscriptions - lo c a l ne w s p a p e r s fo r j o b s - $8 3 . 3 4 x 12 mo s . $1 , 0 0 0 $1 , 0 0 0 Printing & Publications -CSBG Br o c h u r e s an d ot h e r pr o g r a m li t e r a t u r e - $4 1 . 6 7 x 12 mo s $5 0 0 $5 0 0 Specialized Services-Drug Te s t , co p i e s , w a t e r - $8 0 0 x 12 mo s . $9 , 6 0 0 $9 , 6 0 0 Training & Education (Staff tra i n i n g - Co l l e g e cl a s s e s ) - $4 0 0 x 8 st a f f $3 , 2 0 0 $3 , 2 0 0 ~J-OTHER $4 5 , 8 5 0 $4 5 , 8 5 0 OEO!TAB Revised: B/B/2013 CO U N T Y BU D G E T FI S C A L YE A R Ju l y 1 , 20 1 4 - Ju n e 30 , 20 1 5 AGENCY Johnston-L e e - H a r n e t t Co m m u n i t y Ac t i o n , In c . C 0 U N T Y N A M E (S ) Johnston Le e Ha r n e t t (C o u n t y ) (C o u n t y ) (C o u n t y ) ( C o u n t y ) (C o u n t y ) (C o u n t y ) ( C o u n t y ) TO T A L Per County Allocation $355,381 $1 4 1 , 9 2 2 $2 9 1 , 1 7 6 Expense Categories Salaries & Wages $167, 9 3 8 $6 6 , 4 6 0 $1 3 9 , 9 7 8 $3 7 4 , 3 7 6 Fringe Benefits $49, 4 9 9 $2 0 , 0 6 8 $4 3 , 5 8 4 $1 1 3 , 1 5 1 Equipment Communication $5, 3 9 5 $ 2 , 1 5 8 $4 , 4 3 5 $1 1 , 9 8 8 Space Costs $3, 0 0 0 $3 , 0 0 0 Travel $6, 3 6 3 $2 , 5 4 5 $5 , 2 3 1 $1 4 , 1 3 9 Supplies/Materials $3, 7 8 0 $1 ,5 1 2 $3 , 1 0 8 $8 , 4 0 0 Contractual $2, 9 2 5 $1 '1 7 0 $2 , 4 0 5 $6 , 5 0 0 Client Services $67, 6 3 4 $2 8 , 5 9 1 $5 1 , 9 5 5 $1 4 8 , 1 8 0 Other $20, 6 3 3 $8 , 2 5 3 $1 6 , 9 6 4 $4 5 , 8 5 0 Total Direct Costs $327, 1 6 7 $ 1 3 0 , 7 5 7 $2 6 7 , 6 6 0 $7 2 5 , 5 8 4 Indirect Costs $28, 2 1 4 $1 1 , 1 6 5 $2 3 , 5 1 6 $6 2 , 8 9 5 Admin Support (CSBG only) Total Costs $355, 3 8 1 $1 4 1 , 9 2 2 $ 2 9 1 , 1 7 6 $7 8 8 , 4 7 9 loeorrAe Pa g e 1 of 2 Pa g e s !Revised: 8/8/2013 TO T A L AG E N C Y BU D G E T FI S C A L YE A R Ju l ~ 1, 20 1 4 - Ju n e 30 , 2 0 1 5 AGENCY Johnston-Lee - H a r n e t t Co m m u n i ! ~ Ac t i o n , In c . I Pl e a s e ch e c k on e 11NDIRECT COST BASE: To t a l Di r e c t Co s t s X Sa l a r i e s / W a g e s Sa l a r i e s / F r i n g e s INDIRECT COST RATE: 16.8% I I P R O G R A M N A M E S RA P I D CA P A C I T Y 10BJECT CATEGORIES CSBG DS S HA R N E T T WE A T H E R - D O E LI H E A P - H A R R P LI H E A P - W A P EC O DE V RE H O U S I N G BU I L D I N G MP P HE A D ST A R T TO T A L Salaries & Wages $374,37 6 $1 5 , 0 0 0 $1 8 , 7 9 7 $1 0 0 , 4 2 4 $2 4 , 1 1 6 $2 1 , 5 0 2 $4 3 , 7 2 7 $4 , 0 0 0 $2 , 3 1 8 , 9 1 5 $2 , 9 2 0 , 8 5 7 Fringe Benefits $113,15 1 $2 , 5 5 0 $3 8 , 6 9 1 $2 6 , 7 6 2 $8 , 4 6 7 $ 5 , 6 3 9 $3 2 , 4 4 3 $1 , 2 8 0 $7 9 6 , 2 7 4 $1 , 0 2 5 , 2 5 7 Equipment Communication $11,98 8 $2 , 5 0 0 $3 , 8 6 1 $3 9 5 $4 , 3 7 3 $1 , 1 4 6 $3 0 0 $3 0 , 0 0 0 $5 4 , 5 6 3 Space Cost $3,00 0 $4 7 0 $5 4 5 $4 3 0 $7 2 , 0 0 0 $7 6 , 4 4 5 Travel $14,13 9 $1 '1 9 8 $4 , 7 1 0 $3 , 5 0 0 $3 7 , 9 9 1 $6 1 , 5 3 8 Supplies/Materials $8,40 0 $4 , 5 0 0 $1 7 1 , 9 0 9 $1 0 9 , 7 8 0 $4 8 , 2 8 5 $3 0 0 $6 7 , 0 6 2 $4 1 0 , 2 3 6 Contractual $6,50 0 $9 5 , 8 6 0 $2 7 7 , 9 5 8 $4 8 , 6 6 6 $3 4 , 7 0 0 $4 6 3 , 6 8 4 Client Services $148,18 0 $8 2 , 9 9 1 $2 , 0 0 0 $2 3 3 , 1 7 1 Other $45,85 0 $1 3 , 0 2 3 $3 4 , 3 4 7 $3 7 , 3 2 6 $8 9 , 1 9 2 $1 2 , 9 9 4 $1 7 , 1 7 2 $5 9 , 4 8 4 $4 , 1 2 0 $4 4 2 , 8 6 1 $7 5 6 , 3 6 9 Total Direct Costs $725,58 4 $3 7 , 5 7 3 $3 4 , 3 4 7 $3 6 8 , 1 1 2 $6 0 9 , 7 6 6 $1 5 0 , 8 3 1 $1 2 7 , 3 0 4 $1 3 6 , 8 0 0 $1 0 , 0 0 0 $3 , 8 0 1 , 8 0 3 $6 , 0 0 2 , 1 2 0 Indirect Costs $62,89 5 $2 , 5 2 0 $3 , 1 5 8 $1 , 5 1 9 $4 , 0 5 1 $3 9 0 , 3 1 1 $4 6 4 , 4 5 4 Admin Support (CSBG only) ' Total Costs $788,47 9 $4 0 , 0 9 3 $3 4 , 3 4 7 $3 7 1 , 2 7 0 $6 1 1 , 2 8 5 $1 5 4 , 8 8 2 $1 2 7 , 3 0 4 $1 3 6 , 8 0 0 $1 0 , 0 0 0 $4 , 1 9 2 , 1 1 4 $6 , 4 6 6 , 5 7 4 P R O G R A M N A M E S OBJECT CATEGORIES EA R L Y HE A D (I n s e r t Pr o g r a m SCHOOL FOOD NC P K EF S P UN I T E D WA Y SP E C I A L PR E S B Y T E R I A FO O D LI O N OT H E R TO T A L ST A R T NE W H O P E Na m e ) Salaries & Wages $56,93 6 $6 1 1 , 0 3 6 $1 0 2 , 4 6 4 $7 7 0 , 4 3 6 Fringe Benefits $14,88 6 $2 1 2 , 7 0 2 $2 6 , 1 2 9 $2 5 3 , 7 1 7 Equipment Communications $4 , 0 0 0 $1 2 3 $4 , 1 2 3 Space Costs $3 0 , 0 0 0 $3 0 , 0 0 0 Travel $2 1 , 2 5 0 $2 , 1 7 5 $2 3 , 4 2 5 Supplies/Materials $3 5 , 2 1 6 $1 8 , 2 0 7 $5 3 , 4 2 3 Contractual $7 , 2 5 0 $7 , 5 0 0 $1 4 , 7 5 0 Client Services $1 ,O D D $4 5 , 0 0 0 $5 1 , 3 8 8 $1 4 , 1 6 9 $1 , 5 0 0 $5 , 0 0 0 $1 1 8 , 0 5 7 Other $386,09 1 $8 2 , 6 0 0 $2 0 , 1 3 0 $4 8 8 , 8 2 1 Total Direct Costs $457,91 3 $1 , 0 0 5 , 0 5 4 $1 7 6 , 7 2 8 $4 5 , 0 0 0 $5 1 , 3 8 8 $1 4 , 1 6 9 $1 , 5 0 0 $5 , 0 0 0 $1 , 7 5 6 , 7 5 2 Indirect Costs $9,56 5 $1 0 2 , 9 0 6 $1 7 , 2 1 4 $1 2 9 , 6 8 5 Total Costs $467,47 8 $1 , 1 0 7 , 9 6 0 $1 9 3 , 9 4 2 $4 5 , 0 0 0 $51 , 3 ~ 1 3 ~1 4 , 1! ) 9 $1 , 5 0 0 .$ 5 , 0 0 0 $1 , 8 8 6 , 4 3 7 - - · - - - - - OEO/TAB Revised: B/B/2013 Supplies/Materials Other Contractual Client Services Other TOTALS $3,691,29 3 $1,278,97 4 $58,68 6 $106,44 5 $84,96 3 $463,65 9 $478,43 4 $351,22 8 $1,245,19 0 $7,758,87 2 $594,13 9 $8,353,01 1 $4 , 0 0 0 , 0 0 0 $3 , 5 0 0 , 0 0 0 $3 , 0 0 0 , 0 0 0 $2 , 5 0 0 , 0 0 0 $2 , 0 0 0 , 0 0 0 $1 , 5 0 0 , 0 0 0 $1 , 0 0 0 , 0 0 0 $5 0 0 , 0 0 0 $0 TO T A L S B Y OB J E C T CA T E G O R Y Ag e n c y To t a l s by Ob j e c t Ca t e g o r y Sa l . l n o s & W a g i ! S Fr i o g u B e n e f d S Eq u i p m e n t Co m m u n i c a t i o n s Sp o e o C o s \ s &, p p t i e s / M a l e r l a l s O~ e r C < l n l r a e t u a t Ci ~ I S I ! I ' \ ' I c e s Pa g e 2 o f 2 Pa g e s Ad m 1 0 S u p p o r t (C S B G o n t y )