Territory FAMILY SELF-SUFFICIENCY GRANT (FSSG) Program Plan

TerritoryFAMILY SELF-SUFFICIENCYGRANT (FSSG)Program PlanSFY: 2013Territory: Northeast Territory (PJ22)Counties Served: Allamakee (03), Benton (06), Blackhawk (07),Bremer (09), Buchanan (10), Butler (12), Clayton (22), Delaware(28), Dubuque (31), Fayette (33), Iowa (48), Johnson (52), Jones(53), Linn (57), Winneshiek (96)Effective Date: 01-01-2013Submitted ByScott Mather and Gina RobinsonPROMISE JOBS Territory SupervisorsTo be filled out by CODate Approved: 12-18-2012

Table of ContentsI. INTRODUCTION 1II. PLAN OVERVIEW 1III. INTAKE AND ELIGIBILITY 2A. Identifying Applicants 2B. Application Process & Procedures 2C. Eligible Services or Assistance 3D. Excluded Services or Assistance 7E. Supplanting 7F. Documenting Barrier(s) 8G. Procedures when Employed 8H. Follow-up procedures 8I. Staff training 9IV. EVALUATION OF SELF-SUFFICIENCY GRANTS 9A. Program Integrity 9B. Tracking Authorizations & Expenses 9C. Quarterly & Annual Program Performance Reporting 9V. ATTACHMENT ADDENDUM 10Attachment A: Application for AssistanceAttachment B: Notice of DecisionAttachment C: Review process checklistAttachment D: Follow-up Survey-(We call the clients to determine employedor not and fill in the spreadsheet.)Attachment E: Budgetary tracking systemAttachment F: Quarterly Outcome MeasuresAttachment G: Annual Program Evaluation

I. INTRODUCTIONThe purpose of the Family Self-Sufficiency Grant (FSSG) program is to provide immediateand short-term assistance to PROMISE JOBS participants and their families in order toassist in removing barriers related to obtaining or retaining employment. The FSSG programis making available for application monitary assistance not to exceed $1,000 per family in a12-month period to assist with addressing such barriers. The goal of the program is toreduce the length of time a family is depending on the family investment program (FIP).(Legal reference: 441—Chapter 47, Division III)II. PLAN OVERVIEWParticipation in FSSG program services is voluntary. Participants and their eligible familymay qualify for the following maximum grant in a 12 month period:Maximum Territory Limit: $1,000A year for a family shall be the 12 fiscal months following the date of authorization of theinitial payment for the family. A fiscal month begins and ends in different calendar months.The maximum limit can be met with one grant or several smaller grants, which when addedtogether equal no more than the maximum grant limit. While a family may receive more thanone grant in the 12 month period in some circumstances, payments cannot be established asregular or ongoing. For example: A family could receive a grant in January for car repairs of$800 and another grant in February for $115 for steel toed boots. A family cannot receive agrant of $50 a month to cover insurance premiums.Applicants need to have checked with other local resources prior to applying for FSSG funds.FSSG funds cannot be used for services that are available at no cost from other sources.Assistance through FSSG should enable the participant to maintain employment or obtainemployment within two full calendar months following the date of FSSG paymentauthorization. For example, if a payment is authorized on August 20, it should be anticipatedthat the participant can find employment in September or October. Participants shall beconsidered work ready at date of application per recommendation by their local PROMISEJOBS case manager.Each Territory will have a fact sheet on the FSSG program available for distribution. Thesefact sheets will contain information about the program such as purpose of the program,services available, eligibility requirements, program criteria, benefits to program participation,and notification processes. The fact sheets will be made available for distribution atPROMISE JOBS offices, Family Development and Self-Sufficiency (FaDSS) staff, IWD WorkReady Workshop facilitators, Income Maintenance Workers (IMW), DHS offices, and otherlocal community resource locations.IowaWORKS3420 University AveWaterloo IA 50701319-291-2546IowaWORKS4444 1 st Ave, NE, Ste 436Cedar Rapids IA 52402319-365-9474IowaWORKS680 Main St. 2 ndFloorDubuque IA 52001563-556-5800IowaWORKS312 WinnebagoDecorah IA 52101563-382-0457IowaWORKS1700 S 1 st Ave, Ste 11BIowa City IA 52240319-351-1035Page | 1

All DHS county offices and PROMISE JOBS office locations will have for review uponrequest a copy of the local FSSG plan and any additional written policies, procedures ormodifications to the plan.III. INTAKE AND ELIGIBILITYA. Identifying Applicants:1. FSSG program and services outlined are only available to PROMISE JOBSparticipants.2. PROMISE JOBS participants meeting with their case manager, FaDSS worker orIMW will be provided information about the FSSG program when the participantidentifies barrier(s) to obtaining/retaining employment.3. Participation in the program is voluntarya. When appropriate, PROMISE JOBS case managers should present thisopportunity when discussing options to addressing barrier(s) to reaching thePROMISE JOBS program goal; orb. Participant can contact their PROMISE JOBS case manager and requestconsideration.c. Participants choosing to apply and receive funds then opt to not complete theactivity for which they received funds will not be considered as choosing alimited benefit plan (LBP) While the PROMISE JOBS family investmentagreement (FIA) must be honored at all times and renegotiated andamended if family circumstances require it, no family shall be considered tobe choosing an LBP if the family choose not to participate in the FSSGprogram.4. Program eligibility criteria:a. Applicant must have identifiable barrier(s) to obtaining or retainingemployment that can be addressed by utilizing resources provided by theFSSG program.b. Applicant must be employed, have an offer of employment or categorized aswork ready and within two months of securing employment as identified byPROMISE JOBS case manager and/or Family Development Self Sufficiency(FaDSS) worker.c. Applicant may be required to provide documentation showing other localresources were approached prior to FSSG application.d. Applications for assistance must be submitted through PROMISE JOBS casemanager.e. Applications for FSSG program funding where the participant is receiving FIPbenefits under a hardship status must be submitted to the PROMISE JOBSProgram Manager of Workforce Services Division for review and approval.B. Application Process & Procedures:1. PROMISE JOBS participants may request an FSSG application at any timeduring their participation in the PROMISE JOBS programa. Application forms will be made available to program participants at allPROMISE JOBS office locations, from FaDSS workers, and at all countyDHS offices.2. Application procedures:Page | 2

a. Applicant must complete and submit FSSG application form and requiredsupporting documentation to local PROMISE JOBS case manager.b. Application packet will be reviewed by case manager to determine qualifyingcriteria is met and required documentation is included.c. Case manager will submit application packet to one of the following forreview and approval/denial:orLocal review committeePROMISE JOBS supervisor1) The designated committee members will review applications and makerecommendations to the local supervisor who will have final approval andprovide authorization with their signature.2) In the event the PROMISE JOBS supervisor is not available to reviewand authorize, applications may be reviewed by other local manager orforwarded to the PROMISE JOBS Program Manager of the WorkforceServices Division for review, authorization and signature.3) All applications submitted where the applicant is a current or known to bea former IWD, DHS or program subcontractor employee must be sent toPROMISE JOBS Program Manager of the Workforce Services Divisionfor review, authorization and signature. No local approvals will beauthorized in these situations.d. Applications will be reviewed with eligibility and determination made withinten (10) business days of submittal.1) Applicants should not assume eligibility until a Notice of Decisions hasbeen issued.2) A Notice of Decision, form 470-0602 will be issued specifying approval ordenial of the FSSG application, the legal authority for the decision andthe right to appeal the decision.i. Approvals will include type and value of assistance to beprovided.ii.Denials will include reason(s) for denial of application.3) Delays in process can occur if: funding for program has been restricted oreliminated, required documentation is not included with application ornatural disaster causes temporary office closure.C. Eligible Services or Assistance:The following is a listing of services that FSSG funds may provide assistance. This isnot an all encompassing list. If applicant is requesting assistance for a service notlisted below and is not on the Excluded list, those applications will need to besubmitted for review and approval to the PROMISE JOBS Program Manager of theWorkforce Services Division. Review and approval will be made on a case by casebasis.1. Motorized Vehicle Repairs require the following at time of application:a. Only requests for services that are equal to or less than the following will beconsidered. If costs exceed maximum limit, proof that applicant paid for orwill pay over limit costs will be required during application process.Page | 3

Territory Limit: $1,000b. Applicant must provide proof of a valid driver’s license.c. Applicant must provide proof of vehicle insurance.d. Applicant can only have one vehicle registered in their name at time ofapplication.e. Vehicle needing repair must be registered in applicant’s name.f. Vehicle will be defined as mode of transportation that operates on agas/electric powered motor.g. Applicant must provide two estimates for requested repairs from certifiedmechanics or licensed automotive repair shops.1) Towing may be included in the cost if needed.2) Only repairs to ensure vehicle operates will be considered. Cosmetic orunnecessary repairs such as air conditioning, body work, radio/stereorepair or other similar services will be considered unnecessary repairs.h. Payment will be made to vendor only.2. Occupational/Professional Licensure/Testing:a. Only requests for services that are equal to or less than the following will beconsidered. If costs exceed maximum limit, proof that applicant paid for orwill pay over limit costs will be required at time of application.Territory Limit: $1,000b. Covered services may include but are not limited to: Testing fees,Professional recertification, CDL/Chauffeur licenses, Trade/Union dues, orBonding fees.c. Self-employment start-up costs may be considered. Applicant must submit adetailed business plan, marketing plan and documented proof that theapplicant has sought resource assistance at one of the 15 Regional SmallBusiness Development Centers (SBDC).d. Applicant must provide original receipt of payment made or estimate of costsfrom established business/vendor/organization during application process.e. Payment will be made to vendor unless a written justification is providedutilizing original receipt.3. Housing/Relocation assistance:a. Only requests for services that are equal to or less than the following will beconsidered. If costs exceed maximum limit, proof that applicant paid for orwill pay over limit costs will be required during application process.Territory Limit: $1,000b. Relocation assistance may include truck/trailer rental, first month’s rent,and/or utility hook-up fees.Page | 4

1) Job site location must be greater than 30 miles from current residence2) Security or utility deposits will not be considered.3) Applicant must provide proof of employment or job offer with start dateand job site address4) Applications for relocation assistance are limited to once per lifetime.c. Housing assistance in order to retain employment1) Applicant must provide proof of employment at time of application.2) Only one month of rent will be considered.3) Security or utility deposits will not be considered.4) Applications for housing assistance are limited to once per 12 monthperiod, unless extenuating circumstances exist.i. If housing assistance is needed more than once in a 12 month period,applications and supporting documentation must be submitted to thePROMISE JOBS Program Manager of the Workforce ServicesDivision for review and approval. Review and approval will be madeon a case by case basis.d. Payments for housing or relocation assistance will be made to the vendoronly.4. Transportation, other than Vehicle repairs:a. Only requests for services that are equal to or less than the following will beconsidered. If costs exceed maximum limit, proof that applicant paid for orwill pay over limit costs will be required during application process.Territory Limit: $650b. Applications for transportation services will be granted one-time in a 12month period, unless extenuating circumstances exist.1) If transportation assistance is needed more than once in a 12 monthperiod, applications and supporting documentation must be submitted tothe PROMISE JOBS Program Manager of the Workforce ServicesDivision for review and approval. Review and approval will be made on acase by case basis.c. Money for gas, bus pass(es), cab fare(s), or carpooling expense(s) up to timeof 1 st paycheck may be considered as applicable services under this category($100.00 maximum).1) In order to apply for assistance for gas money, applicant must provideproof the following: vehicle ownership, valid Driver’s License and liabilityinsurance.d. Other services that may be considered include: bicycle (non-motorized)purchase/repair; and motorized vehicle titling, licensing (obtaining and/orrenewing Iowa Driver’s license) and registering.1) In order to apply for assistance with vehicle titling, licensing, andregistering, applicant must provide proof the following: vehicle ownership,valid Driver’s License and liability insurance.2) In order to apply for assistance with auto insurance, applicant mustprovide proof of the following: vehicle ownership and valid Driver’sLicense.3) Payment of taxes on vehicle is prohibited.e. Insurance payments will be made one (1) time for up to six months.Page | 5

f. All services for transportation will require proof of employment and job sitelocation.5. Clothing for employment:a. Only requests for services that are equal to or less than the following will beconsidered. If costs exceed maximum limit, proof that applicant paid for orwill pay over limit costs will be required during application process.Territory Limit: $300b. Applications for clothing assistance will be granted one-time in a 12 monthperiod, unless extenuating circumstances exist.1) If clothing for employment assistance is needed more than once in a 12month period, applications and supporting documentation must besubmitted to the PROMISE JOBS Program Manager of the WorkforceServices Division for review and approval. Review and approval will bemade on a case by case basis.c. Items may include: work related uniforms, office attire, or interview clothing.d. In order to apply for work related uniforms, applicant must provide proof ofemployment and statement from employer that is requiring uniform and nameof vendor that carries uniform.e. All applications for clothing assistance will require original receipt of purchaseor estimated cost from vendor.f. Payment will be made to vendor unless a written justification showing proofapplicant will pay for clothing and is seeking reimbursement. If payment is tobe made to applicant, prior approval will need to be made at local level.Applicants should not assume they will be reimbursed without completingapplication process.6. Tools/Equipmenta. Only requests for services that are equal to or less than the following will beconsidered. If costs exceed maximum limit, proof that applicant paid for orwill pay over limit costs will be required during application process.Territory Limit: $1,000b. Items may include: computer equipment & software (medical billing/coding),janitorial equipment, work related safety equipment (safety goggles, eyeglasses, work boots, coveralls, or other related items), and work relatedbackground checks.c. Payment will be made to vendor only.7. Grooming/Personal Carea. Only requests for services that are equal to or less than the following will beconsidered If costs exceed maximum limit, proof that applicant paid for orwill pay over limit costs will be required during application process.Territory Limit: $100b. Applications for Grooming/Personal Care will be granted one time in a 12month period, unless extenuating circumstances exist.Page | 6

1) If grooming/personal care assistance is needed more than once in a 12month period, applications and supporting documentation must besubmitted to the PROMISE JOBS Program Manager of the WorkforceServices Division for review and approval. Review and approval will bemade on a case by case basis.c. Services may include: hair cut, alarm clock, watch, calendar, or day planner.d. Applicant must provide original receipt of payment for items purchased within10 days of payment authorization.e. Applicants should not assume they will be reimbursed without completingapplication process.8. Utility services:a. Only requests for services that are equal to or less than the following will beconsidered. If costs exceed maximum limit, proof that applicant paid for orwill pay over limit costs will be required during application process.Territory Limit: $500b. Services may include: land-line phone, water, gas, or electric services.c. Cell phone purchases are not an allowable expense.d. If payment is for delinquency service, applicant must include a writtenjustification outlining reason for delinquency and details on how they plan tomaintain their utilities in a current standing.e. Payments will be made to vendor only.f. All applications and supporting documentation for assistance with utilitiesmust be submitted to the PROMISE JOBS Program Manager of theWorkforce Services Division. Review and approval will be made on a case bycase basis.D. Excluded Services or Assistance:The following is a listing of services that FSSG funds will NOT provide assistance.This is not an all encompassing list. If applicant is requesting assistance for a servicenot listed below and is not on the Included list, those applications will need to besubmitted for review and approval to the PROMISE JOBS Program Manager of theWorkforce Services Division. Review and approval will be made on a case by casebasis.1. All motorized vehicle purchases and down payments related to the purchase of avehicle2. Cigarettes and alcoholic beverages3. Legal expenses including traffic fines, attorney/lawyer fees, criminal or felonyfines, court costs, or court ordered obligations.4. Cellular phone purchases and service plans5. Controlled substances, illegal or prescribed6. Entertainment expenses7. Food purchases8. Gifts9. Pet care expenses10. Real estate purchases11. Household appliances and furnishingsPage | 7

12. Non work related clothing, jewelry and accessories; and clothing for familymembers13. Payments for delinquent bills, credit cards or installment loans14. Requests for cash15. School expenses (student loans, primary & secondary school expenses, ortuition)16. Vacations17. Childcare expenses18. Health insurance costs19. Direct sales kits (product sample kits, etc.)E. Supplanting:1. Application for services will not be approved when the applicant is currentlyeligible to receive like assistance from another programa. All applications for services will be reviewed to ensure that no otherorganization offers comparable support services.b. Supporting documentation from applicant must include what other localresources were approached for assistance.c. PROMISE JOBS case manager and/or FaDSS worker will have listing ofknown community resources that may be of assistance to address barrier(s).F. Documenting Barrier(s):1. The local PROMISE JOBS case manager will be review applicant’s case file andcommunicate with applicant and FaDSS or IM worker, if applicable, to verifyidentifying barrier(s) to employment.a. Identified barrier(s) to employment will be documented on FSSG applicationb. Written details must be included on application as to how FSSG assistancewill lead to employment by reducing or eliminating identified barrier(s)G. Procedures when Employed:1. Employment procedures and standards (must meet one of the two criteria listedbelow)a. Applicants who have secured employment must provide offer of employmentor statement of earnings as verifiable proof of employment.b. Applicants who are seeking employment must complete or be enrolled inIowa Workforce Development (IWD) work readiness workshop series;attending post secondary training and within two months of graduation orearning of a certificate; or actively enrolled in the PROMISE JOBS JobSearch component and timely submitting job search logs to PROMISE JOBScase manager.H. Follow-up procedures:1. PROMISE JOBS case manager will review case file within 30 calendar days andconduct necessary follow up with applicant to obtain all required proof ofpurchase original receipts for services provided as a result of receiving fundingfrom program.2. PROMISE JOBS case manager will follow up with applicant at the end of thesecond calendar month to determine if desired employment was obtained and/ormaintained and identified barrier(s) were appropriately addressed.Page | 8

I. Staff training:1. The Territory’s FSSG plan, program application, and forms will be accessible toall program staff2. Discussion regarding program plans, use of forms, policies, and procedures willbe provided during staff meetings3. PROMISE JOBS Supervisors may ask for technical assistance from IWD CentralOffice Coordinators & Quality Assurance staff if needed.IV. EVALUATION OF SELF-SUFFICIENCY GRANTSA. Program Integrity1. To ensure all required documentation is included with the application and localplan policies and procedures are followed, the Review Committee or PROMISEJOBS Supervisor will use a program check list.2. Each Territory will provide quarterly a listing of all FSSG approved cases toIWD’s Quality Assurance team. Cases will be randomly selected for monitoring ofprogram goals, performance measure and compliance with plans and rules.B. Tracking Authorizations & Expenses:1. A spreadsheet system will be maintained detailing expenditures, participants’names, state identification case file numbers, reason for expenditure, and datesof authorization.2. Applications with appropriate signatures and payment authorizations will bemaintained in the applicant’s PROMISE JOBS case file.3. Details from the tracking system will be submitted on a quarterly basis to IWDQuality Assurance team and are subject to random selection of monitoringprocesses to ensure policies and procedures were adhered to.C. Quarterly & Annual Program Performance Reporting:1. All quarterly and annual reports will be submitted to the IWD Quality AssuranceProgram Coordinator and QA Analysts on or before October 15, January 15,April 15, and July 15. Annual reports will be due on or before August 15. Thesereports will include:a. Number approved for FSSGb. Amount(s) authorized for eachc. Reason(s) for grant request2. PROMISE JOBS case managers must follow-up on applicants 60 days afterreceiving FSSG funding. This will include all applicants even if they are no longerreceiving FIP benefits.a. Follow-up questions: What was/were barrier(s), Was barrier(s) addressed,Did applicant obtain/retain employment, If retained, were hours/salaryincreased, Is applicant still receiving FIP benefits?3. Outcome Measures to be tracked include:a. Type(s) of barrier(s) addressed as a result of receiving FSSG funding.b. Applicants’ employability at 30 and 60 day intervals from date of paymentauthorization.4. The following information will be included in the Annual Program Evaluationreport:a. Percentage of participants that received FSSG program funding that are nolonger receiving FIP benefits six (6), nine (9), and 12 months after receipt offundingb. Barrier(s) that were resolved as a result of FSSG program fundingPage | 9

c. Number of applicants that chose a LBP after receiving FSSG funding, andwere additional barriers identified that could have been resolved with FSSGfundingV. ATTACHMENT ADDENDUMAttachment A: Application for AssistanceAttachment B: Notice of DecisionAttachment C: Review process checklistAttachment D: Follow-up Survey-(We call the clients to determine employedor not and fill in the spreadsheet.)Attachment E: Budgetary tracking systemAttachment F: Quarterly Outcome MeasuresAttachment G: Annual Program EvaluationPage | 10