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FY 2020/PY 2019 Title V/SCSEP / Senior Community Service Employment Program (SCSEP)

GRANT APPLICATION PACKET

INSTRUCTIONS

APPLICATION FOR TITLE V/SCSEP FUNDING UNDER THE OLDER AMERICANS ACT COVER PAGE

PAGES 1-3: UNIFORM APPLICATION FOR STATE GRANT ASSISTANCE-

Page 1: Agency Completed Section This page is completed by the Illinois Department on Aging. Page 2: Applicant Completed Section Applicant Agency Name (lines 16 and 17): Enter the legal name of the sponsoring agency of the grantee on line 16. On line 17, enter the common name (if the agency uses a different name than your legal name). Agency Type (line 18): Enter the sponsoring applicant agency’s Employer/Taxpayer Identification Number (EIN, TIN). Organizational DUNS Number (line 19): Enter the sponsoring agency’s DUNS number. Sam Cage Code (line 20): Enter your sponsoring agency’s System for Award Management (SAM) registration identifier. Business Address (line 21): Enter the business address of the sponsoring agency. Applicant’s Organizational Unit (lines 22 and 23): Enter Department Name on line 22 and the Division name on line 23. Mark N/A if “Not Applicable” on these lines if the Title V/SCSEP program is not located in a specific Department or Division. Applicant’s Name and Contact Information for Person to be Contacted for Program Matters Involving this Application (lines 24-31): Enter the contact information for the person who manages program activities for the Title V/SCSEP/Senior Community Service Employment Program (Title V/SCSEP/SCSEP) Grant. Note: Organizational Affiliation (line 28): Identify whether this is a staff person of the Title V/SCSEP/SCSEP. Applicant’s Name and Contact Information for Person to be Contacted for Business/Administrative Office Matters Involving this Application (lines 32-39): Enter the contact information for the person to be contacted who manages business and administrative (e.g., financial) activities for the Title V/SCSEP grant.

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Note: Organizational Affiliation (line 36): Identify whether this is a staff person of the Title V/SCSEP. Areas Affected by the Project (line 40): All applicants must identify the Planning and Service Areas (PSAs) and counties that they are proposing to serve in this section of the submitted Uniform Application for State Grant Assistance. List the Planning and Service Areas (PSAs) and counties within the PSAs you propose to serve with this grant application. You can submit the information as an attachment to the grant application. NOTE: Refer to Statewide PSA map included on page 33 of the Grant Instructions. If applying for a PSA, the applicant must serve all counties within the PSA where state slots are distributed. Legislative and Congressional Districts of Applicant (lines 41 and 42): List the applicable Legislative Districts on line 41 and the Congressional Districts on line 42 located in the service area of the applicant. If needed, use the following web site for such information. https://www.elections.il.gov/votinginformation/CongRepDist.aspx Title of Applicant’s Project (line 43): Do not complete. The Illinois Department on Aging has entered this information. Proposed Project Term (line 44): Do not complete. The Illinois Department on Aging has entered this information. Estimated Funding (line 45): Enter your FY 2020/PY 2019 Title V/SCSEP funding allocation on this line. Applicant Certification: Applicants must read this certification and then check or ‘X’ in the “I agree” box shown. Authorized Representative (lines 46-52): The authorized representative and signatory must complete this contact information in these lines. Signature of Authorized Representative (line 53): The original signature of the authorized representative must be included in this line. Date Signed (line 54): The authorized representative must enter the date that she/he signs this document.

PAGE 4: SECTION I: FINANCIAL PLAN

PART I: FINANCIAL PLAN The Uniform Grant Budget Template is mandated due to the General Accountability Transparency Act (GATA). All state agencies are mandated to use the form for all grants funded by the State of Illinois.

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Besides the following instructions, grantees should also review the Instructions for the required budget forms developed by the GATA Office at the Governor’s Office of Management and Budget (OMB). Section A, Page 1 (State of Illinois Funds) Page 1 should only include budgeted costs regarding federal Title V/SCSEP federal funds. Grantees should only enter budget information in the Year 1 column and the Total column.

Enter Organization Name and DUNS# at the top of the form.

Note lines 7, 8, 10 and 13 are shaded in gray. Do not enter information on line 7 (Consultant), line 8 (Construction), line 10 (Research and Development) since these budgeted costs do not apply to the grant. Additionally, do not complete Line 13 (Direct Administration) since Direct Administrative costs should be included in each budget category.

Lines 15 A and B should be used to reflect the enrollee-related budget categories such as enrollee travel, equipment and supplies, etc.

Enter the Total Direct Costs on line 16.

Indirect Costs on line 17. See the Notice of Funding Opportunity Announcement (NOFO) on requirements regarding Indirect Costs. Enter the Total Costs on line 18.

Total budgeted amounts for each budget category must match the total amounts included in the Budget Worksheet and Narrative (Exhibits I.A through I.R) in columns f and g, Title V/SCSEP Share.

Section A, Page 2 (Indirect Cost Rate Information)

Refer to the detailed Instructions developed by the GATA Office at OMB that are included in the NOFO about indirect administrative costs. The grantee must check only one category, and complete mandated follow-up activities (if applicable).

Section B, Page 3 (Other Illinois Funds)

Page 3 should only include budgeted costs regarding local cash and in-kind matching funds. Grantees should only enter budget information in the Year 1 column and the Total column. All Title V/SCSEP recipients are encouraged to budget at least 10% of the total cost of activities carried out under a Title V/SCSEP grant with Non-Federal resources. If an applicant budgets at least 10 percent of the total costs of activities within the submitted grant budgets, applicants will receive additional points in the competitive procurement process.

Enter Organization Name and DUNS# on the top of the form.

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Note lines 7, 8, 10 and 13 are shaded in gray. Do not enter information on line 7 (Consultant), line 8 (Construction), line 10 (Research and Development) since these budgeted costs do not apply to the grant. Additionally, do not complete Line 13 (Direct Administration) since Direct Administrative costs should be included in each budget category.

Lines 15 A and B should be used to reflect the enrollee-related budget categories such as enrollee travel, equipment and supplies, etc.

Total budgeted amounts for each budget category must match the total amounts included in the Budget Worksheet and Narrative (Exhibits 1.A through I.R) in column h and column i, (Non-Federal Share). Enter the Total Direct Costs on line 16.

Enter the Total Costs on line 18.

Certification, Page 4 Enter Organization Name and DUNS# at the top of the form.

This page must be signed by both the Chief Financial Officer and Executive Director (or equivalent) of the grantee and submitted with the other required budget forms.

FFATA Data Collection Form, Page 5 Since Title V/SCSEP funds are federal funds, the grantee must complete and submit this form with the required budget forms. Refer to page 5 for additional information.

Section C (Budget Worksheet & Narrative)

All grantees are required to submit a detailed budget worksheet and narrative with Sections A and B. The grantee must itemize all costs and complete every column of the budget worksheets and narrative since it explains how the costs were estimated and it justifies the need for the costs. The following are detailed instructions for the Budget

EXHIBIT I.A PART A: FEDERAL DOLLARS BY BUDGET CATEGORY Total budgeted amounts for each budget category in Exhibit I.A must match the total amounts included in other spreadsheets in Section C (Exhibits 1.A through I.R) and Section A (State of Illinois Funds) and Section B (Other Funds). Column 1, Administration:

Column 1, lines 1 through 16 reflects direct administration costs. If a grantee has an approved indirect cost rate that is applied to the grant, these indirect administration costs should be reflected on line 17 of Column 1. Administration costs (both direct and indirect) include: accounting, budgeting, financial, and cash management functions; procurement and purchasing functions; property management

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functions; personnel management functions; payroll functions; audit functions; developing systems and procedures, including information systems, required for these administrative functions; and oversight and monitoring responsibilities related to administrative functions. No more than 8.5% of the Title V/SCSEP funds can be used for the administration of the Title V/SCSEP project. This includes direct and indirect administration costs. The total for administration cannot exceed the administrative amount listed for your organization in the FY 2020/PY 2019 Base Level Planning Allocations spreadsheet included on page 32 of the Application Instructions. Please note that the lines that are shaded in grey are not applicable to this grant and should not be completed by the grantee. Line 1, Personnel -

Enter the total amount of salaries or wages budgeted for sub-grantee direct administrative staff as outlined in Exhibit I.B, Part A, Column f, Line 11 (Employee Wages Total).

Line 2, Fringe Benefits -

Enter the total amount of fringe benefits budgeted for sub-grantee direct administrative staff as outlined in Exhibit I.B, Part B, Column f, Line 11 (Fringe Benefits Total).

Line 3, Travel -

Enter the total amount budgeted for sub-grantee direct administrative staff for travel as outlined in Exhibit I.D, Column h, Line 11 (Travel Total).

Line 4, Equipment -

Enter the total amount budgeted for equipment to be purchased for sub-grantee direct administrative staff as outlined in Exhibit I.E, Part A, Column d, Line 11 (Equipment Total).

Line 5, Supplies -

Enter the total amount budgeted for supplies to be purchased for sub-grantee direct administrative staff as outlined in Exhibit I.E, Part B, Column d, Line 11 (Supplies Total).

Line 6, Contractual Services & Subawards

Enter contractual costs to be incurred as direct administrative costs as outlined in Exhibit I.F, Column d, Line 11 (Contractual Total).

Line 7, Consultant –

Do not enter information on line 7 since it is shaded in grey. Consultant costs do not relate to the grant.

Line 8, Construction –

Do not enter information on line 8 since it is shaded in grey. Constructions costs do not relate to the grant.

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Line 9, Occupancy – Rent and Utilities -

Enter the total amount of rental and utility expenses directly related to the direct administration of the program as outlined in Exhibit I.I, Column f, Line 11 (Occupancy Total).

Line 10, Research and Development –

Do not enter information on line 10 since it is shaded in grey. Research and Development costs do not relate to the grant.

Line 11, Telecommunications –

Enter the total amount of telecommunications costs that will be charged as direct administrative costs as outlined in Exhibit I.K, Column f, Line 11 (Telecommunications Total).

Line 12, Training and Education –

Enter the total amount budgeted for sub-grantee direct administrative staff for training and education as outlined in Exhibit I.L, Column f, Line 11 (Training and Education Total).

Line 13, Direct Administrative Costs –

Do not complete Line 13 (Direct Administration) since Direct Administrative costs should be included in each budget category in Column 1.

Line 14, Other/Miscellaneous Costs -

Enter amount of other costs directly related to the direct administration of the program as outlined in Exhibit I.N, Column f, Line 11 (Miscellaneous Total).

Line 15 and Line 16, Part A. and Part B. Grant Exclusive Line Items

Do not enter information since the two lines are shaded in grey. These lines do not relate to Administration.

Line 17, Indirect Cost(s) –

Enter the Rate (%) from the base ($) based on the approved indirect cost rate. Refer to Section B (Indirect Cost Rate Information) instructions for additional information. This may not apply to some applicants, if it does then the applicant should enter information on Line 17 and/or in Exhibit I.Q.

Line 18, Total Title V/SCSEP Costs- Enter the sum of line 1 through line 17. Line 19, Percentage of Total Costs -

Enter the percentage of administration costs of total costs. This is line 18, column 1 divided by line 18, column 5.

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COLUMN 2 - Enrollee Wages/Fringe Benefits Enrollee physicals shall be categorized as a fringe benefit and placed under "Enrollee Wages and Fringe Benefits" rather than as an "Other Enrollee Cost.” Not less than 75% of the total Title V/SCSEP funds must be used to pay for the wages and fringe benefits of participants in Title V/SCSEP. Note: The Department allocated approximately 80% of the federal funds for Enrollee Wages/Fringe Benefits and Other Enrollee Costs such as supportive services, etc. For Enrollee Wages/Fringe Benefits, budgeted costs can only be included on lines 1 and 2 of column 2. Line 1, Personnel -

Enter the total amount of salaries or wages budgeted for enrollees at the state minimum wage rate as outlined in Exhibit I.C, Part A, Column b, Line 6 (Enrollee Wages Total). Note: Effective January 1, 2020, the state minimum wage will increase from $8.25 to $9.25. Both rates should be reflected in the budget.

Line 2, Fringe Benefits -

Enter the total amount of fringe benefits budgeted for enrollees including the cost of physicals as outlined in Exhibit I.C, Part B, column b, Line 10 (Enrollee Wages Total).

Line 18, Total Costs-

Enter the sum of line 1 and line 2. Line 19, Percentage of Total Costs -

Enter the percentage of Enrollee Wages/Fringe Benefits costs of total costs. This is line 18, column 2 divided by line 18, column 5.

COLUMN 3 - Other Enrollee Costs

For Other Enrollee Costs, budgeted costs can only be included on lines 15 and 16 of column 3.

Line 15, Other Enrollee Costs is the total of Travel and Training and Education

Enter the total amount of budgeted “Travel and Training and Education” costs directly related to enrollee participation as outlined in column b, Part A and Part B of Section C, Exhibit 1.O (Grant Exclusive Line Items(s)). Column 3, Line 15 of Exhibit 1.A should equal the sum of Exhibit I.O, column b, line 6 (Enrollee Travel Total) in Part A and Exhibit I.O, column b, line 11 (Enrollee Training and Education Total) in Part B.

Line 16, Other Enrollee Costs is the total of Equipment and Supplies and

Other/Miscellaneous –

Enter the total amount of budgeted “Equipment and Supplies” costs directly

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related to enrollee participation as outlined in column d, Part A and Part B of Section C, Exhibit 1.P (Grant Exclusive Line Items(s)). Column 3, Line 16 of Exhibit 1.A should equal the sum of Exhibit I.P, column d, line 11 (Equipment Total) in Part A and Exhibit I.O, column d, line 11 (Other Miscellaneous Total) in Part B.

Line 18, Total Costs–

Enter the sum of line 15 and 16. Line 19, Percentage of Total Costs –

Enter the percentage of Other Enrollee Costs of total costs. This is line 18, column 3 divided by line 18, column 5.

COLUMN 4 - Other Enrollee Direct Costs The total for Other Enrollee Direct Costs cannot exceed the Max. OEC Direct amount listed for your organization in the FY 2020/PY 2019 Planning Allocations for Title V/SCSEP spreadsheets included on page 32 of the Application Instructions. All funds budgeted using OEC Direct Costs must be used for Title V/SCSEP direct service staff-related costs for outreach, recruitment, selection and intake purposes. For Other Enrollee Direct Costs, budgeted costs can only be included on lines 1, 2 and 3 of column 4. Line 1, Personnel -

Enter the total amount budgeted to the employment specialist for outreach, recruitment, selection and intake as outlined in Exhibit I.B, Part A, Column g, Line 11 (Employee Wages Total).

Line 2, Fringe Benefits -

Enter an appropriate amount budgeted to the employment specialist as outlined in Exhibit I.B, Part B, Column g, Line 11 (Fringe Benefits Total).

Line 3, Travel -

Enter total amount budgeted to the employment specialist for travel costs related to outreach, recruitment, selection and intake purposes as outlined in Exhibit I.D, Column i, Line 11(Travel Total).

Line 18, Total Costs-

Enter the sum of line 1, line 2 and line 3. Line 19, Percentage of Other Enrollee Direct Costs -

Enter the percentage of Other Enrollee Direct Costs of total costs. This is line 18, column 4 divided by line 18, column 5.

Column 5 - Total Title V/SCSEP Costs

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Enter the sum of columns 1 through 4 for each line to equal column 5 (Total Title V/SCSEP Costs). PART B: ALL RESOURCES All Title V/SCSEP recipients are encouraged to budget at least 10% of the total cost of activities carried out under a Title V/SCSEP grant with Non-Federal resources. If an applicant budgets at least 10 percent of the total costs of activities within the submitted grant budgets, applicants will receive additional points in the competitive procurement process. The Department on Aging will not require a sub-grantee or host agency to provide Non-Federal resources for the use of the Title V/SCSEP project as a condition of entering into a sub-grantee or host agency relationship. The non-Federal share of costs may be provided in cash, or in-kind or a combination of the two. Line 1. Non-Federal Share: Local Cash or In-kind contributions that are derived from

matching funds from grantees.

Line a. Local Cash - Enter the amount of Non-federal cash to be contributed to the program in column 1. Line b. In-kind- Enter the amount of Non-federal In-kind contributions to the program in column 1. Line c. Total Non-Federal - Enter total of (a) & (b) in column 1 and percentage of the total costs in column 2 (line 1(c) divided by line 3).

Line 2. Title V/SCSEP Share: Enter amount of funds requested in column 1 and the

percentage of total costs in column 2 (line 2 divided by line 3). Line 3. Total Resources: Enter total of lines 1(c) and line 2. EXHIBIT I.B: ADMINISTRATIVE & OTHER ENROLLEE DIRECT COSTS PERSONNEL DETAIL PART A: PROGRAM-RELATED SALARIES

List each position by title and name of employee, if available. Show the annual salary rate and the percentage of time to be devoted to the grant and length of time working on the project.

Column (a) - List the names of employees who will be working in the Title

V/SCSEP program. Column (b) - List the positions of employees listed in Column (a) who will be

working in the Title V/SCSEP program. Column (c) - Enter the total salary of each position listed in columns (a) and

(b). This represents the entire salary of each position. List 100% of each position’s salary.

Column (d) - Enter the percentage (%) of time each listed employee's full-

time salary is budgeted to the Title V/SCSEP program.

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Column (e) - Enter the length of time (# of months in the year) each listed employee's salary is budgeted to the Title V/SCSEP program.

Column (f) - Enter the Federal share (Title V/SCSEP) of each listed

employee's salary budgeted to the Title V/SCSEP program as Administration.

Column (g) - Enter the Federal share (Title V/SCSEP) of each listed

employee's salary budgeted to the Title V/SCSEP program as Other Enrollee Direct Costs.

Column (h) - Enter the non-federal share of each listed employee's salary

budgeted under the Local Cash category. Column (i) - Enter the non-federal share of each listed employee's salary

budgeted under the In-Kind category. Column (j) - Enter the sum of columns (f), (g), (h), and (i) for each line (lines

1-10). Enter the sum of lines 1 through 10 on the Employee Wages Total line in Columns (f), (g), (h), (i) and (j).

PART B: PROGRAM- RELATED FRINGE BENEFITS Fringe benefits should be based on actual known costs or an established formula. Fringe benefits are for the personnel listed in category (1) direct salaries and wages, and only for the percentage of time devoted to the grant. Provide the fringe benefit rate used a clear description of how the computation of fringe benefits was done. If a fringe benefit rate is not used, show how the fringe benefits were computed for each position. Elements that comprise fringe benefits should be indicated. Column (a) - List the names of employees who will be working in the Title

V/SCSEP program. Column (b) - List the position of employees listed in Column (a) who will be

working in the Title V/SCSEP program. Column (c) - Provide the Fringe Benefit description charged of the sub-

grantee staff employees listed (in column a.) who will be working in the Title V/SCSEP program.

Column (d) Enter the base of the Fringe Benefits in Column (d). Column (e) Enter the rate of the Fringe Benefits in Column (e). Column (f) - Enter the total Title V/SCSEP Administration share of the

budgeted amount of each fringe benefit listed in column (c). Column (g) - Enter the total Title V/SCSEP Other Enrollee Direct Costs share

of the budgeted amount of each fringe benefit listed in column (c).

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Column (h) - Enter the total Non-Federal Share of Local Cash budgeted for each fringe benefit listed in column (c).

Column (i) - Enter the total Non-Federal Share of In-Kind budgeted for each

fringe benefit listed in column (c). Column (j) - Enter the sum of the amounts entered in columns (f), (g), (h)

and (i) for each line. Enter the sum of lines 1 through 10 at the bottom of columns (f), (g), (h), (i), and (j).

EXHIBIT I.C: ENROLLEE WAGES AND FRINGE BENEFITS DETAIL

PART A: ENROLLEE WAGES

Column (a)- Line 1 - Enter number of participants who will be enrolled in the program effective July 1, 2019. Effective January 1, 2020, the state minimum wage will increase from $8.25 to $9.25. Both rates should be reflected in the budget as outlined in Exhibit 1.C.

All Title V/SCSEP participants should be permitted to work 20 hours per week unless otherwise designated by the Illinois Department on Aging. Lines 2-5 - If the sub-grantee has received approval to pay some enrollees an amount higher than the minimum wage, enter the number of enrollees and hourly amount on these lines. In order to receive approval for the higher salary amount, the applicant must submit a request on Attachment A of the grant forms. The Department will have to approve the higher wages before being provided to participants.

Not less than 75% of the total Title V/SCSEP funds must be used to pay for the wages and fringe benefits of participants in Title V/SCSEP.

Column (b) - Enter the amount of federal dollars to be budgeted for enrollee wages in column (b).

Column (c) - Enter the total Non-Federal Share of Local Cash to be budgeted for

enrollee wages in column (c).

Column (d) - Enter the total Non-Federal Share of In-Kind budgeted for enrollee wages listed in column (d).

Column (e) - Enter the sum of the amounts entered in columns (b), (c), and (d) for

each line. Enter the sum of lines 1 through 5 at the bottom of columns (b), (c), (d), and (e).

PART B: FRINGE BENEFITS/DESCRIPTION & RATE

Column (a) - List Fringe Benefits, description, and percentage rate.

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Column (b) - Enter amount of enrollee fringe benefits that will be paid out of federal funds in column (b).

Column (c) - Enter amount of enrollee fringe benefits that will be paid out of Local Cash in column (c).

Column (d) - Enter amount of enrollee fringe benefits that will be paid out of In-

Kind resources in column (d). Column (e) - Enter the sum of the amounts entered in columns (b), (c), and (d) for

each line. Enter the sum of lines 1 through 9 at the bottom of columns (b), (c), (d), and (e).

EXHIBIT I.D: ADMINISTRATIVE & OTHER ENROLLEE DIRECT TRAVEL ANALYSIS DETAIL Exhibit I.D should be used for TITLE V/SCSEP staff travel. NOTE: Enrollee travel costs should be reflected in Exhibit I.O. Travel should include: Origin and destination, estimated costs and type of transportation, number of travelers, related lodging and per diem costs, brief description of travel involved, its purpose.

Column (a) - Enter the purpose/description of Title V/SCSEP Administration and Other Enrollee Direct Travel expense.

Column (b) - Enter the location of the Title V/SCSEP Administration and Other Enrollee Direct Travel expense.

Column (c) - Enter the type of Title V/SCSEP Administration and Other Enrollee Direct Travel expense.

Column (d) - Enter the cost (rate of item) of Title V/SCSEP Administration and Other Enrollee Direct Travel expense.

Column (e) - Enter the basis of Title V/SCSEP Administration and Other Enrollee Direct Travel expense.

Column (f) - Enter the quantity (actual staff number) of Title V/SCSEP Administration and Other Enrollee Direct on Travel expense.

Column (g) - Enter the number of trips of Title V/SCSEP Administration and Other Enrollee Direct Travel expense.

Column (h) - Enter the total Title V/SCSEP Administration share of the budgeted amount of each listed travel cost category.

Column (i) - Enter the total Title V/SCSEP Other Enrollee Direct Costs share of the budgeted amount of each listed travel cost category.

Column (j) - Enter the total Non-Federal Share of Local Cash budgeted for each listed travel cost category.

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Column (k) - Enter the total Non-Federal Share of In-Kind budgeted for each listed travel cost category.

Column (l) - Enter the sum of the amounts entered in columns (h), (i), (j) and (k) for each line. Enter the sum of lines 1 through 10 at the bottom of columns (h), (i), (j), (k), and (l).

EXHIBIT I.E: ADMINISTRATIVE EQUIPMENT AND SUPPLIES DETAIL Exhibit I.E, Part A and Part B should be used for TITLE V/SCSEP staff equipment and supplies. NOTE: Enrollee equipment and supplies should be reflected in Exhibit I.P. Part A: Provide justification for each item. Equipment is defined as an article of tangible personal property that has a useful life of more than one year and a per-unit acquisition cost which equals or exceeds the lesser of the capitalization level established by the non-Federal entity for financial statement purposes or $5,000. PART A: EQUIPMENT Column (a) - List all equipment item budgeted for sub-grantee staff. Column (b) - List the equipment item (cited in column a.) quantity budgeted for

sub-grantee staff. Column (c) - List all equipment item cost(s) budgeted for sub-grantee staff. Column (d) - Enter the total Title V/SCSEP Administration share of the budgeted

amount of each type of equipment listed in column (a). Column (e) - Enter the total Non-Federal Share of Local Cash budgeted for each

type of equipment listed in column (a). Column (f) - Enter the total Non-Federal Share of In-Kind budgeted for each type

of equipment listed in column (a). Column (g) - Enter the sum of the amounts entered in columns (d), (e), and (f) for

each line. Enter the sum of lines 1 through 10 at the bottom of columns (d), (e), (f), and (g).

PART B: SUPPLIES Part B: List items by type (office supplies, postage, training manuals, copying paper, and other expendable items such as books, hand held tape recorders) and show the basis for computation. Generally, supplies include any materials that are expendable or consumed during the course of the project. Column (a) - List all supply items and description of budgeted for applicant staff.

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Column (b) - List the supply items quantity or duration budgeted for sub-grantee

staff listed in column (a). Column (c) - List all supply items cost(s) budgeted for sub-grantee staff. Column (d) - Enter the total Title V/SCSEP Administration share of the budgeted

amount of each type of supply listed in column (a). Column (e) - Enter the total Non-Federal Share of Local Cash budgeted for each

type of supply listed in column (a). Column (f) - Enter the total Non-Federal Share of In-Kind budgeted for each type

of supply listed in column (a). Column (g) - Enter the sum of the amounts entered in columns (d), (e), and (f) for

each line. Enter the sum of lines 1 through 10 at the bottom of columns (d), (e), (f), and (g).

EXHIBIT I.F: ADMINISTRATIVE CONTRACTUAL SERVICES & SUB-AWARDS EXPENSE DETAIL Provide a description of the product or service to be procured by contract and an estimate of the cost. This budget category may include sub-awards. Column (a) - Enter the name of the organization to be contracted for in column (a). Column (b) - Enter the contract or sub-award to be contracted for in column (b). Column (c) - Enter a description of activities or service to be contracted for in

column (c). Column (d) - Enter the total Title V/SCSEP Administration share of the budgeted

amount of each contractual or sub-award item or service listed in column (b).

Column (e) - Enter the total Non-Federal Share of Local Cash budgeted for each

contractual or sub-award item or service listed in column (b). Column (f) - Enter the total Non-Federal Share of In-Kind budgeted for each

contractual or sub-award item or service listed in column (b). Column (g) - Enter the sum of the amounts entered in columns (d), (e), and (f) for

each line. Enter the sum of lines 1 through 10 at the bottom of columns (d), (e), (f), and (g).

EXHIBIT I.G: CONSULTANT SERVICES and EXPENSE DETAIL Applicant is not to complete this budget page of the Title V/SCSEP application.

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EXHIBIT I.H: CONSTRUCTION EXPENSE DETAIL Applicant is not to complete this budget page of the Title V/SCSEP application. EXHIBIT I.I: OCCUPANCY – RENT and UTILITIES EXPENSE DETAIL List items and descriptions by major type and the basis of the computation. Explain how rental and utility expenses are allocated for distribution as an expense to the grant. For example, provide the square footage and the cost per square foot rent and utility, and provide a monthly rental and utility cost and how many months to rent. This budgetary line item is to be used for direct administrative rent and utilities, all other indirect or administrative occupancy costs should be listed in the indirect expense section of the budget worksheet and narrative. Column (a) - Enter the description of Title V/SCSEP occupancy (rent and utilities) expense.

Column (b) - Enter the quantity of the Title V/SCSEP occupancy (rent and utilities) expense.

Column (c) - Enter the basis of Title V/SCSEP occupancy (rent and utilities) expense. Column (d) - Enter the cost of Title V/SCSEP occupancy (rent and utilities) expense.

Column (e) - Enter the length of time of Title V/SCSEP occupancy (rent and utilities)

expense. Column (f) - Enter the total Title V/SCSEP direct Administration share of the

budgeted amount of each listed occupancy (rent and utilities) cost category.

Column (g) - Enter the total Non-Federal Share of Local Cash budgeted for each

listed occupancy (rent and utilities) cost category.

Column (h) - Enter the total Non-Federal Share of In-Kind budgeted for each listed occupancy (rent and utilities) cost category.

Column (i) - Enter the sum of the amounts entered in columns (f), (g), and (h) for

each line. Enter the sum of lines 1 through 10 at the bottom of columns (f), (g), (h), and (i).

EXHIBIT I.J: RESEARCH and DEVELOPMENT EXPENSE DETAIL Applicant should not to complete this budget page of the Title V/SCSEP application.

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EXHIBIT I.K: TELECOMMUNICATIONS EXPENSE DETAIL List items and descriptions by major type and the basis of the computation. This budgetary line item is to be used for direct administrative telecommunications, all other indirect administrative telecommunication costs should be listed in the indirect expense section of the Budget worksheet and narrative. Column (a) - Enter the description of Title V/SCSEP telecommunications expense. Column (b) - Enter the quantity of the budgeted amount of each

telecommunications cost listed in column (a). Column (c) - Enter the basis of the budgeted amount of each telecommunications

cost listed in column (a). Column (d) - Enter the cost of the budgeted amount of each telecommunications

cost listed in column (a). Column (e) - Enter the length of time of the budgeted amount of each

telecommunications cost listed in column (a). Column (f) - Enter the total Title V/SCSEP direct Administration share of the

budgeted amount of each telecommunications expense. Column (g) - Enter the total Non-Federal Share of Local Cash budgeted for each

telecommunications expense.

Column (h) - Enter the total Non-Federal Share of In-kind budgeted for each telecommunications expense.

Column (i) - Enter the sum of the amounts entered in columns (f), (g), and (h) for

each line. Enter the sum of lines 1 through 10 at the bottom of columns (f), (g), (h), and (i).

EXHIBIT I.L: TRAINING and EDUCATION EXPENSE DETAIL Exhibit I.L should be used for TITLE V/SCSEP staff training and education budgeted costs. Enrollee training and education costs should be reflected in Exhibit I.O, Part B. Describe the training and education cost associated with employee development. Include rental space for training (if required), training manuals, speaker fees, and any other applicable expenses related to the training. When training materials (pamphlets, notebooks, videos and other various handouts) are ordered for specific training activities, these items should be itemized. Column (a) - Enter the description of Title V/SCSEP Administration training and

education expense.

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Column (b) - Enter the quantity of the budgeted amount of each training and education cost listed in column (a).

Column (c) - Enter the basis of the budgeted amount of each training and

education cost listed in column (a). Column (d) - Enter the cost of the budgeted amount of each training and education

cost listed in column (a). Column (e) - Enter the length of time of the budgeted amount of each training and

education cost listed in column (a). Column (f) - Enter the total Title V/SCSEP Administration share of the budgeted

amount of each listed training and education cost category. Column (g) - Enter the total Non-Federal Share of Local Cash budgeted for each

listed training and education cost category.

Column (h) - Enter the total Non-Federal Share of In-Kind budgeted for each listed training and education cost category.

Column (i) - Enter the sum of the amounts entered in columns (f), (g), and (h) for

each line. Enter the sum of lines 1 through 10 at the bottom of columns (f), (g), (h), and (i).

EXHIBIT I.M: DIRECT ADMINISTRATION COST(S) EXPENSE DETAIL Applicant is not to complete this budget page of the Title V/SCSEP application since direct administrative expenses are included in each budget category. EXHIBIT I.N: OTHER/MISCELLANEOUS COST(S) EXPENSE DETAIL This category contains items not included in the previous categories. List items by type of material or nature of expense, break down by quantity and cost per unit if applicable. Column (a) - Enter description of the item or service to be purchased in column

(a). Column (b) - Enter the quantity of the budgeted amount of each item or service

listed in column (a).

Column (c) - Enter the basis of the budgeted amount of each item or service listed in column (a).

Column (d) - Enter the cost of the budgeted amount of each item or service listed

in column (a).

Column (e) - Enter the length of time of the budgeted amount of each item or service listed in column (a).

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Column (f) - Enter the total Title V/SCSEP Administration share of the budgeted amount of each item or service listed in column (a).

Column (g) - Enter the total Non-Federal Share of Local Cash budgeted for each

item or service listed in column (a). Column (h) - Enter the total Non-Federal Share of In-Kind budgeted for each item

or service listed in column (a).

Column (i) - Enter the sum of the amounts entered in columns (f), (g), and (h) for each line. Enter the sum of lines 1 through 10 at the bottom of columns (f), (g), (h), and (i).

EXHIBIT I.O: PART A - GRANT EXCLUSIVE LINE ITEMS: OTHER ENROLLEE COSTS – TRAVEL & TRAINING and EDUCATION DETAIL Part A is only for Enrollee travel costs. TITLE V/SCSEP staff travel costs are reflected in Exhibit I.D. Column (a) - List budgeted enrollee travel costs that are related to enrollees in

column (a). Column (b) - Enter the total Title V/SCSEP Administration share of the budgeted

amount of each listed enrollee travel cost category. Column (c) - Enter the total Non-Federal Share of Local Cash budgeted for each

listed enrollee travel cost category. Column (d) - Enter the total Non-Federal Share of In-Kind budgeted for each listed

enrollee travel cost category. Column (e) - Enter the sum of the amounts entered in columns (b), (c) and (d) for

each line. Enter the sum of lines 1 through 10 at the bottom of columns (b), (c), (d), and (e).

Part B is only for Enrollee Training and Education costs. Title V/SCSEP staff training and education costs are reflected in Exhibit I.L. Column (a) - List all training and education items budgeted for enrollees. Column (b) - Enter the total Title V/SCSEP Administration share of the budgeted

amount of each type of training and education items listed in column (a).

Column (c) - Enter the total Non-Federal Share of Local Cash budgeted for each

type of training and education items listed in column (a). Column (d) - Enter the total Non-Federal Share of In-Kind budgeted for each type

of training and education items listed in column (a).

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Column (e) - Enter the sum of the amounts entered in columns (b), (c), and (d) for each Line. Enter the sum of lines 1 through 10 at the bottom of columns (b), (c), (d), and (e).

NOTE: Items for supportive services must be outlined and described in this exhibit.

EXHIBIT I.P: PART B - GRANT EXCLUSIVE LINE ITEMS: OTHER ENROLLEE COSTS – EQUIPMENT & SUPPLIES DETAIL AND OTHER/MISCELLANEIOUS ENROLLEE COSTS DETAIL Part A is only for Enrollee equipment and supplies costs. NOTE: TITLE V/SCSEP staff equipment and supplies costs are reflected in Exhibit I.E. Column (a) - List all enrollee equipment and supplies budgeted for enrollees. Column (b) - Enter the quantity of the budgeted amount of each type of enrollee

equipment and supplies listed in column (a).

Column (c) - Enter the cost of the budgeted amount of each type of enrollee equipment and supplies listed in column (a).

Column (d) - Enter the total Title V/SCSEP Administration share of the budgeted

amount of each type of enrollee equipment and supplies listed in column (a).

Column (e) - Enter the total Non-Federal Share of Local Cash budgeted for each

type of enrollee equipment and supplies listed in column (a).

Column (f) - Enter the total Non-Federal Share of In-Kind budgeted for each type of enrollee equipment and supplies listed in column (a).

Column (g) - Enter the sum of the amounts entered in columns (b), (c), and (d) for

each Line. Enter the sum of lines 1 through 10 at the bottom of columns (d), (e), (f), and (g).

Part B is only for Enrollee Other/Miscellaneous costs. NOTE: Title V/SCSEP staff other/miscellaneous costs are reflected in Exhibit I.N. These costs should primarily reflect supportive services. Column (a) - Enter a description of the item or service to be purchased for

enrollees in column (a). Column (b) - Enter the quantity of the budgeted amount of each item or service

listed in column (a).

Column (c) - Enter the basis of the budgeted amount of each item or service listed in column (a).

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Column (d) - Enter the cost of the budgeted amount of each item or service listed in column (a).

Column (e) - Enter the length of time of the budgeted amount of each item or

service listed in column (a).

Column (f) - Enter the total Title V/SCSEP Administration share of the budgeted amount of each item or service listed in column (a).

Column (g) - Enter the total Non-Federal Share of Local Cash budgeted for each

item or service listed in column (a). Column (h) - Enter the total Non-Federal Share of In-Kind budgeted for each item

or service listed in column (a). Column (i) - Enter the sum of the amounts entered in columns (f), (g), and (h) for

each line. Enter the sum of lines 1 through 10 at the bottom of columns (f), (g), (h), and (i).

NOTE: Items for supportive services must be outlined and described in this exhibit.

EXHIBIT I. Q: INDIRECT COST(S) EXPENSE DETAIL This worksheet is only for grantees that have an indirect cost rate. Refer to Section A (Indirect Cost Rate Information) of the Uniform Budget Template for additional information. Refer to the NOFO for detailed requirements about indirect costs. Column (a) - Enter description of the Indirect Cost in column (a). Column (b) - Enter the base (dollar amount) of the Title V/SCSEP grant award. Column (c) - Enter the rate (in percentage) of the Title V/SCSEP grant award. Column (d) - Calculate the percentage: Take the base (column b) multiplied by the

rate (column c). Enter the calculation in line 1 column (d) and at the bottom of column (d).

EXHIBIT I.R: LOCAL NON-FEDERAL SHARE DETAIL

All Title V/SCSEP recipients are encouraged to budget at least 10% of the total cost of activities carried out under a Title V/SCSEP grant with Non-Federal resources. If an applicant budgets at least 10 percent of the total costs of activities within the submitted grant budgets, applicants will receive additional points in the competitive procurement process. PART A: LOCAL CASH RESOURCES

Column (a) - Lines 1 through 8 outlines potential Local Cash resources that can be

used to provide Non-federal support for the Title V/SCSEP Program.

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Other types can be listed in lines 9 and 10. Column (b) - Enter the type of Local Cash resources for each item listed in column

(a). Column (c) - Enter the cost per unit/hour/etc. for each item listed in column (a).

Column (d) - Enter the total amount of Local Cash budgeted for each item or

service listed in column (a). Enter a grand total on the Local Cash Resources Total line in column (d).

PART B: IN-KIND RESOURCES

Column (a) - Lines 1 through 8 outlines potential In-Kind resources that can be

used to provide non-federal support for the Title V/SCSEP Program. Other types can be listed in lines 9 and 10.

Column (b) - Enter the type of In-kind resources for each item listed in column (a). Column (c) - Enter the cost per unit/hour/etc. for each item listed in column (a). Column (d) - Enter the total amount of local In-Kind budgeted for each item or

service listed in column (a). Enter a grand total on the In-Kind Resources Total line in column (d).

The dollar amounts for local non-federal share detail should match the other budget sections of the application. Page 5 SECTION II: PROGRAM PLAN

The Project Narrative must demonstrate your capability to implement the grant project in accordance with the provisions of this Funding Announcement. It provides a comprehensive framework and description of all aspects of the proposed project. It must be succinct, self-explanatory, and well organized so that reviewers can understand the proposed project. The following instructions provide all of the information needed to complete the Project Narrative. Applicants should carefully read and consider each section, and include all required information in the Project Narrative. The agency will evaluate the Project Narrative using the evaluation criteria identified in the Funding Announcement. Applicants must complete the Project Narrative in the order it is outlined in the Instructions for pages 6 through 11. The Department on Aging will evaluate the Project Narrative using an evaluation criterion. The Project Narrative includes the following the following:

1. Organizational, Administrative & Fiscal Capacity

➢ Capacity to Manage Core Organizational Functions & Program Operations ➢ Capacity to Manage Data

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➢ Financial Stability & Ability to Adjust to Changes in Funding ➢ Reporting and Audits

2. Statement of Need

3. Program Design

➢ Working with Employers & Employer Associations ➢ Recruiting and Managing Host Agencies ➢ Providing Quality Service to Participants

4. Partnerships

5. Activities Under the Workforce Innovation and Opportunity Act

6. Past Performance & Programmatic Capability

Page 6 EXHIBIT II.A: ORGANIZATIONAL, ADMINISTRATIVE & FISCAL CAPACITY Describe in detail your organization’s ability to administer Title V/SCSEP in the Planning and Service Areas (PSAs) where you are requesting authority to provide service. Describe how your organizational, administrative, and fiscal capacity will support the Title V/SCSEP project by addressing the program factors below. For each component, include a comprehensive description of what you have done in the past and what outcomes you have achieved. Include data on your prior experience wherever applicable.

Capacity to manage core organizational functions and program operations

• Describe how you will manage program operations internally and through sub-recipients (if applicable) and local staff. Detail your methods of communications with internal program staff and sub-recipients regarding policies and procedures for Title V/SCSEP, data collection, and resolving any issues regarding program performance, participant services, and fiscal management that may emerge;

• Describe your schedule for monitoring sub-recipients and/or local projects. Describe the monitoring tools and procedures you will use to track sub-recipients’ operations against performance objectives and financial requirements;

• Describe how your system is consistent for prescribing corrective actions and resolving issues of performance, data collection, or fiscal management either internally or for sub-recipients and local projects. Describe at least one instance where you, a sub-recipient, and/or local project have needed to improve performance on a performance measure, a program requirement like service to minorities, data collection or reporting, or fiscal management, and what steps were taken to achieve that improvement. Detail what steps you took to address these situations and what results were achieved;

• Describe your ability to coordinate activities with other organizations at the State and local levels and provide at least one example of when you have done so; and

• Describe your ability to manage a disruption of services in community service assignments at host agencies, e.g., due to a natural disaster.

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• Describe the type and frequency of substantive training that internal program staff and sub-recipients will receive on program policy, Illinois Department on Aging (IDoA) and Department of Labor (DOL) guidance and directives, performance, and fiscal reporting.

Capacity to manage data

Describe your capacity to collect and manage data in a way that ensures consistent, accurate, and expeditious reporting as required by the Illinois Department on Aging and U.S. Department of Labor. Include detailed information on [Note: In PY 2019, the U.S Department of Labor will implement a new Title V/SCSEP data collection system that will replace the Title V/SCSEP Performance and Results Quarterly Performance Report System (SPARQ)]:

• Your past and current use of Title V/SCSEP Performance and Results Performance Report System (SPARQ) or a similar performance tracking system;

• Your plan to ensure the accuracy and timeliness of data entry. Current grantees (both IDoA-funded and Department of U.S. Department of Labor-funded national contractors) must describe in detail your history of timeliness and accuracy, including your rejection rate for the last three years; and

• Your method of data validation. New applicants must explain how you will use SPARQ to track performance data, how you will ensure the accuracy and timeliness of data entry, your current process for ensuring the quality of the data you collected and reported for similar programs over the last three program years, and how you have used your past data collection to improve data reporting or program implementation. Current Title V/SCSEP Grantees (both IDoA-funded and U.S. Department of Labor-funded national contractors) must indicate whether or not you have completed Data Validation as implemented by the U.S. Department of Labor for the past three years and explain how you have used the results of Data Validation to improve data collection and reporting or program implementation.

Financial stability and ability to adjust to changes in funding

• Describe your past experience in implementing a new program or handling an increase in funding for an existing program.

• Demonstrate your ability to respond to reductions in funding while minimizing disruption to participants. Provide an example if appropriate.

• Describe your financial capacity to administer by providing evidence of strong accounting systems, fiscal controls, and previous grant fund management, and a review of audited financial statements. Include detailed descriptions of:

➢ Your capacity for early start-up of financial activities; ➢ The status of your Fiscal Management Information Systems (MIS) and integrated

data sets relative to the system; ➢ The fiscal controls you have in place for auditing and accountability procedures; ➢ Your accounting system’s present ability to handle multiple funding streams; ➢ Your system to track planned expenditures that will allow you to compare actual

expenditures and accrued expenses in real time to planned or estimated expenditures; and

➢ Your system to track forecasted and actual enrollment and forecasted and actual participant wages and fringe benefits.

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Reporting and audits

• Describe your fiscal reporting procedures and audits. Include detailed descriptions of:

➢ The timeliness of your quarterly fiscal and program reporting for Title V/SCSEP and/or other projects, if applicable;

➢ Your ability to make participant financial data available to the Department on Aging (e.g., timesheets, receipts);

➢ Your audit or monitoring findings and recommendations for the past three years; ➢ The status of any corrective action(s); ➢ How you ensure that all grant funds are spent throughout the program year in an

efficient manner. Current Title V/SCSEP grantees (both Illinois Department on Aging-funded and U.S. Department of Labor-funded national contractors) must discuss your past experience with Title V/SCSEP funds and experience managing your spending in the final quarter of each program year;

➢ The number and type of audit findings you have had in the past three years. Include your most recent audited financial statements and, if applicable, the accompanying management letter as attachments.

• Describe how you will prevent fraud or criminal activity within your organization; how you will prevent any serious administrative deficiencies, such as failure to maintain a financial management system, failure to correct deficiencies bought to your attention in writing as a result of monitoring activities, failure to return grant close-out packages within the Illinois Department on Aging’s designated timeframe, and failure to submit timely reports.

EXHIBIT II.B: PROGRAM NARRATIVE / DESCRIPTION OF TITLE V/SCSEP PROGRAM ACTIVITIES Page 7 Statement of Need: Describe, in both quantitative and qualitative terms, the need for assistance for the Title V/SCSEP-eligible population in the counties in your chosen Planning and Service Areas and incorporate demographic information whenever possible. Specifically:

• Identify your proposed service area (Planning and Service Areas (PSAs) and counties within the PSAs) and describe the socio-economic characteristics of the intended Title V/SCSEP service population and the barriers to employment this population faces;

• Describe the economic conditions and employment outlook of the proposed service area, including identification of the growth or high-demand industries or occupations you will target for employment opportunities for Title V/SCSEP participants; and

• Describe the community service needs of the proposed service area and identify community service positions that you will target for participants.

Page 8 Project Design: Provide a comprehensive plan of action that outlines the scope and detail of your Title V/SCSEP project and how you will accomplish the proposed employment and training activities. Describe how

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you will implement Title V/SCSEP by addressing the three program factors listed below. For each component, if you have had experience providing these or similar services, include a discussion of what you have done, what outcomes you have achieved, and what changes to your current program design(s), if any, you will make if awarded a grant under this competition. Describe your partnerships with One-Stop Centers, employers, host agencies, and other organizations and detail the specific roles played by each wherever possible. Include data on your prior experience wherever possible.

Working with Employers and Employer Associations

• Describe how you will leverage existing partnerships and/or develop new partnerships with employers and organizations throughout the grant cycle that will support the participants’ employment and community service assignment goals. Provide at least one example of how you have done so in the past;

• Describe how you will coordinate services with existing partnerships and/or develop new partnerships with agencies, organizations, etc. to help defray or provide at no cost, or at a fair and reasonable cost supportive services, such as transportation, health and medical services, special job-related or personal counseling, incidental such as work shoes, badges, uniforms, tools, etc., necessary to enable participants to engage in employment related activities. (See 20 CFR 641.545);

• Explain how you will engage employers to determine their needs and how you will help them hire older workers from your Title V/SCSEP program; and

• Identify the following employer-based activities that will be used in your Title V/SCSEP project as applicable:

➢ On the Job Experience (OJE);

➢ Inviting employers to have input on your Title V/SCSEP program design; and

➢ Encouraging employers to prioritize hiring qualified Title V/SCSEP participants into job openings.

Recruiting and Managing Host Agencies

• Describe your strategy to recruit host agencies to serve as community service training sites for older workers and describe how you will determine whether potential host agencies’ community service needs align with Title V/SCSEP’s stated goals and whether host agencies can provide appropriate training opportunities for participants;

• Describe your existing relationships with host agencies or your plans to develop new relationships with host agencies and how you plan to leverage those relationships to provide placements for your Title V/SCSEP participants that prepare them for opportunities in in-demand industries and careers and assist them in becoming job-ready; and

• Describe in detail the past contributions of your host agency partners to your Title V/SCSEP or similar project, their roles in preparing Title V/SCSEP participants for unsubsidized employment, and how you will ensure the community service positions provided are consistent with participants’ Individual Employment Plans (IEPs).

Providing Quality Service to Participants

• Describe your plan to recruit Title V/SCSEP participants and the roles that One-Stop Centers and any other partners will play in the recruitment of participants. Cite factors that might promote or discourage the recruitment of eligible participants, including veterans, minorities, Indians or Native Americans, and others that possess at least one of the priority

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characteristics. Current grantees (both Illinois Department on Aging-funded and Department of U.S. Department of Labor-funded national contractors) must cite performance data from the Title V/SCSEP Minority Report to support your description; and the steps the grantee will take to address any under-service or disparities in outcomes for minorities.

• Explain how your selection of sub-recipients in areas with substantial populations of individuals with barriers to employment will result in special consideration to organizations with demonstrated expertise in serving minorities and individuals with barriers to employment, as defined by statute and listed in the Funding Announcement. If you intend to provide services directly, indicate this and describe in detail how you will serve individuals with significant barriers to employment;

• Describe in detail your choice of any general training, specialized training, or OJE that will be provided while the participants are engaged in the program, in addition to the community service training. Explain your choice of training and how it will help participants become self-sufficient and obtain unsubsidized employment. The submitted budget should reflect proposed costs for training as outlined in this program narrative.

• Identify and explain how the project will overcome any potential barriers to placement in community service assignments and unsubsidized employment faced by participants;

• Describe your ability to move participants with barriers to employment from community service assignments into unsubsidized employment and include your proposed timeline for moving participants through the program before they meet their Individual Durational Limit (IDL) of 48 months (see CFR 641.570);

• Describe how participants will be provided with a comprehensive assessment and how they will participate in the development their IEPs. Explain how you will ensure that participants’ training assignments and host agency rotations are consistent with their IEPs; and,

• Describe how you will serve diverse populations in your region(s), including individuals who have limited English proficiency.

Page 9 Partnerships

Describe the relationships you have developed with key partners (e.g. employers, educational institutions, Area Agencies on Aging and other organizations) to support Title V/SCSEP or similar programs and how this coordination of services supports the participants. Do not include activities under the Workforce Innovation and Opportunity Act (WIOA) since this information is required on the following page of the program narrative. Detail the specific roles played by each organization and tie them to your program activities and timeline. Include data on your prior experience where applicable. Specifically:

• Clearly describe how you will collaborate with other organizations to support program implementation and operation throughout the life cycle of the grant, including their specific areas of expertise and training and activities for which they will be responsible;

• Describe the types of agreements you have in place with partners. Describe the types of contributions received through these partners, such as services, materials, and any money received from partners in the last three program years specified as funding, and the dollar amount (both local cash and in-kind), Include the following as attachments, as applicable:

➢ Memorandums of Understanding that describe services and referrals;

➢ Memorandums of Agreement that describe the relationship and obligations of each party;

➢ Signed letters of commitment (not simply letters of support)

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• List the key partners with which you currently have a relationship in administering Title V/SCSEP or a similar program in size and scope and any additional partners with whom you will develop a relationship; and

• Describe your ability to maintain and manage partnerships, including information about:

➢ How you communicate with key partners in your Title V/SCSEP or similar project;

➢ What, if any, changes you will make to your current method of forming and maintaining partnerships if awarded a grant under this competition; and

➢ Any relevant joint achievements.

Page 10 Activities under the Workforce Innovation and Opportunity Act Title V/SCSEP is a required partner under the Workforce Innovation and Opportunity Act, and is part of the One-Stop delivery system. When acting in their capacity of WIOA partners, Title V/SCSEP grantees are required to follow all applicable rules under WIOA and its regulations. Title V/SCSEP grantees must make arrangements through the One-Stop delivery system to provide eligible and ineligible individuals with referrals to WIOA intensive and training services and access to other activities and programs carried out by other One-Stop partners. Title V/SCSEP grantees must comply with the Governor’s Guidelines to State and Local Program Partners Negotiating Costs and Services under WIOA. These guidelines outline Illinois requirements regarding negotiating cost sharing, service access, service delivery and other matters essential to the establishment of effective local workforce development systems under WIOA. These guidelines are included as Supplemental information to the Grant Application Instructions. In addition to the above WIOA-related activities, Title V/SCSEP as an one-stop partner must use a portion of funds made available to the Title V/SCSEP program, to the extent consistent with the Federal law authorizing the partner’s program and with federal cost principles in 2 CFR parts 200 and 2900 (requiring, among other things, that costs are allowable), to work collaboratively with the State and Local WIBs to establish and maintain the one-stop delivery system. This includes jointly funding the one-stop infrastructure through partner contributions that are based upon a reasonable cost allocation methodology by which infrastructure costs are charged to each partner based on proportionate use and relative benefit received. The process for negotiating cost sharing is outlined in the Governor’s Guidelines. Title V/SCSEP grantees must also enter in a Memorandum of Understanding with the Local WIB relating to the operation of the one-stop delivery system that meets the requirements of 20 CFR 678.700.

• Applicants must provide a detailed description of their proposed efforts to partner with Local Workforce Investment Areas (LWIAs) and One-Stop Centers in all the PSAs that you propose to administer the Title V/SCSEP program. Clearly describe how you will collaborate with these WIOA organizations to support program implementation and operation throughout the life cycle of the grant, including their specific areas of expertise and training and activities for which the various partners will be responsible;

• Applicants must describe their current and past experience in developing and implementing Memorandums of Understanding (MOUs) with LWIAs that outline relationships, obligations, services, referrals and cost sharing. If an applicant is currently contributing to the cost sharing

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of One-Stop Centers, the applicant should describe the current amounts of funds (both cash and in-kind) they are contributing to the One-Stop Centers by LWIA. The description should include whether the applicant designate the amount of funds through a state Title V/SCSEP grant funded by the Illinois Department on Aging or a national Title V/SCSEP grant funded by the U.S. Department of Labor.

• Applicants must contribute monetarily and include negotiated cost sharing of Illinois One Stop Centers in the proposed budgets. A summary of current negotiated cost sharing in Illinois is included as supplemental information to the Grant Application Instructions.

• If the applicant has current MOU agreements with LWIAs, these MOUs Agreements should be submitted as an Attachment to the submitted Grant Application.

A copy of the LWIA Map for Illinois is available in the Grant Application Instructions.

For further information regarding this requirement (i.e., WIOA Law, Regulations, Guidelines, Timelines, etc.) see the WIOA Implementation Portal: https://www.illinoisworknet.com/WIOA/Resources/Pages/WIOA-Implementation.aspx

Page 11 EXHIBIT II.C: PAST PERFORMANCE & PROGRAMMATIC CAPABILITY

Section 514(c)(4) of the OAA requires that the U.S. Department of Labor award national grants on the basis of prior performance. The Illinois Department on Aging has adopted this requirement for state Title V/SCSEP grants in Illinois. The Illinois Department on Aging will determine scores based on past performance in administering a Title V/SCSEP grant in the case of current grantees, or based on past performance in administering a similar grant in the case of all other applicants. All proposals will be reviewed based on the same criteria; however, different factors and instructions may apply depending on whether or not the applicant is a current Title V/SCSEP grantee (Illinois Department on Aging-funded and U.S. Department of Labor national grantees). Current TITLE V/SCSEP Grantees Only (Illinois Department on Aging-funded and U.S. Department of Labor National Grantees) Current Title V/SCSEP grantees (Illinois Department on Aging-funded and U.S. Department of Labor national grantees) are required to complete a description in detail about their past performance in meeting Title V/SCSEP performance measures for PY 2015-PY 2017. PY 2018 new performance measures and data will not be used since the year is in progress. If a national Title V/SCSEP grantee serves in Illinois, they should describe their performance both nationally and in Illinois. Title V/SCSEP grantees should address the following performance measures in their description:

• Service Level

• Most-in-Need

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• Community Service

• Entered Employment

• Employment Retention

• Average Earnings Applicants should respond in the order as outlined above and should format the description as described below: Name of Performance Measure

PY 2015 PY 2016 PY 2017 Performance Goal for each PY YTD Rate from the final SPARQ report for the PY The Illinois Department on Aging will also evaluate such performance based on SPARQ data and will average the three PYs for scoring purposes.

All Other Applicants Only: Describe in detail your experience-serving individuals in a program that is comparable to Title V/SCSEP in its complexity and duration for each of the factors below. This description must provide the data specified under each factor and must identify the source of the data, the year(s) the data cover, and whether the data were filed with the project’s funder. Wherever the data exist, please answer with regard to the three most recently completed program years.

1. Ability to serve the greatest number of eligible individuals

• Provide the number of individuals served under a comparable grant or program, compared to the numbers that the funding was designed to support.

2. Greatest economic need, greatest social need, and individuals described above or in 20 CFR 641.710(a)(6)

• The average percentage of participants meeting eligibility or service requirements, if any, put in place by the funding source for participants with incomes at or near the Federal Poverty Level;

• The average percentage of participants who were without a High School degree;

• The average percentage of participants who were minorities, especially the percentage served in proportion to their incidence in the population; and

• The average percent of individuals served who had each of the following barriers to employment, as described above or in 20 CFR 641.710(a)(6), or have other characteristics that the program defines as “most-in-need” (and the rationale for any additional characteristics).

3. Community Service

Describe in detail your experience administering a program comparable to Title V/SCSEP in its complexity and duration that provides community service or employment and training assignments, such as on-the-job training or longer-term work experiences, for eligible individuals in the communities in which the individuals reside, or in nearby communities.

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Your description must provide the data specified under each factor and must identify the source of the data, the year(s) the data cover(s), and whether the data were filed with the project’s funder. Wherever the data exist, please answer with regard to the three most recently completed program years.

4. Unsubsidized Employment & Employment Retention

Describe in detail your experience placing participants into unsubsidized employment. This description must provide the data specified under each factor and must identify the source of the data, the year(s) the data cover(s), and whether the data were filed with the project’s funder. Wherever the data exist, please answer with regard to the three most recently completed program years.

Placement into unsubsidized employment & employment retention

• The average actual performance on the common entered employment rate measure or a similar measure; and

• The average actual performance on the common employment retention measure or a similar measure.

5. Average Earnings

Describe in detail your experience of the average earnings of participants who were placed into unsubsidized employment or comparable performance measure applicable to your program. The description must present data on your past performance, if any, in administering any State- or Federally-funded employment and training, community service, or comparable program. The description must provide the data specified under each factor and must identify the source of the data, the year(s) the data cover(s), and whether the data were filed with the project’s funder. Wherever the data exist, please answer with regard to the three most recently completed program years.

• Data on measures of average weekly wage for those being placed or entering employment for the last three years, if available. Provide the definition of each measure provided, including the numerator and denominator.

Page 12 EXHIBIT II.D: PROPOSED JOB INVENTORY

Indicate the number of jobs by category in the Services to the General Community column and in the Services to the Elderly Community column. On lines #10 and #21 for each column, enter the total.

Page 13 SECTION III: ASSURANCES

Pages 14-19 TITLE V/SCSEP PROGRAMMATIC ASSURANCES – FY 2020/PY 2019 Read, check the boxes, and enter the signature of an individual authorized to commit

the organization to a legally binding agreement. Page 20 ASSURANCE OF COMPLIANCE WITH THE DEPARTMENT OF HEALTH AND

HUMAN SERVICES REGULATION UNDER TITLE VI OF THE CIVIL RIGHTS ACT OF 1964

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Enter applicant agency name in the first line of the document.

Read and complete legal name of applicant, address, signature of an individual authorized to commit the organization to a legally binding agreement, date and typed name and title of the authorized officer.

Page 21 SECTION IV: ATTACHMENTS

Ef Page 22 ATTACHMENT A: PARTICIPANT WAGE WAIVER REQUEST

Complete the waiver form if your agency is proposing to pay more than the State of Illinois minimum wage for any participant. Explain why it is desirable to increase the rate for these participants (this includes any minimum wage deviation that may apply to the City of Chicago participants). This form must be completed for all participants each program year even if higher wages were approved in prior program years.

Page 23 ATTACHMENT B: ON-THE-JOB EXPERIENCE (OJE)

On-the-Job Experience (OJE): If an applicant wants to utilize OJE as an additional training option, it must meet the requirements delineated in Older Worker Bulletin 04-04 and the Department’s OJE policy included in the Title V/SCSEP Manual. Both are provided as supplemental information to the Grant Application Instructions. The Department on Aging must approve the OJE policy and sample contracts before the grantee may exercise this option.

Page 24 ATTACHMENT C: REQUIRED ATTACHMENTS TO BE SUBMITTED BY ALL APPLICANTS All applicants must submit the following attachments with their submitted grant applications.

▪ Most recent audited financial statements and, if applicable, the accompanying management letter with any audit finding.

▪ Memorandums of Understanding (MOUs) that describe services and referrals; Memorandums of Agreement that describe the relationship and obligations of each party; and Signed letters of commitment (not simply letters of support) described on the Partnership Project Narrative page.

▪ Memorandums of Understanding with LWIA organizations described on the WIOA Project Narrative page.

Page 25 ATTACHMENT D: OTHER ATTACHMENTS SUBMITTED BY APPLICANT

All applicants should outline on page 25, Attachment D, the other attachments (not required) submitted with the grant application

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FY 2020/PY 2019 Base Level Planning Allocations for

Senior Community Service Employment Program (Title V)

Authorized Adj. Slots* Adj. Slots* Total Fund Max. Adm. Min. Max. OEC

PSA Slots 0.879 0.784 Distrib. 8.5% EW/FB/OEC Direct

10/01-12/31 1/1-6/30

PSA 01 27 24 21 $186,611 $15,862 $149,289 $21,460

PSA 02 31 27 24 $214,257 $18,212 $171,406 $24,639

PSA 03 7 6 5 $48,381 $4,112 $38,705 $5,564

PSA 04 5 4 4 $34,558 $2,937 $27,646 $3,975

PSA 05 20 18 16 $138,231 $11,750 $110,585 $15,896

PSA 06 4 4 3 $27,646 $2,350 $22,117 $3,179

PSA 07 11 10 9 $76,027 $6,462 $60,822 $8,743

PSA 08 7 6 5 $48,381 $4,112 $38,705 $5,564

PSA 11 5 4 4 $34,558 $2,937 $27,646 $3,975

PSA 12 167 147 131 $1,154,223 $98,109 $923,378 $132,736

PSA 13 34 30 27 $234,992 $19,974 $187,994 $27,024

Total 318 280 249 $2,197,865 $186,817 $1,758,293 $252,755

Percentage of Funds 100.0% 8.50% 80.0% 11.5%

Labor Allocation Amount $2,313,542

IDoA Admin (5%) $115,677

Total Distributive $2,197,865

Total Undistributed $0

*Adjusted Slots are based on the State Minimum Wage of $8.25 from October 1, 2019 through December 31, 2019 and

$9.25 from January 1, 2020 through June 30, 2020.

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ALL WIOA SITES & CENTERS IN ILLINOIS

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Supplemental Information to the Grant Application Instructions

Besides these Grant Application Instructions, the Illinois Department has provided the following supplemental information for applicants:

1. IDoA SCSEP Manual 2. SCSEP Final Rule 20 CFR 641 3. Governor’s Guidelines to State & Local Program Partners Negotiating Costs & Services

Under the Workforce Innovation and Opportunity Act (WIOA) Revision 3, November 2018 4. Older Worker Bulletin 04-04 5. Cost Sharing of One Stop Centers in Illinois 6. Older Worker Bulletin 04-04 7. Minority Reports, Volumes 1 & 2