HomeMy WebLinkAboutbocc.res.108.2011 A RESOLUTION OF THE BOARD OF COUNTY COMMISSIONERS
APPROVING THE COMMUNITY SERVICES BLOCK GRANT CLIENT INCOME
ELIGIBILITY POLICY AND PROCEDURES
Resolution # l�� " ,a //
RECITALS
1. The Community Services Block Grant (CSBG) is a federal grant dedicated to helping low- income
families and individuals achieve personal and economic self - sufficiency. It is administered
through the State Department of Local Affairs (DOLA) to the County, and it is dedicated to
programs that serve those who live or work in Pitkin County with income levels of 125% or
below federal poverty guidelines.
2. Pitkin County is required to establish an operational policy and procedures regarding client
eligibility that guides the distribution of CSBG program dollars.
3. This policy provides direction to Pitkin County Health and Human Services staff and to
subgrantees receiving CSBG funding, on the distribution of these funds to eligible individuals and
families in Pitkin County to strive to alleviate barriers to self - sufficiency.
4. The Board of County Commissioners finds that it is appropriate and in the best interest of Pitkin
County to adopt this new policy.
NOW THEREFORE BE IT RESOLVED by the Board of County Commissioners of Pitkin County,
Colorado, that the CSBG Client Income Eligibility Policy and Procedures 5.01 is hereby approved.
The Health and Human Services Director shall be responsible to maintain adherence to this policy with our
subgrantee recipient of CSBG funds.
INTRODUCED, READ AND ADOPTED ON THE 16 DAY OF NOVEMBER, 2011.
A T: BOARD OF COUNTY COMMISSIONERS OF
PITKIN, COUNTY, COLO' • 0
By • ,/. a. ( By:
Je ette Jones, Dep / Clerk Rach: E. Richards, Chair
Manager's Ap royal
on ea c , County Manager
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(Attachment A)
POLICY TYPE: Health & Human POLICY TITLE:
Services - Operating Community Services Block Grant
Client Income Eligibility
POLICY CSBG 5.01 EFFECTIVE DATE:
Community Services Block Grant November 16, 2011
Reference:
Community Services Block Grant Act SEC. 671 -680
Applies To:
Pitkin County Health and Human Services (PCHHS) Community Services Block Grant (CSBG) Sub -
Grantees.
Purpose
Per the 2011 requirement of the Colorado Department of Local Affairs (DOLA), PCHHS must retain
and implement written income eligibility requirements for use by CSBG recipients.
DEFINITIONS
CSBG - Community Services Block Grant
Department — Pitkin County Health and Human Services Department
DOLA - Colorado Department of Local Affairs
Sub - grantee - Agency under contract with the Department to provide services
FPL - Federal Poverty Level
Household - Any individual or group of individuals who are living together in a dwelling
unit as one economic unit.
Objectives
A. To standardize income verification procedures to establish eligibility for the CSBG
program.
B. To provide guidance to CSBG recipients in the form of written policies and procedures.
Policy
It is the policy of PCHHS to ensure that all those who benefit from CSBG programs meet the income
and residency eligibility requirements.
Procedures
A. CSBG sub - grantees are responsible for determining client eligibility for CSBG assistance.
Individuals and families receiving CSBG supported services must meet income guidelines below
125% of the federal poverty level established in the federal CSBG Act and be lawfully present in
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the United States. Pitkin County CSBG subgrantee agencies are required to conduct eligibility
screening as part of their client intake process each year. Agencies must collect household
information and verifications for all members of the family and use total household gross income
and lawful presence as the basis for determining eligibility. Income includes all employment,
unemployment payments, federal and state benefits, child support, or other money coming into
the household. Verification of income may include paystubs, official benefit award letter, 3rd
party written verification, IRS tax forms or other formal documentation to be included in the file.
A.1. If the CSBG funded program includes direct financial assistance to the participant such as
rent, mortgage, utility, dental, medical, vision, repairs or vouchers, verification of income
must be performed.
A.2. In determining household income, self declaration of income may be used only as a method
of last resort except in the case of shelter residents, emergency food bank users and
participants provided limited services such as bus tokens. If the self declaration method is
used, notation must be on file stating the reason(s) why other verification methods could not
be used. The signature of the client and identification of the intake staff member must
appear on a self - declaration statement in the client file.
B. Sub - grantees will develop their own forms to comply with these requirements. Yearly sub -
grantee monitoring consists of reviewing income verification and eligibility documentation
in client files. Monitoring checklists are completed with the CSBG administrator.
C. Individuals and families receiving CSBG supported services must confirm that they are
lawfully present in the United States by:
C.1. Identification: The applicant shall produce one of the following personal identifications:
o A valid Colorado driver's license or a Colorado Identification card; or
o A United States military card or a military dependent's card; or
o A United States Coast Guard Merchant Mariner card; or
o A Native American Tribal document.
C.2. Affidavit: The applicant shall execute an affidavit provided stating:
o That they are a United States citizen or legal permanent resident; or
o That they are otherwise lawfully present in the United States pursuant to federal
law.
D. Individuals requesting assistance who do not meet the eligibility criteria for CSBG may
not be served using CSBG funds.
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Signed by:
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Director, Health and man Services Date
Chairw man, Pitkin Coun Board of County Commissioners Dat
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(Ail AC 1 - 1�t E N 5 )
44', - -oF � Cot
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AFFIDAVIT
for the Colorado Department of Human Services
and the Department of Health Care Policy and Financing
as Proof of Lawful Presence in the United States
I, , swear or affirm under penalty of perjury under the laws
of the State of Colorado that (check one):
I am a United States citizen, or
I am a legal Permanent Resident of the United States, or
I ant lawfully present in the United States pursuant to federal law.
I understand that this sworn statement is required by law because I have applied
for a public benefit. I understand that state law requires me to provide proof that I am
lawfully present in the United States prior to receipt of this public benefit. I further
acknowledge that making a false, fictitious, or fraudulent statement or representation in
this sworn affidavit is punishable under the criminal laws of Colorado as perjury in the
second degree under Colorado Revised Statute 18 -8 -503 and it shall constitute a separate .
criminal offense each time a public benefit is fraudulently received.
Signature Date
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