ࡱ >
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h h 4 h T " L 6 d$ p $ $ $ $ D $ Q S S S S S S $ w = j0 = = w h h $ $ = h 8 $ $ Q = Q $ 06 3 Q = 0 g 6 z N z ( z = = = = = = = w w ; = = = = = = = z = = = = = = = = = . : FORMULA GRANT/ALLOCATION BASICS -- STATE FISCAL YEAR 2018
Your formula grant amount will be posted on-line (in the form of a contract) as soon as is practicable.
To receive a Formula Grant award, you must forward a Statement of Council on Aging Formula Grant Balance for the Fiscal Year Ending June 30, 2017 (Go to page three (3), below.) The chief municipal finance officer is the typical signatory. (The COA director or board member should not do so!) The sooner all Statement documents are received at Elder Affairs, the sooner contracts can be posted on line.
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Please submit all documents via first class mail to: Elder Affairs, 1 Ashburton Place, 5th Fl., Boston, MA 02108, ATT: COA Formula Grants. The target postmark date (absent an email extension request) noted on the next page. Faxes are not accepted.
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s
The grant State Fiscal Year SFY runs from July 1, 2017 to June 30, 2018. You may legally incur previously authorized Formula Grant costs as of July 1, 2017.
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Eligible Applicants: COAs established under MA General Laws, c. 40, s. 8B.
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Required Materials
Budget Attachment B (available in Word and Excel). The Formula Grant amount will be posted as a contract on line as soon as possible.
Statement of Authorization
Annual Report Form EOEA-SGA Annual reports are required by law.
Statement of Grant Balance (for SFY2017)
There will be one, single Formula Grant payment (unless indicated otherwise).
Eligible Costs, Local Determinations and Applicant Obligations The Guide.
Please refer to The Guide (a/k/a the Green Guide) for FY2018 regarding eligible costs and typical/best practices. If you incur unallowable or ineligible costs, such expenses may be deducted from succeeding year grant awards.
You may revise your budget during the fiscal year; however, we suggest you notify ELD (email is acceptable) to confirm whether changes meet Guide requirements or otherwise represent commonsense/professional and/or best practice solutions.
The Guide is amended from time-to-time based on COA inquiries and experiences. Cost exceptions will be considered on a case-by-case basis by ELD.
Incomplete, unsigned or improperly dated material will be returned. Elder Affairs reserves the right to withhold consideration or processing of applications and/or payments pending satisfactory submission of required documents.
PKG P1 Due Dates, Notes, Attachments for FY2018 Formula Grant Applications
Announcement of Formula Grant/Allocation
The official notice of available funding will be posted on-line AFTER the final budget agreement is reached.
HYPERLINK "http://www.800ageinfo.com" www.800ageinfo.com
COAs may begin to incur SFY2017 previously allowable expenses as of 1 July 2017.
Attachment B Budget
(Word or Excel)
Anticipated Postmark: to be determined.
Statement of Authorization
(Page 21 of the on-line document)
Anticipated Postmark: to be determined.
Please Affix to Att. B budget.)
Statement of Allocation/ Grant Balance
FY 2017
(1 July 2016
30 June 2017
(Page 3 of the on-line document)
Postmark by August 29, 2017
The signatory for this document must be someone from your municipal finance/accounting department.
Late submission of statements will delay distribution of funds!
Any unexpended FY2017 Formula Grant balance will be
applied to your FY2018 state funding.
Annual Report EOEA-SGA
and
Volunteer Resource Sheet
(Word or Excel)Postmark by September 12th, 2017
Volunteer Resource Sheet requested for all --
but required if using the Formula Grant for volunteer
recognition or support.
Postmark by August 28, 2015
r recognition or support.)
derations or concerns.
( Attachment B due date extensions of up to two weeks will be automatically granted based on an email request to Elder Affairs (see e-mail address/es below).
************************************************************************************
Please mail to: Executive Office of Elder Affairs
1 Ashburton Place, 5th Flr.
(Regular surface mail is fine.) Boston, MA 02108
ATT: COA Grants
Questions/concerns may be directed to Emmett Schmarsow: HYPERLINK "mailto:emmett.schmarsow@state.ma.us" emmett.schmarsow@state.ma.us
(1-800-698-9723) or Sherri Sore at HYPERLINK "mailto:sherri.sore@state.ma.us" sherri.sore@state.ma.us (617-223-9928). Thank you.
PKG-P2
Statement of Council on Aging Formula Grant
Balance for the Fiscal Year Ending June 30, 2017
Executive Office of Elder Affairs
1 Ashburton Place, 5th Floor
Boston, MA 02108
Att: COA Program Manager
(Municipal Council on Aging Name)
(PRINT the Name and Title of Signatory completing this form)
** Signatory must be from your municipal finance/accounting department.**
NOTE: telephone #; email address for Signatory
( The Council on Aging FORMULA GRANT balance as of June 30, 2017 was $ .
This unexpended balance is retained by your municipality solely to support the purpose(s) of your COA Formula Grant/Allocation for Fiscal Year 2018. Your Fiscal Year 2018 Formula Grant/Allocation payment will be reduced by the unexpended balance indicated above.
I hereby certify, under the pains and penalties of perjury, that the balance indicated above is true, complete and in accord with the current Eligible Costs and Best Practices Guide and/or as approved by the Executive Office of Elder Affairs.
(signed) (dated)
Additional Information for the Executive Office of Elder Affairs
FY2018 Formula Grant Allocation Program.
Once the state budget (the General Appropriation Agreement or GAA has been signed by the governor, ELD will confirm the anticipated grant allocations (see PRELIMINARY, below) via email to all COAs.
Formula Grant contracts will be posted at HYPERLINK "http://www.800ageinfo.com" www.800ageinfo.com once all COA Statements of Grant Balance for SFY2017 are received at ELD.
You may expend anticipated FY2018 Formula funds for prior year approved purposes as of 1 July 2017.
Attachment B contains two columns for Formula funding: please complete the PRELIMINARY Column (A). (( Column B is used solely for revisions.)
Your Formula Grant is based on the (2010) federal census of persons 60+ in your community. Town with fewer than 500 seniors may submit a budget of up to $5000.
Elder Affairs very much appreciates municipal information in the optional Municipal Funding column on the Attachment B budget. We frequently receive requests from COAs seeking to compare staffing patterns and salaries or rates of pay; this information is of considerable interest within similarly sized communities.
Formula Grant payments will be issued as soon as practicable following receipt of required materials.
Your FY17 Statement of Grant/Allocation Balance is instrumental in Formula contract administration. Any FY2017 unexpended Formula Grant balance will be carried forward to FY2018 and available for purposes (previously) permitted under the COA Formula Grants. Your agencys FY2018 Formula Grant payment will be reduced by your COAs unexpended FY2017 Formula Grant balance.
Job descriptions are optional. However, applicants are encouraged to submit this material for technical assistance and support purposes of ELD and other agencies. Electronic versions (and/or hard copies) are most welcome.
The EOEA-SGA Annual Report is essentially unchanged, except for some small format changes and a new Question IV section on page 1 of 4.
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FY 2017 Formula Grant Allocation Guidelines
Formula monies allow for a wide variety of costs to promote, enhance and/or support the health, wellbeing and independence of seniors in the community. Funds may be used for salary, direct services such as outreach, transportation, health screening and fitness instruction, site and program operating costs, equipment/ furnishings, volunteer development, newsletters, web-site development and other expenses including staff, board training and professional association membership. Conference related information is located in The (Green) Guide.
COA staff and boards should consider how Formula funds may best serve your seniors given unmet needs and available resources. Choices should reflect appropriate public policies not unlike how municipal finance boards/committees evaluate local line items. Elder Affairs gives considerable latitude with respect to costs (but see The (Green) Guide of June 2017) with respect to best practice suggestions and ineligible costs. This guide is updated from time to time.
COAs shall present a complete budget in Word or Excel (Attachment B) and include appropriate information/affirmation(s)/acknowledgements in the NOTES column.
ELD requests, but does not require, a job description for each position to be funded, in whole or in part, with Formula Grant funds: these may be submitted via surface or email. Job descriptions are a valuable reference tool for technical assistance and support to your colleagues. Please know that if an individual holds more than one position, a separate job description should be available for each position.
Job descriptions should typically include:
a) the job title;
b) a brief, general statement of duties; (optional)
c) at least six (6) specific examples of duties to be performed;
d) identification of supervision received or exercised; (optional)
e) the knowledge, skills and/or abilities expected for the position, not the incumbent. Minimum qualifications should be specific to the position;
f) salary range. Note the rate of pay per hour/class/annum or other measure. Fringe benefits and hours per week should be identified. Indicate if there are no benefits.
Additional considerations are noted in The (Green) Guide as well as below.
Our office suggests that job descriptions for individual vendors and contractors address the items cited above. (Signed) contracts must be retained by the Council on Aging. Suggested contract language, as well as a sample format for job descriptions, is available from Elder Affairs.
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Ineligible Costs. See The (Green) Guide for FY2018 for a more complete listing.
Entertainment, contingencies, fines and penalties, bad debts, uncovered insurance losses, contributions, donations, bingo machines or related equipment, televisions, DVDs or similar devices (unless for educational/fitness purposes). Electronic display boards are allowable.
Medical costs, Medicare or Medicaid reimbursable costs and individual medical treatments (e.g., podiatry or massage).
Parties and celebrations.
Consumable arts and craft supplies and related equipment.
Bus/cultural trips and trip coordinators.
Personal emergency response systems (such as "LifeLine"), medical loaner equipment, smoke/fire/CO detectors.
Longevity, unused vacation or length of service pay.
Computer lab/training costs or extended computer warrantee agreements.
Special Eligible Costs
Expenses to enhance participation of seniors with disabilities in center activities are allowable. Language and/or computer instruction must relate to direct service and/or work related duties (by staff and/or dedicated volunteers).
COAs may request site improvements for architectural barrier removal, public health and safety, and energy conservation. Retain/include drawings and plans, as applicable. Cosmetic improvements are ineligible for funding.
The COA shall follow state and/or local procurement procedures, as applicable. ELD encourages the acquisition of equipment and/or supplies through municipal or state purchasing agents, but notes that bid lists do not necessarily represent best value.
Computer: max. $1,000 (includes typical printer, monitor, cables, software) and must include a back-up system (flash drive/disks/the cloud and external hard drives). RAM should be at least 2 GB. Laptops and netbooks are allowable.
Vans must be lift/ramp equipped. (Check out MV-1 type vehicles.) Outreach to unserved or underserved populations should be clearly identified. Funds may not be used for staff vehicles.
Exercise equipment and instruction is allowable for use in preventive, rehabilitative and therapeutically oriented programs. The COA shall ensure that qualified instruction and/or supervision is available prior to equipment use.
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Attachment "B" BUDGET INSTRUCTIONS / OBSERVATIONS
Municipal Funding: Optional but strongly encouraged. ELD seeks a list of all paid employee titles, hours and totals to analyze staffing patterns -- useful to other COAs.
(A), (B) Allocation Formula FY 2018 The preliminary budget will be based on your 2010 federal census; the anticipated minimum will remain at $5,000. Word or Excel format. The final allocation will be posted on-line at HYPERLINK "http://www.800ageinfo.com" www.800ageinfo.com.
TOTAL: At present, the Allocation Formula for FY2018 has yet to be determined (except for communities with 500 or fewer seniors).
Total Hours/Week: Note Total hours per week for each position to be Formula funded. (If noting a range of hours, the anticipated total hours for the year should be cited.)
Personnel: Cite hours of service, rates of pay and specific fringe benefits (types) to be attributed to the Formula Allocation. All paid/contractual employees, full or parttime, regardless of funding source, should be listed on page 1 of Attachment B.
Instructors/Facilitators: Vendors are typically fitness and exercise instructors and support group leaders. Suggested vendor guidelines are available from The Green Guide. List health screening personnel at the line item or at Contractors on page 2.
Please subtotal each column and carry subtotals to the bottom of page 2.
Staff/Volunteer Transportation: Note costs for staff or volunteer transportation, including. ID local rates per mile; the IRS allows up to $ 53.5 cents/mile for business related travel (2017). Vehicle support costs (insurance, maintenance, gas/oil, etc.) should be identified. (ELD does not cover automobile insurance for volunteer drivers.)
Client Transportation: Retain a copy of the contract or purchase of service agreement, with the cost per mile/hour/day or other (specified) unit. Please note anticipated fees or donations (program income) in the Notes column.
Rent/Mortgage: Indicate how space is shared and, if so, whether the COA has priority and full time (or parttime) use of the space. Is the space shared with another entity/ies? How? Retain a copy of the rental/mortgage agreement for your files.
Utilities: Electricity, telephone, gas/oil, etc. May include internet access fees.
Renovation/Construction: Use local bidding/quote procedures. The COA must secure an agreement permitting at least five years use and occupancy from the date improvements are completed and accepted by the municipality.
Equipment/Furnishings: Note model and major distinguishing features/characteristics.
Supplies: Office/consumable supplies.
Facility Maintenance and Supplies: Cleaning service/s (but not staff) and/or supplies.
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Printing/Copying: (Non-newsletter) copying, printing of stationery, brochures, etc.
Postage: Correspondence and routine (non-newsletter) mailing costs.
Dues: Organizational memberships; may include subscriptions.
Newsletter Printing: Newsletter related postage, printing and/or distribution costs. ELD shall be recognized as supporting the newsletter (see Additional Remarks, below).
Conference/Education: For (paid) directors/coordinators, maximum of $900 per year; meals costs may not exceed $30/day with Formula funds. Other paid staff may qualify for this allowance; approval must be secured in advance from Elder Affairs.
Other paid staff and volunteers, including board members, may attend conference/ training events. The total maximum charge to Formula funds will be $500 per conference; related mileage costs need not be charged against the $500 maximum allowance. Overnight expenses must be borne by participants. Elder Affairs will consider modifying the maximum for boards of eleven (11) members or more.
Volunteer Recognition: Recognizing volunteer efforts. Maximum allowance is $16.50 per volunteer/year. Describe service criteria for recognition (e.g., 30 hours per year, if anymust be at least 20 hours per year). ELD requests that recipients conduct/offer in-service training or education in conjunction with or in addition to volunteer recognition. The cost of such in-service training/support is not counted against the $16.50 per person maximum.
Contracts/contractors: Copier/site maintenance, food service contracts are allowable: retain same in your files. Computer service/extended warrantee contracts are not allowed. Note individual contractors on pg. 1 of Att. B under Other.
Other: Any expense not listed above. Identify relevant/significant characteristics.
Additional Remarks:
For direct service programs such as outreach, social service coordination, chore, minor home repair and long distance medical transportation, develop/retain a copy of your intake and/or screening form(s). Keep and post donation and/or sliding fee policies, if /as applicable. Note the maximum dollar value and/or hours of service/s that may be provided any single client annually with Formula funds. ELD suggests posting Standards of Independence (available from ELD) in your senior center. You may consider having participants sign-off that they have read and received same. COAs may also consider posting Standards of Independence for transportation/ rides.
For newsletters, confirm that Elder Affairs is regularly identified (in each issue) as supporting the printing, distribution and/or production of the newsletter.
COAs shall retain complete, current (review/revised within the past three years) job descriptions for all direct service paid and volunteer positions. Please note volunteer hours (including paid staff working beyond paid hours) in Section I of the EOEA-SGA.
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Commonwealth of Massachusetts FY 2017 Annual Report EOEASGA
EXECUTIVE OFFICE OF ELDER AFFAIRS (p. 1 of 4)
1 Ashburton Place, Boston, MA 02108 Please print or type.
Name of COA: Tel. # ( )
FAX # ( )
MAIL Address: (ZIP)
STREET Address: (E-MAIL)
Current Chair:
Current Director/Coordinator:
Days and Hours of Operation:
I. Staff/Volunteer Support
A-1 How many paid staff ; volunteers do you have?
A-2 # Paid Staff # Volunteers ( NOTE: Senior Aides are paid staff!
20 hours/week or more --
5 hrs./wk. to 19.5 hrs./wk. ---
1 hr./wk. to 5 hours/wk. ---
10 hrs./year to 50 hours/yr. ---
Under ten hours per year xxxxxxxxxxxxxxxxxxx
A-4 Total volunteer hours in FY 2017 > > > > > ** A-3 hours are not included in A-4 unless given beyond property tax requirements .
II. Municipal Appropriation to COA in FY 2018: $ (salary/operations).
B-1 Municipal gift/donation account: ( )Y; ( ) N. B-2 Friends of COA: ( ) Y; ( ) N.
B-3 In-Kind from Section IX. (Do not include volunteers, above). $ ( Cf. page 4 of 4.
III. Service Counts ( See page 3, section VI A.)
A. Unduplicated Elders* Served: # ( ) estimated; ( ) actual. [NO penalty for estimates.]
B. Of the Unduplicated Elders in IIIA., note number of WOMEN: ; MEN
Of the Unduplicated Elders in IIIA., indicate percentage of:
% Women % Nursing Home * created by (computerized)
% Men % Disabled alphabetic roster. Do not
% Minority % 75 or over submit names!
D. Non-Elder Service Count: (from VII A.) (See page 16 for instructions on above.)
IV. Inquiry Please X as appropriate: our COA ( ) assists persons with Alzheimers and/or dementia . Scheduled program/support is offered: ( ) weekly; ( ) bi-weekly; ( ) monthly;
( ) other . Programs are on-site ( ); off-site ( ). Are programs (also) offered by other agencies in your community? If so, please note/describe or attach same.
Our COA offers formal ( ); informal ( ) caregiver/ family support for caregiver/s.
IF SO, please offer comments, suggestions on how to create/expand such support. Thank you!
((You may also continue in section VIII).
Annual Report Form EOEASGA
Name of Council: FY 2017 (p. 2 of 4)
Units Elders Use an "A" to note Actual #s only.
of Service NO penalty for Best Estimates.
Conducted ("Duplicated") ("UnDuplicated")
by 1 July 16 - 1 July 16 -
V. Programs, Services COA 30 June 17 30 June 17 N O T E S
& Activities
Actual Actual
OUTREACH/ADVOCACY
a. General information services < > < > UnDuplicated count will be an estimate.
b. Case management/advocacy < > < >
c. Health benefits counseling (SHINE) < > < >
d. Client finding . < > < > (new contacts)
e. < > < >
f. < > < >
PROFESSIONAL SERVICES
g. Group support specify at ID (* < > < > (# of sessions: )*ID
h. Legal assistance ................ < > < >
i. Financial Mgmnt. specify at ID (* < > < > *ID:
j. Mental Health < > < >
k. < > < >
l. < > < >
SUPPORT SERVICES
m. Food shopping assistance .... < > < >
n. Social (supportive) day care .... < > < > (# of days/week: )
o. Friendly Visiting < > < >
p. Telephone Reassurance < > < > (include Are You OK?/RUOK)
q. Durable medical equipment loan < > < > Elder Affairs notes potential liability issues.
r. Employment services ...... < > < >
s. Intergenerational ............. < > < > note chore, other:
t. Transportation (TOTAL) < > < >
ambulatory ....................... < > < >
nonambulatory .............. < > < >
u. Minor Home Repair ........... < > < >
v. Newsletter < > < > xxxxxxxx ( ) monthly; ( ) quarterly; ( ) other
w. < > < >
x. < > < >
ANNUAL REPORT Form EOEA-SGA
Name of Council: __________________________________ FY 2017 (p. 3 of 4)
"Duplicated" "UnDuplicated"
Units of Service ELDERS
Conducted 1 July 16 30 June 17 1 July 16 30 June 17
by
COA Actual Actual
WELLNESS < A>
y. Health screening .............. < > < > (# of sessions: )
z. Other health services............ < > < >
aa. Fitness/exercise ... < > < >
bb. Congregate meals ............ < > < >
cc. Home Delivered Meals ..... < > < >
dd. Health education ..... < > < > (# of sessions: )
ee. < > < >
ff. < > < >
OTHER
gg. Recreation/Socialization........ < > xxxxx xxxxxxxx (# of sessions: )
hh. Cultural events ........... < > < > (# of events: )
ii. Community Education < > < >
jj. < > < >
kk. < > < >
ll. < > < >
VI. A. Determine Unduplicated Elders Served: < > (Do NOT sum!) -- see instructions.
(Also record on page 1
section III. A)
B. Latest ESTIMATE of 60(+) Population: #
(source of this count)
VII. Service to NONELDERS Units of Service Non-Elders
duplicated unduplicated
NE1 General information............. < > < > (Exclude a. above).
NE2 Transportation (under 60).... < > < > (Exclude t above).
NE3 Family assistance. < > < >
< > < >
< > < >
< > < >
VII. A Determine Non-Elders Served: < > (Do NOT sum!) -- see instructions.
(Also record on page 1
section IIID.)
( -- Page intentionally left blank. --) Form EOEA-SGA [pg. 4 of 4]
VIII. Please highlight or summarize notable COA activities from last year: accomplishments, issues/concerns, initiatives, milestones(and/or what did not happen as expected/hoped). This may be a continuation from page 1 of 4. (You may also attach the annual municipal COA report.) For handwritten submissions, please write/print clearly. Thank you.
IX. InKind
In-kind represents tangible goods or services generally considered essential for COA operations, but not paid for out of its budget. Such services are not supervised by the COA, there is no CORI check or written job description, and the COA typically does not provide orientation, screening, periodic reviews and/or formal recognition of such services.
Typical examples follow. Kindly (X) or indicate estimated value in appropriate categories.
In-kind often includes these items and others on the optional Volunteer/In-Kind Resource Sheet/s.
( ) Rent/Space (gross sq. ft.: ) ( ) Speakers/Presenters
( ) Transportation ( ) Entertainers
( ) Utilities ( ) Furniture/Equipment
( ) Van, Garaging & Service ( ) Supplies
( ) Custodial/Maintenance ( ) Renovations
( ) Plowing/Outside Maintenance ( ) Cable TV service
( ) Durable Medical Equipment ( ) Luncheons/food
( ) Recognition Event(s) ( ) Books/Videos/Magazines
( ) Donated goods ( ) Subscriptions
( ) Craft workers ( ) Intergenerational
A. Estimated In-Kind Total. Please transfer to page 1, item II C. Grant funded positions such as Senior Aides, Green Thumb workers and meal site aide (Elder Nutrition Program only) may be included under in-kind. (This list is not exhaustive.)
VOLUNTEER RESOURCE SHEET -- OPTIONAL (but see notes, below) -- VRS p.1
NAME OF COUNCIL: FISCAL YEAR ENDING 30 June 2017
Please note the Possible/typical volunteer Estimated Elder Affairs will assign
# of positions, titles. Modify as needed. Total Hours a standard value if
or use an x. no rate is entered.
Board President/Officers $
Board Members $
Board Liaison w/ AAA-ASAP-Friends $
Newsletter Committee $
Newsletter Editor $
Newsletter Coordinator $
Drivers - Home Delivered Meals $
Drivers Passengers $
Instructor : Computer $
Instructor :Arts/Crafts $
Instructor : $
Instructor : $
Counselors / SHINE $
Counselors / Support Group $
Administrative Support: Receptionist $
Administrative: $
Administrative: $
Tax Assistance $
# Total # of positions & hours; this
SUM and succeeding page/s, if any SUM
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This form is required if Formula funds are to be used for volunteer recognition. Estimates are allowable. For this report volunteers are staff: meaning -- in theory -- they should be paid for their work. Typical/allowable positions are noted (including board members solely for purposes of this report). No volunteer credit is given for tax work-off hours (unless the volunteer has exceeded the hours served for tax relief purposes) or for RSVP service for which the COA is a contractor or for Friends of COA activities.
Please transfer service hours, position SUMs (above) to Section 1 of EOEA-SGA.
(Please review notes at the bottom of the next sheet VRS p.2) VOLUTEER RESOURCE SHEET -- OPTIONAL (but see notes, p. 1 of VRS) -- VRS p. 2
NAME OF COUNCIL: YEAR ENDING 30 JUNE 2017
Please note the Possible/typical volunteer Estimated Elder Affairs will assign
# of positions, titles. Modify as needed. Total Hours a standard value if
or use an x. no rate is entered.
Kitchen Help $
Meal Site Staff $
Friendly Visitor $
(Medical) Escort / Companionship $
Shopping Assistant $
Fix It / Repair Program $
Bill Payer $
Photographer/Videographer $
Health Fair Worker $
Nurse $
Nurse Assistant $
Coordinator : Trip $
$
$
$
$
$
$
$
# < Sum of this page > # (( transfer to VRS p. 1 SUM)
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Do not include nonprofit Friends of COA unless they also volunteer directly at the COA. Hand-crafter hours, or fund raising time, e.g., rehearsal hours, are not in-kind for this report: only the net proceeds of such activities are included in your resource listing. Section IX. of EOEA-SGA lists In-Kind contributions. (You may make additional copies of this sheet.)
( Hourly valuation of volunteer services varies widely. Consider an employee equivalent basis by using a Full Time Equivalent (FTE) calculation. An annual FTE is often 2000 hours of volunteer service (typically based on a 40 hours/week x 50 week annual work year), but local FTE hours may be 35hrs/wk, 37.5hrs/wk or other.
EOEA-SGA Instructions, including the Volunteer Resource Sheet (VRS)
Section I. Staffing/Other Support Valuing Volunteer Services
Volunteers serve of their own free will: they are, in effect, unpaid staff working on behalf of the COA. Anyone engaging in direct, unsupervised contact with seniors is subject to at least a (biennial) iCORI check. The COA director is typically the CORI coordinator.
Volunteers work under the supervision/guidance of the COA director (or volunteer/ activities coordinator) or, where staff does not exist, the COA chair. Volunteers may be students, Foster Grandparents, County Extension, RSVP, Job Corps, VISTA, (vocational) schools, prisoners and other personnel including SHINE workers. A volunteer may receive payment for out-of-pocket expenses and still be considered a volunteer.
Do not include RSVP workers (if you are an RSVP contractor) unless those volunteers work directly for the COA.
Senior Aides, Green Thumb, NCSC, Urban League are InKind, recorded on page 1of EOEA-SGA at item B-3. Anyone from these programs (as well as property tax work-off personnel that give the COA time beyond paid duty) may have their hours recorded on the VRS. You can (and should!) include volunteer hours of COA staff -- including the director -- who give time beyond paid hours of employment.
Property Tax Work-Off hours at/for the COA should be identified at A-3.
Elder Affairs encourages the development, use and /or updating (every three years or less) of written job descriptions (with minimum qualifications) for all volunteers. COAs should screen, orient, supervise, review and otherwise support such unpaid staff.
Other. The Volunteer Resource Sheet (VRS) allows COAs to estimate the value of volunteer services. Independent Sector publishes annual value of various positions. ELD suggests using the FTE equivalent approach noted at the bottom of page two (2) of the Volunteer Resource Sheet. At the very least, use the form to indicate the types of volunteer services and the total HOURS or their FTE equivalent.
Hand-crafting, rehearsals and fund raising hours may be recognized in your local annual report; however, the EOEA-SGA form does not recognize these figures.
Section II. Municipal Appropriation. Self-explanatory.
Section IIB-1, B-2, B-3. (optional) Other local cash contributions. Grants/awards/donations from businesses and/or nonprofit organizations. Please do not include any Area Agency on Aging funding.
*In non-profit accounting, the value of volunteer services can be used on financial statements, grant proposals and annual reports only if a volunteer is performing a specialized skill. The general rule for contributed services to meet Financial Accounting Standards Board (FASB) criteria for financial forms is to determine whether the organization would have (had to) purchase(d) the service/s if they had not been donated. You may visit FASBs website at: HYPERLINK "http://www.fasb.org/pdf/fas116.pdf" http://www.fasb.org/pdf/fas116.pdf. The rule would seem to apply here.
-1- (SGAInst)
Section III. Service Counts. See Section VIA and Section VII figures.
Do not sum section V. The unduplicated count uses original attendance records to create a "master" alphabetic roster or database of names. This roster cross references names only once, regardless of the frequency or type of services or activities. (Think noses.) This total is less than your elder population (unless you have many summer people" or participants from other communities). You need not submit the names. Each municipal consortium member should provide its own figures, if/as practicable.
Section IIIC. Minority
Black/Afro-American Persons originating in the Black racial groups of Africa.
Hispanic Persons of Mexican, Puerto Rican, Cuban, Central or So. American culture or origin.
Asia/Pacific Persons having origins in any of the peoples of the Pacific Far East,
Islander Southeast Asia or the Indian subcontinent.
Native Persons of the original peoples of America who maintain cultural
American identification through tribal affiliations or community recognition.
Nursing Home A resident of a long term care facility.
Disabled A physical and/or mental impairment which affects a major life function, e.g., breathing, eating, walking, hearing, seeing or other.
Section IIID. Non-Elders (under age 60) Served. See Section VII.
This may include information and referral, fuel assistance, MassHealth and food insecurity (SNAP) applications, family counseling, pre-retirement training/job application assistance, property tax work off. ( Remember: you are likely the only public social l service agency in your municipality.
NE1 General Information Most calls of a general assistance nature, e.g., information regarding the day's events and activities, or referrals to other services where followup is not indicated. (1 CALL/CONTACT)
NE2 Transportation (Under 60) Do not include in line "t", section V.
NE3 Family Assistance Information and referral, counseling, or other direct assistance to nonelder family members regarding an elder's care and/or wellbeing.
Section IV. Other (new/current offering/s by your agency), and comments. This information is often very helpful and may be shared with other COAs
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(Section V. Programs, Services and Policies: Notes)
Conducted by COA (Column "COA") Place an (x) in this column for each program, service or activity conducted by the COA during the fiscal year ending June 30th. You may leave this space blank if the programs, services or activities were conducted by a provider on behalf of the COA.
Place an in the "< >" space preceding any number which is an actual count (as opposed to best estimate) of units of service or elders served. There is no penalty for "best estimates."
Units of Service The Duplicated count is the total number of direct service units (e.g., contacts, hours, visits, rides, meals, classes, shots, etc.) provided under a COA program. Each contact as defined below equals one "service unit."
Elders The UnDuplicated count represents the number of "different (unique) persons age sixty* or over" served in each program, service or activity. Each person is recorded (once), alphabetically, under each program in which s/he participates. *or 55/50 if the COA defines elder in that fashion
The key figure of UnDuplicated Elders Served (section VII) is obtained only via an alphabetized list or roster of all participating elders (all programs combined) to ensure that each name is counted only onceregardless of how many times or in which programs he/she participated.
a. General Info Services Calls of a general assistance nature, e.g., information regarding events and activities, or referrals to other services where followup is not indicated. (1 CALL/ CONTACT) This unduplicated count is difficult to obtain and not expected, but the duplicated count is valuable in determining overall service volume.
b. Case management/advocacy Ongoing management of, or advocacy for, client services. Must include a standardized "intake" (and reassessment as needed), monitoring and evaluation. This typically follows referral to your Aging Services Access Point. COAs are encouraged to develop/use a release of information form for tracking referrals made to Aging Services Access Points (ASAPs). (1 CONTACT)
c. Health Benefits Counseling Service under the Serving Health Insurance Needs of Everyone (SHINE) program or other activities designed to assist seniors with information on health insurance related issues. May include filing of claims, appeals and completion of forms. (1 CONTACT)
d. Client Finding Initial efforts made to establish contact with individual elders and to introduce existing services and benefits. May be cold calls or, preferably, conducted in coordination with first responder agencies, organizations or others with frequent contact with seniors. Does not include other support once the need for/awareness of services has been established. (1 CALL/CONTACT) The counts for client finding (a/k/a outreach) do not include casual contacts made at COA events (e.g., blood pressure screening or flu shots) unless/until subsequent (formal) follow-up takes place.
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g. Group support Alzheimer's, widowedwidowed, AA/NA, depression, Parkinsons, deaf/hard-of-hearing seniors, stroke recovery, caregivers, mens or or other support groups. (1 CONTACT) Please use notes column for # and types of sessions. Please note if you have conducted any "Caring for Elders at Home" program/s. Thank you.
h. Legal Assistance Assistance with obtaining legal advice or support and/or direct services. May include individual advocacy and assistance with forms.
i. Financial Management Assistance with bill paying, money management or other. (1 CONTACT)
j. Mental Health Direct contact with an elder to help relieve symptoms of depression, anxiety, confusion, dementia or other circumstances. (1 CONTACT: usually from 20 minutes to 1 hour)
m. Food shopping assistance Personal assistance with grocery shopping for seniors unable to perform this activity on their own. (Not just van driving to/from store.) (1 TRIP/DELIVERY)
n. Supportive Day Care Structured day service program for frail elders. (1 DAY or QUALIFYING PORTION)
o. Friendly Visiting Home visiting/social call may include companionship, letter writing, assistance with meals preparation, playing a game or similar activities. (1 VISIT / HOUR)
p. Telephone Reassurance Daily check up calls to ensure general health and well-being. Please note if you are using regular computer/calling contacts. (1 CALL)
q. Durable Medical Equipment Loan Provides previously used (or new) equipment such as canes, walkers and wheelchairs on a temporary basis to elders. COAs should recognize potential liability issues if the device is not properly fitted or is defective. Occasionally private nonprofits (e.g., VNAs) do the fittings. (1 LOAN)
r. Employment service Locating, matching and/or providing assistance with employment needs (1 PLACEMENT); formal job training other than inservice programs (1 HOUR). Do not include Senior Aides.
s. Intergenerational Shared activities (direct contacts) with persons at least one generation removed from elders. For direct service/s, use HOURS of contact; for all other activities, e.g., classes, programs, etc. use NUMBER of CONTACTS. Please highlight program offerings.
t. Transportation Shopping, medical, other. Non-ambulatory refers to wheelchair lift users. Ambulatory means walks without assistance or uses a device such as a walker, cane or other aid exclusive of a wheelchair. (ONEWAY TRIPs) Note UNDER60 ridership at "NE2."
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u. Minor home repair Residential safety or energy improvements. (1 HOUR/1 COMPLETED JOB)
v. Newsletter The total unduplicated count is not listed for this activity. (1 COPY)
y. Health Screening Screenings, e.g., blood pressure, glaucoma, hearing, stress, diabetes, cholesterol or other. (1 CONTACT) Use notes column for # of sessions.
z. Other health services Flu/pneumonia shots, fileoflife, yellow dots or other. (1 CONTACT)
aa. Fitness/exercise Walking club, dance/exercise. (1 CONTACT) Use notes column for # of sessions.
bb., cc. Congregate, Home delivered meals E.g., box, shelf stable, frozen or special. (1 MEAL)
dd. Health education Attempts made through personal contact--forum, presentation or other format--to improve health status of audience or individuals.
gg. Recreation/socialization Drop in, arts & crafts, cards, BINGO, recognition parties/events or celebrations, movies, outings, picnics, etc. (1 SESSION or PROGRAM) NO unduplicated count.
hh. Cultural Live music, plays, choral groups, displays. (1 EVENT) Unduplicated count may be difficult to obtain.
ii. Community Education Programs of general community interest (not necessarily limited to seniors). May include preretirement planning, cultural programs, forums, etc. Note "Caring for Elders at Home" programs at line "g." Use notes column for # of programs; please highlight program offerings. (1 CONTACT)
General note/other. If you are uncertain as how to classify data, use the least ambiguous reporting category (or create one that you will use consistently). Provide a brief explanation when you change/reclassify categories or data from a previous year.
Please use any undesignated line to cite other services or list special activities, e.g., TRIAD meetings, grandparenting programs or others that might be hidden in another category. Other examples may include: computer training, intergenerational lawn/yard maintenance or chore assistance, weatherization/fuel assistance support
(Section VIII. Self-explanatory)
(Section IX. See notes on that page.)
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FY2017Formula Grant PACKAGE, 7/2018 p19
REVIEW CHECKLIST ~~
~~ IT DOES NOT INCLUDE ATTACHMENT B or STATEMENT OF AUTHORIZATION
[
Job description(s) with minimum qualifications and rate/s of pay
Optional;
suggested.
CORI checks are standard for employees and volunteers with unsupervised contact with seniors. CORI checks are good for a maximum of 24 months.Itemization of equipment to be purchased. Local procurement procedures to be followed. Optional;
Strongly suggested.
Retain file copy.
Plans and/or drawings for eligible improvements
Brief description of work to be funded.
Retain file copy of original of bids, quotes or other relevant documentation.Other, e.g., time lines, intake material, (signed) vendor contracts
Retain locally.
Retain file copy.
One hard copy.
Retain file copy.
One original copy.
Retain file copy.
Annual Report EOEA-SGA
One hard copy.Please forward copy to your area agency on aging.
Volunteer Resource Sheet*
One hard copy.Optional, but *required* if using Formula funds for volunteer recognition.
Statement of Grant Balance
One original copy.Please forward as soon as practicable. (See summary date sheet.)
The (GREEN) GUIDE
(Retain for reference)
RETAIN FOR
FUTURE REFERENCE This document is legally binding and noted in the municipally-signed contract with Elder Affairs.
7/2018:20f FY2018 FORMULA GRANT/ALLOCATION -- STATEMENT OF AUTHORIZATION
(Affix to your Attachment B budget.)
(Name of COA/Agency) (Daytime Phone)
(Mailing Address) (Fax number)
(ZIP)
(Street Address) E-MAIL
The persons whose signatures appear below are authorized to commit the Council on Aging to the Attachment B Formula Grant Allocation Budget and hereby agree to its submission to the Executive Office of Elder Affairs (Elder Affairs).
Elder Affairs reserves the right to modify the purposes and/or proposed Attachment B expenditures prior to execution of the contract agreement. The allocation amount is subject to final appropriation by the General Court.
(x)
(PRINT) Director/Coordinator (signature) (date)
(x)
(PRINT) Chairperson (signature) (date)
(x)
(Print) Chair, Board of Selectmen; Mayor; (signature) (date)
Town or City Manager / Administrator;
Executive Secretary / Administrator;
(other title)
For contract purposes, please note:
The legal address of the municipality:
The payment remittance address
of the municipality (from your W-9):
SFY2018Formula Grant Package, 7.x.2017/p22
A-3 # Estimated Property Tax Work-Off hours at COA. **
Maximum work-off amount per senior in your city/ town: $ .
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