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Notice of Application for Older Adult Home Modification Program GrantCity of Dubuque City Council Meeting Consent Items # 06. Copyrighted November 20, 2023 ITEM TITLE: Notice of Application for Older Adult Home Modification Program Grant SUMMARY: City Manager recommending City Council approval to submit the Older Adult Home Modification Program Grant application in the amount of $1,250,000 to spend over 36 months and further approval to continue through the negotiation process if selected for each qualifying round. SUGGESTED DISPOSITION: ATTACHMENTS: Description MVM Memo RESOLUTION Authorizing the Housing and Community Development Director to execute an application for the Older Adult Home Modification Grant and authorizing the Housing and Community Development Director and the City Manager to approve the application Suggested Disposition: Receive and File; Adopt Resolution(s) Staff Memo Resolution Approving Application Application Abstract Application Narrative Type City Manager Memo Staff Memo Resolutions Supporting Documentation Supporting Documentation THE CITY OF Dubuque DUB TEE1. All -America City Masterpiece on the Mississippi � pp zoo�•*o 13 zoi720zoi9 TO: The Honorable Mayor and City Council Members FROM: Michael C. Van Milligen, City Manager SUBJECT: Notice of Application for Older Adult Home Modification Program Grant DATE: November 16, 2023 Housing & Community Development Director Alexis Steger is recommending City Council approval to submit the Older Adult Home Modification Program Grant application in the amount of $1,250,000 to spend over 36 months and further approval to continue through the negotiation process if selected for each qualifying round. The Older Adult Home Modification Program Grant was first created in 2021 to help residents age in place safely in their current home. The City of Dubuque was one of the first cities awarded funds under this program and has been successfully modifying homes for residents over the age of 62 for the past two years. I concur with the recommendation and respectfully request Mayor and City Council approval. Mic ael C. Van Milligen MCVM:sv Attachment cc: Crenna Brumwell, City Attorney Cori Burbach, Assistant City Manager Alexis Steger, Housing and Community Development Director THE CITY OF Dub E Masterpiece on the Mississippi TO: Michael C. Van Milligen, City Manager FROM: Alexis Steger, Housing and Community Development Director DATE: November 16, 2023 Dubuque MI-AmeNu City 2007-2012.2013 2017*2019 RE: Notice of Application for Older Adult Home Modification Program Grant INTRODUCTION The U.S. Department of Housing and Urban Development (HUD) released funding for an additional round of Older Adult Home Modification Program grant funds and the City of Dubuque is eligible to apply. BACKGROUND The Older Adult Home Modification Program Grant was first created in 2021 to help residents age in place safely in their current home. The City of Dubuque was one of the first cities awarded funds under this program and has been successfully modifying homes for residents over the age of 62 for the past two years. The new funds available would allow Dubuque to expand the program to those that are aging in place in rental units as well as increase the funding for homeowners. The City would apply for $1,250,000 to spend over 36 months. RECOMMENDATION I respectfully request approval to submit the Older Adult Home Modification Program Grant application and further approval to continue through the negotiation process if selected for each qualifying round. Service People Integrity Responsibility Innovation Teamwork Prepared by Alexis Steger, Housing & Community Devel. 350 W. 611 St., Suite 312 (563) 690-6072 Return to Adrienne N. Breitfelder, City Clerk, 50 W. 1311 St., Dubuque, IA 52001, (563) 589-4100 RESOLUTION NO. 374-23 RESOLUTION AUTHORIZING THE HOUSING AND COMMUNITY DEVELOPMENT DIRECTOR TO EXECUTE AN APPLICATION FOR THE OLDER ADULT HOME MODIFICATION GRANT AND AUTHORIZING THE HOUSING AND COMMUNITY DEVELOPMENT DIRECTOR AND THE CITY MANAGER TO APPROVE THE APPLICATION Whereas, the U.S. Department of Housing and Urban Development released funding for a new year of Older Adult Home Modification Grants; and Whereas, the City of Dubuque currently participates in this grant funding and has assisted several residents over the age of 62 age safely in place; and Whereas, the City of Dubuque would benefit from continuing the Older Adult Home Modification Program to assist more of our aging population safely age in their current home. NOW, THEREFORE, BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF DUBUQUE IOWA: Section 1: That the Housing and Community Development Director is hereby authorized and directed to apply for the Older Adult Home Modification Grant; and Section 2: That the City Manager and the Housing and Community Development Director are hereby authorized to approve the application that is submitted to the U.S, Department of Housing and Urban Development; and Section 3: That the City Manager and the Housing and Community Development Director are hereby authorized and directed to take all actions necessary to complete the negotiation process that follows the application. Passed, approved and adopted this 20th day of November 2023. rad Cavanagh Mayor Attest: / Adrienne Breitfelder City Clerk APPLICATION ABSTRACT FOR THE CITY OF DUBUQUE, IOWA This application is for a thirty-six (36) month Older Adults Home Modification Grant Program requesting HUD funding of $1,250,000 to be administered by the City of Dubuque's Housing and Community Development. Matching funds totaling $40,000 are committed by the City of Dubuque local funds. The City of Dubuque is a leader in administering grants effectively, efficiently, and meeting the outcomes set forth. Due to the abilities of the staff and organization, the City of Dubuque has been awarded and successfully completed several federal grants in the past two years, such as Lead and Healthy Homes Grants, Healthy Homes Production Grant, Older Adults Home Modification Grant, Family Self -Sufficiency Grants, VA Supportive Housing Grant, and the Family Unification Program Grant. The City of Dubuque is uniquely situated to financial support grants by increasing local funding and teaming funding sources together to create the greatest impact and outcomes for the community. The 65 and older population in Dubuque makes up 18% of the community, equating to 10,400 people in this target population. Many of these community members reside in lower -income neighborhoods or apartment complexes, some in opportunity zones, and many in homes they raised their families in. Although there are many non -profits in Dubuque, the 62 and older population wanting to age in place is underserved. The Agency of Aging has a small regional office that is often un-staffed, the Department of Human Services went to a regional model, mainly providing children services in the city and very few elderly services. COVID crippled organizations that previously served the elderly since services have become dangerously low to that population. The population in Dubuque is aging with the Boomer Generation aging out of the workforce, and being able to safely age in place is essential in supporting this population in the future. The City of Dubuque is proposing a similar organizational structure that has been used for other federal grants as the 2021 OAHMP federal grant, employing a Project Manager and Financial Specialist who are supported by a Director and Assistant Director. The City of Dubuque will continue to use a skilled partner in Unified Therapy Services to provide an Occupational Therapist. The City of Dubuque will continue to use the same staffing for this grant as was used for the 2021 Older Adults Home Modification Grant which allows the capacity for this grant without any additional hiring. This program expects to serve approximately 145 units with an average cost of $4,800.00 per unit for modifications. Once an applicant is approved for this grant funding an Occupational Therapist or CAPS certified staff member with the oversite of an Occupational Therapist will complete an in -home assessment and create work orders for modifications based on the assessment completed in the Home for Life Software. The assessment will consider ADL's as well as structural deficiencies in the home due to lack of maintenance that will cause safety hazards. The work order will be completed by a licensed contractor and the Occupational Therapist or CAPS certified staff member will return for a follow-up to provide the resident with education on how to use the modifications/equipment installed. The grant model allows for the maximum number of units to be served, with low administrative costs, so the City of Dubuque can successfully help a larger portion of those that can safely age in place with these modifications. THE CITY OF DUS E Masterpiece on the Mississippi RATING FACTOR 1: Capacity of the Applicant and Relevant Organizational Experience The Capability and Qualifications of Key Personnel (See Resumes Attached) a. Key Personnel The Grants Project Manager (Program Manager) for this grant will be Nicole Lytle. She has been the Program Manager for the HUD Healthy Homes Production Grant and the HUD Older Adults Home Modification Grant. Nicole is a Certified Aging in Place Specialist (CAPS) and has almost 2 years of direct project management experience with Older Adult Home Modification Grants from HUD. Stacey Carpenter has 4 years of experience providing intake, relocation services, and processing grant financial documents for HUD grants, and will be dedicated to continuing these services for the Older Adult Home Modification Program. Additional oversight will be provided by the Housing and Community Development Director Alexis Steger who has 9-years of experience in assisting the elderly through housing rehabilitation programs, ADA programs, assisted housing and veteran's assistance. The Director is also a Certified Public Accountant with 10 years of experience with compliance and financial management of federal grants. Alexis also served on the Board of Directors for Luther Manor Communities, providing continuum of care options for seniors in the community. Organizational Experience In 2021, The City of Dubuque began its first Older Adults Home Modification Grant and has successfully partnered with Occupational Therapists from Unified Therapy. The Program Manager also obtained her Certified Aging in Place Specialist designation to ensure the city can complete in -home evaluations within a timely manner. This program has a waiting list of homeowners and a list of those who reside in rentals that the grant cannot assist due to regulations. The City of Dubuque has created a unique approach to home modifications by working closely with Four Mounds to provide an educational experience to students who are preparing to enter the contracting workforce. Additionally, the City of Dubuque has served as a Public Housing Authority for over 40 years and administers housing assistance of over $5,000,000 each year. The City of Dubuque services homeless veterans, elderly/disabled residents, and non -elderly disabled residents with special purpose vouchers. As a Public Housing Authority, the City of Dubuque is also a Fair Housing Organization and is required to further fair housing. The City of Dubuque partners extensively with several organizations that further fair housing including the Human Rights Commission, the NAACP Friends of Fair Housing, and Iowa Legal Aid. The work with these partners focuses on higher level access for persons with disabilities, such as public infrastructure access, ADA enforcement and ensuring housing providers are providing fair opportunities to housing through fair marketing, advertising, and reasonable accommodations. 11Page THE CITY OF DUS E Masterpiece on the Mississippi The City of Dubuque began the Lead Hazard and Control grant in 1997 and has remediated lead hazards in 1,400 homes with grant awards continuously since that time. Dubuque initiated the idea of a home advocate in this program to assess other needs within the social aspects of the home and continues this model in all awarded HUD grants today. The City of Dubuque began the Healthy Homes Production Grant in 2022 to modify homes of residents to increase health and safety in the home. The City of Dubuque created a twenty- nine (29) point inspection checklist to create a comprehensive work plan for the home. This list is utilized when evaluating the health of the home for those aging in place. The City of Dubuque is a CDBG Entitlement Community. For the past 20 years, the City of Dubuque has provided a homeowner rehabilitation program, in which the City funds and hires contractors to complete the rehabilitation of properties. The City of Dubuque is well trained in environmental reviews due to being a CDBG Entitlement City, administering Lead and Healthy Homes grants and the Older Adults Modification Grant. The Older Adult Home Modification Program focuses on maintenance/repair type of activities that are exempt from extensive environmental reviews. The City of Dubuque has over 40 years or experience to help ensure activities are not delayed by exceeding the maintenance/repair thresholds for environmental reviews. The City of Dubuque also has over $20 million in general funds, unassigned, reserves that are readily available for upfront funding to support this grant until reimbursement can be received. b. Partner Organizations Unified Therapy Services, DUNS #804332661 Unified Therapy Services will re-enter into a Memorandum of Understanding with the City of Dubuque to provide an Occupational Therapist to complete the in -home assessments, review the in -home assessments completed by the CAPS certified Program Manager, and recommend home modifications. This assessment will identify safety hazards, including the client's fall risk/functional abilities with ADLs and IADLs. The Occupational Therapist will then create a work order for the contractor. The work will then be completed by a license contractor as required in the State of Iowa. The follow-up assessment and inspection will then be completed by the CAPS certified Program Manager. Unified Therapy Services has over 30 employees and four clinic locations and has been providing occupational therapy services since 2006 in the City of Dubuque. They are national and locally recognized for the quality of care they provide. The team at Unified Therapy services consists of occupational and physical therapists, speech -language pathologists, physicians, medical professionals, and care staff. Key Personnel at Unified Therapy Services are Lauren Hoover OTR/L as the head of the occupational therapy department. She has 15 years of outpatient and early intervention occupational therapy experience. She received her Master of Occupational Therapy from St. 2 1 P a g e THE CITY OF DUS E Masterpiece on the Mississippi Ambrose University in 2008. Terese McMahon OT is an Occupational Therapy Practitioner with 3 years of experience. She received her Master of Occupational Therapy degree from Allen College in 2019. RATING FACTOR 2: Need for the Program a. Demographic and Other Data for Geographic Area Containing the Target Area (1) According to the U.S. Census Bureau ACS 2021 5-year estimate data profiles (https://data.census. aov/table/ACSDP5Y202I .DP05?q=DP05&t=Older+Population&g=1 60XXOOUS1922395&y=2021) the City of Dubuque is home to 13,685 residents that are age 62 and older. Data is not available indicating income level, see (2) below for computation for income. (2) The area median income found via U.S. Census Bureau QuickFacts (https://www.census.aov/quickfacts/fact/table/dubuqueciiyiowa/PST045222) for the City of Dubuque per capita is $32,429. HUDs 80% income limits for the Dubuque MSA area is $49,000 for one person. Since Census does not cover the targeted area for income information at the age level, it can be deduced from these data sources that over 50% of the population is at or below 80% of the Area Median Income, including those over age 62 who rely on only social security for income, which has not adjusted for inflation for many years. (3) The City of Dubuque continues to receive a significant number of applications (26 requests the week of October 91h) and is at full capacity for work, so a second contractor was hired to complete work in the current OAHMP grant. The need will continue to grow as the program becomes well-known, so continued funding is imperative. b. Housing Data for Geographic Area Containing the Target Area (1) According to the 2020 ACS for the City of Dubuque there are 26,214 housing units with 76.4% built prior to 1980 and 30.2% prior to 1940 indicating a very old housing stock in the targeted area. (2) According to the 2020 ACS for the City of Dubuque there are 15,582 owner -occupied housing units and 7,745 renter occupied units. Substandard housing information was last provided in the 2011-2015 CHAS data, with 280 renters and 10 owners living in substandard housing. However, 2,085 renters and 815 owners had a housing cost burden of over 50% of their income. RATING FACTOR 3: Program Strategy and Management a. Program Approach The City of Dubuque will market the program and accept voluntary applications for assistance. The Financial Specialist will help complete the application with residents as needed. This assistance can be provided to the residents' home or over the phone, whichever is preferred by the resident. The application will be processed to ensure the resident is eligible for the program, meeting the age and income requirements. Once approved, the program will follow the below model: 3 1 P a g e THE CITY OF DUS E Masterpiece on the Mississippi Unified Therapy Services will conduct an initial interview and an in -home assessment with the client. This will be completed by an Occupational Therapist or Occupational Therapist Assistant overseen by the Occupational Therapist. The initial interview and in - home assessment will include all care takers as they are available. This assessment will identify safety hazards, including the client's fall risk/functional abilities with ADLs and IADLs. This will be highly individualized, and modifications will not be restricted to the list provided but to those that provide the safest environment for the resident. However, the standard list of improvements that could be made will be part of the checklist at the assessment. Any work identified by the Occupational Therapist as necessary for the individual to age in place but is outside of the scope of work supported by the NOFA will be referred to a partnering department or grant. The work will then be completed by a licensed contractor as required in the State of Iowa within two -weeks. The follow-up assessment and inspection will then be completed by the Program Manager within one week, who is CAPS Certified and will be overseen by the Occupational Therapist. This follow-up assessment will include education on how to safely use adaptive equipment. If any adjustments are needed, additional work orders will be provided to the contractor for completion. Recruitment efforts will include news releases, radio ads, flyers distributed by the Public Housing Authority and other partners. Additionally, program employees will participate in community events hosted by local organizations, disseminating information and outreach materials to community members. Events include but are not limited to: City Expo, Multicultural Family Center's Juneteenth, Downtown Neighborhood Associations Music in the Park, National Night Out, Dubuque County Senior Expo, Dubuque County Fair, and more. An article about the program will also be featured in the City News that is disseminated to all utility billing customers in the City of Dubuque. The City of Dubuque expects to assist 148 units with the following modifications expected to be predominant based on the age of structures and ability to prevent falls/remove safety hazards: 1) Installing handrails on steps to enter/exit home 2) Installing grab bars in bathroom 3) Installing tub cut out to enable easy entry/conversion to shower 4) Installing high rise toilet or toilet riser with handles 5) Replacing doorknobs with lever style handles 6) Repairing floor transitions so there is 0 height difference 7) Adding nonskid strips to tub and/or shower 8) Moving light switches and electrical outlets where they are more accessible 9) Cleaning surface mold 10) Installing carbon monoxide alarms and additional smoke alarms b. Urbanized/ Substantially Rural Designation of Areas 4 1 P a g e THE CITY OF DUS E Masterpiece on the Mississippi The proposed target area is residential units in the City of Dubuque, Iowa. The City of Dubuque is an urbanized area. c. Flow of Funding Purchase Orders will be created upon contract signing for each unit in the amount listed in the contract. Invoices will be paid against the purchase order only after the Program Manager and Unified Therapy sign off that work completed by the contractor is complete in a workmanship -like manner. Unified Therapy Services will submit invoices monthly for all in -home assessments complete and supplied to the Program Manager. The Program Manager will ensure in -home assessments are on file for invoices being paid. The invoices and all other documentation will be kept on file to be submitted to HUD for reimbursement and any audits. d. Addressing Additional Needs of Clients Clients identified with homes in need of major repair will be referred to the Community Development Block Grant division to participate in the homeowner rehabilitation program and to the Healthy Homes Production Grant. Additionally, the VNA will take referrals to help those in need of additional care or transfer to a care facility. DHS will be notified for any older adult identified in the first in -home assessment that may require adult protective services. The administrative plan for the grant will be used for this grant as well and addresses these policies and procedures. e. Project Timeline The following schedule will guide the success of this grant. Meeting milestones will be important to successfully completing all units proposed to be assisted and helps keep workloads consistent throughout the grant. The schedule reflects the initial marketing time when a new grant produces fewer units as they ramp up interest and qualify participants. The City of Dubuque expects to have a waiting list established from the previous grant that can be drawn from for immediate production after ramping up. Quarter Ending Units Complete Total Grant Expenditures June 2024 0 $40,000 September 2024 14 $135,000 December 2024 29 $251,000 March 2025 44 $366,000 June 2025 59 $482,000 September 2025 74 $604,000 December 2025 89 $727,000 March 2026 104 $851,000 June 2026 119 $975,000 September 2026 134 $1,100,000 December 2026 140 $1,220,000 February 2027 148 $1,290,000 5 1 P a g e