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
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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
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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.
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THE CITY OF
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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.
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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:
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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
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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
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