STATE OF ARIZONA SOCIAL SERVICES BLOCK GRANT PLAN 2009-2010 THE ARIZONA DEPARTMENT OF ECONOMIC SECURITY EQUAL OPPORTUNITY EMPLOYER/PROGRAM FOR ALTERNATIVE FORMAT/REASONABLE ACCOMMODATIONS: (602) 542-3882 August 12, 2009 AZ 2009-2010 SSBG PLAN Equal Opportunity Employer/Program  Under Titles VI and VII of the Civil Rights Act of 1964 (Title VI & VII), and the Americans with Disabilities Act of 1990 (ADA), Section 504 of the Rehabilitation Act of 1973, and the Age Discrimination Act of 1975, the Department prohibits discrimination in admissions, programs, services, activities, or employment based on race, color, religion, sex, national origin, age, and disability. The Department must make a reasonable accommodation to allow a person with a disability to take part in a program, service or activity. For example, this means if necessary, the Department must provide sign language interpreters for people who are deaf, a wheelchair accessible location, or enlarged print materials. It also means that the Department will take any other reasonable action that allows you to take part in and understand a program or activity, including making reasonable changes to an activity. If you believe that you will not be able to understand or take part in a program or activity because of your disability, please let us know of your disability needs in advance if at all possible. To request this document in alternative format or for further information about this policy, contact (602) 542-3882; TTY/TDD Services: 7-1-1. August 12, 2009 - ii - AZ 2009-2010 SSBG PLAN TABLE OF CONTENTS SUBJECT PAGE List of Figures...............................................................................................................iv Appendices....................................................................................................................iv Introduction...................................................................................................................1 SSBG Planning Level ....................................................................................................1 TANF Block Grant Funds Transferred to the SSBG...................................................1 SSBG Service Goals.......................................................................................................2 Evaluation......................................................................................................................2 Reporting on Activities Funded ....................................................................................2 SSBG Planning Process.................................................................................................2 State Planned Services...................................................................................................3 Locally Planned Services...............................................................................................3 Arizona Tribal Entities .................................................................................................4 Geographic Areas ..........................................................................................................5 Financial Operations System ........................................................................................5 Proof of Audit ................................................................................................................5 Public Comment and Review........................................................................................5 Plan Amendment ...........................................................................................................8 Catalog of Services ........................................................................................................8 Federal Uniform Definitions of Services Titles ............................................................8 Arizona Dictionary and Taxonomy of Human Services ..............................................9 Crosswalk for Federal SSBG Services to Arizona Taxonomy ...................................19 Service Availability......................................................................................................23 Local and State Planned Levels ..................................................................................25 Target Group Definitions............................................................................................25 Planned Expenditures – SFY 2010 .............................................................................26 August 12, 2009 - iii - AZ 2009-2010 SSBG PLAN LIST OF FIGURES SUBJECT PAGE Figure 1: Title XX Geographic Areas (State map).......................................................6 Figure 2: DES Organization Chart...............................................................................7 APPENDICES SUBJECT PAGE Appendix A. Public Notice .........................................................................................59 Public Notice ..........................................................................................................60 Appendix B. Certifications.........................................................................................61 Certification Regarding Lobbying........................................................................62 Certification Regarding Drug-Free Workplace Requirements ...........................63 Certification Regarding Debarment, Suspension And Other Responsibility Matters...........................................................................................66 Certification Regarding Environmental Tobacco Smoke ...................................69 August 12, 2009 - iv - AZ 2009-2010 SSBG PLAN STATE OF ARIZONA Title XX Social Services Block Grant Plan July 1, 2009 – June 30, 2010 Introduction This document provides information on the types of activities supported and the categories or characteristics of individuals served under the provisions of the Omnibus Budget Reconciliation Act of 1981, Public Law 97-35, Subtitle C - Block Grants for Social Services, which amends Title XX of the Social Security Act. The Arizona Department of Economic Security (DES) under the statutory provisions of the law administers the Arizona Social Services Block Grant (SSBG) Plan (the Plan). The program period covered corresponds to the State Fiscal Year 2010 (SFY 2010), which begins on July 1, 2009, and ends June 30, 2010. SFY 2010 overlaps portions of Federal Fiscal Year 2009 (FFY 2009) and FFY 2010, which run from October 1 through September 30. SSBG Planning Level The specific formula used to estimate the amount of federal SSBG funds that are available for funding the planned services during Arizona’s SFY 2010 is calculated from one-fourth of Arizona’s FFY 2009 allocation and three-fourths of Arizona’s estimated FFY 2010 allocation. Since the actual allotment available to Arizona is determined pursuant to Congressional and Presidential approval, the services and planning levels identified are estimates. The $22,613,100 of TANF Block Grant funds transferred to the SFY 2010 SSBG is included in the Plan in addition to the SFY 2010 estimated funding level of $35,527,187 for a total combined planning level of $58,140,287. The Plan spreadsheets immediately follow the narrative portion of the Plan. There are Plan spreadsheets for each of the DES Administrations/Divisions that plan to use SSBG funding for SFY 2010. The spreadsheets show the Services, Target Group(s), Status Eligibility, and Funding for each of the Locally Planned and State Planned SSBG services. This format allows the DES, local entities, and the U.S. Department of Health and Human Services (DHHS) to see the funds planned for SSBG. TANF Block Grant Funds Transferred to the SSBG The 49th Legislature, First Regular Session HB 2643 (Chapter 12), Section 31 appropriated $22,613,100 of Arizona's Temporary Assistance to Needy Families (TANF) block grant to be transferred to the SSBG for Children Services funding. August 12, 2009 -1- AZ 2009-2010 SSBG PLAN SSBG Service Goals The mission of the Arizona Department of Economic Security is to promote the safety, well-being, and self-sufficiency of children, adults, and families. Arizona’s SSBG-funded services will be directed toward one or more of the following federal goals: I. II. III. IV. V. Achieve or maintain economic self-support to prevent, reduce, or eliminate dependency. Achieve or maintain self-sufficiency, including reduction or prevention of dependency. Prevent or remedy neglect, abuse, or exploitation of children and adults unable to protect their own interests or preserving, rehabilitating, or reunifying families. Prevent or reduce inappropriate institutional care by providing for community-based care, home-based care, or other forms of less intensive care. Secure referral or admission for institutional care when other forms of care are not appropriate or providing services to individuals in institutions. The goals of DES and the five federal SSBG goals are very much aligned particularly in the areas of achieving or maintaining economic self-support to prevent, reduce, or eliminate dependency. The goals of DES are to: Strengthen individuals and families; Increase self-sufficiency; and Develop the capacity of communities. DES facilitates the efficient delivery of a broad array of services aimed at helping individuals and families make effective decisions to increase their safety, stability, and self-sufficiency. Evaluation The appropriate administrations within DES contracting for services funded by the SSBG have the responsibility of monitoring and evaluating the social service programs funded by the SSBG. Reporting on Activities Funded DES will prepare a report on activities carried out with funds allocated in the Plan. The report may be used to determine the extent to which funds were spent in a manner consistent with the Plan. The Annual Report of Services Funded by the Social Services Block Grant for Fiscal Year 2009 will be available to the public after January 1, 2010. To obtain copies of this report, direct your request to the contact person at the telephone number or mailing address listed on page 5 of this Plan. SSBG Planning Process DES is responsible for planning and developing the Plan. This includes providing technical assistance to local planning bodies and tribal entities for locally planned SSBG services. Planning for the use of the balance of available SSBG funds is accomplished as a part of the Department’s annual budget development process. August 12, 2009 -2- AZ 2009-2010 SSBG PLAN State-Planned Services The DES Administrations/Divisions participating in Arizona’s SSBG planning and reporting process are: • • • • • • • • Administration for Children, Youth and Families (ACYF) Child Care Administration (CCA) Office of Community Partnerships & Innovative Practices (CPIP) Division of Aging and Adult Services (DAAS) Division of Business and Finance (DBF) – Policy and Planning Administration (PPA) Division of Developmental Disabilities (DDD) Employment Administration (EA) Rehabilitation Services Administration (RSA) These Administrations/Divisions within DES perform statewide planning activities by coordinating with similar and related programs of other state and local agencies, producing planning documents, fulfilling all federal statutory responsibilities accompanying the administration of programs, and involving local planning agencies in the development of a coordinated planning effort and review in local priorities for incorporation into statewide planning products. Locally Planned Services A significant amount of SSBG services are provided primarily through local service-delivery systems contracted by DES to augment state services and to respond to local needs. Arizona's six Councils of Governments (COGs) contract with DES to facilitate the primary planning for this portion of the SSBG service-delivery system. This primary planning is accomplished by identifying regional priorities, by coordinating planning with other planning entities, and by providing locally based citizen involvement opportunities. The following chart indicates the COGs’ distribution of the allocation for locally planned services. COUNCILS OF GOVERNMENTS (COGs) Maricopa Association of Governments Pima Association of Governments Northern Arizona Council of Governments Western Arizona Council of Governments Central Arizona Association of Governments SouthEastern Arizona Governments Organization TOTAL August 12, 2009 -3- ALLOCATION $4,090,579 1,551,134 431,451 500,125 453,099 438,169 $7,464,557 AZ 2009-2010 SSBG PLAN Arizona Tribal Entities Tribal Nations within Arizona’s tribal entities have been established as separate SSBG Planning and Services areas. Technical assistance in planning and developing SSBG services is provided to tribes, upon request, by DES or by a private agency under a contract from DES. Eighteen of Arizona’s tribes have designated the Inter Tribal Council of Arizona (ITCA) to plan for their SSBGfunded services. Each participating tribal entity is allocated the following share of the state's SSBG allocation that is based on each tribe's Arizona population. ITCA and TRIBES NAME of TRIBE Ak-Chin Indian Community Cocopah Tribe Colorado River Indian Tribes Fort McDowell Yavapai Nation Fort Mojave Tribe Gila River Indian Community Havasupai Tribe Hopi Tribe Hualapai Tribe Kaibab-Paiute Tribe Pascua Yaqui Tribe Quechan Tribe Salt River Pima-Maricopa Indian Community San Carlos Apache Tribe San Juan Southern Paiute Tonto Apache Tribe White Mountain Apache Tribe Yavapai-Apache Nation Total ITCA Services (Aging and Adult) ALLOCATION $ 15,658 17,040 26,097 16,257 19,179 95,425 16,453 96,898 25,374 13,735 25,607 23,862 30,744 92,593 12,086 13,205 115,574 21,397 $ 677,184 $ 64,343 120,644 1,242,896 18,417 $2,123,484 ITCA Planning Tohono O'Odham (Child Care) Navajo (Children's Services) Gila River (Children's Services) TOTALS ITCA planned services may be contracted with each tribal government for the amount shown. Specific services, eligibility criteria, and dollar amounts are determined during the contracting process and are not designated in this Plan. August 12, 2009 -4- AZ 2009-2010 SSBG PLAN Geographic Areas The geographic areas for which services are planned are identified on the map on page 6. These service-planning districts correspond to DES service districts, excluding Arizona’s Tribal Nations. Financial Operations System Arizona uses a federally approved cost allocation plan. DES is responsible for administering a wide variety and large quantity of grants and therefore utilizes multiple methods to assign costs. Indirect costs are typically assigned using modified total direct cost methodology. Other methods of assigning costs include Random Moment Samples, caseload counts, population factors, square footage, and time studies. Proof of Audit In accordance with 42 U.S.C. 1397e, the Single Audit Report for year ending June 30, 2008 was performed by the State of Arizona Auditor General’s office and submitted to the Arizona State Legislature May 26, 2009. Public Comment and Review The proposed Arizona State Fiscal Year 2010 SSBG Plan was made available to the public and local community and tribal social services planning agencies for review. Public notices were posted and the Department held public hearings at the six DES District offices throughout the state in June and July 2009. Please refer to Appendix A for a copy of the public hearings notice and schedules. All interested persons were afforded an opportunity to provide written comments on the proposed plan to the SSBG Community Planning Coordinator by close of business on July 14, 2009 at the address listed below: Arizona Department of Economic Security Marianne Eichinger, SSBG Community Planning Coordinator Policy and Planning Administration 1789 West Jefferson Street - Mail Site Code 837A Phoenix, Arizona 85007 Telephone: (602) 542-6159 E-mail: Meichinger@azdes.gov August 12, 2009 -5- AZ 2009-2010 SSBG PLAN Figure 1: Title XX Geographic Areas (State map) August 12, 2009 -6- AZ 2009-2010 SSBG PLAN Figure 2: DES Organization Chart Figure 2: DES Organizational Chart August 12, 2009 -7- AZ 2009-2010 SSBG PLAN Plan Amendment The Plan may be revised throughout the year as necessary to reflect substantial changes in the activities provided that affect the overall intent of the Plan. Any substantive revisions will be made available for public review and comment from interested persons and federal and public agencies. Service needs and program decisions may make it necessary to add services or make changes in eligibility, geographic and service availability, or the target group to which the service may be directed. These changes may be made in the Department's contracting process or direct servicedelivery process without modifying the Plan. Catalog of Services This section identifies the services that may be funded under terms of the Title XX, SSBG. The services are defined as follows: The Federal Uniform Definitions of Services is a listing of the twenty-nine titles and definitions of services that are required to be used for the purpose of reporting SSBG expenditures to the Federal Government annually. These services are defined in Title 45, Part 96, Appendix A of the Code of Federal Regulations. The twenty-nine titles are listed below.  Services listed in the Arizona Dictionary and Taxonomy of Human Services are provided by DES or through purchase-of-service agreements with local community service providers.  The Crosswalk for Federal SSBG Services to the Arizona Dictionary and Taxonomy for Human Services provides a listing of the Federal Service Titles and the corresponding Arizona Taxonomy Service Titles. Federal Uniform Definitions of Services Titles 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. Adoption Services Case Management Services Congregate Meals Counseling Services Day Care Services - Adults Day Care Services - Children Education and Training Services Employment Services Family Planning Services Foster Care Services for Adults Foster Care Services for Children Health Related and Home Health Services Home Based Services Home Delivered Meals Housing Services Independent and Transitional Living Services August 12, 2009 -8- 17. Information and Referral 18. Legal Services 19. Pregnancy and Parenting Services for Young Parents 20. Prevention and Intervention Services 21. Protective Services for Adults 22. Protective Services for Children 23. Recreational Services 24. Residential Treatment Services 25. Special Services for Persons with Developmental or Physical Disabilities 26. Special Services for Youth Involved In or At Risk of Involvement With Criminal Activity 27. Substance Abuse Services 28. Transportation Services 29. Other Services AZ 2009-2010 SSBG PLAN Arizona Dictionary and Taxonomy of Human Services • Adaptive Aids and Devices A service that provides or fabricates specialized equipment that will assist persons in performing normal living skills, and any necessary installation, fitting, adjustment, and training. • Adaptive Aids and Devices – Repair/Modification A service that repairs or modifies aids and devices that assist persons in performing normal living skills. • Administrative Services Services that enable the effective administration and receipt of services. • Adoption A service that provides for the certification of a family, support services to the family after a child is placed and supervision of the family until the child’s adoption is finalized. • Adoption Services Services that provide for the selection of a family, placement and supervision of a child until an adoption is finalized. • Adoption Subsidy A service that provides payments for special services and/or maintenance for children who might otherwise not be adopted. • Adult Day Care/Adult Day Health Care A service that provides supervised planned care and health-related services to adults in a group setting during a portion of a 24-hour day. • Adult Foster Care A service that provides residential care and supervision of one to four adults in a family setting. • Advocacy Services that take action to protect the rights of individuals and ensure they receive appropriate services and benefits or to seek needed changes in the law and/or administrative rules to protect the rights of individuals and ensure adequate service levels. • Alternative Communication Training A service that provides for a specific curriculum that creates an opportunity for competency in recognized and accepted non-verbal medium. • Alternative Residential Services An alternative setting to an individual’s own home that is licensed or certified to provide one or more of the following: room and board, health care, health related services, behavioral health services, and/or habilitation for residents on a continuing basis. The setting is not a licensed nursing care institution. August 12, 2009 -9- AZ 2009-2010 SSBG PLAN Arizona Dictionary and Taxonomy of Human Services • Assessment/Evaluation Services that provide an evaluation to identify and analyze problems, needs and/or assets and may recommend corrective action and/or treatment. • Attendant Care/Personal Assistance A service that provides a qualified individual to supply needed services in order for an individual to remain in his/her home and/or participate in work/community activities. • Basic Education A service that provides instruction in educational areas necessary for an individual to function effectively. • Behavioral Therapeutic Activities A service that provides therapeutic activities to persons and/or their families in a home, school, preschool, after school, nursery/day care, or other residential or non-office setting. (The Department of Health Services presently calls this service In Home and Community.) • Case Management A service or process that establishes a relationship with an individual or family in order to enhance their functioning and/or integration into the community. Appropriate services and/or benefits are identified, planned, obtained, provided, recorded, monitored, modified when necessary and/or terminated. This may include: assessment to determine their needs and eligibility when applying for/receiving services, assistance in finding necessary resources in addition to covered services to meet basic needs, assistance in obtaining entitlements, communication and coordination of care as well as follow-up of crisis contacts or missed appointments. • Child Care A service that provides supervised planned care for children during a portion of a 24-hour day. • Child Foster Care A service that provides family home care and supervision to child(ren) on a 24-hour/day basis. • Child Support Services that locate absent parents, establish paternity, establish child support obligation, and collect and distribute child/spousal support. • Chore A service that provides for heavy indoor cleaning and may include designated outdoor tasks. • Client Access, Education and Information A service that provides education, information and assistance to individuals and groups regarding the availability of, and accessibility to, human services. August 12, 2009 - 10 - AZ 2009-2010 SSBG PLAN Arizona Dictionary and Taxonomy of Human Services • Community Education and Information A service that provides information on, and/or instructions in, various subjects through public contact and/or meetings, printed materials and media presentations focused on a particular subject, field of interest, agency or service(s). • Community Services Services that provide a range of activities that have a measurable and major impact on causes of poverty. • Companion Services A service that provides companions and supportive services to individuals with special needs. • Comprehensive Service Delivery Services that provide two or more of the following services that assist individuals in accessing or receiving services: Protective Services, Counseling, Home Care, Home Management Training, Reassurance, Home Repair/Adaptation/Renovation, Transportation, Parent Aide Service and Case Management. • Comprehensive Youth Development A service that mobilizes volunteers who are adults to carry out programs that develop the personal fitness and character of youth. • Congregate Meals A service that provides for a nutritious meal containing at least 1/3 of the Recommended Dietary Allowance for an individual in a congregate setting. • Consultation A service that provides professional information and advice to assist in planning, developing, implementing and evaluating individual and service programs and in providing coordination with the professional community. • Coordination A service that promotes efficiency through the cooperation and collaboration of multiple entities concerned with the same issue or need. • Counseling/Intervention Services that provide for a wide range of personal, interpersonal, situational, and functional guidance. • Crisis Shelter Services Services that provide assistance to abused individuals or families. Services include, but are not limited to both the shelter and counseling. August 12, 2009 - 11 - AZ 2009-2010 SSBG PLAN Arizona Dictionary and Taxonomy of Human Services • Day Care Services that provide for, and support the provision of, supervised planned care during a portion of a 24-hour day. • Day Treatment and Training Services that provide training, supervision, therapeutic activities and as appropriate, counseling, to promote skill development in independent living, self care, communication, and social relationships. • Developmental Day Training A service that provides specialized sensorimotor, cognitive, communicative, social, interaction, and behavioral training for some portion of a 24-hour day. • Developmental Disability Day Care A service that provides supervised planned care, daily living skills training, and habilitation services in a group setting during a portion of a 24-hour day. • Drug Abuse Counseling A service that provides an individual an opportunity to learn the effects of drug abuse and counsels the person on alternative life style habits. • Eligibility Determination A service that provides a decision that an individual or household is or is not qualified for services or benefits. • Emergency Human Services Services that respond to crises-related situations where there is an inability to provide for the basic needs. Services may include, but are not limited to: case management, financial and referral. • Emergency Shelter A service that provides immediate shelter to persons who are without shelter or a fixed place of residence. Emergency shelter may usually be provided for a period of up to 120 days. • Employment Related Services Services that provide outreach, intake, eligibility, placement and follow-up activities in support of obtaining employment. Services may include, but are not limited to: occupational/vocational education, assessment, basic education, work experience, counseling, case management, job development and placement, work adjustment training, supported employment, supported employment extended, work exploration, and prevocational training. • Employment Services Services that provide activities and assistance in support of finding, entering or retaining a job for individuals or groups. August 12, 2009 - 12 - AZ 2009-2010 SSBG PLAN Arizona Dictionary and Taxonomy of Human Services • Exemplary Youth Work Program Services that provide various employment-related training activities for youth. Services may include, but are not limited to: occupational/vocational education, assessment, basic education, work experience, counseling, case management, and job placement. • Family Planning A service that provides assistance to individuals to voluntarily implement plans to determine the number and spacing of children. • Food Administration A service that provides for the storage, handling, and distribution of food products. • General Transportation A service that provides or assists in obtaining various types of transportation for specific needs. • Group Home Care A licensed facility for the 24-hour care and supervision of individuals. • Habilitation Services Services that provide a variety of interventions designed to maximize the functioning of persons with developmental disabilities. Services may include, but are not limited to: habilitative therapies, special developmental skills, behavior intervention, and sensorimotor development. • Home Care Services that provide individuals who are at risk of institutionalization with coordinated inhome support needed to remain at home. Services may include, but are not limited to: attendant care/personal assistance, housekeeping/homemaker, chore, home health aid, personal care, respite, and nursing services. • Home Delivered Meals A service that provides for a nutritious meal containing at least 1/3 of the Recommended Dietary Allowance for an individual, delivered to his/her place of residence. • Home Health Aid A service that provides intermittent health maintenance continued treatment or monitoring of a health condition and supportive care for activities of daily living at the individual’s place of residence. • Home Management Skills Training A service that provides training in activities related to routine household maintenance. • Home Recruitment and Study A service that identifies families for either permanent placements or to provide child care services, conducts training to families and prepares the home study for licensure/certification. August 12, 2009 - 13 - AZ 2009-2010 SSBG PLAN Arizona Dictionary and Taxonomy of Human Services • Home Repair/Renovation A service that provides for safety and/or structural repairs to the home. • Hospice A service that provides health care and emotional support to terminally ill individuals and their families/caregivers during the final stages of life. • Housekeeping/Homemaker A service that provides assistance in the performance of routine household activities at an individual’s place of residence. • Housing Search and Relocation A service that provides assistance toward locating suitable housing. • Independent Living A service that provides for individuals living independently and possessing the skills necessary to function at a minimum level of self-sufficiency. • Independent Living Skills A service that provides interpersonal and daily living skills training and counseling to prepare individuals for independent living. • Information and Referral A service that provides or arranges for assistance to individuals to enable them to gain access to services through the provision of accurate and current information and referral to appropriate resources. Referral may involve short-term supportive assistance and followup. • In-Home Family Support Services that provide coordinated support services that will assist the family to remain intact or an individual to remain in his/her home. • Intensive Family Preservation and Reunification Services Services that provide intensive crisis-oriented activities to families whose children are at significant risk of out-of-home placement due to abuse and/or neglect in order to allow those children to safely remain in their own home. Services may include, but are not limited to: counseling, communication and negotiation skills, parenting skills training, home management skills, job readiness training, case management, and development of linkages to community resources. • Interpreter A service that provides a person or equipment to facilitate communication. • Job Development and Placement A service that provides assistance in obtaining employment for job-ready individuals. August 12, 2009 - 14 - AZ 2009-2010 SSBG PLAN Arizona Dictionary and Taxonomy of Human Services • Job Training A service that develops specific vocational skills. • Legal Assistance A service that provides consultation and representation of civil and legal matters. • Legal Services Services that provide for consultation and information based on law. • Mental Health Education A service that provides instruction utilizing a positive life style as the medium of instruction. • Monitoring A service that checks and keeps track of contractor compliance with state, federal and contractual regulations, rules and conditions. • Nursing A service that provides nursing intervention that may include patient care, coordination facilitation and education. • Nutrition Education A service that provides individual or group instruction about food to maintain or improve development. • Occupational Therapy A service that directs the individual’s participation in selected activities to restore, maintain or improve functional skills. • Occupational/Vocational Education A service that provides instruction and/or skills training in technical, business and other trade areas. Training may be provided in a classroom or actual job setting. • Orientation and Mobility Training A service that provides skills training that assists a person in safely navigating an identified environment. • Outreach A service that provides a systematic method to identify and directly contact persons in need of services. • Parent Aide Service A service that provides a range of support services instruction and assistance to parents or caregivers to improve their skills and ability to fulfill parenting roles and responsibilities. • Parenting Skills Training A service that provides training that promotes specific parent or caregiver skills. August 12, 2009 - 15 - AZ 2009-2010 SSBG PLAN Arizona Dictionary and Taxonomy of Human Services • Peer Counseling A service that provides self-help opportunities. • Personal Care A service that provides assistance with personal physical needs. • Personal Escort A service that provides an escort who transports and assists an individual to perform necessary errands away from the residence. • Personal Living Skills Training A service that provides training that promotes specific self-care skills. • Physical Therapy A service that provides treatment to restore, maintain or improve a physical function. • Planning A service that identifies and analyzes priority needs, explores options, establishes goals, and develops a course of action that will bring about a desired condition or event at some specific time in the future. • Prevention Services that provide for planned efforts to prevent specific conditions, illnesses, injuries or environmental hazards that could place an individual, group or community at risk for a negative social, physical, behavioral or health outcome. • Prevocational Training A service that provides sensorimotor, cognitive, communicative, social interaction, and behavioral training necessary for vocational activities. • Professional Family Foster Care Services that provide in a family-based home, care and supervision of a child on a 24-hour basis and include specialized care and support services, which are the responsibility of the licensee who serves as the foster parent. ● Professional Specialty A service that allows for the provision of services not otherwise identified separately in this Arizona Dictionary and Taxonomy of Human Services that requires special expertise, knowledge or credentials in a given area. • Program Administration A service that distributes and administers funds received for programs. • Program Development A service that researches and/or establishes a new service(s); improves, expands, or integrates an existing service(s). August 12, 2009 - 16 - AZ 2009-2010 SSBG PLAN Arizona Dictionary and Taxonomy of Human Services • Program Evaluation A service that assesses systematically the impact and/or efficiency of programs. • Protective Services Services that provide support to individuals who are in abusive, self-neglect, or vulnerable situations. Services may include, but are not restricted to: financial, shelter, legal, counseling, information, and referral and follow-up. • Reassurance A service that provides a regular contact system for individuals restricted to their place of residence. • Rehabilitation Instructional Services Services that provide training in community living skills and activities directed toward personal and social adjustment. • Relinquishment and Severance A service that assists biological and/or legal parents in the decision and/or process of relinquishment or termination of their rights as parents. • Residential Living and Development Services that provide for varying degrees of residential care, supervision, counseling, and training in activities of daily living. • Respiratory Therapy A service that provides treatment to restore, maintain, or improve breathing. • Respite Services that provide different types of respite. • Respite Care A service that provides short-term care and supervision consistent with the health needs of the person to supplement care to provide a safe living environment and/or to support or relieve caregivers for the benefit of the person. • Self-Help Group A service that provides peer intervention in a group setting. • Shelter Services that provide for care, refuge, and protection. • Sheltered Employment A service that provides a controlled and protected work environment, additional supervision, and other supports for individuals engaged in remunerative work either in a sheltered workshop or in the community. August 12, 2009 - 17 - AZ 2009-2010 SSBG PLAN Arizona Dictionary and Taxonomy of Human Services • Social Adjustment A service that instructs multiple domains of a person’s life for improved functioning. • Social Development Services that provide structure and instruction, designed to promote improved social functioning. • Socialization and Recreation A service that promotes mentally and emotionally healthy interaction between participants and that may be organized around leisure activities. • Speech Therapy A service that provides evaluations, program recommendations, and/or treatment/training in receptive and expressive language, voice, articulation, and fluency. • Staff Development and Training A service that provides an organized method of improving needed staff skills. • Substance Abuse Assessment A service that provides for the assessment of an individual to determine substance abuse and dependence and recommend interventions and treatment. • Substance Abuse Screening A service that provides for the screening of an individual to determine the presence of alcohol or drug abuse. (Note: For testing, reference Clinical Laboratory Service.) • Supervised Employment Services that provide for training in an area of employment under guidance of a trained supervisor. • Supported Employment A service that provides job development, assistance in matching the individual with an integrated competitive job, and intensive time-limited supports to an employed individual once placed. • Supported Employment, Extended A service that provides long-term, on-going support services for an employed individual. • Supportive Intervention/Guidance Counseling A service that provides supportive intervention and/or guidance. • Transitional Housing A service that provides long-term shelter for a period of up to two years to homeless persons, who are sufficiently stabilized to pursue some level of self-sufficiency, but may require additional supportive services. The goal of this service is to facilitate movement to permanent housing. August 12, 2009 - 18 - AZ 2009-2010 SSBG PLAN Arizona Dictionary and Taxonomy of Human Services • Transitional Shelter A service that provides short-term care. • Transportation Services that promote or provide mobility. • Unaccompanied Minors Service A service that provides foster care provisions for refugee minors who are in the United States without a qualified parent or legal guardian. • Utility Assistance A service that provides financial and/or non-financial aid to meet residential public service needs. • Volunteer Services A service that provides coordination of volunteer activities. • Work Adjustment Training A service that provides training in the meaning, value and demands of work and in the development of positive attitudes toward work. • Work Experience A service that provides work situations and support services to foster and promote the transition to employment. Crosswalk for Federal SSBG Services to the Arizona Dictionary and Taxonomy of Human Services SSBG Services for Federal Reporting Requirements 1. Adoption Services 2. Case Management Services 3. Congregate Meals August 12, 2009 Arizona Taxonomy Services Approved for SSBG Funding  Adoption  Adoption Services  Adoption Subsidy  Relinquishment and Severance  Case Management  Coordination  Eligibility Determination  Emergency Human Services  Congregate Meals - 19 - AZ 2009-2010 SSBG PLAN Crosswalk for Federal SSBG Services to the Arizona Dictionary and Taxonomy of Human Services 4. Counseling Services 5. Day Care Services-Adults 6. Day Care Services-Children 7. Education and Training Services 8. Employment Services 9. Family Planning Services  Assessment/Evaluation  Counseling/Intervention  Professional Specialty  Supportive Intervention/Guidance Counseling  Adult Day Care/Adult Day Health Care  Companion Services  Day Treatment and Training  Developmental Day Training  Monitoring  Child Care  Day Treatment and Training  Developmental Day Training  Home Recruitment and Study  Monitoring  Alternative Communication Training  Basic Education  Interpreter  Adaptive Aids and Devices  Adaptive Aids and Devices – Repair/Modification  Assessment /Evaluation  Employment Related Services  Exemplary Youth Work Program  Job Development and Placement  Job Training  Occupational/Vocational Education  Prevocational Training  Sheltered Employment  Supported Employment  Supported Employment, Extended  Work Adjustment Training  Work Experience  Family Planning  Adult Foster Care  Home Recruitment and Study 10. Foster Care Services for Adults  Child Foster Care  Home Recruitment and Study  Monitoring  Professional Family Foster Care 11. Foster Care Services for Children August 12, 2009 - 20 - AZ 2009-2010 SSBG PLAN Crosswalk for Federal SSBG Services to the Arizona Dictionary and Taxonomy of Human Services  Home Health Aid  Hospice 12. Health Related and Home Health Services  Administrative Services  Attendant Care/Personal Assistance  Community Services  Home Care  Housekeeping /Homemaker  Orientation and Mobility Training  Parent Aid Service  Personal Care  Personal Living Skills Training  Reassurance  Rehabilitation Instructional Services  Respite 13. Home Based Services  Home Delivered Meals 14. Home Delivered Meals  Emergency Shelter  Home Repair/Renovation  Housing Search and Relocation  Shelter  Transitional Housing 15. Housing Services  Independent Living Skills  Unaccompanied Minors Service 16. Independent and Transitional Living Services  Client Access, Education and Information  Community Education and Information  Coordination  Information and Referral  Outreach  Volunteer Services 17. Information and Referral 18. Legal Services  Legal Assistance 19. Pregnancy and Parenting Services For Young Parents  Community Education and Information  Parenting Skills Training  Advocacy  Behavioral Therapeutic Activities  Comprehensive Service Delivery  Comprehensive Youth Development 20. Prevention and Intervention Services August 12, 2009 - 21 - AZ 2009-2010 SSBG PLAN Crosswalk for Federal SSBG Services to the Arizona Dictionary and Taxonomy of Human Services  Counseling/Intervention  Crisis Shelter Services  Emergency Shelter  In-Home Family Support  Intensive Family Preservation and Reunification Services  Parent Aide Service  Peer Counseling  Supportive Intervention/Guidance Counseling  Transitional Shelter 20. Prevention and Intervention Services (Cont’d) 21. Protective Services for Adults  Emergency Human Services  Protective Services 22. Protective Services for Children  Emergency Human Services  Protective Services  Comprehensive Youth Development  Social Adjustment  Socialization and Recreation 23. Recreational Services  (Not a DES service) 24. Residential Treatment Services  Adaptive Aids and Devices  Adaptive Aids and Devices – Repair/Modification  Alternative Communication Training  Attendant Care/Personal Assistance  Day Treatment and Training  Developmental Day Training  Developmental Disability Day Care  Employment Services  Employment Related Services  Habilitation Services  Home Management Skills Training  Housekeeping/Homemaker  Independent Living  Interpreter  Job Training  Occupational Therapy  Personal Living Skills Training  Physical Therapy 25. Special Services for Persons With Developmental or Physical Disabilities August 12, 2009 - 22 - AZ 2009-2010 SSBG PLAN Crosswalk for Federal SSBG Services to the Arizona Dictionary and Taxonomy of Human Services  Rehabilitation Instructional Services  Respite  Sheltered Employment  Socialization and Recreation  Speech Therapy  Supported Employment  Supported Employment, Extended  Transportation 25. Special Services for Persons With Developmental or Physical Disabilities (Cont’d)  Prevention 26. Special Services For Youth Involved in or at Risk of Involvement with Criminal Activity 27. Substance Abuse Services  Assessment/Evaluation  Case Management 28. Transportation Services  Personal Escort  Transportation 29. Other Services  Program Administration  Program Occupancy *SSBG funds may not be used for direct monetary payments to SSBG clients, purchase of land, build buildings, public school system, and professional medical care. However, there are exceptions that allow the use of SSBG funds for some of these items under certain circumstances. Service Availability The Services, Target Group Eligibility, and Status Eligibility sections are identified below and provide the primary basis for determining eligibility for service. In addition to these areas, service availability will be determined on the basis of programmatic need for service. More specific service availability criteria may be specified in the purchase-of-service contracts with provider agencies. An individual who is determined to be eligible under the above criteria shall not be denied access to services because of any other condition, although providers may use waiting lists and/or set priorities for services based on level of need for the service. A. Services This column lists the services available in the geographic area. Eligibility for service may vary from one geographic area to another, and services may only be available in certain areas of the state. Some services may be identified as being available on a statewide basis. August 12, 2009 - 23 - AZ 2009-2010 SSBG PLAN B. Target Group Eligibility This column identifies the types of individuals eligible for service. The most common target groups identified are adults, children, elderly, persons with disabilities, developmentally disabled, and adults/families/children. The definitions of these target groups are identified on page 25. Combinations of target groups may be identified (e.g., elderly persons with disabilities would be designated as "ELD/PWD"). Also, there may be characteristics added to the target groups (e.g., ELD/PWD/Blind) that further clarify availability of service. C. Status Eligibility This column identifies the financial category for which individuals must qualify in order to be eligible for service. Arizona does not require a means test for SSBG-funded services. Children and their families who receive services that are funded with TANF funds transferred to the SSBG must have incomes less than 200 percent of the federal poverty level. 1. Income Eligibility TANF/SSBG Funds - Services funded by TANF are restricted, transferred funds to SSBG as required by 42 U.S.C. Part A, Title IV, Sec. 404, (d) (3) (B), which reads: EXCEPTION RELATING TO TITLE XX PROGRAMS. All amounts paid to a State under this part that are used to carry out State programs pursuant to Title XX shall be used only to carry out programs and services to children and their families whose income is less than 200 percent of the income official poverty line (as defined by the Office of Management and Budget, revised annually…Act of 1981) applicable to a family of the size involved. 2. Income Eligibility Child Care - The Child Care Administration provides child care assistance to support working families with incomes at or below 165 percent of the federal poverty level. Working families whose incomes are at or below 100 percent of the federal poverty level and working families that are transitioning off of cash assistance with incomes at or below 165 percent of the federal poverty level receive priority status for services. Families referred by Child Protective Services (CPS), children receiving CPS foster care, and families who are receiving cash assistance and are participating in the Employment Administration-Jobs program and/or who are employed receive services without regard to income. 3. Group - All individuals within a specific target group are financially eligible. 4. Unemployed - Service availability is determined on an individual's employment status. Financial income status levels may also be applied. The specific eligibility criteria shall be identified in the contract document with purchase-of-service providers. 5. Homeless - Individuals who have been evicted from a residence, who are residing in an emergency shelter, or who are without a regular nighttime residence and who are without family or friends that are able or willing to share their residence. August 12, 2009 - 24 - AZ 2009-2010 SSBG PLAN Local and State-Planned Levels These columns represent estimates of the federal dollars that may be utilized for the delivery of the services. Target Group Definitions 1. Adults (AD) - Any individual 18 years of age or older. 2. Children (CH) - Any individual under the age of 18. 3. Developmentally Disabled Individuals (DD) - Any individual having a severe, chronic disability attributable to a cognitive disability, cerebral palsy, epilepsy or autism, and which manifested itself before age 18, is likely to continue indefinitely and results in substantial functional limitations in three or more areas of the major life activities; and reflects the need for a combination and sequence of special, interdisciplinary or generic care, treatment, or other services, which are of lifelong or extended duration and are individually planned or coordinated.  "Major life activities" for the purpose of this definition are: (1) self-care; (2) receptive and expressive language; (3) learning; (4) mobility; (5) self-direction; (6) capacity for independent living; and (7) economic self-sufficiency. 4. Elderly (ELD) - Any individual 60 years of age or older. 5. Persons with Disabilities (PWD) - Any individual who has a physical or mental impairment that substantially limits one or more major life activities and has a diagnosis of such impairment.  "Physical or Mental Impairment" includes physiological conditions, cosmetic disfigurements, anatomical losses or mental disorders.  "Diagnosis" means diagnosed or classified as having a physical or mental impairment by a doctor of medicine, a doctor of osteopathy or a psychologist certified by either the Arizona State Board of Psychologist Examiners or the Department of Education.  "Major life activities" for the purpose of this definition are: (1) self-care; (2) receptive and expressive language; (3) learning; (4) mobility; (5) self-direction; (6) capacity for independent living; and (7) economic self-sufficiency. 6. Adults/Families/Children (AFC) - Any individual or family. August 12, 2009 - 25 - AZ 2009-2010 SSBG PLAN ADMINISTRATION FOR CHILDREN, YOUTH, AND FAMILIES (ACYF) SFY 2010 DISTRICT I (MARICOPA COUNTY) SERVICES TARGET GROUP STATUS ELIG. LOCAL PLANNED STATE PLANNED LOCAL & STATE TOTAL $ 38,537 Case Management Pregnancy/ Parenting Youth Group $ 38,537 $ - Counseling/Intervention AFC Group $ - $ 183,484 $ 183,484 Supportive Intervention/Guidance Counseling Children At High Risk Group $ 47,021 $ - $ 47,021 Crisis Shelter Services Children And Group Runaway Children $ 69,676 $ 8,916 $ 78,592 $ 155,234 $ 192,400 $ 347,634 DISTRICT I TOTALS DISTRICT II (PIMA COUNTY) SERVICES TARGET GROUP STATUS ELIG. Case Management Children and Homeless/ $ 18 & 19 year Near old Adults Homeless 38,747 $ - LOCAL & STATE TOTAL $ 38,747 Counseling/Intervention Children Short Term Group $ 11,462 $ - $ 11,462 Transitional Shelter Youth Group $ 41,517 $ - $ 41,517 Supportive Intervention/Guidance Counseling Adults Group $ 157,125 $ - $ 157,125 Supportive Intervention/Guidance Counseling Rural Adults Group & Children $ 15,486 $ - $ 15,486 Supportive Intervention/Guidance Counseling Children & Their Families Group $ 99,586 $ - $ 99,586 Supportive Intervention/Guidance Counseling Adults/ Group Problem Pregnancies $ 6,721 $ - $ 6,721 Behavioral Therapeutic Activities Young Group Children with Behavior Problems in Day Care or Child Care Facilities $ 52,526 $ - $ 52,526 Counseling/Intervention DISTRICT II TOTALS AFC $ $ 423,170 $ $ 33,568 33,568 $ $ 33,568 456,738 August 12, 2009 Group 26 LOCAL PLANNED STATE PLANNED AZ 2009-2010 SSBG PLAN ADMINISTRATION FOR CHILDREN, YOUTH, AND FAMILIES (ACYF) SFY 2010 DISTRICT III (APACHE, COCONINO, NAVAJO, YAVAPAI COUNTIES) SERVICES TARGET STATUS GROUP ELIG. COCONINO COUNTY Supportive Intervention/Guidance Counseling COCONINO TOTALS YAVAPAI COUNTY Community Education & Information Supportive Intervention/Guidance Counseling YAVAPAI TOTALS DISTRICT WIDE Counseling/Intervention Day Treatment and Training DISTRICT WIDE TOTALS DISTRICT III TOTALS All Group LOCAL PLANNED STATE PLANNED LOCAL & STATE TOTAL $ 30,000 $ - $ 30,000 $ 30,000 $ - $ 30,000 Teen Pregnancy Prev. Group $ 12,083 $ - $ 12,083 All Group $ 12,083 $ - $ 12,083 $ 24,166 $ - $ 24,166 Children Group $ - $ 7,462 $ 7,462 Children Group $ $ $ 54,166 $ $ $ 11,188 18,650 18,650 $ $ $ 11,188 18,650 72,816 DISTRICT IV (LA PAZ, MOHAVE, YUMA COUNTIES) SERVICES DISTRICT WIDE Counseling/Intervention TARGET GROUP AFC STATUS ELIG. Group DISTRICT WIDE TOTALS DISTRICT IV TOTALS August 12, 2009 27 STATE PLANNED LOCAL PLANNED LOCAL & STATE TOTAL $ - $ 33,571 $ 33,571 $ $ - $ $ 33,571 33,571 $ $ 33,571 33,571 AZ 2009-2010 SSBG PLAN ADMINISTRATION FOR CHILDREN, YOUTH, AND FAMILIES (ACYF) SFY 2010 DISTRICT V (GILA, PINAL COUNTIES) SERVICES GILA COUNTY Prevention Supportive Intervention/Guidance Counseling GILA TOTALS PINAL COUNTY Prevention Supportive Intervention/Guidance Counseling PINAL TOTALS DISTRICT WIDE Volunteer Services DISTRICT WIDE TOTALS DISTRICT V TOTALS TARGET GROUP STATUS ELIG. GRAHAM COUNTY Prevention GRAHAM TOTALS DISTRICT WIDE Supportive Intervention/Guidance Counseling DISTRICT WIDE TOTALS DISTRICT VI TOTALS August 12, 2009 STATE PLANNED LOCAL & STATE TOTAL AFC Group $ 4,840 $ - $ 4,840 AFC Group $ 8,605 $ - $ 8,605 $ 13,445 $ - $ 13,445 AFC Group $ 11,832 $ - $ 11,832 AFC Group $ 28,506 $ - $ 28,506 $ 40,338 $ - $ 40,338 $ $ $ 53,783 $ $ $ 15,212 15,212 15,212 $ $ $ 15,212 15,212 68,995 AFC Group DISTRICT VI (COCHISE, GREENLEE, GRAHAM, SANTA CRUZ COUNTIES) STATUS SERVICES TARGET ELIG. GROUP GREENLEE COUNTY Supportive Intervention/Guidance Counseling GREENLEE TOTALS LOCAL PLANNED AFC Group LOCAL PLANNED STATE PLANNED LOCAL & STATE TOTAL $ 8,170 $ - $ 8,170 $ 8,170 $ - $ 8,170 AFC Group $ $ 19,780 19,780 $ $ - $ $ 19,780 19,780 AFC Group $ 11,950 $ 15,212 $ 27,162 $ $ 11,950 39,900 $ $ 15,212 15,212 $ $ 27,162 55,112 28 AZ 2009-2010 SSBG PLAN ADMINISTRATION FOR CHILDREN, YOUTH, AND FAMILIES (ACYF) SFY 2010 TRIBAL AND STATEWIDE SERVICES TARGET GROUP STATUS ELIG. TRIBAL ACYF/ITCA Tribal Consultation/Planning LOCAL PLANNED $ STATE PLANNED LOCAL & STATE TOTAL - $ 31,642 Navajo Home Based Services (Tribal Allocation, chart on page 4 of this Plan) $ 1,242,896 $ - $ 1,242,896 Gila Home Based Services (Tribal Allocation, chart on page 4 of this Plan) TRIBAL TOTALS $ 18,417 $ - $ $ 1,261,313 $ 31,642 ADMINISTRATION/OTHER In-Home Family Support $ - $ 680,213 Protective Services for Children $ - $ 3,007,153 $ 3,007,153 Protective Services for Children $ - $ 4,574,414 $ 4,574,414 Protective Services for Children (Caseload Growth CPS In & Out-ofHome) $ - $ $ TANF/SSBG Funds Children's Services (48th Legislature Second Regular Session HB 2209 (Chapter 285) Section 6 $ - $ 22,613,100 $ 22,613,100 Case Management $ - $ 1,440,417 $ 1,440,417 Home Recruitment and Study $ - $ $ ADMIN / OTHER TOTALS TRIBAL AND STATEWIDE SERVICES $ $ 1,261,313 $ 32,640,518 $ 32,672,160 $ 32,640,518 $ 33,933,473 LOCAL PLANNED STATE PLANNED $ 1,987,566 $ 32,980,773 LOCAL & STATE TOTAL $ 34,968,339 286,301 38,920 $ 31,642 18,417 $ 1,292,955 $ 680,213 286,301 38,920 NOTE: TANF Funds Transferred to SSBG Federal Restrictions: TANF/SSBG funds are restricted for use per 42 U.S.C. Part A, Title IV, Sec. 404, (d) (3) (B), which reads: "EXCEPTION RELATING TO TITLE XX PROGRAMS. All amounts paid to a State under this part that are used to carry out State programs pursuant to Title XX shall be used only to carry out programs and services to children and their families whose income is less than 200 percent of the income official poverty line (as defined by the Office of Management and Budget, revised annually… Act of 1981) applicable to a family of the size involved." ALL ACYF SERVICES ACYF TOTALS August 12, 2009 29 AZ 2009-2010 SSBG PLAN CHILD CARE ADMINISTRATION (CCA) SFY 2010 STATEWIDE LOCAL PLANNED $ 120,644 STATE PLANNED $ - LOCAL & STATE TOTAL $ 120,644 Day Care Services - Children $ - $ 163,432 $ 163,432 STATEWIDE TOTALS $ 120,644 $ 163,432 $ 284,076 SERVICES TARGET GROUP STATUS ELIG. Tribal Allocation (Tohono O'odham Nation for Day Care Services Children) (Tribal Allocation, chart on page 4 of this Plan) ALL CCA SERVICES LOCAL PLANNED $ 120,644 CCA TOTALS July 31, 2009 - DRAFT 30 STATE PLANNED $ 163,432 LOCAL & STATE TOTAL $ 284,076 AZ 2009-2010 SSBG PLAN OFFICE OF COMMUNITY PARTNERSHIPS AND INNOVATIVE PRACTICES (CPIP) SFY 2010 DISTRICT I (MARICOPA COUNTY) SERVICES Emergency Shelter Victims of Domestic Violence Group $ 336,352 $ - LOCAL & STATE TOTAL $ 336,352 Supportive Intervention/Guidance Counseling Domestic Violence Group $ 40,332 $ - $ 40,332 Emergency Shelter Homeless Famlies & Individuals Group $ 257,496 $ 133,077 $ 390,573 Transitional Housing ELD/DD Homeless Group $ 83,289 $ - $ 83,289 Transitional Housing HomelessGroup Individuals & Families $ 64,803 $ - $ 64,803 Case Management (Basic Needs) AFC Group $ 983,151 $ 179,280 Case Management Homeless Not Ap. $ - $ 52,170 $ 52,170 Transportation Homeless or Group Unemployed $ 16,167 $ - $ 16,167 Planning Homeless Not Ap. $ - $ 10,000 $ 10,000 Transitional Housing DISTRICT I TOTALS Homeless Not Ap $ $ 1,781,590 $ $ 4,079 378,606 August 12, 2009 TARGET GROUP STATUS ELIG. 31 LOCAL PLANNED STATE PLANNED $ 1,162,431 $ 4,079 $ 2,160,196 AZ 2009-2010 SSBG PLAN OFFICE OF COMMUNITY PARTNERSHIPS AND INNOVATIVE PRACTICES (CPIP) SFY 2010 DISTRICT II (PIMA COUNTY) Case Management AD - low Group income Rural $ 11,615 $ - LOCAL & STATE TOTAL $ 11,615 Case Management AD - young - Group 18-28 HML $ 34,855 $ - $ 34,855 Case Management Adults $ 32,585 $ - $ 32,585 Employment Related Services Unemployed Group Adults $ 46,941 $ - $ 46,941 Supportive Intervention/Guidance Counseling Group Provide ongoing counseling for rape victims,etc. $ 21,171 $ - $ 21,171 Case Management AFC Group $ - $ 25,305 $ 25,305 Crisis Shelter Services Adults Domestic Violence Victims Group $ 49,357 $ 8,207 $ 57,564 Coordination Homeless Not Ap. $ - $ 19,731 $ 19,731 Legal Assistance Low Income Residents Group $ - $ - $ - Shelter All Homeless Not Ap. $ - $ 6,974 $ 6,974 Transitional Housing DISTRICT II TOTALS Homeless $ 196,524 $ $ 7,429 67,646 $ $ 7,429 264,170 SERVICES August 12, 2009 TARGET GROUP STATUS ELIG. Homeless STATE PLANNED LOCAL PLANNED Not Ap 32 AZ 2009-2010 SSBG PLAN OFFICE OF COMMUNITY PARTNERSHIPS AND INNOVATIVE PRACTICES (CPIP) SFY 2010 DISTRICT III (APACHE, COCONINO, NAVAJO, YAVAPAI COUNTIES) SERVICES TARGET STATUS GROUP ELIG. APACHE COUNTY Transitional Housing Homeless Not Ap. APACHE TOTALS COCONINO COUNTY Emergency Shelter LOCAL PLANNED STATE PLANNED LOCAL & STATE TOTAL $ - $ 7,470 $ 7,470 $ - $ 7,470 $ 7,470 AFC - Crisis Intervention Group $ 7,000 $ - $ 7,000 Supportive Intervention/Guidance Counseling AFC Domestic Violence Group $ 7,000 $ - $ 7,000 Case Management AFC - Crisis Intervention Group $ 7,000 $ 3,197 $ 10,197 Transportation ELD/PWD/ Low Income Group $ 12,000 $ - $ 12,000 $ 33,000 $ 3,197 $ 36,197 COCONINO TOTALS NAVAJO COUNTY Emergency Shelter AFC - Crisis Intervention Group $ 19,015 $ - $ 19,015 Case Management AFC - Crisis Intervention Group $ 7,006 $ - $ 7,006 Emergency Shelter Homeless Group $ - $ - $ - Transportation NAVAJO TOTALS AFC Group $ $ 5,002 31,023 $ $ - $ $ 5,002 31,023 YAVAPAI COUNTY Case Management Assistance for Eviction Prevention AFC - Crisis Intervention Group $ 6,041 $ - $ 6,041 Emergency Shelter Homeless Group $ - $ 262 $ 262 Emergency Shelter AFC - Crisis Intervention Group $ 6,041 $ - $ 6,041 Case Management AFC - Crisis Intervention Group $ 12,083 $ - $ 12,083 Transitional Housing Homeless Group $ - $ 3,340 $ 3,340 Transportation YAVAPAI TOTALS All Group $ $ 21,749 45,914 $ $ 3,602 $ $ 21,749 49,516 Low Income Group $ - $ 4,202 $ 4,202 AFC Group $ $ $ 109,937 $ $ $ 4,202 8,404 22,673 $ $ $ 4,202 8,404 132,610 DISTRICT WIDE Community Services Case Management DISTRICT WIDE TOTALS DISTRICT III TOTALS August 12, 2009 33 AZ 2009-2010 SSBG PLAN OFFICE OF COMMUNITY PARTNERSHIPS AND INNOVATIVE PRACTICES (CPIP) SFY 2010 DISTRICT IV (LA PAZ, MOHAVE, YUMA COUNTIES) SERVICES MOHAVE COUNTY Emergency Shelter TARGET GROUP Domestic Violence STATUS ELIG. Group MOHAVE TOTALS YUMA COUNTY Emergency Shelter Emergency Shelter YUMA TOTALS DISTRICT WIDE Community Services DISTRICT WIDE TOTALS DISTRICT IV TOTALS LOCAL PLANNED STATE PLANNED LOCAL & STATE TOTAL $ 50,936 $ - $ 50,936 $ 50,936 $ - $ 50,936 AFC Group $ 28,159 $ - $ 28,159 Homeless Group $ $ 28,159 $ $ 3,687 3,687 $ $ 3,687 31,846 Low Income Group $ $ $ 79,095 $ $ $ 15,434 15,434 19,121 $ $ $ 15,434 15,434 98,216 DISTRICT V (GILA, PINAL COUNTIES) SERVICES GILA COUNTY Emergency Shelter TARGET GROUP STATUS ELIG. STATE PLANNED LOCAL PLANNED LOCAL & STATE TOTAL Domestic Violence Group $ 26,620 $ - $ 26,620 Community Services Low Income Group $ - $ 803 $ 803 Case Management GILA TOTALS AFC Group $ $ 8,352 34,972 $ $ 804 1,607 $ $ 9,156 36,579 Domestic Violence Group $ 52,719 $ - $ 52,719 AFC Group $ 16,703 $ 6,203 $ 22,906 $ $ 69,422 104,394 $ $ 6,203 7,810 $ $ 75,625 112,204 PINAL COUNTY Emergency Shelter Case Management PINAL TOTALS DISTRICT V TOTALS August 12, 2009 34 AZ 2009-2010 SSBG PLAN OFFICE OF COMMUNITY PARTNERSHIPS AND INNOVATIVE PRACTICES (CPIP) SFY 2010 DISTRICT VI (COCHISE, GREENLEE, GRAHAM, SANTA CRUZ COUNTIES) SERVICES TARGET STATUS GROUP ELIG. COCHISE COUNTY Case Management Domestic Violence Group COCHISE TOTALS DISTRICT WIDE Community Services Case Management DISTRICT WIDE TOTALS DISTRICT VI TOTALS LOCAL PLANNED STATE PLANNED LOCAL & STATE TOTAL $ 33,340 $ - $ 33,340 $ 33,340 $ - $ 33,340 Low Income Group $ - $ 4,553 $ 4,553 AFC Group $ $ $ 33,340 $ $ $ 4,554 9,107 9,107 $ $ $ 4,554 9,107 42,447 STATEWIDE Administrative Services $ - $ 403,855 LOCAL & STATE TOTAL $ 403,855 STATEWIDE Comprehensive Service Delivery $ - $ 1,431,535 $ 1,431,535 Coordination: Food Bank - AFC $ - $ 23,090 $ 23,090 Homeless - AFC $ - $ 35,000 $ 35,000 Rural Food Bank Project-Gleaning $ - $ 45,000 $ 45,000 Food (Bank) Administration STATEWIDE ADMIN/OTHER TOTALS $ $ - $ 158,060 $ 2,096,540 $ 158,060 $ 2,096,540 LOCAL PLANNED STATE PLANNED $ 2,304,880 $ 2,601,503 LOCAL & STATE TOTAL $ 4,906,383 SERVICES TARGET GROUP STATUS ELIG. STATE PLANNED LOCAL PLANNED ALL CPIP SERVICES CPIP TOTALS August 12, 2009 35 AZ 2009-2010 SSBG PLAN DIVISION OF AGING AND ADULT SERVICES (DAAS) SFY 2010 DISTRICT I (MARICOPA COUNTY) SERVICES TARGET GROUP STATUS ELIG. Adult Day Care/Adult Day Health Care ELD Group $ 203,322 $ - LOCAL & STATE TOTAL $ 203,322 Adult Day Care/Adult Day Health Care PWD Group $ 13,425 $ - $ 13,425 Congregate Meals PWD Group $ 13,425 $ 1,473 $ 14,898 Supportive Intervention/Guidance Counseling ELD Group $ 177,775 $ 43,450 $ 221,225 Home Delivered Meals ELD Group $ 413,941 $ - $ 413,941 Home Delivered Meals PWD Group $ 19,231 $ - $ 19,231 Transportation ELD Group $ 35,528 $ 7,008 $ 42,536 Home Care ELD Group $ 163,976 $ 448,195 $ 612,171 Home Care PWD Group $ 38,340 $ - $ 38,340 Administrative Services ELD/PWD Group $ - $ 187,137 $ 187,137 Respite ELD/PWD Group $ - $ 95,083 $ 95,083 Case Management ELD/PWD Group $ - $ 59,256 $ 59,256 Coordination Not Ap. Not Ap. $ - $ 18,221 $ 18,221 Legal Assistance ELD Group $ - $ 18,888 $ 18,888 $ 1,078,963 $ 878,711 DISTRICT I TOTALS August 12, 2009 36 LOCAL PLANNED STATE PLANNED $ 1,957,674 AZ 2009-2010 SSBG PLAN DIVISION OF AGING AND ADULT SERVICES (DAAS) SFY 2010 DISTRICT II (PIMA COUNTY) SERVICES TARGET GROUP STATUS ELIG. LOCAL PLANNED STATE PLANNED LOCAL & STATE TOTAL $ 52,000 Adult Day Care/Adult Day Health Care ELD/AD Group $ 15,000 $ 37,000 Home Care (Personal Care, Housekeeping & Home Health) ELD/AD Group $ 274,797 $ 286,687 $ 561,484 Home Care (Shopper Service) ELD/AD Group $ - $ 5,157 $ 5,157 Case Management ELD/AD Group $ 341,210 $ - $ 341,210 Case Management - Intake ELD/AD Group $ - $ 34,670 $ 34,670 Home Repair/Renovation ELD/AD Group $ 23,809 $ 4,193 $ 28,002 Home Delivered Meals ELD/AD Group $ 81,507 $ 14,847 $ 96,354 Administrative Services ELD/AD Group $ - $ 5,594 $ 5,594 Legal Assistance ELD/AD Group $ 97,515 $ - $ 97,515 Advocacy ELD/AD Not Ap. $ - $ 21,116 $ 21,116 $ 833,838 $ 409,264 DISTRICT II TOTALS August 12, 2009 37 $ 1,243,102 AZ 2009-2010 SSBG PLAN DIVISION OF AGING AND ADULT SERVICES (DAAS) SFY 2010 DISTRICT III (APACHE, COCONINO, NAVAJO, YAVAPAI COUNTIES) SERVICES TARGET STATUS GROUP ELIG. LOCAL PLANNED STATE PLANNED LOCAL & STATE TOTAL APACHE COUNTY Home Care ELD/PWD Group $ - $ 8,056 $ 8,056 Case Management ELD/PWD Group $ 12,383 $ 27,885 $ 40,268 Administrative Services ELD/PWD Group $ - $ 4,379 $ 4,379 Home Delivered Meals ELD/PWD Group $ 19,334 $ 3,698 $ 23,032 Transportation APACHE TOTALS ELD/PWD Group $ $ 7,259 38,976 $ $ 44,018 $ $ 7,259 82,994 COCONINO COUNTY Home Delivered Meals ELD/PWD Group $ 15,000 $ 5,107 $ 20,107 Respite ELD/PWD Group $ 10,000 $ 1,443 $ 11,443 Administrative Services ELD/PWD Group $ - $ 4,343 $ 4,343 Case Management ELD/PWD Group $ 4,000 $ 27,503 $ 31,503 Home Care ELD/PWD Group $ 2,000 $ 3,795 $ 5,795 Transportation COCONINO TOTALS ELD/PWD Group $ $ 31,000 $ $ 7,278 49,469 $ $ 7,278 80,469 NAVAJO COUNTY Home Care ELD/PWD Group $ 9,007 $ 7,462 $ 16,469 Administrative Services ELD/PWD Group $ - $ 5,947 $ 5,947 Transportation ELD/PWD Group $ 5,002 $ - $ 5,002 Case Management ELD/PWD Group $ - $ 41,108 $ 41,108 Home Delivered Meals NAVAJO TOTALS ELD/PWD Group $ $ 10,008 24,017 $ $ 4,345 58,862 $ $ 14,353 82,879 August 12, 2009 38 AZ 2009-2010 SSBG PLAN DIVISION OF AGING AND ADULT SERVICES (DAAS) SFY 2010 DISTRICT III (APACHE, COCONINO, NAVAJO, YAVAPAI COUNTIES) continued SERVICES TARGET STATUS GROUP ELIG. LOCAL PLANNED STATE PLANNED LOCAL & STATE TOTAL YAVAPAI COUNTY Home Health Aid ELD/PWD Group $ - $ 30,478 $ 30,478 Administrative Services ELD/PWD Group $ - $ 13,607 $ 13,607 Case Management ELD/PWD Group $ 6,041 $ 68,953 $ 74,994 Supportive Intervention/Guidance Counseling All Group $ - $ 140 $ 140 Home Delivered Meals ELD/PWD Group $ 8,457 $ 5,788 $ 14,245 Respite ELD/PWD Group $ 6,041 $ 15,374 $ 21,415 Adult Day Care/Adult Day Health Care YAVAPAI TOTALS DISTRICT III TOTALS ELD/PWD Group $ 18,124 $ 34,637 $ 52,761 $ $ 38,663 132,656 $ $ 168,977 321,326 $ $ 207,640 453,982 DISTRICT IV (LA PAZ, MOHAVE, YUMA COUNTIES) SERVICES TARGET GROUP STATUS ELIG. LOCAL PLANNED STATE PLANNED LOCAL & STATE TOTAL LA PAZ COUNTY Home Care ELD/PWD Group $ 3,313 $ 12,927 $ 16,240 Administrative Services ELD/PWD Group $ - $ 6,681 $ 6,681 Case Management ELD/PWD Group $ 5,522 $ 17,198 $ 22,720 Home Delivered Meals ELD/PWD Group $ 13,620 $ - $ 13,620 Transportation LA PAZ TOTALS AFC Group $ $ 14,356 36,811 $ $ 36,806 $ $ 14,356 73,617 August 12, 2009 39 AZ 2009-2010 SSBG PLAN DIVISION OF AGING AND ADULT SERVICES (DAAS) SFY 2010 DISTRICT IV (LA PAZ, MOHAVE, YUMA COUNTIES) continued SERVICES TARGET STATUS GROUP ELIG. STATE PLANNED LOCAL PLANNED LOCAL & STATE TOTAL MOHAVE COUNTY Home Care ELD/AD Group $ 37,730 $ 14,762 $ 52,492 Case Management ELD/AD Group $ 39,617 $ 35,098 $ 74,715 Administrative Services ELD/AD Group $ - $ 13,965 $ 13,965 Home Delivered Meals ELD/AD Group $ 37,730 $ - $ 37,730 $ 115,077 $ 63,825 $ 178,902 MOHAVE TOTALS YUMA COUNTY Home Care ELD/PWD Group $ 25,813 $ 4,214 $ 30,027 Case Management ELD/PWD Group $ 21,120 $ 35,684 $ 56,804 Administrative Services ELD/PWD Group $ - $ 15,007 $ 15,007 Adult Day Care/Adult Day Health Care ELD/PWD Group $ 11,733 $ - $ 11,733 Home Delivered Meals ELD/PWD Group $ 23,466 $ - $ 23,466 Transportation AFC Group $ 42,239 $ - $ 42,239 Respite AFC Group $ 4,693 $ - $ 4,693 $ $ 129,064 280,952 $ $ 54,905 155,536 $ $ 183,969 436,488 YUMA TOTALS DISTRICT IV TOTALS August 12, 2009 40 AZ 2009-2010 SSBG PLAN DIVISION OF AGING AND ADULT SERVICES (DAAS) SFY 2010 DISTRICT V (GILA, PINAL COUNTIES) SERVICES TARGET GROUP STATUS ELIG. STATE PLANNED LOCAL PLANNED LOCAL & STATE TOTAL GILA COUNTY Home Care ELD/PWD Group $ 19,280 $ 3,554 $ 22,834 Program Development ELD/PWD Group $ - $ 1,045 $ 1,045 Home Delivered Meals ELD/PWD Group $ 20,594 $ 11,620 $ 32,214 Home Repair/Renovation ELD/PWD Group $ 6,477 $ 5,797 $ 12,274 Case Management ELD/PWD Group $ 27,218 $ 11,218 $ 38,436 Respite ELD/PWD Group $ - $ 1,408 $ 1,408 Administrative Services GILA COUNTY TOTALS ELD/PWD Group $ $ 73,569 $ $ 9,764 44,406 $ $ 9,764 117,975 PINAL COUNTY Home Care ELD/PWD Group $ 8,806 $ 6,051 $ 14,857 Program Development ELD/PWD Group $ - $ 1,779 $ 1,779 Administrative Services ELD/PWD Group $ - $ 16,624 $ 16,624 Home Delivered Meals ELD/PWD Group $ 24,718 $ 19,785 $ 44,503 Home Repair/Renovation ELD/PWD Group $ 7,911 $ 9,870 $ 17,781 Case Management PINAL COUNTY TOTALS DISTRICT V TOTALS ELD/PWD Group $ $ $ 31,256 72,691 146,260 $ $ $ 19,100 73,209 117,615 $ $ $ 50,356 145,900 263,875 August 12, 2009 41 AZ 2009-2010 SSBG PLAN DIVISION OF AGING AND ADULT SERVICES (DAAS) SFY 2010 DISTRICT VI (COCHISE, GREENLEE, GRAHAM, SANTA CRUZ COUNTIES) SERVICES TARGET STATUS GROUP ELIG. STATE PLANNED LOCAL PLANNED LOCAL & STATE TOTAL COCHISE COUNTY Congregate Meals ELD/PWD Group $ - $ 8,028 $ 8,028 Administrative Services ELD/PWD Group $ - $ 13,373 $ 13,373 Respite ELD/PWD Group $ - $ 8,727 $ 8,727 Home Care ELD/PWD Group $ 23,120 $ 8,955 $ 32,075 Home Delivered Meals ELD/PWD/AD Group $ 56,600 $ 8,727 $ 65,327 Case Management ELD/PWD Group $ 7,340 $ 40,207 $ 47,547 Case Management (Grandparents) ELD/PWD Group COCHISE TOTALS $ - $ 5,313 $ 5,313 $ 87,060 $ 93,330 $ 180,390 GRAHAM COUNTY Home Care ELD/PWD Group $ 9,600 $ 1,844 $ 11,444 Administrative Services ELD/PWD Group $ - $ 4,782 $ 4,782 Home Delivered Meals ELD/PWD Group $ 24,350 $ - $ 24,350 Respite ELD/PWD Group $ 4,420 $ 1,745 $ 6,165 Case Management ELD/PWD Group $ - $ 22,812 $ 22,812 Case Management (Grandparents) ELD/PWD GRAHAM TOTALS Group $ $ 38,370 $ $ 1,103 32,286 $ $ 1,103 70,656 August 12, 2009 42 AZ 2009-2010 SSBG PLAN DIVISION OF AGING AND ADULT SERVICES (DAAS) SFY 2010 DISTRICT VI (COCHISE, GREENLEE, GRAHAM, SANTA CRUZ COUNTIES) continued SERVICES TARGET STATUS GROUP ELIG. LOCAL PLANNED STATE PLANNED LOCAL & STATE TOTAL GREENLEE COUNTY Home Care ELD/PWD Group $ 16,530 $ - $ 16,530 Administrative Services ELD/PWD Group $ - $ 3,881 $ 3,881 Home Delivered Meals ELD/PWD/AD Group $ 20,350 $ - $ 20,350 Transportation ELD/PWD Group $ 2,400 $ 646 $ 3,046 Case Management ELD/PWD Group $ - $ 14,591 $ 14,591 Case Management (Grandparents) ELD/PWD Group $ - $ 270 $ 270 $ 39,280 $ 19,388 $ 58,668 GREENLEE TOTALS SANTA CRUZ COUNTY Home Care ELD/PWD Group $ 11,200 $ 330 $ 11,530 Administrative Services ELD/PWD Group $ - $ 4,688 $ 4,688 Home Delivered Meals ELD/PWD/AD Group $ 23,750 $ - $ 23,750 Case Management ELD/PWD Group $ - $ 26,216 $ 26,216 Case Management(Grandparents) ELD/PWD Group $ - $ 1,314 $ 1,314 $ $ 34,950 199,660 $ $ 32,548 177,552 $ $ 67,498 377,212 SANTA CRUZ TOTALS DISTRICT VI TOTALS STATEWIDE SERVICES TARGET GROUP STATUS ELIG. LOCAL PLANNED STATE PLANNED $ 3,200,830 LOCAL & STATE TOTAL $ 3,200,830 677,184 $ $ 677,184 $ 3,200,830 $ 3,878,014 LOCAL PLANNED STATE PLANNED $ 3,349,513 $ 5,260,834 LOCAL & STATE TOTAL $ 8,610,347 Protective Services for Adults $ - Tribal Entities Home Based Services (Tribal Allocations Chart on page 4 of this Plan) $ STATEWIDE TOTALS $ - 677,184 ALL DAAS SERVICES DAAS TOTALS August 12, 2009 43 AZ 2009-2010 SSBG PLAN DIVISION OF DEVELOPMENTAL DISABILITIES (DDD) SFY 2010 DISTRICT I (MARICOPA COUNTY) SERVICES TARGET GROUP STATUS ELIG. Employment Related Services PWDD Group Special Employment Opportunities $ 336,435 $ - LOCAL & STATE TOTAL $ 336,435 Employment Related Services PWDD-In Group Family Home Needs Community or Specialized Employment $ 74,761 $ - $ 74,761 Habilitation Services PWDD Not Eligible for ALTCS Group $ 32,104 $ - $ 32,104 Attendant Care/Personal Assistance PWDD Not Eligible for ALTCS Group $ 28,264 $ - $ 28,264 Respite Caregivers for PWDD Not IDEA Part H Eligible Group $ 32,606 $ - $ 32,606 Transportation PWD Group $ 26,044 $ - $ 26,044 $ 530,214 $ - $ 530,214 DISTRICT I TOTALS August 12, 2009 44 LOCAL PLANNED STATE PLANNED AZ 2009-2010 SSBG PLAN DIVISION OF DEVELOPMENTAL DISABILITIES (DDD) SFY 2010 DISTRICT III (APACHE, COCONINO, NAVAJO, YAVAPAI COUNTIES) SERVICES TARGET STATUS GROUP ELIG. COCONINO COUNTY Supported Employment COCONINO TOTALS YAVAPAI COUNTY Supported Employment YAVAPAI TOTALS DISTRICT III TOTALS LOCAL PLANNED STATE PLANNED LOCAL & STATE TOTAL DD Adults Group $ $ 51,000 51,000 $ $ - $ $ 51,000 51,000 DD Adults Group $ $ $ 6,041 6,041 57,041 $ $ $ - $ $ $ 6,041 6,041 57,041 DISTRICT IV (LA PAZ, MOHAVE, YUMA COUNTIES) SERVICES YUMA COUNTY Job Training Respite YUMA TOTALS DISTRICT IV TOTALS TARGET GROUP STATUS ELIG. LOCAL PLANNED STATE PLANNED LOCAL & STATE TOTAL DD Adults Group $ 56,319 $ - $ 56,319 CH DD Group $ $ $ 2,347 58,666 58,666 $ $ $ - $ $ $ 2,347 58,666 58,666 DISTRICT V (GILA, PINAL COUNTIES) SERVICES GILA COUNTY Employment Related Services GILA TOTALS PINAL COUNTY Employment Related Services PINAL TOTALS DISTRICT V TOTALS August 12, 2009 TARGET GROUP STATUS ELIG. LOCAL PLANNED STATE PLANNED LOCAL & STATE TOTAL DD Group $ $ 30,111 30,111 $ $ - $ $ 30,111 30,111 DD Group $ $ $ 60,222 60,222 90,333 $ $ $ - $ $ $ 60,222 60,222 90,333 45 AZ 2009-2010 SSBG PLAN DIVISION OF DEVELOPMENTAL DISABILITIES (DDD) SFY 2010 DISTRICT VI (COCHISE, GREENLEE, GRAHAM, SANTA CRUZ COUNTIES) SERVICES TARGET STATUS GROUP ELIG. LOCAL PLANNED STATE PLANNED LOCAL & STATE TOTAL COCHISE COUNTY Employment Related Services COCHISE TOTALS AD-DD Group $ $ 44,500 44,500 $ $ - $ $ 44,500 44,500 GRAHAM COUNTY Employment Related Services GRAHAM TOTALS AD-DD Group $ $ 30,100 30,100 $ $ - $ $ 30,100 30,100 GREENLEE COUNTY Developmental Disability Day Care GREENLEE TOTALS CH-DD Group $ $ 6,100 6,100 $ $ - $ $ 6,100 6,100 AD-DD Group $ $ $ 48,280 48,280 128,980 $ $ $ - $ $ $ 48,280 48,280 128,980 SANTA CRUZ COUNTY Employment Related Services SANTA CRUZ TOTALS DISTRICT VI TOTALS STATEWIDE Employment Related Services (DD Target Group) $ - $ 188,285 LOCAL & STATE TOTAL $ 188,285 Case Management (DD Target Group) $ - $ 180,863 $ 180,863 Counseling/Intervention (DD Target Group) $ - $ 159,212 $ 159,212 Case Management $ - $ 269,129 $ 269,129 STATEWIDE TOTALS $ - $ 797,489 $ 797,489 SERVICES TARGET GROUP STATUS ELIG. STATE PLANNED LOCAL PLANNED ALL DDD SERVICES LOCAL PLANNED DDD TOTALS August 12, 2009 $ 46 865,234 STATE PLANNED $ 797,489 LOCAL & STATE TOTAL $ 1,662,723 AZ 2009-2010 SSBG PLAN EMPLOYMENT ADMINISTRATION (EA) SFY 2010 DISTRICT II (PIMA COUNTY) SERVICES Case Management TARGET GROUP STATUS ELIG. Adults Single Head of Households Group DISTRICT II TOTALS LOCAL PLANNED LOCAL & STATE TOTAL STATE PLANNED $ 22,837 $ - $ 22,837 $ 22,837 $ - $ 22,837 ALL EA SERVICES LOCAL PLANNED $ 22,837 EA TOTALS August 12, 2009 47 STATE PLANNED $ - LOCAL & STATE TOTAL $ 22,837 AZ 2009-2010 SSBG PLAN REHABILITATION SERVICES ADMINISTRATION (RSA) SFY 2010 DISTRICT I (MARICOPA COUNTY) SERVICES TARGET GROUP STATUS ELIG. Adaptive Aids and Devices PWD Group $ 15,754 $ - LOCAL & STATE TOTAL $ 15,754 Supportive Intervention/Guidance Counseling PWD Group Employment $ 22,540 $ - $ 22,540 Supported Employment, Extended PWD Group $ 239,452 $ - $ 239,452 Rehabilitation Instructional Services PWD Group $ 16,832 $ - $ 16,832 $ 294,578 $ - $ 294,578 DISTRICT I TOTALS LOCAL PLANNED STATE PLANNED DISTRICT II (PIMA COUNTY) Interpreter PWD (Deaf) Adults Group $ 3,869 $ - LOCAL & STATE TOTAL $ 3,869 Supportive Intervention/Guidance Counseling PWD Impaired Group $ 25,396 $ - $ 25,396 $ 29,265 $ - $ 29,265 SERVICES TARGET GROUP STATUS ELIG. DISTRICT II TOTALS DISTRICT III (APACHE, COCONINO, NAVAJO, YAVAPAI COUNTIES) SERVICES TARGET STATUS GROUP ELIG. LOCAL PLANNED LOCAL PLANNED STATE PLANNED STATE PLANNED LOCAL & STATE TOTAL COCONINO COUNTY Supported Employment COCONINO TOTALS PWD Adults Group $ $ 10,904 10,904 $ $ - $ $ 10,904 10,904 NAVAJO COUNTY Job Training NAVAJO TOTALS PWD Adults Group $ $ 19,015 19,015 $ $ - $ $ 19,015 19,015 PWD Adults Group $ $ $ 6,041 6,041 35,960 $ $ $ - $ $ $ 6,041 6,041 35,960 YAVAPAI COUNTY Employment Related Services YAVAPAI TOTALS DISTRICT III TOTALS August 12, 2009 48 AZ 2009-2010 SSBG PLAN REHABILITATION SERVICES ADMINISTRATION (RSA) SFY 2010 DISTRICT IV (LA PAZ, MOHAVE, YUMA COUNTIES) SERVICES MOHAVE COUNTY Day Treatment and Training MOHAVE TOTALS YUMA COUNTY Employment Related Services Rehabilitation Instructional Services YUMA TOTALS DISTRICT IV TOTALS TARGET GROUP STATUS ELIG. LOCAL PLANNED STATE PLANNED LOCAL & STATE TOTAL AFC Group $ $ 22,639 22,639 $ $ - $ $ 22,639 22,639 PWD Group $ 7,040 $ - $ 7,040 PWD Group $ $ $ 11,733 18,773 41,412 $ $ $ - $ $ $ 11,733 18,773 41,412 DISTRICT V (GILA, PINAL COUNTIES) SERVICES TARGET GROUP STATUS ELIG. LOCAL PLANNED STATE PLANNED LOCAL & STATE TOTAL GILA COUNTY Employment Services GILA TOTALS PWD Group $ $ 16,310 16,310 $ $ - $ $ 16,310 16,310 PINAL COUNTY Employment Services PINAL TOTALS PWD Group $ $ 18,820 18,820 $ $ - $ $ 18,820 18,820 $ 35,130 $ - $ 35,130 DISTRICT V TOTALS August 12, 2009 49 AZ 2009-2010 SSBG PLAN REHABILITATION SERVICES ADMINISTRATION (RSA) SFY 2010 STATEWIDE SERVICES TARGET GROUP STATUS ELIG. LOCAL PLANNED STATE PLANNED LOCAL & STATE TOTAL $ 105,000 Case Management PWD Group $ - $ 105,000 Employment Related Services PWD Group $ - $ 40,000 $ 40,000 Independent Living PWD Group $ - $ 602,443 $ 602,443 $ - $ 747,443 $ 747,443 STATEWIDE TOTALS ALL RSA SERVICES LOCAL PLANNED RSA TOTALS $ STATE PLANNED 436,345 $ 747,443 LOCAL & STATE TOTAL $ 1,183,788 CROSS-PROGRAM SFY 2010 STATEWIDE Case Management $ - $ 709,896 LOCAL & STATE TOTAL $ 709,896 STATEWIDE TOTALS $ - $ 709,896 $ SERVICES August 12, 2009 TARGET GROUP STATUS ELIG. 50 STATE PLANNED LOCAL PLANNED 709,896 AZ 2009-2010 SSBG PLAN PLANNED SFY 2010 SSBG SERVICE ALLOCATIONS LISTED BY FEDERAL SSBG SERVICE DEFINITIONS NUMBERS 1 - 29 INDICATING THE RESPONSIBLE DES ADMINISTRATION THAT PROVIDES OR CONTRACTS FOR THE SERVICE SVC CODE SERVICE (SVC) TITLE ADMIN 1. Adoption Services DAAS RSA EA CCA DDD CPIP ACYF $ $ $ $ $ $ $ TOTAL $ - 2. Case Management Services DAAS RSA EA CCA DDD CPIP ACYF CROSS-PROGRAM $ $ $ $ $ $ $ $ TOTAL $ 985,206 105,000 22,837 1,428,446 77,284 709,896 3,328,669 3. Congregate Meals DAAS RSA EA CCA DDD CPIP ACYF $ $ $ $ $ $ $ TOTAL $ 22,926 22,926 4. Counseling Services DAAS RSA EA CCA DDD CPIP ACYF $ $ $ $ $ $ $ TOTAL $ 258,085 258,085 August 12, 2009 51 ALLOCATION AZ 2009-2010 SSBG PLAN PLANNED SFY 2010 SSBG SERVICE ALLOCATIONS LISTED BY FEDERAL SSBG SERVICE DEFINITIONS NUMBERS 1 - 29 INDICATING THE RESPONSIBLE DES ADMINISTRATION THAT PROVIDES OR CONTRACTS FOR THE SERVICE SVC CODE SERVICE (SVC) TITLE ADMIN 5. Day Care Services--Adults DAAS RSA EA CCA DDD CPIP ACYF $ $ $ $ $ $ $ TOTAL $ 333,241 333,241 6. Day Care Services--Children DAAS RSA EA CCA DDD CPIP ACYF $ $ $ $ $ $ $ TOTAL $ 284,076 38,920 322,996 7. Education and Training Services DAAS RSA EA CCA DDD CPIP ACYF $ $ $ $ $ $ $ TOTAL $ - 8. Employment Services DAAS RSA EA CCA DDD CPIP ACYF $ $ $ $ $ $ $ TOTAL $ 46,941 46,941 August 12, 2009 52 ALLOCATION AZ 2009-2010 SSBG PLAN PLANNED SFY 2010 SSBG SERVICE ALLOCATIONS LISTED BY FEDERAL SSBG SERVICE DEFINITIONS NUMBERS 1 - 29 INDICATING THE RESPONSIBLE DES ADMINISTRATION THAT PROVIDES OR CONTRACTS FOR THE SERVICE SVC CODE SERVICE (SVC) TITLE ADMIN 9. Family Planning Services DAAS RSA EA CCA DDD CPIP ACYF $ $ $ $ $ $ $ TOTAL $ - 10. Foster Care Services for Adults DAAS RSA EA CCA DDD CPIP ACYF $ $ $ $ $ $ $ TOTAL $ - 11. Foster Care Services for Children DAAS RSA EA CCA DDD CPIP ACYF $ $ $ $ $ $ $ TOTAL $ 22,613,100 22,613,100 12. Health Related and Home Health Services DAAS RSA EA CCA DDD CPIP ACYF $ $ $ $ $ $ $ TOTAL $ 30,478 30,478 August 12, 2009 53 ALLOCATION AZ 2009-2010 SSBG PLAN PLANNED SFY 2010 SSBG SERVICE ALLOCATIONS LISTED BY FEDERAL SSBG SERVICE DEFINITIONS NUMBERS 1 - 29 INDICATING THE RESPONSIBLE DES ADMINISTRATION THAT PROVIDES OR CONTRACTS FOR THE SERVICE SVC CODE SERVICE (SVC) TITLE ADMIN 13. Home Based Services DAAS RSA EA CCA DDD CPIP ACYF $ $ $ $ $ $ $ TOTAL $ 2,594,215 24,992 1,292,955 3,912,162 14. Home Delivered Meals DAAS RSA EA CCA DDD CPIP ACYF $ $ $ $ $ $ $ TOTAL $ 886,573 886,573 15. Housing Services DAAS RSA EA CCA DDD CPIP ACYF $ $ $ $ $ $ $ TOTAL $ 58,057 578,219 636,276 16. Independent and Transitional Living Services DAAS RSA EA CCA DDD CPIP ACYF $ $ $ $ $ $ $ TOTAL $ - August 12, 2009 54 ALLOCATION AZ 2009-2010 SSBG PLAN PLANNED SFY 2010 SSBG SERVICE ALLOCATIONS LISTED BY FEDERAL SSBG SERVICE DEFINITIONS NUMBERS 1 - 29 INDICATING THE RESPONSIBLE DES ADMINISTRATION THAT PROVIDES OR CONTRACTS FOR THE SERVICE SVC CODE SERVICE (SVC) TITLE ADMIN 17. Information and Referral DAAS RSA EA CCA DDD CPIP ACYF $ $ $ $ $ $ $ TOTAL $ 18,221 19,731 15,212 53,164 18. Legal Services DAAS RSA EA CCA DDD CPIP ACYF $ $ $ $ $ $ $ TOTAL $ 116,403 116,403 19. Pregnancy and Parenting Services for Young Parents DAAS RSA EA CCA DDD CPIP ACYF $ $ $ $ $ $ $ TOTAL $ 12,083 12,083 20. Prevention and Intervention Services DAAS RSA EA CCA DDD CPIP ACYF $ $ $ $ $ $ $ TOTAL $ 242,481 47,936 2,753,136 2,729,218 5,772,771 August 12, 2009 55 ALLOCATION AZ 2009-2010 SSBG PLAN PLANNED SFY 2010 SSBG SERVICE ALLOCATIONS LISTED BY FEDERAL SSBG SERVICE DEFINITIONS NUMBERS 1 - 29 INDICATING THE RESPONSIBLE DES ADMINISTRATION THAT PROVIDES OR CONTRACTS FOR THE SERVICE SVC CODE SERVICE (SVC) TITLE ADMIN 21. Protective Services for Adults DAAS RSA EA CCA DDD CPIP ACYF $ $ $ $ $ $ $ TOTAL $ 3,200,830 3,200,830 22. Protective Services for Children DAAS RSA EA CCA DDD CPIP ACYF $ $ $ $ $ $ $ TOTAL $ 7,867,868 7,867,868 23. Recreational Services DAAS RSA EA CCA DDD CPIP ACYF $ $ $ $ $ $ $ TOTAL $ - 24. Residential Treatment Services DAAS RSA EA CCA DDD CPIP ACYF $ $ $ $ $ $ $ TOTAL $ - August 12, 2009 56 ALLOCATION AZ 2009-2010 SSBG PLAN PLANNED SFY 2010 SSBG SERVICE ALLOCATIONS LISTED BY FEDERAL SSBG SERVICE DEFINITIONS NUMBERS 1 - 29 INDICATING THE RESPONSIBLE DES ADMINISTRATION THAT PROVIDES OR CONTRACTS FOR THE SERVICE SVC CODE ALLOCATION SERVICE (SVC) TITLE ADMIN 25. Special Services for Persons with Developmental or Physical Disabilities DAAS RSA EA CCA DDD CPIP ACYF $ $ $ $ $ $ $ TOTAL $ 1,030,852 1,662,723 2,693,575 26. Special Services for Youth Involved in or at Risk of Involvement with Criminal Activity DAAS RSA EA CCA DDD CPIP ACYF $ $ $ $ $ $ $ TOTAL $ 63,614 63,614 27. Substance Abuse Services DAAS RSA EA CCA DDD CPIP ACYF $ $ $ $ $ $ $ TOTAL $ - 28. Transportation Services DAAS RSA EA CCA DDD CPIP ACYF $ $ $ $ $ $ $ TOTAL $ 121,716 54,918 176,634 29. Other Services (DES Training,Consultation, Program Occupancy) $ 550,300 TOTAL $ 52,898,689 30 August 12, 2009 Total of the SFY 2010 Planned SSBG Funding Allocations Listed Above for Federal Service Definitions Numbers 1 Through 29 57 AZ 2009-2010 SSBG PLAN PLANNED SFY 2010 SSBG SERVICE ALLOCATIONS LISTED BY FEDERAL SSBG SERVICE DEFINITIONS NUMBERS 1 - 29 INDICATING THE RESPONSIBLE DES ADMINISTRATION THAT PROVIDES OR CONTRACTS FOR THE SERVICE SVC CODE SERVICE (SVC) TITLE 31 Administrative Costs Department All SFY 2010 State and Locally Planned SSBG Funding Allocations Listed by the Administration/Division Responsible for Providing or Contracting for the Services ACYF DDD RSA CCA EA CPIP DAAS CROSS-PROGRAM Other Services Administrative Costs August 12, 2009 ALLOCATION ADMIN 58 $ 5,241,598 TOTAL $ 5,241,598 $ $ $ $ $ $ $ $ $ $ 34,968,339 1,662,723 1,183,788 284,076 22,837 4,906,383 8,610,347 709,896 550,300 5,241,598 TOTAL $ 58,140,287 AZ 2009-2010 SSBG PLAN APPENDIX A PUBLIC NOTICE August 12, 2009 59 AZ 2009-2010 SSBG PLAN PUBLIC NOTICE Issue Date: June 9, 2009 ARIZONA DEPARTMENT OF ECONOMIC SECURITY PUBLIC HEARINGS ON THE STATE OF ARIZONA TITLE XX SOCIAL SERVICES BLOCK GRANT (SSBG) PLAN JULY 1, 2009 – JUNE 30, 2010 The Department of Economic Security (DES) will conduct a public hearing in each District (see attached notice for hearing times and locations) to receive public comment on the above-referenced plan. Copies of the proposed plan are available for public inspection at each of the DES District Headquarters and the other locations listed on the attached notice. You may also obtain a copy by contacting Marianne Eichinger at the address and phone number listed below. The Department will accept oral and written comments on the plan at the public hearings, or written comments may also be mailed to the Department at the following address: Department of Economic Security ATTN: Marianne Eichinger (602) 542-6159 Fax (602) 542-6000 P.O. Box 6123, Site Code 837A 1789 W. Jefferson, Site 837A or Phoenix, AZ 85007 Phoenix, Arizona 85005 E-mail: meichinger@azdes.gov Written comments should be mailed so that the Department will receive them before 5:00 PM, Thursday, July 2, 2009, and should include the signature and mailing address of the person providing comments, as well as the name of any organization that person represents. PERSONS WITH DISABILITIES MAY REQUEST A REASONABLE ACCOMMODATION, SUCH AS A SIGN LANGUAGE INTERPRETER, BY CONTACTING THE COORDINATING PROGRAM MANAGER AT THE DISTRICT OFFICE IDENTIFIED ON THE ATTACHMENT TO THIS NOTICE. REQUESTS SHOULD BE MADE AS EARLY AS POSSIBLE TO ALLOW TIME TO ARRANGE THE ACCOMMODATION. THIS DOCUMENT IS AVAILABLE IN ALTERNATIVE FORMAT BY CONTACTING MARIANNE EICHINGER, AT THE NUMBER AND ADDRESS SPECIFIED ABOVE. REQUESTS SHOULD BE MADE AS EARLY AS POSSIBLE TO ALLOW TIME TO ARRANGE THE ACCOMMODATION. August 12, 2009 60 AZ 2009-2010 SSBG PLAN APPENDIX B CERTIFICATIONS 1. Certification Regarding Lobbying 2. Certification Regarding Drug-Free Workplace Requirements 3. Certification Regarding Debarment, Suspension and Other Responsibility Matters 4. Certification Regarding Environmental Tobacco Smoke August 12, 2009 61 AZ 2009-2010 SSBG PLAN CERTIFICATION REGARDING DRUG-FREE WORKPLACE REQUIREMENTS This certification is required by the regulations implementing the Drug-Free Workplace Act of 1988: 45 CFR Part 76, Subpart, F. Sections 76.630(c) and (d)(2) and 76.645(a)(1) and (b) provide that a Federal agency may designate a central receipt point for STATE-WIDE AND STATE AGENCY-WIDE certifications, and for notification of criminal drug convictions. For the Department of Health and Human Services, the central pint is: Division of Grants Management and Oversight, Office of Management and Acquisition, Department of Health and Human Services, Room 517-D, 200 Independence Avenue, SW Washington, DC 20201. Certification Regarding Drug-Free Workplace Requirements (Instructions for Certification) 1. By signing and/or submitting this application or grant agreement, the grantee is providing the certification set out below. 2. The certification set out below is a material representation of fact upon which reliance is placed when the agency awards the grant. If it is later determined that the grantee knowingly rendered a false certification, or otherwise violates the requirements of the Drug-Free Workplace Act, the agency, in addition to any other remedies available to the Federal Government, may take action authorized under the Drug-Free Workplace Act. 3. For grantees other than individuals, Alternate I applies. 4. For grantees who are individuals, Alternate II applies. 5. Workplaces under grants, for grantees other than individuals, need not be identified on the certification. If known, they may be identified in the grant application. If the grantee does not identify the workplaces at the time of application, or upon award, if there is no application, the grantee must keep the identity of the workplace(s) on file in its office and make the information available for Federal inspection. Failure to identify all known workplaces constitutes a violation of the grantee's drug-free workplace requirements. 6. Workplace identifications must include the actual address of buildings (or parts of buildings) or other sites where work under the grant takes place. Categorical descriptions may be used (e.g., all vehicles of a mass transit authority or State highway department while in operation, State employees in each local unemployment office, performers in concert halls or radio studios). 7. If the workplace identified to the agency changes during the performance of the grant, the grantee shall inform the agency of the change(s), if it previously identified the workplaces in question (see paragraph five). 8. Definitions of terms in the Nonprocurement Suspension and Debarment common rule and Drug-Free Workplace common rule apply to this certification. Grantees' attention is called, in particular, to the following definitions from these rules: Controlled substance means a controlled substance in Schedules I through V of the Controlled Substances Act (21 U.S.C. 812) and as further defined by regulation (21 CFR 1308.11 through 1308.15); Conviction means a finding of guilt (including a plea of nolo contendere) or imposition of sentence, or both, by any judicial body charged with the responsibility to determine violations of the Federal or State criminal drug statutes; Criminal drug statute means a Federal or non-Federal criminal statute involving the manufacture, August 12, 2009 63 AZ 2009-2010 SSBG PLAN distribution, dispensing, use, or possession of any controlled substance; Employee means the employee of a grantee directly engaged in the performance of work under a grant, including: (i) All direct charge employees; (ii) All indirect charge employees unless their impact or involvement is insignificant to the performance of the grant; and, (iii) Temporary personnel and consultants who are directly engaged in the performance of work under the grant and who are on the grantee's payroll. This definition does not include workers not on the payroll of the grantee (e.g., volunteers, even if used to meet a matching requirement; consultants or independent contractors not on the grantee's payroll; or employees of subrecipients or subcontractors in covered workplaces). Certification Regarding Drug-Free Workplace Requirements Alternate I. (Grantees Other Than Individuals) The grantee certifies that it will or will continue to provide a drug-free workplace by: (a) Publishing a statement notifying employees that the unlawful manufacture, distribution, dispensing, possession, or use of a controlled substance is prohibited in the grantee's workplace and specifying the actions that will be taken against employees for violation of such prohibition; (b) Establishing an ongoing drug-free awareness program to inform employees about -(1)The dangers of drug abuse in the workplace; (2) The grantee's policy of maintaining a drug-free workplace; (3) Any available drug counseling, rehabilitation, and employee assistance programs; and (4) The penalties that may be imposed upon employees for drug abuse violations occurring in the workplace; c) Making it a requirement that each employee to be engaged in the performance of the grant be given a copy of the statement required by paragraph (a); (d) Notifying the employee in the statement required by paragraph (a) that, as a condition of employment under the grant, the employee will -(1) Abide by the terms of the statement; and (2) Notify the employer in writing of his or her conviction for a violation of a criminal drug statute occurring in the workplace no later than five calendar days after such conviction; (e) Notifying the agency in writing, within ten calendar days after receiving notice under paragraph (d)(2) from an employee or otherwise receiving actual notice of such conviction. Employers of convicted employees must provide notice, including position title, to every grant officer or other designee on whose grant activity the convicted employee was working, unless the Federal agency has designated a central point for the receipt of such notices. Notice shall include the identification number(s) of each affected grant; (f) Taking one of the following actions, within 30 calendar days of receiving notice under paragraph (d)(2), with respect to any employee who is so convicted -(1) Taking appropriate personnel action against such an employee, up to and including termination, consistent with the requirements of the Rehabilitation Act of 1973, as amended; or (2) Requiring such employee to participate satisfactorily in a drug abuse assistance or rehabilitation program approved for such purposes by a Federal, State, or local health, law enforcement, or other appropriate agency; (g) Making a good faith effort to continue to maintain a drug-free workplace through implementation of paragraphs (a), (b), (c), (d), (e) and (f). (B) The grantee may insert in the space provided below the site(s) for the performance of work done in connection with the specific grant: Place of Performance (Street address, city, county, state, zip code) August 12, 2009 64 AZ 2009-2010 SSBG PLAN CERTIFICATION REGARDING DEBARMENT, SUSPENSION AND OTHER RESPONSIBILITY MATTERS Certification Regarding Debarment, Suspension, and Other Responsibility Matters--Primary Covered Transactions Instructions for Certification 1. By signing and submitting this proposal, the prospective primary participant is providing the certification set out below. 2. The inability of a person to provide the certification required below will not necessarily result in denial of participation in this covered transaction. The prospective participant shall submit an explanation of why it cannot provide the certification set out below. The certification or explanation will be considered in connection with the department or agency's determination whether to enter into this transaction. However, failure of the prospective primary participant to furnish a certification or an explanation shall disqualify such person from participation in this transaction. 3. The certification in this clause is a material representation of fact upon which reliance was placed when the department or agency determined to enter into this transaction. If it is later determined that the prospective primary participant knowingly rendered an erroneous certification, in addition to other remedies available to the Federal Government, the department or agency may terminate this transaction for cause or default. 4. The prospective primary participant shall provide immediate written notice to the department or agency to which this proposal is submitted if at any time the prospective primary participant learns that its certification was erroneous when submitted or has become erroneous by reason of changed circumstances. 5. The terms covered transaction, debarred, suspended, ineligible, lower tier covered transaction, participant, person, primary covered transaction, principal, proposal, and voluntarily excluded, as used in this clause, have the meanings set out in the Definitions and Coverage sections of the rules implementing Executive Order 12549. You may contact the department or agency to which this proposal is being submitted for assistance in obtaining a copy of those regulations. 6. The prospective primary participant agrees by submitting this proposal that, should the proposed covered transaction be entered into, it shall not knowingly enter into any lower tier covered transaction with a person who is proposed for debarment under 48 CFR part 9, subpart 9.4, debarred, suspended, declared ineligible, or voluntarily excluded from participation in this covered transaction, unless authorized by the department or agency entering into this transaction. 7. The prospective primary participant further agrees by submitting this proposal that it will include the clause titled ``Certification Regarding Debarment, Suspension, Ineligibility and Voluntary ExclusionLower Tier Covered Transaction,'' provided by the department or agency entering into this covered transaction, without modification, in all lower tier covered transactions and in all solicitations for lower tier covered transactions. 8. A participant in a covered transaction may rely upon a certification of a prospective participant in a lower tier covered transaction that it is not proposed for debarment under 48 CFR part 9, subpart 9.4, debarred, suspended, ineligible, or voluntarily excluded from the covered transaction, unless it knows that the certification is erroneous. A participant may decide the method and frequency by which it determines the eligibility of its principals. Each participant may, but is not required to, check the List of Parties Excluded from Federal Procurement and Nonprocurement Programs. 9. Nothing contained in the foregoing shall be construed to require establishment of a system of records in order to render in good faith the certification required by this clause. The knowledge and information of a participant is not required to exceed that which is normally possessed by a prudent person in the ordinary course of business dealings. 10. Except for transactions authorized under paragraph 6 of these instructions, if a participant in a August 12, 2009 66 AZ 2009-2010 SSBG PLAN covered transaction knowingly enters into a lower tier covered transaction with a person who is proposed for debarment under 48 CFR part 9, subpart 9.4, suspended, debarred, ineligible, or voluntarily excluded from participation in this transaction, in addition to other remedies available to the Federal Government, the department or agency may terminate this transaction for cause or default. Certification Regarding Debarment, Suspension, and Other Responsibility Matters--Primary Covered Transactions (1) The prospective primary participant certifies to the best of its knowledge and belief, that it and its principals: (a) Are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded by any Federal department or agency; (b) Have not within a three-year period preceding this proposal been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (Federal, State or local) transaction or contract under a public transaction; violation of Federal or State antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property; (c) Are not presently indicted for or otherwise criminally or civilly charged by a governmental entity (Federal, State or local) with commission of any of the offenses enumerated in paragraph (1)(b) of this certification; and (d) Have not within a three-year period preceding this application/proposal had one or more public transactions (Federal, State or local) terminated for cause or default. (2) Where the prospective primary participant is unable to certify to any of the statements in this certification, such prospective participant shall attach an explanation to this proposal. Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion--Lower Tier Covered Transactions Instructions for Certification 1. By signing and submitting this proposal, the prospective lower tier participant is providing the certification set out below. 2. The certification in this clause is a material representation of fact upon which reliance was placed when this transaction was entered into. If it is later determined that the prospective lower tier participant knowingly rendered an erroneous certification, in addition to other remedies available to the Federal Government the department or agency with which this transaction originated may pursue available remedies, including suspension and/or debarment. 3. The prospective lower tier participant shall provide immediate written notice to the person to which this proposal is submitted if at any time the prospective lower tier participant learns that its certification was erroneous when submitted or had become erroneous by reason of changed circumstances. 4. The terms covered transaction, debarred, suspended, ineligible, lower tier covered transaction, participant, person, primary covered transaction, principal, proposal, and voluntarily excluded, as used in this clause, have the meaning set out in the Definitions and Coverage sections of rules implementing Executive Order 12549. You may contact the person to which this proposal is submitted for assistance in obtaining a copy of those regulations. 5. The prospective lower tier participant agrees by submitting this proposal that, [[Page 33043]] should the proposed covered transaction be entered into, it shall not knowingly enter into any lower tier covered transaction with a person who is proposed for debarment under 48 CFR part 9, subpart 9.4, debarred, suspended, declared ineligible, or voluntarily excluded from participation in this covered transaction, unless authorized by the department or agency with which this transaction originated. 6. The prospective lower tier participant further agrees by submitting this proposal that it will include this clause titled ``Certification Regarding Debarment, Suspension, Ineligibility and Voluntary ExclusionLower Tier Covered Transaction,'' without modification, in all lower tier covered transactions and in all August 12, 2009 67 AZ 2009-2010 SSBG PLAN