Transportation assistance to clients to attend mainstream benefit appointments, employment training, or jobs? Yes No Regular follow-ups with participants to ensure mainstream benefits are received and renewed? Yes No Will project participants have access to SSI/SSDI technical assistance provided by the applicant, a subrecipient, or partner agency? Yes No Indicate the last SOAR training date for the staff person providing the technical assistance: _____________ 12. Supportive Services Type and Frequency: A. For all supportive services available to participants, indicate who will provide, how they will be accessed and how often they will be provided regardless of the resources that will be used to pay for the services. For Provider, indicate: if the applicant will provide the service “Applicant” directly; if a subrecipient will provide the service directly; “Subrecipient” if an organization that is not a subrecipient of project but with “Partner” whom a formal agreement or memorandum of understanding (MOU) has been signed will provide the service directly; or, to if a specific “Non-Partner” organization with whom no formal agreement has been established regularly provides the service to clients. Frequency select one per service type – Supportive Services Provider Weekly Monthly N/A Assessment of Service Needs Assistance with Moving Costs Case Management Child Care Education Services Employment Assistance/Job Training Food Housing Search/ Counseling Services Legal Services Life Skills Mental Health Services Outpatient Health Services Outreach Services Substance Abuse Treatment Services Transportation Utility Deposits
Transportation assistance to clients to attend mainstream benefit appointments, employment training, or jobs? Yes No Regular follow-ups with participants to ensure mainstream benefits are received and renewed? Yes No Will project participants have access to SSI/SSDI technical assistance provided by the applicant, a subrecipient, or partner agency? Yes No Indicate the last SOAR training date for the staff person providing the technical assistance: _____________ 12. Supportive Services Type and Frequency: A. For all supportive services available to participants, indicate who will provide, how they will be accessed and how often they will be provided regardless of the resources that will be used to pay for the services. For Provider, indicate: “Applicant” if the applicant will provide the service directly; “Subrecipient” if a subrecipient will provide the service directly; “Partner” if an organization that is not a subrecipient of project but with whom a formal agreement or memorandum of understanding (MOU) has been signed will provide the service directly; or, “Non-Partner” to if a specific organization with whom no formal agreement has been established regularly provides the service to clients. Supportive Services Provider Frequency – select one per service type Weekly Monthly N/A Assessment of Service Needs Assistance with Moving Costs Case Management Child Care Education Services Employment Assistance/Job Training Food Housing Search/ Counseling Services Legal Services Life Skills Mental Health Services Outpatient Health Services Outreach Services Substance Abuse Treatment Services Transportation Utility Deposits
attachment-4-new-project-application.docx