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2011 SCSEP planning and allotments
Summary ETA instructed Senior Community Service Employment Program applicants on program year 2011 grants. It specified application materials, funding allotments, participant transition planning and a June 6, 2011 submission deadline, with eight attachments. The letter rescinded TEGL 28-09 and expired June 30, 2012.
Document
Federal guidance
Agency
U.S. Department of Labor, Employment and Training Administration (ETA)
Document number
TEGL No. 25-10
Date issued
May 10, 2011
Status
Withdrawn
ETA lists this advisory Canceled as of 2026-10-24. The signed letter prints Expiration Date: June 30, 2012 and expressly rescinds TEGL 28-09.
Status last verified October 24, 2026
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Accessible letter PDF: https://www.dol.gov/sites/dolgov/files/ETA/advisories/TEGL/2011/TEGL25-10ACC.pdf
CLASSIFICATION
SCSEP
EMPLOYMENT AND TRAINING ADMINISTRATION
ADVISORY SYSTEM CORRESPONDENCE SYMBOL
OWI-DAS
U.S. DEPARTMENT OF LABOR
Washington, D.C. 20210 DATE
May 10, 2011
ADVISORY: TRAINING AND EMPLOYMENT GUIDANCE LETTER NO. 25-10
TO: SENIOR COMMUNITY SERVICE EMPLOYMENT
PROGRAM (SCSEP) GRANTEES
FROM: JANE OATES /s/
Assistant Secretary
SUBJECT: Program Year 2011 Planning Instructions and Allotments for
SCSEP Grant Applicants
1. Purpose. This guidance provides SCSEP grant applicants with application instructions,
procedures, and allotments for Program Year (PY) 2011 funds, with a period of performance
beginning July 1, 2011.
2. References. For additional information, see:
2006 Older Americans Act Amendments (OAA), (P.L. 109-365; 42 U.S.C. 3056 et.
seq. 20 C.F.R. part 641)
SCSEP Final Rule (75 Fed. Reg., No. 169, 53785; September 1, 2010)
“Revised Income Inclusions and Exclusions and Procedures for Determining SCSEP
Eligibility,” Training and Employment Guidance Letter (TEGL) 12-06
“2011 Federal Poverty Guidelines,” TEGL 18-10
Priority of Service for Covered Persons (Final Rule 20 CFR Part 1010, 73 Fed. Reg.
78132, Dec. 19, 2008)
The Americans with Disabilities Act (ADA), as amended (P.L. 110-325)
SCSEP Performance Data Collection Approval (OMB No. 1205-0040)
Jobs for Veterans Act (JVA) (P.L. 107-288)
3. Background. A “planning guidance” TEGL is released each year to assist all SCSEP grant
applicants in preparing their application for the annual OAA Title V appropriation (P.L. 109-
365 USC 3056 et. seq.; 20 CFR part 641).
4. Overall Approach. PY 2011 funding for SCSEP is significantly less than PY 2010 funding.
Therefore, the Department requests that applicants address their management strategies for
RESCISSIONS EXPIRATION DATE
TEGL 28-09 June 30, 2012
dealing with the reduced PY 2011 funding, with an overall goal of ensuring the least
disruption possible to SCSEP participants.
Individual participant durational limits will come into effect for the first time on July 1, 2011.
Applicants will have the opportunity to adjust their recently-approved durational limit policy
and to describe transition planning and service strategies during PY 2011 for participants
who will reach their individual durational limits in PY 2011. It is especially important that
applicants develop a thoughtful overall strategy of participant training and transition, whether
to employment or other services.
This year’s approach also addresses continuing efforts toward increased minority enrollments
and employment outcomes. In addition, grantees will be asked to submit termination and
grievance policies that are required by current regulations.
5. Grant Application Procedural Requirements. All SCSEP grant applicants must submit a
grant application package in order to receive PY 2011 funding. The Grant Officer will not
approve a grant application that fails to provide any of the required information outlined in
this guidance. The Department requires the following items in the grant application package:
Program Narrative (Attachment B). Applicants must provide a narrative in accordance
with the description in Attachment B.
Programmatic Assurances (Attachment C). Applicants must submit signed
programmatic assurances that reflect standard grant management requirements.
Optional Special Requests (Attachment D). Additional optional narratives, described in
Attachment D, are required from applicants with special requests in one or more of the
following areas:
Waiver for additional funds for training and supportive services
Administration cap increase
Extension of maximum project duration
On-the-job experience (OJE) training option
Cross-border agreements
Budget Forms (Attachments E-G). A signed Application for Federal Assistance SF-424,
a SF-424A Budget Information Form, and a detailed budget narrative must be submitted.
These forms and instructions can be found in Attachments E through G.
Applicants should not include manuals and operating procedures in the application.
Federal Project Officers (FPOs) may request these separately as needed. When the Grant
Officer returns the PY 2011 grant agreement for the applicant’s signature, it will
incorporate the programmatic assurances and the grant narrative as the Scope of Work.
2
Geographic Areas to Be Served. List the cities and counties where you will operate the
grant. Include the number of SCSEP authorized positions that you will establish in each
jurisdiction with PY 2011 funds. Applicants serving a city, as well as its surrounding
counties or jurisdictions, must list authorized positions in the surrounding counties and
jurisdictions. This information can be submitted in an Excel spreadsheet as a separate
attachment, and will also serve to provide information for Item 14 on the Form SF-424.
6. PY 2011 Program Allotments. See Attachments A-1 through A-5 for funding levels and
authorized positions.
7. Schedule and Action Requested. Applicants must comply with the following:
Provide grant application forms SF-424 and SF-424A with narrative to the State
Office on Aging (if not the grantee) and Area Agencies on Aging (AAAs) no later
than the date of submission to the Department.
Submit the PY 2011 grant application to the Department of Labor (DOL),
Employment and Training Administration, Office of Workforce Investment,
Division of Adult Services no later than Monday, June 6, 2011. Applicants are
encouraged to submit their applications as soon as possible.
8. Method of Submission. Applicants must submit electronic copies of the items listed in
section 5 of this TEGL. Materials should be sent via email to [email protected]
with an electronic copy to the applicant’s FPO (Attachment I). If an applicant is unable to
submit electronically, the applicant must submit hard copy applications by fax to
(202) 693-3817, or by overnight delivery to the address below:
Alina Walker
Division of Adult Services
U.S. Department of Labor
200 Constitution Avenue, NW
Room S-4209
Washington, D.C. 20210-0001
Please note that all application packages must have an electronic or actual date stamp no later
than Monday, June 6, 2011. Applicants requiring receipt verification for grant documents
from the grant email box should use the Return Receipt Request under “Options” in their
email program.
9. Grant Application Intergovernmental Review. In accordance with section 502(d) of the
2006 Amendments to the OAA, applicants must share applications on an intrastate basis and
provide appropriate AAAs with copies of the SF-424, Application for Federal Assistance, a
summary of project locations, and an explanation of services that the applicant will provide
in each state. In addition, state applicants should follow procedures established by Executive
Order 12372, which implements the Single Point of Contact (SPOC) system, unless the state
SPOC has waived this requirement. Applicants should include documentation supporting
these requirements with the grant application.
3
10. Eligibility Review/Responsibility Review/Grant Application Review. DOL will conduct a
grant application review as provided at section 514 of the 2006 OAA Amendments and 20
CFR 641.430-440 of the current regulations. DOL will not issue final approval for PY 2011
funding if the grantee:
Fails to meet the eligibility tests of section 514(c) of the 2006 OAA Amendments
and criteria as provided at 20 CFR 641.430 of the current regulations.
Fails to meet the responsibility tests of section 514(d) of the 2006 OAA
Amendments and criteria as provided at 20 CFR 641.440 of the current
regulations.
Fails to submit the materials listed in this TEGL.
11. Inquiries. Questions may be directed to the applicant’s FPO.
12. Attachments.
Attachment A: Funding Allocations and Authorized Positions
Attachment B: Program Narrative Instructions
Attachment C: Programmatic Assurances
Attachment D: Optional Special Requests (Waivers)
Attachment E: SF-424 Instructions
Attachment F: SF-424
Attachment G: SF-424A
Attachment H: List of Federal Project Officers (FPOs)
4
Official attachment PDF: https://www.dol.gov/sites/dolgov/files/ETA/advisories/TEGL/2011/TEGL25-10ATT-A.pdf
Attachment A-1
USDOL/ETA
Senior Community Service Employment Program
PY 2011 Authorized Positions and Funding*
for State Agencies and Territories, by State
States Positions Dollars
State Agencies
Alabama 171 $1,654,281
Alaska 197 1,909,347
Arizona 122 1,187,876
Arkansas 168 1,625,132
California 790 7,659,251
Colorado 93 903,660
Connecticut 101 976,537
Delaware 197 1,909,347
District of Col 53 517,418
Florida 543 5,268,923
Georgia 204 1,982,223
Hawaii 197 1,909,347
Idaho 49 475,366
Illinois 358 3,476,178
Indiana 241 2,339,314
Iowa 118 1,144,150
Kansas 94 910,948
Kentucky 175 1,698,007
Louisiana 156 1,508,530
Maine 57 553,856
Maryland 127 1,231,602
Massachusetts 201 1,945,785
Michigan 307 2,980,622
Minnesota 219 2,120,687
Mississippi 114 1,107,712
Missouri 228 2,208,138
Montana 58 561,144
Nebraska 71 685,033
Nevada 49 475,366
New Hampshire 49 475,366
New Jersey 260 2,521,504
New Mexico 52 502,844
New York 609 5,902,944
North Carolina 241 2,339,314
North Dakota 56 539,281
Ohio 402 3,898,858
Oklahoma 148 1,435,654
Oregon 135 1,311,765
Pennsylvania 493 4,780,655
Puerto Rico 126 1,224,314
Rhode Island 50 480,980
South Carolina 125 1,217,027
South Dakota 64 619,445
Tennessee 188 1,821,896
Texas 511 4,955,557
Utah 62 597,581
Vermont 51 495,555
Virginia 200 1,938,498
Washington 136 1,319,053
West Virginia 104 1,005,686
Wisconsin 236 2,288,302
Wyoming 49 475,366
State Agencies Total 9,805 $95,073,225
Territories
American Samoa 104 1,010,475
Guam 104 1,010,475
Northern Marianas 35 336,825
Virgin Islands 104 1,010,475
Territories Total 347 $3,368,250
* Based on cost per position of $9,698, with enacted minimum wage increase effective 7/24/09
U. S. Department of Labor / Employment & Training Administration Attachment A-2
Senior Community Service Employment Program
PY 2011 Authorized Positions* for Non-Minority National Sponsors, by State
State AARP ABLE ANPPM ES EW GII Mature NCBA NCOA NULI QCSI SER SSAI TWI VATD Total
Alabama 0 0 0 197 0 0 0 0 0 0 0 0 470 0 0 667
Alaska 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Arizona 120 0 127 0 0 104 0 0 0 0 0 0 0 0 0 351
Arkansas 184 0 0 0 353 0 0 119 0 0 0 0 0 0 0 656
California 368 0 411 0 318 0 0 0 235 0 0 1,026 386 0 0 2,744
Colorado 141 0 0 0 0 0 0 0 0 0 0 223 0 0 0 364
Connecticut 0 0 0 187 0 0 0 0 0 0 0 0 0 209 0 396
Delaware 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
District of Col 0 0 63 0 0 0 0 144 0 0 0 0 0 0 0 207
Florida 1,316 0 0 0 513 0 0 151 0 0 0 144 0 0 0 2,124
Georgia 204 0 0 0 453 0 0 0 141 0 0 0 0 0 0 798
Hawaii 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Idaho 0 0 0 0 173 0 0 0 0 0 0 0 0 0 0 173
Illinois 86 0 0 177 398 0 0 95 0 0 0 173 403 0 0 1,332
Indiana 236 0 0 0 281 208 0 0 0 0 0 0 218 0 0 943
Iowa 156 0 0 0 210 0 0 0 0 0 0 0 95 0 0 461
Kansas 0 0 0 0 0 0 0 0 0 0 0 355 0 0 0 355
Kentucky 101 0 0 0 344 0 0 0 237 0 0 0 0 0 0 682
Louisiana 127 0 160 0 192 0 0 0 72 0 0 0 0 0 0 551
Maine 0 222 0 0 0 0 0 0 0 0 0 0 0 0 0 222
Maryland 0 0 0 0 0 0 0 0 0 0 0 0 495 0 0 495
Massachusetts 0 199 0 0 0 0 0 0 0 150 0 0 388 0 0 737
Michigan 365 0 0 0 391 0 0 199 0 191 0 0 0 0 0 1,146
Minnesota 0 0 0 0 385 0 0 0 0 0 156 0 296 0 0 837
Mississippi 0 0 0 0 133 0 0 102 0 0 0 0 209 0 0 444
Missouri 265 0 0 0 601 0 0 0 0 0 0 0 0 0 0 866
Montana 0 0 0 0 224 0 0 0 0 0 0 0 0 0 0 224
Nebraska 0 0 0 0 266 0 0 0 0 0 0 0 0 0 0 266
Nevada 177 0 0 0 0 0 0 0 0 0 0 0 0 0 0 177
New Hampshire 0 173 0 0 0 0 0 0 0 0 0 0 0 0 0 173
New Jersey 0 0 0 347 183 0 0 0 356 132 0 0 0 0 0 1,018
New Mexico 0 0 0 0 0 173 0 0 0 0 0 0 0 0 0 173
New York 505 0 0 378 403 0 0 0 335 195 0 0 499 0 0 2,315
North Carolina 0 0 0 0 0 0 0 268 162 0 0 0 512 0 0 942
North Dakota 0 0 0 0 216 0 0 0 0 0 0 0 0 0 0 216
Ohio 262 0 0 0 374 0 530 144 0 138 0 0 122 0 0 1,570
Oklahoma 172 0 0 0 261 0 0 0 0 0 0 0 0 0 0 433
Oregon 0 0 0 179 351 0 0 0 0 0 0 0 0 0 0 530
Pennsylvania 371 0 115 0 208 211 0 178 505 119 0 0 180 0 0 1,887
Puerto Rico 186 0 0 0 309 0 0 0 0 0 0 0 0 0 0 495
Rhode Island 0 0 0 0 0 0 0 0 0 0 0 191 0 0 0 191
South Carolina 204 0 0 0 286 0 0 0 0 0 0 0 0 0 0 490
South Dakota 0 0 0 0 223 0 0 0 0 0 0 0 0 0 0 223
Tennessee 0 0 0 0 0 0 0 0 154 0 0 0 582 0 0 736
Texas 994 0 0 0 431 0 0 0 0 0 0 300 211 0 0 1,936
Utah 0 0 0 240 0 0 0 0 0 0 0 0 0 0 0 240
Vermont 0 0 0 0 0 0 0 0 0 0 0 0 0 0 197 197
Virginia 248 0 0 0 88 226 0 0 199 0 0 0 0 0 0 761
Washington 263 0 0 0 0 204 0 0 0 0 0 0 0 0 0 467
West Virginia 0 0 0 0 99 0 0 0 306 0 0 0 0 0 0 405
Wisconsin 0 0 0 0 363 0 0 0 0 0 0 256 275 0 0 894
Wyoming 0 0 0 0 173 0 0 0 0 0 0 0 0 0 0 173
Total 7,051 594 876 1,705 9,203 1,126 530 1,400 2,702 925 156 2,668 5,341 209 197 34,683
* Based on cost per position of $9,698, with enacted minimum wage increase effective 7/24/09
U. S. Department of Labor / Employment & Training Administration Attachment A-3
Senior Community Service Employment Program
PY 2011 Authorized Funding* for Non-Minority National Sponsors, by State
State AARP ABLE ANPPM ES EW GII Mature NCBA NCOA NULI QCSI SER SSAI TWI VATD Total
Alabama $0 $0 $0 $1,911,239 $0 $0 $0 $0 $0 $0 $0 $0 $4,559,809 $0 $0 $6,471,048
Alaska 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Arizona 1,164,775 0 1,232,720 0 0 1,009,471 0 0 0 0 0 0 0 0 0 3,406,966
Arkansas 1,784,356 0 0 0 3,423,248 0 0 1,154,013 0 0 0 0 0 0 0 6,361,617
California 3,569,189 0 3,986,241 0 3,084,245 0 0 0 2,279,238 0 0 9,951,054 3,743,769 0 0 26,613,736
Colorado 1,367,773 0 0 0 0 0 0 0 0 0 0 2,163,216 0 0 0 3,530,989
Connecticut 0 0 0 1,812,104 0 0 0 0 0 0 0 0 0 2,025,293 0 3,837,397
Delaware 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
District of Col 0 0 610,596 0 0 0 0 1,395,648 0 0 0 0 0 0 0 2,006,244
Florida 12,764,891 0 0 0 4,975,979 0 0 1,464,664 0 0 0 1,396,766 0 0 0 20,602,300
Georgia 1,978,762 0 0 0 4,394,017 0 0 0 1,367,674 0 0 0 0 0 0 7,740,453
Hawaii 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Idaho 0 0 0 0 1,681,820 0 0 0 0 0 0 0 0 0 0 1,681,820
Illinois 834,188 0 0 1,716,875 3,860,543 0 0 921,486 0 0 0 1,678,075 3,909,043 0 0 12,920,210
Indiana 2,287,717 0 0 0 2,723,935 2,016,293 0 0 0 0 0 0 2,113,231 0 0 9,141,176
Iowa 1,513,335 0 0 0 2,037,182 0 0 0 0 0 0 0 921,582 0 0 4,472,099
Kansas 0 0 0 0 0 0 0 0 0 0 0 3,443,443 0 0 0 3,443,443
Kentucky 979,931 0 0 0 3,337,585 0 0 0 2,299,441 0 0 0 0 0 0 6,616,957
Louisiana 1,230,876 0 1,550,710 0 1,860,851 0 0 0 697,819 0 0 0 0 0 0 5,340,256
Maine 0 2,152,153 0 0 0 0 0 0 0 0 0 0 0 0 0 2,152,153
Maryland 0 0 0 0 0 0 0 0 0 0 0 0 4,800,394 0 0 4,800,394
Massachusetts 0 1,930,468 0 0 0 0 0 0 0 1,455,127 0 0 3,763,929 0 0 7,149,524
Michigan 3,538,826 0 0 0 3,790,906 0 0 1,929,387 0 1,851,824 0 0 0 0 0 11,110,943
Minnesota 0 0 0 0 3,731,566 0 0 0 0 0 1,512,011 0 2,868,944 0 0 8,112,521
Mississippi 0 0 0 0 1,289,353 0 0 988,827 0 0 0 0 2,026,125 0 0 4,304,305
Missouri 2,569,534 0 0 0 5,827,508 0 0 0 0 0 0 0 0 0 0 8,397,042
Montana 0 0 0 0 2,174,038 0 0 0 0 0 0 0 0 0 0 2,174,038
Nebraska 0 0 0 0 2,582,583 0 0 0 0 0 0 0 0 0 0 2,582,583
Nevada 1,714,426 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1,714,426
New Hampshire 0 1,681,820 0 0 0 0 0 0 0 0 0 0 0 0 0 1,681,820
New Jersey 0 0 0 3,364,577 1,774,402 0 0 0 3,451,843 1,279,897 0 0 0 0 0 9,870,719
New Mexico 0 0 0 0 0 1,681,820 0 0 0 0 0 0 0 0 0 1,681,820
New York 4,896,873 0 0 3,665,383 3,907,802 0 0 0 3,248,421 1,890,872 0 0 4,838,693 0 0 22,448,044
North Carolina 0 0 0 0 0 0 0 2,598,598 1,570,795 0 0 0 4,964,487 0 0 9,133,880
North Dakota 0 0 0 0 2,093,789 0 0 0 0 0 0 0 0 0 0 2,093,789
Ohio 2,540,827 0 0 0 3,626,982 0 5,139,841 1,396,485 0 1,338,298 0 0 1,183,133 0 0 15,225,566
Oklahoma 1,666,324 0 0 0 2,528,549 0 0 0 0 0 0 0 0 0 0 4,194,873
Oregon 0 0 0 1,734,606 3,401,378 0 0 0 0 0 0 0 0 0 0 5,135,984
Pennsylvania 3,598,767 0 1,115,521 0 2,017,637 2,046,738 0 1,726,632 4,898,591 1,154,321 0 0 1,746,032 0 0 18,304,239
Puerto Rico 1,803,784 0 0 0 2,996,610 0 0 0 0 0 0 0 0 0 0 4,800,394
Rhode Island 0 0 0 0 0 0 0 0 0 0 0 1,853,040 0 0 0 1,853,040
South Carolina 1,980,308 0 0 0 2,776,314 0 0 0 0 0 0 0 0 0 0 4,756,622
South Dakota 0 0 0 0 2,166,743 0 0 0 0 0 0 0 0 0 0 2,166,743
Tennessee 0 0 0 0 0 0 0 0 1,492,907 0 0 0 5,642,025 0 0 7,134,932
Texas 9,641,411 0 0 0 4,180,531 0 0 0 0 0 0 2,909,883 2,046,617 0 0 18,778,442
Utah 0 0 0 2,327,243 0 0 0 0 0 0 0 0 0 0 0 2,327,243
Vermont 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1,911,403 1,911,403
Virginia 2,403,638 0 0 0 852,904 2,190,413 0 0 1,928,726 0 0 0 0 0 0 7,375,681
Washington 2,551,417 0 0 0 0 1,979,046 0 0 0 0 0 0 0 0 0 4,530,463
West Virginia 0 0 0 0 959,431 0 0 0 2,965,512 0 0 0 0 0 0 3,924,943
Wisconsin 0 0 0 0 3,519,140 0 0 0 0 0 0 2,481,818 2,666,015 0 0 8,666,973
Wyoming 0 0 0 0 1,681,820 0 0 0 0 0 0 0 0 0 0 1,681,820
Total 68,381,928 5,764,441 8,495,788 16,532,027 89,259,391 10,923,781 5,139,841 13,575,740 26,200,967 8,970,339 1,512,011 25,877,295 51,793,828 2,025,293 1,911,403 336,364,073
* Based on cost per position of $9,698, with enacted minimum wage increase effective 7/24/09
Attachment A-4
U. S. Department of Labor / Employment & Training Administration
Senior Community Service Employment Program
PY 2011 Authorized Positions* for Minority National Sponsors, by State
State IID NAPCA NICOA Total
Alabama 0 0 0 0
Alaska 0 0 0 0
Arizona 0 0 135 135
Arkansas 56 0 0 56
California 0 270 69 339
Colorado 0 0 0 0
Connecticut 0 0 0 0
Delaware 0 0 0 0
District of Col 0 0 0 0
Florida 0 0 0 0
Georgia 0 0 0 0
Hawaii 0 0 0 0
Idaho 0 0 0 0
Illinois 0 69 0 69
Indiana 0 0 0 0
Iowa 0 0 0 0
Kansas 0 0 0 0
Kentucky 0 0 0 0
Louisiana 75 0 0 75
Maine 0 0 0 0
Maryland 0 0 0 0
Massachusetts 0 47 0 47
Michigan 0 0 0 0
Minnesota 0 0 21 21
Mississippi 26 0 0 26
Missouri 0 0 0 0
Montana 0 0 0 0
Nebraska 0 0 0 0
Nevada 0 0 0 0
New Hampshire 0 0 0 0
New Jersey 0 0 0 0
New Mexico 0 0 48 48
New York 0 64 0 64
North Carolina 0 0 0 0
North Dakota 0 0 0 0
Ohio 0 0 0 0
Oklahoma 0 0 142 142
Oregon 0 0 0 0
Pennsylvania 0 60 0 60
Puerto Rico 0 0 0 0
Rhode Island 0 0 0 0
South Carolina 0 0 0 0
South Dakota 0 0 32 32
Tennessee 0 0 0 0
Texas 0 62 0 62
Utah 0 0 0 0
Vermont 0 0 0 0
Virginia 0 0 0 0
Washington 0 63 0 63
West Virginia 0 0 0 0
Wisconsin 0 0 29 29
Wyoming 0 0 0 0
Total 157 635 476 1,268
* Based on cost per position of $9,698, with enacted minimum wage increase effective 7/24/09
Attachment A-5
U. S. Department of Labor / Employment & Training Administration
Senior Community Service Employment Program
PY 2011 Authorized Funding* for Minority National Sponsors, by State
State IID NAPCA NICOA Total
Alabama $0 $0 $0 $0
Alaska 0 0 0 0
Arizona 0 0 1,308,952 1,308,952
Arkansas 542,973 0 0 542,973
California 0 2,617,904 669,020 3,286,924
Colorado 0 0 0 0
Connecticut 0 0 0 0
Delaware 0 0 0 0
District of Col 0 0 0 0
Florida 0 0 0 0
Georgia 0 0 0 0
Hawaii 0 0 0 0
Idaho 0 0 0 0
Illinois 0 669,020 0 669,020
Indiana 0 0 0 0
Iowa 0 0 0 0
Kansas 0 0 0 0
Kentucky 0 0 0 0
Louisiana 727,196 0 0 727,196
Maine 0 0 0 0
Maryland 0 0 0 0
Massachusetts 0 455,709 0 455,709
Michigan 0 0 0 0
Minnesota 0 0 203,615 203,615
Mississippi 252,094 0 0 252,094
Missouri 0 0 0 0
Montana 0 0 0 0
Nebraska 0 0 0 0
Nevada 0 0 0 0
New Hampshire 0 0 0 0
New Jersey 0 0 0 0
New Mexico 0 0 465,405 465,405
New York 0 620,540 0 620,540
North Carolina 0 0 0 0
North Dakota 0 0 0 0
Ohio 0 0 0 0
Oklahoma 0 0 1,376,824 1,376,824
Oregon 0 0 0 0
Pennsylvania 0 581,756 0 581,756
Puerto Rico 0 0 0 0
Rhode Island 0 0 0 0
South Carolina 0 0 0 0
South Dakota 0 0 310,270 310,270
Tennessee 0 0 0 0
Texas 0 601,148 0 601,148
Utah 0 0 0 0
Vermont 0 0 0 0
Virginia 0 0 0 0
Washington 0 610,844 0 610,844
West Virginia 0 0 0 0
Wisconsin 0 0 281,182 281,182
Wyoming 0 0 0 0
Total 1,522,263 6,156,921 4,615,268 12,294,452
* Based on cost per position of $9,698, with enacted minimum wage increase effective 7/24/09
Official attachment PDF: https://www.dol.gov/sites/dolgov/files/ETA/advisories/TEGL/2011/TEGL25-10ATT-B.pdf
ATTACHMENT B
PROGRAM NARRATIVE INSTRUCTIONS
FOR PROGRAM YEAR 2011 FUNDS
Format: The text of the application must be double-spaced with one-inch margins at the top,
bottom, and sides. Pages must be numbered and include the applicant’s name. DOL permits the
use of graphs, maps, and tables that are properly labeled. DOL encourages applicants to use
brief topic headings for paragraphs in the text. The narrative must not exceed 20 pages in
length, excluding any attachments.
Content: All applicants must provide a narrative that covers the following areas:
Management Strategies. PY 2011 funding for SCSEP is significantly less than PY 2010
funding. Applicants should describe their management strategies to address funding reductions
in PY 2011, and how funding reductions will impact program operations and participants. This
description should include: (a) financial challenges to reducing high enrollment levels; (b) how
reduced funding will affect enrollment numbers, and how enrollment numbers will be adjusted to
new allotments; (c) how the grantee will address enrollment issues in areas of over-enrollment or
under-enrollment; (d) what methods the grantee will implement to accommodate reductions; and
(e) how the grantee will implement adjustment.
Individual Durational Limit Policy. In PY 2010, grantees received approval for one of the
following durational limit policies to take affect in PY 2011: (1) Option 1: Grantee does not offer
extensions to any participants; (2) Option 2: Grantee offers extensions to each and every
participant who meets any one of the seven waiver factors; and (3) Option 3: Grantee offers
extensions to each and every participant who meets a specific subset of the seven waiver factors.
Applicants should describe: (a) their currently-approved individual durational limit policy; (b)
whether they intend to continue with this policy; and (c) if not, which of the three options above
the applicant proposes to adopt, and the effective date of implementing this revised policy for
new and current enrollees. Please note that any new policy requires DOL approval and must
have an effective date of at least 120 days after approval is received.
Transition-Planning Activities. Applicants must provide a detailed description of their
transition services and planning process for participants who do not achieve unsubsidized
employment prior to reaching their individual durational limit. Applicants should list specific
action steps taken to ensure participants receive timely and coordinated transition planning to the
most appropriate services, and identify relevant community partners and services, including One-
Stop Career Centers.
Termination Policies. Grantees may terminate participants from SCSEP under circumstances
described in 20 C.F.R 641.580 (a)-(e). Grantees must “provide each participant at the time of
enrollment with a written copy of its policies for terminating a participant for cause or
otherwise” as described in 20 CFR 641.580 (g). Applicants must submit a copy of: (a) their
current termination policies; (b) if applicable, optional policies governing “for cause”
terminations, as permitted by sub-section d (must be approved by DOL); (c) if applicable,
1
optional termination policies “for failure to accept a reasonable number of job offers or referrals
to unsubsidized employment consistent with the Individual Employment Plan (IEP) and there are
no extenuating circumstances,” as permitted by 20 CFR 641.580 (e).
Grievance Procedures. Grantees are required by 20 C.F.R. 641.910 to establish grievance
procedures for handling applicant, participant, sub-recipient, and employee complaints.
Applicants should submit a copy of their current written grievance procedures as an attachment.
In addition, in the narrative, applicants should describe when and how the procedures are
conveyed to applicants, participants, sub-recipients, and employees.
Service to Minorities (OAA title V, section 515). Applicants must include a detailed
description of their efforts to serve minority individuals. In April 2011, applicants received an
analysis of their service to minorities for PY 2009. Using this information, and building upon
their PY 2010 grant applications, applicants should describe: (a) changes in enrollment levels or
outcomes for minority individuals during PY 2009 and PY 2010; (b) to what factors these
changes in enrollment and outcomes are attributed; and (c) what steps the applicant will take to
address any under-service to minorities or disparities in outcomes for minorities.
Organizational Structure, Monitoring, and Audits. Applicants must describe their
organizational structure:
a) Identify the grant’s key staff; briefly identify their primary responsibilities and the
amount of time they are assigned to the grant. Include an organizational chart depicting
key staff as an attachment.
b) Indicate whether the applicant has sub-recipients or local affiliates implementing the
grant.
(1) Describe the grantee’s communication strategy for ensuring that policy and
other important information is effectively transmitted to sub-recipients or
local affiliates;
(2) Identify what training the grantee provides to sub-recipient or local staff; and.
(3) Describe how the grantee ensures that policy and other important information
is communicated and implemented throughout the program area.
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Official attachment PDF: https://www.dol.gov/sites/dolgov/files/ETA/advisories/TEGL/2011/TEGL25-10ATT-C.pdf
ATTACHMENT C
PROGRAMMATIC ASSURANCES—PROGRAM YEAR 2011 GRANT
The programmatic assurances below reflect standard grant requirements that DOL has
determined are consistent with sound program practices.
Applicants, please certify that your agency or organization conforms - and will continue to
conform - to these assurances throughout the period of the grant by checking off the assurances
below. This form is designed to be filled out electronically; to check off the assurances, go to the
“View” function, choose “Toolbars,” click on the left side of “Forms,” then click on small lock.
PARTICIPANT ASSURANCES
The Applicant agrees to:
Recruitment and Selection of Participants
Developed and implements methods to recruit and select participants to assure that a
maximum number of eligible individuals are able to participate in the program.
Uses income definitions and income inclusions and exclusions for SCSEP eligibility, as
described in TEGL 12-06, to determine and document participant eligibility. (TEGL 12-
06 may be accessed at olderworkers.workforce3one.org under “Resources.”)
Developed and implements methods to recruit minority populations to ensure they are
enrolled at least in proportion to their numbers in the population in the area.
Developed and implements strategies to recruit applicants who have priority of service as
defined in OAA section 518(b)(1)-(2) and by the Jobs for Veterans Act, P.L. 107-288.
Individuals have priority who:
a) Are covered persons in accordance with the Jobs for Veterans Act (covered
persons – veterans and eligible spouses, including widows and widowers – who
are eligible for SCSEP must receive services instead of, or before, non-covered
persons);
b) Are 65 years or older;
c) Have a disability;
d) Have limited English proficiency;
e) Have low literacy skills;
f) Reside in a rural area;
g) Have low employment prospects;
h) Have failed to find employment after utilizing services provided through the One-
Stop Delivery System;
i) Are homeless or are at risk for homelessness.
Assessment
Assesses participants at least twice per 12 month period.
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Uses assessment information to determine the most appropriate community service
assignments for participants.
Individual Employment Plan (IEP)
Establishes an initial goal of unsubsidized employment for all participants.
Updates the IEP at least as frequently as assessments occur (at least twice per 12 month
period).
Modifies the IEP as necessary to reflect other approaches to self-sufficiency, if it
becomes clear that unsubsidized employment is not feasible for a participant.
For participants who will reach the individual durational limit or would not otherwise
achieve unsubsidized employment, includes provision in the IEP to transition to other
services.
Community Service Assignment (CSA)
Ensures that the initial CSA is based on the assessment done at enrollment.
Uses the IEP to determine when, if appropriate, to rotate participants through
assignments- to acquire skills necessary for unsubsidized employment.
Selects host agencies that are designated 501(c)(3) organizations or public agencies.
Ensures procedures are in place to assure adequate supervision of participants at host
agencies.
Ensures procedures are in place to ensure safe and healthy working conditions.
Recertification of Participants
Recertifies the income eligibility of each participant at least once every 12 months, or
more frequently if circumstances warrant.
Physical Examinations
Offers physical examinations to participants upon program entry, and each year
thereafter, as a benefit of enrollment.
Obtains a written waiver from each participant who declines to have a physical
examination.
Grantee does not receive a copy or use the results of the physical examination.
Host Agencies
Developed and implemented methods for recruiting new host agencies to provide a
variety of training options that will enable participants to increase their skill level and
transition to unsubsidized employment.
Maintenance of Effort: Community service assignments do not reduce the number of
employment opportunities or vacancies that would otherwise be available to individuals
who are not SCSEP participants.
2
Community service assignments do not displace currently employed workers
(including partial displacement, such as a reduction in non-overtime work, wages,
or employment benefits).
Community service assignments do not impair existing contracts or result in the
substitution of Federal funds for other funds in connection with work that would
otherwise be performed.
Community service assignments do not assign or continue to assign a participant
to perform the same work, or substantially the same work, as that performed by an
individual who is on layoff.
Orientation
Provides orientations for its participants and host agencies, including information on:
Program Overview
Project goals and objectives
Community service assignments
Training opportunities
Available supportive services
Availability of a free physical examination
Participant rights and responsibilities
Host agencies
Sub-recipients must also provide sufficient orientation to applicants and particpants,
which should include the following information:
Maximum individual duration policy, including the possibility of waiver
Termination policies
Grievance procedures
Holiday and sick leave
Grantee and local project roles, policies, and procedures
SCSEP goals and objectives
Role of supervisors and host agencies
Evaluation of participant progress
Provision of safe working environment
Annual monitoring and safety assessment
Documentation requirements
Development of Individual Employment Plans
Wages
Provides participants with the highest applicable required wage for time spent while in
orientation, training and community service assignment. The applicable wage is either
the highest of the Federal, state, or local minimum wage.
3
Participant Benefits
Provides benefits that are required by state or Federal law (such as workers’
compensation and unemployment insurance), and the costs of physical examinations.
Includes established written policies relating to compensation for scheduled work hours
during which grantee or sub-recipients are closed for Federal holidays.
Includes established written policies relating to approved breaks in participation and any
necessary sick leave that is not part of an accumulated sick leave program.
Does not use grant funds to pay the cost of pension benefits, annual leave, accumulated
sick leave, or bonuses.
Durational Limits
Maximum Average Project Duration: 27 Months
Complies with an average project duration of 27 months or less, unless DOL approves an
extension to 36 months.
Maximum Participant Duration: 48 Months
Complies with the requirement that participants may participate in the program no longer
than 48 months (whether or not consecutively) unless the grantee’s approved policy
allows for an extension of time and the participant meets the extension criteria.
Notifies participants of its policy pertaining to the maximum duration requirement,
including the possibility of a waiver, if applicable, at the time of enrollment and each
year.
Transition Services
Has a system in place to transition participants to unsubsidized employment or other
assistance before the participants’ maximum enrollment duration has expired.
Provides 30-day written notice to participants prior to durational limit exit from the
program.
Termination Procedures
Provides a 30-day written notice for all terminations that states the reason for termination
and informs the participants of grievance policies.
Written Termination Policies
Written termination policies are in effect and provided to participants at enrollment for:
Provision of false information
Incorrect initial eligibility determination
Income ineligibility determined at recertification
Participant has reached individual durational limit
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Participant has become employed while enrolled
Cause (a for-cause termination policy must be approved by the Department prior
to implementation)
IEP-related termination (an IEP termination policy must be approved by the
Department prior to implementation).
IEP terminations are based on a participant’s refusal to accept a
reasonable number of job offers or referrals to unsubsidized employment
consistent with their IEP, unless there are extenuating circumstances.
Equitable Distribution
Manages slot allotments within equitable distribution guidelines, to the extent feasible, so
that potential participants have equal access to the program.
Over-Enrollment
Manages over-enrollment to minimize impact on participants and avoid layoffs.
Administrative Systems
Ensures representation at any and all DOL-sponsored required grantee meetings.
Communicates grant policy, data collection, and performance developments and
directives to staff, sub-recipients, and local project operators on a regular basis.
Has a written monitoring tool that lists items the grantee will review during monitoring
visits, and provides this tool to sub-recipients and local project operators.
Has a monitoring schedule; notifies sub-grantees and local project operators of
monitoring plans; and monitors sub-grantees and local project operators on a regular
basis.
Provides training to increase sub-recipients’ and local project operators’ skills,
knowledge, and abilities.
When appropriate, prescribes corrective action and follow-up procedures for sub-
recipients and local project operators to ensure that identified problems are remedied.
Monitors the financial systems and expenditures of sub-recipients and local project
operators on a regular basis.
Ensures that sub-recipients and local project operators receive adequate resources to
effectively operate local projects.
Trains sub-recipients and local project operators on SCSEP financial requirements to help
them effectively manage their own expenditures, and provides more general financial
training as needed.
Ensures that all financial reports are accurate and submits them in a timely manner, as
required.
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Has a written plan in place for both disaster response and recovery so SCSEP may
continue to operate and provide services.
Collaboration and Leveraged Resources
Collaborates with other organizations to maximize opportunities for participants to obtain
workforce development, education, and supportive services to help them move into
unsubsidized employment. These organizations may include but are not limited to:
workforce investment boards, One-Stop Career Centers, vocational rehabilitation
providers, basic education and literacy providers, and community colleges.
Supportive Services
Provides supportive services, as needed, to help participants participate in their
community service assignment and to obtain and retain unsubsidized employment.
Has established criteria to assess the need for supportive services and to determine when
participants will receive supportive services, including after obtaining unsubsidized
employment.
Sub-Recipient Selection (If Applicable)
In selecting sub-recipients in areas with a substantial population of individuals with
barriers to employment, national grantees give special consideration to organizations
(including former recipients of national grants) with demonstrated expertise in serving
individuals with barriers to employment, as defined in the statute.
Complaint Resolution
Establishes and uses written grievance procedures for complaint resolution for applicants,
employees, sub-recipients, and participants.
Provides applicants, employees, sub-recipients, and participants with a copy of grievance
procedures.
Procedures for Payroll and Workers’ Compensation
Makes all required payments for participant payroll and pays workers’ compensation
premiums on a timely basis.
Ensures that host agencies do not pay workers’ compensation costs for participants.
Maintenance of Files and Privacy Information
Maintains participant files for three program years after the program year in which all
follow-up activity for a participant is completed.
Ensures that participant records are securely stored and access is limited to appropriate
staff in order to safeguard personal identifying information.
Ensures that participant medical records are securely stored separately from all other
participant records and access is limited to authorized staff for authorized purposes.
6
Has established safeguards to preclude tampering with electronic media, e.g., personal
identification numbers (PINs).
Ensures that the SCSEP national office at DOL is immediately notified in the event of
any potential security breach of personal identifying information, whether electronic files,
paper files, or equipment are involved.
Complies with, and ensures that authorized users under its grant comply with all SPARQ
access and security rules.
Documentation
Maintains documentation of waivers of physical examinations by participant.
Maintains documentation of the provision of complaint procedures to participants.
Maintains documentation of eligibility determinations and recertifications.
Maintains documentations of terminations and reasons for termination.
Maintains records of grievances and outcomes.
Maintains records required for data validation.
Data Collection and Reporting
Ensures that accurate data are submitted in a timely manner to SPARQ, as required by the
national office.
Ensures that those capturing and recoding data are familiar with the latest instructions for
data collection, including DOL administrative issuances, e.g., Older Worker Bulletins,
TEGLs, Data Collection Handbook, Data Validation Handbook, and Internet postings.
Legally obligates sub-recipients to turn over complete data files in the specified
electronic format, as well as hard copy case files, to the grantee when sub-recipients
cease to administer SCSEP.
Legally obligates new sub-recipients to enter complete data related to any participants
whom they acquire upon becoming sub-recipients, including any participants who are
still in the follow-up period.
Non-Web Data Collection System users ensure that accurate data are uploaded to SPARQ
in accordance with Department timelines and administrative guidance.
If any box(es) are not checked, information must be provided on a separate attachment
indicating what specific steps the grantee is taking to conform to those standard grant
requirement(s).
By checking the boxes above, I certify that my organization currently complies with each of
the listed requirements and will remain in compliance for the program year for which we
are submitting this application.
_____________________________________________ ______________________
Signature of Authorized Representative Date
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Official attachment PDF: https://www.dol.gov/sites/dolgov/files/ETA/advisories/TEGL/2011/TEGL25-10ATT-D.pdf
ATTACHMENT D
PROGRAM YEAR 2011 OPTIONAL SPECIAL REQUESTS
Applicants with special requests in one or more of the following areas must submit their requests
and any supporting documentation as an attachment to their PY 2011 grant applications.
Requests for approval should provide a substantive rationale, e.g., improved program
management, better service to participants, or least disruption possible to participants.
Additional Funds for Participant Training and Supportive Services – OAA, sec.
502(c)(6)(C). Any applicant that wishes to request additional funds must provide the specific
information listed in this section. Applicants requesting additional funds for participant training
and supportive services should not submit a separate budget narrative for these activities.
Instead, the detailed budget narrative in the grant application should identify the specific training
and supportive service activities that, if approved, the applicant will provide to participants. The
applicant should also include costs associated with this request in the Forms SF 424 and 424A.
The 2006 amendments to the OAA permit an exception to the 75 percent minimum level of
expenditures on participant wages and fringe benefits. This exception allows grantees to request
to use not less than 65 percent of program funds for wages, benefits, and other costs, so that up to
an additional 10 percent of funds are available for training and supportive services to directly
benefit participants. As required in section 502(C)(6)(C)(IV) of the OAA, applicants seeking
this waiver must provide a work plan that includes the following:
(a) A detailed description of the additional training and supportive services;
(b) An explanation of how activities will directly benefit participants, improve project
effectiveness, and improve employment outcomes for individuals served;
(c) A sequence and timeline for these activities;
(d) If applicable, an explanation concerning whether displacement of eligible individuals
or elimination of positions will occur, and information on the number of individuals
displaced or positions eliminated; and
(e) Which performance measures the applicant expects will improve from the
expenditure of additional funds, and the amounts by which it expects each measure to
improve.
Increase in Administrative Cost Limitations - 20 CFR 641.870. DOL may authorize an
increase in the amount available for administrative costs to not more than 15 percent if it
determines that it is necessary to carry out the project, and the applicant demonstrates that:
(a) It is incurring major administrative cost increases in necessary program components;
or
1
(b) The number of employment positions or eligible minority individuals participating in
the project will decline if administrative costs are not increased; or
(c) The project size is so small that the amount of administrative expenses incurred to
carry out the project necessarily exceeds 13.5 percent of project funding.
General statements that costs have increased do not constitute adequate justification. The
applicant must identify which costs have increased, why they have increased, and how these
costs relate to program operations.
Extension of Maximum Project Duration - OAA sec. 502 (b)(1)(C)(ii). The maximum
average project duration based on overall participation is 27 months. Applicants may request
permission from the Department to increase their maximum average project duration to 36
months.
On-the-Job Experience (OJE). If an applicant wishes to utilize OJE as an additional training
option, it must meet the requirements stipulated in Older Worker Bulletin 04-04. Applicants
must provide an OJE policy and sample contracts to DOL for approval before they can exercise
this option.
Cross-Border Agreements - 20 CFR 641.515(c). State applicants may enter into agreements to
permit cross-border enrollment of eligible participants. These agreements must cover both state
and national grantee slots, and must be submitted for approval by DOL.
2
Official attachment PDF: https://www.dol.gov/sites/dolgov/files/ETA/advisories/TEGL/2011/TEGL25-10ATT-E.pdf
ATTACHMENT E
SF-424 INSTRUCTIONS
Applicant must prepare their application using Standard Form (SF) 424 (Attachment F).
The following instructions are intended to clarify the process of completing the SF-424
grant application for SCSEP. The applicant should review the current authorizing
legislation and regulations, as well as Older Worker Bulletin (OWB) No. 00-20,
Allocation of Indirect Costs; OMB Circular A-87, Cost Principles for State, Local and
Indian Tribal Governments; and OMB Circular A-122, Cost Principles for Non-Profit
Organizations. Sufficient administrative funding must go to local levels of program
operation.
Clarifying Instructions for SF-424. Grantees must complete all required items, which
are identified with asterisks, as well as items that are noted below. If additional space is
needed to complete an item, use an additional electronic document page.
Item 1. For type of submission, check “Application.”
Item 2. For type of application, check “New.”
Item 10. For name of Federal agency, list “U.S. Department of Labor,
Employment and Training Administration”.
Item 12. This item does not need to be filled in as this is not a competitive grant.
Item 14. This item must be completed; however, it contains similar information
to that requested in the program narrative (Attachment B) under “Geographic
Areas Served.” Grantees should indicate in this box to “See attached Excel
spreadsheet” and thoroughly address this item in “Geographic Areas Served.”
Official attachment PDF: https://www.dol.gov/sites/dolgov/files/ETA/advisories/TEGL/2011/TEGL25-10ATT-F.pdf
OMB Number: 4040-0004
Expiration Date: 04/31/2012
Application for Federal Assistance SF-424 Version 02
*1. Type of Submission *2. Type of Application *If Revision, select appropriate letter(s):
Preapplication New
Application Continuation * Other (Specify)
Changed/Corrected Application Revision
*3. Date Received: 4. Application Identifier:
5a. Federal Entity Identifier: *5b. Federal Award Identifier:
State Use Only:
6. Date Received by State: 7. State Application Identifier:
8. APPLICANT INFORMATION:
* a. Legal Name:
* b. Employer/Taxpayer Identification Number (EIN/TIN): *c. Organizational DUNS:
d. Address:
*Street1:
Street 2:
*City:
County:
*State:
Province:
Country: *Zip/ Postal Code:
e. Organizational Unit:
Department Name: Division Name:
f. Name and contact information of person to be contacted on matters involving this application:
Prefix: First Name:
Midd le N a me:
*Last Name:
Suffix:
Title:
Organizational Affiliation:
*Telephone Number: Fax Number:
*Email:
OMB Number: 4040-0004
Expiration Date: 04/31/2012
Application for Federal Assistance SF-424 Version 02
9. Type of Applicant 1: Select Applicant Type:
- Select One -
Type of Applicant 2: Select Applicant Type:
- Select One -
Type of Applicant 3: Select Applicant Type:
- Select One -
*Other (specify):
*10. Name of Federal Agency:
11. Catalog of Federal Domestic Assistance Number:
CFDA Title:
*12. Funding Opportunity Number:
*Title:
13. Competition Identification Number:
Title:
14. Areas Affected by Project (Cities, Counties, States, etc.):
*15. Descriptive Title of Applicant’s Project:
Attach supporting documents as specified in agency instructions.
OMB Number: 4040-0004
Expiration Date: 04/31/2012
Application for Federal Assistance SF-424 Version 02
16. Congressional Districts Of:
*a. Applicant *b. Program/Project:
Attach an additional list of Program/Project Congressional Districts if needed.
17. Proposed Project:
*a. Start Date: *b. End Date:
18. Estimated Funding ($):
*a. Federal
*b. Applicant
*c. State
*d. Local
*e. Other
*f. Program Income
*g. TOTAL $0.00
*19. Is Application Subject to Review By State Under Executive Order 12372 Process?
a. This application was made available to the State under the Executive Order 12372 Process for review on
b. Program is subject to E.O. 12372 but has not been selected by the State for review.
c. Program is not covered by E.O. 12372
*20. Is the Applicant Delinquent On Any Federal Debt? (If “Yes”, provide explanation.)
Yes No
21. *By signing this application, I certify (1) to the statements contained in the list of certifications** and (2) that the statements
herein are true, complete and accurate to the best of my knowledge. I also provide the required assurances** and agree to comply
with any resulting terms if I accept an award. I am aware that any false, fictitious, or fraudulent statements or claims may subject
me to criminal, civil, or administrative penalties. (U.S. Code, Title 218, Section 1001)
**I AGREE
** The list of certifications and assurances, or an internet site where you may obtain this list, is contained in the announcement or
agency specific instructions.
Authorized Representative:
Prefix: *First Name:
Midd le N ame:
*Last Name:
Suffix:
*Title:
*Telephone Number: Fax Number:
*Email:
*Signature of Authorized Representative: Date Signed:
OMB Number: 4040-0004
Expiration Date: 04/31/2012
Application for Federal Assistance SF-424 Version 02
*Applicant Federal Debt Delinquency Explanation
The following field should contain an explanation if the Applicant organization is delinquent on any Federal Debt. Maximum
number of characters that can be entered is 4,000. Try and avoid extra spaces and carriage returns to maximize the availability of
space.
INSTRUCTIONS FOR THE SF-424
Public reporting burden for this collection of information is estimated to average 60 minutes per response, including time for reviewing instructions, searching
existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding the
burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the Office of Management and Budget,
Paperwork Reduction Project (0348-0043), Washington, DC 20503.
PLEASE DO NOT RETURN YOUR COMPLETED FORM TO THE OFFICE OF MANAGEMENT AND BUDGET. SEND IT TO THE ADDRESS PROVIDED
BY THE SPONSORING AGENCY.
This is a standard form (including the continuation sheet) required for use as a cover sheet for submission of preapplications and applications and
related information under discretionary programs. Some of the items are required and some are optional at the discretion of the applicant or the Federal
agency (agency). Required items are identified with an asterisk on the form and are specified in the instructions below. In addition to the instructions
provided below, applicants must consult agency instructions to determine specific requirements.
Item Entry: Item Entry:
1. Type of Submission: (Required): Select one type of submission in 10. Name Of Federal Agency: (Required) Enter the name of the
accordance with agency instructions. Federal agency from which assistance is being requested with
x Preapplication this application.
x Application
x Changed/Corrected Application – If requested by the agency, check 11. Catalog Of Federal Domestic Assistance Number/Title:
if this submission is to change or correct a previously submitted Enter the Catalog of Federal Domestic Assistance number and
application. Unless requested by the agency, applicants may not title of the program under which assistance is requested, as
use this to submit changes after the closing date. found in the program announcement, if applicable.
2. Type of Application: (Required) Select one type of application in 12. Funding Opportunity Number/Title: (Required) Enter the
accordance with agency instructions. Funding Opportunity Number and title of the opportunity under
x New – An application that is being submitted to an agency for the which assistance is requested, as found in the program
first time. announcement.
x Continuation - An extension for an additional funding/budget period 13. Competition Identification Number/Title: Enter the
for a project with a projected completion date. This can include Competition Identification Number and title of the competition
renewals. under which assistance is requested, if applicable.
x Revision - Any change in the Federal Government’s financial
obligation or contingent liability from an existing obligation. If a
revision, enter the appropriate letter(s). More than one may be
selected. If "Other" is selected, please specify in text box provided. 14. Areas Affected By Project: List the areas or entities using
A. Increase Award B. Decrease Award the categories (e.g., cities, counties, states, etc.) specified in
C. Increase Duration D. Decrease Duration agency instructions. Use the continuation sheet to enter
E. Other (specify) additional areas, if needed.
3. Date Received: Leave this field blank. This date will be assigned by the 15. Descriptive Title of Applicant’s Project: (Required) Enter a
Federal agency. brief descriptive title of the project. If appropriate, attach a
map showing project location (e.g., construction or real
4. Applicant Identifier: Enter the entity identifier assigned by the Federal property projects). For preapplications, attach a summary
agency, if any, or applicant’s control number, if applicable. description of the project.
5a Federal Entity Identifier: Enter the number assigned to your 16. Congressional Districts Of: (Required) 16a. Enter the
organization by the Federal Agency, if any. applicant’s Congressional District, and 16b. Enter all District(s)
5b. Federal Award Identifier: For new applications leave blank. For a affected by the program or project. Enter in the format: 2
continuation or revision to an existing award, enter the previously characters State Abbreviation – 3 characters District Number,
th th
assigned Federal award identifier number. If a changed/corrected e.g., CA-005 for California 5 district, CA-012 for California 12
rd
application, enter the Federal Identifier in accordance with agency district, NC-103 for North Carolina’s 103 district.
instructions. x If all congressional districts in a state are affected, enter
6. Date Received by State: Leave this field blank. This date will be “all” for the district number, e.g., MD-all for all
assigned by the State, if applicable. congressional districts in Maryland.
7. State Application Identifier: Leave this field blank. This identifier will x If nationwide, i.e. all districts within all states are affected,
be assigned by the State, if applicable. enter US-all.
x If the program/project is outside the US, enter 00-000.
8. Applicant Information: Enter the following in accordance with agency
instructions:
a. Legal Name: (Required): Enter the legal name of applicant that will 17. Proposed Project Start and End Dates: (Required) Enter the
undertake the assistance activity. This is the name that the organization proposed start date and end date of the project.
has registered with the Central Contractor Registry. Information on
registering with CCR may be obtained by visiting the Grants.gov website.
b. Employer/Taxpayer Number (EIN/TIN): (Required): Enter the
Employer or Taxpayer Identification Number (EIN or TIN) as assigned by 18. Estimated Funding: (Required) Enter the amount requested
the Internal Revenue Service. If your organization is not in the US, enter or to be contributed during the first funding/budget period by
44-4444444. each contributor. Value of in-kind contributions should be
c. Organizational DUNS: (Required) Enter the organization’s DUNS or included on appropriate lines, as applicable. If the action will
DUNS+4 number received from Dun and Bradstreet. Information on result in a dollar change to an existing award, indicate only the
obtaining a DUNS number may be obtained by visiting the Grants.gov amount of the change. For decreases, enclose the amounts in
website. parentheses.
d. Address: Enter the complete address as follows: Street address (Line
1 required), City (Required), County, State (Required, if country is US), 19. Is Application Subject to Review by State Under Executive
Province, Country (Required), Zip/Postal Code (Required, if country is Order 12372 Process? Applicants should contact the State
US). Single Point of Contact (SPOC) for Federal Executive Order
e. Organizational Unit: Enter the name of the primary organizational 12372 to determine whether the application is subject to the
unit (and department or division, if applicable) that will undertake the
assistance activity, if applicable. State intergovernmental review process. Select the
f. Name and contact information of person to be contacted on appropriate box. If “a.” is selected, enter the date the
matters involving this application: Enter the name (First and last name application was submitted to the State
required), organizational affiliation (if affiliated with an organization other
than the applicant organization), telephone number (Required), fax 20. Is the Applicant Delinquent on any Federal Debt?
number, and email address (Required) of the person to contact on (Required) Select the appropriate box. This question applies to
matters related to this application. the applicant organization, not the person who signs as the
authorized representative. Categories of debt include
delinquent audit disallowances, loans and taxes.
If yes, include an explanation on the continuation sheet.
9. Type of Applicant: (Required) 21. Authorized Representative: (Required) To be signed and
Select up to three applicant type(s) in accordance with agency dated by the authorized representative of the applicant
instructions. organization. Enter the name (First and last name required)
A. State Government M. Nonprofit with 501C3 IRS title (Required), telephone number (Required), fax number,
B. County Government Status (Other than Institution and email address (Required) of the person authorized to sign
C. City or Township Government of Higher Education) for the applicant.
D. Special District Government N. Nonprofit without 501C3 IRS A copy of the governing body’s authorization for you to sign
E. Regional Organization Status (Other than Institution this application as the official representative must be on file in
F. U.S. Territory or Possession of Higher Education) the applicant’s office. (Certain Federal agencies may require
G. Independent School District O. Private Institution of Higher that this authorization be submitted as part of the application.)
H. Public/State Controlled Education
Institution of Higher Education P. Individual
I. Indian/Native American Tribal Q. For-Profit Organization
Government (Federally (Other than Small Business)
Recognized) R. Small Business
J. Indian/Native American Tribal S. Hispanic-serving Institution
Government (Other than T. Historically Black Colleges
Federally Recognized) and Universities (HBCUs)
K. Indian/Native American U. Tribally Controlled Colleges
Tribally Designated and Universities (TCCUs)
Organization V. Alaska Native and Native
L. Public/Indian Housing Hawaiian Serving Institutions
Authority W. Non-domestic (non-US)
Entity
X. Other (specify)
Official attachment PDF: https://www.dol.gov/sites/dolgov/files/ETA/advisories/TEGL/2011/TEGL25-10ATT-G.pdf
OMB Approval No. 0348 - 0044
BUDGET INFORMATION - Non-Construction Programs
SECTION A - BUDGET SUMMARY
Grant Program Catalog of Federal
Estimated Unobligated Funds New or Revised Budget
Function Domestic Assistance
or Activity Number Federal Non-Federal Federal Non-Federal Total
(a) (b) (c) (d) (e) (f) (g)
1. SCSEP 17.235 $ $ - $ - $ - $ -
2. - - - - -
3. - - - - -
4. - - - - -
5. Totals $ - $ - $ - $ - $ -
SECTION B - BUDGET CATEGORIES
GRANT PROGRAM, FUNCTION OR ACTIVITY
6. Object Class Categories
(1) (2) (3) (4) (5)
Personnel $ - $ - $ - $ - $
a. Fringe Benefits - - - -
b. Travel - - - - -
c.
Equipment - - - - -
d.
Supplies - - - - -
e.
Contractual - - - - -
f.
Construction - - - - -
g.
Other - - - - -
h.
Total Direct Charges (sum of 6a - 6h) $ - $ - $ - $ - $ -
i.
Indirect Charges - - - - -
j.
TOTALS (sum of 6i and 6 j) $ - $ - $ - $ - $ -
k
7. Program Income $ - $ - $ - $ - $ -
Authorized for Local Reproduction
Previous Editions Usable
Budget-1
Standard Form 424A (Rev.7-97)
Prescribed by OMB Circular A-102
(a) Grant Program (b) Applicant (c) State (d) Other Sources (e) TOTALS
SECTION C - NON-FEDERAL RESOURCES
8. $ $ $ $
9.
10.
11.
12. TOTAL (sum of lines 8 - 11) $ $ $ $
SECTION D - FORECASTED CASH NEEDS
Total for 1st Year 1st Quarter 2nd Quarter 3rd Quarter 4th Quarter
13. Federal $ $ - $ - $ - $ -
14. NonFederal - - - -
15. TOTAL (sum of lines 13 and 14) $ $ $ $ $
SECTION E - BUDGET ESTIMATES FOR FEDERAL FUNDS FOR BALANCE OF THE PROJECT
(a) Grant Program FUTURE FUNDING PERIODS (Years)
(b) First (c) Second (d) Third (e) Fourth
16. SCSEP $ - $ - $ - $ -
17.
Amount of Grant Funds Remaining after first year estimates are entered: $ -
18.
Amount of Grant Funds Remaining after future funding periods are estimated: $ -
19.
20. TOTAL (sum of lines 16 - 19) $ $ $ $
SECTION F - OTHER BUDGET INFORMATION
21. Direct Charges 22. Indirect Charges
See Budget Narrative See Budget Narrative
23. Remarks
See Budget Narrative
Budget-2
Name of Grantee Organization Funding Period
to
Amount Awarded # of Months:
Object Class Category (a.): PERSONNEL
A B C D E
% of Monthly # of
Position Cost
Time Salary/Wage Months
1. $ $
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
TOTAL PERSONNEL $
Budget Narrative - PERSONNEL (Responses exceeding 250 characters should use separate sheet)
Budget - 3
Object Class Category (b.): FRINGE BENEFITS
A B C D E
Position/s Benefit/s Rate Base Amount Cost
1. $ $
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
14.
16.
17.
18.
19.
20.
21.
22.
23.
24.
25.
26.
27.
28.
29.
30.
31.
32.
33.
34.
35.
36.
37.
38.
39.
40.
TOTAL FRINGE BENEFITS $
Budget Narrative - FRINGE BENEFITS (Responses exceeding 250 characters should use separa
Budget - 4
Object Class Category (c.): TRAVEL
A B C D E F
# of # of
Item Unit Type Cost per Unit Cost
Staff Units
1. $ $
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
14.
16.
17.
18.
19.
20.
TOTAL TRAVEL $
Budget Narrative: TRAVEL (Responses exceeding 250 characters should use separate sheet)
Budget - 5
Object Class Category (d.): EQUIPMENT
(Includes equipment costing $5,000 or more and a useful life of more than one year)
A B C D
Item # of Items Cost per Item Cost
1. $ $
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
14.
16.
17.
18.
19.
20.
TOTAL EQUIPMENT $
Budget Narrative: EQUIPMENT (Responses exceeding 250 characters should use separate sheet)
Budget - 6
Object Class Category (e.): SUPPLIES
(Includes equipment costing less than $5,000)
A B C D E
# of Unit
Item Cost per Unit Cost
Units Type
1. $ $
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
14.
16.
17.
18.
19.
20.
TOTAL SUPPLIES $
Budget Narrative: SUPPLIES (Responses exceeding 250 characters should use separate sheet)
Budget - 7
Object Class Category (f.): CONTRACTUAL
A B
Brief Description Cost
1. $
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
14.
16.
17.
18.
19.
20.
TOTAL CONTRACTUAL $
Budget Narrative: CONTRACTUAL (Responses exceeding 250 characters should use separate she
Budget - 8
Object Class Category (h.): OTHER COSTS
(Including Training Expenses)
A B C D E
# of
Item Unit Type Cost per Unit Cost
Units
1. $ $
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
14.
16.
17.
18.
19.
20.
TOTAL OTHER COSTS $
Budget Narrative: OTHER COSTS (Responses exceeding 250 characters should use separate
Budget - 9
Object Class Category (i.): INDIRECT CHARGES
Choose one of the following options to apply indirect charges to the grant:
OPTION A
For grantees that have an approved Indirect Cost Rate Agreement
Federal agency that issued the agreement
What is the approved rate (%)?
What is the base against which rate is applied?
(Note: enter description as specified in the agreement)
What is the the base amount ($)?
Enter the rate (%) that will be used for this grant
Enter the amount ($) that will be used for this grant $ -
OPTION B
For grantees that DO NOT have an approved Indirect Cost Rate Agreement
Enter fixed amount ($) that will be used $ -
(Note: This will be only temporary until your Indirect Cost Rate Application is Submitted and Approved)
TOTAL INDIRECT CHARGES $
Budget Narrative - INDIRECT CHARGES (Responses exceeding 250 characters should use separate
Budget - 10
ADMINISTRATIVE COSTS
Pursuant to 20 CFR 641.867 and 641.870, grantees are advised that there is a 13.5% limitation
on administrative costs on funds administered under this grant. The Grant Officer may,
however, approve additional administrative costs up to a maximum of 15% of the total grant
award amount, if adequate justification is provided by the grantee at the time of the award. In
no event, may administrative costs exceed 15% of the total award amount. The cost of
administration shall include those activities enumerated in 20 CFR 641.853-861.
Budget Narrative - ADMINISTRATIVE COSTS
Budget - 11
Official attachment PDF: https://www.dol.gov/sites/dolgov/files/ETA/advisories/TEGL/2011/TEGL25-10ATT-H.pdf
ATTACHMENT H
PY 2011 FEDERAL PROJECT OFFICER (FPO) LIST FOR SCSEP GRANTEES
Grantee Region FPO Name Phone E-Mail
Alabama III Terri Lonowski (404) 302-5377 [email protected]
Alaska VI John Jacobs (415) 625-7940 [email protected]
Arizona VI Latha Seshadri (415) 625-7937 [email protected]
Arkansas IV Marilyn Brandenburg (972) 850-4617 [email protected]
California VI John Jacobs (415) 625-7940 [email protected]
Colorado IV Cynthia Green (972) 850-4619 [email protected]
Connecticut I Suzanne Pouliot (617) 788-0180 [email protected]
Delaware II Barbara Shelly (215) 861-5541 [email protected]
District of Columbia II Barbara Shelly (215) 861-5541 [email protected]
Florida III Brad Sickles (404) 302-5373 [email protected]
Georgia III Jessica Otieno (404) 302-5370 [email protected]
Hawaii VI Janice Shordike (415) 625-7943 [email protected]
Idaho VI John Jacobs (415) 625-7940 [email protected]
Illinois V Alice Mitchell (312) 596-5413 [email protected]
Indiana V Alice Mitchell (312) 596-5413 [email protected]
Iowa V Alice Mitchell (312) 596-5413 [email protected]
Kansas V Rochelle Bradley (312) 596-5530 [email protected]
Kentucky III Claudine Noel (404) 302-5368 [email protected]
Louisiana IV Rebecca Sarmiento (972) 850-4621 [email protected]
Maine I Keeva Davis (617) 788-0141 [email protected]
Maryland II Barbara Shelly (215) 861-5541 [email protected]
Massachusetts I Keeva Davis (617) 788-0141 [email protected]
Michigan V Alice Mitchell (312) 596-5413 [email protected]
Minnesota V Alice Mitchell (312) 596-5413 [email protected]
Mississippi III Lovie Thompson (404) 302-5379 [email protected]
Missouri V Rochelle Bradley (312) 596-5530 [email protected]
Montana IV Jesus Morales (972) 850-4616 [email protected]
Nebraska V Alice Mitchell (312) 596-5413 [email protected]
Nevada VI John Jacobs (415) 625-7940 [email protected]
New Hampshire I Keeva Davis (617) 788-0141 [email protected]
New Jersey I Keeva Davis (617) 788-0141 [email protected]
New Mexico IV Roseanna Smith (972) 850-4615 [email protected]
New York I Keeva Davis (617) 788-0141 [email protected]
North Carolina III Winston Tompoe (404) 302-5372 [email protected]
North Dakota IV Doug Harris (972) 850-4614 [email protected]
Ohio V Alice Mitchell (312) 596-5413 [email protected]
Oklahoma IV Felecia Blair (972) 850-4643 [email protected]
Oregon VI John Jacobs (415) 625-7940 [email protected]
Pennsylvania II Barbara Shelly (215) 861-5541 [email protected]
Puerto Rico I Keeva Davis (617) 788-0141 [email protected]
Rhode Island I Keeva Davis (617) 788-0141 [email protected]
South Carolina III Toni Buxton (404) 302-5367 [email protected]
South Dakota IV Bernie Cutter (972) 850-4618 [email protected]
Tennessee III Linda Lundy (404) 302-5369 [email protected]
Texas IV Kajuana Donahue (972) 850-4613 [email protected]
Utah IV Cynthia Green (972) 850-4619 [email protected]
Vermont I Keeva Davis (617) 788-0141 [email protected]
Virginia II Barbara Shelly (215) 861-5541 [email protected]
Washington VI John Jacobs (415) 625-7946 [email protected]
West Virginia II Barbara Shelly (215) 861-5541 [email protected]
Wisconsin V Alice Mitchell (312) 596-5413 [email protected]
Wyoming IV Jesus Morales (972) 850-4616 [email protected]
American Samoa VI John Jacobs (415) 625-7940 [email protected]
Guam VI John Jacobs (415) 625-7940 [email protected]
Northern Mariana Islands VI John Jacobs (415) 625-7940 [email protected]
Virgin Islands I Keeva Davis (617) 788-0141 [email protected]
AARP Foundation II Barbara Shelly (215) 861-5541 [email protected]
Asociacion Nacional Pro VI Marc Lambert (415) 625-7957 [email protected]
Personas Mayores
Easter Seals, Inc. V Lori Harris (312) 596-5496 [email protected]
Experience Works, Inc. III Eugene Caso (404) 302-5333 [email protected]
Goodwill Industries
International, Inc. II Barbara Shelly (215) 861-5541 [email protected]
Institute for Indian IV Cynthia Joseph (972) 850-4645 [email protected]
Development, Inc.
Mature Services, Inc. V Rochelle Bradley (312) 596-5530 [email protected]
National Able Network I Suzanne Pouliot (617) 788-0180 [email protected]
National Asian Pacific Center VI Karen Connor (415) 625-7962 [email protected]
on Aging
National Caucus and Center II
on Black Aged, Inc. Barbara Shelly (215) 861-5541 [email protected]
National Council on the II
Aging, Inc. Barbara Shelly (215) 861-5541 [email protected]
National Indian Council on IV Brie Burleson (972) 850-4652 [email protected]
Aging
National Urban League I Suzanne Pouliot (617) 788-0180 [email protected]
Quality Career Services, Inc. V Rochelle Bradley (312) 596-5530 [email protected]
Senior Service America, Inc. II Barbara Shelly (215) 861-5541 [email protected]
SER - Jobs for Progress IV Patricia Evans (972) 850-4644 [email protected]
National, Inc.
Vermont Associates for I Keeva Davis (617) 788-0141 [email protected]
Training and Development,
Inc.
The Workplace, Inc. I Suzanne Pouliot (617) 788-0180 [email protected]
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