Exhibit B - 2026_2027 EF Program Operator Plan.xlsx
XLSX spreadsheet 350 KB Posted
- Solicitation number
- RFP IHGA 2026000227 1
- Issued by
- Denver County, Denver City, Colorado
About this file
This file is an Employment First (EF) Program Operator Plan template for the Colorado Department of Human Services (CDHS) designed for Third-Party Partners (TPPs) seeking to operate the SNAP Employment and Training (E&T) program in Colorado for Federal Fiscal Year 2027 (October 1, 2026 – September 30, 2027). The template requires program operators to submit comprehensive plans addressing program type and funding structure, assurance statements, mission and vision alignment, service areas and caseload information, industry and employer partnerships, case management components, workfare details, work-based learning activities, supportive payments for participants, and detailed budgets. Program operators must select their organization type, identify any subcontractor agreements requiring state approval, declare non-federal funding sources available for program operations, confirm counties served, establish communication protocols with SNAP eligibility teams, prioritize target populations, identify specific occupations for training focus with projected growth data, and detail all program activities including anticipated client numbers, level of effort in hours, and estimated costs per client. The plan requires completion of all applicable tabs with supporting documentation, including assessment tools, individualized service plan templates, organizational charts for TPPs, risk assessment questionnaires, and indirect cost rate agreements where applicable.
Program operators must operate under a reimbursement model where they first expend non-federal funds on approved activities before receiving federal reimbursement of up to fifty percent of allowable costs. Third-Party Partners are subject to administrative holdback percentages applied to federal reimbursement amounts, ranging from zero percent for budgets up to $250,000 in federal reimbursement to three percent for amounts exceeding $1.5 million. Allowable direct program costs include salaries, wages, fringe benefits (maximum 22.01%), non-capital equipment under $5,000 per unit, materials, travel, subsidized work-based learning wages, and contractual costs. Indirect costs may be claimed using either a de minimis rate of fifteen percent or a federally negotiated indirect cost rate, with supporting documentation required. Participant reimbursements (supportive payments) covering expenses such as childcare ($12,000 annual limit), transportation ($1,500 limit), tuition and training fees ($12,000 limit), and various other necessary expenses are detailed with state-established annual per-client limits. Program operators must track performance outcomes including unique clients served, employment gains, median wages, training completion, skill attainment, job retention, ABAWD work requirement compliance, and administrative and participant reimbursement expenditure rates, with targets of seventy-five percent achievement across most metrics. All data entry must be completed in the Colorado Benefits Management System (CBMS) by the sixth of the month following service delivery.
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Table of Contents Program Operator Name Federal Fiscal Year 2027, Version 1 Request for Proposals (RFP) Exhibit B
In Colorado, the SNAP Employment and Training (SNAP E&T) E&T program, known as Employment First (EF), has operated in the CDHS since the program’s inception in 1985 and helps SNAP recipients and applicants in Colorado connect to meaningful employment and succeed in the pursuit of economic well-being.
Employment First Program operators are required to submit a Program Operator Plan to CDHS for review and approval on an annual basis, as outlined in 10 CCR 2506-1 Rule Manual Volume 4.312.1. Plans must adhere to all applicable rules and regulations and may be locally tailored to meet specific community needs and utilize available community partnerships. Program plans are consolidated into a unified EF Colorado State plan, which is submitted to the USDA Food and Nutrition Services annually for review and approval.
| Program Operator Plan Sections | Completed | Not Offering |
| Tab 1: Program Type and Funding | FALSE | FALSE |
| Tab 2: Assurance Statements | FALSE | FALSE |
| Tab 3: Mission, Vision, and Partnerships | FALSE | FALSE |
| Tab 4: Areas Served and Caseload Information | FALSE | FALSE |
| Tab 5: Industry and Employer Partnerships | FALSE | FALSE |
| Tab 6: Components & Case Management | FALSE | FALSE |
| Tab 7: Workfare | FALSE | FALSE |
| Tab 8: Workbased Learning | FALSE | FALSE |
| Tab 9: Supportive Payments | FALSE | FALSE |
| Tab 10: Budget (County) | FALSE | FALSE |
| Tab 10: Budget (TPP) | FALSE | FALSE |
| Additional Supporting Documentation | Provided | Not Provided |
| Copy of the Initial Assessment tool (if different than the EF Comprehensive Assessment) | FALSE | FALSE |
| Copy of the Individualized Service Plan tool (if different than the EF Individualized Service Plan) | FALSE | FALSE |
| Copy of the Organizational Chart (with names & job titles, TPPs only) | FALSE | FALSE |
| Copy of the CDHS Non-county Subrecipient Risk Assessment Questionnaire (TPPs only) | FALSE | FALSE |
| Copy of Federally Negotiated Indirect Cost Rate Agreement (if applicable) | FALSE | FALSE |
| Signature Page Signed (after EF PO Plan approval) | FALSE | FALSE |
https://docs.google.com/document/d/1-D2HN7zHfro8ZsuivuziVsxscCiCQgNxqS6Q-VaqZWY/edit?tab=t.0 Tab 1 Program Operator Name
Tab 1: Program Type and Funding
| Program Operator Contact Information | ||
| Fiscal Manager: | Phone: | Email: |
| Director: | Phone: | Email: |
| Plan Preparer: | Phone: | Email: |
Program Operator Type, Agreements, Funding Sources, and Cost Allocation Plan (please complete rows 15 - 45)
Program Operator Type: As an Employment First program operator, your agency will receive funding for the federal fiscal year (October 1–September 30) to run the program. You may either contract directly with a subcontractor or partner with one to provide employment and training services. Select your organization type from the dropdown in column A. If you're a Third-Party Partner or working with a subcontractor, additional procurement rules apply.
| Does the program operator plan to enter into subcontractor agreements? | If your agency plans to work with any subcontractors or share EF federal funding with them this federal fiscal year, please include their names and a summary of the contract. All subcontractor agreements need to be approved by the State EF team before you can start working together. | |
| Subcontractor Name: | Type: | |
| Summary of contract/partnership: |
| Subcontractor Name: | Type: |
| Summary of contract/partnership: |
| Does your agency have upfront, stable, and/or consistent non-federal funding sources to contribute to program operations? | Employment First is a reimbursement program. This means the program operator must first spend non-federal money on approved activities and allowable costs. After that, the Colorado Department of Human Services (CDHS) can reimburse up to 50% of allowable costs. To be reimbursed, the program operator must follow the rules in this plan and the Statement of Work (which align with federal and state program regulations), and retain records of all spending. | ||
| Please add any all funding sources your agency has available for the FFY to the table below. | |||
| Funding Source Type | Dollar Amount | Name of Non-federal Funding Source |
TOTAL: $0.00
| Administrative Holdback Percentage (Only for Third-Party Partners): This rule doesn’t apply to county human services departments. |
| To help cover state-level oversight and program management, the Colorado Department of Human Services keeps a small percentage of a Third-Party Partner’s federal reimbursement. The percentage held back is based on how much the partner is getting in federal reimbursement—not their total budget. For example, if a Third-Party Partner has a $1,000,000 budget for Employment First and is getting $500,000 in federal reimbursement, they fall into the 1% holdback category. See the table below for details. |
| Total Budget (All non-federal sources + federal reimbursement) | Federal Reimbursement Amount | Holdback Percent |
| Up to $500,000 | Up to $250,000 | 0% |
| $500,000.01 - 1,500,000 | $250,00.01 - $750,000 | 1% |
| 1,500,000.01 - $3,000,000 | $750,000.01 - $1,500,000 | 2% |
| 3,000,000.01 and higher | $1,500,000.01 and higher | 3% |
Select the amount of your total budget for the program year:
Stop Here! You've completed this section. Next up, Tab 2: Assurance Statements - please read through the assurances carefully and check all the required boxes once you've reviewed them.
Tab 2 Program Operator Name
Tab 2: Assurance Statements
| Program Operator Contact Information | |||||
| Fiscal Manager: | 0 | Phone: | 0 | Email: | 0 |
| Director: | 0 | Phone: | 0 | Email: | 0 |
| Plan Preparer: | 0 | Phone: | 0 | Email: | 0 |
| Program Operator Assurance Statements | |
| Check the box next to each statement to show that you have read and understand it. | |
| FALSE | I. The EF PO is accountable for the content and implementation of the EF PO plan and will provide oversight of any sub-contractors. |
| FALSE | II. The EF PO is fiscally responsible for EF activities funded under the plan, will adhere to the costs outlined within this plan, and is liable for repayment for any unallowable costs. |
| FALSE | III. County or TPP education costs will not be supplanted with Federal E&T funds. |
| FALSE | IV. Cash or in-kind donations from other non-Federal sources have not been claimed or used as a match or reimbursement under any other Federal program. |
| FALSE | V. If in-kind goods and services are part of the budget, only public, in-kind services are included. There are no private, in-kind goods or services claimed. |
| FALSE | VI. Documentation of EF PO costs, payments, and donations for approved Employment First activities are maintained by the EF PO and available for internal, State, and federal review and audit. |
| FALSE | VII. Contracts are procured through appropriate procedures governed by the EF PO or State procurement regulations. |
| FALSE | VIII. Program activities are conducted in compliance with all applicable Federal laws, rules, and regulations, including Civil Rights and Office of Management and Budget (OMB) regulations governing cost issues. |
| FALSE | IX. E&T education activities directly enhance the employability of the clients; there is a direct link between education activities and job readiness. |
| FALSE | X. Program activities and expenses are reasonable and necessary to accomplish the goals and objectives of SNAP E&T. |
| FALSE | XI. The local EF program is implemented in a manner that is responsive to the special needs of American Indians on Reservations. The agency shall: consult on an ongoing basis about portions of the EF PO plan which affect them; submit for comment all portions of the EF PO plan that affect the ITO; if appropriate and to the extent practicable, include ITO suggestions in the EF PO plan. (This is for agencies who operate within counties with Indian Reservations only.) |
| FALSE | XII. Consistent and stable non-federal funding is available for total program costs throughout the year. |
| FALSE | XIII. EF PO staff responsible for service delivery, oversight, and fiscal processes have read and understand the Employment First Program Operator Handbook and attachments. |
| FALSE | XIV. The EF PO is responsible for ensuring timely and accurate data entry into the Employment First’s system of record, the Colorado Benefits Management System (CBMS), on all the Employment First related pages, screens, and fields. |
Stop Here! You've completed this section. Next up, Tab 3: Program Design - please add your agency's mission and vision, and partner organizations
Tab 3 Program Operator Name
Tab 3: Mission, Vision, and Partnerships
| Program Operator Contact Information | |||||
| Fiscal Manager: | 0 | Phone: | 0 | Email: | 0 |
| Director: | 0 | Phone: | 0 | Email: | 0 |
| Plan Preparer: | 0 | Phone: | 0 | Email: | 0 |
Vision Statement
Mission Statement
| Partnerships: To run a strong program, it's important to team up with local organizations. These might include schools, job centers, businesses, or industry groups. Please tell us which organizations you plan to work with this year. You don’t need to list any agencies you’ve hired as subcontractors. | ||
| Organization/Entity Name: | Organization/Entity Type: | Explanation: |
Stop Here! You've completed this section. Next up, Tab 4: Areas Served and Caseload Information - please identify the areas you plan to serve, your partnership and communication strategies with the county department's SNAP eligibility team, and the populations you plan to prioritize.
Tab 4 Program Operator Name
Tab 4: Areas Served and Caseload Information
| Program Operator Contact Information | |||||
| Fiscal Manager: | 0 | Phone: | 0 | Email: | 0 |
| Director: | 0 | Phone: | 0 | Email: | 0 |
| Plan Preparer: | 0 | Phone: | 0 | Email: | 0 |
| Counties Served |
| Please select the counties your agency plans to serve (which counties do your clients reside in): |
| Partnership with County Department of Human Services SNAP Eligibility Teams |
| Please describe the communication process (email, phone, form, etc.) your agency uses to contact SNAP eligibility teams. Please describe your processes for communicating with SNAP eligiblity teams when: |
| a) your program is full, |
b) when your team makes a Provider Determination, and
c) when a client might have an exemption to the work requirement.
| Caseload Information |
| What is your anticipated clients served (i.e. caseload size) for the 2027 federal fiscal year? |
| Please provide a narrative and justification on how your organization determinied the number clients to be served. Please also add a narrative and justification on the cost per client calculated on Tab 10) |
| What is the main population your agency plans to serve (over 50% of your caseload)? | ||
| Please select and rank how you will prioritize the populations that you serve in the table below: | ||
| Population | Plan to Serve | Priority Ranking |
| Able-Bodied Adults without Dependents (ABAWDs) | ||
| English language learners | ||
| Individuals experiencing homelessness | ||
| Individuals who are underemployed | ||
| Individuals who are unemployed | ||
| Individuals who need a credential or new skill to obtain employment | ||
| Individuals who need a high school diploma or GED | ||
| Individuals who reside in rural areas | ||
| Individuals with disabilities | ||
| Returning citizens (also known as ex-offenders) | ||
| Single Parents | ||
| Students | ||
| Veterans | ||
| Other (please specify in the yellow text box below): |
Stop Here! You've completed this section. Next up, Tab 5: Industry and Employer Partnerships.
Tab 5 Program Operator Name
Tab 5: Industry and Employer Partnerships
| Program Operator Contact Information | |||||
| Fiscal Manager: | 0 | Phone: | 0 | Email: | 0 |
| Director: | 0 | Phone: | 0 | Email: | 0 |
| Plan Preparer: | 0 | Phone: | 0 | Email: | 0 |
| Industry Partnerships |
| Please check each NAICS industry sector in the list below you will focus on throughout the program year. Please add any employer partnerships you have within the industry to support training, workbased learning or employment placements. |
| Colorado's Top Industries: | ||||
| Please select the industries your agency partners with: | NAICS Industry Sector Offered | Employer Partnerships | ||
| Construction (23) | FALSE | |||
| Manufacturing (31-33) | FALSE | |||
| Retail Trade (44-45) | FALSE | |||
| Professional, Scientific, and Technical Services (54) | FALSE | |||
| Administrative Support & Waste Management Services (56) | FALSE | |||
| Educational Services (61) | FALSE | |||
| Healthcare and Social Assistance (62) | FALSE | |||
| Accommodation and Food Service (72) | FALSE | |||
| Public Administration (92) | FALSE | |||
| Other Services (except Public Administration) (81) | FALSE | |||
| All other industries: | ||||
| Please select the industries your agency partners with: | NAICS Industry Sector Offered | Employer Partnerships | ||
| Agriculture, Forestry, Fishing and Hunting (11) | FALSE | |||
| Mining, Quarrying, and Oil and Gas Extraction (21) | FALSE | |||
| Utilities (22) | FALSE | |||
| Wholesale Trade (42) | FALSE | |||
| Transportation and Warehousing (48-49) | FALSE | |||
| Information (51) | FALSE | |||
| Finance and Insurance (52) | FALSE | |||
| Real Estate and Rental and Leasing (53) | FALSE | |||
| Management of Companies and Enterprises (55) | FALSE | |||
| Arts, Entertainment, and Recreation (71) | FALSE |
| Occupations of Focus Details |
| What are the primary occupations your agency focuses on for training, work-based learning and employment placement (i.e. Flagging, Certified Nursing Assistants, etc.)? Please list the top five main occupations, and provide the projected growth and partnerships used to ensure successful training or employment placement. |
Occupation Projected Growth (ONET) Partnership or Strategy that supports training and employment outcomes
Stop Here! You've completed this section. Next up, Tab 6: Components & Case Management.
https://www.census.gov/naics/?58967?yearbck=2022https://www.onetcodeconnector.org/ Tab 6 Program Operator Name
Tab 6: Components & Case Management
| Program Operator Contact Information | |||||
| Fiscal Manager: | 0 | Phone: | 0 | Email: | 0 |
| Director: | 0 | Phone: | 0 | Email: | 0 |
| Plan Preparer: | 0 | Phone: | 0 | Email: | 0 |
| Case Management |
| All clients must receive case management services at least once a month. Case management services include comprehensive assessments, individualized service plans (ISPs), progress monitoring (monthly check-ins), and coordination with and referrals to other service providers. |
| Please describe how your agency provides each service of case management within the required timeframes | Comprehensive assessments - must be completed annually: | |||
| FALSE | The State provided EF Comprehensive Assessment will be used (do not need to provide a copy) | FALSE | Another assessment will be used |
(must provide a copy for approval)
| Individualized Service Plans (ISPs) - must be completed every 120 days (reviewed monthly): | |||
| FALSE | The State provided EF Individualized Service Plan will be used (do not need to provide a copy) | FALSE | Another individualized plan will be used |
(must provide a copy for approval)
Progress Monitoring (monthly check-ins) - must be completed or attempted monthly:
Coordination and Referrals to other Service Providers - must be completed as needed or during Progress Monitoring:
| Components (Program Activities) Offered |
| Please review the list and definitions on the Employment First Activities section within the FFY2026 EF Program Operator Handbook.pdf and select the activity your agency offers. Please provide the anticipated number of clients, the anticipated number of hours to be spent in the component, known as Level of Effort (LOE), and the estimated cost per client for each component (this information is required for the State Plan). |
| Education/Training Activities | Program Activity | Offered | # of Clients | LOE/ month | Cost per Client | |
| GED Prep and Testing | ||||||
| Adult Basic Education | ||||||
| Literacy Instruction | ||||||
| Post-Secondary Education | ||||||
| Career/Technical/Vocational | ||||||
| English Language Acquisition | ||||||
| Job Search Assistance & Workfare Activities | Self-Employment Training | |||||
| Supervised Job Search | ||||||
| Workfare: Interim Activity (up to 30 days) | Please go to Tab 7 to provide more details on each of the workfare sites and their activities being offered. | |||||
| Workfare: Job Path (up to 30 days) | ||||||
| Workfare: Placement (up to 12 months) | ||||||
| Employability | Work Readiness Training | |||||
| Financial Literacy | ||||||
| Digital Literacy | ||||||
| Subsidized Work-based Learning | Apprenticeship | Please go to Tab 8 to provide more details on each of the subsidized work-based learning activities being offered. | ||||
| Internship | ||||||
| Pre-apprenticeship | ||||||
| Transitional Job | ||||||
| Unsubsidized Work-based Learning | Apprenticeship | Please go to Tab 8 to provide more details on each of the subsidized work-based learning activities being offered. | ||||
| Internship | ||||||
| On-the-Job Training | ||||||
| Pre-apprenticeship | ||||||
| Transitional Job | ||||||
| Job Retention, select one option | ||||||
| (must be offered for at least 30 days and at most, 1 year) | Up to 30 Days | |||||
| 31 days to 3 months | ||||||
| 3 months to 6 months | ||||||
| 6 months to 9 months | ||||||
| 9 months to 12 months |
| Data Entry |
| Please provide a summary of how your agency ensures case management and program activity details, including the level of effort and actual hours spent in the activity are entered into CBMS. |
By checking this box, your agency is aware that data entry for case management and program activites must be entered into CBMS by the 6th of the month following the month of client engagement. FALSE
Stop Here! You've completed this section. Next up, Tab 7: Workfare. If your agency does not plan to offer Workfare, please skip to Tab 8. If your agency will offer Workfare, please provide Workfare site details and selct which pathway they plan to offer.
https://drive.google.com/file/d/16NBcJVrf5IuqM11wlDL7SGhaZhU1NaPK/view?usp=sharing Tab 7 Program Operator Name
Tab 7: Workfare Site Details
| Program Operator Contact Information | |||||
| Fiscal Manager: | 0 | Phone: | 0 | Email: | 0 |
| Director: | 0 | Phone: | 0 | Email: | 0 |
| Plan Preparer: | 0 | Phone: | 0 | Email: | 0 |
| Workfare Sites |
| Please provide details for each of the workfare sites you have agreements with. The cells in the row should appear yellow if a Site Name is provided. The cells in column A should appear with a "N/A" if "No" was selected for the workfare on Tab 6. |
Site Name Site Address Site Contact Person Name Site Contact Telephone Site Contact Email Website Which Workfare Pathway Will Be Offered Number of participants that the Sponsor can properly utilize Types of jobs available with Sponsor for participants (include hyperlinks or copies of work assignment). If a participant demonstrates ability and desire, is there a possibility of employment with the Sponsor? Is your Workfare Site listed on 2-1-1? (This is optional) Workfare Program Agreement Effective Date
Number of Workfare Sites: 0 Number of Participants: 0
| Data Entry | |
| By checking this box, your agency is aware that data entry for case management and program activites, including Workfare, must be entered into CBMS by the 6th of the month following the month of client engagement. | FALSE |
Stop Here! You've completed this section. Next up, Tab 8: Subsidized and Unsubsidized Work-based Learning (WBL). If your agency does not plan to offer WBL, please skip to Tab 9. If your agency will offer WBL, please provide WBL details and selct which activities you plan to offer.
Tab 8 Program Operator Name
Tab 8: Subsidized and Unsubsidized Work-based Learning
| Program Operator Contact Information | |||||
| Fiscal Manager: | 0 | Phone: | 0 | Email: | 0 |
| Director: | 0 | Phone: | 0 | Email: | 0 |
| Plan Preparer: | 0 | Phone: | 0 | Email: | 0 |
| Subsidized Work-based Learning |
| Please anwer all the questions for each of the subsidized work-based learning activities you plan to offer. The cells should appear yellow if "Yes" was selected for the activity on Tab 6. The cells should appear with a "N/A" if "No" was selected for the activity on Tab 6. |
| Apprenticeship |
| What is the length of the activity? |
| What is the industry field of the activity? |
| Describe the "Other" industry field of the activity. |
| What are the training objectives for the activity? |
| Will the participants interact with industry professionals in a real-world setting? |
| What is the source for the non-federal share of the SWBL activity? |
| Were employers or industry sector representatives consulted in the design and training curriculum? |
| Does the provider use a curriculum that includes career-training objectives that the participant is expected to learn and be able to do by the completion of the training? |
| Are employers or industry professionals involved in the development and/or execution of the training element of the activity? |
| Are the training objectives provided to the participant? |
| Is there a process for the provider/employer of record to give feedback to the participant on their progress toward meeting the training objective? |
| Does the work site employer or other industry employer partners hire the majority of the activity graduates? |
| Are participant reimbursements/support services provided to SNAP E&T participants for expenses that are reasonable, necessary and directly related to participating in the activity? |
| Provide a brief explanation that describes how the provider focuses on moving participants promptly into regular, unsubsidized employment. |
| What is the hourly wage rate? | What percentage of wages will be subsidized by SNAP E&T? |
| Indicate the total number of hours that an individual is expected to participate. | Indicate the SNAP E&T funding source to be used. |
| Will the WBL program cover other costs associated with wages, such as Workers Compensation or Payroll Taxes? | What is the total amount of Workers Compensation or Payroll Taxes that is covered or reimbursed by SNAP E&T? |
| What is the total amount of other administrative costs associated with the activity that is covered or reimbursed by SNAP E&T, such as additional case management hours? | |
| Internship | |
| What is the length of the activity? | |
| What is the industry field of the activity? | |
| Describe the "Other" industry field of the activity. | |
| What are the training objectives for the activity? | |
| Will the participants interact with industry professionals in a real-world setting? | |
| What is the source for the non-federal share of the SWBL activity? | |
| Were employers or industry sector representatives consulted in the design and training curriculum? | |
| Does the provider use a curriculum that includes career-training objectives that the participant is expected to learn and be able to do by the completion of the training? | |
| Are employers or industry professionals involved in the development and/or execution of the training element of the activity? | |
| Are the training objectives provided to the participant? | |
| Is there a process for the provider/employer of record to give feedback to the participant on their progress toward meeting the training objective? | |
| Does the work site employer or other industry employer partners hire the majority of the activity graduates? | |
| Are participant reimbursements/support services provided to SNAP E&T participants for expenses that are reasonable, necessary and directly related to participating in the activity? | |
| Provide a brief explanation that describes how the provider focuses on moving participants promptly into regular, unsubsidized employment. |
| What is the hourly wage rate? | What percentage of wages will be subsidized by SNAP E&T? |
| Indicate the total number of hours that an individual is expected to participate. | Indicate the SNAP E&T funding source to be used. |
| Will the WBL program cover other costs associated with wages, such as Workers Compensation or Payroll Taxes? | What is the total amount of Workers Compensation or Payroll Taxes that is covered or reimbursed by SNAP E&T? |
| What is the total amount of other administrative costs associated with the activity that is covered or reimbursed by SNAP E&T, such as additional case management hours? | |
| Pre-apprenticeship | |
| What is the length of the activity? | |
| What is the industry field of the activity? | |
| Describe the "Other" industry field of the activity. | |
| What are the training objectives for the activity? | |
| Will the participants interact with industry professionals in a real-world setting? | |
| What is the source for the non-federal share of the SWBL activity? | |
| Were employers or industry sector representatives consulted in the design and training curriculum? | |
| Does the provider use a curriculum that includes career-training objectives that the participant is expected to learn and be able to do by the completion of the training? | |
| Are employers or industry professionals involved in the development and/or execution of the training element of the activity? | |
| Are the training objectives provided to the participant? | |
| Is there a process for the provider/employer of record to give feedback to the participant on their progress toward meeting the training objective? | |
| Does the work site employer or other industry employer partners hire the majority of the activity graduates? | |
| Are participant reimbursements/support services provided to SNAP E&T participants for expenses that are reasonable, necessary and directly related to participating in the activity? | |
| Provide a brief explanation that describes how the provider focuses on moving participants promptly into regular, unsubsidized employment. |
| What is the hourly wage rate? | What percentage of wages will be subsidized by SNAP E&T? |
| Indicate the total number of hours that an individual is expected to participate. | Indicate the SNAP E&T funding source to be used. |
| Will the WBL program cover other costs associated with wages, such as Workers Compensation or Payroll Taxes? | What is the total amount of Workers Compensation or Payroll Taxes that is covered or reimbursed by SNAP E&T? |
| What is the total amount of other administrative costs associated with the activity that is covered or reimbursed by SNAP E&T, such as additional case management hours? | |
| Transitional Job | |
| What is the length of the activity? | |
| What is the industry field of the activity? | |
| Describe the "Other" industry field of the activity. | |
| What are the training objectives for the activity? | |
| Will the participants interact with industry professionals in a real-world setting? | |
| What is the source for the non-federal share of the SWBL activity? | |
| Were employers or industry sector representatives consulted in the design and training curriculum? | |
| Does the provider use a curriculum that includes career-training objectives that the participant is expected to learn and be able to do by the completion of the training? | |
| Are employers or industry professionals involved in the development and/or execution of the training element of the activity? | |
| Are the training objectives provided to the participant? | |
| Is there a process for the provider/employer of record to give feedback to the participant on their progress toward meeting the training objective? | |
| Does the work site employer or other industry employer partners hire the majority of the activity graduates? | |
| Are participant reimbursements/support services provided to SNAP E&T participants for expenses that are reasonable, necessary and directly related to participating in the activity? | |
| Provide a brief explanation that describes how the provider focuses on moving participants promptly into regular, unsubsidized employment. |
| What is the hourly wage rate? | What percentage of wages will be subsidized by SNAP E&T? |
| Indicate the total number of hours that an individual is expected to participate. | Indicate the SNAP E&T funding source to be used. |
| Will the WBL program cover other costs associated with wages, such as Workers Compensation or Payroll Taxes? | What is the total amount of Workers Compensation or Payroll Taxes that is covered or reimbursed by SNAP E&T? |
| What is the total amount of other administrative costs associated with the activity that is covered or reimbursed by SNAP E&T, such as additional case management hours? |
| Unsubsidized Work-based Learning |
| Please anwer all the questions for each of the unsubsidized work-based learning activities you plan to offer. The cells should appear yellow if "Yes" was selected for the activity on Tab 6. The cells should appear with a "N/A" if "No" was selected for the activity on Tab 6. |
| Apprenticeship |
| What is the length of the activity? |
| What is the industry field of the activity? |
| Describe the "Other" industry field of the activity. |
| What are the training objectives for the activity? |
| Will the participants interact with industry professionals in a real-world setting? |
| Will participants receive wages subsidized by another program? |
| Were employers or industry sector representatives consulted in the design and training curriculum? |
| Does the provider use a curriculum that includes career-training objectives that the participant is expected to learn and be able to do by the completion of the training? |
| Are employers or industry professionals involved in the development and/or execution of the training element of the activity? |
| Are the training objectives provided to the participant? |
| Is there a process for the provider/employer of record to give feedback to the participant on their progress toward meeting the training objective? |
| Does the work site employer or other industry employer partners hire the majority of the activity graduates? |
| Are participant reimbursements/support services provided to SNAP E&T participants for expenses that are reasonable, necessary and directly related to participating in the activity? |
| Provide a brief explanation that describes how the provider focuses on moving participants promptly into regular, unsubsidized employment. |
| Internship |
| What is the length of the activity? |
| What is the industry field of the activity? |
| Describe the "Other" industry field of the activity. |
| What are the training objectives for the activity? |
| Will the participants interact with industry professionals in a real-world setting? |
| Will participants receive wages subsidized by another program? |
| Were employers or industry sector representatives consulted in the design and training curriculum? |
| Does the provider use a curriculum that includes career-training objectives that the participant is expected to learn and be able to do by the completion of the training? |
| Are employers or industry professionals involved in the development and/or execution of the training element of the activity? |
| Are the training objectives provided to the participant? |
| Is there a process for the provider/employer of record to give feedback to the participant on their progress toward meeting the training objective? |
| Does the work site employer or other industry employer partners hire the majority of the activity graduates? |
| Are participant reimbursements/support services provided to SNAP E&T participants for expenses that are reasonable, necessary and directly related to participating in the activity? |
| Provide a brief explanation that describes how the provider focuses on moving participants promptly into regular, unsubsidized employment. |
| On-the-Job Training |
| What is the length of the activity? |
| What is the industry field of the activity? |
| Describe the "Other" industry field of the activity. |
| What are the training objectives for the activity? |
| Will the participants interact with industry professionals in a real-world setting? |
| Will participants receive wages subsidized by another program? |
| Were employers or industry sector representatives consulted in the design and training curriculum? |
| Does the provider use a curriculum that includes career-training objectives that the participant is expected to learn and be able to do by the completion of the training? |
| Are employers or industry professionals involved in the development and/or execution of the training element of the activity? |
| Are the training objectives provided to the participant? |
| Is there a process for the provider/employer of record to give feedback to the participant on their progress toward meeting the training objective? |
| Does the work site employer or other industry employer partners hire the majority of the activity graduates? |
| Are participant reimbursements/support services provided to SNAP E&T participants for expenses that are reasonable, necessary and directly related to participating in the activity? |
| Provide a brief explanation that describes how the provider focuses on moving participants promptly into regular, unsubsidized employment. |
| Pre-apprenticeship |
| What is the length of the activity? |
| What is the industry field of the activity? |
| Describe the "Other" industry field of the activity. |
| What are the training objectives for the activity? |
| Will the participants interact with industry professionals in a real-world setting? |
| Will participants receive wages subsidized by another program? |
| Were employers or industry sector representatives consulted in the design and training curriculum? |
| Does the provider use a curriculum that includes career-training objectives that the participant is expected to learn and be able to do by the completion of the training? |
| Are employers or industry professionals involved in the development and/or execution of the training element of the activity? |
| Are the training objectives provided to the participant? |
| Is there a process for the provider/employer of record to give feedback to the participant on their progress toward meeting the training objective? |
| Does the work site employer or other industry employer partners hire the majority of the activity graduates? |
| Are participant reimbursements/support services provided to SNAP E&T participants for expenses that are reasonable, necessary and directly related to participating in the activity? |
| Provide a brief explanation that describes how the provider focuses on moving participants promptly into regular, unsubsidized employment. |
| Transitional Job |
| What is the length of the activity? |
| What is the industry field of the activity? |
| Describe the "Other" industry field of the activity. |
| What are the training objectives for the activity? |
| Will the participants interact with industry professionals in a real-world setting? |
| Will participants receive wages subsidized by another program? |
| Were employers or industry sector representatives consulted in the design and training curriculum? |
| Does the provider use a curriculum that includes career-training objectives that the participant is expected to learn and be able to do by the completion of the training? |
| Are employers or industry professionals involved in the development and/or execution of the training element of the activity? |
| Are the training objectives provided to the participant? |
| Is there a process for the provider/employer of record to give feedback to the participant on their progress toward meeting the training objective? |
| Does the work site employer or other industry employer partners hire the majority of the activity graduates? |
| Are participant reimbursements/support services provided to SNAP E&T participants for expenses that are reasonable, necessary and directly related to participating in the activity? |
| Provide a brief explanation that describes how the provider focuses on moving participants promptly into regular, unsubsidized employment. |
| Data Entry | |
| By checking this box, your agency is aware that data entry for case management and all WBL activites must be entered into CBMS by the 6th of the month following the month of client engagement. | FALSE |
Stop Here! You've completed this section. Next up, Tab 8: Participant Reimbursements (also known as supportive services).
Tab 9 Program Operator Name
Tab 9: Supportive Payments
| Program Operator Contact Information | |||||
| Fiscal Manager: | 0 | Phone: | 0 | Email: | 0 |
| Director: | 0 | Phone: | 0 | Email: | 0 |
| Plan Preparer: | 0 | Phone: | 0 | Email: | 0 |
| Participant Reimbursements |
| Participant reimbursements (known as Supportive Payments) help cover the out-of-pocket costs that clients may face while participating in EF. These can include expenses like child care, transportation, tools, books, test fees, uniforms, etc. All Supportive Payments must be reasonable and necessary for the client to engage in the program, a program activity, or employment. In the table below, select the Supportive Payments your agency plans to offer and enter the number of available. Reimbursement for supportive payments is dependent on proper data entry and documentation/justification for the expense. |
| Please complete all columns for each supportive service(s) being offered to clients. | |||||
| Participant reimbursement | |||||
| (supportive service) | Method of Disbursement | Clients Served | State's Annual Cost per Client Limit | Does your agency's annual cost per client limit exceed the State's? If yes, please provide the limit. | |
| Childcare (Dependent Care) | $12,000.00 | ||||
| Automobile Repairs (AR) | $3,500.00 | ||||
| Background Checks/Drug Test/Fingerprinting needed for employment or training (BDF) | $500.00 | ||||
| Cell phone bill (CPB) | $100.00 | ||||
| Clothing for job interviews/required for a job/uniforms (CL) | $500.00 | ||||
| Course/ registration fees/student activities fees (RF) | $1,000.00 | ||||
| School supplies/books (SS) | $3,500.00 | ||||
| Equipment for work/ Personal safety items (PSI) | $1,000.00 | ||||
| Personal hygiene items (PHI) | $500.00 | ||||
| Housing assistance (HA) | $3,500.00 | ||||
| Internet services (IS) | $200.00 | ||||
| Laptops/Computers/Tablets/Phones (LCT) | $1,000.00 | ||||
| Legal services/ Documents required for employment or education (LD) | $3,500.00 | ||||
| Licensing and bonding fees for work (LS) | $500.00 | ||||
| Medical services needed/ required for employment (dental needs, tattoo removal, vision needs; eye glasses or exam) (MS) | $3,500.00 | ||||
| Test fees (TF) | $1,000.00 | ||||
| Training materials for short-term, technical, and other training (such as WBL and vocational training) (TM) | $12,000.00 | ||||
| Tuition/Fees for short-term, technical, and other training (such as WBL and vocational training) that result in a new skill, credential, or certificate (TUF) | $12,000.00 | ||||
| Transportation (bus passes, gasoline and costs associated with) (TR) | $1,500.00 | ||||
| Union Dues (UD) | $1,000.00 |
| Participant Reimbursements - Community Partnerships |
| Does your agency plan to collaborate with community partners to provide participant reimbursements? |
| If you selected yes, please confirm that you will enter all participant reimbursements provided by community partners in the Outside Supportive Service page in CBMS, and in CBMS case comments. |
Please confirm that all participant reimbursements provided by your organization will be entered in the Inside Supportive Service page or Outside Supportive Service page in CBMS, and in CBMS case comments.
Reimbursement will not be made without proper data entry and documentation.
Stop Here! You've completed this section. Next up, Tab 9: Budget.
Tab 10 (County) Program Operator Name
Tab 10: Budget (County) ERROR:#NAME? Annual Allotment
| Program Operator Contact Information | |||||
| Fiscal Manager: | 0 | Phone: | 0 | Email: | 0 |
| Director: | 0 | Phone: | 0 | Email: | 0 |
| Plan Preparer: | 0 | Phone: | 0 | Email: | 0 |
| ANTICIPATED # OF CLIENTS SERVED: | 0 |
| AVERAGE COST PER CLIENT*: | ERROR:#DIV/0! |
| FUNDS REQUESTED FROM CDHS (Total CDHS Encumbrance): | $0.00 |
| FUNDS the ORGANIZATION WILL CONTRIBUTE (Non-Federal sources): | $0.00 |
| Holdback Percentage: | $0.00 |
Expense Category Narrative (Please fill out all cells below where funds are requested.) Total Agency Cost (funded by non-federal sources) 50% Federal Program Reimbursement 100% Federal Program Reimbursement Funds CDHS Total Reimbursement (Contracts's Encumbrance)
| I. Direct Program Costs |
| Salary/Wages |
: Salaries/wages of personnel involved in Employment First program.
| ====== | [Provide details for all Salary/Wages included in the requested funding amount. If not requesting funding for this line item, please add N/A here and $0.00 in column F.] | $ - 0.00 | $ - 0 |
| Fringe Benefits: Provide the approved fringe benefit rate below. The max rate is set to 22.01%, unless otherwise approved |
: Benefits of personnel involved in Employment First program and personnel providing administrative support to Employment First program.
You may only choose between option 1 (row 10), option 2 (row 12), or use no rate (zero) and not ask for reimbursement of indirect costs.
For no rate, please leave 0% in cell a11 and $0 in cell c12.
| ====== | [Provide details for all Fringe Benefits included in the requested funding amount. If not requesting funding for this line item, please add N/A here and $0.00 in column F.] | $ - 0 | $ - 0.00 | $ - 0 | ||
| 0.00% | $ - 0.00 | $ - 0 | ||||
| Non-capital equipment |
: Office equipment that does not exceed $5,000/unit.
| ====== | [Provide details for all Non-capital equipment included in the requested funding amount. If not requesting funding for this line item, please add N/A here and $0.00 in column F.] | $ - 0.00 | $ - 0 |
| Materials |
: Supplies, postage, and copying/ printing costs
| ====== | [Provide details for all Materials included in the requested funding amount. If not requesting funding for this line item, please add N/A here and $0.00 in column F.] | $ - 0.00 | $ - 0 |
| Travel |
: This line item should NOT include E&T participant reimbursements for Transportation. Those amounts will be accounted for on the Program Feature 8 Supportive Payments tab.
Conference fees and related travel expenses; Charges for travel for the purpose of fulfilling the approved E&T State plan objectives based on official State, local, or university travel regulations. See the current IRS rate for business miles.
| ====== | [Provide details for all Travel included in the requested funding amount. If not requesting funding for this line item, please add N/A here and $0.00 in column F.] | $ - 0.00 | $ - 0 |
| Subsidized WBL Wages for Clients |
: Subsidized Work-Based Learning Wages for Clients, please refer to the Program Feature 7b tab.
| ====== | Details provided in Tab 7 | $ - 0.00 | $ - 0 | |||
| Subtotal | $ - 0 | $ - 0.00 | $ - 0 | |||
| Contractual Costs |
: Lease or rental costs; sub-contractor agreements; Cost of memberships for the institution (with staff who work directly on Employment First activities) in business, technical, and professional organizations.
| ====== | [Provide details for all Contractual Costs included in the requested funding amount. If not requesting funding for this line item, please add N/A here and $0.00 in column F.] | $ - 0.00 | $ - 0 | |||
| Total Direct Program Costs | $ - 0 | $ - 0.00 | $ - 0 | |||
| II. Indirect Costs: You may only choose one option, between De Minimis Indirect Cost Rate or a Federally Negotiated Indirect Cost Rate. | ||||||
| Option 1: Indirect Costs Using the De Minimis Rate |
The De Minimis Indirect Cost Rate is 15%. If you choose this option, enter 15% in the field below. Organizations with a Federally Negotiated Indirect Cost Rate must use Option 2 instead.
If you do not select the De Minimis option, leave the field as 0%.
15.00% : Personnel that support general office administrative functions; Financial staff that handle all billing activities; General building maintenance and utility expenses.
You may only choose between option 1 (row 33) or option 2 (row 35).
| ====== | [Provide details for all Indirect Costs included in the requested funding amount. If not requesting funding for this line item, please add N/A here and $0.00 in column F.] | $ - 0 | $0.00 | $ - 0 |
| Option 2: Indirect Costs Using a Federally Negotiated Indirect Cost Rate |
If you select this option, enter your Federally Negotiated Indirect Cost Rate percentage in the field below. Otherwise, leave the field as 0%.
You must submit a current copy of your Federally Negotiated Indirect Cost Rate Agreement for the Department to accept the rate entered below.
0.00% : Personnel that support general office administrative functions; Financial staff that handle all billing activities; General building maintenance and utility expenses.
You may only choose between option 1 (row 33) or option 2 (row 35).
: Salaries/wages of personnel involved in Employment First program.
: Benefits of personnel involved in Employment First program and personnel providing administrative support to Employment First program.
You may only choose between option 1 (row 10), option 2 (row 12), or use no rate (zero) and not ask for reimbursement of indirect costs.
For no rate, please leave 0% in cell a11 and $0 in cell c12.
: Office equipment that does not exceed $5,000/unit.
: Supplies, postage, and copying/ printing costs : This line item should NOT include E&T participant reimbursements for Transportation. Those amounts will be accounted for on the Program Feature 8 Supportive Payments tab.
Conference fees and related travel expenses; Charges for travel for the purpose of fulfilling the approved E&T State plan objectives based on official State, local, or university travel regulations. See the current IRS rate for business miles.
: Subsidized Work-Based Learning Wages for Clients, please refer to the Program Feature 7b tab.
: Lease or rental costs; sub-contractor agreements; Cost of memberships for the institution (with staff who work directly on Employment First activities) in business, technical, and professional organizations.
| ====== | [Provide details for all Indirect Costs included in the requested funding amount. If not requesting funding for this line item, please add N/A here and $0.00 in column F.] | $ - 0 | $0.00 | $ - 0 | ||||
| Total Indirect Costs | $ - 0 | $ - 0.00 | $ - 0 | |||||
| Total Administrative Costs | $ - 0 | $ - 0 | $ - 0 | |||||
| CDHS Holdback Part 1 of 2 (Federal funds): | ERROR:#VALUE! | |||||||
| III. Participant Reimbursements | ||||||||
| Childcare (Dependent Care) | Details provided in Tab 8 | $ - 0.00 | $ - 0 | |||||
| All other Supportive Payments | ||||||||
| (i.e. Transportation, etc.) | Details provided in Tab 8 | $ - 0.00 | $ - 0 | |||||
| Total Participant Reimbursement Costs | $ - 0 | $ - 0 | $ - 0 | |||||
| CDHS Holdback Part 2 of 2 (Federal funds): | ERROR:#VALUE! | |||||||
| IV. Total Costs | ||||||||
| Total Costs | ||||||||
| (Total Administrative Costs + Participant Reimbursement Costs) | $ - 0 | $ - 0.00 | $ - 0 | $ - 0 |
| Total CDHS Encumbrance | $ - 0 |
| Total % CDHS Holdback to State Administration (Federal funds): | ERROR:#VALUE! |
| *****MAXIMUM AMOUNT PAYABLE BY STATE TO CONTRACTOR (PROGRAM OPERATOR) | ERROR:#VALUE! |
Stop Here! You've completed this section. Go back to the Table of Contents and check of each of the sections you've completed (or are not offering).
Tab 10 (TPP) Program Operator Name
Tab 9: Budget (TPP) ERROR:#NAME? Annual Allotment
| Program Operator Contact Information | |||||
| Fiscal Manager: | 0 | Phone: | 0 | Email: | 0 |
| Director: | 0 | Phone: | 0 | Email: | 0 |
| Plan Preparer: | 0 | Phone: | 0 | Email: | 0 |
| ANTICIPATED # OF CLIENTS SERVED: | 0 |
| AVERAGE COST PER CLIENT*: | ERROR:#DIV/0! |
| FUNDS REQUESTED FROM CDHS (Total CDHS Encumbrance): | $0.00 |
| FUNDS the ORGANIZATION WILL CONTRIBUTE (Non-Federal sources): | $0.00 |
| Holdback Percentage: | $0.00 |
Expense Category Narrative (Please fill out all cells below where funds are requested.) Total Agency Cost (funded by non-federal sources) 50% Federal Program Reimbursement CDHS Total Reimbursement (Contracts's Encumbrance)
| I. Direct Program Costs |
| Salary/Wages |
: Salaries/wages of personnel involved in Employment First program.
| ====== | [Provide details for all Salary/Wages included in the requested funding amount. If not requesting funding for this line item, please add N/A here and $0.00 in column F.] | $ - 0.00 | $ - 0 |
| Fringe Benefits: Provide the approved fringe benefit rate below. The max rate is set to 22.01%, unless otherwise approved |
: Benefits of personnel involved in Employment First program and personnel providing administrative support to Employment First program.
You may only choose between option 1 (row 10), option 2 (row 12), or use no rate (zero) and not ask for reimbursement of indirect costs.
For no rate, please leave 0% in cell a11 and $0 in cell c12.
| ====== | [Provide details for all Fringe Benefits included in the requested funding amount. If not requesting funding for this line item, please add N/A here and $0.00 in column F.] | $ - 0 | $ - 0.00 | $ - 0 | |
| 0.00% | $ - 0.00 | $ - 0 | |||
| Non-capital equipment |
: Office equipment that does not exceed $5,000/unit.
| ====== | [Provide details for all Non-capital equipment included in the requested funding amount. If not requesting funding for this line item, please add N/A here and $0.00 in column F.] | $ - 0.00 | $ - 0 |
| Materials |
: Supplies, postage, and copying/ printing costs
| ====== | [Provide details for all Materials included in the requested funding amount. If not requesting funding for this line item, please add N/A here and $0.00 in column F.] | $ - 0.00 | $ - 0 |
| Travel |
: This line item should NOT include E&T participant reimbursements for Transportation. Those amounts will be accounted for on the Program Feature 8 Supportive Payments tab.
Conference fees and related travel expenses; Charges for travel for the purpose of fulfilling the approved E&T State plan objectives based on official State, local, or university travel regulations. See the current IRS rate for business miles.
| ====== | [Provide details for all Travel included in the requested funding amount. If not requesting funding for this line item, please add N/A here and $0.00 in column F.] | $ - 0.00 | $ - 0 |
| Subsidized WBL Wages for Clients |
: Subsidized Work-Based Learning Wages for Clients, please refer to the Program Feature 7b tab.
| ====== | Details provided in Tab 7 | $ - 0.00 | $ - 0 | ||
| Subtotal | $ - 0 | $ - 0.00 | $ - 0 | ||
| Contractual Costs |
: Lease or rental costs; sub-contractor agreements; Cost of memberships for the institution (with staff who work directly on Employment First activities) in business, technical, and professional organizations.
| ====== | [Provide details for all Contractual Costs included in the requested funding amount. If not requesting funding for this line item, please add N/A here and $0.00 in column F.] | $ - 0.00 | $ - 0 | ||
| Total Direct Program Costs | $ - 0 | $ - 0.00 | $ - 0 | ||
| II. Indirect Costs: You may only choose one option, between De Minimis Indirect Cost Rate or a Federally Negotiated Indirect Cost Rate. | |||||
| Option 1: Indirect Costs Using the De Minimis Rate |
The De Minimis Indirect Cost Rate is 15%. If you choose this option, enter 15% in the field below. Organizations with a Federally Negotiated Indirect Cost Rate must use Option 2 instead.
If you do not select the De Minimis option, leave the field as 0%.
15.00% : Personnel that support general office administrative functions; Financial staff that handle all billing activities; General building maintenance and utility expenses.
You may only choose between option 1 (row 33) or option 2 (row 35).
| ====== | [Provide details for all Indirect Costs included in the requested funding amount. If not requesting funding for this line item, please add N/A here and $0.00 in column F.] | $ - 0 | $0.00 | $ - 0 |
| Option 2: Indirect Costs Using a Federally Negotiated Indirect Cost Rate |
If you select this option, enter your Federally Negotiated Indirect Cost Rate percentage in the field below. Otherwise, leave the field as 0%.
You must submit a current copy of your Federally Negotiated Indirect Cost Rate Agreement for the Department to accept the rate entered below.
0.00% : Personnel that support general office administrative functions; Financial staff that handle all billing activities; General building maintenance and utility expenses.
You may only choose between option 1 (row…
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