USVI Public Records

Document text

OMB #0970-0234 Exp. Date: Division of Social Services Social Services Block Grant Intended Use Plan The Paperwork Reduction Act of 1995 (Pub. L. 104-13). STATEMENT OF PUBLIC BURDEN: Through this information collection, ACF is identifying plans for State use of Social Services Bock Grant (SSBG) Funding. The purpose of this information is to identify estimated SSBG expenditures and recipients, as well as the intended geographic location and eligibility considerations for planned services. Information will be used to gain insight on the administration of the SSBG program and to provide support to grantees related to the administration of their SSBG program. Public reporting burden for this collection of information is estimated to average 40 hours per response, including the time for reviewing instructions, gathering and maintaining the data needed, and reviewing the collection of information. This is a mandatory collection of information and is required to retain a benefit [45 C.F.R. §96.74.]. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information subject to the requirements of the Paperwork Reduction Act of 1995, unless it displays a currently valid OMB control number. The OMB # is 0970-0234 and the expiration date is . If you have any comments on this collection of information, please contact the Office of Community Services, Social Services Block Grant Program via email: SSBG@acf.hhs.gov. 05/31/2025 05/31/2025 I. General Information 1. State 2. Fiscal Year 3. State Official Contact Information 4. SSBG Contact Information 5. SSBG Award from Previous Year 6. SSBG Expenditures Planned for Current Year 7. TANF Funds Transferred into SSBG 8. Consolidate Block Grant Funds Included in SSBG Budget: YES NO Provide the amount of funding for each applicable funding source for the consolidated block grant. a. Funding Source(s) for the Consolidated Block Grant b. Amount of Funding from Each Program $ 6,994,532.96 $ 9,373,733.14 $ 0.00 Supportive Services $ 195,961.37 Virgin Islands FY2025 Averil E. George -Commissioner Nominee Department of Human Services 1303 Hospital Ground, STE 1 St. Thomas, VI 00802 averil.george@dhs.vi.gov (340) 718-2980 or (340) 642-8817 Lydia Magras - CFO Department of Human Services 1303 Hospital Ground, STE 1 St. Thomas, VI 00802 lydia.magras@dhs.vi.gov (340) 774-0930 x4134 or (340) 642-2586 Congregate Meals/Home-Delivered Meals Family Caregivers LIHEAP Ombudsman Community Based Child Abuse Prevention Childrens Justice Act Community Services Block Grant Nutrition Services Incentive Program Developmental Disabilities Family Violence Prevention and Services Act Social Services Block Grant Independent Living Services Grant $ 2,379,989.34 $ 365,391.55 $ 677,506.62 $ 157,059.82 $ 429,811.47 $ 423,945.15 $ 381,490.50 $ 5,000.00 $ 2,335.00 $ 906,896.37 $ 476,098.53 $ 593,047.25 9. SSBG Carryover Funding from the Previous Year: YES NO a. Source(s) of Carryover Funding b. Amount of Carryover from Each Source Supportive Services $ 52,320.09 $ 823,832.54 $ 171,353.83 $ 269,978.33 $ 83,762.96 $ 136,678.74 $ 130,269.27 $ 97,517.74 $ 5,000.00 $ 2,335.00 $ 255,690.12 $ 135,895.76 $ 214,565.79 Congregate Meals/Home-Delivered Meals Family Caregivers LIHEAP Ombudsman Community Based Child Abuse Prevention Childrens Justice Act Community Services Block Grant Nutrition Services Incentive Program Developmental Disabilities Family Violence Prevention and Services Act Social Services Block Grant Independent Living Services Grant II. Administrative Operations 1. Administering Agency 2. Location 3. Mission/Goals of Agency 4. Description of Financial Operations Systems Virgin Islands Department of Human Services U.S. Virgin Islands The mission of the V.I. Department of Human Services is to provide social services that will enhance the quality of life for individuals and families with diverse needs; and work toward our vision to emerge as a public sector agency empowering individuals and families towards self-sufficiency through a seamless delivery system of services. The Virgin Islands Department of Human Services SSBG funded services will be directed toward the following goals: I. Achieving or maintaining economic self-support to prevent, reduce or eliminate dependency. II. Achieve or maintained self-sufficiency including reduction or prevention or dependency. Ill. Preventing or remedying neglect, abuse or exploitation of children and adults unable to protect their own interests IV. Preventing or reducing inappropriate institutional care by providing for community- based care, home-based care, or other forms of less intensive care. V. Securing referral or admission for institution care when other forms of care are not appropriate or providing services to individuals in institutions. DHS utilizes the Tyler Munis Enterprise Resource Planning (ERP) as the official record of the Government of the Virgin Islands (GVI). All transactions are conducted within t he ERP system. Additionally, a check and balance system are in place which guarantees transparency and accountability of funding. GVI maintains Federal Audit compliance with an annual A133 Single Audit. The DHS Chief Financial Officer ensures the Social Services Block Grant is expended in line with the Intended Use Plan of the V.I. Department of Human Services. The Department of Human Services allocates funds to programs based on the initial intended usage described in this report. However, monthly financial reports are reviewed with programmatic data to determine existing areas of greater needs. Realignments of funds are subsequently made in accordance with the respective findings. The Department's SSBG grant administration occurs within the Office of the Commissioner. The Assistant Commissioners, Chief Financial Officer, Director of Fiscal Affairs and SSBG Grant Administrator, coordinate the programmatic and fiscal management and monitoring across the Department. Monitoring at the individual service level is conducted throughout the Department by the service area's respective program administrator(s). DHS Office of Fiscal Management (OFM) works closely with all program managers to ensure fiscal management of the grant. III. Program Planning 1. Planning for Distribution and Use of Funds Describe the planning process for determining the State’s use and distribution of SSBG funds. 2. Describe the Characteristics of Individuals to be Served Include definitions for child, adult, and family; eligibility criteria; and income guidelines. 3. Public Inspection of Pre-Expenditure Report Describe how the State made available for public inspection and comment the current Pre- Expenditure Report or revision to the report. Supporting documentation for public inspection is also required. (See V. Appendices, Appendix A: Documentation of public Hearing). SEE ATTACHMENT SEE ATTACHMENT SEE ATTACHMENT IV. Program Operations Complete one table for each service category provided by the state during the reporting period. 1. Program Operations – Adoption Services a. Service Category (use uniform definition) – Adoption Services b. SSBG Goal c. Description of Services d. Description of Recipients (eligibility considerations) e. Method of Delivery and Geographic Area f. Partnering State Agency g. Subgrantee / Service Providers N/A Adoption services are those services or activities provided to assist in bringing about the adoption of a child. Component services and activities may include, but are not limited to, counseling the biological parent(s), recruitment of adoptive homes, and pre- and post- placement training and/or counseling. N/A N/A N/A N/A 2. Program Operations – Case Management Services a. Service Category (use uniform definition) – Case Management Services b. SSBG Goal c. Description of Services d. Description of Recipients (eligibility considerations) e. Method of Delivery and Geographic Area f. Partnering State Agency g. Subgrantee / Service Providers Ill. Preventing or remedying neglect, abuse or exploitation of children and adults unable to protect their own interests. Case Management Services are services or activities for the arrangement, coordination, and monitoring of services to meet the needs of individuals and families. Component services and activities may include individual service plan development; counseling; monitoring, developing, securing, and coordinating services; monitoring and evaluating client progress; and assuring that clients' rights are protected. Recipients are children, dependent adults- disabled adults 18-59 and senior citizens 60 years and over. There are no Income Eligibility restrictions for recipients of services. All recipients are eligible by virtue of their susceptibility to neglect, abuse and exploitation In person and virtual services will be provided to recipients in the two districts of the U.S. Virgin Islandsthe St. Thomas/St. John District which includes Water Island and the St. Croix District. N/A Service Providers are employed by the Department of Human Services. No Sub-Grantees for Case Management Services. 3. Program Operations – Congregate Meals a. Service Category (use uniform definition) – Congregate Meals b. SSBG Goal c. Description of Services d. Description of Recipients (eligibility considerations) e. Method of Delivery and Geographic Area f. Partnering State Agency g. Subgrantee / Service Providers IV. Preventing or reducing inappropriate institutional care by providing for community- based care, home-based care, or other forms of less intensive care. Congregate meals are those services or activities designed to prepare and serve one or more meals a day to individuals in central dining areas in order to prevent institutionalization, malnutrition, and feelings of isolation. Component services or activities may include the cost of personnel, equipment, and food; assessment of nutritional and dietary needs; nutritional education and counseling; socialization; and other services such as transportation and information and referral. Eligibility is based on age- Priority for Senior Citizens-Age 60 whose eligibility and need are determined by the Client Assessment Form of our Senior Centers; Secondary in order of priority are Adults with Disablities (Age 18-59); No person shall be excluded from Congregate Meals on basis of income once deemed eligible for Senior Center and participation in other Socio-Recreational Activities. In Person Service of nutritionally sound meals at Senior Centers or other Congregate settings where Seniors and Adults with disabilities are served and meet the age eligibility requirements; Congregates meals are provided in the St. Thomas/St. John District and the St. Croix District. DHS provides the Congregate Meals by contracting with Private Vendors in both districts. However, DHS reserves the right to sub-grant Congregate Meals Services to eligible private non-profit entities. 4. Program Operations – Counseling Services a. Service Category (use uniform definition) – Counseling Services b. SSBG Goal c. Description of Services d. Description of Recipients (eligibility considerations) e. Method of Delivery and Geographic Area f. Partnering State Agency g. Subgrantee / Service Providers N/A Counseling services are those services or activities that apply therapeutic processes to personal, family, situational, or occupational problems in order to bring about a positive resolution of the problem or improved individual or family functioning or circumstances. Problem areas may include family and marital relationships, parent-child problems, or drug abuse. N/A N/A N/A N/A 5. Program Operations – Day Care Services – Adults a. Service Category (use uniform definition) – Day Care Services – Adults b. SSBG Goal c. Description of Services d. Description of Recipients (eligibility considerations) e. Method of Delivery and Geographic Area f. Partnering State Agency g. Subgrantee / Service Providers N/A Day care services for adults are those services or activities provided to adults who require care and supervision in a protective setting for a portion of a 24-hour day. Component services or activities may include opportunity for social interaction, companionship and self education; health support or assistance in obtaining health services; counseling; recreation and general leisure time activities; meals; personal care services; plan development; and transportation. N/A N/A N/A N/A 6. Program Operations – Day Care Services – Children a. Service Category (use uniform definition) – Day Care Services – Children b. SSBG Goal c. Description of Services d. Description of Recipients (eligibility considerations) e. Method of Delivery and Geographic Area f. Partnering State Agency g. Subgrantee / Service Providers N/A Day Care services for children (including infants, pre-schoolers and school age children) are services or activities provided in a setting that meets applicable standards of state and local law, in a center or in a home, for a portion of a 24-hour day. Component services or activities may include a comprehensive and coordinated set of appropriate developmental activities for children, recreation, meals and snacks, transportation, health support services, social service counseling for parents, plan develoment, and licensing and monitoring of child care homes and facilities. N/A N/A N/A N/A 7. Program Operations – Education and Training Services a. Service Category (use uniform definition) – Education and Training Services b. SSBG Goal c. Description of Services d. Description of Recipients (eligibility considerations) e. Method of Delivery and Geographic Area f. Partnering State Agency g. Subgrantee / Service Providers N/A Education and training services are those services provided to improve knowledge or daily living skills and to enhance cultural opportunities. Services may include instruction or training in, but are not limited to such issues as consumer education, health education, community protection and safety education, literacy education, English as a second language, and General Educational Development(G.E.D.). Component services or activities may include screening, assessment and testing; individual or group instruction; tutoring; may include screening, assessment and testing; individual or group instruction; tutoring; provision of books, N/A N/A N/A N/A 8. Program Operations – Employment Services a. Service Category (use uniform definition) – Employment Services b. SSBG Goal c. Description of Services d. Description of Recipients (eligibility considerations) e. Method of Delivery and Geographic Area f. Partnering State Agency g. Subgrantee / Service Providers N/A Employment services are those services or activities provided to assist individuals in securing employment or acquiring or learning skills that promote opportunities for employment. Component services or activities may include employment screening, assessment, or testing; structured job skills and job seeking skills; specialized therapy (occupational, speech, physical); special training and tutoring, including literacy training and pre-vocational training; provision of books, supplies and instructional material; counseling, Transportation; and referral to community resources. N/A N/A N/A N/A 9. Program Operations – Family Planning Services a. Service Category (use uniform definition) – Family Planning Services b. SSBG Goal c. Description of Services d. Description of Recipients (eligibility considerations) e. Method of Delivery and Geographic Area f. Partnering State Agency g. Subgrantee / Service Providers N/A Family planning services are those educational, comprehensive medical or social services or activities which enable individuals, including minors, to determine freely the number and spacing of their children and to select the means by which this may be achieved. These services and activities include a broad range of acceptable and effective methods and services to limit or enhance fertility, including contraceptive methods (including natural family planning and abstinence), and the management of infertility (including referral to adoption). Specific component services and activities may include preconceptional counseling, education, N/A N/A N/A N/A 10. Program Operations – Foster Care Services for Adults a. Service Category (use uniform definition) – Foster Care Services for Adults b. SSBG Goal c. Description of Services d. Description of Recipients (eligibility considerations) e. Method of Delivery and Geographic Area f. Partnering State Agency g. Subgrantee / Service Providers N/A Foster care services for adults are those services or activities that assess the need and arrange for the substitute care and alternate living situation of adults in a setting suitable to the individual's needs. Individuals may need such services because of social, physical or mental disabilities, or as a consequence of abuse or neglect. Care may be provided in a communitybased setting, or such services may arrange for institutionalization when necessary. Component services or activities include assessment of the individual's needs; case planning and case management to assure that the individual receives proper care in the N/A N/A N/A N/A 11. Program Operations – Foster Care Services for Children a. Service Category (use uniform definition) – Prevention and Intervention Services b. SSBG Goal c. Description of Services d. Description of Recipients (eligibility considerations) e. Method of Delivery and Geographic Area f. Partnering State Agency g. Subgrantee / Service Providers III. Preventing or remedying neglect, abuse or exploitaation of children and sults unable to protect their own interests. Foster care services for children are those services or activities associated with the provision of an alternative family life experience for abused, neglected or dependent children, between birth and the age of majority, on the basis of a court commitment or a voluntary placement agreement signed by the parent or guardian. Services may be provided to children in foster family homes, foster homes of relatives, group homes, emergency shelters, residential facilities, child care institutions, pre-adoptive homes or supervised independent living situation. Component services or activities may include assessment of the child's needs; Children in need of the protection and intervention of the child protective services system, children the custody of the Virgin Islands Department of Human Services, including those in extended foster care. Services may be delivered in person, telephonically, via various virtual platforms or in any form necessary to provide services to recipients across both island districts of the Virgin Islands. N/A Determined by agency. 12. Program Operations – Health Related and Home Health Services a. Service Category (use uniform definition) – Health Related and Home Health Services b. SSBG Goal c. Description of Services d. Description of Recipients (eligibility considerations) e. Method of Delivery and Geographic Area f. Partnering State Agency g. Subgrantee / Service Providers N/A Health related and home health services are those in-home or out-of- home services or activities designed to assist individuals and families to attain and maintain a favorable condition of health. Component services and activities may include providing an analysis or assessment of an individual's health problems and the development of a treatment plan; assisting individuals to identify and understand their health needs; assisting individuals to locate, provide or secure, and utilize appropriate medical treatment, preventive medical care, and health maintenance services, including in-home health services and emergency medical N/A N/A N/A N/A 13. Program Operations – Home Based Services a. Service Category (use uniform definition) – Home Based Services b. SSBG Goal c. Description of Services d. Description of Recipients (eligibility considerations) e. Method of Delivery and Geographic Area f. Partnering State Agency g. Subgrantee / Service Providers IV. Preventing or reducing inappropriate institutional care by providing for community- based care, home-based care, or other forms of less intensive care. Home based services are those in-home services or activities provided to individuals or families to assist with household or personal care activities that improve or maintain adequate family well-being. These services may be provided for reasons of illness, incapacity, frailty, absence of a caretaker relative, or to prevent abuse and neglect of a child or adult. Major service components include homemaker services, chore services, home maintenance services, and household management services. Component services or activities may include protective supervision of adults and/or children to help prevent abuse, temporary Eligibility is based on age -Adults with disabilities (ages 18-59) and senior citizens age 60 and older. Physician statement verifying the individual has a current medical need for assistance with personal care task and the other activities of daily living. The client must need assistance with at least one personal care task, and reside in the geographic area described in the agreement. In-person services are delivered in the Homes of eligible recipients by Homemakers, aka Personal Care Attendants, Certified Nursing Assisants N/A None. Services are provided by employees of the Department of Human Services. 14. Program Operations – Home Delivered Meals a. Service Category (use uniform definition) – Home Delivered Meals b. SSBG Goal c. Description of Services d. Description of Recipients (eligibility considerations) e. Method of Delivery and Geographic Area f. Partnering State Agency g. Subgrantee / Service Providers IV. Preventing or reducing inappropriate institutional care by providing for community-based care, home-based care, or other forms of less intensive care. Home-delivered meals are those services or activities designed to prepare and deliver one or more meals a day to an individual's residence in order to prevent institutionalization, malnutrition, and feelings of isolation. Component services or activities may include the cost of personnel, equipment, and food; assessment of nutritional and dietary needs; nutritional education and counseling; socialization services; and information and referral. Disabled adults ages 18 to 59 and seniors (age 60 years or older) that meet agency eligibility criteria after assessment. In person delivery of meals to home bound and other vulnerable disabled adults and seniors in both island districts of the Virgin Islands. N/A Determined by agency. 15. Program Operations – Housing Services a. Service Category (use uniform definition) – Housing Services b. SSBG Goal c. Description of Services d. Description of Recipients (eligibility considerations) e. Method of Delivery and Geographic Area f. Partnering State Agency g. Subgrantee / Service Providers N/A Housing services are those services or activities designed to assist individuals or families in locating, obtaining, or retaining suitable housing. Component services or activities may include tenant counseling; helping individuals and families to identify and correct substandard housing conditions on behalf of individuals and families who are unable to protect their own interests; and assisting individuals and families to understand leases, secure utilities, make moving arrangements and minor renovations. N/A N/A N/A N/A 16. Program Operations – Independent and Transitional Living Services a. Service Category (use uniform definition) – Independent and Transitional Living Services b. SSBG Goal c. Description of Services d. Description of Recipients (eligibility considerations) e. Method of Delivery and Geographic Area f. Partnering State Agency g. Subgrantee / Service Providers II. Achieve or maintained self-sufficiency including reduction or prevention or dependency. Independent and transitional living services are those services and activities designed to help older youth in foster care or homeless youth make the transition to independent living, or to help adults make the transition from an institution, or from homelessness, to independent living. Component services or activities may include educational and employment assistance, training in daily living skills, and housing assistance. Specific component services and activities may include supervised practice living and post-foster care services. Older youth in foster care or homeless youth making the transition to independent living or adults making the transition from an institutiion, or from omelessness to independent living. In person, telephonically, various virtual platforms and any apppropriate means of deliving services to recipients across both Virgin Islands island districts. N/A Determined by agency. 17. Program Operations – Information and Referral a. Service Category (use uniform definition) – Information and Referral b. SSBG Goal c. Description of Services d. Description of Recipients (eligibility considerations) e. Method of Delivery and Geographic Area f. Partnering State Agency g. Subgrantee / Service Providers II. Achieve or maintained self-sufficiency including reducion or prevention or dependency. Information and referral services are those services or activities designed to provide information about services provided by public and private service providers and a brief assessment of client needs (but not diagnosis and evaluation) to facilitate appropriate referral to these community resources. Disabled adults ages 18 to 59 and seniors (age 60 and older). In person, telephone, and via virtual platforms to recipients in both island districts across the Virgin Islands. N/A None. Services provided by agency. 18. Program Operations – Legal Services a. Service Category (use uniform definition) – Legal Services b. SSBG Goal c. Description of Services d. Description of Recipients (eligibility considerations) e. Method of Delivery and Geographic Area f. Partnering State Agency g. Subgrantee / Service Providers Ill. Preventing or remedying neglect, abuse or exploitation of children and adults unable to protect their own interests. Legal services are those services or activities provided by a lawyer or other person(s) under the supervision of a lawyer to assist individuals in seeking or obtaining legal help in civil matters such as housing, divorce, child support, guardianship, paternity, and legal separation. Component services or activities may include receiving and preparing cases for trial, provision of legal advice, representation at hearings, and counseling. Children (under age 18), adults ages 18 to 59 and seniors (age 60 years or older) that meet agency eligibility criteria after assessment. Services may be delivered in person, telephonically, via various virtual platforms or in any form necessary to provide services to recipients across both island districts of the Virgin Islands. N/A Legal Services of the Virgin Islands Inc. 19. Program Operations – Pregnancy and Parenting Services for Young Parents a. Service Category (use uniform definition) – Pregnancy and Parenting Services for Young Parents b. SSBG Goal c. Description of Services d. Description of Recipients (eligibility considerations) e. Method of Delivery and Geographic Area f. Partnering State Agency g. Subgrantee / Service Providers N/A Pregnancy and parenting services are those services or activities for married or unmarried adolescent parents and their families designed to assist young parents in coping with the social, emotional, and economic problems related to pregnancy and in planning for the future. 'Component services or activities may include securing necessary health care and living arrangements; obtaining legal services; and providing counseling, child care education, and training in and development of parenting skills. N/A N/A N/A N/A 20. Program Operations – Prevention and Intervention Services a. Service Category (use uniform definition) – Prevention and Intervention Services b. SSBG Goal c. Description of Services d. Description of Recipients (eligibility considerations) e. Method of Delivery and Geographic Area f. Partnering State Agency g. Subgrantee / Service Providers III. Preventing or remedying neglect, abuse or exploitation of children and adults unable to protect their own interests. Prevention and intervention services are those services or activities designed to provide early identification and/or timely intervention to support families and prevent or ameliorate the consequences of, abuse, neglect, or family violence, or to assist in making arrangement for alternate placements or living arrangements where necessary. Such services may also be provided to prevent the removal of a child or adult from the home. Component services and activities may include investigation; assessment and/or evaluation of the extent of the problem; counseling, including mental health counseling or therapy as Children, adults and families at risk forand/or in need of intervention and protection from maltreatment and exploitation. In person, telephone, and via virtual platforms across both island districts of the Virgin Islands. N/A Determined by agency. 21. Program Operations – Protective Services for Adults a. Service Category (use uniform definition) – Protective Services for Adults b. SSBG Goal c. Description of Services d. Description of Recipients (eligibility considerations) e. Method of Delivery and Geographic Area f. Partnering State Agency g. Subgrantee / Service Providers III. Preventing or remdying neglect, abuse or exploitation of children and adults unable to protect their own interests Protective service for adults are those services or activities designed to prevent or remedy abuse, neglect or exploitation of adults who are unable to protect their own interests. Examples of situations that may require protective services are injury due to maltreatment or family violence, lack of adequate food, clothing or shelter; lack of essential medical treatment or rehabilitation services; and lack of necessary financial or other resources. Component services or activities may include investigation; immediate intervention emergency medical services; emergency shelter; developing case plans; initiation of legal action (if neeed); / Disable adults ages 18-59 and seniors (age 60 and older) that are subjected to maltreatment, explotiation, family violence and/or lack of essential resources. In person, telephone, and/or via virtual platforms to recipients in both island districts of the Virgin Islands. N/A Determined by agency. 22. Program Operations – Protective Services for Children a. Service Category (use uniform definition) – Protective Services for Children b. SSBG Goal c. Description of Services d. Description of Recipients (eligibility considerations) e. Method of Delivery and Geographic Area f. Partnering State Agency g. Subgrantee / Service Providers III. Preventing or remedying neglect, abuse or exploitation of children and sults unable to protect their own interests. Protective Services for Children are those services or activities designed to prevent or remedy abuse, neglect, or exploitation of children who may be harmed through physical or mental injury, sexual abuse or exploitation, and negligent treatment or maltreatment, including failure to be provided with adequate food, clothing, shelter, or medical care. Component services or activities may include immediate investigation and intervention; emergency medical services; emergency shelter; developing case plans; initiation of legal action (if needed); counseling for the child and the family; assessment/evaluation of family circumstances Protective Services for Children are those services or activities designed to prevent or remedy abuse, neglect, or exploitation of children who may be harmed through physical or mental injury, sexual abuse or exploitation, and negligent treatment or maltreatment, including failure to be provided with adequate food, clothing, shelter, or medical care. Component services or activities may include immediate investigation and intervention; emergency medical services; emergency shelter; developing case plans; initiation of legal action (if needed); counseling for the child and the family; assessment/evaluation of family circumstances In person, telephonically or via virtual platforms to recipients in both island districts of the Virgin Islands. N/A Determined by Agency. 23. Program Operations – Recreational Services a. Service Category (use uniform definition) – Recreational Services b. SSBG Goal c. Description of Services d. Description of Recipients (eligibility considerations) e. Method of Delivery and Geographic Area f. Partnering State Agency g. Subgrantee / Service Providers II. Achieve or maintained self-sufficiency including reduction or prevention or dependency. Recreational services are those services or activities designed to provide, or assist individuals to take advantage of, individual or group activities directed towards promoting physical, cultural, and/or social development. Social and Recreational (Socio-Recreation) Services are provided to adults age 60 or older, disabilities and to persons under age 18 who have disabilities and have been declared legal adults. For purposes of this service: "Adult" is defined as "a person aged 18 or older. The Senior Citizen and Adults with Disabilities Seeking membership in the Senior Centers must be able to take care of their personal toileting needs and be able to feed themselves with minimal support. In Person Socio-Recreational Services are provided to eligible Senior Citizens and Adults with Disabilities in the DHS Senior Centers and external settings; In times of Public Health Emergency e.g. COVID-19 Pandemic, staff provides virtual and telephone Wellness Checks and provides recreational activities to the eligible Seniors and Adults with Disabilities by delivering puzzles, board games, books, and other items to keep the recipients socially engaged and mentally stimulated. N/A No Sub-grantees. DHS employees provide the services to the eligible recipients. 24. Program Operations – Residential Treatment Services a. Service Category (use uniform definition) – Residential Treatment Services b. SSBG Goal c. Description of Services d. Description of Recipients (eligibility considerations) e. Method of Delivery and Geographic Area f. Partnering State Agency g. Subgrantee / Service Providers V. Securing referral or admission for institution care when other forms of care are not appropriate or providing services to individuals in institutions. Residential treatment services provide short-term residential care and comprehensive treatment and services for children or adults whose problems are so severe or are such that they cannot be cared for at home or in foster care and need the specialized services provided by specialized facilities. Component services and activities may include diagnosis and psychological evaluation; alcohol and drug detoxification services; individual, family, and group therapy and counseling; remedial education and GED preparation; vocational or prevocational training; training in activities of daily living; supervised recreational and social Children or adults whose problems are so severe or are such that they cannot be cared for at hom eor in foster care and need the speiclaized services provided by specialized facilities. In person, telephonically and via virtual platforms to recipients that are wards of the Government of the Virgin Islands. N/A Agency enters into professional services contracts with various specialized residential facilities. Subfrantees and service providers are determined by agency. 25. Program Operations – Special Services for Persons with Developmental or Physical a. Service Category (use uniform definition) – Special Services for Persons with Developmental or Physical b. SSBG Goal c. Description of Services d. Description of Recipients (eligibility considerations) e. Method of Delivery and Geographic Area f. Partnering State Agency g. Subgrantee / Service Providers II. Achieve or maintained self-sufficiency including reduction or prevention or dependency. Disabilities, or Persons With Visual or Auditory Impairments Special services for persons with developmental or physical disabilities, or persons with visual or auditory impairments, are services or activities to maximize the potential of persons with disabilities, help alleviate the effects of physical, mental or emotional disabilities, and to enable these persons to live in the least restrictive environment possible. Component services or activities may include personal and family counseling; respite care; family support; recreation; transportation; aid to assist with independent functioning in the community; and training in mobility, There is no income requirement and serves persons with disabilities; Services available to children and adults with disabilities. In Person and Virtual Services to include advocacy, family support, assistance to aid with independent functioning in the community, et. Provided to residents in both districts of the Virgin Islands- St. Thomas/St. John District and St. Croix District. N/A OHS reserves the right to sub-grant a portion or all of the funding provided for this Service Category. However, OHS can also provide the services described above in coordination with other public agencies or Offices of the U.S. Virgin Islands and in-house of the Department. 26. Program Operations – Special Services for Youth Involved in or at Risk of Involvement with Criminal Activity a. Service Category (use uniform definition) – Special Services for Youth Involved in or at Risk of Involvement with Criminal Activity b. SSBG Goal c. Description of Services d. Description of Recipients (eligibility considerations) e. Method of Delivery and Geographic Area f. Partnering State Agency g. Subgrantee / Service Providers II. Achieve or maintained self-sufficiency including reduction or prevention or dependency. Special services for youth involved in or at risk of involvement with criminal activity are those services or activities for youth who are, or who may become, involved with the juvenile justice system and their families. Components services or activities are designed to enhance family functioning and/or modify the youth's behavior with the goal of developing socially appropriate behavior and may include counseling, intervention therapy, and residential and medical services if included as an integral but subordinate part of th i Youth who are, or who may become involved with the juvenile justice system and their families. In person telephonically and via virtual platforms to recipients across both island districts of the Virgin Islands. N/A Determined by Agency. 27. Program Operations – Substance Abuse Services a. Service Category (use uniform definition) – Substance Abuse Services b. SSBG Goal c. Description of Services d. Description of Recipients (eligibility considerations) e. Method of Delivery and Geographic Area f. Partnering State Agency g. Subgrantee / Service Providers N/A Substance abuse services are those services or activities that are primarily designed to deter, reduce, or eliminate substance abuse or chemical dependence. Except for initial detoxification services, medical and residential services may be included but only as an integral but subordinate part of the service. Component substance abuse services or activities may include a comprehensive range of personal and family counseling methods, methadone treatment for opiate abusers, or detoxification treatment for alcohol abusers. Services may be provided in alternative living arrangements such as institutional settings and N/A N/A N/A N/A 28. Program Operations – Transportation Services a. Service Category (use uniform definition) – Transportation Services b. SSBG Goal c. Description of Services d. Description of Recipients (eligibility considerations) e. Method of Delivery and Geographic Area f. Partnering State Agency g. Subgrantee / Service Providers I. Achieve or maintained self-sufficiency including reduction or prevention or dependency. Transportation services are those services or activities that provide or arrange for the travel, including travel costs, of individuals in order to access services, or obtain medical care or employment. Component services or activities may include special travel arrangements such as special modes of transportation and personnel to accompany or assist individuals or families to utilize transportation. Recipients are Adults with disabilities (Ages 18-59) and Senior Citizens age 60 and older; OHS provides Transportation for our eligible recipients of Socio-Recreational Services and provides transportation to OHS Personnel who assist individuals eligible for our program services (Meals on Wheels, Home Maker Services, Family Caregiver Support, etc.) provided under the Social Services Block Grant; Caregivers who care for Adults with Disabilities, Senior Citizens, and Older Adults (55 and older) who are primary caregivers of minor children are also eligible for Transportation Services. In person services provided to eligible recipients; Transportation of eligible recipients from their homes to senior centers, or private or public service providers, medical service providers, legal services, shopping, recreational activities, etc. OHS maintains a fleet of Vehicles which provide Transportation and can also pay Private entities or Non-profits to deliver transportation services N/A DHS reserves the right to sub-grant a portion of the funding for Transportation Services to non-profits; Also DHS can purchase transportation services from private providers or para-transit services e.g. V.I. Public Works Department VITRAN Plus; DHS also provides these services with the assistance of DHS employees and Vehicles. 29. Program Operations – Other Services a. Service Category (use uniform definition) – Other Services b. SSBG Goal c. Description of Services d. Description of Recipients (eligibility considerations) e. Method of Delivery and Geographic Area f. Partnering State Agency g. Subgrantee / Service Providers I. Achieving or maintaining economic self-support to prevent, reduce or eliminate dependency. II. Achieve or maintained self-sufficiency including reduction or prevention or dependency. III. Preventing or remedying neglect, abuse or exploitation of children and sdults unable to protect their own interests. Other Services are services that do not fall within the definitions of the preceding 28 services. The definition used by the State for each of these services should appear elsewhere in the annual report. The V. I. Department of Human Services provides LIHEAP benefits to qualifying low-income households, particularly those paying high proportions of household incomes to meet immediate home electricity and/or gas expenses; the benefits are paid directly to the Utility companies. LIHEAP Services are provided to low income households which have gross income at or below 175% of the federal poverty level. Priority is given to applicants age 60 or older, adults with disabilities, and families with young children under age five. The specific populations of Family Caregivers who are eligible to receive services include: 1) Adult family members providing care to individuals 60 years of age and older 2) Adult family member providing care to individuals of any age with Alzheimer's Disease and related In Person services are the usual method of delivery for the LIHEAP and Family Caregiver Support Program; Eligibility determinations may be conducted in person or via su bmission of required support documentation to the Programs via electronic means (Email, Citizen Portal (If available), Submission to Drop Boxes). For the Family Caregiver Support Program In person or Virtual Individual Counseling, Support Groups, Information and Referral, and education to support Caregivers in providing effective care to their relatives. N/A No Subgrantees for the Provision of LIHEAP Services. DHS employees and Private Providers deliver the services to eligible recipients. When deemed appropriate and within federal guidelines the agency subgrants with private, nonprofit and faith-based organizations and programs demonstrating effectiveness in the field of domestic violence services and prevention. V. Appendices Appendix A: Documentation of Public Hearing Attach documentation of public hearing, such as public hearing notices, websites, electronic correspondence, letters, newspaper articles, etc. Appendix B: Certifications Attach signed copies of the following certifications 1. Drug-Free Workplace Requirements 2. Environmental Tobacco Smoke 3. Lobbying 4. Debarment, Suspension and Other Responsibility Matters Appendix C: Proof of Audit Federal regulations state that: “Each State shall, not less often than every two years, audit its expenditures from amounts received (or transferred for use) under this title…Within 30 days following the completion of each audit, the State shall submit a copy of that audit to the legislature of the State and to the Secretary.” (Sec. 2006 [42 U.S.C. 1397a, Sec. 2006]). Provide a copy or link to the most recent audit, or a description of the audit that specifies when the audit occurred and summarizes the results of the audit. Appendix D: SF 424M Scanned copy must be uploaded with application Appendix E: Federal Financial Report (FFR) For SF-425 Federal Financial Reporting (FFR) Form SF-425 Scanned copy must be uploaded with the Intended Use Plan Social Services Block Grant FY 2024 Intended Use Plan APPENDIX A Documentation of Public Hearing Link: Social Services Block Grant FY 2024 Intended Use Plan APPENDIX B Certifications CERTIFICATION REGARDING DEBARMENT, SUSPENSION AND OTHER RESPONSIBILITY MATTERS Certification Regarding Debarment, Suspension, and Other Responsibility Matters - - Primary Covered Transactions Instructions for Certification 1. By signing and submitting this proposal, the prospective primary participant is providing the certification set out below. 2. The inability of a person to provide the certification required below will not necessarily result in denial of participation in this covered transaction. The prospective participant shall submit an explanation of why it cannot provide the certification set out below. The certification or explanation will be considered in connection with the department or agency’s determination whether to enter into this transaction. However, failure of the prospective primary participant to furnish a certification or an explanation shall disqualify such person from participation in this transaction. 3. The certification in this clause is a material representation of fact upon which reliance was placed when the department or agency determined to enter into this transaction. If it is later determined that the prospective primary participant knowingly rendered an erroneous certification, in addition to other remedies available to the Federal Government, the department or agency may terminate this transaction for cause or default. 4. The prospective primary participant shall provide immediate written notice to the department or agency to which this proposal is submitted if at any time the prospective primary participant learns that its certification was erroneous when submitted or has become erroneous by reason of changed circumstances. 5. The terms covered transaction, debarred, suspended, ineligible, lower tier covered transaction, participant, person, primary covered transaction, principal, proposal, and voluntarily excluded, as used in this clause, have the meanings set out in the Definitions and Coverage sections of the rules implementing Executive Order 12549. You may contact the department or agency to which this proposal is being submitted for assistance in obtaining a copy of those regulations. 6. The prospective primary participant agrees by submitting this proposal that, should the proposed covered transaction be entered into, it shall not knowingly enter into any lower tier covered transaction with a person who is proposed for debarment under 48 CFR part 9, subpart 9.4, debarred, suspended, declared ineligible, or voluntarily excluded from participation in this covered transaction, unless authorized by the department or agency entering into this transaction. 7. The prospective primary participant further agrees by submitting this proposal that it will include the clause titled “Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusive-Lower Tier Covered Transaction,” provided by the department or agency entering into this covered transaction, without modification, in all lower tier covered transactions and in all solicitations for lower tier covered transactions. 8. A participant in a covered transaction may rely upon a certification of a prospective participant in a lower tier covered transaction that is not proposed for debarment under 48 CFR part 9, subpart 9.4, debarred, suspended, ineligible, or voluntarily excluded from the covered transaction, unless it knows that the certification is erroneous. A participant may decide the method and frequency by which it determines the eligibility of its principals. Each participant may, but is not required to, check the List of Parties Excluded from Federal Procurement and Nonprocurement Programs. 9. Nothing contained in the foregoing shall be construed to require establishment of a system of records in order to render in good faith the certification required by this clause. The knowledge and information of a participant is not required to exceed that which is normally possessed by a prudent person in the ordinary course of business dealings. 10. Except for transactions authorized under paragraph 6 of these instructions, if a participant in a covered transaction knowingly enters into a lower tier covered transaction with a person who is proposed for debarment under 48 CFR part 9, subpart 9.4, suspended, debarred, ineligible, or voluntarily excluded from participation in this transaction, in addition to other remedies available to the Federal Government, the department or agency may terminate this transaction for cause or default. ************ Certification Regarding Debarment, Suspension, and Other Responsibility Matters - - Primary Covered Transactions (1) The prospective primary participant certifies to the best of its knowledge and belief, that it and its principals: (a) Are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded by any Federal department or agency; (b) Have not within a three-year period preceding this proposal been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (Federal, State or local) transaction or contract under a public transaction; violation of Federal or State antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property; (c) Are not presently indicted for or otherwise criminally or civilly charged by a governmental entity (Federal, State or local) with commission of any of the offenses enumerated in paragraph (1)(b) of this certification; and (d) Have not within a three-year period preceding this application/proposal had one or more public transactions (Federal, State or local) terminated for cause or default. (2) Where the prospective primary participant is unable to certify to any of the statements in this certification, such prospective participant shall attach an explanation to this proposal. Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion - - Lower Tier Covered Transactions Instructions for Certification 1. By signing and submitting this proposal, the prospective lower tier participant is providing the certification set out below. 2. The certification in this clause is a material representation of fact upon which reliance was placed when this transaction was entered into. If it is later determined that the prospective lower tier participant knowingly rendered an erroneous certification, in addition to other remedies available to the Federal Government the department or agency with which this transaction originated may pursue available remedies, including suspension and/or debarment. 3. The prospective lower tier participant shall provide immediate written notice to the person to which this proposal is submitted if at any time the prospective lower tier participant learns that its certification was erroneous when submitted or had become erroneous by reason of changed circumstances. 4. The terms covered transaction, debarred, suspended, ineligible, lower tier covered transaction, participant, person, primary covered transaction, principal, proposal, and voluntarily excluded, as used in this clause, have the meaning set out in the Definitions and Coverage sections of rules implementing Executive Order 12549. You may contact the person to which this proposal is submitted for assistance in obtaining a copy of those regulations. 5. The prospective lower tier participant agrees by submitting this proposal that, should the proposed covered transaction be entered into, it shall not knowingly enter into any lower tier covered transaction with a person who is proposed for debarment under 48 CFR part 9, subpart 9.4, debarred, suspended, declared ineligible, or voluntarily excluded from participation in this covered transaction, unless authorized by the department or agency with which this transaction originated. 6. The prospective lower tier participant further agrees by submitting this proposal that it will include this clause titled “Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion-Lower Tier Covered Transaction,” without modification, in all lower tier covered transactions and in all solicitations for lower tier covered transactions. 7. A participant in a covered transaction may rely upon a certification of a prospective participant in a lower tier covered transaction that it is not proposed for debarment under 48 CFR part 9, subpart 9.4, debarred, suspended, ineligible, or voluntarily excluded from covered transactions, unless it knows that the certification is erroneous. A participant may decide the method and frequency by which it determines the eligibility of its principals. Each participant may, but is not required to, check the List of Parties Excluded from Federal Procurement and Nonprocurement Programs. 8. Nothing contained in the foregoing shall be construed to require establishment of a system of records in order to render in good faith the certification required by this clause. The knowledge and information of a participant is not required to exceed that which is normally possessed by a prudent person in the ordinary course of business dealings. 9. Except for transactions authorized under paragraph five of these instructions, if a participant in a covered transaction knowingly enters into a lower tier covered transaction with a person who is proposed for debarment under 48 CFR part 9, subpart 9.4, suspended, debarred, ineligible, or voluntarily excluded from participation in this transaction, in addition to other remedies available to the Federal Government, the department or agency with which this transaction originated may pursue available remedies, including suspension and/or debarment. ************ Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion - - Lower Tier Covered Transactions (1) The prospective lower tier participant certifies, by submission of this proposal, that neither it nor its principals is presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in this transaction by any Federal department or agency. (2) Where the prospective lower tier participant is unable to certify to any of the statements in this certification, such prospective participant shall attach an explanation to this proposal. _________________________________________________ Signature and Date _________________________________________________ Printed Name _________________________________________________ Title _________________________________________________ Organization ____________ __ __ ________ __ __ __ __________ __ __ __ _ __ _ __ Signature and Date 10/28/24 Averil E George Commissioner Department of Human Services CERTIFICATION REGARDING DRUG-FREE WORKPLACE REQUIREMENTS This certification is required by the regulations implementing the Drug-Free Workplace Act of 1988: 45 CFR Part 76, Subpart, F. Sections 76.630(c) and (d)(2) and 76.645 (a)(1) and (b) provide that a Federal agency may designate a central receipt point for STATE-WIDE AND STATE AGENCY-WIDE certifications, and for notification of criminal drug convictions. For the Department of Health and Human Services, the central point is: Division of Grants Management and Oversight, Office of Management and Acquisition, Department of Health and Human Services, Room 517-D, 200 Independence Avenue, SW Washington, DC 20201. Certification Regarding Drug-Free Workplace Requirements (Instructions for Certification) 1. By signing and/or submitting this application or grant agreement, the grantee is providing the certification set out below. 2. The certification set out below is a material representation of fact upon which reliance is placed when the agency awards the grant. If it is later determined that the grantee knowingly rendered a false certification, or otherwise violates the requirements of the Drug-Free Workplace Act, the agency, in addition to any other remedies available to the Federal Government, may take action authorized under the Drug-Free Workplace Act. 3. For grantees other than individuals, Alternate I applies. 4. For grantees who are individuals, Alternate II applies. 5. Workplaces under grants, for grantees other than individuals, need to be identified on the certification. If known, they may be identified in the grant application. If the grantee does not identify the workplaces at the time of application, or upon award, if there is no application, the grantee must keep the identity of the workplace(s) on file in its office and make the information available for Federal inspection. Failure to identify all known workplaces constitutes a violation of the grantee’s drug-free workplace requirements. 6. Workplace identifications must include the actual address of buildings (or parts of buildings) or other sites where work under the grant takes place. Categorical descriptions may be used (e.g., all vehicles of a mass transit authority or State highway department while in operation, State employees in each local unemployment office, performers in concert halls or radio studios). 7. If the workplace identified to the agency changes during the performance of the grant, the grantee shall inform the agency of the change(s), if it previously identified the workplaces in question (see paragraph five). 8. Definitions of terms in the Nonprocurement Suspension and Debarment common rule and Drug-Free Workplace common rule apply to this certification. Grantees’ attention is called, in particular, to the following definitions from these rules: Controlled substance means a controlled substance in Schedules I through V of the Controlled Substances Act (21 U.S.C. 812) and as further defined by regulation (21 CFR 1308.11 through 1308.15); Conviction means a finding of guilt (including a plea of nolo contendere) or imposition of sentence, or both, by any judicial body charged with the responsibility to determine violations of the Federal or State criminal drug statutes; Criminal drug statute means a Federal or non-Federal criminal statute involving the manufacture, distribution, dispensing, use, or possession of any controlled substance; Employee means the employee of a grantee directly engaged in the performance of work under a grant, including: (i) All direct charge employees; (ii) All indirect charge employees unless their impact or involvement is insignificant to the performance of the grant; and, (iii) Temporary personnel and consultants who are directly engaged in the performance of work under the grant and who are on the grantee’s payroll. This definition does not include workers not on the payroll of the grantee (e.g., volunteers, even if used to meet a matching requirement; consultants or independent contractors not on the grantee’s payroll; or employees of subrecipients or subcontractors in covered workplaces). Certification Regarding Drug-Free Workplace Requirements Alternate I. (Grantees Other Than Individuals) The grantee certifies that it will or will continue to provide a drug-free workplace by: (a) Publishing a statement notifying employees that the unlawful manufacture, distribution, dispensing, possession, or use of a controlled substance is prohibited in the grantee’s workplace and specifying the actions that will be taken against employees for violation of such prohibition; (b) Establishing an ongoing drug-free awareness program to inform employees about - - (1) The dangers of drug abuse in the workplace; (2) The grantee’s policy of maintaining a drug-free workplace; (3) Any available drug counseling, rehabilitation, and employee assistance programs; and (4) The penalties that may be imposed upon employees for drug abuse violations occurring in the workplace; (c) Making it a requirement that each employee to be engaged in the performance of the grant be given a copy of the statement required by paragraph (a); (d) Notifying the employee in the statement required by paragraph (a) that, as a condition of employment under the grant, the employee will - - (1) Abide by the terms of the statement; and (2) Notify the employer in writing of his or her conviction for a violation of a criminal drug statute occurring in the workplace no later than five calendar days after such conviction; (e) Notifying the agency in writing, within 10 calendar days after receiving notice under paragraph (d)(2) from an employee or otherwise receiving actual notice of such conviction. Employers of convicted employees must provide notice, including position title, to every grant officer or other designee on whose grant activity the convicted employee was working, unless the Federal agency has designated a central point for the receipt of such notices. Notice shall include the identification number(s) of each affected grant; (f) Taking one of the following actions, within 30 calendar days of receiving notice under paragraph (d)(2), with respect to any employee who is so convicted - - (1) Taking appropriate personnel action against such an employee, up to and including termination, consistent with the requirements of the Rehabilitation Act of 1973, as amended; or (2) Requiring such employee to participate satisfactorily in a drug abuse assistance or rehabilitation program approved for such purposes by a Federal, State, or local health, law enforcement, or other appropriate agency; (g) Making a good faith effort to continue to maintain a drug-free workplace through implementation of paragraphs (a), (b), (c), (d), (e) and (f). (B) The grantee may insert in the space provided below the site(s) for the performance of work done in connection with the specific grant: Place of Performance (Street address, city, county, state, zip code) Check if there are workplaces on file that are not identified here. Alternate II. (Grantees Who Are Individuals) (a) The grantee certifies that, as a condition of the grant, he or she will not engage in the unlawful manufacture, distribution, dispensing, possession, or use of a controlled substance in conducting any activity with the grant; (b) If convicted of a criminal drug offense resulting from a violation occurring during the conduct of any grant activity, he or she will report the conviction, in writing, within 10 calendar days of the conviction, to every grant officer or other designee, unless the Federal agency designates a central point for the receipt of such notices. When notice is made to such a central point, it shall include the identification number(s) of each affected grant. [55 FR 21690, 21702, May 25, 1990] _________________________________________________ Signature and Date _________________________________________________ Printed Name _________________________________________________ Title _________________________________________________ Organization 10/28/24 Averil E George Commissioner Department of Human Services CERTIFICATION REGARDING ENVIRONMENTAL TOBACCO SMOKE Public Law 103227, Part C Environmental Tobacco Smoke, also known as the Pro Children Act of 1994, requires that smoking not be permitted in any portion of any indoor routinely owned or leased or contracted for by an entity and used routinely or regularly for provision of health, day care, education, or library services to children under the age of 18, if the services are funded by Federal programs either directly or through State or local governments, by Federal grant, contract, loan, or loan guarantee. The law does not apply to children’s services provided in private residences, facilities funded solely by Medicare or Medicaid funds, and portions of facilities used for inpatient drug or alcohol treatment. Failure to comply with the provisions of the law may result in the imposition of a civil monetary penalty of up to $1000 per day and/or the imposition of an administrative compliance order on the responsible entity by signing and submitting this application the applicant/grantee certifies that it will comply with the requirements of the Act. The applicant/grantee further agrees that it will require the language of this certification be included in any subawards which contain provisions for the children’s services and that all subgrantees shall certify accordingly. _________________________________________________ Signature and Date _________________________________________________ Printed Name _________________________________________________ Title _________________________________________________ Organization Averil E George Commissioner Department of Human Services CERTIFICATION REGARDING LOBBYING Certification for Contracts, Grants, Loans, and Cooperative Agreements The undersigned certifies, to the best of his or her knowledge and belief, that: (1) No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of an agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any Federal contract, grant, loan, or cooperative agreement. (2) If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress or an employee of a Member of Congress in connection with this Federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, “Disclosure Form to Report Lobbying,” in accordance with its instructions. (3) The undersigned shall require that the language of this certification be included in the award documents for all subawards at all tiers (including subcontracts, subgrants, and contracts under grants, loans, and cooperative agreements) and that all subrecipients shall certify and disclose accordingly. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by section 1352, title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. Statement for Loan Guarantees and Loan Insurance The undersigned states, to the best of his or her knowledge and belief, that: If any funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this commitment providing for the United States to insure or guarantee a loan, the undersigned shall complete and submit Standard Form-LLL, “Disclosure Form to Report Lobbying,” in accordance with its instructions. Submission of this statement is a prerequisite for making or entering into this transaction imposed by section 1352, title 31, U.S. Code. Any person who fails to file the required statement shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. _________________________________________________ Signature and Date _________________________________________________ Printed Name _________________________________________________ Title _________________________________________________ Organization 10/28/24 Averil E George Commissioner Department of Human Services Social Services Block Grant FY 2024 Intended Use Plan APPENDIX C Proof of Audit See Audit Attachment Social Services Block Grant FY 2024 Intended Use Plan APPENDIX D SF 424M APPLICATION FOR FEDERAL ASSISTANCE SF-424 - MANDATORY OMB Number: 4040-0020 Expiration Date: 02/28/2026 1.a. Type of Submission: Other (specify): 1.b. Frequency: Other (specify): 1.d. Version: 2. Date Received: 3. Applicant Identifier: 4a. Federal Entity Identifier: 4b. Federal Award Identifier: 5. Date Received by State: 6. State Application Identifier: c. UEI: Department Name: Division Name: Street1: Street2: City: County / Parish: State: Province: Zip / Postal Code: Country: b. Employer/Taxpayer Identification Number (EIN/TIN): Prefix: First Name: Middle Name: Last Name: Suffix: Title: Organizational Affiliation: Telephone Number: Fax Number: Email: STATE USE ONLY: 7. APPLICANT INFORMATION: d. Address: a. Legal Name: e. Organizational Unit: f. Name and contact information of person to be contacted on matters involving this submission: Application Plan Funding Request Other Annual Quarterly Other 1.c. Consolidated Application/Plan/Funding Request? Yes No Initial Resubmission Revision Update Explanation US Virgin Islands Department of Human Services 1900000059A1 CPBZB5PFK479 1303 Hospital Ground Suite 1 St. Thomas VI: Virgin Islands USA: UNITED STATES 00802-6722 Ms. Averil E George Commissioner US Virgin Islands Department of Human Services 3407740930 averil.george@dhs.vi.gov 10/28/2024 8a. TYPE OF APPLICANT: Other (specify): b. Additional Description: 9. Name of Federal Agency: 10. Catalog of Federal Domestic Assistance Number: CFDA Title: a. Applicant: b. Program/Project: a. Start Date: b. End Date: a. Federal ($): b. Match ($): 16. IS SUBMISSION SUBJECT TO REVIEW BY STATE UNDER EXECUTIVE ORDER 12372 PROCESS? 13. CONGRESSIONAL DISTRICTS OF: 14. FUNDING PERIOD: 15. ESTIMATED FUNDING: APPLICATION FOR FEDERAL ASSISTANCE SF-424 - MANDATORY Attach an additional list of Program/Project Congressional Districts if needed. F: U.S. Territory or Possession Department of Health and Human Services ACF & ACL 93.667 Social Services Block Grant 11. Descriptive Title of Applicant's Project: US Virgin Islands Social Services Block Grant FY2025 Intended Use Plan 12. Areas Affected by Funding: US Virgin Islands - St. Croix, St. Thomas and St. John 10/01/2024 09/30/2025 6,994,532.96 a. This submission 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 State for review. c. Program is not covered by E.O. 12372. View Attachment Delete Attachment Add Attachment 17. Is The Applicant Delinquent On Any Federal Debt? Prefix: First Name: Middle Name: Last Name: Suffix: Title: Organizational Affiliation: Telephone Number: Email: Fax Number: Signature of Authorized Representative: Date Signed: 18. 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 18, Section 1001) Authorized Representative: Attach supporting documents as specified in agency instructions. APPLICATION FOR FEDERAL ASSISTANCE SF-424 - MANDATORY ** This list of certifications and assurances, or an internet site where you may obtain this list, is contained in the announcement or agency specific instructions. Yes No Explanation ** I Agree Ms. Averil E George Commissioner 3407740930 averil.george@dhs.vi.gov View Attachments Delete Attachments Add Attachments 10/28/24 Social Services Block Grant FY 2024 Intended Use Plan APPENDIX E SF 425 HHS - ADMINISTRATION FOR CHILDREN AND FAMILIES SOSC24 US Virgin Islands Department of Human Services 1303 Hospital Ground Suite 1 Virgin Islands usa 00802-6722 : CPBZB5PFK479 660431678 /1900000059A1 A337B 10/1/23 9/30/24 09/30/2024 4,409,970.22 4,409,970.22 0.00 6,994,532.96 4,409,970.22 4,615,332.79 2,379,200.17 0.00 St. Thomas View Burden Statement 205,362.57 0.00 Lydia Magras Chief Financial Officer 340-774-0930 X 4134 LYDIA.MAGRAS@DHS.VI.GOV 10/28/24 0.00 0.00