DATE: October 3rd, 2014

Request for Applications (RFA) to Develop

A WELLNESS/DROP-IN CENTER PROGRAM

START-UP FUNDING AVAILABLE

Fiscal Years 2014-2017

RFA’s deadline: November 7th, 2014 at 5:00PM

Westside Regional Center (WRC) is requesting applications for the development of wellness/drop-in center program in a safe andintegrated environment. This program will provide supports and services for young adults with developmental disabilities served by WRC, with a special emphasis on individuals dually diagnosed with, or at risk for,co-occurring mental health conditions.

This new and innovative service is being designed to support young adults, 18-25 years of age, during their transition into adulthood by fostering empowerment through psycho-educational supports and other activities. A structured drop-in center mayprovide activities that meet participants’ community integration goals such as vocational support,independent living skills workshops, peer mentoring, counseling, and/orother wellness-focused activities (e.g. art, music, fitness, and nutrition). This program may be open two afternoons per week or one day a week (e.g. Saturday). This program may host mental health provider to deliver individual and/or group therapies and/or assist with intake/assessment and referrals to local mental health agencies. This program may also host an employment specialist to assist young adults with their vocational needs. WRC will assist with recruitment for the program.

The wellness/drop-in center program will be an integrated part of Project UNITE, a project administered by WRC and supported by Mental Health Services Act (MHSA) funding from the Department ofDevelopmental Services. The wellness/drop-in program will be funded for three years (fromthe date of contract award to June 30th, 2017)depending on successful delivery of services outlined in a deliverable-based contract.This service has potential to be vendored by WRC and/or expanded to other regional centers.

Available funds for the wellness/drop-in center are as follows:

  • $30, 368 for fiscal year 2014-2015 (date of contract award till June 30th, 2015);
  • $56,064 for fiscal year 2015-2016 (July 1st, 2015 till June 30th, 2016); and
  • $56,064 for fiscal year 2016-2017 (July 1st, 2016 till June 30th, 2017).

Interested parties are invited to submit applications in accordance with the specifications contained in this Request for Applications (RFA). Applicants responding to this RFA must be able to demonstrate the ability to:

(1)Support individuals with developmental disabilities with or at risk for co-occurring mental health conditions.

(2)Develop and/or modify a program design that incorporates the services and supports to be used in this drop-in center/program as well as describe staffing requirements, certifications, licenses, staffing patterns, staffing training, and record keeping.

(3)Provide integrated environments for participants of wellness/drop-in center and/or their parents or other care providers

(4)Start the programwithin 3 to 6 months of contract award and inthe WRC catchment areas. Optimal locations include Culver City, El Segundo, West Los Angeles, Santa Monica, Westchester, Palms, and Hawthorne.

(5)Demonstrate a system of tracking attendance, services provided/accessed, and long term outcomes for participants.

(6)Communicate effectively with young adults, families, WRC and other program partners/affiliates about the progress of the wellness/drop-in program

(7)Have a working knowledge of systems of care that young adults with developmental disabilities and their family members typically interact with (e.g. regional center, mental health, managed care, IHSS, other general resources) and act as a resource for program participants.

Preference will be given to applicants who have:

(1)At least two years of experience supporting individuals with developmental disabilities through individual, specialized supervision, or behavior management programs.

(2)At least two years of experience supporting individuals with mental health conditions through individual or group therapies.

(3)An established and licensed location for the wellness/drop-in center in WRC’s catchment area with a space for individual and/or group therapy (e.g. a separate small room)

(4)Qualified and experienced direct support professionals to provide services at wellness/drop-in center or ability to identify, hire, and train staff within 3 to 6 months of contract award.

(5)Established relationships with local colleges, programs that offer supports for transition-age youth (e.g. peer mentors, classes, activities, resources, etc.)

If you are interested in developing and administering this program, please complete and submit an application that includes Attachments A through F and your resume. Successful applicants must adhere to the writing guidelines outlined in this RFA and complete each attachment enclosed.

The application isdue to Westside Regional Center by 5:00 p.m. on November 7th, 2014. Hardcopies of the application may be mailed to:

Westside Regional Center

5901 Green Valley Circle, Ste. 320

Culver City, CA 90230

ATTN: Aga Spatzier, Wellness Coordinator

All inquiries regarding this proposal and technical assistance requests should be directed via email to . Technical assistance is limited to information on the requirements for preparation of applications.

Timeline

RFA PostedOctober 3rd, 2014

Deadline for ProposalsNovember 7th, 2014

Finalist Interviews BeginNovember 17th, 2014

Award NotificationDecember 18th, 2014

Deliverable-based contract Signed By_January 23rd, 2015

Project to start operationJune 1st, 2015

Quarterly Reports_effective June 1st, 2015

Instructions for Completing the Application

The applicant is required to submit an applicationthat adheres to the requirements specified below. An application may be disqualified from consideration for failure to follow instructions, complete documents, submit required documents or meet the deadline. Requirements include:

Submit 1 original and 6copies of your application.

Use standard size (8 ½ x 11) paper with size 12 font.

Do NOT place in ring binders or folders, but rather use binder clips or compressor clips

Content Requirements for the Application

The application package should be organized as follows:

  1. Title Page (Attachment A; one page)
  2. Statement of Obligation (Attachment B; one page)
  3. Description/Background of Applicant: Include name of the author of the proposal, a brief history of theapplicant/agency, mission statementand goals, methods for monitoring progress and insuring quality of service, description of partners, consultants and staff (years of experience, terminal degrees), description and demographics of clients served by applicant, and projects with regional centers. Specify any past history of activities which had serious negative impact upon development of projects (e.g. financial loses, investigations or citations). Any information withheld or omitted may result in disqualification of the application or termination of contract(Attachment C; up to two pages).
  4. Project Narrative:Includedescription of the proposed wellness/drop in center program. This is step-by-step action plan, which includes measureable, time-limited activities toward the achievement of specific project tasks and achievement of the proposed outcome. The objectives should be realistically achievable within the time frame. Timeline of project activities has to reflect the contract date (1/23/15) and projected start of program (6/1/15). The action plan should include proposed location, hours, staff, and program’s curriculum(Attachment D; up to three pages).
  5. Financial Statement(Attachment E) or the most recent Audited Financial statement.Plus, 501© (3) Status for non-profit corporations or a certificate of Limited Partnership (LP-1) for limited partners, Limited Liability Company Articles of Incorporation (LLC-1) for limited liability companies.
  6. Program Budget: Include budget narrative describing how each budget line item was calculated (Attachment F).

Application Review Procedure

All applications received by the deadline will undergo a preliminary screening. Late or incomplete applications will not be accepted for review and rating. The RFA Review Committee will be seated by WRC. Applications will be reviewed for completeness, applicant experience, proposed program design, applicant’s fiscal stability, resources of applicant, and ability of applicant to identify and achieve outcomes. After preliminary review and scoring, an interview with the finalists will be scheduled. The final decision of the RFA Review Committee shall be approved by the Executive Director, and is not subject to appeal. All applicants will receive notification of WRC’s decision regarding their applications.

This Committee will review, score, rank, and prioritize the applications. Applications may be rejected for inconsistency with state and federal guidelines, failure to follow RFA instructions, incomplete documents, or failure to submit required (or additional, if needed) documents.

Applications will be reviewed and scored based on the following criteria:

  1. Applicant Qualifications(35 points)
  2. Applicant has educational background and/or practical experience necessary tocomplete a project of this scope.
  3. Applicant’s philosophy and values are consistent with WRC’s missions, values and operating principles.
  4. Applicant has all relevant certifications, licenses, etc., necessary to start this project within WRC catchment area.
  5. Applicant is able to start this project within 3 to 6 months of contract award.
  6. Applicant has qualified and experienced direct support providers available to provide services or can identify, hire, and train staff within 3 to 6 months of contract award.
  7. Applicant has established relationships with local community agencies (e.g. colleges, TAY Centers, other programs) that offer supports for youth and young adults.
  8. Project Design (25 points)
  9. Application provides evidence that the applicant understands the needs of the clients to be served and understanding of the project requirements.
  10. Application includes measurable goals and methods to achieve outcomes.
  11. Applicationincludes activities of the program and reasons for selecting these activities.
  12. Application is clear, innovative, and makes compelling case.
  13. Application describes staffing of the program.
  14. Application describes how data will be gathered to measure success of the program.
  15. Project Budget and Timeline (10 points)
  16. Projected budget is realistic and includes reasonable means of computation.
  17. Budget includes calculations
  18. Budget is appropriate to perform the tasks described in the project design.

In addition to evaluation on the merit of the application, applicants will be evaluated and selected based on any previous performance (including timely completion of projects, a history of cooperative work with regional center or other funders, and a track record consistent with established timelines for development).

Reservation of Rights

Applications responding to the Request of Applications (RFA) shall bear all costs associated with the development and submission of an application. WRC reserves the right to request or negotiate changes in applications, to accept all or part of an application, or to reject any or all applications. WRC may, at its sole and absolute discretion, select no provider for these services, if, in its determination, no applicant is sufficiently responsive to the need. WRC reserves the right to withdrawn this RFA and/or any item within the RFA at any time without notice. WRC reserves the right to disqualify any proposal which does not adhere to the RFA guidelines. This RFA is being offered at the discretion of WRC. It does not commit WRC to award any grant. Award of these funds is at the sole discretion of the selection committee at Westside Regional Center and its Executive Director. The decision of the selection committee and WRC’s Executive Director is final and not subject to appeal. Employees of regional centers and Area Boards are not eligible to apply. Current employees of State Developmental Centers may apply, but are subject to approval following AB 1106 guidelines provided by the Department of Developmental Services (DDS).

ATTACHMENT A

TITLE PAGE

TO: WELLNESS CENTER SELECTION COMMITTEE

Westside Regional Center

5901 Green Valley Circle, Suite 320

Culver City, CA 90230

Attention: Aga Spatzier

PROGRAM TITLE (please print)

NAME OF APPLICANT or ORGANIZATION SUBMITTING PROPOSAL (please print)

ADDRESSCITYSTATEZIP

TELEPHONE NUMBER FAX NUMBER EMAIL ADDRESS

CONTACT PERSON FOR PROJECT (please print)

NAME OF PARENT CORPORATION;if applicable, please indicate: □ Non-profit □For-profit

AUTHOR OR PROPOSAL (if different from applicant identified above)

I affirm that the information presented in this application is true and that the application was developed and authored by the person(s) indicated. I understand that any falsification of information or failure to disclose any history of deficiencies or abuse will be a cause for immediate disqualification. I also understand that failure to meet minimum qualifications as stated in the RFA, late proposal submissions, facsimile proposal copies, and any missing information will also be cause for immediate disqualification. I further understand that, in the event that my application is selected for development and funding, the application itself is not approved conclusively.

SIGNATURE OF PERSON AUTHORIZED TO BIND ORGANIZATION DATE

ATTACHMENT B

STATEMENT OF OBLIGATION

1.The applicant is presently providing supports to persons who have developmental disability. [ ] No [ ] Yes

If yes, indicate name, location, and number of people you support.

2.The applicant is presently providing supports to persons who have mental health condition. [ ] No [ ] Yes

If yes, indicate name, location, and number of people you support.

3.The applicant is currently receiving or planning to apply for grants/funds from any

source to develop social services program?

[ ] No [ ] Yes

If yes, indicate name, location, type and capacity of service(s).

4.The applicant is planning to expand existing service (with or without grant funds) from a source other than Westside Regional Center during Fiscal Year 2014-2015.

[ ] No [ ] Yes

If yes, indicate funding source and scope of grant project.

5.The applicant or member of the applicant’s organization or staff has received a

citation from any agency for abuse (verbal, physical, sexual, fiduciary, neglect)?:

[ ] No [ ] Yes

If yes, indicate agency, type of citation and outcome of investigation.

6.Has the applicant or any member of the applicant’s organization received a

Corrective Action Plan (CAP), Sanction, a notice of Immediate Danger, or an “A”

or “B” citation, or any other citation from a regional center or State Licensing

agency?

[ ] No [ ] Yes

If yes, explain in detail.

7.Describe all other professional/business obligations held by the Licensee and

Administrator, including name, location, type, and capacity (time commitment) of

each obligation.

Do not included services you propose to provide through this proposal.

Signature of Applicant or Authorized RepresentativeDate

ATTACHMENT C

DESCRIPTION/BACKGROUD OF APPLICANT

ATTACHMENT D

PROJECT NARRATIVE
ATTACHMENT E
FINANCIAL STATEMENT

1.CURRENT ASSETS:

Cash in banks
Accounts receivable
Notes receivable
Equipment/vehicles
Inventories
Deposits/Prepaid expenses
Life insurance (cash value)
Investment securities (stocks and bonds)

2.FIXED ASSETS:

Building and/or structures
Real estate holdings
Long term investments
Potential judgments and liens

3.CURRENT LIABILITIES:

Accounts payable
Notes payable (current portion)
Taxes payable

4.LONG-TERM LIABILITIES:

Notes/Contracts
Real estate mortages

5.OTHER INCOME, wages, or revenues from other sources

(specify)

6.LINE OF CREDIT

Amount available (specify)

1