Minnesota Department of Human Services, Mental Health Division

Transcription

1 Minnesota Department of Human Services, Mental Health Division Request for Proposals for a Qualified Grantee to Provide Housing with Supports for Adults with Serious Mental Illness Date of Publication: August 8, 2016 Americans with Disabilities Act (ADA) Statement: This information is available in accessible formats for people with disabilities by calling or by using your preferred relay service. For other information on disability rights and protections, contact your agency s Americans with Disabilities Act (ADA) coordinator.

2 Table of Contents I. Introduction... 2 A. Purpose of Request... 2 B. Objective of this RFP... 2 C. Background... 3 II. Scope of Work... 3 A. Overview... 3 B. Tasks Deliverables... 5 Reporting Requirements... 5 Project Activities... 5 Partnerships... 7 III. Proposal Format... 8 A. Required Proposal Contents... 8 B. Proposal Requirements... 9 C. Required Statements IV. RFP Process A. Responders Conference B. Responders Questions C. Proposal Submission V. Proposal Evaluation and Selection A. Overview of Evaluation Methodology B. Evaluation Team C. Evaluation Phases D. Contract Negotiations and Unsuccessful Responder Notice VI. Required Contract Terms and Conditions VII. State s Rights Reserved Appendix A: Sample State Grant Contract Appendix B: HSASMI Budget, Data, Reporting Tool Appendix C: Cooperative Agreement Housing with Supports for Adults with Serious Mental Illness (HSASMI) Program Requests for Proposals Page 33 Form B-2 (Rev )

3 I. Introduction A. Purpose of Request The Minnesota Department of Human Services, through its Mental Health Division (State), is seeking proposals from qualified responders, as authorized by Minnesota Statutes , subdivision 9 (2),the housing with supports for adults with serious mental illness grant program (HSASMI), to provide supportive services for persons with serious mental illness (SMI) who are homeless, long term homeless, or exiting institutions who have complex needs and face high barriers to obtaining and maintaining housing. Services provided will assist persons to transition to and sustain permanent supportive housing (PSH) which meets the PSH evidence-based practice (EBP) fidelity standards. B. Objective of this RFP The objective of this RFP is to contract with a qualified responder(s) to perform the tasks and services set forth in this RFP. The term of any resulting contract is anticipated to be for up to 18 months, and available from January 2017 until June 2018, with the option for up to 3 years of extensions. Qualified responders are Minnesota counties and tribes, mental health service providers, and other social service agencies with expertise serving the proposed target population(s), including expertise serving underserved or disparately impacted populations. Priority will be given to respondents that can assure service supervision by a qualified mental health professional. Awards will be made in amounts no greater than $500,000. Approximately $3 million is available to be awarded. In order to assure that the persons served by the HSASMI grants have direct access to supportive housing opportunities the respondents are required to establish partnerships with housing partners that have available sustainable supportive housing units, rental subsidies, or other affordable housing opportunities which can be available for the persons served. Additionally, to assure that the persons served have access to a full range of mental health services the respondent must establish a partnership with the county local mental health authority, regional adult mental health initiative, or a tribal nation mental health agency in order to link persons to their choice of the healthcare services and the resources they are eligible for. The respondent will also assure that the services provided are not supplanting state health plan services, and that the opportunities for the persons served to access other state and federal supportive services are maximized. In order to assure that the housing and service needs of racial, ethnic, and cultural communities are met, the Division is specifically seeking grantees that include culturally diverse service providers and/or who provide services to disparately impacted individuals. The Mental Health Division is committed to promoting health equity and reducing disparities for individuals living with serious mental illnesses who are experiencing homelessness or long term homelessness, or exiting institutions with complex needs and are at risk of homelessness. In addition, the Division seeks to assure statewide access to housing support services. The responders will need to demonstrate familiarity with, and a capacity to achieve, the fidelity measures identified in the Substance Abuse and Mental Health Services Administration (SAMHSA) PSH EBP KIT in the Evaluating Your Program document located at: Throughout the grant period, the Mental Health Division will provide training on the PSH EBP, technical assistance, and conduct fidelity review and assessments which the grantees will be required to participate in. Grantees will also need to submit required data, including registering for and utilizing the Mental Health Information System (MHIS). Request for Proposals Page 2 Form B-2 (Rev )

4 Proposals must be submitted by 4:00 p.m. Central Time on September 30, This RFP does not obligate the State to award a contract or complete the project, and the State reserves the right to cancel the solicitation if it is considered to be in its best interest. All costs incurred in responding to this RFP will be borne by the responder. Important RFP dates: August 8, 2016 Request for Proposals listed in State Register August 15, 2016 Responder s Conference September 16 Last day to submit questions September 30, 2016 Proposals due to State C. Background The housing mission statement (Minnesota Statutes, section , subd. 4) was added to the Minnesota Comprehensive Adult Mental Health Act in 1989 and directs the commissioner to ensure that housing services are provided as part of a comprehensive mental health service system. The Act assures that persons with mental illness are allowed to live in stable, affordable housing, in settings that maximize their community integration and opportunities for acceptance; they are supported in their active participation in the selection of their housing from those available to the general public; and that they are provided the necessary support regardless of where they choose to live. In 2007 the Governor s Initiative on Mental Health made available yearly grant funding for the development of housing with supports for persons with serious mental illness. The HSASMI grants provide supports in permanent supportive housing opportunities for persons occupying about 420 units per year. The HSASMI grants support a range of permanent, lease-base, housing models ranging from single site to scattered site housing projects. In alignment with the housing mission statement, the HSASMI grant housing projects have been selected based upon, and are encouraged to meet, the fidelity standards of the PSH EBP. The housing with support grants were expanded in 2015 in order to increase the opportunities for persons with serious mental illness to have the supportive services and housing needed to access and retain housing. Additionally these grants support the use of the PSH EBP as the design and assessment standard for the grants, will provide training for grantees, and support the state resources needed for oversight of the HSASMI grants and fidelity based evaluation of the grantees. The PSH models will assure that tenants have access to affordable housing opportunities which are permanent housing. The definition of permanent housing is lease-based, or ownership-based, housing that does not have a pre-defined time limit. The supportive services will be recovery oriented, person-centered, and will demonstrate capacity to provide or link tenants to best practice and evidence-based mental health services. Examples include certified peer specialist delivered services, individual placement and support (IPS) employment services, and critical time intervention (CTI). II. Scope of Work A. Overview The goal of the HSASMI grants is to assure that all persons with serious mental illness, with significant barriers to housing, can obtain and retain permanent supportive housing. Successful grantees will demonstrate housing access and housing sustainability outcomes. Additional program measures will include tenant linkage to mental health services, linkage to natural community supports, and quality of life indicators. Respondents may also identify proposal specific outcomes and goals. The supportive housing and services responders will meet the fidelity standards of the PSH EBP at application, or identify in the proposal specific objectives to meet fidelity standards within the grant period. Grantees will provide core services that transition persons into housing, and services to assist persons with sustaining tenancy over time. Request for Proposals Page 3 Form B-2 (Rev )

5 Services will be recovery focused, person-centered, culturally competent, and draw on best and evidence based practices. "Culturally competent" means the ability and the will to respond to the unique needs of a person that arise from the person's culture and the ability to use the person's culture as a resource or tool to assist with the intervention and help meet the person's needs. Responders may designate a limited portion of grant funding, no more than 20% of funding, for a direct assistance to cover housing related costs such as deposits and application fees that assist tenants with accessing and establishing a household. Services may include a limited amount of outreach activities to identify and engage potentially eligible persons in housing transition services and mental health services. o Outreach service includes both efforts to contact people who are homeless in the community through street outreach, and outreach to people in segregated settings such as shelters, hospitals, or other institutional settings, which is sometimes called in-reach. o Outreach activities may not use more than 20% of the grant funding and must directly link persons receiving outreach to housing transition services and mental health services. Grantees will provide housing transition services to support persons who need assistance with accessing and establishing housing. Grantees will provide tenancy sustaining services to support persons in maintaining tenancy once housing is secured. Responders will identify a service area within Minnesota, and the targeted units or subsidy resources that will be available for persons with SMI. Grantees must demonstrate compliance with fair housing laws, and may not limit access to the housing or grant based services by establishing requirements which limit fair housing, healthcare, or service access. Grantees must demonstrate strong housing and mental health partnerships by submitting a cooperative agreement identifying the housing agency, grant service provider(s); and the county local mental health authority, regional adult mental health initiative, or a tribal nation mental health agency partners. The cooperative agreement will define the partner s roles and responsibilities. The grantee will serve persons with serious mental illness, which is defined as persons with mental illness as stated in MS , Subd. 20(a), that seriously limits a person's capacity to function in primary aspects of daily living such as personal relations, living arrangements, work, and recreation. Additionally the person must meet any of the following homeless criteria priorities: 1. Persons residing in an institution or other segregated setting who will be homeless upon discharge. 2. Persons experiencing homelessness for one year or more, or multiple times in the last 3 years. 3. People experiencing or at imminent risk of homelessness. Persons with serious mental illness is inclusive of persons with co-occurring chemical dependency, and transition age youth. Transition age youth is defined as a person 25 years of age or younger who is unaccompanied by a parent or guardian, meets one of the homeless criteria above, and will become legally able to enter into a lease agreement for a housing unit within the grant period. Respondents are strongly encouraged to identify specific project priorities that address the service, housing, and culturally specific needs of underserved or disparately impacted populations. Grantees will collect and submit identified data that is accurate and reported timely, including using the Mental Health Information System (MHIS). Grantees will also participate in required technical assistance, fidelity reviews, and assessments. This RFP provides background information and describes the services desired by the State. It delineates the requirements for this procurement and specifies the contractual conditions required by the State. Although this RFP establishes the basis for Responder Proposals, the detailed obligations and additional measures of performance will be defined in the final negotiated contract. Request for Proposals Page 4 Form B-2 (Rev )

6 B. Tasks Deliverables The responder will describe how the following deliverables will be met. Reporting Requirements 1. Data Reporting MHIS: A grantee will be able to report in MHIS by enrolling as a Minnesota Health Care Provider using either National Provider Identifier (NPI), Unique Minnesota Provider Identifier (UMPI), or other eligible identifier. The grantee will also complete MHIS reporting for all HSASMI service recipients as described in the MHIS Manual. Housing Data: Using the HSASMI Budget, Data, Reporting Tool (appendix B) a grantee will submit housing data that identifies the housing models and housing commitments that the service recipients access. The housing data is submitted at the end of each state fiscal year and at the end of the calendar year, the six month periods ending June 30 and December 31, and at contract end. Service Data: Using the HSASMI Budget, Data, Reporting Tool (appendix B) a grantee will submit program service data which cannot be collected via MHIS. The HSASMI service data is submitted at the end of each state fiscal year and at the end of the calendar year, the six month periods ending June 30 and December 31, and at contract end. Service data is reported by each of the HSASMI service types, outreach services, housing transition services, and tenancy sustaining services. 2. Outcome Measures and Reporting HSASMI measures and reporting: Using the HSASMI Budget, Data, Reporting Tool (appendix B) a grantee will submit outcomes twice a year at the six month periods ending June 30 and December 31, and at contract end. The outcome measures address the three service categories: i. Outreach Service outcomes ii. Housing Transition Service outcomes iii. Tenancy Sustaining Service outcomes Grantee outcome measures and reporting: Using the HSASMI Budget, Data, Reporting Tool (appendix B) respondents are encouraged to identify and report on project specific outcomes and measures that reflect the persons served, targeted household(s), and objectives of the project. 3. Fiscal Reporting The Enterprise Grants Management System (EGMS) is required for fiscal reporting. EGMS is an internet based quarterly reporting tool used by DHS for grant management and issuing electronic payments. Budget Report: Using the HSASMI Budget, Data, Reporting Tool (appendix B) at the end of each state fiscal year, at the end of each calendar year, and at contract end, grantees will submit a budget report detailing the use of grant funding. The proposed budget will be submitted using the HSASMI Budget, Data, Reporting Tool (appendix B). Including the HSASMI grant request; expenses for outreach services, housing transition services, tenancy sustaining services, and direct service administrative costs; indirect administration; and direct assistance expenses. Project Activities 1. Direct Supportive Services a. Outreach Services: Reaches out to potentially eligible individuals who are homeless, in an institutional or segregated setting, and not connected with a mental health or housing service. Engages the person in services, provides assessment, and helps to access and transition to sustainable services. The activities of outreach service is comprised of four elements: Request for Proposals Page 5 Form B-2 (Rev )

7 i. Identification Identifying potentially eligible mental health service recipients, locating unserved or underserved persons who are homeless in the community and in institutional or segregated settings. ii. Engagement Contacting a person in order to engage them in services. Engagement establishes trust, builds a working relationship, and educates the person about service and resource options. iii. Assessment Ongoing evaluation of a person s strengths, needs, preferences, recovery goals, and their barriers to accessing services, housing, and resources. iv. Access Assisting the person with identifying their service and housing preferences, helping them to resolving barriers to access, and facilitating the person s transition to sustainable services, housing, and needed resources. b. Housing Transition Services: Is a required service that will provide direct support to persons with SMI who need assistance with accessing housing. The eligible service activities are: i. Conduct tenant screening and housing assessment to identify the person s preferences and barriers to successful tenancy. ii. Develop an individualized housing support plan based on the housing assessment that identifies barriers, measurable short and long-term goals, establishes the person s approach to meeting the goal, and identifies needed providers or services to meet the goal. iii. Assist with the housing search and application process. iv. Identify resources to cover one-time expenses that facilitate access of housing and establishment of a household such as security deposits, moving costs, furnishing, adaptive aids, and environmental modifications. v. Ensure that the living environment is safe and ready for move-in. vi. Assist with arranging for and supporting the details of the move. vii. Develop a housing support crisis plan that includes prevention and early intervention services when housing is jeopardized. c. Tenancy Sustaining Services: Is a required service that will provide direct services to support persons with SMI in sustaining tenancy once housing is secured. The eligible service activities are: i. Provide early identification and intervention for behaviors that may jeopardize housing. ii. Provide education and training on the roles, rights and responsibilities of the tenant and the landlord. iii. Coach on developing and maintaining key relationships with landlords and property managers in order to foster successful tenancy. iv. Assist with resolving disputes with landlords, property managers, and neighbors to reduce the risk of eviction or other adverse action. v. Provide advocacy and linkage to community resources to prevent eviction or other negative housing outcomes. vi. Assist with the housing recertification process. vii. Coordinate with the tenant to review, update and modify their individualize housing support and housing support crisis plans on a regular basis to reflect current goals, needs, and housing retention barriers. viii. Provide ongoing training on responsible tenancy, lease compliance, and support with activities related to household management. d. Service Clinical Supervision: The project staff providing the direct services of outreach, housing transition, and tenancy sustaining services must receive clinical supervision by a qualified mental health professional. Respondents will identify the qualifications of the mental health professional, and the plan for providing supervision of project staff. e. Staff Qualifications: The recommended staff qualifications are mental health professional, mental health practitioner, mental health rehab worker, or certified peer specialists. Other eligible staff are staff who are trained, or have demonstrated experience, in serving persons with serious mental illness or the project priority households. The respondent will describe the staffing, Request for Proposals Page 6 Form B-2 (Rev )

8 qualifications, training, and the clinical supervision plan for the staff. Respondents will describe staff and agency capacity to provide culturally relevant services. The respondent will also identify staffing details in the HSASMI Budget, Data, Reporting Tool (appendix B). i. Respondents that employ certified peer specialists for the provision of direct supportive services may be eligible for additional evaluation points (see section V.C.2.). The respondent should include details on the employment support for and duties of certified peer specialist staff. 2. Direct Assistance: The direct assistance covers housing related costs that assist tenants with accessing and establishing a household. These expenditures are one-time or of limited duration or scope, examples include deposits, application fees, household supplies, tenant education, and rental history remediation. The direct assistance may not be used for ongoing housing related expenditures such as rental assistance, utilities, car payments, or mortgage payments. The proposal may identify and describe a limited direct assistance administration expense for managing the expenditures. 3. Training, Agency Capacity, Fidelity Review and Assessment f. Training: The Mental Health Division will provide technical assistance and training bimonthly via videoconference, phone conference, or webinar for one to two hours which the grantee will be required to participate in. g. Fidelity standards: The fidelity scale identified in the Substance Abuse and Mental Health Services Administration Permanent Supportive Housing Evidence Based Practice KIT in the Evaluating Your Program document will be the fidelity standards used for review and assessment. i. EvaluatingYourProgram-PSH.pdf h. Agency capacity: Respondents will describe how the proposal meets the fidelity standards of permanent supportive housing, and the agency s capacity to achieve and sustain fidelity standards. i. Fidelity review and assessment: Grantees will be reviewed yearly using the Fidelity Scoresheet and must demonstrate, or be actively working to meet, a minimum fidelity score of 21 out of 28 possible points. Upon review grantees that do not meet the minimum fidelity score will put in place a Mental Health Division approved plan to meet the minimum fidelity score. 4. Administration: The allowable administrative expenses are separated into two categories, direct services administration and indirect administration costs. Direct services administration are the expenses specific to supporting staff performing direct delivery of services, including for example staff travel, training, and contracted services. Indirect administration expense are the expenses needed to manage and oversee the program for the responder agency. Partnerships 1. Critical Partnerships: Sustainable PSH for persons with SMI requires critical partnerships that reflect the needs of the persons to be housed and served, and identifies the resources and coordination that the partners can contribute to the proposed project. These partners include, but are not limited to, the respondent service provider; a local county, tribal nation, or AMHI mental health system entity; and the housing owner, property manager, or housing agency that manages the housing resources available. The partners should include agencies with cultural expertise for the targeted service recipients. The partnerships may also include employment partners, continuums of care, other specialized service providers, or other community supports needed to assist the tenants. a. Identify Partners: The proposal should detail the critical partnerships and the role each will have. The respondent will submit with the application a letter of support from each partner or a cooperative agreement representing all partners. Request for Proposals Page 7 Form B-2 (Rev )

9 b. Cooperative Agreement: Selected grantees will submit a cooperative agreement prior to the finalization of the contract. The cooperative agreement will detail the parties involved, term of the agreement, purpose of the agreement, guiding principles, responsibilities of the partners, the rights and responsibilities of tenants, and the implementation, evaluation, and contacts of the agreement. An example cooperative agreement is located in appendix C. 2. Housing Partnerships: Since the available funding does not cover the costs of ongoing housing assistance, the respondent needs to identify in the application the details of the housing partner(s) commitment to making available or targeting housing resources. Additionally using the HSASMI Budget, Data, Reporting Tool (appendix B) the respondent will detail: c. Housing models: They type of housing models and number of proposed units to be accessed by tenants. d. Housing commitment: The types of federal, state, and local rental assistance and the number of households or units to be available. 3. Service Partnership: The respondent will describe the outreach, housing transition, and tenancy sustaining services to be provided, including the proposed number of persons to be served. e. Service commitment: The respondent will also identify in the HSASMI Budget, Data, Reporting Tool (appendix B) the services and number proposed to be served. 4. Priorities: The respondent will identify how they will serve persons with serious mental illness, defined as persons with mental illness as stated in MS , Subd. 20(a), that seriously limits a person's capacity to function in primary aspects of daily living such as personal relations, living arrangements, work, and recreation. The respondent will also describe how they will address the three homeless criteria priorities identified in section II. A. above. Additionally using the HSASMI Budget, Data, Reporting Tool (appendix B) the respondent will detail: f. Required priorities: The number of persons meeting the three homeless criteria priorities identified in section II.A. that are proposed to be served. g. Project priorities: Describe any project specific households to be prioritized for services and the number of households targeted. Describe the agency expertise and capacity to provide relevant services for the priority households. i. Respondents prioritizing persons served by the Projects for Assistance in Transition from Homelessness (PATH) or Bridges Regional Treatment Center (BRTC) programs may be eligible for additional evaluation points (see section V.C.2.). The partnerships needed to support persons served by these programs will need to be described clearly in the application, and be identified in the letters of support and the cooperative agreement. ii. Respondents utilizing Certified Peer Specialists on staff may be eligible for additional evaluation points (see section V.C.2.). h. Additional priorities: Responders who are Targeted Organizations (see section C. 8. and ectionmethod=latestreleased&ddocname=dhs16_198281) are encouraged to demonstrate how they may uniquely improve service delivery to the Target Population. III. Proposal Format Proposals must conform to all instructions, conditions, and requirements included in the RFP. Responders are expected to examine all documentation and other requirements. Failure to observe the terms and conditions in completion of the proposal are at the responder s risk and may, at the discretion of the State, result in disqualification of the proposal for nonresponsiveness. Acceptable proposals must offer all services identified in Section II - Scope of Work and agree to the contract conditions specified throughout the RFP. A. Required Proposal Contents Responses to this RFP must consist of all of the following components (See following sections for more detail on each component). Request for Proposals Page 8 Form B-2 (Rev )

10 1. Cover Page 2. Table of Contents 3. Proposal Requirements a. Executive Summary b. Description of the Applicant Agency c. Description of Target Population i. Priorities d. Project Goals and Objectives e. Project Activities and Implementation Plan i. Direct supportive services ii. Direct assistance f. Partnerships i. Critical partnerships ii. Housing partnerships iii. Service partnerships g. Reporting Requirements i. Data reporting ii. Fiscal reporting h. Evaluation Plan i. Outcome measures and reporting ii. Training, agency capacity, fidelity review and assessment i. Budget Proposal i. Administration j. Professional Responsibility 4. Required Statements a. Responder Information and Declarations b. Exceptions to Terms and Conditions c. Affidavit of Noncollusion d. Trade Secret/Confidential Data Notification e. Submission of Certified Financial Audit, IRS Form 990, or Most Recent Board-Reviewed Financial Statements f. Disclosure of Funding Form g. Human Rights Compliance h. Affirmative Action Data Page i. Equal Pay Certificate 5. Appendix B. a. HSASMI Budget, Data, Reporting Tool B. Proposal Requirements The following will be considered minimum requirements of the proposal. Emphasis should be on completeness and clarity of content. The proposal narrative will be submitted using a standard page format and a maximum page count per section. Submitted narratives will have a page size of 8 ½ x 11 inches, single sided, single spaced, with 1 inch margins. The narrative font will be size 12-point font in black color only. Each page will have the respondent agency name identified in the header right margin, the project name in the footer right margin, and the page number in the footer left margin. Do not bind, staple, or hole punch the submitted narrative. a. Executive Summary (maximum 2 pages): This component of the proposal should demonstrate the responder's understanding of the services requested in this RFP and any problems anticipated in accomplishing the work. The Executive Summary should also show the responder s overall design of the project in response to achieving the deliverables as defined in this RFP. Specifically, the proposal should demonstrate the responder's familiarity with the project elements, its solutions to the problems presented and knowledge of the requested services. Request for Proposals Page 9 Form B-2 (Rev )

11 b. Description of the Applicant Agency (maximum 1 page): This section must include information on the programs and activities of the agency, the number of people served, geographic area served, staff experience, and/or programmatic accomplishments. Include reasons why your organization is capable to effectively complete the services outlined in the RFP. Include a brief history of your organization and all strengths that you consider are an asset to your program. The responder should demonstrate the length, depth, and applicability of all prior experience in providing the requested services. Letters of reference may be included. The responder should also demonstrate the skill and experience of lead staff and designate a project manager with experience in planning and providing the proposed services. c. Description of Target Population (maximum 2 pages): Describe the level of need for services in your community and what group or groups of individuals, including diverse populations, will be targeted for services by the program. Discuss whether your program and activities will have a local, regional or statewide impact and whether they will serve low- and moderate-income individuals and families. Include a description of the referral system(s) used by the program to reach the target population. Describe how the targeted priorities, including the required priorities and project priorities, will be met (Section II.B.11). As a component of your response, you may attach documentation showing your qualification as a Targeted Organization (see section C. 8) and explain how your qualification as a Targeted Organization uniquely improves your ability to provide services to the Target Population. d. Project Goals and Objectives (maximum 2 pages): This section should clearly define and discuss the goals and objectives of the project. Propose and describe specific milestones and outcomes that will be used to demonstrate the program s effectiveness. e. Project Activities and Implementation Plan (maximum 6 pages): All proposals submitted under this RFP must address, in sufficient detail, how the responder will fulfill the expected outcomes and features set forth above. Simply repeating the outcomes and features and asserting that they will be performed is not an acceptable response. This section should detail how the project will be carried out in an effective and efficient manner, including who will be involved, what resources are required, target dates for project activities and the timeframe for completion. Provide a description of the program design you propose to implement. Describe in detail how and by whom the direct supportive services and direct assistance activities will be delivered (Sections II.B.4. and 5.). f. Partnerships (maximum 3 pages): Describe the partnerships (Section II.B.8. to 10.) that the project will rely on to accomplish the work and meet the housing and service outcomes of the tenants, HSASMI program, and the proposed project. Include a summary of contributions and responsibilities of the critical, housing, and service partners involved. Identify how the partnerships will align with the project priorities (Section II.B.11). Responders should submit letters of support from the relevant partners, or a cooperative agreement, indicating these partnerships. g. Reporting Requirements (maximum 1 pages): The respondent will describe their capacity to collect and submit the data reporting, outcome measures, and fiscal reporting requirements identified in Sections II.B.1. through II.B.3. Including respondent capacity to utilize the Mental Health Information System (MHIS) and the Enterprise Grants Management System (EGMS), and the need for any technical assistance to assure the ability to use these systems. h. Evaluation plan (maximum 3 pages): The State is committed to funding services that produce a measurable result for the people of Minnesota. A successful responder must describe how they will utilize the HSASMI outcomes identified in Section II.B.2.a. and detailed in the HSASMI Budget, Data, Reporting Tool (appendix B) to assess and guide the project. The respondent will also detail any project specific outcomes and measures and how these measures will demonstrate the impact of the project (Section II.B.2.b.). The respondent will include all proposed outcomes and measures in the HSASMI Budget, Data, Reporting Tool (appendix B). This section will also describe respondent agency capacity to meet the training expectations, fidelity standards, and comply with fidelity review and assessment as described in Section II.B.6. The respondent will also explain any limitations or difficulty with meeting the training expectations, fidelity standards, and fidelity review and assessment expectations, and what will be needed to meet the requirements. Request for Proposals Page 10 Form B-2 (Rev )

12 i. Budget proposal (maximum 4 pages): This section should specify the grant amount requested and detail all expenses for the proposed project. Describe and explain what the estimated costs pay for by expense type - outreach services, housing transition services, tenancy sustaining services, and direct assistance. Additionally, this budget narrative will describe and explain direct service administration, indirect administration expenses as identified in Section II.B.7. Explain the proposed use of the grant funds and any matching funds. Your explanation should provide sufficient detail to justify the total amount budgeted in each category. The program budget must be complete and reasonable, must link to the proposed program activities, and must specify how the amounts for each budget item were determined. Responders are encouraged to apply for only the amount needed for their proposed programs. The total available funds will not necessarily be divided equally, nor will selected applicants be guaranteed the entire amount requested. Budget proposals will be judged on efficient use of funds (that is, funds are being spent on direct services versus administrative costs, as detailed in their budget proposal) and overall cost-effectiveness. The brief proposed budget must be submitted as part of the HSASMI Budget, Data, Reporting Tool (appendix B). j. Professional Responsibility (maximum 1 page): It is crucial that the State locate reliable grantees to serve our clients. The successful responder must be professionally responsible. Therefore, responders must include in their proposals satisfactory information regarding their professional responsibility. Professional responsibility information includes providing information concerning any complaints filed with or by professional and/or state or federal licensing/regulatory organizations within the past six years against your organization or its employees relating to the provision of services. If such complaints exist, please include the date of the complaint(s), the nature of the complaint(s), and the resolution/status of the complaint(s), including any disciplinary actions taken. All proposals must also include information about pending litigation and/or litigation resolved within the past two years that relates to the provision of services by your organization and/or its employees. If such litigation exists, please include the date of the lawsuit, nature of the lawsuit, and the dollar amount being requested as damages, and if resolved, what the resolution was (e.g. settled, dismissed, withdrawn by plaintiff, verdict for plaintiff with $x damages awarded, verdict for responder, etc.). Responder should also submit information which demonstrates recognition of their professional responsibility. This may include awards, certifications, and/or professional memberships. The information collected from these inquiries will be used in the State s determination of the award of the contract. It may be shared with other persons within the Minnesota Department of Human Services who may be involved in the decision-making process, and/or with other persons as authorized by law. You are not required to provide any of the above information. However, if you choose not to provide the requested information, your organization s proposal may be found nonresponsive and given no further consideration. The State reserves the right to request any additional information to assure itself of a responder's professional status. C. Required Statements Complete the correlating forms found in edocs 1 by searching for the form numbers referenced below, or pasting the form file path name found in the footnotes below to your browser, and submit them as the Required Statements section of your proposal. You must use the current forms found in edocs. Failure to use the most current forms found in edocs in completion of the proposal are at the responder s risk and may, at the discretion of the State, result in disqualification of the proposal for nonresponsiveness. 1. Responder Information and Declarations (Responder Information/Declarations Form DHS-7020-ENG) 2 : Complete and submit the attached Responder Information and Declarations form. If you are required to submit Request for Proposals Page 11 Form B-2 (Rev )

13 additional information as a result of the declarations, include the additional information as part of this form. The Responder may fail the Required Statements Review in the event that the Responder does not affirmatively warrant to any of the warranties in the Responder Information and Declarations. Additionally, the State reserves the right to fail a Responder in the event the Responder does not make a necessary disclosure in the Responder Information and Declarations, or makes a disclosure which evidences a conflict of interest. 2. Exceptions to RFP Terms (Exceptions to Terms and Conditions Form DHS-7019-ENG) 3 : The contents of this RFP and the proposal(s) of the successful responder(s) may become part of the final contract if a contract is awarded. Each responder's proposal must include a statement of acceptance of all terms and conditions stated within this RFP or provide a detailed statement of exception for each item excepted by the responder. Responders who object to any condition of this RFP must note the objection on the attached Exceptions to RFP Terms form. If a responder has no objections to any terms or conditions, the responder should write None on the form. Responder should be aware of the State s standard contract terms and conditions in preparing its response. A sample State of Minnesota, Department of Human Services, Grant Contract is attached in the Appendix for your reference. Much of the language reflected in the contract is required by statute. If you take exception to any of the terms, conditions or language in the contract, you must indicate those exceptions in your response to the RFP. Only those exceptions indicated in your response to the RFP will be available for discussion or negotiation. Responders are cautioned that any exceptions to the terms of the standard State contract which give the responder a material advantage over other responders may result in the responder s proposal being declared nonresponsive. Proposals being declared nonresponsive will receive no further consideration for award of the Contract. Also, proposals that take blanket exception to all or substantially all boilerplate contract provisions will be considered nonresponsive proposals and rejected from further consideration for contract award. 3. Affidavit of Noncollusion (Affidavit of Noncollusion Form- DHS-7021) 4 : Each responder must complete and submit the attached Affidavit of Noncollusion form. 4. Trade Secret/Confidential Data Notification (Trade Secret/Confidential Data Notice Form- DHS-7015-ENG) 5 : All materials submitted in response to this RFP will become property of the State and will become public record in accordance with Minnesota Statutes, section , after the evaluation process is completed. Pursuant to the statute, completion of the evaluation process occurs when the government entity has completed negotiating the contract with the successful responder. If a contract is awarded to the Responder, the State must have the right to use or disclose the trade secret data to the extent otherwise provided in the grant contract or by law. If the responder submits information in response to this RFP that it believes to be trade secret/confidential materials, as defined by the Minnesota Government Data Practices Act, Minnesota Statutes, section 13.37, and the responder does not want such data used or disclosed for any purpose other than the evaluation of this proposal, the responder must: a. clearly mark every page of trade secret materials in its proposal at the time the proposal is submitted with the words TRADE SECRET or CONFIDENTIAL in capitalized, underlined and bolded type that is at least 20 pt.; the State does not assume liability for the use or disclosure of unmarked or unclearly marked trade secret/confidential data; b. fill out and submit the attached Trade Secret/Confidential Information Notification Form, specifying the pages of the proposal which are to be restricted and justifying the trade secret designation for each item. If no material is being designated as protected, a statement of None should be listed on the form; Request for Proposals Page 12 Form B-2 (Rev )

14 c. satisfy the burden to justify any claim of trade secret/confidential information. In order for a trade secret claim to be considered by the State, detailed justification that satisfies the statutory elements of Minnesota Statutes, section and the factors discussed in Prairie Island Indian Community v. Minnesota Dept. of Public Safety, 658 N.W.2d 876, (Minn.App.2003) must be provided. Use of generic trade secret language encompassing substantial portions of the proposal or simple assertions of trade secret interest without substantive explanation of the basis therefore will be regarded as nonresponsive requests for trade secret exception and will not be considered by the State in the event of a data request is received for proposal information; and d. defend any action seeking release of the materials it believes to be trade secret and/or confidential, and indemnify and hold harmless the State, its agents and employees, from any judgments awarded against the State in favor of the party requesting the materials, and any and all costs connected with that defense. This indemnification survives the State s award of a contract. In submitting a response to this RFP, the responder agrees that this indemnification survives as long as the trade secret materials are in the possession of the State. The State is required to keep all the basic documents related to its contracts, including selected responses to RFPs, for a minimum of six years after the end of the contract. Non-selected RFP proposals will be kept by the State for a minimum of one year after the award of a contract, and could potentially be kept for much longer. The State reserves the right to reject a claim if it determines responder has not met the burden of establishing that the information constitutes a trade secret or is confidential. The State will not consider prices or costs submitted by the responder to be trade secret materials. Any decision by the State to disclose information designated by the responder as trade secret/confidential will be made consistent with the Minnesota Government Data Practices Act and other relevant laws and regulations. If certain information is found to constitute a trade secret/confidential, the remainder of the Proposal will become public; only the trade secret/confidential information will be removed and remain nonpublic. The State also retains the right to use any or all system ideas presented in any proposal received in response to this RFP unless the responder presents a positive statement of objection in the proposal. Exceptions to such responder objections include: (1) public data, (2) ideas which were known to the State before submission of such proposal, or (3) ideas which properly became known to the State thereafter through other sources or through acceptance of the responder's proposal. A proposal may fail if a Trade Secret/Confidential Data form is not completed and submitted with the proposal. 5. Documentation to Establish Fiscal Responsibility: The successful responder must be fiscally responsible. Therefore, responders must include in their proposals sufficient financial documentation to establish their financial stability. IRS Form 990s. If a responder is a not-for-profit organization that completed an IRS Form 990 in 2014, responder must submit its IRS Form 990. If responder is concerned that its 2014 IRS Form 990 does not demonstrate its fiscal responsibility, it may supplement its application with any of the additional material described below. An IRS Form 990 is a federal tax return for nonprofit organizations. Nonprofit organizations that are recognized as exempt from federal income tax must file a Form 990 or Form 990 EZ if it has averaged more than $25,000 in annual gross receipts over the past three tax years. Please also submit any information about any pending major accusations that could affect your financial stability. Request for Proposals Page 13 Form B-2 (Rev )

15 Organizations without 2014 IRS Form 990s. (1) Organizations that have not completed an IRS Form 990 should submit a certified financial audit if they have one. A certified financial audit is a review of an organization s financial statements, fiscal policies and control procedures by an independent third party to determine if the statements fairly represent the organization s financial position and if organizational procedures are in accordance with Generally Accepted Accounting Principles (GAAP). Any organization with an annual revenue greater than $750,000 is required to have a certified financial audit completed for any fiscal year in which they have total revenue of more than $750,000. (2) If the organization does not have a certified financial audit, the organization must submit its most recent board-reviewed financial statements if it has a board. (3) If the organization does not have a certified financial audit or board-reviewed financial statements because it does not have a board, the organization should submit a certified statement of assets and debts (balance sheet) and evidence of cash flow including amounts in a checking account. Responders may also include documentations of cash reserves to prevent shortages or delays in receipt of revenue, and/or any other documents sufficient to substantiate responsible fiscal management. State may request additional information from these responders as necessary to determine financial stability. All responders must submit any information about any pending major accusations that could affect your financial stability. In the event a responder is either substantially or wholly owned by another corporate entity, the proposal must also include the most recent detailed financial report of the parent organization, and a written guarantee by the parent organization that it will unconditionally guarantee performance by the responder in each and every term, covenant, and condition of such contract as may be executed by the parties. If the responder is a county government or a multi-county human services agency that has 1) had an audit in the last year by the State Auditor or an outside auditing firm, or 2) meets the requirements of the Single Audit Act, the responder is not required to submit financial statements. However, the State reserves the right to request any financial information to assure itself of a county s financial status. The information collected from these inquiries will be used in the State s determination of the award of the contract. It may be shared with other persons within the Minnesota Department of Human Services who may be involved in the decision-making process, and/or with other persons as authorized by law. If you choose not to provide the requested information, your organization s proposal will be found nonresponsive and given no further consideration. The State reserves the right to request any additional information to assure itself of a responder's financial reliability. If a responder s submission in response to this component does not demonstrate its financial stability, the responder may fail this requirement and be disqualified from further consideration. Request for Proposals Page 14 Form B-2 (Rev )