/ Edmund G. Brown Jr.,Governor

State of California
Health and Human Services Agency
State of California
Department of Rehabilitation
Traumatic Brain Injury Program
Request for Application
RFA 02-24-15

DEPARTMENT OF REHABILITATION

TRAUMATIC BRAIN INJURY PROGRAM

REQUEST FOR APPLICATION

TABLE OF CONTENTS

I. AUTHORITY

II. INTRODUCTION

III. PURPOSE OF THIS RFA

IV. DESCRIPTION OF FUNDING AND GRANT PROGRAM SERVICES

V. ELIGIBILITY AND QUALIFICATION REQUIREMENTS

VI. CASE SERVICES CONTRACTS

VII. SCHEDULE OF GRANT AWARD EVENTS

VIII. GENERAL INQUIRIES AND RESOURCES

IX. APPLICATION SUBMISSION REQUIREMENTS

Required Documents and Application Organization

Mandatory Specifications

X. REVIEW PROCESS AND CRITERIA

Evaluation and Scoring

XI. APPEAL RIGHTS FOR A REVIEW

ATTACHMENT A – APPLICATION SUBMISSION

Narrative Outline

Geographic Map of California

Designated Geographic Areas

ATTACHMENT B – FORMS AND ASSURANCES

Cover Sheet Form

Statement of Assurances Form

ATTACHMENT C – ADDITIONAL MATERIALS

Definition of Terms

Application Checklist

ATTACHMENT D – STANDARD GRANT PROVISIONS

I. AUTHORITY

The Traumatic Brain Injury (TBI) grant is authorized by Welfare and Institutions Codesection 4353-4357, section 19150, and section 14132.992.

II. INTRODUCTION

The Department of Rehabilitation (DOR), through its Independent Living and Assistive Technology Section (ILATS), announces the availability of state grant funds as authorized under Welfare and Institutions Code section 4358-4359. Requestfor Application (RFA) is made available to qualified service providers for the purpose of carrying out the programs and services needed to support individuals with TBI and their families.The term of this grant shall be July 1, 2015 through June 30, 2018.

III. PURPOSE OF THIS RFA

The RFA seeks experienced and qualified nonprofit organizations to provide directly, or by arrangement, all of the five core service areas, as identified in Welfare and Institutions Codesection 4357.

The DOR’s goal is to award seven TBIgrants. Applicants must specify the geographic regionin which they plan to provide services. Attachment Aof this RFA includesthe counties of the three designated regions.An organization must have a physical presence in the area of their proposed service region.

Up to two grants will be awarded in each of the designated northern, central, and southern geographic regions. The seventh grant will be awarded to ahigh-scoring applicant from any of the three geographic regions that serve a geographic area not served by the other six selected applicants.

IV. DESCRIPTION OF FUNDING AND GRANT PROGRAM SERVICES

  1. Description of Funding

Funding for a grant award related to this RFA will be from the TBI Fund, which originates from a small percentage of the California Penalty Fund. The grant awards will be one-seventh of the amount of the funding available over the three-year grant cycle for each year of the grant.

The proposed term of the grant is July 1, 2015 through June 30, 2018, subject to the State's option to renew for an additional (2) two, (1) one-year periods under the same terms and conditions if funds are available. Welfare and Institutions Code section 4359 provides “This chapter shall remain in effect until July 1, 2019, and as of that date is repealed, unless a later enacted statute enacted prior to July 1, 2019, extends or deletes that date.”

  1. Description of Grant Program Servicesand Obligations

Grantees must provide the services and meet the requirements described in Welfare and Institutions Codesection 4357.

(a)Service providers shall identify the needs of consumers and deliver services designed to meet those needs.

(b)Service providers shall match not less than 20 percent of the amount granted, with the exception of funds used for mentoring. The required match may be cash or in-kind contributions, or a combination of both, from the sites or any cooperating agency. In-kind contributions may include, but shall not be limited to, staff and volunteer services.

(c)Service providers shall provide at least 51 percent of their services under the grant to individuals who are Medi-Cal eligible or who have no other identified third-party funding source.

(d)(1)Service providers shall provide, directly or by arrangement, a coordinated service model to include all of the following:

(A)Supported living services.

(B)Community reintegration services.

(C)Vocational supportive services.

(D)Information, referral, and, as needed, assistance in identifying, accessing, utilizing, and coordinating all services needed by individuals with traumatic brain injury and their families.

(E)Public and professional education designed to facilitate early identification of persons with brain injury, prompt referral of these persons to appropriate services, and improvement of the system of services available to them.

(2)The model shall be designed and modified with advice from consumers and their families, and shall be accessible to the population in need, taking into account transportation, linguistic, and cultural factors.

(e)Service providers shall develop and utilize an individual service plan which will allow consumers to move from intensive medical rehabilitation or highly structured living arrangements to increased levels of independence and employment. The goals and priorities of each consumer shall be an integral part of his or her service plan.

(f)Service providers shall seek all third-party reimbursements for which consumers are eligible and shall utilize all services otherwise available to consumers at no cost, including vocational rehabilitation services provided by the department. However, grantees may utilize grant dollars for the purchase of non-reimbursed services or services otherwise unavailable to consumers.

(g)Service providers shall endeavor to serve a population that is broadly representative with regard to race and ethnicity of the population with traumatic brain injury in their geographical service area, undertaking outreach activities as needed to achieve this goal.

(h)Service providers shall maintain a broad network of relationships with local groups of brain injury survivors and families of survivors, as well as local providers of health, social, and vocational services to individuals with traumatic brain injury and their families. The sites shall work cooperatively with these groups and providers to improve and develop needed services and to promote a well-coordinated service system, taking a leadership role as necessary.

(i)Service providers shall furnish uniform data to the department pursuant to subdivision (a) of Section 4355 as necessary to monitor and evaluate the program.

(j)Service providers wishing to continue to participate in the program after July 1, 2013, shall, by that date, be in compliance with additional eligibility requirements established by the department pursuant to Section 4355.

V. ELIGIBILITY AND QUALIFICATION REQUIREMENTS

The RFA is open to any qualified and experienced nonprofit organization capable of performing the program services described in section IV.B.Additional eligibility requirements include the following:

  • By signing the Attachment B, Cover Sheet form, the grantee certifies that neither it nor its principals or subcontractors are presently debarred, suspended, proposed for debarment, declared ineligible or voluntarily excluded from participation in this transaction by any federal department or agency. (Reference website: System for Award Management (SAM) Portal.) Federal and State agencies shall not award assistance to applicants that are debarred or suspended, or otherwise excluded from or ineligible for participation in federal assistance programs under Executive Order 12549.
  • By signing Attachment B, Cover Sheet form, the grantee certifies that neither it nor its principals or subcontractors are presently on either list: Franchise Tax Board (State of California Franchise Tax Board - Delinquent Taxpayers), or the Board of Equalization (California Board of Equalization (BOE) Sales & Use Tax Delinquencies). Any agreement that a State agency enters into after July 1, 2012, is void if the contract is between a State agency and a contractor, or subcontractor, whose name appears on either list of the 500 largest tax delinquencies pursuant to Section 7063 or 19195 of the Revenue and Taxation Code. (Public Contract Code section 10295.4)

VI. CASE SERVICES CONTRACTS

Historically, TBI grant recipients have had the option to enter into a Case Services contract with DOR to provide vocational services as part of the funding for the TBI program. Case Services contracts using TBI grant monies will no longer be a funding option.

VII. SCHEDULE OF GRANT AWARD EVENTS

The DOR will make every effort to adhere to the following schedule. If necessary, applicants will be notified of changes to the Schedule of Events in the form of an addendum that will be posted to the DOR website.

Action / Responsibility / Date
RFA available to prospective applicants / DOR / February 24, 2015
Deadline to submit written questions / Applicants / March3, 2015
Bidders Conference / DOR, Applicants / March 13, 2015
Addendum (questions and answers) posted to DOR website / DOR / March 20, 2015
Application package due / Applicants / March 27, 2015by3:00 p.m.
Application screening and evaluation / Administrative Screening / April 1-8, 2015
Evaluation Panel & Technical Review / April 10-24, 2015
Executive Review & Approval / April 27-29, 2015
Notice of Intent to Award / DOR / April 30, 2015
Last date to file appeal / Applicants / June1, 2015
Preparation and distribution of grant packages / DOR / June 1, 2015
Response to appeals / DOR, Applicants / June 30, 2015
Grant period / DOR, Applicants / July 1, 2015 through June 30, 2018

Submitting Written Questions

  • Questions regarding the RFA must be submitted in writing to the TBI Coordinator at: . Responses will be given at the Bidders Conference and posted onto the DOR’s website.

Bidders Conference

  • A Bidders Conference will be held to answer the submitted written questions. Additional questions also will be addressed at this meeting. Attendance at the Bidders Conference is NOTmandatory.
  • All questions and answers discussed during the Bidder’s Conference will be posted on the DOR’s website in the form of an addendum.

Application Package Due

  • The DOR must receive by hand-delivery or mail all six (6) printed versions and the electronic version on the flash drive by3:00 p.m. on March 27, 2015.The date and time of receipt will be recorded by a DOR staff person for each submission. Application packages received after this deadline will be disqualified.Application packages delivered by email or fax will not be accepted.

Application Evaluation

  • The screening and evaluation of applications will be performed by a qualified, knowledgeable Evaluation Panel appointed by the DOR’s Independent Living and Community Access Division.

Notice of Intent to Award

  • The grants shall be awarded to six applicants based on the two highest final scores in each of the three geographic regions.
  • The seventh grant will be awarded to a high-scoring applicant from any of the three geographic regions that serve a geographic area not served by the other six selected applicants. Notice of the proposed award shall be posted to the DOR website and at the DOR office for 30 days prior to awarding the grant.
  • The DOR will send successful applicants a grant package with a date by which to respond.
  • In the event that terms cannot be reached within the time specified, the DOR reserves the right to finalize a grant with the next most qualified applicant, without undertaking a new procurement process or canceling the award.

Grant Period

  • Services shall not commence until the grant start date ofJuly 1, 2015or until a fully executed grant is in place, whichever date is later.

VIII. GENERAL INQUIRIES AND RESOURCES

Grant Administrator

The DOR has designated a grants analyst whowillmonitor the grants and coordinate with the applicant in regard tomanaging the TBI Program grant, including the appropriate use of State funds.

Any inquiries or requests regarding this RFAshall be submitted to the TBI Coordinator in writing. The address and emailfor inquiries are as follows:

TBI Coordinator

Department of Rehabilitation

721 Capitol Mall, 4th Floor

Sacramento, CA 95814

Email:

Community Resources Development Specialist

The Community Resources Development Specialistwill be the point of contact for any technical assistance to grantees. Their core function is the monitoring of TBI grants. They will provide periodic program reviews of TBI sites to ensure compliance with the standards and assurances of State requirements outlined in Welfare and Institutions Code 4357.

IX.APPLICATION SUBMISSIONREQUIREMENTS

Applications must be in accessible formats. Further information on making documents accessible is available at the following website: California Department of Rehabilitation - Making Documents Accessible.

This requirement applies to all elements submitted in either printed or electronic form. Elements submitted in a non-accessible format will be considered incomplete.

To be considered for funding, grant applications must comply with the instructions and criteria given. Each application must contain one original and five complete printed copies of all items listed below, as well as an electronic version on a flash drive.

Each application must be submitted with the geographic region (North, Central, South) indicated on the envelope.

Required Documents and Application Organization

  1. Table of Contents

The table of contents must contain a list of all sections of the application with corresponding page numbers.

  1. Application Narrative (Attachment A)

Applicantsmustidentify the lettered sectionbeing answered followed by its response to that question. Questions do not need to be restated. Thenarrative has a 20-page limit (8 ½” x 11” paper, single-spaced and 14 point Arial font), excluding any supporting documentation.

  1. Geographic Map of California (Attachment A) or ZIP Code Listing

Applicants will use the map to show the boundaries of their service area for their TBI service recipients. Alternatively applicants may provide a description of their service area boundaries by listing the ZIP codes contained in the organization’s service area.

  1. Statement of Assurances Form and Cover Sheet Form(Attachment B)

This form includes information on the applicant’s corporate, California franchise tax compliance status, insurance, compliance, licensing, and certification status. The applicant must complete and sign this form and includethe specified documentation.

  1. Key Personnel

This section is to include resumes of key personnel and job descriptions of all staff that will provide the TBI services during the grant period.

  1. Cash Flow Documentation
  • Provide your most recent Statement of Financial Position (balance sheet) and all supporting schedules and footnotes
  • Provide documentation of fund sources such as grants, contracts, and in-kind contributions, as well as the start and end dates for each source.
  1. Other Forms and Supporting Documentation

Complete, sign and include all other indicated forms. Applicants may also attach other materials to illustratethe quality of their programs. These materials will not be counted in the 20-page limit.

Mandatory Specifications

All applicants are required to respond in narrative form to each of the lettered section elementsin Attachment Ain the order in which they appear. Questions do not need to be restated. The application should be as concise as possibleand include specifics that address EACH of the requirements, outcomes, and activities detailed in this RFA.

  • Applications must be in asealedenvelope and submitted to DORby3:00 p.m.on March 27, 2015.Application packages received after this date and time will not be considered.
  • An original and five (5) printedcopies of the application must be submitted. The original application must be marked "ORIGINAL." All documents contained in the original application package must have original signatures and must be signed by a person who is authorized to bind the proposing organization. All additional application sets may contain photocopies of the original package.
  • All applications must include an electronic copy of the complete application packet. The electronic version should be clearly labeled with the organization’s contact information, saved onto a flash drive, and submitted along with the printed versions.

How to Submit the Required Versions – Print and Electronic

The proposal envelope must be plainly marked with the RFA number and title, your organization’s name, the geographic region,and"DO NOT OPEN," as shown in the following example:

Department of Rehabilitation

RFA 02-24-15

Traumatic Brain Injury Program

Your Organization’s Name

Region (i.e., North, Central, South)

DO NOT OPEN

Mail or deliver applications(U.S. Postal Service Deliveries, Hand Deliveries, UPS, Express Mail, or Federal Express) to the following address:

Department of Rehabilitation

RFA 02-24-15

Attention: Traumatic Brain Injury Program

Karen Jacoby, TBI Coordinator

721 Capitol Mall, 4th Floor

Sacramento, CA 95814

DO NOT OPEN

  • Applications not submitted in a sealed envelope and marked as indicated maybe rejected.

X. REVIEW PROCESS AND CRITERIA

Phase 1 – Administrative ReviewScreening

The applications that are received will be screenedfor completeness and applicant eligibility. At the completion of the Administrative Review,screeners will make notes regarding missing or incomplete applications. Screeners will also note any information in the submitted documents that may affect the applicant’s eligibility and qualification.Screeners’ notes will be taken into consideration by the Evaluation Panel for scoring purposes.

Phase 2 –Evaluation Panel and Technical Review

The Evaluation Panel and Technical Review Panel are qualified reviewers and subject matter experts who have knowledge and/or experience in services related to TBI programs in the State of California. The Evaluation Panel will review and score the grant proposals in accordance with the RFA scoring criteria. The Technical Review Panel will provide technical expertise of the grant program, consultation to the Evaluation Panel, and oversee the grant evaluation and scoring for consistency purposes.

Evaluation and Scoring

To score the narrative and document submission responses, the Evaluation Panel will use a7-point scale (with 0 being the lowest value and 7being the highest value in the scoring scale). This method allows evaluators to apply the same scale to each element in the applicant’s narrative response and document submission.

The Evaluation Panel members enter the score for each element into the scoring sheet, which is an Excel table containing the weights for each application element. The formula in the table multiplies the evaluator’s score by the weight to produce the weighted score.

Tiebreaker

In the event there is a tie between the toptwo or three applicants in any of the geographical regions, the evaluators will break the tie by awarding the grant to the applicant with the highest score in: