section 1: basic program information… · web viewrequest for proposal (rfp) ... articulation....

Application Washtenaw Coordinated Funders

Request for Proposal (RFP) #6869 2016-2018Printed On: 6 January 2016 1

Request for Proposal (RFP) #6869 2016-2018

Washtenaw Coordinated Funders

Section 1: Basic Program Information

1-1 Program Name*Name of Project.Character Limit: 100

1-2 Length*How long have you been operating this program?

Character Limit: 300

1-3 Previously Funded*Did this program receive funding during the 2014-2016 Coordinated Funding program operations grants cycle?ChoicesYes No

1-3 Previously Funded ExplanationIf yes, please list the program name (if different than the one used on this application):Character Limit: 450

1-4 Amount of Grant Request $ (per year)**Character Limit: 20

1-5 Is the application collaborative in nature?*Is this a collaborative application with more than one partner applying for funding?ChoicesYES NO

1-5 ExplanationIf “YES”, please list out name(s) of all collaborative applicants, including agency name, contact person, and email address for each.Character Limit: 2850



Section 2: Program Strategies

Please select only ONE (1) Community-Level Outcome from the following list based on your program’s alignment with one or more of the evidence-based Program Strategies that aligns with it.

Note: A separate application will need to be submitted for each community-level outcome that you choose; however, a single application could select multiple program strategies under the same community-level outcome. Agencies that select more than one program strategy within a given community outcome will not be scored more favorably than those selecting a single program strategy. Scoring will be based upon clear program alignment with each strategy selected. See Appendix A of this RFP for more detail about the community-level outcomes, corresponding program strategies and measurements.

2-1 SELECT COMMUNITY LEVEL OUTCOME*Appendix A link ChoicesEarly Childhood School-Aged YouthSafety Net Health and Nutrition Housing HomelessnessAging

2-2 SELECT PROGRAM STRATEGY*Please select one (1) or more program strategies that correspond to your selected community- level outcome.ChoicesAGING: Senior Crisis InterventionAGING: Senior Service Network Navigation AGING: Senior Social IntegrationEARLY CHILDHOOD: Parent Engagement and Education EARLY CHILDHOOD: Access to High-Quality Early Learning EARLY CHILDHOOD: Strengthen Social Emotional Health HOUSING & HOMELESSNESS: Homelessness PreventionHOUSING & HOMELESSNESS: Emergency Shelter, Transitional Housing and/or Homelessness Outreach HOUSING & HOMELESSNESS: Rapid RehousingHOUSING & HOMELESSNESS: Permanent Supportive HousingSAFETY NET HEALTH & NUTRITION: Benefits Advocacy and Referral Coordination SAFETY NET HEALTH & NUTRITION: Accessing Care ServicesSAFETY NET HEALTH & NUTRITION: Hunger Relief (Non-Competitive; Do not select unless instructed.) SAFETY NET HEALTH & NUTRITION: Home-Bound Food DistributionSAFETY NET HEALTH & NUTRITION: Nutrition Education Enhanced Produce DistributionSCHOOL-AGED YOUTH: Intervention Programming to Foster Literacy, Academic Success & School Engagement SCHOOL-AGED YOUTH: 21st Century Skills and Youth Leadership Development ProgrammingSCHOOL-AGED YOUTH: Out-of School ProgrammingSCHOOL-AGED YOUTH: Programming that Facilitates Youth-Adult Relationships



SCHOOL-AGED YOUTH: On-Site School Programming

Section 3: Program Description

Higher scores will be awarded to proposals that detail the specific program components and demonstrate that they are aligned with both the selected community-level outcome and corresponding best practice research (see Appendix A for examples of best practice program components for your program strategy/strategies).

3-1 Description*Provide a brief program description that we may use in publications and on our website.


3-2 Services*What are the service(s) provided by this program and how do these services align with the strategy or strategies selected?Character Limit: 4000

3-3 Theory*Describe the program theory used to support the program. Include relevant evidence and/or research based strategies and data (e.g. studies, authors, statistics, etc.).Character Limit: 4000

Tip: A program theory, or theory of change, is your agency’s best thinking and articulation of the components of an intervention, making connections between the different steps explicit, and identifying desired (expected) outcomes as a result of the intervention.

3-4 Change*How do program participants change as a result of this program? (For example, a change in knowledge, skills, condition or behavior)Character Limit: 3150

Section 4: Availability of Same or Similar Services

A fundamental element of sound program design is to understand and fill service gaps/unmet community needs. Higher scores will be awarded to proposals that articulate a strong knowledge of similar agencies/programs in their service area and how their program design makes them unique and/or meets an unmet need.



4-1 Community Issues & Unmet Need*What community issues, unmet needs, or service gaps does this program address? Explain why it is critical for our community to address this issue at this time by using relevant research as well as program and community-level data.Character Limit: 6300

4-2 Other Service Providers*Please identify by name and program any other providers that are delivering similar services in your service area.Character Limit: 3300

4-3 Service Gap*Please describe how your program fills a service gap unmet by the programs identified in question 4-2.Character Limit: 3150

Section 5: Program Demographics

Note: The Program Demographic section is for informational purposes only and is not part of application scoring. If this program is funded this information may inform the source of funding awarded.

5-1 Target Participant*Please describe your target program participant (e.g. for youth eviction prevention, target participant could be a single person under the age of 18).Character Limit: 3150

Tip: Make sure that the participant that is described here aligns with the participant in question 3-4.

5-2 Geographic Area*Describe the current geographies/locales served by your program (e.g. neighborhoods, zip codes, and/or schools/school districts).Character Limit: 3150

5-3 Program Serivce Area. Fill in the fields below indicating the estimated percentage (%) of your program's participants in each of the following jurisdictions (totaling all five fields will equal greater than 100%. Maps of the jurisdictions are available at the Coordinated Funders website and below).

Note: Disregard the # symbol below when entering estimated percentages.



5-3 Washtenaw County*Washtenaw County map link Character Limit: 3

5-3 City of Ann Arbor*City of Ann Arbor map link Character Limit: 3

5-3 Urban County*Urban County map link Character Limit: 3

5-3 Eastern Washtenaw County Zip Codes 48197 and 48198*Eastern Washtenaw County map link Character Limit: 3

5-3 Outside Washtenaw County*Character Limit: 3

5-4 Unduplicated Participants*How many unduplicated participants did this program serve during the last program year?Character Limit: 250

Tip: If a person was provided with services more than once, that person would still be counted only once for the purpose of this unduplicated participant count.

5-5 Estimated Unduplicated Participants*If fully funded for this program, how many estimated unduplicated participants will this program serve during the first program year (July 1, 2016 through June 30, 2017)?Character Limit: 250

5-6 Participant Count Change*Please explain any significant difference between the number of participants you served last year and anticipate serving during the first year of program operations funding.Character Limit: 3150



5-7 Program Demographics*Please select which of the following demographics your program is currently collecting data on or will be able to by July 1, 2016. Supplying participant demographic information is a required component of annual reporting associated with program operations funding.ChoicesSubpopulation - AgeSubpopulation - Female Head of Household Subpopulation - Head of Household with Child Under 6 Subpopulation - Physical or Health Impaired Subpopulation - VeteranRace - White Race - Black Race - AsianRace - American Indian/Alaskan Race - Pacific IslanderRace - American Indian & White Race - Asian & WhiteRace - Black & WhiteRace - American Indian & Black Race - Other Multi-Racial Ethnicity - HispanicEthnicity - Non-Hispanic Gender - Female Gender - MaleGender - Transgender

5-8 Demographic Documentation*Please describe how your agency collects and documents the demographic information discussed in Section 5, above.Character Limit: 3150

Section 6: Participant Income Level

Programs that serve the most economically vulnerable populations in our community stabilize neighborhoods and local economies. Higher scores will be given to proposals whose primary program participants are the most economically vulnerable and align with the income requirements identified with your selected community-level outcome (see Appendix C to view the income requirements for your selected community-level outcome).

6-1 Income Guidelines - For all community outcomes except Housing and Homelessness, please indicate the estimated percentage (%) of your program participants whose household incomes fall at or below the income thresholds listed below using the 2015 Department of Health and Human Services Federal Poverty Guidelines, found in Appendix C and online.



2015 Federal Poverty Guidelines

Character Limit: 3000Request for Proposal (RFP) #6869 2016-

2018Printed On: 6 January 2016 7


6-1 Federal Poverty Level at 100 PercentIncome Level - 100% of Federal Poverty LevelCharacter Limit: 3



6-2 Income Limits – For all Housing and Homelessness programs, please indicate the percentage (%) of your program participants whose household incomes will fall into the categories below using the 2015 Department of Housing and Urban Development income categories, found in Appendix C and online.

Note: Disregard the # symbol when entering estimated percentages.

2015 HUD Income Limits Link

6-2 Area Median Income from 0 to 30 PercentExtremely Low (0% to 30% AMI)Character Limit: 4

6-2 Area Median Income from 31 to 50 PercentVery Low (31% to 50% AMI)Character Limit: 3

6-2 Area Median Income from 51 to 80 PercentLow (51% to 80% AMI)Character Limit: 3

6-2 Area Median Income at 81 Percent and aboveModerate & Above (81% and above)Character Limit: 3

6-3 Income Documentation*Please describe how your agency collects and documents the income information discussed in Sections 6-1 or 6-2 above.




Section 7: Collaboration

Collaboration between agencies and/or programs improves service-delivery for program participants through reduced overhead, increased capacity, improved coordination of services, and other efficiencies. Higher scores will be awarded to proposals that are demonstrating effective collaboration to expand services, reduce overhead, avoid duplication of services, and/or to identify gaps in services. Additionally, higher scores will be awarded for proposals that have formally documented collaborations and evidence of regular Planning & Coordinating participation.

Note: For formal collaborative applications, please describe the the collaboration strategy for this program, including but not limited to: overall participant process flow; clear roles and responsibilities between agencies; communication protocols which enhance information and referral exchange about shared participants.

7-1 Collaborative Relationships*In service of the community-level outcomes, describe the organization's documented collaborative relationships with: local faith-based organizations; schools; law enforcement; neighborhood and community groups; local homeowners' associations; and any local Planning/Coordinating bodies (see Appendix A to view the local Planning/Coordinating body for your selected community-level outcome).Character Limit: 6300

Tip: Coordinated Funding Staff may cross-check stated participation with Planning and Coordinating bodies.

Section 8: Accessibility

Planning for the accessibility of a program to a wide array of customers ensures that services are inclusive of diverse participant needs. Higher scores will be awarded to proposals that articulate clear and appropriate plans which address potential barriers to service access by participants.

Tip: Listing a program's hours of operation or nearby bus-availability does not constitute a clear and appropriate plan to address barriers. The plan must address the specific barriers that your target population may have and how the program design will mitigate these barriers in an effective way.

8-1 Affordability of Services*Character Limit: 630




8-2 Hours of Operation*



8-3 Transportation availability (to and from)*Character Limit: 650

8-4 ADA-accessibility of location and transportation options*Character Limit: 650

8-5 Language/culture barriers*Character Limit: 650

8-6 Literacy barriers (reading/writing/comprehending English)*Character Limit: 650

Section 9: Key People

Note: The Key People section is for informational purposes only, and is not part of application scoring.

The demonstrated capability of the staff supporting program service delivery is an indicator of program effectiveness and impact. Proposals should identify the "key people" (e.g. supervisors and direct staff) who oversee and deliver the identified services and work to achieve the selected program outcomes. Please describe the relevant experience for the three people most responsible for program implementation and/or oversight. For each person identified, complete the following narrative boxes.

9-1 Key Person 1 Name*Character Limit: 100

9-1 Key Person 1 Title*Character Limit: 100

9-1 Key Person 1 Experience*Includes both professional and lived experience.Character Limit: 2520

9-1 Key Person 1 Key Program Duties*Character Limit: 630











Tip: These questions should be answered in a concise manner that only identifies relevant experience, training, education, and duties.

Section 10: Program Budget

Note: The Program Budget section is for informational purposes only, and is not part of application scoring.

10-1 Budget Template - Please download, complete, and upload.*Download the Budget Template here .File Size Limit: 5 MB

Tip: Budget costs may include administrative and operational expenses associated with running the program.

Section 11: Measurement and Program Evaluation

By selecting a community-level outcome and corresponding program strategy(ies), your agency is agreeing to measure pre-determined program outcomes. You must select all of the outcomes that correspond to a strategy, and the program outcome(s) you agree to measure must correspond


Application Washtenaw Coordinated Fundersto the program strategy(ies) you have selected. See Appendix A for the listing of program outcomes under your strategy and how each outcome must be measured.


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11-1 EARLY CHILDHOODWhich outcome(s) from the outcome list will your program report on?ChoicesEarly Childhood: Increase Developmental Readiness 1A Early Childhood: Increase Developmental Readiness 2A Early Childhood: Increase Developmental Readiness 3A

11-1 SCHOOL-AGED YOUTHWhich outcome(s) from the outcome list will your program report on?ChoicesSchool-Aged Youth: Increase High School Graduation 1A School-Aged Youth: Increase High School Graduation 1B School-Aged Youth: Increase High School Graduation 1C School-Aged Youth: Increase High School Graduation 2A School-Aged Youth: Increase High School Graduation 2B School-Aged Youth: Increase Safety 1ASchool-Aged Youth: Increase Safety 1B School-Aged Youth: Increase Safety 1C School-Aged Youth: Increase Safety 1D School-Aged Youth: Increase Safety 2A School-Aged Youth: Increase Safety 2B School-Aged Youth: Increase Safety 2C School-Aged Youth: Increase Safety 2D School-Aged Youth: Increase Safety 2E School-Aged Youth: Increase Safety 3A School-Aged Youth: Increase Safety 3B School-Aged Youth: Increase Safety 3C School-Aged Youth: Increase Safety 3D School-Aged Youth: Increase Safety 3E

11-1 SAFETY NET HEALTH & NUTRITIONWhich outcome(s) from the outcome list will your program report on?ChoicesSafety Net Health & Nutrition: Increase Access 1A Safety Net Health & Nutrition: Increase Access 1B Safety Net Health & Nutrition: Increase Access 2ASafety Net Health & Nutrition: Decrease Food Insecurity 1A Safety Net Health & Nutrition: Decrease Food Insecurity 2A Safety Net Health & Nutrition: Decrease Food Insecurity 2B Safety Net Health & Nutrition: Decrease Food Insecurity 3A

11-1 HOUSING AND HOMELESSNESSWhich outcome(s) from the outcome list will your program report on?ChoicesHousing and Homelessness: Reduce Homelessness 1A



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Housing and Homelessness: Reduce Homelessness 1B Housing and Homelessness: Reduce Homelessness 2A Housing and Homelessness: Reduce Homelessness 2B Housing and Homelessness: Reduce Homelessness 2C Housing and Homelessness: Reduce Homelessness 3A Housing and Homelessness: Reduce Homelessness 3B Housing and Homelessness: Reduce Homelessness 3C Housing and Homelessness: Reduce Homelessness 4A Housing and Homelessness: Reduce Homelessness 4B Housing and Homelessness: Reduce Homelessness 4C

11-1 AGINGWhich outcome(s) from the outcome list will your program report on?ChoicesAging: Increase/Maintain Independent Living Factors 1A Aging: Increase/Maintain Independent Living Factors 1B Aging: Increase/Maintain Independent Living Factors 2A Aging: Increase/Maintain Independent Living Factors 2B Aging: Increase/Maintain Independent Living Factors 3A Aging: Increase/Maintain Independent Living Factors 3B

11-2 Anticipated Participants*Out of the estimated unduplicated participants identified in question 5-5, how many participants are expected to work on each selected outcome in question 11-1?Character Limit: 630

11-3 Measurement Tool(s)*What tool(s) will your program use to measure achievement of the outcomes selected in question 11-1?Character Limit: 1890

11-4 Measuring Progress*How does/do the tool(s) identified in question 11-3 measure progress towards the outcomes selected in question 11-1?Character Limit: 2520

11-5 Outcome Achievement*Please estimate the number and percentage of the participants identified in question 11-2 that will achieve each of the outcomes selected in question 11-1.Character Limit: 630

11-6 Data collection source*From whom will data be collected to document progress towards and achievement of each of the outcomes selected in question 11-1?Choices



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Participants Parents Staff TeachersOther (Please specify, below)

11-6 Other data source explanation.Character Limit: 1260

11-7 Who is achieving this outcome?Choices Children Teens Adults Seniors FamiliesOther (Please specify, below)

11-7 Other outcome achievement explanation.Character Limit: 1260

11-8 Data collection methodology*ChoicesCase notes and observation form SurveysParticipant Records (e.g. health records, school report cards, etc.) Other (Please specify, below)

11-8 Other data collection explanation.Character Limit: 1260

11-9 How will this data be collected?*Identify the title or role of the person who will collect the indicator data on an on-going basis.Character Limit: 1260

11-10 How frequently will this outcome data be collected?*Tip: We would like to know how often you collect data. Program reporting to the funders takes place semi-annually and annually.ChoicesBeginning and end of a service component. Please explain, below. WeeklyMonthly Quarterly Semi-Annually AnnuallyAt the conclusion of services. Please explain, below.



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11-10 Data frequency explanation.Character Limit: 1260

11-11 What is the timeframe for this/these outcomes to be achieved by your program participants?*Please explain, below:Choices Immediate Short-Term Long-Term

11-11 Explanation*Character Limit: 1260

Section 12: Additional Evaluation: Proposal Clarity & Historic Program Performance

In addition to the narrative responses identified above, staff will also evaluate the clarity of your proposal as well as prior program performance. There is no additional narrative response expected from the applicant for these two categories. Further explanation of the criteria on which those categories will be evaluated can be found in the “Scoring Matrix ” in the Appendix of this RFP.

CEO Certification

By entering my name below, I acknowledge the following:

That all information submitted as a part of this online Request for Proposal (RFP) is true and accurate. That the information contained in this online RFP may be shared with other funders. That the funding request detailed in this online RFP is consistent with the organization's mission, articles of incorporation, and by-laws.

CEO Name Certification*Character Limit: 50

CEO Title*Character Limit: 90

Agency Address*



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Office Phone*

Character Limit: 20

Cell PhoneCharacter Limit: 250

Federal Tax ID*

Character Limit: 35

Email address for Purchase Orders*

Character Limit: 40

Date Certification*Character Limit: 10

I understand that under the Act, an “Iran linked business means an individual or one of the above-listed groups who engages in investment activities in the energy sector of Iran, including, but not limited to, providing oil or liquefied natural gas tankers or products used to construct or maintain pipelines used to transport oil or liquefied gas for Iran’s energy sector or a financial institution extending credit to another person to engage in investment activities in Iran’s energy sector.

I further understand that “investment activity” is defined by the Act as an individual or one of the above listed groups that invests $20,000,000.00 or more in Iran’s energy sector or a financial institution that extends credit to another person, if that person uses the credit to engage in “investment activity” in Iran’s energy sector

By signing this bid submission, I certify that I and/or my corporation, company, limited liability company,business association, partnership, society, trust or any other non-governmental entity, organization or group is not an “Iran linked business” as defined by P.A. 517 of 2012 (MCLA 129.311 et seq)(“Act”).

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