Request for Proposal

RFP # 26-052

Competitive Grant for Medical

Respite Facility Wake County, North Carolina

Raleigh, North Carolina 27602

Proposals are due October 8, 2026 before 3:00 pm Eastern Time

Part I. Introduction

A. Purpose and Background

Wake County through a competitive grant process will fund eligible capital investments to create or renovate a quality medical respite facility for individuals who are experiencing unsheltered homelessness. Medical respite provides short-term housing combined with residential care (meals, personal care, wellness services, wound care, medication management, medical appointment transportation, etc.) for individuals who are too frail for the streets but do not require acute hospital care. The goal of providing medical respite is to reduce the utilization of high-cost, acute care services.

B. Eligibility

Wake County seeks grant proposals from applicants intending to establish a new medical respite facility. Facilities will serve eligible individuals who are experiencing homelessness who have been identified as medically fragile or frequent utilizers of social systems such as Human and Homeless Services, EMS, Jail, Emergency Departments or other health care facilities. Individuals will be assessed through coordinated entry or another equitable referral system approved for such referrals and referred for respite shelter and services to address their specific needs. Below is a list of activities that are eligible for funding:

Capital Investment Funds will be available to support acquisition, design, renovation, or construction of a medical respite facility. A minimum of 20 medical respite units must be developed.

Facility must be operational and providing services by January 2028.

Operating Reserve An amount not to exceed 50% of the grant funding may be utilized to establish a dedicated account to cover future, anticipated operating needs. These funds are used to manage cash flow, mitigate risk, and cover unexpected, temporary, or urgent financial needs. Proposals should show the plan to sustain the operating funding for the compliance period of 10 years.

Eligible applicants can be a for-profit or nonprofit entity and must demonstrate the financial and development capacity and experience to carry out the project as detailed in its project application. Proposals must be located in Wake County and uniquely designed to serve eligible individuals. Multiple organizations may apply as a collaborative or joint venture; however, a lead entity must be designated. For the purposes of this RFP, the lead entity must be the owner and developer of the project, as well as financially responsible for any debts secured by the property upon which the Project will be located.

In addition, the applicant must have established partnerships to provide supportive services to the eligible population via internal programming or non-profit agency and must demonstrate a commitment to accommodating a broad array of services preferably on-site, and at minimum easily accessible.

C. Funding

The County will make a one-time grant award of $500,000 available towards the Respite Medical Facility. Funding will be paid to the Grantee on a reimbursement basis and must be used in accordance with the approved budget.

Part II. Submittal Instructions

A. Submission Requirements

Applicants must submit a detailed narrative of the knowledge, skills, and abilities they possess to successfully establish and operate a Medical Respite facility serving eligible individuals.

Submissions must be organized in the following sections and fully address all requirements:

Proposal Summary Please include the legal name of organization, street address (city and zip code), mailing address, Federal Tax ID, DUNS number, and website. Also include information for the primary contact person and person responsible for authorizing the proposal, as well as their titles, phone numbers, and email addresses. Summarize the proposal, including the location of the facility, total funding requested, and the number of respite beds to be created.

Organizational Capacity & Expertise Provide an overview of your organization including the work the organization does and the population it serves; number of employees and years in business; number of years as 501c3, if applicable; number and status of compliance monitoring findings issued in the past five years; and the number of years implementing compatible projects.

Project Information Include the location of the project. Describe the medical and supportive services. Describe how your operating plan will connect people to mainstream services and consider the transportation needs of eligible individuals. Describe how your agency will partner with other agencies to provide relevant services. Describe how your program has and will continue to actively solicit, honor, and utilize input from the voices of those most affected by your services, program participants, and individuals with lived expertise.

Financial Information Include a full budget to include all leveraged revenue sources, including agency cash and in-kind sources, and funding requested from Wake County. Written documentation of funding commitments is desirable. Line-item expenditure budgets should be categorized by development, operating, and supportive services and providing in an Excel workbook.

Please include the organization’s most recent audited financials.

B. Submitting the Response

Applicants are required to prepare their proposals in accordance with the instructions outlined in this part and elsewhere in this RFP. Applicants must submit their responses through the Wake County Bonfire Portal. Any questions or clarification pertaining to this RFP shall be submitted in the WC Bonfire Portal by September 14, 2026 by 5:00 PM. The County will respond to questions by issuing an addendum no later than September 21, 2026. The County must receive proposals no later than 3:00 PM on October 8, 2026. Late applications, regardless of delivery means, will not be accepted.

In regard to this RFP and subsequent selection process, proposers shall initiate NO CONTACTS, either written or verbal, with Wake County employees, evaluation committee members or Wake County Commissioners during the period beginning with the issuance of this document through evaluation team recommendations to the Board of Commissioners.

Any attempt by a proposer to initiate contact of the aforementioned may result in the disqualification of the proposer from award through this RFP.

Proposed Schedule September 2, 2026: RFP Released and Posted on Wakegov.com

September 14, 2026 by 5:00 pm Questions Due to Wake County (submitted in the WC Bonfire Portal by 5:00 pm)

September 21, 2026: Addenda issued to answer questions (if necessary)

October 8, 2026 by 3:00 pm Submittals due in the WC Bonfire Portal by 3:00 pm

October/November 2026: Evaluation Team Reviews and Scores Submittals

November/December 2026: Recommended Projects Presented to BOC

Wake County reserves the right to accept a proposal, based on the initial proposal received from an applicant, without discussion and without conducting further negotiations. The County may also, at its sole discretion, have discussions with those applicants deemed to fall within a competitive range. The County may enter negotiations separately with such applicants. The County shall not be deemed to have finally selected an applicant until a contract has been successfully negotiated and signed by both parties.

Part III. Application Review Process

Proposals will be reviewed and scored by a panel of Wake County staff and community partners. Scoring criteria will consider Organizational Expertise, Project Information, Supportive Services, Financial Capacity, and Community & Client Considerations which are further described below.

Section 1: Organizational Expertise (up to 15 points)

1. Brief summary of organization including services, locations, years in business, and number of full-time employees

2. Organizations experience in working with people experiencing homelessness

3. Applicants’ prior experience with acquisition, renovation, or construction of a facility for the provision of services

4. Prior experience of implementing and/or managing services similar to proposed project

5. Qualifications and experience of proposed staff and staff’s primary responsibilities related to this project

6. Existing organizational partnerships

7. List any pending, anticipated, or settled litigation in which the organization was involved during the past five years

8. Nonprofits must provide by-laws, articles of incorporation, 501(c)3 determination letter, current year operating budget, most recent audited financials or three years of financial statements, and list of board members

Section 2: Project Information (up to 25 points)

1. Explain general approach to fulfilling the Scope of Work, including site selection process, site design, capital campaign, and development of administrative structure at the facility

2. Number of medical respite units built and/or managed

3. Detailed description of how a low barrier model will be operationalized in the project to include documentation of the applicant screening and selection/non-selection process

4. Innovative Approaches to the design and services provided, including operational scope and the proposed relationship with other service providers (Proposers are encouraged to seek multiple partners to contribute to this project)

5. Applicants must be either the current owner of the property or, at the time of application, have a current legally binding contract to purchase the property.

6. Indicate any new hires required to fulfill the Scope of Services, including job titles, responsibilities, and justification for the position

Section 3: Supportive Services (up to 15 points)

1. Applicant’s prior experience in financing, owning and/or operating Medical Respite

2. Organizations experience in providing support services

3. Detailed description of services the applicant will make available to the residents including those accessible through partnerships, contracted services, and/or direct staff.

• Please describe which services will be provided onsite and offsite with an estimation of dedicated service hours, frequency, and/or FTEs for clients residing in medical respite

4. Describe how transportation services will be leveraged

5. Alignment with existing or proposed resources for pre- and post-medical respite discharge

Supportive Services Supportive services are a critical part of Medical Respite. Applicants must be willing to develop a supportive services plan internally or in partnership with a homeless service provider. Applicants are encouraged to partner with multiple service providers to offer an array of services. The applicant is expected to provide on-site office space free of charge to the providers or liaisons to supportive services, including but not limited to case management, medical services, mental health services, substance use treatment, employment and life skills counseling, eviction prevention programs, social and recreational events, and tenant advocacy. Applicants must provide a description of the on-site location where services will be provided, the name of the organization(s) who will provide the services and attach the services plan from the organization(s).

Section 5: Financial Capacity (up to 35 points)

1. Demonstrate the financial feasibility of the proposed project through a detailed source and use spreadsheet for the acquisition, rehabilitation or construction component

• Funding commitments should be documented

2. Provide an annual line-item operating budget for the facility

3. Competitive applications will leverage alternative funding sources for capital and operating needs

4. Demonstrate the applicant’s ability to fund potential cost overruns

5. Explain experience securing and administering government funding, including local, state, and federal resources and programs

6. Applicant must affirm that there are no defaults or negative collection actions relating to any financial obligation, either to Wake County or to any other public agency or private lender.

• Any Applicant, Developer or general contractor who is on the federal, state, county or city debarment list will not be allowed to participate.

• Applicant must have no overdue tax debts as defined by N.C.G.S. 105-243.1 and there must be no outstanding tax liens on any properties owned or managed by the applicant.

Section 6: Community & Client Considerations (up to 10 points)

1. Demonstration that the development has integrated considerations into the design, operations and services provision including design aesthetics, amenities, technology, location, and partnerships

Part IV. Standards

A. Minimum Standards

Funds will be available to support acquisition, renovation or construction of a facility providing a minimum of 20 Medical Respite units. Rehabilitation of any buildings built before 1978 must comply with federal lead-based paint requirements, including lead screening, in accordance with 24 CFR Part 92.355 and 24 CFR Part 35, subparts A, B, J, K, M, and R.

All properties must be free of contaminants/hazardous substances that pose dangers to users of the property or conflict with the intended purpose of the property as explained in 24 CFR 58.5(i)(2)(i). This includes, but is not limited to, toxic mold and asbestos. If there might be a concern that a property contains toxic mold or asbestos, the proposer will be responsible for the testing and either implementation of an O&M plan (operations and maintenance plan) or completion of the abatement process (by a certified asbestos contractor).

The applicant agrees to comply with all applicable local, state, and federal laws, regulations, codes, and standards governing the performance of the work described herein.

B. Program Requirements

All funded applicants must meet ALL of the following requirements.

Service enhancement aligned with B2H model: Projects must operate in accordance with the Bridge to Home program principles, implementing all seven pillars: Flexible Financial Assistance, Comprehensive Case Management, Housing Navigation, Healthcare Connection, Access to Benefits, Transportation, and Permanent Home Furnishings.

Data Expectation and HMIS Participation: All direct service staff and client-facing administration must obtain an HMIS license and adhere to data quality standards.

Reporting: key performance indicators include reductions in acute medical need, improved health outcomes, and exits to permanent housing which are reported monthly.

Active Engagement in Community Collaboration: applicant must participate as active members of Wake County Continuum of Care.

Medical Respite best practices: applicant must show progressive alignment with medical respite best practices established by National Health Care for the Homeless Council.

C. Accessibility Medical respite programs should ensure accessible, person‑centered short‑term residential care for people experiencing homelessness who are too ill to recover on the street.

Projects should include physical accessibility components such as ADA‑compliant entrances, bathrooms, and sleeping areas. Adjustable beds, grab bars, and mobility‑friendly layouts are recommended. Signage should be clear.

The ideal proposal will clearly articulate how acute and post‑acute conditions will be managed safely outside the hospital. Onsite or coordinated access to primary care, wound care, medication management, and behavioral health should be described. Clinical protocols should be clear and aligned with broader healthcare standards.

Care will be person-centered with access to language services (interpreters, translated materials, etc.). Admission criteria is expected to be clear and low barrier. Referral pathways from hospitals, shelters, EMS, and community clinics should be streamlined. Case management, benefits navigation, and housing support should be integrated into care along with discharge planning that prevents return to homelessness.

D. Code Compliance Upon completion, rehabilitated or newly constructed properties must comply with local building code, health code, safety code, and Minimum Property Standards as defined by the applicable jurisdiction.