AFKRFR Provider Packet Template.xlsx
XLSX spreadsheet 49 KB Posted
- Solicitation number
- RFP - 10A - 202606102
- Issued by
- Maine
About this file
This is a Provider Packet Template issued by the Maine Department of Health and Human Services, Office of Child and Family Services (DHHS/OCFS) for organizations contracted to provide Statewide Adoption, Kinship, Foster, and Resource Family Recruitment Services. The packet requires quarterly reporting on performance measures and deliverables throughout a two-year contract period beginning October 1, 2026. Providers must complete performance measure reports tracking three primary metrics: attendance of 75 prospective resource families per quarter at informational sessions (300 annually), submission of 200 applications from prospective resource families excluding kinship families identified by the Department, and completion of 90 percent of identified activities in the Statewide Diligent Recruitment Plan each quarter. Additional reporting requirements include submission of the Diligent Recruitment Plan, meeting minutes with the Department's Youth Leadership Advisory Team, recruitment team meeting reports for each DHHS district office, AFforME Deliverable Data Reports, Adoption Deliverable Reports, Adoptive Families Reports, and Diligent Recruitment Reports detailing individual attendees, applicants, and licensed resource families. All quarterly reports must be completed within 30 days of quarter end and submitted by the specified due dates, with the first quarter (Y1Q1) due January 30, 2027, and final quarter (Y2Q4) due October 30, 2028.
The packet requires providers to maintain full-time recruiters throughout the contract period and track adoption-related activities including loading child and family information into matching software within 60 calendar days, documenting referrals, placements, and adoptive completions. Providers must attest electronically that all submitted information is accurate and that their agency complies with all federal and state regulations and agency policies. The template includes designated fields for provider name, contract agreement number, vendor code, service group classification, and quarter being reported. No additional tabs or modifications to the template are permitted, and all gray-shaded areas must be completed prior to submission to the designated Program Manager and Program Administrator listed in the provider's agreement.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| RFP 202606102 Q | — | |
| AFKRFR Diligent Plan Template.xlsx | XLSX spreadsheet | |
| RFP 202606102 AKFRFR Response Form.docx | DOCX document | |
| RFP 202606102 Statewide AKFRFR_FINAL.docx | DOCX document | |
| RFP 202605083 HOMEBUILDERS_FINAL.docx | DOCX document | |
| RFP 202606102 AFKRFR Cost Form.xlsx | XLSX spreadsheet |
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Text version
Attestation & Signature Page
| DHHS/OCFS PROVIDER PACKET | ||
| ***Do not create additional tabs to this document*** | ||
| Provider Name: | Quarter Being Reported: | |
| Agreement #: | Enter Contract # | Date Completed: |
| Vendor Code: | ||
| Service Group: | Foster & Resource Family Recruitment |
| Dear Provider, |
| This Provider Packet collects information that is required as part of your Agreement with OCFS. Please complete all shaded gray areas of this form before submitting. You will also complete each tab with the requested information and submit any other required material listed below in the supplemental information area. A list of due dates has been provided below. This information must be reported no later than 30 days from the end of each quarter. |
Once complete, you will submit by email to the PROGRAM MANAGER and PROGRAM ADMINISTRATOR listed in your Agreement. We thank you for your efforts in providing this information to ensure compliance with your OCFS contract.
| QUARTERS REPORTED: | DUE BY: | |
| Y1Q1 | 10/01/2026 to 12/31/2026 | January 30, 2027 |
| Y1Q2 | 01/01/2027 to 03/31/2027 | April 30, 2027 |
| Y1Q3 | 04/01/2027 to 06/30/2027 | July 30, 2027 |
| Y1Q4 | 07/01/2027 to 09/30/2027 | October 30, 2027 |
| Y2Q1 | 10/01/2027 to 12/31/2027 | January 30, 2028 |
| Y2Q2 | 01/01/2028 to 03/31/2028 | April 30, 2028 |
| Y2Q3 | 04/01/2028 to 06/30/2028 | July 30, 2028 |
| Y2Q4 | 07/01/2028 to 09/30/2028 | October 30, 2028 |
| I, | the undersigned on behalf of | 0 |
| attest the information included is true to the best of my abilities and knowledge. I do attest to the agency being in compliance with all Federal and State rules and regulations and adherence to all agency established policies and procedures. |
| Electronic Signature: |
| Date: |
Performance Measure Report
| 10/01/2026 to 12/31/2026 | 01/01/2027 to 03/31/2027 | 04/01/2027 to 06/30/2027 | 07/01/2027 to 09/30/2027 | 10/01/2027 to 12/31/2027 | 01/01/2028 to 03/31/2028 | 04/01/2028 to 06/30/2028 | 07/01/2028 to 09/30/2028 |
| YEAR 1 - QUARTER 1 | YEAR 1 - QUARTER 2 | YEAR 1 - QUARTER 3 | YEAR 1 - QUARTER 4 | YEAR 2 - QUARTER 1 | YEAR 2 - QUARTER 2 | YEAR 2 - QUARTER 3 | YEAR 2 - QUARTER 4 |
| Performance Measure | Numerator (N) Definition | Denominator (D) Definition | Target % | Q1 N | Q1 D | Actual % | Q2 N | Q2 D | Actual % | Q3 N | Q3 D | Actual % | Q4 N | Q4 D | Actual % | Q1 N | Q1 D | Actual % | Q2 N | Q2 D | Actual % | Q3 N | Q3 D | Actual % | Q4 N | Q4 D | Actual % | |
| A. | Three hundred (300) prospective Resource Family/Parents attend Informational Sessions Annually; and an average of seventy-five (75) prospective Resource Family/Parents attend each quarter. | The total number of interested persons attending informational sessions per quarter. | Seventy five (75) people per quarter. | 100% | ERROR:#DIV/0! | ERROR:#DIV/0! | ERROR:#DIV/0! | ERROR:#DIV/0! | ERROR:#DIV/0! | ERROR:#DIV/0! | ERROR:#DIV/0! | ERROR:#DIV/0! | ||||||||||||||||
| B. | Two hundred (200) prospective Resource Family/Parents will complete and submit an application, not including Kinship families the Department has identified. | The total number of interested persons following through with an application each quarter, not including Kinship Families the Department has identified. | The total number of interested persons per quarter, not including Kinship Families the Department has identified. | 100% | ERROR:#DIV/0! | ERROR:#DIV/0! | ERROR:#DIV/0! | ERROR:#DIV/0! | ERROR:#DIV/0! | ERROR:#DIV/0! | ERROR:#DIV/0! | ERROR:#DIV/0! | ||||||||||||||||
| C. | Ninety percent (90%) of the identified activities in the Statewide Diligent Recruitment plan will be completed each quarter. | The total number of identified targets in the Statewide Diligent Recruitment Plan completed per quarter. | The total number of identified targets in the Statewide Diligent Recruitment Plan each quarter. | 90% | ERROR:#DIV/0! | ERROR:#DIV/0! | ERROR:#DIV/0! | ERROR:#DIV/0! | ERROR:#DIV/0! | ERROR:#DIV/0! | ERROR:#DIV/0! | ERROR:#DIV/0! |
Reports & Info Required
| SUPPLEMENTAL INFORMATION REQUESTED | |
| Provide a copy of the Diligent Recruitment Plan | |
| Provide copies of the minutes from the meetings with the Department's Youth Leadership Advisory Team | |
| Report on the meetings that are occuring with the recruitment team for each DHHS district office | |
| Performance Measure Report (See tabs below) | |
| AFforME Deliverable Data Report (See tabs below) | |
| Adoption Deliverable Report (See tabs below) | |
| Adoptive Families Report (See tabs below) | |
| Diligent Recruitment Report (See tabs below) |
AFforME Deliverable Data Report
| Provider Name: | 0 | Provider Name: | 0 | ||||||
| Agreement #: | Enter Contract # | Agreement #: | 0 | ||||||
| A FAMILY FOR ME - DELIVERABLE DATA REPORT | A FAMILY FOR ME - DELIVERABLE DATA REPORT | ||||||||
| NAME OF FULL TIME RECRUITER: | DATE HIRED | DATE EMPLOYMENT ENDED | YEAR 1 | NAME OF FULL TIME RECRUITER: | DATE HIRED | DATE EMPLOYMENT ENDED | YEAR 2 | ||
| Q1 | Q1 |
Q2 Q2
Q3 Q3
Q4 Q4
Adoption Deliverable Report
| Provider Name: | December 31, 1899 | Quarter Being Reported: |
| Agreement #: | Enter Contract # | Date Completed: |
| ADOPTION DELIVERABLE REPORT |
| D.5. ADOPTION RECRUITMENT: Load information of the Child/Youth, for whom the Department has obtained legal clearance for Adoption and prospective Adoptive Families into the Adoption Matching Software within sixty (60) calendar days of the start of the initial period of performance. | ||||
| FULL NAME OF CHILD | KATAHDIN ID # | DATE REFERRED TO AMP | DATE CHILD LOADED INTO MATCHING SOFTWARE | NAMES OF POTENTIAL |
ADOPTIVE FAMILIES
AND LOCATION DATE FAMILY SELECTED DATE OF ADOPTIVE PLACEMENT DATE CHILD ADOPTED
Adoptive Families Report
| Provider Name: | December 31, 1899 | Quarter Being Reported: |
| Agreement #: | Enter Contract # | Date Completed: |
| ADOPTIVE FAMILIES REPORT |
| D.5. ADOPTION RECRUITMENT: Load information of the Child/Youth, for whom the Department has obtained legal clearance for Adoption and prospective Adoptive Families into the Adoption Matching Software within sixty (60) calendar days of the start of the initial period of performance. | ||
| NAME OF ADOPTIVE FAMILY | KATAHDIN ID # | DATE LOADED INTO MATCHING SOFTWARE |
Diligent Recruitment Report
| Provider Name: | December 31, 1899 | Quarter Being Reported: |
| Agreement #: | Enter Contract # | Date Completed: |
| DILIGENT RECRUITMENT PLAN REPORT |
| B.2.j. Ensure use of Diligent Recruitment efforts to engage interested parties, promoting attendance at virtual informational sessions and completion of an application to become a licensed Resource Family. | ||
| FIRST & LAST NAME OF EACH INDIVIDUAL WHO ATTENDED AN INFORMATION SESSION | DATE APPLIED | |
| (if applicable) | DATE LICENSED |
(if applicable)
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