AHS-27 Response Document.docx

DOCX document 28 KB Posted

Attached to
Autism Housing Support Pilot
Solicitation number
BD-27-1023-1023C-1023L-134723
Issued by
Massachusetts

About this file

This is a Response Document for a Request for Responses (RFR) issued by the Commonwealth of Massachusetts Department of Developmental Services for the Autism Housing Support (AHS) Pilot program. The RFR seeks qualified providers to deliver housing navigation, stabilization, and tenancy preservation services for adults with autism. The response document requires applicants to select one or more of four pilot program regions: Central West, Northeast, Southeast, or Metro. Prospective providers must complete five substantive questions addressing housing support services, experience with the autism population, staffing plans, service and community collaboration, and data collection capabilities, with responses limited to specified page maximums ranging from one to three pages per section. Additionally, providers must submit an SDP Evaluation Written Narrative not to exceed one page.

The response document functions as a qualification and certification instrument rather than a pricing or contract terms document. Applicants must provide organizational details including provider name, contact information, vendor code, and signatory authorization, and must certify under penalty of law that all statements are true and complete. The document explicitly grants the Department permission to verify staff qualifications and release necessary information to confirm provider eligibility. No specific contract term, renewal options, pricing terms, funding amounts, or award dates are identified in this response form.

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Text version

Response Document RFR AHS-27

Autism Housing Support Pilot Response Document

Commonwealth of Massachusetts Department of Developmental Services Response Document

This form must be completed according to the instructions below. Requirements include completion of questions, submission of required forms and certifying via signature that the provider organization will perform the service as described.

Provider Name

Contact Person

Provider Address

E-mail Address

Vendor Code
VC
Phone Number

Provider Signatory Name

Signatory Email

Check the appropriate box to signify which pilot program(s) this submission is for.

Pilot Programs

|_|
Central West (2)
|_|
Northeast (1)
|_|
Southeast (1)
|_|
Metro (1)

Certification

I certify that the statements made in this proposal are true and complete to the best of my knowledge. Any misstatement of fact may lead to disqualification and dismissal and to such other penalties as may be prescribed by law or regulations. All statements made are subject to verification as a condition of qualification as a provider. By signing this statement, I hereby give permission for the release of any and all information necessary to verify staff qualifications.

Electronic Signature of Authorized Agency Representative

Date

Question 1: Housing Support (maximum of three (3) pages)

1A.

1B.

Question 2: Experience with Autism Population (maximum of two (2) pages)

Question 3: Staffing (maximum of two (2) pages)

3A.

3B.

3C.

Question 4: Service and Community Collaboration (maximum of two (2) pages)

4A.

4B.

Question 5: Data Collection (maximum of one (1) page)

5A.

5B.

5C.

SDP Evaluation Written Narrative (maximum 1 page)

File details come from the government source that posted it. Updated .