Attachment 7 - Commitment Form LDSS AMENDED 5-31-2022.docx
DOCX document 34 KB Posted
- Solicitation number
- 2081627
- Issued by
- Cayuga County, Chautauqua County, Clinton County, Essex County, Greene County, Herkimer County, Kings County, Lewis County, Livingston County, Madison County, Nassau County, Onondaga County, Orleans County, Queens County, Rensselaer County, Richmond County, Rockland County, St. Lawrence County, Saratoga County, Schenectady County, Schuyler County, New York
About this file
This document is a Commitment Form from the New York State Office of Children and Family Services (OCFS) for the Targeted Healthy Families New York (HFNY) Program with Healthy Families America (HFA) Child Welfare Protocols Request for Proposals (RFP). OCFS is seeking applications to provide HFNY home visiting services, including the HFA Child Welfare Protocols, to unserved counties in New York State. The RFP expands the availability of HFNY services by increasing the eligible age for referrals from child welfare to 24 months and adding programs in 21 unserved counties. Approximately $9 million in annual funding will be available, with awards of up to $500,000 per county based on the number of families to be served, which should propose to serve the equivalent of up to 15% of Medicaid births in the county(ies). Applicants must submit a completed Commitment Form from the Local Department of Social Services for each proposed county. The RFP has a due date of June 10, 2022, a contract term of October 1, 2022 to September 30, 2027, and no more than one proposal per county will be approved for funding.
The RFP includes a 15% Minority Owned Sub-Contracting Goal, a 15% Women Owned Sub-Contracting Goal, and a 6% Service-Disabled Veteran-Owned Business Contracting Goal. OCFS will not award an identical or substantially similar procurement contract to any business entity that has been awarded such a contract within the past five years.
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Attachment 7 (Amended 5/31/2022)
Commitment Form: Local Department of Social Services
Targeted Healthy Families New York (HFNY) Program with Healthy Families America (HFA) Child Welfare Protocols New York State Office of Children and Family Services Request for Proposals (RFP)
Instructions:
· This commitment form from the Local Department of Social Services (LDSS) for each county proposed to be served by the applicant is required as noted in Section 3.1, Minimum Qualifications of the RFP.
· LDSS’s may sign this attachment for multiple organizations proposing to serve their county. The LDSS will ultimately work with the one contractor that OCFS awards to serve their county for the duration of the contract period.
· Applicants can only be considered to receive funding to serve counties for which they have submitted a completed Attachment 7.
Department of Social Services for the county of:
Name of entity applying for Healthy Families funding:
By signing this form, I affirm that it is the intention of this department of social services to:
· provide appropriate referrals to the HFNY program for families, including prenatal families; and
· develop a Memorandum of Understanding (MOU) with the HFNY program to align with the Healthy Families America Child Welfare Protocols; and
· seek federal reimbursement for HFNY services provided by the entity listed above (if awarded) under Title IV-E of the Social Security Act if deemed necessary by the New York State Office of Children and Family Services when reimbursement becomes available for families eligible for IV-E funding. In addition, if necessary, this LDSS will enter into a contract with the contractor selected to serve this county to make direct payment to this entity (if awarded) for services provided to Title IV-E eligible families.
Date:
Representative authorized to sign agreements on behalf of the Department of Social Services [first and last name]:
Title of representative:
Signature of representative [inked or electronic]:
Email address and phone number of representative:
File details come from the government source that posted it. Updated .