BPM054661_Targeted Case Management Plus RFA.pdf

EXHIBIT A

STANDARD GRANT AGREEMENT (SGA)

REQUEST FOR APPLICATIONS (RFA)

(COMPETITIVE)

CONTRACT ID NUMBER – BHA25-022 / BPM054661

Issue Date: December 22, 2025

Targeted Case Management Plus Enrollment

NOTICE

A Prospective Applicant that has received this document from the Maryland Department of Health, or that has received this document from a source other than the Contract Officer, and that wishes to assure receipt of any changes or additional materials related to this RFA, should immediately contact the Contract Officer and provide the Prospective Applicant’s name and mailing address so that addenda to the RFA or other communications can be sent to the Prospective Applicant.

04/2025

STATE OF MARYLAND

MARYLAND DEPARTMENT OF HEALTH

RFA KEY INFORMATION SUMMARY SHEET

Request for Applications: Targeted Case Management Plus Enrollment

Application Number: BHA25-022 / BPM054661

RFA Issue Date: December 22, 2025

RFA Issuing Office: Maryland Department of Health

Behavioral Health Administration (Primary Behavioral Health and Early Intervention Division)

Contract Officer: Crystal Hack

Maryland Department of Health Behavioral Health Administration Spring Grove Hospital Center 55 Wade Avenue Vocational Rehab. Building Catonsville, MD 21228 Phone Number: 410-627-6814 E-mail: crystal.hack@maryland.gov

Grant Monitor: Erin Smith Maryland Department of Health Behavioral Health Administration Primary Behavioral Health and Early Intervention Division Spring Grove Hospital Center

55 Wade Avenue Vocational Rehab. Building Catonsville, Maryland 21228 Phone: (443) 835-6548 Fax: (410) 402-8601 Email: erin.smith2@maryland.gov

Applications are to be sent to: eMaryland Marketplace Only (See section 1.5) eMMA is an electronic commerce system administered by the Maryland Department of General Services. In order to receive a Contract award, a Contractor must be registered on eMMA. Registration is free. Go to Login: eMaryland Marketplace Advantage (eMMA), click on “Register” to begin the process, and then follow the prompts.

Closing Date and Time: January 23, 2026 at 02:00PM Local Time

Pre-Application Conference: Tuesday January 6, 2026 2:30pm-3:30pm local time Video call link: meet.google.com/psw-kyvw-gwj Or dial: 8116-436-361(US) +1 PIN: 775481179 mailto:crystal.hack@maryland.gov mailto:rebecca.lakew@maryland.gov https://emma.maryland.gov/page.aspx/en/usr/login?ReturnUrl=%2Fpage.aspx%2Fen%2Fbuy%2Fhomepage https://emma.maryland.gov/page.aspx/en/usr/login?ReturnUrl=%2Fpage.aspx%2Fen%2Fbuy%2Fhomepage https://emma.maryland.gov/page.aspx/en/usr/login?ReturnUrl=%2Fpage.aspx%2Fen%2Fbuy%2Fhomepage https://meet.google.com/vdz-jejp-kpw?hs=224

SECTION 1 - GENERAL INFORMATION

1.1 Summary Statement

1.1.1 The Maryland Department of Health (MDH or the Department), through the Behavioral Health

Administration, is issuing this Request for Application (RFA) to identify an Applicant who will ensure youth under 17 years of age deemed Medicaid- ineligible but in need of assistance to address behavioral health needs, will be linked to a Targeted Case Management Plus (TCM Plus) provider. Applicant will also be responsible for managing the invoicing process for services rendered by TCM Plus providers and other related fiscal management duties to include requests for customized goods and services.

1.1.2 It is the State’s intention to obtain services, as specified in this RFA, from an Agreement between the selected Applicant and the State. The anticipated duration of services to be provided under this Agreement is 7/1/2026

- 6/30/2027 and two option years spanning 7/1/2027 - 6/30/28 and 7/1/2028 - 6/30/2029, respectively.

1.1.3 The Department intends to make a single award as a result of this RFA. All future years’ awards are subject to availability of funding and successful implementation of the services specified in this RFA.

1.1.4 The Department may make an award up to a total of $1,179,765 as a result of this RFA for fiscal year 2027.

The award amount for option year one is $1,179,765 (FY28), and option year two is $1,179,765 (FY29). This and all future years’ awards are subject to the availability of funding and successful implementation of the services specified in the RFA. The total amount of the award is $3,539,295.

1.1.5 Applicants, either directly or through their subcontractor(s), must be able to provide all services and meet all of the requirements requested in this Application. The successful Applicant shall remain responsible for performance regardless of subcontractor participation in the work.

1.1.6 MDH may adjust or cancel this award at any time during the initial grant year (or any option years, if applicable) based on available funding. In the event of a cancellation, MDH will provide at least 60 days notice of the change in funding availability.

1.2 Contract Type

The Agreement resulting from this Application shall be a firm fixed price.

1.3 Contract Officer

The sole point of contact in the State for purposes of this Application prior to the award of any Agreement is the Contract Officer at the address listed below:

Crystal Hack Maryland Department of Health / Behavioral Health Administration Spring Grove Hospital Center 55 Wade Avenue Voc. Rehab. Building Catonsville, MD 21228 Phone Number: 410-627-6814 E-mail: crystal.hack@maryland.gov

The Department may change the Contract Officer at any time by written notice.

mailto:crystal.hack@maryland.gov

1.4 Grant Monitor

The Grant Monitor is:

Erin Smith Behavioral Health Administration Primary Behavioral Health and Early Intervention Division 55 Wade Avenue Spring Grove Hospital Center ℅ Vocational Rehab. Bldg.

Catonsville, Maryland 21228 Phone: (443) 835-6548

Fax: (410) 402-8601 Email: erin.smith2@maryland.gov

The Department may change the Grant Monitor at any time by written notice.

1.5 eMaryland Marketplace Advantage

Each Applicant is requested to indicate its eMaryland Marketplace Advantage (eMMA) vendor number in the Transmittal Letter (cover letter) submitted at the time of its Application submission to this RFA.

eMMA is an electronic commerce system administered by the Maryland Department of General Services. The RFA and associated materials, the Application and summary of the Pre-Application Conference, Applicant questions and the Contract Officer’s responses, addenda, and other Application-related information will be provided via eMMA.

In order to receive a contract award, a vendor must be registered on eMMA. Registration is free. Go to https://emma.maryland.gov/, click on “Register” to begin the process, and then follow the prompts.

1.6 Questions

Written questions from prospective Applicants will be accepted by the Contract Officer. Questions to the Contract Officer shall be submitted via the eMaryland Marketplace Advantage (eMMA.) Please identify in the subject line the Application Number and Title.

Questions are requested to be submitted at least seven days prior to the Application due date. The Contract Officer, based on the availability of time to research and communicate an answer, shall decide whether an answer can be given before the Application due date.

1.7 Application Due (Closing) Date and Time

Applications, in the number and form set forth in Section 4.2 “Applications” must be received by the Contract Officer, at the address listed on the Key Information Summary Sheet, no later than 2:00PM Local Time on January 23, 2026 in order to be considered.

Requests for extension of this time or date will not be granted. Applications received after the due date and time listed in this section will not be considered. Questions regarding this solicitation should be submitted to eMMA only.

mailto:erin.smith2@maryland.gov https://emma.maryland.gov/

Applications may be modified or withdrawn by written notice received by the Contract Officer before the time and date set forth in this section for receipt of Application. Multiple and/or alternate Applications will not be accepted.

1.8 Award Basis

The Grant shall be awarded to responsible Applicant submitting Application that have been determined to be the most advantageous to the State, considering price and evaluation factors set forth in this RFA, for providing the activities as specified in this RFA. See RFA Section 5 for further award information.

1.9 Revisions to the RFA

If it becomes necessary to revise this RFA before the due date for Applications, the Department shall endeavor to provide addenda to all prospective Applicants that were sent this RFA or which are otherwise known by the Contract Officer to have obtained this RFA. Addenda made after the due date for Applications will be sent only to those Applicants that submitted a timely Application and that remain under award consideration as of the issuance date of the addenda.

Acknowledgment of the receipt of all addenda to this RFA issued before the Application due date shall be included in the Transmittal Letter accompanying the Applicant’s Project Narrative. Acknowledgement of the receipt of addenda to the RFA issued after the Application due date shall be in the manner specified in the addendum notice. Failure to acknowledge receipt of an addendum does not relieve the Applicant from complying with the terms, additions, deletions, or corrections set forth in the addendum.

1.10 Cancellation

The State reserves the right to cancel this RFA, accept or reject any and all Applications, in whole or in part, received in response to this RFA, waive or permit the cure of minor irregularities, and conduct discussions with all qualified or potentially qualified Applicant in any manner necessary to serve the best interests of the State. The State reserves the right, in its sole discretion, to award a Grant based upon the written Applications received without discussions or negotiations.

In the event a government entity proposes and receives the recommendation for award, the solicitation may be canceled, and the award processed in accordance with COMAR 21.01.03.01.A(4). If the services that are the subject of the RFA are currently being provided under an interagency agreement with a public institution of higher education and the State determines that the services can be provided more cost effectively by the public institution of higher education, then the RFA may be canceled in accordance with Md. Code Ann., State Finance and Procurement Art., § 3- 207(b)(2).

THE REMAINDER OF THIS PAGE IS INTENTIONALLY LEFT BLANK.

SECTION 2 – MANDATORY REQUIREMENTS

2.1 Applicant Mandatory Requirements

The Applicant must provide proof with its Application that the following Mandatory Requirements have been met:

2.1.1 The Applicant shall be a Social organization as defined per Section 7-402 of the State Finance and

Procurement Article of the Annotated Code of Maryland or a local, state government agency, public college or state university.

2.1.2 For social organization Applicants (not local, state government agency, public college, or state university), the

Applicant must be a nonprofit organization, classified by the IRS as tax-exempt under section 501(c)(3) of the Internal Revenue Code. Applications must include attachments of the following documentation from the applicant:

● Documentation of tax-exempt status of the Applicant or the Applicant’s fiscal sponsor (i.e. IRS tax exempt status determination letter)

2.1.3 The Applicant shall have 0-2 years of experience with providing the services listed in the Scope of Work requirements. The Applicant shall provide with its Application three (3) attestation letters from community partners or other organizations, from the past two (2) years, attesting to the Applicant’s experience in providing the services listed in the Scope of Work. This is not the same as a Letter of Support, as these should be organizations who have worked directly with the applicant.

SECTION 3 – SCOPE OF WORK

3.1 Background and Purpose

Background:

Targeted Case Management Plus (TCM Plus or TCM +) was established by the Behavioral Health Administration to provide needed care coordination availability to youth with private insurance or who otherwise do not meet eligibility criteria for Medical Assistance. It serves as an alternative to the existing, statewide Mental Health Case Management:

Care Coordination for Children and Youth (COMAR 10.09.90), also known as Targeted Case Management (TCM).

Similar to the state-implemented TCM model, TCM Plus employs a comprehensive wrap-around approach, supporting youth and families through Care Coordination Organizations (CCOs). Services rendered through TCM Plus are community-based and must be provided to eligible youth and families across Maryland. Currently, the Behavioral Health Administration (BHA) reviews submitted referrals for TCM Plus, determines eligibility, and authorizes services in six-month increments. Upon authorization for services, the youth and their family meet with TCM Plus staff to develop a plan of care that aims to help the youth with their identified behavioral health needs, to include allowance for therapeutic items, or customized goods and services (CG&S), not covered by standard care.

Through individualized support and guidance, care coordination will assist youth/families in navigating complex systems, connecting them with appropriate providers, and ensuring services are tailored to address their specific needs.

As noted in Health- General §15-1102, this award will fund up to 100 slots for children/youth enrolled in the TCM Plus Program and who are at risk of out-of-home placement. Identified participants will be enrolled in appropriate Care Coordination Organizations (CCOs) to receive TCM Plus. In addition to identifying and linking youth to TCM Plus, Applicant will also operate as the fiscal manager for this service overseeing the disbursement of funds to participating CCOs rendering TCM Plus, to include invoicing of CG&S for which all TCM Plus participants are eligible to receive.

Purpose:

The primary objective of this grant is to expand care coordination- TCM Plus- services to youth and families who possess private insurance, are underinsured or do not otherwise meet the eligibility requirements for Medical Assistance, thereby prioritizing the preservation of family unity and the promotion of youth stability within their community. As part of the implementation of this RFA, Applicant will demonstrate their ability to refer and link eligible youth and families to TCM Plus providers in Maryland; serve as the fiscal manager for this award by assuming responsibility for processing invoices received from the CCOs for TCM Plus services rendered to include CG&S ensuring CCOs receive timely payments; and providing required documentation to BHA as outlined in this

RFA.

Other responsibilities of the successful Applicant include maintaining local policies and procedures for the administration, disbursement, and prioritization of this award, consistent with the provisions outlined in this document. Applicant will report on enrollment and discharges of youth and families receiving TCM Plus services, including all applicable expenditure information. The Applicant will also ensure the identified CCO vendor(s) adheres to reporting expectations and will work with the BHA Primary Behavioral Health Early Intervention (PBHEI) grant monitor, as needed, to ensure identified youth are connected to services.

Lastly, the Applicant will include a clear and concise timeline and a workplan addressing the requirements outlined in this RFA.

3.2 Scope of Work - Requirements

The Applicant shall:

3.2.1 General Requirements

3.2.1.1 The Americans with Disabilities Act: The Americans with Disabilities Act (https:www.ada.gov/) protects qualified individuals with disabilities from discrimination on the basis of disability in services, programs, and activities. Accessibility and inclusion of diverse populations are essential to reduce health disparities for vulnerable populations. Contractors must comply with all ADA requirements in their work to ensure the needs of persons with disabilities and other vulnerable populations are met. This includes, but is not limited to:

● facilities and any venues used for meetings/conferences are accessible;

● requested accommodations are provided in a timely manner; and

● written and printed materials developed in accessible formats (easy to read, large print, etc.), or providing access to alternative formats.

For contracts which include direct patient care or service delivery through a program, the ADA requires entities provide full and equal access for people with disabilities. This includes, but is not limited to:

● reasonable modifications of policies, practices, and procedures;

● effective communication; and

● accessible facilities.

3.2.2 Programming

3.2.2.1 Linkage to TCM Plus:

Applicant will identify, refer and link eligible youth and families to TCM Plus providers in Maryland.

Deliverable(s):

A. Establish referral protocols and procedures:

a. Create guidance document outlining the steps and criteria for identifying eligible youth and families, and the process for referring them to TCM Plus providers.

B. Develop partnership agreements with TCM Plus providers:

a. Establish formal agreements detailing the collaboration between the Applicant and TCM Plus providers, including roles, responsibilities, and communication channels.

C. Create training materials for staff:

a. Develop resources to train internal staff on eligibility criteria, referral processes, and how to effectively link families to services to include integration of family peer support services as needed.

D. Develop outreach and engagement plan:

a. Establish strategies for identifying and engaging eligible youth and families within the community.

E. Establish data tracking and reporting system:

a. Develop and implement a system to monitor referrals, enrollments, linkages, discharges and other outcomes, ensuring accountability and program effectiveness.

F. Develop resource guide of TCM Plus providers:

a. Create a comprehensive list of available TCM Plus providers in Maryland, including contact information, services offered, and geographic areas served.

3.2.2.2 Fiscal Management:

The Applicant will serve as the fiscal manager for this award and will be responsible for maintaining local policies and procedures to ensure the effective administration, disbursement, and prioritization of funds in accordance with program requirements.

Deliverable(s):

A. Fiscal Management Plan:

a. Develop a comprehensive document outlining the Applicant's local policies and procedures for the effective administration, disbursement, and prioritization of funds. This plan should detail:

1. Budgeting Process: How funds will be allocated and budgeted.

2. Expenditure Procedures: Rules and processes for approving and making expenditures.

3. Financial Reporting: Schedule and format for internal and external financial reports.

4. Internal Controls: Measures to safeguard assets, ensure accuracy of financial data, and promote operational efficiency.

5. Compliance Procedures: How the Applicant will ensure adherence to all program requirements and relevant regulations.

6. Audit Procedures: Plans for internal and external audits to ensure accountability.

7. Prioritization of Funds Justification: Documentation explaining how funds are prioritized to align with program requirements and achieve desired outcomes.

b. Develop periodic (e.g., monthly, quarterly, annual) reports demonstrating the effective administration and disbursement of funds. These reports should include:

1. Budget vs. Actual expenditure reports

2. Cash flow statements

3. Balance sheets

4. Narrative explanations of significant variances or financial activities

c. Develop and implement a process of documenting internal or external audits conducted to verify compliance with program requirements and financial policies. This would include:

1. Audit findings

2. Recommendations

3. Corrective actions taken

d. Establish process for submitting TCM Plus referrals & CG&S requests to BHA for authorization.

This would include:

1. Reviewing CG&S referral requests for initial approval, submitting those approved referrals to BHA for final authorization, and maintaining accurate records to track all CG&S expenditures.

e. Maintain accurate records of CG&S and other TCM Plus related expenditures to ensure timely and accurate payments to TCM providers.

3.2.2.3 Meetings with BHA

Applicant will be available to meet with BHA Grant Monitor, and other relevant BHA staff as applicable, to ensure ongoing communication on the implementation and operation of the program.

A. Monthly meetings (virtual or in person) to be scheduled by Applicant with BHA Grant Monitor, and or designee, to discuss program progress.

a. Applicant shall be responsible for meeting minutes

b. Meeting minutes shall be provided to BHA Grant Monitor within one week of the last meeting.

B. Attend ad hoc meetings as requested by BHA Grant Monitor, or designee.

3.2.3 Staffing

Experience and Qualifications of Proposed Staff: Applicant shall propose key personnel and shall describe in the narrative if there is a need to hire additional personnel and how they shall be hired to meet the needs of this award. All other planned positions shall be described generally in the narrative and may not be used to meet company or personnel minimum qualifications. The Applicant shall identify the qualifications and types of staff proposed to be utilized under the Agreement.

Specifically, the Applicant shall:

A. Describe in detail how the proposed staff’s experience and qualifications relate to their specific responsibilities, including any staff of proposed subcontractor(s), as detailed in their Work Plan.

B. Include individual resumes for Key Personnel, including Key Personnel for any proposed subcontractor(s), who are to be assigned to the project if the Applicant is awarded the grant. Each resume should include the amount of experience the individual has had relative to the Scope of Work set forth in this solicitation.

C. Include letters of intended commitment to work on the project, including letters from any proposed subcontractor(s). Applicants should be aware of restrictions on substitution of Key Personnel prior to RFA award.

D. Provide an Organizational Chart outlining Personnel and their related duties. Applicants shall include job titles and the percentage of time each individual will spend on his/her assigned tasks.

3.2.4 Reports

Applicant will:

A. Within 30 days of the end of each quarter, submit quarterly reports which summarize activities under Section 3.2.2 (Programming) as well as 3.2.3 (Staffing) to BHA.

a. Example of submission cadence: October 31, 2025; January 31, 2026; April 30, 2026; & July 31, 2026

B. Within 60 days of the end of the state fiscal year, submit a comprehensive annual report on all program activities with summative data and programmatic recommendations to BHA.

a. Example of submission cadence: August 31, 2026

C. Submit biannual report of data analysis of satisfaction surveys reflecting knowledge increase of CCO staff participating in trainings.

D. Submit monthly meeting minutes capturing talking points and all applicable action steps discussed during scheduled meetings with BHA.

3.3 Invoicing

3.3.1 General

(a) All invoices for services shall be signed by the Grantee and submitted to the Grant Monitor. All invoices shall include the following information:

● Grantee name;

● Remittance address;

● Federal taxpayer identification number (or if sole proprietorship, the individual’s social security number);

● Invoice period;

● Invoice date;

● Invoice number;

● State assigned Contract number;

● State assigned (Blanket) Purchase Order number(s);

● Goods or services provided; and

● Amount due.

Invoices submitted without the required information cannot be processed for payment until the Contractor provides the required information.

(b) The Department reserves the right to reduce or withhold Grant payment in the event the Grantee does not provide the Department with all required deliverables within the time frame specified in the Grant or in the event that the Grantee otherwise materially breaches the terms and conditions of the Grant until such time as the Grantee brings itself into full compliance with the Grant.

3.3.2 Invoice Submission Schedule

The Grantee shall submit invoices in accordance with the following schedule:

Invoices are due on the 15th of the month following the end of the quarter. A copy of the quarterly report must be included with the invoice and sent to bha-fiscal.invoices@maryland.gov and the grant monitor.

● January-March due April 15th

● April-June due July 15th

● July-September due October 15th

● October-December due January 15th

SECTION 4 – APPLICATION FORMAT

4.1 Two Part Submission

Applicant shall submit applications in separate volumes:

▪ Volume I – Project Narrative

▪ Volume II – Budget Justification/Narrative

4.2 Applications

4.2.1 Applications must be submitted via eMMA (eMaryland Marketplace Advantage) listed on the Key

Information Summary Sheet. The Contract Officer will not accept submission after the date and exact time stated in the Key Information Summary Sheet. The date and time of submission is determined by the date and time of arrival in the Contract Officer eMMA inbox. Time stamps on outgoing email from Applicants shall not be accepted.

4.2.1.1 The email submission subject line shall state the RFA Title and number and either Technical Application or Budget Narrative.

4.2.1.2 Two Part Submission:

A. Technical Application (See 4.3.)

B. Budget Narrative (See 4.4)

4.2.2 Applications will be shown only to State employees, members of the Evaluation Committee, or other persons deemed by the Department to have a legitimate interest in them.

*All information submitted as part of this application is subject to release under the Public Information Act (PIA). If you would like the Maryland Department of Health (MDH) to consider redactions in the event that your application is subject to a PIA request, submit a proposed PIA copy including justifications for each redaction and under what statute that justification is qualified for redaction.

4.3 Volume I – Project Narrative

Note: No pricing information is to be included in the Project Narrative (Volume 1). Pricing information is to be included only in the Budget Justification/Narrative (Volume II).

4.3.1 The Technical Application shall include the following documents and information in the order specified as follows:

4.3.1.1 Transmittal Letter:

● Applicant;

● Application Title and Application Number that the Application is in response to;

● Signature, typed name, and title of an individual authorized to commit the Applicant to its

Application;

● Federal Employer Identification Number (FEIN) of the Applicant, or if a single individual, that individual’s Social Security Number (SSN);

● Applicant’s eMMA number;

● Applicant’s MBE certification number (if applicable);

● Applicant’s SBR number (if applicable) – please contact eMMA at 410-767-1492 if you don’t know your number.

4.3.1.2 The Project Narrative shall include the Scope of Work, including the Work Plan (as described in Section 3.2).

4.3.1.3 Mandatory Requirements Documentation (See Section 2)

4.3.1.4 Applicant Technical Response to RFA Requirements and Proposed Work Plan:

a. The Applicant shall address each Scope of Work requirement (Section 3.2) in its Project Narrative and describe how its proposed services, including the services of any proposed subcontractor(s), will meet or exceed the requirement(s). If the State is seeking Applicant agreement to any requirement(s), the Applicant shall state its agreement or disagreement.

Any paragraph in the Project Narrative that responds to a Scope of Work (Section 3.2) requirement shall include an explanation of how the work will be done. Any exception to a requirement, term, or condition may result in having the Application classified as not reasonably susceptible of being selected for award or the Applicant deemed non-responsive.

b. Applicant shall acknowledge they have read the American with Disabilities Act Statement in Section 3.2 and will meet all requirements.

4.3.1.5 Signed W-9 with Contact Person Names and Phone Number

4.4 Volume II – Budget Narrative

4.4.1 Under separate sealed cover from the Project Narrative and clearly identified in the format identified in

Section 4.2 “Applications,” the Applicant shall submit an original unbound copy of the Budget Narrative.

The Budget Narrative shall contain all price information in the format specified in Exhibit C. The Applicant shall complete the Budget Narrative Form only as provided in the Budget Narrative Form.

4.4.2 The Applicant shall attach to the Budget Form Exhibit B document, in Excel format, that details the total cost of the proposed activities. The budget categories may include: Personnel (salary and fringe), Consultants;

Travel; Contractual; Supplies; Operating Costs; and Other project-related costs.

SECTION 5 – EVALUATION COMMITTEE, EVALUATION CRITERIA, AND SELECTION

PROCEDURE

5.1 Evaluation Committee

Evaluation of Applications will be performed by a committee established for that purpose and based on the evaluation criteria set forth below. The Evaluation Committee will review Applications, participate in Applicant presentations and discussions, and provide input to the Contract Officer. The Department reserves the right to utilize the services of individuals outside of the established Evaluation Committee for advice and assistance, as deemed appropriate.

5.2 Project Narrative Evaluation Criteria

The criteria to be used to evaluate each Project Narrative listed below in descending order of importance. (See Section 3.2)

5.2.1 Mandatory Requirements

5.2.1.1 Does the Applicant meet all of the requirements outlined in Section 2.1 to include submission of attestations and required documentations?

5.2.2 General Requirements

5.2.2.1 Does the Applicant acknowledge agreement to meet the American with Disabilities Act Statement in Section 3.2 and will meet all requirements?

5.2.2.2 Does the Applicant’s Project Narrative demonstrate the capacity to implement the Scope of Work as evidenced by response(s) to the Programming subsection (3.2.2)?

5.2.2.3 Does the Applicant’s Project Narrative include an organizational description and adequately demonstrates the Applicant’s capacity to implement the Scope of Work, and includes organizational charts, and any relevant certifications, licenses, resumes, and other supporting documentation (as described in Section 3.2)?

5.2.2.4 Does the Applicant’s Project Narrative attest to adhering to the reporting expectations outlined in subsection 3.2.4 to include submission cadence?

5.3 Budget Narrative Evaluation Criteria

All Qualified Applicants will be ranked from the lowest (most advantageous) to the highest (least advantageous) based on the rating of the Project Narratives. The Budget Narrative (including the Budget Form and Budget Narrative), will be evaluated based on reasonable cost given the time and effort described in the Project Narrative.

The budget line items must be within the stated guidelines set forth in this RFA and as submitted on Exhibit C – Budget Narrative.

5.4 Selection Procedures

5.4.1 General

The Grant will be awarded in accordance with the Standard Grant Agreement method outlined in the Announcement. The State may determine an Applicant to be non-responsive and/or an Applicant’s

Application to be not reasonably susceptible of being selected for award at any time after the initial closing date for receipt of Applications and prior to Grant award. If the State finds an Applicant to be not responsive and/or an Applicant’s Project Narrative to be not reasonably susceptible of being selected for award, that Applicant’s Budget Narrative will be returned if the Budget Narrative is unopened at the time of the determination.

5.4.2 Award Determination

Upon completion of the Project Narrative and Budget Narrative evaluations and rankings, each Applicant will receive an overall ranking. The Contract Officer will recommend award of the Grant to the responsible Applicant that submitted the Application determined to be the most advantageous to the State. In making this most advantageous Application determination, technical factors and financial factors will be weighted equally.

RFA ATTACHMENTS

EXHIBIT B – Budget Form This must be completed and submitted with the Project Narrative in a separate Excel formatted document.

EXHIBIT C—Budget Narrative This form must be completed and submitted with the Budget Form in a separate pdf formatted document from the Project Narrative.

ATTACHMENT A – RFA Document Checklist Use this checklist to ensure that the required documents for the Project Narrative and Budget Narrative are completed.

ATTACHMENT A – Standard Grant Agreement “Sample”

This is the sample grant agreement used by the Department. It is provided with the RFA for informational purposes and is not required to be submitted at the Application submission time. Upon notification of recommendation for award, a completed standard grant agreement will be sent to the recommended awardee for signature. The recommended awardee must return to the Contract Officer the signed copy of the Standard Grant Agreement within five (5) Business Days after receipt. Upon award, a fully executed copy will be sent to the Grantee.

EXHIBIT B – BUDGET FORM

BUDGET FORM

The Budget Narrative shall contain all price information in the format specified on these pages. Complete the Budget Form only as provided in the Budget Form format. Do not amend, alter or leave blank any items on the Budget Form. Failure to adhere to any of these instructions may result in the Budget Narrative being determined non-responsive and rejected by the Department.

Submitted By:

Authorized Signature: ______________________________________ Date: ________________________

Printed Name and Title: __________________________________________________________________ Company Name : ___________________________________________________________________ Company Address: ______________________________________________________________________ Location(s) from which services will be performed (City/State): ___________________________________

FEIN: _________________________________________

eMMA #: ________________________________________ Telephone: (_______) _______-- ____________________ Fax: (_______) _______--____________________ E-mail: _________________________________________

Budget Summary

Line Item Qty Unit Cost Total Cost Salary Fringe Contractual Travel Operating Costs Supplies Other (specify) Other (specify) Other (specify) Other (specify)

TOTAL

Budget cannot exceed $1,179,765 per fiscal year.

IDC: 10% CAP

EXHIBIT C – BUDGET NARRATIVE

BUDGET NARRATIVE TEMPLATE

(Please submit a separate Narrative for each Budget Period)

Sample Line-Item Justification

Personnel (Preventionist): $15,600

Justification: The Preventionist will be responsible for: conducting project-related relationship-building activities with new and existing partners; developing informational materials for community leaders and the public, including fact sheets and social media posts related to the project topic; coordinating and facilitating monthly project meetings with partners; conducting awareness-building activities within key demographic areas in the community to engage the project target audience; developing and providing professional training at targeted local governmental agencies and private businesses; attending community events relevant to the project and the project’s partners. The Project Coordinator will also attend RISEMD meetings, collect data, conduct evaluation activities, prepare reports, and act as a liaison with the MDH Grant Monitor.

$30/hr x 520 hours = $15,600

Template A – Standard Grant Agreement “SAMPLE”

ORGANIZATIONS RECEIVING APPROPRIATIONS FROM THE STATE

STANDARD GRANT AGREEMENT

This Agreement, which is executed in compliance with Section 7-402 of the State Finance and Procurement Article of the Annotated Code of Maryland, is made this <enter day> day of <month, year> , between the State of Maryland (the “State”), acting through the Maryland Department of Health, (the “Department”), located at <enter MDH Address> and the <grantee name> (the “Grantee” ), located at <grantee address> in <county / city> County, <state, zip> , a Maryland Limited Liability Company / Corporation. .

1. Effective on the date of execution of this Agreement, the State is extending to the Grantee a grant in the amount of <amount in words> Dollars ($ xx,xxx.xx) (the “Grant”), which the Grantee shall use only for the following purposes: <grant purpose>

2. Any expenditure of Grant funds that is not consistent with purposes stated in paragraph 1 may, at the sole discretion of the Department, be disallowed. Should any expenditure be disallowed or should the Grantee violate any of the terms of this Agreement, the State may require repayment to the State Treasury, an offset from any State Grant to the Grantee in the current or succeeding fiscal year, or other appropriate action. The Grantee shall repay to the State any part of the Grant that is not used for the purposes stated in paragraph 1 within 3 months after the date of this Agreement.

3. The Grantee may not sell, lease, exchange, give away, or otherwise transfer or dispose of real or personal property, or any part of or interest in real or personal property, acquired with Grant funds without the prior written consent of the Department. This includes transfer or disposition to a successor on the merger, dissolution, or other termination of the existence of the Grantee. The Grantee shall give the Department written notice at least 30 calendar days before any proposed transfer or disposition. Any proceeds from a permitted transfer or disposition shall be applied to repay to the State a percentage of that portion of the Grant allocable to the particular real or personal property transferred or disposed of, unless the Department and the Grantee agree to other terms and conditions. The percentage shall be equal to the percentage of the unadjusted basis of the property that would remain if the property had been recovery property placed in service after December 31, 1980 and if all allowable deductions had been taken up to the time of disposition under the Accelerated Cost Recovery System (ACRS) specified in the United States Internal Revenue Code, Section 168(b)(1).

4. For any item of real or personal property that is acquired with Grant funds and has an original fair market value of Five Thousand Dollars ($5,000) or more, the Grantee shall, at its own expense, and for the reasonable useful life of that item or for 5 years, whichever is less, obtain and maintain insurance. The insurance shall provide full protection for the Grantee and the State against loss, damage, or destruction of or to the real or personal property. The Grantee shall, on request, provide the Department with satisfactory evidence of its compliance with this requirement.

Proceeds of insurance required by this paragraph shall be applied toward replacement of the real or personal property or toward the partial or total repayment of the State of the Grant, in the sole discretion of the Department.

5. The Grantee may not discriminate against any employee or applicant for employment because of race, color, religion, sex, national origin, or any other characteristic forbidden as a basis for discrimination by applicable laws, and certifies that its Constitution or by-laws contains a non-discrimination clause consistent with the Governor’s Code of Fair practices.

6. The person executing this Agreement on behalf of the Grantee certifies, to the best of that person’s knowledge and belief, that:

A.) Neither the Grantee, nor any of its officers or directors, nor any employee of the Grantee involved in obtaining contracts with or grants from the State or any subdivision of the State, has engaged in collusion with respect to the Grantee’s application for the Grant or this Agreement or has been convicted of bribery, attempted bribery, or conspiracy to bribe under the laws of any state or of the United States;

B.) The Grantee has not employed or retained any person, partnership, corporation, or other entity, other than a bona fide employee or agent working for the Grantee, to solicit or secure the Grant or this Agreement, and the Grantee has not paid or agreed to pay any such entity any fee or other consideration contingent on the making of the Grant or this Agreement; the grantee understands and complies with the Conflicts of Interest provision of the Public Ethics Law, Maryland Code Annotated, General Provisions, Title 5, Subtitle 5.

C.) The Grantee, if incorporated, is registered or qualified in accordance with the Corporations and

Associations Article of the Annotated Code of Maryland, is in good standing, has filed all required annual reports and filing fees with the Department of Assessments and Taxation and all required tax returns and reports with the Comptroller of the Treasury, the Department of Assessments and Taxation, and the Department of Labor, Licensing and Regulation, and has paid or arranged for the payment of all taxes due to the State; and

D.) No money has been paid to or promised to be paid to any legislative agent, attorney, or lobbyist for any services rendered in securing the passage of legislation establishing or appropriating funds for the Grant.

E.) Neither the Grantee, nor any of its officers or directors, nor any person substantially involved in the contracting or fund raising activities of the Grantee, is currently suspended or debarred from contracting with the State or any other public entity or subject to debarment under the Code of Maryland Regulations, COMAR 21.08.04.04.

7. Within 60 calendar days after the close of any grant period in which the Grantee receives funds under this Agreement, the Grantee shall provide to the Department an itemized statement of expenditures, showing how the funds were expended for that grant period. In addition, a copy of the statement shall be mailed to the Director, General Accounting Division, Office of the Comptroller of the Treasury, Room 200, Louis L. Goldstein Treasury Building, Annapolis, Maryland 21401. The Grantee shall retain bills of sale or other satisfactory evidence of the acquisition of any real or personal property for at least 3 years after the date of this Agreement. The Department, the Department of Budget and Management, the State Comptroller, and the Legislative Auditor, or any of them, may examine and audit this evidence, on request, at any reasonable time within the retention period.

8. The Grantee shall comply with Section 7-221, 7-402, and 7-403 of the State Finance and Procurement Article of the Annotated Code of Maryland, as applicable.

9. The laws of Maryland shall govern the interpretation and enforcement of this Agreement.

10. This Agreement shall bind the respective successors and assigns of the parties.

11. The Grantee may not sell, transfer, or otherwise assign any of its obligations under this Agreement, or its rights, title, or interest in this Agreement, without the prior written consent of the Department.

12. No amendment to this Agreement is binding unless it is in writing and signed by both parties.

13. The following items are incorporated by referenced and made a part of this Agreement .Appendix A & B, Attachment A, B, C, D, E.&F.

IN TESTIMONY WHEREOF, WITNESS the hands and seals of the parties.

GRANTEE

(Name of Corporation or Association)

By:

. SEAL

Name: .

Title:

DEPARTMENT

Maryland Department of Health.

(Name of Corporation or Association)

By:

SEAL

Name:

Title:

Date:

Date:

APPENDIX A

The Department’s Grant Monitor is: The Grantee’s Grant Monitor is:

<Name and Title of MDH grant monitor> <enter name, title, office, grantee agency, address, <Office> phone number and email > Maryland Department of Health 201 W. Preston Street Baltimore, Maryland 21201 Phone:

Email:

I. BACKGROUND INFORMATION OF AGREEMENT

<Enter background information of the agreement>

II. DUTIES OF THE GRANTEE

SCOPE OF WORK:

<Enter all duties and scopes of work for the grant agreement>

APPENDIX B (insert revised budget)

Cost Estimate for:

<Name of Project>

PERIOD OF PERFORMANCE - <Date of Project>

<Enter Budget>

II. DUTIES OF THE DEPARTMENT

Other than awarding the funds to the <grantee/sub-recipient/sub-awardee> for this project the Behavioral Health Administration will:

● Provide necessary technical support and monitoring to <grantee/sub-recipient/sub-awardee> to ensure state and federal grant compliance.

This includes but is not limited to:

● Completion of the MDH Office of the Inspector General Risk Assessment

● Completion of the Standard Grant Agreement Checklist

● Determination of Good Standing with The State of Maryland

● Review for Debarment, Suspension, or any Exclusion from doing business with Maryland

● Determination regarding No Conflicts of Interest

● Review of Single Audits

● Review for Debarment, Suspension, or any Exclusion from doing business with the Federal Government

SECTION IV. INCORPORATION BY REFERENCE

Both parties hereby agree that the documents described below, if any, are hereby incorporated into and made an integral part of this Agreement: (Type "None", if none)

Exact Title of Document(s)

Number of Pages

Conditions of Award- Attachment A 2

Federal Funds- Attachment B 2

Debarment Affirmation- Attachment C 2

Certification Regarding Tobacco Smoke- Attachment D 1

Certification Regarding Lobby- Attachment E 5

Additional Information required for Prevention and Health Promotion Administration Grants – Attachment F

ATTACHMENT A

CONDITIONS OF AWARD

Maryland Department of Health (MDH)

Behavioral Health Administration Primary Behavioral Health and Early Intervention

<Enter Federal Awarding Agency Here> <Enter Name of Federal Award and Grant Number Here>

Period of Performance: <Enter From and To Dates Here>

Important Dates:

<Enter Date Here>: Quarterly progress report <Enter Date Here>: All funds obligated <Enter Date Here>: All funds must be spent <Enter Date Here>: Final progress and fiscal report due to MDH

The grantee/sub-grantee/sub-recipient (circle one), shall comply with these conditions. Consequences for failure to comply with these conditions may include: a point reduction in score for future competitive and non-competitive applications, a reduction of overall award, audit exceptions and/or reduction in future awards.

Program Requirements:

1. The grantee/sub-grantee/sub-recipient, <Enter Grantee Name Here > agrees to comply with MDH guidelines and initiatives with regards to their expenditures/purchases.

2. When procuring equipment, the recipient must comply with the procurement standards at 45 CFR Part

92.36 and 45 CFR 74.40 through 74.48, including 74.45, which requires the performance and documentation of some form of cost or price analysis with every procurement action.

3. The grantee/sub-grantee/sub-recipient, will perform activities that coordinate, integrate, prioritize and sustain improvements in public health emergency preparedness.

4. The grantee/sub-grantee/sub-recipient, shall cite < Enter Name of Federal Award > and the MDH Behavioral Health Administration as a funding source when publishing or presenting data or programs partially or fully funded by MDH grants.

5. The grantee/sub-grantee/sub-recipient, should inform the MDH Behavioral Health Administration as a courtesy when a presentation or publication is made public that involves programs or data partially or fully funded by MDH, and any federal grants. All reports, data, software, or presentations generated from federal funded projects must be made available to MDH for review and comment prior to release or distribution.

Fiscal Requirements:

1. The grantee/sub-grantee/sub-recipient, shall not use <Enter Name of Federal Award> to:

a. Support the costs of operating clinical trials of investigational agents, equipment or treatments;

b. Make payments directly to recipients of services, except for reimbursement of reasonable and allowable out-of-pocket expenses associated with consumer participation in State or consortia activities;

c. Support legal services;

d. Provide direct maintenance expenses of privately owned vehicles or any other costs associated with a vehicle, such as lease or loan payments, vehicle insurance, or license registration fees;

e. Purchase or improve land, or to purchase, construct, or make permanent improvements to any building, except for minor remodeling;

f. Pay property taxes;

g. Fund capital improvement projects;

h. Supplant personnel costs and/or other activities.

i. Prepare, distribute, or use of any material (publicity/propaganda) or to pay the salary or expenses of grants, contract recipients, or agents that aim to support or defeat the enactment of legislation, regulation, administrative action, or executive order proposed or pending before a legislative body.

2. The grantee/sub-grantee/sub-recipient will comply with all MDH and federal fiscal requirements for timely submission of detailed budgets and budget modifications, including monthly invoice requirements.

3. The grantee/sub-grantee/sub-recipient will return any unspent and unobligated funds to MDH and provide the necessary supporting documentation.

Audits:

The grantee/sub-grantee/sub-recipient shall submit audits in accordance with Federal OMB 2 CFR 200, Subpart F

- Audit Requirements. An electronic copy of all audits (2 CFR 200 Subpart F, as well as independent auditors) performed against federal funding should be forwarded to the Department for review.

Site Visits and Surveys:

1. As requested, the grantee/sub-grantee/sub-recipient shall participate fully in the MDH Behavioral Health Administration Quality Improvement and Technical Assistance activities, which may include, but are not limited to:

a. Comprehensive site visits at the Department’s request within the project period;

b. Interviews of staff, review of fiscal and program records, monitoring, risk assessment, review of inventory purchased against federal funding, interviews with administrators, and observation of program activities/facility.

Equipment Inventory Requirements:

Equipment purchased with federal funds may…