BPM054750_Bipartisan Safer Communities Act (BSCA) Community Outreach Project- RFA.pdf

EXHIBIT A

STANDARD GRANT AGREEMENT (SGA)

REQUEST FOR APPLICATIONS (RFA)

(COMPETITIVE)

CONTRACT ID NUMBER – BHA25-025 / BPM054750

Issue Date: January 5, 2026

Bipartisan Safer Communities Act (BSCA)- Community Outreach Project

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.

STATE OF MARYLAND

MARYLAND DEPARTMENT OF HEALTH

RFA KEY INFORMATION SUMMARY SHEET

Request for Applications: Bipartisan Safer Communities Act (BSCA)- Community Outreach Project

Application Number: BHA25-025 / BPM054750

RFA Issue Date: January 5, 2026

RFA Issuing Office: Maryland Department of Health Behavioral Health Administration

Primary Behavioral Health/Early Intervention

Contract Officer: Crystal Hack Maryland Department of Health

Behavioral Health Administration Finance & Procurement Division 55 Wade Avenue Voc. Rehab. Building Catonsville, MD 21228 Phone: 410-627-6814 Fax: 410-402-8601 e-mail: crystal.hack@maryland.gov

Grant Monitor: Natalee Solomon

Maryland Department of Health Behavioral Health Administration 55 Wade Avenue Catonsville, MD 21228 Vocational Rehabilitation Building Phone: (410) 409-7608 Fax: 410-402-8601 e-mail: natalee.solomon@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 to Login: eMaryland Marketplace Advantage (eMMA) , click on “Register” to begin the process, and then follow the prompts.

Closing Date and Time: Friday January 30, 2026 at 2:00PM Local Time

Pre-Application Conference: Tuesday January 13, 2026 at 10:00am Video Call Link: meet.google.com/khe-jheg-vxn Or Dial: (US) +1 405-656-0122 PIN: 703 534 684# mailto:crystal.hack@maryland.gov https://emma.maryland.gov/page.aspx/en/usr/login?ReturnUrl=%2Fpage.aspx%2Fen%2Fbuy%2Fhomepage

SECTION 1 - GENERAL INFORMATION

1.1 Summary Statement

1.1.1 The Maryland Department of Health (MDH or the Department), through its sub-unit, the Behavioral Health

Administration (BHA), is issuing this Request for Applications (RFA) to provide outreach to clinical programs that serve youth and young adults experiencing first episode psychosis, and to also more specifically focus training on Coordinated Specialty Care (CSC) care and resources for outreach recipients.

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 July 1, 2026- June 30, 2027, with two (2) one option year: July 1, 2027-June 30, 2028 and July 1, 2028-June 30, 2029.

1.1.3 The Department intends to make a single award as a result of this RFA. Contingent upon funding availability.

1.1.4 All future years’ awards are subject to the availability of funding and successful implementation of the services specified in this RFA.

1.1.5 The Department may make an award up to a total of $392,490, ($130,830 per year), as a result of this RFA.

This award is contingent upon available funding.

1.1.6 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 and the successful Applicant shall remain responsible for performance regardless of subcontractor participation in the work.

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

1.1.8 Unless expressly stated by law, award determinations and amounts may not be appealed.

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 Finance & Procurement Division Phone Number: 410-627-6814 Fax: 410-402-8601 E-mail: crystal.hack@maryland.gov mailto:crystal.hack@maryland.gov

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

1.4 Grant Monitor

The Grant Monitor is:

Natalee Solomon

Maryland Department of Health Behavioral Health Administration 55 Wade Ave Voc. Rehab. Bldg.

Catonsville, Maryland 21228 Phone Number: 410-409-7608 Fax Number: 410-402-8601 E-mail: Natalee.solomon@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 Login:

eMaryland Marketplace Advantage (eMMA) , 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 eMaryland Marketplace ONLY! Please identify in the subject line the Solicitation Number and Title.

Questions are requested to be submitted at least 7 business 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 2:00 pm Local Time on January 30, 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:Natalee.solomon@maryland.gov https://emma.maryland.gov/page.aspx/en/usr/login?ReturnUrl=%2Fpage.aspx%2Fen%2Fbuy%2Fhomepage

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 Applicants submitting Applications 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 Offerors 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 at least 0-2 years of experience providing outreach and education, to include training on early serious mental illness and Coordinated Specialty Care (CSC) resources. 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:

In 2022, the Bipartisan Safer Communities Act (BSCA) (P.L. 117-159) was implemented to provide supplemental funding for the Community Mental Health Services Block grant (MHBG), to enable States, the District of Columbia, and territories to expand access to mental health care. The Substance Abuse and Mental Health Services Administration (SAMHSA) is recommending that state behavioral health systems examine what is needed to address the need for mental health services in the aftermath of mass shootings and other traumatic events in communities.

This Act required that ten percent of the award be focused on early serious mental illness/first episode psychosis.

Coordinated Specialty Care (CSC) also known as First Episode Psychosis (FEP) programming, is a multicomponent, evidence-based, early intervention service for individuals experiencing a first episode of psychosis (FEP) that can improve their quality of life and social and clinical outcomes.

A Community Health Worker (CHW) is a frontline public health professional who serves as a liaison between the community and health and social services to improve access to care. They facilitate access to services, educate the community on health behaviors, provide social support, and advocate for individual and community needs. CHWs use their close understanding of the community to provide appropriate care.

Purpose: Provide outreach to clinical programs that serve youth and young adults experiencing first episode psychosis, and to also more specifically focus training on Coordinated Specialty Care (CSC) care and resources for outreach recipients. Additionally, transportation support can be provided to the youth and young adults to travel to health services (primary care and specialty) to support further evaluation and CSC referral/support.

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.

3.2.1.2 Programming

A. Outreach and Education

Deliverables for Outreach and Education (O&E)

i. Provide Outreach and Education, which can be on-site or virtual, at a minimum of 3 sites a month, totaling at least 36 a year. Some O&E can be but not limited to:

a. Mental health crisis programs that are not hospital-based (e.g. Baltimore Crisis Response Inc.)

b. County “warm-line” crisis programs through the State Core Service Agencies

c. School mental health programs for higher-risk teenagers (e.g. non-public day programs, special education programs)

d. Parent and Peer Support specialist providers (e.g. On Our Own)

e. Primary care providers (family medicine and pediatrics) – outreach through our existing Behavioral Health in Pediatric Primary Care state network

f. Homeless shelters for teenagers and young adults that have case management/mental health referral workers

g. Addictions treatment programs

ii. Provide follow-up contact for CSC referral questions and/or assistance (provider is expected to complete at least 25 contacts per year).

iii. Maintain CSC information and resources on a webpage that is easily accessible to any Community Health Worker (CHW) in the state who needs information on CSC services.

B. Training

Deliverables for Training

i. Provide two (2) training courses per quarter, at 8 a year, training may include but not limited to:

a. Introduction to Coordinated Specialty Care Services (CSC) – this can be developed as personalized trainings for mental health and primary care personnel

b. Strategies to engage youth and young adults to utilize CSC services

c. CSC resources in Maryland

d. Recovery goals that can be supported by CSC services

C. Transportation

i. Provide vouchers to support access of youth and young adults to health services (primary care and specialty) to support further evaluation and CSC referral/support.

D. Staffing

Deliverables for Staffing

i. Community Health Worker (CHW) - will provide and support outreach and education.

Bachelor’s degree preferred but not required, in Human Services/Psychology/Social work/Education and/or familiarity with public behavioral system required. An equivalent combination of education and experience may be considered.

ii. The Contractor could recruit for this position and/or use staffing within their organization. Please specify anticipated FTE in proposal for all staff.

E. Reporting

Deliverables for Reporting

a. Submit quarterly reports on summary of activities and progress made during the quarter on reaching the deliverables, 3.2.1, including key accomplishments, challenges and barriers, and implementation updates.

b. The quarterly report is due 15 days after the quarter ends e.g.: January-March, report would be due April 15th.

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 mailto:bha-fiscal.invoices@maryland.gov

SECTION 4 – APPLICATION FORMAT

4.1 Two Part Submission

Offerors 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 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. Please use the separate Excel budget attachment found on eMMA.

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 Acknowledged agreement to meet the American with Disabilities Act Statement in Section 3.2 and will meet all requirements.

5.2.2 Attestations and Required Documentation

Applicant attestations indicate applicant has the ability to provide the services required in the Scope of Work.

5.2.3 Organizational Capacity

5.2.3.1 Project narrative includes 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) which further demonstrate the applicant’s abilities:

a. Outreach and Education

b. Training

c. Transportation

5.2.4 Proposed Work Plan

5.2.4.1 Applicant must describe work plans to implement the General Requirements as described in Section 3.2 to include sustainability of services.

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 – 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.

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

ATTACHMENT C – Work Plan Template

EXHIBIT B – BUDGET FORM

BUDGET FORM (SAMPLE)

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 $392,490

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

ATTACHMENT 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>

The Remainder of This Page is Left Blank

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 <MDH awarding agency> 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)

<Enter Department Here> <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 <Enter Department Here> 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 <Enter Department Here> 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 <Enter Department Here> 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 be recalled or requested to support local, regional and/or statewide emergency response efforts and must be catalogued for future reference and review. Cataloging of equipment should be updated and maintained throughout the project period.

Risk Assessment:

The grantee/sub-grantee/sub-recipient shall be required to participate in an MDH Risk Assessment in accordance with Federal OMB 2 CFR §200.205 (b) thru (d), §200.207, and §200.331 (b) thru (h). As part of this requirement, sub- recipients will be monitored based on a risk level of High, Medium or Low. Each risk level imposes certain monitoring requirements set by the MDH Office of the Inspector General in accordance with the above federal guidelines.

ATTACHMENT B

FEDERAL FUNDS

A Summary of Certain Federal Fund Requirements and Restrictions [Details of particular laws, which may levy a penalty for noncompliance, are available from the Maryland Department of Health.]

1. Form and rule enclosed: 18 U.S.C. 1913 and section 1352 of P.L. 101-121 require that all prospective and present subgrantees (this includes all levels of funding) who receive more than $100,000 in federal funds must submit the form “Certification Against Lobbying”. It assures, generally, that recipients will not lobby federal entities with federal funds, and that, as is required, they will disclose other lobbying on form SF- LLL.

2. Form and instructions enclosed: “Form LLL, Disclosure of Lobbying Activities” must be submitted by those receiving more than $100,000 in federal funds, to disclose any lobbying of federal entities (a) with profits from federal contracts or (b) funded with nonfederal funds.

3. Form and summary of Act enclosed: Sub-recipients of federal funds on any level must complete a “Certification

Regarding Environmental Tobacco Smoke,” required by Public Law 103-227, the Pro-Children Act of 1994.

Such law prohibits smoking in any portion of any indoor facility owned or leased or contracted for regular provision of health, day care, early childhood development, and education or library services for children under the age of 18. Such language must be included in the conditions of award (they are included in the certification, which may be part of such conditions.) This does not apply to those solely receiving Medicaid or Medicare, or facilities where WIC coupons are redeemed.

4. In addition, federal law requires that:

a) OMB 2 CFR 200, Subpart F, Audit Requirements requires that grantees (both recipients and sub-recipients) which expend a total of $750,000 or more in federal assistance shall have a single or program-specific audit conducted for that year in accordance with the provisions of the Single Audit Act of 1984, P.L. 98-502, and the Single Audit Act Amendments of 1996, P.L. 104-156. and the Office of Management and Budget (OBM) 2 CFR 200, Subpart F.

b) All sub-recipients of federal funds comply with Sections 503 and 504 of the Rehabilitation Act of 1973, the conditions of which are summarized in item (C).

c) Recipients of $10,000 or more (on any level) must include in their contract language the requirements of Sections 503 (language specified) and 504 referenced in item (B).

Section 503 of the Rehabilitation Act of 1973, as amended, requires recipients to take affirmative action to employ and advance in employment qualified disabled people. An affirmative action program must be prepared and maintained by all contractors with 50 or more employees and one or more federal contracts of $50,000 or more.

This clause must appear in subcontracts of $10,000 or more:

i. The contractor will not discriminate against any employee or applicant for employment because of physical or mental handicap in regard to any position for which the employee or applicant for employment is qualified. The contractor agrees to take affirmative action to employ, advance in employment and otherwise treat qualified handicapped individuals without discrimination based upon their physical or mental handicap in all upgrading, demotion or transfer, recruitment, advertising, layoff or termination, rates of pay or other forms of compensation, and selection for training, including apprenticeship.

ii. The contractor agrees to comply with the rules, regulations, and relevant orders of the secretary of labor issued pursuant to the act.

iii. In the event of the contractor’s non-compliance with the requirements of this clause, actions for non-compliance may be taken in accordance with the rules, regulations and relevant orders of the secretary of labor issued pursuant to the act.

iv. The contractor agrees to post in conspicuous places, available to employees and applicants for employment, notices in a form to be prescribed by the director, provided by or through the contracting office. Such notices shall state the contractor's obligation under the law to take affirmative action to employ and advance in employment qualified handicapped employees and applicants for employment, and the rights of applicants and employees.

v. The contractor will notify each labor union or representative of workers with which it has a collective bargaining agreement or other contract understanding, that the contractor is bound by the terms of Section 503 of the Rehabilitation Act of 1973, and is committed to take affirmative action to employ and advance in employment physically and mentally handicapped individuals.

vi. The contractor will include the provisions of this clause in every subcontract or purchase order of

$10,000 or more unless exempted by rules, regulations, or orders of the [federal] secretary issued pursuant to section 503 of the Act, so that such provisions will be binding upon each subcontractor or vendor. The contractor will take such action with respect to any subcontract or purchase order as the director of the Office of Federal Contract Compliance Programs may direct to enforce such provisions, including action for non-compliance.

Section 504 of the Rehabilitation Act of 1973, as amended (29 U.S.C. Sec. 791 et seq.) prohibits discrimination on the basis of handicap in all federally assisted programs and activities.