Illinois Department of Human Services Division of Community Health and Prevention

Bureau of Youth Services and Delinquency Prevention

REQUEST FOR PROPOSALS PBC# 000000037691

Teen Responsibility, Education, Achievement, Caring and Hope (Teen REACH)

Released December 8, 2008

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Request for Proposal Teen Responsibility, Education, Achievement,

Caring and Hope (Teen REACH)

Table of Contents PART I: General Requirements PART II: Project Description PART III: Proposal Content

APPENDICES

Appendix 1 - Best and Promising Practices Appendix 2 - Activity Calendar Appendix 3 - Site Information Form Appendix 4 - Chicago Community Areas Appendix 5 - Youth Attendance Plan (Instructions & Forms) Appendix 6 - Application Cover Sheet (Instructions and Form) Appendix 7 - Spending Plan Appendix 8 - Allowable Costs Appendix 9 - Proposal Content Checklist

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Request for Proposal Teen Responsibility, Education, Achievement,

Caring and Hope (Teen REACH)

PART I: GENERAL REQUIREMENTS A. Date of Issuance

December 8, 2008 B. Issuing Organizational Unit

Illinois Department of Human Services Division of Community Health and Prevention Bureau of Youth Services and Delinquency Prevention 535 W. Jefferson Street, 3rd Floor Springfield, IL 62702-5058

Contact Person Dave Robisch 535 W. Jefferson Street, 3rd Floor Springfield, IL 62702-5058 217/524-1893 Submit questions relating to this RFP via e-mail to dhs.youthservicesinfo@illinois.gov . Indicate “TR RFP – Dave” in the subject line of the e-mail. Answers will be returned via e-mail.

C. RFP Availability

Copies of this Request for Proposals (RFP) may be downloaded from the Illinois Department of Human Services (DHS or the Department) web site: http://www.dhs.state.il.us/page.aspx?item=39157

Each applicant must have access to the internet. The Department’s web site will contain information regarding the RFP. It is the responsibility of each applicant to monitor that web site and comply with any instructions or requirements relating to the RFP.

D. Date, Location and Time of RFP Opening

Applications must be received no later than 2:00 p.m. on Friday, January 23, 2009. The proposal container will be time-stamped and opened upon receipt. The Department will not accept applications submitted by email, or by fax.

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Mail the completed grant application to:

Illinois Department of Human Services Bureau of Youth Services and Delinquency Prevention 535 W. Jefferson Street, 3rd Floor Springfield, IL 62702-5058 ATTN: Dave Robisch On Friday, January 23, only, applications may be dropped off in person by 2:00 p.m. at the address given above. Important notices: 1. To be considered, proposals must be in the possession of the Illinois Department

of Human Services staff at the specified location and by the designated date and time listed above. The deadline will be strictly enforced without exception. In the event of a dispute, the applicant bears the burden of proof that the application was received on time at the location listed above.

2. Proposals that are e-mailed, faxed, handwritten, and/or late will not be

accepted and will be immediately disqualified. E. Proposal Container and Format Requirements

All applications must be typed on 8 ½ x 11-inch paper using 12-point type and at 100% magnification. With the exception of letterhead and stationery for letter(s) of support, the entire proposal should be typed in black ink on white paper. The application must be typed single-spaced, on one side of the page, with 1-inch margins on all sides. The proposal narrative must not exceed the page totals specified in Part III, including the Executive Summary. The Attachments, Cover Page, Checklist, letters of support, and Spending Plan forms are NOT included in the page limitation.

The entire application, include appendices, must be sequentially page numbered. Proposals should be bound with a single binder clip in the upper left-hand corner. Applicants must not use any other form of binding, including staples, ring binders, spiral binders, report covers or rubber bands, as well as subject dividers or tabs that extend beyond the 8 ½ x 11-inch page.

Applicants must submit one unbound, clearly identified originally signed proposal and five (5) complete copies of the proposal. Faxed copies will not be accepted. The Department is under no obligation to review applications that do not comply with the above requirements.

F. Eligible Applicants

All public, private, or not-for-profit community-based agencies are eligible to apply for funds under this Request for Proposal. The funding opportunity is not limited to those

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who currently receive funding from the Illinois Department of Human Services, Division of Community Health and Prevention.

Each applicant must have access to the Internet. The Department=s website will contain information regarding the RFP. It is the responsibility of each applicant to monitor that website and comply with any instructions or requirements relating to the RFP.

Agencies awarded funds through this grant must have or obtain a computer that meets the following minimum specifications for the purpose of utilizing the DHS eCornerstone system and receiving electronic program and fiscal information:

Windows XP Pentium 233 megahertz (MHZ) processor or faster (300 MHZ is

recommended) At least 64 megabytes (MB) of RAM (128 MB is recommended) At least 1.5 gigabytes (GB) of available space on the hard disk

These are requirements that are not related to the operating system:

Internet Explorer 6 Internet access, preferably high-speed Email capability

G. Grants Information Conference (GIC)

Three (3) Grants Information Conferences (formerly Bidders Conferences) will be held. Attendance at the Grants Information Conference is OPTIONAL. Conference information is located on the DHS website at http://www.dhs.state.il.us/page.aspx?item=39157 Due to the complexity and innovative nature of this initiative, it is recommended that interested applicants attend a GIC; however, attendance is optional.

H. Questions and Answers Submit questions relating to this RFP via e-mail to dhs.youthservicesinfo@illinois.gov . Indicate “TR RFP – Dave” in the subject line of the e-mail. Answers will be returned via e-mail. Frequently Asked Questions, with answers, will be posted on the DHS web site, located at http://www.dhs.state.il.us/page.aspx?item=39157 The site will be updated periodically.

I. Award Process

The Department anticipates the availability of approximately $17 million for Teen REACH services in FY10. The minimum award amount will be $48,000. The maximum award amount will be $350,000. The Department expects that very few awards will be made at these levels. The average grant award amount is anticipated to be $150,000.

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Of the approximately $17 million, $4.5 million will be granted to one entity for administration of a statewide network of Teen REACH programs, with programs in every area of the state. Agencies applying for funding as a statewide network: must clearly state this intention in their Executive Summary and throughout their

proposal, including the spending plan; must have an existing infrastructure/network of affiliates located throughout the state; must provide programming as described throughout this RFP at each identified

affiliate site; and affiliates included in the statewide application may not also apply for funding as an

individual agency under this RFP. It is expected that the rate per Youth Attendance Hour will be considerably less than $4.50 for this provider as they will be implementing through an established network.

It is anticipated that applicants will receive notification by the Department regarding funding decisions in April 2009. Successful applicants will receive a Notice of Grant Award in writing by letter from the Secretary of the Illinois Department of Human Services. A Notice of Grant Award is not equivalent to an agreement with the Department to commence providing service. In May, 2009, successful applicants should receive the FY10 DHS Community Service Agreement. This agreement will need to be signed and returned per instructions provided at the time. The release of this RFP does not obligate the Department to make an award.

J. Estimated Length of Agreement

The Department estimates that the term of the agreement resulting from this RFP will be one year, beginning July 1, 2009, and continuing through June 30, 2010. With the mutual consent of both parties, and dependent upon the provider’s performance and adherence to program requirements, and dependent upon the availability of funds to the Department, the agreement may be renewed for two additional one-year periods.

K. Withdrawal Disclaimer

The Illinois Department of Human Services may withdraw this Request for Proposals at any time prior to the actual time a fully executed agreement is filed with the State of Illinois Comptroller’s Office.

L. Modifications to Proposals by Applicants

To make a modification to a proposal after it has been submitted, the applicant must submit a complete replacement proposal package, as described above under “Proposal Container and Format Requirements”, accompanied by a letter requesting the replacement modification RFP be considered. This must be received at the prescribed location by the date and time designated under Section D (“Date, Location and Time of RFP Opening”), above.

M. Modifications to Proposals by DHS

If it becomes necessary or appropriate for DHS to change any part of the RFP, a modification to the RFP will be available from the Illinois Department of Human Services (DHS) web site: http://www.dhs.state.il.us/page.aspx?item=39157 and it will be

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issued to all known recipients of the RFP. “All known recipients” refers to those who received the original Notice of Available Funds from the Department. Upon receipt of the modification notice, prospective respondents are requested to send written acknowledgment to the Department’s contact person, listed above in “Issuing Organizational Unit Contact Person.” It will be the applicants’ responsibility to check the DHS website occasionally for modifications to this RFP.

N. Clarifications, Negotiations, or Discussions Initiated by DHS

The Department may contact any applicant prior to the final award for the following purposes: As part of the Department’s review process, the Department may request that an

applicant clarify its bid or proposal. An applicant may not be allowed to materially change its bid or proposal in response to a request for clarification.

Discussions may be held to promote understanding of the Department’s requirements and the applicant’s proposal, and to facilitate arriving at a contract that will be most advantageous to the State, considering price and the other evaluation factors set forth in the RFP.

When the Department knows or has reason to conclude that a mistake has been made, the Department shall request that the applicant confirm the information. Situations in which confirmation should be requested include obvious or apparent errors on the face of the document, or a price unreasonably lower than the price others have submitted, or a price considerably higher than what the Department currently pays for the same services. If the applicant alleges a mistake, the bid or proposal may be corrected or withdrawn following the conditions set forth by the State of Illinois Procurement Code.

O. Late Proposals/Responses

Late proposals will not be considered, but will be retained by the Department. The Department will notify all Applicants whose proposals are not considered because of lateness or non-compliance with proposal requirements.

P. Objections

Applicants who object to any provision of the RFP, who believe their proposal was improperly rejected, or who believe that the selected proposal(s) is/are not in the best interest of the Department, may submit a written protest regarding the Department’s action. The Department will consider all such written protests that are submitted according to the time periods specified below. The Department will investigate all allegations and issue a written response. The decision of the Department is final. Protests must be in writing and will be considered filed when physically received by the State Purchasing Officer at the following address: Illinois Department of Human Services James R. Thompson Center 100 W. Randolph Suite 5-600 Chicago, Illinois 60601 ATTN: Curtis Thompson

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Protests must be filed within seven (7) calendar days after the Protestor knows or should have known of the facts giving rise to the protest. Protests regarding specifications must be filed within seven (7) calendar days after the date the RFP was issued and, in any event, must be filed before the date for opening the proposals. If a protest is received, any award made will not be considered final until the protest is resolved.

Q. Commencement of Service

The Department is not obligated to reimburse applicants for expenses incurred prior to the complete and final execution of the written agreement. If the applicant receives a Notice of Award letter from the Secretary, then it is reasonable to assume that the Department will forward the applicant a contract. No services can be reimbursed prior to the full and complete execution of the contract and filing with the Illinois Office of the Comptroller.

R. Public Information

All information submitted pursuant to this RFP is subject to the Illinois Freedom of Information Act. The successful applicant must recognize and accept that any material marked proprietary or confidential that must be made a part of the contract may be considered open for public inspection. Price information submitted by the successful applicant shall be considered public. Only the record of proposals that are not selected for funding (i.e., a list of those agencies that submitted unsuccessful applications) shall be considered public information, not the applications themselves.

S. Review Panel Proposals will be reviewed by a panel established by staff from DHS, which may include Department staff familiar with the requirements of the program, academics and experts in the field, and/or representatives of community-based social service providers who are not party to applications for funding under this announcement. Panel members will initially read and evaluate applications independently using guidelines furnished by DHS and will subsequently participate in review panel meetings during which proposals will be reviewed and scored collectively. Scoring will be on a 100 point scale. Scoring will not be the sole award criterion. While recommendations of the review panel will be a key factor in the funding decisions, the Department maintains final authority over funding decisions and considers the findings of the review panel to be non-binding recommendations. Any internal documentation used in scoring or awarding of grants shall not be considered public information.

T. Contract

The legal agreement between DHS and the successful applicants will be in the form and format prescribed by DHS. The standard DHS Community Service Agreement will be used when contracting for services. This agreement consists of the Boilerplate which can be found at: http://www.dhs.state.il.us/page.aspx?item=36026 and the Attachment which

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can be found at http://www.dhs.state.il.us/page.aspx?item=34247 If selected for funding, the applicant will be provided a DHS Community Service Agreement for their signature and return.

U. Congressional and Legislative Districts

The applicant must provide their Congressional District (by number), available at the following website: http://www.govtrack.us/congress/findyourreps.xpd?state=IL, as well as the Illinois House and Senate Legislative Districts (by number), available on the Illinois General Assembly website at: Illinois General Assembly website at: http://www.elections.illinois.gov/DistrictLocator/SelectSearchType.aspx?NavLink=1

V. Payment Method Payments to successful programs shall be made on a prospective basis. Expenditures must be consistent with the agency’s approved spending plan on file with the Department. Actual expenditures incurred for the purchase of allowable goods and services necessary for conducting program activities shall be documented, utilizing the Department’s Summary Expenditure Documentation Report Form for reconciliation against the approved budget and total award amount. Unexpended funds will be returned to the Department, per the Grant Funds Recovery process.

W. Funding Formula – The Maximum Grant Amount will be based on the total number of

projected Youth Attendance Hours (YAH) funded at a rate of $4.50.

R x YAH = $

(Where R= Rate, YAH = Projected Youth Attendance Hours and $ = Maximum Grant Amount)

Rate - A rate of $4.50 per youth per hour will be used by the Department as the basis for funding. Youth Attendance Hour - YAH is defined as an hour of programming for which a participant is recorded as being present. Therefore, a projected YAH is an hour in which the agency projects that a youth will participate in the program. To calculate projected Youth Attendance Hours please refer to Part II Section H, “Funding Formula”. Maximum Grant Amount – The total amount of grant funding that may be requested.

Exception: The only exception to the above funding formula will be the award of $4.5 million to a single entity for administration of a statewide network of programs. It is expected that the rate will be considerably less for this provider as they will be implementing through an established network.

X. Performance Based Funding

In order to assure accountability at all levels of service provision, the Illinois Department of Human Services is implementing the practice of performance-based contracting with

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its Teen REACH grantee agencies. Successful applicants will be monitored for achievement of the number of Days Open and their projected Youth Attendance Hours. This information will be tracked via the Department’s e-Cornerstone system and monitored at least quarterly. Performance Based Funding (PBF) criteria: Days Open – 240 days per year. Acceptable performance is 90%. Youth Attendance Hours (YAH) – 100% of YAH as projected in the Youth

Attendance Plan. Acceptable performance is 80%. The Department will consider a program to be open any day that attendance for a youth is recorded in e-Cornerstone. The Department will measure the achievement of a YAH by the number of minutes of attendance recorded for a youth in the e-Cornerstone system. Decisions to increase or decrease funding will be made each year at the end of the fourth quarter and will be based on the grantee’s performance for that previous 12-month period. The Department will compare the 12 months of e-Cornerstone data to the provider’s projected 12-month Youth Attendance Plan. A determination will be made as to compliance for that 12-month period. For New providers (providers not currently receiving Teen REACH funding), decisions to increase or decrease funding will consider the greater of the 12-month period or the final three quarters of the fiscal year (October 1 through June 30). In other words, if the level of performance is better in the final three quarters, this is the period in which performance will be measured. This will accommodate for potentially lesser performance during the start-up period. This accommodation will only be made for the first year of programming. If the provider meets the PBF criteria above, no increase or decrease will occur in funding. If the provider’s performance exceeds that of the PBF criteria the provider will have the potential for a funding increase. However, if the provider’s performance falls below that of the PBF criteria the provider will receive a cut in funding equal to the percentage by which the provider failed to meet the PBF criteria. Example - According to the provider’s 12-month plan, the provider proposed to be open 240 days and projected a total number of Youth Attendance Hours of 28,000. e-Cornerstone data indicate that the provider was open 220 days and delivered 19,600 Youth Attendance Hours. The acceptable performance range for Days Open is 10% and the acceptable performance range for Youth Attendance Hours is 20%. Therefore in this example, the provider met the range for Days Open and failed to meet the range for Youth Attendance Hours by 10% (30% less than what was projected). This provider would therefore receive a 10% reduction in funding for the following year. If the provider falls below the acceptable range in both categories, the grant will be reduced by the greater percentage; the two will not be added together to determine the level of reduction.

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In this example, the provider’s funding would be adjusted for the subsequent year of programming, not the 12-month period in which performance was assessed. However, in order for the Department to be able to assess a full 12 months of data, any adjustment in funding would occur approximately three months into the next state fiscal year and after contracts have been issued. Therefore, any provider receiving a decrease or an increase in funding will have their contract amended accordingly on or about September of the subsequent year. If a provider’s grant amount is adjusted based on PBF criteria, the Department will also adjust the provider’s projected Youth Attendance Hours proportionately. At no time will a provider be allowed to project a program that is open fewer than 240 days and 720 hours. The Department reserves the right to adjust funding any time a grantee fails to meet the PBF criteria. The Department has also established Performance Measurement Standards that address both quantity and quality of program services. Failure to consistently meet and/or demonstrate improvement in these measures may result in the Department taking corrective action up to and including termination of the contract.

Y. Program Evaluation and Reporting Requirements

Successful applicants will be required to participate in evaluation efforts as directed by the Department and/or its subcontractor(s) and collect and report data accordingly. All Providers are required to utilize the Department’s e-Cornerstone web-based reporting system. Providers will be required to participate in a Department directed Standards Assessment review. Providers will also participate as necessary in performance measure reviews with the Department. An annual program plan will be required once per year that includes data, program and outcomes information as well as the annual Youth Attendance Plan and activity calendar in the format provided by the Department. Additional data and information may be requested throughout the year as determined by the Department.

Z. Deliverables Successful applicants will be required to provide the following information to the Department as grantees:

Data via the eCornerstone system Expenditure Documentation Forms (EDFs), in a format provided by the

Department Annual end of year summary report in a format provided by the Department Annual program plan in a format provided by the Department Annual spending plan in a format provided by the Department

AA. Training and Technical Assistance

Programs must agree to receive consultation and technical assistance from authorized representatives of the Department. The program and collaborating partners will be required to be in attendance at site visits. Programs will be required to attend regular

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meetings and training as provided by the Department or a subcontractor of the Department, and should budget accordingly.

BB. Additional Information

The Department reserves the right to request additional information that could assist with its award decision. Applicants are expected to provide the additional information within a reasonable period of time. Failure to provide the information could result in the rejection of the proposal.

CC. Background Checks

Background checks are required for all program staff and volunteers who have one-on-one contact with children and youth. Funded programs are required to have a written protocol on file requiring background checks, as well as evidence of their completion.

DD. Child Abuse/Neglect Reporting Mandate

Per the Child Abuse and Neglect Reporting Act, adults working with children and youth under the age of 18 years old are mandated reporters for suspected child abuse and neglect. All programs funded through this grant opportunity must have a written protocol for identifying and reporting suspected incidents of child abuse or neglect.

EE. Hiring and Employment Policy

It is the policy of the Department to encourage cultural diversity in the work environment and to promote employment opportunities through its programs. The Department’s philosophy is that the program workforce should appropriately reflect the populations to be served, with special attention given to hiring individuals indigenous to those communities. Consistent with Department policy, whenever a position becomes available, funded programs are encouraged to consider Temporary Assistance for Needy Families (TANF) clients for employment, contingent upon their qualifications in the areas of education and work experience.

FF. Sectarian Issues Applicant organizations may not expend federal or state funds for sectarian instruction, worship, prayer or to proselytize. If the applicant organization is a faith-based or a religious organization that offers such activities, these activities shall be voluntary for the individuals receiving services and offered separately from the program.

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Request for Proposal Teen Responsibility, Education, Achievement,

Caring and Hope (Teen REACH)

PART II: PROJECT DESCRIPTION

A. Department’s Need for the Services Illinois’ youth and families face a staggering array of economic demands and social challenges that often make it difficult for young people to reach their full potential. In recent years, there have been dramatic changes in the family structure, increased numbers of parents working outside the home, increased pressure to address gaps in academic achievement from one community or school to another, and high rates of crime and violence in many of our communities. Out-of-school-time programming has been identified as a key strategy for addressing these challenges and helping our young people to build upon their assets and become productive members of society.

The critical need for out-of-school-time programming has emerged in large part because of the unprecedented numbers of parents who are working outside the home. In 82% of households headed by single mothers with children ages 6 to 17, the mother is employed outside of the home. In 64% of all two-parent households with children in this age group, both parents work outside the home.1 With so many parents working away from home, many young people lack adult supervision during the late afternoon and early evening hours on school days – hours during which, research has shown, most risk-taking behavior by youth takes place. High-risk behavior includes, at the least, unhealthy nutritional habits (nearly 80% State YRBS) and lack of physical activity (nearly 80% Chicago YRBS), and at worst, drug and alcohol abuse (40% Downstate YRBS), sexual behavior (57% Chicago YRBS), and/or criminal activity. 2 These behaviors are a particular concern for youth between the ages of 11 to 17.

At the same time, many youth live in communities with high rates of crime and violence both in and outside of the home. In 2002, more than 877,700 youth ages 10 to 24 in the U.S. were injured through violence.3 Additionally in 2005, this age group represented 3,212 or 54% of violence-related admissions to the Illinois Trauma Registry.4 In the U.S., 25 percent of 8th and 9th grade students have been victims of non-sexual dating violence; 8 percent have been victims of sexual dating violence.5 The Illinois Violent Death Reporting System, a comprehensive system in the three counties of Cook, Kane and

1Percentage calculation prepared by the Bureau of Performance Support Services, DCHP, IDHS, October 2008. Data Source: B23008. Age Of Own Children Under 18 Years In Families And Subfamilies By Living Arrangements By Employment Status Of Parents - Universe: Own Children Under 18 Years In Families And Subfamilies. Data Set: 2007 American Community Survey 1-Year Estimates 2 2007 Youth Risk Behavior Survey, weighted results of Illinois Downstate Survey and Chicago Survey 3 The 2004 CDC publication of “Protecting Health for Life” contains last reported statistics (October 2008) 4Illinois Department of Public Health EMS Reporting System - Query Results of Firearm (All Intents) , Intentional Injury/Self-Inflicted, Intentional Injury/Inflicted by Others, Sum of 4 quarters in 2005 5Citation: Foshee, VA; Linder, GF; Bauman, KE; Langwick, SA; Arriaga, XB; Heath, JL; McMahon, PM; Bangdiwala, S. 1996. “The Safe Dates”. Project: Theoretical Basis, Evaluation Design, and Selected Baseline Findings.” American Journal of Preventive Medicine. 12(5 Suppl):39-47. Cited in “The Facts on Teenagers and Intimate Partner Violence”, Family Violence Prevention Fund

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Peoria, centralizes full reporting of data on suicide and homicide deaths. The homicide rate in 2004 for all ages in the U.S. was 5.9; in Illinois it was 6.8; and in 2005 it was 10.3 in the three counties as reported by IVRS.6 According to the Illinois Department of Public Health,6 10 percent of all births in Illinois were to teenage mothers, of whom 98 percent were between the ages of 15 and 19 in 2006. Statistics like these underscore the need for increased positive alternatives and programs for youth.

A growing body of literature suggests that out-of-school-time programs are effective in addressing many of these challenges and provide youth with enrichment opportunities to build positive life skills. Research has shown that out-of-school-time programs can make a difference in areas such as academic achievement, social-emotional development, and the avoidance of delinquent or high-risk behavior. Parents support these programs in part because the programs are addressing their most basic need - that is, the need for safe environments for their children and youth during the otherwise unsupervised after-school hours.

B. Intent of the RFP

The Department is seeking proposals from community-based public, private, or not-for-profit agencies to provide Teen REACH services to at-risk youth. In particular, the intent of this funding is to serve:

1. Older Youth - Current research indicates that older youth are more likely than younger ones to

spend out-of-school time unsupervised, and that there is a greater need for out-of-school time programming for older youth. The Department wishes to emphasize Teen REACH’s originally intended focus of serving this older population. In order to meet the needs of this group, the Department will ensure that all funded applicants have demonstrated the ability and intent to serve youth ages 11 to 17. Agencies serving both younger and older age groups must provide no more than 15% of their services to children ages 6 to 10 (i.e., at least 85% of their services to youth ages 11 to 17). For agencies operating the program at multiple sites, these percentages apply to the total population served by the agency, across all sites, not the number at any individual program site.

2. High-Need Communities - Applicants must demonstrate the ability and intent to target services

to at-risk youth residing in high-risk communities, as identified through a community needs assessment. (Refer to Part II Section E5, “Assessment of Community Need”, below). Resources will be allocated to applicants that have very clearly demonstrated that the funds will be most effectively and efficiently used and will have the greatest impact on at-risk youth living within the community.

3. Youth Employment – Youth who are engaged in honest employment activities in which their

hard work is financially compensated learn the value of such activity. Paid employment opportunities that are effectively supported by positive adult role models and grounded in learning opportunities that can be offered through out-of-school time programs such as Teen REACH have the ability to demonstrate the value of an honest day’s work. The Department wishes to emphasize paid youth employment opportunities through this competitive RFP cycle.

6Table.1: [All Ages 2005] Homicide and suicide rates for the US, Illinois and the three counties participating in IVDRS Illinois Violent Death Reporting System, Vol.1, Issue1, August 2007

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In order to meet this need, the Department will ensure that all funded applicants have demonstrated the ability and intent to provide youth 16 and older with paid employment opportunities. These opportunities may include opportunities to work in the Teen REACH program itself or may include employment opportunities elsewhere in the community. This employment must be supplemented by participation in the Teen REACH program. It is not a requirement that every youth 16 and older be engaged in paid employment. However, it will be a requirement that a minimum of 5% of the Teen REACH grant award be expended on paid youth employment. This amount may not exceed 15% of the Teen REACH grant award.

C. RFP Funding Priorities

Past Performance – Up to 5 additional points will be available under this priority area. The Department intends to fund quality out-of-school time programs. This will be assessed as part of the application scoring process. In addition, for applicants that have been funded to provide Teen REACH programming within the last four (4) fiscal years will have their past performance reviewed by the Department. Priority will be given to those providers that have demonstrated both the ability to provide quality Teen REACH programming and services and the ability to meet or exceed the Department’s expectations as identified in their most recent 12-month period of program implementation. The Department will use the results of the most recent Standards Assessment Review. In the event that no Standards Assessment Review is available, the most recent 12-month Performance Measures Review will be used. Further, the Department intends to give funding priority (up to 3 additional points) to quality applications that demonstrate the ability and intent to work with one of the following three Department initiatives: 1. Safety Net Works – The Department intends to fund at least one qualified applicant to work with

each Safety Net Works Coalition. Applicants are required to submit letters of collaboration with the Safety Net Works Coalition in the area to be served and be willing to become part of the Coalition in order to be considered for priority points in this category.

The Safety Net Works communities are as follows:

Counties/Communities Cook - Cicero Cook - Maywood Macon - Decatur

St. Clair - East St. Louis Winnebago - Rockford

Chicago Community Areas/Neighborhoods

Auburn Gresham Austin Brighton Park East Garfield Park Englewood Gage Park/Chicago Lawn

Grand Boulevard Humboldt Park Little Village North Lawndale Roseland South Shore

For more information about the Safety Net Works initiative please visit the DHS web site at:

http://www.dhs.state.il.us/page.aspx?item=35165

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2. Team Illinois – The Department intends to fund at least one qualified applicant to work in collaboration with the Team Illinois Steering Committee. Applicants are required to submit letters of collaboration with the Team Illinois Steering Committee in the area to be served and be willing to become part of the Steering Committee in order to be considered for priority points

in this category. The Team Illinois communities are as follows:

Counties/Communities Alexander-Cairo Carroll – Savana Cook – Englewood Community

Kane – East Aurora Kankakee – Pembroke Madison – Venice

The ideas behind TEAM Illinois center around the provision of opportunity for the state’s neediest citizens and present evidence of what can be accomplished when good government and innovative leadership partner with community stakeholders in the service of prosperity and self-sufficiency. The goal is to demonstrate that challenged communities can be turned around with concentrated attention of the State’s resources, an engaged and hopeful community, private sector partners, and citizens of this great State organized under the banner of TEAM Illinois. Objectives of TEAM Illinois include:

Restoring Pride and Dignity Developing and Implement Blueprint for Prosperity Demonstrating Citizenship in Action Moving from Dependency to Self-sufficiency Building Capacity Creating Sustainability Networks Changing Expectations - “Nobody Rises to Low Expectations”

3. GEAR UP – It is the intent of the Department to ensure that GEAR UP participants have access

to the full range of quality Teen REACH services. To that end, the Department intends to award additional points in the review process to currently funded GEAR UP providers applying for Teen REACH funds. To be considered for priority points under this category, the applicant must clearly indicate their current status as a DHS funded GEAR UP provider.

For more information about GEAR UP please visit the DHS web site at: http://www.dhs.state.il.us/page.aspx?item=37261

D. Goals to be Achieved

The goal of the Teen REACH program is to expand the range of choices and opportunities that enable, empower and encourage youth to achieve positive growth and development, improve expectations and capacities for future success, and avoid and/or reduce risk-taking behavior. Specifically, this means providing youth with safe environments and caring adults, and guiding them toward marketable skills and opportunities to serve their communities.

The program provides the following prevention-focused core services; additional services appropriate to the youth and/or his community may also be provided:

Improving academic performance Life skills education Parental involvement Recreation, sports, and cultural and artistic activities

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Positive adult mentors Service learning

E. Services to be Performed (Description of Program) - Following is information about important

aspects of the Teen REACH program, with which applicants will be expected to comply:

1. CORE SERVICES - Teen REACH programs must include activities in each of six core service areas. Each youth must participate in activities in all six core service areas. These core services, the outcomes they are designed to achieve, and the developmental assets that are associated with them are as follows: a) Improving Academic Performance -- This includes time to do homework, tutoring in

basic skills, and enrichment programs that encourage creativity. Outcomes

Participant will maintain or improve school attendance. Participant will maintain or improve grades or progress reporting in school. Participants will develop or improve career aspirations and choices.

Developmental assets Participants are actively engaged in learning. Participants are motivated and strive to do well in school Participants are optimistic about a personal future and career

b) Life Skills Education -- This encompasses training and education that promotes the

development of healthy lifestyles, and encourages abstinence from risk-taking behaviors in the areas of alcohol and/or substance use, criminal activity, violence and sexual activity.

Outcomes Participants will increase knowledge of harmful effects of substance use and

abuse. Participants will increase knowledge of harmful effects of early sexual activity

and pregnancy. Participants will increase anger management and conflict resolution skills. Participants will increase decision making and problem solving skills. Participants will increase healthy nutritional choices

Developmental assets Participants believe it is important not to use alcohol and other drugs. Participants believe it is important not to be sexually active. Participants seek to resolve conflict nonviolently. Participants know how to plan ahead and make choices

c) Parental Involvement - Programs must provide opportunities for parents and/or

guardians to meet with staff to discuss their children’s activities, and to participate in events that strengthen parent/child bonds and community involvement.

Outcomes Increase in parental monitoring of academic performance. Increase in understanding of child and adolescent developmental stages and

appropriate expectations. Increase in positive and effective communication with children and teens

regarding alcohol, tobacco and other drug use, sexual activity, abstinence and other life skills.

Increase structured activities that promote positive family interaction

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Developmental assets Parents are actively involved in helping the child succeed in school. Parents understand child and adolescent developmental stages and have

appropriate expectations. Families have clear and consistent rules and consequences. Parents and children communicate positively regarding alcohol, tobacco and

other drug use, sexual activity, abstinence and other life skills. Parents foster resilience. Parents plan and spend time in structured activities that promote positive

family interaction

d) Recreation, Sports, and Cultural/Artistic Activities - This includes providing activities and arranging safe outlets for youth to try new skills and develop new interests, to build friendships, find their place in a group, and gain developmentally relevant experiences.

Outcomes Provide opportunities for participants to engage in cultural enrichment and

fine art activities. Provide opportunities for participants to demonstrate sportsmanship and

athletic skills. Provide opportunities for participants to increase their level of activity.

Developmental assets Participants demonstrate sportsmanship. Participants believe it is important to follow rules Participants respect the ability and contribution of others Participants engage in activities that foster creativity and spirituality. Participants demonstrate positive relationships with peers.

e) Positive Adult Mentors - Programs must allow opportunities for youth to develop and

maintain positive, sustained relationships with caring adults through mentoring and other programs that emphasize one-on-one interactions.

Outcomes Increase support to youth during times of personal or social stress. Increase support for decision making. Increase access to support with academic tasks and/or homework. Increase opportunities for career awareness and mentoring.

Developmental assets Participants have a connection with a caring adult. Participants believe they can be successful. Participants believe they can make good decisions. Participants believe they have a future.

f) Service Learning Activities – Service-learning is a method of teaching and learning that

connects classroom lessons with meaningful service to the community. Students build academic skills while strengthening communities through service. Service learning combines service tasks with structured, youth-driven opportunities that link the task to self-reflection, self-discovery, and the acquisition and comprehension of values, skills and knowledge content with service tasks.

Outcomes Youth determine and meet real, defined community needs.

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Youth learn beyond the classroom through active participation in service experiences.

Youth develop and use skills and knowledge in real-life situations. Youth increase the amount of time spent to reflect by thinking, discussing

and/or writing about service experiences. Youth experience a sense of belonging to a community and an awareness of

their responsibility to that community. Developmental assets Youth experience opportunities for experiential learning. Youth are empowered to assume leadership roles. Youth are involved in the decision making process. Youth place a high value in helping others. Youth develop empathy for others. Youth believes that his/her life has a purpose Youth engage in productive activities that build job and life skills and

reinforce community-mindedness.

Providers will evaluate these objectives and developmental assets through self-developed annual surveys administered to youth and their parents. The provider will report the results to the Department annually. (Please refer to Part II Section E12, “Program Evaluation by Local Agency”, below.)

2. TARGET POPULATION - Teen REACH program services are provided for at-risk children and

youth ages 6 to 17, or any subset within that age range. Accepted age group subsets are 6-10, 11-13, and 14-17. Because the Department only intends to fund applications targeting services to youth ages 11-17, agencies serving both younger and older age groups must provide no more than 15% of their services to children ages 6 to 10 (i.e., at least 85% of their services to youth ages 11 to 17). For agencies operating the program at multiple sites, these percentages apply to the total population served by the agency, across all sites, not the number at any individual program site. The individual and/or family risk factors of youth targeted by the Teen REACH program include but are not limited to the following:

Youth living in a single-parent household Youth residing in a household receiving TANF funds Youth experiencing academic difficulties Youth has witnessed or been a victim of family violence Youth with siblings who dropped out of school Youth with siblings who are teen parents Youth with siblings who are involved in the juvenile justice system Youth with one or both parents who are incarcerated Youth in the DCFS system

3. DAYS AND HOURS OF OPERATION - Programs must be operational for 12 consecutive

months (minimum 240 days) and provide, on average, 3 hours of programming each day open (minimum 720 hours). This will be demonstrated in the agency’s Youth Attendance Plan submitted as Attachment C2. A day/hour open is determined by recording attendance (other than employment) in the e-Cornerstone system.

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Please note that agencies may use ten (10) of the 240 days of program operation for staff training, however, the minimum hours of programming may not be less than 720 hours.

Programs must operate during out-of-school hours, based on the needs of the community. Programs are encouraged to operate the program during the critically important late-afternoon/early evening hours, from 3:00 p.m. to 6:00 p.m. Programs may operate later in the evening if a need is determined based on the community assessment. Programs may operate before school and/or after school. Agencies are encouraged to offer programming on Saturdays and Sundays, and during school breaks. Programs are required to maintain the level of service identified in their Youth Attendance Plan or risk non-compliance with the program contract, which may result in a reduction or loss of grant funds. Level of service will be monitored by the Department utilizing the e-Cornerstone system. Please refer to Part I Section X, “Performance Based Funding,” for more information regarding Performance Based Funding.

4. ENROLLMENT AND ATTENDANCE - Each Teen REACH participant must be enrolled in the program via the eCornerstone system. Drop-in services will not be supported with Teen REACH grant funds. Required program data will be collected and maintained on all youth enrolled in the program in accordance with Department guidelines. Programs are required to maintain attendance at the level for which funding is requested, projected in the Youth Attendance Plan, or risk non-compliance with the program contract, which may result in a reduction or loss of grant funds. Attendance will be monitored by the Department utilizing the e-Cornerstone system. Please refer to Part I Section X, “Performance Based Funding”, for more information regarding Performance Based Funding.

5. ASSESSMENT OF COMMUNITY NEED - Teen REACH programming must be designed to

meet the specific needs of the community in which it is located. Each applicant must conduct a community needs assessment prior to developing their proposal. This will include local youth, family, school and community surveys and focus groups in addition to reviewing all relevant available data and recently completed community assessments. These will be analyzed to determine the level of need in the community and to provide a foundation for developing carefully planned and thoughtful service provision. The results of the assessment will be presented and supported in the application. A thorough description of youth, family and community risk-factors that demonstrate that programming is intended to target services to at-risk youth residing in high-risk communities. There should also be a direct correlation of needs with the activities planned and described in the program description section of the application and in the activities indicated in the completed Activity Calendar(s).

6. COMMUNITY-CENTERED PROGRAMMING - Programming should be comprehensive and

holistic in its approach, offering a range of services designed to have a positive impact on youth participants’ social, creative, physical and cognitive development. Programs must be designed around the six core services described in Part II Section E1 “Core Services”, above.

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Agencies are encouraged to utilize established, evidence-based programming models that have a high potential to be effective with at-risk youth in at-risk community settings. Best practice or promising practice programming models should be utilized, if these models meet community needs and can be implemented. Best practice models are those known to be research-based and proven to be effective at preventing and/or delaying risk-taking behaviors. Promising practices are those for which some data has shown positive effects on delaying risk-taking behaviors, but the data are insufficient to support generalized outcomes. (Please see Appendix 1 for a list of best and promising practices relevant to out-of-school time programs.)

In addition to considering community need in the selection of program model, agencies must also demonstrate their experience in implementing the type of programming they have chosen and discuss their capacity to do so.

The Department recognizes that communities have a unique perspective on what works and what is needed in their own community. Therefore, applicants may adapt best or promising practice models as necessary to meet the unique needs of the community. However, it should be noted that any modifications to established program models might reduce the likelihood of achieving the predicted outcomes. Applicants may also propose programming not included in Appendix 1, if it can be clearly demonstrated that the proposed activities are consistent with commonly accepted guidelines for effectiveness and that those activities are aligned with the specific needs of the community.

7. ACTIVITY CALENDAR - Teen REACH activities must be age-appropriate, conducted in an organized manner, and carried out on a regular, periodic basis. Activities chosen should also be supported by youth, family and/or community needs. A sample Activity Calendar is included as Appendix 2 of this RFP, and must be completed for each site and submitted as Attachment C1 of your application. The completed Activity Calendar(s) will demonstrate that planned program activities will address all six core services and will be carried out on a regular basis. Please note that if a site is planned to have a varied scheduled, please complete additional activity calendars to demonstrate that planned variance. Example: School-Year schedule vs. a Summer schedule.

8. TIME LINE - Applicants must include a proposed time line for implementation of the Teen

REACH program, including any time required for start-up activities, and significant milestone activities and events throughout the year. Applications that indicate a readiness to begin program operations by July 1, 2009 will score higher on this element of their proposal.

9. COMMUNITY ADVISORY COUNCIL - Programs must form and utilize a Community Advisory Council or board in conducting Teen REACH activities in order to integrate active partners who can devote time and resources to the program. Existing councils may be utilized if they properly represent the positive youth development concept of Teen REACH. The Community Advisory Council must include at least two youth who are current or former Teen REACH participants. The Advisory Council must meet, at a minimum, on a quarterly basis. Minutes, agendas and attendance lists must be maintained on file to evidence this activity. The Community Advisory Council membership list (including anticipated members as appropriate) must be included as Attachment A5 of your proposal.

10. TRAINING AND TECHNICAL ASSISTANCE - Programs must agree to receive consultation

and technical assistance from authorized representatives of the Department. The program and collaborating partners will be required to be in attendance at site visits by Department staff.

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Programs will be required to attend regular meetings and specific trainings as required by the Department and should budget accordingly. It is anticipated that this will include three regional meetings, approximately two regional trainings, and one (overnight) statewide conference.

11. PERFORMANCE MEASURES - Each Teen REACH program’s performance on the measures

listed below will be assessed using data gathered from the e-Cornerstone system, the projected information provided by the agency in their proposal, their Youth Attendance Plan, and the total Teen REACH grant amount. These measures have been selected to reinforce the quality findings from various out-of-school time at-risk youth programming research and evaluations. a) Days Open – 240 days open per year. Acceptable performance is 90%. b) Youth Attendance Hours – 100% of Youth Attendance Hours as projected in the Youth

Attendance Plan will be achieved. Acceptable performance is 80%. c) Actual Average Daily Attendance – 100% of projected Average Daily Attendance will be

achieved. Acceptable performance is 80%. d) Actual Population Served – 85% or more youth receiving services will be 11-17 years old. e) Program Dosage (Days) – 100% of enrolled youth will attend on average 5 days per week.

Acceptable performance is 50% enrolled youth will attend on average 4 days per week. f) Youth Employment – 5% or more, up to 15%, of the total grant award will be dedicated to

providing youth employment. g) Cost per Youth per Hour – $4.50 per youth attendance hour.

12. PROGRAM EVALUATION BY LOCAL AGENCY - Awardees may be required to participate in the formal evaluation of the program developed by the Department and must cooperate in the collection of data for this purpose. Toward this end, programs will be required to administer parent and youth surveys in the spring of the year, in a format provided by the Department. These surveys are designed to measure progress toward the objectives and developmental assets detailed in Part II Section E1, “Core Services”, above.

Other data will be collected from programs via the eCornerstone system, including, at a minimum, the following data elements:

unduplicated number of program participants demographic characteristics of program participants individual and family risk factor data annual enrollment data participant attendance data participant employment data hours of programming and operation program service activities participant academic outcomes

Please note that some records and other information obtained by programs concerning the individuals served under this agreement may be confidential pursuant to state and federal statutes and/or administrative rules, and shall be protected from unauthorized disclosure.

13. STAFFING - At a minimum, a .5 FTE (full-time equivalent) Teen REACH Coordinator must be

committed to the program and identified in the organizational chart. Programs must recruit, hire, and take necessary steps to retain staff that are qualified for their positions with the Teen REACH program through education, experience and/or training. The organizational chart must be included as Attachment A2 of the application.

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14. SNACKS AND MEALS - Teen REACH programs must offer nutritious snacks to the participants. All food must be served in accordance with relevant local and state health standards for food preparation and handling and meet the standards of the National Afterschool Association.

While program funds may be used to purchase food, programs must demonstrate that they researched and applied for assistance through the food programs sponsored through the U.S. Department of Agriculture (USDA), found at http://www.usda.gov ; the Illinois State Board of Education (ISBE), found at http://www.isbe.state.il.us ; or through America’s Second Harvest, found at http://www.secondharvest.org .

15. TRANSPORTATION - Program funds may be used to cover reasonable transportation costs for

program participants, with the exception of transportation across state lines. In addition, transportation across state lines will require prior approval from the Department.

If transportation is provided, the agency will be required to develop a written transportation plan directly related to project activities and to maintain the plan on file at the agency. This plan should have the approval of the agency’s governing body and be available for review by the Department upon request.

16. COLLABORATION – The importance of community collaboration cannot be overemphasized.

Working together, youth, families and community entities can design programs that are best suited to meet the needs of local youth and to connect out-of-school time programs with community resources. Community-based agencies, government, faith-based organizations, civic organizations, businesses, foundations, youth and their families, working together, can provide a wide range of resources to support high-quality out-of-school time programs. The issues and concerns of the entire community can best be addressed by drawing upon diverse resources. The key to successful programming is collaborative planning and implementation.

Successful applicants will have developed community partnerships, which, at a minimum, must include strong collaboration with the schools whose students will be attending Teen REACH program activities. In particular, providers are encouraged to collaborate with schools in planning program services, in an effort to address state standards for academic achievement. Programs will be required to submit information about students’ progress, based on grade reports and attendance and suspension records, to the Department. Copies of signed linkage agreements with every school where participants are attending must be included with your proposal, indicating an acknowledgment of the schools’ willingness to provide copies of the above information. Please note that schools will need to obtain parental/guardian consent before school records can actually be submitted to the Teen REACH program.

Additionally, youth and families can play a key role in the development of out-of-school time programming. Programs that include families and youth in the planning draw greater support in the long run and tend to be more culturally relevant. Parents should be involved in all phases of program development and implementation.

Where applicants are proposing youth employment in the community, strong collaborations will be required with those agencies/businesses in which youth will be employed. These collaborations must be demonstrated by linkage agreements.

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Teen REACH also encourages collaboration with other youth serving programs in the community.

17. PROGRAM PARTICIPATION FEES - Programs may develop a sliding scale for payment of

program registration fees. If this is done, programs must develop written policies that ensure that inability to pay a fee will not preclude participation by any eligible youth. In addition, any fees secured must be put back into the Teen REACH program and utilized for direct services activities to youth. This must be demonstrated in the proposed Spending Plan. Fees collected should be captured as “Applicant and Other”.

18. YOUTH EMPLOYMENT – Programs are required to provide paid youth employment

opportunities to youth 16 and older. It is not a requirement for every youth 16 and older be engaged in paid employment. However, it will be a requirement that a minimum of 5% of the Teen REACH grant award be expended on paid youth employment. This amount may not exceed 15% of the Teen REACH grant award. The time a youth spends engaged in employment activity will be counted as time spent in the Teen REACH program and must be captured in the eCornerstone system. While this time will be credited for a youth’s time and days spent in the program, it will not count for the applicant as a day open. Applicants must demonstrate the ability and intent to provide youth with paid employment opportunities. Linkage agreements will be required with any agency/business in which youth employment will be offered. These opportunities may include opportunities to work in the Teen REACH program itself or may include employment opportunities elsewhere in the community. This employment must be supplemented by participation in the Teen REACH program.

F. Teen REACH Focus: A Special Programming Option

Because Teen REACH programming is designed to meet the developmental needs of children and youth between the ages of 6 and 17 and to reflect the specific issues and demographics of the community in which it is located, it is expected that programs will look very different from one location to the next. To further enhance the responsiveness of the program to the unique needs and interests of youth in individual communities, the Department is implementing a special programming option called Teen REACH Focus. The Department is encouraging agencies to develop highly focused initiatives that will provide intense programming for participants. The agency may choose to emphasize one core service or may choose to plan activities for all core services around the Focus theme. This emphasis will be reflected in the Application and in the annual Program Plan. Applicants should indicate in Part III Section 4, “Description of Program/Services”, below, the details of the focus initiative. In addition, applicants should note in Part III Section 7, “Spending Plan Narrative”, below, how grant funds will be designated for the focus initiative. Please note that all agencies are required to present programming in each of the six core services, even if they apply as a Focus program. Teen REACH Focus programs must comply with all requirements of Teen REACH programming. Teen REACH Focus Options:

1. Music Production Entrepreneurship Music Production grantees will provide the opportunity for youth 13 to 17 years of age to

participate in an entrepreneurship program in the area of music and sound production. Programs will use music to engage youth, providing them with opportunities for growth and

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development in a medium that is familiar to them. Positive educational opportunities will include small business management, audio and video production, job readiness training and community service.

2. World View / Cultural World View programs will be designed around the particular culture, orientation or world

view that is shared by a group of participants. Examples would include youth of a particular ethnic culture or those interested in, or working toward, a focus in some area of their lives, such as the history of their community, academics, dance, music, geography, theater, etc.

3. Gender-Specific Gender-Specific programs will provide services and activities tailored to the needs and

abilities of girls only or boys only, helping them to understand and cope with difficult situations in their lives that are unique to their gender, and to build upon skills they may want to develop. Examples of specialized activities under this special focus area might include career building, social confidence/self-esteem, family and/or dating violence, and nutrition and physical activity. Agencies are free to develop programming in other areas that might be of particular interest to one gender or the other. Participants in these programs must be all of one gender or the other.

G. Service Area

The Illinois Department of Human Services is interested in gathering information about the service delivery area for each Teen REACH agency (or each site, if an agency has multiple program sites). This geographic analysis helps us to assure that services are being delivered in the areas of greatest need, in the most efficient and effective manner possible. Because of the importance of this information, your proposed service delivery area will be reviewed in the context of your application and the State’s need for services in that area.

Appendix 3 of this RFP is a Site Information Form, which provides space for you to enter your proposed service area by site. The Site Information Form must be completed for each site, if your agency will have more than one program site. Appendix 4 contains a map and a listing of Community Areas, by name and number, for the use of applicants in the city of Chicago. Submit the Site Information Form(s) as Attachment A7 of your proposal.

H. Funding Formula – The Maximum Grant Amount will be based on the total number of projected Youth

Attendance Hours (YAH) funded at a rate of $4.50.

R x YAH = $ (Where R= Rate, YAH = Projected Youth Attendance Hours and $ = Maximum Grant Amount)

Rate - A rate of $4.50 per youth per hour will be used by the Department as the basis for funding. Youth Attendance Hour - YAH is defined as an hour of programming for which a participant is recorded as being present. Therefore, a projected YAH is an hour in which the agency projects that a youth will participate in the program. Maximum Grant Amount – The total amount of grant funding that may be requested.

Exception: The only exception to the above funding formula will be the award of $4.5 million to a single entity for administration of a statewide network of programs. It is expected that the rate will be considerably less for this provider as they will be implementing through an established network.

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Calculating the projected Youth Attendance Hours (YAH) for the Funding Formula The Youth Attendance Plan (YAP) will be developed by the applicant as the result of a thoughtful and detailed annual planning process for the delivery of Teen REACH program services. An overview of the steps necessary to determine the Total Projected YAH are provided below. For more detailed information, refer to Appendix 5 “Youth Attendance Plan, Instructions and Forms”.

Step 1 – Identify Community Needs Step 2 – Identify Target Population Step 3 – Identify Site Locations for Program Delivery Step 4 – Estimate the Total Enrollment by Site Step 5 – Estimate the Average Daily Attendance, by Site Step 6 – Develop a 12-month program schedule by Site (days and hours planned to be open) Step 7 – Complete the Youth Attendance Plan (YAP) by Site (projections of youth attendance

levels) Step 8 – Complete the YAP Summary Form (compilation of site YAPs) Step 9 – Use the Total Projected YAH to calculate the Maximum Grant Amount

I. Use of Grant Funds

All Teen REACH grant funds must be used for direct costs associated with the provision of program services. Indirect expenses are not allowed under this program.

No more than 20 percent of the total grant funds expended may be used for program-specific administrative costs and services. Administrative costs are those activities performed by staff and costs that are supportive of, and required for, the project for which there is no direct client contact. Examples include administrative and fiscal staff, clerical support, rent, utilities, and general office equipment. Funds may not be used to supplant or duplicate existing services. If funds other than Teen REACH will be utilized to support the provision of Teen REACH services, including in-kind support, it will be necessary to detail those expenses and services in the application to demonstrate the proper utilization of such funds.

A minimum of 5% of Teen REACH grant funds must be spent providing paid youth employment. This amount may not exceed 15% of the total award. These funds may be paid out as stipends to a youth or may be paid to the employer to supplement a wage.

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Request for Proposal Teen Responsibility, Education, Achievement, Caring and Hope

(Teen REACH) PART III: PROPOSAL CONTENT A. Proposal Scoring

Applications will be evaluated by the Department on the following criteria: Executive Summary 0 points Agency Qualifications/Organizational Capacity 20 points Needs Statement 27 points Description of Program/Services 30 points Time Line 5 points Evaluation 8 points Spending Plan 10 points

TOTAL 100 POINTS Priority Points Past Performance 5 points Department Initiatives 3 points (Safety Net Works, Team Illinois or GEAR UP)

TOTAL with Priority 108 POINTS B. Proposal Instructions

Applicants must submit a plan that contains the information outlined below. Each section must begin on a new page and have a heading that corresponds to the headings in bold type listed below after each section number. The total application may not exceed 25 pages, single-spaced. The application cover page, checklist, attachments, letters of support and spending plan forms are not included in the page limitation. If the applicant believes that the subject has been adequately addressed in another part of the application narrative, then provide the cross-reference to the appropriate part of the narrative. The narrative portion must follow the page maximums where prescribed and must be organized in the format outlined below.

Teen REACH Focus: A Special Programming Option If the Applicant is proposing a Teen REACH Focus programming option as described in Part II Section F “Teen REACH Focus: A Special Programming Option.” Please be sure that this is clearly defined in the Executive Summary and throughout the proposal. The Focus option selected must be clearly stated and supported throughout the proposal.

Teen REACH – Statewide

$4.5 million will be granted to one entity for administration of a statewide network of Teen REACH programs, with programs in every area of the state. Agencies applying for funding as a statewide network:

must clearly state this intention in their Executive Summary and throughout their proposal, including the spending plan;

must have an existing infrastructure/network of affiliates located throughout the state;

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must provide programming as described throughout this RFP at each identified affiliate site; and affiliates included in the statewide application may not also apply for funding as an individual

agency under this RFP. It is expected that the rate per Youth Attendance Hour will be considerably less than $4.50 for this provider as they will be implementing through an established network.

1. Executive Summary (2 page maximum)

The Executive Summary will serve as a stand-alone document for successful applicants that will be shared with various state-level stakeholders and others requesting a brief overview of each funded project. Therefore, applicants should be concise and direct in their description. At a minimum, each of the following should be addressed in the summary:

• Description of the target community and identified needs from the Community Assessment

• Target population, including projected total enrollment, average daily attendance, race/ethnicity breakdown, and the percentage/number of youth anticipated in each age category

• Number and location of service delivery sites • Anticipated days and hours of operation • Total anticipated Youth Attendance Hours • Overview of core services and anticipated outcomes • Overview of planned youth employment activities • Total amount of funds requested through this grant

2. Agency Qualifications/Organizational Capacity

The purpose of this section is for the applicant to present an accurate picture of the agency’s ability to provide out-of-school services to at-risk youth as identified in this RFP. Information in this section should include, but not necessarily be limited to, the following:

a) Convincing evidence that the applicant agency is capable of carrying out the proposed program. Include experience that your agency has in conducting programs for at-risk youth. Describe relevant major accomplishments of your organization in the area of services to this population.

b) An organizational chart of the applicant organization, showing where the program and its

staff will be placed. If subcontractors will be used, include the relationship with those organizations in the chart. Please include this as Attachment A1.

c) Identify key staff positions that will be responsible for the program. At a minimum, a .5

FTE Teen REACH coordinator must be committed to the program. Include evidence that this individual is qualified on the basis of education and experience to direct the program. Present his/her resume as Attachment A2 of your proposal. If that individual has not yet been hired, present the Agency Director’s resume and the Teen REACH Coordinator’s job description as Attachment A2.

d) Job descriptions for all employee positions that will be funded with this grant, and an

indication of the percent of time those employees will spend in this program. Programs must recruit and hire staff who are qualified for their positions through education, experience and/or training. Include the job descriptions in Attachment A3.

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e) A description of your agency’s current programs and activities relevant to the services described in this RFP.

f) Please describe how your agency will impact the targeted population, and specify the age

group(s) for which programming will be designed. g) A description of your agency’s readiness for service provision commencing July 1, 2009,

taking particular note of the following: 1) If training is needed, describe what those training needs are, as well as the

agency’s willingness to ensure that all staff in need of training receive it prior to commencement of service delivery. For purposes of the proposal, assume that if your agency requires training on eCornerstone, the Department will provide that training to appropriate staff within your agency prior to commencement of services.

2) Discuss your readiness in terms of the physical space where Teen REACH program activities will be carried out. Describe whether this is space your agency currently occupies (and/or pays for), whether it is under construction, or if arrangements to rent/lease/buy or build a physical facility are not yet final. Include in Attachment A4 of your application copies of any linkage agreements or other documents (lease, rental agreement, etc.) to illustrate your situation with regard to physical space.

h) A description of the Community Advisory Council (CAC) or board that will be involved

in conducting Teen REACH activities. Include a description of how you have ensured a diversity of perspectives, including those of parents, youth (minimum 2), community members, business leaders and others. Please include as Attachment A5 a list of CAC members and indicate which sector of the community they represent.

i) A description of existing linkages your agency has to other community resources and

services essential to the positive development of youth, as detailed in Part II, Section E16, “Collaboration”, of this RFP. Include copies of existing linkage agreements in Attachment A6 of your application. At a minimum, your Attachment A6 of your proposal must include linkage agreements with every school where Teen REACH participants attend, indicating their willingness to provide copies of student grade reports and attendance and suspension records. If significant linkages do not currently exist, include a plan to establish those linkages. In addition, linkage agreements with community agencies/businesses that will be offering youth employment opportunities must be included.

j) Evidence of your agency’s cultural and linguistic competence to serve the youth in your

community. k) Describe your procedure for conducting background checks. l) Any additional information that the applicant feels might be relevant to a reviewer in

determining the agency’s ability to carry out a quality program should be included. m) Include as Attachment A7 the Site Information Form(s) found in Appendix 3 of this

RFP. If your agency has more than one program site, please provide a separate Site Information Form for each site.

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3. Needs Statement

Given the limited resources of the State, as described in Part II, Section B, “Intent of the RFP,” the Department intends to fund applications that target services to at-risk youth residing in high-need communities. Therefore, applications that make a compelling case that is evidenced by the results of the community assessment described in Part II, Section E5, “Assessment of Community Need,” will receive a higher score in this section of their application. The Department believes that relevant surveys and focus groups targeting the various sectors of the community, parents, youth and schools, coupled with an analysis of the most current data and community assessments available describing the youth, families and community needs and risk factors will form the basis for determining a community’s general need for youth-oriented social services. Consider also the individual and family risk factors described in Part II, Section E2, “Target Population”.

Your proposal should address each of the points below: a) Provide a detailed description of the geographic boundaries of the target community(ies),

county(ies) or Chicago Community Area(s). b) Describe the scope and strategy implemented to conduct the assessment of community need

as described in Part II, Section E5, “Assessment of Community Need”. Indicate the persons that were involved in conducting the assessment of need. Indicate the number of surveys, interviews, focus groups, etc. conducted and how many individuals and/or community sectors that participated. Describe the relevant, previously completed assessments that were reviewed and analyzed as part of the assessment. Include copies of sample survey tools utilized, interview and focus group questions and copies of previously completed assessments analyzed as Attachment B1.

c) Describe the target community current resources, strengths and needs for serving the

identified target population. d) Provide a demographic overview of the area to be served, as well as the youth that will be

targeted for services. Indicate the number of youth between the ages of 6 and 17; include their gender, race/ethnicity.

e) Describe in detail the results of your assessment of community needs. f) Include a statement of the need for these services in your community. g) Indicate the desired change or impact your program will have on the youth, families and

community served. This change should be measurable. h) Identify existing community-based resources serving at-risk youth in your community and

describe how the proposed program will enhance or complement these existing resources.

4. Description of Program/Services At a minimum, the proposal must address each of the following components: a) Describe the age group(s) for whom services will be provided. The Department intends to

fund applications that target services to youth ages 11 to 17. Therefore, applications that demonstrate the desire and ability to serve youth in this age range will score higher on this section. Agencies serving both younger and older age groups must provide no more than

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15% of their services to children ages 6 to 10 (i.e., at least 85% of their services to youth ages 11 to 17). For agencies operating the program at multiple sites, these percentages apply to the total population served by the agency, across all sites, not the number at any individual program site. This information will also be captured on the Site Information Form(s) and included with your application as Attachment A7. This form is found as Appendix 3 of this RFP.

b) Describe your program design for an integrated, comprehensive out-of-school-time program,

indicating whether you are adopting an established best or promising practice model, designing your own model or a combination thereof. Describe the basis for your intended programming. If something other than a best or promising practice is proposed, provide the basis for the decision and programming.

c) Include a description of the specific activities that will be carried out to meet each of the core

service areas, as detailed in Part II, Section E, “Services to be Performed (Description of Program)”. Discuss the ways in which those activities were selected and describe how they will address the outcomes and developmental assets for each core service area. Submit as Attachment C1 of your proposal a completed Activity Calendar to demonstrate that planned program activities will address all six core services and will be carried out on a regular basis. An Activity Calendar must be completed for each program site. Please note that if a site is planned to have a varied scheduled, please complete additional activity calendars to demonstrate that planned variance. Example: School-Year schedule vs. a Summer schedule.

d) Describe how the program design and the activities selected to address each core service area

are appropriate and have a direct correlation to the needs identified in the previous section. e) Describe the plan to provide paid youth employment opportunities to youth 16 and older that

participate in the Teen REACH program as described in Part II, Section E18, “Youth Employment”. Include the formula utilized to establish the stipend rate for employment activities. Identify the partner agencies/businesses that will be offering employment opportunities or describe the strategies to be utilized to identify those agencies/businesses. Copies of linkage agreements with these identified partner agencies/businesses must be included with your proposal as Attachment A6. Project the number of youth that will participate in paid youth employment activities as well as the anticipated number of work hours. This will also be captured in the Youth Attendance Plan of your proposal.

f) Demonstrate the agency’s experience in implementing the type of programming proposed,

and discuss the capacity to provide the identified services. g) Describe the agency’s plan for providing snacks and meals as described in Part II, Section

E14, “Snacks and Meals”. h) Provide a description of established or proposed linkages with other youth-serving resources

within your community, and how your program will collaborate with those entities to provide services to youth.

i) Identify other out-of-school time programs in the community and how your proposed

program will provide services not otherwise met and reach youth not otherwise served. j) Discuss your plans for including volunteers in your program, and the role(s) they will play.

32

k) Describe outreach strategies that will be used to recruit program participants. Include a

discussion of how your agency will work with schools, faith-based and other programs to reach youth who are at risk, as indicated by the risk factors listed in Part II Section E5, “Assessment of Community Need”, above.

l) Describe whether transportation will be provided to participating youth and families with

program funds. m) Provide the projected total number of youth that will be enrolled in the program annually as

well as the projected Average Daily Attendance (ADA). Include a discussion of how you intend to maintain attendance at the level for which you are requesting funding, and the activities planned to enhance enrollment retention. Additionally, the total enrollment and ADA projections by site will be included on the Site Information Form and included as Attachment A7 of your application. This form is found as Appendix 3 of this RFP.

n) Complete the Annual Youth Attendance Plan (YAP) found as Appendix 5 in this RFP. A

YAP must be completed for each site. Complete a YAP Cover Page found as Appendix 5 in this RFP. Complete a YAP Narrative found as Appendix 5 in this RFP. These items will be included as Attachment C2 of your proposal.

5. Time Line (1 page maximum)

Applicants must include a proposed time line for implementation. The timeline should include items such as hiring staff, training staff, recruiting participants etc.

6. Evaluation (1 page maximum)

a) Applicants must make a clear statement of their intention to participate in any formal evaluation of the program that may be conducted by the Department or any of its contractors as described in Part I, Section Y, “Program Evaluation and Reporting Requirements”.

b) Applicants must include a clear statement indicating that the agency has computers with

internet service that meet the minimum specifications identified in Part I, Section F, “Eligible Applicants”.

c) Applicants must indicate their ability to collect participant data and report it via the

eCornerstone system as described in Part II, Section E12, “Program Evaluation by Local Agency”.

d) Applicants must indicate their intention and ability to collect and report outcomes data

and developmental assets data to support achievement in each of the six core service areas described in Part II, Section E1, “Core Services”. Describe the applicant’s plan to track and evaluate outcomes and assets.

7. Spending Plan Narrative (2 page maximum)

a) Provide a Spending Plan Narrative in which you clearly describe how appropriate resources and personnel have been allocated for the tasks and activities described in your proposal. Illustrate the use of local, state or federal funds, other than Teen REACH grant funds, which will be used to support the program.

33

b) Complete the Spending Plan Forms found as Appendix 7 of this RFP and include in your proposal as Attachment D1. Refer to Part II, Section I, “Use of Grant Funds”, concerning Administrative costs and refer to Appendix 8 for a list of allowable and non-allowable costs.

c) Clearly indicate that 5 % of the total grant funds will be spent on paid youth employment

as described in Part II, Section E18, “Youth Employment”. These funds may be paid out as stipends to a youth or may be paid to the employer to supplement a wage.

d) If participant fees are collected, ensure they are budgeted for in the Spending Plan. They

should be captured as “Applicant and Other” and described in the Spending Plan Narrative.

e) Clearly mark any one-time start-up funds. Reasonable start-up will be allowed, but the

proposal must indicate how those funds would be used in subsequent years. f) Note that Teen REACH funds may not be used by your agency for federal matching

purposes.

g) Show the formula by which you arrived at the total grant amount you are requesting from the Department, based on the funding formula. Refer to Part I, Section W, “Funding Formula”.

Although the applicant may be eligible to request funding at the maximum amount indicated in the Funding Formula, the applicant is not mandated to request funding at that level, they may request fewer funds, but they may not request additional funds.

The minimum grant award amount will be $48,000. The maximum grant award amount will be $350,000. The Department expects that very few awards will be made at these levels. The average grant award amount is anticipated to be $150,000.

34

APPENDIX 1

BEST & PROMISING PRACTICES

35

APPENDIX 1 Best & Promising Practices

This is a list of “Best & Promising Practices” that have been found to be successful in out of school time programs such as Teen REACH and is in no way comprehensive and Applicants may propose programming not included in this attachment. Academic Achievement

Alpha Smarts (AA01) Destinations 2.0 (AA02) Hooked on Phonics (AA03) Read and Write Now (AA04) Help a Child to Read (AA05) Math Blasters (AA06)

The Princeton Review (AA08) Leap into Literacy (AA09) Lego Engineering Academy (AA10) Kaleidoscope (AA11) Voyager Expanded Learning Program (AA12) After school Science Plus (AA13) Effective Math Tutoring Strategies (AA14)

Life Skills

Life Skills Training Program (Botvin) (LS101) Project Northland (LS102) I CAN Problem Solve (LS103) Preparing for the Drug Free years (LS104) Project Alert (LS105) Postponing Sexual Involvement (PSI) (LS201) Reducing the Risk (LS202) Behavioral Skill Training (HIV) (LS203) Sex Can Wait (LS204) Smart Girls (LS205) Teen Talks (LS206) Good Behavior Game (LS301) Pathways: A Boy's Town Training Program (LS302) Youth Peace (LS303) Sister Net (LS304) Second Step (LS305) Conflict resolution (LS401)

Self Worth (LS402) Peer Relationships (LS403) Communications Skills (LS404) Youth Helping Youth Succeed (LS501) A Peer Mentor Curriculum for Drug and Violence

Prevention (LS502) Project Star/Midwestern Prevention Project (LS106) Play for Peace (LS405) Peace Builders (LS406) Project Trust (LS407) Be Proud! Be Responsible! (LS207) G.R.E.A.T. Gang Resistance Education & Training

(LS503) Resolving Conflict Creatively Program (RCCP)

(LS408) CASASTART – Striving Together to Achieve

Rewarding Tomorrows (LS306) Get Real about AIDS (LS208)

Parental Involvement

Strengthening Families Program (PI001) Families and School Together (FAST) (PI002) Strengthening Families Program for Parents and

Youth 10-14 (PI003) Ages 0-18: NICASA Parent Project (PI004) Effective Black Parenting Ages 2-12 (PI005)

Strengthening Multi-Ethnic Families and Communities Ages 3-18 (PI006)

Families Who Care (PI007) Creating Lasting Connections (PI008) IOWA – Strengthening Families Programs

(PI009) Mentoring

Understanding Mentoring Relationships by Search Institute (PM001) Across Ages (PM002) Mentoring Works! by the National Mentoring Partnerships (PM003)

Sports & Recreation

Project First Choice by the Illinois National Guard (SR001) President's Council on Physical Fitness (SR002) New Games (SR003)

Service Learning

http://www.learnandserve.org (Please refer to this website to access best practice information.)

APPENDIX 2

ACTIVITY CALENDAR

APPENDIX 2 Teen REACH – Activity Calendar

Please complete this form as described in the RFP. You will need to complete a minimum of one calendar per program site. If your annual plan for your program includes a significant variance, please include and additional calendar per site to demonstrate that planned variance. Example: School-year programming vs. Summer Programming. This will be indicated in the “Example Type” section of the heading along with the corresponding site name. Agency Name Site Name/Location Example Type:

Day/Date

Time of

Program Hours

Total Program

Hours

Sports/

Recreation

Life Skills

Academics

Parent

Involvement

Mentoring

Service- Learning

Snacks/ Meals

Monday

Time:

Time:

Time:

Time:

Time:

Time:

Time:

Tuesday

Time:

Time:

Time:

Time:

Time:

Time:

Time:

Wednesday

Time:

Time:

Time:

Time:

Time:

Time:

Time:

Thursday

Time:

Time:

Time:

Time:

Time:

Time:

Time:

Friday

Time:

Time:

Time:

Time:

Time:

Time:

Time:

Saturday

Time:

Time: Time: Time: Time: Time: Time:

Sunday

Time:

Time:

Time:

Time:

Time:

Time:

Time:

Total Hours

APPENDIX 3

SITE INFORMATION FORM

APPENDIX 3 SITE INFORMATION FORM

Please complete one form for each Teen REACH site, if your agency will have multiple sites.

AGENCY NAME: __________________________________________________________________________

SITE NAME: ___________________________________________________________________________

SITE ADDRESS: (street)_____________________________________________________________________

(city)_______________________________________ (ZIP)__________________________

(Community Area - Chicago only) ______________________________________________

SITE MANAGER:___________________________________________________________________________

SITE E-MAIL ADDRESS:_____________________________________________________________________

SITE PHONE: _________________________ SITE FAX: _________________________

PROGRAM OPTION: � Teen REACH � Teen REACH – Statewide � Teen REACH Focus – World View � Teen REACH Focus – Gender-Specific � Teen REACH Focus – Music/Entrepreneurship COLLABORATING SCHOOL(S): _______________________________________________________

_______________________________________________________

_______________________________________________________

_______________________________________________________

SITE SERVICE AREA: Describe the service area, using county(ies), City(ies), and/or ZIP code(s), as appropriate to your description. If your agency is located in the city of Chicago, please use the name of the Community Area(s), as referenced in Appendix 4 of this RFP. Reserve the use of other categories (such as townships, highways, street names) for a situation where that is the only way you can describe the area. If you will serve only a portion of a county, describe which portion. ___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

PROGRAM ESTIMATES

ENROLLMENT/ATTENDANCE (number) Total Enrollment ______ Average Daily Attendance ______

Total Projected Youth Attendance Hours ______ Total Projected Youth Employment Hours ______ (Not including Youth Employment Hours) # of youth involved in paid youth employment ______

AGE (percent) GENDER (percent) RACE (percent) 6 - 10 ______ % Male _____% White/Non-Hispanic ______ % 11 - 13 ______% Female _____% Hispanic ______ % 14 - 17 ______% African American ______ %

Asian ______ % Other or Mixed ______ %

APPENDIX 4

CHICAGO COMMUNITY AREAS

APPENDIX 4 CHICAGO COMMUNITY AREAS

01 Rogers Park 41 Hyde Park 02 West Ridge 42 Woodlawn 03 Uptown 43 South Shore 04 Lincoln Square 44 Chatham 05 North Center 45 Avalon Park 06 Lake View 46 South Chicago 07 Lincoln Park 47 Burnside 08 Near North Side 48 Calumet Heights 09 Edison Park 49 Roseland 10 Norwood Park 50 Pullman 11 Jefferson Park 51 South Deering 12 Forest Glen 52 East Side 13 North Park 53 West Pullman 14 Albany Park 54 Riverdale 15 Portage Park 55 Hegewisch 16 Irving Park 56 Garfield Ridge 17 Dunning 57 Archer Heights 18 Montclare 58 Brighton Park 19 Belmont Cragin 59 McKinley Park 20 Hermosa 60 Bridgeport 21 Avondale 61 New City 22 Logan Square 62 West Elsdon 23 Humboldt Park 63 Gage Park 24 West Town 64 Clearing 25 Austin 65 West Lawn 26 West Garfield Park 66 Chicago Lawn 27 East Garfield Park 67 West Englewood 28 Near West Side 68 Englewood 29 North Lawndale 69 Greater Grand Crossing 30 South Lawndale 70 Ashburn 31 Lower West Side 71 Auburn Gresham 32 Loop 72 Beverley 33 Near South Side 73 Washington Heights 34 Armour Square 74 Mount Greenwood 35 Douglas 75 Morgan Park 36 Oakland 76 O'Hare 37 Fuller Park 77 Edgewater 38 Grand Boulevard 39 Kenwood 40 Washington Park

APPENDIX 5

YOUTH ATTENDANCE PLAN (Instructions & Forms)

Youth Attendance Plan Instructions Youth Attendance Plan Cover Page Instructions Youth Attendance Plan Narrative Instructions Youth Attendance Plan Forms

APPENDIX 5 Youth Attendance Plan Instructions

The Youth Attendance Plan (YAP) is designed to allow the applicant to capture an entire year’s planned schedule for each service delivery site. This Plan is designed to capture the projected number of Youth Attendance Hours (YAH). A YAH is defined as an hour of programming for which a participant is recorded as being present. In addition, the YAP is also designed to capture the total number of Youth Employment Hours (YEH). To calculate the projected YAH, the applicant should follow these steps:

Step 1: Identify the sites where Teen REACH services will be delivered. Step 2: For each day planned to be open, identify the hours that Teen REACH services will be

delivered at each site (e.g., 3:00 pm – 6:00 pm). Note that each site does not have to have the same schedule. If a training day is identified (up to 10 count toward the 240), please indicate “training day” on the calendar for that day. Time and YAH is not necessary.

Step 3: Project the average number of participants that will be present at each site on any given day. Record this number on the Youth Attendance Plan and the Youth Attendance Plan Summary Page. This is the Projected Average Daily Attendance (ADA) for the site. (Note that this number is not necessarily the total number of youth that may be enrolled in the program. However, in order for the site to successfully adhere to the model, the same youth should be targeted for daily attendance.)

Step 4: Consider what issues might affect attendance for any given time period within the service delivery hours (e.g., participants might leave early or come late to attend sports practice or scouts meeting, etc.).

Step 5: Project total YAH for each day. Example: This site is open from 3:00 pm until 6:00 pm. 30 participants will arrive at 3:00 pm; 10 participants will leave at 4:00 pm and the remaining 20 will stay until 6:00 pm. Therefore, 20 participants will receive 3 hours of programming or a projected 60 YAH (20 x 3). 10 participants will only receive 1 hour of programming or a projected 10 YAH (10 x 1). Thus the total projected YAH for this day at this site would be 70 YAH. (It may be necessary to consider partial hours if appropriate.)

Step 6: After completing each month, total the projected YAH and record at the bottom of each month. Continue the process until you have completed 12 months of projections for each site of service delivery.

To calculate the projected YEH, the applicant should follow these steps: Step 1: Project the number of youth at each site to be involved in paid youth employment. Step 2: Project the number of hours each youth will work.

Step 3: Project total YEH for each month. Example: Two youth at Site “A” will work 4 hours at Business “B” two Saturdays in August. Thus, 2 participants will work 4 hours or a projected 8 YEH in August. (It may be necessary to consider partial hours if appropriate.)

It is important to note that these employment hours will not be counted in the YAH for

each month on this form. They will be tracked separately and added into the total YAH on the Summary Page.

Step 4: After completing each month, total the projected YEH and record at the bottom of each month. Continue the process until you have completed 12 months of projections for each site of service delivery.

APPENDIX 5 Youth Attendance Plan Cover Page Instructions

The Youth Attendance Plan Cover Page is designed to summarize the individual site Youth Attendance Plans (YAP) and to arrive at the overall Agency Total Youth Attendance Hours (YAH) projections for use in calculating the Maximum Grant Award. To complete the YAP cover page the applicant should follow these steps:

Step 1: For each site, add each month’s Projected YAH to arrive at an annual Site Projected YAH. Record this number on the YAP Cover Page along with the corresponding site information. Repeat this step for each program site.

Step 2: For each site, add each month’s Projected YEH to arrive at an annual Site Projected YEH. Record this number on the YAP Cover Page along with the corresponding site information. Repeat this step for each program site.

Step 3: Total the Projected Days Open, Hours Open, Average Daily Attendance and the Site Projected YAH and YEH columns. Record these totals in the appropriate space below the table.

Step 4: The Agency Projected YAH and the Agency Projected YEH should be added together and inserted in the funding formula on the bottom half of the form. Calculate the Maximum Grant Amount. This is the maximum grant amount for which the applicant may apply.

Note: Providers may request an award amount that is less than the amount they are eligible to request. Refer to Part I, Section I, “Award Process”, for the anticipated award amounts.

APPENDIX 5 Youth Attendance Plan Narrative Instructions

Include a Youth Attendance Plan Narrative based on the instructions below as part of your completed Youth Attendance Plan. The Narrative should be preceded by the Youth Attendance Plan Cover Page and be followed by the individual site Youth Attendance Plans as Attachment C2 of your proposal. Narrative Instructions: Explain the process by which you arrived at the Projected Youth Attendance Hours as identified in your FY2010 Youth Attendance Plan. Be as detailed as necessary to create a clear picture of your planning process. Use additional pages if necessary. At a minimum, address the following:

Your plan for being open 240 days and providing a minimum of 720 service provision hours per site; Your plan to provide days for staff training; How you projected average daily attendance for each site; Your scheduled time for service delivery for each site; The process by which you arrived at your YAH on any given day, taking into account varying schedules for

participants; Your plan for any extended-hour days if applicable (extended evening hours, weekends, holidays, school

breaks, etc.) Be sure to address how these extended hours have impacted attendance levels; How you projected the number of Youth Employment Hours and the number of youth that would work

those hours.

Agency Name: Site Name: Projected Site Average Daily Attendance:

July 2009

Sun Mon Tue Wed Thu Fri Sat 1 2 3 4

Hours Open: Hours Open: Hours Open: Hours Open: Program Hours: Program Hours: Program Hours: Program Hours: Projected YAH: Projected YAH: Projected YAH: Projected YAH:

5 6 7 8 9 10 11Hours Open: Hours Open: Hours Open: Hours Open: Hours Open: Hours Open: Hours Open: Program Hours: Program Hours: Program Hours: Program Hours: Program Hours: Program Hours: Program Hours: Projected YAH: Projected YAH: Projected YAH: Projected YAH: Projected YAH: Projected YAH: Projected YAH:

12 13 14 15 16 17 18Hours Open: Hours Open: Hours Open: Hours Open: Hours Open: Hours Open: Hours Open: Program Hours: Program Hours: Program Hours: Program Hours: Program Hours: Program Hours: Program Hours: Projected YAH: Projected YAH: Projected YAH: Projected YAH: Projected YAH: Projected YAH: Projected YAH:

19 20 21 22 23 24 25Hours Open: Hours Open: Hours Open: Hours Open: Hours Open: Hours Open: Hours Open: Program Hours: Program Hours: Program Hours: Program Hours: Program Hours: Program Hours: Program Hours: Projected YAH: Projected YAH: Projected YAH: Projected YAH: Projected YAH: Projected YAH: Projected YAH:

26 27 28 29 30 31 Hours Open: Hours Open: Hours Open: Hours Open: Hours Open: Hours Open: Program Hours: Program Hours: Program Hours: Program Hours: Program Hours: Program Hours: Projected YAH: Projected YAH: Projected YAH: Projected YAH: Projected YAH: Projected YAH:

MONTHLY TOTALS: DAYS OPEN: HOURS OPEN: YAH: YEH:

Agency Name: Site Name:

August 2009

Sun Mon Tue Wed Thu Fri Sat 1

Hours Open: Program Hours: Projected YAH:

2 3 4 5 6 7 8Hours Open: Hours Open: Hours Open: Hours Open: Hours Open: Hours Open: Hours Open: Program Hours: Program Hours: Program Hours: Program Hours: Program Hours: Program Hours: Program Hours: Projected YAH: Projected YAH: Projected YAH: Projected YAH: Projected YAH: Projected YAH: Projected YAH:

9 10 11 12 13 14 15Hours Open: Hours Open: Hours Open: Hours Open: Hours Open: Hours Open: Hours Open: Program Hours: Program Hours: Program Hours: Program Hours: Program Hours: Program Hours: Program Hours: Projected YAH: Projected YAH: Projected YAH: Projected YAH: Projected YAH: Projected YAH: Projected YAH:

16 17 18 19 20 21 22Hours Open: Hours Open: Hours Open: Hours Open: Hours Open: Hours Open: Hours Open: Program Hours: Program Hours: Program Hours: Program Hours: Program Hours: Program Hours: Program Hours: Projected YAH: Projected YAH: Projected YAH: Projected YAH: Projected YAH: Projected YAH: Projected YAH:

23 24 25 26 27 28 29Hours Open: Hours Open: Hours Open: Hours Open: Hours Open: Hours Open: Hours Open: Program Hours: Program Hours: Program Hours: Program Hours: Program Hours: Program Hours: Program Hours: Projected YAH: Projected YAH: Projected YAH: Projected YAH: Projected YAH: Projected YAH: Projected YAH:

30 31 Hours Open: Hours Open: Program Hours: Program Hours: Projected YAH: Projected YAH:

MONTHLY TOTALS: DAYS OPEN: HOURS OPEN: YAH: YEH:

Agency Name: Site Name:

September 2009

Sun Mon Tue Wed Thu Fri Sat 1 2 3 4 5

Hours Open: Hours Open: Hours Open: Hours Open: Hours Open: Program Hours: Program Hours: Program Hours: Program Hours: Program Hours: Projected YAH: Projected YAH: Projected YAH: Projected YAH: Projected YAH:

6 7 8 9 10 11 12Hours Open: Hours Open: Hours Open: Hours Open: Hours Open: Hours Open: Hours Open: Program Hours: Program Hours: Program Hours: Program Hours: Program Hours: Program Hours: Program Hours: Projected YAH: Projected YAH: Projected YAH: Projected YAH: Projected YAH: Projected YAH: Projected YAH:

13 14 15 16 17 18 19Hours Open: Hours Open: Hours Open: Hours Open: Hours Open: Hours Open: Hours Open: Program Hours: Program Hours: Program Hours: Program Hours: Program Hours: Program Hours: Program Hours: Projected YAH: Projected YAH: Projected YAH: Projected YAH: Projected YAH: Projected YAH: Projected YAH:

20 21 22 23 24 25 26Hours Open: Hours Open: Hours Open: Hours Open: Hours Open: Hours Open: Hours Open: Program Hours: Program Hours: Program Hours: Program Hours: Program Hours: Program Hours: Program Hours: Projected YAH: Projected YAH: Projected YAH: Projected YAH: Projected YAH: Projected YAH: Projected YAH:

27 28 29 30 Hours Open: Hours Open: Hours Open: Hours Open: Program Hours: Program Hours: Program Hours: Program Hours: Projected YAH: Projected YAH: Projected YAH: Projected YAH:

MONTHLY TOTALS: DAYS OPEN: HOURS OPEN: YAH: YEH:

Agency Name: Site Name:

October 2009

Sun Mon Tue Wed Thu Fri Sat 1 2 3

Hours Open: Hours Open: Hours Open: Program Hours: Program Hours: Program Hours: Projected YAH: Projected YAH: Projected YAH:

4 5 6 7 8 9 10Hours Open: Hours Open: Hours Open: Hours Open: Hours Open: Hours Open: Hours Open: Program Hours: Program Hours: Program Hours: Program Hours: Program Hours: Program Hours: Program Hours: Projected YAH: Projected YAH: Projected YAH: Projected YAH: Projected YAH: Projected YAH: Projected YAH:

11 12 13 14 15 16 17Hours Open: Hours Open: Hours Open: Hours Open: Hours Open: Hours Open: Hours Open: Program Hours: Program Hours: Program Hours: Program Hours: Program Hours: Program Hours: Program Hours: Projected YAH: Projected YAH: Projected YAH: Projected YAH: Projected YAH: Projected YAH: Projected YAH:

18 19 20 21 22 23 24Hours Open: Hours Open: Hours Open: Hours Open: Hours Open: Hours Open: Hours Open: Program Hours: Program Hours: Program Hours: Program Hours: Program Hours: Program Hours: Program Hours: Projected YAH: Projected YAH: Projected YAH: Projected YAH: Projected YAH: Projected YAH: Projected YAH:

25 26 27 28 29 30 31Hours Open: Hours Open: Hours Open: Hours Open: Hours Open: Hours Open: Hours Open: Program Hours: Program Hours: Program Hours: Program Hours: Program Hours: Program Hours: Program Hours: Projected YAH: Projected YAH: Projected YAH: Projected YAH: Projected YAH: Projected YAH: Projected YAH:

MONTHLY TOTALS: DAYS OPEN: HOURS OPEN: YAH: YEH:

Agency Name: Site Name:

November 2009

Sun Mon Tue Wed Thu Fri Sat 1 2 3 4 5 6 7

Hours Open: Hours Open: Hours Open: Hours Open: Hours Open: Hours Open: Hours Open: Program Hours: Program Hours: Program Hours: Program Hours: Program Hours: Program Hours: Program Hours: Projected YAH: Projected YAH: Projected YAH: Projected YAH: Projected YAH: Projected YAH: Projected YAH:

8 9 10 11 12 13 14Hours Open: Hours Open: Hours Open: Hours Open: Hours Open: Hours Open: Hours Open: Program Hours: Program Hours: Program Hours: Program Hours: Program Hours: Program Hours: Program Hours: Projected YAH: Projected YAH: Projected YAH: Projected YAH: Projected YAH: Projected YAH: Projected YAH:

15 16 17 18 19 20 21Hours Open: Hours Open: Hours Open: Hours Open: Hours Open: Hours Open: Hours Open: Program Hours: Program Hours: Program Hours: Program Hours: Program Hours: Program Hours: Program Hours: Projected YAH: Projected YAH: Projected YAH: Projected YAH: Projected YAH: Projected YAH: Projected YAH:

22 23 24 25 26 27 28Hours Open: Hours Open: Hours Open: Hours Open: Hours Open: Hours Open: Hours Open: Program Hours: Program Hours: Program Hours: Program Hours: Program Hours: Program Hours: Program Hours: Projected YAH: Projected YAH: Projected YAH: Projected YAH: Projected YAH: Projected YAH: Projected YAH:

29 30 Hours Open: Hours Open: Program Hours: Program Hours: Projected YAH: Projected YAH:

MONTHLY TOTALS: DAYS OPEN: HOURS OPEN: YAH: YEH:

Agency Name: Site Name:

December 2009

Sun Mon Tue Wed Thu Fri Sat 1 2 3 4 5

Hours Open: Hours Open: Hours Open: Hours Open: Hours Open: Program Hours: Program Hours: Program Hours: Program Hours: Program Hours: Projected YAH: Projected YAH: Projected YAH: Projected YAH: Projected YAH:

6 7 8 9 10 11 12Hours Open: Hours Open: Hours Open: Hours Open: Hours Open: Hours Open: Hours Open: Program Hours: Program Hours: Program Hours: Program Hours: Program Hours: Program Hours: Program Hours: Projected YAH: Projected YAH: Projected YAH: Projected YAH: Projected YAH: Projected YAH: Projected YAH:

13 14 15 16 17 18 19Hours Open: Hours Open: Hours Open: Hours Open: Hours Open: Hours Open: Hours Open: Program Hours: Program Hours: Program Hours: Program Hours: Program Hours: Program Hours: Program Hours: Projected YAH: Projected YAH: Projected YAH: Projected YAH: Projected YAH: Projected YAH: Projected YAH:

20 21 22 23 24 25 26Hours Open: Hours Open: Hours Open: Hours Open: Hours Open: Hours Open: Hours Open: Program Hours: Program Hours: Program Hours: Program Hours: Program Hours: Program Hours: Program Hours: Projected YAH: Projected YAH: Projected YAH: Projected YAH: Projected YAH: Projected YAH: Projected YAH:

27 28 29 30 31 Hours Open: Hours Open: Hours Open: Hours Open: Hours Open: Program Hours: Program Hours: Program Hours: Program Hours: Program Hours: Projected YAH: Projected YAH: Projected YAH: Projected YAH: Projected YAH:

MONTHLY TOTALS: DAYS OPEN: HOURS OPEN: YAH: YEH:

Agency Name: Site Name:

January 2010

Sun Mon Tue Wed Thu Fri Sat 1 2

Hours Open: Hours Open: Program Hours: Program Hours: Projected YAH: Projected YAH:

3 4 5 6 7 8 9Hours Open: Hours Open: Hours Open: Hours Open: Hours Open: Hours Open: Hours Open: Program Hours: Program Hours: Program Hours: Program Hours: Program Hours: Program Hours: Program Hours: Projected YAH: Projected YAH: Projected YAH: Projected YAH: Projected YAH: Projected YAH: Projected YAH:

10 11 12 13 14 15 16Hours Open: Hours Open: Hours Open: Hours Open: Hours Open: Hours Open: Hours Open: Program Hours: Program Hours: Program Hours: Program Hours: Program Hours: Program Hours: Program Hours: Projected YAH: Projected YAH: Projected YAH: Projected YAH: Projected YAH: Projected YAH: Projected YAH:

17 18 19 20 21 22 23Hours Open: Hours Open: Hours Open: Hours Open: Hours Open: Hours Open: Hours Open: Program Hours: Program Hours: Program Hours: Program Hours: Program Hours: Program Hours: Program Hours: Projected YAH: Projected YAH: Projected YAH: Projected YAH: Projected YAH: Projected YAH: Projected YAH:

24 25 26 27 28 29 30Hours Open: Hours Open: Hours Open: Hours Open: Hours Open: Hours Open: Hours Open: Program Hours: Program Hours: Program Hours: Program Hours: Program Hours: Program Hours: Program Hours: Projected YAH: Projected YAH: Projected YAH: Projected YAH: Projected YAH: Projected YAH: Projected YAH:

31 Hours Open: Program Hours: Projected YAH:

MONTHLY TOTALS: DAYS OPEN: HOURS OPEN: YAH: YEH:

Agency Name: Site Name:

February 2010

Sun Mon Tue Wed Thu Fri Sat 1 2 3 4 5 6

Hours Open: Hours Open: Hours Open: Hours Open: Hours Open: Hours Open: Program Hours: Program Hours: Program Hours: Program Hours: Program Hours: Program Hours: Projected YAH: Projected YAH: Projected YAH: Projected YAH: Projected YAH: Projected YAH:

7 8 9 10 11 12 13Hours Open: Hours Open: Hours Open: Hours Open: Hours Open: Hours Open: Hours Open: Program Hours: Program Hours: Program Hours: Program Hours: Program Hours: Program Hours: Program Hours: Projected YAH: Projected YAH: Projected YAH: Projected YAH: Projected YAH: Projected YAH: Projected YAH:

14 15 16 17 18 19 20Hours Open: Hours Open: Hours Open: Hours Open: Hours Open: Hours Open: Hours Open: Program Hours: Program Hours: Program Hours: Program Hours: Program Hours: Program Hours: Program Hours: Projected YAH: Projected YAH: Projected YAH: Projected YAH: Projected YAH: Projected YAH: Projected YAH:

21 22 23 24 25 26 27Hours Open: Hours Open: Hours Open: Hours Open: Hours Open: Hours Open: Hours Open: Program Hours: Program Hours: Program Hours: Program Hours: Program Hours: Program Hours: Program Hours: Projected YAH: Projected YAH: Projected YAH: Projected YAH: Projected YAH: Projected YAH: Projected YAH:

28 Hours Open: Program Hours: Projected YAH:

MONTHLY TOTALS: DAYS OPEN: HOURS OPEN: YAH: YEH:

Agency Name: Site Name:

March 2010

Sun Mon Tue Wed Thu Fri Sat 1 2 3 4 5 6

Hours Open: Hours Open: Hours Open: Hours Open: Hours Open: Hours Open: Program Hours: Program Hours: Program Hours: Program Hours: Program Hours: Program Hours: Projected YAH: Projected YAH: Projected YAH: Projected YAH: Projected YAH: Projected YAH:

7 8 9 10 11 12 13Hours Open: Hours Open: Hours Open: Hours Open: Hours Open: Hours Open: Hours Open: Program Hours: Program Hours: Program Hours: Program Hours: Program Hours: Program Hours: Program Hours: Projected YAH: Projected YAH: Projected YAH: Projected YAH: Projected YAH: Projected YAH: Projected YAH:

14 15 16 17 18 19 20Hours Open: Hours Open: Hours Open: Hours Open: Hours Open: Hours Open: Hours Open: Program Hours: Program Hours: Program Hours: Program Hours: Program Hours: Program Hours: Program Hours: Projected YAH: Projected YAH: Projected YAH: Projected YAH: Projected YAH: Projected YAH: Projected YAH:

21 22 23 24 25 26 27Hours Open: Hours Open: Hours Open: Hours Open: Hours Open: Hours Open: Hours Open: Program Hours: Program Hours: Program Hours: Program Hours: Program Hours: Program Hours: Program Hours: Projected YAH: Projected YAH: Projected YAH: Projected YAH: Projected YAH: Projected YAH: Projected YAH:

28 29 30 31 Hours Open: Hours Open: Hours Open: Hours Open: Program Hours: Program Hours: Program Hours: Program Hours: Projected YAH: Projected YAH: Projected YAH: Projected YAH:

MONTHLY TOTALS: DAYS OPEN: HOURS OPEN: YAH: YEH:

Agency Name: Site Name:

April 2010

Sun Mon Tue Wed Thu Fri Sat 1 2 3

Hours Open: Hours Open: Hours Open: Program Hours: Program Hours: Program Hours: Projected YAH: Projected YAH: Projected YAH:

4 5 6 7 8 9 10Hours Open: Hours Open: Hours Open: Hours Open: Hours Open: Hours Open: Hours Open: Program Hours: Program Hours: Program Hours: Program Hours: Program Hours: Program Hours: Program Hours: Projected YAH: Projected YAH: Projected YAH: Projected YAH: Projected YAH: Projected YAH: Projected YAH:

11 12 13 14 15 16 17Hours Open: Hours Open: Hours Open: Hours Open: Hours Open: Hours Open: Hours Open: Program Hours: Program Hours: Program Hours: Program Hours: Program Hours: Program Hours: Program Hours: Projected YAH: Projected YAH: Projected YAH: Projected YAH: Projected YAH: Projected YAH: Projected YAH:

18 19 20 21 22 23 24Hours Open: Hours Open: Hours Open: Hours Open: Hours Open: Hours Open: Hours Open: Program Hours: Program Hours: Program Hours: Program Hours: Program Hours: Program Hours: Program Hours: Projected YAH: Projected YAH: Projected YAH: Projected YAH: Projected YAH: Projected YAH: Projected YAH:

25 26 27 28 29 30 Hours Open: Hours Open: Hours Open: Hours Open: Hours Open: Hours Open: Program Hours: Program Hours: Program Hours: Program Hours: Program Hours: Program Hours: Projected YAH: Projected YAH: Projected YAH: Projected YAH: Projected YAH: Projected YAH:

MONTHLY TOTALS: DAYS OPEN: HOURS OPEN: YAH: YEH:

Agency Name: Site Name:

May 2010

Sun Mon Tue Wed Thu Fri Sat 1

Hours Open: Program Hours: Projected YAH:

2 3 4 5 6 7 8Hours Open: Hours Open: Hours Open: Hours Open: Hours Open: Hours Open: Hours Open: Program Hours: Program Hours: Program Hours: Program Hours: Program Hours: Program Hours: Program Hours: Projected YAH: Projected YAH: Projected YAH: Projected YAH: Projected YAH: Projected YAH: Projected YAH:

9 10 11 12 13 14 15Hours Open: Hours Open: Hours Open: Hours Open: Hours Open: Hours Open: Hours Open: Program Hours: Program Hours: Program Hours: Program Hours: Program Hours: Program Hours: Program Hours: Projected YAH: Projected YAH: Projected YAH: Projected YAH: Projected YAH: Projected YAH: Projected YAH:

16 17 18 19 20 21 22Hours Open: Hours Open: Hours Open: Hours Open: Hours Open: Hours Open: Hours Open: Program Hours: Program Hours: Program Hours: Program Hours: Program Hours: Program Hours: Program Hours: Projected YAH: Projected YAH: Projected YAH: Projected YAH: Projected YAH: Projected YAH: Projected YAH:

23 24 25 26 27 28 29Hours Open: Hours Open: Hours Open: Hours Open: Hours Open: Hours Open: Hours Open: Program Hours: Program Hours: Program Hours: Program Hours: Program Hours: Program Hours: Program Hours: Projected YAH: Projected YAH: Projected YAH: Projected YAH: Projected YAH: Projected YAH: Projected YAH:

30 31 Hours Open: Hours Open: Program Hours: Program Hours: Projected YAH: Projected YAH:

MONTHLY TOTALS: DAYS OPEN: HOURS OPEN: YAH: YEH:

Agency Name: Site Name:

June 2010

Sun Mon Tue Wed Thu Fri Sat 1 2 3 4 5

Hours Open: Hours Open: Hours Open: Hours Open: Hours Open: Program Hours: Program Hours: Program Hours: Program Hours: Program Hours: Projected YAH: Projected YAH: Projected YAH: Projected YAH: Projected YAH:

6 7 8 9 10 11 12Hours Open: Hours Open: Hours Open: Hours Open: Hours Open: Hours Open: Hours Open: Program Hours: Program Hours: Program Hours: Program Hours: Program Hours: Program Hours: Program Hours: Projected YAH: Projected YAH: Projected YAH: Projected YAH: Projected YAH: Projected YAH: Projected YAH:

13 14 15 16 17 18 19Hours Open: Hours Open: Hours Open: Hours Open: Hours Open: Hours Open: Hours Open: Program Hours: Program Hours: Program Hours: Program Hours: Program Hours: Program Hours: Program Hours: Projected YAH: Projected YAH: Projected YAH: Projected YAH: Projected YAH: Projected YAH: Projected YAH:

20 21 22 23 24 25 26Hours Open: Hours Open: Hours Open: Hours Open: Hours Open: Hours Open: Hours Open: Program Hours: Program Hours: Program Hours: Program Hours: Program Hours: Program Hours: Program Hours: Projected YAH: Projected YAH: Projected YAH: Projected YAH: Projected YAH: Projected YAH: Projected YAH:

27 28 29 30 Hours Open: Hours Open: Hours Open: Hours Open: Program Hours: Program Hours: Program Hours: Program Hours: Projected YAH: Projected YAH: Projected YAH: Projected YAH:

MONTHLY TOTALS: DAYS OPEN: HOURS OPEN: YAH: YEH:

APPENDIX 5 Youth Attendance Plan Cover Page

Agency Name: Site Name Site

Projected Average Daily Attendance

Site Projected Day Open

Site Projected Hours Open

Site Projected Youth Attendance Hours

Site Projected Youth Employment Hours

Agency Projected Totals

A. Agency Projected Youth Attendance Hours:

B. Agency Projected Youth Employment Hours:

C. Add A and B above to arrive at the Agency Total YAH: Funding Formula:

X $4.50 = (Agency Total YAH) (Maximum Grant Request)

APPENDIX 6

APPLICATION AND PLAN FOR HUMAN SERVICES PROGRAM

COVER PAGE

APPENDIX 6 APPLICATION AND PLAN FOR HUMAN SERVICES PROGRAM

ILLINOIS DEPARTMENT OF HUMAN SERVICES

535 WEST JEFFERSON STREET SPRINGFIELD, ILLINOIS 62702

Division of Community Health and Prevention

4. PROJECT PERIOD: 5. TYPE OF ORGANIZATION: ____ Governmental Entity ____ *Not-For-Profit Corporation ____ Corporation ____ Medical/Health Care Provider Corporation ____*Tax Exempt Organization (IRC 501(a) only) * Must provide documentation of current status 6. LEGISLATIVE DISTRICT: CONGRESSIONAL: ____________________ LEGISLATIVE: ________________________ (State Senate District) REPRESENTATIVE ____________________ (State Representative District) IMPORTANT NOTICE:

1. APPLICANT ORGANIZATION: NAME: ________________________________ ADDRESS: _____________________________

______________________________________

TELEPHONE:( )________________________ E-MAIL: ________________________________ TIN/FEIN-NUMBER: ______________________ *Attach IRS Form 575K or Form W-9, when applicable 2. DATE OF SUBMISSION: _________________________________________Month Day Year 3.APPLICANT CERTIFICATION:

To the best of my knowledge, the data and statements in this application are true and correct. The applicant agrees to comply with all State/Federal statutes and Rules/Regulations applicable to the program.

AUTHORIZED OFFICIAL: Typed name _______________________________ Title ____________________________________ _____________________________________ Signature Date

APPENDIX 6 INSTRUCTIONS FOR COMPLETING

"APPLICATION AND PLAN FOR HUMAN SERVICES PROGRAM" All applications shall be submitted as required in the Request for Proposal or other instructions distributed by DHS. 1. Provide applicant name and address as it is to appear in the contracts for services that will be developed

for successful applicants.

TIN number: Provide the applicant’s nine-digit federal Taxpayer Identification Number (also known as the Federal Employer Identification Number, FEIN) or the state assigned Governmental Unit Code. Governmental agencies (county or municipality) should use the Governmental Unit Code, which generally begins with 20 or 30; non-governmental agencies or multi-county agencies should use the FEIN, which generally begins with 36 or 37.

Applicants not currently receiving funding from the Division of Community Health and Prevention should attach a copy of the applicant’s Internal Revenue Service (IRS) Form 575K, Notice of New Employee Identification Number Assigned, or an IRS Form W-9 in which the applicant’s name and TIN number is consistent with the information on record with the Secretary of State and the IRS.

2. Enter the date the application is forwarded to the Department. 3. Provide the name and title of the person authorized to enter into contracts or otherwise obligate the agency

to provide services. This information will be used for the signature block for contracts offered to successful applicants.

Signature of "Authorized Official" certifies compliance with all requirements as described in the Request for Proposal, applicable program Rules and Regulations and applicable state and federal Rules and Regulations.

4. Enter the project period to be covered by this application, if different than that indicated. 5. Mark (X) to indicate the type of organization. Documentation of current status such as a Certificate of

Good Standing from the Secretary of State or other comparable proof of status must be provided for all applicants other than Governmental Entities.

6. Provide the appropriate district numbers for the area(s) to be served.

APPENDIX 7

SPENDING PLAN FORMS AND INSTRUCTIONS

APPENDIX 7 INSTRUCTIONS FOR COMPLETING THE PROGRAM SPENDING PLAN a. Complete the Spending Plan summary page; this page should show the total cost from all sources of

providing the product or service; this total is then allocated to "Applicant and Other" fund sources and the amount “Awarded from IDHS.” The lower part of this page will identify the source and amounts of the funds shown in the "Applicant and Other" column above; this amount is further broken down to required "match or cost participation" and "Other".

b. Personal Services - instructions are printed on the back of the page. Please pay close attention to the

formula for calculating the Personal Services amount for each position. The proper procedure for calculating this amount is:

1. Multiply the monthly salary in column (2) times the number of months this position will work on this product/service. The number of months as shown in column (3)

2. Then multiply this amount times the percent of time this position spends on this product/service. The percent of time this position spends on this product/service as shown in column (4).

3. The result of this calculation will provide the total Spending Plan amount applicable to this product/service. This total is then allocated among funds from this grant (Amount Assistance Awarded from IDHS) and all other fund sources (Grantee and Other). Insert proper codes to identify source(s) of other funds.

Fringe Benefits - a total percentage rate is acceptable for this Spending Plan process; however, actual individual expenditure amounts must be reported when requesting reimbursement from the Department. It is desirable to indicate the items and applicable rates that are included in the applicant’s fringe benefits claim.

c. Contractual services - itemize and be as specific as possible. All Personal service contracts and sub-grants

must be identified and explained. Registration fees, repairs and maintenance costs are shown here. d. Supplies - itemize and be as specific as possible. Show all printing and paper costs in this line. e. Travel - Indicate mileage rates for used by the agency; show estimated cost for mileage, lodging, etc. as

indicated. f. Equipment - itemize and be as specific as possible. All equipment purchases require approval either

approval through this program Spending Plan and approval process or specific approval during the award period. Equipment purchases should be completed during the early months of the award period.

Spending Plan justification - as instructed, provide additional information or justification for specific items listed in the detailed Spending Plan for which the need is not self-evident. Personal Services contracts and all sub-grants are to be explained and justified in this section.

APPLICATION AND PLAN FOR HUMAN SERVICES PROGRAM FY2010

SPENDING PLAN, Summary

APPLICANT AGENCY: Tin #:

PROGRAM: FOR THE PERIOD:

THROUGH:

SPENDING PLAN SUMMARY SOURCES OF FUNDS IDHS Components (specify) LINE ITEM (Category)

Total for the Program

Applicant and Other

Requested from IDHS

Administrative Cost Direct Service Cost

Personal Services

Contractual Services

Supplies

Travel

Equipment

TOTAL, Direct Costs

SOURCES OF FUNDS - Applicant and Other Sources Required Match Other Support Total

TOTAL, Applicant and Other Sources

USE ADDITIONAL SHEETS IF NECESSARY Spending Plan, Page 1

INSTRUCTION TO APPLICANT SPENDING PLAN SUMMARY

GENERAL SPENDING PLAN INFORMATION The Spending Plan for this proposal is to reflect the total cost of the project from all sources. The Spending Plan Summary provides a one-page compilation of these costs. Individual line items are to be itemized in detail on the following pages. Additional information and justification are to be shown on the Spending Plan Justification page(s). The Spending Plan must comply with the allowable costs for the program, the applicable Administrative Rules and Regulations, the laws of the State of Illinois and any applicable federal guidelines or requirements. All amounts are to be expressed in whole dollars; each line item is to be rounded to the nearest one hundred-dollar amount. If additional pages are required, please note applicant agency name and program name on each additional page and number all additional pages as appropriate using the following sequence: Page 1a, Page 1b, Page 2a, Page 2b, and so on. Applications are disassembled and copied by the Department and these page number references will assist reassembly and help to ensure all copies are complete. SPENDING PLAN SUMMARY Enter the totals from each detail line-item section and sum these amounts to show the TOTAL, Direct Costs for the program. SOURCES OF FUNDS columns: The total estimated cost for each line item of the program is to be broken out by funds to be provided from sources other than this RFP (Applicant and Other) and by the amount requested in this proposal (Requested from IDHS). IDHS Components (specify): The amount requested in this proposal (Requested from IDHS) is to be further broken out by program component(s) as instructed in the Program Description section of the RFP. SOURCES OF FUNDS - Applicant and Other

Identify the source and amount of all funds shown in the Applicant and Other column of the Spending Plan Summary. Enter the amounts proposed to meet the program's matching or cost participation requirements, if any, in the Required Match column; enter all other program support costs in the Other Support column. The total of the Required Match and Other Support columns must equal the total of the Applicant and Other column of the Spending Plan Summary. Examples of Applicant and Other fund sources include Applicant funds such as tax revenues; fees or other program income; donations; other corporate funds; and other program support such as other state and or federal grant awards (i.e. WIC, Title X, Title XIX, and Title XX) both from the IDHS and from other agencies.)

ILLINOIS DEPARTMENT OF HUMAN SERVICES APPLICATION AND PLAN FOR HUMAN SERVICES PROGRAM

SPENDING PLAN SECTION, Personal Services

APPLICANT AGENCY: Tin #:

PROGRAM: FOR THE PERIOD: THROUGH:

PERSONAL SERVICES (Position title and Name of Incumbent)

Monthly Salary

Number of Months Spending Planed

Percent of time on Program

Total for the Program

Sources of Funds IDHS Components (specify)

Applicant and Other

Requested from IDHS

Administrative Cost

Direct Service Cost

PERSONAL SERVICES, Subtotal

FRINGE BENEFITS (Rate: %) Components and rates must be itemized in Spending Plan justification section.

PERSONAL SERVICES AND FRINGE TOTAL

USE ADDITIONAL SHEETS IF NECESSARY Spending Plan, Page 2

INSTRUCTIONS TO APPLICANT PERSONAL SERVICES SPENDING PLAN

PERSONAL SERVICES Enter the position title and name of the current incumbent; if the position is new or currently not filled, enter "Vacant".

Example: Nurse - Mary Jones Sally Smith Vacant

Program Coordinator - Joyce Johnson Vacant Enter the monthly salary for each position that will be filled for all or any part of the period. Enter the number of months the position will be filled by an incumbent working on the program. Enter the percent of time the incumbent will devote to the program during the months shown. Enter the total amount of support to be provided for the program, as computed from the information shown, using the following formula: [Monthly Salary] times [Number of Months Spending Planned] times [Percent of time on Program] = [Total for the Program]. The Total for the Program is then broken out by the amount to be provided from sources other than this application (Applicant and Other) and the amount requested as part of this proposal (Requested from IDHS). The amount Requested from IDHS is further broken out by the various program components (IDHS Components) if the Program Description section of the RFP requests that program components be identified separately. FRINGE BENEFITS The components included in the applicant agency's fringe benefit rate are to be itemized (listed by component and rate) in the Spending Plan Justification section. The total fringe benefits rate is entered on the Fringe Benefits line; this rate is then applied to the Personal Services, Subtotal shown as Total for the Program. If the applicant agency includes fringe benefits in the amount Requested from IDHS and the various IDHS Components, the amounts for fringe benefits may not exceed the fringe benefits rate times the Personal Services, Subtotal for those columns.

ILLINOIS DEPARTMENT OF HUMAN SERVICES APPLICATION AND PLAN FOR HUMAN SERVICES PROGRAM

SPENDING PLAN, Contractual Services

APPLICANT AGENCY: Tin #:

PROGRAM: FOR THE PERIOD: THROUGH:

CONTRACTUAL SERVICES (Itemize) SOURCES OF FUNDS IDHS Components (specify)

Total for the Program

Applicant and Other

Requested from IDHS

Administrative Cost Direct Service Cost

TOTAL, Contractual Services

USE ADDITIONAL SHEETS IF NECESSARY Spending Plan, Page 3

INSTRUCTIONS TO APPLICANT

CONTRACTUAL SERVICES SPENDING PLAN

CONTRACTUAL SERVICES List the costs directly attributable the program estimated to be incurred during the period covered by this application. Examples of Contractual Services include conference registration fees; repair and maintenance of furniture and equipment; postage; UPS or other carrier costs; software; subscriptions; training and education costs; and telecommunications costs. See also the Allowable Costs section of the Spending Plan. Payments (or pass-through) to subcontractors or subgrantees are to be listed here. All subcontracts or subgrants require an attached detailed line-item Spending Plan supporting this contractual amount. The Department must approve, in writing, all subcontracts or subgrants.

ILLINOIS DEPARTMENT OF HUMAN SERVICES APPLICATION AND PLAN FOR HUMAN SERVICES PROGRAM

SPENDING PLAN, Supplies and Travel

APPLICANT AGENCY: Tin #:

PROGRAM: FOR THE PERIOD: THROUGH:

SUPPLIES (Itemize) SOURCES OF FUNDS IDHS Components (specify)

Total for the Program

Applicant and Other

Requested from IDHS

Administrative Cost Direct Service Cost

TOTAL, Supplies

TRAVEL (Itemize) SOURCES OF FUNDS IDHS Components (specify)

Total for the Program

Applicant and Other

Requested from IDHS

Administrative Cost Direct Service Cost

Mileage

(Rate per mile:

$ )

Lodging Meals/PerDiem Commercial Transportation Other: TOTAL, Travel

USE ADDITIONAL SHEETS IF NECESSARY Spending Plan, Page 4

INSTRUCTIONS TO APPLICANT SUPPLIES AND TRAVEL SPENDING PLAN

SUPPLIES

List the costs, directly attributable to the program, estimated to be incurred during the period covered by this proposal. Examples of Supplies include office supplies; medical supplies (consumable items such as syringes, tape and gauze, other than drugs); educational and instructional materials; cleaning supplies; copy paper and other paper supplies; and letterpress, offset printing, and other printing services. See also the Allowable Costs section of the Spending Plan. TRAVEL List the costs, directly attributable to the program, of applicant agency's employees' transportation, mileage, per diem, meals, etc. necessary for carrying out the activities described in the proposal. Unless specifically stated in the Spending Plan, the mileage rate will be assumed to be the same as that authorized for state employees by the Governor's Travel Control Board. See also the Allowable Costs section of the Spending Plan. Travel costs for contractual consultants are to be included in the Contractual Services line.

ILLINOIS DEPARTMENT OF HUMAN SERVICES APPLICATION AND PLAN FOR HUMAN SERVICES PROGRAM

SPENDING PLAN, Equipment

APPLICANT AGENCY: Tin #:

PROGRAM: FOR THE PERIOD: THROUGH:

EQUIPMENT (Itemize) SOURCES OF FUNDS IDHS Components (specify)

Total for the Program

Applicant and Other

Requested from IDHS

Administrative Cost Direct Service Cost

TOTAL, Equipment

USE ADDITIONAL SHEETS IF NECESSARY Spending Plan, Page 5

INSTRUCTIONS TO APPLICANT EQUIPMENT

EQUIPMENT List those items costing over $100.00 each, with a useful life of more than one year, that are required for the successful completion of the activities described in the application. Equipment costs shall include all freight and installation charges. Equipment may include office furniture and equipment, such as desks, chairs, computers, printers and calculators; training materials; reference books; and films. All Equipment purchases must be either approved by the Department, through this Spending Plan or via specific request for items not included in the Spending Plan as submitted. See also the Allowable Costs section of the Spending Plan.

ILLINOIS DEPARTMENT OF HUMAN SERVICES APPLICATION AND PLAN FOR HUMAN SERVICES PROGRAM

SPENDING PLAN BENEFITS JUSTIFICATION

APPLICANT AGENCY: Tin #:

PROGRAM: FOR THE PERIOD: THROUGH: Show justification for specific items listed in the detailed Spending Plan for which the need is not self-evident. Justifications should clearly indicate the items being requested are essential to the achievement of the state program objectives. Fringe Benefits -

FICA (Social Security) %

Pension/Retirement %

Group Health Insurance %

Group Life Insurance %

Unemployment Insurance %

Workmen's Compensation %

Other:

%

%

%

%

TOTAL, Fringe Benefits Rate %

Other Spending Plan Justification -

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APPENDIX 8

ALLOWABLE COSTS

-38-

APPENDIX 8 ALLOWABLE COSTS FOR REIMBURSEMENT

UNDER GRANT AGREEMENT To be reimbursable under DHS/CHP Grant Agreement, expenditures must meet the following general criteria:

a. Be necessary and reasonable for proper and efficient administration of the program and not be a general expense

required to carry out the overall responsibilities of the agency. b. Be authorized or not prohibited under federal, state or local laws or regulations. c. Conform to any limitations or exclusions set forth in the applicable rules, program description or grant agreement. d. Be accorded consistent treatment through application of generally accepted accounting principles appropriate to the

circumstances. e. Not be allocable to or included as a cost of any other state or federally financed program in either the current or a prior

period. f. Be net of all applicable credits. g. Be specifically identified with the provision of a direct service or program activity. h. Be an actual expenditure of funds in support of program activities, documented by check number and/or internal

ledger transfer of funds. Examples of allowable costs include the following. This is not meant to be a complete list, but rather specific examples of items within each line item category. Personal Services:

Gross salary paid to agency employees directly involved in the provision of program services. Employer's portion of fringe benefits actually paid on behalf of direct services employees; examples include FICA (Social Security), life/health insurance, workers compensation insurance, unemployment insurance and pension/retirement benefits.

Contractual Services:

Conference registration fees Contractual employees (require prior program approval) Repair & maintenance of furniture and equipment

Postage, postal services, UPS or other carrier costs Software for support of program objectives Subscriptions Training and education costs

Payments (or pass-through) to subcontractors or subgrantees are to be shown in the Contractual Services section - all subcontracts or subgrants require an attached detailed line-item Spending Plan supporting this contractual amount.

Allocation of the applicable portion of the following costs are allowable only if approved by the program and the allocation methodology is approved as part of the application process:

Rent or lease of space or facilities Utility costs

Insurance Copy machine rental or lease Costs of improvements to real property

-39-

ALLOWABLE COSTS FOR REIMBURSEMENT UNDER GRANT AGREEMENT

Allowable Costs

Travel:

Mileage (at state rate unless specifically noted otherwise) Airline or rail transportation expense Lodging Per diem or meal costs Operation costs of agency owned vehicles Commodities (Supplies):

Office supplies Medical supplies

Educational and instructional materials and supplies, including booklets and preprinted pamphlets Household, laundry and cleaning supplies Parts for furniture and office equipment Equipment items costing less than $100.00 each Printing (include in Supplies): Letterpress, offset printing, binding, lithographing services Photocopy paper, other paper supplies Envelopes, letterhead, etc. Equipment (requires prior written program approval when items are over $1,000):

Equipment is defined as items costing over $100.00 each, with useful life of more than one year. Costs shall include all freight and installation charges.

Office equipment and furniture Allowable medical equipment Reference and training materials and exhibits Books and films Telecommunications (include in Contractual Services): Telephone services Answering services

Repair, parts and maintenance of telephones and other communication equipment Unallowable costs include, but are not limited to: Bad debts Contingencies or provision for unforeseen events Contributions and donations Entertainment, alcoholic beverages, gratuities Fines and penalties Interest and financial costs Legislative and lobbying expenses Real property payments or purchases Indirect cost plan allocations

-40-

APPENDIX 9

PROPOSAL CHECKLIST

-41-

APPENDIX 9 PROPOSAL CONTENT CHECKLIST

The following is a detailed listing of what constitutes an acceptable response (application) to the RFP. PROGRAMMING OPTION

The appropriate programming option is clearly identified in the Executive Summary. Yes No

� Teen REACH � Teen REACH – Statewide

� Teen REACH Focus – World View � Teen REACH Focus – Gender-Specific � Teen REACH Focus – Music/Entrepreneurship

FUNDING PRIORITIES

Eligible to receive additional points based on the Part II, Section C “RFP Funding Priorities” Yes No DHS Funded Teen REACH provider (last 4 fiscal years) Yes No Department Initiatives (Letter of collaboration included for Safety Net Works or Team Illinois.) Yes No

GRANT AMOUNT

Requested Grant amount is less than or equal to the Funding Formula calculation AND is within the minimum/maximum grant award range identified in Part I, Section I “Award Process”. Yes No

REQUIREMENTS

The proposal reflects that 85% or more services are to be provided to youth 11-17. Yes No

The proposal and Spending Plan indicate 5% of the grant to be utilized to provide paid youth employment to Teen REACH youth 16 and older. Yes No

The proposal and the Youth Attendance Plan demonstrate a plan to provide services a minimum 240 days and 720 hours per site per year. Yes No

APPLICATION PACKAGE

The following items must be included, in the order below:

1. Application and Plan for Human Services Program – Cover Page

2. This Completed “Proposal Content Checklist”

3. Cover Letter – OPTIONAL and NOT considered when scoring

4. Proposal Narrative Content

a) Executive Summary (2 page max)

b) Applicant Qualifications/Organizational Capacity

c) Needs Statement

d) Description of Program/Services

e) Time Line (1 page max)

-42-

PROPOSAL CONTENT CHECKLIST CONTINUED

f) Evaluation (1 page max)

g) Spending Plan (Narrative - 2 page max)

5. Proposal Attachments (attachments follow the narrative and are not intermingled within the narrative.)

a) Attachment A1 – Organizational Chart

b) Attachment A2 – Coordinator Resume/Job Description

c) Attachment A3 – Job Descriptions (Grant Funded)

d) Attachment A4 – Programming Space – Linkage Agreements/Documents

e) Attachment A5 – Community Advisory Council Membership List

f) Attachment A6 – Linkage Agreements – Schools, Employment etc

g) Attachment A7 – Site Information Forms

h) Attachment B1 – Assessments/Survey Tools etc.

i) Attachment C1 – Site Activity Calendars

j) Attachment C2 – Youth Attendance Plan (Cover, Forms & Narrative)

k) Attachment D1 – Spending Plan Forms

APPLICATION FORMAT

Narrative is 12 point font, single spaced, one-sided, white paper

Narrative (item 4 this document) does not exceed 20 pages and follows page

limits where prescribed, excluding the application cover page, checklist,

attachments, assurances, and spending plan forms

Attachments are appropriately labeled and ordered based on section 5 this document.

Cover Page (item 1 this document) is signed by authorized official

Complete package includes one clearly identified original application and 5 complete copies.