R EGION I W ORKFORCE I NVESTMENT B OARD

200 NEW RIVER TOWN CENTER BECKLEY, WV 25801

Request for Proposals For Comprehensive Youth Services

July 1, 2011

As required by State and Federal Laws and Regulations, the Region 1 WORKFORCE West Virginia Career Center system does not discriminate on the basis of sex, race, color, religion, handicap condition, marital status, or national origin in employment or in its educational programs and activities. Auxiliary aids and services are available upon request to individuals with disabilities. Alternative formats will be made available upon request.

TABLE OF CONTENTS I. II. III. IV. V. VI. VII. VIII. IX. X. XI. XII. XIII. XIV. XV. XVI.
RFP Schedule General Information and Background Purpose Available Resources Requested Services Participant Eligibility Requirements Youth Service Provider (Bidder) Guidelines Collaboration Guidelines Performance Goals Statement of Work Bidder’s Conference Proposal Submission, Deadline and Format Who Can Submit a Proposal Required Documentation Renewal Evaluation of Proposals Pg. 1 Pg. 2 Pg. 3 Pg. 4 Pg. 4 Pg. 6 Pg. 7 Pg. 7 Pg. 8 Pg. 8 Pg. 11 Pg. 11 Pg. 11 Pg. 12 Pg. 12 Pg. 12 Pg. 13 Pg. 14 Pg. 14 Pg. 16

XVII. Evaluation of Criteria XVIII. Disclosures XIX. XX.
Contract Award Transition Plan

Attachments:

1. Proposal Transmittal Document 2. Proposal Package Inventory List 3. Checklist for Service Providers 4. Certification Regarding Lobbying 5. Certification Regarding Debarment, Suspension, etc. 6. Equal Opportunity Non-Discrimination Notice 7. Certification Regarding Drug-Free Workplace 8. Youth Program Budget & Narrative Instruction 9. Self Evaluation 504 Checklist

Pg. 17 Pg. 18 Pg. 19 Pg. 23 Pg. 24 Pg. 25 Pg. 26 Pg. 27 Pg. 28

I. The Region 1 Workforce Investment Board (R1WIB) is issuing a Request for Proposal (RFP) to solicit agencies/organizations with the capacity and expertise to administer and operate the Workforce Investment Act In-School and Out-of-School Youth programs in the 11-county region. The expected term for contracts awarded under this solicitation will be from September 1, 2011 and extending through June 30, 2012. The R1WIB reserves the right to renew the contract for an additional one year period beyond June 30, 2012.

RFP Schedule

Date

Time

RFP Available

July 1, 2011

8:30 AM

Bidder’s Conference

July 15, 2011

2:00 PM

Proposal Due

August 5, 2011

4:00 PM

Announcement of Awards

August 12, 2011

4:00 PM

Contract Negotiations

August 19, 2011

10:00 AM

Transitional Meeting

August 24, 2011

10:00 AM

Program Startup

September 1, 2011

Region 1 Youth Council

Vision Statement
The Region 1 Youth Council provides opportunities and guidance through coordinated efforts to empower youth to become skilled, selfsufficient members of their communities.
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II. A.

General Information and Background
Region 1 Workforce Investment Board

The Region 1 Workforce Investment Board (R1WIB) is a non-profit organization designated as an administrative entity of Workforce Investment Act (WIA) funds for the eleven (11) county region encompassing the West Virginia counties of Fayette, Greenbrier, Mercer, McDowell, Monroe, Raleigh, Nicholas, Pocahontas, Summers, Webster, and Wyoming. This Request for Proposal (RFP) is issued to solicit proposals for innovative workforce development programs serving In-School and Out-of-School youth under the provisions of the Workforce Investment Act. Targeted populations include youth between the ages of 14-21, are low income, and who have one or more barriers to employment as defined by the Workforce Investment Act and also listed in Section VI Participants Eligibility of this RFP. Funds awarded must be utilized to serve Region 1 Workforce Investment Act eligible youth at a ratio of 30% In-School and 70% Out-of -School Youth. All In-School and Out-of -School proposals must include one or more of the following key program components as described in Section V Requested Services of this RFP: a) Character Building b) Skill Enhancement c) Employability Bidders may submit proposals designed for one or more program components; however, a separate program proposal is required for the In-School and Out-of -School population. Note: Once a Bidder selects the program component(s) they wish to administer they must submit both an In-School and Out-of -School proposal for review. If a proposal consists of more than one of the key components then a separate budget for each component must be submitted. (Budgets cannot be combined). B. Legislation

A portion of R1WIB’s programs are funded through the Workforce Investment Act (WIA). Therefore, each Bidder must be familiar with state and federal requirements of this program and the R1WIB’s strategic plan. Specific information can be found in the Workforce Investment Act, Section 129(c) and 20 CFR Part 664. C. Information Resources

Internet web addresses for additional workforce development resource information:
Region 1 Workforce Investment Board WorkForce West Virginia US Department of Labor, Employment & Training Federal Laws and Regulations US Workforce www.region1workforcewestvirginia.org www.wvcommerce.org/business/workforcewv/default.aspx http://www.doleta.gov http://thomas.loc.gov http://usworkforce.org

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III.

Purpose

The mission of the Region 1 Workforce Investment Board (R1WIB) Youth Council is to encourage the development of comprehensive programs that are fully transparent and accountable with services that will ensure Region 1 youth have the necessary skills and personal qualities to become successful productive adults. The basic principles of the Workforce Investment Act are:
• • • • • • •

Move from one-time, short-term intervention to a consolidated, long-term approach. Ensure non-duplication of services. Provide a broad array of youth services. Design a comprehensive youth plan and system. Include strong business involvement. Align training with needs of the job market. Ensure performance accountability.

All proposals should emphasize a youth development perspective designed to meet the human development needs of youth and to build a set of core assets and competencies needed to participate successfully in adolescent and adult life. The youth service provider will be required to track customer progress throughout enrollment and will assume all follow-up responsibilities for youth carried in from the previous service provider. All proposals must include comprehensive counseling and follow-up for at least 12 months after the youth exits the program or whenever the program ends; whichever comes first. Proposals must include explicit plans for follow-up procedures and estimated budget reserve to provide follow-up services. The intent of the Workforce Investment Act legislation is to move away from one-time, shortterm interventions for youth and move towards a longer term, systematic set of service strategies that establishes close link to the labor market and occupational demands. The youth program provider is expected to develop a strong relationship with executive and legislative officials, business leaders, and economic development and educational representatives. This collaboration should expand, strengthen and align relationships and resources between workforce development organizations, economic development agencies, and education representatives. The youth program provider must ensure that any applicants who meet the WIA eligibility enrollment requirements, but cannot be served through the youth program, are referred for additional assessment and/or other services through WORKFORCE West Virginia Career Center partners. All youth service proposals must be designed around the 10 key elements outlined within Section V Requested Services of this RFP and are required to meet specific performance measures outlined in Section IX Performance Goals/Common Measures of this RFP. Successful proposals will not create or duplicate services that already exist and are easily accessible in Region 1. The youth service provider is encouraged to seek funding from a variety of sources beyond just Workforce Investment Act (WIA)-based resources and create incentives for businesses to share cost and resources with the public sector training programs, once again focusing resources on proven success.

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The youth service provider will be required to maintain and monitor the confidentiality of all youth records and will also be required to provide documentation that worksites comply with local, state, and federal child labor laws. The youth service provider must document that it has made on-site visits to ensure compliance and to ensure the safety of all youth participants. IV. Available Resources

The estimated funds* available for all of Region 1 for the period September 1, 2011 through June 30, 2012 for Out-of-School Youth total is up to $ 500,000 for all 11 counties within the region. Proposal must include a detailed budget for each component. The estimated funds* available for all of Region 1 for the period of September 1, 2011 through June 30, 2012 for In-School Youth total up to $_500,000 for all 11 counties within the region. Proposal must include a detailed budget for each component. The youth service provider will be advanced 20% of the value of the award (to be used as start up funds and not to be maintained as a reserve). The youth service provider must submit projected cost documentation for the 20% advance. Actual cost documentation must be submitted for each draw inclusive of the 20% advance as well as the continued draw downs on an as-needed monthly basis. Draw downs may take up to 14 working days to process from time received at the Region 1 Workforce Investment Board office. When submitting your budget, please incorporate a copy of your individual approved cost rate. Indirect cost rates in excess of three percent (3%) must include detailed explanations which may result in contract modifications. (See Attachment 8) * Resources available are solely based on availability of funds because of the funds being awarded from a state/federal program, recessions and/or a change in overall budget may occur at any point throughout the contract period. Therefore, if funds are forthcoming through WIA for the 2011-2012 program year, only then will the grant be available. V. Requested Services

All of the Program Designs must include the following:

Recruitment: Service Provider will be responsible for recruiting at-risk youth into the Connections program who are in the targeted population. (See Section VI Participant Eligibility Requirements) Eligibility & Registration: Eligibility determination for WIA funded programs must be complete prior to enrollment/ registration. This encompasses collecting eligibility documentation including income used to determine WIA eligibility. R1WIB will provide technical assistance on this process. Orientation: All participants must receive information regarding services available through the One Stop partners and other providers. Assessment: An objective assessment must be done on each youth participant of his/her academic, employment skills, and supportive service needs; including a review of educational skill level, occupational skills, prior work experience, employability, interests, and aptitudes. 4

Follow Up: Service Providers will be responsible for twelve (12) months follow-up activities for each youth participant after exit. Participants are to be contacted at least once a month with proper documentation noted in each individual’s case notes file and the Service Provider is required to enter Case Management notes in the state approved MACC system.

Bidders must submit In-School and Out-of-School proposals which must include at least one of the 3 Key Components listed below or may include two or all three of the Key Components. However, all proposals submitted must include a separate budget for each of the Key Components included in the Bidders proposals. The 3 Key Components including their services are: A) Character Building
• • •

Mentoring Leadership Development Community Service Job Readiness Work Experience Job Shadowing Summer Employment Job Placement Skill Attainment/Certificate Tutoring Numeracy/Literacy GED Prep Post Secondary Education

B) Employability
• • • • •

C) Skill Enhancement
• • • • •

The 10 Elements required by the Workforce Investment Act must be made available to all youth participants; however, all youth do not need to take part in each of the elements. The 10 Required Elements are:
1.

Comprehensive guidance and counseling, which may include drug and alcohol abuse counseling and referrals. Tutoring, study skills, and instruction leading to completion of secondary school, including dropout prevention strategies. Alternative secondary school services. Summer employment opportunities directly linked to academic and occupational learning. Paid or unpaid work experiences including job shadowing and internships. Occupational skills training. 5

2.

3. 4.

5. 6.

7.

Leadership development opportunities, which may include community services and peercentered activities encouraging responsibility and other positive social behaviors during non-school hours. Supportive services may include transportation, childcare and needs-related payments that are necessary to participate in activities. Adult mentoring for the period of participation and subsequent period, for a total of not less than 12 months. Follow-up services for not less than 12 months after the completion of participation.

8.

9.

10.

VI.

Participant Eligibility Requirements*

In accordance with the Workforce Investment Act (sec. 101(13)), an eligible youth is defined as an individual who at the time of application is: 1. Age l4-21; and 2. Low income individual, as defined in the WIA section 101(25); and 3. With one or more of the following six serious barriers to employment: a. A school dropout b. Deficient in basic literacy skills as defined by WIA (at or below a grade level of 8.9) or who is unable to compute or solve problems, read, write or speak English at a level necessary to function on the job, in a family, or in society c. Pregnant or parenting d. Homeless, runaway or foster child e. An offender; or f. Individual (including a youth with a disability) who requires additional assistance to complete an education program, or to secure and hold employment. Those barriers as identified by the Region 1 Workforce Investment Board include the following:
• • •

Youth most at risk of dropping out of school. Youth at risk of court involvement. Youth of incarcerated parents.

4. A United States citizen or eligible non-citizen; and 5. Meets the Selective Service requirements. *WIA Re-Authorization Amendments Prevail

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VII.

Youth Service Provider (Bidder) Guidelines

A. Requirements for In-School Youth Service Providers

Bidder must have Memoranda of Understandings with the 11 local Boards of Education. [A letter of intent to receive a Memorandum of Understanding (MOU) from each local Board of Education will satisfy this requirement prior to grant award. Letters of Intent must be included in the proposal.] However, MOUs with Boards of Education will be expected to be received by the WIB office within the first 30 days of the start of the contract period. In addition to each MOU per county Board of Education a current letter of support from each local Board of Education is required. Bidder must limit the In-School participants to 30% of total youth served. In-School youth must be served by programs already available in their area with WIA services concentrating on summer and with after-school activities.

• •

B. Requirements for Youth Service Provider (Bidder)

Meet all administrative requirements including providing all required reports to the Region 1 WIB on a quarterly basis. Limit administrative costs to a maximum of 10% of award. 70% of program costs must go directly to participants. Execute an MOU with the comprehensive WORKFORCE Career Centers for Out of School youth to enter and be tracked within the system. Maintain at least one physical office in a Region 1 comprehensive WORKFORCE West Virginia Career Center during the contract period by September 1, 2011. All participant records must be kept in one central location within the Region. All services must demonstrate the ability to serve all Region 1 counties through coordinated resources, partnerships, and/or collaborative agreements. Evaluation of the total program will be an ongoing process. Although the youth service provider is responsible for the evaluation, a systematic means of communication must be established which allows the Region 1 Executive Director and/or a monitoring agency of the Region 1 Workforce Investment Board to monitor and observe, making recommendations, and commendations at any time during the grant period.

• • •

• •

VIII. Collaboration Guidelines No duties may be subcontracted with other agencies. The youth service provider must accept full responsibility for contract performance and monitoring. Again, it is important to state, where possible, the youth service provider should leverage other funds and/or resources with partnering organizations that eliminates duplication or resources and services.

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IX. A.

Performance Goals

Core/Common Measures Youth (Age 14-21)

All providers will be subject to capture the WIA Core Performance Measures Indicators as well as the Common Measures Performance Indicators and the negotiated standards will be financially tied to their contracts. While the negotiated performance standards for the 2011-2012 program year are still unknown at the time of this RFP, we will use the 2010-2011 negotiated standards until those are made known. They are as follows:

PY%* 62%

Youth Measures Placement in Employment or Education Attainment of a Degree or Certificate by Participants Literacy and Numeracy Gains

Definition Percentage of participants who are in employment, the military, post-secondary education, and/or advanced training/occupational training during 1st quarter after program exit. Percentage of participants who are in education who attained a diploma, GED or certificate by the end of the 3rd quarter after exit. Number of participants who increase one or more educational functioning levels within one year of the date of participation.

Exclusions 1) Youth in post-secondary education, employment or the military at date of participation. 1) Youth not enrolled in education at the date of participation or at any point during the program. 1) Out-of-School youth who are not basic skills deficient. 2) In-School youth.

56%

51%

*Note: Any participants institutionalized/incarcerated or relocated to a mandated residential program at exit, customers exited for health/medical reasons or deceased, and participants called up for active duty are excluded from all performance measures.

X.

Statement of Work

Bidder must clearly indicate whether the services outlined in this proposal are for either InSchool Youth or Out-of School Youth. The Statement of Work should sufficiently describe the proposed program in detail, including a demonstrated understanding of the challenges, the work to be performed, the needs of the youth participants, already existing resources, and the desired results. 1. Statement of the Challenges: In order to provide a foundation for the proposal being made, describe the challenges that your proposed program seeks to correct or improve. The statement of the challenges must relate to the goals and objectives you will identify later in the proposal. The proposal should focus on the needs and/or challenges of the population targeted to be served, not on the needs/ challenges of the agency. This section should be no longer than six pages. 2. Work Plan: Describe the technical plan in narrative form for accomplishing the work proposed, indicating which components are already in place and a time line for implementation of planned components. At a minimum, include the following components:

Measurable goals and objectives with a listing of the actual numbers of eligible youth whom the proposed program will serve. A description of the methods to be implemented in achieving the stated goals and objectives and why these methods will work. 8

A description of existing or planned strategic collaboration among multiple partners, including community involvement. (Memoranda of Understandings or agreements and or letters of support from existing collaborations with service providers can be made as attachments to your proposal.) A description of how the Bidder plans to leverage funds and link with existing programs. Define how the proposed program builds on existing services/resources in your agency; what their funding source is; which services will be funded with WIA dollars; how you will leverage other funding sources and how you plan to generate additional funds to support the program outcomes. A description of how the Bidder will coordinate its services with communitybased organizations, including those that are faith based. A description of how the Bidder will solicit the help of Youth Council members, WIB members and LEO members. Proposals for Out-of-School Youth must include information on how your agency plans to reach hard-to-serve populations. Describe your recruitment techniques for Out-of-School Youth and your ability to serve this population. A description of how you will ensure the safety of all work sites for youth. A description of your record-keeping methods and how you will maintain the confidentiality of youth participants. A description of the comprehensive year-round Youth Program that incorporates the appropriate 10 key elements in accordance to the Program Design : * Tutoring, study skill training and instruction leading to the completion of secondary school, including dropout prevention * Alternative secondary school services * Summer employment opportunities directly linked to academic and occupational learning * Paid or unpaid work experiences including Job Shadowing & Internships * Occupational skills training * Leadership development opportunities * Supportive services (may include transportation, childcare, need-related payments that are necessary to participate in activities) * Adult mentoring for not less than 12 months * Follow-up services for not less than 12 months after exit * Comprehensive guidance and counseling

• •

The 10 elements do not have to be provided with WIA funds or by WIA funded partners. It is not only acceptable, but also desirable, to connect WIA youth to other community resources and services while monitoring service delivery. At a minimum, all proposals must address providing comprehensive guidance and counseling and providing follow-up services.

9

The R1WIB and its Youth Council recognize the desire and need in our region to introduce youth to various opportunities. The provider will be expected to offer an introduction and facilitate exploration of options, including but not limited to, workshops, field trips, mentoring connections, and work experiences. This section should be no longer than 20 pages (not including attachments). 3. Agency Information: Provide a narrative description of your agency to include when, how, and why the organization was started; its purpose, goals and philosophy, prior and current relevant activities, accomplishments, size and characteristics of clients served, linkages and/or coordination with other agencies and services in the community. This section should form the basis for determining whether or not your agency is qualified and credible to deliver the program as proposed. Information should include experience in the past or currently on-going training/service programs that are relevant to the training/service being requested through this Request for Proposal. Briefly describe the facility(ies) where this system is to be principally operated; include size, location, accessibility, and any special features relevant to the system. If specialized equipment is proposed, please include description and quantity. (Resumes may be attachments and should not be included in page count.) State the ADA compliance status of facility(ies) by submitting a completed Self-Evaluation for Compliance with Section 504 of the Rehabilitations Act of 1973 Checklist. (Checklist submitted as an attachment and should not be included in page count.) This section should be no longer than one page plus personnel narratives, resumes, and 504 Checklist. 4. Performance Outcomes: Discuss the measurable results and benefits anticipated and how they will be measured against the program’s goals and objectives. Describe the process, outcomes expected, and how you will evaluate and monitor your program’s performance. Discuss how your program’s outcomes correlate with the Region 1 Workforce Investment Board performance goals for youth. This section should state clearly the actual numbers the proposed program will serve and the costs per youth. (Efficiency rate.) Include examples of past performances serving WIA participants and with whom the service contract was made. Strategically, our Board is reinventing the delivery of services to its customers. It is very important that the Youth Service Provider creatively and innovatively thinks “out of the box” as to how to provide services that are quality oriented and connects leadership opportunities to the customer. It should be noted that these factors will also be included during performance monitoring of the Youth Service Provider throughout the program year. This section should be no longer than three pages. The entire Statement of Work should be no longer than 30 pages not including attachments.

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XI.

Bidders Conference

All parties interested in submitting proposals for the Region 1 In-School and Out-of-Youth services program MUST attend the mandatory bidders’ conference at 200 New River Town Center, Beckley, WV, March 15, 2011, 2:00 p.m.. Technical assistance will not be provided after that date and proposals from parties who did not attend the bidder’s conference will not be considered. XII. Proposal Submissions, Deadline and Format

In order to be considered for funding in the program period September 1, 2011 – June 30, 2012 your proposal must be submitted no later than August 5, 2011, 4:00 p.m. An original, 5 copies, and an electronic copy (thru email or CD) must be submitted to the Region 1 Workforce Investment Board office at 200 New River Town Center, Beckley, WV 25801. The proposal packet must be sealed and clearly marked “Youth Services Bid” on the outside. FAX OR ELECTRONIC COPIES ONLY WILL NOT BE ACCEPTED. An acknowledgement receipt of each proposal will be given to or mailed to the proposing agency, indicating time and date received. A proposal received after the closing date will not be considered. The Bidder assumes all responsibility for the submission of the proposal and meeting all of the required deadlines. Proposals should be prepared simply and economically providing a straightforward, concise description of the operator’s intentions and ability to meet the administrative and operational requirements of the program. Emphasis should be on completeness, clarity of content, program quality, leveraging of resources, and effective customer service delivery. Bidder must follow the instructions outlined in this RFP package and submit all appropriate forms. All proposals must be typewritten, single-spaced, single-sided, on 8.5” X 11” paper in a 12-point font and a binder clip or paper clip used for each individual copy. DO NOT USE STAPLES OR ANY OTHER TYPE OF BINDING. For proposals that exceed the section page limitations, only the number of pages that are within the set page limits for each section will be considered. Evaluators will not read proposals beyond the set page limit. Incomplete proposals will be considered non-responsive and will not be considered; therefore, they will be returned to sender. XIII. Who Can Submit a Proposal All public or private not-for-profit 501(c)(31) or (6) corporations, an education organization, governmental units, public agencies, community-based organizations, faith-based organizations or private-for-profit corporations properly organized in accordance with State and Federal law and been in existence for 5 years, may submit a proposal for funding. No entity may compete for funds if: (1) the entity has been debarred or suspended or otherwise determined to be ineligible to receive federal funds by an action of any governmental agency; (2) the entity’s previous contracts with the R1WIB have been terminated for cause; (3) the entity has 11

not complied with an official order to repay disallowed costs incurred during its conduct of programs or services. The Region 1 Workforce Investment Board is an equal opportunity/affirmative action employer and agency. XIV. Required Documentation 1. Proposal Transmittal Document 2. Proposal Package Inventory List 3. Check List for Service Providers 4. Executive Summary 5. Statement of Work Narrative 6. Budget Preparation Sheet and Narrative 7. Detailed Budget 8. Resumes of Staff 9. Letters of Intent 10. Certificate of Insurance 11. Copy of most recent agency audit 12. Self-Evaluation for Compliance with Section 504 (Proof of ADA Compliance) 13. Certification Regarding Lobbying 14. Certification Regarding Debarment, Suspension, etc. 15. Equal Opportunity Non-Discrimination Notice 16. Drug-Free Workplace Statement 17. Memorandum of Understandings and Letters of Support from eleven (11) Board of Educations located within Region 1 XV. Renewal

Although the initial award will be for a 12-month period, the Region 1 Workforce Investment Board will have the option to negotiate continued funding and performance standards for an additional 12-month period based on funding allocations, timeliness of start-up, quality of service, and successful performance. XVI. Evaluation of Proposals All proposals submitted in accordance with this RFP will be rated based on the criteria outlined in the Evaluation Criteria section. The Region 1 Workforce Investment Board’s Ad Hoc RFP Evaluation Committee will rate the proposals. The Board may choose to have the process monitored by an outside neutral observer. 12

The Ad Hoc RFP Committee will complete evaluation summaries based upon the ratings of the proposals and forward a recommendation for all Requests for Proposals to the Region 1 Workforce Investment Board Executive Committee. After the final decision is made by the Executive Committee with the approval of the Region 1 Workforce Investment Board and the Local Elected Official Board, the Executive Director will be responsible for the award announcement, the final negotiations, and the contract signing. All individuals involved in the development, evaluation and award process of this RFP must adhere to the Region 1 Conflict of Interest Policy. Bidders should disclose potential conflict of interest issues by identifying any relationship to a board or committee member in a letter submitted with the original proposal. XVII. Evaluation Criteria Proposals will be evaluated using the following criteria: A. Program Design - 25 Points

The extent to which the proposal understands and addresses the challenges in assisting and mentoring youth. The ability to access other services/resources to encourage the development of comprehensive programs and services. Creates a program to ensure that youth have the necessary skills and personal qualities to become successful, productive adults. The extent to which the proposal designs a year-round program around the 10 key program elements required by WIA. For out-of-school youth, the Bidder’s ability to recruit this hard-to-serve population of youth must be addressed. The methodology and ability to provide for one year follow-up on participants no longer receiving services. The ability of the Bidder to meet the outlined performance goals and objectives, including placement in employment or education, attainment of a degree or certificate, and literacy/numeracy gains. The extent and successful history the Bidder has of designing and delivering high-quality, innovative and comprehensive programming for the target populations. The ability of the Bidder to leverage funds and link with existing programs and services, involving the local community, Youth Council, WIB, and LEO members. The ability of the Bidder to develop significant partnerships with employers to provide ample work-based career experiences and mentoring activities. Ability to build on existing services in Bidder’s agency. The ability of the Bidder to build a collaborative consortium of youth service providers to achieve desired outcomes. 13

B. Soundness of Approach/Responsiveness to the Required Elements - 30 Points

C. Leveraging Funds/Partnership Collaboration/Community Involvement - 15 Points

• •

The ability to integrate with WORKFORCE West Virginia Career Centers and its partners while also involving youth participants in one-stop services. The ability in which Bidder links to Career and Technical Education Centers, Community Colleges, and other educational institutions in building career pathways and ladders. The cost per youth of the proposed program is evaluated to determine if it is fair and reasonable. The demonstrated ability of the Bidder to provide accurate reports for prior existing contracts for services. The congruence of the budget with the proposed program. The ability to limit administrative funds with emphasis in maximizing dollars expended directly on the customer. The competency of the professional personnel involved in the delivery of the service. Close scrutiny will be applied to the qualifications of the staff who will be providing the training/services/activities directly to the youth, measured by experience and education.

D. Financial Management/Program’s Cost Effectiveness - 15 Points

• •

E. Agency Qualifications/Qualifications of Personnel - 15 Points
• •

The proposal shall be signed by an official authorized to bind the agency and shall contain a statement to the effect that the proposal is a firm bid until withdrawn in writing by the submitting organization. The proposal shall also provide the name, title, address, e-mail, and telephone number of the individual(s) with authority to negotiate during the period of contract negotiations. Any evidence of fraud in the proposal or in the performance of the resulting contract will be turned over to the proper authorities for enforcement. XVIII. Disclosures The United States Congress is in the process of reauthorizing the Workforce Investment Act of 1998 which may bring about changes and/or additions to the current law. The Region 1 Workforce Investment Board reserves the right to resend, amend, modify and/or add to this Request for Proposal and any precipitating grant(s) awarded there under to comply with subject legislation, recessions, and/or grant allowed allocations. The Region 1 Workforce Investment Board and its youth services program are under no obligation to award any contract(s) prepared in response to this Request for Proposal. The Region 1 Workforce Investment Board and its Youth Council are under no obligation to reimburse any party for the fees involved in the submission of any such proposals. XIX. Contract Award A. Announcement The R1WIB intends to award a contract(s) to the organization(s) whose proposal best meets the needs and goals outlined in this RFP. The contracts may be awarded based on proposals received without discussion of such proposed programs with the bidders. Therefore, each offer should be submitted in most favorable terms from a price and technical standpoint that the bidder 14

can make to the R1WIB. The announcement of awards to the intended contract awardee(s) is expected to be made no later than April 19, 2011. The R1WIB reserves the right to designate and fund the type and mix of specialized services that ensure the creation and maintenance of Youth Programs that enhance the range and quality of workforce services to be made available in its constituent counties. B. Protests or Disputes Any Bidder denied funding through this RFP may submit a letter to the R1WIB’s Executive Director requesting further details on the evaluation of the proposals. In the event the response is not satisfactory to the applicant, an appeal to the R1WIB’s Executive Committee may be written. The decision of the R1WIB’s Executive Committee shall be final. C. Type of Contract Proposed costs will be analyzed and a contract will be negotiated on a demonstrated performance basis. All contracts awarded will have a significant portion of the funds tied to the achievement of measurable outcomes. The type of contract will be determined at the time of contract negotiation with each bidder. All budgets should be designed in anticipation of performance-based funding and all costs will be reimbursed based upon adequate and allowable expenditures and the documentation thereof. D. General Contract Conditions Should a proposal be selected for funding, the Bidder will then complete contract negotiations. In order for a contract to be executed, the successful Youth Services Provider must meet the following requirements: • • • • All programs must be operational September 1, 2011. Must have current fiscal and compliance audits as required by law. Required to be an Equal Employment Opportunity Employer (EEO). Must provide a certificate of insurance for comprehensive general public liability insurance with combined single-limit coverage of at least $1,000,000 and Worker’s Compensation Insurance with the Region 1 Workforce Investment Board and the Region 1 Local Elected Officials Board becoming “also insured” at the time of contract implementation. Other insurance coverage may be required and is subject to negotiation. Ensure by signing the contract, that adequate and qualified staff will be dedicated to the contracted program services. Qualifications of key staff associated with the implementation of this program should be included in the proposal. Must provide criminal background checks, drug screening, and child clearances for all staff directly involved with youth either prior to contracting or prior to hiring the staff. Must agree to arrange for and have completed an independent, stand-alone financial audit no later than 90 days after the program year end. Auditors must be Certified Public Accountants or supervised by a Certified Public Accountant.

• •

E. Contract and/or Budget Modifications The successful Youth Service Provider is ensuring, by signing a contract, that the negotiated contract/budget for services provided cannot be changed without the R1WIB’s approval. All requests for contract/budget modifications must be submitted to the R1WIB with written justification prior to implementation of any changes. 15

XX.

Transition Plan

In the event during or at the end of the contract year, a new Youth Services Provider is selected, the existing provider must be willing to invest uncompensated time and effort to the transition process in order for services to continue with no interruptions. Describe how your organization would deal with this investment in order to conduct an orderly transition to another provider to ensure that there is no disruption in services or negative impact on youth participants. It is important for Bidders to understand that the infrastructure for delivery of services is in place and that no break in services to current youth participants can be experienced as a result of a transition. It is important for current Providers to understand that a transition plan may also be required for significant changes in processes.

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Attachment 1

Region 1 Workforce Investment Board
Proposal Transmittal Document I. Proposing Organization: Street Phone: E-Mail Address: Authorized Representative: Collaborative: In Place ( ) II. In Development ( ) (List Partners) Other Funds City Fax: State Zip Code

Address:

Dollar Amount of Proposal: WIA Funds Number of Participants to be served Projected Cost per participant

III. IV.

Federal Employer Identification Number: (If consortium, list number of lead organization) Category of Proposal: ( ) In School Youth Programs ( ) Out of School Youth Programs
(Each category requires a separate proposal)

V. Certification: I, ______________________________, certify that I have read, understand, and accept the terms and conditions of the solicitation as stated in the R1WIB Proposal Package; that the enclosed package is a firm offer effective through the ______day of _____, 2012; and that the information contained therein is true and correct to the best of my knowledge. I am authorized by my Board of directors, Trustees, other legally qualified officer or as the owner of this agency or business to submit this proposal. I understand that if any information has been misrepresented or is found to be untrue, this proposal will be disqualified for consideration and may be grounds for contract cancellation. Signature: Title: Date: 17

Attachment 2

PROPOSAL PACKAGE INVENTORY CHECKLIST

€ € € € € € € € € € € € € € € € € € €
Agency: Signed: Date:

Proposal Transmittal Document Proposal Package Inventory List Check List for Service Providers Executive Summary Statement of Work Narrative Budget Preparation Sheet and Narrative Detailed Budget Resumes of Staff Letters of Intent Certificate of Insurance Copy of Most Recent Agency Audit Self-Evaluation for Compliance with Section 504 (Proof of ADA Compliance) Certification Regarding Lobbying Certification Regarding Debarment, Suspension, etc. Equal Opportunity Non-Discrimination Notice Drug-Free Workplace Statement One Original, 5 Copies, and an electronic copy of the Proposal Package Memorandum of Understandings and Letters of Support from the eleven (11) Boards of Education located within Region 1 Other pertinent information that may lend strength to your proposal

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Attachment 3 Checklist For Service Providers APPLICANT: ____________________________________________________ Agency Information Please provide information relative to applicant’s status, experience, qualifications, etc. Please check appropriate responses. 1. Organization _______ Corporation _______ Partnership _______ Individual Ownership or Sole Proprietorship _______ City Agency _______ State Agency _______ Educational Institution 2. Status _______ For Profit _______ Non-Profit 3. Experience/Information _______ Number of years in business _______ Number of years in “Training” business _______ Number of permanent employees (salaried and hourly) 4. Have any of the applicant’s Federal, State or City contracts or grants ever been terminated or suspended (either totally or partially) for any reason? _______ Yes _______ No If “YES”, briefly explain on an attached sheet of paper. 5. Is applicant in receivership or bankruptcy, or are any such proceedings pending? _______ Yes _______ No If “YES”, briefly explain on an attached sheet of paper. 6. Has the applicant’s organization ever been cited, fined or reprimanded for any law or code violation within the last three years or has any business license been suspended or revoked? _______ Yes _______ No If “YES”, briefly explain on an attached sheet of paper. 19

Attachment 3 7. Are all of the applicant’s required permits current? _______ Yes _______ No List on an attached sheet all of your required permits and expiration dates. 8. Subcontracting Will the applicant subcontract for any of the services? ______ Yes _______ No If “YES”, type in the page number(s) where the subcontracting is described in the proposal. Page(s) _______________________ Will the applicant utilize the services of a consultant in the operation of this program? _______ Yes _______ No If “YES”, type in the page number(s) where the consultant services are described in the proposal. Page(s) ________________________ 9. Union Concurrence List any and all unions that may be associated with this training. Does your agency have union approval of the proposed training? _______ Yes _______ No If YES, please attach written proof of union concurrence. 10. Insurance Coverage Are persons authorized to handle and disburse governments fidelity bonded? _______ Yes _______ No If yes, attach proof of fidelity bonding. Note: If you cannot show proof of your ability to obtain fidelity bonding, Region I WIB cannot contract with the applicant, and the proposal will be returned. Does applicant carry General Liability Insurance? _______ Yes _______ No If yes, attach proof of General Liability Insurance. Note: If you cannot show proof of general liability insurance, Region 1 WIB cannot contract with the applicant and the proposal will be returned. 20

Attachment 3 Does the applicant carry Workers’ Compensation Insurance? _______ Yes _______ No If yes, attach proof of General Liability Insurance. Note: If you cannot show proof of your ability to obtain workers’ compensation insurance, Region 1WIB will not contract with the applicant and the proposal will be returned. Is the applicant current with Unemployment Insurance? _______ Yes _______ No Note: If you cannot show proof of good standing with Unemployment Insurance, Region 1 WIB will not contract with the applicant, and the request for proposal will be returned. 11. Fiscal Responsibilities Does the applicant organization presently have any outstanding unresolved audit deficiencies with any Federal, State or Local agencies? _______ Yes _______ No If yes, please explain on attached sheet of paper. List the date of most recent independent audit and by whom. Is the applicant providing an AUDITED financial statement for the past accounting year which identifies all sources of revenue, donations, and income as well as the offsetting expenses? _______ Yes _______ No If your response is NO, your proposal will be returned to you. 12. Are your facilities and other planned sites to be used accessible to individuals with disabilities? _______ Yes _______ No 13. Certification and Compliance Does the applicant certify and agree to provide assurances of Equal Opportunity and nondiscrimination and to develop appropriate mechanisms to ensure that affirmative action will be taken in all practices and program activities? _______ Yes _______ No If you answered “no” please explain on a separate sheet of paper. 21

Attachment 3 Does the applicant agree to comply with all applicable Federal, State and local laws and directives relating to equal opportunity and affirmative action in services and program operations? _______ Yes _______ No If you answered “no” please explain on a separate sheet of paper. 14. A copy of the organizations’ cost allocation plan must be included to support all costs budgeted for this program that are not directly related to the project. These items are usually rent, utilities, insurance and other overhead items.

____________________________________________ Typed Name of Authorized Representative ____________________________________________ Original Signature of Authorized Representative _________________ Date

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Attachment 4 CERTIFICATION REGARDING LOBBYING Certification for Contracts, Grants, Loans, and Cooperative Agreements The undersigned certifies, to the best of his or her knowledge and belief, that: 1. No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of an agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any Federal contract, grant, loan, or cooperative agreement. 2. If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, “Disclosure Form to Report Lobbying,” in accordance with its instructions. 3. The undersigned shall require that the language of this certification be included in the award documents for all sub-awards at all tiers (including subcontracts, sub grants and contracts under grants, loans, and cooperative agreements) and that all sub recipients shall certify and disclose accordingly. This certification is a material representation of fact upon which reliance was place when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by section 1352, title 31, U.S. Code. Any person who fails to file the required certification shall be subjected to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. _______________________________________________________________________ Organization _______________________________________________________________________ Name of Certifying Official Signature Date

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Attachment 5 Certification Regarding Debarment, Suspension, and Other Responsibility Matters Primary Covered Transactions This certification is required by the regulations implementing Executive Order 12549, Debarment and Suspension, 29 CFR Part 98, Section 98.510, participant’s responsibilities. The regulations were published as Part VII of the May 26, 1988 Federal Register (pages 19 16019211.) (BEFORE SIGNING CERTIFICATION, READ ATTACHED INSTRUCTIONS WHICH ARE AN INTEGRAL PART OF THE CERTIFICATION) 1. The prospective primary participant certifies to the best of its knowledge and belief, that it and its officers/ principals: a. Are not presently debarred, suspended, proposed for debarment, declared ineligible or voluntarily excluded from covered transactions by any Federal, State or local governmental department or agency. b. Have not been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (Federal, State, or local) transaction or contract under a public transaction: violation of Federal or State antitrust statutes or commission or embezzlement, theft, forgery, bribery, falsification or destruction of statutes or commission or embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property: c. Are not presently indicted for or otherwise criminally or civilly charged by a government entity (Federal, State, or local) with commission of any of the offenses enumerated in paragraph (1) (b) of this certification; and d. Have not had one or more public transactions (Federal, State, or local) terminated for cause or default. 2. Where the prospective primary participant is unable to certify to any of the statements in this certification, such prospective participant shall attach an explanation to this proposal. _______________________________________________________________________ Organization _______________________________________________________________________ Name of Certifying Official Signature Date

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Attachment 6 EQUAL OPPORTUNITY NON-DISCRIMINATION NOTICE ______________________________________________ (Name of agency), as a recipient of Workforce Investment Act (WIA) Title I financial assistance, shall provide initial and continuing notice that it does not discriminate on any prohibited ground to: registrants, applicants, eligible applicants/recipients, participants, applicants for employment, employees, and members of the pubic; including those with impaired vision or hearing, and unions or professional organizations holding collective bargaining or professional agreements with the recipients. ASSURANCE As a condition of the award of financial assistance from the U. S. Department of Labor under Title I of WIA, the grant applicant assures that it will comply fully with the nondiscrimination and equal opportunity provisions of the following laws: Section 188 of the Workforce Investment Act of 1998 (WIA), which prohibits discrimination against all individuals in the United States on the basis of race, color, religion, sex, national origin, age, disability, political affiliation or belief, and against beneficiaries on the basis of either citizenship/status as a lawfully admitted immigrant authorized to work in the United States or participation in any WIA Title I financially assisted program or activity. Title VI of the Civil Rights Act of 1964, as amended, which prohibits discrimination on the basis of race, color, and national origin; Section 504 of the Rehabilitation Act of 1973, as amended, which prohibit discrimination against qualified individuals with disabilities; The Age Discrimination Act of 1975, as amended, which prohibits discrimination on the basis of age; and Title IX of the Education Amendments of 1972, as amended, which prohibits discrimination on the basis of sex in educational programs. The grant applicant also assures that it will comply with 29 CFR part 37 and all other regulations implementing the laws listed above. This assurance applies to the grant applicant’s operation of the WIA Title I financially assisted program or activity. The grant applicant understands that the United States has the right to seek judicial enforcement of this assurance. _______________________________________________________________________ Typed Name of Agency Official and Title _______________________________________________________________________ Signature Date

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Attachment 7 CERTIFICATION REGARDING DRUG-FREE WORKPLACE REQUIREMENTS
A. The contractor certifies that it will or will continue to provide a drug-free workplace by: a. Publishing a statement notifying employees that the unlawful manufacture, distribution, dispensing, possession, or use of a controlled substance is prohibited in the contractor’s workplace and specifying the actions that will be taken against employees for violation of such prohibition; b. Establishing an ongoing drug-free awareness program to inform employees about: 1. The dangers of drug abuse in the workplace; 2. The grantee’s policy of maintaining a drug-free workplace; 3. Any available drug counseling, rehabilitation, and employee assistance programs, and 4. The penalties that may be imposed upon employees for drug abuse violations occurring in the workplace. c. Making it a requirement that each employee to be engaged in the performance of the grant be given a copy of the statement by paragraph “a” above; d. Notifying the employee in the statement required by paragraph “a” that, as a condition of employment under the grant, the employee will: 1. Abide by the terms of the statement; and 2. Notify the employer in writing of his or her conviction for a violation of a criminal drug statute occurring in the workplace no later than five (5) calendar days after such conviction; e. Notifying the agency in writing, within 10 calendar days after receiving notice under subparagraph “d.2” from an employee or otherwise receiving actual notice of such conviction. Employers of convicted employees must provide notice, including position title, to every grant officer or other designee on whose contract activity the convicted employee was working, unless the Federal agency has designated a central point for the receipt of such notices. Notice shall include the identification number(s) of each affected grant; f. Taking one to the following actions, within thirty (30) calendar days of receiving notice under subparagraph “d.2”, with respect to any employee who is so convicted: 1. Taking appropriate personnel action against such an employee, up to and including termination, consistent within the requirements of the Rehabilitation Act of 1973, as amended: or, 2. Requiring such employee to participate satisfactorily in a drug abuse assistance or rehabilitation program approved for such purposed by Federal, State, or local health, law enforcement, or other appropriate agency. g. Making a good faith effort to continue to maintain a drug-free workplace through implementation of paragraphs “a”, “b”, “c”, “d”, “e”, and “f ”. Applicant Organization Name of Certifying Official Date Submitted Signature

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Attachment 8 Youth Program RFP Budget & Instruction
Vendor Name: Program Name: Program Period: I. Funds Requested

Category
Staff Positions

Basis

Total Amount

Fringes (Describe)

Other Costs (Describe) Rent Supplies Travel Communications Equipment * Allowances Wages - Participants Audit Youth Supportive Services Costs (Describe)

Subcontracts (Describe)

Total
II. In-Kind Funds Requested Description Source Amount

Total
*Any equipment purchased must be approved in advance, with title passing to the R1WIB at the conclusion of the contract terms. Use additional pages as necessary for the line item budget narrative.

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Attachment 9 Self-Evaluation for Compliance With Section 504 I. Introduction The Department of Labor regulations implementing Section 504 of the Rehabilitation Act of 1973, as amended, require at section 32.6 (c) that entities which receive financial assistance from the Department conduct a self-evaluation of their policies and practices to assess their programs’ accessibility. Programs shall be accessible to persons with mobility impairments, hearing and vision impairments, and mental problems, and any other conditions which substantially limit a major life activity. The regulations do not prescribe a specific format for the self-evaluation. The Department’s Civil Rights Center has prepared this self-evaluation tool to assist recipients with this requirement. Recipients may, however, develop their own tool/instrument. Ideas and language for the format and content of this instrument were obtained from the “Section 504 Self-Evaluation and Checklist” assessment tools developed by the Federal Programs Advisory Service, a Washington, D.C. entity, publishers of the Handicapped Requirements Handbook. A. Office/Program to be evaluated. Name: Address: B. Individual completing evaluation. Name: Title: Date: C. Disabled individual (s) assisting in the completion of the self-evaluation. Name (s): Title: Organization: Address: Administrative Practices A. Staff information: List steps to be taken to ensure that all staff involved in any aspect of this program (e.g., recruitment, admission, testing, the conduct of the program, the provision of any services or benefits, etc.) will be informed periodically of, and understand fully, your policy of nondiscrimination on the basis of disability. ___________________________________________________________________ ___________________________________________________________________ 28 __________________________________________ __________________________________________ __________________________________________ __________________________________________

Attachment 9 B. Contracts, agreements, and sub-grants (e.g., labor unions, referral agencies, insurance companies, sub-grantees, educational institutions, etc.). 1. Are entities with which you hold contracts, agreements, and/or sub-grants aware of your policy of nondiscrimination on the basis of disability? No: Yes: If yes, explain how.

___________________________________________________________________ ___________________________________________________________________ 2. 3. III. Do you require these entities to sign an “assurance of compliance?” No: Yes: Have these entities been required to complete a self-evaluation of the programs and activities they conduct for you? No: Yes:

Recruitment and Advertisement A. Do you engage in any of the following kinds of activities to recruit program participants or otherwise inform persons about the services provided? No Yes • Oral presentations/orientations _______ _______ • Printed recruitment materials _______ _______ • Printed informational materials _______ _______ • Advertisements (radio, newspaper, etc.) _______ _______ B. C. Do all materials and advertisements include a notice that you do not discriminate against persons with disabilities? No: Yes: Is the general public notified of the existence and location of services, activities, and facilities that are accessible to persons with disabilities? No: Yes: If yes, explain. ___________________________________________________________________ ___________________________________________________________________ If “outside” persons or organizations are involved in your recruitment, advertisement or information efforts, have they been informed of your nondiscrimination policy? No: Yes: If yes, explain. ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ Are posters recognizing the rights of individuals with disabilities prominently displayed for employees, applicants, and participants to read? No: Yes: If yes, list which. ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ 29

D.

E.

Attachment 9 F. Are articles on the accomplishments of participants with disabilities publicized in the agency’s publications? No: Yes: If yes, list examples.

G.

Are organizations representing persons with disabilities contacted for advice, technical assistance, and referrals? No: Yes: If yes, list examples.

IV.

Program Eligibility Requirements and Admission A. Are there any limitations on the number of qualified disabled persons who may participate or be admitted to the program? No: Yes: If yes, explain.

B.

Are any of the following criteria used in the admission process?
• • • • • • • • • • • • • •

Residency requirements _________________ Letters of recommendation _________________ Economically disadvantaged _________________ Educational attainment _________________ Age _________________ Physically fit _________________ Emotionally fit _________________ No dependence on drugs _________________ No dependence on alcohol _________________ Unemployed _________________ Able and available for work _________________ Work experience _________________ Tests _________________ Other: ___________________________________________________________ ________________________________________________________________ ________________________________________________________________

C.

Have applications been reviewed for questions relating to health, receipt of Workers Compensation, and particular disabling conditions? Unless clearly related to the particular activity for which the application is used, delete those questions. No: Yes: If tests are used for screening applicants, describe the skill, level of achievement, or other factors being considered, and whether tests are written or oral. Name of Test: ___________________________________________________________________ ___________________________________________________________________ 30

D.

Attachment 9 Name of Test: ______________________________________________________ __________________________________________________________________ E. Identify any test (s) that has (or could have) a disproportionate, adverse impact on applicants with disabilities, i.e., tests that instead of measuring only the factors the test purport to measure, are measuring the applicant’s impaired manual and/or sensory skills (except where those are the skills being measured.) Name of Test: ______________________________________________________ Possible adverse impact: ______________________________________________ ___________________________________________________________________ ___________________________________________________________________ F. Are employees which administer tests prepared to give alternative tests and/or to modify the method of administering tests in order to accommodate persons who have disabilities that impair sensory and/or manual skills? No: Yes: Describe some of the possible arrangements the staff are prepared to undertake: Examples: No Yes
• • • • • • • • • • • •

G.

Eliminate the “speed” factor for persons with _____ _____ Visual or manual impairments _____ _____ Use aids such as braillers and abaci by persons _____ _____ With visual impairments _____ _____ Use of translators or typed material to provide _____ _____ Information on tests instructions to persons with _____ _____ Hearing impairments _____ _____ Provide auxiliary aids to persons who cannot _____ _____ Make the marks required for mechanically scored _____ _____ Objective tests _____ _____ Other: __________________________________________________________ Other: __________________________________________________________

H.

Describe the steps to be taken to ensure that criteria for testing alternatives and modifications will be adequately communicated to all potential program participants, including those with hearing and vision impairments. ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________

I. J.

Is an interview required prior to an applicant’s entrance into the program? (Including intake interview.) No: Yes: ___ From the following list, check the actions which have been taken/will be taken to ensure nondiscrimination in interviewing: 31

Attachment 9 No

Yes _____

Estimate the frequency of staff contact with sensory impaired persons Contact and consult with sensory impaired persons or organizations that represent them to discuss the particular communication needs of these persons and to gather input as to how best to alleviate these challenges Determine how staff will identify the specific language need of an individual at the initial contact, i.e., how they prefer to communicate (e.g., the interviewer may have key phrases written on cards, tapes of key phrases and messages, etc.) Make formal arrangements with individuals or organizations to provide qualified interpreters / when needed Develop a list of all persons, organizations, or staff persons with whom interpreter arrangements have been made, including terms of the arrangement, telephone numbers, addresses, etc. Identify staff who will be responsible for implementing effective communication with sensory impaired persons Write down decisions made on all the above items and notify and train all staff on its implementation.

_____

_____

_____

_____

_____

_____

_____

_____

_____

_____

_____

V.

Program Accessibility A. B. C. Are post-admission inquiries made regarding disability status in order to make accommodations for individuals with disabilities? No: Yes: Is the information requested voluntarily, not used to affect any disabled person adversely, and kept confidential? No: Yes: Is there an orientation program for new participants? No: Yes:

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Attachment 9 D. Have steps been taken to ensure that persons with visual and hearing impairments can understand the information, communicate with the staff, and use the written materials provided during the orientation? No: Yes: If yes, describe. ___________________________________________________________________ ___________________________________________________________________ ________________________________________________________________ __ List the specific activities that comprise your program: (e.g., orientation, intake, classroom training, residential, sports, counseling, referrals, etc.) ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ For each activity listed above, list those that are, or have the potential to be, inaccessible to individuals with disabilities. Activity ___________________________ ___________________________ G. Reason ______________________________ ______________________________ _______________________________ _______________________________

E.

F.

Describe steps to be taken to attain accessibility of those activities identified in “F” above, e.g., provision of auxiliary aids, use of alternative materials, special tools or equipment, modification of equipment, renovation of facility, moving program to another facility, etc. Activity ___________________________ ___________________________ Reason ______________________________ ______________________________ _______________________________ _______________________________

H.

Has a method been implemented for soliciting voluntary indications of disability status and requests for accommodations, i.e., channels for a disabled person to bring his or her disability to the attention of management? No: Yes: If yes, describe method. ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ From the following list of possible reasonable accommodations, check those which you would be willing to make for disabled program participants:
• • •

I.

Modifying written examinations Modifying work site Making facilities accessible

_____________________ _____________________ _____________________ 33

Attachment 9
• • • • • • • •

Adjusting work schedules Restructuring jobs Providing assistive devices Providing readers and interpreters Adopting flexible leave policies Reassigning and retraining participants Eliminating transportation barriers Others, depending on the person’s particular disability

_____________________ _____________________ _____________________ _____________________ _____________________ _____________________ _____________________ _____________________

VI.

Facilities A. List all facilities, or portions of facilities, used to conduct your program. Facility ________________________ ________________________ ________________________ ________________________ Address __________________________ __________________________ __________________________ __________________________

B. The Uniform Federal Accessibility Standards (UFAS) (50 Federal Register, 49045, November 29, 1985) contain the specifications recipients should comply with when designing, constructing or altering facilities. Recipients may need to alter or construct facilities when other alternatives are not successful in ensuring disabled persons full access to programs. The following sample items illustrate the range and specificity of the accessibility standards your program must meet: a. b. c. d. e. f. g. h. i. Ground should be graded, even if it is contrary to existing topography, so that Public walks should be at least 48 inches wide and should have a gradient not Parking spaces that are accessible and proximate to the facility should be set A ramp shall not have a slope greater than 1 foot rise in 12 feet, or 8.33 At least one primary entrance to each building shall be accessible to individuals in wheelchairs. Doors shall have a clear opening of no less than 32 inches when open and shall be operable by a single effort, including doors to restrooms. Stairs should, whenever possible, and in conformation with existing step Floors shall have a surface that is non-slip. Some mirrors and shelves shall be provided above lavatories at a height as low as possible and no higher than 40 inches above the floor, measured from the top of the shelf and the bottom of the mirror. 34

Attachment 9 j. k. l. Water fountains or coolers shall have up-front spouts and controls. An appropriate number of public telephones should be equipped for those with hearing disabilities and so identified with instructions for use. At least one toilet stall shall be/have: • 3 feet wide • 4 feet 8 inches deep • A door that is 32 inches wide and swings out • Handrails on each side, 33 inches high and parallel to the floor, 1-1/2 inches in diameter, with 1-1/2 inches clearance between rail and wall, fastened securely to the wall at the ends and center • A toilet seat of 17-19 inches from stand Elevators shall be accessible to, and usable by, the physically disabled on the level that they use to enter the building, and at all levels normally used by the general public. Switches and controls for light, heat, ventilation, windows, draperies, fire alarms, and all similar controls of frequent or essential use, shall be placed within the reach of individuals in wheelchairs. Raised letters or numbers shall be used to identify rooms or offices. Audible warning signals shall be accompanied by simultaneous visual signals for the benefit of those with hearing disabilities. Access panels or manholes in floors, walks and walls can be extremely hazardous, particularly when in use, and should be avoided.

m.

n.

o. p. q. C.

Using the aforementioned sample items, for each facility listed in “A”, identify those inaccessible features that limit program accessibility. Facility e.g., (1) 200 M. Street ____________________________ _____________________________ Inaccessible Feature (use letter corresponding to sample item) c., e., m.______________________ ______________________________ ______________________________ ______________________________ ______________________________

D.

Identify person(s) who will be responsible for developing and implementing a corrective action plan for the elimination of the barriers identified in “C” above. ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________

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Attachment 9 VII. Employment Practices No A. Recruitment 1. Are disabled employees included in promotional and recruitment advertising? Are contacts maintained with educational institutions which train individuals with disabilities? Are organizations which represent individuals with disabilities contacted for advice, technical assistance, and referrals? Does all recruitment literature indicate that the program does not discriminate on the basis of disability? No Yes Yes N/A

2.

___

3.

___

4.

___ NA

B.

Job Vacancies 1. Are all vacancy announcements reviewed to ensure that physical, mental and communication requirements are job related and accurately reflect job functions? Are managers willing to consider reasonable accommodations for the disability of otherwise qualified applicants?

___

2.

___ No Yes NA

C.

Job Interviews 1. Is every hiring supervisor informed of the requirement that all questions asked in the job interview must be related to duties and functions of the job? Is every hiring supervisor aware of where and how to obtain assistance to interview an applicant with a hearing impairment? Is the interviewing area accessible to an applicant in a wheelchair?

___

2.

___ ___

3.

36

Attachment 9 D. Physical Examinations 1. Does your organization conduct or require any medical exams prior to making offers of employment? If yes, * Are all entering employees subject to the medical exam? * Are all offers of employment conditional based on the results of the exam? Are the medical results not used in a discriminatory manner? Is all the information gathered maintained confidentially? No Yes NA

___

2.

___

___ ___ ___

* * 3.

Is every hiring supervisor aware of the fact that no offer of employment may be withdrawn on the basis of medical conditions that are not job-related? No

___ Yes N/A

E.

Reasonable Accommodations 1. Has a method been implemented for soliciting voluntary indications of disability status and requests for accommodations? Have disabled employees requested that you make accommodations in consideration of their limitations? If employees with disabilities have responded, is the information kept confidential? Have you ever denied a request for reasonable accommodations? If so, was your denial based on the concept of “undue hardship”?

___

2.

___

3.

___ ___

4. 5.

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