REQUEST FOR PROPOSALS For FY 2014 Special Funding Opportunity for 1. Needs Assessment Priorities 2. Infrastructure/Capitol

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The Community Mental Health Board (CMHB) of Oak Park Township REQUEST FOR PROPOSALS For FY 2014 Special Funding Opportunity for 1. Needs Assessment Priorities 2. Infrastructure/Capitol May 22, 2013 Synopsis of Request: Funding will be provided for affiliate organizations, as well as qualified partner Consortium organizations, that have infrastructure, technology, training, or other requests related to increasing the quality of their programs and services in the areas of behavioral health or developmental disabilities. The proposal must benefit Oak Park residents. Priority will be given to Consortium agencies that are actively working with the CMHB to strengthen the behavioral health or developmental disability systems of care.

I. PROPOSAL OVERVIEW This Request for Proposal (RFP) is for the purpose of 1. Enhancing or improving information, access, and quality of services at the agency and system levels of care as identified in the Youth and Family, Multicultural Behavioral Health, Developmental Disability, and Homeless Consortiums/Coalition s priorities and goals, and 2. Improving agency efficiency and quality of client care by addressing infrastructure, capitol and other capacity needs. All requests must follow evidence-based best practices and have a direct relationship to improving care for Oak Park residents with mental health, substance use disorder, or developmental disabilities needs. CMHB funds should be leveraged with other funds if the proposal will benefit a larger geographical area than Oak Park Township. A demonstrated need and benefit (outcome) must be in all submissions, as well as plans for how the benefit will be sustained beyond the award period. All activities and related expenses must be initiated and expensed by March 31, 2014. All final decisions will be made by the CMHB members at the July 16, 2013 Board meeting. These funds are for one-time requests only, unless otherwise instructed by CMHB staff. II. PROPOSAL COMPONENTS Proposals should include the seven areas listed below: 1. Executive summary 2. Service/Project/Training design (Include applicable areas: Development, Implementation, Marketing, Staffing, Oversight, Evaluation) 3. Agency and/or independent contractor qualifications (For Consortiums/Coalitions, discuss the membership in general and all independent contractors qualifications) 4. Job description(s) (If applicable) 5. Outcome(s) expected (Attachment A) 6. Budget narrative and budget spreadsheet (Attachment B) 7. Timelines 8. Summary of how this award will benefit Oak Park residents III. SUBMISSION REQUIREMENTS Please submit one emailed version by June 18 th, 2013. The text should be in Microsoft Word (font size at least 10) and the budget spreadsheet in Microsoft Excel. The document should not exceed 5 pages (excluding job description). If we feel the proposal is comprehensive and fits within the scope of the RFP we will ask you to submit 5 hard copies and attend the July Board meeting to answer questions regarding your proposal. Indirect costs where applicable must be equal to the rate generally utilized across your organization, but cannot exceed 20%. If the request is for partial funding, the other funds must be secured at time of award. Only one RFP will be approved per applicant. If an

agency is a member of a Consortium or Coalition application, they may still be eligible to submit a separate infrastructure. RFP Awardees will be notified after the July 16, 2013 Board meeting. The CMHB of Oak Park Township Funding Guidelines will apply to all requests for one time funding. If you would like a copy of the Funding Guidelines, please contact us or go to www.cmhb.networkofcare and click on Mental Health Board Information. SUBMISSION DEADLINE: The deadline for consideration at the July 16, 2013 Board meeting is June 18, 2013. IV. REPORTING REQUIREMENTS A year-end report will be due to the CMHB by April 15 th, 2014. The CMHB may also request monthly updates to awards that involve client or community services. An example of the FY13 RFP report template is attached for reference (Attachment C). CONTACT INFORMATION: Lisa DeVivo CMHB Executive Director 1010 Lake Street Suite 616 Oak Park, Illinois, 60301 708-358-8855 Or email ldevivo@cmhb-oakpark.org. Or Vanessa Matheny CMHB Project Coordinator 1010 Lake Street Suite 616 Oak Park, IL 60301 708-358-8855 Or email: vmatheny@cmhb-oakpark.org

ATTACHMENT A Format for Outcome Objectives (No more than two goals. No more than two outcome objectives per goal) Goal 1: Objective 1: Your outcome objective must contain the following information: WHO? (Targeted group) WILL DO WHAT? (Expected change in behavior, attitude, or education) HOW will this be changed? WHEN will change occur? MEASURED HOW?

ATTACHMENT B Format for Budget Narrative and Budget Spreadsheet 1. Sample Budget Narrative IF THE CMHB FUNDING REQUEST IS TO BE COMBINED WITH OTHER SOURCES OF FUNDING TO COMPLETE A LARGER PROGRAM/CAPITOL PROJECT, THE BUDGET BELOW SHOULD REFLECT THE BUDGET FOR THE LARGER PROGRAM/CAPITOL PROJECT. DIRECT EXPENSES Personnel Salary: Project Coordinator @ 15% of $40,000 $6,000 Fringe Benefits @ 25% $1,500 Personnel TOTAL $7,500 Contractual Public awareness events 2 @ $400 each $800 Room rental $250 Refreshments and snacks for 30 participants @ $5 each $150 Speaker fee 2 @ $325 each $650 Meeting Costs 5 @ $50 each $250 Costs for holding project planning meetings are approximated. The meetings will include refreshments and meeting materials. Contractual TOTAL $1,700 Supplies Office Supplies Project Coordinator requires typical office supplies such as paper, pens, folders, etc. over the 12 month period. $17 X 12=$204 $204 Supplies TOTAL $204 Travel Mileage for 2 mtgs in Springfield. 2 X 356 miles = 712 X.50= $356 Per Diem $50 per day X 2 $40 Hotel $100 per day X 2 $200 Travel TOTAL $596 Direct Expenses TOTAL $10,000

Management and General/All Indirect Expenses @18% of direct expenses $1,800 GRAND TOTAL $11,800 2. Sample Budget Spreadsheet THE SPREADSHEET MUST BE DONE IN EXCEL AND RECONCILE WITH YOUR BUDGET NARRATIVE Budget Line Item Totals Personnel Contractual Supplies Travel Management and General *GRAND TOTAL AMOUNT REQUESTED FROM CMHB: REVENUE FROM OTHER SOURCES: *GRAND TOTAL Sources of Other Revenue: List each source separately 1. 2. 3. Amount $ $ $ TOTAL *GRAND TOTAL (CMHB and Other Revenue) * All GRAND TOTALS should be the same amount

ATTACHMENT C Community Mental Health Board of Oak Park Township FY13 REQUEST FOR PROPOSALS RFP Year End Report for Infrastructure Funds Due April 15, 2013 Instructions to Agency Please finish the following: Status of Project Service Statistics (If applicable) Impact/Outcomes for Oak Park Township RFP Budget Against Actuals Receipts Do not exceed two pages for your report. All Year End Reports are due on April 15 th. A 2-week extension may be granted per request, but will delay your first quarter advance for FY14. Please email this form back to Lisa DeVivo @ ldevivo@cmhb-oakpark.org. AGENCY NAME Amt. Awarded: Amt. Spent: Purpose: Status of Project(s): Service Statistics: Unduplicated Oak Park Clients= Units of Service received by Clients listed above= Units of Service (Staff, classes, etc) billed against the RFP= Impact/Outcomes for Oak Park Township: (May be in general, client specific, or both. Refer to the outcomes in your RFP) RFP Budget Against Actuals: (You may attach an excel spreadsheet or word document) Receipts: (choose one) 1. Sent already? Yes/no 2. On file upon an audit? 3. Attached to this report?