Business Intelligence System Request for Proposal
Version 1.0
Last Updated: March 11, 2010 1
REQUEST FOR PROPOSAL (RFP)
Project Name: Business Intelligence System
RFP Number:
OK Contact Information
Manager Name: Jorge Fernandez
Email Address: [email protected]
Our Kids of Miami‐Dade/Monroe, Inc. 401 NW 2nd Avenue, Suite S‐10th Floor
Miami, Florida 33128
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Table of Contents
1. INTRODUCTION ........................................................................................................................................... 4
2. RFP PROCESS ............................................................................................................................................... 6
3. PROGRAMMATIC REQUIREMENTS .............................................................................................................. 9
4 VENDOR PROFILE QUESTIONNAIRE FORM .................................................................................................. 14
5. REFERENCES OR LETTERS OF SUPPORT ..................................................................................................... 14
6. DESCRIPTION OF EVALUATION CRITERIA ................................................................................................... 15
7. FINAL VENDOR SELECTION ....................................................................................................................... 15
8. ENCLOSURES ............................................................................................................................................ 16
9. VENDOR AUTHORIZATION PROCEDURES .................................................................................................. 24
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1. INTRODUCTION
Our Kids is issuing this RFP in order to obtain a Web‐Based, business intelligence (BI) tool in order to combine data from various new and existing databases and produce awareness to high risk situations for foster care clients, give immediate and accurate decision making prowess to case workers and case worker supervisors, and generate productivity improvements throughout the organization.
1. Statement of Need:
The intent of this project is to gather and track user input from more than one system and transform related information into real‐time, usable intelligence. Our Kids would like to provide a web‐based dashboard for its staff that is always available, secure and easy to use.
2. Statement of Purpose:
The purpose of the BI system is to exploit and protect investments in existing case management systems. It will allow a user base of over three hundred to immediately know the areas of high risk and to pinpoint agencies and units that require attention. The system will allow us to isolate cases that are in breach of terms and will add visibility to unproductive case management in order to act on and correct the issues. It will enforce consistency and timeliness of case management, raise awareness to escalating issues for proactive response and watch for case file patterns to determine predictability. It should put decision making prowess in hands of managers, supervisors and workers by using productivity tools specifically designed for field staff. These efficiencies should result in reduced turnover by making the caseworkers duties a bit more efficient.
3. Major Program Goals:
The program should allow us to get awareness to high risk situations so we can implement immediate and accurate decision making. Through proactive action, we will get productivity improvements, Cost Savings (through automation and workload management) and knowledge and understanding to make decisions. We will use the system for projection of upcoming status to mitigate risk and create assessment of current situations to enable a proactive approach. Through continuous extraction of surrounding conditions we will have constant maintenance of clear and relevant intelligence and produce output with tactical responses and action plans that can assist in eliminating accidents due to human error.
4. Term of Agreement:
Contract will begin on or about April 1, 2010 for a term of one year.
Small Businesses, Certified Minority, and Women’s Business Enterprises are encouraged to participate in any conferences, pre‐solicitation, or pre‐bid meetings which are scheduled and to submit a proposal.
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Company Background
About Us
Our Kids is the non‐profit lead agency for Community Based Care in Miami‐Dade and Monroe counties. We contract with the Florida Department of Children & Families to provide foster care and related services to abused and/or neglected children. Our Kids vision is that the at‐risk children of Miami‐Dade and Monroe counties grow up in safe, permanent Families Guiding Principles Customer Service: Ensure that customer needs are met in a manner that is both child and family focused and in a manner that demonstrates commitment to being responsive and respectful to cultural diversity, transparency, and accountability. System and Process: Ensure services are seamless, cohesive, comprehensive, and collaborative within and across vendors and stakeholders. Performance: Require performance throughout the system of care, utilizing ongoing quality assurance and adopting best practices, in order to realize the highest quality of service. Fiscal Fiduciary Responsibility: Maximize existing resources, pursue additional funding sources, create operating efficiencies, and effectively manage costs to reinvest in continually improved quality of service. Innovation: Develop new resources and new business practices designed to maximize success. Customer Satisfaction: Engage all key stakeholders, especially children, families and caregivers, in the planning, delivery, monitoring and continuous improvement of the system. Leadership and Stewardship: Maintain an independent board of community leaders that oversee the system of care. The Board’s primary focus is to establish a strategic direction, advice on policy, advocate for system enhancements and innovation and facilitate relationships. The mission of Our Kids is to oversee and lead a coordinated system of care delivering excellence to abused, abandoned, and neglected children and their families in Miami‐Dade and Monroe counties
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2. RFP PROCESS
A. Contact [email protected]
Or by mail to: B.I. System RFP Our Kids of Miami‐Dade/Monroe, Inc. PO Box 010951 Miami, Florida 33101
B. Posting This RFP solicitation was posted on the Our Kids website on the date and time specified in section D. under Schedule of Events and Deadlines. All subsequent announcements, addendums and/or notices will be promptly posted on the website. It is vendor’s responsibility to monitor the Our Kids website for all updates and submit timely and accurate proposals regarding same.
C. Limitations on Contacting Our Kids Personnel
Vendors are permitted to email their questions to the contact. All communications and questions regarding this RFP or any part thereof from vendors and other sources must be directed as follows: Email to: [email protected]
Note: No direct questions will be taken by Our Kids staff members. Any attempt to request additional information from Our Kids Inc. by any method other than an mail or email submission to the addresses identified in section 2.A may result in rejection of the vendor's proposal.
To assure complete distribution of all information, all questions will be summarized and reviewed by a committee. The committee will be composed of Our Kids staff members and representatives from the proposing companies. The companies will be extended an invitation to participate when the meeting date is finalized. The committee will convene at a time and place of Our Kids’ choosing, but will be held prior to selection of a vendor. Vendors are also encouraged to present their questions during the solicitation conference, if applicable.
D. Schedule of Events and Deadlines
Milestone Scheduled Date & Time (All times are denoted in Eastern Standard Time.)
Posting of RFP on Our Kids website March 11, 2010 Conduct Solicitation Conference (if applicable) March 18, 2010 Vendor RFP Responses Due March 25, 2010 by 5:00 pm EST Vendor Selection Date March 31, 2010 Post the Notice of Intent to Award March 31, 2010
Our Kids reserves the right to modify the schedule as circumstances may warrant.
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E. Proposal Deadline
Vendor RFP responses including all attachments and supporting documentation must be received by Our Kids no later than the date and time specified in section D. under Schedule of Events and Deadlines. VENDOR RFP RESPONSES SHOULD BE SUBMITTED IN A SIMILAR FORMAT TO THE RFP. Any reply submitted must remain a valid offer for at least 90 days after the proposal submission date. Vendor RFP responses including all attachments and supporting documents should be submitted via email to [email protected].
F. Receipt Statement Vendor RFP responses not received by the date and time specified in section D. under Schedule of Events and Deadlines may be rejected. Our Kids will not return any vendor RFP responses.
G. Right to Reject or to Waive Minor Irregularities Statement I. Our Kids reserves the right to reject any or all replies or to waive minor irregularities when to do so
would be in the best interest of Our Kids. II. Minor irregularity is defined as a variation from the Request for Proposal terms and conditions, which
does not adversely impact the interest of Our Kids. At its sole discretion, Our Kids may correct minor irregularities but is under no obligation to do so.
H. Notice of Intent to Award
The Notice of Intent to Award will be posted on the Our Kids website (www.ourkids.us) for 72 hours (excluding Saturday, Sunday and state holidays). If no written notice of protest is submitted to the Our Kids Contract Manager, the Intent to Award becomes final.
Please Note: The Notice of Intent to Award shall not be construed as a contract with Our Kids of Miami‐
Dade/Monroe, Inc.
I. Protests and Disputes Any person who is adversely affected by the terms, conditions and specifications contained in a solicitation, including any provisions governing the methods for ranking bids, proposals, or replies, awarding contracts, reserving rights of further negotiation, or modifying or amending any contract, shall submit a written notice of protest within 72 hours (Saturdays, Sundays and State holidays excluded) to: Brenda Martin, Contract Manager Our Kids of Miami‐Dade/Monroe, Inc. PO Box 010951 Miami, Florida 33101 [email protected]
FAILURE TO FILE A PROTEST WITHIN 72 HOURS OF THE POSTING OF THE NOTICE OF INTENT TO AWARD ON THE OUR KIDS WEBSITE, SHALL CONSTITUTE A WAIVER OF VENDOR’S RIGHT TO PROTEST.
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J. Reference Checks
Our Kids may conduct reference checks on prospective vendors throughout the procurement process. Our Kids may also contact any person or organization for information regarding a vendor regardless of the references provided by the vendor.
K. Proposal Disposition
All materials submitted in response to this RFP shall become Our Kids' property.
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3. PROGRAMMATIC REQUIREMENTS
A. Scope of Service. • Provide 300+ VPN‐based users with access to a web‐based performance dashboard. • Achieve approvals/credentials to process data extracts with or on behalf of Our Kids where the extracts
will be transformed into a DB2 database for access by the tracking and analytics solution as well as any additional access desired by Our Kids.
• Work with Our Kids to define and configure business rules and triggers on any information contained in
the data extracts from the state information system, Florida Safe Families Network (FSFN)
• Work with Our Kids on any other data sources that Our Kids desires to have reflected in the business intelligence infrastructure.
• Produce real‐time dashboards for daily use including but not limited to the following:
⋅ Visitations ⋅ Runaways ⋅ Staffing ⋅ Reunification ⋅ Eligibility
• Enable alerting and notifications based on business rules using email addresses on file. • Work with Our Kids to establish desired trend reports.
• Meet specific Service Level Agreements for customer and application support as defined in the following
section.
B. Service Delivery 1. Host the web‐based business intelligence dashboard application in a secure hosting solution.
2. Provide phone‐based support for the solutions end users during business hours (8am to 6pm) and
should include a. A level based priority structure which includes resolution time guarantees. b. Clearly defined escalation paths for issues not resolved in the time frames allotted.
3. Provide support for the application including, Installation configuration and Incident support for the hosted application. The desired Service Level Goals (SLG) for incident priority and response times are:
a. A level based priority structure which includes resolution time guarantees. b. Clearly defined escalation path for issues not resolved in the times allotted. c. Provide notification at least 24 hours in advance of any scheduled outage. d. Equipment/Network Availability: 99% 24 hours per day, 7 days per week, 365 days a year. e. Reports on incident reporting times and results should be available to Our Kids on demand.
4. Development and integration of new reports, views, queries and other B.I. functionality 5. Integration of new data sources as they become available
6. Integration of new data into existing new reports, views, queries and other B.I. functionality
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7. Confidentiality and Security of Data:
a. The hosting site for the business intelligence dashboard must meet or exceed the standards set in section 282.318 of the Florida Statutes – “Security of Data and Information Technology” and the State of Florida, Dept. of Children and Families policy CFOP 50‐2 covering “Security of Data and Information Technology Reserves”.
b. SAS 70 Type 1 or Type 2 audit certification of the data center is preferred.
C. Client General Description & Eligibility. Clients are Caseworkers and Caseworker supervisors as well as contracted full case management agency staff and select Our Kids partners.
D. Contract Limits.
One year from date of contract initiation
The above number of units to be served is a planning estimate only and Our Kids reserves the right to alter or adjust the locations and the number of affected units by any amount.
a. System will be implemented using the existing Our Kids data from a Business Objects data warehouse.
Our Kids will review and identify changes needed to existing data. Modifications and new development will be prioritized and phased in over a schedule to be determined with vendor.
b. Our Kids top reporting priorities are called Metrics. The highest priority metrics for this implementation are; Safety Metrics, Permanency Metrics, Visitation with Biological Parent and Home Visits Metrics. The remainder of the metrics will be prioritized for follow up deliveries.
c. Product will be hosted at the vendor premises – Our Kids & Our Kids’ Partners will access through a VPN connection from the Our Kids network. Users will be authenticated and security classes assigned using Our Kids’ existing security structures.
d. Application will use existing user base for alerts & notifications – if the data (e.g.; emails, phone numbers) are not correct, the recipient will not receive alerts or notifications.
e. The system will be exclusively used for Business Intelligence Reporting. These reports must be available as defined, be web‐accessible, and be secure per the Our Kids security specifications for web based delivery.
f. Reports must be dynamically generated and available on‐demand and within seconds. E. Staffing Levels.
The selected vendor should have at least one developer and one Project Manager available for all phases of this project. Each vendor shall include his or her proposed staffing for technical, administrative, and clerical support. The successful vendor shall maintain an adequate administrative organizational structure and support staff sufficient to fulfill its contractual responsibilities.
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F. Professional Qualifications or Licenses. The selected vendor will have verifiable experience implementing similar BI systems in organizations the size of Our Kids or larger. The successful vendor shall staff the project with key personnel identified in the vendor’s proposal which are considered by Our Kids to be essential to this project.
G. Service Delivery Location.
All deliverables will be web‐based and delivered online using agreed‐upon security structures (to be defined).
H. Service Times & Hours of Operation. The system must be available 24 hours per day, 7 days per week and 365 days a year.
M. Equipment & Technology.
The delivered system will be web‐based non browser specific.
N. Performance Measures
1. Host the web‐based business intelligence dashboard application in a secure hosting solution. 2. Provide phone‐based support for the solutions end users during business hours (8am to 6pm) which
includes a. A level based priority structure which includes resolution time guarantees. b. Clearly defined escalation path for issues not resolved in the times allotted.
3. Provide support for the application including installation configuration and Incident support for the
hosted application. The desired Service Level Goals (SLG) for incident priority and response times are: a. A level based priority structure which includes resolution time guarantees. b. Clearly defined escalation path for issues not resolved in the times allotted. c. Provide notification at least 24 hours in advance of any scheduled outage. d. Equipment/Network Availability: 99% 24 hours per day, 7 days per week, 365 days a year. e. Reports on incident reporting times and results should be available to Our Kids on demand.
4. Development and integration of new reports, views, queries and other B.I. functionality
5. Integration of new data sources as they become available 6. Integration of new data into existing new reports, views, queries and other B.I. functionality 7. Confidentiality and Security of Data:
a. The hosting site for the B.I. must meet or exceed the standards set in section 282.318 of the Florida Statutes – “Security of Data and Information Technology” and the State of Florida, Dept. of Children and Families policy CFOP 50‐2 covering “Security of Data and Information Technology Reserves”.
b. SAS 70 Type 1 or Type 2 audit certification of the data center is preferred.
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O. Performance Evaluation Methodology.
Our Kids will evaluate the selected vendor’s performance based on the vendor’s ability to meet the availability requirements and the integrity of the data for the business intelligence dashboard.
P. Coordination with Other Vendors/Entities.
Must be an approved vendor for the State of Florida and the Department of Children and Families.
Q. Our Kids Obligations.
1. Provide Dashboard measures definition and methodologies to vendor 2. Provide Dashboard sample reports for Metrics 3. Provide vendor with initial Our Kids data for sandbox 4. Establish VPN connection between Our Kids and vendor 5. Submit list of users for vendor
R. Monitoring Requirements.
The selected vendor must participate in scheduled project team meetings and provide updates as requested. These can be daily during some phases and less often during others. At minimum, there will be weekly meetings, application reviews.
S. Records and Documentation.
Some of the documentation the selected vendor will produce include: outlines and drafts of technical documentation and specifications, SOW’s both for the project and, when needed, for additional developments and updated staff roster and contact list for vendor’s project team members.
T. FINANCIAL DATA/PRICING: The vendor shall submit its budget in the format outlined below. The vendor shall identify any key
assumptions used to support the revenue and/or expense amounts shown below. Total Price Proposed: $___________________________ per month.
Please Note: There will be no start‐up funding in association with this RFP.
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Amount Budget Narrative
Revenue Our Kids ‐ Services 0 Expenditures Personnel Salaries ‐ Direct Care Benefits ‐ Direct Care Total Direct Labor & Benefits 0 Staff Recruitment Employee Screening Fees and Permits Office Supplies Staff Lunches and Retreats Training Materials Total Supplies and Expenses 0 Postage & Printing Subscriptions and Publications Telephone & Data Lines Total Communications 0 Air Travel Lodging Meals and Entertainment Car Rental Staff Mileage Total Travel 0 Insurance Rent Equip Repair & Maintenance Household and Janitorial Depreciation and Amortization Total Occupancy 0 Administrative Costs 0 Total Expenditures 0 Net Surplus/Deficit 0
4 VENDOR PROFILE QUESTIONNAIRE FORM
Question Response
Year founded:
Headquarters location:
Local office(s):
Total gross revenues:
Average rate of growth in sales over the last three years: Percentage of gross revenues invested in research and development:
Past year:
Past three years:
Number of full‐time personnel:
Total company:
Management:
Support:
Research and development:
Number of total customers:
Past year:
Past three years:
Number of new customers:
Past year:
Past three years:
5. REFERENCES OR LETTERS OF SUPPORT
The vendor may include any references or letters of support to be used in consideration for this RFP.
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6. DESCRIPTION OF EVALUATION CRITERIA
Each vendor will be rated on the following evaluation criteria based on the vendor’s RFP response. The following rate form should be used: 4 = Vendor’s response(s) exceeds criteria outlined in the RFP. 3 = Vendor’s response(s) meets criteria outlined in the RFP. 2 = Vendor’s response(s) meets some specifications of the criteria outlined in the RFP. 1 = Vendor’s response(s) does not meet criteria outlined in the RFP.
Vendor Name: _________________________________________
EVALUATION CRITERIA WEIGHT POINTS SCORE (POINTS X WEIGHT)
EXAMPLE
2 4 8
Meets SAS 70 Data Center Requirements 15
Meets Security Requirements 15
Experience with Child Welfare 15
Customer base similar to Our Kids 15
Approved State of Florida vendor 10
Proposed Budget 20
Timeliness of Deliverables and/or Reports 10
TOTAL SCORE
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FINAL VENDOR SELECTION
Required Documents Documents Received Comments
Certification Regarding Lobbying Yes / No
Certification Regarding Debarment Yes / No
Civil Rights Compliance Yes / No
Licenses and/or Professional Certifications
Yes / No
Insurance Declaration Page (if applicable)
Yes / No
W‐9 Form
Yes / No
Our Kids reserves the right to negotiate with all vendors deemed qualified based on the evaluation process. A final vendor will be selected based upon the overall benefit/cost ratio derived from the vendor’s RFP response.
8. ENCLOSURES
The vendor shall complete and sign the enclosed forms and submit them along with its proposal.
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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 an 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 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 subawards at all tiers (including subcontracts, subgrants, and contracts under grants, loans and cooperative agreements) and that all subrecipients shall certify and disclose accordingly.
This certification is a material representation of fact upon which reliance was placed 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 subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. ___________________________________ __________________ Signature Date
___________________________________ Name of Authorized Individual __________________________________ Name and Address of Organization
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CERTIFICATION REGARDING DEBARMENT, SUSPENSION, INELIGIBILITY AND VOLUNTARY EXCLUSION
CONTRACTS/SUBCONTRACTS This certification is required by the regulations implementing Executive Order 12549, Debarment and Suspension, signed February 18, 1986. The guidelines were published in the May 29, 1987 Federal Register (52 Fed. Reg., pages 20360 ‐ 20369).
Terms of Agreement 1. Each vendor whose contract/subcontract equals or exceeds $25,000 in federal and/or State of Florida moneys must sign this certification prior to execution of each contract/subcontract. Additionally, vendors who audit federal programs must also sign, regardless of the contract amount. Our Kids of Miami‐Dade/Monroe, Inc. (“Our Kids”) cannot contract with these types of vendors if they are debarred or suspended by the federal government or by the State of Florida.
2. This certification is a material representation of fact upon which reliance is placed when this contract/subcontract is entered into. If it is later determined that the signer knowingly rendered an erroneous certification, Our Kids may pursue any or all available remedies.
3. The vendor shall provide immediate written notice to the contract manager at any time the vendor learns that its certification was erroneous when submitted or has become erroneous by reason of changed circumstances.
4. The terms “debarred”, “suspended”, “ineligible”, “person”, “principal”, and “voluntarily excluded”, as used in this certification, have the meanings set out in the Definitions and Coverage sections of rules implementing Executive Order 12549. You may contact Our Kids contract manager for assistance in obtaining a copy of those regulations.
5. The vendor agrees by submitting this certification that, it shall not knowingly enter into any subcontract with a person or business who is debarred, suspended, declared ineligible, or voluntarily excluded from participation in this contract/subcontract unless authorized by the Federal Government and/or State of Florida.
6. The vendor further agrees by submitting this certification that it will require each subcontractor of this contract/subcontract, whose payment will equal or exceed $25,000 in federal and/or State of Florida moneys, to submit a signed copy of this certification.
7. Our Kids may rely upon a certification of a vendor that it is not debarred, suspended, ineligible, or voluntarily excluded from contracting/subcontracting unless it knows that the certification is erroneous.
8. This signed certification must be kept in the Our Kids contract manager’s contract file. Subcontractor’s certification must be kept at the vendor’s business location.
Page 2 of Certification
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CERTIFICATION REGARDING
DEBARMENT, SUSPENSION, INELIGIBILITY AND VOLUNTARY EXCLUSION CONTRACTS/SUBCONTRACTS
Certification
(1) The prospective vendor certifies, by signing this certification, that neither the business nor principals of business is
presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in this contract/subcontract by any federal department or agency or State of Florida department or agency.
(2) Where the prospective vendor is unable to certify to any of the statements in this certification, such prospective
vendor shall attach an explanation to this certification. ____________________________________ ___________________ Signature Date ____________________________________ ___________________ Name (type or print) Title
CIVIL RIGHTS CERTIFICATE
ASSURANCE OF COMPLIANCE WITH TITLE VI OF THE CIVIL RIGHTS ACT OF 1964, SECTION 504 OF THE REHABILITATION ACT OF 1973, TITLE IX OF THE EDUCATION AMENDMENTS OF 1972, THE AGE DISCRIMINATION ACT OF 1975, AND THE OMNIBUS BUDGET RECONCILIATION ACT OF 1981.
The applicant provides this assurance in consideration of and for the purpose of obtaining Federal grants, loans, contracts (except contracts of insurance or guaranty), property, discounts, or other Federal financial assistance to programs or activities receiving or benefiting from Federal financial assistance. The applicant assures that it will comply with: 1. Title VI of Civil Rights Act of 1964, as amended, 42 U.S.C. 2000d et seq., which prohibits discrimination on the basis of race,
color, or national origin in programs and activities receiving or benefiting from Federal financial assistance. 2. Section 504 of the Rehabilitation Act of 1973, as amended, 29 U.S.C. 794, which prohibits discrimination on the basis
handicap in programs and activities receiving or benefiting from Federal financial assistance. 3. Title IX of the Education Amendments of 1972, as amended, 20 U.S.C. et seq., which prohibits discrimination
on the basis of sex in education programs and activities receiving for benefiting from Federal financial assistance.
4. The Age Discrimination Act of 1975, as amended, 42 U.S.C. 6101 et seq., which prohibits discrimination on the
basis of age in programs or activities receiving or benefiting from Federal financial assistance. 5. The Omnibus Budget Reconciliation Act of 1981, P.L. 97‐35, which prohibits discrimination on the basis of sex
and religion in programs and activities receiving or benefiting from Federal financial assistance. 6. All regulations, guidelines, and standards lawfully adopted under the above statutes.
The applicant agrees that compliance with this assurance constitutes a condition of continued receipt of or benefit from Federal financial assistance, and that it is binding upon the applicant, its successors, transferees, and assignees for the period during which such assistance is provided. The applicant further assures that all contractors, subcontractors, subgrantees or others with whom it arranges to provide services or benefits to participants or employees in connection with any of its programs and activities are not discriminating against those participants or employees in violation of the above statutes, regulations, guidelines, and standards. In the event of failure to comply, the applicant understands that the Grantor may, at its discretion, seek a court order requiring compliance with the terms of this assurance or seek other appropriate judicial or requiring compliance with the terms of this assurance or seek other appropriate judicial or administrative relief, to include assistance being terminated and further assistance being denied. The person(s) whose signature(s) appear(s) below is/are authorized to sign this application, and to commit the applicant to the above provisions. __________________________________________________ _________________ Authorized Official(s) Date
__________________________________________________ Vendor _______________________________________________________________________________________________________________________
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Vendor Address City State Zip Code
CIVIL RIGHTS COMPLIANCE CHECKLIST
PART I. 1. Briefly describe the geographic area served by the program/vendor/facility and the type of service(s) provided:
PROGRAM/VENDOR/FACILITY COUNTY REGION/DISTRICT
Address
City, State, Zip Code Date Telephone
2. POPULATION OF AREA SERVICED. List source of data:
Total #
% White % Black % Hispanic % Other
% Female % Male 3. STAFF CURRENTLY EMPLOYED. Effective date:
Total #
% White % Black % Hispanic % Other % Female % Male % Disabled
4. CLIENTS CURRENTLY ENROLLED OR REGISTERED. Effective date:
Total #
% White % Black % Hispanic % Other % Female % Male % Disabled
5. ADVISORY OR GOVERNING BOARD, IF APPLICABLE:
Total #
% White % Black % Hispanic % Other % Female % Male
PART II: USE A SEPARATE SHEET OF PAPER FOR ANY EXPLANATIONS REQUIRING MORE SPACE. 6. Is an Assurance of Compliance on file with the Department of Children and Families? If NA or NO, explain.
NA YES NO
7. Compare staff composition to the population. Are staff representative of the population? If NA or No, Explain.
NA YES NO
8 Compare the client composition to the population. Are race/gender composition representative of the population?
NA YES NO
9. Are employees, applicants and recipients informed of their protection against discrimination? If YES, how? Verbal Written Poster If NA or NO, Explain.
NA YES NO`
10. Do recruitment and notification materials advise applicants, employees, and recipients of your non‐discrimination policy?
YES NO
11. Is there an established grievance/complaint procedure to resolve complaints of discrimination regarding service delivery or employment decisions? If NO, explain.
YES NO
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12. Provide the number and current status of any discrimination complaints regarding services or employment filed against the program/vendor/facility within the last year.
NA NUMBER
13. Are eligibility requirements for services applied to clients and applicants without regard to race, color, national origin, gender, age, religion, or disability?
NA YES NO
14. Are benefits, services, and facilities available to applicants and participants in an equally effective manner regardless of race, gender, color, age, national origin, religion or disability?
NA YES NO
15. Are room assignments made without regard to race, color, national origin or disability for in‐patient services? If NA or NO, explain.
NA YES NO
16. Are Limited‐English Proficient (LEP) applicants and recipients provided equal access to benefits including free interpreter services? If NA or NO, explain.
NA YES NO
17. Are the programs/facilities/services accessible to mobility, hearing, and sight impaired individuals? If NA or NO, explain.
NA YES NO
18. Are auxiliary aids available to assure accessibility of services to hearing and sight impaired individuals? If NO, explain. YES NO
19. Has a self‐evaluation been conducted to identify any barriers to serving individuals with disabilities? If NO, explain.
YES NO
20. State the name of the designated Section 504 Coordinator for compliance activities: _________________________________
21. Has Civil Rights training been conducted for local staff? If NA or NO, explain.
NA YES NO
22. SIGNATURE:_________________________________________________________________ Date:_____________________ Signature and Title of Person Completing This Form
OUR KIDS USE ONLY
Date of Receipt Signature of Program Manager or Designee Notice of Corrective Action Required: If “Yes”
Date Reviewed by Compliance Officer: Response Due:
Type of Review:
Response Received: Comments:
Date of Last Compliance Review:
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INSTRUCTIONS
PART I.
1 Descr ibe the geograph ic serv ice are , such as reg ion , distr i ct , ci ty or other local i ty . I f the program/provider/faci l i ty serves a speci f ic t a r ge t popu la t ion , such a s ado le scent s , descr ibe the t a rge t popu la t ion Desc r ibe the t ype of se r v i ce s prov ided , such a s i npat ient hea l th care , substance abuse re s ident i a l t reatment , outpatient counseling, etc.
2 En te r t he t o t a l number and pe r cen t age o f t he popu l a t i on se r ved by race and gender . The popu lat ion area in c ludes persons in c i t y , c o u n t y o r o t h e r r e g i o n a l a r e a s . P o p u l a t i o n s t a t i s t i c s c a n b e obtained f rom loca l chambers of commerce , l ibrar ies or any publ i cat ion f rom the 2000 Census conta in ing F lor ida populat ion s t a t i s t i c s I n c l u d e t h e s o u r c e o f y o u r p o p u l a t i o n s t a t i s t i c s . ( "Other" races inc lude As ians/Pac i f i c I s landers and Amer ica Indians/Alaskan Natives.)
3 Enter the tota l number of fu l l ‐ t ime staff and their percent by race, gender and disability. Include the effective date of your summary.
4 Enter the tota l number of c l ients who are enro l led , reg i stered or current ly served by the program, the provider or fac i l i ty , and l i s t thei r percent by race , gender and disab i l i ty . Inc lude the ef fect ive date that enro l lment was counted . Th i s in format ion may be obtained f rom Distr i ct Management Systems Directors , through manual tabulat ion of c l ient records on ‐si te , or other ver i f iab le means.
5 En te r t he t o t a l number o f adv i so r y boa rd member s and t he i r percent by race , gender and disab i l i t y . I f there i s no adv isory or governing board, leave this section blank.
PART II
6 Each re c ip ien t of f edera l f i n anc ia l a s s i s t an ce must have on f i l e an a s su rance tha t the prog ram wi l l be conducted i n comp l i an ce wi th a l l non ‐discr iminatory provi s ions as requ ired in 45 CFR 80. This i s usua l ly a s tandard part of the contract l anguage for DCF rec ip ients and their sub‐grantees. [45 CFR 80.4(a)]
7 Compare the race and gender compos i t ion of the s ta f f . I s i t ref lect ive of the genera l popu lat ion? For example , i f 10% of the populat ion i s Hispan i c , i s there a comparab le percentage of Hispanic staff?
8 Compare t he r a ce and gende r popu l a t i on o f c l i en t s t o t he gene ra l populat ion . I f there i s s ign i f i cant var ia t ion between the race and gender of the c l ient s and the i r presence in the populat ion , the program/provider/fac i l i ty has the responsib i l i ty to determine the reason (s ) for such var ia t ion and t ake act ion necessary to cor rect any discr iminat ion . Some l eg i t imate d ispar i t ies may exi s t when prog rams a re sanct i oned to se rve t a rge t popu l a t i ons such a s elderly or disabled persons. [45 CFR 80.3(b) and (c)]
9 . Programs/prov ider s/ f ac i l i t i e s must make in fo rmat ion regard ing the non‐discr iminatory provis ions of Tit le VI and other appl icable civi l r i g h t s l aws a va i l a b l e t o t h e i r pa r t i c i p an t s , bene f i c i a r i e s o r any other in terested part ies . Th is shou ld inc lude in format ion on the ir r i g h t t o f i l e a c omp l a i n t o f d i s c r i m i n a t i o n w i t h t h e F l o r i d a Department of Ch i ld ren and Fami l ies , or the U.S . Department of HHS The in format ion may be supp l ied verba l ly or in writ ing to every ind iv idua l , or may be suppl ied through the use of equa l opportunity pol icy posters disp layed in a publ ic area of the fac i l i ty . [45 CFR 80.6(d) and 45 CFR 80.7(c)]
10 Cont inu ing s teps must be taken to not i f y emp loyees and the pub l i c of the program's/provider's/faci l i ty 's pol icy of non ‐discr imination on the basi s of disab i l i t y . Th is inc ludes recru i tment mater ia l , not i ces for hearings, newspaper ads, and other appropriate written communication. [45 CFR 84.8(a)]
11 Programs/prov ide r s/ f ac i l i t i e s that employ 15 or more persons must adopt gr ievance procedures tha t i n co rporate appropr ia te due process s tandards and prov ide fo r the prompt and equ i t ab le resolut ion of complaints al leg ing any act ions prohib ited by Sect ion 504 of the Rehabilitation Act. [45 CFR 84.7(b)]
1 2 P r o g r ams /p r o v i d e r s / f a c i l i t i e s w i l l p r o v i d e t h e numbe r a nd t h e current status of a l l discr iminat ion complaints regard ing services or employment f i l ed aga ins t the program/prov ider/ f ac i l i t y with in the last year [45 CFR 80.6(d) and 45 CFR 80.7]
1 3 P e r s o n i n p r o t e c t e d g r o u p s s h a l l n o t b e e x c l u d e d f r o m t h e provisions of services. Evidence of such may be indicated in staff and c l ient representa t ion and through on ‐ s i t e record ana lys i s of persons who app l i ed but were den ied se rv i ces of emp loyment . [45 CFR 80.3(a) and 45
CFR 80.3(b)(2)]
14 . Part i c ipant s or c l i ent s must be prov ided serv i ces such as medica l , nurs ing , denta l care, laboratory serv ices , phys ica l and recreat iona l therap ies , counse l ing and soc ia l serv i ces without regard to race , gender, color , nat ional or ig in , re l ig ion, age or disabi l i ty . Courtesy t i t l e s , a ppo i n tmen t s c h e du l i n g an d a c c u r a c y o f r e c o r d k e e p i n g mus t be app l i e d un i f o rm l y and wi t hou t r e g a r d t o r a c e , gende r , color , nat ional or ig in , re l ig ion, age or disabi l i ty . Entrances, wait ing rooms , r e cep t i on a rea s , r e s t r ooms , and o the r f a c i l i t i e s mus t a l so be equally available to all clients. [45 CFR 80.3(b)]
15 Fo r i n ‐pat ien t se rv i ces , r e s iden t s must be ass i gned to rooms , wa r d s , e t c . , w i t h o u t r e g a r d t o r a c e , c o l o r , n a t i o n a l o r i g i n o r d i sab i l i t y . Al so , res ident s must not be asked whether they are wil l ing to share accommodat ions with persons of a d if ferent race , color, national origin, or disability. [45 CFR 80.3(a)]
16 The prog ram/prov ider / f ac i l i t y and a l l se rv i ces must be acces s ib le to part i c ipant s and app l i cant s , i n c lud ing those persons who are L imited ‐Engl i sh Prof i c ient . In geograph ic areas where a s ign i f i cant p o p u l a t i o n o n n o n ‐E n g l i s h s p e a k i n g p e o p l e l i v e , p r o g r a m access ib i l i ty wil l inc lude f ree language serv ices in accordance with Execut ive Order 13166. I t i s necessary to have a pol i cy or plan to a d d r e s s t h e n e e d s o f t h e L i m i t e d ‐ E n g l i s h P r o f i c i e n t c l i e n t o r applicant. [45 CFR 80.3(a) and Executive Order 13166]
17 The program/prov ider/fac i l i ty must be phys ica l ly access ib le to d i s ab l ed i n d i v i d ua l s . Phy s i c a l a c c e s s i b i l i t y i n c l u de s , bu t i s no t l i m i t e d t o , d e s i g n a t e d p a r k i n g a r e a s , c u r b c u t s o r l e v e l approaches , r amps and adequate width s to ent rance s . The l obby , publ ic te lephone, restroom fac i l i t ies , water fountains, in format ion a n d a dm i s s i o n s o f f i c e s s h o u l d b e a c c e s s i b l e . D oo r w i d t h s a n d t r a f f i c a r e a s o f a dm i n i s t r a t i v e o f f i c e s , c a f e t e r i a s , r e s t r o om s , r e c r e a t i o n a r e a s , coun t e r s and s e r v i n g l i n e s s hou l d be ob se r v ed f o r d o o r w i d t h , a n d B r a i l l e o r r a i s e d n umb e r s . Sw i t c h e s a n d contro ls for l ight heat , vent i lat ion, f i re alarms, and other essent ia ls should be insta l led at an appropr iate height for mobi l i ty impaired individuals.
Acce s s i b i l i t y mus t meet o r be equ i va l en t t o t he s t anda rd s se t by t he Amer i can Nat iona l S t anda rds I n s t i tu te (ANS I ) . I f the p rogram or fac i l i t y i s not access ib le to d isab led persons , there must be an equa l ly effect ive program ava i lab le in the area where serv ices can be obta ined . Al ternat ive serv ice providers must be l i s ted i f the program is not accessible. [45 CFR 84.22]
18 Programs/prov ide r s/ f ac i l i t i e s that employ 15 or more persons must p r o v i d e a p p r o p r i a t e a u x i l i a r y a i d s a t n o c o s t t o p e r s o n s w i t h impa i red sensory , manua l or speak ing sk i l l s where necessa ry . Auxi l iary aids may include, but are not l imited to, interpreters for hear ing impaired indiv iduals , taped or Brai l le mater ia l , or any a l ternat ive resources that can be used to provide equa l ly effect ive services. [45 CFR 84.52(d)]
1 9 S e c t i o n 5 0 4 o f t h e Re h ab i l i t a t i o n A c t o f 1 9 7 3 r e q u i r e s t h a t a rec ip ient of f edera l f inanc ia l ass i s t ance conduct a se l f ‐eva lua t ion to ident i fy any access ib i l i t y barr iers . Se l f ‐evaluat ion i s a four step process:
• Wi t h t h e a s s i s t a n c e o f a d i s a b l e d i n d i v i d u a l / o r g a n i z a t i o n , eva luate current pract i ces and pol i c ies to ident i f y any pract i ces and policies that do not comply with Section 504.
• Modify pol ic ies and pract ices that do not meet Sect ion 504 requirements.
• Take remedia l steps to el iminate any discr iminat ion that has been identified.
• Mainta in sel f ‐evaluat ion of f i le . (Th is checkl ist may be used to sat i s fy th i s requ irement i f these four s teps have been fo l lowed. ) [45 CFR 84.6]
20 Programs/prov ider s/ f ac i l i t ie s that emp loy 15 or more persons must des ignate at l east one person to coord inate ef fort s to comply with Section 504. [45 CFR 84.7(a)]
21 Programs/prov iders/fac i l i t ies who prov ide d irect serv ices to c l ients will train employees on all appropriate Civil Rights Laws.
22 The program/prov ider/fac i l i ty person complet ing th i s form must sign, provide job title, and date the form.
9. VENDOR AUTHORIZATION PROCEDURES
I certify that I (as the undersigned representative) have reviewed Our Kids’ RFP for __________.
This proposal constitutes the Undersigned Company’s response to Our Kids’ RFP for the above‐mentioned
project/service. I further certify that I am authorized to negotiate for and contractually bind the undersigned
company in all discussions with Our Kids for the procurement of the services/products named above. All
contacts with the Undersigned
Company should be directed to:
Company Representative’s Name Representative’s Title Company Address Telephone (Primary Contact) Fax (Primary Contact) Email (Primary Contact
Signature: Date:
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