Fatherhood Steering Committee

SUBMIT THIS PAGE STATE OF COLORADO DEPARTMENT OF HUMAN SERVICES PROMOTING RESPONSIBLE FATHERHOOD COMMUNITY ACCESS GRANT

REQUEST FOR APPLICATION (RFA) – Funding Cycle October 1, 2010 – September 29, 2011

IMPORTANT: Applications submitted in response to this RFA MUST include the REQUEST FOR APPLICATION SIGNATURE PAGE. Applicants should carefully read this entire RFA document and instructions before submitting an application. Applications must be signed in ink by the Board Chair or Authorized Person as listed on page 2, section A. Application Forms and Instructions are available at www.colorado dads.com (click on “The Program” and then “Funding” tabs). Submissions that do not follow the application instructions may not be reviewed. Application response information is limited to space in provided locked boxes. TAB between boxes. Click to mark check boxes.

The total amount available for awards through this grant in each funding cycle is $1,155,400.00. Applicants may request up to $50,000.00 and are asked to request what they need for a 12-month period. At least 70% of the available funds will be awarded to community and faith-based organizations that: have a social services-based mission, are headquartered in the community they serve, have an operating budget of $300,000.00 or less, or have six (6) or fewer full-time equivalent employees.

TYPE OF APPLICANT (PLEASE CLICK ON ALL BOXES THAT APPLY):

of 71 SUBMIT THIS PAGE

Other, please describ

A. REQUEST FOR APPLICATION SIGNATURE PAGE AND APPLICANT DATA A. SIGNATURE AND CONTACT INFORMATION TABLE Full Legal Name of Applicant (Agency): Physical Address: Mailing Address (if different than above): City: Zip Code: County: Phone: Fax: Email: Website: FEIN or SSN:

A. REQUEST FOR APPLICATION SIGNATURE PAGE AND APPLICANT DATA (CONTINUED)

A1. Signature and Contact Information Table Name of Board Chair/Authorized Official: Title of Authorized Official: Signature of Board Chair/Authorized Official: Date: Total Funding Request: Director’s Name and Title: Director’s Phone: Director’s Email: Fatherhood Program Contact Name: Fatherhood Program Contact Title: Fatherhood Program Contact Phone: Fatherhood Program Contact Email:

A2. If applicant is a non-profit (community-based) or faith-based organization, please attach a copy of the 501C-3 or 509(a)1 letter approving tax-exempt status. If letter is not available, please attach a letter indicating tax status. (PLEASE LABEL THIS ATTACHMENT 1.)

A3 Attach a copy of the Secretary of State Certificate in Good Standing (PLEASE LABEL THIS ATTACHMENT 2). Certificate may be found at the following link: http://www.sos.state.co.us/biz/BusinessEntityCriteria.do

A4. Attach a copy of the fatherhood project logic model (PLEASE LABEL THIS ATTACHMENT 3). This is required for all applicants. If your agency has a logic model, please include that also, however, an agency logic model cannot be submitted in place of the fatherhood project’s logic model (PLEASE LABEL THIS ATTACHMENT 3a).

A5. Provide a summary of the fatherhood project. Include an outline of a plan of action that describes the scope and detail of how the proposed work will be accomplished. This section should only include proposed work that will be funded by this grant. Activities provided by your agency, under additional funding sources may not be included in this section (Response is limited to 17 lines, click on box to type answer.)

A6. FATHERHOOD PROGRAM STATISTICS – IF AVAILABLE. Only submit known statistics. These statistics should apply to the following time frame: April 1, 2009 – March 31, 2010. Total # of Families Served: Total # of Custodial Fathers Served: Total # of Non-Custodial Fathers Served: Total # of Families Served with incomes under $75,000 per year: # of Community Education Presentations: # of Active Volunteers:

A7. Provide an applicant history including how long the applicant has been providing services to promote responsible fatherhood and/or the relevant experience the applicant has in working with fathers. Please describe services you have offered to fathers. (Response is limited to 34 lines.) If available, attach a sample of applicant’s brochure, promotional, marketing materials, or fact sheet that highlight relevant services potentially funded under this grant. (PLEASE LABEL THIS ATTACHMENT 4.)

A8. Use the space below to clearly identify the physical, economic, social, financial, institutional, and/or other problems requiring a solution from a fatherhood perspective in the applicant’s community or communities. Include information such as data related to local community fatherhood program needs, which will assist the selection committee in better understanding the application. Please note: this question is specific in regards to information related to fatherhood. Please do not identify problems in this section that do not relate to and/or would not be addressed by fatherhood funding. (Response is limited to 17 lines.)

A9. State your target population. Please address how your proposed services will meet the needs of your target population. (Response is limited to 17 lines.)

A10. List the other promoting responsible fatherhood services providers also serving the applicant’s geographic area (if known) and nature of collaborative relationship if applicable. (Response is limited to 8 lines.)

A11. Attach a copy of Articles of Incorporation or similar document. (PLEASE LABEL THIS ATTACHMENT 5.)

A12. Provide a copy of By-Laws. (PLEASE LABEL THIS ATTACHMENT 6.)

A13. If available, provide a copy of applicant’s annual report. (PLEASE LABEL THIS ATTACHMENT 7.)

A14. Type Applicant’s Mission Statement from By-Laws in box below. (If statement exceeds 4 lines create a separate attachment. PLEASE LABEL THIS ATTACHMENT 8.)

B. SERVICE PROVISION PROCEDURES B1. Describe the applicant’s plan for recruiting and retaining clients. How will potential clients be referred to applicant’s fatherhood program? Is this an existing process, with existing relationships, or will your agency need to develop this process and/or relationships? Please be specific to your agency’s intended activities in regards to this question rather than solely documenting the expected referral actions of your collaborative partner(s). (Response is limited to 24 lines.)

B. SERVICE PROVISION PROCEDURES (CONTINUED)

B2. Participants of services provided under this grant must do so voluntarily. What provisions does the applicant have in place to assure that fathers engage in program services voluntarily? Participants may not be court ordered to your program. They may however, choose your program from a list of mandated options. (Response is limited to 17 lines.)

B3. Describe the applicant’s policy regarding the client grievance process or handling of client complaints. (Response is limited to 17 lines.)

B4. Faith-based organizations must submit a statement of non-proselytization. What is the applicant’s policy with regard to non-proselytization for services provided under this grant? Address how the program will ensure that any staff working on both funded and non-funded services (within your agency) will be able to clearly identify which specific hours are spent on the funded program. (Response is limited to 17 lines.) Applicants that are not a faith-based organization please respond with Not Applicable.

B5. What is the applicant’s commitment that funds set forth in this grant will be used only for the services allowed under this grant. Specifically address the applicant’s policy on involvement in child visitation/custody proceedings, lobbying and legislative advocacy –these activities are not allowed under this grant. (Response is limited to 17 lines.)

B6. Describe how the applicant will provide services in the following ten areas and if there is a need for technical assistance and/or training. Please describe, if known, what types of training/assistance is needed. Responses are REQUIRED for B6a, B6b and B6c. Remaining service areas are optional.

B6a. (REQUIRED SERVICE AREA) Help fathers establish positive relationships with their children (specifically how the applicant encourages fathers to be positive non-violent role-models and encourages fathers to be nurturing). (Response is limited to 4 lines.)

B6b. (REQUIRED SERVICE AREA) Assesses potential fathers for domestic violence and provides assurances that services promote the safety and well-being of fathers’ partners and their children. (Response is limited to 4 lines.)

B6c. (REQUIRED SERVICE AREA) Collaborations or dynamic ongoing relationships with local TANF offices, child support enforcement, child welfare, domestic violence crisis centers, substance abuse programs, mental health programs, health care services or other human services or community-based entities. (Response is limited to 4 lines.)

B6d. (OPTIONAL SERVICE AREA) Young fathers or too-early fatherhood. (Response is limited to 4 lines.)

B6e. (OPTIONAL SERVICE AREA) Improving fathers’ economic circumstances. (Response is limited to 4 lines.)

B6f. (OPTIONAL SERVICE AREA) Community education programs - specifically how the applicant increases public awareness about responsible fatherhood. (Response is limited to 4 lines.)

B6g. (OPTIONAL SERVICE AREA) Fathers who have children with disabilities. (Response is limited to 4 lines.)

B6h. (OPTIONAL SERVICE AREA) Single, custodial fathers. (Response is limited to 4 lines.)

B6i. (OPTIONAL SERVICE AREA) Non-residential fathers. (Response is limited to 4 lines.)

B6j. (OPTIONAL SERVICE AREA) Recipients of child protective services from a county department of human social services. (Response is limited to 4 lines.)

C. COMMUNITY ACCESSIBILITY PLAN C1. Who are the underserved populations in the applicant’s catchment area? (example: include populations underserved because of ethnicity, race, religion, culture, age, language barrier, sexual orientation or geographic location) (Response is limited to 17 lines.)

C. COMMUNITY ACCESSIBILITY PLAN (CONTINUED)

C2. How did the applicant determine the underserved populations? (Response is limited to 17 lines.)

C3. What specific activities has the applicant accomplished in the past 12 months to provide information and services to each of these groups defined as underserved? (Response is limited to 17 lines.)

C4. What specific activities is your agency planning on providing to meet the needs of the identified underserved populations, under this grant? (Response is limited to 17 lines.)

C5. List the percentage of people of color, bilingual and bicultural staff, volunteers and Board of Directors members associated with the operation of the applicant’s fatherhood program.

People of Color Bilingual Bicultural Staff Volunteers Board of Directors

C6. What recruitment effort has the applicant made to assure staff, volunteer and Board of Directors (or advisory board) representation reflects the community served? (Response is limited to 17 lines.)

C7. Is the applicant’s office physically accessible to persons with disabilities (as described under the Americans with Disabilities Act)? (Examples include TTY phone line, physical accessibility.)

CLICK BOX TO THE LEFT OF RESPONSE:

C7a. If yes, please describe the features that promote accessibility. (Response is limited to 17 lines.)

C8. Is the applicant’s agency prepared to offer services to women, upon request, as per the federal equal access guidelines? CLICK BOX TO THE LEFT OF RESPONSE:

C8a. If yes, please describe the agency’s plan to accommodate and/or incorporate women into the fatherhood project’s services.

C9. If no to question C7, and/or C8, what plans are in place to improve the accessibility to the office to provide services for persons with disabilities and/or to provide services to women upon request? (Response is limited to 17 lines.)

C10. What hours are the applicant’s services available and how does the applicant’s hours of service meet the needs of fathers who work? Does your agency have a plan for revisiting the proposed hours of services if the needs of the participants do not match the planned service hours? (Response is limited to 17 lines.)

D. APPLICANT STRUCTURE/RESOURCES D1. Attach a dated organizational chart with each copy of the application. The chart should indicate both paid staff and volunteer positions within the organization. Each position should be clearly marked. This chart must be dated within the six (6) months prior to submission of this RFA. (PLEASE LABEL THIS ATTACHMENT 9.)

D2. Attach a dated list of members of the CURRENT Board of Directors. (PLEASE LABEL THIS ATTACHMENT 10.)

D3. Attach CURRENT job descriptions including qualifications for all positions that are providing direct services to fathers under this grant (paid staff and volunteer.) (PLEASE LABEL THIS ATTACHMENT 11.)

D. APPLICANT STRUCTURE/RESOURCES (CONTINUED)

D4. Provide fiscal information as outlined below.

D4a. Identify who has or will have fiscal or financial responsibility/oversight for the applicant’s fatherhood program.

Name Title Staff person with fiscal or financial responsibility and oversight: Staff person with fiscal or financial responsibility and oversight: Board of directors person with fiscal or financial responsibility and oversight: Board of directors person with fiscal or financial responsibility and oversight

D4b. What procedures are in place to assume board fiscal or financial oversight? Examples include monthly fiscal reports, finance committee meetings, etc. (Response is limited to 17 lines.)

D5. What additional resources does the applicant have available to provide the proposed promoting responsible fatherhood services? (Examples include personnel, funding, in-kind contributions, etc. Please note: in-kind contributions or program match are not a requirement of this grant. (Response is limited to 17 lines.)

D. APPLICANT STRUCTURE/RESOURCES (CONTINUED)

D6. Explain the training the applicant’s staff and volunteers have received regarding promoting responsible fatherhood. Include in this response the process used for new staff and board member orientation and training, training on cross-cultural topics, accessibility, domestic violence, confidentiality, mandatory reporting and documentation processes. Also provide information on any training needed that is currently unavailable based on applicant’s resources. (Response is limited to 24 lines.)

D7. Describe the actions the applicant has taken to diversify funding sources. (Response is limited to 17 lines.)

E. Demonstrated Community Support, Cooperation and Collaboration (15 points) Letters of support from appropriate entities should substantiate community support, cooperation and collaboration. The letters must support the application and describe the specific working relationship between the applicant and the entity providing the letter. Examples include: county human services (child protection, TANF, child support enforcement), social service organizations or other fatherhood programs. Applicants must submit four (4) letters as outlined below. The letters must be dated within six months of the application deadline and must be included with the application.

E1. One (1) and no more than one letter that provides general support for the application. (PLEASE LABEL THIS ATTACHMENT 12.) List the name of the supporting individual and his/her affiliation or supporting organization in the text box below.

E2. One (1) and no more than one letter that documents a current and ongoing collaborative or cooperative relationship. (PLEASE LABEL THIS ATTACHMENT 13.) List the name of the supporting individual and his/her affiliation or supporting organization in the text box below.

E3. One (1) and no more than one letter that documents a developing or current collaborative or cooperative relationship with a local domestic violence organization (crisis center for victims). This letter must indicate the nature of the relationship and should outline the goals of the relationship. (PLEASE LABEL THIS ATTACHMENT 14.) List the name of the supporting individual and his/her affiliation or supporting organization in the text box below.

E4. One (1) and no more than one letter that provides client testimonial. This letter must be no more than one page

and should not identify the client. (PLEASE LABEL THIS ATTACHMENT 15.)

F. APPLICANT FINANCIAL INFORMATION (10 POINTS) County applicants may provide a budget summary in lieu of the complete county budget.

F1. Attach a year-end organizational financial statement. (PLEASE LABEL THIS ATTACHMENT 16.)

F2. Attach a year-to-date organizational financial statement. (PLEASE LABEL THIS ATTACHMENT 17)

F3. Attach the applicant’s most recent organizational financial review or audit, regardless of budget size. All submitted audits must be dated 2008 or later. (PLEASE LABEL THIS ATTACHMENT 18.)

G. EVALUATION, OUTCOMES & STATISTICS (55 POINTS) Check the Eligible Service Components for which funding is being requested. The three eligible service components are 1) fatherhood parent skills training (required) 2) healthy marriage/couple relationship training (optional) 3) activities to foster economic stability (optional).

IDENTIFIED SERVICE COMPONENTS (check all that apply):

Healthy Marriage/ Healthy Relationship

G1. Define the outcomes and impacts the applicant intends to achieve through services provided under this grant. (Response is limited to 17 lines.)

G2. Explain how the applicant will measure the degree to which the promoting responsible fatherhood grant- funded activities are achieving the intended outcomes and impacts. (Response is limited to 17 lines.)

G3a. GOALS, OUTCOMES AND MEASUREMENTS

Goal #1: (Response is limited to 4 lines.)

Outcomes (Short and/or Long-term): (Response is limited to 8 lines.)

Measurement Tools: (Response is limited to 8 lines.)

G. EVALUATION, OUTCOMES & STATISTICS (CONTINUED)

G3b. GOALS, OUTCOMES AND MEASUREMENTS

G3c. GOALS, OUTCOMES AND MEASUREMENTS

G4. What is the applicant’s proposed service provision timeline (i.e. what is the sequence of services provided, are services ongoing or are they offered at specific times of the year)? Please indicate a timeline of services for each of the quarters of the contract listed below. Please note: if your program will need a period of program development, please indicate this below in Quarter #1.

Direct program services must be provided through the end of Quarter #4 and must be provided throughout the year (with the sole exception of a period of program development allowed during Quarter #1 for newly funded programs that shall last no longer than December 31) with no breaks in service longer than 2 consecutive weeks. Responses are limited to 4 lines per quarter.

Quarter #1 October 1 – December 31:

Quarter #2 January 1 – March 31

Quarter #3 April 1 - June 30

Quarter #4 July 1 – September 30

G5. Indicate the projected program services statistics for the grant period October 1– September 29.

SERVICE AREA TARGET NUMBERS FOR 10/01/09 – 9/29/11 Total # of Parent Skills Training Sessions to be Offered: If you are offering more than one type of parent skills training, please separate them below and indicate target participant #s for the October 2010 – September 2011 period (#s below should add up to the Total # Offered)

Total # of Relationship Skills Training Sessions to be Offered: If you are offering more than one type of relationship skills training, please separate them below and indicate target participant #s for the October 2010 – September 2011 period (#s below should add up to the Total # Offered)

Total # of Economic Stability Training Sessions to be Offered: If you are offering more than one type of economic stability training, please separate them below and indicate target participant #s for the October 2010 – September 2011 period (#s below should add up to the Total # Offered)

Total # of Custodial Fathers Anticipated: Total # of Non-Custodial Fathers Anticipated: Total # of Families Served with incomes under $75,000 per year Anticipated: Total # of Young Fathers (ages 14-26) Anticipated: # of Community Education Presentations Anticipated: # of Active Volunteers Anticipated: Other Please indicate): Other (Please indicate):

G6. Please outline below the position(s)/person(s) responsible for each aspect of service provision (i.e. program management, program facilitation, data collection/data entry, administrative oversight, etc) and who supervises them. (Response is limited to 20 lines.)

G6a. How will services be monitored? Please describe your agency’s internal Quality Assurance (QA) processes. (Include activities involved, frequency and procedures in place to ensure services are consistently provided, and processes for addressing QA issues identified). (Response is limited to 17 lines.)

H. APPLICATION BUDGET (20 POINTS) H1. PROPOSED BUDGET FOR REQUESTED FATHERHOOD FUNDS.

Applicants may request funds based on the categories below. Personnel requests must be for direct services staff ONLY. Direct services staff must provide support and delivery of core services to the target population of this grant. Staff who provide administrative support are only eligible in the extent that they serve the administrative requirements of the grant (MIS, reporting etc.) and also provide some direct services to fathers. Miscellaneous expenses must not be more than 10% of total request. Overhead expenses such as rent and utilities are not eligible under this grant. Expenses labeled “other” are subject to approval by the selection committee.

A. PERSONNEL (DIRECT SERVICES STAFF ONLY) AMOUNT (Use whole dollars only) Job Title: Job Title: Job Title: Job Title: A. Subtotal: B. SUPPLIES AND MATERIALS AMOUNT (Use whole dollars only) Supplies: Duplication: Materials: B. Subtotal: C. COMMUNICATIONS AMOUNT (Use whole dollars only) Telephone: Advertising/Newsletter: Brochures: Postage: C. Subtotal: D. MISCELLANEOUS (not more than 10% of total AMOUNT (Use whole dollars only) request) Offsite Facility Rental: Business Mileage: Books/Subscriptions for Staff/Volunteers: D. Subtotal: E. OTHER (components must be fully explained in the AMOUNT (Use whole dollars only) budget narrative section) Indirect (not more than 10%) DV Collaboration Specify: Specify: E. Subtotal: TOTAL (A+B+C+D+E) (Use whole dollars only)

H. APPLICATION BUDGET (CONTINUED)

H2. Budget Narrative – please describe how the requested funds will be used. Responses are limited to 4 lines in each category.

Personnel – Direct Services Providers:

Supplies and Materials:

Communications: