TENDER APPLICATION FORM - DOC by AndrewBrocklehurst

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									                                                           TENDER APPLICATION FORM
                                                                         DADHC 09.23
                                           Community Participation Program, Woollahra LGA
                                              Funded under the Disability Services Program
                             FOR SERVICES TO BE PROVIDED FROM 1 JANUARY 2010


PART 1A: ORGANISATION DETAILS

         Name of Organisation:                                                                                  Consortium:
                                                                                                                 Yes/ No


         Status of Organisation:                                                                                ABN

         (e.g. Co-operative Limited, Incorporated Association, Company Limited by
         Guarantee, Local Government, Registered Housing Organisation, or other 1,
         please specify)
         Address of Organisation (this is the physical location of the head office of the organisation):


                                                                                          Postcode:
         Address of Service Outlet (this is the physical location or area where the outlet will be
         operational).


         Please list the Local Government Areas that will be serviced by this outlet.


         Name & Title of Contact Person: (should be available for 4 weeks following the closing date)


         Contact Telephone Number:                                               Contact Fax Number:


         Contact Email Address:


If your organisation is not currently incorporated, but intends to be incorporated if successful,
describe the steps you have taken/intend to take to achieve this. Please note that proof of
incorporation will be required before any funding is provided should the application be
successful.



1
  The organisation must be a not for profit organisation. In this context, DADHC classifies a not-for-profit organisation as an
organisation whose primary objective is not the generation of profit, but to support some matter of public interest, for non-commercial
purposes. Accordingly, such an organisation would use any operating surpluses or profits for reinvestment in its support of the matter
of public interest.
Tender Application Form: Community Participation Program (DADHC 09.23)                                                       1
PART 1B: CONSORTIUM DETAILS (OUTLET)
Please fill in this page only if a consortium of organisations is submitting this application.
The application must include and have attached “Letter(s) of Intent” or a “Memorandum of
Understanding” showing the signed agreement of the proposed members to enter into a
consortium arrangement.

Lead agencies must acknowledge that all funding liabilities will be with them and that they
will be required to:
    a) properly account for funds allocated to other bodies for the purposes of the
       consortium;
    a) have higher levels of accounting and financial management skills to fulfil the
       responsibilities of a lead agency that will fall to them; and
    b) ensure that all other legal liabilities, including liabilities to clients and staff, are
       applied through their subcontracting arrangements with the other consortium
       members.

Lead Agency Name:

_____________________________________________________________________

New Consortium Name (if applicable):

_____________________________________________________________________

Other Member Organisations:

_____________________________________________________________________

_____________________________________________________________________

_____________________________________________________________________

_____________________________________________________________________
Description of internal arrangements between member organisations
Considering the responsibilities outlined above, please describe below:
    a) how the consortium will be set up, including the nature of the legal relationship
       between parties;
    b) how the lead agency will manage and oversee internal arrangements; and
    c) details about the other member organisations.




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PART 2: CERTIFICATION (ORGANISATION)

The Certification should be signed AFTER completing the Application Form. The
Certification is the organisation's validation of the information provided in the application.
Individuals eligible to sign this Certification are:
             for Local Government agencies, the General Manager or an appropriately
              delegated officer; or
             for community based organisations, two (2) duly delegated officers; or
             for organisations not yet incorporated, two (2) members delegated to sign.


We, the undersigned, certify that the information in this document is true and correct, and
agree to the following undertakings on behalf of the organisation, should the application be
successful:
1. The organisation agrees to comply with the Department's Funding Agreement, and
   understands that the service specification, the application, any attachments and any
   subsequently developed Service Description Schedules may form part of the Agreement
   for the delivery of the service.

2. The organisation will operate the proposed service in accordance with the stated
   Community Participation Program Guidelines and Standards, and any relevant reform
   strategies that the Department may be in the process of implementing.

3. The organisation certifies that none of its office bearers, employees or agents have been
   charged or convicted of committing a criminal offence which will reasonably affect the
   ability of the organisation to undertake service delivery as specified in this tender
   application.



1.       Signature:_____________________________________ Date: __________

         Name:(please print)______________________________________________

         Position/Title: (please print) _______________________________________




2.       Signature:_____________________________________ Date: ___________

         Name: (please print) _____________________________________________

         Position/Title: (please print)________________________________________




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PART 3: REFEREES (ORGANISATION)
Please provide details of two (2) referees who may be contacted by the Assessment Panel to
provide confirmation of the claims made in the application in respect to the capacity of your
organisation to deliver the proposed service.
The Department will expect the referees to be able to comment on the organisation's ability
to meet the assessment criteria. Applicants should ensure that nominated referees are aware
of the organisation’s intent to submit a tender and the nature of the service for which they
are applying.
Referees should be available during the four weeks after the tender closing date, should the
Assessment Panel wish to contact them.
The referees should be from the following types of agencies and work closely with your
organisation:
          a local consumer organisation;
          a local service provider;
          a government department; or
          a local government organisation.
A family member or carer of a service user may act as a referee. Like all referees they will
need to be able to comment on the organisation's ability to meet the assessment criteria
Do not include an officer of DADHC as a referee. References will also not be accepted from
individuals directly or recently connected with the organisation as a member of staff or
management committee.

Referee 1:
Name:             _____________________________________________________________
Position:         ____________________________________________________________
Organisation:________________________________________________________
Telephone:        ____________________                           Facsimile: _________________
Mobile:           ____________________
Email Address:_______________________________________________________
Connection to the applicant: __________________________________________

Referee 2:
Name:             _____________________________________________________________
Position:         ____________________________________________________________
Organisation:________________________________________________________
Telephone:        ____________________                           Facsimile:_________________
Mobile:           ____________________
Email Address:_______________________________________________________
Connection to the applicant:____________________________________________


Tender Application Form: Community Participation Program (DADHC 09.23)                          4
  IMPORTANT NOTE: BEFORE COMPLETING THIS APPLICATION FORM
   TENDERERS SHOULD CAREFULLY REVIEW BOTH THE REQUEST FOR
 TENDER AND THE COMMUNITY PARTICIPATION PROGRAM GUIDELINES



PART 4:           OPERATION OF SERVICE TYPE (OUTLET)

4.1 IDENTIFY THE LOCATION OF THE OUTLET FROM WHICH THE
    SERVICE TYPE WILL BE OFFERED

For each outlet provide the location where it is proposed that the service type will be offered:
        address including postcode (may be the administrative centre or the service delivery
         centre depending on the service type); and
        the catchment or operational area of the service (i.e. specify the Local Government
         Area(s) and/or DADHC Local Planning Area(s), as applicable). This must align with
         the localities you listed in Part 1, Page 2)

4.2 DESCRIBE THE OPERATION OF SERVICE TYPE

Describe the operation and/or approach to implementation and the features of the service
type.

4.2.1    Centre Based with Community Access

             Describe how participation and activities will be structured including size and
              operation of groups and provision of individual support where needed.

             Describe the type of activities to be offered, how these may vary according to
              individual need and how service users will choose between activities.

             Indicate the activities to be delivered at the centre and in the community and
              describe how activities in the community will facilitate the development of
              friendships and social networks and community inclusion for service users.

             Describe the approach to ensuring activities are age and culturally appropriate.

             Describe the physical relationship of the service centre relative to other
              community services and outline strategies to develop links between the centre
              and mainstream community services.




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4.3 REQUIREMENTS FOR A CENTRE BASED – COMMUNITY ACCESS SERVICE

Describe:
        what type of information and support will be provided to Program service users to
         inform their choice of service provider;

        the average proportion of time to be allocated (20-40% or more) to learning and skill
         development activities and how this proportion may vary across funding bands,
         where applicable;

        additional individual personal support to be provided to service users to enable them
         to participate in the Program such as assistance with eating or behaviour support;

        where more than one service type is proposed to be offered from the same service
         delivery location, how individual service users will be assisted to move between
         services according to changing needs and goals;

        the level of support the organisations propose to provide, in line with the funding
         bands specified in Section 19 of the Community Participation Program Guidelines; and

        how the delivery of the service will vary according to the level of support needs
         across the four funding bands.


4.4 REQUIREMENTS FOR SERVICES FOR SPECIFIC POPULATION GROUPS


        Describe how the service user’s individual program of activities will be designed to
         meet the specific needs of this population group.
        Describe how the organisation will work with and, where needed, contract specialist
         supports and services for this population group.




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PART 5:           IDENTIFY MINIMUM AND PREFERRED/MAXIMUM
                  SERVICE CAPACITY FOR THE OUTLET

5.1   Identify the minimum number of service users that you are seeking for the outlet.
      (Note: The minimum number of service users is the minimum number required to
      operate a viable service, i.e. where income is sufficient to cover expenses.)


5.2   Describe how you calculated your total minimum number of service users (e.g. whether
      you based it on the likely relative distribution of funding bands). Your description
      should address other relevant factors such as the application of existing or potential
      cost efficiencies if applicable.


5.3   Complete Table 5.1 indicating your preferred/maximum number of service users after
      reviewing the instructions for completion set out in section 6 of the Request for Tender.

      Table 5.1: Proposed PREFERRED/MAXIMUM Number of Community Participation Service Users

         Proposed MAXIMUM/                    Proposed MAXIMUM/ PREFERRED comprises the
        PREFERRED number of                        following numbers of existing and new
        Community Participation                    Community Participation service users
             service users
                                         Minimum no. of service users       Additional no. of service
                                            (This must be the same as the   users
                                                   number in 5.1)




5.4   Describe how you calculated your total preferred/maximum number of service users
      (e.g. whether you based it on the likely relative distribution of funding bands). Your
      description should address other relevant factors such as the application of existing or
      potential cost efficiencies if applicable.




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PART 6.           HOURS OF SERVICE AT THE OUTLET

6.1    Indicate the average number of hours per week to be provided to service users in each
       funding band noting that it is a condition of funding that a minimum of 24 hours per
       week for young people in the Moderate and High funding bands and 30 hours for
       those in the Very High and Exceptional funding bands is to be provided to each young
       person in 2008 (Note: the average number of hours must relate to the information you
       provide in the minimum/maximum budgets).


6.2    Indicate the number of weeks per year that the service will operate, noting that services
       must be offered for a minimum of 48 weeks a year. Indicate which weeks in the year
       the service will be closed, noting that the services will be closed between Christmas
       and New Year. (Note: Refer to the Request for Tender (Section 2.6.2) for further details
       about organisations operating in remote locations).


6.3    Indicate operating hours and days per week for the service.


6.4    If applicable, describe the approach to offering additional hours of support where
       requested by a service user or their family that is beyond the hours funded by the NSW
       Government.




Tender Application Form: Community Participation Program (DADHC 09.23)                       8
PART 7.           SERVICE STAFFING AT THE OUTLET


7.1    Describe the proposed workforce including qualifications and skills.


7.2    Describe the staffing structure including the service user to staff ratio for each funding
       band. (Note: Refer to the Request for Tender (Section 8) for advice about completing
       ratios).


7.3    Describe how staff will be supervised, provision for training and professional
       development.


7.4    Describe what role (if any) will be played by volunteers in supporting service delivery.




Tender Application Form: Community Participation Program (DADHC 09.23)                        9
PART 8:           ARRANGEMENTS FOR INDIVIDUAL PLANNING
                  (ORGANISATION)


8.1    Describe how the person and their family/advocate will be supported to develop and
       review their Individual Plan.

8.2    Indicate how the differing goals, skills and experience (and related learning,
       development and support needs) will be reflected in their Individual Plan, including
       consideration of age, gender, Aboriginality, culture, language and religious diversity.

8.3    Indicate how the Individual Plan will incorporate an understanding of the person’s
       achievements at school and in other areas of their life, including their living,
       communication and social skills, and their physical and behavioural support needs.

8.4    Indicate how the intended results of the Community Participation Program will be
       achieved through the Individual Plan through a focus on areas such as independent
       living skills, communication skills, learning, personal care and development, social
       skills and opportunities, health and wellbeing, community inclusion and longer term
       opportunities.

8.5    Describe administrative arrangements for ensuring that Individual Plans are
       developed within three months of a person commencing in the Program and reviewed
       every six months.




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PART 9:           ABORIGINAL SERVICE PROVISION AT THIS OUTLET

9.1    Identify the local Aboriginal communities to whom you propose to promote your
       services to improve their access to your services.

9.2    Describe strategies to establish networks and trusted relationships with Aboriginal
       families and communities including consulting with Aboriginal communities about the
       design and delivery of Community Participation services and the needs of local young
       Aboriginal people and their families.

9.3    Describe strategies to provide clear and culturally appropriate information to
       Aboriginal people including information about the purpose of the program and the
       rights of young people and their families. Outline how Aboriginal communities will be
       consulted to identify culturally appropriate communication strategies.

9.4    Describe strategies to ensure that services are responsive to Aboriginal culture and
       history including:

             provision for involvement of Aboriginal families and communities;
             access to and brokerage of local Aboriginal community services and
              organisations;
             operating from culturally appropriate spaces;
             responding to cultural issues affecting young Aboriginal people as part of
              Individual Planning; and
             recruitment of Aboriginal staff and/or development of the cultural competency of
              non Aboriginal staff through training and other development. Where Aboriginal
              staff will be recruited indicate how they will be supported to build and maintain
              networks with other Aboriginal people working in disability or community
              services.




Tender Application Form: Community Participation Program (DADHC 09.23)                     11
PART 10: CALD SERVICE PROVISION AT THIS OUTLET

10.1 Identify CALD communities in your service provision area to whom you propose to
     promote your service to improve their access to your services.

10.2 Describe the approach to establishing and developing networks with CALD
     organisations in the local area including consulting with community leaders and
     organisations to identify attitudes to disability and disability services, community
     needs, and existing community supports and networks relevant to Community
     Participation service delivery.

10.3 Describe approaches to providing responsive services to young people from culturally
     diverse communities including:
           promoting services to local young people from culturally diverse families and
            communities, including information about the Program in community languages;
           consulting with CALD communities to ensure information is provided in forms
            and through channels appropriate to local CALD communities and using language
            services where necessary;
           supporting family members from culturally diverse backgrounds to be involved as
            partners in the individual planning process, with the consent of the young person;
           using relevant cultural knowledge in skill development and other activities,
            including accessing and brokering services from CALD community organisations
            and networks;
           supporting the observation of cultural and religious practices; and
           adopting flexible approaches to service delivery to meet the needs of CALD service
            users, such as brokerage models that employ specific CALD workers or services
            when needed.

10.4       Describe approaches to providing culturally competent services through, for
           example:

            recruiting and retaining staff who reflect the cultural and linguistic diversity of
             local communities;
            ensuring that all staff are culturally competent; and
            utilising local community leaders or CALD families to advise staff of the specific
             needs of young people from culturally diverse communities.




Tender Application Form: Community Participation Program (DADHC 09.23)                      12
PART 11: COOPERATIVE RELATIONSHIPS WITH MAINSTREAM
         SERVICES, ORGANISATIONS AND NETWORKS AT
         THIS OUTLET

11.1     Describe the organisation’s understanding of, and experience with, disability and the
         mainstream service system in the service outlet location.

11.2     Describe how community relationships will be established and/or maintained.

11.3     Indicate which mainstream community services, organisations and networks are
         intended to be accessed.

11.4     Indicate how access for service users will be facilitated and how known barriers to
         accessing community services will be overcome.

11.5     Describe the organisation’s experience in, or approaches to, working with other
         support services required by service users to ensure a coordinated approach to
         meeting individual needs.




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PART 12: ABILITY OF THE ORGANISATION TO PROVIDE THE
         PROPOSED SERVICE

12.1     Describe the service and funding history of the organisation.

12.2     If applicable, indicate how many Community Participation service users are currently
         placed with your organisation. If these services are at more than one outlet, indicate the
         number of service users at each outlet.

12.3     If applicable, describe other comparable services currently delivered by the organisation
         such as Transition to Work, Post School Options or day programs and the number of
         service users.

12.4     Demonstrate experience in, or the capacity for, meeting the needs of your proposed
         population groups.




Tender Application Form: Community Participation Program (DADHC 09.23)                    14
PART 13: ORGANISATIONAL ARRANGEMENTS

13.1     Describe the purpose and objectives of the organisation.

13.2     Provide details of the service infrastructure, administrative support and information
         systems that will support operation of Community Participation services.

13.3     Describe the management structures at the outlet, demonstrating how it will ensure that
         services will be effectively delivered.

13.4     Describe strategies to evaluate and improve service quality and the results of any service
         evaluations and quality assurance processes in place.

13.5     Describe human resources arrangements including qualifications and experience and
         provision for staff development and training.

13.6     Describe strategies for recruiting and retaining motivated, quality staff.

13.7     Describe processes to effectively communicate with staff, young people and their families.

13.8     Describe insurance arrangements including public liability and worker’s compensation
         coverage.

13.9     Demonstrate a history of financial viability and provide the last two year’s financial
         reports.




Tender Application Form: Community Participation Program (DADHC 09.23)                       15
PART 14: COMPLIANCE WITH THE DISABILITY SERVICE
         STANDARDS

14.1     Has the organisation had an on-site review under DADHC’s Integrated Monitoring
         Framework (IMF)?

                 Yes               No

14.2     If the organisation has had an on-site review as part of the Integrated Monitoring
         Framework, policies and protocols illustrating compliance with the Disability Service
         Standards will not need to be provided but progress against any Action Plan resulting from
         the on-site review will need to be described.

14.3     Other applicants must provide at least two examples of key policies and protocols
         illustrating compliance with the Disability Service Standards. Where an applicant does not
         currently provide services under the Disability Services Act, it must provide evidence that
         it has the capacity to develop policies and practices that would ensure compliance with the
         Disability Service Standards.




Tender Application Form: Community Participation Program (DADHC 09.23)                    16
PART 15: IMPLEMENTATION STRATEGY AND TIMEFRAME FOR
         THIS OUTLET

15.1 For new locations or new service types indicate the lead time to commence service operation
     and steps in the implementation process such as staff recruitment, service promotion and
     establishing service networks.




Tender Application Form: Community Participation Program (DADHC 09.23)                 17
PART 16: DETAILED OUTLET BUDGET

16.1     RELATIONSHIP TO OTHER PROGRAMS AT THE SERVICE OUTLET
Where the organisation operates a Transition to Work, Post School Options or day program at the
service outlet, outline how service delivery under these programs will provide opportunities for
cost efficiencies to be achieved.
Complete Table 16.1 indicating how many service users are currently in Community Participation,
Transition to Work, Post School Options and day programs that operate from the same service
outlet. Also include the total minimum number of Community Participation service users sought
for the service outlet.
Review the instructions for completion of Table 16.1 set out in Section 17.2.1 of the Request for
Tender.

Table 16.1 Number of current service users, as at 1 January 2009

PROGRAM                                                     TOTAL NUMBER
Transition to Work
Post School Options
Community Participation (existing)
Community Participation (proposed minimum)
Day programs
TOTAL




The tender Budget should be submitted in the Excel format available from
http://www.dadhc.nsw.gov.au/dadhc/Doing+business+with+us/.

An electronic copy should be submitted via email to etenders@dadhc.nsw.gov.au with prior
arrangement with the Project Officer (Metro South) as detailed in the Request for Tender.




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16.3      COMMUNITY PARTICIPATION TENDER BUDGET AND OPERATIONAL DATA
In completing the Budget for each service outlet, details are to be provided in each of the following
categories:
4. Number of estimated service users in each funding band
The number of estimated service users in each funding band for the Community Participation
service outlet must be included:
          1. Moderate
          2. High
          3. Very high
          4. Exceptional
Income and expenditure
All provider Income and Expenditure associated with the delivery of the Community Participation
Program at the service outlet must be included as Direct or Indirect costs in one of the categories
below. Direct Costs are those costs that can be specifically traced to or associated with the
provision of client services. When a cost cannot be traced directly to the provision of services it
should be classified as an Indirect Cost.
Income

All estimated income received for the service outlet must be included in one of the following
categories:
       5. DADHC Funding: Estimated funding from the Department of Ageing, Disability and Home
          Care for Community Participation by the service for this outlet.
       6. Fees: received from clients (weekly fees only, not one off contributions for special activities)
          at this service outlet.
       7. Transport – user contributions: Contributions received from service users for transport
          provided by the service at this service outlet.
       8. Other Income: Any other income received by the provider for this service outlet that is built
          into the general operating costs each year (eg money raised in an annual fund raising
          event).
Direct Costs
All Direct Costs associated with the delivery of the Community Participation Program at this
service outlet must be included in one of the following categories:
    9. Employee related and on costs: Salaries and wages or proportion of wages relating to staff
       associated with providing services directly to service users at this service outlet. This
       should include the cost of directs staff and managers/or supervisors. On costs include
       those other items associated with staff remuneration such as leave loadings and workers
       compensation.
    10. Brokerage/purchase of services and contractors: Costs for services provided by people
        outside the employment of the provider used directly in the provision of services at this
        service outlet.
    11. Program costs: Those items such as consumables or food used in the provision of services
        at this service outlet.
    12. Training: Costs associated with training for staff employed by the provider involved in and
        relating to the provision of services at this service outlet.



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    13. Language services: Costs associated with interpreters used by service users (sign and
        community language) at this service outlet.
    14. Transport and motor vehicles: Costs associated with the vehicles used for transporting staff
        and service users to and from the service outlet or in relation to activities undertaken by the
        service user.
    15. Property and maintenance: Costs such as rent, maintenance and other costs that relate to
        property used in the provision services at this service outlet.
    16. Insurance: All insurance costs that relate to property, motor vehicles, public liability and
        other assets used in the provision of services directly to service users at this service outlet.
    17. Depreciation: All depreciation relating to assets used in the provision of services at this
        service outlet.
    18. Other: Utility and cleaning costs associated with the delivery of services directly to service
        users at this service outlet.
Indirect Costs
All Indirect Costs associated with the delivery of the Community Participation Program at this
service outlet must be included in one of the following cost groups:
    19. Head Office allocation: Costs paid to head office for support activities not directly involved
        in the provision of services to service users at this service outlet. This only applies where
        the provider has a head office.
    20. Management salaries and other management costs: The proportion of staff wages and on
        costs allocated to management tasks and other staff activities not involved in the provision
        of services at this service outlet. This includes costs associated with administration,
        transport and motor vehicle, property and insurance not directly related to the provision of
        services directly to service users at this service outlet.
    21. Other: All other costs not associated with providing client services such as utility and
        cleaning costs not associated with the provision of services directly to service users at this
        service outlet.
16.3 BUDGET AND OPERATIONAL ASSESSMENT
The criteria that will be used by Assessment Panels to tenders include:
For all service types:
    A. Average hours of support that will be provided per service user per week
    B. Number of weeks per year that a service will be provided
    C. % of time that service users spend in skill development and learning each week
    D. % of total staff time spent as direct time with service users
    E. Average weekly fees per service user (excluding one off activity fees) (if relevant)
    F. Average weekly service provider transport fee (if relevant)
    G. % of direct costs spent on employee related costs
    H. % of other direct costs
    I.   Service user to staff ratios by funding band




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