Cal. Code Regs. Tit. 10, § 6656 - Navigator Program Request for Application and Selection Criteria
(a) Navigator Program applicants shall submit
an application in response to a request for application in accordance with the
following process:
(1) The individual or
entity shall submit an application that includes all information,
documentation, and declarations required in subdivision (b) of this
Section.
(2) Grants will be awarded
under the Navigator Program to successful applicants using the following
evaluation criteria:
(A) Cost
effectiveness;
(B) Ability to carry
out the duties described in Section
6664; and
(C) Existing relationship, or ability to
establish relationships with the consumers likely to be eligible for enrollment
in a Qualified Health Plan (QHP).
(3) Individuals and Entities selected to
participate in the Navigator Program shall:
(A) Submit the following:
1. An executed agreement conforming to the
Roles and Responsibilities defined in Section
6664;
2. Proof of general liability insurance with
coverage of not less than $1,000,000 per occurrence with the Exchange named as
an additional insured, and workers compensation insurance; and
3. A completed STD. 204, payee data
record.
(B) Complete the
training requirements pursuant to Section
6660.
(4) The Exchange shall review the application
and, if applicable, request missing information necessary to select a Navigator
applicant.
(5) Entities not
selected to participate in the Navigator Program may submit a protest in
writing to the Exchange at 1601 Exposition Blvd., Sacramento, 95815, which
shall:
(A) Be in writing, signed by an
individual who is authorized to contractually bind the applicant;
(B) Be received by the Exchange within five
(5) business days of the date the rejected applicant is notified they have not
been selected to participate in the Navigator Program; and
(C) Provide a statement of reason(s) for the
protest, including facts and evidence to explain why the applicant believes the
Exchange has incorrectly rejected the applicant.
(6) Final decisions regarding the selection
of entities to participate in the Navigator Program and responses to protests
will be reviewed by the Exchange's Executive Director, or his or her designee,
in accordance with the following criteria:
(A)
Submission of an application that includes all required information and
documentation, as set forth in subdivisions (a)(1) and (a)(4);
(B) Ability of the applicant to meet the
Navigator Program criteria, as set forth in subdivision (a)(2);
(C) Compliance with the requirements of
submitting a protest, as set forth in subdivision (a)(5); and
(D) Evaluation and investigation of the facts
and evidence as detailed in the protest letter.
(7) Within 30 days of the Exchange receiving
the written protest from a rejected applicant, the Exchange's Executive
Director, or his or her designee, shall mail the final determination of the
protest to the rejected applicant.
(b) The Navigator Program Grant Application
shall contain the following information:
(1)
Individual or Organization information:
(A)
Full and legal name;
(B) Federal
Employer Identification Number;
(C)
Name of person authorized to enter into contractual obligation;
(D) Physical address of primary
office;
(E) Mailing address, if
different;
(F) Office phone
number;
(G) E-mail address;
and
(H) Website
address.
(2) Primary
contact information:
(A) Primary contact
name;
(B) Physical
address;
(C) Phone number;
and
(D) E-mail
address.
(3)
Identification of applicant's status as an eligible entity type pursuant to
Section 6652 and a copy of supporting
documentation.
(4) Previous
experience performing the Navigator Program activities.
(5) Funding from other sources for similar
activities including any federal, state, or county grants awarded for outreach,
education, or enrollment activities.
(6) Requested funding amount.
(7) Subcontractor('s) information:
(A) Full and legal name;
(B) Federal Employer Identification
Number;
(C) Name of person
authorized to enter into contractual obligation;
(D) Physical address of primary
office;
(E) Mailing address, if
different;
(F) Office phone
number;
(G) E-mail address;
and
(H) Website
address.
(8)
Subcontractor('s) primary contact information:
(A) Primary contact person;
(B) Physical address;
(C) Phone number; and
(D) E-mail address.
(9) Subcontractor('s) letter of intent to
participate.
(10) Identification of
subcontractor('s) eligibility type pursuant to Section
6652 and a copy of supporting
documentation.
(11) Indication of
region or population the applicant proposes to reach and estimated percentage
by ethnicity, language, age group and federal poverty level.
(12) Cover Letter including the following
information:
(A) Title of the grant
application;
(B) Submission date of
the proposal;
(C) Requested funding
amount;
(D) A summary of the
proposed project, including a description of the populations and communities
targeted by the project, proposed approach, and likely impact; and
(E) Signature of an individual authorized to
enter into contracts on behalf of the proposer.
(13) Narrative description of the applicant's
qualifications.
(14) Letter(s) of
reference from organizations that have previously collaborated with the
applicant.
(15) Description of the
staffing strategy and capacity for the lead organization and
subcontractors.
(16) Description of
the approach and strategy for reaching the target population.
(17) Description of setting and venue where
Navigator activities will take place.
(18) Description of project management and
quality monitoring activities.
(19)
Description of project costs.
Notes
2. New section refiled 5-12-2014 as an emergency pursuant to Government Code section 11346.1, subdivision (h); operative 5-12-2014 (Register 2014, No. 20). A Certificate of Compliance must be transmitted to OAL by 8-11-2014 or emergency language will be repealed by operation of law on the following day.
3. New section refiled with amendments 7-21-2014 as an emergency pursuant to Government Code section 100504(a)(6), as modified by Senate Bill 857 (Stats 2014, c.31); operative 7-21-2014 (Register 2014, No. 30). A Certificate of Compliance must be transmitted to OAL by 7-15-2015 pursuant to Government Code section 100504 or emergency language will be repealed by operation of law on the following day.
4. Senate Bill 75 (Stats. 2015, Ch. 18) modified Government Code section 100504(a)(6) to change the date upon which a Certificate of Compliance must be transmitted to OAL. Pursuant to Government Code section 100504(a)(6), as modified by Senate Bill 75 (Stats. 2015, Ch. 18), a Certificate of Compliance must be transmitted to OAL by 2-10-2017 or the language in the emergency order of 7-21-2014 will be repealed by operation of law on the following day (Register 2015, No. 38).
5. Certificate of Compliance as to 7-21-2014 order, including further amendment of section, transmitted to OAL 11-6-2015 and filed 12-23-2015 (Register 2015, No. 52).
6. Repealer of subsections (b)(1)(G), (b)(2)(D), (b)(7)(G) and (b)(8)(D), subsection relettering and amendment of subsections (b)(2)(A), (b)(2)(C), (b)(4), (b)(8)(C) and (b)(14) filed 3-7-2018; operative 3-7-2018 pursuant to Government Code section 11343.4(b)(3) (Register 2018, No. 10).
Note: Authority cited: Sections 100502 and 100504, Government Code. Reference: Sections 100502 and 100503, Government Code; and 45 CFR §§ 155.205, 155.210 and 155.260.
2. New section refiled 5-12-2014 as an emergency pursuant to Government Code section 11346.1, subdivision (h); operative 5-12-2014 (Register 2014, No. 20). A Certificate of Compliance must be transmitted to OAL by 8-11-2014 or emergency language will be repealed by operation of law on the following day.
3. New section refiled with amendments 7-21-2014 as an emergency pursuant to Government Code section 100504(a)(6), as modified by Senate Bill 857 (Stats
4. Senate Bill 75 (Stats. 2015, Ch. 18) modified Government Code section 100504(a)(6) to change the date upon which a Certificate of Compliance must be transmitted to OAL. Pursuant to Government Code section 100504(a)(6), as modified by Senate Bill 75 (Stats. 2015, Ch. 18), a Certificate of Compliance must be transmitted to OAL by 2-10-2017 or the language in the emergency order of 7-21-2014 will be repealed by operation of law on the following day (Register 2015, No. 38).
5. Certificate of Compliance as to 7-21-2014 order, including further amendment of section, transmitted to OAL 11-6-2015 and filed 12-23-2015 (Register 2015, No. 52).
6. Repealer of subsections (b)(1)(G), (b)(2)(D), (b)(7)(G) and (b)(8)(D), subsection relettering and amendment of subsections (b)(2)(A), (b)(2)(C), (b)(4), (b)(8)(C) and (b)(14) filed 3-7-2018; operative
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