(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;
(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.
(c) At least one of the grants shall be awarded to each of the following:
(1) A non-profit Community Organization as described in Section 6652, subdivision (a)(10); and
(2) Any one of the other categories listed in Section 6652.
Credits
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.
History
1. New section filed 2-10-2014 as an emergency pursuant to Government Code section 11346.1, subdivision (h); operative 2-10-2014 (Register 2014, No. 7). A Certificate of Compliance must be transmitted to OAL by 5-12-2014 or emergency language will be repealed by operation of law on the following day.
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).
This database is current through 5/10/24 Register 2024, No. 19.
