Current through Register 2024 Notice Reg. No. 38, September 20, 2024
(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.
(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.
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).
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.
