2024 OC EMSD Program Project Nominatio n - O peratin g Projects Complete Application Checklist for OPERATING Projects
All Atta chment files should be clearly named prior to upload. ✓ Application Narrat ive Responses
General Information
Part I - Applicant Profile
Agency Information
Agency Geographic Area
Applicant Profile
Audited Financial Statement
Title VI and ADA Requirements and Complaints
Project Need
Error! Reference source not found.
Funding Request Summary
Application Funding Request Summary
Proposed Local Match Source for Operating Requests
Requested Programming Year
General Questions
General Question s
Part Ill - Scored Questions
A. Goals and Objectives {10 Points)
B. Project Implementation (15 Points)
C. Program Performance Indicators (10 Points)
D. Coordination, Outreach, and Sustainability (11 Points) E. Emergency Planning and Preparedness (4 Points)
Part IV - Certifications
Private Non-profit Agency- Corporation Status Inquiry
Private Non-profit Information
Public Agency Certification
Certification of No Readily Available Service Providers General Certifications and Assurances
Coordinated Plan Certification
Application Certificat ion
Attachment s - List attachments below as needed, expand upon if necessary Attachment 1: Purpose and Program Supporting Documentation Attachment 2: Agency Geographic Area
Attachment 3: Audit ed Financial Statement
Atta chment 4: Transportation Needs Assessment for Seniors and Individuals with Disabilities Attachment 5: Match Source Documentation
Attachment 6: Operating Assistance/Mo bility Management Plan Supporting Documentation Attachment 1
2024 OC EMSD Program Project Nomination - Operating Projects Attachment 7: Transportation Services Assessment and Client Needs Analysis Attachment 8: Letters of Support
Attachment 9: Private Non-profit Agency - Corporation Status Inquiry Documentation Attachment 10: Private Non-profit Information
Attachment 11: Proof of a Public Hearing Notice or Formal Letter Certification Attachment 12: Certification of No Readily Available Service Providers Documentation Attachment 13:
General Information
Agency (Applicant) Legal Name: City of Costa Mesa
Physical Address (No P.O. Box): 77 Fair Drive
City, County, ZIP: Costa Mesa, Orange, 92626
Applicant Contact Name : Kevin Stoddart
Applicant Contact Title: Senior Recreation Supervisor
Email: [email protected] I Phone: I 114.321-1s61 Alternate Contact: Enyelber Franco
Alternate Email: Enyelber [email protected] I Phone: I 714-327-7544 Application Type: Capital & Operating
Please indicate Capital or
Operating
Project Title: Senior Taxi Program
Phase of Work that request would Service Continuity
support (New Services, Service
Expansions, Service Restoration,
Mobility Management, Driver and
Travel Related Trainin gs, and First-
and- Last Mile Connections, etc.) Be
sure to include a brief description
for each item:
Brief Project Description - Includ e
an explanation of the type of
service, management, training, or
connections being provided with
app licable details:
Total EMSD Reguest $ $228,000
Total Project Cost (Match includ ed) $ $285,000
App lication Priority to app licant Priority 1 of 1
agency:
1 2024 OC EMSD Program Project Nomination - Operating Projects Part I - Applicant Profile
Agency Information
Briefly describe your agency's purpose and program. Include days and hours of the operation of your transportation program and the services your agency currently provides or intends to provide. Supporting documentation must be attached (e.g., agency brochure). Attachment 1 included? l2J Yes O No The City of Costa Mesa Senior Center Senior Taxi Program is funded through the Orange County Transportation Authority (OCTA} Project U funds, a 20% match from the City's general fund, and a $75,000 grant from Hoag Hospital to provide transportation through contractor California Yellow Cab (CVC} to eligible seniors living in the City of Costa Mesa. The program is offered at no-cost to eligible Senior Center members, Monday through Friday between 8a.m. to 4p.m. (excluding observed holidays).
Agency Geographic Area
Service Area (briefly indicate areas served by proposed project, additional detail should be provided in the required map attachment) Transportation requests are restricted to the City's boundaries, except for non-emergency medical rides.
The Senior Taxi Program also provides transportation to non-emergency medical appointments within the City of Costa Mesa and to medical facilities outside of the City including: Anaheim, Fountain Valley, Garden Grove, Huntington Beach, Irvine, Midway City, Newport Beach, Orange, Santa Ana, Tustin, Westminster and the Long Beach VA.
Please attach a clear and high-quality map delineating the service boundaries of your agency and relevant to this application. Attachment 2 included? l2J Yes O No
Applicant Profile
Provide the total number of clients currently served by the agency, and provide a breakdown of those who are seniors, disabled, or a wheelchair user. If a client can be identified in more than one category, choose the one category that is most limiting to the client. A client is counted only once. For example, an elderly person who uses a wheelchair would be counted once, as a wheelchair user.
A person with disabilities is someone of any age who is not able to use fully accessible public fixed-route services, whether temporarily or on a long-term basis, regardless of whether they need to use a wheelchair.
Race/Ethnicity/National Origin information is collected for reporting purposes.
Total number of clients currently served by your agency's Race/Ethnicity/National Origin served by your program by transportation program (do not duplicate or double count) percentage. (Total 100%) Number of seniors 337 American Indian & Alaska Native 0.6 % Number of individuals w/disabi liti es 565 Asian 9.2 %
Number of wheelchair/ lift users 144 Black or African American 1.0 % TOTAL NUMBER OF CLIENTS 1,046 Hispanic or Latinx 10.5 % Native Hawaiian & Pacific Islander 0.5 %
Midd le Eastern or North African 1.3 %
White & European American 55.8 %
Total number of wheelchair/lift clients All Other 21 %
divided by clients 14 % Specified Race: I %
TOTAL MUST BE 100% 100 I%
Annual Operating Budget
Estimated Income
a. Passenger Revenue: $ 0
2 2024 OC EMSD Program Project Nomination - Operating Projects b. Other Revenue: $ 0
C. Total Grants1, Donations, Subsidies from Other Agency Funds: $ 201,000 TOTAL INCOME $
Estimated Expenses
a. Wages, Salaries and Benefits (non-maintenance personnel) $ 0 b. Maintenance & Repair (salaries and estimated costs for current and requested vehicles/equipment) $ 0
C. Fuels $ 0
d. Casualty & Liability Insurance $ 0
e. Administrative & General Expense $ 0
f. Other Expenses (e.g., materials & supplies, taxes) $ 0 g. Contra ct Services (specify): I California Yellow Cab taxi service $ $360,000 TOTAL EXPENSES $ $360 ,000
Ooerating Fund Sources
Operating Fund Sources Prior Year Current Year Next Year a. Hoag Hospital Grant $ $50,000 $ $75,000 $ 75,000
b. M2 Project U $ $126,000 $ $126,000 $ 132,000
C. City's General Fund $ 31,500 $ 31,500 $ 63,000
d. $ $ $
TOTAL OPERATING $ 270,000
Audited Financial Statement
Attac h a copy of your agency's current (i.e., wit hin the last 2 years) audited financial statement showing no instance of non-compliance as an attachment. Provide a summary of the results/findings. Attachment 3 include d ? /gJ Yes O No The City of Costa Mesa's 2023 Annual Comprehensive Financial Report is attached.
Title VI and ADA Requirements and Complaints
Describe any lawsuits or complaints against your entire agency within the last year alleging Title VI discriminati on on the basis of race, color, or national origin, and/or any lawsuit s or complaints in regard to the Americans wit h Disability Act. At a minimum , please include the date and description of compla int(s) or lawsuit(s), and current status. A written response is required . N/A is not an acceptable response.
The City of Costa Mesa has had no lawsuit against it for non-compliance with Title VI.
Project Need
The Orange County Enhanced Mob ility for Senior s and Disabled (EMSD) grant program is intended to enhance the mobility of seniors and individuals with disabilitie s by provid ing local transportati on fundin g to meet the tran sportation needs of seniors beyond traditional public transportation and individuals with disabilities.
1. Check the app ropriate box below as applicable. One box must be checked. /g/ Insufficient : Available public transportation and paratransit services are insuffic ient to meet the needs of the target population or equipment needs replacement to ensure continu ed service (i.e., service at capacity; service 1 Grants in this instance does not include this grant request. 3 2024 OC EMSD Program Project Nomination - Operating Projects parameters, routes, hours and/or needs are not met due to eligibility and/or trip criteria ; projected futur e need; lack of or need of additional accessible vehicles, etc.).
0 Inappropriate: Target population has needs that are difficult or impossible to serve on available public transportation and/or paratransit.
Existing Transit Service
2. Please describe how existing public transit or paratransit , including fixed-route, ADA complementary paratransit and private paratransit does not meet the needs of your senior and disabled clients.
There are no known public transit services that provide door to door transportation at no cost to a service area as large as the City's non-medical transportation service area with a booking time of 48 hours or less in advance. The combination of free transportation in a large service area with taxi cabs and California Yellow Cab's quality customer service has caused the program to grow beyond current funding sources.
3. Describe the transportation needs of seniors and individuals with disabilities to be served by the proposed project.
This is an assessment of transportation needs for individuals with disabilities or seniors which may be based on the experience and perceptions of the planning partners or on more sophisticated data collection efforts , and gaps in service. Attachment 4 included? IZJ Yes O No
The Coordinated Plan Section speaks about the growing population of older adults and frail older adults.
With the increase population something that has become popular for this group is age-in-place . Which means older adults are choosing to remain in their local areas. This is causing an increase in local trip programs. With frail older adults, long trip times and the need for door-through-door transportation programs has seen an increase in demand.
4 2024 OC EMSD Program Project Nomination - Operating Projects Part II - Funding Request
Funding Request Summary
Step 1: Check and complete the funding request summary form below to summarize all projects proposed under the operating project category . If you are requesting multiple projects under a category, please make copies of the tab les for each project as applicab le.
• Mobility Management
• Operating Assistance
Step 2: Complete and attach a separate project budget for each of your proposed projects.
Are you a current recipient of any of the following funds? 0 FTA 5310 0 Jobs Access and Reverse Commute/New Freedom IZJ Senior Mobility Program (Project U} IZJ Community Circulator (Project V) 0 Other: ----- - ---------- ------- Have you also submitted a Capital Project application under this year's EMSD grant program? 0 Yes IZJ No Application Funding Request Summary- Note· Fill in once remaining section is completed Project Total Project Match Match %2 Funding Indirect Cost Contingency Component Cost Request3 (10% maximum) (5-10%)
(Request+ Match) (Total - Match)
Operating $ 285,000 $ 57,000 0 % $ 228,000 $ 0 $ 22,800 Assistance
Mobility $ N/A $ N/A N/A % $ N/A $ N/A $ N/A Management TOTAL $ 285,000 $ 57,000 0 $ $228,000 $ $ 22,800
Please note that the total funding request per applicant may not exceed $1.5 million.
Proposed Local Match Source for Operating Requests
Project Component Local Match Amount Local Match Sources (consistent with previous table)
Operating Assistance $57,000 City's General Fund
Mobility Management N/A
Requested Programming Year
Please indicate in which Fiscal Year (FY) funding is planned to be requested. Note that applicants may request programming funds for FY 2024/25, 2025/26, or 2026/27 ONLY (fiscal years endi ng June 30). See the Timely-Use of Funds Section of the guide lines for more information.
Operations Programing FY Request FY 24/25-
25/26
Mobility Management Programming FY Request FY N/A
2 20% minimum for Operating Assistance and 10% for Mobility Management. 3 Up to 80% (for Operating Assistance) or 90% (for Mobi lity Management) of project cost or no greater than $1 million -fu nding request should consider indirect and contingency costs, not to exceed a combined $1 million. 5 2024 OC EMSD Program Project Nomination - Operating Projects Detailed Mobility Management and Operating Assistance Funding Reauests Funding Request for Mobility Management (MM) 4
Scope:
ln:!ud2 serv,:e peri::x:i
Activity Brief Description
$
$
$
$
Subtotal $
Indirect Costs -Activity Brief Description
$
$
$
$
Indirect Subtotal (No greater than 10% of the total project cost) $ Contingency Line Item (to account for changes due to cost increases, project delays, etc .. ) 5-10% $ TOTAL REQUEST FOR MOBILITY MANAGEMENT $
Funding Request for Operating Assistance (OA)4
Scope:
Cost
Requesting operating assistance to fund the City of Costa Mesa's Senior Medica l Transportation program at its current capacity in order to keep the program free of charge to the City's qualifying seniors.
Activity Brief Description Cost
Non-Emergency Medical Free door to door transportation for non-emergency medical $ $360,000 Transportation FY 24/25 appointments from Costa Mesa to non-emergency medical - FY 25/26 appointments in the aforementioned operationa l area beginning January 2025 through the end of FY 25/26, for a total of 18 months.
Anticipated monthly cost is $20,000 per month. Requesting EMSD operat ing support to fund 13.5 of this 18 month period, with the remainder to be covered by the existing annual grant from Hoag Hospital, which is estimated at $112,500 for the aforementioned 18 month period.
Non-medical Cost of providing non-medical rides for all other allowable purposes $ $270,000 Transportation FY 24/25 under M2 Project U within the boundaries of the City of Costa Mesa. - FY 25/26 Non-medical transportation will not be funded by any EMSD grant. $
$
Subtota l $ $630,000
Indirect Costs-Activity Brief Description
$
$
4 The maximum request amount per applicant for operating type projects is $1,000,000 for two years of service operation s, that is eith er for mobili ty management or operating assistance or a combination of the two . The total maximum applicant request for capital and operating combined is $1.5 million .
6 2024 OC EMSD Program Project Nomination - Operating Projects I $
I $
Indirect Subtotal (No greater than 10% of the total project cost) $ Contingency Line Item (to account for changes due to cost increases, project delays, etc .. ) 5-10% $ $22,800 TOTAL REQUEST FOR OPERATING ASSISTANCE $ $285,000
TOTAL COST OF PROJECT5 I $ I $630,000
General Questions
1. Indicate the type(s) of proposed transportation service for the project. (Check all that apply.) 0 Expansion of existing paratransit service beyond
the minimum requirements of ADA
0 New or continuation of paratransit service
beyond the minimum requirements of ADA
0 Expansion of an existing mobility management
project
IZJ First and last mile trips
0 New mobility management project
0 Expansion of existing driver and/or
travel training project
0 New driver and/or travel training
project
2. Is the proposed project an expansion of current service supported by a prior funding award from OCTA? 0 No IZJ Yes - Provide grant program and agreement number: '-I _c_-8_-_18_8_1 ____ ____ __ ___J
3. Does your agency intend to use a third-party contractor for the proposed project service? 0 No IZJ Yes
3a. If yes, is your contract on file with OCTA?
0 N/A O No IZJ Yes - If yes, Provide the name of the vendor and agreement num ber below:
I Cabco Yellow DBA California Yellow Cab
3b. If yes, what is the operat ing period of the existing third -party service contract? 0 N/A July 1, 2021-June 30, 2026
What was the service period :
3c. Is there a written option in the contract to extend beyond the base years? ,----'-- ---------- -----, 0 N/A 121 No O Yes - Identify page/paragraph number:
5 Total project cost will includ e Local Match + Mobility Management and/o r Operating Assistance Request(s) + Contingency Cost+ Indirect Costs
7 2024 OC EMSD Program Project Nomination - Operating Projects Part Ill - Scored Questions
A. Goals and Objectives (10 Points}
l. Briefly describe a detailed project description. Please include service operating period (up to a maximum of two years of service) Provide the following informatio n as it pertains to this project - infor mation can be found at https://www.census.gov/quickfacts/fact/table/US/PST0452l9 . (3 Points- 3-High, 2-Mediu m, 1-Low) a. Total Population (number of people) in Your Service Area: 108,354 people. I ~--~ b. Number of Eligible Individuals with Disabilities Served by This Project: 1,046 people. I The City currently operates an existing program through a combination of grant funding and General Fund dollars.
Funding will be exhausted by February 2025 at current ridership levels, which makes the funding of this application even more vital to the continuity of services for our elderly and disabled commun ity members .
2. Briefly describe how your proposed project is consistent with the goals and objectives of the EMSD grant program for Operating Projects as stated in the Program Goals of the Appli cation Instructions. Specify how your proposed project is included in the current Orange County Public Human Services Transportat ion Coordination Plan (Coordinated Plan) by referencing the relevant goal, objective and/or strategy. (Indicate t he section/page numbers). A copy of the Coordination Plan is available for review at: https://www .octa.net/pdf/HumanServicesTransportation.pdf . (5 Points - 5-High, 4-Medium-High, 3-Medium, 2-Medium-Lo w, 1-Low) This program aligns with the stated EMSD program goals through support of local agencies providing service within their communities. This will serve to continue services that our aging and disabled community significantly rely upon without imposing fees or reductions in service. Additionally, funding this important service will avoid gaps in mobility, aligning with Page 72 of the Orange County Public Human Services Transportation Coordination Plan's stated goal of restoring and enhancing the specialized public transit network to meet the needs of the target populations in a post covid-19 environment.
3. Explain how the project meets the program requir ement of providing transportatio n related activities and/or service beyond those required by the ADA. Describe how the project increases or enhances the availability of transportation of the targeted population. (2 Points -Appropriate , 1-Adaquate, 0-lnadequate) Currently the Costa Mesa Senior Center offers a door-through-door service program free of charge for residents of Costa Mesa ages 60 and older. The purpose of the program is to allow participants to integrate themselves back into the community and to keep themselves out of isolation at home . The program is available to give rides in the attached service area and operates from Monday through Friday from 8 a.m.- 4 p.m. Under the agreed upon service plan with OCTA and the City of Costa Mesa, the program is available to provide ride requests for the Costa Mesa Senior Center, medical appointments, nutrition, shopping, personal care, and social/recreation rides to include amusement parks, aquarium/zoo, beach/park, community-cultural events, education/employment, family-friends, funeral/memorial service, government office/service, library/museum/historical site, movies/theater/concert, religious institutions, restaurants, sporting/fitness, transit center/hub .
B. Project Implementation (15 Points}
l. For Operating Assistance projects, describe your operational plan that includes defined routes, schedules, current/pro jected ridership, key personnel, and marketing strateg ies. For Mobility Management projects, describe your implementat ion plan that includes project tasks timeframe s, benchmarks, key milestones, key personnel, deliverab les and estim ated completion dates. Attach supporti ng documentat ion to substantiate this plan(s). (8 Points - 8-High, 6-Medium -High, 5-Medium, 4 Medium-Low, 2-Low) Attachment 6 included? 121 Yes O No 8 2024 OC EMSD Program Project Nomination - Operating Projects Currently, eligible members of the City's Senior Taxi Program may book rides with 48 hours notice. All rides are free and operate in the aforementioned and attached service area. In January 2023, the program was providing a combined total of approximately 700 rides per month between both medical and non-medical components of the program. In May 2024, the program provided approximately 2,200 rides. The senior populat ion in Costa Mesa has seen steadily growing for the past decade and doesn't show signs of plateauing or declining. In an attempt to capture this increasing populat ion the Senior Center does periodic outreach through its in-house licensed social worker and distribution of the Center's monthly Newsletter which features a write up about the transportation program. With the marketing efforts, increasing senior population, and the want/need for social/recreational rides, the Costa Mesa Senior Center is providing a level of service that cannot be sustained without additional funding.
2. Please describe how your current services have met your prior performance goals and objectives. How is this project proposal different than what is existing, and what do you intend to accomplish with the new funding? (7 Points- 7-High, 5 to 6-Medium-High, 4-Medium , 2 to 3-Medium-Low, 1-Low) Prior transportation service demand was sufficiently funded by M2 Project U funding, the City's match, and a grant from Hoag Hospital. The City's operat ional mode l for the Senior Taxi Program is totally free, has a huge service area, and rides can be scheduled on short notice. This has caused the program to expand beyond the annual budget. The EMSD grant will allow current medical ridership levels to remain where they are, with no impact to the cost or the boundaries. If ridership continues to expand beyond the levels funded through this grant, the city will implement more restrictive boundaries on non-emergency medical rides more in line with the operation of SMP programs from surrounding cities in Orange County.
C. Program Performance Indicators (10 Points)
1. Please provide the performance measures and objectives for your proposed project(s) below. Check and complete applicable project category. (2 Points -Appropriate, 1-Adaquate, 0-lnadequate) Operating Assistance Annual Performance Measures and Objectives Existing Service
IZJ Current Geographic Coverage Number of one-way trips per day: Approximately 42 medical rides per day
IZJ Current Service Hours/Days Number of new miles (one-way) on weekdays: No new miles IZJ Current System Capacity Number of new miles (one-way) on weekends: No weekend operation 0 Current access/Connections
Service Expansion
0 Current Geographic Coverage Number of one-way trips per day: N/A 0 Current Service Hours/Days Number of new miles (one-way) on weekdays: N/A 0 Current System Capacity Number of new miles (one-way) on weekends: N/A 0 Current access/Connections
Mobility Management
0 Mobility Management
Number of customer contacts: N/A
Number of one-way trips : N/A
0 One Stop Center/Customer Referral Number of customer contacts: N/A 0 Trip/Itinerary Planning Number of customer contacts: N/A 0 One-on-One Travel Training Number of people trained N/A 0 Group Training Number of people trained : N/A
0 Internet-Based Informat ion Number of web hits: N/ A
0 Information Materials/Marketing Description of materia ls/distributi on: N/A 0 Driver Training Number of drivers trained: N/ A
9 2024 OC EMSD Program Project Nomination - Operating Projects
2. Identify the performance measures/indicators to track the effectiveness of your project and include the number of people you anticipate being served, and the number and purpose of trips that the project will provide (and other measurable units of service). Include the desired outcome (impact) that the project will have on the target community. (5 Points - 5-High, 4-Medium-High, 3-Medium, 2-Medium-Low, 1-Low) The program is currently providing non-emergency transportation to qualifying seniors in the aforementioned operational area. Approximately 800 to 1000 rides are provided per month at a cost of approximately $20,000. The EMSD grant will help sustain this level of ridership for non-emergency medical rides in the operational area at no cost.
3. Based on the performance objectives/ outcomes that you provided in the question C.2, describe methodologies and procedures for ongoing monitoring and evaluation of the project or service. (3 Points - 3-High, 2-Medium, 1-Low) Ridership will continue to be monitored monthly through monthly reports/invoices from California Yellow Cab. If ridership grows beyond the financial capacity of the program, the operational area will shrink accordingly. If necessary, fees will be implemented as a last resort.
D. Coordination, Outreach, and Sustainability (11 Points)
1. Describe the available non-profit, public transit, or paratransit, including fixed route, ADA complementary paratransit services available in your agency's geographic area, and identify the relevant section/page number of the Coordinated Plan. Describe the transportation needs of your senior and disabled clients to be served by the proposal and identify the relevant section/page number of the Coordinated Plan. (2 Points-Appropriate, 1-Adaquate, 0-lnadequate) Attachment 7 included? 0 Yes l2J No
at the price point, with as large of an operational area, and with as much scheduling ease as the City's current model. On Page 39 of the coordinated plan, getting to and from medical appointments are listed as the greatest need for seniors in Orange County and cost of getting transportation is listed as the biggest barrier.
2. List all stakeholders involved in the proposed project. Describe how the project will be coordinated wit h other social service agencies and/or public transportation providers. (e.g., sharing vehicles, dispatching, scheduling, maintenance, coordinating client trips, training, etc.) Attach your letters of support from stakeholders to the grant application. (3 Points - 3-High, 2-Medium, 1-Low) Attachment 8 included? l2J Yes O No City of Costa Mesa is bringing a presentation to City Council on July 16 to solicit feedback from local non-profits. No stakeholders at the time of writing the application. Cottie Petrie-Norris's office has endorsed the City's grant application.
3. What outreach was done with your senior and disabled clients to demonstrate the need for this project? How was the feedback incorporated into the proposed project(s)? (3 Points - 3-High, 2-Medium, 1-Low) The City of Costa Mesa has placed an item on their agenda for a public hearing at the Council meeting on July 16 to formally discuss the continuity of the project and solicit community feedback. 10 2024 OC EMSD Program Project Nomination - Operating Projects
4. Please describe your outreach methods with your senior and disabled clients to ensure their needs are being met and adjustments to service are made accordingly. Describe the strategies for sustaining this program beyond the two-yea r funding cycle. (3 Points -3-High, 2-Medium, 1-Low) Surveys are sent out to all Senior Taxi Program participants twice per year. Senior Center members are also urged to call the senior center directly with comments, questions, and concerns about the program and all complaints are logged and shared with California Yellow Cab. California Yellow Cab follows up with all complaints and senior center staff resolve complaints with the senior center members.
The current agreement with California Yellow Cab ends on June 30 2026. The City will conduct an RFP for a shuttle service within the City of Costa Mesa and for a cab service for non-medical rides outside the county to ensure maximum efficiency for both programs.
E. Emergency Planning and Preparedness (4 Points)
1. What policies and procedures does your agency have in place to address emergency planning and preparedness? Has your agency participated in Countywide or Citywide emergency drills in the past year? (4 Points - , 4-High, 3-Medium-High, 2-Medium-Low, 1-Low) The City employs an Emergency Services Manager that oversees emergency planning. City Staff are required to complete NIMS and SIMS training modules and Parks & Community Services Staff also complete Red Cross Shelter Fundamentals training . The Parks & Community Services Department has mobilized twice in the last twelve months in anticipation of a necessity of shelter services within the city. 11 2024 OC EMSD Program Project Nomination - Operating Projects Part IV - Certifications
Private Non-profit Agency- Corporation Status Inquiry
The EMSD grant program is intended to enhance mobility for seniors and individuals with disabilities by providing local transportation funding to private non-pro fit organizations, or to public agencies where no private non-profits are readily available to provide the proposed service.
To document eligibility as an EMSD grant applicant based on your status as a private nonprofit organization, verification of your incorporation number and current legal standing must be obtained from the California Secretary of State Information Retrieval /Certification & Records Unit (IRC Unit ). The "Status Inquiry" document must be attached as an appendix to the application. To assist you in obtaining this informat ion, use one of the fol lowing methods:
• To obtain Corporate Records Information over the Internet, go to https://bizfi leonline.sos.ca.gov/search/bus iness and enter your agency name. If you are active, print the page or screenshot for use as proof. If the verification of your status is not available at the time you submit your application, you must indicate the date on which you requested the verifica tion and the estimated date it will be forwarded to OCTA.
If you are unable to locate the information online, you can obtain the "Status Inquiry" document by making a written request to :
California Secretary of State
Information Retrieval/Certification Unit {IRC)
1500 11th Street, 3rd Floor
Sacramento, CA 95814
(916) 653-6814
Please do not attach articles of incorporati on, bylaws or tax status documentation.
Attachment 9 included? 0 Yes IZJ No
Private Non-orofit Information
Legal Name of -Non-profit Applicant:
State of California Articles of Incorporation Number:
Date of Incorporation:
Attachment 10 included? 0 Yes IZJNo
Public Agency Certification
To enhance mobility for seniors and individuals with disabilities, the EMSD grant program also offers local transportation funding opportunities to public agencies where no private non-profit organizations are readily available to provide the proposed service.
A public agency must certify that no non-profit organizations are readily available to provide the proposed service, by completing and signing the Public Agency Certification below. A public hearing is required as part of the application process and should be completed by the application due date of June 27, 2024. Further, please attach th e following to your application:
1. Submit proof of a public hearing notice, a copy of the contact lett er/not ice sent to non-profit transportatio n providers inform ing them of the hearing and minutes or documentation that the hearing took place.
2. Submit a resolution that no non-profit agencies are readily available to provide the proposed service.
3. Complete Public Agency Certification.
4. Submit proof of contact with all non-profit transportation providers regarding notice of public hearing.
Attachment 11 included? IZJ Yes IZJ No
12 2024 OC EMSD Program Project Nomination - Operating Projects Certification of No Readily Available Service Providers The public agency, City of Costa Mesa , certifies that there are no non-profit agencies readily available to provide the service proposed in this application.
Name of Certifying Representative: I
Title : I
Signature: / Date: I
Date of Hearing:
Attachment 12 0 Yes O No O Formal Letter Attached as Alternative provided?
General Certifications and Assurances
1. The use of grant -fund ed vehicles or grant-funded activities beyond the scope of an awarded project is prohibited. A deviation from the awarded project scope requires prior approval from OCTA.
2. Grantees shall fo llow compet itive procurement practices in the purchase of vehicles and the selection of vendors for all services which it does not provide using its own workforce.
3. Any procurement of vehicles or services will specify the use of vehicles meeting Americans with Disabilities Act accessibility standards.
4. Grant-funded vehicles must provide a minimum of 10 hours of service per week per vehicle or in coordination with other agencies.
5. Grantees shall perform, or ensure that a contracted vendor performs proper maintenance of all vehicles, including, at a minimum:
a) Daily Pre-Operation Inspections.
b) Scheduled preventative maintenance that meet s or exceeds manufacturer require ments, including the maintenance of all accessibility features of the vehicles. c) Maintenance records for each vehicle shall be retained for 5 years.
6. Grantees cooperate fully in annual motor coach carrier terminal inspections conducted by the California Highway Patrol.
7. Grantees shall procure and maintain adequate insurance coverage during the term of the project and throughout the useful life of the vehicle. Coverage shall be full coverage or subject to self-insurance provisions.
8. Grantees shall ensure that its operators, or its contracted vendor's operators, are properly licensed and trained to profi ciently perform duties safely, and in a manner that treats its riders with respect and dignity. Disability awareness and passenger assistance will be included in this training.
9. Grantees shall ensure that it maintains adequate oversight and control over all aspects of services that are provided by a contracted vendor.
10. Grantees shall submit a quarterly report to OCTA's Community Transportation Services, which includes, at a minimum, a monthly and fiscal year-to-date summary of service and expenditures. Additional reporting may be requested as needed.
11. Grantees shall participate in OCTA marketing and outreach efforts to encourage use of transit services by seniors and individuals with disabilities.
12. Grantees shall note OCTA sponsorship in any promotional materia l for service funded under this agreement and may be required to display OCTA program logo on vehicles used in this program (excluding taxis).
13. Grantees shall ensure comp liance with all applicable provisions of Title VI of the Civil Rights Act, Americans with Disabilities Act, and promptly notify OCTA of any issues or compla ints.
14. Non-comp liance to program requi rements may result in relinquishment of vehicles and/or equipment to OCTA.
Coordinated Plan Certification
The proje cts selected for funding under the Orange County Enhanced Mobility for Seniors and Disabled (EMSD) grant program must be supported by the Coordinat ed Plan, which was develop ed throug h a process that includes 13 2024 OC EMSD Program Project Nomination - Operat ing Projects representat ives of public, private, and non-profi t tran sportatio n and human services provide rs and participation by members of the Orange County commu nity.
Orange County's current Coordin ated Plan was adopted by the Orange County Transporta t ion Authority (OCTA) Board of Directors on November 23, 2020. The Coordinated Plan is available for down load and review at h ttps :/lwww .octa.net/pdf/OCT A %20Coordination %20Plan. pdf I certify that the project in this application is supported by Human Services Transportation Coordination Plan for Orange County.
Agency (Applicant) Legal Name: City of Costa Mesa
Auth orizing Agency Representati ve (Print) : Kevin Stodd art Title: Senior Recreation Supervisor
Signature:
Application Certification
2 Date:
Authorizing Representative must certify the information contained in this application is true and accurate and has signature authority to enter into grant agreements on behalf of the applicant organization.
Signatur e: b
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Date:
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