California Department of Healthcare Services

Grants-In-Aid for Clinics Program Request for Application

• 2007-2008 Request For Application (RFA) Announcement (Word)
• 2007-2008 Grants in Aid (GIA) for Clinics Program RFA (Word)
•   Attachment A - Checklist-Table of Contents (Word)
•   Attachment B - Coversheet (Word)
•   Attachment C - Clinic Site Info (Word)   
•   Attachment D - MUA-MUP Cert of Services (Word)  
•   Attachment E - Program Summary (Word)   
•   Attachment E -1 Age of Patients Served Fiscal Year 2006-2007  
•   Attachment F - Funding Need - Stabilization (Word)   
•   Attachment G - Funding Stability - Stabilization (Word)  
•   Attachment H - Funding Need - Tech Assistance (Word)  
•   Attachment I - Funding Stability - Tech Assistance (Word)  
•   Attachment J - Work Plan (Word)  
•   Attachment K - Budget Detail Worksheet (Word)   
•   Attachment L - Budget Justification (Word)  
•   Attachment M - Match Documentation (Word)   
•   Attachment N - Sources of Funding (Word)   
•   Attachment O - Authorization to Bind (Word)   
•   Attachment P - Payee Data Record (Word)  
•   Attachment Q - Board of Directors form (Word)  
•   Attachment R - Attestation (Word)  
•   Exhibit 1 Grievance Procedure for Grants (Word)  
•   Exhibit 2 Scoring Tool (Weighted) (Excel)  
•   Exhibit 2A Evaluation and Rubic (Word)  
•   Exhibit 3 Sample of Stabilization (Word)  
•   Exhibit 4 Sample of Tech Assistance (Word)  
•   Exhibit 5 - MUA or MUP Designation Online (Word)   
•   Exhibit 5A sample (PDF)