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Fillable Printable Letter Of Interest -COUNTY OF LOS ANGELES

Fillable Printable Letter Of Interest -COUNTY OF LOS ANGELES

Letter Of Interest -COUNTY OF LOS ANGELES

Letter Of Interest -COUNTY OF LOS ANGELES

COUNTY OF LOS ANGELES - DEPARTMENT OF MENTAL HEALTH
Adult Justice, Housing, Employment and Education Services
Mental Health Services Act Housing Program
LETTER OF INTEREST INSTRUCTIONS
1. LEAD AGENCY CONTACT INFORMATION
Project Sponsor's Entity Name, Contact Person and related Contact Information.
2. COLLABORATIVE PROJECT PARTNERS
3. PROJECT NAME & ADDRESS
Project Name and Address - The project's name (if any) and the physical address of the project.
Service Planning Area - Please indicate the number of the service planning area of the project.
4. PROPOSED POPULATION TO BE SERVED
Please enter the number of tenants in the box of the population to be served.
5. TYPE OF HOUSING AND NUMBER OF UNITS
For the "Other" section, please indicate both the number of units and the type of housing in the box.
6. TARGET INCOME LEVELS
Indicate the percentage ofArea Median Income (AMI) of all units.
7. AMOUNT OF MHSA FUNDS REQUESTED
8. SOURCES OF FUNDS
9. USES OF FUNDS
Indicate the amount of the related use of funds.
10. SUPPORTIVE SERVICES
In the "Estimated Service Cost" column, indicate the monetary value assigned to the service.
11. NARRATIVE DESCRIPTION
Contact Persons and Contact Information for the project's Developer, Property Manager, Primary
Service Provider, Long Term Owner (if different from the Developer or Project Sponsor)
Supervisorial District - Pleaseindicate the name and number of the Supervisorial District ofthe
project.
Unincorporated Area - Please indicate the name of the Cityor Unincorporated Area of the project (if
applicable).
Please indicate the number of MHSAunits and total units in the appropriate box. For Shared
Housing, the units represent the number of bedrooms. For Rental Units, the units representthe
number of apartments.
Indicate the number ofunits (Total and MHSAunits) in theappropriate box, being aware ofthe total
number of units. For Shared Housing, "units" represent bedrooms. For Rental Units, "units"
represent apartments.
Indicate the amountof funding requested for each projectcomponent. To determine the "Per MHSA
Unit" number, divide the "Total Capital Request" and/or "Total Operations Request" by thetotal
number of MHSA Units.
Indicate all funding sources related to the project and the related Predevelopment, Construction and
Permanent amounts.
In the "Committed Funding?" boxes, please indicate with a "yes" and the date awarded or "no."
In the "Committed Funding?" boxes, please indicate with a "yes" and the date awarded or "no."
In the "List Type of Proposed Services By Location" Column, place an "X" in the Offsite or Onsite
column as appropriate.
In the "List Funding Source by Type" column, place the name of the funding source in either the "In-
Kind" column or in the "Cash" Column.
In the "Committed Funding?" boxes, please indicate with a "yes" and the date awarded or "no."
Attach the Narrative Description with one (1) inch margins andusing font Arial 12 with a maximum of
ten (10) pages.
COUNTY OF LOS ANGELES - DEPARTMENT OF MENTAL HEALTH
Adult Justice, Housing, Employment and Education Services
Mental Health Services Act Housing Program
LETTER OF INTEREST CHECKLIST
The Mental Health Services Act (MHSA) Housing Program offers permanent financing and capitalized operating
subsidies for the purpose of developing permanent supportive housing, including both rental housing and
shared housing, to serve persons with serious mental illness who are homeless or at risk of homelessness (as
defined by the MHSAHousing Program guidelines) and who otherwise meet the MHSAHousing Program target
population description. The California State Department of Mental Health (StateDMH) has defined the MHSA
Housing Program target population in the MHSA Housing Program Guidelines, which may be found on the State
DMH website at http://www.dmh.ca.gov/mhsa/Housing. This program is jointly administered by the California
Housing Finance Agency and State DMH.
The following checklist serves as a guide to the essential information that the County of Los Angeles -
Department of Mental Health (DMH) is seeking through this Letter of Interest (LOI). Please check either
YES or NO below to indicate whether or not each statement is applicable.
The project sponsor has sitecontrol for this project and can provide evidence of
site control if required
The project sponsor is a Qualified Developer as defined in MHSA Housing Program
Guidelines
The project developer has completed at least two affordable housing projects
comparable to the proposed project
The project sponsor understands that all tenants in MHSA-funded units must be
DMH clients at the time of move-in
The project sponsor understands that DMH must certify all tenants of MHSA-
funded units prior to move-in
The provider of onsite service coordination (if already determined) has at least two
years of experience providing services to the project's proposed target population
The project sponsor understands that the MHSAHousing AdvisoryBoard uses
funding principles as part of the process to determine whether or not to recommend
the project for further planning and development
yes
no
yes
yes
yes
no
no
no
yes
no
yes
no
yes
no
COUNTY OF LOS ANGELES - DEPARTMENT OF MENTAL HEALTH
Adult Justice, Housing, Employment and Education Services
Mental Health Services Act Housing Program
LETTER OF INTEREST
file:///usr/share/nginx/html/yummydocs/file/letter-of-interest-template-0595820.xls
Attachment I
1. LEAD AGENCY CONTACT INFORMATION
Project Sponsor
Project Sponsor's Entity Name
Project Sponsor's Contact PersonExecutive Director
AddressCityZip Code
TelephoneFaxE-Mail Address
2. COLLABORATIVE PROJECT PARTNERS
Developer
Contact PersonOrganizationTelephone
AddressCityZip CodeE-Mail Address
Property Manager
Contact PersonOrganizationTelephone
AddressCityZip CodeE-Mail Address
Primary Service Provider
Contact PersonOrganizationTelephone
AddressCityZip CodeE-Mail Address
Long Term Owner (if different from Developer or Project Sponsor)
Contact PersonOrganizationTelephone
AddressCityZip CodeE-Mail Address
3. PROJECT NAME & LOCATION
Project Name and Address
Project Name (if any)Projected Occupancy Date
AddressCityZip Code
Service Planning AreaSupervisorial DistrictUnincorporated Area (if applicable)
COUNTY OF LOS ANGELES - DEPARTMENT OF MENTAL HEALTH
Adult Justice, Housing, Employment and Education Services
Mental Health Services Act Housing Program
LETTER OF INTEREST
file:///usr/share/nginx/html/yummydocs/file/letter-of-interest-template-0595820.xls
Attachment I
4. PROPOSED POPULATION TO BE SERVED (check all that apply)
IndividualFamily
Age Group# of Homeless*# At Risk*# of Homeless*# At Risk*
Children (ages 0 - 15 )
TAY (ages 16 - 25)
Adults (ages 26 - 59)
Older Adults (ages 60+)
*As defined in the MHSA application
5. TYPE OF HOUSING AND NUMBER OF UNITS
Shared HousingRental Units
Other (Specify)
Type of Housing1 - 4 Unit StructureSingle Family HomeMulti-Family Building - 5 or More Units
Total Number of Units
6. TARGET INCOME LEVELS
Unit Size Number of Total Units/Bedrooms
MHSA FUNDED UNITS
Percentage ofAMINumber of MHSA Units
Studio
1 Bedroom
2 Bedroom
3 Bedroom
4 Bedroom
Total
7. AMOUNT OF MHSA FUNDS REQUESTED
MHSA CAPITAL REQUEST MHSA OPERATIONS REQUEST
PredevelopmentOperations Request
Site AcquisitionPer MHSA Unit
Construction
Rehabilitation
Total Capital Request $ -
Per MHSA UnitMHSA GRAND TOTAL REQUESTED $ -
Number of Units Requesting
MHSA Funding
COUNTY OF LOS ANGELES - DEPARTMENT OF MENTAL HEALTH
Adult Justice, Housing, Employment and Education Services
Mental Health Services Act Housing Program
LETTER OF INTEREST
file:///usr/share/nginx/html/yummydocs/file/letter-of-interest-template-0595820.xls
Attachment I
TOTAL PROJECT COST
8. SOURCES OF FUNDS
Sources
Permanent Amount
Total $ - $ - $ -
9. USES OF FUNDS
Fund UsesAmounts
Acquisition Costs
Construction (Rehabilitation) Costs
Soft Costs
Financing Costs
Total $ -
10. SUPPORTIVE SERVICES
Estimated Service Cost
List Funding Source by Type
OffsiteOnsiteIn-KindCash
11. NARRATIVE QUESTIONS
Please attach a maximum of 10 pages to respond to the following 13 questions:
Predevelopment
Amount
Construction
Amount
Committed
Funding?
You have been awarded
funding.
Pending Funding?
Please indicate date you
applied/will apply.
Committed
Funding?
You have been awarded
funding
Pending Funding?
Please indicate
date you applied/will apply
List Type of Proposed Services by
Location
Committed
Funding?
You have been awarded
funding
Pending Funding?
Please indicate
date you applied/will apply
1. Provide a brief project description, includingthe specific roles and responsibilities ofeach Collaborative Project Partner. Indicate whether the
project will be newconstruction, an acquisition/rehabilitation, or acquisition only. Indicate the projected construction start date, construction end
date and the projected occupancy date.
COUNTY OF LOS ANGELES - DEPARTMENT OF MENTAL HEALTH
Adult Justice, Housing, Employment and Education Services
Mental Health Services Act Housing Program
LETTER OF INTEREST
file:///usr/share/nginx/html/yummydocs/file/letter-of-interest-template-0595820.xls
Attachment I
7. What is the current zoning designation(s) for the site?
8. Is it possible to build the proposed affordable housing development "by right" based on existing zoning?
9. Is a zone change required? If yes, please describe.
11. Will CEQA or NEPA be required? If yes, what is the status of any applicable clearances?
12. Please outline the current status and estimated time line for securing each of the required entitlements approvals described above.
Lead Agency (Executive Director): ____________________________________________________ Date:_______________________________
original signature required
2. Doesthe project involve currently occupied units requiring a relocation plan? If yes, describe how that plan will be funded and describe how
your project will not contribute to a net loss of affordable housing units in the County of Los Angeles.
3. Please describe in detail the proposed targetpopulation for this project and explain howthis target population meets MHSAHousing Program
eligibility requirements.
4. Briefly summarize the proposed Project Developer's relevant experience, including developing housing for the project's proposed target
population.
5. Briefly summarize the proposed supportive services plan for theproject, including types of services and programs, services provider(s) and
provider experience serving the project's target population.
6. Does the project Sponsor have site control for this project? If yes, briefly describe the status of the project's site control as well as zoning, public
approvals or any other significant issues that may be required to proceed with construction.
10. Are there any other discretionary zoning-related approvals required (e.g. conditional usepermit, variance, density bonus, lotline adjustment,
etc.)? If yes, please describe.
13. Describe how your project will contribute to the Department's goal of geographic dispersion. If your projectis located in an area of the county
whereseveral other supportive housing projects alreadyexist, describehowyour project meets a demonstrated need for more supportive housing
units in that area.
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