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
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 of Area 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 - Please indicate the name and number of the Supervisorial District of the
project.
Unincorporated Area - Please indicate the name of the City or Unincorporated Area of the project (if
applicable).
Please indicate the number of MHSA units and total units in the appropriate box. For Shared
Housing, the units represent the number of bedrooms. For Rental Units, the units represent the
number of apartments.
Indicate the number of units (Total and MHSA units) in the appropriate box, being aware of the total
number of units. For Shared Housing, "units" represent bedrooms. For Rental Units, "units"
represent apartments.
Indicate the amount of funding requested for each project component. To determine the "Per MHSA
Unit" number, divide the "Total Capital Request" and/or "Total Operations Request" by the total
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 and using 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 MHSA Housing Program guidelines) and who otherwise meet the MHSA Housing Program target
population description. The California State Department of Mental Health (State DMH) 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 site control 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 MHSA Housing Advisory Board 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 Person Executive Director
Address City Zip Code
Telephone Fax E-Mail Address
2. COLLABORATIVE PROJECT PARTNERS
Developer
Contact Person Organization Telephone
Address City Zip Code E-Mail Address
Property Manager
Contact Person Organization Telephone
Address City Zip Code E-Mail Address
Primary Service Provider
Contact Person Organization Telephone
Address City Zip Code E-Mail Address
Long Term Owner (if different from Developer or Project Sponsor)
Contact Person Organization Telephone
Address City Zip Code E-Mail Address
3. PROJECT NAME & LOCATION
Project Name and Address
Project Name (if any) Projected Occupancy Date
Address City Zip Code
Service Planning Area Supervisorial District Unincorporated 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)
Individual Family
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 Housing Rental Units
Other (Specify)
Type of Housing 1 - 4 Unit Structure Single Family Home Multi-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 of AMI Number 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
Predevelopment Operations Request
Site Acquisition Per MHSA Unit
Construction
Rehabilitation
Total Capital Request $ -
Per MHSA Unit MHSA 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 Uses Amounts
Acquisition Costs
Construction (Rehabilitation) Costs
Soft Costs
Financing Costs
Total $ -
10. SUPPORTIVE SERVICES
Estimated Service Cost
List Funding Source by Type
Offsite Onsite In-Kind Cash
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, including the specific roles and responsibilities of each Collaborative Project Partner. Indicate whether the
project will be new construction, 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. Does the 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 target population for this project and explain how this target population meets MHSA Housing 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 the project, 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 use permit, variance, density bonus, lot line adjustment,
etc.)? If yes, please describe.
13. Describe how your project will contribute to the Department's goal of geographic dispersion. If your project is located in an area of the county
where several other supportive housing projects already exist, describe how your project meets a demonstrated need for more supportive housing
units in that area.
