Q1: Can our organization apply as a solo applicant and not as part of a partnership if we have the capacity to provide 100% of the required grant activities?

A1: No, a partnership is required for this particular funding opportunity. The goal of this funding opportunity is to strengthen systems of care for TGI Californians beyond one provider. A TGI-Serving Organization (as defined in HSC §150900) that provides direct medical services must still submit an application that includes a partnership with either another TGI-Serving Organization or medical partnership to address all three critical elements as stated in the RFA: priority direct clinical services, system capacity building or improvement, and access to care.

Applicant organizations, however, have the flexibility to determine the scope of the partnership including activities and levels of funding allocated amongst partners for the proposed project.​

Q2: Is there any possibility to modify the partnership requirement? 

A2: No. Applicants must follow the RFA requirements as stated.

Q3: Can our organization list one of its current Medical Provider staff to meet the partnership requirement? 

A3: The partnership requirement is to help build and/or enhance sustainable systems of care for TGI Californians. The partner organization, as listed in the RFA (pg. 8-9, Section 2.5.), must possess 501(c)(3) status and be either a TGI-serving organization or a public hospital, medical clinic or other provider. Examples include, but are not limited to, TGI-serving nonprofit organizations, UC Hospitals, surgical centers, healthcare systems (like Kaiser Permanente, or non-profit health clinics). Medical providers who are staff of the applicant organization do not qualify as a partner organization.

Q4: Can a Medical Provider partner with more than one TGI-serving organization? The RFA mentions a scenario with multiple medical providers that can be funded under the grant but does not mention multiple TGI-serving Organizations in that regard.

A4: Yes, a Medical Provider partnering with multiple TGI-serving organizations is allowable.

Q5: Our current grant with the TGI Unit is specific to a region. If we were to apply for the new opportunities with a scope/region not currently funded, would we be eligible?

A5: Applicants who have already received a grant from the TGI Fund are welcome to submit an application if they meet the minimum qualifications listed in the RFA.  Please keep in mind that applicants should not propose activities for which the grant award will supplant existing funding.

Q6: Is an out-of-state organization that currently provides telehealth services to Californians eligible to apply? Is a physical California service location required at the time of application or within the grant performance period?

A6: There is no prohibition against entities that are based outside of California. However, applicants must demonstrate that services provided with this funding will only benefit TGI Californians. Additionally, the applicant review team considers during the review process if applicants have a history of providing services to the priority populations within California, as listed in the RFA (pg. 7-8, Section 2.3.).

Q7: Is providing services that are inclusive of youth required? Pg. 10 of the RFA states “…any age, including youth…” - not sure if that means that we can propose any age group of patients as opposed to must include services for youth. Similarly, under the capacity building section, it says “increasing capacity…for all ages, including youth" — does that mean that capacity building efforts are required to be inclusive of those under 18?

A7: Applicants are not required to include youth (and/or individuals under the age of 18) in their proposed project. Children and youth are one of the TGI Fund Priority Populations listed in the RFA (pg. 7-8, Section 2.3.). All applications are required to center at least one TGI Fund Priority Population but do not need to center all.

Q8: Will you only be answering questions in writing on 12/8, or will you be responding to questions via email as they come in?

A8: The Request for Applications process requires us to provide the same information to all applicants at the same time to avoid giving any one applicant an advantage. That said, we will not respond to questions individually via email and will publish questions and answers on our “Questions and Answers web page." Our team will update this page again by December 8^th. Please submit all written questions by December 3^rd before 5:00 p.m. (PDT) to ensure that we can update the web page.

Q9: The RFA states that required templates are available on your website but I cannot find it. Would it be possible to provide these?

A9: These templates will be provided via email. To receive copies of the required templates, email the TGI Unit inbox at TGIUnit@cdph.ca.gov.

Q10: Regarding the ability of our organization to meet the preferred qualification of "demonstrating a commitment to and/or successful record of serving TGI populations(s)", specifically concerning current staff/board members with lived experience. Our organization is a clinic that has long provided comprehensive sexual and reproductive health care services for the diverse, low-income community, and have recently added gender affirming care to our practice. Our clinic staff and partnering organizations reflect the diversity of the community, however, our board of directors is less diverse. Can you advise as to whether our application would be disqualified as a result of this shortcoming?

A10: The minimum qualifications for this RFA are listed in Section 3.1. Failure to meet these will result in disqualification. As you point out, the demonstration of commitment to and/or successful record of serving TGI populations(s) is a preferred qualification and thus will not be assessed during Stage 1. It is not a minimum qualification and cannot be used to automatically disqualify an application unless the section is blank or otherwise left incomplete. If your application reaches Stage 2 review, all preferred qualifications will be scored according to the criteria listed in the RFA.

Note: This application requires a partnership consisting of a TGI-Serving Organization (as defined in Health and Safety Code Section 150900) and a hospital, health care clinic, or other medical provider. Any application that fails to include a partnership as specified will fail administrative compliance.

Q11 : The TGI partner in our application provides behavioral health services by licensed clinicians/supervisors and license eligible interns but is not a licensed behavioral health facility. Is this sufficient to document Minimum Qualifications in Attachment 3?

A11: Yes. There is no requirement that either partner must be a licensed behavioral health facility.

Q12: As a TGI-focused mental health clinic, we are open to serving as the partner organization for any medical clinic or organization applying for the Gender-Affirming Clinical Care Systems Grant. Is there a process or recommended way for us to communicate this availability to the pool of grant applicants?

A12: CDPH is unable to connect or suggest specific organizations for partnership under this opportunity.

Q13: Is the following scenario permissible? Or would Organization B also need to be a TGI-Serving Organization? Organization A (primary applicant): a TGI-Serving Organization that also qualifies as a Medical Provider. Organization B (subgrantee): a 501c3 organization that focuses on capacity building but is not a TGI-Serving Organization.

A13: If the TGI-Serving Organization is the applicant, then the partner organization must be a nonprofit hospital, health care clinic or other medical provider. If the 501(c)3 organization doesn’t meet minimum qualifications as a TGI-serving organization or nonprofit hospital, health care clinic, or other medical provider, then the application wouldn't meet the necessary partnership requirements.

Q14: We are an RCFCI, a Residential Care Facility for the Chronically Ill, and provide 24-hour nursing care to low-income people living with HIV/AIDS recovering from surgery, illness, or in need of palliative/hospice care. Through our residential care services, we provide a unique service to the TGI community: a pre-/post- gender-affirming surgery recovery room where people receive 24-hour nursing care, meals, mental health care, and case management. I'd like to apply to expand our services to provide gender-affirming care in partnership with a TGI-serving organization.  Would we qualify as a medical provider under your definitions, given our status as a medical facility that provides residential nursing care?

​​A14: Yes, this would qualify.​

Q15: Does both the fiscal sponsor and the partnering organization have to have a 501c3 established before Jan 1st 2025?

​A15: The January 1^st, 2025 date only applies to the TGI-Serving Organization's mission statement. It does not pertain to when either organization was established.​​

Q16: Do both organizations need to have explicit TGI language in their mission statement or only one?

A16: Only the TGI-Serving Organization's mission statement must center TGI people.​

Q17:Is the 65% threshold client base only for the sponsoring organization, the clinic or both?

A17: The 65% threshold serves to determine whether an organization qualifies as a TGI-Serving Organization. A clinic in partnership with a TGI-Serving Organization would not need to meet this criteria.​

Q18: To sign Attachments 3, may we extract from the pdf RFA, sign it, then re-insert it into our final pdf submission?

​​A18: Yes, you may.

Q19: Do you require the submission to be paginated with consecutive page numbers?

A19: No, this is not required. However, it would be most helpful for our reviewers if pages were numbered.

Q20: What sorts of licensure and certifications are you looking for? Business license, professional licenses of allocated staff? Other? What scenarios would preclude an organization from having to submit this attachment?

​A20: For services provided to the public, you must provide any professional licensure and/or certification as required by law. It is the responsibility of the applicant to determine which items apply. 

Q21: For the TGI-Serving Organization that is required as a partner, can we fiscally sponsor a clinic that does not have 501c3?

​A21: Per Health and Safety Code Section 150900, a TGI-Serving Organization may utilize a fiscal sponsor if they do not have 501(c)3 status, but there is not the same allowance for a medical provider. Both the TGI-Serving Organization and the hospital, health care clinic or other medical provider must be a 501(c)3 nonprofit organization.

Q22: Can we partner with a TGI-Serving Organization, a community organization for capacity building and training that we also fiscally sponsor?

A22: Yes. Please note this in your application.

Q23: Can we provide incentives to help clients stay in their homes?

A23: This funding opportunity lists supportive housing programs as an unallowable activity. As such, vouchers for housing security would be unallowable under this RFA.

Q24: Given that providers are now newly trying to start youth care outside of organizations, do these entities need to be fully formed to partner with another organization? I am a medical provider who is forming a legal entity to provide medical care for trans youth. I would be partnering with a 501c3 TGI-serving organization to add to that.

A24: Applicants must possess the minimum qualifications listed in the RFA upon application. If an organization does not meet these requirements, they are ineligible.

Q25: If a medical nonprofit was founded in February 2025, would they qualify?

A25: Yes. The date requirement only applies to the TGI-Serving Organization.

Q26: Is there a minimum grant amount or grant percentage that should be set aside/budgeted for the partner organization?

A26: There is no minimum grant amount or grant percentage required. Applicants have the flexibility to determine how the scope and budget are distributed between partners. However, the RFA states that budgets should "demonstrate meaningful partnership between applicant organizations." A budget that includes a small or token percentage to the TGI-Serving Organization may be scored lower than one that is viewed as more fully involved in the implementation and operation of the program.

Q27: We are a Federally Qualified Health Center with a dedicated program that exclusively serves TGI individuals (100% of clients). While our organization as a whole serves a broader patient population, all clients within the program meet the TGI requirement. Could you please confirm whether eligibility can be determined at the program level, rather than at the organizational level, for this funding opportunity?

A27: These requirements apply to the entire organization. A program within an FQHC does not qualify the FQHC as a TGI-Serving Organization.

As stated in section 3.1, page 13 of the RFA, “The mission statement and client percentage requirements…must belong to that of the entire organization. A program within a non-profit organization or university is not eligible to be awarded funds under state law."

However, an FQHC would qualify as a medical provider and could partner with a TGI-Serving Organization in an application.​

Q28: For resumes, are "key personnel" all positions included in the project budget? Or just certain positions (e.g., director level)?

A28: Key personnel would include all staff or positions that are included in the project budget.

Q29: Does the medical provider partner organization have to also be a 501c3? If so how long does it have to have been founded?

A29: Yes, both partners must have 501(c)3 status. More information can be found in section 3.1, page 12 of the RFA on minimum qualifications for both organizations. There is not a requirement for how long the Medical Provider partner organization needs to have been founded.

Q30: We are a membership organization for family physicians who provide care state-wide in all settings. Would providing gender-affirming education to these primary care providers that count as direct clinical services?

A30: No. Educating providers would fall under the second element: "clinical capacity building." As a reminder, submitted proposals must clearly address all three elements listed in the RFA.

However, your organization could partner with applicants to provide that service.

Q31: Are the specific definitions of "medical provider" required to apply?

A31: The purpose of this RFA is to increase access to gender affirming care clinical services. We expect that “Medical Providers" includes those who provide clinical services related to gender affirming care. Examples include, but are not limited to, physicians, nurse practitioners, nurses, mental health professionals, surgeons, and electrologists. If there is a specific type of provider that you have in mind and would like clarity on, please email our Unit at TGIUnit@cdph.ca.gov.

Q32: We are an LGBTQ+ organization with a mental health clinic. Our clinic serves 70% TGI and this is the focus of our application. Our organization with general programming included serves 45% TGI. Our mission is as follows: “The Center inspires and advocates for the LGBTQ+ people of Anonymous counties… allowing individuals to build resiliency and thrive." Does our organization qualify for this grant?

A32: Your organization would not qualify as a TGI-Serving Organization under HSC §150900. However, as a medical provider, you can submit an application in partnership with a TGI-Serving Organization.

Q33: While our organization isn't a TGI-led or exclusively TGI-serving organization, our program is a TGI-serving program with its own staff, budget, income streams, community accountability, and a strong focus on gender-affirming harm reduction for TGI PWUD and TGI sex workers. We're exploring a partnership with an organization that could qualify as either the medical provider or TGI-Serving Organization. I wanted to confirm whether this would qualify us to apply as the TGI-Serving Organization applicant under this RFA.

A33: As stated in Section 3.1, page 13 of the RFA. “The mission statement and client percentage requirements...must belong to that of the entire organization. A program within a non-profit organization or university is not eligible to be awarded funds under state law." As such, your organization would not be eligible to apply as the TGI-Serving Organization.

For this RFA, the “lead applicant" (the actual legal entity applying for the grant) must be either a TGI-Serving Organization OR a nonprofit hospital, health care clinic or other medical provider. Both types of entities must be included in the application to qualify for funding. If your organization would be providing the gender-affirming clinical harm reduction services you mentioned as the “other medical provider," then your application would need to have a TGI-Serving Organization as a partner.​​