1.01Introduction and Program Description
The Department of Health (DOH or Department), Division of Senior and Disabilities Services (DSDS or SDS), is requesting proposals from eligible applicants to provide Health Promotion and Disease Prevention (HPDP) services for the State of Alaska in FY2025 through FY2027. Program Services are authorized under 7 AAC 78 Grant Programs. Additional governing statutes are Title III Older Americans Act (OAA); AS 47.05.010 Duties of the Department of Health; and AS 47.65 Service Programs for Older Alaskans and Other Adults. State of Alaska statutes and regulations are accessible at the Department of Law Document Library or through the contact person identified on the cover page of this Request for Proposals (RFP).
Older American’s Act (OAA) Title IIID funds are required to be used for Health Promotion and Disease Prevention programs and activities that have been demonstrated through rigorous evaluation to be evidence-based and effective. Older adults represent the most sedentary segment of the adult population and inactivity increases with age. They are also disproportionately affected by chronic disease. Evidence-based programs help empower older adults to take control of their health by maintaining a healthy lifestyle through increased self-efficacy and self-management.
Evidence-based health promotion programs build self-efficacy, which plays a role in whether people feel that they can successfully manage challenging situations and achieve their goals. Health self-management requires that older individuals have the skills to obtain, understand, and use basic health information to set goals, and meet personal challenges, such as preventing or mitigating the effects of illness or aging. Program participants learn how to take on fitness challenges through commitment to activities and organizing and mastering tasks, resulting in increased confidence in personal resourcefulness.
There is increasing evidence that ongoing physical activity can prevent, slow the progress of, and reduce the impact of disease. Physical activity has a positive impact on physical illness, depression, and cognitive losses. Development of health self-management skills also helps the elder Alaskan share in decision-making with health care providers instead of being a passive "patient". It can also reduce the need for more costly medical interventions.
Personal goal setting and tracking has been found to contribute to motivation and adherence to physical activity and wellness behaviors. Participants can measure improvement and experience the rewards of increased fitness and confidence. Participants become more uniquely themselves through choices and behaviors with outcomes consistent with their desired quality of life.
1.02Program Goals and Anticipated Outcomes
The proposed project must demonstrate a thorough understanding and support of the pre-determined grant program goal and outcomes anticipated by the Department.
The goal of HPDP evidence-based interventions is to empower Older Alaskans to take control of their health by maintaining a healthy lifestyle through increased self-efficacy and self-management.
Working toward this goal will result in the following anticipated outcomes:
- The number of evidence based HPDP participants is maintained or increased.
- Participants maintain or increase ability to manage their health.
- Consumers maintain or increase satisfaction with services.
- Projected cost (to the grant) per consumer is maintained.
Applicants must provide the official name of the proposed intervention and describe the activities to be employed in the project.
Please refer to NCOA: Evidence-Based Falls Prevention Programs for a list of Evidence Based Programs for older adults and to ACL: Health Promotion for more information about Evidence Based programming for older adults.
1.03Program Services/Activities
Applicant proposals must describe the ways in which the project aligns with grant program intent, as well as the department priorities, core services, and objectives listed in Section 1.04 below. The proposal must also provide a comprehensive description of how the applicant will recruit participants, including seniors from outside the current senior center attendees.
Applicants must upload a timeline for the initiation or maintenance of services and project activities.
Logic Model Development
In support of project planning narratives, the applicant must complete a Logic Model using the instructions and template found in section 4.03, question five. The submitted Logic Model must identify resources available to the proposed project; summarize project activities for each proposed evidence-based program; and clearly state anticipated outputs with metrics, which will support the pre-determined goal and outcomes that are compliant with program intent.
Applicants agree to comply with the following additional program requirements and service standards:
- Services under the grant must maintain fidelity to the original evidence-based program it is being modeled after. For example, if classes were held three times per week, it is expected that services under the grant must be held three times per week. If activities were for one hour in the original model, grant funded activities must have a duration of one hour. Any proposed variations in structure and timing of intervention must be pre-approved by the DSDS Health Program Manager. If the program selected has screening, assessment and/or biometric measures, it is expected that the grantee must maintain fidelity to the chosen evidence-based intervention.
- Applicants must detail how they plan to attain and maintain certified instructors if required by the proposed program.
- All services and activities must include a participant self-evaluation component. Older adults will consciously focus on personal and achievable goals and write them down. With coaching and support, they will each develop a meaningful wellness plan. As seniors implement the program, they will record successes and limitations and update plans. At a minimum, each consumer will do a pre and post evaluation. Applicants must provide a copy of the tool that will be used to help the older adults develop their personalized wellness plan and measure their success.
1.04Program Evaluation Requirements and Reporting
The proposed project and required Logic Model must demonstrate a thorough understanding and must be clearly supportive of the grant program goals and outcomes anticipated by the Department.
Logic Model Development
The Logic Model form includes the goal(s), and outcomes anticipated for this program, as well as the effectiveness and efficiency measures to be tracked by the grantee for use by the Department in evaluating the results of services provided by the grant project.
Results Based Budgeting Framework
Results Based Budgeting provides a framework in which allocated resources support, and are justified by, a set of outputs and expected results. Within this framework, actual performance and achieved outcomes are measured by objective performance measures.
Projects must align with program objectives expressing Department priorities and core services. Projects must use performance measures to evaluate progress toward meaningful outcomes, and to initiate data collection and reporting consistent with Department priorities.
The Department Priorities, Core Services, Objectives, and Performance Measures of Effectiveness and Efficiency for this program are:
Department Priorities
- 1 Health & Wellness Across the Life Span
Department Core Services
- 1.1 Protect and Promote the Health of Alaskans
Department Objectives
- 1.1.1 Improve the health status of Alaskans
Effectiveness Measure
- Number who report interventions have improved their ability to manage their health
Efficiency Measure
- Cost (to the grant) per consumer
In addition to the Effectiveness and Efficiency Performance Measures required by the Department, additional performance measures specific to the grant program will be required as follows:
Additional Performance Measures
- Increase (or maintain) the number of individuals in the target population who participate
- Maintain projected cost per consumer
- Minimum of 75% report improved ability to manage health
- Minimum of 75% report satisfaction with services
Successful grantees will survey their participants for program satisfaction using a relevant consumer survey tool which must incorporate the effectiveness performance measure provided above and any of the four additional performance measures, also identified above. Applicants can propose other performance measures in addition to those above for evaluating the project’s progress in achieving results supportive of program goals and outcomes.
Grant Reporting
Required reporting for this grant will include:
- Quarterly Cumulative Fiscal Report recording overall grant and match expenditures by budget line,
- Quarterly Cumulative Fiscal Report 2, recording the quarterly expenditures by service,
- Biannual Progress Narrative Report, and
- Monthly service delivery data entry in the states online database.
1.05Target Population and Service Area
Applicants must clearly describe the population targeted by the project, including the area or communities that will be served. The qualifying circumstances that meet the priority of medically under-served and economic need designations must be provided. Applicants must provide an estimated number of consumers to be reached with each activity and a comprehensive description of how they will recruit participants, including seniors from outside the current senior center attendees. Proposals will be scored for compatibility with the intended target population identified in this solicitation.
Target Population The target population for the services requested in this solicitation includes individuals over the age of sixty (60) and their caregivers (if applicable). Priority is given to Older Alaskans living in medically under-served areas who are of greatest economic need. Medically under-served areas are areas with a lack of access to primary care services.
Service Areas and Communities The service areas and communities requested for the services solicited are all service areas and communities Statewide. Applicants must provide the qualifying circumstances that meet the priority of medically under-served and economic need designations.
Applicants must provide an estimated number of consumers to be reached with each activity, and a comprehensive description of how they will recruit participants, including seniors from outside the current senior center attendees. Proposals will be determined by PEC scores evaluating the strength of the proposal and the compatibility with the intended target population.
1.06Program Funding
Funds available for this program are anticipated to total $167,400 per fiscal year, which is comprised of $44,171 General Fund Match, and $123,229 Federal Funds. Overall total for the duration is estimated at $502,200.
There is no limit to the amount of funding an applicant can request, as long as the request is justified in the proposal. Funding determinations will be based on historical funding levels, service delivery data, the number of successful applicants, the applicant's proposed services, and the need of the target population in each community.
Match Requirement: The budget must include matching funds equal to 10% of the proposed DOH funds.
Calculate Required Match with the following formula: Total Requested Grant Award x Required Match Percentage = Required Match
Federal grant funds may not be used to match Federal funds awarded through this grant program, and State grant funds may not be used to match State funds awarded through this grant program.
Eligible sources of matching funds include:
- Local Cash: local sources, including local tax receipts, municipal revenue sharing, cash donations
- Local In-Kind: donated items of value for which the applicant incurs no cost, including volunteer labor and donations of supplies, equipment, space
- Other Sources: government and non-government grant awards, third party receipts, direct receipts such as gaming or sales of goods
- Grant Income: earnings anticipated as a result of this project proposal receiving award, and Medicaid reimbursements if award of this grant is required for the applicant to bill Medicaid for awarded services
- Medicaid: includes Medicaid, which is not Grant Income, as well as other third party receipts
Proposed Budget: The applicant must submit a budget proposal for the first fiscal year of the project. The proposed budget detail and narrative, including required match, must support the program’s results-based service delivery and staffing requirements stated in this RFP.
The proposed budget must be fully compliant with the limitations described in this RFP, and those detailed in 7 AAC 78.160 (Costs). Regulations are provided under the GEMS Documents tab.
Allowable Costs
- Salary and honorarium* for program facilitators if this is not already covered by salary or with funding for activities already being implemented. If existing activities are expanded or enhanced, additional salary may be considered an allowable cost.
- Equipment or supplies and participant materials needed for the specific activity.
- Facility cost.
- Costs of transportation for participants if needed to access group activities if other sources of senior transportation are not available.
- Costs for participation in online group competitions (if applicable), such as the National Senior League.
- Reasonable and approved outreach activities to recruit participants (not to exceed 10% of award).
- Cost of training for facilitator, who must be responsible for managing or facilitating activities, must be considered on a case-by-case basis if costs are commensurate with the services to be delivered. Training for staff/facilitators, volunteers/peer facilitators may be allowed if the employee or volunteer contracts in writing for at least 6 months of provision of the service related to the training, or that reimbursement of training costs must be on a prorated basis.
*Honorariums may be paid with federal funds only. This is not an allowable expense with state funds.
Disallowed Costs
- Passive activities such as presentations or lectures unless these are an integral part of the overall evidence-based health promotion program strategy.
- Health screening and services, unless these are an integral part of the overall evidence-based health promotion program strategy AND participants are assisted to maintain a record of findings.
- Purchase of any equipment or supplies, unless they are an essential part of an ongoing facilitated HPDP program that includes physical activity.
- Memberships or subscriptions to web-based programs that do not directly contribute to applicant's ability to provide specific HPDP activities for participants.
- General information and referral.
- Any activity for which the applicant can provide no evidence of effectiveness.
Resources specific to budgeting are also available under the GEMS Documents tab. DOH Grant Budget Preparation Guidelines provide information and guidance about budget lines, cost detail groupings, and narrative requirements. Grantee User Manual Part I provides detailed instructions for entering a budget proposal in the chapter "Responding to a Solicitation."
Other Agency Funding: Prior to submitting a proposal, applicants must list all other agency funding received and applied for. This task must be completed by an Agency Power User in the Other Funding section of the Agency Administration tab. This is part of the pre-award risk assessment required under Uniform Guidance 2 CFR 200.
Indirect Costs: If the proposed budget includes indirect costs, 7 AAC 78.160(p) requires a copy of the agency’s current federally approved Indirect Cost Rate Agreement. The agreement must be uploaded in the Agency Administration tab. Lapsed agreements can be used if uploaded with the negotiating federal agency’s written approval to continue using the rate until a new agreement is negotiated. If an agency has never entered into a federally approved Indirect Cost Rate Agreement or no longer has a federally approved agreement in place, the recently updated Federal Uniform Guidance 2 CFR 200 now allows that agency to budget the 10% de minimis.
Payment for Services/Grant Income: If applicable to the services proposed in response to this solicitation, awarded grantees must have a Medicaid Provider Number or apply to obtain one, and will make reasonable effort to bill all eligible services to Medicaid and any other available sources of payment before seeking grant support for delivery of the proposed services. DOH funds are the payer of last resort.
In the applicant’s proposed budget, anticipated receipts and expenditures for all grant income must be evident in the detail and narrative. Fiscal reports for awarded income generating projects must include the receipts and expenditure of all grant income.
Planned Services & Expenditures
In addition to the budget, applicants must provide a Planned Services & Expenditures (PSE) on the form provided, that indicates planned expenditures by service(s) and estimated units of intervention and participant self-evaluation. The PSE should be consistent with activities and outputs from the logic model. PSE expenditures should be consistent with the budget, and the cost per service unit should be reasonable.
Expenditures by service will be reported quarterly on the CFR2 and Biannual Program Narrative Report will explain the services delivered compared to the services forecasted on the PSE.
Funding determinations will be based on justification of the budgeted amount, the applicant’s proposed service delivery, the needs of the target population in each community, the proposals PEC score and funding recommendations from the PEC. Applicants must provide information to substantiate that the intended population is in a medically underserved area and in economic need.