1.01Introduction and Program Description
The Department of Health and Social Services (DHSS or Department), Division of Behavioral Health (DBH or Division), is requesting proposals from eligible applicants to provide Emergency Grants to Address Mental Health and Substance Use Disorder services during COVID 19- Small Communities for the State of Alaska in FY2021. Program Services are authorized under 7 AAC 78 Grant Programs. Additional governing statutes are AS 47.30.475. Grant-in-Aid Program, AS 47.30.520-620 Community Mental Health Services Act, 7AAC 70 Behavioral Health Services, 7AAC 135 Medicaid Coverage for Behavioral Health Services, AS 47.37 Uniform Alcoholism and Intoxication Treatment Act, AS 47.30.655-.915 Alaska Civil Commitment Statutes, AS 47.30.011-.061 Alaska Mental Health Trust Authority. State of Alaska statutes and regulations are accessible at http://www.law.state.ak.us/doclibrary/doclib.html or through the contact person identified on the cover page of this Request for Proposals (RFP).
A Request for Information (RFI) regarding this program yielded responses that exceeded the available program resources, and consequently two competitive solicitations have been issued; this RFP for small communities and a separate RFP for large communities. Agencies that submitted an application in response to the RFI must now submit an application to the applicable RFP in order to be considered for funding. Agencies meeting 7 AAC 78.030 that did not respond to the RFI may also submit an application to one of these two RFP's.
This project utilizes SAMHSA funding to address the needs of a range of individuals with mental health and substance use disorders who have been impacted by the COVID-19 pandemic. The Division recognizes that many individuals with pre-existing serious disorders were affected by this emergency including adults with a Serious Mental Illness, children and youth with a Serious Emotional Disturbance, and individuals with a Substance Use Disorder. Additionally, as a result of this crisis, many other individuals have and will struggle with increases in depression, anxiety, trauma, grief, and substance misuse. The purpose of this program is to provide crisis intervention services, mental health and substance use disorder treatment, crisis counseling, and related supports to all the above populations impacted by the COVID-19 pandemic.
Seven grants, are being offered to communities throughout Alaska through this solicitation, excluding the Anchorage, Fairbanks, Palmer/Wasilla, Kenai and Juneau Community Planning Areas.
A “Community”, for the purposes of this proposal, is defined as one of the 29 Community Planning Areas (see Attachment 1) identified by the Division of Behavioral Health (DBH) for the Community Action Planning process and for Psychiatric Emergency Services. Applicants must be either a Psychiatric Emergency Services provider or show a plan to coordinate with the local PES provider for those types of services.
Agencies serving more than one Community Planning Area can apply for more than one Area but must submit separate proposals for each.
1.02Program Goals and Anticipated Outcomes
Applicants must describe how they will satisfy all of the following goals, objectives, and outcomes either through their own agency or in collaboration with others.
Goals
- Implement a comprehensive plan of evidence-based mental and/or substance use disorder treatment services for individuals impacted by the COVID-19 pandemic.
- Implement Crisis mental health services, including 24-hour emergency response, emergency crisis intervention services including psychiatric/medical assessment and where indicated, and medication administration.
- Provide a comprehensive range of treatment services for individuals with a Serious Mental Illness, for children and youth with a Serious Emotional Disorder and for individuals with a Substance Use Disorder.
- Provide outreach and services to other individuals in the community who are struggling with increases in depression, anxiety, trauma, grief, and substance misuse as a result of the pandemic.
Outcomes
- Clients receive timely, accessible care.
- Clients receive the most appropriate level of care.
- Clients are provided culturally and linguistically appropriate services.
- Clients are provided trauma-informed and trauma treatment services.
- Client recovery, resilience, and community integration is enhanced.
- Client access to sources of insurance including Medicaid is maximized.
Projects must meet or exceed anticipated minimum outcomes described in this RFP.
1.03Program Services/Activities
Applicant proposals must describe the ways in which the project aligns with program intent. The submitted project proposal will identify agency resources available to the project; describe how the project activities listed below will be accomplished; and clearly state the project’s anticipated goals, outputs, and outcomes.
- Describe which Community Planning Area (Attachment 1) your agency is applying for. Describe how you will provide crisis mental health services, including 24-hour emergency response, emergency crisis intervention services including psychiatric/medical assessment and where indicated, medication administration. Services can include mobile response teams. Collaboration with another community provider to provide these services is permissible, but must be documented through a current Letter of Commitment specific to this project.
- Describe how your agency will provide a comprehensive range of treatment services for individuals with a Serious Mental Illness, for children and youth with a Serious Emotional Disorder and for individuals with a Substance Use Disorder. Services can include outpatient, intensive outpatient and residential services. Services should include medication management for both individuals with SMI and SUD including those with Opioid Use Disorder. Evidence based practices should be employed whenever possible. Services should also include recovery support services such as linkages to nutrition/food services (grant funds may not be used to purchase food/meals), individual support services (including peer support), linkages to housing services and transportation services. It’s expected that 78% of funds will be directed to these populations. Collaborations with other community providers to provide these services are permissible but must be documented through a Letter of Commitment.
- Describe how your agency will provide outreach and services to other individuals in the community who are struggling with increases in depression, anxiety, trauma, grief, and substance misuse as a result of the pandemic. Services provided should include crisis intervention services, crisis counseling, and mental health and substance use disorder treatment. It’s expected that 22% of funds will be directed to this population.
Applicants will upload a timeline and corresponding narrative describing activities for the initiation of services and continued project activities. Service delivery must begin by August 1, 2020 at the latest.
1.04Program Evaluation Requirements and Reporting
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 are required to align with program objectives expressing Department priorities and core services. Projects will 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
Department Performance Measures
- Days Elapsed Between Intake and First Service.
- Percentage of Clients who are "Low Income/Non-Resourced".
The applicant’s proposed evaluation plan will incorporate the performance measures of effectiveness and efficiency identified above. Applicants can propose additional performance measures for evaluating the project’s progress in achieving results supportive of program goals and outcomes.
Grant Reporting
Required reporting will include:
- Cumulative Fiscal Reports recording overall grant and match expenditures by budget line; and
- Program Reports in the format prescribed by the program.
- All sub-recipients of this SAMHSA funding are required to collect and report certain data so that SAMHSA can meet its obligations under the Government Performance and Results (GPRA) Modernization ACT of 2010. Recipients will be required to report client-level data at intake to services, every six months thereafter, and at discharge from services.
Data elements will include, but not limited to diagnoses, services received, criminal justice status, hospitalizations, employment, mental health functioning, social connectedness, and substance use. This information will be gathered using a uniform data collection tool provided by SAMHSA. Recipients are required to submit data via SAMHSA's data entry and reporting system; access will be provided upon award. Data submission to SAMHSA may require utilizing Alaska's AKAIMS system. An example of the type of GPRA data collection tool can be found at https://www.samhsa.gov/grants/gpra-measurement-tools. Recipients will be expected to complete a GPRA interview on all clients in their specified unduplicated percent. DBH may include additional reporting requirements as appropriate and feasible. Please document your agreement to comply with GPRA and other data collection requirements. (NOTE: for some funding opportunities, SAMHSA has recently permitted modifications to its GPRA data collection to facilitate data collection via appropriate phone/web technology rather than face-to face during the COVID 19 pandemic.)
1.05Target Population and Service Area
Applicants must clearly describe the population targeted by the project, and the specific Community Planning area and communities that will be served. Proposals will be evaluated for compatibility with the program’s intended target population identified in this solicitation.
Target Population: The target population for the solicited services are individuals affected by the COVID 19 pandemic with Serious Mental Illness, children and youth with a Serious Emotional Disturbance, or Substance Use Disorders (with or without a co-occurring serious mental illness). The target population also includes individuals impacted by the epidemic but with less severe disorders such as depression, anxiety, trauma, grief, and substance misuse.
Service Areas and Communities: The service areas and communities requested for the services solicited are communities throughout Alaska excluding the Anchorage, Fairbanks, Palmer/Wasilla, Kenai and Juneau Community Planning Areas described in Attachment 1. A maximum of one proposal will be funded in a Community Planning Service Area.
Applicants are expected to serve all communities within the Community Planning Area proposed.
Applicants serving more than one Community Planning Area can apply for more than one area but must submit separate proposals for each.
1.06Program Funding
Funds available for this program are anticipated to total $669,123 in federal funding for FY21. Seven awards are being offered with a maximum funding amount of $95,589. Note: If additional funding is available after making these seven awards, additional awards may be made based on Proposal Evaluation Committee scores until funding has been fully utilized.
Match Requirement: The budget must include matching funds equal to 25% of the proposed DHSS 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), will support the program’s results based service delivery and staffing requirements stated in this RFP.
The proposed budget will 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.
Resources specific to budgeting are also available under the GEMS Documents tab. DHSS 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 are required to 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 is to 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.
Payment for Services/Grant Income: If applicable to the services proposed in response to this solicitation, awarded grantees will 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. DHSS funds are the payer of last resort.
Recipients must utilize third party reimbursements and other revenue realized from the provision of services to the extent possible and use grant funds only for services to individuals who are not covered by public or commercial health insurance programs, individuals for whom coverage has been formally determined to be unaffordable, or for services that are not sufficiently covered by an individual’s health insurance plan.
Recipients are also expected to facilitate the health insurance application and enrollment process for eligible uninsured clients. Recipients should also consider other systems from which a potential service recipient may be eligible for services (for example, the Veterans Health Administration or senior services), if appropriate for and desired by that individual to meet his/her needs. In addition, recipients are required to implement policies and procedures that ensure other sources of funding are utilized first when available for that individual.
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 will include the receipts and expenditure of all grant income.