1.01Introduction and Program Description

The Department of Health, Division of Behavioral Health, is requesting proposals from eligible applicants to provide Youth Suicide Intervention Pathways to Care services for the State of Alaska in FY2023 through FY2028. 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 Department of Law Website or through the contact person identified on the cover page of this Request for Proposals (RFP).

Applicants will provide Youth Suicide Intervention Pathways to Care services by piloting the Zero Suicide initiative within their current acute care site for the State of Alaska. The Zero Suicide Initiative is a systemic framework intended to create assiduous care pathways for those at risk of suicide, including screening, risk assessments, safety planning, and transitions. The Division is seeking two hospitals willing to pilot this initiative within their agency. Selected pilot sites will be responsible for engaging with the Division to implement the whole of the Zero Suicide framework, including creating and adjusting appropriate policies, establishing continuous quality improvement measures, training staff, ensuring universal screening and systematic risk assessments are occurring, establishing safety planning protocols, and implementing best practices in care transitions.  This request for proposals is to provide funding to assist two hospital sites to pilot the Zero Suicide initiative. The Division will support the selected pilot sites through contracting training, consultation, tool-based support, transition services, and syndromic surveillance based data reports as well as supplying direct support for a part-time position which will act as a point of contact for the Division, help lead internal work, and maintain grant required reporting elements. 

Zero Suicide is an evidence-based initiative that provides a framework for implementing safer suicide care within healthcare settings. Zero Suicide is a priority of the National Action Alliance for Suicide Prevention and, through the Suicide Prevention Resource Center, a project of the Education Development Center. The Division will support the selected pilot sites through providing training from the Education Development Center regarding Zero Suicide evidence-based practices, consultation, and tool-based support such as tablet-based therapeutic interventions for young adults, youth and their families when presenting at the emergency department because of suicidal ideation, a suicide attempt, or suicidality is identified during the visit. The Zero Suicide framework consists of seven components outlined below.

• LEAD system wide culture change committed to reducing suicides
• TRAIN a competent, confident, and caring workforce
• IDENTIFY individuals with suicide risk via comprehensive screening and assessment
• ENGAGE all individuals at risk of suicide using a suicide care management plan
• TREAT suicidal thoughts and behaviors directly using evidence-based treatments
• TRANSITION individuals through care using warm hand-offs and supportive contacts
• IMPROVE policies and procedures through continuous quality improvement

Zero Suicide is an organizational commitment to safer suicide care that has been widely implemented throughout the nation and across the globe. This holistic approach to safer suicide care is also a timely intervention for Alaska’s hospitals who have experienced a recent influx of youth admitted for suicide risk and mental health crisis. This RFP is intended to aid the healthcare system in responding to suicide risk by providing evidenced based practices, training, tools, and staffing assistance to two hospital pilot sites. 

1.02Program Goals and Anticipated Outcomes

The proposed project must demonstrate a thorough understanding and support of the grant program goals and outcomes anticipated by the Department.

The intention of this RFP is to expand suicide safer care practices in acute settings, in the selected pilot sites through the implementation of the Zero Suicide framework. The selected pilot sites will implement Zero Suicide within their organizations, including suicide screening, assessment, safety planning, lethal means safety, brief intervention, referral to treatment, supported transitions, and quality improvement practices. Goals of the Zero Suicide framework can be found on the Zero Suicide website and in the Zero Suicide workplan.  

Projects must meet or exceed anticipated minimum outcomes described in this RFP.

Selected pilot sites will be expected to improve their fidelity to the Zero Suicide framework. 

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 project activities; and clearly state the project’s anticipated goals, outputs, and outcomes. If appropriate, applicants should specify efforts currently underway to meet Joint Commission’s National Patient Safety Goal 15 (Suicide Prevention).

Applicant’s proposals must include a description of how the following activities will be incorporated into workflow and standardized practice. If the applicant agency is already engaging in the following activities, this must be specified with practices and evidence-based tools identified. 

1. Universal screening for suicide risk
2. Systematic suicide risk assessment practices
3. Safety planning
4. Lethal means safety
5. Evidence-based, suicide specific brief intervention
6. Post discharge contacts
7. Suicide focused quality improvement efforts

Applicants will upload a timeline for the initiation of services and project activities. To support the transition to safer suicide care practices amongst selected pilot sites, the Division will contract several services. Applicants will be expected to participate in and utilize various contracted resources by the Division. Initiation of said resources should be incorporated into applicant timelines. These fully Division funded activities are listed below.

• Applicants will be expected to participate in the Zero Suicide workshop hosted by the Zero Suicide Institute.
• Applicants must engage with the Zero Suicide Institute’s consultation and implementation support service. 
• Applicants must send selected staff to Division funded staff trainings. 
• Applicants will refer patients as appropriate to transition services provided by the Alaska Careline to include transition support and post discharge contacts. 
• Applicants will utilize technology-based interventions to assist staff in suicide care practices including suicide screening, risk assessments, safety planning, lethal means safety, and brief interventions. Utilization of the EPIC platform is preferred, but not required, as this technology-based intervention can integrate with the EPIC platform at the agency’s request. 
• Applicants will engage with the Public Health syndromic surveillance system. This will allow applicants to receive reports from Public Health and Behavioral Health on data trends from their hospital data. 

To assess fidelity to the model, applicants will complete the Zero Suicide workforce survey at year one, and four of the grant cycle. Applicants will also complete the Zero Suicide organizational self-study at year four of the grant cycle. These activities should be included in applicant timelines. 

In support of project planning narratives, the applicant must complete the Zero Suicide Organizational Self-Study worksheet (Attachment 1) to this RFP and include this with their proposal. 

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

Effectiveness Measures

• Number of new embedded policies and practices for safer suicide care

Efficiency Measures 

• Number of clients screened for suicide
• Number of clients who receive a suicide safety plan through the DBH provided technology
• Number of clients who receive lethal means counseling through the DBH provided technology

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:

1. Cumulative Fiscal Reports recording overall grant and match expenditures by budget line; and
2. Program Reports in the format prescribed by the programs and must include:
   1. Number of staff trained
   2. Number of individuals screened for suicide.
   3. Number of individuals referred to crisis or other mental health related services for suicide risk, ideation, or behavior.
   4. The number and percent of individuals receiving mental health or related services after referral if known or referred services are provided interagency. 

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. 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 is youth aged 10-24 years accessing acute care settings. 

Service Areas and Communities: This solicitation is being put out for acute care settings throughout the state. There are no service area or community restrictions. 

1.06Program Funding

Federal funds are anticipated to total $75,000 per year for each acute care pilot site, for the first two-years of the grant period and $50,000 per year for the final two years of the grant, for a total funding amount of $500,000. 

Proposed Budget: The applicant must submit a budget proposal for the first partial fiscal year of the project. The proposed budget detail and narrative 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. The Department's 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. 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 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. Department 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 will include the receipts and expenditure of all grant income. 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.

2.01Agency Experience

Proposal evaluation will include consideration of the applicant’s history of compliance with service and grant requirements, and previous experience in providing the same or similar services. Evaluation may include Department site reviews, program audits, and confirmation of the successful resolution of any findings. This is part of the pre-award risk assessment required under Uniform Guidance 2 CFR 200.

The applicant must describe previous experience providing services the same or similar to those proposed. The description must clearly identify the time period over which services were provided and the target population served.

2.02Project Staffing

Project staffing must be sufficient to implement the proposed activities in order to meet program goals and the anticipated outcomes.

Resumes and position descriptions for key project personnel must be uploaded as part of the response. This is part of the pre-award risk assessment required under Uniform Guidance 2 CFR 200.

If the grant award is being used to provide staffing for grant activities and reporting, proposals must include a position description. 

2.03Administrative, Management, and Facility Requirements

The applicant must demonstrate the agency's sustainable fiscal and administrative capacity. Executive, administrative, and financial staff must be qualified, as indicated by the resumes of position holders uploaded as an element of the proposal. This is part of the pre-award risk assessment required under Uniform Guidance 2 CFR 200.

1. The applicant must ensure procedures are in place to protect client confidentiality compliant with State and federal standards.
2. The applicant must ensure its most recent financial audit was submitted to the appropriate state office (see Audit Requirements below), and any findings identified have been resolved.

Awarded proposers will be required to submit additional agency information if the agency GEMS record is not current.

Audit Requirements:

Federal Requirements: Agencies spending $750,000 or more total Federal Financial Assistance in the agency fiscal year may be required to comply with conditions of the Single Audit Act of 1984, P.L. 98-502, as amended by the Single Audit Act Amendments of 1996, P.L. 104-156, and as defined in 2 CFR 200.

State Requirements: Agencies spending $750,000 or more total State Financial Assistance in the agency fiscal year are required to comply with the conditions of 2 AAC 45.010-090. The current regulations may be viewed at the State of Alaska, Department of Law website, or copies may be obtained from the contact identified on the cover page of the RFP.

Information on State and Federal Single Audit Acts compliance may be obtained from:

State Single Audit Coordinator
Department of Administration
Division of Finance
PO Box 110204
Juneau, AK 99811-0204
Telephone: (907) 465-4666
Fax: (907) 465-2169

Department of Health Program Audit Requirements: All DOH grantees are subject to the requirements of 7 AAC 78.230. If awarded, agencies which are not required to file State Single Audits under 2 AAC 45.010 must ensure a fiscal audit of the agency operations under the grant program is performed by an independent, licensed, certified public accountant at least once every two years and submitted to:

State of Alaska Department of Health
Finance and Management Services
Audit Section
PO Box 110602
Juneau, AK  99811-0602
Telephone: (907) 465-3120

Facility, Service Access, and Safety:

1. The applicant must address potential safety concerns for clients and staff in the management of services proposed in response to this RFP.
2. The applicant should describe client accessibility to services and the way in which that will enhance project success.
3. All applicants for Department grants should have a written plan for emergency response and recovery that provides for potential safety concerns and the safe evacuation of clients and staff. This plan is mandatory for agencies providing residential and/or critical care services as noted in the State Grant Assurances.

2.04Support/Coordination of Services

Applicants must demonstrate the proposed project has the necessary support and coordination for the successful delivery of services. The proposal must address the following:

1. Community support where services are proposed;
2. Involvement of the public and potential service recipients in the planning process;
3. Partnerships and collaborations specific to the proposed project; and
4. Coordination with necessary referring agencies and the role of each described.
5. A letter of leadership support and commitment for the proposed project

3.01Eligibility

Applicants must be eligible to apply under 7 AAC 78.030 (Eligible Applicants). Eligible applicants are state agencies; political subdivisions of the state such as cities, organized boroughs, and Regional Educational Attendance Areas; nonprofit organizations and consortia of nonprofits; and Alaska Native entities. As follows, eligibility will be verified by Grants and Contracts.

1. Political subdivisions of the state and Regional Educational Attendance Areas will be verified by State records.
2. Eligible nonprofits are listed in the State's database of registered nonprofit entities or the US Internal Revenue Service's register of tax-exempt organizations. Nonprofit subsidiaries of nonprofit corporations must also provide a letter from the parent organization confirming nonprofit status.
3. Alaska Native entities as defined in 7 AAC 78.950(1) must submit, with the application, a legally binding resolution waiving the entity’s sovereign immunity to suit through the duration of the program, identified in RFP Subsection 3.05. The resolution must be authorized in compliance with the tribe’s constitution, either by the tribal council or by majority vote of the tribal membership. The required template is provided at Subsection 4.02, Other Technical Requirements.

Federal Funding Accountability and Transparency Act (FFATA): In accordance with 2 CFR Chapter 1, Part 170 Reporting Sub- Award And Executive Compensation Information, reporting is required of any grant award with federal funding equal to or greater than $30,000. FFATA is intended to hold the federal government accountable for spending decisions. Accountability data is available to the public at U.S. Government Spending. Reporting requirements extend to recipients of State-issued awards with federal funds. An Agency Power User must complete the FFATA form under Federal Reporting in the GEMS Agency Administration tab. The report data will reflect the audited figures of the agency's most recently completed fiscal year. The report captures expenses and executive compensation for your agency. More information regarding FFATA requirements can be found at Federal Funding Accountability and Transparency Act Subaward Reporting System..

Effective April 4th, 2022, the US Federal Government transitioned from the Dun & Bradstreet Data Universal Numbering System (DUNS) number to a System for Award Management (SAM) generated Unique Entity Identifier (UEI) alpha-numeric value for federal awards management. All grantees receiving awards with federal funds are required to have a UEI. More information regarding this transition can be found on the U.S. General Services Administration webpage.

The Grants Electronic Management System (GEMS) has been updated to include fields for both the DUNS nine-digit number and the UEI twelve-digit alpha-numeric value under the General section of the Agency Administration tab. An Agency Power User must confirm the current UEI number is listed in GEMS. The DUNS number will continue to be displayed in GEMS until further notice.

Applicant agency GEMS records must contain the agency's current State of Alaska Business License number, and a current governing board roster which includes titles, contact information, and terms of office for each seat. The roster must include emergency contact information outside the applicant agency for one or more officers.

Grants and Contracts will verify neither the applicant agency nor its principals are presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from receiving grant assistance from any State or federal department or agency. If an agency or its principals are excluded from receiving grant assistance, the proposal may not be considered.

If this grant program includes Federal funding, effective November 12, 2020 Federal Uniform Guidance 2 CFR 200 requires that agencies be registered on the System for Award Management (SAM) website at System for Award Management (SAM). If an applicant is recommended for award and is not registered on this site, the offered award will not be executed, and funds will not be issued until agency registration is confirmed.

Applicants who have had a contract or grant to help produce this RFP are not eligible to apply and any submitted proposal will not be considered.

3.02Acceptance of Terms

By submitting a proposal, an applicant accepts all terms and conditions of this RFP including all identified attachments and guidelines, 7 AAC 78, and any other applicable statutes and regulations. Copies of these may be accessed through the contact person identified on the cover page or through the web address(es) identified in this RFP.

If a grant is awarded, this RFP and the applicant’s proposal become part of the grant agreement. The applicant will be bound by the provisions contained in the awarded proposal unless the Department agrees that specific parts of the proposal are not part of the agreement.

Proposals and other materials submitted in response to this RFP become the property of the State and may be returned only if the State allows. Proposals are public documents and may be inspected or copied by anyone after grants have been awarded.

3.03Inquiries

Applicants should immediately review this RFP for defects and questionable or confusing content. Questions that can be answered by directing the applicant to a specific section in the RFP may be answered verbally by the contact person identified on the RFP cover page. Questions that cannot be answered by directing an applicant to a specific section of the RFP may be declared substantive. The applicant will be directed to submit the question in writing to the contact person at the email address on the cover page no later than the Deadline for Written Inquiries, also identified on the cover page. This will allow issuance of any necessary amendments and/or clarifications to all prospective applicants.

Applicants are responsible for monitoring GEMS or the State’s Online Public Notices website for any clarifications or amendments that may be issued regarding this solicitation.

Proposals will not be accepted after 3:59 PM prevailing local time on the due date identified on the cover page.

3.04Proposal Costs and Content

The Department will not be responsible for any expenses incurred by the applicant prior to the authorized grant performance period. All costs of responding to this RFP are the responsibility of the applicant.

The applicant is responsible for the content of the proposal.

3.05Duration

This RFP is for fiscal year, 2024 beginning 7/1/2023 through 6/30/2028. At the discretion of the Department, a project funded under this RFP may be considered for continued funding in subsequent program year(s). The annual decision to continue funding for the subsequent year(s) of the 4-year grant cycle is based on the following general conditions:

1. the Department's judgment that there is a continued need for the grant project service;
2. the grantee's satisfactory performance during the previous grant year;
3. the availability of sufficient grant program funds, and whether continuation of the financing is consistent with public health and welfare; and
4. the ability of the grantee and the Department to agree on any adjustments in payments or service.

Applicants will submit a budget proposal for year one of the grant only. Funding in each subsequent year will require submission and approval of documents needed to update service plans, evaluation measures, and budgets. Grants and Contracts will notify grantees of specific submission requirements necessary to qualify for consideration of continued funding.

This RFP is for fiscal year FY2024, 7/1/2023 through 6/30/2024.

3.06Proposal Review

Following the deadline for receipt of proposals, no revisions will be accepted unless provided in response to a request from the contact person named in this RFP. Proposals will be reviewed as follows:

1. Proposals will be evaluated in a manner that will avoid disclosure of contents before notices of grant award have been issued.
2. Department of Health staff will evaluate each proposal for minimum responsiveness and other technical requirements and eliminate nonresponsive proposals from consideration.
3. Using the criteria set out in this RFP and 7 AAC 78.100 (Criteria for Review of Proposals), Department staff will evaluate each responsive proposal. Scores for each criterion will be based solely on the response to the associated question. Points will not be earned if the information was provided in response to another question in Section 4. Department staff will also review relevant departmental documentation regarding the applicant. Staff recommendations regarding awards and levels of funding will include consideration of the following:
   1. a history of the applicant's compliance with grant requirements, to include records of program performance, on-site program reviews, and prior year audits;
   2. priorities in applicable State health and social services plans;
   3. requirements of applicable State and federal statutes; and
   4. municipal ordinances or regulations applicable to the grant program.

If there are multiple responsive proposals for which there is insufficient money to fully fund, or supplementary expertise is deemed necessary to the review of proposed services, the Department may appoint a Proposal Evaluation Committee (PEC) as an additional advisory body. PEC members will initially evaluate proposals, independently of other committee members. As a committee the PEC will meet in a closed session (7 AAC 78.090 Review of Proposals) to further review proposals and develop recommendations. Scores will be assigned based on the applicant's response to each individual question and the associated criteria. Applicants will not earn points for a given question based on a response to another question in the RFP. The PEC review will include discussion of each proposal’s merits. PEC recommendations will rank proposals in priority order and include approval or disapproval for award, modifications to the proposed project, and special compliance conditions.

All staff advisory recommendations and, if applicable, those of the PEC, and all review materials will be submitted for consideration by the Division Director, who will make recommendations to the Commissioner of the Department of Health or the Commissioner's designee.

3.07Final Decision Authority

Recommendations are advisory only, including those from any PEC that may be held. The final decision to approve or disapprove award, the amount of each award, and whether to impose special conditions or modifications rests with the Commissioner or Commissioner's designee.

NOTE: The final decision may include additional considerations, such as a lack or duplication of services in certain locations, or alternative services that may be available; a critical need for services by vulnerable populations; and matters of health, life and safety. The Department has the responsibility to ensure public monies are utilized in a manner that protects the interests of the people of the State and retains the right to make final awards that ensure responsible distribution of grant funds.

3.08Notification of Grant Award and Appeals

Within fifteen (15) days after the decision regarding grant awards, applicants will be notified of the final funding decisions, and, if awarded, any conditions of award or modifications. Following any necessary negotiations for revisions to the proposed budget and scope of services, successful applicants will be issued a grant agreement. This formal agreement will contain specific performance and reporting requirements consistent with Department policy and procedure and 7 AAC 78.

Per 7 AAC 78.305 (Request for Appeal), an applicant may appeal a final grant award decision. Requests for hearing must be addressed to the Commissioner and received in writing at the address below within 15 days after the applicant receives notification of the decision. The request must contain the reasons for the appeal and must cite the law, regulation, or terms of the grant upon which the appeal is based.

With a copy to the contact identified on the solicitation cover page, send appeal to:

Heidi Hedberg, Commissioner
Department of Health
3601 C Street, Suite 902
Anchorage, Alaska 99503-5923

3.09Cancellation of the RFP/Termination of Award

Contingent upon funding appropriations and the Governor's approval, the Department may fund proposals from eligible applicants. The Department may withdraw this RFP at any time and reserves the right to refrain from making an award when such action is deemed to be in the best interest of the State. Funds awarded for a grant as a result of this RFP may be withheld and the grant terminated by written notice from the State to the grantee at any time for violation by the grantee of any terms or conditions of the grant award, or when such action is deemed to be in the best interest of the State.

4.01Minimum Responsiveness Criterion per 78.100(2)(A)

Proposals that fail to meet the minimum responsiveness requirements below will be eliminated from consideration per 7 AAC 78.090(b)(2).

4.02Other Technical Requirements per 7 AAC 78.060, 78.090(b) and 78.100

Response & Organizational Documentation

4.03History of Compliance with Grant Requirements per 7 AAC 78.100(2)(B)

4.04Questions and Criteria Related to Program Policy, Goals, Outcomes, and Activities

4.05Applicant Qualifications - Criteria Relating to Personnel, Management, and Facilities

4.06Demonstration of Support/Coordination of Service