1.01Introduction and Program Description
The Department of Health and Social Services (DHSS or Department), Division of Behavioral Health, is requesting proposals from eligible applicants to provide State Opioid Response: Recovery Housing services for the State of Alaska in FY2019 through FY2021. Program Services are authorized under 7 AAC 78 Grant Programs. Additional governing statutes are 7AAC 78 - Grant Programs; 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; 7 AAC 10.930 Request for a Variance. 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).
Over the last several years, Alaska has seen a dramatic rise in opioid misuse and opioid overdose related deaths. In 2017, 144 drug overdose deaths occurred in Alaska, 100 of which were opioid related. Opioid overdose deaths over the past 5 years show an increase trending from 72 deaths in 2013 to 100 in 2017. The service areas targeted have been identified with the highest prevalence of opioid use disorders, opioid death rates, and opioid related emergency room visits. Individuals who complete treatment are often unable to find affordable housing in an environment which supports their recovery. Outcome studies show the longer an individual remains in a treatment or recovery environment, the greater their chances of sustaining long-term recovery. Recovery housing is associated with numerous positive outcomes including decreased substance use, reduced probability of relapse, lower rates of incarceration, higher income, increased employment, and improved family functioning.
The intent of State Opioid Response – Recovery Housing is to increase the number of recovery housing options across the state for individuals with an Opioid Use Disorder, or at risk of an Opioid Use Disorder. The program will expand the operations of recovery residences and develop a standard under which they will operate, to include the establishment of up to ten new houses within the targeted regions. Grant awards may also be made under this program for existing sober residences if adequately justified; proposals from all eligible and responsive applicants will be evaluated according to the requirements of this solicitation. Funds will be awarded to support the operations of recovery housing projects including but not limited to rent, utilities, and basic supplies for residents. All awards under this grant program are operating grants intended to support operations and services; they cannot be used for purchase of real property or facilities, significant renovations, or purchase of major fixed or movable equipment such as vehicles. Applicants may propose basic household furnishings be purchased with grant award funds, as equipment costing less than $5,000 per unit, but with a useful life expectancy of more than one year (see DHSS Grant Budget Preparation Guidelines, in GEMS). Grant projects will be expected to address fiscal, operation, recovery supports, property, and good neighbor standards.
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.
These Recovery Residences will be substance-free housing for individuals with an Opioid Use Disorder (OUD) or at risk for an OUD. Recovery Residences refer to a range of housing models that create safe, healthy, and substance-free living environments. These are mutually-supportive communities where individuals improve their physical, mental, spiritual, and social well-being and gain skills and resources to sustain their recovery. Given the immediate Opioid crisis and the ongoing challenge of substance misuse and addiction in Alaska, it is critical for Recovery Residences to become more available to those who need them.
This RFP is a response to the need to expand the availability of Recovery Residences. While recovery residences vary greatly in structure, all are centered on peer-support and a connection to services that promote long-term recovery. Recovery housing benefits individuals in recovery by reinforcing a substance-free lifestyle and providing direct connections to other peers in recovery and recovery services and supports. Many residents live in recovery housing during and/or after outpatient addiction treatment. Length of stay varies but can last from several months to a year or more. Residents often share resources, give experiential advice to each other about how to access health care and social services, find employment, budget and manage finances, handle legal problems, and build life skills. Projects will be expected to follow Recovery Residence guidelines from the National Association of Recovery Residences (Level I or II) and prepare to become certified as a NARR Certified Recovery Residence once that certification is established in Alaska.
Overall goals include:
- Development of safe, healthy, substance-free living environments that support individuals in recovery from addiction.
- Locations with access to community resources
- Clear procedures for decision making/leadership
- Maintenance of physical property
- Good neighbor relations
- Promoting direct connections to other peers in recovery and recovery services and supports.
- Encouragement of 12-step programs and/or continued outpatient treatment
- Mutual support for accessing health and social services, legal services, managing finances, and finding/maintaining employment
Anticipated Outcomes include:
- Decrease in substance abuse
- Decrease in incarceration
- Increase in employment
- Increase in income
Projects must meet or exceed anticipated minimum outcomes described in this RFP.
1.03Program Services/Activities
Applicants will upload a timeline for the initiation of services and project activities. Timeline will include development of a Policies and Procedures Manual, prioritizing implementation of those policies and procedures necessary to the safety, security, and well-being of residents and the community prior to operations start-up.
Start-up of residence no later than June 1, 2019.
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.
Applicants agree to comply with the following additional program requirements and service standards.
Each residence to provide service to at least 5 individuals over the course of grant year 1, ending June 30, 2019; and at least 10 individuals over the course of grant year 2, ending June 30, 2020.
Follow guidelines of the National Association of Recovery Residences (NARR) for a Level I or II Residence. Programs should follow Version 1.0 Standards and work to achieve the updated Version 2.0 2015 Guidelines (see attachments for both).
Note: With any discrepancy between NARR Standards and the requirements of this solicitation, requirements of this solicitation supersede the NARR standards.
Guidelines address:
Organizational/Administrative Standards
- Residences should determine whether they will be democratically run and/or have a house manager or senior resident.
- A manual of Policies and Procedures must be developed to implement all applicable standards addressed within the guidelines of this solicitation.
- Non-profit status
- Mission/vision
- Code of Ethics
- Owner/operator has liability insurance appropriate to the level of support.
- Comply with any state, local, and federal requirements.
- Maintain drug and alcohol free environments.
- Have written permission from the owner of record to operate a Recovery Residence on their property.
Fiscal Management Standards
- Maintain an accounting system that fully documents all resident financial transactions such as fees, payments, and deposits (see also Section 2.03 of this application).
Operation Standards
- Post emergency numbers, protocols, and evacuation map.
Recovery Support Standards
- Use a consistent applicant screening process that helps to maintain a safe and supportive environment.
- Clarify anticipated costs to residents.
- Adhere to confidentiality laws; keep records secure.
- Provide a grievance policy and procedure for residents and ensure each resident understands its use.
- Establish and enforce written rights and responsibilities.
- Have an orientation process.
- Have house meetings, community gatherings, recreational and other recovery support activities.
- Have policies that address relapse, drug-screening or toxicology protocols, prescription and non-prescription medication usage and storage.
- Encourage each resident to establish their own recovery plan.
- Encourage the use of local treatment and recovery services including 12 step programs.
Property Standards
- Follow all local building codes.
- Storage for each resident food and personal items.
- Fire extinguishers, smoke detectors, carbon monoxide detectors.
- Non-smoking internal living environment.
- Community room for meetings and sleeping rooms that adhere to local and state square footage requirements, and fire egress requirements.
- Accessible laundry services.
- Maintain interior and exterior in a functional, safe, and clean manner compatible with the neighborhood.
- Appliances and furniture in good working condition.
- Address routine and emergency repairs in a timely fashion.
Good Neighbor Standards
- Provide neighbors with the responsible person(s) contact information. That individual responds to neighbor complaints even if it’s not possible to resolve the issue.
- Have rules regarding noise, smoking, loitering and parking that are responsive to neighbor’s reasonable complaints.
- Have and enforce parking courtesy rules where street parking is scarce.
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:
- Increase in employment income
Efficiency:
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. (The applicant's evaluation plan must include indicators and data gathering strategies that will be used.)
This grant requires the recipient to conduct Government Performance and Results (GPRA) interviews. This information will be gathered using SAMHSA’s Performance Accountability and Reporting System (SPARS); access will be provided upon award. Examples of the type of data collection tools required can be found here: https://www.samhsa.gov/grants/gpra-measurement-tools/csat-gpra/csat-gpra-discretionary-services. Data will be collected via a face-to-face interview using this tool at four data collection points: intake to services, three months post intake, six months post intake, and at discharge. Recipients will be expected to do a GPRA interview on all clients in their specified unduplicated target number and are also expected to achieve a three-month follow-up rate of 80 percent and a six-month follow-up rate of 80 percent. GPRA training and technical assistance will be offered to recipients.
Grantees will be required to report client-level data on elements including but not limited to: diagnosis, demographic characteristics, substance use, services received; length of stay in treatment; employment status, criminal justice involvement, and housing. Additional data elements will also be required and will be provided upon award. Grantees are required to ensure all data reported to DBH are accurate.
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.
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 those individuals with an Opioid Use Disorder (OUD) or at risk of an OUD.
Service Areas and Communities: The service areas and communities requested for the services solicited are: 1) Municipality of Anchorage, 2) Fairbanks North Star Borough, 3) Kenai Peninsula Borough, 4) Matanuska-Susitna Borough, 5) Southeast Alaska, and 6) Southwest Alaska, as identified on the attached Public Health Regions map.
1.06Program Funding
Funds available for this program are estimated to total $1,021,000 per year, Federal Funds. Total estimated funding for the 2-year duration is $2,042,000.
Funding estimated above will support the development of up to ten recovery residences, one or more in each of the six service areas listed in Section 1.05.
There is no Required Match for this State Opioid Response - Recovery Housing grant program.
Proposed Budget: The applicant must submit a budget proposal for the first fiscal year of the project, January 1, 2019 through June 30, 2019. The proposed budget detail and narrative will support the program’s results based services delivery and staffing requirements stated in this RFP. In addition, applicants must submit a supplemental budget showing the amount of grant funds needed for year two of the project (FY20).
Please note: annual award amount per recovery housing residence will be limited to $110,000.
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."
Sustainability Plan: The applicant must include with their proposal a sustainability plan for recovery residence operation after the end of grant funding.
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.
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.
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.