1.03Program Services/Activities
The Senior In-Home (SIH) Services grant program includes a menu of services and activities including chore, respite, extended respite, personal care, case management, service coordination, and supplemental services to support program goals and anticipated outcomes.
Chore
Chore services assist the client in keeping a safe and clean environment to live independently in their own home. Chore services may be provided to assist individuals with activities such as meal preparation, grocery shopping, managing money, using the telephone, laundry, performing light housekeeping, performing heavier housekeeping, yard work, chopping wood, hauling water, sidewalk maintenance or other chore-type tasks as approved by the SDS Program Manager. SIH Chore services mirror Medicaid/Community First Choice Chore services and provision of the services must adhere to current conditions of participation located at Alaska Department of Health Senior Disabilities Services Resources Conditions of Participation.
Allocation of Chore services
- Chore services are available up to a maximum of 25 hours per month per client or household; and
- Chore services may not be provided in a household when an able-bodied adult resides in the home.
Respite and Extended Respite Care
Respite and Extended Respite Care services provide support and relief to families and other caregivers. Respite Care services provide substitute care for adults with declining physical and cognitive functions to allow intermittent or temporary relief or rest to a primary caregiver who is most often a family member. Services may be provided on either a planned or emergency basis in a variety of settings such as in the family or caregiver's home, the Respite worker's home, a licensed assisted living home, residential care facility, hospital, or nursing facility. Extended Respite is the provision of 24-hour care usually out of the home in a licensed facility. SIH Respite and Extended Respite Care services mirror Medicaid/Community First Choice Respite services and provision of the services must adhere to current conditions of participation located at Alaska Department of Health Senior Disabilities Services Resources Respite Care Services.
Allocation of Respite services
- Respite services are available up to a maximum of 40 hours per month; and
- Extended Respite services are available up to a maximum of one week per year of 24-hour care; and
- Extended Respite hours may not be utilized in the same manner as regular Respite hours; and
- The intent of Extended Respite is to provide the caregiver with 24-hour relief; and
- Individuals living in the same home as the recipient may not be employed to provide Respite.
Personal Care
Personal Care is intended to promote the optimum level of independence and functioning of individuals with declining physical and cognitive functions to remain living at home independently. Personal Care provides support related to an individual’s activities of daily living (ADLs) such as bathing, dressing, or eating. SIH Personal Care mirror Medicaid/Community First Choice Personal care services and provision of the services must adhere to current conditions of participation located at Alaska Department of Health Senior Disabilities Services Resources Personal Care.
Allocation of Personal Care Services
- Personal Care for Independence services is available up to a maximum of 20 hours per month; and
- Individuals who live independently should be prioritized for services.
Grant funds for personal care services are limited and are intended to provide only short-term or emergency support to assist individuals who are waiting for Medicaid approval, experiencing crisis, or have another temporary need. Grant funded personal care services are not designed to cover the full cost of ongoing personal care needs. Individuals who require regular or long-term personal care support should apply for Medicaid to ensure more sustainable support than grant funding can provide.
Allowable Service Delivery Models:
In-Home Services can be delivered to the consumer in one of three ways.
Applicants must propose to provide services following one of the following service delivery models:
Agency-Based Care
In agency-based care, the grantee agency is responsible for recruiting, hiring, training, and supervising caregivers, as well as managing schedules, payroll, and service documentation. The agency also monitors service quality regularly and ensures caregivers meet the consumers’ assessed needs and required care standards.
Consumer-Directed Care
In consumer-directed care, the consumer selects, trains, and schedules their caregiver, while the agency serves as the fiduciary by handling hiring requirements, payroll, required compliance training, and service documentation. The agency also monitors services regularly to ensure care and program standards are met.
Sub-Contracting
In subcontracting, the grantee agency establishes a formal agreement with a subcontractor agency outlining services, roles, and payment terms, including who will select, train, and schedule caregivers. The grantee agency coordinates introductions, monitors services regularly, pays invoices, and maintains required service documentation.
(For additional information on each service delivery method see attachment)
Case Management
Case Management services are intended to assist persons in gaining access to needed medical, social, educational, other programs and services needed. Through comprehensive assessment of the physical, emotional, cognitive, and social needs, Case Managers develop a network of services, both formal and informal, unique to the specific individual. Case Managers complete Plans of Care acceptable to the client and family and assist the client in obtaining the specified services. While receiving services, Case Managers provide ongoing monitoring of the client's situation to ensure that the Plan of Care meets the individuals’ changing needs to remain in their home and community of choice for as long as possible. Case Management services may be short-term or long-term.
The list of items below involved Case Management activities under this grant program:
- Assessing an individual's needs requires the provision of services by formal service providers, family caregivers, and other formal support using SIH Case Management Assessment/Plan of Care form, home safety and falls prevention; and
- Developing a plan of care that identifies a course of action to respond to the assessed needs of the eligible individual using the standardized SDS Plan of Care form or one approved for use by the SIH Program Manager; and
- Client monitoring that includes the scope and frequency of contact to ensure the plan of care is implemented and adequately addresses the recipient’s needs (For clients receiving ongoing, longer-term case management, at least one contact by phone or face to face per month is expected); and
- Annual review and update of the assessment and plan of care.
Service Coordination
Service Coordination services involve using the SIH Case Management Assessment/Plan of Care form, or one developed by the service provider and approved by SDS, to coordinate Chore, Respite, and Personal Care services which includes evaluating the individual's daily living activities and instrumental activities of daily living, developing a service plan, monthly monitoring to ensure that the service plan is executed and meets the individual's needs, and an annual review to evaluate whether any adjustments to the existing service plan needs to be made.
If the applicant plans to provide in-home services (chore, respite, personal care), they must also provide service coordination.
Supplemental Services
Supplemental Services assist the "low-income" senior in attaining or maintaining a safe and healthy environment to avoid a crisis that would jeopardize their ability to remain independently in their own home.
For the purposes of this RFP, "low income" refers to an individual 60 years of age or older whose income is at or below the Medicaid long term care eligibility for seniors. This limit is currently $2,523 per month per individual and each additional individual residing in the home is allowed up to $1,145 per month. Other resources for funding should always be explored before application is made for this service. Supplemental services are not meant to take the place of ADRD mini grants but rather provide a similar mechanism for individuals who do not have ADRD. Individuals who have ADRD must first apply for an ADRD mini grant. Individuals who receive an ADRD mini-grant may not be eligible for Supplemental Services depending upon circumstances, but circumstances but will be considered on a case-by-case basis. This service can be provided as a stand-alone service (it does not need to accompany the other services described in this RFP) and is available to any senior who is eligible under this grant program and who resides within the grantee’s service area.
Eligible items and services may include, but are not limited to the following: assistive devices, home safety interventions, personal emergency response alarm systems, minor home modifications; access to medical, dental and vision care; or special health care needs such as personal care assistance for up to two weeks after a hospital discharge (must be approved by the SDS Program Manager and may be approved for up to a maximum of one month depending upon circumstances). Assistance with items or services to avert a crisis that is not covered by another funding source may be allowable (e.g., medical transportation and winter clothing).
Allocation of Supplemental Services
- Approved on a case-by-case basis by the SDS Program Manager on the prescribed form; and
- Limited to $500 annually per client or household depending upon the request, and
- Provider agencies will purchase services or goods for the client; a voucher system will not be allowed.
- No more than 15% of the grantee’s SIH award budget will be allocated to supplemental services.
Services provided under the grant must meet the above stated goal and result in measurable outcomes. Proposals must include the following:
- Description of the activities for each service that the applicant will provide under this program, and the description must support the goals and outcomes as described above; and
- Plan for Services using the attached FY2027 Senior In-Home (SIH) Planned Services and Expenditures form; and
- Timeline showing the proposed initiation and implementation of services and activities to begin July 1, 2026
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.
In support of project planning narratives, the applicant will complete a logic model using the instructions and template attached to this RFP. The logic model will identify resources available to the proposed project; summarize project activities; and clearly state anticipated goals, outputs, and outcomes compliant with program intent.
The applicant must indicate in their proposal which in-home services they will provide as well as which method of service delivery they will employ for each in-home service they propose to provide.
Required Service Delivery Standards:
Applicants agree to comply with the following additional program requirements and service standards.
Case Notes, Service Standards, and Policies and Procedures for Services
- Case Notes are required for all recipients receiving services. The Case Notes must follow standard Human Services Practice and be sufficient for liability protection and historical tracking; and
- Current Standards of Practice for Services found within “Conditions of Participation” (COP) located in Standard Practice for Services.
Grantees will be required to submit a copy of their Policy and Procedure Manual for Services upon grant award.
Changes to Approved Grant Project
As per 7AAC 78.260, any changes to the service plan must be submitted in writing to the SDS Program Manager for approval prior to implementation of the change. The SDS Program Manager must be notified immediately whenever it becomes known to the grantee that a key staff position will become vacant. The grantee must submit a copy of the resume for the new hires for positions supported in whole or in part by the grant funds, matching funds, or with grant income earned through this program.
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
- 1.2 Provide Quality of Life in a Safe Living Environment for Alaskans
Department Objectives
- 1.2.3 Increase the number of Older Alaskans who live safely in their communities
Effectiveness Measure
- Number of individuals who receive services
Efficiency Measure
- Grant expenditure per individual
In addition to the Effectiveness and Efficiency Performance Measures required by the Department, the Senior In-Home grantees will be responsible for reporting to the Division of Senior and Disabilities Services the additional performance measures specific to the grant program as listed on the Performance Measure Framework, including final fiscal year data to be submitted in the final 4th quarter reports.
The additional Effectiveness Performance Measures for this program are:
- Number of individuals with ADRD served,
- Number of individuals with 2 or more ADLs,
- Number of individuals surveyed for satisfaction, and
- Out of those surveyed 80% or better rated services good to excellent.
The revised Federal Uniform Guidance 2 CFR 200 now requires that the State inform potential sub-recipients via our solicitation and resulting grant awards of all performance measures.
SIH Logic Model
As an attachment to the proposal, the applicant must complete and submit the predesigned Logic Model that includes resources, activities, outputs, outcomes/results, and goals compliant with the grant project and program intent. The applicant must indicate the resources and activities applicable to their proposed project. Utilizing this framework, SDS Program Managers and grantees will use predetermined performance measures to evaluate progress to meet meaningful outcomes and initiate data collection and reporting consistent with Department priorities.
Evaluation Plan
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 Logic Model/Evaluation Plan must include indicators and data gathering strategies that will be used.
Grant Reporting
Required reporting will include:
- Quarterly Cumulative Fiscal Reports recording overall grant and match expenditures by budget line; an
- Program Reports are in the format prescribed by the program including:
- CFR2 (quarterly expenditures by funding source and service on the Expenditures by Services Category); and
- Biannual Narrative Progress Reports; and
- Monthly Data entry of service delivery and consumer characteristics into the division’s Aging and Disability Data Management System (GetCare); and
- Annual Performance Measure Framework (includes data from Annual Consumer Survey).
- Cumulative Detailed Expenditure Report verifying amounts reported in Cumulative Fiscal Reports due at the time of Q2 and Q4.
- Grantee will be required to submit consumer demographic information and service delivery data for program recipients using GetCare.
1.06Program Funding
Funds for this program are expected to total $3,394,877 per year in State funding, for a total of $10,184,631 over the three-year grant period (State FY27–FY29).
Match Requirement: The budget must include matching funds equal to 10.00% of the proposed Department funds. Calculate required match with the following formula.
Total Requested Grant Award x Required Match Percentage = Required Match
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. 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 to 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 15% De Minimis.
Payment for Services/Grant Income: 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.
A sliding fee scale for Chore, Respite, and Personal Care services based on the most current Federal Poverty Guidelines for Alaska, as well as a sliding fee scale policy, and the application or worksheet to evaluate the recipient's income in determining the co-pay will need to be submitted with the application.
Grant Income includes receipts from recipients or their family through the sliding fee scale. Grant income must be reported each quarter.