1.01Introduction and Program Description
The Department of Health, Division of Senior and Disabilities Services, is requesting proposals from eligible applicants to provide National Family Caregiver Support services for the State of Alaska in FY2027 through FY2029. Program Services are authorized under 7 AAC 78 Grant Programs. Additional governing statutes are AS 47.05.010 (16) and (17) Duties of the Department; AS 47.65 Service Programs for Older Alaskans and Other Adults; Title III E of the Older Americans Act. 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).
The National Family Caregiver Support Program (NFCSP) was established by the 2000 enactment of the Older Americans Act.
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.
Families are the primary provider of long-term care for their loved ones, but research has shown that caregiving exacts a heavy emotional, physical, and financial toll. Many caregivers are working and providing care for their children and older loved ones at the same time.
Family caregivers in Alaska spend an average of 30 hours per week providing informal care. Over fifty percent of Alaskan family caregivers have their own chronic health conditions, including depression and poor physical health.
Seventy-four percent of caregivers in the program report that services enabled them to provide care longer than would have been possible otherwise. Eighty-eight percent of caregivers reported that services helped them to be better caregivers and nearly sixty-two percent of caregivers indicated that without the services they received, the care recipient would be living in a nursing home.
This grant program helps meet the state Department of Health’s priorities of health and wellness across the lifespan, providing quality of life in a safe living environment and increasing the number of older Alaskans who can age safely in their homes. These priorities mirror the federal programs priority of assisting family and informal caregivers to care for their loved ones at home for as long as possible.
Additional state goals and outcomes include:
Goal:
Caregivers participating in the program will maintain optimum health and well-being to continue providing care for their loved ones in the home for as long as possible.
Anticipated Outcomes:
- Increase or maintain the number of family caregivers receiving NFCSP service
- Increase or maintain the number of caregivers caring for individuals with Alzheimer's Disease and Related Disorders
- Caregivers report satisfaction with NFCSP services
- Caregivers maintain NFCSP services helped them continue care
Projects must meet or exceed anticipated minimum outcomes described in this RFP.
1.03Program Services/Activities
The NFCSP provides a system of support options that connect caregivers to the resources necessary to reduce the strain of caregiving. Studies have shown that these services can reduce caregiver depression, anxiety, and stress, and enable them to provide care longer, thereby avoiding or delaying the need for costly institutional care.
Family caregivers need information, assistance, counseling, training, and respite to continue caring for their loved one(s) at home. States are called upon to work in partnership with local community service providers to provide the five basic services for family caregivers:
- Information about available services via public education;
- Assistance in gaining access to the services through individual information and assistance; or case management;
- Individual counseling, organization of support groups, and caregiver training to assist family caregivers in those areas in which they provide support, including health, nutrition, complex medical care, and financial literacy, and in making decisions and solving problems relating to their caregiving roles;
- Respite care to enable caregivers to be temporarily relieved from their caregiver responsibilities
- Supplemental services, on a limited basis, to complement care provided by caregivers
Applicants must describe the proposed activities and how they support the goals and outcomes of the project.
In a community where there is more than one provider proposing to serve under the NFCSP grant, providers are encouraged to do Memorandum of Agreements defining which type of service each agency will provide. This funding may not be used to supplant existing programs funded through alternative sources that provide essentially the same service(s) to caregivers. Recommendations for award will pay particular attention to making sure services are dispersed across the state as equitably as possible to reach the target populations and priorities for services of the RFP.
Service Delivery Activities and Reporting Standards
In addition to the narrative description, applicants must attach the intake and assessment tools used for assessing caregivers receiving registered services. The intent of an assessment is to measure the caregiver’s stress, burden, coping, and family support.
Planned Services and Expenditures
Applicants must submit a Planned Services and Expenditures (PSE) form using the template provided in section 4.04 question 5. The PSE indicates which program is being proposed and identifies the communities, services, and expenditures by service category.
Applicants will upload a timeline for the initiation of services and project 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.
Logic Model Development
In support of project planning and evaluation, the applicant will complete a logic model using the template provided in section 4.04 question 2. The logic model document includes the goal and outcomes anticipated for this program, as well as the effectiveness and efficiency measures to be tracked by the grantee. Applicants must identify the available resources, proposed activities, and projected outputs, including measures, applicable to the proposed project.
Successful applicants agree to comply with the following additional program requirements and service standards.
Service Documentation
- Develop log forms to collect necessary attendance information for training, support groups or other family caregiver program public events.
- Document caregiver progress notes as necessary.
The NFCSP consists of registered and unregistered services, each requiring a different set of demographics and characteristics to be collected on the caregiver and the individual(s) for whom they are caring. Applicants shall refer to the attachment, FY27 NFCSP Program Manual, for detailed descriptions of all the service types. Services proposed to be offered under a subcontract and services offered statewide must be indicated as such on the planned services and expenditure form.
Caregiver Survey of Services
Develop and conduct an annual survey providing caregivers the opportunity to evaluate and give feedback about NFCSP services received.
Caregiver Complaint and Grievance Procedure
Develop a client complaint and grievance procedure that includes what steps are taken to investigate and resolve client complaints about services, making sure the process includes situations that require reporting critical incidents, and harm to vulnerable adults.
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
- Health & Wellness Across the Life Span
Department Core Services
- Provide Quality of Life in a Safe Living Environment for Alaskans
Effectiveness Performance Measures
- Number of caregivers who receive services
- Number of caregivers caring for individuals with ADRD
Efficiency Performance Measures
- Cost to provide services with grant funds per recipient
Additional Performance Measures
- Number of caregivers caring for an individual with 2 or more ADLs
- Number of caregivers surveyed
- Number of caregivers who report they can continue care due to NFCSP services
The applicant's Logic Model, PSE, and end of year satisfaction survey 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 (CFR) recording overall grant and match expenditures by budget line;
- CFR2 reporting units and expenditures by service quarterly. Cost per unit is calculated. Quarterly award amount and cumulative total must match the CFR.
- Cumulative Detailed Expenditure Report verifying amounts reported in Cumulative Fiscal Reports due at Q2 and Q4.
- Biannual Progress Report narrating the progress of the project over the previous six-month period or full year. Explanation of changes from expected services and expenditures must be provided.
- Monthly recording of service delivery data for program into the division’s Data Management System (GetCare).
- Annual update of consumer data in GetCare.
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 are the following:
- A Caregiver of an Older Adult - an adult (18+) providing informal unpaid care to an older adult(s) or to an individual of any age with Alzheimer’s disease and related disorders
- Priority will be given to older adult caregivers with greatest economic and/or social need.
- An Older Relative Caregiver is a caregiver who is age 55 or older; who lives with, is the primary caregiver for and is providing informal, unpaid care to a child, or a relative with a disability, by blood, marriage, or adoption.
- In the case of a child, the caregiver is a grandparent, step grandparent, or other relative (other than parent) by blood, marriage, or adoption; and has a legal relationship to the child, or is raising the child informally.
- In the case of a caregiver for an individual with a disability, the caregiver is the parent, grandparent, or other relative by blood, marriage, or adoption, of the individual with a disability.
- Priority shall be given to:
- Caregivers who are older individuals with greatest social need, and older individuals with greatest economic need (with particular attention to low-income older individuals); and
- Older relative caregivers of children with severe disabilities, or individuals with severe disabilities.
- The term "greatest social need" refers to a need caused by:
- Physical and mental disabilities
- Language barriers
- Cultural, social, or geographic isolation, including isolation caused by racial or ethnic status that:
- restricts the ability of an individual to perform normal daily tasks; or
- threatens the capacity of the individual to live independently.
Service Areas and Communities: The service areas and communities requested for the services solicited are Statewide with the emphasis toward providing services in underserved communities through local providers. Applicants are encouraged to provide services to as many communities as possible. Applicants will identify communities they propose to serve on the Planned Services and Expenditures form
Three types of caregiver programs will be funded. Applicants proposing to provide multiple types of programs MUST submit separate proposals for each.
- Caregivers of Older Adults - multiple programs may be funded.
- Grandparents and other older relatives serving children - One Statewide program will be funded in an amount not exceeding 10% of the total funding amount annually.
- Legal assistance to caregivers - One Statewide program will be funded, with state-recognized credentials to provide Statewide legal services to both target populations, an amount not exceeding 5% of the total funding amount annually.
1.06Program Funding
Funds available for this program are anticipated to total $3,979,518 over the three-year duration of the procurement ($1,326,506 annually) in combined Federal and State General funds.
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
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. 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 15% 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.