1.01Introduction and Program Description
The Department of Health and Social Services (DHSS/Department), Division of Senior and Disabilities Services (DSDS), is requesting proposals from eligible applicants to provide Early Intervention/ Infant Learning Program (EI/ILP) services for the State of Alaska in FY2018 thru FY2020. Program Services are authorized under 7 AAC 78 Grant Programs, AS 47.20.060-AS 47.20.290 Special Services for Certain Children, 7 AAC 023.010 thru 7 AAC 23.900 Programs for Children with Disabilities, and 34 CFR Part 303 Early Intervention Program for Infants & Toddlers with Disabilities Part C of the Individuals with Disabilities Education Act (IDEA). Access State of Alaska statutes and regulations at http://www.law.state.ak.us/doclibrary/doclib.html or through the contact person listed on the cover page of this RFP. Federal regulations can be accessed at https://www.gpo.gov/fdsys/pkg/FR-2011-09-28/pdf/2011-22783.pdf.
Program Description
EI/ILP services are available to all families with infants and toddlers, ages birth to three years, who experience developmental delay/disabilities as defined by Alaska Part C Policy. All activities and services are provided in a family-centered manner that addresses the priorities of the family and child. Following are the core values of the Early Intervention/Infant Learning Program:
- Relationship-focus – All early learning takes place in the context of relationships with primary caregivers. The relationship between parents and providers is the vehicle through which intervention and support takes place. The early interventionists work in partnership with parents. Their methods support, not supplant, the central role of the family.
- Strengths-based – All families have strengths and are valued for their unique capacities, experience, and potential. Early interventionists work with the family to build on what is already going well and foster confidence and competence in families. Working within the Strengthening Families framework, teams mobilize partnerships to build family strengths to promote optimal development and reduce child abuse and neglect.
- Family-centered – Families have the power to make all important decisions regarding their child and family. Intervention practices respond to family-identified priorities respecting and supporting family values, cultures, beliefs, and decisions.
- Outcomes-based – Programs use outcomes data for program evaluation and improvement.
- Reflective practices – The early interventionists step back and think about what they are seeing and hearing from families so that they can consider a variety of possibilities for providing services that will support families. They consider how their own perspective may affect their observations of the family situation. Reflection occurs at individual, team, supervisory and programmatic levels.
- Effective team practices – All decisions in the areas of assessment and program planning, implementation, and evaluation are made through a team process. Team members accept and accentuate each other's knowledge and strengths to benefit the family and child.
- Natural environment – Services are delivered where the child lives, learns and plays within the context of the family's everyday routines and activities in order to support the NATURAL flow of family life. This requires flexible scheduling to allow services to take place at various times and locations that are part of the child’s day.
1.02Program Goals and Anticipated Outcomes
The proposed project must demonstrate a thorough understanding of the EI/ILP grant program goals and outcomes anticipated by the Department. Proposed projects must meet or exceed the anticipated outcomes described herein.
A strategic work plan with implementation strategies, timelines, and evaluation plan that addresses the program goals and objectives (listed in Section 1.04) must be included in the proposal. Proposed timelines for project implementation of the applicant's strategies must be reasonable and compliant with grant program timelines.
Program Goals
- Eligible infants and toddlers and their families receive appropriate early intervention services in natural and community environments that result in improved social-emotional outcomes.
- Assurance of a regional, comprehensive, coordinated Child Find effort that results in the identification and referral of all eligible infants and toddlers to the services and support they need to have integrated care.
- Through effective administrative systems including supervision and inter-agency coordination, families receive timely, evidence-based services that reduce long-term reliance on healthcare and educational services.
Anticipated Outcomes
- All infants and toddlers with IFSPs receive the early intervention services on their IFSPs in a timely manner.
- All infants and toddlers with IFSPs receive early intervention services in the home or in other natural settings.
- Infants and toddlers with IFSPs demonstrate improved:
- Positive social-emotional skills (including social relationships);
- Acquisition and use of knowledge and skills (including early language/communication); and
- Use of appropriate behaviors to meet their needs.
- Maintain or increase the percent of families participating in EI/ILP who report that services have helped the family
- know their rights,
- effectively communicate their child’s needs, and
- help their child develop and learn.
- As a result of comprehensive Child Find activities, Infants (0-1) receive needed services identified on an IFSP in a timely manner.
- Through a comprehensive Child Find process and public awareness activities, increase the number of children referred to appropriate services prior to their third birthday.
- All eligible infants and toddlers have an evaluation, assessment and an initial Individualized Family Service Plan (IFSP) meeting within 45 days of referral.
- All children are transitioned to school-based services within the required timeframe.
- Maintain or increase the number of highly qualified early intervention personnel who provide services to eligible infants and toddlers with Individualized Family Service Plans (IFSPs) and their families.
For more information regarding the anticipated outcomes as well as the systematic improvement plan, please
click here.EI/ILP goals and objectives are aligned with the State of Alaska Department of Health and Social Services Mission: To Promote and Protect the Health and Well-being of Alaskans, and Vision: Alaska Individuals, Families and Communities are Safe and Healthy.
1.03Program Services/Activities
Applicants must describe the proposed activities that support the goals and outcomes to be employed in the project. The applicant must also upload a timeline for initiating services and project activities as an attachment to their proposal.
Applicants agree to comply with all of the following additional program requirements and service standards: Service delivery strategies and practices must be evidence-based and appropriate to the individual needs of Part C enrolled infants and toddlers and their families. Applicants must describe the service delivery model(s) to be utilized. The proposed service delivery model(s) must be well-developed, reasonable, and support program intent.
EI/ILP Models for Service Delivery: Programs are responsible for the coordination and delivery of all activities and services outlined in Section 1.02 Program Goals & Anticipated Outcomes. To address the various situations in Alaska's vast and sparsely populated geographic regions, the State EI/ILP allows several different service delivery models:
- Agency employs a multidisciplinary team which participates in the evaluation/assessment, IFSP development, and delivery of services in the natural environment (including therapy services when appropriate) to best meet the individual needs of children and their families.
- A primary provider/coaching model, which can include tele-practices, that encourages the participation of multi-disciplinary therapies or other services as indicated by the child assessment and IFSP team recommendations.
- Agency employs primary service providers and contracts with related specialties as appropriate to ensure access to a multidisciplinary team and one which encourages a trans-disciplinary approach.
NOTE: Grantees will access specific low incidence disability consultation (e.g. Hearing, Vision Impaired, Deaf-Blind) as appropriate. Proposals must describe how program funds will be used to integrate low incidence disability consultant services into their service delivery model.
1.04Program Evaluation Requirements and Reporting
The applicant must provide an Evaluation Plan that addresses the performance measures listed below. The applicant's Evaluation Plan must include indicators and data gathering strategies that will be used to evaluate the progress of the grant project toward achieving the program goals and outcomes. The Evaluation Plan must also include confirmation that the applicant has the administrative capability to meet reporting requirements described in this RFP.
Results Based Budgeting Framework
As part of the continuing work to identify outcomes for success and improve services, grant programs will be required to align with the Department’s priorities and core services. Utilizing a results-based budgeting framework, FY2018 grantees will work to use performance measures to evaluate progress in order to meet meaningful outcomes and initiate data collection and reporting consistent with Department priorities. Grantees will continue to work closely with DHSS Program Managers to develop or refine those measures.
Below are the Department Priorities, Core Services, Objectives, and Effectiveness and Efficiency Performance Measures for this program.
Department Priority
- Health & Wellness Across the Life Span
Department Core Service
- Protect & Promote the Health of Alaskans
Department Objective
- Improve the Health Status of Alaskans
Effectiveness Performance Measure
- Total number of children receiving services through the EI/ILP program that have improved outcomes/skills
Efficiency Performance Measure
- Cost (to the grant) per individual served
Projects must meet or exceed anticipated minimum outcomes and performance measures described in this RFP.
Grant Reporting
The proposal must describe the reporting that will be performed for the proposed program, including the agency's ability to access the EI/ILP web database. Required reporting for this grant will include:
- On-line Cumulative Fiscal Report (overall grant and match expenditures are reported quarterly by budget line item).
- On-line Quarterly Narrative Report (improvement activities and progress toward goals) are reported quarterly in the EI/ILP web based data system.
- No later than 30 days following the end of each FY quarter reported, grantees will be required to report quarterly data in the EI/ILP web based data system which is the required method of reporting for this program;
- Grantees will need to access high-speed Internet for the web database used for reporting. The web-based EI/ ILP data system requires grantees' computers to be configured with a current version of web browser software (i.e. Microsoft Internet Explorer, or other comparable web browser). This is the only software required to run this program.
- Grantees also need broadband Internet access in order to get optimal performance from the web application. Grantees should have at least 512 megabytes per second download speed and 256 mbps upload speed, if it’s available. And if grantees are connecting to the Internet through an internal network, that network should use fast Ethernet or wireless technology.
- Individual computer workstations should have adequate processor speeds and memory. The suggested minimum processor speed is 1.5 gigahertz and minimum RAM should be 512 megabytes. Applicants need to budget the amount required for this system.
- FFATA: If funding for this program includes federal funds with reporting requirements that include those imposed under the Federal Funding Accountability and Transparency Act (FFATA), an agency power user must complete a FFATA form in the GEMS Agency Administration tab. Federal reporting requirements are not limited to prime awardees (such as the State) but include awards with federal funds that the State grants out (sub awardee).
1.05Target Population and Service Area
Applicants must provide a statement of need that clearly describes the population targeted by the project, including the area or communities that will be served. Applicants must identify how many children and families they propose to service under their project. Proposals will be evaluated for compatibility with the intended target areas identified in this solicitation.
Target Population: The target population for the services requested in this solicitation includes infants and toddlers, age's birth to three years, with a disability. The exhaustive definition for eligibility criteria is available at Early Intervention/Infant Learning (EI/ILP) Policy & Procedures. Infants or Toddler with a Disability means an individual under three years of age who needs early intervention services because the individual is experiencing a 50% or greater developmental delay, as measured by a multidisciplinary team using appropriate diagnostic instruments and procedures, in one or more of the following areas:
- Cognitive development
- Physical development, including vision and hearing
- Communication development
- Social or emotional development
- Adaptive development
The eligibility definition also includes infants and toddlers that have a diagnosed physical or mental condition that has a high probability of resulting in developmental delay, and includes conditions such as:
- Chromosomal abnormalities
- Genetic or congenital disorders
- Sensory impairments
- Inborn errors of metabolism
- Disorders reflecting disturbance of the development of the nervous system
- Congenital infections
- Severe attachment disorders and disorders secondary to exposure to toxic substances, including fetal alcohol syndrome
This list includes Homeless children, and Child Abuse Protection and treatment Act (CAPTA) referrals of children under the age of three who were the subject of a substantiated case of child abuse or neglect. The multidisciplinary team may use written verification from a qualified medical professional that the child’s medical condition typically results in a substantial development delay in addition to appropriate diagnostic instruments and procedures.
Service Areas and Communities: Comprehensive early intervention services must be available to eligible infants and toddlers and their families statewide. The designated service areas within Alaska can be seen on this map. Applicants may propose to provide services in more than one service area or portions of a service area to ensure a fully-accessible EI/ILP service delivery system. Agencies that have capacity to serve under-served areas (or regions) will score higher on the agency’s application evaluation. Proposals must describe their administrative capacity to support the areas they identify in their service population.
In the statement of need, applicants must describe how infants and toddlers with disabilities who are eligible for early intervention services under Part C of IDEA are identified, located, and evaluated, including but not limited to:
- 1.05.1 American Indian or Alaska Native infants and toddlers with disabilities residing on a reservation geographically located in Alaska (including coordination, as necessary, with tribes, tribal organizations, and consortia to identify infants and toddlers with disabilities in the State based, in part, on the information provided by them to DHSS EI/ILP under 34 CFR §303.731(e)(1));
- 1.05.2 Infants and toddlers with disabilities who are homeless, in foster care, and wards of the State; and
- 1.05.3 Infants and toddlers with disabilities who are:
- 1.05.3.1 The subject of a substantiated case of child abuse or neglect; or
- 1.05.3.2 Identified as directly affected by illegal substance abuse or withdrawal symptoms resulting from prenatal drug exposure as required at 34 CFR §303.303(b).
The statement of need must also clearly document the problem(s) that funded services will address. The problem statements must be supported by statistics and data or a local needs assessment. additionally, thhe statement must cite the source(s) and information from knowledgeable local persons and organizations, and include evidence drawn from the applicant's experience. Applicants must indicate how the proposed services will impact the stated problem and how they relate to existing services (regional population for ages birth to three, number of births, hospital/clinic admissions, CAPTA (Child Abuse Prevention and Treatment Act) referrals, etc...).
1.06Program Funding
Funds available for this program are anticipated to total $9,291,700 per year in State and Federal Part C funds. Successful applicants to this solicitation may establish a provider agreement with the department to claim Medicaid administrative activities.
Match Requirements: There are no match requirements for this grant.
Restrictions for Part C Funds: Federal Part C funds may only be used for Child Find, eligibility determination and services to children who meet the Alaska Part C Eligibility Guidelines. Part C funds are the payer of last resort; in accordance with the requirements of 34 CFR, Part C funds may be spent only for Part C activities after other federal, state, local and/or third party funding has been accessed and applied. Part C will supplement, not replace, existing resources including program income. Grantees are expected to facilitate the coordination of payment for early intervention services from Federal, State, local and private sources (including public and private insurance coverage).
Proposed Budget: The applicant must submit both detailed and narrative budgets for the first fiscal year of the grant which is fully compliant with the limitations described in 7 AAC 78.160 (Costs), and supports program staffing and service delivery requirements stated in this RFP. Agencies requesting State Funds must complete the State Funds budget detail and narrative in section 4.04(5). Agencies requesting Federal Part C funds must complete a separate Federal Part C funds budget detail and narrative in section 4.04(6). Any agencies requesting State and Federal Part C funds must complete two separate budgets. The GEMS portal provides applicants instructions and the ability to enter budget details and narrative for the project budget. More detailed instructions can be accessed in the DHSS Budget Guidelines available online at https://gems.dhss.alaska.gov/Home/Documents. In developing program budgets, applicants must show the coordination of all anticipated Federal, State and local dollars that will be used to implement a comprehensive local Part C program.
Administrative Costs: In accordance with program regulation 7 AAC 23.060(9), proposed budgets must limit the total administrative costs to no more than 25% of the total State grant award. Administrative costs include (A) salaries and benefits for administrative personnel; (B) office rent and utilities for administrative personnel; (C) accounting, bookkeeping, and auditing services; (D) liability and malpractice insurance premiums; (E) office supplies, equipment, and equipment repairs; and (F) indirect costs. Grantees with approved indirect rate agreements are required to use whichever rate is lower between the regulation limit of 25% for administrative costs or their current approved indirect rate. Identify in the budget narrative which costs are administrative and the fund source. For personal services, include the percent of the position designated as administrative.
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. Agencies with current DHSS grant agreements can review the Indirect Cost Rate Agreement information in GEMS. Agencies without current grant agreements with the Department must upload a copy of the Indirect Cost Rate Agreement in the "Agency Administration" tab of the GEMS portal. Help instructions are available in the portal to upload and review such documents.
Grant Income: DHSS is the payer of last resort. If applicable to the services provided under this agreement, the grantee will have a Medicaid Provider Number (National Provider ID), or apply to obtain one, and will make reasonable effort to bill all eligible services to Medicaid or any other available sources of payment before seeking payment through this grant agreement.
In the applicant’s proposed budget, both anticipated receipts and expenditures for all grant income must be clearly evident in both the detailed and narrative budgets and actual receipts and expenditures must be reported on a quarterly basis.
Alaska Medicaid Assistance Program: Successful applicants will be required to enroll in the Alaska Medicaid Assistance Program as providers of ILP targeted case management (TCM) services. Programs must seek third party reimbursement for case management and other services listed on the IFSP whenever possible. Training on ILP TCM service provision and billing requirements will be provided for all ILP grantees through the Medicaid Alaska Training Portal for enrolled EI/ILP providers. Applicants must attach a copy of their billing policies to the proposal. The billing practices must include:
- 1.06.1 implementation of rates set by Medicaid;
- 1.06.2 method of billing for all third party payers;
- 1.06.3 identification of all services for which fees will be assessed; and
- 1.06.4 procedures in place for family cost participation according to state EI/ILP System of Payment Policies (Section XVIII, EI/ILP Policies and Procedures).
Travel: Successful applicants agree to provide mileage reimbursement to employees utilizing their personal vehicle to provide the services under the resulting grant. Travel costs (including mileage reimbursement) are limited to the more restrictive of the applicant's current travel policy or the current basic rates approved under the general government unit employees' agreement with the State. Mileage reimbursement does not apply to travel to and from work.
Applicants must include in their proposed budget the following estimated travel costs (per diem, lodging, etc) to travel to Anchorage for the following meetings:
- Required Coordinator Meeting(s) (1-2 days)
- 1 All Staff Training plus Coordinator Meeting (2-3 days)