1.01Introduction and Program Description
The Department of Health, Division of Behavioral Health, is requesting proposals from eligible applicants to provide Rural Peer Support services for the State of Alaska in FY2025 through FY2027. Program Services are authorized under 7 AAC 78 Grant Programs. Additional governing statutes are AS 47.30.520-620 The Community Mental Health Services Act, AS 47.30.520-620 Community Mental Health Services Act, and AS 47.376 Uniform Alcoholism and Treatment 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 Rural Peer Support program is to promote the expansion of peer support services and increase positive outcomes supplied by peer support. Applicants for this proposal can be new, prior funded or established programs. This grant is to be awarded to Community Clinics, Community Behavioral Health Centers, or Peer Run agencies to provide peer support services in remote rural areas. Agencies/clinics are to initiate peer support services in a rural location(s) within their current service area. These programs will help rural communities understand the role of peer support within the continuum of care. Rural peer support will provide services to children and youth experiencing serious emotional disturbance (SED), adults experiencing serious mental illness (SMI) or co-occurring (COD) SMI and substance use disorder (SUD), and/or family members of individuals experiencing SED, SMI, SUD and/or COD. Service areas of the proposed project must be located outside of the Municipality of Anchorage, the City of Fairbanks, and the City and Borough of Juneau.
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 intent of the Rural Peer Support program is to promote the expansion of peer support services into behavioral health systems in rural areas, and to provide an increase in positive outcomes supplied by peer support.
Peer support is a type of help provided by someone who has experienced the same or similar problems of being diagnosed with mental health conditions, substance use disorders, or both. Peer support can offer emotional, social, practical, or knowledge-based assistance. Peer support is based on shared humanity and commonalities and can promote connection and hope. This mutuality—often called “peerness”—between a peer support worker and person in or seeking recovery promotes connection and inspires hope. (Substance Abuse and Mental Health Services Administration (SAMHSA), 2017)
The proposed program is to implement and expand peer support services into existing rural settings. Peer Supports Professionals are individuals who are in recovery from a substance misuse and/or a mental health condition, who assist others in navigating their path to recovery. Peer Support Professionals help peers walk the recovery path by offering hope, self-help education and link people to tools and resources. Additionally, Peer Support Professionals help create a roadmap for peers to work towards their goals. This program would use different evidence-based programs, such as the Wellness Recovery Action Plan (WRAP), Whole Health Action Management (WHAM), and Intentional Peer Support to assist peers in setting goals and making life changes. Applicants will need to address in the proposals which evidence-based practices will be used in the program.
Specific criteria must be met for Peer Support Professionals. Individuals with specialized training, supervision, and lived experience are hired as Peer Support Professionals. These individuals must have the lived experience in order to qualify as a “peer support professional.” Peer support professionals must be certified or in process of becoming certified through the Alaska Commission on Behavioral Health Certification. Applicants must describe how peer support professionals will be trained and supported toward certification.
Services are expected to be provided in rural Alaskan community environments. Following outreach, in reach and engagement services, some participants will continue to be served by the Rural Peer Support program long term and others will be offered a warm hand off to other community-based services. Other community-based services to which participants can be connected include community behavioral health centers, employment services, housing services, non-medical recovery such as mutual support and 12 step programs or other educational and natural supports as defined and desired by the participant. Community-based supports should also include assisting participants with resources to meet their basic needs, such as food and clothing banks, utility assistance and public entitlements.
Rural peer supports are expected to assist individuals in remaining in their community and decrease institutional placements, Department of Corrections (DOC) and Department of Juvenile Justice (DJJ) involvement, and/or Office of Children's Services (OCS) involvement. In addition, rural peer support services are expected to increase recovery progress and outcomes as indicated by improvements such as development of recovery/wellness tools, improved independent housing, employment, education, self-reported recovery, and overall satisfaction with the quality of life. Rural peer support programs are expected to implement a recovery philosophy as evidenced by an organizational top-down vision that all individuals can recover and by following the SAMHSA definition of recovery as follows: Recovery is a process of change through which individuals improve their health and wellness, live self-directed lives, and strive to reach their full potential.
Applicants must demonstrate a thorough understanding and support of the grant program goals and outcomes anticipated by the Department. The goals of the Rural Peer Support Program (RPS) are:
1) To develop and expand peer support in the behavioral health system in rural Alaska;
2) to enhance positive treatment outcomes for clients receiving peer support services in rural Alaska. Peer support services are provided in a deliberate and organized way that maximizes the diversity of consumers;
3) to assist individuals and families in recovery obtain basic needs to enhance the quality of life; and
4) to increase individuals and families receiving support services to maintain living safely in the least restrictive environment.
Outcomes anticipated include:
- Incorporates peer support services into a rural clinic's behavioral health continuum of care.
- Provide linkage to basic resources for individuals.
- Utilization of evidence-based practices.
- Provide culturally and linguistically appropriate services.
- Promotion of recovery, resilience, and community integration.
These services must be both supportive and practical. An applicant may propose to have additional program goals beyond the two required but must be clear in the proposal that grant funds will only be used to attain these State-identified goals.
Proposals must meet or exceed anticipated minimum outcomes described in this RFP.
1.03Program Services/Activities
Applicants must agree to adhere to program requirements and service standards, including those specified in DBH Grant Programs and Service Standards Manual FY23, section 5. Peer and Consumer Support Services (Peers). Applicants agree to comply with all of the following additional program requirements and service standards:
- All peers working within this program must have the 40-hour core training from an approved DBH curriculum on peer support. Approved curriculums can be found in the Training Resources Guide for Peer Support Professionals.
- All peers working within this program must become certified by the second quarter of services. Certification information is at Alaska Commission for Behavioral Health Certification.
- Advocating for people in recovery.
- Building community and relationships.
- Leading recovery groups and individual skill building to peers.
- Mentoring
- Destigmatization
- Inspire hope that people can and do recover.
- Walk with people on their recovery journeys; dispel myths about what it means to have a mental health condition or substance use disorder.
- Provide self-help education and link people to tools and resources.
- Support people in identifying their goals, hopes, and dreams, and creating a roadmap for getting there.
- Serve as an advocate and provide information and peer support for consumers in emergency, outpatient or inpatient settings.
- Maintain frequent in-person or telephonic contact with their peer support group and individuals in order to provide support.
- Perform a wide range of tasks to assist consumers in regaining control over their own lives and over their own recovery process.
Peer Support Professionals will provide these services in conjunction with strategic sharing, strategic understanding, affirmation, and normalization.
Applicants will upload a timeline for the initiation of services and project activities. DBH understands that applicants may be operational; however, a timeline is still required. The timeline should include any trainings and certification plans for the project. It should also include at a minimum: outreach plans, education to the community regarding the available peer support services of the project, data collection procedures, and supervision for peers. The timeline must specify a project start date of July 1, 2024 with service delivery beginning no later than September 1, 2024.
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 must agree to adhere to program requirements and service standards, including those specified in DBH Grant Programs and Service Standards Manual FY23, section 5. Peer and Consumer Support Services (Peers).
Applicants must agree to follow Behavioral Health Medicaid Service standards adopted per regulation 7 AAC 70 Behavioral Health Services.
Applicants must describe the manner in which they will ensure substantial consumer input into programming for consumer directed services and program decision making. Applicants must describe a plan for sustainability to include the following;
- Sustainability of vision, mission, purpose and values.
- Sustainability of program activities over a period of no less than 2 years after the initial grant award period.
- Fiscal sustainability that identifies all possible revenue streams with realistic projections of actual income over a period of not less than 2 years after the initial grant award period.
- Plan for increase in other revenues over the 3-year grant period to include annual reporting of progress over the grant award period.
Possible revenue streams may include but are not limited to Medicaid, Division of Vocational Rehabilitation, Private Foundations, and/or donations.
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
- Improve the Health Status of Alaskans
Department Objectives
- 1.1 Protect and Promote the Health of Alaskans
- 1.2 Increase the number of Alaskans with disabilities who are living safely in the least restrictive environment.
- 1.3 Increase the number of Alaskans with behavioral health issues who report improvement in key life domains.
FY 25 RBB Objectives/Performance Measures required:
Measure 1: Percent of participants who access community resources to meet basic needs and/or enhance the quality of life.
Data Collection: For this measure, the grantee will measure the number of individuals accessing community-based resources.
Collection Method: Agency Count as reflected in DBH Program Reports.
Target: 25% or higher
Measure 2: Cost per participant.
Data Collection: total amount of grant expenditures divided by total number of unduplicated program participants per fiscal year.
Collection Method: Cumulative Fiscal Report and DBH Program Reports.
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 program.
Applicants must agree to comply with any reporting needs the Program Manager may have throughout the year.
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 children and youth experiencing SED, adults experiencing SMI or co-ocurring SMI and SUD, and/or family members of individuals experiencing SED, SMI, SUD or COD.
Service Areas and Communities: The solicitation requests proposals for services in rural Alaska only. Service areas must be outside of the Municipality of Anchorage, City of Fairbanks, and the City & Borough of Juneau.
1.06Program Funding
Funding available for this program is anticipated to total $133,156.38 per fiscal year. Total estimated funding for the three-year duration is $399,469.14 in general funds.
Match Requirement: The budget must include matching funds equal to 25.00% 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, and 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 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.