1.01Introduction and Program Description
The Department of Health (Department or DOH), Division of Behavioral Health (Division or DBH), is requesting proposals from eligible applicants to provide Positive Pathways for Alaska Recovery: Expanding Harm Reduction services for the State of Alaska in FY2026 through FY2027. Program services are authorized under 7 AAC 78 Grant Programs. Additional governing statutes are AS 47.30.475 - Grant-in-Aid Program, AS 47.30.520-620 - Community Mental Health Services Act, AS 47.30.655-.915 - State Mental Health Policy, 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, 7 AAC 138 - 1115 Substance Use Disorder Waiver Services, and 7 AAC 139 - Behavioral Health 1115 Waiver Services. State of Alaska statutes and regulations are accessible at the Department of Law Document Library or through the grants administrator identified on the cover page of this Request for Proposals (RFP).
Positive Pathways for Alaska Recovery: Expanding Harm Reduction program will enhance and expand Syringe Service Programs (SSPs) across the state. This initiative aims to strengthen community health and safety by funding up to three agencies to build or support existing SSPs to advance their services in key areas, including:
- Capacity and Partnership Building: Foster collaborations and strengthen organizational infrastructure to enhance SSP effectiveness.
- Linkage to Care: Facilitate seamless pathways to substance use disorder treatment and recovery services.
- Overdose Prevention and Response: Expand access to naloxone and provide education on overdose response strategies.
- Infectious Disease Prevention: Reduce the spread of HIV, hepatitis, and other infections through safe syringe distribution and disposal.
- Health and Safety Promotion: Educate communities on harm reduction practices and safer substance use.
- Basic Needs and Support Supplies: Provide essential items such as hygiene products, clothing, and food to SSP participants.
- Program Expansion: Increase the geographic reach and service capacity of SSPs to underserved areas.
- Integrated Primary and Behavioral Health Care: Offer comprehensive care, integrating mental health and medical services into SSPs.
This grant program seeks to empower agencies to address public health challenges effectively, reduce harm, and support Alaskans in achieving healthier outcomes.
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 goal of this program is to reduce overdose-related deaths and harms by implementing a comprehensive harm reduction program that incorporates evidence-based or promising practice harm reduction interventions, while fostering community engagement and reducing stigma among people who use substances.
Minimum Outcomes:
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- Service Expansion: By June 30, 2027, the program will increase the number of individuals served by at least 10% compared to the baseline established on July 1, 2025.
- Reduction in infectious disease transmission rates (e.g., HIV, Hepatitis C).
- Decrease in overdose deaths in the target population or service area.
- Improvement in linkage to treatment, including substance use disorder treatment, mental health care, or primary care services.
Projects must meet or exceed anticipated minimum outcomes described in this RFP.
1.03Program Services/Activities
A. Applicants may request funding for any of the listed services and initiatives, however priority will be given to proposals which most closely align with demonstrated community needs summarized in the proposal. For additional guidance on allowable harm reduction supplies and services, refer to the Substance Abuse and Mental Health Services Administration (SAMHSA) Harm Reduction Framework
B. Implementation of one or more of the following activity categories:
- Capacity and Partnership Building: Explain how your agency will foster collaborations and strengthen organizational infrastructure to enhance the effectiveness of Syringe Service Programs (SSPs).
- Linkage to Care: Describe how your agency will facilitate seamless pathways to substance use disorder treatment and recovery services for SSP participants.
- Overdose Prevention and Response: Explain how your agency will expand access to naloxone and provide overdose prevention education in the communities you serve.
- Infectious Disease Prevention: Describe how your agency will reduce the spread of HIV, hepatitis, and other infections through harm reduction strategies.
- Health and Safety Promotion: Explain how your agency will educate communities on harm reduction practices and safer substance use.
- Basic Needs and Support Supplies: Describe how your agency will provide essential items to SSP participants to support overall well-being.
- Program Expansion: Explain how your agency will increase the geographic reach and service capacity of SSPs, particularly in underserved areas.
- Integrated Primary and Behavioral Health Care: Describe how your agency will offer comprehensive care by integrating mental health and medical services into your SSP.
Applicants must provide detailed descriptions, including implementation strategies, staffing plans, community partnerships, and anticipated challenges for each section. The proposal should clearly outline how the agency will meet the objectives of this grant and track measurable outcomes to assess program effectiveness. This structured approach ensures that funded agencies can effectively expand harm-reduction services, strengthen public health efforts, and improve outcomes for Alaskans impacted by substance use.
C. Applicants must submit a timeline for the initiation of services and project activities, with a required start date no later than July 1, 2025. The submitted timeline should outline:
- Key project phases, including service implementation, expansion, sustainability planning over the two-year period.
- Major milestones related to harm reduction services, such as overdose prevention, treatment referrals, and community engagement.
- Dates for key activities, including start and end dates, with responsible positions identified.
- Evaluation and reporting checkpoints to track progress and inform adjustments.
Project Proposal Requirements
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 demonstrate how their project aligns with program intent by detailing:
- Agency resources allocated to harm-reduction activities.
- Core project activities and service delivery strategies.
- Anticipated goals, outputs, and outcomes for the grant period.
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.
1.04Program Evaluation Requirements and Reporting
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.)
Evaluation Requirements
Applicants must submit a Program Evaluation Plan within six months of the project start date, aligning with the reporting requirements outlined in this RFP. The plan must describe the methodology for tracking program effectiveness, ensuring data quality, and applying findings for continuous improvement. The plan should also integrate performance measures related to:
- Service expansion and impact
- Overdose prevention efforts
- Linkage to treatment services
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 Priority
- 1 Health & Wellness Across the Lifespan
Department Core Services
- 1.1 Protect and Promote the Health of Alaskans
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 included in our federal award.
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.)
Grant Reporting Requirements
Required reporting will include:
- Cumulative Fiscal Reports recording overall grant and match expenditures by budget line.
- Program Reports to include the following:
The awardee(s) must comply with State Opioid Response grant reporting requirements as set by SAMHSA, ensuring accurate and timely submission of all required data.
Reports must include:
- Naloxone distribution: Total units purchased and distributed.
- Overdose reversals: Number of reported reversals using naloxone.
- Fentanyl test strips: Purchase and distribution data.
- Community education efforts: Number of individuals trained, including school-aged youth, first responders, and key community members.
- Program implementation progress: Quarterly updates on service expansion, outreach efforts, and changes in overdose prevention strategies.
- Accomplishments & challenges: Summary of key successes, barriers encountered, and adjustments made to improve program effectiveness.
- Strategies to increase accessibility: Efforts to expand harm reduction outreach to target groups and special populations.
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 for this Harm Reduction initiative includes individuals at high risk of substance-related harm in Alaska, particularly those impacted by opioid and stimulant use. This population includes:
- People Who Use Drugs (PWUD): Individuals using fentanyl, methamphetamine, heroin, or other substances, particularly those engaged in polysubstance use.
- Pregnant Individuals: People who are pregnant and using substances, requiring specialized care and harm reduction support.
- Individuals at Risk of Overdose: Alaskans at increased risk due to fentanyl exposure, past overdoses, or non-prescribed opioid use.
- Persons Experiencing Homelessness or Housing Instability: A subgroup with limited access to healthcare and harm reduction services, disproportionately impacted by substance use-related harms.
- Justice-Involved Individuals: People recently released from incarceration, a population at elevated overdose risk due to loss of opioid tolerance.
- Indigenous and Rural Alaskans: Communities with geographic barriers to harm reduction services and increased health disparities related to substance use.
- Individuals at Risk of Infectious Disease Transmission: Those at high risk of contracting HIV and Hepatitis C due to syringe sharing or unsafe drug use practices.
- Young Adults (25-44): The age group experiencing the highest rates of overdose fatalities in Alaska.
- Men at Disproportionate Risk: Given that 65% of overdose deaths in Alaska occur among males, with a concentration in Anchorage and the Matanuska-Susitna Valley.
Service Areas and Communities: The service areas and communities requested for the services solicited are:
- Region 1: Anchorage Municipality
- Region 2: Gulf Coast Region
- Region 3: Interior Region
- Region 4: Mat-Su Region
- Region 6: Southeast Region
- Region 7: Southwest Region
A detailed map of these service regions is provided in Attachment 1 of this solicitation.
1.06Program Funding
Funding is estimated at $350,000 per fiscal year, totaling $700,000 over two years. Funding source is SAMHSA State Opioid Response funding. Up to three agencies may be funded.
(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, 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 following funding restrictions apply as outlined by the funding source:
- Syringes are not to be purchased.
- Liability insurance cannot be purchased.
- Food can be included as a necessary expense for participants receiving SAMHSA-funded mental and/or substance use disorder prevention, harm reduction, treatment, and recovery support services, not to exceed $10.00 per person per day.
- Program funds may not be expended through the award or a sub-award by any agency which would deny any eligible client, patient, or individual access to services because of their use of FDA-approved medications for the treatment of substance use disorders (e.g., methadone; buprenorphine products, including buprenorphine/naloxone combination formulations and buprenorphine monoproduct formulations; naltrexone products, including extended-release and oral formulations; or long-acting products, such as extended release injectable or buprenorphine). Specifically, patients must be allowed to participate in methadone treatment rendered in accordance with current federal and state methadone dispensing regulations from an Opioid Treatment Program and ordered by a practitioner who has evaluated the client and determined that methadone is an appropriate medication treatment for the individual’s OUD. Similarly, medications available by prescription or office-based injection must be permitted if it is appropriately authorized through prescription or administration by a licensed prescriber or provider. In all cases, MOUD (Medications for Opioid Use Disorder) must be permitted to be continued for as long as the prescriber or treatment provider, in conjunction with the patient, determines that the medication is clinically beneficial. Recipients must ensure that participants will not be compelled to no longer use MOUD as part of the conditions of any programming if stopping is inconsistent with a licensed prescriber’s recommendation or valid prescription.
- Funds may not be used to make direct payments to individuals to enter treatment or continue to participate in prevention or treatment services; see 42 U.S.C. § 1320a-7b: 42 USC 1320 .
Note: Sub-recipients are permitted to offer noncash incentives of up to $30 per individual for participation in required GPRA data collection follow-up interviews. This incentive may be provided for each required follow-up interview, helping to ensure compliance with federal reporting standards. However, these incentive amounts may be subject to change based on updated funding or policy guidance.
For programs that incorporate Contingency Management (CM) as part of treatment, additional restrictions apply. Participants may not receive more than $750 in total contingencies per budget period, ensuring compliance with funding limitations. Additionally, participants may not be enrolled in more than one program offering Contingency Management incentives at the same time. These guidelines are in place to maintain the integrity of incentive-based treatment approaches while ensuring fair and equitable distribution of resources.
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, as part of the pre-award risk assessment required under Uniform Guidance 2 CFR 200. 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 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: 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.