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 Residential Substance Use Disorder (SUD) services through the CBHTR (Comprehensive Behavioral Health Treatment and Recovery) Residential Withdrawal Management and Residential SUD program for the Southeast region of the State of Alaska from February 1, 2025 through FY2026.
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, 7AAC 70 Behavioral Health Services, 7AAC 135 Medicaid Coverage for Behavioral Health Services, AS 47.37 Uniform Alcoholism and Intoxication Treatment Act, AS 47.30.655-.915 Alaska Civil Commitment Statutes, and AS 47.30.011 - .061 Alaska Mental Health Trust Authority. 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).
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 to provide Residential Substance Use Disorder (SUD) Treatment Services:
The goals for this program are to treat adults who, because of specific functional limitations, need safe and stable settings to develop and demonstrate sufficient recovery skills so that they can maintain their recovery upon transfer to a less intensive level of care.
The general overall goals for Residential SUD Treatment services are:
- Providing timely, accessible care
- Providing effective care as indicated by program outcomes
- Utilization of evidence-based practices
- Provision of culturally and linguistically appropriate services
- Provision of trauma-informed services
- Promotion of recovery, resilience, and community integration.
The applicant must clearly identify the service to be provided.
Projects must meet or exceed anticipated minimum outcomes described in this RFP.
1.03Program Services/Activities
RESIDENTIAL SUD TREATMENT
Proposed Residential SUD Treatment services must meet ASAM Level 3.1, 3.3, 3.5, or 3.7 criteria for adults found in the ASAM 3rd Edition Criteria Text, and the proposed ASAM Level to be provided must be identified.
Level 3.1 services may be offered in a freestanding, appropriately licensed facility located in a community setting (3.3 Adult Only), and 3.5 services are provided in a 24-hour supportive treatment environment, typically in a residential treatment facility or a therapeutic community with a length of stay determined by medical necessity and by appropriate, clinically trained staff (as stated in section 2.02 of this RFP). The duration of treatment depends upon medical/clinical necessity. Residential treatment assists individuals whose addiction is currently so unmanageable that they need 24-hour treatment to initiate or continue a recovery process that has failed to progress. Their needs cannot safely be treated in less intensive levels of care. Note: Priority admissions are required for pregnant injection-drug users, pregnant women, injection-drug users, and Office of Children Services (OCS-engaged) families.
Support Services must include:
- Availability of emergency services 24 hours a day, 7 days a week;
- Direct affiliations with other levels of care or close coordination through referral to more and less intensive levels of care and other services (such as vocational assessment and training, literacy training, and adult education); and
- Arranged medical, psychiatric, psychological, laboratory, and toxicology services as appropriate to the severity and urgency of the patient's condition, including the use of pharmacotherapy to treat their addiction as clinically relevant.
Therapies must include:
- Clinical services to improve the patient's ability to structure and organize tasks of daily living and recovery (such as personal responsibility, personal appearance, and punctuality), and to develop and practice pro-social behaviors.
- Planned clinical program activities to stabilize and maintain stabilization of the patient's addiction symptoms, and to help him or her develop and apply recovery skills. Activities may include relapse prevention, exploring interpersonal choices, and development of a social network supportive of recovery. Counseling and clinical monitoring to promote successful initial involvement or reinforcement in regular, productive daily activity such as work or school and, as indicated, successful reintegration into family living.
- Random drug screening to shape behavior and reinforcement treatment gains as appropriate to the patient's individual treatment plan.
- A range of evidence-based cognitive, behavioral and other therapies administered on an individual and group basis, medication education and management, addiction pharmacotherapy, educational skill building groups, and occupational or recreational activities adapted to the patient's development stage and level of comprehension, understanding and physical abilities. This therapy includes facilitating access to all forms of medication for opioid use disorder including methadone, buprenorphine, and buprenorphine/naloxone.
- Motivational enhancement and engagement strategies appropriate to the patient's stage of readiness and desire to change. Motivational therapies and other evidence-based practices are used in preference to confrontational strategies.
- Counseling and clinical interventions to facilitate teaching the patient the skills needed for productive daily activity (such as work or school) and, as indicated, successful reintegration into family living. Health education services are also provided.
- Monitoring of the patient's adherence to taking any prescribed medications, and/or any permitted over-the-counter medications or supplements.
- Planned clinical activities to enhance the patient's understanding of his or her substance use and/or mental disorders.
- Scheduled professional services, including interdisciplinary assessments and treatment designed to develop and apply recovery skills. Such services may include relapse prevention, exploring interpersonal choices, and development of a social network supportive of recovery. Such services also may include medical services, nursing services, individual and group counseling, psychotherapy, family therapy, educational and skills-building groups, occupational and recreational therapies including art, music, or movement therapies, physical therapy, and vocational rehabilitation activities.
- Planned community reinforcement designed to foster pro-social values and milieu or community-living skills.
Assessment/Treatment Plan must include:
- An individualized, comprehensive bio-psychosocial assessment of the patient's substance use or addictive disorder conducted or updated by staff who are knowledgeable about addiction treatment. This assessment is used to confirm the appropriateness of placement, and to help guide the individualized treatment planning process, which is focused on the patient's strengths, needs, abilities, preferences, and desired goals.
- An individualized treatment plan, which includes problem formulation and articulation of short-term measurable treatment goals and activities designed to achieve those goals. The plan is developed in collaboration with the patient and reflects the patient's personal goals while considering the capabilities and resources available to achieve the patient's personal goals.
- A bio-psychosocial assessment, treatment plan, and updates that reflect the patient's clinical progress, as reviewed by an interdisciplinary treatment team in collaboration with the patient.
- A physical examination, performed within a reasonable time, as determined by the patient's medical condition consistent with facility policy or legal requirements.
Documentation must include:
- Alaska Automated Information Management System (AKAIMS) Minimal Data Set.
- Individualized progress notes that clearly reflect implementation of the treatment plan and the patient's response to therapeutic interventions for all disorders treated, as well as subsequent amendments to the plan.
- Documentation in the treatment plan of treatment plan reviews conducted at specified times.
Applicants for this RFP agree to comply with all of the following Residential SUD Treatment program requirements and service standards:
- Residential SUD Treatment services are intended to serve individuals who require structured therapy and 24-hour programmatic milieu to promote treatment progress and recovery.
- Residential SUD Treatment services are intended to serve those individuals who present with severe substance use disorders.
- Residential SUD Treatment services are intended to serve those individuals transferring into services after withdrawal management but are not yet ready for outpatient treatment, and who need immediate placement into Residential SUD Treatment but most often encounter wait lists and repeated failures to be admitted.
- The Division also requires the provider to demonstrate the capability of providing co-occurring mental health services, either on-site or closely coordinated off-site as appropriate to the individual needs of the client.
- Applicants responding to this RFP must demonstrate the capability of maintaining a person recently initiated into a MAT program, including transportation, assisting with the storage and/or administration of all forms of medication for opioid use disorder including methadone, buprenorphine, and buprenorphine/naloxone.
Applicants will upload a timeline for the initiation of services and project activities beginning February 1, 2025. Please note that priority will be given to those applications proposing to provide category 3.5 Residential Services.
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.
Providers must agree to accept all individuals eligible for services, regardless of their ability to pay.
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:
- Providing timely, accessible care
- Providing effective care as indicated by program outcomes
- Utilization of evidence-based practices
- Provision of culturally and linguistically appropriate services
- Provision of trauma-informed services
- Promotion of recovery, resilience, and community integration.
Department Priorities
- 1 Health & Wellness Across the Life Span
Department Core Services
- 1.1 Protect and Promote the Health of Alaskans
Department Objective
- 1.2 Decrease Substance Use and Dependency
Performance Measures of Effectiveness and Efficiency
- Efficiency: Maintain a bed utilization of at least 85%
- Effectiveness: Meet or exceed the State average for program completion rates as documented in AKAIMS (to include Satisfactory Completion or Referral to another program with satisfactory progress, or Transfer to another facility for health reasons)
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
Required reporting will include:
- Cumulative Fiscal Reports recording overall grant and match expenditures by budget line; and
- Program Reports in the format prescribed by the program.
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 adults with substance use disorders or co-occurring substance use and mental health disorders.
Service Areas and Communities: The service area and communities requested for the services solicited are the following regions of the State of Alaska:
- Region 7 - the Northern Southeast Region; and
- Region 8 - the Southern Southeast Region.
(Please refer to the map in Attachment 1 of this RFP).
1.06Program Funding
One award will be funded through this solicitation. Funds available for this program are $202,594.70 for FY25 (February 1, 2025 - June 30, 2025), and $270,126.27 for FY26 ($472,720.97 funding total) from Substance Abuse Prevention and Fed Rcpts. program.
(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 February 1 - June 30, 2025 of FY25 only, which is within 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 applying 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 expenditures of all grant income.