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 FY2024 through FY2026. 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. The program funds a range of supports that assist family and informal caregivers to care for their loved ones at home for as long as possible.
Families are the major provider of long-term care, but research has shown that caregiving exacts a heavy emotional, physical, and financial toll. Many caregivers who work and provide care experience conflicts between these responsibilities. Family caregivers spend an average of 25 hours per week providing care. Regardless of employment status, unpaid caregivers report that positive activities in their respective daily lives are reduced by 27% because of their caregiving responsibilities. Seventy four percent of caregivers of program clients 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 a better caregiver and nearly sixty two percent of caregivers indicated that without the services they received, the care recipient would be living in a nursing home.
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.
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 to caregivers about available services
- Assistance to caregivers in gaining access to the services
- Individual counseling, organization of support groups and caregiver training
- 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
For more detailed definitions, review the Older Americans Act of 1965 Document.
Applicants must describe the proposed activities that support the goals and outcomes of the project.
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 context.
If new applicant or if new services are being proposed, applicants will upload a timeline for the initiation of services and project activities.
Planned Services and Expenditures
Applicants must submit a Planned Services and Expenditures form using the template provided in section 4.04 question 3. The PSE indicates which program is being proposed and identifies the communities, services, and expenditures by service category.
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 metrics, 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, FY24 DOH NFCSP Service Matrix, for detailed descriptions of all the service types. Services proposed to be offered under a subcontract and services proposed under the family caregiver to elders program that are offered statewide must be indicated as such on the planned services and expenditure form.
Caregiver Records
- Maintain a caregiver file that includes information listed above under “forms, intake, assessment and documentation.”
- Develop an audit schedule for caregiver records.
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
1. Health & Wellness Across the Life Span
Department Core Services
1.2 Provide Quality of Life in a Safe Living Environment for Alaskans
Department Objectives
1.2.2 Increase the number of older Alaskans who live safely in their communities
Efficiency Performance Measure
- Cost to provide services with grant funds per recipient
Effectiveness Performance Measures
- Number of caregivers who receive services
- Number of caregivers caring for individual with ADRD
In addition to the Effectiveness and Efficiency Performance Measures required by the Department, the applicant will be responsible for reporting to the Division of Senior and Disabilities Services additional Performance Measures specific to the grant program shown below.
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
Grant Reporting
Required reporting will include:
- Monthly data entry into SDS online database
- Cumulative Fiscal Reports recording overall grant and match expenditures by budget line
- CFR2- service numbers and units are reported by service type and expenditures are reported by services. Cost per service unit is calculated.
- Biannual Progress Report
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:
- A Family Caregiver, is an adult 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 the 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, is the parent, grandparent, or other relative by blood, marriage, or adoption, of the individual with a disability.
- Priority shall be given to:
- 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
- To older relative caregivers of children with severe disabilities, or individuals with disabilities who have 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, 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: This a statewide program 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.
1.06Program Funding
Funds available for this program are anticipated at $1,295,368 in NFCSP funding annually for the full duration of the RFP.
Proposals using evidence-based programming will be looked upon more favorably. Examples of evidence-based programs include Resources for Enhancing Alzheimer’s Caregiver Health (REACH), Benjamin Rose Institute (BRI) Care Consultation and Tailored Caregiver Assessment & Referral (TCare). 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 in making sure services are dispersed across the state as equitably as possible to reach the target populations and priorities for services of the RFP.
Three types of caregiver programs will be funded. Applicants proposing to provide multiple types of programs MUST submit separate proposals for each.
- Caregivers serving elderly individuals - multiple programs may be funded.
- Grandparents and other elderly individuals serving children - 1 statewide program will be funded an amount not exceeding 10% of the total funding amount annually.
- Legal assistance to caregivers - 1 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.
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 award.
- Medicaid: includes Medicaid which is not Grant Income, as well as other third-party receipts)
Proposed Budget: The applicant must submit a proposed budget for the first fiscal year of the project. The proposed budget detail and narrative, (including required match), will support the program's 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.