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  Funding Opportunity Details
 
 -344698-FY21 RFA for Community Based Programs of Maternal Health, Child & Adolescent Health (including Hawki Outreach, I-Smile™ and I-Smile™ @ School)
  Title V Services
  Application Deadline: 06/18/2020 4:00 PM
 
 
Award Amount Range: Not Applicable
Project Start Date: 10/01/2020
Project End Date: 09/30/2021
Award Announcement Date: 08/17/2020
Eligible Applicant: Refer to RFA
Program Officer: Melana Hammond
Phone: 515-281-4900 x
Email: melana.hammond@idph.iowa.gov
Categorical Area: Child Health, Community Development, Health, Prevention/Treatment, Maternal and Child Oral Health, Maternal Health
 
 
Description
 
 

It is the responsibility of the Applicant to review all attachments listed in the section below for additional details regarding this Request for Application (RFA).

The issuance of the Funding Opportunity in no way constitutes a committment by IDPH to award a contract.

A Virtual Applicant's Conference was held on April 16, 2020 12:00 pm - 3:00 pm local Iowa time.  The link to the MCAH RFA Application Conference YouTube Video and a PDF of the conference slides are attached below.

Excerpts from the RFA:

Purpose

The purpose of this RFA is to provide guidance for current contractors to submit continuation applications to the Iowa Department of Public Health (referred to as Department) to renew service provisions as described by and within the project period established by the RFP #58816024 (Project Period October 1, 2016 through September 30, 2020) and Sole Source Procurement (Project Period October 1, 2020 through September 30, 2022) to extend the delivery of services except as noted in Section 2 of this RFA. Services covered by this application include public health services at the community level for Maternal Health (MH) and Child & Adolescent Health (CAH). CAH includes Hawki Outreach, Early ACCESS, Healthy Child Care Iowa (HCCI) and Oral Health (OH). OH components include the I- Smile™, I-Smile™ @ School and CH Dental projects.

Schedule of Important Dates (All times and dates listed are local Iowa time)

The following dates are set forth for informational purposes. The Department reserves the right to change them.

EVENT

DATE

RFA Issued

March 19, 2020

Written Questions and Responses

 

Round 1 Questions Due:

Responses Posted By:

March 26, 2020

April 2, 2020 

Round 2 Questions Due:

Responses Posted By:

April 23 2020

April 30, 2020

Final Questions Due:

Responses Posted By:

May 7, 2020

May 14, 2020

Applications Due

 June 18, 2020 by 4:00 PM Local Iowa Time

Post Notice of Intent to Award

August 17, 2020

 
 
 
 Attachments
 
 Click on the File Name to open attachment
 
Description File Name File Size
A RFA FFY2021 Maternal Health and Child & Adolescent Health including Hawki Outreach, ISmile and ISmile at School A RFA FFY2021 Maternal Health and Child & Adolescent Health including Hawki Outreach, ISmile and ISmile at School.pdf 827 KB
Amendment 1 FFY2021 MCAH RFA Amendment 1 FFY2021 MCAH RFA.pdf 141 KB
Amendment 2 FFY2021 MCAH RFA Amendment 2 FFY2021 MCAH RFA.pdf 165 KB
Amendment 3 FFY2021 MCAH RFA Amendment 3 FFY2021 MCAH RFA.pdf 127 KB
Amendment 4 FFY2021 MCAH RFA Amendment 4 FFY2021 MCAH RFA.pdf 137 KB
Amendment 5 FFY2021 MCAH RFA Amendment 5 FFY2021 MCAH RFA.pdf 120 KB
Amendment 6 FFY2021 MCAH RFA Amendment 6 FFY2021 MCAH RFA.pdf 278 KB
Amendment 7 FFY2021 MCAH RFA Amendment 7 FFY2021 MCAH RFA.pdf 121 KB
B IowaGrants Registration Instructions B IowaGrants Registration Instructions.pdf 874 KB
C IDPH Application Instruction Guidance C IDPH Application Instruction Guidance.pdf 1.9 MB
D Draft FFY2021 Maternal Health and Child & Adolescent Health including Hawki Outreach, ISmile and ISmile at School Contract Template D Draft FFY2021 Maternal Health and Child & Adolescent Health including Hawki Outreach, ISmile and ISmile at School Contract Template.pdf 327 KB
E Draft FFY2021 Maternal Health and Child & Adolescent Health including Hawki Outreach, ISmile and ISmile at School Review Tool E Draft FFY2021 Maternal Health and Child & Adolescent Health including Hawki Outreach, ISmile and ISmile at School Review Tool.pdf 409 KB
F Revised Funding Table MCAH FY21 RFA (5-1-2020) F Revised Funding Table MCAH FY21 RFA (5-1-2020).pdf 88 KB
G National Performance Measures (NPM) and State Performance Measures (SPM) G National Performance Measures (NPM) and State Performance Measures (SPM).pdf 189 KB
H I-Smile Partner Phases Handout Attachment H I-Smile Partner Phases Handout Attachment.pdf 86 KB
I RFA Application Forms Checklist I RFA Application Forms Checklist.pdf 48 KB
J HCCI Funding by county J HCCI Funding by county.pdf 45 KB
K MCAH Iowa Youth Survey Q&A K MCAH Iowa Youth Survey Q&A.pdf 41 KB
L 2018 IYS Participating and Not Participating Schools 9-4-18 L 2018 IYS Participating and Not Participating Schools 9-4-18.pdf 101 KB
MCAH Applicants Conference Training Slides MCAH Applicants Conference Training Slides.pdf 1.4 MB
 
 
 Website Links
 
 Click on the URL to go to website
 
URL Description
https://idph.iowa.gov/Portals/1/userfiles/88/DHSRulesforDocumentationofServicesFeb2016.pdf Documentation guidelines established by Medicaid in IAC 441-79.3
http://www.legis.iowa.gov/docs/aco/chapter/641.76.pdf IAC 641-76 Maternal and Child Health Program
http://idph.iowa.gov/finance/funding-opportunities/general-conditions IDPH General Conditions
http://idph.iowa.gov/hipaa-statement IDPH HIPAA Statement
http://youtu.be/GgeBbJmRjGE MCAH RFA Applicants Conference YouTube Video
http://www.thinkculturalhealth.hhs.gov/pdfs/EnhancedNationalCLASStandards.pdf The National Standards for Culturally and Linguistically Appropriate Services in Health and Health Care
 
 
Questions
 
 
Submitted Date Question Answer
03/25/2020 Can HCCI funds be used to pay for MCAH (non-nursing) staff time to make outreach calls to child care centers and homes to explain CCNC services and offer to arrange CCNC visits, as a way to expand the CCNC's reach and capacity? The plan would be to have the CCNC complete all visits and other consultations as described in the role guidance. Due to the limited HCCI funding available, funds should be utilized for meeting CCNC Performance Measures which include activities by the CCNC (visits, TA, special needs care planning, training). Often during outreach contacts with providers, the CCNC is asked questions about child care health and safety and original intent of the contact (for outreach) turns into Technical Assistance (TA) on a specific topic (i.e.: immunization requirements, infectious disease exclusion, etc.). The TA is a CCNC performance measure that can only be captured by the CCNC. Agencies can also utilize other staff to promote CCNC as an in kind/match for CCNC funds.
03/26/2020 Under Addressing Health Disparities/Priority Populations: We are a small agency with limited MCAH staffing. We don't have internal coalitions, committees or program planning groups. So how do we write activities ensuring priority populations are involved in community coalitions/committees, etc that our agency isn't in charge of? a. This question relates to the required activity: Recruit membership from priority populations: Recruit individuals from priority populations to sit on agency boards, coalitions or committees related to MCAH. However, several activities in this section relate to developing relationships with agencies, individuals and families from the priority populations to assess the effectiveness of activities, to implement culturally and linguistically appropriate goals, garner feedback on services, to plan activities and services that meet the needs of the whole population in your service area, including priority populations. If the agency does not currently have a mechanism (other than satisfaction surveys) for community input into their programs and services, this would be an opportunity to develop a committee, coalition or program planning group made up of community stakeholders and families, including those from and/or serving priority populations. Development of a group like this could help with several goals in the health equity section, as well as in other sections where family engagement is important. b. The IRS requires a 501(c)3 to have a Board of Directors, non-profits are typically required to have a Board of Directors, and each LPHA has requirements around hosting Community Health Needs Assessment Advisory Committees and other community health-related coalitions of which agencies could support community member engagement. This could also spill over into other activities in this section such as creating a policy about the membership of Boards and committees.
03/26/2020 CAH activities: On Iowa Grants I am not finding the enabling services to complete the SPM 4 activities that are required. Yes, that is correct. We noted the error and are in the process of fixing the problem. Amendment #1 will be posted shortly to address this.
03/26/2020 Maternal Health/NPM 5 Birthing Hospital Safe Sleep Collaboration: We do not have a birthing center in our service area. This is a required activity so how would you like us to answer or modify this activity? Refer to the instructions for the narrative from the MH Strategies and Activities Table, Birthing Hospital Safe Sleep Collaboration activity, in the RFA: Birthing Hospital Safe Sleep Collaboration: Narrative activity(ies) will describe which birthing hospital the Applicant will partner with. For applicants without a birthing hospital in the service area, indicate this in the narrative field as this activity is not applicable.
03/26/2020 Maternal Health/NPM 4 Hospital Lactation Consultant: We no longer have a birthing center in our service area so how do we proceed with writing this required activity that specifically states we need to identify which birthing hospital we plan to partner with? Refer to the instructions for the narrative from the MH Strategies and Activities Table, Hospital Lactation Consultant activity, in the RFA: Hospital Lactation Consultant: Narrative Activity(ies) will include which birthing hospital the Applicant intends to partner with (or other organization if no birthing hospital), and how the Applicant plans to work with birthing hospitals in the services area over the course of the project and ensure mutual referrals. Additional clarification: If there is not a birthing hospital in your service area, you may work with another organization that provides lactation consultation services to ensure that there is collaboration and mutual referrals between your Title V agency and the lactation consultant.
04/02/2020 If you do not have a tier two county in your service area are you able to use your MH Title V funds to provide enhanced education and services that are only required in tier two counties for non Medicaid or uninsured clients if you elect to still provide these services. Yes, grant funds may be used to provide direct care services to non-Medicaid or uninsured clients, in addition to Medicaid eligible women as you will retain the ability to bill Medicaid. If an applicant chooses to provide direct services in a Tier 1 county, they cannot provide services to Medicaid eligible clients only; and will be expected to use grant funds to provide services to non-Medicaid and uninsured clients. Applicants need to ensure that they are able to also complete the required infrastructure and enabling activities to address the NPMs and SPMs prior to providing direct care services.
04/06/2020 On Page 61 under ASQ or ASQ-Se Referrals it states that ALL documentation results should be sent to PCP. We have 1st Five within our agency and work closely with her to make sure we are providing just "gap filling" ASQ visits. Since her role is to enlist providers in providing ASQ and ASQ:SE within their practices, it has been detrimental to her program when providers have received ASQs in the past from our CAH program. They do not see the need to continue screenings since our agency is providing them (even if we are just providing screens at the visits they do not). It is really important not to reverse the progress that 1st Five has made and have PCP office discontinue screenings because they see that others are providing the service. In collaborating with our 1st Five program, could we only provide results to those providers not participating in 1st Five? A. Title V is a medical home model. All services that can be provided in the medical home should be included in the medical home. Increased communication between public health and primary care is important for patient care. The Department does not want to inadvertently discourage screening by Primary Care Providers in any way. This is an opportunity for open communication and education about the role of the PCP as the primary source of well child visits and screening and Title V as gap-filling. B. IDPH has been working with primary care providers and organizations representing primary care providers to assess barriers and their reasons for not providing screening services. The most often cited barrier is that providers think, or the parent reports the service “has already been done at WIC”. Primary care providers have repeatedly requested to know when screenings are being done and to receive a copy of the results. With that in mind, the Department reached out to primary care providers and shared these concerns about this decreasing the services provided in primary care. Providers responded that it was important for the screening results to be reported to the medical home, regardless of result and felt that communication about roles and care coordination of services should result in stronger collaboration and better service provision. Child and Adolescent Health staff also discussed this concern with 1st Five staff, and they remain on board with this expectation of Title V. C. In the event that specific circumstances exist with specific primary care providers or practices, an agency could submit an Exception to Policy to address that specific circumstance. Expect that Exceptions to Policy will be time-limited in nature and that action steps toward sharing all results will be expected.
04/07/2020 For counties that were identified as needing to provide lead screening - does this mean the MCAH "pokes the finger for lead" or partner/collaborate with another entity to "poke the finger" A. The goal is to increase the number of one and two year olds being tested in the counties in the state that have the smallest percentage of children being tested. The MCAH agency may subcontract with another agency to provide the testing in the county; however, this must be to provide additional testing of one and/or two year olds beyond what the subcontractor is already doing. Providing referrals to an agency, clinic, the child’s PCP/medical home for the testing, or collaborating with an agency to provide the same level of testing they are currently doing would NOT meet criteria. If a (non-MCAH) agency is already providing testing, and will now provide testing at an additional site in the county, or add specific additional hours with a focus on one and two year olds due to the collaboration with MCAH, this would meet criteria. B. Applicant’s who are planning to partner with an agency to provide the testing may contact their Regional Consultant or Analisa Pearson for technical assistance.
04/08/2020 The MCAH FTE Details Form will not accept anything other than whole numbers. The instructions in the guidance and in the Iowa Grants system say to use decimal amounts for FTEs. Please advise. For less than a whole FTE, applicants must enter “0.” followed by the decimal (e.g.0.5, 0.22).
04/08/2020 For Health Equity activities do we have to address all the populations listed? Applicants are not required to address all 8 priority populations identified. They must address at least one in each activity that requires them to address at least one priority population. Applicants could address the same population (one of the eight) in each activity or have different activities addressing different populations. If an agency wants to address a locally identified population such as the Amish, foster children, families with an incarcerated family member, etc. may do so in addition to addressing at least one of the State specified populations. Contact Analisa Pearson or your Regional Consultant for assistance if needed.
04/09/2020 Two of our maternal health nurses are also lactation consultants. We would have them provide those services rather than referring out since they've already established relationships with the client. While we can certainly build relationships with other lactation consultants in those areas, it doesn't make sense to refer a client out if we can provide the service. In the areas where these nurses provide services, the number of referrals would be low. Will there be a penalty or some other negative effect on our project if we are providing the service rather than referring out? No, in this situation there will not be a negative effect on your program/agency for low referral numbers. The important aspect of this activity is for agencies (with in-house lactation consultants) to collaborate with other local lactation consultants and hospital based lactation consultants to ensure that there is an open line of communication to help women get the assistance that they need with breastfeeding. This collaboration would ideally open a line of referrals from the hospitals where your clients deliver to your agencies for home visits/postpartum lactation services.
04/09/2020 Does the project need to join a breastfeeding coalition if our maternal health nurses are lactation consultants and already participate with a coalition or does their participation "count" for the activity? Their participation in the coalition counts for this activity and should be included in the RFA response and reported accordingly.
04/10/2020 On Page 42, under "Assure staff receive the most updated information on best practices" for NPM 4B, In the section on Staff Training, it says to ensure staff attendance at CEU approved training (minimum of one staff; required for Tier 2 only). Does this mean this whole block is Tier 2 only (Even though it is in the category of Required Tier 1 and Tier 2)? The whole block is Tier 1. The only activity in that block that is tier 2 is the following: Assure staff receive the most updated information on best practices: Staff Training: Ensure staff attendance at the annual WIC breastfeeding conference or other nursing CEU-approved training (minimum of one staff person; required for Tier 2 only); Includes the HCCI (CCNC) DHS approved child care provider Breastfeeding Basics training. Narrative Activity (ies) will include which staff and which conferences applicant plans to send staff to. Additionally, the HCCI training is an option for an approved training and is not an additional requirement.
04/13/2020 On page 33 of the RFA, it says we must provide services in two of the settings. We currently provide MH services at 2 separate WIC locations in a FQHC that provides OB primary/prenatal care. Would this count as 2 settings? The intent of this requirement is to reach maternal health clients in more than one way, and to offer services in ways to meet varying needs of women in your community. If both locations are seeing women via the same service delivery model (i.e. WIC), this does not meet the requirement of seeing different populations. If clients can access all services in a different way in each location, then the requirement is met. The requirement includes offering each service delivery model for all services. For example, if an applicant provides antenatal services in WIC and postpartum home visits, this would not be considered two separate service delivery models unless clients can also access antenatal services via home visit and postpartum services at WIC. Our clients have different preferences and needs, thus this approach seeks to meet clients where they are at.
04/14/2020 On p13 of the draft contract, CH performance criteria - please clarify the baseline for your definition of ECE providers. Also clarify your definintion of "serves" in that same paragraph. “For CAH Programs, the Contractor shall serve at least 37% of ECE providers in the service area. If the Contractor serves more than 37% of ECE programs in the service area between October 1, 2020, to March 31, 2021, will receive an incentive of $1,000. This performance measure will be measured using Contractor data entered into the Child Care Nurse Consultant (CCNC) Incentive Progress Report IowaGrants.gov.” p 13 of draft contract. For ECE provider baseline numbers per service area, refer to the HCCI Funding By County Attachment J. “Serves” refers to the number of ECE programs “participating” with the CCNC. Participating ECE providers have a signed Business Partnership Agreement (BPA) with the CCNC. Examples of participating with the CCNC include: onsite provider visits, onsite training, special needs care planning, etc. This performance measure also includes child care nurse consultant activities where the consultant is working on specific activities/assessments/consultation with a provider to improve quality. “Participating” does not include newsletters, mass emails to providers, general outreach, etc.
04/14/2020 We are a tier one multi-county service area and have 1 county that is wanting to provide direct services for Maternal health (tier 2). How do we note this on our application? On the service delivery table, applicants will need to select the option of providing direct services in tier 1 counties. From there, applicants will be able to indicate which county they plan to provide services in. Applicants who choose to provide direct services in a Tier 1 county, cannot provide services to Medicaid eligible clients only; and will be expected to use grant funds to provide services to non-Medicaid and uninsured clients. Applicants need to ensure they are able to complete the required infrastructure and enabling activities to address the NPMs and SPMs prior to choosing to provide direct care services.
04/15/2020 CCNC SPM 3 - "delivery" of 2 minimum required HCCI DHS approved ECE provider trainings by CCNC. What happens to us when we offer trainings and not enough sign up? What is you definition of "not enough" in the past CCR&R has indicated at least 8. I'm not sure if one is enough. What say you? Delivery of 2 HCCI DHS approved provider trainings is the minimum expectation. The CCNC will need to offer and schedule, with CCR&R, the 2 required trainings listed in the CCNC role Guidance (refer to FY20 Medication Administration Skills Competency). If a training is cancelled due to low enrollment, the CCNC should assess trainings that haven’t been offered in their service area and schedule additional training opportunities that may be of more interest to providers. Work with your CCR&R Region (and funding organization) to determine minimum training enrollment. Since CCR&R Regions set the minimum requirements, agencies should take the unique needs of their child care provider community into consideration when negotiating their minimum enrollment.
04/15/2020 p 42 Staff training ensure staff attend training on breastfeeding. Is that for only Tier 2 counties? As the instructions go on it includes CCNC. Does this mean if we are not Tier 2 we need to send our CCNC? Ours took the training in 2018. Please clarify. For this activity (related to NPM 4B), it is only required that an agency with a tier 2 county send 1 nurse to a conference that is approved for CEUs. The HCCI approved conference was just given as an example of an approved conference.
04/15/2020 Clarify IDPH defintion of maternal mortality please. I've seen different definitions. I can't seem to find any county level data on this topic. What are they dying from? What are the demographics? It would be nice to have an idea before pledging to do something about an issue with no data to create activites around. A. Definition of Maternal Mortality: Iowa Administrative Code 641 chapter 5 - A maternal death is any death occurring while a woman is pregnant or of a woman within one year after delivery. This includes but is not limited to deaths resulting from abortions, ectopic pregnancies and all deaths during pregnancy, childbirth, puerperium or deaths from complications of childbirth. B. Maternal Mortality Rates: There has been an increase in maternal morbidity and mortality nationally and in Iowa. The most recent Iowa Maternal Mortality review committee report is available at https://idph.iowa.gov/Portals/1/userfiles/38/Final%202020%20MMRC%20report.pdf and includes demographic data for Iowa, because the numbers are so low, data cannot be further broken down to the county level. The committee provides recommendations in this report for ideas to work on with populations in your service area. The following CDC data sets, and maternal mortality information, provide accurate demographic information for maternal deaths on a national level: https://www.cdc.gov/reproductivehealth/maternal-mortality/pregnancy-mortality-surveillance-system.htm?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Freproductivehealth%2Fmaternalinfanthealth%2Fpregnancy-mortality-surveillance-system.htm#trends. C. Health equity activities specifically for maternal health only require applicants to identify gaps in staff knowledge in working with specific populations and address those gaps through training.
04/16/2020 On Page 7, it lists the criteria for the funding formulas. The formula for the Medicaid Administrative Funds for Child Health does not include “Translator Needed”. However, translation services are required to provide informing and care coordination services. Can you explain why this was omitted from the funding formula? Due to the limited numbers of interpretation services documented in Signify, the formula uses a proxy measure of non-white children to estimate the potential for interpretation service needs.
04/16/2020 On Page 8, under Match Requirements, it states MH and CAH funds, including HCCI (CCNC) must be matched at a rate of 1:4. If Tier 1 agencies don’t bill for direct care services, how are matching funds generated? HCCI funds do not generate any revenue for the program, how is a match expected here? Please refer to Amendment 3 for this RFA for clarification on match. The contractor must have a total match of 1:4 for all Title V grant funds. If your agency does not bill direct MH services, revenue from billing CAH services may be used to fulfil this requirement. Because HCCI funds in this RFA are Title V Block Grant Funds, the match requirements are in place. This match can be met by ECI or other non-federal funding used for CCNC services. If your agency does not receive additional funding for HCCI services, then the match could be covered with match in the CAH budget.
04/16/2020 On Page 17, it states, “Applicants must be credentialed with a minimum of two private insurers”. So, are MH agencies not allowed to provide enhanced services, and bill Medicaid for these services if they aren’t credentialed with 2 private insurers? And is the state going to provide any guidance on the credentialing process? Federal Medicaid guidelines require that before Medicaid payment is issued, there must be a denial from private insurance for maternal health clients that have both private and Medicaid coverage. Without credentialing with private insurance, you will not receive Medicaid reimbursement for those clients. Because the major insurers are not the same in all regions of the state and do not have the same credentialing requirements, it will be up to the agency to determine which private insurers make the most sense to enroll with. The expectation is that agencies make a good faith effort to credential with two private insurers. If unsuccessful, applicants should document this and share with their regional consultant during their site visit. Title V must be a payer of last resort (IAC 641-76). In order to use Title V grant funds for women with both private insurance and Medicaid, there should be a denial from the private insurance company and Medicaid before Title V funds can be used. Thus, agencies must make reasonable efforts to credential with private payers.
04/16/2020 Please clarify: are Tier 1 agencies allowed to use MH grant funds to provide Enhanced Services. After reading the RFA, it appears this isn’t allowed. Some of the clients who are most at-risk in our service area are those who do not qualify for Medicaid. Are we now not allowed to help this population any longer because we won't be able to afford to without using grant funds? Yes, applicants may use their grant funds to provide direct care services to non-Medicaid or uninsured clients, in addition to Medicaid eligible women as you retain the ability to bill Medicaid. If applicants intend to provide direct services in a Tier 1 county, they cannot provide services to Medicaid eligible clients only, and will be expected to use grant funds to provide services to non-Medicaid and uninsured clients. Applicants must ensure that they are able to complete the required activities to address the NPMs and SPMs prior to choosing to provide direct care services.
04/16/2020 Could you provide examples of activities you are expecting agencies to develop for the “Cultural and Linguistically Appropriate Goals” sections? Yes, slide 12 of the MCAH Applicant’s Conference Training Slides.pdf (located in the Attachments section) provided one full example and a list of ideas that could be considered. If applicants would like additional examples or to talk through examples, or have an idea, please feel free to contact your Regional Consultant or Analisa Pearson.
04/16/2020 How are we to comply with “recruit membership from priority populations” for coalitions, committees, related to MCAH if we don’t have any coalitions or committees? A. If the agency does not currently have a mechanism (other than satisfaction surveys) for community input into their programs and services, this would be an opportunity to develop a committee, coalition or program planning group made up of community stakeholders and families, including those from and/or serving priority populations. Development of a group like this could help with several goals in the health equity section, as well as in other sections where family engagement is important. B. The IRS requires a 501(c)3 non-profits to have a Board of Directors. Each LPHA has requirements around hosting Community Health Needs Assessment Advisory Committees and other community health-related coalitions of which agencies could support community member engagement. C. Creating a committee or coalition could also meet requirements for the activity. “Cultural and Linguistically Appropriate Goals: Identify a minimum of one activity to address culturally and linguistically appropriate organizational goals, policies and/or management accountability.”
04/16/2020 In the MH Strategy to “Partner with Tobacco Control Community Partnerships”, it states, “Collaborate with the Tobacco Control Community Partnerships to provide community education on the impacts of smoking in pregnant women, infants, and children in the home”. Our agency already has 2 Tobacco Coalition staff outside of our agency and they provide community education as part of their grant requirements. They actually ask to come into our agency to provide the education. Wouldn’t this be a duplication of services since they are already required to provide the service? Are we allowed to report on the number of community partners they educate? For this activity, applicants must describe their partnership and how they will collaborate with them to provide outreach services specifically for pregnant women in their service area. This is something the agency may already be doing. The Department encourages applicants to report this as a partnership and include the name of the liaison. For your reference, the Department has provided a link to recent information on tobacco use in pregnant women in Iowa:https://idph.iowa.gov/Portals/1/userfiles/115/surveillance%2C%20evaluation%20and%20statistics/IowaSmokingInfographicFinals2%20Statewide%20%281%29_1.pdf.
04/16/2020 For the “Birthing Hospital Safe Sleep Collaboration”, what if hospitals are not willing to complete an audit? Most hospitals are already overburdened with their own documentation requirements. It’s hard to imagine they are going to be willing to complete an audit from an outside organization. IDPH will work with applicants to find a different activity and amend their activity worksheets accordingly. However, the Department expects to see the communication between your agency and the hospital decline for this activity prior to working with you to create a new activity. More information about how to do this audit and how to reach out to hospitals will come at the fall conference. For the purpose of the RFA, please list the hospital you plan to work with and any steps you plan to take to build this relationship. Maternal Health is focusing much of the infrastructure building and enabling work on creating partnerships and referral relationships within your communities. This activity can help to build camaraderie between public health and inpatient hospital settings, if existing relationships are not in place.
04/16/2020 When will the state office have the required” health equity related to pregnant women” training available to local agencies? This will be available by the start of the contract period.
04/16/2020 In regard to the “Educate and Connect families with resources or cribs” Strategy. Is the state implying that all service areas have resources for clients to obtain cribs at low or no cost? This is not a service available in our 5-county service area. How are we to report on a service that’s not available? Applicants should report that it’s not available, and include any steps taken to help connect or educate mothers with safe sleep options.
04/16/2020 In the Child Health section, it refers to connecting with the “Children’s Mental Health System Regions” in several places. Can you explain what this service is and who the contact people are? The expectations in regard to “system building” with this group are rather excessive considering this “system” isn’t even known in many of the service areas. The following website provides the requested information. The link can also be found on Slide 31 of the MCAH Applicant Conference Training Slides.pdf (attachment section): https://dhs.iowa.gov/mhds-providers/providers-regions/regions. The requirement for connecting with the Children’s Mental Health Systems Regions is listed twice, once under NPM 6 (page 57) and again under SPM 4 (page 70). Agencies could design an activity(ies) to accomplish both measures at the same time.
04/16/2020 It appears small agencies with limited staff almost need to hire a full-time staff person just to complete “Environmental Scans” after reading the RFA. Was this taken into consideration? It is very frustrating that there are this many changes and requirements for an RFA. Did the state consider waiting and making all these changes during the RFP? It’s difficult to even grasp exactly what needs to be done when trying to sort through a 129-page RFA and a 54-page Review Tool. A. Assessment is an important core function of public health. In order for Title V to effectively prioritize services and strategies at the local and state level, assessment of what is already happening in the community and where gaps exist is critical. An example of a way to combine the four environmental scans into one activity was provided in the Virtual MCAH Applicant’s Conference through the use of a web-based feedback survey (Google Form, SurveyMonkey, Microsoft Access, etc.). A survey could be given in hard copy if the agency prefers. In discussing the activity with some Agencies, during their already scheduled visits to these providers 1st Five, I-Smile, HCCI, CLPPP, etc., staff would conduct the survey face to face while conducting the business already scheduled. The size of the agency is likely proportional to the number of providers needing to be surveyed. Agencies with 1st Five have likely already completed the scan of health care providers, and can include that information in the report. Other community partners may also have some of this information already compiled, or may want to work jointly to obtain or update the information. The timeframe for the environmental scans was set to provide the agency the ability to prioritize and plan services for the remainder of FFY21 and in time to address needs in FFY22. B. In regards to the length of the RFA, IDPH staff took a new approach in writing the RFA to make the application more manageable as requested by agencies. Staff specifically wrote more guidance, and wrote out the specific expectations for the foundational activities and assurances, so that applicants would not need to write narrative for these activities. Activities that were required in each program were combined into a single Foundational section. The majority of the activities in the RFA are now checkboxes or short answers. Applicants will write narrative for significantly fewer activities than ever before in a Title V application. The activity worksheet sections of the application were converted from paragraph format to a table format. This results in considerably less information per page, which while adding to the overall length of the document, was designed to assist the applicant in following the requirements and writing the application. The RFA was redesigned into a linear format with all the Maternal Health information in one section, followed by the Child and Adolescent Health information, then I-Smile. Budgets were kept separate but follow the same flow as the rest of the RFA. Previous RFAs jumped back and forth between Maternal Health and Child and Adolescent Health guidance and forms. Activities that were or would have been a single activity were also broken apart for clarity. For example the environmental scan has two activities - conducting the scan and the write up, that is still essentially one activity. Educating families was broken out by topic versus a general educate families on a listing of several topics. The intent was to make the application and requirements much easier to follow, and prevent applicants from missing one or more items in a list. As you are aware, this year was originally scheduled to be an RFP; however, IDPH determined it was in the best interest to extend the current project period for an additional two years. The Title V needs assessment initiated the changes to the application. While the scope of the Title V program remains the same, the activities have changed to align with the results of the needs assessment. The Department does not expect every activity to happen on October 1, 2020 and the agency is able to propose a timeline that works for them to plan and complete the activities.
04/20/2020 Regarding informing change in hours. Please provide data source validating requirements that informing calls during non- business hours results in higher completion rates. The Department is unable to pull days and hours as Informing is not a service that requires time in/time out. Informing calls are made to chart best dates and times from signifyCommunity. In reviewing the protocols of agencies with the highest inform completion rates, those agencies provided informing during evening and weekend hours.
04/20/2020 There are 48 activities requiring extensive work, data collection and documentation in this application, not counting the optional ones. What is the estimated FTE that IDPH calculated would be needed to complete all the additional requirements? The amount of FTE will vary due to the different size and populations of the counties and service areas. Agencies should budget FTEs based on the amount of funding available.
04/21/2020 We have reviewed the funding matrix and understand how it was allocated for FY21. You indicated in the video conference this was somewhat of a trial If part of the formula continues to be based on prior year actuals, how are we assured to have enough funding from year to year? Often services increase or decrease; when would we see the effects in our allocations? The allocations will be reviewed annually based on the services provided by the agency. The benefit of allocating the funds through the formula is that you know exactly how much funding you have for the year and can budget staffing accordingly, without the variation in service numbers from month to month.
04/21/2020 FFS was based upon the number of service units provided; Medicaid Admn funds are a bulk dollar allocation based on a funding formula. Consequently, agencies will be making a change from a unit based system to primarily a staff time based system. We track this in our agency, however, are there reports available in Signify to review/compare time spent on these services to assist with the budget? There is a folder in signifyCommunity for FFS with this information. Agencies enter time in and time out for care coordination, but are not required to do so for PE or informing. Agencies may enter time in and time out for PE and Informing so that they can track time spent on these items.
04/22/2020 Will the Medicaid Administrative Funds be allowed to be retained as part of an agency's three-month operating capital balance? Yes, this is allowable.
04/22/2020 On the conference call, a question was asked in regard to Tier 1 MH agencies providing enhanced services and if they could pick and chose which services to provide. State staff mentioned “minimum required services”. Could you please indicate what the MH “minimum required services” are for a Tier 1 agency? Minimum services expected would be the current required MH services (prenatal risk assessment, health education, psychosocial and/or home visit, dependent on the service model used by the agency). IDPH understands there may be instances in which Tier 1 agencies would not provide these services, and therefore intend to work directly with applicants proposing direct services in Tier 1 counties to develop a direct services protocol in October 2020. Examples of reasons agencies may not provide all required services include providing lactation classes only, providing postpartum home visits only, or to avoid duplication with another agency providing the same service(s). Applicants should select all services they intend to provide and will be expected to develop a protocol for how services will be provided.
04/22/2020 It was not possible to read the Narrative Examples during the conference call due to them being so lengthy and the PowerPoint being forwarded to the next slide so quickly. Now that agency staff can read them, based on the examples provided, it appears the state staff have expectations for local staff to begin building some of these “partnerships” prior to October 1. Several examples state, “Project Director has reached out as a part of this application” and “Initial Meeting to define mutual goals and collaboration opportunities will occur prior to start of Contract”. The contract period for these new requirements is from October 1, 2020 – September 30, 2021. Are you expecting local agencies to start on these new required “partnerships” prior to the contract period? We already have FY’20 requirements that we are struggling to accomplish, particularly with having a Public Health Emergency that we are dealing with. Shouldn’t these initial contacts and meetings be part of the FY’21 action steps? Agencies are not required to conduct FFY21 activities prior to FFY21.
04/22/2020 In the state example for NPM 10: Adolescent Well Visit, the example given states, “agency will provide meal and pay families a stipend for participation”. Is this something that is really expected? Are the examples given in these narratives even realistic? Is there a reason that the bulk of these changes and added activities are in the Child Health section? A. Engaging families and community partners will often require mutual goals that meet the needs of the family or other organization. Agencies should anticipate compensating individuals for their expertise and time. If an agency is able to engage their target population through meeting another of the population’s goals or needs that is fine. It is standard practice to provide an incentive or stipend for this type of work. B. Examples were crafted based on similar work already being done. The examples listed for Adolescent Well Visit were based on the work IDPH and agencies performed in 2017-2018 as part of the Adolescent and Young Adult CoIIN. Agencies are not obligated to use the examples provided. C. The Maternal Health and I-Smile programs are more clinical/direct care focused programs, providing direct care services not available through primary care providers (psychosocial, extensive health education, listening visits, etc.), or are largely unavailable to children and pregnant women due to a lack of dentists providing care to Medicaid and uninsured clients. Children and adolescents in Iowa do not have the same lack of access to services as the other two program areas. There is not currently a lack of primary care providers to provide well child visits and screening services. Therefore, the Child and Adolescent Health Program is much more focused on the Public Health Services and Systems and Enabling levels of the MCH pyramid. SPM 4 would be the exception as there is a demonstrated need for additional mental health service providers and provision of mental health direct services. The needs assessment demonstrated change in needs for children and adolescents in two areas, lead screening and adolescent mental health. Developmental screening and Adolescent Well Visit were both identified in the previous needs assessment, as well as the current assessment demonstrating additional, ongoing work is needed. Therefore, those are the areas that Title V will focus on providing public health services and systems, enabling and gap filling services.
04/22/2020 During the conference call, state staff mentioned they were aware of the difficulty MCH agencies were having with becoming credentialed with private insurers. Yet, you are now requiring applicants to be credentialed with a minimum of two private insurers. Can you explain why you are requiring something that you are admitting is a barrier for local agencies? Federal Medicaid guidelines require that before Medicaid payment is issued there is a denial from private insurance for maternal health clients that have both private and Medicaid coverage. Without credentialing with private insurance, you will not receive Medicaid reimbursement for those clients. Because the major insurers are not the same in all regions of the state and do not have the same credentialing requirements, it will be up to the agency to determine which private insurers make the most sense to enroll with. The expectation is that agencies make a good faith effort to credential with two private insurers. If unsuccessful, applicants should document this and share with their regional consultant during their site visit. Title V must be a payer of last resort (IAC 641-76). In order to use Title V grant funds for women with both private insurance and Medicaid, there should be a denial from the private insurance company and Medicaid before Title V funds are used. Thus, agencies must make reasonable efforts to credential with private payers.
04/22/2020 Will the state be providing examples of the various “Environmental Scans” that are to be completed? For the amount of time it is going to take local agencies to get a grasp on exactly what is required for each of them, it would be more efficient for state staff to develop exactly what they’re expecting local agencies to collect. MCH staff will develop examples of environmental scans by October 1, 2020. Because the needs and resources are different in each service area, it will likely be necessary for the contractor to modify or add to the examples prior to administering the scan/survey.
04/22/2020 One of the state comments during the conference call was in regard to, “Families prefer a one-stop shop, trust MCH staff and rely on us to provide the services”. However, it appears the state is taking away the option for local agencies to continue to provide a one-stop shop and want us to focus on “Environmental Scans” and educating outside organizations/agencies on how to provide the quality services that we are currently providing. Is this where the future of Title V services is heading? A. The statement above was made during the discussion of the need to provide a justification for providing direct services in the Child and Adolescent Health Service Delivery Table. The statement was made as an example that would not meet criteria as justification for providing services, as this would be true of primary care providers, as well. B. Title V is a medical home model. This is not a change or new direction for Title V. All services that can be provided in the medical home should be included in the medical home. The vast majority of time and resources of Title V agencies should be spent in Public Health Services and Systems (environmental scans, partnerships and education with community organizations and primary care providers) and Enabling activities to decrease barriers, increase access and quality of services in the medical home. Refer to page 24 of the original RFP for more information on the MCH Pyramid of Services. C. Direct care services are intended to be gap filling only.
04/23/2020 In the Foundation strategies for Local Boards of Health assurances, hiring or contracting with interpreters and/or bilingual staff is required. Because of Joint Commission, JACHO restrictions, this is not an option for our agency, please advise on meeting this assurance. A. This is not a new requirement, interpretation has been a required service. In order to better address this question we would need to know the restrictions prohibiting the hiring or contracting of interpreters or bilingual staff that are being cited as part of these accrediting bodies. B. All providers who receive federal funds from HHS for the provision of Medicaid/CHIP services are required to make language services available to those with Limited English Proficiency (LEP) under Title VI of the Civil Rights Act and Section 504 of the Rehab Act of 1973. C. Agencies typically rely on the use of telephonic interpretation services. However, if telephonic interpretation does not meet the needs of the client or is not possible in a situation, the agency is expected to provide interpreter services through hiring or contracting with an interpreter. D. Clarification: This requirement is foundational under Addressing Health Disparities not Local Boards of Health.
04/23/2020 Looking to explore opportunities to provide culturally and linguistically appropriate materials for reminders. We do not have a very diverse population. The Hawki information letter has a "minority statement and resource at the bottom" Not understanding fully how this works, is there any information already out there about how we can incorporate something like this in well child reminders, immunization reminders etc. There are many resources related to providing culturally and linguistically appropriate materials readily available. Some that an agency could use include: https://www.cdc.gov/ncbddd/disabilityandhealth/pdf/disabilityposter_photos.pdf or https://www.un.org/en/gender-inclusive-language/guidelines.shtml or https://thinkculturalhealth.hhs.gov/clas.
04/23/2020 We are a Tier 1 agency with a MH client base of approximately (15). Why are we required to spend time and effort to credential with (2) private insurers? Often this process takes several weeks and we have no guarantee the provider will allow us to bill services, particularly due to low utilization. Currently MCOs rarely pay for these services. Is there an alternative solution? Federal Medicaid guidelines require that before Medicaid payment is issued there is a denial from private insurance for maternal health clients that have both private and Medicaid coverage. Without credentialing with private insurance, you will not receive Medicaid reimbursement for those clients. Because the major insurers are not the same in all regions of the state, it will be up to the agency to determine which private insurers make the most sense to enroll with. The expectation is that agencies make a good faith effort to credential with two private insurers. If unsuccessful, applicants should document this and share with their regional consultant during their site visit. Title V must be a payer of last resort. Since services provided to clients with private insurance and Medicaid will need to be covered by Title V grant funds, agencies must make reasonable efforts to credential with private payers.
04/23/2020 For the Tier 1 MH services, it is not clear what the minimum direct services are that were referenced several times in the power point presentation. I cannot find the documentation in the guidance. I can foresee some areas that might benefit from depression screening when other direct services are all being provided by others. This is not clear. Minimum services expected would be the current required MH services (prenatal risk assessment, health education, psychosocial and/or home visit, dependent on service model agency uses). IDPH understands there may be instances in which Tier 1 agencies would not provide these services, and therefore intend to work directly with applicants proposing direct services in Tier 1 counties to develop a direct services protocol in October 2020. Examples of reasons agencies may not provide all required services include providing lactation classes only, providing postpartum home visits only, or to avoid duplication with another agency providing the same service(s). Applicants should select all services they intend to provide and will be expected to develop a protocol for how services will be provided.
04/23/2020 What if you have areas without low and no cost cribs? Pg. 44 Enabling Services Educate and Connect families with resources for cribs. Applicants should report that this service is not available, and include the steps taken to help connect or educate mothers with safe sleep options.
04/23/2020 In many rural counties in Iowa, there are no retailers selling/displaying infant sleep items. What do we do with this requirement on page 44 for those counties? This was only given as an example, any community organization or business working with pregnant women, new parents, fathers, and/or grandparents who may be watching infants is an acceptable partner for this activity. This could include resellers, social media swap pages, and parenting groups.
04/23/2020 With the number of assurances required (at least 90) and the large number of lengthy narratives required, there seems little time or staff to provide any services beyond these requirements. It hardly seems like a 128 page application should qualify as a part of the original RFA as a renewal. With the public health scenario that we are faced with at this time and the likelihood that it will continue for at least a year to come, it seems this will all be beyond the limits of the local agency’s, as well as IDPH’s time. Can this application be revisited to take a realistic approach? The current RFA is based on the results of the Title V Needs Assessment and the capacity assessment that was completed by MCAH agencies at the Fall Seminar. Because of the changes required to meet federal requirements, the Department does not plan to make major changes to the requirements. Applicants activity worksheet should reflect the work that your agency can adequately accomplish to meet the requirements of the RFA.
04/23/2020 6In deaing with large system-wide medical practices, how do we propose we change their protocols for seeing adolescents? Many of their protocols are not made locally. Meeting with local providers/office managers/staff to learn their current practices and what protocols they follow would be a recommended first step. If protocols/practices do not meet best practices, educating local providers/office managers/staff on best practices. Then finding out the interest level of providers/office managers/staff to make changes toward best practices, and what practices can be changed at the clinic level. Finally, working with and supporting clinic staff to advocate for those changes through their chain of command.
04/23/2020 In the CAH delivery table, you can only pick one service. If you are doing lead screening you can bill lead analysis, E&M, etc. So do we do the table more than once for that? Applicants can add all counties and sites where they are providing the service, so they only need to fill the service out one time. However, applicants will need to repeat to add another service. The Department will try to put combinations together in the next RFA so applicants don’t have to repeat the table information for a combination service. Since applications have already been started, the agency will be unable to correct this feature for this year. For example: If applicants are providing lead testing in 3 counties and at 2 sites within each county, all 6 sites can be listed under a single line for “lead analysis”. Applicants would then need to add those 3 counties and 6 sites again under the E&M service.
04/23/2020 In the I-Smile Budget 1 & 2 it ask how many hours per year. Should the number of hours in both budgets be the same or do you want the number of hours that will be worked during each budget period? Yes, the number of hours per year for contracted providers should be the same on both I-Smile 1 and I-Smile 2. For salaried staff applicants do not need to include the hours per year. See RFA pages 117 and 119.
04/27/2020 Can you please define what is meant by "outside normal business hours" on page 51 and 54 of the RFA? Our normal hours are 8-4:30pm Mon-Fri. So anything after 4:30pm Mon-Fri or weekends would count as "outside normal business hours"? The purpose of this requirement is to reach families that may work traditional daytime hours. In general, normal business hours would be around 8:00-5:00, but may vary based on the hours of operation of your agency. So to have hours outside of normal hours, the applicantwould need to hold office hours into the evening (past 5:00) or over the weekends. Sufficient evening and weekend hours to provide informing follow ups for all eligible clients will be needed. Agencies should consider typical commute times to make hours meaningful and effective in reaching families. For example, only making calls until 5:30 pm may not actually increase the agency's inform completion rates.
04/28/2020 Seeking to reaffirm - the only way you'll know if we intend to provide developmental screenings is to list that on the CAH service delivery table, correct? Yes, including gap-filling direct services in the Service Delivery Table is sufficient. An applicant may include a gap-filling direct service as part of a Public Health Services and Systems or Enabling activity narrative if there is something special you want to describe or it is part of another strategy - a special population, a new partnership that will include screening, etc.
04/29/2020 Under "Required Direct Care Services" for Tier 2 Maternal Health in the guidance, it doesn't delineate that if a pregnant woman scores "low risk" she would not be eligible for all of the services. Should we be enrolling those low risk women in Maternal Health? Or should there be a different listing of required services between low and high risk patients? What is the difference between "care plan" and "individualized care plan"? If the patient enters the Maternal Health program, but then "no shows" and eventually drops off, how is the "postpartum follow up" to be completed? I am thinking we will need additional guidance from IDPH on "postpartum follow up" for those situations. Thank you! a. MH agencies may still enroll low-risk women into the maternal health program, they would not receive services designated for high risk clients (psychosocial and nutrition education). This does not need to be specified in the service delivery table, applicants are indicating which services are available to clients, when appropriate, in this form. b. The individualized care plan is a requirement of Medicaid for high risk clients, and is the same as the required “care plan” referred to for maternal health services. c. Postpartum follow up will be documented in Signify. Guidance will be provided to agencies once this functionality is available in Signify. If the client is “no show” or lost to follow up, discharge them from the Maternal Health program, complete the outcome summary, and indicate in Signify the reason they were discharged before completing the program. In cases of “no show” or lost to follow up, it is recommended that applicants still attempt a follow-up call after the client’s due date, however agencies are not required to do post-partum follow up on clients who are lost to follow up.
04/29/2020 Under the "Optional Tier 2 Services" for Maternal Health, we provide domestic violence, drug/alcohol screening, tobacco screening, as well as brief intervention as appropriate. Do we really need to enter all of those services separately? Or can we just list "alcohol/substance abuse screen with brief intervention", even though not all patients would receive the brief intervention? The service(s) applicants select depends upon what you are billing. Refer to the Maternal Health Services Summary for which codes are billed for the different options for these screenings. If applicants screen all clients with the intent to provide brief intervention when appropriate, they only need to select “alcohol/substance abuse screen with brief intervention”. The annual alcohol screening and alcohol screening and/or drug screening should be selected if only providing the screen but do not use SBIRT. Applicants should select domestic violence screening separately. Tobacco screening is included in the required Tier 2 direct services.
04/29/2020 Under the "Optional Tier 2 Services", "Lactation Classes" are listed. We do not provide "lactation classes", but we do provide individualized breastfeeding support with our certified lactation counselors. How do you want us to indicate that service? We also provide individualized childbirth classes for those pregnant women who need that need extra support which is not available in group childbirth classes. How would you like us to indicate that through the "Optional Tier 2 Services"? The “Lactation Classes” option in the Optional Tier 2 Services section is intended for applicants who will bill Medicaid specifically for the Lactation Class service. This service is only intended for those agencies that are providing group-based Lactation education. The individual breastfeeding support and individualized childbirth classes should be provided as part of the health education service or a home visit depending on the model your agency uses. The content of the applicants health education will be included in their agency's direct care protocol that will be developed in the new contract year.
04/29/2020 Under "Optional Tier 2 Services", our Maternal Health team provides lots of health education regarding nutrition, appropriate weight gain especially for obese clients. We are struggling with this form as we feel we need more definition as to what those services should entail to assure we receive the appropriate credit for the services we provide. Are these supposed to be services we can actually bill and receive reimbursement for providing? Or services we provide health education on for our pregnant patients regardless of reimbursement? The form seems a little redundant to enter the same information for each service. Thank you for the clarification! If these topics are included in your agency’s general health education, they would not need to be listed separately, but will need to include the topics included as part of your direct care protocol (which will be developed after October 1, 2020 with IDPH guidance). Applicants who intend to bill Medicaid for those specific services separately from health education or psychosocial services should select them separately. Nutrition counseling must be provided by a dietitian. When appropriate, Obesity Counseling provided by a licensed dietitian or an RN may be billed. IDPH will be providing training on the new 5-2-1-0 education tool kit for pregnant women and providing the tool kit. This should help staff who will be providing Nutrition or Obesity Counseling.
04/29/2020 Under the "Maternal Health Activity Worksheet", I feel like we need a little more clarity for the narrative section. Are we to just describe how we are going to accomplish that activity? Are they to be written as SMART goals and activities with a timeline? Evaluation methods are indicated in the guidance. Are those what we will be evaluated on? (ie. Number of pregnant women referred to Quitline. I am not sure this is measurable through Signify.) Specific steps that will be taken to accomplish the requirements outlined in the RFA should be included in the narrative activities. This should include specific partners as applicable, and any additional details as to how the activity will be accomplished. Applicants do not need to identify how activities will be measured as this has been determined by the Department. The Department will ensure there are mechanisms to track measures and training for agency staff on ensuring appropriate documentation to meet these requirements.
05/04/2020 We noticed that in Amendment #6, all of the Environmental Scans had been removed as a requirement except for the blood lead test environmental scan (page 68). Was this an error or should we still plan on completing this environmental scan? Contractors will still be required to do the environmental scan related to lead screening.
05/05/2020 In Amendment #6, Section F, it is noted "due to changes in the required activities, the CAH column of the funding table has been updated and reposted". IDPH reduced overall CAH funding by $85,000. How did IDPH determine that a 7% reduction in CAH funding per agency was appropriate? How will those funds be used at the State level? To carry out the activities in the federal Title V work plan, the reduction was made to allow for the Department to contract with an outside entity to conduct the three environmental scans that were removed from the RFA. The amount was based on other evaluation and data analysis contracts held within the Bureau of Family Health.
05/07/2020 Our agency is currently providing direct maternal health services, but with the changes in this RFA and lack of payment from MCO's for FY21 we will only be providing Tier 1 services. How will we work with women that we enroll in FY20 but will be delivery during the FY21 grant cycle? Do we need to enter the direct services on the service delivery table even though all new women enrolled during the FY21 grant cycle will not be offered direct services? Applicants who will not be providing MH direct services in FFY21, do not need to enter services into the service delivery table. To close out currently enrolled clients, applicants will use their FFY20 service delivery table as the basis for service delivery. Because each agency’s service delivery model may be different, please reach out to your IDPH regional consultant for assistance with discontinuation of MH services.
 
 
 
 
 
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