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  Funding Opportunity Details
 
 -450352-FY23 RFP 58823005 for Child and Adolescent Health and Oral Health Programs
  Title V Services
  Application Deadline: 06/15/2022 4:00 PM
 
 
Award Amount Range: Not Applicable
Project Start Date: 10/01/2022
Project End Date: 09/30/2023
Award Announcement Date: 08/17/2022
Eligible Applicant: See Section 1.03 of the RFP Document
Program Officer: John McMullen
Phone: 515-380-2968 x
Email: john.mcmullen@idph.iowa.gov
Categorical Area: Child Health
 
 
Description
 
 

It is the responsibility of the Applicant to review all Attachments listed below for additional details regarding this Funding Opportunity.

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

Excerpts from the RFP:

Purpose

The purpose of this Request for Proposal (RFP) # 58823005 is to solicit applications that will enable the Iowa Department of Public Health (referred to as Department) to select the most qualified applicant to provide public health services at the community level for Child & Adolescent Health (CAH) services. CAH services include Hawki Outreach, Early ACCESS, Healthy Child Care Iowa (HCCI), and I-Smile™. The I-Smile™ program also includes I-Smile™@ School.

Schedule of Important Dates

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

to change them.

EVENT

DATE

RFP Issued 

April 06, 2022 

Written Questions and Responses

 

Round 1 Questions Due:

Responses Posted By:

April 20, 2022 

April 27, 2022 

Round 2 Questions Due:

Responses Posted By:

May 11, 2022 

May 18, 2022 

Final Questions Due:

Responses Posted By:

June 01, 2022 

June 08, 2022 

Applications Due

June 15, 2022 by 4:00 PM Local Iowa Time

Post Notice of Intent to Award

August 17, 2022

 
 
 
 Attachments
 
 Click on the File Name to open attachment
 
Description File Name File Size
A. RFP 58823005 Child and Adolescent Health and Oral Health Programs A. RFP 58823005 Child and Adolescent Health and Oral Health Programs.pdf 6.4 MB
B. IowaGrants Registration Instructions Updated 2016 B. IowaGrants Registration Instructions Updated 2016.pdf 873 KB
C. IDPH Application Instruction Guidance 2016 C. IDPH Application Instruction Guidance 2016.pdf 1.9 MB
D. FY23 Child and Adolescent Health and Oral Health Programs RFP Draft Contract D. FY23 Child and Adolescent Health and Oral Health Programs RFP Draft Contract Template.pdf 319 KB
E. Phase 1_ Child and Adolescent Health Draft Technical Review Tool E. Phase 1_ Child and Adolescent Health...pdf 91 KB
F. Phase 2: Child and Adolescent Health and Oral Health Programs RFP Draft Application Score Tool F. Phase 2_ Child and Adolescent Health and Oral Health Programs RFP Draft Application Score Tool (1).pdf 305 KB
G. Funding Allocation Table G. Funding Allocation Table.pdf 96 KB
H. CCNC FTE & Funding H. CCNC FTE & Funding.pdf 220 KB
I. SPM 3 CAH FY21 Data I. SPM 3 CAH FY21 Data.pdf 59 KB
J. HCCI DHS Approved Trainings 03242022 final J. HCCI DHS Approved Trainings 03242022 final.pdf 466 KB
K. Lead Data K. Lead Data.pdf 483 KB
L. I-Smile Partnership Assessment Tool FFY23 L. I-Smile Partnership Assessment Tool FFY23.pdf 500 KB
M. I-Smile @ School Minimum Screening Requirements M. I-Smile @ School Minimum Screening Requirements.pdf 97 KB
N. Frequency of services for clients age 0-2 N. Frequency of services for clients age 0-2.pdf 549 KB
O. Collaborative Service Area Census 2020 Race and Ethnicity Data O. Collaborative Service Area Census 2020 Race and Ethnicity Data.pdf 149 KB
P. Dental Care Coordination Protocols P. Dental Care Coordination Protocols.pdf 114 KB
 
 
 Website Links
 
 Click on the URL to go to website
 
URL Description
http://www.cdc.gov/vaccines/schedules/hcp/index.html A. ACIP Immunization Schedules
http://shop.aap.org/hpv-vaccine-when-why-and-how/ B. American Academy of Pediatrics HPV Training: HPV: When, Why, and How
http://datacenter.kidscount.org/data/tables/9287-uninsured-children?loc=17&loct=5#ranking/5/any/true/1984/any/18370 C. The Annie E. Casey Foundation - Kids Count Data Center - Uninsured Children in Iowa
http://idph.iowa.gov/Portals/1/userfiles/106/Screening_Tool_and_Guidelines_v09-2021.pdf D. Blood lead testing guidelines
http://iowaccrr.org/data/2018_county_data_sheets/desert-data-2018/ E. Child Care Desert Data
http://www.idph.iowa.gov/hcci/consultants F. Child Care Nurse Consultant (CCNC) Role Guidance
http://www.iafamilysupportnetwork.org/families/child-development/ G. Child development page
http://www.cdc.gov/vaccines/schedules/hcp/index.html H: Childhood Immunization Schedules for birth through 18 years
http://idph.iowa.gov/Environmental-Health-Services/Childhood-Lead-Poisoning-Prevention I. Childhood Lead Poisoning Prevention Program
http://idph.iowa.gov/Portals/1/userfiles/106/FY21-CLPPP-Service-Area-Map.pdf J. CLPPP Service Area Map/Childhood Lead Poisoning Prevention Programs (CLPPP) in the CSA
http://idph.iowa.gov/family-health/CSA K. Collaborative Service Areas (CSAs) Map
http://dhs.iowa.gov/contract-terms L. DHS Terns for Service Contracts
http://www.iafamilysupportnetwork.org/families/early-access/ M. Early ACCESS webpage
http://www.minorityhealth.hhs.gov/assets/pdf/hhs/HHS_Plan_complete.pdf?utm_campaign=fyi_newsletter&utm_medium=email&utm_source=govdelivery N. HHS Action Plan to Reduce Racial and Ethnic Health Disparities
http://idph.iowa.gov/finance/funding-opportunities/general-conditions O. IDPH General Conditions
http://idph.iowa.gov/immtb/immunization/data-and-reports P. IDPH Immunization Annual Report
http://idph.iowa.gov/immtb/immunization/iris Q. Immunization Program?s IRIS Website
http://www.insurekidsnow.gov/ R. Insure Kids Now
http://www.legis.iowa.gov/DOCS/ACO/IAC/LINC/4-6-2011.Rule.441.79.3.pdf S. Iowa Administrative Code 441 Chapter 79.3
http://www.legis.iowa.gov/law/administrativeRules/rules?agency=641&chapter=76&pubDate=12-01-2021 T. Iowa Administrative Code 641 Chapter 76
http://www.legis.iowa.gov/docs/iac/rule/641.77.3.pdf U. Iowa Administrative Code 641 Chapter 77.3(137)
http://www.legis.iowa.gov/docs/code/2016/135.157.pdf V. Iowa Code Section 135.157
http://das.iowa.gov/state-accounting/travel-relocation/state-travel W. Iowa Department of Administrative Services In-State Travel
http://www.iowaepsdt.org/iowa-epsdt/periodicity-schedule/ X. Iowa EPSDT Dental Periodicity Schedule
http://www.iowaepsdt.org/ Y. Iowa EPSDT Website
http://www.iafamilysupportnetwork.org/ Z. Iowa Family Support Network website
http://www.iafamilysupportnetwork.org/families/printed-materials/ Z1. Iowa Family Support Network Printed Materials
http://www.iowagrants.gov/index.do Z2. IowaGrants.gov Electronic Grant Management System
https://stophtiowa.org/certified-locations Z3. Iowa Office to Combat Human Trafficking (certified lodging)
http://tracking.idph.iowa.gov/Health/Immunization/Childhood-Immunizations/Childhood-Immunization-Data Z4. Iowa Public Health Tracking Portal
http://www.cdc.gov/ncbddd/actearly/index.html Z5. Learn the Signs. Act Early
http://idph.iowa.gov/Environmental-Health-Services/Childhood-Lead-Poisoning-Prevention/Providers-Labs-and-Schools/School-Lead-Screening Z6. Mandatory Blood Lead Testing
http://idph.iowa.gov/Environmental-Health-Services/Childhood-Lead-Poisoning-Prevention/Providers-Labs-and-Schools/Mandatory-Reporting Z7. Mandatory Reporting of Blood Lead Test Results
http://drive.google.com/file/d/10CD9vUhSeC9SnZOAnHNFe8b-PhFbP6D4/view Z8. MCAH Data System User Manual - General Information
http://drive.google.com/file/d/1YbNcLhGxpdd-WESLStD2urwAddB6cQhT/view Z9. MCAH Data System User Manual - Child and Adolescent Health
http://www.cdc.gov/ncbddd/actearly/milestones-app.html ZZ1. Milestone Tracker App
http://www.nashp.org/wp-content/uploads/sites/default/files/Engaging_Parents_as_Partners_0.pdf ZZ2. National Academy for State Health Policy Tiered Approach to Family Engagement
http://dhs.iowa.gov/ime/providers/tools-trainings-and-services/medicaid-initiatives/pe ZZ3. Presumptive Eligibility
http://dhs.iowa.gov/sites/default/files/470-5200%20Application%20for%20Certification%20to%20Become%20a%20Qualified%20Entity_0.pdf ZZ4. Qualified Entity
http://dhs.iowa.gov/sites/default/files/Scenter.pdf?111620212124 ZZ5. Screening Centers Providers Manual
http://idph.iowa.gov/Portals/1/userfiles/88/2023%20Title%20V%20Administrative%20Manual.pdf ZZ6. Title V Administrative Manual - draft
http://data.census.gov/cedsci/table?q=United%20States&t=Disability&g=0100000US_0400000US19%240500000&tid=ACSST5Y2019.S1810 ZZ7. US Census ACS 2019 5 Year Estimates Table
http://idph.iowa.gov/immtb/immunization/vfc ZZ8. Vaccine for Children (VFC) program
http://www.iowadatacenter.org/data/decennial/2020-race-ethnicty ZZ9. 2020 Census Data
http://www.hhs.gov/sites/default/files/ocr/privacy/hipaa/administrative/combined/hipaa-simplification-201303.pdf ZZZ1. 45 CFR part 160 and 164
 
 
Questions
 
 
Submitted Date Question Answer
04/11/2022 For I-Smile@School, are we required to offer direct services to every school that qualifies at or above 40% F&R lunch? In previous years we have been able to choose between providing education only or direct services. If a school qualifies that is "online", are we required to provide services? Yes, all students in 2nd and 3rd grades in all schools with 40% or higher free and reduced lunch rates must be offered program services, which includes oral screenings, risk assessments, fluoride varnish, and sealants. (RFP page 99 and 104)

No, schools that are only “online” are not required to have I-Smile @ School services provided.
04/15/2022 Are all lead tests sent through the state hygienic lab reported to to IDPH automatically? Yes, all blood lead tests analyzed by the SHL are electronically submitted to IDPH and directly uploaded into HHLPSS. If not using the SHL for analysis, Applicants should contact any labs they are using to process specimens collected through the CAH program to ensure they meet state and federal requirements, and to understand the process the lab uses for processing and reporting results.

Section 2.08B.9 (p. 71) Notification of Department: Applicants providing blood lead testing must: Ensure compliance with mandatory test reporting by providing results of all blood lead tests to the Department, specifically to the IDPH Lead Poisoning Prevention Program regardless of results; Document notification of the Department in the MCAH data system.
04/19/2022 On page 86 of the application, item "e" under #2 states "Applicants are to spend a minimum of 25% of this staff time conducting outreach and PE outside regular business hours" - is that percentage evaluated weekly, monthly, quarterly or at the end of the year? Monthly
04/22/2022 Guidance for HCCI, page 82; 8. Training: the successful applicant shall assure that each CCNC will offer a minimum of four (one each quarter) HCCI DHS approved trainings annually. Please clarify: if the CSA directly employs one CCNC to cover the majority of the area and subcontracts with another agency for a CCNC to provide services in one county (with that contracted CCNC also providing services for a different CSA), do both of these CCNCs have to provide the four trainings? Or is the requirement meant to ensure four required trainings within each CSA, regardless of which CCNC provides them? To further clarify our question, does this requirement mean that we have 2 CCNCs providing services, we must provide 8 required trainings within our CSA? Each CCNC employed or contracted to provide services in the CSA is required to provide at minimum 4 HCCI DHS approved trainings (one each quarter). For example if the CSA has 2 CCNCs employed/contracted providing services a minimum of 8 trainings are required to be offered.
04/22/2022 Grant funding appears lower this year as compared to the 2017 levels used to pre-plan subcontracts, etc. Federal Title V funds appear to have stayed level to slightly increased. Is there an explanation for the reduced funding? The reduced Title V funding is a result of the reduced scope of work related to Title V NPMs and SPMs based on feedback received over the past few years from current contractors. Examples of this reduction in scope of work include working with primary care providers to increase the quality and capacity of screening services in the community, and the work related to advancing NPM 10 (adolescent well visits) and SPM 4 (adolescent mental health). This funding and associated work is being routed through other mechanisms.
04/22/2022 Can RDH and other health-related staff be crossed trained as phlebotomists to complete lead screenings while providing services in the community? Other health-related staff: The CAH program does not dictate who may provide blood lead testing. All qualified and trained staff covered by the standing order may provide blood lead testing. All staff must operate within their scope of practice.

RDH: Per Iowa Administrative Code, phlebotomy is not currently listed within the services that can be provided under public health supervision for a dental hygienist (RDH).
04/22/2022 Can programs co-located with CLPPP programs utilize those CLPPP staff to complete offer lead testing to the required age groups in required counties? “Applicants shall partner with all Childhood Lead Poisoning Prevention Programs (CLPPP) in the CSA in testing assurance and promotion of lead poisoning prevention.” (Section 2.08-B.4.p. 68) Applicants may partner in different ways, for example the CAH program could focus on testing and education of 12<36 month olds, while the CLPPP focuses on testing and education for children 36 months and older. The partnership could be coordinating sites and times available so that one program is offering day hours and one is offering evening and weekend hours, or testing is offered in a variety of locations in the county to be more accessible to families who struggle to access their medical home for blood lead testing. Contractors must ensure that all appropriate legal agreements are in place prior to sharing any confidential data between programs.

“The applicant is permitted to subcontract for the performance of certain services required under the contract.” (Section 1.18 A. p. 15) Applicants may subcontract with the CLPPP program to provide additional testing of 12<36 month olds, but need to ensure the testing is in addition to what the CLPPP offers.

CAH applicants are responsible for the work, services, and requirements related to blood lead poisoning prevention outlined in this funding opportunity. Applicants can not claim the testing already being done by the CLPPP or any other programs in their CSA to absolve the applicant of needing to provide testing in required counties. “Applicants must describe what is currently being done in each county of the CSA for blood lead testing of children and how the applicant will further expand blood lead testing for clients ages 12<36 months.” (Section 2.08-C.2 p 72) Applicants shall describe what testing CLPPPs, health departments, other organizations, and the applicant are currently providing in each county of the CSA.Then describe how the applicant will further expand blood lead testing. The current testing available in the community has resulted in testing rates that fall below the state goal/state average, generating the required testing in this funding opportunity.

Contractors may not “double dip” by providing one service and billing two payment sources (CLPPP grant funds and CAH grant funds, etc.) for that service, nor supplant existing funds. “Title V and Medicaid Administrative Funds (MAF) shall not supplant other funds. Applicants with programs/funding from other sources to support the same or similar health outcomes and activities (Childhood Lead Poisoning Prevention Program, Immunization grantee, HeadStart, United Way, etc.) shall disclose this information in the application. The work plan for this RFP shall either only include the activities that are planned and funded by this RFP or shall specifically describe how this RFP will add new or enhanced services to the other program. Funds may be braided, but what is funded by each program/funding source shall be clearly and distinctly identified. For example, an applicant has an Immunization promotional campaign planned as part of their Immunization grant. The applicant shall not cite that promotional campaign to meet the requirement to promote immunizations in this RFP. If the applicant wants to add CAH funding to the campaign and enhance the campaign in cooperation with their Immunization Program that is allowable. The applicant must clearly cite the enhancement. ‘The immunization grant is funding four bus wraps for the campaign. CAH funds will add two additional bus wraps for buses that run in neighborhoods with higher populations of African American/African/Black and Hispanic/LatinX’.” (Section 2.01-C Form Instructions 11.e.xvi p. 37)
04/22/2022 The CCNC FTE guidance is confusing. The RFP document, requires 0.4 FTEs for CCNC (page 81), but the table in the CCNC FTE document specifies 2.4 FTE CCNC for CSA 14. Which is it? All CCNCs in the CSA must work in the role a minimum of 0.4 FTE. The CCNC FTE and Funding document includes the recommended total CCNC FTE for the CSA based on the total number of ECE providers.
04/27/2022 When applying for I-Smile funds, if our I-Smile Coordinator is also an I-Smile Silver Coordinator and currently splitting her time, how should this be addressed in our application for meeting the minimum time requirements? Per the RFP (page 93) " I-Smile™ Coordinators must work at least 32 hours a week on activities to build local public health system capacity and to ensure enabling and population-based OH services are provided." Your CAH application must meet these minimum requirements regarding the I-Smile™ Coordinator's time spent on the I-Smile™ program.
05/02/2022 On page 81, #1 states successful applicants shall provide CCNC FTE based on the ECE provider count in the CSA counties, with a reference to Attachment H for recommended number of FTEs. Is the CCNC FTE listed in Attachment H recommended or required for the CSA? Recommended based on the number of ECE providers and CCNC year end data.
05/02/2022 For the statement “CCNCs must work a minimum of 0.4 FTE”, is the requirement to have a minimum of 0.4 FTE for the CSA, or per individual working as a CCNC? The 0.4 FTE is the minimum FTE per individual CCNC, as established in the CCNC Role Guidance.
05/06/2022 In 2.07-B Immunization Promotion Work and Services section, #6 on page 63, the RFP states “The service of vaccine administration also includes related assessment, education, anticipatory guidance, and follow-up”. What is expected for follow-up? Follow-up" in relation to immunization administration includes, but is not limited to:

1. making plans for subsequent doses of the vaccine, either through the contractor or another location, (2.07-B, 3)

2. making plans for other vaccines not offered at the contractors location, if applicable to the patient, and (2.07-B, 3)

3. documenting doses in IRIS and providing documentation to the client/family. (2.07-B, 3)

4. providing enabling services such as assisting the family in establishing a medical home, and accessing health care coverage including Presumptive Eligibility, care coordination, transportation and interpretation services, as needed. (2.07-B, 5)
05/06/2022 Are incentives (e.g., gas cards, store gift card) to promote equitable focus group attendance as part of a workplan activity or food purchased for consumption during a focus group allowable expenses? Yes. Section 2.03-B Family Engagement Work and Services p. 45. “Medicaid Administrative Funds (MAF), Title V grant funds, and Title V match funds can be used to support the work dedicated to CAH family engagement.” The incentive/gift card should be used to compensate the participant for their time and expertise engaged with the project and commensurate with the time spent attending focus group activities. Incentives should not be used for entertainment purposes, such as raffles or prizes.
05/06/2022 For the Direct Dental Service Planner FTE referred to in 2.13, which budget should the FTE hours be included in, the CH Dental, I-Smile, or I-Smile @ School? The FTE for the Direct Dental Service Planner (DDSP) may be included in any or all of the budgets, as appropriate, based on the services the DDSP is providing. Per the RFP:

1. The CH Dental funds must be used for services to build public health system capacity that provide support for developing and maintaining comprehensive OH service systems in communities; costs associated with limited direct dental services provided by CAH staff for non-Medicaid enrolled children and adolescents, birth through age 21;

2. I-Smile™ funds must be used for services to build public health system capacity that provide support for developing and maintaining comprehensive oral health service systems in communities, costs associated with building public health system capacity and assuring non-billable population-based oral health services.

3. I-Smile™ @ School funds must be used for costs associated with administering a school-based sealant program within schools with at least 40% or greater participation in the free/reduced lunch program and/or Community Eligibility Provision (CEP) designation, based on data from the Iowa Department of Education.

4. CAH or MH Medicaid Administrative Funds are for enabling services for Medicaid-enrolled children or pregnant women. 5. Program income can be used for Gap-filling direct care services for the Medicaid population, and support for grant work related to direct care services and national and state performance measures. Program income can be listed on the I-Smile™ Budget or the I-Smile™ @ School Budget.
05/06/2022 In the I-Smile workbook Free and Reduced Lunch numbers are blank. Please give guidance on eligibility for schools. The I-Smile™ @ School Program Workbook must be downloaded from the forms section of the RFP. When downloaded the free and reduced lunch rates should appear in column “T”. If the column has hash marks in it, instead of numbers, you may need to expand the column. If you still can’t get the free and reduced lunch rates to show up, contact the IowaGrants helpdesk for assistance.
05/09/2022 What process did IDPH utilize to determine the mandatory requirements of this grant are financially and physically possible at the local level? It seems a huge number of billable services are required for local agencies to just meet payroll. Are there even enough children on Medicaid in the area to whom to provide the billable services? A. Section 1.01 Purpose p. 5. “The purpose of this Request for Proposal (RFP) # 58823005 is to solicit applications that will enable the Iowa Department of Public Health (referred to as Department) to select the most qualified applicant to provide public health services at the community level for Child & Adolescent Health (CAH) services. CAH services include Hawki Outreach, Early ACCESS, Healthy Child Care Iowa (HCCI), and I-Smile™. The I-Smile™ program also includes I-Smile™ @ School.”

The work and services are determined by the mission, vision, and scope of work required by the Title V block grant, including the 2021-2026 Title V Needs Assessment, and the Omnibus Agreement with the Department of Human Services (Section 2.01-A p. 21-26). Title V state staff with input from current contractors, DHS and other state departments, MCAH Advisory Committee, Health Equity Advisory Committee, MCH Workforce Development 2021 Cohort Team, federal technical assistance, consultation with other state Title V programs, community stakeholders, available data and clients and their families determined the activities to meet the requirements of the Title V block grant and DHS Omnibus Agreement to be included in the CAH program and this RFP.

B. The work and services included in the RFP are primarily at the Public Health Services and Systems and Enabling levels of the MCH Pyramid (Section 2.01-A MCH Pyramid of Services p. 24). Billable direct care services are the smallest proportion of the CAH program and this RFP. There are no newly required direct care billable services in this RFP. The required direct care billable services are the same as were required in the 2021 and 2022 RFAs, and similar to those required in the 2017 RFP, therefore the Department believes these services do not provide an increased financial burden over past RFPs.

Section 1.05 Medicaid and Other Sources of Funding p. 8. “In addition to funds received from the Department, CAH programs will need to have additional sources of funds, such as Early Childhood Iowa, community foundations, United Way, tax levies, etc., to build and sustain the program.

Successful CAH applicants must apply for, and be awarded, designation as a Medicaid Screening Center. CAH programs are eligible to receive income from Medicaid reimbursements, Medicaid Managed Care Organizations (MCOs), Prepaid Ambulatory Health Plans (PAHPs), patient fees, contributions, and other third party payments.”

The funds outlined in the RFP are intended to support the work and services outlined in the RFP. Historically, contractors have reported that their agency’s costs to provide direct services supasses the reimbursed amount from Medicaid. Agencies will need to determine whether or not their business plan supports optional direct care services.

C. Section 1.05 Funding Formula Basis p. 9-10 outlines how the funding included in the RFP is determined. The number of children and adolescents enrolled in Medicaid is included in the funding formula and is proportional to the funding allotted per CSA for the Medicaid Administrative Funds, CH Dental, and I-Smile™ allocations.
05/09/2022 To get an accurate assessment of the entire grant responsibilities, please provide the mid-year and year-end reporting requirements (# of narratives, attachments, statistics, etc.). The amount of work on these does have a bearing on whether agencies have the personnel to manage the grant. The reporting requirements are still in the process of being developed.
05/09/2022 On page 85 of the grant application under Item 2, b, ii: Outreach may include visits with staff but "shall include times when attendees/members are present such as worship times, events, etc. Applicants shall pursue outreach opportunities with all the different faith groups..." In other words, when they are extremely outnumbered. I watched the events of Jonestown, Guyana unfold on TV as a young person so have serious concerns about sending a staff member into a the "variety of denominations and sects" (cults?) you have defined. I'm strong in my faith and would not go my myself. Maybe for this one you would consider simply mailing information? I do not know enough about "all the different faith groups" to be able to guarantee physical or spiritual safety of my staff to comfortably send them. Section 2.11-B.2.b.ii p. 85 “Faith-based organizations - outreach may include visits with staff, but shall include times when attendees/members are present such as worship times, events, etc. Applicants shall pursue outreach opportunities with all the different faith groups (e.g., Abrahamic religions, Eastern religions, Indigenous Ethnic religions, a variety of denominations/sects, etc.) throughout the CSA.”

Faith-based organizations are a required population with which applicants shall conduct Hawki Outreach and Presumptive Eligibility. A requirement of the RFP is that applicants conduct outreach and Presumptive Eligibility during times attendees/members are present and all faith groups shall be pursued.

The intent of the Hawki Outreach program/funding is to assure health care coverage for children of working families in Iowa. Applicants shall serve all eligible children, adolescents, and their families who meet the eligibility requirements for Hawki without discrimination based on race, gender, religion, political affiliation, etc.
05/09/2022 Confirming lead screening for children ages 1-2 is a state performance measure but for 2-3 year old's it is not a performance measure - right?. (If I missed it, I apologize). We completely understand the importance of lead testing in this age group but we're just trying to survive and it does add another burden to an extremely taxing application. Is there a rationale that I have missed to require an activity that is NOT a part of the SPM or the NPM? Thanks! Section 2.01-A p. 23 Title V Statewide Needs Assessment “SPM 2 Percent of children ages 1 through 2 years, with a blood lead test in the past year.” The State Performance Measure for FFY 2021-2026 includes children ages 1 through 2 years or 12<36 months.
05/09/2022 If an agency has 90-100% inform completes with 4 hours of outside "normal business hours," do we still have to schedule staff time after 5:30 p.m. for an additional 21 hours to reach the 25 hours? A. Section 2.05-B.2.C.ii Provide Informing p.52. “A minimum of 25 hours per month outside normal business hours must be scheduled and utilized on Informing attempts to reach newly eligible families. CSA 8 must provide a minimum of 40 hours per month outside normal business hours. The hours scheduled must be sufficient to make at least one attempt for each client not successfully contacted during normal business hours. These hours must:

1. Consist of staff actively making contact attempts and available live to answer calls/texts and/or face to face contacts.

2. Be communicated in the Initial Inform packet as times the client/family can expect calls, texts, or visits and that staff will be available to return calls and texts. Applicants will provide the schedule in the Informing Services Delivery Table. As needed, as staff are available, ad hoc, etc. does not meet criteria.

3. Must be spread over a minimum of four days per month.”

A requirement of the RFP is that staff time to conduct inform follow ups/completions be scheduled as outlined on p. 52. The majority of service areas have changed with the move to CSAs, past time spent in Informing services may not be indicative of time needed in the new project period. Year 1 of the project period will be used to establish baselines for the coming years.

B. Section 4.07 Contract Performance Measures p. 130. Informing Performance Measure The goal for Inform Completions in each CSA is 75%. The Contractor must attain a minimum average Inform Completion rate of 40% for the entire CSA by July 31, 2023. The Department will pull the Inform Completion data on or after August 15, 2023, to determine the average completion rate in each CSA. The baseline average Inform Completion rate will determine the percent improvement required by each successful Contractor for their CSA in FFY24.” Beginning in FFY24, the table above [p. 131 of RFP] is anticipated to outline the required annual average improvement or maintenance of Inform Completion rate for the CSA.” FFY 23 will establish a baseline for service provision in the CSA. Beginning in FFY 24 contract requirements may change based on the contractor’s Inform Completion Rate.
05/09/2022 The RFP does not seem to have considered the efficiency of people in the roles as it specifies the hours or FTEs for the positions. For example, if our Direct Dental Service Planner completes all the duties of the position in 0.4 FTE, is it possible to use her in other positions or do we need to create busy work to maintain the 0.5 FTE? The Direct Dental Service Planner (DDSP) position must be a minimum of 0.5 FTE. The RFP (page 93) states the responsibilities of the DDSP include: organizing direct service provider schedules, setting up locations/direct service sites, ordering supplies, distributing and collecting forms (e.g., consent forms), and ensuring accurate data entry. This would include all services provided as part of the I-Smile™ @ School program, including the direct services provided at the schools. The DDSP may also provide preventive dental services, provide care coordination (CC) services, and complete data entry.
05/09/2022 On average, how much time to expect it will take to complete this application? Again, on average. We know everyone works at a different pace, some have help with the grant, etc., but I would expect you would have an anticipated # of hours it will take to complete it. The Department does not have a required or expected amount of time that must be spent on the application. The amount of time applicants spend on the application is not collected or scored as part of the RFP process. The Department extended the normal 6-8 weeks timeframe for completion to 10 weeks to complete the application.
05/09/2022 On the 2023 Title V Administration Manual Draft page 115 for Informing, it refers to one call being between business hours of 8am-5:30pm M-F, and 1 attempt after business hours or on the weekend. If our business hours are 8-4:30pm M-F, would the "after hours" time begin then at 4:31pm, or would it mean we need to wait until 5:30pm? Additionally, does the staff making the inform call need to have specific credentials? A. Section 2.05-B.2.C.i. Provide Informing p.52. “Complete Inform Follow-ups by making phone, text, and/or face-to-face attempts to reach the client/families with the goal of having a dialogue about the benefits available to them through Medicaid. Inform Follow-ups are required to use the following methods:

i. A minimum of two attempts to contact the client/family must be made with at least one attempt during normal business hours (8:00 a.m - 5:30 p.m. M-F) and at least one attempt outside normal business hours. (i.e., 7:30-8 a.m.; 5:30 p.m. - 9:00 p.m. and any time on weekends).”

This same information is included on page 115 of the Draft Title V Administrative Manual. The RFP and Manual designate the business hours to be 8am-5:30pm Monday through Friday, and therefore attempts to reach clients for Inform Completion that will count toward the required minimum of 25 hours (40 hours for CSA 8) each month will be outside this designated time. A call at 4:31pm Monday through Friday would be considered a call during business hours, even if the applicant’s office is not open at that time. A call on Saturday or Sunday at 4:31pm would count as outside business hours.

The RFP does not address credentials or educational qualifications for individuals providing Informing services. Training Section 2.05-B.5 Staff Training. p.53 does set forth the requirement “All staff, including subcontractors, working in/providing services to CAH clients shall be trained on the Informing process, and have access to the Informing scripts, policies, and procedures which shall include guidance on documentation of the Informing process in the MCAH data system.”

Page 95 of the RFP states: “Provide training and ensure competency of trained staff that complete the Informing process about the importance of routine preventive care and the dental benefits offered through Medicaid, Dental Wellness Plan (DWP), and DWP Kids.”

The Draft Title V Administrative Manual outlines required competencies individuals providing Informing services must possess in Policy 702: Informing Services on p. 117. “Personnel: 1. Contractors are required to designate employees to carry out informing services. Staffing is dependent upon the number and needs of clients in the CSA. Staff need the following competencies to provide the Informing service: a. Communicate complex information in an understandable way using plain, nontechnical language with clients. Utilize the client’s primary language. Engage a qualified interpreter when needed. See 708 Interpretation Services Policy. b. Relate to clients to encourage involvement in preventive health care and to assess client needs and barriers. c. Be knowledgeable of community resources and refer to appropriate providers to meet client needs. d. Tailor informing services to address client choices, preference, and special needs such as language barriers, low literacy levels, and hearing or sight impairment. e. Understand the Medicaid program, including components of Iowa’s Periodicity schedule. f. Understand the CDC and ACIP Childhood Immunization Schedules for birth through 18 year olds and be able to communicate the schedule to clients. g. Understand and explain child and adolescent growth and development. h. Establish and maintain linkages with local providers and community resources.” Additional training is outlined in the RFP and Draft Title V Administrative Manual related to documenting, use of the Title V MCAH data system and health equity.
05/09/2022 The Democratic Party has deemed Iowa not diverse enough to automatically host the first in the nation political caucuses, yet a significant portion of this grant is spent in the pursuit of “priority populations.” If the Democrats are right, we seem to be poor stewards of the resources given to us. Are the Democrats right or wrong? This question is not related to the requirements of this RFP.
05/09/2022 Can a registered dietitian serve as the project director? Section 2.01-B Personnel Requirements p. 30 “The project director is required to be an employee of the successful applicant, have a minimum of six months experience in health or human services, and demonstration of the following skills and experience:

Ability to synthesize quantitative and qualitative data to make decisions for program implementation;

Strong interpersonal skills and experience building and maintaining relationships with a variety of partners, and positive conflict resolution skills;

Communication skills, including the ability to communicate with individuals, small and large groups about programs and services;

Lived experience as a member of a priority population (as listed in Section 2.02A) or experience working with priority populations;

Experience convening and facilitating groups, such as coalitions or committees, with a focus on a specific topic, health outcome, or population;

Understanding of health equity and child and adolescent health disparities.

Experience in community or public health is strongly preferred. The project director must possess at least one of the following:

Bachelor’s degree in a health or human services field; or Current license as a registered nurse (RN) with a bachelor’s degree in any field.”

A registered dietitian possessing these requirements would be eligible to be Project Director.
05/10/2022 In the CAH Subcontracting Plan there is nowhere to indicate that we will not be utilizing subcontractors. Should we mark this as complete and not address anything in the plan? Correct, applicants with no subcontracts shall leave the form empty and mark as complete.
05/10/2022 Can the Hawki coordinator be subcontracted to another agency? Yes
05/10/2022 If a contractor subcontracts with another agency to provide CAH services in some counties of the CSA, will the lead staff of the subcontracted agency be able to attend coordinator meetings? Section 1.18.C.1. p. 16. Use of Subcontractors. Successful applicants subcontracting work and services of this RFP must develop and implement a robust subcontract management plan, including communication plans for disbursement of Department communication, and ensuring inclusion in quality assurance activities.

Overall, it is the responsibility of the Project Director/Contractor to collect feedback from staff and subcontractors to bring to meetings, and to disperse information from meetings back out to staff and subcontractors. Some meetings may invite all involved staff to attend, such as the Fall Seminar, Child Care Nurse Consultant State and Regional Meetings, etc. Required and optional meeting attendees will be determined on a meeting by meeting basis.
05/10/2022 On page 85 of the RFP #2b it states "Applicants are required to meet with a minimum of 16 entities per month to provide Hawki Outreach and Presumptive Eligibility." Can you define "meet" would this include in person, virtual and phone meetings? Primarily in person meetings. As stated the intent is to provide Hawki Outreach and Presumptive Eligibility. The section goes on to outline additional requirements that further show the intent is in person such as “focus on times/events when potentially eligible families are present in school settings. Parent-Teacher Conferences, back-to-school events, community and adult education, summer lunch distribution, etc.” (Section 2.11-B.2.b.i.p. 85); “outreach may include visits with staff, but shall include times when attendees/members are present such as worship times, events, etc.” (Section 2.11-B.2.b.ii.p. 85); “outreach shall include visits with independent contractors (Gig workers), self-employed, and employees that are part-time or lack access to employer sponsored health insurance (e.g., restaurant/grocery stores/food service industry, retail, child care providers, entrepreneur incubators, artist cooperatives, farm cooperatives, etc.) in their CSA.” (Section 2.11-B.2.b.iv.p. 85); and Applicants are required to spend a minimum of 65% of their Hawki Outreach funds on staff providing Hawki Outreach and PE in the community (outside the contractor/subcontractor agency and service sites) (Section 2.11-B.2.d. p. 86).

Section 2.11-B.2.c. P. 85 “Each county in the CSA is required to be visited at least three times a year for Hawki Outreach and to provide PE.” This shall mean being physically present in the county for in person visits in that county.

Some virtual meetings and rare phone calls to best meet the needs of families are allowed, however all requirements in this section must still be met.

Attending a community event or meeting with several agencies or families would be one visit/meet. Example: While attending a back to school event at an elementary school, the Hawki Outreach Coordinator interacts with 15 parents, completes a Presumptive Eligibility with one family with 3 children and interacts with the principal, school nurse, and 4 teachers. This is one visit/meet-the back to school event at an elementary school, not 2, 3, 15, 18, 21, 24, etc. visits.
05/10/2022 If a contractor subcontracts CAH services in some counties of the CSA, can the subcontractor contract nurses and dental hygiene staff from a hospital or other medical facility? a. Attachment D. FY23 Child and Adolescent Health and Oral Health Programs RFP Draft Contract Template. Article XII.1 - Additional Conditions: “Subcontractors are prohibited from further subcontracting.”

No, the subcontractor is prohibited from further subcontracting, all subcontracts would be with the contractor. In this situation, the contractor would subcontract with the nurses, dental hygienists, hospital, or medical facility to work in the designated county in cooperation with other subcontractors in that county.
05/11/2022 How were the priority populations identified in 2.02-C Health Equity form determined for each of the CSAs? 2020 Census Data was used to select the racial and ethnic priority populations most prevalent in the CSA. However, the Department also looked to ensure inclusion of each of the racial and ethnic priority populations. Hispanic, LatinX is the most prevalent ethnic priority population in the state, without adjusting to purposefully include other groups we would not necessarily have statewide inclusion.
05/11/2022 Please provide more information on the funding formula for counties or the amount allocated to each county, as this will be helpful for distributing funds for subcontractors. Due to the weighting of data and minimum funding per CSA, county level data is not available.
05/11/2022 Please clarify - on the sealant workbook, if the correct grades in a building are listed with inaccuracy's please give guidance on how to report the needed correction to reflect our workplan. Example 6 grade is not listed but 9th grades but the building services 6th, 7th and 8th grade. a. Any corrections needed for the I-Smile @ School Workbook would be noted in Column “Y”. RFP page 105 states: In column Y, briefly describe any of the following potential situations:

i. Schools listed on your applicant tab that will be served by a non-Department-funded sealant program (verification letter required, see below)

ii. Schools listed on your applicant tab that are not physically in the applicant’s CSA

iii. School in which students will be served with non-grant funds; such as Medicaid reimbursement

iv. Schools that have grades mistakenly listed on the applicant’s tab, not currently at the school

v. Schools that have historically had free or reduced lunch rates over 40%, but appear lower in this workbook that the applicant would like to serve using grant funds. An explanation of historic data, prior to the emergency proclamation allowing all students to receive free lunch during the pandemic, should be included

vi. Any additional information that is pertinent to this application
05/11/2022 This RFP outlines several required positions – is it necessary for the grant holder to employ all required positions, or could a subcontractor be responsible for one or more of the required positions? Section 2.01-B Personnel Requirements. p. 30. “The project director is required to be an employee of the successful applicant”. This is the only required position that must be employed by the contractor. Subcontracts can be used to fulfill the remaining required positions.
05/11/2022 Can one required position be filled by more than one employee (if the minimum time requirements are met by the combined total of staff)? Section 2.01-B Personnel Requirements. p. 29 “Personnel may hold more than one of the required positions, but must have the capacity to fulfill the duties of each role.”
05/11/2022 For positions that require a minimum FTE, how is that FTE applied – weekly, monthly, quarterly, or yearly? Are there different requirements for different positions? a. Weekly.

i. The I-Smile™ Coordinator: Minimum of 0.8 FTE spent on building public health system capacity, enabling, and population-based services (32 hours a week); RFP page 93.

ii. The Direct Dental Service Planner: Minimum of 0.5 FTE spent on planning direct services which may include time spent providing direct services (20 hours a week); RFP page 94.

iii. Each Child Care Nurse Consultant (CCNC) should be dedicated at least 0.4 FTE weekly for providing CCNC services to early care and education providers.
 
 
 
 
 
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