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Comprehensive Services and Health Systems Approaches to Improve Asthma Control in New York State

Grants to New York Nonprofits, Agencies, and IHEs
to Reduce the Burden of Asthma in High-Risk Areas

Agency Type:

State

Funding Source:

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New York State Department of Health (NYSDOH), Center for Community Health, Division of Chronic Disease Prevention, Bureau of Community Chronic Disease Prevention

Conf. Date:

08/01/17

LOI Date:

07/31/17

Deadline Date:

09/18/17 4:00 PM EST

Description:

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Grants to New York nonprofits, government agencies, hospitals, and academic institutions for the implementation or expansion of asthma control services. Applicants are strongly encouraged to submit an LOI by July 31. The purpose of this program is to enhance health outcomes and address the asthma burden in designated high-risk counties.

The aim of this Request for Applications (RFA) is to fund organizations serving high-risk areas to expand the availability and quality of evidence-based comprehensive asthma control services by improving the quality of
guidelines-based health care, ensuring the provision of appropriate asthma self-management education, and promoting policies supportive of asthma control. Improved asthma control will be achieved through a population-based, sustainable systems approach designed to deliver seamless, guidelines-based comprehensive asthma control services across public health, community and health care sectors. The RFA seeks organizations that will work to reduce the racial/ethnic and community disparities in the burden of asthma, with a primary focus on children ages 0 to 17 years.

Comprehensive Services and Health Systems Approaches to Improve Asthma Control in NYS aims to align with statewide NYSDOH community and health system initiatives, such as the NYS Prevention Agenda, Delivery System Reform Incentive Payment Program (DSRIP), Population Heath Improvement Program (PHIP), the State Health Innovation Plan, Healthy Neighborhoods Program contractors and Advancing Tobacco-Free Communities and Health Systems for a Tobacco-Free New York contractors.

Description of Program:

Funding awarded through this RFA is anticipated to support five contractors in high asthma burden geographic areas to expand the availability and quality of comprehensive asthma control services to reduce the burden of asthma in NYS, as demonstrated by a decrease in asthma-related emergency department visits and hospitalizations. This will be accomplished by identifying children and adults with poorly controlled asthma, linking them to quality guidelines-based care, providing and referring to asthma self-management education, and either referring to or providing home-based asthma services. Contractors will implement and support strategies in health systems, community and home- based settings aimed at reducing the burden of asthma among priority populations and improving the quality of care and quality of life for people and families with asthma in each region. The Project Logic Model (Attachment 1) illustrates the strategies, activities, milestones and expected outcomes of the initiative.

The work under this RFA will center on translating current national asthma guidelines into practice in awarded regions. The National Asthma Education Prevention Program, Expert Panel Report 3, 2007: Guidelines for the Diagnosis and Management of Asthma (NAEPP Guidelines) provides “recommendations for the diagnosis and management of adults and children with asthma to help clinicians and patients make appropriate decisions about asthma care”.

The NAEPP Guidelines provide four key components of asthma care:
1. Assessment and monitoring of asthma severity and control;
2. Patient education for a partnership in care;
3. Control of environmental factors that affect asthma; and
4. Pharmacologic treatment.

The 2008 Guidelines Implementation Panel (GIP) Report was published to provide recommendations and strategies for overcoming barriers to implementing the recommendations of the NAEPP Guidelines to improve acceptance and use of the asthma guidelines. The GIP provides six priority messages for the broader asthma community that, when acted upon, would most likely result in improvement in asthma care processes and outcomes.

These six priority messages are:
1. Assess asthma severity to determine type and level of initial asthma therapy;
2. Assess asthma control to guide asthma therapy;
3. Review allergen and irritant exposure to provide a multipronged strategy for reduction;
4. Use inhaled corticosteroid for long-term management of persistent asthma control;
5. Complete Asthma Action Plans for all people who have asthma to guide self-management; and Plan follow-up visits at periodic intervals to assess control and treatment.
6. The following strategies should be implemented in the same geographic locations to ensure access to comprehensive NAEPP Guidelines-based asthma control services.

Asthma Services:

Asthma Services interventions targeting priority populations will address all of the following strategies:

1) Asthma Self-Management Education: Ensure the delivery of evidence-based asthma self- management education in a variety of settings. Asthma self-management education should address key elements from the NAEPP Guidelines (basic pathophysiology of asthma, correct usage of medications and improved medication adherence, monitoring symptoms, and avoiding triggers). Home-based services (taking place in the home) will be provided to individuals whose asthma is not well controlled. Home-based services should be multicomponent interventions that include, at a minimum, asthma self-management education, a home environmental assessment, and multi-trigger reduction services.

2) Linkages to Care: Assure linkage to guidelines-based care for people with asthma including support for medication adherence and trigger reduction services.

3) Training of Caregivers: Coordinate and deliver asthma management training based on NAEPP Guidelines to caregivers (e.g. family members, community health workers, and home visitor staff).

4) Policies Supportive of Asthma Control: Support the adoption and implementation of evidence- based policies supportive of asthma control including trigger reduction, and improved air quality.

Health Systems:

Health systems interventions targeting priority populations will address all of the following strategies:

1) Quality Improvement: Implement quality improvement processes in health care settings. Quality improvement strategies may include practice facilitation, academic detailing, and health system redesign. Intensive quality improvement efforts will focus specifically on pediatric primary health care settings by employing proven improvement methods, such as those described by the Institute for Health Care Improvement (IHI), for making and sustaining system change interventions. Participating practices will set project team aims, establish measures and report data, and select, test, implement and spread evidence-based interventions aimed at improving asthma outcomes.

2) Team-Based Care: Promote the use of team-based care and other health care delivery models with health care organizations and partners to improve coordination of asthma care.

3) Coverage and Reimbursement: Promote coverage for and utilization of comprehensive asthma control services including medicine, devices, self-management education, and home visits.

4) Community-Clinical Linkages: Support the development of connections between public health programs and the clinical setting to coordinate delivery of comprehensive asthma control services.

Awardees will be required to work across both Asthma Services and Health Systems to implement all of the strategies outlined above simultaneously.

Geographic Area:

Eligible Service Areas have a total population greater than 700,000 and include one or a contiguous group of eligible counties identified as being among the 25 highest asthma burden counties in NYS. Asthma burden is defined using the following asthma indicators: asthma-related hospitalization rates and asthma-related emergency department visit rates for adults and children

Eligible Counties:

-Region 1, Service Area 1: Albany, Fulton, Montgomery, Rensselaer, and Schenectady Counties

-Region 1, Service Area 2: Dutchess, Orange, Sullivan, Ulster, and Westchester Counties

-Region 2, Service Area 3: Erie and Niagara Counties

-Region 2, Service Area 4: Monroe County

-Region 3, Service Area 5: Nassau and Suffolk Counties

-Region 4, Service Area 6: Bronx County

-Region 5, Service Area 7: New York, Queens, Kings, and Richmond Counties

GrantWatch ID#:

GrantWatch ID#: 125351

Estimated Total Program Funding:

$4,500,000

Number of Grants:

One contract will be awarded in each of five regions as outlined in Table 1.

Estimated Size of Grant:

Grants will be valued at up to $180,000 for a five-year total of $900,000 each.

Term of Contract:

The Department anticipates awarding contracts for a five-year period, from March 1, 2018 through February 28, 2023.

Additional Eligibility Criteria:

Eligible applicants include public and private not-for-profit agencies and organizations in NYS, including but not limited to: local public health agencies/municipalities, hospitals, health care systems, not-for-profit primary care networks, academic institutions, community-based organizations, voluntary associations, foundations, and scientific or professional associations.

Applicants should have an established presence and be located in and provide services to children and families in the Service Area they are proposing to serve. Organizations located in and serving the following counties are eligible to apply: Albany, Bronx, Dutchess, Erie, Fulton, Kings, Monroe, Montgomery, Nassau, New York, Niagara, Orange, Queens, Rensselaer, Richmond, Schenectady, Suffolk, Sullivan, Ulster, and Westchester. Applications that propose to work in counties not included in a Service Area defined in Table 1 will not be reviewed.

Applicants may apply to serve more than one Service Area, however, in this case, a separate application must be submitted for each proposed Service Area. Any single application received that includes more than one proposed Service Area will be disqualified.

The applicant needs to be both the fiscal agency and the lead agency responsible for implementing the work described in this RFA. The applicant should perform a substantial role in carrying out the project and not merely serve as a conduit for an award to another organization that is ineligible.

Applicants may subcontract components of the work. A minimum of 51 percent of the total award funding and effort is to be retained by the applicant organization. For those applicants that propose subcontracting, it is preferable to identify subcontracting agencies during the application process.

Applicants that plan to subcontract are expected to state in the application the specific components of the scope of work to be performed through subcontracts. Applicants should note that the lead organization (contractor) will have overall responsibility for all contract activities, including those performed by subcontractors, and will be the primary contact for NYSDOH.

Applicants are required to have a written policy establishing a 100% tobacco-free worksite facility, including outdoor areas under control of the applicant, or commit to implementing such a policy within one-year of receiving the notice of award. Applicants should complete, sign and upload the Tobacco- Free Policies Attestation document (Attachment 5) in pre-submission uploads. The Tobacco-Free Policies Attestation is a requirement for award.

In addition, applicants should read Section IV. Administrative Requirements, P. Refusal of Funds from Tobacco Related Entities for additional contract requirements related to tobacco. The sample New York State Master Grant Contract for this funding opportunity can be viewed within the Forms Menu of your application. Attachment A-1 Part B includes the Refusal of Funds from Tobacco Related Entities clause.

Preferred Eligibility Requirements:

Preferred applicants will successfully demonstrate a history of leadership, effective collaboration and cooperation among a diverse group of stakeholders, and success in implementing evidence-based population-based interventions with measurable results. Preference will be given to applicants that secure a range of strategic partners to support the delivery of evidence-based comprehensive asthma control services in identified communities as demonstrated through letters of commitment. Strategic partners should include people with asthma, families of children with asthma, primary care physicians and specialists, hospitals, pharmacists, health care insurers and payers, certified asthma educators, local public health and environmental health agencies and organizations, school districts and school-based health clinics, and other community-based organizations.

Preference will be given to applicants from lead organizations who can demonstrate, and whose subcontractors (if applicable) can demonstrate, experience with the following:

-Leading change strategies and initiative(s) to conduct population-based, sustainable, evidence- based, multi- level systems interventions in partnership with key stakeholders to improve health outcomes for a specific target population;

-Making policy and system changes in community and health care settings for the purpose of improving health outcomes among disparate, high-need populations;

-Showing commitment to addressing health disparities in communities served and maximizing reach to individuals with asthma within the proposed Service Area;

-Conducting program activities in a culturally competent manner and experience working with low- income populations, diverse racial/ethnic groups, and persons with disability in the identified high- need communities;

-Using data to assess local asthma burden, experience collecting and analyzing health data, monitoring, evaluating, reporting intervention results, and utilizing process and outcome data to make system improvements.

Awarded applicants will be required to utilize "People First" language in all communications including, but not limited to, documents, publications, media relations and correspondence.

Pre-proposal Conference:

The applicant conference is schedule for August 1, 2017.

Failure to attend the Applicant Conference/Webinar will not preclude the submission of an application.

Pre-Application Information:

Prospective applicants are strongly encouraged to complete and submit a Letter of Interest. Submission of a letter of interest is not a requirement or obligation upon the applicant to apply. Applications may be submitted without first having submitted a letter of interest.

Once the application is complete, prospective grantees are strongly encouraged to submit their applications at least 48 hours prior to the due date and time. This will allow sufficient opportunity for the applicant to obtain assistance and take corrective action should there be a technical issue with the submission process.

Both NYSDOH and Grants Reform staff are available to answer applicant’s technical questions and provide technical assistance prior to the application due date and time.

Key Dates:
-RFA Release Date: July 18, 2017
-Letter of Interest and Questions Due: July 31, 2017 at 5:00 PM
-Applicant Conference Registration Deadline: July 31, 2017 at 5:00 PM
-Applicant Conference: August 1, 2017
-Questions, Answers and Updates Posted: August 17, 2017
-Applications Due: September 18, 2017 at 4:00 PM

To learn more about this opportunity, please go to the NYS Grants Gateway at:
https://grantsgateway.ny.gov/IntelliGrants_NYSGG/module/nysgg/goportal.aspx?NavItem1=3

Contact Information:

Before starting your grant application, please review the funding source's website listed below for updates/changes/addendums/conferences/LOIs.

Potential applicants should register for the August 1 conference by following this link:
https://meetny.webex.com/meetny/k2/j.php?MTID=t44d4d79bcd3fcef8fa1c6c2b047443d8

Holly Teal
518-408-8578
asthma@health.ny.gov

Bureau of Community Chronic Disease Prevention
New York State Department of Health
150 Broadway, Suite 350
Albany, NY 12204

Funding or Pin Number:

Request for Applications #1612280202 / Grants Gateway ID: DOH01-ASTHM1-2017

URL for Full Text (RFP):

Geographic Focus:

USA: New York City: Bronx, New York, Queens, Kings, and Richmond Counties;   New York: Albany, Fulton, Montgomery, Rensselaer, Schenectady, Dutchess, Orange, Sullivan, Ulster, Westchester, Erie, Niagara, Monroe, Nassau, and Suffolk Counties