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Innovative Approaches: Improving Systems of Care for Children and Youth with Special Health Care Needs (CYSHCN)

Grants to North Carolina Local Health Departments to Develop an
Action Plan to Improve Health Services for Children and Youth

Agency Type:

State

Funding Source:

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North Carolina Department of Health and Human Services (DHHS) - Division of Public Health, Women’s and Children’s Health Section, Children and Youth Branch

LOI Date:

10/08/18

Deadline Date:

11/19/18 5:00 PM Receipt

Description:

Request a Grant Writer

Grants to North Carolina local health departments to assess and develop plans to improve systems of care for children and youth who have special health care needs. Funding is intended to support the development of an action plan that will address the systemic changes needed to improve health services for the target population.

The Children and Youth Branch in the Women’s and Children’s Health Section of the Division of Public Health (DPH) develops, implements, promotes and monitors programs and services that are consistent with Federal Title V Maternal and Child Health Bureau’s goals to protect and enhance the health and well-being of children and their families. There is a strong emphasis on Children and Youth with Special Health Care Needs (CYSHCN).

The purpose of the Innovative Approaches (IA) initiative is to thoroughly examine and foster improvement for community-wide systems of care that will effectively meet the needs of families of children and youth with special health care needs, resulting in increased family satisfaction with services received and improved outcomes for children and youth with special health care needs. The Children and Youth Branch is seeking approximately five local health departments that are interested in assembling families of CYSHCN along with providers and community agencies to conduct an in-depth assessment of the local system of care for CYSHCN and develop a community action plan.

DPH is looking for applications with a clearly written operational plan to organize and maintain a steering committee to collect data, identify systems issues, and develop a clear and actionable plan to address the identified system changes. Your Innovative Approaches action plan will be implemented after a 6-9 month planning process. Action plans will have clearly written objectives and activities to change policies, procedures or practices that improve the system of care for CYSHCN. The system change activities outlined in the action plan must be the result of needs identified by families of CYSHCN in the community and result in a long-standing change in the system of care.

DPH is seeking applicants with a history of commitment to serving children and youth with special health care needs and a sufficient track record to indicate a good chance of success. The proposed Innovative Approaches initiative shall include all partners necessary to assure access to a full range of services including prevention, primary, specialty physician services, inpatient and outpatient hospital care, local public health programs and services to include non-medical support services, pharmacy, behavioral health, foster care, home health and other care providers as needed. The steering committee must be able to identify system gaps and plan for a system that will provide coordinated family-centered services that include preventive, acute, basic procedures, support services, referral, follow-up and ongoing care for chronic conditions.

Innovative Approaches uses a systems change approach rather than a program-based approach to address community improvements for families of CYSHCN. Systems change is the core of Innovative Approaches.

"Systems change" is a shift in the way that a community makes decisions about policies, programs, and the allocation of its resources, usually through regulations, procedures, and protocols set down in formal written documents, and ultimately, in the way it delivers services to its citizens. To undertake systems change, a community must build collaborative bridges among multiple agencies, community members, and other stakeholders.

Scope of Services

Input:

1. Funding will begin June 1, 2019 and end May 31, 2022. Providing a three-year project period.
2. Funding, depending on the number of projects selected, up to five (5) grant awards of no more than $132,400 each will be made through an application review process. Funding is contingent on funding availability.
3. Local health departments must create and maintain a steering committee representative of the community and identify dedicated staff to the project, as well as collect and analyze qualitative and quantitative data from families and providers.

Output:

1. Recruiting, convening, and coordinating an Innovative Approaches (IA) steering committee of at least 11 individuals serving children and youth with special health care needs and families.

Members should include:
a. Two to four family members of CYSHCN
b. Local Health Department Director
c. Local Department of Social Services Director
d. Social service agency representatives (child protective services and/or foster care services)
e. County Partnership for Children (Smart Start) staff
f. Mental health agency representative
g. Two school system representatives (school’s Exceptional Children program staff and School Nurse)
h. Local health care provider
i. Representatives from other community agencies involved in the Local Health Department’s targeted systems changes. Steering Committee leadership should consist of three co-chairs (one parent, the health director, and the social services director) to lead the committee in the creation and implementation of the systems change IA action plan.

2. Hiring one full-time, qualified staff person or one full-time equivalent (1 FTE), to serve as IA Coordinator, to lead the development of the IA needs assessment and the IA action plan. The DPH Program Contact will be involved in the hiring process for all project staff, including developing job descriptions, interviewing, and assisting in final staff selection.

3. Participating in monthly IA Coordinator calls facilitated by DPH Program Contact in which local IA Coordinators provide site updates and share information with their peer counterparts across the state.

4. Coordinating formal mechanisms to receive input from parents of CYSHCN regularly. Family surveys and/or focus groups should occur at a minimum of two times per year. Family survey tools assess the prevalence and impact of special health care needs and evaluate change over time. Focus groups provide a structured format to further explore CYSHCN topic specific issues with parents and professionals working with CYSHCN.

5. Developing a current and comprehensive needs assessment for the county at the initiation of the Agreement Addendum and updated annually as per the requirements outlined in the IA Implementation Manual.

6. Developing and maintaining an IA action plan to include system change objectives, action steps, and results using the specified Children and Youth Branch IA action plan template.

7. Developing a sustainability plan for the Local Health Department’s county at the initiation of the project and updating the plan quarterly. The sustainability plan should include strategies for the following beyond the period of funding availability:
a. Identification and coaching of a county lead agency by the Local Health Department to continue IA work
b. Funding sources to provide a stable base of resources
c. Transfer of assets, if applicable, from the Local Health Department to the newly identified agency
d. Securing broad based community support for involvement in CYSHCN projects
e. Use of CYSHCN data and research to shape policy in response to changing community conditions
f. Assuring families ongoing and meaningful input into systems for CYSHCN.

8. Managing all financial aspects of the IA, including meeting expenses, expert faculty, participant reimbursements, and subcontracts.

9. Assuring IA steering committee member attendance at all planning and professional development training sessions coordinated by the Division of Public Health as communicated via monthly mandatory IA Coordinator calls.

10. Attending and purchasing all required Division of Public Health training sessions, technical assistance, and evaluation efforts.

11. Providing mentoring assistance to other counties’ local health departments as requested by the Division of Public Health

Outcome

1. Process measures will include the number of families, providers, and agencies involved in Innovative Approaches, number of qualitative data collection events, the number of internal IA meetings held, the number of external meetings attended, the number of professional development programs held, and participants trained, the number of community interventions.

2. Outcome measures will include the number of policy, procedure, or practice changes, as evidenced by written documents.

3. The goals of IA are based on the national Maternal and Child Health Bureau outcome measures focused on the percentage of children with special health care needs receiving care in a wellfunctioning system. To ensure access to needed and continuous systems of care for children and youth with special health care needs, IA goals focus on six components of a well-functioning system (noted below). Impact measures will include changes in the following Maternal and Child Health Bureau National Outcome Measures (NOM) and National Performance Measures (NPM)

As reported by families of CYSHCN in your community, changes in process and outcome measures will result in increases in the following components of a well-functioning system:

1. Families of children and youth with special health care needs will partner in decision making at all levels and will be satisfied with the services they receive.
2. All children and youth with special health care needs will receive coordinated ongoing comprehensive care within a medical home.
3. Families of children with special healthcare needs have adequate health insurance and financing to pay for needed services.
4. All children will be screened early and continuously for special health care needs.
5. Services for children and youth with special health care needs and their families will be organized in ways that families can use them easily.
6. All children and youth with special health care needs will receive the services necessary to make appropriate transitions.

GrantWatch ID#:

GrantWatch ID#: 184436

Estimated Total Program Funding:

$662,000

Number of Grants:

Up to five LHDs will be awarded.

Estimated Size of Grant:

$132,400 per FY

Term of Contract:

Funding will begin June 1, 2019 and end May 31, 2022, providing a three-year project period.

Additional Eligibility Criteria:

Any local health department is eligible to apply. Please note the four eligibility areas outlined below. Consideration will be given to applications involving one or more counties.

1. Local Health Departments Initially Applying for Innovative Approaches (IA) Funding Local Health Departments (LHDs) that have not previously received IA funds in any funding cycle are eligible to apply to serve either a single county or a multi-county area (maximum of three counties).

2. Restrictions on Re-applying for Local Health Departments that have participated in One Prior Funding Cycle (2010-2013, 2013-2016 or 2016-2019) - Local Health Departments (LHDs) that have participated in one prior funding cycle are eligible to re-apply for IA funds to serve the original county(ies) that received three years of funding with the caveat that they expand to at least one additional county within their geographical region and where families of CYSHCN often travel to and/or from to access needed services and resources. A maximum of three counties may be served.

3. Restrictions on Re-applying for Local Health Departments that have participated in Two Prior Funding Cycle (2010-2013, 2013-2016 and/or 2016-2019) Local Health Departments (LHDs) that have participated in two prior funding cycles are eligible to re-apply.
a. Work in the original county(ies) that have received six years of funding is limited to 10% of effort in the original county(ies) for 1 year and 0% the following 2 years.
b. Work in county(ies) that have received three years of funding are eligible to continue.
c. If a LHD chooses to expand, expansion county(ies) should be within applicant’s geographical region and where families of CYSHCN often travel to and/or from to access needed services and resources.
d. A minimum of two and a maximum of three counties may be served.

4. Restrictions on Re-applying for Local Health Departments that have participated in Three
Prior Funding Cycles (2010-2013, 2013-2016 and 2016-2019). Local Health Departments (LHDs) that have participated in three prior funding cycles are eligible to re-apply.
a. Work in the original county(ies) that have received funding across all three funding cycles should be sustained external to IA funding. No percentage of work time or funds is allotted to these county(ies).
b. Work in county(ies) that have received six years of funding is limited to 10% of effort in year 1 and 0% the following 2 years
c. Work in county(ies) that have received three years of funding are eligible to continue.
d. If a LHD chooses to expand, expansion county(ies) should be within applicant’s geographical region and where families of CYSHCN often travel to and/or from to access needed services and resources.
e. A minimum of two and a maximum of three counties may be served.

Pre-Application Information:

Any local health department that plans to submit an application is requested to submit a Notice of Intent no later than 5pm on October 8, 2018 to Heidi Austin.

Applications will be received until 5 PM on November 19, 2018. Successful LHDs will be notified by December 7, 2018.

Written email questions concerning the specifications in this Request for Applications will be received by email to Heidi Austin until October 15, 2018. As an addendum to this RFA, a summary of all questions and answers will be emailed, by October 22, 2018 to all LHDs sent a copy of this Request for Applications.

Application Process Summary Dates:

- October 1, 2018: Issue date
- October 8, 2018: Notice of Intent due
- October 15, 2018: Questions received through email
- October 22, 2018: Questions and answers sent to all LHD
- November 19, 2018: Applications due by 5pm
- December 7, 2018: Notification of award
- June 1, 2019: Agreement Addenda proposed start date

Funding Available $1,986,000 for June 1, 2019- May 31, 2022:

- FY 19-20: $662,000
- FY 20-21: $662,000
- FY 21-22: $662,000

Contact Information:

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

Send all applications directly to the funding agency address as indicated below:

Mailing Address:
Heidi Austin, Director Innovative Approaches Initiative
Children and Youth Branch
Women’s and Children’s Health Section
NC Division of Public Health
5601 Six Forks Road
1928 Mail Service Center
Raleigh, NC 27699-1928

Street/ Hand Delivery Address:
Heidi Austin, Director Innovative Approaches Initiative
Children and Youth Branch
Women’s and Children’s Health Section
NC Division of Public Health
5601 Six Forks Road
Raleigh, NC 27609-3811

Heidi Austin
Heidi.Austin@dhhs.nc.gov
Phone: 919 -707-5603

Funding or Pin Number:

RFA # A360

URL for Full Text (RFP):

Geographic Focus:

USA: North Carolina