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Publications iconKansas Register

Volume 41 - Issue 15 - April 14, 2022

State of Kansas

Department for Aging and Disability Services

Request for Applications

The Department for Aging and Disability Services (KDADS), announces the release of a Request for Applications (RFA) to qualified applicants to provide services to produce outcomes requested in the goal areas identified within the RFA. Applications will be accepted no later than 5:00 p.m. (CDT) June 1, 2022. A complete copy of the RFA with details of important dates and timelines may be found at https://www.kdads.ks.gov/provider-home/providers/bhs-funding-opportunities. Additional files may be located at this website throughout the process so please monitor on a regular basis for changes.

I. Overview

KDADS solicits applications from Licensed Community Mental Health Centers (CMHCs) to develop and provide Assertive Community Treatment ACT) Programs. KDADS was awarded a Substance Abuse and Mental Health Services Administration (SAMHSA) Center for Mental Health Services (CMHS) grant. This one-time CMHS Block Grant COVID Supplemental funding is available through March 14, 2023. SAMHSA recommends that states use the COVID-19 Enhancement Relief supplemental funds wherever possible to develop and support evidence-based crisis services development and to increase access to evidenced based treatment and coordinated recovery support for individuals diagnosed with a serious mental illness who are un-insured or underinsured. Funding available is $800,000. Grant funding must be expended by or before March 14, 2023.

Once application/proposal is submitted, the Quality Assurance (QA) Team will review applications and determine awardees based upon the most critical needs in a drawdown fashion. The KDADS QA Team will compile a scope of work based on the application and the needs analysis to be performed by the QA Team.

II. Purpose

The Community Mental Health Block Grant (MHBG) supports states in reducing their reliance on psychiatric inpatient services and facilitates the development of effective community-based mental health services and programs. The MHBG supports critical services for individuals with a serious mental illness that Medicaid or state funds do not cover, such as crisis programming efforts. The purpose of this funding opportunity is to aid in the implementation of the ACT model in communities across the state of Kansas.

III. Eligibility

To be considered for this funding opportunity, you must be a CMHC who will be providing ACT services to their surrounding communities. Priority will be given to those CMHCs who will be providing specialized services to their local Nursing Facilities for Mental Health (NFMHs) and will not be part of the first group to become a Certified Community Behavioral Health Center (CCBHC). However, we encourage all CMHCs to apply as consideration will be given to communities who are in most need.

Selected applicants shall sign a Notice of Grant Award (NOGA), an agreement that KDADS will provide. The application submitted to KDADS shall become part of the NOGA.

IV. Targeted Populations

The MHBG program targets adults with serious mental illnesses. Includes persons aged 18 and older who have a diagnosable behavioral, mental, or emotional condition—as defined by the Psychiatric Association’s Diagnostic and Statistical Manual (DSM) of Mental Disorders. Their condition substantially interferes with, or limits, one or more major life activities, such as:

  • Basic daily living (for example, eating or dressing)
  • Instrumental living (for example, taking prescribed medications or getting around the community)
  • Participating in a family, school, or workplace

ACT is an evidenced-based practice designed to assist individuals with Serious Mental Illness (SMI), primarily those who have been diagnosed with schizophrenia, bipolar disorder, borderline personality disorder, and who struggle living independently within the community, have been unsuccessful in traditional treatments, engage in emergency services frequently, have housing instability, have legal issues, and/or have co-occurring substance use/mis-use diagnosis. ACT has been shown to reduce psychotic hospitalizations, improve housing stability among participants, improve quality of life, reduce symptoms, and improve social functioning, as well as improve individual and family satisfaction. (Phillips, et. al., 2001)

The ACT model is a team-based, transdisciplinary treatment approach that is capable of being more flexible based upon individual needs than a more traditional approach. This transdisciplinary treatment program can provide intensive wrap around services within the assembled team rather than referring to external providers. Services are available 24 hours a day, seven days a week, and 365 days a year. Furthermore, services are provided primarily within the community and home-based setting. Minimums of 80% of direct contact hours, as individuals are encouraged to engage within their environment throughout services.

V. Terms of the Grant

Programs are expected to begin to provide services to the target population who qualify for ACT services immediately after the grant has been awarded.

We have identified four main components crucial to the implementation of the ACT model:

  1. Staffing and team formation to adequately address 24/7 crisis availability. (The ACT team should include the following members: Team leader, psychiatrist, psychiatric nurses, employment specialists, housing specialists, substance abuse specialists, peer support specialists, program assistant, and any additional mental health professionals as needed).
  2. Facilitate team member to individual ratio of approximately 1:10.
  3. Time unlimited services-there is no timeline for services to end and services are available for as long as the individual needs them.
  4. Community Treatment and Care Coordination services are provided to the individual when and where they are needed.

These four components must be successfully administered to achieve high fidelity, ensuring greater outcomes for individuals who participate.

VI. Deliverables and Reporting

Services to be Provided by ACT Team

Services are individually tailored with the input of individuals through relationship building, individual assessment and planning, and active involvement with individuals for them to gain independence and maintain work in community jobs, better manage symptoms, and improve recovery outlook. The team is mobile and delivers services in the community to meet with individuals where they are most comfortable and convenient. Eighty percent (80%) or more of direct service is performed in the community. Individuals can receive contact multiple times per day, or in rural areas they may receive extended individual contacts with less frequency due to geography. Due to the intensity of the services individual to staff ratios are limited. Full time staff member to individual ratio is limited to 1 to 10.

Services that are expected to be provided within the team, as directed within an individualized treatment plan, include:

  • Crisis intervention
  • Clinical evaluation/assessment for co-occurring care and substance use treatment; treatment provided where applicable
  • Psychiatric care
  • Case management
  • Medication administration and management
  • Illness management and recovery skills
  • Individual supportive therapy
  • Supportive employment services such as pursuing education or vocational training
  • Assistance with activities of daily living such as skill development addressing housing, performing household activities, personal hygiene and grooming tasks, money management, accessing and using transportation resources, accessing medical or dental resources, and accessing other applicable benefits, including training and coaching to promote greater independence in these areas
  • Intervention with family and natural supports
  • Coordination of care between team members and/or external services
  • Housing assistance

Service Definitions

Crisis Intervention

Services that are offered 24 hours per day, seven days a week for individuals who are at risk of and/or experiencing a crisis.

Clinical Evaluation/Assessment

A comprehensive assessment that addresses current and past information from the individual and family and/or support systems regarding: 1) mental and functional status; 2) effectiveness of past treatment; 3) current treatment, rehabilitation, and support needs to achieve individual goals and support recovery; and 4) individual strengths that can act as resources towards achieving individual goals. The information gathered is used to: 1) establish appropriate intensity of care; 2) set initial goals and develop the first person-centered treatment plan; and 3) plan of utilization of client strengths and support network in treatment. [See NAC 458 and associated Division Criteria related to Clinical Evaluation and Assessment].

Psychiatric Care

Includes psychiatric medical assessment, treatment and education regarding an individual’s mental health and substance use issues.

Case Management

Ongoing process that connects individuals to resources and supports to help them live in the community, manage their mental illness, and meet their personal goals.

Medication Administration and Management

A collaborative effort between the individual and the psychiatric prescriber with the participation of the ACT team to evaluate the individual’s previous experience with psychotropic medications and side-effects; to identify and discuss the benefits and risks of psychotropic and other mediation; to choose a medication treatment; and to establish a method to prescribe and evaluate medication according to evidence-based practice standards.

Illness Management and Recovery Skills

Combination of psychosocial approaches facilitating the learning and use of illness self-management strategies that help people make progress towards personally meaningful goals including relapse prevention planning, coping skills training, illness education, and promoting a healthy lifestyle.

Individual Supportive Therapy

Includes verbal therapies that help people make changes in their feelings, thoughts, and behavior to move towards recovery, clarify goals, and address stigma.

Supportive therapy and psychotherapy also help individuals understand and identify symptoms to find strategies to lessen distress and symptomatology, improve role functioning, and evaluate treatment and rehabilitative services.

Supportive Employment

Includes work-related services to help individuals value, find, and maintain meaningful employment in community-based job sites as well as job development and coordination with employers.

Family and Natural Supports

Includes psychoeducation and support in partnership with families and natural supports (supportive services built in their community in which the individual accesses, i.e., church, stable housing) to provide current information about mental illness and to help them develop coping skills for handling problems posed by mental illness as experienced by a significant other in their lives.

Coordination of Care Between Team Members and/or External Services

A process of organization and coordination within the transdisciplinary team to carry out the range of treatment, rehabilitation, and support services based upon the individualized treatment plan for individuals. Service coordination also includes coordination with community resources, including self-help and advocacy organizations that promote recovery.

Housing Assistance

Varies based upon individual needs. It may include finding safe, affordable housing, negotiating leases, and assisting clients in paying their rent, purchasing, and repairing household items, or developing relationships with landlords.

Reporting

Grant recipients will be required to submit a monthly report of activity by the 20th of each month to the KDADS QA Manager, as well as a final summary report addressing the results reached at grant term end March 14, 2023.

In addition, a financial report provided by KDADS shall be completed monthly, documenting all expenditures for the previous month, and submitted for reimbursement by the 20th of each month until all awarded funds are exhausted for the grant. The final report shall be expected March 20, 2023.

CMHCs who are awarded this funding must provide accurate and timely quarterly reports on their progress towards full fidelity, this will include: the number of participants, a list of team members and their roles, and the average length in participating in the ACT program. The reporting will be on the prior quarters deliverables and is due to KDADS QA Manager by the end of the first month of each quarter (January 2023 and April 2023). Following this grant period, the CMHC will be evaluated annually based upon Kansas’s ACT Fidelity Scale.

VII. Overview of Grant Awards

Applications/proposals may be submitted by 5:00 p.m. June 1, 2022, with specifics of proposed activities to meet the purpose of this sub-award as requested above.

VIII. Notification of Grant Awards

Funding awards will be announced by email July 1, 2022.

IX. Application

  1. Instructions:
    1. Submit one electronic application to KDADS.QA@ks.gov.
      • Due Date: June 1, 2022
      • Time: 5:00 p.m. (CDT)
    2. Complete the required cover sheet and submit with a Project Narrative(s).
    3. Applications must consist of a Project Narrative and a Proposed Budget (Appendix B- provided spreadsheet):
      • The boundaries of the areas to be served and communities of focus.
      • An explanation as to why the areas were selected (current service needs and gaps within the area).
      • Any demographic data to support your selection, cite your sources.
      • Methods planned for addressing the above-mentioned crucial components.
      • How data will be collected and reported back to KDADS.
      • A general timeline for completion of the project (must be completed by March 14, 2023).
      • A proposed line-item budget which includes personnel and fringe benefits, travel, supplies, and/or other related expenses (Appendix B: attached spreadsheet).
    4. Format the Project Narrative using one-inch margins at the top, bottom, and both sides; a font size of 12 point; and sequentially paginated pages.
    5. Please adhere to any funding limitations that may be listed within the project description.
  2. Only U.S. Food and Drug Administration (FDA) approved products and methods may be purchased with APRA funds.
  3. Grants are intended to fund practices that have a demonstrated evidence base and that are appropriate for the population(s) of focus. An evidence-based practice (EBP) refers to approaches to prevention, treatment, or recovery that are validated by some form of documented research evidence.
  4. Funds may not be expended through the grant or a sub-award by any agency which would deny any eligible client, patient, or individual access to their program because of their use of FDA approved medications for the treatment of substance use disorders.
  5. Funds may not be used, directly or indirectly, to purchase, prescribe, or provide marijuana or treatment using marijuana. Treatment in this context includes the treatment of opioid use disorder. Funds also cannot be provided to any individual who or organization that provides or permits marijuana use for the purposes of treating substance use or mental disorders. See, e.g., 45 C.F.R. § 75.300(a) (requiring HHS to “ensure that Federal funding is expended . . . in full accordance with U.S. statutory . . . requirements.”); 21 U.S.C. §§ 812(c) (10) and 841 (prohibiting the possession, manufacture, sale, purchase, or distribution of marijuana). This prohibition does not apply to those providing such treatment in the context of clinical research permitted by the DEA and under an FDA-approved investigational new drug application where the article being evaluated is marijuana or a constituent thereof that is otherwise a banned controlled substance under federal law.
  6. The grantee agrees to abide by all state, federal and local laws, rules, and regulations prohibiting discrimination in employment and controlling workplace safety. Any violation of applicable laws, rules or regulations may result in termination of this Grant.
  7. Budget information – Appendix B (attached spreadsheet).
  8. Below is a timeline and due dates for this RFA. If KDADS finds a need to alter the timelines listed herein, either an addendum or correction notice will be issued announcing the alternate timeline.

Release of Request for Application April 14, 2022
Written Questions Submitted May 1, 2022
Applications Due June 1, 2022
Awards Announced July 1, 2022
Grant Phase August 2022 – March 2023

Note: Submit application and questions to KDADS.QA@ks.gov.

Appendix A: Application Cover Sheet

Legal Name of Organization:

Official Administrative Address:

City, State, Zip+4:

Federal ID #:

Authorized Contract Signor and Title:

Contact for Application and Title:

Email Address:

Telephone:

Populations Served:

Appendix B: Budget Template

Separate spreadsheet template provided as an attachment. Budget Request tab example:

BUDGET REQUEST
(RFA - Attachment B)
APPLICANT:
TITLE OF RFA:
DESCRIPTION BUDGET REQUEST PERCENT OF TOTAL MATCH*
Personnel $0.00 % $0.00
Fringe Benefits $0.00 % $0.00
Travel $0.00 % $0.00
Equipment $0.00 % $0.00
Supplies $0.00 % $0.00
Contractual $0.00 % $0.00
Building $0.00 % $0.00
Training $0.00 % $0.00
Other 1 (please specify) $0.00 % $0.00
Other 2 (please specify) $0.00 % $0.00
Other 3 (please specify) $0.00 % $0.00
Indirect Costs $0.00 % $0.00
TOTAL BUDGET REQUEST $0.00 % $0.00

Laura Howard
Secretary

Doc. No. 050018