Program Evaluation Design and Implementation of Texas Health Community Impact Grants

Texas Health Resources Request for Proposals Program Evaluation Design and Implementation of Texas Health Community Impact Grants Proposals due on or before 5 p.m. CST, Nov. 2, 2018 Texas Health Resources 612 E. Lamar Blvd., Suite 300 Arlington, Texas 76011 Attention: Catherine Oliveros, DrPH catherineoliveros@texashealth.org 682-236-6170

Texas Health Resources Request for Proposals: Program Evaluation Design and Implementation of Texas Health Community Impact Grant Projects I. Overview Texas Health Resources (THR) Community Health Improvement (CHI) Department invites proposals from qualified researchers to design and conduct an evaluation of Texas Health Community Impact (THCI). THCI is THR s place-based initiative aimed at reducing health disparities, addressing social determinants of health and improving targeted health outcomes. The contracted scope of work will include evaluation design and implementation of THCI and initiative grantees. Grantees will be identified by March 2019. Evaluation design will begin January 2019 to establish appropriate measures of success, protocols for data capture, tools and training needs for grantees, as well as processes for reporting. THR will consider proposals where training to grantees is offered by the evaluation team or a train-the-trainer model is used to train THR staff who will support THCI grantees. Communities targeted for strategic investments were prioritized by local THCI Leadership Councils in support of the THCI strategy. Evaluation work will examine granted projects in 16 target zip codes across the THR service area. The funding cycle for first-year grantees will extend from Q2 of 2019 to Q4 of 2020. Cross-sector collaborative programs to be evaluated address behavioral health issues, including depression, social isolation and resiliency, as well as social determinants such as food insecurity, access to health services, and/or transportation. Evaluation efforts ensure THR can define to what extent THCI grantees have contributed to the attainment of established regional strategies and objectives as defined in the regional Impact Plans developed by the THCI Leadership Councils. Additionally, THR is interested in assessing the degree to which THCI work effects healthcare utilization and cost savings. THCI evaluation results will be key in ascertaining effectiveness of models that can be scaled up across THR s 16- county service area and establishing a long-term Key Performance Indicator (KPI) for THCI. II. Background: Texas Health Funding Allocations and Areas of Focus Texas Health s funding allocations as approved by the THCI Board include: Texas Health Community Impact Tarrant/Parker Leadership Council: $1,150,000 to address depression and food insecurity among low-income older adults 55+ in 76010

and 76082 to include transportation; as well as depression in people with chronic disease and food insecurity in 76119. Texas Health Community Impact Southern Leadership Council: $900,000 to address depression and food insecurity among low-income seniors 55+ in 76401, 76031, 76059, 75143 and 75161. Texas Health Community Impact Dallas/Rockwall Leadership Council: $1,350,000 to address depression and health access among low-income individuals ages 10-34 in 75212 and 75217, and individuals 25-54 in 75032. Texas Health Community Impact Denton/Wise Leadership Council: $900,000 to address resiliency and food insecurity among youth and adolescents ages 12 to 21 in zip codes 75057, 76266 and 76426. Texas Health Community Impact Collin Leadership Council: $900,000 to address depression and food insecurity among older adults 55+ in 75069 and depression and health access in youth ages 12-18 in 75074. Texas Health Community Impact program objectives and strategies include: Program Goal 1: Maximize the impact of initiatives addressing Behavioral Health Program Objective 1: Decrease depression by one stage of severity as measured by the PHQ-9 among low-income individuals age 55+ in East Arlington (76010), North Parker County (76082), Erath (76401), Johnson (76031, 76059), Kaufman (75143, 75161), and East McKinney (75069) by December 2020. o Program Strategy 1.1: By September 2019, decrease depression and social isolation among seniors by establishing a program, such as PEARLS. o Program Strategy 1.2: Increase access to developed program by establishing a referral network, including non-traditional partners by December 2019. Program Objective 2: Reduce depression by one stage of severity as measured by the PHQ-9 among low-income individuals 18-64 with a chronic condition in South East Fort Worth (76119) December 2020. o Program Strategy 2.1: Implement locally accessible behavioral health services, such as telemedicine services, for population at risk in 76119 by December 2019. o Program Strategy 2.2: Promote awareness of mental health issues for adults age 18 to 64 through evidence-based education that reduces stigma of mental illness, such as Meadows Foundation s Okay to Say Program by February 2020. Program Objective 3: Increase resiliency scores by 10 percent in youth (12-21) living in Lewisville (75057), Bridgeport (76246) and Sanger (76266) by December 2020.

o Program Strategy 3.1: Provide evidence-based education for teachers, counselors and parents on coping strategies for youth by December 2019. o Program Strategy 3.2: Design and implement a network which creates a supportive environment for youth who have experienced a traumatic event by August 2019. o Program Strategy 3.3: Establish a Community Navigator in identified schools to address Social Determinants of Health by July 2019. o Program Strategy 3.4: Establish a process at targeted schools to identify students and connect them to the appropriate level of care by August 2019. Program Objective 4: By the end of 2020, reduce depression by one stage of severity among underserved individuals 10-34 in West Dallas (75212) and Southeast Dallas (75217), and individuals 25-54 in South Rockwall (75032). o Program Strategy 4.1: Design and implement community-based interventions to promote positive outcomes in at least 500 individuals at risk for depression by year-end 2020. o Program Strategy 4.2: Break the stigma related to mental illness by establishing a team of 15 Mental Health First Aid Certified Instructors equipped to train approximately 900 individuals to understand, recognize and respond to someone experiencing a mental health or substance abuse crisis by year-end 2020. o Program Strategy 4.3: Screen at least 2,000 individuals for depression and bring services to non-traditional settings where people need them and feel safe using them by year-end 2020. o Program Strategy 4.4: Incorporate the voice of the community through three community-based neighborhood councils, each with up to 10 active and passionate community leaders from all sectors within three months of the grant announcement in 2019. Program Goal 2: Maximize the impact of initiatives addressing Social Determinants of Health Program Objective 1: Address food insecurity among low-income individuals age 55+ in East Arlington (76010), North Parker County (76082), Erath (76401), Johnson (76031, 76059), Kaufman (75143, 75161), East McKinney (75069), as well as low-income people with chronic disease in South East Fort Worth (76119) and youth (12-21), in Lewisville (75057), Bridgeport (76246) and Sanger (76266) by increasing the number of places offering healthy foods by December 2020. o Program Strategy 1.1: By September 2019, increase access to affordable, nutritious food through a collaborative partnership. Make improvements to local program/systems (i.e. voucher incentive programs, increased electronic benefit

transfer acceptance where food is purchased, improved transportation routes to food stores, access to healthier foods at community venues). Program Objective 2: Address transportation needs among low-income individuals age 55+ in East Arlington (76010) and East McKinney (75069) by establishing a transportation referral system by December 2020. o Program Strategy 2.1: By September 2019, increase the number of people using alternative transportation options through a collaborative partnership. Make improvements to local program/systems (i.e. partnerships with LYFT/UBER, improving Via system, etc.). Program Objective 3: Address access barriers among low-income youth (12-18) and their caregivers in East Plano (75074), by utilizing a Community Health Worker in identified schools to help connect students and their parents to resources in the community by December 2020. o Program Strategy 3.1: By September 2019, increase access to affordable, nutritious food through a collaborative partnership. Make improvements to local programs/systems (i.e. voucher incentive programs, increased electronic benefit transfer acceptance where food is purchased). o Program Strategy 3:2: Establish improved transportation options for target youth and their caregivers by December 2019. o Program Strategy 3:3: Identify and establish Faith-Based partnerships to provide mentoring, transportation, and homelessness prevention by December 2019. Program Objective 4: By December 2020, assess the viability of executing longer-term strategies to navigate the underserved to readily available resources in all target areas, and to create a safer community in the target neighborhood in South Rockwall (75032) through a purpose-built project. o Program Strategy 4.1: Partner with local health systems to explore the development and/or refinement of a comprehensive virtual information tool that would provide individuals with access to information on available community resources by year-end 2019. o Program Strategy 4.2: Create a taskforce and investigate the feasibility of creating a purpose-built community in the target neighborhood in South Rockwall by year-end 2019.

III. Scope of Work The scope of work requires a team of researchers from a research institution and/or consulting firm ( Research Team ) to execute the project. Proposals should include an overview of contributors and their research experience, an outline of the research and analysis to be conducted, a work plan, and a timeline of reports and deliverables. Please describe in submitted proposals how the Research Team will develop the following: 1. Data collection and analysis research methods for the THCI program model and all THCI grantees. The detailed methodology should be formed by and include a careful review of the THCI program goals (as presented in background) and specific grantee metrics as presented in approved grant applications. The proposal must also include a description of research approach, with discussion of the relative merits of preferred approach versus other options. 2. Data collection protocol to obtain updated, accurate performance and outcome metrics for THCI grantees and demonstrate progress towards program goals. This task will require establishing consistent data collection process and tools across all programs to ensure continuity and alignment between proposed grantee metrics and overall THCI program goals and objectives. 3. Necessary training approach and tools around data collection processes targeted to THCI staff and grantees. THR will consider proposals where training to grantees is offered by the evaluation team or a train-the-trainer model is used to train THR staff who will support the THCI grantees. 4. Database and dashboard as well as other appropriate reporting tools to communicate program and grantee metrics. 5. Approach to gather qualitative data from THCI grantees to supplement evaluation of THCI program and document best practices for sustainability and scalability purposes. IV. Deliverables The Research Team will be expected to submit quarterly reports, a draft final report, and upon THR approval, a final report with an executive summary that integrates, summarizes, and interprets key findings of the evaluation. The final report will provide an overview of zip code, THCI region and system level findings. The report should be written for non-technical audiences and relate the narrative discussion to descriptive statistics, analytical graphs, maps and tables where appropriate. Technical details, data tables, and details regarding methodology should be presented in appendices. The final report must be submitted electronically in Word and PDF and should be accompanied by Excel workbooks or Access database of all relevant data compiled during the evaluation period. The Research Team will provide metadata (field name description, definition, source, source data, and equation if computed) for all raw and

computed data fields. Geographic information systems (GIS) mapping databases, map images, and map documents developed for the project should also be submitted with the final report. V. Methodology The Research Team will develop a complete methodology to conduct the analysis specified in the scope of work related to program metrics for THCI grantees and the THCI program overall. It will include a description of: The analytical framework, research methods, and statistical techniques to be used for the proposed analysis. The proposal should discuss the relative merits of various approaches and outline the advantages and limitations of the selected approach. Methodology that aligns THCI work with key healthcare indicators such as: healthcare utilization and cost benefits (ROI). The decision process and protocols to be used for selecting and conducting case studies of meaningful programs and best practices. A method to summarize evaluation results by zip code, THCI region and THR system. VI. Solicitation Schedule and Submission RFP distributed October 12, 2018 Written questions submission deadline October 19, 2018 Q&A document posted on THR CHI website October 22,2018 Deadline for electronic submission November 2, 2018 Top proposals invited to present plan November 9, 2018 Finalists present to THCI Board in Arlington, TX November 26, 2018 Notifications to finalists December 2018 Proposals (including corresponding attachments) must be emailed in PDF and Word on or before 5p.m. CST, Nov. 2 to: CatherineOliveros@texashealth.org with a copy to AmberRiley@texashealth.org. Email Subject Line: THCI Program Evaluation Vendor RFP Proposal. Proposals submitted late or using other methods WILL NOT be accepted and/or considered. Organizations submitting proposals will receive email confirmation acknowledging receipt of proposal. Questions about this proposal can be directed in writing to Catherine Oliveros, DrPH, VP Community Health Improvement, at CatherineOliveros@texashealth.org by Oct. 19, 2018. Email Subject Line: THCI Program Evaluation RFP Questions. Submitted questions and corresponding answers will be posted on the THR CHI website on Oct. 22, 2018.

Expenses related to proposal submission including related travel, if invited to present as a finalist, will be covered by the applicant. VII. Proposal Evaluation All proposals will be evaluated based on the following criteria: Technical Capability Clearly articulated, logical study design and technically competent methodology. Demonstrated knowledge of existing research and practice relevant to the information outlined in the RFP, program evaluation methods and experience, and effective programmatic/grantee data collection methods. Management Strength Qualifications, relevant prior experience, command of existing research on public health programs, and ability to present findings in a useful manner. Credible management proposal for staffing and strong timeline for completion. Cost Effectiveness Feasible cost breakdown for proposed evaluation design and implementation scope of work. Technical, Management, and Cost Criteria Overview Narrative should not exceed 10 pages, using normal margins and no less than 11-point font. Please include the following information: Technical Capability Methodology: Provide a brief abstract of the proposal by summarizing the background, goals and objectives, proposed methodology, and expected output and outcome metrics for the research study. The technical proposal should reflect an understanding of the THCI program and a detailed approach to addressing the scope of work. Outline the step by step approach that will be taken to achieve the program s goals and objectives and arrive at research findings and conclusions. Describe how these methods will accomplish the desired results outlined in the RFP. The proposal should also identify any difficulties that may be encountered in executing the work and propose practical and sound solutions to limitations. Project Work Plan and Milestones: The proposal should briefly describe several phases into which the proposed work can logically be divided and performed. A schedule of milestones and deadlines should be specified for the completion of the various

elements, including: review of THCI program and approved grant proposals, data collection design, tool development, training execution, data collection, reporting, analysis, progress reports, preliminary drafts and final report. Data Requirements: THR will provide necessary background information on THCI. The proposal should identify any additional data to be supplied by THR. Additionally, the proposal should identify the points and tasks, in the research scope, that will require participation by THR Community Health Improvement staff. Management Strength: The resource capability and program management for planning and performing the work will be considered in the proposal selection process. Personnel performing the work must be described in this section in terms of numbers of people and their professional classification (e.g. project manager, economic analyst, strategic planning, etc.). Brief resumes detailing the education and relevant experience of the key personnel proposed for this project are required. The selected contractor will be required to furnish the services of those identified in the proposal as key personnel. Any change in key personnel is subject to approval by THR. Specific requirements for this section include: Business Management Organization and Personnel: The proposal must provide a brief narrative description of the organization that will perform the proposed work, and the authority responsible for controlling resources and personnel. This should also include an organization overview of any proposed subcontractors. Staffing Plan: Describe the proposed staff distribution to accomplish this work, including an organization chart that clearly presents the relationships of key proposed staff to manage/direct the project, lead key tasks, etc. The staffing plan should also present a chart that partitions the time commitment of each professional staff member to the project s tasks and schedule. The proposal should clearly identify the relationship of key project personnel to the contracting organization, including subcontractors and consultants. Relevant Prior Experience: The proposal should describe the qualifications and experience of the organization and the individual personnel to be assigned to the project. Information should include direct experience with the specific subject-matter area and client references including organizations, addresses, contact persons, and telephone numbers. Contract Agreement Requirements: This section of the proposal should contain any special requirements that the applicant wants to have included in the contract.

Cost Effectiveness Proposals must contain thorough budget information, including direct labor costs consistent with the staffing plan, labor overhead costs, travel (if appropriate), estimated cost of any subcontracts, as well as other direct costs (such as those for creating or maintaining data bases). The applicant should include estimated expenses (if applicable) for at least two-in person meetings at THR offices in Arlington, Texas. This should include a kick off meeting to clarify and refine the schedule, scope, roles of the applicant and THR staff, and any key issues/challenges. Another in person meeting is needed for presentation of study findings at a one-day meeting at THR offices in Arlington, Texas. This activity will be over and above routine conference calls, email communications and/or meetings (in person if local) with THR staff. The contract awarded for this research project will allow for payments on a quarterly schedule based on completing identified deliverables and each quarterly progress report and final report. The contract terms shall remain firm during the project and shall include all charges that may be incurred in fulfilling the terms of contract.