REQUEST FOR APPLICATIONS. School Nurse Intervention Program

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REQUEST FOR APPLICATIONS School Nurse Intervention Program Mississippi Department of Education Office of Healthy Schools 359 North West Street P. O. Box 771 Jackson, MS 39205-071 Contact: Estelle Watts Telephone: (601) 359-1737 Issue Date: March 25, 2014 Application Due Date: May 1, 2014

TABLE OF CONTENTS Part A: General Information & Application Procedures Part B: School Nurse Information Sheet Part C: Nurse to Student Ratio Part D: Standard Terms & Conditions, Assurances & Certifications Part E: Benchmarks Part F: School Nurse Job Description Part G: School Nurse Program Part H: Budget Part I: Evaluation Rubric 2

Introduction Part A GENERAL INFORMATION & APPLICATION PROCEDURES The Mississippi Department of Education s (MDE), Office of Healthy Schools is accepting applications for the School Nurse Intervention Program. The Mississippi Legislature appropriates funds during each Legislative Session, as the Mary Kirkpatrick Haskell-Mary Sprayberry Public School Nurse Program. The Legislature directs that the funds be used to support the School Nurse Intervention Program established in Section 37-14-3 of the Mississippi Code. From and after July 1, 2007, funds have been transferred to the State Department of Education, Office of Healthy Schools from the State Department of Health. Purpose The Mississippi Department of Education, through the Office of Healthy Schools, shall develop standards, procedures and criteria for the public school nurse programs in Kindergarten through Grade 12. The Office of Healthy Schools shall assume the responsibility for promoting a statewide school nurse program designed to prepare local school districts to incorporate a school nurse program into their local educational programs. Each application should stand alone in its plans to improve student health through the hiring of a school nurse. A limit of two applications per school district will be accepted. Grant Award Funding The MDE will award five year grants of $50,000 each fiscal year and a school district may receive up to two $50,000 awards to support multiple clinics. All grant awards are subject to availability of funds contingent upon legislative appropriation. The MDE reserves the right to negotiate grant award amounts with all Grantees. Grantees must meet specific benchmarks in order to continue in the Program each fiscal year. Benchmarks are identified in Part E of this RFA. Grant Period The grant period will be July 18, 2014 to June 30, 2019. Each year of the grant is based on a twelve month performance period beginning July 1 of each fiscal year and contingent upon continued legislative appropriation. 3

APPLICATION PROCEDURES Requests for Information Written questions regarding the RFA should be emailed to: Estelle Watts, State School Nurse Consultant Office of Healthy Schools Mississippi Department of Education ewatts@mde.k12.ms.us The deadline for submitting written questions by email is April 1, 2014. Answers to written questions will be posted on the Mississippi Department of Education s website under the Public Notice section. Procedures for Delivery of Applications One (1) application and an electronic copy saved to a CD or USB/Flash Drive in a read only PDF format must be received by 3:30 pm Central Standard Time on May 1, 2014 based on the delivery method used: Hand Deliver Proposals to: Mail Proposals to: Ship Proposals to: (FedEx, UPS, etc.) Lorraine Wince Office of Procurement Mississippi Department of Education Central High School, Suite 307 359 North West Street Jackson, MS Lorraine Wince Office of Procurement Mississippi Department of Education Post Office Box 771 Jackson, MS 39205-0771 Lorraine Wince Office of Procurement Mississippi Department of Education 359 North West Street Jackson, MS 39201 Risk of Delivery The applicant is responsible for ensuring the applications are delivered by the required time and assumes all risks of delivery. Applications will not be accepted after the deadline. 4

At the time of receipt of the application, the application will be open, date stamped, and recorded in Suite 307 of Central High School Building. Incomplete applications will not be evaluated and will not be returned for revisions. No late, faxed or emailed copies will be accepted. The application must be signed by an authorized official to bind applicants to the proposal provisions. Acceptance of Applicatons The MDE reserves the right, in its sole discretion, to waive minor irregularities in proposals. A minor irregularity is a variation from the RFA that does not affect the application, or give one applicant an advantage or benefit not enjoyed by other applicants, or adversely impacts the interest of the MDE. Waivers, when granted, shall in no way modify the RFA requirements or excuse the party from full compliance with the RFA specifications and other grant requirements if the party is awarded the grant. Rejection of Applications The MDE may reject applications that do not conform to the requirements of this RFA. Applications may be rejected for reasons that include, but are not limited to, the following: The application contains unauthorized amendments to requirements of the RFA The application is conditional The application is incomplete or contains irregularities that make the proposal indefinite or ambiguous The application contains false or misleading statements or references The application does not meet all requirements of the RFA The application is submitted without an electronic copy saved to a CD or USB/Flash Drive in a read only PDF format The application is not submitted by the designated deadline The application is not signed by authorized representative of the applicant The applicant has previously been cited with major and or significant deficiencies by the MDE in one or more programs. Disposition of Applications All proposals become the property of the State of Mississippi. Timeline March 25, 2014 April 1, 2014 May 1, 2014 Release RFA Deadline for RFA Questions Proposals due by 3:30 p.m. Central Standard Time (CST) to the Office of Procurement 5

May 7-9, 2014 July 18, 2014 Evaluation of Applications Approval by State Board of Education and Notification of Awards Fall 2014 Initial payment of $40,000 June 2015 Final payment of $10,000 contingent upon completion of monthly/annual reporting requirements Evaluation Criteria (See page 16, PART I for Evaluation Rubric) A Review Committee authorized by the MDE will evaluate applications using the selection criteria indicated below. Grants will be awarded to the districts that have the highest points, whose applications are the most advantageous to the MDE, and/or are comprehensive and responsive as determined by the evaluation committee. The MDE reserves the right to reject any or all application, to negotiate with the best offerors to address issues other than those described in the proposal, or to not make any award if the evaluation committee determines that this is in the best interest of the MDE. A maximum of 100 points will be allowed based upon the selection criteria listed below. I. School Readiness (20 points) The school district must demonstrate readiness through documentation of a School Health Council and approved wellness policy. All completed documents should be included in packet and signed where applicable. II. III. Quality Project Design/Administrative Support (20 points) The school district administrator and school nurse when available, should work together to complete Part F and G of this application. Include a narrative of the school nurse program and a job description. The design of the school nurse role is supported by school administration through involvement in school health promotion and quality improvement activities. (examples: school health council membership/leadership, school health policy development and/or improvement, participation in health surveys such as YRBS and SHIPPS, professional development) (20 points) School Profile and Budget Appropriateness (20 points) A nurse must be hired who is a Registered Nurse (RN) with a current Mississippi license. Data must be reported monthly to the Office of Healthy Schools. A minimum of twenty-five percent (25%) of his/her time must be devoted to tobacco education and/or programs. All funds from the grant must be used to support the school nurse program. Please attach the Budget (Part H) to reflect anticipated use. A recommended school nurse salary scale for can be found at www.mde.k12.ms.us/healthy-schools/health-services Identify the type of school nurse program currently in place. Using the description below, describe your plans should you be awarded the grant. (See Part F) 6

A. No current School Nurse Program- Identify needs and how a School Nurse program will uniquely benefit the school/district by receiving the award. B. Functioning School Nurse Program- Outline successes and any plans to improve or increase student health services which will uniquely benefit the school/district by receiving the award. IV. Purposes aligned with MDE priorities and Plan with Clear Objectives (40 points) The National Association of School Nurses recommends a nurse:student ratio of 1:750 in a general education population, both statewide and within the districts/schools. Identify the ratio level that this application will address and whether it is applicable to the district or school. Complete Part C to identify the nurse to student ratio. A coordinated effort should be used to align MDE priorities and a plan using clear objectives to strengthen the school nurse program for the purposes of this application. 1. Include the impact of this grant on the current school/district ratio. 2. Include the plan and purpose for School Health services improvement. 3. Include innovations being considered to build or improve a quality school nurse program. 4. Sustainability is defined as involving methods that give the ability to last or continue. Include a forward looking approach to sustainability of health services beyond the current resources. Proposal Requirements Application must include the following components: School Nurse Information Sheet (Part B). Nurse to Student Ratio (Part C) Indicate nurse to student ratio based on current status as well as status if awarded grant. Statement of Standard Terms and Conditions, Assurances and Certifications (Part D) The statement of assurances must be signed by the superintendent of the district. Benchmarks (Part E) Indicate your agreement to the benchmarks by checking the blanks. The list also designates the documents that should be attached to proposal. This form must be signed by the superintendent of the district as well as the school principal. School Nurse Job Description (Part F) Provide job description based on the documents listed on the form as well as address the elements of the law as indicated. School Nurse Program (Part G) Provide a narrative description of the proposed project design of the school nurse program. Limit the narrative to 3 pages, 12 point font, double spaced. Budget (Part H) Indicate the budget for 5 years. Budget must include salary. 7

Part B SCHOOL NURSE INFORMATION SHEET School District: Address: City: Zip Code: Phone Number: Fax Number: Nurse: License # Mailing Address for Nurse: City: Zip Code: Primary Phone Number: Fax Number: Email Address of Nurse: School Site(s) School Phone Number Grade Levels No. of Students Nurse is a: Registered Nurse ADN/ASN/Diploma BSN MSN Nurse Practitioner (APRN) Nurse will attend the Fall Regional School Nurse Meeting. Yes No Nurse is a first-time School Nurse. Yes No Nurse will submit electronic data monthly Yes No This page may be duplicated if applying for two awards 8

Part C NURSE TO STUDENT RATIO This grant is intended to maintain or improve the districts nurse to student ratio when compared to the current ratio. The national standard is 1:750 healthy students. Nurse to student ratio is calculated by dividing student enrollment by number of nurses. To follow is an example: (a) (b) (b)/(a)=1:(c) # of School Nurse(s) in District/School Nurse: Student Ratio District/School Enrollment 2 900 1:450 1. Please indicate if the following information is for district or school? 2. Please indicate what is your current nurse to student ratio? 3. Based on award of this application, what would be your nurse to student ratio? This information may be duplicated if applying for multiple awards 9

Part D Mississippi Department of Education STATEMENT OF STANDARD TERMS AND CONDITIONS, ASSURANCES AND CERTIFICATIONS By signing this statement, the Grantee hereby certifies and assures that the school district and school site submitting this application shall comply with the following Standard Terms and Conditions, Assurances and Certifications in accordance with state regulations, MDE policy and requirements pertaining to this program. The applicant certifies further that the information submitted on this application is true and correct. Standard Terms and Conditions Changes This agreement shall not be modified, altered, or changed except by mutual agreement by an authorized representative(s) of each party to this agreement, and must be confirmed in writing through the Mississippi Department of Education grant modification procedures. Independent Grantee The grantee shall perform all services as an independent grantee and shall discharge all of its liabilities as such. No act performed or representation made, whether oral or written, by grantee with respect to third parties shall be binding on the Mississippi Department of Education. Termination The Mississippi Department of Education, by written notice, may terminate this grant, in whole or in part, if funds supporting this grant are reduced or withdrawn. To the extent that this grant is for services, and if so terminated, the Mississippi Department of Education shall be liable only for payment in accordance with payment provisions of this grant for services rendered prior to the effective date of termination. The Mississippi Department of Education, in whole or in part, may terminate this grant for cause by written notification. Furthermore, the Mississippi Department of Education and the grantee may terminate this grant, in whole or in part, upon mutual agreement. Either the Mississippi Department of Education or the grantee may terminate this agreement at any time by giving written notice to the other party of such termination and specifying the effective date thereof. The grantee shall be paid an amount which bears the same ratio to the total compensation as the services actually performed bear to the total services of the grantee covered by the agreement, less payments of compensation previously made. Access to Records The grantee agrees that the Mississippi Department of Education, or any of its duly authorized representatives, at any time during the term of this agreement, shall have access to, and the right to audit and examine any pertinent books, documents, papers, and records of grantee related to grantee's charges and performance under this agreement. Such records shall be kept by grantee for a period of five (5) years after final payment under this agreement, unless the Mississippi Department of Education authorized their earlier disposition. Grantee agrees to refund to the Mississippi Department or Education any overpayments disclosed by any such audit. However, if any litigation, claim, negotiation, audit or other action involving the records has been started before the expiration of the five year period, the records shall be retained until completion of the action and resolution of all issues which arise from it. Laws This agreement, and all matters or issues collateral to it, shall be governed by, and construed in accordance with, the laws of the State of Mississippi. 10

Legal Authority The grantee assures that it possesses legal authority to apply for and receive funds under this agreement. The grantee certifies they have not been barred from contracting or otherwise doing business with the State or Federal Governments Equal Opportunity Employer The grantee shall be an equal opportunity employer and shall perform to all affirmative action and other applicable requirements; accordingly, grantee shall neither discriminate nor permit discrimination in its operations or employment practices against any person or group of persons on the grounds of race, color, religion, national origin, handicap or sex in any manner prohibited by law. Further, the applicant agrees to comply with the Civil Rights Acts of 1964, Title IX of the Education Amendments of 1972, Section 504 of the Rehabilitation Act of 1973, the Age Discrimination Act of 1975, the Americans with Disabilities Act of 1990, and the No Child Left Behind Act of 2001; Copyrights MDE grants to the Grantee the right to copyright materials and articles that may result from research carried out under this grant. MDE shall have unlimited royalty free license to use, reproduce, translate or publish all product(s) produced under this agreement for and on behalf of the MDE and the public school districts of the State of Mississippi. Personnel Grantee agrees that, at all times, the employees of grantee furnishing or performing any of the services specified under this agreement shall do so in a proper, workmanlike, and dignified manner. Assignment Grantee shall not assign or subcontract in whole or in part, its rights of obligations under this agreement without prior written consent of the Mississippi Department of Education. Any attempted assignment without said consent will be void and of no effect. Property, Equipment and Supplies Property, equipment and supplies purchased, in whole or in part, with funds provided under this agreement shall be procured, accounted for and disposed of in accordance with applicable State and Federal laws and regulations. Title to any equipment and supplies purchased under this agreement shall be vested in the grantee. Mississippi Ethics It is the responsibility of the grantee to ensure that subcontractors comply with the Mississippi Ethics Law in regard to conflict of interest. A statement attesting to said compliance shall be on file by the grantee. No indirect cost will be applied to this grant. Original Signature of Superintendent Date Typed or Printed Name of Superintendent 11

Part E BENCHMARKS Please indicate agreement to the following benchmarks or requirements by checking the blanks. The list also designates the documents that should be attached. A registered Nurse (RN) with a current un-restricted Mississippi license must be hired through this School Nurse Program. License verification is attached. The school nurse is allowed/encouraged by administration to participate in the following school health promotion and quality improvement activities. Check all that apply School health council membership/leadership School health policy development and/or improvement Participation in health surveys such as YRBS and SHIPPS Professional development opportunities Wellness policy and School Health Council activities are attached. The school nurse will submit monthly data collection, due on the 10 th of each month. The school nurse will participate in mandatory training, provided by The Office of Healthy Schools, on at least an annual basis. Our school nurse will devote at least twenty-five percent (25%) their time to tobacco education and/or programs. Funds received from this grant will only be used to directly support the school nurse program. Signature of Superintendent Date Signature of School Principal Date 12

Part F SCHOOL NURSE JOB DESCRIPTION MS Code: 37-14-7, the Mary Kirkpatrick Haskell- Mary Sprayberry Public School Nurse Act of 2007, requires that MDE is responsible to develop procedures and standards of care, school nursing criteria, and recommend a salary structure for school districts while administering these grant funds. Below are elements in the law that should be addressed. a. Serve as coordinator of the health services program and provide nursing care b. Provide health education--as a supplement to the regular classroom requirements c. Implement activities to promote health and prevention of tobacco, alcohol and substance use and abuse d. Identify health and safety concerns in the school environment, promoting a nurturing environment e. Provide administration of medications and help student manage their specific health diagnosis-directly or indirectly through management resources f. Support healthy food services programs g. Promote healthy physical education, sports policies and practices h. Promote dropout prevention programs i. Participate with allied health programs introducing students to health careers The application should include a job description that is based on the following documents: 1. Mary Kirkpatrick Haskell-Mary Sprayberry Public School Nurse Act of 2007 (MS Code 37-14-7) 2. Mississippi School Nurse Procedures & Standards of Care 2013 Manual 3. School Nurse Recommended Salary Scale 4. Administrators Guide: Managing the School Nurse Resource. All of these documents can be found on the MDE, Office of Healthy Schools website: http://www.mde.k12.ms.us/healthy-schools/health-services 13

Part G SCHOOL NURSE PROGRAM Application should include a narrative description of the proposed project design of the school nurse program. Using the guide below identify and discuss the school nurse program. The focus should be on the plans for student health improvements including innovation and sustainability. Limit to three pages, 12 point font, double spaced. This section should indicate if the request is for one or multiple awards. A. No current School Nurse Program- Identify needs and how a School Nurse program will uniquely benefit the school/district by receiving the award. Describe whether the plan includes a district level or school level implementation. Use your available health data to justify the need. Proposed project design should address the impact on the nurse to student ratio. B. Functioning School Nurse Program- Outline successes and any plans to improve or increase student health services which will uniquely benefit the school/district by receiving the award. Describe whether the plan includes a district level or school level implementation Use artifacts or current data that support the current school nurse program successes. Proposed project design should address the impact on the nurse to student ratio. 14

Part H BUDGET Categories Year 1 Year 2 Year 3 Year 4 Year 5 Salary and Benefits Travel Training Equipment Commodities Totals for each year Awards will be in the amount of $50,000 for each fiscal year. A school district may receive up to two $50,000 awards to support multiple nurses. Budget should indicate for each fiscal year a request of $50,000 for one and $100,000 for multiple school nurses. No indirect cost rate shall be allowed. Budget must include salary This form is a required element of the grant application. Grant awards are subject to availability of funds contingent upon legislative appropriation. The Mississippi Department of Education reserves the right to negotiate grant award amounts with all Grantees. 15

Part I EVALUATION RUBRIC I. School Readiness Forms Completed/Signed Maximum Points 20 A. School Nurse Information Sheet Included (part B) 5 B. Signed Standard Terms & Condition, Assurances & 5 Certifications Included (part D) C. Nurse to Student Ratio Included(part C) 5 D. Confirmed Items on Benchmark Checklist & Signature 5 Included (part E, wellness policy, and school health council documents) Comments: Total Points Awarded Points Awarded II. Quality Project Designed Job Description A. Job description provided evidence the listed documents were used as guidance B. The design of the school nurse role is supported by school administration through involvement in school health promotion and quality improvement activities. (examples: school health council/leadership, school health policy development and/or improvement, participation in school health survey s such as YRBS and SHIPPS, professional development) Total Points Awarded Comments: Maximum Points 20 10 10 Points Awarded III. School Profile and Budget Appropriateness Identify the Current School Nurse Program (Select between no current school nurse program or functioning school nurse program) A. No Current School Nurse Program Does the application include student health data (ex: asthma, diabetes, obesity, teen pregnancy, community involvement, etc.) Maximum Points 20 15 Points Awarded 16

A. Functioning School Nurse Program The application includes artifacts from the current program (ex: documentation of successes, publications, changes in health data, budget report, community involvement, etc.) B. Budget Budget completed with expected expenditures. Salary required. Could also include travel, training, equipment, and supplies. Total Points Awarded Comments: 15 5 IV. Support of MDE Priorities and Clear Objectives Application includes these Narrative Components A. The Application identifies the expected impact on the current nurse to student ratio. B. The Application gives detailed plans for Student Health Improvement. C. The Application identifies innovative approaches to a quality School Nurse Program. D. The Application identifies plan for sustainability of the School Nurse Program. Total Points Awarded Comments: Maximum Points 40 10 10 10 10 Points Awarded 17