WASHINGTON STATE DEPARTMENT OF HEALTH P.O. Box 47903 Olympia, WA 98501-7905 101 Israel Rd. SE Tumwater, WA 98501 Request for Grant Application (RGA) # N19933 PROJECT TITLE: Breastfeeding Support in Community Health Centers and Clinics APPLICATION DUE DATE: February 28, 2013 EXPECTED TIME PERIOD FOR CONTRACT: March 20, 2013 through September 29, 2013 REQUEST FOR GRANT APPLICATION The Washington State Department of Health (DOH) Healthy Eating Active Living Program has been awarded supplemental federal funding from the Centers of Disease Control and Prevention (CDC) - DP08-805501PPHF12 Nutrition, Physical Activity and Obesity Program which funds the Breastfeeding Promotion and Support Project. The Healthy Eating Active Living Program is pleased to announce this new grant opportunity: Breastfeeding Support in Community Health Clinics. This grant opportunity supports breastfeeding practices for Washington State community health centers and clinics (CHCs) serving communities of color, primarily African American, American Indian/Alaska Native, and Latino communities. This funding opportunity is a competitive application process. Up to ten (10) health centers and clinics will be awarded up to $38,000 in federal funds over the project period. ELIGIBLITY Eligible Applicants include community health centers and clinics that provide services to communities of color, including migrant health centers, Federally Qualified Health Centers, and tribal health clinics. Local Health Jurisdictions that provide clinic services are also eligible to apply.
SCHEDULE (these are anticipated due dates subject to change) Due Date/Time RGA Release Date February 12, 2013 Questions due from Applicants February 15, 2013 DOH s Response to Questions February 20, 2013 Applications Due February 28, 2013 Evaluation/Scoring of Applications March 1-5, 2013 Announcement of Apparently Successful Applicants March 5, 2013 Projected Contract Start Date March 20, 2013
TABLE OF CONTENTS Contents 1. INTRODUCTION AND PURPOSE... 4 2. OBJECTIVE... 4 3. SELECTION CRITERIA... 5 4. FUNDING... 5 5. SUBMITTAL OF APPLICATIONS... 5 6. FORMATS... 6 7. COMMUNICATION THROUGH RGA COORDINATOR... 6 8. APPLICANTS QUESTIONS AND DOH ANSWERS... 6 9. NON-RESPONSIVE APPLICATIONS... 6 10. WITHDRAWAL OF APPLICATIONS... 6 11. PUBLIC DISCLOSURE... 7 12. RGA AMENDMENTS... 7 13. EVALUATION AND AWARD PROCEDURES... 7 14. SCORING METHODOLOGY... 7 15. NOTICE OF AWARD... 7 16. DEBRIEFING CONFERENCE... 7 17. CONTRACT TERMS... 8 18. EXHIBITS... 8 EXHIBIT A Draft Statement of Work... 9 EXHIBIT B GRANT PROJECT APPLICATION... 11
1. INTRODUCTION AND PURPOSE Mothers consistently identify the support from health care providers as the single most important intervention for help with breastfeeding. Conversely, mothers identify lack of culturally relevant support from health care providers as a major barrier to breastfeeding. The role of the health care provider is to provide consistent and evidence-based advice and support to help mothers start and continue breastfeeding. Benefits to your clinic: The Breastfeeding Support in Community Health Clinics Project will provide resources and training to help health care providers and clinic staff in CHCs serving diverse ethnic and geographic populations to enhance their capacity in supporting mothers to breastfeed their babies. Your clinic will have trained staff and current and evidence-based breastfeeding support policies and protocols in place by the end of the project. The Surgeon General s Call to Action to Support Breastfeeding 2011 http://www.surgeongeneral.gov/library/calls/breastfeeding/index.html outlines an implementation strategy to support small community-based organizations to address the challenges that breastfeeding mothers encounter and increase the support needed for mothers to continue breastfeeding, especially in communities of color. Examples of these types of services that can be provided include, but are not limited to, training of current, existing staff in lactation care, counseling skills, case management, etc.; provision of walk-in locations for lactation expertise and support (baby cafés); and activities that systematically connect breastfeeding mothers to culturally appropriate and relevant resources within their communities. The Centers for Disease Control and Prevention has funded six states, including Washington State to do this important work. This project also supports the Washington State Nutrition and Physical Activity Plan http://depts.washington.edu/waaction/plan/index.html and the Tribal Maternal-Infant Health Strategic Plan http://www.doh.wa.gov/portals/1/documents/1200/phsd-aihcplan.pdf. Further information regarding the evidence-based best practices that this project is based on can be found at the Centers for Disease Control and Prevention Breastfeeding webpage at http://www.surgeongeneral.gov/library/calls/breastfeeding/executivesummary.pdf. 2. OBJECTIVE The main objective of this project is that by September 29, 2013, the clinics that have been awarded serving primarily African American, American Indian/Alaska Native, and Latino communities, will adopt best practices in education, procedures, and systems to improve breastfeeding success among mothers and babies. Qualified clinics will work closely with the Washington State Department of Health, WithinReach and the University of Washington to achieve the following required objectives: Achieve evidence-based best practice recognition Train staff and providers on clinical and clinic-level best practices to encourage and support breastfeeding Integrate improved breastfeeding support policies, protocols, and outcomes into ongoing clinic operations RGA N19933 Page 4 of 17
3. SELECTION CRITERIA Demonstrated ability to reach African American, American Indian/Alaska Native, or Latina women Commitment to identifying and sending select staff to: o A contractors kick-off meeting o A regional breastfeeding training Commitment and capacity to participate in the evaluation process by collecting breastfeeding data Demonstrated capacity to complete contract deliverables as written in the attached draft Statement of Work The DOH evaluation team will review, evaluate and score grant applications based on their assessment of the quality of the grant application responses. 4. FUNDING DOH has budgeted for an amount $38,000.00 in federal funds for this project. No payments, in advance or in anticipation of goods or services to be provided, under any resulting grant shall be made. Any grant awarded is contingent upon the availability of funding. DOH, at its sole discretion, may elect to extend this contract via amendment on the contingency of availability of funding. 5. SUBMITTAL OF APPLICATIONS The Project Application, Exhibit B, must be sent to the RGA Coordinator listed below electronically as an attachment via email. To help the RGA Coordinator identify incoming Project Applications, please include in the email subject line Response to RGA # N19933. Email the required Project Grant application to: Contact: E-mail Address: Telephone: Holly Jones, DOH RGA Coordinator Department of Health Contracts Unit Holly.Jones@doh.wa.gov (360) 236-3904 (for inquires). Your application must be sent via email to the RGA Coordinator no later than February 28, 2013 3:00 p.m., local time. Late applications will not be accepted and will automatically be disqualified from further consideration. DOH assumes no responsibility for delays caused by Applicant s e-mail, network problems or any other party. RGA N19933 Page 5 of 17
6. FORMATS Submission of Applications accepted in Portable Document Format (Adobe Acrobat PDF) only When scanning documents to be submitted in PDF format, scanner resolution should be set to at least 200 dots per inch. Please note that we cannot accept compressed or.zip files due to security concerns. 7. COMMUNICATION THROUGH RGA COORDINATOR Upon release of the RGA all communications concerning this RGA must be directed only to the RGA Coordinator. Any communication directed to DOH staff, or anyone other than the RGA Coordinator, may result in disqualification. E-mail is the method for any communication required in this Grant Application. The RGA Coordinator will also communicate with you utilizing the same method. DOH does not take responsibility for any problems in the e-mail or Internet delivery services. 8. APPLICANTS QUESTIONS AND DOH ANSWERS Any questions Applicants may have are required to be submitted in writing via e-mail to the RGA Coordinator. Questions will be accepted until the date set forth in the Application Schedule. Early submission of questions is encouraged. Questions and their answers will be emailed to all Applicants included in the original distribution list. Applicants may only rely on statements and/or amendments issued via email, by the RGA Coordinator. Any oral communications are unofficial and are not binding on DOH. 9. NON-RESPONSIVE APPLICATIONS DOH may reject an application at any time as nonresponsive for any of the following reasons: Submission of an application that proposes services that deviate from the technical requirements set forth in this document Failure to comply with any part of this RGA Submission of incorrect, misleading, or false information Late submission of application 10. WITHDRAWAL OF APPLICATIONS After an application has been submitted, an Applicant may withdraw its application at any time up to the application submission date and time specified in the application Schedule. A written request via email to withdraw the application must be submitted to the RGA Coordinator. After withdrawing an application, the Applicant may submit another application at any time up to the application submission date and time. RGA N19933 Page 6 of 17
11. PUBLIC DISCLOSURE Materials submitted in response to this RGA shall become the property of DOH and the applications shall be deemed public records as defined by RCW 42.56. If DOH receives a request to view or copy an Application, DOH will respond according to applicable law and DOH policy governing public disclosure. DOH will not disclose any information marked Proprietary in an Application without giving the Applicant (10) days notice to seek relief in superior court per RCW 42.56.450. 12. RGA AMENDMENTS DOH reserves the right to amend this RGA. DOH will send any RGA amendments to all Applicants who were sent the RGA on the original distribution list via email. This RGA and all amendments will be posted to the DOH website: http://www.doh.wa.gov/home.aspx. 13. EVALUATION AND AWARD PROCEDURES DOH will initially screen each application to determine if the Applicant has complied with the submittal instructions. If an application meets all requirements, the application will be moved forward to an Evaluation Team for evaluation and scoring. A selected evaluation team by DOH will review, evaluate and score applications. 14. SCORING METHODOLOGY The evaluation team includes experts in the field. They will review the applications. Total points possible, 100. Each question has points assigned. Questions 1, 4, 5, 6, and 7 will be scored on comprehensive information given. Questions 2 and 3 (Project Grant Application, Exhibit B) will be scored by percentage. The higher percent of women of color served, the higher points will be given. Points will be totaled. The top 10 clinics/centers (or up to 10) that scored the highest will be offered the funds to participate in the project. 15. NOTICE OF AWARD DOH will notify the Apparently Successful Applicants in writing via email of its selection on or about the date and time specified in the Application Schedule. DOH will also notify unsuccessful Applicants on or about the date and time specified in the Application Schedule. 16. DEBRIEFING CONFERENCE Once the Apparently Successful Applicants have been announced, all unsuccessful Applicants may request a telephone debriefing conference. Contact the RGA Coordinator in writing via email to schedule a conference. RGA N19933 Page 7 of 17
17. CONTRACT TERMS The Apparently Successful Applicant is expected to sign a Contract with DOH and any subsequent amendments that may be required to address specific work or services as needed. For a copy of the contract boilerplate, contact the RGA Coordinator in writing via email. Any alternate contract language you wish to propose, for clarification or procedural purposes, to the Terms and Conditions must be in a separate document but must be attached in the same email as your Project Application submission. In no event is an Applicant to submit its own standard contract terms and conditions as a response to this requirement. The Applicant needs to address the specific language and submit whatever exceptions or exact contract modifications that they may have to the proposed Terms and Conditions. Applicant s new and/or modified paragraphs will be the only ones that will be subject to discussion during contract negotiation. 18. EXHIBITS EXHIBIT A DRAFT STATEMENT OF WORK EXHIBIT B GRANT PROJECT APPLICATION RGA N19933 Page 8 of 17
EXHIBIT A Draft Statement of Work Statement of Work Date of Execution through September 29, 2013 Task 1: Planning Breastfeeding Support in Community Health Centers project In partnership with WithinReach, discuss existing clinic capacity and resources to implement project, and assess the needs and interests of clinic healthcare providers, staff and administration related to promoting breastfeeding. Work with WithinReach to develop objectives using the 2011 Surgeon General s Call to Action to Support Breastfeeding as a guide. o Required Objectives: 1. Send staff and providers to a training on best practices to support breastfeeding mothers and work to integrate these practices into ongoing clinic operations. 2. Activate a referral network with the local hospital and community-based support groups and organizations. 3. Take steps to actively promote breastfeeding by not giving out formula samples unless medically indicated, as well as discontinuing the posting of formula advertisements. 4. Participate in pre and post assessments as well as quarterly interviews with the University of Washington evaluation team. 5. Integrate best practices into ongoing clinic operations and policy 6. Apply for recognition as a breastfeeding friendly health clinic through WA Steps Up for Breastfeeding Success. o Optional objective ideas: 1. Develop clinic based breastfeeding drop-in support groups. 2. Conduct peer breastfeeding education classes. 3. Conduct follow-up contact with mothers by phone. 4. Integrate breastfeeding support with home visiting and post partum care programs. 5. Establish partnership for coordinated care after discharge. 6. Other options that clinic leadership feels would best support breastfeeding families. Develop a detailed project plan to meet identified objectives. Collaborate with the University of Washington and Department of Health to develop and report on quarterly milestones of progress, accomplishments and reach. Communicate with Department of Health, Within Reach and the University of Washington regularly via in-person meetings and conference calls as scheduled. Deliverables: Submit quarterly milestone reports via Catalyst on required activities. Submit project plan. Due Dates: Quarterly milestones reports: April 30, 2013, July 15, 2013, and September 27, 2013 Project Plan: April 30, 2013 RGA N19933 Page 9 of 17
Pre and Post-Assessments: TBD and scheduled by University of Washington Quarterly interviews: TBD and scheduled by University of Washington Payment: Reimbursement for costs incurred not to exceed $38,000.00. RGA N19933 Page 10 of 17
EXHIBIT B GRANT PROJECT APPLICATION Breastfeeding Support in Community Health Centers Project Thank you for your interest in the Breastfeeding Support in Community Health Centers project. Instructions: (refer page 4, section 3 for selection criteria) This is a competitive selection process. Please fill out this application as completely as possible. Your application will be scored on a 1-100 point scale based on the criteria described below. Community Health Center/Clinic Contact Information: 0 Points Clinic Name: Click here to enter text. Contact Name: Click here to enter text. Address: Click here to enter text. Phone: Click here to enter text. Email: Click here to enter text. 1) Describe your clinic: include number of clients seen, ethnic distribution of clients served, and number of pregnant and early postpartum (birth through two months) women seen in an average month. 10 points Click here to enter text. 2) How many breastfeeding women of each ethnicity do you anticipate seeing in your clinic on a monthly basis? 10 points African American women: Click here to enter text. American Indian/Alaska Native women: Click here to enter text. Latina women: Click here to enter text. Other women of color: Click here to enter text. Caucasian women: Click here to enter text. 3) How many women in the early post-partum period (birth through two months) does your clinic see on a monthly basis? 10 points Click here to enter text. African American women: Click here to enter text. American Indian/Alaska Native women: Click here to enter text. Latina women: Click here to enter text. Other women of color: Click here to enter text. Caucasian women: Click here to enter text. 4) Describe your clinic s interest and capacity for implementation of a project to support breastfeeding. 25 points Click here to enter text. Page 11 of 17
5) Describe your clinic s providers and staff. Include types (RN, Ob/Gyn, etc.), number of each and ability to attend offered trainings. 15 points Click here to enter text. 6) Describe your clinic s capacity to collect data for the evaluation process. 25 points Click here to enter text. 7) Has your clinic done any quality improvement projects, or made clinic-level changes in the past to improve the breastfeeding support and guidance given to postpartum mothers? 5 points Click here to enter text. Page 12 of 17
101 Israel Road SE, Town Center 1 - PO Box 47905 - Olympia, Washington 98504-7905 RGA N19933 Breastfeeding Support in Community Health Centers and Clinics Amendment 1 February 20, 2013 To: From: Purpose: Prospective Applicants Holly Jones, RGA Coordinator, email: holly.jones@doh.wa.gov DOH Response to Applicants Question, and clarification on entities that require internal approvals Clarification It is not required by DOH for entities to be pre approved by their internal governing bodies, i.e., councils, commissions, etc., to apply for this RGA. DOH will be as flexible as possible for determining an Applicants start date for their contract due to those entities that won t be able to get their internal approvals completed by the Application due date of February 28, 2013. If any Applicant that has been awarded these funds decides that this project is something they cannot commit to or end up not getting approved from their internal governing bodies, then funds will be offered to the next Applicant in rank. Applications will be scored in rank by highest to lowest. Questions and Answers 1. Q. Who qualifies as a "Community Health Center" (CHC)? A. This grant is intended for public funded/supported community based clinics. A community health centers provide comprehensive, culturally competent, quality primary health care services to medically underserved communities and vulnerable populations. Health centers are communitybased and patient-directed organizations that serve populations with limited access to health care. Any health center or clinic that primarily serves women of color qualifies such as: Federally Qualified Health Clinics, Tribal Health Clinics, community migrant health centers, etc. 2. Q. Could you clarify the available amount of funds? I interpret this RGA as there is $38,000 in funds that will be used to fund up to ten projects. A. Each of the ten clinic s that is funded will receive up to $38,000. 3. Q. My clinic is very interested in applying for the funds; however getting approval to apply for the funds won t happen until after February 28. Can I still apply for the Project Grant Application? Page 13 of 17
A. Yes, you can still apply for the RGA Project Grant Application. If your clinic is required to seek approval from a governing body, we will work with you to accommodate your schedule. Please submit the application so we can use the data to determine whether your clinic qualifies. We will rank all clinics and offer funds to the top 10 clinics. If your approval process goes beyond the application due date, know that your contract will most likely start after the projected contract start date of March 20, 2013. 4. Q. Can you provide us with any more specifics on the type of training that our staff members will be required to attend? A. At least two clinic staff are expected to attend each of the following meetings during the project period: a. Individual clinic meeting with WithinReach staff held at your clinic to draft clinic goals and basic work plan. b. Contractor s kick off meeting, tentatively scheduled for 4 hours during the week of April 15 th, held in the Puget Sound region. c. Staff training. More clinical and administrative staff are expected to attend this 1-day training meeting. Providers will receive extra training on clinical lactation management skills during the same day. There will also be monthly or bi-monthly phone checks in WithinReach. In addition clinics may choose to spend their funds on additional trainings if they think that would be beneficial (ex. Sending select staff to Bastyr s 5-day breastfeeding course for staff to become Certified Lactation Educators). 5. Q. Would just one training session be necessary or would multiple sessions be required to attend? A. See response to Question #5. 6. Q. Where would the training(s) be held and how many days would each session consist of? A. The trainings will most likely be held in King County. They would be ½ to 1 full day. Depending on the location of the chosen clinics we may chose to do the trainings elsewhere (ex. If 6 of our clinics are in Eastern Washington we would consider holding the trainings in a more central location). 7. Q. Could the grant funds be used to pay for the training(s) and subsequently required travel costs (i.e. mileage, hotel)? A. Yes. 8. Q. Education materials: would these materials be supplied to us or would we be required to supply our own? A. Within Reach will provide all educational materials. 9. Q. Could the grant funds be used to help cover the cost of advertising upcoming breastfeeding classes and/or support groups? A. Yes. Page 14 of 17
10. Q. Is it safe to assume that the grant funds could be used to also cover wages for staff members who are selected to be part of the new breastfeeding team? A. Yes, however it is important to keep in mind that this is a one-time grant. It is important to consider sustainability when choosing how to spend the money as well as a project s ability to have continued impact after the grant funds have been spent. Part of the training will include how to bill for lactation services, which should help increase the sustainability of your clinic s breastfeeding promotion efforts. 11. Q. Do you have any more information about the WA Steps Up for Breastfeeding Success! recognition program? A. WA Steps Up! is a new effort focused on increasing best-practices for supporting breastfeeding in primary care clinics, hospitals and worksites. This funding announcement is an opportunity to pilot test the new recognition program in the clinic setting. Once finalized, WA Steps Up! will be released to all clinics, hospitals and employers/worksites across the state. We are working on finalizing a 1-page overview to describe this new effort and will be able to share this soon. WA Steps Up for Breastfeeding Friendly Clinics is a 10-step program, focused on the adoption of research-based best practices such as having a clinic breastfeeding policy, a breastfeeding friendly office environment, culturally relevant care, community partnerships for coordinated care and more. For every two steps a clinic implements, one star will be awarded, up to 5 stars. While ideal, not every clinic will receive 4 or 5 stars; the idea is to acknowledge and provide recognition for step by step process improvements in providing best-practice breastfeeding support in the clinic. WA Steps Up! encourages primary care clinics to promote and support breastfeeding one step at a time, and acknowledges commitment and progress. Recognition will be awarded from the Department of Health. Regarding this funding opportunity, it is not expected that funded clinics will necessarily adopt all 10 steps by the end of this project. Each clinic will be asked to select which steps they plan to make progress on and will receive recognition once those steps are implemented. 12. Q. What criteria must a clinic meet to be eligible for the recognition program? A. There are no criteria for a clinic to be eligible to apply. It is open to all and all clinics are encouraged to apply for recognition. 13. Q. What data will we have to collect for this project? A. Evaluation will be conducted by the University of Washington Center for Public Health Nutrition (CPHN). You will be asked to collect some data and participate in the evaluation process, but you will not be asked to carry out your own evaluation of your project activities. You will be asked to provide and participate in the following: Quarterly progress reports online form that will ask about your progress implementing breastfeeding supportive policies and procedures. The form will be open response and asks about your successes, challenges, and activities on required objectives. Self-assessment online form that will ask you about your current policies and procedures for breastfeeding support and management, referral systems, staff training, clinic environment (i.e., use of formula marketing materials and/or breastfeeding promotion materials), procedure for tracking and monitoring patient breastfeeding status (if any), and billing practices regarding lactation services. You will be asked to complete the selfassessment twice: once at the beginning of the project and once at the end. Telephone interviews Three telephone interviews lasting approximately 30 minutes. You will schedule interviews with CPHN staff following completion of each quarterly reporting form. You will be asked about your project successes, challenges, and about how the project has impacted your patients. Page 15 of 17
Staff and provider survey Online survey of your clinic s staff and providers. Survey should take no more than 10 minutes to complete. You will be asked to remind staff and providers to complete the survey. 14. Q. Can funds be used to purchase equipment that supports breastfeeding such as breast pumps or weight scales for clinic use? A. Yes, however DOH must approve prior to purchase. Page 16 of 17
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