Request for Proposals

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Request for Proposals April 7, 2015 The Virginia Health Care Foundation (VHCF) is delighted to announce the availability of new funds to establish or expand local Medication Assistance Programs (MAPs) via VHCF s RxRelief Virginia initiative. This opportunity is made possible via a new appropriation by Virginia s General Assembly. Once awarded, the grants can be renewed annually as long as state funding remains available and the grantee is successful in meeting performance metrics. MAPs are designed to increase access to free or low-cost prescription medicines for chronically ill, uninsured Virginians. MAPs utilize full or part-time caseworkers, who obtain the needed medications from the brandname pharmaceutical companies Patient Assistance Programs (PAPs) and several discount generic distributors by using The Pharmacy Connection, a special web-based software created by VHCF. MAPs can be found in a variety of settings including community health centers, free clinics, hospitals, nonprofit social service organizations, health departments, cancer centers, and community service boards. RxRelief Virginia grants support the salary and benefits of Medication Assistance Caseworkers (MACs). There are currently 30 RxRelief Virginia grantees serving 69 localities. In FY14, the RxRelief Virginia MACs helped 16,450 uninsured Virginians obtain 112,867 prescription medicines valued at over $85 million (Average Wholesale Price). It is expected that these additional grant funds will help more uninsured Virginians with chronic diseases obtain the medicines they need. The document RxRelief Virginia Request for Proposals Guidelines sets forth the details, timeframe, process and competitive criteria for this special grant initiative. Proposals must demonstrate need, community support, and detailed logistics regarding how patients will obtain their medications. Funding may not be used to supplant support for existing personnel. Proposal Process Timeline April 29, 2015 June 19, 2015 August 31, 2015 October 1, 2015 Pre-proposal workshop Proposals due Notice of awards Start date A prerequisite for submitting a proposal is attendance at a MANDATORY PRE-PROPOSAL WORKSHOP on April 29, 2015, from 10:00-1:00 in Richmond. Click here to register by April 24, 2015. Questions about this RFP? Please contact: Sarah Jane Stewart Program Officer, RxRelief Virginia Virginia Health Care Foundation 707 E. Main Street, Suite 1350 Richmond, Virginia 23219 Phone: (804) 828-5804; 434-361-0331 cell sarahjane@vhcf.org ABOUT THE FOUNDATION The Virginia Health Care Foundation is a public-private partnership established to improve access to primary health care for uninsured and medically underserved Virginians. VHCF was initiated by the General Assembly s Joint Commission on Health Care in 1992. In the past 17 years, VHCF s The Pharmacy Connection generated $2.7 billion in free prescription medicines for 283,829 uninsured Virginians with chronic illnesses. www.vhcf.org

RxRelief Virginia Request for Proposal Guidelines BACKGROUND Importance of Access to Medications No one should have to choose between feeding his/her family and filling a prescription, but thousands of uninsured Virginians do so everyday. With the cost of prescription drugs on the rise, it is often impossible for people to afford the medicines they need. In an effort to address the continuing need for prescription medications, Virginia s General Assembly has appropriated additional funds to the Virginia Health Care Foundation (VHCF) for the creation or expansion of local Medication Assistance Programs (MAPs) throughout the Commonwealth. Medication Assistance Caseworkers (MACs) are employed by local organizations to help uninsured individuals with chronic illnesses obtain needed prescriptions free of charge or at a low cost. This initiative is known as RxRelief Virginia (RxRVa) Patient Assistance Programs (PAPs) and The Pharmacy Connection (TPC) The nation s brandname pharmaceutical companies operate over 270 Patient Assistance Programs (PAPs), which provide many medicines free of charge to eligible, uninsured patients with chronic illnesses (e.g., diabetes, hypertension, heart disease, depression, asthma). While these programs offer tremendous support to thousands, each is different and has its own forms, procedures and eligibility criteria. It is difficult and time-consuming to complete multiple applications without help. Fortunately, Virginia has The Pharmacy Connection (TPC), a special web-based software created by VHCF to facilitate access to the free prescription medications in these PAPs. In addition, it also has two low-cost generic programs. Currently, 146 organizations throughout Virginia use TPC in their medication assistance efforts. They include community health centers, free clinics, hospitals, cancer centers, community service boards, area agencies on aging, departments of social services, health departments, and a variety of private nonprofit service agencies. In FY14, these organizations helped more than 52,000 eligible, uninsured Virginians with chronic illnesses receive more than $449 million in free medications. REQUEST FOR PROPOSALS The Virginia Health Care Foundation (VHCF) is delighted to have this opportunity to expand RxRVa for the first time in seven years. This Request for Proposals for RxRelief Virginia is designed to support the creation and/or expansion of Medication Assistance Programs throughout Virginia. This initiative is intended to increase the number of Medication Assistance Caseworkers utilizing The Pharmacy Connection to help eligible Virginians receive free and/or low-cost medications. GRANT ELIGIBILITY To be considered for a RxRelief Virginia grant, an applicant must: 1. Be a local public agency or private non-profit agency with 501(c)(3) tax-exempt status; 2. If already an RxRVa grantee, be in good standing at the end of FY14 in reaching patient and/or requests goals.

3. Have the technological capabilities to efficiently use TPC, including high-speed internet access (see computer specifications on Page 5); 4. Commit to participating in semi-annual regional roundtable discussions with other TPC users and RxRVa grantees to learn and discuss best practices; and 5. Attend the mandatory Pre-Proposal Workshop, April 29, 2015, from 10:00-1:00, at the Virginia Community Healthcare Association, 3831 Westerre Parkway, Richmond, VA 23233. Click here to register. PLEASE NOTE: Proposals will only be accepted from those organizations attending the Pre-Proposal Workshop. REQUIREMENTS OF A FORMAL PROPOSAL A formal proposal must contain no more than 8 pages which include: 1. A completed Executive Summary and Cover Sheet supplied by the Foundation on its website (2 pages). 2. A concise project narrative of no more than 7 pages that clearly: Provides a brief description of the proposed project which includes specifics about the geographic area and the specific population to be served by the MAP; Describes the need/rationale for the project using community data to describe the potential number of patients to be served; Describes the organization s policies and experience providing prescription medicines for its patients, including PAPs and generics; if applicable, include TPC Total Requests by Center report for the date range 4/1/2014 3/31/15. Identifies the patient population the MAP will target (e.g. clinic patients, community doctors, all local residents); Indicates the partners in your referral network (e.g. physician offices, local department of social services, local area agency on aging, local hospitals, health safety net providers); Identifies all other local collaborators or sponsors, and specifies their project-related roles, contributions, and responsibilities; provides letters of support from collaborators or sponsors. Describes in detail the logistics of the MAP to include the following: - how patient is referred; - income and insurance eligibility determination; - application completion; - provider signature; - if and how bridge or interim medicine is provided; - how patient is notified when medicine arrives; - where pick-up occurs; and - refill process Specifies project objectives and timeframes, including: - Recruitment and hiring of Medication Access Caseworker(s); and - Patient service goals (number of patients, number of prescriptions, and estimated average wholesale value of medications accessed). Provides names, affiliations, qualifications, and leadership experience of the project management team and personnel; Provides a brief description of applicant organization, and evidence of its success administering 2

previous grants. Describes any cash, in-kind contributions applicant organization will provide (e.g., supervisory personnel, infrastructure specifics, administrative support, computers, volunteer support) 3. A proposed 12-month budget and budget narrative. The budget should represent only the revenue and expenses associated with the project. Note: You must use the budget format supplied by the Foundation (on its website under RxRelief Virginia RFP) and the budget must be accompanied by an itemized rationale. Include any cash or in-kind contributions your organization is providing to the project. If the project will be a part of a larger organization, please provide the latest annual budget and other funding sources for the organization as an attachment. 4. A specific plan to market the availability of the proposed Medication Assistance Program to the target population and referral sources in the community throughout the grant period, including the use of media. 5. Support letters from community partners evidencing any commitments identified in the proposal and budget (e.g., referral partners, participating physicians and/or pharmacies, other collaborators). 6. Resume of the supervisor of the proposed project and a signed letter of intent from the individual(s) who will serve as fiscal agent. 7. Evidence of the applicant s tax-exempt status. The narrative of the formal proposal should be no longer than 7 typewritten, double-spaced pages. The Executive Summary, marketing plan, support letters, and budget are not included in the seven-page limit. Please use the standard font size (12 point) and 1" margins. The Foundation requires an original and 3 copies of the entire proposal. APPLICATION PROCESS and TIMETABLE The application process is straightforward. Each applicant must attend a Pre-Proposal Workshop, which will provide important information about what the proposal is expected to contain and how it will be evaluated. There is a strong desire to initiate these programs as soon as possible. The following timetable will assure this: Pre-Proposal Workshop April 29, 2015 Formal proposals and letters of support* June 19, 2015 By 5:00 PM. in VHCF s office (707 E. Main St. Suite 1350, Richmond, VA 23219) Notification of awards made August 31, 2015 Grant awards effective October 1, 2015 *Please Note: Proposals will only be accepted from those organizations attending the Pre-Proposal Workshop. SPECIAL INSTRUCTIONS, POLICIES AND INFORMATION Collaboration from two or more organizations that plan to serve the same community will be accepted and is encouraged. In these cases, one organization must be identified as the lead coordinating agency and fiscal agent. Please examine your proposal carefully to ensure you have provided all the information requested by the Foundation and that your proposal meets all the specifications outlined in these guidelines. The Foundation will not review incomplete proposals or those which do not follow the Foundation s specifications. 3

All attachments and additional materials should be submitted with the formal proposal. The Foundation will not accept any materials, including Letters of Support, received under separate cover. The Foundation will not acknowledge receipt of proposals. Applicants are responsible for verifying the receipt of a proposal in the Foundation s office by the deadline. The Foundation will not review proposals that are received after the deadline. Foundation funds may not be used to pay indirect costs, administrative assessments or fees of universities or other institutions with which a VHCF project is affiliated. CONDITIONS FOR GRANT ACCEPTANCE Each grantee must sign a Letter of Agreement with the Virginia Health Care Foundation which delineates the terms and specific objectives of the project, and requires the grantee to submit requested data and reports on a timely basis, and to participate in any requested evaluation process. DECISIONS The Foundation s Board of Trustees will make all decisions regarding applications. All decisions will be made and communicated to applicants by August 31, 2015. For more information about RxRelief Virginia, please contact: Sarah Jane Stewart, RxRelief Virginia Coordinator Virginia Health Care Foundation 707 E. Main St. Suite 1350 Richmond, Virginia 23219 Phone: (804) 828-5804 or (434) 361-0331 Fax: (804) 828-4370 E-mail: SarahJane@vhcf.org 4

Web-Based Requirements for TPC PC (*Windows VISTA or higher), or MAC (any operating system) One of the following Web Browsers: Internet Explorer Version 9 or higher Firefox Maintain current version, or one prior to (19) Google Chrome Maintain current version, or one prior to (25) Safari Maintain current version, or one prior to (6) Any PDF Viewer (To view & access forms and letters) Compliant with Adobe standards (Example: Adobe Reader and the latest version is compatible) Microsoft Office (Word is needed to create & generate custom letters, generate & edit labels and prescriptions. Excel can be used to export reports.) Internet Access To determine if your web browser meets the requirements, go to the toolbar of your software, select Help and the name of the current version will be displayed. If you need help, please contact Juliet Tinsley or Lisa Hueston at (804)-828-5803, or email tpc@vhcf.org. 5