AFC Ryan White CARE Act Request for Proposals Frequently Asked Questions (FAQ) Friday August 14th, 2015 The following is a compilation of questions posed by applicants at Bidders’ Conferences and via email and phone. AFC responses are provided for each question. An updated document will be posted by September 4th as additional questions are submitted. No additional questions will be accepted after Thursday September 3 rd 4:00pm.

Standard Operating Procedures Question 1: Updated Standard Operating Procedures We would like a copy of the current Case Management Standard Operating Procedures (SOPs).

AFC Response: Agencies should submit email requests for the Standard Operating Procedures.

Send your requests for this document to Bashirat Osunmakinde at [email protected]

Question 2: Forms and Templates post RFP Awards How will agencies access reporting templates and other forms to be utilized after awards have been granted?

AFC Response: The Standard Operating Procedures Appendices will include all the necessary forms and templates funded agencies are required to utilize.

Request for Proposal Submission & Proposal Organization NOTE: Proposal Submission Format As you review the RFP document and prepare your proposal package, please take notice of an error in the Proposal Organization section Table 7 (page 13).

Table 7 includes a reference to a Project Abstract as Section 1. However, the Project Abstract IS NOT included in the RFP Narrative Workbook. Unfortunately, the Project Abstract was not removed from Table 7.

Please do not include a Project Abstract (as Section 1) in your proposal. Please follow the RFP Narrative Workbook when constructing your proposal. Please note, if you inadvertently include the Project Abstract in your proposal it will not be evaluated or scored. Sections should be numbered following the numbering in the Narrative Workbook. Section numbering can start with the Title Page as Section 1 as referenced in the RFP Narrative Workbook.

On page 13 the line spacing is referenced as 1.5". This is incorrect. Please use 1.5 as the spacing from the MS Word document formatting/line spacing window.

AFC reposted a revised version of the RFP Narrative Workbook on the AFC website.

Question 1: Applying for Multiple Service Categories & Proposal Package Submission Are we allowed to submit a single proposal for multiple service categories?

AFC Response: No. For each service category requested, a single proposal package is required. Do not combine multiple service categories in a single application. Doing so will disqualify the application for review. Applicants must submit one MS Narrative Workbook and one Forms Workbook for EACH category being requested. A single category requires two file uploads to the DropBox® folder. Please see RFP, page 14 “Proposal Submission Guidelines” for instructions.

For common narrative sections like “Agency Experience” or “Cultural Linguistic Capacity,” applicants may use the same narrative for multiple services categories. This can be done by copying and pasting the content into the appropriate section for each service category proposal. Do not “reference” other service category proposal sections. Each service category proposal should include narrative for each section even if the

Version 8/14/2015 1 AFC Ryan White CARE Act Request for Proposals Frequently Asked Questions (FAQ) Friday August 14th, 2015 narrative is the same across all proposals. Refer to page 12, “Proposal Preparation Guidelines”; and page 14 “Proposal Submission Guidelines” section.

Use only one Intent to Apply form to indicate interest in multiple service categories.

Question 2: Intent to Apply & Proposal Title Page What if our agency isn’t sure which services we are requesting funding for? Which services should we select on the Intent to Apply form? Which services should we submit a final proposal for using the Proposal Title Page form?

AFC Response: If your agency anticipates pursuing any of the funded service categories, select these service categories on the Intent to Apply form. AFC strongly recommends selecting any and all possible service categories, regardless of what proposals are eventually submitted. Agencies are prohibited from submitting proposals for service categories NOT initially selected on the Intent to Apply form.

Question 3: Agency with several locations Can an agency submit one application although they have several locations in different counties?

AFC Response: Yes. Please make sure all services are selected in the intent to apply form for all locations.

Question 4: MS Workbooks Formatting If our agency cuts/pastes narrative from another documents into the RFP Workbooks will the formatting change? Do we have to make sure that the formatting is consistent with the RFP Workbook?

AFC Response: The RFP Workbook and RFP documents are formatted in Cambria 10 font with a 1” margin. When cutting/pasting narrative into the RFP Workbooks, ensure that margins, font sizes, etc. adhere to RFP specifications. Agencies should use MS Word functionality to ensure that the final submitted documents meet requirements. This means that the RFP Workbook may have to be “adjusted” to ensure that formatting requirements are met. Refer to RFP page 12, Proposal Preparation Guidelines section.

Question 5: RFP Narrative Workbook and Forms Workbook Page Numbering Are we to paginate across the two files of each category for the table of contents? So, for instance, the narrative file would be pages 1 – 40 and the forms/appendices file would pick up at 41. Or should we start at page one in each file?

AFC Response: Start at page 1 in the RFP Narrative Workbook and start at page 1 in the RFP Forms Workbook. Page numbering between workbooks does not need to be continuous.

Question 6: Target Population Template / Client Demographics Template The RFP references a target population template in the narrative; however the actual form is titled Client Demographic Template. Are they the same?

AFC Response: Yes, these terms are interchangeable. Agencies should use the Client Demographic Template included in the RFP Forms Workbook.

Question 7: Target Population Template / Client Demographics Template In the demographics worksheet in the RFP Forms workbook, what is meant by “affected patients”? Would you please define this population?

Version 8/14/2015 2 AFC Ryan White CARE Act Request for Proposals Frequently Asked Questions (FAQ) Friday August 14th, 2015 AFC Response: The table in the Client Demographic Template form allows applicants to indicate when services reach “affected” populations. Language in the RFP, on page 10, states that Essential Services can be delivered to HIV-affected individuals, including partners or family members of HIV-positive persons when the service supports a health outcome for the HIV-infected client. Affected individuals may qualify for services under this RFP if those services link, retain, or re-engage the HIV positive individual (e.g. spouse/partner/parent/household member) in primary care services. Agencies should submit demographic information for any affected individuals (partners, children, guardians, etc) of service recipients who also receive services at the agency. The information can be left blank for any agencies who do not provide services to individuals who are not living with HIV.

Question 8: Client Demographics Template For the demographics worksheet, should we only be reporting on the demographics for the clients utilizing a specific service type or can we report on the demographics of our HIV patients in total for all applications? For example, for mental health would we only list the demographics for those HIV patients utilizing mental health services or the demographics of the entire HIV population? Similarly for Case Management, would we only list the demographics of those who are case managed?

Using the “Client Demographics Template,” please report demographics for clients utilizing the service category for which you are applying. Agencies may refer to the total number of patients living with HIV receiving services in the “Agency Experience” section of the narrative.

Question 9: Uploading additional Documents Can an agency upload documents that may be helpful supportive documentation, for example, can a payer of last resort policy be uploaded?

AFC Response: Only required documents and appendices can be included in this RFP. The Payer of Last Resort Policy is a required appendix. Refer to RFP page 13, Proposal Organization section Table 7. If a document or appendix is not listed as required in Table 7, it should NOT be included in submissions.

Question10: DropBox® & Proposal Submission Does DropBox® require software activation? How will AFC share their folder with our agency?

AFC Response: When you activate your DropBox® account you can download software to any computer that will access drop box. Downloading the software creates a drop box folder on your personal computer. However, downloading the software is not necessary. You can access the DropBox® website from any computer or mobile phone using your login password.

When an agency submits an Intent to Apply form, AFC will send a link that shares a DropBox® folder to all the email addresses listed on the Intent to Apply form. The link will provide access to your specific agency’s folder and sub-folders for each service category listed on your Intent to Apply form. Later when your proposal package is finished, you will upload your proposal package to the specific to DropBox service category folders created by AFC.

If after you send an Intent to Apply form, you do not receive an email from AFC, check your Junk/Spam folder for the AFC sharing link email.

IMPORTANT NOTE: DropBox® Account & the Intent to Apply Form Ensure that the email address used to create your DropBox® account is the SAME email address on the Intent to Apply form. This is the email address to which AFC will send a DropBox® sharing email and link. Multiple email addresses can be included on the Intent to Apply form. All email addresses listed on the form will receive a DropBox® invitation link.

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Co-Location of Services Question 1: Colocation of services Is there an expectation that Medical Case Management be colocated at an Ambulatory care site?

AFC Response: No. A primary care site or a community based organization can apply for medical case management funds.

Case Management Services Question 1: Case Management Model / Start Date When does new Case Management model begin?

AFC Response: Aspects of the new case management model are still under development and will be shared with awardees. Refer to RFP page 6, Revised Operational Standards section.

Question 2: Case Management Model Required Activities Are agencies applying for medical case management required to conduct both medical and supportive (essential) case management services?

AFC Response: Yes. It is widely accepted that both Medical and Non-Medical Case Management services are necessary to move through the continuum of care. Refer to RFP page 5, Changes to the Case Management Model; and pages 8–9 Funded Service Category Requirements sections for activities expected of the service categories.

Question 3: Case Management Services Does an agency have to provide all activities defined under each service category?

AFC Response: For Case management services, all activities must be provided. For non-case management service categories, NOT all activities must be provided.

Question 4: Levels Case Management Services Will Medical and Non-Medical Case Management provide the same level of case management services?

AFC Response: Yes, the activities will be similar, but the collaborations will be different. Medical Case Managers will work collaboratively with Early Intervention Services and RW funded Ambulatory Care providers, while Non- medical Case managers will work collaboratively with outreach workers, bridge workers and non-RW funded Ambulatory Medical Providers.

Question 5: Service provision vs funding source Will Medical Case Managers be able to provide case management services to both Part A and Part B clients?

AFC response: Yes

Question 6: Agency Eligibility for Ambulatory/Outpatient Medical Care Our agency is not currently funded for Ambulatory/Outpatient Medical Care Part A. Are we allowed to apply for medical and/or non-medical case management funding?

AFC Response: Yes. Agencies must meet agency eligibility requirements and demonstrate that they can provide any of the funded service categories as per expectations outlined in the RFP. Refer to RFP page 4 Eligible Respondents;

Version 8/14/2015 4 AFC Ryan White CARE Act Request for Proposals Frequently Asked Questions (FAQ) Friday August 14th, 2015 and page 10 Ambulatory/Outpatient Medical Care service category table. Applicants are not required to be a currently funded Ambulatory/Outpatient provider to be an eligible medical or non-medical case management provider.

Question 7: Agency Eligibility Medical and/or Non-Medical Case Management Can any type of agency apply for medical and non-medical case management?

AFC Response: Agency qualifications are outlined in the RFP on page 4 of Eligible Respondents section.

Question 8: How to Apply for Part A and Part B Medical Case Management Funding Will agencies need to submit a separate application for Part A and Part B medical case management?

AFC Response: No. Agencies must submit a single proposal package for each service category being requested. Agencies applying for Part A/B medical case management can submit a single proposal package for “medical case management”. AFC will determine which Ryan White CARE act “part” will be allocated to agencies. Refer to RFP page 12 Proposal Preparation Guidelines; and page 14 Proposal Submission Guidelines sections.

Question 9: How to apply for Case Management when delivering services in Cook and Collar counties. We are contemplating applying for case management for our Cook and Lake Counties programs in one application. Would this be acceptable? Are we also able to submit one letter of intent for both programs?

AFC Response: The RFP does not ask agencies to submit separate Intent to Apply forms or proposals by county (Cook or Collar). Agencies are required to submit separate proposal packages for each service category being applied for regardless of the county in which services are being delivered.

Question 10: Case Management Budget forms The budget template for Case Management Services states, “Note AFC applies a standard 5% to the fringe rate upon a successfully awarded contract.” Does this mean 5% will be allotted for indirect expenses? Or does it actually mean you’ll apply an additional 5% of fringe?

AFC Response AFC applies a flat 5% for any agency that does not delineate the costs related to the fringe rate. Whenever possible AFC attempts to cover all fringe related expenses based on the percentage requested for the case manager.

Question 11: Non-Case Management & Case Management Service Costs Are Administrative/ Indirect Rate Costs allowed? If IRC costs are not allowed, what can be provided to agency administrative offices [by AFC] as confirmation that these costs are not allowed?

AFC Response: An indirect cost is referred to as “non-allocated programmatic” cost and is included as a line item on the Unit Cost template. Non-Case Management Unit Cost Calculation - All costs that are “part of” / “included as” the cost of delivering a service should be included in the calculation of unit cost i.e., program and/or administrative costs. Use the “Unit Cost Template” in the RFP or utilize your agency’s template. Refer to RFP page 19, Unit Cost section. Also refer to the following resource: www.careacttarget.org/library/2011/DeterminingUnitCost.pdf

Case Management Budget Justification – Refer to all allowable costs outlined for case management services. Refer to RFP page 19, Budget Justification section.

Question 12: Case Management Model / Non-Medical Case Management Client Profile

Version 8/14/2015 5 AFC Ryan White CARE Act Request for Proposals Frequently Asked Questions (FAQ) Friday August 14th, 2015 Who is considered a non-medical case management client? Are non-medical case management clients only clients who are referred by CDPH Bridge Workers? Or can non-Ryan White in-house clinic affiliated clients be considered non-medical case management clients?

AFC Response: A client who is not currently or did not recently receive medical care as a part of the Ryan White program is eligible for non-medical case management. Agencies will determine the most appropriate case management service type (medical versus non-medical) based on the clients’ source of HIV primary care as outlined in the request for proposals. AFC will work with currently funded agencies and newly funded agencies to ensure that there are no gaps in case management services for any client. All current clients will be re-determined for the appropriate level of case management and a supportive transition will be made for clients who will transfer agencies. Any clients who are currently receiving care at non-Ryan White funded clinics can continue to receive or be transferred to non-medical case management services.

Questions 13: Case Management Model / Clients that Receive Supportive Services Where would a client who historically received supportive case management services “fall” in the new case management model?

AFC Response: The appropriate level of case management will be determined based on the source of HIV primary care. Current medical case management clients may be transitioned in to non-medical case management and vice versa. For example, if a client has been engaged in non-medical case management services and receives medical care from a non-Ryan White provider, the client can continue to stay in non-medical case management. However, if a client has been engaged in non-medical case management services and receives medical care from a Ryan White provider, under the new model, the client will be transferred to a medical case manager.

Question 14: Case Management Full Time Employee (FTE) Requirement How does AFC derive the case management FTE and client range requirement?

AFC Response: The Illinois Department of Public Health sets many case management services standards including the total number of full time employees that can effectively manage client caseloads. For this funding opportunity, AFC applies guidelines and allows agencies to fund one FTE per 25-100 clients. This range can include clients needing either/or both medical and non-medical case management services.

AFC expects that agencies will provide sufficient justification for all FTEs being requested. Agencies must demonstrate that the request is driven by relevant epidemiology, geography, client need and the target population.

NOTE: AFC will make case management client referrals across the Chicago EMA to all agencies funded to provide case management. Refer to Exhibit A that outlines AFC referral standards. Upon successful award, AFC and the awarded agency will set the final FTE allocations during contract negotiations. Refer to page 9, Case Management service category.

Question 15: Definition of MCM vs NMCM What does “recently” in RW funded Ambulatory Outpatient Medical Care mean? How is “recently” defined?

AFC Response: Additional standards and procedures are under development and will be shared with Case Management awardees. AFC will work with CDPH, IDPH, and selected grantees to build an even more impactful, more responsive model of service delivery. AFC invites applicants who are innovative and will collaboratively develop and test the new model.

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Question 16: Billing for Case Management Services Will billing be fee for service or expense based?

AFC Response: Agencies that provide non-casemanagement services will bill on a fee-for-service basis. Applicants that wish to provide non-case management services must provide unit cost justification. Refer to the “Unit Cost Template” in the RFP (RFP page 19 Unit Cost section). Also refer to the following resource: www.careacttarget.org/library/2011/DeterminingUnitCost.pdf Agencies providing case management services will bill on a reimbursement basis. Applicants must provide a budget justification. Refer to the Case Management Budget Justification (RFP page 19 Budget Justification section).

Other CDPH Funded Ambulatory Care Providers Question 1: Non-AFC Case Management Funded Agencies What are the 5 agencies not funded by AFC for case management, but funded by CDPH for ambulatory care?

AFC Response: Ann & Robert H. Lurie Children’s Hospital AIDS Healthcare Foundation Loyola University health Systems South shore Hospital Corporation Lawndale Christian Health Center

For a list CDPH funded Ryan White providers refer to the following link on the City of Chicago website: http://www.cityofchicago.org/content/dam/city/depts/cdph/HIV_STI/RyanWhiteFY15Funding_022315.pdf

Other Non-Case Management Services Question 1: Part A Ambulatory Services If we are already a Part A Ambulatory Service grantee with the City of Chicago, are we still permitted to apply for that service category through this opportunity?

AFC Response: Yes.

Question 2: Psychosocial Services Identifying the most appropriate service category. Domestic Violence included in Psychosocial Services Are domestic violence counseling services included in psychosocial services activities?

AFC Response: The service is allowable if it addresses a barrier to care. For example, if an HIV+ client dealing with domestic violence issues attends a support group to address this challenge, it is an allowable activity under psychosocial support. However, if the client seeks one-on-one counseling for domestic violence, then this would be classified under Mental Health Services.

Question 3: Mental Health Services / Peer Led Support Groups For the Mental Health service category, can support groups be peer led? Are there any credentialing restrictions including LCSW, LCPC, LSW, etc.?

AFC Response: No. Services must be provided by a licensed mental health professional, typically including psychiatrist, psychologist and licensed clinical social workers.

Question 4: Substance Abuse / Methadone Treatment as a Unit Cost

Version 8/14/2015 7 AFC Ryan White CARE Act Request for Proposals Frequently Asked Questions (FAQ) Friday August 14th, 2015 Can methadone treatment services be included in the unit cost calculation for Substance Abuse services?

AFC Response: Yes. Refer to RFP page 10, Substance Abuse Outpatient Services. Refer to the “Unit Cost Template” in the RFP or utilize your agency’s template (RFP page 19, Unit Cost section).

Question 5: Non-Case Management Service Delivery & Billing Our agency provides mental health counseling for substance abuse issues. For example, our client receives diagnostic and prescription/treatment services at an alternate agency but receives counseling at our agency, is this allowable? Are both psychiatric and psychological counseling required to be provided by our agency?

AFC Response: Yes, a client can receive a component of the service category at an alternate agency and receive a different component of the same service category at your agency. However, an agency cannot receive funding for any services NOT delivered at your site. Note, the agency can only bill for the visits the client receives at/or through your site.

The service category definitions outline the types of services an agency can provide under that service category. This does not mean that the agency must provide all of the services listed as part of the service category.

Question 6: Indirect Costs / Non-Case Management Services Is there a cap on indirect costs? Are indirect costs allowable?

AFC Response: An indirect cost is referred to as “non-allocated programmatic” costs and is included as a line item on the Unit Cost template. Refer to the “Unit Cost Template” in the RFP (RFP page 19 Unit Cost section). Also refer to the following resource: www.careacttarget.org/library/2011/DeterminingUnitCost.pdf

Question 7: Current Funding Allocations / Psychosocial & Legal Funding Collar Counties Why is there no funding for collar counties for psychosocial services?

AFC Response: AFC modeled RFP after current funding allocations. However, if an agency can demonstrate a sufficient need for these services in their collar county location, that agency is may apply for (but is not guaranteed) funding for these service categories.

Review Panelist, Evaluation & Scoring Question 1: Review Panelist Recruitment, Assignment & Evaluation How are the review panelists selected? What is the review panel process?

AFC Response: AFC is recruiting at least 50 independent review panelists from a variety of sources including community members across the Chicago EMA, internal non-Ryan White Care employees, etc. Interested parties can download the Review Panelist application from the aidschicago.org/RyanWhite2016 website.

Review panelists will be assigned to a single service category panel. Service categories that have fewer submitted proposals will be combined into a single category. For example, Food Bank /Home Delivered Meals may be combined with Legal Services, whereas the Medical and Non-Medical case management review panels will not be combined because of the likely volume of applications. .

Version 8/14/2015 8 AFC Ryan White CARE Act Request for Proposals Frequently Asked Questions (FAQ) Friday August 14th, 2015 Panelists will review proposals in a single category and provide scores for those proposals. If a panelist is assigned and reviews applications for more than one service category, applications will only be rated/scored against other applications from the same category. In the previous example, the reviewer will review and evaluate all proposals submitted for Food Bank / Home Delivered Meals separately from Legal Services proposals.

Score comparison occurs only within the service category not between service categories.

Question 2: Scoring & Evaluation / Sub-Category Evaluation Add-On Questions What are the sub-category evaluation add on questions? My agency is only applying for Mental Health services. Will our agency be held to the scoring points of the Ambulatory, Case Management, and Non-case management categories?

AFC Response: No. Agency competition for funding occurs within the service category not between service categories. Agencies not applying for Ambulatory, Case Management, and Non-case management categories will not receive nor be held to the scoring standards outlined for these categories. Refer to page 20, Proposal Evaluation & Scoring section. Agencies submitting proposals for non-case management or non-ambulatory services can score a maximum of 554 points which excludes narrative of the Ambulatory/Outpatient Medical Care section (7) and Case Management section (8).

Agencies applying for either Ambulatory Outpatient Medical Care, Medical Case Management and/or Non- Medical Case Management will have an additional scoring section. Agencies submitting proposals for these services can score a maximum of 779 points which includes all 14 narrative sections.

Question 3: Final Scores / Provided to the Agency Will AFC provide the agency’s final score if they do not receive funding?

AFC Response: AFC will provide the final review panel consensus score upon request. Individual review panelist comments and scores will not be provided.

Funding & Award Question 1: Service Category by Funding Source Are the service categories listed funded under Part A or B?

AFC Response: Medical Case Management services are funded by Part A and B. Non-Medical Case Management is funded by Part A, and all the Non-Case management service categories are funded by Part B. Please refer to the RFP page 3, the Available Funding section.

Question 2: Funding Source Selection Are agencies to select the funding source A or B for case management or will AFC make this decision?

AFC Response: AFC will make the decisions about which Parts (A or B) fund awards.

Question 3: Agency Performance and Funding Award Considerations Our agency scored well on the AFC audit. How does our performance factor into the overall scoring process?

AFC Response: Review panelists will score proposals based on objective review of the submitted narrative. However, AFC may consider factors such as an agency’s past performance when making final award decisions. Additionally, to ensure geographic distribution of services, AFC reserves the right to recommend qualified funding

Version 8/14/2015 9 AFC Ryan White CARE Act Request for Proposals Frequently Asked Questions (FAQ) Friday August 14th, 2015 proposals that do not adhere to the review panel consensus scores. If an insufficient number of qualified proposals are submitted in any service category, AFC reserves the right to directly solicit and select appropriate providers to fill existing gaps in service. Refer to RFP page 22, Proposal Evaluation and Scoring section.

Other / Miscellaneous Question 1: Medical Benefits Coordination Will there be any specific designation for benefits coordination as a specialty in case management? AFC Response: RFP will not fund case managers to focus on benefits counseling. If one of the barriers a person may experience in accessing or being retained in primary care is benefits/payment related, it is AFC’s expectation that case managers will address them either directly or through the appropriate referrals to medical benefits coordinators.

Question 23: Best-Practices Defined What is a “best practice”?

AFC Response A “best practice” is a technique or methodology that, through experience, research or observation, has proven to reliably lead to a desired result. A commitment to using the best practices in any field is a commitment to using all the knowledge and technology at one's disposal to ensure success.

Agencies applying for under this RFP may have attained their own program best practices and/or attained the same or similar best practices from other major entities like the Centers for Disease Control and Prevention (CDC) released an updated version of their “Compendium of Evidence-Based Interventions and Best Practices for HIV Prevention”. This resource is an example of program best practices as noted by the CDC. This resource is available on the CDC website at: http://www.cdc.gov/hiv/prevention/research/compendium/lrc/

Agencies are not expected to adhere to the best practices cited by the CDC. IF the agency, is able to cite internal programmatic best practices, agencies are encouraged to include best practices references in their narrative.

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