REQUEST FOR APPLICATIONS (RFA)

 I. Timeline of Events

Table 1: Timeline of Events

August 11, 2020
Competitive Application Released via Puerto Rico Department of Health Website
August 14, 2020
August 19, 2020
Question and Answer Virtual Meeting. Join the session at 2:00 to 3:00 p.m. AST (Will be held in Spanish)
August 25, 2020
Applications Due via Email by 5:00 p.m. AST
August 31, 2020
Anticipated Notification of Awards


The Q&A meeting will be done via the Zoom application and you can access from the link above. If you have a question about how to access it via Zoom, please contact Dr. Eduardo Zavala at prod2acommunityprevention@salud.pr.gov

 II. Purpose 


The Overdose Data to Action (OD2A) Community Prevention Grant is funded by the Centers for Disease Control and Prevention (CDC). The goal of this funding opportunity is to build, strengthen and enhance the capacity of rural and urban communities. Emphasis will be placed on promoting strategies and activities to address opioid overdose in high burden areas, particularly those identified by the OD2A, which include to prevent morbidity and mortality associated with opioid overdoses. It also includes strategies that prevent opioid overuse, misuse, use disorder, overdose, and opioid-related harms. Funded activities should combine the best of what the entity/organization knows to be effective, with the unique ability of communities to innovate and test new approaches that promote the implementation of intervention and prevention activities guided by an evidence base.

Proposed multi-sector and community-based projects must address at least one of the following focus areas: Integration of State Local Prevention and Response Efforts, Establish Linkages to Care and Providers and Health Systems Support.  In addition, it is based on the idea of achieving greater effectiveness in the development and implementation of prevention strategies aimed at reducing the consumption of opioids and other substances, substance use disorders, overdoses, and health damage, among others. It is important to focus these efforts on the particular situations of each community identified as high burden areas.


 III. Award Information and Funding Availability


Awarded local entity/organization will receive funding for prevention activities from September 1, 2020 through August 31, 2021, based on availability of funding, satisfactory completion of annual deliverables and compliance with federal grant expectations.

    Anticipated notice of award:  8/31/2020

    Contract Period: 9/01/2020-8/31/2021

The project budget may range from $ 80,000 to a maximum of $ 95,000 covering the contract period.

Grant funding is expressly dependent on the availability of funds to Puerto Rico Department of Health according to the allocation of federal funds. Applications may be approved according to the availability of funds and the obtained scorfrom the panel's review process.

Number of Awards:  It is anticipated there will be 4-6 proposals approved, based on the number of applications received and quality of applications, Puerto Rico Department of Health may issue modified awards.

In fairness to all applicants, Puerto Rico Department of Health staff cannot comment on your specific project idea prior to your submittal. An applicant Q&A virtual meeting is scheduled for 8/14/2020 at 2:00 p.m. AST at this Zoom Link:

https://us02web.zoom.us/meeting/register/tZwoc-6vpz4pGdEDCtLp0nbyhc_Q_6IKe5_U

 IV. Project Requirements


Puerto Rico Department of Health recognizes that the needs of communities vary considerably. Some communities have relatively limited capacity in addressing opioid overdose and need support to strengthen their ability to collect, analyze, and apply data, as well as translate data into action in the form of a comprehensive strategy to combat the harmful effects of opioid overdoses in Puerto Rico. Other communities are at a higher state of readiness and need resources and support to scale up a comprehensive program and/or advance a multi-pronged, multi-year prevention program. To this end, strengthening and enhancing the capacity of communities is a goal of this funding opportunity. Emphasis will be placed on promoting strategies and activities that build local capacity to prevent morbidity and mortality associated with opioid overdoses. These include strategies that prevent opioid overuse, misuse, use disorder, overdose, and opioid-related harms. Interventions will address drivers of use of both prescription and illicit opioids and may address other prescription or illicit drugs to the extent that they are associated with the opioid overdose epidemic.

 

Any activities proposed should be theoretically informed and driven by experiential and contextual evidence and should have reasonable expectation of achieving demonstrable impact on at least one of the outcomes related to the project's focus (please see Table 2 below).

Table 2: Overview of Strategy Areas and Outcomes

Strategy Area: Applicants must choose one CDC-required strategy; applicants may choose more than one.

Outcomes: Applicants must report on at least one of the following required outcomes pertaining to their project’s strategy (for more details and examples refer to Activities and Target Population section.)

Integration of State Local Prevention and Response Efforts

  • Increased support to the state involment in community, municipality, or region-level prevention efforts

Establish Linkages to Care

  • Increased awareness and coordination of linkages to care
  • Increased referrals to and engagement in evidence-based treatment

Providers and Health Systems Support

  • Increased awareness of the risks of prescription and illicit opioids
  • Greater awareness of opioid overdose epidemic on public and mental health professionals in formation and health care providers


Eligible Entities/Organizations: The community grant prevention program is limited to local  entities/organizations such as local health clinics like IPA´s and 330 Centers (knowns as primary health care's centers), Chronic Kidney Disease Centers (CKD), State and private universities, Centers for diagnostic and treatment (CDT´s), township governments, non-governmental organizations, and coalitions.

V. Activities and Target Populations


Applicants must select at least one of the strategies for implementation and are encouraged to develop innovative activities, according to their expertise, selecting relevant target populations to impact. The following are proposed activities and target population examples that may be related to the required strategy and corresponding outcomes.

    A. Integration of State and Local Prevention and Response Efforts

This strategy helps applicants propose activities that will provide state and local support for prevention to address resources needed to implement comprehensive prevention strategies for morbidity associated with opioid overdoses. These include strategies that prevent drug overdoses, opioid overuse, misuse, use disorder, overdose, and opioid-related harms. Activities proposed under this strategy must demonstrate support for integration of state and local prevention and response efforts. 


Outcome A1: Increased state involvement in local-level prevention efforts.
Activity Examples
  1. Develop a needs assessment and characterization of the opioid problematic in high burden areas per health region, municipality, or community.
  2. Development of health educational workshops focused on the problem of opioid use including, for example, the development and administration of a survey.
  3. Implementation of community-level interventions in "hot spots" or high burden/spike areas by data from OD2A collaborators per NOFO.
  4. Other examples may include activities for capacity building for more effective and sustainable surveillance and prevention efforts including the creation of a multi-disciplinary data-focused group convening stakeholders from local public health, public safety and first responders.

Target Population Examples
  1. ​Communities with high poverty levels residing in rural areas of Puerto Rico
  2. Populations who have been historically underserved such as homeless population
  3. People who have experienced Adverse Childhood Experiences
  4. Non-mainland municipality regions such as Vieques and Culebra
  5. State and local agencies 


    B. Establishing Linkages to Care

Linkages to Care are the bridges that connect the work of public health with that of other agencies and partners. Connections or linkages to care may be viewed as the vehicle by which one system meaningfully coordinates with another. This is an opportunity to leverage systems and upstream prevention effort to ensure that people are connected with the care they need. Partners from a broad range of practices and disciplines can become a part of linkage to care efforts. Applicants are encouraged to broaden their thinking and to innovate around what linkages to care may look like. 

Outcome B1: Increased awareness and coordination of linkages to care

Outcome B2: Increased referrals to and engagement in evidence-based treatment

Activity Examples
  1. Coordination of linkages to care (specialized services and patient support services for opioid overdose risk populations)
  2. Provide follow-up through integrated services that include primary care, psychological services, Medically Assisted Treatment, counseling, social work, and support services.
  3. Design and implement pilot projects for the establishment of a treatment and service level coordinated program
  4. Care and treatment effectiveness evaluation efforts
  5. Staffing emergency departments with peer navigators to connect directly with individuals who have experienced an overdose to ensure awareness of and connection to treatment and other services

Target Population Examples
  1. ​People with Opioid Use Disorder
  2. Pregnant women with opioid use
  3. Homeless people
  4. People with opioid overdose risk
  5. Patients recovering from opioid overdose referred by the Emergency Departments or Urgent Care facilities of Puerto Rico


    C. Providers and Health Systems Support

Applicants may propose strategies in this domain that equip providers and health systems to make evidence- based prescribing decisions, have timely and complete information regarding non-opioid medications and non-pharmacologic treatments, and identify patients at risk for overdose or opioid use disorder and can then either offer or connect their patients with appropriate care.


Outcome C1: Increased awareness of the risks of prescription and illicit opioids.
Activity Examples
  1. Develop media campaigns (Example: CDC "Rx Awareness Campaign") with the purpose of increasing awareness of the prescription risks of licit and illicit opioids. The campaign will involve the participation of people free of problematic opioid use or survivors who will give their testimony of how their abuse of opioids affected their lives. Additionally, the campaign will focus on describing the danger opioids can cause, as well as the addiction their misuse can address. The organization will oversee creating, developing and disseminating technological tools and educational media, both virtual and face-to-face. Some of these would be:
  • Videos
  • Academic detailing
  • Educational platforms
  • Playbook
  • Web page
  • Web ads
  • Forums
  • Webinars
  • Workshops
  • Conferences

Target Population Examples
  1. This campaign is aimed at all populations susceptible to risk of problematic opioid use.


Unallowable Activities:

  • Purchasing naloxone, implementing, or expanding drug "take back" programs or other drug disposal programs (e.g. drop boxes or disposal bags), purchasing fentanyl test strips, or directly funding or expanding direct provision of substance abuse treatment programs.
  • Research.
  • Purchase of syringes, fentanyl test strips, harm reduction kits, furniture, or equipment.
  • Drug disposal. This includes implementing or expanding drug disposal programs or drug take back programs, drug drop box, drug disposal bags. However, promotion of safe disposal is an allowable activity.
  • Public safety activities that do not include clear overlap/collaboration with public health partner and objectives.
  • The purchase of naloxone is not supported by this funding opportunity, however, provision of auxiliary services to organizations and agencies responsible for naloxone purchase to support appropriate distribution and implementation is authorized. Such auxiliary services include naloxone training and awareness, tracking, resources mapping, and evaluation efforts. 
​ VI. Application Instructions and Submission Information


Eligible Applicants:

The community grant prevention program is limited to local entities/organizations such as local health clinics like IPA´s and 330 Centers (knowns as primary health care centers), Chronic Kidney Disease Centers (CKD), State and private universities, Centers for diagnostic and treatment (CDT´s), township governments, non-governmental organizations, and coalitions. Non-governmental organizations must have a 501c3 status.

Application Deadline:

Submission of the numbered Project Description, Project Plan using format in Appendix A, and Project Budget using format in Appendix B, constitute a complete application. Applications must be submitted via e-mail to Dr. Eduardo Zavala at prod2acommunityprevention@salud.pr.gov by 5:00 p.m. AST, August 25, 2020. Please put "OD2A Community Prevention Grant Application" in the email subject line. Please PDF the files before sending. It is preferred that you submit the Project Description, Project Plan and Project Budget as one PDF file. If that is not possible, please label each document with your organization's name and the name of document. All applications submitted that meet the required criteria will be reviewed. Applications that fail to meet the formatting and submission requirements will not be reviewed.

Format:

Narrative responses must be double-spaced, 8 ½" x 11", with 1" margins on all sides and font size 12 points in Times New Roman.  The narrative must not exceed 15 pages in Spanish or English.  Please number the narrative responses according to prompts below. Charts may use smaller fonts and be single spaced. Include applicant name in the header or footer of each page. The Budget and Project Plan do not count toward narrative page limit.

Reasonable Accommodations:

The Puerto Rico Department of Health will provide reasonable accommodations, including the provision of informational material in an alternative format, for qualified individuals with disabilities upon request. If you think you need accommodations at any time during the Request for Applications (RFA) process, contact  Dr. Eduardo Zavala, Project Director at prod2acommunityprevention@salud.pr.gov.

Application Components

Project Description:

This is your opportunity to describe your project, why it is needed in your community and how that was determined, and how it will build your community's capacity to prevent morbidity and mortality associated with opioid overdoses. Please, complete the following information using the PROD2A Form 20-1:

  1.  Please provide the name, role, and contact information (email, phone, and mailing address) for at least one key programmatic representative and one key fiscal representative that will serve as the contacts for this project.
  2. What are the goals and objectives for use of the PROD2A funding?
  3. Which required strategy area(s) does your project align with? Which required outcome(s) does this project contribute to? (Please see Project Requirements section)
  4. How will this project contribute to meeting the required strategy area outcomes in your community? What evidence-based practice or practice-based evidence informs this project?
  5.  How does this project meet the needs of your community or target population?
  6. Describe existing community efforts that may have goals similar to this project, and how you will coordinate, leverage, and align implementation without duplicating efforts. If applicable, please explain how these funds will be used to supplement similar work being done with other state and federal funding sources, rather than supplant it.
  7. How will an increased capacity to prevent morbidity and mortality associated with opioid overdoses be demonstrated in your community? What changes in policy, procedure, protocols, and/or partnerships do you anticipate will demonstrate this?
  8. Describe your organization's ability to effectively implement this project. How do you understand that you are the best candidate to carry out the elaboration and development of the proposal?
  9. Describe the experience and qualifications of the key personnel responsible for the day-to-day implementation of project activities, submission of progress reports, and meeting financial reporting requirements. 
  10. What barriers or challenges might hinder your ability to complete the work plan activities? How do you plan to manage these potential barriers or challenges?
  11. What metrics will be tracked to measure the impact of the funds used?  

Project Plan: 

This is your opportunity to demonstrate: the steps and time frame needed to achieve the outcomes; who will be responsible for the work; what process and outcome indicators will be collected to demonstrate success; and how they will be collected. The Project Plan is not included in the maximum allowable page limit.

The Project Plan (Appendix A) should cover the entire project period (9/1/2020-8/31/2021).  Based on quarterly reporting, adjustments may be made to the plan in consultation with the contract monitor, in order to best meet your community's and organization's capacity. You are encouraged to carefully consider the amount of staff time needed to build the relationships and infrastructure necessary to ensure that the multi-sector, community-based project is successful, and plan and budget accordingly.

 

For purposes of this RFA, evaluation includes a systematic process for collecting information (process and outcome data), making sense of the information, making process improvements, as well as documenting impact. In addition to the collection of indicators outlined in the Project Plan, quarterly Reflection and Progress Reports (Appendix C) will be required of all awardees. These reports are used to ensure regular reflection and if necessary, adaptation of the project. You are encouraged to carefully consider the amount of staff time needed to collect and report indicators and plan and budget accordingly. Because of the importance of the monitoring and evaluation component of this project, Puerto Rico Department of Health staff will be available to provide technical assistance to awardees on identifying indicators and creating evaluation plans. There is a section on the Project Plan form to indicate anticipated needs for technical assistance with monitoring and evaluation.

 

Project Budget:                                                                                                                    

The Budget format is included in Appendix B. You may add lines to the expense categories and/or justifications as needed.  The Budget is not included in the maximum allowable page limit. Please see the Unallowable Expenses section for a list of expenses not allowed.

All allowable expenses required to meet the outcomes of the OD2A Community Prevention Grant project are to be included in the budget. The budget must clearly align with tasks, staffing, and outcomes listed in the Project Plan. Over the course of the project, adjustments may be made to line items in the budget in consultation with the contract monitor, in to order meet project outcomes.

A budget justification is required for each expense category. The justification clarifies how the amounts were determined and connects the budget items to the overall project. Include all relevant information that demonstrates how the budget aligns with the Project Plan.

An indirect cost rate of up to 15% is allowed in the budget.   

​ VII. Application Review Information


Applications will be reviewed by a panel composed of three (3) members of different programs of the Puerto Rico Department of Health. Applicants will be awarded based on the application score as determined by the review panel using the scoring rubric in Appendix D.

 

Discussions and Modifications:

Puerto Rico Department of Health reserves the option to conduct discussions with applicants. The purpose of these discussions will be to provide clarification and to assure full understanding of and responsiveness to the application requirements. If discussions are conducted, applicants will be invited to modify their applications. Puerto Rico Department of Health reserves the right to award grants for less than the proposed amount.

VIII. Post-Award Reporting Requirements

If you are awarded funds under this announcement, you will be required to collect and report the indicators listed on your project plan and provide quarterly reflection and progress reports using the format provided in Appendix C.

 

Retention of Rights

The Puerto Rico Department of Health retains the right to accept or reject any or all applications if it is deemed to be in the best interest of Puerto Rico. All applications become the property of Puerto Rico Department of Health upon receipt.