24-Hour Stabilization Services Request for Applications (RFA) Conference
Springfield, Illinois and Teleconference
July 21, 2015
NOTE: At the conclusion of the conference, it was announced that the application deadline will be extended until 2:00 p.m. August 14, 2015.
The conference was called to provide the Illinois Department of Human Services' Division of Developmental Disabilities with an opportunity to emphasize key components of the RFA and its intent and to offer an opportunity for participants to ask questions and/or share comments. Participation in the conference was not required of prospective applicants.
Approximately 25 persons participated in person or by telephone.
Reta Hoskin presented an overview of the RFA and stated that crisis services are an area of focus for the Division.
- The Division is looking at options to improve the system's capacity for crisis services availability when individuals with developmental disabilities are experiencing difficulties that are or may jeopardize the continuation of their current living arrangement.
- The Support Services Teams were implemented several years ago and the Division, more recently, has been able to expand their availability.
- An amendment is pending with the federal government to expand the number of hours per year available for behavior services under the Medicaid Waiver for Adults with Developmental Disabilities from 66 to 104 hours per year.
- It is expected this RFA will identify prospective applicants with strong organizational expertise, experience and paraprofessional/professional skills to deliver stabilization services in temporary homes for adults. Two (2) four-person homes in each of the two (2) geographical areas (northern and central\southern) of the state are both the minimum and the maximum scope of the RFA.
- Each home in a geographical area might be in close proximity to the other home to offer some strengthened oversight, convenience and economies of scale.
- The successful applicant in each geographical area must be able to serve both men and women. The Division included language in the RFA intended to offer latitude to applicants; to not dictate a specific manner of serving both men and women in each geographical area. It would be acceptable for one home in a geographical area to be for men and the other for women or an applicant might propose to provide services and safeguards for men and women in the same home.
- The RFA anticipates a length of stay of 30 days or less although the Division recognizes that, in the beginning, average lengths of stay might exceed 30 days as the Division and\or operators further refine policies, procedures, training, planning processes, etc.
- Environments will provide behavioral expertise at a level more intense than typically now available in other residential environments.
- Environments will provide a ratio of QIDPs to individuals served of 1:4 with QIDP presence in the program environment for a substantially greater percentage of time that other residential environments.
- An additional 20 hours of training will be required for QIDPs and Direct Support Persons (DSPs).
- Applicants' proposals may call for increased services of nurses, physicians and psychiatrists.
- The Division hopes for enthusiastic and innovative proposals in response to the RFA. There will be separate agreements for each geographical area although it is possible that a single applicant might be awarded the grant for both geographical areas.
Questions and Answers
- Question: What is the process for securing housing stock?
Answer: This subject was intentionally left open-ended in the RFA in order to not limit the thought processes and application opportunities for any applicant. The budget forms identify categories under "Room and Board" for applicants' completion. The Division has provided assurances to the federal CMS that we will fund Room and Board but not claim Room and Board for Federal Financial Participation (the matching 50%) purposes. There may be some costs (reinforcing walls, windows, etc.) which the Department may claim for reimbursement, thus, it is extremely important that budget information, including Room and Board, start-up and renovations, be presented clearly, separately and in detail.
- Question: Will the Department claim SSI for Room and Board?
Answer: No. For this brief, temporary placement, it is anticipated that the SSI funds will stay with the individual/family or agency to which the individual is expected to return.
- Question: What details are needed about home modifications?
Answer: It was again emphasized that this information should be provided separately in the submission of budget materials and in great detail.
- Question: What about when homes are at less than capacity?
Answer: The Division will be attentive to processes presented by applicants which focus on addressing the stabilization needs of the individual and returning the individual to their previous home or an appropriate alternative. The Division recognizes the need of applicants to provide in their proposals information about ongoing costs when a home has one or more vacancies. Caution will be exercised to ensure there is no incentive for the operators to continue the residency of the individual any longer than is necessary and appropriate. It was emphasized that these are stabilization environments and are not intended to address every need the individual may have. The Division will manage all admissions. Any factors used by the applicant related to utilization must be clearly and separately presented in the submitted budget materials.
- Question: What is the referral process?
Answer: The Division will approve all referrals/admissions. In many cases, it is anticipated that the individual will have received services via CART and/or the Support Services Teams. It is also possible that the individual might participate in stabilization services without previously or currently receiving any other services. See Part II, C., 12. in the RFA.
- Question: What if some services, such as psychiatric services, are under managed care for an individual?
Answer: The Division's Waivers are not part of managed care at this time, thus, stabilization services will not be part of managed care at this time. However, it is possible that an individual may be receiving a medical service covered under managed care. The operator should coordinate services with all medical providers for the individual. The applicant may choose to indicate the need and costs for general consultation services, such as psychiatric consultation services, in its submitted budget materials.
- Question: Did the Division consider what other states may be doing?
Answer: Yes, activities in other states such as North Carolina, Ohio and New Jersey, were considered but it was determined that this RFA process is the best alternative for Illinois at this time. The RFA process is very flexible and provides both the Department and the applicant with opportunities for creative thinking, planning and joint development without the limitations typically found in a Request for Proposal. The RFA process provides an avenue for the Division to work with applicants, talk with applicants and modify, as necessary, to secure program services that are the best possible and are affordable to the State of Illinois.
- Question: Can there be bidders from out of state?
Answer: Yes, there is no prohibition limiting applicants to those in the State of Illinois.
- Question: The RFA calls for two printed originals of the application. What must include original signatures?
Answer: The cover letter for each original application should include original signatures. Items such as letters of support do not require original signatures.
- Question: Could/should the homes be close to SST offices?
Answer: There is no requirement for such and no preference will be given to applicants who propose operating homes in close proximity to SST offices.
- Question: Are these homes operated as CILAs?
Answer: The applicant must be or become a licensed CILA provider but the emphasis of the Division and the RFA will be on the enhanced, temporary services provided in each home. The Division will work with the Bureau of Accreditation, Licensure and Certification and the Division's own Bureau of Quality Management regarding operating criteria and quality review activities.
- Question: Is there a required start date for the program?
Answer: No. The Division chose not to provide a specific required start date in order to not exclude applicants considering new construction, extended implementation activities, etc. It is important to note that the initial funding will come from federal Balancing Incentive Program (BIP) funds which must be spent by September 30, 2017.
- Question: What about after the BIP funds are gone?
Answer: Assuming a successful program, the Division intends to continue to fund the program at approved rates with General Revenue Funds; securing the 50% Federal Financial Participation match. This is represented in a sustainability statement provided to the federal government by the previous administration and supported by the current administration.
- Question: While in temporary placement for stabilization services, is participation in a day program required?
Answer: No. The current needs of the individual must be considered and addressed. Staff will be required to organize meaningful structure of the day, evening and night for each individual.
- Question: Is there or will there be specific criteria related to discharge from the temporary environment?
Answer: No, although that may be something which will be developed as the program matures. Discharge planning will begin at the time of referral/admission and will involve all parties in open, collegial discussion to benefit the individual as placement occurs and services are implemented.
- Question: Does the Department have to accept the lowest bid(s)?
Answer: No. The Department anticipates accepting the best proposal(s) at a cost that is appropriate and affordable to the State of Illinois.
- Question: In the Target Population section of the narrative outline, there is a reference to "area(s) of excellence for support services." Can you explain what this means?
- Answer: The phrase "area(s) of excellence for support services" asks applicants to elaborate on the experience and expertise they possess in serving the target population. For example, applicants could detail what their services plans include and when applicable, provide examples and/or data that verify superior outcomes.
- Question: For the timeline and work plan, can we present these in a table format? If so, can this be single spaced with landscape orientation to allow for more information per line under each column and a full year's timeline?
- Answer: An applicant may submit information in a table and the table may be in landscape orientation. However, other format conditions should still followed: "All applications must be typed on 8 1/2 x 11 inch paper using 12 point type and at 100% magnification (not reduced). With the exception of letterhead and stationery for letter(s) of support/collaboration, the entire proposal should be typed in black ink on white paper. The program narrative must be typed, double-spaced, on one side of the page, with 1-inch margins on all sides."
- Question: Can you give us a definition for "theory of action." Does this refer to a specific "if, then" logic model or are you using the phrase more generally? Note from Division: The phrase "theory of action" is found in APPLICATION CONTENT, B.2. Organization's History, Background, and Experience, 8th bullet point.
- Answer: The phrase is used generally to broadly indicate the base logic, over-arching policies, core guiding principles, etc. that direct practices and strategies of operations.
The application deadline has been extended to 2:00 p.m. August 14, 2015.
Questions should be directed to Dave.Adden@illinois.gov by no later than close of business July 29, 2015 to ensure a response and further posting of questions and answers.-