AIDS Foundation of Chicago

Request for Proposals (RFP)

Key Dates

RFP Release Date: October 30, 2009

Bidders’Teleconference: November 6, 2009 10AM-11:30AM CST

Intent to Apply Letter Due: November 13, 2009

Application Due: January 4, 2010 4 PM CST

Contract Start Date: April 1, 2010

Contract End Date: March 31, 2011

TABLE OF CONTENTS

I. Program Authority...... 3

II. Purpose...... 3

III. Background ...... 3

A. Overview of the CookCountyand Collar Counties Service Area………………………....... 3

B. Key Program Changes ...... 4

IV. Eligibility Requirements for Applicants...... 4

V. BiddersTeleconference...... 4

VI. Available Funding ...... 5

VII. Eligible Part B Program Activities and Priorities ...... 5

A. Service Category Definitions and Allowable Activities...... 9

B. Funding Requirements and Priorities...... 20

VIII. Instructions for Completing an Application...... 22

A. Intent to Apply...... 23

B. Application Preparation Guidelines ...... 23

C. Application Checklist ……………………………………………………………………………………………….30

IX. Submission Guidelines...... 30

X. Evaluation of Applications...... 31

XI. Reporting and Other Requirements for Successful Applicants ...... 34

XII. Compliance with Laws, Statutes, Ordinances and Executive Orders...... 34

Appendices

A. Intent to Apply Form...... 36

B. FacePage...... 37

C. Program Work Plan…………...... 38

D. Program Budget Forms ...... 39

E. Service Category Budget Form...... 40

F. Application Checklist……….……………………………………………………………………………………….41

I. Program Authority

The Part B program is authorized by Title XXVI of the Public Health Service Act, as amended by theRyan White HIV/AIDS Treatment Modernization Act of 2006 (RW).

II. Purpose

These funds are used to develop or enhance access to a comprehensive continuum of high quality, state-of-the-art care forlow-income persons living with HIV/AIDS (PLWHA). All services must be consistent with Health and Human Service (HHS) Treatment Guidelines, performance guidelines and all other applicable professional regulations and licensurerequirements. See for the HHS performance measure guidelines.

III. Background

This request for proposals (RFP) identifieseligible program activities, identifies priority program activities, provides guidance in developing andsubmitting an application, and informs applicants of key dates.All programmatic questions regarding this RFP (i.e., objectives, review criteria, work plan, budget components, etc.) and assistance with the application guidelines should be referred to Alicia Bunton, AIDS Foundation Chicago Telephone: 312-334-0958 Email:

A. Overview of the Cook and Collar Counties Service Area

The Collar Counties and Cook County have8,272, 768 residents and is home to 43.3% of Illinois residents. The county is divided into thirty different townships. Geographically, the area is the fifth largest in Illinois by land area and shares the state's coast line on Lake Michigan with Lake County. 2005 Census estimates placed the non-Hispanic white population of at 45.4% of the total population of the area. Other racial groups were African-Americans at 26.4%, Latinos at 22.2% and Asians at 5.5%.

HIV/AIDS is a serious health problem greatly affecting Cook County and its surrounding Collar Counties. According to the 2008 Illinois Department of Public Health Surveillance Report for December 2008; in the Collar Counties and Cook County there were a reported 1,728 individuals with HIV (Non-AIDS), and an additional 691 individuals with of AIDS. Likewise there are 14,795 individuals reported to be living with HIV and 14,871 reported to be living with AIDS in the defined Cook and Collar counties service area. Approximately 80% of PLWHA in the defined Cook and Collar county service area are male and 20% are female. More than half (53%) of PLWHA in the same area are non-Hispanic Black; 29% are non-Hispanic White; 16% are Hispanic; and 1% are non-Hispanic/Other. Overall, 52% of people living with HIV disease acquired infection through male-to-male sexual contact (MSM); 23% were a result of injection drug use (IDU); and 16% were acquired through heterosexual contact. Among males, 57% of those living with HIV disease acquired infection through MSM.

B. Key Program Changes

This section outlines some changes that affect the Chicago EMA’s RWPart B program. Thelegislation previously known as the Ryan White CARE Act was amended in 2006 and renamed the RyanWhite HIV/AIDS Treatment Modernization Act of 2006 (RW). The RW legislation can beobtained at: RW made a number of changes regarding allowableservice categories and their definitions.

IV. Eligibility Requirements for Applicants

Funds are available to public and private not-for-profit organizations located within or providing services to residents of Cook, Du Page, Grundy, Kane, Kendall, Lake and Mc Henry County. Eligiblerecipients include hospitals, community-based organizations, hospices, ambulatory care facilities,community health centers, migrant health centers, homeless health centers, currently providing Part A, B, or C dental services.

Applicants must submit the Intent to Apply form (Appendix A) that includes all the informationrequested by Friday, November 13, 2009. The form may besubmitted via e-mail, fax or US postal system mail to:

Alicia Bunton

Director of Care and Quality Improvement

AIDS Foundation of Chicago

200 West Jackson Blvd, Suite 2200

Chicago, Il, 60606

Phone 312-334-0958

Fax: 312-922-2916

Email:

The Intent to Apply form is required, as this form is used to assistAFC in notifying potential applicants of any changes that may arise with the RFP, application submission requirements as well as the planning of the proposal review process.

V. Bidders’ Teleconference

One Bidders’ Teleconference has been scheduled for this RFP. The call will take place on Friday,November 6, 2009 at 10:00 AM-11:30AM CST. The purpose of the Bidders’ Teleconference is to provide an overview of this RFP, describe theapplication review process, and answer prospective applicants’ questions. Organizations planning toapply for funding are strongly encouraged to participate in the Bidders’ Conference. Participants are asked to join the call 10 minutes prior to the calls start time. To receive the presentation slides for this meeting you must RSVP with Alicia Bunton via email by 12 noon on November 4, 2009.To join the teleconference please use the number provided below

Toll Free Number: 1-866-206-0240 Participant Pin #: 783468#

VI. Available Funding

Approximately $1,658,000.00 in RW Part B funds will be available through this RFP.Awards will begin on April1, 2010. Contracts will be for a twelve (12) month periodand all funds must be expended by March31, 2011. Based upon performance, grants are renewable annually up to three(3) contract years.

Available Service Category Funding At a Glance
Cook County - $1,339,00 / Collar Counties - $319,000
Ambulatory Care- $ 558,000
FoodBank/Home delivered meals- $218,000
Housing- $ 117,000
Legal- $ 62,000
OutpatientMental Health - $ 266,000
OutpatientSubstance Abuse–
$118,000 / Ambulatory Care- $ 113,000
Emergency Financial Assistance - $ 3,000
Food bank/Home delivered meals- $ 32,000
Housing- $ 45,000
Medical Nutrition Therapy- $ 24,000
OutpatientMental Health- $ 39,000
Oral Health- $10,000
OutpatientSubstance Abuse- $ 53,000

There are non-allowable activities in this grant application.

Funds may not be used to make cash payments to recipients of services.

Funds may not be used to makepayment for any item or service if payment has already been made or can reasonably expected to be madeunder any State compensation program, any insurance policy or any Federal or State health benefitsprogram or by an entity that provides health services on a pre-paid basis (42USC 300ff-15(a)(6)).

Fundsmay not be used to supplement third-party reimbursement.

Funds may not be used to purchase orimprove land or to purchase, construct or make permanent improvement to any building. Minorremodeling is not allowed under this RFP (42USC 300ff-14(g)).

All contracts will be paid on a reimbursement basis.

VII. Eligible Part B Program Activities and Priorities

A. General Service Category Service Guidelines, Service Category Definitions and Allowable Activities

Services rendered within Cook County and its Collar Counties are the only services that will be funded under this RFP. The State of Illinois Ryan White Part B Service Guidelines that each applicant agency must comply with are listed below.

GENERAL SUBCONTRACTOR SERVICE GUIDELINES

The following statements are general service guidelines that apply to all service categories:

  • The Ryan White program funds must be used as a last resort when other federal/state/local resources have been exhausted.
  • Clients who are Medicaid beneficiaries must utilize Medicaid-certified providers for their medical care. Eligible clients may access services through subcontracted providers while they are in Medicaid spend-down status.
  • Ryan White funds may not be used for co-payments of services covered by clients who have private insurance plans. Funds may still be used, however, for allowable services not covered by client insurance plans.
  • Payment for services must be made directly to appropriate subcontracted providers.
  • Services are a part of the coordinated continuum of HIV/AIDS care.
  • Services should adhere to professional, clinical, and programmatic guidelines and regulations.
  • Services are individualized and tailored to client needs.
  • Services are offered in a safe and secure environment.
  • Services are offered in such a way as to overcome barriers to access and utilization.
  • Services are culturally sensitive and competent; service providers have received cultural competency training that incorporated race/ethnicity, as well as, cultural characteristics of individuals receiving these services.
  • Services utilize effective management practices (in areas such as cost effectiveness, human resources, and quality improvement).
  • Providers are knowledgeable, accepting, and respectful of the needs of individuals with HIV/AIDS. Providers must demonstrate their ability to work with underserved/hard-to-reach populations, including, but not limited to, youth/adolescents, injecting drug users and other substance users, men who have sex with men (MSM), people of color, women, and rural clients.
  • Providers uphold consumer rights.
  • Providers offer a comprehensive set of services on-site or by referral that address consumer and family needs.
  • Providers must demonstrate their ability to coordinate services and cooperate with other agencies providing HIV/AIDS services.
  • Subcontractor must comply with standards of their profession.
  • Client confidentiality is maintained at all times and client files are kept in a locked file/room and/or a secured database.
  • Grievance procedure must be available and understandable to clients.
  • Provider’s facilities are compliant with federal Occupational Safety and Health Administration, Centers for Disease Control and Prevention, Environmental Protection Agency, and Americans with Disabilities Act.
  • Subcontractor must have liability and malpractice insurance, if applicable.
  • Subcontractor must have a client confidentiality policy.
  • Subcontractor must have a nondiscrimination policy in place.
  • Subcontractor must have a client record storage and access policy.
  • Computer files must be secure from unauthorized personnel.
  • Subcontractor must have a client rights and responsibilities policy.
  • Client satisfaction survey must be administered on an annual basis.
  • Subcontractor must provide documentation of services provided, costsand monthly billing to the lead agency.
  • Providers must maintain appropriate relationships with entities in the regional area that constitute key points of access to the health care system for individuals with HIV infection for the purpose of facilitating early intervention for those newly diagnosed with HIV disease and those who are knowledgeable of their status but not in care.
  • Providers comply with the applicable provisions of the Health Insurance Portability and Accountability Act (HIPAA).
  • All providers and subcontractors must collect and maintain unduplicated client-level data to be used by the lead agency and the grantee to create aggregate counts for the purpose of completing required data reports.
  • Permit quality assurance evaluations to be scheduled during regular business hours at mutually agreed upon times and to be conducted in a manner that will provide minimal disruption in the provision of services, which includes facilitating the quality assurance process by assisting the lead agency in arranging record reviews, interviews with service recipients and sub grantee site visits.
  • When applicable, the grantee shall make all reasonable efforts to pursue third-party payments for services subject to this agreement, including Medicaid, Medicare, and private insurance. Funds provided for services pursuant to this contract are restricted for clients infected with HIV who have no other means of payment available. If a client becomes eligible for Medicaid, the grantee and its sub grantees, when applicable, shall retroactively bill Medicaid for covered services provided with Ryan White Program funding during the time in which eligibility was being determined.
  • At a minimum, grantee must be able to demonstrate that Part B primary care, supportive services, medical, dental and mental health are consistent with Public Health Service treatment guidelines for adults, adolescents, pediatrics, perinatal exposure, non-occupational exposure, primary medical care worker exposure, opportunistic infections and tuberculosis. Current treatment guidelines are available at <

The State of Illinois imposes service cost maximums per client on funded Ryan White Part B services that AFC, the lead agent must monitor. The chart below details yearly client maximum expenditures for service categories funded in the request for proposals. Client maximum expenditures are based on Federal poverty thresholds.

Part B State of Illinois

SERVICES, INCOME ELIGIBILITYAND

YEARLY MAXIMUM EXPENDITURES

Effective 04/23/09

Service / Yearly Maximum Expenditure Per Client / Income Eligibility Based on Individual Federal Poverty Levels (FPL) or Household Median Income (MI)
Core Services
Medical Case Management / N/A / None
Medical Nutritional Therapy / $1,000 / 400% (FPL)
Mental Health Care / $2,000 / 400% (FPL)
Oral Health Care / $3,000 / 400% (FPL)
Outpatient/Ambulatory Health Services / $4,000 / 400% (FPL)
Substance Abuse Services-Outpatient / $2,000 / 400% (FPL)
Support Services
Emergency Financial Assistance:
Utility Assistance / $2,000 Part B
(max. 7 months year*)
$2,000 HOPWA
(max. 21 weeks or 5 months per year*) / 50% MI (household)
Food Bank/Home Delivered Meals / N/A / 200% (FPL)
Housing Assistance:
Emergency Rent / $1,000 Part B only
(max. 2 payments year*) / 50% MI (household)
Rental Assistance / $2,000 Part B
(max. 7 months per year*, 24 months lifetime total per household)
$2,000 HOPWA
(max. 21 weeks or 5 months per year*) / 50% MI (household)
Mortgage Assistance / $2,000 HOPWA only
(max. 21 weeks or 5 months per year*) / 50% MI (household)
Legal Assistance
Only covers powers of attorney, do-not-resuscitate orders, or access to eligible benefits / $1,000 / 200% (FPL)
Psychosocial Support Services / $500 / 400% (FPL)

All objectives should be quantified using the established Units of Service. These units are defined by service category on the following pages.

Category 1: Ambulatory/Outpatient Medical Care - Cook and CollarCounties

Core Medical Service

Estimated amount available: $671,000

Defined Unit of services: is defined as one (1) office visit with a medical provider,(1) lab visit and/or one (1) medical assessment for service provided.

Outpatient/Ambulatory Health Services

Definition: Outpatient/ambulatory health services are the provision of professional diagnostic and therapeutic services rendered by a physician, physician's assistant, clinical nurse specialist, or nurse practitioner in an outpatient setting. Settings include clinics, medical offices, and mobile vans where clients generally do not stay overnight. Emergency room services are not outpatient settings. Services includes diagnostic testing, early intervention and risk assessment, preventive care and screening, practitioner examination, medical history taking, diagnosis and treatment of common physical and mental conditions, prescribing and managing medication therapy,education and counseling on health issues, well-baby care, continuing care and management of chronic conditions, and referral to and provision of specialty care (includes all medical subspecialties). Primary medical care for the treatment of HIV infection includes the provision of care that is consistent with the Public Health Service’s guidelines. Such care must include access to antiretroviral and other drug therapies, including prophylaxis and treatment of opportunistic infections and combination antiretroviral therapies. The services includes treatment adherence counseling when provided in by medical personnel in a clinical, outpatient setting.

Outpatient/Ambulatory Health Services Guidelines

  • Subcontractor must have a current state license.
  • Subcontractors who treat Medicaid beneficiaries must have a valid Medicaid provider certification number.
  • Access to services is available irrespective of substance use, risk behavior, stage of illness and sexual orientation.
  • Services must meet minimal established clinical standards of comprehensive medical care.
  • Subcontractors provide care in a manner consistent with Public Health Services guidelines for primary medical care of HIV infection. Such care includes access to antiretrovirals and other drug therapies, including prophylaxis and treatment of opportunistic infections and combination antiretroviral therapies.
  • Subcontractor must screen clients for Hepatitis and provide vaccinations, or documentation that the client has previously received vaccinations.
  • Care is integrated into a multi-disciplinary continuum, available on-site or by referral.
  • Subcontractors must comply with standards of their practice.
  • Subcontractor must promote enrollment in clinical trials.
  • Service plans are appropriate to circumstances.
  • Treatment environment is safe and secure.
  • There is a reasonable wait for clinic/office appointments.
  • There is adequate transportation to clinic/office appointments.
  • Subcontractor’s facility uses equipment designed for infection control.
  • Clients must have a complete treatment plan, tailored to his/her individual needs and containing a medical history as well as current conditions; the plan should be monitored appropriately and updated as needed. It also should include an appropriate recall/follow-up schedule.
  • Emergency services are first priority for service delivery.
  • Subcontractor has a referral resource listing of appropriate specialists.
  • Services may include the provision of genotype testing, phenotype testing, Trofile assay, and HLA-B 5701, in accordance with Department policy and procedure.
  • Services may include ophthalmological care; however, services shall not include prescriptions for eyewear necessitated for vision correction conditions not associated with HIV.
  • Services shall not include the provision of pharmaceuticals.
  • All outpatient/ambulatory health service providers shall have in place a written protocol for screening HIV infected clients for treatable STDs, including syphilis, gonorrhea, chlamydia, and trichomoniasis. HIV care medical providers shall report STDs using their established reporting procedures.

Category 2: Emergency Financial Assistance (EFA)- Collar Counties Only