Request for Applications

RFA#: 2018-19.2.3a

Using Natural Supports to Build Greater Community Engagement

FUNDING AGENCY: North Carolina Council on Developmental Disabilities (NCCDD), NC Department of Health and Human Services (DHHS), Office of the Secretary

ISSUE DATE: August 18th, 2017

DEADLINE DATE: September 20th, 2017

Receipt of applications online at is preferred, but not required. All applications must be received by 5:00 pm EDT on September 20th, 2017. Please notify at least two weeks in advance of the due date if you need application materials in an alternate format or otherwise require accommodations under the Americans with Disabilities Act.

Direct all inquiries concerning this Request for Applications (RFA) to:

Mailing Address:

NCCDD-RFA

North Carolina Council on Developmental Disabilities

3125 Poplarwood Court, Suite 200

Raleigh, NC 27604

Via Email:

Delivery Information:

Applicants for this RFA are strongly encouraged to submit the application electronically in the DD Suite online database found at Applicants that submit in hard copy are responsible for including all required elements in the submission packet.

Table of Contents

  1. Introduction...... Page 3
  1. Background...... Page 4
  1. RFA Background, Deliverables, and Contractor Responsibilities...... Page 5
  1. Applicant Eligibility...... Page 12

Use of funds

Performance Monitoring/Quality Assurance

  1. Application Procurement Process and Application Review...... Page 13
  2. Attachments to be completed upon award...... Page 14

I. INTRODUCTION

The NCCDD makes funds available to fulfill its mission in accordance with the Developmental Disabilities Assistance and Bill of Rights Act (DD Act) and the Council’s Five-Year State Plan. The NCCDD’s major funding source is the United States Administration on Intellectual and Developmental Disabilities. The NCCDD makes funds available primarily through competitive bids or Requests for Applications (RFAs). A general description of the current RFA is included in this document. The complete RFA package is available through DD Suite ( or may be requested in alternate formats or by mail. Please complete and submit the Notification of Intent to Apply if your organization or agency intends to apply.

Applications are welcomed from any university, non-profit, for profit, or government agency that demonstrates that their agency is qualified, responsible, and capable of conducting the activities described. Eligible entities include any organization, agency, or non-profit demonstrating an expertise in the focus area of this initiative. To be eligible, the non-profit private entity that is awarded this contract must submit proof of 501(c)(3) status with a current IRS determination letter. The Council will not consider applications submitted by agencies that do not meet eligibility to apply for funding.

Private non-profit and for-profit applicants must be registered with the North Carolina Secretary of State to conduct business in North Carolina, or be willing to complete the registration process in conjunction with the execution of the contract documents (see

II. BACKGROUND

NCCDD

The North Carolina Council on Developmental Disabilities, authorized under Public Law 106-402, the DD Act, is one of 56 entities of its type in the United States and the territories. The NCCDD is an independent agency located in the NC DHHS. Its activities are governed by a 40-member body, appointed by the Governor, and comprised of at least 60 percent people with intellectual and other developmental disabilities (I/DD) and their families. Other members include legislators and policymakers representing various agencies and organizations having a vested interest in people with I/DD. The Council’s quarterly meetings are open to the public.

The mission of the NCCDD is to assure that individuals with I/DD and their families participate in the design of and have access to culturally competent services, supports, and other assistance and opportunities that promote independence, contribution, self-determination, integration and inclusion in the community. The NCCDD achieves this mission by promoting advocacy and leadership, community capacity building and systems change activities. It also serves in an advisory capacity, under state law, to the NC Department of Health and Human Services (DHHS).

The NCCDD has established goals and objectives in its Five-Year Plan (2017-2021). These goals represent the most pressing needs as identified by stakeholders in North Carolina. These goals are approved by the Council as the framework for its work within the context of the Five-Year Plan.

GOAL 1: By 2021, increase financial security through asset development for individuals with intellectual and other developmental disabilities.

GOAL 2: By 2021, increase community living for individuals with intellectual and other developmental disabilities.

GOAL 3: By 2021, increase advocacy for individuals with intellectual and other developmental disabilities.

This RFA will address Goal 2.

For further information on the work of the NCCDD, please see the NCCDD Five-Year State Plan at our website:

III. RFA BACKGROUND, DELIVERABLES AND CONTRACTOR RESPONSIBILITIES

Background

The North Carolina Council on Developmental Disabilities (NCCDD) intends to fund an initiative focusing on the importance of non-paid relationships in the lives of individuals with intellectual and other developmental disabilities (I/DD). This initiative aims to foster opportunities for natural supports to develop and sustain in the life of a person with I/DD.

To become a contributing member of the community, a person must have friends and acquaintances as well as participate in reciprocal relationships that are not based on the person’s disability. This process of relationship building can allow natural supports to form. The Lanterman Developmental Disabilities Services Act in California defines natural supports as:

“personal associations and relationships typically developed in the community that enhance the quality and security of life for people, including, but not limited to family relationships; friendships reflecting the diversity of the neighborhood and the community; association with fellow students or employees in mainstream classrooms and workplaces; and associations developed through participation in clubs, organizations, faith communities, and other civic activities.”[1]

With these relationships and associations comes a natural system of support that can prevent minor problems from becoming overwhelming challenges. Additionally, natural supports broaden the world view of a person with I/DD and that of the individuals providing those natural supports.

“Natural supports help to create opportunities for learning and integration when they allow the consumer to assume greater responsibility and become more independent.”[2] There is no single method or easy answer for developing a system of natural supports. Developing and nurturing natural supports may require considerable time and energy. “The support developer and consumer must think in terms of years, because natural supports must evolve.”[3]

Natural supports are not paid support professionals who provide services such as driving an individual with I/DD to a job, acting as a job coach for an individual with I/DD, or serving as a community navigator guiding individuals with I/DD to various resources available in the community. While some individuals with I/DD may develop friendships with paid support providers, the system of paid support does not foster the development of long-term relationships because support providers can change frequently. Instead, natural supports are friendships and relationships that form naturally, not those where the individual providing support is paid to do so.

The National Core Indicators (NCI) Adult Family Survey, State Outcomes, North Carolina Report for 2015-2016 data indicates the need for North Carolinians with I/DD to develop natural supports. For example, among the family members responding:

  • 29 percent of individuals with I/DD do not have friends other than paid support workers or family.
  • 19 percent take part in family-to-family networks.

A national data chart on the proportion of people with I/DD who feel lonely indicates that 29 percent feel lonely sometimes, and ten percent often feel lonely. The data indicates that, while a high number of North Carolinians with I/DD have friends (other than paid support workers or family) who could possibly function as natural supports, 29 percent do not have friends in this category, and a significant number of individuals with I/DD (39 percent) feel lonely at times.

As individuals with I/DD learn how to enter into healthy community relationships, they can experience rejection. However, “rejection does not necessarily mean failure” as long as they “use it as a learning experience.”[4]

Although the overall goal of natural supports is not to save money in the I/DD system of services by eliminating paid support or provider staff, developing a personal network will reduce the cost burden to agencies that have limited financial resources because the natural supports will replace services that the individuals may require.

Currently, there are small-scale operations of entities building natural support networks for individuals with I/DD in the state of North Carolina, and these examples can inform the work of adapting a model of developing natural support networks. One such example is the First in Families Lifetime Connections program. This model recognizes five components of creating a good life:

  1. Relationships
  2. Personal vision
  3. Giving back to one’s community
  4. Choice
  5. Financial stability

The first step in this process is establishing a personal network: a group of people in a relationship with an individual who are committed to helping that individual attain his or her dreams and life goals. A personal network thus forms a bridge between the individual and active community inclusion. See for more information.

Various North Carolina Council on Developmental Disabilities (NCCDD) initiatives aim to create opportunities for individuals to assume greater control of their lives and become more fully integrated into their communities. The “Rethinking Guardianship: Building a Case for Less Restrictive Alternatives” initiative has brought together a stakeholder group that has identified ways in which individuals with I/DD can remain their own guardian and tap into networks where supported decision making can provide the necessary assistance without losing autonomy and self-determination. Additional Council-funded initiatives, such as the relaunch of a statewide self-advocacy empowerment network, are tackling this issue to provide more training to enhance self-determination skills and emphasize individual responsibility that will allow individuals with I/DD to be able to engage in healthy relationships.

In addition to the benefits to the individual with I/DD and the benefits to the people providing natural supports, developing a personal network will reduce the cost burden to agencies that have limited funding because the natural supports will replace services that the individuals may require. However, the primary goal is not to reduce costs but to assist individuals in integrating more fully into the community without the need for certain paid services. Additionally, fostering personal network development will build community capacity and provide benefits to the entire community by strengthening the ties that link all individuals residing within the community.

Deliverables and Contractor Responsibilities

In releasing these funds, the North Carolina Council on Developmental Disabilities (NCCDD) seeks to promote systems change innovations that will establish supportive strategies toward expanding non-paid natural supports while identifying and remove barriers that hinder the opportunity for individuals with I/DD to develop natural supports (as defined in the background section of this RFA).

The grantee will be responsible for activities including, but not limited to:

  1. Creating strategies leading to opportunities for community involvement and developing valuable and lasting interpersonal relationships. These strategies will require creative energy, innovation, and out-of-the-box thinking.
  2. Working in collaboration with other currently funded initiatives to build on the principles of community living, self-advocacy, and family involvement.
  3. Working with LME/MCOs, provider agencies, advocacy organizations, social and civic organizations, and other non-traditional partners to:
  1. Create opportunities for community involvement.
  2. Increase networking for employment.
  3. Decrease the need for guardianship.
  4. Promote the ability to ask for help when needed.
  5. Build valued friendships.
  6. Educate individuals with I/DD on how to enter into safe, healthy relationships.
  1. Producing recommendations and a framework to adapt or create a model and blueprint that will foster opportunities to develop natural supports in both rural and urban communities in North Carolina. This activity will involve creating a guide of “dos” and “don’ts” for individuals, agencies, and organizations that want to better understand how natural supports develop and sustain themselves.
  2. Developing a marketing and outreach program to promote the program and to recruit interested individuals with I/DD to be involved:
  3. A minimum of 25 individuals with I/DD representing a diverse range of support needs from somewhat limited to very extensive, who will be involved over the course of initiative. These individuals should have limited existing natural support networks. Additional individuals with I/DD can join and participate throughout this effort, especially as the contractor learns what principles and methods support the development of natural supports.
  4. Individuals involved live in both urban and rural areas.
  5. the grantee will be responsible for organizing at least ten events or activities in different communities across the state, including both urban and rural communities and follow-up activities with individuals in fostering the development of natural support networks.
  6. The grantee must advertise these opportunities widely using NCCDD’s communication channels, partner agencies and organizations, e-mail blasts, social media networks, media outlets, word of mouth, and any other methods of communication that the grantee may want to use.

Measuring Success:

The grantee will be responsible for measuring the success of the strategies of the initiative in the lives of the individuals with I/DD through use of a validated process. Strong consideration will be given to the applicant that employs the use of the Council on Quality and Leadership Personal Outcome Measures (CQL-POM) assessment process.

  1. Use of the CQL-POM assessment process provides a validated and tested set of criteria and probes (questions) designed to measure the presence of natural supports and friendships.

The CQL has developed, tested, and validated a personal outcome assessment that measures 25 outcomes in the lives of individuals (of all ages) with I/DD. Two specific outcomes include:

  • People have friends.
  • People are connected to natural support networks.

The section on natural support networks lists the following values:

  • Connection to a natural support network of family and very close friends provides a sense of security and safety net for people.
  • People choose the extent and frequency of contact with their support network.

It also offers principles to guide organizations in creating opportunities for natural supports to develop. These include:

  • Facilitating continuity in people’s existing relationships and building the capacity of potential support networks, consistent with their choices and preferences.
  • Providing the supports to enable them to maintain connections to people in their support network.
  • Assisting people who may have lost contact with family members to re-establish communication and develop their natural support network, if desired.

The publication offers an information-gathering guide that includes suggested questions for having a conversation with the person with I/DD to determine who is in the individual’s natural support network and how well this network is assisting the individual. The guide also offers suggested follow-up questions for those individuals who know the person with I/DD best to gather more information about how the person with I/DD utilizes his or her natural support network. The guide then offers Personal Outcome questions to determine if the person with I/DD has developed a natural support network, individualized support questions to assist the organization in understanding what the individual needs to build and maintain a successful natural support network, and additional considerations.

  1. If an applicant wishes to employ an alternative assessment process (other than CQL-POM), this must be clearly and thoroughly justified by the applicant and must be a validated and tested assessment protocol that will accurately measure the development and presence of natural support networks in the life on an individual with I/DD.

Data gathered during year one of this initiative may help influence the direction of this initiative and its activities in years two and three and may assist the grantee in planning activities that will produce stronger outcomes. As pointed out above, natural supports do not develop rapidly, so evaluation data may not be readily available after an initiative activity or a series of activities.

The grantee will be responsible for creating a written guide that explains how natural supports can form and the benefits of creating opportunities for natural supportsto develop. The grantee will make copies of the guide available on-line in an accessible format and in print if requested for individuals unable to access it on-line. The grantee will also be responsible for translating the guide into Spanish or making key information from the guide available in Spanish per NCCDD’s targeted disparity focus on North Carolina’s Hispanic and Latino I/DD community.

The grantee will submit a final report to NCCDD evaluating the success of the events and activities occurring throughout this initiative, the lessons learned, the opportunities for cross-collaboration between different NCCDD initiatives as well as different North Carolina agencies and organizations, and the grantee’s recommendations for improving opportunities for natural supports to develop for individuals with I/DD in North Carolina. The report shall highlight success stories that the grantee gathers over the course of the initiative.

The applicant selected for the Using Natural Supports to Build Greater Community Engagementinitiative will be expected to establish and operationalize activities that facilitate the initiative’s established goals, outlined in Section III.

Also, the applicant selected for the Using Natural Supports to Build Greater Community Engagementinitiative will be expected to establish and operationalize activities to facilitate outreach to and inclusion of the Hispanic/Latino I/DD community.The 2017 – 2021 state plans of Councils on Developmental Disabilities must identify disparity among a subpopulation of the state’s I/DD community and address that disparity. The NCCDD identified a barrier to services and supports for the Hispanic/Latino community caused by language access issues in response to the Administration on Community Living’s(ACL) mandate.Outreach to, and collaboration with, the Hispanic/Latino community to increase engagement and involvement is the Council’s proposed intent.