Download Click here for the Round 2 RFP.

Request for Proposals
Minnesota Accountable Health Model
Emerging Professions Integration Grant Program
Round Two
July 28, 2014
Table of Contents
Minnesota Accountable Health Model ........................................................................................... 1
Overview ......................................................................................................................................... 3
State Innovation Model (SIM) ..................................................................................................... 3
Background ..................................................................................................................................... 6
Why Emerging Professions? ........................................................................................................ 6
Community Health Worker ......................................................................................................... 7
Community Paramedic ................................................................................................................ 8
Dental Therapist .......................................................................................................................... 9
Goals and Outcomes ..................................................................................................................... 10
Eligible Applicants ......................................................................................................................... 12
Available Funding and Estimated Awards .................................................................................... 13
Grant Timeline .............................................................................................................................. 13
Application Instructions ................................................................................................................ 14
Required Application Documents ................................................................................................. 15
Proposal Review Process .............................................................................................................. 17
Contact Information...................................................................................................................... 17
Appendix A .................................................................................................................................... 18
Proposal Cover Form ................................................................................................................. 18
Appendix B .................................................................................................................................... 19
Budget Form .............................................................................................................................. 19
Appendix C .................................................................................................................................... 20
Minnesota Emerging Professions Integration Grant Program
2
Overview
The Minnesota Department of Health (MDH) requests proposals for the Minnesota Emerging
Professions Integration Grant Program with the goal of integrating emerging professions into
the workforce, including models of accountable care. The grant program will have three funding
cycles. This request for proposals (RFP) is for the Minnesota Emerging Professions Integration
Grant Program - Round Two. Grant funds from round two are focused on three emerging
professions: community health workers, community paramedics and dental
therapists/advanced dental therapists. Funds may be used to support professional salary and
fringe benefits during the grant period, in order to facilitate the integration of emerging
professions into care delivery models.
The emerging professional must be a new hire or an existing employee moving into a new role,
and have the appropriate training and credentials in one of the three above mentioned
emerging professions.
Priority will be given to emerging professions practitioners who will work in, or closely
partner/coordinate care with, behavioral health, long-term care, local public health, and/or
social services settings, and organizations that are participating in, or preparing to participate
in, an Accountable Care Organization or similar health care delivery model that provides
accountable care (including, but not limited to, the Medicare Shared Savings Program, the
Medicare Pioneer ACO Program, or the Medicaid Integrated Health Partnerships program).
As health reform continues to change towards deeper coordination of services, better sharing
of information, and more accountability for the care delivered, this grant opportunity intends to
explore new relationships and team-based approaches using the work of emerging professions
as a tool for employers seeking this change. Emerging professions can act as a bridge between
clinical or programmatic goals and broader outcomes such as population-based health
initiatives. MDH is especially interested in how integrating emerging professions into a team
environment changes the work and capacity of others on the team and seeks to evaluate this.
For example, by bringing on a community health worker, what changes occur in the output of
others on the team, and is the quality of care affected?
State Innovation Model (SIM)
The Minnesota Emerging Professions Integration Grant Program is part of the Minnesota
Accountable Health Model being implemented through the State Innovation Model (SIM) grant.
The Minnesota Accountable Health Model (MAHM) is a State Innovation Model (SIM) testing
grant awarded by the Center for Medicare & Medicaid Innovation (http://innovations.cms.gov)
Minnesota Emerging Professions Integration Grant Program
3
to the Minnesota Department of Human Services (DHS) and Minnesota Department of Health
(MDH) in 2013. The purpose of the SIM-Minnesota project is to provide Minnesotans with
better value in health care through integrated, accountable care using innovative payment and
care delivery models that are responsive to local health needs. The funds will be used to help
providers and communities work together to create healthier futures for Minnesotans, and
drive health care reform in the state.
The vision of the Minnesota Accountable Health Model is as follows:
•
•
•
•
Every patient receives coordinated, patient-centered primary care.
Providers are held accountable for the care provided to Medicaid enrollees and other
populations, based on quality, patient experience and cost performance measures.
Financial incentives are fully aligned across payers and the interests of patients, through
payment arrangements that reward providers for keeping patients healthy and
improving quality of care.
Provider organizations effectively and sustainably partner with community
organizations, engage consumers and take responsibility for a population’s health
through Accountable Communities for Health that integrate medical care,
mental/chemical health, community health, public health, social services, schools and
long-term supports and services.
The Minnesota Accountable Health Model will test whether increasing the percentage of
Medicaid enrollees and other populations in accountable care payment arrangements will
improve the health of communities and lower costs of health care delivery. To accomplish this,
the state will expand the Integrated Health Partnerships (IHP) demonstration, formerly called
the Health Care Delivery Systems (HCDS) demonstration, administered by the Department of
Human Services.
(http://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&RevisionS
electionMethod=LatestReleased&dDocName=dhs16_161441)
The expanded focus will be on the development of integrated service delivery models and use
of coordinated care methods to integrate health care, behavioral health, long-term and postacute care, local public health and social services centered on patient needs.
To achieve the vision of shared cost and coordinated care, the Minnesota Accountable Health
Model includes key investments in five Drivers that are necessary for accountable care models
to be successful
(http://www.dhs.state.mn.us/main/groups/sim/documents/pub/dhs16_182962.pdf).
Minnesota Emerging Professions Integration Grant Program
4
•
•
•
•
•
Driver 1 is Health Information Technology/Health Information Exchange: Providers
have the ability to exchange clinical data for treatment, care coordination and quality
improvement.
Driver 2 is Data Analytics: Providers have analytic tools to manage cost/risk and
improve quality.
Driver 3 is Practice Transformation: Expanded numbers of patients are served by teambased integrated/coordinated care.
Driver 4 is Accountable Communities for Health (ACH): Provider organizations partner
with communities and engage consumers, to identify health and cost goals, and take on
accountability for population health.
Driver 5 is Accountable Care Organization (ACO) Alignment: ACO performance
measurement, competencies and payment methodologies are standardized, and focus
on complex populations.
The activities contained in this RFP, focusing on integrating emerging professions into the care
delivery team, are linked to Driver 3.
Through the Minnesota Accountable Health Model, Minnesota is working to achieve the vision
of the Triple Aim: improved consumer experience of care, improved population health, and
lower per capita health care costs. The Minnesota Accountable Health Model: Continuum of
Accountability Matrix
(http://www.dhs.state.mn.us/main/idcplg?IdcService=GET_FILE&RevisionSelectionMethod=Lat
estReleased&Rendition=Primary&allowInterrupt=1&noSaveAs=1&dDocName=dhs16_181836)
is designed to illustrate the basic capabilities, relationships and functions that organizations or
partnerships should have in place to achieve the long-term vision of the Minnesota Accountable
Health Model. It will help the state to identify criteria and priorities for investment, and to lay
out developmental milestones that indicate organizations or partnerships are making progress
towards the vision.
In addition, the Minnesota Accountable Health Model: Continuum of Accountability Matrix
Assessment Tool (http://www.health.state.mn.us/e-health/mahmassessmenttool.docx) is an
interactive tool that allows organizations to determine their location on the matrix continuum.
MDH and DHS will use this tool to better understand SIM-Minnesota participants and their
status in achieving the goals of the Minnesota Accountable Health Model, what SIM supports
are needed to achieve the goals, and how we may be able to provide additional tools or
resources. This tool will be used to help us develop targets and goals for participating
organizations, and to assess their progress.
In the Assessment Tool, the terms ‘organization’ and ‘provider’ are meant to include a broad
range of health and health care providers and support services providers that may or may not
Minnesota Emerging Professions Integration Grant Program
5
formally be part of an existing ACO, but that are moving towards greater accountability for
quality, cost of care and health of the populations they serve. Many types of organizations,
including not only providers of medical care but also organizations that operate in the
behavioral health, social services, local public health, long term care/post-acute care settings,
community organizations, and other public/private sector partners that provide supportive
services to individuals and families, can all have a role in convening, leading or participating in
these models.
For more information on the SIM grant, the Minnesota Accountable Health Model and other
health reform activities visit the State Innovation Model Grant website
(http://www.mn.gov/sim).
Background
The goal of the Minnesota Emerging Professions Integration Grant Program is to foster the
integration of emerging professions into the workforce in roles that support the broad goals of
the Minnesota Affordable Health Model (MAHM) related to providing coordinated care, across
settings, for complex patients, populations and models of accountable care. The background
information provides an overview of the emerging professions that are targeted in round two:
community health workers, community paramedics and dental therapists/advanced dental
therapists.
Why Emerging Professions?
Minnesota has an ongoing program to track and analyze the state’s health care workforce,
centered in the MDH’s Office of Rural Health and Primary Care (ORHPC). As part of this ongoing
work, MDH conducts regular workforce surveys covering a wide range of licensed professions,
works with stakeholders around the state to identify, synthesize, and as appropriate respond to
emerging workforce concerns, and serves as the lead content experts for discussions on current
and future healthcare workforce needs and strategies to resolve potential shortages. Through
these and other activities, Minnesota has previously identified a current and growing shortage
of primary care and related providers that will, if not addressed, present challenges to
accomplishing the state’s health reform goals.
MDH continues both its statewide workforce monitoring and its state investments in health
professions education, loan forgiveness and other workforce development strategies. In
addition, through this federal State Innovation Model (SIM) Program, MDH will advance the
development of and monitor the impact of three emerging professions: the Community Health
Worker (CHW); the Community Paramedic (CP); and Dental Therapy – which includes the
Minnesota Emerging Professions Integration Grant Program
6
Dental Therapist (DT) and the Advanced Dental Therapist (ADT). MDH has been involved in the
conception and development of these occupations, in large part because of their potential to
contribute to the spread of team care models and the roll out of Health Care Homes and other
emerging models of care delivery.
Emerging professions have the potential to work for a wide range of organizations and in a wide
range of settings. For example, a medical clinic may hire a community health worker to partner
with local public health and extend a range of services to an underserved community. A
hospital may hire a community paramedic and partner with long-term care organizations to
provide services through transitions of care. A dental clinic may hire a dental therapist and
work across sectors to expand services to behavioral health patients. These examples, and
similar scenarios, display how emerging professions may be integrated into the workforce in
ways that align with the overall goals of the SIM grant.
Community Health Worker
According to the American Public Health Association, a CHW is a frontline public health worker
who is a trusted member of and/or has an unusually close understanding of the community
served. This trusting relationship enables the CHW to serve as a liaison/link/intermediary
between health/social services and the community to facilitate access to services and improve
the quality and cultural competence of service delivery. A CHW also builds individual and
community capacity by increasing health knowledge and self-sufficiency through a range of
activities such as outreach, community education, informal counseling, social support and
advocacy. (http://www.apha.org/membergroups/sections/aphasections/chw)
According to Minnesota Statute 256B.0625, subdivision 49,
(https://www.revisor.mn.gov/statutes/?id=256B.0625) the state’s Medical Assistance (MA)
program covers care coordination and patient education services provided by a CHW if the
CHW has:
1. Received a certificate from the Minnesota State Colleges and Universities System
approved community health worker curriculum; or
2. At least five years of supervised experience with an enrolled physician, registered nurse,
advanced practice registered nurse, mental health professional as defined in section
245.462, subdivision 18, clauses (1) to (6), and section 245.4871, subdivision 27, clauses
(1) to (5), or dentist, or at least five years of supervised experience by a certified public
health nurse operating under the direct authority of an enrolled unit of government.
Community Health Workers must work under the supervision of a Medical Assistance-enrolled
physician, registered nurse, advanced practice registered nurse, mental health professional as
defined in section 245.462, subdivision 18, clauses (1) to (6), and section 245.4871, subdivision
Minnesota Emerging Professions Integration Grant Program
7
27, clauses (1) to (5), or dentist, or work under the supervision of a certified public health nurse
operating under the direct authority of an enrolled unit of government. Care coordination and
patient education services covered under this subdivision include, but are not limited to,
services related to oral health and dental care.
Minnesota’s Medicaid program has covered CHW services since 2009. Covered services are
defined as “diagnosis-based health education” as ordered by the CHW’s supervising provider.
As defined above, many provider types may supervise CHWs, including physicians, dentists,
public health nurses and mental health professionals among others. The supervising provider is
responsible for developing the patient health curriculum with the CHW, ordering the service,
and billing Medicaid on the CHW’s behalf.
Community Paramedic
A 2012 Legislative Report from the Minnesota Department of Human Services describes how
the concept of the Community Paramedic (CP) grew from the traditional career ladder of
Emergency Medical Technicians (EMTs). Most EMTs begin with a basic curriculum in emergency
medicine and, over the course of a career, gain new skills and certifications through training.
The typical ladder begins as a certified First Responder, then an Emergency Medical Technician
– Basic (EMT-B), then an Emergency Medical Technician – Intermediate (EMT-I). Eventually,
EMTs can obtain a certification to become an Emergency Technician – Paramedic (EMT-P). The
Community Paramedic certification offers career Paramedics a new level of training and a new
way to contribute their skills. (http://mnemscp.org/wp-content/uploads/2012/03/CommunityParamedics-Legislative-Report.pdf)
According to Minnesota Statute 256B.0625, subdivision 60
(https://www.revisor.leg.state.mn.us/laws/?id=169&doctype=Chapter&year=2012&type=0#la
ws.0.1.0) Medical Assistance covers services provided by community paramedics who are
certified under section 144E.28, subdivision 9, when the services are provided in accordance
with this subdivision to an eligible recipient.
Payment for services provided by a CP under this subdivision must be a part of a care plan
ordered by a primary health care provider in consultation with the medial director of an
ambulance service and must be billed by an eligible provider enrolled in medical assistance that
employs or contracts with the community paramedic. The care plan must ensure that the
services provided by a CP are coordinated with other community health providers and local
public health agencies and that CP services do not duplicate services already provided to the
patient, including home health and waiver services. Community Paramedic services are to
include health assessment, chronic disease monitoring and education, medication compliance,
immunizations and vaccinations, laboratory specimen collection, hospital discharge follow-up
care, and minor medical procedures approved by the ambulance medical director. Services
Minnesota Emerging Professions Integration Grant Program
8
provided by a CP to an eligible recipient who is also receiving care coordination services must
be in consultation with the providers of the recipient’s care coordination services.
Community Paramedic services have been covered by Minnesota’s Medicaid program since
2012, and Minnesota is the first state to cover this newly developed profession. Community
Paramedics work under the direct supervision of the Medical Director of an ambulance service,
who is responsible for coordinating CP services with the patient’s primary care provider.
Dental Therapist
Dental Therapists (DT) and Advanced Dental Therapists (ADT) in Minnesota practice as part of a
dental team to provide educational, clinical and therapeutic services. Minnesota law defines
specific educational, examination and practice requirements for licensed dental therapists and
advanced dental therapists. One distinctive provision is that, according to Minnesota Statute
150A.105, Subdivision 2 and 3,
(https://www.revisor.mn.gov/statutes/?id=150A.105#stat.150A.105), a DT or ADT is limited to
primarily practicing in settings that serve low-income, uninsured, and underserved patients or
in a dental health professional shortage area. A DT or ADT must enter into a written
collaborative management agreement with a Minnesota-licensed dentist. A collaborating
dentist is limited to entering into a collaborative agreement with no more than five DTs or ADTs
at any one time. Collaboration agreement specifications for dental therapists
(http://www.dentalboard.state.mn.us/Portals/3/Licensing/Dental%20Therapist/DT%20%20CMA%20Approved%20Sept%2024%202010.pdf) and advanced dental therapists
(http://www.dentalboard.state.mn.us/Portals/3/Licensing/Dental%20Therapist/ADTCMA%2012-4-10approved.pdf) are available from the Minnesota Board of Dentistry.
A collaborating dentist must be licensed and practicing in Minnesota. The collaborating dentist
shall accept responsibility for all services authorized and performed by the DT or ADT pursuant
to the management agreement. Any licensed dentist who permits a DT or ADT to perform a
dental service other than those authorized under this section or by the board, or any DT or ADT
who performs an unauthorized service, violates sections 150A.01 to 150A.12. Collaborative
management agreements must be signed and maintained by the collaborating dentist and the
DT or ADT. Agreements must be reviewed, updated and submitted to the board on an annual
basis. Minnesota Statute 150A.105, subdivision 4-8
https://www.revisor.mn.gov/statutes/?id=150A.105#stat.150A.105) provides further detail on
the scope of practice, dispensing authority, and use of dental assistants for DTs or ADTs.
Dental Therapists and Advanced Dental Therapists can significantly expand access to
underserved populations by expanding the reach of a supervising dentist through a
collaborative management agreement (in the case of DTs) or through independent practice (for
ADTs). These midlevel professionals have the potential not only to increase access generally,
Minnesota Emerging Professions Integration Grant Program
9
but also to reduce emergency visits for dental pain and infection. Minnesota Statute 150A.106,
subdivisions 2 – 4 (https://www.revisor.mn.gov/statutes/?id=150A.106#stat.150A.106)
provides further detail on the scope of practice, practice limitation and medications for
advanced dental therapists.
Goals and Outcomes
The goal of the Minnesota Emerging Professions Integration Grant Program is to foster the
integration of emerging professions into the workforce in roles that support the broad goals of
the Minnesota Affordable Health Model (MAHM) related to providing coordinated care, across
settings, for complex patients, populations and models of accountable care. Grant funds from
round two are focused on three emerging professions: community health workers, community
paramedics and dental therapists/advanced dental therapists. Funds may be used to support
professional salary and fringe benefits during the grant period, in order to facilitate the
integration of emerging professions into care delivery models, including accountable care
organizations.
The Minnesota Emerging Professions Integration Grant Program has three main objectives to
reach the goal of integrating emerging professions into the workforce. First, MDH will provide
funds to support an employer who wants to include an emerging professional as a part of their
team. The grant-supported position will be a new position, or an existing position moving into a
new role, and will remain beyond the grant period. MDH recognizes that the grant award is not
sufficient to cover all salary and fringe costs for such a position, and applicants will need to fund
the difference through reimbursement for services or other sources. If the emerging
professional terminates his/her position during the grant period, funds may then be re-directed
to another candidate, with notification of and approval by the State.
Applicants may or may not have identified the grant-supported professional to hire at the time
of application. If the professional has been identified, the applicant may name him/her in the
application. If the professional has not been identified, MDH recommends that the applicant
begin the recruiting process as soon as possible. In that case, the applicant may include up to 30
days of recruitment time in the project work plan.
Second, MDH will provide resources and technical assistance to grantees to help them integrate
the emerging professional. MDH has an Emerging Professions Coordinator who will serve as the
grant manager and can provide support to grantees. This may include assistance in recruitment
of an emerging professions practitioner, facilitation of occasional meetings to monitor progress,
Minnesota Emerging Professions Integration Grant Program
10
and assistance with components of the evaluation process during and at the completion of the
grant period.
Third, MDH will collect information from grantees to evaluate the level of success in emerging
profession integration. Grantees will participate in an evaluation that will include reporting at
the mid- and end-point of the grant period. Along with meeting the self-defined goals and
objectives required as a part of the application, grantees should expect to provide qualitative
feedback and quantitative data through a variety of evaluation activities, and to share tools or
resources they have developed as part of their funded project. Evaluation activities may include
key informant interviews, patient/client satisfaction surveys and data sharing. Grantees should
include evaluation participation in their work plan, particularly near the end of the project.
MDH expects that grantees will:
•
•
•
•
Hire an emerging professions practitioner full-time, for the duration of the grant
o Any costs in excess of the grant dollars available will be incurred by the grantee
Participate in activities required for monitoring grant progress
Fulfill reasonable requests for information and data related to evaluation of the grant
Share resources developed and lessons learned during the grant period
Grantees are also strongly encouraged to participate in other SIM activities, such as statewide
learning collaboratives or topic-specific learning communities, as appropriate for their funded
project and their organizational needs.
In combination, the goals, objectives and outcomes of the Minnesota Emerging Professions
Integration Grant Program will build a base of knowledge around emerging professions. MDH
will continuously update and share information with internal and external partners about the
progress of the program. Lessons learned from this grant program will also contribute to the
development of several toolkits, which will be broadly shared as they are completed.
Minnesota Emerging Professions Integration Grant Program
11
Eligible Applicants
Eligible applicants for this RFP include any type of organization that has the capacity to employ
a community health worker, community paramedic, dental therapist or advanced dental
therapist. These emerging professions have the potential to work for a wide range of
organizations in a wide range of settings. Potential examples of eligible applicants may include
hospitals, clinics, ambulatory services, health care homes, emergency medical services, health
care providers, nonprofits, educational settings, mental health centers, dental offices, senior
centers, faith-based programs, nursing homes, local public health programs, group homes,
inpatient mental health facilities, and human services programs, including substance use
disorder treatment programs.
Priority will be given to emerging professions practitioners who will work in, or closely
partner/coordinate care with, behavioral health, long-term care, local public health, and/or
social services settings, and organizations that are participating in, or preparing to participate
in, an Accountable Care Organization (ACO) or similar health care delivery model that provides
accountable care (including, but not limited to, the Medicare Shared Savings Program, the
Medicare Pioneer ACO Program, or the Medicaid Integrated Health Partnerships program).
Eligible applicants may receive funding for only one round of the Minnesota Emerging
Professions Integration Grant Program. Applicants must include information about any other
grant funding associated with the work of an emerging professions practitioner to be funded by
this grant.
Minnesota Emerging Professions Integration Grant Program
12
Available Funding and Estimated Awards
MDH will release three Requests for Proposals under the Minnesota Emerging Professions
Integration Grant Program. Release dates and award amounts are subject to change based on
available funding.
1. Minnesota Emerging Professions Integration Grant Program – Round One
RFP Release Date: Monday, April 21, 2014
Estimated Grant Period: July, 2014 – June 30, 2015
Total Funding Available: $180,000
Estimated Number of Grant Awards: Two (2) grants for each emerging profession, for a
total of up to six (6) grants.
Maximum Award Amount: Each grant is up to $30,000.
2. Minnesota Emerging Professions Integration Grant Program – Round Two
RFP Release Date: Anticipated July 2014
Grant Period: November, 2014 – October, 2015
Total Funding Available: $120,000
Estimated Grant Awards: Up to four (4) grants available; each grant is up to $30,000
3. Minnesota Emerging Professions Integration Grant Program – Round Three
RFP Release Date: Anticipated July 2015
Grant Period: October 1, 2015 – September 30, 2016
Total Funding Available: $50,000
Estimated Grant Awards: Up to two (2) grants available; each grant is up to $25,000.
Grant Timeline
Below is the timeline for the Minnesota Emerging Professions Integration Grant Program –
Round Two.
RFP posted:
RFP informational call:
Proposals due to MDH:
July 28, 2014
August 6, 2014 from 3:00 p.m. – 4:00 p.m.
(Call-in Number: 1-888-742-5095, Passcode: 5163675926)
September 19, 2014 by 4:00 p.m. CST
Estimated notice of awards:
Estimated Grant start date:
Grant end date:
October, 2014
November 3, 2014
One year from execution of the grant agreement
Minnesota Emerging Professions Integration Grant Program
13
Application Instructions
This RFP and all of the required application documents are available on the MDH website
(http://www.health.state.mn.us/divs/orhpc/workforce/emerging/index.html). You can also
receive the documents by emailing Kay Herzfeld at [email protected] with “Application
Documents” as the subject line.
Applicants should only submit the documents listed in the “Required Application Documents”
section. Extraneous materials will be discarded and not passed on to reviewers.
Applicants must submit one unbound signed original and three unbound, copies of the
application. Application forms must be completed using word processing and spreadsheet
software. Narrative documents must be double-spaced with one-inch margins, and no longer
than the designated page limit. The font size on forms and narratives must be 12-point font. All
pages must be numbered sequentially. If possible, please send an electronic copy of the
application, in addition to your paper submission, to [email protected].
Proposals must be received by 4:00 p.m., Friday, September 19, 2014, at the following address:
Minnesota Department of Health
Office of Rural Health and Primary Care
ATTN: Kay Herzfeld
Courier Address:
85 East 7th Place
Saint Paul, Minnesota 55101
Mailing Address:
P.O. Box 64882
Saint Paul, Minnesota 55164-0882
Out of fairness to the other applicants, late proposals will not be considered.
Minnesota Emerging Professions Integration Grant Program
14
Required Application Documents
Proposals for the Minnesota Emerging Professions Integration Grant Program must include
the components outlined below. Proposals must not exceed 12 pages of double-spaced 12point font. The 12-page limit includes only items 2-4 below.
1. Proposal Cover Form (see Appendix A)
2. Project Summary (1-2 pages). Brief summary of the emerging professions integration
project including the hiring organization, areas/populations to be served, key partner
organizations, demonstrated financial need and goals.
3. Emerging Professions Integration Description (6-8 pages)
a. Brief description of the organization seeking to hire an emerging professional:
Community Health Worker, Community Paramedic, Dental Therapist or Advanced
Dental Therapist.
b. Identify the grant-supported professional, if known. Identify the professional’s
credentials, and whether the professional is a new hire or an existing employee
moving into a new role. If the emerging professional has yet to be identified, include
plans for recruitment.
c. Identify the supervisor who will be responsible for overseeing the work of the
emerging professions employee.
d. Describe the role of the grant-supported professional (goals/outcomes/objectives)
with respect to community health needs and health care services.
e. Describe how the emerging professions employee will be used to coordinate care
across other sectors – for example, behavioral health, long-term care, local public
health, and/or social services. Include, if relevant, a description of partner
organizations with which the organization or employee will be working.
f. Describe any existing or planned participation by the applicant organization in an
Accountable Care Organization (ACO) model or any similar shared-risk arrangement.
g. Describe plans to orient the emerging professions employee and include how their
work will be integrated into the workflow of the organization. Include plans for
position sustainability beyond the grant period. Describe how the work of the
emerging professions employee will impact the work of others in the organization.
h. Describe the specific goals that the organization will achieve through grant funding,
and how progress towards these goals will be measured. Examples could include
number or type of patients served, types of services (including care coordination)
provided, partnerships established, revenue, patient satisfaction, patient outcomes,
or other indicators.
i. Describe how the grant funding will be used to achieve the goals of accountable care
and the triple aim of improving quality and patient experience and reducing costs.
Minnesota Emerging Professions Integration Grant Program
15
4. Target Population (1-2 pages)
a. Identify the target patient population and communities the emerging professions
employee will serve. Include details on how the emerging professions employee will
serve the needs of the population. If applicable, describe how this project meets the
needs of the community in rural and/or underserved areas. Priority will be given to
projects that focus on patients/clients who are transitioning between care settings
or from a care setting to home, who have multiple chronic conditions (including
behavioral health as well as physiological conditions), or who are receiving medical
and social services supports, or who are in need of primary prevention services.
b. Describe how this project may improve health outcomes of the community to be
served. Include a description of the emerging professional’s potential to impact
health disparities in the community or population being served. Describe how this
project aligns with local public health needs assessment, hospital community health
needs assessments, county gaps analysis survey for long-term care, and/or other
state or local health planning efforts specific to the community being served.
5. Work Plan
Describe the work plan to achieve all of the goals/objectives proposed in the project
description section. Include a timeline for the work plan. Include plans to participate in
evaluation activities.
6. Budget
Salary and fringe benefit costs are eligible grant expenses for integrating the emerging
professional. Attach a line-item budget as a separate document (see Appendix B for
Budget Form). If applicable, include matching funds and revenue projections of
Medicaid or other third-party billing for the emerging professional.
Budget Narrative
Provide information on how each of the line items shown in the budget were calculated.
For example, include hourly wage and salary dollars and fringe benefit calculations.
7. Include a completed copy of Assessment Tool Results from the Minnesota Accountable
Health Model: Continuum of Accountability Matrix Assessment Tool
(http://www.health.state.mn.us/e-health/mahmassessmenttool.docx). Note: This
Minnesota Accountable Health Model: Continuum of Accountability Matrix location
and/or specific assessment results will not be part of the criteria for grant award or
funding decisions. It is a requirement of all grantees that receive SIM funding, and for
purposes of this grant is being used primarily as a self-assessment tool
8. Applicant must complete the Financial Capability Form (please see Appendix C).
9. Applicant must submit an internal financial statement, an IRS Form 990, or the most
recent certified financial audit.
Minnesota Emerging Professions Integration Grant Program
16
Proposal Review Process
Grant proposals will be reviewed and evaluated by a panel familiar with the Minnesota
Accountable Health Model and the goals of integrating emerging professionals. The panel may
include staff from the Minnesota Department of Health, Minnesota Department of Human
Services, Advisory Task Force members and the community at large. The panel will recommend
selections to the Commissioners of Health and Human Services. In addition to panel
recommendations, the commissioners may also take into account other relevant factors in
making final awards.
The grant proposals will be scored on a 100-point scale as listed below.
Criteria
Maximum Points
Project Description
Target Population
Work Plan
Budget
30 points
30 points
30 points
10 points
Total
100 points
Contact Information
Questions about the Minnesota Emerging Professions Integration Grant Program and the
proposal process should be directed in writing to:
Kay Herzfeld
Office of Rural Health and Primary Care
Minnesota Department of Health
Email: [email protected]
Other personnel are NOT authorized to discuss this request for proposal with Responders, with
the exception of the RFP informational call, before the proposal submission deadline. Contact
regarding this RFP with any personnel not listed above could result in disqualification.
Minnesota Emerging Professions Integration Grant Program
17
Appendix A
Proposal Cover Form
1. Please select the Emerging Profession that will be supported with this grant:
Community Health Worker
Community Paramedic
Dental Therapist/Advanced Dental Therapist
2. Lead Applicant Organization- organization that will serve as the fiscal agent for project.
Grant agreement will be executed with this organization
Legal Name
Federal Tax ID #
State Tax ID #
3. Total amount of state grant funds applied for: $
Total dollar value of match (cash or in-kind): $
4. Contact Person for Further Information on Proposal:
Name Title
Organization:
Address:
Phone
e-mail:
I certify that the information contained herein is true and accurate to the best of my knowledge,
and I have been authorized to submit this proposal on behalf of the applicant organizations listed
above.
Signature of Authorized Official
Title of Authorized Official
Minnesota Emerging Professions Integration Grant Program
Date
18
Appendix B
Budget Form
Categories
Salary
Grant Funding
Requested
Funding from
Other Sources
Total
Fringe
TOTAL
Note: The budget must be accompanied by a budget justification narrative that explains each
line item. Include other funding sources and calculations, including revenue projections from
third-party billing.
Minnesota Emerging Professions Integration Grant Program
19
Appendix C
The Accounting System and Financial Capability Questionnaire is on the next page. This form is
also available on the MDH Office of Rural Health and Primary Care website
(http://www.health.state.mn.us/divs/orhpc/workforce/emerging/index.html).
Minnesota Emerging Professions Integration Grant Program
20
ACCOUNTING SYSTEM AND FINANCIAL CAPABILITY QUESTIONNAIRE
This is the standard form to be used in order to determine the financial capacity of grant applicants. The creation and implementation
of this form is in response to the best practices stated in the Office of Legislative Auditor’s report “State Grants to Nonprofit
Organizations,” January 2007.
This form should be used for applicant agencies that: are requesting, or will receive, more than $50,000; are new to state granting; are
recently incorporated (five years or less); had previous unfavorable financial performance with federal and/or state funds; had
significant audit findings; or for any applicant whose financial capacity is unknown or questionable.
No applicants will be excluded from receiving funding based solely on the answers to these questions.
SECTION A: APPLICANT INFORMATION
1. Organization Name and Address
2.Employer
Identification Number
3.Number of Employees
Full Time:
Part Time:
4. When did the applicant receive its 501(c)3 status? (MM/DD/YYYY)?
5. Is the applicant affiliated with or managed by any other organizations (Ex.
regional or national offices)?
YES
NO If “Yes,” provide details:
6a. Total revenue in most recent accounting period
(12 months).
5b. Does the applicant receive management or financial assistance from any other
YES
NO If “Yes,” provide details:
organizations?
6b. How many different funding sources does the
total revenue come from?
7. Does the applicant have written policies and procedures for the following business processes?
a. Accounting
Yes
No
Not Sure If yes please attach a copy of the table of contents
Yes
No
Not Sure If yes please attach a copy of the table of contents
b. Purchasing
c. Payroll
Yes
No
Not Sure If yes please attach a copy of the table of contents
SECTION B: ACCOUNTING SYSTEM
1.Has a Federal or State Agency issued an official opinion regarding the adequacy of the applicants accounting system for the collection,
identification and allocation of costs for grants
Yes
No
Note: If a financial review occurred within the past three years, omit Questions 2 – 6 of this Section and 1-3 of Section C.
a. If yes, provide the name and address of the reviewing agency:
2. Which of the following best describes the accounting system?
b. Attach a copy of the latest review and any
subsequent documents.
Manual
Automated
3. Does the accounting system identify the deposits and expenditures of program funds for
each and every grant separately?
4. If the applicant has multiple programs within a grant, does the accounting system record
the expenditures for each and every program separately by budget line items?
5. Are time studies conducted for an employee(s) who receives funding from multiple
sources?
6. Does the accounting system have a way to identify over spending of grant funds?
Combination
Yes
No
Not Sure
Yes
No
Not Sure
Not Applicable
Yes
No
Not Sure
No Multiple Sources
Yes
No
Not Sure
1. Is a separate bank account maintained for grant funds?
Yes
No
Not Sure
2. If grant funds are mixed with other funds, can the grants expenses be easily identified?
Yes
No
Not Sure
3. Are the officials of the organization bonded?
Yes
No
Not Sure
Yes
No
Not Sure
SECTION C: FUND CONTROL
SECTION D: FINANCIAL STATEMENTS
1. Did an independent certified public accountant (CPA) ever examine the organization’s
financial statements?
SECTION E: CERTIFICATION
I certify that the above information is complete and correct to the best of my knowledge.
1. Signature
2. Date
/
/
3. Title
21