Community Health Worker Funding RFP
2023-2024 Community-Based Care Coordination:
Community Health Worker Funding
Request for Proposals
Application Deadline: May 31, 2023, at 5:00pm PST
Elevate Health Background
Elevate Health is a Pierce County-based non-profit organization dedicated to improving the health and well-being of all Pierce County residents through community, equity, and innovation. As one of Washington’s nine Accountable Communities of Health (ACH) organizations, Elevate Health works to narrow the gap between unmet health and social needs and the delivery of health and social care. Elevate Health is committed to the principle that all should be treated with equity, dignity and respect, no matter their stations in life. To achieve these objectives, Elevate Health partners with local organizations, community groups, community members and other stakeholders to uplift community voice in pursuit of “whole-person health” for those who live, work, and play in the South Sound Region.
Context and Purpose
Community Health Workers are frontline public health workers who are trusted members of and/or have “unique understanding of the experience, language, and culture of a particular population.” They serve as their community’s links to health and social services and help to improve the quality of care and cultural sensitivity of services delivered. Community Health Workers help to increase individuals’ and community’s health knowledge, and they support individual dignity and autonomy through outreach, education, advocacy-based counseling, emotional and social support, and resource navigation and connecting.
Community Health Workers or Traditional Health Workers may include Peer Support Specialists, Sobriety Coaches, or like professionals with lived experience and/or deep understanding of the communities and populations they serve. Community Health Workers are uniquely able to serve individuals regardless of healthcare insurance membership or primary care assignment and are able to follow those they assist throughout multiple systems and care service sectors to best support the individuals and communities they live in and serve.
Recent equity research by the University of Washington, in cooperation with the Tacoma Pierce County Health Department and Pierce County community partners, has recommended the increase of the CHW workforce as a central need and policy area of address for our region.
Many individuals in Pierce County face systemic obstacles to health due to “the conditions in which people are born, grow, live, work, and age,” known as Social Determinants of Health (SDOH). Research suggests that whole health is affected more by SDOH and health behaviors than by clinical care (20 percent of county-level variation in health outcomes). Factors such as economic instability, lack of access to preventative healthcare, lack of quality educational opportunities, poor social or public supports, and unsafe domestic and built environments create unequal disease burdens for different populations within our region.
Over the past few years, the COVID-19 pandemic highlighted longstanding and deep-seated inequities in health and social care. Communities of color, people experiencing low socioeconomic status, under- and un-insured individuals, and the elderly have been the most vulnerable to these inequities. The COVID-19 pandemic also highlighted previously unrecognized efforts of frontline health workers like Community Health Workers who have long served their communities when formal systems of care have had challenges in engaging with their communities. During the COVID-19 pandemic, Community Health Workers were vital in getting information out into their communities and connecting their community members to health and social care resources. Now, as the public health emergency (PHE), and the public assistance that came with the PHE, is being lifted nationally and within our state, CHWs continue to be needed within their communities to address social needs. In recognition of this continued need for Community Health Workers (CHW) who can address disparities in health and social care, investments to increase, sustain, and maintain CHW services are required. Community-Based Care Coordination services delivered by Community Health Workers who address needs rooted in social determinants of health and who support their community members in positive health behaviors can improve poor health outcomes, reduce burden of illness, and increase support mental and emotional support for Pierce County residents to live fuller and healthier lives.
Continuing its support of Community-Based Care Coordination services delivered by Community Health Workers, Elevate Health is investing in CHW and Traditional Healthcare workers in 2023 and 2024. In a recent Frontiers in Public Health article about the value of CHWs, it was noted that more awareness of CHWs and the value of their work through research and studies on return on investments was needed. Community Health Workers supported by this grant will be asked to document within a care coordination and client management platform provided by Elevate Health, so information about the services offered by CHWs and the value of their work may be gathered.
Frequently Asked Questions
Are previous Elevate Health CBCC CHW Grant awardees eligible to apply for the 2023-2024 CBCC CHW Grant?
Yes.
Can our provided metrics include zip codes outside of Pierce County?
Yes, if the priority is Pierce County residents. If you see high numbers for other counties, they may need to be referred to a CHW in that county.
Can we enroll individuals outside of Pierce County in our program?
Your program retains the right to enroll anyone at your discretion. However, your metrics need to indicate a priority of Pierce County clients.
Should clients be individuals only? What if my organization works with families?
Work with families will focus on the head of household. If the head of household indicates that another family member needs services, this may qualify as a separate referral for that individual.
How will metrics be documented in these scenarios?
All grantees will receive training on documentation and use of CCS, including metrics capture specific to your organization’s needs.
Do virtual encounters qualify as "clients enrolled and served?"
Yes, but in-persons are encouraged, especially during intakes and assessments.
Do client encounters within a group session or activity qualify as "clients enrolled and served?"
No, only 1:1 service qualifies.
What information should organizations provide when asked about current funding applications and sources?
First, this question applies to all funding received by your organization, not just funding received from Elevate Health. Secondly, when responding to this question, it may be helpful to think in terms of statement of need; that is, how will the funds be used to achieve or sustain wholeness for CHW work?
For example, you might indicate that you will receive or have applied for funds from another source to pay CHWs, but your current funding is not sufficient to cover the payroll costs of additional CHWs you plan to hire soon. In that case, you could indicate that you are receiving funds for this purpose and require additional funds. Elevate Health does not require identification of your funding sources.
What information should be provided regarding my organization's total revenue?
Please indicate the revenue recorded in your organization’s most recent financial statement.
What does the acronym CCS refer to?
A The Care Coordination System (CCS) is the documentation platform used by Elevate Health to record and review details of services rendered and resulting metrics.
Will grantees be provided with a CCS demo in advance of application submission?
Elevate Health is working to determine if a demo is available.
What are the reporting and deliverables requirements of the grant?
Information about quarterly reporting is included in the RFP. All grantees will receive an onboarding packet describing the reporting and deliverables requirements. Some of the reports will be pulled from the CCS platform. There may be additional reports required; Elevate Health is currently finalizing these requirements.
My organization is anticipating large-scale transitions within its programming that may require enrollees/clients to be transferred to a different program within our organization. This will require our CHWs to spend time educating enrollees/clients about these transitions and about different programs. How should these transitions be captured in CCS?
If the CHW continues to provide direct services to the enrollee/client after the transfer, there are documentation forms in CCS that capture services rendered that are specific to educational support.
For example, a client might be transferred out of a limited healthcare support program into a comprehensive healthcare support program and may require education to successfully transition/participate. The CHW would provide this education and can then document this in CCS as a service rendered.
What are the requirements for reporting and deliverables?
All grantees will receive training on documentation and the use of CCS, including information on expectations for reporting.
My organization uses [a documentation platform other than CCS]. Is there a way for data to be shared between platforms so CHWs do not have to enter the data twice?
Unfortunately, CCS does not currently support data sharing or transfer between platforms. CHWs can copy and paste contact/service notes into the appropriate fields in CCS rather than typing them out twice.
If selected as grantees, will we be able to adjust terminology and milestones to better match our organization's work?
When using CCS, we ask that you use terminology as indicated in the documentation platform.
For example, a listed contract milestone uses the term graduated to refer to progress or completion of a recommended service. Grantees are required to use the term graduated in this context when using the documentation platform CCS, even if this term is not typically used by your organization. However, grantees may continue to use their organization’s terminology outside of the platform at their discretion.
Our organization is moving enrollees from one program to another according to need. Can these enrollees be counted as "new unique enrollees?"
If the enrollee is staying with the same CHW, they would only be a new client once, regardless of what other programs they may be referred to.
Does CCS include time billing or time tracking?
CCS will automatically track documentation time, e.g., the amount of time a CHW or CHW Supervisor is logged into the client’s profile. If a field is provided where time can be entered and time capture is beneficial for your organization, please enter the time in the field or indicate it elsewhere, such as in service notes. Our contract does not require metrics as to time billed; it focuses on the quantity of client interactions.
Will non-CHWs receive training in CCS?
CCS training will be provided to CHWs and CHW supervisors/managers. Supervisors must take both the CHW and Supervisor training for CCS. Supervisory time should be indicated in the budget you provide in the application.
What documents should be provided to demonstrate fulfillment of HIPAA training requirements for CHWs?
Please provide copies of the most recent annual HIPAA certificate for all CHWs & Supervisors, including those that completed HIPAA training with another employer.
My organization has a large staff, which requires us to stagger training rather than train all staff at one time. Will there be an issue if relevant staff are not trained by July 1?
Staff must be trained before the indicated contract start date, which must be no later than September 1, 2023. Please indicate your preferred contract start date in the application.
Will rolling training be offered given the possibility that additional CHWs will be hired after the contract's start date?
The initial training session will take place in July 2023. Rolling training will not be offered; however, additional training sessions will be offered between grant year Q1 and Q2, and again between grant year Q3 and Q4.
Is this funding for 1 year starting on July 1, 2023?
Yes, provided your organization is prepared to begin the contract on July 1. If your organization is not prepared to begin the contract on July 1, Elevate Health will support a contract beginning on September 1, 2023, and ending August 31, 2024, including a second training session to be scheduled after September 1.
Can grant funds be used to produce linguistically and culturally appropriate resources used by CHWs, such as printed materials and/or web translation and edits?
No, the current grant would not cover these needs as they are indirect service costs. Elevate Health is currently considering these options for future funding opportunities and reviewing existing organizational relationships that might support this need.
Can grant funds be used to produce marketing or promotional materials to be used by CHWs, such as giveaways or brochures for community events?
No, the current grant would not cover these needs as they are indirect service costs. Elevate Health is currently considering these options for future funding opportunities and reviewing existing organizational relationships that might support this need.
Our organization is expecting a change in the number of staff. How do we note this in the application?
1) Note the anticipated staffing change in the application.
Ex: "We currently have 7 employees but have plans to move into the 8-10 employees category."
2) Please also indicate your potential FTEs in the grant budget form.
My organization is currently receiving funding from another source to cover the costs of CHWs; however, this funding will terminate in the middle of the term. If selected for Elevate Health’s grant, will my organization be able to retrieve funding mid-term as described?
Yes; please include information as to the prospective timeline for funding needs.
Can grant funding be used for grant management?
No; please refer to the section titled How Funds May Be Used, located on page 5 of the RFP, which is available for download on Elevate Health’s website. As described, this grant is intended solely to support the work of CHWs and those who directly support CHWs, such as their supervisors. Our financial department has identified grant management and the functions of grant managers as indirect costs that cannot be funded through this grant.
Will grantees have access to summary reports and data regarding outcomes?
Elevate Health will provide and discuss such data during individual site visits with grantees. Deidentified, non-partner-specific data will also be shared with all grantees at the contract period's end.
Can we include unofficial CHWs in our FTEs?
Elevate Health understands that organizations may have staff performing CHW duties to cover community needs. If your staff member is of the Pierce County community and is regularly performing some or all functions of CHWs in service to the Pierce County community, they should be included in your FTEs. CHW certification is not required.
My organization is experiencing barriers to completing the written application. Are there other application options available?
A Elevate Health is happy to offer virtual interviews, where organizations can discuss and dictate responses to application questions while an Elevate employee transcribes those responses. As a reminder, there is no conflict of interest as Elevate will not be scoring the applications. If you need a virtual interview, please email us at RFP@elevatehealth.org.
Can my organization send a video application?
Yes. Please send an email to RFP@elevatehealth.org that states your organization’s need to submit a video application. Elevate will reply with an invitation to Box, a secure cloud-based content management platform, along with instructions on how to submit your video application.
How are point allocations determined for grant applicants?
Elevate Health will not be scoring grant applications; this task will be completed by third-party community members. Points will be allocated within several criteria. When all criteria have been scored, the scores will be averaged to create a final overall impact score. For example, one criterion is organization size: larger organizations will receive 1 point while smaller organizations will receive a higher number of points.