Employing Navigators to Increase Linkage to Care for People Who Use Drugs Funding Application

Summary

The Wisconsin Department of Health Services (DHS) is soliciting applications from organizations to provide navigator services to people who use drugs (PWUDs) and may be at risk of an overdose. Navigators will work to meet PWUDs where they are and connect them with community resources, harm reduction services, and facilitate connection to treatment/recovery services. Eligible organizations include syringe service providers, community-based organizations, non-profit organizations, municipal, county, or Tribal agencies, including, but not limited to health and human services (HHS), and social services, and health systems/clinics. Applications in response to this request for applications (RFA) must be submitted online using this application survey. Applicants must conduct their work in the state of Wisconsin and must be comfortable with navigators participating in harm reduction work.

The deadline to apply for this funding opportunity is 11:59 p.m. on July 1, 2024.

Do not include personally identifiable information (PII) or protected health information (PHI) in your responses.

Questions about RFA

These are questions that have been sent in by potential applicants. Answers to these questions have been posted here in order to provide all potential applicants with the same information.

Questions related to this RFA must be submitted in writing to Lataysha James at Lataysha.James@dhs.wisconsin.gov and may be submitted through June 26, 2024.

The funding announcement and a courtesy copy of the application can be found after the questions section on this page. Questions and answers will be posted to this page on a weekly basis.

Question: I have a goal to open five high quality sober recovery homes in the next 18 months. The first home will open September 2024. Would DHS have a need for recovery living homes? And if so, would this qualify for the below DHS funding program? Or are there other DHS funding programs that may be a better fit?
Answer: In response to your question about whether a recovery/sober living house is eligible to apply: Eligible applicants are syringe service providers, community-based organizations, non-profit organizations, and/or municipal, county, or Tribal agencies (including, but not limited to, health and human services, and social services).
We cannot comment on other funding opportunities through DHS at this time. We encourage you to continue to review the grant opportunities page of the DHS website, which is the most up-to-date resource for available funding being offered through DHS.

Question: Why are for-profits excluded from applying? Does the funding source exclude them from applying?
Answer: This was a programmatic decision based on the identified intentions for the funding.

Question: I submitted an application but did not add letters of support. Is that something that I can obtain and email to you?
Answer: Yes, you may send letters of support to Lataysha James at Lataysha.James@dhs.wisconsin.gov. All letters must be received by the due date for this funding opportunity, 11:59 p.m. on July 1, 2024. Letters or other application materials that are not received by this deadline will not be included in the application.

Question: Will the agency receive direct referrals for the program and or where do the referrals come from as this is a reporting outcome? Do the referrals come from Harm Reduction Technical Assistance Center?
Answer: Navigators will be tasked with establishing referral networks in the community including housing, transportation, and medical care partners and building referral pathways and warm handoffs between key systems and acute care settings.

Question: Will the agency be responsible for buying and providing the overdose prevention and reversal tools (Narcan?) and drug testing strips or would this come out of the budget for the program as this is a reporting outcome?
Answer: Navigators will be responsible for ensuring PWUD have access to overdose prevention and reversal tools, treatment options, and drug checking supplies, which can be through referrals or resource guides. CDC (Centers for Disease Control and Prevention) restricts the purchase of naloxone/Narcan® with these funds, however the purchase of other supplies such as testing strips is allowable. Navigator programs are encouraged to tap into the multiple other resources available in the state for access to free naloxone for distribution.

Question: Are there DHS-funded navigators currently providing these services?
Answer: There may be navigators providing these services in different departments within DHS.

Question: Data collection: DHS will work with awarded agencies to collect, and report required metrics. Will this be given to the agency?
Answer: The selected applicant must follow all reporting requirements as defined by DHS. Quarterly reporting requirements will include a summary of expenditures, number of harm reduction supplies distributed, types of referrals provided, and an account of program accomplishments or other relevant metrics resulting from awarded funds. Agencies will be provided templates and guidelines for how to report required metrics.

Question: Agency is to provide trauma-responsive case management. Does this refer to the coordination of resources and referrals and what would the documentation look like for this?
Answer: Navigators will be responsible for connecting people who use drugs with community resources, harm reduction services, and facilitating connection to treatment/recovery services. Navigators will be required to document all encounters, referrals, outcomes, and other program indicators through systems created in collaboration with DHS staff.

Question: Can you confirm that no for-profit businesses are able to apply for this? Even if they're providing the service for free to the community?
Answer: For profit entities are not eligible to apply for this funding opportunity.

Question: Can one organization submit more than one, separate and distinct, application?
Answer: Applications in response to this RFA must be for separate and distinct programs.

Question: Can specialized software used for client tracking be purchased with this grant opportunity?
Answer: The CDC harm reduction guide states that educational activities, including mass media, print media and digital technologies to improve knowledge, attitudes, beliefs and behaviors of harm reduction strategies, including harm reduction messaging, overdose prevention, linkage to care, safer injection methods, awareness of fentanyl in the drug supply, stigma reduction, SSPs and linkage to care at SSPs , administration of naloxone are allowable costs.

Question: Are there any other specific EXCLUSIONS (such as Narcan) from this grant opportunity (example: syringe kits, first aid kits, other harm reduction supplies)?
Answer: At this time, guidance has been provided that the purchase of naloxone products is excluded as is the purchase of syringes not used for the administration of naloxone.

Question: Are there any specific staff requirements (i.e. full-time coordinator)?
Answer: No. Staffing will be determined by the selected applicant in collaboration with DHS staff.

Question: Can these funds be used to purchase an application that can be designed and then used to help PWUD navigate treatment services things like support groups, treatment location, instructions on how to use Narcan, etc.?
Answer: The CDC harm reduction guide states that educational activities, including mass media, print media and digital technologies to improve knowledge, attitudes, beliefs and behaviors of harm reduction strategies, including harm reduction messaging, overdose prevention, linkage to care, safer injection methods, awareness of fentanyl in the drug supply, stigma reduction, SSPs and linkage to care at SSPs, administration of naloxone are an allowable cost at this time.

Question: Can these funds be used to provide cab vouchers to aid PWUD get to the services they need?
Answer: The CDC harm reduction guide states that, "Vehicle lease, purchase, or other transportation (Uber/Lyft/other car services, taxi, etc.) for linkage to care and/or post-overdose outreach harm reduction activities" are an allowable cost at this time.

Question: Can funds be used to purchase gift cards, or provide “stipend” for people who are in recovery assisting us with programing to help PWUD?
Answer: The CDC harm reduction guide states that, "Low cost incentives for disproportionately affected populations to recruit for overdose prevention services (food, snacks, water, etc.)" are an allowable cost at this time.

Question: Can funds be used to put on “events” or “classes” where people who use drugs can participate in? We did focus groups with people in recovery and a big take away people were wanting basic life classes- like creating a budget, education in planning and hobbies classes, so PWUD can learn hobbies to aid in recovery.
Answer: The CDC harm reduction guide states that "Direct outreach methods, including trainings and community events, to raise awareness and distribute educational products related to harm reduction and Training and education on SUD and harm reduction" are an allowable cost at this time.

Question: Our organization has multiple locations. The way I understand the grant as it is currently written is that the grant funding would support one navigator in each location. I assume writing the grant in that manner in lieu of writing two identical grants (one for each site) is appropriate but just to be safe I wanted to verify?
Answer: Applications in response to this RFA must be for separate and distinct programs. Each award has a maximum of approximately $104,000. It is up to the applying agency to decide how many navigators can be supplied with the awarded amount.

Background

The overdose epidemic impacts the lives of every person in Wisconsin in one way or another. The number of overdose deaths in Wisconsin more than doubled between 2014 and 2022 and the number of overdose deaths involving any type of opioid have increased by approximately 127 percent. In order to combat opioid-related harm and deaths, DHS has partnered with various organizations; however, the number of opioid-related overdose fatalities continues to increase each year with 1,459 deaths in 2022. Considering the gravity of the situation, it is imperative that focus be placed on harm reduction services that keep people alive and as healthy as possible during a risky time. One of the main ways this objective can be met is through the use of navigators to connect people to wraparound services, increase access to harm reduction services, facilitate access to treatment, and improve access to recovery support services.

Funding opportunity

This funding opportunity is seeking applications from organizations to establish and/or expand the use of navigators within their organizations to connect PWUD and those who are at risk of overdose to services. A navigator is defined as any person who works directly with individuals with use substances to ensure they have the tools and resources to seek care. Importantly, they aide PWUD in accessing harm reduction services and social supports, as well as assisting with accessing treatment and supporting retention in substance use disorder (SUD) care.

For the purposes of this program, navigators are required to link individuals to either evidence-based treatment for SUDs, including medication for opioid use disorder (MOUD), cognitive behavioral therapy (CBT), or contingency management, or harm reduction services, such as syringe services, wound care, drug checking supplies, or other activities that help lessen the harms associated with drug use and related behaviors. A navigator can include certified peer recovery specialists, peer support specialists, case managers, patient navigators, community health workers, persons with lived experience (PWLE), and other individuals who link PWUD to care and harm reduction resources.

This opportunity is funded through the CDC (Centers for Disease Control and Prevention) Overdose Data to Action for States (OD2A-S) program.

Intended program outcomes

Short-term outcomes

• Increased use of navigators to link PWUD to care and services
• Increased access to harm reduction education and services, including increased distribution of naloxone
• Increased availability of, and decreased barriers to, care/services especially for those disproportionately affected by overdose and those previously underserved by overdose prevention programs and the healthcare system
• Increased awareness of the drug overdose epidemic, harm reduction efforts, and evidence-based approaches

Intermediate outcomes

• Increased linkages to care and engagement in care across various settings
• Increased equitable delivery and improved access to care and services
• Reduced health disparities related to access to, and receipt of, care
• Expanded utilization of evidence-based approaches to prevent and respond to overdoses

Long-term outcomes

• Increased uptake of evidence-based treatment and retention with long-term recovery supports, with a primary focus on opioid and stimulant use disorders
• Improved health equity
• Decreased fatal and nonfatal overdoses

Program requirements

• Use navigators to connect people to services, access harm reduction services, and link people to care (evidence-based treatment for substance use disorders, such as MOUD, CBT, contingency management).
• Ensure PWUD have access to overdose prevention and reversal tools, treatment options, and drug checking supplies.
• Establish referral networks in the community including housing, transportation, and medical care partners.
• Develop, implement, and/or utilize a client data collection system.
• Participate in collaborative meetings with other DHS-funded navigators in order to build relationships, troubleshoot challenges, brainstorm pivots, and celebrate successes.
• Build referral pathways and warm handoffs between key systems and acute care settings.
• Provide trauma-responsive case management.
• Support people who use drugs to address barriers and connect them to resources.
• Collaborate with awarded applicant from the Harm Reduction Technical Assistance Center Funding Application (anticipated award announcement in July 2024).

Reporting requirements

A combination of quantitative and qualitative data will be required annually for federal evaluation purposes including: number of navigators overall and by work setting (health/clinical setting, harm reduction, public safety, any other settings), number of referrals to services (i.e. MOUD, behavioral health treatment (without MOUD), harm reduction services), number of the harm reduction service encounters and location of encounters, and number of naloxone doses distributed within zip codes. In addition, grantees will need to report on their health equity efforts, work to expand the reach of harm reduction services, overall program accomplishments; and other relevant metrics resulting from awarded funds. DHS will work with awarded agencies to collect and report required metrics.

Expectations

In addition to program and reporting requirements, organizations receiving this award will be expected to work with DHS to:

• Create a specific statement of work with deliverables.
• Engage in regular coordination and communication with DHS partners to facilitate collaboration, assess resources, and eliminate repetition amongst navigators across the state.
• Document all encounters, referrals, outcomes, and other program indicators.
• Identify and provide reporting metrics for project evaluation.
• Modify program implementation as necessary.

Eligibility

Eligible applicants are syringe service providers, community-based organizations, non-profit organizations, and/or municipal, county, or Tribal agencies (including, but not limited to health and human services, and social services). Eligible organizations will practice inclusion and may not discriminate on the basis of race, ethnicity, religion, sex, sexual orientation, gender identity and/or expression, age, disability, or national origin in their staffing policies, use of volunteers, or provision of services.

Funding terms and conditions

• This application is for an initial award period from September 1, 2024–August 31, 2025. Contracts will be awarded annually with the possibility of three contract renewals based on the availability of funds, and the ability of the grantee to meet all contractual objectives.
• Applicants should plan and budget for one year of funding.
• Carryover of funds into a second year may be possible based on the availability of funds and vendor performance.
• DHS reserves the right to increase or decrease award levels and scope of individual contracts during the contract period, and/or reconfigure the program model at any time during the funding cycle based on the conditions noted above or a lack of adequate performance on the part of the grantee.
• DHS will negotiate the terms of the award, including the award amount, with the selected applicant(s) prior to entering into a contract.
• If contract negotiations cannot be concluded successfully with a recommended applicant, DHS may terminate contract negotiations with that applicant.
• The contracts resulting from this request for applications will be between DHS and the awarded applicant(s).
• Grantees using subcontractors will be responsible for ensuring subcontractors abide by all terms and conditions of the grant.
• There is no match requirement for this grant.
• The selected applicant must follow all reporting requirements as defined by DHS. Quarterly reporting requirements will include a summary of expenditures, number of harm reduction supplies distributed, types of referrals provided, and an account of program accomplishments or other relevant metrics resulting from awarded funds.

Funding Amount: up to $104,000 annually

Number of Awards: 4-6

Expected 12-month grant cycles

• Year 1 (FY25): September 1, 2024–August 31, 2025 (initial award)
• Year 2 (FY26): September 1, 2025–August 31, 2026 (contract renewal)
• Year 3 (FY27): September 1, 2026–August 31, 2027 (contract renewal)
• Year 4 (FY28): September 1, 2027–August 31, 2028 (contract renewal)

Funding application

Section 1: Applicant Contact Information

All applications must be submitted using this online submission format. A courtesy copy of the application is available on the DHS website along with the funding announcement and a glossary of terms and common acronyms used in this announcement. It is recommended that applicants use a word processing program to complete the sections of the application to ensure word limits are observed for each question and pasted into the online submission format.

This application consists of five sections:

1. Applicant Contact Information (not scored),
2. Organizational Capacity (30 points),
3. Program Narrative (40 points)
4. Equity and Engagement (20 points), and
5. Budget (10 points).

In addition, letters of support from project partners are encouraged, but not required. Letters of support can be uploaded at the end of the application. All applications will be reviewed and scored by an evaluation committee. Applicants may not contact members of the evaluation team.

Below is information requested in the application. * Denotes information that is required.

• Organization name*
• Organization address*
• Name of person we can contact regarding this application*
• Email address of person we can contact regarding this application*
• Confirm email address of person we can contact regarding this application*
• Phone number of person we can contact regarding this application*
• Provide the service area (i.e. county, municipality, tribe) where the applying agency intends to provide navigator services.*

Section 2: Organizational Capacity (30 points)

1) Has your agency ever employed navigators (or those who operate in a similar capacity under a different job title)?*
( ) Yes
( ) No

If yes, describe the duties and responsibilities of prior navigators and their impact. (300 words)*
If no, describe your agency’s capacity to employ navigators to link people who use drugs to care and harm reduction services. (300 words)*

2) Describe any harm reduction services your organization currently provides and your experience providing services to people who use drugs. Include in your response how this proposal fits within your organization’s current programming and overall vision. (500 words)*

3) Describe the system you have in place (or will create) to document client or participant interactions (type and amount of services received, referrals, etc.), particularly as it relates to meeting the reporting requirements listed in this RFA. This may include documentation through databases, case management systems, staff notes, etc. (300 words)*

Section 3: Program Narrative (40 points)

4) Provide a high-level overview of your overall project goals, the environment in which you wish to employ navigators (health/clinical setting, harm reduction, public safety, etc.), the anticipated number of individuals to be served through this project, and the intended project impacts. Include in your response the number of navigators you plan to employ to meet your proposed goals. (500 words)*

5) Describe how your project will use navigators to provide linkages to care, including evidence-based substance use disorder treatment, community resources, health services, harm reduction tools, and care for PWUD. (400 words)*

6) Specify which organizations and/or community partners you intend to collaborate with for this project (including name, geographical area, and any past collaboration experiences with the organization). (300 words)*

Section 4: Equity and Engagement (20 points)

7) Specify which population(s) below are intended populations of focus for your program during the course of this award (select all that apply). If your agency has previous experience working with this population, briefly describe your experiences engaging with the population. If you have not previously focused on this population, mark N/A in the text box.*

Section 5: Provisional Budget and Budget Justification (10 points)

We anticipate awarding up to $104,000 annually for this work. Please fill out the basic budget form for each anticipated line item below, indicating the total amount requested. DPH will negotiate the final budget upon award with the awarded agency.

Make sure this amount includes funding needed for the work itself, subcontracts with partner agencies, as well as associated administrative costs, including accounting services, and agency operating costs. For each line item include a brief justification for the amounts you entered. This should include how you arrived at the total dollar amount requested for the expense. Example: Personnel: $10,000; Personnel Justification: Personnel is calculated based on a 0.20 FTE Program Coordinator at $24.04/hour = $10,000.
Provisional Budget*
________Personnel
________Fringe
________Operations
________Supplies
________Travel
________Contractual Services
________Other
________Indirect

Personnel Justification: Describe your personnel expenses for this project. If none, mark N/A.*

Fringe Justification: Describe your fringe expenses. If none, mark N/A.*

Operations Justification: Describe your operational costs (internet, phone, administrative expenses, etc.) for this project If none, mark N/A.*

Supplies Justification: Describe your supply costs for this project. If none, mark N/A.*

Contractual Services Justification: Describe any contractual partners you will fund (training provider, school district, etc.) for this project If none, mark N/A.*

Other Justification: Describe any other costs associated with this project. If none, mark N/A.*

Indirect Cost Justification: Describe your indirect cost rate (if applicable) for this project. If none, mark N/A.*

Section 5: Letters of Support

Letters of support from project partners are encouraged, but not required. We encourage all applicants to combine letters of support into one pdf for upload. You may upload up to five files.

If you experience any difficulties uploading letters of support, contact Lataysha James at Lataysha.James@wisconsin.gov.