Notice of Funds Available (RFP)

Texas Council for Developmental Disabilities
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2019-2 :  Complex Mental Health Needs and People with IDD

Specifications

Posted Applications Due Start Date End Date Amount MatchPoverty Match Council Staff
Dec 06, 2019 Apr 01, 2020 Mar 31, 2025 $0.00 $0.00$0.00 Linda Logan

Application Steps

To submit a proposal for this RFP, review all of the information pertaining to the RFP below. Once you are ready to apply, complete the application in DD Suite (here) and attach a completed Supplemental Forms Packet to your DD Suite application. The packet can be found as an attachment at the bottom of this RFP.

Introduction

TCDD has approved funding for the Complex Mental Health Needs and People with IDD. TCDD may award projects within a range of funding. Project budgets may be as low as $25,000 or as high as $300,000 per year, per project, for up to five years. Match must be calculated based on the requested amount. The budget must include justification for all proposed expenses.

Each organization submitting a proposal will propose the funding amount needed to achieve the expected outcomes. TCDD will ensure the proposed funding is reasonable and appropriate for the staffing, consulting, travel, materials development, evaluation, and other activities or resources needed to meet the expected outcomes and achieve sustainability. TCDD will negotiate the budget as needed and may choose not to award funding for these projects.

Project durations will be proposed by the applicant, but projects will not be funded for more than five years. Proposals can be for a minimum of one year and a maximum of five years.TCDD does not automatically continue funding each year and may terminate funds prior to the end date in this RFP.

The Council may also choose to not fund any project.

If you have questions after reading this RFP, contact Fernando Rodriguez, TCDD Operations Assistant, at Grants2@tcdd.texas.gov or at 512-437-5432.


Who May Apply

Any organization that meets the requirements set forth in this RFP can apply. Types of organizations could include:

  • government agencies,
  • nonprofits,
  • colleges and universities,
  • faith-based institutions,
  • technical and/or professional schools, and
  • for profit businesses.
The organization that applies for this grant must administer the grant and receive, disburse and account for grant funds.

Individuals may not apply for this grant.


Background

The purpose of the Complex Mental Health Needs and People with IDD RFP is to create and support promising practices that enable people dually diagnosed with intellectual and developmental disabilities (IDD) and mental illness (MI) to be fully included in their communities and to have control over their own lives.

Many people with IDD also have one or more mental illnesses. Although a prevalence rate of 30-35% is widely used as a point of reference, reliable studies have recently cited figures as high as 55%, or more than half of all people with IDD (Diagnostic Manual – Intellectual Disability: A Clinical Guide for the Diagnosis of Mental Disorder in Persons with Intellectual Disability, DM-ID 2, 2016).

People with IDD experience the same psychiatric disorders as people without IDD, such as major depression, bipolar disorders, anxiety disorders, impulse control disorders, and schizophrenia. Moreover, people with IDD experience trauma significantly more often than people without IDD. Because of behavioral differences in how symptoms can be expressed, making an accurate diagnosis and identifying the most effective forms of treatment can be challenging.

For example, when a person’s expressive and receptive communication skills are limited, diagnoses are often based only on observable behavior and reports from other people. These and other diagnostic and treatment challenges mean that focused efforts are needed to make systemic changes to provide education and training, to improve quality of care and access to care, and to conduct the research necessary to enhance policies and practices. Such changes can ensure that behavioral health services are IDD-informed and all gaps in the provision of IDD services are identified and comprehensively addressed in all affected programs and agencies. Without targeted and sustainable system changes, psychiatric disorders and trauma experienced by individuals with IDD will continue to go unrecognized and untreated until a crisis arises.

TCDD has recognized that sustainable systems improvements in multiple areas are needed to provide the appropriate, timely, and effective responses to needs of individuals who are dually diagnosed with IDD and MI (IDD-MI).

State Plan reference: Goal 1, Objectives 1.1, 2.1, and 2.3 (TCDD 2017-2021 State Plan).

Project Description and Milestones

TCDD recognizes there are multiple gaps in the current system of support for individuals with complex mental health needs and IDD. This includes:

  • education and training (individuals and families, healthcare providers, and educators);
  • improving health services (quality of care and access to mental health services); and
  • investigating other mental health needs to improve state practices (policy improvement and closing service gaps).

TCDD is mandated by the Developmental Disabilities Assistance and Bill of Rights Act to engage in activities to better understand system barriers and to test new models to improve the way individuals with IDD and their families are supported in Texas. Therefore, TCDD seeks projects under this RFP that propose new initiatives and test new models to address complex mental health needs in the areas mentioned above.

All proposals must:

  • address at least one of the gaps listed above,
  • clearly describe the purpose and scope of the project,
  • outline the specific activities to be conducted,
  • detail the outcomes that will be achieved,
  • specify the duration of the project in years, and
  • include a budget that directly links to the scope and activities proposed.

Education and Training

Education and Training for Individuals and Families

An education and training project for individuals and families would focus on increasing knowledge about possible signs and symptoms of mental illness and how to access appropriate assessment and treatment from available community-based resources, with an emphasis on identifying providers with expertise in treating people with IDD-MI.

Applicants must clearly describe how the education and training will improve the following outcomes for participants (individuals and families):

  • Understanding of psychiatric disorders and symptoms that could require evaluation
  • Understanding of trauma and its effects
  • Ability to identify and evaluate providers of clinical and support services for people with IDD-MI
  • Ability to identify and obtain assistance from local resources both for routine care and in a crisis
  • Confidence in communicating with providers around issues related to services and supports

The list above is not exhaustive and applicants may propose additional outcomes.

Education and Training for Healthcare Providers

An education and training project for healthcare providers would support emerging and existing professionals who work in the field of intellectual and developmental disabilities or mental health to develop advanced knowledge and skills to support people with IDD-MI.

Fortunately, many training opportunities and resources are already available to support providers in diagnosing and treating mental health issues in people with IDD before a crisis occurs. However, availability of training opportunities may be limited and the ability to reach all providers in Texas is challenging. For example, continuing education and training gaps often occur in rural regions of the state and among specific groups of providers (e.g., primary care physicians, nurses, physician assistants, social workers).

Projects should include the development of new training content or focus on expanding the dissemination of existing training modules, such as the American Medical Association-endorsed ECHO model and others listed in Appendix A. Projects should test models that (A) connect providers across mental health and IDD disciplines for purposes of cross-training, or that (B) connect providers with individuals with IDD-MI and their families to increase understanding of their experiences.

Applicants must clearly describe how the professionals trained through the project will become part of a pool of knowledgeable leaders who:

  • improve their skills, knowledge, and leadership abilities to impact meaningful changes in their organization and/or across the state;
  • increase their commitment to self-direction and full participation of individuals dually diagnosed with IDD and MI;
  • improve communication with other key decision-makers at the state and local levels;
  • share knowledge of IDD and MI dual diagnosis services and supports with other staff and future leaders; and
  • improve their ability to support individuals with IDD-MI and their family members.

The list above is not exhaustive and applicants may propose additional outcomes.

Education and Training for Educators

An education and training project for educators would advance the knowledge and skills needed to improve the way Texas supports students with IDD-MI. Projects would include instructors in elementary through high school special and general education programs in order to increase identification and referral of students with IDD-MI. Projects will analyze, improve upon, and integrate existing state requirements for educator training on topics that affect students with IDD-MI.

Applicants will clearly describe how the educators trained through the project will became part of a pool of knowledgeable leaders who:

  • improve their skills, knowledge, and leadership abilities to impact meaningful changes in their school or school district and/or across the state;
  • increase their commitment to self-direction and full participation of students with IDD-MI;
  • deliver IDD-informed educational services and supports;
  • share knowledge of IDD-MI dual diagnostic services and supports with other staff and future leaders; and
  • improve their ability to support students with IDD-MI and their family members.

The list above is not exhaustive and applicants may propose additional outcomes.


Improving Health Services

Models to Improve Quality of Care in Services to People with IDD-MI

Quality in mental health care means providing the care the patient needs when the patient needs it, in an affordable, safe, and effective manner. Quality healthcare means engaging and involving the patient, so the patient takes ownership in preventive care and in the treatment of diagnosed conditions. Projects related to improving quality of care will include:

  • integrating adult developmental medicine into mental health assessment teams to enhance mental wellness,
  • early treatment and intervention, and/or
  • crisis prevention.

Models could be developed to connect providers across disciplines for improved coordination, consensus development on interdisciplinary issues, care plans, or treatment options.

Applicants should define clear outcomes and measures of quality of care, and design a data collection plan to demonstrate improvements before and after the project.

Models to Expand Access to Mental Health Services for People with IDD

Access to mental health services means "the timely use of personal health services to achieve the best health outcomes" and requires three distinct steps:

  1. Gaining entry into the health care system (usually through payment or insurance coverage)
  2. Accessing a location where needed health care services are provided (geographic availability)
  3. Finding a knowledgeable provider whom the patient trusts and can communicate with (personal relationship)

In the most recent National Core Indicators survey, more than 50% of respondents with IDD reported a gap in access to enough services and staff to stay healthy and participate in the community. Specifically, respondents identified gaps in access to:

  • services for complex medical needs,
  • services for complex behavioral needs, and
  • staff for effective service delivery.

In 2015, the 84th Texas Legislature made investments in local intellectual and developmental disability authorities (LIDDAs) to develop and implement behavioral health intervention supports, including crisis services, mobile crisis units, and respite. These services continue in local communities, yet individuals with IDD continue to report that more is needed.

Applicants should define clear outcomes and measures of access to care (defined above). Applicants should also design a data collection plan. The plan will illustrate how more individuals with IDD will receive community-based mental health services and supports from providers with expertise in this field. Data will be collected before and after the project.


Investigating Other Mental Health Needs to Improve State Practices

Despite existing education and training, expansion of some services through Texas LIDDAs, and the inclusion of people with IDD in the state behavioral health plan (Texas Health and Human Services Commission (HHSC) Statewide Behavioral Health Strategic Plan FY17 – FY21, see Appendix B), individuals and families continue to experience barriers to accessing needed supports and services by providers who have expertise in caring for people with IDD-MI. In order to fully address complex mental health needs among individuals with IDD, state leaders may benefit from additional information on remaining gaps that exist in the state system.

A project may include, but is not limited to, the following:

  • Review & Analysis: A project could conduct a review of national and state data, existing literature, and outcomes data of existing evidence-informed programs for people with IDD. The goal would be to better describe the mental health treatment problems that exist, to identify other best practice prevention strategies, and to specify care plan and treatment components that meet the needs of individuals with IDD.
  • Data Collection: A project could develop a data collection protocol to identify and track across multiple service and funding silos the specific needs of Texans with IDD who have mental health challenges.
  • Statewide Conversation: A project could facilitate a statewide conversation among mental health experts and family members to (A) better understand the experience of an individual who navigates the Texas mental health and IDD systems, and (B) to identify priorities for systems change.
  • Recommendations: A project could develop a compilation of recommendations for action Texas can take to more effectively address complex mental health needs among individuals with IDD.

Outputs and Outcomes

All project proposals must define and describe the specific outputs, outcomes, and evaluation plan. Components of the data collection and evaluation plan may include, but are not limited to, the items listed below.

  1. Ongoing collection of data (by cohort as applicable) for all activities, with numbers of persons participating, demographic breakdown, role or position, and other descriptors pertinent to the goals of your project. Examples of activities for which data collection is required include, but are not limited to, the following:
    • pre- and post-testing of general knowledge about dual diagnoses, local services and supports, and facts relevant to effectively conducting your project;
    • pre- and post-testing of participants on key principals of the curriculum or protocol, if any;
    • focus groups held, including numbers of persons in each focus group; and
    • interviews conducted, including purpose and results.
  2. Written analysis of results of data collection and recommendations for further data collection.
  3. Lessons learned during your project and alterations made to the project design in response.
  4. Voluntary personal stories relevant to the project from at least 10% of participants.
  5. Recommendations to TCDD for improving requirements and expectations for similar projects in the future as well as for projects that build on the outcomes of your work.

Important Dates

Informational Webinar: November 4, 2019

TCDD will hold an informational webinar to provide more information about TCDD's processes for proposal review and grant award. You are not required to attend in order to apply.

The informational webinar will be held November 4, 2019 at 1:00 PM. To register for the webinar, contact Linda Logan at grants2@tcdd.texas.gov.

Deadline to Submit Questions: November 8, 2019

Submit all questions about the RFP or application to Linda Logan at grants2@tcdd.texas.gov by 5:00 p.m. Central Time on November 8, 2019.

TCDD will not answer questions about the RFP or application after that date and time. TCDD will post questions and answers on DD Suite as an attachment to this RFP by 5:00 p.m. Central Time on November 15, 2019.

Deadline to Submit a Proposal: December 6, 2019

Proposals must be received by 5 p.m. Central Time on December 6, 2019 to be considered by the Council in February 2020. TCDD does not consider late applications under any circumstances, including user error.

If you have questions about DD Suite and cannot find answers in the DD Suite Guide attached to this RFP, email Fernando Rodriguez, Operations Assistant at grants2@tcdd.texas.gov or call 512-437-5432. This should be done as early in the process as possible.

Award Notification: February 2020

TCDD intends to notify applicants about funding decisions after the February Council Meeting (review dates subject to change).

Match

Grantees must provide a matching contribution each year. This may include:

  • funding from non-federal sources,
  • volunteer hours, or
  • other "in- kind" donations, such as office space and utilities.

Other federal funds may not be used as match. Items or funds that are used for match for another federally-funded project may not be used as match. TCDD prefers that the amount of match increase each year of the project.

Match Amount:

The General Information section of this RFP provides the amount of match expected for non-poverty counties and for poverty counties if you request the full amount. Requesting less than the full amount will reduce the amount of match you must provide. A Match Calculator is attached to this RFP to help you calculate match.

Poverty counties are counties in which at least 20% of the people in the county live in poverty. Attached to this RFP is a document that lists poverty counties.

  • Non-poverty counties: Project activities located in counties not designated as federal poverty areas require matching resources equal to at least 25% of total project costs.
  • Poverty counties: Project activities located in counties designated as federal poverty counties require matching resources equal to at least 10% of the total project costs.

Continuation Funding

Organizations that are awarded funding must apply for continuation funding each year. Continuation funding will not exceed the maximum per-year funding amount stated in the RFP. Continuation funding is based on the availability of TCDD funds and a review of:

  • the project's accomplishments,
  • progress toward stated goals and objectives,
  • management of funds,
  • compliance with reporting requirements,
  • the most recent program audit,
  • findings of TCDD's onsite reviews, if conducted, and
  • development of methods through which sustainability will be achieved.

Continuation funding is not automatic and TCDD may choose not to award continuation grants. Continuation proposals are generally due approximately three months before the end of the grant year.


Expectations of All Grantees

Reporting: You must submit progress reports quarterly. You must submit financial documents, including reimbursement requests, at least quarterly. You must also provide required evaluation and survey data, information about systems change measures, contact information for project participants, annual continuation proposals, personal stories related to impact of project activities, and a final report. Failure to meet reporting and spending requirements may impact continuation or future grant awards.

Continuation proposals: You may be asked to provide information about public policy implications and sustainability in your application for continuation funding.

Advisory committee: You may be asked to develop a project advisory committee (PAC).

TCDD support: TCDD will serve as a resource to support grantees to be successful. You may be asked to participate in grants management training during the project period. You may also receive calls from TCDD staff about outcome and performance measures, public policy issues that relate to your project, products produced, and project events (if applicable). All grantees are required to attend a new grant kick-off at TCDD’s office in Austin, Texas. If your project is funded for additional years, you may be asked to present about your project’s progress at a quarterly Council meeting (typically held in Austin). Kick-off meetings and Council meetings should be factored into your annual budget. TCDD may share opportunities for you to present at state and/or national conferences.

Project communications: Grantees will work with TCDD to develop and execute a communications plan for their project. Plans could include promoting grantee activities via external communications, raising awareness about products created as part of the project (if any), and developing required stories about the project’s impact at both the community and personal level. All communications products must be approved by TCDD.

Grants Manual: All Grantees are expected to adhere to the TCDD Grants Manual which is a 44-page document that provides information related to program policies and procedures, financial regulations, financial guidelines, and more. The manual is available online at https://tcdd.texas.gov/grantee/?page_id=1037.

Terms and Conditions

Applicants must agree to the following terms and conditions:

  • Applicants must disclose any conflicts of interest between themselves and TCDD Council members, employees, or their immediate families.
  • Applicants must use People First Language or Identity-First Language (where appropriate) in all materials.
  • All printed materials must be available in Spanish and in an appropriate accessible format — including digital, tagged PDF, or large print. Funding for this should be included in the budget.
  • Videos, DVDs and teleconferencing and distance learning activities produced by this project must be fully accessible. Any videos or DVDs must be captioned.
  • TCDD will retain the rights to all products and other assets created using funding awarded through this RFP. The grantee will retain rights to materials that were created prior to receiving the grant and the rights to materials created without using funds that are associated with this project.
  • Proposals received by TCDD are subject to release consistent with provisions of the Texas Public Information Act.
  • Applicants may not use TCDD funds to supplant non-Federal funds that would otherwise be made available for the purposes for which the funds are provided.
  • Applicants may not use TCDD funds to provide, duplicate, or replace services for individuals with developmental disabilities and their families who are eligible for Federal assistance under other State programs.
  • Funds awarded under this RFP may not be used for direct services and supports.
  • Funds awarded under this RFP may not be used for food, beverages, or promotional items.
  • TCDD reserves the right not to fund any proposal under this announcement. All funding decisions will be based on the availability of funds and funding amounts for projects could increase or decrease.

See "Assurances" in the attached Supplemental Forms Packet for other terms and conditions relating to this RFP. The Assurances form must be signed and submitted as part of your application packet.


How to Apply

To have your application considered, complete the steps listed below by the due date. Applications and all associated documents must be submitted via DD Suite. Documents received by fax, email, hand delivery, or mail will not be accepted. Applications that do not include the items listed below, or that include incomplete items, will not be considered.

Application steps:

  • DD Suite: Complete all required sections of the application in DD Suite, which includes a workplan and project evaluation plan.
  • Supplemental Forms Packet
    • Complete all sections of the Supplemental Forms Packet, which includes financial information (budget), assurances, and other forms. All forms must be signed before being submitted. The packet is attached to this RFP. With the packet, you’ll submit a project profile and financial information, as well as certify you understand and will comply with TCDD Assurances and TCDD Required Approvals. The Budget Justification Information (Part II: Financial Information, Section D) must:
    • be detailed enough to show how calculations were made in the Budget Detail (Sections B and C), and
    • explain any zeros in the Fringe Benefits table of the Budget Detail (Section B).
    • Sign the documents in the Supplemental Forms Packet.
    • Upload the Supplemental Forms Packet and other required documents to DD Suite as attachments to your proposal.
    • Letters of Support: Letters of Support are optional. If you have Letters of Support or letters from other entities or individuals that state they will partner with you on the project, upload them to DD Suite as an attachment to your application. A maximum of up to five letters can be submitted as part of your application.

    Submit Your Application


    The Review Process

    Your proposal will be reviewed based only on the quality and details provided in your:

    • DD Suite application (workplan and narrative),
    • Supplemental Forms Packet, (including budget and justification) and
    • [Optional] Letters of Support and/or letters from organizations committing to partnering with you.

    You will not have the opportunity to provide additional information or to clarify questions about your proposal following submission. Below is the process for RFP review.

    Step 1: TCDD Staff Review

    TCDD staff review proposals upon submission for compliance with the requirements of the RFP and ensure that all sections are complete. Incomplete applications and applications that do not meet the requirements of the RFP will not be considered.

    Step 2: Independent Review Panel

    Proposals that meet the requirements will be reviewed by an Independent Review Panel consisting of three to five people with expertise related to the RFP. The panel’s review focuses on the quality of the proposed plan, the feasibility of completing the plan, and how well the proposed project may move TCDD closer to meeting the TCDD State Plan Goals and Objectives. The panel will only consider the contents of an applicant’s proposal.

    Step 3: Executive Committee Review and Decision

    The TCDD Executive Committee reviews information related to the steps above and makes the final funding decisions. If you have received a grant in the last five years, TCDD staff inform the Executive Committee about your performance on the past project.

    Note: TCDD may give priority to proposals that address the needs of people who are unserved or underserved. This may include, but is not limited to:

    • people living in rural areas,
    • people who experience poverty,
    • people of color, and
    • people with limited English proficiency.

    Supporting Documents