Solicitation ID #: BPM054659

Advancing Cross-Cutting Engagement and Service Strategies for People Who Use Drugs (ACCESS)

Applicant Questions & MDH Responses

Updated: January 8, 2026

Questions from prospective ACCESS applicants submitted through eMMA or during the Pre-Application Conference webinar (January 5, 2026) are listed below along with MDH’s response to each question. Questions and responses are grouped based on the RFA section that the question is most relevant to. This document will be updated with additional questions as they are received by MDH and responses are made available. MDH requests that prospective applicants submit questions no later than 5:00 PM EST on January 15, 2026, to best ensure MDH has sufficient time to provide a response.

Section 1: General Information

1. “Should we request that extension [potential optional 1-year extension] in our initial application or provide supportive documentation in case of that possibility?”

MDH Response: No. The application should cover only the initial 1-year project period. As stated in RFA Section 1.1.4, any optional extensions to awards executed by MDH shall be contingent upon a grantee demonstrating progress toward successfully implementing the project, maintaining compliance with ACCESS Conditions of Award (COA), and submitting an approved non-competing continuation application for the extension period. If MDH intends to issue optional extensions, it will communicate the specific process for non-competing continuation applications to grantees after the initial awards have been issued.

2. “Are there criteria for who can apply for the extension and how is the extension requested?”

MDH Response: As stated in RFA Section 1.1.4, any optional extensions to awards executed by MDH shall be contingent upon a grantee demonstrating progress toward successfully implementing the project, maintaining compliance with ACCESS Conditions of Award (COA), and submitting an approved non-competing continuation application for the extension period. If

MDH intends to issue optional extensions, it will communicate the specific process for non-competing continuation applications to grantees after the initial awards have been issued.

Section 2.1: Applicant Eligibility

1. “While this RFA is applicable to local government agencies, it seems that it would not be applicable to local law enforcement agencies, correct?”

MDH Response: As agencies of local government, local law enforcement agencies that meet the additional applicant eligibility requirements listed in RFA Section 2.1 (including being currently authorized by MDH to operate an Overdose Response Program) are eligible to apply.

To be considered for an ACCESS award, eligible applicants must submit complete applications proposing projects that align with the goals and objectives of the grant program outlined in Sections 3.1 and 3.2 of the RFA. All applications will be evaluated based on the criteria listed in Section 5.2.

2. “IF we are not currently an OADPOP and are not permitted to become one, should we apply anyway or not apply?”

MDH Response: Organizations do not have to be a state-authorized OADPOP in order to be eligible to apply to the ACCESS RFA or receive an ACCESS award. Applicant eligibility criteria are listed in RFA Section 2.1.

Section 2.2: Applicant-Specific Annual Funding Limit

1. Multiple questions were received during the Pre-Application Conference Webinar regarding applicants’ inability to obtain their applicant-specific annual funding limit using Attachment B - ACCESS Budget Narrative Worksheet (MS Excel file), including:

● “When I downloaded the excel file [attachment B], I do not have boxes to check. It is showing FALSE in those areas.”

● “I am having the same issue… it is showing FALSE in answer to the "does your organization have an FY2026 ACCESS award" and no total is provided when our FY26 grant number is entered.”

● “Same Issue- FALSE and no $$ is provided.”

MDH Response: These issues appear to be the result of check boxes embedded in the Summary worksheet of Attachment B not displaying properly, potentially due to compatibility problems with the specific version of Microsoft Excel being used to open and edit the workbook.

To address these issues, applicants should enter “TRUE” in any cell containing a check box that they wish to check. This should produce the same result as checking the box if the check box was displaying properly.

For example, current ACCESS grantees should enter “TRUE” in cell B24 of the Summary worksheet, as displayed in the image below. The applicant’s funding limit should then display in cell B20 as long as a correct BHA award number is also entered in cell A28:

Similarly, applicants that are NOT current ACCESS grantees should enter “TRUE” in any cell in Column B immediately to the right of the name of the Maryland jurisdiction(s) where they are proposing to provide services. This should produce the same result as checking the boxes next to each jurisdiction name if the check boxes were displaying properly. For example, the image below shows how this would work for an applicant proposing to provide services in Allegany County:

2. “Does the calculator for determining applicant-specific funding limit account for the 30% restriction on the amount by which a current grantee’s funding can increase?”

MDH Response: Yes, the calculator incorporates the percentage increase cap above current award amounts for existing ACCESS grantees into the formula used to calculate the applicant-specific annual funding limit. The 30% increase cap applies to current ACCESS grantees that are state-authorized Opioid-Associated Disease Prevention and Outreach Programs (OADPOP).

3. “If you are applying to provide services over multiple counties, does the funding ceiling take that into account?”

MDH Response: Yes, the applicant-specific annual funding limit calculator incorporates jurisdiction-level substance use vulnerability measures into its formula. For applicants proposing to provide services in multiple jurisdictions, the jurisdiction with the highest vulnerability index rating will be used to determine the funding limit.

4. “What's the funding limit like bracket”

MDH Response: Applicants can use Attachment B to calculate their applicant-specific funding limit. RFA Section 2.2 describes the factors considered in determining an applicant's funding limit.

5. “Is the Specific Annual Funding Limit assuming we are replicating the same SOW for which we have been under contract and costs are just increasing by 15%?”

MDH Response: MDH has defined an applicant-specific annual funding limit for each prospective applicant organization based on the formula described in RFA Section 2.2.2. This funding limit applies to an applicant regardless of what specific activities or services they propose to implement in their application.

6. “If a current grantee wants to propose a substantial expansion in geographic area and/or service offerings, is there a way to request a funding limit increase if the amount they would be allowed as a new applicant is higher than the identified applicant specific funding limit?”

MDH Response: No. As stated in RFA Section 2.2.2: “Applications may not include a funding request that exceeds the Applicant-specific annual funding limit, as determined by MDH.

Applicants may request a one-year total funding amount that is less than, or equal to, the Applicant-specific limit. Applications that include a one-year budget that exceeds the Applicant-specific limit may be excluded from further consideration for award under this RFA.”

7. “BHSB also does not have an award number for FY26 since we still don't have an executed agreement. If a full list of FY26 award numbers could be provided that might be helpful and cover everyone in one fell swoop.”

MDH Response: BHSB’s FY26 ACCESS award has been processed by MDH and sent to BHSB for signature. The FY26 award is issued under the same BHA award number as the FY25 award, so the FY25 award number can be used to obtain BHSB’s applicant-specific funding limit in Attachment B.

Award numbers are specific to organizations and should not be shared publicly or among grantees by BHA. Each entity received their FY26 award number with their award packet and should refer to this documentation.

8. “Will organizations who are ORPs and previously received SOR funding for these activities be grandfathered in as "existing ACCESS grantees" for future grant applications?”

MDH Response: No. The funding formula for current ACCESS grantees only applies to organizations that have SFY26 ACCESS awards.

Section 3: Scope of Work

1. “Will there be limitations on what type of training that staff may attend? ie, "harm reduction". 2) Are we allowed to host subject specific training sessions and open it to all peers, cprs, etc?”

MDH Response: The list of Other Allowable Activities in RFA Section 3.2.5 includes the following activities related to training:

● “Provide (or provide connections to) education and training for local organizations to improve their competency in serving people who use drugs.”

● “Provide training, education, and professional development for staff through BHA-approved trainings, symposia, conferences, and other resources.”

Although ACCESS does not specifically prohibit grantees from hosting subject-specific trainings that are open to the public, MDH cannot confirm whether any proposed training initiative that is not explicitly listed in Section 3 will be considered allowable without reviewing the full application proposal to determine alignment with ACCESS grant program goals, priorities, and allowable costs. If MDH selects an application for award, fund source determinations for training activities may be based on whether the specific training is allowable or unallowable under a specific fund source.

2. “Second the questions about trains, and would like to add trainings that have CEU attached for peers and social workers”

MDH Response: Training that provides CEUs is an allowable expense. What is not allowable is the cost of a certification or licensure that is specifically for a staff.

Section 4.2: Applications

1. “Are we essentially submitting two responses in eMMA? The first with the narrative documents and then the second with the budget documents?”

MDH Response: Applicants should make one full submission per organization, as eMMA allows applicants to upload multiple documents as a part of their single submission. All documents uploaded as part of Volume I: Technical Application should be separate from documents uploaded as part of Volume II: Budget Narrative. When uploading each individual document, eMMA allows the applicant to apply a label to the document that is distinct from the document’s file name. Applicants should label each document accordingly to clearly identify whether it is part of Volume I or Volume II.

2. “Technical question: when logged in to the eMMA portal, trying to save the solicitation returns the prompt: "To respond to this Solicitation, please acknowledge receipt." Do you know how we are supposed to acknowledge receipt? It's not really clear. Thanks”

MDH Response: Click the title of the solicitation and click “Add to My Solicitations”. The following should appear:

Select “I acknowledge receipt of this Solicitation”. You will then be prompted to choose “Will Respond” or “Not Respond”.

Section 4.4: Budget Narrative

1. MDH has received multiple questions related to ACCESS award requirements for subdividing budgets into multiple budget periods, including:

● “In attachment B, we are only being asked for one full-year budget, whereas we've had to do a July-Sept budget + Oct-June budget in the past - will there still be a specific number for Q1 that we are required to spend down?”

● “Will the project period be broken down July-Dec and then Jan-June?”

MDH Response: As stated in the RFA, application budgets should be structured for a full 1-year project period corresponding with state fiscal year (SFY) 2027, i.e. a start date of July 1, 2026, and an end date of June 30, 2027. If the applicant is selected for an award, the grantee may be required to submit a revised budget for the SFY2027 project period that subdivides the budget into multiple distinct budget periods. The start and end dates for these budget periods typically correspond to distinct budget periods for any federal funds included in an individual ACCESS award. ACCESS grantees are expected to treat these as distinct and separate budget periods and aim to fully spend down funds within each budget period in accordance with their MDH-approved award budget. Due to federal grant requirements, MDH cannot guarantee that federal funds in an ACCESS grant that remain unspent at the end of one budget period will continue to be available for use by the grantee in a later budget period.

2. “Do we break out supplies in medical supplies/ other supplies as we have in past years?”

MDH Response: Applicants should include all supplies under the “Supplies” budget category in the Budget Narrative regardless of the type of supply. Although ACCESS grantees are required to submit award budgets that distinguish between types of supplies based on the fund source being used for their purchase, this is not required for the Budget Narrative submitted as part of the application.

3. “In the budget workbook, last year staff requested we put client transportation under "Travel", even though it doesn't look like it fits there. Where should we include it this year?”

MDH Response: Applicants should complete their Budget Narrative in accordance with the guidance provided in RFA Section 4.4.5 and should also review Attachment G - ACCESS Allowable and Unallowable Costs for any relevant information. MDH will communicate more specific budgeting requirements to applicants selected for award.

4. MDH received multiple questions related to the 37.81% fringe rate cap referenced in RFA Section 4.4.5, including:

● “The Fringe rate for state employees is much higher than that percentage due to health care coverage. Our fringe percentage ranges from 30.03% to 89.74%”

● “it is rare for a merit employee to have a fringe rate < 37.5% since FICA and Retirement alone are 29% and then when you add Health Insurance and Retiree HI it is significantly over 37.5%”

MDH Response: MDH issued an addendum to the RFA on January 8, 2026, to revise relevant sections of Exhibit A, Attachment B, and Attachment C that include instructions related to fringe calculations. The revised instructions include the following language:

“For Applicants that meet the definition of a “social organization” in RFA Section 2.1.1 (i.e.

private nonprofit organizations), the total fringe cost for a position cannot exceed 37.81% of the position’s total salary cost.

For Applicants that are a local or state government agency, public college, or state university, fringe costs should be calculated in accordance with applicable agency budget guidelines, including annually updated budget guidance issued by the Maryland Department of Budget and Management, as appropriate”

5. MDH has received multiple questions related to indirect cost (IDC) rate that can be charged to ACCESS awards, including:

● “Can you please confirm what the IDC rate is?”

● “Is there an indirect cost limit? In years past it’s been 10% but this RFA only referenced the federal IDC rate agreement. For our organization this will seriously limit the amount of funding that goes directly to our project.”

MDH Response: If a nonprofit organization gets a state-funded grant or contract (whether fully state-funded or a mix of state and other non-federal funds), the nonprofit must be allowed to get reimbursed for its indirect costs. The allowed reimbursement rate depends on the nonprofit’s situation: If the nonprofit already has a federally approved indirect cost rate, or has negotiated one with another non-federal funder using federal cost rules, they can use that same rate. If the nonprofit does not have a negotiated rate, they must be allowed to use whichever is higher: The standard federal default (known as the “de minimis” rate), or 15% of eligible direct costs (based on federal rules for how to calculate them). Important Note: This only applies to nonprofit organizations that are tax-exempt under section 501(c)(3), (4), or (6) of the IRS code.

Section 5 - Evaluation Committee, Evaluation Criteria, and Selection Procedure

1. “Do you factor in other grants (such as Opioid Restitution Funds) that have been provided in each jurisdiction?”

MDH Response: No. Award decisions will be based on applying the evaluation criteria specified in the RFA Section 5.2. The evaluation criteria do not include consideration of other funding going to the jurisdiction where an applicant is proposing to provide services.

RFA Attachments

1. “I do not see attachment F in eMMA (referenced on slide 26 as “Attachment F: ACCESS Grant Program Conditions of Award”)”

MDH Response: Attachment F is included in the RFA Exhibit A PDF, starting on page 20. All attachments other than Attachments B, C, D, and E are included within the Exhibit A PDF.

2. “Is there a link to the excel file for attachment B? I am not finding it or the file in the RFP, just reference to it.”

MDH Response: Yes. Attachment B is available as a separate document in the RFA posting on eMMA. Attachment B may be downloaded from eMMA at this link:

https://emma.maryland.gov/bare.aspx/en/fil/download_public/3cf76295-e7d6-452f-b43f-15a025 5664f5?file_context[containerUrl]=%2frfp%2frfp_info_extranet%2f87262%2f&file_context[rfp]=8 7262 Attachments B, C, D, and E are uploaded as separate documents in eMMA. Any other attachments are included within the RFA PDF (Exhibit A).

3. “Attach B - sheet is locked, is there a code to unlock?”

MDH Response: Attachment B - ACCESS Budget Narrative Workbook (MS Excel) is password protected to prevent editing of the worksheet, formulas, and other features included to ensure accurate auto-calculations and standardized data capture. Applicants do not need the password or to disable these protections in order to enter the required information into the workbook.

Applicants should not attempt to disable these protections or otherwise alter the workbook structure.

Other Questions

1. “OADPOP?”

MDH Response: OADPOP is an acronym that refers to organizations authorized by MDH to operate an Opioid-Associated Disease Prevention and Outreach Program under Health-General Article, Title 24, Subtitle 9, Annotated Code of Maryland, or an organization approved to operate as a satellite site of a state-authorized OADPOP. OADPOPs deliver a comprehensive array of drug user health services, including distribution of sterile supplies to reduce infectious disease transmission.

3. “Will the slides be in eMMA or sent via email for those who were not able to attend?”

MDH Response: The PowerPoint slides and responses to all questions will be available to all applicants through eMMA.

4. “When will awards be announced?”

https://emma.maryland.gov/bare.aspx/en/fil/download_public/3cf76295-e7d6-452f-b43f-15a0255664f5?file_context[containerUrl]=%2frfp%2frfp_info_extranet%2f87262%2f&file_context[rfp]=87262 https://emma.maryland.gov/bare.aspx/en/fil/download_public/3cf76295-e7d6-452f-b43f-15a0255664f5?file_context[containerUrl]=%2frfp%2frfp_info_extranet%2f87262%2f&file_context[rfp]=87262 https://emma.maryland.gov/bare.aspx/en/fil/download_public/3cf76295-e7d6-452f-b43f-15a0255664f5?file_context[containerUrl]=%2frfp%2frfp_info_extranet%2f87262%2f&file_context[rfp]=87262

MDH Response: Though a specific date of announcement has not yet been identified, relaying award information is a priority. It is MDH’s intention to provide an announcement as quickly as possible with the goal of fully executing awards by the start of the state fiscal year 2027.

5. “Approximately how many grantees do you anticipate awarding?”

MDH Response: The number of SFY27 ACCESS awards issued by MDH will be dependent upon available funding and the number of qualified applications received.

6. “Since a for profit company does not apply, are there any ideas on how to secure funding for wound care supplies for substance abuse treatment centers (since Medicaid does not cover the supplies)?”

MDH Response: A potential option could be to partner with an ACCESS grantee to provide services and/or supplies on site or refer clients to the ACCESS grantee for wound care.

7. “We are an approved and operating ORP program. We educate and distribute Naloxone and test strips: Fentanyl, Medetomidine, Xylazine. We receive $0 funding. How do we continue as we are? Thanks”

MDH Response: MDH authorizes organizations to operate an Overdose Response Program (ORP) under Health-General Article, Title 13, Subtitle 3, Annotated Code of Maryland. This authority to operate an ORP and provide services is separate and distinct from the ACCESS Grant Program. Your organization may continue to provide overdose response education, distribute naloxone and drug testing strips, and request purchase of these supplies through MDH as long as you maintain your ORP authorization in good standing. Please email mdh.naloxone@maryland.gov with any questions about your organization’s ORP authorization status.

8. “We received notification of the RFA on the afternoon of 12/23, when many staff were already off for the holiday break. As you know, harm reduction work carries significant stress and burnout, and this time is often the only opportunity for staff to rest. A later due date would allow organizations to develop more thoughtful, strategic applications for

FY27.”

MDH Response: Thank you for your thoughts surrounding the time frame of the RFA. The RFA timeline was established to best ensure awards are fully executed by the SFY27 start date, i.e., July 1, 2026.

mailto:mdh.naloxone@maryland.gov

2.“IF we are not currently an OADPOP and are not permitted to become one, should we apply anyway or not apply?”

Section 2.2: Applicant-Specific Annual Funding Limit

1.Multiple questions were received during the Pre-Application Conference Webinar regarding applicants’ inability to obtain their applicant-specific annual funding limit using Attachment B - ACCESS Budget Narrative Worksheet (MS Excel file), including:

7.“BHSB also does not have an award number for FY26 since we still don't have an executed agreement. If a full list of FY26 award numbers could be provided that might be helpful and cover everyone in one fell swoop.”

8.“Will organizations who are ORPs and previously received SOR funding for these activities be grandfathered in as "existing ACCESS grantees" for future grant applications?”

Section 3: Scope of Work

1.MDH has received multiple questions related to ACCESS award requirements for subdividing budgets into multiple budget periods, including:

4.MDH received multiple questions related to the 37.81% fringe rate cap referenced in RFA Section 4.4.5, including:

●“Can you please confirm what the IDC rate is?”

Section 5 - Evaluation Committee, Evaluation Criteria, and Selection Procedure

1.“Do you factor in other grants (such as Opioid Restitution Funds) that have been provided in each jurisdiction?”

RFA Attachments

3.“Attach B - sheet is locked, is there a code to unlock?”

Other Questions