PHPA 1991 - BPM037561 - Increasing Referrals to Tobacco Treatment and Lung Cancer Screening RFA 4.21.pdf

EXHIBIT A

STANDARD GRANT AGREEMENT (SGA)

REQUEST FOR APPLICATIONS (RFA)

(COMPETITIVE)

PROCUREMENT ID NUMBER – PHPA-1991

Issue Date: April 21, 2023

Increasing Referrals to Tobacco Treatment and Lung Cancer

Screening

NOTICE

A Prospective Applicant that has received this document from the Maryland Department of Health, or that has received this document from a source other than the Procurement Officer, and that wishes to assure receipt of any changes or additional materials related to this RFA, should immediately contact the Procurement Officer and provide the Prospective Applicant’s name and mailing address so that addenda to the RFA or other communications can be sent to the Prospective Applicant.

09/2021

STATE OF MARYLAND

MARYLAND DEPARTMENT OF HEALTH

RFA KEY INFORMATION SUMMARY SHEET

Request for Applications: Increasing referrals to Tobacco Treatment and Lung Cancer Screening

Solicitation Number: PHPA 1991 / BPM037561

RFA Issue Date: May 3, 2023

RFA Issuing Office: Maryland Department of Health Prevention and Health Promotion Administration Center for Tobacco Prevention and Control

Procurement Officer: Danielle Fields Procurement Officer

201 W. Preston Street Baltimore, Maryland 21201 1st Floor Phone: 410 767-5555 Email: DanielleA.Fields@maryland.gov

Grant Monitor: Anastasia Lambropoulos, MS Cessation and Health Systems Initiatives

Center for Tobacco Prevention and Control Maryland Department of Health Prevention and Health Promotion Administration 201 West Preston Street Baltimore, MD 21201

Applications are to be sent to: The State's eMaryland Marketplace Advantage (eMMA) e-Procurement system. Instructions on how to submit Applications electronically can be found at:

https://procurement.maryland.gov/wp-content/uploads/sites/12/2021/01/5-eMMA-QRG- Responding-to-Solicitations-Double-EnvelopeRFP.pdf For questions or technical assistance, please contact the eMMA help desk at eMMA.HelpDesk@maryland.gov

Closing Date and Time: May 31, 2023 at 2pm Local Time mailto:DanielleA.Fields@maryland.gov https://maps.google.com/?q=201+West+Preston+Street+%0D%0ABaltimore,%C2%A0MD%C2%A021201&entry=gmail&source=g https://maps.google.com/?q=201+West+Preston+Street+Baltimore,+MD+21201&entry=gmail&source=g https://procurement.maryland.gov/wp-content/uploads/sites/12/2021/01/5-eMMA-QRG-Responding-to-Solicitations-Double-EnvelopeRFP.pdf https://procurement.maryland.gov/wp-content/uploads/sites/12/2021/01/5-eMMA-QRG-Responding-to-Solicitations-Double-EnvelopeRFP.pdf https://procurement.maryland.gov/wp-content/uploads/sites/12/2021/01/5-eMMA-QRG-Responding-to-Solicitations-Double-EnvelopeRFP.pdf mailto:eMMA.HelpDesk@maryland.gov

SECTION 1 - GENERAL INFORMATION

1.1 Summary Statement

1.1.1 The Maryland Department of Health (MDH or the Department), Center for Tobacco Prevention and Control

(CTPC), is issuing this Request for Applications (RFA) – “Increasing Referrals to Tobacco Treatment and Lung Cancer Screening” – to award applicants to implement an initiative to increase referrals to evidenced-based tobacco treatment interventions, including the Maryland Tobacco Quitline, and lung cancer screening for high-risk adults (ages 50 to 80 years of age who have had a 20-pack-year history of smoking or have quit within the last 15 years). Integration of evidence-based strategies into routine clinical care policies, protocols and systems can help healthcare providers provide continued long-term support for patients.

This initiative will address several cross-cutting goals and strategies in the 2021-2025 Maryland Statewide Comprehensive Cancer Control Plan, as well as from national initiatives such as the CDC tobacco cessation evidence-based interventions, the 2020 Surgeon General’s Report on Smoking Cessation and the U.S. National Cancer Institute. Treating Smoking in Cancer Patients: An Essential Component of Cancer Care, National Cancer Institute Tobacco Control Monograph 23 and the Maryland Comprehensive Cancer Control Plan.

Please see Attachment D “Resources” for links to above-mentioned-resources.

1.1.2 It is the State’s intention to obtain services as specified in this RFA, from an Agreement between the selected Applicant and the State. The anticipated duration of services to be provided under this Agreement will begin on or about July 1, 2023 - June 30, 2024; to include 2 - 1-Year Options; Option Year 1 (July 1, 2024, to June 30, 2025 and Option 2 July 1, 2025 to June 30, 2026).

1.1.3 The Department intends to make one (1) award. The amount of the award will not exceed $150,000. The The Department may exercise up to two (2) – one (1) option years for this grant.

1.1.4 Applicants, either directly or through their subcontractor(s), must be able to provide all services and meet all of the requirements requested in this solicitation and the successful Applicant shall remain responsible for performance regardless of subcontractor participation in the work.

1.2 Contract Type

The Agreement resulting from this solicitation shall be a firm fixed price.

1.3 Procurement Officer

1.3.1 The sole point of contact in the State for purposes of this solicitation prior to the award of any Agreement is the Procurement Officer at the address listed below:

Danielle Fields

Procurement Officer Maryland Department of Health Prevention and Health Promotion Administration 201 West Preston Street

Phone Number: 410-767-5555

E-mail: DanielleA.Fields@maryland.gov

1.3.2. The Department may change the Procurement Officer at any time by written notice.

1.4 Grant Monitor

1.4.1 The Grant Monitor is:

Anastasia Lambropoulos, MS

Cessation and Health Systems Initiatives Center for Tobacco Prevention and Control Maryland Department of Health Prevention and Health Promotion Administration 201 West Preston Street

1.4.2 The Department may change the Grant Monitor at any time by written notice.

1.5 eMaryland Marketplace Advantage

1.5.1 Each Applicant is requested to indicate its eMaryland Marketplace Advantage (eMMA) vendor number in the Transmittal Letter (cover letter) submitted at the time of its Application submission to this RFA.

1.5.2 eMMA is an electronic commerce system administered by the Maryland Department of General Services. The RFA and associated materials, the solicitation and summary of the Pre-Application Conference, Applicant questions and the Procurement Officer’s responses, addenda, and other solicitation-related information will be provided via eMMA.

1.5.3 In order to receive a contract award, a vendor must be registered on eMMA. Registration is free. Go to https://procurement.maryland.gov/, click on “Register” to begin the process, and then follow the prompts.

1.6 Questions

1.6.1 Written questions from prospective Applicants will be accepted by the Procurement Officer. Questions to the Procurement Officer shall be submitted via e-mail to the following e-mail address: DanielleA.Fields@maryland.gov.

Please identify in the subject line the Solicitation Number and Title.

1.6.2 Questions are requested to be submitted no later than the date indicated on the Key Information Summary Sheet. The Procurement Officer, based on the availability of time to research and communicate an answer, shall decide whether an answer can be given before the Application due date.

1.7 Pre-Application Conference

1.7.1 A Pre-Application Conference (the Conference) will be held at the date, time, and location indicated on the RFP Key Information Summary Sheet. A Pre-Application Conference will be held via teleconference. See Attachment E for instructions.

1.7.2 All prospective Offerors are encouraged to attend in order to facilitate better preparation of their Application.

mailto:DanielleA.Fields@maryland.gov https://maps.google.com/?q=201+West+Preston+Street+%0D%0ABaltimore,%C2%A0MD%C2%A021201&entry=gmail&source=g https://maps.google.com/?q=201+West+Preston+Street+Baltimore,+MD+21201&entry=gmail&source=g https://procurement.maryland.gov/ mailto:DanielleA.Fields@maryland.gov

If there is a need for sign language interpretation and/or other special accommodations due to a disability, please notify the Procurement Officer at least five (5) Business Days prior to the Pre-Application Conference date. The Department will make a reasonable effort to provide such special accommodation.

1.8 Application Due (Closing) Date and Time

1.8.1 Applications, in the number and form set forth in Section 4.2 “Applications'' must be received by the Procurement Officer, in eMMA, no later than 2:00 pm Local Time on (due date, May 31, 2023) in order to be considered.

1.8.2 Requests for extension of this time or date will not be granted. Applications received after the due date and time listed in this section will not be considered. Questions regarding this solicitation should be directed (By e-mail only, no phone calls will be accepted) to the PROCUREMENT OFFICER.

1.8.3 Applications will not be accepted by mail, e-mail, facsimile, and/or hand-delivery.

1.8.4 Applications may be modified or withdrawn by written notice received by the Procurement Officer before the time and date set forth in this section for receipt of Application. Multiple and/or alternate Applications will not be accepted.

1.9 Award Basis

1.9.1 The Grant shall be awarded to responsible Applicants submitting Applications that have been determined to be the most advantageous to the State, considering price and evaluation factors set forth in this RFA, for providing the activities as specified in this RFA. See RFA Section 5 for further award information.

1.10 Revisions to the RFA

1.10.1 If it becomes necessary to revise this RFA before the due date for Applications, the Department shall endeavor to provide addenda to all prospective Applicants that were sent this RFA or which are otherwise known by the Procurement Officer to have obtained this RFA. Addenda made after the due date for Applications will be sent only to those Applicants that submitted a timely Application and that remain under award consideration as of the issuance date of the addenda.

1.10.2 Acknowledgment of the receipt of all addenda to this RFA issued before the Application due date shall be included in the Transmittal Letter accompanying the Applicant’s Project Narrative. Acknowledgement of the receipt of addenda to the RFA issued after the Application due date shall be in the manner specified in the addendum notice.

Failure to acknowledge receipt of an addendum does not relieve the Applicant from complying with the terms, additions, deletions, or corrections set forth in the addendum.

1.11 Cancellations

1.11.1 The State reserves the right to cancel this RFA, accept or reject any and all Applications, in whole or in part, received in response to this RFA, waive or permit the cure of minor irregularities, and conduct discussions with all qualified or potentially qualified Offerors in any manner necessary to serve the best interests of the State. The State reserves the right, in its sole discretion, to award a Grant based upon the written Applications received without discussions or negotiations. In the event a government entity proposes and receives the recommendation for award, the procurement may be canceled, and the award processed in accordance with COMAR 21.01.03.01.A(4). If the services that are the subject of the RFA are currently being provided under an interagency agreement with a public institution of higher education and the State determines that the services can be provided more cost effectively by the public institution of higher education, then the RFA may be canceled in accordance with Md. Code Ann., State Finance and Procurement Art., § 3- 207(b)(2).

THE REMAINDER OF THIS PAGE IS INTENTIONALLY LEFT BLANK.

SECTION 2 – MANDATORY REQUIREMENTS

2.1 Applicant Mandatory Requirements

The Applicant must provide proof with its Application that the following Mandatory Requirements have been met:

2.1.1 The Applicant shall be a Social organization as defined per Section 7-402 of the State Finance and

Procurement Article of the Annotated Code of Maryland or a local, state government agency, public college or state university.

2.1.2 For social organization Applicants (not local, state government agency, public college, or state university), the Applicant must be a nonprofit organization, classified by the IRS as tax-exempt under section 501(c)(3) of the Internal Revenue Code. Applications must include attachments of the following documentation from the applicant:

● DOCUMENTATION REQUIRED: Documentation of tax-exempt status of the Applicant or the Applicant’s fiscal sponsor (i.e., IRS tax exempt status determination letter)

2.1.3 The Applicant shall not be currently providing services to an entity that is a part of the tobacco industry, as either a manufacturer of tobacco products or a distributor thereof and shall not have provided such services to such an entity since November 1998.

• DOCUMENTATION REQUIRED: Applicant must complete, sign, and submit Exhibit F.

SECTION 3 – SCOPE OF WORK

3.1 Background and Purpose

3.1.1 General Background

The Center for Tobacco Prevention and Control (CTPC) oversees a comprehensive statewide tobacco control program. The structure of CTPC is based upon the five core components outlined in the Centers for Disease Control and Prevention (CDC) Best Practices for Comprehensive Tobacco Control Programs: (1) State and Community Interventions, (2) Mass-Reach Health Communication Interventions, (3) Cessation Interventions, (4) Surveillance and Evaluation, and (5) Infrastructure, Administration and Management. The overall goals for the Center for Tobacco Prevention and Control are aligned with the CDC Best Practices, and include:

● Prevent initiation among youth and young adults.

● Promote quitting among adults and youth.

● Eliminate exposure to secondhand smoke.

● Advance health equity by identifying and eliminating commercial tobacco product-related inquiries and disparities.1

To reach its goals, Maryland has created an infrastructure that encompasses:

● The Maryland Tobacco Quitline, 1-800-QUIT-NOW, a free evidence-based telephone, web, and text counseling service to help tobacco users quit (www.smoingstopshere.com);

● Local health department tobacco control programs in each of Maryland’s 24 major political jurisdictions;

● Community-based initiatives;

● Health communications activities;

● Network of statewide supporters and partners; and

● Two statewide resource centers:

○ Legal Resource Center for Public Health Policy (LRC;

http://www.law.umaryland.edu/programs/publichealth/index.html) and

○ Maryland Tobacco Cessation Resource Center (Maryland TCRC); https://marylandtcrc.org/

Maryland Tobacco Use Dependence Treatment Services The Maryland Tobacco Quitline (QL) is a free proactive phone counseling service supported by the Maryland Department of Health that provides tobacco treatment to Marylanders over the age of 13 to quit all tobacco, including electronic devices (ESDs). Services are provided in English, Spanish, and additional languages. Callers who speak Asian languages can be transferred to the Asian Smoker’s Quitline should they choose this option.

Phone-, web- and text-based program services are available 24 hours a day, 7 days a week, and are provided by highly trained Quit Coaches, who work one-on-one with individuals.

The QL offers free Nicotine Replacement Therapy (NRT) (i.e. patch, gum and/or lozenge), while supplies last, for callers 18 and older. NRT is mailed directly to a participant’s home. If desired, callers can also be referred to their Local Health Department (LHD) for in-person and virtual cessation counseling and free medications.

Residents have the option between two levels of QL service: (1) a brief single call intervention along with mailed support materials; or (2) multiple call (up to four calls) counseling sessions along with mailed support materials.

The QL offers specialized support programs for those with chronic health conditions, pregnant people, and youth ages 13-17; follows an intensive Behavioral Health protocol; and offers Web Coach® web support with NRT, and Text2Quit® text support. The QL has a quit rate seven times higher than people quitting on their own and over a 93 percent satisfaction rate. Providers can refer clients to the QL by fax, web, email or electronic

1 Centers for Disease Control and Prevention. Best Practices for Comprehensive Tobacco Control Programs. Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, 2014. Accessed 12 May 2022 at https://www.cdc.gov/tobacco/stateandcommunity/best_practices/pdfs/2014/comprehensive.pdf https://d.docs.live.net/24e4fa316338c6b8/Documents/MDOH/CDC%20Grant/BH%20RFP/www.smoingstopshere.com http://www.law.umaryland.edu/programs/publichealth/index.html https://marylandtcrc.org/ https://www.cdc.gov/tobacco/stateandcommunity/best_practices/pdfs/2014/comprehensive.pdf https://www.cdc.gov/tobacco/stateandcommunity/best_practices/pdfs/2014/comprehensive.pdf referrals, thus allowing the QL to proactively call the client to enroll them in services. The current QL vendor for Maryland is Optum.

Lung Cancer Rates and Screening in Maryland According to the 2021 Cancer Data Cigarette Restitution Fund Program Cancer Prevention, Education, Screening and Treatment Program Report, lung cancer was the leading cause of cancer death for both men and women in Maryland, accounting for 22.6% of all 10,927 cancer deaths in 2018. From 2014 to 2018, overall lung cancer incidence and mortality rates decreased Statewide and declined for both White and Black residents after stratifying by race. Tobacco use is the primary cause of lung cancer, with smoking causing an estimated 81% of lung cancer deaths in the U.S.2 Smoking rates among Maryland adults continue to decline. In 2020, 10.9% of adults ages 18 years and older were current smokers. Maryland has attained the Healthy People 2020 goal of reducing the percentage of adult smokers to 12.0%3.

As noted by the American Lung Association's State of Lung Cancer 2022- Report, Maryland’s lung cancer screening score rating is “average”. Lung cancer screening for those at high-risk using Low-Dose Computed Tomography (LDCT) is estimated to reduce lung cancer-specific mortality by 20% compared to chest radiography. LDCT is an evidence-based practice for early detection of lung cancer, shown to decrease mortality. In Maryland, 7% of individuals at high-risk were screened using LDCT. Despite exceeding the national rate of 6% the Maryland screening rate remains low. This may be due to lack of access and/or knowledge of lung cancer screening services -including the fee-for-service Medicaid coverage for lung cancer screening in Maryland - among patients and providers.4

In 2022, the Centers for Medicare and Medicaid Services issued a national coverage determination that provides Medicare coverage for LDCT screening for patients ages 50 to 77 years old with a smoking history of at least 20 pack years, who currently smoke or have quit smoking within the last 15 years. Incorporating lung cancer screening with tobacco use dependence treatment offers a high potential benefit in terms of reducing lung cancer deaths and increasing life-years. The U.S. National Cancer Institute, Treating Smoking in Cancer Patients: An Essential Component of Cancer Care, National Cancer Institute Tobacco Control Monograph 23 states that smoking increases the risk of lung cancer approximately 20-fold. In June 2022, the National Cancer Institute issued its publication on Monograph 23, entitled “NCI Tobacco Control Monograph 23 Treating Smoking in Cancer Patients: An Essential Component of Cancer Care,” which highlights effective cessation treatment for patients with cancer who smoke as the fourth pillar of cancer care.5

Best Practices in Addressing Tobacco Use Dependence Treatment in Health Systems The CDC Best Practices for Comprehensive Tobacco Control Programs (2014) states that “Comprehensive tobacco control cessation activities can focus on three broad goals: (1) promoting health systems change; (2) expanding insurance coverage of proven cessation treatments; and (3) supporting state Quitline capacity.”6 The recently released CDC Tobacco Cessation Change Package (TCCP) “presents a list of process improvements that clinicians can implement as they seek to deliver optimal treatment to patients who use tobacco. It was developed to give clinical

2 Maryland Department of Health, 2021 Cancer Data Cigarette Restitution Fund Program Cancer Prevention, Education, Screening and Treatment Program, September 2021https://health.maryland.gov/phpa/cancer/Documents/2021%20CRF%20Cancer%20Report_FINAL.pdf 3 Maryland Department of Health, 2021 Cancer Data Cigarette Restitution Fund Program Cancer Prevention, Education, Screening and Treatment Program, September 2021https://health.maryland.gov/phpa/cancer/Documents/2021%20CRF%20Cancer%20Report_FINAL.pdf 4 American Lung Association, State of Lung Cancer Report 2022 - Maryland, https://www.lung.org/research/state-of-lung-cancer/states/maryland 5 U.S. National Cancer Institute. Treating Smoking in Cancer Patients: An Essential Component of Cancer Care. National Cancer Institute Tobacco Control Monograph 23. Bethesda, MD: U.S. Department of Health and Human Services, National Institutes of Health, National Cancer Institute; 2022.

https://cancercontrol.cancer.gov/sites/default/files/2022-06/Mon23_FullVolume.pdf 6 Centers for Disease Control and Prevention. Best Practices for Comprehensive Tobacco Control Programs—2014. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2014. Accessed April 6, 2021 from https://www.cdc.gov/tobacco/stateandcommunity/best_practices/pdfs/2014/comprehensive.pdf https://cancercontrol.cancer.gov/sites/default/files/2022-06/Mon23_FullVolume.pdf https://cancercontrol.cancer.gov/sites/default/files/2022-06/Mon23_FullVolume.pdf https://cancercontrol.cancer.gov/sites/default/files/2022-06/Mon23_FullVolume.pdf https://health.maryland.gov/phpa/cancer/Documents/2021%20CRF%20Cancer%20Report_FINAL.pdf https://health.maryland.gov/phpa/cancer/Documents/2021%20CRF%20Cancer%20Report_FINAL.pdf https://www.lung.org/research/state-of-lung-cancer/states/maryland https://cancercontrol.cancer.gov/sites/default/files/2022-06/Mon23_FullVolume.pdf teams a practical resource to increase the reach and effectiveness of tobacco cessation interventions and to incorporate these interventions into the clinical workflow”.7 The TCCP contains evidence-based resources, shared by health systems and clinicians that can be adapted to the clinical setting and patient population. Each change idea is paired with practical tools and resources from the field. The TCCP can be implemented by health professionals in outpatient, inpatient, pharmacy, and behavioral health settings, and can be found at:

https://millionhearts.hhs.gov/files/tobacco_cessation_change_pkg.pdf. The TCCP can complement existing protocols and guidance, creating a suite of materials that a clinical team can put into action.

Increasing Referrals to Tobacco Treatment and Lung Cancer Screening CTPC is seeking applicants to institute an initiative to increase training for healthcare professionals to increase referrals to evidenced-based tobacco use treatment/cessation resources, including the Maryland Tobacco Quitline, and LDCT screening strategies for high-risk adults (ages 50-80 years of age who have had a 20-pack-year history of smoking or have quit within the last 15 years). The Maryland Tobacco Quitline is an evidence-based resource to support tobacco treatment among Marylanders. LDCT is an evidence-based practice for early detection of lung cancer, shown to decrease mortality. Both the QL and lung cancer screening are currently underutilized, and the use of evidence-based implementation strategies are needed to increase utilization. Pairing lung cancer screening education, referrals to the QL, use of patient navigators, and referrals to LDCT capitalizes on the teachable moment where callers can be encouraged to consider screening for lung cancer and strives to increase both tobacco treatment and lung cancer screening. Integration of evidence-based strategies into routine clinical care policies, protocols and systems can help healthcare providers provide continued long-term support for patients.

CTPC Support

Throughout the duration of the project period, CTPC will provide technical assistance and support to Applicants in addressing evidence-based implementation strategies to increase referrals to tobacco treatment and lung cancer screening.

3.2 Scope of Work - Requirements

3.2.1 General Requirements: The Applicant shall meet ongoing deliverables and programmatic responsibilities outlined in their Work Plan according to Section 3.2. Unless otherwise noted, all deliverables shall be laid out as annual work products to be completed each state fiscal year (July 1, 2023 -June 30, 2024), including any option years.

Applicants will be required to implement an initiative to increase referrals to evidenced-based tobacco treatment interventions, including the Maryland Tobacco Quitline, and lung cancer screening for high-risk adults (ages 50 to 80 years of age who have had a 20-pack-year history of smoking or have quit within the last 15 years). Using concepts associated with goals and strategies in the 2021-2025 Maryland Statewide Comprehensive Cancer Control Plan, CDC tobacco cessation evidence-based interventions, the 2020 Surgeon General’s Report on Smoking Cessation, the U.S. National Cancer Institute Treating Smoking in Cancer Patients: An Essential Component of Cancer Care, and the National Cancer Institute Tobacco Control Monograph 23, applicants will develop and inform their Work Plan for this grant.

3.2.2 Concepts and Change Ideas: Applicants will develop and implement concepts and change ideas to increase referrals to tobacco treatment and lung cancer screenings. The work of the funded applicant(s) shall emphasize the increase of evidenced-based tobacco treatment interventions, including referrals to the Maryland Tobacco Quitline, and referrals of eligible smokers to lung cancer screening. Examples of anticipated outcomes that may result, but are not limited to:

7 Centers for Disease Control and Prevention. Tobacco Cessation Change Package. Atlanta, GA: Centers for Disease Control and Prevention, US Department of Health and Human Services; 2020. Accessed April 6, 2021 fromhttps://millionhearts.hhs.gov/files/tobacco_cessation_change_pkg.pdf.

https://millionhearts.hhs.gov/files/tobacco_cessation_change_pkg.pdf

• Increase in clients screened for tobacco use and lung cancer by reducing barriers to tobacco among minority/ethnic and high-risk populations, including, but not limited to, those with lower socio-economic status (SES), non-English speaking clients/patients, Hispanic, Asian, African American, LGBTQ, and individuals with behavioral health conditions.

• Increase evidence-based cessation interventions and support services (i.e., FDA approved cessation medications, and counseling).

• Develop and institute curriculum and implement training program for healthcare providers and staff, including patient navigators, to include, but not limited to, readiness/motivational interviewing, integration of tobacco treatment referral to the Maryland Tobacco Quitline or other evidence-based tobacco treatment, and shared decision-making regarding referral to (LDCT) lung cancer screening.

• Build clinical decision support into the electronic health record (EHR) to achieve tobacco use intervention and lung cancer screening.

Concepts and Change Ideas may be found at:

https://millionhearts.hhs.gov/files/tobacco_cessation_change_pkg.pdf.

3.2.3. Work Plan and Timeline. Applicants will include a detailed Work Plan and timeline with their Application that outlines their approach to implement the specific requirements. The timeline shall cover activities to be conducted with the grant funds. (See Section 4.3)

Initiatives proposed in response to this solicitation will include a statement or Work Plan activities on how the program will be sustained beyond the project end date and have demonstrable in-kind organizational support throughout the grant term. Awarded recipients may also be asked to provide technical assistance to guide other organizations on replication of efforts and successful implementation.

3.2.4 Trainings. Applicants will conduct trainings for health care providers and their staff, including patient navigators, regarding the relationship between tobacco use and lung cancer and the need for increasing referrals to tobacco treatment and lung cancer screening. (See Section 3.2.2) Applicants will also provide quarterly updates within the quarterly reports regarding the number of trainings offered and the number of individual participants.

3.2.5 Data Collection, Monitoring and Reporting. Applicants shall prepare quarterly reports for monitoring, measuring, and evaluating all proposed strategies/activities and their outcomes achieved over the project period. (See Section 3.3.2 for dates/deadlines). Each report shall include a quarterly summary/narrative and description of deliverables completed, major accomplishments, lessons learned, data reporting, planned next steps, challenges. The updates will include the number of trainings offered/completed, number of participants including their demographic makeup, technical assistance requests and other items upon discussion with the grant monitor after award. Satisfactory quarterly reports are due with quarterly invoices. (See Section 3.3.2) The fourth report will include a summation of all activities and data collection for the funded year. The Department will review reports for completeness and may require edits. CTPC may request additional data collection from Applicants throughout the project period, and as needed, to remain in compliance with federal funding requirements. Edits shall be the responsibility of the Applicant.

3.2.6 Evaluation Plan. The Applicant shall provide an evaluation plan in the project narrative of how selected outcomes will be achieved over the project period. Examples of evaluation plans are the Centers for Disease Control and Prevention's Re-Aim Framework and SMART Objectives. The Applicant shall describe evaluation objectives and identify how data will be collected to measure progress towards achieving the selected outcomes in the proposed work plan. Please see Attachment C entitled, “Resources” to obtain links to the CDC Centers for Disease Control and Prevention, Best Practices for Comprehensive Tobacco Control

Programs, 2014, example of the Centers for Disease Control and Prevention, Pragmatic Applications of RE- AIM for Health Care Initiatives in Community and Clinical Settings, and Re-Aim Framework document entitled, Planning and Evaluation Questions for Initiatives Intended to Produce Public Health Impact, and SMART Objectives which may also be used.

3.2.7 Health Equity: Applicants will provide a description of how the proposed activities will address the goal of eliminating tobacco use health disparities and increasing lung cancer screening. Applicants will then propose and develop strategies and activities to promote and increase health equity related to tobacco use treatment and lung cancer screening. Applicants will provide performance measure outcomes that align with the identified strategies/activities that address tobacco use treatment and lung cancer screening health disparities. Disparate populations include but are not limited to those with lower socio-economic status (SES), non-English speaking clients/patients, Hispanic, Asian, African American, LGBTQ, and individuals with behavioral health conditions.

Helpful links can be found in Attachment C “Resources.”

3.2.8 Organizational Capacity: Applicants will describe the organizational experience and structure of their organization as well as identify key staff to be involved in the grant. (See Section 4.3)

3.2.9 The Americans with Disabilities Act: The Americans with Disabilities Act (www.ada.gov/) protects qualified individuals with disabilities from discrimination on the basis of disability in services, programs, and activities.

Accessibility and inclusion of diverse populations are essential to reduce health disparities for vulnerable populations. Contractors must comply with all ADA requirements in their work to ensure the needs of persons with disabilities and other vulnerable populations are met. This includes, but is not limited to:

● facilities and any venues used for meetings/conferences are accessible;

● requested accommodations are provided in a timely manner; and

● written and printed materials developed in accessible formats (easy to read, large print, etc.), or providing access to alternative formats.

For contracts which include direct patient care or service delivery through a program, the ADA requires entities provide full and equal access for people with disabilities. This includes, but is not limited to:

● reasonable modifications of policies, practices, and procedures;

● effective communication;

● and accessible facilities.

3.3 Invoicing

3.3.1 General

(a) All invoices for services shall be signed by the Grantee and submitted to the Grant Monitor. All invoices shall include the following information:

● Grantee name;

● Remittance address;

● Federal taxpayer identification number (or if sole proprietorship, the individual’s social security number);

● Invoice period;

● Invoice date;

● Invoice number http://www.ada.gov/

● State assigned Contract number;

● State assigned (Blanket) Purchase Order number(s);

● Goods or services provided;

● Amount due; and

● Separate, detailed financial report that provides a breakdown of each employee, by name, salary, fringe, etc., for each pay period, quarter, with each quarterly and end-of year invoice.

Invoices submitted without the required information cannot be processed for payment until the Contractor provides the required information.

(b) The Department reserves the right to reduce or withhold Grant payment in the event the Grantee does not provide the Department with all required deliverables within the time frame specified in the Grant or in the event that the Grantee otherwise materially breaches the terms and conditions of the Grant until such time as the Grantee brings itself into full compliance with the Grant.

3.3.2 Invoice Submission Schedule

The Grantee shall submit invoices in accordance with the following schedule:

The Grantee shall submit quarterly invoice packages with a detailed invoice narrative, documentation and/or receipts as requested, and a completed quarterly progress report (See Section 3.2.5).

Completed invoice packages are due no later than the last day of the month for deliverables completed in the quarter prior: April 30 (for January-March), July 31 (for April-June), October 31 (for July-September), and January 31 (October-December).

THE FINAL INVOICE IS DUE NO LATER THAN 60 CALENDAR DAYS AFTER THE END

OF THE CONTRACT.

SECTION 4 – APPLICATION FORMAT

4.1 Two Part Submission

Offerors shall submit Applications in separate volumes:

▪ Volume I – Project Narrative

▪ Volume II – Budget Justification/Narrative

4.2 Applications

4.2.1 Applications must be submitted via eMMA. The Procurement Officer will not accept submission after the date and exact time stated in the Key Information Summary Sheet.

4.2.1.1 The eMMA submission subject line shall state the RFA Title and number and either Technical Application or Budget Narrative.

4.2.1.2 Two Part Submission:

A. Technical Application (See 4.3.)

B. Budget Narrative (See 4.4)

4.2.2 Applications will be shown only to State employees, members of the Evaluation Committee, or other persons deemed by the Department to have a legitimate interest in them.

*All information submitted as part of this Application is subject to release under the Public Information Act (PIA). If you would like the Maryland Department of Health (MDH) to consider redactions in the event that your Application is subject to a PIA request, submit a proposed PIA copy including justifications for each redaction and under what statute that justification is qualified for redaction.

4.3 Volume I – Project Narrative

Grant Application narratives shall be no more than 12 pages in length and be written in no smaller than 12-point font. Content must be double spaced and paginated. The Abstract, Work Plan chart, resumes, budget forms, executive summary, and letters of support do not count in the page limit. Please include the following information in your grant Application narrative in the order that is outlined below.

Note: No pricing information is to be included in the Project Narrative (Volume 1). Pricing information is to be included only in the Budget Justification/Narrative (Volume II).

The Technical Application shall include the following documents and information in the order specified as follows:

4.3.1 Transmittal Letter:

● Applicant;

● Solicitation Title and Solicitation Number that the Application is in response to;

● Signature, typed name, and title of an individual authorized to commit the Applicant to its

Application;

● Federal Employer Identification Number (FEIN) of the Applicant, or if a single individual, that individual’s Social Security Number (SSN);

● Applicant’s eMMA number;

● Applicant’s MBE certification number (if applicable);

● Applicant’s SBR number (if applicable) – please contact eMMA at 410-767-1492 if you don’t know your number.

4.3.2 Abstract Page: Provide a short abstract summary of need and work to be performed, not to exceed 200 words, written in lay terms for release to the general public should this Application be selected for funding.

The Abstract Page is not included in the page limit. The page must be completed in full, signed and dated by the Project Director granting MDH permission to publish the abstract if the Application is selected for funding

(Exhibit D).

4.3.3 Executive Summary: Include an Executive Summary, no more than two (2) pages in length, that describes the following:

A. The name of the institution(s) involved in implementing the Increasing Referrals to Tobacco Treatment and Lung Cancer Screening grant;

B. Maryland jurisdiction(s) of focus (i.e., geographic region/reach) and population groups to be served within the selected jurisdiction of focus;

C. How the grant funds will be used;

D. Describe staff expertise in tobacco prevention, lung cancer screening, and education of patients that will be involved in the grant activities or a description of how they will gain that experience;

E. What setting and evidence-based tobacco treatment concepts/strategies, including the Maryland Tobacco Quitline, and lung cancer screening that will be utilized to increase referrals for high-risk adults (ages 50 to 80 years of age who have had a 20-pack-year history of smoking or have risk within the last 15 years as recommended by the U.S. Preventive Services Task Force);

F. What curriculum will be used to train healthcare providers and staff, including patient navigators;

G. How the Applicant will engage staff and clients in the project;

H. Institutional experience in education of public on tobacco use prevention, use of the Maryland Tobacco Quitline to quit smoking and experience in increasing referrals to lung cancer screening;

I. Description of services to be offered, including education and policy initiatives;

J. Expected outcomes that will result from project funds.

The Executive Summary is not included in the page limit.

4.3.4 Statement of Need: Describe the Applicant’s institutional structure in place in terms of addressing lung cancer screening, referrals to the Maryland Tobacco Quitline, and access/utilization to LDCT as an evidence-based practice for early detection of lung cancer in effort to decrease mortality in the above-mentioned targeted adult population(s). Please include efforts addressing patients, employees, and campus-wide policies.

4.3.5 The Project Narrative shall include the Scope of Work, including the Work Plan (as described in Section 3.2). Applicants shall include the following in their Application narrative:

A. Work Plan: A proposed Work Plan must be included that addresses the Applicant’s Application to increase evidenced-based tobacco treatment interventions, referrals to the Maryland Tobacco Quitline, and referral of eligible patients/smokers to lung cancer screening. The Work Plan must include how efforts achieve the outcomes highlighted in Section 3.2.3. The Applicants shall include in their Work Plan activities for sustainability to maintain ongoing program services and ensure the institutionalization of implemented activities following the grant period. The Work Plan shall include:

1. Work Plan chart with the Goals, Objectives, and Services/Activities to be offered with the grant funds for each award fiscal year, using the template provided in

Exhibit E. Objectives must be written using the S.M.A.R.T. (Specific, Measurable, Attainable, Realistic, and Time-phased) format. Work Plans do not count in the overall page limit;

2. Data to be collected to measure the progress of the Objective(s);

3. How the Applicant will assess the progress toward meeting the Objective(s);

4. Staff who will be responsible for accomplishing the Objective(s); and

5. How the Applicant will ensure sustainability beyond the project end date, as well as an overview of in kind organizational support throughout the grant term.

B. Timeline: Provide a timeline showing the expected start date and completion date for each activity to be conducted with the grant funds. Include adequate start-up time to hire staff (if applicable), or to establish an infrastructure. All required activities must be completed and deliverables submitted within the specified project period.

At a minimum, the Application will provide a timeline of expected tasks, activities to be conducted, timeline and milestones to be completed during the duration of the project.

4.3.6 Trainings. Describe plans to train health care providers and their staff, including patient navigators, regarding relationship between tobacco use and lung cancer, need to increase referrals to tobacco treatment and lung cancer screening referrals. (See Section 3.2.2) Applicants will provide quarterly reports on activities. (See Section 3.2.4) If applicable, describe previous staff training efforts relevant to tobacco use and lung cancer screening.

4.3.7 Data Collection, Monitoring and Reporting. Explain how the proposed strategies/activities will be achieved, monitored, measured and evaluated over the project period. Describe participation in the following components and how these efforts will result in the anticipated outcomes as proposed in the Work Plan.

a. Data Collection. Describe how data will be collected, monitored and reported on regarding the performance measures on a quarterly basis throughout the project period. (See Section 3.2.5)

b. Reporting. Prepare quarterly reports, which are due with the quarterly invoices, and track progress towards key deliverables throughout the project period, including a quarterly summary and description of deliverables completed, major accomplishments, lessons learned, data reporting, planned next steps, challenges, and technical assistance needs and training details. Provide a comprehensive final report covering the entire grant period no later than 60 days after the date the grant period ends. The final report will summarize the entire project period including: major accomplishments, lessons learned, challenges, data reporting, and plans to sustain project activities into the future.

c. Evaluation Plan. Describe plans to develop and implement an evaluation plan as mentioned in Section 3.2.6.

4.3.8 Organizational Capacity. Describe organizational capacity to implement desired project outcomes. Explain how existing policies, staff, resources, and other factors will facilitate the implementation of proposed project activities within the Work Plan according to the timeline.

a. Organizational Experience. Describe organizational experience along with concrete examples of organization’s success in implementing similar tobacco prevention and control activities and tobacco treatment intervention in terms of lung cancer screening.

b. Staffing. Describe key staff to be involved in the project, including:

1. If existing staff will be used in the project, a description of the experience of the Key Staff in carrying out similar activities; and a job description of their role in carrying out this project;

2. If existing staff will be used, please describe how the staff member’s time on current projects will be reduced;

3. If new staff will be hired for the grant, a job description of the staff responsible for carrying out the project;

4. Resumes must be included as a grant attachment. (The resumes are not included in the page limit).

4.3.9 Non-Supplantation. Applicants shall complete Exhibit G: Certification for the Increasing Referrals to Tobacco and Lung Cancer Screening Grant, the applicant certifies that it will not use any grant funds to supplant existing tobacco prevention and control activities, educational programs/training of healthcare providers/staff, tobacco treatment, or lung cancer screening referral services. If an Applicant receives funding for similar activities, provide a brief explanation of the activities supported by the other funding sources. Include a list of the funding sources, amount of the funding received, and the funding period for each activity.

4.3.10 Letters of Support: Applicants shall provide at least two (2) letters of support from any other institution with whom the Applicant will collaborate with on this project. The letter must outline what support or services will be provided and must describe the roles and responsibilities for each organization. The Letters of Support are not included in the page limit.

4.3.11 Mandatory Requirements Documentation See Section 2.1

4.3.12 Applicant Technical Response to RFA Requirements and Proposed Work Plan:

a. The Applicant shall address each Scope of Work requirement (Section 3.2) in its Project Narrative and describe how its proposed services, including the services of any proposed subcontractor(s), will meet or exceed the requirement(s). If the State is seeking Applicant agreement to any requirement(s), the Applicants shall state its agreement or disagreement. Any paragraph in the Project Narrative that responds to a Scope of Work (Section 3.2) requirement shall include an explanation of how the work will be done. Any exception to a requirement, term, or condition may result in having the Application classified as not reasonably susceptible of being selected for award or the Applicants deemed non-responsive.

b. Applicant shall acknowledge they have read the American with Disabilities Act Statement in Section 3.2 and will meet all requirements.

4.3.13 Conflicts of Interest. The Applicants shall disclose all conflicts of interests (obvious or not), if any, and describe in detail how the conflicts will be ameliorated. If the Applicant is receiving other funds for tobacco control efforts, describe how this funding is being used and the source of funding. (Exhibit F)

4.3.14 Signed W-9 with Contact Person Names and Phone Number

4.4 Volume II – Budget Narrative

4.4.1 Under separate sealed cover from the Project Narrative and clearly identified in the format identified in

Section 4.2 “Applications,” the Applicant shall submit an original unbound copy of the Budget Narrative.

The Budget Narrative shall contain all price information in the format specified in Exhibit C. The Applicants shall complete the Budget Narrative Form only as provided in the Budget Narrative Form.

4.4.2 The Applicants shall attach to the Budget Form Exhibit B document that details the total cost of the proposed activities. The budget categories may include: Personnel (salary and fringe), Consultants; Travel; Contractual;

Supplies; Operating Costs; and Other project-related costs.

SECTION 5 – EVALUATION COMMITTEE, EVALUATION CRITERIA, AND

SELECTION PROCEDURE

5.1 Evaluation Committee

Evaluation of Applications will be performed by a committee established for that purpose and based on the evaluation criteria set forth below. The Evaluation Committee will review Applications, participate in Applicant oral presentations and discussions, and provide input to the Procurement Officer. The Department reserves the right to utilize the services of individuals outside of the established Evaluation Committee for advice and assistance, as deemed appropriate.

5.2 Project Narrative Evaluation Criteria

The criteria to be used to evaluate each Project Narrative listed below in descending order of importance.

5.2.1 Executive Summary, Statement of Need. To what degree does the Applicant explain the justification/need for increasing referrals to tobacco treatment and lung cancer screening described by the Applicant. (See Section 4.3.3 and 4.3.4)

5.2.2 Organizational Capacity/Experience/Structure and Staffing. To what degree of experience does the Applicant have in tobacco use prevention, treatment and lung cancer screening? If none, to what extent did the Applicant provide a description of how they will gain that experience? (See Section 3.2 and 4.3.8)

5.2.3 Project Narrative (includes proposed Work Plan and Timeline). To what degree does the Applicant address the strategies and activities that will achieve the goals and objectives set forth in the Work Plan?

(See Section 3.2; 4.3.5)

5.2.4 Healthy Equity: To what degree does the Applicant propose to address the issue of eliminating disparities and promoting health equity. (See Section 3.2.7)

5.2.5 Conflicts of Interest. Are there any conflicts of interest involving services provided for the Tobacco Industry? (Exhibit F)

5.2.6 Letters of Support. Does the Applicant provide at least two (2) relevant letters of reference (See Section 2.1) To what extent do the letters of reference demonstrate its abilities to complete…