GENERAL INFORMATION I. INTRODUCTION Salt Lake County is the Local Substance Abuse Authority and Local Mental Health Authority through statutory mandate of Title 17-43-201 & 301 et. seq. of the Utah Code. Substance Use Disorder Prevention services are administered through the Salt Lake County Health Department. In its capacity as the local authority, Salt Lake County, hereafter referred to as the County, provides advocacy and coordination of Substance Use Disorder health services in association with other public and private programs in Salt Lake County. Substance Use Disorder will hereafter be referred to as SUD. Salt Lake County Health Department is responsible for the planning and delivery of SUD Prevention services for the residents of Salt Lake County. As the local authority, Salt Lake County contracts SUD Preventions funds to local public and private agencies. This model of contracted services will be referred to as a network model. Member organizations of this network model are hereafter referred to as Contractors. The competitive selection process is the preferred method of source selection in public purchasing, and is conducted in accordance with Salt Lake County Ordinance, Chapters 3.16, 3.20, 3.22 and 3.24. II. PURPOSE The purpose of this Request for Application (RFA) is to solicit applications from experienced and professional Contractors so the County may purchase a full continuum of evidence-based SUD prevention services ranging across the lifespan of the agreement. Purchased prevention and wellness services must be accessible, efficient, collaborative, integrated and outcome-based. This system of care will be responsible for attending to the multiple needs of individuals, families, and communities in Salt Lake County who are experiencing problems, or potential problems, associated with substance misuse and abuse. Salt Lake County intends to purchase prevention and wellness services for universal, selective, and indicated populations. The selected provider(s) must implement evidence-based programs with particular attention to maintaining the highest possible level of quality and fidelity. Any deviations from the original program that was shown to be effective through published, peer-reviewed research must be clearly outlined and accompanied by a justification articulating why the program modifications were made. Joint applications from multiple partners are allowed, as are subcontracts where a primary grant recipient works with other providers in order to increase reach and diversity of program offerings. III. TERM OF AGREEMENT Contracts awarded subsequent to this RFA will be for a one-year period beginning July 1, 2019 through June 30, 2020; contracts may be renewed for 2 additional one (1) year periods. Decisions for contract renewal will be based on available funding, demonstrated adherence to guidelines stated within this RFA, services outlined in the 2019 Salt Lake County Area Plan, and the 2019 Prevention Services Plan. WRITTEN AGREEMENT REQUIRED The selected Contractors must be willing to enter into a written agreement with Salt Lake County. A binding agreement between Salt Lake County and any Contractor will be dependent upon the negotiation, preparation, and execution of a formal contract. If a Contractor wishes to alter any of the conditions present in the RFA, Attachments or any Addendums issued, that item must be specifically mentioned in the application with a reasonable alternative presented (Attachment). V. PROJECTED SCHEDULE FOR THE RFA PROCESS Activity Date RFA Release by February 15, 2019 Pre-Application Meeting February 25, 2019 Final Day to Submit Questions for Pre-Application Meeting March 1, 2019 Final Day to Submit Questions on the RFA March 8, 2019 Application Due Date March 15, 2019 Committee Review Process March 2019 Contractor Interviews March 2019 Recommendation to Mayor April 2019 Contract Awarded by May 31, 2019 Contract Commencement July 1, 2019 VI. STATEMENT OF SERVICES TO BE PURCHASED Through this RFA, Salt Lake County will award approximately $1.6 million for substance misuse and abuse prevention and wellness services. Funding for subsequent years of the contract period is contingent on future funding allocations and priorities. SUD prevention services being solicited must be in conformance with the 2019 Area Plan, which has been approved by the State Health Department of Substance Abuse and Mental Health (See attachment "Completed Logic Model" in documents section). Based on the County’s Prevention Services Plan, county archival data, state and national trends, comparisons with in-state data, and the current 2017 Student Health and Risk Prevention (SHARP) surveys, the following are the County’s prioritized risk and protective factors: Risk Factors identified that need to be reduced: 1. Parental Attitudes Favorable to Antisocial Behavior (Family Domain) 2. Attitudes Favorable to Antisocial Behavior (Peer Individual Domain) 3. Perceived Risk of Drug Use (Peer Individual Domain) 4. Low Commitment to School (School Domain) Protective Factors identified that need to be strengthened: 1. Rewards for Prosocial Involvement (Community Domain) 2. Interaction with Prosocial Peer (Peer-Individual Domain) 3. Family Attachment (Family Domain) 4. Rewards for Prosocial Involvement (Family Domain) The County also prioritizes the following: 1. Past 30-day alcohol use by individuals under the age of 21 2. Past 30-day tobacco and nicotine use by individuals under the age of 21 3. Past 30-day marijuana use by individuals under the age of 21 4. Misuse of prescription medication or over the counter medication PREFERRED PRACTICE GUIDELINES The Health Department recognizes the need for services outweighs the available resources. In an environment of limited resources, the County historically focuses on higher-risk populations. The County is committing more resources to groups and individuals who have been identified on the basis of biological, psychological, social and/or environmental risk factors known to be associated with substance misuse and abuse. The County will also commit resources to those who may be exhibiting signs of early use or behaviors associated with substance misuse and abuse. In addition to this focus on selective populations, the county will also commit resources to populations that can be shown, using valid and reliable data, to have a localized need within Salt Lake County. Applications that request funding for at risk groups or specific populations need to include data that document the groups or populations are high risk. It is the aim of the County to prioritize needs identified using processes that follow the Strategic Prevention Framework (SPF) in a way that engages the community throughout the process utilizing coalitions following an evidence-based model such as Communities That Care, the CADCA coalition model, PROSPER or similar best practice model. The SPF Process is a five step planning, implementation, and evaluation process. It is critical to consider that this is not necessarily a linear process. Brief descriptions of the five steps are as follows: 1. Assessment: Using valid and reliable data, demonstrate that there is a need to address a problem behavior within a given community. 2. Capacity: Assess and increase the capacity for addressing the identified problem behavior in terms of both resources and readiness. 3. Planning: A process including; prioritizing the risk and protective factors that affect the problem behavior; selecting evidence-based prevention interventions; and developing a comprehensive, logical, and data-driven plan for implementation and evaluation. 4. Implementation: Implementing the prevention intervention(s) with fidelity and a plan for evaluation. 5. Evaluation: Measuring the process, impact, and outcomes that the prevention intervention is having on the target population. This process is most impactful when the target population and surrounding community are included from the beginning as active participants in a meaningful way. The services being solicited and the process of organizing prevention and wellness efforts are in conformance with The Center for Substance Abuse Prevention (CSAP) Steps for Prevention Planning. Evidence-Based Interventions- Evidence-based practices are those strategies, activities or approaches that have been shown to be effective in preventing or delaying substance abuse. Evidence-based programs reduce risk factors, increase protective factors and positively impact the behaviors, consumption and consequences of its participants. All contracted providers must implement evidence-based substance use disorder programs with fidelity. Evidence-based status of programs can be determined by the following methods: • Inclusion in private or federal registries that identify SUD evidence-based interventions proven to result in sustained positive benefits to individuals or communities; • Have been reported in peer-reviewed journals (with positive effects of achieving the primary targeted SUD outcome); or • Have documented effectiveness supported by other sources of information, the consensus judgment of informed experts, AND receive a minimum rating of Tier III by the Utah SUD Evidence-based Workgroup. Contractors shall implement all evidence-based programs with fidelity. Any deviations from the original program that was shown to be effective through published, peer-reviewed research must be clearly outlined and accompanied by a justification articulating why the program modifications were made. YOUR RFA MUST SIGHT THE REFERENCE WHICH SHOWS THE PROGRAM IS EVIDENCE BASED. Contractors may propose to provide services for the following three prevention service levels as defined by The Institute of Medicine (IOM) and the American Society for Addiction Medicine (ASAM): (NOTE: A separate application with color-coded cover sheet must be submitted for each service level; however, within each application, a Contractor may elect to provide services to several different subgroups.) a. Universal Approximately $400,000 available Prevention interventions that are targeted to the general public or a whole population group that has not been identified on the basis of individual risk. The interventions are desirable for everyone in this group. Agencies and communities have the opportunity to collaborate and apply for coalition funding. b. Selective Approximately $750,000 available Prevention interventions that are targeted to individuals or to a subgroup of the population whose risk of developing mental, emotional, or behavioral disorders is significantly higher than average. The risk may be imminent or it may be a lifetime risk. Risk groups may be identified on the basis of biological, psychological, or social risk factors that are known to be associated with the onset of a disorder. Those risk factors may be at the individual level for nonbehavioral characteristics (e.g., biological characteristics such as low birth weight), at the family level (e.g., children with a family history of substance abuse but who do not have any history of use), or at the community/population level (e.g., schools or neighborhoods in high-poverty areas). c. Indicated Approximately $450,000 available Prevention interventions that are targeted to high-risk individuals who are identified as having minimal but detectable signs or symptoms that foreshadow mental, emotional, or behavioral disorder, as well as biological markers that indicate a predisposition in a person for such a disorder but who does not meet diagnostic criteria at the time of the intervention. VII. ADDITIONAL CONSIDERATIONS AND SERVICES Additional consideration will be given to programs or services stated in the Health Department’s 2019 Prevention Services Plan regarding priorities and directions. The Health Department has identified the following as additional considerations for services to be purchased that may not have been identified in the Prevention Services Plan: • Increased focus on earlier prevention • Reduce 30-day drug or alcohol use • Reduce 30-day marijuana use • Reduce 30-day e-cigarette use • Prevent underage alcohol use • Preventing prescription drug abuse • Emphasis on unique populations with an identified need • Emphasis on healthy choices and wellness • Supporting prevention-ready communities • Supporting coalitions implementing an evidence-based model or process • Targeted services for older adults • Culturally aware and sensitive services • Collaborative school programming shown to impact ATOD use and/or associated risk and protective factors • Services being provided on location or in the identified community • Services to minority youth and families • If proposing to serve refugees: • Active participation in refugee stakeholder meetings hosted by the State Refugee Office, the Department of Health and the County. • Collaborate with existing refugee projects