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

Summary
The Wisconsin Department of Health Services (DHS) is soliciting applications from organizations to provide navigator services to people who use drugs (PWUDs) who may be at risk of an overdose. Navigators will work to meet PWUDs where they are and connect them with community resources, harm reduction services, and facilitate connection to treatment/recovery services. Eligible organizations include syringe service providers, community-based organizations, non-profit organizations, municipal, county, or Tribal agencies (including, but not limited to health and human services (HHS), and social services), and health systems/clinics. Applications in response to this request for applications (RFA) must be submitted online using this application survey. Applicants must conduct their work in the state of Wisconsin and must be comfortable with navigators participating in harm reduction work. The deadline to apply for this funding opportunity is 11:59 p.m. on July 1, 2024. Questions related to this RFA must be submitted in writing to lataysha.james@dhs.wisconsin.gov and may be submitted through June 26, 2024. This funding announcement, a courtesy copy of the application, and question/answer document can be found on the DHS website. 

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

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

Funding opportunity
This funding opportunity is seeking applications from organizations to establish and/or expand the use of navigators within their organizations to connect PWUD and those who are at risk of overdose to services. A navigator is defined as any individual who works directly with individuals with use substances to ensure they have the tools and resources to seek care. Importantly, they aide PWUD in accessing harm reduction services and social supports, as well as assisting with accessing treatment and supporting retention in substance use disorder (SUD) care. For the purposes of this program, navigators are required to link individuals to either evidence-based treatment for SUDs (including medication for opioid use disorder (MOUD), cognitive behavioral therapy (CBT), or contingency management), or harm reduction services such as syringe services, wound care, drug checking supplies, or other activities that help lessen the harms associated with drug use and related behaviors. A navigator can include certified peer recovery specialists, peer support specialists, case managers, patient navigators, community health workers, persons with lived experience (PWLE), and other individuals who link PWUD to care and harm reduction resources.

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

Intended program outcomes

Short-term Outcomes

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

Intermediate Outcomes

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

Long-term Outcomes

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

Program requirements

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

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

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

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

Funding terms and conditions 

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

Funding Amount: up to $104,000 annually

Number of Awards: 4-6

Expected 12-month grant cycles
Year 1 (FY25): September 1, 2024–August 31, 2025 (initial award) 
Year 2 (FY26): September 1, 2025–August 31, 2026 (contract renewal) 
Year 3 (FY27): September 1, 2026–August 31, 2027 (contract renewal)
Year 4 (FY28): September 1, 2027–August 31, 2028 (contract renewal)