This is archived content, for historical reference only.

Note: Due to the number of people impacted by wildfires and power outages throughout California, the deadline has been extended from October 31 to November 5.

I. Summary

The California Health Care Foundation (CHCF) is an independent philanthropy dedicated to advancing measurable improvements in the health care delivery system for the people of California, particularly those with low incomes and those not well served by the status quo.

This request for proposals (RFP) is intended to identify a grantee to coordinate a process to advance the California Future Health Workforce Commission (Commission) Community Health Workers / Promotores (CHW/Ps)¹ recommendation (PDF) to “scale the engagement of community health workers, promotores, and peer providers through certification, training, and reimbursement.” This project is specifically focused on developing recommendations for state certification of training programs and curricula for CHW/Ps, in collaboration with stakeholders.

II. Project Background

The CHW/P workforce offers unique expertise to a range of challenges faced by underserved patients in safety-net systems. Numerous studies demonstrate the effectiveness and cost efficiency of CHW/Ps to improve health outcomes and to address health disparities across populations and conditions.² CHW/Ps’ knowledge of local community context, health equity, and health navigation has demonstrated improvements in health outcomes for individuals and communities.

Many believe that the pace of CHW/P expansion in California has been slow compared to that of other states and that staffing remains too reliant on grants and time-limited initiatives. Others emphasize the need to carefully attend to integrating CHW/Ps into the health care system’s regulatory environment and financing streams without compromising the core elements of CHW/P effectiveness.

In California and other states, CHW/Ps are expanding both as part of the health workforce and more broadly to support primary prevention and public health. Within the health care delivery system, there is increased accountability for health outcomes, coupled with a recognition of the role of social needs in health that is further driving the integration of CHW/Ps into health teams. This project is focused on CHW/Ps who are working in or interacting with health care systems. The goal of this project is to ease the pathway for integration of CHW/Ps into health care systems — for both employers and the workers themselves — with the ultimate goal of transforming health care systems and their capacity to advance health equity.

CHW/Ps fill diverse roles in a variety of settings. This project will define an overarching structure and core competencies for CHW/P training in California that is amenable to CHW/Ps working in diverse settings but will dive more deeply into the components of that certification and curricula that are deemed central to the role of CHW/Ps working in or with the health care sector.

This project will forge a path for CHW/P training in California. There are other critical elements of advancing the CHW/P workforce including, but not limited to, advancement and employment pipelines for CHW/Ps, greater incorporation of CHW/Ps into academic settings, and improving the capacity of employers to support and sustain CHW/Ps. These are outside the scope of this project.

III. Project Goals

• California will have a detailed and actionable plan for the certification of training programs and curricula for CHW/Ps.
• The plan will have the endorsement of a diverse stakeholder group, including CHW/P training and advocacy entities, health plans, and CHW/P employers.

The grantee will lead a process to convene and coordinate a diverse group of California stakeholders and stakeholder organizations (CHW/P training programs and institutions, CHW/P advocacy organizations, health plans, community health centers, hospitals, and community-based organizations) to endorse recommendations for the certification of training programs and curricula for CHW/Ps.

A content expert and report author (content consultant) will be identified by CHCF and the grantee through a separate process (in early 2020) to write the recommendations report, to collaborate on the design of the stakeholder group meetings and content, and to collaborate on the endorsement process.

The final, documented recommendations report for the training certification process will include the following components (those in italics are likely to require group endorsement):

Background

• An overview of the evidence related to community health workers
• An overview of the landscape of community health workers in California
• Lessons and examples from two or three states related to training and certification
• Lessons from two or three other analogous health professions (e.g., medical assistants, interpreters, behavioral health peers)

Structure

• The overall structure and design of training certification for the state
• Agreed-upon core competencies for CHW/Ps, including specific competencies for CHW/Ps working in or with health care settings
• Competency-aligned curricular components of CHW/P training in health care settings
• Eligibility requirements for training programs
• Recommendation for an implementation and oversight body or bodies

Additional Recommendations and Considerations

• Recommendations for training affordability and accessibility for CHW/Ps
• Recommendations for building the capacity of existing training programs
• Financing considerations
• Policy considerations for certification plan implementation

The content consultant will issue a report with the above content along with a detailed implementation plan. Although the grantee for this RFP is not responsible for preparing this report, the grantee will work very closely with this content consultant to coordinate and support the process and overall program plan to ensure that timelines are met and that the report endorsement process is clear and transparent. The grantee will be the party responsible for obtaining endorsement of the report, which will require that they work in close collaboration with CHCF and the content consultant. The grantee will provide input to CHCF during the selection process for the content consultant. The grantee should include adequate time in the project budget to collaborate with the content consultant.

IV. Project Activities, Deliverables, and Timeline

There are four major components of the project activities for which this grantee will be the project lead:

1. Project management and evaluation
   1. Grantee will be responsible for managing the overall project. This will include managing groups and subgroups, coordinating several consultants, and managing timelines. Applicant should indicate their philosophy and approach to project management, the tools they use to manage projects, their approach to ensuring the accountability of third parties, and specific examples of complex stakeholder-involved projects that they have successfully managed.
   2. Grantee will be responsible for the design and implementation of an ongoing project evaluation and improvement plan. This plan should include a process for ongoing stakeholder group feedback and subsequent improvement to ensure that grantee and consultants can make appropriate course corrections and changes to the process, project plan, or structure as necessary. Applicant should include a proposed approach to the evaluation and improvement plan — the types of tools and processes they would use to ensure that there is ongoing, timely feedback and rapid improvement.
2. Convene and actively facilitate a stakeholder group and subgroups
   1. Grantee will design the stakeholder group architecture and group governance process. The grantee will work with CHCF and the content consultant to create the architecture for the stakeholder group, which will include a core group and subgroups. Additionally, the grantee will design a governance process that includes a transparent and clear set of expectations for the endorsement of recommendations. Applicant should address what they perceive to be key considerations for the architecture and governance of the stakeholder group and subgroups. Applicant should provide a sample group architecture (the setup of groups and subgroups) and offer potential approaches to the endorsement of recommendations (incremental endorsement, processes for dissent, etc.)
   2. Grantee will be responsible for overseeing the endorsement process and for ensuring that all parties are engaged in the project. Applicant should address how the endorsement process could work and how they would work with the content consultant to ensure alignment between the report content and the endorsement process and outcome.
   3. Grantee will plan and facilitate stakeholder group and subgroup virtual meetings and in-person convenings during the project period. Applicant should indicate the anticipated numbers of stakeholder group and subgroup meetings, including an estimate of how many would be in-person convenings versus virtual meetings. There should be a maximum of 16 meetings with no more than 8 held in person, including subgroup meetings. All in-person meetings would be held in California, and reimbursement should be available to participants who request it. This should include reimbursement for travel for all in person meetings and for one night of hotel for any meetings that are longer than one day. Two-day meetings should be minimized, both out of consideration of participant time and to ensure that the budget is maximized. Applicant should address their approach to and philosophy of group facilitation, including building and maintaining trust and creating an inclusive process. Applicant should provide one or two examples of similarly multifaceted group processes they have successfully helped facilitate.
   4. Grantee will coordinate and deploy stakeholder group education and support. The grantee will make every effort to ensure that all members of the stakeholder group are supported to be active participants, directly and indirectly. It is critical that group members have a shared understanding of a variety of topics. This process of education and support might include pre-meetings and preparatory sessions, webinars to provide background information for fuller participation at stakeholder meetings, pre-meeting assignments, etc. Outside experts from around the country will need to be engaged to deliver webinars or to speak in person. The content consultant will be actively engaged in identifying and recommending expert speakers for stakeholder meetings in partnership with the grantee. Logistics, agendas, and facilitation will be the responsibility of the grantee.
3. Develop and implement the project strategic communications plan. Grantee will be responsible for designing and executing a strategic communications plan. The plan should include ongoing communication considerations and strategies for both the stakeholder group and for external audiences (e.g., entities, individuals, or policy champions) who may, ultimately, play a role in successful implementation of the recommendations. The plan should also include report dissemination strategies. Applicant should articulate their approach to and expertise around strategic communications and should cite an example of strategic communications they have deployed related to successful policy initiatives, ideally, in California. Applicant should address what they perceive to be key communications considerations for this project and the tools they might recommend using to effectively execute the communications plan (e.g., social media, web, email, in-person briefings, one-on-one meetings).
4. Convene funders. There are multiple funders working to build a diverse health workforce through complementary strategies. As such, there may be an opportunity to coordinate this work with other interested funders. Grantee will be responsible for coordinating between two and four funder meetings (two in person, two virtual) as necessary. Applicant should articulate their experience working on multifunder collaboratives, lessons learned, and any related considerations for this project.

The grantee will also be responsible for thought partnership and for high-level project management for the components of the project outlined below. The project budget should include adequate time to coordinate and partner with CHCF and consultants on these activities. Applicant should articulate how they would effectively carry out their collaborative and oversight role for the following activities:

5. Support stakeholder participant selection process. Grantee will work closely with CHCF to identify the criteria and process for identifying and selecting the stakeholder group and subgroups. This process will be executed by CHCF. The grantee may be asked to give input on the applicant pool (to ensure alignment with the proposed architecture) and on the solicitation and selection processes. The stakeholder group will include a balance of representatives from CHW/P training programs and institutions, CHW/P advocacy organizations, employers, health centers, hospitals, academic institutions, health plans, and individuals representing the CHW/P workforce.
6. Provide input and thought partnership on stakeholder financial support. Grantee will work closely with CHCF to design a process of direct financial support for more grassroots CHW/P entities to enhance their organizational ability to participate actively in the stakeholder project. This grantmaking process would be managed and deployed by CHCF.
7. Coordinate with the content consultant who will publish the final report and recommendations. The content consultant will be responsible for developing a final report that represents the deliberations of and recommendations proposed by the stakeholder group. This report will provide the evidence and the legal, technical, and policy background necessary for the report to be immediately actionable. Grantee will coordinate closely with the content consultant to carefully consider the timing, phasing, content, and audiences for this report to maximize the likelihood of successful implementation. Grantee will be responsible for shepherding the endorsement of the report. Grantee may be responsible for developing communications products based on the report that are presented in an amenable and accessible form to diverse audiences.

V. Deliverables

Below is an outline of the project deliverables for each project activity outlined above.

Project Activity	Deliverables
Project manage and evaluate	Detailed project plan Documented process improvement and evaluation plan Final, high level evaluation report outlining overall project learnings and recommendations for future efforts
Convene and actively facilitate a stakeholder group and subgroups	Documented stakeholder group and subgroup architecture including structure, members, governance, decisionmaking authority and endorsement responsibility, group charters, roles/responsibilities, etc. Meeting schedule and locations Meeting materials including agendas and minutes and all supporting documents Documented plan for stakeholder education (subject matter, schedules, and speakers) developed with the active engagement of the content consultant Supporting documents for all pre-meetings, preparatory sessions, and webinars Endorsement process and timeline (e.g., initial high-level recommendations, draft report, final report) endorsed and agreed upon by the content consultant Stakeholder endorsement of the recommendations and of the final report
Employ strategic communications	Documented strategic communications plan for stakeholder group and external audiences Communications infrastructure and supporting documents (e.g., web pages, blog posts, mailing lists, collateral materials, etc.) Communications collateral including project microsite (hosted by CHCF or by grantee), two blog posts, up to five presentations to nonstakeholder external audiences (one out of state and four in California) and two or three presentation decks, two or three additional communications pieces (one to two pages each) based on content in the final report
Convene funders	Participating funder list Meeting materials including agendas, minutes, outline of next steps/follow-up, and all supporting documents
Coordinate with content consultant and CHCF on items 5–7 above	Thought partnership and suggested names/organizations for stakeholder group and subgroups Two or three rounds of documented review of the recommendations report for both the draft and final versions Thought partnership on grantmaking process for grassroots stakeholder group participants

VI. Suggested Timeline

Activity	Timeline
Grantee selected	January 2020
Content expert / report author selected	February/March 2020
Stakeholder group convened and project launched	May/June 2020
Preliminary endorsement by stakeholders of key concepts	October/November 2020
Endorsement of draft report	March 2021
Final report release and dissemination	September 2021

VII. Budget

The proposed budget for this project is $600,000. Grantees should include bids consistent with completing all work described in the activities and timeline section above. However, applicants can propose how additional funding (up to $150,000) could support a more robust stakeholder process and the costs and benefits of those additions.

VIII. Core Competencies

The following core competencies have been identified. The diversity of competencies required for this project may require a partnership (e.g., two entities applying together or one primary entity with multiple subcontractors) to maximize the likelihood of success.

1. Facilitation
   1. Seen as a neutral facilitator
   2. Experience successfully facilitating complex stakeholder processes and building trust among, and with, stakeholders
   3. Facilitates with an equity lens, welcoming and soliciting diverse perspectives
2. Project management and oversight
   1. Demonstrated success in managing complex projects and processes including, but not limited to, coordinating travel, logistics, food, lodging, subcontracts, agendas, preparation materials, etc.
   2. Excellent project management skills and strong tools for project management
   3. Demonstrated ability to partner with multiple entities (e.g., content expert / report writer) to achieve common project goals and create shared accountability
3. Strategic communications
   1. Experience producing or coordinating the production of communications content (e.g., videos, policy briefs, microsite, social media)
   2. Experience developing and executing communications strategies for projects — ideally, in the California policy arena

IX. Proposal Packet

Include the following materials in the proposal packet:

1. Proposal cover sheet (available at http://www.chcf.org/grantinfo/solicited). This does not count toward the 10-page limit.
2. Proposal narrative. The proposal narrative should be no more than 10 pages of text, single-spaced, in a 12-point font. Applicants are expected to honor the space limitations. The proposal narrative should describe:
   1. Overall project design and approach (recommend four to five pages). In your proposal, please discuss the approaches you would use to complete the activities outlined in Section IV of this RFP. We welcome unique approaches to this work that build on the strengths and capabilities of the applicant. Please address the applicant questions noted in Section IV.
   2. Work plan for the project (recommend one to two pages). Please develop a high-level workplan and describe responsibilities, time frames, and deliverables based on the activities described above. You may use the activities and timeline presented in Sections IV and V as a starting point.
   3. The challenges you see in this work and how to address them (recommend one-half to one page).
   4. The qualifications, capacities, and roles of your key team members (recommend one to two pages). Describe each team members’ relevant experience. Why are you the best team to conduct this work? Who will conduct each of the project activities? It is strongly encouraged that grantee should be able to identify all the people in project leadership roles at the point of submission and be able to reasonably guarantee that they would remain consistent if the grant were awarded. Subcontracting: Grantees may subcontract as appropriate and should include the qualifications of proposed subcontractors to the degree they are known at the point of proposal submission. If subcontracts are included, the budget should demonstrate a reasonable balance of core staff to subcontractors in order to provide appropriate subcontractor oversight. Additionally, core staff should be responsible for the primary coordination with the content expert / report writer.
   5. Plan for meaningful inclusion of community health workers and promotores (recommend one-half to one page). How will grantee incorporate CHW/Ps in a way that honors the spirit of the American Public Health Association recommendation for CHW/P inclusion?
3. Appendices. Appendices do not count toward the 10-page limit.
   1. Brief bio-sketch or CV. Include a brief bio-sketch or CV for all key team members.
   2. Budget form and budget narrative description. Please submit a detailed budget and budget narrative for the entire length of the project. Line item and time/materials budget forms are available at http://www.chcf.org/grantinfo/solicited/. How would you allocate the budget among your suggested project components? Specify major budget categories such as staff, travel, data collection/analysis, strategic communications, meeting management, collaboration with partner consultants, subcontracts, and indirect costs. The budget form and budget narrative should cover the budget of $600,000. If you are proposing an additional budget (up to $150,000), submit a separate budget form and narrative for this add-on budget outlining the budget categories and costs. Your narrative should include the benefits of the additional funding.
   3. If available, links to samples of related work or projects. If examples of other similar projects or work (websites, published reports/findings as outcomes of larger stakeholder input processes, strategic communication plans, etc.) are included, please be clear which members of the proposed project team worked on those projects.
   4. References. Please include the names, email addresses, and phone numbers of two or three references. Please provide a two- or three-sentence project description for each reference to provide context for their work with you.

X. Proposal Submission

Proposals must be delivered by email in one PDF or Microsoft Word file, to Lauren Vandam, program associate, no later than November 5, 2019, at 5 PM Pacific. Proposals will be acknowledged by a return email within 24 hours. Hard copies will not be accepted.

XI. Stakeholder Calls

CHCF will hold one bidders conference call on October 10 at 11:30 AM to answer questions about the RFP and the project in general for any applicants. The call will be recorded and made available on CHCF’s website.

Please register for the bidders call by emailing your name and organization name (if applicable) to Lauren Vandam.

XII. Selection Criteria and Timeline

The grantee selection committee will make its selection using the following criteria to assess proposals:

• The strength of the applicant’s narrative response
• The strength of the applicant’s experience as it relates to the core competencies in Section VIII
• A staffing/consulting/stakeholder group plan that is reflective of the cultural and linguistic diversity of the CHW/P workforce
• Appropriateness of the proposed budget(s)
• Preferred: Some knowledge of the California health care and policy landscape and of the CHW/P space.

CHCF will not provide individual critiques of proposals submitted.

The timeline for the proposal process is:

Activity	Timeline
RFP released	October 1, 2019
Bidders conference	October 10, 2019
Full proposal due	November 5, 2019
Finalist interviews	December 4, 2019
Recipient announced	December 13, 2019
Project begins	January 2020

Please note that we will be holding interviews for finalists on December 4, 2019, so please hold this date for your team members to be available.

XIII.  For More Information

For questions about the project or the proposal submission process, review this list of FAQs, or contact Melissa Schoen.

NOTE: Applicants for this RFP may be eligible to fill the content expert role as well. Alternatively, there may be applicants who do not apply for this RFP but are interested in the content expert role. For those who are interested in receiving the content expert RFP when announced, please email Lauren Vandam.

1. The Amer. Public Health Assn. definition: A community health worker is a frontline public health worker who is a trusted member of and/or has an unusually close understanding of the community served. This trusting relationship enables the worker to serve as a liaison/link/intermediary between health/social services and the community to facilitate access to services and improve the quality and cultural competence of service delivery.
2. J. Nell Brownstein and Catlin Allen, Addressing Chronic Disease Through Community Health Workers: A Policy and Systems-Level Approach, 2nd ed., Centers for Disease Control and Prevention, April 2015, http://www.cdc.gov/dhdsp/docs/chw_brief.pdf (PDF).