Request for Proposal for HIV Alternative Testing Site Expansion
//
Santa Clara County
Public Health Department
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A division ofSanta Clara Valley Health & Hospital System
Request for Proposal
The Santa Clara County Public Health Department HIV/AIDS Prevention and Control Program
(HAP)is currently seeking proposals to expand HIV alternative testing sites in Santa Clara
County. The goal is to make rapid testing accessible to Santa Clara County’s most at-risk
populations. The Department will fund a maximum of five (5) community-based organizations
(CBOs)to provide rapid HIV testing and counseling with the minimum required standards
stipulated by the California Department of Health Services(CA DHS)and the Centers for
Disease Control and Prevention(CDC). These standards are presented in the CBO HIV
Alternative Testing Sites Work Plan (Attacliment A). The standards have been incorporated as
necessary “starl-up ” infrastructure development that selected community-based organizaiiuns
will need to have in place prior to beginning HIV testing.
A total of$300,000 will be made available to those organizations that can most effectively
address HIV testing expansion funding priorities, preferred capacities, and requirements in their
proposals. The contract period will be November 1, 2006 to October 31, 2007. To be eligible, an
organization must be a public or private nonprofit organization that is classified as 501(c)(3) tax
exempt under the Internal Revenue Code. An RFP information meeting is scheduledfor
September 8, 2006, 3:00p.m. to 5p.m., at 770 S. Bascom, Room 136. The deadline for
proposals is 5 p.m. on September 20, 2006.
This Request for Proposal(RFP) is organized as follows:
I. Background
II.
III.
IV.
V.
VI.
VII.
VIII.
Local HIV Data
CDC Best Practices Based on Science and Evidence-Based Approaches
HIV Testing Expansion Funding Priorities, Preferred Capacities, and Requirements
Application Process
County Contract Requirements
Proposal Deadline
Selection Criteria
IX. Appeals/Objections
X. RFP Attachments
L Background
Santa Clara County’s plan to expand HIV alternative testing sites and identify more residents
who are HIV+ is important for many reasons. In the past, an HIV+ diagnosis was a death
sentence—typically within five years due to fatal opportunistic infections. This is no longer true.
Today, county residents with HIV can expect to live much longer with appropriate medication
and proper care. As HIV+ status evolves into a more manageable chronic condition and greater
numbers of people are living with HIV/AIDS, there is a greater chance of more residents
becoming infected. In addition to the number of residents with HIV/AIDS who have currently
been identified, the CDC estimates that approximately 25% of persons with HIV/AIDS are not
aware of their diagnosis. And, evidence suggests that as many as two-thirds of the new HIV
infections each year occur through transmission from persons who are unaware of their HIV+
status.' The incidence and spread of the disease will not be curtailed until barriers to early
diagnosis are reduced. Expansion of HIV alternative testing sites will address barriers to early
diagnosis and provide referrals to HIV+ residents, who will benefit from access to appropriate
medication and proper care.
As more residents become aware of their HIV-H status, there will be greater need for appropriate
medication and care. The Ryan White Care Act provides critical support for Santa Clara
County’s continuum of HIV/AIDS care, which includes primary medical care, case management,
mental health services, oral health care, food, transportation, substance use/abuse treatment, and
other services for county residents diagnosed with HIV/AIDS. At this time, changes in the
funding formula are moving toward a formula based on the total number of persons living with
HIV/AIDS. Increasing identification of HIV+ individuals in Santa Clara County will protect
current funding and will likely result in additional resources for HIV/AIDS services through
Ryan White and other similar formula-driven grants. These resources will be needed as more
residents are identified as HIV+ through the expansion of HIV alternative testing sites.
Board ofSupervisors Budget Allocation and Requestfor Implementation Plan
On June 6, 2006 the Board of Supervisors approved a one-time budget allocation of $375,000 for
FY 2006-07 for expansion of HIV testing and counseling sites for targeted at-risk populations in
Santa Clara County. The purpose of this allocation is to address gaps and barriers to the
continuum of HIV/AIDS services in the county by(1)Expanding testing and counseling sites to
targeted communities;(2) Expanding availability of rapid testing;(3) Expanding outreach and
counseling by increasing the number of certified counselors; and (4) Continuing to work with
medical providers regarding reporting requirements via the Department’s Surveillance Unit. The
Health and Hospital Comrhittee recommended that $75,000 of the $375,000 go to the Public
Health Department for administrative costs and for campaign marketing costs to maximize
awareness of the availability of expanded HIV testing.
1
CDC,“Advancing AIDS Prevention, AHP Overview, Interim Technical Guidance for Selected
Interventions, Introduction,” http://www.cdc.gov/hiv/topics/prev_prog/AHP/resources/guidelines
/Interim-Guidance.htm (accessed 7/2006).
2
At that time, the Public Health Department was asked to submit an implementation plan for
review by the Health and Hospital Committee. In response, the Public Health Department
developed an implementation plan for alternative rapid HIV test sites that reflects the voice of
the community. Public Health participated in several meetings with representatives of the HIV
Planning Council and Community Planning Group. Their priorities and concerns are
incorporated throughout the implementation plan, which was developed in coordination with
both groups. The plan is also consistent with the Santa Clara County Comprehensive Planfor
HIV/AIDS Services 2006-2008 and the Santa Clara County HIV Prevention Plan 2006-2008.
Implementation Plan Goal and Prioritiesfor Target Populations and Geographic Areas
The goal of the HIV Testing Expansion program is to reduce the prevalence and incidence of
HIV/AIDS through testing, counseling, and referral to care and treatment of residents who are at
risk of HIV/AIDS by 1) increasing the number of certified test counselors in the community, and
2) conducting a minimum of6,944 tests in the target population, 2% of which will test positive
for HIV antibodies (140 positive results).
Priority Populations for Expanded HIV Alternative Testing Sites are:
■ Men who have Sex with Men(MSM)
■ Females who have Sex with Men who have Sex with Men(FSMSM)
■ Transgender persons who have Sex with Men(TSM)and Transgender Injection Drug
Users(IDU)
■
IDU and MSM-IDU
Groups identified among priority populations for expanded HIV testing are:
■ People of Color
■
Sex Workers
■
Youth
Geographic Area Priorities are:
■ City of San Jose, where the HIV/AIDS epidemic continues to be concentrated.
■ North County (Sunnyvale, Mountain View, Palo Alto and Los Altos), where the next
highest percentage of reported HIV cases is.
■ South County, which has the smallest number of reported HIV cases to date, but isolation
and limited access to services create challenges that need special attention.
Approval ofthe HIV Alternative Testing Sites Implementation Plan
The implementation plan was submitted to the Health and Hospital Committee on August 16,
2006. The Health and Hospital Committee accepted the plan and forwarded a positive
recommendation to the Board of Supervisors. The Board of Supervisors approved the plan on
August 29, 2006.
The Public Health Department’s HIV/AIDS Prevention and Control Program(HAP) will
administer these funds and provide technical assistance to and coordination for the CBO
alternative testing and counseling programs.
3
II. Local HIV Data
From July 2002 through March 2006, 1008 people in Santa Clara County have been diagnosed
H1V+. Nine hundred ninety six (996) are alive. The following tables were prepared by the Santa
Clara County Publie Health Department, Data Management and Statistics.
Gender
Male
Female
Number
%
861
Number
Total*
%
130
86.4
991
13.1
Race/Ethnicity
African
White
Asian/Pacific
American
Number
%
497
Number
52.0
96
Islander
Hispanic
%
Number
310
10.1
%
Total*
%
Number
32.5
52
955
5.4
Age Group
0-12
13-19
20-29
30-39
40-49
50-59
60+
Total*
Number/%
Number/%
Number/%
Number/%
Number/%
Number/%
Number/%
Number
7/0.7%
19/1.9%
276/27.9%
404/40.8%
201/20.3%
68/6.9%
16/1.6%
991
Mode of Exposure and Gender
Mode of
Total
Male
Female
Exposure
Number/%
Number/%
Number/%
630/63.6%
MSM
630/73.2%
0/0.0%
IDU
56/5.7%
39/4.5%
17/13.1%
MSMTDU
61/6.2%
61/7.1%
0/0.0%
127/12.8%
47/5.5%
80/61.5%
102/10.3%
80/9.3%
22/16.9%
15/1.5%
4/0.5%
11/8.5%
991/100%
861/100%
130/100%
Heterosexual
Contact
Risk Not
Specified
Other
Total*
Mode of Exposure and Race/Ethnicity
Asian/Pacific
African
Mode of
Total
White
American
Hispanic
Islander
Exposure
Number/%
Number/%
Number/%
Number/%
Number/%
MSM
630/63.6%
370/74.4%
32/33.3%
190/61.3%
29/55.8%
IDU
56/5.7%
33/6.6%
11/11.5%
12/3.9%
0/0.0%
MSM/IDU
61'6.2%
33/6.6%
5/5.2%
21/6.8%
2/3.8%
127/12.8%
28/5.6%
29/30.2%
57/18.4%
12/23.1%
Specified
102/10.3%
26/5.2%
16/16.7%
27/8.7%
7/13.5%
Other
15/1.5%
7/1.4%
3/3.1%
3/1.0%
2/3.8%
991/100%
497/100%
Heterosexual
Contact
Risk Not
Total*
96/100%
310/100%
52/100%
4
HIV
City
Number/%
San Jose
617/64.7%
Santa Clara
60/6.3%
Mountain View
53/5.6%
Sunnyvale
Campbell
50/5.2%
29/3.0%
Palo Alto
29/3.0%
Milpitas
20/2.1%
Gilroy
18/1.9%
Los Gatos
17/1.8%
Missing
17/1.8%
Los Altos
12/1.3%
Cupertino
Morgan Hill
Saratoga
10/1.0%
8/0.8%
Los Altos Hills
1/0.1%
10/1.0%
Stanford
1/0.1%
Total*
954/100%
* The total does not equal 996 in the tables above because information was not recorded or numbers were
too small to maintain confidentiality (e.g., for Native Americans).
III. CDC Best Practices Based on Science and Evidence-Based Approaches
The HIV Planning Council, HIV Prevention Community Planning Group, and the HIV/AIDS
Prevention and Control Program are committed to promoting and supporting the most promising
practices in HIV testing and counseling. All programs funded by the Public Health Department
must incorporate promising practices and operate with established standards of care that are
consistent with national and local standards.
Advancing HIV Prevention. The Centers for Disease Control and Prevention(CDC)announced
a major new initiative to reduce new infections of HIV in the United States in April 2003. This
initiative. Advancing HIV Prevention: New Strategiesfor a Changing Epidemic (AHP), is
comprised of four strategies to address and meet the needs of all persons who are at increased
risk for HIV. The rationale for this new initiative was that despite much success in the
prevention of HIV infection, the current reality is that an estimated 40,000 new HIV infections
are still occurring in the United States each year, there has been an increase in racial/ethnic
disparities in the last 25 years, and an estimated 25% of persons living with HIV do not know
they are infected and are at considerable risk for developing AIDS and unknowingly transmitting
HIV.2
One of AHP’s four strategies is to implement new modelsfor diagnosing HIV infections outside
medical settings, the focus of the implementation plan for expansion of HIV testing sites. HIV
^ CDC,“Evolution of HIV/AIDS Prevention Programs: United States, 1981-2006,” MMWR 55,
21,(June 2, 2006): 597-603.
5
testing programs in nontraditional settings are more likely to reach some racial/ethnic minorities
and persons who report increased risk for HIV, but do not have access to medical care. The rate
of positive test results in non-traditional settings is generally higher compared with conventional
test sites in medical settings. The recently approved rapid HIV tests can be done outside of a
traditional laboratory setting. They reduce the time it takes to process tests from two weeks to 20
minutes.^ This advance in HIV testing technologies provides Santa Clara County with the
opportunity to effectively create alternative HIV testing sites to reach residents who are most at
risk for being infected with HIV and to increase the number of at-risk residents who know their
HIV status. This strategy emphasizes the use of proven public health approaches to reducing the
incidence and spread of disease and utilizes the most current HIV testing technologies.
There are two CDC AHP demonstration projects that can serve as models for Santa Clara
County’s alternative testing sites: Rapid HIV Testing in Nonclinical Settings and Using Social
Network Strategies to Reach Persons at High Riskfor HIV Infection in Communities ofColor.
For the Rapid HIV Testing in Nonclinical Settings demonstration project, CDC provided
funding for eight CBOs based in six cities; Boston, Chicago, Detroit, Kansas City, Los Angeles,
and Washington, DC. The CBOs provided rapid HIV testing in nonclinical settings, such as
parks and bars. As of June 2005, 17,149 persons had been tested for HIV and 249 had received
confirmed positive results. The positivity rate was about 1.5%. Further information on this
initiative can be found at:
http://www.cdc.gov/hiv/topics/prev_prog/AHP/resources/guidelines/Interim-rapidtest.htm.
For the Using Social Network Strategies to Reach Persons at High Riskfor HIV Infection in
Communities of Color demonstration project, CDC funded nine CBOs in seven cities: Boston,
Lafayette (LA), New York City, Orlando (FL), Philadelphia and San Francisco. This strategy is
based on the concept that individuals are linked together to form large social networks and that
infectious diseases often spread through these networks. It is a programmatic, peer-driven,
recruitment strategy that is employed in conjunction with HIV testing and counseling. Through
October 2005, the CBOs’ 408 recruiters had persuaded 2,878 persons in their social, sexual, or
drug-using networks to get tested for HIV. 160 of these network associates were confirmed as
HIV+(with a positivity rate of 5.6%), which is five times the average prevalence reported by
publicly funded counseling, testing and referral sites. Further information on this initiative can
be found in the June 24, 2005, Morbidity and Mortality Weekly Report and at
http://www.cdc.gov/hiv/resources/guidelines/snt/pdf/SocialNetworks.pdf
The following are the Santa Clara County HIV Prevention Plan 2006-2008 program
recommendations based on CDC best practices for HIV/AIDS prevention that are applicable to
the alternative rapid test site funding.
^ CDC,“Questions and Answers: The Science Behind the New Initiative,” September 2003,
http;//www.cdc.gov/hiv/topics/prev_prog/AHP/resources/qa/AHP_Science.htm (accessed
7/2006),
6
■
Use a risk behavior model—targeting populations based on the behavior that puts them at
high risk for HIV infection—for HIV prevention and rapid testing. The following are
priority populations and sub-populations based on high-risk for HIV infection.
Priority Populations
TSM & Transgender IDUs
(Men who have Sex
(Females who have
(Transgender persons who
with Men)
Sex with MSM)
have Sex with Men)
Priority Sub-Populations for Access to Testing;
■ People of Color
■ Methamphetamine Users
MSMs
■
FSMSM
■
Sex Workers
■
Youth
IDUs and MSM-IDUs
(Injection Drug Users)
Ensure that alternative test sites provide Counseling, Testing, and Referral(CTR), a riskreduction counseling model conducted with HIV testing. CTR is a personalized, clientcentered encounter in which individuals can learn their HIV status. In addition, the counselor
helps the client identify and acknowledge personal HIV risk behaviors and commit to a
single, achievable behavior change step that could reduce the client’s HIV risk.
With rapid testing, a positive result is considered a preliminary positive. Whenever a client
has a preliminary positive result, a confirmatory test is needed and the confirmatory test or a
referral for one should be given at that time. When a high degree of trust is developed and
tests results indicate a preliminary positive, the counselor should also explore partner
notification. Relevant Standards and Guidelines for CTR include:
■
o
CDC’s Revised Guidelines for HIV Counseling, Testing, and Referral, 2001
(http://www.cdc.gov/hiv/testing.htm)
o
CDC’s Quality Assurance Guidelines for Testing Using the OraQuick Rapid
HIV-1 Antibody Test, 2003 (http;//www.cdc.gov/hiv/rapid_testing/)
o
California Department of Health Services, Office of AIDS, HIV Counseling
and Testing Guidelines, 1997(http;//www.dhs.ca.gov/ps/ooa/)
o
California Department of Health Services, Office of AIDS, Supplement to the
HIV Counseling and Testing Guidelines, 1997- OraQuick Rapid Testing in
Counseling and Testing Settings, 2003 (http://www.dhs.ca.gov/ps/ooa/)
Provide Outreach at community venues where and at times when priority populations and
sub-populations are most accessible. The purpose of outreach in context of this funding is to
recruit individuals into CTR. Examples of community venues where and times when priority
populations and sub-populations are most accessible for outreach and CTR that have been
identified are;
o Venues: gay bars, adult bookstores, head shops, parks or public sex environments,
areas frequented by injection drug users, and areas frequented by sex workers—
transgender MTF(male to female) and heterosexual females—near gas stations,
convenience stores, and in parks in East San Jose. Additional venues include
7
Needle Exchange Program sites, homeless shelters, and chemical dependency
programs.
o
Times: late night and weekend hours.
■
All CTR and Outreach will be culturally competent and appropriate for the intended
population. Staff and volunteers should reflect the broad range of languages spoken in Santa
Clara County.
■
Make free condoms available with all prevention and testing services. CDC and CPG
support a harm reduction approach to HIV prevention in which clients and community
members are encouraged to engage in safer sexual practices.
■
Work collaboratively^ by providing linkages and referrals, a core component of effective CTR
and outreach. The HIV epidemic exists in the context of a host of other health and social
issues, including poverty, homelessness, substance abuse, mental health, incarceration,
immigration, and sexually transmitted diseases that are compounded by deep-rooted social
problems and inequities, such as, racism, homophobia, and gender inequality. HIV
alternative test site providers must be familiar with the multiple needs of the individuals and
communities they serve and attempt to address these needs through a network of providers to
which they can refer and link their clients.
■
Design and implement cost-effective programs. Cost-effectiveness is often thought of in
terms of cost savings.| An example would be the costs that would be avoided if the estimated
25% of persons living with HIV and not knowing they are infected received testing and knew
their HIV status so that, if they were HIV-H, they could reduce their risk for developing AIDS
and of unknowingly transmitting HIV to others. Cost-effectiveness is also making use of
community volunteers when they can effectively reach target populations. Successful
volunteer testing programs, such as the San Francisco Department of Public Health’s, can
serve as models for replication.
A copy of the Santa Clara County HIV Prevention Plan 2006-2008 is available at
http://www.sccgov.org/SCC/docs/SCC%20Public%20Portal/keyboard%20agenda/Committee%2
0Agenda/2006/February%208,%202006/TMPKeyboard201387529.pdf
IV. HIV Testing Expansion Funding Priorities, Preferred Capacities, and Requirements
The Santa Clara County Public Health Department funding for HIV Alternative Testing Site
Expansion is a one-time l|udget allocation to expand rapid HIV testing in Santa Clara County.
The goal is to make rapid testing accessible to Santa Clara County’s most at-risk populations.
Funding Priorities:
•
Rapid testing sites will be accessible to/target the most at-risk populations in the county
(MSMs, MSM Methamphetamine users, FSMSMs,IDUs, MSM-IDUs, Transgender IDUs
8
and TSMs)and the following sub-populations within each target population (people of color,
sex workers, and youth). HIV Outreach and testing sites will be:
o in locations and during hours that will most effectively reach these at-risk
populations,
o in the San Jose area, where the HIV/AIDS epidemic is concentrated, as well as in
north county, which has the next highest percentage of reported HIV cases, and in
south county, where isolation and access to services is a challenge,
o implemented on a consistent schedule to capitalize on word-of-mouth as residents
become familiar with the service.
■
The HIV/AIDS Prevention and Control Program(HAP) will coordinate testing site locations
and schedules. CBOs may be asked to change sites and/or locations based on the need for
testing of all priority populations or due to changes identified through analysis of HIV/AIDS
data by Public Health Department(PHD)epidemiologists.
■
History as a recipient of HIV Education and Prevention Funding within the last three years is
preferred due to the complexity of setting-up and operating an HIV alternative testing site.
■
For interested CBOs that do not have a history as a recipient of HIV Education and
Prevention Funding, partnership/collaboration with a previous recipient of this funding to
apply for these funds is encouraged.
■
Collaboration among agencies in applying for these funds—with the goal of having the most
effective staff working with priority populations—is encouraged.
Preferred Capacities:
■
Culturally competent and appropriate outreach, testing and counseling for the county’s
populations most at-risk and in communities prioritized in this implementation plan.
■
Demonstrated access to and established trust with targeted high-risk populations.
■
Effective collaboration with care and support services for HIV/AIDS clients.
■
Capacity for effective health education dissemination.
■
Strategies as cost-effective as possible, such as, making use of community volunteers as test
technicians and counselors when they can effectively reach the target population.
Requirementsfor Alternative Testing Sites:
■
All Alternative Testing Sites operated by funded-CBOs will use Rapid Testing technology to
provide voluntary, anonymous and confidential free or low cost($5) HIV testing. Test kits
will be provided at no cost by HAP.
9
■
All testing sites will operate in compliance with relevant state and local regulations and CDC
guidelines applicable to HIV Rapid Testing. HAP will provide technical assistance to CBOs
in preparing Alternative Testing Sites. Requirements are presented in the CBO Alternative
Testing Sites Work Plan (Attachment A).
■
All testing and counseling staff will be certified after participating in training provided by the
State Office of AIDS, which is available at no cost, and maintain up-to-date certification.
■
Collect data as required by HAP (e.g., the HIV Counseling Information Form, Lab Slips, and
Testing Consent Forms for all clients; HIPAA consent for confidential clients; and any
additional recordkeeping required by HAP and Public Health Laboratory).
■
All funded CBOs will commit to participating in the program evaluation. PHD will perform
the evaluation based on the HIV Testing Expansion Evaluation Plan (Attachment B).
V. Application Process
1. Complete and attach the “Application Coversheef’(Attachment C).
2. Proposal Narrative: Describe the following in a maximum of five (5) double-spaced
pages.
a. Organization Overview and Capacity. Describe your organization’s past experience:
■ Working with HIV/AIDS clients.
■ Working with the priority population(s).
■ Working in the priority geographical area(s) where the priority population(s) are
most accessible.
■
■
Providing health education.
Setting-up and operating complex programs relevant to an HIV alternative
testing and counseling site,
b. Describe how your organization will address funding priorities, preferred capacities,
and requirements presented in Section IV, including:
■ Target population(s).
■ Specific location(s) within priority geographic areas.
■ Proposed outreach and testing/counseling sites and schedules with rationale
for selection of site(s) and schedule(s).
■ Proposed staffing and why they will be effective in reaching proposed target
population(s).
■ Approach to setting-up and operating an HIV alternative test site(s).
3. Complete the Scope of Work Template (Attachment D).
4. Submit budget and budget narrative (Attachment E). Indirect expenses can equal no
more than 10% of the total project budget.
10
Please Note; Successful bidders will not be funded for provision of services that are
concurrently funded by other sources.
5.
Provide resume(s)/job description(s) of personnel responsible for implementation of the
proposal.
6.
Provide proof of insurance coverage as required in Section VI of this proposal
(Attachment F).
7.
Review Confidentiality of Patient Information (Attachment G). You may sign it and
include it with your proposal, but this is not required.
VI. County Contract Requirements
A. Contractual Requirements.
Applicants may submit only one(1) proposal. The successful bidder must comply with
County contractual requirements, including: indemnification and insurance provisions.
County Contracting Principles, non-discrimination provisions, client confidentiality, and
other contract provisions included in the “Service Agreemenf’(Attachment H). Proof of
insurance coverage for requested funding, based on requirements in Attachment F,
must be provided with the proposal.
Requirements for evaluation will be included in the “Service Agreemenf’ and will include
collection of all required data (e.g., the HIV Counseling Information Form, Lab Slips, and
Testing Consent Forms for all clients; HIPAA consent for confidential clients; and any
additional recordkeeping required by HAP)and commitment to participating in the Public
Health Department’s evaluation of the HIV testing expansion program (Attachment B). All
projects will be in effect from the date the Agreement is executed through October 31, 2007.
B. County Rights/Obligations
1. The Santa Clara Valley Health and Hospital System(SCVHHS)reserves the right to
reject proposals, as well as the right to cancel this RFP at any time. The County retains
the right to open this solicitation to additional bidders at any time prior to execution of
tbe final Agreement.
2. Contractor will not be reimbursed for any costs associated with the preparation or
submittal of responses to this RFP.
j.
SCVHHS reserves the right to waive any minor irregularities or informalities in any
proposal and request clarification of information from any bidder.
4. The California Public Records Act set forth in Government Code sections 6250 et seq.
governs access to public records. The Act provides that access to information concerning
the conduct of the public’s business is a fundamental and necessary right of a person in
11
the state. Consequently, all Proposals, attachments and other materials submitted in
response to this RPP are considered public information (except as provided herein) and
become the exclusive property of the County.
5. Notwithstanding the foregoing, no Proposal materials will be released to the public nor
may the public have access to such Proposal materials during the RFP process.
Thereafter, the public will have access to the Proposal materials, as provided in this RFP.
VII. Proposal Deadline
The original plus 10 copies of the completed proposal must be delivered to the Santa Clara
County Public Health Department, Attn: HAP,3003 Moorpark Avenue, San Jose, CA,95128 no
later than 5 p.m., Wednesday,September 20,2006. No exceptions will be allowed. Each
proposal must be in a secured folder, stapled or otherwise secured, and include completed forms
and responses to Attachments C-F. Faxes, electronic copies, incomplete or late submittals will
not be accepted and will be returned to bidders.
Contact the HAP Manager, Kevin Hutchcroft, in writing by e-mail with any questions;
Kevin.Hutchcroft@hhs.CO.santa-clara.ca.us. All questions and responses will be made public to
all vendors on the website: www.sccgov.org/rfp_list.
VIII. Selection Criteria
The Public Health Department will conduct a review of the submitted proposals. The review
may also include interviews of the prospective bidders. A contract will be negotiated with
bidder(s) whose proposal(s) best demonstrates the ability to address funding priorities at a
reasonable cost. The Public Health Department reserves the right to cancel or reopen the RFP
process as it deems appropriate. Notification of the County’s decision will be provided to all
applicants no later than October 2, 2006.
The following review criteria will be applied in the selection process:
Review Criteria
Proposal Narrative (up to 50 points):
Organization Overview and Capacity:
■
■
Presentation and clarity.
Experience and past successes.
■
■
■
■
Capacity to work effectively with the target population(s).
Capacity to work effectively in priority geographic area(s).
Capacity to set-up and operate an HIV alternative testing site(s).
Capacity to provide health education.
Approach to addressing funding priorities, preferred capacities,
Points
0-20
0-30
and requirements:
12
■
■
Presentation and clarity.
Quality of approach/strategies to addressing funding priorities:
■ Target population(s).
■ Locations within priority geographic area(s).
■ HIV Outreach and Testing/Counseling Site(s)
and rationale for selection.
■
■
Proposed staff and ability to reach target population(s).
Setting-up and operating an HIV alternative test site(s).
Scope of Work Template (Attachment D)
0-20
Budget;
■ Proposed budget and budget narrative.
■ Maximum of 10% for indirect cost(s).
0-20
Proposal Attachments:
■ Completed Application Cover Sheet with required signature.
■ Job Descriptions/Resumes for key staff.
■ Proof of Insurance Coverage (see Section V, VI, and Attachment F).
O-IO
Local Preference* Bonus Points
5
*When two or more competing vendors are equally qualified, local firms shall be given
preference.(Board of Supervisor’s policy 5.3.13)
IX. Appeals/Objections
Appeals or objections to a rejection or award under this RFP must be submitted in writing within
five (5) business days of the postmarked notice of award or rejection. Such an appeal or
objection must be specific, identifying the nature of the protest or objection and stating all the
facts that form the basis for the appeal. All reason(s) for the appeal or objection, citing law, rule,
regulation or procedures upon which the appeal is based must be specified. Any appeal or
objection must be forwarded to the County by certified or registered mail or delivered in person,
with proposer obtaining a receipt of delivery, in the time provided herein to the following
address;
Dolores Alvarado, MSW, MPH
Division Director, Community Health Promotion
Santa Clara County Public Health Department
3003 Moorpark Avenue
San Jose, CA 95128
All appeals or objections received after the five (5) business day period described above will be
automatically disallowed and the original decision that is the subject of the protest or objection
will be upheld. All appeals that are timely will be referred to the Director of the Public Health
Department for review and consideration. Applicants submitting appeals or objections will be
13
notified by the Director of the Public Health Department of the decision on any such appeal. The
Public Health Director’s decision on any appeal or objection will be final.
X. RFP Attachments
A.
CBO HIV Alternative Testing Sites Work Plan
B.
HIV Testing Expansion Program Evaluation Plan
C.
Application Cover Sheet
D.
Scope of Work Template
E.
Budget and Budget Justification Template
F.
Insurance Requirements for Standard Service Contracts (Insurance Exhibit B-2A)
G.
Confidentiality of Patient Information
H.
Sample Service Agreement Template
I.
RFP Timeline
14
Attachment A
CBO HIV Alternative Testing Sites Work Plan
Activities
Meet HIV testing certification requirements:
■ Participate in mandatory certification training (60
hours).
■ Participate in annual continuing education
training to keep certificate up-to-date.
■ Perform at least 12 tests per month.
Participate in trainings and meetings as arranged by
HAP.
Identify coordinator for ATS project.
Select Alternative Testing Sites;
■ Identify sites at high-risk venues: gay bars, adult
bookstores, head shops, parks or public sex
environments, areas frequented by injection drug
■
■
Responsible Party
Timeframe
CBO/ATS Staff and
11/2006-1/2007
Volunteers
CBO/ATS Staff and
Ongoing
Volunteers
CBO Administration
11/2006
CBO/ATS Staff
11/2006-1/2007
CBO/ATS Staff
11/2006-1/2007
CBO/ATS Staff
11/2006-1/2007
CBO/ATS Staff
11/2006-1/2007
users, and areas frequented by sex workers—
transgender MTF(male to female) and
heterosexual females—near gas stations,
convenience stores, in parks in East San Jose,
Needle Exchange Program sites, homeless
shelters, and chemical dependency programs.
Assess proposed settings for feasibility of
implementing rapid HIV testing and counseling
(e.g., does the setting have acceptable lighting for
test readability, temperature control, private space
for providing counseling and test results).
Coordinate with the HAP ATS Coordinator to
ensure priority risk behavior and geographic
coverage (San Jose plus north and south county).
■ Create a site plan (locations and schedules).
Develop systems and procedures to ensure client
privacy and confidentiality.
Establish procedures for protecting all client-related
data.
Develop systems and procedures for informed
consent procedures in accordance with local and state
requirements and CDC guidelines.
■ Establish unambiguous and easy to implement
guidelines to define sobriety standards and to
identify chronic mental health conditions that
may interfere with ability to provide informed
consent.
15
Activities (cont.)
Develop a process to document consent for testing
and testing results, and to track specimens sent for
Responsible Party
Timeframe
CBO/ATS Staff
11/2006-1/2007
CBO/ATS Staff
11/2006-1/2007
CBO/ATS Staff
11/2006-1/2007
CBO/ATS Staff
11/2006-1/2007
CBO/ATS Staff
11/2006-1/2007
CBO Staff
1/2007
CBO Staff
2/2007-11/2007
CBO Staff
2/2007-11/2007
confirmatory testing.
Develop a process for obtaining detailed locating
information on clients whose test results are
preliminary positive so that they can be contacted and
encouraged to come in for care if they fail to return
for their follow-up appointment.
Develop a plan to ensure compliance with the
Clinical Laboratory Improvement Amendment
(CLIA) regulations related to HIV rapid testing
(which will be explained in detail at the 9/30 RFP
information meeting) and with relevant state and
local regulations applicable to HIV Rapid Testing.
Refer to :www.cms.hhs.gov/CLIA
Develop a plan for handling infectious waste,
complying with the regulations of the Occupational
Safety and Health Administration, and handling
potential occupational exposures.
Develop a plan to maintain staff and volunteer safety
at settings that may pose a risk to them (e.g., safety
training and taking precautions, such as, working in
teams).
Participate in site visit by Public Health staff(HAP
and Laboratory staff) to confirm readiness to begin
HIV testing (required before testing can begin).
Operate alternative test sites and outreach at high-risk
venues, as coordinated with HAP ATS Coordinator.
■
■
■
Provide HIV testing and counseling to high-risk
clients(MSMs, MSM Methamphetamine users,
FSMSMs,IDUs & MSM IDUs, TSMs, and
Transgender IDUs).
Whenever a client has a preliminary positive test
result, have a system in place for confirmatory
testing (see OraQuick Guidelines).
Provide condoms for prevention (harm
reduction).
Collect Data:
■
Complete the HIV Counseling Information Form
(CIF), Lab Slips and Testing Consent Forms for
all clients; HIPAA consent for confidential
clients; and any additional HAP requirements.
16
I
Activities (cont.)
Manage Referrals;
■
Link with Public Health Laboratory for
confirmatory testing of preliminary positive rapid
Responsible Party
Timeframe
CBO Staff
2/2007-11/2007
CBO Staff
11/2007-12/2007
test specimens.
■
■
Arrange linkages with medical and social
referrals for comprehensive follow-up.
Develop procedures for making referrals,
assisting clients with getting to referrals, and
confirming that referred clients acted on the
referrals and received, or are receiving, services
as a result of the referral.
Participate in Public Health Department evaluation.
17
Attachment B
HIV Testing Expansion Program Evaluation Plan
FY 08
Program Name
HIV Rapid Testing and Counseling Expansion Implementation Plan
Target Population
Residents of Santa Clara County who are High Risk Population for HIV/AIDS:(1) men who have sex with
men(MSM),(2) MSM Methamphetamine users,(3) Female partners of MSM (FSMSMs),(4)Intravenous
Drug Users(IDUs) and MSM IDUs,(5) Transgender IDUs and TSMs.
Problem Statement
Increasing rates of HIV infection in several identified populations are posing threat to the public health of
Santa Clara County. Both CDC and local estimates indicate about 25% of those living with HIV/AIDS are
unaware of their diagnosis. In Santa Clara County, there are an estimated 879 persons who are living with
HIV/AIDS who are unaware of their diagnosis. The local positive rate for testing at the Public Health
Department Laboratory is 1.67%, while the statewide average positive rate is 2.6%. The local positive rate for
MSM is 2.4-4.0%, while the statewide MSM rate is 12-20%.
Overall Program
To reduce the prevalence and incidence of HIV/AIDS through testing, counseling, referral to care and
Goals
treatment to residents who are at risk of HIV/AIDS.
1.
Program
Components
Assessment
2. Outreach
3. Clinical Health Services (Testing, Health Education, Counseling, Treatment)
4. Community Collaboration
Program
Description
Confidential and anonymous testing will be provided at HIV test sites. Rapid testing will be used at locations
where populations at greater risk for HIV/AIDS will be more likely to access services. Counseling and
referrals are also provided to clients as needed.
Program Theory
Health Belief Model
Trans-theoretical model (Stages of change)
Harm reduction
18
Program Component: Outreach, Clinical services
Measurable
Program Activities to Evaluation Methodology
Objectives
achieve objectives
1. By December
a. Targeting high risk
Data collection - reports
2007, at least 2% of
populations such as
from testing sites on
number of tests
MSM,TSMs,IDUs
people will test
positive for HIV
conducted, results and
and their partners, and
antibodies among
females having sex
demographics of clients
test sites within
Data
Reporting
Source
Timeframe
HIV 6
Quarterly
ELI
Link to ES Indicator
Essential Service(ES)7:
Link people to needed
health services and assure
the provision of health
care when otherwise
with MSM.
unavailable.
Santa Clara County.
b. Conducting at least
6944 HIV tests
Program Component; Clinical services (counseling and referral)
Measurable
Program Activities
Evaluation Methodology
Data
Reporting
Source
Timeframe
Link to ES Indicator
Objective
2. By December
2007, 100% of
a. Training staff on
a. Count number of training
a. Staff
resources available to
sessions and number of staff
reports &
Essential Service(ES)7:
Link people to needed
clients who are
refer clients
participating
survey
health services and
to achieve objectives
HIV positive will
Quarterly
staff who
assure the provision of
be referred to
b. Providing adequate
b. Determine percentage of clients
received
health care when
care.
resources to clients
referred to care
training
otherwise unavailable.
c. Report from testing site on # of
referrals to which providers
b. HIV 6
d. Record offollow-up activities
(phone calls to clients, providers,
etc.)
e. Record of referral information
provided to client
19
Program Component: Community collaboration
Measurable objective
3. By December 2007,
Program activities
to achieve objectives
a. Conducting focus
at least 70% of the
groups
community providers
and partners will report
high level of
b. Administering the
Community Provider
satisfaction with the
and Partner
Public Health
Satisfaction Surveys
Evaluation methodology
Data source
Reporting
Link to ES indicator
Timeframe
a. Conduct 2 to 3 focus
a. Notes/
groups with community
providers and partners
Annual
Results
Essential Service(ES)7:
Link people to needed
from focus
health services and
assure the provision of
groups
b. Analysis of results from
satisfaction survey to
community providers
Department
health care when
b. Provider
otherwise unavailable.
and Partner
satisfaction
surveys
Program Component: Clinical Health Services
Measurable objective
4. By the end of
December 2007, at least
80% of the clients will
report high levels of
satisfaction with the
Community-Based
Organizations providing
Program activities
to achieve objectives
a. Conducting client
satisfaction surveys
focusing on the
quality and
accessibility of the
services provided
Evaluation
Data source
methodology
Analysis of survey
results(SPSS)
Reporting
Link to ES indicator
Timeframe
Client
Annual
satisfaction
Essential Service(ES)7;
Link people to needed
survey
health services and assure
the provision of health
care when otherwise
unavailable.
services.
20
Program Component: Community collaboration, clinical services
Measurable objective
Program activities
Evaluation
to achieve
methodology
Data source
Reporting
Links to ES indicators
Timeframe
objectives
5. By the end of
December 2007,
a. Inelude
questions(s) on the
Analysis of survey
results(SPSS)
Client
satisfaction
Quarterly
Essential Service (ES) 7:
Link people to needed
80% of elients who
client satisfaction
participate in the
survey to assess
the provision of health
risk reduction
whether there was
eare when otherwise
counseling session
inerease in
unavailable.
will have increased
knowledge about
HIV prevention
knowledge of
personal
survey
health services and assure
HIV/AIDS
prevention
strategies.
* The Centers for Disease Control’s(CDC)National Public Health Performance Standards Program’s Ten Essential Services of Publie
Health document presented a method to organize the many diverse programs within the Department and support eonclusions about
overall department impact. The essential services represent the ten core responsibilities of a local department of public health.
21
Santa Clara County M
Public Health Department ^
A division ofS<Ma Clara Valley Health <4 Hospital System
Attachment C
I.
APPLICATION COVERSHEET
Fill out completely and include as thefront page ofthe application.
Name of Project: Alternative Testing Site at DeFrank Center
Applicant Name/Organization; The Billy DeFrank LGBT Community Center
Mailing Address: 938 The Alameda
City:
San Jose
, CA Zip:
Phone: 408.293.3040
Contact Person:
Title:
Fax:
95126
408.298.8986
Other:
Aejaie Sellers
Executive Director
Tax Identification Number:
Phone:
4Q8.293.3Q4Q, ext. 103
94r285n49&
Funding Amount Requested: $ 90,898
Briefdescription ofthe proposed project: The DeFrank Center will create a FIIV alternative
testing site utilizing rapid test technology at the Center and provide a total of 30 hours of HIV
testing. Primary emphasis will be placed on testing MSM,transgender persons who have sex
with men (TSM), and MSM who inject drugs(MSM-IDU)and secondary emphasis will be
placed on youth, people of color, and methamphetamine users within the primarily emphasized
groups. We anticipate testing a minimum of 1600 unique individuals tliroughout calendar year
2007.
Applicant understands that the submission of this document does not guarantee funding, nor that funding
will be allocated at the level requested. Final contract provisions will take precedence over the
information contained in the proposal.
The undersigned hereby affirms that they have read the attached County of Santa Clara Contracting
Principles, Insurance requirements, Nondiscrimination Policy and other required County Contract
provisions provided in the RFP packet. Further, statements contained in the application package are true
and complete to the best of the applicant’s knowledge. The undersigned recognizes that all proposals,
attachments, and other materials submitted in response to this RFP shall be considered public information
and open to public inspection. The undersigned further understands that if selected, the contractor will
perform all work and services described in the Agreement as an independent contractor and not as an
officer, agent, servant or employee of the County of Santa Clara.
Person authorized to sign:
Signature:
Date:
22
Attachment D
SCOPE OF WORK Template
CBO Name:
Proposed Alternative HIV Outreach and Testing Sites(add rows to the table as needed to include all proposed sites)
Target
Population(s)
Target
Location
Proposed
Numbers
of Site(s)
Schedule
for Testing
Activity
(Outreach/
Testing/
Counseling)
Staff Responsible
(include strengths re: reaching the
target population)
We will work with HAP to perform all activities in the CBO HIV Alternative Testing Site Work Plan (Attachment A)and ensure
compliance with State and CDC rules and regulations regarding HIV rapid testing. □ Yes □ No
We will monitor staff participation in training and maintenance of certification. □ Yes
We will complete and submit all required data collection, as requested by HAP.
We will work closely with HAP and participate in HIV rapid testing meetings.
□ Yes
□ Yes
□ No
□ No
□ No
We will participate in the Public Health Department’s HIV Testing Expansion Evaluation Plan (Attachment B).
□ Yes □ No
23
Santa Clara County
Public Health Department
tVV
¥/
A division ofSanta Clara Valley Health & Hospital System
Request for Proposal
The Santa Clara County Public Health Department HIV/AIDS Prevention and Control Program
(HAP)is currently seeking proposals to expand HIV alternative testing sites in Santa Clara
County. The goal is to make rapid testing accessible to Santa Clara County’s most at-risk
populations. The Department will fund a maximum of five (5) community-based organizations
(CBOs)to provide rapid HIV testing and counseling with the minimum required standards
stipulated by the California Department of Health Services(CA DHS)and the Centers for
Disease Control and Prevention(CDC). These standards are presented in the CBO HIV
Alternative Testing Sites Work Plan (Attacliment A). The standards have been incorporated as
necessary “starl-up ” infrastructure development that selected community-based organizaiiuns
will need to have in place prior to beginning HIV testing.
A total of$300,000 will be made available to those organizations that can most effectively
address HIV testing expansion funding priorities, preferred capacities, and requirements in their
proposals. The contract period will be November 1, 2006 to October 31, 2007. To be eligible, an
organization must be a public or private nonprofit organization that is classified as 501(c)(3) tax
exempt under the Internal Revenue Code. An RFP information meeting is scheduledfor
September 8, 2006, 3:00p.m. to 5p.m., at 770 S. Bascom, Room 136. The deadline for
proposals is 5 p.m. on September 20, 2006.
This Request for Proposal(RFP) is organized as follows:
I. Background
II.
III.
IV.
V.
VI.
VII.
VIII.
Local HIV Data
CDC Best Practices Based on Science and Evidence-Based Approaches
HIV Testing Expansion Funding Priorities, Preferred Capacities, and Requirements
Application Process
County Contract Requirements
Proposal Deadline
Selection Criteria
IX. Appeals/Objections
X. RFP Attachments
L Background
Santa Clara County’s plan to expand HIV alternative testing sites and identify more residents
who are HIV+ is important for many reasons. In the past, an HIV+ diagnosis was a death
sentence—typically within five years due to fatal opportunistic infections. This is no longer true.
Today, county residents with HIV can expect to live much longer with appropriate medication
and proper care. As HIV+ status evolves into a more manageable chronic condition and greater
numbers of people are living with HIV/AIDS, there is a greater chance of more residents
becoming infected. In addition to the number of residents with HIV/AIDS who have currently
been identified, the CDC estimates that approximately 25% of persons with HIV/AIDS are not
aware of their diagnosis. And, evidence suggests that as many as two-thirds of the new HIV
infections each year occur through transmission from persons who are unaware of their HIV+
status.' The incidence and spread of the disease will not be curtailed until barriers to early
diagnosis are reduced. Expansion of HIV alternative testing sites will address barriers to early
diagnosis and provide referrals to HIV+ residents, who will benefit from access to appropriate
medication and proper care.
As more residents become aware of their HIV-H status, there will be greater need for appropriate
medication and care. The Ryan White Care Act provides critical support for Santa Clara
County’s continuum of HIV/AIDS care, which includes primary medical care, case management,
mental health services, oral health care, food, transportation, substance use/abuse treatment, and
other services for county residents diagnosed with HIV/AIDS. At this time, changes in the
funding formula are moving toward a formula based on the total number of persons living with
HIV/AIDS. Increasing identification of HIV+ individuals in Santa Clara County will protect
current funding and will likely result in additional resources for HIV/AIDS services through
Ryan White and other similar formula-driven grants. These resources will be needed as more
residents are identified as HIV+ through the expansion of HIV alternative testing sites.
Board ofSupervisors Budget Allocation and Requestfor Implementation Plan
On June 6, 2006 the Board of Supervisors approved a one-time budget allocation of $375,000 for
FY 2006-07 for expansion of HIV testing and counseling sites for targeted at-risk populations in
Santa Clara County. The purpose of this allocation is to address gaps and barriers to the
continuum of HIV/AIDS services in the county by(1)Expanding testing and counseling sites to
targeted communities;(2) Expanding availability of rapid testing;(3) Expanding outreach and
counseling by increasing the number of certified counselors; and (4) Continuing to work with
medical providers regarding reporting requirements via the Department’s Surveillance Unit. The
Health and Hospital Comrhittee recommended that $75,000 of the $375,000 go to the Public
Health Department for administrative costs and for campaign marketing costs to maximize
awareness of the availability of expanded HIV testing.
1
CDC,“Advancing AIDS Prevention, AHP Overview, Interim Technical Guidance for Selected
Interventions, Introduction,” http://www.cdc.gov/hiv/topics/prev_prog/AHP/resources/guidelines
/Interim-Guidance.htm (accessed 7/2006).
2
At that time, the Public Health Department was asked to submit an implementation plan for
review by the Health and Hospital Committee. In response, the Public Health Department
developed an implementation plan for alternative rapid HIV test sites that reflects the voice of
the community. Public Health participated in several meetings with representatives of the HIV
Planning Council and Community Planning Group. Their priorities and concerns are
incorporated throughout the implementation plan, which was developed in coordination with
both groups. The plan is also consistent with the Santa Clara County Comprehensive Planfor
HIV/AIDS Services 2006-2008 and the Santa Clara County HIV Prevention Plan 2006-2008.
Implementation Plan Goal and Prioritiesfor Target Populations and Geographic Areas
The goal of the HIV Testing Expansion program is to reduce the prevalence and incidence of
HIV/AIDS through testing, counseling, and referral to care and treatment of residents who are at
risk of HIV/AIDS by 1) increasing the number of certified test counselors in the community, and
2) conducting a minimum of6,944 tests in the target population, 2% of which will test positive
for HIV antibodies (140 positive results).
Priority Populations for Expanded HIV Alternative Testing Sites are:
■ Men who have Sex with Men(MSM)
■ Females who have Sex with Men who have Sex with Men(FSMSM)
■ Transgender persons who have Sex with Men(TSM)and Transgender Injection Drug
Users(IDU)
■
IDU and MSM-IDU
Groups identified among priority populations for expanded HIV testing are:
■ People of Color
■
Sex Workers
■
Youth
Geographic Area Priorities are:
■ City of San Jose, where the HIV/AIDS epidemic continues to be concentrated.
■ North County (Sunnyvale, Mountain View, Palo Alto and Los Altos), where the next
highest percentage of reported HIV cases is.
■ South County, which has the smallest number of reported HIV cases to date, but isolation
and limited access to services create challenges that need special attention.
Approval ofthe HIV Alternative Testing Sites Implementation Plan
The implementation plan was submitted to the Health and Hospital Committee on August 16,
2006. The Health and Hospital Committee accepted the plan and forwarded a positive
recommendation to the Board of Supervisors. The Board of Supervisors approved the plan on
August 29, 2006.
The Public Health Department’s HIV/AIDS Prevention and Control Program(HAP) will
administer these funds and provide technical assistance to and coordination for the CBO
alternative testing and counseling programs.
3
II. Local HIV Data
From July 2002 through March 2006, 1008 people in Santa Clara County have been diagnosed
H1V+. Nine hundred ninety six (996) are alive. The following tables were prepared by the Santa
Clara County Publie Health Department, Data Management and Statistics.
Gender
Male
Female
Number
%
861
Number
Total*
%
130
86.4
991
13.1
Race/Ethnicity
African
White
Asian/Pacific
American
Number
%
497
Number
52.0
96
Islander
Hispanic
%
Number
310
10.1
%
Total*
%
Number
32.5
52
955
5.4
Age Group
0-12
13-19
20-29
30-39
40-49
50-59
60+
Total*
Number/%
Number/%
Number/%
Number/%
Number/%
Number/%
Number/%
Number
7/0.7%
19/1.9%
276/27.9%
404/40.8%
201/20.3%
68/6.9%
16/1.6%
991
Mode of Exposure and Gender
Mode of
Total
Male
Female
Exposure
Number/%
Number/%
Number/%
630/63.6%
MSM
630/73.2%
0/0.0%
IDU
56/5.7%
39/4.5%
17/13.1%
MSMTDU
61/6.2%
61/7.1%
0/0.0%
127/12.8%
47/5.5%
80/61.5%
102/10.3%
80/9.3%
22/16.9%
15/1.5%
4/0.5%
11/8.5%
991/100%
861/100%
130/100%
Heterosexual
Contact
Risk Not
Specified
Other
Total*
Mode of Exposure and Race/Ethnicity
Asian/Pacific
African
Mode of
Total
White
American
Hispanic
Islander
Exposure
Number/%
Number/%
Number/%
Number/%
Number/%
MSM
630/63.6%
370/74.4%
32/33.3%
190/61.3%
29/55.8%
IDU
56/5.7%
33/6.6%
11/11.5%
12/3.9%
0/0.0%
MSM/IDU
61'6.2%
33/6.6%
5/5.2%
21/6.8%
2/3.8%
127/12.8%
28/5.6%
29/30.2%
57/18.4%
12/23.1%
Specified
102/10.3%
26/5.2%
16/16.7%
27/8.7%
7/13.5%
Other
15/1.5%
7/1.4%
3/3.1%
3/1.0%
2/3.8%
991/100%
497/100%
Heterosexual
Contact
Risk Not
Total*
96/100%
310/100%
52/100%
4
HIV
City
Number/%
San Jose
617/64.7%
Santa Clara
60/6.3%
Mountain View
53/5.6%
Sunnyvale
Campbell
50/5.2%
29/3.0%
Palo Alto
29/3.0%
Milpitas
20/2.1%
Gilroy
18/1.9%
Los Gatos
17/1.8%
Missing
17/1.8%
Los Altos
12/1.3%
Cupertino
Morgan Hill
Saratoga
10/1.0%
8/0.8%
Los Altos Hills
1/0.1%
10/1.0%
Stanford
1/0.1%
Total*
954/100%
* The total does not equal 996 in the tables above because information was not recorded or numbers were
too small to maintain confidentiality (e.g., for Native Americans).
III. CDC Best Practices Based on Science and Evidence-Based Approaches
The HIV Planning Council, HIV Prevention Community Planning Group, and the HIV/AIDS
Prevention and Control Program are committed to promoting and supporting the most promising
practices in HIV testing and counseling. All programs funded by the Public Health Department
must incorporate promising practices and operate with established standards of care that are
consistent with national and local standards.
Advancing HIV Prevention. The Centers for Disease Control and Prevention(CDC)announced
a major new initiative to reduce new infections of HIV in the United States in April 2003. This
initiative. Advancing HIV Prevention: New Strategiesfor a Changing Epidemic (AHP), is
comprised of four strategies to address and meet the needs of all persons who are at increased
risk for HIV. The rationale for this new initiative was that despite much success in the
prevention of HIV infection, the current reality is that an estimated 40,000 new HIV infections
are still occurring in the United States each year, there has been an increase in racial/ethnic
disparities in the last 25 years, and an estimated 25% of persons living with HIV do not know
they are infected and are at considerable risk for developing AIDS and unknowingly transmitting
HIV.2
One of AHP’s four strategies is to implement new modelsfor diagnosing HIV infections outside
medical settings, the focus of the implementation plan for expansion of HIV testing sites. HIV
^ CDC,“Evolution of HIV/AIDS Prevention Programs: United States, 1981-2006,” MMWR 55,
21,(June 2, 2006): 597-603.
5
testing programs in nontraditional settings are more likely to reach some racial/ethnic minorities
and persons who report increased risk for HIV, but do not have access to medical care. The rate
of positive test results in non-traditional settings is generally higher compared with conventional
test sites in medical settings. The recently approved rapid HIV tests can be done outside of a
traditional laboratory setting. They reduce the time it takes to process tests from two weeks to 20
minutes.^ This advance in HIV testing technologies provides Santa Clara County with the
opportunity to effectively create alternative HIV testing sites to reach residents who are most at
risk for being infected with HIV and to increase the number of at-risk residents who know their
HIV status. This strategy emphasizes the use of proven public health approaches to reducing the
incidence and spread of disease and utilizes the most current HIV testing technologies.
There are two CDC AHP demonstration projects that can serve as models for Santa Clara
County’s alternative testing sites: Rapid HIV Testing in Nonclinical Settings and Using Social
Network Strategies to Reach Persons at High Riskfor HIV Infection in Communities ofColor.
For the Rapid HIV Testing in Nonclinical Settings demonstration project, CDC provided
funding for eight CBOs based in six cities; Boston, Chicago, Detroit, Kansas City, Los Angeles,
and Washington, DC. The CBOs provided rapid HIV testing in nonclinical settings, such as
parks and bars. As of June 2005, 17,149 persons had been tested for HIV and 249 had received
confirmed positive results. The positivity rate was about 1.5%. Further information on this
initiative can be found at:
http://www.cdc.gov/hiv/topics/prev_prog/AHP/resources/guidelines/Interim-rapidtest.htm.
For the Using Social Network Strategies to Reach Persons at High Riskfor HIV Infection in
Communities of Color demonstration project, CDC funded nine CBOs in seven cities: Boston,
Lafayette (LA), New York City, Orlando (FL), Philadelphia and San Francisco. This strategy is
based on the concept that individuals are linked together to form large social networks and that
infectious diseases often spread through these networks. It is a programmatic, peer-driven,
recruitment strategy that is employed in conjunction with HIV testing and counseling. Through
October 2005, the CBOs’ 408 recruiters had persuaded 2,878 persons in their social, sexual, or
drug-using networks to get tested for HIV. 160 of these network associates were confirmed as
HIV+(with a positivity rate of 5.6%), which is five times the average prevalence reported by
publicly funded counseling, testing and referral sites. Further information on this initiative can
be found in the June 24, 2005, Morbidity and Mortality Weekly Report and at
http://www.cdc.gov/hiv/resources/guidelines/snt/pdf/SocialNetworks.pdf
The following are the Santa Clara County HIV Prevention Plan 2006-2008 program
recommendations based on CDC best practices for HIV/AIDS prevention that are applicable to
the alternative rapid test site funding.
^ CDC,“Questions and Answers: The Science Behind the New Initiative,” September 2003,
http;//www.cdc.gov/hiv/topics/prev_prog/AHP/resources/qa/AHP_Science.htm (accessed
7/2006),
6
■
Use a risk behavior model—targeting populations based on the behavior that puts them at
high risk for HIV infection—for HIV prevention and rapid testing. The following are
priority populations and sub-populations based on high-risk for HIV infection.
Priority Populations
TSM & Transgender IDUs
(Men who have Sex
(Females who have
(Transgender persons who
with Men)
Sex with MSM)
have Sex with Men)
Priority Sub-Populations for Access to Testing;
■ People of Color
■ Methamphetamine Users
MSMs
■
FSMSM
■
Sex Workers
■
Youth
IDUs and MSM-IDUs
(Injection Drug Users)
Ensure that alternative test sites provide Counseling, Testing, and Referral(CTR), a riskreduction counseling model conducted with HIV testing. CTR is a personalized, clientcentered encounter in which individuals can learn their HIV status. In addition, the counselor
helps the client identify and acknowledge personal HIV risk behaviors and commit to a
single, achievable behavior change step that could reduce the client’s HIV risk.
With rapid testing, a positive result is considered a preliminary positive. Whenever a client
has a preliminary positive result, a confirmatory test is needed and the confirmatory test or a
referral for one should be given at that time. When a high degree of trust is developed and
tests results indicate a preliminary positive, the counselor should also explore partner
notification. Relevant Standards and Guidelines for CTR include:
■
o
CDC’s Revised Guidelines for HIV Counseling, Testing, and Referral, 2001
(http://www.cdc.gov/hiv/testing.htm)
o
CDC’s Quality Assurance Guidelines for Testing Using the OraQuick Rapid
HIV-1 Antibody Test, 2003 (http;//www.cdc.gov/hiv/rapid_testing/)
o
California Department of Health Services, Office of AIDS, HIV Counseling
and Testing Guidelines, 1997(http;//www.dhs.ca.gov/ps/ooa/)
o
California Department of Health Services, Office of AIDS, Supplement to the
HIV Counseling and Testing Guidelines, 1997- OraQuick Rapid Testing in
Counseling and Testing Settings, 2003 (http://www.dhs.ca.gov/ps/ooa/)
Provide Outreach at community venues where and at times when priority populations and
sub-populations are most accessible. The purpose of outreach in context of this funding is to
recruit individuals into CTR. Examples of community venues where and times when priority
populations and sub-populations are most accessible for outreach and CTR that have been
identified are;
o Venues: gay bars, adult bookstores, head shops, parks or public sex environments,
areas frequented by injection drug users, and areas frequented by sex workers—
transgender MTF(male to female) and heterosexual females—near gas stations,
convenience stores, and in parks in East San Jose. Additional venues include
7
Needle Exchange Program sites, homeless shelters, and chemical dependency
programs.
o
Times: late night and weekend hours.
■
All CTR and Outreach will be culturally competent and appropriate for the intended
population. Staff and volunteers should reflect the broad range of languages spoken in Santa
Clara County.
■
Make free condoms available with all prevention and testing services. CDC and CPG
support a harm reduction approach to HIV prevention in which clients and community
members are encouraged to engage in safer sexual practices.
■
Work collaboratively^ by providing linkages and referrals, a core component of effective CTR
and outreach. The HIV epidemic exists in the context of a host of other health and social
issues, including poverty, homelessness, substance abuse, mental health, incarceration,
immigration, and sexually transmitted diseases that are compounded by deep-rooted social
problems and inequities, such as, racism, homophobia, and gender inequality. HIV
alternative test site providers must be familiar with the multiple needs of the individuals and
communities they serve and attempt to address these needs through a network of providers to
which they can refer and link their clients.
■
Design and implement cost-effective programs. Cost-effectiveness is often thought of in
terms of cost savings.| An example would be the costs that would be avoided if the estimated
25% of persons living with HIV and not knowing they are infected received testing and knew
their HIV status so that, if they were HIV-H, they could reduce their risk for developing AIDS
and of unknowingly transmitting HIV to others. Cost-effectiveness is also making use of
community volunteers when they can effectively reach target populations. Successful
volunteer testing programs, such as the San Francisco Department of Public Health’s, can
serve as models for replication.
A copy of the Santa Clara County HIV Prevention Plan 2006-2008 is available at
http://www.sccgov.org/SCC/docs/SCC%20Public%20Portal/keyboard%20agenda/Committee%2
0Agenda/2006/February%208,%202006/TMPKeyboard201387529.pdf
IV. HIV Testing Expansion Funding Priorities, Preferred Capacities, and Requirements
The Santa Clara County Public Health Department funding for HIV Alternative Testing Site
Expansion is a one-time l|udget allocation to expand rapid HIV testing in Santa Clara County.
The goal is to make rapid testing accessible to Santa Clara County’s most at-risk populations.
Funding Priorities:
•
Rapid testing sites will be accessible to/target the most at-risk populations in the county
(MSMs, MSM Methamphetamine users, FSMSMs,IDUs, MSM-IDUs, Transgender IDUs
8
and TSMs)and the following sub-populations within each target population (people of color,
sex workers, and youth). HIV Outreach and testing sites will be:
o in locations and during hours that will most effectively reach these at-risk
populations,
o in the San Jose area, where the HIV/AIDS epidemic is concentrated, as well as in
north county, which has the next highest percentage of reported HIV cases, and in
south county, where isolation and access to services is a challenge,
o implemented on a consistent schedule to capitalize on word-of-mouth as residents
become familiar with the service.
■
The HIV/AIDS Prevention and Control Program(HAP) will coordinate testing site locations
and schedules. CBOs may be asked to change sites and/or locations based on the need for
testing of all priority populations or due to changes identified through analysis of HIV/AIDS
data by Public Health Department(PHD)epidemiologists.
■
History as a recipient of HIV Education and Prevention Funding within the last three years is
preferred due to the complexity of setting-up and operating an HIV alternative testing site.
■
For interested CBOs that do not have a history as a recipient of HIV Education and
Prevention Funding, partnership/collaboration with a previous recipient of this funding to
apply for these funds is encouraged.
■
Collaboration among agencies in applying for these funds—with the goal of having the most
effective staff working with priority populations—is encouraged.
Preferred Capacities:
■
Culturally competent and appropriate outreach, testing and counseling for the county’s
populations most at-risk and in communities prioritized in this implementation plan.
■
Demonstrated access to and established trust with targeted high-risk populations.
■
Effective collaboration with care and support services for HIV/AIDS clients.
■
Capacity for effective health education dissemination.
■
Strategies as cost-effective as possible, such as, making use of community volunteers as test
technicians and counselors when they can effectively reach the target population.
Requirementsfor Alternative Testing Sites:
■
All Alternative Testing Sites operated by funded-CBOs will use Rapid Testing technology to
provide voluntary, anonymous and confidential free or low cost($5) HIV testing. Test kits
will be provided at no cost by HAP.
9
■
All testing sites will operate in compliance with relevant state and local regulations and CDC
guidelines applicable to HIV Rapid Testing. HAP will provide technical assistance to CBOs
in preparing Alternative Testing Sites. Requirements are presented in the CBO Alternative
Testing Sites Work Plan (Attachment A).
■
All testing and counseling staff will be certified after participating in training provided by the
State Office of AIDS, which is available at no cost, and maintain up-to-date certification.
■
Collect data as required by HAP (e.g., the HIV Counseling Information Form, Lab Slips, and
Testing Consent Forms for all clients; HIPAA consent for confidential clients; and any
additional recordkeeping required by HAP and Public Health Laboratory).
■
All funded CBOs will commit to participating in the program evaluation. PHD will perform
the evaluation based on the HIV Testing Expansion Evaluation Plan (Attachment B).
V. Application Process
1. Complete and attach the “Application Coversheef’(Attachment C).
2. Proposal Narrative: Describe the following in a maximum of five (5) double-spaced
pages.
a. Organization Overview and Capacity. Describe your organization’s past experience:
■ Working with HIV/AIDS clients.
■ Working with the priority population(s).
■ Working in the priority geographical area(s) where the priority population(s) are
most accessible.
■
■
Providing health education.
Setting-up and operating complex programs relevant to an HIV alternative
testing and counseling site,
b. Describe how your organization will address funding priorities, preferred capacities,
and requirements presented in Section IV, including:
■ Target population(s).
■ Specific location(s) within priority geographic areas.
■ Proposed outreach and testing/counseling sites and schedules with rationale
for selection of site(s) and schedule(s).
■ Proposed staffing and why they will be effective in reaching proposed target
population(s).
■ Approach to setting-up and operating an HIV alternative test site(s).
3. Complete the Scope of Work Template (Attachment D).
4. Submit budget and budget narrative (Attachment E). Indirect expenses can equal no
more than 10% of the total project budget.
10
Please Note; Successful bidders will not be funded for provision of services that are
concurrently funded by other sources.
5.
Provide resume(s)/job description(s) of personnel responsible for implementation of the
proposal.
6.
Provide proof of insurance coverage as required in Section VI of this proposal
(Attachment F).
7.
Review Confidentiality of Patient Information (Attachment G). You may sign it and
include it with your proposal, but this is not required.
VI. County Contract Requirements
A. Contractual Requirements.
Applicants may submit only one(1) proposal. The successful bidder must comply with
County contractual requirements, including: indemnification and insurance provisions.
County Contracting Principles, non-discrimination provisions, client confidentiality, and
other contract provisions included in the “Service Agreemenf’(Attachment H). Proof of
insurance coverage for requested funding, based on requirements in Attachment F,
must be provided with the proposal.
Requirements for evaluation will be included in the “Service Agreemenf’ and will include
collection of all required data (e.g., the HIV Counseling Information Form, Lab Slips, and
Testing Consent Forms for all clients; HIPAA consent for confidential clients; and any
additional recordkeeping required by HAP)and commitment to participating in the Public
Health Department’s evaluation of the HIV testing expansion program (Attachment B). All
projects will be in effect from the date the Agreement is executed through October 31, 2007.
B. County Rights/Obligations
1. The Santa Clara Valley Health and Hospital System(SCVHHS)reserves the right to
reject proposals, as well as the right to cancel this RFP at any time. The County retains
the right to open this solicitation to additional bidders at any time prior to execution of
tbe final Agreement.
2. Contractor will not be reimbursed for any costs associated with the preparation or
submittal of responses to this RFP.
j.
SCVHHS reserves the right to waive any minor irregularities or informalities in any
proposal and request clarification of information from any bidder.
4. The California Public Records Act set forth in Government Code sections 6250 et seq.
governs access to public records. The Act provides that access to information concerning
the conduct of the public’s business is a fundamental and necessary right of a person in
11
the state. Consequently, all Proposals, attachments and other materials submitted in
response to this RPP are considered public information (except as provided herein) and
become the exclusive property of the County.
5. Notwithstanding the foregoing, no Proposal materials will be released to the public nor
may the public have access to such Proposal materials during the RFP process.
Thereafter, the public will have access to the Proposal materials, as provided in this RFP.
VII. Proposal Deadline
The original plus 10 copies of the completed proposal must be delivered to the Santa Clara
County Public Health Department, Attn: HAP,3003 Moorpark Avenue, San Jose, CA,95128 no
later than 5 p.m., Wednesday,September 20,2006. No exceptions will be allowed. Each
proposal must be in a secured folder, stapled or otherwise secured, and include completed forms
and responses to Attachments C-F. Faxes, electronic copies, incomplete or late submittals will
not be accepted and will be returned to bidders.
Contact the HAP Manager, Kevin Hutchcroft, in writing by e-mail with any questions;
Kevin.Hutchcroft@hhs.CO.santa-clara.ca.us. All questions and responses will be made public to
all vendors on the website: www.sccgov.org/rfp_list.
VIII. Selection Criteria
The Public Health Department will conduct a review of the submitted proposals. The review
may also include interviews of the prospective bidders. A contract will be negotiated with
bidder(s) whose proposal(s) best demonstrates the ability to address funding priorities at a
reasonable cost. The Public Health Department reserves the right to cancel or reopen the RFP
process as it deems appropriate. Notification of the County’s decision will be provided to all
applicants no later than October 2, 2006.
The following review criteria will be applied in the selection process:
Review Criteria
Proposal Narrative (up to 50 points):
Organization Overview and Capacity:
■
■
Presentation and clarity.
Experience and past successes.
■
■
■
■
Capacity to work effectively with the target population(s).
Capacity to work effectively in priority geographic area(s).
Capacity to set-up and operate an HIV alternative testing site(s).
Capacity to provide health education.
Approach to addressing funding priorities, preferred capacities,
Points
0-20
0-30
and requirements:
12
■
■
Presentation and clarity.
Quality of approach/strategies to addressing funding priorities:
■ Target population(s).
■ Locations within priority geographic area(s).
■ HIV Outreach and Testing/Counseling Site(s)
and rationale for selection.
■
■
Proposed staff and ability to reach target population(s).
Setting-up and operating an HIV alternative test site(s).
Scope of Work Template (Attachment D)
0-20
Budget;
■ Proposed budget and budget narrative.
■ Maximum of 10% for indirect cost(s).
0-20
Proposal Attachments:
■ Completed Application Cover Sheet with required signature.
■ Job Descriptions/Resumes for key staff.
■ Proof of Insurance Coverage (see Section V, VI, and Attachment F).
O-IO
Local Preference* Bonus Points
5
*When two or more competing vendors are equally qualified, local firms shall be given
preference.(Board of Supervisor’s policy 5.3.13)
IX. Appeals/Objections
Appeals or objections to a rejection or award under this RFP must be submitted in writing within
five (5) business days of the postmarked notice of award or rejection. Such an appeal or
objection must be specific, identifying the nature of the protest or objection and stating all the
facts that form the basis for the appeal. All reason(s) for the appeal or objection, citing law, rule,
regulation or procedures upon which the appeal is based must be specified. Any appeal or
objection must be forwarded to the County by certified or registered mail or delivered in person,
with proposer obtaining a receipt of delivery, in the time provided herein to the following
address;
Dolores Alvarado, MSW, MPH
Division Director, Community Health Promotion
Santa Clara County Public Health Department
3003 Moorpark Avenue
San Jose, CA 95128
All appeals or objections received after the five (5) business day period described above will be
automatically disallowed and the original decision that is the subject of the protest or objection
will be upheld. All appeals that are timely will be referred to the Director of the Public Health
Department for review and consideration. Applicants submitting appeals or objections will be
13
notified by the Director of the Public Health Department of the decision on any such appeal. The
Public Health Director’s decision on any appeal or objection will be final.
X. RFP Attachments
A.
CBO HIV Alternative Testing Sites Work Plan
B.
HIV Testing Expansion Program Evaluation Plan
C.
Application Cover Sheet
D.
Scope of Work Template
E.
Budget and Budget Justification Template
F.
Insurance Requirements for Standard Service Contracts (Insurance Exhibit B-2A)
G.
Confidentiality of Patient Information
H.
Sample Service Agreement Template
I.
RFP Timeline
14
Attachment A
CBO HIV Alternative Testing Sites Work Plan
Activities
Meet HIV testing certification requirements:
■ Participate in mandatory certification training (60
hours).
■ Participate in annual continuing education
training to keep certificate up-to-date.
■ Perform at least 12 tests per month.
Participate in trainings and meetings as arranged by
HAP.
Identify coordinator for ATS project.
Select Alternative Testing Sites;
■ Identify sites at high-risk venues: gay bars, adult
bookstores, head shops, parks or public sex
environments, areas frequented by injection drug
■
■
Responsible Party
Timeframe
CBO/ATS Staff and
11/2006-1/2007
Volunteers
CBO/ATS Staff and
Ongoing
Volunteers
CBO Administration
11/2006
CBO/ATS Staff
11/2006-1/2007
CBO/ATS Staff
11/2006-1/2007
CBO/ATS Staff
11/2006-1/2007
CBO/ATS Staff
11/2006-1/2007
users, and areas frequented by sex workers—
transgender MTF(male to female) and
heterosexual females—near gas stations,
convenience stores, in parks in East San Jose,
Needle Exchange Program sites, homeless
shelters, and chemical dependency programs.
Assess proposed settings for feasibility of
implementing rapid HIV testing and counseling
(e.g., does the setting have acceptable lighting for
test readability, temperature control, private space
for providing counseling and test results).
Coordinate with the HAP ATS Coordinator to
ensure priority risk behavior and geographic
coverage (San Jose plus north and south county).
■ Create a site plan (locations and schedules).
Develop systems and procedures to ensure client
privacy and confidentiality.
Establish procedures for protecting all client-related
data.
Develop systems and procedures for informed
consent procedures in accordance with local and state
requirements and CDC guidelines.
■ Establish unambiguous and easy to implement
guidelines to define sobriety standards and to
identify chronic mental health conditions that
may interfere with ability to provide informed
consent.
15
Activities (cont.)
Develop a process to document consent for testing
and testing results, and to track specimens sent for
Responsible Party
Timeframe
CBO/ATS Staff
11/2006-1/2007
CBO/ATS Staff
11/2006-1/2007
CBO/ATS Staff
11/2006-1/2007
CBO/ATS Staff
11/2006-1/2007
CBO/ATS Staff
11/2006-1/2007
CBO Staff
1/2007
CBO Staff
2/2007-11/2007
CBO Staff
2/2007-11/2007
confirmatory testing.
Develop a process for obtaining detailed locating
information on clients whose test results are
preliminary positive so that they can be contacted and
encouraged to come in for care if they fail to return
for their follow-up appointment.
Develop a plan to ensure compliance with the
Clinical Laboratory Improvement Amendment
(CLIA) regulations related to HIV rapid testing
(which will be explained in detail at the 9/30 RFP
information meeting) and with relevant state and
local regulations applicable to HIV Rapid Testing.
Refer to :www.cms.hhs.gov/CLIA
Develop a plan for handling infectious waste,
complying with the regulations of the Occupational
Safety and Health Administration, and handling
potential occupational exposures.
Develop a plan to maintain staff and volunteer safety
at settings that may pose a risk to them (e.g., safety
training and taking precautions, such as, working in
teams).
Participate in site visit by Public Health staff(HAP
and Laboratory staff) to confirm readiness to begin
HIV testing (required before testing can begin).
Operate alternative test sites and outreach at high-risk
venues, as coordinated with HAP ATS Coordinator.
■
■
■
Provide HIV testing and counseling to high-risk
clients(MSMs, MSM Methamphetamine users,
FSMSMs,IDUs & MSM IDUs, TSMs, and
Transgender IDUs).
Whenever a client has a preliminary positive test
result, have a system in place for confirmatory
testing (see OraQuick Guidelines).
Provide condoms for prevention (harm
reduction).
Collect Data:
■
Complete the HIV Counseling Information Form
(CIF), Lab Slips and Testing Consent Forms for
all clients; HIPAA consent for confidential
clients; and any additional HAP requirements.
16
I
Activities (cont.)
Manage Referrals;
■
Link with Public Health Laboratory for
confirmatory testing of preliminary positive rapid
Responsible Party
Timeframe
CBO Staff
2/2007-11/2007
CBO Staff
11/2007-12/2007
test specimens.
■
■
Arrange linkages with medical and social
referrals for comprehensive follow-up.
Develop procedures for making referrals,
assisting clients with getting to referrals, and
confirming that referred clients acted on the
referrals and received, or are receiving, services
as a result of the referral.
Participate in Public Health Department evaluation.
17
Attachment B
HIV Testing Expansion Program Evaluation Plan
FY 08
Program Name
HIV Rapid Testing and Counseling Expansion Implementation Plan
Target Population
Residents of Santa Clara County who are High Risk Population for HIV/AIDS:(1) men who have sex with
men(MSM),(2) MSM Methamphetamine users,(3) Female partners of MSM (FSMSMs),(4)Intravenous
Drug Users(IDUs) and MSM IDUs,(5) Transgender IDUs and TSMs.
Problem Statement
Increasing rates of HIV infection in several identified populations are posing threat to the public health of
Santa Clara County. Both CDC and local estimates indicate about 25% of those living with HIV/AIDS are
unaware of their diagnosis. In Santa Clara County, there are an estimated 879 persons who are living with
HIV/AIDS who are unaware of their diagnosis. The local positive rate for testing at the Public Health
Department Laboratory is 1.67%, while the statewide average positive rate is 2.6%. The local positive rate for
MSM is 2.4-4.0%, while the statewide MSM rate is 12-20%.
Overall Program
To reduce the prevalence and incidence of HIV/AIDS through testing, counseling, referral to care and
Goals
treatment to residents who are at risk of HIV/AIDS.
1.
Program
Components
Assessment
2. Outreach
3. Clinical Health Services (Testing, Health Education, Counseling, Treatment)
4. Community Collaboration
Program
Description
Confidential and anonymous testing will be provided at HIV test sites. Rapid testing will be used at locations
where populations at greater risk for HIV/AIDS will be more likely to access services. Counseling and
referrals are also provided to clients as needed.
Program Theory
Health Belief Model
Trans-theoretical model (Stages of change)
Harm reduction
18
Program Component: Outreach, Clinical services
Measurable
Program Activities to Evaluation Methodology
Objectives
achieve objectives
1. By December
a. Targeting high risk
Data collection - reports
2007, at least 2% of
populations such as
from testing sites on
number of tests
MSM,TSMs,IDUs
people will test
positive for HIV
conducted, results and
and their partners, and
antibodies among
females having sex
demographics of clients
test sites within
Data
Reporting
Source
Timeframe
HIV 6
Quarterly
ELI
Link to ES Indicator
Essential Service(ES)7:
Link people to needed
health services and assure
the provision of health
care when otherwise
with MSM.
unavailable.
Santa Clara County.
b. Conducting at least
6944 HIV tests
Program Component; Clinical services (counseling and referral)
Measurable
Program Activities
Evaluation Methodology
Data
Reporting
Source
Timeframe
Link to ES Indicator
Objective
2. By December
2007, 100% of
a. Training staff on
a. Count number of training
a. Staff
resources available to
sessions and number of staff
reports &
Essential Service(ES)7:
Link people to needed
clients who are
refer clients
participating
survey
health services and
to achieve objectives
HIV positive will
Quarterly
staff who
assure the provision of
be referred to
b. Providing adequate
b. Determine percentage of clients
received
health care when
care.
resources to clients
referred to care
training
otherwise unavailable.
c. Report from testing site on # of
referrals to which providers
b. HIV 6
d. Record offollow-up activities
(phone calls to clients, providers,
etc.)
e. Record of referral information
provided to client
19
Program Component: Community collaboration
Measurable objective
3. By December 2007,
Program activities
to achieve objectives
a. Conducting focus
at least 70% of the
groups
community providers
and partners will report
high level of
b. Administering the
Community Provider
satisfaction with the
and Partner
Public Health
Satisfaction Surveys
Evaluation methodology
Data source
Reporting
Link to ES indicator
Timeframe
a. Conduct 2 to 3 focus
a. Notes/
groups with community
providers and partners
Annual
Results
Essential Service(ES)7:
Link people to needed
from focus
health services and
assure the provision of
groups
b. Analysis of results from
satisfaction survey to
community providers
Department
health care when
b. Provider
otherwise unavailable.
and Partner
satisfaction
surveys
Program Component: Clinical Health Services
Measurable objective
4. By the end of
December 2007, at least
80% of the clients will
report high levels of
satisfaction with the
Community-Based
Organizations providing
Program activities
to achieve objectives
a. Conducting client
satisfaction surveys
focusing on the
quality and
accessibility of the
services provided
Evaluation
Data source
methodology
Analysis of survey
results(SPSS)
Reporting
Link to ES indicator
Timeframe
Client
Annual
satisfaction
Essential Service(ES)7;
Link people to needed
survey
health services and assure
the provision of health
care when otherwise
unavailable.
services.
20
Program Component: Community collaboration, clinical services
Measurable objective
Program activities
Evaluation
to achieve
methodology
Data source
Reporting
Links to ES indicators
Timeframe
objectives
5. By the end of
December 2007,
a. Inelude
questions(s) on the
Analysis of survey
results(SPSS)
Client
satisfaction
Quarterly
Essential Service (ES) 7:
Link people to needed
80% of elients who
client satisfaction
participate in the
survey to assess
the provision of health
risk reduction
whether there was
eare when otherwise
counseling session
inerease in
unavailable.
will have increased
knowledge about
HIV prevention
knowledge of
personal
survey
health services and assure
HIV/AIDS
prevention
strategies.
* The Centers for Disease Control’s(CDC)National Public Health Performance Standards Program’s Ten Essential Services of Publie
Health document presented a method to organize the many diverse programs within the Department and support eonclusions about
overall department impact. The essential services represent the ten core responsibilities of a local department of public health.
21
Santa Clara County M
Public Health Department ^
A division ofS<Ma Clara Valley Health <4 Hospital System
Attachment C
I.
APPLICATION COVERSHEET
Fill out completely and include as thefront page ofthe application.
Name of Project: Alternative Testing Site at DeFrank Center
Applicant Name/Organization; The Billy DeFrank LGBT Community Center
Mailing Address: 938 The Alameda
City:
San Jose
, CA Zip:
Phone: 408.293.3040
Contact Person:
Title:
Fax:
95126
408.298.8986
Other:
Aejaie Sellers
Executive Director
Tax Identification Number:
Phone:
4Q8.293.3Q4Q, ext. 103
94r285n49&
Funding Amount Requested: $ 90,898
Briefdescription ofthe proposed project: The DeFrank Center will create a FIIV alternative
testing site utilizing rapid test technology at the Center and provide a total of 30 hours of HIV
testing. Primary emphasis will be placed on testing MSM,transgender persons who have sex
with men (TSM), and MSM who inject drugs(MSM-IDU)and secondary emphasis will be
placed on youth, people of color, and methamphetamine users within the primarily emphasized
groups. We anticipate testing a minimum of 1600 unique individuals tliroughout calendar year
2007.
Applicant understands that the submission of this document does not guarantee funding, nor that funding
will be allocated at the level requested. Final contract provisions will take precedence over the
information contained in the proposal.
The undersigned hereby affirms that they have read the attached County of Santa Clara Contracting
Principles, Insurance requirements, Nondiscrimination Policy and other required County Contract
provisions provided in the RFP packet. Further, statements contained in the application package are true
and complete to the best of the applicant’s knowledge. The undersigned recognizes that all proposals,
attachments, and other materials submitted in response to this RFP shall be considered public information
and open to public inspection. The undersigned further understands that if selected, the contractor will
perform all work and services described in the Agreement as an independent contractor and not as an
officer, agent, servant or employee of the County of Santa Clara.
Person authorized to sign:
Signature:
Date:
22
Attachment D
SCOPE OF WORK Template
CBO Name:
Proposed Alternative HIV Outreach and Testing Sites(add rows to the table as needed to include all proposed sites)
Target
Population(s)
Target
Location
Proposed
Numbers
of Site(s)
Schedule
for Testing
Activity
(Outreach/
Testing/
Counseling)
Staff Responsible
(include strengths re: reaching the
target population)
We will work with HAP to perform all activities in the CBO HIV Alternative Testing Site Work Plan (Attachment A)and ensure
compliance with State and CDC rules and regulations regarding HIV rapid testing. □ Yes □ No
We will monitor staff participation in training and maintenance of certification. □ Yes
We will complete and submit all required data collection, as requested by HAP.
We will work closely with HAP and participate in HIV rapid testing meetings.
□ Yes
□ Yes
□ No
□ No
□ No
We will participate in the Public Health Department’s HIV Testing Expansion Evaluation Plan (Attachment B).
□ Yes □ No
23
Document
The Santa Clara County Public Health Department HIV/AIDS Prevention and Control Program seeking proposals to expand HIV alternative testing sites in Santa Clara County
Initiative
Collection
James T. Beall, Jr.
Content Type
Request for Proposal
Resource Type
Document
Date
2006
District
District 4
Creator
Santa Clara County Public Health Department
Language
English
City
San Jose
Rights
No Copyright: http://rightsstatements.org/vocab/NoC-US/1.0/