Single Source Procurement: Community Health Worker Training Program (CHWTP)

Pursuant to New York State Finance Law § 163.10(b), The New York State Department of Health is presenting the following summary of relevant circumstances, and material and substantial reasons why a competitive procurement was not feasible.

The Bureau of Women, Infants and Adolescent Health (BWIAH) will enter into a sole source contract with Cicatelli Associates, Inc., for a one year period July 1, 2015 to June 30, 2016, for a Community Health Worker Training Program (CHWTP). There was a previous contract C021387 with Cicatelli Associates for the same services ended June 30, 2014. The CHWTP provides knowledge-based training on maternal and infant health topics and skills-based training on outreach, engagement and home visiting to prepare community health workers (CHWs) to handle the challenges of outreaching to and serving high-need pregnant and parenting women and their infants. The CHWTP training contract will support: 4 eight-day core trainings for CHWs and CHW supervisors, (2 in upstate NY and 2 in NYC); and 2 two-day CHW supervisory trainings (held in Albany). All new CHWs and CHW supervisors must complete core training within the first year of employment.

The CHWPT will provide training to the 125 CHWs and 25 CHW Supervisors utilized by the New York State Department of Health's (NYSDOH) 24 Maternal and Infant Community Health Collaboratives (MICHC) projects and the 100 to 125 CHWs and 25 CHW Supervisors to be supported by 6 projects under NYSDOH's Delivery System Reform Incentive Payment (DSRIP) program as described below.

BWIAH recently awarded 24 MICHC contracts via a competitive procurement, DOH RFA #1027271237. MICHC is a new initiative which began October 1, 2013, and integrated and replaced 3 former maternal and infant health programs: Comprehensive Prenatal-Perinatal Services Networks, Community Health Worker Program (CHWP) and Healthy Mom – Healthy Babies, all of which ended September 30, 2013. The MICHC initiative requires implementation of strategies at the individual, organizational and community levels. The core individual-level strategy required is the use of CHWs to perform a combination of community outreach and home visits to provide a source of enhanced social support and create a bridge between high-risk women and healthcare and social service providers. While the CHWP as a discrete program ended, the use of CHWs continues as an integral strategy of the MICHC initiative. 12 of the 24 MICHC contractors are former CHWP contractors and have a level of experience providing CHW services. The other 12 MICHC contractors are new to CHW services and require training immediately.

A Request for Proposals (DOH RFP #15318) to establish a Maternal and Infant Health - Center of Excellence (MIH-COE) to provide training, technical assistance, data collection, and quality assurance support to the MICHC contractors was issued February 11, 2014. Due to delays in the procurement process, the award for the new MIH-COE was not made until April 9, 2015, with a planned start date of July 1, 2015. In accordance with the schedule of deliverables, the MIH-COE will develop web-based introductory training on maternal and child health topics for CHWs by the end of 9 months from the start of the contract term, and will conduct annual in-person trainings on enhanced topics and skills building for the MICHC's 125 CHWs and 25 CHW supervisors. The CHW web-based will be the means to prepare CHWs for home visiting services, but this training will not be available until April 2016, according to the schedule allowed. While the in-person trainings may be conducted sooner – this is a one-day training on enhanced topics such as outreach and recruitment of hard to reach populations and will not take the place of the core training necessary to prepare CHWs to provide home visiting services.

In addition to the MICHC CHWs, it is anticipated that 100 to 125 CHWs and 25 CHW supervisors will be supported under the NYSDOH's Delivery System Reform Incentive Payment (DSRIP) program. DSRIP provides incentives for Medicaid providers to create and sustain an integrated, high-performing health care delivery system that can effectively and efficiently meet the needs of Medicaid eligible populations and individuals by improving care, improving health, and reducing costs. The use of CHWs is an allowable project under DSRIP Doman 3 – Clinical Improvement Projects: Project 3.f.i "Increase support programs for maternal and child health," which allows for the implementation of a CHW program on the model of the MICHC program; and DSRIP Project 4.d.i, "Reduce premature births," which allows for the use of CHWs to provide health information, navigation and connection to services, and enhanced social support to high-risk pregnant women. The NYS DSRIP Project Toolkit states that CHW duties and qualifications are per the NYSDOH criteria and that DSRIP projects using CHWs will access the NYSDOH-funded CHW training program. Safety net providers were required to submit applications as Performing Provider Systems (PPS). Initial applications identifying specific DSRIP projects were received December 2014. Out of a total of 29 PPSs in the state, 3 will implement CHW services under DSRIP Project 3.f.i, and 2 PPSs will use CHW services under DSRIP Project 4.d.i. Final detailed applications for DSRIP projects are due July, 2015, with projects scheduled to being soon after.

With the former CHWPT contract having ended June 30, 2014, and the delay in establishing the new MIH-COE, new MICHC CHWs have gone untrained. While the new MIH-COE will start July 1, 2015, new CHW web-based training will not be ready until mid-2016, as per the scope of work. To fill the gap in training until the MIH-COE is established and has developed new training, BWIAH will enter into a one-year sole source contract with Cicatelli Associates, Inc. to provide knowledge-based training on maternal and infant health topics, skills-building training on outreach, engagement and conducting home visits to CHWs and CHW supervisors. The competitively procured MIH-COE will then take over and handle all subsequent trainings.

Procurement / Program Name Community Health Worker Training Program (CHWTP)
Contractor Name(s) Cicatelli Associates, Inc.
Contract Period 7/1/2015 – 6/30/2016
Contract Number(s) C030518