Gaston County Opioid Settlement Request for Proposal Application

Gaston County Opioid Settlement Request for Proposal Application
All applications must be completed and submitted to Stephanie Jamoulis at
stephanie.jamoulis@gastongov.com. The budget narrative spreadsheet along with other required
documents must be submitted as separate attachments to the email listed above. All project
applications should not exceed a two-year period.
This Request for Proposals is specifically looking for programs that focus on Early Intervention as
defined below:
Early Intervention - Fund programs, services, or training to encourage early identification and
intervention for children or adolescents who may be struggling with problematic use of drugs or mental
health conditions, including Youth Mental Health First Aid, peer-based programs, or similar approaches.
Training programs may target parents, family members, caregivers, teachers, school staff, peers,
neighbors, health or human services professionals, or others in contact with children or adolescents.
The following list represents the type of eligible activities that could be included in your application;
related activities consistent with the NC MOA may also be proposed in your application:
a. Implement use of evidence-based screening tools for youth to identify risk of developing opioid use
disorder and link those youth at risk to appropriate services (e.g., Screening to Brief Intervention;
Brief Screener for Alcohol, Tobacco, and other Drugs; Alcohol Screening and Brief Intervention for
Youth).
i. Develop protocol for linking youth to appropriate MH/OUD services as needed
ii. Connect youth to peer support groups that strengthen recovery
iii. Connect families to support groups to enable strong support of their children who may be
struggling
b. Provide training for parents, caregivers, school staff, peers, human service professionals, etc. in early
identification of opioid use disorder and mental health disorders (e.g., Youth Mental Health First
Aid).
c. Provide evidence-based programs that strengthen families and communities to enhance support of
youth (e.g., Strengthening Families).
d. Engage in trauma-informed trainings and improve programs focused on youth and adolescents to be
more trauma-informed

Early Intervention Request for Proposal Application
Organization Name
Organization Point of
Contact
Point of Contact Email
Point of Contact
Phone Number
Organization Address
Project Name
Proposed Start and
End Dates
Requested Amount
New or Existing New Existing
Program
Proposal Summary
Provide a brief (no more than 250 words) overview of the planned project. Summary must include a
purpose statement describing how your application will address the needs of people who use
drugs in the community with particular considerations for historically marginalized populations.
[Required, maximum 250 words]
Project Narrative
Suggested page limits are listed beside each section of the Project Narrative below and in the
accompanying application. This limit applies only to the Project Narrative section. Be as specific
as possible in the project narrative section. This will be the basis for evaluating applications and
monitoring the selected organization's performance.
1. Assessment of Community Need - Suggested page limit: 1 12 pages

List the geographic area to be served by the proposed project and the overdose burden
in that area according to DHHS poisoning data
(https://www.injuryfreenc.ncdhhs.gov/DataSurveillance/Poisoning.htm).
Provide any pertinent and/or necessary information as it relates to the need for this
work in your community. Identify any gaps in services you intend to address by
identifying and/or defining current programs/providers.
Describe the needs of the priority population that this proposal will serve and how
those needs were determined (e.g., focus groups, survey, patient engagement).
NOTE: Provide citations/reference sources for any included community demographic or health
status data. Current and relevant data is available at:
* https://ncopioidsettlement.org/data-dashboards
* https://www.ncdhhs.gov/opioid-and-substance-use-action-plan-data-dashboard
* https://injuryfreenc.ncdhhs.gov/DataSurveillance/Poisoning.htm
* https://nc211.org/data/
* https://medicaid.ncdhhs.gov/reports/dashboards#annual
2. Project Description and Program Sustainability - Suggested page limit: 2 12 pages
Clearly identify which implementation strategy from the NC MOA's Option A or Option B
list of eligible strategies are included in the proposal, including the number (e.g.,
"Strategy 2: Evidence-Based Addiction Treatment"). Only one eligible strategy may be
selected for each proposal.
Describe the proposed project in detail, including:
Project activities and the evidence-base about their effectiveness for the priority
population;
Plans to incorporate feedback from program participants to inform delivery of
the selected activity or activities;
How the project will address identified community needs and/or service gaps;
The project's expected impact on preventing opioid overdose, increasing
access and linkages to care for the most marginalized and underserved
populations; and,

How the project will build local infrastructure to respond to the opioid overdose
crisis.
Explain how you will engage or have already engaged the priority population in
developing this proposed project.
Detail how this project will advance your organization's goals.
Include timelines for project implementation with specific program objectives as they
relate to performance measures and budget (e.g., hiring staff or subcontractors,
purchasing supplies, establishing policies and protocols, enrolling participants, etc.)
including who is responsible for associated activities.
Explain how the project will increase the capacity of your organization or your
community over time to address opioid use disorder. Note that applications must
describe how they will plan for enhancements, improvements, or increases
achieved during the project year to be sustained past the funding secured during
the project period.
Describe obstacles that may affect your organization's ability to sustain this program
after the project cycle and potential solutions to identified challenges.
Detail any other funding sources that will be used towards this project.
3. Equity Impact- Suggested page limit: 34 page

Describe how the proposed project addresses health inequities and/or social determinants
of health (transportation, housing, employment, etc.) directly or through collaboration with
other agencies.
Describe how the proposed project reaches, benefits, and equitably engages historically
marginalized populations and addresses the needs of the uninsured and underinsured.
4. Organizational Readiness - Suggested page limit: 2 pages
Describe the capacity of the fiscal agent/organization that will take total responsibility for
the fiscal, reporting, and grant-related compliance requirements to manage grants and
comply with financial and monitoring requirements.
If applicable, identify any proposed subcontractors and their role on the proposed project.
If the specific subcontractor is not yet identified, describe how the subcontractor will be
selected.
Provide specific examples of the organization's or partnership/collaboration of multiple
organizations' capacity to deliver information in a culturally humble, sensitive, and
appropriate manner. The applicant must demonstrate an understanding of issues
specifically affecting people who use drugs (PWUD) and/or other intersecting historically
marginalized populations. A successful applicant will have staff and/or volunteers with
diverse backgrounds who are sensitive to drug user health issues.
If applicable, provide specific examples of how any identified subcontractors demonstrate
these capacities.
Describe your organization's or partnership/collaboration of multiple organizations' history
promoting the health and dignity of individuals and communities impacted by drug use or

your plans to incorporate this mission into your core activities and how your organization
will be delivering program activities in a culturally appropriate manner.
If applicable, provide specific examples of how any identified subcontractors demonstrate
these capacities.
If applicable, highlight if your organization or partnership/collaboration of multiple
organizations and/or any proposed subcontractors serve the following prioritized groups:
* Those experiencing homelessness and housing instability,
* Black, Indigenous, and People of Color (BIPOC),
* Federal or NC recognized tribal communities, and/or
* Those transitioning from correctional settings to the community.
5. Evidence of Collaborations/Partnerships- Suggested page limit: 1 14 pages
Describe how you will collaborate on this project or initiative with other relevant
organizations in your community and how this project will improve collaboration between
local stakeholders and/or engage new ones.

Describe how you will verify that projects or services are not being duplicated in the
community and with the population served.
6. Performance Measures and Program Evaluation - Suggested page limit: 1 page
Detail how you will evaluate your project.
Describe how you will engage the priority population in the design and implementation of the
evaluation of this project.

Recipients providing direct services will be required to report client-level data on elements
including but not limited to demographic characteristics, substance use, diagnosis(es),
services received, and types of medications for opioid use disorder received. Explain how
you will capture this data. (See
https://nctopps.ncdmh.net/dev/gettingstartedwithnctopps.asp for a suggested tool.)
Explain how you will monitor the project and capture metrics for each of the supported
strategies included in your project. You may wish to include metrics in a table format.
Consult suggested metrics provided below:
Additional Required Documents to be sent to Stephanie Jamoulis:
Letters of Commitment and Letters of Support
Letters of commitment must be included from any agency or community organization integral to
the success of proposed activities. Additional letters of support that are relevant and descriptive
will strengthen applications. Each key partner referenced in the application narrative and/or the
budget should have an accompanying letter of commitment/support to demonstrate evidence of
collaboration. The partnership highlighted in the letter of commitment/support should also be
reflected in the application narrative. Letters of commitment/support will not be scored, but they
will be considered in connection to the scored Evidence of Collaborations/Partnerships section of
the Project Narrative.
Letters must be included with each application as an appendix and will not count toward the
narrative page limit. Do not have letters sent separately to Gaston County. Letters sent separately
from applications will not be read by reviewers.
Budget and budget narrative
Use the Budget Worksheet to document your anticipated program budget, including line-item
calculations and a budget narrative.