State Capacity Building Initiative
About The RFP
The purpose of these temporary, two-year grants is to enhance long-term state support for Lifeline affiliated call centers and boost in-state answer rates. Properly resourcing such centers means more
calls can be answered in-state and fewer calls will be routed into Lifeline’s national backup network. This will result in greater numbers of callers experiencing shorter wait times and more efficient linkages to local treatment, support, and crisis/emergency services. Vibrant Emotional Health will award up to $5 million in grants in FY20 and up to another $5 million in FY21 to the same FY20 awardees so that local, regional and state-wide call centers are better able to manage Lifeline call volume.
The number of awards to be made depends on the budget levels of successful applicants. As the lead applicants, state/territory agencies must partner with Lifeline-affiliated call centers of their choosing and in their state/territory for this grant competition. Special provisions will be made for states/territories with no current Lifeline-affiliated centers (see Section II: Eligibility Information). The applicants must also provide robust sustainability plans in order to ensure answer rate gains are maintained after the grant period ends. States and U.S. Territories eligible for this grant competition are those with in-state answer rates less than 70%: AK, AL, GA, IL, IN, KS, KY, MA, MI, MN, NV, NY, PA, RI, SC, TN, TX, VA, VT, WI, WY, as well as American Samoa, Guam, Puerto Rico, and the U.S. Virgin Islands.
Applications are due no later than August 30, 2019. Directions and application requirements are listed within the RFP. Frequently asked questions will also be added to this page regularly.
What counts toward the 12 page limit of the grant narrative?
The 12 page limit only applies to sections A-E that constitutes the project narrative. We apologize that there is a confusing reference in the RFP which suggests Section F (Budget Justification, Other Supporting Documentation) is also part of the 12 page limit. Section F is not part of the 12 page limit.
Why is the Lifeline sharing this information with centers if the states are the ones who apply for the grant and they also receive the grant?
These capacity-building grants are designed to promote collaborations/relationship-building between the local centers, the states and the Lifeline. While it is true that the state agency will receive the grant, they are required to pass along at least 85% of the total funds to Lifeline member centers. The grants also require that a liaison be designated at the state agency as well as at any Lifeline member call center receiving sub-awarded grant funds as a way of ensuring these collaborations occur regularly and efficiently.
At a broader level, if states have not prioritized supporting Lifeline crisis centers to answer Lifeline calls in their crisis funding efforts, this grant is designed to help them do so. It will clarify that Lifeline callers from their state are their callers, for which they should take some responsibility for assisting. It will also underscore the value of the work that local Lifeline member centers are performing in their state.
These capacity-building grants are designed to promote collaborations/relationship-building between the local centers, the states and the Lifeline. The grants require that a liaison for each entity be designated to ensure that these collaborations occur regularly and efficiently.
Traditionally, federal funding for local services supports flow through State Mental Health Authorities (Block Grants, Medicaid/Medicare dollars, CCBHC grants, GLS grants, etc). This funding model that applies funds from a national, federally-funded entity to a state to support local crisis services establishes a precedent for future collaborations between federal/national and state authorities to fund local crisis centers, should future federal funds for crisis centers emerge.
Why can’t you fund every center or enlarge the stipend for everyone? And why are only states with low answer rates allowed to apply?
Increasing all center stipends incrementally with the funds available on this grant would do little to solve our capacity problems. Solving such problems is our first priority for callers seeking help in crisis.
We estimate that it would cost over $50 million annually for all current Lifeline centers to receive full funding to answer 90% of their Lifeline calls in-state. That cost does not include the expenses of administering the entire Lifeline network as a whole. With approximately 1/10 of that amount available in this grant for addressing our capacity challenges, we need to target our limited funds wisely to address the areas where we have the most problems.
By helping a few states in significant ways, we help all states. About 60% of calls to our national backup centers come from 6 states. The more we can successfully target the states where capacity is most challenged, the more we can help Lifeline callers from all states. No state answers 100% of Lifeline calls, so some calls from every state flow to our national back-up centers. If national back-up centers become less burdened, callers from your state that end up at the backup centers will not have to wait as long to get the help they need.
States with strong answer rates where Lifeline centers are currently better resourced to respond to Lifeline calls may be eligible for future funds, if they become available. In fall 2019, for example, we are looking to make a limited number of one-year emergency funds available to centers with Lifeline answer rates above 70% and who answer a significant number of Lifeline calls, but who are threatened with temporary funding interruptions. More information and announcements will be forthcoming.
If a state receives money, but does not achieve the expected goals, must funds be returned?
We expect awardees to do their best to reach the required minimum in-state answer rate gains over the two-year grant. We have factored call volume increases into our grant expectations so that the number of additional calls to be answered is realistic. This latter measure can serve as another measure of success in the event call volume increases are much higher than expected and answer rates are not fully achieved. If a grantee has done their best on the grant, spent the money appropriately, submitted ongoing required data and worked with the Lifeline to make any necessary adjustments along the way but yet do not meet answer rate gains, then no funds will need to be returned.
Would non-Lifeline centers be eligible for funding from the state instead of Lifeline centers?
No, only Lifeline member centers who have been answering Lifeline calls for at least six months are eligible to be sub-contracted by the state using these grant funds.
Is there an option for centers to apply for funding if the state agency declines to apply?
No, these funds must flow through a state agency.
Are we supposed to wait for the state agency to reach out to us?
We encourage centers to proactively reach out to their state agencies for partnership opportunities on this grant.
I am part of a crisis center that wishes to be considered for the RFP. Who do I reach out to?
A list of the state suicide prevention coordinators may be found in the Appendix section of the RFP or you may also visit http://www.sprc.org/states
How will states decide which centers they want to partner with?
The Lifeline and Vibrant Emotional Health does not have influence on how states designate a center or centers in their region as partners for this application. The state agency will make these determinations independently. The Lifeline will provide them with access to Lifeline member center contact information in their state, as well as data showing center level call volume, regional call volume and, if requested, center level answer rates from the January-March 2019 period. This information could be helpful in their thinking, and may or may not affect their decision-making.
How will funds go from the state to the center?
Vibrant Emotional Health will give the funds to the awarded state(s), who will then distribute it to their Lifeline center(s), as detailed in their application. The states will subcontract with whatever Lifeline member centers they designate to receive the funding. At least 85% of the funds must go to the centers towards building capacity to answer calls. Year one funds will be paid to the state agency upfront and Year two funds will be distributed quarterly.
Should centers be working together as a consortium or preparing to compete for funding on their own?
This is a decision best negotiated between call centers and the state because centers are not eligible to apply directly for the grant. States will make this decision based on what they think is the most efficient, effective strategy to improve answer rates and meet the grant goals.
If a center is currently in the application process, but has not yet been approved (gone live) can they be eligible for Y2 funding from the state?
Yes, provided they have been answering calls for 6 months prior to receiving sub-contracted grant funds.
Please comment on sustainability, since grant funding seems to rest substantially on the sustainability plan of applicants. This seems like a bit of a catch 22: if we had sustainable funding to increase capacity in our state’s Lifeline system, we wouldn’t need this grant funding. Seems to me the grant funding offers a concrete way of seeing what it realistically costs to build capacity in our state, especially in heavily populated metro areas where personnel costs are higher than many places across the state and nation.
Sustainability is a major component of this grant, hence the grant name as well as why we turned this into 2-year project period. We hope that the two years and relative straightforward nature of the work scope allows time for states and centers to work together and figure out creative ways to sustain the major grant efforts. This is also why we set realistic answer rate gains relative to baseline levels, allowed for call volume increases and factored in reasonable cost per call estimates.
Creative ways to sustain efforts could be highly varied and may well include shared investments from state and county. or state and city, or all three, or all three and private sources, or even increased levels of volunteer call line worker recruitment at centers that utilize such talent. We hope that this grant helps jump start such state/local level conversations beyond those that may have occurred in the past.
When are applications due?
Applications are due Friday August 30, 2019 at 5:00 p.m. EST
When does the Lifeline plan to announce the awards?
We hope to have award announcements made by September 27, 2019. However, this date may change if the review process takes longer than expected due to a large number of applications.
Is there any connection between this grant opportunity and the N-1-1 initiative?
There is no direct connection between this grant opportunity and the N-1-1 initiative.
What is the page maximum for the RFP Application?
The page maximum for the RFP application is 12 pages. There was a previous mistake in one of our grant related power points that indicated the length was 10 pages.
What is our state’s in-state answer rate?
You can find your in-state answer rate in the appendices section, “Appendix 5: Answer Rate.”
Is my state eligible to apply for this RFP if our in-state answer rate is not below 70%?
If your state has an in-state answer rate higher than 70%, it is not eligible for this specific funding opportunity.
What Technical Assistance can the Lifeline provide to states?
The Lifeline can provide the state applicant with contact information for local call centers (included in the RFP), as well as call volume data by center, answer rates, call volume by county, and call center coverage areas/hours. States are strongly encouraged to gain further information about these details from the centers themselves. As necessary, the Lifeline can also provide states with information about Lifeline’s best practice standards for risk assessment, imminent risk, center accreditation, establishing call center metrics, and staff/call center training.
Who can I contact for additional data needed to apply?
For any additional data relevant to this grant please contact Devon Morera, Lifeline’s Coordinator of New Member Services at [email protected]
What other Lifeline centers are in my state?
You can find centers that are a member in your state by going to the Crisis Center Map on the Our Network page: https://suicidepreventionlifeline.org/our-network/
Can the grant be used to pay call center staff salaries?
The RFP says applicants should ‘ensure a plan for 24/7 staffing including at least one dedicated counselor answering only Lifeline National calls at all times.’ For call centers that are answering local crisis line phone numbers, how does the Lifeline envision a call room operating with the above requirement? Would triage protocol for prioritizing calls coming in on the NSPL be sufficient to meet this requirement or would you need an additional staff person who does not take any local crisis line calls?
Most of the Lifeline-member call centers answer multiple crisis lines. What is of critical importance to this grant, especially because it represents a significant level of funding above our typical annual stipends, is that Lifeline calls are not placed in a lower priority status relative to the other lines. While the Lifeline recognizes the importance of all crisis lines, this funding is intended for greater numbers of Lifeline calls to be answered locally and for less calls to roll out of state into our backup network.
We often hear from centers themselves that sometimes they feel they have to make choices to keep counselors available to answer calls on their otherlines, because there is a belief that, since the Lifeline has a backup network, the call will get answered somewhere if they don’t answer. Such choices get made when, for example, they are short staffed or when other lines have stringent state or county performance metrics that need to get met in a limited timeframe.
For this reason, we want to ensure that at least one staff person is dedicated to answering only Lifeline calls and that the grantee will ensure that in its overall call center efforts Lifeline calls are not being placed on a lower priority or that Lifeline funds are primarily supporting other crisis line metrics above Lifeline’s. This requirement was established mainly with large call centers in mind who have higher call volume. We very much want to see that there is sufficient staffing during high call volume hours so that Lifeline calls are answered at the same priority as other calls. That being said, we certainly recognize that in periods of short staffing the counselor(s) funded by this grant may need to answer other crisis lines if there are no Lifeline calls at that moment. We also recognize that in smaller centers and centers with lower call volume it may not be feasible from an economic or efficiency perspective to have a person only allowed to answer Lifeline calls.
Our biggest barrier to expanding Lifeline Capacity is that our current call centers do not exist in organizations that are open 24/7. Expanding them to 24/7 capacity goes beyond staffing someone to answer the phone, it is the cost of keeping large organizations open for 14 more hours in a day. However, we do have an option for an existing 24/7 call line to become a crisis center. Is that off the table as an action plan to build capacity with this grant?
Using the grants to build 24/7 coverage is important. If that is not viable for you with your current Lifeline call centers or even ones that are soon to join the Lifeline network, then you should explore this option for an existing 24/7 call line to become a crisis center. From our perspective that is viable IF they could make this transition and start receiving calls by the end of the 4th Q in Y1.
If an organization is designated by the state to provide services, undergoes quality and compliance reviews and is under our oversight, can that count as accreditation? (In reference to RFP State/county licensure in Appendix 1 – accreditation bodies.)
Yes, we may be able to accept ‘state designation’ as provisional accreditation, with the approval from SAMHSA. Centers in provisional accreditation status must work to receive accreditation within 3 years from one of the standard accreditation organizations we accept. Having such external accreditation is an important quality assurance step for the Lifeline as a whole because we do not have the resources to conduct on-site QA work with all centers.
Nevertheless, the $25 cost per call was taken from centers that factored their admin/overhead into this unit, as well as related supervision, training and other costs, on top of staff time to assist the caller.
Is there is any ability for two or more states to apply for this grant together? We know the goal in to improve in-state call response, but we also the know the goal is swift and effective call response. Within our small region it may be most effective to pool our efforts, so we thought it worth asking and especially if our only call center cannot provide 24/7 coverage.
Multi-state partnerships would get tricky for us and could become a slippery slope of multiple states asking. Such a structure is not appropriate for this grant competition. Different states, different contracting structures, different agency jurisdictions, different sustainability opportunities/constraints – it all could become very complicated. Applicants must ensure there is an in-state Lifeline member call center they are partnering with. However, in instances where the only in-state call center(s) are not 24/7 operations, we would not be opposed if a state decided that one way to address the after-hours coverage gaps might could be to sub contract with a Lifeline member call center in a neighboring state. The applicant would need to demonstrate that this call center for after-hours coverage understands local norms and referral options in your state and optimally has a history of taking some of your state’s Lifeline calls. If awarded the state grant, we’d have to work with you to figure out the routing so in-state answer rates rise accordingly despite their location, but with a clear mid to long-term plan of building 24/7 capacity with a call center located in your state.
What if a specific area of the state is over 70% in-state, but the state itself is under 70% in-state answer rate? Is that area eligible?
It’s the state’s answer rate that determines eligibility, not individual areas of the state. As long as the state is below 70%, then the state is eligible.
In terms of call routing, does the Lifeline have the ability to split up our state’s calls by region of the state?
Yes, we can split call coverage / call routing by regions in the state. Centers may select coverage areas at: the statewide level, county level, zip code level, or area code.
Our state applied for capacity building grants in a previous year but did not get an award. We think it was because we couldn’t guarantee new state funding would be allocated to sustain the grant. Is the same likely to be true this year if we still can’t guarantee it?
Guarantees are a difficult thing to come by. States must provide a funding strategy that demonstrates a reasonable possibility that sustainable funding can be obtained and maintained, for a period of at least two years after the grant concludes. Lifeline and our partners at the National Association of State Mental Health Directors will work closely with state liaisons to identify and implement funding strategies, based on other successful state crisis center funding models and evolving, new strategies for funding that continue to emerge.
Our call center has an indirect cost rate. What is the limit for indirect costs and are these costs supposed to be wrapped into our cost per call estimates or above and beyond those estimates?
We have a set a limit of 15% for indirect costs at the center level as well as state agency level. At the center level, the indirect costs should be wrapped into the cost per call budget projections.
How was the rate of $25/hour determined?
The grant RFP indicates centers may budget for up to $25 per Lifeline call. It is not a $25/hour figure. The $25 cost per call was taken from a sampling of high-performing Lifeline call centers in different parts of the U.S. who have different staffing requirements. In helping us determine this cost-per-call average, the centers factored in staff time to assist the caller. They also factored in their admin/overhead into this price, as well as related supervision, training and other costs.
How should we track/record Veteran status for well-known/frequent callers?
Each call needs to be counted independently. If for some reason this is not viable at your center because of frequent caller protocols, we will be happy to work with you on realistic data tracking post-award.
In Section D of the grant, states have to report on data partnering call centers provide. The data includes call volume and answer rates, average speed to answer, etc. I know these are reports the state has to provide monthly. Can you provide clarification as to when the state has to submit the first of these reports?
Monthly data reporting will be due from the state to the Lifeline on the 15th of the month for the prior months data, unless otherwise negotiated between the state and the Lifeline post-award. Assuming a start of the grant on or near the beginning of October, and in order to allow some time for contracting and other coordination between the states and the centers, we will be asking for the first full month of data reporting to be November. Thus, the first report will be due by December 15, 2019.
The RFP indicates that an ACD phone system without Active Answer, or without the ability to implement Active Answer, is not eligible to participate. We have checked with our vendor, and they have advised that they are unaware of the term “Active Answer” as it applies to an ACD system. They do have the ability to reply with true DTMF but they cannot send a DTMF tone once a call is given to a counselor. They say they can’t build this in as there is no connection back to the originator of the call, in this case the Lifeline, once the call is disconnected from the originator. Your stated purpose of receiving the Active Answer, the “1”, is to be able to re-route the call if it is not received in a specified amount of time. We are not telephony experts and so we do not understand why the Lifeline can’t re-route the call once the time limit has been reached without the “1” being sent back. Can you clarify this for us?
Currently, when we route a call to a center using automatic call distribution, our system can’t detect the difference between when a call is answered by a center’s ACD system as opposed to when a call is actually answered and the caller is successfully served by a live counselor. Active Answer fixes that, by enabling crisis counselors to indicate to the Lifeline system, by pressing 1, that a counselor is helping the caller, so that the caller does not have to wait in a long queue. In fact, if no one at your center presses 1, we won’t release the call to your center in the first place and we will then go ahead and re-route the call to another center.
Though we do understand that some centers do not have systems that can send DTMF tones, we do need centers who wish to eligible for the grant to work with their phone providers to modify their telephony systems in order to meet that requirement.
Can we use the grant money to recruit new call centers if we don’t have enough centers in our state?
Lifeline has a general policy of only providing grant awards to call centers who have answered Lifeline calls for at least six months. This allows us, and the center, to be assured that membership in the Lifeline network is the right fit. It also helps ensure quality standards are being met. In special circumstances, such as when all call centers in a state are leaving the network and a new center is coming onboard rapidly, exceptions to this general policy may be merited. More importantly, we respect the hard work of the current members of the Lifeline network. Many of these centers have been taking Lifeline calls for years and have been doing so while under-resourced. For that reason and for reasons of quality assurance, Capacity Grant Building funds in Year One which are sub-awarded by the state may only go to Lifeline member call centers who have been answering Lifeline calls prior to January 1, 2019.
We also recognize that some states may need to incentivize more call centers in their state to join the Lifeline network. In such instances, states are strongly encouraged to recruit those centers so they work through the Lifeline new center application process during Year one of the grant. After the new centers have answered Lifeline calls for six months, they would be eligible to receive sub-awarded Capacity Grant Funds, for example, in Year Two of the grant.