As of January 2009, all Requests for Proposals/Applications (RFP/A) issued from New York’s Department of Health, Center for Community Health (CCH) must reflect the needs of people with disabilities and minorities, regardless of where the funding is coming from — the state or the private sector. In March 2010, the policy was extended to the Department’s AIDSInstitute.
The new integration policy reflects a universal design approach — that the delivery of services and programs to people with disabilities should be “baked in” rather than “layered on top.” This eliminates duplication of effort, reduces costs and ensures that health programs serve the needs of people who might otherwise be overlooked in the design, planning and implementation of public health programs and services. Like most states today, New York is struggling financially, having to make do with less. The RFP integration policy enables Disability and Health to permeate the procurement process, extending its impact across all of public health. And Disability and Health Programs in other states are watching.
The Process
Until everyone becomes acclimated to the new process, Theresa Paeglow, Director of New York’s Disability and Health Program, reviews bi-weekly reports from CCH that track RFPs and RFAs in progress in each division, program and bureau. That way, she can offer assistance to the RFP developers early in the process.
“There is a learning curve,” says Paeglow. “While some of those involved are enthusiastic right from the start — wondering why we didn’t do this sooner — others are a little confused at first. Some don’t fully understand the need to target smoking cessation or pregnancy prevention programs to teens with disabilities.” But they learn, both about the need and about how to respond, making doubters into converts.
New York State’s RFP/A development and approval process is complex; start to finish, the process can take as long as a year. The developer of the RFP/A contacts Paeglow in the Disability and Health Program early in the RFP development process, and she helps them incorporate the appropriate inclusion language and strategies specific to the initiatives to be funded by the RFP.
So far, the Program has participated in the development of 17 RFA/RFPs. Of those 17, five have been released and applications received. Award recipients have been announced only for one, which involves 22 contracts that started July 1. It might be early days, but the new policy is already making a difference. After the RFAs currently in the pipeline are fulfilled, there will be roughly 200 health and wellness contracts integrating the needs of people with disabilities and minorities, including programs to prevent adolescent pregnancy, improve student health and nutrition, and stop smoking.
Contractor progress reports will be monitored to assess the reach of these programs to people with disabilities, which should provide interesting and useful data in the future. Unfortunately, the Disability and Health Program’s budget doesn’t allow for a rigorous outcome evaluation of integration initiatives at the state or community level right now. But the program is generating momentum in the right direction —Integration!