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684057 - FY27 RFP PHTHOPD27001 for Public Health Lead Entities
Funding Opportunity Details
HHS - PH (HP) - Local Public Health Performance
Final Application Deadline: Oct 8, 2026 12:00 PM
Status Posted
Posted Date Aug 27, 2026 1:45 PM
Award Amount RangeNo Limit - No Limit
Project Dates 01/01/2027 - 06/30/2032
Award Announcement Date 11/20/2026
Categorical Area
Recurring Opportunity No
Program Officer Margot McComas
Phone (515) 281-0443 x
Email [email protected]
Description
It is the responsibility of the Applicant to review all Attachments listed below for additional details regarding this Funding Opportunity.
The issuance of this Funding Opportunity in no way constitutes a commitment by Iowa HHS to award a contract.
Excerpts from the RFP:
Purpose
The purpose of this Request for Proposal (RFP) #PHTHOPD27001 is to solicit Proposals that will enable the Iowa Department of Health and Human Services (referred to as Agency) to select the most qualified applicant in each Iowa HHS District (“District”) to be designated as a public health Lead Entity (“Lead Entity”).
Each Lead Entity will serve as the district-level partner within the Iowa Public Health Service System.
Schedule of Important Dates
EVENT
DATE
RFP Issued
August 27, 2026
Written Questions and Responses
Round 1 Questions Due:
Responses Posted By:
September 4, 2026, by 12:00 PM (noon)
September 10, 2026, by 4:00 PM
Letter of Intent
September 18, 2026, by 4:00 PM
Written Questions and Responses
Round 2 Questions Due:
Responses Posted By:
September 18, 2026, by 12:00 PM (noon)
September 24, 2026, by 4:00 PM
Applications Due
October 8, 2026, by 12:00 PM (noon)
Applicant’s Oral Presentations, if requested by the Agency
On or around November 18, 2026
Post Notice of Intent to Award
On or around November 20, 2026
Anticipated Start Date of Contract(s)
January 1, 2027
| Description | File Name | Type | Size | Upload Date |
|---|---|---|---|---|
| A. RFP PHTHOPD27001 Public Health Lead Entity | A. RFP PHTHOPD27001 Public Health Lead Entity.pdf | 555 KB | 08/27/2026 01:33 PM | |
| B. HHS Application Forms Instruction Guidance IowaGrants | B. HHS Application Forms Instruction Guidance IowaGrants.pdf | 2 MB | 08/11/2026 03:30 PM | |
| C. PHTHOPD27001 Work Plan Formatting Specifications | C. PHTHOPD27001 Work Plan Formatting Specifications.pdf | 222 KB | 08/27/2026 01:07 PM | |
| D. Phase 1 Sample Draft Contract | D. Phase 1 Sample Draft Contract.pdf | 5 MB | 08/27/2026 01:14 PM | |
| E. Phase 2 Sample Draft Contract | E. Phase 2 Sample Draft Contract.pdf | 5 MB | 08/27/2026 01:49 PM | |
| F. Iowa HHS District Map | F. Iowa HHS District Map.pdf | 670 KB | 08/11/2026 03:38 PM |
| Description | Link |
|---|---|
| A. IowaGrants Registration and Login Instructions | https://dom.iowa.gov/state-government/grant-management |
| B. General Terms and Contingent Terms | https://hhs.iowa.gov/initiatives/contract-terms |
| C. Notice of Intent to Award | https://hhs.iowa.gov/about/funding-opportunities/notice-intent-award |
| D. HHS District Map | https://hhs.iowa.gov/media/19018/download?inline |
| Submitted Date | Question | Answer |
|---|---|---|
| Sep 1, 2026 12:51 PM | Q1: During Phase 2, who will have final authority to determine the allocation of District funding among the Lead Entity, counties, local public health agencies, and other providers? Will Iowa HHS establish an allocation methodology or minimum funding requirements for local providers, or will the Lead Entity determine the methodology through the District Public Health Service System Plan and contracting process? | A1: During Phase 2, Iowa HHS retains final authority over all District funding decisions. While the Lead Entity is responsible for administering funds and coordinating financial arrangements with counties, local public health agencies, and other providers, any funding allocation must align with the Agency‑approved line‑item budget and comply with all requirements outlined in the contract. Iowa HHS reviews and approves each annual budget and may request revisions before funds are made available. The RFP and contract do not establish a predetermined funding formula or minimum amounts that must be directed to local providers. Iowa HHS expects the Lead Entity to assess District needs, maintain a strong local provider network, and propose budget allocations that ensure consistent access to the Priority Public Health Core Services across all counties within the District. All allocations must support the implementation of the District Public Health Service System Plan and adhere to allowable cost requirements, funding restrictions, and Agency guidance. |
| Sep 1, 2026 12:51 PM | Q2: What process will be used when a County Board of Health or designated local public health agency disagrees with the Lead Entity regarding provider capacity, identification of a service gap, allocation of resources, remediation requirements, or implementation of the District Public Health Service System Plan? Will counties and local providers have a formal process to respond to or appeal such determinations? | A2. Counties remain independent public‑health authorities under Iowa Code and participate in the district’s public‑health activities as program partners. When counties disagree with planning decisions or identify gaps differently than the Lead Entity, the expectation is that the Lead Entity will maintain collaborative communication, document concerns, and bring the issue to Iowa HHS through required reporting channels. There is no appeal process between counties and the Lead Entity because the Lead Entity does not direct county operations. Iowa HHS will continue working with the Lead Entity and counties to resolve participation challenges through program engagement and coordination—not through contractual enforcement. Counties retain their statutory responsibilities and continue participating in district planning and discussions regardless of disagreement. |
| Sep 1, 2026 12:52 PM | Q3: Section 2.3.2.4.1.6 requires an attestation from each Board of Health that the county will "operationally and financially support the obligations outlined in Iowa Code." Please clarify the specific operational and financial obligations covered by this attestation and whether execution creates any obligation beyond those already imposed upon counties under Iowa law. Please also clarify the consequences if a County Board of Health declines to execute the attestation. | A3. Execution of the attestation does not create any obligation beyond those already imposed upon Iowa Counties under Iowa law. The consequences if a County Board of Health declines to execute the attestation will remain the same as how HHS would currently handle a Local Board of Health not meeting it's obligations in Iowa statute now. |
| Sep 1, 2026 12:52 PM | Q4: If an existing local public health agency is currently providing a Priority Public Health Core Service and demonstrates sufficient capacity and performance, is there a presumption that the agency will continue providing that service during Phase 2? May a Lead Entity replace that provider, reassign funding, or directly provide the service within another county without the agreement of that county's Board of Health or designated local public health agency? Please clarify which parties must provide the "mutual agreement" referenced in the RFP regarding direct provision of services by a Lead Entity. | A4: Counties and local public health agencies remain responsible for delivering core services within their jurisdictions. The Lead Entity model does not replace or reassign county‑level providers, nor does it have authority to deliver services inside a county without collaboration. Core service funding flows to counties based on program needs, and counties continue to determine how services are provided locally. There is no Lead Entity authority to override a county’s provider decisions. Any proposed funding changes or service delivery adjustments must be submitted through the Lead Entity’s annual line‑item budget, reviewed by Iowa HHS, and approved prior to implementation. Iowa HHS retains final authority over funding decisions and ensures that all allocations support consistent access to Priority Public Health Core Services across the District |
| Sep 1, 2026 12:53 PM | Q5: Does the Lead Entity have authority to require a County Board of Health or designated local public health agency to modify its local service-delivery model, staffing structure, subcontractors, or local public health activities? If so, please identify the source and limits of that authority. | A5: The RFP and contracts do not grant the Lead Entity authority to require a County Board of Health or designated local public health agency to change its local service‑delivery model, staffing structure, subcontracting arrangements, or locally controlled public health activities. Counties retain statutory authority for local public health under Iowa Code, and that authority is unchanged by this procurement. Local Boards of Health continue to be responsible for meeting Iowa Code obligations and maintaining oversight of local public health services. The Lead Entity’s role is to coordinate, support, and strengthen districtwide delivery of the Priority Public Health Core Services—not to direct or override county‑level operations. |
| Sep 1, 2026 12:54 PM | Q6: Will Lead Entities be required to conduct competitive procurements when selecting local providers or subcontractors during Phase 2, including when the existing provider is a County Board of Health or its designated local public health agency? If so, what procurement requirements will apply? | A6: Iowa HHS will work with the Lead Entity develop an agreement templates for use with local providers and partners. |
| Sep 1, 2026 12:55 PM | Q7: May a Lead Entity directly provide a Priority Public Health Core Service within another county without approval of that county's Board of Health or designated local public health agency? Please clarify which parties must agree for direct provision of services to satisfy the RFP's requirement that such arrangements be "mutually agreed upon through coordination and planning efforts within the District." | A7. No. A Lead Entity may not directly provide a Priority Public Health Core Service within a county without the agreement of that county’s Board of Health or its designated local public health agency. Counties retain their statutory authority under Iowa Code for local public health governance, service delivery, and staffing decisions. |
| Sep 1, 2026 12:56 PM | Q8: May Iowa HHS withhold, reduce, recoup, or otherwise adjust funding to the Lead Entity or District because of a performance deficiency attributable to an individual local provider? If so, how will HHS distinguish between Lead Entity performance and local provider performance? | A8. Yes. Iowa HHS may withhold, reduce, or adjust funding to the Lead Entity based on performance issues, but only when the deficiency relates to the Lead Entity’s responsibilities under the contract. The contract does not authorize Iowa HHS to take remedial funding actions directly against a county or local provider. Instead, all funding flows through the Lead Entity, which is accountable to HHS for ensuring required deliverables, coordination, monitoring, and districtwide access to Priority Public Health Core Services. |
| Sep 1, 2026 12:56 PM | Q9: When HHS requires the Lead Entity to develop a remediation plan because of concerns regarding an individual local provider's service delivery or capacity, what authority will the Lead Entity have to require the provider or County Board of Health to implement corrective actions? | A9: The Lead Entity does not have authority under the RFP or contracts to compel a County Board of Health or designated local public health agency to make changes to service delivery, staffing, subcontracting, or local public health operations, even when HHS requires the Lead Entity to submit a remediation plan. Counties retain statutory authority and responsibility for local public health under Iowa Code, and nothing in this procurement changes or limits that authority. When a remediation plan is required, Iowa HHS is directing the Lead Entity, not the county, to outline how it will support coordination, address service gaps, strengthen provider capacity, and ensure districtwide continuity of Priority Public Health Core Services. The remediation plan describes actions the Lead Entity will take, not actions it may impose on local providers. The Lead Entity may request changes, offer technical assistance, and facilitate discussions, but it does not have authority to require a county or provider to adopt corrective actions. Only Iowa HHS may determine whether additional actions are required beyond the Lead Entity’s plan. If HHS determines that county-level changes are necessary, the Agency would work directly with the county under its existing statutory oversight, not through delegated Lead Entity authority. |
| Sep 1, 2026 12:58 PM | A10: The RFP prohibits use of contract funds to supplant existing state, local, tribal, or private funding of infrastructure or services, including staff salaries. Please clarify how this prohibition will apply when an existing local public health agency becomes a Phase 2 provider and currently uses county funds to support personnel or infrastructure necessary to provide a Priority Public Health Core Service. Will Phase 2 funds be permitted to support the portion of existing personnel costs attributable to new, expanded, or transferred responsibilities under the District Public Health Service System Plan? | A10: The RFP and contract prohibit supplanting—meaning Phase 2 funds cannot replace existing state, local, tribal, or private funding that already supports infrastructure or services, including salaries for staff performing existing work. This applies when a local public health agency becomes a Phase 2 provider and currently uses county funds for personnel or infrastructure associated with the Priority Public Health Core Services. However, the prohibition on supplanting does not prevent Phase 2 funds from supporting new, expanded, or transferred responsibilities that arise from implementation of the District Public Health Service System Plan. If a local provider undertakes additional activities, takes on expanded responsibilities, or assumes work that was not previously funded by the county, Phase 2 funds may be used to support the portion of personnel or infrastructure costs attributable to that new or expanded scope of work. These costs must align with the Agency‑approved budget and fall within allowable expenditures. |
| Sep 1, 2026 1:01 PM | Q11: What procurement requirements will apply when a county serving as Lead Entity contracts or subcontracts with other counties, County Boards of Health, designated local public health agencies, nonprofit organizations, or other providers? Please clarify whether Iowa HHS procurement requirements, the Lead Entity county's procurement policies, Iowa Code requirements, or some combination thereof will govern provider selection. | A11: The RFP and contracts do not impose a separate Iowa HHS competitive procurement requirement on Lead Entities when selecting local providers or subcontractors. Lead Entities, including counties, must follow their own governing procurement policies and applicable state and federal rules and must also comply with the subcontract review requirements contained in the contract. |
| Sep 1, 2026 1:01 PM | Q12: Please clarify how liability is anticipated to be allocated among Iowa HHS, the Lead Entity, counties, and local providers for activities performed under the District Public Health Service System Plan. Will Iowa HHS establish minimum insurance, indemnification, or risk-management requirements for Lead Entity subcontracts and intergovernmental agreements? | A12: The lead entity is required to comply with the contractual terms outlined in the draft sample contracts. Per Section 2.12.9 For purposes of this Contract, third parties who perform any of the Contractor’s obligations pursuant to this Contract are considered subcontractors. The Contractor shall notify the Agency in writing of all subcontracts relating to Deliverables to be provided under this Contract prior to the time the subcontract(s) become effective. The Agency reserves the right to review and approve all subcontracts. The Contractor may enter into these contracts to complete the project provided that the Contractor remains responsible for all Deliverables provided under this Contract. All restrictions, obligations, and responsibilities of the Contractor under this Contract shall also apply to the subcontractors and the Contractor shall include in all of its subcontracts a clause that so states. Iowa HHS will work with the Lead Entity develop an agreement templates for use with local providers and partners. |
| Sep 1, 2026 1:12 PM | Q13: Beyond the required Project Director, what staffing levels or competencies does HHS anticipate a Lead Entity will need for finance, contracting, data, administration, and program management in Phase 2? | A13: The RFP and Phase 2 contract do not prescribe specific staffing numbers or mandate particular job titles beyond the required Project Director. However, Phase 2 expectations make clear that Lead Entities must have sufficient administrative, financial, contracting, data, and program management capacity to fully support districtwide implementation of the Priority Public Health Core Services starting July 1, 2028. |
| Sep 1, 2026 1:13 PM | Q14: During Phase 2, will the Lead Entity be expected to pay providers before receiving reimbursement from HHS, and if so, what working-capital or cash-flow capacity does HHS expect the Lead Entity to maintain? | A14: Under the Phase 2 contract, Iowa HHS reimburses Lead Entities based on claims submitted for allowable expenses. The contract does not require Lead Entities to pay local providers or subcontractors before receiving reimbursement from HHS. Lead Entities may pay providers before reimbursement if they choose to, but this is not an HHS requirement and is not specified in the contract. Lead Entities must submit claims within required timelines, and HHS verifies accuracy and compliance before issuing payment. The contract does not establish any minimum working‑capital or cash‑flow requirements, nor does it impose expectations regarding the timing of payments that Lead Entities must make to local providers. Each Lead Entity may determine how to manage cash flow and provider payments in accordance with its internal policies, local procurement rules, and financial practices. |
| Sep 1, 2026 1:21 PM | A15: If a county lacks sufficient local public health capacity to perform required communicable disease response activities, i.e. a measles outbreak, and another county is unable or unwilling to provide assistance, how is the Lead Entity expected to fulfill its contractual responsibility to ensure the service is provided? | A15: During Phase 2, the Lead Entity is responsible for ensuring that communicable disease response services remain available across the District, even when a county lacks capacity and neighboring counties cannot assist. Although the Lead Entity cannot compel counties or local public health agencies to change their operations, it must coordinate districtwide solutions, maintain and strengthen the provider network, identify service gaps, facilitate cross‑county communication, and escalate issues to Iowa HHS when capacity cannot be resolved locally. The Lead Entity may directly provide services within a county only if the county agrees, consistent with the RFP requirement that such arrangements be mutually agreed upon through district coordination and planning. When local capacity issues threaten required communicable disease response, the Lead Entity must also follow contract mechanisms designed to ensure continuity of core services. These include documenting the gap, notifying Iowa HHS, and submitting a remediation plan if requested by the Agency. Remediation plans outline actions the Lead Entity will take—not actions imposed on counties—and Iowa HHS retains authority to determine any additional steps needed to maintain coverage. If immediate response is required and county‑level agreement cannot be achieved, Iowa HHS may provide direction or additional support while the Lead Entity continues coordinating communication and system-level problem‑solving. |
| Sep 1, 2026 4:26 PM | Q16: When will Iowa HHS have their statewide priorities defined? And when will these be communicated to the other partners across the Shared Responsibility model? Knowledge of these specific priorities as soon as possible would be helpful as Lead Entities prepare their application and gauge the complexity or ease in which their district assessments, budget needs, timelines and data sets will align and/or require more extensive restructuring. | A16: This topic is outside the application requirements for the Lead Entity RFP. |
| Sep 2, 2026 1:39 PM | Q17: In sections 2.3.2.2 and 2.3.2.3, will the Agency hold meetings with all 7 lead entities in attendance, or will these meetings be one on one between the Agency and each lead entity? | A17: This will be determined during the contract negotiation period. |
| Sep 2, 2026 2:03 PM | Q18: On page 41, Section 3.02 of the RFP it states "For each District the Applicant is submitting a proposal for, the Applicant must include letters of support from other recognized local public health agencies and/or County Boards of Health within the District they are applying for. Applicants may also choose to include letters of support from other proposed partners within the District." If the applicant is a local public health agency, should they submit a letter of support from their own board of health? If they should not, do you need to adjust the total # of letters of support needed to meet the 50% and 100% threshold in the scoring matrix? | A18: Yes, the applicant should submit a letter of support from their own board of health. |
| Sep 2, 2026 3:27 PM | Q19: Q19.a. Will there be any rules preventing meetings both with the state and within districts from being recorded to ensure 2.3.3.4 “The Lead Entity shall maintain records of communication, coordination, and navigation activities…” is met? Q19.b. Can you provide examples for 2.3.6.2.2 around staffing levels and what the lead entity would be responsible for vs what the lead entity would not be responsible for to meet the deadlines set forth by the Agency? Q19.c. Would meeting invite responses meet the requirement in 2.3.8.1.2? Q19.d. Since the Lead entity is responsible for the level of staffing, would it be safe to understand that they are also responsible for ensuring the quality of the staffing? Q19.e. Lead Entity is responsible for services and accuracy. Would we be responsible for billing accuracy? Even for Immunizations- verifying VFC vaccine went to the correct people and IRIS data is correct? Q19.f. Can we get examples of the services required for each core area? What level of analysis would be needed, what services are going to be covered in area? Q19.g. How will statutory duties under Iowa Code be split or coordinated between individual county LBOHs and the District Lead Entity? Q19.h. If a LBOH does not follow up on a code-required activity, is it the Lead Entity's responsibility or will the state intervene due to the Code requirement? Q19.i. In the case of disagreements within the district, who decides how to resolve that? Will State act as an arbitrator, or will it fall to the lead entity’s decision? Q19.j. Are initial software purchases or system integration fees required for district-level tracking allowable as direct costs during the Phase 1 planning grant window? Q19.k. What formal agreements must be executed between individual county health departments and the Lead Entity to allow compliant sharing of client-level data? Q19.l. Clarify lead entity Authority vs. Coordination responsibility. Q19.m. Address the June 30 to July 1 phase 1 to phase 2 problem- The RFP says that by July 1, 2028, the lead entity must have administrative, finance, contracting, and other staff necessary for implementation in place so there is no gap in service. But the interim district plan is not due until June 30, 2028, leaving no time to transition from planning to implementation. Q19.n. Can you define what “assure”, “ensure”, “support”, “coordinate”, and “oversee” mean operationally? Q19.o. What are applicants expected to know about the district before applying? | A19.a: Sections 2.3.3.4 & 2.3.8.12 requires documentation of communication, coordination and navigation activities. How this requirement is met will be addressed through the contracting process. A19.b: This topic is outside the application requirements for the Lead Entity RFP and have been addressed in the FAQ process. A19.c: Sections 2.3.3.4 & 2.3.8.12 requires documentation of communication, coordination and navigation activities. How this requirement is met will be addressed through the contracting process. A19.d: Yes. A19.e: Sections 2.3.9 & 2.3.6.2 addresses that the Lead Entity is responsible for administration, oversight, data accuracy and compliance with reporting requirements. A19.f: This topic is outside the application requirements for the Lead Entity RFP. A19.g: Section 2.01 states that counties retain statutory authority; Lead Entity coordinates but does not supersede county authority. A19.h: Counties retain statutory obligations; HHS oversees statewide compliance. A19.i: Lead Entity Coordinates; HHS retains final decision authority. A19.j: Phase 1 is a deliverable based budget as outlined in Section 2.04. A19.k: Data sharing agreements must meet the legal requirements of the Lead Entity. A19.l: Section 2.01 states that counties retain statutory authority; Lead Entity coordinates but does not supersede county authority. A19.m: This topic is outside the application requirements for the Lead Entity RFP. A19.n: In the context of the RFP and contracts, these terms describe the specific ways a Lead Entity is expected to function within the Shared Responsibility Model and the District Public Health Service System. Assure: Operationally, “assure” means the Lead Entity is responsible for confirming that a required service or function is happening somewhere within the District. This does not mean the Lead Entity must deliver the service itself, but rather that it must verify the service is available, identify gaps, and work with counties and providers to address barriers so the public ultimately receives the required core service. Ensure: “Ensure” means the Lead Entity must take active steps to make certain a requirement is fulfilled. This includes verifying delivery, monitoring performance, following up on issues, and communicating with Iowa HHS if concerns arise. The Lead Entity does not assume county statutory authority, but it must make sure the District-level system performs as intended. Support: “Support” means the Lead Entity assists providers and counties through communication, technical assistance, problem-solving, facilitation, and resource alignment. Support does not mean directing or controlling local public health operations. Instead, it means helping local partners succeed and strengthening the Districtwide provider network. Coordinate: “Coordinate” means the Lead Entity brings together counties, local providers, and partners to align activities, clarify roles, maintain communication, and organize how services are delivered across the District. It includes convening meetings, fostering collaboration, monitoring districtwide capacity, and ensuring consistency in approach—but not dictating how counties must operate. Oversee: “Oversee” means the Lead Entity monitors districtwide implementation of core services and provider performance as required in the contract. Oversight involves maintaining documentation, tracking service availability, reviewing data, identifying challenges, and reporting to Iowa HHS. Oversight does not give the Lead Entity authority to manage or direct county-level staff or replace statutory functions assigned by Iowa Code to local boards of health. A19.o: Applicants are expected to have a general understanding of the counties within the District they are applying to serve, including familiarity with the structure of local public health agencies, the roles of county Boards of Health, and the basic landscape of local public health service delivery. The RFP does not require applicants to have completed a formal analysis of provider capacity, service gaps, or local public health performance before applying. These detailed assessments are part of the Phase 1 Scope of Work and will be conducted after the contract is awarded. Applicants should know enough about their District to propose a feasible Phase 1 approach—meaning they should understand how they will organize districtwide planning, engage counties and providers, gather the information necessary for the Districtwide Public Health Service System Analysis, and begin building relationships across the Shared Responsibility Model. However, the RFP does not expect applicants to enter the process with pre‑determined solutions, full knowledge of district challenges, or already‑developed plans. The purpose of Phase 1 is to generate this detailed knowledge through structured analysis, partner engagement, and collaborative planning. |
| Sep 4, 2026 3:28 PM | Q20: Within the budget, does the applicant need to list all staff and salaries for other LPHAs who will be participating in Phase 1 & Phase 2, or does the applicant only list the lead entity agency staff? | A20: Applicants are only required to list Lead Entity staff in the budget. The RFP does not require applicants to include staff or salaries for other local public health agencies, county Boards of Health, or external partners who may participate in Phase 1 or Phase 2 activities. Local provider staffing and expenses are not included in the Lead Entity’s personnel budget unless those costs are part of an approved subcontract. If an LPHA or other provider will be subcontracted for specific work under Phase 1 or Phase 2, the financial terms of that subcontract—such as allowable expenses—should be reflected in the subcontract budget line, not in the Lead Entity’s internal staffing lines. All subcontract budgets must follow the Lead Entity’s budgeting structure and must comply with contract rules, including HHS review requirements for subcontracts valued at $5,000 or more. |
| Sep 3, 2026 1:17 PM | Q21: What type of agreement will be required between the lead entity and other public health departments (e.g., subcontract, mou, 28e) so they can be funded for approved work? | A21: Iowa HHS will work with the Lead Entity to develop an agreement template for use with local providers and partners. |
| Sep 3, 2026 1:18 PM | Q22: Should lead entities subcontract or create agreements with other counties Boards of Health or the public health agencies? | A22: Iowa HHS will work with the Lead Entity to develop an agreement template for use with local providers and partners. |
| Sep 3, 2026 1:18 PM | Q23: Will lead entities be able to roll over funding from phase 1 to phase 2 for use for administration fees or to pay out to counties? | A23: Phase 1 payments are deliverable‑based, meaning the Lead Entity earns funding when specific Phase 1 deliverables are completed and approved. Once earned, the Lead Entity may use those deliverable‑based payments as it determines appropriate and consistent with the contract. |
| Sep 3, 2026 1:20 PM | Q24: Could you provide details on how this is expected to save time for local health department staff and shift the administrative burden to the lead entity? Where do you anticipate seeing the reduction in time? | A24: This topic is outside the application requirements for the Lead Entity RFP. |
| Sep 3, 2026 1:21 PM | Q25: Will lead entities be allowed to pay out subcontractors (other local health departments) based on deliverables? | A25: Yes. Lead Entities may choose to pay subcontractors—including other local public health departments—based on deliverables if the payment structure is consistent with the Lead Entity’s own procurement policies and applicable county requirements, and the arrangement is clearly documented in the subcontract. The RFP and Phase 2 contract do not restrict Lead Entities from using deliverable‑based payments with subcontractors. What the contract requires is that payment terms be included in the subcontract and aligned with the Agency‑approved budget. All agreements should meet General Terms Section 2.12.9, Use of third party. Iowa HHS will work with the Lead Entity to develop an agreement template for use with local providers and partners. |
| Sep 3, 2026 1:50 PM | Q26: Can Iowa HHS please elaborate on how and which State roles will shift as the Lead Entities assume the State's existing roles? (example - current PHIG workforce team charged with hiring, retaining, supporting and training public health infrastructure shifting to now being the responsibility of the Lead Entity; current Regional Consultants in charge of collaboration among agencies to Lead Entities being responsible for districtwide collaboration; etc) As we map out the application's workplan, it would be pertinent to know where the State will retain roles and where they anticipate downsizing as they shift work to the District levels. | A26: This topic is outside the application requirements for the Lead Entity RFP and have been addressed in the FAQ process. |
| Sep 3, 2026 1:58 PM | Q27: Can you provide language around what advocacy roles District Lead entities will be entitled to (allowed) when under contract with Iowa HHS as a lead entity? While the re-alignment process will hopefully help us better utilize our existing resources and funding, it does not pump more money into public health to overcome the already noted underfunded, understaffed public health system we have across Iowa. And if the answer is Lead Entities are not allowed to champion public health conversations to the legislature, who does Iowa HHS anticipate that champion to be? | A27: This topic is outside the application requirements for the Lead Entity RFP. |
| Sep 3, 2026 3:37 PM | Q28: Can two contiguous HHS districts jointly apply as one applicant and receive one Lead Entity award for both districts? | A28: No. The RFP does not allow two districts to jointly apply or be combined under a single Lead Entity award. Each of the seven HHS districts is competitively procured individually, and applicants must submit separate applications for each district they wish to serve. The RFP evaluation, scoring, award process, and contract structure are all district‑specific, and a Lead Entity is selected per district, not per multi‑district configuration. |
| Sep 3, 2026 4:25 PM | Q29: Throughout the RFP you discuss Priority Public Health Core Services: Communicable and Infectious Disease Control, Environmental Health and Chronic Disease and Injury Prevention. On page 21 you summarize possible activities under each that the lead entity will be required to fulfill. Will there be guidance on what the required activities will be, or are the required activities simply those included in Iowa Code? | A29: Activities will be identified through the state plan and district plan process. |
| Sep 3, 2026 4:25 PM | Q30: Page 34 of the RFP states at a minimum a projector director needs to be identified. Is there a corresponding FTE requirement for that position? Per page 13 of the contract can this position be subcontracted out? | A30: The RFP requires all applicants to identify a Project Director, but it does not prescribe a specific FTE requirement for that position. Lead Entities must ensure that the Project Director has sufficient time and capacity to fulfill the responsibilities described in the RFP and contract, but the exact FTE level is determined by the Lead Entity and must be supported by the staffing plan and budget submitted in IowaGrants. Regarding subcontracting, the Phase 2 contract requires the Lead Entity to maintain an accurate personnel roster for “staff specified and accountable for project implementation.” The Project Director is part of the Lead Entity’s core administrative and programmatic structure, responsible for meeting contract deliverables and participating in required coordination and monitoring activities. Because this position is integral to Lead Entity accountability, HHS expects the Project Director to be directly employed by the Lead Entity, not provided through a subcontract. Subcontracted personnel may support components of the work, but the Project Director role must remain within the Lead Entity’s organizational structure to ensure direct accountability for performance, reporting, and contract compliance. |
| Sep 3, 2026 4:26 PM | Q31: Per page 28 of the RFP when will the Agency have tools and templates available to complete the districtwide public health services system analysis? | A31: Tools and templates will be provided during Phase 1. |
| Sep 3, 2026 4:27 PM | Q32: Based on phase 2 funding amounts, those look to be combined amounts of current LPHS, Immunization and CLPP awards per county. There are several counties in our district that do not receive CLPP funding and rely on state IHHS staff to complete this work. Is it the expectation that the lead entity cover the counties that were previously covered by IHHS with no additional funds? Projected phase 2 funding already does not cover preexisting funding levels to the counties for these services, nor to support lead entity administration. | A32: Under Phase 2, the Lead Entity is responsible for ensuring district‑wide delivery of the Priority Public Health Core Services—including Childhood Lead Poisoning Prevention Program (CLPPP) activities—for all counties in the District, regardless of historical funding patterns. Some counties have not historically received CLPPP funds; however, Iowans in all counties will benefit from a coordinated system that promotes blood lead testing, provides case management, and conducts education and outreach across the District. Phase 2 funding represents a consolidated district‑level allocation, not a continuation of historical county‑level awards. Because funding is designated specifically for Priority Public Health Core Services, Lead Entities may use the funds allocated for the district, for the delivery of core service activities, to support targeted CLPPP‑related work in counties across the district, according to their distict plan. This approach supports the statewide transition toward a unified, coordinated public health system in which resources are aligned to the Priority Public Health Core Services rather than historical program structures. While the consolidated funding structure may require Lead Entities to re‑evaluate how CLPPP activities are organized, districts may prioritize testing, case management, and outreach efforts to ensure that resources are targeted to areas of greatest need and are distributed equitably. Lead Entities will use Phase 1 to assess CLPPP‑related needs across all counties, evaluate capacity, and determine the best combination of staffing, partnerships, and service‑delivery approaches within available resources. |
| Sep 4, 2026 9:11 AM | Q33: Given that several of these services do not occur or occur in varying capacities in county public health, what training and technical assistance does IHHS have planned for the following areas: • Environmental screening and testing • Environmental surveillance and detection • Environmental hazards and education and communication Please provide the vendor or provider of technical service and please list the surveillance systems available for environmental hazard detection. | A33. Iowa HHS will develop materials and support tools and will collaborate with Lead Entities during implementation to identify district needs and provide appropriate guidance. Vendors, technical service providers, and surveillance systems will be determined and communicated as part of ongoing statewide planning and program support. |
| Sep 4, 2026 9:11 AM | Q34: What current HHS Injury prevention programs exist? Several counties are not currently providing these services or contracted with HHS services to provide. Please provide a list and by county. | A34: Lead Entities may use the funds allocated for the district, for the delivery of core service activities, to support injury-prevention related work in counties across the district, according to their distict plan. |
| Sep 4, 2026 9:11 AM | Q35: Service Areas for Emergency Preparedness overlap with lead entities. How will funding be allocated across lead entity regions? Please provide the formula. Is it per capita? Is it based on performance? Is it based on deliverables? | A35: At this time we are not changing the Emergency Preparedness regions, contract, or funding. |
| Sep 4, 2026 9:12 AM | Q36: What considerations have been discussed to mirror the emergency preparedness regions to the lead entity structure? The previous service areas were created to build a comprehensive system of care for time critical conditions. Wouldn’t adjusting or undoing these regions to this new model cause harm by changing, in the least, would it not require a new study to be done? | A36: At this time we are not changing the Emergency Preparedness regions, contract, or funding. |
| Sep 4, 2026 9:12 AM | Q37: How will the lead entity model impact CADE service regions? | A37: This topic is outside the application requirements for the Lead Entity RFP. |
| Sep 4, 2026 9:12 AM | Q38: In terms of the lead entity responsibilities and CADE field epidemiologists. What is the expectation for the lead entity to cover vs CADE staff in terms of outbreak response? It is often we hear that CADE staff support and supplant local public health capacity in these cases. Are you able to guarantee that this support will remain? If so, how? If not, why? | A38: See A15. |
| Sep 4, 2026 9:12 AM | Q38: If a local public health department is unable to fund their services fully, ultimately shuttering their doors, what will the lead entity be expected to do in terms of service provision for that county? Is the expectation to terminate the contract? Will the state inquire, coordinate, and search for an entity that the county board of health could designate as the local public health agency? | A39: If a local public health agency is no longer able to operate, the Lead Entity remains responsible for ensuring that Priority Public Health Core Services continue to be accessible to residents in that county. The RFP and Phase 2 contract require the Lead Entity to assure districtwide service delivery, identify capacity gaps, coordinate solutions, and provide operational support as needed so that no interruption in required services occurs. The closure of a local agency does not trigger contract termination; rather, it requires the Lead Entity to work with Iowa HHS to establish an alternative service arrangement that ensures continuity of core services across the District. In situations where a county’s designated local public health agency ceases operations, Iowa HHS will work directly with the Lead Entity and the county Board of Health to determine next steps. The Board of Health maintains authority under Iowa Code to designate a local public health agency, and Iowa HHS will support coordination efforts as needed. If the Board of Health designates a new provider, the Lead Entity may establish a funding mechanism with that provider under Phase 2. If no local provider is available, the Lead Entity may deliver services directly, provided this is established through coordination with the county and consistent with contract requirements. Termination of the Lead Entity’s contract is not expected in this circumstance. |
| Sep 4, 2026 9:13 AM | Q40: If a board of health is fully removed by their Board of Supervisors, how will the state support the lead entity and the existing public health department of the county affected without a board of health? | A40: There will be no difference in response to this situation from current practice. |
| Sep 4, 2026 9:13 AM | Q41: What sort of activities can the state commit to, to work with lead entities or other local public health agencies to acquire more funding to do this workload? What sort of joint coordination can be expected to seek funding? This activity, currently does not occur regularly to knowledge. | Q41: This topic is outside the application requirements for the Lead Entity RFP and have been addressed in the FAQ process. https://hhs.iowa.gov/initiatives/system-alignment/public-health-service-system/public-health-service-system-faqs |
| Sep 4, 2026 9:13 AM | Q42: Does IHHS expect the lead entity to subcontract for training to provide the provisions in: 2.3.1.1 or is the expectation to possess the knowledge and skill prior to application? | A42: The RFP does not require applicants to possess all knowledge and skills described in Section 2.3.1.1 prior to application. Lead Entities are expected to demonstrate the capacity to meet these requirements through a combination of internal expertise, hiring, onboarding, training, and partnerships. Phase 1 is designed to support development of foundational knowledge through planning, engagement, assessment, and coordination activities. Therefore, applicants are not required to enter the procurement already equipped with every competency described in the RFP nor are they required to subcontract for training unless they determine it is the best approach for their district’s needs. |
| Sep 4, 2026 9:13 AM | Q43: How does IHHS define “capacity” in 2.3.2.4.1.1? Is this workforce by FTE? Is this skill and capacity measured by workforce assessments? Is this electronic systems? | A43: “Capacity” means the ability to carry out the required core services and is measured using a combination of workforce, skills, infrastructure, systems, and operational readiness, not a single indicator like FTE count. |
| Sep 4, 2026 9:14 AM | A44: Given the core services per foundational public health service are vague, what is the expectation of IHHS to assess providers ability to deliver these services in 2.3.2.4.1.4 | A44: Iowa HHS expects Lead Entities to assess provider ability using a comprehensive, practical evaluation of whether the provider can reliably carry out the Priority Public Health Core Services in their county. Because foundational core services are intentionally broad, the assessment focuses on functional capability rather than rigid or prescriptive criteria. Lead Entities should evaluate providers using multiple sources of information, including workforce skills and availability, operational experience, local service delivery history, infrastructure and data‑reporting systems, partnerships, and the provider’s ability to participate in coordination processes required under the Shared Responsibility Model. This assessment should be grounded in the Districtwide Public Health Service System Analysis completed in Phase 1, which identifies county‑level strengths, gaps, barriers, and workforce considerations. Lead Entities should incorporate local provider input, observed capacity, historical performance, and districtwide needs when determining whether a provider can reliably deliver core services. The expectation is not that providers meet a uniform statewide checklist, but that Lead Entities use the analysis to determine if each provider can perform the core service functions consistently, safely, and effectively within the district’s coordinated structure. In summary, Iowa HHS expects Lead Entities to assess provider capacity holistically—using workforce, skills, systems, experience, readiness, and local context—rather than relying on a single metric or predefined standard. |
| Sep 4, 2026 9:14 AM | Q45: What sort of access to systems will be provided to lead entities to collect data for use, reporting, and sharing? Is the system something the BHASO lead entity is utilizing? | A45: The RFP and contract do not prescribe a single statewide software platform that Lead Entities must use. Instead, Lead Entities will be required to use Agency‑supported reporting software or formats designated by Iowa HHS for data submission, monitoring, evaluation, and performance reporting. This may include systems currently used for immunization reporting, communicable disease documentation, lead‑related reporting, or other public health data tools supported by Iowa HHS. The contract specifies that Lead Entities must collect and submit all required data "using Agency‑supported reporting software or formats," and Iowa HHS will provide instructions on the system(s) to be used and the data elements required. The RFP does not state that Lead Entities will use the same data systems as the Behavioral Health Administrative Services Organization (BHASO), nor does it require alignment with BHASO platforms. While certain shared functionalities—such as reporting, coordination, or monitoring—may resemble BHASO processes, the Lead Entity data systems will be defined based on the needs of the Public Health Service System and the reporting requirements attached to the Priority Public Health Core Services. Lead Entities should expect that Iowa HHS will provide access, training, and guidance for any required system and will detail reporting expectations within the Grant Tracking Site during contract implementation. Lead Entities will use Agency‑supported systems designated by Iowa HHS, but those systems are not defined in the RFP and are not required to be the same systems used by BHASO. |
| Sep 4, 2026 9:14 AM | Q46: Does IHHS have a minimum expatiation of staffing requirements for project implementation? If so, please provide a ballpark estimate. It would be beneficial to know if the lead entity should expect to hire more or specific roles to support the project. | A46: The Agency does not prescribe specific staffing roles or minimum qualifications beyond the required Project Director. Lead Entities should propose staffing structures that fit their district’s needs and ensure adequate capacity for coordination, communication, documentation, and fiscal responsibilities. Iowa HHS will review and approve each Lead Entity’s staffing plan based on its overall adequacy, and Lead Entities may collaborate with Iowa HHS during implementation to refine staffing approaches, but no additional required positions are defined in the RFP. |
| Sep 4, 2026 9:15 AM | Q47: Will the lead entity have to establish data sharing agreement with each county to conduct its work or will the lead entity inherit the ability to review county level data within its lead entity boundary? | A47: The RFP and contract do not require Lead Entities to establish formal data‑sharing agreements with each county in order to perform their contractual responsibilities. Lead Entities will be granted access to the data necessary to collect, use, report, and share information relevant to the Priority Public Health Core Services, as directed by Iowa HHS. This access is tied to the Lead Entity’s role in coordinating the Public Health Service System at the district level and supporting statewide reporting and monitoring requirements on behalf of Iowa HHS. Counties and local public health agencies retain responsibility for their own local public health operations and statutory duties under Iowa Code. The Lead Entity’s access to data will be aligned with district‑level coordination, system‑planning needs, and the data expectations outlined in the RFP. If specific local systems or county‑owned platforms require formal agreements to permit access, the Lead Entity and county may use memoranda of understanding (MOUs) or other local agreements. However, these are not mandated statewide requirements, and the need for such agreements will depend on each county’s systems, policies, and data‑governance practices—not the Phase 2 contract. Lead Entities will receive the access needed to fulfill contractual reporting and coordination responsibilities, and formal county‑by‑county data‑sharing agreements are not required unless local system rules or policies necessitate them. |
| Sep 4, 2026 10:40 AM | Q48: How does the Deliverable-based Reimbursement chart specify what funding amount stays with the Lead Entity and what goes to the subcontracting counties? Is the funding formula a local decision? Or does the Deliverable-based Reimbursement chart mean that during phase one $331,428 is divided by the counties in the district and the remaining $260,000 remains with the Lead Entity? | A48: The Deliverable‑based Reimbursement chart in Phase 1 does not determine how funding is split between the Lead Entity and counties, nor does it require the Lead Entity to divide reimbursement amounts among counties. The chart identifies the fixed payment amounts Iowa HHS will pay the Lead Entity upon completion of each Phase 1 deliverable. These payments are tied to deliverables completed by the Lead Entity—not individual counties—and the funding is not automatically divided or apportioned across counties within the District. It is up to the Lead Entity to determine how Phase 1 funds will be used to support planning activities, including subcontracting with counties or other partners if needed. Payments to counties or local providers for Phase 1 activities occur only if the Lead Entity decides to subcontract work or establish a separate fiscal process, but any subcontract valued at $5,000 or more must be submitted to Iowa HHS for review prior to execution. Iowa HHS does not prescribe a formula for how the Lead Entity must distribute Phase 1 funds among partners. In summary, the Deliverable‑based Reimbursement chart does not allocate funds to counties. All funding is paid to the Lead Entity, and any distribution to counties is determined locally by the Lead Entity through its budget, staffing plan, funding and subcontracting decisions. |
| Sep 4, 2026 10:44 AM | Q49: In the Phase two contract, under Deliverables/General Requirements, it reads “ the Contractor shall ensure staffing levels reach those approved by the Agency (State) by a date specified by the Agency.” What does this mean? Our public health agency sits in the lowest funded district. The funding may not allow Lead Entities to increase staff to the State approved level and fund partner public health agencies adequately. | A49: In the Phase 2 contract, the term “Contractor” refers to the Lead Entity—the legal organization that enters into the contract with Iowa HHS and is directly responsible for fulfilling all contractual deliverables, meeting performance measures, maintaining required staffing, submitting reports, and assuring districtwide access to the Priority Public Health Core Services. The Contractor is the entity named on the contract’s declarations page and is the sole party legally accountable to Iowa HHS for implementation. Counties, Boards of Health, subcontractors, or local public health agencies are not considered the Contractor unless they are the designated Lead Entity under the award. The requirement that “the Contractor shall ensure staffing levels reach those approved by the Agency” means that the Lead Entity must have adequate staffing—whether through employees or subcontracted support—to carry out Phase 2 responsibilities. Iowa HHS does not impose a fixed FTE number or staffing formula. Instead, the Lead Entity must identify project personnel that are realistic, appropriate for the District, and affordable within the Phase 2 funding allocation. Once Iowa HHS approves project personnel, the Lead Entity is responsible for reaching and maintaining those staffing levels by the date specified. |
| Sep 4, 2026 10:45 AM | Q50: In the case that a Board of Supervisors decides to not fund a local public health agency, what is the Lead Entity’s responsibility to that county? | A50: Under Iowa Code Chapter 137, county Boards of Health are responsible for public health matters of the county and as such the county has obligations to address those matters, including assuring public health matters are addressed either through the direct provision of services or through other agreements that ensure those services are provided. If a county’s Board of Supervisors discontinues funding for its designated local public health agency and that agency is no longer able to operate, the Lead Entity remains responsible for assuring that Priority Public Health Core Services continue to be accessible within that county. The Lead Entity’s contractual obligations do not change due to a local agency’s closure. Under Phase 2, the Lead Entity must identify service gaps, coordinate solutions, and work with Iowa HHS to ensure core public health services are delivered without interruption throughout the District. Local Boards of Health retain statutory authority under Iowa Code to designate a local public health agency. If the existing agency cannot continue operations, Iowa HHS will collaborate with the Lead Entity and the county Board of Health to determine the most appropriate next steps. The Board of Health may designate a new provider for service delivery. If no local provider is available, the Lead Entity may deliver services directly in coordination with the county and Iowa HHS, consistent with the requirements of the Phase 2 contract. Contract termination is not expected; rather, the focus is on maintaining service continuity for county residents. |
| Sep 4, 2026 10:48 AM | Q51: Section 2.04(B)(5)(c) prohibits supplanting existing funding, including staff salaries, while the August 21 FAQ states that Iowa HHS is open to shared FTEs covering both Lead Entity and local public health responsibilities. If an existing locally funded employee is formally reassigned a documented percentage of work capacity to new Lead Entity or District responsibilities, with their prior locally funded responsibilities correspondingly reduced, may the Lead Entity grant fund that percentage of salary without it being considered supplanting? If not, may grant funds support compensation specifically attributable to the additional responsibilities, such as an additional-duty stipend or overtime? | A51: Yes. Grant funds may support a portion of an existing employee’s salary if the employee is formally assigned new, additional responsibilities that are directly tied to Phase 2 deliverables and the District Public Health Service System Plan, and their previous locally funded responsibilities are reduced accordingly. In this situation, the Lead Entity would be funding new work, not replacing (“supplanting”) existing funding. The key requirement is clear documentation showing how the employee’s job duties, time allocation, and funding sources have changed. As long as federal or state Phase 2 funds are used only for the newly assigned Lead Entity responsibilities, this is not considered supplanting. |
| Sep 4, 2026 10:49 AM | Q52: Section 1.18(C) states that the Lead Entity is fully responsible for work performed by subcontractors, while the August 21 FAQ states that Iowa HHS will not indemnify Lead Entities for local-provider actions and that Lead Entities should include appropriate protections in their own agreements. Please clarify the intended allocation of financial and contractual responsibility among Iowa HHS, the Lead Entity, and funded local providers in Phase 2. Specifically, what minimum enforcement provisions will Iowa HHS require or permit the Lead Entity to include in local-provider agreements, including authority to withhold or suspend payments, recover questioned or disallowed costs, require corrective action, obtain audit and federal award information, and terminate or redirect funding for noncompliance? If the Lead Entity has established required agreements, completed appropriate fiscal and program monitoring, and taken timely corrective or enforcement action, will the Lead Entity nevertheless remain financially responsible to Iowa HHS for a local provider’s noncompliance, questioned or disallowed costs, failure to perform, or other breach outside the Lead Entity’s direct control? | A52: Under the Phase 2 contract, the Lead Entity is the contracted party (“Contractor”) and is therefore accountable to Iowa HHS for ensuring all work performed under the contract—including work carried out by subcontractors—meets contract requirements. Iowa HHS does not indemnify Lead Entities for subcontractor actions, meaning Lead Entities must protect themselves contractually when delegating work. Local providers, counties, and other entities receiving funding from the Lead Entity are not parties to the state contract and therefore must be managed through binding subcontracts that establish expectations, accountability, and consequences for nonperformance. Iowa HHS does not dictate a specific enforcement framework, but the contract permits Lead Entities to include appropriate provisions in subcontracts to ensure compliance. These provisions may include: withholding or suspending payments; requiring corrective action plans; requiring repayment of questioned or disallowed costs; requiring access to fiscal, audit, and award information needed to meet federal and state requirements; terminating or redirecting funding for noncompliance; and adding other performance remedies consistent with local procurement rules. These mechanisms ensure the Lead Entity can enforce contractual expectations and protect itself from downstream risk. Iowa HHS will work with the Lead Entity to develop an agreement template for use with local providers and partners. |
| Sep 4, 2026 10:49 AM | Q53: Authority and liability of the Lead Entity Q53.a. What is the legal and operational relationship between the Lead Entity and the other county health departments within the district? 53.b. Specifically, what responsibilities, authority, and liabilities will the Lead Entity assume for activities performed or not performed by the other participating counties? County participation/accountability 53.c. What is the expectation if the Lead Entity does not receive attestations from all counties? 53.d. What mechanism will be used to ensure county compliance? 53.e. Will the Lead Entity be held accountable for a county's failure to comply with the requirements? 53.f. What authority will the Lead Entity have to require or enforce compliance by participating counties? 53.g. If a county chooses not to participate or fails to fulfill its responsibilities, does that work then become the responsibility of the Lead Entity? 53.h. If so, how is the Lead Entity expected to operate within that county without an attestation from the county's Board of Health? 53.i. More broadly, what authority does the Lead Entity have to provide or direct services within a county that has not provided the required attestation? Indemnification 53.j. Will the contract include a mutual indemnification clause to appropriately allocate liability between the parties? 53.k. The Lead Entity appears to be taking on liability, which we would presumably want to pass on to the counties in the region. What if a participating county is unwilling to indemnify the Lead Entity? Staffing requirements 1. Section 2.3.6.2.2 states that the Lead Entity shall ensure that staffing levels reach those approved by the Agency. 53.l. Does this requirement apply to staffing levels for the Lead Entity only, or does it apply to each local health department? 53.m. What specific staffing levels or positions have the Agency approved or expects under this provision? 53.n. Will the Agency provide the Lead Entity with the approved staffing levels in writing? Phase 1 53.o. Are there any stipulations regarding when the Phase 1 funds must be spent? 53.p. If 100% of the funds are not utilized during Phase 1, can the remaining funds be carried forward and used for eligible expenses in a future contract period? Funds 53.q. How will the funds be provided? Will they be paid as a lump sum to the Lead Entity, or will funding be provided on a reimbursement basis? 53.r. If the funds are provided as a lump sum, may the Lead Entity retain and reinvest any interest earned on those funds? Scope of injury prevention 53.s. What activities, services, or programs are intended to fall under the “injury prevention” category? Contract 53.t. There appears to be no way for the Lead Entity to exit the contract absent an uncured material breach by the State. What if the Lead Entity wants to exit the contract for other reasons, such as it is no longer fiscally feasible, or a variety of other unforeseeable reasons? | A53: A53.a. Iowa HHS cannot provide legal advice to entities outside the Agency. Each Lead Entity and county should consult their own legal counsel to understand how local laws, county governance structures, and intergovernmental agreements apply to their specific situation. Participating county health departments maintain their independent statutory authority and control over their own local public health operations. Counties continue carrying out Iowa Code–required duties and delivering public health services within their jurisdictions. The Lead Entity’s role is programmatic and fiscal, not supervisory or directive. The Lead Entity does not assume legal liability for county statutory responsibilities and does not replace county authority. Instead, the Lead Entity supports county participation, passes through eligible costs, coordinates common district functions, and reports fiscal and program information to Iowa HHS. A53.b. Iowa HHS cannot provide legal advice to entities outside the Agency. Each Lead Entity and county should consult their own legal counsel regarding how local laws, governance, and intergovernmental arrangements apply to their specific circumstances. Participating county health departments maintain their independent statutory authority and control over their own local public health operations. Counties continue carrying out Iowa Code–required duties and delivering public health services within their jurisdictions. The Lead Entity’s role is programmatic and fiscal, not supervisory or directive. The Lead Entity does not assume legal liability for county statutory responsibilities and does not replace county authority. Instead, the Lead Entity supports county participation, passes through eligible costs, coordinates common district functions, and reports fiscal and program information to Iowa HHS. A53.c. If a county does not provide an attestation, the Lead Entity should still engage the county in planning, communication, and coordination activities to the extent possible. Iowa HHS will continue working with the Lead Entity and the county to encourage participation and resolve barriers, but a missing attestation does not prevent the Lead Entity from performing its fiscal‑agent duties or from ensuring service access in that county. As in the Preparedness model, program participation is expected, but funding and coordination responsibilities remain with the fiscal agent regardless of individual county administrative actions. A53.d. Iowa HHS cannot provide legal advice to entities outside the Agency. Counties should consult their own legal counsel regarding statutory responsibilities and local governance requirements. Counties remain responsible for fulfilling their statutory public‑health duties under Iowa Code, and their ongoing participation in district activities is expected as part of the statewide Public Health Service System. If a county is not participating as expected, the Lead Entity should continue outreach, maintain communication, document its efforts, and notify Iowa HHS through established reporting channels. Iowa HHS will work directly with the county to resolve participation challenges through program support and engagement—not through contractual or punitive mechanisms. A53.e.A53.e: No. Each county remains responsible for fulfilling its own statutory public‑health duties and expected program activities. The Lead Entity will not be held accountable for a county’s independent decisions or non‑performance as long as the Lead Entity meets its responsibilities for coordination, communication, documentation, and fiscal management. A53.f. A53.f: The Lead Entity does not have authority to require or enforce compliance by counties. Each county remains responsible for its own statutory public‑health duties and for participating in district activities as expected. The Lead Entity’s role is coordination, communication, documentation, and distribution of core service funding—not enforcement. If a Lead Entity determines it needs additional support or accountability, it may choose to establish its own agreements with counties or partner agencies. These locally determined arrangements are governed by county policies and legal guidance. A53.g. Iowa HHS cannot provide legal advice to entities outside the Agency. Each Lead Entity and county should consult their own legal counsel to understand how local laws, county governance structures, and intergovernmental agreements apply to their specific situation. Participating county health departments maintain their independent statutory authority and control over their own local public health operations. Counties continue carrying out Iowa Code–required duties and delivering public health services within their jurisdictions. The Lead Entity’s role is programmatic and fiscal, not supervisory or directive. The Lead Entity does not assume legal liability for county statutory responsibilities and does not replace county authority. Instead, the Lead Entity supports county participation, passes through eligible costs, coordinates common district functions, and reports fiscal and program information to Iowa HHS. A53.h.The Lead Entity does not assume responsibility for county‑level statutory duties, and Iowa HHS does not provide legal advice to entities outside the Agency. If a county does not provide an attestation or is not participating as expected, the Lead Entity should continue communication and coordination efforts, document outreach attempts, and notify Iowa HHS through established reporting processes. The absence of an attestation does not prevent the Lead Entity from carrying out its district‑level coordination role or from distributing core service funding to participating counties. Counties remain responsible for their own public‑health obligations and may choose to establish agreements—including subcontracting with another county—if they need support or accountability structures for completing required activities. Iowa HHS will work directly with counties that are not participating to resolve concerns, while the Lead Entity continues fulfilling its coordination, documentation, and fiscal responsibilities. A53.i. The Lead Entity does not have authority to direct or provide services within a county that has not submitted an attestation. Counties retain responsibility for their own statutory public‑health duties, and Iowa HHS does not provide legal advice to entities outside the Agency. If an attestation has not been received, the Lead Entity should continue communication, coordination, and documentation efforts and report participation concerns to Iowa HHS. The absence of an attestation does not give the Lead Entity authority to assume or direct county responsibilities. Iowa HHS will work directly with the county to address participation issues, while the Lead Entity continues supporting district coordination and distributing core service funding to participating counties. A53.j. No. The contract will not include a mutual indemnification clause. Iowa HHS does not provide legal advice to entities outside the Agency, and each Lead Entity and county should consult their own legal counsel regarding liability questions. The Lead Entity’s responsibilities relate to fiscal management, coordination, documentation, and distribution of core service funding. Counties remain independently responsible for their own statutory public‑health duties and program activities. Because the relationship between the Lead Entity and counties is programmatic—not supervisory or contractual—mutual indemnification provisions are not necessary and will not be included in the contract. A53.k. Iowa HHS does not provide legal advice to entities outside the Agency. Counties and Lead Entities should consult their own legal counsel on indemnification questions. The Phase 2 contract will not include mutual indemnification requirements. Counties participate in the Public Health Service System as independent governmental public‑health authorities and are responsible for their own statutory duties. The Lead Entity is responsible only for the fiscal, coordination, communication, and documentation expectations outlined in the contract. If the Lead Entity chooses—based on its own county’s policies, state and federal rules, and legal guidance—to establish a subcontract or agreement with a county that includes indemnification provisions, the county may decide whether it is willing to sign such terms. If a county is unwilling to indemnify the Lead Entity, the Lead Entity may proceed without a subcontract and continue to distribute core service funding through program participation. The Lead Entity does not assume county‑level liability when meeting its own contractual responsibilities. A53.l. This requirement applies only to the Lead Entity’s staffing. The Lead Entity must have sufficient staff to meet the coordination, communication, documentation, and fiscal responsibilities outlined in the contract. It does not apply to staffing levels within each county or local public health department. Counties determine their own staffing independently based on their statutory responsibilities and local needs. A53.m. The contract does not prescribe specific staffing levels or require particular positions. Iowa HHS will review and approve the Lead Entity’s staffing plan based on whether it provides enough administrative, fiscal, and coordination capacity to meet the responsibilities outlined in the contract. This requirement applies only to the Lead Entity’s staffing—not to the staffing of counties or local public health departments. Each Lead Entity should propose staffing that fits its district’s needs and can be supported within its budget; Iowa HHS will evaluate the plan for adequacy rather than mandate specific roles or FTEs. A53.n. Yes. Iowa HHS will provide written approval of the Lead Entity’s staffing plan after reviewing the staffing levels proposed in the application and any updates submitted during implementation. The Lead Entity is responsible only for meeting the staffing levels included in its own approved plan; the requirement does not apply to county or local public health department staffing. A53.o. Phase 1 uses deliverable‑based payments, and Lead Entities must complete Phase 1 deliverables within the specified timelines in order to receive payment. Phase 1 funds are tied directly to the completion and approval of deliverables and must be earned within the Phase 1 contract period. A53.p. Phase 1 payments are deliverable‑based, meaning the Lead Entity earns funding when specific Phase 1 deliverables are completed and approved. Once earned, the Lead Entity may use those deliverable‑based payments as it determines appropriate, consistent with the contract. A53.q. Phase 1 payments are deliverable‑based. The Lead Entity completes each required deliverable, submits it for review, and receives the established payment amount once the deliverable is approved. Payments are not reimbursement‑based, and they are not paid as a lump sum at the start of the phase. The Lead Entity may use earned Phase 1 payments at its discretion for eligible Phase 1 activities during the Phase 1 contract period. Phase 2 uses a reimbursement‑based payment structure. Lead Entities submit claims in IowaGrants for allowable expenses within the Agency‑approved budget, and payments are made after Iowa HHS reviews and approves the claims. Funds are not provided as a lump sum and must be tied to eligible Phase 2 activities. A53.r. The treatment of interest earnings depends on federal and state requirements governing the specific funding sources, as well as local fiscal and audit policies. Lead Entities should consult their own financial officers or legal counsel to determine how interest must be managed. A53.s. The RFP does not define or prescribe specific injury‑prevention activities, and Iowa HHS will provide additional guidance on program expectations through statewide planning, District planning support, and future policy or technical assistance. A53.t. Under the draft language, the Lead Entity may exit the contract only in the case of an uncured material breach by the State. |
| Sep 4, 2026 10:49 AM | Q54: For the application, is the lead entity responsible for answering the Disclosure of Contract Default questions under the Business Organization Form about each potential subcontracting public health agency in their district? | A54: No. The Lead Entity is responsible only for answering the Disclosure of Contract Default questions about its own organization. The RFP does not require Lead Entities to provide disclosure information for other counties, local public health agencies, or any prospective partners within the district. If the Lead Entity later chooses—based on county policies and legal guidance—to enter into a subcontract with another entity, any required disclosures would be addressed during the subcontract development process, not during the Lead Entity’s application. |
| Sep 4, 2026 10:54 AM | Q55: For Phase 2, will Iowa HHS establish minimum fiscal and federal compliance requirements that a local provider must satisfy before receiving funds through the Lead Entity, including, as applicable, subrecipient risk assessment, Single Audit/Federal Audit Clearinghouse review, resolution of prior audit findings, federal award and SEFA information, financial reporting, record retention, and access to records for monitoring? If a provider does not satisfy those requirements or develops material compliance concerns after funding begins, what authority will the Lead Entity have to condition, reduce, suspend, terminate, or redirect funding while continuing to meet the RFP’s districtwide service-coverage requirements? | A55. The required monitoring and oversight will be part of Phase 1 planning. |
| Sep 4, 2026 10:57 AM | Q56: Section 1.05 provides that Iowa HHS may adjust, reduce, or withdraw funding, while Section 2.3.6 states that, beginning in Phase 2, the Lead Entity is responsible for administering Priority Public Health Core Service funds while “ensuring there is no gap in funding or geographic coverage.” Section 2.3.6.2.1 further requires the Lead Entity to assume full administrative responsibility for the Priority Public Health Core Services and ensure that no gap in program timing or geographic availability occurs. If available Iowa HHS funding is insufficient to maintain the service levels, geographic coverage, staffing, or provider capacity required by the Agency-approved District Public Health Service System Plan, is the Lead Entity required to use county/local funds or other non-HHS resources to make up the shortfall? Please clarify how these coverage requirements will apply when Iowa HHS reduces or withdraws funding, a provider withdraws or becomes unavailable, no qualified provider can be secured at the available funding level, or actual service costs exceed the HHS funding available. Thank you. | A56: The RFP does not require Lead Entities to use their own county or local funds, or any other non‑HHS resources, to supplement Phase 2 core service funding in other counties. Likewise, the RFP does not define how statewide coverage requirements apply in situations where funding changes, provider availability shifts, or service costs exceed the funding available. These matters will be addressed through contract development, statewide planning, and ongoing program guidance from Iowa HHS. Lead Entities should apply only the core service funding available through the contract and are not required to contribute additional local dollars. If funding adjustments, provider changes, or other challenges arise, Iowa HHS will work directly with the Lead Entity and the affected counties to determine next steps for maintaining access to Priority Public Health Core Services. |
| Sep 4, 2026 10:57 AM | Q57: The Phase 2 sample contract establishes insurance requirements for the Contractor and its subcontractors. For purposes of Phase 2, please clarify how Iowa HHS expects those requirements to apply to counties, local public health agencies, health systems, and other local providers receiving funds through the Lead Entity. Will each funded provider be required to maintain specified insurance or governmental self-insurance/risk-pool coverage, and will the Lead Entity be responsible for obtaining and monitoring evidence of that coverage? Will Iowa HHS establish minimum insurance requirements that should be incorporated consistently into agreements with local providers across all seven Districts? | A57. Iowa HHS will work with the Lead Entity to develop an agreement template for use with local providers and partners. |
| Sep 4, 2026 10:57 AM | Q58: The August 21 FAQ indicated that Iowa HHS does not currently plan to provide legal advice regarding agreements between Lead Entities and local providers. Now that the RFP expressly contemplates subcontracting and makes the Lead Entity responsible for subcontracted performance, does Iowa HHS anticipate establishing a required or recommended agreement structure for Phase 2 local-provider relationships? Specifically, should participating counties or local public health agencies generally be engaged through subcontracts, 28E agreements, MOUs, or another mechanism? Will Iowa HHS provide standardized provisions or model language for requirements that should be consistent statewide, including scope of work, performance measures, payment terms, federal grant requirements, records access, insurance, monitoring, corrective action, termination, and recovery of questioned or disallowed costs? | A58. Iowa HHS will work with the Lead Entity to develop an agreement template for use with local providers and partners. |
| Sep 4, 2026 10:57 AM | Q59: What is the legal and operational relationship between the Lead Entity and the other county health departments within the district? | A59: The Lead Entity does not have legal or supervisory authority over county health departments. Each county remains an independent governmental public‑health authority responsible for its own statutory duties under Iowa Code. The Lead Entity’s role is district‑level coordination, communication, documentation, and distribution of core service funding, not direction or oversight of county operations. County health departments participate in the Public Health Service System as program partners. They determine how services are delivered locally, while the Lead Entity facilitates districtwide planning, supports shared activities, manages fiscal processes, and ensures information flows to Iowa HHS as required. If a Lead Entity believes it needs additional structure or accountability, it may choose—based on its own legal guidance—to establish agreements, including subcontracting with another county or partner. Iowa HHS does not prescribe or require specific agreement types and does not provide legal advice. |
| Sep 4, 2026 10:58 AM | Q60: Specifically, what responsibilities, authority, and liabilities will the Lead Entity assume for activities performed or not performed by the other participating counties? | A60: See A53.b |
| Sep 4, 2026 10:58 AM | Q61: What is the expectation if the Lead Entity does not receive attestations from all counties? | A61: See A53.c |
| Sep 4, 2026 10:58 AM | Q62: Given the Lead Entity’s Phase 2 responsibility for contracting with and overseeing multiple local providers, what legal and contracting support does Iowa HHS envision being available to Lead Entities and their District partners? | A62: Iowa HHS cannot provide legal advice to entities outside the Agency. |
| Sep 4, 2026 10:58 AM | Q63: What mechanism will be used to ensure county compliance? | A63: This topic is outside the application requirements for the Lead Entity RFP. |
| Sep 4, 2026 10:58 AM | Q64: Will the Lead Entity be held accountable for a county's failure to comply with the requirements? | A64: Please submit clarification of question in Round 2. Clarify what types of requirements (i.e. statutory, contractual, etc.) |
| Sep 4, 2026 10:58 AM | Q65: What authority will the Lead Entity have to require or enforce compliance by participating counties? | A65: Each county is responsible for its own statutory public‑health duties and expected program participation. The Lead Entity will not be held accountable for a county’s independent decisions or non‑performance when the Lead Entity has fulfilled its own coordination, documentation, communication, and fiscal responsibilities. If a county is not meeting expectations, the Lead Entity should notify Iowa HHS, and Iowa HHS will work directly with the county to address the issue. |
| Sep 4, 2026 10:59 AM | Q66: What local provider and/or county Board of Health obligations will remain for legal consultation regarding Priority Public Health Core Services? For example, for quarantine and isolation enforcement, would it be the responsibility of the Lead Entity, Local Provider, or county Board of Health to provide legal consultation regarding communicable disease control core services? | A66: Legal consultation responsibilities remain with each county and its Board of Health. Absent an agreement between local providers that addresses transfer of authority, counties retain independent statutory authority under Iowa Code for communicable‑disease control, including quarantine and isolation actions. The Lead Entity does not assume county‑level legal responsibilities and does not provide legal consultation for county enforcement activities. Local public health agencies and county Boards of Health should consult their own legal counsel on matters related to statutory authority, enforcement, and legal processes associated with communicable‑disease control and other Priority Public Health Core Services. The Lead Entity’s role is coordination, documentation, communication, and distribution of core service funding, not legal interpretation or enforcement. Iowa HHS does not provide legal advice to entities outside the Agency. |
| Sep 4, 2026 10:59 AM | Q67: If a county chooses not to participate or fails to fulfill its responsibilities, does that work then become the responsibility of the Lead Entity? If so, how is the Lead Entity expected to operate within that county without an attestation from the county's Board of Health? More broadly, what authority does the Lead Entity have to provide or direct services within a county that has not provided the required attestation? | A67: There will be no difference in response to this situation from current practice. |
| Sep 4, 2026 10:59 AM | Q68: While recognizing that Iowa HHS may not provide legal advice to individual contractors, may Lead Entity funds be used for county attorney time, outside legal counsel, or specialized grant/contract consulting necessary to develop and administer local-provider agreements, interpret federal flow-down requirements, address noncompliance, and support District implementation? | A68: The RFP does not specify whether Lead Entity funds may be used for legal services or specialized consulting. Decisions about the allowability of these expenses will be established during Phase 2 contract negotiations and will depend on applicable federal and state funding requirements, the approved budget, and guidance provided during implementation. ayments must comply with federal funding restrictions Lead Entities should consult their own legal counsel and financial officers when proposing or requesting such costs. |
| Sep 4, 2026 10:59 AM | Q69: Will the contract include a mutual indemnification clause to appropriately allocate liability between the parties? | A69: see A53.j |
| Sep 4, 2026 10:59 AM | Q70: Does Iowa HHS anticipate providing centralized legal/contracting guidance, model provisions, or other technical assistance so that each of the seven Lead Entities does not independently develop substantially the same contractual infrastructure? | A70: Iowa HHS cannot provide legal advice to entities outside the Agency. |
| Sep 4, 2026 11:00 AM | A71: Section 2.3.2.4.1.6 on page 29 of the RFP includes a requirement that “An attestation from each board of health within the District that the county will operationally and financially support the obligations outlined in Iowa Code.” If the board of health from a county within the District does not provide an attestation, what option does the Lead Entity have for recourse or release from assurance of this requirement? | A71: If an attestation is not provided, the Lead Entity should continue communication and coordination with the county, document outreach efforts, and notify Iowa HHS through established communication channels. Iowa HHS will work directly with the county to address participation concerns. The Lead Entity remains responsible only for its coordination, documentation, and fiscal duties and is not required to assume county‑level responsibilities when an attestation is not provided. |
| Sep 4, 2026 11:00 AM | Q72: Question: Does the Agency have preferred formats or templates for documenting stakeholder communication and coordination activities, or is local discretion permitted as long as required elements are captured? RFP Citation: RFP requires documentation of communication, coordination, and navigation support but does not specify documentation formats. (RFP Sections 2.3.3.1.2 & 2.3.8.1.2, pg. 30, 32) | A72: The RFP does not prescribe a specific format for documenting communication or coordination activities. Local discretion is permitted as long as the required information is captured. Iowa HHS will develop and provide materials, tools, and templates to support this documentation, and Lead Entities may work collaboratively with Iowa HHS to refine or adapt these materials to meet district needs. |
| Sep 4, 2026 11:00 AM | Q73: Section 2.3.6.2.2 states that the Lead Entity shall ensure that staffing levels reach those approved by the Agency. Does this requirement apply to staffing levels for the Lead Entity only, or does it apply to each district health department? | A73: See A53.l |
| Sep 4, 2026 11:00 AM | Q74: For the required line-item budget for Phase 2, should the Lead Entity plan to budget according to the requirements of Iowa Administrative Code 641, Chapter 80.4(1) LPHS funds? If so, what guidance can the Agency give to determine funding allocation by county? | A74: Utilize the Projected Phase 2 Funding Allocations provided in Section 1.05 of the RFP. |
| Sep 4, 2026 11:01 AM | Q74; Section 1.18 allows for the use of subcontractors and section 2.03 outlines the scope of work of a Lead Entity. Are subcontractors allowed for Lead Entity scope of work? | A75: Yes. Subcontractors may be used for portions of the Lead Entity’s scope of work when this is appropriate and consistent with local county policies, procurement rules, and legal guidance. The RFP permits the Lead Entity to engage subcontractors as needed to support coordination, communication, documentation, data activities, or other responsibilities identified in the contract. |
| Sep 4, 2026 11:01 AM | Q76: Page 31, Section 2.3.6.2.2 states that the Lead Entity shall ensure that staffing levels reach those approved by the Agency. What specific staffing levels or positions have the Agency approved or expects under this provision and will the Agency provide the Lead Entity with the approved staffing levels in writing? | A76: See A53.m and A53.n. |
| Sep 4, 2026 11:02 AM | Q77: Are there any stipulations regarding when the Phase 1 funds must be spent? | A77: See A53.o |
| Sep 4, 2026 11:02 AM | A78: If 100% of the funds are not utilized during Phase 1, can the remaining funds be carried forward and used for eligible expenses in a future phase or contract period? | A78: See A53.p |
| Sep 4, 2026 11:02 AM | Q79: How will the funds be provided? Will they be paid as a lump sum to the Lead Entity, or will funding be provided on a reimbursement basis? | A79: See A53.q |
| Sep 4, 2026 11:02 AM | Q780: If the funds are provided as a lump sum, may the Lead Entity retain and reinvest any interest earned on those funds? | A80: See A53.r |
| Sep 4, 2026 11:02 AM | Q81: What activities, services, or programs are intended to fall under the “injury prevention” category? [LC currently does not have an injury prevention program.] | A81: See A53.s |
| Sep 4, 2026 11:03 AM | Q82: There appears to be no way for the Lead Entity to exit the contract absent an uncured material breach by the State. What if the Lead Entity wants to exit the contract for other reasons, such as it is longer fiscally feasible, or a variety of other unforeseeable reasons? | A82: See A53.t |
| Sep 4, 2026 11:03 AM | Q83: The Lead Entity appears to be taking on liability, which we would presumably want to pass on to the counties in the region. What if the participating county is unwilling to indemnify the Lead Entity? | A83: This question will be answered during Round 2. |
| Sep 4, 2026 11:05 AM | Q84: If allowable by the Lead Entity organization, are funds from Phase 1 allowed to be rolled over to Phase 2 for activities as outlined in the District Public Health Service System Plan? | A84: See A53.p |
| Sep 4, 2026 11:06 AM | Q85: In Phase 2, if funds allocated for a contract period are not fully expended by the District, may they be maintained by the District and rolled over to the next contract period (FY29 to FY30, for example) if allowed by the Lead Entity organization? | A85: Carry-forward allowances depend on the federal or state funding sources included in Phase 2 and will be clarified during implementation. Lead Entities must comply with funding-source rules; the RFP does not authorize automatic carry-forward. |
| Sep 4, 2026 11:09 AM | Q86: Will the Agency provide a required template for the Phase 1 Project Plan and Timeline or should Applicants develop their own format based on the listed requirements? (RFP Section 2.3.2.1 pg. 28) | A86: The RFP does not prescribe a specific template for the Phase 1 Project Plan and Timeline. Applicants may develop their own format as long as all required elements listed in Section 2.3.2.1 are clearly addressed. |
| Sep 4, 2026 11:09 AM | Q87: For the provider network analysis does the Agency expect submission of quantitative metrics (e.g., staffing numbers, service volumes) in addition to qualitative narrative descriptions? (RFP Section 2.3.2.4.1.4, pg. 29) | A87: Iowa HHS will develop templates and supporting materials to assist Lead Entities with documentation requirements, and Lead Entities may collaborate with the Agency to adapt these tools to meet district needs. |
| Sep 4, 2026 11:10 AM | Q88: The Draft Interim District Public Health Service System Plan requires Lead Entity to describe how counties will meaningfully participate in District-level planning and decision-making. Can the Agency clarify expectations for demonstrating “meaningful participation”? (RFP Section 2.3.2.5.1.2, pg. 29) | A88: Applicants should describe reasonable and practical approaches for ensuring counties are engaged in district planning and decision‑making based on their local structures and statutory responsibilities. Iowa HHS will develop templates, guidance materials, and planning tools to support this documentation, and Lead Entities may work collaboratively with Iowa HHS to adapt these resources to meet district needs. |
| Sep 4, 2026 11:10 AM | Q89: For the proposed methods to support delivery of Priority Public Health Core Services, does the Agency expect detailed operational planning such as staffing models, resource allocation, and budget assumptions? (RFP Section 2.3.2.5.1.3, pg. 29) | A89: The RFP does not require detailed operational plans—such as staffing models, resource allocation breakdowns, or budget assumptions—in response to this section. Applicants should describe their overall approach for supporting delivery of the Priority Public Health Core Services, but detailed operational planning will occur during Phase 1 and Phase 2 implementation. Iowa HHS will provide templates and materials to assist Lead Entities, and Lead Entities may collaborate with the Agency to refine those tools as District needs are identified. |
| Sep 4, 2026 11:10 AM | Q90: Does the Agency expect Applicants to propose formal governance or advisory structures for District-level coordination, or will the Agency define statewide expectations for governance? (RFP Section 2.3.3.1, pg. 29-30) | A90: The RFP does not require Applicants to establish or propose formal governance or advisory structures for District‑level coordination. Applicants may describe reasonable approaches for engaging counties and partners, but there is no expectation that formal governance models be created as part of the application. |
| Sep 4, 2026 11:10 AM | Q91: Will the Agency provide more detailed expectations regarding required collaboration activities and any performance measures associated with pre-existing or new partnerships? (RFP Sections 2.3.5.2 & 2.3.5.2.3, pg. 30, 31) | A91: This topic is outside the application requirements for the Lead Entity RFP. |
| Sep 4, 2026 11:11 AM | Q92: Collection and submission of data requires use of Agency-supported reporting software. Can the Agency identify the specific system(s) that will be used and clarify whether training and onboarding will be provided? (RFP Section 2.3.4.2, pg. 30) | A92: The RFP does not identify the specific data‑reporting system(s) that will be used in Phase 2. Iowa HHS will provide that information during implementation, along with instructions, templates, and supporting materials. The Agency will also provide onboarding and training for Lead Entities and counties to ensure they can effectively use the required systems and meet all reporting expectations. Lead Entities may work collaboratively with Iowa HHS to refine and adapt training and documentation tools as needed for their District. See also A45. |
| Sep 4, 2026 11:16 AM | Q93: Section 2.04(B)(5)(c) prohibits supplanting existing funding, including staff salaries, while the August 21 FAQ states that Iowa HHS is open to shared FTEs covering both Lead Entity and local public health responsibilities. If an existing locally funded employee is formally reassigned a documented percentage of work capacity to new Lead Entity or District responsibilities, with their prior locally funded responsibilities correspondingly reduced, may the Lead Entity grant fund that percentage of salary without it being considered supplanting? If not, may grant funds support compensation specifically attributable to the additional responsibilities, such as an additional-duty stipend or overtime? | A93: See A51 |
| Sep 4, 2026 11:17 AM | Q94: Section 1.18(C) states that the Lead Entity is fully responsible for work performed by subcontractors, while the August 21 FAQ states that Iowa HHS will not indemnify Lead Entities for local-provider actions and that Lead Entities should include appropriate protections in their own agreements. Please clarify the intended allocation of financial and contractual responsibility among Iowa HHS, the Lead Entity, and funded local providers in Phase 2. Specifically, what minimum enforcement provisions will Iowa HHS require or permit the Lead Entity to include in local-provider agreements, including authority to withhold or suspend payments, recover questioned or disallowed costs, require corrective action, obtain audit and federal award information, and terminate or redirect funding for noncompliance? If the Lead Entity has established required agreements, completed appropriate fiscal and program monitoring, and taken timely corrective or enforcement action, will the Lead Entity nevertheless remain financially responsible to Iowa HHS for a local provider’s noncompliance, questioned or disallowed costs, failure to perform, or other breach outside the Lead Entity’s direct control? | A94: See A52 |
| Sep 4, 2026 11:17 AM | Q95: For Phase 2, will Iowa HHS establish minimum fiscal and federal compliance requirements that a local provider must satisfy before receiving funds through the Lead Entity, including, as applicable, subrecipient risk assessment, Single Audit/Federal Audit Clearinghouse review, resolution of prior audit findings, federal award and SEFA information, financial reporting, record retention, and access to records for monitoring? If a provider does not satisfy those requirements or develops material compliance concerns after funding begins, what authority will the Lead Entity have to condition, reduce, suspend, terminate, or redirect funding while continuing to meet the RFP’s districtwide service-coverage requirements? | A95: See A55 |
| Sep 4, 2026 11:17 AM | Q96: Section 1.05 provides that Iowa HHS may adjust, reduce, or withdraw funding, while Section 2.3.6 states that, beginning in Phase 2, the Lead Entity is responsible for administering Priority Public Health Core Service funds while “ensuring there is no gap in funding or geographic coverage.” Section 2.3.6.2.1 further requires the Lead Entity to assume full administrative responsibility for the Priority Public Health Core Services and ensure that no gap in program timing or geographic availability occurs. If available Iowa HHS funding is insufficient to maintain the service levels, geographic coverage, staffing, or provider capacity required by the Agency-approved District Public Health Service System Plan, is the Lead Entity required to use county/local funds or other non-HHS resources to make up the shortfall? Please clarify how these coverage requirements will apply when Iowa HHS reduces or withdraws funding, a provider withdraws or becomes unavailable, no qualified provider can be secured at the available funding level, or actual service costs exceed the HHS funding available. | A96: See A56 |
| Sep 4, 2026 11:18 AM | Q97For Phase 2, will Iowa HHS establish minimum fiscal and federal compliance requirements that a local provider must satisfy before receiving funds through the Lead Entity, including, as applicable, subrecipient risk assessment, Single Audit/Federal Audit Clearinghouse review, resolution of prior audit findings, federal award and SEFA information, financial reporting, record retention, and access to records for monitoring? If a provider does not satisfy those requirements or develops material compliance concerns after funding begins, what authority will the Lead Entity have to condition, reduce, suspend, terminate, or redirect funding while continuing to meet the RFP’s districtwide service-coverage requirements? | A97: See A55 |
| Sep 4, 2026 11:19 AM | Q98: Section 1.05 provides that Iowa HHS may adjust, reduce, or withdraw funding, while Section 2.3.6 states that, beginning in Phase 2, the Lead Entity is responsible for administering Priority Public Health Core Service funds while “ensuring there is no gap in funding or geographic coverage.” Section 2.3.6.2.1 further requires the Lead Entity to assume full administrative responsibility for the Priority Public Health Core Services and ensure that no gap in program timing or geographic availability occurs. If available Iowa HHS funding is insufficient to maintain the service levels, geographic coverage, staffing, or provider capacity required by the Agency-approved District Public Health Service System Plan, is the Lead Entity required to use county/local funds or other non-HHS resources to make up the shortfall? Please clarify how these coverage requirements will apply when Iowa HHS reduces or withdraws funding, a provider withdraws or becomes unavailable, no qualified provider can be secured at the available funding level, or actual service costs exceed the HHS funding available. | A98: See A56 |
| Sep 4, 2026 11:19 AM | Q99: The Phase 2 sample contract establishes insurance requirements for the Contractor and its subcontractors. For purposes of Phase 2, please clarify how Iowa HHS expects those requirements to apply to counties, local public health agencies, health systems, and other local providers receiving funds through the Lead Entity. Will each funded provider be required to maintain specified insurance or governmental self-insurance/risk-pool coverage, and will the Lead Entity be responsible for obtaining and monitoring evidence of that coverage? Will Iowa HHS establish minimum insurance requirements that should be incorporated consistently into agreements with local providers across all seven Districts? | A99: The RFP does not require counties or local public health agencies to be subcontractors, and the standard insurance requirements in the Phase 2 contract apply only when the Lead Entity voluntarily establishes a subcontract with another entity. Counties and local public health agencies that participate as program partners and receive core service funding without a subcontract are governed by their own statutory or organizational insurance structures; Iowa HHS does not impose additional insurance requirements on those entities. If a Lead Entity chooses—based on its county’s procurement policies or legal guidance—to enter into a subcontract with a county, local public health agency, health system, or another provider, the subcontractor must meet the insurance requirements in Section 1.8 of the contract. In those cases, the Lead Entity is responsible for obtaining and monitoring evidence of coverage. Iowa HHS will not establish statewide minimum insurance requirements for local agreements across the Districts. Agreement structures and insurance terms should be determined locally according to county policies, procurement rules, and legal counsel. |
| Sep 4, 2026 11:19 AM | Q100: The August 21 FAQ indicated that Iowa HHS does not currently plan to provide legal advice regarding agreements between Lead Entities and local providers. Now that the RFP expressly contemplates subcontracting and makes the Lead Entity responsible for subcontracted performance, does Iowa HHS anticipate establishing a required or recommended agreement structure for Phase 2 local-provider relationships? Specifically, should participating counties or local public health agencies generally be engaged through subcontracts, 28E agreements, MOUs, or another mechanism? Will Iowa HHS provide standardized provisions or model language for requirements that should be consistent statewide, including scope of work, performance measures, payment terms, federal grant requirements, records access, insurance, monitoring, corrective action, termination, and recovery of questioned or disallowed costs? | A100: See A55 |
| Sep 4, 2026 11:19 AM | Q101: Given the Lead Entity’s Phase 2 responsibility for contracting with and overseeing multiple local providers, what legal and contracting support does Iowa HHS envision being available to Lead Entities and their District partners? | A101: See A58 |
| Sep 4, 2026 11:20 AM | Q102: What local provider and/or county Board of Health obligations will remain for legal consultation regarding Priority Public Health Core Services? For example, for quarantine and isolation enforcement, would it be the responsibility of the Lead Entity, Local Provider, or county Board of Health to provide legal consultation regarding communicable disease control core services? | A102: See A62 |
| Sep 4, 2026 11:20 AM | Q103: While recognizing that Iowa HHS may not provide legal advice to individual contractors, may Lead Entity funds be used for county attorney time, outside legal counsel, or specialized grant/contract consulting necessary to develop and administer local-provider agreements, interpret federal flow-down requirements, address noncompliance, and support District implementation? | A103: See A66 |
| Sep 4, 2026 11:20 AM | Q104: Does Iowa HHS anticipate providing centralized legal/contracting guidance, model provisions, or other technical assistance so that each of the seven Lead Entities does not independently develop substantially the same contractual infrastructure? | A104: See A68 |
| Sep 4, 2026 11:20 AM | Q105: Section 2.3.2.4.1.6 on page 29 of the RFP includes a requirement that “An attestation from each board of health within the District that the county will operationally and financially support the obligations outlined in Iowa Code.” If the board of health from a county within the District does not provide an attestation, what option does the Lead Entity have for recourse or release from assurance of this requirement? | A105: See A70. |
| Sep 4, 2026 11:21 AM | Q106: For the required line-item budget for Phase 2, should the Lead Entity plan to budget according to the requirements of Iowa Administrative Code 641, Chapter 80.4(1) LPHS funds? If so, what guidance can the Agency give to determine funding allocation by county? | A106: See A74 |
| Sep 4, 2026 11:21 AM | Q107: Section 1.18 allows for the use of subcontractors and section 2.03 outlines the scope of work of a Lead Entity. Are subcontractors allowed for Lead Entity scope of work? | A107: See A75 |
| Sep 4, 2026 11:21 AM | Q108: If allowable by the Lead Entity organization, are funds from Phase 1 allowed to be rolled over to Phase 2 for activities as outlined in the District Public Health Service System Plan? | A108: See A84 |
| Sep 4, 2026 11:22 AM | Q109: In Phase 2, if funds allocated for a contract period are not fully expended by the District, may they be maintained by the District and rolled over to the next contract period (FY29 to FY30, for example) if allowed by the Lead Entity organization? | A109: See A85 |
| Sep 4, 2026 11:29 AM | Q110: Since the Phase 1 analysis and Interim District Plan will determine the final provider network and allocation methodology, how should applicants identify Phase 2 subcontractors and allocations that are not yet known? | A110: Applicants are not required to identify Phase 2 subcontractors or funding allocations in the RFP application. The RFP recognizes that these decisions will be informed by the Districtwide Public Health Service System Analysis and the Interim District Plan developed during Phase 1. Applicants should describe their general approach to coordination, planning, and engagement with counties and local partners, but they are not expected to propose specific subcontractors, provider arrangements, or allocation models at the application stage. Iowa HHS will provide templates, guidance, and opportunities for collaboration during Phase 1 to support the development of the District plan and the identification of the provider network. |
| Sep 4, 2026 11:35 AM | Q111: Will the Agency provide standardized data elements, reporting templates, or data dictionaries to ensure consistency across Districts? (RFP Section 2.3.4 & 2.3.9, pg. 30, 33) | A111: Yes. Iowa HHS will provide standardized data elements, reporting templates, and data dictionaries to ensure consistency across Districts. The RFP requires use of Agency‑supported reporting systems but does not specify formats; these materials will be developed and shared during implementation. Lead Entities may work collaboratively with Iowa HHS to refine or adapt these tools to meet district needs while maintaining consistency in statewide reporting. See A92 and A45. |
| Sep 4, 2026 11:36 AM | Q112: Aside from the Project Director required under Section 2.3(C), page 34, does the Agency intend to define minimum staffing roles or qualifications for Phase 1 or Phase 2 activities? (RFP Section 2.3(C), pg. 34) | A112: No. The Agency does not prescribe specific staffing roles or minimum qualifications beyond the required Project Director. Lead Entities should propose staffing structures that fit their district’s needs and ensure adequate capacity for coordination, communication, documentation, and fiscal responsibilities. Iowa HHS will review and approve each Lead Entity’s staffing plan based on its overall adequacy, and Lead Entities may collaborate with Iowa HHS during implementation to refine staffing approaches, but no additional required positions are defined in the RFP. |
| Sep 4, 2026 11:37 AM | Q113: Section 2.3.6.2.1 states staffing levels must be in place by a date specified by the Agency. When will this date be announced, and is phased implementation of staffing acceptable? (RFP Section 2.3.6.2.1, pg. 31) | A113: Iowa HHS will work with Lead Entities to ensure expectations are clear. Phased implementation of staffing may be acceptable if it aligns with the Agency‑approved staffing plan. |
| Sep 4, 2026 11:42 AM | Q114: Does the Agency have preferred formats or templates for documenting stakeholder communication and coordination activities, or is local discretion permitted as long as required elements are captured? RFP Citation: RFP requires documentation of communication, coordination, and navigation support but does not specify documentation formats. (RFP Sections 2.3.3.1.2 & 2.3.8.1.2, pg. 30, 32) | A114: See A72 |
| Sep 4, 2026 11:43 AM | A115: Will the Agency provide a required template for the Phase 1 Project Plan and Timeline or should Applicants develop their own format based on the listed requirements? (RFP Section 2.3.2.1 pg. 28) | A115: See A86 |
| Sep 4, 2026 11:43 AM | Q116: For the provider network analysis does the Agency expect submission of quantitative metrics (e.g., staffing numbers, service volumes) in addition to qualitative narrative descriptions? (RFP Section 2.3.2.4.1.4, pg. 29) | A116: See A87 |
| Sep 4, 2026 11:43 AM | Q117: The Draft Interim District Public Health Service System Plan requires Lead Entity to describe how counties will meaningfully participate in District-level planning and decision-making. Can the Agency clarify expectations for demonstrating “meaningful participation”? (RFP Section 2.3.2.5.1.2, pg. 29) | A117: See A88 |
| Sep 4, 2026 11:43 AM | Q118: For the proposed methods to support delivery of Priority Public Health Core Services, does the Agency expect detailed operational planning such as staffing models, resource allocation, and budget assumptions? (RFP Section 2.3.2.5.1.3, pg. 29) | A118: See A89 |
| Sep 4, 2026 11:43 AM | Q119: Does the Agency expect Applicants to propose formal governance or advisory structures for District-level coordination, or will the Agency define statewide expectations for governance? (RFP Section 2.3.3.1, pg. 29-30) | A119: See A90 |
| Sep 4, 2026 11:43 AM | Q120: Will the Agency provide more detailed expectations regarding required collaboration activities and any performance measures associated with pre-existing or new partnerships? (RFP Sections 2.3.5.2 & 2.3.5.2.3, pg. 30, 31) | A120: See A91 |
| Sep 4, 2026 11:43 AM | Q121: Collection and submission of data requires use of Agency-supported reporting software. Can the Agency identify the specific system(s) that will be used and clarify whether training and onboarding will be provided? (RFP Section 2.3.4.2, pg. 30) | A121: See A110 |
| Sep 4, 2026 11:44 AM | Q122: Will the Agency provide standardized data elements, reporting templates, or data dictionaries to ensure consistency across Districts? (RFP Section 2.3.4 & 2.3.9, pg. 30, 33) | A122: See A110 |
| Sep 4, 2026 11:44 AM | A123: Aside from the Project Director required under Section 2.3(C), page 34, does the Agency intend to define minimum staffing roles or qualifications for Phase 1 or Phase 2 activities? (RFP Section 2.3(C), pg. 34) | A123: See A111 |
| Sep 4, 2026 11:44 AM | Q124: Section 2.3.6.2.1 states staffing levels must be in place by a date specified by the Agency. When will this date be announced, and is phased implementation of staffing acceptable? (RFP Section 2.3.6.2.1, pg. 31) | A124: See A112 |
| Sep 4, 2026 11:44 AM | Q125: Will the state continue to hold regional administrator meetings with current regional consultants once the lead entity is in place, or will the lead entity assume this role? | A125: Scoring is based solely on the evaluation criteria described in Section 4.02 of the RFP; additional attachments or formatting choices do not affect scoring unless explicitly stated in the RFP. |
| Sep 4, 2026 11:44 AM | Q126: In Section 4.02, page 43, scoring guidelines, what actions or proposals constitute going “above and beyond minimum requirements” to achieve a score of 4? (RFP Section 4.02, pg. 43) | A126: The RFP does not define or require specific actions to be considered “above and beyond minimum requirements.” Applicants should fully address each scoring criterion and may provide additional detail, clarity, or thoughtful approaches where helpful. However, scoring is based solely on the evaluator’s determination of how well the response meets the criteria in Section 4.02, and the RFP does not prescribe examples of what would earn a higher score. Attachments or supplemental materials do not increase scoring beyond their mandatory inclusion requirements. |
| Sep 4, 2026 3:30 PM | Q127 Will the state continue to hold regional administrator meetings with current regional consultants once the lead entity is in place, or will the lead entity assume this role? | A127: Submitted after the 12:00PM deadline stated in the RFP Section 1.06 Schedule of Important Dates (page 5; Question will be answered in Round 2 Q&A) |
| Sep 4, 2026 3:31 PM | Q128: Will the state continue to hold regional administrator meetings with current regional consultants once the lead entity is in place, or will the lead entity assume this role? | A128: Submitted after the 12:00PM deadline stated in the RFP Section 1.06 Schedule of Important Dates (page 5; Question will be answered in Round 2 Q&A) |
| Sep 4, 2026 4:04 PM | Q129: How does Iowa HHS expect lead entities to treat downstream awards? As subcontracts, subawards, or grants for Chapter 8F purposes? | A129: Submitted after the 12:00PM deadline stated in the RFP Section 1.06 Schedule of Important Dates (page 5; Question will be answered in Round 2 Q&A) |
| Sep 4, 2026 4:15 PM | A130: If a County Board of Health does not participate in district planning, declines to provide the required attestation, or does not operationally or financially support its statutory public health obligations, what authority and responsibility does the Lead Entity have to assure service coverage? What enforcement role will Iowa HHS retain in these circumstances? | A130 Submitted after the 12:00PM deadline stated in the RFP Section 1.06 Schedule of Important Dates (page 5; Question will be answered in Round 2 Q&A) |
| Sep 4, 2026 4:16 PM | Q131: Please clarify what Iowa HHS will require in the attestation that each County Board of Health will “operationally and financially support” its obligations under Iowa Code. Does this represent a maintenance-of-effort expectation or minimum level of local financial support? | A131: Submitted after the 12:00PM deadline stated in the RFP Section 1.06 Schedule of Important Dates (page 5; Question will be answered in Round 2 Q&A) |
| Sep 4, 2026 4:16 PM | Q132: If a Local Provider or county is unable or unwilling to maintain adequate capacity for a Priority Public Health Core Service, what contractual responsibility does the Lead Entity assume for that gap, and what options may the Lead Entity use to restore coverage? | A132: Submitted after the 12:00PM deadline stated in the RFP Section 1.06 Schedule of Important Dates (page 5; Question will be answered in Round 2 Q&A) |
| Sep 4, 2026 4:17 PM | Q133: If a county lacks capacity to provide a Priority Public Health Core Service, may the Lead Entity arrange cross-county coverage, contract with another provider, create shared regional capacity, or directly provide the service? What approvals are required from Iowa HHS or the affected Local Board of Health? | A133: Submitted after the 12:00PM deadline stated in the RFP Section 1.06 Schedule of Important Dates (page 5; Question will be answered in Round 2 Q&A) |
| Sep 4, 2026 4:17 PM | Q134: Please clarify how Lead Entity administrative expenses are expected to be funded from the combined Phase 2 grant funds, including whether there is a prescribed or expected percentage available for Lead Entity administration, finance, contracting, data, project management, and other required infrastructure. | A134: Submitted after the 12:00PM deadline stated in the RFP Section 1.06 Schedule of Important Dates (page 5; Question will be answered in Round 2 Q&A) |
| Sep 4, 2026 4:17 PM | Q135: Please clarify how the anti-supplanting requirement applies when existing county employees take on new Lead Entity responsibilities. May Phase 1 or Phase 2 funds support the incremental portion of an existing employee’s FTE that is newly dedicated to Lead Entity work? | A135: Submitted after the 12:00PM deadline stated in the RFP Section 1.06 Schedule of Important Dates (page 5; Question will be answered in Round 2 Q&A) |
| Sep 4, 2026 4:18 PM | Q136: Will Iowa HHS establish minimum funding levels, allocation formulas, required provider awards, or other restrictions on how Lead Entities distribute Phase 2 funding to Local Providers, or will allocations be determined through the District Plan with local input? | A136: Submitted after the 12:00PM deadline stated in the RFP Section 1.06 Schedule of Important Dates (page 5; Question will be answered in Round 2 Q&A) |
| Sep 4, 2026 4:18 PM | Q137: What minimum staffing levels or functional capacities does Iowa HHS anticipate requiring for Phase 2, particularly for project leadership, grant administration, finance, contracting, provider monitoring, data/evaluation, and system coordination? | A137: Submitted after the 12:00PM deadline stated in the RFP Section 1.06 Schedule of Important Dates (page 5; Question will be answered in Round 2 Q&A) |
| Sep 4, 2026 4:18 PM | Q138: What authority and infrastructure will Lead Entities have to access, aggregate, and share districtwide public health data, including communicable disease surveillance, environmental health, and chronic disease information? What data use agreements, privacy standards, and reporting systems will Iowa HHS provide or require? | A138: Submitted after the 12:00PM deadline stated in the RFP Section 1.06 Schedule of Important Dates (page 5; Question will be answered in Round 2 Q&A) |
| Sep 4, 2026 4:19 PM | Q139: lease clarify the expected scope of “system navigation” and “coordinated navigation processes.” Is the Lead Entity expected to provide direct individual-level care coordination or case management, or is the responsibility to develop, coordinate, monitor, and improve districtwide referral and navigation systems? | A139: Submitted after the 12:00PM deadline stated in the RFP Section 1.06 Schedule of Important Dates (page 5; Question will be answered in Round 2 Q&A) |
| Sep 4, 2026 4:19 PM | Q140: Please clarify how the 15% administrative cost limitation is calculated, including the applicable direct-cost base and whether pass-through or subcontracted provider funds are included in that calculation. | A140: Submitted after the 12:00PM deadline stated in the RFP Section 1.06 Schedule of Important Dates (page 5; Question will be answered in Round 2 Q&A) |
| Sep 4, 2026 4:22 PM | Q141: Please clarify how the 15% administrative cost limitation is calculated, including the applicable direct-cost base and whether pass-through or subcontracted provider funds are included in that calculation. | A141: Submitted after the 12:00PM deadline stated in the RFP Section 1.06 Schedule of Important Dates (page 5; Question will be answered in Round 2 Q&A) |
| Sep 4, 2026 4:22 PM | Q143: Please clarify the expected scope of “system navigation” and “coordinated navigation processes.” Is the Lead Entity expected to provide direct individual-level care coordination or case management, or is the responsibility to develop, coordinate, monitor, and improve districtwide referral and navigation systems? | A143: Submitted after the 12:00PM deadline stated in the RFP Section 1.06 Schedule of Important Dates (page 5; Question will be answered in Round 2 Q&A) |
| Sep 10, 2026 4:07 PM | Q144: The answer is not for the following question. Please respond to the question. Sep 4, 2026 10:49 AM Q51: For the application, is the lead entity responsible for answering the Disclosure of Contract Default questions under the Business Organization Form about each potential subcontracting public health agency in their district? A51: Yes. Grant funds may support a portion of an existing employee’s salary if the employee is formally assigned new, additional responsibilities that are directly tied to Phase 2 deliverables and the District Public Health Service System Plan, and their previous locally funded responsibilities are reduced accordingly. In this situation, the Lead Entity would be funding new work, not replacing (“supplanting”) existing funding. The key requirement is clear documentation showing how the employee’s job duties, time allocation, and funding sources have changed. As long as federal or state Phase 2 funds are used only for the newly assigned Lead Entity responsibilities, this is not considered supplanting. | A144: Submitted after the 12:00PM deadline stated in the RFP Section 1.06 Schedule of Important Dates (page 5; Question will be answered in Round 2 Q&A) |