Request for Application (RFA) for Mississippi Delta Health Collaborative Community Pharmacy Medication Therapy Management Program

The Mississippi State Department of Health Delta Health Collaborative (MDHC) is seeking proposals from qualified community pharmacies to provide Medication Therapy Management (MTM) services to the defined patient population. The goal of this RFA is to partner with community pharmacies that can deliver comprehensive MTM services to enhance medication adherence, optimize therapeutic outcomes, and improve overall patient health, particularly for those with and at the highest risk of hypertension and high cholesterol.

Up to twelve (12) eligible community pharmacies will receive up to $10,000 annually over the next 4 years to implement the MDHC Community Pharmacy MTM Program in one of the 18 Counties of the MS Delta Region: Bolivar, Carroll, Coahoma, DeSoto, Holmes, Humphreys, Issaquena, Leflore, Panola, Quitman, Sharkey, Sunflower, Tallahatchie, Tate, Tunica, Warren, Washington, and Yazoo.

Background

Cardiovascular disease (CVD) remains the leading cause of death both in Mississippi and the United States.  The 18-county MS Delta, defined by the space between the Mississippi and Yazoo rivers, faces profound health challenges, marking it as a severely medically underserved area.  The MDHC operates to identify and mitigate the impact of heart disease and stroke by establishing community-clinical linkages that connect at-risk individuals to evidence-based programs, including Medication Therapy Management (MTM). The MDHC Community Pharmacy MTM Program intends to promote the adoption of MTM by community pharmacists and clinical providers to manage hypertension, high cholesterol, and lifestyle modification.

Project Details

• Reference ID: 2026-RFA-030
• Department: Preventive Health and Health Equity
• Department Head: Cassandra Brown (Director, Office of Preventive Health)

Important Dates

• Questions Due: 2026-04-15T22:00:00.000Z

Evaluation Criteria

• Organizational Capacity Overview (45 pts) —

  Applicants will receive high scores if they have a defined and clear organizational structure; organizational experience in federal grants; qualified and capable personnel with experience in federal grants or equivalent credentials or experience; or can otherwise demonstrate that they will be a reliable subgrantee who will use all awarded funds in a manner consistent with law and the requirements of this RFA.

  • Describes the type of organization applying and its organizational structure. (20)
  • Describes the services provided. (15)
  • Describes the pharmacy’s experience with MTM services. (10)
• Project Management (30 pts) —
  • Describes who will be responsible for executing the MTM program's critical tasks such as recruitment, conducting MTM sessions, patient follow up, monitoring of the project’s ongoing progress, preparation of reports, and communication with partners. (20)
  • Describes the staff’s ability to participate in the MTM program, meetings, and reporting. (10)
• Collaboration (20 pts) —
  • Describes how the community pharmacy uses a team-based care approach to identify patients’ social service and support needs and to improve hypertension and cholesterol management and treatment. (5)
  • Describes staff qualifications, experience, and capacity to provide clinical support to populations at highest risk for hypertension. (5)
  • Describes any history or evidence of collaboration with healthcare systems or community-based organizations and partnerships to address the barriers to social services and support needs. (5)
  • Describes plans to engage stakeholders (e.g., local healthcare providers, patients, CHWs) to enhance MTM service delivery. (5)
• Performance Outcomes (10 pts) —
  1. 1. 1. Subgrantees Seeking Renewal - Applicants will receive higher scores if their agency met the performance requirements outlined in the previous subgrant agreement. If any of those applicants did not meet the required performance metrics during the previous program year, applicants will receive higher scores if a clear and reasonable justification for not meeting the performance requirements is provided.
        2. New Applicants - Applicants that have not previously received this funding will receive higher scores if a strong description of experience and quality outcomes relevant to this project is provided.
• Quality of Application (10 pts) —

  Applications will receive higher scores if the information presented is accurate, complete, well-presented, and free of spelling, grammatical, and mathematical mistakes. Additionally, all acronyms must be spelled out at their first mention, indicating their abbreviation in parenthesis.

• Project Resources (5 pts) —
  • Lists any potential faith-based organizations, community organizations, or healthcare systems that the community pharmacy will plan to partner with to conduct blood pressure screenings and referrals of local participants for MTM services. (2)
  • Lists available resources to support the project, including adequate technology (pharmacy dispensing software, etc.) and supplies (blood pressure monitor and cuff, etc.). (1)
  • Describes commitment to ongoing staff training and development related to MTM services. (2)

Submission Requirements

• Community Pharmacy Information
• Applicant Organization Name (required) —

  Please provide the full legal name of the Applicant Organization that should be listed on an agreement or contract. Be sure to include any other "doing business as" names, or any previous names the organization used.

  NOTE: Name must match the UEI Number

• Applicant Organization UEI Number (required) —

  Please enter the full EUI Number of the Applicant Organization here.

• UEI Number Upload (required) —

  Please upload a copy or printout of your registration from SAM.gov.

• Applicant Organization Address (required) —

  What is the full physical/mailing address of the community pharmacy?

  Please be sure to include the full street name and address, City, State, and Zip Code.

• Applicant Organization Telephone Number —

  Please list the phone number for the community pharmacy.

• Applicant Organization Fax Number —

  Please list the fax number for the community pharmacy.

• Applicant Organization Email Address —

  Please list the email address for the community pharmacy.

• Applicant Lead Contact Information - Name (required) —

  Please provide the full name of the Applicant's Point of Contact for this Application.

• Applicant Lead Contact Information - Title (required) —

  Please provide the full title of the Applicant's Point of Contact for this Application.

• Applicant Lead Contact Information - Telephone Number (required) —

  Please provide the full telephone number (including area code) of the Applicant's Point of Contact for this Application.

• Applicant Lead Contact Information - Email Address (required) —

  Please provide the full email address of the Applicant's Point of Contact for this Application.

• Eligible Entity (required) —

  Party submitting this application certifies that Applicant Organization is an eligible entity as defined by this RFA.

• Debarment or Suspension Confirmation (required) —

  Party submitting this application certifies that Applicant Organization is not presently debarred or suspended.

• W9 (required) —

  Upload a copy of your current W9 here.

• Applicant's Organizational Overview —

  The Applicant’s Organization Overview section shall contain the following information about the Applicant. If the Application is a cooperative or joint venture between two or more entities, all information required in this section shall be provided for all entities, even if a new legal entity has been created or is planned to be created for the purposes of the Subgrant.

• Describe the overall organizational structure of the pharmacy and services provided. (Please include the counties served, pharmacy staff, and services offered). (required)
• Describe your organization’s project management structure and approach for implementing the MDHC Community Pharmacy MTM Program award, including the roles and responsibilities of project staff. (required) —

  Please describe how your organization will manage day-to-day project operations, including:

  a) Project leadership and oversight
  b) Roles and responsibilities of project team members
  c) Processes for monitoring project implementation and progress
  d) Processes for preparing reports
  e) Communication and coordination with partners and stakeholders
  f) Capacity and commitment to participate in required trainings, MTM Advisory Task Force meetings, and MACH Learning Collaborative activities

• Federal Grants Experience (required) —

  Upload a description of Applicant’s previous experience with receiving federal funds. This shall include, but not be limited to, experience receiving federal funds as a direct recipient or a subgrantee. Applicant should describe and demonstrate knowledge of the Uniform Grant Guidance / HHS Grants Guidance (as applicable), as well as any specific experience with the particular federal program and funding source that funds this RFA.

• Programmatic Experience (required) —

  Upload a description of Applicant’s experience with the type of programming or work contained in the Project Description, or other relevant work.

• Pharmacy Support Staff (required) —

  Does your pharmacy have a pharmacy technician who is well-suited, willing, and capable of sensitively assessing patients’ social determinants of health (e.g., housing, transportation, food insecurity, insurance status) and facilitating appropriate referrals to community resources? If yes, please describe.

• Agreements Terminated or Costs Disallowed (required) —

  Applicant must provide a summary of any agreements executed within the last five (5) years with federal awarding agencies or pass-through entities (either as grant agreements, cooperative agreements, subawards, or contracts) that:

  • Were terminated for cause; or
  • Where Specific Conditions were placed on Applicant (see 2 CFR § 200.208 or 45 CFR § 75.207).
• Pharmacy Technology Systems
• Please list the name of your pharmacy dispensing software vendor (e.g., Rx30, Pioneer, QS1). (required)
• Please list any additional electronic platforms your pharmacy uses (e.g., EQuIPP, PrescribeWellness). (required)
• Do you have personnel support who can assist in extracting data? (indicate if support is onsite, contractual, or if there is no personnel support) (required)
• Does your pharmacy software have the capability to document patient referrals to social service and support resources? (required)
• Patient Population Demographics and Clinical Characteristics —

  Please provide exact numbers when possible. If exact numbers are unavailable, estimated percentages based on available data are acceptable. Please clearly indicate when percentages are provided instead of counts.

• What is the total number of adult patients (18 years and older) served by your pharmacy? (required)
• What is the gender distribution of your adult patient population? (required) —

  Exact counts are preferred; however, if unavailable, estimated percentages based on available records may be provided. Please clearly note when percentages are used in place of counts.

  Please report the number of adult patients in each of the following categories:  

  • Male

  • Female

  • Non-binary

• What is the race distribution of your adult patient population? (required) —

  Exact counts are preferred; however, if unavailable, estimated percentages based on available records may be provided. Please clearly note when percentages are used in place of counts.

  Please report the number of adult patients in each of the following categories: 

  • American Indian or Alaska Native

  • Asian

  • Black or African American

  • Native Hawaiian or Other Pacific Islander

  • White

• What is the ethnicity distribution of your adult patient population? (required) —

  Exact counts are preferred; however, if unavailable, estimated percentages based on available records may be provided. Please clearly note when percentages are used in place of counts.

  Please report the number of adult patients in each of the following categories: 

  • Hispanic or Latino

  • Not Hispanic or Latino

• What is the insurance coverage distribution of your adult patient population? (required) —

  Exact counts are preferred; however, if unavailable, estimated percentages based on available records may be provided. Please clearly note when percentages are used in place of counts.

  Please report the number of adult patients in each of the following categories: 

  • Medicare

  • Medicaid

  • Commercial / Private Insurance

  • Federal Coverage (VA, TRICARE, etc.)

  • Uninsured / Self-Pay

• What is the total number of adult patients with hypertension served by your pharmacy? (required) —

  Medication profiles may be used to infer potential diagnoses.

  Exact counts are preferred; however, if unavailable, estimated percentages based on available records may be provided. Please clearly note when percentages are used in place of counts.

• What is the total number of adult patients with dyslipidemia served by your pharmacy? (required) —

  Medication profiles may be used to infer potential diagnoses.

  Exact counts are preferred; however, if unavailable, estimated percentages based on available records may be provided. Please clearly note when percentages are used in place of counts.

• Conflicts of Interest
• Other Current MSDH Contracts (required) —

  List all other current agreements/contracts with MSDH, including the dollar amount associated with the agreement/contract and the beginning and ending dates. If no other funds are received, please mark N/A.

  Please provide each entry in the following format:

  MSDH Program or Agreement/Contract Name #1

  • Dollar Amount
  • Contract Beginning Date
  • Contract Ending Date
• Organization Governing Body (required) —

  Please list the name of each member of your organization’s Board of Directors or other governing body (i.e., trustee, alderman, partner, owner).

• Governing Body or Project Staff Affiliations (required) —

  Are any members of the governing body or project staff also MSDH employees, MSDH Board Members, or spouses, parents, or children of MSDH employees?

• Governing Body or Staff Affiliations - Explanation (required) —

  You have indicated that one or more members of your governing body or project staff are also MSDH employees, MSDH Board Members, or spouses, parents, or children of MSDH employees.

  Please provide the following for all such individuals:

  • Name of Individual
  • Indicate if individual is an MSDH Employee, MSDH Board Member, or relative type of MSDH employee.
  • Applicable position held with MSDH
• Income From Business (required) —

  Does the MSDH Board Member, Employee, or Relative receive more than $2,500.00 per year in income from the business?

• Ownership Status - Percentage (required) —

  Does the MSDH Board Member, Employee, or Relative own ten (10%) percent or more of the fair market value in the business, either directly or indirectly through another business?

• Ownership Status - Amount —

  Does the MSDH Board Member, Employee, or Relative have ownership interest in the business, in which the fair market value exceeds $5,000.00?

• Position Within Business (required) —

  Is the MSDH Board Member, Employee, or Relative a director, officer, or employee of the business?

• Conflict of Interest Certification (required) —

  I hereby certify that the information set forth above is true and complete to the best of my knowledge and that no MSDH employee, spouse, parent, or child of an MSDH employee, serves as a member of the governing body, project staff, or has an ownership or pecuniary interest in the agreement/contract or organization. I agree to notify MSDH within thirty (30) days if any of these conditions change during the agreement/contract.

• Other
• Does your pharmacy currently participate in any form of collaborative practice agreement with a local healthcare provider? (required) —

  If yes, please include the name of the healthcare system.

• Please list potential faith-based organizations, clinics/healthcare systems, or community based organizations within your community that your pharmacy may partner with to conduct blood pressure screenings and refer local participants. (required)
• Debarment, Suspension, and Eligibility (required) —

  The applicant certifies that they or any of its principals _____ presently debarred, suspended, proposed for debarment, or declared ineligible for award of federal or state contracts.

  Select the answer which best fills in the blank for the applicant.

• Charges From A Government Agency (required) —

  The applicant certifies that they or any of its principals _____ presently indicted for, or otherwise criminally or civilly charged by a government entity.

  Select the answer which best fills in the blank for the applicant.

• Conviction or Acknowledgment of Fault (required) —

  The applicant certifies that they or any of its principals _____ within the last five (5) years, been the subject of a federal or state criminal proceeding resulting in a conviction or other acknowledgment of fault, been the subject of a federal or state civil or administrative proceeding resulting in a finding of fault with a monetary fine, penalty, reimbursement, restitution, and/or damages greater than $5,000 or other acknowledgment of fault;  convicted of or had a civil judgment rendered against them for commission of fraud or criminal offense in connection with obtaining, attempting to obtain, or performing a public (federal, state or local) contract or subcontract; violation of Federal or State antitrust statues relating to the submission of offers; or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements or receiving stolen property.

  Select the answer which best fills in the blank for the applicant.

• Contract Termination By Default (required) —

  The applicant certifies that they or any of its principals _____ within the last five (5) years preceding this offer, had one or more contracts terminated for default by any federal agency.

  Select the answer which best fills in the blank for the applicant.

• Felony Criminal Violations (required) —

  The applicant certifies that they or any of its principals _____ within the last five (5) years, been convicted of a felony criminal violation under federal or state law.

  Select the answer which best fills in the blank for the applicant.

• Financial Records (required) —

  Does the applicant have a financial management system that provides records that can identify the source and award-supported activities and provides control and accountability of project funds, property, and other assets?

• Audit Status / Fiscal Responsibility (required) —

  Does the applicant receive an annual audit in accordance with Uniform Guidance §200.514 (formerly A-133)?

• Most Recent Audit (required) —

  What is the most recent fiscal year for which this audit was completed?

• Report Findings (required) —

  Were there any audit findings in the most recent report?

  If "Yes", please be sure to provide an explanation in the applicable upcoming question. Failure to provide an explanation may cause your submittal to be deemed non-responsive.

• Recent Audit Report —

  Please upload a copy of your most recent Uniform Guidance §200.514 (formerly A-133) Audit Report.

• Explanation or Other Information (required) —

  Please provide any additional information around your Audit Status that you feel is necessary here. This includes an explanation regarding any audit findings in your most recent audit.

  If you have nothing to add here, please state that you have no additional information to provide.

• No Annual Audit (required) —

  You have stated that the applicant does not receive an annual audit in accordance with Uniform Guidance §200.514 (formerly A-133).

  Please select the option which best fits the reason why.

• No Annual Audit - Other (required) —

  If you selected "Other" in the previous question regarding why you do not receive an annual audit in accordance with Uniform Guidance §200.514 (formerly A-133) please specify here.

  If your answer to the previous question was not "Other", please respond here with "N/A".

• Supplemental Information —

  Applicant will provide any required supplemental information as outlined in this Request to be submitted with the Application. 

• Please acknowledge that any work performed prior to execution is done at the vendor’s own risk and may not be eligible for payment. MSDH reserves the right, in its sole discretion, to determine on a case-by-case basis whether payment is allowable based on the particular circumstances. (required)
• Competition/Joint Efforts Verbiage (required) —

  Should the language for Competition/Joint Efforts be used in this RFA?

• Statement of Need (required) —

  Is there a Statement of Need required with submittals for this RFA?

• Estimated Dollar Amount (required) —

  What is the estimated dollar amount budgeted for this request?

• Funding Information —

  Be sure that the following three financial info pieces add up to 100% or this will not be approved.

• Internal Order (required) —

  Please specify the internal order information. Be sure to include the % of each internal order. If there are multiple internal orders, please separate each with a comma and be sure they add up to 100% or your posting will not be approved.

  EXAMPLE 1
  30000035771  100%

• Functional Area (required) —

  Please specify the functional area information. Be sure to include the % of each functional area. If there are multiple functional areas, please separate each with a comma and be sure they add up to 100% or your posting will not be approved.

  EXAMPLE 1
  13010101000000DV  100%

• Cost Center (required) —

  Please specify the cost center information. Be sure to include the % of each cost center. If there are multiple cost centers, please separate each with a comma and be sure they add up to 100% or your posting will not be approved.

  EXAMPLE 1
  1301010707  100%