Northeast Hospital Corporation’s Community Collaborative Grant.Request for Proposal

Overview

Northeast Hospital Corporation (NHC), includes a full continuum of acute inpatient, outpatient and behavioral health services to North Shore residents at a variety of locations including Beverly and Addison Gilbert hospitals, full service community hospitals providing quality, patient-centered care in maternity, pediatrics, surgical, cardiology, orthopedics, as well as other specialties. NHC is staffed by 2,700 employees, has over 600 physicians and staff, and receives volunteer contributions from 350 members of the community.

For more information, please visit our web site at

NHC seeks to address health concerns through a grant initiative, the Northeast Hospital Corporation’s Community Collaborative Grant. NHCrequests applications for funding that relate to one of the main focuses of the Community Health Needs Assessment. These include the following:

  • Mental and Behavioral Health
  • Chronic Disease Management (Heart Disease, Diabetes and Cancer)
  • Access to Healthcare Services

Grantmaking Objective: In October 2012,NHC will allocate up to $40,000 in grant funding to support innovative initiatives that are designed to:

  1. Promote mental and behavioral health education, prevention,and early intervention.
  2. Improve chronic disease prevention (as it relates to diabetes, stroke, cancer, and heart disease) and promote healthy lifestyles.
  3. Publicize available health resources and activities in the community.

Available Funding: Up to $40,000 in total funding is available for the 2013grant cycle. The program expects to award three grants at $10,000 each. Grant requests may be submitted for up to $10,000 per organization in any one category. The funding period is one year, from January 1, 2013 – December 31, 2013.

Geographic Focus: Programs or services under this grant initiative must be delivered within the NHS primary service area: Beverly, Boxford, Danvers, Essex, Gloucester, Hamilton, Ipswich, Lynn, Manchester, Middleton, Peabody, Rockport, Salem, Swampscott, Topsfield and Wenham.

Eligibility: Eligible applicants include local coalitions or collaborative efforts that are interested in improving community health. All applicants must have an appropriate fiscal agent such as a 501(c)(3) or municipality.

Application Guidelines

Applicants must complete the following:

  1. The first step in applying for a grant is submitting a letter of intent not to exceed two pages in length.NHS will accept only one letter of intent per applicant. Letters of intent are due by October 19, 2012. Lettersmay be mailed or emailed to the contact on page 2. Letters should include:

The grant category under which you will apply.

A summary of the nature of the project; target population and geographic area(s) served; the number of individuals affected by the proposed project; the project cost and the dollar amount requested.

Brief description of your organization and contact information.

  1. If invited to submit a full proposal, thefull grant application is due by November 16, 2012. Grant applications must include the following:

A cover sheet with complete contact information.

A narrative that is no longer than six pages, 12-point font, with one-inch margins, including an action plan. The budget and action are part of the six page count.

A budget and budget narrative that follows the sample budget format included in the application.

Northeast Hospital Corporation’s Community Collaborative Grant. Request for Proposal

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Timeline

September 2012 / RFP is posted
October 19, 2012 / A letter of intent to apply for a grant is due
November 16, 2012 / If invited, grant applications are due
Week of November 19 / Grant review team reviews applications
December 28, 2012 / Grant recipients will be notified
Upon notice of award / Grant recipients must submit an invoice to NHS to receive grant funds
Grant period / January 1, 2013 – December 31, 2013
Final report due / January 27, 2014

Process for Evaluating Applications

An objective grant review team will review and score all proposals, and make final funding decisions. Any application that does not meet the timeline may not be reviewed and/or may receive a lower total score. Reviewers will be screened out for any potential conflict of interest in the funding decision.

Requirements of Recipient Organizations

  1. Upon notice of award, an invoice must be submitted to NHCto receive grant funds. Gerald B. MacKillop, Jr. is the contact at or fax to 978-236-1670.
  2. Identify NHC as a co-sponsor of events/activities in any media and/or public relations efforts; and
  3. Submit a final report on the project. Send any copies of newspaper clippings or media coverage on the project with final report.

Mail Letters of Intent and Applications to:

Gerald B. MacKillop Jr. MBA, Public Relations Manager

Northeast Health System

500 Cummings Center, Suite 6500, Beverly, MA01915

phone/fax: 978-236-1615 / 978-236-1670

email: (for grant questions and letters of intent, only)

Applications must be received in the mail by October 19, 2012. Request delivery without signature of receipt.

GRANT CATEGORIES

Category 1: Mental and Behavioral Health

Statement of Need: There is a growing appreciation of the impact that mental health and substance abuse problems have on the general public and on the healthcare system overall. National research suggests that roughly 33 percent of the population will experience some kind of mental health or substance abuse problem in any given year. (Kessler RC et al) The data collected from the Beverly Hospital Health Needs Assessment reinforces these findings. There are high rates of mental health issues, substance abuse, and related risky behaviors (e.g., feeling sad/blue/stressed, risky/binge drinking, and driving while under the influence) as well as extremely limited capacity for behavioral health screening, assessment, and treatment services, particularly for children, adolescents, and low income families.

Community Benefit: Children and adults with mental health and substance issues will have access to needed, high quality education, counseling, self-management support, and treatment services that will help them to cope with and address their health conditions. Children and adults will also benefit from education, raised awareness, and knowledge of available resources related to the signs, symptoms, and treatment of mental and behavioral health problems.

Intended Outcomes:

1) Develop new community partnerships and better coordinate existing activities and partnerships.

2) Educate and raise awareness about preventative measures, risk factors, and available resources related to mental health and

substance abuse.

Category 2: Chronic Disease Management (Heart Disease, Stroke, Cancer and Diabetes)

Statement of Need: Heart Disease, cancer and stroke are the leading causes of death in the region and diabetes is in the top 10. The rates of lifestyle risks and healthy habits such as smoking, regular exercise, consumption of fruits and vegetables are also not favorable compared to the State and nation. The morbidity and mortality related to chronic disease is extreme and there are ample opportunities to identify and address existing chronic disease, reduce risky behaviors, and promote healthier lifestyles.

Community Benefit: Children and adults with chronic illnesses will have access to needed, high-quality education, counseling, self-management support, and treatment services that help them to better manage their health conditions. Children and adults will also benefit from education, raised awareness, and knowledge of available resources related to chronic disease generally and specifically cardiovascular disease, cancer, and diabetes.

Intended Outcomes:

1) Increase the number of NorthShore residents receiving prevention education materials, messages,and resources geared to chronic disease management, reducing risky behaviors, and promoting healthier lifestyles.

2) Maximize the number of NorthShore residents receiving preventative screening, identification, referral, and treatment services that help them to better manage their chronic health conditions.

Category 3: Education/Awareness of Healthcare Services

Statement of Need: A health disparity is a population-specific difference in the presence of disease, health outcomes, or access to health (HRSA, 2000). New public health trends link health equity with social justice, citing negative social conditions such as economic and social insecurity; racial and gender inequality; lack of participation and influence in society; absence of affordable housing; and toxic environments as contributors to inequity and therefore, poor health status.

Community Benefit: NorthShore residents will have equitable access to health services, activities, and resources, ensuring healthcare access, treatment and outcomes.

Intended Outcomes:

1) Increase collaborative relationships among public health partners, including health departments, councils on aging, senior providers, schools, advocacy organizations, philanthropic organizations, community health centers, and other health and social serviceproviders.

2) Increase education and awareness activitiesto maximize number of NorthShore residents who achieve positive health outcomes.

Strategies for reducing health disparities are not limited to, but may include:

Increase healthcare utilization for underserved populations.

Focus on target populations such as racial/ethnic minority groups, underserved females, males, and youth, people with low income, rural and urban residents.

Diversify the public health workforce.

Increase the cultural competence of the health and social service workforce.

Educate the public and providers on defining and determining local health disparities.

Applicants are encouraged to clearly define a local disparity and program need based on data.

* A joint letter from each collaborative partner must be sent in the initial application letter. This letter must disclose the roles of each partner.

APPLICATON COVER PAGE

Name of Organization or Group:
Address:
City, State, Zip
Project Title:
Grant Category:
Amount of Funding Requested:
Contact Person:
Title:
Phone:
Email:
Fiscal Agent (if different from your organization):
Fiscal Contact:
Address:
City, State, Zip
Phone:
Email:

APPLICATION NARRATIVE QUESTIONS

Please answer the following questions about your project (no longer than six pages including budget). Please include both the question, and your response. Use a one-inch margin and 12-point font. Abstract should not be more than a half page at most and will be used to describe your program to others.

1. Provide a brief project abstract. Include: a brief statement identifying the project, its goals, and intended outcomes. Identify the target population and main strategies. Identify if this is anew program/concept, or building on services that exist. Include the community(ies) in which the program or service will be delivered, as well as the estimated number of people that will be impacted.

2. Provide a full description of the project, including: demonstrated need (quantitative and qualitative data), strategies, and how they will be implemented. In addition, clearly define each collaborating organization and its specific role with the project. Collaborative roles will be reviewed against your narrative, action plan, program budget and references.

3. Provide a project plan. Outline specific project goals and objectives, correlating activities, measures, and timeline, and entity responsible for implementing. Use the following grid format. Goals/objectives must be measurable. Activities must correlate with each goal. See sample plan on page 7.

Goal 1:

Objective 1.

Strategies/Activities / Benchmark/Measures / Timeline / Responsible

4. Describe your intended evaluation methods and tools used to determine whether the project met the stated goals/objectives.

5. How will you apply what you learn from this funding opportunity to future work? Please identify two or more of the following ways your program/service will continue beyond this current one-year funding period.

The lead organization(s) have demonstrated a financial commitment (in writing) to continue the program or services

Capital improvements have been achieved and support program continuation (describe)

Tools, policies, procedures, and systems developed through this grant are in place and will continue beyond funding

Staff competencies are gained and applied to work

The program/service is being replicated

Cost-sharing models are in place

There is a plan for matching funds

There is a plan for fundraising efforts specific to project/service

A source of program revenue is identified

A source of program funding is identified

6. Why should your organization be awarded this grant? Make a compelling case. If this grant is not received, will the project be partially or fully implemented? Explain.

7. Provide an itemized one-year budget for the total amount of funding you are requesting through this grant. Use the sample budget format on page 9. Expenses for the total grant request must be itemized. Any additional supporting funds must be identified in a total project budget. The total project budget includes funds from a larger project that may support this initiative as well as any additional matching or contributing funds. If you plan to use funds for staff time, consultants, or capital improvements your budget narrative must describe how this is necessary to meet and/or sustain program objectives. Programs that fund staff time without demonstration of how services will continue beyond the lifecycle of this grant will not be favored. Up to 5% of funds applied for may be used for administrative overhead. For example, if you apply for $7,500 you may budget 5% or up to $375 for administrative costs.

APPLICATION SAMPLE PLAN

Goal 1: Maintain normal weight gain for Harborview Housing Complex children ages 6-12 over 8-week summer period

Objective 1: 30 percent of families report increased convenience of purchasing fresh fruits and vegetables at the affordable Housing Complex on Canal Street

Objective 2:50 percent of tenants report increased weekly consumption of fresh fruits and vegetables

Strategies/Activities / Measures / Timeline / Responsible
Survey to assess consumption of fresh fruits and vegetables and shopping habits/barriers among housing tenants / Pre-post survey of convenience barriers to getting to market / May / University volunteer
Collect baseline BMI data on families / 20-30 families participate
50 youth participate in baseline measures / June / CommunityHealthCenter Nurse
Set up a volunteer on-site at the housing complex to collect weekly orders from the Farmers market and deliver fresh produce door to door / # orders collected
Volume of fresh fruits and vegetables delivered / July-Aug / Farmers Market Staff and Youth volunteers

Objective 3: Increase daily caloric expenditure thru increased physical activity.

Strategies/Activities / Measures / Timeline / Responsible
Implement family walking hours in neighborhood / Total hours walked, # and frequency of adults and youth participating / July / YMCA staff

APPLICATION SAMPLE BUDGET

Organization Name:

Project Title:

Total program budget: $28,155

Total being requested: $7,500

Expense Category / Funding Request / In-Kind or Other Funding Sources / Total Budget
Personnel
Program Director / $5,000 / $5,000
Project Coordinator / $4,000 / $10,000 / $14,000
Subtotal / $4,000 / $15,000 / $15,000
Tax and Fringe / $760 / $2,850 / $2,850
Total Personnel / $4,760 / $17,850 / $17,850
$0
Program Expenses / $0
Supplies / $1,500 / $3,000 / $4,500
Printing / $283 / $283
Advertising / $200 / $200
Postage / $250 / $250
Travel Expense / $400 / $1,000 / $1,400
$0
Sub Total / $7,143 / $22,100 / $24,483
Administrative Costs (5% Max of Subtotal) / $357 / $3,315 / $3,672
TOTAL / $7,500 / $25,415 / $28,155

Budget Narrative

Personnel: The Program Director’s salary (7 hrs/week x 20 wks x $35.71 = $5,000) will be covered by a State Grant. The Project Coordinator’s salary will total $14,000 (28 hrs/week x 20 wks x $25/hr = $14,000), $10,000 will be covered by the aforementioned State Grant and Harborview is requesting $4,000. Tax and Fringe is based on the agencies rate of 19%.

Program Expenses: The supplies needed on this project will only include the medical screening kits which cost $9 a person ($9 x 500 participants = $4,500). $3,000 will be covered by a grant from Pharmatech and Harborview is requesting $1,500. Harborview is requesting $283 to print out 500 flyers to help promote the program. Also $200 is requested to place the flyer in the local newspaper. The State grant will be covering the expense to mail the follow-up survey to the participants ($750). 45 $20 cab vouchers will be available to those who can not travel to and from Harborview ($500 will be covered by the State Grant and $400 is requested). The State Grant will also cover the travel expenses for the Coordinator who will be traveling locally and to three statewide meetings (1,220miles x $.41mile = $500)

Administrative Costs: Total administrative cost will be $3,672. $357 or 5% is being requested and $3,315 or 15% will be covered by the state grant.

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