CHNA 15 Request for Proposals

Funding for Collaborative Grants

Copies of the RFP and all attachmentsare available at

CHNA 15 is seeking proposals for funding from non-profit entities to support projects that depend on meaningful collaborations between organizations or between communities in the CHNA 15 region. The focus of this grant is to fund projects that will create or enhance ongoing collaborationthat would be unlikely to happen without the support of this grantand that will make systemic changes that will last over time. Projects must be focused on the CHNA’s current priority areas of elder health or youth behavioral health, and must be developed and carried out in a participatory, multi-sectoral way that is aligned with the Healthy Communities approach[1]. We expect to award up to threeCollaborative Grants of up to $25,000.

Successful applicants will work actively with their key partners, including representatives from sectors other than their own, to develop strategies (e.g. programmatic, policy, systems, or environmental change[2]) that promote and sustain community-based health promotion and chronic disease prevention. Collaborative projects must address Elder Health or Youth Behavioral Health with a focus on at least one of the followingsubtopicsthat emerged from The CHNA’splanning process in 2016.

  1. Elder Health, with a focus on:
  2. Depression and Isolation
  3. Chronic Disease and Unhealthy Lifestyles
  4. Alcohol Abuse
  5. Fragmentation of Health Services
  6. Youth Behavioral Health, with a focus on:
  7. Depression and Anxiety
  8. Alcohol, Prescription Drug and Opioid Use
  9. Access to Mental Health and Addiction Treatment Services
  10. Obesity and Fitness

Eligibility

CHNA 15 is seeking applications for funding from non-profit organizations and/or public entities including service providers, health and community-based organizations and coalitions, municipalities, schools, and communities of faith who are interested in improving community health. Hospitals are not eligible for funding, but are encouraged to participate as partners. Previous recipients of a CHNA 15 Collaborative Grant are not eligible. Previous recipients of all other CHNA 15 grant(s) are eligible.

Eligibility Requirements:

  • Applicant must serve people in one or more of the CHNA 15 communities.
  • Collaboration must be demonstrated and a lead agency identified.
  • Lead applicant must be a tax-exempt 501C3 under the IRS code or a public entity. If applicant is not a 501C3 they must have a Fiscal Agent who is a 501C3 or partner with an agency with an IRS designation as a 501C3, a Section 170, or other IRS non-profit designation.
Requirements and Assessment Criteria

Budget Exclusions and Requirements:

  • No application may exceed a $25,000 budget request.
  • Capital expenses may not exceed 10% of the total budgetunless justification is provided as to why additional capital expense funds are needed for project success AND a clear plan for ongoing sustainability, maintenance and storage is presented.
  • If agency overhead is included, it may not exceed 7% of the total budget.
  • Grant funds can be spent only on staff andexpenses related to the Collaborative Grant project.

Proposals will be evaluated against the following Assessment Criteria:

  • Complete numbered responses to all Application Components
  • Content and Quality of the proposal – as considered by reviewers: Contentis an assessment of whether the applicant has responded to each sub-section of the Question; that is, the presence or absence of the required information. Qualityof a response is its degree of excellence.

Instructions for Submission of Responses

  1. Attend an Information Session on February 7, 2018 at from 1:00 – 2:00 PM at Minuteman Senior Services, 26 Crosby Drive, Bedford. It is REQUIRED that potential applicants attend, even if you have previously applied for a CHNA 15 Grant.
  2. Submit a Notification of Intent to Apply by email by Wednesday, February 14, 2018. The Intent to Apply may be brief including organizational contact information: e-mail address, phone number, contact person, and community/ies and/or organization(s) your proposal will likely include. Submit Notification of Intent to Applyvia email to Randi Epstein, CHNA 15 Coordinator, . Submit proposals via mail and email to: Randi Epstein, CHNA 15 Coordinator, 59 Bonwood Road, Needham, MA 02492 and
  3. Submit complete electronic and hard copies of proposal. An emailed copy in PDF format is due by 5 PM on Friday, March 16, 2018. One (1) original copy of your proposal, marked Original, plus five (5) copies must be postmarked by 5 PM on March 16, 2018. Proposals postmarked or received via email after the deadline will not be eligible for review or funding. All applicants will receive notification of receipt of proposals.

Applications that do not meet ALL requirements will NOT be considered. No exceptions.

Unrequested attachments will not be reviewed.

Proposals must be written in 8 ½ x 11 inch format, single-spaced, using twelve point Arial font, and must be single-sided with one-inch margins.

A 10-point Arial font may be used for the charts in Questions 1 and 6.

Your response to proposal narrative questions must be numbered and correspond to the question numbers.

Application Requirement Checklist

Completed CHNA 15 Collaborative Grant Cover Page as the first page of submitted proposal

Project narrative with responses to questions 1-7. 5 page limit.

Completed Budget Form and Justification. 2-page limit.

Signed CHNA 15 Collaborative Grant Project Agreement

Documentation of Tax Exempt Status or, if applicable, verification of designated Fiscal Agent and

501c3 status of that agent

No more than two signed Letters of Commitment from key community collaborators

Electronic copy submitted as a single PDF by email

One original and five hard copies of proposal submitted by mail

Timeline

Information Session (participation required) on February 7, 2018.

Notification of Intent to Apply must be emailed by February 9, 2018.

Proposals must be postmarked and emailed by March 16,2018.

Awards will be announced by April 6, 2018.

Start-up is April 9, 2018 and project must be completed by June 30, 2019.

Who We Are

CHNA 15 has the following Mission Statement: We pledge ourselves to work together to build healthier communities through community-based prevention planning and health promotion.

To enhance its purpose CHNA 15 established a vision statement as follows: We envision that each and every community will bea safe and supportive environment that empowers community members to develop self-esteem and personal responsibility to make positive and healthy life choices.

CHNA 15 is one of 27 Community Health Networks across Massachusetts created by the Department of Public Health in 1992. Active since that time, CHNA 15 is a partnership between the Massachusetts Department of Public Health, residents, hospitals, local service agencies, schools, businesses, boards of health, municipalities, and other concerned citizens who work together through local collaborations to identify health needs of member communities,find ways to address those needs, and improve the social and physical health of the community.CHNA 15 is composed of citizens from Acton, Bedford, Boxborough, Burlington, Carlisle, Concord, Lexington, Lincoln, Littleton, Wilmington, Winchester and Woburn. Participation is open to those interested in joining others to work toward the goal of healthier communities.

CHNA 15 members and associates

  • network and share ideas with people with similar interest in building healthier communities,
  • gain knowledge about a range of health related issues and topics,
  • participate in designing and implementing health improvement projects,
  • advocate for health issues that are important to their community,
  • benefit from scholarships and Capacity Building Grants for themselves and their agencies,
  • apply for grants for projects for community physical and social health improvement, and
  • attend and/or provide a variety of trainings designed to enhance & strengthen community work.

Anyone interested in becoming involved, wanting information on activities, wishing to be added to our ListServ, or any other opportunities offered by CHNA 15, may contact:Randi Epstein, CHNA 15 Coordinator, at or visit our website at.

Proposal Narrative
  1. Project Description:20Points

Describe your project and provide a detailed timeline for carrying it out using the table below. Include activities related to collaboratively planning the work, carrying out the work, and measuring your success. (You may add rows to the chart and you may use 10-point font in the chart.)

Action/Task / Person Responsible / Dates
  1. Lead Agency Qualifications: 10 Points

Why is your agency or institution well-positioned or well-suited to lead this project?

Describe your agency’s and project staff’s relevant experience, expertise and connections and explain how they will contribute to the project’s success.

  1. Collaboration:25Points

Why is it important for your project to be collaborative? Explain why your agency would not be able to do the project alone and why the collaboration will strengthen your efforts. For each collaborating agency please list the way that they will be involved and the unique strengths that they bring to the project.

Submit signed Letters of Commitment from two collaborators reflecting an understanding of the project. Letters should indicate what relationship the writer has to the project and specifically what role they agree to have in the project during and after the funding period. (The Letters of Commitment are not included in the five pages allowed for questions 1-7.)

  1. CHNA Health priorities: 5 Points

What CHNA health priority area(s) will your project address? Why is the issue that you will be addressing important to your community/ies? Use qualitative or quantitative data to explain why you think the issue is important.

  1. Systems change: 10 points

What policy, systems or environmental change do you expect your project to make? (for more information and definitions see Appendix B)

  1. Impact: 10Points

How will you know if the project has been successful? This question should be answered by filling out the chart below. What will be different at the end of the grant period? You may include products that you will have created, policies that will be created or changed, changes in knowledge, behavior or attitudes, changes in services, changes in health status, or other changes that you hope to see. (You may add rows to the chart and a 10-point font may be used in the chart.

What will be different after the project? / How will you count or measure the change? / When will you measure the change?
Example: parents who participate in our workshops will know about 3 new ways to dispose of prescription medications / Example: Results of a Pre and post-test given to parents who participate in workshops / Example: before and after each monthly workshop
  1. Sustainability:10 Points

How will the impacts of the project continue after the funding period? How will the collaboration described in your proposal help to sustain the impacts of what you do?

  1. Budget: 10 Points (See Attachment 4)

Complete an itemized budget (using the template below) for your proposed project. Include line item costs and a brief description of each. At the bottom of the budget template include justification for each line item. Justification is limited to two pages and should not include program details not already described elsewhere in your proposal. This justification will be used only to score the budget, not to score the narrative questions. Accuracy will be considered. Please check your math. The itemized budget and budget narrative are not included in the five pages allowed for questions 1-7.

Contact for questions or clarification: Randi Epstein, CHNA 15 Coordinator, at .

CHNA 15 Collaborative Grant Budget Form

Itemize all expenses and summarize all revenue and in-kind support for the project

Line Item* / Amount Requested in Application
(add columns for additional partners as needed) / In-Kind and Other (Amount and Sources) / Total Project Costs
Name of Lead: / Name of Partner 1: / Name of Partner 2: / Name of Partner 3:
Staff
Fringe
Contract Services
Travel/
Supplies
Equipment
Agency Overhead
Other Expenses
Total

Definitions:

Partner: Indicate organizations actively involved in discussion and development of project.

Staff: Indicate number of hours to be applied to this project and hourly rate.

Fringe: If applicable. (Check with your agency for how this is calculated and include a breakdown of included charges.)

Contract Services: Identify contractor and number of hours.

Capital Expenses: Capital expenses include equipment purchases. Capital Expenses may not exceed 10% of requested budget unless justification is provided as to why additional capital expense funds are needed for project success AND a clear plan for ongoing sustainability, maintenance and storage is presented.

Agency Overhead: May not exceed 7% of requested budget.

Other Expenses: List and explain

In Kind: Indicate source and amount of donated goods and services provided by both partners and non-partners.

CHNA 15 Collaborative Grant Budget Justification

The budget justification must explain the relevant details of each line item. Justification should not include program details not identified elsewhere in your proposal. If needed, additional space, not to exceed two pages, may be used.

CHNA 15 FY’2018Collaborative Grant Cover Page

Submission Date: ______Project Title ______
Project Description:______
______
Lead Agency/ Organization:______Contact Person: ______
Focus Area: Please put a check to the left of the focus area(s) you will address:
Elder Health Depression and Isolation / Youth Behavioral Health Depression and Anxiety
Elder Health Chronic Disease and Unhealthy Lifestyles / Youth Behavioral Health Alcohol, Prescription Drug and Opioid Use
Elder Health Alcohol Abuse / Youth Behavioral Health Access to Mental Health and Addiction Treatment Services
Elder Health Fragmentation of Health Services / Youth Behavioral Health Obesity and Fitness
Anticipated number of people that will be impacted by your project? ______
What communities will be impacted by your project?
Acton / Bedford
Boxborough / Burlington
Carlisle / Concord
Lexington / Lincoln
Littleton / Wilmington
Winchester / Woburn
Other – please list
Lead Agency/ Organization Street Address:______
City:______State:_____ Zip: ______Phone:(___)______
Fax: (___)______Email:______Website:______
Amount of Funding Requested: $______Federal Tax ID #______
Geographic Area Served by Project:______
HAS YOUR AGENCY RECEIVED ADDITIONAL CHNA 15 FUNDING TOWARD THIS PROJECT? ____YES ____ NO
If your organization has a fiscal agent/conduit other than the applicant named above, please complete
Name of fiscal Agent/ Conduit:______
Name of fiscal Contact Person:______
Address: ______
City:______/ State:______/ Zip Code: ______
phone: (____)______Fax: (___)______EMAIL:______

CHNA 15 RFP 2018 Collaborative Grant

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CHNA 15 Collaborative Grant Agreement

If awarded a CHNA 15 Collaborative Grant, we agree to the following:

  • We agree to ensure that at least one informed person representing our project shall attend each CHNA 15 Healthy Community Resource Forum to share achievements and updates.
  • We agree to submit
  • A Progress Report midway through the project (template to be provided). Second payment will be made after Progress Report is received.
  • A Summary Report (template to be provided), plus evaluation and year-end itemized expense sheet, to the CHNA 15 Coordinator within one month following the completion of the funded project.
  • We agree to complete the project with all funds spent by the end of the stated project period. Any unused funds shall be returned to CHNA 15.
  • We agree to display and discuss the project at CHNA 15 Showcase following completion of the project.
  • If our project is unable to proceed as specified in the application, weagree to contact the CHNA 15 Coordinator as soon as possible and submit an addendum for the proposed change. We understand that the CHNA 15 Steering Committee will consider the proposal. Continued funding is not an automatic guarantee. Completion and other reporting requirements would remain as specified in the original application.
  • We agree to include the following statement in all funded project descriptions, products, and related publicity:

This project is funded through CHNA 15 DoN fundsfrom Lahey Hospital Medical Center.

Project Title:______

Signature of Authorized Signatory (lead agency):______

Date:______

Lead Agency:______

CHNA 15 2018 Collaborative Grant
Appendices

Appendix AHealthy Communities Principles

Appendix BPolicy, Systems and Environmental Changes

Appendix CDefinition of Terms

Appendix DScoresheet

Appendix A: Healthy Community Focus and Healthy Community Principles

CHNA 15 programming and funding efforts focus on establishing a broader, more comprehensive approach to developing healthier communities. Healthy Communities is an approach to understanding and improving health and well-being built on decades of work and the thinking of individuals and organizations around the world.

The Healthy Communities concept facilitates new collaborations and brings together a variety of community members to identify shared visions and to create new projects. CHNA Members are encouraged to work toward creating healthier communities in each of the twelve CHNA 15 communities, between or among organizations, or between CHNA 15 member towns.

Within Healthy Communities efforts, health is not merely access to healthcare and the absence of disease, but strengthening positive social, mental, physical, economic and environmental conditions conducive to health and well-being. The focus is deliberately broad to encompass the ideals of CHNA 15 as well as a member’s agency’s mission. A healthy community is defined as one that supports the health and welfare of its members by following the Healthy Community Principles as listed below.

Healthy Community Principles
Source: DarvinAyre, Gruffie Clough, Tyler Norris Principals, Community Initiatives, LLC.
Communities across the nation are using a variety of change models and planning processes to work together to achieve their vision of improved health. Regardless of approaches taken to meet their challenges, the following principles are guiding the most successful initiatives.
A broad definition of "health" Health is not just the absence of disease. Health is defined broadly to include the full range of quality of life issues. It recognizes that most of what creates health is lifestyle- and behavior-related. Other major factors are genetic endowment and the socio-economic, cultural and physical environment. Health is a by-product of a wide array of choices and factors, not the simply the result of a medical care intervention.
A broad definition of "community" By using as broad a definition as possible of what makes up a community, individuals and partnerships can address their shared issues in the most fruitful way possible. Communities are inclusive and can be based on faith, perspective, land and profession, as well as being determined by geographic lines.
Shared vision from community valuesA community's vision is the story of its desired future. To be powerful and inspiring, a community's vision should reflect the core values of its diverse members. A vision is not just a statement on the wall - it is a living expression of shared accountability to priorities.
Address quality of life for everyoneHealthy communities strive to ensure that the basic emotional, physical and spiritual needs of everyone in the community are attended to.
Diverse citizen participation and widespread community ownership All people take active and ongoing responsibility for themselves, their families, their property and their community. A leader's work is to find common ground among participants, so that everyone is empowered to take direct action for health and influence community directions.
Focus on "systems change"This is about changing the way people live and work together. It is about how community services are delivered, how information is shared, how local government operates, and how business is conducted. It's about resource allocation and decision making, not just "nice" projects.
Build capacity using local assets and resourcesThis means starting from existing community strengths and successes and then investing in the enhancement of a community's "civic infrastructure." By developing an infrastructure that encourages health, fewer resources need to be spent on "back end" services that attempt to fix the problems resulting from a weak infrastructure.
Benchmark and measure progress and outcomesHealthy communities use performance measures and community indicators to help expand the flow of information and accountability to all citizens, as well as to reveal whether residents are heading toward or away from their stated goals. Timely, accurate information is vital to sustaining long-term community improvement.

Appendix BPolicy, Systems and Environmental Changes