Request for Proposals

RFP 09-101

A one-step application process; no concept paper is required.

Application Instructions

for

BRIDGE GRANTS

Expanding access to health care

through a safety net system

Proposals Due:

5:00 p.m., Thursday, October 23, 2008

Request for Proposals

RFP 09-101

Information in This Document

I.About the Sunflower FoundationPage 3

II. When to Use This RFPPage 3

III.Issue BackgroundPage 3

IV.RFP Specifications Page 4

V.Instructions for Preparing a ProposalPage 5

VI.Proposal SubmissionPage 9

VII.RFP Telephone BriefingsPage 9

Proposal Cover PageBack Page

Application Documents to Download

Available at:

  • Application Instructions – BRIDGE GRANTS
  • Budget Form
  • Logic Model Form
  • RFP Definitions & Tips
  • KansasCounty Abbreviations
  • Proposal Checklist

NOTE: If you have problems downloading these documents or need them mailed to you, please contact the foundation.

I. ABOUT THE SUNFLOWER FOUNDATION

The Sunflower Foundation’s mission is to serve as a catalyst for improving the health of Kansans. For complete information about the foundation’s history, organization, grantmaking and interestareas, visit

II. WHEN TO USE THIS RFP

This RFP may be used if ALL of the following are true:

You are a safety net clinic, community health center, mental health center or public health department providing direct medical, behavioral or dental health care to the uninsured and the underinsured in Kansas.
You are seeking funding to provide new or expanded medical, behavioral, dental and/or public health services.
You can provide the required cash match of $1 for every $1 requested from the Sunflower Foundation.
You can submit a Bridge Grant proposal by the submission deadline:5:00 p.m., Thursday, October 23, 2008.

Do NOT respond to this RFP if:

Your organization cannot meet ALL of the above requirements.

Additionally, please note the following special application conditions:

If your organization is currently receiving Bridge Grant funding from the Sunflower Foundation, please contact the foundation program staff before applying to discuss your eligibility.
If your organization is currently receiving Dental Hub funding, you may not apply for funding for new or expanded oral health services under this RFP.

III. Issue Background

The Sunflower Foundation has identified improving access to health care as a priority interest area, with a focus on addressing barriers to access and disparities in health care for the uninsured and underinsured. These vulnerable populations often rely on the health care safety net for their primary care.

IV. RFP SPECIFICATIONS

  • FUNDING FOCUS
  • The goal of the Bridge Grants funding program is to provide transitional financial support for new or expanded services for medical, behavioral, or dental care.
  • USE OF GRANT FUNDS
  • Bridge Grants are available for:
  • Salaries, benefits and allowable indirect expenses for practitioners (such as: MD, RN, ARNP, PA, DDS, PhD, PsyD, LCSW, LSCSW, LSW, etc.) secured in order to:

-Expand or establish primary care and/or primary prevention services;

-Expand clinic hours; and/or

-Expand reach of services into a new neighborhood or community.

  • Administrative services (e.g. billing and medical record clerks, clerical staff) appropriate to support the new or expanded practitioner services for which funding is being requested from the Sunflower Foundation.
  • TIMELINE
  • Proposals are due at the Sunflower Foundation office by 5:00 p.m., Thursday, October 23, 2008.
  • Bridge Grant awards will be announced by Friday, January 9, 2009.
  • ELIGIBILITY
  • To apply for a Bridge Grant from the Sunflower Foundation, organizations must meet one of the following criteria:
  • Organizations that demonstrate a tax-exempt status under Section 501(c)(3) of the Internal Revenue Service Code.
  • Organizations recognized as an instrumentality of state or local government, provided Sunflower Foundation support will not replace existing project funding.
  • TARGET APPLICANTS
  • Bridge Grants are intended for safety net clinics, community health clinics, mental health centers and public health departments that provide primary care and prevention services to the uninsured and the underinsured.
  • APPLICATION PROCESS
  • Unlike previous applications, this RFP is a one-step process, requiring only the submission of a proposal. No concept paper is required. Funding decisions will be based on the information in the proposal, so it is important that all requested information is provided.
  • AWARD LIMITS
  • Bridge Grants are highly competitive and only a limited number will be awarded. Grants will not exceed $200,000 each.
  • LENGTH OF GRANTS
  • Grants are for a maximum of three years.
  • MATCHING FUNDING REQUIREMENT
  • Applicants must demonstrate a cost share in the project through a cash match of $1 to $1 of the total amount requested from the Sunflower Foundation.
  • The cash match may include most expenses incurred by the applicant that are directly related to the new or expanded services, including contributions to salaries.
  • FUNDING EXCLUSIONS
  • The following general exclusions apply to all Sunflower Foundation funding:
  • Ongoing general operating expenses or existing deficits
  • Fundraising campaigns, events or materials
  • Routine continuing education (such as licensure, accreditation, etc.)
  • Travel to conferences not directly related to the project (e.g. general conferences, national and regional annual meetings)
  • Individual medical care or support
  • Medical equipment
  • Capital equipment (except for allowable technology)
  • Political purposes
  • Support of organizations that practice discrimination
  • These additional exclusions apply specifically to Bridge Grants:
  • Organizations receiving “Dental Hub” funding are not eligible to apply for a Bridge Grant for new or expanded dental health services under this RFP.
  • Recruitment or relocation expenses are not allowed.

Note: If your organization is currently receiving Bridge Grant funding from the Sunflower Foundation, please contact the foundation program staff before applying to discuss your eligibility.

V. INSTRUCTIONS FOR PREPARING A PROPOSAL

There are five (5) components required for all Bridge Grant applications. They are listed in the chart below and described in detail on the next few pages. Please collate these documents in the order they appear on the chart. Also be sure to review the RFP Definitions & Tips document for important information about preparing your proposal.

ONLY HARD COPIES OF THESE COMPLETED FORMS MAY BE SUBMITTED; e-mail or fax copies will not be accepted. Note in the chart below the number of hard copies required.

Components / Page Limits / Hard Copies Required / Electronic Files
  1. Proposal Cover Page
/ 1 page / 1 signed original
and 5 copies / Note: If funded, you will be expected to maintain an electronic file of your proposal for a period of three years following the expiration of your grant.
  1. Project Narrative
/ 8 pages / 6 copies
  1. Logic Model
/ No page limit / 6 copies
  1. Budget & Budget Narrative
/ Budget Form: 1 page; Narrative: No limit / 6 copies
  1. Supporting Documents
/ No page limit / 1 copy, unless otherwise noted

A. PROPOSAL Cover Page

Complete the Proposal Cover Page form (attached at the end of this document) and ensure that all requested information is provided, including the required original signatures. Do not exceed this one-page format.

B. project Narrative

Applicants must submit a comprehensive narrative addressing all of the following points in the order listed. To assist reviewers in evaluating proposals, responses must be labeled according to each section number, title and bullet.

  1. Introduction – Tell us about your organization:
  2. Briefly describe your mission, history and site(s).
  3. Identify which of the following you accept:
  • Private Insurance
  • Medicaid/HealthWave
  • Medicare
  • Self-pay
  • Do you have a sliding scale fee schedule for clients? If so, who is eligible?
  • Do you accept all clients regardless of ability to pay?
  • Describe the status of any projects previously funded by the Sunflower Foundation and if this request is related.
  1. Background – Tell us about the population you serve, your service area and relationships with other providers and key partners:
  2. List other health care providers that provide similar care to your target population.
  3. Explain the relationships you have with them regarding duplication of services or arrangements to cover gaps in services for the target population.
  4. Identify any significant barriers your target population has in health care (e.g. geographic, health insurance, providers willing to accept charitable care).
  1. Need – Explain the need:

Need for the project:

  1. Describe the health care services you will provide and why they are needed by your target population. Be specific to any health conditions or threats that affect the target population. Also include results of any community assessment or surveys that document the gaps in services and support this need.
  2. Discuss if the target population currently has access in your service area to the services you are proposing.

Need for Sunflower Foundation funding:

  1. Explain why a grant from the Sunflower Foundation is necessary to support this project.
  1. Project Goal, Objectives and Activities – Tell us about the expected goal(s) (short-term within the next year as well as long-term within the next several years), objectives and activities of the project.

Goals: A goal is a broad statement of your project’s purpose. Your project’s goals should be directly linked to the identified needs.

  1. Identify your project’s short-term (within the next year) and long-term goal(s).

Objectives: Objectives are concrete and measurable. They clearly and specifically state what you intend to accomplish and by what date. To evaluate the success of your project, it is important to identify the objectives you plan to achieve.

  1. List the project objectives.
  2. Explain why this approach is the best way for your organization to address your identified need.

Activities: Activities are the action steps to achieving your objectives.

  1. Describe the project activities. Discuss what will occur, when and where it will occur, and how these activities will address the identifiedneed and project objectives.
  1. Staffing – Tell us about your staffing:
  1. List the current level of staffing.
  2. List the new or expanded staff proposed for this project, including the hours to be worked and anticipated schedule.
  3. Describe the staff/patient ratio used to calculate the proposed services and how the ratio was determined to be appropriate for the desired productivity.
  4. Indicate if requested positions will be provided by employment or contract.
  5. Describe your plan and timeline for recruiting these positions.
  1. Additional Program Details –
  2. Identify the current number of clients and encounters.
  3. Provide the anticipated changes in service volume that will occur as a result of your proposed project (clients and encounters).
  4. Briefly outline the outreach strategy for this new program or expansion.
  5. Link statements of identified need with the proposed project objectives.
  6. Explain how the project will:
  7. Change the way care is delivered to patients;
  8. Increase the establishment of a medical home for patients;
  9. Improve quality of care and coordination of health care services; and/or
  10. Improve health outcomes.
  1. Evaluation – Tell us how you intend to evaluate the project:
  2. Explain how you will know your project is successful, what data you will collect and how you will collect it.
  1. Resources/Capabilities – Tell us about your organization’s ability to carry out the project:
  1. Identify key staff responsible for the project and the skills these individuals bring to the project.
  2. Provide a scope of work for any project consultants.
  1. Sustainability – Tell how you will sustain the project:
  2. Explain how the cost of this project (e.g. practitioner costs, including salary and benefits) will be sustained beyond Sunflower Foundation funding. Provide specific data from financial planning, including patient and revenue projections (and the basis for calculating them) that will contribute to the sustainability of this project.
  3. If your organization is also planning to apply for Federal/State/local resources to help support this project, please provide details (i.e. who, when, and how much).

C. LOGIC MODEL

Logic Model Form– Complete the Logic Model Form. Note the definitions for each column and the instructions to include a timeline for each activity entered. Describe the expected outcomes of the project in clear and measurable terms. The Logic Model Form may be lengthened as necessary.

Note: The Logic Model is intended to be a visual representation of the proposed project, from development to evaluation. Unfortunately, however, it is sometimes viewed as a requirement for application, rather than a useful planning tool. See the RFP Definitions & Tips document for guidance on the use of the Logic Model.

D. BUDGET & BUDGET NARRATIVE

Proposal Budget Form and Budget Narrative – Complete all appropriate Budget entries (all rounded to nearest dollar) on the downloadableBudget Form. On a separate page (please label as “Budget Narrative”), provide a Budget Narrative that explains the following:

  • the amounts requested for each line of your budget (e.g. FTE allocations, benefits and indirect costs);
  • how each item supports the achievement of proposed project objectives;
  • a calculation of benefits;
  • any in-kind support from partners and/or applicant organization; and
  • documentation of a $1 to $1 cash match for the project from the applicant organization.

Note: If you have a multiple-year budget, please complete a budget form for each year and a cumulative budget and ensure your narrative addresses each year of the budget.

E. SUPPORTING DOCUMENTS

  1. IRS Letter of Determination (1 copy)
  2. IRS Form 990 (all pages)
  3. Most recent annual audit, including notes (1 copy)
  4. Current financial statements; include income statement and balance sheet (1 copy)
  5. List and brief biographical sketches of key project staff (6 copies)
  6. Roster of the organization’s governing board (6 copies)
  7. Documentation of scope of work and fee schedule for project consultants(6 copies)
  8. Memoranda of Understanding (MOUs) and/or Letters of Support (6 copies)

Note: Other documentation may be requested during the review process.

VI. PROPOSAL SUBMISSION

If you have questions about any of these instructions, please do not hesitate to contact the Sunflower Foundation. A downloadable Proposal Checklist is available for your use to help ensure you submit a complete proposal.

Proposals are accepted in hard copy format only (no faxes or e-mails). Whether submitted via mail or hand-delivered, all proposals must reach the Sunflower Foundation by 5:00 p.m. on Thursday, October 23, 2008.

Mailing address: Sunflower Foundation

1200 SW Executive Drive, Suite 100

Topeka, KS66615-3850

Directions to the Sunflower Foundation office are available on our Web site; see:

VII. RFP TELEPHONE BRIEFINGS

A series of telephone briefings are offered to provide an opportunity to discuss details of and ask questions about this RFP with foundation staff and to assist participants in determining their match to this RFP. Questions about this RFP process and application tips will be addressed during the telephone briefings.

All prospective applicants are strongly encouraged to participate in one of the scheduled telephone conference calls. Participants will be given a telephone briefing ID number to enteron the Proposal Cover Page found at the back of these instructions.

Calls are expected to last one hour or less. To participate in a call, dial 1-888-387-8686, enter Room number 8407364 and press #. The telephone briefings to discuss Bridge Grant proposals will be offered three times:

  • 2:00 p.m., Thursday, September 11, 2008
  • 1:00 p.m., Monday, September 15, 2008
  • 11:00 a.m., Tuesday, September 16, 2008

1200 SW Executive Drive, Suite 100, Topeka, KS 66615-3850 – 785.232.3000 – Toll Free 866.232.3020 – Fax 785.232.3168

RFP 09-101 / BRIDGE GRANTS Application Instructions Page 1 of 10

Proposal Cover Page – BRIDGE GRANTS – RFP 09-101

1200 SW Executive Drive  Suite 100 Topeka, KS 66615-3850  785.232.3000  Toll Free 866.232.3020 

DUE 5:00 p.m., Thursday, October 23, 2008

Applicant Organization Information
Lead Organization: / Telephone Briefing ID#
Executive Director/Official: / Title:
Mailing Address:(street/city/state/zip code) / County:
Phone: / Fax: / E-mail: / Web address:
Project Manager (if other than above):
Name:
Title:
Mailing Address:
(street/city/state/zip code)
Phone:
Fax:
E-mail: / IRS Classification
( ) 501(c)(3)
( ) Governmental tax exempt
( ) Other: ______
E.I.N./Tax I.D.# ______
------
NOTE: Remember to include the supporting documents as outlined in the RFP guidelines. / Please complete the following if the Fiscal Agent is a separate entity from the applicant organization:
Organization Name:
IRS Status ( ) 501(c)(3) other (specify)______
Name of Financial Manager:
Title:
Mailing Address:
Phone: Fax:
E-mail:
NOTE: Please include fiscal agent’s supporting documents as outlined in the RFP guidelines.
Project Information
Project Title: / Start date:
End date: / Term:
(months)
Project Summary: (Please summarize succinctly the “who, what, where” of your project.)
Population Served by Project
Kansas counties served by project: (Please specify by county abbreviation - see attached list, include additional page if necessary.)
______( ) Statewide
Age group(s) targeted: ( ) Infants 0-3 ( ) Children 4-12 ( ) Youth 13–18 ( ) Young Adults 19–23
( ) Adults 24–64 ( ) Seniors 65-79 ( ) Elderly 80+ ( ) All ages
Gender:( ) Male ( ) Female ( ) Both
Race/Ethnicity:( ) American Indian / Alaska Native ( ) Black / African American ( ) Hispanic / Latino
( ) Asian / Pacific Islander ( ) Caucasian / White ( ) All
Project Budget (Amounts should match those on Budget Form)
Requested from Sunflower Foundation1: $ / Other Funding (Applicant and/or other sources)3: $