San Joaquin County Public Health

Physical Activity Mini-Grant Application 2013-14

Goal:

To improve physical activity among low-income youth in San Joaquin County

San Joaquin County Public Health Services

1601 E. Hazelton Ave, Stockton, CA 95205

(209)468-8637

This application is also available on the Public Health website.

Childhood Obesity in San Joaquin County:

Childhood obesity has become a growing concern in San Joaquin County and across the nation. According to Centers for Disease Control’s Pediatric and Pregnancy Nutrition Surveillance System (CDC PEDNSS) data, over 40% of San Joaquin County school-aged children (ages 5 to 20) are considered overweight or obese (meaning above 85th percentile for height and weight). Levels of physical activity among County youth and teens have fallen below the statewide average. In addition, opportunities for daily physical activity continue to decline.

In response to the dire need for obesity prevention, San Joaquin County Public Health Services (SJCPHS) provides a wide range of health promotion and chronic disease prevention programs and services. The mission of SJCPHS, in partnership with the community, is to promote a healthy future for San Joaquin County. Programs such as the Breastfeeding Initiative, Mothers Invested in Baby (MI Baby), and Network for a Healthy California provide nutrition education and empowerment to parents, caregivers, educators, providers, and youth through classes, presentations, trainings, and peer-to-peer interactions.

In an effort to increase physical activity resources in the community, SJCPHS ispartnering with the Ricky Barnes Foundation to provide physical activity mini-grants for programs serving low-income children.The mission of the Ricky Barnes Foundation is to promote the physical and mental well-being of children. The Foundation encourages active lifestyles and making healthy choices to boost self-esteem and confidence.

Public Health Services Mini-Grant Funding Opportunity

SJCPHS understands that overweight children are more likely to become overweight adults unless they acquire and maintain healthy eating and physical activity behaviors. Hence, SJCPHS will provide mini-grant opportunities for eligible youth-servingagencies, schools, and afterschool programs serving low-income children.At least four eligible agencies will be selected to receive mini-grants of up to $5,000 each for the 2013-2014 fiscal year (July 1, 2013- June 30, 2014). Mini-grant payment is in arrears. Mini-grant recipients will receive “train-the-trainer” training and funding to purchase equipment and to support ongoing physical activities.

The funds will allow the recipient to purchase equipment for the CATCH (Coordinated Approach to Child Health) education program, an evidence-based physical activity education curriculum for elementary and middle school-age children. The SJCPHSNetwork for a Healthy California Program will provide “train-the-trainer” training to grant recipients on the use of CATCH curriculum and equipment as well as any technical assistance needed throughout the grant period.In return, grant recipients will be required to report use of the curriculum training and submit a semi-annual and final report to include progress on an action plan describing how physical activity opportunities will be sustained using the CATCH training and purchased equipment.

ProposalGuidelines

  1. Applicants must be an established school, youth-serving agency, or afterschool program serving low-income populations in operation for at least one year and located in San Joaquin County. A completed W-9 Form will be requested from all successful applicants.
  1. Applicants will submit the following items for the application packet. Failure to submit any of these items may result in delay of the application. (Please be sure to keep a copy of the application for your own records.):

1) Form 1 (Application Cover Sheet)

2) Form 2 (Project Budget and Budget Narrative)

3) Four-page maximum Project Narrative

ProposalSubmission

Proposalsfor the SJCPHS Physical Activity mini-grant project must submit:

  • A typed original application packet(marked “original” on Form 1), and
  • Four (4) copies of the packet (marked “copy” on Form 1).

Hand-deliver proposals in-person:

San Joaquin County Public Health Services

Network for Healthy California

420 S. Wilson Way

Stockton, CA 95205

Attn: Holly Stetson

Phone: (209) 468-8637

OR

Mail proposals to address:

San Joaquin County Public Health Services

Network for Healthy California

Attn: Holly Stetson

1601 E. Hazelton Ave.

Stockton, CA 95205

All proposalsmust be received by 4:00 p.m. on Friday, May 3, 2013.

PROPOSALS SUBMITTED BY FAX OR EMAIL WILL NOT BE ACCEPTED.

Proposal Scoring

Proposals for the SJCPHS Physical Activity mini-grant must be presented in the correct format. Handwritten applications will not be accepted.

Application forms must be submitted according to the following guidelines:

  1. Must include one (1) original (marked “Original” on Form 1) application, and four (4) copies (also marked “Copy” on Form 1).
  1. Must be single-spaced, with 1-inch margins and no smaller than 12-point font.
  1. Must include Forms 1 and 2, and a 4-page maximum Project Narrative. Additional pages may be used for the Budget Narrative in Form 2 (Budget).
  1. Must not be bound, or inserted into folders. A simple clasp, paperclip, or staple is preferred and all pages must be on 8.5” x 11” paper.
  1. Proposals should be submitted in the following order:
  2. Page 1: Form 1 (Cover Page) – (5 points) Must include original signature of an authorized representative of the agency.
  3. Page 2: Form 2 (Budget Request Form) – (25 points) May use additional pages as needed.
  4. Application Narrative – (70 points) See below.
  1. Application Narrative –Narrative must be no more than four pages. Submittals must be typed, single-spaced, with no smaller than a 12-point font, and one inch margins. Hand-printed applications will not be accepted. Applicants are encouraged to number their answers to correspond with the application narrative questions so that reviewers may score applications properly. Questions are not required in the narrative.

Timeline and Process Overview

All applications must be received by Friday, May 3, 2013 at 4:00pm.

ACTIONS / DUE DATE
Release of RFP / April 8, 2013
Bidders’ Workshop
The non-mandatoryWorkshop will take place at:
San Joaquin County Purchasing Department
44 N. San Joaquin Street, Suite 540
Stockton, CA 95205
(Teleconferencing is available. Please contact Lourdes Piojo at or call 209-468-3256 by Tuesday, April 16, by 1:00 p.m. for access.) / April 18, 2013
1:00 p.m.
Application Deadline (All applications must be received by 4:00 p.m.) / May 3, 2013
Notice of Intent to Award / TBD
Contract Commencement Date / July 1, 2013

*Dates are subject to change.

Evaluation, Monitoring and Budget Guidelines

Evaluation

All mini-grant recipients will be required to submit a semi-annual and final progress report and submit an activity report form after project activities have been implemented. The activity report form will help track the activities and funding use.The activity report form and progress reports will be provided to funded organizations during the CATCH training.

Monitoring

SJCPHS will monitor areas of agreement in compliance, achievement of goals, and financial expenditure. In addition to the required reports, site visits will be conducted to verify project compliance and provide any technical assistance as needed. Each mini-grant recipient is required to maintain records for a period of three years to ensure that mini-grant funds are spent as set forth in the agreement.

Budget Guidelines

Applicants are required to provide a summary of anticipated expenses during the grant term by completing the budget estimate portion of the Application (Form 2). When determining the project budget, please note that projected expenses should relate specifically to proposed project activities.

Allowable project expenses may include the following:

  • Purchase of CATCH activity equipment (required)(see Attachment A)
  • Materials production (i.e. printing, copying, paper, etc.)
  • Stipend for a project coordinator
  • Costs for additional educational materials and equipment to enhance learning environment

Application Narrative and Scope of Work

Application Cover Page (Form 1) (5 points)

The Application Cover Page must be complete and include the original signature of an authorized representative of the agency.

Application Narrative (70 points)

In the 4-page maximum Narrative, include a brief description of the applicant agency, including:

  1. Related agency mission/goals and a demonstrated organizational commitment to childhood health promotion, nutrition, and/or physical activity. (10 points)
  2. Experience to undertake this project. At a minimum, demonstrate that the agency possesses one year of experience in conducting nutrition education and/or physical activity promotion to low-income youth.(10 points)
  3. Describe the project coordinator and his/her qualifications. Include any experience as it relates to physical activity, nutrition, and/or childhood health promotion. (10points)
  4. Ability to initiate project on start date (e.g., including a timeline of what is required for obtaining internal or external approvals in an expedient manner). (10 points)
  5. Describe how the materials and equipment purchased will increase childhood health promotion and physical activity at the organization. (10 points)
  6. Describe the methods that will be used to sustain project activities beyond the duration of the grant. (10 points)
  7. Describe the methods you will use to evaluate the outcome of the overall project (e.g., measure changes in the capacity of the program). (10 points)

Application Budget (Form 2) (25 points)

Applicants are asked to complete a Budget and Budget Justification using estimated expenses in the appropriate categories. The Budget and Budget Justification should include the following information:

  1. Provide sufficient detail in the Budget to support proposedactivities.
  2. Provide a list of staff in Budget that will ensure completion of activities.If staff is not included in the Budget, please be sure to address in the Narrative and/or Budget Justification section(s).
  3. Ensure the proposed salary/wage rates for in-house and subcontracted personnel are reasonable and necessary based on the assigned level of responsibility, if applicable.
  4. Ensure the total Operating, Equipment, Travel, and/orOther Costs are reasonable and necessary, and kept to a minimum.
  5. Make sure Budget calculations are accurate.

Invoicing

Monthly invoices shall be submitted for payment within fifteen (15) days following the end of each month in which costs were incurred in the performance of the mini-grant, unless the mini-grant period has reached the expiration or termination date, or a later or alternate deadline is agreed to in writing by SJCPHS.

Upon receipt and approval of the invoices along with any reporting as required by the mini-grant, SJCPHS agrees to compensate the mini-grant recipient for actual expenditures incurred in accordance with the approved Budget.

Invoice shall:

  1. Be prepared on the recipient’s letterhead and be signed by the authorized official, employee, or agent certifying that the expenditures claimed represent actual expenses incurred under this mini-grant.
  2. Bear the mini-grant recipient’s name as shown on the Application.
  3. Show an invoice date reflecting when the invoice was prepared.
  4. Show the mini-grant recipient’s remittance address.
  5. Itemize costs for the period in the same or greater level of detail as indicated in this mini-grant. Subject to the terms of this mini-grant, reimbursement may only be sought for those costs and/or cost categories expressly identified as allowable.

Acknowledgement of Funding Source

Identify San Joaquin County Public Health Services and the Ricky Barnes Foundation in any published documents, videopresentations, training programs, training material, brochures, T-shirts,and any other material and/or programs which are developed as a result of this funding award.

Page 1

FORM 1: Project Application Cover Sheet

San Joaquin County
Public Health Services
Physical Activity Mini-Grant
July 1, 2013—June 30, 2014
DUE: Friday, May 3, 2013 by 4:00 p.m.
Agency Name: Click here to enter text.
Applicant Name & Title:Click here to enter text.
Agency Address:Click here to enter text.
City:Click here to enter text. / Zip:Click here to enter text.
Email Address:Click here to enter text.
Phone #:Click here to enter text. / Fax #:Click here to enter text.
Designated Project Coordinator:Click here to enter text.
Information About Organization
Organization Type:
☐School☐Afterschool Program☐Youth Serving Agency
☐Other:______
Project Proposal
Amount requested: $______
Number of Youth to be Served by Project:______
Click here to enter text. / Click here to enter text. /
Name of Chair, Board of Directors, or Authorized Representative / Title
Click here to enter text.
Signature and Title (Signature Required) / Date

Page 1

FORM 2: Budget Estimate

San Joaquin County
Public Health Services
Physical Activity Mini-Grant
July 1, 2013—June 30, 2014
DUE: Friday, May 3, 2013 by 4:00 p.m.
Budget
  1. Personnel Salaries

Name/Title / Amount
Click here to enter text. / $ Click here to enter text.
Click here to enter text. / $ Click here to enter text.
Click here to enter text. / $ Click here to enter text.
Click here to enter text. / $ Click here to enter text.
Subtotal: / $ Click here to enter text.
  1. Fringe Benefits

Details / Amount
Click here to enter text.% of Personnel Salaries: / $ Click here to enter text.
Subtotal: / $ Click here to enter text.
  1. Operating Expenses

Details / Amount
Click here to enter text. / $ Click here to enter text.
Click here to enter text. / $ Click here to enter text.
Click here to enter text. / $ Click here to enter text.
Click here to enter text. / $ Click here to enter text.
Subtotal: / $ Click here to enter text.
  1. Equipment Expenses

Details / Amount
CATCH Equipment Package (required)
Click here to enter text. / $ Click here to enter text.
Click here to enter text. / $ Click here to enter text.
Click here to enter text. / $ Click here to enter text.
Subtotal: / $ Click here to enter text.
  1. Travel

Details / Amount
Click here to enter text. / $ Click here to enter text.
Click here to enter text. / $ Click here to enter text.
Click here to enter text. / $ Click here to enter text.
Subtotal: / $ Click here to enter text.
Direct Costs (A+B+C+D+E) Subtotal: / $ Click here to enter text.
  1. Indirect Costs

Details / Amount
Click here to enter text.% of Total Salaries (A)
OR
$Click here to enter text. Actual Indirect Cost (Provide cost calculations below) / $ Click here to enter text.
Subtotal: / $ Click here to enter text.
Budget (A+B+C+D+E+F) Grand Total: / $ Click here to enter text.

Budget Justification

For each line item above, detail how the funds will be used for the project.

A. Name/Title of Project Staff (including project time and pay rates)

(e.g., John Doe, Project Coordinator: 5 hrs. per week x 10 weeks @ $12/hr.=$600)

Click here to enter text.

B. Fringe Benefits (%of Personnel Salaries)

(e.g., 15% of salaries ($1000): 15% x $1000 = $150)

Click here to enter text.

C. Operating Expenses (i.e., office supplies, printing, postage, etc.)

(e.g., $100 for printing recruitment fliers: 1000x $0.10/copy= $100,

$46 for stamps for community mailings: 100 x $0.46/stamp= $46)

Click here to enter text.

D. Equipment Expenses (CATCH equipment and other physical activity items needed)

(e.g., $1,025 for CATCH early childhood kit, $50 for extra set of bean bags, 10 copies of Instant Recess DVD kit= $19.50)

Click here to enter text.

E. Travel (mileage reimbursement rate @ $0.565 per mile)

(e.g., Project Coordinator mileage reimbursement, 100 miles/year:

$0.565 x 100 = $56.50)

Click here to enter text.

F. Indirect Costs (% of Total Salaries ORActual Indirect Costs of up to 8% of Salaries)Indirect costs, including administrative and overhead costs, should be proposed in accordancewith the County’s Indirect Cost Rate Guideline, which can be accessed at “Popular Links”. Provide details of cost calculations here.

(e.g., 8% of Personnel Salaries ($4000): 8% x $4000 = $320)

Click here to enter text.

ATTACHMENT A: CATCH Physical Education Activity Kits

The following CATCH Physical Education equipment and activity kits are recommended for the age/grade levels indicated. They may be purchased at:

Packages can be customized to fit your needs. Contact the company for more information.

CATCH Early Childhood [Ages 3-5] Kit (#W17887)

Based on the evidence-based CATCH Coordinated School Health Program, CATCH Early Childhood (CEC) is designed to promote physical activity and healthy food choices among preschool children ages 3-5. Through CEC, children are motivated to walk, run, jump, dance, and move their whole bodies while playing and having fun!

This CEC Kit features a Teacher’s Manual with 10 easy-to-teach lessons encouraging healthy eating and activity, English/Spanish parent tips sheets, coloring activities and hand puppets to use while reading stories in the CATCH manual; specially selected equipment that is developmentally appropriate, safe, and gets little ones excited about being active; and the CEC Activity Box with over 500 activity and picture cards providing detailed instruction for fun, non-elimination games using the equipment included with this kit. These games are aimed at increasing children’s moderate-to-vigorous physical activity while they are engaged and having a blast. CATCH Early Childhood Equipment Set with Manual and Activity Box includes all of the following:

  • CEC It’s Fun to Be Healthy Teacher’s Manual
  • CEC Hand Puppets – set of 4 CATCH characters
  • CEC Activity Box with over 500 5" x 8" activity and picture cards and 2 music CDs
  • Colored Spot Markers
  • 24 CATCH 7" Playground Balls (4 each in red, blue, yellow, and green)
  • 24 Beach Balls 20"-dia.
  • 16 CATCH 9" Cones (4 each in red, blue, green, and yellow)
  • 1 Colorful 24" Parachute with SuperChute Grip
  • 24 Fleece 3" Balls (4 each in red, blue, green, yellow, orange, and purple)
  • 24 Scarves (assorted colors)
  • 16 CATCH Beanbags (4 each in red, blue, green, and yellow)
  • 24 CATCH 30" Hula H oops
  • 3 White Mesh Bags

Price: $1,025.00