TOBACCO PREVENTION AND CESSATION COMMISSION
REQUEST FOR APPLICATIONS
FOR STATEWIDE PARTNERSHIPS

The Tobacco Prevention and Cessation Commission of the Indiana State Department of Health (TPC/ISDH) announcesa request for applications (RFA) for statewide tobacco prevention and cessation partnership grants. The funding period is from July 1, 2018 – June 30, 2019. This RFA is an invitation to join together to make the Tobacco Prevention and Cessation Commission’s vision…. To significantly improve health in Indiana and reduce the disease and economic burden tobacco use places on Hoosiers of all ages…a reality for the State of Indiana.

The ISDH Tobacco Prevention and Cessation Commission (TPC) exists to prevent and reduce the use of all tobacco products in Indiana and to protect citizens from exposure to tobacco smoke.
Indiana’s Tobacco Control Strategic Plan has four priority areas:

  • Decrease Indiana youth tobaccouse rates.
  • Increase proportion of Hoosiers not exposed to secondhand smoke.
  • Decrease Indiana adult smoking rates.
  • Maintain state and local infrastructure necessary to lower tobacco use rates.

Who May Apply

A public or private, state, or local entity may apply for the statewide partnership grant program. To avoid any potential or perceived conflict of interest between TPC/ISDH’s grant recipients and tobacco-related entities, the TPC/ISDH has adopted a contractual funding condition that requires any grantee shall not accept any funding, grant,gift, or in-kind donation from any tobacco manufacturer, distributor, or other tobacco-related entity.

TPC/ISDH reserves the right to correct any errors in and/or omissions in the Request for Applications.

Rationale and Focus Areas

TPC/ISDH announces a request for applications(RFA) to support statewide partnership grants for tobacco prevention and cessation. It is intended that the statewide grants will help to advance the work that is outlined in the Indiana Tobacco Control Strategic plan. Awards issued for these grants must focus on the strategies outlined in the strategic plan according to the four priority areas above.

Emphasis will be given to partnership proposals that support decreasingtobacco use through:

1)Health systems change for tobacco treatment; and

2)Reaching populations with a high rate of tobacco use

Health systems change for tobacco treatment:

Strategies and recommendations from the U.S. Public Health Service Clinical Practice Guideline on Treating Tobacco Use and Dependence provide effective clinical treatments for addressing tobacco dependence. The overarching goal of these recommendations is that clinicians strongly recommend the use of effective tobacco dependence counseling and medication treatments to their patients who use tobacco, and that health systems, insurers, and purchasers assist clinicians in making such effective treatments available.

Applications should focus the strategies listed below in at least one of the following settings:

  • Healthcare systems
  • Healthcare providers including those who serve pregnant women, children and families
  • Health Plans and Insurers
  • Community health centers and similar clinics
  • Behavioral health centers and addiction treatment professionals
  • Dental practices
  • Employer worksite wellness
  • Health care provider training programs

One or more of the following strategies should be addressed within at least one of the specific provider settings. A combination of strategies is preferred.

Within at least one of the specific settings, the following strategies should be implemented:

  • Implement a tobacco user identification system, such asan office-wide system that ensures that for every patient at every clinic visit, tobacco use status is queried, documented, and referred to treatment (including the Indiana Tobacco Quitline).
  • Provide education, resources, and feedback to promote provider intervention.
  • Educate all staff in the health care setting. On a regular basis, offer training on tobacco dependence treatments, and provide continuing education (CE) credits and/or other incentives for participation.
  • Provide resources such as ready access to the Indiana Tobacco Quitline and other community resources, self-help materials, and information about effective tobacco use medications.
  • Encourage the location to dedicate staff to provide tobacco dependence treatment, and recommend assessing the delivery of this treatment in staff performance evaluations.Consider designating a tobacco dependence treatment coordinator.
  • Promote hospital policies that support and provide inpatient tobacco dependence services and offer tobacco dependence treatment to all hospitalized patients who use tobacco.

In order to implement the above strategies, grantees may choose to conduct academic detailing initiatives. These include:

  • Providing training and technical assistance on evidence-based tobacco dependence treatment and assist with quality improvement and integration of cessation treatment protocols for clinics, hospitals, health care systems, insurers, dental practices, social service agencies, and substance use and mental health programs.
  • Promoting the Indiana Tobacco Quit Line (ITQL) and assist health care systems to refer (fax, electronic or online) patients to the quitline as a cessation treatment extender.

(Refer to Chapter 5 of the Public Health Service Clinical Practice Guideline, Treating Tobacco Use and Dependence: 2008 Update. Addressing Tobacco Use through Healthcare System and Healthcare Provider Reminder Systems, Provider Education, and Patient Education for more information.)

Reach populations with a high rate of tobacco use:

As smoking rates in the general population have declined, the gaps in rates among some sub-populations have widened. One of the conclusions in the 2014 The Health Consequences of Smoking—50 Years of Progress: A Report of the Surgeon General on smoking states, that “Although cigarette smoking has declined significantly since 1964, very large disparities in tobacco use remain across groups defined by race, ethnicity, educational level, and socioeconomic status and across regions of the country.”

Applications should provide details on ways the organization reaches populations with high rates of tobacco use. See page 23 of the 2020 Indiana Tobacco Control Strategic Plan, as well as the CDC Best Practices User Guide on Health Equity in Tobacco Prevention and Control.

Funding Level

The funding period is from July 1, 2018-June 30, 2019. There will not be a guaranteed allotment for this call for applications. The grant award will vary by need, program model and available funding. It is the intention of TPC to award several grantswith this call for applications. Submission of grant application, even one that meets all grant requirements, does not guarantee receipt of an award.

All grants are contingent upon the availability of funding. “When the Director of the State Budget Agency makes a written determination that funds are not appropriated or otherwise available to support continuation of performance of this contract, the contract shall be canceled. A determination by the Director of the State Budget Agency that funds are not appropriated or otherwise available to support continuation of performance shall be final and conclusive.” Financial Management Circular #2007 -1.

TPC will NOT consider applications for:

  • Costs of nicotine replacement therapy and pharmaceuticals or other smoking cessation products
  • Basic research or clinical trials
  • Direct, individual services to patients, clients or customers.
  • Projects focusing on substances other than tobacco
  • Grants to support operating deficits
  • Construction of buildings or building renovations; depreciation of existing buildings or equipment; contributions, gifts, donations,entertainment; automobile purchases, rental and/or leases; interest and other financial costs; fines and penalties; bad debts; contingency funds; food; political contributions; or to pay for personal items or for expenses that do not relate to the purpose of the project.

Program and fiscal accountability

Activities are reported monthly on a Statewide Program Report. Funds will be paid to the organization monthly or quarterly upon receipt of invoice and compliance with program and fiscal reports.

How to Apply

Applicants should submit a grant proposal to the Tobacco Prevention and Cessation Commission using the guidelines provided in this announcement.

Applications will be accepted through April 30, 2018by midnight EST.

  • The completed application forms and all attachments must be submitted electronically via email at . Applications will ONLY be accepted at the EMAIL address above.

Technical Assistance

Applicants should submit questions by email regarding proposals to the TPC/ISDH by 4:00pm on April 11, 2018. All questions and answers will be posted on April 17, 2018 on the TPC/ISDH website at Questions should be submitted to .

The application must include:

Application Cover Sheet (See form)

Executive Summary--Summarize the Grant Proposal (No more than 1 page).

Applicant Organization Capacity and History to Complete Tobacco Control Population-Based Intervention-- This section should briefly introduce the organization’s main accomplishments and experience in tobacco control, if applicable. This section should include experience related to the priority area the applicant is applying to completeand current infrastructure to support this work. (No more than 2 pages).

Sustainability Statement--This section should explain how the program will be sustained if funding is no longer available. The application should answer the question: How will the work in this grant continue if funding is not available for subsequent years? (No more than 1 page).

Project Narrative(No more than 10 pages)

The project narrative should outline the following:

  1. Statement of Need and Project Rationale
  2. This section should describe how the proposal responds to a clear, documented tobacco control need in Indiana for supporting the strategies outlined in the strategic plan. Explain how your organization reaches and impacts the target population(s).
  3. Project Objectives
  4. Objectives must be clearly stated, measurable, reasonable in scope, and tied directly to the project need and rationale.Objectives must clearly link to strategies outlined in the State’s strategic plan and the focus areas on pages 1-2.
  1. Evaluation Plan
  2. Please outline how you will measure the objectives described in the project and provide data sources. Funded grantees will be required to report activities monthly to TPC/ISDH.

Project Outcomes, Activities, Dates and Deliverables--The overall project strategy along with activities, dates and deliverables should be outlined on Project Work Plan Form. Use additional pages of this form as necessary.

Itemized and Detailed Budget--The budget should contain all anticipated funds. UseBudget Worksheet and Budget NarrativeForms.

Job description: Include all job description(s) for positions that are proposed to be paid by or will support the work of the project.

Scope of Work – Bullet pointed summaryof project deliverables - Use Form

TPC Declarations Page– Signed

Audited Financial Statements--This applies to any non-governmental entities. Non- governmental entities need to submit audited financial statements not over two periods old.

A limited number of items may be included in an Appendix including letters of support and relevant staff biographies and resumes; however, there is no guarantee that these materials will be part of the review process.

Review Process

All applications submitted will undergo a review process that willinclude a technical analysis by TPC staff and review by a team of state and national experts.

Review Criteria

Applications will be assessed on the basis of the following criteria:

Organizational capacity and accomplishments:

The proposal should:

Provide evidence of organizational experience;

Provide evidence of experience in working in the tobacco control priority areaand strategy selected in the application;

Demonstrate the applicant's ability to provide sound programmatic and fiscal oversight;

Statement of need and program rationale

The proposal should:

Include a needs assessment including source documentation, a review of current tobacco cessation or prevention activities relevant to the proposed effort, and a description of the targeted population;

Soundness of proposed plan, strategy, activities, dates
The proposal should:

Include a detailed summary of the project's principal objectives and expected outcomes

Demonstrate evidence based tobacco control efforts;

Demonstrate a strong likelihood for a sustainable effort after the contract period;

Include a plan for measuring objectives outlined in the project.

Proposed budget and cost

The proposal should:

Include a cost-effective budget appropriate to the scope and nature of the project;

Demonstrate how the requested funds relate to the applicant's organization budget

Use of Funds

TPC/ISDH expects that funds allocated through this request for proposals will only support program development, implementation, and coordination for the proposed project.

Declaration

It is TPC/ISDH policy that any organization or individual receiving funding from TPC/ISDH must agree as a condition of receiving funds that they will not accept any funding from the tobacco industry.

The TPC/ISDH may seek additional information from an applicant prior to or during the review of the application.

The TPC/ISDH reserves the right to negotiate a modification of the proposed work plan and/or budget and will award funds after agreement has been reached.

The TPC/ISDH reserves the right to examine the physical location, all books, documents, papers, accounting records, and other evidence (Records) pertaining to administration of the program upon request, and copies thereof shall be furnished at no cost to TPC/ISDH. Grantees may be subject to amonitoring engagement per TPC/ISDH’s request.

Tobacco Prevention and Cessation Program

July 1, 2018 – June 30, 2019

LEAVE BLANK FOR TPC/ISDH USE ONLY

NUMBER ______DATE RECEIVED ______

Statewide Grant

Agency Name:

County:

Agency Contact, Director or CEO:

Address:

City: Zip Code:

Telephone:

Fax:

Email:

Signature of Agency Contact:

______

Primary Contact to TPC/ISDH:

Primary Contact Address if different from above:

City: Zip Code:

Telephone:

Fax:

Email:

Signature of Primary Contact:

______

Primary Contact’s Direct Supervisor:

Supervisor Address if different from above:

City: Zip Code:

Telephone:

Fax:

Email:

Signature of Primary Contact’s Direct Supervisor:______

Agency Financial Contact Person:

Address if different from above:

City: Zip Code:

Telephone:

Fax:

Email:

Signature of Agency Financial Contact Person: ______

Total Funding Requested:$

Project Work plan

Project focus area
Objective(s):
Data source:
Activities to Accomplish Objective / Dates / Deliverables

BUDGET EXPLANATION

Description of Budget Line Items

The following line items should be included if applicable. Use the budget form provided or a similar format. Explanation of budget items must be submitted on a separate page or incorporated into a budget form.

1. Personnel

  1. Salaries and Wages

For each staff position proposed, include the title of the position, percentageof time (FTE), annual salary, number of years salary requested, and asummary of the job description or responsibilities. Staff position(s) paid by statewide partnership funds must be dedicated only toapproved tobacco use prevention activities in the work plan. Full-timeemployees paid with the grant may not have another full-time position outside of the TPC grant.TPC does not recommend that a lead agency employ a part-time person to do tobacco control work funded by this grant that currently has another full-timeposition. The position requires personnel to attend mandatory activities duringthe day and periodically during evening hours. TPC does not take exception toan incumbent employed by the grant that works two part-time positions; part-timeposition is defined as 20 hours or less per week or as defined by the lead agency.Variations from strict full-time (37.5 to 40 hours/week, or as defined by lead agency)or part-time assignments (20 hours or less per week, or as defined by lead agency)must be reviewed and approved on a case-by-case basis.

Tobacco programming activities must occur during the calendar month for which the staff is being paid salaries and wages. Paid staff must documenthours worked and summarize activities performed on a daily log. Salariesand wages paid to staff must be for hours worked in the same calendarmonth and evidenced by the daily log.

Salary and wage increases for staff are effective only after an individual hasworked toward approved plan goals for more than 12 months. A cap onannual salary increases is limited to the consumer price index – all urbanconsumers, as published by the U.S. Department of Labor, Bureau of LaborStatistics Data ( or 3% of the current approved salary andwages, whichever percentage is less. Please apply the percentage, not toexceed the 3% limit, as applicable, by checking the year and month thatcorresponds with the one-year anniversary of the staff person in question.Please remember that the earliest date staff could have been activelyemployed is the initial term date on the grant contract. The finalsignature date is the date the contract is considered fully executed, the date the contract is signed by the Indiana State Attorney General’s office.

b. Fringe Benefits

For each position, indicate the rate and compute the amount charged forfringe benefits usually and customarily provided by the Lead Agency foremployees. TPC grant funding cannot be used to provide benefits in excessof those normally and customarily offered to all employees. If the LeadAgency does not provide fringe benefits to all employees, TPC grant dollarscannot be used to provide benefits not normally and customarily offered.Please refer to the human resources department of your Lead Agency forwritten guidance on this budget line item.

2. Travel

Expenditures for travel will be limited to the rate customarily paid by the agency or the current rate being paid by the State of Indiana, whichever is less. A chart summarizing the maximum reimbursement amounts is included for reference.