Safety Net RFP - Safety Net Health Care RFP

Safety Net RFP - Safety Net Health Care RFP 2010 Safety Net - 1 Safety Net Health Care RFP 1. HCF Information and RFP Goals Vision Healthy People in Healthy Communities Mission To provide leadership, advocacy and resources that eliminate barriers to quality health for the uninsured and underserved in our service area. Guiding Principles The Foundation’s values are explained in the Guiding Principles (click to open) and include the values of stewardship, compassion, advocacy, collaboration, inclusion, transparency, diversity and cultural competence and evaluation. The Foundation is committed to supporting high-quality activities that produce measurable improvement in access and quality of health. HCF grantees are expected to demonstrate the need for grant-funded activities, tracking/reporting outcomes, and responsible use of grant funds. Cultural competence is essential. This includes the provision of services and information in appropriate languages, at appropriate comprehension and literacy levels, and in the context of individuals’ cultural health beliefs and practices. Consideration is given to all organizations, communities and populations who meet the stated criteria. II. Goal(s) of RFP Program The broad goal of this initiative is a safety net health care system that provides quality care more efficiently and effectively to the medically indigent in the HCF service area. Enhanced ―safety net‖ health care is central to the mission of the Health Care Foundation of Greater Kansas City. The Health Care Foundation through this Foundation Defined Grant will support work that augments safety net health care with emphasis on (1) Improving Efficiency and Access to Care. (2) Strengthening Organizational Capacity (3) Delivering Culturally Competent Services and (4) Enabling Community-based Health Planning THE HEALTH CARE SAFETY NET The Institute of Medicine (IOM) in its landmark report, ―America’s Health Care Safety Net: Intact but Endangered,‖ noted that in the absence of universal health insurance the 2010 Safety Net - 2 health care “safety net” is the default system of care for individuals who are poor, uninsured or underserved. According to the IOM, safety net providers are those that deliver a significant level of health care to uninsured, Medicaid, and other vulnerable patients. The IOM further distinguishes what it terms “core safety net providers” as those that maintain open-door policies (a commitment to serve all patients regardless of their ability to pay). These providers have two distinguishing characteristics: (1) either by legal or explicitly adopted mission, they offer care to patients regardless of their ability to pay for those services; and (2) a substantial share of their patient mix are uninsured, Medicaid, and other vulnerable patients (Lewin & Stuart, 2000). However, understanding the health care safety net system is complicated by the fact that the composition and functioning of the safety net varies tremendously from one local area to another. In fact, the health care safety net system has been described as a patchwork of institutions, clinics, and physicians offices, supported with a variety of financing options that vary from state to state and community to community. Traditional core safety net providers typically include a variety of health centers (e.g. Community Health Centers, Migrant Health Centers, The Health Care for the Homeless Program, and the Public Health Housing Program) community-based clinics, public hospitals, local health departments, as well as special service providers such as AIDS and school based clinics, and many teaching hospitals. Moreover, a substantial amount of safety net care is provided in hospital emergency departments and private physicians’ offices. At the same time, understanding the health care safety net system requires more than just focusing attention on ―traditional‖ core safety net providers; it requires that we also take into account ―non-traditional‖ providers who are part of the total landscape of safety net health care services, and include a diverse group of not-for profit, social service and faith-based organizations. The broad goal of this initiative is to improve the safety net health care system so that the uninsured and underserved in the Foundation’s service area can improve their chances of attaining positive health outcomes. Through this Foundation Defined Grant, the Health Care Foundation will support work that results in quality safety net care, with special emphasis on the following areas: (1) Improving Efficiency and Access to Care. Provides support for projects that improve access and quality of care for the uninsured and underserved. Examples may include some of the following: , Expanding an organization’s capacity to serve more patients/clients by increasing the number of patients served or the types of services that are available to the uninsured and underserved (i.e. expanding hours of care; adding oral health care). , A project to improve access, efficiency and quality of care by adopting elements of a patient-centered care model (i.e. practice re-design, staff, coordination of care and communication, Health Information Technology, and ―24/7 access‖). 2010 Safety Net - 3 (2) Strengthening Organizational Capacity: Provides support for projects that seek to maintain, expand and/or improve the organization’s capacity to fulfill its mission—to implement safety net care programs and services—effectively and achieve its objectives measurably. Examples may include some of the following: , Strengthening an organization’s capacity to prevent and improve diabetes care by hiring a diabetes/nutrition specialist to educate and monitor patients with diabetes or at risk of developing diabetes. , Projects that strengthen organizational infrastructure through activities such as providing salaries for key program staff, covering operating expenses, the collection of reliable data, evaluation, engaging in strategic planning and other strategies that affect utilization and health outcomes of low-income and other vulnerable patients. (3) Delivering Culturally Competent Services: Provides support for the development and implementation of culturally competent safety net care programs/services that address the barriers that interfere with racial, ethnic and other minority groups’ access to healthcare. Examples may include some of the following: , A project that delivers culturally competent education and follow-up treatment to African Americans and Latinos who may not seek or may delay screening and treatment for colorectal cancer because of cultural belief/attitudes (i.e. distrust, fear) resulting in a higher risk of being diagnosed with advanced stage cancer. , A project to improve access to safety net health care for ethnic minorities (Latinos, Somalis) who need monitoring and treatment for a chronic disease. Funds could be used to hire and train culturally competent bi-lingual patient navigators to help patients navigate the healthcare system. (4) Enabling Community-based Health Planning: Provides support for the implementation for community-based health planning strategies aimed at reducing gaps and fragmentation in access to health care for the uninsured and underserved. Examples may include some of the following: , Community partners work together to improve coordination of services and collaboration between health care providers/organizations to overcome gaps in services (i.e. care coordination; integration of physical/behavioral health care). , Community partners develop a plan to simplify the process used to identify and expedite the enrollment of children who are eligible, but are not enrolled in Medicaid. , A community-based health plan to address a public health emergency (i.e. pandemic flu, HPV) with an emphasis on strategies that target the uninsured and underserved. 2010 Safety Net - 4 Many aspects of patients'/clients' lifestyles and of health care delivery systems affect health behaviors and the ways that care is provided. Improvements in safety net health care access, efficiency and quality of care require recognition and response to barriers to quality health created by being uninsured or underinsured, by health disparities, social determinants of health, and differences in beliefs about health and care that are culturally based. Following is an overview of some of the barriers that safety net health care must address if improvements in health outcomes are to be attained. ACCESS TO HEALTH CARE The Uninsured and Underserved Access to health care means having “the timely use of personal health services to achieve the best health outcomes” (National Health Care Quality Report, 2009). Not having health insurance is important because Americans with no insurance are much less likely than those with private insurance to obtain recommended care, especially preventive services. The uninsured are more likely to forgo or postpone needed care, and when they do attain care, they generally receive fewer services than those with insurance, leading to poorer health outcomes and higher mortality rates (Kaiser, 2009). The latest Census data indicates that 46.3 Million people in the United States had no health care insurance coverage in 2008; that includes one in every six (17%) of the population under the age of 65. However, advocates note that census data is not an accurate representation of the uninsured because it only considers people uninsured if they were not covered by any type of health insurance for the entire year, leaving out those that were uninsured part of the year. In Missouri, between 2007 and 2008, there were approximately 1.5 million people uninsured under 65 years of age, almost three out of every ten or 29.5 percent. The lack of health coverage, disproportionately affected Missouri’s communities of color: While 27.0 percent of the state’s non-elderly were uninsured at some point in that two- year period, 37.9 percent of non-elderly African Americans, and 55 percent of Latinos were uninsured (Families USA, 2009). In Kansas, 748,000 people under 65 years of age were uninsured at some point in the 2007-2009 time period – 31.4 percent of the non-elderly population. Almost three-quarters (71.4 percent) were uninsured for at least six months. While 27.7 percent of the state’s non-elderly whites were uninsured at some point in that two-year period, 37.9 percent of non-elderly African-Americans were uninsured and 55 percent of Hispanics were uninsured. In the Kansas City Metropolitan area, several studies sponsored by the Healthcare Foundation of Greater Kansas City (HCF) found that the rates of uninsured individuals range from 5 to 20 percent (Health Management Associates, 2007). The Mid-American Regional Council (2008) reported a 28 percent increase in the uninsured in the Metro Area between 2000 and 2008. According to estimates reported by MARC there were 245,439 uninsured people and 203,989 people on Medicaid within an eight county area (MARC, 2008). [The MARC data represents estimates for the greater metropolitan area 2010 Safety Net - 5 and were not limited to the Foundation’s service area] It is anticipated that the number of uninsured will continue to climb during the economic downturn as workers are laid off and more businesses cut costs by eliminating health coverage. The lack of access to needed health care services for vulnerable populations (working poor, low-income children, people of color, the mentally ill, immigrants and the elderly), denies them the opportunity for early diagnosis, prevention and treatment. As Americans wait for elements of Health Care Reform to develop and implementation begin to take place, people are still left with a highly fragmented health care delivery system that for many is not easy to access or navigate and often falls short of providing the right care at the right time in a way that is respectful of people’s values and needs. Health Disparities Quality health care means doing the right thing at the right time in the right way for the right person and having the best results possible” (Agency for Healthcare Research and Quality, 1998).Quality health care delivers these services in a way that is safe, timely, patient centered, efficient, and equitable (Institute of Medicine, 2001). However, for some, care can be delivered too late or without full consideration of a patient’s preferences and values. Many times, our system of health care distributes services inefficiently and unevenly across populations (National Health Care Quality Report, 2009). Too often vulnerable populations do not receive care that they need, or they receive care that causes harm. Findings from the 2009 National Healthcare Disparities Report (NHDR) confirm that the quality of health care is different for different people and that some Americans receive worse care than others. This is true for the poor and is particularly true for racial and ethnic minorities who often are less likely to have access to health insurance and less likely to get the treatments they need. While some racial differences in lack of insurance have narrowed in the past decade, disparities related to ethnicity, income, and education remain large. Moreover, it is important to note that minorities tend to receive a lower quality of healthcare than non-minorities, even when access-related factors, such as patients’ insurance status and income, are controlled. Findings from the 2009 NHDR show that disparities in care for cancer, heart failure, and pneumonia exist across populations. Furthermore, quality improvement has not necessarily translated to disparities reduction, which is critical for high-quality care. Delivering Culturally Competent Safety Net Care One of the strategies advocated for reducing health disparities is the provision of ―culturally competent‖ health programs and related services. Cultural Competence is a set of congruent behaviors, attitudes and policies that come together in a system, agency, project or among professionals and enable the system, agency, project or those professionals to work effectively in cross-cultural situations (Cross, Bazron, Dennis, Isaacs, 1989). It implies having the capacity to function effectively as an individual and an organization within the context of the cultural beliefs, behaviors, and needs, skills, service approaches, techniques, and outreach strategies 2010 Safety Net - 6 that match the individual’s culture and increase the quality and appropriateness of care and outcomes. Because health care is a cultural construct, arising from beliefs about the nature of disease and the human body, cultural issues are central in the delivery of health related services. By understanding, valuing, and incorporating the cultural differences of America's diverse population and examining one's own health-related values and beliefs, health care organizations, practitioners, and others can support a health care system that responds appropriately to, and directly serves the unique needs of populations whose cultures may be different from the prevailing culture. If not addressed, cultural competence can interfere with people’s ability to access quality health care and health related services (National Standards for Culturally and Linguistically Appropriate Services –CLAS standards-in Health Care Final Report, OMH, 2001). Cultural Competence in Safety Net Care: A culturally competent framework relies on a range of practice approaches and supports that are derived from, and supportive of, the positive cultural attributes of the particular group being served. Culturally competent interventions are based on practice-based evidence or evidence-based practices that incorporate the values and preferences of the group being served and they are implemented by staff that shares some common characteristics (i.e. race, ethnicity) as the group being served. The Health Resources Services Administration (HRSA) identified four indicators of cultural competence in health care organizations that may be used as a starting point for assessing cultural competence in organizations, these include: , Structure indicators are used to assess an organization's capability to support cultural competence through adequate and appropriate settings, instrumentalities, and infrastructure, including staffing, facilities and equipment, financial resources, information systems, governance and administrative structures, and other features related to the organizational context in which services are provided. , Process indicators are used to assess the content and quality of activities, procedures, methods, and interventions in the practice of culturally competent care and in support of such care. , Output indicators are used to assess proposed results of culturally competent policies, procedures, and services that can lead to achieving positive outcomes. , Outcome indicators are used to assess the contribution of cultural competence to the achievement of intermediate objectives relating to the provision of care, the response to care, and the results of care. The Foundation believes that diverse voices and viewpoints deepen our understanding of differences in health outcomes and health care delivery, and strengthen our ability to fashion just solutions. As a result, the Foundation wants to support programs and projects that are based on practice-based evidence or evidence-based practices that incorporate the values and preferences of the group being served and are implemented 2010 Safety Net - 7 by staff that share some common characteristics (i.e. race, ethnicity) as the group being served. Social Determinants of Health Another strategy to decrease the pervasive health inequality (disparities) in our society is to look beyond the immediate causes of disease. The Commission on Social Determinants of Health (World Health Organization, 2005) focused on the 'causes of the causes' - the social factors which determine how people grow, live, work and age. Social determinants of health are the circumstances in which people are born, grow up, live, work and age, and the systems put in place to deal with illness. The conditions in which people live and die are, in turn, shaped by political, social, and economic forces. The underlying determinants of health inequities are interconnected and therefore, they must be addressed through comprehensive and integrated policies, responsive to the specific context of each country and region. The Foundation agrees with the notion that the development of a society, rich or poor, can be judged by the quality of its population’s health, how fairly health is distributed across the social spectrum, and the degree of protection provided from disadvantage as a result of ill-health (WHO-Commission on social determinants of health, 2008). As such the Foundation is committed to provide its leadership and resources to address some of the social determinants of health. III. Eligibility Criteria Applicant not for profit organizations must be tax-exempt as defined by the IRS code, section 501(c) (3) and must be incorporated by the Secretary of State or be established by statute within a State and are therefore not required to be incorporated. Eligible applicant organizations include: , State or local government agencies, or a unit of government, provided that they have enabling statutes and use a Federal Employer Identification Number. The Foundation must be assured that our grant does not supplant existing funding for programs the grant supports and the governmental agency must agree to at a minimum continue the total level of funding provided by the grant when the grant expires. , An applicant organization that is exempt under section 501(c)(1) or 501(c)(6) or 501(c)(9) but lacks annually audited financial statements may apply for Foundation funding provided an organization that is exempt under Section 501(c)(3) and is annually audited agrees to serve as fiscal agent which potentially will allow for multiple co-applicants. , Applicant organizations must maintain ongoing operations, including staffing and programs, within Kansas City, Missouri, and/or the Missouri or Kansas service areas. All funded services/programs must be designed and carried out for the benefit of the target population living in these areas. 2010 Safety Net - 8 , Applicant organizations must be in compliance with local, state, and federal regulations related to non-discrimination, wage and hour laws, workplace safety, licensure, protection of confidential health care information and all other laws and regulations applicable to the staff, patients, consumers and the workplace of the applicant. , Applicant organizations must have the demonstrated capacity to carry out program work funded by the grant, exercise financial controls and use generally accepted accounting procedures and they must have an annual audit performed by an independent CPA. Ineligible Activities: The following are not eligible for funding: , Individuals for any reason, including paying for medical procedures, prescriptions, paying for health insurance, education, training, etc. , Basic or applied biomedical research, biotechnology, laboratory studies , Endowments or contributions to permanent funds or accounts that are intended to yield interest or dividend-bearing income for the support of staff, programs, services, or other operations , Construction, purchase, non-mandated renovation, demolition or re-purposing of any physical facilities or real property , Supplanting or offsetting the maintenance of effort by government, public entities , Political campaigns to support and/or oppose candidates for public office , Evangelizing activities of religious organizations , Payment of bonds, loans, notes or any other form of sponsorship or outstanding debts of an applicant or its affiliate(s) , Lobbying any public official about specific legislation , Annual fundraising appeals , To comply with the settlement agreement that created the HCF, grants in excess of $250,000 may require additional consultation with staff. IV. Total Awards and Duration The Foundation anticipates awarding approximately $5.25 million in Safety Net Care grants. Grant periods can range from 12 months to 3 years. Approvals of multi-year funding requests will affect the number of grants that the foundation can award for the given funding round. Therefore, applications for MULTI- YEAR GRANTS ARE REQUIRED TO EXPLAIN WHY SUCCESS OF THE PROPOSED PROJECT REQUIRES MULTI-YEAR FUNDING. Applicants that receive multi-year awards will be ineligible during the grant period for additional HCF Foundation Defined Grants in support of the same project costs. However, applicants with multi-year grants will be eligible to seek HCF Applicant Defined Grants and Foundation Defined Grants for other projects. 2010 Safety Net - 9 V. Selection Criteria A team of external reviewers organized by the Foundation shall have initial responsibility for considering requests for grant funding. Reviewers’ recommendations will be presented to the Program/Grants Committee in regular session for consideration of the merits of the proposed activities versus the funds available. The Program/Grants Committee will provide its recommendations to the HCF Board of Directors, which makes final decisions to approve or decline requests for grant funding. The Committee may also recommend further negotiation, modification or technical assistance in lieu of grant funding. Collaboration and the leveraging of funds are important to the Foundation, and preference will be given to applicants that leverage resources from other sources. The Foundation will consider requests for a maximum of 50 – 75% of the cost of the proposed project or activity. It is recommended that matching funds use a balanced approach of cash and in-kind resources. (click to open) The Health Care Foundation will not fund more than 50% of an organization’s operating budget. [Note – this includes the sum of all current grants HCF has with the organization.] The Foundation reserves the right to reject any or all proposals submitted, to request additional information or clarification from any or all applicants, and/or negotiate modifications with applicants at any time before, during or after the award process. All application materials submitted to the Foundation become public information that is subject to review by others upon request. Grant awards are made at the sole discretion of the Foundation. No entitlement to funding for any organization at any level is expressed or implied. Successful applicants enter into a contract that gives the Foundation rights to review and evaluate grant-funded activities. Note: Grant seekers are encouraged to carefully review HCF funding priorities (click to open) before submitting a funding request. We realize that seeking funds can be a time-consuming and sometimes difficult process. Unfortunately the foundation will be able to fund only a small percentage of the requests we receive because of limited financial resources. VI. Application Schedule for Electronic Grant Submission Announcement Date May 20, 2010 RFP document and process posted on HCF web site May 20, 2010 Pre-Proposal Conferences June 22, 2010 Letter of Intent Due July 28, 2010 (by 5 PM) Proposal Submission Due August 25, 2010 (by 5 PM) Awards Announcement November 18, 2010 2010 Safety Net - 10 VII. How to Apply Organizations interested in applying for a 2010 Safety Net grant will be expected to complete the Electronic –Safety Net Grant Application available on the HCF web site www.healthcare4kc.org. (under Grant Submissions). The application process requires applicants to complete two steps: The Letter of Intent and The Proposal Narrative. Step 1: Letter of Intent & Attachments Applicants are required to submit a Letter of Intent. The following information should be included in your Letter of Intent: A completed online application form, including uploaded attachments. Attachments include: 1) Letter of Intent Narrative, a document of up to three pages that provides the following information: - a Need or Case Statement that discusses the problem or need to be addressed by your project or program - a Grant Purpose Statement that explains the project/program that the proposed grant will fund, followed by a brief description of project/program activities - the Amount of Funding to be requested and the proposed grant period 2) 501c3 IRS Letter of Determination Complete & submit the electronic Letter of Intent application with these two required attachments. Instructions on how to upload attachments are on page 4 of the electronic application. The deadline for submitting the completed electronic Letter of Intent application is July th28 at 5:00 PM. Applicants will receive an automated e-mail reply indicating that the electronic Letter of Intent application was received and that the applicant should proceed with the full proposal. The e-mail will contain an electronic link to access your application. (If you do not receive an e-mail within 24 hours of submission, please contact the Foundation.) Organizations that lack the capacity (i.e. computer/IT skills) to complete the electronic grant application may submit a standard hard copy proposal. Hard-copy proposals should include an HCF cover page and be printed in 12-point font. Format and contents of proposals should conform to the instructions provided below. Only those proposals that meet the criteria in this RFP will be given consideration. Hard-copy proposals may be mailed or hand-delivered to the Foundation during regular business hours prior to the close of business on the due date. Emailed or faxed proposals will not be considered. 2010 Safety Net - 11 For hard-copy applications, Submit the original and four copies of the Letter of Intent to: Graciela Couchonnal, Ph.D, Program Officer The Health Care Foundation of Greater Kansas City th2700 East 18 Street, Suite 220 Kansas City, MO 64127 Phone: 816.241.7006 E-mail: gcouchonnal@healthcare4kc.org *NOTE: If submitting hard copies as opposed to online, all submissions must be hand-delivered or post-marked by the due date. Step 2: Full Proposal Narrative & Attachments Submission Online The Narrative should include the information indicated below with each section clearly identified with a heading in boldface (i.e., Abstract, Problem or Need, Project Overview, Outcomes Evaluation, Sustainability and Diversity Information). The document should not exceed 12 pages. The page limit applies to sections B & C (see below). Not included in the 12 page limit are the Abstract, the optional Logic Model and the Outcomes Measurement Framework, the Diversity Statement and the Proposal Attachments. Foundation staff will confirm receipt of each proposal submitted by the due date. Staff and review panelists will evaluate requests against a 100-point scale as assigned below. A. Abstract of Narrative (please include as separate page - not included in page count) A description of up to two paragraphs (not to exceed 250 words) that summarizes the funding request and includes the following information: , the general purpose of the grant, , the amount of funding to be requested from the HCF , a synopsis of the project description, and , major outcome(s) to be achieved. Examples: 1. Second Street Family Clinic (SSFC) requests $75,000 from the Health Care Foundation of Greater Kansas City to provide comprehensive oral health services to medically indigent clients. The proposed project will operate under the title of Healthy Families, Healthy Smiles and will serve 315 existing SSFC clients and up to 200 eligible clients referred to the program by four neighborhood associations and three churches in the area bounded on the north by Washington Boulevard, on ththe south by Marshall Avenue, on the east by 25 Street, and on the west by Pueblo Trafficway. Grant outcomes include improved client awareness of personal oral health needs, client commitment to a treatment schedule for needed care, and improved daily oral health care by clients. 2. Operation H is a hypertension awareness and management program offered collaboratively by the Central City Health Group, the Hispanic Health League, and 2010 Safety Net - 12 the Native American Health Council. As lead organization for the consortium delivering the program, the Native American Health Council requests $36,000 from the HCF to support this program for a year. The program will serve approximately 90 individuals with diagnosed hypertension or with blood pressure readings that identify them as borderline hypertensive. The core program will consist of hypertension prevention and management education, regular screenings, and medical treatment indicated by the screenings. Program delivery will be customized to the needs of the client groups served. Program success will be indicated by lower blood pressure readings, dietary changes reported, weight loss, and client reports of increased frequency of exercise. B. Problem or Need (up to 20 points). Describe the specific need or problem that your proposed project/program seeks to address. Please include data, information, or other evidence that documents this need, and be specific about how the problem/need impacts the proposed target group(s) or community(ies). C. Project Overview (up to 70 points). Describe the proposed project and its intended activities, outcomes, and timeline including: 1.) Brief History of Organization: including current programs and services. Explain the fit between the organization’s mission and the proposed project. Keep in mind that those who will be reviewing your proposal are from outside the Kansas City area and do not know your organization nor its reputation; therefore, the historical overview of your organization is your opportunity to convey your successes and to make the case for why your organization would be the right one to implement this project. 2.) The Target Population/Community(ies): the specific demographic(s) and health- related characteristics of the people you hope to serve with this project, and your recruitment or access strategy. If applicable, please explain how recruitment or access strategies show cultural competence or show respect for the values and preferences of racial and ethnic minorities. 3.) Proposed Project Activities: description of the specific program components HCF funding would support, including units of service, the total number of clients to be served, the geographic location(s) of services/activities, and the specific methods and approaches you will use to provide culturally competent services within the proposed activity. Also, please indicate whether the proposed project is currently in operation or if it is a new program. If it is an ongoing program, describe how it is being financially supported and provide a brief assessment of the project’s effectiveness to date. 4.) Outcomes & Evaluation: description of how the outcomes of your proposed project/program will be measured, including methods for information gathering and documentation, and the qualifications of personnel involved in the evaluation. Describe in narrative form the role of evaluation in supporting program improvement and determining effectiveness. If the program incorporates additional evaluation activities (instruments, design elements, analyses, etc.), please describe them or include 2010 Safety Net - 13 documentation as an appendix. The Program Logic Model and Outcome Measurement Framework (click to open) are two potential aids for identifying measurable program outcomes and outcomes evaluation planning. Applicants are encouraged, but not required to use and include these tools as part of the Narrative Statement (not counted in the Narrative Section page count). 5.) Staffing and Capacity: Describe the credentials and experience of the individual(s) who will perform the work. If applicable, include agency or facility accreditation or licensure. If there are multiple applicants, please describe the qualifications and experience each brings to the proposed project. Identify the relationship of the lead contact for this proposal to the Applicant organization. If applicable, please describe the organization and the project staff’s cultural competence expertise and fit for working with the target population (i.e. member of racial/ethnic target population, language proficiency, cultural competence training/education, practice experience). 6.) Collaboration: The Roles of other Services/Organizations in developing the proposed program, and how the proposed program will involve them in operations. Describe how various sources of support (financial, in-kind, personnel, facilities, etc.) complement one another in the proposed program. Multi-sector collaboration is encouraged. Comprehensive projects may incorporate appropriate key collaborator(s) outside the health disciplines. If applicable please describe efforts to collaborate with key stakeholder groups/organizations that are recognized for their ties/services and advocacy efforts on behalf of the target population (e.g. racial/ethnic groups). 7.) Sustainability: The plan for sustaining the proposed project or activity after the HCF grant ends. Please describe specific mechanisms and/or sources of support to achieve sustainability. 8.) Rationale Multi-Year Funding: If you are requesting multi-year funding, please include the following: , Rationale explaining why success of proposed project requires multi-year funding , An implementation timeline for the proposed years of funding D. Diversity Information (up to 10 points). HCF Guiding Principle: Diversity: The Foundation views diversity as a fundamental element of social justice and integral to its mission. HCF uses the term, diversity, broadly to encompass both differences in individual attributes: race, ethnicity, age, gender, sexual orientation, physical ability, religion, and socioeconomic status and of organizations’ attributes: size, years of operation and location within the Foundation’s service area. Please describe the different ways your organization promotes diversity within the organization, the proposed project, staffing and Board. 2010 Safety Net - 14 E. Proposal Attachments (the following items are not counted in the Narrative Section page count) 1.) Budget Worksheet, a form provided on the HCF web site. Two Budget worksheet versions are available. Please use the budget worksheet that applies to your request for 12 month or Multi-year funding. (click to open one-year) (click to open multi-year) 2.) Budget Narrative, a narrative that explains the budget line items for the project. Include as a Microsoft Word document. When describing other sources of funding for your project, please indicate whether the funding source is committed or pending. When explaining the expenses for your request, please indicate the amount you are asking HCF to fund per each line item. For salary coverage, please note the % FTE for each position HCF is being asked to fund. 3.) For non-profit applicant organizations or fiscal sponsors/agents, please include copies of: , Certificate of incorporation , IRS Non-Profit Determination Letter , Copy of organization’s most recent IRS 990 Report (nonprofit tax return) , Most recent audit , Roster of your board of directors and information about the board’s demographic composition related to race, ethnicity and gender , Board-approved operating budget For governmental entities that are the applicant organization or fiscal agent, please include copies of: , Enabling statute/legislation or official description of the entity’s responsibility or purpose , Most recent audit, and , List of elected and/or appointed officials who oversee the entity’s performance 4.) Letters of Commitment. If the proposal is a joint application, each organization that will receive a portion of the grant funds must provide a Letter of Commitment on the organization’s official letterhead. The Letter must state the organization’s commitment to the project and indicate the organization’s specific role in the project and its share of the grant proceeds. Letters of Commitment are also required to confirm the dollar value of In-Kind gifts of space, staff, supplies and equipment. Letters of Support from partnering organizations that will not share in grant proceeds may also be included as attachments. 2010 Safety Net - 15 Application Summary , Complete & Submit Electronic Full Proposal Application & any required attachments. [Note - Attachments that you will need to complete and upload to your electronic application are found on our website by clicking on Grant Submissions, then Application and Reporting Forms. Instructions on how to upload attachments are on page 4 of the electronic application.] , The deadline for submitting the electronic Full Proposal Application & ndattachments is August 25, at 5:00 PM. Applicants will receive an automated e-mail reply indicating that the electronic Full Proposal application was received. (If you do not receive an e-mail within 24 hours of submission, please contact the Foundation.) For more information about the electronic grant application process please refer to the Frequently Asked Questions (FAQ)-Electronic Application Process at www.healthcare4kc.org. In addition, we would like to encourage prospective applicants to contact us via telephone or email with any questions regarding the electronic application process. Organizations that need to submit hard copies should submit the original and four copies of the Proposal Narrative and all attachments, excluding the IRS 990 and financial audit report. Only one copy of each of those attachments is needed. Submit proposal packets to: Graciela Couchonnal, Ph.D, Program Officer The Health Care Foundation of Greater Kansas City th2700 East 18 Street, Suite 220 Kansas City, MO 64127 Phone: 816.241.7006 E-mail: gcouchonnal@healthcare4kc.org DO NOT SUBMIT VIDEOS, AUDIO TAPES, CDs OR OTHER MATERIAL THAT IS NOT SPECIFICALLY REQUESTED ABOVE.