Statement of Interest for HealthMatters, Kentucky!

Grant opportunity generously funded by the National Institute on Disability and Rehabilitation Research (NIDRR), Department of Education, grant number H133B130007.

HealthMatters, Kentucky! is a health promotion initiative aimed at improving health and health promotion of people with intellectual and developmental disabilities (I/DD) throughout the state of Kentucky. The HealthMatters, Kentucky! is a part of larger scale-up project led by HealthMatters Program team at the Rehabilitation Research and Training Center on Developmental Disabilities and Health (RRTCDD) at the University of Illinois at Chicago, partnering with Human Development Institute at the University of Kentucky and the Kentucky Division of Developmental and Intellectual Disabilities to assist provider agencies with promoting healthy lifestyles to people with I/DD while meeting the requirements of the National Core Indicators. Up to 5 provider organizations will be selected to participate and will receive resources to benefit people with I/DD receiving services, the organization, and their employees. Through in-state support, free consultations on Wellness Committee and Strategic Plan development, convenient training via webinar, and evidence-based curriculum tailored to improve health and wellness of people with I/DD, participating provider Organizations will be equipped to improve their health promotion programming for people with disabilities. In addition, at least three staff members will ultimately become Certified Instructors to teach 12- week HealthMatters Program to people with I/DD.

Our Provider Organization HealthMatters Teams agrees to commit to the following program requirements:

1. Creating a Wellness Committee (if not in place) June/July 2016

2. Completing organizational HealthMatters August 1st, 2016 Assessments

Page 1 of 4 Statement of Interest for HealthMatters, Kentucky! 3. Creating and adhering to Strategic Plan for health June 2016 – June 2017 promotion implementation

4. Attending three (3) 75-minute HealthMatters Train- September 2016 (Check website for the-Trainer Webinars (minimum 3 participants) exact dates)

5. Running at least one 12-week HealthMatters September 2016 – June 2017 Program (4-6 hours per week; meet 3 times per week) (start within 2 weeks of the last for people with I/DD (minimum 6 participants) webinar)

6. Providing structured time for staff and Wellness June 2016 – June 2017 Committee to meet

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As a reminder, Organization HealthMatters Teams must include but are not limited to: two (or more) staff leaders and HealthMatters team Coordinator who will become Certified Instructors.

Name Role/Title Signature

HealthMatters team Coordinator

Staff leader

Staff leader

Participating organizations will have access to ongoing support and technical assistance provided by the national HealthMatters Program Team at the RRTCDD, the Human Development Institute, and the Kentucky Division of Developmental and Intellectual Disabilities.

Executive Director Signature Organization Name

Executive Director Name Date

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Executive Director Email

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