Barnstable County Department of Human Services Mass In Motion Community-Based Grants Program July 1, 2012 – June 30, 2013 Request for Proposals (RFP) Application Documents

A focus on the Barnstable County Mass In Motion objective to increase the availability of healthier food options at Cape Cod Hunger Network food pantries and meal programs. Grant Application Checklist Please provide materials in the order shown.

GRANT APPLICATION CHECKLIST

COVER SHEET

GRANT NARRATIVE

PROJECT BUDGET

AGREEMENT TO WORK WITH THE BCDHS MASS IN MOTION PROJECT MANAGER ON A PROJECT PLAN, EVALUATION, STATUS REPORT AND FINAL REPORT

PROOF OF 501 c NON-PROFIT STATUS OR NOT FOR PROFIT STATUS

LETTERS OF SUPPORT (Encouraged, Not Required)

Barnstable County Department of Human Services and the Resource Development Office have aimed to limit the time this proposal will take to complete while ensuring we collect information needed to evaluate proposed initiatives.

BCDHS Mass In Motion Community-Based Grant RFP Cape Cod Hunger Network Members 1 Application Cover Sheet Mass In Motion Community-Based Grant Program July 1, 2012 – June 30, 2013 Applicant Organization:

Towns Served:

Contact Person: Title: Full Mailing Address:

Telephone: Fax:

Email: Website:

Project Title: Budget Amount Match/ requested: $ In Kind: $ Total project cost: $

If our organization is awarded a grant, we agree to work with the BCDHS Mass in Motion Project Manager who will assist our organization with:  Finalizing a project plan based on the funded scope of work.  Setting up and completing a feasible evaluation plan that tracks initiative successes and challenges and documents results.  Guidance on the six-month status report and final report.  Identifying free and low cost resources for clients for healthy eating and active living within the service area.

Authorized Signatory:

Name Title

Signature Date

BCDHS Mass In Motion Community-Based Grant RFP Cape Cod Hunger Network Members 2 Grant Narrative Please complete Part I and Part II of the Grant Narrative using no more than 6-pages total, 12 point font, single spaced. I. Organization Description

1. When did your organization start offering food pantry or meal program services?

2. What services do you currently provide to clients through your food pantry or meal program?

3. What are your usual days and hours of operation of your food pantry or meal program?

4. In calendar year 2011, what was the unduplicated count of individuals and households to which you provided services – if you cannot provide an unduplicated count, please explain why not. 1

Food Pantry…. Individuals: Households: Meal Program… Individuals: Households:

5. In the last calendar month for which you have data summarized, what was the unduplicated count of individuals and households to which you provided services – if you cannot provide an unduplicated count, please explain why not. 2

What month? What Year?

Food Pantry…. # of individuals: # of households: Meal Program… # of individuals: # of households:

1 See page 9 of the RFP for the definition of unduplicated count. 2 Ditto BCDHS Mass In Motion Community-Based Grant RFP Cape Cod Hunger Network Members 3 6. How many paid staff members operate your food pantry and/or meal program? Please list their titles and hours per week:

7. How many volunteers do you have available to you currently?

8. Approximately how many total volunteer hours do you utilize each month? {For example, you have 2 volunteers who work 4 hours a month and 3 who work 2 hours a month – total volunteer hours per month is 14 hours (2 X4 and 3 X 2)}

II. Proposed Approaches Instructions (please do not include these in your five-page narrative):

Your narrative must describe your approach to both:

A) Increase the volume of non-perishable healthy foods available at your pantry or meal program, as well as of local fresh produce when in season, and

B) Encourage clients’ use of healthy foods for meals and snacks at home and discourage unhealthy foods.

Your approach can be new or expand an existing one. Also, we value approaches that incorporate activities which:  Encourage clients to purchase healthy foods and avoid unhealthy ones when grocery shopping.  Reach children and youth.  Encourage opportunities for increased physical activity.  Are implemented across your caseload to encourage the default decision to be healthy eating and active living for all.  Incorporate fun, happiness and hope. End of instructions

BCDHS Mass In Motion Community-Based Grant RFP Cape Cod Hunger Network Members 4 A. Proposed approach to increase the volume of non-perishable healthy foods available at your pantry or meal program, as well as of local fresh produce when in season 1. In the past year, what activities – if any – have your food pantry or meal program undertaken to increase availability of non-perishable healthy foods and fresh local produce in season? (Please do not include regular orders from the Boston Food Bank or participation in the Stop & Shop Healthy Food on Pantry Shelves project as we are aware of these.)

2. What activities will you undertake through this grant opportunity?

3. If any, who are partners you will work with on the activities, such as other organizations, agencies, and businesses in your service area?

4. What is your time line for implementing the proposed activities?

5. What challenges do you anticipate in achieving your activities and ways you might overcome them?

6. What strengths and assets within or external to your organization will help you achieve these activities?

7. How will you sustain your approach at the end of the grant period?

B. Proposed approach to encourage clients’ use of healthy foods for meals and snacks and discourage use of unhealthy foods. 1. In the past year, what activities – if any – have your food pantry or meal program undertaken to encourage use of healthy foods in meals and snacks and discourage use of unhealthy foods?

2. What activities will you undertake through this grant opportunity?

3. If any, who are partners you will work with on the activities, such as other organizations, agencies, and businesses in your service area?

BCDHS Mass In Motion Community-Based Grant RFP Cape Cod Hunger Network Members 5 4. What is your time line for implementing the proposed activities?

5. What challenges do you anticipate in achieving your activities and ways you might overcome them?

6. What strengths and assets within or external to your organization will help you achieve these activities?

7. How will you sustain your approach at the end of the grant period?

8. What is the estimated unduplicated count of individuals you will reach July 1, 2012 to June 30, 2013 with this approach to encourage clients’ use of healthy foods for meals and snacks and discourage use of unhealthy foods? 3 Children and youth through age 18 years: Adults 19 – 64 years: Adults age 65 years and over:

3 See page 9 of the RFP for the definition of unduplicated count. BCDHS Mass In Motion Community-Based Grant RFP Cape Cod Hunger Network Members 6 Project Budget Please complete the table below to indicate the major categories needed to carry out your proposed approach.

(A) (B) (C) Category Detail Grant Organization in Other (A+B+C) Request kind Sources Total Cost Additional Staff Hourly rate: $ $ $ $ $ Time Number of hours: Contractors/ Hourly rate: $ $ $ $ $ consultants Number of hours: Supplies List types: $ $ $ $

Mileage @ 41 # of miles: $ $ $ $ cents/mile & Other travel: other travel Printing List types: $ $ $ $

Advertising List types: $ $ $ $

Postage Purpose: $ $ $ $

Other Description: $ $ $ $

Other Description: $ $ $ $

Other Description: $ $ $ $

Regular Staff Description: NA $ $ $ Time Volunteers – Description: $ $ $ NA approx. value Overhead Description: $ $ $ (rent, phone, NA computer, etc.) TOTAL NA NA S S $

Budget Narrative: Please provide a brief justification for each major category needed to carry out your proposed initiative (contractors/consultants, supplies, travel, printing, etc.) and brief explanation of the distribution of grant request, organization in-kind, and funds from other sources.

BCDHS Mass In Motion Community-Based Grant RFP Cape Cod Hunger Network Members 7