UNITED WAY OF LAPEER COUNTY
HEALTH INITIATIVE REQUEST FOR PROPOSALS
DUE OCTOBER 30, 2015
Note: The issues, indicators, measurement and applications listed on pages 8 and 9 may not be changed. Any application that does not address one or more community indicator listed in the matrix on pages 8-9 will not be considered for funding.
FOR AN ELECTRONIC COPY OF THIS RFP VISIT WWW.UNITEDWAYLAPEER.ORG CLICK THE “PARTNER AGENCIES” TAB
Request for Proposals—Health 1 | 2 0 1 5 COMMUNITY INVESTMENT GRANT FUNDING REQUEST FOR PROPOSALS HEALTHY LIVING 2015
PURPOSE
The vision of United Way of Lapeer County is to create long- lasting community change by addressing the underlying causes of the most significant issues facing Lapeer County residents. We work to advance the common good by focusing on three priority areas; education, income and health. These are the building blocks for a good life: a quality education that leads to a stable job, enough income to support a family through retirement, and good health. This funding opportunity was established to build community capacity to support individuals and families with immediate needs and establish a foundation for long-term change.
Since 2008, we’ve been working to achieve our bold, 10-year goal: to increase by one-third the number of youth and adults who are healthy and avoid risky behaviors by 2018. Whether it is a neighbor without health insurance, a victim of abuse or someone struggling with mental illness or an addiction, United Way is working to ensure everyone has access to affordable and quality care. Achieving our goal requires us all to become more aware of health risks and the potential effects they have on ourselves and others. Working to change policies and practices, such as extending health care coverage, will enable more people to live healthier lives.
OUR APPROACH AND PRIORITIES
We believe that it is important to work simultaneously in the areas of policy, grant-making and engagement of diverse stake-holders. Our strategy includes bringing together experts to problem solve and commit themselves to improving the health of everyone in Lapeer County. Grant making provides an important opportunity to support on-the-ground efforts. We are looking for innovative ideas that can help the uninsured gain access to routine and preventive care and to help us all lead healthier lives. To that end United Way will provide funding to organizations that engage in any of the following strategies:
Request for Proposals—Health 2 | 2 0 1 5 1. Everyone should experience safety in their personal relationships Issue: Families and homes are free of violence Indicator: Decrease the incidence of family violence in Lapeer County by 15% by 2015
United Way will fund one or two community organizations that can provide programming that will create and implement comprehensive domestic violence prevention and/or dating violence program that includes intervention activities on the individual, relationship, and community level. 2. Access to Health Care Issue: People who are uninsured and underinsured have access to regular healthcare through a health care home Indicator: Improve the way people gain services from healthcare delivery systems.
United Way will fund one community organization that can create a community case management system that will connect clients to medical homes and ensure more comprehensive, coordinated care. Using a “wrap-around” approach this partner will be encouraged to develop a team approach to create a community-based network of care for the low-income uninsured to close the gaps in health-care, eliminate barriers and encourage healthy living.
ELIGIBILITY and GENERAL CRITERIA
All public or private, tax-exempt, health and human service organizations serving residents of Lapeer County are eligible to submit proposals.
Organizations may apply and compete for funding only if the project it proposes is in alignment with one of United Way’s initiatives outlined above. Any application that does not align with these priorities will not be considered for funding.
The organization submitting a proposal for a project that addresses the requirements of the initiative must submit a complete application. Application instructions begin on page five (5).
Organizations that discriminate on the basis of ethnicity, race, color, creed, religion, gender, national origin, age, disability, marital status, sexual orientation, gender identity, or any veteran’s status will not be funded.
Request for Proposals—Health 3 | 2 0 1 5 It is the expectation that multi-year funding will be needed to ensure that the outcomes sought by United Way are achieved. Renewal of grant funding will be based on the community organization’s ability to meet agreed upon benchmarks. Grant renewal is at the sole discretion of United Way. Any failure of a funded partner organization to comply with any conditions set forth in the grant agreement may result in loss or suspension of funding. In addition, funding levels are subject to modification based on United Way’s fundraising success.
PROPOSAL REVIEW PROCESS
Applications will be reviewed and scored with priority given to proposals that are most closely aligned with funding priorities.
Finalists may be interviewed by United Way staff and/or Community Impact Team members before final recommendations are made to the United Way Board of Directors. Winning agencies may be asked to submit additional organizational documents
FUNDING REQUIREMENTS
Requirements of the funding agreement with United Way of Lapeer County are outlined in the application for funding. By signing the Assurances, you acknowledge that you have read the funding requirements and that your proposal is submitted in good faith.
Request for Proposals—Health 4 | 2 0 1 5 TIMELINES
October 1, 2015 RFP available on www.unitedwaylapeer.org
October 30, 2015 Applications Due to United Way
November 19, 2015 Volunteer Review
November 25, 2015 Grants Awarded
December 15, 2015 Grant documents due to United Way
December 30, 2015 Grant payments begin
SUBMISSION INFORMATION
Proposals are due at the United Way offices on: October 30, 2015
Please submit one original and (5) copies of your proposal to:
ATTN: Community Investment Grant Funding United Way of Lapeer County, Inc. 3333 John Conley Drive, Suite 102 Lapeer, MI 48446
Request for Proposals—Health 5 | 2 0 1 5 PROPOSAL INSTRUCTIONS
General Requirements
1. PAGE LIMIT: The narrative portion of the proposal must be limited to eight pages (not including required forms, attachments and cover page).
2. Refer to the proposal checklist to make sure that you have included all required sections and attachments with your proposal.
3. Number all pages including attachments and include a header with your agency/program name at the top.
4. Please secure each copy with paper clips or clamps, do not have it professionally bound as it will be disassembled.
5. Do NOT send other materials with your proposal including brochures, photos, video material, etc. Additional material will not be reviewed.
Request for Proposals—Health 6 | 2 0 1 5 PROPOSAL OUTLINE
A. Proposal Cover Sheet 1 Form
Complete all sections on the Proposal Cover Sheet and include it as the first sheet of your proposal.
B. Narrative Limit of 8 pages
======NOTE: The narrative portion of the proposal should be organized into sections using each of the numbered sub-headings below. Do NOT include the entire text of each of the bulleted questions.
You are encouraged to answer the bulleted questions in order, but we recognize that this isn’t always possible and it is not required; however, be sure to address all the bulleted points in your discussion under each sub-heading. ======
1. Program Overview
. Briefly describe the history, mission and services, numbers of staff and volunteers and major sources of community support for the organization.
. What specific services or activities will be delivered by this project – what, how, where and what work schedule do you anticipate?
. Describe plans for outreach to the target population.
. Discuss plans to obtain participant referrals and the criteria for determining appropriateness for services. Include any policies or processes of other funders and/or collaborating or referring agencies that may affect enrollments.
. How does your program collaborate with other agencies to impact the problem?
2. Leveraging of Resources
. In addition to United Way funding, what other sources of revenue are used for this project? Include government and foundation grants, individual donations and corporate sources of revenue, etc.
Request for Proposals—Health 7 | 2 0 1 5 . Identify any in-kind resources that will be used for this project. Include personnel, space, equipment, supplies, volunteer time, etc., and who will provide them. Include how the project will leverage time, talent and/or resources from within the target community.
3. Targeted Outcomes (Reference the initiative matrix on the following page)
. What are the expected individual outcomes for participants of the project? These are the outcomes you will track and report throughout the length of the funding.
. Explain how the outcome(s) you have identified align with the chosen Impact Area(s) and Long-term Goals of United Way’s Income and Financial Attainment initiative. How do the outcome(s) demonstrate incremental progress toward the Long-term Goal(s)?
. Briefly describe your plan to measure individual participants’ progress on the outcome(s). Will you use a standardized assessment, a survey, case notes, observation, etc? When and how often will assessments take place and who will collect the data and evaluate progress? Identify if and how program participants and members of the target community will be supported to participate in the outcome evaluation activities.
Note: All agency proposals must address one of the community indicators (including measurement) listed on page eight of this document, and may not be changed. Any application that does not address one or more community indicator listed in the priority matrix will not be considered for funding.
Request for Proposals—Health 8 | 2 0 1 5 Request for Proposals—Health 9 | 2 0 1 5 Issue Indicator Measurement Application Families and their Decrease the MSP Incident data by RFP for a partner to provide homes are free of incidence of county (violent crimes programming in the following violence family against persons) area: violence in Lapeer County Creation/Implementation of a by 15% by comprehensive domestic violence 2015. prevention program/plan that includes intervention activities on the individual, relationship, and community level. People who are Improve the CDC and MDCH data RFP for a partner to provide uninsured and way people Percentage of patients programming in the following underinsured have gain services presenting to emergency area: access to regular from room for basic care healthcare through a healthcare Create a community case health care home delivery management system that will systems. connect clients to medical homes and provide more comprehensive, coordinated care.
Internal Programs: 2-1-1 Healthcare information and referral and prescription assistance matrix Children have basic Children and Percentage of children Internal programs: healthcare coverage youth receive under the age of 18 who and preventative care timely, do not have health care Children’s health insurance regular, insurance outreach—2-1-1 preventive health care Youth and adults are Increase the Health behaviors index, RFP for a partner to provide healthy and avoid percentage of Health rankings programming in the following area: behaviors that persons age statistics by county Request for Proposals—Health 10 | 2 0 1 5 decrease their health 13 and over Create/implement a program focused quality who are on environmental interventions healthy and across four domains: Community, avoid risky Social Networks, Habitat and Inner behaviors by Self. Transform the way the residents eat, work, exercise, and 20% by year play to increase vitality and 2015 decrease risky behaviors.
Request for Proposals—Health 11 | 2 0 1 5 E. Budget 1 Form
PROJECT BUDGET (form): Use the budget form on the following page and include:
Fiscal Year End: Indicate the fiscal year end date of your agency Column 1 – Amount Requested from United Way. Include the amount of your request under the revenue section, and all estimated expenses under the expenses section. Detail the sources of revenue and expenses expected in identified fiscal year for the entire organization. Column 2 –Funded Project Budget This represents the revenue and expenditures of the entire proposed project. Are you expecting other revenue for the program, or will there be other expenses not covered by United Way? List those in Column two. UWLC does not require a specific match or leverage amount but it is anticipated that there may be other committed partners who bring resources to the project. Column 3 – Total Agency Budget. Detail sources of revenue and expenses expected in the identified fiscal year for the entire organization.
Request for Proposals—Health 12 | 2 0 1 5 Fiscal Year Agency or Fiscal Agent Name: Project Name: End:
Budget Summary PROJECT FUNDING
TOTAL REQUESTED TOTAL TOTAL FROM PROJECT AGENCY REVENUE UNITED WAY BUDGET BUDGET 1 2 3 A CONTRIBUTIONS/FUNDRAISING INCOME B UNITED WAY DONOR-DIRECTED DESIGNATIONS C GRANTS FROM FEDERAL GOVERNMENT AGENCIES D GRANTS FROM STATE GOVERNMENT AGENCIES EXPENSESGRANTS FROM LOCAL GOVERNMENT AGENCIES F FOUNDATION GRANTS G PROGRAM SERVICE FEES H OTHER REVENUE I TOTAL REVENUE $ - $ - $ - EXPENSES J SALARIES K PAYROLL TAXES AND EMPLOYEE BENEFITS L PROFESSIONAL FEES & CONTRACTED SERVICES M OPERATIONS (rent, utilities, equipment, maintenance, etc.) N MATERIALS & SUPPLIES O TRAVEL T MISCELLANEOUS EXPENSES P TOTAL EXPENSES $ - $ - $ - Balance 0 0 0 Total Project Budget - Amount Requested from United Way $ -
Request for Proposals—Health 13 | 2 0 1 5 UNITED WAY OF LAPEER COUNTY, INC. COMMUNITY INVESTMENT GRANT FUNDING 2015-2016 PROPOSAL COVER SHEET Fiscal Agent Org. EIN# or (Fed. Tax I.D.#): Organization: Organization Address:
Request for Proposals—Health 14 | 2 0 1 5 City: State: Zip: Phone:
Executive Name: Signature Director: Phone: Ext: Email:
Board Name: Signature President: Phone: Ext: Email: PROJECT FOR WHICH YOU ARE REQUESTING FUNDING: Project Name: Program Name: Title: Contact: Phone: Ext: Email: Dollar Amount of Request for this Project (Annually): $ Is this a new service __ New If it is an existing or an existing program, how long has it program? __ Existing been underway? If Yes, when was it When: Has this project __ Yes funded by United Way previously received and how much was the United Way Funding? __ No Funding: $ funding?
ALIGNMENT WITH UNITED WAY FUNDING PRIORITIES For this section, Refer to the Funding Priorities Document Under which Priority Area are you applying? (Type an “X” to choose ONE ONLY) Education Income Health
Which Priority Area Issue will this project be Addressing? (See page 8 of the RFP for reference)
Request for Proposals—Health 15 | 2 0 1 5 F. Required Attachments
1. Proposal Coversheet 2. Project Budget 3. IRS Form 990 (Most recent year completed) 4. Agency Audit or Financial Statements, 5. Board roster and meeting schedule 6. Anti-discrimination policy 7. Bylaws (for any agency applying for the first time in 2015) 8. Articles of Incorporation (for any agency applying for the first time in 2015) 9. State of Michigan License to Solicit
Request for Proposals—Health 16 | 2 0 1 5