Northwest Suburban Health Alliance/ CHNA 15



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Encompassing the towns of:

Acton, Bedford, Boxborough, Burlington, Carlisle, Concord, Lexington, Lincoln, Littleton, Wilmington, Winchester and Woburn

CHNA 15 Request for Proposals

Funding FISCAL YEAR 2021 MiniGrants to Create Healthier Communities

Recipients of Calendar YEAR 2020 (Jan 1- Dec 31, 2020) MiniGrants are NOT Eligible.

CHNA 15 is seeking applications to fund up to TEN MiniGrants of up to $7,500 each for projects serving one or more communities within the CHNA 15 area.

Using a Healthy Communities approach (see Appendix C) that defines physical and social health broadly and emphasizes community collaboration, proposals should:

1. Be designed to enhance community health and well-being,

2. Incorporate proven, innovative practices to improve primary care and preventive health services for vulnerable populations.

3. Address a priority focus area. We are specifically looking for grants that primarily address the overlapping Youth Behavioral Health and Elder Health issues that have been identified through CHNA 15’s 2016 planning process, the 2018 Emerson Hospital Community Health Needs Assessment, the 2019 LHMC and Winchester Hospital Community Health Needs Assessments, and the MA State Priorities. 1,2 These priority focus areas included:

a. Elder Health, with a focus on:

• Depression and Isolation

• Chronic Disease and Unhealthy Lifestyles

• Alcohol/Substance Abuse

• Fragmentation of Health Services

• Access to Healthy Food

b. Youth Behavioral Health, with a focus on:

• Depression and Anxiety

• Alcohol, Prescription Drug and Opioid Use

• Access to Mental Health and Addiction Treatment Services

• Obesity and Fitness

• Access to Healthy Food

• Domestic Violence

• Isolation

NOTE: Limited funding has been allocated for projects that address additional priority focus areas identified in the processes noted above. These could include: Low Resource Individuals/Financial instability; Transportation; Housing or Additional MA State Priorities as indicated in Appendix D

[1] See Appendix D for 2015-2020 MA State Priorities

2 See 2019 Community Health Needs Assessments from Lahey and Winchester Hospitals and the 2018 Community Health Needs Assessment from Emerson Hospital for more information and data to support your application:

;



Notification of Intent to Apply should be emailed by FRIDAY, MAY 15, 2020 at 5:00 PM.

Proposals must be emailed and postmarked by FRIDAY, JUNE 5, 2020 at 5:00 PM.

Awards will be announced in late June.

Start-up is July 1, 2020 and projects must be completed between June 30, 2021 and September 30, 2021.

Due to the coronavirus, all grantees will receive a three month extension on their MiniGrant project, if needed. Grantees who can move forward with their projects will be encouraged to do so. Grantees needing further extension will have the opportunity to request one at the mid-point of their project.

As part of a statewide effort to develop, implement, and integrate community projects to effectively utilize community resources to create healthier communities, CHNA 15 has this Mission Statement:

We pledge ourselves to work together to build healthier communities through community-based prevention planning and health promotion.

To enhance its purpose CHNA 15 established a vision statement as follows:

We envision that each and every community will be a safe and supportive environment that empowers community members to develop self-esteem and personal responsibility to make positive and healthy life choices.

Further information on CHNA 15 and its work is included in Appendix E.

Funding for CHNA 15 is provided from Lahey Hospital and Medical Center and Winchester Hospital through the Massachusetts Department of Public Health’s Determination of Need (DoN) process.

Instructions for Submission of Responses

1. Submit a Notification of Intent to Apply by email to CHNA15Coordinator@ by Friday, May 15, 2020. The Intent to Apply may be brief including organizational contact information: e-mail address, phone number, contact person, and community/ies and/or organization(s) your proposal will likely include.

2. Submit both electronic and hard copies of proposal.

➢ An emailed copy is due by 5 PM on Friday, June 5, 2020 and should be emailed to CHNA15Coordinator@.

➢ One (1) original copy of your proposal, marked Original, plus ten (10) copies must be postmarked by 5 PM on Friday, June 5, 2020 and mailed to Randi Epstein, CHNA15 Coordinator, 59 Bonwood Road, Needham, MA 02492. Proposals postmarked or received via email after the deadline will not be eligible for review or funding. All applicants will receive notification of receipt of proposals.

➢ Proposals must be written on plain 8 ½ x 11 inch paper, single-spaced, twelve point Calibri font, and single-sided with one-inch margins.

➢ A 10 point Calibri font may be used for the chart in Question 3.

➢ Your response to questions 1 - 4 may not exceed five pages and must be numbered.

➢ It is REQUIRED that there be space between each paragraph in order for application to be readable.

➢ Proposals exceeding this page limit will not be considered.

➢ All responses must correspond to the numbered/ lettered format in proposal. (2a, 2b, etc.)

Application Component Checklist

Completed CHNA 15 MiniGrant Cover Page as the first page of proposal

Completed Target Population Chart

Completed project narrative with responses to questions 1 – 4 not exceeding 5 pages.

Completed Budget Detail and Narrative

Signed CHNA 15 MiniGrant Project Agreement

Documentation of Tax Exempt Status or, if applicable, verification of designated Fiscal Agent and 501C3 of that agent

Electronic copy submitted by 5:00 PM on Friday, June 5, 2020.

One original and ten hard copies of proposal postmarked by 5:00 PM on Friday, June 5, 2020.

If proposal responds to Question 1d then a CHNA 15 MiniGrant Final Report and Final Budget must be submitted.

Strict adherence to the 5-page limit, and inclusion of ALL above-listed components is required. Unrequested attachments will not be reviewed.

Copies of the RFP and all attachments are available at

CHNA 15 Fiscal Year 2021 MiniGrant Cover Page

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|Submission Date: ____________________________ |

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|Project Title: _____________________________________________________________________________ |

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|Project Description: ________________________ _______________________________________________ |

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|___________________________________________ _____________________________________________ |

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|Lead Agency/ Organization: __________________________________________________________________ |

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|Contact Person: ___________________________________________________________________________ |

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|Street Address: ____________________________________________________________________________ |

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|City: _____________________ State: _____ Zip: _________ PHONE :(___) ______________________________ |

| |

|Fax: (___) _____________ EMAIL: _____________________________ Website: _________________________ |

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|Collaborative Partners: ____________________________________________________________________ |

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|____________________ ____________________________________________________________________ |

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|Amount of Funding Requested: $______________Federal Tax ID #__________________________________ |

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|Geographic Area Served by Project: _____________________________________________________________ |

|If your organization has a fiscal agent/conduit other than the applicant named above, please complete. |

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|Name of fiscal Sponsor: ___________________________________________________________________ |

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|Name of fiscal Contact Person: __________________________________________________________________ |

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|Address: ____________________________________________________________________________________ |

| City: _____________________________ | | |

| |State: __________ |Zip Code: ______________________ |

| |

|phone: (____) __________________________________ Fax: (____) ___________________________________ |

| |

|Email: ______________________________________________________________________________________ |

Target Population Chart

What communities will be involved in / impacted by your project?

|Acton |Bedford |

|Boxborough |Burlington |

|Carlisle |Concord |

|Lexington |Lincoln |

|Littleton |Wilmington |

|Winchester |Woburn |

|Other – please list |

Anticipated number of people that will be impacted by your project? _______________________

What is the target population for this project?

← Youth

← Adults

← Elders

← Other (please specify):

Which of the following health priorities does your project address (you can check more than one)?

← Mental Health or Behavioral Health

o Youth

o Adult

o Elder

← Elder Health

← Substance Use

← Public Safety

o Domestic Violence

o Isolated Residents

← Food and Nutrition

o Access to Healthy Food

o Obesity and Overweight

← Other (please specify):

If you are a service provider which population/health priority areas do you serve? Check all that apply.

|Housing/Homeless |General Population |

|Substance Abuse |Older Adults |

|Mental Health |Youth/Children |

|HIV/AIDS |Immigrants |

|Health Care |Early Intervention |

|Depression & Anxiety |Access to Healthy Food |

|Isolated Residents |Obesity & Overweight |

|Domestic Violence | |

|Other (specify) |

Proposal Narrative

Responses to questions 1-4 limited to five pages.

Please do not include footnotes with additional data and information. Complete instructions for submission of responses is included on PAGE 3.

1. Project Introduction/Summary/Lead Agency

Provide a clear description of your project. Include your project goal and the specific issue(s) to be addressed.

a. Who is the lead agency?

b. What is the mission of your organization?

c. How do the mission and experience of your agency/organization demonstrate ability to respond to the identified project?

d. If this is a continuation or expansion of a CHNA 15 MiniGrant project provide a brief description of how the project will be different and/or new to the population it will serve, and include a copy of the Final Report and Final Budget which will be provided to reviewers.

e. If this is a new or one-time event, explain how this project fit in/contributes to a broader, comprehensive goal? 25 points

2. Determination of Need and Project Measurement

a. How have you documented/determined the need for this project?

b. Present data that documents the identified need.

c. How is project informed by best practices?

d. Describe the target population and those that will benefit from your project?

e. Specify how the project will impact target population and meet the need.

f. Describe evaluation strategies and/or tools you will use to measure outcomes and achievement of project goals. 25 points

3. Timeline and Other Funding

a. Provide a project timeline in table format as below to convey implementation strategies.

(A 10-point font may be used in the chart.)

|Action/Task |Person Responsible |Dates |

| | | |

b. Describe other funding that exists or that you are seeking to undertake this project.

c. Discuss the potential for fiscal and programmatic sustainability of the project and its effects beyond the one-year grant period. 25 points

4. Healthy Community Principle

Select the Healthy Community Principle (See Appendix C) that best reflects the intent of your project and describe how your project aligns with that Principle. 5 points

5. Budget

Complete an itemized budget for your proposed project. Include line item costs and a brief description of each. Include justification for each line item. Justification is limited to two pages and should not include program details not already described elsewhere in your proposal. Accuracy will be considered. Please check your math. The itemized budget and budget narrative are not included in the five pages allowed for questions 1-4.

20 points

Contact for questions or clarification:

Randi Epstein, CHNA 15 Coordinator, at CHNA15Coordinator@

CHNA 15 MiniGrant Budget Form

Itemize all expenses and summarize all revenue and in-kind support for the project.

| |Amount requested in |IN-KIND and OTHER |TOTAL PROJECT COSTS |

|Line Item |application |SOURCES of funding | |

| | |(Source and Amount) | |

| | |In-kind designates donated goods or services. | |

| Staff | | | |

|(Indicate number of hours to be | | | |

|applied to this project and hourly | | | |

|rate.) | | | |

|Fringe/Agency Overhead | | | |

|If applicable (May not exceed 7% of | | | |

|requested budget. Check with your | | | |

|agency for how this is calculated | | | |

|and include a break down of included| | | |

|charges.) | | | |

|Contract Services | | | |

|(Identify contractor and number of | | | |

|hours.) | | | |

| Local Mileage | | | |

|(Hotel and other travel are not | | | |

|eligible expenses.) | | | |

| Supplies | | | |

| Equipment | | | |

|(Capital expenses may not exceed 10%| | | |

|of requested budget.) | | | |

|Agency Overhead | | | |

| Other Expenses | | | |

|(list and explain) | | | |

| | | | |

|TOTAL | | | |

MiniGrant Budget Justification

The budget justification must explain the relevant details of each line item.

Justification should not include program details that are not identified elsewhere in your proposal.

If needed, the budget justification may use up to two (2) additional pages.

CHNA 15 MiniGrant Project Agreement

If awarded a CHNA 15 MiniGrant, we agree to the following:

Agreement A

• To ensure that at least one informed person representing our project will attend each CHNA 15

General Meeting to share achievements and updates.

Agreement B

• To submit

o A Progress Report midway through the project (template to be provided). Second payment will be made after Progress Report is received.

o A Summary Report (template to be provided), plus evaluation and year-end itemized expense sheet, to the CHNA 15 Coordinator within one month following the completion of the funded project.

• To complete the project with all funds spent between June 30, 2021 and September 30, 2021. Should there be unused funds, they will be returned to CHNA 15.

• To display and discuss the project at CHNA 15 Showcase 2021 in the spring of 2021.

• If project is unable to proceed as specified in the application, the organization should contact the CHNA 15 Coordinator as soon as possible and submit an addendum for proposed change. The CHNA 15 Steering Committee will consider the proposal. Continued funding is not an automatic guarantee. Completion and other reporting requirements would remain, as specified in the original application.

• To include the following statement in all funded project descriptions, products, and related publicity:

This project is funded through CHNA 15 DoN funds from Lahey Hospital and Medical Center and Winchester Hospital.

Project Title: __________________________________________________________________

Signature of Authorized Signatory: ________________________________________________

Date: _______________________________________________________________________

Lead Agency: _________________________________________________________________

CHNA 15 towns included in project: _______________________________________________

____________________________________________________________________________

CHNA 15 FY 2021 MiniGrant

Appendices

Appendix A: Important CHNA 15 MiniGrant Dates

Appendix B: Eligibility and Assessment Criteria

Appendix C: Healthy Communities Principles

Appendix D: Massachusetts State Priorities

Appendix E: CHNA 15 Information

Appendix F: Definition of Terms

Appendix A

Important CHNA 15 Mini-Grant Dates

May 15, 2020: Notification of Intent to Apply must be emailed or postmarked.

June 5, 2020: Proposals must be postmarked and emailed

Late June, 2020: Awards announced

July 1, 2020: Project start up. Recipients awarded 50% of project funds.

January 15, 2021: Mid-Project report due. Remaining 50% of funds awarded upon receipt of mid-project report.

May, 2021: Report due for Showcase 2021 booklet.

Spring, 2021: CHNA 15 Showcase 2021 featuring MiniGrants and other CHNA 15 funded projects

6/30 – 12/31/21: Projects must be completed. Summary Report, evaluation, and year-end itemized expense sheet

due within one month following completion of the funded project.

Appendix B Eligibility and Assessment Criteria

Eligibility

CHNA 15 is seeking applications for funding from non-profit organizations and/or public entities including service providers, health and community-based organizations and coalitions, municipalities, schools, and communities of faith who are interested in improving community health. Hospitals are not eligible for funding, but are encouraged to participate as partners. Current Calendar Year 2020 MiniGrant recipients (January 1 – December 31, 2020 projects) are NOT eligible. Previous recipients of any other CHNA 15 grant(s) are eligible.

Eligibility Requirements:

• Applicant must serve people in one or more of the CHNA 15 communities.

• Collaboration must be demonstrated and a lead agency identified.

• Applicant must be a tax-exempt 501C3 under the IRS code or a public entity. If applicant is not a 501C3 they must have a Fiscal Agent who is a 501C3 or partner with an agency with an IRS designation as a 501C3, a Section 170, or other IRS non-profit designation.

MiniGrant Application Requirements and Assessment Criteria

Budget Exclusions and Requirements:

➢ No application may exceed a $7,500 budget request.

➢ Capital expenses may not exceed 10 % of the total budget

➢ If agency overhead and/or fringe benefits are included, it may not exceed 7% of the total budget.

➢ Grant funds can be spent only on staff expenses related to the MiniGrant project.

➢ Hotel and transportation expenses, beyond local mileage expenses, are NOT eligible expenses and should not be included in proposed budget.

Proposals will be evaluated against the following Assessment Criteria:

➢ Complete numbered responses to all Application Components

➢ Likelihood of potential success with project

➢ Content and Quality of the proposal – as considered by reviewers:

Content is an assessment of whether the applicant has responded to each sub-section of the question; that is, the presence or absence of the required information. Quality of a response is its degree of excellence.

Appendix C Healthy Community Focus and Healthy Community Principles

CHNA 15 programming and funding efforts focus on establishing a broader, more comprehensive approach to developing

healthier communities. Healthy Communities is an approach to understanding and improving health and well-being built

on decades of work and the thinking of individuals and organizations around the world.

The Healthy Communities concept facilitates new collaborations and brings together a variety of community members to identify shared visions and to create new projects. CHNA Members are encouraged to work toward creating healthier communities in each of the twelve CHNA 15 communities, between organizations, or between CHNA 15 member towns.

Within Healthy Communities efforts, health is not merely access to healthcare and the absence of disease, but strengthening positive social, mental, physical, economic and environmental conditions conducive to health and well-being. The focus is deliberately broad to encompass the ideals of CHNA 15 as well as a member’s agency’s mission. A healthy community is defined as one that supports the health and welfare of its members by following the Healthy Community Principles as listed below.

|Healthy Community Principles |

|Source: Darvin Ayre, Gruffie Clough, Tyler Norris Principals, Community Initiatives, LLC. |

|Communities across the nation are using a variety of change models and planning processes to work together to achieve their vision of improved health. Regardless of approaches |

|taken to meet their challenges, the following principles are guiding the most successful initiatives. |

|A broad definition of "health" Health is not just the absence of disease. Health is defined broadly to include the full range of quality of life issues. It recognizes that |

|most of what creates health is lifestyle- and behavior-related. Other major factors are genetic endowment and the socio-economic, cultural and physical environment. Health is a|

|by-product of a wide array of choices and factors, not the simply the result of a medical care intervention. |

|A broad definition of "community" By using as broad a definition as possible of what makes up a community, individuals and partnerships can address their shared issues in the |

|most fruitful way possible. Communities are inclusive and can be based on faith, perspective, land and profession, as well as being determined by geographic lines. |

|Shared vision from community values A community's vision is the story of its desired future. To be powerful and inspiring, a community's vision should reflect the core values |

|of its diverse members. A vision is not just a statement on the wall - it is a living expression of shared accountability to priorities. |

|Address quality of life for everyone Healthy communities strive to ensure that the basic emotional, physical and spiritual needs of everyone in the community are attended to. |

|Diverse citizen participation and widespread community ownership All people take active and ongoing responsibility for themselves, their families, their property and their |

|community. A leader's work is to find common ground among participants, so that everyone is empowered to take direct action for health and influence community directions. |

|Focus on "systems change" This is about changing the way people live and work together. It is about how community services are delivered, how information is shared, how local |

|government operates, and how business is conducted. It's about resource allocation and decision making, not just "nice" projects. |

|Build capacity using local assets and resources This means starting from existing community strengths and successes and then investing in the enhancement of a community's |

|"civic infrastructure." By developing an infrastructure that encourages health, fewer resources need to be spent on "back end" services that attempt to fix the problems |

|resulting from a weak infrastructure. |

|Benchmark and measure progress and outcomes Healthy communities use performance measures and community indicators to help expand the flow of information and accountability to |

|all citizens, as well as to reveal whether residents are heading toward or away from their stated goals. Timely, accurate information is vital to sustaining long-term community|

|improvement. |

Appendix D Massachusetts State Priorities

Massachusetts State Priorities 2015-2020

• Health and Racial Equity: Promote health and racial equity across all MCH domains by addressing racial justice and reducing disparities.

• Preventive Care: Promote equitable access to preventive health care including sexual and reproductive health services.

• Substance Use: Address substance use among women of reproductive age to improve individual and family functioning.

• Healthy Lifestyle: Improve environments, systems, and policies to promote healthy weight, nutrition, and active living.

• Violence & Injury: Promote safe, stable, nurturing environments to reduce violence and the risk of injury.

• Environmental Health: Reduce the impact and burden of environmental contaminants on children and their families.

• Medical Home: Increase connections to Medical Home for all children, including those with special health needs.

• Transitions: Support effective health-related transition to adulthood for adolescents with special health care needs.

• Oral Health: Promote equitable access to dental care and preventive measures for pregnant women and children.

• Emotional wellness & social connectedness: Promote emotional wellness and social connectedness across the lifespan.

Appendix E

CHNA 15

Website:

CHNA 15 is one of 27 Community Health Networks across Massachusetts created by the Department of Public Health in 1992. Active since that time, CHNA 15 is a partnership between the Massachusetts Department of Public Health, Regional Center for Healthy Communities, residents, hospitals, local service agencies, schools, businesses, boards of health, municipalities, and other concerned citizens who work together through local collaborations to:

• identify health needs of member communities,

• find ways to address those needs, and

• improve the social and physical health of the community.

CHNA 15 is composed of citizens from Acton, Bedford, Boxborough, Burlington, Carlisle, Concord, Lexington, Lincoln, Littleton, Wilmington, Winchester and Woburn. Participation is open to those interested in joining others to work toward the goal of healthier communities.

CHNA 15 activities are funded by Lahey Hospital and Winchester Hospital through the Department of Public Health’s five-year Determination of Need (DoN) process.

CHNA 15 members and associates

• network and share ideas with people with similar interest in building healthier communities,

• gain knowledge about a range of health related issues and topics,

• participate in designing and implementing health improvement projects,

• advocate for health issues that are important to their community,

• benefit from scholarships and Capacity Building Grants for themselves and their agencies,

• apply for grants for projects for community physical and social health improvement, and

• attend and/or provide a variety of trainings designed to enhance & strengthen community work.

As part of this statewide effort to develop, implement, and integrate community projects that effectively utilize community resources to create healthier communities, CHNA 15 has the following Mission Statement:

We pledge ourselves to working together to build healthier communities through community-based prevention planning and health promotion. To enhance its purpose CHNA 15 established a Vision Statement as follows: We declare that each and every community will be a safe and supportive environment that empowers community residents to develop self-esteem and personal responsibility to make positive and healthy life choices.

Anyone interested in becoming involved, wanting information on activities, wishing to be added to our ListServ, or any other opportunities offered by CHNA 15, may contact: Randi Epstein, CHNA 15 Coordinator, at CHNA15Coordinator@ or visit our website at .

Appendix F Definitions of Terms[2]

Lead: The lead is responsible for overseeing the grant, and making sure that the project is moving along with team. The lead is also the primary contact person for the CHNA with respect to questions and reporting. Funding is given to the lead, and then is dispersed according to the proposal. The lead has ultimate responsibility for the grant.

Goal: The goals state in broad terms what you want to accomplish.  They incorporate the purpose and the outcomes.

Objective: Objectives state in measurable terms the desired outcomes of the project.

Outcome: An outcome objective describes a change or a result.

Activity: An activity is what the people who deliver the program do: provide counseling, teach classes, create websites, make art, etc. OR what the people who receive program services or participate in programs do: attend counseling sessions, go to class, use websites, make art, etc. An activity is a task, a method, an approach, an ACTION.

Sustainability3: The continuation of community health and quality of life benefits over time2 achieved through the availability of other resources necessary to implement the work, or through other strategies.

Best Practices: A best practice is a technique or methodology that, through experience and research, has been proven to reliably lead to a desired result.

In-Kind: Paid or given in goods, commodities, or services instead of money; paying or returning something of the same kind as that is received or offered.

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[1] Definitions of “Lead, Goal, Objective, Outcome, and Activity” are from a Grantwriting training conducted by Cynthia Barger for the Regional Center for Healthy Communities (Metrowest).

3Sustainability Toolkit, Center for Civic Partnerships

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