Questions? Contact Kate Shirah (Kate@rexendowment.org or 919-781-5852).

Letters of intent must be e-mailed by 5 PM on Thursday, November 6, 2008 to: Kate@rexendowment.org

Grantmaking Rationale

The John Rex Endowment invests in the development and support of activities, programs and organizations that improve the health of underserved people in Wake and surrounding counties. Currently, the Endowment supports visible and measurable improvements in the health of children and youth by improving access to health services, by promoting healthy behaviors and by providing opportunities for growth and development.

For the current grant cycle, the John Rex Endowment is distributing this request for proposals (RFP) for programs that fit within the "Access to Care" portfolio.

Relevant Wake County Statistics:

Percent of Children (age 0-17) Without Health Insurance (2005)*

Number of Medicaid Eligibles (June 2007 Totals)*

Percent of Medicaid-Enrolled Children (age 0-18) Receiving Health Check Preventive Services (2006/2007)*

Number of Wake County Children Served in Public Mental Health System*

Funding Guidelines

The Endowment funds 501(c) (3) nonprofits designated as public charities and government agencies that focus on improving the health of children and youth in Wake County.

The Endowment requests proposals that benefit underserved children and/or youth in Wake County. Proposals that demonstrate collaborations among organizations are encouraged.

Both the grant term and the financial request should be determined by the desired outcomes of the proposal. Grantees must be able to submit interim and final written reports on their programs and participate in one-on-one and/or group meetings for mutual learning and development.

Submitted proposals should target one of the following outcomes: 1) improving the system of primary physical and/or mental health care for children and youth; 2) reducing disparities in access to physical and/or mental health care for children and youth; or 3) improving the information technology (IT) capacity of agencies providing physical and mental health services to underserved children and youth.

• Proposals should incorporate strategies using the best available evidence of effectiveness in addressing targeted outcomes. Such demonstration can include established best practice guidelines, reviews of the research evidence, and/or a foundation in theory.
• Preference will be given to proposals that provide evidence of a sustained benefit beyond the term of the grant (i.e., programs that seek to improve access to care through changing organizational or community policies and environments).
• Preference will be given to new programs, or existing programs to be improved through incorporation of new strategies.

1. Improving the system of primary physical and/or mental health care for children and youth.

Priority consideration will be given to programs that:

• Develop a collaborative process to ensure a coordinated, comprehensive, and culturally-appropriate system of care for children and youth.
• Foster or strengthen connections between physical, mental, and/or behavioral health providers through:
  • Creating stronger linkages between physical, mental, and behavioral services for children and youth by improving assessment and referral processes; OR
  • Maximizing the appropriate and effective use of pediatric primary care physical and/or mental health services.
• Implement support programs for pediatric primary care providers with the goal of increasing their capacity to provide services to underserved children and youth.

Resources:

• North Carolina Department of Health and Human Services
• American Academy of Pediatrics
• Centers for Disease Control and Prevention "Healthy Youth!"

2. Reducing disparities in access to physical and/or mental health care for children and youth.

Priority consideration will be given to programs that:

• Develop programs that identify and address factors contributing to differential access to physical and/or mental health care by race/ethnicity, age, socioeconomic status or geography.
• Explore ways to streamline the process to enroll and/or re-enroll children and youth in public health insurance.
• Build permanent capacity in traditional health systems for making operations more accessible and culturally-appropriate.
• Strengthen connections and promote collaboration between community-based programs for underserved children and/or youth and traditional health systems through:
  • Integrating information and education resources regarding existing community health services or public health insurance programs into the services of agencies serving children and/or youth that do not currently focus on health; OR
  • Developing resource and referral programs to improve the ability of traditional health systems to connect children, youth, and/or their families to existing health or social service programs in the community.

Resources:

• North Carolina Office of Minority Health and Health Disparities
• American Public Health Association Health Disparities Database

3. Improving the information technology (IT) capacity of agencies providing physical and mental health services to underserved children and youth.

The Endowment recognizes the effect of an agency's IT capacity on their ability to provide high quality and efficient services. Thus, the Endowment will accept proposals to help agencies pursue their missions more effectively through the acquisition and implementation of new technology. Eligible agencies for proposals related to this outcome are 501(c)(3) nonprofits designated as public charities that either (1) primarily focus on providing physical and mental health services to Wake County children and/or youth, or (2) fulfill a core function in the Wake County physical or mental health system of care for underserved children and/or youth.

Priority consideration will be given to programs that:

• Streamline service or billing data entry and tracking mechanisms; therefore, allowing providers to invest more time in direct client services.
• Develop or improve information systems that support providers in the delivery of high quality care (e.g., a resource and referral system).

Application Instructions

Proposal process and timeline:

The grant review process involves two steps:

• Step 1: Grantseekers must submit a letter of intent via email (Kate@rexendowment.org) no later than 5 PM on Thursday, November 6, 2008 for consideration by the Endowment for a full review. Grantseekers will be notified of their consideration status by noon on Wednesday, November 12, 2008.
• Step 2: Grantseekers invited to apply for full review must submit a proposal in hard copy and by e-mail. Both versions must be received by noon on Friday, January 9, 2009.
  • In addition to individual meetings, grantseekers applying for a full review will have the opportunity to participate in a call-in information session from 11:15 AM to 12:30 PM on Wednesday, November 19, 2008.
  • The Endowment's Health Improvement Committee will review proposals by the end of January 2009. Grantseekers will be notified of status following the Health Improvement Committee meeting.
  • The Health Improvement Committee will take funding recommendations to the Board of Directors in February 2009 for funding approval. Grantseekers will be notified of status following the Board meeting.

Step 1: Letter of Intent Guidelines

Grantseekers responding to this RFP must submit a letter of intent to be considered for full review. The letter should be no more than two pages, and must be typed using a font size of 10 pt or larger. The letter of intent must include the following information:

1. Name and type--501(c) (3) or government--of agency/organization(s) requesting funds. Please note whether the program involves a collaboration with one or more agencies (and list names of key partners).
2. Contact name, telephone number, and email address for the program.
3. Name and brief description of the purpose of the program. The program description should clearly state which targeted outcome and desired strategies listed in this RFP will be addressed.
4. Target population, including how this population fits within the Endowment's focus on addressing the needs of underserved children and youth.

For programs addressing Outcomes 1 or 2:

5. A concise statement summarizing: a brief description of the assessed need(s) or gap(s) in services specific to Wake County for the target population you've identified, how the program will address the need(s) or gap(s) in services, and why your agency/organization(s) is well-suited to implement this program.

For programs addressing Outcome 3:

6. A statement describing how your agency fits the specified eligibility criteria for programs addressing this outcome.
7. A brief description of your agency's IT capacity needs and how the program will improve your agency's ability to provide high quality and efficient services to underserved children and/or youth.

Step 2: Full Proposal Guidelines

If invited, grantseekers should be prepared to submit a full proposal. The proposal must be typed using a font size of 10 pt or larger and must not exceed ten pages (including cover and signature page). The proposal will need to include the following components in the order listed:

1. Proposal cover page.
2. A description of your agency/organization, including background, goals, and current programs.
3. A statement of need summarizing the issue that the proposed program addresses and the target population. The statement of need should not include generally accepted knowledge (e.g., improving access to care is related to better health outcomes). Rather, the statement of need should focus on describing the need(s) or gap(s) in services specific to Wake County and/or your agency/organization: What about Wake County makes this need a priority? What do you know from your client and service data that highlights this issue as a need?
4. A description of the proposed program. This information may be presented in narrative, with a table, using a logic model, or any combination of these. The program description should include the following elements:
   1. A statement of purpose and intended outcomes (the changes or benefits you wish to see happen as a result of the program). You should include short-term and long-term outcomes.
      • Examples of short-term outcomes might include: increased referral rates to behavioral health services from primary physical and mental health providers or ability of primary care providers to use a resource and referral database.
      • Examples of long-term outcomes might include: reduced school suspension and expulsion rates or the development of new services to address gaps in the system of care for adolescents.
   2. Your strategy or approach (e.g., a provider education program on appropriate and effective care for adolescents) in achieving intended outcomes. Please include a summary of the best available evidence demonstrating effectiveness, or the strong potential thereof, of this strategy: Why is this strategy the best choice for addressing the stated need?
   3. Key, or major, activities that will be implemented in line with your designated strategy. For the sample strategy above--a provider education program--example key activities might include the following: 1) assessment of existing resources and training materials for providers of adolescent primary care, 2) implementation of a training program for primary care providers, and 3) development of an ongoing system for continuing education opportunities on adolescent health in Wake County.
   4. d) Program timeline.
5. If this program represents a collaboration, a list of key partner agencies/organizations. The list should specify for each key partner what role the agency/organization will fulfill and/or what resources the agency/organization will contribute.
6. An outline of how your agency/organization(s) will evaluate the implementation of the program (i.e., what worked and what didn't) and whether the program achieves intended outcomes. This outline should include specific questions you want to answer about your program as well as some ideas of ways you can answer these questions.
7. Evidence of the organizational capacity and appropriateness to implement and sustain the program.
8. A statement of expectation as to whether grant-supported key activities will continue after Endowment funding. If not, briefly state why. If yes, briefly describe the fiscal plan to continue the program.
9. The amount and term (months) of financial support sought from the Endowment, as well as a brief description of how intended funds will be used. Please include a justification for each significant line item expense.
10. The proposed program budget using the Endowment's budget spreadsheet. Endowment funds may be used to cover both direct and indirect expenses associated with the proposed program. The Endowment will consider payment for indirect expenses not to exceed 8% of Endowment-paid direct expenses.
    • Direct expenses are clearly and easily attributable to a specific program and to the objectives of the proposal.
    • Indirect expenses, or overhead, are not easily identified with a specific program but are necessary to conduct the grant. Examples of indirect expenses include rent, utilities, housekeeping, bookkeeping and Internet charges.
11. A list of your agency/organization's board of directors and key management staff.
12. A copy of your agency/organization's operating budget with revenue sources for the current fiscal year. (Not included in 10-page limit)
13. Proposal signature page.