Susan G. Komen Southwest Florida Community Grants Program Request for Applications (RFA)

Transcription

1 Susan G. Komen Southwest Florida Community Grants Program Request for Applications (RFA) Applications are due by 11:59 p.m. EST on December 11, 2015 Funding Opportunity Susan G. Komen Southwest Florida (SGKSF) is currently offering grants through its Community Grants program of up to $75,000 for projects in the area of breast cancer screening, diagnosis, treatment, and support services programs. The amount of funds requested should be proportionate to the potential number of clients served by the project. All proposals should target services not otherwise available to the medically underserved populations of Charlotte, Collier, Glades, Hendry, and Lee counties. Grants are awarded in one-year cycles, based on a competitive grant review process. SGKSF awards grants based on the merit of current requests; it also reviews grant requests, in the aggregate, to insure the broadest coverage to the Affiliate s entire service area. About Susan G. Komen Nancy Brinker promised her dying sister, Susan G. Komen, that she would do everything in her power to end breast cancer. In 1982 that promise became the organization that launched the global breast cancer movement. Komen has funded more than $847 million in research and provided more than $1.8 billion in funding to screening, diagnosis, treatment, and education serving millions of people in more than 30 countries worldwide. About Komen Southwest Florida Susan G. Komen Southwest Florida was established in late The Affiliate joined hundreds of thousands of breast cancer survivors and activists around the globe who form the world s largest and most progressive grassroots network fighting breast cancer. Annually, SGKSF awards 75% of its net proceeds directly back to its local service area through its Community Grants program. Organizations receiving funds provide breast health and breast cancer services for eligible individuals in the geographic service area who do not have health insurance or who are medically underinsured. Through events like the Komen Southwest Florida Race for the Cure, more than $7.1 million in grant funding has been awarded since 2002 through the competitive grant process. 1

2 The remaining 25% of SGKSF s net annual proceeds is awarded to the Susan G. Komen for the Cure Award and Research Grant Programs to support research, educational, and scientific programs around the world. To date, Southwest Florida has provided more than $2.2 million to the global research program. Community Profile for Komen Southwest Florida The Community Profile is a needs assessment used to determine funding priorities as it relates to SGKSF s key funding priorities (see section below). Komen Southwest Florida s last Community Profile was published in 2011 and the process for compiling data for the 2015 Community Profile is well underway. Applicants can access both of these documents on the komenswfl.org website as of November 1, Funding Priorities of Komen Southwest Florida SGKSF has identified the following needs to be addressed in this year s grant cycle: 1. Within a continuum of care, provide access to screening, diagnosis, and treatment for eligible individuals in the geographic service area who do not have health insurance or who are medically underinsured. 2. Within a continuum of care, cultivate Charlotte County community outreach and services as defined by the 2016 Community Profile. 3. Within a continuum of care, use evidenced-based, culturally competent education and outreach methods designed to increase mammography utilization among at-risk eligible individuals. 4. The Affiliate will insure that grant awards are made to a minimum of three counties in the Affiliate s service area: Charlotte, Collier, and Lee counties. Program Areas to be Funded The priority areas to be addressed are screening, diagnostics, treatment, and support services. Screening Programs A screening program increases access to screenings and/or changes attitudes and beliefs that affect behavior related to breast cancer control and breast cancer outcomes. Examples of screening program interventions include, but are not limited to: o Reducing the costs of mammography to patients o Reducing barriers to mammography o Providing translation/interpretation services o Using both out-reach and in-reach methods to enroll clients o Patient navigation 2

3 Diagnosis Programs A diagnosis program influences attitudes and beliefs that impact adherence to treatment, advocates prevention protocol, and promotes behaviors that lessen treatment-related morbidity. Examples of diagnosis program interventions include, but are not limited, to: o Reducing the costs of diagnostic services o Reducing barriers to diagnostic services o Providing translation/interpretation services o Patient navigation Treatment Programs A treatment program influences the attitudes and beliefs of breast cancer patients on compliance to treatment and prevention protocols. Examples of treatment program interventions include, but are not limited, to: o Reducing the out-of-pocket costs for treatment o Reducing costs for treatment services o Patient navigation For the purposes of navigation, the position of Breast Health Navigator must comply with the following definition: A Breast Health Navigator should be a Registered Nurse who will provide patient navigation services to guide local breast cancer patients through the healthcare system by assisting with access issues, coordinating with service providers, etc. This person should be responsible for promoting breast health - and assist uninsured/underinsured individuals in obtaining breast health services. Additionally, the Breast Health Navigator is expected to track interventions and outcomes. This person must have a background and familiarity with women s health issues and breast cancer, as well as possess knowledge of community resources and hospital processes regarding a diagnosis of breast cancer, Support Services Programs SGKSF will fund Support Services programs at a rate not to exceed 20% of the total amount available to award for Community Grants. A support program assists breast cancer patients with physical, emotional, and psychosocial issues associated with cancer. Examples of treatment support interventions include, but are not limited to: o Providing financial assistance in the form of rent and insurance payments during treatment o Support groups o Side-effect management o Reducing barriers to treatment such as transportation etc. 3

4 Education Programs Note: These programs will not be funded in the grant cycle; however the SGKSF Affiliate encourages grantees to collaborate with the Affiliate on such efforts. An education or outreach program educates health care providers, at-risk populations, and/or the general population about breast health and breast cancer. Education program include, but are not limited, to: o One-on-one education o Group education o Developing communication tools for specific populations o Hosting events in accessible venues Health Care Delivery/Systems Change Programs SGKSF does not provide funding for Health Care Delivery/Systems Change Programs. 4

5 Guidelines and Instructions for Applicants Eligibility Applicants must meet the following eligibility criteria to be considered for funding: Program must be specific to breast health and/or breast cancer. If a program includes other health issues along with breast cancer, such as a breast and cervical cancer program, funding may only be requested for the breast cancer portion. All past and current Komen-funded grants or awards to Applicant are up-to-date and in compliance with Komen requirements. Applicant has current tax exempt status under the Internal Revenue Service code. Applicant must be a non-profit organization located in or providing services to one or more of the following locations: Charlotte, Collier, Hendry, Glades, and Lee counties. If applicant, or any of its key employees, directors, officers or agents is convicted of fraud or a crime involving any other financial or administrative impropriety in the 12 months prior to the submission deadline for the application, then applicant is not eligible to apply for a grant until 12 months after the conviction. After such 12 month period, applicant must demonstrate in its application that appropriate remedial measures have been taken to ensure that any criminal misconduct does not recur. Non-profit agency demonstrates good financial stewardship by providing evidence of good practice. Such evidence can include one of the following, or another related document: an organizational policy statement regarding revenue and expense ratios, a standard of fund accountability, financial statements, IRS Form 990, a national non-profit rating, etc. Funding and Allowable Expenses Applicants may request funding up to $75,000 for one year. Funds may be used for the following types of expenses provided they are directly attributable to the program: Salaries and fringe benefits for program staff. Salaries, if requested, are for personnel expense related to this program only and not the general work of employee. Such salaries must not exceed competitive rates. A cap of 50% of an individual s salary can be included in the grant request and only the portion of the individual s salary that pertains to the grant program may be included in the grant application. For example, if the total salary is $50,000 and the individual spends 90% of their time on the grant program, then only 50%, of 90% of the salary, may 5

6 be included in the request. Ninety percent of the $50,000 total salary equals $45,000; the grants will cover up to 50% of the salary, or $22,500. A complete job description must be included in the grant request. Clinical services or patient care costs. Diagnostic and treatment reimbursement costs are defined by 2016 Medicare reimbursement schedules. Supplies, e.g. brochures, booklets, videos, etc. that further the Komen educational mission (Komen-branded supplies). A breakdown of these program supplies should be explained in the narrative portion of the grant. Reasonable staff travel/patient transportation costs related to the execution of the program (screening, diagnostics, treatment, and education/outreach). Other Expenses A breakdown of non-medical items should be explained in the narrative portion of the grant. Funds may not be used for the following purposes: Medical or scientific research Development of educational materials or resources Construction or renovation of facilities Consultants Equipment/Computers Political campaigns or lobbying Endowments General operating funds (including indirect costs) Debt reduction Annual fund-raising campaigns Event sponsorships Meeting costs Projects completed before the date of grant approval Individuals Reimbursement for specific individuals direct services Capital campaigns Employee matching gifts Land acquisition Program-related investments/loans Scholarships or fellowships Conferences for personnel Education regarding breast self exams/use of breast models Thermography 6

7 Important Granting Policies Please note these policies before submitting a proposal as they are non-negotiable. No expenses may be accrued against the grant until the agreement is fully executed. Any unspent funds within the grant cycle must be returned to Komen. Grantee will be required to submit scheduled progress reports and one final report that will include, among other things, a detailed itemized accounting of expenditures. A fully executed Grant Contract will be the legal mechanism for funding. Certain insurance coverage must be demonstrated at the execution of the grant agreement, if awarded: o Commercial general liability insurance with combined limits of not less than $1,000,000 per occurrence and $2,000,000 in the aggregate for bodily injury, including death, and property damage; o Workers compensation insurance in the amount required by the law in the state(s) in which its workers are located and employers liability insurance with limits of not less than $500,000; and o Excess/umbrella insurance with a limit of not less than $5,000,000. o In the event any transportation services are provided in connection with program, $1,000,000 combined single limit of automobile liability coverage will be required. o If any medical services (other than referrals) are provided or facilitated, medical malpractice coverage with combined limits of not less than $1,000,000 per occurrence and $3,000,000 in the aggregate will be required. o Grantees are also required to name Susan G. Komen Breast Cancer Foundation, Inc., Susan G. Komen [Affiliate name], its officers, employees and agents as Additional Insured on the above policies. o Grantees are required to name Susan G. Komen Southwest Florida as an Additional Insured on each of the above policies. Educational Materials and Messaging Susan G. Komen is a source of information about breast cancer. To reduce confusion and reinforce learning, we require that grantees provide current educational messages and materials that are consistent with those promoted by Komen, including promoting the messages of Breast Self Awareness: 1) Know your risk 2) Get screened 3) Know what is normal for you 4) Make healthy lifestyle choices 7

8 Komen does not recommend monthly breast self-exams and therefore will not fund education programs that teach monthly breast self-exam procedures or that use breast models. The consistent and repeated use of the same messages will improve retention and the adoption of the actions we think are important. Please visit the following webpage before completing your application and be sure that your organization can agree to promote these Breast Self Awareness messages rather than breast self-exam messages: Komen materials should be used and displayed whenever possible. To view our educational materials, visit Komen Grantees are eligible to receive preferred pricing for Komen educational materials. Susan G. Komen has developed a Breast Cancer Education Toolkit for Hispanic/Latina communities. It is designed for educators and is a great resource that organizations can implement in their communities. This tool is available free online in both English and Spanish versions at Submission Requirements All applications must be submitted online through the Komen Grants Electronic Management System (GeMS): This includes the application and all required attachments, progress reports, and the organization s final report. Applications must be received in the GeMS system on or before December 11, 2015 at 11:59 p.m. EST. No late submissions will be accepted by the GeMS system. Number of Grants Awarded The number of awarded grants will depend on the amount of funding available for the grant year, the number of grant applications approved by the independent review panel, and the requested amount per project. The Affiliate desires to award grants to applicants covering our five-county region with emphasis on Charlotte, Collier, and Lee counties. Confirmation of Receipt of Application When the application has been submitted, GeMS will send the applicant s Authorized Signer an automated indicating that an authorized signature is required. The Authorized Signer will need to log-in to GeMS and change the status of the application to Submitted. The Authorized Signer will receive an automated once the status has changed. 8

9 Application Input into GeMS The application must be completed and submitted via Komen s Grants Electronic Management System (GeMS), available at If the applicant already has access to GeMS, the organization may begin the application process by clicking on My Opportunities on the GeMS homepage once the RFA becomes available. When initiating an application on GeMS, please make sure it is a Community Grants application, designated CG. Applicants needing access to GeMS will need to contact Dr. Noreen Thomas at SGKSF at noreen@komenswfl.org for help with the registration and log-in procedures. Throughout the application, adherence to the word count limit is very important. It is recommended that you prepare and save your grant in Microsoft Word and then move it over by section to GeMS. Development of your grant application in Word will allow you to use features such as spell-check and grammar check. The following is a brief outline of the application categories. A GeMS Applicant User Guide has detailed instructions for how to fill out the application. Application Instructions The application will be completed and submitted via the Komen Grants e-management System (GeMS), The required sections/pages in GeMS are listed in ALL CAPS and described below. For an application instruction manual, please visit the Affiliate s Grants webpage, or contact Dr. Noreen Thomas at or noreen@komenswfl.org. When initiating an application on GeMS, please make sure it is a Community Grants application, designated CG, and not a Small Grants ( SG ) application to apply to this RFA. PROJECT PROFILE This section collects basic organization and project information, including the title of the project, contact information and partner organizations. Attachments for the Project Profile page (if applicable): Letters of support or memoranda of understanding from proposed collaborators To describe the nature of the collaboration and the services/expertise/personnel to be provided through the collaboration. ORGANIZATION SUMMARY This section collects detailed information regarding your organization s history, mission, programs, staff/volunteers, budget, and social media. 9

10 PROJECT PRIORITIES AND ABSTRACT (limit 1,000 characters) This section collects important information to classify the focus of the project, the priorities to be addressed and a summary of the project (abstract). This abstract should include the target communities to be served, the need to be addressed, a description of activities, the expected number of individuals served and the expected change your program will likely bring in your community. The abstract is typically used by the Affiliate in public communications about funded projects. PROJECT NARRATIVE This section is the core piece of the application. On the Project Narrative page of the application on GeMS, please address the requests below for each section. Statement of Need (limit- 5,000 characters) Describe the population to be served. Describe evidence of the risk/need within that population, using the RFA funding priorities and the 2016 Community Profile as a guide. Provide population characteristics (race, ethnicity, economic status, and breast cancer statistics) specific to the target population. Describe how this program aligns with Komen Southwest Florida Affiliate target communities and/or RFA funding priorities. Program Design (limit- 5,000 characters) Explain the program s goal and objectives, as outlined in your Project Work Plan. Explain how the program will increase the percentage of people who enter, stay in, or progress through the continuum of care. Explain how the program is culturally competent. Explain if and how the program is evidence-based and/or uses promising practices (please cite references). Applicants should include references/citations (e.g., in Program Design text box or separate reference page upload, what style of citations). Describe program collaboration and the roles and responsibilities of all organizations or entities participating in the program. Explain how the collaboration strengthens the program and why partnering organizations are best suited to assist in carrying out the program and accomplishing the goal and objectives set forth in this application. Organization Capacity (limit- 5,000 characters) Explain why the applicant organization, Project Director and staff are best-suited to lead the program and accomplish the goals and objectives set forth in this application. Please include appropriate organization or staff licenses, certifications and/or accreditations. Describe evidence of success in delivering breast health/cancer services to the proposed population. If the breast health/cancer program is newly proposed, describe relevant success with other programs. 10

11 Describe the equipment, resources, tools, space, etc., that the applicant organization possesses or will utilize to implement all aspects of the program. Describe fiscal capability to manage the delivery of the proposed goals and objectives and ensure adequate measures for internal control of grant dollars. Describe the organization s current financial state. How has your organizational budget changed over the last three years? Please explain increase or decrease. Describe the plan to secure and allocate resources (financial, personnel, partnerships, etc.) to sustain the program at the conclusion of the grant period. Describe the efforts you will take to communicate this program to your organizational leadership to ensure long-term support/buy-in. Address the financial stewardship of your organization by discussing your expense/profit ratio or any other standard you employ to insure financial stewardship. Monitoring and Evaluation (limit- 5,000 characters) Grantees will be required to report on the following outputs and outcomes in the progress and final reports: successes and accomplishments, challenges, lessons learned, best practice example, story from an individual that was served with the funding and number of individuals served for each objective (county, race and ethnicity, age and population group). Describe in detail how the organization(s) will measure progress against the stated program goal and objectives. Please include any templates, logic models, or surveys as attachments in the Project Work Plan Objectives page. Describe how the organization(s) will assess how the program had an effect on the selected priority. Please include any templates, logic models, or surveys as attachments in the Project Work Plan Objectives page. Describe how the organization(s) will assess program delivery. Please include any templates, logic models, or surveys as attachments in the Project Work Plan Objectives page. Describe the monitoring and evaluation (M&E) expertise that will be available for this purpose. Describe the resources available for M&E during the course of the program. Specify if these resources are requested as part of this grant, or if they are existing organizational resources. PROJECT TARGET DEMOGRAPHICS This section collects information regarding the various groups you intend to target with your program. This does not include every demographic group your program will serve but should be based on the groups on which you plan to focus your program's attention. 11

12 PROJECT WORK PLAN In the Project Work Plan component of the application on GeMS, you will be required to submit the goal and objectives: Goals are high level statements that provide overall context for what the program is trying to achieve. Objectives are specific statements that describe what the program is trying to achieve to meet the Goal. An objective should be evaluated at the end of the program to establish if it was met or not met. The project goal should have at least one objective; there is no limit to the number of objectives. Please ensure that all objectives are SMART objectives: Specific; Measurable; Attainable; Realistic; and Time-bound You will also be required to submit the timelines, the anticipated number of individuals to be served, and the evaluation method you will utilize for each objective. Write your Project Work Plan with the understanding that each item must be accounted for during progress reporting. The Project Work Plan should only include a goal that will be accomplished with funds requested from Komen Southwest Florida. Objectives that will be funded by other means should not be reported here, but instead, can be included in your overall program description. Example Work Plan GOAL: Provide patient navigation to women with screening abnormalities in order to reduce delays in and barriers to diagnostic care. OBJECTIVE 1: During grant period, patient navigator will contact all women with an abnormal screening within three business days to schedule follow-up appointment. OBJECTIVE 2: By end of grant period, provide 30 uninsured/underinsured women free/reduced cost diagnostic procedures. Attachments for the Project Work Plan page: 1. Monitoring and Evaluation forms, surveys, logic model, etc. To monitor progress and determine the effectiveness of the proposed program. BUDGET Provide a detailed total program budget for the entire requested grant term. Budget sections include Key Personnel/Salaries, Supplies, Travel, Patient Care, and Other. For 12

13 each line item in the budget, provide a brief justification for how the funds will be used and why they are programmatically necessary. Attachments 1. Information regarding Key Personnel For key personnel who are funded by the grant and who are currently employed by the applicant organization, provide a resume or curriculum vitae (one-page limit per individual). For new or vacant positions, provide job descriptions (two-page limit per individual). 2. Proof of Tax Exempt Status To document your federal tax-exempt status, attach your determination letter from the Internal Revenue Service. Evidence of state or local exemption will not be accepted. Please do not attach your Federal tax return. 3. Letters of support or memoranda of understanding from proposed collaborators (if applicable) To describe the nature of the collaboration and the services/expertise/personnel to be provided through the collaboration. 4. Evaluation forms, surveys, logic model, etc. To demonstrate the effectiveness of your program as defined in your Project Work Plan. 5. Documentation of Good Stewardship -- Non-profit agency demonstrates good stewardship by providing evidence of good practice. Such evidence can include one of the following, or another related document: an organizational policy statement regarding revenue and expense ratios, a standard of fund accountability, financial statements, IRS Form 990, etc. Project Budget Summary This section will auto-fill with the information already input in the Salaries, Supplies, Travel, and Patient Care costs section. In the Cash and In-Kind sections, applicants can input additional funding or in-kind services provided by partners that the program may have. The first total under Requested from Komen will outline the amount of money the program is requesting and the Total Required is a number for reviewers to see the actual costs of running the program. Applicants will be required to fill out the percentage of total funds allocated between categories. If the majority of a program s funding is directed towards screening (even if that funding is in-kind), then the screening section should have the highest percentage. If your program is providing mostly diagnostic services, then the diagnostic section should have the highest allocation of percentage. These percentages should align with the program classifications that the applicant input in the Project Abstract. 13

14 Finally, applicants will be required to provide details about any in-kind or cash funding identified in the above section. At this time, the only financial document that needs to be uploaded is proof of 501(c)3 status (one- to two-page document from the federal government). Submission Applications can only be submitted by Authorized Signers from the applying institution. Please refer to the GeMS Applicant User Guide for instructions for submitting the application. Applicant Support Questions should be directed to: Noreen Thomas Susan G. Komen Southwest Florida (239) or (239)

15 Review Process Each grant application will be checked for compliance with the RFA requirements. All applications in compliance with these requirements will be sent to the SGKSF Grants Review Panel for consideration. The Review Panel is an independent, diverse group of community volunteers who will read, score, and rank the applications. The Review Panel will consider the merit of each application, based on the following criteria: Statement of Need: Does the program provide services to one or more of the target communities described in the Affiliate s Community Profile? How closely does the program align with the funding priorities stated in the RFA? Program Design: Is the program culturally competent? Is the program evidence-based? How likely is it that the objectives and activities will be achieved within the scope of the funded program? Is the program well planned? Is the budget appropriate and realistic? Does the budget justification explain in detail the reasoning and need for the costs associated with the program? If the proposed program includes collaboration with other organizations, are the roles of the partners appropriate, relevant and clearly defined? Impact: Will the program have a substantial positive impact on increasing the percentage of people who enter, stay in, or progress through the continuum of care? Will the program have a substantial impact on the need described in the funding priority selected? Is the impact likely to be long-term? Organization Capacity: Does the applicant organization, Project Director and his/her team have the expertise to effectively implement all aspects of the program? Is there evidence of success in delivering services to the target population? Is the organization fiscally capable of managing the grant program, including having appropriate financial controls in place? Does the applicant organization have the equipment, resources, tools, space, etc., to implement all aspects of the program? Does the organization or staff have appropriate licenses, certifications, accreditations, etc. to deliver the proposed services? Does the organization have a plan to obtain the resources (financial, personnel, partnerships, etc.) needed to sustain the program beyond the grant term (if awarded)? Are collaborations (if proposed) likely to be sustained beyond the grant term? Does the applicant organization have long-term support from organizational leadership? Monitoring and Evaluation: Is there a documented plan to measure progress against the stated program goal and objectives, and the resulting outputs and outcomes? Is there sufficient monitoring and evaluation (M&E) expertise for the program? Are there sufficient resources in place for M&E efforts? The grant application process is competitive, whether or not an organization has received a grant in the past. Funding in subsequent years is never guaranteed. 15

16 SGKSF takes many actions to ensure that the grant review process is unbiased and produces funding recommendations that represent the priorities set forth by the Community Profile and/or the Request for Applications. Notification of Award All applicants, regardless of whether or not their application was approved for funding, will receive notification of their application s status at the conclusion of the Review Panel s recommendation process. Reporting and Payment Upon receipt of the signed grant contract, the payment process will begin, with the first payment being made. Additional payments will be made on a scheduled basis determined by SGKSF which will be announced at award time. The grantee will complete a progress report(s) located on the Grants e-management System (GeMS). Upon approval of the progress report, the Grantee will receive their next payment. A final report is due within thirty days of the completion of the grant period. Grantees will be expected to host the Affiliate for a site visit(s) during the grant year. Recognition of Funder Komen Grantees are required to recognize Komen Southwest Florida on all printed and/or electronic materials related to the awarded grant by properly using the current Komen Southwest Florida logo. All material must be approved by Komen Southwest Florida prior to written or electronic publication. Funder Support Applicants are strongly encouraged to attend both the Grant Applicant Workshop. See Important Dates below. If funded, Grantees are encouraged to attend SGKSF events throughout the grant cycle year. Grantees are required to participate and fundraise in the annual Race for the Cure event. For example, this may include staffing of their own organization s info table in the Expo Area of the Race. This is an important aspect of the entire grant process because it allows community supporters to have a concrete understanding of how the monies raised are being invested back into their own community. 16

17 Important Dates The Award Period for the grants (known as the 2016 grants) is April 1, March 31, Grant Writing Workshop November 5, :30 a.m.-12 Noon Attendance is strongly recommended RSVP your attendance to (239) Workshop Location: Hodges University, Naples Campus Gainer Bldg. Room G Northbrooke Dr. Naples, FL Application Deadline December 11, 2015 at 11:59 p.m. EST Award Notification April 16, 2016 (on or about) Reporting and Site Visits New Grantees* may have a customized reporting structure to follow. *Includes Grantees who have experienced significant staff or programmatic changes, as determined by Komen Southwest Florida Returning Grantees: August 31, 2016 Progress Report #1 Due Fall 2016 Formal Site Visit December 30, 2016 Progress Report #2 Due May 15, 2017 Final Report Due 17

18 Appendix Community Profile for Komen Southwest Florida A summation of key quantitative data findings for Komen Southwest Florida s Community Profile are identified below. Because the data was collected by county it has been categorized below the same way. Komen Southwest Florida is providing the information as generalized data for reference only and is not asking for grant applications to be written based on geography. Rather, Komen Southwest Florida wants applications to be written in accordance with the Program Areas to Be Funded section of this document. 1. Charlotte County Charlotte County currently meets the target of 41.0 cases per 100,000 females based on the CDC s HP2020 target goals for latestage breast cancer; Charlotte County s base rate for the years is 33.5 cases per 100,000 females. It is predicted that Charlotte County will need 5 years to meet the breast cancer death rate target of the Centers for Disease Control and Prevention s (CDC) Healthy People 2020 (HP2020) goals. Charlotte County s base rate for the years is 21.4 cases per 100,000 females and the HP2020 target is 20.6 cases per 100,000 females. The proportion of women age who self-reported having had a screening mammogram within the last two years was only 72.2% in Charlotte County, lower than Florida s 76.6% and the nation s 77.5%, indicating that Charlotte County women may not have the needed access to mammogram screenings. Over 19% of Florida s females are 65 years and older. Charlotte County s older female population is much higher at 36.0% and care should be taken to ensure that this age group is receiving mammogram screenings as warranted. 2. Collier County Collier County is on track to meet both the late-stage incidence of breast cancer cases and the breast cancer death rate target of the CDC s HP2020. Programs and services are needed to ensure that these favorable trends continue. 18

19 As with all counties, we know that there are particular communities that are underserved. Collier County has several large Hispanic communities as well as a large percentage of foreign-born residents. Some of the areas in which these residents live are rural and have limited public transportation. Over one-third of Collier County s adult population age does not have health insurance, nearly double that of the nation average. Of Collier County s adult population age 40-64, 13.5% have an income below 100% of federal poverty level; over one-third are below 250% federal poverty level. 3. Lee and Western Hendry counties Lee County is on target to meet the breast cancer late-stage breast cancer diagnoses and death rate target of the CDC s HP2020 guidelines. Because Lee County is the most populous in the 5- county service area, it is important to continue to provide adequate breast health options to ensure that these favorable trends continue. Western Hendry County, which includes LaBelle, is on target to meet the breast cancer death rate target and the late-stage breast cancer diagnoses of the CDC s HP 2020 guidelines. Approximately 20% of Lee County women in the key age group might not be getting a screening mammogram at least every two years. (Respective data for Hendry County is suppressed due to small numbers.) Nearly 25% of Lee County s age group does not have any health insurance, compared to the national average of 16.6% without health insurance. In Hendry County, 34% of the population ages does not have any health insurance, the highest in the five-county service area. This is staggeringly high compared to Florida s 24.2% and the nation s 16.6% who have no health insurance. Of the five counties, Hendry County has the highest percentage of Black female residents at 14.5%, which is slightly higher than the national average. Hendry County has 46.8% Hispanic women; comparatively, Florida has 22.6% Hispanic females and there are 16.2% Hispanic females in the United States. 19

20 Hendry County s socioeconomic factors (low education levels, poverty, high unemployment, foreign born, language barriers, rural and higher incidences of uninsured residents) require that focus be placed on creating adequate breast health access systems for this population. Western Hendry, due to its limited resources, relies heavily on neighboring Lee County for medical resources. Definitions Activities: The activities are the steps a program takes to meet its objectives, tasks that will be done to accomplish this objective. Examples include reviewing evaluation data, recruiting 100 participants to attend educational sessions and following up with people who attended the sessions. Breast Health Navigator: A breast health navigator should be an RN who will provide patient navigation services to guide local breast cancer patients through the healthcare system by assisting with access issues, coordinating with service providers and help tracking interventions and outcomes. This person should be responsible for promoting breast health in the affiliate service area and assist uninsured/underinsured individuals in obtaining breast health services. This person must have a background and familiarity with women s health issues and breast cancer, possess knowledge of community resources and hospital processes regarding a diagnosis of breast cancer, and possess a minimum of an associate degree in a related health care area. Data: A list of sources that will be used to gather information on measures of effectiveness, especially for the Program Work Plan. Data sources may include: people, observations and documents. Education Programs: These are culturally-appropriate breast health programs for the target population and must link program participants with breast cancer screening and follow-up, as necessary. Programs must incorporate Susan G. Komen recommendations for Breast Self Awareness: 1) Know your risk, 2) Get screened, 3) Know what is normal for you, and 4) Make healthy lifestyle choices. Goal: A goal is a broad-based statement of the ultimate result of the program being undertaken. For example, a support program goal could be to improve the emotional wellbeing of 100 (estimate the number you expect to reach) breast cancer survivors. Grant Period and Contracts: Awarded grants will begin April 1, 2016 and will conclude on March 31, A grant contract will be the legal mechanism for funding. 20

21 Grant Review Panel: The Review Panel is an independent, diverse group of community volunteers who will read, score, and rank the applications. Letters of Collaboration: Collaboration among organizations is highly encouraged. Applicants should form partnerships with organizations that will help achieve program goals and/or provide services for the target population. Each Letter of Collaboration must define what services each collaborating organization will provide. We are not looking for letters of support. Measures (or Indicators) of Effectiveness: These measures translate program concepts and expected impacts into specific measures that can be analyzed and interpreted. There should be at least one measure of effectiveness for each objective. The change measured by an indicator should represent progress a program has made toward achieving goals and objectives. Examples of indicators include: participation rates, individual behavior, health status, and attitude. Success in achieving the goal of maintaining coalition partnerships could be measured by analyzing participation rates or the number of members at the beginning, throughout and near the end of plan implementation. An increase (or decrease/no change) in participation rate indicates level of progress toward meeting the goal. Objective: An objective is a measurable, time-specific result that the organization expects to accomplish as part of the grant. Objectives are specific approaches to achieve the goal. Objectives must be SMART: Specific, Measurable, Achievable/ Attainable, Realistic/Relevant, and Time-bound. For example, a support program objective could be: Using pre-tests at the beginning and post-tests at the end of the sixweek program, breast cancer patients will report a 75% improvement in their ability to manage stress. Patient Care: In the budget form, this section includes medical services such as screening mammograms, diagnostic services and/or treatment. It may include biopsy, diagnostic mammogram, lumpectomy, mastectomy and other related services; it does not include support services or temporary gap funding. Screening and Treatment: Refers to programs that perform free screening mammograms, diagnostic services and/or treatment with appropriate follow up for abnormal findings. Support Programs: Refers to programs that provide services for breast cancer patients ( survivors ) and their families. Examples include emotional support programs, support groups, and temporary gap funding. 21

22 Temporary Gap Funding: Temporary gap funding is a support program for breast cancer patients and their families to help them through a financial crisis. This may include transportation to appointments, insurance payments, co-pays or deductible payments that if not made would interrupt cancer treatment. Organizations that offer Temporary Gap Funding must establish and document a review board and administration guidelines. Underinsured/Uninsured: Uninsured refers to individuals who do not have health insurance. Underinsured refers to individuals who have insurance, but that insurance does not include breast cancer screening, diagnosis or treatment services or that the co-payments are prohibitively expensive. 22