EMPOWERING PEOPLE, ENERGIZING SCIENCE

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1 Because breast cancer is everywhere, SO ARE WE. At Susan G. Komen, we are committed to ENDING breast cancer forever by EMPOWERING PEOPLE, ENERGIZING SCIENCE to find the cures and ensuring QUALITY CARE for all people, everywhere. REQUEST FOR APPLICATIONS COMMUNITY GRANTS - FACILITATING ACCESS TO BREAST HEALTH SERVICES IN ISRAEL Susan G. Komen 5005 LBJ Freeway, Suite 250 Dallas, Texas Website:

2 KEY DATES Request for Application Released: January 10, 2014 Application Deadline: February 6, 2014, 12:00 p.m. Eastern Time, 17:00 GMT Award Notification: On or around April 1, 2014 Award Period: One Year ABOUT SUSAN G. KOMEN Susan G. Komen is the world s largest breast cancer organization, funding more breast cancer research than any other nonprofit while providing real-time help to those facing the disease. Since its founding in 1982, Komen has funded more than $800 million in research and provided more than $1.6 billion in funding to screening, education, treatment and psychosocial support programs serving millions of people in more than 50 countries worldwide. Komen was founded by Nancy G. Brinker, who promised her sister, Susan G. Komen, that she would end the disease that claimed Suzy s life. Visit komen.org. FOCUS AREA: ACCESS TO CARE IN ISRAEL Israel has the 5 th highest breast cancer incidence in the world and the highest in the Middle East (GLOBOCAN, 2008). In 2010, more than 5,700 women were diagnosed with breast cancer in Israel, with 1 in 7 women at risk of being diagnosed with breast cancer in their lifetime. 1 The objective of this request for applications is to solicit proposals for programs that facilitate access to services across the breast cancer continuum of care. Please see Appendix A: The Continuum of Care for additional details. Komen is only seeking proposals that address breast cancer disparities among vulnerable and underserved populations and/or among those who are at an increased risk for hereditary breast cancer. ELIGIBLE APPLICANTS/DESIGNATED RECIPIENTS Applicants must meet the following eligibility criteria: In compliance with United States Internal Revenue Service (IRS) tax laws, we only accept proposals from taxexempt/non-profit organizations. We are unable to provide funding directly to individuals. Proof of non profit status is required. Only one application can be submitted per organization/ institute. If multiple departments within an organization/ institute are interested in applying, please work collaboratively to submit one application. The project must be specific to breast health/breast cancer. Any past and current Komen-funded grants to the applicant must be up-to-date and in compliance with Komen requirements. 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, then applicant is not eligible to apply for a grant during this current cycle and will not be eligible to apply for a new grant until the later of 12 months after the conviction or until applicant can demonstrate that appropriate remedial measures have been taken to ensure that any criminal misconduct does not recur. 1 The Challenge Ahead: Progress and Setbacks in Breast and Cervical Cancers. Institute for Health Metrics and Evaluation 2011 (available at RFA 2014: Facilitating Access to Breast Health Services in Israel Page 2 of 10

3 FUNDING INFORMATION AND GRANT TERM Komen anticipates funding several applications between $50,000 and $100,000; however, applications requesting over $100,000 will not be considered. This project term must be one year. Funds may be used for the following types of program expenses: Salaries and fringe benefits for program staff. Consultant fees. Meeting costs. Supplies. Reasonable travel costs related to the execution of the programs. Other direct program expenses. Equipment, not to exceed $5,000. Indirect costs, not to exceed 10% of direct costs. Publication and printing costs. Visa costs. Funds may not be used for the following purposes: Medical or scientific research. Construction or renovation of facilities. Political campaigns or lobbying. Endowments. General operating funds (except indirect cost). Debt reduction. Annual fund-raising campaigns. Event sponsorships. Projects completed before the date of grant initiation. Building/renovation. Capital campaigns. Employee matching gifts. Land acquisition. Program-related investments/loans. Scholarships. Education regarding breast self-exams/use of breast models. Thermography. Professional membership dues. IMPORTANT GRANTING POLICIES Please carefully review these policies before submitting a proposal. These policies are non-negotiable. No expenses may be accrued against the grant until the agreement is fully executed. The contracting process can take up to 16 weeks from the date of the award letter. Any unspent funds over $1.00 must be returned to Komen. The number of no cost extensions is limited to one six-month extension per grant. Grant payments will be made in installments pending receipt of satisfactory progress reports. Grantee will be required to submit semi-annual progress reports and a final report to include all expenditures. Grantee is required to maintain general liability insurance, including errors and omissions providing coverage against bodily injury, death and property damage, or advertising injury, which may arise out of or in connection with the project. If Grantee provides transportation services in connection with its project, Grantee will be required to maintain appropriate automobile liability insurance for any owned, hired, and non-owned vehicles in order to adequately protect against any potential liabilities for all bodily injury and vehicle damage or theft. Grantee will be required to provide Komen a certificate of insurance evidencing the above coverage. RFA 2014: Facilitating Access to Breast Health Services in Israel Page 3 of 10

4 EDUCATIONAL MATERIALS AND MESSAGES Susan G. Komen is a source of information about breast cancer for people all over the world. To reduce confusion and reinforce learning, we require that grantees provide educational messages and materials that are consistent with those promoted by Komen, including promoting the messages of breast self-awareness - know your risk, get screened, know what is normal for you and make healthy lifestyle choices. 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 messages: Susan G. Komen is an evidence-based organization. Engaging in activities that are not supported by scientific evidence does not reflect our status as a reliable source of information on breast health and breast cancer. Therefore, we do not recommend monthly breast self-exams and will not fund programs that teach monthly breast self-exams or use breast models. Komen grantees are eligible to receive preferred pricing for Komen educational materials. Komen materials should be used and displayed whenever possible. To view our educational materials, visit APPLICANT INSTRUCTIONS The application must be completed on all required templates and submitted to internationalgrants@komen.org. Please internationalgrants@komen.org to request all forms and templates. Applicants must follow the application submission instructions, including page limits, and submission of required application materials. All application materials must be in English and must be submitted to internationalgrants@komen.org. No paper applications will be accepted. Failure to adhere to these instructions will result in applications being administratively withdrawn from consideration prior to peer review, without appeal. Applications must be received on or before February 6, 2014, 12:00 p.m. Eastern Time, 17:00 GMT. Applicants are strongly encouraged to complete, review, and submit their applications with sufficient time to allow for technical difficulties, varying time zones, human error, loss of power/internet, sickness, travel, etc. Extensions to the submission deadline will not be granted to allow for lateness, corrections or submissions of missing information, with the rare exception made for severe extenuating circumstances at the sole discretion of Komen. Formatting guidelines and Application Sections All application submitted materials must adhere to the following document and image guidelines. Document Format Please follow the formatting requirements below. Applications not adhering to these format requirements will be administratively withdrawn prior to review. Must be in PDF file format, Microsoft Excel, or Microsoft Word. Font Size: 12 point or larger. Font Type: Times New Roman or Arial. Single Spacing: No more than six lines of type within a vertical inch (2.54 cm). Page Size: No larger than 8.5 inches x 11.0 inches (21.59 cm x cm). RFA 2014: Facilitating Access to Breast Health Services in Israel Page 4 of 10

5 Margins: At least 1 inch (1.54 cm) in all directions (top, bottom, right, and left). Headers or Footers: May only be used for page numbers, but margins must remain at least 1 inch (1.54 cm) with the header or footer. Page Numbering: All pages must be numbered successively. Recommended lengths for each narrative section of the application are provided. Guidelines for Images Reduce the file size of documents with images by inserting the image (as opposed to cutting and pasting ). Insert only PNG, GIF or JPG graphic files as images in your Word document. Other graphical file formats are either very large or difficult to manipulate in the document. Do not insert Quick Time or TIFF objects into your document. Anchor the images you embed in your document. Once you have anchored the inserted image, you can format text to wrap around the image. Do not edit your images in Word. Use a graphics program. Do not embed your images in tables, text boxes, and other form elements. Do not add annotations over the images in Word. Add annotations to the images in a graphics program. APPLICATION REQUIREMENTS All applications must follow the guidelines set out below. Applications should consist of four sections presented in the following order: 1. Application Cover page. 2. Narrative section. 3. Budget. 4. Required attachments. Application Cover Page (maximum of 1 page) The application cover page consists of general information about the project/application and background information of your organization/ institution. Please, internationalgrants@komen.org to request the template. Cover page is limited to 1 page. Application Narrative (maximum of 8 pages) Please limit the application narrative to 8 pages or less. Additional pages will be removed prior to review. Narrative sections must be properly labeled and submitted single-spaced on 8½ inch by 11 inch pages with one inch left and right margins. See Formatting Guidelines above for additional information. The following sections are required in the Application Narrative, and MUST not be eliminated, combined, or otherwise altered. Failure to follow these guidelines will result in administrative withdrawal of the application without appeal. Section A: Title and Responsiveness (1 page recommended) Describe how the proposed application addresses the purpose of the grant as described in RFA. Section B: Approach and Feasibility (3 pages recommended) Describe the targeted population, including the breast health and breast cancer needs of the targeted population. RFA 2014: Facilitating Access to Breast Health Services in Israel Page 5 of 10

6 Describe in detail how the proposed project addresses needs within the continuum of care. Describe the specific deliverables of the proposed project. Describe potential problems and potential solutions. Indicate if the proposed project complements activities undertaken and/or policies promoted by the Ministry of Health to address the health needs. If yes, please explain how. If no, please explain why not. Section C: Timeline (1 page recommended) Include a timeline of activities to be conducted within the project and specific deliverables. Section D: Expertise, Resources (1 page recommended) Describe the organization s mission. Describe the expertise and technical capabilities of the organization and the project team to effectively conduct all aspects of the project. Describe the organization s impact -- what have been the organization s most significant projects in the health sector in the past three to five years? Describe the organization s experience with related work in Israel and existing in-country partnerships, particularly with the MOH. Section E: Collaboration/Access (1 page recommended) Describe how the organization will have access to resources necessary for the successful conduct of the proposed project (such as access to cancer registry data, reports from the MOH, etc). Describe any plan to maximize the use of resources and to avoid unnecessary duplication of effort. Specify how the proposed project differs from programs conducted by other organizations in the targeted area. Describe the role of any partners. If partners will be participating in the project, letters of support are required. See Section 4: Required Attachments for additional information. Section F: Evaluation (1 page recommended) Describe in detail how the organization(s) will measure achieving project goals and objectives and how the impact of the project on the target population will be assessed. A strong evaluation plan measures both the quantity and quality of strategy implementation and outcomes. Describe the evaluation expertise that will be available for this purpose. Describe the resources are allocated for evaluation activities in the project budget. Budget Please, internationalgrants@komen.org to request the template. Application budgets must: Adhere to budget form template. Include budget justifications. Include contractual/consortium budgets (if applicable). Adhere to budget restrictions. Budget Justification Instructions Applications must include sufficient justification of proposed expenditures in the boxes provided in the budget template provided can be used. For personnel justification, include name, expertise, and roles of personnel, including the need for their expertise in the context of the proposed program. RFA 2014: Facilitating Access to Breast Health Services in Israel Page 6 of 10

7 For non-personnel expenditures explain the need for these expenditures in each category listed in this section. For travel expenses, include the reason, expense, and traveler for each trip. Attachments Letter of support from collaborating organizations, if any, outlining the specific roles and responsibilities of all proposed collaborating organizations. Resumes/curricula vitae for key staff, qualifications and responsibilities of each staff member. Limit to two pages each. Proof of non-profit status. References: List references (journal articles, statistics, studies, etc) cited in the grant application (if any) as full citations. Each citation must include names of all authors, publication title, book or journal title, volume number, page numbers, and year of publication. Example: Znaor A, van den Hurk C, Primic-Zakelj M, Agius D, Coza D, Demetriou A, Dimitrova N, Eser S, Karakilinc H, Zivkovic S, Bray F, Coebergh JW. Cancer incidence and mortality patterns in South Eastern Europe in the last decade: gaps persist compared with the rest of Europe. Eur J Cancer 49(7): , ADMINISTRATIVE COMPLIANCE All applications must be submitted in strict compliance with these instructions: All documents need to be submitted in PDF format, Microsoft Excel, or Microsoft Word. No deviations from the instructions are permitted. All guidelines must be followed exactly, including but not limited to the formatting requirements such as the page limitations, prescribed font, and margin size. No changes, additions, deletions, or modifications of any kind to the templates are permitted. All application materials must be written in English and must be submitted by at internationalgrants@komen.org. Failure to adhere to these instructions will result in applications being administratively withdrawn from consideration prior to peer review, without appeal. APPLICANT RESPONSIBILITY Applicants are responsible for completing, reviewing, and submitting their applications with sufficient time to allow for technical difficulties, varying time zones, human error, loss of power/internet, sickness, travel, etc. Applicants are responsible for ensuring that their applications meet the administrative compliance guidelines and are complete and accurate at the time of submission. Applicants may review their submissions for accuracy until the application submission deadline to ensure compliance. Extensions to the application submission deadline will not be granted to allow for lateness, corrections, or submissions of missing information, with the rare exception made for severe extenuating circumstances at the sole discretion of Komen. APPLICATION DEADLINE The applicant organization must submit the application including supporting documents by February 6, 2014, 12:00 p.m. EST / 17:00 GMT to internationalgrants@komen.org. RFA 2014: Facilitating Access to Breast Health Services in Israel Page 7 of 10

8 Questions? If you have questions regarding the application, please us at The subject line of your should read Israel 2014 Grant. REVIEW PROCESS AND SELECTION CRITERIA Review Process Susan G. Komen utilizes a multi-step approach to application and review for this Grant mechanism. Applications are first administratively reviewed for eligibility, submission of all required application materials, adherence to formatting requirements, and responsiveness to the program focus area specified in this RFA. Applications that do not meet eligibility and formatting requirements will be administratively withdrawn and WILL NOT be reviewed. Each qualified application is then reviewed by a panel of experts that assess the strengths and weaknesses of each application based on the defined review criteria, described below. Reviewers assess the strengths and weaknesses of each application based on the defined review criteria described below. The grant application process is competitive. Regardless of whether or not an organization has received a Komen grant in the past, funding in subsequent years is never guaranteed. Applicants will be notified of application review decisions via . REVIEW CRITERIA Responsiveness Does the proposal address the objective described in the RFA? Approach & Feasibility Expertise, Resources and Timeline Collaboration How likely is it that the objectives and activities will be achieved within the scope of the funded program? Is the project well-planned? Is the budget appropriate and realistic? Is it enough to support all components of the program? Is the overall budget inflated? Does the budget justification explain in detail the reasoning and need for the costs associated with the project? Are the applicants and any other collaborators well suited to conduct the project successfully? Do the applicants and any other collaborators have a demonstrated and ongoing record of accomplishments? Is there a sufficient plan to maximize the use of resources and to avoid unnecessary duplication of effort? Does the timeline provide a reasonable expectation of progress throughout the project? Does this program enhance collaboration among organizations with similar or complementary goals? Did the lead organization select appropriate partners? Are the roles of the partners appropriate and relevant? Does collaboration as presented ensure that the applicant will have access to data and information in an appropriate manner? RFA 2014: Facilitating Access to Breast Health Services in Israel Page 8 of 10

9 Evaluation Is there a plan in place to monitor progress toward project goals? Will the impact of the project on the target population be assessed? Does the organization(s) have adequate evaluation expertise? Are enough resources allocated for evaluation in the project budget? RFA 2014: Facilitating Access to Breast Health Services in Israel Page 9 of 10

10 APPENDIX A: The Continuum of Care The continuum of care refers to the delivery of health care over a period of time. In patients with a disease, this covers all phases of illness from diagnosis to the end of life (Source: National Cancer Institute at the U.S. National Institute of Health). The continuum of care includes: screening, diagnosis, treatment, and follow up (survivorship/end of life care). In addition, education and awareness occur throughout the continuum of care to ensure women are empowered and equipped to take action. RFA 2014: Facilitating Access to Breast Health Services in Israel Page 10 of 10