Ball State University Northeast Indiana AHEC

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Northeast Indiana AHEC Mini-Grant Program Spring/Summer 2019 Request for Proposals Connecting students to careers, professionals to communities, and communities to better health Funding for the Spring/Summer 2019 NEI-AHEC Mini-Grant Program is provided by the Indiana State Department of Health, through its grant to Indiana University and a subgrant from IU to.

Northeast Indiana AHEC (NEI-AHEC) Mini-Grant Program Spring/Summer 2019 Request for Proposals Northeast Indiana AHEC (NEI-AHEC), administered by the College of Health at, is releasing this Request for Proposals (RFP) to solicit proposals from federally tax-exempt organizations working to further the mission of NEI-AHEC. The proposed projects must benefit residents in at least one of the following counties in Indiana: Adams, Allen, Blackford, DeKalb, Delaware, Elkhart, Grant, Huntington, Jay, Kosciusko, LaGrange, Noble, Randolph, Steuben, Wabash, Wells, and/or Whitley. If you have any questions about this RFP, the mini-grant award process, or NEI- AHEC, please contact: Justin Tobyas Assistant Director, Northeast Indiana Area Health Education Center (NEI-AHEC) CA 108 Muncie, Indiana 47306 Phone: 765-285-5688 Fax: 765-285-4989 Email: jjtobyas@bsu.edu Web: www.bsu.edu/neiahec DEADLINE December 15, 2018 All proposals must be submitted by email to jjtobyas@bsu.edu no later than 5:00 PM Eastern Standard Time on December 15, 2018. Deadlines that fall on a holiday or weekend still apply. 2

Background: The Northeast Indiana AHEC works to improve the distribution, diversity, and quality of the health care workforce in Northeast Indiana. NEI-AHEC is one of eight regional AHECs in Indiana, and these regional AHECs are coordinated by the Indiana AHEC Network Office located at the Indiana University School of Medicine at IUPUI. The mission of the Indiana AHEC Network is to improve health by recruiting, educating, and retaining health care professionals in underserved communities. This mission is accomplished through these three broad programming areas, with examples of activities listed: 1. Engaging youth (middle/high school) in health careers through education and promotion (health career awareness experiences, field trips, summer camps, enrichment programs, etc.); 2. Creating targeted clinical training experiences for students in health professions programs (clinical rotations, outreach programs, inter-professional education experiences, and service learning); and 3. Developing continuing education programs for practicing health professionals (interprofessional education opportunities, conferences, workshops, and professional development). All of these programming areas include a focus on improving health in underserved areas, and improving the diversity and quality of the health professions workforce in Northeast Indiana. Primary care and public health are critical components to improving health and health care in Indiana. These areas are also central to the work of NEI-AHEC. Funding: There is approximately $10,000 of total state funding available for this NEI-AHEC minigrant program. The average award is between $1,000 and $2,500. The number of mini-grant awards will be dependent on the number and quality of the proposals submitted. Mini-grant award funding will be on a cost-reimbursement basis. Payment for actual budgeted costs incurred, not to exceed the designated maximum award as listed in the award documentation, will be made from mini-grant funds upon successful completion of the project, submission of authorized receipts and invoices, and all reporting requirements. The source of funds for this mini-grant program is an initial prime grant from the Indiana State Department of Health to the Indiana University School of Medicine, which then issues a subgrant to (BSU) to administer the NEI-AHEC program. Ball State, in turn, will issue Mini- Grants under its subgrant from IU pursuant to this RFP. All NEI-AHEC mini-grants must be in accordance with BSU policy, terms and conditions of BSU s subgrant, and applicable Indiana laws and regulations. Eligibility: To submit a proposal to the NEI-AHEC Mini-Grant Program Spring/Summer 2019, an organization must be a federally tax-exempt entity. Examples (not meant to be exhaustive) of organizations that qualify to apply for funding include 501(c)(3) organizations, K- 3

12 schools, and institutions of higher education. Proposals submitted by an individual or organizations that are not federally tax-exempt will not be reviewed. Project Period: The project must start and end during this project period: Begin after February 1, 2019 End before May 15, 2019 unless the project is a summer camp, in which case the project must end by June 15, 2019. Receipts for reimbursement must be within the project period timeline. Target Area and Populations: Projects funded under this RFP must reach community members in one or more of the following NEI-AHEC counties: Adams, Allen, Blackford, DeKalb, Delaware, Elkhart, Grant, Huntington, Jay, Kosciusko, LaGrange, Noble, Randolph, Steuben, Wabash, Wells, and Whitley. The Northeast Indiana AHEC seeks proposals for projects under this mini-grant program that address barriers to creating a diverse, qualified health care workforce throughout our entire seventeen-county region. Examples of barriers include socioeconomic and educational disadvantage, as well as cultural, language, and geographic challenges. Project Evaluation and Reporting: Evaluation is a key component of NEI-AHEC s programming. All grantees will be required to participate in project evaluation through the collection and reporting of data. NEI-AHEC staff will provide the data collection tools to ensure the required information will be reported by mini-grant recipients. In addition to the Subgrantee Final Financial Report, a final narrative report will be due no later than May 31, 2019 for non-summer camp mini-grants and June 17, 2019 for summer camp mini-grants. The final narrative report will require submission of completed data collection tools, as well as a comprehensive description of the project and its outcome. Photos, press releases, media coverage, and any other supplementary information must be provided to NEI-AHEC as part of the final narrative report. Submitting a Proposal: Proposals must be submitted by email by 5:00 PM EST to jjtobyas@bsu.edu Deadline: December 15, 2018 Applicants must submit: 1. Completed Cover Page Form 2. Project Narrative (following outline on page 7 of RFP) 3. Completed Budget Form 4. Budget Justification 5. Clearly state whether you are planning a Summer Camp or Non-summer Camp project Grant Announcement & Publicity: Applicants must acknowledge NEI-AHEC as providing funding for projects on all publications and media coverage related to the funded project. Where appropriate, the NEI-AHEC official logo should be included. The logo will be provided to recipients in electronic format, along with a copy of the national AHEC guidelines for use of the logo. Prior review and approval of all press releases, ads and other publicity must be obtained from NEI- 4

AHEC s Director in consultation with the BSU office of the Associate Vice President for Strategic Communications. A copy of all promotional, media, and educational materials must be submitted with the final report. Review Process: The NEI-AHEC will review proposals and make funding decisions. Proposals will be evaluated based on the proposal review criteria provided on page 9 of this RFP. Time Line: Grant Opportunity Announced 11/05/2018 Proposals Due By 5:00 PM 12/15/2018 Mini-Grant Recipients Announced 1/15/2019 Grant Programs May Begin After 2/01/2019 Non-Summer Camp Grant Programs Must End Prior To 5/15/2019 Summer Camp Grant Programs Must End Prior To 6/15/2019 Non-Summer Camp: Invoice, Receipts, Final Reports Due 5/31/2019 Summer Camp: Invoice, Receipts, Final Reports Due 6/17/2019 ***After receiving the Mini-Grant award contract from s Sponsored Projects Administration (SPA), Mini-grant awardees will have 2 weeks (14 days) to review and return a signed copy of the Mini-Grant contract. Failure to return the signed contract within this time period will result in forfeiture of the award.*** Proposal Checklist: A complete proposal package will include the following: Completed Cover Page Form (page 6 of RFP) Completed Project Narrative (limited to six, single-spaced pages; details on page 7 of RFP. (One additional page for previous grant recipients to respond to additional questions). Completed Project Budget Form (page 8 of RFP) Completed Budget Justification (limited to one, single-spaced page; details on page 8 of RFP) 5

Northeast Indiana AHEC (NEI-AHEC) Mini-Grant Program Spring/Summer 2019 COVER PAGE FORM PROJECT TITLE: PROJECT TYPE (SELECT ONE): SUMMER CAMP NON-SUMMER CAMP PROJECT CONTACT AND TITLE: ORGANIZATION NAME: ORGANIZATION CONTACT AND TITLE (AUTHORIZED SIGNATORY): ADDRESS: COUNTIES SERVED: EMAIL: PHONE: FAX: NAME OF FEDERALLY TAX-EXEMPT ORGANIZATION TO BE REIMBURSED: FEDERAL TAX ID: TOTAL AMOUNT REQUESTED: PROJECT DATES: NON-SUMMER CAMP PROJECTS MUST OCCUR BETWEEN FEBRUARY 1 MAY 15, 2019 SUMMER CAMP PROJECTS MUST OCCUR BETWEEN FEBRUARY 1 JUNE 15, 2019 TARGET PROGRAMMING AREA (Choose One) Health Careers Promotion, Preparation and Diversity Pipeline (Pre-health profession students) ü Increase representation of individuals from under-represented minority and disadvantaged backgrounds and from medically underserved communities Community Based Student Education and Clinical Training Programs (Students enrolled in health profession training programs) ü Improve the readiness, willingness and ability of health professions trainees to effectively care for medically underserved communities and health disparity populations in Northeast Indiana Professional Education and Support / Continuing Education Programs (Primary care health professionals) ü Increase health professionals access to training resources that support practice, reduce professional isolation, disseminate best practices, and improve quality of health care for medically underserved communities SIGNATURE AND TITLE OF APPROVING PROJECT CONTACT SIGNATURE AND TITLE OF APPROVING ORGANIZATIONAL CONTACT Date Date 6

Northeast Indiana AHEC (NEI-AHEC) Mini-Grant Program Spring/Summer 2019 PROJECT NARRATIVE The project narrative must include the following information in the order listed. Use Times New Roman or Arial font, 12 point, limited to six, single-spaced pages. a. Project Abstract Less than or equal to 250 words b. Geographic area served What is the service area targeted for the project, including information on any medical, mental health, or dental underservice or professional shortage designations? c. Project participants Who are the project participants, what is their age (if youth), and how many will participate in the project? How will project participants be recruited? If working with youth, how will you target participants from among under-represented minority groups, as well as educationally or economically disadvantaged students? If working with health professions students or health professionals, how will the project contribute to improving the distribution, diversity, or quality of the health professions workforce in Northeast Indiana? d. Project Objectives What is to be accomplished, including the learning goals? If working with youth, how will this project influence a student to pursue a health career? If working with health professions students or health professionals, how will the project improve quality of care provided by primary care health professionals and/or students? Will the project impact knowledge and awareness about health care issues in medically underserved communities? Will the project impact skills and competencies of participants? Will the project impact participants intention to serve or continue to practice in a rural or medically underserved area? e. Project Description What activities or strategies will be used? Will the project be sustainable after grant funding ceases? f. Project Timeline When will project activities or strategies be completed? g. Relationship to AHEC mission How does the project relate to the AHEC mission? h. Evaluation How will impact of the project be assessed? Previous NEI-AHEC grant recipients also need to respond to the following questions responses for the following are limited to one additional single-spaced page. a. Geographic Area Served Is this project addressing the same geographic area as a previously funded project? Was the previous project able to reach the targeted geographic area? Were any barriers identified in addressing the targeted geographic area? b. Project Participants Is this project targeting the same project participants as the previously funded project? What portion/percentage of the previous participants came from the targeted population (under-represented minority, educationally disadvantaged or economically disadvantaged students or primary care health professionals and/or students)? Were any barriers identified in reaching targeted participants? c. Project Objectives Is this project addressing the same objectives as the previously funded project? If it is different, please explain. Were there any barriers identified in addressing the objectives? 7

Northeast Indiana AHEC (NEI-AHEC) Mini-Grant Program Spring/Summer 2019 PROJECT BUDGET FORM PROJECT TITLE: Categories (Provide line item details within each category) Salaries and Wages: In-Kind Local Support Mini-Grant Request from NEI- AHEC Total Project Budget Comments/Explanation Fringe Benefits: Equipment: Supplies and Materials: Contractual: Travel: Other Direct Costs: TOTAL BUDGET JUSTIFICATION Explain how the cost of each budgeted item is calculated, and how each is related to accomplishing project goals Include positions for personnel and names for consultants, if known. Describe costs listed as Other Direct Costs in your budget. In-kind may be listed as part of your local contributions but not a requirement. Costs for food, as well as indirect costs, are not permitted. The budget justification is limited to one, single-spaced page. This is in addition to the page limit for the project narrative. 8

PROPOSAL REVIEW CRITERIA Each proposal will be evaluated based on the categories below. Each category will be weighted equally. 1. Service Area Does the proposed activity occur in one or more of the counties within the NEI-AHEC region? [Adams, Allen, Blackford, DeKalb, Delaware, Elkhart, Grant, Huntington, Jay, Kosciusko, LaGrange, Noble, Randolph, Steuben, Wabash, Wells, and/or Whitley.] Does the proposal narrative describe how the targeted geographic areas was established, as well as include information about medically underserved or health professional shortage area designations? Will the proposed project help distribute NEI-AHEC activities throughout the service region? 2. Project Participants Does the proposal narrative describe the project participants that will be targeted? Is the targeted population appropriate for the NEI-AHEC Mini-Grant Program? Does the proposal describe how participants will be targeted in marketing this project? If working with youth, does the proposed marketing description reflect a strategy that will reach under-represented minority, educationally disadvantaged, or economically disadvantaged youth? If working with health professions students or health professionals, how will the project target primary or public health care professionals and/or students? 3. Project Description/Objectives Does the project narrative reflect the identified programming area in this RFP? Does the project description include appropriate learning goals? Does the proposal ensure the sustainability of the project, after grant funding ceases? If working with youth, how will this project influence a student to pursue a health career? If working with health professions students or health professionals, how will the project improve quality of care and/or reduce health disparities in Northeast Indiana? If working with youth, how will this project influence a student to pursue a health career? If working with health professions students or health professionals, how will the project improve quality of care provided by primary care health professionals and/or students? How does the project enhance public health knowledge, skills behavior? How is cultural competency integrated into the project? 4. Evaluation To what extent does the proposal include the collection and evaluation of data not only for required reporting, but also for effective continuous quality improvement? Does the proposal demonstrate adequate commitment to participating in the evaluation required by NEI-AHEC and the Indiana AHEC Network? 5. Proposed Budget and Budget Justification Does the budget appear to be reasonable are the budget items relevant and appropriate for accomplishing the proposed project? Does the budget appear to be adequate have all of the resources that will likely be needed to accomplish the proposed project been included? Does the budget justification provide adequate description of each budget line item? 9