CHRISTOPHER & DANA REEVE FOUNDATION PARALYSIS RESOURCE CENTER HIGH IMPACT INNOVATIVE ASSISTIVE TECHNOLOGY (HIIAT) QUALITY OF LIFE GRANTS FOR STATE ASSISTIVE TECHNOLOGY-ACT FUNDED PROGRAMS 2018 APPLICATION INSTRUCTIONS Before you begin the application, please read the following: List of Application Questions (available on website) Application Instructions (this document) People First Language Guide (available on website) A Quick Guide to Establishing Evaluation Indicators (available on grant website) Overview General Information About the Grant Program Assistive technology can be a powerful tool to increase the independence of people with disabilities, assist them to participate fully in the communities of which they are a part, and enhance their social, employment, education or finance-related quality of life. The High Impact Innovative Technology Assistance (HIIAT) Grant Program is a competitive grant program, funded through the Christopher & Dana Reeve Foundation s federal cooperative agreement with the Department of Health and Human Services, Administration for Community Living (ACL), awarding up to five one-year grants of up to $75,000 to state programs funded through the State Assistive Technology Act, including implementing agencies and organizations subcontracted by implementing agencies for Assistive Technology (Section 4) activities, for innovative, one-year programs or services that: Target a specific, well-defined underserved population within the broader disability community in their state; Through assistive technology devices or services, increase access to services, increase the independence or inclusion of people within the underserved population within their communities; and When complete, will have a demonstrable, direct impact on people affected by the project. Proposals may focus on a significant expansion of an existing program or service (e.g., escalating an existing project to reach additional individuals in the target population) or a new project or service (e.g., implementing a new project to reach a target population that has until now gone unserved). Regardless of which type of project is proposed, applications must 1
address how the project will be sustained after the grant period is over (see Sustainability below). The broad category People with Disabilities is not an acceptable target population for this grant. TARGETED UNDERSERVED POPULATION GROUPS may include one or more of the following: Current military service members and/or veterans and their families Ethnic minorities Homeless Indigenous or tribal communities LGBTQ Limited English proficiency Low-Income and/or poverty populations Newly injured people with paralysis and their caregivers Persons at risk of incarceration, current or released prisoners Rural residents Other (please describe) HIGH IMPACT, INNOVATIVE Definitions This grant program is intended to support projects that will have a significant positive effect on quality of life for individuals with paralysis and their families, using a new idea, method or device, or doing something in a new way. PARALYSIS Definition The Reeve Foundation uses a functional definition of paralysis: difficulty and/or inability to use arms and/or legs due to neurological conditions including (but not limited to) spinal cord injury, traumatic brain injury, stroke, cerebral palsy, spina bifida, ALS, post-polio syndrome, etc. Collaboration This grant program is designed to encourage and foster collaboration among existing agencies, nonprofits and networks to enhance services and better meet the needs of individuals living with paralysis and their families and caregivers. Eligibility Eligibility for this grants program is restricted to state programs funded by the State Assistive Technology Act as the implementing agency for their states, as well as organizations 2
subcontracted by the implementing agency for Assistive Technology (Section 4) services. Organizations that have previously received funding through the HIIAT Grant Program are not eligible to reapply for this opportunity. This program recognizes that finances are often a major roadblock to individuals living with paralysis in attaining the assistive technology that they need in order to maximize their independence. While alternative financing may be a component of proposed projects, HIIAT grants may not solely fund alternative financing initiatives. Unallowable Costs Grant funds cannot be used for food, grants awarded directly to individuals, or new construction. In addition, indirect costs, sometimes called Facility and Administrative Costs (FAC) or overhead costs are not allowed under this grant program. Please note that organizations that already have in place a federally-negotiated indirect cost rate agreement may use the agreed upon FAC rate for this grant. Projects funded under this grant program are intended for direct services to underserved populations. Proposals which include system change activities such as attempting to change laws or policies will not be reviewed. Sustainability These are one-time, one-year grants. Continuation grants will not be considered. Applicants should describe how they intend to sustain key project activities beyond the one-year grant period. Grant Payments This program will award up to five grants of up to $75,000 in two payments. The initial payment of up to $37,500 (half of the total amount awarded) will be sent after the award notification. The remaining funds will be sent after the review and approval of the six-month grant report. Application Online Portal To access the online application and all of the information needed to submit, please go to www.christopherreeve.org and click on Get Support then click on Funding for Nonprofits and scroll down to Application Process and click on Find out More. On the right side of the Application Process page, you will see a vertical bar. In that bar, click on High Impact Innovative Quality of Life Grants, where you will find everything needed to apply. To start the online application, click on the link and then enter your email address. If your organization previously applied, please enter the password that you created. If it is your first time applying, please click on Create New Account. 3
Restricted Access Code The restricted access code for this year s application is: HI2018. Application Sections In the online application, you will complete eight sections. Here are instructions for each section. 1. Organizational Information Please indicate whether or not applicant is the implementing agency for the Assistive Technology Act-funded program in your state. Please indicate whether or not applicant is subcontracted by the implementing agency for the Assistive Technology Act-funded program in your state to provide assistive technology services. Please indicate whether or not your agency is required to file an annual single audit. Please indicate if your organization receives federal program funding for expenditure categories listed in the Catalog of Federal Domestic Assistance (CFDA). 2. Proposed Project Information Project Name: Please give your proposed project a name. The Reeve Foundation uses a functional definition of paralysis: difficulty and/or inability to use arms and/or legs due to neurological conditions including (but not limited to) spinal cord injury, traumatic brain injury, stroke, cerebral palsy, spina bifida, ALS, post-polio syndrome, etc. Numbers of people with paralysis and/or their families and caregivers How many people living with paralysis (and family members) will be served by the proposed project? Paralysis-Causing Conditions This grant program may fund projects that target one (or more) specific paralysis-causing condition(s), OR projects that are not targeted to a specific paralysis-causing condition. 4
Is the proposed project targeted to one (or more) specific paralysis-causing conditions(s) (e.g., spinal cord injury)? Specific Paralysis-Causing Conditions If you answered yes to the question above, please enter n/a or non-specific. Targeted Underserved Population Group(s) The broad category people with disabilities is not an acceptable target population for purposes of this grant program. Please check the underserved group(s) listed below to which your proposed project is targeted: Current military service members and/or veterans and their families Ethnic minorities Homeless Indigenous or tribal communities LGBTQ Limited English proficiency Low-Income and/or poverty populations Newly injured people with paralysis and their caregivers Persons at risk of incarceration, current or released prisoners Rural residents Other (if other is checked, please explain) Problem Statement Describe the challenges faced by the target population that the proposed project will address. Describe the barriers to independent living, inclusion or community integration faced by this population. If it is available, use existing data to document the nature of the problem(s) faced by the target population. 3. Project Plan and Timeline Major Goals and Objectives Describe the major goals and objectives of the project (what you wish to accomplish). Expected Impact 5
Describe the extent to which the proposed project is likely to have a significant, direct impact on the target population. What difference will the proposed project make in the lives of individuals living with paralysis and their families? Activities Describe specific project activities that will accomplish these goals and objectives, start and end dates for each activity. Please include evaluation activities, including when each will be conducted and completed. Project Leaders Identify individuals who will undertake each of these activities. (Note: brief bio-statements of key project personnel should be placed in the Project Staffing Plan section (see below); do not include them here.) Project Goals Table Please download the Project Goals Table which has been created to help you to provide clarity on the relationships between your project goal(s), objective(s), expected impact, activities, and associated staff lead. The completed Project Goals Table should be uploaded using the Project Goals Table attachment upload button in the online application. 4. Collaboration Describe how your organization will establish partnerships with other disability organizations or other agencies within the state, territory, and/or region and how these partnerships will increase the probability of success of the proposed project. Examples of collaboration may include such things as serving on project advisory boards (if one is proposed), participating in outreach or dissemination activities, serving as a site at which the proposed project will be carried out, or conducting or participating in the project evaluation. Potential collaborators include (but are not limited to): Independent Living Centers or Statewide Independent Living Councils, Alternative Finance Programs, Developmental Disability Planning Councils, Protection and Advocacy agencies, University Centers of Excellence Developmental Disabilities Education, Research, and Service (UCEDD s,) local or state or national level Committees or Councils on disability, non-profit disability organizations targeting the proposed population, or others. Letters of Collaboration 6
Applications must include documented commitments in the form of letters of collaboration by those partners described in the answer to the Collaboration question above. Partners are not required to commit funding to the project, but must demonstrate that they are making a measurable commitment that will help increase the probability of success of the proposed project. Letters of collaboration are required and should be scanned into one document and uploaded into the online application using the Letters of Collaboration attachment upload button. Applications that do not contain letters of collaboration will not be reviewed. PLEASE NOTE: Applications submitted by a subcontracted agency must include in the Letters of Collaboration a letter from their State AT program that verifies there is a written agreement with the subcontractor agency to provide Section 4 activities and that the agency provides data for the AT Annual Performance Report (APR). This will ensure the State AT Program is aware of the application and may indicate support for the proposal. General Letters of Support In addition to letters of collaboration, applicants may submit general letters of support that do not commit the supporting organization to participate in the project. General letters of support are optional but may be included to augment your application. General letters of support should be scanned into one document and uploaded in the online application using the General Letters of Support attachment upload button. 5. Demonstrating Impact: Project Evaluation Plan Before completing this section of the application, please read the Quick Guide to Evaluation Indicators on the High Impact Innovation Grant home page on the PRC website. Evaluation Indicators Describe the evaluation indicators you will use to measure the success of the proposed project. Indicators must be a combination of both input and outcome indicators, and must be measurable. As funded projects are expected to result in high impact for the targeted population, qualitative indicators as well as quantitative indicators are encouraged. Evaluation Methods Describe the evaluation methods you will use, including surveys, interviews, focus groups or review of program documents as applicable. Under no circumstances do we want to see any privileged client information that is protected by HIPAA! 7
Please list who will conduct the evaluation. Please note: A brief description of the qualifications and experience of individuals conducting the evaluation will be requested in the Project Staffing Plan section of the application and should not be included here. 6. Project Staffing Plan Bio-Statements of Key Staff Please provide brief bio-statements of between two and four paragraphs of each person named in the proposal, including the person(s) responsible for evaluation. Please include qualifications and experience that make the individuals qualified to undertake the activities identified for them in the project plan. (Please note: do not include formal resumes or CVs for project personnel). 7. Sustainability Describe how your organization intends to ensure that key project activities can be sustained beyond the one-year grant period. The use of cost/benefit analysis that correlates requested budget items with project goals, activities and expected impact may be a useful tool to help demonstrate project sustainability. 8. Project Budget Total Budget What is the total budget for the entire project? Amount Requested What is the total amount of grant funds requested from Reeve Foundation? (Maximum grant amount is $75,000 requests for full funding are encouraged.) Please download the project Budget Worksheet Template and complete it following the instructions below. HIIAT Grant Application Project Budget Instructions The project Budget Worksheet Template, an Excel template found on the website and within the online application, must be completed and uploaded with the online application. PLEASE NOTE THAT FAILURE TO FOLLOW INSTRUCTIONS BELOW WILL RESULT IN LOWER SCORES AND POSSIBLE AUTOMATIC DECLINATION OF YOUR REQUEST. 8
PLEASE PROVIDE DETAILED BREAKDOWNS FOR ALL COST ESTIMATES. For example, if equipment is included in your project budget, DO NOT ENTER A LUMP SUM WITH NO EXPLANATION. You may include quotes for your breakdowns as attachments, using the vendor quote upload buttons in the online application. Other Sources of Funding: Complete this section only if funds from other organizations (including your own organization) will be used for this project. If only Reeve Foundation funds are being used, skip this section. A. In column A, list the name of each organization from which you have received or requested funds for this project. Do not include the funds you are requesting from the Reeve Foundation. If you have requested or received funds from outside your organization, list the name of the other organization. If internal funds (from within your own organization) are being used, enter "internal funds". B. In Column B, list the dollar amount of funds that you have requested or received from each funding source. C. In Column C, state whether the funds have been committed (this includes funds that have been approved even if you haven't actually received the money), or whether the funds are pending (you do not know yet whether or not they will be approved). Sample Budget Table: A: Source of Other Funding B: Dollar Amount Individuals $7,000 Received Foundations $5,000 Pending Corporations $10,000 Pending Government $30,000 Received Other $500 Received C: Is This Funding Committed or Pending? BUDGET INFORMATION FOR FUNDS REQUESTED FROM THE REEVE FOUNDATION The information in this section applies only to the funds you have requested from the Reeve Foundation. Do not include funds you have requested or received from other funding sources. Applications that do not have the information requested below on funds requested from the Reeve Foundation or that contain information on funds from other organizations in this section will not be reviewed. There are six categories of expenses. Each category has a table below into which you should enter information about funds you are requesting from the Reeve Foundation for that category. Please read 9
the descriptions of the categories before deciding which funds go into which category. There are specific instructions about each category above the table for that category. If you are not requesting funds for one or more of the categories, leave that table blank. The total dollar amount of all the categories must be equal to the dollar amount you requested from the Reeve Foundation above. "Personnel" includes salaries or wages of people who currently work for your organization who will work on the proposed project. It does not include people from outside your organization - these funds go in the "Consultants/Contractors" category. "Equipment" includes the cost of renting or purchasing equipment you will use to complete the project. Any type of equipment from to machines to computers should go in this category. "Consultants/Contractors" includes people or organizations who do not work for your organization that will provide services and receive money from the Reeve Foundation grant to work on the project. "Supplies" includes all types of supplies you will use to complete the project. These may be office supplies, building supplies, or other types of supplies. "Travel" includes the cost of travel for people from your own organization, clients or others that will be used to complete the project. This includes airfare, mileage reimbursement, hotels, and other travel-related expenses (with the exception of meals). "Other" includes anything that does not fit into one of the five categories above. Be sure to describe what the expense is for. PERSONNEL A. Under column "A", list the name of each employee of your organization that will receive salaries or wages from Reeve Foundation funds you are requesting. Use a separate row for each employee. B. Under column "B", list the role and project-related activities of each employee of your organization involved in the proposed project for which you seek Reeve Foundation funding. C. Under column C, list the amount of time each employee will spend on the project with funds from the Reeve Foundation. Examples include "10 hours per week for five weeks," "50 hours total" or ".10 FTE for five weeks." D. Under column "D", list the amount of money you are requesting for that person from the Reeve Foundation to work on the project. You can include fringe benefits in the figure or list them separately. We do not need to know the person's total salary or wages. 10
E. Do not include donated or "in-kind" services of your employees. List only people whose salaries or wages will paid by Reeve Foundation funds if your application is accepted. If both Reeve Foundation funds and in-kind contributions will be used, list only the time of the employee in the table that will be paid for by Reeve Foundation funds. Note in-kind contributions of time in the project application itself. F. Be sure to enter the total dollar amount of all personnel requested from the Reeve Foundation in the gray box next to "Total Personnel Funds Requested" in the last row. Sample Personnel Table: A: Name Jan Roberts B: Role/Activities of Employee in this Project Support Group Leader facilitates support group and provides project management C: How much time will he or she spend on the project? 5 hours per week/10 weeks D: How much money from Reeve grant funds will be used for this person? $1,000 TOTAL PERSONNEL FUNDS REQUESTED: EQUIPMENT A. Under column "A", describe the equipment you will rent or purchase from Reeve grant funds if your application is successful. Examples include "purchase of one XYZ 9400 computer," "rental of one front-loader for 20 hours, "purchase of six sports wheelchairs" or "rental of wheelchair accessible van." Vendor quotes may be uploaded using the other label in the online application. Please indicate in budget section if quotes are attached. B. Use a separate row for each type of equipment. C. Under column "B", list the dollar amount of Reeve grant funds that will be used for the rental or purchase of that equipment. In the examples above, you would enter the actual purchase price of the computer; $3600 for the wheelchairs (six wheelchairs @ $600 per chair = $3600); $2000 for the front-loader (20 hours rental @ $100 per hour = $2000) and $1,050 for the accessible van (three weeks @ $350 per week = $1,050). D. Do not include donations of equipment (e.g., someone has agreed to donate the use of equipment). Note in-kind donations in the project narrative itself. E. Be sure to enter the total dollar amount of all equipment requested from the Reeve Foundation in the gray box next to "Total Equipment Funds Requested" on the last row. Sample Equipment Table: A: Description of Equipment B: Funds Requested From Reeve 11
Purchase of 1 Large-Screen Laptop Computer for administration of program, email correspondence with participants, etc. (Please see vendor quotes attached). $1,000 Foundation TOTAL EQUIPMENT FUNDS REQUESTED: $1,000 CONSULTANTS/CONTRACTORS A. Consultants and contractors are people who do not work for your organization or are outside businesses that you will hire. B. Under column "A", list each consultant or contractor for which you are requesting Reeve Foundation funds to work on the project and provide a one-sentence description of the services they will provide. Examples include "Gray Computer Consulting for installation and programming of adaptive speech recognition programs" or "Fox Landscaping for grading of playground area and installation of rubber base." C. Use a separate row for each consultant or contractor. D. Under column "B", list the dollar amount of Reeve grant funds that will be used for that consultant or contractor. Examples include a simple dollar amount or an hourly or daily rate and a total ("forty hours @ $50 = $2000"). E. Do not include donations of services (e.g., someone has agreed to donate their services) in the table. Note in-kind donations in the project narrative itself. F. Be sure to enter the total dollar amount of all consultants and contractors requested from the Reeve Foundation in the gray box next to "Total Consultant/Contractor Funds Requested" on the last row. Sample Consultant Table: A: Name of Consultant or Contractor (person or company) and one-sentence description of services Daniel Connor, Registered Recreational Therapist, will provide expert recommendations regarding appropriateness of various locations for recreational trips. One-time flat fee includes site visits, travel expenses, etc. B: Funds Requested From Reeve Foundation $250 TOTAL CONSULTANT/CONTRACTOR FUNDS REQUESTED: $250 12
SUPPLIES A. Under column "A", list each type of supply which you are requesting Reeve Foundation funds to work on the project. Examples include "Office supplies: 5 months @ $50 per month"; building supplies "lumber and other supplies for construction of ramp." B. Use a separate row for each type of supply; if you are requesting funds for a ramp, you do not have to itemize each single piece of lumber or hardware. C. Under column "B", list the dollar amount of Reeve grant funds that will be used for that type of supply. In the examples above, the total figure for the office supplies would be $250 (five months @ $50 per month) and the building supplies for the ramp would be the actual cost of those supplies. D. Do not include donations of services (e.g., someone has agreed to donate supplies) in the table. Note in-kind donations in the project narrative itself. E. Be sure to enter the total dollar amount of all supplies requested from the Reeve Foundation in the gray box next to "Total Supply Funds Requested" on the last row. Sample Supply Table: A: Description of Supplies Office supplies 12-months @ $50 per month $600 TOTAL SUPPLY FUNDS REQUESTED: $600 TRAVEL C: Funds Requested From Reeve Foundation A. Under column "A", list each type of travel for which you are requesting Reeve Foundation funds for the project and provide a one-sentence description of the purpose of the travel. Examples - mileage reimbursements ("3 case manager visits to clients per week for ten weeks = 30 visits @ 100 miles per visit = 3000 miles x 32 cents per mile); other travel costs ("4 round-trip airline tickets @ $500 per ticket"); hotel costs (3 nights hotel for two people = six nights @ $150 per night) or miscellaneous travel costs ("parking reimbursement"). B. Use a separate row for each type of travel. For example, if case managers will be traveling to visit clients, you do not have to list each trip on a separate line. C. Under column "B", list the dollar amount of Reeve grant funds that will be used for that type of travel. In the examples above, the total mileage reimbursement would be $960 (3 visits per week x 10 weeks = 30 visits x 100 miles per visit = 3000 miles x.32 = $960); the total airfare would be $2000 (4 tickets @ $500 per ticket) and the total hotel cost would be $900 (3 nights for two people = six nights x $150 per night). 13
D. Do not include donations of travel costs (e.g., someone has agreed not to charge for mileage or has donated the cost of airline tickets) in the table. Note in-kind donations in the project narrative itself. E. Be sure to enter the total dollar amount of all travel funds requested from the Reeve Foundation in the gray box next to "Total Travel Funds Requested" on the last row. Sample Travel Table: A: Type of Travel and One-Sentence Description of Purpose Rental of wheelchair-accessible van for recreational outings 6 times per year at $400 each B: Funds Requested From Reeve Foundation $2,400 TOTAL TRAVEL FUNDS REQUESTED: $2,400 OTHER COSTS A. This category should be used for anything that you don't feel fits under any of the five categories above. As stated above, indirect costs [also called facilities and administration costs (FAC) or "overhead"] are not allowed in this grant. PLEASE NOTE: organizations that have in place a federally-negotiated FAC rate may include FAC expenses at the negotiated rate. B. Under column "A", describe the thing for which you are requesting Reeve Foundation funds for the project and provide a one-sentence description of the purpose. C. Under column "B", list the dollar amount of Reeve grant funds that will be used. D. Do not include donations or in-kind contributions in the table. Note in-kind donations in the project narrative itself. E. Be sure to enter the total dollar amount of all Other funds requested from the Reeve Foundation in the gray box next to "Total Other Funds Requested" on the last row. Sample Other Table: A: Item (Good or Service) and One-Sentence Description of Purpose Event insurance for 1 year for 6 recreational outings per year C: Funds Requested From Reeve Foundation $1,500 14
TOTAL OTHER FUNDS REQUESTED: $1,500 SUMMARY OF FUNDS REQUESTED FROM THE REEVE FOUNDATION This table is auto-filled within the template and can be used to double-check your budget figures. Please upload the completed Budget Worksheet Template in the online application using the Budget Worksheet Template attachment upload button. Vendor Quotes Vendor quotes are not required but may be helpful to support budget items, particularly in the equipment and contractors sections. Please scan vendor quotes into one document and upload in the online application using the Vendor Quote attachment upload button. Submission After the online application is completed and all of the attachments are uploaded, click the submit button. You should receive an automated email response from the application system that confirms your submission. If you do not receive this email after submitting your application, please contact QoL@ChristopherReeve.org as soon as possible so that we can confirm it for you. Review Process Applications will go through a three-part review process. Phase One Eligibility Determination: the Director of the Quality of Life Grant Program will conduct an eligibility determination of all applications, including unallowable costs as described above. Phase Two Proposal Review Committee: Applications will be reviewed by Reeve Foundation staff and a panel of external experts on assistive technology and disability. Phase Three Proposal Review Committee finalizes funding recommendations through the Administration for Community Living. 2018 Program Time Line: Online Application opens: 11/20/18 Funding Opportunity Announcement: 11/20/18 Application Technical Assistance Webinar: 11/27/18 15
Application Submission Deadline: 1/3/19 Application Review: 1/4/19 2/4/19 Decision Announcements Emailed: 2/22/19 Initial Grant Payment (1/2 total award) Sent: 2/25/19 One-year grant period: 3/1/19 2/28/20 Interim report due: 8/16/19 Final Grant Payment (1/2 total award) Sent After Review and Approval of Interim Report Final report due: 4/15/20 Reporting Grantees are required to submit two reports. Detailed instructions on completing the reports will be sent to awardees. An interim progress report describing progress made towards goals and objectives contained in the application during the first six months of the grant period, challenges encountered during the first half of the grant and how those challenge were or are being overcome is due no later than the end of month seven. This report will be due 8/16/19. As stated above, the second of two payments will be made after review and approval of interim report. A final project report is due 4/15/20. The final report will include information on how the goals and objectives contained in the application were met, results of the project evaluation and a report on how project funds were used. Evaluation A brief program evaluation survey will be included in the final project report. Questions? Please contact QoL@ChristopherReeve.org 16