Center fr Advancing Hlcaust Survivr Care Request fr Prpsals and Prgram Guidelines Innvatins in Persn-Centered, Trauma-Infrmed Supprtive Services fr Hlcaust Survivrs 1
Overview The Jewish Federatins f Nrth America (JFNA) Center fr Advancing Hlcaust Survivr Care is seeking prpsals fr the expansin f persn-centered, trauma-infrmed supprtive services fr Hlcaust survivrs thrughut the United States. Persn-centered, traumainfrmed care is a hlistic apprach t service prvisin that prmtes the dignity, strength, and empwerment f trauma victims by incrprating knwledge abut the rle f trauma in victims lives int agency prgrams, plicies, and prcedures. See http://www.samhsa.gv/nctic/traumainterventins and http://stre.samhsa.gv/shin/cntent/sma14-4884/sma14-4884.pdf fr mre infrmatin. JFNA anticipates awarding apprximately twenty-five (25), 2-year grants each year fr the next five years, dependent n the availability f federal funds (which are nly guaranteed fr the current fiscal year). The intent is fr prpsals that receive funding in Year 1 t receive funding in Year 2 at half the funding level. This will free up funds t initiate new prpsals, while still supprting existing prjects. Grantees will need t cmply with all prgram requirements in Year 1 in rder t receive the funding in Year 2. Grantees will be eligible t submit additinal applicatins in Year 2 fr additinal prjects. Prpsals relating t Hlcaust survivrs living in pverty, survivrs frm the Frmer Sviet Unin (FSU), and survivrs frm the Orthdx Jewish cmmunity are especially encuraged. Matching funds are required fr each grant. JFNA anticipates annuncing awards by January 31, 2016. Fr mre infrmatin regarding the grant prcess r applicatin, please cntact: Shelley Rd Prject Directr HlcaustCenter@jewishfederatins.rg. Cntents Sectin 1: Eligibility Requirements, Timelines and Deadlines, Prject Backgrund and Gals, Target Ppulatins and Service Categries, Grant Size Categries, Match Requirements, Expectatins and Reprting Requirements, Grant Cmpliance, DUNS & SAM Registratin....3 Sectin 2: Review Prcess and Criteria....11 Sectin 3: Applicatin Steps and Cmpnents.. 14 2
Sectin 1: Eligibility Requirements, Timelines and Deadlines, Prject Backgrund and Gals, Target Ppulatins and Service Categries, Grant Size Categries, Match Requirements, Expectatins and Reprting Requirements, Grant Cmpliance, DUNS & SAM Registratin 1. Eligibility Requirements T be eligible fr funding, applicants must be: Classified as a 501(c)(3) public charity by the Internal Revenue Service, including religius institutins; A direct service prvider t lder adults; Based in the U.S.; and Registered in SAM and have a DUNS number by the time funding is disbursed (p. 10). JFNA will nt fund: Endwments, capital campaigns r fund-raising events Publicatin subsidies and advertising Lbbying r plitical activities Attendance at cnferences r prfessinal develpment activities unrelated t the prject Grants t individuals r grups fr schlarships Medical r institutinal care, incme maintenance, r cash assistance Basic research Cnstructin r rehabilitatin f buildings Equipment purchases, unless such equipment is demnstrated t be necessary t carry ut an activity therwise fundable under Title IV f the Older Americans Act 2. Timelines and Deadlines The deadline fr all grant applicatins is Wednesday, December 2, 2015, at 11:59 pm EST. Tw (2) ptinal, infrmatinal cnference calls will be held fr interested parties. Please register fr nly 1 call. Please nte the fllwing timeline: Wednesday, Nvember 4, 2015, 2:00 pm EST Thursday, Nvember 12, 2015, 2:00 pm EST Phne number: 1-877-304-2955 Passcde: 2027365880# RSVP: www.hlcaustsurvivrcare.rg Friday, Octber 30, 2015: Applicatin available nline. Wednesday, Nvember 4, 2015, 2:00 pm EST: Cnference call fr interested parties. Thursday, Nvember 12, 2015, 2:00 pm EST: Cnference call fr interested parties. 3
Friday, Nvember 13, 2015: Required nline submissin f Intent t Apply due. Wednesday, December 2, 2015, 11:59 pm EST: Applicatins due. Sunday, January 31, 2016: Anticipated date fr awards annuncements. Mnday, February 1, 2016: Implementatin fr Year 1 grant perid begins. Mnday, March 14, 2016: Service delivery begins. 3. Prject Backgrund and Gals In 2015, JFNA received a grant frm the U.S. Administratin fr Cmmunity Living/Administratin n Aging (ACL/AA) fr the purpse f advancing persn-centered, trauma-infrmed (PCTI) supprtive services fr Hlcaust survivrs living in the United States. This new prgram is anticipated t last five years subject t the availability f federal funds each year. JFNA will use the grant and additinal funds raised thrugh private philanthrpy t: Prmte lcal PCTI innvatins fr Hlcaust survivrs using the RFP prcess; and Build natinal capacity t prvide PCTI-based services t Hlcaust survivrs thrugh cnference calls and webinars n Hlcaust and PCTI-related issues, the establishment f a natinal technical assistance website, and nging cnsultatin with grantees n the implementatin, evaluatin, disseminatin, and sustainability f their lcal PCTIbased prjects. Thrughut JFNA s five year grant perid, the Center fr Advancing Hlcaust Survivr Care expects t supprt and disseminate innvative PCTI mdels and t increase the capacity f the Aging Services Netwrk t prvide PCTI supprtive services t Hlcaust survivrs and ther victims f trauma. JFNA plans fr the fllwing utcme t emerge frm this system-level change: The PCTI services apprach will becme the nrmative strategy fr serving and supprting Hlcaust survivrs within the aging services system. Expected grantee utcmes include the incrpratin f PCTI-based services fr Hlcaust survivrs int agency peratins, increased capacity t serve and supprt Hlcaust survivrs and ther victims f trauma using PCTI-based principles, increased capacity t engage in the develpment, implementatin, and evaluatin f innvatins fr ther vulnerable lder adult ppulatins, and increased leadership skills and recgnitin in the cmmunity as a leader n Hlcaust survivr supprtive services and trauma-infrmed care. 4. Target Ppulatins and Service Categries Prgramming supprted by this grant must include new and/r innvative methds f delivering PCTI care t Hlcaust survivrs, whether thrugh new prgramming, the expansin f an existing prgram using PCTI based principles, a new fcus n an under-served ppulatin in an existing prgram, r the incrpratin f new and innvative methds f delivering PCTI care int an existing prgram. JFNA will nt fund a straight cntinuatin f an existing prgram. 4
Prpsals relating t Hlcaust survivrs living in pverty, survivrs frm the Frmer Sviet Unin (FSU), and survivrs frm the Orthdx Jewish cmmunity are especially encuraged. There is n incme/asset limit under this grant, but the expectatin is fr services t be prvided t the mst vulnerable Hlcaust survivrs. Please nte that funds awarded by JFNA are mstly cmprised f federal funds and cnsidered gvernment grant dllars. If used fr hme care hurs, these funds will cunt as gvernment funded hme care hurs. If a survivr als receives hme care funded by the Claims Cnference, then these JFNA/gvernment-funded hme care hurs must be reprted t the Claims Cnference. Applicatins are sught in fur service categries. Applicants must address ne r mre f these categries in their prpsal. Services listed in each categry are examples and are nt intended t be an exhaustive list f prgrammatic pssibilities. Applicants must describe the innvatins they prpse t develp t make these services mre persn-centered and traumainfrmed, the activities they will undertake t implement thse innvatins, and the utcmes they hpe t achieve. Physical health: Services in this categry are designed t prmte the physical health and well-being f Hlcaust survivrs and include wellness prgrams, meals, falls preventin, chrnic disease self-management, and educatin and training prgrams. Mental health: Services in this categry are designed t prmte the mental, emtinal, and spiritual health f Hlcaust survivrs; decrease depressin, anxiety, and feelings f lneliness and islatin; and/r reduce/mitigate the effects f dementia n Hlcaust survivrs. Services in this categry include individual and grup cunseling, supprt grups, scializatin prgrams; spiritual/chaplaincy prgrams, and educatin and training prgrams. Accessibility: Services in this categry are designed t prmte access t services and include utreach, infrmatin and referral, case management, transprtatin, legal assistance, benefits cunseling and eligibility assistance, and financial planning. Family caregiving: Services in this categry are designed t prmte the physical, emtinal, and financial health f family members and friends wh prvide assistance, care, and supprt t Hlcaust survivrs. Services in this area may include caregiver assessment, cunseling and supprt grups, educatin and training, and respite. 5. Grant Size Categries As a result f JFNA s successful natinal funding effrts and the award f the federal grant, JFNA anticipates allcating $2.8 millin in Year 1. The award funds will cme frm bth federal gvernment and JFNA surces. JFNA will award grants in tw funding categries. Large Grants ($100,000 - $500,000) Small Grants ($15,000 - $75,000) The grant pl is limited, and few prpsals will receive funding. Furthermre, few awards will be made at the highest award levels in each funding categry. Please plan prpsal budgets and prgrams accrdingly. 5
Large Grant ($100,000 - $500,000) Characteristics and Uses JFNA expects t fund up t 15 prpsals in this funding categry in a range f sizes t equal apprximately 80% f the ttal available funding. Agencies applying fr grants in this funding categry must be recipient agencies f the Cnference n Jewish Material Claims Against Germany (Claims Cnference) and currently prvide services t Hlcaust survivrs using funds frm the Claims Cnference. Large grants may be apprpriate fr rganizatins serving many Hlcaust survivrs, rganizatins with waiting lists, r rganizatins with Hlcaust survivrs in the cmmunity whse needs are nt being met. Large grants may als supprt areas with high ptential fr imprvements in PCTI care. Grantees in this funding categry will be expected t design, implement, test, and evaluate ne r mre PCTI innvatins develped thrugh this grant. These prgrams can address different ppulatins served, different pririty service categries, r different integratins f the PCTI apprach. If multiple prgrams r innvatins are prpsed, applicants shuld indicate which prgrams r innvatins are mst imprtant t their agencies in the event that full funding is nt available. Small Grant ($15,000 - $75,000) Characteristics and Uses JFNA expects t fund up t 15 prpsals in this funding categry in a range f sizes t equal apprximately 20% f the available funding. Agencies applying fr grants in this funding categry are nt required t be, but can be, recipient agencies f the Claims Cnference. Small grants may be apprpriate fr agencies serving fewer survivrs. JFNA anticipates that these funds may be used t increase utreach t survivrs. Small grants may als supprt areas with high ptential fr imprvements in PCTI care. Small grants may als be apprpriate fr agencies serving large numbers f survivrs if there is a discrete prject that wuld benefit frm this funding level. Grantees in this funding categry will be expected t design, implement, test, and evaluate ne PCTI innvatin develped thrugh this grant. 6
6. Match Requirements Large Grant Match Requirements Grantees in this funding categry are required t cntribute matching funds at a 3:2 rati. Fr every $3 f federal grant mney received, grantees will be expected t cntribute $2. Fr example, an agency applying fr a grant f $120,000 will be expected t cntribute $80,000 in matching funds, bringing the ttal prgram budget t $200,000. Large Grant Match Requirement examples: JFNA/Federal Prtin (60%) Grantee Match (40%) Ttal Prject Budget (100%) (highest level pssible) $500,000 $333,333 $833,333 $420,000 $280,000 $700,000 $300,000 $200,000 $500,000 $240,000 $160,000 $400,000 $180,000 $120,000 $300,000 $120,000 $80,000 $200,000 Fr a large grant, funding fr the match must be new, and at least 50% must be in cash. The rest f the match can be made up f new in-kind resurces, but matches made up entirely f cash are preferred. Small Grant Match Requirements Grantees in this funding categry are required t cntribute matching funds at a 3:1 rati. Fr every $3 f federal grant mney received, grantees will be expected t cntribute $1. Fr example, an agency applying fr a grant f $75,000 will be expected t cntribute $25,000 bringing the ttal prgram budget t $100,000. Small Grant Match Requirement examples: JFNA/Federal Prtin (75%) Grantee Match (25%) Ttal Prject Budget (100%) (highest level pssible) $75,000 $25,000 $100,000 $56,250 $18,750 $75,000 $37,500 $12,500 $50,000 $ 30,000 $10,000 $40,000 $15,000 $5,000 $20,000 While new cash funding is the preferred surce f the match, fr small grants an agency can als satisfy the match with new in-kind cntributins. 7
Elements f the Match Cmmn t Bth Funding Categries Subject t availability f federal funds and cmpliance with all requirements, the intent is fr prpsals that receive funding in Year 1 t receive funding in Year 2 at half the funding level. Grantees will need t meet the same match rati in Year 2 as in Year 1. The applicant s prpsal must detail where matching resurces will cme frm. Pssible surces f the match include, but are nt limited t: Philanthrpy Fundatins Jewish Federatins Lcal r State gvernment funds fr Hlcaust survivr services The match must cnstitute new resurces fr the rganizatin within the prgrammatic fiscal year f these sub-grants (February 1, 2016 January 31, 2017). Limited exceptin t the abve requirement that the matching funds must be cmprised f entirely new mney: If the grantee is in the middle f a multi-year prgrammatic grant r typically receives an allcatin fr cre-perating supprt, that grant r allcatin cannt be diverted t be used as the matching funds fr this prgram. Hwever, new funding received by the rganizatin within the rganizatin s current fiscal year that includes at least fur mnths f JFNA s prgrammatic fiscal year fr these grants (February 1, 2016 January 31, 2017) can be used fr this match. Fr instance, if a grantee received a new prgrammatic grant n July 1, 2015 that is designed t be spent thrughut the rganizatin s wn fiscal year (hypthetically July 1, 2015 June 30, 2016) and these funds are fr the same prject that is the subject f this applicatin, the rganizatin can use that grant as matching funds fr the JFNA grant. The fllwing funds cannt be used by an rganizatin tward the JFNA/Federal match: Federal funds; Claims Cnference dllars; and Funds used t meet the Claims Cnference s required match. Grantees must demnstrate t JFNA receipt f matching funds by July 31, 2016. If grantees cannt raise the required matching funds by July 31, 2016, they will lse their 2 nd year funding. 8
6. Expectatins and Reprting Requirements Expectatins Grantees will jin a cmmunity f practice and are expected t participate in the technical assistance activities assciated with the JFNA Center fr Advancing Hlcaust Survivr Care, including: Pre and pst grant interviews and ther prject mnitring activities including peridic check-in calls and site visits by JFNA prject staff; Bi-mnthly JFNA cnference calls and 5-6 webinars per year devted t Hlcaust survivrs and the PCTI apprach; Reginal and annual cnferences that feature innvatins n PCTI supprtive services fr Hlcaust survivrs; Disseminatin f prject materials and innvatins at natinal cnferences and publicatins; Trainings t becme pinin leaders in the field; and Lcal and natinal evaluatins f the PCTI apprach. Nte: Sme f these requirements may be waived r amended fr small grants at the discretin f JFNA. In additin, grantees will be expected t fully sustain their prgram beynd Year 2. All prgrams must be sustainable and shuld include effrts t sustain new PCTI-based prgrams and innvatins by btaining cntinuatin funding, incrprating the prgram r innvatin int agency infrastructure and peratins, and seeking new and expansive supprt fr the prgram in the cmmunity. Applicatins withut viable and reasnable sustainability plans will nt scre well. Reprting Requirements All grantees will be required t submit written reprts in electrnic frmat t JFNA n a semiannual basis. In additin t the number f Hlcaust survivrs served, grantees will be asked t reprt n: Activities cnducted during the prject perid and hw they helped achieve the measurable utcmes identified in the prject prpsal. Accmplishments during the reprting perid and hw they helped the agency reach prject gal(s) and bjective(s), including any significant prject partners and their rle in prject activities. Challenges encuntered during the reprting perid and actins taken t address them, including any changes t prject gal(s), bjective(s), r activities that were made as a result f challenges faced. Materials prduced during the reprting perid and hw they have been disseminated, including articles, issue briefs, fact sheets, newsletters, survey instruments, spnsred cnferences and wrkshps, websites, audivisuals, and ther infrmatinal resurces. 9
7. Grant Cmpliance This grant prgram is funded by JFNA thrugh a grant frm the Administratin fr Cmmunity Living/U.S. Administratin n Aging. The statutry authrity fr grants is cntained in Title IV, Sectin 411, f the Older Americans Act (OAA) f 1965, as amended by the OAA Amendments f 2006, P.L. 109-365. (Catalg f Federal Dmestic Assistance 93.048, Title IV Discretinary Prjects). The sub-awards that will be awarded in respnse t this Request fr Prpsals (RFP) will include federal funds. The applicants will need t agree t cmmit t the terms and cnditins fr receiving federal funds frm JFNA (which may change r be updated by the federal gvernment during the prject perid). Awardees will be subject t the fllwing general prvisins f 45 CFR Part 75, and in particular 45 CFR 75.351 and 75.352. 8. DUNS & SAM Registratin ALL applicants must btain a Data Universal Numbering System (DUNS) number and register in the federal System fr Award Management (SAM) system. Registratin must be cnfirmed with JFNA befre funds will be dispersed. This prcess is nt difficult t accmplish, but registratin can take up t ne mnth s please begin nw. Organizatins need a DUNS number in rder t register in SAM. Please fllw these instructins fr registering: DUNS Number: A Data Universal Numbering System (DUNS) number is needed befre registering in SAM. DUNS numbers are unique fr each physical lcatin registering. A DUNS number can be requested at n cst by visiting Dun & Bradstreet (D&B) http://fedgv.dnb.cm/webfrm r by calling the dedicated tll-free DUNS number request line at 1-866-705-5711. It takes 1-2 business days t btain a DUNS number. SAM: The rganizatin is referred t as an Entity. Register the entity t d business with the U.S. Federal gvernment by cmpleting the registratin prcess in SAM. SAM is the fficial free, gvernment perated website there is NO charge t register r maintain yur entity registratin recrd in SAM. Click here: www.sam.gv/sam/transcript/quick_guide_fr_grants_registratins.pdf Fr general guidance, click here: https://www.fws.gv/internatinal/pdf/sam-dunsregistratin-instructins.pdf 10
Sectin 2: Review Prcess and Criteria 1. Review Prcess JFNA will cnvene an Allcatins Cmmittee t review prpsals. The Cmmittee will be cmprised f experts with knwledge f Hlcaust survivrs, Hlcaust survivr prgrams, aging services, prgram planning and evaluatin, trauma-infrmed care, technical assistance r rganizatinal capacity building. Each prpsal will be scred based n criteria utlined in this RFP. Allcatins Cmmittee members will develp funding recmmendatins based n prpsal scres, the range f agency size, target ppulatins, gegraphic regins, service categries, and type f PCTI innvatins necessary t create the diverse pl f grantees required t meet the verall gals f the prgram. Awards may be granted fr less than the amunt requested by the applicant based n the availability f funds and quality f applicatins. The size f the awards will be determined as a result f the review prcess. Nt every prpsal will receive funding. Final decisins abut funding, including award amunts, will be made by JFNA. 2. Review Criteria Large Grants Large grant applicatins ($100,000 - $500,000) will be reviewed n a 100 pint scale using the fllwing criteria: DEMONSTRATED COMMUNITY NEED (15 pints) Applicant demnstrates knwledge f Hlcaust survivr ppulatin in cmmunity (including demgraphic infrmatin) and unmet needs f Hlcaust survivrs The prpsal addresses unmet Hlcaust survivr needs in the cmmunity and is in accrdance with and capable f advancing the gals f the JFNA-ACL grant AGENCY CAPACITY (25 pints) Applicant has a histry f serving Hlcaust survivrs, including implementing prgrams specifically fr Hlcaust survivrs Applicant has a histry f successfully planning, implementing, evaluating, and sustaining new prgrams and innvatins Applicant apprach t meeting the required match is feasible and realistic, with a preference fr the match t be in cash Applicant has the infrastructure (staffing, administrative supprt, technlgy, financial resurce management, etc.) t successfully meet the lcal and natinal requirements f the grant as specified in the RFP Applicant has histry f partnering with scial service rganizatins in the implementatin f its prgrams and this prpsal includes strategies t include cmmunity partners in all aspects f the prpsed PCTI prgram r innvatin 11
PROPOSED PROGRAM (50 pints) Applicant has knwledge f PCTI, a demnstrated histry f prviding PCTI care (even withut using that terminlgy) and clearly explains hw it will be used in the prgram Prgram represents an innvatin in PCTI care The prpsal targets at least ne f the fur pririty service categries specified in the RFP The prpsal prmtes PCTI services fr under-served pr survivrs, survivrs frm the FSU, and/r Orthdx Jewish survivrs The prpsal includes strategies t include Hlcaust survivrs and /r family members in the planning and implementatin f the prpsed PCTI prgram r innvatin The prpsed timeline seems reasnable, with prgram beginning by February 1, 2016 and service delivery beginning by March 14, 2016 The prpsal includes measurable utcmes fr prgram participants The prpsal includes an evaluatin plan capable f demnstrating impact n prgram participants The prpsal includes a plan t sustain the PCTI prgram r innvatin at the end f the grant perid The rles and respnsibilities f prject staff are clearly defined and linked t specific bjectives and tasks STRENGTH OF OVERALL APPLICATION (10 pints) The prpsal narrative is chesive, cnsistent with the budget, and likely t result in desired prject activities and utcmes The prpsed budget cvers tw years, is reasnable, and apprpriately meets the gals and utcmes f prpsal Small Grants Small grant applicatins ($15,000-$75,000) will be reviewed n a 50 pint scale using the fllwing criteria: DEMONSTRATED COMMUNITY NEED (8 pints) Applicant demnstrates knwledge f Hlcaust survivr ppulatin in cmmunity (including demgraphic infrmatin) and unmet needs f Hlcaust survivrs The prpsal addresses unmet survivr needs in the cmmunity and is in accrdance with and capable f advancing the gals f the JFNA-ACL grant AGENCY CAPACITY (9 pints) Applicant has a histry f serving Hlcaust survivrs Applicant apprach t meeting the required match is feasible and realistic, with a preference fr the match t be in cash Applicant has the infrastructure (staffing, administrative supprt, technlgy, financial resurce management, etc.) t successfully meet the lcal and natinal requirements f the grant as specified in the RFP 12
PROPOSED PROGRAM (27 pints) Applicant demnstrates knwledge f PCTI apprach and clearly explains hw it will be used in the prgram Prgram represents an innvatin in PCTI care The prpsal targets at least ne f the fur pririty service categries specified in the RFP The prpsal prmtes PCTI services fr under-served pr Hlcaust survivrs, survivrs frm the FSU, and/r Orthdx Jewish survivrs The prpsed timeline seems reasnable, with prgram beginning by February 1, 2016 and service delivery beginning by March 14, 2016 The prpsal includes measurable utcmes fr prgram participants The prpsal includes an evaluatin plan capable f demnstrating impact n prgram participants The prpsal includes a plan t sustain the PCTI prgram r innvatin at the end f the grant perid The rles and respnsibilities f prject staff are clearly defined and linked t specific bjectives and tasks STRENGTH OF OVERALL APPLICATION (6 pints) The prpsal narrative and budget are chesive, cnsistent, and likely t result in desired prject activities and utcmes The prpsed budget cvers tw years, is reasnable, and apprpriately meets gals and utcmes f prpsal 13
Sectin 3: Applicatin Steps and Cmpnents A. Optinal, infrmatinal phne calls Nvember 4, 2015; 2pm EST and Nvember 12, 2015; 2pm EST 877-304-2955, participant cde: 2027365880# RSVP at www.hlcaustsurvivrcare.rg *Please nly sign up fr ne call, as the cntent will be duplicative. If pssible, please gather with clleagues t save phne lines. Questins received in advance at HlcaustCenter@JewishFederatins.rg will receive pririty n the call. Yu may email additinal questins during the call. Answers t questins discussed n the call will be psted nline. B. Intent t Apply Nvember 13, 2015 All applicants are required t submit their intentin t apply at: www.hlcaustsurvivrcare.rg. When cmpleting the frm, please prvide the fllwing infrmatin: Name and address f rganizatin Name, title and cntact infrmatin fr applicatin cntact Gegraphic area served by prgram, being as specific as pssible Estimated size f grant (indicate Large r Small grant categry) (this can be changed in the applicatin) Anticipated service categry t be addressed (see pp. 4-5) (this can be changed in the applicatin) Anticipated target ppulatin t be addressed (see pp. 4-5) (this can be changed in the applicatin) Cnfirmatin f 501 (c) (3) status Indicate status f SAM registratin and DUNS number C. Applicatin Wednesday, December 2, 2015 at 11:59pm EST at www.hlcaustsurvivrcare.rg Submit basic infrmatin in nline frm, and Uplad pdf f cmplete applicatin including Cver Page, Narrative, Budget and Attachments as described belw. 14
Center fr Advancing Hlcaust Survivr Care Grant Applicatin fr PCTI Innvatins The deadline fr grant applicatins is Wednesday, December 2, 2015 at 11:59 pm EST Please include all f this infrmatin in ne single pdf file saved using the fllwing file name frmat: Name f Organizatin_City. Fr example, XYZServiceOrganizatin_AnyCity SECTION 1. Cver Page Please include a cver page listing the fllwing details. SECTION 2. 1. Name f rganizatin 2. City and state 3. Specific gegraphic area served by the prgram 4. Grant Amunt Requested 5. If yur rganizatin receives Claims Cnference funding, please list current grants by fund and amunt f allcatin Prject Narrative Please address the fllwing tpics within a maximum f 10 pages fr a small grant and a maximum f 15 pages fr a large grant; duble spaced with 1 inch margins; and in Arial fnt, size 11. Please divide yur narrative int these sectins. Clearly address all aspects f the review criteria cvered n pp. 11-13, as the applicatin will be scred based ff f these criteria. A. Demnstrated Cmmunity Need Describe the Hlcaust survivr ppulatin in yur cmmunity (including demgraphic infrmatin) and their current unmet needs Describe hw yu will address Hlcaust survivr unmet needs in the cmmunity and hw the prpsed prgram will be in accrdance with, and capable f advancing the gals f the JFNA-ACL grant B. Agency Capacity Describe the agency s: Histry f serving Hlcaust survivrs 15
Apprach t meeting the required match, with a preference fr the match t be in cash Infrastructure (staffing, administrative supprt, technlgy, financial resurce management, etc.) and hw it is sufficient t meet the lcal and natinal requirements as specified in the RFP C. Prpsed Prgram Describe: The agency s knwledge f PCTI care, histry f prviding PCTI care (even withut using that terminlgy), and hw it will be used in the prgram Hw the prpsed prgram represents an innvatin in PCTI care Hw prpsal addresses at least ne f the fur pririty service categries specified in the RFP (see pp. 4-5) Hw the prpsed prgram prmtes PCTI services fr under-served pr Hlcaust survivrs, survivrs frm the FSU, and/r Orthdx Jewish survivrs r ther survivr ppulatins The prpsed timeline, with prgram beginning by February 1, 2016 and service delivery beginning by March 14, 2016 The measurable utcmes fr prgram participants The evaluatin plan and hw it is capable f demnstrating impact n prgram participants The plan t sustain the PCTI prgram r innvatin at the end f the grant perid The rles and respnsibilities f prject staff and hw they are linked t specific bjectives and tasks D. These elements are required fr Large Grants ONLY. Describe the agency s: Histry f successfully planning, implementing, evaluating and sustaining new prgrams and innvatins Histry partnering with cmmunity rganizatins in the funding and/r implementatin f agency prgrams, and strategies t invlve cmmunity rganizatins/partners in the prpsed PCTI innvatin Strategy t include Hlcaust survivrs and /r family members in the planning and implementatin f the prpsed PCTI prgram r innvatin SECTION 3. Budget Please submit the fllwing using the template prvided. Clearly list the JFNA/Federal request amunt, the grantee's match, and the ttal prject budget. A 2-year prgrammatic budget detailed in tw annual categries cvering the perids frm 2/1/2016 1/31/2017 and frm 2/1/2017 1/31/2018. The budget shuld be as specific as pssible. It must include bth the full prgrammatic budget fr the prject, regardless f the amunt f funding sught frm JFNA, and the prgrammatic funds specifically sught in this grant applicatin. 16
Prject Revenue brken up by surce Prject Expenses All prject persnnel (full r part-time) directly emplyed by agency Fringe benefits (n mre than 35% f persnnel line) Travel Equipment and supplies Cntractual (such as utsurced cngregate meal prgram r third-party hme health aides) Miscellaneus (This culd include space and verhead, including prgram administratin, but these cllectively cannt cnstitute mre than 10% f the amunt the agency is seeking in the grant.) SECTION 4. Attachments Please attach the fllwing supplementary dcuments: A cpy f the rganizatin s current IRS tax-exempt status determinatin letter r mst current Frm 990, OR certificate f Incrpratin r equivalent dcument fr qualified religins rganizatins nt required t file Frms 990 and 1023 Independent audit letter r review letter, if available. Fr rganizatins that cannt prvide such infrmatin, ther financial reprting data culd be sufficient Full agency budget fr mst recent fiscal year cmpleted Full agency budget fr current fiscal year DUNS number and SAM registratin cnfirmatin, r verificatin that registratin is in prcess 17