Request for Applications (RFA) This is an Electronic Submission RESPONSE DUE April 28, 2017 Applications must be submitted via the link below: https://www.grantrequest.com/sid_946?sa=sna&fid=35415 Grant Period: July 1, 2017 June 30, 2018 Grant Awards: $30,000-$50,000 Questions: Susanna Osorno-Crandall, Community Benefit Manager Phone Number: 510-752-1504 Email: Susanna.Osorno-Crandall@kp.org Incomplete applications will be rejected. Applications submitted past the due date indicated above will not be accepted.
Thank you for your interest in the Kaiser Permanente East Bay Community Benefit Program. Each year through our programs, we support local organizations that are working to improve the health of the communities we serve. For 70 years, Kaiser Permanente has been committed to improving the health of our members and the communities we serve. Social responsibility and community involvement are part of the Kaiser Permanente legacy, and are crucial to our mission. Through partnerships with community groups, schools, and government organizations, we work to benefit the community at large by addressing issues and concerns that affect overall health. Kaiser Permanente Community Benefit Program provides funding and resources to support community partners, organizations and agencies in the following cities in Northern Alameda and West Contra Costa counties: Oakland, Alameda, Albany, Berkeley, Emeryville, Piedmont, El Cerrito, El Sobrante, Hercules, Pinole, Richmond, Rodeo and San Pablo. Programs for which funding is being requested must be based within our service area. The East Bay Community Benefit Program provides funding and support to local nonprofit organizations addressing the priority health needs identified in the Kaiser Foundation Hospital (KFH) Oakland and KFH Richmond 2016 Community Health Needs Assessment (CHNA). For more information about our CHNA process and reports please visit: www.kp.org/chna Community Benefit Grant Priorities The Kaiser Permanente East Bay Community Benefit Program will consider grant requests from local community organizations and programs that align with one of the identified Community Benefit priorities listed below: Healthy Eating Active Living Strategies Increase access to healthy, affordable foods, including fresh produce, and decrease access to unhealthy food. Increase enrollment in and use of federal food programs. Increase access to physical activity opportunities in the community and in schools. Outcomes Increased consumption of fruits and vegetables. Increased enrollment and participation in federal food programs. Increased physical activity.
Access to Care and Coverage Strategies Support outreach, enrollment, retention and appropriate utilization of health care coverage programs. Increase access to primary and specialty care. Improve navigation to obtain access to appropriate care within the health care system. Provide support to increase enrollment in public benefit programs (including federal food programs) among vulnerable and low income populations. Outcomes Increase in the number of lowincome patients that enroll in health care coverage programs. Increased integration of primary and specialty health care services. Improved capacity of safety net providers to assuming capitated risk. Increase in referrals and coordination to non-medical social services. Mental and Behavioral Health Strategies Support opportunities to prevent and reduce the misuse of drugs and alcohol. Provide access to programs, services or environments that evidence suggests improves overall social/emotional wellness. Support opportunities to reduce stigma through education and outreach in school, community and workforce settings. Support hiring and Increase access to training and education for diverse populations currently underrepresented in the behavioral health care workforce. Increase the capacity to respond appropriately to individuals and/or communities that have experienced trauma and/or violence. Improve navigation to appropriate care within the health care system and support services in the community Outcomes Increased participation in drug and alcohol prevention programs Increase in help seeking behavior for accessing behavioral health care. Increase in the number of people from underrepresented groups enrolling in education and job training programs. Improved access to quality care for youth, families and communities experiencing violence. Increased integration of primary and behavioral health care services.
Community and Family Safety Strategies Improve law enforcement and community relations. Increase availability of education, job training and enrichment programs for youth. Support programs that promote non-violent solutions to conflict and alternatives to punitive responses Support programs that prevent and address family violence through reducing risk factors, enhancing protective (resilience) factors and linking to appropriate resources. Support targeted gang/previously incarcerated individual outreach and case management. Provide victims of violence with services needed for recovery or increase the capacity to respond to individuals/communities exposed to trauma. Support integration of health care with community based programs and services that address violence-related issues among patients and the community. Outcomes Increase trust between law enforcement and community members Increased enrollment and completion of education and job training programs for youth. Improved capacity of systems or organizations to implement nonviolent solutions to conflict and alternatives to punitive responses. Increased participation in prevention programs and support services for those at risk of family violence. Decreased recidivism. Increased organizational capacity to offer quality services to individuals and communities experiencing trauma/violence. GRANT AWARDS: $30,000-$50,000 ELIGIBILITY GUIDELINES Kaiser Permanente East Bay will consider requests that meet the following criteria: Serve Oakland, Alameda, Albany, Berkeley, Emeryville, Piedmont, El Cerrito, El Sobrante, Hercules, Pinole, Richmond, Rodeo and San Pablo. Only nonprofit (with 501(c)3 IRS status) or public benefit organizations are eligible to receive funding; unincorporated groups or agencies can make arrangements to utilize an eligible nonprofit organization as a fiscal sponsor. Projects must address a health priority identified in the Community Health Needs Assessment. Strategies must be consistent with those outlined under the health priorities listed above and consistent with the values and mission of Kaiser Permanente. In good standing with KP; has submitted all previous grant requirements for previous funding if applicable.
FUNDING LIMITATIONS Kaiser Permanente Community Benefit Department will not consider funding requests from the following types of organizations or for the following activities/purposes: Any organization that discriminates on the basis of sex, age, economic status, educational background, race, color, ancestry, national origin, sexual orientation, gender identity, or marital status in their programs, services, policies, and administration Any program that directly and solely benefit Kaiser Permanente members and/or staff Contributions to endowments or memorials Emergency loans Youth sports leagues Political campaign (Kaiser Permanente is legally prohibited from funding political campaigns) Religious purposes (Kaiser Permanente may fund faith organizations providing secular programs that serve the greater community. These organizations must apply under a fiscal sponsor. A community nonprofit partner with an eligible 501(c)3 IRS status can apply for funding as a fiscal sponsor on behalf of an interfaith collaborative.) Individuals and/or personal requests such as scholarships, individual tuition, payment for educational purposes, conferences, etc. DEADLINES / IMPORTANT DATES Event/Task Date Grant Application WebX Prior to Grant Submission RFA Deadline April 28, 2017 Contract Start Date July 1, 2017 Notification of Award or Declination June 23, 2017 Grantee Orientation July August (TBD) Progress Report Due January 19, 2017 Site Visit January - February (TBD) Final Report July 31, 2018
CONFLICT OF INTEREST Organizations must disclose any potential conflicts of interest with our organization in the application, including whether any Kaiser Permanente executives, managers, directors, physicians, other employees or their family member serves as a board member, director, officer, manager, employee or fiduciary agent of your organization; or has a compensation arrangement or financial interest with your organization. REQUIRED DOCUMENTS The following documents are required for submission and must be uploaded as part of the submission. The application cannot be submitted through the online system without attaching these documents. 1. Request on organization s letterhead: the request on the organization s letterhead should include the legal name of the organization, the organization s address, the amount requested, project title, and a project summary. 2. Tax exempt status verification: For tax exempt status verification, the following documents must be submitted: For nonprofit organizations: Copy of current IRS determination letter indicating appropriate tax-exempt status with Tax ID number (preferable), or Copy of the certification from the Office of the State Attorney General where the qualified organization is registered. For government/public entities: Notarized letter from the organization's Chief Financial Officer or Certified Public Accounting Firm indicating the government/public agency has been granted tax exemption or Affirmation letter from the IRS with the Federal Identification Number. 3. Current list of Board of Directors and their affiliations 4. In addition to the requirements above, the following two pieces of information are also required for all requests at or above $25K Most recent form 990: Most recent 990 Most Recent Audited Financial Statement 5. Organization Operating Budget 6. Completed Project Budget Template (provided in application): Download the required project budget template and save it to your computer. Upload completed template under General Project Information in the online application. All items listed on the budget must be for the project identified in the application. Complete the narrative
column of the budget for all items listed. Make sure all budget items properly reflect the project description and workplan. 7. If Fiscal Agent is required: If a fiscal agent is being used, the request and required information must also be submitted on the fiscal agency s letterhead along with a copy of the Memorandum of Agreement. Tax Exception Verification of Fiscal Agent Fiscal Agent MOU: Memorandum of Agreement between your organization and your Fiscal Agent. Request on Fiscal Agent Letterhead: Letter should include the legal name of your Fiscal Agent, Fiscal Agent Federal Tax ID, Fiscal Agent s address, requested amount, project summary and project title. 8. Project Workplan (provided in application): Download workplan template and save it to your computer. Upload completed workplan in the online application under Project Description. Make sure your workplan reflects the project description and aligns with the project goals and objectives. ONLINE SUBMISSION PROCESS All applications are submitted via IGAM, our grant application system. To enter the application system click here. You will be asked to create an account. Create one user account for the organization applying for funding. If you already have an account for the organization you are requesting funding for do not create a new account. If you forgot your account password, please follow the on-screen instructions from the Account login page to retrieve your password. If this method does not work, please send an email to: KP-Community@kp.org with IGAM Password Reset in the subject line to reset your password. Once you create your user account you will be taken to the online application. Tips: You may want to click on Save & Finish Later before entering data to bookmark the My Account page URL as you will need it if you don t complete the application in one session. After starting your application, the only way to get back to it is with URL: https://www.grantrequest.com/sid_946?sa=am. In addition, through the My Account page you can view a history of open applications and completed submissions as well as email yourself a copy of a draft or completed submission. Prior to submitting your online application, you will be able to review your grant application. Please note that once a grant application has been submitted, it cannot be edited.
UPLOADING INSTRUCTIONS When attaching the files, all files must be labeled as follows Organization Name_Document Title. For example - Valley Clinic_Board of Directors. When ready to attach the files, please do the following: 1. Select from the pulldown list the document ready to be attached 2. Click Browse button and select the file 3. The file you selected will then be displayed 4. Click the Upload button and your file will be attached Please complete these steps for each required document. The maximum size for all attachments combined is 100 MB. Please note only doc, xls, jpg or pdf format files can be uploaded. Please note that these instructions are specific to Internet Explorer. Depending on the browser you are using, you may see slight differences in upload tools. PROCESSING GUIDELINES All applicants receive a system-generated email confirmation, confirming their application was submitted. It may take 8-10 weeks after submission to process your request. An award or declination notice will be sent by June 23, 2017. For those awarded grants please make sure we have the correct mailing address for the mailing of the Grant Agreement letter. All Grant Agreements must be signed and returned before funds are released. Once funds are received a payment acknowledgement statement must be sent to the Community Benefit department within 90 days. A payment acknowledgment will be sent along with the payment. The statement must contain the following information: Legal name of the organization that received the contribution. Payment date on the check when the contribution was made. Amount of the contribution. Whether or not goods and services were provided in exchange for the contribution. CONTACT US If you have any questions about the application system or experience technical difficulties, please contact KP-Community@kp.org. If you have questions about the application content, contact Susanna Osorno-Crandall at Susanna.Osorno-Crandall@kp.org Thank you for your interest in the Kaiser Permanente East Bay Grant Program.