Roadmaps to Health Community Grants

40 YEARS OF IMPROVING HEALTH AND HEALTH CARE Roadmaps to Health Community Grants 2012 Call for Proposals Brief Proposal Deadline May 2, 2012

Program Overview (For complete details, refer to specific pages/sections noted below.) Purpose (The Program) The Roadmaps to Health Community Grants program (Community Grants) will support communities to implement policy or system changes to address one of the social or economic factors that, as defined by the County Health Rankings, most strongly influence health outcomes in their community. These include: education; employment and income; family and social support; and community safety. Grantees will be organizations that participate in established coalitions or networks that span multiple sectors and perspectives and may include representatives from business; education; public health; health care; community organizations; community members; policy advocates; foundations; and policy-makers. Applicants must engage community members in the planning and implementation of projects, and must collaborate with organizations having expertise in improving the health of the public. Applicants must secure 100 percent matching support, including a cash match of at least 50 percent with the balance as in-kind support. Total Awards (Page 12) Up to 20 grants will be awarded in this solicitation. Grantees will receive awards of up to $200,000 each for up to 24 months to implement their proposed policy or system change strategy. Eligibility Criteria (Page 13) To be eligible, an applicant organization must be located in the United States or its territories and be a: nonprofit organization that is tax-exempt under Section 501(c)(3) of the Internal Revenue Code; tribal group recognized by the U.S. federal government; or state or local agency. Selection Criteria (Page 14) Complete selection criteria can be found starting on page 14. Key Dates and Deadlines (Timetable) March 20 and April 10, 2012 (12:00 1:30 p.m. ET) A series of two applicant Web conference calls. Registration is required. Details can be found at www.rwjf.org/cfp/roadmaps. May 2, 2012 (3 p.m. ET) Deadline for receipt of brief proposals. July 25, 2012 (3 p.m. ET) Deadline for receipt of full proposals. How to Apply (Page 16) Proposals for this solicitation must be submitted via the RWJF online system. Visit www.rwjf.org/cfp/roadmaps and use the Apply Online link. If you have not already done so, you will be required to register at http://my.rwjf.org before you begin the application process. Please direct inquiries to: Alexis Brimage-Major, Community Catalyst Phone: (617) 275-2865 Email: roadmaps@communitycatalyst.org www.countyhealthrankings.org/roadmaps 2

Background We know that much of what influences our health happens outside of the doctor s office in our schools, workplaces and neighborhoods. The ability to find good jobs, to prepare our children for college and career success, to establish financial security, and to live in safe communities that promote positive relationships among family and friends are not usually thought of as health interventions. However, these factors play an important role in our ability to lead long and healthy lives. To better illustrate how these factors influence people s health where they live, learn, work and play, and to identify solutions that make it easier for people to be healthy in their own communities, the Robert Wood Johnson Foundation (RWJF) and the University of Wisconsin Population Health Institute (UWPHI) have collaborated to establish the County Health Rankings & Roadmaps program. This program includes the County Health Rankings project, launched in 2010, and the newer County Health Roadmaps projects that mobilize local communities, national partners and leaders across multiple sectors to improve health. The County Health Rankings (Rankings) are based on a model of population health (See Figure 1 on page 21) that emphasizes the many factors that, if improved, can lead to better health. The County Health Rankings are released annually, providing a ranking of overall health for every county in all 50 states. In addition, the Rankings identify the crucial factors that drive health in communities, such as high school graduation rates, unemployment rates, rates of violent crime, and percentage of children in poverty. The Rankings, based on the latest data available for each county, are unique in their ability to measure the overall health of each county in all 50 states on the multiple factors that influence health. Intended to serve as a call to action, the Rankings have ignited important conversations and activities 3

focused on improving health in communities across the country. In these communities, we ve seen the emergence of multisector collaborations that include business; education; public health; health care; community organizations; community members; foundations; and policy-makers working together to take aim at the root causes of poor health brought to light by the Rankings. These groups are identifying their community s health needs, assets and priorities, and developing strategies to improve their residents health. To encourage further, similar use of the Rankings, RWJF and UWPHI have developed the County Health Roadmaps projects. Together, the County Health Rankings & Roadmaps program is a way for local leaders, concerned citizens and policy-makers to create strong, healthy communities. This approach encourages communities to work together to translate the Rankings into action by identifying priorities for change, and then using evidence about what works to change policies and systems in ways that make it easier for people to be healthy and improve their quality of life. The Roadmaps project includes the Roadmaps to Health Community Grants program; grants to national organizations working with local leaders in business, government, non-profit organizations, and health care to improve population health; the Roadmaps to Health Prize to recognize communities whose promising efforts have led to better health; and customized technical assistance to communities on strategies to improve health with a specific focus on policy and system change. 4

The Program The Roadmaps to Health Community Grants projects (Community Grants) are a key part of the County Health Rankings & Roadmaps program. Participants in this grant program will demonstrate how a range of partners from multiple sectors in their communities can work together to translate the Rankings into actions that improve health. This program focuses on supporting communities using data and evidence to pursue policy or system changes that address the social and economic factors that most strongly influence health. Applicants must secure 100 percent matching support, including at least a 50 percent cash match from one or more local, state, regional or national funding partners; the balance can be in kind support. The initial round of Community Grants was awarded to 12 organizations in 2011. Information on those projects is available at www.countyhealthrankings.org/roadmaps. Community Catalyst, a national nonprofit health advocacy organization with expertise in collaborating with national, state and local consumer organizations, policy-makers and foundations, will work with UWPHI and RWJF to manage the Community Grants program. Community Catalyst will provide technical assistance to grantees, including strategies to guide community engagement and local policy and advocacy activities. Resources, such as tools, materials and stories of communities translating the Rankings into evidence-informed, strategic efforts will be shared broadly to help mobilize others to tackle the root causes of poor health in their communities. Multisector Coalitions or Networks Having health insurance and quality health care are important to our health, but we need leadership and action beyond health care to make America a healthier place and to keep people from becoming sick in the first place. To achieve this goal, we believe that it will take efforts from a broad range of organizations representing a variety of sectors not traditionally 5

considered to be part of health such as education, housing, transportation, public safety, and agriculture. We are particularly interested in proposals that can demonstrate participation by government officials and policy-makers; businesses; funders; hospitals or other care providers; policy advocates; public health agencies or organizations; and/or community organizations. Successful applicants will feature a multisector coalition or network with the necessary expertise to ensure it can appropriately address the targeted social or economic factor and related health impacts. Accordingly, coalitions must include participation from organizations with expertise in the social or economic factor being addressed. While the applicant organization and the coalition need not have an explicit focus on health, the coalition must include participation from organizations with expertise in improving the health of the public. By collaborating with organizations such as a public health department or institute; an academic institution; health policy organization; or other community health improvement organization, the coalition will be better able to describe, understand, and demonstrate its role in achieving positive health impacts. The coalition or network should have a track record of working together previously and applicants must clearly explain how the members will participate in the proposed project. Given the focus on multisector engagement, it is expected that the coalition or network may grow during the course of the project to include representation from sectors necessary to achieve success, but the core members must have a history of collaborative effort. Applicants must fully describe how their coalition or network will be managed, and enlarged as necessary, to facilitate achieving impact. Social and Economic Factors The four social and economic factors described below are the focus of this program because, as described in the County Health Rankings model (Figure 1 6

on page 21), they have a significant impact on population-level health outcomes even more than medical care and genetic factors. We recognize that the social and economic factors identified in the County Health Rankings model are interconnected with other health factors, such as health behaviors, the environment, or clinical care and that, together, they can have a significant impact on health outcomes. While proposals may discuss the relationship among the four key health factors and other factors that influence health, the primary focus of the application must be on implementing policy or system change strategies to address one of the four social or economic factors described below. Applicants must clearly describe a proposed policy or system change objective that addresses one of the following social or economic factors that affect health: Education Education has been shown to influence health outcomes in several ways. People who complete higher levels of education are more likely to live longer, experience better health outcomes, and practice health-promoting behaviors. Education can also lead to improved health by increasing health knowledge and health literacy, which helps improve an individual s health behaviors and informs healthrelated choices. Finally, education influences a variety of social and psychological factors that also influence health by reducing stress and providing other practical and emotional supports. Employment and Income Employment, income and financial resources are very important to health, allowing individuals to afford healthy food, safe housing, and other essential basics; to access a variety of resources that help people maintain or improve their health; and to obtain health insurance and pay for medical care. Unemployment has been linked to adverse mental 7

health conditions, including stress and depression, as well as declines in health status, ranging from self-reported physical illness to mortality, especially suicide. Unemployment can also lead to an increase in unhealthy behaviors and other risk factors such as inadequate child care. Family and Social Support A person s health is also affected by the quality of relationships he or she has with family members, with friends, colleagues, and acquaintances, as well as the extent of his or her involvement in community life. Inadequate family and social supports are associated with declines in health and premature death. Policies such as those that build social capital at the community level or encourage social connectedness among adults, special populations, or youth can improve social networks, social capital, and social support and reduce social isolation, which all lead to healthier outcomes. Community Safety The health impacts of community safety are far reaching, from the obvious and immediate impact of violence on a victim to the symptoms of post traumatic stress disorder and psychological distress felt by those who are routinely exposed to violence. People who live in high-crime, high violence neighborhoods are more likely to suffer from stress and psychological distress. Such living conditions are also associated with a variety of risk factors, such as increased substance use, increased isolation, decreased physical activity and reduced social support. Policy or System Change The projects funded by Roadmaps to Health Community Grants should demonstrate how communities can take action to seek change in the laws, regulations, institutions or systems that shape the social and economic factors that affect people s health. By supporting non-lobbying activities focused on 8

either policy change (which includes changing public laws, regulations, rules or mandates) or system change (which includes changing the priorities, protocols or practices within organizations or across a group of organizations), these efforts can have an impact on larger segments of the population. The overall goal is ensuring sustainability of the changes made over a much longer period of time than just the grant period. Successful applicants will describe a policy or system change that addresses one of the four social or economic factors listed above. Applicants must further describe how their proposed policy or system change will be effective in addressing that factor and lead to improved health outcomes. For examples of how some currently funded grantees are addressing the factors, please consult the Frequently Asked Questions document or www.countyhealthrankings.org/roadmaps. Note that those examples are intended to assist, not restrict, applicants in selecting strategies to improve health. Applicants must describe the process that was used for assessing the health needs and resources of the community and the process for selecting the proposed policy or system change. The assessment process should include the use of data from the County Health Rankings and other sources. Furthermore, applicants must describe how representatives from the community, including those most likely to benefit from the changes, helped select the proposed policy and system change objective from a range of competing needs. This grant program will demonstrate community efforts focused on advancing policies or changing systems that affect education, employment and income, family and social support and community safety. Increasing the scope and availability of existing community programs is not the primary goal of this grant program, so applications must be clearly focused on a policy or system change goal. 9

Matching Fund Requirements To be eligible for funding, applicants must secure 100 percent matching support. At least 50 percent of the match must be a cash match from one or more local, state, regional or national funding partners. The balance may be in-kind support provided by organizations other than the applicant organization. In-kind support is defined as contributed services that have a dollar value, such as a percentage of an individual s salaried time, office space, duplicating and printing support, etc. The purpose of the match is to expand the funding base and support for the proposed action strategy, increase the sustainability of the effort, and to provide resources for activities that RWJF cannot fund (e.g., lobbying). Matching Funds Matching funds may come from organizations, such as independent and private foundations, family and community foundations, corporate foundations and other philanthropies; business partners; coalition member organizations; or from city, county, state and federal funds. The Roadmaps to Health Community Grants program is designed to support efforts that are distinct from, yet may work synergistically with the federal-funded community prevention programs that are focused on addressing healthy behaviors, the built environment, and clinical care. Therefore, federal funds issued as part of Communities Putting Prevention to Work and the Community Transformation Grants, are not eligible as cash match for this program, but are eligible as in-kind match. Federal funds coming from other programs are eligible as both cash and in-kind match. Applicants must clearly document that all matching funds, in particular, those from city, county or state funds, are designated solely for the proposed project. Additionally, the matching funds must come from sources other than RWJF itself or RWJF awards to an organization. 10

At the time of brief proposal submission, applicants are expected to submit a description of the anticipated match. Upon notification that the full proposal is being recommended for funding, all finalists will be required to confirm that matching funds have been secured. Written confirmation should be in the form of a grant or funding commitment letter for cash match and must be provided to RWJF within seven business days of being notified as a finalist in order to move forward in the approval process. Expectations of Grantees As part of the Community Grants program, grantees will be expected to: Collaborate with organizations from multiple sectors (as described above on pages 5 and 6) with a focus on a social or economic determinant of health in all aspects of the planning and implementation of the proposed policy or system change strategy. Engage community representatives and advocates from multiple sectors in the policy or system change process. Educate policy-makers and the public about the proposed policy or system change strategy and incorporate messages about the County Health Rankings model, including how factors outside the doctor s office affect health. Advocate for the proposed policy proposed policy or system change by using available evidence and by making a persuasive case for how the proposed policy or system change will improve health factors, outcomes and provide other benefits to the community. Work collaboratively with Community Catalyst, UWPHI and RWJF staff, other grantees, consultants, technical assistance providers, evaluators and participate in training, communications, and dissemination of lessons learned. Share findings, models, case examples and lessons learned with external audiences. 11

Secure matching funding from local, state, regional or national organizations to ensure sustainability of the efforts beyond the RWJF grant funding. Participate in regular conference calls and webinars and an annual in-person grantee meeting. More information on the current grantees and other communities that have used data to spur action are available at the County Health Ranking website at www.countyhealthrankings.org or the What Works? Policies and Programs to Improve Wisconsin s Health database available at www.whatworksforhealth.wisc.edu. Total Awards Up to 20 grants will be awarded in this solicitation. Grantees will receive awards up to $200,000 each for up to 24 months to implement their proposed policy or system change strategy. This program is a collaboration of the RWJF Public Health and Vulnerable Populations teams and reflects the Foundation s commitment to addressing the social and economic determinants of health through integrated changes in policies, norms and practices, social supports and the physical environment. For more information, see www.rwjf.org. 12

Eligibility Criteria RWJF seeks proposals from organizations that participate in established coalitions or networks that have representation from a range of sectors and from community stakeholders. For purposes of this program, an eligible community is defined as a municipality, county, tribe, district, state or region. Successful applicants will be able to define community from a variety of perspectives, including geography, demographic data, and likelihood to benefit from the proposed policy or system change. Although there is no minimum requirement for population size, initiatives focused on individuallevel change or that have limited population impact generally would not be considered competitive. Proposals from all communities are welcome, but we are especially interested in under-resourced, high-need communities. Additionally, we seek to support grantees that are diverse in location, type of organization, coalition composition and that have developed specific policy or system change targets. If funded, the applicant organization will assume leadership in managing the grant funds and implementing its project. However, it is expected that the applicant organization will represent an established coalition or network that includes a wide range of community stakeholders. To be eligible, an applicant organization must be located in the United States or its territories and be a: nonprofit organization that is tax-exempt under Section 501(c)(3) of the Internal Revenue Code; tribal group recognized by the U.S. federal government; or state or local agency. 13

Selection Criteria The Roadmaps to Health Community Grants Review Committee, comprising RWJF, UWPHI, Community Catalyst staff, and other expert reviewers, will review proposals. All proposals will be screened for eligibility and then reviewed using the following criteria: Commitment to and capacity of the grantee organization to implement the proposed project; manage the grant funds; and administer and track lobbying and non-lobbying expenditures and funding. Demonstrated experience conducting effective policy or system change advocacy. A clearly defined focus on one of the four social and economic factors included in the County Health Rankings model, including: education; employment and income; family and social support; and community safety. Rationale for how the policy or system change will address the selected social or economic factor and how that change will lead to improved health outcomes. A clearly defined objective that specifies a policy or system change, identifies which decision-makers have the authority to make the desired change, and how those decision-makers will be engaged consistent with the lobbying prohibition applicable to RWJF funds. A clear and feasible plan with benchmarks for achieving the proposed policy or system change and a time line of key events. An analysis of the anticipated opportunities and challenges in the local environment that are likely to affect the project, including a plan for how challenges will be addressed. Demonstrated partnerships among the applicant organization and coalition or network partners, including engagement and commitment from representatives of multiple sectors, such as business, government, health and other non-health sectors. A clearly identified population to be affected by the policy or system change. 14

Evidence that the proposed policy or system change addresses a need that the community has prioritized. Evidence that members of the population affected by the policy or system change have been involved in the development of the proposed action strategy and will be engaged throughout the project. Potential for the proposed action strategy to be sustained and valued within the community. Potential for the project to serve as a model for other communities seeking similar change. Commitment of matching funds and in-kind support to the project. A budget that includes both grant and matching funds, and aligns spending with objectives and strategies. Evaluation and Monitoring Mathematica has been selected and funded by RWJF to plan an evaluation of the overall County Health Rankings & Roadmaps program. As a condition of accepting RWJF funds, grantees will be required to participate in the evaluation with the cohort of 12 current grantees. Grantees are also expected to communicate regularly with and participate in activities arranged by Community Catalyst, the national program office for this grant program. Grantees are expected to meet RWJF requirements for the submission of narrative and financial reports, as well as periodic information needed for overall project performance monitoring and management. Project directors are expected to participate in periodic meetings and give progress reports on their grants. At the close of each grant, the grantee is expected to provide a written report on the project and its findings suitable for wide dissemination. 15

Use Of Grant Funds Grant funds may be used for project staff salaries, consultant fees, data collection and analysis, meetings, supplies, project-related travel, and other direct project expenses, including a limited amount of equipment essential to the project. In keeping with RWJF policy, grant funds may not be used to subsidize individuals for the costs of their health care, to support clinical trials of unapproved drugs or devices, to construct or renovate facilities, for lobbying, or as a substitute for funds currently being used to support similar activities. Grantees are expected to include in their budgets travel for two people to participate in two annual grantee meetings, using the Foundation s travel cost estimate of $1,360 per person for a two-night/two-day trip where air travel is required. This $5,440 should be included within the proposed application budget. How To Apply Proposals for this solicitation must be submitted via the RWJF online system. Visit www.rwjf.org/cfp/roadmaps and use the Apply Online link. If you have not already done so, you may be required to register at http://my.rwjf.org before you begin the application process. There are two stages in the competitive proposal process: (1) applicants submit a brief proposal that describes the project and include a one-page preliminary budget; and, if invited, (2) select applicants then submit a full proposal, line-item budget, budget narrative, and other documentation, including at least three and up to five letters of support from key partner organizations. Note that letters of support should not be form letters. Stage 1: Brief Proposals Applicants must submit a brief proposal that describes the project and include a one-page preliminary budget. These brief proposals should total no more than five pages in length. The brief proposal must include the following brief descriptions of: 16

The applicant organization and how the organization s mission aligns with the proposed project. The applicant organization s capacity to undertake the project, including experience conducting policy or system change advocacy. The social or economic factor to be addressed, including data describing that factor in the targeted population. The evidence base or rationale that supports the proposed policy or system change as a strategy to address a factor that influences health. The policy or system to be changed. The plan and strategy for achieving the policy or system change, including identification of key decision-makers. The proposed coalition or network members and a brief description of the group s experience working together. The role and experience of each key partner in the project. Additional partners needed to achieve coalition or network goals, and a plan to develop these partnerships. Population that will be affected by the policy or system change, including data on population size and need within the targeted community. Process used to define, assess and prioritize the community s needs, and a description of how the proposed policy or system change target was selected. How members of the population affected by the policy or system change were involved in the development of the proposed action strategy and how they will be engaged throughout the project. Anticipated matching funding partners. The name, title and contact information for the project director. 17

Estimated total budget request. Expected duration of the proposed grant, which is not to exceed two years. A series of two Web conference calls will be held on March 20 and April 10, 2012 from 12:00 1:30 pm ET to provide applicants with additional information on the program and the application requirements. Interested applicants are encouraged to visit www.rwjf.org/cfp/roadmaps for more information and to view frequently asked questions. Stage 2: Full Proposals Selected Stage 1 applicants will be invited by email on June 13, 2012 to submit a full proposal accompanied by a budget, budget narrative and additional documentation. Applicants invited to submit a full proposal will be expected to elaborate on the brief proposal. Applicants invited to submit full proposals will also be expected to submit letters of support that describe the interest and participation of key stakeholders, and, if selected, to participate in virtual site visits conducted by members of the proposal review team. Further description of the proposal requirements will be provided to successful Stage 1 applicants. 18

Program Direction Direction and technical assistance for Roadmaps to Health Community Grants are provided by Community Catalyst, which serves as the Roadmaps to Health Policy and Advocacy Lead located at: Community Catalyst, Inc. 30 Winter Street, 10th Floor Boston, MA 02108 Phone: (617) 275-2865 Fax: (617) 451-5838 Email: roadmaps@communitycatalyst.org Website: www.communitycatalyst.org Responsible staff members at Community Catalyst are: Phillip Gonzalez, program director Deborah Katz, associate director Susan Sherry, deputy director, Community Catalyst Responsible staff members from the Robert Wood Johnson Foundation Public Health team: Abbey Cofsky, program officer Kristin Schubert, senior program officer and interim team director Tom Andruszewski, senior grants administrator Responsible staff members from the Robert Wood Johnson Foundation Vulnerable Populations Portfolio: Jamie Bussel, program officer Jane Lowe, senior program officer and team director 19

Additional Resources County Health Rankings: www.countyhealthrankings.org RWJF Public Health: www.rwjf.org/publichealth RWJF Vulnerable Populations: www.rwjf.org/vulnerablepopulations Community Catalyst: www.communitycatalyst.org What Works? Policies and Programs to Improve Wisconsin s Health: www.whatworksforhealth.wisc.edu 20

Figure 1: County Health Rankings Model Health Outcomes Mortality (length of life) 50% Morbidity (quality of life) 50% Tobacco use Health behaviors (30%) Diet & exercise Alcohol use Unsafe sex Clinical care (20%) Access to care Quality of care Health Factors Education Social and economic factors (40%) Employment Income Family & social support Community safety Programs and Policies Physical environment (10%) Environmental quality Built environment County Health Rankings model 2010 University of Wisconsin Population Health Institute 21

Notes 22

Timetable n March 20 and April 10, 2012 (12:00 1:30 p.m. ET) A series of two informational Web conference calls. Registration is required. See details on the program s website at www.rwjf.org/cfp/roadmaps. May 2, 2012 (3 p.m. ET) Deadline for receipt of brief proposals.* June 13, 2012 Applicants notified if they have been invited to submit a full proposal. July 25, 2012 (3 p.m. ET) Deadline for receipt of full proposals.* September 5 September 12, 2012 Virtual site visits. Late September 2012 Notification of awards. November 1, 2012 Start of grants. * Applications for this solicitation must be submitted via the RWJF online system. All applicants should log in to the system and familiarize themselves with online submission requirements well before the final submission deadline. Staff may not be able to assist all applicants in the final 24 hours before the submission deadline. In fairness to all applicants, late submissions will not be accepted.

About the Robert Wood Johnson Foundation The Robert Wood Johnson Foundation focuses on the pressing health and health care issues facing our country. As the nation s largest philanthropy devoted exclusively to improving the health and health care of all Americans, the Foundation works with a diverse group of organizations and individuals to identify solutions and achieve comprehensive, measurable and timely change. For 40 years, the Foundation has brought experience, commitment and a rigorous, balanced approach to the problems that affect the health and health care of those it serves. When it comes to helping Americans lead healthier lives and get the care they need, the Foundation expects to make a difference in your lifetime. For more information, visit www.rwjf.org. Sign up to receive email alerts on upcoming calls for proposals at http://my.rwjf.org. Route 1 and College Road East P.O. Box 2316 Princeton, NJ 08543-2316 February 2012