UPDATE October 28th: Due to a large number of proposals, we will not be able to provide notification by 10/30. We apologize for any inconvenience.

Notices will be sent out as soon as the scoring is completed.


September 2, 2015

Request for Proposals: Closed
Letter of Intent: Closed

Questions and Answers - Updated October 7, 2015

Background

The New Hampshire Comprehensive Cancer Collaboration (NH CCC), managed by the Foundation for Healthy Communities, is a partnership of individuals and organizations committed to reducing the burden of cancer, the leading cause of death in New Hampshire (NH).  NH CCC is governed by a Board of Directors. The 2015-2020 New Hampshire Comprehensive Cancer Control Plan serves as the blueprint that will guide activities toward achieving the three overarching goals of the Plan:

Goal 1: Foster communities and systems that support and reinforce healthy lifestyles.

  • Targeted efforts toward public policy as well as community and organizational systems change
  • Areas of interest:
    • tobacco use
    • tanning
    • healthy eating and active living
    • breastfeeding
    • HPV vaccine

Goal 2: Prevent and detect cancer at its earliest stage.

  • Address health equity & improving health systems to navigate patients and improve community-clinical linkages
  • Areas of interest:
    • breast, cervical, and colon cancer screening
    • informed decision making for lung and prostate cancer

Goal 3: Optimize quality of life for those affected by cancer.

  • Focus on improving access to high quality health services through policy, system and environmental strategies that promote access to comprehensive and cutting-edge treatments & services.
  • Areas of interest:
    • Access to quality diagnostic & treatment services
    • Clinical trials / research
    • Palliative care
    • Survivorship programs
    • End of life care

These three goals were developed with the recognition that:

  • There is a link between health status and where people live
  • Communities that support healthy lifestyles will have better health outcomes
  • Efforts that support policy, community and organizational systems interventions, or environmental changes are effective and sustainable strategies to improve population health outcomes.
  • Screening at appropriate intervals can prevent and detect some types of cancer at early stages
  • Screening rate disparities exist in NH
  • Improving the health and well-being of cancer patients, their families and caregivers begins at the time of diagnosis and continues across the natural trajectory of the disease.

Three Task Forces (Equity, Quality of Life, and Shared Decision Making) are currently engaged in activities related to objectives in the Cancer Plan. The Task Forces represent themes that cross cut all three goals of the Plan. Two co-leaders facilitate the meetings and activities of each Task Force.

NH CCC originated in 2003 through the National Comprehensive Cancer Control Program‘s effort to reduce the burden of cancer using a collaborative approach within communities when partners combine, share, and coordinate resources to reduce the burden of cancer. The Centers for Disease Control and Prevention fund states, territories and tribes to address cancer. Additional information about the NH CCC is available at www.NHCancerPlan.org.

Purpose:

The purpose of this funding for 2015-16 is to support evidence-based strategies or promising practices that are directly linked to objectives identified in the NH Cancer Plan and will advance the implementation of the Plan. Activities must use a policy, systems or environmental change (PSE) strategy that offers opportunities to further develop community partnerships and/or advance health equity. (Examples of PSE approaches are listed on page 5.) The 2015-2020 NH Comprehensive Cancer Control Plan includes 15 objectives. 

Approved proposal activities must be completed by Thursday, June 30, 2016, and all funds awarded must be spent by June 30, 2016.  Cost extensions will not be granted, and budget revisions must be approved by no later than Friday, May 13.

In 2015, $20,000 is available for Implementation Funding awards. 

Eligible Applicants:

Proposals will only be accepted from individuals who can cite active or prior participation in the Collaboration.  Budget narratives must clearly justify funds requested based on proposal of work engaging the Collaboration. 

Funding Awards (total of $20,000)

Award 1: Available only to current Task Force Co-Leaders

Pairs of Task Force Co-Leaders are eligible to apply for $1,000 for Task Force Implementation funding to address an activity from the work plan that supports the pending work of the Task Force.

Award 2: Available to Collaboration Members and Task Force Co-Leaders (if the activity warrants a higher award)

Up to $17,000 is available for proposals from applicants that can cite active or prior participation in the work of the Collaboration.

Proposals will be reviewed based on alignment with the strategies and objectives of the NH Cancer Plan.   A non-profit organization must be identified on the cover sheet to serve as the fiscal agent for the proposal. Funding may only be used to serve the population of NH.

Timeline:
September 2, 2015 Request for Proposals issued
September 25, 2015 Required Letter of Intent due. Use template posted at http://www.nhcancerplan.org/index.php/featured-content/250-loi-september-2015-funding-opportunity.
October 8, 2015 Deadline to submit questions (in writing via email only to This email address is being protected from spambots. You need JavaScript enabled to view it.. Please do not ask questions by phone call or verbal request. All questions and answers will be posted at www.NHCancerPlan.org.
October 15, 2015

Proposals due via email only by 4 pm to Regina Flynn: This email address is being protected from spambots. You need JavaScript enabled to view it.

October 30, 2015 Selected applicants will be notified
May 13, 2016 Deadline for re-budgeting
June 30, 2016 Projects must be completed and funds spent
July 29, 2016 Final written and financial report due


Proposal Outline, Forms, and Review Criteria

These forms* will be sent to those who submit the required Letter of Intent using the template provided at http://www.nhcancerplan.org/index.php/featured-content/250-loi-september-2015-funding-opportunity

  • Cover Page (see form*)
  • Proposal Narrative (no more than 5 pages in size 11 font, and at least 1 in. margins)
  • Work plan (see form*)
  • Budget (see form*) Funds may not be used for indirect costs
  • Budget Narrative (Provide descriptive explanation for each budget item; Include description of  other income sources either secured or pending)

Exclusions/Limitations:

The grant program’s current guidelines preclude support for:

  • Funding of ongoing staff positions. However, contract staff positions will be considered for funding. Funding of positions cannot supplant existing funds.
  • Funding of activities that serve populations outside of NH
  • Individuals
  • Endowments
  • Capital campaigns
  • Organizations that advocate, support or practice discrimination based on race, religion, age, national origin, language, sex, sexual preference, or physical handicap
  • Religious purposes
  • Food and beverages
  • Medical services/equipment, screening tests, labs, or supplies.
  • Fundraising
  • Lobbying

Examples of using Policy, Systems and Environmental Change approaches

  • Add night/weekend healthcare provider office hours
  • Electronic Health Record changes to improve patient outcomes
  • Incorporate sidewalks and recreation areas into community design
  • Offer healthy vending machine options
  • Create a tobacco-free campus

Policy, Systems and Environment definitions and examples:
http://www.naccho.org/topics/HPDP/mcah/upload/issuebrief_pse_webfinal.pdf

Proposal Review Criteria 

At least three individuals will review each proposal to ensure that it addresses the purpose of this funding opportunity and evaluate how well it meets the criteria listed below:

  • There is a clear and concise explanation of how the project is linked to implementation of at least one objective in the 2015-2020 NH Comprehensive Cancer Control Plan.
  • The proposed activities use a PSE approach
  • The applicant is a prior or active participant in at least one of the NH CCC’s Task Forces or Committees.
  •  The proposal will advance an objective in the 2015-2020 NH Cancer Plan or the work of an existing Task Force.
  • There is evidence of collaboration with other organizations.
  • The proposal aims to improve health equity
  • There is a well-defined, specific, and feasible work plan that the project will use to achieve its stated objectives.
  • Wherever possible, the project activities are supported by data and are drawn from proven and/or evidenced-based strategies.
  • The proposal demonstrates the applicant’s ability to successfully implement the project.
  • The timeline is realistic for completing activities by June 30, 2015.
  • The budget is realistic, consistent with project objectives, and organized to reflect contributions by all organizations involved.
  • The proposal offers opportunities to leverage other funds.
  • The proposal demonstrates that the project does not duplicate any other services already available in the community.
  • The letter of intent is submitted on time.
  • The proposal meets page limit, font, and margin criteria.
  • Commitment to share project results
  • The applicant has a record of successful completion of any prior projects

Funding Status:

The status of proposed projects will fall within one of three categories:

Funded
The proposal is funded in full with no budgetary or programmatic modifications recommended by the review team.

Funded with Modifications
The proposal is funded, but with budgetary or programmatic conditions.

Unable to Fund
The proposal will not be funded.

Funding Awards

Funds will be awarded to applicants contingent upon availability of funds at the Foundation for Healthy Communities (FHC). The FHC provides management services for the NH CCC through a contract with the NH Division of Public Health Services.  Selected applicants will be asked to sign a letter of agreement (LOA) with the FHC. Note that funds may be awarded in divided payments. Selected applicants for larger awards will be asked to report progress regularly to the NH Division of Public Health Services. Payments will be made to the identified fiscal agent. Failure to submit the final report by July 29, 2016 could disqualify an applicant from eligibility for future funding opportunities.

Questions and Answers (updated 10/7/15)

Q1.  Could you suggest what would be a realistic amount of funding to request? I see that there is $17,000 available statewide, but how does that translate (roughly) into a range that each applicant should consider when developing our applications?

A1.  We are being flexible and allowing applicants to consider what they can deliver given their current capacity.  We don't have any amount set aside by region.  We may fund one application for $17,000 or several for smaller amounts depending on the quality of the applications.


 

Q2.  Is it okay to have two organizations on the grant but just one will receive the grant if awarded?

A2.  It is allowable to have two organizations listed on the grant.  Be sure to clarify the roles of each organization and whether or not it is a joint application.  If one of the organizations is acting as the fiscal agent or providing technical assistance (vs. being a co-applicant) it must be stated in the application.


 

Q3.  We work closely with a NH Comprehensive Cancer Collaboration member but do not have a formal member in our organization.  We are actively working on increasing cancer screening rates and have implemented many changes to do so.  I just wanted to check on our ability to qualify before we move forward.

A3. You qualify to apply for the funding.


 

Q4. What are the HEAL (Healthy Eating Active Living) NH defined high need communities of need referenced in the Cancer Plan?

A4. 

  • Using the Social Vulnerability Index (SVI), HEAL identified census tracts (CT) which have 4 or more vulnerability measures (there are 16 total vulnerability measures in the NH SVI).
  • “Flagged” census tracts with 4 or less vulnerability measures above the 90th percentile were removed (see Table 1).  Flagged communities are those communities with unusually high concentrations of college students as identified as age group, living in group quarters, having no car, and reporting crowded housing.  This can distort the SVI of a community as these same measures are used to document poverty.  Therefore, these communities were removed because other measures in the SVI indicate that the community is not impoverished.
  • Remaining census tracts were then expanded to the community level and the final list of priority “communities of need” in NH were identified.

HEAL NH Identified High Need Communities

Top 10:  5 or more vulnerability measures > 90%ile:

  • Manchester
  • Nashua
  • Concord
  • Claremont
  • Berlin
  • Haverhill
  • Winchester
  • Hampton Beach
  • Salem
  • Coos Cluster (Census Tracts 9502, 9504 including:  Columbia, Colebrook, Stark, Northumberland, Stratford, Odell)

High need communities with 4 vulnerability measures > 90%ile:

  • Rochester
  • Franklin
  • Ossipee
  • Coos Cluster  (Tract 9501:  Pittsburg, Clarksville, Stewartstown)

It is recommended that HEAL strategies in these communities are focused on the census tracts within the community that have highest SVI.

Table 1:  Census Tracts and Communities with SVI >4:*

Tract County City/town ACS 2009-2012 population estimate SVI Percentile persons 18-24 years of age
010700 HILLSBOROUGH Nashua 1323 14 79.5%
001400 HILLSBOROUGH Manchester 2202 13 90.4%
010800 HILLSBOROUGH Nashua 7283 12 42.5%
001500 HILLSBOROUGH Manchester 3020 11 93.2%
2000 HILLSBOROUGH Manchester 2465 10 91.8%
032900 MERRIMACK Concord 4079 10 90.8%
001600 HILLSBOROUGH Manchester 4534 9 88.4%
010500 HILLSBOROUGH Nashua 3795 9 64.7%
001900 HILLSBOROUGH Manchester 3327 9 96.6%
001300 HILLSBOROUGH Manchester 3528 8 81.2%
000300 HILLSBOROUGH Manchester 3085 8 79.8%
010600 HILLSBOROUGH Nashua 5227 8 84.9%
000800 HILLSBOROUGH Manchester 2576 7 91.4%
002100 HILLSBOROUGH Manchester 4712 7 83.2%
950600 COOS Berlin 4185 7 72.6%
975902 SULLIVAN Claremont 3437 7 62.7%
950800 COOS Berlin 2463 7 69.2%
000600 HILLSBOROUGH Manchester 1987 6 26.4%
200400 HILLSBOROUGH Manchester 3045 6 94.2%
950200 COOS Columbia, Colebrook 2867 6 3.1%
001800 HILLSBOROUGH Manchester 5246 5 88.7%
011402 HILLSBOROUGH Nashua 5136 5 30.8%
100302 ROCKINGHAM Salem 4333 5 84.2%
065008 ROCKINGHAM Hampton 2029 5 88.0%
975901 SULLIVAN Claremont 4798 5 82.2%
960600 GRAFTON Haverhill 4673 5 58.2%
971700 CHESHIRE Winchester 4332 5 38.0%
950400 COOS Stark, Northumberland, Stratford, Odell 3668 5 65.4%
001200 HILLSBOROUGH Manchester 1918 4 43.8%
032300 MERRIMACK Concord 1629 4 48.3%
000902 HILLSBOROUGH Manchester (Well apt) 5280 4 85.3%
084300 STRAFFORD Rochester 5660 4 82.5%
010200 HILLSBOROUGH Nashua 6881 4 89.4%
043001 MERRIMACK Franklin 4161 4 66.4%
955900 CARROLL Ossipee 4341 4 57.9%
950100** COOS Pittsburg, Clarksville, Stewartstown 2348 4 2.1%

* 4 census tracts with an SVI of 4, and flagged due to high proportion of 18-24 yr olds, were removed:  Durham (2), Dover (1), and Keene (1) because other community measures in the SVI indicate that the community is not impoverished. 

** Atkinson-Gilmanton Academy Grant was removed because its population is zero.



Q5.
Is the proposal single or double spaced?

A5.  It can be up to five pages single spaced.



Q6.
Can funding be applied to patient incentives (such as a monthly raffle of a $25 grocery store gift card)?

A6. Patient incentives have not been found to increase cancer screenings per The Community Guide to Preventive Services (http://www.thecommunityguide.org/cancer/screening/client-oriented/index.html).  

The Guide found that reducing structural barriers was effective:

  • Reducing time or distance between service delivery settings and target populations
  • Modifying hours of service to meet client needs
  • Offering services in alternative or non-clinical settings (e.g., mobile mammography vans at worksites or in residential communities)
  • Eliminating or simplifying administrative procedures and other obstacles (e.g., scheduling assistance, patient navigators, transportation, dependent care, translation services, limiting the number of clinic visits)  

Such interventions often include one or more secondary supporting measures, such as:

  • Printed or telephone reminders
  • Education about cancer screening
  • Information about screening availability (e.g., group education, pamphlets, or brochures)
  • Measures to reduce out-of-pocket costs to the client (though interventions principally designed to reduce client costs are considered to be a separate class of approaches)

For more information about understanding the The Community Guide Task Force Findings and Recommendations go to: http://www.thecommunityguide.org/about/categories.html

NH CCC would allow incentives which reduce out of pocket costs as an allowable patient incentive.

There is also some evidence documenting the role of Medical Assistants in improving colorectal cancer screening.  Incentives for Medical Assistants would be allowed for improving all cancer screenings.

http://www.sutterhealth.org/smntips/improvingcoloncancerscreeningrates.pdf



Q7. 
The RFP says funding cannot be used for “ongoing staff positions.” Does that include a staff position that does not exist now (it would be created under this grant), but that we would hope will become ongoing in the future? The criteria states that money can be used for contract positions, so we might be able to make this a contract position rather than a staff position if that is the only way the position could qualify for funding – but our preference would be for it to be a staff position, if allowable.

A7. The funding can be for a new position or a contractor.  Our intent is that the collaboration funding does not displace existing funds that support a position.


Q8. In the work plan, should the Outcomes/Progress column be left blank when the proposal is submitted – to be completed later as part of a progress report? If not, what should go in that column?

A8. It should be left blank and filled out as the project is implemented.