Application

Be A Buddy: A Community-Based Climate Health Resiliency Pilot Project

Proposal Transmittal Sheet

All applicants must submit a PDF format of the responsesthat are succinct and self-explanatory. The application must address outcomes and activities to be conducted over the entire project period.

The applicant must type this Proposal Transmittal Sheet. The certification section at the bottom must be signed by the Project Director for the application and the Executive Director of the applying organization. Where possible, the transmittal sheet should be reproduced on the applicant’s official letterhead.

Vendor’s Legal Entity Name:
Vendor Employer Identification Number:
Project Director Name:
Project Director Title:
Project Director Mailing Address:
Contact E-mail:
Phone Number:
Certifications:
As Project Director, I certify that all information provided in this application is correct and accurate to the best of my knowledge.
Project Director Signature ______Date:
As the Executive Director for the organization submitting this application, I am supportive of this application and commit my organization to fully engaging in the work plan provided in this application:
Executive Director Signature______Date:
If said individual is not the applicant’s Chief Executive Officer, this document shall attach evidence showing the individual’s authority to bind the proposing entity.

Applicant Eligibility Criteria

Non-profit organization / Community-based organization
Faith-based organization
Service Provider
Other ______
Organization is located in: / Bronx CD 1, 2, or 3
Manhattan CD 9, 10 or 11
Brooklyn CD 3, 4, 5 or 16
Does your organization conduct outreach and/or provide programming, support or services to older adults (65+ years)? □ Yes □ No

Proposal: Approach [20 Points]

1.Purpose: Please describe the purpose of your organization and how it is consistent with the goals outlined in Section I Background [Maximum Score = 5 points; Up to 250 words]
2. Strategies and Activities: Propose strategies, activities and intended outcomes that describe how the organization plans to achieve the goals outlined in Section I Background: Activities should be SMART (Specific, Measurable, Achievable, Realistic, and Time-phased). Preference will be given to applicants who can extend project during the contract time-frame to one or more of the following at-risk groups, in addition to older adults (65+ years) [Maximum Score = 10points; Up to 600 words]
  • Adults with chronic medical conditions (e.g. obesity, diabetes, lung disease, and heart disease)
  • Adults with severe mental health illness
  • Adults who use drugs or drink heavily
  • Adults with limited mobility
  • Adults who are socially isolated

3. Localized Innovation:Describe how the strategies and activities you proposed represent an innovative approach to community-based services that is hyperlocal to one of the targeted communities. [Maximum Score = 5 points; Up to 200 words]

Proposal: Experience [40 points]

1. Volunteer Management:Demonstrate experience in coordinating and implementing volunteer activities (e.g., local, ongoing or one-time projects, canvassing, other). Programs must describe how volunteers are recruited, screened, and trained. Applicants must also include the type of response volunteers are used for and the level of volunteer engagement. [Maximum Score = 15 points; Up to 700 words]
2. Communication Capacity: Demonstrate prior experience in coordinating and implementing large-scale communications to reach staff, clients and volunteers (e.g., phone trees, canvassing operations, other). Description should include information on how communication and project delivery are conducted and any technological systems currently used to activate large scale communication and deployment. Describe what additional capacity would be needed to complete deliverables.
[Maximum Score = 10 points; Up to 300 words]
3. Collaboration: Applicant must describe experience working with other local stakeholders, including representatives from at-risk populations. Applicant should include a plan for increasing engagement with other locally based organizations (e.g. faith-based or community-based organizations, service agencies). [Maximum Score = 15 points, Up to 700 words]

Proposal: Monitoring, Data Management, Evaluation and Reporting [10 points]

Selected recipients will be required to collect information on each at-risk individual identified and engagement efforts with that individual, including, but not limited to, the number and type of referrals provided. Programs must also collect information on “Be A Buddy” activations, including number of activations, and circumstances for the activation (e.g., heat wave, power outage). Aggregated, de-identified data must be reported to DOHMH and FPHNY quarterly, as well as information on trainings and other community outreach activities related to the project.

Pleasedescribe a clear monitoring and evaluation plan for proposed activities, including current data collection and analysis capabilities. Additionally, describe the organization’s current ability or plan to monitor and evaluate project including number of contacts with at-risk individuals, referrals, community efforts, volunteers, and partnerships with other community orgs/institutions. Please describe the data collection process to monitor project activities and outcomes. The description should address the following questions:
  • How will the data be organized and stored? Which staff member(s) of your organization will be tasked with data organization, storage, and reporting?
  • Describe how you will ensure the submission of timely and complete quarterly reports to DOHMH and FPHNY.
  • How will you provide feedback to DOHMH and FPHNY regarding best practices and lessons learned to inform other community resilience efforts?
[Maximum Score = 10 points; Up to 300 words]

Proposal: Organizational History, Infrastructure and Capacity [10 Points]

1. Please describe the organization’s overall mission and activities, including a description of clients served anddemonstrate neighborhood rootedness quantified in years in the community served as well as examples of local success(es). Please also demonstrate organizational infrastructure, capacity and resources to be able to implement the proposed activities by showing relevant experience in program designing and planning, performance monitoring (both outcome and process), program evaluation, budget management, and personnel management. The organization must share resumes of staff designated to work on “Be A Buddy”, clearly identify who would lead the effort within the organization (provide resume and where they fit within the organization’s structure), provide any staff support, and evidence of any emergency response planning to date and evidence of project or activity delivery via a volunteer base. The narrative and submitted budget must also include any additional staff, if any, that will be needed to develop and implement the project.
[Maximum Score = 10 points; Up to 350 words]
2. Please provide an organizational chart with the titles and supervisory relationships of all involved staff and existing positions and responsibilities related to this funding.

Proposal: Proposed Budget [20 points]

1. Please complete the attached budget template. Items listed in Section III of this RFP will be provided by DOHMH free of charge and should not be included in the budget.
  1. The proposed budget should provide the estimated cost of providing the proposed services for the contract period (April 1, 2018 – March 31, 2019), operating at capacity.
  2. All costs associated with the project must be delineated and the narrative description must clearly justify each budget line item.
2. Applicants must provide their last two years of financial records.

Proposal: Budget Template

Organization Name:

Personnel Services / Amount Requested
Position Title / Salary amount to be covered
Fringe / Fringe amount to be covered
Personnel Services Total
Other Than PersonnelServices / Amount Requested
Equipment and Supplies
Travel
Consultants
Other:
Other Than Personnel Services Total
Total Direct Charges
Indirect (max 10% of Allowable Base)
TOTAL BUDGET

No direct lobbying activities are permitted. Maximum budget is $90,000.

In addition to the above line item budget, provide a budget narrative below (a brief description and explanation of each budget item, including calculations for multiples of any item).

Total Maximum Score for the Budget is 20 points.

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