Health First Program Overview

Grant Program Guidance & Application Information

I. Program Information

Overview

Pursuant to Indiana Code (IC) 16, Clinton County, by way of the Clinton County Health Department (CCHD) and the Health First Clinton County (HFCC) grant program, fulfills the statutory responsibility of providing the core public health services. The utilization of our various hospital systems as a form of primary care creates financial burdens to the entire healthcare system. To reduce health care burdens and improve public health, it is in the County’s best interest to support programs that can effectively provide the Core Public Health Service (CPHS) needs of all citizens through partnerships with the Clinton County Health Department.

The Clinton County Health Department strives to model the Center for Disease Control and Prevention’s 10 Essential Public Health Services framework for the provision of core public health services that protect and promote healthy outcomes. The Clinton County Health Department actively promotes policies, systems, and overall environmental conditions that enable optimal health and wellness for all residents.

Purpose

The decision of the Board of Commissioners of Clinton County to receive the State of Indiana allocated Local Public Health Fund beginning January 2024 allows the Clinton County Health Department to annually award contracts or establish a grant to an individual, employer, employer association, nonprofit organization, for-profit organization, institution of higher education, health insurance plan, health ministry, or any combination thereof for the purpose of providing core public health services to Clinton County residents. Financial assistance is allocated to protect and promote the health of all people in communities within the jurisdiction of the Clinton County Health Department to support identified gaps in core public health service delivery.

II. Program Opportunity

(A)   Funding Description

The Clinton County Health Department is requesting applications for competitive funding to issue a contract or grant that must include measurable and specific improvement in Clinton County in one (1) or more core public health services. The purpose of this Request for Applications (RFA) is to award a contract or grant for the purpose of improving health outcomes and preventing or reducing the prevalence of the health issues related to the core public health services. In awarding the contracts or grants, the Health Department shall prioritize:

1. Directly provided core public health services within the Clinton County Health   Department jurisdictional areas;
2. Currently operational local health care providing entities including hospitals, clinics, physicians, pharmacies, and home health agencies;
3. Evidence-based practices to achieving desired health outcomes, including the use of behavioral incentives; and
4. Initiatives that contract collaboratively with proven outcome-based health improvement providers or services.

The Clinton County Health Department and the Indiana Department of Health (IDOH) have identified priority core public health service areas, key performance indicators (KPI) and measurable metrics for activities which include but are not limited to:

• Maternal and Child Health
  • Direct or warm referrals/linkages to care and resources
  • Improved birth outcomes through evidence-based programs such as safe sleep, breastfeeding, healthy eating, and physical activities
• Chronic Disease Prevention
  • Services that prevent and reduce chronic diseases such as obesity, diabetes, cardiovascular disease, hepatitis C, and cancer.
• Access to and Linkage to Clinical Care
  • Connect residents to clinical resources such as substance use disorder, health screenings, infectious disease testing and prenatal care.
• Trauma and Injury Prevention
  • Deliver harm reduction for substance use, peer recovery and rehabilitation services.
  • Establish trauma and injury prevention initiatives.
  • Educate and promote fall prevention, gun safety, substance abuse, suicide prevention.
• Fatality Prevention Initiatives
  • Identify and implement evidence-based programs or activities for prevention initiatives.
• Tobacco Prevention and Cessation
  • Implement tobacco and vaping prevention and cessation programs addressing youth and young adults.

Background  

This funding application process is open to all projects proposing to address gaps in core public health services in Clinton County per IC 16. Applicants may identify one or more of the core public health service areas and may submit an application that combines two or more health areas to be funded. The application must include a spending plan/budget and an evaluation plan for the purpose of providing core public health services. The evaluation plan must have identifiable and measurable outcomes for the funding period. Funds must be spent by December 31 of the year issued. To remain eligible for funding the awardee must maintain compliance with financial reports submitted to the Clinton County Health Department as required during the funding period. Funding awarded cannot be used to supplant funding currently in place for these activities and must be used only for its stated purpose.

Proposal Requirements

Each proposal must include the following elements:

• SMART Objectives for describing the proposed project:
  • Specific - What exactly is going to be accomplished and for whom?
  • Measurable - Is it quantifiable and can it be measured?
  • Attainable/Achievable - Can the objective be accomplished in the proposed time frame with        the resources and support available?
  • Relevant - Will this objective influence the desired goal or strategy?
  • Time bound - When will this objective be accomplished?
• Identify the area and population served by the proposal to be delivered within the population served by the Clinton County Health Department.
• Evidence based programs to prevent or reduce the prevalence of health issues or improve the health and/or behavioral health of Clinton County residents.
• Description of how the proposal will address/impact health gaps in core public health services.
• Identify measurable and specific improvement(s) in one or more of the core public health services within a defined cohort. The cohort may be defined by any health, demographic, or geographic criteria, or any combination of these.
• Time frame to achieve the proposed measurable improvement(s) incorporating the described potential funding award date below. The timeframe in which an initial proposed measurable improvement will be achieved may not be more than two years.
• Explanation of how the proposed activities will be sustained past the funding period.
• Overall budget summary of project expenditures and attach Itemized breakdown with justifications. See Appendix 1 for Sample Application & Budget information that will be required with submissions

Reporting Requirements

Awardees will be required to submit the following reporting elements:

Awardees will be required to submit four (4) reports in any grant award year comprised of three (3) standard quarterly reports and one (1) final/annual report in accordance with the following timelines and on supplied templates provided by the CCHD. Access to reports will open two weeks prior to the due date.

• Q 1 report due March 31st
• Q 2 report due June 30th
• Q 3 report due September 30th
• Q 4/Final Report due December 31^st

A person awarded a contract or grant shall report de-identified aggregate information concerning the implementation of the core public health services contract or grant and metrics concerning the core public health services to the Clinton County Health Department as required by IC 16-20-1-12(e).

A CPHS Key Performance Indicator and Metrics document will be maintained on the Health First Clinton County website:

The required metrics for each of the quarterly reports for all awardees will contain information such as:

• What accomplishments occurred during the reporting period?
• De-aggregated demographic data (Numbers, Languages, Project focused sub-topic categories);
• Health barriers addressed by the project during the reporting period;
• Additional metrics defined within the grant proposal itself as applicable; and
• Outcomes of any activity related to the funded project/program
  • Provide any additional gaps or amendment needed to achieve improvement

Additional reporting guidance may be provided by the Indiana Department of Health to meet state budget agency requirements. Awardees will be updated as needed.

(B) Award Mechanism

Upon receiving the notification of award, the Clinton County Government will draft a contract reflective of the awarded total, key deadlines, allowable activities, and any relevant administrative reporting to be completed by the awardee. In accordance with Indiana law, all local health departments must post all RFA/Contracts to the public for at least thirty (30) days before they may enter into the final contract with an entity if the agreement is for the provision or administration of core public health services using the Local Public Health Fund. CCHD will post the perspective RFA and contract template on the HFCC website. Once the required posting time has been completed and successful awardees are notified, they are expected to return a signed contract within fifteen (15) business days of receipt.

*Awardees must acknowledge that their applications, contract, de-aggregated data, and project progress reports may be shared publicly unless otherwise protected by law.

(C) Eligibility Information

In accordance with IC 16-46-16-.7(2), eligible applicants include an individual, employer, employer association, nonprofit organization, for-profit organization, institution of higher education, health insurance plan, health ministry, or any combination thereof such as a health coalition providing core public health services in partnership with the Clinton County Health Department.

(D) Application and Submission Information

CCHD may award additional contracts after the Award Period Begins date for priority projects able to be completed and reported in accordance with the annual award period.

Awardees may receive one or more payments during the grant period, if performance measures are being achieved and data is being submitted on reports as required per the grant agreement.

Application Submission sections

1. General
   1. Applicants must describe how they are well-suited to administer the core public health services under this award, including how the applicant is positioned to be successful in providing core health services.
   2. Applicants should demonstrate that they understand the purpose of the funding and the challenges associated with the priority area to be funded.
2. Project Proposal
   1. Applicants must identify one or more core public health service(s), clearly describe the activities to be funded, and provide the specific measurable improvement metrics within the described population. The population may be defined by any covered health issue, demographic, or geographic criteria, or any combination of these. A cohort defined using demographic criteria may include criteria based on employment in a particular industry or having particular job duties.
      1. Indicate an estimated number of people expected to benefit from the proposed activities.
      2. Indicate what cities, towns, unincorporated areas, and/or zip codes are expected to benefit from the proposed activities.
   2. Applicants must outline the timeframe to achieve the proposed measurable improvement(s) described above. The timeframe in which an initial proposed measurable improvement is achieved may not be more than two years.
   3. Sustainability Statement: Applicants must explain how activities will be maintained/supported once the award period has ended.
      1. What other source of funding is used by the organization to achieve the project.
   4. Health Equity Statement
      1. Applicants should describe how the impact of proposed activities will remove health care barriers for underinsured and underserved populations.r
   5. Budget with core public health service justifications.
      1. Applicant will include a budget for all proposed expenses associated with project activities including the following:
         1. A statement of justification for the requested funding amounts for all activities.
         2. A description of project alternatives if 100% of the requested amount is not able to be provided.

   Submission Requirements and Deadlines

   To be considered for this competitive funding, a completed application must be received by the Clinton County Health Department no later than the Application Due Date, at 4:30 p.m. Eastern time. Applications must be submitted to Clinton County Health Department using the following email: healthfirst@clintonco.com . All sections of the application must be fully completed to be considered a viable application submission for consideration. Applications missing any section will not be reviewed. Application submission does not guarantee an award. In some cases, awards may be less than the amount requested.

   (E) Application Review

   Review Criteria

   The following criteria will be used to review all submitted applications:

   1. Overview and applicant agency description
      1. Demonstrable expertise and understanding of grant purpose.
      2. Provide a clear description of the agency and the proposed core public health service collaborative effort.
   2. Project proposal
      1. Clear purpose, scope, deliverables, and timeline of outcome evaluation;
      2. Appropriate project scaling to population served within Clinton County Health Department area of responsibility;
      3. Inclusion and description of partners;
      4. Use of evidence-based programming;
      5. Measurable, specific improvement in core public health service(s) on specified population; and
      6. How project addresses service equity for underserved and underinsured populations.
   3. Sustainability Statement
   4. Budget with core public health service justifications

   Review and Selection Process

   Eligible and complete applications will be evaluated for merit by Clinton County Health Department staff in accordance with the review criteria stated above. Submissions that do not comply with the technical requirements set in the RFA or as otherwise explained herein are considered nonresponsive and will be rejected. The review panel will be comprised of select Clinton County Health Department staff, Clinton County Board of Health representative(s) and the Health Officer. Recommendations for funding awards will be made to the Clinton County Commissioners in the form of a Memorandum of Understating (MOU)/Contract as prescribed by Clinton County policy based upon the quality of the submitted proposal and the ability of the applicant to meet the stated criteria. The Clinton County Council and County Auditor will be informed of financial reports and impacts of funding disbursed in Clinton County.

   (F) Additional Information

   Award Notices

   All applicants will be notified no later than November 15th, regarding award status and amount.

   Awardee Responsibilities:

   The award recipient will have primary responsibility for the following:

   1. Accomplishing the objectives and completing the deliverables listed in the final contract agreement.
   2. II. Providing quarterly and annual progress reports to the Clinton County Health Department as required in the final contract agreement.

   Clinton County Responsibilities:

   The Clinton County Health Department will have the primary responsibility for the following:

   1. Communicate with the awardee point of contact.
   2. Monitor the terms of the agreement.
   3. Disperse funding according to the terms of the contract agreement.
   4. Provide technical assistance and guidance, as appropriate.
   5. Report as required to the Indiana Department of Health, Clinton County Council, and Clinton County Commissioners

   PROJECTS/PROGRAMS/ITEMS WHICH WILL NOT/CANNOT BE FUNDED:

   Funds may not be used for the following per the State of Indiana (this may not be an exhaustive list):

   • Personal Items
   • Items not related to IC 16-46-10-3 (*pursuant to changes made during the 2023 legislative session)
   • Alcoholic Beverages
   • Duplicate Payments and Overpayments
   • Capital expenses not permitted by IC 16-46-10-3(c) (such as vehicles, motorized items, trailers, buildings/structures, renovations, etc.)
   • Scholarships
   • Donations
   • State or Federal Lobbying or any Political Activity
   • Food/Beverages
   • Any unallowable expenditure as determined by the Indiana State Board of Accounts
   • Any expenditure not allowed by Indiana State Law
   • Incentives (unless educational or a protective public health measure in nature and with prior approval by the Clinton County Health Department)
   • Other activities or purchases deemed inappropriate by the CCHD.

   For More Information

   Application, FAQ and more may be found on the Health First Clinton County website: https://www.in.gov/localhealth/clintoncounty/health-first-program

   General questions regarding this RFA and application process may be sent to the following email: healthfirst@clintonco.com

   Clinton County reserves the right to amend this guidance to provide additional information or correct errors.

   Appendix 1

   Clinton County Health Department

   Health First Clinton County

   Grant Application Program Information

   The following basic information will be required for submitting a grant application. Please prepare this information for entry into the Health First Clinton County online grant submission portal (or on a paper version) during the open grant application period. Applications are due by March 31^st.

   • Name of Proposed Project
   • Organization Name
   • Mailing Address
   • City, State, Zip Code
   • Telephone
   • Website
   • Organization Mission Statement
   • EIN
   • Federal Tax ID
   • Authorizing Official & Title
   • Grant Contact and Title
   • Grant Contact Phone
   • Grant Contact Email
   • Name of Proposed Project
   • Amount Requested
   • Proposal Percentage of Organizations Annual Operating Budget

   Primary Core Public Health Service must be provided: (check all that apply)

   • Tobacco Prevention and Cessation
   • Chronic Disease Prevention
   • Access to and Linkage to Clinical Care
   • Trauma and Injury Prevention
   • Fatality Prevention Initiatives
   • Maternal and Child Health

   REQUESTED NARRATIVE

   1. Primary Programs and Services of Organization
      Describe how applicant is well-suited to administer the core public health services under this program, including how the applicant is positioned to be successful in providing a core health service gap in Clinton County. Applicants should demonstrate that they understand the purpose of the funding and the local challenges associated with the core public health services priority areas to be funded.
   2. Project Proposal
      Identify one or more core public health services, clearly describe the service gap and activities to be funded. Describe how the proposal will address/impact health gaps in core public health services using evidence-based programs to prevent or reduce the prevalence of health issues or improve the health and/or behavioral health of Clinton County residents. Provide the specific measurable metrics within the described population to be reported as measurements of improvement of health and well-being. The population may be defined by any covered health issue, demographic, or geographic criteria, or any combination of these.
      1. Indicate an estimated number of people expected to benefit from the proposed activities.
      2. Indicate what cities, towns, unincorporated areas, and/or zip codes are expected to benefit from the proposed activities.
      3. Outline the timeframe to achieve the proposed measurable improvement(s) described above. The timeframe in which an initial proposed measurable improvement is achieved.
      4. Describe how the impact of proposed activities will remove health care barriers within Clinton County.
   3. Sustainability Statement:
      1. Explain how activities will be maintained/supported once the award period has ended or if funding is not 100% provided.
      2. Address what other sources of funding are used by the organization to achieve project goals/objectives.
   4. IV. Health Equity Statement:
      1. Provide a health equity statement indicating how the proposed project and impact of proposed activities will remove health barriers for underinsured and underserved populations.
   5. V. Budget with justifications:
      1. Include a budget for all proposed expenses associated with project activities, including:
         1. A statement of justification for the requested funding amounts for all activities.
            1. Funds can be used to expand existing services but not to supplant current funding used to provide current service levels.
   • ITEMIZED BUDGET INFORMATION 
     • A fillable document is provided on the HFCC website to be attached to online applications   

   BUDGET SUMMARY INFORMATION (this section will be entered in the online application submission)

   Budget Category	Amount Requested	Justification
   Salary/Contractual:*
   Fringe:*
   Supplies:
   Equipment:
   Travel and Training:*
   Other:

   *Must be preapproved before inclusion in budget request in application package.

   SUBMISSION REQUIREMENTS AND DEADLINES

   • To be considered for this competitive funding, a completed application must be received by the Clinton County Health Department no later than the Application Due Date, at 4:30 p.m. Eastern time.
   • All sections of the application must be fully completed to be considered a viable application submission for consideration. Applications missing any section will not be reviewed.
   • Additional agency information and documentation can be attached to the application.
   • Application submission does not guarantee an award and in some cases, awards may be than the amount requested.

   Questions may be submitted at any time to Clinton County Health Department using the following email: healthfirst@clintonco.com