2014-115 Mental Health and Addictions Grant Program: Enhancing Community Supports Part 1- Application Guidelines Part 2 – Application Form March, 2014 Page 1 of 13 PART 1 – APPLICATION GUIDELINES A few general comments: the application form should be strictly followed. Adhere to any designated limitations on the length for sections indicated. If you feel any addition information is required attach as an appendix. If you have any questions about how to complete this template or the application process in general you can contact via email Tony Prime primets@gov.ns.ca or Francine Vezina Francine.Vezina@gov.ns.ca Mental Health and Addictions Community Linkage Grants Program These Guidelines contain information on the 2014-15 application process for the Mental Health and Addictions Community Grants Program funded through the Government of Nova Scotia’s Mental Health and Addictions Strategy “Together We Can”. Each proposal for funding should include the following: A completed application form (see attached) Two (2) letters of support Any additional supporting documents/resources INTRODUCTION The Mental Health and Addictions Community Grants is a component of the provincial mental health and addictions strategy “Together We Can” released May, 2012. The aim of the Grants Program is to improve the overall lives of individuals living with mental health disorders and substance use and gambling problems and their families. FUNDING GUIDELINES Grant Applications Applicants must be led by not-for-profit organizations in Nova Scotia but may be a partnership with the formal system (DHAs/IWK). None of the funding can be used for the personal benefit of salaried staff of the organization (increase salary of salaried staff). Note: 2014-2015 grants will be for one year only and those projects that are in collaboration with other organizations will be given the highest priority. Two grants for $100,000 each will be awarded for collaborative initiatives. Ineligible Expenses Contributions to annual fundraising drives Pre-existing core operating expenses (e.g. heat, light, core organizational staff) {Operational expenses related to the initiative are eligible} Page 2 of 13 Capital expenditures (e.g. housing,construction/building renovations etc.) Projects/initiatives that duplicate existing activities in your community/region. PROPOSAL DEVELOPMENT GUIDELINES Prepare your funding proposal using the following guidelines to complete the attached Application Form. 2014-15 Priority Areas: Only two one year grants for $100,000 each will be awarded for collaborative initiatives this year. Community Linkage Grants are given to reduce barriers between NGOs, community health boards, formal mental health and addictions systems, and government departments, thereby creating and enhancing collaboration and coordination to provide continuous linked informal and formal supports for people living with mental illness/mental health challenges/addictions throughout their lifespan. Within the Enhancing Community Supports Grant Program, the goal of community linkage grants are to encourage, facilitate, and support collaboration to: increase sharing of skills, knowledge and resources between groups, NGOs, and health care professionals to identify and refer first voices to the most appropriate provider at the most opportune time throughout their recovery and across the lifespan, and when the person has indicated a willingness to engage the service or support; increase the number of organizations that identify gaps and partnership opportunities and work together to offer seamless services in mental illness/mental health challenges/addictions for individuals across the lifespan; increase the number of organizations that identify gaps and partnership opportunities and work together to offer education and training for people experiencing mental illness/mental health challenges/addictions. Partnerships: List all groups and organizations which will be contributing to the planning, implementation and evaluation of the project and what their roles will be. Project Title: □1Year Amount: _________________________ Organization(s) Strengths Briefly explain why the organization(s) is/are in a position to carry out the project (e.g. highlight previous successes/experiences working with community projects or initiatives). Page 3 of 13 Project Summary: Provide a brief summary of the project explaining what the project is about and what you hope to accomplish. Rationale: Explain why this project is needed in your community (e.g. need identified through needs assessment, community meeting or forum, etc.) Explain why you have chosen this project to address the need (e.g. the identified need and identified target audience(s)should be based on available population data, based on best or promising practice (please include references of support literature, builds on existing strengths within the community/district, etc.) Community Capacity Building: Describe how the project will help build capacity within your community/communities. This involves the active involvement of individuals in improving their mental health and well-being and may also improve the mental health of the community and reduce harmful substance use and gambling related harms. Goals & Objectives: Explain the project goal(s) that is what you want to achieve as a result of your project. These are general statements of what your project is trying to do. These goals should follow the S.M.A.R.T. approach and be specific, measurable, achievable, realistic, and time-bound.Objectives flow from your goals. These are statements that inform how the goals will be achieved…it is important to note that you may use more than one objective to reach your goal. Clear project objectives are essential to guide the project work and evaluation Plan of Action: List the activities (outputs) which you and your partner(s) will undertake to meet each objective; identify who is responsible for each activity and the timelines. Intended outcomes: Describe what outcomes you expect to occur as a result of your project. These can be identified in terms of participant’s awareness/knowledge, skills, attitudes or behaviours. A combination of outcomes from these general areas should be used. It may be helpful to identify these outcomes in terms of short term to long term and overall outcome of the project. Evaluation Plan: Describe how you will evaluate the impact the project has had on the participants and/or the community. Include any plans to share evaluation results and lessons learned with other communities/regions . Communication Plan: Describe your plans to share Project reports and progress with your partners , target groups, community/district and Department of Health & Wellness Completed project Evaluation results and lessons learned Page 4 of 13 Project Management: Describe who will be responsible for the direction and day-to-day management of the project. Include job descriptions and qualifications, outlining roles and responsibilities of the positions. Budget: Eligible expenses should be listed in terms of item, cost, partner contributions, in-kind contribution and requested amount. Applicant must adhere to forecasted budget as outlined in the proposal. Programs must submit a semi-annual report and financial statement and end of project report with evalution outcome and financial staement. Other Funding Sources: List any other grants that you have applied for and/or have received to support any part of the project. Include name(s) of funding agency/organization(s), amount of funding and if applicable, identify the part(s) of the project that will be supported. Signatures: Signatures of all partners are required on the application form from each organizations’ executive. Additional Documents: a. Aletter of agreement is required from each organization that will be partnering with you in the development/implementation of the program. b. Terms of Reference, memberships and current programs for your organization if applicable, should be included as an appendix to your proposal. REPORT REQUIREMENTS Applicants approved for funding will be required to submit a semi-annual (6 month) report and a year end reports. this shall outline: a) Which shall outline utilization statistics,& interim outcome measures for the initiative if available b) Financial expenditures c) update of progress toward meetings goals and objectives and what deliverables have been completed and/or implemented All evaluation reports to be submitted at agreed upon intervals APPLICATION DEADLINE Submissions for the 2014-15 Mental Health and Addictions Community Grants must be received at the DHW by midnight July 4, 2014. Must be submitted electronically. Applications to be sent to: Tony Prime Page 5 of 13 Department of Health and Wellness Mental Health, Children’s Services& Addictions Box 488, 14th Floor Barrington Tower 1894 Barrington St., Halifax, NS B3J 2R8 Contact: By email only Tony Prime or Francine Vezina E-mail: Anthony.prime@gov.ns.ca Francine.vezina@gov.ns.ca Applications will be reviewed and initial funds issued by late August to mid-September2014 LETTERS OF CONFIRMATION All applicants will receive notification from The Department of Health and Wellness about the status of their proposal. Successful applicants will be required to sign a Memorandum of Understanding or a contract. Page 6 of 13 PART 2 - Mental Health and Addictions Community Grants Program Application Form Department of Health & Wellness Date Received: Date Reviewed: PLEASE FOLLOW THE GUIDELINES WHILE COMPLETING THIS FORM 1. Organization(s){provide info for each partner organization} Identify lead organization. Name of organization(s):____________________________________________________ Name of Main Contact Person:_____________________________________________ Mailing Address: _________________________________________________________ Phone number:__________________ Fax Number:_________________________ E-mail address:___________________________________________________________ Project Title: □1year□ Amount: 2. 2014-15 Priority Areas: Only two one year grants for $100,000 each will be awarded for collaborative initiatives this year. Within the Enhancing Community Supports Grant Program, the goal of community linkage grants are to encourage, facilitate, and support collaboration to: increase sharing of skills, knowledge and resources between groups, NGOs, and health care professionals to identify and refer first voices to the most appropriate provider at the most opportune time throughout their recovery and across the lifespan, and when the person has indicated a willingness to engage the service or support; Page 7 of 13 increase the number of organizations that identify gaps and partnership opportunities and work together to offer seamless services in mental illness/mental health challenges/addictions for individuals across the lifespan; increase the number of organizations that identify gaps and partnership opportunities and work together to offer education and training for people experiencing mental illness/mental health challenges/addictions. Organization(s) Description: Briefly describe why your organization is in a position to carry out the program (e.g. highlight previous success/experiences working with community projects or initiatives) Should not exceed a typed ½ pg. 8 ½ / X 11 in Calibri 12 font single spaced 3. Project Summary ( Not more than 1 typed pg. 8 ½ X 11 in Calibri 12 font single spaced) Page 8 of 13 4. Rationale (Should not exceed ½ typed pg. 8 ½ / X 11 in Calibri 12 font single spaced) 5. Community Capacity Building (Should not exceed ½ typed pg. 8 ½ / X 11 Calibri 12 font single spaced ) 6. Goals and Objectives ( Not more than 1 typed pg.8 ½ X 11 Calibri 12 font single spaced ) specific, measurable, achievable, realistic, and time-bound Page 9 of 13 7. Plan of Action (Should not exceed 1 pg. 8 ½ / X 11) Action Responsibility Timeline 8. Intended Outcomes (Should not exceed ½ typed pg. 8 ½ / X 11 Calibri 12 font single spaced) Page 10 of 13 13.Evaluation Plan (Should not exceed 1 typed pg. 8 ½ / X 11 Calibri 12 font single spaced) 9. Communication Plan 10. Project Management and Personnel (Day to day management of your project){ Should not exceed ½ typed pg 8 ½ / X 11 Calibri 12 font single spaced ) Page 11 of 13 11. Budget Summary (use the following table as a guide, add rows as required for additional items) Item Cost Minus In-Kind Contributions TotalRequested Amount Travel Communications Salaries Honoraria” First Voice” Materials Evaluation Other Total $ $ $ 12. Other Funding Sources 13. Identify all partners for the project and identify lead organization: Partnerships with other organizations: Identify organization(s) and their role(s). Organization: __________________________ Contact Person: ________________________ Role: Organization: __________________________ Contact Person: ________________________ Role: Page 12 of 13 Organization: __________________________ Contact Person: ________________________ Role: Signatures: Lead organizationIndividual Submitting Proposal 1) ____________________________ Date:_______________ Position ___________________________ Individual for each partner organization involved in Project 2) ____________________________ Date:________________ Position ___________________________ Page 13 of 13