Susan G. Komen Central Wisconsin Affiliate announces
Local affiliate releases request for proposals (RFP) for fiscal year 2016-2017 grant
funding
The Central Wisconsin Susan G. Komen Affiliate announces the release for the 20162017 Community Grants. The GeMS (Grants eManagement System) will be the format
used for all grant requests.
The Central Wisconsin Affiliate current focuses are for those who serve women in or
from the following counties: Langlade, Lincoln, Marathon, Portage, Taylor, Wood and
western Shawano—in Central Wisconsin. The Community Profile and funding priorities
can be found on our affiliate website:
http://www.komencentralwisconsin.org/grants/funding-priorities/
The training for the application process is available on our website. The training will be
available during the RFP process. In addition, the GeMs grantee application manual is
available on our website. The RFP is available for you to download from our website.
The grant will be available on November 6, 2015.
The
application
will
be
completed
and
submitted
on
GeMS,
https://affiliategrants.komen.org. Please contact Patty Krug at 715-748-1410 or
patty.krug@co.taylor.wi.us with any questions you may have about the grant process or
the GeMS training and site. When initiating an application on GeMS, please make sure it
is a Community Grants (CG) application (2016).
The affiliate grant cycle runs from April 1, 2016 through March 31, 2017. Applications
must be submitted through GeMS by 1 pm, January 15, 2016. Announcements of
funding decisions will be made the week of March 7, 2016. The affiliate accepts RFAs
that range from $10,000 to more than $100,000.
The promise of Susan G. Komen for the Cure is to save lives and end breast cancer
forever by empowering people, ensuring quality care for all and energizing science to
find the cures. The organization runs one of the most innovative, responsive grant
programs in breast cancer today. The Central Wisconsin affiliate is proud to have made a
difference with over $1,000,000 in local grants for area breast health programs.
About Susan G. Komen for the Cure® and the Komen Central WI Affiliate
Nancy G. Brinker promised her dying sister, Susan G. Komen, she would do everything
in her power to end breast cancer forever. In 1982, that promise became Susan G. Komen
for the Cure and launched the global breast cancer movement. The Central WI Affiliate
of Komen for the Cure is working to better the lives of those facing breast cancer in the
local community, joining more than 1 million breast cancer survivors and activists around
the globe as part of the world’s largest and most progressive grassroots network fighting
breast cancer. Through events like the Komen Race for the Cure®, the Central WI
Affiliate has invested over $1,000,000 in community breast health programs in our seven
county area, Central WI region. Up to 75 percent of net proceeds generated by the
Affiliate stays in Central WI. The remaining income goes to the national Susan G.
Komen for the Cure Grants Program to fund research.
For more information, visit http://www.komencentralwisconsin.org
Grant Available: November 6, 2015
Grant Application Deadline: January 15, 2016
Grant Announcement: Week of March 7, 2016
Contact Information: Patty Krug
715-748-1410
patty.krug@co.taylor.wi.us
REQUEST FOR PROPOSAL (RFP)
Central Wisconsin Affiliate
Grant applications now being accepted for
Breast Health and/or Breast Cancer
Education, Treatment Support or Screening Projects
The mission of the Susan G. Komen for the Cure is to save lives and end breast cancer forever by
empowering people, ensuring quality care for all and energizing science to find the cures. Affiliates
of Susan G. Komen for the Cure represent one of the nation’s largest private funding sources for
breast health and breast cancer screening, education and treatment support programs.
The Central Wisconsin Affiliate of the Susan G. Komen for the Cure, Inc. is currently offering grants
for innovative projects in the areas of breast health and breast cancer education, outreach,
screening, and treatment support targeting services not otherwise available to the medically
underserved populations of Langlade, Lincoln, Marathon, Portage, Taylor and Wood Counties, as
well as the western portion of Shawano County . Grants are available for up to one (1) year.
Important Note
Applications will be accepted for any breast health or breast cancer screening,
treatment, education, or support project in the listed counties. However, projects
that specifically address the objectives outlined in the “Statement of Need” below
and incorporating evidence-based programs or methodologies will be given
priority. All requests for science research funding should be directed to the Susan
G. Komen for the Cure’s Award and Research Grant Program. More
information on research funding is available at www.komen.org/grants.
Statement of Need: Through a community needs assessment the Central Wisconsin
Affiliate of the Susan G. Komen Breast Cancer Foundation has identified the following
needs:
 Projects focusing on increasing opportunities for rural and minority women to
receive health screening, particularly mammography;
 Remove the barriers that prevent rural and minority women from getting the
screening and breast health care they need with a focus on Marathon and Lincoln
Counties. Barriers may include, but are not limited to:
o Lack of transportation
o Lack of child care
o Low income for care and treatment following a positive diagnosis
o Lack of insurance
o Navigating the system
o Paying bills
o Cultural factors
o Stress
 Develop relationships with diverse partners to eradicate breast cancer as a lifethreatening disease by advancing research, education, screening and treatment with a
focus on Lincoln County
 Projects that reach out to women who may not be included in traditional outreach
methods
APPLICATION DEADLINE IS JANUARY 3, 2014. APPLICATIONS MUST BE
SUBMITTED VIA GEMS.
GUIDELINES AND INSTRUCTIONS FOR APPLICANTS
The purpose of this program is to address the breast health and breast cancer
screening, treatment, and education needs of Langlade, Lincoln, Marathon, Portage,
Taylor and Wood Counties, as well as the western portion of Shawano County. Of these
service areas, Lincoln County is the primary focus for grant funding.
QUALIFICATIONS:
Applications are accepted from US nonprofit institutions; US citizenship or
residency is not required. Applications must be submitted in English. Applicant organizations must
be providing services in Langlade, Lincoln, Marathon, Portage, Taylor and Wood Counties, and/or
the western portion of Shawano County.
RESTRICTIONS:
 Project must be specific to breast health and/or breast cancer; e.g. if a project is a
combined breast and cervical cancer project, funding may only be requested for the
breast cancer portion.
 Applicants must be a US nonprofit (federally tax-exempt) organization, e.g.
nonprofit organizations, educational institutions, government agencies and Indian
tribes are eligible.
 Services must be provided in Langlade, Lincoln, Marathon, Portage, Taylor and Wood
Counties, and/or the western portion of Shawano County.
 Salaries, if requested, are for personnel related to this project only and not the
general work of employee.
Funds may be used for the following types of program expenses:
 Salaries and fringe benefits for program staff
 Consultant fees
 Clinical services or patient care costs
 Meeting Costs
 Supplies
 Travel
 Other direct program expenses
 Equipment, not to exceed $5,000.
 Indirect costs, not to exceed 15% of direct costs
Funds may not be used for the following purposes:
 Medical or scientific research
 Scholarships or fellowships
 Construction or renovation of facilities
 Political campaigns or lobbying
 Endowments
 Debt Reduction
CRITERIA:
Criteria: During the application review and grant award process, particular attention will be
given to how well the application addresses the following:
 Impact: How well the project/program will have a s substantial positive impact
on breast cancer disparities and the priority area(s) selected? How is the service
area for the affiliate addressed, with a focus on Lincoln County? How has evidence
based practice/research etc. been used to shape the project/program? Are the
objectives well defined, measurable and attainable? Is the evaluation method
proposed reflective of the objectives stated and meaningful;
 Feasibility: How likely that the objectives and activities will be achieved within
the scope of the project/program? How realistic is the timeline? Is the budget
realistic and achievable;
 Capacity: How does the organization, grant leadership and/or team demonstrate
that capacity, including the expertise to effectively implement all aspects of the
project/program? How is respect and value by the target population demonstrated
for the applicant;
 Collaboration: How does the project/program minimize/avoid duplication of
services and enhance the collaboration among organizations with similar or
complementary goals? Does the project/program promote collaboration
between/among the Central Wisconsin Affiliate and other organiztion(s); and
 Sustainability: How likely is it that the project/program will be sustained and/or
have a long-term impact?
Educational Materials and Messages
Susan G. Komen for the Cure® is a source of information about breast cancer for people all
over the world. To reduce confusion and reinforce learning, we require that grantees
provide educational messages and materials that are consistent with those promoted by
Komen for the Cure. Please visit the following website before completing your application
and be sure that your organization can agree to promote these messages:
http://www.shopkomen.com/educational-materials/index.php?c=7000
Komen for the Cure grantees are eligible to receive preferred pricing for Komen
educational materials. Komen for the Cure materials should be used and displayed
whenever possible. To view our educational materials, visit www.shopkomen.org.
REVIEW: Applications received complete, and meeting compliance with these guidelines,
will be submitted for grant review by a panel established through the local grants committee.
CONTRACTS: A grant contract will be the legal mechanism for funding.
GRANT PERIOD: Grant period begins April 1, 2014 and will conclude on March 31, 2015.
PAYMENT AND REPORTING: The first payment will be made no later than thirty (30) days
after receipt of the fully executed contract. The first progress report is due at the end of the
first six (6) months of the contract. A final report is due within forty-five (45) days of
completion of the grant period.
LETTERS OF SUPPORT AND ADDITIONAL MATERIALS: DO NOT send additional materials
(i.e. reprints, complete curriculum vitae or general letters of support). These will not be
reviewed.
CONFIRMATION OF RECEIPT OF APPLICATION: Confirmation of receipt of application will
be made through GeMS to the project director following review for compliance to
guidelines. Please do not contact the Central Wisconsin Affiliate of Susan G. Komen for
the Cure regarding the status of the application during the review period.
ANNOUNCEMENT: Announcement of grants awarded will be made by the Central
Wisconsin Affiliate by March 31, 2014. Project directors will be notified of the outcome of
the review through GeMS.
NUMBER OF GRANTS TO BE AWARDED: The actual number of awards will depend on the
amount of funding granted per project.
APPLICATIONS SHOULD INCLUDE AND BE ORDERED AS FOLLOWS:
A. Cover Page (Form attached)
Note: Signature of approving institutional personnel, other than project director,
required.
B. Project Description (This section should not exceed five typewritten pages. Font size
should be no smaller than a ten-point typeface.)
1. Brief explanation of project/program (Abstract form attached)
2. Statement of need/problem to be addressed.
3. Description of constituency to be served and how they will be benefited (please
indicate number of women to be served).
4. Description of program goals and measurable objectives*.
5. Description of input necessary (materials, resources, money, time, etc.) and activities
planned to accomplish these goals*. Is this a new or ongoing activity of your
hospital or organization?
6. Description of any measurable outputs (material products, number of people
reached, number of sessions, etc.)*
7. Timetable for accomplishing goals (Please note: six months reports are required).
8. Description of other organizations or entities, if any, participating in the Program.
Although general letters of support should not be included, if applicable, specific
letters of collaboration should be included from each organization where a
collaborative effort is being proposed.
9. Long term strategies for sustaining the impact over time including an explanation of
funding of the Program after initial funding (grant cycle).
C.
D.
E.
F.
10. A review of comparable programs offered in this service area and an explanation of
how this program is unique and non-duplicative.
11. A description of evidence-based practice/research used in the project/program. If
this project/program is modeled after or based upon an evidence-based
project/program, a description of the evidence-based program, why it is applicable in
this community, and a description of any modifications/considerations.
13. Definition of success for the Program and how it will be measured.
14. Use of the Program's results and how they are to be disseminated.
* a summary chart is included to address these issues.
Financial Information (Not to exceed three typewritten pages).
1. Budget for requested funds (Form attached).
2. Budget justification (Form attached).
3. List of other sources of current funding for the project.
Biosketch form for project director and attendant personnel listed in budget request (no
more than two pages per person) (Form attached).
Proof of non-profit status for applicant institution.
Most Recent Progress Report: Previous grantees of the Central Wisconsin Affiliate of
Susan G. Komen for the Cure must attach their six-month or final report for their most
recent grant.
Applications must be submitted via GeMS. We will not accept any paper copies of the
grant applications. Failure to adhere to these guidelines will result in delayed
processing or refusal of the application.
Inquiries should be addressed to Patty Krug at 715-748-1410 or
patty.krug@co.taylor.wi.us.