In partnership with the Minnesota Department of Education HEALTH CAREERS PROMOTION GRANT PROGRAM 2011

In partnership with the Minnesota Department of Education HEALTH CAREERS PROMOTION GRANT PROGRAM 2011 1 TABLE OF CONTENTS GENERAL INFORMATION……………...
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In partnership with the Minnesota Department of Education

HEALTH CAREERS PROMOTION GRANT PROGRAM 2011

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TABLE OF CONTENTS GENERAL INFORMATION……………………………………….…………Pages 3-4 Background and purpose Eligible applicants Grant requirements Anticipated programs Total available funding Application timeline Grant period Matching fund requirements Reporting requirements State legislative authority Contact information APPLICATION FORMS AND INSTRUCTIONS..………….……………Pages 5-12 Application Content Checklist Application Review Process Application Instructions Forms: Cover Sheet Plan and Project Narrative Budget Summary and Budget Narrative Statement of Assurance

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GENERAL INFORMATION Background/purpose Minnesota Statutes Section 144.1499, passed by the 2001 Legislature, authorizes the Commissioner of Health to award grants to qualifying consortia to assist them in developing intergenerational programs to encourage middle and high school students to work and volunteer in health care and long term care settings. Eligible Applicants: Consortia or partnerships must include at least one eligible health or long term care employer and an institution of higher education. Priority will be given to consortia that include a school district partner. “Eligible employer” may be a nursing facility, small rural hospital (50 or fewer beds), intermediate care facility for persons with mental retardation or related conditions, waivered services providers, home health services provider, personal care assistant services provider, semi-independent living services provider, day training and habilitation services provider, or similar provider of health care or human services. Other partners that do not fit these criteria may also be included, so long as the partnership includes an eligible employer and a higher education partner. Grant Requirements: 1. Grants must be used to develop or improve health science or health/career exploration programs and/or curriculum(s) at the middle/junior and/or secondary school levels. 2. Applications must provide evidence of alignment with the currently applicable Minnesota graduation requirements and national health care skill standards. 3. Grant applications must provide evidence of broad based community support in their applications by listing their consortium advisory group members. Anticipated Programs The grant application will address one or more of the following: 1. Develop and implement a secondary health science education program that aligns with the currently applicable Minnesota graduation requirements and national health care skill standards. 2. Establish a secondary health science technology education program of study leading to one or more post-secondary health science pathways. 3. Develop a medical career exploration program primarily targeted at middle and/or junior high school students. Total Available Funding: $147,000 in FY2011. Average grants in past years: 10 awards per year between $5,000 to $20,000 each. Capital expenditures are limited to $5,000 and written justification is required. Funds will be released upon receipt of an invoice with a quarterly report of activities and expenditures.

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Application timeline The application is due to the Minnesota Department of Health-Office of Rural Health and Primary Care 4 p.m. Tuesday, November 30, 2010. Grant period Contracts will begin January 1, 2011, with all activities completed by December 31, 2011, the end of the grant period. Matching Fund Requirements Ten percent of grant request (non-state funds or in-kind services). Reporting Requirements A midterm report of activities and expenditures is due no later than 30 days after the midterm of the contract. A final report summarizing activities and curriculum is due no later than 30 days after the contract expires, or January 31, 2012; final 25 percent of award will be withheld pending receipt of final invoice, report and curriculum. State legislative authority: Minnesota Statutes Section 144.1499 and 116L.11 (4) Contact Information: For questions, consultation or program guidance in completing the application, contact: Mike Mitchell, Health Science Education Specialist, Center for Post Secondary Success, Minnesota Department of Education at (651) 582-8513 or [email protected]. For questions regarding the application or award process, contact: Lawrence Colaizy, Minnesota Department of Health-Office of Rural Health & Primary Care, at (651)201-3851 or [email protected].

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Application Content Checklist 

Application Cover Sheet



List of consortium partners



Plan and Project Narrative



Budget Summary and Budget Narrative



Statement of Assurance



THE ORIGINAL AND SIX COPIES



No attachments necessary



Authorized signature(s) only



Application criteria have been addressed.

Mailing/Delivery Information

NO FAXED APPLICATIONS

ORIGINAL AND SIX COPIES due in the Minnesota Department of Health-Office of Rural Health and Primary Care no later than 4 p.m. on Tues., November 30, 2010. Mail to: Lawrence Colaizy Minnesota Department of Health Office of Rural Health and Primary Care P O Box 64882 St. Paul, MN 55164-0882

Or courier to: Lawrence Colaizy Minnesota Department of Health Office of Rural Health and Primary Care 85 East Seventh Place, Suite 220 St. Paul, MN 55101

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Application Review Process Applications will be reviewed by a panel familiar with program criteria, which will recommend selections to the Commissioner of Health. In addition to panel recommendations, the Commissioner may also take into account other relevant factors in making final funding determinations. Evaluation Criteria – Reviewers will evaluate applications based solely on information included in the application Consortium qualifies under M.S. 116L.11 (4) o Required - Includes public or private institution of higher education o Required - Includes one or more eligible employers (nursing facility, small rural hospital, intermediate care facility for persons with mental retardation or related conditions, waivered services provider, home health services provider, personal care assistant services provider, day training and habilitation services provider, or similar provider of health care or human services)

If you do not meet the above criteria, you do not qualify.

o Recommended – Includes a K-12 school district partner o Must demonstrate a plan for evaluation and sustainability of activities for the program Finance narrative requirements (budget summary and budget narrative) o Leverages funding from other sources (Perkins, Tech Prep, and/or other) o Clearly explains budget line items o Clearly reflects project objectives o Demonstrates a plan for financial sustainability of the project and o In-kind match identified (10 percent of grant amount minimum requirement) The proposal must clearly demonstrate how it will develop or implement all of the following grant requirements that apply to the proposed program: Describe how the Grant program will develop or implement one or more of the following: o A process for aligning program and courses with the currently applicable Minnesota and national academic standards and graduation requirements o A process that will be used to establish post secondary credit (secondary education only) o A plan to measure technical skill attainment and/or student assessment o Processes that will be used to establish a health science technical education or academic program of study and pathway o Plans for programming for middle and junior high schools interested in developing health career exploration programs o Activities of Consortium Advisory Group to support program development and improvement o Technical support to participating providers to enable the use of the employers’ facilities and programs o A process for identifying high wage, high skill or high demand health occupations o How the Health Careers Program will be promoted to students, parents, and area health care industry employers o Budget allocation for sustainable professional development activities including MDE/MDH curriculum development workshops. 

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Plan for assessment and evaluation Grant funds may be used for third party pre and post program testing to evaluate the effectiveness of the program. Involvement and support of local/regional partners in the grant proposal development Plans for dissemination of project results 6

Application Instructions

Use the forms provided, make copies as needed and fill in the blanks. Type, except where a signature is required. Include six complete copies of the application packet plus the signed original. 1. Cover Sheet Line 4 is for those grant related services Applicant name and address should be the typed identified as communicative. It includes faxes, name of the organization member who is given mailing services, photocopying services, the authority to apply for the grant. postage, electronic services, and courier services. Applications cannot be processed without the appropriate tax identification number of the Line 5 is the category specifically for student fiscal agent. Fill out the projected dates for the transportation and travel for student instructional activities, career fairs, field program work and the grant category. The trips, etc. This does not include project end date must be on or before transportation for daily classes. December 31, 2011, for all applications. Line 6 is for costs specific to professional staff development and travel. Report in-state professional travel separately from out-of-state travel and explain the relationship to the grant. Include attendance at relevant workshops, seminars, or technical assistance sessions.

Check the box that most closely identifies the applicant’s organization or specify the type of organization in the box labeled “other.” 2. Plan and Project Narrative This form may be reproduced, but should not exceed five pages. The complete application should not exceed eight pages. Address all the questions in the form through the narrative of your plan, project and budget.

Line 7 is for payment to Minnesota Districts/ Other Agencies. Line 8 is used for required instructional supplies either school-based or work-based.

3. Budget Summary and Narrative Lines 1-2 are cost categories used for program staff salaries and fringe, and are restricted to non-instructional supplemental activities, such as curriculum design, planning and meetings for grant program activities. These activities should not include activities that are the current responsibilities of participants. Funding for fiscal

Line 9 equipment and capital purchases limited to $5,000 with justification required. Line 10 is a miscellaneous cost category. Always specify the use of funds in this cost category and explain the relationship to grant activities in the budget narrative.

management/ administrative staff is limited to 5 percent of total grant award.

The Budget Summary and Budget Narrative must be submitted with each program final report. These documents, together with the program report and invoice, will be required to initiate final program payment.

Line 3 is the category for listing professional or technical contract services, including third party program evaluation. Grant funds cannot be used to pay for the cost of applying for the grant. NOTE: Costs/work plan for consultant services must be delineated in the budget narrative and approved by MDH.

4. Statement of Assurance Applicants are required to read, sign, and return the statement of assurance. The applicant should keep a signed copy on file.

Award letters will be sent from the Minnesota Department of Health-Office of Rural Health and Primary Care. Once the application is approved, the grant will take 4-6 weeks to go through the signature process and it is fully executed. Expenses cannot be incurred until all appropriate signatures are secured.

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APPLICATION COVER SHEET Submit original and six copies.

Faxed applications not accepted.

Applicant Organization and Address (Print/type legal name and address) Name of Consortium

Start Date

Applicant Organization

End Date

Street Address

Amount Requested $ Type of Applicant Business Org. Community K-12 School Higher education institution Health/Long Term Care Employer Organization Other

City Zip

State Contact Phone

December 31, 2011

(name of person submitting grant)

Fax E-mail

Authorized signature

Title

Print name Fiscal Agent Name and Address, if different than above Name Street Address State

City Contact E-mail

Phone

Zip Fax

MN Tax ID#

Federal Employer ID#

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PLAN AND PROJECT NARRATIVE (no more than eight pages) Demonstrate or describe the following: 1) Scope and purpose of the project 2) Outcomes of the project, including activities to reach the desired outcomes 3) How the budget reflects the project outcomes and how the project utilizes and aligns funding resources 4) Plan for assessment and evaluation 5) Plan for financial sustainability of the project 6) Involvement of partners in the development and review of the grant proposal and 7) Plan for dissemination of project results.

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BUDGET SUMMARY

January 1, 2011 – December 31, 2011 Grantee: Budget Categories State Funding Requested

In-Kind/ Matching Funds

Funding from Other Sources (Fed/State/Local/ Private)

Total Proposed

1 Administrative* 2

Teaching staff noninstructional support

Consultants/ Subcontractors 3 (include budget and work plan) 4

Communications/ postage

Student 5 transportation (see explanation) 6

Professional development/travel

Payments to 7 Minnesota districts/ Other agencies 8

Instructional supplies and materials

9 Equipment** 10 Other Project Total

*Restricted to 5 percent of grant award unless described in program criteria differently. ** Equipment and capital expenditures limited to $5,000. Justification required. NOTE: Authorization required when a change in line item exceeds 10 percent. The budget must be accompanied by a budget justification narrative that explains each line item. Subcontractors must be identified. If contractors have not yet been identified, explain the selection process you intend to use. Identify all sources of funding (cash or in-kind) in addition to state funding requested under this grant and include a description in the budget narrative.

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BUDGET NARRATIVE Briefly describe the line item allocations indicated on the Budget Summary, including how each item supports the sustainability of the program.

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STATEMENT OF ASSURANCE 1)

(Consortium, school district, organization or unit of government name representing consortium)

is applying for a Health Careers Promotion Grant from the Office of Rural Health and Primary Care of the Minnesota Department of Health. 2)

(Consortium, school district, organization or unit of government name representing consortium)

certifies that it will comply with the requirements of the Health Careers Promotion Grant Program, including the requirements in Minnesota Statutes 144.1499. 3)

(Consortium, school district, organization or unit of government name representing consortium)

will enter into a grant contract with the State of Minnesota if the application is successful. 4)

,

(Name)

is hereby authorized to execute contracts and certifications as required to implement the organization’s participation in the Minnesota Health Careers Promotion Grant Program.

(Authorized signature) Date

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