We recommend that you begin by reading all of the requirements for this application before starting. We encourage you to review the Trait Scoring Rubric that will be used to assess all valid applications. Any content submitted by you as part of this application must be in English. You must propose a project and budget for $1.5 million (USD), not less, which would be apportioned over a project timeline of at least two years and not to exceed three years. Your application must target a specific community or set of communities within Allegheny County – applications which propose Allegheny County-wide proposals are not allowed. Sections of your applications may be published on this website or elsewhere and will be shared with others during the evaluation process.

Be sure to review your application as it will appear after it has been submitted (link at the bottom of the page) and confirm your changes have been saved. When you have completed all of the requirements, a message will be displayed on the screen. At that point, you can submit your final application. Once you have submitted your final application, you will no longer be able to make changes.

You must submit your final application no later than Tuesday, November 19, 2019, at 5:00 PM Eastern time.

A. Executive Summary

This is your opportunity to make a strong first impression. Offer a brief and compelling overview of your proposal. Avoid using jargon. Describe your proposal in ordinary language that anyone can understand.

Project Title (10 words)

Choose a name for your project that easily identifies your solution and distinguishes it from any other projects.

Project Description (25 words)

Provide a short description for your project in one sentence.

Quick Pitch (150 words)

Write an overview of your project that answers the following four questions:

• What is a brief description of the problem that you are trying to solve?
• How will you attempt to solve it?
• What is your target population and geography?
• How will your solution change the lives of the people that you wish to serve?

Your quick pitch should be a stand-alone statement of the problem and solution. It should not require any other context to clearly explain what you are seeking to accomplish. Your quick pitch may be extracted from your application and shared with others to provide a broad overview of the proposal.

B. Your Team

Now that you’ve provided a brief overview of your project, focus on the talent and management of your team.

Principal Organization

During the registration process, you identified your organization. Should you be invited to receive a grant from the Henry L. Hillman Foundation, then you must designate a Principal Organization that would be responsible for taking accountability for those grant funds, as well as providing the direction, control, and supervision for the project. The Principal Organization must be an entity under section 501(c)(3) of the Internal Revenue Code that has received a tax determination letter from the Internal Revenue Service. If the organization that you named during registration is not the Principal Organization, please select Edit Registration Form from the Profile menu to update this information, so that the organization identified during registration is the designated Principal Organization.

Principal Organization Website or Social Media Page (5 words)

What is the URL of the website or social media page of choice for the Principal Organization? If your Principal Organization does not have a website or social media page, then please enter “Not Applicable.”

Partners (200 words)

The Healthy Allegheny Challenge is a team-based competition. Partner organizations may include other certified 501(c)(3)s, grassroots community organizations, volunteer groups, government agencies, school districts, or other public partners, and any private sector entities. Projects must be proposed for a sub-geography within Allegheny County, with a focus on underserved communities. Countywide proposals will not be considered for funding. Therefore, each partnership must include strong relationships with government and other community leadership where the work is proposed. For example, if your team is proposing to implement a project in multiple locations, then your team should include partnerships with relevant municipal or neighborhood leaders in each place where you are proposing to implement your project. With these instructions in mind, name each partner. Limit your description to an explanation of the relationship between the parties. Later, you will describe how the partnership is well-positioned to deliver the solution as an integrated team, but this is your opportunity to describe the number, type, and arrangement between the partners. Every team must consist of a minimum of two organizations.

Letters of Support

For each named partner, you must execute and provide a Letter of Support between the parties. The Principal Organization must maintain discretionary control over any partnership, and each Letter of Support needs to define the specific commitment(s) between the parties. Letters of Support must contain specific references to the project and should contain explicit support for the intended outcome. After you have compiled all of the Letters of Support for each partner named in this application, you must combine those documents into a single PDF file. The PDF may not exceed 10MB. 

Case for Partnerships (250 words)

Explain how your team is uniquely positioned to deliver results and why you are the best choice to solve this problem. Your response can include:

• How your solution aligns with the primary purpose of your team members or, if there is loose or indirect alignment, explain why you have decided to solve this problem together;
• Your team's previous performance or relevant experience that highlights the ability to deliver results;
• Description of the largest project that members of your team have overseen in the past (financially and/or in terms of the number of people involved);
• Description of what draws the leaders of the team to this project on a personal level. What are your team’s core values?

Emphasize that you have the right capabilities, experience, and commitment to execute your project.

Biographies of Key Staff (200 words)

For each of the top three key staff members who are responsible for the success of the project, please provide a name (First/Last), affiliation, title for the affiliated organization, and a brief biographical statement. One of the top three key staff members must be the lead executive for the Principal Organization. The biographical statements should briefly emphasize the credentials and experiences which are most relevant to the project.

Proof of Engagement with Target Communities (200 words)

While not a member of your team, it is important to illustrate that you know and understand the target population of your proposed solution. And, it is required that you reveal how and to what extent those communities have informed or helped shape the development of your project. Explain how you’ve approached individuals within Allegheny County who represent the target population and provide evidence that you have engaged with them in a way that is both authentic and meaningful. If you are proposing to implement your solution within multiple communities, then you must select representatives or show levels of engagement that best represent each of those communities. We encourage you to prioritize populations that have experienced health inequities. Your application must target a specific community or set of communities within Allegheny County. Allegheny County-wide proposals will not be accepted.

Primary contact

Enter the name of the Principal Organization’s primary contact, who will assume a role coordinating the team and affiliated organization(s), answer any questions, and have a working knowledge of roles and responsibilities identified in the application. Your primary contact must have specific knowledge about both the technical and logistical or operational aspects of the application.

First Name:

Last Name:

Affiliation and title:

Phone:

Email:

C. Problem Statement

Choosing the right problem to solve is the first step towards developing an effective solution. Show that you understand the nuances of the challenges ahead. You will describe the Problem Statement in the context of the Plan for a Healthier Allegheny (PHA); see here. Take time to read the PHA before proceeding.

PHA Objectives

The Plan for a Healthier Allegheny contains 25 objectives across five (5) Priority Areas. Each of the Priority Areas has been carefully crafted after an extensive period of stakeholder engagement with local communities across Allegheny County. You are required to select a minimum of one and a maximum of three objectives that align with your proposal. Your chosen objectives may cross-over between Priority Areas. Later, you will have an opportunity to explain why you selected specific objectives over others and how your selection(s) relate(s) to broader goals of the PHA. Check up to three.

Your Objectives (200 words)

Within the framework of the PHA, offer an explanation for why you chose the specific PHA objectives (above). Use the PHA to establish related goals, outcome indicators, projected impact, target populations, data sources, and/or any relevant strategies. You may build upon information available in the PHA, but you are responsible for making a clear case as to why those selected objectives align with your strategic and operational approach. Make it personal.

Problem Statement (150 words)

Describe the specific challenges that your solution will address, using non-expert language (do not cite papers or studies). Share the most specific articulation of those issues and, if appropriate, connect them to any larger social concerns or systems. As part of your description address:

• Who is impacted by the problem?
• Why does the problem persist within the current environment?
• What factors, if any, have inhibited progress towards solving the problem?

Focus on setting the stage for your solution (versus describing how you intend to solve it).

Demand to Address the Problem (150 words)

Is the chosen problem recognized as urgent among stakeholders (target population, local leaders, government agencies) in the communities where you are planning to implement your solution? Is there currently a demand for solving the problem among those stakeholders, and how is that demand verifiable? If not, why?

Local Conditions (150 words)

Describe the community or communities where you intend to implement the solution. Explain your understanding of the local conditions that are critical to your success. The best proposals align with an integral awareness of local challenges. Show that you’ve taken time and invested resources in understanding those local conditions.

D. Your Solution

This section provides the opportunity for you to more fully explain how you to intend to solve the problem.

Theory of Change (200 words)

Describe the logic of how your solution will lead to the desired outcome. Your Theory of Change should read as a narrative explanation of both the projected and desired outcomes. Emphasize the methodologies that you intend to employ and how they create a causal link to your shorter-term, intermediate, and longer-term goals. As you develop your response, consider this Practical Guide for Creating a Theory of Change.

Technical Approach (250 words)

You’ve already provided an overview of your solution. Now, you will offer a deep-dive into the technical aspects of your approach to the project. Describe any scientific, medical, engineering, or social process that is at the core of your solution. As you describe your technical approach, include any links or citations to validate claims of effectiveness. Show through third-party research and/or other sources of information that your technical approach will work as described. For teams offering less technical approaches, include literature among social science sources to validate your claims.

Projected Impact (200 words)

Offer a detailed accounting of the projected impact of the project. Be specific. Identify those who will benefit from the solution that you are proposing and the metrics that you plan to use to measure your success. Describe the durability of your solution.

Diversity, Equity, and Inclusion (200 words)

Compelling proposals will fully demonstrate a commitment to the values of diversity, equity, and inclusion. Not only do we expect that teams will be thoughtful about how to work with a range of people, but we also expect teams to think carefully about how to actively plan for and include the most vulnerable from within those populations that are impacted by the solution. 

1. Explain how you will ensure, or have ensured, that the design and implementation of your solution authentically embraces diversity, equity, and inclusion across all aspects, including persons with disabilities, religious or ethnic minorities, people of color, native/Indigenous peoples, women, gender identity, and sexual orientation.
2. How will you provide opportunities and reasonable accommodations for all people, including religious or ethnic minorities, people of color, native and Indigenous people, sexual orientation, gender identity, and women to actively participate and/or benefit from your solution, including as staff, advisors, partners, consultants, etc.

Monitoring, Evaluation, and Learning (200 words)

The Henry L. Hillman Foundation values monitoring, evaluation, and learning activities that are capable of adapting as a project gets underway. However, those activities must be rigorous in their design and ensure that the implementing team is learning as they go. Describe what your team expects to learn as you implement the solution, and how your team plans to learn from the experience. This is the first step toward developing a more comprehensive Monitoring, Evaluation, and Learning plan. Your response should address:

• How are you thinking about evaluating your solution?
• What are your methods for collecting data?
• How will that data be used in ongoing performance improvement?
• How will you use data to learn if the project is successful?

E. Resource Requirements

Explain your project plans and the related costs to implement your solution.

Project Plan (250 words)

Provide a narrative description of your project plan for implementing your solution. Your project plan should contain critical tasks in a strategic sequence of phases over a project timeline of at least two years and not to exceed three years. The duration of your project plan should correspond to other descriptions of your resource requirements (below). This is your opportunity to explain the specific steps that you will take to achieve success. Be concise.

Budget Narrative (250 words)

Offer a broad and narrative description of your budget needs for a $1.5 million (USD) grant, not less. As you draft this narrative, map your costs against the tasks described in your project plan, where applicable. As you link descriptions of your budget needs to the project plan that you have previously described, a reviewer should be able to read these descriptions as a cohesive narrative to understand how your budget relates to the milestones that you are planning to achieve over a project timeline of at least two years and not to exceed three years. Where cost categories may cut across any phases of the project plan (e.g., to ensure reasonable accommodations for people with disabilities, to include Indirect Costs, a budget buffer, and/or cost for Monitoring, Evaluation, and Learning), you are welcome to describe where and how much they relate to your budget narrative for each phase. 

Detailed Budget

Provide a detailed breakdown of your total costs. Cost categories should include, but are not to be limited to, descriptions that you’ve already explained in more detail as part of your Budget Narrative.. You are encouraged also to include any more detailed cost categories that support a more thorough description of your total costs over a project timeline of at least two years and not to exceed three years. Use this opportunity to reflect and clarify any general explanations provided in your Budget Narrative and elsewhere in your application. As you describe each line item, avoid terms that are ambiguous or vague (e.g., miscellaneous). Instead, offer descriptions of costs which directly correlated to your previous explanations. A reader should be able to review your detailed budget and understand how the pieces fit together. All budgets must total $1.5 million (USD) for proposals to be eligible.

Other Funders (150 words)

If you have already received funding for this project from other sources, please describe each source of additional funding, the amount of additional funding from each source, and any stipulations imposed as a result of receiving those funds. If you have not received other sources of funds, please enter “Not Applicable.”

Financial Sustainability (150 words)

How do you plan to operate and sustain the impact of your project over time? If your plan requires additional resources in the future above and beyond the $1.5 million (USD) budget to be sustainable, describe the most likely pathway for securing any additional and ongoing support. If you believe your plan will NOT require additional financial resources to be sustainable, explain why. 

This is your opportunity to describe your need for any non-financial resources to achieve the goals articulated in your plan.

F. Video Pitch

You are required to submit a video that captures your project and why it should be funded. The video is an opportunity to showcase your passion and to present your case in a succinct format.  We want you to share your vision with the judges in a way that is different from the written proposal format. This DOES NOT need to be a professionally produced video.

In order to complete this part of your application, you will upload a short digital film using YouTube.

Set the Privacy Settings on your video to Public or Unlisted – do not set them to Private.

Your video may be extracted from your submission and made available to the public and other donors. Appeal to a broad audience. Video submissions should follow these guidelines, or your application may be disqualified:

• A length of no more than 90 seconds.
• Your pitch must be in English.
• Instructions on how to use You Tube automatic captioning.
• Your video should not contain identifiable children without parent consent.

Here are general suggestions for delivering a high-quality video presentation:

• Introduce yourself and your organization(s) or team.
• Describe the problem that you are committed to solving.
• Explain your solution.
• Explain what is unique about your solution.
• Describe how you would you plan to measure success and achieve broad but meaningful impact.

ADDITIONAL INFORMATION

If you are selected for any further investigation into your capacity to receive the $1.5 million grant through the Health Allegheny Challenge, then you may be required to provide additional information to the Henry L. Hillman Foundation and/or any designated representative. That information includes but is not limited to the following:

• A Tax Determination Letter as a 501(c)(3) organization.
• Articles of Incorporation, Charter, or similar documentation.
• A monitoring, evaluation, and learning plan for the project.
• Existing policies, if any, addressing conflicts of interest, whistleblower, internal controls, anti-money laundering, intellectual property, human subjects research, code of conduct, ethics, gifts, and any similar policies governing the organization(s) directly involved in the proposed project.
• If relevant, a statement that any Henry L. Hillman Foundation grant funds will not be used for lobbying purposes.

The Henry L. Hillman Foundation reserves the right to perform background checks on key individuals associated with the project, and the refusal by the key individuals to provide necessary authorizations will be a reason to reject any application for further consideration. Background information and the results of any background checks will be kept confidential.