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United Way Request For Proposals Training for Applicant Agencies

Assisting Vulnerable Seniors and Adults with Disabilities

July 10, 2009



United Way’s Move to Community Impact

Bob Nelkin, President &

Chief Professional Officer



Executive Committee Agreement Changes to Allocation Process

June 15, 2006Open Allocations Process

Focused on Critical Community Needs

To Performance Based Organizations

Achieving Measurable Outcomes Against Specific Objectives



United Way Brand

• Well managed by professional staff

• Well governed by a volunteer board using best practices

• Financially sound

• Demonstrating results for a population with great needs



Three Key Steps in ImplementingThe New Strategic Direction

IDENTIFY/ADDRESSCRITICAL

COMMUNITY NEEDS

SELECT AGENCIESWITH GREATEST

IMPACT ONCRITICAL NEEDS

RAISE FUNDINGFOR SELECTED

NEEDS/AGENCIES



United Way of Allegheny County Mission:…to Get Maximum Impact for Donor $

HEALTHAND

HUMANSERVICENEEDS

INALLEG.

COUNTY

MOSTCRITICAL

NEEDS(WHERE

DONORS CANHAVE IMPACT)

HEALTHHEALTHANDAND

HUMANHUMANSERVICESERVICE

AGENCIESAGENCIESININ

ALLEG.ALLEG.COUNTYCOUNTY

BESTBESTPERFORMINGPERFORMING

AGENCIESAGENCIES(IN CRITICAL(IN CRITICALNEED AREAS)NEED AREAS)

IMPACTIMPACT

DONORDONORCONTRIBUTIONSCONTRIBUTIONS



Making the Shift • From

– Success measured in dollars raised

– Funding needs defined by agencies

– Sole focus on agency outcomes

• To– Success measured in

impact against desired outcomes

– Funding strategies implemented by agencies and other partners for community impact

– Ultimate focus on community outcomes



Community Impact

• Review Connecting Progam Outcome Measurement to Community Impact, United Way of America

• Discussion



Allocations RedesignRFP Steps, Requirements

& Scoring Criteria

Jenny Michaux, Director

Community Impact



Needs Assessment Results

Focus Impact Fund allocations to achieve better outcomes for:

• Teens, Young Adults and Children

• Seniors & Adults with Disabilities

• Financially Struggling Adults & Families



Phase-in for Multi-Year Allocations & Funding Periods during Transition (revised):

Children/Teens/Youth Need Area• Year 1 - Oct 1, 2008 to Sept 30, 2010 (8 quarters-extended fm 7)• Year 2 – Oct 1, 2009 to Sept 30, 2010 (4 quarters)• Year 3 – Oct 1, 2010 to June 30, 2013 (11 quarters)

Seniors/Adults with Disabilities Need Area• Year 1 – April 1, 2009 to Mar 31, 2011 (8 quarters-decreased fm 9)

• Year 2 – April 1, 2010 to Mar 31, 2011 (4 quarters)• Year 3 – April 1, 2011 to June 30, 2014 (13 quarters)

Financially Struggling Families• Year 1 - Oct 1, 2009 to Sept 30, 2012 (12 quarters-extended fm 11)• Year 2 – Oct 1, 2010 to Sept 30, 2012 (8 quarters)• Year 3 – Oct 1, 2011 to Sept 30, 2012 (4 quarters)• Year 4 – Oct 1, 2012 to June 30, 2015 (11 quarters)



Vulnerable Seniors & Adults with Disabilities

2008 RFP Process

31 Agencies Submitted Step 1 Forms 12 Agencies Invited for Step 2 7 Agencies Invited for Step 3 Site Visits 5 Agencies Selected for 2-Year Grants



Schedule for Seniors/Adults with Disabilities

• RFP Announcement – July 1, 2009• Orientation & Training for Step 1 – July 8 & 10• Step 1 forms due August 3, 5:00 pm• Agencies invited for Step 2 applications - Sept 8• Training for Step 2 - Evaluation/Measurement –

Sept 14, 16• Step 2 forms due Sept 28, 5:00 pm• Agencies invited for Step 3 participation Oct 16• Site visits occur Oct 21- 28• Recommendations to Impact Cabinet Nov 3



Review & Selection of Proposals

• Volunteers assist UW staff with the reviews (corporate/business, public sector, community, foundation and university volunteers)

• UW staff & volunteer review teams report recommendations to the Selection Committee

• Selection Committee reports recommendations to the Impact Cabinet

• Impact Cabinet reports recommendations to the Executive Committee and the full Board



Criteria for Selection

• The program serves a population with great needs

• The program utilizes a sound approach • The program achieves measurable results• Program achieves or leads to community-level

outcomes that are aligned with United Way’s preferred long term outcomes



Criteria for Proposal Reviews

1) Population with Great Needs:

• Serves one or more of the target populations

• Serves high need neighborhood/s



Criteria, Cont’d.

2) Utilizes a Sound Approach:• Evidence that program or model is

effective• Response to cultural norms of participants• Key public and private partners have

endorsed the proposal• Collaboration is part of the program’s

design, or partnerships are in place



Criteria, Cont’d.

• Budget is reasonable/appropriate use of UW funds for new, expanded, enhanced service

• Sustainability and ability to leverage other dollars



Criteria, Cont’d.

3) Achieves Measurable Results:• Evidence that program achieves desired

outcomes

• Reliable data system (to record participant demographics, participation and results) which is part of process for continuous improvement



Criteria, Cont’d.

4) Program Achieves or Leads to Community-level Outcomes Aligned with United Way’s Preferred Long Term Outcomes:

• Works across systems • Initiates or leads to policy or system changes• Designed to prevent serious problems in future• Could be replicated more broadly• Impacts well-being of the community



Review of RFP ProcessThree Step Application Process:

Step 1 – Agency Cover Page, Budget Summary, Proposal Summary & Logic Model plus Organizational Eligibility Tool

Step 2 – Full Proposal with Logic Model, Evaluation Plan plus Agency Capacity Self-Assessment Tool, Audit, IRS Form 990, Board list

Step 3 – On-site Visit



Organizational Eligibility Tool

• It is scored on Pass/Fail basis

• Agency must be in compliance with local, state, and federal statutes related to: – Board Governance– Legal and Ethical Considerations– Financial and Administrative Practices– Resource Development

• UW Identified Industry Best Practices



Assessment Process

• (say what you do and why) Define Organizational Aspirations and Purpose

• (do what you say you do) Demonstrate ability to evaluate and modify their programs and services

• (prove it) Demonstrate consistent measurement and communicate their impact



Key Indicators of High Performance

• Leadership (Board & Organization): Vision, Mission, Culture, Strategic Planning & Leadership Development, Organizational Alignment, Decision Making Processes

• Measurement: Setting and monitoring Goals & Performance Targets, Planning Systems, Benchmarking

• Results: Extent to which the organization consistently achieves its targeted outcomes (client goals, employee goals, quality/productivity goals, growth goals, financial goals)

• Continuous Improvement: Evidence of continuous improvement culture, improvement of programs and processes



Critical Needs

Vulnerable Seniors and Adults with Disabilities in Allegheny

County

Mary Phan-Gruber, Consultant



Aging in Allegheny County, PA• Older, more disabled, more below

poverty level• Dispersed to suburban municipalities• More single households • Growing housing & basic living

expenses; Old housing stock• Increasing # of seniors struggling to

care for adult children with disabilities• Low engagement in preventative

care/health and wellness programs



Increasing Poverty Among SeniorsPoverty Rates for Seniors in Allegheny County, 1999-2005

0.0%

2.0%

4.0%

6.0%

8.0%

10.0%

12.0%

65 to 74 years 75 years and over

1999

19992005

2005



Poor Seniors Are Primarily WomenPoverty Among Allegheny County Seniors, 2005

0

2,000

4,000

6,000

8,000

10,000

12,000

14,000

65-74 75+

# B

elo

w t

he

Po

vert

y L

ine Men in Poverty

Women in Poverty

77%Women

60%Women



Nearly Half of Age 75+ SeniorsHave Disabilities

Disabilities Among Elderly in Allegheny Co. 2005

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

65-74 yrs 75+ yrs

2+ Disabilities1 Disability



Population Growth Among “Old-Old”with More Seniors in the Future

Allegheny Co. Population Change by Age, 2000-2005

-20.0%

-15.0%

-10.0%

-5.0%

0.0%

5.0%

10.0%

15.0%

20.0%

60-64 65-69 70-74 75-79 80-84 85-89



Female Senior Alone

Senior FemaleHouse-holders Living Alone



Poor Senior Pop-

ulation, Age 65+and

Senior Ctrs.



Disability, by Age Group



Caregiving is a Family Affair• 80% of all care provided to older adults in our country is

provided by family members

• A recent study sponsored by Evercare, Survey of the Economic Downturn and its Impact on Family Caregiving, revealed:– In last 12 months, 21% of caregivers report moving into the

same household with their loved one. – One in three working caregivers reports having to work more

hours or get an additional job.– Six out of ten caregivers who reported increasing their

caregiving spending also reported having difficulty paying for their own basic necessities.



Caregiving of Adults with Disabilities

• Concern regarding number of older adults who are no longer able to support care of disabled adult children without outside assistance

• Over 40% of people registering for mr/dd care from 2004-2007 did not receive subsidies

• 67% of 6,000 registrants were adults aged 21-64



Volunteer Shortfall

• The need for volunteers to serve frail seniors reveals a shortfall of nearly a third in meeting the demand in recent UW Study

• The core group of volunteers are older adults who themselves are aging



United Way Focus

Assisting Vulnerable Seniors and Adults with Disabilities



UW Target Population• Seniors (age 65+) at 125%-300% of the federal poverty

guidelines, & need more home & community based services

• Seniors with one or more functional disability • Seniors over age 85• African American or single female seniors • Living in area with high no. of poor seniors lacking

adequate access to home & community-based services

• Isolated Seniors who live alone with one of these above listed risk factors

• Adults with disabilities without access to MR/DD subsidized services



UW Preferred Outcomes

• Long-Term Outcomes– Increase number of frail/vulnerable seniors or

adults w/ disabilities who remain safely in homes or in a least restrictive setting

– Increase the number of caregivers able to keep their family members at home



UW Preferred Outcomes• Supporting Outcomes

– Increase in preventive services (safety checks, home modifications, clinical prevention services)

– Increase in adequate/improved nutritional, health, and functional status

– Increase in access to subsidized programs (rent rebates, tax abatements, SSI)

– Increase no. of families with integrated and enhanced access to subsidized services/supports to families with vulnerable senior caregivers and adults with disabilities



Vulnerable Seniors & Adults with Disabilities2008 RFP Process

Five agencies funded for two years through 2008 RFP:

AgeWell Pittsburgh (collaboration of JCC, JAA and JF&CS) 15 programs to help additional 430 vulnerable adults live independently at home

East Liberty Family Health Center- 100 homebound seniors receive in-home visits by nurses & medical assistants

Family Services/Interfaith Volunteer Caregivers assist 2000 seniors through congregational volunteers

Northern Area Co/Multi-Service Center—serve seniors and people with disabilities living in 16 county public housing communities.

Vintage-Chronic Disease Self-Management Program trains seniors to manage disease and improve health.



What has the UW learned?

• Agencies have difficulty with “results orientation”

• Database development is a process

• Organizations can transform themselves



Evidence-Based Practice• Synthesis of scientific evidence to improve

quality and effectiveness

• Explicit approach to problem solving and continual professional learning using current best evidence

• Programs or practices proven to be successful through research

What is the evidence base for an intervention or program?



Evidence-Based Approach: Resources

• National Registry of Evidence-based Programs and Practices (NREPP), Substance Abuse and Mental Health Services Administration (SAMHSA): http://www.nrepp.samhsa.gov/

• Agency for Health Care Research and Quality (AHRQ): http://www.ahrq.gov/clinic/epcix.htm



Aging Best Practices• Identify evidence base

• Review programs that best fit your objectives– Target population– Risk and protective factors– Program resources

• Develop and/or revise your program based on review



Using the e-CImpact Online RFP Application Process

Presentors:

• Mary Phan-Gruber, Consultant

• Andy Rind, Senior Manager, Northern Area Multi-Service Center (former UW)



e-CImpact Online RFP Application• Use of online grant applications spreading• Web-based system allows agency users

unlimited access to enter and modify until submission

• Each agency has its own website and can control user access

• Creates efficiency for UW in information management and reporting impact



Using the e-CImpact Online RFP Application Process

• We will follow the Online Checklist—feel free to make notes.

• We will display the application screens—you will see similar screens in the training manual.

• Manual will also be on our UW website as well as the Resource Center section of the online RFP application.

• PASSWORD- We will supply your user name and password at the end of the session.



Logic Model and Evaluation Plan Susan Chase

ConsultantOpen Minds LLC

[email protected]



• Picture of your program or intervention

• Graphic representation of the “theory of action” – what is invested, what is done, and what will result

Wisconsin Extension Services

Logic model



• What gets measured gets done• If you don’t measure results, you can’t tell success

from failure• If you can’t see success, you can’t reward it• If you can’t see success, you can’t learn from it• If you can’t recognize failure, you can’t correct it.• If you can demonstrate results, you can win public

support and make the case for sustainability. Re-inventing government, Osborne & Gaebler, 1992

Logic Model Forces Specificity and Explicit Statement of What Causes What

Wisconsin Extension Services



Purposes of a Logic Model

• Program Planning

• Program Management (and Measurement)

• Communication

• Consensus Building

• Fundraising



Logic Model – Common Components

• Problem Statement (or issue, or situation)• Goal (overall purpose of the program)• Resources (HR, Finance, Facilities, Technology) Separate

“Have” from “Need”• Constraints – External factors that may limit success.• Activities (What you do to achieve your goal)• Outputs (Tangible results of the activities)• Outcomes (Measureable changes that result from program

activities)



Work Backwards from your Outcome Goal

Inputs Activities OutputsInitial

OutcomesIntermediate Outcomes

Long-Term

Outcomes

A program’s resources and constraints

What a program does with its inputs to meet goal

Products of a program’s activities

Changes in participants’ knowledge, attitudes, or skills

Changes in participants’ behavior that result from their new knowledge, attitudes, or skills

Changes in the condition or status of the participants

Assumptions

What theoretical assumptions are you making about how your program will work?

What assumptions are you making regarding participants, staff, environment?

After OCD, U Pittsburgh, 2008

“Process” “Short term” “Medium term”



If – Then Relationships in the Logic Model

IF THEN

Resources are available Activities can be implemented

Activities are implemented Outputs are delivered

Outputs are delivered Short term outcomes occur (attitude & knowledge changes)

Short term outcomes occur (attitude & knowledge changes)

Intermediate term outcomes occur (behavior changes)Long term outcomes occur (condition or state changes)

Intermediate term outcomes occur (behavior changes)



Outputs vs. OutcomesOutputs Outcomes

400 Home visits provided to teen mothers

Teen mothers keep well baby appointments.

12 Conflict resolution training sessions provided to 15 juvenile first time offenders

Participants identify nonviolent alternatives to conflict

120 young adult books distributed

Middle school students report higher rate of leisure reading.



Outcomes are client-focused; process or output measures are program focused

• Outcomes– Did our program

increase involvement of seniors in social activities?

• Process measures– Did our program make

social activities available to senior citizens?• Process measures or outputs focus on the

number of activities delivered and the number of clients served. • Outcomes focus on the change occurring in the client.



Not Outcomes

• Recruiting and training staff and volunteers, purchasing or upgrading equipment, and various support and maintenance activities

• Number of participants served

• Participant satisfaction (may sometimes be appropriate but should be supplemented with other outcomes)



Levels of Outcome - Samples



Biggest Challenge: State important, feasible, measurable outcome

SMART objectives: Specific, measurable, attainable, results-oriented, timed

Who/what Change/desired effect

In what way By when

Low-income older adults with disabilities

Maintain community-based living status

Assessment;

Referral to appropriate community service;

Service plan developed;

Service delivered

% reached over defined interval:

xx/month



Logic Model Examples

Activ-ities

Outputs Short Term Outcomes(Knowledge)

Intermediate Outcomes(Behavior)

Long Term Outcomes(Condition)

Parent-ing & child

birth classes

Twice weekly classes provided to 25 teen mothers with additional risk factors.

20 Participants will show increased knowledge of healthy prenatal behaviors and the impact on fetal development

15 Participants will increase intake of healthy food and decrease intake of unhealthy foods.

15 Participants who smoke will stop or eliminate cigarettes.

15 Participants will reduce or quit alcohol during the pregnancy

15 Participants will increase their likelihood of having a full term baby



Program Activities, Process Outputs, and Outcomes All Need Measurable Indicators

Input Program Activity

Process Outputs

Outcome

Program resources:

Staff available, training, supporting resources

Provide on-site social work and nursing hours in low-income housing

I&R and health screening delivered to residents on site

Residents remain

in apartments

Hr/week, FTE, rotation across sites

Number of clients assessed; number of service units provided

% reduction in failed apartment inspections and emergency dept admits



Indicators of Outcomes

• An indicator is the evidence or information that will tell you whether your program is achieving its intended outcomes.

• Indicators are measureable and observable characteristics

• They answer the question – how will we know change occurred.

• Indicators should be:

Meaningful Direct Useful Practical to Collect



Indicators (useful for evaluation)• Specific, observable characteristics,

accomplishments, or changes that tell us whether an outcome has been achieved

• Outcome and activity require indicators: measurable units, specified targets

– What does the outcome look like when it occurs?– How do you know when you have succeeded?



Now that you’ve completed the logic model ...

• You’ve developed a logic model that is reasonable and plausible

• The model identifies client-based outcomes that follow logically from your program

• You’ve determined what to measure at each stage of your program

• You’ve developed appropriate SMART indicators



Check your logic model

1. Is it meaningful?

2. Does it make sense?

3. Is it feasible?

4. Can it be verified?

After Wisconsin Extension Services



Logic Model: Conclusions

• Work from short and long-term outcomes backwards to process indicators, activities, and inputs

• Look for measurable indicators at every stage• Aim for specificity• Break down objectives and activities into

component elements• Use it to generate evaluation plan



What is Evaluation?

The systematic collection of information about a program that enables stakeholders to better understand the program, improve its effectiveness, and/or make decisions about future programming



. Evaluation Provides Information

• Were program inputs inadequate to meet process goals?– Failure of implementation

• Were goals met, but these activities did not lead to changes in outcome?– Failure of theory or logic of intervention



Two Major Forms of Evaluation

Implementation Evaluation• Performing activities as planned?• Reaching the target population?• Reaching the intended number of participants?

Outcome EvaluationIs the target audience experiencing hoped for

changes in knowledge, attitudes and condition?



Relationship of Logic Model to the Evaluation Plan



What else do you need to know?

• Questions?

united way of allegheny county were all in this together. live united. give. advocate. volunteer. ...

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united way request

united way brand

united ways

quarters year

county best

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volunteer board

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