SIGNED PRE-APPLICATION_MAPP PILOT 2022.PDF
Extracted text (via pymupdf)
4118 characters
MARICOPA COUNTY DEPARTMENT OF PUBLIC HEALTH
NEW GRANT OPPORTUNITY PRE-APPLICATION SURVEY
1
The purpose of the Pre-Application Survey is to allow a Program within Public Health to request review
and approval of a grant opportunity that meets the Department’s mission and vision
and complies with Maricopa County’s policy and procedure.
Complete this survey if the grant is new to Public Health. Contact your Grants/Contracts
Administrator if you have questions.
COMPLETE IN ITS ENTIRETY.
SECTION I (boxes expand when typing information)
Today’s Date_11/17/2021_____
A.
Public Health Program applying for the grant:
Office of Community Empowerment
B.
Estimated funds to be requested per year of term (Example: $50k per year over 3 years=150k):
$10,000
C.
Grant Funder Name:
NACCHO
D.
Grant Name, Description, and Term (Begin and End dates):
2022 MAPP 2.0 Pilot Test of Phases 1 & 2
E.
Grant Due Date:
10/31/21
SECTION II
A.
Will this grant address a mandated service?
No
B.
What community needs or benefits will this grant address if awarded?
It will provide technical assistance, tools, and professional development to better engage community partners
who participate in the Health Improvement Partnership for Maricopa County through the updated MAPP
(Mobilizing for Action through Planning and Partnership) which is the methodology that MCDPH uses to conduct
its Community Health Needs Assessment and Community Health Improvement Plan.
C.
How is this grant consistent with MCDPH’s mission and vision?
Aligns with mission and vision to support community health and wellbeing.
D.
Principal staff (Program Manager and Accountant):
Lilliana Cardenas, Program Manager
E.
Will the Program contract or partner with other community organizations? Briefly explain.
We will contract via task order or RFP to hire a coach to help us with this process.
F.
How would staffing be affected? Create new positions, additional responsibilities for current personnel,
etc. Does the Program have the capacity/infrastructure/space to manage this grant?
This work was already going to happen, this small grant mostly provides technical assistance and tools that we
can use to be more effective in our work. No new staffing or space needs.
MARICOPA COUNTY DEPARTMENT OF PUBLIC HEALTH
NEW GRANT OPPORTUNITY PRE-APPLICATION SURVEY
2
G.
What additional resources would the Program need for this grant to be successful?
Maintain current staff working with our HIPMC coalition.
SECTION III
A.
Does this grant require “match funds” from MCDPH/Program? If yes, how much ($$ or %) and how will
this be achieved?
no
B.
Is full indirect allowed? If no, what is the allowable rate? How will uncovered costs be subsidized?
Funding is a flat $10,000 for participating, MCDPH can allocate those funds as needed so full indirect can be
used.
C.
Does this grant require future/ongoing contributions? If yes, how will this be subsidized?
Yes, but this is already a partnership and collaborative that is in plance
D.
What is the type of grant compensation? i.e. cost reimbursement, one time lump sum, flat fee etc.
Two invoice cycle: April – May 2022 ($5,000) and June– July 2022 ($5,000)
SIGNATURES (Need All 3)
DATE
Program Manager
11/17/2021
Program Administrator
11/29/21
Department Director/Deputy Director
11/29/21
Department Director certifies that the grant being applied for
meets pre grant submission requirements contained in MC Policy #A-2505.
GRANT/CONTRACT REVIEW
DATE
Grants/Contracts Administrator
Notes:
DATE PROGRAM NOTIFIED ______________________________________________________________
Updated 07/28/2020
FOR AND ON BEHALF OF MARICOPA COUNTY
________________________________________
Bill Gates Date
Chairman, Board of Supervisor
ATTEST:
________________________________
Clerk of the Board Date
APPROVED AS TO FORM:
___________________________________
Attorney for Maricopa County Date