Breast Cancer Research/Education Trust Fund Logging
Instructions

Breast Cancer Research and Education Program Grant Application


In accordance with 902 KAR 23:010, mission of the Breast Cancer Research and Education Trust Fund (BCTF) is to enhance efforts to reduce breast cancer incidence and mortality. These efforts target the program needs and challenges specific to population groups and geographic regions.


Eligible grant applicants include non-profit entities (501c3), educational institutions and government agencies in the Commonwealth of Kentucky. Each applicant must offer a program or service that seeks to address the needs of the women in need of breast cancer services in the Commonwealth.


The following program/service/grant application criteria will be taken into consideration:

  • Must be relevant to the mission of the Breast Cancer Research and Education Trust Fund
  • Must offer a program or service in the areas of research, education, awareness, screening and /or treatment
  • Must be applicable to the medically underserved population
  • Must propose to address the following areas that the Board has identified (Research, Education, Awareness, Screening and/or Treatment)
  • First preference will be given to programs who support disparate populations, never and rarely screened, and translational research in clinical demonstration projects
  • Will enhance, but not duplicate, a program or service currently provided in same geographic area

The following components must be submitted with the grant cover sheet:


Project Description

  • State the need of the program or service.
  • List the goals and objectives of the program or service including the number of people you expect to serve and geographic area to be served
  • List the outcomes directly related to the impact of the program or service
  • Provide an implementation plan that desribes how program objectives will be met.
  • Provide a timeline with a start and end date for each program activity.
  • Include an evaluation plan and describe the success of the program will be measured.
  • Provide a breakdown of budget activity, by line item.

The following screening criteria will be utilized by the Objective Review Committee in the ORC determination of BCTF grant awards:


The Breast Cancer Research and Education Trust Fund Scoring Criteria

  • Project is relevant to the Breast Cancer Research and Education Trust Fund mission to reduce the incidence and mortality from breast cancer.
  • Project offers a program or service in the areas of research, education, awareness, screening and/or treatment
  • Project proposes to serve the medically underserved population.
  • Project directly addresses the prioritized list of programs and research projects the BCTF Board has identified.
  • Goals and objectives are clearly outlined, measurable and attainable.
  • Implementation plan is clearly outlined.
  • Timelines are realistic to meet objectives.
  • Evaluation plans are clearly defined.
  • Program or service is not being duplicated in same geographic area and budget is outlined and appropriate.
  • Applications, including budget, NOT to exceed 10 pages.
  • What type of impact the project will have on the community in serving the mission of the trust fund.

The following information provides budget details received by the Breast Cancer Research and Education Trust Fund.

  • Detailed budget of requested funds to not exceed $20,000.
  • Purchase of food is not an approved expense covered in the reimbursement process.
  • Indirect costs are not an approved expense covered in the reimbursement process.
  • Other funding sources for this program or service includes in-kind participation.
  • Grantees are required to include the following statement on all promotional materials: “Printed with Breast Cancer Research and Education Trust Funds”.

Financial Reimbursement Process

  • Local health department BCTF grantees shall be reimbursed according to monthly revenue and expense statements.
  • Invoice on activity performed by grantee shall be submitted to the Division of Women’s Health office.
  • Invoices must be submitted on the invoice template provided by the Breast Cancer Trust Fund. Request for exemption from this request will be considered on a case by case basis.
  • Invoice is reviewed by the Division of Women’s Health for appropriate spending in accordance with the budget submitted.
  • Once invoice is approved, a check will be processed within 30 days.
  • All grantees may be subject to a financial site review during the fiscal year grant period. This will include a review of purchases made with grant funds, proof of receipt for line items included on approved budget, and the progress in which the project has provided.
  • The BCTF Board has the right to request proof of receipt at any time an audit is required necessary. While receipts are not required with invoices for reimbursement, it is strongly recommended that grantees keep proof of receipt for all transactions for accounting purposes.


All applications shall be submitted on line at website link


Mail one original signed copy postmarked by February 15, 2020


The Breast Cancer Research and Education Trust Fund

Kentucky Department for Public Health

Division of Women’s Health

Cindy Arflack

275 East Main Street, HS1WF

Frankfort, Ky. 40621


1. An Objective Review Committee will review and score all applications. The BCTF Board will make all final funding decisions.

2. Successful applicants will be notified within ninety (90) days after application deadline, in writing, by certified mail. Grant agreements will be distributed for signature by successful applicants and must be signed, submitted back to the Division of Women’s Health and postmarked within two (2) weeks of receipt. Incomplete applications will not be considered and will be returned.

3. The BCTF Board shall notify in writing any grant recipient that does not make satisfactory progress toward meeting grant objectives . The grant recipient shall submit to the board within thirty (30) days of receiving the notice a corrective action plan which addresses the objectives that are not being met. Reimbursement of grant funds received to date will be required if the corrective action plan is not implemented.

4. Institutional Review Board (IRB) approval is required prior to project implementation for research projects.

5. If you have further questions, please call the Kentucky Department for Public Health, Division of Women’s Health at 502-564-3236.

6. Grantees are responsible for notifying the Division of Women's Health with changes in grantee information including contact information. If any changes occur to grantee's address, email, phone number or contact name, it is the grantee's responsibility to inform the board of this change within ten (10) business days of the change.

Open Ended Questions

Please answer the open-ended questions in seperate WORD or NOTEPAD documents. Complete the following fields and click SUBMIT. You will then be taken to the Upload Page. Upload each document into the database, noting in the description which question is being answered. When you are done, click FINISH. If documents are not loaded appropriately, the application will be considered nonresponsive. For technical questions related to the application submission process, please contact Cindy Arflack at 502 564-3236


A. Please provide a short description of the program or service to be funded. Please describe the medically underserved populations this project will reach. This information may be used for publication if application is selected to be funded. (Not to exceed 150 words)


B. State the need of the program or service (Not to exceed 350 words)


C. List the goals and objectives for the proposed project. Include the number of people the proposal expects to serve. (Not to exceed 350 words)


D. Provide an Implementation plan describing how the proposal will meet its objectives. (Not to exceed 350 words)


E. Include your evaluation plan and describe how you will measure the success of the program or service. (Not to exceed 350 words)


Organization
Organization:
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Project Director Name:
Project Director Title:
EIN Number:
Address 1:
Address 2:
City:
State:
Zip Code:
Phone:
Email:
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Fax Number:
Requested Amount:
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Title of Project:
Current BCTF grantee?
Focus Area Addressed:




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Counties Served:
District Served:
Detailed Budget for Entire Budget Period
Grantee Name:
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Employees

Name:
Role on Project:
Salary Requested:
Fringe Benefit:
Total:


Travel:
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Supplies:
*
Equipment:
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Other Expenses:
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Subtotal- Direct Costs:
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Total Funding Request:
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