RFP release date: November 15, 2011

Proposal deadline: January 5, 2012

Grant decision date: May 22, 2012

The Trust is seeking to support projects that will facilitate the successful implementation of health care reform in Illinois, and increase awareness of eligibility provisions under the Affordable Care Act to our community residents.

Problem Statement/Overview

For over thirty years, health system change and access to comprehensive health care services has been a priority of the Trust. With the enactment of the 2010 health care reform legislation, the Trust has also supported programs and research that supports the successful implementation of health care reform in Illinois, and increases the awareness of eligibility for Illinois residents. This request for proposals seeks to continue that support.

The Patient Protection and Affordable Care Act (ACA) of 2010 promotes greater health coverage by building on the existing public-private system for providing health insurance coverage. The ACA fills in existing gaps in coverage by expanding the Medicaid program, building on employer-based coverage, and providing premium subsidies to make private insurance more affordable. The major coverage expansions will be implemented in 2014, with some provisions taking effect earlier.

According to the Kaiser Family Foundation, beginning in 2014, Medicaid will be expanded to nearly all individuals under age 65 with incomes at or below 138% of the federal poverty level. This expansion will create a uniform minimum Medicaid eligibility threshold across states and will provide a new avenue for coverage for many low-income adults without dependent children who are currently not eligible for Medicaid in most states.

Changes in Medicaid enrollment due to implementation of the ACA will vary greatly by state, depending on the state’s current Medicaid eligibility and the share of its population that is low income. In Illinois, Medicaid enrollment is expected to increase by 25 percent, with expansion to incomes at or below 133% of the federal poverty level (Kaiser Family Foundation, state health facts 2011). This expansion is significant in light of the growing numbers of uninsured residents in the state.

In a 2009 health report commissioned by The Chicago Community Trust as part of the Chicago Metropolitan Agency for Planning’s GOTO 2040 plan, rates of people lacking insurance vary greatly across the region. The highest rates are in Cook County, estimated at more than 16%, with lowest rates in Lake County, at just over 7%. Rates people lacking insurance in other counties are estimated to range between 9% ‐12%. As a whole, more than 1.5 million Illinois residents are estimated to lack health insurance. Both public and private health care providers at the state, county and local levels must prepare for ACA implementation, and develop strategies to reach the newly eligible uninsured.

Outcomes Sought

The scope of the ACA federal healthcare reform legislation is broad and deep, impacting how health care and support services are delivered, financed and regulated. The changes—some immediate and some rolling out over the next several years—will affect people of all ages, incomes and health status. The bulk of implementation will rest with states. There are many decisions to be made, creating opportunities to shape the law so that it best meets the needs of people in Illinois and the Chicago metropolitan area.

Several organizations, networks and partnerships are positioned to represent the interests of their respective constituencies and support them through these changes. There is a compelling need for all of the interested groups to coordinate the response to the reforms in ways that are most effective, efficient and inclusive.

Successful implementation of The Patient Protection and Affordable Care Act for the Chicago region, as evidenced by the following:

• Effective public policies and practices to maximize the potential benefits of healthcare reform, especially for previously uninsured individuals and vulnerable populations. Examples include:
    a. Facilitating the implementation of Health Information Technology (HIT)
    b. Ensuring development of a Health Insurance Exchange that addresses the needs of all Illinois residents
• Successful innovative approaches/strategies for the delivery of health care services through better coordination of services and more focus on prevention
• New approaches/strategies for health care payment reform. Examples could include:
    a. Pay-for-performance
    b. Episode of care payment
    c. Shared savings approaches
• Successful approaches/strategies to reach the eligible uninsured. Examples could include:
    a. Basing eligibility determination on reliable data whenever possible
    b. State/consumer partnerships that ensure consumers receive hands-on assistance with completing necessary forms for enrollment
    c. Creating consumer-friendly enrollment systems
    d. Coordinating efforts among health agencies with a role in health care reform

Eligible Applicants

• Nonprofit organizations with evidence of tax-exempt status under Section 501(c)(3) of the Internal Revenue Code or those using a 501(c)(3) fiscal agent
• Organizations located within and/or primarily serving residents of Cook County, except for regional, statewide or national projects or research that may benefit a substantial portion of Cook County residents
• Organizations with a commitment to diversity and inclusion for their governance, staffing, and populations served; and explicit adherence to non-discriminatory practices in the hiring of staff or in providing services on the basis of race, religion, gender, sexual orientation, age, national origin or disability
• Organizations with a successful track record in addressing the needs of low-income residents
• Organizations with a successful track record in system change that can work effectively with public agencies, community organizations and/or the business community

Evaluation Criteria

Incomplete proposals will not be considered. Proposals for grants must answer all the basic questions about the organizations and should include a narrative that responds to the questions posed in the application. Grant proposals will be evaluated, on a competitive basis, using the following criteria:

• Clarity of project description and alignment of project activities to achieve desired outcomes with a high likelihood of success
• Achievable timeline that corresponds to the key activities
• Meaningful benchmarks and indicators of success
• Innovative and effective strategies with potential for systems change
• Organizational capacity to implement project—including staffing and leadership, operational and fiscal management
• Established track record in the specific program area under consideration, or potential to achieve needed expertise in this program area
• Ability to leverage financial, human and technical resources leading to greater impact
• Ability to contribute new knowledge to the field
• Opportunities to scale or expand proven models while maintaining local relevance, or test new approaches that, if successful, can be grown and replicated
• Opportunities for collaborative work and bringing public and private partners together with nonprofit organizations. Priority funding will be given to collaborative projects
• Demonstrated knowledge of the sector and its trends

*Special note on diversity and inclusion

The Trust requires all applicants to either adopt the Trust's Diversity Statement or have a similar policy adopted by their boards. The Trust believes that the diversity of our community is a fundamental strength of our region. Our mission to improve the quality of life for the residents of our region is best fulfilled when we embrace diversity as a value and a practice. We define diversity to include, but not limited to, age, disability status, economic circumstance, ethnicity, gender, race, religion and sexual orientation.

Additionally, the Trust asks that applicants provide demographic data on board and staff as well as clients/beneficiaries of the projects. The Trust believes that the board and staff composition of grantees should reflect the diversity and demographics of the clients/community being served, and include diversity among its leadership at the board and senior staff levels to ensure the diverse perspectives needed at the decision-making levels. For this reason, the Trust does take into consideration the demographic make-up of the board, staff and clients of a grant applicant as an important proposal evaluation criterion.

Total Awards

The Trust will make between 5 and 10 grants under this RFP. Grants will be in the range of $25,000 to $150,000 for each grant awarded. Successful applicants will receive a one-year grant. The Trust recognizes some projects may require multi-year support and grant renewal will be considered subject to performance of grant recipient and availability of funds. Please think carefully about all aspects of the proposal project that require support, prioritize what you need and budget for those items. Budget requests will be closely analyzed and applicants should include a budget narrative that makes clear the necessity of the project's specific line items.

Application Process

To submit a proposal, please visit our online application system, where you can register to submit your project information.

Back to Health