Application Completion - Susan G Komen® Central Mississippi

Applicant User Manual
Komen Central Mississippi Steel Magnolias
2015-2016
Version 3.0
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Contents
Contact Information............................................................................................................ 3
Grant Program Overview .................................................................................................... 3
Grants eManagement System ............................................................................................ 4
Login and Registration .................................................................................................... 4
Internet Explorer Users ................................................................................................... 4
User Registration ............................................................................................................ 5
Organization Information ............................................................................................... 8
User Homepage .............................................................................................................. 9
Starting an Application...................................................................................................... 11
Getting to Your Application .......................................................................................... 12
The CG Application Menu ............................................................................................. 13
View, Edit and Complete Forms.................................................................................... 14
Access Management Tools ........................................................................................... 15
Application Completion .................................................................................................... 16
Forms Navigation .......................................................................................................... 16
Recommended Workplan for Access RFA .................................................................... 22
Recommended Workplan for Education RFA ............................................................... 25
Project Workplan Goals ................................................................................................ 26
Project Workplan Objectives ........................................................................................ 27
Budget ........................................................................................................................... 27
Attachments.................................................................................................................. 29
Application Submission ..................................................................................................... 30
Change the Status ......................................................................................................... 30
Helpful Hints and Troubleshooting ................................................................................... 32
Error Messages ............................................................................................................. 32
PDF Version ................................................................................................................... 32
Copy and Paste.............................................................................................................. 32
Text Limits ..................................................................................................................... 32
Application Checklist ......................................................................................................... 34
Appendix A: Scoring Procedures ....................................................................................... 35
Appendix B: Resources for your program planning .......................................................... 36
Appendix C: Important Dates ........................................................................................... 37
Appendix D: Review Panel Cheat Sheet ............................................................................ 38
Appendix E: Workplan Template ...................................................................................... 40
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Contact Information
Catherine Young
Executive Director
601-932-3999
cyoung@komencentralms.org
How to Apply for Funding: http://komencentralms.org/grants/applying-for-communitygrants/how-to-apply-for-funding/
Funding Priorities and Community Needs: http://komencentralms.org/grants/applyingfor-community-grants/funding-priorities-2/
Grant Program Overview
Susan G. Komen Central Mississippi Steel Magnolias - along with those who generously
support us with their talent, time and resources - is working to better the lives of those
facing breast cancer in our community. We join hundreds of thousands of breast cancer
survivors and activists around the globe as part of the world’s largest and most
progressive grassroots network fighting breast cancer. Through events like the Komen
Central Mississippi Jackson Race for the Cure® and Gulf Coast Race for the Cure®, we
have invested more than $3 million in local breast health and breast cancer awareness
projects in 59 counties. Up to 75 percent of net proceeds generated by the Komen
Central Mississippi Steel Magnolias stay in our 59-county service area. The remaining
income goes to the Susan G. Komen Research Program, which supports grants and
scientific partnerships to find the cures.
Susan G. Komen® is the world’s largest breast cancer organization, funding more breast
cancer research than any other nonprofit while providing real-time help to those facing
the disease. Since it’s founding in 1982, Komen has funded more than $800 million in
research and provided more than $1.7 billion in funding to screening, education,
treatment and psychosocial support programs serving millions of people in more than
30 countries worldwide. Komen was founded by Nancy G. Brinker, who promised her
sister, Susan G. Komen, that she would end the disease that claimed Suzy’s life. Visit
komen.org or call 1-877 GO KOMEN. Connect with us on Facebook at
facebook.com/susangkomen and Twitter @SusanGKomen.
In 2014-2015, $170,780 was awarded to 7 local programs. Grant recipients address
breast health and breast cancer education, screening and treatment services assisting
the medically underserved in the service area. Komen Central Mississippi Steel
Magnolias also contributes to cutting-edge breast cancer research through Komen’s
Research Grants and Awards Program. Small grant RFAs are also released on an as
needed basis.
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Grants eManagement System
Login and Registration
To access Susan G. Komen GeMS,
type
https://affiliategrants.komen.org into
the address bar of your web browser
and hit “Enter.” The page you see
should look like the image shown
below.
Internet Explorer Users
By default Internet Explorer 10 in Windows 8 does not run in compatibility mode. This is
easily tested by logging into GeMS. If the compatibility mode is not enabled, the
progress wheel in GeMS will simply spin without ever completing an action.
To enable the compatibility mode for Internet Explorer 10, follow these steps:
Windows 7 users start at step 2.
1. Windows 8 only - From the Windows 8 start screen select the Desktop.
2. From the Desktop launch Internet Explorer 10.
3. Press the Alt key on your keyboard to bring up the top menu.
4. Go to Tools | Compatibility View settings
5. Either
 Add https://affiliategrants.komen.org/ to the Compatibility View websites
or
 Select Display all websites in Compatibility View
NOTE: enabling the compatibility mode using either option will affect all GeMS web
sites.
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User Registration
Welcome to GeMS! In order to use the system you must first be granted access to it.
Each person from an organization who accesses GeMS must register, create an account,
and be approved before accessing the system. We recommend you take some time to
think through what system roles are appropriate for the individuals in your organization.
There is also an order in which registration should occur so
Helpful Hint:
users at your organization should plan this step first. Each
The Project Director must be the first
project will have a project director (project’s lead contact,
individual at your organization to
responsible for validating new users from your organization
register a new organization account.
and all administrative functions in GeMS) and an
authorized signer (authority to sign legal documents on
The Project Direct can then approve all
behalf of the organization, responsible for electronically
other users from your organization- or
signing applications and contracts).
you can notify Komen Central MS for
approval.
GeMS User Roles
Project Director:
The role of Project Director should be assigned to the individual at your organization
that will serve as the project’s lead contact. This individual is responsible for validating
all new users when they register for the system under their organization. This individual
will have the highest level of access in the system and will be responsible for overseeing
all administrative functions available, such as application creation and completion.
Authorized Signer:
The role of Authorized Signer should be assigned to the individual at your organization
that has the authority to sign legal documents on behalf of the organization. This
individual is responsible for electronically signing the application before submission and
the grant contract if the organization is awarded funds.
Viewer:
The role of viewer should be assigned to any individual at your organization who needs
access to view the organization’s information, but does not need the functionality to
save, add, edit, or change anything within the organization’s information.
Writer:
The role of writer should be assigned to any individual who needs access to an
organization’s application process to help complete the application but does not have
the authority to complete the submission process. This individual cannot change the
status of an application and will not have administrative function availability.
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To create a new user account:
From the Susan G. Komen GeMS system homepage click the “register now” link located
towards the bottom of the homepage.
1. Complete the user form
in its entirety. Once any
user has created a user
account and gained
access to the system,
they will never have to
request access again.
There is no need for
multiple accounts
within GeMS.
2. Fill in all information as
required. All items
marked with an ‘*’ are
required to create your
account.
3. If a question has a pink
“GO” button next to it,
complete the question
and then select the
“GO” button and wait 5
seconds before advancing to the next question.
4. Always select “applicant” in the “What is your position at your Affiliate”
question. Once you select “applicant” and click the pink “GO” button, after a few
seconds more questions should appear at the bottom of the page.
5. For “Organization”, select the Affiliate for which you are reviewing grants.
6. The “Username” field must consist of all letters and numbers, minimum length 5
characters, maximum length 20 characters
7. The “Password” field must consist of all letters and numbers, minimum length 7
characters, maximum length 20 characters
Helpful Hint:
8. The fields “Password” and “Confirm Password”
Make sure you choose the exact correct
must be the same.
name of your organization.
9. Click “Save” in the upper right hand corner to save
the data.
. Komen Reviewer User Guide 5
Next, your account must be approved before you can
access the system. If you attempt to access the
system prior to getting approved/validated you will
receive the following message:
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You will receive notification that your registration has been submitted for approval and
when access has been granted, you will receive an email message confirming that your
account has been validated.
Record your account information below for reference. If you ever become locked out or
forget your password, you can retrieve your password with your e-mail on the home
page, or contact Komen Columbus. Your account will freeze after too many unsuccessful
log-in attempts, but will re-set after 15 minutes.
Susa
GeMS username:
GeMS password:
User Guide 6
User Approval
After the Project Director is registered, they
can approve all other organization users by
following the steps below.
1. The Project Director will receive an
email when a user within their
organization has
registered and needs to
be validated.
2. The Project Director
logs in to GeMS and will
select the “My
Administration” tab at
the top of the User
Homepage.
3. Select the “User
Approval for Project
Directors” link within
the My Administration
section.
4. Once on the Komen
Project Director User
Approval Page (above),
enter the new
registrants name in the
search criteria. You
could also search the
system for “new users” in the User Type field to perform a broader search.
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5.
6.
7.
8.
Select the pink “Search” button.
Select the checkbox next to the users name in the Search Results section.
Select “Approval Type” to Approve User or Deny.
Assign the person’s organization to the exact same
Helpful Hint:
organization listed as the Project Director’s.
Instead of approving new users yourself,
9. Select a role for the user – Authorized Signer,
the Project Director or new users can
Writer, or Viewer.
contact affiliate staff to request
10. The current date will appear in the “Active Date”
approval.
field. You do not have to enter anything into the
“Inactive Date” field unless you know the date you would like the user’s access
to be inactivated.
11. Select the “Approve Selected User” button to complete the user’s
validation/approval.
12. The new user will receive an email notification when they have been approved
and can now access GeMS.
Organization Information
Project Directors must keep their organization information updated for all applications.
In the menu, choose “My Organization”, and make sure all Organization Information,
Organization Members and Organization Details are updated.
In the Organization Details, be sure to
upload your most recent documentation of
non-profit or tax-exempt status. That
documentation should be uploaded here,
not on your Project Budget Summary Page.
It does not need updated every year unless a
change has occurred in your status.
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User Homepage
When a user logs into GeMS, they will land on the
User Homepage. The content of the page and links
across the top of the screen are described below.
Helpful Hint:
To view/edit/complete applications
that are already in progress, go to
your “My CG Applications” tab. To
initiate a new or additional
application, click on the “View
Available Proposals” button.
My Home: Brings the user back to their homepage
My CG Applications: Access to all community grant
applications already in progress
My SG Applications: Access to all small grant
applications already in progress
My CG Reports: Access to all community grant progress and final reports already in
progress
My SG Reports: Access to all small grant final reports already in progress
My Administration: Administrator functions, user approval; this tab will only appear for
authorized users
My Organization: Current information about your organization (this information can be
updated at any time by authorized users)
My Profile: Individual user information (this information can be updated at any time)
Logout: Logout of the system
View Available Proposals: Initiate a new grant application offered by the Affiliate
My Inbox: System notifications regarding system users and application status
My Tasks: List of current tasks you must complete
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Automatic E-Mail Notifications
Automatic email notifications may be sent to you periodically throughout the grant year.
These messages will be sent by the system according to an automatic process or as the
result of a user triggered event. These messages might be triggered by the submission
of an application, an application being sent for modifications, or when a pending duedate is approaching. These messages are intended to help you know what is occurring in
the system that pertains to you or your Organization. These messages may also be sent
by Komen GeMS Affiliate personnel. These messages are designed to help keep you up
to date with the progress of your application while also serving as reminders when
action is required on your part.
In order to receive these messages it is important you include an active, frequently used
email address when creating your profile in the system. If you provide an incorrect
email address or an address to an account that is either inactive or full, you will not be
able to receive these important messages.
System Messages
In addition to the automatic email notifications, there is an area referred to as System
Messages that manages messages sent to you, either from the system itself or from
Komen GeMS Affiliate personnel. You can view or edit your System Messages by
following these steps:
Click the “Open
My Inbox” button
under the “View
My Inbox” section
on the main
menu.
You can read the
message from
that screen and
may then
perform any of
the following actions:
Click the “Reply” button to reply to the system message
Click the “Close” button to close the system message
Click the name of the sender to send an email to the sender of the message
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Starting an Application
The Project Director, Authorized Signer, and Writer roles are permitted to initiate
applications through the local Affiliate. In order to create an application, follow these
steps:
1. From the User Homepage, click the “View Opportunities” button under the
“View Available Opportunities” section on the main menu. This section will show
you all of the grant program types where you may apply for a new grant.
2. F
o
r
t
hose grant programs where you are eligible to apply, you will
see an “Apply Now” button under the description of the grant.
Click the “Apply Now” button.
3. Take care to select the correct opportunity for the RFA you
intend to apply for. There will be two Community Grant
application opportunities: one for Access applications and one
for Education applications.
4. A confirmation page will appear. By clicking the “I Agree”
button, you will initiate a new application. An application will
be created and you will be taken to the “CG Application Menu”
where you can begin filling out the various sections of the
application.
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Getting to Your Application
After your application is created, you will access your application by going to My CG
Applications in your menu bar.
The easiest way to get to the correct application most quickly is to leave all the search
fields blank and click Execute. This will search for all your applications in the system.
Then you can look in the Results for the correct application, noted by the status
“Application in Progress” and the year 2015.
Click the Application Name to enter your Application.
You can also access your application through My Tasks in the main menu.
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The CG Application Menu
The CG Application Menu is divided into various sections to help organize the
application tasks and information. These sections are displayed and described below.
Helpful Hint:
The CG Application Menu allows you to access:
 All sections of the application, including
project plan and budget summary.
 Status change options.
 The CG Application Menu is home base for the
majority of forms and pages you will need to
complete the 2015-2016 Grant Application.
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View, Edit and Complete Forms
This section contains all of the forms associated with your application. To view the
application forms, simply click the “View Forms” button and then click on the name of
the form you wish to view.
Helpful Hint:
The View Forms Menu contains all the forms of your
application.
Refer to the Completing your Application section of this
manual and the RFA for more detail on the information
required in each form.
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Access Management Tools
The Access Management Tools section allows certain administrative responsibilities,
such as the ability to add/edit people from the application and view the status history of
the application. Functionality is based on your user role.
Examine Related Items
The Examine Related Items section is where you will find items related to an application
or grant. An example of a related item would be a Progress Report. This function is not
usually utilized during the application process.
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Application Completion
If you click on the “View Forms” button of the View, Edit and Complete Forms section
on the CG Application Menu, the various pages of the application are displayed. These
are the forms you MUST complete before the application can be submitted. The
following will lead you through the necessary steps for accomplishing this goal.
Forms Navigation
There are three basic methods for navigating through the forms of your application.
You may either use the “Back” link at the top of any page within the application, the
breadcrumb links just below the “Back” link, or the links listed in the “Forms” section at
the bottom of the page.
The image shown below is the “Back” link with the “You are here” breadcrumb trail
below it. These two tools will be commonly used when navigating through the various
pages of your application.
By clicking the “Back” button, you will be taken back to the Forms Menu and you can
click on the next page you wish to complete. You do not have to complete the pages of
the application in any particular order. Note that the “Back” button in the system is
different than your internet browser back button. Be sure you are using the system
button and not your browsers. The “Forms” navigation tool can be found at the bottom
of the page. To access the form, simply click on the page name.
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Helpful Hint:
Please refer to the 2015-2016 Request for Applications (RFA) and the Additional Support
Tools on Komen Central MS website for specific information related to the various forms
and required information associated with the 2015-2016 Grant Application.
Project Profile
In this section, contact information for your program’s primary contact for the affiliate,
your program’s community contact for referral, and financial contact for payments will
be listed. You will list all partnering organizations, the services they will provide, years of
partnership and supporting letters of support, memorandums of understanding, etc. For
Education RFAs, this section should include any sources you plan to refer and link clients
to, as well as any mobile mammography partnerships. Previous support form Komen will
auto-populate here.
Organization Summary
This section collects detailed information regarding your organization, including indepth information regarding your organization background and structure. Provide a
brief description of:
 the organization's history. If your program is part of a larger organization, briefly
explain the mission of the larger entity and your relationship to it;
 the mission of the organization;
 current programs and accomplishments;
 how your organization seeks to be diverse and inclusive; and
 the number of paid full time staff, volunteers and total annual organization
budget.
Project Abstract
This section collects important information regarding the main focus for your project as
well as the abstract. This abstract should be detailed and address the reason for the
program, important project activities, methods for evaluation, and the impact your
program will make on breast cancer in your community.
This section will require you to choose the priorities your program will address from the
RFA. Any priority you select must be addressed with objectives directly in your proposal
workplan.
Project Narrative
The Project Abstract should provide a brief description of the proposal including the
purpose of the program, a description of key activities, a summary of evaluation
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methods and the expected or resulting change(s) your program will likely bring in your
community.
On the Project Narrative page of the application on GeMS, please address the requests
below for each section.
Organization Capacity (limit- 3,500 characters)
 Explain why the applicant organization is best-suited to lead the project and
accomplish the goals and objectives set forth in this application
 Describe evidence of success in delivering breast health/cancer services to the
proposed population
 Describe fiscal capability to manage the delivery of the proposed goals and
objectives and ensure adequate measures for internal control of grant dollars.
Statement of Need (limit- 3,500 characters)
 Describe the population to be served
 Describe evidence of the risk/need within that population
 Provide population characteristics (race, ethnicity, economic status, and breast
cancer statistics) specific to the target population
Project Description (limit- 3,500 characters)
 Explain how the project’s goals and objectives, as outlined in your Project Work
Plan addresses one or more of the priorities outlined in the Affiliate’s
Community Profile/Statement of Need.
 Explain how the project will increase the percentage of people who enter, stay
in, or progress through the continuum of care in context of the priorities of the
Access RFA.
 Please provide an estimate of the overall cost per woman served by your grant,
including your calculation for this figure (i.e. total budget dedicated to patient
service divided by number of women served by the project).
 Clearly state eligibility criteria for who the program will serve, and how you will
recruit audience and participants. Reviewers want to see a very targeted
approach for identifying the appropriate gaps and target audience, and a plan for
reaching them.
Collaboration (limit- 3,500 characters)
 Describe the roles and responsibilities of all organizations or entities
participating in the project.
 Explain how the collaboration strengthens the project and why these
organizations are best suited to carry out the project and accomplish the goals
and objectives set forth in this application.
Sustainability (limit- 3,500 characters)
 What resources (financial, personnel, partnerships, etc.) will be needed to
sustain the effort over time? How will those resources be secured by the end of
the funded project period?
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
What are your organization’s plans to support the project lead to implement,
manage and oversee all aspects of the proposed project?
 What efforts will you take to communicate this project to leadership to ensure
buy-in?
 Describe the organization’s current financial state. Has your organizational
budget increased or decreased from last year? Please explain why.
Evaluation
 Describe in detail how the organization (s) will measure achieving project goals
and objectives and how will the impact of the project on the priority selected will
be assessed.
 Describe the evaluation expertise that will be available for this purpose.
 What resources are allocated for evaluation in the project budget?
 A strong evaluation plan measures both the quantity and quality of strategy
implementation and outcomes.
 Impact Evaluation: Assesses the changes that can be attributed to a particular
intervention, such as a project, program or policy. Impact Evaluation helps us to
answer key questions such as, what works, what doesn’t, where, why and for
how much?
 Process Evaluation: Assesses the delivery of programs. Process evaluation
verifies what the program is and whether it is being implemented as designed.
It answers the questions of what is delivered in reality and where are the gaps
between program design and delivery?
 Applicants to the Education RFA should be able to demonstrate that they can
identify, measure and report on:
o Number of interventions conducted
o Number of people participating in each intervention
o Demographics of people attending each intervention
o Of those participants that indicated they intended to take a specific
action, the number of people that acted on their intention within 30
days, 31-60 days, 61-90 days, and 91+ days.
 Applicants to the Access RFA should be able to demonstrate that they can
identify, measure and report on:
o Appropriate quality indicators or participant evaluations
o Number of interventions conducted
o Number of people participating in each intervention
o Demographics of people attending each intervention
o Of those participants that indicated they intended to take a specific
action, the number of people that acted on their intention within 30
days, 31-60 days, 61-90 days, and 91+ days.
o Appropriate quality indicators or participant evaluations
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Evidence-base
 A clear explanation of how the program will lead to action or intent to act should
be included. Evidence-based practices refer to an intervention/activity that has
been tested and shown to be effective through repeated, rigorous, quantitative/
empirical data collection and analysis. The following websites are examples of
resources of evidence-based interventions:
o National Cancer Institute: (http://rtips.cancer.gov/rtips/index.do) RTIPs is
a searchable database of cancer control interventions and program
materials, and is designed to provide program planners and public health
practitioners’’ easy and immediate access to research-tested materials.
o NACCHO Model Practices:
(http://www.naccho.org/topics/modelpractices/) Online, searchable
database of innovative best practices across public health areas. These
practices allow an individual to benefit from other professionals’
experiences, to learn what works, get strategies on how to re-implement
effective programs with good results, and save time and resources.
o AHRQ Innovation Exchange:
(http://www.innovations.ahrq.gov/index/aspx) The Exchange helps to
solve problems, improve health care quality and reduce disparities as
being a resource to find evidence-based innovations and quality tools,
view new innovations and tools published and learn from experts
through events and articles.
o The Guide to Community Preventive Services:
(www.thecommunityguide.org) The Guide is a resource to assist
organizations in selecting programs and policies to improve health and
prevent disease in the community. Systematic reviews are used to
answer the following questions: Which program and policy interventions
have been proven effective? Are there effective interventions that are
right for the community of interest? What might effective interventions
cost; what is the likely return on investment?
o Cancer Control P.L.A.N.E.T (Plan, Link, Act, Network with Evidence-based
Tools): (http://cancercontrolplanet.cancer.gov/index.html): Web-based
resource that can assist in assessing cancer and/or risk factor burden
within a given state; identifying potential partners that may already be
working with high-risk populations; understanding current research
findings and recommendations; assessing and downloading evidencebased programs and products; and finding guidelines for planning and
evaluation.
o The Community Tool Box: (http://ctb.ku.edu) This comprehensive
resource offers more than 7000 pages of practical guidance on a wide
range of skills essential for promoting community health. Tool kits (under
the “Do Work” tab) provide outlines, examples, and links to tools for
topics such as community assessment and evaluation.
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Project Target Demographics
This section collects information regarding the various demographic groups you intend
to target with your program. This does not include every demographic group your
program will serve but should be based on the individuals you plan to focus your
program's attention on. You can select between 1-4 target populations and unlimited
target locations. If you are not targeting any populations, please do not check a target
population.
Key Personnel
This section collects information regarding the personnel that will be needed to
complete the previously described project. Any individual playing a key role in the
project should be included in this section.
If a patient navigator is listed, please be sure to include documentation of their training
and qualifications. Throughout the award period, this area should be kept updated with
any staffing changes.
Project Workplan
In the Project Workplan component of the application on GeMS, you will be required to
submit goals (high level statements that provide overall context for what the project is
trying to achieve. E.g. improve the quality of breast care) and objectives (low level
concrete statements that describe what the project is trying to achieve. An objective can
be evaluated at the end of the project to establish if the objective was met or not met.
E.g. reduce the time from screening to diagnosis by two days).



As you write your workplan, consider that each item must be accounted for in
progress and final reporting, and that your workplan should only include items
goals that will be accomplished with funds requested from Komen Central
Mississippi Steel Magnolias.
Objectives that will be funded by
Helpful Hint:
other means should not be
Workplan drafts may be submitted during the
reported here, but instead, in
question period for staff feedback. Insufficient
your overall program description.
workplans will be returned for revision during
Your workplan will be evaluated
compliance review.
by the reviewers and compared
You are encouraged to use the workplan template in
against your proposed budget.
Appendix E to draft your workplan, and then to enter
Please select only one
it into GeMS.
intervention type per objective,
so that your later reports will
match your workplan.
Recommended Workplan for Access RFA
Goals
 Remove barriers to the continuum of
care for women experiencing financial
hardship and other barriers by directly
providing free or low-cost services
(screening mammograms, diagnostics
and treatment) to women
experiencing financial barriers.
 Provide patient assistance with
barriers to diagnostics and treatment,
including transportation, childcare,
and medication costs.
Objectives/ Interventions
Reminder systems
directed at patients
Reminder systems
directed at providers
Outreach programs (that
result in new
appointments, new
patients)
In-reach programs (that
result in getting existing
patients to get a
mammogram)
Reduce costs to patient
for mammography (e.g.
free or low cost
mammography)
Expand hours for breast
health services to
evenings and weekends
Reduce other barriers to
mammography (e.g.
transportation, childcare)
Provide translation/
interpretation services
Accessible facilities for
screening
Reduce costs to patient
for diagnostic services
(ultrasound, biopsies)
Outcomes you’ll be expeted to report if awarded:
Other
Number of individuals who were referred for a low cost clinical
breast exams
Number of individuals who were referred for a low cost clinical
breast exams
Number of individuals who were referred for a low cost clinical
breast exams
Number of individuals who completed low-cost clinical breast
exams with your Komen funds, whether stationary or mobile
Other
Number of individuals who received childcare assistance for a
screening and/or diagnostic appointment, Number of individuals
who received rides/ gas cards/ bus passes/ taxi vouchers to or from
screening and/or diagnostic appointments
Number of individuals who received translation/ interpretation
throughout screening and/or diagnostics
Other
Number of individuals who completed diagnostic services with
Komen funds (e.g. ultrasounds, biopsies)
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Reduce other barriers to
diagnostic services
(transportation, childcare)



Provide evidence-based activities
throughout the continuum of care,
including patient navigation,
patient/provider communication,
education about diagnostic and
treatment options (refer to patient
navigation description in appendix)
Genetic testing
Implement quality improvement
strategies to improve quality of
screening, diagnostics and/or
treatment
Clinical trials education
Directly provide side-effect
management services associated with
late effects or sequelae resulting from
breast cancer treatment (e.g,
treatment and therapy for
Patient navigation
Reduce other barriers to
treatment (transportation,
childcare)
One-on-one education
(specific to treatment and
diagnostic options)
Interventions to increase
the quality of health care
delivery
Process improvement
strategies
Individual counseling/
psychotherapy
Exercise/nutrition
programs
Complementary therapies
Number of individuals who received childcare assistance for a
screening and/or diagnostic appointment, Number of individuals
who received rides/ gas cards/ bus passes/ taxi vouchers to or from
screening and/or diagnostic appointments
Number of individuals who completed genetic testing with Komen
funds, Number of individuals who were referred for genetic testing
services, Number of individuals who received genetic counseling
with Komen funds
Number of individuals who received navigation services throughout
the duration of their treatment, Number of individuals who
received navigation services through screening and diagnostic
procedures, Please see appendix for patient navigation service
definitions
Number of individuals who were educated about clinical trials,
number of individuals who were enrolled in a clinical trial study
Number of individuals who received ride/ gas cards/ bus passes/
taxi vouchers to or from treatment appointments, Number of
individuals who received childcare assistance for a treatment
related appointment
Number of family units who received caregiver support while their
loved one was actively undergoing treatment
Other
Other
Number of survivors who participated in individual, professional
counseling
Number of survivors who participated in complementary therapies
(e.g. meditation, yoga, acupuncture, art therapy)
Number of survivors who participated in complementary therapies
(e.g. meditation, yoga, acupuncture, art therapy)
24



lymphedema)
Implement quality improvement
strategies to improve quality of
survivorship care
Provide wellness programs that
improve health outcomes through
quality of life and/or psychosocial
focus, especially in underserved
populations
Provide individual counseling,
psychotherapy
Side-effect management
Interventions to increase
the quality of health care
delivery
Process improvement
strategies
Number of individuals who received support related to managing
treatment side effects (e.g. prosthetics, lymphedema therapy)
Other
Other
25
Recommended Workplan for Education RFA
Goals
Objectives/ Interventions

Public education (e.g. radio, television,
newspaper, e-communications, social
networking)


Provide evidence-based and targeted outreach
and education programs to increase the number
of women who enter the continuum of care, that
document linkage of project participants to
breast cancer services, including culturally
competent outreach for groups experiencing
mortality or screening disparities (African
Americans and Hispanics and persons with
disabilities)
Reduce patient recidivism using evidence-based
approaches; increase percentage of returning
patients adhering to screening
recommendations.
Provide medical provider education for primary
care physicians and OB/GYNs about screening
recommendations, risk assessment for high-risk
women (family history, BRCA1/2) and/or
available resources for women
Group education (e.g. lectures,
workshops, seminars, webinars)
One-on-one education
Events (e.g. health fairs) in accessible
venues
Health care professional training and
provider education
Outreach programs (that result in new
appointments, new patients)
In-reach programs (result in getting
existing patients to get a mammogram)
Outcomes you’ll be expected to report if
awarded:
Number of public education messages you
released through small and mass media
outlets such as radio, television, newspaper,
e-communications, social networking
Number of individuals who participated in an
educational lecture, workshop, seminar or
webinar
Number of individuals you reached through
one-on-one education contacts
Number of events you hosted (e.g. free
screening days, hosting a mammography van,
etc.- does not include group education events)
Number of health care providers you
educated
Referrals for free or low-cost clinical breast
exams, referrals for free or low-cost screening
mammograms
Referrals for free or low-cost clinical breast
exams, referrals for free or low-cost screening
mammograms
Project Workplan Goals
Goals are higher level statements about what the objectives are trying to achieve.
Example Goals:
 Reduce barriers to women in obtaining screening mammography.
 Increase quality and utilization of patient navigation
In the creation of the goals and objective forms, the “Add” button is used to create
additional fields so the applicant can list each item that falls under a particular category.
Project Work Plan - Goals, for example, will typically consist of more than one item. Any
form that has an “Add” button allows you to have multiple instances of that particular
form. The following picture shows the
available “Add” button on a page where
multiple pages can be created.
When multiple pages
have been created for a
particular form, you can
choose between them. A
dropdown menu will
appear on the far right of
the button toolbar.
Select the Item and hit
the “Go” button and it
will take you to that
item’s page.
When additional pages
have been created, a
number in parentheses
will appear after the form
name to indicate the
number of pages connected with the
particular link.
27
Project Workplan Objectives
Follow the process as above to add each objective under each goal in your plan,
following the workplan you have drafted.
Objectives are specific, obtainable, measurable, and concrete items you will use to work
toward the goal.
For each objective, you will enter:
 timelines,
 the intended intervention to be utilized
(choose ONE PER OBJECTIVE from the
priorities listed),
 the individual responsible for completion of
each objective,
 the anticipated number of individuals to be
served,
 and the evaluation method you will utilize.
Helpful Hint:
If you are a previous grantee, use your data
evaluation report from last years’ grant to
inform this years’ application.
Choose only one intervention per objective.
Use the Appendix E to develop your
workplan.
At your six month and final reports, it is expected that each objective will be reported
on with the number of individuals served by that objective, and demographics
describing those served individuals.
Project Work Plan Summary
You can use the project work plan summary to see an overview of all your goals and
objectives in one place. No information needs to be entered here.
Budget
Salaries, Consultants, Supplies, Travel, Patient Care, Sub-contracts, Other Forms
For each form, provide a detailed total program budget. For each line item in the
budget, provide a brief justification for how the funds will be used and why they are
programmatically necessary. Make sure that the budget, especially the patient care
budget, match the interventions/objectives of your workplan. For example, if one
objective is to provide 100 free screening mammograms, be sure that your budget in
patient care reflects that.
Automatic Calculations
When possible, GeMS will automatically calculate totals for you. Click the “Save” button
to perform calculations – calculations will not occur until the “Save” button is selected.
28
The “Budget Summary” page is another example of automatic calculations. When the
Budget Summary is opened, the system will take the values you have entered in the
Budget pages and display the information in the Budget Summary.
Finally, be sure to enter any in-kind your organization will be contributing to your work.
This is used by the reviewers, and is often overlooked by applicants. Take credit for what
your organization is contributing!
29
Attachments
1. Information regarding Key Personnel on Key Personnel Form– For key
personnel that are currently employed by the applicant, provide a resume or
curriculum vitae. For new or vacant positions, provide job descriptions (Two
page limit per individual).
2. Proof of Non-Profit Status on My Organization, Organization Details page– To
document you federal tax-exempt status, attach your determination letter
from the Internal Revenue Service. Evidence of state or local exemption will
not be accepted. Please do not attach your Federal tax return.
3. Letters of support or memoranda of understanding from proposed
collaborators (if applicable) on Project Profile page– To describe the nature
of the collaboration, MOUs, etc. demonstrating your partnerships and the
services/expertise/personnel to be provided through the collaboration.
4. Evaluation forms, surveys, logic model, etc. in workplan- to demonstrate the
effectiveness of your program as defined in your Project Work Plan.
5. Scholarly articles or other resources cited as the evidence-base for your
program on project budget summary page
Note: Insurance will not be required at the time of application, but will be required for
execution of the grant agreement, if awarded.
For some pages, form fields are not enough to capture the type of information that may
be required. In those situations, a file upload field may be provided to allow you to
upload a file instead. Files of the following types are allowed as uploads: bmp, doc,
docx, gif, jpg, pdf, png, ppt, tif, txt, wpd, xls and xlsx. To upload a file, click the “Browse”
button. Uploads should be 4 mgs or less.
Browse to the folder that contains the file you would like
to upload and either double-click the file or click the file
and then click the “Open” button.
After the page reloads, you must then click the page “Save” button to save the uploaded
file.
30
Application Submission
Change the Status
The “Change the Status” section allows the Project
Director and Authorized Signer to change the status of an
application or report. Status options are dependent on
the current status of the document and the role of the
user. Click the “View Status Options” button to see what
status “push” options you currently have available.
Application In
Progress
•Automatically occurs
when application is
initiated
Authorized
Signature
Required
•After the Project
Director/ Writer
completes the entire
application
Helpful Hint:
In GeMS, “changing the
status” equals “turning in” or
“submitting” to the next step
in the submission process.
Application
Submitted
•Authorized Signer
completes as final
submission step
The Project Director must change the status of the application to “Authorized Signature
Required” to begin the application submission process. After the Project Director has
changed the Application status, the Authorized Signer must finalize the submission by
changing the status to “Application Submitted”.
Project Director logs in and clicks “Open
My Tasks.”
1. Select the grant you would like to
submit in your task list.
2. Click “View Status Options” to see
the possible statuses.
3. Click “Apply Status” under the
appropriate status.
If any errors exist on any of the
application’s forms when the Project
Director attempts to change the status to
Authorized Signature Required or the
Authorized Signer attempts to submit,
they will receive an error message
directing them to the form(s) with errors.
All errors must be fixed before GeMS will
allow an application to be submitted. If no errors exist, the grantee will be
prompted to confirm his or her submission. You can check for errors at any
time using the Global Errors link.
31
1. Authorized Signer logs in
to GeMS and clicks “Open
My Tasks.”
2. Select the grant you
would like to submit in
your task list.
3. Click “View Status
Options” to see the
possible statuses.
4. Click “Apply Status” for
“Application Submitted.”
32
Helpful Hints and Troubleshooting
Error Messages
If any required field is not completed within an application form or there are business
rules violated, an error message will be displayed in red across the top of the page
immediately after the “Save” button is clicked. During form completion it is not
necessary to correct errors right away. You may return to the form at a later time and
fix errors. If for some reason any errors remain when you attempt to submit the
application, you will receive an error message. The Komen GeMS system will require
the errors be fixed
before the application
submission can be
completed. See the
example below.
PDF Version
In many pages, once the page is saved, a “Print Version” button will be available that
will automatically create a PDF for you with the data you provided for each form. These
dynamic PDF’s can be printed or saved to your computer for reference.
Copy and Paste
Applicants should be cautious when utilizing copy and paste. We suggest you copy to
NotePad first, then to GeMS. Copying to NotePad will remove all formatting.
Text Limits
Applicants must also be aware of the character limits of each text box, as attempting to
copy and paste text larger than the allotted amount of space will yield an error. The
character limit may be found at the bottom left of each text box. If you exceed the
allowed length, do not exit the document until you have edited it down to the allowed
text limit; otherwise your text will be lost.
33
Helpful Hints
• Always hit “save” to save your data. If you do not hit “save” and you navigate away
from the screen, your data will be lost.
• If you scroll over the first aid kits, help content will be available for that specific
question.
• The system will log out after 45 minutes with no activity. If the system logs out
automatically, the last data entered will not be saved if the save button was not selected
prior to the log out.
• If you copy and paste text from Word, you must hit the backspace button within the
text field for the character count to be shown.
• Print versions of the blank application and completed application are available within
the Access Management Tools section of the application menu.
• Always use the “Back” button within the system when trying to return to a previous
page.
 When completing the application within GeMS, please review the Request for
Applications and additional support tools provided by the local Affiliate for details on
each application page and submission requirements.
 The Project Work Plan Summary is a report of all of the goals and objectives entered
on the Project Work Plan pages.
 You should only enter on intervention per objective in your Project Workplan, for the
most effective evaluation at the time of your progress and final reports. Keep in mind
that your reports will be expected to reflect the success of each item in your
workplan.
 When in doubt, contact the Affiliate staff –at 601-932-3999. Affiliate staff is available
for:
o Registration and log-in troubleshooting
o General system troubleshooting
o Further explanation of application requirements
34
Application Checklist
Your GeMS username: _____________________
Your GeMS password: _____________________
 Register a Project Director and Authorized Signer for your Organization, or identify them
from previous years in GeMS
 Make sure your “My Organization” section is up to date
 Non-profit or tax-exempt documentation is in Organization Details
 Create an application through View Opportunities
 Use recommended workplan ideas and Workplan Template to create your workplan
 Complete all forms in the View Forms section
 Project Profile
 Organization Summary
 Project Abstract
 Project Narrative
 Project Target Demographics
 Key Personnel
 Resumes, job descriptions, training, qualifications
 Project Workplan- Goals
 Project Workplan- Objectives
 Evaluation tools (we do recommend you use our tracking sheet)
 Salaries
 Consultants
 Supplies
 Travel
 Patient Care
 Sub-contracts
 Other
 Project Budget Summary (Including in-kind)
 W-9
 Evidence-base documentation
 Change the status to “Authorized Signature Required to begin the submission process
 Confirm with Authorized Signer that they have submitted by changing the status
to “Application submitted”
35
Appendix A: Scoring Procedures
After submission, all applications will be checked for compliance to the application guidelines in
the RFAs. Applications that do not pass the compliance check process will be returned for
modifications and have at least 48 hours to re-submit the application.
At least three reviewers will score each grant application. Each application will be evaluated on
the basis of the following criteria:
30% Impact: Will the project have a substantial positive and measurable impact on increasing the
percentage of people who enter, stay in, or progress through the continuum of care? Will the
project have a substantial and measurable impact on the priority selected? How closely does
the project align with the funding priorities, target populations and counties stated in the
RFA? Does the project have a sufficient and documented plan to evaluate its impact?
15% Feasibility: How likely is it that the objectives and activities will be achieved within the scope
of the funded project? Is the project well planned? Is the budget appropriate and realistic?
Does the budget justification explain in detail the reasoning and need for the costs associated
with the project?
15% Capacity: Does the organization, Project Director and his/her team have the expertise to
effectively implement all aspects of the project? Is the organization respected and valued by
the target population? Is it culturally competent?
15% Collaboration: Does this project enhance collaboration among organizations with similar or
complementary goals without duplicating services? Are the roles of the partners appropriate
and relevant? Does the partnership efficiently benefit the partner(s) by sharing a service that
would not otherwise be available? Is overlap in the system minimized so as to effectively use
funds to the maximum benefit?
10% Sustainability: Is the project likely to be sustained? Are partnerships likely to be sustained
past project period? Is the impact likely to be long-term?
15% Evidence-base: Does the project demonstrate awareness of and/or potential replication of
best practice models in the design and delivery of the stated priorities for funding? Does the
grant application clearly articulate the best practice and evidence-based methods for
successful implementation of states goals and objectives? What lessons learned from other
projects are being applied to this project?
Each reviewer will assign a numerical rating for each of the criteria above. Scores may range
from 1 to 7, with 1 being the worst and 7 being the best. Each scoring criteria is weighted as
noted above. In addition to the numerical rating, each reviewer will provide brief comments
about the strengths and weaknesses. Reviewers will meet to discuss the applications and
determine the rank order of the applications. In addition to the scores, comments, and
rankings, reviewers may also consider geographical distribution of the grants, populations
served, potential duplication of services, and other important variables.
36
Appendix B: Resources for your program planning
All Patient Navigator requests should be supported with a job description and resume, including
training information, included as attachments to the application.
Defining Patient Navigation:
Patient Navigators are trained, culturally sensitive health care workers who provide support
and guidance throughout the cancer care continuum. They help people "navigate" through the
maze of doctors' offices, clinics, hospitals, outpatient centers, insurance and payment systems,
patient-support organizations, and other components of the health care system. Services are
designed to support timely delivery of quality standard cancer care and ensure that patients,
survivors, and families are satisfied with their encounters with the cancer care system. Patient
Navigator activities designed to achieve these outcomes include:
Job duties:
 Coordinating appointments with providers to ensure timely delivery of diagnostic and
treatment services.
 Maintaining communication with patients, survivors, families, and the health care
providers to monitor patient satisfaction with the cancer care experience.
 Ensuring that appropriate medical records are available at scheduled appointments.
 Arranging language translation or interpretation services.
 Facilitate financial support and assist with paperwork
 Arrange transportation and/or child/elder care
 Facilitate linkage to follow-up services
 Help locate local support groups
 Help patients fill out the proper paperwork
 Assist patients with understanding of their diagnosis and available treatment options
 Coordinate multidisciplinary conferences
 Provide educational material to patients
Other Navigator activities include community outreach, providing access to clinical trials, and
building partnerships with local agencies and groups (e.g., referrals to other services and/or
cancer survivor support groups).
Patient Navigators can be:
 A licensed Social Worker
 A licensed Registered Nurse
 Someone with a Baccalaureate degree in health education, public health, or other
health related field
A Patient Navigator should not be limited to billing, scheduling and tracking patients, but should
encompass the activities and description listed above. The outcomes listed above should be
reported and evaluated for any patient navigators funded through a grant project.
Survivorship Care Planning:
http://livestrongcareplan.org/
http://journeyforward.org/
37
Appendix C: Important Dates
Grant writing Workshop
Question Period
Application Deadline
Revision Period
Award Notification
Award Period
TBD. (Attendance required)
September 30- November 18th, 2014 (Questions and
proposal ideas may be submitted for comments, discussion
and guidance from staff)
TBD.
TBD
April 2015
April 1, 2015- March 31, 2016
38
Appendix D: Review Panel Cheat Sheet
The reviewers will score your application on impact, feasibility, sustainability, capacity,
collaboration and evidence-base. Below, you can view the parts of the application the
reviewers often refer to for each criteria, to help you create an application that provides the
reviewers with the information they need to review your program.
Should we even rank this application for
funding?
SWOT Analysis Here
Meeting priority 1: you can give up to 7 as highest score
Meeting priority 2: you can give up to 5 as highest score
Workplan: Goals and objectives, how many women will they reach?
Statement of Need: Will they target a population in need effectively?
Evaluation: Will they be able to show it? Have they built impact AND process evaluation?
Project Description: Have they connected all the dots in their description of their
plan/ project?
Workplan/budget: Does the budget match the workplan?
Project Target Demographics/ Narrative: Have they built the cultural competency to
reach the people they say they will?
39
Key Personnel
Organization Capacity: Does the organization have the
infrastructure to deliver the program, including staffing? Need
salary?
Collaboration: are the right partners at the table to reach the desired
audience (target demographics)?
If you believe there may be overlap with other organizations, state it
here
Budget: In-kind, cash
Sustainability: Have they demonstrated good partnerships or effort
to reach out for sponsors or other grant/funding? Are the start-up
costs expensive or is this already running?
New section for Evidence-base will look to your Project Narrative for a description of best
practices or evidence based interventions you will use.
40
Appendix E: Workplan Template
Use this template to draft a workplan that will be compatible with your GeMS application. You may copy this page for more cells.
You will have multiple objective per goal, and one intervention per objective.
Goal
Objective
Timeline
Intervention from
list (one per
objective)
Who is
responsible?
How many will be
served or reached
with this
intervention?
How will you
track the
number of
individuals
served?
Notes
41
Education Interventions:
Public education (e.g. radio, television, newspaper, e-communications,
social networking)
Group education (e.g. lectures, workshops, seminars, webinars)
One-on-one education
Material development and dissemination (multi-cultural, and in accessible
and alternative formats)
Events (e.g. health fairs) in accessible venues
Health care professional training and provider education
Screening Interventions:
Reminder systems directed at patients (e.g. letters, phone calls)
Reminder systems directed at health care providers (e.g. chart reminders)
Outreach programs (that result in new appointments, new patients, etc.)
In-reach programs (result in getting existing patients to get a
mammogram)
Reduce costs to patient for mammography (e.g. free or low-cost
mammography)
Expand hours for breast health services to evenings and weekends.
Provide free or low-cost screenings (clinical breast exams and/or screening
mammograms)
Reduce other barriers to mammography (e.g. transportation, childcare)
Provide translation/interpretation services to include sign language
interpreters
Genetic testing
Patient navigation
Accessible facilities for screening (education, awareness)
Diagnosis Interventions:
Provide translation/interpretation services
Reduce costs to patient for diagnostic services (e.g. ultrasound, biopsies)
Patient navigation
Reduce other barriers to diagnostic services (e.g. transportation, childcare)
Treatment Interventions:
Reduce out-of-pocket costs for treatment (e.g. co-pay or prescription drug
assistance
Reduce costs for treatment services (e.g. free chemotherapy, radiation,
surgery)
Clinical trials
Patient navigation
Treatment Support Interventions:
Provide financial assistance for day-to-day costs during treatment (e.g.
housing, utilities)
Reduce other barriers to treatment (e.g. transportation, childcare)
Support groups
Individual counseling/psychotherapy
Side-effect management (e.g. prosthesis, wigs, lymphedema therapy)
Nutrition services (e.g. meal delivery)
Complementary therapies (e.g. meditation, yoga, acupuncture, art
therapy)
End of life care (e.g. hospice/palliative care)
Legal services
Caregiver support (e.g. respite programs, training for caregivers)
Survivorship Interventions:
Support groups
Individual counseling/psychotherapy
Exercise/Nutrition programs
Complementary therapies (e.g. meditation, yoga, acupuncture, art
therapy)
Side-effect management (e.g. prosthesis, wigs, lymphedema therapy)
Health Care Delivery/Systems Change Interventions:
Interventions to increase the quality of health care delivery
Process improvement strategies