Page Limit: 1 page
Points: Pass/Fail (0 points allocated)

Briefly describe your organization, including the type of organization, mission/purpose, geographic area(s) served, types of programs provided and target population served.

Page Limit: 1 page
Points: Pass/Fail (0 points allocated)

Briefly describe the community needs your organization or project will address, including any research and data to support the need.

Page Limit: 4 pages
Points: 40/100 points allocated

Provide a detailed description of the program, including but not limited to:

●      Target audience

●      Geographic area(s) to be served 

●      Program description

●      Number of anticipated clients/recipients, including the number of SilverSummit Members

●      How the program will meet the cultural and diverse needs of all its participants

●      How the program addresses a specific health disparity, if applicable

●      Program timeline 

●      Citations of evidence-based practices that the program follows, including:

1. How the organization intends to maintain fidelity to achieve intended results
2. A brief description of curriculum that may be used, if applicable
3. A description of training that the staff may receive

Page Limit: 1 page
Points: 25/100 points allocated

Describe how the organization will engage with SilverSummit Members, including:

●      How many SilverSummit Members do you anticipate serving?

●      How will you identify that SilverSummit Members are being served?

●      How will you promote the program to ensure SilverSummit Members are served?

Page Limit: 2 pages
Points: 25/100 points allocated

Note: Awardees are required to submit a final report, due January 31, 2026. Reporting for SilverSummit Members (name, and unique identifier) will be required as part of the final report.

Use the following guidelines as a template to complete this section. This section should rely heavily on numbers and limit the narrative to specifically answering the questions below.

See below for an example of a goal and specific expected outcomes.

1. Program’s goal statement.

2. Program objective(s): Identify the objectives(s) that the program is expected to achieve.

3. Define the metric(s) that will be collected.

4. Define how the metrics will be collected and at what cadence.

5. Previous outcomes (if applicable):

    • Provide previous outcomes that this program has achieved.

    •  Include the timeframe associated with these outcomes. If available, provide year-over-year improvements the program has achieved, and provide information on changes made to improve.

GOAL AND OUTCOMES EXAMPLE:

Goal: To remove the barrier of financial stress and increase clients' successful completion of

treatment and subsequent integration into the community with sustained recovery, employment, supportive resources, and housing.

Outcomes and Metrics:

• 40 women will complete residential treatment at NV Community Partner and move on to transitional housing.  Of the 40 women who complete the program 12 will be SSHP Members.

    - Metrics: NV Community Partner's electronic client database system. This information can be accessed for snapshot data or data within a specific rage, and enrollment data will be tracked quarterly.

• 40 women will access a maximum of 19 hours of substance use disorder therapy per week. Of the 40 women, 12 will be SSHP Members.

    - Metrics: Group attendance is tracked in the database. While CIP data will be tracked quarterly, NV Community Partner's clinical team tracks group (and individual) attendance weekly. NV Community Partner will track CIP data quarterly.

• 90% of the 40 women served and who moved to transitional housing will complete treatment successfully.

    - Metrics: This data will be accessed in database on case management notes, presented at weekly staffing meetings and tracked for CIP quarterly.

Page Limit: 1 page narrative, plus the Budget Template
Points: 10/100 points allocated

SilverSummit recognizes the funding challenges that non-profits and other organizations are currently experiencing given changes in the funding landscape. As a result, we will be funding indirect costs at 15% of the total budget. Please do not include additional indirect costs in your budget. For example, do not include the CFO’s salary in your budget, unless the CFO is actively engaging with the program’s participants.

• Complete the Budget Template.
• Explain how the program will be sustained without future funding from SilverSummit.
• Describe and justify all line items in the completed Budget Template.
  
  Pro-Tips:
• Do not request funding in excess of the stated funding range. Requests in excess of the stated funding range will not be considered.
• Do not exceed the 15% allotment for indirect costs.

Application Attachments: Are additional attachments required beyond the details listed on the web site – Application Face Sheet, the narrative responses listed, and the budget template? No, there aren’t additional attachments required. Our goal is to streamline the process so that the Selection Committee can conduct a complete analysis based on the requested application requirements. Submitting attachments that cause the application to fall outside of the requested page number count can cause the application to fail the technical requirements review.

Engaging SilverSummit’s Members: Can you clarify this section in the application? Based on your organization’s services/programs, please indicate the number of SilverSummit Healthplan Members you plan to serve by providing the services that you outline in your proposal. In addition, indicate the methods that you use to identify SilverSummit’s Members that you currently serve, or that you plan to serve.  SilverSummit is interested in innovative ways that your organization may suggest as a means of identifying and serving Members.

Budget Template’s “Other Funding Sources”: Are other funding sources required? No, additional funding sources are not required, however the Committee is interested in additional resources that will be allocated to the initiative beyond the funds being requested. The committee is interested in the long-term sustainability of the proposed programming. 

Budget: If awarded, can the organization use funding differently than what was outlined in the proposal? The funds should be spent based on what is indicated in the proposal, unless approval is given. Awardees will be required to submit bi-annual reports to provide metrics, outcomes, and updates.

Payments: Are payments paid through reimbursement? No, a lump-sum payment is provided once the awards have been made. SilverSummit works diligently to provide payments by December of the funding year.

Reporting: Are grantees required to submit reports if funding is awarded? Yes, failure to submit reports by the required deadlines can impact future funding.