Community Impact Investment Fund - Letter of Interest

At IU Health, we believe investing in our communities is critical to help make Indiana one of the healthiest states in the nation. To do so, we must look beyond the walls of our hospitals and medical offices to address the social, economic, environmental and generational health disparities that contribute to poor health outcomes many Hoosiers face. To demonstrate our commitment to this effort, the IU Health Board designated $200 million to establish the Community Impact Investment Fund to support these community efforts (“CII Fund”). Managed by the IU Health Foundation, a percentage of earnings on investment from the CII Funds are granted each year to support initiatives that address mission-based projects that fit within the goals of the CII Fund. This allows for continued use of the CII Funds to support projects into the future. It is expected that for 2024 a total of approximately $6 million in CII Funds will be awarded for projects throughout the state. Research and scientific evidence show people’s health is greatly determined by their physical and social environments and health behaviors, in many cases more than by the medical care they receive from physicians and hospitals. Factors such as housing, education, employment, and access to clean air and water, healthy food availability and consumption, and use of tobacco or misuse of drugs, are significant drivers of what makes a community healthy. In addition to these social determinants of health, health outcomes can be negatively impacted by those experiencing disparate access to healthcare, inadequate housing, underemployment, and unequal educational opportunities. Our vision is to address social determinants of health strategically and intentionally at the root cause level and remove health disparities for Indiana’s most vulnerable, marginalized and minoritized persons in our communities with solutions that are community driven and collaborative in approach. The engagement of community partners and stakeholders who share this same vision is imperative to being successful in these efforts. The purpose of the CII Funds is to support this vision and fund collaborative projects and programs to solve for the disparities that exist today and work to eliminate them in the future. We do this by focusing on three pillars of interest: place-based initiatives, workforce development and educational attainment projects. A document describing these pillars can be found on our website, linked at the end of this opportunity. At this time, we are soliciting Letters of Interest (LOI) from those interested in seeking CII Funds for projects meeting the vision of IU Health and the purpose of CII Funds. Select parties will later be invited to submit a full application for consideration to receive CII Funds. Awarded projects will foster long-lasting partnerships between IU Health and a diverse group of collaborators to address community challenges to positively impact social, economic, and environmental factors that impact the health and well-being of those we serve. Regional Focus Areas New for the 2024 process, we are seeking ideas and initiatives specific to each of our regions to support the vision and purpose of CII. Projects in each region that fall outside of the defined regional pillar focus area will not be considered. Although a primary focus area is identified for each region and should serve as the primary focus, it is possible and encouraged, through collaboration and partnership, that multiple pillars can be included in a project. Counties within each regional geographic area are listed below and a map of the regions can be found on our website, linked at the end of this Opportunity. Projects can impact one or more counties or communities within a region. Academic Health Center and Riley Children’s Hospital – Marion County To improve the health and safety of communities and neighborhoods, we know collaborative programs and initiatives are needed to decrease high-risk behaviors and stop violence as well as increase community connectedness. We are seeking PLACE-BASED projects that achieve this by providing access to safe and affordable housing, healthy foods, or adequate and safe transportation options. To advance equity, projects can focus on a specific population (e.g., those living with behavioral health challenges) or geographic location (e.g., neighborhood or zip code) within Marion County that is impacted by certain determinants of health. These placed-based projects can also include other services that support populations from a holistic approach, like workforce or wellness services. East Central Region – Blackford, Jay, Delaware, Randolph, and Henry Counties A key to improving a person’s ability to break a poverty cycle is education. We are seeking EDUCATIONAL ATTAINMENT projects focused on strategies that support closing learning gaps, improve graduation rates, and programs that provide education/certification opportunities while in school. Projects should focus on students who do not have access to, qualify for, or are not often reached through other educational opportunities. These educational attainment projects can also include other services that support populations from a holistic approach, like wellness or other supportive services. Indy Suburban Region – Tipton, Hamilton, Boone and Hendricks Counties Having access to opportunities to improve or maintain health often comes in the form of employment that offers a living wage and benefits. We are seeking WORKFORCE DEVELOPMENT projects focused on improving the employability of the local community, creating a catalyst to change to the economic trajectory of low-income and/or less-educated workers and their families. Projects may include skills training for unemployed or underemployed persons or communities, aiding in the development of employment/career track opportunities, and/or expanding the number of high school students eligible for entry-level jobs that will lead to meaningful careers. These workforce development projects can also include components of other services that support populations from a holistic approach, like transportation or other supportive services. Northeast Region – Allen County We recognize that improving infant and maternal health outcomes in our state will require collaborative programs and initiatives to support this population and advance equity. We are seeking PLACE-BASED projects focused on improving health outcomes for persons who are pregnant or postpartum and their young children through projects focused on improving access to transportation, safe housing and healthy food as well as providing other supportive services to families. These place-based projects can also include other services that support populations from a holistic approach, like workforce development initiatives to support this population, or access to childcare services. South Central Region - Morgan, Owen, Monroe, Lawrence, and Orange Counties Persons living with mental health and substance use disorder can find it difficult to identify and navigate the variety of services beneficial to remain in stable and safe situations. We are seeking PLACE-BASED projects focused on providing supportive or wrap-around services for persons with mental health or substance use disorder needs including case management, safe and healthy housing, access to nutrition and financial management training. Projects should focus on persons in recovery or in unstable situations with the skills needed to live successfully in a healthy way in their community. These place-based projects can also include other services that support this population from a holistic approach, like workforce services. West Central Region – Benton, White, Tippecanoe, Carroll, and Clinton Counties We know the place in which a person lives has an impact on their overall health. We are seeking PLACE-BASED projects focused on improving living conditions to create dynamic, attractive and healthy neighborhoods and communities where this does currently not exist. These place-based projects may include providing safe and affordable housing, enhancing transportation options and connectivity, or expanding access to resources such as local healthy food options. Community Partnership Community engagement and support is necessary to advance our vision and we seek partners who align with this goal. Strong leadership, collaboration, and involvement from community partner organizations is critical, which includes partner organizations working together to more holistically serve those in need. It is desirable to have projects where the following are present: • Input for the project has been solicited from the communities that will be impacted, and strong community support exists. • The community organization is representative of the community it serves, through volunteers, board members or staff. • The community organization and IU Health are able to collaborate, and CII funds are utilized in the community being served. • The community organization is collaborating with other organizations in addressing the need being addressed. Sustainability Community support and partnerships can also help to create financial and programmatic sustainability of the good work accomplished through these initiatives, which is imperative to the communities we serve. It is our hope that the work being done will encourage others to support these projects along-site funding that may be awarded from CII. Priority will be given to projects that reflect the involvement of community stakeholders and demonstrate financial support from private, public, and/or philanthropic sources. If there are potential co-investment opportunities or needs for outside funding for the proposed project, we ask that the IU Health Foundation be included in discussions regarding these external funding opportunities or needs in advance of LOI submission. Please contact Jami Marsh, Vice President with the IU Health Foundation, at jmarsh4@iuhealth.org for coordination of these opportunities. Measurement and Alignment of Goals As we look to develop strategies to address health improvement efforts at the community level, reporting on project outcomes is critical to the CII program and a key component to helping to us understand what measures are successful. To illustrate IU Health’s vision for measuring programmatic goals for projects funded by CII, an evaluation framework has been created that will be used in the development of evaluation plans for selected projects and support project reporting activities. For informational purposes, the evaluation framework can be found on our website, linked at the end of this opportunity. For those invited to submit a full application, completion of the evaluation framework will be required, but it is not required for submission of a LOI. In addition, consideration will be given to project requests that meet some or all the following criteria: • Projects that are innovative and transformative in approach. • Projects demonstrating how the initiative will be sustained beyond the term of the grant. This is especially critical for any requests for staffing costs. • Projects with existing momentum to build upon, or defined models for pilot projects. • The organization has institutional capacity and structure for the project to be managed successfully. • There is a proven need for the project that has included the voice of the community to be served. • The number of people served by the project, and the scale and impact, are proportional to the amount requested. • Projects that take into consideration needs and findings from the region’s IU Health’s Community Health Needs Assessment (“CHNAs”) • Demographics for the populations to be served by the project are identified. • The number of people served is significant for the community and the amount of funding is proportional to the scale and impact of the efforts to be funded by the grant.

There is a limited amount of funding available each year for CII projects, and not all applicants will receive funding. It is also possible grant awards will total less than what is requested in the application. Award minimum and maximum levels are reflected below. The grant term can be from one to three years. For grants covering multiple years, annual continuation of the grant award will depend on progress in meeting project goals and objectives, timely submission of the required data and reports. Failure to comply with the grant and sub-grant agreement terms and conditions may result in suspension or termination of the award. Grant funding will not be renewed. Please note the following non-negotiable policies for recipients of funds: • No expenses may be accrued against the project until a grant and sub-grant agreement is fully executed by IU Health and the community partner. • Any unspent funds over $1.00 must be returned to IU Health. Ineligible Projects or Expenses For any type of project, CII funds cannot be used to support the following: • Requests for financial support greater than three years. • Projects inconsistent with IU Health’s vision and purpose. • Projects proposed for communities/regions where IU Health does not have a presence. • Grants or funds to individuals or to entities that are not non-profit organizations exempt from tax under Internal Revenue Code Section 501(c)(3). • Requests with no collaboration between IU Health and external community partners. • Funds to support lobbying or political activities. • Travel expenses and attendance at conferences or other educational events. • Expenses such as lease payments, maintenance costs, demolition, fundraising, insurance, interest costs, and other soft costs such as design work are ineligible for funding. • Food expenses not provided to the community served through the project. Capital Projects CII funds may be sought for a capital project if the project aligns with the identified regional focus area, the project is needed to meet a critical community need and is within the mission of the organization. A capital project is one that utilizes funds to make a long-term investment such as the construction of a facility, the purchase of a building, and renovation activities. A capital project should strengthen the organization’s ability to effectively carry out its work and expand the programming or support provided to the community. Applicants must demonstrate the financial and administrative ability to complete the project, as well as financially and administratively operate the completed project. Expenses such as lease payments, maintenance costs, fundraising, insurance, interest costs, and other soft costs such as design work are ineligible for capital costs. CII Funds cannot total more than 25 percent of the total capital project need. In addition to general CII fund requirements, capital requests will also consider the following items: • The demand for programs and services of the organization are stable or increasing, with a well-documented need justifying a new/improved facility. • The project will increase the capacity, effectiveness, efficiency, quality and/or success of the community program. • There is strong board, administrative and program staff leadership in place to accommodate the increased programming offered by completion of the project. • A fundraising strategy is in place to support securing the additional 75%+ funds needed to complete the funding need of the project, and to support future on-going expenses that will result upon completion of the project. • A timeline and budget for the project are established, including a plan for procuring any construction services and supplies/equipment needed for the project (including selection of a qualified and competent contractor). • The scope of the project has defined-cost estimates based on architectural plans, and regulatory approvals and/or permits for the project are identified. • The project is appropriately sized relative to the organization’s current and future needs. • For real estate purchases, purchase agreements or options are in hand or negotiations have begun.

Indirect costs are costs for activities or services that support the organization as a whole rather than any particular program or project. Examples of such costs may include finance and accounting support, human resources, technology, etc. and also including expenses such as lease payments, maintenance costs, fundraising, insurance, interest costs, and other soft costs such as design work. In submitting a project budget, grantees will not be required to quantify these indirect costs .

If invited to submit a full application, the application must be submitted in collaboration with an IU Health team member. Collaboration support with an IU Health team member will be provided to those community organizations invited to apply.

An informational presentation is posted on the CII website. Question and Answer sessions for potential applicants will be held virtually by region. During these sessions, potential applicants are welcome join the Question and Answer session in their region to ask any questions regarding the application process and the regional focus area. Attendance at one of these sessions for LOI submission is not required. A map of the IU Health regions and more information regarding the pillars can be found on our website, linked at the end of this opportunity. If you would like to attend the question and answer session for your region, please find the information below and RSVP using the link provided. The virtual connection information will be sent to you via e-mail once your registration is submitted. Academic Health Center – Marion County Place-based Thursday, March 28, 2:00-3:00 PM https://forms.office.com/r/pUQyxckETW East Central Region – Blackford, Jay, Delaware, Randolph, and Henry Counties Education Attainment Monday, March 25, 9:00-10:00 AM https://forms.office.com/r/fMCSG8WZHG Indy Suburban Region – Tipton, Hamilton, Boone and Hendricks Counties Workforce Development Thursday, March 28, 2:00-3:00 PM https://forms.office.com/r/pUQyxckETW Northeast Region – Allen County Place-based Monday, March 25, 1:00-2:00 PM https://forms.office.com/r/dqXV4gWG2d South Central Region – Morgan, Owen, Monroe, Lawrence, and Orange Counties Place-based Tuesday, March 26, 11:30 AM - 12:30 PM https://forms.office.com/r/eUF7CLw2zj West Central Region – Benton, White, Tippecanoe, Carroll, and Clinton Counties Place-based Friday, March 22, 10:00-11:00 AM https://forms.office.com/r/ksGvXYXVX8

The IU Health Foundation’s status as a “supporting organization” to IU Health limits its granting abilities to IU Health and to public charity hospitals in Indiana that are “operated, supervised, or controlled” by or in connection with IU Health. While the IU Health Foundation may only award grants to these parties, the IU Health applicant is permitted and expected to sub-award CII funds to community partners. A sub-grant agreement on a form approved by the IU Health Foundation will be required for any sub-award. Projects must be in the State of Indiana and should primarily impact regions or individual communities served by IU Health. We encourage innovative approaches to tackling the health challenges our communities face and will consider grant support for pilot projects. In such cases, strong consideration will be given to those projects that have demonstrable measures of success identified and a path for identifying whether the project can be expanded beyond the pilot phase. Any project proposed must be feasible in approach, with opportunities to adjust as needed to achieve outcomes. And while each community is unique, we are looking for opportunities where IU Health can potentially support the replication of a successful project in other communities IU Health serves.

The Community Impact Investment Fund site contains pillar focus examples, regional map and evaluation framework, as well as an informational video, FAQ and information regarding previous grantees.

Reporting Grantees will be required to submit progress and financial reports as directed in the grant and sub-grant agreement, and one final report that will include, among other things, an accounting of expenditures and a description of project achievements. Additional reports may be requested, and we may request grantees continue reporting outcomes for a specified period beyond the initial funding term.