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2019 BHT Grant Scoring

This grant review questionnaire will tabulate your score for each grant proposal on a scale of 0-100. Please select a response for each criterion. Each criterion is worth a total of 5 points, except for the 2 Outcome Measures criteria in question number 5, those are worth up to 10 points each. Please include comments that identify the proposal's strengths, weakness, and any needed clarification. Do not click done until you know what your score is finalized. You will be able to re-enter this database by clicking on the link to update your score as long as you don't click "done".

Question Title

* 1. Name of Person Completing the Survey:

Question Title

* 2. Rate the criteria for: Describe the Need for the Project (30 Points)

	5. Excellent	4. Very Good	3. Satisfactory	2. Fair	1. Poor	0. Unacceptable
The need is clearly linked to one or more of the priority areas	The need is clearly linked to one or more of the priority areas 5. Excellent	The need is clearly linked to one or more of the priority areas 4. Very Good	The need is clearly linked to one or more of the priority areas 3. Satisfactory	The need is clearly linked to one or more of the priority areas 2. Fair	The need is clearly linked to one or more of the priority areas 1. Poor	The need is clearly linked to one or more of the priority areas 0. Unacceptable
Data supports the need	Data supports the need 5. Excellent	Data supports the need 4. Very Good	Data supports the need 3. Satisfactory	Data supports the need 2. Fair	Data supports the need 1. Poor	Data supports the need 0. Unacceptable
The proposal describes the health status changes it intends to make and is based on evidence	The proposal describes the health status changes it intends to make and is based on evidence 5. Excellent	The proposal describes the health status changes it intends to make and is based on evidence 4. Very Good	The proposal describes the health status changes it intends to make and is based on evidence 3. Satisfactory	The proposal describes the health status changes it intends to make and is based on evidence 2. Fair	The proposal describes the health status changes it intends to make and is based on evidence 1. Poor	The proposal describes the health status changes it intends to make and is based on evidence 0. Unacceptable
The program is "innovative"- new to the targer population	The program is "innovative"- new to the targer population 5. Excellent	The program is "innovative"- new to the targer population 4. Very Good	The program is "innovative"- new to the targer population 3. Satisfactory	The program is "innovative"- new to the targer population 2. Fair	The program is "innovative"- new to the targer population 1. Poor	The program is "innovative"- new to the targer population 0. Unacceptable
The target population is well defined	The target population is well defined 5. Excellent	The target population is well defined 4. Very Good	The target population is well defined 3. Satisfactory	The target population is well defined 2. Fair	The target population is well defined 1. Poor	The target population is well defined 0. Unacceptable
The program is a collaborative effort, and all partners understand their role	The program is a collaborative effort, and all partners understand their role 5. Excellent	The program is a collaborative effort, and all partners understand their role 4. Very Good	The program is a collaborative effort, and all partners understand their role 3. Satisfactory	The program is a collaborative effort, and all partners understand their role 2. Fair	The program is a collaborative effort, and all partners understand their role 1. Poor	The program is a collaborative effort, and all partners understand their role 0. Unacceptable

Other (please specify)

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* 3. Rate the criteria for: Plan of Operations (25 Points)

	5. Excellent	4. Very Good	3. Satisfactory	2. Fair	1. Poor	0. Unacceptable
The program is within the organization's mission and has the capacity to host the program	The program is within the organization's mission and has the capacity to host the program 5. Excellent	The program is within the organization's mission and has the capacity to host the program 4. Very Good	The program is within the organization's mission and has the capacity to host the program 3. Satisfactory	The program is within the organization's mission and has the capacity to host the program 2. Fair	The program is within the organization's mission and has the capacity to host the program 1. Poor	The program is within the organization's mission and has the capacity to host the program 0. Unacceptable
The plan is clear, the timeline is realistic, and is linked to the health status improvement goals	The plan is clear, the timeline is realistic, and is linked to the health status improvement goals 5. Excellent	The plan is clear, the timeline is realistic, and is linked to the health status improvement goals 4. Very Good	The plan is clear, the timeline is realistic, and is linked to the health status improvement goals 3. Satisfactory	The plan is clear, the timeline is realistic, and is linked to the health status improvement goals 2. Fair	The plan is clear, the timeline is realistic, and is linked to the health status improvement goals 1. Poor	The plan is clear, the timeline is realistic, and is linked to the health status improvement goals 0. Unacceptable
The roles and responsibilities are clearly defined and the staff is qualified	The roles and responsibilities are clearly defined and the staff is qualified 5. Excellent	The roles and responsibilities are clearly defined and the staff is qualified 4. Very Good	The roles and responsibilities are clearly defined and the staff is qualified 3. Satisfactory	The roles and responsibilities are clearly defined and the staff is qualified 2. Fair	The roles and responsibilities are clearly defined and the staff is qualified 1. Poor	The roles and responsibilities are clearly defined and the staff is qualified 0. Unacceptable
The resources for facilities and equipment are well planned and coordinated	The resources for facilities and equipment are well planned and coordinated 5. Excellent	The resources for facilities and equipment are well planned and coordinated 4. Very Good	The resources for facilities and equipment are well planned and coordinated 3. Satisfactory	The resources for facilities and equipment are well planned and coordinated 2. Fair	The resources for facilities and equipment are well planned and coordinated 1. Poor	The resources for facilities and equipment are well planned and coordinated 0. Unacceptable
The marketing plan describes how the target audience will be informed and recruited to the program	The marketing plan describes how the target audience will be informed and recruited to the program 5. Excellent	The marketing plan describes how the target audience will be informed and recruited to the program 4. Very Good	The marketing plan describes how the target audience will be informed and recruited to the program 3. Satisfactory	The marketing plan describes how the target audience will be informed and recruited to the program 2. Fair	The marketing plan describes how the target audience will be informed and recruited to the program 1. Poor	The marketing plan describes how the target audience will be informed and recruited to the program 0. Unacceptable

Other (please specify)

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* 4. Rate the criteria for: Outcome Measures (20 Points

	10. Excellent	8. Very Good	6. Satisfactory	4. Fair	2. Poor	0. Unacceptable
The program has a system to track and report process measure (numbers served, % of target population, cost per client, completeness of service, satisfaction)	The program has a system to track and report process measure (numbers served, % of target population, cost per client, completeness of service, satisfaction) 10. Excellent	The program has a system to track and report process measure (numbers served, % of target population, cost per client, completeness of service, satisfaction) 8. Very Good	The program has a system to track and report process measure (numbers served, % of target population, cost per client, completeness of service, satisfaction) 6. Satisfactory	The program has a system to track and report process measure (numbers served, % of target population, cost per client, completeness of service, satisfaction) 4. Fair	The program has a system to track and report process measure (numbers served, % of target population, cost per client, completeness of service, satisfaction) 2. Poor	The program has a system to track and report process measure (numbers served, % of target population, cost per client, completeness of service, satisfaction) 0. Unacceptable
There are plans to measure the health status of those served to show what proportion achieved improved health status compared to the baseline data (measurement tools are included)	There are plans to measure the health status of those served to show what proportion achieved improved health status compared to the baseline data (measurement tools are included) 10. Excellent	There are plans to measure the health status of those served to show what proportion achieved improved health status compared to the baseline data (measurement tools are included) 8. Very Good	There are plans to measure the health status of those served to show what proportion achieved improved health status compared to the baseline data (measurement tools are included) 6. Satisfactory	There are plans to measure the health status of those served to show what proportion achieved improved health status compared to the baseline data (measurement tools are included) 4. Fair	There are plans to measure the health status of those served to show what proportion achieved improved health status compared to the baseline data (measurement tools are included) 2. Poor	There are plans to measure the health status of those served to show what proportion achieved improved health status compared to the baseline data (measurement tools are included) 0. Unacceptable

Other (please specify)

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* 5. Rate the criteria for: Financial Information (25 Points)

	5. Excellent	4. Very Good	3. Satisfactory	2. Fair	1. Poor	0. Unacceptable
The budget is reasonable and is a cost effective use of BHT funds	The budget is reasonable and is a cost effective use of BHT funds 5. Excellent	The budget is reasonable and is a cost effective use of BHT funds 4. Very Good	The budget is reasonable and is a cost effective use of BHT funds 3. Satisfactory	The budget is reasonable and is a cost effective use of BHT funds 2. Fair	The budget is reasonable and is a cost effective use of BHT funds 1. Poor	The budget is reasonable and is a cost effective use of BHT funds 0. Unacceptable
Budget is complete and includes line items for salaries, operating expenses, other expenses, etc.	Budget is complete and includes line items for salaries, operating expenses, other expenses, etc. 5. Excellent	Budget is complete and includes line items for salaries, operating expenses, other expenses, etc. 4. Very Good	Budget is complete and includes line items for salaries, operating expenses, other expenses, etc. 3. Satisfactory	Budget is complete and includes line items for salaries, operating expenses, other expenses, etc. 2. Fair	Budget is complete and includes line items for salaries, operating expenses, other expenses, etc. 1. Poor	Budget is complete and includes line items for salaries, operating expenses, other expenses, etc. 0. Unacceptable
The budget narrative is complete and clear	The budget narrative is complete and clear 5. Excellent	The budget narrative is complete and clear 4. Very Good	The budget narrative is complete and clear 3. Satisfactory	The budget narrative is complete and clear 2. Fair	The budget narrative is complete and clear 1. Poor	The budget narrative is complete and clear 0. Unacceptable
The project has a realistic plan to become self-sustaining	The project has a realistic plan to become self-sustaining 5. Excellent	The project has a realistic plan to become self-sustaining 4. Very Good	The project has a realistic plan to become self-sustaining 3. Satisfactory	The project has a realistic plan to become self-sustaining 2. Fair	The project has a realistic plan to become self-sustaining 1. Poor	The project has a realistic plan to become self-sustaining 0. Unacceptable
The budget lists other sources of financial support	The budget lists other sources of financial support 5. Excellent	The budget lists other sources of financial support 4. Very Good	The budget lists other sources of financial support 3. Satisfactory	The budget lists other sources of financial support 2. Fair	The budget lists other sources of financial support 1. Poor	The budget lists other sources of financial support 0. Unacceptable

Other (please specify)