A Three-Question Approach to Grants

Grants provide opportunities for agencies to move in directions they might otherwise not have been able to because they lacked the
resources needed to proceed on their own. However, grants require a significant planning effort in order
to be successful. With that in mind, many grantors require a minimum level of planning to be disclosed
during the application process – and may require additional planning efforts to be detailed in
the associated deliverables.

The planning process for matching a grant to an agency usually falls into three stages, each of
which can be represented by a question, worded more or less as follows:

Stage 1 – Is the Grant “a Good Fit”?
Every grant requires that minimum criteria be provided in terms of the type of agency requesting the
grant, the specific area of government involved, and/or the mission to be accomplished. The agency has
to “fit” the grant, of course. But of greater importance is the fact that the grant not only has to fit
the agency but also should enhance the ability of that agency to carry out a specific mission. If the
answer to this “Stage 1” question is “No,” the agency probably should look elsewhere for a more
appropriate grant.

Stage 2 – What Will It Take to Implement the Grant?
This stage isentical in many respects to the planning stage of any project. The agency requesting the
grant should start with a well defined goal and draw a clear path or “road map” from the current status
quo to that goal; obviously, though, the path may be broken into sections or milestones to make it more
manageable. Using the path as a guide, the planning agency can and should prepare a budget and any other
implementation documentation required by the granting agency. The implementation documents of a plan in
the EMS (Emergency Medical Services) field, for example, would usually include some medical protocols
– i.e., the specific rules and procedures that govern the ways, and limits, in which
paramedics and emergency medical technicians must operate. Those protocols spell out the details that
determine how and when a treatment can be used – and, not incidentally, provide the legal
foundation that allows EMS staff to follow those rules. (Here it should be noted that, in addition to
new plans and documents, all current plans and documents should be periodically updated to include new
types of treatment and equipment items.)

One of the most important, but often overlooked, aspects of planning involves the “change” or
“implementation” plan. This section details: (a) the steps that must be completed prior
to full implementation of each milestone; (b) the training that is required; and (c) the specific
guidelines that spell out not only the deadlines established for each milestone in the implementation
process but also the evolution of the plan if those milestones are not met by the
deadline(s) projected.

Stage 3 – What Are the Estimated Continuing Costs of the Project?
All grants have a functional end date after which the agency seeking the grant cannot or at least should
not expect the allocation of additional funds. It is vitally important, therefore, that agency managers
consider how to continue the “enhancements” after the original grant funding runs out. This is
particularly true in the EMS field, which straddles a middle position between the emergency-response and
medical communities. It is very difficult, after a specific treatment capability is implemented, to
degrade the response provided back to what it was in the pre-grant state. In some cases, in fact, it may
be better to turn down an upgrade that cannot be sustained rather than have to abandon it later.

A granting agency that is willing to provide equipment to an EMS agency is by any definition a
boon to that agency. However, before accepting such a grant, consideration must be given to several
planning concerns – e.g., the cost and maintenance of new equipment; the replacement of
equipment at the end of its life span; and the purchase responsibility for the consumable products
required for operation of the equipment needed. In this way, grants resemble donations in some but not
all respects.

The bottom line is that grants are not and should not be considered simply as “free money.” In
order to successfully apply for, obtain, and properly use a grant, considerable hard work and careful
planning are required. However, for planners who are willing to put in the necessary effort, grants can
help agencies reach capabilities that might otherwise be unachievable.

Joseph Cahill
Joseph Cahill

Joseph Cahill is the director of medicolegal investigations for the Massachusetts Office of the Chief Medical Examiner. He previously served as exercise and training coordinator for the Massachusetts Department of Public Health and as emergency planner in the Westchester County (N.Y.) Office of Emergency Management. He also served for five years as citywide advanced life support (ALS) coordinator for the FDNY – Bureau of EMS. Before that, he was the department’s Division 6 ALS coordinator, covering the South Bronx and Harlem. He also served on the faculty of the Westchester County Community College’s paramedic program and has been a frequent guest lecturer for the U.S. Secret Service, the FDNY EMS Academy, and Montefiore Hospital.



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