Examples of Problem Statements from Actual Proposals

[Examples and full proposals are made available through 4Good, a collaborative online resource

for non-profits and are intended for reference purposes only.
Visit them: https://4good.org/]

Contents

Example #1: Funder: Grossmont Health Care District
Submitted by: ElderHelp

Example #2: Funder: Federal Government, Department of Health and Human Services

Submitted by: The Family Service Association of Western
Riverside County (FSA)

Example #3: Funder: Unnamed foundation funding senior health

Submitted by: Little Tokyo Service Center (LTSC)

Example #4: Funder: Riverside County, California

Submitted by: The Family Service Association of Western
Riverside County (FSA)

Example #5: Funder: Private Regional Foundation

Submitted by: State Association

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*Examples and full proposals were made available through 4Good, a collaborative online resource
for non-profits. Visit them: https://4good.org/

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Example #1

Foundation: Grossmont Health Care District

Grant seeker: ElderHelp

Grant request: $75,000

Project summary: To fund the ElderHelp Concierge Club to combine high quality care
management services with in-home volunteer services and use an innovative fee-based system ?
membership program that delivers the support systems seniors need at a price they can afford ?
that will support ElderHelp to both serve more seniors and better sustain the program over time.

Full proposal available on IdeaEncore at: https://www.ideaencore.com/item/4769/files

Problem Statement / Needs Assessment
There is a tremendous need for coordinated and accessible home-based services for seniors in
the Grossmont Healthcare District. According to the San Diego County Survey of Older
Americans completed by the County?s Aging and Independent Services in December of 2008, the
eastern areas of the county have some of the highest populations of seniors in the county with
the highest in La Mesa (21%). ElderHelp has identified additional census tracks within the
communities of San Carlos, La Mesa, Lemon Grove, Spring Valley, Santee, Lakeside and El Cajon
where 35% of the population is over the age of 65. According to the 2000 Census, within these
areas there are 10,221 seniors who are over the age of 65 living on their own. Many are female
living on less than $16,000 per year.

As the economy continues to decline and the state cuts services for seniors, the need for more
cost effective and coordinated community-based solutions deepens throughout the region and
in the Grossmont Healthcare District area.

? According to Aging and Independent Services, 20% of seniors have serious concerns
about finding affordable homecare services.

? Of the seniors surveyed, 35% lived alone and nearly 40% felt they did not have enough
money to live on.

? Activities seniors rated as difficult or unable to complete included housework, shopping,
preparing meals and accessing transportation.

? These services are not just inaccessible but they are also expensive. According to the
UCLA Centers for Health, seniors in San Diego will pay on average $519 per month ($6,228
annually) for just six hours of services and phone support from a case manager.

? These services seem to be especially out of reach for single women.

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? Alternatively, seniors and their families may turn to the newspaper or Internet and hire
someone without a background check, which can be dangerous and leave seniors
susceptible to elder abuse.

Healthcare issues and chronic disease also compound these struggles. As people age they
become more susceptible to chronic disease which is the major cause of death among older
adults.

? The top three causes of death for U.S. adults aged 65 or older are heart disease (32% of all
deaths), cancer (22%), and stroke (8%).

? These reasons account for 62% of all deaths of older adults.
? In San Diego, 72 % of local seniors receive flu shots annually and 61% are vaccinated for

pneumonia, both falling below the ?Healthy People? benchmarks.
? According to the San Diego Senior Health Report released in May of this year, nearly 21%

of San Diego County seniors have heart disease, 31% have had cancer, 15% have been
diabetic and more than 50% are overweight.

Chronic disease in older adults can lead to limitations in daily activities, reduce health-related
quality of life for seniors and increase the use of emergency healthcare and hospitalizations.
Chronic disease can cause disabilities that result in falls and injuries and also contribute to
debilitating pain and depression. Certainly there are many health options for seniors in East
County, but they are for those seniors who are mobile and able to get places on their own
without aid or assistance.

The Concierge Club is an innovative model that addresses these growing health and human
challenges that seniors and their families are facing. There are currently no coordinated in home
options for seniors that are affordable and community-based. ElderHelp plans to grow the
Concierge Club from its current membership and expand its services within the Grossmont
Healthcare District.

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Example #2

Funder: Fed Government – Department of Health and Human Services

Submitted by: Family Service Association of Western Riverside County (FSA)

(Grant amount not included)

Project Summary: To fund a new program entitled ? ?No HIV for Me? that will provide realistic,
gender-specific prevention education services focused on the intersection between juvenile
delinquency and STD/HIV infection for female adolescents. The program will specifically target
young women ages 9-17 who are deemed at risk for juvenile delinquency and will provide a
gender specific approach that is focused on HIV/AIDS awareness, prevention and support
services in a collaborative manner.

Full proposal available on IdeaEncore at: https://www.ideaencore.com/item/grant-proposal-fsa-
department-health-and-human-services

Problem Statement: The risk factors and co-occurring issues for girls who are identified as at-risk
for juvenile delinquent and/or sexually risky behavior.

Let?s face it, teens are having sex. In high schools across the U.S., nearly one-half (47 percent) of
students state they are having sexual intercourse. The average teenager feels invincible and has
little fear of becoming HIV+. Most believe that HIV only happens to other people. However,
teens and young adults make up the largest number of HIV cases reported in recent years. In fact,
the Centers for Disease Control (CDC) estimate that there are at least 15,000 HIV+ young people
between the ages of 13 to 24 years old living in the U.S. Yet, most HIV+ teens remain unaware of
their infection, or that they were even at risk for HIV.

Adolescent women are at even greater risk than adult women. The vagina and cervix of young
women are less mature and are less resistant to HIV and other STIs, such as Chlamydia and
gonorrhea. Changes in the reproductive tract during puberty make the tissue more susceptible to
penetration by HIV. Also, hormonal changes associated with the menstrual cycle often are
accompanied by a thinning of the mucus plug, the protective sealant covering the cervix. Such
thinning can allow HIV to pass more easily. Young women produce only scant vaginal secretions,
providing little barrier to HIV transmission.

In addition to these increased physiological risk factors, many behaviors put teenagers at risk of
HIV/STI.

? Many teens are sexually active and a large percentage of sexually active teens fail to use
condoms consistently and correctly.

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? Teens have high rates of STI. In fact among American females, teens normally have the
highest incidence of reported STI.

? A small minority of teens injects drugs, but teens commonly report using alcohol and/or
non-injection drugs which can inhibit their judgment. In fact, drug and alcohol use is
among a cluster of risk behaviors, including unprotected sexual intercourse, that teens
frequently report.

The association between disadvantage on the one hand and HIV infection on the other is evident
from the statistics. For example, in the United States,

? More than 50 percent of all adolescent AIDS cases occur among female teens, and the
overwhelming majority of these cases occur among African Americans and Latinas.

? Youth are at risk for HIV infection, and youth of color, regardless of gender or sexual
orientation, are at disproportionate risk of HIV infection.

? Latinos were the only minority group to demonstrate a doubling of new HIV infections
between 2001 and 2006 ? 23 to 51 percent for females. This is of particular relevance to
the ?No HIV for Me? project, given that over 50% of the population in Riverside County is
ethnic minorities (primarily Latinos @ 43.2% and African Americans @ 6.6%).

According to the CDC, following are some of the behavioral and socioeconomic factors that
negatively affect sexual risk-taking behavior among young women, especially those of color:

1. Poverty and access to care?Young women of color are disproportionately members of
the working poor who often lack access to affordable, culturally sensitive, and youth-
friendly health services. As a result many receive little preventive health information,
including strategies that reduce their risk for HIV infection.

2. Heterosexual contact?The largest category for being infected with HIV among women

of color is heterosexual contact?having sex with a man who uses injection drugs, is HIV-
infected, or whose HIV status is unknown to the young woman.

3. Communication ? Patterns of communication about sexuality differ by ethnicity, age,

socioeconomic status, and level of acculturation. Reticence in discussing sexuality occurs
among minority populations as frequently as among the U.S. population as a whole. Some
Latino and Asian Pacific Islander cultures prohibit or discourage open discussion of topics
like condom use, disease, and sexual behaviors. African American adolescent females, on
the other hand, report receiving information about and discussing HIV and sexuality at
school and with family. Young African American women also report feeling comfortable
in assertively asking about partners’ past sexual risks, although they are often reluctant to
ask about same-sex sexual behavior or substance use?behaviors of male partners that
can put the young women most at risk.

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4. Trust in monogamy?The safety provided by monogamy is limited by each partner’s past
and current risk behaviors. Trusting a male partner who is not monogamous is a serious
risk factor for any woman and may put many young Latina and African American women
at risk for HIV and other STIs

5. Older male partners?A quarter of sexually active men ages 22 to 26 and 19 percent of

males ages 20 to 21 report sexual intercourse with a teenage partner during the last year. A
significant proportion of Latina and African American adolescent females also report first
sexual intercourse with older male partners. Sexual intercourse with older men can expose
young women to a sexual partner who has had sex with multiple partners, varied sexual
experiences, and/or a history of injection drug use. Differing age and sexual experience
may also create power imbalances that limit the ability of young women, including those
of color, to negotiate safer sex. Finally, young women sometimes rely on older sex
partners for guidance about protection and may receive misinformation that can
negatively affect the young women’s sexual health.

6. Cultural barriers – Cultural barriers prevent many young women of color from gaining the

skills and knowledge they need to lessen their risk for HIV or other STIs. Ethnic groups
may face different barriers posed by customs, religion, and history. For example, the
African American community did not initially view HIV/AIDS as a threat. Early case reports
indicated that high-risk groups included white gay men, injection drug users, hemophiliacs,
and Haitians. As a result, many African American women have not recognized their own
risk. Today, suspicion of government agencies, worry about genocide, and continuing
conspiracy theories remain current among many African Americans. These factors may
result in an unwillingness to be tested or treated for HIV.

Latinas often face a significant barrier to negotiating safer sex?Roman Catholicism, the
predominant religion of the Latino population. Roman Catholicism does not condone the
use of condoms or other contraceptives, even though correct and consistent condom
use is the best HIV prevention method for sexually active individuals. In this regard,
studies indicate that Latinas are the least likely teens to report condom use.

Catholicism also idealizes female submissiveness to men in relationships and in sexual
activities. Cultural imperatives for females’ being submissive directly conflict with
prevention strategies that ask women to be assertive, to negotiate safer sex, and to be
responsible for their own sexual health.

7. Unprotected Sex – One of the most common ways HIV is transmitted among teens is
through unprotected sex – not using a condom during vaginal and anal intercourse. A
reason for this is that teens are less likely to use a condom or other forms of protection
during intercourse. Not using condoms also put teens at risk for other sexually
transmitted diseases (STDs). In fact, one-fourth of all STDs each year occur among teens.
This is especially alarming because the presence of an STD greatly increases a person’s

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likelihood of acquiring or transmitting HIV. People who have an STD such as syphilis,
genital herpes, Chlamydia, or gonorrhea are at greater risk for getting HIV during sex with
infected partners. Consistently using condoms significantly reduces the chances of getting
STDs.

8. Alcohol and Drug Use – Young people in the U.S. use alcohol and drugs at high rates. Many

teens are curious about drugs and feel pressure from peers to try them. Teens are more
likely to engage in high-risk behaviors, such as unprotected sex, when they are under the
influence of drugs or alcohol. In 2005, 23 percent of high school students who had sex
during the past three months drank alcohol or used drugs. Runaways and other homeless
young people are at high risk for HIV infection if they trade sex for drugs or money. Drug
use can also increase the risk of HIV infection if needles are shared. This includes using
needles for injecting drugs, skin-popping, injecting steroids, piercing the ears and body,
and tattooing.

While researchers have concluded that there is no single path to delinquency and note that the
presence of several risk factors often increases a youth?s chance of offending, studies point to
the interaction of risk factors (multiplicative effect) when several risk factors are present. The
Office of Juvenile Justice and Delinquency Programs, in a publication entitled Risk Factors for
Juvenile Delinquency ? An Overview, cites the following risk factors:

1. Individual Level Factors ? Several psychological, behavior and mental characteristics seem to

be linked to delinquency, for example: aggression, hyperactivity, concentration or attention
problems, impulsivity and risk taking. Low verbal IQ and delayed language development have
also been linked to delinquency. Children with low academic performance, low commitment
to school, and low educational aspirations during elementary and middle grades are at higher
risk for delinquency as well.

2. Social Factors: Family characteristics such as poor parenting skills, family size, home discord,

child maltreatment and antisocial parents are risk factors linked to juvenile delinquency.
Additionally, poor parental supervision, parental conflict, and parental aggression, including
harsh, punitive discipline increase chances of offending. Peer influences and involvement in a
delinquent peer group lead to delinquent behavior.

3. Community Factors: Neighborhood and community factors such as poverty, high rates of

unemployment, and other adverse environmental factors such as weak social networks,
isolation among residents, residential turnover, concentration of delinquent peer groups and
gangs, access to weapons, and high crime levels and rates of violence contribute to the risk of
delinquent behavior.

4. Environmental Factors: Environmental factors play an important role in creating conditions

that can contribute to a culture of violence among a particular group of people or in a given
community. Some of the factors at this level that have been linked to violence include

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poverty, media exposure to violence, and the general disenfranchisement of young people in
our society. Socioeconomic status has been consistently found to be an important
contributing factor to violence in many studies. Depressed economic conditions coupled with
individual cases of unemployment and limited economic opportunity contribute to higher
levels of violence in a given community. Researchers have confirmed that youth living in
poverty are more likely to engage in violent behavior.

5. Youth often also experience specific barriers when seeking employment, such as employers

who would prefer not to hire them, limited job skills or appropriate vocational training, or
physical obstacles, such as poor transportation. Other research indicates that exposure to
violence in the media, particularly prolonged exposure by children, may contribute to
aggressive behavior and desensitization to violence. The media also may contribute to the
perception of violence as a normative behavior, reinforcing and sensationalizing violence as
an appropriate and justifiable problem-solving strategy.

6. Finally, many adults have a disregard and mistrust of young people, and our culture has largely

failed to recognize youth as a valuable asset. As a result, many youth may find it difficult to
engage in meaningful and substantive relationships with adults both individually and within
the larger community. This lack of connection may contribute to youth feelings of alienation
and disassociation from mainstream society, thus increasing risk for delinquent or violent
behavior.

Community-based organizations such as Family Service Association (FSA) have a special
responsibility to protect young people from becoming affected with HIV. The consequences of
decisions made too young can lead to the devastation and death from AIDS. Although there are
new treatments that have reduced the AIDS death rates for youth, there has been no decline in
the number of new HIV infections among young people. Any young person who engages in the
normal experimentation and sexual curiosity that mark adolescence as a development period is at
some risk for HIV infection, especially in geographic regions with high HIV prevalence (such as
California that is ranked second in the nation for AIDs cases). But, as it does with adults, HIV and
AIDS most threaten youth who already face poverty, racism, homophobia, gender inequality and
other power differentials in relationships, poor access to health care, and homelessness.
Homeless and runaway street youth, and those at risk as juvenile offenders and other young
people who exchange sex for drugs, money or affection are particularly at risk.

The FSA Project entitled ? ?No HIV for Me? will benefit from the experience and expertise of the agency
in working with youth with multiple risk factors, including those for juvenile delinquency and sexually risky
behavior. The project also involves collaboration with two additional CBO?s to ensure that the project
reaches additional high-risk youth, the YWCA and Operation SafeHouse, serving both at-risk girls and
runaway and homeless youth.

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Example #3

Funder: Unnamed Foundation funding senior health

Submitted by: Little Tokyo Service Center (LTSC), Community Development Corporation

Grant request: $50,000

Project summary: To support the Senior Services Program and its endeavors to serve Japanese
and API seniors living in Los Angeles. Three areas of particular need in this senior population are
bilingual case management, care giving to delay nursing home care and alleviate isolation, and
transportation services.

Full proposal available on IdeaEncore at: https://www.ideaencore.com/item/grant-proposal-
support-senior-services-program-ltsc

NEED FOR THE PROJECT

Japanese and API seniors living in Los Angeles and surrounding areas do not have access to
needed services either because existing programs do not provide linguistically and culturally
competent services or they do not qualify for services due to residency requirements. Even
without specific government funding LTSC is attempting to provide services to these seniors
because they have nowhere else to go for assistance. Ironically, despite the fact that LTSC is
based in Little Tokyo, it currently does not have government funding to serve Japanese seniors
living in the Little Tokyo area. More requests for assistance come from this area than any other
area mainly because Japanese seniors continue to relate to Little Tokyo as a culturally
comfortable and pedestrian-friendly neighborhood, and there are a number of large government-
subsidized housing projects for seniors here (including some of LTSC?s own housing
developments).

Based on LTSC?s client intake analysis, of all the seniors that request service from LTSC 22.8%
reside in the area surrounding LTSC?s office. Based on the population data for this area it is clear
why so many requests for service come from this area. In Little Tokyo 52% of the population is
Japanese and 60% of the population is 65 years old or older. Further, since many of the seniors
live in government-subsidized affordable housing developments, the majority of them are low-
income.

The remaining requests for service come from all over the County. In Los Angeles County there
are over 150,000 Asian seniors over the age of 65. (U.S. Census 2006 American Community
Survey.) Of all Asians in Los Angeles County 79.9% speak a language other than English at home
and of those who speak another language at home 42.1% speak English less than ?very well.? (U.S.

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