Equity and Innovation Grants

Primary Project Lead First Name *

Primary Project Lead Last Name *

Primary Project Lead Email Address *

Secondary Project Lead First Name *

Secondary Project Lead Last Name *

Secondary Project Lead Email Address *

DPH Sponsor First Name *

DPH Sponsor Last Name *

DPH Sponsor Email *

Please also confirm the name of the ZSFG Executive Sponsor and UCSF Chief from whom you have obtained approval for your project scope and budget line items. Please attach a copy of the approval emails to your application.*

Project approvals are required from your DPH Sponsor, a ZSFG Executive*, and a UCSF Service Chief**

Your DPH sponsor should complete the Proposal Notification Form (PNF) as a required step to apply for this grant.

You can refer to the table below listing respective personnel for each role. Applicants must provide a draft proposal to the designated ZSFG Executive and UCSF Service Chief by June 16.

*ZSFG Executive approval reference list:

NAME	TITLE
Angelica Almeida	Chief Integrative Officer
Jeffrey Critchfield	Vice Dean
Susan Ehrlich	Chief Executive Officer
Christine Falvey	Chief Communications Officer
Angelica Journagin	Chief Administrative Officer
Hemal Kanzaria	Chief of Performance Excellence
Mary Mercer	Chief of Staff
Gabriel Ortiz	Chief Medical Officer
Gillian Otway	Chief Nursing Officer
Sabrina Robinson	Chief Operating Officer
Adrian Smith	Chief Quality Officer
Eric Wu	Chief Financial Officer
Justin Dauterman	Chief Experience Officer

** A UCSF Chief is not required to approve the proposal if it is focused exclusively on DPH-operated services. In that case, no copy of an approval email from a UCSF chief is required.

This proposal is focused exclusively on DPH operated services

This proposal is not focused exclusively on DPH operated services

Please attach a copy of the approval email from your DPH sponsor here. *

Please attach a copy of the approval email from your ZSFG executive sponsor here. *

If applicable, please attach a copy of the approval email from your designated UCSF service chief.

ZSFG Executive Sponsor First Name *

ZSFG Executive Sponsor Last Name *

ZSFG Executive Sponsor Email *

UCSF Chief First Name

UCSF Chief Last Name

UCSF Chief Email Address

Please upload your Proposal Notification Form (PNF) here. *

The PNF should be completed by your DPH Sponsor and uploaded in Word format. Note that only the yellow highlighted fields need to be completed.

Proposal Notification Form

Project Title *

(in 4 words or less)

1) Project Summary (Executive Summary): Please provide a general description of the proposed project in 1-3 sentences. *

(maximum 1000 characters with spaces)

2) Project Description: Describe the proposed project and the overall impact your project attempts to make. Please outline any partnerships or collaborations, and how this project will play an impactful role in the hospital / the community. This description can also be copied and pasted or summarized for the PNF question #17 (Grant Application Summary). *

(maximum 3000 characters with spaces)

3) Statement of Need: Describe the issue the project is attempting to address. Provide concrete details of the specific challenges or obstacles, and cite data if possible. *

(maximum 3000 characters with spaces)

4) Hospital Alignment: How does this project align with the ZSFG True North Key-Performance Indicators, the SFHN Quality Incentive Program, or the CMS Star Rating? *

See RFP here for more details.

(maximum 3000 characters with spaces)

5) Measurable Objectives: Outline the project implementation plan for the intended 2-year funding timeframe. *

State at least three measurable objectives and the activities that will help to achieve each objective, with a timetable for completion of each objective. One or more objectives should use data directly from the ZSFG True North Dashboard, SFHN Quality Incentive Dashboard, or CMS Hospital Compare Website. Please also include the number of patients treated and/or number of staff trained as one of the objectives.

(maximum 3000 characters with spaces)

6) Overall Impact: Is there potential for the project to be scaled up or replicated to beneﬁt a broader population or additional healthcare settings? If so, please explain. *

(maximum 1500 characters with spaces)

7) Anticipated Outcomes: What are the anticipated short- and long-term outcomes of the project, particularly in terms of improving health outcomes, reducing disparities, and advancing health equity? *

(maximum 1500 characters with spaces)

8) Optional: Please include or upload any supplemental materials (e.g. videos, deck presentations, flyers, articles, etc.) that have already been created and can contribute to describing your proposed project.

9) Detailed Budget: Please use the Budget Form and provide as much detail within your budget as possible. *

If multiple items fall within one category (e.g. materials and supplies), please add additional rows for further breakdown of the details within line items. You may need to include multiple rows, for example general supplies, medical supplies, other supplies, etc. Include in your basis of cost estimates additional details, such as what supplies include, cost and number of items to be purchased. Your selected categories might change to better align with the hospital’s budget accounts.

For any UC personnel who will be included in the requested budget, they must already be approved through the Affiliation Agreement in order to be reimbursed.

Budget Form

Equity and Innovation Grants 2026 Application

Equity and Innovation Grants 2026 Application

Equity and Innovation Grants 2026 Application