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All
sample proposals were prepared by Grants West, which has raised $100 million for nonprofit groups.
The
proposal outlines a specific health care program serving homeless adults.
PROPOSAL NARRATIVE
NEED STATEMENT
St. Francis
Center is the
primary daytime gathering place for people who are homeless. Each day,
between 400 and 500 men and women visit St.
Francis Center
seeking shelter, showers, employment services and counseling. The shelter
also provides a health clinic for basic needs, mental health case management
and counseling, and substance abuse counseling.
The Issues and Substantiating Research
The National Health Care for the Homeless Council, in its 1997 report,
"Increased Demand and Decreased Capacity" found that federally-funded
Health Care for the Homeless projects nationally reported increases of
HIV/AIDS, tuberculosis, chronic mental illnesses, substance abuse, diabetes,
and hypertension (O'Connell, J., Lozier, J., and Gingles, K., 1997). These programs experienced a 30
percent increase in the numbers of homeless individuals seeking care (Oakley
and Dennis, 1996, "Responding to the Needs of Homeless People with
Alcohol, Drug, and/or Mental Disorders,"). Approximately 22% of Health
Care for the Homeless clients were diagnosed as
suffering from substance abuse disorders (Bureau of Primary Health Care,
1995).
The National Coalition for the Homeless (NCH), in a review of research
data, found that both chronic and acute health problems are extremely high
among the homeless population, and that people who are homeless are far more
likely to suffer from every category of chronic health problem with the
exception of obesity, strokes, and cancer. NCH cites the high rate of
frostbite, leg ulcers and upper respiratory infections as frequently being the
direct result of homelessness. NCH also found that homeless people are also
at greater risk of trauma resulting from muggings, beatings, and rape. In
addition, NCH identified that some homeless people suffering from mental
illness may use drugs or alcohol to self-medicate, and those with addiction
disorders are also often at risk of HIV and other communicable diseases
(National Coalition for the Homeless, 1998). Homelessness also often
precludes good nutrition, good personal hygiene, and basic first aid.
The Local Need
Over ten years ago, staff from Stout Street Clinic, the leading provider of comprehensive
health services for the homeless in Denver, recognized the need to provide
basic and preventative health care for the homeless at a location where they
were gathering, and helped launch the clinic at St.
Francis Center.
Today St. Francis Center operates its clinic independently of Stout
Street, but
coordinates closely to meet the health care needs of the homeless.
Stout Street Clinic typically requires appointments for its health
services, and drop-in patients with non-severe health care needs sometimes
must wait hours to receive care. St.
Francis Center
does not intend to provide the comprehensive level of services offered by
Stout Street Clinic, but it developed a program model that helps men and
women with non-severe healthcare needs receive help immediately.
Need 1: St.
Francis Center
helps relieve the overflow demand at Stout
Street by providing
wound care, wellness assessments, cold care, preliminary
diagnosis of disease, screenings, respiratory care, and relief for colds,
sores, blisters, headache, and digestion problems. Because a large volume of
homeless men and women come to St.
Francis Center,
the shelter is an ideal location for distributing personal care items,
condoms, hygienic materials, flu vaccines, and for providing education on
health and mental health. In 1997, St.
Francis Center's
clinic provided 8,100 units of service with one full time nurse, three
volunteer nurses, and a budget of $47,000. However, the quantity of supplies
necessary to meet the demand at the shelter is very high, and additional
funds are needed to provide this level of care.
Need 2: People who are homeless have difficulty paying for even the
most basic health care costs. With little or no income, costs for eye exams,
a physical (required before a person can enroll in substance abuse treatment
services), and transportation to medical services are often out of reach. When
clinic patients are immediately referred to the Denver
Medical Health
Center
or another medical care provider, they frequently do not have money to pay
for taxi or bus transportation.
Need 3: St. Francis
Center has seen increased
demand for substance abuse counseling and treatment services. An Alcoholics
Anonymous group was formed in 1996, and the staff nurse uses her extensive
background in substance abuse programs to help guide people who are addicted
into treatment programs. However, there is a tremendous need for follow-up
for people who are going through a treatment program and are still homeless.
The pressures of being homeless combined with a tendency to associate with
peers who are still engaged in substance abuse may lead a person to relapse. St.
Francis Center
would like to design a program to help people stay on track during their
substance abuse treatment and recovery.
PROJECT GOALS AND OBJECTIVES
Goal: The project goal is to encourage the maintenance of good health through
health promotion, screening, and prevention of illness.
Objective: The project objective is to offer 8000 units of wellness health
care services to homeless men and women, and providing monthly education
programs promoting health and mental health.
PROGRAM DESIGN
St. Francis Center's
clinic services include drug and alcohol counseling and referral, basic
medical treatment, and mental health counseling. Three volunteer nurses from
Health SET assist Joan Spero, the St.
Francis Center
full time staff nurse, in providing care. The health clinic is open six days
a week, and help from the volunteer nurses ensures that Joan can meet with
patients on a one to one basis, provide health promotion activities, and
assist with the payee program. She spends many hours with patients providing
health education one-on-one.
St. Francis Center has established a payee program to manage Social
Security Income checks for individuals with substance abuse addictions or
mental illness, and helps them access health care, treatment programs and
housing. The Denver
Health Medical
Center's
mobile unit tests and treats patients for tuberculosis, the flu, STDs, and
other communicable diseases. A caseworker from the Mental Health Corporation
of Denver
provides case management and referrals.
We are seeking funding for from Health One for the following purposes:
1) Basic Wound Care
Homeless adults face constant exposure to the elements. A majority of those
seeking clinic services have not had a recent tetanus shot. Without
preventative care, a minor cut can turn into an acute problem and require
immediate emergency room care. Stout Street Clinic often refers follow-up patients
to St. Francis Center
for regular wound care and dressing treatment. We are
committed to providing basic wound care, and request funding for the
following items to do so:
Item
Monthly quantity Annual
quantity
Unit
Cost
Total Cost
2 x 2
sponges
5
boxes
60
boxes
2.37/box
$142.20
4 x 4
sponges
5
boxes
60
boxes
3.12/box
$187.20
TelfaPads
3
boxes
36
boxes
4.35/box
$156.60
Conforming rolls 20
rolls
240
rolls
1.10/each * 25 $ 27.50
of gauze
Surgical
tape
3
boxes
36
boxes
8.55/box
$307.80
Hydrogen Peroxide 5
bottles
5 cases of 12 bottles 5 cases @
$1
$ 5.00
Normal
Saline
3
bottles
3 cases of 12 bottles
$3.50/case
$ 10.50
Sterile Applicators 2/3
box
8
boxes
$3.20/box
$ 25.60
SUBTOTAL
$862.40
2) HIV/AIDS Prevention
Research has found that homeless men and women are likelier to engage in high
risk behaviors which can lead to HIV/AIDS (National Coalition for the
Homeless, 1997). To address this risk, St. Francis
Center plans to provide education on HIV/AIDS
and distribute condoms to shelter guests (until recently, Denver Health
provided condoms for distribution at the shelter). St.
Francis Center
is determined to break down negative attitudes toward condoms and educate
shelter guests about the risks of HIV/AIDS. St.
Francis Center
projects the following quantities and costs.
Item
Annual
Quantity
Unit
Cost
Total Cost
Condoms
165
boxes
$8.65/box
$1427.25
SUBTOTAL
$1427.25
3) Podiatric Care
Many men and women who come to St. Francis
Center walk long distances, even in bad weather.
Their feet often suffer from untreated blisters, athlete's foot, corns and
fungus. St. Francis
Center plans to
provide inner soles, foot powder, anti-fungal powder, corn pads and socks to
relieve foot pain, and a schedule of quantities and costs is outlined below.
Foot Care
Item
Annual
Quantity
Unit Cost
Total Cost
Inner
soles
200
$1.19
each
$238.00
Foot
powder
40
$2.00
each
$ 80.00
Antifungal
preparation
50
$3.29
each
$164.50
Corn
pads
100
$1.15
each
$115.00
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