1. Mobile Health Clinic of Otsego County
Lori Belger, Carrie Hallihan, Amy Polzin
Ferris State University

2. Introduction of Service
“About one-third of adults are obese in the 10-county region (31% in Otsego; 32% in Montmorency)” (Northern Michigan, 2012, pg 4).
Otsego County revealed key issues and “ranked top priorities as follows: obesity and chronic disease prevention; access to healthcare, including mental health and maternal and child health; substance abuse prevention; and abuse and neglect” (Northern Michigan, 2012, pg 7).
Ability to access health care services or the
health status of many underserved, uninsured, and
underinsured groups becomes less of a priority.
Healthy People 2020 states, “Disparities in access to health services affect individuals and society. Limited access to health care impacts people's ability to reach their full potential, negatively affecting their quality of life. Barriers to services include lack of availability, high cost, and lack of insurance coverage” (Healthy People, 2016).
Healthy People 2020 says the uninsured, underinsured patients are less likely to receive medical care, more likely to die early and are more likely to have poor health status By improving health care services by using evidence-based preventive services, this will prevent illness by detecting early warning signs and symptoms before disease (primary prevention) and detect disease at an earlier, and more treatable stage (secondary prevention), (Healthy People, 2020).
The residents of Otsego County barriers to receiving health care include having to travel long distances for appointments with health care providers (Northern Michigan). Mobile Health Clinic of Otsego County can help bridge that gap by providing a mobile health screening services brought directly into rural communities.

3. Introduction of Service
We are proud to announce a great new non-profit organization in Otsego County that focuses on improving the health of others. Our focus will be on providing the highest quality of health care services to the underserved, uninsured and underinsured.
Primary and secondary prevention
providing nutritional assessments,
counseling, exercise assessments,
and offering support with agriculture
(CSA) of fresh fruits and vegetables.

4. Summary of Service Our Mission: Goals:
Promote primary and secondary health prevention to the uninsured or underserved adult population of Otsego County in preventing disease or injury or reducing the impact of disease in their lives. We want to build healthier lives one step at a time.
Goals:
The goals that our clinic have developed include:
Community Value – plan and implement services that result in improving the quality of life within the community.
Compassionate Care – servicing the community with a smile and caring nature to make everyone feel they are important and their health matters to us.
High Quality Healthcare – delivering exceptional quality care each and every time to the community in which we serve.

5. Summary of Service Goals Continued:
Educate Community – provide the most accurate education and teaching to the community on primary and secondary health prevention.
Safeguard the community members so they have the resources, knowledge and support to apply healthy eating behaviors into their lives.
Identify those at most risk for the development of chronic illness and facilitate appropriate referrals.
Include nurses, exercise therapy, and dietary students to develop their knowledge and community health awareness.

6. Summary of Service Objectives:
Evaluate the effectiveness of a mobile health clinic in the rural area servicing underserved and uninsured with health screenings and compare initial data with follow-up data after 3 months.
Provide a program that meets the needs of the community we are serving through assessment, testing, and evaluations at each clinic visit.
Empower and educate community members in utilizing the Community Supported Agriculture (CSA) program offered to incorporate healthy eating.

7. Summary of Service Objectives:
Provide recipes using fresh ingredients provided by the CSA giving community members an idea of where to start and how to utilize the new program.
Facilitate career development opportunities for local nursing, exercise, and dietary students in assisting at our various clinics upon the first 3 months of opening the mobile health clinic.
Educate the underserved, uninsured
community on the 5 food groups and
knowing what healthy choices are vs.
unhealthy choices.

8. Summary of Service Objectives:
Promote awareness of healthy living and its impact on physical health and mental health among the community by quarterly reviews of participation and health statistics.
Provide awareness and education of spiritual health and wellbeing by their first clinic visit and follow-ups along the year.
Educate and provide resources on the importance
of physical exercise.

9. Job Descriptions
Mobile Health Clinic of Otsego County is an equal opportunity/affirmative action employer. The positions include the following:
Nurse Practitioner
Register Nurse
Medical Assistant
Nursing Students
Mobile Health Clinic of Otsego county with collaboration with Munson Medical Center-Grayling is launching a community-wide mobile preventive health program that will bring a Mobile Health Clinic to local churches and county high schools across the community, providing primary and secondary health screenings, referrals, and education health and wellness information to Otsego counties most vulnerable residents.
The Nurse Practitioner is responsible for successful operation of the Mobile Health Clinic of Otsego County. The candidate will provide functional supervision to the allied health care staff, RNs, Medical Assistants, and students. If making a different in the lives of the underserved, we want to talk with you. Qualified candidates must be currently licensed by the State of Michigan as a Nurse Practitioner, a minimum of three years of recent primary care practice experience, CPR Certification and current National Board Certification. Position is Monday-Thursday 32 hours a week, no weekend, no holidays.
The Registered Nurse is responsible for providing nursing care to patients with a diverse healthcare background. The nurse will be responsible but not limited to utilizing the nursing process to provide patient care for the assigned patient population. The nurse will provide functional supervision to allied health staff, nursing, dietary and physical therapy students. The Registered Nurse will work with the Nurse Practitioner to carry out clinical standards for various medical diagnoses. Qualified candidates must have a BSN, Current Licensure to practice in the State of Michigan, a minimum of five years of recent nursing experience. The candidate must demonstrate essential skills with nursing assessment, clinical decision making, ability to prioritize, problem solve and delegate.
Position is 32 hours a week, Monday, Tuesday, Wednesday, Thursday-No Weekends or Holidays.
The Medical Assistants responsibilities include obtain client’s past medical history., educate clients on dietary changes and/or restrictions, collect and prepare laboratory specimens and perform some laboratory testing. Work under the supervision of the Nurse Practitioner and Registered Nurse on staff, completing delegated tasks. Current certification as a Medical Assistant in the State of Michigan, Minimum of One year of practicing experience as a Medical Assistant providing direct patient care. CPR Certification. 32 hours per week, Monday-Thursday, no weekends or holidays.
Nursing students will be recruited from local RN programs in accordance with their requirements for community service.

10. Marketing Plan & Strategies
Mobile Health Clinic of Otsego County will be working directly with Munson Healthcare-Grayling in posting the Nurse Practitioner, Register Nursing and Medical Assisting positions within their online job openings.
Positions will be posted across the Munson Health System and Clinics at no charge.
Advertisement in the Gaylord Times- Over 5,000 subscriptions throughout upper Michigan.
Mobile Health Clinic of Otsego County will be working directly with Munson Healthcare-Grayling in posting the Nurse Practitioner, Register Nursing and Medical Assisting positions within their online job openings. There are no costs of advertising in the online job posting board across the Munson Health systems. This posting will be available across the ten Munson Health Systems and Clinics in Cadillac, Traverse City, Kalkaska, Charlevoix, St. Ignace and Gaylord.
The advertisement in the Gaylord Times is a paper and e-Edition paper serving Otsego county including surrounding Petoskey, Charlevoix and Grayling with over subscriptions throughout upper Michigan (Gaylord Herold Times, 2016).

11. Marketing Plan & Strategies
Advertisement in the American Nurses Association.
Premium 30-day job posting
Posting ed to thousands of nursing professionals
Viewed by over 100,000 members
Online posting through the American Nurses Association
No text limit-cost effective
The American journal of Nursing provides a proposed financial investment for advertising open positions on-line through the American Nurses Association. This advertisement methodology has the capabilities of reaching over 100,000 members with job advertisements ed to thousands of nursing professionals. The American Nurses Journal (TAN) has the following statistics, 57% of readers keep TAN or pass it on after reading it. 90% of TAN readers have full-time jobs, 29% have a bachelor’s degree, 40% have a master’s degree and 11% have a doctorate degree.
The Mobile Health Clinic of Otsego County will advertise for 30 days in The American Nurse to potentially recruit highly skilled quality, professional healthcare professionals. Further plans to advertise and recruit nursing students, dietary students and exercise therapy students from local colleges in Northern Michigan to meet their program requirements for community based health interventions as a requirement for the completion in their specific programs.

12. Appraisal of Service Plan Budget
Essential Supplies
Anticipated Cost
Mobile Medical Vehicle
Glucometers
Blood pressure cuffs
Stethoscopes
Thermometers
Pulse oximeters
Scale
Computers/tablets
Miscellaneous supplies (Medical tape, gauze, bandages, etc.)
Donated van for transporting equipment
$4,000 annually for gas, vehicular maintenance, etc.
$1,500 annually for computers/tablets, software updates, repairs, replacements
$5,000 initially and $5,000 annually for supplies and restocking
The supplies we anticipate needing include a vehicle for transporting our supplies and equipment between locations. The van is a charitable donation but we still estimate needing $4,000 annually in our budget for gas, repairs, and maintenance. We also need glucometers, blood pressure cuffs, stethoscopes, pulse oximeters, a scale, computers or tablets, and miscellaneous medical supplies. We factored $1,500 annually into our budget for the computers and tablets to include the initial purchase, software updates, repairs, and replacements. We also estimated needing $5,000 for our medical supplies initially, and $5,000 annually for restocking.

13. Appraisal of Service Plan Budget
Employees and Payroll
One Nurse Practitioner
Part Time, 32 hours per week: $70,200 annually
One Registered Nurse
Part Time, 32 hours per week: $40,560 annually
One Medical Assistant
Part Time, 32 hours per week: $21,840 annually
Undetermined number of Nursing student volunteers, unpaid positions
Total annual payroll budget of $132, 600
We will require three paid part time positions that include a Nurse Practitioner, a Registered Nurse, and a Medical Assistant. Each employee will be budgeted for 32 hours per week. The NP will earn $70,200 annually. The RN will earn $40,560 annually. The Medical Assistant will have an annual salary of $21,840. We will also utilize nursing students as volunteers when needed. Our expected annual payroll budget adds up to $132,600.

14. Rationale of Service Plan Budget
Rationale for Mobile Health Clinic Proposal
Service to a community of uninsured, underserved, and underinsured
Support from Community Health Systems
Financial support from
The National Association of Free & Charitable Clinics
The American Medical Association Foundation
Munson Health Systems of Northern Michigan
Cost to provide services (i.e. staff, labor, supplies, etc.) covered by grants, donations, fund raisers and support the listed organizations above.
We felt that our mobile clinic should be considered a free clinic to the community in which we are serving, in particular the uninsured, underserved, and underinsured. “We must value ourselves as providers and think of our practice within a context of organizational viability and quality of care. To do this, we must add ‘financial thinking” to our repertoire of nursing skills and we must determine whether the services we proved add value for patients. Services that add value are of high quality, affect health outcomes positively, and minimize costs” (Yoder-Wise, ). We researched clinics around the country and really felt strongly about the way the National Association of Free & Charitable Clinics reimburses their services and handles their services in association with the American Medical Association Fondation. The National Association of Free & Charitable Clinics “recognize that health care was not being provided at a local level to the working poor, uninsured and underinsured in our country in a way that was cost effective, accessible and affordable” (Building a healthy America, 2016).
We are most certain that the services we provide will be welcomed by the community because so many people are in need of these services. The likelihood of community support is definitely favorable. “Free Medical Clinics are often supported through charitable donations and typically receive little or no government support

15. Conclusion
The need for this service is evident from the research and statistics for Otsego County.
We feel that this health care opportunity will benefit not only the patients but also the community as a whole in primary and secondary health prevention.
Mobile Health Clinic of Otsego County feels strongly that our mobile clinic will see a patient increase in the next 6 months to 1 year as we reach out to the underinsured, underserved, and underinsured.
Everyone’s health should be a priority!
The Organization Strategic Plan (OSP) group two created the Mobile health Clinic of Otsego County, located in Otsego County, Michigan concentrating on primary and secondary preventive care to the underserved, uninsured and underinsured in Otsego County Michigan. We are most certain that the services we provide will be welcomed by the community because so many people are in need of these services. The likelihood of community support is definitely favorable. Free Medical Clinics are often supported through charitable donations and typically receive little or no government support.

16. Thank-You!

17. References
American Nurses Association. (2016). Products and rates: ANA Career Center. Retrieved from:
AdvertisingMediakit/tan5783.html
Healthy People.gov (2016). Access to Health Services. Retrieved from
Services
Northern Michigan 2012 Community Health Assessment – Montmorency County & Otsego
County. (2012). Retrieved from Report_with_attachments_-_OMH_ pdf , pg. 4, 7, 47
Yoder-Wise, P.S. (2015). Leading and managing in nursing (sixth ed.). St. Louis, MO: Elsevier, pg. 217, 294, 296, 145.