Native Hawaiian Prenatal Spa and Clinic

1888. Kalakaua Ave STE C312

Honolulu, Hawaii 96815

(808) 555-1234

National Institutes of Health

9000. Rockville Pike

Bethesda, MD 20892

To: Patricia Kaneshiro, Grants Administrator

From: Anthony Wallace, Executive Administrator/Sr. Healthcare Broker

Dear Grants Administrator,

My name is Anthony Wallace and I am the executive administrator of Native

Hawaiian Spa and Birthing Center, located in Honolulu, Hawaii. I am inquiring about

your grant hosted on the grants.gov website. The title of the grants is pregnancy

women with disabilities, opportunity number PAR-11-259. This grant opportunity

will service the growing population Oahu, Maui, and Kauai counties.

Native Hawaiian Spa and Birthing Center is a non-profit organization that is

minority owned and operated with the intent to render maternity care, birthing

education, and ante and post partum care in the patients’ home. We want to expand

our network by including those with disabilities by educating and employing

specialized nurses to conduct maternity care without the patient being in the hospital

environment.

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Grant funding will help those that are considered low-income or socially-

economically challenged by providing quality health care by experienced

professionals. According to the American Disability Act, “Rehabilitation prohibits

discrimination on the bases of disability in programs that are federally funded or

conducted by governmental agencies” (United States Department of Justice , 2009).

Our agency also provides network resources for those that are considered socially

economically challenged such as state counseling, free charity care clinics, and food

pantries just to name a few.

We are seeking funding for this program to commence in the summer of 2014.

The funding will be used to implement and sustain the program within Oahu. We are

seeking to expand the program to other islands and counties outside of Oahu tourist

district. We are requesting a full announcement and any additional requirement to

meet the minimum qualifications to become a grantee. If you have any additional

questions, please feel free to contact our office at (808) 555-1234.

Take care and be in good health,

Anthony Wallace, ACHE

Native Hawaiian Spa and Birthing Center

Aw

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Pregnancy in Women with Disabilities

Opportunity Number PAR-11-259

National Institutes of Health Grant

Requested Amount $150,000.00

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Goal and Objective

The goals and objectives of the program will define our care models that our

agency will use to care for individuals within the community. We are seeking

funding to initiate and sustain our program for those patients that are considered

social-economically challenged. Our program goals and objective will reflect our

mission statement to the community at large and the state, which governs midwives.

Program Goals

The agency will properly screen and assess those patients that may qualify

for state funded programs such as WIC, AFCD, or SNAP food stamps

The agency will provide local transportation to and from the spa for prenatal

treatments and clinic visits.

The agency will provide public health education and measurements on

compliance and retention learning.

Our agency will provide a safe and reliable service to those that are on our

census.

We will conduct research and formulate outreach programs with information

from QSEN as a foundational guide for our staff midwives.

Our agency will promote patient-centered care throughout our care planning

processes.

The care planning and delivery of services will have a slight opposition to

conventional maternity care due to our mission statement and the foundations of

Naturopathic care. Our mission statement is to discover unwanted health habits with

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respect to the patients’ culture and personal beliefs and shed God’s answers to

ultimate health as a beacon of light.

Statement of Need

We are seeking funds to create and initiate our maternity program geared to

educating and providing care to those Hawaiians that are physically disabled.

Hawaii is an island of fantasy and beauty; therefore, most do not realize that Hawaii

is a state that is suffering economically. There is a limited amount of resources for

disabled citizens of Hawaii, yet a pregnant woman who is disabled may face

disadvantages based on social norms and stereotypes. According to the United

States Census Bureau of 2013, there were 1,404,054 people living in Hawaii

(United State Census Bureau, 2011). The demographic in the chart shows the need

for viable health care resources on the islands.

50%

5%

23%

22%

U.S. Census Demographics in Hawaii 2013

White Black Native Hawaiian Hispanic

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This chart represents the total demographic population of Hawaii. This chart

will be used to conduct a community needs assessment to determine the types of

services that we can offer the community, the types of cultures our agency services,

and the impact of rendered services. The demographic chart clearly displays that our

agency needs to offer care with sensitivity to culture and respect for natural health.

We chose Hawaii because of its natural habitat and its respect for natural health

concepts.

The chart below represents the income level of the native counterparts in

Hawaii. As spoken before, Hawaii can become a very expensive place to live and

raise children. The land is beautiful, but at a cost that many find its citizens poor and

out on the street. There are very few industries, in which most will consider gaining

certifications or degrees to gain employment. The employment industries who are

most considered to have a promising financial stability are tourism, hotel and

hospitality, ocean sciences, spa sciences, and restaurant. Back on the mainland,

people can venture into many industries, but in Hawaii, there are fine line choices in

educational opportunities.

In Hawaii, 10.8% of the population is living below poverty level (United State

Census Bureau, 2011). Tourists that come to Hawaii never see the real Hawaii.

Some Hawaiians sleep in the national parks, forest, or open fields. Most Hawaiian

survive by performing in street shows or hula shows to pay their rent at the YMCA.

Most come to the Hawaiian Islands to chase a dream of living in paradise, but it

comes at a steep price.

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The economic housing market in Hawaii as of 2013 is a minimum of

$517,000.00 and this is for your typical frame house. On the main land, this house

may cost roughly $50,000.00 depending on the location and in which the house is

located. The median income as of 2013 is $67,492.00 and that is the minimum

income that will keep a family above the poverty line. The population of disabled

pregnant women may become a burden on society resources because of the

limitations of mobility or mental capacity. Adjusting to a handicap can become an

emotional rollercoaster, but our agency will provide the counseling needed to

mentally prepare the women for the expectation of the birthing process and welfare

of the child.

Our targeted population is females within the age brackets of 15 – 20 years of

age. We will accept patients beyond the age bracket, but the grant monies used will

be targeted for this population. The total population of pregnant disabled Hawaiians

is unknown to the public, but the statistics of teen pregnancies are available to the

public for review.

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20 yr34%

15-17 yr8%

18-19 yr25%

15-19 total33%

Female Preganacies in Hawaii

The chart below also represents teen pregnancies, but it gives demographical

references to the population that is most affected.

White14%

Black/AA2%

Asian63%

Hispanic21%

Hawaii Teen Pregnancy De-mographics

The statistics were taken from the reproductive health website hosted by the

United States department of health and human services (US Department of Health

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and Human Services , 2013). The statistics show that the Asian population will

benefit most by the programs objectives. The Asian population is the largest

population of pregnancies in the Hawaiian Islands. Our agency wants to incorporate

healthy lifestyle teaching by incorporating patient-centered care models,

collaboration between other health agencies to establish a vital link to continuity in

care, provide safety for practitioners and patients, and establish a quality care

system to effectively ensure program goals and objectives meet the community’s

needs (QSEN Institute, 2013).

Impact

The impact of our goals will reduce the amounts of teen pregnancies in

Hawaii. Our agency will conduct public health seminars for females that are

disabled and at risk for pregnancy. Focusing on the grant criteria, our agency will

incorporate goals and objectives based on the families that we presently serve.

Every care plan is customized with the patient-centered care model in mind (QSEN

Institute, 2013). Programs such as this one do not exist in the counties of Oahu,

Maui, and Kauai. This program will enable the patients to live independently

without the need of health care services.

The agency embraces the philosophy of natural healing by linking

conventional and naturopathic interventions together to accomplish the goal of

independent living for both mother and baby. The impact of our efforts will also

enable us to serve the community without the need to cut other services for the sake

of funding.

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Sustainability

Native Hawaiian Spa and Birthing Clinic will sustain its funding by

accepting major insurance carriers such as Blue Cross Blue Shield and state

insurance such as Medicaid. The research supports our target population of

adolescent to early adult females. Our agency is requesting $150,000.00 USD to

implement the program as major insurance carriers may take weeks to reimburse the

agency for services rendered. The funds will be used to implement the program,

open depression accounts, and establish charity funds for those patient that may

qualify based on income.

The spa is open to all demographics, but the grant money will be used to

enhance the lives of many disabled women who desire to have children. To save

funds, the agency will employ subcontractors from other agencies that will provide

physical and occupation therapy to patients on our services. By taking this action,

our agency will save money in labor cost, DME material, and reimbursements in

travel time and other expenses.

The spa will sustain its programs by renewal grants funding, private

donations, and payments from major insurance carriers and state funded Medicaid.

Native Spa agency is nationally accredited by JACHO to accpet Medicare funding

for other services within the clinic such as prescribed aesthetician treatments for

psoriasis and message therapy for prevention of breach deliveries.

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Budget

Spa and Birthing Clinic, Inc Monthly Profit Loss and Gain

Total Expenses Accounts Receivables

Rent 5,000 Grants 150,000Utilities 480 Foundations 40,000Employee Labor Cost

9,000 Insurance 100,000

Supplies 700 Donations 3,000.00Reimbursements 200 Onsite Petty cash 300Property Taxes 8,000.00

Total Liabilities (23,680.00) Profit gain 29,300.00

Net profit 5,620.00

The budget is a snap shot of the present state of our program. The grant

section is a Hawaii state grant for midwives. We want to incorporate more funding

into our existing program that will include caring for pregnant disabled individuals

in Oahu. The grants that we are seeking will add more stability to our present

program as we expand our mission to other parts of the Hawaiian Islands.

The facilities space that we are presently renting will be essential to our

program. The space that is located next door will be an addition to our present

space. The space that is available for rent has more square footage that can

accommodate more patients that are in need of services. The space is multi versatile

and dimensional that can be used for group counseling services or classroom space

for birthing and wellness simulation for home living.

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Project management

The program will target disabled youths that are pregnant and meet financial

criteria that categorizes them as socially-economically disadvantaged. The program

has three stages in operation. First being the research, then initiation and

implementation of the plan, and lastly evaluation and monitoring. The program

implementation is listed below as follows,

The goals and objective will be met by hiring expert staff to administrate over the

program. The administrator will assign the program administration and evaluation

duties to a registered nurse who possesses a doctor of nursing practice degree. The

administrator over the program will assign tasks closely related to a formal study.

The project will be evaluated and monitored quarterly over a period of one year.

The program will be divided into sub blocks that will give the administrator snap

Evaluate the goals and objectives to ensure the program has satisfied in

intent.

Implement the program with expert teams to ensure quality

and committment to the patients.

Formulation of data and establishing program to meet

the need.

Foundational research and discovery of health problems.

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shots of the demographic of all patients, service upgrade and downgrades, and

evaluation of goals and objectives.

The project will have an organizational structure that will enable those that

have expert power to lead the team. Organizational structure will permit allied

health, nursing, and auxiliary professionals to commit to a scope of practice and

salary requirements.

The program will be evaluated for quality, financial stability, and risk

management every 90 days. Native Hawaiian spa is aimed to catching healthcare

waste. We do not want to offer services to clients that do not need them. According

to Nash, Healthcare cost consume one-sixth of our nation’s gross domestic products,

accounting for some $2.3 trillion annually in medically related expenditures and

significantly more in health related productivity losses (Nash et al, 2011).

RN Administrator

Allied Health Professionals

(NDs/MWs/Counselors

Nursing Assistant/ Medical Assistants

Message Therapy/Therapy

Associates

Public Health Professionals

Marketing and other professionals

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We want to make our healthcare program assessable, affordable, and reliable

for those patients that meet the financial obligation to receive care from our

program.

Enclosures

All documents have been submitted on the grants.gov website to support our

grant funding. The enclosures will include our small business organizational

structure and our banking information for electronic deposits. The grant criteria in

meeting the minimal requirements only specified the application and the narrative

statements. The enclosure that were scanned on the government website are facility

brochures, pricing list, 501 C 3 certification, and our contact information with the

local state government.

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EVALUATION MATRIX TEMPLATE

(Summary of an Evaluation Plan)

Title of Program to be Evaluated Pregnancy in Women with Disabilities

Evaluation Questions or Objectives

Evaluate the need for independent living and maternity education with pregnant disabled females in Oahu, Honolulu County. The goal is to expand the program to the other Hawaiian Island due to the great need.

Information Required Our agency has sought the information that is needed to apply for the grant to cover the expenses of an Island health care program.

The grantor is requiring that the agency informed them of the need for this program and the criteria that will be used to either eradicate the problem or build infrastructures to a solution.

Information Source The information about the issue at hand came from the Hawaii.gov website and the United States Health and Human Service reproductive agency.

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Method for Collecting Information

Our agency will conduct valid testing by participants that qualify based on income requirements. We will collect data by face-to-face interviews and informal surveys.

Information Collection Arrangements

By whom: The assigned employee, which may include the administrator of the program and the medical assistants.

Conditions: Electronic computer gathering with rating scales. Either the patients will come into the facility or we will conduct the short survey in their homes.

When: The program is separated in sub quarter blocks. The measurement will give our evaluators a snap shot in quality delivery, maintenance of health integrity, and collaboration with other service providers.

Analysis Procedures The agency will seek electronic measurement systems to ensure accuracy of the raw data collected.

The data will be interpreted and forwarded to the facility administrator for immediate decision as to changes in the program or disqualify the program.

Risk management analysis and financial test will be conducted and reviewed to ensure that the program

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is within limits of the grant funds.

Interpretation Procedures The data is then interpreted by the administrator of the program and then forwarded to the facility administrator and the IRB. The manager of the program will receive a program goal and objective change model or a permission to precede letter to continue to the study.

Reporting of Information Once the final report is generated and the program goals and objectives have been met, the program grant writer will continue to apply for grants in this area of study. The program will become a permanent program in our organization.

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References

Carter, B. (2013). Great prenancy exercise. Prenatal Yoga, pg 1. Retrieved from Prenatal Exercise. http://www.babycenter.com/pregnancy-exercises

Pender, N. M. (2011). Health promotion in nursing practice 6th (ed) . Upper Saddle River, NJ: Pearson Publishing .

QSEN Institute. (2013). Graduate level QSEN competencies: Knowledge, skill and attitiude. Retrieved from Quality Safety Education for Nurses: http://qsen.org/competencies/graduate-ksas/

United State Census Bureau. (2011). State and county quick facts. Washington D.C.: United State Census.

United States Department of Justice. (2009). A guide to disability rights and laws . Retrieved from US Department of Justice Civil Rights Division : Retrieved from: http://www.ada.gov/cguide.htm#anchor64984

US Department of Health and Human Services.(2013).Reproductive health . Retrieved from Office of Adolensant Health: Retreieved from http://www.hhs.gov/ash/oah/adolescent-health-topics/reproductive-health/states/hi.html