Healthy Hearts in Kent County

1. Healthy Hearts in Kent County Alanna Fant, Julie Ivey, Cassandra Kotlarczk, Aundrea Robinson-Burris, Ashley Weststrate Ferris State University NURS 440 http://www.kentcountychna.org/pdfs/KentCoCHNA_Final.pdf

2. Introduction/Need for Service Heart disease is the leading cause of death and hospitalizations in Kent County (Michigan Department of Community Health, 2012). For many people, the first sign of heart disease is a heart attack (Centers for Disease Control and Prevention, n.d.). In Kent County, people who have an annual income of less than 20,000 dollars a year have higher risks of developing heart disease than those who have higher annual incomes (Kent County Health Department, 2010). Through a brief review of the health statistics for this community it was determined that a need exists for a mobile health unit that offers screening and education to address heart disease for the residents of Kent County at times and locations that are convenient for the communities who are at higher risk for this disease.

3. Mission Statement/Philosophy Mission Statement Healthy Hearts in Kent County is a mobile nonprofit organization that pursues excellence in healthcare by improving the accessibility of education and preventative services to communities in the Kent County area that are vulnerable to heart disease. This organization is committed to helping individuals and families of Kent County improve their quality of life and prevent harmful diseases; primarily heart disease and diseases and conditions that increase the risk of developing heart disease. Philosophy Healthy Hearts in Kent County is an organization that will use the American Nurses’ Association Standards of Practice to improve the heart health of communities in the Kent County area. We value diversity, health promotion, education, and quality care. Through education and evaluation of the Kent County community using the nursing process, we will uphold a commitment to standards of care and respect of the nursing profession. Using the Nursing Code of Ethics as a guideline we seek to improve access to healthcare in communities at risk for developing heart disease. Our work will be based on evidence based research to ensure that we are optimizing our resources. Overall, we believe that everyone has the right equal health care despite their background, ethnicity, race, socioeconomic background or social status.

4. Goals 1. Ensure low income and uninsured people of the community have access to preventative health screens and education regarding cardiac disease. 2. To decrease cardiac heart disease in the community by educating the public and providing screenings. 3. Provide accessible health care with convenient hours for working people via a mobile health vehicle that goes to the people. 4. Help the community take control of their health by communicating, educating, and encouraging engagement of each individual's care. 5. Provide information about community programs in the area that will assist with their health. 6. Provide information and resources on smoking cessation and teach how smoking and heart disease are directly related.

5. Objectives •To evaluate a client’s blood pressure, heart rate, resting respiratory rate, Sp02, blood sugar, and BMI at every visit and discuss what it means. •To evaluate a client’s cholesterol and schedule a follow-up to go over the result and what it means at the first visit. •To continuously educate clients about heart disease, its symptoms and the long-term effects of the disease during the course of their involvement in the program. •To educate clients on identifying and reducing their own risk factors for heart disease on the first visit. •To provide clients with a pamphlet of nutritional information and where to purchase healthy foods in different areas in Kent County at every visit. •To continuously educate clients about the importance of physical activity and its relevance to heart disease during the course of their involvement in the program.

6. Summary of Job Descriptions CEO The Chief Executive Officer (CEO) will manage strategic and operational function of Healthy Hearts in Kent County’s staff, programs, expansion, and execution of its mission (Bridgespan Group Inc., 2010). This individual will develop an excellent display of knowledge of the organization's philosophy, mission, goals and objectives. This individual will collaborate with the Board of Directors (Bridgespan Group Inc., 2010). This individual will enable the Board to fulfill its governance function while also giving direction and leadership toward the achievement of the organization's philosophy, mission, goals and objectives and represent the organization as an ambassador to the community (Bridgespan Group Inc., 2010). The Chief Executive Officer (CEO) will manage strategic and operational function of Healthy Hearts in Kent County’s staff, programs, expansion, and execution of its mission (Bridgespan Group Inc., 2010). This individual will develop an excellent display of knowledge of the organization's philosophy, mission, goals and objectives. This individual will collaborate with the Board of Directors (Bridgespan Group Inc., 2010). This individual will enable the Board to fulfill its governance function while also giving direction and leadership toward the achievement of the organization's philosophy, mission, goals and objectives and represent the organization as an ambassador to the community (Bridgespan Group Inc., 2010)..

7. Summary of Job Descriptions Chief Nursing Officer The Chief Nursing/Medical Officer provides advanced client assessment and education based on the mission and values of Healthy Hearts in Kent County. This individual will provides client education and referrals within the nursing scope of practice as indicated by the American Nurses Association Standards of Professional practice and the Nursing Code of Ethics.

8. Summary of Job Descriptions Chief Financial Officer Position This individual will provide financial information to management and staff of Healthy Hearts in Kent County by keeping numbers and analyzing accounting data and preparing reports for staff meetings. This individual will work as a team member on the board of directors and act as counselor to the CEO in all financial areas. Job duties: Develop, implement, modify, and document recordkeeping and accounting systems, making use of current computer technology. • Reports to the Chief Executive Officer • Will participate as a board member on the board of directors. • Will maintain confidentiality in all aspects of health care and finances. • Prepares asset, liability, and capital account entries by compiling and analyzing account information • Documents financial transactions by entering account information. • Recommends financial actions by analyzing accounting options. • Summarizes current financial status by collecting information; preparing balance sheet, profit and loss statement, and other reports.. • Guides CEO, board of directors, and all nursing staff financially by coordinating activities and answering questions. • Reconciles financial discrepancies by collecting and analyzing account information. • Secures financial information by completing data base backups. • Maintains financial security • Answers accounting procedure questions by researching and interpreting accounting policy and regulations. • Complies with federal, state, and local financial legal requirements by studying existing and new legislation, enforcing adherence to requirements, and advising management on needed actions. • Prepares special financial reports by collecting, analyzing, and summarizing account information and trends. • Maintains customer confidence and protects operations by keeping financial information confidential. • Maintains professional and technical knowledge by attending educational workshops and reviewing professional publications

9. Summary of Job Descriptions Chief Administrative Officer (Administrative Assistant) Position: • Reports to the Chief Executive Officer • This position shall be the primary person responsible for all secretarial and clerical work associated with the mobile health clinic for Healthy Hearts in Kent County. • This position must handle all matters in a professional and confidential manner. • This is a full-time position located in the Kent County area, specifically the Baxter Community, and has variable hours to accommodate the community. Duties and Responsibilities: • Work as part of a team to provide quality patient care and assist with the daily functions of the mobile health unit. • Demonstrates interpersonal communication skills with an upbeat, positive attitude. • Ability to work a clerical position. • Answer phone calls, emails and messages. • Process incoming mail. • Assist in preparation for all meetings. This includes compilation of agendas, distribution of materials, preparation of meeting minutes and meeting area, as directed. • Assist patients with setting up office visit appointments or follow up with the mobile health clinic for further testing or results on tests. • Maintain inventory, order and organized office supplies. • Maintain professional appearance, professional office and working environment. • Be willing to travel with the mobile health unit as needed.

10. Summary of Job Descriptions Board Member Job Description The Board will support the work of Healthy Hearts in Kent County and provide mission-based leadership and strategic governance (Bridgespan Group Inc., 2010). While day-to-day operations are led by Healthy Hearts in Kent County’s Chief Executive Officer (CEO), the Board-CEO relationship is a partnership, and the appropriate involvement of the Board is both critical and expected (Bridgespan Group Inc., 2010). Board of Directors will include: • Chief Executive Officer (CEO) • Chief Financial Officer (CFO) • Chief Nursing Officer (CNO) • Administrative Assistant

11. Summary of Job Descriptions RN The Registered nurse provides patient assessment and education based on the mission and values of the Healthy Hearts in Kent County. The registered nurse complies patient history and assess risk factors for cardiovascular disease and provides education in healthy behavior choices and risk factor reduction. Also provides referrals to the appropriate agencies as needed. Nursing Assistant The assistive personnel will assist the registered nurse in basic information compilation of patient information, measurement of client vital signs, and Accu check blood glucose measurements. Provide client care within the mission and values of Healthy Hearts in Kent County.

12. Summary of Job Descriptions Bus Driver: Skilled work in the operation of light and heavy buses in driving health care staff and volunteers to and from specific areas in the county.

13. Marketing Plan and Strategies • The local newspaper Grand Rapids Press found at www.mlive.com.grpress. Cost to advertise: $195 for 30 days • The American Nurses Association found at www.ana.org Cost to advertise: $125 for 30 days • Other advertising sources: Radio and personal mail • The bus itself will provide mobile advertising/Billboard

14. Advertisement Calling All Nurses!!! Discover what you can achieve when you're not only encouraged to transform care, but given the opportunities as well. Healthy Hearts in Kent County is more than a career, it's a calling. Come and join our team of nurses dedicated to health promotion and illness prevention and make a difference in the lives of those in Kent County who need it most. ARE YOU LOOKING FOR AN EXCITING JOB WHERE YOU CAN MAKE A DIFFERENCE IN THE COMMUNITY? GET ON THE BUS AND JOIN OUR TEAM! Healthy Hearts in Kent County-Grand Rapids, MI

15. Service Plan Budget “The basic financial document in most healthcare organizations is the budget—a detailed financial plan for carrying out the activities an organization wants to accomplish for a certain period of time” (Yoder-Wise, 2011, p. 239). Budgets are important for any business and organization because it examines the proposed income and expenditures in terms of dollars. A one-year budget was calculated for Healthy Hearts in Kent County by looking at personnel salaries, hours of service, reimbursement/funding, and supplies and operating expenses. By putting together a budget, this “requires managers to plan ahead and to establish explicit program goals and expectations (Yoder-Wise, 2011, p. 239).

16. Budget- Personnel Salaries Chief Executive Officer (CEO) Full time Salary: $130,000-150,000/year Chief Financial Officer (CFO) Full time Salary: $150,000- 175,000/year Chief Nursing Officer Full time Salary: $102,000-156,000 Non-Profit Administrative Assistant Part time Salary: $25,000/year

17. Budget- Personnel Salaries (cont) Registered Nurse Full time Salary: $58,000-64,000/year Part time Paid by the hour: $26-40/hour Certified Nursing Assistant Full time Salary: $20,000-24,000 Part time Paid by the hour: $9.50-12/hour Bus Driver Full time Salary: $35,520/year Part time Paid by the hour: $17.08

18. Hours of Operation Two week repeating schedule: Tuesday-Friday 1pm-9pm Saturday 10am-6pm Monday-Friday 1pm-9pm Closed Sundays, New Year's Day, Easter, Memorial Day, Independence Day, Labor Day, Thanksgiving and Christmas

19. Reimbursement • sliding scale fee based on income will be used *patients with family incomes between 100-200% of the FPL are charged according to a sliding scale of discounts, which should reflect a nominal charge. • Kent County has their own local grants • Robert Wood Johnson Foundation Grants • The Mobile Health Clinics Association website has multiple grants • donations and fundraising events *Donations can come from local nursing organization chapters, churches, hospitals in the area, primary care practices, and the American Heart Association. Local YMCAs can also do fundraising events through bike-a-thons or swim-a-thons to raise money and awareness to Healthy Hearts in Kent County’s cause.

20. Supplies and Operating Expenses Cholestech LDX System $260 Lifepak 12 cable & limb leads & Blood Glucose Monitoring $520 Lifepak 126-wire EKG leads X-Large Adult BP cuff $90 Thermometer Blood Glucose Monitoring $19.95 Scale Test Lancets (100/box) $14.85 Stethoscopes Test Strips (50/box) Computers BG Monitoring Control Soln Medical program Lifepak 12 BMI chart Quick combo able (for AED) information packets (paper, Hands free paddles (for AED) Gloves (different sizes) BP hose Masks Sp02 extension cable Miscellaneous Sp02 sensor Manual blood pressure cuff BP cuff small adult Total Cost: $10,308.78 BP cull Large Adult Mobile Health Clinical Vehicle: $80,000.00

21. Compare the Costs "In 2010, the total costs of cardiovascular diseases in the United States were estimated to be $444 billion. Treatment of these diseases accounts for about $1 of every $6 spent on health care in this country" (Centers for Disease Control and Prevention, 2010, para 3). The average cost per hospital stay for heart valve disorders is $36,700 (Tillman, 2012). The projected annual cost for Healthy Hearts in Kent County to operate properly in its first year of inception is $746,243.60. The beginning base salaries were used to allow room for growth and to recognize the initiation of a new program.

22. References ANA nurse's career center (n.d.). Retrieved fromhttp://jobs.ana.org/rates.cfm Bridgespan Group Inc. (2010). Chief executive officer job description. Retrieved from http://www.bridgespan.org/getattachment/cf0eabfc-c5d4-4870 -816b-e004f27eef7f/Board-Member-ob-Description-Sample.aspx Centers for Disease Control and prevention. (2010, July 21). Heart Disease and Stroke Prevention: Addressing the Nation's Leading Killers. Retrieved from http://www.cdc.gov/chronicdisease/resources/publications/AAG/dhdsp.htm Education Portal (2013) Retrieved from http://education-portal.com/articles/Healthcare_ Accounting_Job_Descriptions_and_Education_Requirements.html Harkness, G.A., & DeMarco, R.F. (2012). Community and Public Health Nursing: Evidence for Practice. Philadelphia, PA: Wolters Kluwer Health/ Lippincott Williams & Wilkins.

23. References Indeed. (2013). Chief nursing officer salary in Michigan. Retrieved from http://www.indeed.com/salary?q1=Chief+Nursing+Officer&l1=Michigan Indeed. (2013). RN Salary in Grand Rapids, MI. Retrieved from http://www.indeed.com/salary/q-RN-l-Grand-Rapids,-MI.html Kent County Health Department. (2010). 2008 Behavioral risk factor survey. Retrieved from http://www.accesskent.com/Health/HealthDepartment/ Post jobs and search resumes in Michigan (n.d.). Retrieved from http://www.mlive.com/jobs/products/ Tillman, A. (2012, February 23). What you need to know about the real cost of heart disease. http://www.lifehealthpro.com/2012/02/23/ what-you-need-to-know-about-the-real-cost-of-heart Yoder-Wise, P.S. (2011). Leading and Managing in Nursing. (5th ed.) St. Louis, MO: Elsevier Mosby.