The Grand Rapids Group Care Free Clinic is requesting a $125,000 grant to start a diabetes clinic and program. The clinic currently provides free healthcare to underserved individuals in Grand Rapids, Michigan. The diabetes program objectives are to maintain primary healthcare services and provide specialty diabetic care through a wellness program, education, and integrating treatment into daily operations. The funding would support staffing, supplies, and evaluating the program's effectiveness in managing diabetes and preventing its spread in the community over one year.

1. 12/09/15
Ms. Michelle Wooddell
BaileyDog Foundation
Grand Valley State University
244c DeVos Building
Pew Campus
Grand Rapids, MI
RE: Grand Rapids Group Care Free Clinic’s Diabetes Clinic & Program
Dear Ms. Wooddell,
The Grand Rapids Group Care Free Clinic (GRGCFC) is pleased to present this proposal for
review. We look very forward to a collaborative effort with the BaileyDog Foundation in order
to provide exceptional healthcare in the field of Diabetic Care. The GRGFC in Grand Rapids,
Michigan is a free healthcare clinic that provides primary and specialty care to the underserved
and uninsured of Grand Rapids Michigan. Its’ mission is to provide free equality healthcare to
whomever may need it. GRGFC’s vision is to address the significant need for quality healthcare
services and to eliminate healthcare disparity among the underserved and uninsured. Objectives
for the clinic are to maintain a state of the art primary healthcare clinic and to provide timely
healthcare access to all in need of primary or specialty care, whether children or adults, with no
healthcare insurance, nor existing means in order to avoid infrequent, disjointed emergency room
visits thereby creating a convenient location for medical services.
GRGCFC seeks a grant in the amount of $125,000 to address the needs of the Grand Rapids
population suffering from diabetes mellitus by implementing a Diabetes Wellness Program as
well as providing Diabetic Care into the clinic’s daily operations.
The GRGCFC has seen great success in the first one and a half years of operation by providing
access to 25,000 individuals who do not have access to healthcare by not being able to afford it.
The GRGCFC takes pride in caring for the underserved community and being able to provide the
highest quality of healthcare to individuals who would not normally be able to have access to it.
The clinic recently received its certification as a nationally recognized free health care clinic and
has won awards based on the excellence of healthcare and the staff that we have. With that
success, we would like to address the concerns of a debilitating chronic disease that is affecting
the Greater Grand Rapids area and that is Diabetes Mellitus. With the help of this grant, we hope
not only to continue to provide excellent healthcare to the underserved communities but also to
provide the best level of diabetic care to individuals that would normally not have the ability to
manage their diabetes care. The program would also like to prevent diabetes through Wellness
Education and proper Nutrition.

2. We appreciate the interest of the BaileyDog Foundation in our endeavors. If you have any
questions about the grant or would like any information do not hesitate to give me a call at (616)
843-6521.
Thank you,
Dr. Keondae R. Ervin, MD, FACS
CEO/President of Grand Rapids Group Care Free Clinic & Operations
5685 S. Division Ave
Kentwood, MI 49548
Kyle Smith, PA-C
Physician Assistant at Spectrum Butterworth Hospital
President of the Board of Directors
(Signature indicating the approval for the board going forward with proposal)
Dr. Miranda Sloan, DrPH, MPH
Hospital Epidemiologist at Spectrum Butterworth Hospital
Vice President of the Board of Directors
(Signature indicating the approval for the board going forward with proposal)

3. Organizational Information
Main Contact Person for Proposal:
Dr. Keondae R. Ervin, MD, FACS
CEO/President of Grand Rapids Group Care Free Clinic & Operations
ervin1kr@msu.edu
(616) 843-6521
Mission and Background of Organization:
Our Mission: Grand Rapids Group Care Free Clinic exists to provide free quality healthcare to
the underserved and uninsured in greater Grand Rapids.
Vision: To address the significant need for quality healthcare services and to eliminate
healthcare disparity among the underserved and uninsured.
Objectives:
 Maintain a state of the art primary health care clinic
 Provide timely healthcare access to all in need of primary or specialty care, whether
children of adults, with no healthcare insurance, nor existing means in order to avoid
infrequent, disjointed emergency room visit thereby creating a convenient location for
medical services.

4. Diabetes Mellitus which is known as diabetes occurs as a result of metabolic diseases that
occur when there is a prolonged time of high blood sugar levels. According to the CDC, more
than 29 million Americans have diabetes (which equates to 9.3%) However, one out of every
four individuals do not know that they have diabetes. The statistics are up from 26 million
individuals which was measured in 2010. Another discouraging fact is that upwards of 86
million American adults are disposed to diabetes by having a condition known as prediabetes.
This condition occurs when the blood sugar levels are in fact higher than normal, but do not fit
the criteria to be classified as type 2 diabetes. This translates to more than one out of three
Americans. The CDC also states that individuals (roughly 15 to 30%) that have prediabetes are
destined to develop type 2 diabetes within a timeframe of five years without proper diet and
exercise.
The Greater Grand Rapids area has expressed a need for the care of Diabetes Mellitus for
the individuals that cannot afford healthcare. There is about 28% of individuals in the Greater
Grand Rapids area that live below the poverty level and with roughly 41% of the individuals in
the Greater Grand Rapids area that cannot afford healthcare, the need has been dire. With a
collaboration effort from Grand Valley State University Nursing School, Michigan State
University College of Human Medicine, and Spectrum Health, adding this program to the Grand
Rapids Group Care Free Clinic (GRGCFC) located in Grand Rapids, MI was ideal. The
GRGCFC has been successful for the past one and half years and has been thriving with the help
of private donations, successful grants and fundraising. This free healthcare clinic has addressed
the issue of providing free and quality healthcare to the individuals of need in the Greater Grand
Rapids area. The Clinic is certified by the Association of Free Primary Healthcare Clinics and

5. has won many awards in the community for the excellent healthcare given to the population of
need.
The objectives of the proposed diabetic health clinic is twofold. Both ideals build upon
the success of the existing healthcare clinic. In addition, the objectives of the proposed addition
consists of maintaining a state of the art primary health care clinic and well as a diabetic
specialty clinic. In addition, another objective is to provide timely healthcare access to all in need
specialty care more specifically endocrinology and diabetic care, whether children of adults, with
no healthcare insurance, nor existing means in order to avoid infrequent, disjointed emergency
room visit thereby creating a convenient location for medical services. Another objective of the
diabetic clinic is to consult individuals in emergent situations by providing the necessary care to
stabilize the patient, then be able to help the patient receive the full care that they are needing.
The last but primary objective is to provide a well-rounded education in the prevention of
diabetic care as well as diabetic care.

6. Main Focal Points of the Project:
 Diabetes Wellness Program
 Patient Engagement Platform (In conjunction with Spectrum Health’s Department of
Endocrinology)
 Essential Nutrition
 The overarching goal of Grand Rapids Group Care Free Clinic’s diabetes program
 Non-profit research for people with diabetes (In conjunction with Spectrum Butterworth
Hospital)
 Be a catalyst for reduction in statistics of cases of diabetes mellitus.
Projected Time Frame of Diabetic Clinic Plan
6 Months Prior to the Start of the Grant:
 Hire Marketing Professional for the Program and begin implementing the tools for the
advertising of the program.
 In Collaboration of existing Medical Director of the Clinic and the Endocrinologist
contracted through Spectrum Butterworth Hospital, create advertisements for the hiring
of the support staff including Nurses, Receptionist, PH Professional, Nutritionist,
Analyst/Evaluator and a PA.
Four Months Prior to the Start of the Grant:
 Finalize the hiring of the support staff
 Assess the Marketing techniques done by the Marketing Professional

7.  Meet with the Collaboration Schools/Programs in order to set up the education of future
health professionals
o Meeting with the heads of the Grand Valley State University Nursing School,
MSU College of Human Medicine and the Spectrum Butterworth Hospital and
implementing internships and externships with medical and health education
1-2 Months Prior to the Start of the Grant:
 Purchase the necessary equipment for the program
 Begin the training programs and protocols for the Diabetes Clinic
 Continue and Finalize Marketing Techniques
 Bring Professionals from Collaborative institutes to give approval and modifications as
necessary for the opening of the Diabetic Clinic.
 Finalizing Medical Education and Nursing Education with internships.
Open the Clinic with the proposed hours: Monday, Wednesday & Friday 8 am to 5 pm and
Saturday from 9 am to 1 pm. Also provide Diabetic Education Programs Tuesday and
Thursday evening from 5:30 pm to 7:30 pm.
3-6 Months after the Program Starting:
 Implement the Analyst/Evaluator for the program. The Evaluator will analyze:
o The effectiveness of the healthcare staff through surveys and shadowing
o The effectiveness of the Diabetes Wellness Education Program through surveys
and shadowing.
o Analyze the Clinical Aspects of the Diabetic Cases via Healthcare Analysis

8. o Collaborate the Healthcare Analysis with the consulted cases turned over to
Spectrum Butterworth Hospital to evaluate the care of the emergency cases.
o Analyze the effectiveness of the program and ensure that it can run for another
year.
o Complete cost analyst to make necessary cost cutting measures for the future of
the program.
 After determining the effectiveness of the program, meet with the board and implement
other methods of program funding for the next year.
Up to a year prior to the Opening (Post six months):
 Continue Analysis/Evaluations
 Preparation for the next year
The Geographic Boundaries of the proposed program include:
 Wyoming, MI
 Kentwood, MI
 Greater Grand Rapids, MI (bounded by city limits)
 Walker, MI
 Allendale, MI
The following ZIP codes that are included in the proposed program include:
49534, 49504, 49503, 49506, 49507, 49508, 49548, 49546, 49512

9. Relevant Qualifications of Staff:
 Physician Assistant
o Have an individual certified by the Board of Physicians Assistants (State of
Michigan Certification)
o Have experience in Internal Medicine/Endocrinology
o Have 3-5 years experience of being a PA
o Have all necessary medical certifications and training done (Bloodborne
pathogens, CPR certification, Advanced Cardiac Care etc.)
 Nutritionist/Dietitian
o Board Certified as a Nutritionist
o Have Experience in Diabetic Nutrition
o Have 2-3 years experience of being a Nutritionist
o Have all necessary medical/health professional certifications.
 Nurses (R.N.)
o Have Certification of being a Nurse in the State of Michigan
o Have experience in Diabetic Care
o 1-2 years experience as a registered nurse.
o Have all necessary medical certifications and training done (Bloodborne
pathogens, CPR certification, Advanced Cardiac Care etc.)
 Receptionist
o Have Experience in a Medical Office Setting/Customer Care Setting
o Have 1-3 years experience.
 Evaluator/Analyst

10. o Have a B.S. or M.S./M.H.A./M.S.A/M.B.A in Healthcare Administration,
Finance, Business Administration
o Have experience in Health Care Analysis through work experience or
internship(s): 0-2 years of experience.
o Have experience in Statistical Packaging Software (SAS, Minitab)
o Have experience with Healthcare Software related to the analysis of Healthcare
Data
 PH Educator
o Have completed a M.P.H or Public Health related degree
o Have CHES certification
o Have experience in Health Education/Endocrinology Education
o 0-2 years experience
 Marketing Professional
o Have a Bachelor Degree or higher in Marketing
o Have a proven track record of success
o Have 1-3 years experience as a Marketing Professional

11. Affiliations and Partnerships
 Spectrum Health/Butterworth Hospital
o Responsible for the Hiring and Retention of the Endocrinologist
o Collaborative effort of the Transportation of the Lab Specimens
o Collaborative Effort of the Evaluator/Analyst between the Clinic and the referred
cases to Spectrum Butterworth Hospital
 Michigan State University College of Human Medicine
o Affiliate of Medical Students with rotations in Internal Medicine during Medical
Students Internship years.
o Implementation of selection and retention of medical students.
 Grand Valley State University College of Nursing
o Affiliate of Nursing Students with rotations during Nursing School Internships
o Implementation of selection and retention of nursing students

12. This is an addition to the free health clinic, there are costs that would normally be associated
with the costs of the program, however these costs are already covered based on the already
existing clinic. There are also things that are not included in the budget because there is no cost.
All things included (not towards the budget are):
 Medical Director for the Clinic: This cost was already allocated prior to the addition of
the diabetes clinic.
 Medical Students: They are learning for their education and they are still in training and
is in collaboration with Michigan State University College of Human Medicine.
 Nursing Students: They are learning for their education as well and are still in training
and is in collaboration with Grand Valley State University.
 Endocrinologist: A highly specialized physician who has been contracted from Spectrum
Butterworth Hospital via hospital affiliation. This physician gets paid through Spectrum
Health.
The requested grant amount is $125,000.00
Direct Costs (Used for the staffing of the program): The clinic is only open 31 hours per week,
and salary/wages will reflect that.
 Physician Assistant specialized in Internal Medicine/Endocrinology at an hourly wage of
$51.22/hour. 30 hours/week = $79,903.20 (without medical benefits)

13.  Nurses (Part-time). There will be three nurses (R.N.) hired for part-time work at an
hourly rate of 27.58/hour for twenty hours per week for a total of 60 hours per week =
$86049.50
 Nutritionist: Who is licensed and certified with experience. Hired for part time work at 15
hours/week at a rate of 24.29/hour = 18,946.20
 Receptionist: Who will work the desk and schedule appointments and make referrals will
be provided with no medical benefits. Person will work at an hourly rate of 14.86/hour
for 31 hours/week = $23954.32
 Evaluator/Analyst: To assess the medical treatments/databases and evaluate the program
at a fixed contracted rate of $8,500.00
 Marketing: An individual whose sole responsibility it to market the diabetes clinic prior
to the opening of the clinic and the first few months of the clinic. The hourly rate will be
$23/hour for 30 hours per week for 16 weeks for a total of $11,040.00
 Public Health Specialist who has a CHES certification and will conduct Diabetes
Education courses twice per week. The hourly rate will be $32/hour and work totaling 8
hours per week for a total of $13,312.00
Direct Costs Total: $241,705.22
Indirect Costs for the Program
 Transportation (Of Specimens for Lab Work transported to Area Spectrum Hospital) at
$150.00/week for a total of $7,800.00
 Technology for the Clinic
o Two computers: $1,000.00

14. o Projector/Equipment for Education: $850.00
o Printer (Multi-system including fax): $250.00
 Fliers for the Marketing Program: $250.00
 Medical Supplies related to the care of Type 2 Diabetes: $13144.98
Indirect Costs Total: $23,294.98
Grand Total: $265,000.00
For the $125,000 grant, the organization will put up the required 50% for the grant as well
as additional monies through private donations and fundraising totaling $140,000.00. The
$140,000.00 has already been procured through previous mentioned sources and help from
the affiliation of Spectrum Health System. The Proposed funds and the budget are to last
for one fiscal year.

15. Line Item Budget
Direct Costs
Physician Assistant $79,903.20
Nurses $86,049.50
Nutritionist $18,946.20
Receptionist $23,954.32
Evaluator/Analyst $8,500.00
Marketing $11,040.00
Public Health Specialist $13,312.00
Indirect Costs
Transportation of Lab
Specimens
$7,800.00
Two Computers $1,000.00
Projector/Equipment $850.00
Multi-system Printer $250.00
Fliers for Marketing $250.00
Medical Supplies for Care $13,144.98
Grand Total: $265,000.00
Provisions of the proposed budget for the future will be contingent upon the success of the
Diabetes Clinic and the need (reduction or expansion) for staff. The budget can vary by
several thousands of dollars and will need to be evaluated 4-6 months prior to the next year
of the program.

16. Insert the Organization Operational Budget for the Fiscal Year

17. Insert Copy of the Recent Certified Financial Audit

18. Insert Copy of the Most Recent IRS 501 (c) Federal Tax Exemption Letter

19. Insert List of Current Board of Directors (in Affiliation with Spectrum Butterworth
Hospital)

20. Insert Letters of Support From the Affiliation Programs/Partners

21. Insert Resumes of Support Staff for the Program

22. Insert Copy of the Most Recent Annual Report