2. Presentation by Amber Gall, Allyson Grutter, Sarah Gurd, Shirley Iler, and Kimberly Kerridge

3.  According to Yoder-Wise (2011) “Changing economic and demographic characteristics of many communities are resulting in a larger number of uninsured individuals. Geographic isolation often limits access to necessary health services” (p. 129).  Barry County, Michigan Population 58,820 (2010 Census Bureau)  8.9% living below poverty  15% elderly over the age of 65.  19% Urban and 81% rural (City-Data, 2010)  January, 2011 unemployment rate 9.1% (Find the Data, 2012).

4.  9.1% of population in Barry County is diagnosed with Diabetes – greater than national average of 8.3%  Obesity rate is over 30% (Find the Data, 2012).  Diabetes accounted for 5.1% of preventable hospitalizations in Barry County (Department of Community Health, 2012b).

5. On the Road to Diabetes Wellness is a not- for-profit healthcare organization that will work to improve the health of the diabetic population in Barry County by providing education and support to reduce the burden of diabetes in an underserved population.

6.  We believe ◦ In improving the health of the diabetic population ◦ The need exists to reach the underserved population. ◦ Providing a means for healthcare to be more accessible will allow the patient to take an active role in managing their illness. ◦ Educating patients about their diabetes will promote healthier lifestyles with less complications, and thus, less hospitalizations. ◦ In providing current, evidence-based, nursing care.

7. To improve the overall health of the diabetic population To provide community support for the diabetic population To develop a comprehensive, individualized plan of care for each diabetic patient.

8.  To educate patients and caregivers on how to identify and achieve appropriate blood sugar levels, A1C levels, and proper foot inspections within the first visit.

9.  To travel to at least four rural communities each month and offer diabetes education classes.  To develop an individualized plan of care for each diabetic patient to include nutrition plans, physical activity, monitoring and treatment of blood sugar levels, medication adherence and administration, and lab testing.

10.  On the Road to Diabetes Wellness is aligned within the organizational chart of Pennock Health Systems. ◦ Medical Director – Already on staff and will add oversight of this program to his/her current duties. ◦ Registered Nurse – 0.5 FTE position to be posted. ◦ Medical Assistant – 0.5 FTE position to be posted. ◦ Volunteers – Recruited from local medical and nursing programs as needed.

11.  Current licensure as registered nurse, BSN preferably, with at least 2 years of clinical experience.  Utilization of the nursing process to coordinate, plan and implement care of diabetic patients.  Ability to function independently and use critical thinking skills.  Use of electronic medical record.  Use evidence-based practice to promote preventative health measures.  Provide diabetic education to a diverse community.  Collaborate with other team members.  Valid driver’s license.  Basic life support certification.

12.  Current medical assistant certification.  Provide support services to RN and MD.  Knowledge of medical terminology.  Knowledge of third party billing.  Obtain lab specimens.  Obtain patient history and vital medical information.  Strong computer skills and use of electronic medical record.  Ordering of medical supplies.  Maintain diagnostic equipment.  Valid driver’s license.  Basic Life Support certification.  Ability to work with a diverse population.

13. ExpensesProjected 2012Budget 2012 Wages$45,240 Fringe Benefits$16,000 Medical Supplies$ 1,570 Office Supplies$ 482$ 508 Small Equipment$ 3,660$ 3,850 Mileage$ 4,015$ 4,225 Maintenance$ 1,003$ 1,056 Advertising$ 112$ 117 Other$ 575$ 605 Bad Debt$$ 10 TOTALS$72,657$73,261

14. Gross Patient Revenue 12 pts/day @ $35 each $1,680/month X12 months $20,160.00 InsurancePayor MixAdjustment BCBS336.00299.04 (299.04) Commercial 84.00 75.60 ( 75.60) Medicaid252.00 37.80 ( 37.80) Medicare756.00302.40 (302.40) Self-Pay 84.00 Deduct./Copay 84.00 Grants$10,000.00 Donations$ 5,000.00 Fundraiser$ 2,800.00 TOTAL$37,413.16

15. Community Public service announcements, hospital website, medical practices, schools, community organizations  Marketing will take place in the following locations: ◦ Pennock Healthcare Systems ◦ Charitable Organizations ◦ Local Auto Dealership ◦ Medical Practices  Strategies ◦ Identify the need – share the external environmental assessment findings. ◦ Share the mission, objectives, and goals. ◦ Open communication ◦ Create a timetable of activities and monitor performance

16.  Vision directed program  Enhancing the care of diabetic population within rural communities.  We are taking the service, diabetic education and management, directly to the patients

17.  City-Data. (2010). Barry County, Michigan (MI). Retrieved from http://www.city-data.com/county/Barry_County-MI.html  Department of Community Health. (2012b). Total population estimate by county Michigan, 2010. Retrieved from http://www.mdch.state.mi.us/pha/osr/CHI/POP/PO10CO1.htm  Find the Data. (2012). Barry county, Michigan health information 2007. Retrieved from http://diabetes- obesity.findthedata.org/1/4378/Barry-County-MI  National Diabetes Information Clearinghouse (NDIC). (2012). National diabetes statistics, 2011. Retrieved from http://www.diabetes.niddk.nih.gov/dm/pubs/statistics/#fast  United States Census Bureau. (2012). United States census bureau state and county quickfacts. Retrieved from http://quickfacts.census.gov/qfd/states/26/26015.html  Yoder-Wise P.S. 2011 Leading and managing in nursing (5 ed.). St. Louis, MO: Elselvier-Mosby.