Health Care on Wheels Contact: Debbie Adams Phone: 713.974.1217 Email: dadams@rmhcghg.org Houston Children’s Charity Funding Request The Ronald McDonald Care Mobile® is a two-room medical unit that travels to the most medically underserved areas of our community and provides free basic healthcare and education to children who may not receive these services otherwise. It is operated by Texas Children’s Hospital and staffed by Baylor College of Medicine. We are requesting $86,798.00 for operating costs.
Key Words Healthcare, Education, Underprivileged Youth
Table of Contents Introduction
5
Description of Organization
5
Statement of Need
6
Project Description
8
Goal #1
9
Objective #1
9
Evaluation
9
Goal #2
10
Objective #1
10
Evaluation
10
Objective #2
10
Evaluation
11
Methodology
11
Sustainability
11
Budget Budget Narrative
12 14
Salaries and Benefits (Baylor Staff)
14
Salaries and Benefits (Non-Baylor Staff)
14
Automobile Operating Expense
14
Supplies and Related
14
General and Administrative
14
Depreciation
14
Final Summary
15
Appendix A [IRS Determination Letter]
16
Appendix B [​ Board of Directors​ and Support Team]
18
Appendix C [Biographies of Key Personnel]
19
Appendix D [Letter of Support]
20
The Ronald McDonald Care Mobile travels to the most medically underserved areas of Houston and provides free health services and educational tools to the children in our community. The vast majority of our patients attend Title 1 schools and fall below the poverty line. Our staff provides immunizations, well-child checkups, physicals, and other basic health services. They also help families apply for Medicaid and other health insurance programs so their children can secure a medical home. Without our services, many of these children would either make non-emergency trips to already overburdened emergency rooms or go without any health care at all. The Care Mobile is operated by Texas Children’s Hospital and staffed by Baylor College of Medicine. Ronald McDonald House Charities of Greater Houston/Galveston® is responsible for funding 20% of the program’s annual projected costs ($86,798.00).
Introduction We are writing you to request operating funds for the Ronald McDonald Care Mobile. This two-room mobile medical unit was donated to Texas Children’s Hospital by Ronald McDonald House Charities of Greater Houston/Galveston (RMHCGHG) in January 2006. The clinic travels with a bilingual staff, including a Texas Children’s pediatrician, pediatric nurse practitioner, licensed vocational nurse and medical assistant. It travels to the most medically underserved areas of our community and provides many non-emergency health and educational services to children who would otherwise go without them. These services include: well-child and illness examinations, vaccinations, sports physicals, non-emergency care, help applying for public health insurance, such as Medicaid, Children’s Health Insurance Program (C.H.I.P.) and Harris County Gold Card, referrals to medical and social services as needed, health care and nutrition education for children and families, and referrals to permanent and trusted medical homes.
Description of Organization Ronald McDonald House Charities of Greater Houston/Galveston was established in June 1990. Our mission is to create, find and support programs that directly improve the health and well being of children. We believe that when you change a child’s life, you change a family’s, which can change a community, and ultimately, the world. There are currently 43 Ronald McDonald Care Mobiles throughout the world, RMHCGHG is one of only a few chapters that operates more than one mobile unit. In August 2012, we unveiled a three-room mobile dental unit, which is operated through a partnership with UTHealth School of Dentistry and staffed by a pediatric dental team. RMHCGHG also boasts four Ronald McDonald C.H.E.E.R! (Children's Health Education Enrichment Resource) Rooms in Pearland, Pasadena, Katy, and Conroe. These rooms are located within UTMB Regional Maternal and Child Health Program clinic locations. These vibrant, fun rooms are staffed by non-clinical workers (typically early education students at local universities), who provide short, condensed lessons in health and wellness to children while their mothers are receiving vital prenatal care at the health clinics. This program allows mothers to focus on the health of their unborn babies while having peace of mind that their older children are safe and well cared for. In partnership with local McDonald’s Owner/Operators, we participate in the RMHC
U.S Scholarship Fund. A portion of all french fry sales are donated to the scholarship fund, for which RMHC matches the total donation. Each spring, we award 85 local graduating high school seniors $2000 towards higher education.
Statement of Need In Texas, 1.2 million children are without health insurance today. These children often go without routine check ups, lack basic health education, and even forego emergency medical care in the worst case scenarios. When individuals do not have insurance, many times, they go without the most basic of health care services, including well-child exams, which aim to catch treatable conditions and address basic concerns before they become catastrophic. In some cases, children without insurance are forced to go to local emergency rooms, though their conditions might have been able to be treated earlier with basic medical care, such as yearly vaccinations. When children are not vaccinated, not only is their health endangered, but the health of others is also negatively affected. One outbreak of a preventable disease can have a devastating effect on a community as a whole. It is reasonable to assume that families who cannot afford health care for their children also cannot afford massive ER bills, and this creates a further financial strain on the families. On top of dealing with impossible amounts of accrued debt for medical expenses, their children are sometimes strapped with lifelong issues related to their medical conditions. Thankfully though, sometimes, the Ronald McDonald Care Mobile is able to prevent such travesties. The Ronald McDonald Care Mobile helped a 12-year-old boy who had been limping for two months and whose family didn’t have medical insurance didn’t know where to turn. When the Ronald McDonald Care Mobile visited nearby Lewis Elementary, the child’s father stopped by to ask if they might be able to help his son. When the father learned of the free services offered by the Care Mobile, he brought his son in and the staff saw him immediately. When he arrived at 3PM, the staff diagnosed him with Slipped Capital Femoral Epiphysis (SCFE), a disorder of the hip, which required immediate surgery. By 7PM, he was receiving vital surgery at Texas Children’s Hospital. Without this surgery, his mobility would have been severely, permanently limited. The Ronald McDonald Care Mobile was there to diagnose his condition and facilitate treatment, which gave him a more positive outcome and the possibility for a more normal childhood and a brighter future. Another example of the impact the Ronald McDonald Care Mobile has had on the community started with a rash. Rashes come in all shapes and sizes, but this time, a nine-year-old girl developed one that her parents couldn’t explain. Unfortunately, her
father had recently lost his job and they had no health insurance. Because he couldn’t afford to take his daughter to the doctor, he decided to search for a free clinic in Houston and he found the Ronald McDonald Care Mobile. When the child visited the Ronald McDonald Care Mobile, the staff diagnosed her with a bacterial skin infection and provided her with the necessary antibiotics to treat the condition, free of charge. The Ronald McDonald Care Mobile currently travels to Cornelius Elementary, Lewis Elementary, Golfcrest Elementary, and Bonner Elementary on a regular basis. They are widely considered to be the most medically underserved areas of our community. These are the areas with both the highest levels of uninsured children and poverty in the Houston area. At Golfcrest Elementary School, according to the Texas Education Agency, 97% of students are Hispanic (state average is 48%), 97% are considered “economically disadvantaged,” (state average is 55%), and a staggering 63% of students are considered “limited English proficient (state average is 17%). Sadly, the statistics for the other schools are comparable. These statistics work together to unveil a social problem, one that the Ronald McDonald Care Mobile works to address. It is well-known that racial minorities and those with less education place less emphasis on basic health care. In fact, a new report by the United States Census Bureau shows that of all racial and ethnic groups, Hispanics are the least likely to seek medical care, and most experts on the subject cite a lack of access to medical care as the culprit for this trend. The Hispanic community is the demographic least likely to have health insurance, at a 30% uninsured rate. This number reflects a growing population of people who don’t see a doctor regularly, and who likely won’t see a doctor, even when they fall ill. This number is perhaps due to self employment, low-paying jobs and part-time work. Though their jobs might not be very lucrative, being employed sometimes disqualifies someone from applying for public-health programs. Unfortunately, these individuals do not make enough money to be able to afford health care, but at the same time, they are unable to qualify for programs that would benefit them and their families. It stands to reason that if a parent is uninsured, his or her children would be uninsured, as well. Though being uninsured is one of the greatest reasons people do not see the doctor and do not take their children to the doctor, another issue is that they do not have a medical home, such as a physician’s office or practice that they visit when in need of medical attention. In 2007, it was reported that nearly 50% of children did not have a medical home. One of the things the Ronald McDonald Care Mobile’s staff does is refer children to a permanent care physician so that they can work on building a trusting provider/patient relationship for their health needs. Though we have budgeted the $86,798.00 that we are asking for, finding an outside
funder for our portion of yearly operating costs will allow us to work on furthering our other programs, which will also benefit the community. In August 2012, we unveiled our second Care Mobile, a three-room dental unit. It operates much in the same way as our medical unit, serving economically disadvantaged areas and people. However, because it is bigger, it is more expensive to maintain. One of the goals of our organization’s mission is to focus on the critical needs of children, and we believe this extends past medical care, to dental care and beyond. Eventually, we would like to be able to expand all of our programs to reach more individuals in need. We believe that by changing a child’s life through health care and health care education, we are providing them with a solid foundation for the future and the tools to break the cycle we witness through our work. Though the Ronald McDonald Care Mobile does not claim to completely solve the problems we address, we know that the services provided make a measurable impact in the lives of the children and families we serve, and that’s exactly what we aim to do. We developed this program as a response to the need we saw in our community. We modeled it after the already successful programs run by other Ronald McDonald House Charities chapters throughout the country and around the world. Because it has been hugely impactful thus far, we hope to continue our outreach in the coming year. Through the Ronald McDonald Care Mobile, we hope to impact not only the lives of children, but the lives of their families, as well, in the coming year and beyond.
The Ronald McDonald Care Mobile continues to make not only a measurable impact on the health and well-being of the most disadvantaged children in our community, but also a measurable economic impact in the Houston area. In 2011, the economic impact was almost 1.1 million dollars. It is estimated that approximately 90.0% of all expenditures by the Program are made within the local area; This total is computed to be $458,905. Additionally, the Ronald McDonald Care Mobile is responsible for creating 15.9 jobs in our community. So too, nearly $546,610 of the total economic impact is labor income due to the increased employment needed to create incremental goods and services.
Project Description The Ronald McDonald Care Mobile travels to medically underserved areas of our community and provides medical services to anyone under the age of 18 completely free
of charge. Services we provide include: Well-child checks (height and weight measurements, ensuring that a child has met his or her developmental, physical, and emotional milestones, blood pressure check, discussing any medical concerns, etc.) immunizations such as DTaP and chicken pox, illness examinations, sports physicals, non-emergency care, help applying for public health insurance, such as Medicaid, Children’s Health Insurance Program (C.H.I.P.) and Harris County Gold Card, referrals to medical and social services as needed, health care and nutrition education for children and families, and referrals to permanent and trusted medical homes.
The Ronald McDonald Care Mobile is run by Texas Children’s Hospital and staffed by Baylor College of Medicine. We have a full-time, certified pediatrician and nurse on staff throughout the week. We visit four area elementary schools on a rotating basis. Generally, the Ronald McDonald Care Mobile will visit each of our locations once a week. For these locations, the Care Mobile is parked in the parking lot of the schools in a very accessible location. Children do not have to attend school at the location where the Care Mobile is parked to receive services. Sometimes, area McDonald’s restaurants will have Family Nights and other community events that the Ronald McDonald Care Mobile will be present for, as well. When the Ronald McDonald Care Mobile is on location, we also rely on the help of community volunteers to help with intake and paperwork.
Goal #1 Treat children in medically underserved areas who would otherwise go without basic health care. Our services are unique to the community because they truly are life-saving, even the preventative ones (immunizations, well-child checks). Without this kind of care, so many treatable illnesses go undiagnosed, and thus, untreated. We are able to make a difference in the Houston area.
Objective #1
Serve 5% more children on average in a year than we currently serve. It’s a simple idea--the more children the Ronald McDonald Care Mobile serves, the more lives we impact. We know that having access to health care has positive impacts on other areas of a child’s life. A child who is able to see a doctor when they become ill avoids excessive ER bills, missing work or school (which can have a negative impact on education and long term effects on financial stability and success), and even interpersonal relationships. The work done by our staff has the ability to positively affect
all areas of the life of our patients and their families. Evaluation
Our objective is easy to evaluate, as we track the number of patients we serve each and every day, as well as the amount of time spent with them, and what they are treated for when they visit the Ronald McDonald Care Mobile. By continuing to track the number of patients of the Ronald McDonald Care Mobile and comparing it to the data collected in previous years, we have a solid idea of how many patients we have served and at the end of the year, we know if we have satisfied our objective.
Goal #2 Educate the people we serve. In parts of our community that lack basic health care, it is also reasonable to assume a lack of resources and educational materials. Because so many of the conditions we treat are preventable, we want to educate our patients and their families so that they are better equipped for the future. Objective #1
Assist more of our patients and their families with applying for services such as the Harris County Gold Card and C.H.I.P. (Children’s Health Insurance Program), a form of Medicaid. Often times, people are unaware of the free and/or reduced cost services available to them. Perhaps they are overwhelmed at the thought of applying for government assistance. We want to help ease that burden and assist our patients’ families in applying for the health care services they need most and that they deserve. Evaluation
Because many of the children attend the schools we serve, this objective could be evaluated by conducting a survey at 3, 6, 9, and 12 months post-visit. At the time of the visit, we would collect a phone number to contact the patient’s family. Much of the work we do is possible through the work of volunteers, so we would ask our volunteer team to follow up with the families at the aforementioned intervals. This will help us not only to keep track of the number of people who applied for aid because of the services received with the Ronald McDonald Care Mobile, but it would also give us a chance to check back in and see how our patients are doing and give us an opportunity to remind them to schedule well-child checks with their pediatrician or to come back to the Ronald McDonald Care Mobile, as appropriate. Because we know that life sometimes gets in the way, following up with our patients’ families will help us ensure that we are actually impacting the long term health of Houston’s children. Calling the parents of our patients would give them an opportunity to ask questions and request more help in applying for Medicaid programs, if they had not done so at the time of their child’s appointment.
While we like to see our work positively affect the lives of children today, our ultimate goal is to have healthier children and families in the long run. Objective #2
Increase the number of educational opportunities we can provide to those that visit the Ronald McDonald Care Mobile. Currently, we emphasize the importance of good nutrition and injury prevention education, but we recognize that we can do more. Many of the illnesses and ailments we treat are preventable, but they can only be prevented through the education. By expanding the amount of topics we cover in appointments with patients’ families (and patients themselves), we are providing them with the tools to take ownership and responsibility for their own well being, which is beneficial not only to the individual and his or her family, but to the community, as well. By blocking out more time for educational conversations, including question/answer sessions with each family, we are equipping them with the knowledge they need and that we aim to provide. Currently, it is estimated that we spend only 20 minutes with each patient, with 10 dedicated to health education. We plan to spend 15 minutes on education in the coming year, instead of the 10 spent in previous years. Evaluation
We can measure the success of this objective simply by logging the amount of time spent with each patient along with a breakdown of how that time was spent. While we recognize that in the long run, our time is best spent with our patients, as opposed to recording our activities, this small administrative step will help us accomplish a long term goal of a healthier, more informed community.
Methodology In 2010, we served 3,656 children, most of whom saw the Ronald McDonald Care Mobile staff at local area elementary schools. As the Ronald McDonald Care Mobile is already a highly successful program, we believe that additional funding will help us to expand our reach in the community and allow us to positively impact the lives of many more children. Because we keep track of how many children we serve, we are able to see a measurable impact in our community. We hope to continue to reduce the amount of children served by area emergency rooms and increase the number of children that we serve, and the number of children with access to medical care by helping their parents/guardians apply to the appropriate programs.Â
Sustainability In order to fund the Ronald McDonald Care Mobile on a yearly basis, RMHCGHG is responsibly for 20% of the annual operating costs. To meet this expectation of funds, we rely on donations from the public and fundraising events throughout the year.
Because 100% of the people we serve do not have health insurance, one key service is to helping them apply for social welfare/health care programs. It is our hope that 100% of our patients and their families will be covered by these services so that our focus can be placed on other areas throughout Houston that need our help. We hope to equip them with the education necessary to apply for these programs so that they can see their primary care providers or pediatricians when needed. So too, we hope that they will be knowledgeable enough to teach their friends and neighbors who do not visit the Ronald McDonald Care Mobile how to apply for these same services.
Budget
Budget Narrative Salaries and Benefits (Baylor Staff)
The Ronald McDonald Care Mobile is run by Texas Children’s Hospital and staffed by Baylor College of Medicine. Thus, these employees are employed by Baylor and are paid the percentage of their salaries relative to the amount of time they dedicate to the Ronald McDonald Care Mobile.
Salaries and Benefits (Non-Baylor Staff)
Some of the pediatricians, nurses, etc. are Texas Children’s employees. They are not employed full-time by the Ronald McDonald Care Mobile, so this number is equivalent to the percentage of their salaries relative to the amount of time they dedicate to the program.
Automobile Operating Expense
This expense includes fuel and maintenance costs for the Ronald McDonald Care Mobile.
Supplies and Related
This expense includes the medical supplies used by the Ronald McDonald Care Mobile staff.
General and Administrative
This expense includes filing/office supplies for our staff to maintain patient records.
Depreciation
This expense takes into account the rate of depreciation for the Ronald McDonald Care Mobile.
Final Summary We firmly believe that this program has the ability to positively impact the lives of countless children in our area, and we would love the opportunity to call Houston Children’s Charity a partner in our work. Please feel free to contact us at 713.974.1217 or dadams@rmhcghg.org if you have any questions or would like to tour our mobile clinic. Thank you for your time, attention, and consideration.
IRS Determination Letter
Board of Directors Executive Board Debbie Adams, President/ McDonald's Owner/ Operator Judy Schmid, Vice-President/ McDonald's Owner/ Operator Marcia Brewer , Secretary/ USA Today Kimberly Elizondo , Treasurer/ McDonald's Owner/ Operator
Directors/Advisors Denise Bentham , Director/ McDonald's Owner/ Operator Leslie Bourne, Director/Exec Director Houston's Ronald McDonald House Stuart Brown , Director/ McDonald's Owner/ Operator Margie Chavarria, Director/Exec Director Ronald McDonald House Galveston Mikki Donnelly , Director/Dev Director Houston's Ronald McDonald House Carolyn Klevenhagen , Director Jeff Lawhorne, Director/ Coca-Cola Jill McClenny, Director/The Martin-Brower Co. Anne Murray, Director Fredell Rosen, Director Mary Redmond , Director/ McDonald's Owner/ Operator Flo McGee , Advisor Marilyn Mogas, Director Cari Sepulveda , Director/ McDonald's Owner/ Operator Stacie Spindle , Director/ McDonald's Regional Office
Support Team
Ruth Garcia-Wolf, Marketing & Communications Tammie Headlee, Bookkeeper Melanie Lay , Ronald McDonald C.H.E.E.R.! Room Program Coordinator Ginny Lee , Ronald McDonald Care Mobile Program Coordinator Denise Mommsen, Grant Writing & Graphic Design Sheri Shoemake , Volunteer Coordinator
Biographies of Key Personnel Debbie Adams - It is my honor and privilege to serve as President of RMHC. I have officially been a member of the Board for the last 17 years, and I’ve spent the last 10 years serving as President. McDonald’s was my first job through high school and college. I went on to get a BSN in Nursing from UT School of Nursing in the Texas Medical Center. I enjoyed 12 exciting years in nursing as an ER nurse in one of our local trauma centers, taught EMT’s and Paramedics at Houston Community College and for the last five years of my career, worked as a flight nurse, before the opportunity to become a McDonald’s Owner/Operator presented itself. This year marks my 24th year as a McDonald’s Owner/Operator, but hands down my most favorite job has been serving as President for RMHC of Greater Houston/Galveston, Inc. I truly believe in our mission of directly benefiting children and am incredibly proud of the impact our programs deliver in our community.
Ginny Lee - I work part-time for Janus 1 Unlimited, a McDonald's franchise, in human resources and customer care. I have been married 23 years and we have 4 children ranging from 14-19 yrs old. In my spare time, I volunteer with my church in a variety of ministries. I am also a co-leader of a girl scout troop. I began assisting Ronald McDonald House Charities, in small administrative ways in 2007. Since September 2009, I have served as the Ronald McDonald Care Mobile Coordinator. My current position with RMHC is coordinating the Ronald McDonald Care Mobile program and also the RADAR administrator and special projects, as needed. RMHC is a charity of integrity. It is one of the few charities which actually "practices what it preaches". Every day children around the world have access to medical care and educational opportunities they could never have received otherwise without this global organization. RMHC means hope for those who are in need.