Executive Summary
The requested ($86,798) funds will be use to cover RMHCGHG’s portion of the annual Ronald McDonald Care Mobile budget for fiscal year 2014. The Ronald McDonald Care Mobile and its staff travel to the most medically underserved areas of Houston and provide free health services and educational tools to the children in our community. Our staff provides immunizations, well-child checkups, physicals, and other basic health services to children without any form of health insurance.
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 operate more than one mobile unit. In August 2012, we unveiled our second Ronald McDonald Care Mobile, a threeroom 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. Non clinical workers (typically early education majors at local universities) staff these vibrant, child-friendly, fun rooms They 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 is donated to the scholarship fund, for which RMHC Global matches the total donation. Each spring, we award 85 local graduating high school seniors $2000 towards higher education.
Statement of Need Two million children in the state of Texas are without health insurance today. 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 also, 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 relating to their medical conditions. Thankfully though, sometimes, the Ronald McDonald Care Mobile is able to prevent such travesties. 100% of the children we serve have no form of insurance. According to Texas Department of Health Services, 284,366 children in the 10 counties served by Ronald McDonald Care Mobile Programs are without health insurance of any kind, which means that they are eligible for care. The areas we serve are the areas with both the highest levels of uninsured children and highest poverty levels in the Houston area. At Golfcrest Elementary School, according to NCES (2010-2011), 97% of students are Hispanic (state average is 50%), and according to the Texas Education Agency (2007-2008), 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 we serve are comparable. In Houston, 31.5% children live below the poverty line, and in Galveston, 34.6% of children live below the poverty line (State average is 24.2%). Nearly 12% of children in Houston live below 50% of the poverty line and nearly 20% of children under 5 years of age live below 50% of the poverty line in Galveston. (Source: city-data.com). For reference, according to the United States Department of Health and Human Services, the poverty line for a family of four in 2013 is $23,550. Lack of health insurance and access to medical care means missed school days and thus, a decreased quality of life. According to the Harmony Health Clinic, lack of health care exacts an indirect toll on society in terms of more disability, lower productivity, and an increased burden on the health care system.
Project Description
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 the globe. We aim to benefit individuals, families, and communities through the Ronald McDonald Care Mobile. In 2010, we served 3,619 patients, in 2011 we served 4,195 patients, and in 2012, we served 4325 patients. We hope to increase our outreach in 2014 to affect more communities and more children who need our services.
The Care Mobile visits four area elementary schools on a rotating daily basis. Generally, the 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 Ronald McDonald Care Mobile is parked in order to receive services.
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. We are able to make a difference in the Houston area.
Objective #1 Serve [insert number here] 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 person’s life. A person 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, too. The work done by the Ronald McDonald Care Mobile staff has the ability to positively affect all areas of the life of our patients and their families, as well.
Evaluation Our objective is easy to evaluate, as we keep track of 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 visitors to the Care Mobile and comparing it to the data collected last year, we will have a solid idea of how many patients we have served and at the end of the year, we will 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
See more of our patients and their families apply 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 Care Mobile. 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 lessons 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 spread of knowledge. 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 also 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 the 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.
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.