Grant Project Description/Narrative

1) Executive Summary Southwest Detroit Food & Wellness Collaborative requests $75,000 from the Detroit Community Foundation – Healthy Neighborhoods Fund to operate the Mobile Fresh Market & Bilingual Nutrition Coaching from January 1, 2026 to December 31, 2026 (12 months). The project serves low-income Black and Latino/a residents—especially seniors, families with children, and adults at risk of diabetes—in Southwest Detroit, Michigan (ZIPs 48209 and 48210). Over the year, we will bring affordable produce to neighborhood sites, connect households to SNAP (food assistance), and provide culturally responsive, bilingual nutrition coaching that helps families eat well on a budget. The expected result is improved access to healthy food, better food budgeting skills, and measurable progress on diet and diabetes risk.

2) Organizational Capacity Founded in 2017, Southwest Detroit Food & Wellness Collaborative is a 501(c)(3) focused on food access and nutrition education. We have run pop-up produce events since 2019, distributing 200,000+ pounds of produce alongside budget-friendly cooking demos. Our systems include: compliant fiscal controls (QuickBooks, board finance committee), data tools (Airtable, Excel), and standard operating procedures (SOPs) for food safety, client consent, and incident reporting. Staff hold ServSafe and Michigan food handler certifications. We maintain formal partnerships with Gleaners Community Food Bank, La Vida Health Clinic, Iglesia Santa María, and Wayne Metro Community Action Agency. We are ready to scale to a predictable mobile market route with embedded coaching and SNAP enrollment.

3) Community Need Southwest Detroit faces high rates of poverty, low car access, and preventable chronic disease. Many residents speak Spanish at home and encounter language barriers when navigating benefits or health services. Corner stores often lack affordable, high-quality produce, and transportation to full-service grocers is inconsistent. Older adults and people managing diabetes report difficulty affording fresh food month to month. Evidence shows that improving access to fruits and vegetables, paired with practical nutrition support and connections to benefits, can improve diet quality and reduce chronic disease risks.

4) Program Design & Logic Model Logic chain: - Inputs: Mobile market vehicle; refrigeration, tents, scales; produce from Gleaners and local growers; 0.8 FTE Program Coordinator; 0.5 FTE Registered Dietitian; 0.25 FTE Driver/Logistics; 0.2 FTE Data Assistant; 25 trained volunteers; partner MOUs; Airtable database; SNAP materials; interpretation. - Activities: 36 market days at neighborhood and faith-based sites; onsite bilingual nutrition coaching; SNAP enrollment and re-certification assistance; clinic-led screenings at select markets; home delivery pilot for homebound seniors; resident advisory circles; reminder texts and budgeting tips. - Outputs: 36 market days; 800 unduplicated households served; 60,000 pounds of produce distributed; 120 coaching clients enrolled; 150 SNAP enrollments or re-certifications; 2 advisory circles; 1 midyear focus group; 1 year-end survey. - Short-term outcomes (by 6 months): 60% of coaching clients increase fruit/vegetable intake by ≥1 serving/day; 85% of participants report improved food budgeting skills; 70% of SNAP-eligible households maintain benefits at 6 months. - Long-term outcomes (by 12 months): 40% of diabetic/pre-diabetic coaching clients reduce A1C by ≥0.5 percentage points (with clinic support); sustained access to affordable produce in target ZIPs; stronger community–clinical linkages.

SMART objectives (Jan 1–Dec 31, 2026): - Deliver 36 mobile market days reaching 800 unduplicated households and distributing 60,000 pounds of produce. - Enroll 120 clients in bilingual nutrition coaching; 60% will increase fruit/vegetable intake by at least 1 serving/day within 6 months. - Facilitate 150 SNAP enrollments or re-certifications; 70% of enrolled households will maintain benefits at 6 months. - Among coaching clients with diabetes or pre-diabetes, 40% will reduce A1C by ≥0.5 percentage points within 6–12 months (with consented clinic data). - 85% of surveyed participants will report improved food budgeting skills by year-end.

5) Implementation Plan & Timeline - Month 1: Finalize MOUs; hire 0.2 FTE Data Assistant; confirm market route and host sites (Program Coordinator). Dependency: vehicle lease signed. - Month 2: Volunteer training; purchase refrigeration and tents; develop bilingual materials (Coordinator, Dietitian). Dependency: materials vendor availability. - Month 3: Launch markets (3 sites) and enroll first 30 coaching clients; implement sign-in and inventory logs (Coordinator, Volunteers). - Month 4: Add clinic screenings at one site; begin SNAP outreach days (Clinic Partner, Wayne Metro). Dependency: clinic staffing. - Month 5: Expand to 4th site; hold first resident advisory circle to adjust produce mix (Coordinator). Dependency: participant recruitment. - Month 6: Quarter 2 review; adjust schedule for evening hours; share dashboard with funder (Data Assistant, Director). - Month 7: Pilot home delivery for 20 homebound seniors; cross-train Driver and Coordinator (Coordinator). Dependency: insurance rider. - Month 8: Midyear focus group; refresh volunteer cohort; add Arabic interpretation on-call (Dietitian, Volunteers). - Month 9: Co-host diabetes prevention workshop with clinic; target A1C screenings for 50 clients (Dietitian, Clinic). - Month 10: Weather contingency shift to indoor host sites; test text reminders for market days (Coordinator). - Month 11: Prepare year-end report; plan sustainability asks to grocer sponsor; re-enrollment push for SNAP (Director, Wayne Metro). - Month 12: Summative survey; lessons-learned session; finalize data and closeout (Data Assistant, Director).

6) Staffing & Partnerships - 0.8 FTE Program Coordinator (bilingual Spanish/English; 5+ years in community nutrition) manages route, volunteers, and partner coordination. - 0.5 FTE Registered Dietitian (RD) leads coaching, develops materials, and co-facilitates workshops. - 0.25 FTE Driver/Logistics (CDL preferred; food safety certified) handles transport, setup, and cold chain. - 0.2 FTE Data & Evaluation Assistant (Airtable/Excel) maintains databases and dashboards. - In-kind: Board Treasurer 0.05 FTE for fiscal oversight; 25 trained volunteers (2–4 per market day). - Backup coverage: Coordinator cross-trained to drive; Dietitian cross-trained on inventory and ordering. - Partners (MOUs): Gleaners Community Food Bank (weekly produce and cold chain guidance); La Vida Health Clinic (screenings, data-sharing with consent); Iglesia Santa María (host site); Wayne Metro (SNAP outreach).

7) Equity & Accessibility - Bilingual Spanish/English materials; interpretation available in Spanish and Arabic on request. - ADA-compliant setup with wide aisles and seated check-out; home delivery for homebound seniors. - Evening/weekend hours; bus vouchers for transit; no ID or residency proof required. - Resident advisory circle shapes routes, product selection, and hours; plain-language materials with visual prompts and prices per item.

8) Evidence Base & Innovation - Approach aligns with the USDA SNAP-Ed Toolkit, which recommends mobile markets and healthy retail strategies paired with education to improve diet quality. - The Centers for Disease Control and Prevention (CDC) supports community–clinical linkages (screenings, referrals, coaching) to prevent chronic disease. - Robert Wood Johnson Foundation reports link improved healthy food access to better health outcomes. - Low-risk adaptations include a small home-delivery pilot for homebound seniors and text reminders; safeguards include cold-chain SOPs, insurance riders, and opt-in communications.

9) Evaluation & Learning - Data sources: sign-in sheets, produce inventory logs, SNAP enrollment forms, partner clinic REDCap export (with HIPAA-compliant consent), participant surveys (Qualtrics), and volunteer observation notes. - Cadence: weekly Airtable updates; monthly team huddles; quarterly intercept surveys at markets; pre/post 6-month surveys for coaching clients; quarterly dashboards and brief narrative to the funder; semiannual learning sessions with partners to adjust routes, content, and hours. - Analysis: track outputs and outcomes vs. targets; disaggregate by ZIP, language, age, and SNAP status; apply rapid-cycle improvements based on findings.

10) Risks & Mitigation - Produce supply variability: diversify suppliers; maintain backup purchase orders. - Weather disruptions: reserve indoor host sites; weather text alerts; tents with sidewalls. - Staff turnover: cross-training, SOPs, and temp staffing pool. - Vehicle breakdown: rental van contingency and AAA coverage. - Data privacy: HIPAA-compliant consent and encrypted storage; limited-access permissions.

11) Budget & Sustainability - Personnel: $42,000 (Coordinator, Dietitian, Driver, Data Assistant) - Fringe/benefits: $6,300 - Produce procurement/gap fill: $8,000 - Vehicle lease/fuel/maintenance: $6,500 - Supplies (tents, tables, refrigeration): $4,000 - Evaluation/data systems: $2,200 - Communications/translation/printing: $1,400 - Indirect (10%): $4,600 - Total: $75,000 In-kind/match: volunteer hours ($12,000) and donated produce ($25,000). Sustainability plan: grow SNAP and Double Up Food Bucks revenue; launch a monthly donor campaign; secure a local grocer sponsorship; pilot a sliding-scale CSA; apply for MDHHS SNAP-Ed subaward and corporate health grants; explore shared staffing with the clinic.

12) Funder Alignment & Compliance The project advances Healthy Neighborhoods Fund priorities by increasing equitable access to healthy food, embedding resident voice, and strengthening cross-sector partnerships that improve health. Compliance steps: quarterly narrative and financial reports; use funder branding; provide 501(c)(3) and insurance certificates; maintain City food handling permits; HIPAA-compliant data use agreement with the clinic; photo/audio release forms for testimonials.

13) Conclusion With the Foundation’s $75,000 investment, the Mobile Fresh Market & Bilingual Nutrition Coaching will deliver 36 reliable market days, practical coaching, and benefits navigation to 800 Southwest Detroit households in 2026. The program is community-guided, evidence-based, and designed for measurable results on diet, budgeting skills, and diabetes risk. Our lean, bilingual team and committed partners are in place; the routes, safeguards, and evaluation plan are ready. We welcome the opportunity to partner in building a healthier, more equitable Southwest Detroit.

Prepared by Maria Alvarez, Executive Director, 2025-11-02.

1) Executive Summary Heartland Reentry Collaborative (HRC) requests $250,000 from United Way of Greater Kansas City’s Workforce Stability Fund to launch Pathways to Employment: Reentry Workforce Initiative, a 24‑month program (January 1, 2026 – December 31, 2027). The initiative serves justice‑involved adults ages 18–35 returning to Jackson County, Missouri, and residing in the Kansas City metropolitan area (Jackson County, MO and Wyandotte County, KS) who face barriers to employment including criminal records, unstable housing, and limited credentials. Participants will gain job readiness, industry‑recognized credentials, and placement into unsubsidized jobs with retention supports, leading to higher wages, stability, and reduced recidivism. United Way’s investment will accelerate employer partnerships, supportive services, and data capacity to achieve measurable workforce and public safety outcomes.

2) Organizational Capacity HRC is a reentry workforce nonprofit that pairs trauma‑informed coaching with sector‑based training and employer engagement. We maintain a secure case management and outcomes system (Salesforce), formal referral pathways with probation and community organizations, and established relationships with local employers and training providers. Our leadership team includes professionals with advanced credentials in social work, data analysis, HR/employer relations, financial coaching, and legal navigation. The organization adheres to best practices in client consent, data privacy, nondiscrimination, and fiscal stewardship, and has board oversight and written policies for procurement, supportive‑service documentation, and continuous quality improvement. This proposal builds on HRC’s core competencies: individualized case management, credential pathways aligned to local labor demand, and post‑hire retention supports.

3) Community Need Young adults returning from incarceration in Jackson County face compounded barriers: criminal records that limit hiring; gaps in work experience and credentials; unstable housing; limited access to transportation and childcare; and outdated digital skills. County‑level recidivism is approximately 28% at 12 months, with employment a strong protective factor. Regional employers report persistent hiring needs in construction, utilities, food safety, and entry‑level IT support—sectors that accept short‑term credentials and offer pathways to family‑supporting wages. Without structured supports, many returning citizens cycle between precarious jobs and justice involvement. Pathways to Employment directly addresses these barriers with employer‑informed training, legal navigation, digital literacy, and retention coaching.

4) Program Design & Logic Model Program model - Cohort‑based job readiness and soft skills (evening/weekend options). - Short‑term credentials in demand sectors (OSHA‑10, ServSafe, CompTIA IT Fundamentals+). - Case management with trauma‑informed, culturally responsive coaching. - Supportive services (transportation, tools/gear, IDs, childcare during class). - Employer engagement for interviews, placements, and fair‑chance hiring. - Financial coaching, legal clinics for expungement/record sealing, and housing navigation. - Post‑placement retention supports and peer mentors through 12 months.

Logic chain - Inputs: United Way funding; HRC staff (Program Manager, Case Managers, Employer Lead, Data Analyst, Financial Coach, Legal Navigator); training partners (Metropolitan Community College); employer partners; facilities and ADA‑accessible training lab; Salesforce MIS; participant advisory council; MOUs with Jackson County COMBAT/Probation. - Activities: Outreach/enrollment; intake and assessment (TABE, Northstar Digital Literacy); cohorts for job readiness; credential courses; supportive services; employer roundtables and hiring events; legal and financial coaching; job placement services; retention check‑ins at 30/90/180/365 days; data collection and PDSA improvement cycles. - Outputs (24 months): 320 enrollments; 260 complete job readiness; 200 earn credentials (OSHA‑10, ServSafe, CompTIA ITF+); 150 unsubsidized job placements; 60 employer partners engaged; 240 participants receive supportive services. - Short‑term outcomes (0–6 months): 75% improve digital literacy by one Northstar level; median starting wage ≥ $17/hour; 65% obtain stable housing within 6 months. - Long‑term outcomes (6–12+ months): 70% retain employment at 90 days; 12‑month recidivism ≤ 15% (vs. ~28% county baseline); increased household stability and reduced justice system costs.

SMART objectives (by 12/31/2027) 1) Enroll 320 justice‑involved adults ages 18–35 and ensure 260 (81%) complete job readiness within 8 weeks of enrollment. 2) Support 200 participants (63% of enrollees) to earn at least one industry credential (OSHA‑10, ServSafe, or CompTIA ITF+) within 4 months of cohort start. 3) Place 150 participants (47% of enrollees) into unsubsidized employment with a median starting wage of at least $17/hour. 4) Achieve 70% employment retention at 90 days among those placed; conduct retention check‑ins at 30, 90, 180, and 365 days. 5) Engage 60 employer partners and provide supportive services to at least 240 participants (75% of enrollees), contributing to ≤15% 12‑month recidivism, 65% housing stability within 6 months, and 75% digital literacy gains.

5) Implementation Plan & Timeline (January 1, 2026 – December 31, 2027) - Q1 (Jan–Mar 2026): Finalize MOUs and data‑sharing with Probation and Metropolitan Community College; hire Data & Evaluation Analyst; launch two cohorts (evening/weekend). Responsible: Program Manager. Dependency: training lab availability. - Q2 (Apr–Jun 2026): Begin OSHA‑10 and ServSafe courses; convene employer roundtable; set up Salesforce dashboards and outcomes pipelines. Responsible: Employer Engagement Lead; Data Analyst. Dependency: vendor schedules. - Q3 (Jul–Sep 2026): Add IT Fundamentals bootcamp; implement transportation/tools supports; start quarterly wage record match. Responsible: Case Managers, Analyst. Dependency: state data access. - Q4 (Oct–Dec 2026): Conduct midyear evaluation and PDSA cycle; expand employer pool by 10 new partners; host expungement/record‑sealing clinic. Responsible: Legal Navigator. - Q5 (Jan–Mar 2027): Launch construction and utility‑prep cohorts; deepen retention services with 90‑ and 180‑day check‑ins. Responsible: Case Managers. - Q6 (Apr–Jun 2027): Host sector hiring fair; begin peer mentor stipends; publish learning brief to United Way. Responsible: Program Manager, Analyst. Dependency: employer participation. - Q7 (Jul–Sep 2027): Scale placements to 45 per quarter; add housing navigation workshops; conduct second wage data match. Responsible: Analyst. - Q8 (Oct–Dec 2027): Summative evaluation; participant focus groups; sustainability planning with WIOA and SNAP Employment & Training; final report to United Way. Responsible: Director of Programs.

6) Staffing & Partnerships Staff (lean team with cross‑coverage) - Program Manager (1.0 FTE; MSW; 8 years reentry/workforce leadership): oversees cohorts, partnerships, quality, and compliance. Trained on Salesforce for coverage. - Case Managers (2.0 FTE; credentialed peer support specialists; trauma‑informed): intake, coaching, barrier resolution, retention check‑ins; cross‑cover caseloads. - Employer Engagement Lead (0.75 FTE; 5+ years HR/industry partnerships): employer cultivation, hiring events, job development, fair‑chance policies. - Data & Evaluation Analyst (0.5 FTE; Salesforce; IRB experience): MIS, data quality, wage record matches, dashboards, reporting. - Financial Coach (0.25 FTE; Accredited Financial Counselor®): budgeting, credit building, income supports navigation. - Legal Clinic Navigator (0.25 FTE; paralegal): record sealing/expungement clinics, IDs, rights education. - Executive Director (0.1 FTE in‑kind): oversight, fiscal and risk management.

Key partners (MOUs/data‑sharing as applicable) - Jackson County COMBAT/Probation: referrals, data‑sharing on recidivism and supervision status. - Metropolitan Community College: short‑term credentials (OSHA‑10, ServSafe, CompTIA ITF+). - The Grooming Project; Hope Faith: soft skills, basic needs, wraparound supports. - Employer partners: Evergy, Burns & McDonnell, XYZ Manufacturing and others with fair‑chance hiring pledges. - reStart Inc.: housing navigation and access to community resources.

7) Equity & Accessibility - Trauma‑informed, culturally competent coaching; peer mentors with lived experience. - Evening/weekend cohorts; bus passes and gas cards; tools and clothing vouchers; on‑site childcare during classes. - ADA‑accessible facilities and accommodations; materials at 8th–10th grade reading level. - No exclusion for most criminal backgrounds; translation and interpretation available. - Participant Advisory Council (stipended) informs curricula, schedules, and supportive services; feedback integrated via quarterly PDSA cycles. - Legal clinics for record sealing/expungement; assistance with government IDs.

8) Evidence Base & Innovation - Sectoral training with wraparound supports is associated with higher earnings and sustained employment; MDRC’s multi‑site evaluations of WorkAdvance found significant wage and credential gains compared to control groups. - Employment‑focused reentry strategies reduce recidivism when paired with cognitive‑behavioral and support services; National Institute of Justice meta‑analyses and Urban Institute research highlight employment and housing stability as key factors in reentry success. - Short‑term, industry‑recognized credentials are linked to wage gains and employer demand; National Skills Coalition briefs document positive returns for OSHA‑10, ServSafe, and IT fundamentals in entry‑level roles. This initiative adapts these proven elements to local demand in construction/utilities, hospitality/food safety, and IT support, and integrates legal navigation for record barriers. The innovation is a low‑risk adaptation with safeguards: staged cohort launches, employer advisory input, and ongoing data monitoring to adjust dosage and supports.

9) Evaluation & Learning Data systems and sources - Salesforce MIS for intake, service tracking, and outcomes. - Baseline and exit assessments: TABE for basic skills; Northstar Digital Literacy for digital skills. - Employer verification forms; credential registries; attendance rosters. - State wage records (with participant consent) matched quarterly. - HMIS fields for housing stability; participant surveys and focus groups.

Cadence and analysis - Retention and wage checks at 30/90/180/365 days post‑placement. - Quarterly performance reviews with dashboards; root‑cause analysis of attrition and non‑completion. - PDSA cycles semiannually to refine cohort pacing, supports, and employer engagement. - Biannual outcome reports to United Way of Greater Kansas City – Workforce Stability Fund with narrative context and data visualizations.

Learning and feedback loops - Participant Advisory Council meets quarterly; findings incorporated into curricula and schedule adjustments. - Employer roundtables provide real‑time skill and hiring feedback. - Summative evaluation in Q8 includes trend analysis on wages, retention, digital literacy gains, housing stability, and recidivism.

10) Risks & Mitigation - Employer demand shifts: diversify sectors; use real‑time labor market information; maintain 60+ employer partners. - Participant attrition: flexible scheduling; transportation/childcare supports; stipends for peer mentors; frequent check‑ins and milestone incentives. - Data‑sharing delays: execute MOUs in Q1; use employer verification and participant pay stubs while awaiting wage records. - Legal barriers to employment: host expungement/sealing clinics; educate employers on fair‑chance practices; assist with occupational licensing when possible. - Funding gaps: braid Workforce Innovation and Opportunity Act (WIOA) Individual Training Accounts and SNAP Employment & Training (E&T) reimbursements; secure employer sponsorships and on‑the‑job training reimbursements.

11) Budget & Sustainability Summary budget (24 months; total project cost $272,000) - Personnel: $165,000 - Fringe (22%): $36,300 - Training vendors/tuition/fees: $18,000 - Supportive services (passes, tools, IDs): $16,000 - Participant stipends: $6,000 - Employer engagement/events: $3,500 - Data/evaluation: $3,200 - Supplies/printing: $2,000 - Indirect (10%): $22,000 - Total: $272,000 Amount requested from United Way: $250,000 Confirmed/anticipated match: $22,000 from unrestricted funds and employer sponsorships.

Sustainability plan - Braid WIOA ITAs and supportive services for eligible participants. - Leverage SNAP E&T 50/50 reimbursement for allowable coaching and training costs. - Pursue Missouri reentry funds and local employer sponsorships; expand on‑the‑job training and customized cohort fee‑for‑service. - Seek recurring United Way allocation and align with city/county workforce initiatives. - Publish outcomes to strengthen eligibility for public‑private partnerships and performance‑based contracts.

12) Funder Alignment & Compliance Alignment with Workforce Stability Fund - Focus on workforce participation, retention, and wage growth for residents with significant barriers. - Emphasis on employer partnerships, job quality, and supportive services that lead to stability. - Clear metrics, rigorous reporting, and continuous learning.

Compliance commitments - Quarterly outcome and financial reports to United Way; adherence to branding guidelines. - Annual independent audit and board financial oversight. - Equal employment opportunity and nondiscrimination assurances. - Client data privacy, informed consent, and secure data storage; background checks for staff (clients are not excluded based on background). - Documentation and controls for all supportive service disbursements and stipends.

13) Conclusion Pathways to Employment will equip 320 justice‑involved young adults in the Kansas City metro to earn recognized credentials, secure unsubsidized jobs at a median starting wage of at least $17/hour, and retain employment—while reducing 12‑month recidivism to 15% or less. With United Way of Greater Kansas City’s $250,000 investment over 24 months, HRC will deliver measurable results: 260 job‑readiness completions, 200 credentials, 150 placements, 60 engaged employer partners, and 240 participants receiving barrier‑removal supports. This proposal is grounded in evidence, optimized for equity and accessibility, and designed for sustained impact through braided funding and strong employer relationships. We welcome the opportunity to partner with United Way to advance workforce stability and community well‑being.

Selected references - MDRC, WorkAdvance evaluations: sectoral training with wraparounds improved earnings and credential attainment. - National Institute of Justice, meta‑analyses on reentry programs’ effects on recidivism and the role of employment. - Urban Institute, employment‑focused reentry research on combining services, supervision, and labor market strategies. - National Skills Coalition, briefs on industry‑recognized credentials and wage outcomes.

Prepared by Jordan M. Ellis, Director of Development, 2025-11-02.

1) Executive Summary California Rural Health Network (CRHN) requests $1,500,000 from The California Endowment – Building Healthy Communities to expand telehealth access for farmworker families in California’s Central Valley over 36 months (July 1, 2026 – June 30, 2029). The project serves farmworker families—including Spanish and Indigenous-language speakers (Mixteco, Purépecha, Triqui), uninsured residents, and Medi-Cal beneficiaries—across rural and unincorporated communities in Fresno, Tulare, and Kern Counties. We will reduce barriers to virtual care by providing devices, connectivity, culturally and linguistically matched coaching, and clinic workflow support. By project end, families will experience faster access to care, better chronic disease control, and higher-quality, language-accessible telehealth.

2) Organizational Capacity CRHN is a statewide nonprofit that convenes rural clinics, community organizations, and public partners to strengthen access to care. We specialize in digital health adoption, patient engagement, and rural systems improvement. Our operations include: - Program management and clinic technical assistance: workflow mapping, clinician training, and change management. - Data privacy and security: HIPAA-compliant practices, Business Associate Agreements (BAAs), secure file transfer, and Mobile Device Management (MDM). - Community engagement: partnerships with farmworker-serving organizations, faith groups, and schools; bilingual and bicultural staff; paid community advisory boards. - Evaluation: in-house analytics capacity and external evaluation partnerships.

CRHN has implemented multi-clinic telehealth projects, digital navigator models, and interpreter integration across rural settings. We maintain vendor-neutral relationships with electronic health record (EHR) and telehealth platforms and have executed data-sharing agreements with Federally Qualified Health Centers (FQHCs). Our finance and compliance teams use standard internal controls and follow Uniform Guidance when funds are blended with federal sources. The Chief Operating Officer provides executive oversight.

3) Community Need Central Valley farmworker families face persistent barriers to care: - Broadband and device gaps: Rural households have lower broadband adoption and device ownership and higher dead zones, which limit video visits (Federal Communications Commission data on broadband disparities). - Language and cultural access: Many families are Spanish-speaking or speak Indigenous languages; standard telehealth workflows rarely include Indigenous interpreters. Low digital literacy compounds these barriers. - Transportation and work schedules: Long work hours, seasonal migration, and limited transportation make in-person visits difficult; telehealth can bridge access if connectivity and support are in place. - Health disparities: Farmworker communities experience high rates of occupational injury, diabetes, hypertension, and delayed care. Medi-Cal members can use telehealth, but uptake depends on navigation support, trust, and clinic readiness (California Health Care Foundation research in Medi-Cal).

Community listening sessions (2024–2025) conducted with farmworker organizations emphasized the need for evening and weekend support, interpreters in Mixteco and Purépecha, simple devices, privacy assurances, and trusted promotores (community health workers). This project responds directly to these priorities.

4) Program Design & Logic Model Goal: Expand equitable, language-accessible telehealth access and outcomes for farmworker families in Fresno, Tulare, and Kern Counties.

Logic Chain - Inputs: $1.5M grant; CRHN project team; FQHC partners (Family HealthCare Network, Clinica Sierra Vista); Central Valley Farmworker Foundation; school district and ISP partners; UC Merced CITRIS (evaluation and usability); devices and peripherals; mobile digital hubs; MDM and data systems; Indigenous-language interpreters; community advisory board. - Activities: - Onboard 12 clinics; integrate EHR telehealth workflows and prompts. - Deploy 4 mobile digital hubs in farmworker neighborhoods and labor camps. - Distribute 3,000 configured devices with data plans and peripherals (e.g., blood pressure cuffs for enrolled patients). - Deliver 6,000 digital navigator coaching sessions (individual and group) in Spanish and Indigenous languages. - Provide real-time telehealth troubleshooting; coordinate remote interpretation. - Train 150 promotores and clinic super-users; host quarterly learning collaboratives. - Outputs: - 12 clinics with executed MOUs and BAAs; zero-rated data agreements. - 3,000 households equipped; 25,000 telehealth appointments supported. - 150 promotores trained; multilingual materials developed; ADA-compliant kiosks deployed. - Short-term Outcomes (Year 1–2): - Increased telehealth use among coached clients; reduced no-shows; improved patient satisfaction. - Improved clinician confidence using interpreters and telehealth tools. - Long-term Outcomes (Year 3 and beyond): - 20% improvement in hypertension and diabetes control rates among participating patients versus baseline (HEDIS measures). - Faster time-to-appointment for primary care (10% reduction). - Sustained navigator roles embedded in clinic budgets; normalized language access in telehealth.

SMART Objectives (by June 30, 2029) 1) Onboard 12 clinics and deploy 4 mobile hubs; complete 6,000 navigator coaching sessions and support 25,000 telehealth appointments; distribute 3,000 devices. 2) Train 150 promotores/super-users; 75% of coached clients complete at least one video visit within 60 days of coaching. 3) Reduce telehealth no-show rates by 30% across participating clinics compared to baseline. 4) Achieve at least 85% patient satisfaction with telehealth (surveys in Spanish and Indigenous languages). 5) Among participating patients with hypertension and diabetes, improve control rates by 20% versus baseline and reduce average time-to-appointment for primary care by 10%.

5) Implementation Plan & Timeline - Year 1, Q1 (Jul–Sep 2026): Hire project team; execute MOUs/BAAs with 6 clinics; select devices and mobile hub specs; convene community advisory board. Responsible: Project Director. Dependency: procurement approval. - Year 1, Q2 (Oct–Dec 2026): Deploy 2 mobile hubs; train first 60 promotores/digital navigators; pilot at 3 clinics; stand up MDM and data pipelines. Responsible: Regional Coordinators, IT contractor. Dependency: EHR integration. - Year 1, Q3 (Jan–Mar 2027): Expand to 6 clinics; distribute first 1,000 devices; begin multilingual group coaching; launch zero-rated data agreements. Responsible: Coordinators, ISP partner. - Year 1, Q4 (Apr–Jun 2027): First learning collaborative; analyze baseline and first two quarters; adjust workflows; add Indigenous-language interpreters. Responsible: Evaluation Lead.

- Year 2, Q1–Q2 (Jul–Dec 2027): Onboard remaining 6 clinics; deploy 2 additional hubs; distribute 1,200 devices; quarterly quality metric review and CME trainings. Responsible: Project Director, UC Merced. (Additional 50 promotores trained.) - Year 2, Q3–Q4 (Jan–Jun 2028): Scale navigator hours to evenings/weekends; device refresh and replacements; midterm evaluation report to funder; optimize EHR prompts for telehealth. Responsible: Data Engineer.

- Year 3, Q1 (Jul–Sep 2028): Final 800 devices distributed; deep dive on no-show reduction; prepare reimbursement pathways with health plans. Responsible: Grants/Compliance Manager. - Year 3, Q2 (Oct–Dec 2028): Summative focus groups; sustainability MOUs with FQHCs; publish toolkit; external audit of outcomes. Responsible: Evaluation Lead, UC Merced. - Year 3, Q3–Q4 (Jan–Jun 2029): Transition navigators to clinic payrolls; archive data; final report and policy brief to funder; closeout and dissemination webinar. Responsible: Project Director.

6) Staffing & Partnerships Core Team (lean, cross-covered): - Project Director (1.0 FTE; MPH; 12 years in telehealth and rural systems): overall leadership, clinic partnerships, learning collaboratives, risk management. - Regional Coordinators (2.0 FTE; bilingual Spanish/English): clinic onboarding, mobile hub operations, navigator supervision, ISP coordination. - Digital Navigators/Promotores (6.0 FTE; community-based, certified): device setup, coaching, visit troubleshooting, interpretation coordination, data entry. - Evaluation Lead (1.0 FTE; PhD/MPH): evaluation design, dashboards, outcomes analysis, reports, human-subjects protections. - Data Engineer (0.5 FTE): EHR integration, MDM, data pipelines, zero-rated data monitoring. - Grants/Compliance Manager (0.5 FTE; HIPAA/CCPA): BAAs/DYAs, procurement, policies, reporting. - Contractors: IT systems integrator (0.25 FTE equivalent) for EHR/MDM; Indigenous-language interpreters (as needed). - Backup: Coordinators cross-cover; COO provides 0.1 FTE executive oversight; documented coverage plan for staff absences.

Partnerships (MOUs to be executed or updated): - Family HealthCare Network and Clinica Sierra Vista (FQHCs): EHR integration, referrals, space for navigators, shared metrics. - Central Valley Farmworker Foundation: outreach, hub sites, community advisory board co-facilitation. - Local school districts: evening hub locations and device charging stations. - ISP partners: discounted data and zero-rating for telehealth traffic. - UC Merced CITRIS: usability testing, external evaluation, independent validation of outcomes.

7) Equity & Accessibility - Language access: Coaching and materials in Spanish, Mixteco, and Purépecha; access to Triqui on request; all consent and privacy notices in preferred language. - Cultural relevance: Trusted promotores hired from the communities served; flexible evening/weekend hours; field-based support at labor camps and community centers. - Transportation and childcare: Mobile hubs bring services to neighborhoods; childcare offered during group sessions when possible. - Eligibility: Device lending with no credit check; priority for uninsured and Medi-Cal members; simple, plain-language enrollment. - Accessibility: ADA-compliant kiosks and interfaces; large-font and icon-based guides; options for audio instructions; privacy screens and headsets. - Community voice: A paid community advisory board will guide hub locations, materials, and feedback loops; stipends and food provided; findings shared back to the community each quarter.

8) Evidence Base & Innovation The approach builds on a strong evidence base: - Telehealth improves access and patient satisfaction and can maintain or improve outcomes when paired with patient support (Agency for Healthcare Research and Quality Telehealth Evidence Map). - Integrating social care and navigation into health care improves outcomes and reduces barriers for low-income populations (National Academies reports on social care integration). - Telehealth use among Medi-Cal members increased with supportive policies; sustained uptake depends on addressing broadband and usability gaps (California Health Care Foundation analyses). - Broadband disparities are greatest in rural and low-income areas, affecting telehealth readiness (Federal Communications Commission data).

Innovations are low-risk adaptations: pairing mobile hubs with zero-rated data, embedding Indigenous-language interpreters, and using device pre-configuration and MDM to reduce setup burden. Safeguards include phased pilots, external evaluation by UC Merced, and continuous quality improvement to adjust workflows.

9) Evaluation & Learning Design: Mixed-methods, with quantitative tracking and qualitative feedback to drive real-time improvement.

Data Sources: - EHR extracts: telehealth visit counts, appointment/no-show logs; HEDIS quality metrics for hypertension (BP control) and diabetes (A1C control) for participating patients under data use agreements. - MDM analytics: device activation, app usage, security status. - Navigator records: coaching sessions, language, topics, referrals. - Participant surveys: satisfaction, digital skills (pre/post), barriers. - ISP reports: connectivity uptime and zero-rated data usage.

Cadence and Analysis: - Monthly data pulls for utilization and no-shows; quarterly dashboards shared with clinics and the advisory board. - Semiannual analysis of quality metrics with comparison to baseline and to non-participating patients where feasible. - Annual external review by UC Merced; usability testing with think-aloud protocols. - Quarterly learning collaboratives to refine workflows (e.g., reminder scripts, interpreter scheduling, after-hours sessions). - Reporting to The California Endowment: semiannual narrative and financial reports; a midterm report in Year 2 and a final summative report with a policy brief and toolkit in Year 3.

Key Measures: - Process: clinics onboarded, hubs deployed, devices distributed, coaching sessions, interpreter use. - Outcomes: no-show rates, first successful video visit among coached clients, patient satisfaction, HEDIS control rates, time-to-appointment, emergency department diversions when available. - Equity: disaggregation by language, geography (rural/unincorporated), insurance.

10) Risks & Mitigation - Broadband gaps: Provide hotspots; deploy offline-friendly workflows; negotiate zero-rated data with ISPs; schedule in-hub visits in coverage areas. - Device loss/damage: Use MDM geofencing, remote wipe; simple user agreements; maintain a low-cost replacement pool; device labeling. - Privacy/security: Execute HIPAA BAAs; align with California Consumer Privacy Act (CCPA); enforce role-based access; multilingual consent; private spaces for telehealth at hubs. - Clinic adoption barriers: Offer CME-accredited trainings; map workflows; identify super-user champions; incremental rollouts with feedback. - Policy shifts: Align with Medi-Cal telehealth guidance; collaborate with the California Primary Care Association (CPCA) for timely updates and advocacy. - Workforce turnover: Cross-train staff; maintain a bench of promotores; offer retention stipends; document standard operating procedures.

Compliance Steps: MOUs/BAAs executed; procurement per CRHN policy; ADA, HIPAA, and CCPA compliance; conflict-of-interest and whistleblower policies; OMB Uniform Guidance adherence if blended with federal funds; semiannual reporting and acknowledgment requirements met for The California Endowment.

11) Budget & Sustainability Three-year Budget Summary (Total: $1,627,000; Request: $1,500,000; Secured match: $127,000 from health plans and ISP sponsorships) - Personnel: $780,000 (Project Director, Coordinators, Navigators, Evaluation Lead, Data Engineer, Grants/Compliance Manager). - Fringe (28%): $218,400. - Devices and peripherals: $210,000 (3,000 devices and selected peripherals). - Data plans/connectivity: $90,000 (hotspots, zero-rating administration). - Training and translation: $55,000 (materials in Spanish and Indigenous languages; CME costs). - Evaluation (UC Merced subaward): $85,000 (external review, usability testing). - IT integration/MDM: $32,000 (MDM licenses, integration support). - Travel and mobile hub operations: $20,000 (fuel, maintenance, pop-up clinics). - Indirect (10%): $136,600.

Budget-to-Activity Link: - Devices/connectivity enable distribution targets and successful video visits. - Personnel and training deliver coaching, interpreter coordination, and clinic workflow support. - Evaluation funds enable rigorous measurement and learning collaboratives. - IT/MDM protects privacy and ensures device uptime.

Sustainability Plan: - Embed navigator and interpreter costs into FQHC budgets through Medi-Cal reimbursement and CalAIM Community Supports where applicable. - Establish cost-sharing with health plans for no-show reduction and chronic care outcomes; negotiate ongoing ISP sponsorships for zero-rated data. - Device recycling/refresh fund through refurbished stock and philanthropic device donations. - Publish a toolkit to enable replication and attract additional partners; align with permanent telehealth flexibilities to sustain reimbursement.

12) Funder Alignment & Compliance This project advances The California Endowment’s Building Healthy Communities priorities by: - Improving access to care in under-resourced rural neighborhoods. - Advancing health equity for immigrant and Indigenous-language farmworker families through language access, community power, and paid advisory roles. - Strengthening community infrastructure via mobile hubs, school partnerships, and trusted promotores. - Supporting prevention and chronic disease control through timely access to primary care and care management via telehealth.

CRHN will meet all compliance expectations: - Semiannual narrative and financial reports; midterm and final summative reports. - Funder acknowledgment on materials and hubs. - Executed MOUs and HIPAA BAAs; ADA and CCPA compliance; procurement consistent with CRHN policies. - Data security and privacy training for all staff and contractors.

13) Conclusion Farmworker families in the Central Valley deserve timely, language-accessible care that works with their lives. With The California Endowment’s $1,500,000 investment, CRHN and partners will equip 3,000 households, train 150 promotores, deploy four mobile digital hubs, and support 25,000 telehealth visits—leading to fewer missed appointments, higher satisfaction, and better control of diabetes and hypertension. The project is community-guided, evidence-based, and designed for lasting adoption in clinic operations. We welcome the opportunity to partner in building healthy, connected rural communities across Fresno, Tulare, and Kern Counties.

Prepared by Jordan Ramirez, Grants Manager, 2025-11-02