CHL 620 Week 6 Community Health Grant Proposal Example

Neighbors in Health: A Three-Year Grant Proposal for a Community Health Worker Program on a Yakima Valley East Side

[Student Name]

University of Phoenix

CHL/620: Community Health Engagement and Organizing

Week 6 Assignment

[Instructor Name]

[Date]

The coalition, program, partners, budget, targets and funder are composites written for a model proposal modeled on Yakima, Washington; city estimates come from CDC PLACES, and research findings come from the sources cited.

Executive Summary

The East Side Health Coalition, Salud del Este, requests $612,000 over three years to launch Neighbors in Health, a community health worker program serving adults with chronic conditions on the east side of a central Washington city. Six bilingual community health workers from the neighborhood will each support about 40 adults at a time, helping them get timely primary care, manage appointments and transportation, resolve billing problems and meet social needs. Over three years, the program will serve 720 adults, reduce emergency visits and hospital days among participants and build a sustainable model funded by Medicaid.

Statement of Need

The east side is home to about 32,000 people, most of them Hispanic families working in agriculture and food processing. In CDC's 2023 citywide estimates, 19.7% of working-age adults lack health insurance, 12.9% of adults have diagnosed diabetes and 26.8% rate their health as fair or poor, roughly double the estimates for Seattle (Centers for Disease Control and Prevention [CDC], 2025).

Residents' Own Evidence

When promotoras surveyed 612 east side households door to door, close to a third of adults named no regular place for care, and nearly two in five had postponed care over cost. A participatory study with eight resident co-researchers found five reasons for delay: clinic hours that conflict with work, difficulty booking appointments, needing grown children to drive and translate, fear of surprise bills and past experiences of disrespect. One farmworker put it plainly: a missed shift costs more than a visit is worth to him.

Goals and Objectives

Goal: improve access to primary care and reduce preventable hospital use among east side adults with chronic conditions. Objectives by the end of year three: serve 720 adults; 80% of participants keep at least two primary care visits in six months, up from an estimated 45%; emergency visits among participants fall by 25% compared with the year before enrollment; hospital days fall by 30%; and 85% of participants rate their care as good or excellent.

Program Design

The program adapts IMPaCT, a standardized community health worker model. Workers are hired for lived experience and trained in a 120-hour curriculum, then work with each participant to set goals, build a tailored plan and provide about six months of support: booking appointments, arranging rides, attending visits if requested, resolving bills, linking families to food and housing resources and checking in after any hospital discharge.

Evidence for the Model

The model has strong evidence. Researchers in Philadelphia randomized 592 patients from high-poverty neighborhoods, each living with at least two chronic illnesses, at three primary care practices; those assigned community health workers rated their physical health no differently at follow-up, but the program improved patient-perceived quality of care and reduced total hospital days, from 345 to 155 at six months and from 471 to 300 at nine months, with lower odds of repeat hospitalization (Kangovi et al., 2018). Fewer than half as many hospital days in six months is the kind of result funders and Medicaid plans both notice.

Return on Investment

The model also pays for itself. A return-on-investment analysis based on the same trial estimated that a typical Medicaid payer would recoup $2.47 within the same fiscal year for each dollar spent on the program, and it noted that estimates from pre-post designs often overstate returns because of regression to the mean (Kangovi et al., 2020).

Adaptation for the East Side

The program adapts the model for the community: workers are bilingual residents; services are offered evenings and weekends; workers meet participants at churches and the flea market as well as homes; and workers coordinate with the clinic's new evening hours and the evening bus pilot won by residents.

Recruitment of Participants

Participants will be referred by the clinic, the hospital's emergency department, the Medicaid plan and community health workers' own outreach at churches and events. Eligibility requires living on the east side, having at least one chronic condition and either an emergency visit or a year without seeing a primary care clinician. Enrollment is voluntary and free.

Hiring and Supporting Workers

Workers will be hired through the coalition's networks, with interviews that include residents. The model hires for traits such as empathy and reliability rather than credentials, then trains skills. Workers receive weekly supervision, peer support meetings and protected time for their own health, since the work can be emotionally demanding.

Partners

The community health center employs and supervises workers and integrates them into care teams. The hospital refers patients after emergency visits and provides hospital use data. The health district supports evaluation. A Medicaid managed care plan refers members and will negotiate payment by year three. The community college trains workers. Churches host outreach. Letters of commitment are attached.

Community Governance

Salud del Este's governing council, a majority of whom are residents, oversees the program, approves hiring standards and reviews results quarterly. Resident co-chairs sign off on annual plans.

Evaluation Plan

The health district will evaluate the program. Process measures include participants enrolled, contacts and services provided. Outcome measures include kept primary care visits, emergency visits and hospital days from hospital and plan data, compared with the year before enrollment and with a matched group of eligible patients not enrolled, and participant-rated care quality. Results will be reported to residents and the foundation each year.

Budget

Year one: $204,000. Six community health workers at part-time equivalent of four full-time positions, $152,000; supervisor time, $18,000; training, $9,000; mileage, phones and bus passes, $11,000; evaluation, $8,000; community meetings and interpretation, $6,000. Years two and three follow a similar pattern, for a total of $612,000. The hospital contributes a coordinator and space as in-kind support.

Budget Justification

Worker pay is set at a living wage for the region to reduce turnover, which disrupts relationships participants depend on. Supervision follows the model's standard ratio. Evaluation is set at 4% of the budget. Interpretation and meeting costs reflect resident governance, which the coalition treats as a core program cost rather than overhead.

Risks and Responses

Risks include worker turnover, slow referrals and delays in Medicaid payment negotiations. The program responds with living wages and career paths, referral agreements signed before launch and early data sharing with the Medicaid plan so that payment talks begin in year two rather than year three.

Sustainability

By year three, the coalition will seek Medicaid reimbursement through the managed care plan, supported by the program's own results and the published return on investment. The hospital has agreed to continue funding one position as community benefit. The health center will bill for eligible services where state rules allow.

Conclusion

Neighbors in Health addresses barriers residents named themselves with a model tested in a randomized trial and shown to return more than it costs. Local data and residents' research document the need, partners bring the capacities the program requires, residents govern it and evaluation and Medicaid payment offer a path to sustainability.

References

Centers for Disease Control and Prevention. (2025). PLACES: Place data (GIS friendly format), 2025 release [Data set]. data.cdc.gov. https://data.cdc.gov/d/vgc8-iyc4

Kangovi, S., Mitra, N., Grande, D., Long, J. A., & Asch, D. A. (2020). Evidence-based community health worker program addresses unmet social needs and generates positive return on investment. Health Affairs, 39(2), 207-213. https://doi.org/10.1377/hlthaff.2019.00981

Kangovi, S., Mitra, N., Norton, L., Harte, R., Zhao, X., Carter, T., Grande, D., & Long, J. A. (2018). Effect of community health worker support on clinical outcomes of low-income patients across primary care facilities: A randomized clinical trial. JAMA Internal Medicine, 178(12), 1635-1643. https://doi.org/10.1001/jamainternmed.2018.4630