NATIVE AMERICAN COMMUNITY HEALTH CENTER, INC. DBA NATIVE HEALTH.PDF

Created: 02/23/2018 • Last updated: 02/27/2018
General information
Organization Native American Community Health Center, Inc. dba NATIVE
HEALTH
Contact First name Lisa
Contact Last name Wathogoma
Contact e-mail lwathogoma@nachci.com
Contact phone number 602-279-5262
Address
Street 4041 N. Central Avenue, Building C
City Phoenix
State Arizona
ZIP Code 85012
From what tribe is the Gila River Indian Community
organization requesting the
grant?
Total grant amount request 74344.54
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The Gila River Indian Community offers multi-year awards. If your organization is
requesting a multi-year grant for this project or program from the Gila River Indian
Community, enter the amount to be requested each year.
Amount
Year 1 (Gila River Indian
74344.54
Community Grants Only)
Year 2 (Gila River Indian
Community Grants Only)
Year 3 (Gila River Indian
Community Grants Only)
Year 4 (Gila River Indian
Community Grants Only)
Year 5 (Gila River Indian
Community Grants Only)
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Gila River Indian Community Grant Application
Grant Cycle 2018
Cover Sheet
Municipality Information
1. Date of Application: 2/23/2018 (NOTE: Click or use up/down arrow keys to move among fields)
2. Name of City, Town or County: Maricopa County
3. Mayor (City or Town) or Board of Supervisor’s Chairman (County): Steve Chucri
4. Mailing Address: 301 W. Jefferson Ave., Suite 960
5. City: Phoenix State: Arizona Zip Code: 85003
6. Acknowledgement of Submission by Authorized Municipality Representative:
Typed Name/Title: Zachary Wolfe, Finance Department Signature:
Applicant Information
7. Department/Organization Name: Native American Community Health Center, Inc. DBA NATIVE HEALTH
8. Is this a 501c non‐profit Organization? No Yes If yes, attach IRS Determination Letter
9. Application Contact Person: Lisa Wathogoma Title: Small Grants/Donor Relations Specialist
10. Phone Number: 602‐279‐5262 x3117
11. Mailing Address: 4041 N. Central Ave., Bldg C
12. City: Phoenix State: Arizona Zip Code: 85012
13. Email Address: LWATHOGOMA@NACHCI.COM Website Address: www.nativehealthphoenix.org
Project Information
14. Project Name: Mesa Medical Expansion Project
15. Purpose of Grant: Exam room and other office furniture for new medical facility in Mesa, AZ.
16. Priority Funding Area Healthcare
17. Annual amount requested $74,344.54
18. Number of years that funding is requested 1 year
19. Total amount requested (annual amount x $74,344.54
number of years)
20. Has your organization received past funding 2008 ‐ $45,000
from GRIC? If yes, list each year and amount 2015 ‐ $85,850 Dental Equipment for Enhanced Services
21. Geographic area served Maricopa County
For Office Use Only:
Data Entry Receipt Evaluation
Outcome  Approval Recommended/Amount $  Denial

Gila River Indian Community Grant Application
Grant Cycle 2018
Narrative
Please structure your proposal to provide the following information in the order indicated. Provide the narrative in
paragraph form in the text field provided. Please be thorough but strive for brevity.
1. Briefly describe the organization’s history, mission and goals.
NATIVE HEALTH was founded and incorporated as a Non‐Profit, 501 (c)(3) in August 1978. Initial funding was
from Indian Health Services for a Community Health Nursing Program. The agency has since expanded to
include Behavioral Health Services, WIC Nutrition program, Medical, Dental and numerous other health
maintenance or preventative services. The agency also provides social programs, including services directed to
young parents and their children to assure childhood development, household safety and school readiness.
A second Family Practice‐ Community Health Center was initiated in July of 2009. This enabled NATIVE HEALTH
to broaden the agency consumer base to include underserved patients residing in Central Phoenix regardless of
race or ethnicity.
As healthcare barriers continue, and access to adequate healthcare become more arduous for urban Native
Americans and other underserved populations; NATIVE HEALTH strives to assure accessibility to vital health and
wellness services. The agency provides a uniquely comprehensive array of services. NATIVE HEALTH is
dedicated to improving the health status of individuals, families and communities that experience disparities in
health associated with issues of poverty and oppression. These services include but are not limited to the
following.
Programs (Partial List): Primary Medical Care, Dental Care, WIC Nutrition Services, Health Promotion Education,
Heatlh Start (A Young Mothers Program), Diabetes Prevention and Education, Home Visiting Program (A school
readiness program), Substance Abuse Treatment, HIV Prevention Services, AHCCCS (Medicaid) Erollment
Services, Arizona Long Term Care Services (Case Management for persons with disabilities), Youth and Family
Counseling, Prenatal Care, Outreach Services and Domestic Violence Services.
The Goals/Strategies developed in NATIVE HEALTH Strategic Plan to expand from 2017 through 2020 are as
follows;
 NATIVE HEALTH will continually work toward being the preferred health partner in our communities.
 NATIVE HEALTH will ensure financial health and stability.
 NATIVE HEALTH demonstrates a culture of inclusion and respect.
 NATIVE HEALTH will provide timely accesss to needed care.
Mission Statement: NATIVE HEALTH provides holistic, patient centered, culturally sensitive health and wellness
services.
Vision Statement: Healthy People in Healthy Communities.
2. If the applying organization is non‐municipal or a non‐profit 501c, please describe your relationship with Arizona
municipalities including past and present support, whether through partnerships, collaborations, in‐kind
contributions, grants, tax‐based funding or other. Describe the supporting municipality’s role in this project. If
the applying organization is a municipality governmental sub‐division please enter the text “Not applicable.”

Gila River Indian Community Grant Application
Grant Cycle 2018
NATIVE HEALTH partners and collaborates with Maricopa County and the City of Phoenix on various projects
through the community graden projects and literacy and food insecurity programs provided to the Phoenix
and Mesa areas. The agency has also received in‐kind donations in the form of children’s books for the Little
Free Libraries located at all NATIVE HEALTH facilities. NATIVE HEALTH has several colaborations with
Maricopa County Public Health including the Maricopa County Health Improvement Partnership and a
community health needs assessment with the epidemiology department. Maricopa County will serve as the
pass through for NATIVE HEALTH if funding on this project should it be awarded.
3. Describe the proposed project and planned goals and activities.
NATIVE HEALTH is requesting support from Gila River Indian Community to provide financial assistance for
medical exam room and office furniture for a medical clinic in Mesa, Arizona. NATIVE HEALTH has recently
purchased a building in the City of Mesa to provide an array of services to the underserved populations residing
in the eastern part of the county. (The facility is located close to Tempe, Guadalupe and Chandler) NATIVE
HEALTH is commited to providing services targeted to underserved populations as the primary consumer base
for the services to be provided.
The new medical facility is one of five buildings purchased, and is in process of development to house medical
and behavioral health services. Another building is already being utilized for provision of family support services
in cluding WIC, Health Start, Home Visiting, food distribution, nutrition education programs and dental fluoride
application for children. As a non‐profit organization on a tight budget; the agency has budgeted funds for
faciliaty design and renovations. NATIVE HEALTH is requesting support to help alleviate the costs of purchasing
necessary equipment, furniture and other materials required for primary care services delivery. The agency has
preioviously utilized used and donated fixtures in development of new clinics and is hoping to attain funds to
enable purchase of furniture and medical fixtures that are consistant with the clinic design and ambiance. The
new facility is designed to contain eleven Medical Exam rooms and ten Behavioral Health Talk rooms. The
medical exam rooms will serve as space where patients will receive medical care. The behavioral health talk
rooms will be furnished with patient chairs, a small table and a provider office chair where patients who seek
behavioral health counseling or services can be provided care within the medical setting. This serves as an
objective for NATIVE HEALTH’s Care Model which promotes medical and behavioral health care integration.
The facility is being renovated to be state of the art and designed for optimal efficiency. It is going to have new
fixtures that will compliment the aesthetics of the medical clinic very well. The exam room and office furniture
to be purchased with funding from Gila River Indian Community will only enhance the agency’s professional
appearance.
To enable use of the eleven medical exam rooms; NATIVE HEALTH is requesting funds to purchase an exam base
table with compatible top, a wall mount panel with integrated dianostic systems, provider stool, side patient
chairs, and sharps container for each exam room. Other equipment include laptops, office chairs, computers and
mobile workstations for medical providers, nurses and medical assistants to use for obtaining and recording
patient records.The request for funds to purchase other necessary equipment for the operation of the ten

Gila River Indian Community Grant Application
Grant Cycle 2018
behavioral health talk rooms is as listed: provider office chair, patient guest chairs, and a small table/desk for
each room.
With the expansion into the City of Mesa, NATIVE HEALTH can increase capacity to provide medical care to the
underserved residents of the Mesa and surrounding communities who might otherwise go without proper
medical care.
The Project Goals and Objectives are as follows:
Goals:
 Low income and minority underserved residents of Mesa and surrounding cities will have
improved access to high quality medical care in a comfortable and efficient environment.
Objectives:
1. NATIVE HEALTH will have purchased and received the necessary medical and other office
equipment for the medical clinic by November 2018.
2. NATIVE HEALTH will open a clinic to serve the needs of low income Maricopa County residents by
January 1, 2019.
4. Describe how the proposed project satisfies one or more of the priority funding areas identified by the Gila River
Indian Community.
The proposed NATIVE HEALTH project addresses the Gila River Indian Community priority for Healthcare.
NATIVE HEALTH provides health care services including behavioral health care targeted to the needs of urban
American Indians and low income populations residing through‐out the metropolitan areas of Maricopa County.
The agency will be providing primary medical care and behavioral health services to the underserved
populations of Mesa and will soon establish a dental clinic by 2020.
The project also addresses the Gila River Indian Community priority for economic development. As NATIVE
HEALTH expands capacity to serve populations in Mesa, overall agency earnings will be increased; which will
enable growth within the NATIVE HEALTH Mesa location. The expansion into the east valley is based upon
results achieved from the agency facilitating a Community Needs Assessment among improverished residents
and current patients. The agency has experienced tremendous growth over the past three years and expects to
continue to serve an ever increasing load of improverised and disenfranchised residents.
5. Identify the needs/problems to be addressed, target population and number of people to be served by the
project.
The agency is funded through several sources to provide services targeted to minority and low income families
and individuals. A grant from the Health Resources and Services Administration to enable health care for
persons that do not have insurance or capacity to pay out of pocket. Additionally the agency receives grants
from other federal entities for provision of services to meet numerous needs including nutrition, diabetes risk,

Gila River Indian Community Grant Application
Grant Cycle 2018
HIV and other health and wellness concerns. The agency service area is generally defined as all of Maricopa
County outside of Tribal lands. Although the agency receives grants to serve urban American Indians; NATIVE
HEALTH provides services to anyone that presents for care regardless of race, ethnicity, and income level. The
target population generally includes people with income below 200% of the Federal Poverty Rate. The majority
of patients served report incomes beneath 100% of the Poverty Rate. On average NATIVE HEALTH serves
approximately 17,000 individuals annually. This results in approximately 80,000 patient encounters. NATIVE
HEALTH’s current facilities include medical, dental clinics and behavioral health care services.
The service area NATIVE HEALTH is developing is located in the City of Mesa, at the intersection of Southern
Avenue and Extension. The facility is strategically located in an area of Mesa that has a significant higher
underserved populations as compared to other areas of the city. Mesa Community College (MCC) is in close
proximity and NATIVE HEALTH expects to serve the needs of community college students. This new service area
will have an established medical and behavioral health clinic in late 2018; a dental clinic will be soon added as a
provision of care by 2020. About 21.2% of Mesa residents have income below the federal poverty rate. NATIVE
HEALTH foresees to have a positive impact on the low‐income populations in Mesa and surrounding
communities that lack the financial resources to receive quality medical and behavioral health care.
6. Define the project as a new or continuing program.
The project is a new endeavor as related to this request for assistance from the Gila River Indian Community.
Expansion and the circumstances that make this expansion viable at this time have been in the works for a few
years.
7. Provide a brief timeline including start and finish dates. Indicate if the timeline is flexible.
NATIVE HEALTH proposes to consult medical equipment and furniture vendors whom the agency has conducted
business within the past to begin the ordering process. A final report will be provided at the end of September
2019 regarding installation of the fixtures and the impact.
 March 2018: Application notification of resolution from city/town council or county board of
supervisors.
 July 2018: Applicant notification of disposition of the application from GRIC and Initial
Consultation with vendor on purchase of equipment.
 September 2018: Resolution from city/town council or county board of supervisors due to GRIC.
 October 2018: GRIC Notification of Award
 November 2018: Distribution of Funds and final consultation with vendor on purchases and
installation
 December 2018: Installment of fixtures and purchases completed
NATIVE HEALTH expects to have improvements completed for all proposed areas by the end of December 2018.
The agency will purchase all necessary fixtures as soon as the requested grant is awarded. The NATIVE HEALTH
Mesa facility will begin seeing patients for both medical and behavioral health care by January 1, 2019.

Gila River Indian Community Grant Application
Grant Cycle 2018
8. Identify other organizations, partners or funders participating in the project and their roles.
NATIVE HEALTH will utilize grant funds and earned income form provision of billable services to provide medical
and behavioral health care to the City of Mesa. The agency will utilize AHCCCS to provide medical care under
Medicaid for the residents of the east valley. NATIVE HEALTH has partnered with other agencies to provide
ancillary services from the NATIVE HEALTH Mesa location and those partners include Midwest Food Bank, WIC,
Raising a Reader, and the local library.
9. Would you be able to implement the proposed plan if your organization received partial funding for this project?
Yes, NATIVE HEALTH would be able to furnish the medical exam and behavioral health talk rooms with partial
funding. The itemized budget would be used as a guide to pick and choose those parts of the request that would
be purchased based upon the amount allocated. Other grants, donations or earned income will be utilized to
address the un‐met costs.
10. Describe your plan for project financial sustainability beyond the grant period. If this is a program/project
previously funded by the Gila River Indian Community describe efforts made towards the previously described
sustainability plan.
NATIVE HEALTH plans to receive funding from the following federal funding sources to enable continued patient
care as income will be sustained by billing and earnings.
AHCCCS and other Insurance providers: The agency continues to increase billing and earnings from Medicaid
and private insurance sources.
IHS: NATIVE HEALTH receives federal funding to provide services; the requested grant will enable capacity
expansion.
HRSA: NATIVE HEALTH receives federal funding to provide services; the requested grant will enable capacity
expansion.
11. Describe your plan to document progress and results.
NATIVE HEALTH plans to follow the implement time table as follows.
 July 2018: Begin consultation with vendor on purchase of furniture and equipment.
 October 2018: Notification of Award from GRIC.
 November 2018: Distribution of Funds to agency and purchase of furniture and equipment finalized.
 December 2018: Installments and final purchases completed.
 Mid to late December 2018: Medical and Behavioral Health services initiated.
 September 2019 or earlier: Final Report outlining impact.

Gila River Indian Community Grant Application
Grant Cycle 2018
12. Indicate any application to and/or awards made by a tribe other than the Gila River Indian Community for state
shared revenues for this and any other project for the past five (5) years. If this information is included in a
separate attachment, please indicate that here.
NATIVE HEALTH has received funding from the Gila River Indian Community in 2015 for a Dental Service
Expansion Project in the amount of $85,850 to provide enhanced dental equipment for the NATIVE HEALTH
Central Phoenix facility. The agency anticipates to request funding from Fort McDowell Yavapai Nation, the
Tohono O’odham Nation, foundation and community donors for similar needs that will address other office
space and upgrades to the NATIVE HEALTH Mesa facility which will include the medical waiting room,
registration area and future expansions including a dental clinic.

Gila River Indian Community Grant Application
Grant Cycle 2018
Project Budget
Budget Period: November 2018 – January 2019
For each budget item listed here please provide a narrative description on the following Project Budget Detail page.
Proposed Budget Expense Amount Amount In Kind Total Budget
(list each budget item) requested from requested or contributions
GRIC secured from
other funders
1. Exam Table Base $ 18,217.54 $0 $0 $18,217.54
2. Exam Table Top $ 5,465.90 $0 $0 $ 5,465.90
3. Provider Stool $ 3,216.40 $0 $0 $ 3,216.40
4. Side Chairs $ 3,784.00 $0 $0 $ 3,784.00
5. Sharps Containers $ 329.45 $0 $0 $ 329.45
6. Wall Mount Panel for Integrated $ 10,612.91 $0 $0 $ 10,612.91
Diagnostic System
7. Mobile Lapton Workstation $ 7,361.94 $0 $0 $ 7,361.94
8. Mesh Task Chair $9,799.65 $0 $0 $ 9,799.65
9. Laptops $ 1,499.94 $0 $0 $ 1,499.94
10. Provider Chair $ 979.90 $0 $0 $ 979.90
11. Patient Chair $ 2,399.80 $0 $0 $ 2,399.80
12. Small Table/Desk $ 980.00 $0 $0 $ 980.00
13. Service Fees & Shipping $ 9,697.12 $0 $0 $ 9,697.12
14. Click here to enter text. $0 $0 $0 $0
15. Click here to enter text. $0 $0 $0 $0
16. Click here to enter text. $0 $0 $0 $0
17. Click here to enter text. $0 $0 $0 $0
Total Budget $ 74,344.54 $0 $0 $ 74,344.54

Gila River Indian Community Grant Application
Grant Cycle 2018
Project Budget Detail
Please provide a narrative description for each of the project budget items listed on the previous page. Include the
dollar figure and how it was derived.
1. Exam Table Base: Medical exam table base to provide medical examinations in private room. ($1,656.14/base x 11
rooms = $18,217.54)
2. Exam Table Top: Medical exam table top compatible with base to provide medical examinations in private room.
($496.90/table top x 11 rooms = $5,465.990)
3. Provider Stool: For Medical Provider use during medical exam with patient. ($292.20/stool x 11 rooms = $3,216.40)
4. Side Chair: Chair for medial exam rooms for family or other persons accompanying patient. ($172.00/chair x 11 rooms
x 2 chairs /room = $3,784.00)
5. Sharps Container: Disposal of sharps/needles in medical exam room. ($29.99/container x 11 rooms = $329.45)
6. Wall Mount Panel for Integrated Diagnostic Systems: Wall mount for patient diagnostics. ($964.81/wall mount x 11
rooms = $10,612.91)
7. Mobile Workstation: Laptop mobile workstantion stand for easy movement in and out of medical exam rooms.
($1,226.99/workstation x 6 = $7,361.94)
8. Mesk Task Chair: Chair for medical staff including Behavioral Health Providers, nurses, medical assistants and Physian
Assistants to use during patient record entry and other office duties. ($279.99/chair x 35 = $9,799.65)
9. Laptops: Laptop computers for use of patient record entry during the medical exam. ($249.99/laptop x 6 = $1,499.94)
10. Provider Office Chair: Chair to be used for Behavioral Health Provider in Talk rooms. ($97.99/chair x 10 rooms =
$979.90)
11. Patient Chair: Guest chairs for patients in Talk rooms. ($119.99/chair x 10 rooms x 2 chairs/room = $2,399.80)
12. Small Table: Small table or desk to be utilized by Behavioral Health Provider for note taking in Talk rooms.
($98.00/table x 10 rooms =$980.00)
13. Service Fee & Shipping: Costs of service fees and shipping at 15% of overall total. ($64,647.43 x 0.15 = $9,697.12)
14. Click here to enter text.

Gila River Indian Community Grant Application
Grant Cycle 2018
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