CIRCLE THE CITY APPLICATION GRIC 2017.PDF

Created: 01/13/2017 • Last updated: 03/03/2017
General information
Organization Circle the City
Contact First name Kimberly
Contact Last name O'Leary
Contact e-mail koleary@circlethecity.org
Contact phone number 602-357-4257
Address
Street 300 W. Clarendon Ave., Suite 200
City Phoenix
State AZ
ZIP Code 85013
From what tribe is the Gila River Indian Community
organization requesting the
grant?
Total grant amount request 150,000
1 / 2

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
50000
Community Grants Only)
Year 2 (Gila River Indian
50000
Community Grants Only)
Year 3 (Gila River Indian
50000
Community Grants Only)
Year 4 (Gila River Indian
Community Grants Only)
Year 5 (Gila River Indian
Community Grants Only)
2 / 2

INTERNAL REVENUE SERVICE DEPARTMENT OF THE TREASURY
P. O. BOX 2508
CINCINNATI, OH 45201
Employer Identification Number:
Date: SEP -9 Z006 26-2420730
DLN:
17053191342048
CIRCLE THE CITY Contact Person:
C/O ADELE OSULLIVAN NANCY L HEAGNEY ID# 31306
220 S 12TH AVE Contact Telephone Number:
PHOENIX, AZ 85007 (877) 829-5500
Accounting Period Ending:
June 30
Public Charity Status:
l70(b) (1) (M (vi)
Form 990 Required:
Yes
Effective Date of Exemption:
March 6, 2008
Contribution Deductibility:
Yes
Advance Ruling Ending Date:
June 30, 2012
Addendum Applies:
No
Dear Applicant:
We are pleased to inform you that upon review of your application for tax
exempt status we have determined that you are exempt from Federal income tax
under section 501(c) (3) of the Internal Revenue Code. Contributions to you are
deductible under section 170 of the Code. You are also qualified to receive
tax deductible bequests, devises, transfers or gifts under section 2055, 2106
or 2522 of the Code. Because this letter could help resolve any questions
regarding your exempt status, you should keep it in your permanent records.
Organizations exempt under section 50l(c) (3) of the Code are further classified
as either public charities or private foundations. During your advance ruling
period, you will be treated as a public charity. Your advance ruling period
begins with the effective date of your exemption and ends with advance ruling
ending date shown 'in the heading of the letter.
Shortly before the end of your advance ruling period, we will send you Form
8734, Support Schedule for Advance Ruling Period. You will have 90 days after
the end of your advance ruling period to return the completed form. We will
then notify you, in writing, about your public charity status.
Please see enclosed Publication 4221-PC, Compliance Guide for SOl(c) (3) Public
Charities, for some helpful information about your responsibilities as an
exempt organization,
Letter 1045 (DO/CG)

-2-
CIRCLE THE CITY
Sincerely,
Robert Choi
Director, Exempt Organizations
Rulings and Agreements
Enclosures: Publication 4221-PC
Statute Extension
Letter 1045 (DO/CG)

Gila River Indian Community Grant Application
Grant Cycle 2017
Cover Sheet
Municipality Information
1. Date of Application: January 16, 2017 (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): Denny Barney
4. Mailing Address: 301 W. Jefferson, 10th Floor
5. City: Phoenix State: Arizona Zip Code: 85003
6. Acknowledgement of Submission by Authorized Municipality Representative:
Typed Name/Title: Melody Henderson, Maricopa County Government Relations Signature:
Applicant Information
7. Department/Organization Name: Circle the City
8. Is this a 501c non-profit Organization? No X Yes If yes, attach IRS Determination Letter
9. Application Contact Person: Kimberly O'Leary Title: Grants Specialist
10. Phone Number: 602-357-4257
11. Mailing Address: 300 W. Clarendon Ave., Suite 200
12. City: Phoenix State: Arizona Zip Code: 85013
13. Email Address: koleary@circlethecity.org Website Address: www.circlethecity.org
Project Information
14. Project Name: Medical Respite Care for People Expereincing Homelessness
15. Purpose of Grant: To provide critical medical respite care and wrap-around services to men and women experiencing homelessness while ill or injured.
16. Priority Funding Area Healthcare
17. Annual amount requested $50,000
18. Number of years that funding is requested 3 years
19. Total amount requested (annual amount x $150,000
number of years)
20. Has your organization received past funding Yes. CTC received $70,000 for FY2014 and $25,000 for FY2016.
from GRIC? If yes, list each year and amount
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 2017
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 mission, history and goals.
Circle the City is a rapidly growing non-profit community health organization dedicated to creating and
delivering innovative healthcare solutions that compassionately address the needs of men, women, and children
facing homelessness in Maricopa County. Incorporated in 2008 by Sister Adele O’Sullivan, CSJ, MD, Circle the
City offers a continuum of homeless healthcare that is one-of-a-kind in the state and one of the only models of
its type in the nation. In 2012, Circle the City launched the state’s first and only medical respite center for men
and women experiencing homelessness while ill or injured. Always looking for opportunities to fill critical gaps in
the homeless healthcare system, in September 2015, Circle the City opened The Parsons Family Health Center, a
homeless-specialty primary care facility that provides comprehensive medical care as well as on-site wrap-
around services including case management. Furthering its community outreach, Circle the City also launched a
two-room mobile medical clinic that visits parks, supportive housing complexes, and other homeless community
service agencies in order to provide healthcare to those who cannot access the fixed primary care site.
Collectively, Circle the City expects to serve more than 4,000 individuals in FY2017. Ultimately, Circle the City is
committed to ending homelessness by providing high quality medical care and social services that give patients
the tools and resources to lead healthy, independent lives.
2. If the organization is a non-municipal or a non-profit 501c, please describe your relationship with Arizona
municipalities including past and present support, whether it be 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.”
Circle the City was the recipient of a 2016 Maricopa County CDGB grant. Additionally, the
organization partnered with the Maricopa Association of Governments (MAG) on a 2014 Dignity Health
Community of Care grant that worked to test the Service Prioritization Decision Assistance Tool (SPDAT) on
medically vulnerable homeless persons in order to prioritize and expedite access to supportive housing for
these individuals.
3. Describe the proposed project and planned goals and activities.
Project:

Gila River Indian Community Grant Application
Grant Cycle 2017
Before the Medical Respite Center opened in 2012, Phoenix was the largest metropolitan area in the
country without a medical respite facility for men and women experiencing homelessness. Hospitals provided
temporary medical care for the most acutely ill and injured but there was no post-discharge option for patients
to receive recuperative care. As a result, patients were discharged back to the streets or emergency shelters
where—without a clean bed, access to medication, oversight from a physician, and assistance from a
caregiver—recovery was difficult, if not impossible. Many patients suffered complications and, often via
expensive 911 calls, returned to hospitals and emergency rooms again and again, overutilizing an already
overburdened system and costing local taxpayers untold millions of dollars.
Since launching four years ago, the 50-bed, 24/7 Medical Respite Center has cared for more than 950
patients and has quickly become one of the nation’s leading models for holistic, homeless-focused integrated
healthcare. Approximately 30% of the patient population is either uninsured or under-insured but, at Circle the
City, no patient is ever turned away because of an inability to pay. In FY2017, Circle the City expects to provide
more than $1.2 million in charitable care to these patients.
Goals:
1. Provide more than 15,300 bed days of acute medical services and case management to ill or injured
homeless individuals. Of the approximately 340 total patients who will be cared for, upwards of 125 are
expected to be uninsured or under-insured;
2. Establish integrated, holistic plans of care for 100% of these patients;
3. Maintain the necessary engagement to ensure that at least 75% of these patients successfully complete all
goals established in their respective care plans;
4. Successfully connect at least 90% of these patients with relevant benefits or entitlements, including
nutritional assistance, health insurance, income, and housing;
5. Successfully transition at least 75% of these patients into living situations other than the streets or
emergency shelter system.
Activities:
Each patient interacts daily with compassionate doctors and nurses and receives wrap-around services
on-site including psychiatric evaluation, physical therapy, and substance abuse intervention. Patients also meet
regularly with case managers to apply for identification and other documents, benefits, and housing to ensure
that they are successfully discharged to living environments other than the streets or emergency shelter system.
Additionally, more than 150 volunteers lead activities and events for patients including art classes, bingo, crafts

Gila River Indian Community Grant Application
Grant Cycle 2017
sessions, and tutoring. These activities are an important component in reintegrating patients back into the
community from which homelessness has isolated them.
4. Describe how the proposed project satisfies one or more of the priority funding areas identified by the Gila River
Indian Community.
This request meets the Gila River Indian Community’s Healthcare priority area, specifically direct patient care.
5. Identify the needs/problems to be addressed, target population and number of people to be served by the
project.
Needs:
Homelessness has devastating effects on a person’s health. In one study, the prevalence rate of chronic
medical illness in the homeless was one-half of the surveyed population compared with less than one-quarter of
the housed population (Donovan et al., 2007). Because of a lack of income, insurance, or transportation, these
health conditions are left untreated and are complicated by high incidences of mental health and substance
abuse disorders. As a result, people experiencing homelessness are some of the most frequent and costly users
of healthcare services. They visit emergency departments 9 to 12 times more than people who are housed, have
higher rates of hospitalization, and stay longer per admission (S.W. Hwang et al., 2011). But medical respite care
has proven to be a cost-effective and safe stabilization point for men and women to land after long and complex
periods of hospitalization or for individuals living in homelessness whose complicated illnesses or injuries have
begun to spiral out of control. For the average cost of one day of hospitalization--$2,194—Circle the City
provides each patient with more than 10 days of holistic, physican-supervised medical respite care in a safe and
clean environment.
Target Population:
Men and women experiencing homelessness while ill or injured are the Medical Respite Center’s target
population. Approximately 42% of Circle the City’s patients are age 55 and older. This data aligns directly with a
national phenomenon called “The Aging of the Homeless,” which was discussed in the October 2014 issue of The
Lancet medical journal. The median age of the homeless population in the United States has risen to nearly 50
years of age. Individuals between the ages of 50-61 have experienced homelessness at higher rates throughout
their lives than previous generations did. This is creating a more intensive medical need for the care of chronic
disease, geriatric conditions, frailty, and end-of-life issues. Circle the City has positioned itself to meet the needs
of this particularly vulnerable and growing population.
Number of People Served:
Circle the City expects to care for at least 340 patients in FY2017.
6. Define the project as a new or continuing program.

Gila River Indian Community Grant Application
Grant Cycle 2017
The medical respite care program is a continuing project that began in October 2012. FY2017 begins
July 1, 2016, and ends June 30, 2017.
7. Provide a brief timeline including start and finish dates. Indicate if the timeline is flexible.
Medical respite care is an ongoing patient care program and, as such, the timeline is flexible with
patients being admitted and discharged on a continual basis. Please see the attachment for an example of a
timeline of one patient’s Medical Respite Center stay.
8. Identify other organizations, partners or funders participating in the project and their roles.
Circle the City collaborates with numerous community partners to provide an array of services for all its
patients, including those who are uninsured and under-insured. Four major hospital systems (Abrazo
Community Health Network, Banner Health, Dignity Health, and Honor Health) maintain referral contracts with
Circle the City and send patients experiencing homelessness to the Medical Respite Center for recuperative care
to heal from serious illnesses and injuries. While these hospital contracts pay for a portion of patient stays, Circle
the City must use charitable care monies to fund the balance for patients from hospitals or community settings
who are uninsured or under-insured.
Another important partner is Hospice of the Valley, which owns Circle the City’s building and exchanges
reduced rent for end-of-life care for homeless hospice patients.
Collaborating with additional local agencies is a critical means for meeting patients’ social service needs,
including post-discharge housing. These partners include Native American Connections, Arizona Housing Inc.,
and Ozanam Manor.
Circle the City also has academic affiliations with medical and nursing schools that rotate students into
the Medical Respite Center to learn about homeless-specific medical care. Participating schools include A.T. Still
University (first- and second-year medical students); Creighton University (fourth-year medical elective course);
Mayo School of Graduate Medical Education (resident education in neurology and internal medicine); and
Midwestern University (resident education in podiatry). Finally, employee groups from corporations such as
Willis of Arizona and Intel provide volunteers for various projects and conduct company-wide collections of
items needed by patients.
9. Would you be able to implement the proposed plan if your organization received partial funding for this project?
Yes. Circle the City’s ability to meet the needs of vulnerable members of the community—especially
those who are uninsured or under-insured—depends on the generosity of donors and grantors. Circle the City is
grateful for all levels of financial support. But in the unfortunate case that adequate funding is not secured to
support this activity, the organization would scale back either services or scope of operation until key resources
are once again secured.

Gila River Indian Community Grant Application
Grant Cycle 2017
10. Describe your plan for project 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.
Since the Gila River Indian Community’s last grant, Circle the City has secured bed contracts with local
hospitals; continued to put on three annual fundraisers; and has held periodic need-specific campaigns. One of
the most important strategic achievements for sustainability occurred in 2014 with the successful integration
of the Medical Respite Center into the local Medicaid (AHCCCS) health plans. Additionally, in May 2015, Circle
the City received the highly competitive designation of Federally Qualified Health Center (FQHC). This
designation allows Circle the City to receive enhanced Medicare and Medicaid reimbursement for eligible
medical services. In this new funding environment, Circle the City is able to leverage each philanthropic dollar
granted to the organization by a factor of three to four by matching it with the enhanced health services
revenue. In FY2017, Circle the City projects to provide, organization-wide, nearly $8M worth of holistic, high-
quality healthcare on total fundraising of $2M.
11. Describe your plan to document progress and results.
Circle the City’s most advanced method for monitoring outcomes is its electronic medical record (EMR),
which tracks patient demographics, frequency and length of engagements with medical providers, and
outcomes, both medical and social. Provider notes, charts, and documents are scanned into the integrated
medical record, which is then reported on and analyzed to track outcomes for uninsured and under-insured
patients.
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.
Circle the City is applying for additional state shared revenues from the Fort McDowell Yavapai Nation for this
project, and from the Tohono O'odham Nation for a separate project.

Gila River Indian Community Grant Application
Grant Cycle 2017
Project Budget
Budget Period: July 1, 2017 to June 30, 2018
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. Salaries & Wages $25,904 $1,687,709 $0 $1,713,613
2. Consultants & Professional Fees $1,432 $80,724 $0 $82,156
3. Insurance & Benefits $5,870 $377,730 $0 $383,600
4. Supplies $2,080 $129,920 $0 $132,000
5. Direct Program Expenses $1,994 $126,406 $0 $128,400
6. Occupancy $9,621 $600,580 $31,199 $672,599
7. Professional Services & Admin. $3,099 $203,501 $0 $206,600
8. Click here to enter text. $0 $0 $0 $0
9. Click here to enter text. $0 $0 $0 $0
10. Click here to enter text. $0 $0 $0 $0
11. Click here to enter text. $0 $0 $0 $0
12. Click here to enter text. $0 $0 $0 $0
13. Click here to enter text. $0 $0 $0 $0
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 $50,000 $3,237,769 $31,199 $3,318,968

Gila River Indian Community Grant Application
Grant Cycle 2017
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. Salaries & Wages ($25,904 grant; $1,713,613 total) includes salaries for medical staff, behavioral health staff, case
managers, and other program direct staff.
2. Consultants & Professional Fees ($1,432 grant; $82,156 total) includes payment for services provided by contract labor,
including physical therapists and contract physicians.
3. Insurance and Benefits ($5,870 grant; $383,600 total) includes benefits for program staff.
4. Supplies ($2,080 grant; $132,000 total) includes medical supplies, linen and laundry, etc.
5. Direct Program Expenses ($1,994 grant; $128,400 total) includes patient dental services, food & beverage,
transportation, vision care, shoes & clothing, etc.
6. Occupancy Expenses ($9,621 grant; $672,599 total) include telephone, internet, IT & maintenance, property & building
maintenance, kitchen equipment, medical equipment, utilities, etc.
7. Professional Services & Admin ($3,099 grant; $206,600 total) includes administrative direct charges and allocation.
8. Click here to enter text.
9. Click here to enter text.
10. Click here to enter text.
11. Click here to enter text.
12. Click here to enter text.
13. Click here to enter text.
14. Click here to enter text.
15. Click here to enter text.
16. Click here to enter text.
17. Click here to enter text.
Other explanation: Click here to enter text.

try
Circle the City (CTC) provides medical
care and social support that allows patients
to rest, heal, and eventually pursue healthy,
healing independent living.
here
#healingthecity
Prior to 2012, homeless individuals experiencing Our Facility
major illness or injury faced the nearly impossible 50 beds: 40 beds for
challenge of recovering on the streets. Hospitals men; 8 beds for
women; 2 private rooms
provided temporary relief for the most acutely ill, but
were inevitably left with no option but to discharge On-site clinic with
two exam rooms for
homeless individuals back to the street or emergency 24/7 medical and
shelters. Without a clean bed, access to medication, nursing consultation
physician oversight, and assistance from a Two dining
caregiver, recovery was virtually impossible. Patients rooms serving three
frequently had no choice but to return to hospitals and meals per day
emergency rooms, often via expensive 911 calls. Living room with a
Tragically, some even died on the street. television, games,
library, and
computer stations
Circle the City Provides: Dedicated physical
therapy space, speech
• A clean bed in a dignified environment of care. and occupational
• Round-the-clock medical and nursing services. therapy services
as needed
• Behavioral health supports including psychiatry,
Interfaith chapel
counseling, and substance abuse services.
• Case management services including assistance
with housing placement.
• An array of volunteer-led activities including
AA meetings, art classes, recreation offerings,
and pet therapy.

try
97% of patients who complete their
stays at CTC are connected with a primary care
physician before discharge.
healing
82% of patients who complete their stays at
CTC are discharged to a setting other than
the street or emergency shelter.
here
CTC Partners Led by founder Sister Adele O’Sullivan, CSJ, M.D.,
Dignity Health CTC’s robust medical team includes primary care
Banner Health providers, a psychiatrist, physical therapists, behavioral
Scottsdale Healthcare health specialists, and a team of nurses dedicated to
Mayo Clinic meeting the needs of each patient admitted to the
Arizona Cardinals Medical Respite Center. Additionally, our team of case
Phoenix Symphony managers and volunteer patient advocates work to
Arizona Diamondbacks connect our patients with healthcare, income, housing,
and many others. and other benefits after discharge.
CTC is made possible by innovative contracts with
local hospital systems and the generosity of the
surrounding community. We are deeply grateful for
this support and collaboration.
CTC is an Arizona Qualifying Charitable Organization.
As such, monetary gifts to CTC are eligible for Arizona’s charitable
tax credit. Please also consider leaving a gift to Circle the City
in your will or trust.
a time and place to heal Medical Respite Center info@circlethecity.org
333 W. Indian School Road www.circlethecity.org
Circle the City
Phoenix, AZ 85013 phone 602.776.9000