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Kiran Siddiqui Hamdard Center for Health & Human Svcs.
Printed On: 23 January 2014 General Grants September 2013 Board Meeting 1
Patient Centered Medical HomeGeneral Grants September 2013 Board Meeting
Hamdard Center for Health & Human Svcs.Ms. Kiran Siddiqui 228 E. Lake StreetAddison, IL 60101-2889
[email protected]: 773-465-4600F: 773-465-4666
Ms. Kiran Siddiqui 1542 W. Devon AvenueChicago, IL 60660-1344
[email protected]: 773-465-4600, ext. 27F: 773-465-4666
Kiran Siddiqui Hamdard Center for Health & Human Svcs.
Printed On: 23 January 2014 General Grants September 2013 Board Meeting 2
Application Form
Report FieldsProject Name*Name of Project
Patient Centered Medical Home
Project Description*Please describe the project you are requesting funding for in one or two sentences.
Hamdard seeks to establish a Patient Centered Medical Home for critically underserved individuals, integrating its premier behavioral health and social services with comprehensive primary medical care. Hamdard requests $40,000 to support a Nurse Practitioner and expand primary care access.
Amount Requested*Amount Requested
$40,000.00
Target Population*Various Ages
Internal Grant NumberInternal Grant Number
14_05
Setting*Community-Based Services
Community Settings*If the program is other than home-based, please indicate the setting.
Other Community Clinic
Type of Support*Please indicate which type of support you are seeking.
Salary Only
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Nursing*Will this grant support the salary of a nurse, or nurses?
Yes, an NP/Advanced Practice Nurse
Program Type*Primary and/or Chronic Disease Care
Chicago Geographic Area*Please select the geographic area that your project serves. If your program is in the city of Chicago please refer to the maphere to see how VNA defines the North, South and West sides. If the program is in the suburbs or collar counties please choose the county it's it in from the list that pops up.
City & Suburbs
Geographic Area ContinuedIf your project will serve more than one county then please select the other county from the list below.
DuPage
Percent Female*Please indicate the percentage of the population served by your organization that is female. (Note that 1-3 should total 100%)
59%
Percent Male*Please indicate the percentage of the population served by your organization that is male.
41%
Percent Transgender*Please indicate the percentage of the population served by your organization that is transgender.
0%
Percent African/American*Please indicate the percentage of the population served by your organization that is African/American. (Note: The total of question 1-6 should equal 100%)
6%
Percent Asian American/Pacific Islander*Please indicate the percentage of the population served by your organization that is Asian American/Pacific Islander.
44%
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Percent Caucasian*Please indicate the percentage of the population served by your organization that is Caucasian.
36%
Percent Hispanic/Latino*Please indicate the percentage of the population served by your organization that is Hispanic/Latino.
7%
Percent Native American*Please indicate the percentage of the population served by your organization that is Native American.
0%
Percent Other*Please indicate the percentage of the population served by your organization that would be considered under another race/ethnicity.
6%
Homeless*Are the majority of the the people served by the program homeless, or formerly homeless?
No
Internal Geographic AreaIf this is a project for an area outside of the standard geographic area the administrator should enter the geographic area here. Otherwise, enter N/A.
[Unanswered]
Board Meeting Date09/12/2013
Site Visit Date08/07/2013
Fund UsedFund Used
[Unanswered]
Kiran Siddiqui Hamdard Center for Health & Human Svcs.
Printed On: 23 January 2014 General Grants September 2013 Board Meeting 5
Organization Information
Organization Budget*What is the total organization budget for the current year?
$1,932,299.00
Date of Incorporation*What is the organization's date of incorporation?
12/15/1992
United Way Funded*Is the organization funded by the United Way?
Yes
FEIN Number*What is the organization's FEIN number? This must be the FEIN number for the organization whose name you are applying under.
363917885
Section 501(c)(3)*Is your organization tax exempt under Section 501(c)(3)?
Yes
Section 509(a)(1)*Is your organization tax exempt under Section 509(a)(1)?
No
Section 509(a)(2)*Is your organization tax exempt under Section 509(a)(2)?
No
Fiscal AgentIf your organization is not tax exempt, do you have a fiscal agent? If so, please list the organization, contact person and phone number in the area below.
Not Applicable
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Organization Mission*Please summarize the organization's mission in the are below. Please limit the information to two to three sentences.
The mission of Hamdard Center for Health and Human Services is to promote the physical and emotional health and psychological well-being of individuals and families by offering hope, help and healing.
Professional and Support Staff Information
Professional and Support Staff*Please provide your agency's staff composition, listing the number of professional and support staff who are paid full time, paid part time, volunteers and interns/others. If the staff member is part time indicate what their full time equivalent is.
Hamdard employs 14 full-time Professional Staff, 4 full-time Support Staff and the following part-time staff:
10 Part-time Professional• Social Worker LCSW .3 FTE• Assessment Coordinator .5 FTE• Nurse .5 FTE• Addictions Counselor .6 FTE• Psychologist .6 FTE• Mental Health Counselor .75 FTE• PAIP Facilitator .14 FTE• Art Therapist .18 FTE• Psychiatrists: 1 at .2 FTE, 1 at .28 FTE
5 Contracted Part-Time Professional• Dir. Of Mental Health .35 FTE• Psychiatrists: 1 at .28 FTE, 1 at .4 FTE• Psychologist .12 FTE• Cardiologist .05 FTE
10 Part-time Support Staff• Shelter Intake Workers: 1 at .75 FTE, 2 at .6 FTE, 2 at .38 FTE, 1 at .3 FTE• Caregivers: 9 ranging from .38 to.75 FTE• Mental Health Intake Worker .6 FTE• Adult Day Program Aid .63 FTE• Youth Program Aid .75 FTE• Driver .2 FTE
1 Volunteer
Project Details
Kiran Siddiqui Hamdard Center for Health & Human Svcs.
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Project Start Date*What is the estimated project start date?
01/01/2014
Project End Date*What is the estimated end date of the project?
12/31/2014
Other Funding Sources*Please either upload a document with a list of other private and public funding sources for this particular request or type in the information in the area below. Please be sure to include the following details:1. Complete name of the source2. Whether the funding has been received or is pending3. Amount4. Date Received5. Or, If pending, the date of notification
Hamdard’s Board of Directors is committed to allocating $53,000 from individual contributions for the Nurse Practitioner salary. Hamdard is also pursuing the following foundation prospects to implement a Patient Centered Medical Home.
1. Blowitz-Ridgeway Foundation, $10,000, To Submit, Notification: December 2013
2. Chicago Community Trust, $100,000, To Submit, Notification: January 2014
3. Anonymous Foundation Pre-Application, $75,000, To Submit, Notification: September 2013
4. Grant Healthcare Foundation Letter of Intent, $40,000, Pending, Notification: August 2013
5. Washington Square Health Foundation, $31,000, Pending, Notification: August 2013
Budget
Organization Expenses*What were the expenses for the last fiscal year?
$1,266,201.00
Organization Revenue*What was the organization's revenue for the last fiscal year?
$1,266,411.00
Project Budget*What is the total budget for this project?
Kiran Siddiqui Hamdard Center for Health & Human Svcs.
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$372,248.00
Electronic Signature
Electronic Signature Step 1*Enter your full name, business title and the date of submission. (e.g.: Erin Smith, Executive Director, 13 June 2009)
Kiran Siddiqui, M.Ed., LCPCExecutive DirectorJuly 25, 2013
Electronic Signature Step 2*By entering your signature information above and clicking "I Agree" below, you certify that the statements contained in this application are true and correct to the best of your knowledge and belief.
I Agree
Proposal NarrativePlease provide the following information. The total space allowed for this section is five pages, including spaces and punctuation.
A. Background
1. Organization's mission, history, overall goals and/or objectives.*Hamdard Center for Health and Human Services (Hamdard) is a not-for-profit health and social service
agency whose mission is “to promote the physical and emotional health and psychological well-being of individuals and families by offering hope, help, and healing.” Hamdard has a 20-year history of unparalleled expertise in providing culturally sensitive and linguistically appropriate care to a highly diverse, heavily immigrant constituency from across Metropolitan Chicago and specializes in meeting the profound social and mental health needs of the predominantly Muslim South Asian, Middle Eastern and Bosnian communities. Hamdard operates facilities in Addison Village, DuPage County and in Chicago’s Rogers Park neighborhood.
Hamdard was established in 1992 by co-founders Mohammad Hamid, PhD, and his late wife, Farzana Hamid, PhD, in response to profound unmet needs in the South Asian and Middle Eastern communities on the North Side of Chicago. They specialized in treating refugees with Post Traumatic Stress Disorder and worked very closely with Bosnian refugees in the early 1990s. They collaborated with World Relief-Chicago and assisted in developing the Horizon’s Clinic, which treated men, women and children with a range of mental health issues. In 1992, they founded Hamdard Center as a multilingual, multicultural and comprehensive health care center.
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“Hamdard” means “empathizer” and the Center has made a substantial impact on the community through specialized services in counseling, case management, primary health care, mental health treatment, senior supportive care, domestic violence services, youth services, a batterer’s program and a crisis line. Hamdard’s holistic philosophy promotes treating the whole person through integrated, comprehensive, and culturally and linguistically appropriate services. Hamdard serves racial/ethnic minorities of different ethnicities and faiths; however, its main target populations are predominately Muslim. These doubly marginalized individuals have come to rely on Hamdard because of the agency’s insistence on cultural and linguistic competency as a cornerstone of effective service provision. Hamdard is not a large organization but collectively its personnel speak over 40 different languages and dialects. Specific languages spoken by Hamdard’s staff include the following, listed alphabetically: Arabic, Bosnian, Croatian, English, French, Gujarati, Hindi, Punjabi, Russian, Serbian, Spanish, Telugu and Urdu.
2. Description of current programs, activities and achievments.*In addition to its flagship Behavioral and Mental Health Services, Hamdard offers state-licensed Child
Welfare and Adult Day services for Seniors; In-Home Care for Seniors; After-School and Youth Enrichment; Employment Counseling and Case Management; and Domestic Violence Assistance, Intervention and Prevention, including a 24-hour crisis line, Residential Shelter Facility and Transitional Housing Program. In 2004, Hamdard initiated limited primary health care and has served 2,500 individuals to date.
Highlights of agency achievement in Fiscal Year 2013 include Hamdard Center’s recognition as an outstanding organization by the Illinois Attorney General during Asian Pacific Islander Heritage Month. Hamdard increased capacity for behavioral health services by adding a fourth psychiatrist at the Chicago site and began renovations to expand primary care services. In May 2013, Hamdard Center launched In-Home Care Services for Seniors. Dependable caregivers assist seniors in their homes with household tasks, personal care and accompanying seniors on medical visits. Hamdard hosted its 20th annual fundraiser netting $175,000 and surpassing its fundraising goal by 10%. In addition, Hamdard attracted first-time funding from two private foundations. Hamdard also restructured its Board of Directors to meet FQHC compliance requirements of a patient/consumer majority board.
Number Served Last Year*How many people were served by the program you are requesting funding for (if it's an existing program), and the agency overall, last year?
Hamdard Center served 1,760 unduplicated individuals in Fiscal Year 2013. Thirty-six individuals received cardiology services.
3. Description of formal and informal relationships with other organizations.*Emphasize those relevant to the program or activities for which you seek funding.
As a trusted provider of behavioral health and social services, Hamdard collaborates with many organizations. Hamdard’s decision to implement a Patient Centered Medical Home and pursue FQHC status has been met with enthusiasm. Robust support is reflected in Memoranda of Understanding and Letters of Support submitted with Hamdard’s New Access Point application in April 2013 and uploaded with this proposal. Existing relationships with the Muslim Community Center, Bosnia United and the Coalition of Limited English Speaking Elderly, for example, will be strengthened. Swedish Covenant Hospital and Presence St. Joseph Hospital have agreed to accept admissions regardless of patients’ ability to pay. Erie Family Health Center will provide dental services. Devon Pharmacy, CommunityHealth, (Illinois’ largest free clinic with a pharmaceutical access program) and Inner-City Muslim Action Network (IMAN) Clinic (a free clinic serving the Muslim community) are committed to defining pathways for care coordination. All FQHCs with sites in Hamdard’s proposed service area (Access Community Health Center, Asian Human Services, Erie Family
Kiran Siddiqui Hamdard Center for Health & Human Svcs.
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Health Center, Heartland International Health Center, Heartland Health Outreach) are supportive and committed to ongoing collaboration and care coordination with Hamdard as are the Chicago Department of Public Health, Cook County Health and Hospital System and the Illinois Department of Human Services.
B. Purpose of Funding Request
1. Please state how this grant will be used and its overall goals.*Hamdard proposes the implementation of comprehensive primary health care services to increase access
for the low income medically underserved. Hamdard respectfully requests $40,000 to support a full-time Nurse Practitioner. Hamdard attaches a letter of intent from Renuka Patel, a qualified candidate who would accept employment upon notification of award. Remaining Nurse Practitioner compensation and related costs will be secured from Hamdard’s strong base of individual and corporate donors, which annually contributes $245,000. Hamdard leadership and key donors are committed to a significant fundraising initiative for the Patient Centered Medical Home.
Hamdard Center’s comprehensive primary care strategy is divided into the following three stages:
• Stage 1: As described in this proposal, Hamdard will initiate a sustainable, modest scale of a PatientCentered Medical Home through implementation of primary care services, dental referrals, and integration of primary medical and dental services with Hamdard’s existing behavioral health and social services.
• Stage 2: Become an FQHC Look Alike (LAL), with increased capacity and scope of services, madepossible through enhanced Medicaid reimbursement. Hamdard’s FQHC Look Alike application will be submitted in January 2014, with Health Resources and Services Administration (HRSA) approval anticipated in Spring 2014.
• Stage 3: Become a funded FQHC New Access Point, with further expansion of capacity and scope ofservices. Hamdard’s New Access Point (NAP) application was submitted in April 2013 and could be approved as soon as August 2013, or through subsequent rounds of approvals in 2014 or beyond.
Hamdard is committed to initiating and sustaining Stage 1 of its comprehensive primary care strategy in response to profound unmet community need and Affordable Care Act (ACA) reforms. Hiring a Nurse Practitioner is a powerful and essential first step in manifesting this vision. A full-time Nurse Practitioner will deliver general primary medical care to patients of all ages in consultation with a contracted Family Practice Physician.
2. Needs Addressed and Population Served*Identify the needs or problems that this program will address, including the population served, and describe how the program addresses these needs.
Despite seven FQHCs in Hamdard’s service area, HRSA reports 118,442 low income residents remain unserved. Projected demand for primary care under ACA reforms will exacerbate this profound unmet need. Illinois Health Matters ranks Hamdard’s Chicago service area within the Top Ten Illinois communities for the number of people (84,657) who will be newly eligible for Medicaid or subsidized insurance in 2014. Demand from the newly insured combined with predicted provider shortages will widen the primary care service gap. As a trusted provider, Hamdard is uniquely positioned to educate and enroll the newly eligible in the Illinois Health Marketplace and expand quality healthcare access to a complex population with distinct cultural and linguistic needs.Through a successful application with the Asian Health Coalition for the State’s In-Person Counselor grant, Hamdard will begin education and enrollment in the coming weeks.
Kiran Siddiqui Hamdard Center for Health & Human Svcs.
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Hamdard’s services will be designed especially to meet the needs of South Asian, Bosnian, and Middle Eastern patients, many of whom have experienced domestic violence or trauma, or are refugees or genocide survivors. Hamdard also serves low income Latino residents of the service area and will extend services to the broader population in need. Hamdard’s service area comprises northeast Chicago (Albany Park, Edgewater, Lincoln Square, North Park, Rogers Park, Uptown, and West Ridge) and the Addison Village area in DuPage County.
Hamdard’s target population reveals alarming rates of poverty and uninsurance. Over a quarter (8,656; 25.6%) live below 100% Federal Poverty Level (FPL). An additional 6,871 (20.3%) live between 100–199% FPL. The uninsurance rate for Hamdard’s target population rate is a striking 33.4%. Furthermore, despite high rates of poverty, Medicaid participation is infrequent (7.9%), especially among Hamdard’s South Asian patients.
Hamdard’s target population exhibits a high prevalence of cardiovascular disease, diabetes, hypertension, post-traumatic stress disorder, depression, intimate partner violence and the use of tobacco products. Moreover, among South Asians, disproportionately high rates of diabetes and cardiovascular disease are complicated by low rates of traditional risk factors (e.g. hypertension, obesity, smoking) and genetic predisposition factors.
Hamdard’s target population confronts barriers to healthcare access and utilization as a result of cultural and Muslim religious beliefs that conflict with Western norms including diet and food prohibitions, interpersonal space and modesty concerns, gender roles, and symptom management.
Language is also a principal barrier to care. Nearly half (48.3%) of the service area population speaks a language other than English at home. Moreover, census data reveal uniformly high rates of those who speak a language other than English and speak English “less than well” in Hamdard’s service area with West Ridge, North Park, Albany Park and Addison Village exceeding 50%.
Number Served*How many people would be served by this grant and/or program?
Hamdard will increase access to comprehensive primary health care services for an estimated 997 patients by the end of Year 1 with 2,992 visits provided by the Nurse Practitioner. Additional patient visits will be provided as follows from current staff: Psychology 1,232; Psychiatry 2,722; Cardiologist 176.
3. Methodology*Describe the program methodology or intervention strategy.
The barriers and disparities experienced by Hamdard’s population underscore the critical importance of comprehensive primary care that is linguistically and culturally appropriate, integrated with behavioral health and enabling services, and connected to a continuum of care. Hamdard will establish such a care model by expanding current primary care services, leveraging existing collaborative relationships and establishing new relationships as needed. Hamdard’s model will constitute a Patient Centered Medical Home (PCMH), consistent with National Center for Quality Assurance standards. Demonstrated outcomes of the PCMH Model include improved access, clinical quality, patient satisfaction and reduced emergency room utilization. inpatient admissions, cost and provider burnout.
Under Stage 1 Hamdard will provide a full range of pediatric, general adult and women’s health care, with referrals to Swedish Covenant Hospital for obstetrical care; oral health screenings and education in the primary care setting; on-site cardiology; psychiatry, psychology and counseling; case management, health education, outreach, translation and transportation. An adjoining pharmacy currently serves insured patients; uninsured patients’ will receive medications through CommunityHealth’s MedAccess Program.
Kiran Siddiqui Hamdard Center for Health & Human Svcs.
Printed On: 23 January 2014 General Grants September 2013 Board Meeting 12
Dental services will be provided through referrals to Erie Family Health Center. All other services required of FQHCs and aligned with PCHM expectations will be fulfilled through referral relationships already established by MOUs signed in Spring 2013.
Stage 1 implementation calls for 1 FTE Nurse Practitioner, 1 FTE Medical Assistant, Oral Health, the existing .05 FTE Cardiologist, and a collaborative agreement with a Family Practice Physician. Hamdard will integrate its existing enabling services and behavioral health team into primary care for a PCMH care model. Stage 1 implementation also calls for implementation of an Electronic Health Record that is certified for meaningful use.
4. Outcome Measures*What are the specific outcome measures and related baselines (please see our website for examples).
Hamdard will improve the following health outcomes:
1) 75% of patients age 18 to 75 years with Type 1 or Type 2 diabetes and seen at least twice during theyear will have HbA1c less than or equal to 9%. 75% is chosen as the target, based on Illinois average of 69.3%, and two health centers with comparable patient populations, Heartland International Health Center (69.3%) and Asian Human Services (84.3%)
2) 71% of patients age 18 to 85 years with hypertension and seen at least twice during the year will havesystolic blood pressure less than 140 mm Hg and diastolic blood pressure less than 90 cc Hg. 71% is chosen as the target, as an improvement over Hamdard’s 65% baseline, the Illinois average of 63.8%, and two health centers with comparable patient populations, Heartland International Health Center (62.4%) and Asian Human Services (65.7%). UDS National Performance is 63.3% and Healthy People 2020 goal is 61%.
3) 65% of female patients age 24-64 years and seen at least once during the year will receive at least onePap test during or two years prior to the measurement year. 65% is chosen as the target, based on Illinois average of 61.6%, and two health centers with comparable patient populations, Heartland International Health Center (61.6%) and Asian Human Services (50.0%). UDS National Performance is 57.8% and Healthy People 2020 goal is 90%.
4) 90% of children with their third birthday and at least one visit during the year will be fully immunized.90% is chosen as the target, based Asian Human Services (88.9%) with a comparable patient population. UDS National Performance is 43.8% and Healthy People 2020 goal is 80%.
5) At least 85% of patients age 18 to 75 years who have been seen by the psychiatrist at least twice duringthe year will report taking their medications according to prescription. Adherence to antidepressants, antipsychotics, anxiolytics, mood stabilizers and sedative hypnotics is frequently estimated at 35% to 45% depending on the type of medication. Hamdard’s current patient base has long-established provider-patient relationships and is older than the expected patient base, two variables that would predict a higher-than-average percentage of medication-adherent patients.
5. Staffing*Describe any specific staffing needs to accomplish the activities for which funding is requested. Identify key staff and their qualifications.
The hire of a Nurse Practitioner is key to initiating Hamdard Center’s establishment of a Patient Centered Medical Home. Hamdard has a letter of commitment from Renuka Patel, a Board Certified Family Nurse Practitioner of South Asian ethnicity, to accept employment. Ms. Patel received her Master of Science as a Family Nurse Practitioner from Northern Illinois University and is a member of the American College of Cardiology. She speaks Hindi and Gujrati.
Kiran Siddiqui Hamdard Center for Health & Human Svcs.
Printed On: 23 January 2014 General Grants September 2013 Board Meeting 13
Since 2004, Hamdard Center has contracted cardiologist Dr. Muhammad Saudye to respond to the high prevalence of cardiovascular disease among Hamdard clients. Dr. Saudye currently provides patient care 8 hours/month.
In Stage 1, Hamdard will establish a collaborative agreement with a Family Practice Physician (FP) to consult with the Nurse Practitioner as required by law. A full-time FP will be hired under Stage 2 FQHC Look Alike.
The project will be overseen by Hamdard Center’s Executive Director, Kiran Siddiqui. Ms. Siddiqui has a Masters of Education in Community Counseling from Loyola University and is a Licensed Clinical Professional Counselor. She has 14 years of experience working in the field of behavioral health and nine years of management experience. Prior to coming to Hamdard, she worked at Apna Ghar, a domestic violence organization for South Asian women, as a counselor for four years and as the program’s director for five years. She possesses a wide range of experience including program management and implementation, clinical counseling, geriatric care, and homeless prevention. She is fluent in Hindi and Urdu.
6. Sustainability*Please tell us how you plan to sustain the program for which you seek funding after the termination of this grant.
The addition of a Nurse Practitioner is the cornerstone of Hamdard’s overall strategy to implement a Patient Centered Medical Home as an FQHC. Of the three-stage strategy described above, the FQHC New Access Point is the most robust and well-funded. The NP position would be sustained by Hamdard’s expanded service capacity, FQHC enhanced Medicaid reimbursement rates, and a federal grant. Independent of FQHC status, Hamdard’s planned implementation of an Electronic Health Record that is certified for Meaningful Use will capture bonuses from the Center for Medicaid and Medicare Services for providers who achieve Meaningful Use benchmarks.
Hamdard submitted its FQHC application in April 2013. Multiple award cycles are anticipated. Since competition is particularly keen for New Access Point grants, Hamdard is preparing to submit an FQHC Look Alike application (LAL) in January 2014. LALs also receive enhanced billing rates but no grant funds. Since LALs must offer all primary care services required of FQHCs upon submission, pursuing LAL status only becomes possible once a Nurse Practitioner is in place. Thus a grant from the VNA Foundation is key to initiating Hamdard’s PCMH as it pursues long-term sustainability as an FQHC.
Under each stage of its primary care strategy, Hamdard’s Board of Directors is committed to substantially increasing private contributions. This increase becomes viable due to Hamdard’s new scope of services, and new private prospects whose philanthropy aligns with comprehensive primary care. Furthermore, ACA implementation will lead to significant enrollment into Medicaid and private insurance by currently uninsured clients; increased benefits for substance abuse and mental health services for those currently and newly insured; and a new landscape for provider reimbursement mechanisms. Hamdard will, therefore, capture new, sustainable patient revenue from Medicaid, Medicare and private insurance for primary care.
Required Documents
Kiran Siddiqui Hamdard Center for Health & Human Svcs.
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A. Finances
1. Organization BudgetPlease upload the organization's budget. Please do not use Excel headers on the budget because this application system adds a title over the header, and then they are both difficult to read. Please leave at least 3/4 of an inch blank at the top and bottom of the page.
Hamdard Program Budget VNA
2. Program Budget*Please upload the program budget with narrative. Please do not use Excel headers on the budget because this application system adds a title over the header, and then they are both difficult to read. Please leave at least 3/4 of an inch blank at the top and bottom of the page.
Hamdard Organizational and Program Budget Stage 1.pdf
3. Capital Budget & Campaign Committee MembersIf your organization is in the midst of a capital campaign please upload the capital budget and a list of capital campaign committee members.
[Unanswered]
4. Funding Sources*Please upload a list of foundations, corporations, or government agencies that funded the organization in the last fiscal year, including amounts contributed ($1,000 and above).
Hamdard FY 2013 Funding Sources-Final.pdf
Please e-mail your most recent audited financial statements to [email protected].
B. Other Supporting Materials1. Board List*Please upload a current board list with related employment affiliations.
Hamdard Board of Directors.pdf
2. Staff QualificationsPlease upload the qualifications of professional program staff (if applicable)
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3. Agency CollaborationIf the project for which funding is sought is a collaboration with other agencies, include letters of agreement from the collaborating agencies.
Hamdard-MOUs-VNA.pdf (example included)
4. Letters of SupportPlease upload any letters of support or reviews (if applicable).
Letters of Support.pdf (example included)
5. Verification of Tax-Exempt Status*Please upload your most recent IRS Determination Letter stating your status or your fiscal agent's status as a 501(c)(3) organization with a 509(a)(1) or 509(a)(2) designation. If using a fiscal agent, please include Letter of Authorization.
Hamdard Ltr of Determination.pdf
6. Annual Report*Please upload the latest annual report or a summary of the organization's prior year's activities.
Hamdard Annual Report FY2012.pdf
Hamdard Center FY14 Program Budget
EXPENSES Personnel Cardiologist $7,500 Nurse Practitioner $85,000 Certified Medical Assistant $27,000 Facilities/Housekeeping/Driver $1,300 Fringe (14.89%) $17,335 TOTAL PERSONNEL $138,135 Travel Board & Provider Training $500 TOTAL TRAVEL $500 Equipment Clinical Equipment $3,600 Laptops (5) $3,750 EHR Licenses $35,000 TOTAL EQUIPMENT $42,350 Supplies Lab, Medical & Pharmaceutical Supplies
$16,993
Office Supplies $3,000 Cleaning & Maintenance Supplies
$3,000
Health Education Supplies $4,000 Staff Uniforms $960 TOTAL SUPPLIES $27,953 Contractual Lab Services $10,010 Consultation for Revenue Cycle Management, QA, CLIA Compliance
$30,000
Chart Audit $3,000 EHR Implementation Costs $23,000 Contracted Cleaning Service $13,185 Contracted Dental Service $23,000 Contracted Medical & Behavioral Providers
$20,000
TOTAL CONTRACTUAL $122,195 Other Transportation Assistance (Oral Health)
$4,650
Medical Waste Removal $1,800 Reminder Calls/Message $3,729
Hamdard Center FY14 Program Budget
Service Telephone/Pager Communications
$3,600
Software Maintenance $21,591 Organizational Dues & Membership
$12,000
Insurance $8,550 TOTAL OTHER $55,920 TOTAL EXPENSES $387,053
REVENUE Charitable Revenue to be Raised VNA $40,000 (Pending) Chicago Community Trust $100,000 (App. In progress) Blowitz Ridgeway $10,000 (App. In progress) Washington Square Health Foundation
$31,000 (Pending)
Board Fundraising $53,000 (Committed) Additional Board Fundraising $20,750 (Projected) Program Fees $137,498 (Projected) TOTAL REVENUE $392,248
Description for Primary Care
Program
Hamdard Current
Programs and
Administration
Primary Care Program
Total, Including Costs
for EHR in Current
Behavioral Health
Total FY14
Organizational Budget Oral Health Nurse Practitioner Cardiologist
Electronic Health
Record
REVENUE:
Applicant
$ 821,851 $ 821,851
$ 47,000 $ 47,000
$ 243,000 $ 243,000
$ 245,000 7,500$ $ 252,500 7,500$
New Sources of Private
Revenue to support primary
care strategy
227,250$ $ 227,250 43,000$ 93,000$ 7,250$ 43,000$ 41,000$
Billing for nurse practitioner and
cardiologist assumes Medicaid
rates as of July 1, 2013, with
high proportion of new patients,
and small proportion of third
party insurance.
$ 140,200 137,498$ $ 277,698 130,287$ 7,211$
Rental and training income $ 63,000 $ 63,000
TOTAL REVENUE $ 1,560,051 $ 372,248 $ 1,932,299 $ 43,000 $ 223,287 $ 21,961 $ 43,000 $ 41,000
EXPENSES:
Salary & Wages
Family practice physician Hire under LAL scenario $ - $ -
Other Specialty Physcians
Dr. Muhammad Saudye, 8
hours/month, current schedule.
Contracted.
$ 7,500 $ 7,500
Nurse practitioner
1 FTE at $85,000. 5%
dedicated to oral health
education and referral in
primary care
$ 85,000 $ 4,250 $ 80,750
Breakout Portions of Primary Care ProgramAnnual Budget
Federal Grants
Hamdard Center - Stage 1
Budget: Initiate Primary Care
Local Foundations, Individual
and Corporate Gifts (new)
Individual and Corporate Gifts
(usual level of current support)
EHR for Current
Behavioral
Health Services
State Grants
Local City Grants
Local Foundations (usual level
of current support)
Program Fees and Patient
Service Revenue, net of all
discounts and bad debt.
Description for Primary Care
Program
Hamdard Current
Programs and
Administration
Primary Care Program
Total, Including Costs
for EHR in Current
Behavioral Health
Total FY14
Organizational Budget Oral Health Nurse Practitioner Cardiologist
Electronic Health
Record
Breakout Portions of Primary Care ProgramAnnual Budget
Hamdard Center - Stage 1
Budget: Initiate Primary Care
EHR for Current
Behavioral
Health Services
Certified Medical
Assistants
1 FTE at $27,000. 5%
dedicated to oral health
education and referral in
primary care
$ 27,000 $ 1,350 $ 25,650 $ -
OTHER STAFF
Facilities/Housekeeping/D
river
5% of exisiting driver dedicated
to driving patients from two
Hamdard locations to dental
visits
$ 1,300 $ 1,300
TOTAL: SALARY & WAGES (A) 857,834$ 120,800$ $ 978,634 6,900$ 106,400$ 7,500$ -$
#### TOTAL: FRINGE (B) 14.89% of salaries and wages 127,731$ $ 17,335 $ 145,066 $ 1,056 $ 16,279 $ - $ -
TOTAL: PERSONNEL (A + B) $ 985,565 $ 138,135 $ 1,123,700 $ 7,956 $ 122,679 $ 7,500 $ - $ -
TRAVEL
Conferences $ -
Board & Provider training $ 2,500 $ 500 $ 3,000 $ 500 $ -
Local Travel 2,500$ $ 2,500
TOTAL: TRAVEL $ 5,000 $ 500 $ 5,500 $ 500 $ -
Equipment
Minor Clinical Equipment
At Each of two sites: 1 EKG
($600) and 1 portable blood
pressure units ($1200)
$ 3,600 $ 3,600 $ 3,600
Laptops for clinic use
Five laptops total - two for NP
and MA; three for behavioral
health and cardiologist as
shared resources
$ 3,750 $ 3,750 $ 1,500 $ 2,250
Copiers Leases &
maintenance $ 5,800 $ 5,800
Description for Primary Care
Program
Hamdard Current
Programs and
Administration
Primary Care Program
Total, Including Costs
for EHR in Current
Behavioral Health
Total FY14
Organizational Budget Oral Health Nurse Practitioner Cardiologist
Electronic Health
Record
Breakout Portions of Primary Care ProgramAnnual Budget
Hamdard Center - Stage 1
Budget: Initiate Primary Care
EHR for Current
Behavioral
Health Services
EHR Licenses
eClinicalWorks. Permanent
licenses Total $40,000 {based
on provider levels ($10,000 first
full-time provider, $5,000 each
addtl) and part time providers at
$2,500 each.}
$ 35,000 $ 35,000 $ 12,500 $ 22,500
TOTAL: EQUIPMENT $ 5,800 $ 42,350 $ 48,150 $ - $ 3,600 $ - $ 14,000 $ 24,750
Supplies
Lab supplies, Medical
Supplies and
Pharmaceuticals
Total $4.10 per all medical
visits. (Detail: Lab supplies
$1.10 per medical visit, Medical
supplies calculated on $3 per
visit); plus $5 per self pay visit
for pharmaceuticals.
$ 500 $ 16,993 $ 17,493 $ 16,007 $ 986
Office supplies:
Clinic forms; HIPAA disclosure
statements. Increased use of
regular office supplies]
$ 3,200 $ 3,000 $ 6,200 $ 2,833 $ 167
Cleaning & Maintenance
supplies,
For example, disinfectants and
other materials needed to clean
the two medical center, paper
towels, toilet paper , air
refreshners etc
$ 3,000 $ 3,000 $ 2,833 $ 167
Description for Primary Care
Program
Hamdard Current
Programs and
Administration
Primary Care Program
Total, Including Costs
for EHR in Current
Behavioral Health
Total FY14
Organizational Budget Oral Health Nurse Practitioner Cardiologist
Electronic Health
Record
Breakout Portions of Primary Care ProgramAnnual Budget
Hamdard Center - Stage 1
Budget: Initiate Primary Care
EHR for Current
Behavioral
Health Services
Health Education
Supplies:
Posters in exam rooms,
educational DVDs for use in
waiting rooms and outreach
events, waiting room
educational material displays
and educational models, breast
feeding educations, nutrition
supplies for classes, diabetes
educational material, such as
glucometers, lancets etc...
$ 4,000 $ 4,000 $ 2,000 $ 1,750 $ 250
Staff uniforms:
Uniforms for medical and
clinical support staff & on going
cleaning cost ($80/monthly cost)
$ 960 $ 960 $ 850 $ 110
TOTAL: SUPPLIES $ 3,700 $ 27,953 $ 31,653 $ 2,000 $ 24,274 $ 1,679 $ - $ -
Contractual
Contracted lab services
$12.50 average cost per self-
pay patient, cost covers routine
labs , and health promotional
lab tests such as free
pregnancy & diabetic tests
$ 10,010 $ 10,010 $ 9,350 $ 660
Audit and Legal $ 38,000 $ 38,000
Consultation for Revenue
Cycle Management, QA,
CLIA Compliance
Consultation to enhance
revenue cycle and support CLIA
lab set-up.
$ 10,000 $ 10,000 $ 10,000
Description for Primary Care
Program
Hamdard Current
Programs and
Administration
Primary Care Program
Total, Including Costs
for EHR in Current
Behavioral Health
Total FY14
Organizational Budget Oral Health Nurse Practitioner Cardiologist
Electronic Health
Record
Breakout Portions of Primary Care ProgramAnnual Budget
Hamdard Center - Stage 1
Budget: Initiate Primary Care
EHR for Current
Behavioral
Health Services
EHR Implementation
Costs -
Practice Implementation:
Installation, project mgt, site
survey/workflow, set-up and
configuration, onsite and go-live
training; business intelligence
consulting, post go-live training)
20 days of consultation:
$21,000. Plus $1000 travel for
Implementation and Training
staff and one-time data
migration $1000.
$ 23,000 $ 23,000 $ 23,000
Contracted coverage for
OB Call service
None. Partner with surrounding
FQHCs for maternal care until
LAL status would be awarded.
$ - $ -
Contracted cleaning
service
Clean the clincs at Devon &
Addison, 3 hrs/day; 293 days@
$15/hour;
$ 13,185 $ 13,185 $ 13,185
Contracted Dental Service
Assume 250 uninsured visits in
yr 1 at $92/visit; Priority will be
selecting diabetic adults, &
other chronically ill patients.
$ 23,000 $ 23,000 $ 23,000
Contracted medical &
behavioral providers,
Contract with oral health expert
($5,000) to educate Hamdard
providers and clinical support
staff regarding oral health
exams and education in primary
care setting. Conract with FP
physician ($15,000) to provide
collaborative agreement and
consultation.
$ 85,920 $ 20,000 $ 105,920 $ 5,000 $ 15,000
Description for Primary Care
Program
Hamdard Current
Programs and
Administration
Primary Care Program
Total, Including Costs
for EHR in Current
Behavioral Health
Total FY14
Organizational Budget Oral Health Nurse Practitioner Cardiologist
Electronic Health
Record
Breakout Portions of Primary Care ProgramAnnual Budget
Hamdard Center - Stage 1
Budget: Initiate Primary Care
EHR for Current
Behavioral
Health Services
Chart Audit
2 days of contracted certified
coder to perform a semi annual
internal chart audit for
compliance with Medicaid &
Medicare regulations.
$ 3,000 $ 3,000 $ 2,500 $ 500
TOTAL CONTRACTUAL $ 123,920 $ 102,195 $ 226,115 $ 28,000 $ 50,035 $ 1,160 $ 23,000 $ -
OTHER
Recruitment: $ 1,500 $ 1,500
Fund raising expenses $ 85,000 $ 85,000
Postage, & Courier, $ 6,548 $ 6,548
Alarm System $ 2,000 $ 2,000
Transportation assistance
Oral heatlh transportation =
4,690 miles by Hamdard's driver
(175 trips from Devon and 75
from Addison) at 56.5 cents per
mile; plus 200 one-day bus
passes at $10 each.
$ 15,000 $ 4,650 $ 19,650 $ 4,650
Patient client incentives $ 32,431 $ 32,431
Medical waste removal $150 per month $ 1,800 $ 1,800 $ 1,200 $ 600
Waste and snow removal $ 12,000 $ 12,000
Facility costs $ 220,219 $ 220,219
Reminder calls/message
service
$0.15/call/month first 1000;
$0.10 for all over 1000
(eClinicalMessenger)
$ 3,729 $ 3,729 $ 2,800 $ 929
Telephone/Pager
Communications
$300/month for answering
service for after-hours calls for
primary care
$ 16,000 $ 3,600 $ 19,600 $ 2,000 $ 1,600
Description for Primary Care
Program
Hamdard Current
Programs and
Administration
Primary Care Program
Total, Including Costs
for EHR in Current
Behavioral Health
Total FY14
Organizational Budget Oral Health Nurse Practitioner Cardiologist
Electronic Health
Record
Breakout Portions of Primary Care ProgramAnnual Budget
Hamdard Center - Stage 1
Budget: Initiate Primary Care
EHR for Current
Behavioral
Health Services
Software maintenance,
On going cost for EHRS & other
systems such as accounting
system. ASP hosting $115 per
month per provider + $1250 one
time setup, clearinghouse
integration $79/provider/month,
electronic coding searching tool
@ $65 per provider per year
$ 21,591 $ 21,591 $ 5,411 $ 16,180
Organizational dues &
membership
IPHCA membership plus &
CommunityHealth MedAccess
to gain access to free
prescriptions for uninsured
patients (no NACHC
membership)
$ 12,000 $ 12,000 $ 6,000 $ 6,000
InsuranceAdd Commercial Policy for
Professional Liability $ 28,000 $ 8,550 $ 36,550 $ 8,000 $ 550
$ -
TOTAL: OTHER $ 418,698 $ 55,919 $ 474,617 $ 4,650 $ 20,000 $ 9,679 $ 5,411 $ 16,180
$ 1,542,683 $ 367,052 $ 1,909,736 $ 42,606 $ 221,088 $ 20,018 $ 42,411 $ 40,930
$ 17,367 $ 5,196 $ 22,563 $ 394 $ 2,199 $ 1,943 $ 589 $ 71
1.1% 1.4% 1.2% 0.9% 1.0% 8.8% 1.4% 0.2%
TOTAL EXPENSES
Net Operating Margin
Description for Primary Care
Program
Hamdard Current
Programs and
Administration
Primary Care Program
Total, Including Costs
for EHR in Current
Behavioral Health
Total FY14
Organizational Budget Oral Health Nurse Practitioner Cardiologist
Electronic Health
Record
Breakout Portions of Primary Care ProgramAnnual Budget
Hamdard Center - Stage 1
Budget: Initiate Primary Care
EHR for Current
Behavioral
Health Services
Renovations and One-Time Equipment
Minor Renovations at
Devon $ 20,000 $ 20,000
Minor Revnoations at
Addison $ 17,000 $ 17,000
AutoclaveOne each at two locations,
$15,000 $ 30,000 $ 30,000
Blood AnalyzerOne each at two locations,
$12,000 $ 24,000 $ 24,000
DefibrillatorOne each at two locations,
$1,000 $ 2,000 $ 2,000
Furnish and equip exam
rooms
Two exam rooms at each
location, $4000 each $ 16,000 $ 16,000
109,000$ 109,000$ -$ $ 109,000 -$ -$
$ -
109,000$ 109,000$
TOTAL Renovations and One-
Time Equipment
Capital to Raise from
Foundations, Individuals and
Corporations
Hamdard Center for Health and Human Services Funding Sources Fiscal Year 2013
$1000 and Above
IL Department on Aging 215,314
Department of Children and Family Services 132,500
Illinois Department of Human Services 171,627
Illinois Attorney General 21,365
Illinois Criminal Justice Information Authority 76,359
City of Chicago 39,377
DuPage County (HSGF) 7,580
Northern Trust 25,000
Anonymous Foundation 10,000
Field Foundation 16,000
Community Memorial Foundation 16,140
Exchange Club of Naperville 3,750
Ravenswood Health Care Foundation 10,000
Susan G. Komen Foundation 8,820
Altria 7,116
IL Coalition of Immigrant & Refugee Rights IFRP Program
41,500
Efroymson Family Fund 100,000
United Way 15,000
Total 917,448
Board of Directors
Syed Anwar, M.D. President
Psychiatrist
Robert Cook
Treasurer
CEO Dream Capital Advisors, LLC
Khalid Mahmoud Secretary
Retired Accountant
Irfan Sufi, M.A. Clinical Psychologist
Jela Simic Hamdard client
Draginja Orescanin Hamdard client
Gurucharan Kaur Hamdard client
Ismet Mujkanovic Hamdard client
Bahra Puskar Hamdard client
Fatima Weldingwala Hamdard client
1
Letters of Support -
secured
Letter of Intent-Chief Financial Officer Letter of Intent-Chief Medical Officer
Access Community Health Network Asian Human Services Family Health Center, Inc
Asian Health Coalition
Bosnia United
Cook County Health and Hospitals System
City of Chicago Department of Public Health
Coalition of Limited English Speaking Elderly
Illinois Department of Human Services
Erie Family Health Center
Goldie’s Place
Heartland Health Outreach, Inc
Heartland International Health Center
llinois Primary Health Care Association
Muslim Community Center
Muslim Women’s Resource Center
SGA Youth & Family Services
Mile Square Health Center
Inner-City Muslim Action Network
17
- IPHCA Illinois Primary Health Care Association
www.iphca.org
Bruce A. Johnson President & Chief Executive Officer
Gordon Eggers, PA-C, Chair Crusader Community Health
Henry Taylor, Chair-Elect Mile Square Health Center
Berneice Mills-Thomas, Secretary Near North Health Service Corporation
Linnea Windel, RN, Treasurer VNA Health Care
Kim Mitroka, Immediate Past Chair Christopher Greater Area Rural Health Planning Corporation
March 15, 2013
Dr. Mo hamm ad Hamid, Chairman
Hamdard Center for Health and Hum an Services
228 E. Lake St.
Addison, IL
Dear Dr. Hamid,
On behalf of the Illino is Primary Health Care Association (IPHCA), I am writing in support of the Hamdard Center for
Health and Human Services' New Access Point application to the Bureau of Primary Health Care, to become a Federally
Qualified Health Center (FQHC). For the past 20 years, Hamdard has provided exemplary mental health and social
services primarily to South Asian, Middle Eastern and Bosnian communities. IPHCA welcomes Hamdard's addition of
primary care to its service array, establishing a patient centered medical home.
Hamdard's services include mental health, senior and youth services, case management, and domestic violence
including housing, employment and batterer's counseling, and a 24-hour crisis line. Hamdard's linguis tic competencies
in Bosnian, Serbian, Croatian, Russian, Arabic, Spanish, Hindi, Urdu, Punjabi, Gujarati, Telugu, French and English are
evidence of your ability to serve limited-English profic ient res idents. In addition, Hamdard demonstrates cultural
competency for the Muslim population. Finally, Hamdard's acclaimed psychiatric and psychological services benefit
trauma survivors inc luding Bosnian, Burmese and Iraqi refugees and domestic violence victims. By employing highly
qualified personnel representative of its target population, Hamdard addresses re lig ious, cultural and linguistic barriers
to health services, and its sliding fee scale ensures access regardless of a patient's ability to pay.
As the sole non-for-profit trade association representing Illino is Community/Migrant Health Centers, IPHCA has worked
closely with Hamdard over the years and we look forward to the opportunity this grant provides your organization to
create a new access point to provide quality primary care. IPHCA strives to improve the health status of medically
underserved populations by fostering the provision of high-quality, comprehensive health care that is accessible,
coordinated, community-d irected, culturally sensitive, and linguistically competent.
Hamdard has worked d iligently to take the next s teps to open a community health center to service Chicago by
reaching out to IPHCA for technical support. IPHCA hopes this application receives a favorable review. Hamdard is a vital
link in the Greater Chicago health safety net. IPHCA commends Hamdard's application and looksforward to collaborating
with Hamdard to s trengthen our collective response to healthcare needs across Greater Chicago.
Springfield - 500 S. Ninth St. • Springfield, ll62701 • tel (217) 541-7300 • fax (217) 541-7301
Chicago - 542 S. Dearborn, Suite 300 • Chicago, ll 60605 • tel (312) 692-3000 • fax (312) 692-3001
Serving the Medically Underserved Across Illinois for Over 30 Years
Example
I
communityhealth
BOARD OF DIRECTORS
Joseph B. O'Malley
President
Valery E. Gallagher
Vice President
Rebekah Kohmescher
Treasurer
Leo F. Voet
Assistant Treasurer
Andrew Palumbo
Secretary
Sally Benjamin Young
Assistant Secretary
Babs Waldman. M.D.
Medical Director
Rebecca s. Busch
Michael A. Dunlap,
D.D.S James M. Durkin
Sandra F. Durley,PharmD
Jillian R. Foucre
Joseph M.Hamngtoo
John J. Koenlgsknecht.Esq .
Cheryl Lullas
Karen Nichols, D.O.
David J. Rice.Esq.
H. Scott Sarran. M.D.
Thad E.Smith
Thomas M. Suttredln
Daniel VIcencio, M.D.
EMERITUS DIRECTORS
April 1, 2013
Dr. Mohammad Hamid
Chairman
Hamdard Center for Health and Human Services
228 E. Lake Street Addison, IL
Dear Dr. Hamid,
I am writing in support of Hamdard Center for Health and Human Services' New Access Point application to the Bureau
of Primary Health Care, to become a Federally Qualified Health Center. For the past 20 years, Hamdard has provided
much needed mental health and social services primarily to South Asian, Middle Eastern and Bosnian communities. We
welcome Hamdard's addition of primary care to its service array.
Hamdard provides a range of culturally competent programming including: mental health, senior and youth services,
case management, and domestic violence services (including housing, employment and batterer's counseling), and a 24-
hour crisis line. Hamdard's linguistic competencies (Bosnian, Serbian, Croatian, Russian, Arabic, Spanish, Hindi, Urdu,
Punjabi, Gujarati, Telugu, French and English) are evidence of its ability to serve limited-English proficient residents. In
addition, Ha.mdard's psychiatric and psychological services benefit trauma survivors including Bosnian, Burmese and
Iraqi refugees and domestic violence victims. By employing qualified personnel representative of its target population,
Hamdard addresses religious, cultural and linguistic barriers to health services, and its sliding fee scale ensures access
regardless of a patient's ability to pay.
CommunityHealth is Illinois' largest free medical clinic, and is the leader in delivering comprehensive, high-quality,
patient-centered health care at no cost to low-income, uninsured individuals in need of a medical home. Our unique
service model is supported by three pillars: philanthropy, volunteerism, and partnerships. If approved for NAP funding,
Hamdard and CommunityHealth will collaborate in the following endeavors:
• Community outreach, education and enrollment of newly eligible individuals into Medicaid or subsidized
health insurance.
• Mutual referrals.
• Additionally, CommunityHealth will welcome an application from Hamdard to become a partner in our on-site,
licensed MedAccess Chicago Pharmacy. MedAccess, the only pharmacy of its kind in the region, is designed
To ensure that prescription medications are within reach of those who desperately need but cannot afford them.
SeratlnoGarella. M.D.
Founder John F. Benjamin
Robert K. Mendonsa
Arnold L WIden. M.D.
Hamdard is a vital link in the Greater Chicago health safety net. CommunityHealth commends Hamdard's application
and looks forward to collaborating with Hamdard to strengthen our collective response to healthcare needs across the
region.
Immediate Past President Sincere!y,
EXECUTIVE DIRECTOR
Judith Haasls
Judith Haasis
Executive Director
lllinois' largest volunteer-based health center providing free care to the uninsured www.communityhealth.org
Lederman Family Health Center at West Town 2611 W. Chicago Ave.,Chicago. IL 60622 Admin: 773.395.9901 I Patient Care: 773.395.9900
Englewood Health Center 641 W. 63n:l Street. Chicago. IIL 60621 Patient Care: 773.994.1515
Example
ANNUAL REPORT
2011-2012
FAMILY PRESERVATION PROGRAM
In 1998, Hamdard established a Child Welfare Agency, duly licensed by the Illinois Department of Children and Family
Services. Since 2001, Hamdard Center has been providing services to South Asian, Middle Eastern, and Bosnian
families thanks to a grant from the Illinois Department of Children and Family Services.
The main project activities are:
Violence prevention
Stabilization of high-risk families
Parenting skills training
Supportive counseling
Supervised visitation
Referrals and linkages to community resources
Mentoring and support to mothers
Community based outreach programs for hard-to-reach families
Awareness and education in the target and mainstream communities
Expanded collaboration with all available community resources
Offering an alternative to violence: non-violence conflict and resolution for children.
VICTIMS ASSISTANCE, INTERVENTION, AND PREVENTION
Domestic Violence Services As an increasing number of immigrants and refugees are making their homes in this country and facing difficulties
integrating into mainstream communities, the need for culturally tailored intervention becomes a necessity. Many
families experience high stressors and emotional instability due to the changes in life styles that make it critical to
address issues of domestic violence to maintain health family. The victims representing immigrant minorities have
severe cultural barriers in accessing mainstream services.
Hamdard Center has been providing culturally tailored multilingual services to domestic violence victims and abusers
since 1993. Hamdard Center owns and operates its own licensed shelter facility and a 24-hour toll free crisis line. The
shelter is fully functional and can accommodate up to thirteen individuals at any given time. All shelter staff members
are trained and certified in domestic violence and serve the victims and their children in the most professional and
effective manner possible. The program is designed to prevent and reduce violence and abuse in homes that can destroy
families.
The primary mission of the Hamdard Domestic Violence Program is to ensure the safety of victims, provide early
intervention, and offer services that foster the preservation and stabilization of families. All services are free,
2011-2012
Number of Clients Served 479*
Number of Families Served 263*
ANNUAL REPORT
2011-2012 confidential and culturally compatible.
Available Services for Families of Domestic Violence
Women
Comprehensive and collaborative IDHS protocol compliant program
Onsite residential shelter and off-site shelter with certified staff on duty 24-hour a day
Counseling, advocacy, training in survival and parenting skills in restructuring their lives
Assistance with public benefits, employment skills, training etc.
Legal advocacy for order of protection, victim impact statement, child custody, and immigration issues
24-hour toll-free crisis hotline
Community education and outreach
Hospital and school based programs
Transitional housing facilities based on eligibility
Children
Activity groups to promote learning/self expression
Provide safe, caring, nonjudgmental setting for children to visit with their non-custodial parents
Individual counseling
Training to promote nonviolent problem solving skills
Community
Community outreach and education, volunteer recruitment, and training
Collaboration with regional and local networks in advocacy and raising awareness
Outreaching to schools and universities on issues related to domestic violence and sexual assault
Providing 40-hour training and certification to staff, volunteers, and partner agencies
Transitional Housing for Women and Children Hamdard’s Transitional Housing Program offers hope and help to families (mothers and children) who are victims of
domestic violence and homelessness. Hamdard’s Transitional Housing Program strengthens families by helping them in
areas such as employment assistance, parenting skills, job training, budgeting, and life skills.
The goal of the program is the restoration of self-sufficiency and dignity for women, mostly with children, who have
come through experiences that have shattered their lives. These women are often left in an untenable cycle of
dependence, poverty, homelessness, unemployment, and the responsibility to care for emotionally scarred young
children who cannot be left unmanaged.
Hamdard’s program provides women with the necessary assistance to rebuild their lives. Initially, women and their
dependents receive a safe residence. Relieved from the pressures of monthly rent and utility bills, the domestic violence
survivors then receive counseling and support in reestablishing their emotional and social identities. A case manager is
then assigned to assist them step-by-step through to career training, job placement, child care, placement in local
schools, and eventual employment. Survivors of domestic violence graduate to transitional housing program after their
stay in the emergency shelter and can reside in the transitional housing units for up to 24 months
The Transitional Housing Program at Hamdard began in September 2001. Today, Hamdard Center now operates two
transitional housing units. Since its establishment, all of the clients have successfully completed their stay at the
program and have moved onto independent living. They have jobs, cars, and savings for the future. Their children have
also improved their self-confidence and made significant academic progress.
2011-2012
Total Clients Served 59*
Total Counseling/Advocacy Hours 811
ANNUAL REPORT
2011-2012
24-HOUR TOLL-FREE CRISIS LINE
1-866-305-3933
Hamdard has operated a 24-hour crisis line since 1993, which is staffed 24 hours a day, seven days a week live people
that are trained and certified professionals who speak a variety of languages. Through this line, Hamdard provides
assessment and brief and intermediate crisis intervention, assurance, support, information, and referral. The Center
receives hundreds of crisis calls every year from men, women, and teenagers personal and family crisis, emotional
distress, isolation, depression, and abuse and neglect.
FAMILY INTERVENTION PROGRAM
(PROGRAMS FOR MEN WHO BATTER)
Partner Abuse Intervention Program (PAIP) Hamdard Center began the Family Violence Intervention Program, now the Partner Abuse Intervention Program in July
of 2000. This is a specialized service catering to males who have committed acts of domestic violence against their
spouses or partners. Professionals trained in the area of domestic violence staff the program and are culturally sensitive
to the needs of the target community. Beginning July 2011, this program is now offered from both Hamdard’s Addison
and Chicago offices.
The goal of this program is to help these individuals to recognize, understand, and ultimately change their abusive
behavior. Working toward that goal, the men participate in a psycho-educational program, which consists of a two-hour
session per week over a twenty-six week period. Topics dealing with non-violent interactions are discussed, and
homework assignments are given. The program is based on the internationally recognized Duluth Domestic Intervention
Project Model. This program is Illinois Department of Human Services Program Compliant.
Program Referrals
Clients are either referred through the court system or are self-referrals. In either case, a trained Hamdard staff
determines if they are appropriate candidates for the Family Violence Intervention Program must evaluate participants.
Education Curriculum
All prospective candidates undergo an initial assessment for suitability into the program. Those selected will be required
to sign a contract agreeing to attend prescribed number of sessions, and abide by the rules and spirit of the program. A
release form is also signed allowing Hamdard to share information with the courts and their spouses/partners.
Participants pay for the services rendered and some on a sliding fee schedule according to their financial capabilities.
Some of the topics discussed in weekly sessions include:
Non-violence, non-threatening behavior
2011-2012
Total number of clients served 11*
Completion rate of employment goals 100%
2011-2012
Total Number of Hotline Calls 1,099
ANNUAL REPORT
2011-2012 Respect, support and trust
Honesty and accountability
Sexual respect, partnership
Negotiation and fairness
As part of the program, services are also provided including:
Assessment
Counseling
Anger Management and Abuse prevention
Community Education
Outcome
It is Hamdard’s hope that men who participate in this program will take full responsibility for their behavior and
embrace a more egalitarian approach in partnership, respect for the rights of women and develop skills for handling
conflict in a non-violent manner. Hamdard Center is dedicated to assisting men in putting their lives back in order.
HEALTH SERVICES
Behavioral and Mental Health Services Hamdard’s program philosophy is deeply rooted in our family and community values and our cultural and religious
traditions and practices. One of the highly prioritized goals of our programs and services is the preservation,
stabilization, and rehabilitation of our dysfunctional families. Hamdard program and services are designed to strengthen
and support families and to give people in distress a sense of hope. Hamdard uses a holistic, integrated service delivery
model with a heavy emphasis on prevention and early intervention.
Trained and credentialed mental health counselors, social workers, clinical psychologist, and psychiatric consultants
staff Hamdard’s mental health services. Mental health is the most widely used program by men, women, children, and
elders seeking professional help for depression, anxiety, adjustment at work and at home, acculturation difficulties,
family conflicts, intergenerational conflicts, marital problems, just to name a few. Hamdard helps elderly clients who
feel abandoned and lost. Hamdard also provides assessments and evaluations for disability benefits and Social Security
Income (SSI). The Agency’s professionals frequently run into teenage girls who have attempted to hurt themselves due
to the overwhelming family pressure and multiple stressors, but most notably violence at home.
Hamdard receives referrals from area hospitals, schools, courts, Department of Children and Family Services (DCFS),
religious centers, and other social service agencies. Hamdard sees parents who have been mandated by the courts to
seek help at Hamdard for assessment and counseling, especially when there are children in DCFS custody. Over the last
several years, Hamdard has seen a growing number of men and women initiating self-referrals to seek help for
themselves and their families.
Hamdard’s professionals have seen positive outcomes when clients seek help at an early stage, especially in cases of
marital discord and family violence. The Agency staff has also noted that most community members who seek help at
Hamdard suffer from chronic, multiple problems and have severe barriers accessing mainstream services. All services
are free and strict confidentiality is maintained.
The goal of the Mental Health program is early detection, and intervention to reduce further damage to emotional
health. Chicago area is growing in numbers with the refugee population. Most of the refugees coming to Hamdard to
seek mental health services have severe trauma and Post Traumatic Stress Disorder (PTSD) symptoms. Hamdard staff
understands the unique need of refugees to help them adjust to living in a new culture.
2011-2012
Total Number of Men Served 38*
ANNUAL REPORT
2011-2012
Mental Health Services for Men, Women, Children/Teens and Elderly
All services are offered to everyone, and those without insurance pay according to a federally-approved sliding fee
scale. Bilingual and bi-cultural counselors and psychiatrists provide services. Currently, Hamdard can offer services in
Arabic, Bosnian, Hindi, Urdu, and Punjabi including:
Crisis intervention
Psychiatric evaluation
Medication monitoring
Mental Health Assessment
Education and Outreach
Individual, Couples and Family Therapy
Group Therapy
Case Management
Collaboration with schools, hospitals and social service
agencies
Primary Health Care Clinic The Hamdard Center strives to improve the health status of medically underserved populations by fostering the
provision of high-quality, comprehensive health care that is accessible, coordinated, community-directed, culturally-
sensitive, and linguistically competent. Hamdard began its primary health care clinic in 2004 as a response to the
increasing need for health services in the medically underserved area of Rogers Park and Edgewater. Hamdard’s
physician provides general medical examinations, blood testing, and Echo cardiograms. Due to the growing need for
services in the community, Hamdard is in the process of applying for Federally Qualified Health Center (FQHC) status,
which would allow Hamdard to serve a greater number of clients in need of specialized and affordable medical services.
Internship and Training Program In partnership with surrounding area universities, Hamdard offers intensive internship and practicum programs to the
graduate level of students. This program is supervised by licensed psychiatrists, clinical psychologists and licensed
counselors. Due to the diverse nature of the agency, many students have chosen Hamdard to finish their professional
training. Hamdard fulfills all the requirements of professional training for such students. During the 2011-2012 school
year, a total of 17 interns have successfully finished their internship/practicum requirements with Hamdard.
CASE MANAGEMENT
Hamdard provides comprehensive case management services that are culturally sensitive to serve our target populations
in DuPage and Cook Counties. In April 2009, Hamdard expanded its case management services by opening a Case
Management office out of its Addison office. The Case Managers assist clients with accessing public assistance and
other community resources. Clients receive both internal and external referral sources including Hamdard’s mental
health and domestic violence programs and the Department of Health and Human Services. Hamdard provides
assistance to individuals and families by providing access to the following services: Medicare/Medicaid, Supplemental
Security Income/Disability, Access DuPage, LINK Card, Women Infants and Children (WIC), Temporary Assistance
for Needy Families (TANF), low-income housing, subsidized child care/day care, enrollment for free bus passes for
seniors, legal advocacy, and translation. In addition, Hamdard’s Chicago location serves as a certified Low Income
2011-2012
Total Number of Clients Served 383*
Total Number of Counseling Hours 809
2011-2012
Total Clients Served 13*
ANNUAL REPORT
2011-2012
Housing Energy Assistance Program (LIHEAP) intake site. Legal advocacy is also provided in the form of providing
referrals to Legal Aid and court accompaniment as well as providing emotional support and translation to clients.
Outreach efforts are also made to raise awareness and to educate the target population further about available
community resources.
EMPLOYMENT SERVICES
Due to the generous contribution of a community foundation, the Employment Counseling Office launched in
September 2011. Stationed in the Addison location, the Employment Counseling office offers one-on-one employment
counseling services and group presentations free-of-charge to individuals looking for assistance with a variety of
employment-search related assistance. Services include: rand cover letter writing, interview skills, general job search
techniques, job hunting in today's economy, and community referrals for ESL, GED, and vocational training courses.
ADULT DAY SERVICES
The Adult Day Services program empowers seniors in the community by providing them with hope, help, and healing.
In response to the growing needs of seniors in Hamdard’s target populations, the Center launched its senior initiative,
Community Outreach Program for Elders (COPE), in October 2002. In 2004, Hamdard’s Adult Day Service Program
was licensed by the Illinois Department on Aging. The Adult Day Program provides structured programs and activities
for 4-5 hours daily to individuals who are sixty years of age or older. Some of the salient features of the Adult Day
Service include: (1) health monitoring (triage by a Registered Nurse), (2) socialization, (3) recreational activities
including outdoor activities, (4) exercise, (5) health education, (6) English conversation and reading, (7) computer
learning, and 8) in-language newspapers and television. All of the clients attending the Adult Day Service Program are
served a hot nutritious, culturally compatible meal daily. Each client has an individualized service plan based on their
unique services. The primary focus of Adult Day Services is to help clients maintain their emotional, cognitive, and
physical functioning and to support independent living.
2011-2012
Total Clients Served 68*
Total Meals Served 3,663
Health Monitoring, Instruction &
Exercise Hours Provided by Nurse 150
2011-2012
Total Clients Served 664*
Total Number of Service Hours 2,988
Total Number of Translation Hours 738
Total Number of Outreach Hours 541
2011-2012
Total Clients Served 21*
Total Number of Community Presentations 4
ANNUAL REPORT
2011-2012
YOUTH SERVICES
Hamdard Center’s Youth Enrichment Program has made great strides in addressing the needs of its target communities
since its inception in 2007. The program serves children ages 6-12, the majority of whom are bi-lingual in Spanish. The
program runs throughout the academic year followed by a six week summer program. The summer program is a literacy
and arts based program featuring workshops on writing shorts stories, improving reading abilities, drama, and various
forms of art. The Hamdard After-School Program includes social skill-building, reading, art, dance, martial arts, youth
led and academic workshops. Our program also focuses on goal setting to improve academic weaknesses. Each month,
tutors and students prepare 2 goals to improve on and do four weeks of workshops to meet their goals. In addition, the
program includes a strong focus on homework help. Hamdard staff, along with tutors from Loyola University Chicago,
work with students during homework time to help answer questions and problem solve. The results anticipated by the
end of the academic school year are: an overall improvement in grades, developed positive study habits, and increased
confidence and independence in completion of schoolwork. The desired results for the following academic year:
improvement in grades, increased overall understanding of material that is being taught in school, and increased
expression through arts and writing.
CONTINUOUS QUALITY IMPROVEMENT (CQI) COMMITTEE
The Continuous Quality Improvement (CQI) committee was formed in February 2006 to help improve documentation
of service delivery, operations and administration, and fiscal and risk management as suggested by the Council of
Accreditation (COA). The CQI committee is composed of program managers and the management at Hamdard Center.
The goal of the Hamdard Center’s quality improvement program is to empower staff to initiate self-determined change
in incremental steps, which will benefit clients through improved service quality and delivery.
The CQI committee meets monthly to assure that a process of regular and systemic review of specific document
program information, service techniques, and agency task performance relative to the delivery of health and human
services. The plan is intended to review, evaluate, and improve the effectiveness and efficiency of services consistently
and incrementally. All departments have put in considerable efforts to increase accuracy of the documentation as well
as improve overall service delivery including client satisfaction.
In 2012, the focus of the CQI Committee has been:
Assessing and improving organizational performance
Monitoring the effectiveness of the services
Replicating model performance
Promoting a task-oriented team approach
Revising the policy and procedure manuals
*Represents unduplicated number
2011-2012
Total Children Registered 43*
Total Number of Program Days 169