Psycho (Alfred Hitchcock, 1960)RUNNING HEAD Community H.docx

Psycho (Alfred Hitchcock, 1960)
RUNNING HEAD: Community Health Program (CHP)
Community Health Program (CHP)
Community Health Program
Jennifer Coble, Emley Jennifer Tenorio, Mary Walsh
HCA-620
January 8th, 2020

The American Heart Association and hypertension
Introduction
The American Heart Association and hypertension is a non-
profit making organization that is mandated by the federal
government to create a medical awareness program about heart
and hypertension conditions among the United States residents.
The main aim of initiating this activity is to help in solving
health issues relating to heart and hypertension cases that are
currently common in different parts of the United States.
DESCRIPTION OF SERVICES
The American Heart Association and hypertension program aim
at creating outreach awareness about heart diseases and
disorders and hypertension conditions. The process of creating
public awareness will tend to reach a large number of people
from areas to inner cities where most people reside. A mobile
health care promotion program will use a public address to
announce to invite the public to come for free heart and
hypertension screening. The screening process will involve
testing members of the public who will make to mobile
screening centers.
Currently, there are various cases relating to heart and
hypertension cases in different states in the United States.
Statistically, the aging population is the most affected groups
which have been reporting cases of heart and hypertension
disorders. Usually, it is challenging to detect these conditions at
early stages (Huebner, Milgrom, Mancl, Smolen, Sutherland,

Weinstein & Riedy, 2014). As such, this has led to many deaths
since many cases are detected when the disease is at an
advanced stage, which is challenging to treat. Therefore, this
program is essential because it will help in assisting members of
the public in knowing whether they are suffering from such
conditions. In doing so, this will help to initiate early medical
actions to help in reducing the number of deaths associated to
heart and hypertension conditions.
Description of Mobile Health Promotion Outreach Program
Community Health Programs (CHPs) are increasingly
regarded as an integral component of primary healthcare
(Schneider, 2019). The organizations senior leadership asked a
team of medical professionals to put together a mobile health
promotion outreach program able to reach a diverse population
from inner-city areas to rural communities with a focus on
promoting and providing screening activities for The American
Heart Association (AHA) and Hypertension. AHA is the world’s
leading voluntary organization dedicated to building healthier
lives, free of cardiovascular diseases, and partner in building
healthier communities (2018). AHA branded health screenings
conducted at a community-based health events designed to help
consumers become aware of their personal health risk factors,
motivate them to make behavior changes on their own or seek
support for lifestyle changes and follow-up medical care (2018).
AHA convenes with community organizations regularly to find
and implement solutions that make a difference in people’s
health where and how they need it (2018). Health screening
services will be made available for community-sponsored events
(2018).
Current literature supports that Mobile Health Clinics
(MHCs) play a significant role in the U.S. healthcare system
and are successful in reaching vulnerable populations, by
delivering services directly at the curbside in communities of
need and flexibility adapting their services based on the
changing needs of the target community (Yu et al., 2017).
MHCs are an innovative model of healthcare delivery that could

help alleviate health disparities in vulnerable populations and
individuals with chronic diseases (Yu et al., 2017). As defined
by The American Heart Association, high blood pressure also
referred to as HBP, or hypertension is when your blood
pressure, the force of blood flowing through your blood vessels,
is consistently too high and nearly half of American adults have
high blood pressure and the best way to know if you have it is
to have the blood pressure checked (AHA, 2020). MHCs are
sometimes considered alternatives to other healthcare models
and serve as a platform to help them navigate the more
convoluted systems of the wider healthcare structure and to
connect with the medical and social resources in the community
(Yu et al., 2017). Studies show that these MCHs are effective in
facilitating access to health care, particularly for minority
groups who have poorer health, and face a higher number of
barriers in accessing health services (Yu et al., 2017). The
target population include vulnerable population such as the
homeless, displaced population, immigrants, migrant workers,
the under-insured, and children who are often disconnected
from traditional healthcare settings and require support in
accessing healthcare (Yu et al., 2017). According to a 2017
report, patient barriers to accessing care showed 50% of low
income adults don’t trust healthcare, 20% deterred by high
healthcare costs, 25% lack transportation to medical
appointments, 11% lack insurance coverage and other report
social isolation, racial or economic barriers, or language and
cultural barriers (Health, S, 2018).
Mobile clinics can successfully reduce barriers in
access to healthcare and can provide more opportunities for
underserved populations to screen for various conditions and to
properly manage their health (Yu et al., 2017). They are an
effective setting for chronic disease management such as
hypertension which is notoriously difficult to adhere to and
therefore, these mobile clinics patients have a reported increase
sense of self-confidence and ability to manage and navigate the
healthcare system (Yu et al., 2017). Additionally, mobile health

clinics are making their mark on healthcare, as the advisory
board reported, there are about 2,000 MHCs on the road and the
operational cost is $429,000 annually (Health, S, 2018). These
clinics make a dent in the most vulnerable, safety-net
populations, as reported 60% of the patients are uninsured, and
another 31% have public insurance (Health, S, 2018). MHCs
address the social determinants of health, and promote value-
based care and fill in the gaps that have been proven extremely
effective at connecting high-risk patients with primary and
preventive care (Health, S, 2018).
Operational Plan
The health system’s executive leadership, and
policymakers developed innovative interventions that will help
manage chronic diseases and promote preventative health such
as the mobile health promotion outreach program. The Sinai
Mobile Health Unit project will be launched in the year 2021,
which is a Medical Health System entity. The use of extensive
research in cost effectiveness, senior leadership was able to
provide grants to this project from a network of organizational
donations. It will be available initially for the first 5 years in
the heart of a rural community and will continue to provide
mobile health care depending on the outcomes and return on
investment in the succeeding years. The Mobile Health Unit will
provide primary and preventive care and has connection
between community-based, churches, other hospitals, and clinic
that often connect community members with both medical and
social services (Yu et al., 2017).
The Sinai Mobile Health Unit Goals
1. To increase access to healthcare services (Yu et al., 2017).
2. To create impact on improving patient health outcomes
(Yu et al., 2017).
3. To address social determinants of health (Yu et al., 2017).
4. To advance population health in chronic diseases (Yu et
al., 2017).
5. To decrease healthcare costs (Yu et al., 2017).
Contract or lease

A new business model has to develop a contract or
lease to acquire a 1 or 2 mobile health unit that will give more
value to the project. The location where the mobile health unit
should be close to the urban community and the team needs to
conduct a population search prior to leasing or contracting.
Safety features are mandatory, and services should be accessible
to all types of patients and must comply with the American
Disabilities Act (ADA) standards.
Employer and employee qualifications
Clients of mobile clinics may have a diverse
background of social circumstances and cultural beliefs (Yu et
al., 2017). Employee has to be culturally competent, model a
friendly, and nonjudgmental care and must have the ability to
foster trusting relationships (Yu et al., 2017). Experience in
collaborative efforts, comfortable working in small spaces, and
is willing to accept the risks of going into underserved
neighborhoods (Yu et al., 2017).
Production, Distribution and Customer service plans
The health system needs to identify a convenient
location to park the mobile conveniently close to the community
residents. The services include preventative health screenings,
and initiating chronic disease management. Other services
include counseling, outreach, and education, employment
assessments and referrals. Both public and private payers can
participate in this program. Accountable care organizations
(ACOs), a healthcare management model under the Affordable
Care Act are responsible for patient population to improve
healthcare quality and cost through utilizing mobile clinic
model (Yu et al., 2017).
Contingency plans for interruptions in supply or labor issues
The mobile health program may encounter difficulty
in sustainability, difficulty in hiring clinicians (Heath, 2018),
has a risk of increased fragmentation of care, finances or lack of

steady source of support from the sponsors or non-profit
organizations, constraints by space and clinic structure which
can affect confidentiality and privacy, and challenges in
logistical planning when staff is not coming to work for fear
that patients are either homeless or IV drug users (Yu et al.,
2017). Various solutions such as corporate sponsorships,
collaboration with community partners, and more frequent
maintenance checks, have been developed to combat the issue of
financial insecurity (Yu et al., 2017).
Key Personnel
Medical Director – responsible for outlining the business
structure and the key personnel and their roles and
responsibilities in the mobile health outreach program and for
seeing all clinic aspects of the care provided, including but not
limited to supervision of staff, development and implementation
of quality assurance program, quality improvement, and risk
management initiatives (www.ama-assn.org).
Director – oversight of the operational functions, clinical
aspects of patient care, budget, and personnel. Ensures quality
of care is not compromised (www.ama-assn.org).
Clinical Manager – must be a registered nurse or mid-level
practitioner, under the supervision of the director, manages the
day-to-day operations, ensuring policies and procedures are
followed, and can relieve the medical director or certain
management activities, including quality assurance issues,
patient record reviews and follow up consults (www.ama-
assn.org).
Nurse – responsible referred patients, should function under
established medical protocols, support patients during diagnosis
and treatment, obtain health history and assess health and
illness status, provide patient education in the areas of health
promotion, and preventive medicine, referral of patients as

necessary to other health providers and social service agencies,
and appropriate follow up of patients with chronic and acute
health problems (www.ama-assn.org).
Treasurer – charge and custody of and responsible for funds,
provide oversight over the financial books, and month financial
reports (www.ama-assn.org).
MARKETING COMPONENTS
Marketing of the program will be done through mass
sensitization of members of the public to visit mobile clinics to
get screened from the heart hypotension conditions. The
sensitization process will be done using motor vehicles and
public addresses to reach as many people as possible.
Marketing and promotion
Marketing and promotion of the program will be done per
region. The public address will be used by sub-counties to
create awareness and invite members of the public to attend the
program. In cities and urban areas, promotion of the program
will be done in estates where most people reside to attract the
attention of many people. The latter will help to reach many
people in urban areas since some people in urban areas spend
more time in their residential areas.
Motor vehicle selection
The model of vehicle to use in the sensitization process will
depend on the geographical settings of rural areas. The model
and type of cars to use in the process will also depend on the
infrastructure of rural areas. Land cruiser modern design will be
used as a mobile clinic where the medical test will be
conducted. A land cruiser, a four-wheel-drive, thus will access
all different places with poor infrastructures (White,
McIlfatrick, Dunwoody & Watson, 2019). Five motor vehicles
will be used in the process to help in serving many people when
the turnover is high. This will help to save time as well as
increasing the number of people being served at a time.
Besides, there will be vehicle maintenance team will be

responsible for fixing motor vehicle issues that might be
experienced during this program. Proper maintenance will help
in facilitating the smooth running of activities during this
program. Fuelling of vehicles will be financed by the county
government that will fund the program. Insurance and wear and
tear issues will be taken care of ensure continuity of the
program.
Scheduling of staff and locations for events
A schedule of this program will consider various factors. The
population and geographical location are some of the most
critical factors that will be considered when scheduling events.
The program will be conducted in different parts of the Texas
States. However, the study will focus on the activities done in
Dallas County. For participants of the program to reach the
target of the program, clinical staff will be divided into groups
to help in serving a large number of people.
Training
Training of health care professionals and other personnel who
will take part in this program is an essential process. It helps in
equipping all staff who will take part in this program to
understand their roles appropriately. Conference training of
health care professionals will be done before the program to
ensure proper preparation for the activities.
Training materials
Educating and training materials for health care professionals
who will take part in this program will be mainly medical
materials. These materials will contain concepts, ideas, and
guidelines that will enable health professionals to perform their
duties correctly.
Permitting
The primary aim of this program is to reach a large number of
people within the county to be screened for heart and
hypertension condition. The program is a healthy activity that
aims at improving the quality of life among members of the
public. As such, the local authority will approve to provide a

legal practice permit that authorized the program to be
conducted (Willis, Reynolds & Keleher, 2012).
FINANCIAL INFORMATION
Funding for the program
The main goal of this program is to help in improving the
quality of life among members of the public. As such, the
program will be funded through donations for other non-
governmental organizations. Some of the donors of the program
will be the World Health Organization, UNICEF, and other non-
profit organizations.
The state government of Texas and the county government of
Dallas will also provide grant funding to support the program.
The allocation for the program will be made through the health
sector to facilitate the provision of quality screening of
members of the public for heart and hypertension conditions to
improve the quality of life in Dallas and neighboring counties.
OPERATIONAL PLAN
In this section, various activities that will determine the success
of the program will be done. In will help in ensuring that all
operations are performed to achieve all its goals and objectives.
The key aspects discussed in this section include the following:
Legal and regulatory issues
These issues include matters relating to liabilities issues, local
government restrictions, and the department of transportation
issues. For the whole process to run efficiently, the
management of the program will ensure all legal and regulatory
requirements are met to avoid problems restriction the process
of running this program from taking place. Working permits
will be acquired from both local and state governments to allow
for the smooth running of the activities during the process,
creating awareness and screening the public for heart and
hypertension conditions (Willis et al., 2012).
Besides, a working permit will be obtained for the
transportation department to allow the team who will involve in

this program to use a public address to reach members of the
public. Getting these legal documents will give participants of
this program to right to perform their activities without any fear
of interference.
Cultural and language issues
Usually, cultural and language problems are some of the critical
issues that always adversely affect the smooth running of
activities of a program. As such, the management of the
program will pay more attention to these issues to help in
supporting businesses of the program. First, during the
application, all those who will take part in the process will obey
and recognize the cultural practices of the local community they
serve (Schensul, Denelli-Hess, Borrero & Bhavati, 2019).
Respecting and appreciating the cultural traditions of the local
communities will assist in creating a good relationship between
members of the public and health professionals who will be
taking part in this process.
On the other hand, the language issue also is likely to affect the
success of this program. Therefore, the management of this
program will engage members of the community to help serving
members of the public to avoid language berries when offering
their services.
Patient flow
Patient flow during this program will depend on the ability of
service providers to reach members of the public. Since services
will be provided to members of the public for free, a large
number of people is expected to show up to be screened for
heart and hypertension condition. In areas where patients flow
is high, more health professionals will be deployed to attend to
them. This will help in reducing workload among service
providers to improve the quality of service offered to members
of the public (Willis et al., 2012).
Sanitary needs and sterilization
Maintaining a clean working environment is one of the factors
that will help in improving the quality of services offered to
members of the public. Therefore, service providers will ensure

that a clean working environment is maintained in all working
stations. The latter will be done by proper disposal of all
restorative material used and sterilizing reusable items to avoid
transmission of germs.
Marketing Components
The current patient demographics that this project plans to
market towards are patients in rural and urban communities that
require preventative screenings and services through a mobile
outreach clinic. The goal of this project is to reach the defined
market segment of patients within the community who lack
adequate access to necessary preventative care. To properly
address the appropriate market segment the plan needs to
identify the demographics, economics, lifestyle, sociocultural,
location, and behavior of the population the organization plans
to serve (Moseley 2009). The current project is a mobile clinic
that provides patients with services to evaluate their heart
health and blood pressure while providing care for patients in
need of preventative health services. The goal of this project is
to improve access to care through provision of services in
disadvantaged communities to improve the community health
for patients who lack access to care through either economic or
distance from services. The project plans to utilize marketing
strategies in coordination with local organizations and providers
to increase the quantity of patients who lack access to necessary
services. The American Heart Association’s campaign for this
project is “Providing care close to home”. The current budget
for the advertising campaign is $15,000 to be allocated as
necessary for each project. Funding is limited due to the goal to
improve the quality of patient care while decreasing costs as
necessary, thus requiring the clinic to heavily rely on
partnerships within the community to spread the organization’s
message.
Internal Marketing
Marketing within an organization is the first step to
success as it enable staff to better promote the organization by
motivating and empowering employees while building a

relationship with the patients. This environment promotes
employee contribution to the organization through identifying
necessary changes and improving policies to benefit the
organization and patients. The internal marketing campaign will
focus on promoting the mission while stating the importance of
the objectives and goals along with the steps staff members can
take to achieve these goals. The internal marketing strategy will
be designed around employee satisfaction and the organization’s
mission statement. Focusing on these two factors will allow
staff to collaborate to achieve a holistic approach to patient care
that promotes healthy relationships with the community. The
use of internal marketing will create the foundation for all other
marketing platforms as it enables employees to provide quality
service. When the idea of internal marketing was introduced it
specified that satisfied employees will provide better service
which will increase patient retention. The first step of the
mobile clinic will be implementation of organizational
citizenship behavior to enable staff to create a positive
atmosphere between the staff on site with the organization. This
method has shown to increase productivity and empower
employees to work cohesively. The second step of this project is
to focus of customer-oriented behavior to advocate for patient
needs and satisfaction. The third goal of internal marketing will
be to promote organizational loyalty through management to
ensure staff remain with the organization and work in the
organization’s best interest to reduce costs and improve the
environment. The final goal is to improve organizational
performance based efficacy, growth, and financial targets to
produce an environment that employees act in the best interest
of both the patients and organization (Abbasi, Haghighi,
Maskan, Ashkani, & Mohammadi 2017). In many cases a mobile
clinic may feel disengaged from the organization due to the
constantly changing environment and lack of stability within
daily events. As a result forming an environment within the
organization that promotes a cohesive community that focuses
on both employee and patient satisfaction is necessary for

success. This method of marketing is a low cost solution for
internal marketing as it focuses on staff engagement through
communication.
External Marketing
External marketing for this project should focus on
identifying the community’s needs and how the organization can
best meet those needs. The mobile clinic is serving both urban
and rural communities so there needs to be an effective method
to inform potential patients of the services being provided
(Purcarea 2019). There are two primary demographics that
require slightly different strategies to inform the patients of
services. Within urban communities the patient demographic
that the organization is attempting to appeal to is frequently
economically disparaged individuals that lack regular access to
preventative health care. To reach individuals within this
demographic it would be beneficial to collaborate with local
communities to inform potential patients of their services. The
primary marketing technique utilized would be compassionate
neighborly care for the patients that would require to mobile
clinic to be located within an area that potential patients have
access to. Having a regular schedule for patients to receive
preventative care and creating a relationship within the
community is a strong marketing technique to increase
patronage. By locating the clinic in the heart of the community
it improves access to care for communities unable to receive
access to care otherwise. When working with the community
from local doctor’s offices and hospitals there is the benefit of
patients being referred to the clinic by other health
professionals who work with these patients. Further marketing
within the community would be to advertise within grocery
stores and other frequently visited locations to notify the public
of the clinic’s presence and services within the community
(Aung, Hill, Bennet, Song, and Oriol 2015). By comparison
rural communities are typically more decentralized and would
benefit greatly from regional marketing such as radio
advertisements indicating time and location of services

provided. Direct to consumer advertising is an effective method
of informing potential patients of the availability of services
within the community. The use of radio advertisements within a
rural community my enable potential patients to use the services
provided within the clinic (Limbu, Huhmann, & Peterson 2012).
The advertising budget is heavily allocated towards radio
broadcasting due to the higher cost of advertising that must be
directly negotiated with local radio stations. The ability to
directly inform local communities of upcoming events and
services is heavily relied upon in rural communities. Utilizing
both methods in urban and rural communities will have a
significant impact on the ability of patients to receive services
by being informed and comfortable seeking care.
With the advent of technology, the most important
tool for this project is the utilization of social media to inform
the community of the clinic’s services and location. Social
media has the ability to reach potential patients that would
otherwise not be aware of the potential services. The use of
social media in healthcare marketing has shown a direct
relationship with the community through building a network
that improve health promotion. Social media has brought a new
found connectedness to the world to enable health organizations
to better reporting of health crises and improve health literacy.
Social media is a low cost option to share health information as
it provides customizable daily updates to the community
(Gupta, Tyagi, & Sharma 2013). There will be implementation
of a social media presence within the community to share health
facts and information regarding the mobile health clinic. The
use of social media in implementation of this project is essential
in both rural and urban communities as it allows staff to inform
patients of important information. Focusing on provision of a
social media presence is a low-cost option to notify the public
of events and health issues. The team can work collaboratively
to producing a social media presence with the parent
organization to achieve the ideal message and obtain health
goals.

The ultimate goal of the marketing campaign is to
gain the trust of the community through collaborative efforts
within the community and focusing on provision of patient
centered care. When working in communities that lack access to
health care it is necessary to gain their trust by providing direct
communication to the patients. The mobile clinic must take
steps to improve the quality of life through providing a service
that many communities need. The first step in fulfilling
organizational goals for improved public health is a marketing
campaign focused on reaching out to patients and forming a
relationship that enables people to take control of their own
lives.
Financial Information
Within the United States there is around two thousand mobile
health clinics that deliver health care for around five million
visits annually within urban and rural communities. The benefit
of mobile health clinics is that they can be customized to fit the
needs of the community being served. The return of investment
(ROI) for mobile clinics out weight the costs of emergency care
by providing preventative care to patients in need in partnership
with local health care providers and community leaders. The
ability for mobile health clinics to provide inexpensive
preventative care is paramount for improving community health
as it removes barriers many disadvantaged patients face. Mobile
health clinics are a solution to at risk communities by providing
community focused care and education within the community
(Aung, Hill, Bennet, Song, & Oriol 2015). Within the United
States fifty percent of patients diagnosed with hypertension
have the condition under control. Patients treated by a mobile
health clinic were found to have a lower incidence of
myocardial infarction by 45% and lower blood pressure in 32%
of the patients treated than in the general public. It was found
that the implementation of mobile health clinics enabled staff to
better address the needs of their patients and helping them
adhere to necessary lifestyle changes. Due to the lack of
preventative in certain communities, the use of the emergency

department (ED) for non-emergency use and preventative care
revolve around 40% of the care provided costing $558 million.
The rate at which impoverished communities utilized the ED for
non-emergency use was three times the average. Further
research indicated that use of mobile health clinics reduced the
average hospital stay from 7.9 days to 5.8 days while reducing
the cost of care from $13 thousand to $10 thousand in elderly
populations (Yu, Hill, Ricks, Bennet, & Oriol 2017). Research
suggests the implementation of mobile health clinics as an
effective method of improving community health while
decreasing the cost of care within communities that lack access
to care. The American Heart Association and Hypertension is
dedicated to improving the quality and access to care within the
United States through addressing disparities within
communities.
The American Heart Association operates as a non-
profit organization that provides funding to research, education,
training, and community services. The organization currently
operates with a mixed asset portfolio that in 2019 equated to
$1,441,873 and a total liability of $496,329. The organization
currently $130 million in long term investments and $150 in
short term investments as of June 2019 (American Heart
Association 2019).
Assets
Current assets:
Previous Year
Current Year
Cash
64,917.00
64,509.00
Investments
732,887.00
746,680.00
Inventories

66,701.00
72,476.00
Accounts receivable
385,583.00
393,433.00
Prepaid expenses
15,242.00
15,856.00
Other
147,586.00
148,919.00
Total current assets
1,412,916.00
1,441,873.00
Figure 1. Yearly organization assets for the American Heart
Association
Income Statement
Mobile Health Clinic
2020
Financial Statements in U.S. Dollars
Revenue
Income: Grants, Donations, & Insurance
550000

Less Allowances
20000
Net
530000
Cost of Goods Sold
Beginning Inventory
0
Add: Purchases
60000
Freight-in
20000
Direct Labor
150000
Indirect Expenses
100000
Inventory Available
330000

Less: Ending Inventory
0
Cost of Goods Sold
330000
Gross Profit (Loss)
200000
Expenses
Advertising
15000
Bad Debts
10000
Depreciation
5000
Employee Benefit Programs
15000

Insurance
3000
Interest
2000
Legal and Professional Fees
2000
Licenses and Fees
500
Miscellaneous
1000
Office Expense
1000
Payroll Taxes
15000
Repairs and Maintenance
10000
Supplies
2500

Telephone
2000
Travel
4000
Utilities
4000
Vehicle Expenses
20000
Wages
75000
Total Expenses
187000
Net Operating Income
13000
Other Income
Gain (Loss) on Sale of Assets
2000

Interest Income
20000
Total Other Income
22000
Net Income (Loss)
35000
Figure 2. Income statement for the mobile health clinic
Figure 3. Projected revenue through donations and other
funding
The cost of implementation of a mobile health clinic can be
anywhere from $500-$600 thousand a year, but the net return is
indicated by decreased use of the ED resulting in $3 million in
health care savings. Many patients that visited one mobile
health clinic in Boston stated that they would have visited the
ED if this service was not available (Worth 2013). By
partnering with local hospitals, the mobile health clinic will be
able to offset some of the costs of operation by utilizing
hospital staff members to provide preventative health services.
It is in the best interest of the current community health care
providers to partner with the American Heart Association to
provide diagnostic services from checking blood pressure and
provision of EKGs as necessary. A partnership between the
local hospitals is paramount for the success of this program as it
alleviates the burden of care from the hospitals while decreasing
the cost incurred by the American Heart Association. By serving
the disenfranchised patients before their condition worsens,
hospitals can reduce inpatient costs by fulfilling a nonprofit
commitment to provide low cost preventative care.

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