Bridgeway Community Health Worker Academy

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Executive Summary

Bridgeway Community Health Worker Academy is a nonprofit in North Carolina that trains neighbors to become community health workers (CHWs): trusted members of a community who help people get the care and support they need. Our 14-week training program prepares adults from the communities we serve for real jobs at health systems, clinics, health departments and community organizations, and our Career Coach helps every graduate find one.

Community health workers are a bridge between the health system and the people it too often misses. A CHW helps a new mother sign up for coverage, goes with an older man to his first diabetes appointment, helps a family find food and a ride, and makes sure the doctor's instructions make sense at home. Because CHWs come from the community and often share its language and experiences, people trust them. Health systems and clinics increasingly want to hire them, but many employers cannot find trained candidates, and many people who would be excellent CHWs cannot afford to stop working to train.

With this grant we will train three cohorts of about 16 adults each in Year 1, 48 trainees in all. Each trainee completes 140 hours of classroom learning on evenings and Saturdays, and 100 hours of supervised field experience with a host employer. We pay a modest training stipend and help with childcare and transportation so cost and caregiving are not barriers. We expect about 38 graduates in Year 1, and we will work with employers so that at least 70% are working in a CHW or related health job within six months. We do not promise a job to any trainee.

Our Year 1 budget is about $344,500, growing to about $411,000 by Year 5 as we grow to four cohorts a year of up to 20 trainees. Each year's budget is planned to balance, with a small surplus each year. We have 5 paid staff in Year 1 and 6 by Year 3. Employers and the local workforce board sponsor training seats for graduates they want to hire, so grants fall from about 75% of our income in Year 1 to about 49% in Year 5.

We are asking the Piedmont Workforce Health Fund for $90,000 for our Program Director and Lead Instructor, trainee stipends, and childcare and transportation support. Sponsored seats, other grants and local donors cover the rest, so this grant is one part of a shared funding plan.

I am Naomi Carter, the Executive Director. The numbers in this proposal are estimates based on the assumptions listed at the end, not promises.

Company Description

Bridgeway Community Health Worker Academy is a nonprofit organization in North Carolina. We are a 501(c)(3) public charity (or a program of one, through a fiscal sponsor), governed by a volunteer board of directors. We will provide our IRS determination letter, board list and most recent financial statements with this proposal.

Our mission. To prepare people from our communities for meaningful careers as community health workers, and to strengthen the health of the neighborhoods they serve.

What we believe. The people closest to a problem are often closest to the solution. Lived experience is a qualification, not a barrier. A good training program respects adult learners, pays attention to the realities of their lives and prepares them for real jobs with fair pay. Health improves when people feel seen, heard and supported by someone who understands them. Employers and training programs should work together, not separately.

How we started. Bridgeway began when the director of a community health center, a county health department nurse and a longtime community health worker noticed the same thing from three directions. The health center had open CHW jobs it could not fill. The health department had a wait list of community members who wanted to do the work. And experienced CHWs said they learned by doing, with no formal training and no path to advance. They ran two pilot training cohorts in a church classroom with volunteer instructors. Of 29 trainees, 24 graduated, and 17 were hired within a few months by clinics and nonprofits. This proposal asks for support to turn that pilot into a permanent, staffed academy.

What we offer:
- A 14-week CHW training program. 140 classroom hours on Tuesday and Thursday evenings and Saturday mornings, covering the core roles and skills of community health workers, and 100 hours of supervised field experience with a host employer.
- Supports so trainees can finish. A modest training stipend, childcare help, bus passes or gas cards, and a laptop to use in class.
- Career coaching and placement. Resume help, interview practice, introductions to employers and follow-up for at least 12 months after graduation.
- Employer partnerships. Agreements with health systems, clinics, health departments and community organizations that host field placements, advise on the curriculum and sponsor seats for graduates they want to hire.
- Continuing education. Short workshops for working CHWs and for the supervisors who manage them, because CHWs succeed when their supervisors understand the role.

What we do not do. We do not provide health care, and trainees do not provide clinical care. Trainees in the field work under the direct supervision of the host employer and our field coach. We do not promise anyone a job, and we do not take a fee from trainees.

How we are run. A seven-member volunteer board of directors oversees the organization and approves the budget each year. The board includes a community health center director, a county health department nurse, an experienced community health worker, a hospital workforce manager, a community college instructor, a graduate of our pilot cohort and a certified public accountant. The Executive Director manages the organization and partnerships, the Program Director leads the curriculum and instruction, and an outside accountant reviews our books every year.

Where things stand today. Five employers have signed letters offering field placements and interviews for our graduates, and the local workforce development board has invited us to apply to be an approved training provider. We have a letter of intent for a 1,800 square foot classroom suite near a bus line. Before we begin, we will confirm North Carolina's current rules for CHW training and any certification, align the curriculum with them, and have an attorney review our employer and lease agreements.

Problem & Opportunity

Why this program is needed.

Health care is more than what happens in an exam room. Whether a person gets the care they need often depends on things the clinic cannot see: whether they have a ride, understand the instructions, trust the system, can afford their medication or have someone to call. Community health workers, who are trained members of the community and often share its background and language, help close these gaps. Research and program experience in many places suggest they can help people manage chronic conditions, keep appointments and get connected to services. The federal government and many states recognize CHWs as an important part of the health workforce.

The gaps we see:
1. Employers want CHWs and cannot find trained candidates. Health centers, hospitals, health departments and community organizations are creating CHW jobs. They often struggle to find people with both the community connections and the skills, and they have few places to send candidates for training.
2. Training is hard to reach. Existing training may be offered during the workday, far from the neighborhoods where candidates live, or at a cost many cannot pay. Some people with the strongest community ties have left school early or have no college credits.
3. Adults who would make great CHWs cannot afford to train. A person working or caring for family cannot take a month off to study without pay. A missing ride or childcare arrangement can end an adult's training.
4. Many CHWs learned on the job with no recognized training. Experienced CHWs may have no credential and no path to advance. Employers have no common standard to rely on.
5. Supervisors are untrained. A CHW's success depends on a supervisor who understands the role and does not treat the CHW as a clerk or a driver. Many supervisors have never been trained to supervise CHWs.
6. Communities with the greatest health needs have the fewest resources. People in our neighborhoods are more likely to go without regular care and to use the emergency room for problems that could be managed earlier. A CHW from the neighborhood can help.
7. Rules and payment are changing. North Carolina and other states are exploring how to certify CHWs and how Medicaid and other payers might pay for CHW services. Programs need to prepare people for a field that is evolving, and to align with whatever standards the state adopts.

How we know there is demand. In our pilot, we received 84 applications for 29 seats. Five partner employers told us they expect to hire at least 40 CHWs in the next two years, and none had a reliable pipeline.

How we will show the need. Before we submit this proposal, we will add the number of CHW and related job openings in our region from employer letters and job postings, the typical wage from the U.S. Bureau of Labor Statistics (community health workers) and local postings, the unemployment rate and share of adults with no postsecondary education in our target neighborhoods from the U.S. Census Bureau, and health indicators for those neighborhoods from the county health department. We will also add the results of our pilot cohorts.

Who benefits first. Adults ages 18 and older who live in our target neighborhoods, especially people who are unemployed or underemployed, people with lived experience of caring for family members with chronic conditions, people in recovery, parents returning to work and people with limited English. Patients and families in those neighborhoods who gain a trusted guide, and employers who gain trained staff.

Products & Services

What the grant will pay for and what we will do.

1. Recruit trainees from the communities we serve. We recruit through churches, health centers, community colleges, the workforce board, libraries and word of mouth. Applicants complete a short application and an interview. We look for people with strong ties to the community, good listening skills, reliability and a desire to help, not for a particular degree. We hold seats for people with lived experience of the health system. About 16 trainees join each cohort.

2. Teach a 14-week core curriculum. Classes meet Tuesday and Thursday evenings from 6 to 9 p.m. and Saturday mornings from 9 a.m. to 1 p.m., for 140 classroom hours. The curriculum follows the nationally recognized core roles and skills for CHWs identified by the Community Health Worker Core Consensus (C3) Project, and meets any North Carolina requirements. Topics include:
- The CHW role, ethics, boundaries and confidentiality (including HIPAA, the federal health privacy law).
- Communication and active listening, motivational interviewing basics and cultural humility.
- Outreach and home and community visits, including personal safety.
- Care coordination and system navigation: insurance, Medicaid enrollment, referrals, appointments and patient portals.
- Health education on common conditions such as high blood pressure, diabetes, asthma, and maternal and child health, with an emphasis on teaching and referring, not diagnosing or treating.
- Mental health and substance use basics, including Mental Health First Aid and overdose response training.
- Advocacy and community organizing.
- Documentation, data and working in a team with clinicians.
- Taking care of yourself and preventing burnout.
- Skills labs where trainees practice taking blood pressure, using a scale and a glucose meter in a teaching setting, and role-play real situations.
Trainees also earn certificates in CPR and first aid and in the other short courses that employers often require.

3. Give every trainee real experience. Each trainee completes 100 hours of supervised field experience with a host employer, such as a health center, a hospital, a health department or a community organization. A host employer assigns a supervisor, and our CHW Instructor and Field Coach visits each trainee and supervisor regularly. Trainees shadow experienced CHWs, help with outreach and navigation tasks, and begin building their own caseload under supervision. Trainees do not give medical advice or clinical care.

4. Remove barriers. Each trainee receives a training stipend of $750 over the program, childcare help, bus passes or gas cards, and a loaner laptop. We pay these supports directly to providers, transit agencies or stores whenever possible. The stipend is for training time, not wages, and we confirm the right treatment with an attorney and our accountant.

5. Coach every graduate to a job. Our Career Coach and Placement Specialist works with each trainee from the first month. They help with a resume and an interview, introduce graduates to hiring managers, follow up on applications and check in with graduates and employers for 12 months after graduation. We do not promise a job, and we never charge a trainee or take a fee for placing someone.

6. Support employers. Host employers advise on the curriculum, interview graduates and may sponsor seats for graduates they plan to hire. Twice a year we hold a short workshop for CHW supervisors, and we offer continuing education workshops for working CHWs.

How we will measure results. We track applications, enrollment, attendance, completion, test and skills scores, field hours completed, supervisor ratings, trainee and employer feedback, and employment outcomes: whether a graduate is working in a CHW or related health job at 3, 6 and 12 months, the wage, and whether the person is still employed. With a trainee's permission, we ask employers to confirm results.

Our Year 1 goals:
- About 48 trainees enroll in three cohorts, with at least 80% completing the program, about 38 graduates.
- At least 90% of graduates complete all 100 field hours with a positive supervisor rating.
- At least 70% of graduates are working in a CHW or related health job within 6 months.
- At least 70% of graduates employed at 6 months are still employed at 12 months.
- At least 90% of trainees say they would recommend the program.
- At least 90% of host employers say they would host another trainee.
- About 4 continuing education workshops for about 60 working CHWs.
These are goals, and we will report our real results to the Fund, including where we fall short. We do not promise a job or a wage to any trainee.

Market Analysis

Who we serve and how many.

The people. Adults ages 18 and older who live in our target neighborhoods and who have a desire to help others and strong ties to the community. We welcome people of every background, and we reach out especially to people who are unemployed or underemployed, parents returning to work, people who have cared for a family member with a long-term condition, people in recovery, people with limited English and people with a record of past challenges that do not conflict with the safety requirements of the field placement. Applicants must be able to pass the background check required by host employers, and we help applicants understand and prepare for this before they apply.

Where we work. A leased classroom suite near a bus line in the center of our service area, with field placements at employers in the surrounding counties. Evening and Saturday classes allow people to keep their jobs while training.

How many we will reach:
- Year 1: three cohorts of about 16, or 48 trainees, about 38 graduates and about 27 working in a CHW or related health job within 6 months, with 24 seats sponsored by the workforce board and employers.
- Year 2: three cohorts of about 18, or 54 trainees and about 43 graduates, with 34 sponsored seats.
- Year 3: four cohorts of about 16, or 64 trainees and about 51 graduates, with a second CHW Instructor and 48 sponsored seats.
- Year 4: four cohorts of about 18, or 72 trainees and about 58 graduates, with 56 sponsored seats.
- Year 5: four cohorts of about 20, or 80 trainees and about 64 graduates, with 60 sponsored seats.
Over five years we expect to enroll about 318 trainees and graduate about 254, plus continuing education for working CHWs and supervisors.

Who else benefits:
- Patients and families. People in our neighborhoods gain trusted guides who help them navigate care.
- Employers. Health systems, clinics, the health department and community organizations gain trained, committed staff who understand the community.
- Graduates' families. A steady job with benefits improves a household's stability.
- The health system. Better-connected patients may keep more appointments and use emergency care less often, though we do not promise this.
- The community. Money earned by graduates is spent locally, and many graduates become leaders in their neighborhoods.

How we will size the need before we submit. We will add the number of CHW and related job openings expected at our partner employers, the typical hourly wage for community health workers in our region, the share of adults in our target neighborhoods with no postsecondary education or who are unemployed or underemployed, and the number of people who applied to our pilot. These come from employer letters, the U.S. Bureau of Labor Statistics, the U.S. Census Bureau, the North Carolina Department of Commerce and our own records.

Competitive Landscape

Other options people have, and how we fit.

- Community college programs. Some community colleges offer CHW or related courses. They can be an excellent route, often with college credit. But they are typically offered during the day, can cost money, require placement tests and rarely provide stipends, childcare help or direct placement. We work with the community college, refer students both ways and aim to align our curriculum so graduates can earn credit.
- Training offered by a single employer. Some health systems train their own CHWs. This works well for their own hires but does not help people who want to work elsewhere, and the training varies. We offer a shared pathway that several employers recognize.
- Statewide and national CHW associations and online courses. These offer standards, training and networking and are valuable. We use their materials and encourage trainees to join. Online courses alone lack the hands-on field experience and the personal support that help adults finish.
- On-the-job learning. Many CHWs learn by doing. This works, but it leaves workers without a recognized credential and gives employers no common standard.
- General workforce programs. The workforce board funds job training in many fields. We are applying to be an approved training provider so that eligible participants can use workforce funds for our program, and we work with the board to refer participants.

The gap we fill. In our region, no program combines evening and Saturday classes that fit working adults, supervised field experience with host employers, financial and childcare support, and career coaching and placement, built with the employers who will hire.

Our partners:
- Five employers: a community health center, a hospital system, the county health department and two community organizations, which host field placements, advise on the curriculum and interview graduates.
- The local workforce development board, which refers participants and may sponsor seats.
- A community college, which hosts guest sessions and helps with college credit alignment.
- An experienced CHW network, which provides guest speakers and mentors.
- Churches and community groups, which help recruit and host events.
- A managed care plan that has expressed interest in hiring CHWs and sponsoring seats.

Marketing & Sales Strategy

How trainees, employers and supporters will find us and stay connected.

Reaching trainees:
- Community channels. Churches, libraries, laundromats, food pantries, family resource centers and neighborhood associations share our flyers and invite us to speak.
- Employers and clinics. Health centers and clinics tell patients, volunteers and interpreters who would make good CHWs about the program.
- Workforce and education partners. The workforce board, the community college, adult education programs and community action agencies refer candidates.
- Graduates. Our best recruiters are people who completed the program and now work as CHWs. They speak at information sessions and share their stories, with their permission.
- Information sessions held in the evening and on Saturday, with a meal and childcare, before each cohort.
- A simple website and a text number, in English and Spanish.

Making it easy to apply and finish:
- The application is short, and staff help applicants who need it.
- We tell applicants up front about the schedule, the stipend, background checks and field requirements.
- Trainees are in small cohorts, so they get to know one another and study together.
- If a trainee misses two classes, the Program Coordinator calls the same week to solve the problem, such as a ride, a childcare gap or a work conflict.
- Each trainee has a goal-setting conversation in week one and a progress review at weeks 5 and 10.

Reaching employers:
- Our Career Coach visits employers, explains the program and invites hiring managers to join the advisory group.
- Employers meet trainees during field placements and a graduation event, and can interview graduates before they graduate.
- Supervisor workshops build relationships and make sure CHWs are used well.

Reaching supporters. We invite employers, health systems, businesses and individuals to sponsor a seat, a cohort or the childcare fund. We share results twice a year with funders and partners as totals.

Outreach budget. Recruitment, outreach and evaluation together are about $7,000 a year in Year 1, growing about 4% a year. The sign, brochures and website are paid for once from startup money ($2,500).

Operations Plan

How the program will be carried out.

Timeline for Year 1:
- Months 1 to 3: Sign the lease, prepare the classroom, hire the Program Director and Lead Instructor, the CHW Instructor and Field Coach and the Career Coach, sign agreements with host employers, confirm North Carolina's rules, finalize the curriculum and apply to be an approved training provider.
- Month 4: Recruit and interview applicants for Cohort 1. Instructor training and orientation for host supervisors. Background checks for trainees and instructors.
- Months 5 to 8: Cohort 1 runs for 14 weeks, followed by field experience. Recruit Cohort 2.
- Months 7 to 10: Cohort 2 runs. Cohort 1 graduates begin job search with the Career Coach.
- Months 9 to 12: Cohort 3 runs. First employment results for Cohort 1. First supervisor workshop and continuing education workshop. Year-end review, report to funders and planning for Year 2.

Space. A leased classroom suite of about 1,800 square feet near a bus line, with a classroom for 16 trainees, a skills lab area, a small office and an accessible restroom. Classroom space and utilities are about $18,000 a year in Year 1. Skills lab practice uses a teaching setting, never real patients.

Equipment. We buy about $15,000 of equipment once at the start: sixteen trainee laptops with a charging cart ($8,000), skills lab equipment such as blood pressure cuffs, scales, glucose meters, pulse oximeters and teaching models ($3,500), a projector, screen, whiteboards and a sound system ($1,500), and classroom tables, chairs and a locking cabinet ($2,000). After Year 1, we set aside about $2,500 to $3,500 a year to replace and add equipment. Paint, flooring and sound dampening are a one-time cost of $6,000.

Curriculum, textbooks and certification fees are about $9,000 a year in Year 1, including the fees for CPR, first aid and Mental Health First Aid courses and any state certification fees.

Staffing. In Year 1: an Executive Director, a Program Director and Lead Instructor, a CHW Instructor and Field Coach, a Career Coach and Placement Specialist and one part-time Program Coordinator. A second CHW Instructor and Field Coach joins in Year 3 so we can run four cohorts a year. Instructors have lived experience as CHWs or extensive experience in community health.

Field placement rules. Every host employer signs a written agreement and names a supervisor. Trainees work only under direct supervision, with tasks suited to their training. Trainees do not give medical advice or provide clinical care, and they do not enter a home alone before they have completed the safety module and been cleared by the host supervisor. Hosts confirm their own insurance and background check rules. Field placement supervision and employer engagement cost about $6,000 a year in Year 1. Rules on stipends and unpaid or paid training, and on trainees' status during field experience, can be complex, so an attorney and our accountant review our approach and our host agreements before we begin.

Privacy and confidentiality. Trainees sign a confidentiality agreement and complete privacy training before they enter a placement. Patient information stays with the host employer under its own rules, and our records contain only each trainee's own training information. Trainee records are kept in a secure, locked, password-protected system, and we report results to funders only as totals.

Fair and safe program. We are open to people of every background. We do not charge trainees. We follow all laws on equal opportunity and accommodations, and we help trainees who need adjustments. We have a written policy on respectful behavior and a way for trainees to raise concerns.

Support controls. Stipends are paid in installments tied to attendance. Childcare and transportation supports are paid directly to providers, transit agencies or stores whenever possible. Each payment is approved by the Program Director and recorded, and the board reviews a list each quarter.

Insurance and records. We carry general liability, property, professional liability and workers' compensation insurance, and we confirm that field placements are covered. Insurance is about $6,000 a year in Year 1. Grant money is tracked separately so we can show each funder how their money was spent, and an outside accountant reviews our books every year.

Management & Organization

Who leads the organization.

Naomi Carter, Executive Director. Naomi leads the organization, raises money, manages grants and employer partnerships, supervises staff and reports to the board. She spent 11 years in health center operations and 4 years as a workforce development coordinator, and she co-led our pilot cohorts. Planned salary: $60,000 a year.

Program Director and Lead Instructor. Leads the curriculum, teaches core classes, oversees trainee progress and works with host employers on field placements. Must have experience in community health, adult education or workforce training, with lived experience as a CHW as a strong plus. One in every year at a planned salary of $52,000. The Piedmont Workforce Health Fund grant would support this position.

CHW Instructor and Field Coach. Teaches skills labs and communication sessions, visits trainees and supervisors during field placements and mentors trainees. One in Years 1 and 2 and two from Year 3, at a planned salary of $44,000 each.

Career Coach and Placement Specialist. Helps trainees prepare for jobs, builds relationships with employers and follows graduates for 12 months. Planned salary: $42,000 a year.

Program Coordinator (part-time). Handles applications, attendance, stipends, childcare and transportation supports, records and scheduling, about 25 hours a week. Planned pay: $24,000 a year.

Pay figures include payroll taxes and workers' compensation insurance.

Staff in each year: 5 paid staff in Years 1 and 2, and 6 from Year 3 on.

Guest instructors and mentors. About 20 experienced CHWs, nurses, social workers and health center staff who teach sessions or mentor trainees as volunteers or on small contracts.

The board. A seven-member volunteer board approves the budget, reviews results twice a year and helps raise money. Board members serve three-year terms. The board's certified public accountant chairs the finance committee. The board's experienced CHW and the graduate of our pilot cohort help keep the program grounded in what trainees need.

People who help us. An outside accountant who reviews our books every year, an attorney who reviews our lease, employer agreements and stipend policy, an insurance agent who understands training programs, and an employer advisory group that meets each semester to tell us what skills they need and what is working.

Training. Instructors complete training in adult learning, trauma-informed teaching and the curriculum before the first cohort, and attend at least two trainings a year.

Money management. Grant money is tracked separately for each funder. The Executive Director and a board member must both approve any payment over $2,500.

Milestones Narrative

Our goals for each year and how we will measure them.

- Year 1: Open the academy, run three cohorts and enroll about 48 trainees, with about 38 graduates and at least 70% working in a CHW or related health job within 6 months. A balanced budget of about $344,500, with a small surplus of about $9,500. 5 paid staff.
- Year 2: Run three cohorts of about 18, enrolling about 54 trainees and graduating about 43. Begin follow-up with Year 1 graduates at 12 months and hold the first workshops for supervisors. A balanced budget of about $349,500, with a small surplus of about $9,500. 5 paid staff.
- Year 3: Add a second CHW Instructor and Field Coach and run four cohorts, enrolling about 64 trainees and graduating about 51. A balanced budget of about $399,500, with a small surplus of about $9,200. 6 paid staff.
- Year 4: Run four cohorts of about 18, enrolling about 72 trainees and graduating about 58. Invite graduates to mentor new trainees. A balanced budget of about $405,000, with a small surplus of about $8,700. 6 paid staff.
- Year 5: Run four cohorts of about 20, enrolling about 80 trainees and graduating about 64, with sponsored seats covering about 36% of our budget. Report five years of employment results and share the curriculum with other programs. A balanced budget of about $411,000, with a small surplus of about $8,400. 6 paid staff.

What we measure:
- Applications, enrollment, attendance and completion by cohort.
- Skills scores and field supervisor ratings.
- Employment in a CHW or related health job at 3, 6 and 12 months, and wages.
- Trainee and employer satisfaction.
- Seats sponsored by employers and the workforce board.
- Continuing education workshop attendance.
- Stipend and support payments and the cost per graduate.

How we review results. The Program Director reviews attendance and progress every week. After each cohort, staff, instructors and our advisory group review the results and change what is not working. Twice a year, the board reviews results and we share them with funders and partners as totals. Every number in this plan is a goal, and we will report what really happens.

Funding Request

What we are asking for, and how the money will be used. Our request: $90,000 from the Piedmont Workforce Health Fund for our Program Director and Lead Instructor, trainee stipends, and childcare and transportation support, for July 2027 through June 2028.

The request is spread across these budget lines:
- Personnel: Program Director and Lead Instructor salary, $52,000.
- Other: Trainee stipends, $28,000 (other funds add $8,000).
- Other: Childcare and transportation support for trainees, $10,000 (other funds add $4,000).

Other money in the program. Sponsored seats, other grants and local donors pay the other $12,000 of those lines, plus the Executive Director's salary ($60,000), the CHW Instructor and Field Coach ($44,000), the Career Coach and Placement Specialist ($42,000), the part-time Program Coordinator ($24,000), classroom space and utilities ($18,000), curriculum, textbooks and certification fees ($9,000), field placement supervision and employer engagement ($6,000), recruitment, outreach and evaluation ($7,000), insurance ($6,000) and administration and accounting ($14,000).

Year 1 budget: about $344,500, planned to balance with a small surplus (about $9,500 after the yearly wear on equipment). Year 1 money coming in: grants $259,500 (this request plus other grants we are applying for), workforce board and employer sponsored seats $60,000 (24 seats at $2,500 each) and donations and local sponsors $25,000. Year 1 costs: Executive Director $60,000; Program Director and Lead Instructor $52,000; CHW Instructor and Field Coach $44,000; Career Coach and Placement Specialist $42,000; Program Coordinator $24,000; trainee stipends about $36,000 ($750 for each of 48 trainees); childcare and transportation support about $14,000; classroom space and utilities about $18,000; curriculum, textbooks and certification fees about $9,000; field placement supervision and employer engagement about $6,000; recruitment, outreach and evaluation about $7,000; insurance about $6,000; administration and accounting about $14,000; and about $5,400 a year for the wear on equipment.

About sponsored seats. An employer, a managed care plan or the workforce board may pay $2,500 for a seat when they expect to hire the graduate or when the trainee is eligible for workforce funding. A sponsor pays for training, not for a hire, and a trainee is free to apply anywhere. Approval as a workforce training provider can take months, so Year 1 is planned with 24 sponsored seats out of 48, growing to 60 out of 80 by Year 5. The amounts are planning estimates, not promises.

One-time startup costs. Startup costs of $40,500 are paid once from startup money, not from the yearly budget: $15,000 of equipment (laptops, skills lab equipment, a projector and whiteboards, and classroom furniture), $6,000 for paint, flooring and sound dampening, $4,500 for the lease deposit and first month of rent, $2,000 for the opening supplies and workbooks, $1,500 for training program approval and eligible training provider fees, $6,000 for the curriculum license, an attorney's review of employer and lease agreements and accounting setup, $2,500 for the sign, brochures and website, and $3,000 for background checks and the first insurance payment.

How we got our startup number. The Funding Need Calculator in this plan adds the startup costs ($40,500), the cash we need to cover the wait for the first payments (about $4,700) and a cash cushion of about $83,000, which is about three months of Year 1 costs. That comes to $128,500. We start with $20,000 of our own savings and $115,000 in startup support from a community foundation, a health system partner and our board, $135,000 in all, which covers that amount with room to spare.

The next five years. Our budget grows from about $344,500 in Year 1 to about $411,000 in Year 5. Grants are planned at $259,500, $232,500, $239,500, $215,000 and $201,000 in Years 1 to 5. Workforce board and employer sponsored seats grow from $60,000 to $150,000, and donations and local sponsors grow from $25,000 to $60,000. We add a second CHW Instructor and Field Coach in Year 3. Grants fall from about 75% of our income in Year 1 to about 49% in Year 5.

Savings. We plan to keep several months of costs in savings. The lowest year-end balance in the plan is about $115,300, at the end of Year 1. Some payments arrive after we bill, so we plan for about $17,225 owed to us at the end of Year 1.

After the grant. Our plan is for sponsored seats to cover a growing share of the cost, because employers and the workforce system get trained, committed staff, and for local donors and businesses to sponsor cohorts. Some states and Medicaid plans are beginning to pay for CHW services, which could make CHW jobs more stable and encourage more employers to sponsor seats. Rules differ and change, so we will follow them closely. We also plan to share our curriculum and training for supervisors with other programs for a fee in later years.

Risks and how we will handle them:
- Too few applicants or too many dropouts. We recruit through many channels, hold information sessions with meals and childcare, call after two missed classes and build in supports.
- Graduates cannot find jobs. We build the program with employers, host field placements with those who may hire and offer career coaching for 12 months. We do not promise jobs.
- State rules on certification or training change. We confirm the rules each year and adjust the curriculum.
- Approval as a workforce training provider takes longer than planned. We plan with fewer sponsored seats in Year 1 and keep a cash cushion.
- A host employer drops out. We have more host agreements than we need and a waiting list of others.
- A grant ends. We keep savings, grow sponsored seats and donors each year.

If you are just starting. A new organization can begin before it has its own 501(c)(3) status through a fiscal sponsor: an established nonprofit that receives grants for you and passes them to your program, usually for a fee (commonly around 5% to 10% of the grant, sometimes more; ask before you agree). Another way is to start smaller: one cohort of about 12 trainees in donated classroom space with volunteer instructors and two host employers, tracked carefully. Strong results from a small start make larger grants easier to win.

Appendix Notes

Documents to attach with this proposal:

- Your IRS 501(c)(3) determination letter, or your fiscal sponsor agreement.
- Your most recent financial statements and your current year budget.
- A list of your board members and what each one does.
- Resumes for your Executive Director, Program Director and Lead Instructor.
- Your curriculum outline and how it matches the core roles and skills for community health workers.
- Letters from host employers about field placements, interviews and hiring plans.
- A letter from the workforce board, or proof you have applied to be an approved training provider.
- The letter of intent for the lease, or a letter from the landlord.
- Results from your pilot cohorts, shown as totals.
- Your trainee application, stipend policy, attendance policy, confidentiality agreement and field placement agreement.
- Proof of liability and workers' compensation insurance, or quotes.
If you don't have any of this yet, no worries - let's continue.

The assumptions behind our numbers (change them in the Financials section to match your own):
- Grant Revenue: $259,500 in Year 1, then $232,500, $239,500, $215,000 and $201,000.
- Workforce Board and Employer Sponsored Seats: $2,500 per sponsored seat. 24 seats in Year 1 ($60,000), then 34 ($85,000), 48 ($120,000), 56 ($140,000) and 60 ($150,000).
- Donations and Local Sponsors: $25,000 in Year 1, growing to $60,000.
- Trainees: 48 in Year 1 (three cohorts of 16), then 54, 64, 72 and 80, with about 80% completing.
- Pay (a full year, per person, including payroll taxes and workers' compensation): Executive Director $60,000, Program Director and Lead Instructor $52,000, CHW Instructor and Field Coach $44,000 (one in Years 1 and 2, two from Year 3), Career Coach and Placement Specialist $42,000, Program Coordinator (part-time) $24,000.
- Other yearly costs in Year 1: Trainee Stipends $36,000 ($750 per trainee), Childcare and Transportation Support $14,000, Classroom Space and Utilities $18,000, Curriculum, Textbooks and Certification Fees $9,000, Field Placement Supervision and Employer Engagement $6,000, Recruitment, Outreach and Evaluation $7,000, Insurance $6,000, Administration and Accounting $14,000. These grow between 4% and 5% a year.
- Equipment: $15,000 at the start, then $2,500 to $3,500 a year.
- Startup costs: $40,500, paid once from $135,000 in startup money.
- About 5% of each year's income is still owed to us at year end.
- Tax: none, as a nonprofit.
- Every dollar amount is an estimate. Replace them with your own quotes and real budget.

Startup Costs