MindBridge Rural Mental Health Teletherapy Program

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Executive Summary

MindBridge Rural Mental Health Teletherapy Program is a nonprofit in Montana that brings licensed therapy to rural communities through private telehealth rooms in libraries, clinics and community buildings. A trained navigator at each hub sets up sessions, licensed therapists see clients by secure video and fees follow a sliding scale, with Medicaid and insurance billed where possible.

Many rural counties have no therapist, and people who need counseling must drive a long way or go without. Home internet is often slow, and privacy is a concern in small towns.

With this grant we will serve about 100 clients in Year 1 at 3 community hubs. We are not an emergency service. Every client has a written safety plan and our crisis plan names 988 and 911. We explain the limits of confidentiality and we do not promise any outcome. We promise licensed care, private rooms and honest records.

Our Year 1 budget is about $362,500, growing to about $646,000 by Year 5 as we add sites, coaches and participants. Each year's budget is planned to balance, with a small surplus each year. We have 6 staff in Year 1 (an Executive Director, a Clinical Director, two therapists and a part-time navigator) and 12 by Year 5.

We are asking the Big Sky Rural Wellness Foundation for $82,000 for a Licensed Teletherapist, the telehealth platform, clinical supervision and broadband support. Our other income and startup support cover the rest. These numbers are estimates based on the assumptions listed at the end of this proposal, and we do not promise any result beyond what we describe.

Company Description

MindBridge Rural Mental Health Teletherapy Program is a nonprofit organization in Montana. We are a registered charity with a volunteer board of directors, a written conflict-of-interest policy and a yearly budget the board reviews.

Our mission. People in rural communities should be able to see a licensed therapist without driving hours or waiting months.

What we do.
- Place private telehealth rooms in rural libraries, clinics and community buildings with fast, secure internet.
- Connect clients with licensed therapists by video, with a trained navigator at each hub.
- Offer evening hours, group therapy and care for adults, teens and families.
- Provide a sliding fee scale and bill Medicaid and insurance where possible.
- Help clients who prefer to join from home with devices and hotspots.
- Coordinate with primary care and local emergency services.

Our values. Respect for every participant, honesty with families and partners, safety first and a place for everyone who wants to belong.

What we do not do. We are not an emergency service: each client has a written safety plan with local emergency contacts, and our staff follow a crisis plan that names 988 and 911. Therapists are licensed in the state where the client is located. We explain the limits of confidentiality at the first visit. We do not promise any outcome. We follow the rules of our partner sites and our insurer.

How we got here. A group of counselors, a librarian and a rural clinic nurse began offering video therapy sessions from a quiet room in the library after a local counselor retired. The room was booked every week. We kept simple records of sessions and what clients told us. This proposal asks for support to move from one library room to a steady program with paid, trained staff and the materials to match.

Problem & Opportunity

Many rural counties have no therapist, and people who need counseling must drive a long way or go without.

Cost. Gas, time off work and child care make distant therapy costly, and many rural residents are uninsured or underinsured.

Access. Rural clinics have few mental health providers, and home internet is often slow or missing.

Safety and trust. Clients worry about privacy in small communities, and funders want to see safe, licensed care and a clear crisis plan.

Missed benefits. Untreated depression, anxiety and trauma affect work, families and farms and raise the risk of crisis.

What we hear.
- A rancher says the nearest counselor is two hours away.
- A teacher says she has students with no one to talk to.
- A nurse says her patients need therapy more than another prescription.
- A client says she could not be seen by neighbors in the library room.

We do not claim that a program can solve every challenge. We believe that a private room, a fast connection and a licensed therapist can bring care to places that have none.

Products & Services

MindBridge Rural Mental Health Teletherapy Program gives rural adults, teens and families who need counseling a safe, welcoming place to get counseling close to home.

How the program works.
1. Hubs. We partner with libraries, clinics and community buildings that provide a private room.
2. Navigators. A trained site navigator greets clients, sets up the session and offers privacy and support.
3. Scheduling. Clients book a session by phone or online, with evening and weekend hours.
4. Therapy. A licensed therapist provides individual, family and group sessions by secure video.
5. Safety plan. Every client completes a written safety plan with local emergency contacts.
6. Fees. Fees follow a sliding scale, and Medicaid and insurance are billed where possible.
7. Coordination. With permission, we share information with the client's primary care provider.

What a typical session looks like. Participants arrive and check in with a staff member, settle in together, work on the day's activity in small groups and finish with a short talk about what went well. Staff praise effort, correct mistakes kindly and make sure no one is left out.

Staff. Our therapists are licensed clinicians who pass a background check, complete our training in telehealth and crisis response and are paid for their time. A clinical director supervises care.

Access and fairness. Programs are free. Care is available regardless of ability to pay. We welcome every rural resident who needs counseling and offer sessions in English and Spanish.

Market Analysis

Who we serve. Rural adults, teens and families in our service area who need counseling and have limited access to a therapist. Eligibility is need for counseling and where a person lives, and no one is turned away for inability to pay.

How we estimate need. We cannot count every young person who could benefit, so we plan from what we can see. In our library room every slot was filled and we kept a waiting list. Clinics and schools told us that many more people need counseling than the area offers. For Year 1 we plan to serve about 100 participants at 3 community hubs. By Year 5, with more staff and sites, we plan to serve about 300.

Where participants come from.
- Clinics and primary care providers.
- Schools, libraries and churches.
- Sheriff's offices and health departments.
- Clients who tell a friend.

Who else benefits. Families gain a healthier adult or teen. Clinics gain a place to refer. Employers gain healthier workers.

What the numbers mean. Every number here is a person who got an appointment without a long drive. We keep our early counts modest and honest so we can do the work well.

Competitive Landscape

What young people can find today, and how we are different.

1. Rural mental health centers. Essential and often have long waits and few staff. We add capacity.

2. Private therapists in distant towns. Skilled and hours away. We bring care to the local hub.

3. Direct-to-consumer telehealth apps. Convenient and not private or reliable for every home. We offer a private local room.

4. Primary care clinics. Prescribe and have little time for therapy. We provide the next step.

5. School counselors. Support students and cannot treat adults. We partner.

What makes us different.
- A private room in the community.
- Licensed therapists and a clinical director.
- Site navigators who help with technology.
- Sliding-scale fees and Medicaid.
- A written safety plan for every client.

Why this gap matters. Existing programs do good work, and most serve people who can already pay or who live close to them. The people we serve are the ones left over: they live in the wrong neighborhood, have the wrong schedule or have no one to ask. We are built to reach them.

We have spoken with rural clinics, libraries, schools and other telehealth programs to make sure we are filling a gap and not duplicating services. Their letters of support are in the attachments.

Marketing & Sales Strategy

How young people and partners will find us.

Reaching young people.
- Clinics and primary care providers. We will give staff a short referral form and a named contact.
- Libraries and schools. We will share flyers and information.
- Churches, sheriff's offices and health departments. We will talk with leaders who know families.
- Local radio and newspapers. We will share clear, private ways to book.
- Word of mouth. Clients tell friends.
- A simple website and a phone line with a text option.

Reaching staff and sponsors.
- Recruit therapists through licensing boards, universities and telehealth networks.
- Offer an orientation, a background check and training in safety, privacy and respectful practice.
- Give partners a short report each quarter with counts of participants and what they said.

How we decide who joins. We use a simple sign-up form and enroll participants in the order received, with priority for those with the greatest need and for people new to the program. We keep a waiting list when the program is full.

What we watch. Sign-ups, attendance, sessions held, hubs opened and how many participants return for a second season.

Operations Plan

How the program will be carried out.

Timeline for Year 1:
- Months 1 and 2 (July and August): Hire the staff, buy equipment and materials, finalize the waiver, consent form and privacy policy with our attorney and sign site agreements.
- Month 3 (September): Open the first hubs and begin sessions.
- Months 4 to 10: Provide therapy and navigation at each hub with monthly clinical supervision.
- Months 11 and 12: Survey clients and partners, report to funders and plan Year 2.

Space. Each hub provides a private, soundproofed room with equipment we supply, in a library, clinic or community building.

Safety and privacy.
- Every client has a written safety plan with local emergency contacts, and staff follow a crisis plan that names 988 and 911.
- Hub rooms are private and soundproofed, and records are kept in a secure system.
- Every staff member and volunteer passes a background check and completes safety training.
- Staff work in pairs or in view of others whenever participants are minors or in a vulnerable situation.
- We keep an emergency plan at every site, and participants complete an emergency contact form.
- We keep records private, share them only with a participant's permission or as the law requires and follow a written policy.

Equipment. We buy about $18,000 of equipment once at the start: telehealth kits for three hubs (laptops, cameras and headsets) ($9,000), private room setup, soundproofing and furnishings ($6,000), hotspots and backup internet equipment ($3,000). Later years replace or add a few items.

Staffing. In Year 1 I serve as Executive Director. The Clinical Director, a licensed clinician paid $66,000 a year, supervises care. Two Licensed Teletherapists, each paid $56,000 a year, see clients. Three part-time site navigators, each paid $22,000, support the hubs. We add therapists and hubs as demand grows.

Management & Organization

Dr. Karen Lindqvist, Executive Director. I lead the organization, report to the board and am responsible for budgets, partnerships and reporting. I came to this work as a rural counselor who drove hours between clients. I will complete the training we require of our navigators so I understand the program from the inside. (Replace this paragraph with your own background.)

Staff. The Clinical Director, a licensed clinician, supervises care, licensed therapists provide sessions and part-time site navigators support each hub. Each passes a background check. These positions are part of our grant request.

Board of directors. Our volunteer board includes a rural counselor, a clinic nurse, a librarian, a banker who serves as treasurer, an attorney and a rancher. The board meets every other month, approves our budget and reviews our safety plan. No board member is paid, and members with a conflict of interest step out of related decisions.

Advisory partners. A telehealth specialist, a county health director and a psychiatrist give guidance twice a year.

Staffing and pay in this plan: Executive Director, paid $54,000 a year; clinical Director, paid $66,000 a year; licensed Teletherapist, paid $56,000 a year; site Navigator (part-time), paid $22,000 a year.

Milestones Narrative

Our goals, how we will measure them and when we plan to reach them.

Year 1 outcomes (July 2027 through June 2028):
- Serve about 100 participants at 3 community hubs.
- Run at least two full seasons and a summer session.
- Have at least 85 percent of participants attend most sessions.
- Have at least 80 percent of participants return for a second season.
- Receive positive feedback from at least 90 percent of families who answer our short survey.

What we count and how.
- Participants enrolled, sessions and games attended, from our records.
- Skills learned and goals met, from the coach's checklist.
- Equipment issued and returned, from our log.
- Participant and family feedback, from a short, confidential form.
We report what we find, including what did not work, and use it to improve.

Growth over five years.
- Year 2: About 150 participants at 4 community hubs.
- Year 3: About 200 participants at 5 community hubs.
- Year 4: About 250 participants at 6 community hubs.
- Year 5: About 300 participants at 7 community hubs.

Learning along the way. At the end of each quarter, the director and the board review the numbers and decide whether we are on track. If we are behind, we will adjust our outreach, our sites or our schedule before asking for more money.

After the grant. By Year 5, grants make up about 61 percent of our budget, down from about 74 percent in Year 1, as partners and donors give more. We will keep building those relationships every year.

Funding Request

What we are asking for, and how the money will be used. Our request: $82,000 from the Big Sky Rural Wellness Foundation for a Licensed Teletherapist, the telehealth platform, clinical supervision and broadband support, for July 2027 through June 2028.

The request is spread across these budget lines:
- Personnel: Licensed Teletherapist salary, $56,000.
- Other: Telehealth platform and security, $14,000.
- Other: Clinical supervision for therapists and navigators, $8,000.
- Other: Broadband support for community hubs, $4,000.

Other money in the program. This request is about 31% of our Year 1 grant income. Other grants and the income lines below pay for everything it does not cover.

Year 1 budget: about $362,500, planned to balance with a small surplus (about $14,900 after the yearly wear on equipment). Year 1 money coming in: Grant Revenue $268,500; state Rural Health Funding $60,000; medicaid and Insurance Reimbursement $24,000; individual Donors $10,000. Year 1 costs: executive Director $54,000; clinical Director $66,000; licensed Teletherapist $56,000; site Navigator (part-time) $22,000; telehealth Platform and Security about $10,000; private Room Operations about $8,000; clinical Supervision about $8,000; broadband Support about $5,000; training about $3,000; administration and Insurance about $12,000; about $6,400 a year for the wear on equipment.

One-time startup costs. Startup costs of $28,500 are paid once from startup money, not from the yearly budget: $9,000 for telehealth kits for three hubs (laptops, cameras and headsets); $6,000 for private room setup, soundproofing and furnishings; $3,000 for hotspots and backup internet equipment; $3,000 for attorney review of the consent form, telehealth policy and crisis plan; $1,800 for flyers, signs and a simple website; $2,200 for navigator and therapist training and background checks; $3,500 for first insurance payment.

How we got our startup number. The Funding Need Calculator in this plan adds the startup costs ($28,500), the cash the program uses before it balances (about $0) and a cash cushion of about $86,000, which is about three months of Year 1 costs. In all, that comes to $114,500. We start with $8,000 from our founding board and $109,000 in startup support from a health foundation and a rural clinic, $117,000 in all, which covers that amount with room to spare.

The next five years. Our budget grows from about $362,500 in Year 1 to about $646,000 in Year 5. Grants are planned at $268,500, $313,000, $300,000, $345,500 and $392,000 in Years 1 to 5. Other income grows: state Rural Health Funding from $60,000 to $100,000; medicaid and Insurance Reimbursement from $24,000 to $128,000; individual Donors from $10,000 to $26,000. Our surplus is planned at about $14,900 in Year 1, about $18,900 in Year 2, about $21,200 in Year 3, about $25,900 in Year 4 and about $31,400 in Year 5. We grow from 3 community hubs to 7 by Year 5, adding a part-time coach for each new site.

Savings. We plan to keep several months of costs in savings. The lowest year-end balance in the plan is about $103,000, at the end of Year 1. Some grant payments and partner payments arrive after we bill, so we plan for about $14,500 owed to us at the end of Year 1.

Cost per client. In Year 1, our total costs are about $3,476 per client served, which includes setting up the program. By Year 5, with more client served and a trained team in place, that falls to about $2,049 per client.

After the grant. State rural health funding, corporate sponsors and individual donors grow every year, so grants become a smaller share of our budget. Participants and families share their stories, and businesses can sponsor a team or a season by name. We will look for partnerships with schools and the city that want a safe, free rural teletherapy option for every child.

Risks and how we will handle them:
- An injury. Certified coaches, proper equipment, groups matched by age and skill, a written emergency plan and insurance.
- A site is no longer available. We keep agreements with more than one site and a plan for bad weather.
- A coach leaves. We keep a list of trained backup coaches and share lesson plans.
- Low attendance. We adjust sites, times and rides based on family feedback.
- A privacy problem. We follow a written policy, use secure systems and train every staff member and volunteer.
- A grant ends. We keep savings and grow partner and donor support 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 neighborhood, a handful of clients and a small team, 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.
- Signed letters of support from partner schools, agencies and sites.
- Your site agreements and your insurance certificate.
- Your consent, waiver and privacy policy.
- Your safety plan and background check policy.
- Your program outline and schedule.
- Quotes for equipment and materials.
- Resumes for your Executive Director and key staff.
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: $268,500 in Year 1, growing to $392,000 in Year 5.
- State Rural Health Funding: $60,000 in Year 1, growing to $100,000 in Year 5.
- Medicaid and Insurance Reimbursement: $24,000 in Year 1, growing to $128,000 in Year 5.
- Individual Donors: $10,000 in Year 1, growing to $26,000 in Year 5.
- Pay (a full year, per person, including payroll taxes and workers' compensation): executive Director $54,000; clinical Director $66,000; licensed Teletherapist $56,000; site Navigator (part-time) $22,000.
- Other yearly costs in Year 1: telehealth Platform and Security $10,000; private Room Operations $8,000; clinical Supervision $8,000; broadband Support $5,000; training $3,000; administration and Insurance $12,000. These grow between 4% and 5% a year.
- Equipment: $18,000 at the start, then $3,000 to $4,000 a year.
- Startup costs: $28,500, paid once from $117,000 in startup money.
- Participants served: about 100 in Year 1, growing to about 300 in Year 5. Sites: 3 in Year 1, growing to 7 by Year 5. Sessions are available year-round, including evenings and weekends.
- About 4% 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