Clear Skies Rural Counseling

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Executive Summary

Clear Skies Rural Counseling is a nonprofit in Kentucky that provides counseling by video and phone to people in rural and mountain communities where mental health care is hard to find. Licensed therapists see clients on a sliding fee scale, a care coordinator helps with insurance and appointments and a device loan program lends tablets and phone plans to people without good internet or equipment.

Many rural residents live an hour or more from the nearest therapist, and stigma and cost keep many from asking for help. With this grant we will pay a licensed therapist and telehealth devices for the loan program. Counseling is provided only by licensed therapists. We cannot promise any result. If someone is in danger, call 911. If someone is thinking of suicide, call or text 988.

What we are asking for. Our program has a Year 1 budget of about $303,500. We are asking for $65,000 from an Appalachian community trust to a licensed therapist salary and telehealth devices. The rest of the budget comes from other grants, sponsors and donors that are listed in the funding section. Every dollar amount in this plan is an estimate and none of it is a promise of any result for the people we serve.

Company Description

Clear Skies Rural Counseling is a nonprofit organization recognized under section 501(c)(3) of the tax code, governed by a volunteer board that includes rural residents and a clinician. The board meets monthly, approves the budget and oversees the executive director. A new organization without its own determination letter can use a fiscal sponsor, explained in the funding section.

What we believe. Mental health care is health care, and people in rural communities deserve it close to home. We respect privacy, culture and faith and meet people where they are.

What we do:
- Telehealth counseling. Licensed therapists provide individual, couples and family counseling by video or phone.
- Sliding fee scale. Fees are based on income, and no one is turned away because of cost.
- Care coordination. A coordinator helps with insurance, scheduling and referrals to doctors and other services.
- Device loan program. We lend tablets and phone plans to people who lack equipment or internet.
- Community education. Talks about mental health at churches, schools and community centers.

Licensing and scope. Counseling is provided only by therapists licensed in Kentucky. We do not provide emergency or crisis services and refer people in crisis to 988 and 911.

Who we serve. Residents of rural counties who need counseling, with priority for people with low incomes and those who have no nearby provider.

Our board has at least five members, including at least one person who has used our services or lives in the community we serve, and only a minority of board members may be related to each other or paid by the organization.

We keep a written conflict of interest policy, a whistleblower policy and a record retention policy, and the board reviews them every year.

Problem & Opportunity

Mental health care is hard to reach in rural areas.

1. Few providers. Many rural counties have few or no therapists.
2. Distance and transportation. A visit may mean hours of driving.
3. Cost. Many people are uninsured or underinsured.
4. Stigma. People worry about privacy in small communities.
5. Weak internet and devices. Some people lack broadband or a device for telehealth.

Why it matters now. Telehealth has made it possible to bring care to people at home, and rural communities face high rates of depression, substance use and suicide.

How we know the need is real. We reviewed provider counts and travel distances in our counties, surveyed 150 residents and talked with clinics and churches. Residents said they would use counseling if it were private, affordable and close, and clinics said they had long waiting lists. The numbers are in the appendix.

We update these facts every year using public data, partner reports and what the people we serve tell us, and we change the program when the facts change. If a need turns out to be smaller than we thought, we will say so and put the money where it is needed most.

Products & Services

What the funded project will do. With this grant we will pay a licensed therapist and telehealth devices for the loan program for a full year.

How a client takes part:
1. Contact. A person calls, signs up online or is referred by a clinic, school or church.
2. Intake. The care coordinator explains fees, helps with insurance and, if needed, loans a device.
3. Counseling. A licensed therapist meets the client by video or phone, usually weekly at first.
4. Safety planning. The therapist makes a safety plan with any client at risk and knows how to reach emergency help.
5. Coordination. The coordinator helps with referrals and follow-up.
6. Closing. When counseling ends, the client leaves with a plan for support.

What the grant pays for. The request covers the therapist's salary and telehealth devices for the loan program.

What we do not promise. We do not promise that any client will feel better by a certain time. We track clients served and their own ratings and report honestly.

Safety and privacy. Sessions use secure video and are kept private. We call 911 for emergencies and direct anyone in crisis to 988, the Suicide and Crisis Lifeline. Therapists follow the law on reporting suspected abuse.

We start small, check what works and grow only when we can do the work well. Every few months we review the numbers and the stories from the people we serve and change the plan where it is not working.

We write plain-language handouts for every step so people know what to expect, what it costs and who to call with questions, and we ask each person at the end whether the help was useful and what we could do better.

Market Analysis

Who benefits from this project are residents of our rural service area who need counseling and the families and communities around them.

Who we serve. Adults, teens with a parent's consent and families of all backgrounds, many with low incomes, many without insurance and many who live far from a clinic.

How many people we plan to serve. In Year 1 we plan to serve about 280 clients with about 3,000 sessions and to loan about 60 devices. By Year 5 we plan to serve about 700 clients a year. We chose these numbers from the capacity of two therapists at first and three by the third year.

Where we serve. Rural counties in our region, with clients at home, in libraries and in churches with a private room.

Who else benefits. Employers with healthier workers, schools and clinics with a referral partner and families.

How we will be careful. Sessions are private, records are secure and we collect only the information we need.

We choose how many people to serve from the number of staff, hours and rooms we really have, not from the size of the need. If we reach fewer people than planned, we will report it and explain why.

Competitive Landscape

Other choices in our area.

1. Community mental health centers. Provide services but often have waiting lists and distance barriers.
2. Private therapists. Provide care but are few and costly.
3. Primary care clinics. Provide some mental health care but with limits.
4. National telehealth companies. Offer care but may not accept local insurance or understand rural life.
5. Faith leaders and friends, who provide comfort but not therapy.

What makes us different. We are local, offer sliding-scale telehealth with licensed therapists, and lend devices to people who need them. We work with clinics and community mental health centers and refer to them when they are a better fit.

How we avoid duplication. We meet with clinics and the community mental health center each quarter to share capacity and referrals.

We keep a written list of every other organization that does similar work in our area and review it each year. If another group can serve a person better, we refer the person and say so plainly. Funders can expect us to tell the truth about overlap, to share what we learn and to work as part of a larger network of help.

Marketing & Sales Strategy

How we will reach clients once the project is funded.

Referral partners. Clinics, schools, churches, emergency responders and county agencies will refer people.

Community presentations. Talks at churches, libraries and community centers explain how telehealth works and address privacy.

Word of mouth. Clients tell family and friends. With permission, we share anonymous stories.

Digital outreach. A website and social media will explain fees and how to sign up. We will not post personal information.

Access. Materials will be in plain language and large print, we offer evening hours and phone sessions for people without video and we provide devices and data plans.

Local credibility. We recruit therapists who understand rural culture, and we respect faith and family values.

Measuring outreach. We will track how each client heard about us and adjust our outreach where it is not working.

Marketing budget. Outreach and printing are part of the program budget.

Most people hear about services from someone they already trust, so we spend more time with partners and neighbors than on advertising. We write our materials in plain language, test them with a few people from the community and fix anything that confuses them.

Operations Plan

How the project will be carried out, in plain terms.

Timeline for Year 1. Months 1 and 2: hire the therapist and coordinator, finish privacy and security review and buy devices. Months 3 to 12: serve clients, loan devices and hold community talks.

Space. Therapists work from a private office. Clients can use a private room at partner libraries and churches.

Partners. Clinics, libraries, churches, schools and the county health department. Each has a written agreement.

Clinical, safety and privacy rules. Counseling is provided only by licensed therapists. We use a secure platform, verify each client's identity and location at the start of each session so we can send help in an emergency, and keep records secure. We call 911 for emergencies and direct anyone in crisis to 988. Therapists follow the law on reporting suspected abuse.

Device loans. Devices are cleaned and reset between clients and clients sign a loan agreement.

Records and reporting. We track clients, sessions and ratings and report anonymous numbers to funders each quarter.

Training. Staff receive training in telehealth, suicide prevention and rural cultural awareness.

We write down every step of the project in a short manual so that any trained staff member can carry it out the same way. We hold a short team meeting every week to review problems, safety concerns and numbers, and we ask the people we serve for feedback at least twice a year.

Management & Organization

The executive director leads the organization and manages the budget and partners. Licensed therapists provide counseling and the care coordinator manages intake, insurance and the device loan program.

The team. Pay figures include payroll taxes and workers' compensation insurance. The numbers in parentheses are how many people we plan to have in Years 1 through 5.
- Executive Director: 1, 1, 1, 1, 1 (Years 1 to 5), about $62,000 a year each.
- Licensed Therapist: 2, 2, 3, 3, 3 (Years 1 to 5), about $62,000 a year each.
- Care Coordinator: 1, 1, 1, 1, 2 (Years 1 to 5), about $42,000 a year each.

Governance and money controls. A volunteer board of directors oversees the budget and the executive director. Two people review every payment, the board reviews financial statements every month, an outside accountant prepares the yearly tax return and audit-ready records, and every grant is tracked in its own budget line. We screen staff and volunteers who work with the people we serve, train everyone on privacy and safety and keep written policies on conflicts of interest and complaints.

Staff and advisors. Therapists hold the licenses required in Kentucky and we welcome staff who live in the communities we serve. An advisory group of a pastor, a nurse, a teacher and a client meets quarterly.

Feedback and complaints. Anyone we serve can give feedback or a complaint by phone, in writing or in person, and can ask to speak with the board chair. We reply within five working days, keep a log of every complaint and report the themes to the board each quarter. No one loses services for speaking up.

Milestones Narrative

Goals for each of the first five years and how we will measure results. These are goals, not promises.
- Before the grant starts (3 to 4 months before the grant starts): hire the therapist and coordinator, finish the privacy and security review, buy devices and sign partner agreements
- Year 1: serve about 280 clients with about 3,000 sessions and loan about 60 devices. The budget is $303,500.
- Year 2: add a third therapist and a teen group. The budget is $306,500.
- Year 3: add evening and weekend hours and more partner sites. The budget is $373,500.
- Year 4: grow insurance participation. The budget is $377,000.
- Year 5: serve about 700 clients a year and publish a plain results report. The budget is $424,000.

How we will measure results: clients served, sessions held, devices loaned, clients' own ratings of well-being, time from referral to first session and partner satisfaction. We report results to funders in the same plain numbers we use here, and we say honestly when a goal was missed and what we changed.

We report to funders every quarter and send a short plain-language summary to our board each month. At the end of each year we review all of the goals, publish a short results report and update the plan for the next year.

Funding Request

What we are asking for, and how the money will be used. Our request: $65,000 from an Appalachian community trust for a licensed therapist salary and telehealth devices, for January through December 2027.

The request is spread across these budget lines:
- Personnel: Licensed Therapist salary, $55,000.
- Supplies: Telehealth devices for the loan program, $10,000 (other funds add $3,000).

Other money in the program. This request is about 26% of our Year 1 grant income. Other grants and the income lines below pay for everything it does not cover.

Year 1 budget: about $303,500, planned to balance with a small surplus (about $10,900 after the yearly wear on equipment). Year 1 money coming in: grant revenue $247,500; individual donations $26,000; insurance reimbursements and sliding-Scale fees $30,000. Year 1 costs: executive director $62,000; licensed therapist $124,000; care coordinator $42,000; telehealth devices for the loan program about $20,000; telehealth platform and privacy tools about $10,000; clinical supervision and liability insurance about $9,000; transportation and outreach about $8,000; administration and insurance about $16,000.

One-time startup costs. Startup costs of $19,800 are paid once from startup money, not from the yearly budget: $4,200 for secure laptops, headsets and webcams for therapists, $3,800 for a private telehealth room with soundproofing and a locking cabinet, $3,200 for opening supply of loan tablets and data plans, $3,800 for licensure verification, privacy compliance and security review, $2,600 for staff training in crisis response and telehealth, and $2,200 for flyers, signs and a simple website.

How we got our startup number. The Funding Need Calculator in this plan adds the startup costs ($19,800), the cash the program uses before it balances (about $2,700) and a cash cushion of about $72,800, which is about 3 months of Year 1 costs. In all, that comes to $95,500. We start with $16,000 of our own savings and $81,000 in startup support from a local foundation and our board, $97,000 in all, which covers that amount with room to spare.

The next five years. Our budget grows from about $303,500 in Year 1 to about $424,000 in Year 5. Grants are planned at $247,500, $232,500, $281,500, $267,000, $296,000 in Years 1 to 5. Other income grows as sponsors and donors join. The program plans a small surplus each year, about $10,900, $10,500, $11,900, $11,600 and $12,700 in Years 1 to 5, which we put into savings.

Savings. We plan to keep several months of costs in savings. The lowest year-end balance in the plan is about $86,300, at the end of Year 1. Some grant payments and partner payments arrive after we bill, so we plan for about $15,175 owed to us at the end of Year 1.

After the grant. Individual donors and insurance reimbursements and sliding-scale fees grow each year, so grants become a smaller share. Clinics and health systems may contract for services.

Risks and how we will handle them:
- A client may be in crisis. Therapists follow a safety plan and call 911 or direct to 988.
- A therapist may leave. We cross-train and keep substitutes.
- A grant may end. We grow donors and reimbursements each year and keep savings.
- Internet may fail. We offer phone sessions and devices.
- A privacy breach could occur. We use secure tools and train staff.

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 with one site or one staff member and track results carefully. Strong results from a small start make larger grants easier to win.

Appendix Notes

Documents to attach before you send this proposal:

- Your IRS determination letter showing 501(c)(3) status, or your fiscal sponsor agreement.
- Your board list and board minutes approving the application.
- Your most recent budget and financial statements.
- A list of other funders and what each has given or been asked to give.
- Therapists' licenses and professional liability insurance.
- Your privacy and security policy and telehealth consent form.
- Agreements with libraries, churches and clinics.
- Letters of support from clients and partners.
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: $247,500 in Year 1, growing to $296,000 in Year 5.
- Individual Donations: $26,000 in Year 1, growing to $42,000 in Year 5.
- Insurance Reimbursements and Sliding-Scale Fees: $30,000 in Year 1, growing to $86,000 in Year 5.
- Staff pay is shown in the management section and includes payroll taxes and workers' compensation.
- Other yearly costs in Year 1: telehealth devices for the loan program $20,000, telehealth platform and privacy tools $10,000, clinical supervision and liability insurance $9,000, transportation and outreach $8,000, and administration and insurance $16,000. These grow between 4% and 6% a year as the program grows.
- Grant and partner payments arrive after we bill, so about $15,175 (5% of Year 1 income) is owed to us at the end of Year 1.
- The program does not pay income tax. Any surplus stays in the program.
- Every dollar amount is an estimate. Replace them with your organization's real numbers.

Plain words used in this proposal:
- Grant: money given for a specific purpose that does not have to be paid back, as long as it is spent as promised.
- Request: the part of the budget we are asking this funder to pay for.
- Surplus: money left over after a year's costs. A small surplus is healthy because it builds savings for slow months.
- Startup costs: one-time costs, such as equipment, paid once before the program runs at full speed.
- Working capital: cash kept in the bank to pay bills while waiting for grant payments.
- In-kind: goods or services given instead of money, such as donated space.
- Fiscal sponsor: an established nonprofit that receives grants for a new group and passes the money to its program, usually for a fee.
- 501(c)(3): the tax status that lets a nonprofit receive tax-deductible gifts and many grants.

How to read the numbers. Every income and cost figure is a plan, not a result. Income rises as sponsors and donors join, costs rise a little each year, and each year's budget is planned to balance with a small surplus. Startup costs are shown separately because they are paid once. If a real number turns out different, we will update the plan and tell our funders why.

Startup Costs