Wellspring Senior Health and Wellness Center

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Executive Summary

Wellspring Senior Health and Wellness Center is a nonprofit in Michigan that helps older adults stay strong, healthy and connected, so they can keep living the lives they want for as long as possible. We open a welcoming wellness center where people age 60 and older can come for exercise and balance classes, health screenings and wellness checks with a registered nurse, workshops on managing long-term conditions, brain health and caregiver support, and the company of other people. A ride to the center is available for those who need one.

Most older adults want to stay independent and in their own homes. What stands in the way is often not one big thing but a series of smaller ones: a fall that could have been prevented, a blood pressure reading nobody checked, a medicine mix-up, a vaccine missed, a lonely winter with no reason to leave the house. Many older adults in our area have no easy place to turn for this kind of everyday, preventive help. Doctor visits are short and far apart. Gyms are expensive and not built for them. Our center gives older adults a friendly place to build strength and confidence and to catch small problems before they become big ones.

With this grant we will open the center and serve about 300 older adults in Year 1. About 120 will complete an 8-week falls prevention program, about 80 will complete a 6-week workshop on managing chronic conditions, and our nurse will provide about 600 health screenings and wellness checks. We will host about 4 vaccination clinics with a pharmacy partner, a weekly caregiver and memory support group for about 40 people, and about 1,200 round-trip rides to the center. Members come for about 6,000 visits to exercise classes and activities in the year. We do not diagnose or treat. We screen, teach, encourage and connect people to their own doctors.

Our Year 1 budget is about $343,000, growing to about $444,000 by Year 5 as we add a second Fitness and Wellness Coordinator and a second Outreach Specialist. Each year's budget is planned to balance, with a small surplus each year. We have 5 paid staff in Year 1 and 7 by Year 4. Area Agency on Aging and county contracts and member contributions add steady support, so grants fall from about 75% of our income in Year 1 to about 63% in Year 5.

We are asking the Great Lakes Aging Foundation for $85,000 for our Fitness and Wellness Coordinator, exercise class instructors, health screening and vaccination clinic supplies, transportation to the center, caregiver and memory programs and nutrition education. Other grants, contracts and donors cover the rest, so this grant is one part of a shared funding plan.

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

Company Description

Wellspring Senior Health and Wellness Center is a nonprofit organization in Michigan. 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 help older adults stay healthy, active and connected, so they can live independently and with dignity.

What we believe. Aging is not a disease. Older adults have wisdom, strength and goals, and good health programs build on those. Prevention works best when it is fun, social and close to home. Dignity means choice: we invite and encourage, and we never lecture. Small, steady habits, such as strength and balance training, can make a large difference, and no one is too old to start.

How we started. Wellspring began when a retired nurse and a physical therapist started a free chair exercise class in a church hall. Within a year more than 60 older adults were coming every week. Members asked if someone could check their blood pressure after class. Neighbors who had stopped coming to church because of a fall asked if the class could help them get steady again. A local pharmacist offered to hold a flu shot clinic, and the area's aging agency asked whether we could grow. Over three years, the class reached more than 200 people. This proposal asks for support to open a permanent, staffed wellness center.

What we offer:
- Exercise and falls prevention. Chair exercise, tai chi, walking and strength and balance classes, plus an evidence-based falls prevention workshop series. Classes are designed for all ability levels, and every exercise can be adapted.
- Health screenings and wellness checks. A registered nurse provides blood pressure, blood sugar, weight, pulse and oxygen checks, fall risk screening and a conversation about how a person is doing, with a note to bring to the doctor if anything needs attention. A pharmacist partner helps with medication reviews at special events.
- Chronic condition workshops. A 6-week, evidence-based self-management program that helps people with conditions such as high blood pressure, diabetes, arthritis and heart disease set goals, solve problems and work with their health care team.
- Vaccination clinics. Held with a licensed pharmacy partner, who gives the vaccines, for flu and other vaccines recommended for older adults.
- Brain health and caregiver support. Talks on keeping the mind active, memory screening events that refer people to their doctors, and a weekly support group for family caregivers.
- Nutrition education. Short classes and healthy snacks, with referrals to home-delivered and group meal programs run by others.
- Rides to the center. Round-trip rides for older adults who cannot drive or do not have a ride.
- Connection. Friendly phone calls, clubs and social events to help people who feel alone.
- Navigation. Help finding the right services, including referral to free counseling on Medicare and other benefits through the state's health insurance counseling program.

What we do not do. We are not a medical clinic. We do not diagnose or treat, prescribe or give medical advice that replaces a doctor. Our nurse screens, teaches and refers, within the scope of nursing practice allowed by Michigan. We do not give vaccines ourselves, and we do not sell any products.

How we are run. A seven-member volunteer board of directors oversees the organization and approves the budget each year. The board includes a geriatrician, a pharmacist, a physical therapist, a retired nurse, a pastor, an older adult who attends our classes and a certified public accountant. The Executive Director manages the organization, the Wellness Nurse leads health screening and education, and an outside accountant reviews our books every year.

Where things stand today. We have signed letters from the local Area Agency on Aging, two churches, a hospital's community health department and a pharmacy that has agreed to hold vaccination clinics. We have a letter of intent for a 2,200 square foot suite in a shopping plaza on a bus line, with a large exercise room, a private screening room and a kitchenette. Before we sign the lease, an attorney will review it and our privacy policies.

Problem & Opportunity

Why this program is needed.

America is growing older, and so are the communities we serve. Older adults make up a large and growing share of our area's residents. Many are active and healthy, and many want to stay that way. But staying well takes more than good intentions. It takes regular movement, early attention to health changes, social connection and help when problems begin.

The gaps we see:
1. Falls. Falls are a leading cause of injury among older adults. The Centers for Disease Control and Prevention (CDC) reports that about one in four older adults falls each year, and a fall can lead to a broken bone, a hospital stay, a loss of confidence and a loss of independence. Many falls can be prevented with strength and balance exercise, a check of medicines and a safer home, but few older adults have a place to get this help. Before we submit, we will confirm the latest CDC figures.
2. Chronic conditions go unmanaged. High blood pressure, diabetes, arthritis and heart disease are common among older adults. Managing them takes daily choices and good communication with a doctor, and many people do not get education or support.
3. Few preventive touchpoints. Doctor visits are short, often months apart and hard to reach for people without a ride. Small changes, such as a rising blood pressure reading or a new unsteadiness, can go unnoticed.
4. Medication confusion. Many older adults take several medicines from several doctors and pharmacies. Mix-ups, missed doses and side effects are common and preventable.
5. Missed vaccines. Many older adults miss flu and other recommended vaccines because of cost, transportation or lack of information.
6. Loneliness and isolation. Many older adults live alone, have lost a spouse or friends and have few reasons to leave home. Isolation is linked to poorer health and a greater risk of depression. Winters in Michigan make it worse.
7. Caregivers are stretched. Family members who care for a person with memory loss or a long-term illness often have little support.
8. Transportation. Older adults who no longer drive may not be able to reach a gym, clinic or class.
9. Unequal access. Older adults with limited income, who live alone, who live in rural areas or who belong to communities with fewer health services face higher risks and fewer options.

How we know people want this. Our volunteer exercise class grew from 8 to more than 60 older adults a week in a year. Members ask us each week for blood pressure checks, a ride, a place to meet and help for a spouse. The hospital's community health department told us it sees older adults in the emergency room after falls it believes could have been prevented.

How we will show the need. Before we submit this proposal, we will add the number and share of residents age 60 and older and age 75 and older in our service area from the U.S. Census Bureau, the share living alone and below the poverty line, local fall injury and emergency visit data from the Michigan Department of Health and Human Services or the hospital, the rate of chronic conditions among older adults from the county health department, and the number of older adults on our volunteer list. We will confirm the latest CDC figures on falls.

Who benefits first. Adults age 60 and older in our service area, with a focus on those age 75 and older, those who live alone, those with limited income, those who live in rural areas, those with chronic conditions, those who have fallen and those who care for a spouse or relative.

Products & Services

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

1. Open the wellness center. We lease and prepare a suite with a large exercise room, a private screening room, a kitchenette and a social area, and open with an Executive Director, a Wellness Nurse, a Fitness and Wellness Coordinator, a Community Health Outreach Specialist and a part-time Program Coordinator.

2. Offer exercise and falls prevention. About 10 classes a week: chair exercise, tai chi, strength and balance, and gentle walking, led by our Fitness and Wellness Coordinator and contracted instructors. Every new member fills out a short health questionnaire, and members who report certain conditions are encouraged to check with their doctor first. Classes can be adapted to any level, and no one is pushed beyond their comfort. We also offer an 8-week, evidence-based falls prevention program that is approved for use with funds under the Older Americans Act, which teaches practical ways to reduce the fear of falling and to stay active. About 120 older adults complete a falls prevention program in Year 1.

3. Provide health screenings and wellness checks. Our Wellness Nurse is at the center during open hours and offers walk-in blood pressure, pulse, oxygen, weight and blood sugar checks, a fall risk screening and a friendly conversation about health. When a reading is outside the usual range, the nurse explains what it means, helps the person write down questions and encourages a call to their doctor. If a reading is dangerously high or a person is unwell, the nurse follows our emergency plan and calls 911. We expect about 600 screenings and wellness checks in Year 1. Our nurse does not diagnose or treat.

4. Review medicines safely. Twice a year, we host a "brown bag" medicine review, at which a pharmacist partner helps participants bring in all their medicines and supplements and looks for duplicates and questions to take to their doctors.

5. Teach people to manage long-term conditions. A 6-week, evidence-based self-management workshop, led by two trained leaders, helps people with conditions such as high blood pressure, diabetes, arthritis and heart disease set goals, solve problems, plan healthy eating and activity and talk with their doctors. About 80 people complete the workshop in Year 1.

6. Hold vaccination clinics. About 4 clinics a year, run by a licensed pharmacy partner who gives the vaccines and bills insurance. We provide space, outreach and reminders.

7. Support brain health and caregivers. Talks on keeping the mind active, a memory screening event with a referral to a doctor for anyone with concerns, and a weekly support group for family caregivers. About 40 caregivers take part in Year 1. Memory screening is not a diagnosis.

8. Offer healthy snacks and nutrition education. A short class each month and a healthy snack at each activity, with referrals to meal programs run by the Area Agency on Aging and others.

9. Provide rides. Round-trip rides to the center for older adults who cannot drive or have no ride, through a contracted transportation provider. About 1,200 round trips in Year 1.

10. Build connection. Friendly calls from trained volunteers, clubs, outings and holiday events, so that no one has to be alone.

11. Navigate services. Our Outreach Specialist helps people find the right help, makes referrals to meal programs, home care, housing and benefits counseling, and follows up.

How we will measure results. For every member we record visits, classes and screenings, and referrals made and completed. Members complete a short survey at the start and every 6 months on how steady they feel, how confident they are about avoiding a fall, how often they exercise, how connected they feel and whether they have had falls. For the falls and chronic condition workshops we measure attendance and completion and changes in confidence. We track how many older adults with an abnormal reading talk with a doctor. We ask members for feedback and share what we learn.

Our Year 1 goals:
- About 300 older adults served and about 6,000 visits to classes and activities.
- About 120 older adults complete a falls prevention program, and at least 70% report more confidence in avoiding a fall.
- About 80 older adults complete the chronic condition workshop, and at least 70% report making a health goal.
- About 600 health screenings and wellness checks, and at least 80% of people with an abnormal reading report talking with their doctor within 30 days.
- About 4 vaccination clinics.
- About 40 caregivers in the support group.
- About 1,200 round trips by ride.
- At least 70% of members who felt lonely at the start report feeling more connected after 6 months.
- At least 90% of members say they were treated with respect.
These are goals, and we will report our real results to the Foundation, including where we fall short. We do not promise any health result for any person.

Market Analysis

Who we serve and how many.

The people. Adults age 60 and older in our service area, and family caregivers of any age. We welcome everyone, whether or not they have insurance, and we reach out especially to older adults who are 75 and older, who live alone, who have limited income, who live in rural parts of our area, who have chronic conditions, who have fallen, who recently lost a spouse and who care for a loved one. There is no charge to join, and voluntary contributions are welcome.

Where we work. Our center is in a leased suite on a bus line, with rides available from the surrounding towns. In Year 3 we begin offering weekly classes and screenings at a second site in an outlying town.

How many we will reach:
- Year 1: about 300 older adults, about 6,000 visits, about 120 in falls prevention, about 80 in the chronic condition workshop and about 600 screenings.
- Year 2: about 450 older adults, about 9,000 visits, about 150 in falls prevention, about 100 in the workshop and about 900 screenings.
- Year 3: about 600 older adults across two sites, with a second Fitness and Wellness Coordinator, about 12,500 visits, about 200 in falls prevention and about 1,300 screenings.
- Year 4: about 720 older adults, with a second Outreach Specialist, about 15,000 visits and about 1,600 screenings.
- Year 5: about 800 older adults, about 17,000 visits and about 1,800 screenings.
Over five years we expect to reach about 2,900 older adults. Many members return year after year, so they are counted more than once.

Who else benefits:
- Family members. Adult children and spouses worry less when a loved one is active, connected and watched over.
- Doctors and hospitals. Patients who come to appointments with notes, readings and questions are easier to care for, and fewer falls and missed vaccines may mean fewer emergency visits, though we do not promise this.
- Pharmacies and clinics. They gain a trusted site to reach older adults.
- Volunteers. Retirees and students gain meaningful roles.
- The community. Active, connected older adults support local businesses, churches and neighbors.

How we will size the need before we submit. We will add the number of older adults in our service area, the share age 75 and older, the share living alone, the share with income below the poverty line, local data on fall injuries and emergency visits, and the number of older adults on our volunteer list. These come from the U.S. Census Bureau, the Michigan Department of Health and Human Services, the county health department, the local hospital and our Area Agency on Aging.

Competitive Landscape

Other places older adults can go, and how we fit.

- Doctors and clinics. They are essential for diagnosis and treatment, but visits are short, far apart and focused on illness. We are not a replacement. We encourage regular medical care, and we send people to their doctors with readings, notes and questions.
- Senior centers. Many senior centers offer lunch, cards and social activities. We work with them and refer people to each other. Our focus is health and wellness: exercise, falls prevention, screenings and condition management.
- Gyms and fitness programs. Commercial gyms and some insurance fitness benefits can be a good fit for some older adults. Many older adults find them intimidating, expensive or too far, and few have staff trained to adapt exercise for people with health conditions or fear of falling.
- Home health and physical therapy. These provide care when an older adult is ill or injured and is eligible. Our programs help people stay well and may help prevent the need for them.
- The Area Agency on Aging and its network. They fund and coordinate meals, home care, transportation and caregiver support, and they have been strong partners. We provide the exercise, screening and workshops that they often cannot, and we refer people to their services.
- Faith communities. Many churches offer visits and social support. We partner with them and welcome their members.
- Hospital community programs. Hospitals offer occasional classes and screenings. We work with them and offer a permanent, central place.

The gap we fill. In our service area, no program offers falls prevention, nurse-led screenings, condition self-management workshops, vaccination clinics, caregiver and brain health support, and a ride in one welcoming, local place.

Our partners:
- The local Area Agency on Aging, which funds and refers.
- A hospital's community health department, which refers patients and shares data on falls.
- A pharmacy, which holds vaccination clinics and helps with medicine reviews.
- Two churches, which host events and promote the center.
- A university physical therapy program, which places student volunteers in later years.
- A contracted transportation provider for rides.
- The state's health insurance counseling program, to which we refer people for free Medicare questions.

Marketing & Sales Strategy

How older adults and families will find us and how we keep them engaged.

Reaching older adults:
- Doctors, nurses and pharmacists. A referral card that a doctor or pharmacist can hand to an older adult who has fallen, has a health condition or seems isolated.
- The Area Agency on Aging and meal programs. Their staff and volunteers tell the people they serve.
- Hospitals and home health. Staff tell patients leaving a hospital or rehab that we can help them keep building strength.
- Churches, clubs and housing communities. We give short talks, offer trial classes and invite members for a free first visit.
- Word of mouth. Members bring friends, and our founding class grew from 8 to more than 60 without advertising.
- Mailings, large-print flyers, the local newspaper, radio and community bulletin boards. Many older adults do not use the internet, so we do not rely on it.
- A simple website and a phone line answered by a person, with large print and easy language.

Making it easy to come:
- There is no charge. Voluntary contributions are welcome and never required.
- A person can walk in without an appointment, and a friendly greeter is at the door.
- Rides are available, and the center is on a bus line.
- The center is accessible, with parking close to the door, grab bars, non-slip floors and good lighting.
- A first visit includes a tour, a trial class and a cup of coffee, with no pressure.

Keeping members engaged:
- Classes are social and fun, with music and a coffee hour afterward.
- Members who miss a few classes get a friendly call, not a scolding.
- Members help shape the center, and some become volunteers and leaders.
- We celebrate milestones, such as completing a workshop or a first year at the center.

Reaching supporters. Pharmacies, banks, hospitals and local businesses are invited to sponsor a class, a ride program or a vaccination clinic. We share results twice a year with funders and partners, using totals and never names.

Outreach budget. Outreach is part of staff time and the evaluation, accounting and administration budget (about $13,000 a year in Year 1). Large-print brochures, the sign and a website are paid for once from startup money ($2,500).

Operations Plan

How the center will operate.

Timeline for Year 1:
- Months 1 to 3: Attorney review of the lease and privacy policies, sign the lease, prepare the suite with non-slip flooring, grab bars and better lighting, hire the Wellness Nurse, the Fitness and Wellness Coordinator and the Outreach Specialist, contract with instructors, a pharmacy partner and a ride provider, and set up the secure records system.
- Month 4: Staff and volunteer training in emergency response, falls prevention, privacy, safe exercise and recognizing abuse and neglect. Soft opening for referral partners.
- Months 5 to 8: Open to members. Classes, screenings and rides begin. First falls prevention and chronic condition workshops.
- Months 9 to 12: First vaccination clinics and brain health talks. Caregiver group begins. Review of results and member feedback, a year-end report to funders and planning for Year 2.

Space. A leased suite of about 2,200 square feet on a bus line, with a large exercise room, a private screening room, a kitchenette, a social area and an accessible restroom. Rent and utilities are about $30,000 a year in Year 1. Non-slip flooring, grab bars, better lighting and an accessible restroom update are a one-time cost of $8,000.

Equipment. We buy about $15,000 of equipment once at the start: exercise equipment such as sturdy chairs, light weights, resistance bands, balance and walking aids and mats ($5,000), health screening equipment such as blood pressure monitors, scales, pulse oximeters, glucose meters, a privacy screen and an exam table ($4,000), furniture, a sound system and a projector ($3,500), and three laptops and a secure printer ($2,500). After Year 1, we set aside about $2,500 to $3,000 a year to replace and add equipment. The center also has an automated external defibrillator (AED), a first aid kit and a wall phone, bought as part of the screening equipment and furniture budget.

Staffing. In Year 1: an Executive Director, a Wellness Nurse (a registered nurse), a Fitness and Wellness Coordinator, a Community Health Outreach Specialist and a part-time Program Coordinator. A second Fitness and Wellness Coordinator joins in Year 3 and a second Outreach Specialist in Year 4. Exercise instructors are contracted for specific classes and are trained in working with older adults.

Safe exercise. Every new member completes a health questionnaire. Members with certain conditions are encouraged to check with their doctors first. Instructors adapt every exercise, teach members to listen to their bodies and stop if they feel pain, dizziness or shortness of breath. Classes are held with another trained adult present, and chairs and support are always available.

Emergency plan. All staff and instructors are trained in first aid and CPR, and in using the AED. If a person is seriously ill or hurt, staff call 911 right away, begin first aid and stay until help arrives. We keep a list of emergency contacts for each member, with permission. We follow a written plan for falls and for severe weather.

Nursing scope and screenings. Our Wellness Nurse works within the scope of practice for a registered nurse in Michigan. The nurse screens, teaches and refers, and does not diagnose or treat. We follow written protocols for what to do when a reading is high or low, approved by a physician advisor on our board. Because rules differ, we confirm Michigan's current requirements before we begin. Health screening and vaccination clinic supplies cost about $8,000 a year in Year 1.

Vaccines. Vaccines are given only by a licensed pharmacy partner, who is responsible for storage, records and billing. We provide the space and outreach.

Rides. We contract with a licensed transportation provider that uses trained drivers and accessible vehicles, and we confirm the provider's insurance and driver checks. Transportation costs about $14,000 a year in Year 1.

Privacy and safeguarding. Member health information is kept in a locked cabinet and a secure, password-protected system, and shared only with the member's permission, except where the law requires otherwise. An attorney reviews our policies to confirm which privacy laws apply, including HIPAA. We report results to funders only as totals. All staff and volunteers pass background checks. Staff are trained to recognize signs of abuse, neglect and financial exploitation of older adults, and to report suspected abuse as the law requires. We also offer short talks to help members avoid scams.

Insurance and records. We carry general liability, property, professional and abuse liability, non-owned auto and workers' compensation insurance. Insurance is about $7,000 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.

Linda Kowalski, RN, Executive Director. Linda leads the organization, raises money, manages grants and partnerships, supervises staff and reports to the board. She is a registered nurse with 20 years of experience in community and public health nursing, and she founded our volunteer exercise class. Planned salary: $60,000 a year.

Wellness Nurse (RN). Provides health screenings and wellness checks, teaches health classes, helps members prepare for doctor visits and makes referrals, within the scope of practice for a registered nurse. Must hold a current Michigan registered nurse license and complete a background check. Experience with older adults is a strong plus. One in every year at a planned salary of $72,000.

Fitness and Wellness Coordinator. Plans and leads classes, trains and supervises instructors, runs the falls prevention program and encourages members. This role requires training in fitness or physical therapy and experience working with older adults, and CPR. One in Years 1 and 2 and two from Year 3, at a planned salary of $42,000 each. The Great Lakes Aging Foundation grant would support the first Fitness and Wellness Coordinator.

Community Health Outreach Specialist. Welcomes new members, helps them find services, makes referrals, coordinates rides, supports volunteers and leads friendly calls. One in Years 1 to 3 and two from Year 4, at a planned salary of $40,000 each.

Program Coordinator (part-time). Handles scheduling, records, data entry and events, 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, 6 in Year 3 and 7 from Year 4 on.

Volunteers. About 40 trained volunteers in Year 1 who greet members, make friendly calls, help at events and clinics and assist with rides. Volunteers complete a background check and orientation.

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 geriatrician, pharmacist and physical therapist advise on health protocols and safety.

People who help us. An outside accountant who reviews our books every year, an attorney who reviews our lease, privacy policies and agreements, an insurance agent who understands programs for older adults, and an advisory group of members, caregivers and a hospital nurse who meet each semester to tell us what is working.

Training. All staff and volunteers complete training in first aid and CPR, emergency response, privacy, recognizing abuse and neglect and respectful communication before starting, and again each 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 wellness center, serve about 300 older adults with about 6,000 visits, run falls prevention for about 120 and the chronic condition workshop for about 80, provide about 600 screenings, hold 4 vaccination clinics and provide about 1,200 rides. A balanced budget of about $343,000, with a small surplus of about $9,000. 5 paid staff.
- Year 2: Serve about 450 older adults with about 9,000 visits and about 900 screenings. Begin 6-month and 12-month follow-up surveys with members. A balanced budget of about $347,000, with a small surplus of about $8,600. 5 paid staff.
- Year 3: Add a second Fitness and Wellness Coordinator and a second site in an outlying town, serving about 600 older adults with about 12,500 visits. A balanced budget of about $394,000, with a small surplus of about $8,900. 6 paid staff.
- Year 4: Add a second Outreach Specialist and serve about 720 older adults with about 15,000 visits. A balanced budget of about $439,500, with a small surplus of about $9,600. 7 paid staff.
- Year 5: Serve about 800 older adults with about 17,000 visits and about 1,800 screenings, with Area Agency on Aging and county contracts covering about 25% of our budget. Share what we have learned with other communities. A balanced budget of about $444,000, with a small surplus of about $9,000. 7 paid staff.

What we measure:
- Members, visits, classes and screenings.
- Falls prevention and workshop attendance and completion.
- Member surveys on steadiness, confidence in avoiding falls, exercise, connection and falls.
- Readings outside the usual range and whether members spoke with a doctor.
- Vaccines given at clinics, caregiver group attendance and rides.
- Whether members felt respected and what they want next.
- Cost per member served.

How we review results. The Executive Director and Wellness Nurse review numbers and safety reports every month. Twice a year, staff, the board and our advisory group review results and member feedback together, and we change what is not working. We share results 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: $85,000 from the Great Lakes Aging Foundation for our Fitness and Wellness Coordinator, exercise class instructors, health screening and vaccination clinic supplies, transportation to the center, caregiver and memory programs and nutrition education, for July 2027 through June 2028.

The request is spread across these budget lines:
- Personnel: Fitness and Wellness Coordinator salary, $42,000.
- Contractual: Exercise class instructors, $10,000.
- Supplies: Health screening and vaccination clinic supplies, $8,000.
- Other: Transportation to the wellness center, $14,000.
- Other: Caregiver and memory programs, $6,000.
- Other: Nutrition education and healthy snacks, $5,000.

Other money in the program. Other grants, Area Agency on Aging and county contracts and member contributions and donors pay the Executive Director's salary ($60,000), the Wellness Nurse ($72,000), the Community Health Outreach Specialist ($40,000), the part-time Program Coordinator ($24,000), rent and utilities ($30,000), insurance ($7,000) and evaluation, accounting and administration ($13,000).

Year 1 budget: about $343,000, planned to balance with a small surplus (about $9,000 after the yearly wear on equipment). Year 1 money coming in: grants $258,000 (this request plus other grants we are applying for), Area Agency on Aging and county contracts $60,000 and member contributions, donations and sponsors $25,000. Year 1 costs: Executive Director $60,000; Wellness Nurse $72,000; Fitness and Wellness Coordinator $42,000; Community Health Outreach Specialist $40,000; Program Coordinator $24,000; wellness center rent and utilities about $30,000; exercise class instructors and equipment about $10,000; health screenings, supplies and vaccination clinics about $8,000; nutrition education and healthy snacks about $5,000; transportation to the center about $14,000; caregiver and memory programs about $6,000; insurance about $7,000; evaluation, accounting and administration about $13,000; and about $5,200 a year for the wear on equipment.

About the contracts. The federal Older Americans Act provides funds to states and Area Agencies on Aging for services that include disease prevention and health promotion, and a program must meet the evidence-based standards the law requires. Our local Area Agency on Aging has invited us to apply, and our falls prevention and self-management programs are the kind that qualify. The amounts in this plan are our planning estimates, not promises, and agency budgets and rules can change. We plan for grants to cover the gap if they do.

One-time startup costs. Startup costs of $41,800 are paid once from startup money, not from the yearly budget: $15,000 of equipment (exercise equipment, screening equipment, furniture and a sound system, and laptops), $8,000 for non-slip flooring, grab bars, lighting and an accessible restroom update, $5,500 for the lease deposit and first month of rent, $2,500 for opening supplies, $800 for the business license and permits, $4,500 for an attorney's review of the lease and privacy policies and accounting setup, $2,500 for the sign, large-print brochures and website, and $3,000 for background checks, first aid and CPR training and the first insurance payment.

How we got our startup number. The Funding Need Calculator in this plan adds the startup costs ($41,800), the cash we need to cover the wait for the first payments (about $8,600) and a cash cushion of about $82,800, which is about three months of Year 1 costs. That comes to $133,500. We start with $20,000 of our own savings and $120,000 in startup support from a community foundation, a hospital community benefit gift and our board, $140,000 in all, which covers that amount with room to spare.

The next five years. Our budget grows from about $343,000 in Year 1 to about $444,000 in Year 5. Grants are planned at $258,000, $245,000, $269,000, $291,500 and $278,000 in Years 1 to 5. Area Agency on Aging and county contracts grow from $60,000 to $110,000, and member contributions, donations and sponsors grow from $25,000 to $56,000. We add a second Fitness and Wellness Coordinator in Year 3 and a second Outreach Specialist in Year 4. Grants fall from about 75% of our income in Year 1 to about 63% in Year 5.

Savings. We plan to keep several months of costs in savings. The lowest year-end balance in the plan is about $116,400, at the end of Year 1. Contract and grant payments often arrive after we bill, so we plan for about $20,580 owed to us at the end of Year 1.

After the grant. Our plan is to grow Area Agency on Aging and county contracts as agencies see results, to invite hospitals, health plans, pharmacies and banks to sponsor classes and clinics, and to grow member contributions and individual donors, including families of members. Some Medicare Advantage plans and health systems pay for community-based falls prevention and self-management programs, and we will explore this. Rules and payments differ and change, so we will follow them closely. Volunteers and trained members who lead classes help us do more at a low cost.

Risks and how we will handle them:
- A member is hurt in a class. Instructors are trained, exercises are adapted, a first aid kit and an AED are on site and we have a written emergency plan.
- Older adults do not come at first. We build trust through doctors, churches and the Area Agency on Aging, offer a free trial visit and rides, and keep the atmosphere warm.
- A nurse or coordinator leaves. Protocols and member plans are written down, and we keep a list of qualified applicants.
- Contracts are delayed or reduced. We plan with a cash cushion, stage hiring so costs follow funding and apply to other funders.
- A ride provider fails. We contract with more than one provider and have volunteer drivers as a backup, with the proper checks.
- A grant ends. We keep savings and grow funders 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: a weekly chair exercise and blood pressure check morning in a donated church hall, with a volunteer nurse and a volunteer instructor, 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.
- Licenses and resumes for your Wellness Nurse and the job description for the Fitness and Wellness Coordinator.
- Letters of support from the Area Agency on Aging, the hospital, the pharmacy and churches.
- The letter of intent for the lease, or a letter from the landlord.
- Your member health questionnaire, nursing screening protocols and emergency plan.
- Your falls prevention and chronic condition program information, with the evidence that supports them.
- Your privacy policy, abuse and neglect reporting policy and ride provider agreement.
- Proof of liability insurance, or a quote.
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: $258,000 in Year 1, then $245,000, $269,000, $291,500 and $278,000.
- Area Agency on Aging and County Contracts: $60,000 in Year 1, growing to $110,000.
- Member Contributions, Donations and Sponsors: $25,000 in Year 1, growing to $56,000.
- Pay (a full year, per person, including payroll taxes and workers' compensation): Executive Director $60,000, Wellness Nurse (RN) $72,000, Fitness and Wellness Coordinator $42,000 (one in Years 1 and 2, two from Year 3), Community Health Outreach Specialist $40,000 (one in Years 1 to 3, two from Year 4), Program Coordinator (part-time) $24,000.
- Other yearly costs in Year 1: Wellness Center Rent and Utilities $30,000, Exercise Class Instructors and Equipment $10,000, Health Screenings, Supplies and Vaccination Clinics $8,000, Nutrition Education and Healthy Snacks $5,000, Transportation to the Wellness Center $14,000, Caregiver and Memory Programs $6,000, Insurance $7,000, Evaluation, Accounting and Administration $13,000. These grow between 4% and 5% a year.
- Equipment: $15,000 at the start, then $2,500 to $3,000 a year.
- Startup costs: $41,800, paid once from $140,000 in startup money.
- About 6% 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