Funding Alternativeseffective Curriculum Ideas

1. The Business Plan 6. You, the Entrepreneur 7. Do your research 2. Ideas.Sources of good entrepreneurial business ideas.
2. Creators must set a funding goal and a time that the fundraising must occur within. Backers are not charged for a pledge towards a project unless it reaches its funding goal. Creators are required to create rewards to share a piece of their project with their backer community (e.g. A copy of the program or a unique experience).

A competitor to Lending Club, Funding Circle will grant between $25,000 and $50,000 in small business loans — interest rates run between 4.99 and 27.79% — as well as give you the option to invest money. If we have music-based platforms, then it stands to reason we’d have at least one for. The IDEAS Program small grants competition awards up to $35,000 to accredited U.S. HEIs to create, expand, and/or diversify their U.S. Study abroad programs. The IDEAS Program also offers both virtual and in-person trainings and resources to expand capacity in the wider U.S. Study abroad community. The IDEAS Program small grants competition and capacity building activities are open to all accredited U.S. Colleges and universities.

169CHAPTER 8

Financial Support and Budget planning for Curriculum Development or Revision

Sarah B. Keating

OBJECTIVES

Upon completion of Chapter 8, the reader will be able to:

1.Analyze the influence that financial costs and budgetary management have on curriculum development or revision

2.Itemize the costs associated with curriculum development or revision

3.Identify resources for financial support for curriculum development and revision activities

4.Analyze the roles of faculty, administrators, and staff in budgetary planning, management, and the procurement of funds for curriculum development and revision Fusion 20112012teach to be happy.

OVERVIEW

Activities associated with curriculum development for new programs or revision of existing ones require financial support for the time spent by personnel on the project and its associated costs. The costs may be minor or major depending upon the extent of the changes or new program development. For example, if it is a revision, it may not call for additional faculty, but perhaps renovation of the physical facilities and other instructional support needs are indicated. These costs apply to new programs but also could indicate the need for additional faculty and staff. New programs usually require start-up costs associated with their initiation such as the time spent on developing the program prior to student admission, approval from accreditation agencies and regulating bodies, and increased recruitment activities for students and new faculty. Chapter 8 discusses the types of costs that occur; their impact on the proposed program or revision, budget planning, and management; and possible resources for funding. The roles of administrators, faculty, and staff are described.

170FINANCIAL COSTS AND BUDGETARY PLANNING

Financial Costs

The process for evaluating an existing program for possible revision and conducting a needs assessment for possible changes or creating a new program involves administrative, faculty, and staff. Depending upon the extent of the change or development, the time spent may be part of the usual role of these personnel. For example, faculty curriculum committee members review recommendations for change in the curriculum as part of committee activities, which in turn are part of the service role expectations for faculty. Another example is when planning and managing the budget, the administrator may find that one of the tracks in the overall program is losing money owing to low student enrollments, while another track is turning away applicants. Analyzing the problem and bringing it to the attention of the faculty is the next step to address the problem and is considered a usual administrative responsibility.

Although activities associated with program changes normally take place in faculty curriculum committees and the time spent on these activities is considered a part of the faculty service role, faculty time over and above the usual service activities may be necessary. The costs associated with the additional time occur in the form of released time or a stipend for individual faculty members, or a consultant may be hired to coordinate the project. Staff support for the activities such as taking and recording minutes for meetings held, coordination of participants’ schedules for meeting times, collecting data for assessment, and so on must be included in the costs.

When calculating the costs associated with curriculum development, both direct and indirect costs must be considered. Direct costs are those that can be attributed to new costs and includes additional personnel; physical facilities such as offices, labs, classrooms, and furnishings; staff and instructional support equipment; computers and their hardware and software; office supplies, and so on. Indirect costs are those associated with the use of existing staff, physical facilities such as offices and meeting rooms, utilities, furnishings, and supplies that the institution provides from its resources. These indirect costs are usually estimated on a percentage basis of the total and can range from approximately 3% to 40% of the total costs. Personnel costs represent the largest expenditure for supporting curriculum change or development. However, there are a few other associated direct costs such as fees associated with data collection when conducting a needs assessment, office supplies, new computer hardware and software, and travel for data collection or consultation purposes.

Costs of Nursing Programs in Academe

Although the literature on the costs of program development is sparse, two articles were identified that related to the cost of nursing programs in comparison to other disciplines and how to estimate the costs and benefits for a new program. The reader may find them useful when involved in curriculum development and planning. A summary of the articles follows.

171Nursing programs must often defend themselves from other disciplines that assume that nursing education is an expensive proposition. Certainly, the nursing faculty to student ratio required for clinical supervision in health care agencies is costly. However, large theory classes where lecture prevails as the modality for entry-level programs and the use of simulation help to counterbalance the expense. Also, clinical instructors are often part time or serve as adjunct faculty who cost less than tenured or tenure-track faculty who are full time. Booker and Hilgenberg (2010) conducted a study in a small private university and developed a model for comparing the costs of nursing in comparison to other academic programs The model examined the quality (Q), potential (P), and cost (C) (QPC) of programs to compare disciplines from a cost-benefit perspective. In using the model, the authors demonstrated that while nursing fell into the costly category, it also rated as a high-quality discipline with a moderate potential index, especially for the RN to bachelor of science in nursing (BSN) program. Based on the results from the use of the model, and the decrease in applications to the basic program, the decision was made to increase enrollments for the RN to BSN program and modestly cut back on enrollments in the baccalaureate program. The QPC model described in the article provides details for measuring the quality, potential, and cost of an educational program that can be useful to other programs in the process of curriculum development or revision. It provides details for analyzing the costs and the potential benefits from a program and contributes to the decision-making process within a sound financial environment.

Fagerlund and Germano (2009) describe a cost and benefit analysis model for development of a nurse-midwifery educational program that is useful in identifying not only the costs for starting a program but also the potential benefits to the public, home institution, the health care system, clinical sites, and students. Costs that apply to an academic institution fall into three categories: (1) direct costs, such as faculty and staff salary and benefits; (2) indirect costs, such as library and student services; and (3) capital costs, such as building additions, improvement, or replacement. Universities tend to have complex financial and accounting structures and, while it is possible to list each indirect cost, for the purposes of the cost-benefit model described by the authors, indirect costs were allocated on a percentage basis. For this study, a 40% indirect cost rate was applied. The 40% indirect cost rate was used because, according to the authors, it is a typical rate used by academic institutions for estimating indirect costs for federal grants. The prototype used in this model provides a persuasive argument for the establishment of a program and is a useful model for other institutions planning new programs.

Budgetary Planning and Management

The chief nursing officer (CNO; dean, director, or chair) of the educational program is responsible for managing the budget. Administrative support staff assists in the management of the budget allocation, although in some smaller nursing programs, these responsibilities may be included in the expectations for the CNO. Planning for the future, both annually and long term, is part of the CNO role. Schools of nursing and their parent institutions have strategic goals and plans for 172the future, usually within a 5-year framework. In addition, most schools have a master plan of evaluation. These plans, with their goals and objectives, provide guidelines for projected curriculum revisions, new program proposals, and program and accreditation activities. Thus, a section in the budget for curriculum development and evaluation should be part of the planning process. When planning annual budgets in association with the development of short- and long-term goals, administrators should involve faculty and staff to assist in the identification of current and potential needs for curriculum revision and the development of new programs and their related costs.

Specific items in budgets that relate to curriculum planning include faculty released time to identify possible revisions or new programs; released time for conducting a needs assessment; consultant fees if indicated for major revisions or new program development; and additional staff support, office supplies, and communications and technology support. According to the program’s long-range goals or strategic plan, these costs may be for 1 year or several depending upon the extent of the changes. As the planning process develops, indications for change or new programs require further planning for the future based on the costs for developing new programs and, perhaps, discontinuing programs that no longer meet the goals of the program. Table 8.1 lists the elements to consider in planning annual budgets as they apply to curriculum revision or development of new programs.

Costello (2011) discusses a planning process for annual budgeting that ties program costs, including maintenance of the program and anticipated needs, to the overall program goals. He offers a budget balanced scorecard model that lists items and their costs and assigns values to them and their contribution to the program goals. He recommends limiting the number of items so that they are achieved within the year rather than having numerous unachieved goals. Costello describes the process of planning as “gathering correct information, having clear goals, understanding the risk, and outlining an approach that’s more like a path than a tightrope” (p. 64).

A description for building a business plan for a small grant and its management serves as a model for planning budgets (Sakraida, D’Amico, & Thibault, 2010). The authors expand on Sahlman’s (1997) formula for critical factors to consider when budget planning (people, opportunity, context, risks, and rewards). Included in their expanded considerations are the personnel involved and their tasks, communication systems, and the establishment of networks of key people for support. They recommend that people who manage the grant have training in preparing budgets, working with administrators who oversee the project, knowledge of institutional policies, conducting monthly reviews of expenses according to allowable costs, and ensuring that expenditures tie to the goals of the project.

Several articles from the literature discuss the financial aspects for new program planning. Stuart, Erkel, and Shull (2010) report on the planning process in a school of nursing that considered the development of a new doctoral program that would not add to the costs of the existing nursing program. The authors present a model for analysis of the costs for existing tracks in a program that lead to decisions for cutting programs that are no longer financially viable. Items for analysis 173of costs and revenues for each track included faculty resources, faculty to student ratios, student enrollments, faculty salaries and benefits, and revenues from tuition and fees. While not addressing the costs of the time spent on the analysis and for planning a new program, the model provides ideas for managing nursing education budgets and planning for change.

Gantt (2010) describes how to use the strategic planning model SWOT (strengths, weaknesses, opportunities, threats), for building a business case to add a simulation lab for a nursing program. Gantt points out that the plan provides for annual review to measure the success or failure of the program as to its match to the program’s overall strategic plans and thus justifies its existence.

174Poirrier and Oberleitner (2011) describe in detail an entry-level accelerated BSN program designed for nonnurse college graduates. The school of nursing collaborated with four large medical centers to secure funding for a 5-year project to prepare the college graduates for nursing. Five other smaller hospitals participated in the project by providing additional clinical sites for student practice. More than $1 million were donated to the school from the health care agencies and the university contributed funds from students’ tuition and fees as additional funds to manage the program. The article describes in detail budget items that were included to fund the program and is useful for budget planning purposes. As mentioned previously, financial environments can influence the development and maintenance of educational programs and in this instance, the program was phased out after the 5-year period owing to changes in the financial and employment climates.

If a program decides to offer a new program based on the findings from a needs assessment, planning for a budget to start the program and maintain it is a crucial step. Costs to develop the curriculum, recruit students, and add faculty, staff, and physical facilities and supplies must be part of the cost side of the budget, along with the revenue side of the budget for its source of financial support. See Table 8.2 for a listing of the items to include in a budget when planning for a new program.

SOURCES FOR FINANCIAL SUPPORT

There are three major sources of funding for curriculum development and planning other than the home institution’s support in its regular budget. Depending on the nature of the home institution, the majority of funds for the budget come from the general funds (if state-supported), tuition and fees, endowments, grants, and donations. When considering funds for curriculum development, the three major resources for funds are grants (private and public), philanthropy (donations and endowments), and partnerships with the community. Each of these sources is discussed with ideas from the literature for procurement of funds.

Grants

The major resource for program development and student and faculty support at the federal level comes from the Health Resources and Services Administration (HRSA), Division of Nursing (2014). Included in the program of grants are traineeships for advanced practice students, faculty loans, support for nurse managed health care services, and program development. The program development funds, for the most part, focus on starting up new programs and a large part of the funds support curriculum development. It is not permanent funding and is intended as an incentive to increase the advanced practice nursing workforce and to support other types of advanced nursing education programs, for example, education and public health. For detailed information on this major resource, go to the HRSA website (bhpr.hrsa.gov/nursing/index.html).

In addition to federal grants, there are major private foundations and organizations interested in supporting nursing education programs. They include the Bill and Melinda Gates Foundation (2014), Robert Wood Johnson Foundation (2014), the W. K. Kellogg Foundation (2014), the Josiah Macy Jr. Foundation (2014), the Gordon and Betty Moore Foundation (2014), and many others. A listing of other private resources can be found at the UCLA Office of Contract and Grant Administration (2014; www.research.ucla.edu/ocga/sr2/Private.htm).

175TABLE 8.2ELEMENTS FOR BUDGET PLANNING FOR NEW PROGRAMS

176Many universities and colleges offer courses in grant writing and there are a few that are online. One online site from the General Services Administration (2014) offers ideas for Developing and Writing Grant Proposals (www.nmfs.noaa.gov/trade/howtodogrants.htm).

Funding Alternativeseffective Curriculum Ideas Middle School

Partnerships

There is a long history of partnerships between nursing education programs and health care agencies. The purpose for these partnerships is not only to provide clinical experiences for students, but also to support schools of nursing in preparing professionals for the workforce. These partnerships take many forms, including work–study or internship experiences for students who may earn a modest salary and at the same time earn academic credits, contribution of nursing clinicians to the school as instructors, use of facilities for laboratory and simulation experiences, continuing education and research opportunities for both faculty and staff, and scholarship or loan programs for students in exchange for contracts to work for the agency upon graduation. The numbers and amount of financial support available from agencies seem to ebb and flow according to nursing workforce demands and the financial climate at the time.

A model for partnerships between health care systems and educational institutions is the Veterans Affairs (VA) Nursing Academy project, which supplied $60 million to establish partnerships with the VA and baccalaureate schools of nursing. It funds faculty positions using expert clinicians from the VA system (or the community if there is a lack), provides clinical practice experiences for students, and recruits new graduates into the VA system. There are four established regions including the western, midwest, south, and northeast regions of the United States. Benefits for the schools and the VA include current updates on clinical practice and an increase in the faculty workforce as well as the nursing workforce. This model serves as an example for other health care systems wishing to increase the 177nursing workforce and, at the same time, participate in updating nursing curricula and addressing the nursing faculty shortage (Bowman et al., 2011).

Bentley and Seaback (2011) describe a collaborative program among 12 nursing programs and two clinical agency partners to provide faculty development workshops on clinical simulation strategies. Its purpose was to increase student enrollments and enhance their clinical experiences and skills. It was funded by a grant from the Texas Team and the Texas Workforce Commission. Thirty percent of the nursing programs were able to increase enrollments owing to faculty’s increased use of simulation in place of clinical experiences.

Budgeting schemata for forging partnerships between health care agencies and nursing education programs are discussed by De Geest et al. (2010). The University of Pennsylvania and the University of Bezel in Switzerland developed academic and service partnership models that provide guidelines for developing partnerships between health care agencies and nursing education programs. The models are useful tools on how to balance agreements between the two institutions and include specific budgetary items for planning and management of the financial support system. Of special interest is the appointment of a full-time coordinator to manage the agreement when the arrangements become complex and involve many personnel, students, and resources from both institutions.

Philanthropy

Philanthropic funds come from donations to the nursing programs. A large majority of these donations are earmarked for scholarships for students. However, there are times when programs receive donations for program development. For example, Andrews et al. (2011) describe a partnership established between several schools of nursing and the Transcultural Nursing Society to prepare nursing faculty and students in cultural competence. The project was funded by a federal grant; however, the society had a major role in helping to develop the program and serves as an example of how professional organizations can contribute to nursing curricula development.

Peeples (2010) presents recommendations for universities and colleges, especially Historically Black Colleges and Universities, which apply to nursing educators for securing funding for curriculum development. She recommends three major strategies to obtain donations from philanthropic individuals and organizations. These are (1) identify funders who connect to your institutional mission and vision (p. 258), (2) infuse creativity and collaboration into your strategy (p. 256), and (3) engage alumni in giving (p. 259).

Alumni organizations are a good resource for nursing programs and schools should encourage the support of alumni organizations through special functions such as reunions at the time of graduation, research events, and guest lecturers. Fostering alumni participation can begin early in the professional socialization process through the nursing student association with faculty mentoring and support. An editorial describing the importance of alumni building contains useful material for schools of nursing to gain support from alumni associations (Cleary, Jackson, Vehviläinen-Julkunen, Lim, & Chan, 2012).

178ROLE OF ADMINISTRATORS, STAFF, AND FACULTY IN FINANCIAL SUPPORT FOR CURRICULUM DEVELOPMENT ACTIVITIES

Administrators and Staff

When a curriculum revision is indicated or a new program is in the offing, additional administrator and faculty time is expected and usually it is over and above the normal job expectations. Therefore, released time and related costs are expected and must be planned for in the budget. Administrators, with faculty input, should include a line item for program planning in the budget to cover these anticipated costs. While indirect funds from a grant can provide for the released time spent on program planning, they usually are not available until after the fact, that is, the grant is approved and funded after initial activities took place. Depending on the institution’s policies regarding indirect funds, administrators may have the discretion to use funds for program development generated from other grants. Otherwise, funds for program planning should be part of the regular budgeting process.

If administrative staff has responsibility for the management of the school budget, records of expenditures for curriculum revision or new program development should be kept. They are especially useful to illustrate the purpose for the funding and its tie to the grant/project goals. If the administrator manages the budget, the same processes apply and provide documentation for accounting purposes. Each year, during the budget review and projections for the future, administrators, staff, and faculty should identify continuing funding needs for program development. Needs vary according to the amount of curricular revision or new program development indicated. A discussion on the costs of program review, evaluation, and accreditation can be found in Section V, “Program Evaluation and Accreditation.”

Faculty

Curriculum development and evaluation is an ongoing process built into the educational program activities. Nurse educators in the process of delivering the curriculum through instructional activities such as classroom lectures, seminars, conferences, laboratory practice, simulation activities, and clinical supervision gather information on how well the curriculum is delivered. This ongoing assessment of teaching effectiveness and student learning outcomes is part of the role of teaching. It is a job expectation and, therefore, as part of the usual responsibilities, is supported through faculty salaries. Yet another aspect of faculty work is the participation in work groups such as course and level and curriculum committee meetings. These activities are considered part of the service role for faculty and from a budgetary point of view are a part of the salary paid to faculty and the expected responsibilities of the role. If major curriculum revisions or a new program are indicated, conducting a needs assessment and developing the curriculum can require faculty time over and above the usual expectations. In that case, the administrator and faculty in the program need to identify sources of funds to support the released time for these activities and to plan for them in the budget.

Ideas into Action

To help North Dakota communities address the top health needs identified through their Community Health Needs Assessment (CHNA), models and examples are listed on this page as potential resources. Not all ideas listed will apply or be practical for all communities; rather it is a list of ideas that could be modified or tailored to fit your needs, or serve as a springboard for new ideas.

These ideas are not evidence-based best practices. Rather, they serve as additional qualitative data and can act as conversation starters to help think of activities that may have worked in other rural settings in North Dakota. For more information on evidence-based practices, check out County Health Rankings & Roadmaps, 'What Works For Health.' It may be helpful to look at those and then cross-reference to these ideas for what is feasible in a rural context.

On This Page:

Access to Needed Equipment/Facility Update

Funding Alternativeseffective Curriculum Ideas 4th Grade

• Acquire new or updated equipment (i.e. CT scanner)
• Publicize when new equipment has been purchased to explain how it is beneficial to community
• Update website to include information about new equipment and technology acquisitions

Aging Population Services

• Promote public transportation services
• Offer mobile screening services so seniors don't have to leave their home
• Offer Meals on Wheels
• Great Plains Senior Services Collaborative provides the following services in North Dakota: Aging Life Care Management that connects participants with an advisor to navigate later life care. Services include care coordination, crisis management, patient advocacy, and transitional care; Remote Caregiver uses technology to support senior caregivers as they take care of older loved ones; and Volunteer Companions provide social engagement and help with household chores

Attracting & Retaining Young Families

• Develop hospital sponsored day care opportunities for staff and community members
• Develop and offer health and wellness programs
• Collaborate with other community organizations such as the school to offer health education programs and exercise equipment.
• Promote Bismarck-Mandan Young Professionals Network
• Market and promote the rural community culture – feeling of safety (low crime), strong education systems, active faith community, strong and vital health sector, lower cost of living
• Contact North Dakota Department of Commerce for economic development ideas
• Create leadership opportunities for community members in their 20’s and 30’s – hospital board, community health task force, membership and chairing a committee
• Develop a community job site wellness program – contact North Dakota Department of Health and BCBSND
• Fund (with other community organizations) a health career scholarship program with an obligation to return to the community for service for a specified period of time.
• Consider Rural Health Outreach Grants, Network Development Grants, and Network Planning grants to address a number of ideas for both the community but also a regional network to address common issues.

Bullying

• Cyberbullying in School: Prevention and Support – Discusses what cyberbullying is and its potentially devastating consequences. These can include stress, depression, self-harm and suicidal thoughts. There's advice about what to do if you're being cyberbullied, including how to get support and how to block bullies online. There's also some great information and preventative strategies relevant to each group - teachers, parents, and students. It also includes social media safety tips, which provides key strategies for students, such as not responding to abusive posts or allowing programs to track location.

Cancer

• Form cancer support groups for patients and caregivers
• Promote online support groups though Cancers Survivors Network sponsored by American Cancer Society
• Promote skin cancer awareness at local events
• Form a Knitting for Charity group to knit hats and blankets for chemotherapy patients

Chronic Disease Management

• Provide space and equipment for fitness center
• Offer mobile diabetic screenings in community
• Organize a community event related to physical activity and/or nutrition, such as walk/run-a-thon, healthy food potluck, etc.
• Organize speaker for community Senior Group to raise awareness of diabetes, serve a healthy meal, and distribute healthy eating recipes
• Institute a wellness page on hospital website
• Implement comprehensive, sustainable wellness and disease management program based on improving baseline health numbers (e.g., weight, BMI, body composition, cholesterol, glucose, blood pressure) through evidence-based practices, shared medical appointments, and a health coach
• Implement health coach program in which coaches work with patients on self-management skills, nutrition counseling, etc. during the four-week period following hospital or clinic discharge; through either telemedicine or home visits

Concerns of Low Customer Service & Quality of Care

• Provide comment box in waiting room to allow for anonymous customer feedback
• Ensure a clean and quiet waiting room with updated magazines
• Hold employee trainings on confidentiality

Cost and Adequacy of Health Insurance

• Support community awareness of Medicaid Expansion
• Promote open enrollment of Marketplace
• Promote North Dakota Department of Human Services website for financial assistance and healthcare coverage application
• Launch marketing campaign to increase access and awareness of Marketplace and other options such as sponsoring education, articles in the paper, interviews on radio

Elevated Level of Uninsured Adults

• Hire financial service counselor who can educate patients about insurance policies
• Hire a Medicaid Expansion Navigator
• Post requirements of Affordable Care Act on hospital website, along with resources relating to meeting those requirements
• Distribute flyers in clinic about requirements of Affordable Care Act
• Organize a speaker for senior groups or other community clubs about the requirements of the Affordable Care Act

Elevated Rate of Adult Smoking

• Use social media to advertise availability of smoking cessation assistance
• Promote nicotine replacement therapies in hospital waiting rooms
• Set up tobacco prevention booth and give cessation presentations at oil field/business health fairs
• Place information about quitting at “man camps”
• Display visual representation of healthy vs. diseased lung at high school
• Create smoke-free environments through policy changes

Elevated Level of Excessive Drinking/Alcohol Use

• Partner with Safe Communities Program for beer goggle simulation and reaction simulation
• Develop public service announcement and videos of real alcohol- related accidents from own communities
• Collaborate with student groups to produce video/media campaign to educate that “buzzed driving is drunk driving”
• Park “drunk driving car” (car that has been damaged as the result of an alcohol-related crash) outside of high school
• Collaborate with law enforcement to increase random checkpoints for driving under the influence
• Collaborate with law enforcement to perform no-consequence breathalyzer tests in bars to promote awareness and education about levels of intoxication, along with distributing information about excessive and binge drinking
• Collaborate with city council to make the approval of liquor licenses contingent on all servers taking server training
• Develop poster to use at fair booth about prescription drug abuse and proper disposal of prescription drugs
• Develop media campaign (based on CDC and attorney general’s office models) to present on local cable and radio about prescription drug abuse and proper disposal of prescription drugs

Emphasis on Wellness, Education & Prevention

• Engage with employers in area to offer blood pressure checks, promote awareness of physical therapy services, and offer prevention education services (e.g., prevention of diabetes, chronic disease, and back injury)
• Offer one or more cooking classes to educate participants about healthy eating and diabetic meals
• Dedicate space in hospital newsletter, as well as space on hospital website, to a “Wellness Update”
• Use hospital newsletter and website to educate community members about services and facilities available within the community and from consumers’ health insurance companies
• Send hospital staff member to wellness program training
• Host booth at community festival which highlights alternative, healthy cooking and baking options
• Partner with senior center and other community organizations to offer dinner and dance class to encourage wellness and healthy recipes
• Engage with county extension service and public health to find ways to promote community wellness events and activities
• Implement comprehensive, sustainable wellness and disease management program based on improving baseline health numbers (e.g., weight, BMI, body composition, cholesterol, glucose, blood pressure) through evidence-based practices, shared medical appointments, and a health coach
• Launch media campaign through radio, newspaper and website to raise awareness and education about cancer screening services and obesity services
• Implement weight management program that includes meal replacement program and nutrition coaching
• Offer “Stepping On” program, which helps older people reduce falls and increase self confidence in situations where they are at risk of falling
• Offer 12-week weight management program that features comprehensive health evaluation along with detailed exercise prescription, dietary/eating suggestions, three months of fitness center membership, ongoing monitoring of health measures, mobile phone apps for recording progress, follow-up phone calls, weekly weigh-ins, and one-on-one guidance with a physical therapist to teach use of exercise equipment

Healthcare Workforce Shortages (physicians, visiting specialists, healthcare professionals)

• Increase postings on hospital’s social media sites, including Facebook, that convey vision of future healthcare delivery and present a positive message of where the hospital is going
• Form Marketing Group involving hospital, economic development, Chamber of Commerce to promote strengths of community
• Hold meeting/workshop with community members who meet with physician candidates and share a consistent, positive vision of the future of healthcare delivery in the community
• Support local student in medical school
• Prepare written and visual materials about the future medical facilities to share with physician candidates that will present the short-term and long-term vision of what future healthcare will look like
• Engage with medical school residents to encourage them to return to community to practice medicine
• Work with Center for Rural Health on physician recruitment
• Work to build stable, well-liked staff of nurse practitioners and physician assistants that includes both female and male providers
• Implement or increase use of Telehealth programs, including emergency Telehealth
• Present recruitment efforts in a better light by using professionally designed and printed marketing materials that include information about hospital services, clinic services, and community information
• Create a video to highlight the hospital’s work and community’s assets, to recruit providers as well as educate community members about available services; send it on a flash drive to prospective provider candidates and show it at the local theater prior to movies
• Apply for grant funding to assist with travel costs (airfare, hotel, etc.) associated with community visits by physicians (and their spouses) being recruited by the hospital

Financial Viability of Hospital

• Meet with stakeholders and community groups to help disseminate information and tell story of hospital’s strengths/value of to community (tourism, economic development)
• Increase promotion and marketing of current services by improving web presence, developing marketing campaign (possibly featuring patient testimonials), sponsoring weekly newspaper column, and using local electronic marquee
• Promote locally available services to discourage local residents to travel for specialty healthcare services (e.g., surgery, etc.)
• Explore alternate uses for hospital
• Implement strategy to effectively communicate with community about hospital’s challenges
• Communicate about finances and what’s behind “bad debt”
• Educate community to help people understand why sales tax is needed
• Reduce dependence on locum physicians through promotion and greater use of existing nurse practitioners and physician assistants
• Expand geographic service area by marketing new nurse practitioners and physician assistants to nearby communities

Higher Costs of Healthcare for Consumers

• Hire a Medicaid Expansion Navigator

Lack of Affordable Housing

• Partner with North Dakota Housing Finance Agency (NDHFA) to increase stock of affordable housing
• Advertise funds available from Housing Incentive Fund (HIF) administered by NDHFA
• Appeal for more federal low-income housing tax credits (LIHTCs) in oil patch
• Research zoning models in other U.S. cities for affordable housing policies and solutions

Lack of Collaboration with Community

• Increase hospital presence at community events through sponsorship of events or information booths
• Form steering committee with hospital representatives, public health, and other local healthcare providers to promote collaboration

Lack of Daycare

• Offer incentives in the form of subsidies for licensed home daycare providers
• Create babysitting online exchange through Babysitter Exchange
• Promote Child Care Aware of North Dakota as resource to find local child care centers
• Offer extended Clinic hours, in evenings and weekends, for working parents

Maintaining EMS

• Research potential funding sources to assist with first responder training
• Work with high school to encourage students to volunteer for emergency service careers
• Organize event to recruit ambulance drivers
• Explore alternate models of emergency care, such as community paramedicine

Marketing/Promotion of Hospital Services

• Announce hospital services and schedule of visiting specialists on outgoing hospital phone line and run while callers are put on hold
• Advertise clinic hours, visiting specialists on electronic signs in town (banks, community buildings)
• Create hospital Facebook page
• Distribute flyer listing services to local businesses
• Partner with area businesses to host health fair and offer free food, screenings and advertise services
• Develop professionally printed marketing materials that include information about hospital and clinic services, community information, and provider bio cards; distribute them to clients, patients, at community events, and at recruitment and health fairs
• Run advertisements in local newspaper that promote and educate the public about some of the underutilized, and sometimes unknown, services offered by hospital
• Create a video to highlight the hospital’s work and community’s assets to recruit providers as well as educate community members about available services; send it on a flash drive to prospective provider candidates and show it at the local theater prior to movies

Mental Health (including substance abuse)

• Promote national suicide hotline: 1 (800) 273 TALK (8255)
• Promote and utilize the Substance Abuse and Mental Health Services Administration as a resource
• Inventory available community services including oil companies' safety offices and conflict resolution assistance
• Develop mental health screenings in schools; research granting agencies (Gates Foundation, Robert Wood Johnson Foundation, Helmsley Foundation)
• Promote national suicide hotline
• Develop network/resources for runaways
• Increase promotion, through advertising and public relations efforts, of counseling services that currently are available, including those through Telehealth
• Collaborate with schools on educational seminars for students about mental health issues and increase interaction with school counselors
• Continue collaboration with ministerial groups, including potential training of group by social worker
• Train Emergency Room personnel on how to effectively facilitate mental health committals, transportation, and other responses, including training on paperwork and patient interactions
• Establish support groups (such as families with mental health crises, grief group) led by a social worker

Funding Alternativeseffective Curriculum Ideas Preschool

Not Enough Jobs with Livable wages

Funding Alternativeseffective Curriculum Ideas Economicas

• Promote jobs in healthcare as they tend to provide high paying jobs. Jobs.net website lists all jobs by North Dakota community
• Create a liaison between hospital and area economic or jobs development corporation to promote economic impact of healthcare jobs. North Dakota CAHs have an average economic impact of $6.4 million and contribute about 220 jobs to the community
• Start a local scholarship for health education with understanding recipient returns to the community for service for a specified period of time

Obesity & Physical Inactivity

• Create and promote community facility available for indoor walking
• Grant community access to school fitness center that includes weight and cardio equipment
• Organize adult co-ed volleyball, pickleball, and basketball leagues
• Promote availability of fitness opportunities though hospital website, cable television, post office signage, and via schools and churches
• Partner with Extension Office to plant community or school garden
• Develop community farmer’s market
• Host a 5K or 10K race (running, walking, rollerblading, biking)
• Implement comprehensive, sustainable wellness and disease management program based on improving baseline health numbers (e.g., weight, BMI, body composition, cholesterol, glucose, blood pressure) through evidence-based practices, shared medical appointments, and a health coach
• Pilot wellness programs using hospital staff with the idea, “How can you get your community healthy if your staff is not healthy?”
• Implement weight management program that includes meal replacement program and nutrition coaching
• Hold monthly cooking classes focused on better nutrition choices with take-home recipes, informational materials, and placemats; incorporate blood pressure checks and cholesterol tests into the class time
• Offer 12-week weight management program that features comprehensive health evaluation along with detailed exercise prescription, dietary/eating suggestions, three months of fitness center membership, ongoing monitoring of health measures, mobile phone apps for recording progress, follow-up phone calls, weekly weigh-ins, and one-on-one guidance with a physical therapist to teach use of exercise equipment

Sexually Transmitted Infections/Spreadable Disease

• Contact North Dakota Health Department for STD informational material and supplies
• Discuss with public health and primary care clinic how to collaborate to address the issue for the community
• Work with the local school on sex education curriculum
• Contact business community as part of worksite wellness education – include STD screenings
• Use social media to raise awareness, especially among young people, of STDs and prevention strategies

Traffic Safety & Elevated Motor Vehicle Crash Death Rate

• Sponsor defensive driving course through Highway Patrol for community members
• Partner with ND Safety Council on projects
• Promote Distracted Driving course at high school
• Reinstate SADD (Students Against Distracted/Drunk Driving) at high school
• Display wrecked vehicle during community events
• Offer Defensive Driving course with speaker's panel consisting of DUI victim and those who have been affected by drunk driving to share experience of loss and impact of loss
• Have high school student create video about distracted driving and show movie as trailer at local movie theater. Hold community contest to see who can make most effective video
• Promote public transportation on hospital's webpage

Violence

• Promote Safer Tomorrows to increase awareness on child exposure to violence
• Partner with Cut It Out: Salons Against Domestic Abuse to get training materials for hair stylists and other professionals to get employees to recognize signs of abuse
• Contact Community Violence Intervention Center (in Grand Forks) for programming ideas, education, treatment and collaborative work for peace to prevent violence