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Matthew’s Hope ProjectRichard Amason, William Carswell, Rebecca Uma Clark, Cindy Grow, Holly WardUniversity of Central FloridaAbstractThe healthcare needs of indigent uninsured individuals put a great burden on the medical resources of a community. The Matthew’s Hope Ministries, which began as a faith-based homeless shelter has evolved with the collaboration of local churches. Healthcare assistance to homeless families and individuals has begun to be developed as a part of this collaborative effort. The graduate students of the UCF College of Nursing have worked each semester since fall 2013 to help facilitate the progression of the Matthew’s Hope free medical clinic. UCF-ARNP students set goals that would identify potential framework for: community partners, funding, and the framework for a free standing clinic. Barriers and facilitators of the project are outlined, as well as an evaluation of the outcomes of this project and what could have possibly been done differently to create more success with Matthew’s Hope free medical clinic planning. keywords: Matthews Hope, homeless, barriers, healthMatthew’s Hope ProjectProblem IdentificationThere is an unmet need for medical delivery to the homeless in the city of Orlando, as evidenced by the University of Central Florida College of Nursing Community Health project in conjunction with Matthews Hope Ministries. The graduate nurse practitioner students from UCF met with Pastor Scott Billue, who founded Matthew’s Hope Ministries. The group was able to identify needs for the community project as well as set goals for this semester. This is a two part project which is directed at the development of a free standing medical clinic for homeless individuals in the greater Orlando area. Matthew’s Hope Ministries is in need of funding to support their efforts in providing free medical services to local homeless populations. The students and Pastor Scott discussed identification of community partners who may be willing to donate or contribute to the needs of Matthew’s Hope free medical clinic. Additionally, determining potential grants that may be available was another objective for meeting the financial needs for this free clinic. Lastly, establishing a framework for the development of the free clinic was also a prudent objective. Project PlanThere are many things to consider in developing a community medical clinic. The effort for starting a free standing clinic was found to be an arduous task that requires a great deal of time, effort and planning. It was important for planners to break things down into manageable parts. Resources such as the Bureau of Primary Health Care, Health Resources and Services Administration (Bureau of Primary Health Care, 2014) provide assistance for health center development.The goals of this project were a culmination of identified needs and objectives. Three key objectives were outlined for the focus goals of the project. The first objective was to identify community partners (Appendix E table 3) who may be willing to donate financially or contribute goods and/or services to Matthew’s Hope free medical clinic. The second objective was to research available grants for developing this clinic along with an outline for pertinent information for the grant application process (Appendix F table 4). The third and last objective was to identify a working framework from which the free standing clinic could work from in order to develop grant proposal writing and to receive federal and state funding (Appendix C table 1, Appendix D table 2). State and federal funds obtained for Matthew’s Hope free medical clinic are projected to supplement private donations from potential community donors.Standard lists for medical supplies are important for a number of reasons. Standard lists help in identifying priority supplies and equipment needed to prevent and treat common health problems. Standard lists improve the use of available resources by: providing a framework for budgeting, avoiding the obtaining of items that are rarely or never used, reducing duplication of items, and preventing expensive and wasteful over-stocking (Trompeter, et al., 2011). Also, standard lists help when targeting potential community donors, asking for monetary donations, and asking for specific goods and/or services in need. Identifying potential community partners that may be willing to make financial donations or provide needed goods and/or services was completed by identifying community clinicians, hospitals, and diagnostic ancillary facilities. A list comprised of area healthcare providers who may provide support was compiled. Additionally, contacts with local administrative partners for Florida Hospital Winter Garden and a private laboratory services was included. Partnering with clinicians and institutions in the community is prudent as local practitioners and medical facilities are aware of the ongoing health needs of the community. Local organizations have identified successful therapies, health strategies, and tools to improve the health and wellness of community members (Jameson et al, 2012). Community healthcare providers and organizations understand the barriers to health and wellness within their community and can often suggest practical solutions to those barriers. It is often the case that faith-based organizations, like Matthew’s Hope Ministries, are instrumental in partnering with community healthcare providers and organizations in addressing the unmet healthcare needs of homeless populations (Taylor, Buckner, Walker, Blumenthal, 2011). Additionally, faith-based community healthcare provides unique learning and collaborative opportunities for students at various levels of education.Funding for this project was identified in part through section 330 (h) of the Public Service Act. This is a federal legislation which authorizes federal funding for community health centers serving medically underserved homeless adults, families and children. The Health Resources and Services Administration and the Bureau of Primary Health Care are federal resources which have published guidelines for the development of medical clinics for underserved populations (U.S. Department of Health and Human Services, n.d.). An outline of suggestions based on federal publications is included for the development of this free medical clinic service to the community.Literature ReviewCommunity PartnersThe partnership of faith-based organizations and community healthcare providers to administer quality healthcare for all those in need is necessary to maximize the health and wellness of the entire community. A literature review began with an inquiry of databases within the subject of nursing. A basic search in the subject area yielded published literature in journals from the databases CINAHL, Academic Search Premier, Cochrane Database of Systematic Reviews, and Health Source: Nursing/Academic Edition. These databases were searched for articles with combinations of relevant key words and phrases. There were three articles which were identified that provided supportive literature regarding the importance of community partnership and faith-based organizations for successful delivery healthcare. One of the resources outlined the importance of faith-based organizations in conjunction with community healthcare partners for improvements in the health outcomes for people with anxiety (Jameson et al., 2012). The research concluded that the development of a cohesive partnership between academic institutions, faith-based organizations, and community stakeholders, can effectively address barriers of those in need and successfully treat anxiety morbidities. Taylor, Buckner, Walker, & Blumenthal (2011) identified the importance of faith-based organizations, academic institutions, and community partners working collaboratively to meet the health needs of indigent community members. Furthermore, the authors highlighted the significance of faith-based organizations in addressing the health promotion needs of individuals within the community. This model of health promotion is a useful tool for student clinicians interested in public health and wellness. Understanding the needs and barriers to health is a key component for faith-based clinics, clinicians and healthcare organizations which provide services to those in need. The barriers are multifaceted and vary from patient to patient and from one circumstance to another. Duffy (2006) looked at the patient’s experience in a free clinic setting and identified unique patient barriers along with clinician perspectives. The study concluded that clinicians must be able to identify patient stressors and hardships in order to provide patient-centered care. Creating a trusting, respectful, and caring relationship in a free medical clinic facilitates successful health promotion, treatments for illnesses, and maximum wellness among patients. Grant OpportunitiesWhen reviewing grant opportunities for the development of free medical clinics, it became apparent that federal grants pertaining to this area are challenging to obtain due to the complicated list of requirements and the application process. Gibbs & Gibbs (2010) explains that federal grant applications for free medical clinics are long and complex, and that much of each dollar awarded is spent in reporting requirements. The other challenge when looking for funding is that there are numerous nonprofit organizations also trying to obtain money; so competition is high. To improve the chances of obtaining a grant, it is important to be able to show evidence of support from the community members, including local healthcare providers, hospitals, citizens, and political leaders (Gibbs & Gibbs, 2010). Upon comprehensive search for any potential funding opportunities, there was a major deficit of grants to be found. Most grants listed on websites, such as and grants, have very specific requirements that are not applicable to the goals of Matthew’s Hope Ministries. The complexity of finding funding for a free medical clinic is overwhelming and challenging. Grant opportunities are continuously coming and going based on funds allotted by each organization, so frequently checking on what is available is necessary in order to meet application deadlines. The results of our search for grants are outlined below. The first grant opportunity identified was the Street Outreach Program. This program focuses on providing services to homeless youth in an attempt to increase their safety, well-being, and self-sufficiency (U.S. Department of Health and Human Services, 2014). Grantees are required to develop and implement their programs using a positive youth development (PYD) approach. PYD is a comprehensive framework outlining the supports all young people need to be successful. The program environment should be caring and supportive, have high expectations for young people, and offer youth the opportunity to develop positive relationships and connections with adults, peers, and the larger community (U.S. Department of Health and Human Services, 2014). Grantees must also be able to guarantee runaway, homeless, and street youth access to an age-appropriate emergency shelter 24 hours a day,?including host homes (U.S. Department of Health and Human Services, 2014).Program activities that are suggested include contacting runaway, homeless, or street youth through street-based or site-based outreach, and providing information on employment, job readiness, and support services at the local, state, and federal levels. Additional suggestions include offering education, prevention, and access to intervention services on issues related to domestic violence, sexual abuse, or the exploitation runaway, homeless, and street?youth. Responding to the immediate needs of youth in crisis, including food, clothing, emergency shelter, survival aid, treatment, counseling, individual assessments, and follow-up support or aftercare are suggested. Program goals should be clearly directed at helping youth exit the street and achieve safe, stable living arrangements (U.S. Department of Health and Human Services, 2014). The application deadline for this program is May 12, 2014. Once the applying organization registers with the website, they can apply for any of the many grants available.The second funding opportunity found was from the American Medical Association (AMA) Foundation. The AMA (2014b) is helping to support non-profit clinics which bring together physicians, health care professionals, and other community volunteers to offer free or low cost health care to low-income, uninsured and under-insured people. The AMA website explains that clinic funding is generally raised at the local level as there is little, if any, government funding or support (AMA, 2014b). The AMA (2014b) reports that in a recent AmeriCares survey, 89% of the nation’s free clinics reported a steady rise in patient visits within the past three years. That increase raised the demand on resources resulting in resource?constraints that have forced 56% of these clinics to turn away eligible patients (American Medical Association, 2014a). Responding?to this critical need, the AMA Foundation is offering awards of $10,000-$25,000 grants to physician-led free clinics (AMA, 2014a). The deadlines are yet to be posted for this program, but it does say that sometime within April more information will be posted in regards to application due dates. The AMA website also provides guidelines on how to request funding from their foundation, which gives tips for a successful chance at acceptance. Lastly, the Health Resources and Services Administration (HRSA) allocates grant funds for local health centers. The HRSA website explains that a clinic is classified as either a health center (receives section 330 funding) or a look-alike health center (does not receive section 330 funding). One type of available grant is the New Access Points Grants, which provide funding to support new service delivery sites. This pertains to health centers that will offer comprehensive primary health care and access to oral and mental health services. Applicants can be existing grantees or new organizations that do not currently receive section 330 grant funds (Health Resources and Services Administration, n.d., b.). When looking over the requirements for this federal grant, there are many specific conditions and stipulations that may not be possible for the Matthew’s Hope Project to meet. For example, the health center must have admitting privileges at a local hospital to ensure continuity of care, have after hours coverage for medical emergencies, and must be able to provide all required primary and preventive health services needed by the population served (Health Resources and Services Administration, n.d., b). This may not be attainable with a volunteer medical staff. Clinic Framework According to Suk (2012), sovereign immunity was originally defined as absolute immunity from lawsuits in favor of the sovereign, which was historically the government. This is not a blanket protection and negligence can still be found in the areas of duty, breach, causation, and harm. Generally speaking, when the government is at the planning level such as in denying admission to a hospital, the government is immune. However, at the operation level, once the patient is admitted to a hospital "reasonable care" must be carried out. Reasonable care is a concept of tort/negligence law. The Federal Claims Tort Act allows for parties to sue either the individual, the health provider or the government. The State of Florida lists itself as the defendant for medical malpractice cases in lieu of the physician. This is as long as providers are agents of indigent county hospitals, teaching hospitals owned by the state, and state medical schools acting in such locations. An extension of Florida's own sovereign immunity specifications is Florida Department of Health's Volunteer Health Services Program (VHSP). According to Geletko, Beitsch, Lundberg, & Brooks (2009), the VHSP was established in 1992 when Florida legislature passed the Access to Health Care Act. The Act allows licensed professionals to donate their services to free standing clinics or see patients in their own private facilities. It gives these providers the same Sovereign Immunity benefits as State of Florida healthcare workers. The health needs of the homeless population places a strain on the medical resources of the community in urban populations. Literature review was conducted on the subject of creating a free medical clinic for the urban homeless. Gurfel, Lund & Gundlapalli (2009) found that the creation of a free medical clinic to provide health care for urban homeless populations presents a significant challenge. Homeless individuals experience 8 to 9 concurrent medical illnesses and a reduced life expectancy compared to the average population. Homeless patients tend to present with a higher acuity of disease with subsequent longer hospital stays resulting in higher medical costs. These issues are due to barriers to health care access including lack of insurance, lack of providers, and lack of access to resources such as transportation, access to medications and proper nutrition (Gurgel, Lund, & Gundlapalli, 2009). Many of our homeless veterans are additionally impacted by unmet medical delivery in urban areas. Gordon et al. (2010) found that homeless veterans have at least one medical as well as one psychiatric problem or are concurrently alcohol dependent, and are more likely to be homeless longer than their counterparts. An example of homeless population health disparities was studied in a cohort of 504 homeless patients who presented to EDs with community acquired pneumonia (CAP). Hospitalization risk was higher than among non homeless patients. Homeless patients often present with ongoing alcohol, substance abuse, and tobacco use to a greater degree than non-homeless populations. These lifestyle factors were shown to contribute to higher admission rates in the case of CAP (Jones et al., 2013).A pilot substance abuse harm reduction model called the Prenatal Addiction Treatment Clinic of Hawaii was built to investigate the usefulness of homeless outreach services to methamphetamine addicted pregnant women. This study reported that prior to these clinic services, over 50% of the women had lost custody of their infants due to substance abuse. Over the 3 year study, greater than 90% of the women who had participated retained custody of the infants and those that maintained custody chose long-acting contraception while those that lost custody had a greater than 50% rate of repeat pregnancy within 9 months of post-delivery (Write, 2012). This study as well as others in this literature review shows the value of homeless outreach services and free faith based clinics in the community by evidence of peer review and research based statistical data. Community Assessment EffortsCommunity PartnersObtained current list of healthcare providers and facilities in and near the Winter Garden area.Phoned several contacts listed to introduce Matthew’s Hope Project. Grant OpportunitiesResearched extensively the process involved with grant applications.Researched for funding opportunities available.Clinic Framework1. Created medical supply list needs with administrative frame work flow-diagram.2. Obtained Sovereign Immunity application for free standing clinic along with potential direction for future goals of this outreach project.Analysis of Assessment Data:Identification of Barriers and Facilitators of the Project Community PartnersObtaining contact information for healthcare providers and facilities from the Winter Garden Chamber of Commerce was a reasonable task. However, initiating successful contact with providers and facilities is both time consuming and frustrating. Barriers to making influential contact with both potential and interested community partners are many. First, when phoning potential community partners, speaking with someone who will allow time and forward information to the stakeholders is difficult. Also, healthcare providers and facilities did not return phone calls in a timely manner. This process requires persistent dedication to making contact and providing the appropriate information to the decision makers. Facilitators to identifying potential community partners are organizations like the chamber of commerce. Grant OpportunitiesMany barriers to finding funding for a free medical clinic were encountered. There is an extensive amount of fine print that must be read for each offered grant, which is time consuming. In addition, the application process is laborious and quite complex. Federal grants are the worst offenders in relation to this. To understand what is needed to apply for a grant, one must go through page after page of information to pick out what is important. Also, grant opportunities fluctuate on a constant basis so one must be vigilant in searching for available grants weekly. In conclusion, much devotion is needed just for finding funding for opening and running a free clinic. This omits the hard work required to find volunteers, obtain equipment and an operable site, and create a budget that is sustainable. Clinic FrameworkThere are no clear, cut and dry guidelines for development of a free community homeless health clinic. There are a myriad of ways to go about obtaining resources, identifying community needs and goals, and establishing administrative and clinical framework for the execution of the free standing community health clinic. Creating a free health clinic to meet community needs is truly a community partnership that evolves through what the community needs, in this case homeless individuals of the City of Orlando, and partnerships developed within the community. Additionally, lack of malpractice protection was a strong barrier for providers who would otherwise donate their time to provide care. Development of partnerships and framework evolves with extensive time and effort. In order to establish the working structure of a volunteer based clinic these partnerships will need to be established alongside funding and infrastructure development. They all connect and depend on the other and work hand in hand. Evaluation and Analysis of Outcomes of Project What Would be Changed if Done in the Future Delivery of access to health care must be developed with careful planning and organization. It is much easier to build a house with a blueprint in hand rather than getting one or two measurements here and there as you go along. In this case we have begun to develop a blue print for which Pastor Scott can start to build Matthew’s Hope Ministry’s free medical clinic upon.We have concluded that opening a free medical clinic is a much more daunting task than originally thought. It would require full-time effort from a group of dedicated professionals to get established and obtain needed funding. Based on the information received from Pastor Scott, we do not think he has what would be necessary to accomplish this task at this time. We feel it may be a better option at this point for Matthew’s Hope Ministries to continue to provide individual health services to the local population on an as needed basis and with current available resources, with the goal of possibly opening a free clinic in the future. Reaching out to other local community resources such as hospitals, health centers, and other local health providers can be useful in collaborating to help the homeless and underserved population. Going forward, research and development of Mathew’s Hope Ministries free medical clinic should include pursuing the potential partnership with Florida Hospital Winter Garden and encouraging the continued partnership and support from UCF College of Nursing. Contact person Darlene Hilkert was identified as Volunteer Health Services Staff Coordinator for Region 5 of Florida (D. Hilkert, personal communication April 11, 2014). Darlene offered sovereign immunity questionnaire materials as direction for Matthew's Hope. Darlene also directed us towards the Florida Free Clinic Association which would have an assembly in Central Florida. Additionally, we encourage Matthew’s Hope Ministries to continue communications with Mark Cruise, Interim Executive Director of the Florida Association of Free and Charitable Clinics to find out further information about the up and coming 2-day workshop this fall regarding how to start of free standing clinic from the ground up ReferencesAmerican Medical Association (2014a). Guidelines to request funding from the AMA foundation. Retrieved from American Medical Association (2014b). Healthy communities/healthy America. Retrieved from of Primary Health Care (2014). Grants. Retrieved from, Duffy, P. (2006). Holes in the health care safety net: Voices of the underserved. Journal Of Physical Therapy Education, 20(3), 67-72.Florida Department of Health (2014). Volunteer health services staff directory. Retrieved April 15th, 2014. Geletko, K., Beitsch, L., Lundberg, M., & Brooks, R. (2009). Reducing the impact of the health care access crisis through volunteerism: A means, not an end. American Journal of Public Health, 99(7), 1166-1169. Gibbs, R. D., & Gibbs, P. H. (2010). Free clinics. Archives of Internal Medicine, 170(11), 953-954.Gordon, A., Haas, G., Luther, J., Hilton, M., & Goldstein, G. (2010). Personal, medical, and healthcare utilization among homeless veterans served by metropolitan and nonmetropolitan veteran facilities.?Psychological Services,?7(2), 65-74.Gurgel, R., Lund, G., & Gundlapalli, A. (2009). Role of otolaryngologists in health care for the homeless.?Annals Of Otology, Rhinology & Laryngology, 118(7), 471-474.Health Resources and Services Administration (n.d., a). How to apply. Retrieved from Resources and Services Administration (n.d., b). Program requirements. Retrieved from , J., Shrestha, S., Escamilla, M., Clark, S., Wilson, N., Kunik, M., & Stanley, M. (2012). Establishing community partnerships to support late-life anxiety research: Lessons learned from the calmer life project. Aging & Mental Health, 16(7), 874-883. doi:10.1080/13607863.2012.660621Jones B, Gundlapalli A, Jones J, Brown S, Dean N. (2013). Admission decisions and outcomes of community-acquired pneumonia in the homeless population: A review of 172 patients in an urban setting.?American Journal Of Public Health 103(2), 289-293.National Association of Free and Charitable Clinics (n.d.). State/regional associations. Retrieved from Taylor, B. D., Buckner, A. V., Walker, C., & Blumenthal, D. S. (2011). Faith-based partnerships in graduate medical education: The experience of the Morehouse School of Medicine Public Health/Preventive Medicine residency program. American Journal of Preventive Medicine, 41(4, Suppl. 3), S283-S289.Trompeter, T., Bright, J., Peoples, B., Rossel, S., Byrnes, P., Mitchem, F., Shea, J., Byrnes, P., & Hirschfeld, J. (2011). So you want to start a health center: A practical guide for starting a federally qualified health center. National Association of Community Health Centers. Retrieved from, %20Manual-September%202011.pdf U.S. Department of Health and Human Services (n.d.). Starting a rural clinic: A how-to manual health resources and services administration, Office of Rural Health Policy with the National Association of Rural Health Clinics. Retrieved from, U.S. Department of Health and Human Services (2014). Street Outreach Program. Retrieved from , T.E., Schuetter, R., Fombonne, E., Stephenson, J., & Haning, W.F. (2012). Implementation and evaluation of a harm-reduction model for clinical care of substance using pregnant women. Harm Reduction Journal.Appendix A Copy of Signed Contract by NP StudentsAppendix B Copy of Signed Contract by Pastor ScottAppendix C Medical Needs ListTable 1Start Up Medical Clinic Needs List Matthew’s Hope Ministries Medical ClinicEquipment2 exam tablesStanding exam light2 otoscopes with interchangeable ophthalmoscope heads2 manual BP machines2 stethoscopes2 portable pulse oximeters2 glucometers2 digital type thermometers1 privacy screen2 ambu bags with adult and pediatric size interchangeable face masksHeight and weight scaleMedical supplies needed for clinicBoxes of alcohol swabsBoxes of disposable latex free gloves ( small, med and lg)BandaidsGauze bandages and wrapMedical tape (reg. and paper)Ace bandagesTongue depressorsLancets and strips for glucometersRolls of paper for exam tablesHospital approved hand sanitizerHospital approved hand soapMedical type disinfectant wipesIodine, hydrogen peroxide, rubbing alcohol, sterile salinePaper exam gownsBiohazard waste receptacles and sharps disposal containersSpecialized equipment and servicesChemical examinations of urine Blood sugar Pregnancy test Specialized physician services Specialized diagnostic and laboratory services Interpreter for foreign language if indicated Interpreter for deaf and devices to assist communication with blind patientsPaper/charting suppliesHanging filesFoldersPatient Health Records - Each clinic must maintain an accurate and up-to-date record keeping system that ensures patient confidentiality. A description of the Clinic’s system must be included in a policy and procedures manual. Clinic staff must be involved in the development of this record keeping system. All medical records must also be compliant with the HIPAA privacy laws.Records must include the following information: ? Identification data ? Physical exam findings ? Social data ? Consent forms ? Health status assessment ? Physicians orders ? Consultative findings ? Diagnostic and laboratory reports ? Medical history ? Signatures of the physician or other health care professionals (Trompeter, et al., 2011) (U.S. Department of Health and Human Services, n.d.)Appendix D Clinic Framework Flow ChartTable 2.Matthew’s Hope Administrative Guide Flow Chart“There is no “one true path” to establishing a successful health center”—National Association of Community Health Centers(Trompter, et al., 2011) (U.S. Department of Health and Human Services, n.d.)Appendix E Potential Community PartnersPotential Community Partners/DonorsTable 3PREPARED 3/27/14,10:30:39 LICENSE ACTIVITY REPORT BY BUSINESS NAME PAGE 1City of Winter Garden ALL LICENSES FOR YEAR: 2014 BETWEEN: 00/00/00 TO 99/99/99PROGRAM OL122L DEPT: CITY CLERK OFFICE (FIXED) CLASS: PHYSICIAN, EACH INDIVIDUAL------------------------------------------------------------------------------------------------------------------------------------LIC # BUSINESS NAME ISSUED TYPE CLASSIFICATION BUSINESS ADDRESS OWNER NAME & ADDRESS BUS PHONE #------------------------------------------------------------------------------------------------------------------------------------PHYSICIANS:14-00005902 ALL ABOUT KIDS PEDIATRICS 9/26/13 RNW PHYSICIAN, EACH INDIVIDUAL 4020 WINTER GDN VINELAND RD 407-354-0717 WINTER GARDEN FL 3478714-00005907 ARMANDO GARCIA M.D. 9/26/13 RNW PHYSICIAN, EACH INDIVIDUAL 4020 WINTER GDN VINELAND RD GARCIA, ARMANDO 407-354-0717 WINTER GARDEN FL 34787 13136 HEATHER MOSS DR, APT 418, ORLANDO FL 3283714-00004020 ARSLANIAN, EDWARD J 8/14/13 RNW PHYSICIAN, EACH INDIVIDUAL 1080 S DILLARD ST EDWARD J ARSLANIAN, MD 407-615-9360 WINTER GARDEN FL 34787 5945 HIDDEN BEACH CIRCLE, NEW JERSEY DRIVERS LICENSE, ORLANDO FL 3281914-00005848 BOGDANY, RICA S M.D. 10/01/13 RNW PHYSICIAN, EACH INDIVIDUAL 505 S DILLARD ST BOGDANY, RICA S 407-654-7276 WINTER GARDEN FL 34787 427 KASSIK CIR, ORLANDO FL 3282414-00005613 CAPPLEMAN, JOHN MD 9/23/13 RNW PHYSICIAN, EACH INDIVIDUAL 436 N DILLARD ST 407-521-3500 WINTER GARDEN FL 3478714-00007180 CELEBRITY MEDICAL SPA LLC 8/09/13 RNW PHYSICIAN, EACH INDIVIDUAL 36 S MAIN ST ELDAR BAIGABATOV 407-865-3588 WINTER GARDEN FL 34787 171 LAKEVIEW RESERVE BLVD, WINTER GARDEN FL 3478714-00007359 CELEBRITY MEDICAL SPA LLC 8/09/13 RNW PHYSICIAN, EACH INDIVIDUAL 36 S MAIN ST ELDAR BAIGABATOV 407-865-3588 WINTER GARDEN FL 34787 171 LAKEVIEW RESERVE BLVD, WINTER GARDEN FL 3478714-00003611 CHOKSHI, DIGESH, MD PA 8/23/13 RNW PHYSICIAN, EACH INDIVIDUAL 1002 S DILLARD ST S 122 DIGESH CHOKSHI 407-656-4222 WINTER GARDEN FL 34787 5402 BLUE TICK CIR, ORLANDO FL 3281014-00007881 CHOKSHI, DIGESH, MD PA 3/20/14 TRN PHYSICIAN, EACH INDIVIDUAL 1002 S DILLARD ST S 122 DIGESH CHOKSHI 407-656-4222 WINTER GARDEN FL 34787 5402 BLUE TICK CIR, ORLANDO FL 3281014-00005903 DAVID DUANY M.D. 9/26/13 RNW PHYSICIAN, EACH INDIVIDUAL 4020 WINTER GDN VINELAND RD DUANY, DAVID M 407-354-0717 WINTER GARDEN FL 34787 8106 TIBET BUTLER DR, WINDERMERE FL 3478614-00004017 DESAI, VIVEK S 9/11/13 RNW PHYSICIAN, EACH INDIVIDUAL 13750 W COLONIAL DR S 250 VIVEK DESAI 407-398-6470 WINTER GARDEN FL 34787 8924 SOUTHERN BREEZE DR, ORLANDO FL 3283614-00007353 FHMG FAMILY MEDICINE AT FOWLER 8/08/13 RNW PHYSICIAN, EACH INDIVIDUAL 3131 DANIELS RD S 106 407-877-0616 WINTER GARDEN FL 3478714-00007354 FHMG FAMILY MEDICINE AT FOWLER 8/08/13 RNW PHYSICIAN, EACH INDIVIDUAL 3131 DANIELS RD S 106 407-877-0616 WINTER GARDEN FL 3478714-00005994 FIELDS, ANGELA L, M.D. 9/26/13 RNW PHYSICIAN, EACH INDIVIDUAL 4020 WINTER GDN VINELAND RD FIELDS, ANGELA L 407-354-0717 WINTER GARDEN FL 34787 11446 JASPER KAY TERRACE #1013, WINDERMERE FL 3478614-00007625 FLORIDA WOMAN CARE 8/12/13 NEW PHYSICIAN, EACH INDIVIDUAL 4048 WINTER GDN VINELAND RD 407-339-2229 WINTER GARDEN FL 3478714-00005558 J MICHAEL HAM-YING, MD 8/23/13 RNW PHYSICIAN, EACH INDIVIDUAL 13275 W COLONIAL DR J MICHAEL HAM-YING 407-877-4340 WINTER GARDEN FL 34787 8724 SOUTHERN BREEZE DR, ORLANDO FL 3283614-00007876 J MICHAEL HAM-YING, MD 3/18/14 TRN PHYSICIAN, EACH INDIVIDUAL 13275 W COLONIAL DR J MICHAEL HAM-YING 407-877-4340 WINTER GARDEN FL 34787 8724 SOUTHERN BREEZE DR, ORLANDO FL 3283614-00000302 KHOUZAM, NAGUI N, MD PA 7/31/13 RNW PHYSICIAN, EACH INDIVIDUAL 54 E PLANT ST NAGUI N KHOUZAM 407-656-4549 WINTER GARDEN FL 3478714-00007297 KID MD PEDIATRICS, LLC 9/17/13 RNW PHYSICIAN, EACH INDIVIDUAL 13848 TILDEN RD S 230 407-697-8500 WINTER GARDEN FL 3478714-00007126 MOHAMMAD H GHARAVI, MD 8/12/13 RNW PHYSICIAN, EACH INDIVIDUAL 13650 W COLONIAL DR S100 407-905-0012 WINTER GARDEN FL 3478714-00006241 OBSTETRICS AND GYNECOLOGY ASSC 8/05/13 RNW PHYSICIAN, EACH INDIVIDUAL 4048 WINTER GDN VINELAND RD DR DOUGLAS G WINGER M.D. 407-846-7200 WINTER GARDEN FL 34787 4048 WINTER GDN VINELAND RD, WINTER GARDEN FL 3478714-00006242 OBSTETRICS AND GYNECOLOGY ASSO 8/05/13 RNW PHYSICIAN, EACH INDIVIDUAL 4048 WINTER GDN VINELAND RD JUAN REINSOS M.D. 407-846-7200 WINTER GARDEN FL 34787 4048 WINTER GDN VINELAND RD, WINTER GARDEN FL 3478714-00004018 OTEGBEYE, AYODEJI B 9/11/13 RNW PHYSICIAN, EACH INDIVIDUAL 13750 W COLONIAL DR S 250 AYODEJI OTEBEYE 407-398-6470 WINTER GARDEN FL 34787 511 SYLVAN DR, WINTER PARK FL 3278914-00007806 PHYSICIAN ASSOCIATES, LLC 1/03/14 NEW PHYSICIAN, EACH INDIVIDUAL 3724 WINTER GDN VINELAND RD PHYSICIAN ASSOCIATES, LLC 407-654-2727 WINTER GARDEN FL 34787 235 N. WESTMONTE DRIVE, ATTN: LIZ, ALTAMONTE SPRINGS FL 3271414-00004016 SOREMI, OLUDAPO F 9/11/13 RNW PHYSICIAN, EACH INDIVIDUAL 13750 W COLONIAL DR S 250 OLUPADO SHOREMI 407-398-6470 WINTER GARDEN FL 34787 1349 BALLENTYNE PLACE, APOPKA FL 3270314-00006261 SUE ANN FRANCISCO M.D. 9/26/13 RNW PHYSICIAN, EACH INDIVIDUAL 4020 WINTER GDN VINELAND RD SUE ANN FRANCISCO M.D. 407-354-0714 WINTER GARDEN FL 34787 8500 COMMODITY DR, ORLANDO FL 3281914-00003652 UNIVERSAL SLEEP DISORDER 8/12/13 RNW PHYSICIAN, EACH INDIVIDUAL 884 S DILLARD ST HARBINDER GHULLDU 407-903-9399 WINTER GARDEN FL 34787 7758 WALLACE RD #D, ORLANDO FL 3281914-00007587 WEST ORANGE FAMILY MEDICAL 9/06/13 RNW PHYSICIAN, EACH INDIVIDUAL 1002 S DILLARD ST S 102 MICHAEL MERCADO 407-877-3577 WINTER GARDEN FL 34787 2218 BUTLER BAY DR N, WINDERMERE FL 3478614-00007690 WINTER GARDEN CHILDREN'S HEALT 9/24/13 NEW PHYSICIAN, EACH INDIVIDUAL 13275 W COLONIAL DR C. SORRELL, PA-C 407-905-8827 WINTER GARDEN FL 3478714-00007692 WINTER GARDEN CHILDREN'S HEALT 9/24/13 NEW PHYSICIAN, EACH INDIVIDUAL 13275 W COLONIAL DR C. SORRELL, PA-C 407-905-8827 WINTER GARDEN FL 3478714-00007871 WINTER GARDEN CHILDREN'S HEALT 3/18/14 TRN PHYSICIAN, EACH INDIVIDUAL 13275 W COLONIAL DR C. SORRELL, PA-C 407-905-8827 WINTER GARDEN FL 3478714-00007873 WINTER GARDEN CHILDREN'S HEALT 3/18/14 TRN PHYSICIAN, EACH INDIVIDUAL 13275 W COLONIAL DR C. SORRELL, PA-C 407-905-8827 WINTER GARDEN FL 3478714-00005822 WINTER GARDEN DIALYSIS 8/15/13 RNW PHYSICIAN, EACH INDIVIDUAL 1222 WINTER GDN VINELAND RD 10 SOUTH CENTRAL FL DIALYSIS PRTN 407-877-0364 WINTER GARDEN FL 34787 CONTACT: BRIDGET CUFFIE, 5200 VIRGINIA WAY, BRENTWOOD TN 3702714-00007788 WINTER GARDEN FAMILY HEALTHCTR 12/06/13 NEW PHYSICIAN, EACH INDIVIDUAL 13275 W COLONIAL DR MARK FREEMAN - CEO 407-877-4300 WINTER GARDEN FL 34787 P.O. BOX 1249, APOPKA FL 3270314-00007798 WINTER GARDEN FAMILY HEALTHCTR 12/20/13 NEW PHYSICIAN, EACH INDIVIDUAL 13275 W COLONIAL DR MARK FREEMAN - CEO 407-877-4300 WINTER GARDEN FL 34787 P.O. BOX 1249, APOPKA FL 3270314-00007874 WINTER GARDEN FAMILY HEALTHCTR 3/18/14 TRN PHYSICIAN, EACH INDIVIDUAL 13275 W COLONIAL DR MARK FREEMAN - CEO 407-877-4300 WINTER GARDEN FL 34787 P.O. BOX 1249, APOPKA FL 3270314-00007879 WINTER GARDEN FAMILY HEALTHCTR 3/18/14 TRN PHYSICIAN, EACH INDIVIDUAL 13275 W COLONIAL DR MARK FREEMAN - CEO 407-877-4300_________________________________________________________________________________________________________________________________________NURSES:14-00007696 INTUITIVE RECONNECTIONS 9/25/13 NEW NURSES 314 E PLANT ST A-107 504-247-2310 WINTER GARDEN FL 3478714-00007423 WEST ORANGE FAMILY MEDICAL 9/06/13 RNW NURSES 1002 S DILLARD ST S 102 MICHAEL MERCADO 407-877-3577 WINTER GARDEN FL 34787 14-00007691 WINTER GARDEN CHILDREN'S HEALT 9/24/13 NEW NURSES 13275 W COLONIAL DR C. SORRELL, PA-C 407-905-8827 WINTER GARDEN FL 3478714-00007872 WINTER GARDEN CHILDREN'S HEALT 3/18/14 TRN NURSES 13275 W COLONIAL DR C. SORRELL, PA-C 407-905-8827 WINTER GARDEN FL 3478714-00007095 WINTER GARDEN FAMILY HEALTHCTR 8/23/13 RNW NURSES 13275 W COLONIAL DR MARK FREEMAN - CEO 407-877-4300 WINTER GARDEN FL 34787 P.O. BOX 1249, APOPKA FL 3270314-00007875 WINTER GARDEN FAMILY HEALTHCTR 3/18/14 TRN NURSES 13275 W COLONIAL DR MARK FREEMAN - CEO 407-877-4300 WINTER GARDEN FL 34787 P.O. BOX 1249, APOPKA FL 32703________________________________________________________________________________________________________________________________FACILITIES:14-00007579 ADVENTIST HEALTH SYSTEMS/ SUNB 8/19/13 RNW SERVICES: MISCELLANEOUS 15502 STONEYBROOK WEST PKWY S WINTER GARDEN FL 3478714-00004967 AGE ADVANTAGE DBA OF 8/06/13 RNW SERVICES: MISCELLANEOUS 525 W PLANT ST JENNIFER CAMPBELL 407-347-2050 WINTER GARDEN FL 34787 237 ZACHARY WADE ST., WINTER GARDEN FL 3478714-00006888 ALLEYCAT'S PET SERVICE 8/20/13 RNW SERVICES: MISCELLANEOUS 313 LAKE AMBERLEIGH DR 407-401-3382 WINTER GARDEN FL 3478714-00007404 ALOHA FAMILY DENTAL 7/31/13 RNW SERVICES: MISCELLANEOUS 15505 STONEYBROOK WEST PKWY S 407-656-6555 WINTER GARDEN FL 3478714-00002170 CENTRAL FL KIDNEY CENTERS INC 8/01/13 RNW SERVICES: MISCELLANEOUS 741 S DILLARD ST KERRY M KELLY 407-843-6110 WINTER GARDEN FL 34787 918 OSCEOLA AVE, ORLANDO FL 3280614-00003504 CVS/PHARMACY #1820 9/20/13 RNW SERVICES: MISCELLANEOUS 13697 W COLONIAL DR STEPHEN MURPHY WINTER GARDEN FL 34787 CVS EGL COLONIAL WINTER GDN FL, LLC - LICENSING DEPT-1 CVS DR, WOONSOCKET RI 0289514-00007821 DEAF TALK, LLC 1/27/14 NEW SERVICES: MISCELLANEOUS 641 LAKE COVE POINTE CIR 407-233-0889 WINTER GARDEN FL 3478714-00007288 DILLARD STREET DENTAL 8/09/13 RNW SERVICES: MISCELLANEOUS 516 S DILLARD ST 407-656-3334 WINTER GARDEN FL 3478714-00007352 FHMG FAMILY MEDICINE AT FOWLER 8/08/13 RNW SERVICES: MISCELLANEOUS 3131 DANIELS RD S 106 407-877-0616 WINTER GARDEN FL 3478714-00007623 FLORIDA WOMAN CARE 8/12/13 NEW SERVICES: MISCELLANEOUS 4048 WINTER GDN VINELAND RD 407-339-2229 WINTER GARDEN FL 3478714-00007702 INTEGRATED CHIROPRACTIC HEALTH 9/27/13 NEW SERVICES: MISCELLANEOUS 1023 S DILLARD ST 407-347-5953 WINTER GARDEN FL 3478714-00007298 KID MD PEDIATRICS, LLC 9/17/13 RNW SERVICES: MISCELLANEOUS 13848 TILDEN RD S 230 407-697-8500 WINTER GARDEN FL 3478714-00007673 LITTLE LIFE IMAGING LLC 9/11/13 RNW SERVICES: MISCELLANEOUS 213 S DILLARD ST 110-A PENELOPE CARLENE WICHER 407-892-1059 WINTER GARDEN FL 34787 1800 CHERRYWOOD CT, ST CLOUD FL 3476914-00007480 PLANT STREET ACUPUNCTURE, INC. 9/03/13 RNW SERVICES: MISCELLANEOUS 314 E PLANT ST A-101 407-608-2600 WINTER GARDEN FL 3478714-00007342 PRECISION MEDICAL GROUP LLC 9/09/13 RNW SERVICES: MISCELLANEOUS 13650 W COLONIAL DR S150A 407-614-2630 WINTER GARDEN FL 3478714-00007679 SENIORS HELPING SENIORS 9/16/13 NEW SERVICES: MISCELLANEOUS 14011 FOX GLOVE ST 407-429-4913 WINTER GARDEN FL 3478714-00005791 VITRECTOMY RECOVERY SOLUTIONS 8/01/13 RNW SERVICES: MISCELLANEOUS 15227 STARLEIGH RD 407-656-8892 WINTER GARDEN FL 3478714-00007772 WINTER GARDEN BODY CONTOURING 11/13/13 NEW SERVICES: MISCELLANEOUS 16 E JOINER ST JOHANNA ROSALY NUNES MONTANEZ 407-792-8463 WINTER GARDEN FL 34787 1309 VIC KAY CT, WINTER GARDEN FL 3478714-00007693 WINTER GARDEN CHILDREN'S HEALT 9/24/13 NEW SERVICES: MISCELLANEOUS 13275 W COLONIAL DR C. SORRELL, PA-C 407-905-8827 WINTER GARDEN FL 34787HospitalFlorida Hospital Winter GardenEstimated date of opening: Emergency department and outpatient imaging is 2014, The second and third floor will be future outpatient surgery centers expected to open in 2015.Contact: Administrator: Amanda Maggard Email: amanda.maggard@Independent LaboratoryAny Lab Test Now11867 E. Colonial Dr.?Orlando, FL 32826Phone: (407) 737-8378Contact: Sherry Freitag Email: sfreitag@Appendix F Grant ResourcesTable 4Health Resources and Service Administration- Resources and Service Administration- American Medical Association Foundation- Abuse and Mental Health Services Administration- Kresge Foundation- Primary Care Association- for Children and Families (Street Outreach Program)- Medical Women’s Association- . Department of Housing and Urban Development- (Homeless Grants)- (Community Service Grants)- . Department of Health and Human Services- Coalition for Homeless Veterans- . Department of Veteran Affairs- G: Contact for Free Clinic ServicesContact information for Darlene HilkertDarlene HilkertVolunteer Health Services Staff Coordinator, Region 5 (Orange County)P.O. Box 592127Orlando, FL 32859(407) 249-4704, C (407) 516-7736Fax (407) 583-5188Darlene_Hilkert@doh.state.fl.usContact for information for Mark Cruise: Florida Association of Free ClinicsMark CruiseInterim Executive Director of the Florida Association of Free and Charitable Clinics 8095 NW 12th Street, Suite 300Doral, FL 33126Phone: (305) 592-1452 ext. 101Fax: (305) 592-0589mark@(Florida Department of Health, 2014) (National Association of Free and Charitable Clinics, n.d.) Appendix H: Sovereign Immunity Application ................
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