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Mecosta County Weight Management ClinicMelissa Burleson, Angela Ekema, Sarah Elser, Gena Furgeson,Lai Harper, Rhonda Jones, Vinitha ManuelFerris State UniversityAbstractThe following document contains the organizational strategic plan for the creation of the Mecosta County Weight Management Clinic (MCWMC). The mission and guiding philosophy of the clinic are described. The goals and objectives of the clinic are discussed as they relate to the community needs assessment. The purpose of the clinic to provide a welcoming, affordable, neighborhood health center that assists local residents in achieving their weight management goals is explored. The clinic and budget, while initially small, this document details multiple areas for growth based on usage, needs of the community, and research opportunities. This document includes a community needs assessment, budget proposal for the first year of operation, and job descriptions. Marketing and advertising needs for a job search at both the local, national and international level, along with clinic promotion are discussed. An organizational flow chart of the proposed staffing details the positions necessary for clinic operation. Finally, the document discusses the potential research opportunities at the clinic through member participation. The usage of clinic research data to procure funding or create additional clinics to other low income areas throughout the country are discussed as future research directions.Mecosta County Weight Management ClinicThe Mecosta County Weigh Management Clinic (MCWMC) is the culmination of extensive research and investments. The MCWMC was created to address the need for healthy weight management strategies for the unemployed and underemployed residents of Mecosta County. Weight management resulted from a careful screening of individuals to create database for community improvement. Overweight and obesity are defined as a body mass index (BMI) of 25-29.9 and greater than 30 respectively. True assessment of health in clients who are overweight or obese includes “Skin fold thickness, waist circumference, [and] waist-to-hip circumference ratios” to determine an adult’s weight management status. Adults who are overweight or obese have an increased risk for diabetes, cardiovascular diseases, and morbidity (Centers for Disease Control and Prevention, 2012, para. 2). The incidence of chronic diseases in low income areas is well documented and statistically signification. However few studies exist on the outcomes for low income populations in the presence of affordable leisure-time physical activities. Below is the community assessment and resulting budget proposal for the creation of the munity AssessmentAccording to the community health needs assessment, 32.3 percent of the residents in Mecosta County are overweight, and 28.7 percent are obese (District Health Department #10, 2013, p. 25). Mecosta County rates are greater than the Michigan averages of 30.1 percent for overweight residents, but lower than the 35.6 percent average for those considered obese (District Health Department #10, 2013, p. 25). The Big Rapids 2010 demographic characteristics, a city in Mecosta County, indicate the population composition includes 86.5 percent non-Hispanic Whites, 6.7 percent African American, 2.4 percent Hispanic, and 1.5 percent Asian (United States Census Bureau state, 2013, para. 1).Overweight and obesity are associated with limited physical activity or inadequate fiber intake. Inadequate fiber intake is defined as “consuming fruits and vegetable, on average, fewer than five times per day over the past seven days” (District Health Department #10, 2013, p. 26). Eighty-one percent of adults living in Mecosta County reported inadequate fruit and vegetable consumption, as compared to 78.2 percent of Michigan residents (District Health Department #10, 2013, p. 26). Limited physical activities refers to a lack of participation in running, calisthenics, golfing, gardening, or walking during the past month; 25.7 percent of Mecosta County residents reported no leisure-time physical activity (District Health Department #10, 2013, p. 27).Limited access to healthy food and recreational facilities exacerbated by easy, affordable access to fast food restaurants creates a physical environment that fails to promote positive influences to decrease obesity in Mecosta County. Easy access to multiple fast food restaurants in Mecosta County discourages the preparation of a healthy nutritious meal at home for busy families. Forty-five percent of the restaurants in Mecosta County serve fast food as compared to 49 percent in Michigan and 27 percent for the US benchmark (Robert Wood Johnson Foundation & University of Wisconsin, 2013). Ten percent of low-income populations have limited access to healthy food at a grocery store in Mecosta County, while the Michigan average is only 6 percent and the national benchmark is 1 percent (Robert Wood Johnson Foundation & University of Wisconsin, 2013). Access to recreational facilities is also comparatively limited in Mecosta County and Michigan. The number of recreational facilities per 100,000 residents for Mecosta county, Michigan, and the national benchmark are 9, 9, and 16 respectively (Robert Wood Johnson Foundation & University of Wisconsin, 2013).Unemployed and underemployed populations lack the financial resources to pursue preventative measures and healthy eating due to limited incomes. The unemployment rate from 2000-2010 in Mecosta County was 12.1 percent while the national average was 9.6 percent (District Health Department #10, 2013, p. 8). The unemployment rate in Big Rapids was 22.3 percent while the Michigan average was 12.3 percent (United States Census Bureau state, 2013, para. 1). The percentage of people with an income below the poverty line in Mecosta County, specifically Big Rapids, from 2007 to 2011 was 48.1 percent and the Michigan average was 15.7 percent (District Health Department #10, 2013, p. 9; Robert Wood Johnson Foundation & University of Wisconsin, 2013).Rising unemployment rates, increasing insurance premiums, rising copayments, and the decreasing number of employers offering healthcare coverage results in limited access to healthcare services. Those at the highest risk are the uninsured population who seeks medical care only in emergencies. Under the age of 65, 17 percent of the population in Mecosta County is uninsured versus 14 percent in Michigan and 11 percent for the national benchmark (Robert Wood Johnson Foundation & University of Wisconsin, 2013). Unemployment can lead to depression, poor eating habits, and a decline in healthy habits.Residents living in poverty have limited access to transportation, fitness centers, health clubs, gymnasiums, healthy food, weight management counseling, and surgical intervention. Unemployed or uninsured residents may not be able to afford the fees for fitness centers or programs. While there are multiple fitness centers available in the area, none of them cater to residents who are unemployed, underemployed, or lack financial resources to contribute to their health. However, access availability to multiple fitness centers may discourage investors from financing the implementation of a new weight management clinic. Unfortunately the cost of membership to many of these fitness centers make healthy habits unattainable.Mecosta County has multiple fitness centers available and open to the public. The fitness centers offer a fitness boot camp aimed at weight loss and various support groups for overeaters and surgical weight loss. Current health programs and fitness centers are the community strengths at Big Rapids, such as “TNT Gym, BullDawg Fitness, BeagleFIT (2013), Racquet & Fitness Center, PT Plus, FSU Ropes Course, Charles E. Fairman Community Pool” (Mecosta County Area Convention & Visitors Bureau, n.d., para. 1).The average monthly membership fees at the BeagleFIT (2013), a 24-hour family-owned gymnasium, are $45 for an individual, $65 for a couple, and $85 for a family (para. 1). The Ferris State University Racquet and Fitness Center (2013) offers discounts for students, employees, and senior citizens; however, the membership fees during the fall or winter semester for the public are $220 for an individual, $325 for a couple, and $385 for a family of three or more (para. 10). The existing community fitness centers provide limited access to populations who would benefit the most from increased physical activity. The development of a new weight management clinic would provide increased affordable access in the neighborhoods previously limited by the factors discussed. Local community groups continue to work towards increasing health services while addressing weight management issues. When considering the community needs assessment, there are two environmental variables that need to be addressed, the internal and external environment of the organization.Internal EnvironmentInternal environment refers to “the conditions, entities, events, and factors within an organization that influence its activities and choices, particularly the behavior of the employees . . . the organization's mission statement, leadership styles, and its organizational culture” (Internal environment, 2013). The MCWMC employees are selected through a rigorous interview process from local, national, and international talent searches. Additionally, the clinic is promoted both locally, through business collaboration with active incentives program, online, and through the MCWMC website. Employers who support the clinic financially comprise the active incentives program and their employees participate in a free or reduced cost membership program to meet their weight management goals.Mission StatementOur mission at the MCWMC is to promote a healthy lifestyle through high quality, compassionate, and cost-effective care through a partnership of staff in the fields of medicine, counseling, exercise, and nutrition, alongside volunteers who empower and support Mecosta County in managing and maintaining their weight while setting attainable goals.PhilosophyThe MCWMC believes that effective provision of our services, in the Big Rapids area, benefit the individual client, family members, and society. At MCWMC, we are committed to the pursuit of quality by providing education, exercise programs, healthy eating classes, and emotional support to clients in a safe and comfortable environment. Using an interdisciplinary approach, we are able to create individualized care plans for patients and families. Excellence in care occurs through shared decision-making and the utilization of evidence-based practice.?GoalsHelp the client set, achieve, and maintain their weight management goals across the continuum of care. Ensure every client has access to weight management resources that will aid in achieving desired goals and objectives. Incorporate an interdisciplinary approach through shared decision-making and utilization of evidence-based practice. Develop a judgment-free zone where clients feel comfortable attending and fully participating in the services the clinic offers to achieve their highest potential. Provide community education that will enhance the skills and knowledge needed to become healthy individuals both emotionally and physically and as a community. Ensure goals are consistently being met in an effective and efficient manner by continuously monitoring our performance and its impact on our clients and community. ObjectivesThe MCWMC has several objectives towards community weight management that is broken down into consistent objectives or expectations for each session. First the team member and the client will identify three personal reasons for weight management and help the client create three personal goals and objectives that will be specific, measureable, attainable, realistic and tangible by the end of the clients first session. The second objective is to identify weight loss and healthy eating barriers, emotional support needs, and establish coping skills. Identification of easily accessible resources to assist with healthy eating, exercise, and support is important to client success. Third, weekly collaboration with the interdisciplinary will ensure the client is meeting and maintaining their goals and objectives. Each client will establish a rapport with one member of the interdisciplinary who will function as a mentor and create a positive relationship and connection with the clinic. The clinic will provide monthly education topics and fitness events. Finally, the clinic’s primary objective is to increase the number of adult clients who engage in leisure time physical activities by 10 percent and decrease the number of residents classified as obese or overweight by 10 percent both by the end of 2016. To evaluate the effectiveness and progress of the clinic, quarterly and annual reviews will reassess organizational goals, community needs assessment, economic outcomes, and client satisfaction.External EnvironmentExternal environment refers to “conditions, entities, events, and factors surrounding an organization that influence its activities and choices, and determine its opportunities and risks, also called operating environment” (External environment, 2013). Current obesity rates, declining health, and chronic diseases necessitate the development of a weight management clinic. Socio-economic status, demographic characteristics, physical environments, health behaviors, and sensitive indicators will drive the development of a weight-loss program in Mecosta County.In Mecosta County, the economic and financial resources of healthcare organizations can either foster growth or delay the implementation of a new weight management clinic. The Mecosta County Medical Center (MCMC) performed a quantitative and qualitative community needs assessment of Big Rapids, 61 percent of respondents reported the importance of obesity education, and 72 percent expressed the need for wellness and prevention programs (MCMC, 2013, p. 8). The Michigan Department of Community Health and the District Health Department #10 are collaborating with community partners to support health programs and monitor measurable health behaviors and indicators related to obesity (Mecosta County Medical Center, 2013, Appendix 4). Based on the external environmental assessment, there is an ongoing community need for promoting a healthy lifestyle and reducing the risk of morbidity associated with the rising overweight and obese population. In July 2013 the Spectrum Health System merged with the Mecosta County Medical Center, becoming the Spectrum Health Big Rapids Hospital. The Spectrum Health Big Rapids Hospital is the primary non-profit healthcare provider of inpatient and outpatient services in the area (Spectrum Health, 2013, p. 1). The creation of Spectrum Health Big Rapids Hospital opened doors for additional services. Non-profit healthcare organizations, which accept government tax benefits, are responsible for providing services to the uninsured (Mancini healthcare, 2011, p. 120). The MCMC directors prior to the merger discussed options for supporting more affordable specialty health services for uninsured and underinsured residents (MCMC, p. 24). A research study on community health needs, by Spectrum Health, focused on increasing cardiology and cancer services while expanding access to healthcare services for Medicare and Medicaid residents (2013, p. 2-3). However, despite the community needs assessment performed by MCMC, Spectrum Health (2013) announced that obesity and wellness programs would not be included in the implementation plan (p. 4). Spectrum Health’s service plan may include a weight management clinic, but inclusion depends on funding procurement and the establishment of a self-sustaining program.Limited financial resources are a risk factor for developing a new weight management program in Big Rapids. However, based on the community needs assessment it is essential to promoting healthy weight management in Mecosta County. Community grants and corporate partners whose mission is to provide funding for non-profit healthcare organizations promoting community health for the uninsured will continue to fund the clinic and program development (Blue Cross Blue Shield of Michigan Foundation, 2012, p. 7). The Council of Michigan Foundations (2007) provides valuable information regarding non-governmental foundation grant applications, such as “independent, family, company-sponsored, public charity” (p. 2).Organizational Structure and EmploymentAn effective organization is able to clearly define employee roles, expectations, and reporting structure. Organizational outlining sets the tone for culture, norms, traditions, and actions, which demonstrate the company’s values and beliefs (Mancini understanding, 2011, p. 140). Job descriptions of all positions and the MCWMC organizational chart are presented as appendices D through anizational ChartAn organizational chart illustrates the reporting structure and functionality within an organization. It is a visual representation of the division of labor and responsibility among employees. The organizational chart depicts the formal lines of communication and reporting, known as a chain of command (Siegel, Sorenson, & Richtermeyer, 2003, p. 39). The MCWMC organizational chart (Appendix D), illustrates employee working relationships and the chain of command. These working relationships are also detailed in each job description.Job DescriptionsJob descriptions provide potential employees a clear, concise, description of the position for which they are applying. A job description serves as a guide to the roles, responsibilities, work assignments, and reporting expectations. Job descriptions for interdisciplinary team members who provide direct care and indirect services to clients can be found in appendices E through L.Job AdvertisementThe national and international job search for a registered nurse (RN) will be through the American Journal of Nursing (AJN). While the local job search will be advertised in the Big Rapids Pioneer (BRP). To reduce the marketing costs, the Michigan Talent Bank (MTB), and the MCWMC website will provide free advertising for our clinic, health promotion programs, and available job openings.The job advertisement for a registered nurse (RN) position describes the available position in a manner that is attractive to a prospective employee. The advertisement specifies the necessary and preferred qualifications of an ideal candidate. Finding a qualified candidate for a position can be time consuming and requires precious resources to attract candidates, review applications, and perform interviews. The job posting should be general enough to attract a diversified group of individuals, but with a very specific skill set.The AJN has been the voice of nursing since 1900 (Lippincott, Williams, & Wilkins, 2013). The AJN is published monthly with a circulation of approximately 340,000 (Lippincott, Williams, & Wilkins, 2013). This allows for both a national and international talent search for the RN position (Lippincott, Williams, & Wilkins, 2013). The publication deadline for the January 2014 issue was November 25, 2013and a digital pdf file was submitted and approved (Lippincott, Williams, & Wilkins, 2013). The job advertisement (Appendix C) was ?th of a page at the cost of $2675 per issue (Lippincott, Williams, & Wilkins, 2013). Publishing the position in only one issue could limit viewers, but libraries and individuals retain most professional journals for a period of time, which can extend the job posting exposure.Local newspapers in Michigan were reviewed. It was determined that the newspaper with the greatest exposure to potential applicants within the community, largest circulation, and most budget conscious choice was the BRP. The BRP publishes a newspaper six days per week, and serves Mecosta, Osceola, Lake, and Newaygo counties (The Pioneer newspaper about us, 2013). The size selected to meet the clinic budget was a ? page (3x10), black and white advertisement for $360 per week (The Pioneer newspaper classifieds, 2013). The initial run depending on candidate response will be approximately one month, unless all positions are filled. The advertisement will be reassessed on a weekly basis.The MTB was selected as the third source for advertising the RN position. The MTB is a free service that allows both employers and prospective employees to search for jobs or candidates (Michigan Works, 2011). Visitors to the site can post or view resumes, search available job postings, or add a new job posting (Michigan Works, 2011). The use of free services such as the MTB and the MCWMC website for advertising helps reduce the startup costs for the clinic.Hours of OperationThe MCWMC will be open Monday through Friday from 8am to 5pm. There is a future possibility of expansion of these hours to meet patient needs as the clinic grows. Appointments are recommended, but walk-ins are always welcome. Hours may vary depending on staffing and patient scheduling, please call ahead to ensure the clinic is open. The clinic is closed on weekends and holidays unless the clinic hosts a special event or appointments are prearranged through management. Clinic hours of operation will be reassessed six months after opening using staff and client suggestions along with census monitoring data. Census and time monitoring will be achieved by a computer monitored debit punch card system as members enter the clinic. Prepaid membership cards will be kept at the entrance for use at the clinic.Budget and Fiscal ResponsibilityEstablishing a new business requires a carefully planned budget and strategic development plan to maintain the clinic over time. The estimated budget proposal for opening and maintaining the MCWMC over the next fiscal year can be found in appendices A and B (Stafford, 2011). Nurse leaders and managers need to be cost conscious when balancing the budget within healthcare organizations (Stafford, 2011). As part of the strategic planning process, an estimated annual operating expense budget was prepared. The budget was created through careful planning and collaboration with the director, staff, financial advisors, and managers to meet the organizational goals, objectives, expectations, and outcomes (Stafford, 2011). Any changes that affect expenses need prior approval from the director. The operating budget covers only the daily expenses of the organization (Stafford, 2011). Additional expenses such as “equipment or physical plant” (Stafford, 2011, p. 242) repairs, are typically taken from a capital budget, which will be created in the second year of the clinic. Any capital budget needs will come out of the discretionary fund until the capital budget fund can be created and accumulates for the following fiscal year. The manager tracking of both operational and capital budgets increases the accuracy of proposals for the subsequent fiscal year (Stafford, 2011). The proposed personnel budget (Appendix B), of $270,500 includes the cost of salaries and annual health and leave benefits at $8,000 per full time employee and $4,000 per part time employee. The additional cost of $74,500 will cover building and office expenses, marketing, maintaining professional licenses, and a discretionary fund. Full and part time employees will be utilized for business and clinic operations. Volunteers will assist in non-clinical areas.The Centers for Medicare and Medicaid Services (2011) will not reimburse for obesity screenings and weight management therapies unless physicians, nurse practitioners, clinical nurse specialists, or physician assistants at primary care clinics provide them. Therefore, the majority of income for the clinic will come from private insurance companies and a combination of public and private grants. The public health grant sources include The Robert Wood Johnson Foundation (2013), The United States Department of Health and Human Services (2013), and the Blue Cross Blue Shield of Michigan Foundation (2013). Reimbursement through commercial insurance companies such as Blue Care Network of Michigan (2013) will provide additional funding. Blue Care Network supports RN led health promotion and wellness programs that create individualized care plans. The care plans include educating clients about “disease, nutrition, mediation, and preventative care” (Blue Care Network of Michigan, 2013, p. 49). Clients are advised to check private insurance companies for wellness coverage prior to scheduling an appointment. Clinic staff can assist, if needed, with any correspondence related to diagnostic codes for billing or prior authorization.ConclusionThe MCWMC is an important step towards improving health and decreasing obesity in Mecosta County. The primary focus of the clinic is outreach to the uninsured, unemployed, underemployed, and low-income residents seeking weight management solutions. While the clinic is not essential, it is necessary to improve the health of those it serves in the community. Many residents of Mecosta County cannot afford a gym membership, fresh fruits and vegetables, or a dietician to help create weight management goals. The creation of a sustainable, self-supporting clinic will bring weight management to those who could not afford healthy choices. Through the procurement of grants, supplemented incomes, and careful planning those goals can be accomplishments. Weight management improves overall health and wellness of the community, which translates to fewer chronic health problems, and decreases in improper usage of emergency department resources. Research opportunities and grants will continue to provide income and encourage other struggling communities to adopt similar weight management programs. The hope is that peer-reviewed studies from this program may eventually influence coverage and reimbursement for weight management programs by both private insurance companies and the Centers for Medicare and Medicaid services.ReferencesBeagleFIT 24 hour gym. (2013). About BeagleFIT and membership fees. Retrieved from Care Network of Michigan. (2013). Evidence of coverage. Retrieved from . pdf/bcna2013/evidence-of-coverage-elements.pdfBlue Cross Blue Shield of Michigan Foundation. (2012). Community health matching program: Solving community health problems. Retrieved from dam/public/Consumer/Documents/help/faqs/community-health-match-grant-brochure-2012.pdfBlue Cross Blue Shield of Michigan Foundation. (2013). Grant programs. Retrieved from for Disease Control and Prevention. (2012, April 27). Overweight and obesity. Retrieved from for Medicare and Medicaid Services. (2011, November 29). Decision memo for intensive behavioral therapy for obesity. Retrieved from 20Behavioral%20Therapy%20for%20Obesity&bc=ACAAAAAAIAAA&NCAId=253&Council of Michigan Foundations. (2007). Information for seeking foundation and corporate grants. Retrieved from 516&DID=10301&DOC=FILE.PDFDistrict Health Department #10. (2013). Community health needs assessment. Retrieved from environment. (2013). In WebFinance’s online dictionary. Retrieved from State University. (2013). Racquet and fitness center membership information. Retrieved from environment. (2013). In WebFinance’s online dictionary. Retrieved from , Williams, & Wilkins. (2013). American Journal of Nursing-Recruitment. Retrieved from , M. E. (2011). Healthcare organizations. In P. S. Yoder-Wise (Ed.), Leading and managing in nursing (5th ed., pp. 116-136). St Louis, MO: Elsevier Mosby.Mancini, M. E. (2011). Understanding and designing organizational structures. In P. S. Yoder-Wise (Ed.), Leading and managing in nursing (5th ed., pp. 137-155). Saint Louis, MO: Elsevier Mosby. Mecosta County Area Convention & Visitors Bureau. (n.d.). Things to do: Adult sports and fitness. Retrieved from County Medical Center. (2013). Community health needs assessment 2012-2013. Retrieved from 20Hospital/MCMC_CHNA.PDFMecosta County Weight Management Clinic. (2013). Job opportunities. Retrieved from Works. (2011). Michigan Talent Bank. Retrieved from employer/Robert Wood Johnson Foundation & University of Wisconsin. (2013). County health rankings and roadways. Retrieved from 2013/mecosta/county/outcomes/overall/snapshot/sort-0Robert Wood Johnson Foundation. (2012). Local funding partnerships: Funding opportunities. Retrieved from , G., Sorensen, J. E., & Richtermeyer, S. B. (2003). Becoming a business partner: Part 2. Strategic Finance 85(4), pp. 37–41. Retrieved from . ferris.edu/ehost/detail?vid=3&sid=8f9ecac4-e399-4f4d-ba8f-323a99c103ef% 40sessionmgr112&hid=108&bdata=JnNpdGU9ZWhvc3QtbGl2ZQ%3d%3d#db=ofs&AN=510295968Spectrum Health. (2013). Implementation plan for needs identified in community. Health needs assessment for Mecosta County Medical center d/b/a Spectrum Health Big Rapids Hospital. Retrieved from? 20Rapids%20Hospital/Big_Rapids_Implementation_Plan.pdfStafford, T. B. (2011). Managing costs and budgets. In P. S. Yoder-Wise (Ed.), Leading and managing in nursing (5th ed., pp. 228-248). St Louis, MO: Elsevier Mosby.The Pioneer Newspaper. (2013). About us. Retrieved from Pioneer Newspaper. (2013). Classifieds AdOwl. Retrieved from , D. M. (2011). Selecting, developing, and evaluating staff. In P. S. Yoder-Wise (Ed.), Leading and managing in nursing (5th ed., pp. 293-306). Saint Louis, MO: Elsevier Mosby. United States Census Bureau. (2013, June 27). American fact finder: American community survey, five-year estimates, Big Rapids, Michigan. Retrieved from . faces/tableservices/jsf/pages/productview.xhtml?src=bkmkUnited States Census Bureau. (2013, June 27). State and county quick facts: Big Rapids, Michigan. Retrieved from States Department of Health and Human Services. (2013). find open grant opportunities. Retrieved from ATable 1: Budget Proposal: First-Year Operating ExpensesOperating ExpenseEstimated Annual ExpensePersonnel*$270,500Lease (3,000 sq. feet)$30,000Utilities$15,000Office Supplies$12,000Professional Services /Licenses$10,000Marketing$6,000Discretionary Fund$6,500??Total$350,000* Expense breakdown as Appendix BAppendix BTable 2: Personnel Budget Proposal BreakdownPersonnelEmployment StatusWageBenefitsTotal ExpenseDirectorFull-time$61,000$8,000$69,000Registered NurseFull-time$45,000$8,000$53,000Administrative AssistantFull-time$28,000$8,000$36,000Medical AssistantFull-time$26,000$8,000$34,000Social WorkerPart-time$26,000$4,000$30,000DieticianPart-time$23,500$4,000$27,500Athletic TrainerPart-time$17,000$4,000$21,000?????Total Personnel Expense??$270,500Appendix C635325534Help WantedRegistered NurseWe are seeking a full time registered nurse who is experienced, enthusiastic, and energetic, to join the team at the newly established Mecosta County Weight Management Clinic. Candidate must have a valid license to practice as a registered nurse in the State of Michigan. Minimum education ADN, but BSN preferred. Candidate should have at least two years of experience in a related field, and be able to work M-F 8am-5pm, no weekends, or holidays. If you are interested, please send a resume and cover letter to the Mecosta County Weight Management Clinic at MCWMClinic@, or visit our website at mcwmclinic@ and complete an application. Please visit our webpage for a complete listing of job openings. 020000Help WantedRegistered NurseWe are seeking a full time registered nurse who is experienced, enthusiastic, and energetic, to join the team at the newly established Mecosta County Weight Management Clinic. Candidate must have a valid license to practice as a registered nurse in the State of Michigan. Minimum education ADN, but BSN preferred. Candidate should have at least two years of experience in a related field, and be able to work M-F 8am-5pm, no weekends, or holidays. If you are interested, please send a resume and cover letter to the Mecosta County Weight Management Clinic at MCWMClinic@, or visit our website at mcwmclinic@ and complete an application. Please visit our webpage for a complete listing of job openings. Figure 1: Registered Nurse Job Description Advertisement and Sample Business AdvertisementsInitial AdvertisementPlease join us for the Mecosta County Weight Management Clinic Grand Opening and Open House on Saturday November 30, 2013. We will be featuring equipment orientation, weight management classes, on-site dietitians to jump-start your holiday substitutions, and weight management plans to keep off or lose those unwanted holiday pounds. Please join our free event and learn how affordable and easy weight management can be. Please come and help make this organization part of your family and community. Free memberships and other door prizes will be given away throughout the day with healthy alternative foods provided.Business AdvertisementMecosta County Weight Management Clinic wants to collaborate with you and your business to establish creative solutions for employee active incentives to prevent chronic diseases associated with obesity. Please contact us about our active incentives program. We welcome any financial support to continue this community outreach.Maintenance Advertisement after Grand OpeningMecosta County Weight Management Clinic offers affordable solutions to your healthy habits. We offer supplemented gym memberships, low cost memberships, an on-site dietitian, physical therapist, and athletic trainer. We have a nurse practitioner to meet any medical needs, well visits or emergency needs. We have a social worker who can help you navigate the financial aspects of healthy living and eating while maintaining constant communication with your primary care provider to bring continuity to your care. Please join us and see how easy and affordable a healthy lifestyle can be. Financial assistance is available to cover all of our services and we accept insurance from all sources.Appendix DFigure 2: Mecosta County Weight Management Clinic Organizational ChartAppendix EMecosta County Weight Management ClinicBig Rapids, MichiganJOB DESCRIPTIONTitle: DirectorFull-Time / 40 hours per weekGeneral SummaryThe director will plan, organize, direct, and control the daily overall operations of Mecosta County Weight Management Clinic. Responsibilities and DutiesOperational management.Administration activities including: record maintenance, safety, employee relations, budget and financial control, policy and procedure development, planning, equipment, and supply election. Workflow assessment/analysis/implementation.Assist any and all other positions with client care during times of high volume.Personnel oversight.Volunteer coordinator. Ensure that all services are provided in a high quality and cost effective manner.Promotes the organization's image in the community through active participation in outside organizations. Required Knowledge and SkillsEducationLicensed Registered Nurse in the State of Michigan.Master of Science in Nursing Degree.Basic Cardiac Life Support (BCLS) certification required.ExperienceMinimum of two years management experience preferred. InterpersonalMust have effective communication skills.Must have customer service plexitiesMust be able to work in a self-directed environment and collaborate with other members of the organization. .Reporting RelationshipResponsible for reporting to Ferris State University Board of Directors. Receives report from Administrative Assistant, Social Worker, and Registered Nurse. All other positions may report to the director as needed.Appendix FMecosta County Weight Management ClinicBig Rapids, MichiganJOB DESCRIPTIONTitle: Administrative AssistantFull-Time / 40 hours per weekGeneral SummaryThe administrative assistant will answer phones, disperse messages, schedule client appointments, and accept payment for services rendered. Responsibilities and DutiesAnswers phones with appropriate greeting, screens and handles all calls efficiently, schedules client appointments, and delivers messages in a timely manner. Screens vendors and visitors then directs them to staff as needed. Assists with payroll.Management of clients’ charts, filing, and assembling information for admission.Orders office supplies.Sorts and distributes incoming mail and management of outgoing mitment to positive client experience by providing excellent service.Data entry of client records. Required Knowledge and SkillsEducationMust be a high school graduate or have obtained GED certificate. Knowledge of medical terminology preferred. Ability to type 30 to 40 WPM.Experience working with a variety of computer programs.ExperienceAt least one year of experience in a clerical position, preferably in a health related field. InterpersonalGood communication skills and telephone etiquette. Exceptional customer service skills.Professional communication both written and verbal. Physical Must be able to sit for extended periods, bend, and lift up to 25 lbs. Reporting RelationshipReports directly to the director of the clinic.Collaborates with the Registered Nurse and Social WorkerDual responsibility with Registered Nurse for VolunteersAppendix GMecosta County Weight Management ClinicBig Rapids, MichiganJOB DESCRIPTIONTitle: Registered Nurse (RN)Full Time / 40 hours per weekGeneral SummaryThe registered nurse will provide educational instruction to clients at the Mecosta County Weight Management Clinic for wellness promotion, illness prevention programs, and creation of a client individualized treatment plan including goals and interventions. Responsibilities and DutiesPerform initial consultation to establish individualized client plan. Meet with clients weekly to evaluate plan and make revisions to plan with clients to achieve client satisfaction and weight management success. The ability to work autonomously in an outpatient setting within the Scope of the Nursing Practice. Work professionally and communicate efficiently with other disciplines and contribute to the development of the weight management program.Participates in weekly staff meetings and in-service mitment to continuous improvement of the patient’s experience which includes quality evidence based care and excellent service. Supervises and teaches other staff as required. Communicate and collaborate with client’s primary care physician as needed.Required Knowledge and SkillsEducationCurrent license to practice as registered nurse in the State of Michigan required. Associates Degree required; Bachelor’s Degree preferred.Basic Cardiac Life Support (BCLS) certification required.ExperienceMinimum two years’ experience in a related field.Strong organizational and teaching skills. InterpersonalEffective communication skills. Must be able to work in a self-directed and collaborative environment. Physical Able to sit, stand, walk, stoop, and lift up to 25 lbs. Reporting RelationshipReports to the director of the clinic.Collaborative role with Administrative Assistant and Social Worker.Responsible for delegation and supervision of medical assistants, dietician, athletic trainers, volunteers, and others as needed. Appendix HMecosta County Weight Management ClinicBig Rapids, MichiganJOB DESCRIPTIONTitle: Registered DietitianPart-Time / 20 hours per weekGeneral SummaryThe registered dietitian at the Mecosta County Weight Management Clinic will provide nutritional education and counseling to weight management program clients in conjunction with nursing, physical fitness staff, social work, and medical staff. The Weight Management Clinic dietitian will also evaluate the effectiveness and appropriateness of the nutritional plan.Responsibilities and DutiesProvide initial and recurring nutritional assessments as needed for weight management program clients. Plan, structure, and implement weekly nutritional counseling sessions for these clients.Assess client’s readiness for dietary and nutritional change. Establish goals with clients to achieve optimal client satisfaction and weight management success.Effectively complete assigned tasks and projects.Work professionally and communicate efficiently with other disciplines and contribute to the development of the weight management program.Required Knowledge and SkillsEducationBachelor’s Degree in Nutrition or Dietetics.Michigan State Licensed and Registered Dietitian.Certification in Adult Weight Management preferred.Basic Cardiac Life Support (BCLS) certification required.ExperienceOne to two years’ experience in a related field preferred.InterpersonalMotivational and coaching skills necessary to optimize clients’ success.Ability to self-mange and direct to utilize time effectively and efficiently.Professional communication skills to contribute to successful team environment.PhysicalAble to sit, stand, walk, bend, stoop, and lift up to 25 lbs.Reporting RelationshipReports to the RNAppendix IMecosta County Weight Management ClinicBig Rapids, MichiganJOB DESCRIPTIONTitle: Athletic TrainerPart-Time / 20 hours per weekGeneral SummaryThe certified athletic trainer collaborates with the multidisciplinary team for the assessment, development, implementation, and evaluation of the client’s individualized wellness program for increasing physical activities. Responsibilities and DutiesAssess the client’s readiness for increased physical fitness. Develop the personalized fitness or rehabilitation plan for clients.Implement the physical fitness program.Assess for risk of, prevent, and treat sports-related injuries.Evaluate the effectiveness of the client’s physical activities in relation to the weight management goals and make adjustments as necessary. Work professionally and communicate efficiently with other disciplines and contribute to the development of the weight management program.Motivate clients about the safe fitness plans and work with the multidisciplinary team in the clinical environment. Required Knowledge and SkillsEducationCompletion of an accredited Athletic Trainer Certification Program.Licensed Certified Athletic Trainer in Michigan.Bachelor’s Degree in athletic training.Basic Cardiac Life Support (BCLS) certification required.ExperienceAt least one-year work experience for the recovery of clients with chronic conditions or sports-related injuries.InterpersonalCollaboration with the multidisciplinary team for the progress of the clients’ physical activities.Professionally written or verbal communication with the multidisciplinary passionate, empathetic, and respectful communication skills with clients.Physical Ability to stand and walk for a prolonged period of time.Reporting RelationshipReports to the RN.Appendix JMecosta County Weight Management ClinicBig Rapids, MichiganJOB DESCRIPTIONTitle: Social WorkerPart-Time / 20 hours per weekGeneral SummaryThe social worker will assist the clients and families of the Mecosta County Weight Management Clinic in understanding the illness/disabilities and the process of resolving complex personal, financial, and environmental difficulties which affect their daily lives. Provides consultation to the interdisciplinary team regarding the impact of psychosocial factors on patients’ care and assists patient and families with insurances and medical supplies needs. Performs duties in accordance with the mission, vision, and values of Mecosta County Weight Management Clinic and any applicable federal, state, and/or regulatory statues/guidelines.Responsibilities and DutiesAssesses each client individually and creates support plan/goals if needed.Provides direct services to patients and families in relation to emotional problems of anxiety or stress precipitated by illness or disability.Plans, implements, and evaluates support groups/educational needs of patients.Stays consistent with the stated mission, vision, values, and plan of the clinic while implementing short and long term goals to meet the psychosocial needs to the clients.Work professionally and communicate efficiently with other disciplines and contribute to the development of the weight management program.Required Knowledge and SkillsEducationMust be licensed by the State of Michigan.Must possess a Master’s Degree from an Accredited School of Social Work (MSW).ExperiencePreferred two years in a clinical setting.InterpersonalRequires a high level of interpersonal skills to provide counseling to patients and families in time of need and to work well with interdisciplinary team.PhysicalMust be able to move intermittently through the building throughout the workday.Reporting RelationshipReports to the clinic’s Director. Appendix KMecosta County Weight Management ClinicBig Rapids, MichiganJob DescriptionTitle: Medical Assistant (MA) Full-Time / 40 Hours per weekGeneral SummaryWorks under the supervision of a registered nurse (RN) in conjunction with the interdisciplinary team to plan and evaluate care for the client in the weight management clinic setting. Responsibilities and DutiesAssists in assessment of client needs; then plans, implements and documents care under the direction of the RN.Reports condition changes and the need for nursing measures beyond his/her scope of practice.Document legibly and accurately in the client’s medical record.Assist other health care team members in providing continuity of care, which may include emotional, physical, spiritual, and psychological support of the client.Maintains professional knowledge and/or license through continuing education and company sponsored in-services.Employee must be committed to the continuous improvement of the patient experience, which includes but is not limited to patient safety, quality of care, education, and patient satisfaction.Work professionally and communicate efficiently with other disciplines and contribute to the development of the weight management program.Knowledge, Skills, and Abilities Required:EducationCurrent Medical Assistant Certification required.Basic Cardiac Life Support (BCLS) required.ExperienceOne year of recent experience in acute care setting, clinic, physicians practice, or other medical setting; clinic experience preferred.InterpersonalMust treat our clients equally and maintain a nonjudgmental atmosphere for our clients and families.Must be self-directed, take an initiative, collaborate with team members, and have excellent communication skills.PhysicalCandidate must be able to climb stairs, sit, stand, bend, and lift up to 50 pounds.Reporting RelationshipReports to the RN. Appendix LMecosta County Weight Management ClinicBig Rapids, MichiganJob DescriptionTitle: VolunteerNon-compensated PositionGeneral SummaryWorks under the supervision of the clinic director to assist clients and families with reception, registration, appointment management, clerical duties, notifies staff of client arrival, client waiting room management, light housekeeping, and clinic tours. Responsibilities and DutiesAssists client to learn about and navigate through all aspects of the clinic under the direction of the RN.Provide clerical support to staff using phone, facsimile, and electronic methods as needed. Some assistance to billing may be required.Assist staff and other volunteers in the use of office equipment. Anticipate office supply needs, order supplies, and maintain equipment as needed.Reports patient concerns, needs, and schedule changes to primary RN.Create receipts, appointment cards, and lab or follow-up testing forms legibly and accurately based on information provided by the medical staff.Assist other health care team members in providing continuity of care, which may include emotional, physical, spiritual, and psychological support of the client.Perform light housekeeping to maintain a clean waiting room, bathroom, and work environment which includes but is not limited to cleaning, sanitation, and mitted to the continuous improvement of the client experience, which includes but is not limited to patient safety, quality of care, education, and patient satisfaction.Knowledge, Skills, and Abilities Required:EducationMust be a high school graduate or equivalent.May be a high school vocational education student in their junior or senior year interested in the medical or weight management profession.ExperiencePrior experience as a clerical staff member or in a medical setting will be helpful, but not required.InterpersonalMust treat our clients equally and maintain a nonjudgmental atmosphere for our clients and families. Volunteer may be required to train new volunteers.Must maintain patient confidentiality at all times according to HIPPA standards. PhysicalVolunteer must be able to climb stairs, sit, stand, bend, and lift up to 50 pounds.Reporting RelationshipReports to the Administrative Assistant or the RN as needed. ................
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