1. Project Title:
Sokaogon Chippewa Health Clinic Health Management Structure Billing Best Practices Implementation
2. Requested Award Amount:
$300,000 over three years.
3. Applicant Organization Name:
Sokaogon Chippewa Health Clinic
4. Applicant Organization Address:
3144 VanZile Road
Crandon, WI 54520
5. Applicant Organization Facility Type (e.g., Rural Health Clinic, Critical Access Hospital, Tribe/Tribal Organization, Health System, Institute of Higher Learning, Community-based Organization, Foundation, Rural Health Network, etc.):
The Sokaogon Chippewa Community Health Clinic is a Tribal 638 Title I Health Clinic
6. Project Director Name and Title (should be the same individual designated in Box8f of the SF-424 Application Form)
Tawny Booth
Grants Manager, Sokaogon Chippewa Health Clinic
7. Project Director Contact Information (phone and email)
(P) 715-478-6418
tawny.booth@scc-nsn.gov
8. EIN/DUNS Number Exception Request in Attachment 8? (Y/N):
Yes
9. How the Applicant First Learned About the Funding Opportunity(select one: State Office of Rural Health, HRSA News Release, Grants.gov, HRSA Project Officer, HRSA Website, Technical Assistance Provider, State/Local Health Department):
Grants.gov
10. Target service area (must be exclusively rural, as defined by the Rural Health Grants Eligibility Analyzer):
a. Fully Rural Counties: Provide the county name and state
Forest County, WI
b. Partially-Rural Counties: Provide county name, state, and the rural census tract (list of rural census tracts)
N/A
11. Brief Description of the Target Population
Residents of (and nearby to) the Mole Lake Reservation. The target population is primarily SCC Tribal Members and Tribal employees.
88% of SCC Tribal Members identify as Native American. Because the Sokaogon Chippewa Community Health Clinic is a Tribal 638 Title I Health Clinic located on the SCC Mole Lake Reservation, the overwhelming majority of patients are SCC Tribal Members and Tribal employees (most of whom are themselves SCC members). This data is reported by the Census Bureau and the Clinic also tracks a range of patient demographics.