1. Project Title:
Sokaogon Chippewa Community Special Diabetes Program for Indians
2. Requested Award Amount:
$75,019 year 1
3. Applicant Organization Name:
Sokaogon Chippewa Community 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. Program Supervisor Name and Title
Suzette Katchko, FNP
9. Program Supervisor Contact Information (phone and email)
(P) 715-478-5180
suzette.katchko@scc-nsn.gov
10. Program Coordinator Name and Title
Crista Tracy
RN Nursing Supervisor
11. Program Coordinator Contact Information (phone and email)
(P) 715-478-5180
crista.tracy@scc-nsn.gov
12. EIN/DUNS Number Exception Request in Attachment 8? (Y/N):
Yes
13. 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
14. 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.