An Intro to Grant Writing at CCHC

Charlotte Community Health Clinic (CCHC) relies on a significant amount of grant funding from diverse organizations. These include local faith groups, national non-profits, and the state and federal government. During my year at the clinic, I was given the chance to work on a number of these grants. Here’s three things I’ve learned as a result of my foray into grant writing:

Know your audience: It’s important to think about exactly who the funder is, in terms of what you write and how you write it. When I wrote a request to a local church, there was more flexibility to talk about individuals and their stories, express our organization’s belief in the right to access care and the inherent worth of individuals we care for. While that’s all well and good, when writing a grant request to the NC Office of Rural Health, they tend to care more about things like, well, money. In that grant request, we were careful to emphasize ROI, calculating potential community savings brought about by prevention of unnecessary ER trips. Different outcomes constitute impactful results for different audiences.

It’s a team effort: For some of the more formal grants I worked on this year, as many as five or six people would be involved in their writing. Typically, I would get to take a first stab at the narrative and work to find any clinical, local, or national data we might need to support our request. Requests for general operating funds were pretty straightforward because I could use fairly similar wording across grants. However, when writing for a new program, like when we wanted one of our providers to work onsite at a public housing location, I needed information from clinical staff to understand what the program would actually look like. Often times, the individuals that would know this (namely, our Chief Operating Office), would be busy with other things, like you know, keeping the clinic running, so I would take a stab at outlining the program. Then, when I had a chance to sit down with the COO she’d provide input as to what resources would be needed for the program to succeed and what I missed in the narrative. She would also help come up with reasonable objectives, usually with support from our data analyst. This would then get passed on to my supervisor, the Director of Development, who would work on the detailed budget and make my narrative sound a lot nicer (despite my Writing 101 professor’s best efforts, I’m the queen of unnecessary commas). When she was done, it would go back to the COO and CEO for final approval.

Outcomes are really, really tricky: Outcomes are what support the worth of your work. They give the grantor an idea of the tangible results that we anticipate coming if they fork over the money. However, there are a lot of things that make coming up with these objectives tough. Sure, we know that having a nurse who coordinates the care of our patients with chronic disease improves outcomes for them, but how do we measure that? 150 unnecessary ER trips avoided? Lower A1c levels for our diabetics by 1? A 25% increase in access to a patient care team? Are these objectives too broad, do they have too little direct correlation to the nurse coordinator, or are they too hard to measure? Even if we already track this data, do we have the capability to export it from our Electronic Health Records system? Additionally, what we think are significant goals may not seem that impactful to funders. For example, when we say the hire of a nurse coordinator will improve outcomes for our diabetics by 5%, we’re taking into account the many social determinants that impact our patients and the comorbidities that they often present with. But for some funders who may not understand our patient population as well, a 5% improvement may hardly seem a worthy investment.

It has certainly been a challenge to attempt to convey the value of our work to those who will never have the chance to meet our patients, but one I have very much enjoyed. It’s also been pretty great to start seeing the results of our efforts. Over the last two weeks we have received notice of having been awarded more than $170,000 for various grants we wrote earlier this year. While this may seem like a drop in the bucket, for us it means kick starting our effort to provide onsite services in public housing, buying medical supplies for our pediatric patients, providing health education workshops for seniors, and covering the cost of part of our nurse care coordination team. As I’m currently finishing out my final weeks here at the clinic, I won’t be around to see these funds in action. However, I’m grateful to have been given a chance to play a small part in tracking down the resources needed to let our clinic staff do more of their incredibly important work.

From Directionless to DIF and On…


As I approach the last quarter of my time as a Fellow and head on to pursue my Masters of Public Health next fall, the DIF’s fearless leader in Career Development asked if I might share how I got here from last year when I had no inkling of what I might do the next year, let alone for the rest of my life. So here goes…

During undergrad, it seemed like most of my friends figured out what they loved early on, from chem research to music theory, and stuck with it. Meanwhile, I had a blast bouncing around from gene editing and behavioral ecology to as many East Asian religions classes as I could sneak in (take a class with Dr. Pang and thank me later). But even after hours lounging outside the Union listening to tour guides assure parents that Davidson produced students before athletes (“Athletes and other students all go to the same classes AND eat in the same dining hall!”), I can’t deny swimming was my thing. I enjoyed going to class, but heading to Baker to try and chase down the guys at the end of a long set? That was what I loved.

Then senior year rolled around, and I was still sitting outside the Union drinking gallons of Honest Tea, now mulling over the fact that “run of the mill athlete in low interest sport” didn’t have a great post-collegiate outlook. I decided to buy more time by applying to a bunch of one year positions to put off figuring out what I actually wanted to do. I got an interview for the DIF’s Community Health Cohort despite having no significant public health background nor having taken a single public health centered class. The interview fell while I was off at NCAAs that spring, so I watched some quick webinars on the US health care system in between sessions, Skyped in from my hotel, and hoped for the best. Three months later, I walked in to my first day of work at Charlotte Community Health Clinic (CCHC).

Fortunately, my colleagues cared less about what I knew how to do and more about what I could learn to do quickly. I started by researching and writing grants, getting trained in EPIC (our electronic medical records system), and learning about the data gathering and analysis required for our federal grants. I taught myself our donor management system and became responsible for it. I worked with our referral coordinator on our follow-up process, rewrote our volunteer program, and worked with the community at outreach events. I interviewed our patients for advocacy and development purposes, analyzed our clinical and demographic data, and worked on program planning for expanding our women’s clinic and HIV services. I had the opportunity to sit in on a variety of health related community coalitions and work with my own cohort on writing a grant proposal for a resource we identified as missing from all of our clinics. And, I find value in the work I do. When I get tired of sitting at my desk for ten hours, I think of one of the countless stories that trickle back from clinical staff of lives changed and of individuals able to do the things they love most because of CCHC’s work. It’s more than enough to keep me going.

So, if you don’t know what you want to do next year, find an opportunity like this one that lets you try a little bit of everything. The exposure to a wide range of experiences allowed me to quickly identify what was not my thing (development) and what might be (health intervention implementation). By the time late fall rolled around, I had realized community focused public health was something I could imagine myself doing for the rest of my career. I look forward to getting to play with data while trying to communicate it in a way that creates the potential for systems level change. I’m excited to still work with the strict quantitative perspectives I revered in bio classes interwoven with the unpredictable challenges that surface when you try to apply them in real communities. I love how public health pulls from the multitude of disciplines and experiences I enjoyed at Davidson but never quite figured out how to tie together.

So, should I have tried to narrow my academic focus more while at Davidson? Probably. If I had to redo it, would I do anything different? Probably not. I had the time of my life making swimming my thing at Davidson. And, despite not finding my exact academic passion while at school, I’m still confident that I gained the writing, communication, and critical thinking skills that will allow me to tackle the challenges of a career in health interventions. I’ve now lived one of the benefits of a liberal arts education: my time at Davidson prepared me for a career I didn’t even know I was interested in while at school. So to any panicking seniors that don’t know where you’ll end up, go get yourself a Union Egg & Cheese Wrap (potentially what I miss most about Davidson), relax, and maybe apply for a DIF Fellowship or two. When you eventually figure out where you want to be, chances are Davidson has already given you many of the skills you’ll need to succeed there.

Adding Voices to the Numbers: Stories as Advocacy at Charlotte Community Health Clinic

Last week, the clinic that I work for, Charlotte Community Health Clinic (CCHC), participated in National Health Center Week. During this week, across the nation, Federally Qualified Health Centers (FQHCs) put on free events like pediatric immunizations and health fairs for the community. Since FQHCs differ from free clinics in that they are more dependent on federal funding, this week is also used in part to let elected officials learn more about the work health centers do. As a part of this task, we spent some time interviewing and photographing patients and staff to learn more about their stories so we could try and share them with the elected officials who attended our events. The end result was small note cards with quotes pulled from the stories of patients and staff that we put on the tables at our big celebratory breakfast.

It was a strange to see the people we had interviewed, including some patients who had talked to us for hours, whittled down to a sentence or two taken out of context. It felt like I had done our patients an injustice in not having conveyed the complexity of their stories. In describing the community we serve, our patients tend to get thrown in big categories, like “low-income,” “homeless,” “unemployed,” or “immigrant.” Yet, the first thing many of the patients I interviewed tried to do was make clear that that they didn’t fit neatly into one of those molds. From the patients who had worked as teachers or engineers for thirty-some years before being laid off, to the Pakistani immigrant who had been a US citizen for decades and paid taxes since day one, many of these patients were aware of the stereotypes that tend to be associated with those seeking low cost healthcare. For some, fighting those assumptions was why they were willing to share their stories.

The stories themselves ranged from frustrating to heartbreaking. There was the woman who searched and searched for somewhere to have a mammogram but by the time she found us and got one through our clinic she was diagnosed with Type II breast cancer and went on to have a double mastectomy. Or there was the family whose grandmother simply could not get her diabetes under control, not because she wasn’t trying, but because she had to eat whatever her neighbors were kind enough to give her. Since one son had been killed, and the other deported, she couldn’t afford to be choosy as she struggled to take care of all her grandchildren. Others were more pragmatic, describing how primary care keeps people working and keeps people away from expensive ER trips. Some stories, like the woman whose daughter had a lump in her breast but couldn’t afford the further testing to determine if it was cancerous, were almost inconceivable.

As it turns out, it’s impossible to capture the injustice of not being able to afford to find our whether your daughter is going to live or die in a sentence or two on a notecard. At the same time, it’s hard not to wonder who might be compelled to action if you could. At our National Health Center Week events, both Mayor Jennifer Roberts and Congresswoman Alma Adams made clear that there is a clear need for increased health care access in Mecklenburg County, and Congresswoman Adams acknowledged, “A medical emergency does not care if you are a Republican or Democrat.”  While that’s a hard statement to argue with, many across the country still seem to disagree about whether the care for that emergency should be a right or a privilege. For my part, I wonder how many more people would support the right to basic health care access if they had the opportunity to meet the people whose complex stories and struggles are lost behind the numbers thrown around regarding our health care system.  One challenge I look forward to as I continue my year at CCHC is figuring out how I can better amplify those voices, as I have no doubt that these are stories that deserve, and need, to be heard.