Penobscot Community Health Center

HEALTH CENTER CLUSTER

HEALTH CENTER CLUSTER

AMERICAN RESCUE PLAN ACT FUNDING FOR HEALTH CENTERS

AFFORDABLE CARE ACT TEACHING HEALTH CENTER (THC) GRADUATE MEDICAL EDUCATION (GME) PAYMENT PROGRAM

AFFORDABLE CARE ACT - CAPITAL DEVELOPMENT GRANTS

ARRA - CAPITAL IMPROVEMENT PROGRAM

HEALTH CENTER CORONAVIRUS AID, RELIEF, AND ECONOMIC SECURITY (CARES) ACT FUNDING

WELLNESS INTEGRATED SUPPORTIVE HOUSING (WISH)

ANE - NURSE PRACTITIONER RESIDENCY PROGRAM

ADVANCED NURSING EDUCATION- NURSE PRACTITIONER RESIDENCY FELLOWSHIP PROGRAM

AFFORDABLE CARE ACT TEACHING HEALTH CENTER (THC) GRADUATE MEDICAL EDUCATION (GME) PAYMENT PROGRAM

CONGRESSIONALLY DIRECTED SPENDING FOR CONSTRUCTION PROJECTS - PENOBSCOT COMMUNITY HEALTH CENTER’S (PCHC) CDS FUNDING REQUEST IS TO RENOVATE EXISTING SPACE OWNED BY PCHC AND TO PURCHASE FFE (FURNITURE, FIXTURES, EQUIPMENT) TO OPEN A DENTAL CLINIC IN BELFAST, MAINE. THE DENTAL CLINIC WILL BE CO-LOCATED WITH PCHC’S PRIMARY CARE PRACTICE, SEAPORT COMMUNITY HEALTH CENTER (SCHC), AND AVAILABLE TO SCHC’S PRIMARY CARE PATIENTS AS WELL AS NON-PATIENTS. THE DENTAL PRACTICE WILL OFFER COMPREHENSIVE DENTAL SERVICES. DENTAL CARE ACCESS IN WALDO COUNTY IS EXTREMELY LIMITED, ESPECIALLY FOR MAINECARE, UNINSURED AND UNDERINSURED PATIENTS. THE U.S. HEALTH RESOURCES AND SERVICES ADMINISTRATION (HRSA) DESIGNATES THE BELFAST, WALDO COUNTY AREA AS A “HEALTH PROVIDER SHORTAGE AREA” IN BOTH MENTAL HEALTH AND DENTAL FIELDS AND CONSIDERS THE ENTIRE COUNTY TO BE A “MEDICALLY UNDERSERVED AREA.” ACCORDING TO COUNTY RURAL HEALTH PROFILE DATA, NEARLY 30% OF WALDO COUNTY RESIDENTS ARE AT 150% OR BELOW OF THE FEDERAL POVERTY LEVEL, INCLUDING 11% OF SENIORS, A SIGNIFICANTLY HIGHER RATE THAN THE STATE AVERAGE OF 8.7%. MEDIAN HOUSEHOLD INCOME IN WALDO COUNTY IS NEARLY 13% LOWER THAN THE STATE AVERAGE ($42,221), IN A STATE WHERE MEDIAN INCOME LAGS THE NATIONAL AVERAGE SIGNIFICANTLY. THERE IS A HIGHER RATE OF PUBLICLY INSURED AND UNINSURED PATIENTS IN WALDO COUNTY THAN IN THE REST OF MAINE. THOUGH PRIVATE PRACTICE DENTISTS EXIST IN THE REGION, THEY ACCEPT FEW, IF ANY MAINECARE PATIENTS AND DO NOT HAVE A SLIDING FEE SCALE FOR LOW INCOME, SELF-PAY PATIENTS. WITHOUT ACCESS TO COMPREHENSIVE DENTAL CARE, ORAL DISEASES PROGRESS RAPIDLY, BECOMING EMERGENT AND LEADING TO LOSS OF TEETH, WHICH EXACERBATES OTHER HEALTHCARE CONDITIONS. LACKING PREVENTIVE CARE, PEOPLE OVERUTILIZE HOSPITAL EMERGENCY ROOMS AND OTHER MEDICAL FACILITIES TO HELP MANAGE DENTAL PAIN, DRIVING UP THE TOTAL COST OF CARE TO THE HEALTHCARE SYSTEM. DENTAL PAIN IS AMONG THE TOP DRIVERS OF EMERGENCY ROOM UTILIZATION. ATTEMPTS TO SELF-MANAGE PREVENTABLE DENTAL PAIN ASSOCIATED WITH ORA L DISEASE CAN ALSO LEAD TO OPIOID ADDICTION AND OTHER SUBSTANCE USE DISORDERS (SUDS). MOREOVER, POOR ORAL HYGIENE LEADS TO POOR NUTRITION, LOW CONFIDENCE, LOWER EMPLOYMENT RATES, AND A DOWNWARD SPIRAL IN HEALTH AND WELLBEING AND SOCIOECONOMIC STATUS. IN NOVEMBER 2021, PCHC, MAINE’S LARGEST FQHC, PURCHASED THE FORMER BANK OF AMERICA COMPLEX IN BELFAST, MAINE IN ORDER TO SECURE SPACE TO EXPAND ITS PRIMARY CARE CLINIC. SCHC HAS PROVIDED INTEGRATED PRIMARY CARE IN THE REGION FOR OVER 40 YEARS, BUT IN THE PAST DECADE DEMAND FOR PRIMARY, MENTAL HEALTH AND SUBSTANCE USE DISORDER SERVICES HAS GROWN EXPONENTIALLY. PCHC RECENTLY RENOVATED AND NOW HOUSES SCHC’S EXPANDED PRIMARY CARE CLINIC ON THE FIRST FLOOR OF BUILDING 5 OF THE COMPLEX. CDS FUNDS WILL BE USED TO RENOVATE A PORTION OF THE SECOND FLOOR OF THIS BUILDING, APPROXIMATELY 4,500 SF, AND TO PURCHASE EQUIPMENT FOR A NEW DENTAL CLINIC. THE SCOPE OF THESE RENOVATIONS INCLUDES NEW INTERIOR WALLS, NEW ELECTRICAL, NEW HVAC DISTRIBUTION, AND THE INSTALLATION OF THE DENTAL EQUIPMENT NECESSARY FOR AN 8-CHAIR DENTAL CLINIC. THIS PROJECT WILL NOT REQUIRE RENOVATIONS TO THE EXTERIOR OF THE FACILITY OR GROUND DISTURBANCE. THIS REQUEST FOR CDS FUNDING WILL SIGNIFICANTLY IMPROVE ACCESS TO ORAL HEALTHCARE IN WALDO COUNTY FOR ALL, REGARDLESS OF ABILITY TO PAY. THE CLINIC WILL SERVE A PROJECTED 7,200 PATIENTS EACH YEAR. WE WILL ALSO PROVIDE ACUTE/WALK-IN DENTAL CARE SERVICES, SIGNIFICANTLY REDUCING ED UTILIZATION FOR EMERGENT DENTAL NEEDS. THE RENOVATION PROJECT WILL ADD APPROXIMATELY 15 FTE CONSTRUCTION JOBS. THE CLINIC WILL EMPLOY 13-15 FTE PERMANENT DENTAL TEAM MEMBERS. ADDING DENTAL SERVICES IS A WIN FOR THE COMMUNITY AND THE HEALTHCARE SYSTEM: IT WILL INCREASE JOBS, SUPPORT ECONOMIC DEVELOPMENT, EFFICIENTLY LEVERAGE TAXPAYER DOLLARS FLOWING TO FQHCS, AND REDUCE THE TOTAL COST OF CARE TO MAINE’S HEALTHCARE SYSTEM.

RECOVERY ACT HEALTH CENTER CLUSTER PROGRAM

HEALTH CENTER INFRASTRUCTURE SUPPORT

TELEHEALTH NETWORK GRANT PROGRAM

FY 2020 EXPANDING CAPACITY FOR CORONAVIRUS TESTING (ECT)

RURAL COMMUNITIES OPIOID RESPONSE-IMPLEMENTATION

HEALTH INFRASTRUCTURE INVESTMENT PROGRAM

HEALTH CENTER PROGRAM SERVICE EXPANSION - SCHOOL BASED SERVICE SITES (SBSS)

RESIDENCY TRAINING IN GENERAL AND PEDIATRIC DENTISTRY

NURSE EDUCATION PRACTICE, QUALITY AND RETENTION

ARRA - INCREASE SERVICES TO HEALTH CENTERS

CAPITAL DEVELOPMENT

ARP ECONOMIC DEVELOPMENT GRANT FOR RURAL HEALTH CARE FACILITIES

WELLNESS INTEGRATED SUPPORTIVE HOUSING (WISH)

HEALTH CENTER PROGRAM SERVICE EXPANSION - SCHOOL BASED SERVICE SITES (SBSS)

TEACHING HEALTH CENTER GRADUATE MEDICAL EDUCATION PROGRAM

AFFORDABLE CARE ACT (ACA) GRANTS FOR SCHOOL-BASED HEALTH CENTERS CAPITAL PROGRAM

FY 2023 EXPANDING COVID-19 VACCINATION

FY 2020 CORONAVIRUS SUPPLEMENTAL FUNDING FOR HEALTH CENTERS

FY 2023 BRIDGE ACCESS PROGRAM

HOMELESS ASSISTANCE

HOMELESS ASSISTANCE

HOMELESS ASSISTANCE

HOMELESS ASSISTANCE

CONTINUUM OF CARE PROGRAM

CONTINUUM OF CARE PROGRAM

CONTINUUM OF CARE PROGRAM

CONTINUUM OF CARE PROGRAM

CONTINUUM OF CARE PROGRAM

CONTINUUM OF CARE PROGRAM

CONTINUUM OF CARE PROGRAM

CONTINUUM OF CARE PROGRAM

CONTINUUM OF CARE PROGRAM

RYAN WHITE TITLE III HIV CAPACITY DEVELOPMENT AND PLANNING GRANTS - CATEGORY: HIV CARE INNOVATION ACTIVITY: STRATEGIC PARTNERSHIPS/PARTNERSHIP DEVELOPMENT REQUEST: $150,000 PENOBSCOT COMMUNITY HEALTH CENTER, INC. (PCHC) 103 MAINE AVE, BANGOR, ME 04401 WWW.PCHC.COM PROGRAM DIRECTOR: AMY WEST, FNP-C, CARN-AP, AMY.WEST@PCHC.COM, 207-404-8000 CONTACT: HEATHER BLACKWELL, HBLACKWELL@PCHC.COM, 207-992-9200 EXT. 1504 PCHC IS THE LARGEST FQHC IN MAINE AND THE 6TH LARGEST IN NEW ENGLAND. WHILE WE SERVE 3 COUNTIES, OUR MAIN OFFICES AND MOST OF OUR SERVICE SITES ARE LOCATED IN BANGOR, PENOBSCOT COUNTY, WHICH IS CENTRALLY POSITIONED IN THIS GEOGRAPHICALLY VAST AND RURAL STATE. BANGOR IS CURRENTLY FACING AN HIV OUTBREAK, AND PCHC IS AT THE FOREFRONT OF EFFORTS TO CONTAIN IT. HISTORICALLY, HIV RATES IN OUR REGION AND STATE HAVE BEEN LOW. OVER THE PAST 5 YEARS, PENOBSCOT COUNTY AVERAGED 2 NEW HIV CASES/YEAR, WITH 1 NEW DIAGNOSIS ANNUALLY AMONG PEOPLE WHO INJECT DRUGS (PWID). HOWEVER, ON 2/26/24, THE MAINE DEPARTMENT OF HEALTH AND HUMAN SERVICES ISSUED A PUBLIC HEALTH ADVISORY ANNOUNCING A CLUSTER OF 3 NEW HIV DIAGNOSES AMONG PWID IN PENOBSCOT COUNTY. ALL CASES TRACED BACK TO A LARGE ENCAMPMENT IN BANGOR, FORMED BY INDIVIDUALS EXPERIENCING HOMELESSNESS AROUND THE ONSET OF THE COVID-19 PANDEMIC. IN RECENT YEARS, BANGOR’S UNHOUSED POPULATION HAS SPIKED, AND THE COMMUNITY HAS STRUGGLED TO MANAGE THIS INCREASE, PARTICULARLY DURING THE PANDEMIC, WHICH COMPLICATED INFECTION CONTROL EFFORTS. THE FIRST HIV CASE WAS DIAGNOSED IN OCTOBER 2023. GIVEN WE HAD HISTORICALLY BEEN A LOW-CASE AREA, OUR HEALTHCARE SYSTEMS AND SUPPORT SERVICES WERE UNPREPARED FOR THIS SITUATION. WE LACKED THE INFRASTRUCTURE TO EFFECTIVELY MANAGE IT, AND THE NUMBER OF CASES HAS CONTINUED TO RISE. AS OF 3/1/25, THE MAINE CDC REPORTED 21 CONFIRMED CASES IN THIS CLUSTER. ALL 21 INDIVIDUALS HAD INJECTED DRUGS WITHIN 1 YEAR OF THEIR HIV DIAGNOSIS, 20 WERE CO-INFECTED WITH HEPATITIS C, AND 19 HAD BEEN UNHOUSED WITHIN 1 YEAR OF DIAGNOSIS. THE SITUATION HAS ESCALATED TO THE POINT WHERE THIS IS NOW CLASSIFIED AS AN OUTBREAK. THIS OUTBREAK IS RESPONSIBLE FOR A 119% INCREASE IN NEW HIV DIAGNOSES STATEWIDE IN 2024 (COMPARED TO THE PREVIOUS 5 YEARS' AVERAGE) AND A 750% INCREASE IN PENOBSCOT COUNTY. DESPITE FACING SEVERE HEALTHCARE WORKFORCE SHORTAGES, FINANCIAL CHALLENGES FOLLOWING THE PANDEMIC, AND LACK OF FUNDING ASSISTANCE, PCHC AND OTHER KEY PARTNERS HAVE WORKED TIRELESSLY TO CONTAIN THIS OUTBREAK. HRSA FUNDING WILL ENABLE US TO STRENGTHEN OUR RESPONSE AND DEVELOP THE INFRASTRUCTURE NECESSARY TO MANAGE CURRENT PATIENTS, ADDRESS NEW DIAGNOSES RESULTING FROM THIS OUTBREAK, AND PREPARE FOR POTENTIAL FUTURE OUTBREAKS. SINCE THIS OUTBREAK PRIMARILY AFFECTS UNHOUSED INDIVIDUALS AND PWID—MANY OF WHOM DO NOT ENGAGE WITH SHELTER PROGRAMS AND ARE EITHER LIVING ON THE STREETS OR IN ENCAMPMENTS—THIS GROUP REPRESENTS OUR TARGET POPULATION. THE MAIN GOALS OF OUR PROJECT ARE TO (1) INCREASE ACCESS TO HIGH-QUALITY HIV PRIMARY HEALTHCARE SERVICES FOR LOW-INCOME AND UNDERSERVED PEOPLE LIVING WITH HIV, AND (2) STRENGTHEN ORGANIZATIONAL AND REGIONAL CAPACITY TO RESPOND TO HIV. KEY ACTIVITIES WILL INCLUDE HIRING A PARTNERSHIP SYSTEMS-BUILDING CONSULTANT TO PROVIDE SHORT-TERM OUTBREAK COORDINATION AND HELP BUILD A LONG-TERM STRATEGIC SYSTEM FOR MANAGING HIV IN OUR REGION. THIS CONSULTANT WILL FORMALIZE OUR CURRENT PARTNERSHIPS INTO A CONSORTIUM, OPTIMIZE EACH PARTNER'S EXPERTISE, AND DEVELOP AN INFRASTRUCTURE AND ACTION PLAN FOR ONGOING WORK. WE WILL CREATE AND MAINTAIN A COMPREHENSIVE REFERRAL LIST AND ENHANCE PROVIDER EDUCATION EFFORTS. ADDITIONALLY, PCHC WILL COLLABORATE WITH PARTNERS TO OFFER “STREET OUTREACH” SERVICES TO OUR TARGET POPULATION, PROVIDING EARLY LINKAGE TO CARE AND SUPPORT TO ENGAGE “HARD-TO-REACH” INDIVIDUALS IN THE HIV CARE CONTINUUM. OVER THE COURSE OF OUR ONE-YEAR PROJECT, WE AIM TO STRENGTHEN OUR CAPACITY TO ADDRESS ALL FIVE STAGES OF THE HIV CARE CONTINUUM AND BUILD A SUSTAINABLE INFRASTRUCTURE TO CONTINUE THIS WORK IN THE FUTURE.

HEALTH INFRASTRUCTURE INVESTMENT PROGRAM