Medical Care Development Incorporated

ACCELERATING THE REDUCTION OF MALARIA MORBIDITY AND MORTALITY PROGRAM (ARM3)

USAID MALARIA CAPACITY STRENGTHENING (MCAPS) IN NAMPULA, ZAMBEZIA AND MANICA PROVINCES OF MOZAMBIQUE

TO IMPLEMENT THE MALARIA DIAGNOSTICS ACTIVITY IN SUPPORT OF THE NATIONAL MALARIA CONTROL PROGRAM (NMCP) PROGRAMS.

ZIKA COMMUNITY RESPONSE (ZICORE)

RURAL BEHAVIORAL HEALTH WORKFORCE COORDINATING CENTERS ? NORTHERN BORDER REGION

COMMUNITY HEALTH WORKER TRAINING PROGRAM - ADDRESS: 107 SECOND AVE. SUITE 2A, HALLOWELL, ME 04347 PROJECT DIRECTOR: ELIZABETH FOLEY, MBA PHONE: 207-622-7566 X297 EMAIL: EFOLEY@MCD.ORG WEBSITE: WWW.MCD.ORG FUNDING REQUESTED: $2,968,351 FUNDING PREFERENCE(S) REQUESTED: YES (ADD WHICH ONES) MEASURABLE OBJECTIVES: 255 CHWS, AT LEAST 191 OF WHOM WILL BE NEWLY CERTIFIED AND AT LEAST 58 OF WHOM WILL PARTICIPATE IN A DEPT. OF LABOR REGISTERED CHW APPRENTICESHIP PROGRAM. HRSA CLINICAL PRIORITIES TO BE ADDRESSED: HEALTH EQUITY WHO/WHAT/WHEN/WHERE/WHY/HOW: MCD IS A NON-PROFIT PUBLIC HEALTH INSTITUTE BASED IN MAINE. MCD HAS AN EXISTING CHW TRAINING PROGRAM THAT HAS BEEN UTILIZED BY CHWS IN EACH OF THE FIFTY STATES AND MORE THAN A DOZEN OTHER COUNTRIES. INITIAL RECRUITMENT FOR PARTICIPANTS IN THIS GRANT SUPPORTED TRAINING TO BECOME NEW CHWS AND TO PARTICIPATE IN APPRENTICESHIPS WILL INITIALLY FOCUS ON MAINE, AND SPREAD TO OTHER AREAS AS POSSIBLE. UPSKILLING AND EXPANDED OPPORTUNITIES FOR CONTINUING EDUCATION FOR EXISTING CHWS WILL BE MADE AVAILABLE NATIONALLY. MCD IS ABLE TO OFFER CHW CORE COMPETENCY TRAINING IN PERSON AND IN 100% VIRTUAL FORMATS. MCD OPERATES A LARGE HEALTH SUPPORT WORKER ONLINE LEARNING MANAGEMENT SYSTEM THAT IS CLOUD BASED. BOTH WILL BE EXPANDED THROUGH THIS GRANT FUNDING. PROJECT SUMMARY: MCD PROPOSES TO INCREASE THE NUMBER OF COMMUNITY HEALTH WORKERS (CHWS) AND ENHANCE THE SKILLS OF EXISTING CHWS ("UPSKILL") UTILIZING NEW AND EXISTING TRAINING CURRICULUMS MCD WILL RECRUIT AND TRAIN CHWS, AND LINK CHWS WITH EMPLOYMENT. CHWS WILL ALSO ENHANCE THEIR SKILLS THROUGH FIELD PLACEMENTS, AND APPRENTICESHIPS IMPLEMENTED BY THE APPLICANT WITH A NETWORK OF COMMUNITY-BASED AND CLINICAL PARTNERS TO ASSURE THE CHW AND HEALTH SUPPORT WORKERS ARE ABLE TO RESPOND TO PUBLIC HEALTH EMERGENCIES AND SUPPORT PROVISION OF ESSENTIAL PUBLIC HEALTH SERVICES. STRATEGIES TO ADDRESS HEALTH EQUITY INCLUDE EMPHASIS ON IDENTIFYING, RECRUITING, AND TRAINING APPROPRIATE INDIVIDUALS FROM UNDERSERVED C OMMUNITIES. THE PREPARED CHWS AND HEALTH SUPPORT WORKERS WILL BECOME PART OF INTEGRATED CARE TEAMS THAT WILL HELP REDUCE HEALTH DISPARITIES.

TELEHEALTH TECHNOLOGY-ENABLED LEARNING PROGRAM

GH/HIDN/ID 936-3100 AAD

REGIONAL TELEHEALTH RESOURCE CENTERS

TELEHEALTH RESOURCE CENTER GRANT PROGRAM

GABONESE DEFENSE AND SECURITY FORCES (FDSG) PARTNERSHIP FOR SUSTAINABLE HIV EPIDEMIC CONTROL

MILITARY SPECIFIC HIV/AIDS PREVENTION, CARE AND TREATMENT PROGRAM FOR GABON

THE PURPOSE OF THIS MODIFICATION IS TO PROVIDE INCREMENTAL FUNDING IN THE AMOUNT OF $904,865.

TELEHEALTH RESOURCE CENTER GRANT PROGRAM

CATEGORY C: COMMUNITY-BASED PUBLIC HEALTH WORKFORCE INCLUDES AN ARRAY OF HEALTH PROMOTION AND DISEASE PREVENTION PROGRAM STAFF, COMMUNITY HEALTH WORKERS (CHWS), HEALTH NAVIGATORS, AND PEER SUPPORT WORKERS EMPLOYED BY NON-PROFIT ORGANIZATIONS, INCLUDING BUT NOT LIMITED TO COMMUNITY-BASED ORGANIZATION - MCD PROPOSES TO IMPROVE ORGANIZATIONAL AND SYSTEMS INFRASTRUCTURE AND PERFORMANCE ACROSS THE PUBLIC HEALTH SYSTEM TO ULTIMATELY IMPROVE HEALTH OUTCOMES AND REDUCE HEALTH DISPARITIES AND ACHIEVE HEALTH EQUITY THROUGH STRENGTHENING THE NON-PROFIT NON-GOVERNMENTAL PUBLIC HEALTH SECTOR WITH A FOCUS ON THE COMMUNITY-BASED PUBLIC HEALTH WORKFORCE. THE COMMUNITY-BASED PUBLIC HEALTH WORKFORCE INCLUDES AN ARRAY OF HEALTH PROMOTION AND DISEASE PREVENTION PROGRAM STAFF, COMMUNITY HEALTH WORKERS (CHWS), HEALTH NAVIGATORS, AND PEER SUPPORT WORKERS EMPLOYED BY NON-PROFIT ORGANIZATIONS, INCLUDING BUT NOT LIMITED TO COMMUNITY-BASED ORGANIZATIONS (CBOS). NON-PROFIT PUBLIC HEALTH ORGANIZATIONS MAY INCLUDE COMMUNITY HEALTH CENTERS, SCHOOLS, SOCIAL SERVICE AGENCIES, COMMUNITY ACTION PROGRAMS, AND PRIMARY CARE PROVIDER ORGANIZATIONS. MCD WILL DO THIS THROUGH PROVIDING CAPACITY BUILDING ASSISTANCE (CBA) VIA TRAINING AND TECHNICAL ASSISTANCE (TTA), INFORMATION SHARING, TECHNOLOGY TRANSFER, AND OR MATERIALS DEVELOPMENT IN THE FOLLOWING AREAS: ORGANIZATIONAL CAPACITY AND PERFORMANCE IMPROVEMENT; WORKFORCE; INFORMATION TECHNOLOGY; PARTNERSHIP DEVELOPMENT AND ENGAGEMENT; AND BEST PRACTICE PROGRAMS. THE NON-PROFIT PUBLIC HEALTH WORKFORCE IS A CRITICAL COMPONENT OF THE U.S. PUBLIC HEALTH SYSTEM AND KEY TO PUBLIC HEALTH EMERGENCY RESPONSE, MANAGEMENT OF CHRONIC CONDITIONS, HEALTH DISPARITIES AND INCREASING HEALTH EQUITY AMONG UNDERSERVED POPULATIONS. MCD'S PROPOSED PERFORMANCE MEASURES DIRECTLY CORRELATE WITH OUR STRATEGIES AND ACTIVITIES AND WILL CONTRIBUTE TO ACHIEVING THE FOLLOWING CDC-RFA-PW-24-0080 OUTCOMES. • SHORT-TERM OUTCOME: INCREASED AVAILABILITY OF AND ACCESS TO CBA SERVICES AND PRODUCTS THAT ADDRESS THE STRATEGIC AREAS. • INTERMEDIATE OUTCOME: INCREASED AWARENESS AND UNDERSTANDING OF RECOMMENDED PROCESSES, POLICIES, PROGRAMS, AND PRACTICES WITHIN THE STRATEGIC AREAS. • INTERMEDIATE OUTCOME: ENHANCED SKILL AND ABILITY TO SUPPORT DECISION-MAKING TOWARD APPLYING RECOMMENDED PROCESSES, POLICIES, PROGRAMS, AND PRACTICES WITHIN THE STRATEGIC AREAS INTENDED FIVE YEAR OUTCOME: IMPROVED ORGANIZATIONAL AND SYSTEMS CAPACITY TO ADDRESS EQUITY FOCUSED PUBLIC HEALTH PRIORITIES. STRATEGY (PRIMARILY BUT NOT EXCLUSIVELY): PARTNERSHIP DEVELOPMENT AND ENGAGEMENT • ACTIVITIES (PRIMARILY BUT NOT EXCLUSIVELY) IMPROVE DEVELOPMENT AND MAINTENANCE OF RESULTS-DRIVEN PARTNERSHIPS AT VARIOUS LEVELS. CBA TO FOCUS ON ADDRESSING NEEDS SUCH AS: CONDUCTING ASSESSMENT AND IMPROVEMENT PLANNING, ENGAGING WITH COMMUNITY POPULATIONS, PARTNERS, AND MULTIPLE SECTORS; ENGAGING COMMUNITY MEMBERS AND POPULATIONS USING COMMUNITY-DRIVEN, CULTURALLY INFORMED APPROACHES TO IMPROVE OUTCOMES PERIOD OF PERFORMANCE OUTCOME: AUG.1, 2024 – JULY 31, 2025: INCREASED AVAILABILITY OF AND ACCESS TO CBA SERVICES AND PRODUCTS THAT ADDRESS THE STRATEGIC AREAS. OUTCOME MEASURE: INCREASED AVAILABILITY OF AND ACCESS TO CBA SERVICES AND PRODUCTS THAT ADDRESS THE STRATEGIC AREAS. STRATEGIC AREA: PARTNERSHIP DEVELOPMENT AND ENGAGEMENT PROCESS MEASURE: ELIGIBLE NON-PROFIT NON-GOVERNMENTAL PUBLIC HEALTH ORGANIZATIONS ARE AWARE THAT CBA IS AVAILABLE TO THEM AT NO COST FROM MCD. PERIOD OF PERFORMANCE OUTCOME: AUG.1, 2024 – JULY 31, 2025: INCREASED AVAILABILITY OF AND ACCESS TO CBA SERVICES AND PRODUCTS THAT ADDRESS THE STRATEGIC AREAS. OUTCOME MEASURE: INCREASED AWARENESS AND UNDERSTANDING OF RECOMMENDED PROCESSES, POLICIES, PROGRAMS, AND PRACTICES WITHIN THE STRATEGIC AREAS. STRATEGIC AREA: PARTNERSHIP DEVELOPMENT AND ENGAGEMENT PROCESS MEASURE: AT LEAST 25 NON-PROFIT NON-GOVERNMENTAL PUBLIC HEALTH ORGANIZATIONS RECEIVE CBA SERVICES OR PRODUCTS DURING YEAR ONE.

TECHNOLOGY-ENABLED LEARNING COLLABORATIVE PROGRAM - MEDICAL CARE DEVELOPMENT, INC., (MCD) A NON-PROFIT PUBLIC HEALTH INSTITUTE AND DARTMOUTH HEALTH (DARTMOUTH), AN ACADEMIC MEDICAL CENTER WITH AFFILIATED CLINICAL SITES PROPOSE TO ESTABLISH A NORTHERN NEW ENGLAND – TECHNOLOGY-ENABLED COLLABORATIVE LEARNING PROGRAM (NNE-TCLP) TO SERVE MAINE, NEW HAMPSHIRE, AND VERMONT. MCD, THE LEAD APPLICANT, AND SUB-RECIPIENT DARTMOUTH HAVE WELL OVER 100 YEARS OF COMBINED EXPERIENCE WORKING WITH RURAL HEALTH CARE PROVIDERS TO PROVIDE TRAINING AND TECHNICAL ASSISTANCE (TTA), CAPACITY BUILDING ASSISTANCE (CBA), AND ACCESS TO CLINICAL SPECIALISTS AND SUBJECT MATTER EXPERTS (SME). HRSA-24-121 PROVIDES AN OPPORTUNITY FOR TWO ORGANIZATIONS WITH A LONG HISTORY OF COLLABORATION TO FORMALLY WORK TOGETHER TO ADDRESS EMERGING “SECOND LEVEL” NEEDS AMONG RURAL PROVIDERS IN A MANNER THAT WILL HELP REDUCE PROVIDER ISOLATION AND CAN CONTRIBUTE TO REDUCING TURNOVER IN THE WORKFORCE. THROUGH AN ARRAY OF OTHER GRANTS AND INITIATIVES BOTH MCD AND DARTMOUTH HAVE BEEN USING TECHNOLOGY-ENABLED APPROACHES TO ADDRESS MANY OF THE PRIMARY CONTRIBUTORS TO INEQUITY IN ACCESS TO CARE FOR RESIDENTS OF RURAL NORTHERN NEW ENGLAND AND TO REDUCE ISOLATION AMONG RURAL PROVIDERS. WE MAY NOT BE ABLE TO FIX TRANSPORTATION PROBLEMS, FOR EXAMPLE, BUT WE CAN USE TECHNOLOGY TO VIRTUALLY TRANSPORT PEOPLE AND PROVIDERS TO ONE ANOTHER TO ENABLE BETTER ACCESS AND CONNECT PROVIDERS TO ONE ANOTHER TO REDUCE ISOLATION AND INCREASE THE USE OF BEST PRACTICES WHILE SUPPORTING THE ABILITY OF CLINICIANS TO PROVIDE HIGH QUALITY CARE IN THEIR RURAL COMMUNITIES. IF FUNDED THE PROJECT WOULD EMPLOY 2.28 FULL-TIME POSITIONS AND STIPENDS FOR MANY FACULTY AND SUBJECT MATTER EXPERTS; ENABLE PROVISION OF THREE PROJECT ECHO® PROGRAMS OF 8-10 SESSIONS EACH DURING EACH PROJECT YEAR; ENABLE PROVISION OF TWO RECOVERY JOBS FOR BEGINNERS EACH YEAR; AND ASSURE ADEQUATE DATA COLLECTION AND ANALYSIS TO INFORM CONTENT DECISIONS AND DOCUMENT LESSONS LEARNED AND PROJECT IMPACT THRO UGH PRESENTATIONS AND PUBLICATIONS. APPROXIMATELY 250 PEOPLE FROM 15 OR MORE ORGANIZATIONS WOULD DIRECTLY BENEFIT EACH YEAR BY PARTICIPATING IN THE TECHNOLOGY-ENABLED COLLABORATIVE LEARNING PROGRAMS. OUTREACH WOULD EMPHASIZE RECRUITING PARTICIPATION AMONG PROVIDERS FROM FEDERALLY QUALIFIED HEALTH CENTERS AND LOOK-ALIKES, COMMUNITY MENTAL HEALTH CENTERS, CRITICAL ACCESS HOSPITALS, RURAL HEALTH CLINICS ASSOCIATED WITH DARTMOUTH HEALTH, AND PROVIDERS OF CARE TO STUDENTS IN GRADES K-12. THE SECONDARY IMPACT COULD REACH AS MANY AS ONE-THIRD OF ALL RESIDENTS IN RURAL COUNTIES IN MAINE, NEW HAMPSHIRE AND VERMONT OVER THE FIVE-YEAR PERIOD OF AWARD.

CORONAVIRUS TELEHEALTH RESOURCE CENTERS

COMMUNITY MOBILIZATION FOR SA PREVENTION

TELEHEALTH RESOURCE CENTER GRANT PROGRAM

HEALTHY LINCOLN COUNTY SUBSTANCE USE PREVENTION PARTNERSHIP - PROJECT NAME: HEALTHY LINCOLN COUNTY SUBSTANCE USE PREVENTION PARTNERSHIPLINCOLN COUNTY, MAINE IS MADE UP 19 TOWNS, INCLUDING ONE OFF-SHORE ISLAND COMMUNITY, SPREAD ACROSS OVER 450 SQUARE MILES OF LAND, WITH 450 MILES OF ROCKY COASTLINE IN THE MID-COAST REGION. OUR POPULATION IS ABOUT 34,000. WE HAVE NO CITIES IN OUR COUNTY, AND THE NEAREST ?BOX STORE? IS AT LEAST A 30-40-MINUTE DRIVE EITHER EAST, WEST, OR NORTH. THE COASTAL GEOGRAPHY, WITH ITS MANY PENINSULAS JUTTING MILES INTO HARBORS, CONTRIBUTES TO STRONG LOCAL VILLAGE CULTURE, AS WELL AS ISOLATION. WE HAVE AN ECONOMIC DIVIDE WHICH OUR YOUTH COALITION MEMBER DESCRIBED AS ?LOBSTER BOATS AND SAIL BOATS?. FOR EXAMPLE, THE MEDIAN FAMILY INCOMES OF SOMERVILLE (AN INLAND VILLAGE) AND BOOTHBAY HARBOR ARE $39,063 AND $81,250, RESPECTIVELY. THE BEAUTY OF THE AREA BRINGS TOURISTS, AND WEALTHY RETIREES, MAKING OUR COUNTY THE OLDEST IN MAINE (ALMOST 28% OF OUR POPULATION IS 65 OR OLDER). YET 18.5% OF OUR CHILDREN ARE LIVING IN POVERTY (PRE-COVID), AND THERE EXISTS A ?BRAIN DRAIN? OF YOUNG PEOPLE LEAVING FOR COLLEGE AND RARELY COMING BACK DUE TO A SCARCITY OF JOBS. ALMOST 97% OF RESIDENTS DESCRIBE THEMSELVES AS WHITE/NON-HISPANIC. LINCOLN COUNTY HAS ONE OF THE HIGHEST RATES OF YOUTH WHO IDENTIFY AS LGBTQ IN MAINE, AND MANY LGBTQ ADULTS AND FAMILIES ARE INTEGRATED INTO COMMUNITIES AND ORGANIZATIONS WITH VARYING LEVELS OF ACCEPTANCE. WHILE SMALL TOWN LIFE CREATES SUPPORT AND A SENSE OF DUTY TO CARE FOR ONE ANOTHER, OUR COMMUNITIES ARE CHALLENGED BY LONG-STANDING RELIANCE ON SUBSTANCES TO MANAGE STRESS IN THE FACE OF ECONOMIC AND SOCIAL PRESSURES. ACCORDING TO THE 2018 LINCOLN COUNTY HEALTH PROFILE, OUR CHRONIC HEAVY DRINKING RATE FOR ADULTS IS ABOUT 9%, COMPARED TO 7.6% (MAINE) AND 5.9% (US), AND IS COMMON AMONG MULTI-GENERATIONAL FAMILIES, PARTICULARLY IN THE SEAFARING COMMUNITIES. WITH THE DECRIMINALIZATION OF MARIJUANA IN MAINE, WE EXPECT OUR FIRST RETAIL MARIJUANA SHOPS TO OPEN IN SUMMER OF 2020. YOUNG CHILDREN GROWING UP IN FAMILIES WHO WORK IN THE MARIJUANA INDUSTRY ARE CONFUSED WHEN PROVIDED PREVENTION EDUCATION, WITH ONE SIXTH GRADER NOTING, ?MY PARENTS FINALLY HAVE A STEADY PAYCHECK? FROM THEIR MARIJUANA BUSINESS. THESE FACTORS ARE JUST SOME OF THE CONTEXT WHICH IS CONTRIBUTING TO OUR YOUTH SUBSTANCE USE.THIS PROJECT SEEKS TO CONTINUE ENGAGING OUR COMMUNITY IN PREVENTING AND REDUCING YOUTH SUBSTANCE USE, BUILDING ON OUR SUCCESSES OF THE PAST AND TAKING A DEEPER LOOK INTO SPECIFIC DISPARITIES, SOLIDIFYING OUR SYSTEMS FOR LONG-TERM SUCCESS, AND EQUIPPING THE ADULTS IN OUR COMMUNITY WITH THE SKILLS THEY NEED TO MORE EFFECTIVELY HELP OUR YOUTH MAKE HEALTHY, LOW RISK CHOICES. WE SEEK TO REDUCE THE PERCENT OF OUR YOUTH WHO REPORT DRINKING ALCOHOL AND USING MARIJUANA IN THE PAST 30 DAYS, AND TO INCREASE THEIR ACCESS TO HEALTHY ALTERNATIVES. WE WILL CREATE A ROBUST SYSTEM TO SUPPORT OUR RETAILERS SO THEY CAN CONTINUE TO DO THE RIGHT THING, AND WE WILL MORE FULLY INCORPORATE RESTORATIVE PRACTICES INTO OUR SCHOOLS, ORGANIZATIONS, AND COMMUNITY. WE ARE MOTIVATED TO SHAPE OUR COMMUNITY?S ENVIRONMENT WITH POLICIES AND PRACTICES WHICH FOSTER A HEALTHY, SUBSTANCE-FREE LIFE FOR EVERYONE WHO LIVES, WORKS, AND PLAYS IN LINCOLN COUNTY, AND IN PARTICULAR, OUR YOUNGEST RESIDENTS.

RURAL ACCESS TO EMERGENCY DEVICES

RURAL NORTHERN BORDER REGION OUTREACH PROGRAM - MEDICAL CARE DEVELOPMENT, INC. (MCD), 105 2ND STREET, SUITE 2A, HALLOWELL, ME 04347 (RURAL CENSUS 010700), FACILITY TYPE: 501(C)3 PUBLIC HEALTH INSTITUTE, WWW.MCD.ORG MCD PROJECT CO-DIRECTOR: ANDREW SOLOMON, SENIOR PROGRAM MANAGER, TECHNOLOGY INITIATIVES, 207-622-7566 OR ASOLOMON@MCD.ORG IN COLLABORATION MAINE SEACOAST MISSION (MSM) PROJECT CO-DIRECTOR, MARGARET SNELL, ISLAND SERVICES PROGRAM COORDINATOR, 207-610-3550 OR MSNELL@SEACOASTMISSION.ORG PROJECT TITLE: SEACOAST CARE COLLABORATIVE PROJECT GOALS: THE SEACOAST CARE COLLABORATIVE (SCC) CONSORTIUM AIMS TO SERVE UNBRIDGED ISLAND COMMUNITIES BY: FACILITATING ACCESS TO AND PROVIDE HEALTH CARE SERVICES THROUGH A STRONG COLLABORATIVE AND CONSORTIUM; EXPANDING THE DELIVERY OF NEW OR ENHANCED HEALTH CARE SERVICES THROUGH EVIDENCE-BASED OR EVIDENCE-INFORMED TELEHEALTH MODELS; AND IMPROVE POPULATION HEALTH, HEALTH OUTCOMES, AND SUSTAINABILITY. PROPOSED SERVICE AREA: MAINE RURAL COUNTIES OF HANCOCK, KNOX, WALDO, AND LINCOLN. PRIMARY TARGET POPULATION: ISOLATED, MAINE ISLAND RESIDENTS WHO FACE SIGNIFICANT BARRIERS TO IN-PERSON CARE. FOCUS AREAS: TO IMPROVE ACCESS TO CHRONIC CARE AND ACUTE CARE SERVICES THROUGH TELEHEALTH. SCC MEMBER PARTNERS: 1.) MDI HOSPITAL, CRITICAL ACCESS HOSPITAL/PRIMARY CARE PROVIDER; 2.) NORTHERN LIGHT HEALTH, INTEGRATED HEALTH SYSTEM; 3.) MAINE GENERAL HOSPITAL, INTEGRATED HEALTH SYSTEM; 4.) ST. JOSEPH HOSPITAL; COMMUNITY HOSPITAL, AND 5.) ISLAND COMMUNITY MEDICAL SERVICES, RURAL FQHC. TOGETHER, WITH MCD AND MSM, 85% (6 OF 7) OF MEMBER’S PROJECT LOCATION ARE IN HRSA-DESIGNATED RURAL AREAS. PROJECT ACTIVITIES WILL INCLUDE: 1.) LEAD THE SCC THROUGH SHARED STAFFING, PROJECT MANAGEMENT, AND PARTNER ENGAGEMENT IN PLANNING AND RESOURCE DEVELOPMENT; 2.) MAINTAIN PROGRAM SERVICES AND OPERATIONS PLANS TO DOCUMENT BEST PRACTICES AND DEVELOP RESOURCES TO MANAGE AND SUPPORT ADOPTION AND IMPLEMENTATION; 3.) ACTIVELY SUPPORT SCC MEMBERS TO IMPLEMENT AND OPTIMIZE TELEHEALTH THROUG H TECHNICAL ASSISTANCE AND CONSULTING; 4.) PROVIDE HEALTHCARE NAVIGATION OF SCC RESOURCES FOR ISLANDERS DURING IN-PERSON ISLAND VISITS BY THE SUNBEAM BOAT; 5.) MAINTAIN AN EVALUATION PLAN TO MONITOR PROJECT ACTIVITIES, POPULATION HEALTH OUTCOMES, AND PROCESS MEASURES; AND 7.) DISSEMINATE BEST PRACTICES THROUGHOUT THE NORTHERN BORDER. EXPECTED OUTCOMES WILL MEASURE METRICS ON ACCESS TO CARE, QUALITY OF CARE, TELEHEALTH OPERATIONS AND PROCESS OUTCOMES, AS WELL AS CARE COORDINATION AND NETWORK INFRASTRUCTURE COMPLETION MEASURES. CAPACITY TO SERVE RURAL: EACH NETWORK MEMBER HAS A HISTORY OF SERVING MAINE’S RURAL, UNDERSERVED POPULATIONS. MCD IS BASED IN MAINE AND LEADS THE HRSA-FUNDED NORTHEAST TELEHEALTH RESOURCE CENTER (NETRC) AND THE COLLABORATIVE FOR ADVANCING RURAL EXCELLENCE AND EQUITY (CARER2). MSM IS A NON-PROFIT COMMUNITY SERVICE ORGANIZATION WITH A LONG, TRUSTED HISTORY OF SERVING MAINE’S ISLAND COMMUNITIES, DELIVERING HEALTHCARE, COMMUNITY SUPPORT, AND OTHER RESOURCES THROUGH THEIR BOAT, THE SUNBEAM. CONSORTIUM MEMBERS INCLUDE ALL PRIMARY HEALTH SYSTEMS SERVING THE MAINLAND GEOGRAPHY ACCESSIBLE FROM THE ISLAND COMMUNITIES. THE SCOPE OF THIS PROPOSAL WAS IDENTIFIED BY MCD, MSM, AND CONSORTIUM MEMBERS THROUGH A HRSA RURAL HEALTH NETWORK PLANNING GRANT (P10RH50528). ALL SCC MEMBERS HAVE EXISTING COLLABORATION WITH MCD AND HAVE ESTABLISHED SOME EXISTING TELEHEALTH INFRASTRUCTURE. ALL NETWORK MEMBERS HAVE EXPRESSED A COMMITMENT TO AN INTEGRATED COLLABORATION, FACILITATED BY MCD AND MSM, TO IMPROVE ACCESS TO CARE FOR THESE ISLAND COMMUNITIES. FUNDING OPPORTUNITY NOTIFICATION: THE APPLICANTS LEARNED OF THE OPPORTUNITY THROUGH GRANTS.GOV. FUNDING PREFERENCE: ATTACHMENT 10 INCLUDES PROOF THAT THAT OUR PROJECT SERVICE AREA MEETS FUNDING PREFERENCE ELIGIBILITY QUALIFICATION 1: HEALTH PROFESSIONAL SHORTAGE AREA (HPSA) AND QUALIFICATION 2: MEDICALLY UNDERSERVED COMMUNITY/POPULATIONS (MUC/MUPS). ADDITIONAL INFORMATION, INCLUDING RURAL CENSUS TRACT NUMBERS, ARE INCLUD ED IN ATTACHMENT 7.

HEALTHY LINCOLN COUNTY, IN COLLABORATION WITH LOCAL FARMS, FARMERS MARKETS, AND STATE-LEVEL PARTNERS, WILL PROVIDE MARKETING SUPPORT, TRAINING, TECHNICAL ASSISTANCE TO INCREASE SALES OF LOCALLY GROWN, RAISED, AND PRODUCED FOODS IN LINCOLN COUNTY, MAINE. PROJECT ACTIVITIES WILL BUILD LOCAL FARM FARMERS MARKET CAPACITY TO ENGAGE SNAP EBT AND E WIC SHOPPERS IN LINCOLN COUNTY, MAINE - A LARGELY UNTAPPED MARKET WORTH MORE THAN 3.5M DURING THE SUMMER MARKET SEASON ALONE. TARGET OUTCOMES INCLUDE 270,500 IN COMBINED SALES REVENUE FROM SNAP WIC OVER THREE YEARS, A 20X INCREASE BY YEAR 3 COMPARED TO BASELINE. OUR PROJECT ENGAGES DIVERSE FOOD SYSTEM STAKEHOLDERS, INCLUDING NEW, BEGINNING, UNDERSERVED FARMERS, TO SUPPORT THE DEVELOPMENT, EXPANSION, AND SUSTAINABILITY OF THESE DIRECT PRODUCER-TO-CONSUMER MARKET OPPORTUNITIES. PROJECT BENEFICIARIES: LINCOLN COUNTY S MANY SMALL MID-SIZED FARMS (FRUITS, VEGETABLES, DAIRY, AQUACULTURE, MEAT, POULTRY EGGS, GRAINS, BEANS), PRODUCERS (CREAMERIES PRODUCERS OF VALUE-ADDED FOOD PRODUCTS), AND FIVE FARMERS MARKETS, AS WELL AS 3,500 SHOPPERS WHO PARTICIPATE IN SNAP, WIC, OTHER BENEFIT PROGRAMS. BENEFITS WILL INCLUDE NEW MARKET REACH AND INCREASED SALES REVENUE FOR LOCAL FARMS PRODUCERS INCREASED ACCESS TO LOCALLY GROWN, RAISED, PRODUCED FOODS FOR SNAP WIC SHOPPERS MARKETING ADMINISTRATIVE SKILLS FOR FARMS TO CONTINUE CONNECTING WITH THESE MARKETS AS STABLE SOURCES OF RECURRING REVENUE MARKET TRACTION AMONG SNAP WIC SHOPPERS, INCLUDING NEW SPENDING HABITS SOCIAL NORMS AROUND SHOPPING AT FARMERS MARKETS AND MORE VIBRANT, INCLUSIVE FARMERS MARKETS AND LOCAL FOOD ECONOMY.

RURAL COMMUNITIES OPIOID RESPONSE PROGRAM ? NORTHERN BORDER RURAL WORKFORCE - RURAL COMMUNITIES OPIOID RESPONSE PROGRAM – NORTHERN BORDER RURAL WORKFORCE

HEALTHY LINCOLN COUNTY SUBSTANCE ABUSE PREVENTION PARTNERSHIP

RURAL HEALTH CARE SERVICES OUTREACH GRANT PROGRAM

COMPREHENSIVE ADDICTION AND RECOVERY ACT (CARA) LOCAL DRUG CRISIS GRANT PROJECT IN LINCOLN COUNTY, MAINE - HLC?S SUBSTANCE USE PREVENTION PARTNERSHIP (HLC-SUPP) IS ?THE COALITION? SERVING LINCOLN COUNTY?S 19 TOWNS, ONE ISLAND, 34,457 RESIDENTS, AND 15,149 HOUSEHOLDS. OF THE 15,149 HOUSEHOLDS, 24.7% HAD CHILDREN UNDER THE AGE OF 18 LIVING WITH THEM. LINCOLN COUNTY IS SIGNIFICANT FOR ITS THOUSANDS OF MILES OF COASTLINE, WHICH ARE HOME TO A LARGE PROPORTION OF MAINE?S GENERATIONS OF FISHING FAMILIES. THE GEOGRAPHIC MAKE-UP AND BARRIERS TO ECONOMIC AND SOCIAL SUPPORTS ARE ISOLATING FOR YOUTH AND FAMILIES. LINCOLN COUNTY ALSO HAS A HIGH NUMBER OF LESBIAN, GAY, BISEXUAL, AND TRANSGENDERED (LGBTQ) YOUTH. THE CARA COMMUNITY-BASED COALITION ENHANCEMENT GRANTS WILL ALLOW FOR ENHANCED PREVENTION OF OPIOID, METHAMPHETAMINE, AND/OR PRESCRIPTION DRUG USE/MISUSE AMONG YOUTH AGES 12-18 IN TWO KEY RURAL AND UNDER-SERVED POPULATIONS ? LGBTQ AND MARINE INDUSTRY YOUTH AND FAMILIES. IN ORDER TO IDENTIFY THE SUBSTANCE USE PROBLEMS IN LINCOLN COUNTY, WE COLLECT AND ANALYZE DATA TO CONSIDER THE STRENGTHS AND GAPS IN THE COMMUNITY AS WELL AS RISK AND PROTECTIVE FACTORS. DATA INDICATORS ARE IDENTIFIED TO DETERMINE THE MOST PREVALENT MISUSE OF OPIOIDS, METHAMPHETAMINE, AND PRESCRIPTION DRUGS AND WHY THESE OCCUR WITH AN EMPHASIS ON EXAMINING OUR ENHANCED TARGET POPULATIONS. HLC-SUPP (?COALITION?) UTILIZES THE STRATEGIC PREVENTION FRAMEWORK (SPF) SEVEN STRATEGIES FOR COMMUNITY LEVEL CHANGE, AND PROCHASKA'S STAGES OF CHANGE HEALTH BEHAVIOR MODEL TO SHAPE ONGOING ASSESSMENT, PLANNING, AND IMPLEMENTATION OF COALITION PROJECT GOALS, OBJECTIVES, AND ACTIVITIES.

TELEMEDICINE GRANT

HEALTHY LINCOLN COUNTY SUBSTANCE ABUSE PREVENTION PARTNERSHIP

21 REASONS STOP PROJECT, PORTLAND, MAINE

HEALTHY LINCOLN COUNTY STOP ACT - PROJECT NAME: HEALTHY LINCOLN COUNTY STOP ACT HEALTHY LINCOLN COUNTY (HLC)’S STOP ACT PROJECT SEEKS TO EXPAND AND BUILD ON OUR DRUG FREE COMMUNITY (DFC) COALITION EFFORTS TO PREVENT AND REDUCE UNDERAGE DRINKING IN RURAL LINCOLN COUNTY, MAINE. OUR PROJECT AIMS TO 1) DECREASE UNDERAGE DRINKING BY DECREASING YOUTH ACCESS TO ALCOHOL AND INCREASING YOUTH PERCEPTION THAT THEY WOULD BE CAUGHT BY PARENTS, AND 2) INCREASE YOUTH PROTECTIVE FACTORS BY INCREASING YOUTH MATTERING AND SENSE OF SUPPORT FROM ADULTS. WE AIM TO ACHIEVE A 10% IMPROVEMENT IN EACH OF THESE INDICATORS BY 2025 AND A 20% IMPROVEMENT BY 2027 AS MEASURED BY THE MAINE YOUTH INTEGRATED HEALTH SURVEY (MIYHS). HLC’S SUBSTANCE USE PREVENTION PARTNERSHIP (SUPP) SERVES ALL 34.457 RESIDENTS OF LINCOLN COUNTY WITH A FOCUS ON SERVING MIDDLE AND HIGH SCHOOL STUDENTS AND THEIR PARENTS (APPROXIMATELY 7,000 PEOPLE). OUR COASTAL COUNTY IS ENTIRELY RURAL, WITH 19 TOWNS, ONE ISLAND, AND 77.3 PEOPLE PER SQUARE MILE. THE 2021 LINCOLN COUNTY SHARED COMMUNITY HEALTH NEEDS ASSESSMENT INDICATES THAT 16.4% OF CHILDREN IN OUR COUNTY LIVE IN POVERTY, COMPARED TO THE 13.8% MAINE BENCHMARK. ACCORDING TO THE 2021 MIYHS, OUR MIDDLE SCHOOL AND HIGH SCHOOL BINGE DRINKING RATES ARE HIGHER THAN THE STATE AVERAGE, AS ARE OUR MIDDLE SCHOOL 30-DAY ALCOHOL USE, TOBACCO USE, AND LIFETIME MARIJUANA USE RATES. OUR HIGH SCHOOL HEROIN, ECSTASY, AND METHAMPHETAMINE LIFETIME USE RATES ARE ALSO HIGHER THAN THE STATE’S. 38.7% OF OUR HIGH SCHOOL STUDENTS REPORT LIVING WITH AN ADULT WHO HAS HAD A PROBLEM WITH ALCOHOL OR DRUGS, COMPARED TO 32.8% STATEWIDE. DESPITE OUR RURALITY, LINCOLN COUNTY HAS 163 LIQUOR-LICENSED ESTABLISHMENTS, INCLUDING BOTH ON-PREMISES AND OFF-PREMISES RETAILERS, AND OUR 2019 AND 2021 MIYHS HAD A HIGHER PERCENTAGE OF MIDDLE SCHOOL AND HIGH SCHOOL YOUTH REPORTING THAT ALCOHOL WOULD BE “EASY” OR “VERY EASY” THAN STATEWIDE. OUR STOP ACT PROJECT WILL BUILD ON EXISTING EFFORTS WITH NEW STRATEGIES INCLUDING COMMUNITY TRAININGS, MEDIA STRATEGIES, AND AWARENESS EVENTS TO REDUCE FURNISHING/SALES OF ALCOHOL TO MINORS; PARENT EDUCATION EVENTS, MESSAGING, AND COMMUNICATIONS TO INCREASE PARENTAL MONITORING PRACTICES; YOUTH-LED COMMUNITY FORUMS AND MEDIA STRATEGIES TO INCREASE YOUTH MATTERING; AND SCHOOL POLICY CHANGES TO REDUCE EXCLUSIONARY DISCIPLINE PRACTICES AND INCREASE YOUTH SENSE OF HAVING SUPPORT FROM ADULTS. OUR PROJECT WILL SERVE APPROXIMATELY 7,000 YOUTH AND PARENTS PER YEAR, WITH A CUMULATIVE IMPACT OF ROUGHLY 14,000 INDIVIDUALS OVER 4 YEARS. HLC IS PART OF THE STATE OF MAINE’S COORDINATED PREVENTION INFRASTRUCTURE, THE MAINE PREVENTION NETWORK (MPN), VIA A CONTRACT WITH MAINEHEALTH TO IMPLEMENT PREVENTION SERVICES, INCLUDING YOUTH ALCOHOL PREVENTION IN LINCOLN COUNTY. MPN IS A COLLABORATIVE EFFORT OF THE MAINE CENTER FOR DISEASE CONTROL AND PREVENTION AND COMMUNITY PARTNERS THAT COORDINATES WORK ACROSS THE STATE TO PREVENT OBESITY, TOBACCO, AND OTHER SUBSTANCE USE. IN ADDITION, HLC IS PART OF THE MAINE NETWORK OF HEALTHY COMMUNITIES AND THE MIDCOAST PUBLIC HEALTH COUNCIL, WHICH ARE COORDINATED GROUPS WHO MEET AND COLLABORATE ON RELEVANT PUBLIC HEALTH ISSUES.

21 REASONS RVHCC DFC MENTOR PROJECT

21 REASONS MENTORING PROJECT

PORTLAND, MAINE DFC MENTORING PROGRAM FOR CASCO BAY COMMUNITY

RURAL HEALTH NETWORK DEVELOPMENT PLANNING GRANT PROGRAM

RURAL HEALTH NETWORK DEVELOPMENT PLANNING GRANT PROGRAM

NO-COST EXTENSION NEW PERIOD OF AGREEMENT EXPIRATION DATE IS 9-30-2009INSERT APPROVED BRANDING AND MARKING PLAN