Mary Hitchcock Memorial Hospital

COLORECTAL CANCER SCREENING PROGRAM FOR THE NEW HAMPSHIRE REGION.

NEW HAMPSHIRE COLORECTAL CANCER SCREENING PROGRAM (NHCRCSP)

FAILURE TO RESCURE-PATIENT SAFETY LEARNING LAB (FTR-PSLL)

PROJECT LAUNCH UPPER VALLEY: PROMOTING A HEALTHY START FOR YOUNG CHILDREN AND THEIR CAREGIVERS

INTERVENTIONS TO INCREASE CLINIC-LEVEL RATES OF HIGH-QUALITY CRC SCREENING THROUGH CLINICAL PARTNERSHIPS

PARTNERS TO PROMOTE SAFETY, PERMANENCY AND WELL-BEING FOR FAMILIES AFFECTED BY SUBSTANCE USE (P2P)

RURAL BEHAVIORAL HEALTH WORKFORCE COORDINATING CENTERS ? NORTHERN BORDER REGION

RURAL COMMUNITIES OPIOID RESPONSE PROGRAM-CHILD AND ADOLESCENT SUPPORT

RURAL MATERNITY AND OBSTETRICS MANAGEMENT STRATEGIES PROGRAM

RYAN WHITE TITLE IV WOMEN, INFANTS, CHILDREN, YOUTH AND AFFECTED FAMILY MEMBERS AIDS HEALTHCARE

RYAN WHITE PART C OUTPATIENT EIS PROGRAM

HIGH GROWTH

STATE MATERNAL HEALTH INNOVATION PROGRAM - MARY HITCHCOCK MEMORIAL HOSPITAL’S (MHMH) MATERNAL HEALTH INNOVATION (MHI) PROJECT TEAM, NH STATE PARTNERS AND COMMUNITY COLLABORATORS WILL WORK TOWARD ADVANCING THE MHI OVERARCHING PURPOSE OVER 5 YEARS. FOR THIS MHI PROJECT MHMH WILL WORK WITH THE NH MATERNAL CHILD HEALTH DEPARTMENT/TITLE V PROGRAM (NHMCH), PERSONS WITH LIVED EXPERTISE OF PREGNANCY AND DISPARATE PERINATAL HEALTH OUTCOMES, BIRTHING HOSPITALS, COMMUNITY ORGANIZATIONS, AND OTHER NH PERINATAL HEALTH STAKEHOLDERS. THE PROJECT WILL ACHIEVE THE FOLLOWING GOALS OVER 5 YEARS: 1) RECRUIT, ENGAGE, AND CONVENE A MATERNAL HEALTH TASK FORCE (MHTF) TO DRAFT AND FINALIZE A MATERNAL HEALTH STRATEGIC PLAN (MHSP) THEN IMPLEMENT MHSP ACTIVITIES; 2) CO-CREATE A COMPREHENSIVE MHI EVALUATION PLAN TO ASSESS AND REPORT ON PROGRAM ACTIVITIES OVER THE FULL PERFORMANCE PERIOD; 3) IMPROVE STATE-LEVEL MATERNAL HEALTH SURVEILLANCE DATA QUALITY, COLLECTION AND APPLICATION; 4) CONTINUE TO INCREASE NUMBER PERSONS WITH LIVED EXPERTISE OF PREGNANCY AND PERINATAL HEALTH DISPARITIES WHO ARE MEMBERS OF THE MHTF AND SHARE IN DECISION-MAKING RE: MHSP PRIORITIES, ACTIVITIES AND EVALUATION; 5) RELEASE A PUBLIC MATERNAL HEALTH ANNUAL REPORT EACH YEAR OF THE PERIOD OF PERFORMANCE; AND 6) TOGETHER WITH THE MHTF WILL SUPPORT IMPLEMENTATION OF INNOVATIVE INITIATIVES BASED ON THE MHSP TO IMPROVE MATERNAL HEALTH AND IDENTIFY THOSE WITH POTENTIAL FOR SCALING AND REPLICATION. OUR UNDERLYING APPROACH AIMS TO BUILD OUT A STATEWIDE SYSTEM OF 12 REGIONAL PERINATAL TASK FORCES (RPTF) ASSOCIATED WITH THE MHTF, EACH WITH THE CAPACITY TO IMPLEMENT INNOVATION ACTIVITIES OF THE MHSP. MHMH’S MHI STAFF LEADERS HAVE ALREADY STARTED IMPLEMENTING AND BUILDING SUPPORT OVER THE LAST 12 MONTHS, AND MHI SUPPORT WILL ALLOW US TO CONTINUE IMPROVING AND GROWING MHTF ENGAGEMENT, PARTNERSHIPS, AND DATA SYSTEMS NEEDED TO COMPLETE THE MHSP. MORE THAN 200 NH STAKEHOLDERS, INCLUDING PERSONS AFFECTED BY PERINATAL HEALTH DISPARITIES HAVE PARTICIPATED TO- DATE IN DEVELOPING THE IDEAS THIS MHI PROJECT WILL IMPROVE AND BRING TO SCALE. A CORE ASPECT OF OUR MHI APPROACH IS CO-PRODUCTION WITH ALL STAKEHOLDERS INCLUSIVE OF THOSE WITH LIVED EXPERTISE FROM COMMUNITIES DISPROPORTIONALLY IMPACTED BY MATERNAL MORTALITY AND SEVERE MATERNAL MORBIDITY. MHMH IS WELL-QUALIFIED TO LEAD THIS MATERNAL HEALTH INNOVATION PROJECT (MHI). FOR 20+ YEARS, MHMH HAS LED THE NORTHERN NEW ENGLAND PERINATAL QUALITY IMPROVEMENT NETWORK (NNEPQIN), WHICH FOSTERS DISSEMINATION OF PERINATAL KNOWLEDGE AND BEST PRACTICES BETWEEN HOSPITALS IN VT, NH, AND ME. THIS SAME STAFF TEAM HAS WORKED FOR 20+ YEARS WITH NHMCH TO IMPROVE PERINATAL DATA SYSTEMS, IMPLEMENT AIM BUNDLES IN BIRTHING HOSPITALS; AND FACILITATE MATERNAL MORTALITY REVIEW COMMITTEE SERVICES. FOR THE PAST 12 MONTHS, THIS SAME TEAM HAS LED DEVELOPMENT OF A NH-SPECIFIC PERINATAL QUALITY COLLABORATIVE THAT INCLUDES MANY STATEWIDE PARTNERS WHO WILL BECOME PART OF THE MHTF IN OUR MHI PROJECT. THIS LONG HISTORY OF COLLABORATIVE WORK WITH OUR STATE PARTNERS ENSURES OUR MHI PROJECT WILL BUILD OFF EXISTING STATE WORK OF TITLE V AND OTHER NHMCH INITIATIVES AVOIDING DUPLICATION AND THE SUPPORT OF VARIED STAKEHOLDERS.

IMPROVING CARE FOR CHILDREN AND YOUTH IN NH WITH TRAUMA AND INTELLECTUAL AND DEVELOPMENTAL DISABILITIES (PROJECT TIDD) - IMPROVING CARE FOR CHILDREN AND YOUTH IN NH WITH TRAUMA AND INTELLECTUAL AND DEVELOPMENTAL DISABILITIES (PROJECT TIDD) POPULATION TO BE SERVED AND NEED: OUR GOAL IS TO IMPROVE OUTCOMES FOR CHILDREN AND YOUTH AGES 0-21 WITH INTELLECTUAL AND DEVELOPMENTAL DISABILITIES, INCLUDING AUTISM (IDD) WHO ARE AFFECTED BY TRAUMA, ACROSS THE STATE OF NEW HAMPSHIRE (NH). WE AIM TO BOLSTER THE KNOWLEDGE AND SKILLS OF MULTIDISCIPLINARY PROVIDERS TO IDENTIFY, ENGAGE, SCREEN AND TREAT TRAUMA-AFFECTED CHILDREN AND YOUTH WITH IDD. THE SMALL SIZE OF NH AND THE EXPERTISE AND LEADERSHIP OF THE PROPOSED TEAM WITHIN THE TRAUMA AND IDD SYSTEMS WILL ALLOW OUR PROJECT TO HAVE A MAJOR IMPACT ON STATE-WIDE PRACTICES AND POLICIES. OUR CATCHMENT AREA ENCOMPASSES THE ENTIRE STATE OF NH, WHICH INCLUDES OVER 10,000 CHILDREN AND YOUTH WITH IDD. WE WILL ALSO HAVE A SPECIAL FOCUS ON CHILDREN AND YOUTH EXPERIENCING THE TRIPLE INTERSECTION OF TRAUMA, IDD, AND TRANSGENDER IDENTITY, A COMMON CO-OCCURRING SCENARIO FOR THE TRANSGENDER POPULATION. CHILDREN WITH IDD, AND WITH IDD AND TRANSGENDER IDENTITY, ARE AT HIGHER RISK FOR TRAUMA (E.G., VIOLENCE, ABUSE, BULLYING), HAVE FEWER RESOURCES AVAILABLE FOR IDENTIFICATION AND TREATMENT, AND REQUIRE PROPERLY MODIFIED AND ADAPTED INTERVENTIONS DUE TO THE COMPLEXITY OF THEIR SYMPTOMS THAN DO THOSE WITHOUT IDD. COMMUNITY-BASED MENTAL HEALTH (MH) PROVIDERS ARE NOT ADEQUATELY PREPARED TO DIAGNOSE AND TREAT THESE POPULATIONS, AND THE MULTI-DISCIPLINARY IDD AND TRANSGENDER WORKFORCE ARE NOT SUFFICIENTLY KNOWLEDGEABLE ABOUT TRAUMA AND ITS EFFECTS. STRATEGIES/EVIDENCE-BASED PRACTICES: OUR PROJECT WILL FOCUS ACTIVITIES IN FIVE “BUCKETS”: 1) TRAUMA-INFORMED TRAINING AND CONSULTATION TO A MULTI-DISCIPLINARY WORKFORCE (E.G., PEDIATRICIANS, IDD PROVIDERS, RESIDENTIAL STAFF, TRANSGENDER PROVIDERS) USING THE NCTSN PRODUCED ROAD TO RECOVERY AS WELL AS NEWLY DEVELOPED CURRICULUM TARGETING DIFFERENTIAL DIAGNOSES AND ASSESSMENT AND TREATMENT AROUND THE TRIPLE INTERSECTION OF TRAUMA, IDD, AND TRANSGENDER/NON-BINARY IDENTITY; 2) SCREENING AND ASSESSMENT FOR TRAUMA IN IDD AND TRANSGENDER SETTINGS AND A FOCUS ON INTEGRATING RESULTS INTO CARE PLANS; 3) IMPLEMENTATION OF TRAUMA-FOCUSED CBT; 4) TRAINING IN ADVANCED CBT FOR TRAUMA AND IDD AND FOR TRAUMA AND LGBTQ TO PROVIDERS ALREADY TRAINED IN CBT; 5) IMPLEMENTATION OF ADAPTED CHILD-ADULT RELATIONSHIP ENHANCEMENT (CARE CONNECTIONS) FOR CAREGIVERS AND OTHER PROFESSIONALS. GOALS AND MEASURABLE OBJECTIVES: OUR GOAL IS TO IMPROVE OUTCOMES FOR CHILDREN AND YOUTH AGES 0-21 WITH IDD WHO ARE AFFECTED BY TRAUMA ACROSS THE STATE OF NH. BY THE END OF THE PROJECT, OUR OBJECTIVES ARE TO: 1) PROVIDE TRAUMA-INFORMED TRAINING AND ONGOING CONSULTATION TO 395 PROFESSIONALS AND STAFF FROM MULTIDISCIPLINARY SECTORS; 2) INSTALL SCREENING/ASSESSMENT AND EXPERT CARE PLANNING WITHIN 6 IDD AND TRANSGENDER SERVICE SETTINGS; 3) DELIVER TF-CBT TRAINING AND CONSULTATION TO 30 MH PROVIDERS; 4) DELIVER ADVANCED CBT FOR IDD AND MODIFIED TF-CBT FOR LGBTQ TRAINING AND CONSULTATION TO 130 MH PROVIDERS; 5) DELIVER CARE CONNECTIONS TO 125 CAREGIVERS AND OTHER PROFESSIONALS; AND 6) CONVENE A MULTIDISCIPLINARY AND PARENT ADVISORY BOARD TO GUIDE THE PROJECT.

DARTMOUTH LEAD PARTICIPATION IN NCI NATIONAL CLINICAL TRIALS NETWORK

RURAL COMMUNITIES OPIOID RESPONSE PROGRAM ? NEONATAL ABSTINENCE SYNDROME - RURAL COMMUNITIES OPIOID RESPONSE PROGRAM – NEONATAL ABSTINENCE SYNDROME

EMSC PARTNERSHIP GRANTS

SEE NOTICE OF AWARD, ATTACHMENT 1 - TERMS AND CONDITIONS, ATTACHMENT D - STATEMENT OF WORK, ABSTRACT

AWARD PURPOSE:THE PURPOSE OF WORC ROUND 6 IS TO INCREASE ACCESS TO STABLE, HIGH-QUALITY, FAMILY-SUSTAINING JOBSFOR WORKERS IN THE APPALACHIAN, DELTA, AND NORTHERN BORDER REGIONS, INCLUDING THOSE IN CRITICALSECTORS SUCH AS INFRASTRUCTURE AND CLEAN ENERGY. IMPROVING ACCESS TO THESE GOOD JOBS WILL ENABLETHESE WORKERS TO REMAIN WITHIN THEIR REGION. THIS FOCUS ALSO IS CONSISTENT WITH THE BIDEN-HARRISADMINISTRATIONS COMMITMENT TO EXPAND ACCESS TO QUALITY JOBS, AS DEFINED BY THE GOOD JOBSPRINCIPLES, A SHARED FEDERAL VISION OF JOB QUALITY PUBLISHED BY THE DEPARTMENTS OF LABOR ANDCOMMERCE, AND THE RURAL PARTNERS NETWORK, AN ALL-OF-GOVERNMENT PROGRAM THAT CONNECTS RURALCOMMUNITIES WITH RESOURCES AND FUNDING TO CREATE JOBS, BUILD INFRASTRUCTURE, AND SUPPORT LONGTERMECONOMIC MOBILITY.ACTIVITIES PERFORMED:ALLOWABLE PROJECT ACTIVITIES FOR WORC ROUND 6 GRANT AWARD RECIPIENTS INCLUDE WORKFORCE TRAININGACTIVITIES AND CAREER SERVICES, SUPPORTIVE SERVICES, EMPLOYER SERVICES, STRATEGIC PLANNING ACTIVITIES,AND EQUIPMENT AND RENOVATION PURCHASES.DELIVERABLES:WORC ROUND 6 GRANT AWARD RECIPIENTS IDENTIFY THE TOTAL NUMBER OF ELIGIBLE PARTICIPANTS PROJECTED TOBE ENROLLED DURING THE PERIOD OF PERFORMANCE, AND THE TOTAL NUMBER OF ELIGIBLE PARTICIPANTSPROJECTED TO ENTER GOOD JOBS OR OBTAIN NEW OR ENHANCED EMPLOYMENT AS A RESULT OF THE PROJECT.SEE NOTICE OF AWARD, TERMS AND CONDITIONS, ATTACHMENT D, STATEMENT OF WORK, ABSTRACTINTENDED BENEFICIARY(IES):ELIGIBLE PARTICIPANTS FOR WORC ROUND 6 GRANT AWARDS INCLUDE: 1) NEW ENTRANTS TO THE WORKFORCE:FOR THE PURPOSES OF THIS FOA, THE CATEGORY OF NEW ENTRANTS TO THE WORKFORCE REFERS TO THOSE WHOHAVE NEVER WORKED BEFORE OR WHO HAVE BEEN OUT OF THE WORKFORCE FOR A LONG ENOUGH TIME TO MAKE ITAS IF THEY ARE ENTERING THE WORKFORCE FOR THE FIRST TIME 2) DISLOCATED WORKERS: FOR THE PURPOSES OFTHIS FOA, THIS TERM REFERS TO THE DEFINITION FOUND AT SECTION 3(15) OF WIOA AND 3) INCUMBENTWORKERS: FOR THE PURPOSES OF THIS FOA, THIS TERM REFERS TO INDIVIDUALS WHO ARE EMPLOYED BUT NEEDEMPLOYMENT AND TRAINING SERVICES TO SECURE FULL-TIME EMPLOYMENT, ADVANCE IN THEIR CAREERS, ORRETAIN THEIR EMPLOYMENT. WITHIN THESE ELIGIBLE PARTICIPANT CATEGORIES (NEW ENTRANTS, DISLOCATEDWORKERS, AND INCUMBENT WORKERS), APPLICANTS MUST PRIORITIZE HISTORICALLY MARGINALIZED POPULATIONSAND COMMUNITIES WITHIN THE LOCAL OR REGIONAL ECONOMIC AREA SERVED BY THE GRANT, INCLUDING WOMEN,PEOPLE OF COLOR, JUSTICE-INVOLVED INDIVIDUALS, INDIVIDUALS WITH DISABILITIES, VETERANS, INDIVIDUALS WITHLIMITED ENGLISH PROFICIENCY, INDIVIDUALS WITH A HISTORY OF SUBSTANCE DEPENDENCY OR OTHER BEHAVIORALHEALTH CONDITIONS, OR OTHER POPULATIONS WHO WILL BENEFIT FROM IMPROVED JOB QUALITY AND CAREERADVANCEMENT OPPORTUNITIES.SUBRECIPIENT ACTIVITIES:WORC ROUND 6 GRANT AWARD RECIPIENTS MAY PARTNER WITH SUBRECIPIENTS AS WELL AS PROVIDE SERVICESTHROUGH AMERICAN JOB CENTERS WITHIN THE AREA COVERED BY THE GRANT AS APPROPRIATE.

RURAL COMMUNITIES OPIOID RESPONSE-IMPLEMENTATION

COMMUNITY PROJECT FUNDING/CONGRESSIONALLY DIRECTED SPENDING - CONSTRUCTION - PHYSICAL LOCATION: THIS RENOVATION TO EXPAND PEDIATRIC SPECIALTY SERVICES WILL TAKE PLACE AT DARTMOUTH HITCHCOCK CLINICS MANCHESTER. PHYSICAL ADDRESS IS 100 HITCHCOCK WAY, MANCHESTER, NH. THE CLINIC IS A TWO STORY BUILDING WITHIN A WOODED SETTING THAT OFFERS ADULT AND PEDIATRIC SERVICES IN PRIMARY CARE, MULTI-SPECIALTY, URGENT CARE, LABORATORY, IMAGING, AMBULATORY SURGERY, AND MEDICAL INFUSION SERVICES. DESCRIPTION OF SCOPE: THE SCOPE WILL ONLY INCLUDE INTERIOR BUILDING RENOVATIONS AND EQUIPMENT FOR THE CHILDREN’S WING OF THE MANCHESTER CLINIC. THERE WILL BE NO IMPACTS TO THE EXTERNAL BUILDING NOR THE SURROUNDING SPACE OF THE BUILDING. CONSTRUCTION WILL INCLUDE SOME INTERIOR WALL DESTRUCTION, CONSTRUCTION, FLOORING, PAINTING, AND SEVERAL WORK SPACE IMPROVEMENTS THAT INVOLVE RENOVATIONS. THIS WILL CREATE NEW CLINICAL PATIENT CARE ROOMS, CLINICAL WORK AREAS IMPROVED SOILED WORK ROOM AND CLEAN SUPPLY ROOM, AND NEW PATIENT RECEPTION AND EXITING LOCATION IN THE EXISTING WAITING ROOM. THE HRSA GRANT BUDGET OF $1,000,000 WILL BE DEDICATED TO THE ARCHITECTURAL AND ENGINEERING DESIGNS AND CONSTRUCTION COSTS AS NOTED IN THE BUDGET SF424C FORM. PROJECT ACTIVITY SPECIFICATIONS: THE PROJECT WILL INCLUDE 2,700 SQUARE FEET OF RENOVATED SPACE. THE IMPACTED ROOMS ARE NOTED IN THE FLOOR PLAN REPRESENTING: 4 PATIENT CARE ROOMS, 2 PATIENT CONSULTATION ROOMS, 2 TEAM WORK ROOMS, CLEAN/DIRTY/STORAGE ROOMS, 4 SUPPORT OFFICES, AND RECEPTION/WAITING ROOM. THE RENOVATIONS AND RELOCATIONS WILL RESULT IN AN ADDITIONAL 8,000 PEDIATRIC SPECIALTY PATIENT VISITS ANNUALLY. TYPE OF CONSTRUCTION: THIS PROJECT INCLUDES ARCHITECTURAL SPACE DESIGN, INTERIOR DEMOLITION, CONSTRUCTION AND MODERNIZATION OF EXISTING INTERIOR SPACES. PROCUREMENT WILL BE CONSTRUCTION MANAGEMENT AND CONSTRUCTION TYPE IS INDUSTRY STANDARD, COMMERCIAL GRADE MEDICAL OFFICE CONSTRUCTION. TIMELINE: PLANNING: 1 MONTH DESIGN: 2 MONTHS OBTAINING REQUIRED PERMITS AND/OR VARIANCES: 1 MONTH MEETING FEDE RAL ENVIRONMENTAL AND HISTORIC PRESERVATION REQUIREMENTS: NOT APPLICABLE. SOLICITATION OF BIDS AND AWARDING OF CONTRACTS: 2 MONTHS MATERIAL PROCUREMENT PERIOD: 6 MONTHS ALTERATION/RENOVATION CONSTRUCTION PERIOD: 6 MONTHS EXPECTED PROJECT COMPLETION DATE: NOVEMBER 2023 EQUIPMENT LIST (IF APPLICABLE): NOT APPLICABLE. CONSTRUCTION RELATED COSTS ONLY INCLUDED IN $1M BUDGET.

RYAN WHITE TITLE IV WOMEN, INFANTS, CHILDREN, YOUTH AND AFFECTED FAMILY MEMBERS AIDS HEALTHCARE

PROJECT ALIGN: ALIGNING SYSTEMS AND PRACTICES TO PREVENT DOMESTIC VIOLENCE AND SUPPORT SURVIVORS AND THEIR CHILDREN

COMMUNITY PROJECT FUNDING/CONGRESSIONALLY DIRECTED SPENDING - CONSTRUCTION - THE REHABILITATION PROJECT WITH THE FUNDING FROM HRSA ADDRESSES THE NEED FOR REHABILITATIVE THERAPY SERVICES FOR SURVIVORS OF SPINAL CORD INJURY, TRAUMATIC BRAIN INJURY, STROKE, CEREBRAL PALSY, AND OTHER NEUROLOGICAL CONDITIONS, A HISTORICALLY UNDERSERVED COMMUNITY, IN NEW HAMPSHIRE. APPROXIMATELY 15,000- 20,000 PEOPLE IN THE STATE NAVIGATE SOME FORM OF DEBILITATING PARALYSIS. THE PROJECT ADDRESSES INEQUITIES IN HEALTHCARE ACCESS FOR THIS SPECIAL POPULATION, ENABLES EFFECTIVE AND EFFICIENT DELIVERY OF HEALTHCARE VIA ADVANCED TECHNOLOGY TO PROMOTE REINTEGRATION, REDUCING DEPENDENCE ON CARE PROVIDERS AND FAMILY, AND NEED FOR MAJOR HOME RENOVATION AND SPECIAL TRANSPORTATION REQUIREMENTS WHILE REDUCING LONG-TERM COSTS FOR PARALYSIS SURVIVORS WHO GAIN INDEPENDENCE, REDUCING FALLS/ACCIDENTS AND RESULTING COMPLICATIONS POST-DISCHARGE AND RE-HOSPITALIZATION. CONGRESSIONALLY DIRECTED FUNDING WOULD PROVIDE MUCH-NEEDED HHS DOLLARS THAT WOULD TYPICALLY MISS A COMMUNITY LIKE THE CHESHIRE MEDICAL CENTER (TCMC), WHICH HAS THE ABILITY TO GROW AND PROVIDE BETTER CARE TO THESE SPECIAL POPULATIONS IN AN ACCESSIBLE COMMUNITY SETTING BUT LACKS THE RECURRING RESOURCES TO REGULARLY WRITE GRANT APPLICATIONS FOR VERY COMPETITIVE STATE AND FEDERAL PROGRAMS TAILORED TO BIG TRADITIONAL HEALTHCARE INSTITUTIONS. THE ACQUISITION OF FDA-APPROVED MEDICAL DEVICES WILL IMPROVE CAPACITY AND EXPAND CARE OPTIONS, INCLUDING IN-PATIENT AND OUT-PATIENT SERVICES, HELPING PEOPLE WALK AGAIN AND IMPROVE THEIR QUALITY OF LIFE. APPROXIMATELY 3,225 PEOPLE IN TCMC’S SERVICE FOOTPRINT SUFFER FROM PARALYSIS AND WOULD BENEFIT FROM THIS REQUEST. OF THOSE, MANY INDIVIDUALS LIVE IN RURAL COMMUNITIES IN KEY REGIONS WE SERVE. THE CHESHIRE MEDICAL CENTER CURRENTLY SERVES APPROXIMATELY 67,955 PATIENTS IN THE STATE OF NEW HAMPSHIRE. TCMC’S IN-PATIENT REHABILITATIVE PROGRAM CURRENTLY SERVES OVER 178 PATIENTS PER YEAR WITH OVER 947 VISITS PER MONTH. APPROXIMATELY HALF OF THOSE PATIENTS ARE ADULTS WITH NEUROLOGICAL, TRAUMATIC OR PHYSICAL DISABILITIES, AND CHRONIC MEDICAL CONDITIONS; AND THE OTHER HALF ARE SENIOR CITIZENS WITH VARIOUS TRAUMATIC OR PHYSICAL DISABILITIES OR CHRONIC CONDITIONS. TCMC’S OUT-PATIENT REHABILITATION PROGRAM PROVIDES OVER 36,000 VISITS PER YEAR. NEW REHABILITATIVE EQUIPMENT WILL ALLOW FOR NEW AND MORE EFFECTIVE THERAPIES TO BE DELIVERED ON-SITE WHICH WILL INCREASE TCMC’S CAPACITY TO SERVICE GRANITE STATERS AND MAKE CHESHIRE MORE MARKETABLE. THERAPIES WILL INCLUDE PHYSICAL THERAPY, OCCUPATIONAL THERAPY AND RECREATIONAL THERAPY UTILIZING FDA-APPROVED POWERED LOWER LIMB EXOSKELETON DEVICES FOR GAIT THERAPY AND TREATMENT OF SPINAL CORD INJURY, TRAUMATIC BRAIN INJURY, STROKE, AND OTHER INDICATIONS; AND A FDA-APPROVED TETHERED GAIT TRAINING SYSTEM FOR NEUROMUSCULAR RE-EDUCATION FOR MORE EVIDENCED-BASED GAIT TRAINING. THE PROJECT WILL DELIVER DIRECT BENEFITS TO GRANITE STATERS SEEKING SPECIALIZED REHABILITATIVE CARE IN AN ACCESSIBLE SETTING WITH EFFECTIVE THERAPIES, USING ADVANCE TECHNOLOGIES, FOR PARALYSIS AND BRAIN INJURY RECOVERY.

NH MCH LEADERSHIP TRAINING PROGRAM

INCREASE COLORECTAL CANCER SCREENING THROUGH PARTNERSHIPS USING EVIDENCE-BASED INTERVENTIONS. - DESPITE BEING LARGELY PREVENTABLE THROUGH SCREENING, COLORECTAL CANCER (CRC) REMAINS THE SECOND MOST COMMON CAUSE OF DEATH FROM CANCER IN THE U.S. CRC SCREENING TESTS CAN PREVENT CRC BY REMOVING PRE-CANCEROUS GROWTHS CALLED POLYPS BEFORE THEY CAN DEVELOP INTO CRC, AND SCREENING TESTS ALSO ALLOW CRC TO BE FOUND AT EARLIER STAGES (EARLY DETECTION). INCREASING SCREENING SIGNIFICANTLY DECREASES THE INCIDENCE AND DEATHS FROM CRC, BUT MUCH WORK REMAINS TO BE DONE TO ACCOMPLISH THAT ESSENTIAL PUBLIC HEALTH GOAL. THE 2022 BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM (BRFSS) SHOWED THAT OVER 32% OF ELIGIBLE AMERICANS AGE 45-75 HAVE NEVER BEEN SCREENED, AND IN NH INDIVIDUALS AGE 45-54 HAVE A 50% SCREENING RATE. UNDERSERVED POPULATIONS EXPERIENCE MULTIPLE BARRIERS TO CRC SCREENING, WHICH RESULTS IN MUCH LOWER SCREENING RATES AND HIGHER INCIDENCE OF CRC IN THOSE POPULATIONS. INDIVIDUALS LESS THAN AGE 50 HAVE BEEN FOUND TO HAVE A CONCERNING INCREASE IN CRC OVER THE PAST FEW DECADES; THIS IS ALSO THE CASE IN NEW HAMPSHIRE (NH). OUR PROGRAM WORKS TO INCREASE CRC SCREENING FOR UNDERSERVED PEOPLE AGE 45-75; PEOPLE AT RISK FOR EARLY ONSET COLORECTAL CANCER ARE PART OF THAT FOCUS. THE WORK OF OUR PROPOSED PROJECT IS TO DEVELOP PARTNERSHIPS TO INCREASE SCREENING RATES, TARGETING THOSE EFFORTS TO CLINICS THAT SERVE PEOPLE EXPERIENCING THE GREATEST LACK OF SCREENING RESOURCES AND THEREFORE LEAST LIKELY TO BE RECEIVING THIS LIFE-SAVING HEALTH CARE. USING EVIDENCE-BASED INTERVENTIONS (EBIS), WHICH ARE INTERVENTIONS THAT HAVE BEEN SHOWN TO BE EFFECTIVE (SUCH AS PATIENT REMINDERS), WE WORK TO INCREASE HIGH-QUALITY CRC SCREENING IN OUR PARTNER CLINICS. NH IS ONE OF THE MOST RURAL STATES IN THE U.S., AND OUR PARTNER CLINICS ARE LOCATED IN COUNTIES THAT ARE AMONG THE MOST RURAL IN THE STATE. IN ADDITION TO GEOGRAPHIC BARRIERS, HIGHER RATES OF BEING UNINSURED AND LOWER ANNUAL HOUSEHOLD INCOME ARE AMONG THE MANY OBSTACLES FACED BY THIS POPULATION. NH HAS A RAPIDLY EXPANDING AGING POPULATION, AS WELL AS MUCH RECENT POPULATION GROWTH, LEADING TO MANY ADDITIONAL PEOPLE FOR WHOM SCREENING RATES ARE WELL BELOW STATE AND NATIONAL AVERAGES. MANY OF THESE INDIVIDUALS ARE SERVED WITHIN FQHC HEALTH CENTERS. THEREFORE, AN IMPORTANT PART OF OUR PROPOSED WORK IS COLLABORATION WITH THE NEW HAMPSHIRE (NH) COMMUNITY HEALTH ACCESS NETWORK (CHAN), WHICH SUPPORTS MANY ELECTRONIC HEALTH RECORD (EHR) FUNCTIONS FOR FQHCS. WORKING WITH OUR CLINIC PARTNERS AND CHAN, WE WILL BE ABLE TO MAKE MAJOR IMPROVEMENTS IN CLINIC EHRS, WHICH WILL SUPPORT PROVIDERS IN INCREASING CRC SCREENING IN NH FQHCS. IN NH THE CDC COLORECTAL CANCER CONTROL PROGRAM (CRCCP), KNOWN AS THE NH COLORECTAL CANCER SCREENING PROGRAM (NHCRCSP), HAS BUILT A LARGE AND ACTIVE NETWORK OF PARTNERS, CHAMPIONS, AND COLLABORATORS, AND CURRENTLY IS WORKING WITH 9 CLINICS, 341 ACTIVE PROVIDERS, AND MANY OTHER PARTNERS. BY DEVELOPING ADDITIONAL PARTNERSHIPS AND MEANINGFUL COLLABORATIONS THROUGH THIS FUNDING OPPORTUNITY, NHCRCSP WILL CONTINUE TO SUCCESSFULLY IMPLEMENT EBIS WITH NEW PARTNERS AND THEREBY INCREASE CRC SCREENING RATES, RESULTING IN MANY ADDITIONAL PEOPLE SCREENED AT OUR PARTNER CLINICS. NHCRCSP HAS A STRONG FOUNDATION THAT WILL ALLOW US TO WORK SUCCESSFULLY WITH NEW AND EXISTING PARTNERS, REACHING THE UNDERSERVED AND UNSCREENED IN THE MOST RURAL AREAS OF THE STATE. TO REACH THE LONG-TERM GOAL OF DECREASING THE INCIDENCE AND MORTALITY OF CRC, WE MUST INCREASE PREVENTION AND EARLY DETECTION THROUGH SCREENING, AND THAT IS THE OVERALL GOAL OF OUR WORK.

COMMUNITY PROJECT FUNDING/CONGRESSIONALLY DIRECTED SPENDING - CONSTRUCTION - DARTMOUTH HITCHCOCK CLINIC (DHC) IN NASHUA IS A MULTISPECIALTY GROUP PRACTICE WITH PROVIDERS ACROSS 26 DIFFERENT SPECIALTIES. THE NASHUA FACILITY OPENED IN 2011, AND THIRTEEN YEARS LATER, IT IS NEARLY FULL CAPACITY. ENDOCRINOLOGY IS A GROWING MEDICAL SPECIALTY, YET ONE WITHOUT A PRESENCE AT DHC IN NASHUA. ENDOCRINOLOGISTS PROVIDE SPECIALIZED CARE AND TREATMENT OF PATIENTS WITH DIABETES, DISEASES OF THE PANCREAS, AND OTHER ENDOCRINE SYSTEMS SUCH AS THE THYROID, PITUITARY GLAND, AND ADRENAL GLANDS. THESE DISEASES MAY INCLUDE BUT ARE NOT LIMITED TO: HYPERTHYROIDISM AND HYPOTHYROIDISM, PITUITARY DISEASES, HORMONE ABNORMALITIES, REPRODUCTIVE DISORDERS, OSTEOPOROSIS, DIABETES AND LIPID METABOLISM. APPROXIMATELY 113,110 PEOPLE IN NEW HAMPSHIRE, OR 10.1% OF THE ADULT POPULATION, HAVE DIAGNOSED DIABETES. AN ADDITIONAL 29,000 PEOPLE IN NEW HAMPSHIRE HAVE DIABETES BUT DON’T KNOW IT, GREATLY INCREASING THEIR HEALTH RISK. THE SERIOUS COMPLICATIONS INCLUDE HEART DISEASE, STROKE, AMPUTATION, END-STAGE KIDNEY DISEASE, BLINDNESS AND DEATH. EVERY YEAR AN ESTIMATED 9,505 PEOPLE IN NEW HAMPSHIRE ARE DIAGNOSED WITH DIABETES. DARTMOUTH HITCHCOCK CLINIC NASHUA IS REQUESTING FUNDING TO RENOVATE AND CONSTRUCT A NEW OUTPATIENT/AMBULATORY CLINICAL POD OF 3 EXAM ROOMS AND 2 CONSULT ROOMS FOR A NEW TEAM OF ENDOCRINOLOGY PROVIDERS TO PROVIDE GREATER ACCESS TO CARE.

TELEHEALTH NETWORK GRANT PROGRAM

UPPER VALLEY SUBSTANCE MISUSE PREVENTION PARTNERSHIP

UPSTREAM 2: INCREASING MENTAL HEALTH AND TRAUMA IDENTIFICATION AND REFERRALS FOR YOUTH AGES 12-18 YEARS - PROJECT NAME: UPSTREAM 2: INCREASING MENTAL HEALTH AND TRAUMA IDENTIFICATION AND REFERRALS FOR YOUTH AGES 12-18 YEARS POPULATION TO BE SERVED AND NEED: THE PROPOSED 5-YEAR UPSTREAM 2 PROJECT WILL TARGET 900 PROVIDERS AND PROFESSIONALS SERVING YOUTH AND YOUNG ADULTS AGES 12 TO 18 YEARS AND THEIR FAMILIES. THE CATCHMENT AREA ENCOMPASSES 6 PRIMARILY RURAL, BORDERING COUNTIES OF NEW HAMPSHIRE AND VERMONT SPANNING 5,519 SQUARE MILES. THE POPULATION IS LARGELY CAUCASIAN, AND MANY TOWNS SUFFER FROM HIGHER THAN AVERAGE POVERTY AND UNEMPLOYMENT LEVELS. THE TARGETED COUNTIES CONTINUE TO BE IN THE MIDST OF A DEVASTATING OPIOID CRISIS. NUMEROUS SERVICE SECTORS HAVE OBSERVED AN UNPRECEDENTED INCREASE IN THE MENTAL HEALTH (MH) NEEDS OF YOUTH DUE TO THE RISES IN CHILD NEGLECT AND ABUSE ASSOCIATED WITH THIS CRISIS. THESE NEEDS HAVE BEEN ACCENTUATED BY COVID-19 RESTRICTIONS AND ISOLATION. PROFESSIONALS AND PROVIDERS WORKING WITH YOUTH ARE OVERWHELMED BY THE INFLUX OF MH NEEDS. MANY ARE UNFAMILIAR WITH HOW TO IDENTIFY MH NEEDS, DE-ESCALATE CRISES, OR MAKE TARGETED REFERRALS FOR TREATMENT. YET EARLY INTERVENTION IS KEY TO PREVENTING OR MITIGATING THE LONG-TERM EFFECTS OF MH DISORDERS. STRATEGIES/EVIDENCE-BASED PRACTICES: UPSTREAM 2 WILL PROVIDE EVIDENCE-BASED MH AND TRAUMA TRAINING, CONSULTATION, RESOURCES, AND REFERRAL LINKAGES TO EDUCATORS, EMERGENCY RESPONDERS, ORGANIZATIONS SUPPORTING MILITARY FAMILIES, AND OTHER COMMUNITY AND SERVICE PROVIDERS SERVING YOUTH AGES 12-18 YEARS OLD. TRAINING AND CONSULTATION WILL OCCUR IN TWO 30-MONTH COHORTS SPANNING 6 COUNTIES ALONG THE VT AND NH BORDER ALONG THE CONNECTICUT RIVER. WE WILL USE A STANDARDIZED, 6-HOUR EVIDENCE-BASED CURRICULUM, REFINED IN A PRIOR MHAT GRANT AND TAILORED TO THE TARGET AGE RANGE. THE TRAINING FOCUSES ON IDENTIFYING SIGNS OF TRAUMA AND MH SYMPTOMS, STRATEGIES FOR DE-ESCALATION, IDENTIFYING RESOURCES IN THE COMMUNITY, AND PROCESSES AND TOOLS TO FACILITATE REFERRALS TO PARTNERING MH AGENCIES IN EACH COMMUNITY. TRAINEES WILL ALSO HAVE ACCESS TO THE UPSTREAM 2 CONSULTATION PROGRAM CONNECTING THEM WITH A COUNTY-BASED MH EXPERT TO ASSIST WITH THE IDENTIFICATION OF MH DISORDERS IN YOUTH AS WELL AS LINKAGES TO TREATMENT. GOALS AND MEASURABLE OBJECTIVES: OUR GOAL IS TO INCREASE THE CAPACITY FOR EDUCATORS, EMERGENCY RESPONDERS, THOSE SUPPORTING MILITARY FAMILIES, AND OTHER COMMUNITY AND SERVICE PROVIDERS TO IDENTIFY TRAUMA AND MH NEEDS IN YOUTH AND TO LINK YOUTH TO NEEDED SERVICES. OUR PRIMARY OBJECTIVES ARE TO: 1) TRAINING: WE WILL PROVIDE 30 IN-PERSON TRAININGS (4-8 ANNUALLY), SPREAD ACROSS 6 COUNTIES AND TWO COHORTS. WE AIM FOR 30 PARTICIPANTS PER TRAINING, TOTALING 900 TRAINEES (~120-240 ANNUALLY); 2) CONSULTATION: WE WILL PROVIDE 720 HOURS OF ONGOING CONSULTATION (~90-180 HOURS ANNUALLY) THROUGH COUNTY-BASED YOUTH MH EXPERTS; 3) RESOURCE DISSEMINATION: WE WILL DISSEMINATE AT LEAST 5 DIFFERENT MH RESOURCES, INCLUDING COUNTY-SPECIFIC REFERRAL DOCUMENTS, TO 900 TRAINEES (~120-240 PEOPLE ANNUALLY); AND 4) REFERRALS: WE WILL INCREASE THE NUMBER OF REFERRALS TO THE PARTNERING MH AGENCIES IN EACH RESPECTIVE COUNTY BY 30% WITHIN EACH OF THE TWO COHORTS.

COMPREHENSIVE GERIATRIC EDUCATION PROGRAM

RURAL HEALTH CARE SERVICES OUTREACH GRANT PROGRAM

RURAL COMMUNITIES OPIOID RESPONSE PROGRAM ? NEONATAL ABSTINENCE SYNDROME

COMMUNITY PROJECT FUNDING/CONGRESSIONALLY DIRECTED SPENDING - NON-CONSTRUCTION - PROJECT TITLE: CENTER FOR RURAL HEALTH EQUITY (CARHE) APPLICANT ORGANIZATION: MARY HITCHCOCK MEMORIAL HOSPITAL (DBA DARTMOUTH-HITCHCOCK); 1 MEDICAL CENTER DRIVE, LEBANON, NH 03756-001; WWW.DARTMOUTH-HITCHCOCK.ORG PROJECT DIRECTOR: SALLY KRAFT, MD, MPH GRANT PROGRAM FUNDS REQUESTED: $448,000 BRIEF DESCRIPTION OF PROPOSED PROJECT: THE CENTER FOR ADVANCING RURAL HEALTH EQUITY (CARHE) AT DARTMOUTH HEALTH WILL FOCUS ON THREE CORE AREAS OF WORK DURING THIS 12-MONTH AWARD PERIOD: 1. WE WILL CONTINUE TO DEVELOP THE ADMINISTRATIVE AND PROGRAMMATIC CENTER INFRASTRUCTURE, POLICIES, AND PRACTICES NECESSARY TO CONVENE COMMUNITY ORGANIZATIONS, PERSON WITH LIVED EXPERIENCE, RESEARCHERS, STUDENT LEARNERS, AND HEALTH CARE DELIVERY PROFESSIONALS TO EQUITABLY ADDRESS COMMUNITY-DEFINED HEALTH NEEDS. 2. WE WILL TEST AND REFINE CARHE’S PRACTICES AND VALUE-ADDED SUPPORTS BY APPLYING THEM TO AT LEAST TWO CURRENTLY OPERATIONAL PROJECTS. 3. WE WILL DESIGN AND BEGIN TO IMPLEMENT AT LEAST THREE NEW PROJECTS THAT ADDRESS COMMUNITY-DEFINED HEALTH EQUITY NEEDS USING CARHE’S MULTI-DISCIPLINARY APPROACH. NEEDS TO BE ADDRESSED: WE ARE DEVELOPING CARHE TO ADDRESS KEY BARRIERS THAT LIMIT HEALTHCARE SYSTEMS AND COMMUNITY ORGANIZATIONS ABILITIES TO ACHIEVE EQUITABLE HEALTH OUTCOMES AND REDUCE HEALTH DISPARITIES IN RURAL NH. THESE CHALLENGES INCLUDE: 1. LIMITED AVAILABILITY OF HEALTHCARE DELIVERY SYSTEM AND PUBLIC HEALTH DATA IN RURAL AREAS, WHICH MAKES IT DIFFICULT TO DESCRIBE HEALTH CHALLENGES AND RESPOND TO THEM IN REAL TIME WITH GEOGRAPHICALLY-TARGETED, POPULATION-SPECIFIC STRATEGIES; AS WELL AS LIMITED STRATIFICATION OF DATA TO UNDERSTAND DISPARITIES IN HEALTH OUTCOMES AND HEALTH FACTORS BY RACE, ETHNICITY, SEXUAL ORIENTATION, INCOME LEVEL, GENDER IDENTITY, AND OTHER DEMOGRAPHIC CHARACTERISTICS. 2. SIGNIFICANT GEOGRAPHIC AND SOCIO-ECONOMIC BARRIERS TO PARTICIPATION OF PERSONS WITH LIVED EXPERIENCE IN CO-CREATING AND IMPLEMENTING SOLUTIONS TO HEALTH OUTCOMES AND FACTORS INFL UENCING THEIR HEALTH. 3. MISMATCHES OF SCOPE, TIMING, FUNDING INCENTIVES, AND OTHER DYNAMICS LIMITING THE ABILITY OF RESEARCHERS, STUDENT LEARNERS, HEALTH CARE PROVIDERS, COMMUNITY MEMBERS, SOCIAL SERVICE ORGANIZATIONS, AND OTHER COMMUNITY PARTNERS’ TO MEANINGFULLY WORK TOGETHER. 4. LIMITED EVOLUTION OF THE CONCEPTS OF HOW TO DEFINE AND MEASURE HEALTH EQUITY; AS WELL AS RESULTING LIMITED AND DISPARATE DEVELOPMENT AND APPLICATION OF THE SYSTEMS, POLICIES, PRACTICES, AND TOOLS TO SUPPORT IMPROVED EQUITY OF HEALTH OUTCOMES IN OUR RURAL AREAS. PROPOSED SERVICES: CARHE’S LEADERSHIP COUNCIL WILL SOLICIT AND SELECT TWO EXISTING AND THREE NEW HEALTH-RELATED IMPROVEMENT AND IMPLEMENTATION PROJECTS PROPOSED BY COMMUNITY STAKEHOLDERS DURING THIS 12-MONTH PERIOD. CARHE WILL PROVIDED THESE PROJECTS WITH STAFF AND SUPPORT SERVICES, INCLUDING PROJECT MANAGERS; STAFF TO IMPROVE THE COLLECTION AND USE OF PROJECT SPECIFIC DATA; AND AN IMPLEMENTATION/RESEARCH COACH TO GUIDE THE USE OF COMMUNITY AND PROJECT DATA TO IMPROVE PROJECT ADAPTATION AND OUTCOMES. CHOSEN PROJECTS WILL ALSO RECEIVE DIRECT FUNDING SUPPORT TO ENABLE PARTICIPATION OF COMMUNITY PARTNER ORGANIZATIONS AND PERSONS MOST IMPACTED BY THE FOCAL AREA OF PROJECTS IN ALL ASPECTS OF PROJECT PLANNING AND IMPLEMENTATION. WHILE PROVIDING THESE SERVICES, WE WILL BE TESTING AND IMPROVING THE SERVICE MODEL OF CARHE, DEVELOPING, APPLYING, AND LEARNING HOW BEST TO SUPPORT OUR RURAL COMMUNITIES TO IMPROVE HEALTH OUTCOMES. POPULATION GROUP(S) TO BE SERVED: RESIDENTS OF RURAL NH COUNTIES, INCLUDING CHESHIRE, SULLIVAN, GRAFTON, COOS, CARROLL, AND BELKNAP COUNTIES.

MOVING UPSTREAM: BUILDING A TRAUMA-INFORMED COMMUNITY RESPONSE FOR OUR YOUNGEST VICTIMS OF THE OPIOID CRISIS IN CHESHIRE COUNTY

SEE NOTICE OF AWARD, ATTACHMENT 1 - TERMS AND CONDITIONS, ATTACHMENT D - STATEMENT OF WORK, ABSTRACT

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

SMALL HEALTH CARE PROVIDER QUALITY IMPROVEMENT

UPPER VALLEY SUBSTANCE MISUSE PREVENTION PARTNERSHIP

RYAN WHITE PART C OUTPATIENT EIS PROGRAM

TELEMEDICINE GRANT

TELEMEDICINE GRANT

EVIDENCE-BASED FALLS PREVENTION PROGRAMS FINANCED SOLELY BY 2017 PREVENTION AND HEALTH FUNDS (PPHF-2017) - 2017

2020 EMPOWERING COMMUNITIES TO REDUCE FALLS AND FALLS RISK

RURAL HEALTH CARE SERVICES OUTREACH GRANT PROGRAM - TRACK: SPECIAL TRACK SPECIAL TRACK FOCUS: MATERNAL HEALTH TARGET POPULATION: THE HEALTHY FOODS HEALTHY BIRTHS PROJECT WILL SERVE PREGNANT AND POSTPARTUM PEOPLE AND THEIR INFANTS IN RURAL COMMUNITIES IN ORANGE AND WINDSOR COUNTIES, VT AND GRAFTON AND SULLIVAN COUNTIES, NH. THIS PROJECT FOCUSES ON LOW-INCOME AND UNDERSERVED PEOPLE WHO EXPERIENCE DISPROPORTIONATELY WORSE FOOD INSECURITY AND MATERNAL AND CHILD HEALTH OUTCOMES, INCLUDING RACIAL/ETHNIC MINORITIES, MEDICAID PATIENTS, AND THOSE IN OUR MOST RURAL COMMUNITIES. GOAL AND OBJECTIVES: THE GOAL OF THIS PROJECT IS TO IMPROVE FOOD AND NUTRITION SECURITY AND MATERNAL, NEONATAL, AND INFANT HEALTH OUTCOMES THROUGH A COORDINATED FOOD IS MEDICINE (FIM) SERVICE AND BREASTFEEDING SUPPORT FOR RURAL PERINATAL PATIENTS. OUR OBJECTIVES ARE TO: 1. CREATE SHARED REFERRAL PATHWAYS AND PROVIDE MEDICALLY TAILORED MEALS TO AT LEAST 320 PREGNANT AND POSTPARTUM PATIENTS EXPERIENCING FOOD INSECURITY AND OTHER HEALTH AND SOCIAL NEEDS ACROSS CONSORTIUM MEMBER SITES BY APR 30, 2029. 2. PROVIDE AT LEAST 400 PREGNANT AND POSTPARTUM PATIENTS WITH SHARED, STANDARDIZED AND CULTURALLY AND LINGUISTICALLY APPROPRIATE NUTRITION EDUCATION RESOURCES (HEALTHY EATING INFO, BREASTFEEDING SUPPORT, CULINARY SKILL BUILDING, ETC.) AND REFERRALS TO COMMUNITY-BASED SERVICES (FOOD PANTRIES, WIC) BY APR 30, 2029. 3. PROVIDE SUPPORTED IN-HOME LACTATION COUNSELING IN THE PATIENT’S PREFERRED LANGUAGE TO 40 PREGNANT AND POSTPARTUM PATIENTS PER YEAR THROUGH A SHARED SERVICES MODEL ACROSS OUR CONSORTIUM MEMBERS. APPROACH: WE WILL IMPLEMENT AN EVIDENCE-INFORMED FOOD IS MEDICINE (FIM) MODEL ADAPTED FOR THE PERINATAL PERIOD. FIM APPROACHES PROVIDE FOOD-BASED NUTRITION SERVICES INTEGRATED INTO HEALTH CARE. THERE IS GROWING INTEREST AT STATE AND FEDERAL LEVELS FOR THE USE FIM TO IMPROVE HEALTH AND INCREASING EVIDENCE FOR ADAPTING THESE APPROACHES TO ADDRESS FOOD INSECURITY AND POOR NUTRITION FOR PREGNANT AND POSTPARTUM PATIENTS. WE WILL CREATE A COORDINATED SYSTEM WITH SHARED WORKFLOWS AND REFERRAL PROCESSES TO MORE CONSISTENTLY AND EQUITABLY PROVIDE FIM SERVICES ACROSS OUR CARE CONTINUUM. OUR FIM APPROACH WILL INCLUDE MEDICALLY TAILORED MEALS, NUTRITION EDUCATION, FOOD AND NUTRITION RESOURCES, AND BREASTFEEDING SUPPORT DURING THE PERINATAL PERIOD. OUTCOMES: OUR EXPECTED OUTCOMES AMONG PREGNANT AND POSTPARTUM PEOPLE AND THEIR INFANTS IN RURAL TARGET COMMUNITIES INCLUDE: REDUCED FOOD INSECURITY, IMPROVED DIET QUALITY, IMPROVED PREGNANCY OUTCOMES (DEPRESSION, HEALTHY WEIGHT GAIN, GESTATIONAL DIABETES, ANEMIA), IMPROVED BIRTH OUTCOMES (TERM BIRTH AND BIRTH WEIGHT), REDUCED POSTPARTUM DEPRESSION, AND INCREASED BREASTFEEDING INITIATION AND DURATION. CAPACITY: OUR CONSORTIUM MEMBERS HAVE LONGSTANDING RELATIONSHIPS AND HAVE COLLABORATED TO IMPROVE FOOD SECURITY AND MATERNAL HEALTH. OUR MEMBERS INCLUDE: MARY HITCHCOCK MEMORIAL HOSPITAL, LITTLE RIVERS HEALTH CARE, AND NEW LONDON HOSPITAL/NEWPORT HEALTH CENTER, ALL OF WHICH SERVE RURAL UNDERSERVED PREGNANT AND POSTPARTUM PATIENTS. OUR PROJECT TEAM MEMBERS HAVE LED THE DEVELOPMENT OF FOOD SUPPORT PROGRAMS AT ALL CONSORTIUM MEMBER SITES. OUR PROJECT LEADERSHIP TEAM HAS FORMED AND PARTICIPATED IN SEVERAL HEALTHCARE-COMMUNITY CONSORTIUMS INCLUDING THE HRSA-FUNDED NORTH COUNTRY MATERNITY NETWORK, AND THE NH PERINATAL QUALITY COLLABORATIVE. TOGETHER, OUR CONSORTIUM MEMBERS HAVE SUBSTANTIAL EXPERTISE AND EXPERIENCE IMPLEMENTING PROGRAMS AND COLLABORATING TO MEET THE NEEDS OF UNDERSERVED PREGNANT AND POSTPARTUM PATIENTS IN OUR RURAL REGION. MHMH QUALIFIES FOR THE HPSA, MUC, AND THE FOCUS ON PRIMARY CARE AND WELLNESS AND PREVENTION STRATEGIES FUNDING PREFERENCES BECAUSE 1) ALL CONSORTIUM MEMBERS ARE IN DESIGNATED HPSAS, 2) CONSORTIUM MEMBERS SERVE DESIGNATED MEDICALLY UNDERSERVED AREAS, AND 3) THE PROJECT FOCUSES ON PERINATAL CARE AS DE FACTO PRIMARY CARE AND ON FOOD AND NUTRITION STRATEGIES.

HEALTH CARE AND OTHER FACILITIES

UPSTREAM UPPER VALLEY: INCREASING EARLY CHILDHOOD MENTAL HEALTH AND TRAUMA AWAREN

HEALTH CARE AND OTHER FACILITIES

COMMUNITY PROJECT FUNDING/CONGRESSIONALLY DIRECTED SPENDING - NON-CONSTRUCTION

RURAL NORTHERN BORDER REGIONAL PLANNING

SOBER TRUTH STOP ACT GRANT - THE ALL TOGETHER COALITION SERVING THE UPPER VALLEY OF NEW HAMPSHIRE AND VERMONT IS APPLYING FOR THE SOBER TRUTH STOP ACT GRANT. THE STOP FUNDING WILL ALLOW THE REGIONAL COALITION TO EXPAND CURRENT INITIATIVES AND BEGIN NEW STRATEGIES TO REDUCE UNDERAGE DRINKING. THIS GRANT WOULD SUPPORT BEST PRACTICES IN ALCOHOL PREVENTION FOR THE COALITION’S FOCUS POPULATION OF 1,719 HIGH SCHOOL AGE YOUTH IN FOUR HIGH SCHOOLS, AND OVER 1,433 MIDDLE SCHOOL AGE YOUTH IN SIX MIDDLE SCHOOLS IN THE UPPER VALLEY. IF FUNDING IS AWARDED, THE GOALS OF ALL TOGETHER IS TO DECREASE RATES OF 30-DAY ALCOHOL USE AMONG HIGH SCHOOL STUDENTS IN OUR REGION BY: PROVIDING INFORMATION, EDUCATION AND TRAINING; THROUGH POLICY CHANGE EFFORTS AFFECTING EASE OF ACCESS, AND NORMS. WE WILL DO THIS BY FOCUSING ON THE FOLLOWING OBJECTIVES: INCREASING THE PERCEPTION OF PARENT DISAPPROVAL OF ALCOHOL USE; DECREASING ADULT ATTITUDES FAVORABLE TOWARD YOUTH ALCOHOL USE; INCREASING THE PERCEPTION THAT BINGE DRINKING IS HARMFUL; DECREASING YOUTH ACCESS. ALL OF THESE OBJECTIVES WILL BE MEASURED BY THE VERMONT AND NEW HAMPSHIRE YOUTH RISK BEHAVIOR SURVEY. ALL TOGETHER HAS IDENTIFIED THE FOLLOWING STRATEGIES AND INTERVENTIONS TO ACCOMPLISH THIS GOAL: PROVIDE INFORMATION AND EDUCATION VIA MULTI-MEDIA SOCIAL MARKETING CAMPAIGNS, ONE CHOICE, “TALK. THEY HEAR YOU,” AND DON’T SERVE TEENS TO PARENTS, YOUTH, AND COMMUNITY ACROSS THE REGION TO STRENGTHEN PROTECTIVE PARENTAL SOCIAL NORMS, CHALLENGE YOUTH USE NORMS, AND SPOTLIGHT SOCIAL HOST LIABILITY. STRENGTHEN SCHOOL AND COMMUNITY POLICIES RELATED TO SUBSTANCE USE VIOLATIONS AND IMPROVE THE QUALITY OF POLICY IMPLEMENTATION; UTILIZE TOWN HALL EVENTS TO GAIN FEEDBACK FROM THE COMMUNITIES ON UNDERAGE DRINKING ISSUES AND UTILIZE THIS FEEDBACK TO IMPLEMENT CHANGE; STRENGTHEN COLLABORATION AMONG COMMUNITIES AND STATE AND LOCAL GOVERNMENTS TO REDUCE ALCOHOL USE AMONG YOUTH AND YOUNG ADULTS. ESTIMATED NUMBER OF PEOPLE TO BE SERVED ANNUALLY AS A RESULT OF THE AWARD OF THIS GRANT: 3,152.

SOBER TRUTH APPLICATION: ALL TOGETHER

EMSC PARTNERSHIP GRANTS

RYAN WHITE HIV/AIDS PROGRAM PART C EIS COVID-19 RESPONSE

RURAL HEALTH NETWORK DEVELOPMENT PLANNING GRANT PROGRAM

REPLACEMENT GRANT FOR 90CO1099

DRUG FREE COMMUNITIES COMPETING CONTINUATION APPLICATION: ALL TOGETHER

RYAN WHITE HIV/AIDS PROGRAM PART D WICY COVID-19 RESPONSE

POLLINATOR ENHANCEMENT OF FARMACY GARDEN URBAN AGRICULTURE

RURAL HEALTH NETWORK DEVELOPMENT PLANNING GRANT PROGRAM

NH MCH LEADERSHIP TRAINING PROGRAM