Elliot Hospital Of The City Of Manchester

GEOGRAPHIC SCOPE: REGIONAL SOUTHERN NEW HAMPSHIRE HILLSBOROUGH COUNTY TARGETING THE GREATER MANCHESTER AND NASHUA METROPOLITAN AREAS AND SURROUNDING TOWNS.PROPOSED NUMBER OF PARTICIPANTS WHO START TRAINING: 300SUMMARY OF PROJECT PURPOSE AND EMPLOYMENT AND TRAINING ACTIVITIES OFFERED: THE PURPOSE OF THE PROJECT IS TO EXPAND AND DIVERSIFY THE PIPELINE OF NURSES AT THE LPN, RN, AND MSN LEVELS TO MEET UNPRECEDENTED DEMAND FOR NURSING PROFESSIONALS IN NHS LARGEST CITIES OF MANCHESTER (A DESIGNATED HEALTH PROFESSIONAL SHORTAGE AREA HPSA) AND NASHUA. BOTH CITIES ARE DESIGNATED MEDICALLY UNDERSERVED AREAS (MUAS) AS WELL, WITH NOTABLY HIGHER PERCENTAGES OF POVERTY, DIVERSITY, HOMELESSNESS, HIGH BEHAVIORAL HEALTH AND SUBSTANCE USE DISORDERS, AND LANGUAGE BARRIERS THAN OTHER NEW HAMPSHIRE REGIONS. THE PROJECT WILL (1) EXPAND EDUCATIONAL AND TRAINING OPPORTUNITIES DESIGNED TO REMOVE BARRIERS, AND SUPPORT DIVERSITY, INCLUSION AND EQUITY TO ALLOW TRADITIONALLY UNDERSERVED COMMUNITY MEMBERS ACCESS TO NURSING PROGRAMS (2) PROVIDE CAREER DEVELOPMENT SUPPORTS AND A STANDARDIZED PORTABLE PRECEPTOR PROGRAM TO INCREASE THE NUMBER OF PRECEPTORS AVAILABLE TO MENTOR NEW NURSES (CURRENTLY LIMITING ON-THE-JOB TRAINING AND CLINICAL SITE CAPACITY) (3) REDUCE BURDEN ON STAFF HEALTHCARE PROVIDERS BY SUPPORTING WORKER-CENTRIC STAFFING MODELS THAT SUPPORT WORK LIFE BALANCE AND TIME INCENTIVES FOR TRAINING AND MENTORING (4) LEVERAGE FINANCIAL SUPPORTS FROM PARTNERS TO MAXIMIZE PROGRAM ENROLLMENT (THROUGH MULTIPLE-AGENCY TUITION SUPPORT), AND PROGRAM RETENTION AND COMPLETION (THROUGH LEVERAGED SUPPORT FUNDS AND SERVICES OF THE PROJECTS COMPREHENSIVE PARTNER NETWORK) AND (5) GROW AND DIVERSIFY THE PIPELINE THROUGH COLLABORATIVE OUTREACH AND MARKETING WITH OUR WORKFORCE AND COMMUNITY ORGANIZATION PARTNERS TO INFORM AND RECRUIT YOUTH, MINORITIES, IMMIGRANTS AND REFUGEES, CAREER CHANGERS, OLDER AND DISABLED WORKERS, AND INDIVIDUALS RECEIVING PUBLIC ASSISTANCE. THE PROJECTS PROVEN STRATEGIES WILL BE SUSTAINED THROUGH PROJECT PARTNER RELATIONSHIPS, PROCESSES, PROGRAMS AND SYSTEMS DEVELOPED, AND THE PROJECTS SUCCESS WILL BE REPLICATED ACROSS THE STATE THROUGH THE DELIVERY OF EDUCATIONAL FORUMS THAT SHARE PROGRAMS DEVELOPED AND LESSONS LEARNED.EMPLOYMENT AND TRAINING ACTIVITIES INCLUDE ENROLLMENT IN CREDENTIALED AND TRANSFERABLE PROGRAMS THAT RESULT IN LPN, ASN, RN, BSN, AND OR MSN CERTIFICATE OR DEGREE CREDENTIALS THAT ARE STACKABLE STEPS ALONG THE NURSING CAREER PATHWAY. EDUCATION PARTNERS HAVE MATRICULATION AGREEMENTS AND PATHWAYS ESTABLISHED THAT OFFER SMOOTH TRANSITION AND ENROLLMENT TO ADVANCED PROGRAMS ON THE NURSING PATHWAY. PROGRAM DELIVERY METHODS INCLUDE CLASSROOM, ONLINE, SIMULATED LABS, CLINICALS, AND WORK-BASED LEARNING. A NEW LPN REGISTERED APPRENTICESHIP PROGRAM (RAP) WILL BE EXPANDED TO PROVIDE PARTICIPANTS THE OPPORTUNITY TO EARN AN LPN CREDENTIAL AND EARN WHILE THEY LEARN AT HEALTHCARE PARTNER ORGANIZATIONS. COMPREHENSIVE WRAP-AROUND SUPPORT AND CASE MANAGEMENT SERVICES WILL BE PROVIDED TO ALL PARTICIPANTS THROUGH THE PROJECTS EXTENSIVE AND FULLY COMPREHENSIVE WORKFORCE AND COMMUNITY ORGANIZATIONS. THIS WILL INCLUDE CHILDCARE AND TRANSPORTATION SUPPORT, AND EXTRA HELP AND SUPPORT IN PREPARATION FOR LICENSURE EXAMS.TARGET POPULATIONS TO BE SERVED: UNEMPLOYED, UNDEREMPLOYED AND INCUMBENT WORKERS, WITH TARGET GROUPS INCLUDING TEMPORARY ASSISTANCE FOR NEEDY FAMILIES (TANF) RECIPIENTS, VETERANS AND VETERAN FAMILIES, IMMIGRANTS AND REFUGEES, DISADVANTAGED YOUTH, PEOPLE OF COLOR, WOMEN MOTHERS EXPERIENCING HOMELESSNESS, INDIVIDUALS WITH DISABILITIES, AND OTHER UNDERREPRESENTED POPULATIONS.SELECTED TRAINING TRACK: NURSING CAREER PATHWAYSTARGETED OCCUPATIONS: LICENSED PRACTICAL NURSES (LPN), REGISTERED NURSES (RN)

THE LIVE FREE PROJECT - SUMMARY: LIVE FREE EXPANDS MAT AND RELATED PSYCHOSOCIAL SERVICES WITHIN NH’S LARGEST CITY OF MANCHESTER, KNOWN AS THE EPICENTER OF THE STATE’S DRUG CRISIS. TARGETING JUSTICE-INVOLVED INDIVIDUALS WITH OUD OR THOSE AT-RISK OF INCARCERATION, LIVE FREE INCLUDES A ROBUST COMMUNITY EDUCATION CAMPAIGN THAT FOCUSES ON REDUCING STIGMA AND DISPARITIES IN TREATMENT TO IMPROVE RECOVERY RESULTS. POPULATION OF FOCUS (POF): JUSTICE-INVOLVED INDIVIDUALS WITH AN OPIOID USE DISORDER (OUD) WHO ARE: (1) WITHIN 90 DAYS OF RELEASE FROM INCARCERATION; OR 2) CURRENTLY ON PAROLE OR PROBATION; OR (3) DRUG COURT PARTICIPANTS; OR (4) IDENTIFIED AS AT RISK OF INCARCERATION DUE TO PREVIOUS OR CURRENT ALTERCATIONS WITH LAW ENFORCEMENT; AND THOSE PRESENTING WITH OUD-RELATED HEALTH CRISES AT THE EMERGENCY DEPARTMENT WHO ARE MORE LIKELY TO BECOME JUSTICE-INVOLVED BASED ON CURRENT DEMOGRAPHIC DISPARITIES THAT ARE PREVALENT WITHIN THE INCARCERATED POPULATION (INCLUDING LGBTQIA+, RACIAL/ETHNIC MINORITIES, & HOMELESS/LIVING IN POVERTY). STRATEGIES/INTERVENTIONS: TO ATTACK CAPACITY GAPS AND DISPARITIES IN ACCESS TO TREATMENT FOR THE POF, LIVE FREE WILL IMPLEMENT A COMPREHENSIVE RECOVERY TEAM APPROACH – PROVIDING A COHESIVE UNIT TO PROVIDE MAT (BUPRENORPHINE, NALOXONE, SUBOXONE, VIVITROL, ETC.) AND THE RELATED PSYCHOSOCIAL TREATMENT INTERVENTIONS AND WRAPAROUND SUPPORT SERVICES NEEDED TO PREVENT RELAPSE/OVERDOSE, REDUCE RECIDIVISM, AND HELP THESE VULNERABLE INDIVIDUALS BE SUCCESSFUL ON THEIR RECOVERY PATH. LIVE FREE’S DIRECT SERVICES TEAM WILL INCLUDE AN ADVANCED REGISTERED NURSE PRACTITIONER TO ADMINISTER MAT, A LICENSED MENTAL HEALTH COUNSELOR/CLINICAL SOCIAL WORKER TO PROVIDE MENTAL HEALTH AND SUBSTANCE USE ASSESSMENTS, COUNSELING AND CONCURRENT TREATMENT REFERRALS; A NURSE CARE COORDINATOR (NCC) TO PROVIDE “CASE MANAGEMENT” AND PATIENT COORDINATION/REFERRAL TO RESOURCES ADDRESSING OTHER MEDICAL/HEALTH NEEDS AND SOCIAL DETERMINANTS OF HEALTH, AND A PEER RECOVERY COACH/RESOURCE NAVIGATOR TO SUPPORT CLIENTS AND ACCOMPANY THEM THROUGH ALL PHASES OF THEIR RECOVERY JOURNEY, INCLUDING HELPING TO IDENTIFY AND SECURE FUNDAMENTAL NEEDS NECESSARY TO RECOVERY SUCCESS, SUCH AS EMPLOYMENT AND SAFE HOUSING. TO IMPROVE SYSTEMIC SERVICES RELATIVE TO OUD, THE PROJECT PARTNERS WITH MAKIN’ IT HAPPEN TO PROVIDE EDUCATIONAL FORUMS AND OUTREACH TARGETED TOWARD VARIOUS COMMUNITY SECTORS (HEALTHCARE, JUSTICE SYSTEM, BUSINESS, HOUSING/LANDLORDS, ETC.) TO REDUCE STIGMA ASSOCIATED WITH THE POF AND IMPROVE UNDERSTANDING OF MAT AND OUD. A SEQUENTIAL INTERCEPT MODEL MAPPING EVENT WILL BRING DIFFERENT SECTORS TOGETHER TO IDENTIFY DIVERSION OPPORTUNITIES TO STEER THOSE WITH OUD INTO TREATMENT VS. INCARCERATION, AND A ROBUST “LIVE FREE” CAMPAIGN AND MENTORSHIP PROGRAM WILL ENCOURAGE, TRAIN, MENTOR, AND AWARD DOCTORS AND PRACTITIONERS WILLING TO EXPAND OR INTRODUCE MAT WITHIN THEIR PRACTICES, TO RESULT IN INCREASED MAT ACCESS POINTS THROUGHOUT THE CITY. PROJECT GOALS/MEASURABLE OBJECTIVES: TO INCREASE AVAILABILITY & ACCESS TO MAT TREATMENT; INCREASE PARTICIPANT RETENTION IN MAT TREATMENT; INCREASE RECOVERY SUSTAINABILITY; REDUCE STIGMA/BIAS AND ACHIEVE BUY-IN THROUGH MAT EDUCATION AND AWARENESS OF DISPARITIES. MEASURABLE OBJECTIVES INCLUDE: ACTIVELY TARGET, RECRUIT, AND ENROLL A MINIMUM OF 675 HIGHLY VULNERABLE MARGINALIZED INDIVIDUALS (LGBTQIA+, RACIAL/ETHNIC MINORITIES, & HOMELESS/LIVING IN POVERTY) TO RECEIVE MAT DURING 5-YR. PROJECT PERIOD, TO ADDRESS DISPARITIES/ENSURE EQUITABLE ACCESS BY MEETING OR EXCEEDING 62% OF TOTAL PARTICIPANTS; ACHIEVE RE-ARREST RATE 6-MONTHS POST-RELEASE WHICH IS 20% LOWER THAN THOSE NOT USING MOUD, 100% OF PARTICIPANTS WILL RECEIVE CASE MANAGEMENT AND WRAPAROUND SERVICES SUPPORT, 80% OF PARTICIPANTS WILL PARTICIPATE IN EVIDENCE-BASED COGNITIVE BEHAVIORAL THERAPIES, AND OTHERS. TOTAL NUMBER SERVED: 1,085 UNDUPLICATED PEOPLE OVER 5-YEAR PROJECT; ANNUAL AVERAGE SERVED: 217

COMMUNITY PROJECT FUNDING/CONGRESSIONALLY DIRECTED SPENDING - CONSTRUCTION - WE ARE SEEKING TO UPGRADE IMAGING CAPABILITY TO HIGH-RESOLUTION 3D MAMMOGRAPHY AT THE ELLIOT BREAST HEALTH CENTER. THIS TECHNOLOGY ALLOWS US TO TAKE ONE TOMOGRAPHIC IMAGE AND SYNTHESIZE A 2D IMAGE FROM IT WITHOUT EXPOSING THE PATIENT TWICE. IT REDUCES DOSE BY APPROXIMATELY 50%. IT ALSO PROVIDES HIGHER QUALITY IMAGES FOR PATHOLOGY DETECTION AND INCREASE RADIOLOGIST EFFICIENCY IN INTERPRETATION. THIS UPGRADE OF 3 MACHINES WILL ENABLE US TO SEE AN ADDITIONAL 2 PATIENTS PER DAY, PER MACHINE. OUR CURRENT MAMMOGRAPHY EQUIPMENT WAS INSTALLED IN 2013. THE RADIOLOGIST MONITORS ARE NOW AT END OF LIFE PER HOLOGIC (DOCUMENTATION IS FILED) AND WILL BE FURTHER SUPPORTED UNLESS REPLACED. THESE MONITORS ARE 7 YEARS OLD. THE UPGRADE OF THESE MACHINES WILL IMPROVE EFFICIENCY, ALLOW OUR PROVIDERS TO SCREEN MORE PATIENTS, REDUCE PATIENT RADIATION DOSE AND EXPOSURE AND REPLACE AN AGING INFRASTRUCTURE. OTHER BENEFITS WILL DECREASE OUR HIGH-RISK CLINIC BACKLOG FOR SCREENINGS, IMPROVE SAFETY AND REDUCE DOWNTIME FROM OLDER EQUIPMENT.