Ammonoosuc Community Health Services Inc

HEALTH CENTER CLUSTER

HEALTH CENTER CLUSTER

ARRA - FACILITY INVESTMENT PROGRAM

AMERICAN RESCUE PLAN ACT FUNDING FOR HEALTH CENTERS

RURAL NORTHERN BORDER REGION OUTREACH PROGRAM - RURAL NORTHERN BORDER REGION OUTREACH PROGRAM • PROJECT TITLE ACHS FOOD AS MEDICINE PORTABLE TEACHING KITCHEN (FMPTK) AND TRIP MARKETPLACE FOR TRANSPORTATION (TRIP – MFT) • PROJECT GOAL • FMPTK – HABITUATE FOOD AS MEDICINE INTO THE ACTIVITIES OF DAILY COOKING AND EATING TO IMPROVE INDIVIDUAL HEALTH AND COMMUNITY POPULATION WELLNESS • TRIP – MFT – PRODUCE A HYPER-LOCAL TRANSPORTATION SOLUTION TAILORED TO THE UNIQUE NEEDS OF RURAL COMMUNITIES LEVERAGING TRUST AND IS/IT LOGISTIC APPLICATIONS. • PROJECT OBJECTIVES • FMPTK • PARTICIPANTS WILL DEVELOP THE HABIT OF FOOD AS MEDICINE IN THEIR MENU PLANNING, COOKING ROUTINES, AND CONSUMPTION OF HEALTHY FOODS. OG1 • THE METRICS FOR OBESITY, DIABETES, AND HYPERTENSION SHOW A CORRELATION OF IMPROVEMENT WITH PARTICIPATION IN ACHS FOOD AS MEDICINE PORTABLE TEACHING KITCHEN (FMPTK) EXPERIENCES. OG2 • ACHS FOOD AS MEDICINE PORTABLE TEACHING KITCHEN (FMPTK) SECURES PRIVATE/ PUBLIC SUSTAINABILITY FUNDING FOR TWO FTE CHW POST PROJECT PERIOD. OG3 • THE ACHS FOOD AS MEDICINE PORTABLE TEACHING KITCHEN (FMPTK) “META-STORY” ENABLES REPLICATION FOR OTHER UNIQUELY RURAL AREAS. THIS PROVIDES AN ROI FOR THIS FUNDING IN MULTIPLES OF THE INVESTMENT. OG4 • TRIP – MFT • THE TRIP MARKETPLACE FOR TRANSPORTATION SYSTEM WILL BE THE EASE OF USE CHOSE FOR DRIVERS AND RIDERS FOR ELIMINATING TRANSPORTATION BARRIERS AMONGST FRIENDS, FAMILIES, AND NEIGHBORS. OG1 • THE TRIP MARKETPLACE FOR TRANSPORTATION SYSTEM WILL HAVE REACHED A MARKET PENETRATION TO ENSURE STABILITY AND SUSTAINABILITY BASED ON THE DIFFUSION OF INNOVATION CURVE. OG2 • DRIVERS AND RIDERS WILL RATE THE TRIP MARKETPLACE FOR TRANSPORTATION SYSTEM ON WITH A PROMOTER RATING OF 9 AND 10 WHO ARE LOYAL ENTHUSIASTS WHO WILL MOST LIKELY TO OTHERS AND HELP ATTRACT NEW DRIVERS AND RIDERS. SCORES OF 7 AND 8 ARE PASSIVE AND SATISFIED. GREAT SCORES ARE 30-70 AND EXCELLENT IS 70-100 . OG3 • THE TRIP MARKETPLACE FOR TRANSPORTATION “META-STORY” ENABLES REPLICATION FOR OTHER UNIQUELY RUR AL AREAS. THIS PROVIDES AN ROI FOR THIS FUNDING IN MULTIPLES OF THE INVESTMENT. OG4 TARGET POPULATION THE TARGET POPULATION TO BE SERVED IS IN A 100% RURAL AREA DESIGNATED AS MEDICALLY UNDERSERVED AREA WITH A MEDICALLY UNDERSERVED POPULATION EXPERIENCING A DEARTH OF PROVIDERS AS DEMONSTRATED THROUGH THE MEDICAL, MENTAL, AND DENTAL SHORTAGE AREA DESIGNATIONS AS DOCUMENTED IN THE NARRATIVE. FOCUS AREA • THE FOCUS IS ON FOOD AS MEDICINE AND TRANSPORTATION THAT CUTS ACROSS ALL RESIDENTS AT VARIOUS TIMES AND LEVELS OF ACCESS. THE RESOLUTION OF WHICH IS SYSTEMIC WITH SIGNIFICANT CLINICAL AND FINANCIAL RETURNS ON INVESTING IN SOLUTIONS FOR THIS TWO UPSTREAM FROM HEALTH ACTIVITIES OF DAILY LIVING, VITAL CONDITIONS OF HEALTH IN THE AREA OF SOCIAL DETERMINANTS OF HEALTH. PROJECT ACTIVITIES BRIEF DESCRIPTION OF THE PROPOSED ACTIVITIES AND/OR SERVICES ACTIVITIES ARE HIGHLY PROXIMAL TO THOSE IN NEED OF HEALTHY FOODS AND TRANSPORTATION. THE ACTIVITIES ARE EXPERIENTIAL (FOOD) AND/ OR SYSTEM DEVELOPMENT (TRANSPORTATION) EXECUTED BY MINIMAL ESSENTIAL TEAM OF 2 FTE CHW AND 0.1FTE OF A PI/PD. LEVERAGING EXISTING HIGHLY MATURE (SINCE 1997) NORTH COUNTRY HEALTH CONSORTIUM EXPEDITES ACTION ALONG TUCKMAN’S EVOLUTION OF COLLABORATIVE TEAMS TO “PERFORMING. ACTIVITIES ARE IN THREE STAGES, 1) ACHS – SERVICE AREA, 2) EXPANSION THROUGH COÖS COUNTY, 3) LEVERAGING ‘META-STORY” FOR REPLICATION AND FINANCIAL SUSTAINABLY AS A BUSINESS PER FORMA AND ROI ARE PART OF THE META-STORY. EXPECTED OUTCOMES HIGH HABITUATION OF FOOD AS MEDICINE THROUGH THE ACHS FOOD AS MEDICINE PORTABLE TEACHING KITCHEN (FMPTK) RESULTING IN OPTIMAL INDIVIDUAL HEALTH AND COMMUNITY PUBLIC WELLNESS, ESPECIALLY IN CHRONIC DISEASES INCLUDING AND NOT LIMITED TO OBESITY, DIABETES AND HYPERTENSION. RESOLUTION OF THE UNIQUE RURAL TRANSPORTATION BARRIERS BY LEVERAGING HYPER-LOCAL COMMUNITIES OF TRUST WITH FEWER (1-2) DEGREES OF RELATIONAL SEPARATION AND IS/IT APPLICATION OF RIDE SHARING TO RESOLVE LOGISTICS OF DRIVERS AND RIDERS FI NDING EACH OTHER.

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

HEALTH CENTER INFRASTRUCTURE SUPPORT

ARRA - CAPITAL IMPROVEMENT PROGRAM

CONGRESSIONALLY DIRECTED SPENDING FOR CONSTRUCTION PROJECTS

FY 2023 EARLY CHILDHOOD DEVELOPMENT

FY 2020 EXPANDING CAPACITY FOR CORONAVIRUS TESTING (ECT)

ACHS - WAREN RENOVATION FOR RESILIENCE & REGENERATION - AMMONOOSUC COMMUNITIES HEALTH CENTER (ACHS) IS SEEKING $250,000 TO SUPPORT THE ACHS–WARREN RENOVATION FOR HEALTH, PREVENTION, AND COMMUNITY RESILIENCE, A PROJECT THAT WILL MODERNIZE A CRITICAL RURAL HEALTHCARE ACCESS POINT SERVING RESIDENTS OF WARREN AND SURROUNDING COMMUNITIES IN NEW HAMPSHIRE. THIS INVESTMENT WILL STRENGTHEN HEALTHCARE DELIVERY, EXPAND PREVENTIVE HEALTH PROGRAMMING, IMPROVE FOOD SECURITY, AND INCREASE COMMUNITY RESILIENCE IN A FEDERALLY DESIGNATED HEALTH PROFESSIONAL SHORTAGE AREA (HPSA) AND MEDICALLY UNDERSERVED AREA (MUA). ACHS–WARREN IS LOCATED AT 333 NH ROUTE 25 WARREN NH AND SERVES AS THE ONLY READILY ACCESSIBLE HEALTHCARE PROVIDER AND FOOD PANTRY WITHIN APPROXIMATELY 25 MILES. AS A FEDERALLY QUALIFIED HEALTH CENTER (FQHC), ACHS PROVIDES PRIMARY CARE, BEHAVIORAL HEALTH, COMMUNITY-BASED SERVICES, AND SUPPORT FOR VULNERABLE POPULATIONS, MANY OF WHOM EXPERIENCE TRANSPORTATION, ECONOMIC, AND HEALTHCARE ACCESS BARRIERS. THE COVID-19 PANDEMIC REINFORCED THE FACILITY'S IMPORTANCE AS A TRUSTED COMMUNITY ASSET WHILE HIGHLIGHTING THE NEED FOR INFRASTRUCTURE IMPROVEMENTS TO ENSURE CONTINUITY OF CARE, EMERGENCY PREPAREDNESS, AND LONG-TERM OPERATIONAL SUSTAINABILITY. THE PROJECT DIRECTLY ALIGNS WITH U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES FISCAL YEAR 2026 PRIORITIES AND THE MAKE AMERICA HEALTHY AGAIN (MAHA) INITIATIVE BY ADDRESSING THE ROOT CAUSES OF CHRONIC DISEASE, PROMOTING NUTRITION AND HEALTHY LIFESTYLES, SUPPORTING PREVENTIVE CARE, IMPROVING RURAL HEALTH ACCESS, AND MAXIMIZING THE VALUE OF TAXPAYER INVESTMENTS. THE RENOVATION WILL ENABLE ACHS TO EXPAND EVIDENCE-BASED PROGRAMS FOCUSED ON NUTRITION, FOOD SECURITY, CHRONIC DISEASE PREVENTION, HEALTH EDUCATION, AND COMMUNITY WELLNESS. PROJECT ACTIVITIES INCLUDE COMPREHENSIVE WEATHERIZATION IMPROVEMENTS, ROOF REPLACEMENT AND INSULATION UPGRADES, ADA ACCESSIBILITY ENHANCEMENTS, INSTALLATION OF A SOLAR MICROGRID SYSTEM, AND MODERNIZATION OF INDOOR AND OUTDOOR COMMUNITY GATHERING SPACES. THESE IMPROVEMENTS WILL SUPPORT ACHS'S GROWING FOOD AS MEDICINE INITIATIVE, PORTABLE TEACHING KITCHEN, NUTRITION EDUCATION PROGRAMS, DIABETES PREVENTION EFFORTS, AND COMMUNITY WELLNESS CLASSES. THE FACILITY WILL ALSO SERVE AS A RESILIENT COMMUNITY RESOURCE HUB CAPABLE OF PROVIDING WARMING AND COOLING SPACE, COMMUNICATIONS ACCESS, DEVICE CHARGING, AND SUPPORT SERVICES DURING EMERGENCIES AND PUBLIC HEALTH CRISES. UPON COMPLETION, THE PROJECT WILL REDUCE ANNUAL UTILITY COSTS BY MORE THAN $4,500 AND OFFSET APPROXIMATELY 96–98% OF THE ELECTRICAL DEMAND FOR BOTH THE ACHS–WARREN CLINIC AND FOOD PANTRY FACILITIES. OPERATIONAL SAVINGS WILL BE REINVESTED INTO DIRECT PATIENT CARE, PREVENTIVE HEALTH SERVICES, AND UNMET COMMUNITY HEALTH NEEDS. THE RENOVATED FACILITY WILL STRENGTHEN PARTNERSHIPS AMONG ACHS, THE TOWN OF WARREN, LOCAL BUSINESSES, RESIDENTS, AND UTILITY PROVIDERS TO ENHANCE LOCAL PREPAREDNESS AND RESILIENCE WHILE PROMOTING HEALTHIER LIFESTYLES AND IMPROVED HEALTH OUTCOMES. BY COMBINING INFRASTRUCTURE MODERNIZATION, PREVENTIVE HEALTHCARE, NUTRITION-FOCUSED PROGRAMMING, AND COMMUNITY RESILIENCE PLANNING, THE ACHS–WARREN RENOVATION FOR HEALTH, PREVENTION, AND COMMUNITY RESILIENCE PROJECT REPRESENTS A SUSTAINABLE RURAL HEALTH INVESTMENT THAT ADVANCES THE SHARED GOALS OF IMPROVING HEALTH OUTCOMES, REDUCING CHRONIC DISEASE BURDEN, STRENGTHENING COMMUNITY WELL-BEING, AND ENSURING LONG-TERM ACCESS TO QUALITY HEALTHCARE FOR UNDERSERVED POPULATIONS.

ARRA - INCREASE SERVICES TO HEALTH CENTERS

FY 2023 EXPANDING COVID-19 VACCINATION

FY 2020 CORONAVIRUS SUPPLEMENTAL FUNDING FOR HEALTH CENTERS

FY 2023 BRIDGE ACCESS PROGRAM

COMMUNITY PROJECT FUNDING/CONGRESSIONALLY DIRECTED SPENDING - CONSTRUCTION - AMMONOOSUC COMMUNITY HEALTH SERVICES HRSA-22-134 CDFA 93.493 COMPETITION ID 8752 OPPORTUNITY PACKAGE ID PKG00273079 ________________________________________ ABSTRACT AMMONOOSUC COMMUNITY HEALTH SERVICES, INC., (ACHS) IS REQUESTING $500,000 OF CONGRESSIONALLY DIRECTED SPENDING (CDS) FOR A CONSTRUCTION PROJECT. THE CONSTRUCTION PROJECT IS FOR THE ACHS – WHITEFIELD CARE DELIVERY SITE LOCATED AT 14 KING SQUARE WHITEFIELD, NH 03598-3346. ACHS – WHITEFIELD IS AN 1890 FRENCH MANSARD STYLE BUILDING COMPRISED OF THREE LEVELS ABOVE AND ON LEVEL BELOW STREET LEVEL GRADE. - LOWER LEVEL = 3,828 SQ FT - LEVE 1 = 3,828 SQ FT - LEVEL 2 = 1,276 SQ FT - LEVEL 3 = 1,276 SQ FT THE CDS FUNDS OF $500,000 ARE BEING LEVERAGED WITH $462,292 OF AMERICAN RESCUE PLAN (ARP) FUNDS. THIS ENABLES A MORE COMPREHENSIVE COST-EFFECTIVE RENOVATION. - $418,600 OF APR FUNDS ARE BUDGETED FOR RENOVATION OF CARE DELIVERY TO ENHANCE EFFECTIVE, EFFICIENT, AND SAFE CARE DELIVERY FOR PATIENT AND EMPLOYEE ALIKE. - $5,707 OF ARP FUNDS ARE BUDGETED FOR EMPLOYEE IDENTIFICATION CARD ACCESS CONTROL TO STANDARDIZE ACCESS AND SECURITY FOR EMPLOYEES ACROSS ALL ACHS CARE DELIVERY LOCATIONS. - $37,985 ARE BUDGETED FOR THE HVAC AND CONTROL SYSTEM INCREASING ENVIRONMENTAL COMFORT, AIR QUALITY, AND ESTABLISH THE INFRASTRUCTURE FOR FUTURE INVESTMENT IN GEO-THERMAL HEATING AND COOLING AS WE HAVE DONE AT ACHS – WOODSVILLE. THE $500,000 OF CDS FUNDS ARE BEING INVESTED IN - $20,000 IN ARCHITECTURAL AND ENGINEERING FEES. - $20,000 IN DEMOLITION FEES. - $310,000 IN CONSTRUCTION ENABLING BETTER INTEGRATION OF MEDICAL, BEHAVIORAL HEALTH WITH COMMUNITY-BASED EFFORTS TO ADDRESS SOCIAL DETERMINANTS OF HEALTH AND MULTIPURPOSE COMMUNITY ACTIVITY SPACE FOR NUTRITION, BONE-BUILDER, TAI CHI ETC., - $150,000 IN EQUIPMENT (HVAC SYSTEM TO ENABLE FUTURE GEO-THERMAL SYSTEM $962,292 IS THE COMBINED INVESTMENT OF CDS AND ARPA FUNDS. THE COMBINED INVESTMENT WILL ENABLE ADDRESSING THE ENTIRE BUILDING ENVELOP TOWARD OPTI MAL ENERGY EFFICIENCIES FROM WHICH ALTERNATIVE ENERGY SOURCES MAY BE CONSIDERED IN THE FUTURE INCLUDING GEOTHERMAL AND SOLAR. IN 1998 THE THEN OWNER LITTLETON REGIONAL HOSPITAL (LRH) WITH A UNITED STATES DEPARTMENT OF AGRICULTURE COMMUNITY DEVELOPMENT BLOCK GRANT. THIS INVESTMENT INCLUDED THE INSTALLATION OF AN ADA COMPLIANT ELEVATOR CONNECTING BELOW STREET GRADE, FIRST AND SECOND LEVELS.