Bays Inc

HURRICANE HARVEY SHORELINE PROJECTS

THIS AWARD WILL LAUNCH THE OYSTER RESTORATION INITIATIVE, AN ESTUARY-SCALE OYSTER RESTORATION PROJECT IN PENSACOLA BAY. THE PROJECT WILL DESIGN MORE THAN 1,000 ACRES OF OYSTER RESTORATION AND INITIATE CONSTRUCTION OF THIS AMBITIOUS VISION. AN ASSESSMENT OF SEDIMENT LOADS WILL BE COMPLETED TO HELP PRIORITIZE LOCATIONS FOR OYSTER RESTORATION SITES. THE PROJECT WILL ALSO COMPLETE THE EARLY STAGES OF PLANNING FOR THE SANDY HOLLOW GULLY RESTORATION PROJECT, WHICH WILL ADDRESS UPSTREAM SEDIMENTATION SOURCES IMPACTING DOWNSTREAM OYSTER HABITAT QUALITY. A NEW PROGRAM WILL PROVIDE COST ASSISTANCE TO ENCOURAGE THE USE OF LIVING SHORELINES AND OTHER NATURE-BASED SOLUTIONS BY LOCAL PROPERTY OWNERS.

GERIATRICS WORKFORCE ENHANCEMENT PROGRAM

DRUG INJECTION SURVEILLANCE AND CARE ENHANCEMENT FOR RURAL NORTHERN NEW ENGLAND (DISCERNNE)

IMPACT OF HEALTH REFORM ON OUTPATIENT SUBSTANCE ABUSE TREATMENT PROGRAMS

AFFORDABLE CARE ACT: PRIMARY CARE RESIDENCY EXPANSION

IMPROVING PARTICIPATION IN PULMONARY REHABILITATION THROUGH PEER-SUPPORT AND STORYTELLING - ABSTRACT EXACERBATIONS OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) LEAD TO ROUGHLY 1.5 MILLION ED VISITS AND 700,000 HOSPITALIZATIONS ANNUALLY. RECOVERY IS SLOW, AND ACCOMPANIED BY HIGH LEVELS OF ACUTE CARE UTILIZATION AND MORTALITY. PULMONARY REHABILITATION (PR) IS A STRUCTURED PROGRAM OF EXERCISE AND SELF-MANAGEMENT SUPPORT THAT HAS BEEN SHOWN TO RELIEVE DYSPNEA AND IMPROVE QUALITY OF LIFE. CLINICAL GUIDELINES RECOMMEND PR FOR PATIENTS WITH STABLE COPD AND AFTER AN EXACERBATION. UNFORTUNATELY, EVEN WHEN REFERRED BY PHYSICIANS, OUR RESEARCH HAS SHOWN THAT FEW PATIENTS WHO MIGHT BENEFIT FROM PR EVER BEGIN TREATMENT. THE PRIMARY GOAL OF THIS PROJECT IS TO IDENTIFY EFFECTIVE STRATEGIES FOR PROMOTING AND SUSTAINING PARTICIPATION IN PR. PEER SUPPORT INVOLVES PAIRING A PATIENT WITH A TRAINED PEER FROM A SIMILAR BACKGROUND, AND FACING SIMILAR HEALTH CHALLENGES, WHO HAS COMPLETED PR. THERE IS A GROWING BODY OF EVIDENCE DEMONSTRATING THE FEASIBILITY, ACCEPTABILITY, AND EFFECTIVENESS OF TELEPHONIC PEER SUPPORT FOR CHRONIC DISEASE MANAGEMENT. NARRATIVE INTERVENTIONS, OR `STORYTELLING', ARE NOVEL APPROACHES FOR CHANGING ATTITUDES AND BEHAVIORS OF PATIENTS THAT INVOLVE CREATING AND DISSEMINATING VIDEOS NARRATED BY INDIVIDUALS WITH LIVED EXPERIENCE WITH THE SAME CONDITION OR FACING THE SAME TREATMENT. STORYTELLING INTERVENTIONS HAVE BEEN SHOWN TO HELP PATIENTS ACHIEVE BETTER BLOOD PRESSURE CONTROL, AND STORYTELLING IS BEING STUDIED IN A VARIETY OF OTHER CLINICAL CONTEXTS. IN THE R61 PHASE, WE WILL RECRUIT AND TRAIN A COHORT OF PEER COACHES IN BEHAVIOR CHANGE TECHNIQUES, AND WILL RECRUIT A DIVERSE GROUP OF STORYTELLERS, CAPTURE THEIR NARRATIVES ON VIDEO, AND CREATE A LIBRARY OF 6-8 POWERFUL STORIES. WE WILL FINALIZE OUR PROTOCOL, TRIAL INFRASTRUCTURE, AND PILOT OUR RECRUITMENT STRATEGY. DURING THE R33 PHASE, WE WILL RECRUIT 305 ADULTS TREATED FOR EXACERBATION OF COPD, AND RANDOMIZE THEM TO 1) ENHANCED “USUAL CARE” (EUC); 2) EUC + STORYTELLING; OR 3) EUC + PEER SUPPORT. WE WILL EVALUATE THE EFFECTIVENESS OF EACH STRATEGY COMPARED TO EUC, AND TO EACH OTHER, AT PROMOTING PARTICIPATION IN PR AT 6 MONTHS. USING A MIXED-METHODS APPROACH, WE WILL EVALUATE INTERVENTION ACCEPTABILITY, SUSTAINABILITY, AND COST, FROM THE PERSPECTIVES OF THE PATIENTS AND PEER COACHES AS WELL AS PR PROGRAM STAFF AND HOSPITAL LEADERSHIP. WE WILL USE THESE FINDINGS TO REFINE THE STRATEGIES AND TO DISSEMINATE AN IMPLEMENTATION PACKAGE THAT WILL ENABLE OTHER PR PROGRAMS TO ADOPT THESE APPROACHES. THIS PROJECT ENGAGES KEY STAKEHOLDERS IN STUDY CONCEPTUALIZATION, EXECUTION, AND DISSEMINATION, AND IS RESPONSIVE TO THE NHLBI/CDC COPD NATIONAL ACTION PLAN THAT CALLS FOR THE DEVELOPMENT OF STRATEGIES TO INCREASE THE NUMBER OF AMERICANS THAT BENEFIT FROM PR.

GERIATRICS WORKFORCE ENHANCEMENT PROGRAM

IMPLEMENTING EFFECTIVE SMOKING CESSATION PHARMACOTHERAPY FOR HOSPITALIZED SMOKERS WITH CARDIOPULMONARY DISEASE - PROJECT SUMMARY TOBACCO USE REMAINS THE LEADING CAUSE OF DEATH IN THE UNITED STATES AND CONTRIBUTES TO MORE THAN 7 MILLION HOSPITALIZATIONS ANNUALLY. HOSPITALIZATION OFFERS A CRITICAL WINDOW FOR INTERVENTION: HOSPITAL POLICIES PROHIBIT SMOKING, PATIENTS ARE HIGHLY MOTIVATED TO QUIT, AND SOCIETAL GUIDELINES RECOMMEND THAT CLINICIANS SHOULD COUNSEL PATIENTS AND PRESCRIBE SMOKING CESSATION PHARMACOTHERAPY (SCP) TO VIRTUALLY ALL SMOKERS. NEVERTHELESS, ONLY 22% OF PATIENTS ARE EVER PRESCRIBED SCP WHILE HOSPITALIZED AND ONLY 1% OF PATIENTS ARE PRESCRIBED GUIDELINE-CONCORDANT SCP. THIS FAILURE ULTIMATELY CONTRIBUTES TO A 70-80% SMOKING RELAPSE RATE, MOST OF WHICH OCCURS WITHIN A FEW DAYS OF HOSPITAL DISCHARGE – WELL BEFORE OUTPATIENT FOLLOW-UP CAN OCCUR. IF WE ARE TO CAPITALIZE ON THE OPPORTUNITY THAT HOSPITALIZATION PROVIDES TO MAXIMIZE SMOKING CESSATION TREATMENT AND OUTCOMES, NEW STRATEGIES ARE NEEDED TO OVERCOME THE LOW UPTAKE OF GUIDELINE-CONCORDANT SCP BY PHYSICIANS AND PATIENTS. TO ADDRESS THIS PROBLEM, WE PROPOSE TO DEPLOY A NURSE PRACTITIONER-LED, HOSPITAL- BASED TOBACCO TREATMENT TEAM TO: 1) PRESCRIBE INDIVIDUALLY TAILORED AND GUIDELINE-CONCORDANT SCP; 2) COUNSEL AND MOTIVATE PATIENTS TO USE SCP PROPERLY; AND 3) AND MANAGE A MOBILE PHONE-BASED TEXT-MESSAGING SYSTEM TO KEEP PATIENTS MOTIVATED AND ADHERENT TO SCP. OUR PRELIMINARY DATA SUGGEST THAT SUCH AN APPROACH IS FEASIBLE AND ACCEPTABLE TO PATIENTS, PHYSICIANS, AND HOSPITAL ADMINISTRATORS. IN AIM 1, WE WILL PERFORM A PARALLEL-GROUP IMPLEMENTATION-EFFECTIVENESS RANDOMIZED TRIAL AMONG 424 HOSPITALIZED SMOKERS WITH A CARDIOPULMONARY DISEASE IN A LARGE TERTIARY HOSPITAL. WE WILL COMPARE RATES OF SCP USE AND SMOKING CESSATION BETWEEN PATIENTS WHO RECEIVED THE INTERVENTION AND THOSE WHO DID NOT. IN AIM 2, WE WILL MEASURE THE ECONOMIC VALUE OF THE INTERVENTION FROM BOTH A HOSPITAL AND PAYER PERSPECTIVE TO BETTER INFORM HOSPITAL AND INSURANCE POLICIES AND SUSTAINABILITY. IN AIM 3, WE WILL PERFORM QUALITATIVE INTERVIEWS WITH PATIENTS, PHYSICIANS, STAFF MEMBERS, AND HOSPITAL ADMINISTRATORS TO EVALUATE THE ACCEPTABILITY AND SUSTAINABILITY OF OUR STRATEGIES. WE HYPOTHESIZE THAT OUR INTERVENTION WILL: IMPROVE GUIDELINE-CONCORDANT SCP USE; INCREASE 6- MONTH SMOKING CESSATION RATES; BE ACCEPTABLE TO PATIENTS, CLINICIANS, AND ADMINISTRATORS; AND BE COST-EFFECTIVE AND SUSTAINABLE. OUR MULTI-DISCIPLINARY TEAM HAS BROAD EXPERIENCE IN CARDIOPULMONARY MEDICINE, TOBACCO TREATMENT, IMPLEMENTATION SCIENCE, MEDICATION ADHERENCE, QUALITATIVE METHODS, HEALTH ECONOMICS, AND TEXT MESSAGE TECHNOLOGY. AT THE CONCLUSION OF THIS GRANT, OUR TEAM WILL DEVELOP A DETAILED, EVIDENCE-INFORMED IMPLEMENTATION GUIDE FOR A HOSPITAL-BASED TOBACCO TREATMENT TEAM. ULTIMATELY, WE ANTICIPATE THE KNOWLEDGE GAINED FROM THIS STUDY WILL FACILITATE WIDESPREAD AND EFFECTIVE HOSPITAL-BASED TOBACCO TREATMENT SO THAT MORE PATIENTS LEAD LIVES FREE FROM TOBACCO AND CARDIOPULMONARY DISEASE.

CHILD ADVOCACY TRAINING AND SUPPORT CENTER (CATS) - THE CHILD ADVOCACY TRAINING AND SUPPORT CENTER (CATS) AT BAYSTATE MEDICAL CENTER WILL COORDINATE AND CONSOLIDATE THE VAST RESOURCES AND EXPERTISE OF THE NATIONAL CHILD TRAUMATIC STRESS NETWORK (NCTSN) TO SUPPORT CHILD ADVOCACY CENTERS (CACS) IN MEETING THEIR MISSION AND THE NATIONAL CHILDREN’S ALLIANCE’S (NCA) STANDARDS FOR ACCREDITED MEMBERS WITH THE PRIMARY GOAL OF INCREASING ACCESS TO TRAUMA INFORMED SERVICES FOR CHILDREN AND THEIR FAMILIES. THE CATS CENTER TEAM, IN PARTNERSHIP WITH NATIONAL EXPERTS ON CAC SERVICE DELIVERY, EVIDENCE-BASED TREATMENT (EBT) TRAUMA CURRICULUM DEVELOPERS, AND STAKEHOLDERS REPRESENTING EACH MULTIDISCIPLINARY TEAM (MDT) DISCIPLINE WILL IMPLEMENT COMPREHENSIVE, COORDINATED CAPACITY-BUILDING EFFORTS FOCUSED ON DISSEMINATION OF TRAUMA-FOCUSED EBTS. THE CATS CENTER WILL BE THE VEHICLE FOR DISSEMINATION OF TRAUMA INFORMED CARE (TIC) ACROSS THE CAC SYSTEM, EMBEDDED WITHIN THE MDT MODEL IN A WAY THAT WILL PROMOTE COMPREHENSIVE TIC AND SUSTAINABILITY, EFFECTIVELY IMPACTING THE 350,000 YOUTH WHO ARE SERVED THROUGH CACS ANNUALLY. THE CATS CENTER WILL ACHIEVE THIS IN THE FOLLOWING WAYS: 1) ESTABLISH A NATIONAL TRAINING CENTER TO SUPPORT CACS IN ENSURING THEIR MDT MEMBERS ARE TRAUMA-INFORMED AND HAVE SPECIALIZED TOOLS, SKILLS, AND RESOURCES FOR EFFECTIVE SERVICE DELIVERY BY LEVERAGING EXISTING EXPERTISE AND PARTNERSHIPS. 2) INCREASE SYSTEM CAPACITY AND COMPETENCIES OF THE CAC MDT PROFESSIONALS’ (I.E., MEDICAL, MENTAL HEALTH, LAW ENFORCEMENT, CHILD-WELFARE, VICTIM ADVOCATES) TRAUMA-INFORMED RESPONSE USING A LEARNING COLLABORATIVE MODEL AND SPECIALIZED CURRICULUM SPECIFIC TO EACH DISCIPLINE. (MEETING 8 HOURS OF CHILD ABUSE TRAINING OUTLINED AS AN ESSENTIAL COMPONENT IN THE STANDARDS) 3. INCREASE AVAILABILITY OF TRAINING IN EBTS, SUCH AS TRAUMA-FOCUSED COGNITIVE-BEHAVIORAL THERAPY TO MENTAL HEALTH PROFESSIONALS WITHIN CACS (MEETING 40 HOURS OF TRAINING IN EBTS ANOTHER ESSENTIAL COMPONENT OF THE STANDARDS). 3) SUPPORTING SUSTAINABILITY OF TIC THROUGHOUT CAC MDTS BY SERVING AS A CONTINUING RESOURCE FOR TRAINING, CONSULTATION, AND TECHNICAL ASSISTANCE TO CAC MDTS FOR 6 MONTHS AFTER THEIR INITIAL ILC AND PROVIDING ADDITIONAL TRAINING AND CONSULTATION REGARDING PRIORITY AREAS SUCH AS COMMERCIAL SEXUAL EXPLOITATION AND TRAFFICKING, PROBLEM SEXUAL BEHAVIORS, SCREENING AND ENGAGEMENT, AND SECONDARY TRAUMATIC STRESS PREVENTION. 4) DEVELOP AND CONSOLIDATE NCTSN PRODUCTS SPECIFICALLY FOR CAC SERVICE SYSTEMS SUCH AS FACTSHEETS AND WEBINARS, AND CREATE A SPECIFIC LOCATION FOR THESE RESOURCES ON THE NCTSN WEBSITE FOR EASE OF ACCESSIBILITY, WITH LINKAGE TO NCA. THE CATS CENTER WILL REACH 80% OF ALL CACS THROUGH TRAINING AND RESOURCE DISTRIBUTION WITH EMPHASIS ON SELECTING CACS THAT ARE UNDER RESOURCED OR ATTEMPTING TO MEET THE NCA’S STANDARDS FOR ACCREDITED MEMBERS.

AFFORDABLE CARE ACT: PRIMARY CARE RESIDENCY EXPANSION

SURVIVING TRAUMA WITH EVIDENCE-BASED PRACTICES (STEP)

A MIXED METHODS STUDY TO ANALYZE THE USE OF PULMONARY REHABILITATION FOLLOWING HOSPITALIZATION FOR COPD, AND TO IDENTIFY EFFECTIVE STRATEGIES FOR INCREASING RATES OF PARTICIPATION

SYSTEM FACTORS INFLUENCING THE POSTPARTUM TRANSITION TO PRIMARY CARE FOR CARDIOVASCULAR DISEASE RISK MANAGEMENT AMONG WOMEN WITH HYPERTENSIVE DISORDERS IN PREGNANCY - PROJECT SUMMARY CARDIOVASCULAR DISEASE (CVD) IS THE LEADING CAUSE OF DEATH AMONG WOMEN IN THE UNITED STATES. WOMEN WHO EXPERIENCE HYPERTENSIVE DISORDERS IN PREGNANCY (HDP), INCLUDING CHRONIC HYPERTENSION, GESTATIONAL HYPERTENSION, AND PRE-ECLAMPSIA/ECLAMPSIA, FACE SUBSTANTIALLY HIGHER FUTURE CVD RISK. ABOUT ONE IN SEVEN WOMEN EXPERIENCE HDP BY THE END OF THEIR CHILDBEARING YEARS, WITH HIGHER RATES AMONG WOMEN OF COLOR. TRANSITIONING TO PRIMARY CARE POSTPARTUM IS RECOMMENDED FOR ALL WOMEN, BUT HAS PARTICULAR URGENCY FOR WOMEN WITH HDP. WOMEN WITH HDP HAVE A HIGH RISK OF ADVERSE OUTCOMES IN THE IMMEDIATE POSTPARTUM PERIOD (E.G. MATERNAL MORBIDITY AND MORTALITY), ONE TO THREE YEARS POSTPARTUM (E.G., HYPERTENSION, METABOLIC SYNDROME ONSET), AND LONG-TERM (E.G. ISCHEMIC HEART DISEASE, HEART FAILURE, STROKE). THE LIMITED EXISTING RESEARCH ON POSTPARTUM PRIMARY CARE UTILIZATION SHOWS THAT UP TO 80% OF WOMEN WHO EXPERIENCED HDP DO NOT RECEIVE PRIMARY CARE IN THE YEAR FOLLOWING BIRTH. PRIMARY CARE IS AN APPROPRIATE SETTING FOR SHORT AND LONG-TERM CVD RISK MANAGEMENT, INCLUDING IDENTIFICATION AND TREATMENT OF HYPERTENSION AND HYPERLIPIDEMIA. HOWEVER, LITTLE IS KNOWN ABOUT THE PRIMARY CARE PROVIDED FOR POSTPARTUM WOMEN WITH HDP AND WHETHER IT RESPONDS TO THEIR HEIGHTENED CVD RISK. DESPITE LOW RATES OF POSTPARTUM TRANSITION TO PRIMARY CARE FOR WOMEN WITH HDP, LITTLE IS KNOWN ABOUT HOW SYSTEMS FACTORS IMPACT THIS TRANSITION AND PRIMARY CARE CVD RISK ASSESSMENT AND MANAGEMENT IN THE POSTPARTUM YEAR. USING AN EXPLANATORY-SEQUENTIAL MIXED METHODS DESIGN, WE EXAMINE THE POSTPARTUM TRANSITION TO PRIMARY CARE FOR CVD RISK MANAGEMENT FOR WOMEN WITH HDP IN MASSACHUSETTS AND NATIONALLY. THESE AIMS ADDRESS NHLBI’S STRATEGIC OBJECTIVE TO “INVESTIGATE FACTORS THAT ACCOUNT FOR DIFFERENCES IN HEALTH AMONG POPULATIONS,” WHICH INCLUDES MANAGING CARDIOMETABOLIC RISK TO IMPROVE HEALTH TRAJECTORIES IN SEX-SPECIFIC POPULATIONS. THE SPECIFIC AIMS ARE 1) TO DETERMINE THE ROLE OF SYSTEMS FACTORS IN THE TRANSITION TO PREVENTIVE PRIMARY CARE FOR WOMEN WITH HDP IN THE POSTPARTUM YEAR; 2) TO CHARACTERIZE AND EXAMINE CLINICIAN AND ORGANIZATIONAL FACTORS INFLUENCING CARDIOMETABOLIC RISK ASSESSMENT AND MANAGEMENT IN PRIMARY CARE IN THE POSTPARTUM YEAR; AND 3) TO IDENTIFY ORGANIZATIONAL AND CONTEXTUAL FACTORS SHAPING THE POSTPARTUM TRANSITION TO PRIMARY CARE AND CVD RISK MANAGEMENT IN PRIMARY CARE. WITH INPUT FROM A MULTI-STAKEHOLDER ADVISORY BOARD, WE WILL INTEGRATE RESULTS ACROSS AIMS TO DEVELOP PRACTICE AND POLICY RECOMMENDATIONS TO IMPROVE CARE QUALITY FOR WOMEN WITH HDP TO REDUCE FUTURE CVD RISK. RESULTS FROM THIS STUDY WILL CONTRIBUTE TO AN IMPROVED UNDERSTANDING OF SYSTEMS FACTORS ASSOCIATED WITH SUCCESSFUL TRANSITION TO POSTPARTUM PRIMARY CARE FOR WOMEN AT HIGH CVD RISK, AND HELP TO IDENTIFY INTERVENTIONS, HEALTHCARE QUALITY METRICS, AND POLICY LEVERS TO IMPROVE CLINICAL PRACTICE.

CASE MANAGEMENT FOR UNDERSERVED HISPANIC TYPE 2 DIABETES POPULATIONS

IMPROVING OUTCOMES FROM CARDIAC REHABILITATION AMONG OLDER ADULTS THROUGH EXERCISE TESTING AND INDIVIDUALIZED EXERCISE INTENSITY PRESCRIPTIONS - PROJECT SUMMARY HEART DISEASE AND ITS TREATMENTS, INCLUDING HOSPITALIZATION, SURGERY, AND PROCEDURES, CAN RESULT IN DEVASTATING LOSS OF FUNCTION, PARTICULARLY IN INACTIVE OLDER ADULTS, WHO OFTEN FACE A PROLONGED RECOVERY. MAXIMIZING FITNESS AND PROMOTING ADEQUATE PHYSICAL ACTIVITY (PA) ARE CRITICAL TARGETS FOR HEALTHY AGING AND RECOVERY AFTER A CARDIAC EVENT. CARDIAC REHABILITATION (CR) PROVIDES UP TO 36 SUPERVISED EXERCISE TRAINING SESSIONS AND LIFESTYLE COUNSELING TO THESE PATIENTS AND IS THUS IDEALLY POSITIONED TO PROMOTE FULL RECOVERY, ENCOURAGE REGULAR PA, OPTIMIZE CARDIAC HEALTH, AND SUPPORT MORE SUCCESSFUL AGING FOR THESE PATIENTS. HOWEVER, MANY CR PROGRAMS FAIL TO MEET ESTABLISHED BENCHMARKS FOR IMPROVING FITNESS AMONG THEIR PATIENTS. THIS FAILURE IS LIKELY ATTRIBUTABLE TO MARKED DIFFERENCES IN EXERCISE INTENSITY PRESCRIPTION PRACTICES ACROSS CR PROGRAMS, WHICH HAVE RECENTLY BEEN IDENTIFIED. SPECIFICALLY, THE MOST COMMON METHOD FOR PRESCRIBING EXERCISE INTENSITY IN CR IS THE USE OF RATINGS OF PERCEIVED EXERTION (RPE) COUPLED WITH A “RULE OF THUMB” APPROACH TO ACHIEVE AN EXERCISE TRAINING HEART RATE (HR) THAT IS 20-30 BPM HIGHER THAN RESTING HR. WHILE EASY TO IMPLEMENT, THESE USUAL CARE (UC) TECHNIQUES OFTEN RESULT IN A SELF-SELECTED AND SUBOPTIMAL EXERCISE INTENSITY. THIS, IN TURN, LEADS TO LOWER GAINS IN FITNESS AND FAILURE TO REACH ESTABLISHED BENCHMARKS. INSTEAD, SOCIETAL GUIDELINES RECOMMEND PATIENTS UNDERGO A GRADED EXERCISE TEST (GXT) TO MEASURE A PEAK EXERCISE HR AND BE PRESCRIBED EXERCISE INTENSITY USING A COMPUTED TARGET HEART RATE RANGE (THRR). THIS APPROACH (GXT-THRR) ALLOWS TAILORING OF EXERCISE BASED ON THE INDIVIDUAL PATIENT’S RESPONSE TO ACUTE EXERCISE. HOWEVER, NO STUDIES TO DATE HAVE TESTED THE EFFICACY OF GXT- THRR COMPARED TO UC, AND THIS CRITICAL KNOWLEDGE GAP IS LIKELY RESPONSIBLE FOR THE MARKED DIFFERENCES IN EXERCISE INTENSITY PRESCRIPTION TECHNIQUES ACROSS PROGRAMS. OUR PRELIMINARY DATA SUGGEST GXT-THRR WILL LEAD TO GREATER GAINS IN FITNESS IN CR, BOOST SELF-EFFICACY, REDUCE FEAR OF EXERCISE, AND IMPROVE OUTCOMES. TO ADDRESS THIS FUNDAMENTAL QUESTION, WE WILL PERFORM A 320-PERSON RANDOMIZED TRIAL COMPARING GXT- THRR TO UC AMONG OLDER ADULTS WITH HEART DISEASE ATTENDING CR. IN AIM 1, WE WILL MEASURE IMPROVEMENTS IN FITNESS DURING CR. IN AIM 2, WE WILL ASSESS THE IMPACT OF GXT-THRR ON PSYCHOLOGICAL FACTORS ASSOCIATED WITH EXERCISE ADHERENCE (SELF-EFFICACY AND FEAR). IN AIM 3, WE WILL EVALUATE HOW THE USE OF GXT-THRR IMPACTS LONG-TERM PA, QUALITY OF LIFE, FITNESS, AND CLINICAL OUTCOMES. OUR MULTI-DISCIPLINARY TEAM HAS BROAD EXPERIENCE IN ALL ASPECTS OF THIS PROPOSAL, INCLUDING EXERCISE PHYSIOLOGY, CR, CARDIOLOGY, GERIATRICS, AND PSYCHOLOGY. OUR APPROACH IS INFORMED BY A SUCCESSFUL PILOT TRIAL WHICH DEMONSTRATED THE CLEAR FEASIBILITY AND POTENTIAL EFFECTIVENESS OF GXT-THRR. ULTIMATELY, WE ANTICIPATE OUR RESULTS WILL PROMOTE EVIDENCE-BASED EXERCISE INTENSITY PRACTICES IN CR PROGRAMS, LEADING TO GREATER IMPROVEMENTS IN FITNESS, PA, AND EXERCISE SELF-EFFICACY, AND MORE SUCCESSFUL AGING.

ACUTE LUNG INJURY GROUP NEW ENGLAND PROGRAM TO SUPPORT PETAL NETWORK RESEARCH

PARTNERS IN CARE: COMMUNITY-BASED IMPLEMENTATION OF EBT

BRIDGE IN MOTION - BAYSTATE MEDICAL CENTER, THE HAMPDEN COUNTRY SHERIFF'S DEPARTMENT, CODAC, HOLYOKE HEALTH CENTER, CARING HEALTH CENTER AND THE CENTER FOR ADDICTION RECOVERY WILL COLLABORATE ON BRIDGE IN MOTION, EXPANDING ACCESS TO MEDICATION ASSISTED TREATMENT (MAT) IN JAIL/TREATMENT AND AFTER RELEASE TO HAMPDEN COUNTY SHERIFF'S DEPARTMENT FACILITIES' OFFENDERS AND CIVILLY COMMITTED WITH AN OPIOID USE DISORDER (OUD) IN WESTERN MASSACHUSETTS. OUR POPULATION OF FOCUS IS MEN AND WOMEN, 18 YEARS AND OLDER, WHO HAVE AN OUD, AND ARE WITHIN FOUR MONTHS OF SCHEDULED RELEASE FROM HAMPDEN COUNTY SHERIFF'S DEPARTMENT (HCSD) TO RETURN TO THEIR COMMUNITY IN HAMPDEN COUNTY, MA. THIS INCLUDES INDIVIDUALS WHO ARE IN TREATMENT FUR TO CIVIL COMMITMENT FOR OUD, INDIVIDUALS WHO ARE PRETRIAL WITH A BAIL OF $5,000 OR LESS, AND INDIVIDUALS WHO ARE INCARCERATED FOR A CRIMINAL OFFENSE. OUR DESIRED OUTCOMES ARE: 10 AN INCREASE IN THE NUMBER OF INDIVIDUALS RECEIVING MAT BEFORE AND AFTER RELEASE AND 2) A DECREASE IN ILLICIT OPIOID DRUG USE AND PRESCRIPTION OPIOID DRUG MISUSE AT THREE AND SIX MONTHS POST RELEASE. THE SHERIFF'S DEPARTMENT'S ELECTRONIC MEDICAL RECORD SYSTEM SHOWS AN OUD PREVALENCE RATE OF 40% FOR MEN AND 53% FOR WOMEN. OVER TWO-THIRDS OF THE NEWLY RELEASED PERSONS WITH AN OPIOID DISORDER WILL SEEK TO ENGAGE IN TREATMENT SERVICES WHEN THEY RETURN TO THEIR HOME COMMUNITY. RISK OF OPIOID OVERDOSE IN MARKEDLY INCREASED FOLLOWING RELEASE FROM INCARCERATION/COMMITMENT. CASE MANAGEMENT STAFF WILL SERVE AS THE CRUCIAL LINK TO COMPREHENSIVE PSYCHOSOCIAL AND HEALTH CARE SUPPORT SERVICES, INCLUDING PRIMARY HEALTH CARE, MENTAL HEALTH CARE AND PEER SUPPORT PROGRAMS TO SUSTAIN TREATMENT AND RECOVERY. WE WILL USE THE EVIDENCE-BASED CRITICAL TIME INTERVENTION (CTI) PROGRAM MODEL, WHICH INVOLVES TWO COMPONENTS: 1) STRENGTHENING THE INDIVIDUAL'S LONG-TERM TIES TO SERVICES, FAMILY AND FRIENDS; AND 2)PROVIDING EMOTIONAL AND PRACTICAL SUPPORT DURING THE TRANSITION BACK TO THE COMMUNITY. IT IS EXPECTED THAT CONTINUATION OF MAT SERVICES AND OPIOID USE ABSTINENCE AFTER RELEASE WILL INCREASE WITH INTENSIVE CASE MANAGEMENT AND COMMUNITY SUPPORT. WE WILL ALSO USE MOTIVATIONAL INTERVIEWING. THROUGH THE BRIDGE IN MOTION PROGRAM, WE AIM TO IMPROVE OVERALL HEALTH BY PROVIDING A COMPREHENSIVE NETWORK OF SUBSTANCE USE AND MENTAL HEALTH TREATMENT AND RECOVERY SUPPORT SERVICES THAT WILL REDUCE THE LIKELIHOOD OF RECIDIVISM. EACH YEAR OF THE GRANT PERIOD, WE WILL SERVE 50 CLIENTS. THE TOTAL NUMBER OF UNDUPLICATED INDIVIDUALS WE WILL SERVE OVER THE FIVE-YEAR GRANT PERIOD IS 250.

IMPLEMENTATION AND OUTCOMES OF NONINVASIVE VENTILATION IN COPD

BUILDING RESILIENCY IN YOUNG CHILDREN (BRYC) - THE BUILDING RESILIENCY IN YOUNG CHILDREN (BRYC) PROGRAM AT BAYSTATE MEDICAL CENTER HAS THE OVERARCHING GOAL OF IMPROVING ACCESS TO AND QUALITY OF TRAUMA-INFORMED SERVICES FOR ALL CHILDREN 0-5 YEARS OLD, PRIORITIZING LATINO CHILDREN, WHO SHOW EARLY SIGNS OF OR WHO HAVE BEEN DIAGNOSED WITH MENTAL ILLNESS DUE TO ADVERSE LIFE EXPERIENCE, INCLUDING NEGLECT SECONDARY TO PARENTAL SUBSTANCE MISUSE OR MULTIGENERATIONAL TRAUMA, AND THEIR CAREGIVERS. BRYC WILL ACHIEVE THIS GOAL IN THE FOLLOWING OVERLAPPING PHASES: 1. INCREASE COMMUNITY-LEVEL OUTREACH AND ENGAGEMENT IN ORDER TO RAISE AWARENESS OF EARLY CHILDHOOD TRAUMA AND IMPROVE IDENTIFICATION OF CHILDREN 0-5 Y/O EXHIBITING EARLY SIGNS OF MENTAL HEALTH NEEDS. THIS WILL BE DONE BY COLLABORATING WITH EXISTING INFANT AND EARLY CHILDHOOD SYSTEMS OF CARE ALREADY IN EXISTENCE TO PROVIDE EDUCATIONAL OPPORTUNITIES AND SHARING OF RESOURCES. 2. EXPAND ACCESS TO AND COORDINATION OF TRAUMA-INFORMED EARLY CHILDHOOD MENTAL HEALTH SERVICES FOR CHILDREN 0-5Y/O AND THEIR CAREGIVERS BY PROVIDING TRAUMA-INFORMED MENTAL HEALTH ASSESSMENTS (450 ASSESSMENTS OVER THE COURSE OF THE PROJECT), EVIDENCE-BASED TRAUMA-INFORMED THERAPY (400 CHILDREN AND FAMILIES SERVED OVER THE COURSE OF THE PROJECT), AND PSYCHOEDUCATION GROUPS FOR FOSTER PARENTS AND BIOLOGICAL CAREGIVERS, IN ORDER TO PROMOTE RESILIENCE WITHIN THE NATURAL SUPPORT SYSTEM. ADDITIONALLY, BRYC WILL ENSURE THAT ALL CHILDREN RECEIVING A NEEDS ASSESSMENT ARE REFERRED TO APPROPRIATE SERVICES (410 CHILDREN OVER THE COURSE OF THE PROJECT). 3. BUILD THE CAPACITY OF CHILD-SERVING SERVICE SYSTEMS TO IDENTIFY, RESPOND EFFECTIVELY TO, AND PREVENT TRAUMA IN CHILDREN 0-5Y/O WHO ARE AT RISK FOR OR HAVE EXPERIENCED TRAUMA AND THEIR CAREGIVERS. BRYC WILL USE NCTSN DEVELOPED TRAUMA-INFORMED CURRICULUM TO INCREASE THE TRAUMA-INFORMED PRACTICE WITHIN EARLY CHILDHOOD CHILD-SERVING SYSTEMS. ADDITIONALLY, CONSULTATION IN SPECIALTY TOPICS ENSURING CULTURAL COMPETENT CARE OF LATINO CHILDREN AND FAMILIES AFTER TRAUMA, WORKING WITH CAREGIVERS RECOVERING FROM SUBSTANCE MISUSE, AND SUPPORTING RESILIENCE IN YOUNG CHILDREN WILL BE PROVIDED TO IMPROVE COMPETENCE OF PROFESSIONALS WORKING WITH THE TARGET POPULATION (800 TOTAL PROFESSIONALS WILL RECEIVE THIS SUPPORT). LASTLY, TO SUPPORT SUSTAINABILITY IN THE CHILD SERVING WORKFORCE, INTERVENTIONS WILL BE PROVIDED REGARDING SECONDARY TRAUMATIC STRESS AND VICARIOUS TRAUMA. DURING THE COURSE OF THIS PROJECT 1260 CHILDREN WILL BE SERVED WITH TRAUMA-INFORMED EVIDENCE-BASED PRACTICES.

DESCRIPTION:THIS AWARD PROVIDES FUNDING THROUGH THE BIPARTISAN INFRASTRUCTURE LAW (BIL) (ALSO KNOWN AS THE INFRASTRUCTURE INVESTMENT AND JOBS ACT (IIJA)) FOR IMPLEMENTATION OF THE EPA APPROVED DELAWARE CENTER FOR THE INLAND BAYS PROGRAM COMPREHENSIVE CONSERVATION AND MANAGEMENT PLAN (CCMP) UNDER SECTION 320 OF THE CLEAN WATER ACT (CWA), WHICH WILL HELP RESTORE AND MAINTAIN THE WATER QUALITY AND ECOLOGICAL INTEGRITY OF THE DELAWARE INLAND BAYS ESTUARY. THIS PROJECT OVERSEES THE IMPLEMENTATION OF PROJECTS OUTLINED UNDER DELAWARE CENTER FOR THE INLAND BAYS ESTUARY PROGRAM (CIB) WORKPLAN, THROUGH WHICH THE FEDERAL FUNDS AND OUTLINED ACTIVITIES IMPLEMENT THE NATIONAL ESTUARY PROGRAM'S (NEP) COMPREHENSIVE CONSERVATION AND MANAGEMENT PLAN (CCMP). THE PURPOSE OF THIS AWARD IS TO SUPPORT THE IMPLEMENTATION OF THE CIB CCMP.ACTIVITIES:UNDER THIS AWARD, CIB INTENDS TO IMPLEMENT ACTIONS RELATED TO ACTIVITIES THAT SUPPORT THE IMPLEMENTATION OF VARIOUS GOALS WITHIN THEIR CCMP. THESE ACTIVITIES ARE DRIVEN BY SPECIFIC PRIORITY GOALS, INCLUDING: DECREASING NUTRIENT LOADING THROUGHOUT THE WATERSHED; PRESERVING AND PROTECTING MARSHES, SHORELINES AND NEAR-SHORE HABITATS; FACILITATING AND MONITORING CONSERVATION AND RESTORATION PROJECTS; AND, EDUCATING THE PUBLIC TO SUPPORT KNOWLEDGEABLE DECISION-MAKING FOR THE COMMUNITY AND ITS FUTURE. SPECIFIC ACTIVITIES TO BE PERFORMED UNDER THIS AWARD INCLUDE: COASTAL HABITAT RESTORATION, WATER QUALITY MONITORING, PUBLIC EDUCATION AND OUTREACH, CLIMATE CHANGE RESILIENCY EFFORTS, LIVING SHORELINE IMPROVEMENTS, STORMWATER INFRASTRUCTURE IMPROVEMENTS, AND MAINTAINING CAPACITY TO IMPLEMENT CCMP GOALS.SUBRECIPIENT:NO SUBAWARDS ARE INCLUDED IN THIS ASSISTANCE AGREEMENT.OUTCOMES:ANTICIPATED DELIVERABLES RELATED TO THIS AWARD INCLUDE THE REDUCTION OF NUTRIENT POLLUTION AND ITS IMPACTS, REDUCING OTHER POLLUTANTS AND THEIR IMPACTS, SUSTAINING DRINKING WATER FLOW FOR DRINKING WATER AND ECOSYSTEMS, INCREASING COMMUNITY RESILIENCE AND ACCESS, IMPROVING PUBLIC AWARENESS AND STAKEHOLDER ENGAGEMENT, PREVENTING WETLAND LOSS, STEMMING FOREST LOSS, AND, INCREASING AND IMPROVING FISH AND SHELLFISH HABITAT. THIS WILL INCLUDE THE INSTALLATION OF NATURAL SHORELINE TO ERODED AREAS, AND THE DEVELOPMENT OF NEW AND STANDING ENVIRONMENTAL EDUCATION AND COMMUNITY GRANT PROGRAMS. OUTCOMES FROM THIS AWARD INCLUDE IMPROVED ENVIRONMENTAL LITERACY AND GROWTH IN ENVIRONMENTAL STEWARDSHIP IN THE WATERSHED, INCREASED COMMUNITY STEWARDSHIP AND BEHAVIOR CHANGE AROUND ENVIRONMENTAL ISSUES, AND THE PRESERVATION/ENHANCEMENT OF WATER QUALITY, CRITICAL HABITAT AND COASTAL RESILIENCE RESOURCES. INTENDED BENEFICIARIES OF THIS AWARD INCLUDE THE CITIZENS OF THE LOCAL WATERSHED, VISITORS TO THE INLAND BAYS ESTUARY, AND THE LOCAL ECOSYSTEM AS A WHOLE.

DESCRIPTION:THIS AWARD PROVIDES FUNDING THROUGH THE BIPARTISAN INFRASTRUCTURE LAW (BIL) (ALSO KNOWN AS THE INFRASTRUCTURE INVESTMENT AND JOBS ACT (IIJA)) FOR IMPLEMENTATION OF THE EPA APPROVED MARYLAND COASTAL BAYS COMPREHENSIVE CONSERVATION AND MANAGEMENT PLAN (CCMP) UNDER SECTION 320 OF THE CLEAN WATER ACT (CWA), WHICH WILL HELP RESTORE AND MAINTAIN THE WATER QUALITY AND ECOLOGICAL INTEGRITY OF THE MARYLAND COASTAL BAYS. THIS PROJECT OVERSEES THE IMPLEMENTATION OF PROJECTS OUTLINED UNDER MARYLAND COASTAL BAY'S (MCBP) WORKPLAN, THROUGH WHICH THE FEDERAL FUNDS AND OUTLINED ACTIVITIES IMPLEMENT THE NATIONAL ESTUARY PROGRAM'S (NEP) COMPREHENSIVE CONSERVATION AND MANAGEMENT PLAN (CCMP). THE PURPOSE OF THIS AWARD IS TO SUPPORT THE IMPLEMENTATION OF THE MCBP CCMP.ACTIVITIES:UNDER THIS AWARD, MCBP INTENDS TO IMPLEMENT ACTIONS RELATED TO 52 ACTIVITIES THAT SUPPORT THE IMPLEMENTATION OF VARIOUS GOALS WITHIN THEIR CCMP. THESE ACTIVITIES ARE DRIVEN BY SPECIFIC PRIORITY GOALS, INCLUDING: DECREASING NUTRIENT LOADING THROUGHOUT THE WATERSHED; PRESERVING AND PROTECTING MARSHES, SHORELINES AND NEAR-SHORE HABITATS; FACILITATING AND MONITORING CONSERVATION AND RESTORATION PROJECTS; AND, EDUCATING THE PUBLIC TO SUPPORT KNOWLEDGEABLE DECISION-MAKING FOR THE COMMUNITY AND ITS FUTURE. SPECIFIC ACTIVITIES TO BE PERFORMED UNDER THIS AWARD INCLUDE: COASTAL HABITAT RESTORATION, WATER QUALITY MONITORING, PUBLIC EDUCATION AND OUTREACH, CLIMATE CHANGE RESILIENCY EFFORTS, LIVING SHORELINE IMPROVEMENTS, STORMWATER INFRASTRUCTURE IMPROVEMENTS, SUPPORTING DISADVANTAGED COMMUNITIES AND HBCU INSTITUTIONS, AND MAINTAINING CAPACITY TO IMPLEMENT CCMP GOALS.SUBRECIPIENT:WITH THE GOAL OF PROMOTING IDEAS AND PROJECTS THAT ADDRESS CLIMATE RESILIENCE- AND ENVIRONMENTAL JUSTICE-ORIENTED NEEDS, COMPETITIVE GRANTS OF VARIOUS SIZES WILL BE AWARDED TO CCMP PARTNERS AND OTHER STAKEHOLDERS IN THE WATERSHED. GRANTS MAY INCLUDE A MIX OF LARGER AWARDS FOR SIGNIFICANT PROJECT OR RESEARCH ACTIVITIES AND SMALLER AWARDS FOR MORE LIMITED PROJECTS BY SMALLER COMMUNITY ORGANIZATIONS. THE INTENTION IS TO RESERVE A CERTAIN PERCENTAGE OF GRANT FUNDING FOR PROJECTS/ORGANIZATIONS FOCUSED ON CLIMATE RESILIENCE AND ENVIRONMENTAL JUSTICE ISSUES.OUTCOMES:ANTICIPATED DELIVERABLES RELATED TO THIS AWARD INCLUDE THE RESTORATION OF NONTIDAL WETLAND HABITAT FROM AGRICULTURAL LAND, THE INSTALLATION OF NATURAL SHORELINE TO ERODED AREAS, THE IMPROVEMENT OF STORMWATER INFRASTRUCTURE IN UNDERSERVED AREAS, THE DESIGN OF VARIOUS HABITAT AND COMMUNITY IMPROVEMENT PROJECTS, AND THE DEVELOPMENT OF NEW AND STANDING ENVIRONMENTAL EDUCATION AND COMMUNITY GRANT PROGRAMS. OUTCOMES FROM THIS AWARD INCLUDE IMPROVED ENVIRONMENTAL LITERACY AND GROWTH IN ENVIRONMENTAL STEWARDSHIP IN THE WATERSHED, INCREASED COMMUNITY STEWARDSHIP AND BEHAVIOR CHANGE AROUND ENVIRONMENTAL ISSUES, AND THE PRESERVATION/ENHANCEMENT OF WATER QUALITY, CRITICAL HABITAT AND COASTAL RESILIENCE RESOURCES. INTENDED BENEFICIARIES OF THIS AWARD INCLUDE THE CITIZENS OF THE LOCAL WATERSHED, VISITORS TO THE EASTERN SHORE AND COASTAL BAYS, INDUSTRIES AND BUSINESSES THAT RELY ON THE COASTAL BAYS, STUDENTS AND FACULTY OF THE LOCAL SCHOOL SYSTEM AND OF UMES, AND THE LOCAL ECOSYSTEM AS A WHOLE.

DESCRIPTION:THESE FUNDS FOR COASTAL BEND BAYS AND ESTUARIES PROGRAM (CBBEP) SUPPORT IMPLEMENTATION OF THE COMPREHENSIVE CONSERVATION AND MANAGEMENT PLAN (CCMP) AND ACCOMPANYING STRATEGIC PLAN TO IMPROVE THE WATER QUALITY, PROTECT THE NATURAL HABITAT AND LIVING RESOURCES, AND SUPPORT SUSTAINABLE HUMAN USES OF THE COASTAL BEND BAYS AND ESTUARIES. THIS AGREEMENT IS SUPPORTED BY FUNDING PROVIDED UNDER THE INFRASTRUCTURE INVESTMENT AND JOBS ACT (IIJA) (PL 117-58).ACTIVITIES:ALL ACTIVITIES FOCUS ON MAINTAINING, RESTORING, AND/OR IMPROVING WATER QUALITY. THE ACTIVITIES TO BE PERFORMED BY THE COASTAL BEND ANDBAY ESTUARY PROGRAM INCLUDE THE FOLLOWING ACTIVITIES: 1) TERN ISLAND PROTECTION AND RESTORATION, PHASE II - THE OBJECTIVE IS TO INCREASE THE AMOUNT OF BIRD NESTING HABITAT ON TERN ISLAND BY (1) COMPLETING THE ENGINEERING DESIGN, PERMITTING, AND CONSTRUCTION OF A ROCK BREAKWATER AROUND THE PERIMETER OF THE ISLAND AND (2) EXPANDING THE ACREAGE OF TERN ISLAND THROUGH THE PLACEMENT OF IMPORTED FILL MATERIAL BEHIND THE NEWLY CONSTRUCTED BREAKWATERS. 2) COPANO BAY SHORELINE PROTECTION AND RESTORATION, PHASE I - THE OBJECTIVE OF THIS PROJECT IS TO COMPLETE A FEASIBILITY STUDY AND ALTERNATIVES ANALYSIS FOR AN ERODING SHORELINE IN COPANO BAY. 3) OSSF ASSISTANCE PROGRAM, PHASE I - THE OBJECTIVE IS TO ADDRESS NUTRIENT AND BACTERIA PROBLEMS IN TARGETED WATERSHEDS BY INSPECTING, REPAIRING, AND REPLACING OSSFS THAT ARE FAILING OR NON-EXISTENT, FOCUSING ON UNDERSERVED COMMUNITIES WITH LIMITED RESOURCES. 4) TRAINING PROGRAM FOR WASTEWATER OPERATORS IN THE BAFFIN BAY WATERSHED - THE OBJECTIVE IS TO ADDRESS NUTRIENT AND BACTERIA PROBLEMS IN THE BAFFIN BAY WATERSHED BY IMPLEMENTING A 24-MONTH TRAINING PROGRAM FOR PERSONNEL AT WASTEWATER FACILITIES, FOCUSING ON INCREASING THE HUMAN CAPITAL OF UNDERSERVED COMMUNITIES WITH LIMITED RESOURCES. 5) ACCESS IMPROVEMENTS AND TRAIL DEVELOPMENT AT THE HELD-MORAN SANCTUARY - THE OBJECTIVES INCLUDE (1) CONSTRUCTING OFF-STREET, GRAVEL PARKING LOT ON THE NORTH SIDE OF THE HELD-MORAN SANCTUARY ON MEDITERRANEAN DRIVE WITH ENOUGH SPACE FOR FOUR TO FIVE CARS; (2) DESIGNING AND INSTALLING A HALF-MILE LOOP-TRAIL, ORIENTED NORTH TO SOUTH, FROM THE PROPOSED PARKING AREA; AND (3) REPAIRING AND REPLACING DAMAGED BOLLARD AND CABLE SYSTEM THAT IS DESIGNED TO LIMIT ACCESS TO THE INTERIOR OF THE PROPERTY BY MOTORIZED AND/OR WHEELED VEHICLES. 6) ARANSAS BAY BIRD ISLAND RESTORATION, PHASE II - THE OBJECTIVES ARE TO INCREASE THE AMOUNT OF BIRD NESTING HABITAT IN THE ARANSAS BAY SYSTEM BY (1) COMPLETING THE FINAL ENGINEERING/DESIGN AND CONSTRUCTION OF A ROCK BREAKWATER AROUND THE PERIMETER OF DEADMAN ISLAND AND (2) EXPANDING THE ACREAGE OF THE ISLAND THROUGH THE PLACEMENT OF IMPORTED FILL MATERIAL BEHIND THE NEWLY CONSTRUCTED BREAKWATERS. 7) TOWN OF BAYSIDE SHORELINE PROTECTION AND PUBLIC ACCESS, PHASE II - THE OBJECTIVE IS TO COMPLETE THE PRELIMINARY ENGINEERING AND DESIGN AND PERMITTING FOR A SHORELINE PROTECTION STRUCTURES NEAR THE TOWN OF BAYSIDE. THE PROJECT WILL SEEK TO REDUCE AND PREVENT EROSION OVER TIME AT BAYSIDE CITY PARK, WHILE ALSO CREATING AND RESTORING HABITAT FOR AQUATIC AND AVIAN SPECIES AND IMPROVING PUBLIC ACCESS OPPORTUNITIES. 8) CBBEP CLIMATE CHANGE RISK-BASED ADAPTATION PLAN AND EQUITY STRATEGY - THE OBJECTIVE IS TO DEVELOP A CLIMATE CHANGE RISK-BASED ADAPTATION PLAN THAT CONTAINS EFFECTIVE SOLUTIONS THAT CBBEP AND OUR PARTNERS CAN IMPLEMENT TO BETTER MANAGE POTENTIAL RISKS FROM A CHANGING CLIMATE. THE PROJECT WILL ALSO FOCUS ON DEVELOPING AN EQUITY STRATEGY THAT ENSURES CBBEP IS REVIEWING POTENTIAL PROJECTS AND UTILIZATION OF OUR FUNDS THROUGH LENS OF EQUITABLE AND FAIR ACCESS FROM OUR PROGRAMS TO ALL INDIVIDUALS. 9) COASTAL BEND REGIONAL WASTEWATER TREATMENT FACILITY FEASIBILITY STUDY - THE OBJECTIVE IS TO ADDRESS NUTRIENT AND BACTERIA PROBLEMS IN THE BAFFIN BAY WATERSHED BY CONDUCTING A FEASIBILITY STUDY FOR THE PROPOSED CONSTRUCTION OF A REGIONAL WAS

PVLSI BREAST CANCER RESEARCH PROGRAM: BIOMARKERS AND CHEMOPREVENTION

PURPOSE: TO PROVIDE GRANTS TO COMMUNITY DEVELOPMENT FINANCIAL INSTITUTIONS (CDFIS) FOR THE FOLLOWING PURPOSES 1) TO EXPAND LENDING, GRANT MAKING AND INVESTMENT ACTIVITIES IN LOW OR MODERATE INCOME COMMUNITIES AND TO BORROWERS THAT HAVE HISTORICALLY EXPERIENCED SIGNIFICANT UNMET CAPITAL AND FINANCIAL SERVICES NEEDS AND WERE DISPROPORTIONATELY IMPACTED BY THE COVID 19 PANDEMIC; AND 2) TO ENABLE CDFIS TO BUILD ORGANIZATIONAL CAPACITY AND ACQUIRE TECHNOLOGY, STAFF, AND OTHER TOOLS NECESSARY TO ACCOMPLISH THE ACTIVITIES UNDER A CDFI ERP AWARD. PLANNED ACTIVITIES: ELIGIBLE ACTIVITIES INCLUDE FINANCIAL PRODUCTS, FINANCIAL SERVICES, DEVELOPMENT SERVICES, GRANTS, LOAN LOSS RESERVES AND CAPITAL RESERVES THAT MAY BE USED TO MITIGATE THE IMPACT OF THE COVID 19 PANDEMIC ON UNEMPLOYMENT, CHILDCARE, HEALTHCARE, MENTAL HEALTHCARE, AFFORDABLE HOUSING, AFFORDABLE HOUSING FINANCE, SMALL BUSINESS, SMALL FARMS, BROADBAND INTERNET, AND FOOD SUFFICIENCY. IN ADDITION, TO SUPPORT CDFIS IN BUILDING THEIR CAPACITY TO RESPOND TO THE ECONOMIC IMPACT OF COVID 19, CDFI ERP AWARDS MAY BE USED FOR COMPENSATION PERSONAL SERVICES; COMPENSATION FRINGE BENEFITS; PROFESSIONAL SERVICE COSTS; TRAVEL COSTS; TRAINING AND EDUCATION COSTS; EQUIPMENT; SUPPLIES. END GOALS: EXPANDED FINANCING FOR LOW TO MODERATE INCOME COMMUNITIES AND INDIVIDUALS THAT HAVE HISTORICALLY EXPERIENCED SIGNIFICANT UNMET CAPITAL AND FINANCIAL SERVICES NEEDS AND WERE DISPROPORTIONATELY IMPACTED BY THE COVID 19 PANDEMIC INCLUDING SPECIFIC DESIGNATED COVID IMPACTED CDFI ERP ELIGIBLE GEOGRAPHIES AS AREAS THAT MAY BENEFIT FROM CDFI ERP ASSISTANCE. BENEFICIARIES: CERTIFIED CDFIS WHICH MAY BE FOR PROFIT ORGANIZATION, PRIVATE NONPROFIT INSTITUTION/ORGANIZATION, AND OTHER PRIVATE INSTITUTION/ORGANIZATION, AS DEFINED IN 12 C.F.R. 1805, AND LOW AND MODERATE INCOME INDIVIDUALS AND FAMILIES. SUBRECIPIENTS: THERE ARE NO SUBRECIPIENTS FOR THIS PROGRAM. BROADBAND: SPECIFIC ACTIVITIES RELATING TO BROADBAND USAGE ARE NOT KNOWN AT THE TIME OF AWARD. REASON/PURPOSE OF MODIFICATION: NOT APPLICABLE.

DESCRIPTION:THE PURPOSE OF THIS COOPERATIVE AGREEMENT IS TO SUPPORT THE IMPLEMENTATION OF THE DELAWARE CENTER FOR THE INLAND BAYS NATIONAL ESTUARY PROGRAM'S COMPREHENSIVE CONSERVATION AND MANAGEMENT PLAN (CCMP) UNDER SECTION 320 OF THE CLEAN WATER ACT (CWA), WHICH WILL HELP TO RESTORE AND MAINTAIN THE WATER QUALITY AND ECOLOGICAL INTEGRITY OF THE DELAWARE INLAND BAYS SYSTEM. ACTIVITIES UNDER THIS PROJECT INCLUDE HABITAT RESTORATION, WATERSHED MONITORING, AND EDUCATION/OUTREACH EFFORTS. ACTIVITIES:THE RECIPIENT WILL CONDUCT THE FOLLOWING ACTIVITIES AS PART OF THE PROJECT FUNDED BY THIS AWARD: RESTORATION PROGRAMS, HABITAT PROJECTS, TECHNICAL ANALYSIS, COORDINATION OF SCIENCE AND TECHNICAL ADVISORY COMMITTEE, WEBSITE OPERATION AND MAINTENANCE, EDUCATIONAL PARTNERSHIPS AND PROGRAMS, HOLDING AND PARTICIPATING IN TARGETED PUBLIC EVENTS AND FESTIVALS ACROSS THE ESTUARY, CCMP TRACKING AND NEPORT DATA COLLECTION, AND PROGRAM PLANNING AND IMPLEMENTATION.SUBRECIPIENT:NO SUBAWARDS ARE INCLUDED IN THIS ASSISTANCE AGREEMENT.OUTCOMES:THE OUTPUTS AND OUTCOMES OF THE ACTIVITIES UNDER THIS PROJECT INCLUDE IMPROVED WATER QUALITY, IMPROVED COASTAL HABITAT CONDITIONS, AND INCREASED COMMUNITY AWARENESS AND KNOWLEDGE ON ENVIRONMENTAL MATTERS. THE BENEFICIARIES OF THIS PROJECT INCLUDE THE RESIDENTS AND VISITORS OF THE DELAWARE INLAND BAYS REGION.

DESCRIPTION:THIS COOPERATIVE AGREEMENT PROVIDES FUNDING TO MARYLAND COASTAL BAYS PROGRAM UNDER THE NATIONAL ESTUARY PROGRAM (NEP) TO SUPPORT IMPLEMENTATION OF THE NEP COMPREHENSIVE CONSERVATION AND MANAGEMENT PLAN (CCMP) AND EPA STRATEGIC PLAN GOAL 5: ENSURE CLEAN AND SAFE WATER FOR ALL COMMUNITIES AND OBJECTIVE 5.2: - PROTECT AND RESTORE WATERBODIES AND WATERSHEDS TO IMPROVE THE WATER QUALITY, PROTECT THE NATURAL HABITAT AND LIVING RESOURCES, AND SUPPORT SUSTAINABLE HUMAN USES IN THE ESTUARY. SECTION 320 OF THE CWA AUTHORIZES THE ADMINISTRATOR OF THE EPA TO CONVENE MANAGEMENT CONFERENCES TO DEVELOP COMPREHENSIVE CONSERVATION AND MANAGEMENT PLANS FOR ESTUARIES OF NATIONAL SIGNIFICANCE THAT ARE THREATENED BY POLLUTION, DEVELOPMENT, OR OVERUSE. ACTIVITIES:THE PROJECTS INCLUDED WILL SUPPORT ACTIVITIES THAT ADDRESS THE KEY CHALLENGES FACING THE ESTUARY INCLUDING ASSESSING TRENDS IN WATER QUALITY, HABITATS, NATURAL RESOURCES AND USES; COORDINATING IMPLEMENTATION OF THE CCMP BY THE NEP, ALONG WITH THE STATE, FEDERAL, LOCAL AGENCIES, STAKEHOLDERS, NGOS, CITIZENS, PARTNERS, AND OTHERS; AND MONITORING THE EFFECTIVENESS OF ACTIVITIES CONDUCTED UNDER THE MANAGEMENT CONFERENCE APPROVED CCMP AND ANNUAL WORKPLAN. SOME SPECIFIC WORK AND ACTIONS TO BE ACCOMPLISHED THROUGH THIS AWARD INCLUDE CONTINUATION OF ONGOING PROJECTS TO RESTORE IMPORTANT COASTAL AND INLAND HABITATS AND SPECIES OF SIGNIFICANCE; DEVELOPMENT OF A NEW CCMP; PLANNING AND EXECUTION OF A PROGRAMMATIC EVALUATION; CONDUCTING PUBLIC ENVIRONMENTAL EDUCATION PROGRAMMING, COMMUNITY OUTREACH CAMPAIGNS; MONITORING STREAMS AND COASTAL BAYS FOR CONTINUOUS EFFORTS; AND DEVELOPING TECHNICAL AND PUBLIC REPORTS.SUBRECIPIENT:SUPPORTING THE WORK OF THE CHESAPEAKE CONSERVATION CORPS IN IMPLEMENTING THE MCBP CCMP; SUPPORTING THE WORK OF UNIVERSITY OF MARYLAND CENTER FOR ENVIRONMENTAL STUDIES IN THEIR DEVELOPMENT OF ANNUAL REPORT CARD AND ECO-HEALTH REPORTING RESOURCES AND ACCESS. OUTCOMES:DELIVERABLES INCLUDE THE MCBP ANNUAL REPORT CARD ON WATERSHED QUALITY AND HEALTH AND THE CONTINUED SUPPORT OF UNIVERSITY OF MARYLAND - EASTERN SHORE (UMES) THROUGH THE LEAP MOU PROGRAM. MCBP ANTICIPATES HOSTING FOUR PROFESSIONAL DEVELOPMENT WORKSHOPS AND 12 COMMUNITY VOLUNTEER AND PUBLIC EDUCATION EVENTS. THEY ALSO ANTICIPATE APPLICATIONS FOR DESIGN/IMPLEMENTATION FUNDING FOR PRIORITIZED PROJECTS AND PROFESSIONAL DEVELOPMENT OF MCBP STAFF AS A DELIVERABLE. OUTCOMES FROM THIS AWARD INCLUDE IMPROVED ENVIRONMENTAL LITERACY AND GROWTH IN ENVIRONMENTAL STEWARDSHIP IN THE WATERSHED, INCREASED COMMUNITY STEWARDSHIP AND BEHAVIOR CHANGE AROUND ENVIRONMENTAL ISSUES, AND THE PRESERVATION/ENHANCEMENT OF WATER QUALITY, CRITICAL HABITAT AND COASTAL RESILIENCE RESOURCES. INTENDED BENEFICIARIES OF THIS AWARD INCLUDE THE CITIZENS OF THE LOCAL WATERSHED, VISITORS TO THE EASTERN SHORE AND COASTAL BAYS, INDUSTRIES AND BUSINESSES THAT RELY ON THE COASTAL BAYS, STUDENTS AND FACULTY OF THE LOCAL SCHOOL SYSTEM AND OF UMES, AND THE LOCAL ECOSYSTEM AS A WHOLE.

THIS AWARD WILL PROVIDE FUNDING FOR IMPLEMENTATION OF THE EPAAPPROVED MARYLAND COASTAL BAYS COMPREHENSIVE CONSERVATION AND MANAGEMENT PLAN (CCMP) UND

THIS AWARD WILL PROVIDE FUNDING FOR IMPLEMENTATION OF THE EPA-APPROVED MARYLAND COASTAL BAYS COMPREHENSIVE CONSERVATION AND MANAGEMENT PLAN UNDER SEC

SPECIAL PROJECTS OF NATIONAL SIGNIFICANCE

IMPLEMENTATION OF INTERPROFESSIONAL TRAINING TO IMPROVE UPTAKE OF NONINVASIVE VENTILATION IN PATIENTS HOSPITALIZED WITH SEVERE COPD EXACERBATION

THE BRIDGE-EL PUENTE PROGRAM

BAYSTATE BEHAVIORAL HEALTH CENTER FOR YOUNG CHILDREN AND FAMILIES (CYCAF) - THE BAYSTATE BEHAVIORAL HEALTH CENTER FOR YOUNG CHILDREN AND FAMILIES (CYCAF) AT BAYSTATE HEALTH HAS THE OVERARCHING GOAL OF ADDRESSING CRITICAL GAPS IN SERVICES FOR INFANTS AND YOUNG CHILDREN AGES 0-5, PRIORITIZING LATINO CHILDREN, WHO SHOW EARLY SIGNS OF OR WHO HAVE BEEN DIAGNOSED WITH MENTAL ILLNESS INCLUDING SERIOUS EMOTIONAL DISTURBANCE (SED) AND/OR SYMPTOMS THAT MAY BE INDICATIVE OF DEVELOPING SED, INCLUDING CHILDREN WITH A HISTORY OF IN-UTERO EXPOSURE TO SUBSTANCES AND THEIR CAREGIVERS. CYCAF WILL ACHIEVE THIS GOAL IN THE FOLLOWING OVERLAPPING PHASES: 1. INCREASING ACCESS TO ASSESSMENTS AND EVIDENCED BASED PRACTICES (EBP) FOR TREATMENT OF EARLY CHILDHOOD MENTAL HEALTH CONCERNS FOR CHILDREN 0-5 Y/O AND THEIR CAREGIVERS BY PROVIDING TRAUMA INFORMED MENTAL HEALTH ASSESSMENTS (350 ASSESSMENTS OVER THE COURSE OF THE PROJECT), MULTIGENERATIONAL EVIDENCED-BASED THERAPY (250 CHILDREN AND FAMILIES SERVED OVER THE COURSE OF THE PROJECT) AND ACCESS TO A PEER NAVIGATOR WITH LIVED EXPERIENCE TO HELP ENGAGEMENT, COORDINATION OF SERVICES AND PROVIDE SHORT TERM FOLLOW UP (SERVING 375 FAMILIES OVER THE COURSE OF THE PROJECT). 2. PROVIDING SPECIALIZED IECMH CONSULTATION TO EARLY CHILDHOOD EDUCATIONAL PROGRAMS INCLUDING DIRECT CARE WORKERS (50 GROUP CONSULTATIONS A YEAR USING REFLECTIVE SUPERVISION TO IMPROVE ENGAGEMENT AND DECREASE BURNOUT IN STAFF, 500 CHILDREN SERVED THOUGH ON-DEMAND CLASSROOM CONSULTATION) AND BUILDING THE CAPACITY OF INFANT AND EARLY CHILD-SERVING SERVICE SYSTEMS (CSSS) TO IDENTIFY, RESPOND EFFECTIVELY TO, AND PREVENT MENTAL ILLNESS IN CHILDREN 0-5Y/O WHO ARE AT RISK FOR OR HAVE BEEN DIAGNOSED WITH MENTAL ILLNESS AND THEIR CAREGIVERS BY PROVIDING TRAINING IN THE DIAGNOSTIC CLASSIFICATION OF MENTAL HEALTH AND DEVELOPMENTAL DISORDERS OF INFANCY AND EARLY CHILDHOOD (DC-0-5), COLLABORATIVE PROBLEM SOLVING, AND SPECIAL TOPICS RELATED TO THE TARGET POPULATION (890 CSSS PROFESSIONALS TRAINED OVER THE COURSE OF THE PROJECT). 3. STRENGTHENING IECMH COMPETENCE IN THE MENTAL HEALTH WORKFORCE AT ALL STAGES OF CAREER IN ORDER TO PROMOTE SUSTAINABILITY BY PROVIDING TRAINING IN THE FOLLOWING EBPS: PARENT-CHILD PSYCHOTHERAPY, COLLABORATIVE PROBLEM SOLVING, MOTHERING FROM THE INSIDE OUT, AS WELL AS DC 0-5 FOR CLINICAL PROFESSIONALS (122 MENTAL HEALTH PROVIDERS TRAINED IN THE COURSE OF THE GRANT) AND INCORPORATING IECHM DIDACTICS IN MENTAL HEALTH HIGHER EDUCATIONAL LEVELS (PSYCHIATRY RESIDENTS AND FELLOWS, PSYCHOLOGY AND SOCIAL WORK STUDENTS) AND CREATING CYCAF ROTATIONS FOR TWO CHILD PSYCHIATRY FELLOWS AND TWO PSYCHOLOGY DOCTORAL STUDENTS A YEAR IN ORDER TO PROMOTE INTEREST AND INCREASE COMPETENCY EARLY IN THEIR CAREERS. THUS, CYCAF WILL ADDRESS CRITICAL GAPS IN SERVICES FOR INFANTS AND YOUNG CHILDREN WITH BEHAVIORAL HEALTH NEEDS WITH THE ULTIMATE GOAL TO ACHIEVE BETTER LONG-TERM OUTCOMES FOR CHILDREN AND CAREGIVERS BY IDENTIFYING, AND INTERVENING WITH, CHILDREN AT AN EARLY AGE IN ORDER TO PREVENT THE DEVELOPMENT OF SED.

CDFI RAPID RESPONSE PROGRAM AWARD

A TYPE I HYBRID EFFECTIVENESS-IMPLEMENTATION TRIAL OF "MOTHERING FROM THE INSIDE OUT" (MIO) - PROJECT SUMMARY/ABSTRACT MOTHERS WITH SUBSTANCE USE DISORDERS (SUDS) FACE UNIQUE CHALLENGES WITH RESPECT TO THE INTERSECTION OF PARENTING AND RECOVERY. FOR THIS REASON, THEY RARELY BENEFIT FROM EVIDENCE-BASED PARENTING INTERVENTIONS THAT HAVE BEEN BROUGHT TO SCALE WITH THE GENERAL PUBLIC OR CHILD BEHAVIORAL PROBLEMS IN MIND. A DIFFERENT APPROACH IS NEEDED. MOTHERING FROM THE INSIDE OUT (MIO) IS THE FIRST ATTACHMENT-BASED PARENTING INTERVENTION FOR MOTHERS WITH SUDS THAT TARGETS PARENTAL REFLECTIVE FUNCTIONING (RF). PARENTAL RF IS THE CAPACITY TO (A) IDENTIFY AND REGULATE EMOTIONS THAT ARE ACTIVATED DURING STRESSFUL PARENTING SITUATIONS AND (B) ACCURATELY RECOGNIZE AND UNDERSTAND YOUNG CHILDREN’S NEED FOR STABILITY, SECURITY, AND SENSITIVITY IN THE MOTHER-CHILD RELATIONSHIP. MIO HAS BEEN SHOWN TO HAVE BIGENERATIONAL BENEFIT BY IMPROVING PARENTAL RF, MATERNAL CAREGIVING, AND CHILDREN’S ATTACHMENT SECURITY WHILE ALSO REDUCING MATERNAL PSYCHIATRIC DISTRESS AND RELAPSE TO SUBSTANCE USE WHEN DELIVERED BY RESEARCHERS IN RANDOMIZED CLINICAL TRIALS WITH MOTHERS ENROLLED IN OUTPATIENT SUBSTANCE USE TREATMENT. HOWEVER, IN THE THIRD COMMUNITY-BASED EFFICACY TRIAL WHEN DELIVERED BY SUD TREATMENT COUNSELORS, MIO WAS NOT ASSOCIATED WITH THE SAME MAGNITUDE OF IMPROVEMENT IN RF OR CAREGIVING BEHAVIORS, RAISING IMPORTANT QUESTIONS ABOUT THE SCIENCE-TO-SERVICE GAP. THERE REMAINS A CRITICAL NEED TO UNDERSTAND THE IMPLEMENTATION FACTORS THAT MAY BE RELATED TO ENHANCED TREATMENT OUTCOMES FOR MIO WHEN DELIVERED UNDER ‘REAL-WORLD’ CONDITIONS. THEREFORE, WE PROPOSE TO TEST MIO’S EFFECTIVENESS WHEN DELIVERED IN FOUR SUBSTANCE USE TREATMENT PROGRAMS WHERE RESPONSIBILITY FOR MIO TRAINING AND DELIVERY WILL BE ASSUMED BY COMMUNITY-BASED TREATMENT PROVIDERS. WE ALSO PROPOSE TO CONDUCT AN IMPLEMENTATION EVALUATION TO EXAMINE KEY IMPLEMENTATION CONSTRUCTS WHEN INTEGRATED IN FOUR OUTPATIENT SUD TREATMENT CLINICS. IN THIS TYPE I HYBRID EFFECTIVENESS- IMPLEMENTATION STUDY, WE WILL (A) CONDUCT A RANDOMIZED EFFECTIVENESS TRIAL WHERE 200 MOTHERS WILL BE RANDOMIZED TO RECEIVE MIO PLUS STANDARD OUTPATIENT SUD SERVICES VERSUS STANDARD OUTPATIENT SUD SERVICES ALONE; (B) REPLICATE TESTING OF THE MIO MECHANISM OF CHANGE WITH A LARGER COHORT OF COUNSELORS AND CLIENTS; AND (C) ASSESS THE IMPACT OF KEY IMPLEMENTATION CONSTRUCTS ON REAL-WORLD DELIVERY OF MIO. DATA COLLECTED IN THE EFFECTIVENESS TRIAL AND THE IMPLEMENTATION EVALUATION WILL ALLOW US TO TEST CAUSAL EFFECTS AND MECHANISMS OF CHANGE WITHIN MIO UNDER NATURAL CONDITIONS WHILE ALSO GAINING GREATER UNDERSTANDING OF THE IMPLEMENTATION PROCESS TO GUIDE FUTURE LARGE-SCALE IMPLEMENTATION AND DISSEMINATION PROJECTS. MIO HAS DEMONSTRATED THE POTENTIAL TO INTERRUPT A PERNICIOUS CYCLE INVOLVING THE DISRUPTION OF EARLY ATTACHMENT RELATIONSHIPS THAT REPRESENTS RISK FOR THE HEALTH OF BOTH MOTHER AND CHILD. THIS TYPE I HYBRID EFFECTIVENESS-IMPLEMENTATION STUDY WILL ACCELERATE OUR PROGRESS IN BRINGING MIO TO SCALE WHILE ENSURING CONTINUED METHODOLOGICAL RIGOR AIMED AT OPTIMIZING TREATMENT OUTCOMES UNDER REAL-WORLD CONDITIONS.

THE PURPOSE OF THIS AWARD IS TO SUPPORT THE IMPLEMENTATION OF THE MARYLAND COASTAL BAY PROGRAM'S COMPREHENSIVE CONSERVATION AND MANAGEMENT PLAN (CCMP) UNDER SECTION 320 OF THE CLEAN WATER ACT (CWA), WHICH WILL HELP TO RESTORE AND MAINTAIN THE WATER QUALITY AND ECOLOGICAL INTEGRITY OF THE MARYLAND COASTAL BAYS SYSTEM. ACTIVITIES UNDER THIS PROJECT INCLUDE HABITAT RESTORATION, WATERSHED MONITORING, AND EDUCATION/OUTREACH EFFORTS. THE OUTPUTS AND OUTCOMES OF THE ACTIVITIES UNDER THIS PROJECT INCLUDE IMPROVED WATER QUALITY, IMPROVED COASTAL HABITAT CONDITIONS, AND INCREASED COMMUNITY AWARENESS AND KNOWLEDGE ON ENVIRONMENTAL MATTERS. THE BENEFICIARIES OF THIS PROJECT INCLUDE THE RESIDENTS AND VISITORS OF THE MARYLAND COASTAL BAYS REGION.

THE PURPOSE OF THIS AWARD IS TO SUPPORT THE IMPLEMENTATION OF THE DELAWARE CENTER FOR THE INLAND BAYS NATIONAL ESTUARY PROGRAM'S COMPREHENSIVE CONSERVATION AND MANAGEMENT PLAN (CCMP) UNDER SECTION 320 OF THE CLEAN WATER ACT (CWA), WHICH WILL HELP TO RESTORE AND MAINTAIN THE WATER QUALITY AND ECOLOGICAL INTEGRITY OF THE DELAWARE INLAND BAYS SYSTEM. ACTIVITIES UNDER THIS PROJECT INCLUDE HABITAT RESTORATION, WATERSHED MONITORING, AND EDUCATION/OUTREACH EFFORTS. THE OUTPUTS AND OUTCOMES OF THE ACTIVITIES UNDER THIS PROJECT INCLUDE IMPROVED WATER QUALITY, IMPROVED COASTAL HABITAT CONDITIONS, AND INCREASED COMMUNITY AWARENESS AND KNOWLEDGE ON ENVIRONMENTAL MATTERS. THE BENEFICIARIES OF THIS PROJECT INCLUDE THE RESIDENTS AND VISITORS OF THE DELAWARE INLAND BAYS REGION.

THIS AWARD WILL PROVIDE FUNDING FOR IMPLEMENTATION OF THE DELAWARE INLAND BAYS EPA APPROVED COMPREHENSIVE CONSERVATION AND MANAGEMENT PLAN (CCMP) UND

BRIDGE II OFFENDER REENTRY PROGRAM

PRIMARY CARE TRAINING AND ENHANCEMENT - RESIDENCY TRAINING IN MENTAL AND BEHAVIORAL HEALTH

THIS AWARD WILL PROVIDE FUNDING FOR IMPLEMENTATION OF THE EPA-APPROVED MARYLAND COASTAL BAYS COMPREHENSIVE CONSERVATION AND MANAGEMENT PLAN (CCMP) UN

DRUG INJECTION SURVEILLANCE AND CARE ENHANCEMENT FOR RURAL NORTHERN NEW ENGLAND (DISCERNNE)

THIS AWARD PROVIDES FUNDING FOR IMPLEMENTATION OF THE EPA-APPROVED MARYLAND COASTAL BAYS COMPREHENSIVE CONSERVATION AND MANAGEMENT PLAN (CCMP) UNDER SECTION 320 OF THE CLEAN WATER ACT (CWA), WHICH WILL HELP RESTORE AND MAINTAIN THE WATER QUALITY AND ECOLOGICAL INTEGRITY OF THE MARYLAND COASTAL BAYS.

THIS AWARD PROVIDES FUNDING FOR IMPLEMENTATION OF THE EPA APPROVED CENTER FOR THE INLAND BAYS COMPREHENSIVE CONSERVATION AND MANAGEMENT PLAN (CCMP) UNDER SECTION 320 OF THE CLEAN WATER ACT (CWA), WHICH WILL HELP RESTORE AND MAINTAIN WATER QUALITY AND ECOLOGICAL INTEGRITY OF THE DELAWARE INLAND BAYS.

THIS AWARD PROVIDES FUNDING FOR IMPLEMENTATION OF THE EPA APPROVED MARYLAND COASTAL BAYS COMPREHENSIVE CONSERVATION AND MANAGEMENT PLAN (CCMP) UNDER SECTION 320 OF THE CLEAN WATER ACT (CWA), WHICH WILL HELP RESTORE AND MAINTAIN THE WATER QUALITY AND ECOLOGICIAL INTEGRITY OF THE MARYLAND COASTAL BAYS.

BAYSTATE ED COMPLEX ADDICTION AND PAIN SERVICE TEAM (BAYSTATE CAPS) - WITH A SAMHSA ED-ALT AWARD, BAYSTATE MEDICAL CENTER (BMC) IN SPRINGFIELD, MASSACHUSETTS WILL CREATE AND LAUNCH AN EMERGENCY DEPARTMENT BASED COMPLEX ADDICTION AND PAIN SERVICE (CAPS) TEAM. THE CAPS TEAM WILL BE A MULTIDISCIPLINARY TEAM OF MEDICAL PROFESSIONALS WITH THE GOAL OF IMPROVING CARE IN PAIN MANAGEMENT AND OUD IN THE BMC ED AND ADDRESSING CONTINUITY OF CARE AND FOLLOW UP DISPARITIES THAT IMPACT RESIDENTS OF HAMPDEN COUNTY, WHICH HAS SECOND HIGHEST OPIOID DISPENSING RATE AND THE HIGHEST RATE OF DRUG OVERDOSE DEATHS IN MASSACHUSETTS. IN THE THREE YEARS OF THE ED-ALT GRANT PROJECT, THE CAPS TEAM WILL SERVE MORE THAN 3,000 RESIDENTS, WITH A FOCUS ON THE HISPANIC COMMUNITY WHO HAS SUFFERED THE GREATEST IMPACT OF THE OPIOID EPIDEMIC AND THE HIGHEST RATES OF DRUG OVERDOSE DEATHS. THE CAPS TEAM WILL CONSIST OF A FULL-TIME NURSE PRACTITIONER WITH EXPERIENCE IN PAIN MANAGEMENT AND ADDICTION, A FULL TIME BILINGUAL (SPANISH/ENGLISH) SUBSTANCE USE DISORDER RECOVERY COACH, AND A PART TIME PHYSICIAN SUPERVISOR WITH EXPERIENCE IN BOTH EMERGENCY AND ADDICTION MEDICINE. SUPPORTING THE TEAM WILL BE A PART TIME PAIN MANAGEMENT PHYSICIAN, AN EMERGENCY DEPARTMENT CLINICAL PHARMACIST, HOSPITAL-BASED IT CONSULTANT, AND BIOSTATISTICIAN. THE PRIMARY ROLE OF THE CAPS TEAM WILL BE TO PROVIDE DIRECT CARE TO ED PATIENTS WITH COMPLEX PAINFUL CONDITIONS, THOSE ON CHRONIC OPIOID MEDICATIONS FOR PAIN, AND FOR PATIENTS WITH OUD. THE CAPS TEAM WILL ALSO EDUCATE ED STAFF ON PAIN MANAGEMENT OPIOID ALTERNATIVES, TREATMENT OF OUD AND CULTURALLY COMPETENT HARM REDUCTION STRATEGIES, AS WELL AS WORK WITH IT CONSULTANTS TO CREATE ELECTRONIC HEALTH RECORD (EHR) STRUCTURE AND PROGRAMS TO PROMOTE EVIDENCE BASED, CONSISTENT CARE.

THIS AWARD WILL PROVIDE FUNDING FOR IMPLEMENTATION OF THE DELAWARE INLAND BAYS EPA-APPROVED COMPREHENSIVE CONSERVATION AND MANAGEMENT PLAN (CCMP) UNDER SECTION 320 OF THE CWA, WHICH WILL HELP RESTORE AND MAINTAIN THE WATER QUALITY AND ECOLOGICAL INTEGRITY OF THE DELAWARE INLAND BAYS.

THIS AWARD PROVIDES FUNDING FOR IMPLEMENTATION OF THE EPA-APPROVED MARYLAND COASTAL BAYS COMPREHENSIVE CONSERVATION AND MANAGEMENT PLAN (CCMP) UNDER

THIS AWARD WILL PROVIDE FUNDING FOR IMPLEMENTATION OF THE DELAWARE INLAND BAYS EPA-APPROVED COMPREHENSIVE CONSERVATION AND MANAGEMENT PLAN (CCMP) UND

PROJECT MOTION

SOMERSET COUNTY SPF-PFS - THE SOMERSET COUNTY SPF-PFS PURPOSE IS TO BUILD THE PREVENTION CAPACITY AND TO STRENGTHEN THE CAPACITY OF LOCAL COMMUNITY PREVENTION PROVIDERS. THE GOALS ARE TO: (1) REDUCE THE ONSET AND PROGRESSION OF SUBSTANCE MISUSE AND ITS RELATED PROBLEMS BY SUPPORTING THE DEVELOPMENT AND DELIVERY OF COMMUNITY-BASED SUBSTANCE MISUSE PREVENTION AND MENTAL HEALTH PROMOTION SERVICES AND (2) EXPAND AND STRENGTHEN THE CAPACITY OF LOCAL PREVENTION PROVIDERS TO IMPLEMENT EVIDENCE-BASED PROGRAMS. THE COMMUNITY-LEVEL PREVENTION CAPACITY WILL IDENTIFY AND ADDRESS LOCAL SUBSTANCE USE PREVENTION CONCERNS SUCH AS MARIJUANA AND OPIOIDS.

QUALITY OF CARE AND OUTCOMES OF HEALTHCARE-ASSOCIATED PNEUMONIA

THIS AWARD WILL PROVIDE FUNDING FOR IMPLEMENTATION OF THE DELAWARE INLAND BAYS EPA-APPROVED COMPREHENSIVE CONSERVATION AND MANAGEMENT PLAN (CCMP) UND

THIS AWARD WILL PROVIDE FUNDING FOR IMPLEMENTATION OF THE DELAWARE INLAND BAYS EPA APPROVED COMPREHENSIVE CONSERVATION AND MANAGEMENT PLAN (CCMP) UN

THIS AWARD WILL PROVIDE FUNDING FOR IMPLEMENTATION OF THE EPA-APPROVED MARYLAND COASTAL BAYS COMPREHENSIVE CONSERVATION MANAGEMENT PLAN (CCMP) UNDER

PROGRAMMING SUPPORTS A COMPREHENSIVE NETWORK OF COOPERATIVE STUDY UNITS TO FACILITATE COOPERATIVE RESEARCH, TECHNICAL ASSISTANCE, EDUCATION, AND TRAINING TO INFORM SCIENCE-BASED MANAGEMENT OF THE NATIONAL PARK SYSTEM. THE STUDY UNITS FACILITATE MULTI-DISCIPLINARY SCIENCE AND INTEGRATED INFORMATION PRODUCTS ACROSS MULTIPLE GEOGRAPHIC REGIONS OF THE NATIONAL PARK SYSTEM. THIS PROJECT FUNDS THE MARYLAND COASTAL BAYS FOUNDATION TO IMPLEMENT A SALTMARSH RESTORATION EFFORT AT ASSATEAGUE ISLAND. THIS EFFORT WILL RESTORE DEGRADED WETLAND HABITATS AND RAISE PUBLIC AWARENESS ABOUT HOW HEALTHY COASTAL ECOSYSTEMS CAN MITIGATE IMPACTS RELATED TO CLIMATE CHANGE AND SEA LEVEL RISE. BENEFICIARIES INCLUDE STATE AND LOCAL GOVERNMENTS, REGIONAL COASTAL LAND MANAGERS, PUBLIC PRIVATE NONPROFIT ORGANIZATIONS, NONPROFIT INSTITUTIONS OF HIGHER EDUCATION, AND THE GENERAL PUBLIC.

SUBSTANCE ABUSE AND HIV INTEGRATED PREVENTION SERVICES - PREVENTION NAVIGATORS (SHIPS-PREVENTION NAVIGATORS)

RURAL COMMUNITIES OPIOID RESPONSE-IMPLEMENTATION

SOUTH CAROLINA CYBER GRIND

CANCER CENTER EQUIPMENT AND TECHNOLOGY FOR THE LOGAN REGIONAL HOSPITAL

TAS::89 0222::TAS PIONEER VALLEY LIFE SCIENCES INSTITUTE PROGRAM IN ENDOCRINOLOGY AND METABOLISM; PI: LAWRENCE SCHWARTZ

IDEAS FOR A HEALTHY BABY: REDUCING DISPARITIES IN CONSUMER USE OF QUALITY DATA

DESCRIPTION:THIS AGREEMENT PROVIDES FUNDING UNDER THE INFRASTRUCTURE INVESTMENT AND JOBS ACT (IIJA) (PL 117-58) TO DELAWARE CENTER FOR INLAND BAYS. THE RECIPIENT WILL SUPPORT IMPLEMENTATION OF THE COMPREHENSIVE CONSERVATION AND MANAGEMENT PLAN (CCMP) AND STRATEGIC PLAN TO IMPROVE WATER QUALITY, PROTECT THE NATURAL HABITAT AND LIVING RESOURCES, AND SUPPORT SUSTAINABLE HUMAN USES. THE PROJECTS PROPOSED FOR FUNDING VIA THE BIPARTISAN INFRASTRUCTURE LAW (BIL) WILL LEVERAGE EXISTING EFFORTS. SPECIFICALLY, THE RECIPIENT WILL IMPLEMENT PROJECTS WITH ACTIVITIES THAT INCLUDE THE CAPACITY BUILDING, EXPANSION OF THE OUTREACH AND EDUCATION PROGRAM, JAMES FARM SHORELINE MANAGEMENT PLAN, RESILIENCE PLANNING, TERRAPIN SIGNAGE, LOW IMPACT DEVELOPMENT PILOT PROJECT FOR OYSTER REEFS, AND MORE. ACTIVITIES:THE ACTIVITIES INCLUDE PROJECTS THAT ADDRESS THE KEY CHALLENGES FACING THE ESTUARY INCLUDING ASSESSING TRENDS IN WATER QUALITY, HABITATS, NATURAL RESOURCES AND USES; COORDINATING IMPLEMENTATION OF THE CCMP BY THE NEP, ALONG WITH THE STATE, FEDERAL, LOCAL AGENCIES, STAKEHOLDERS, NGOS, CITIZENS, PARTNERS, AND OTHERS; AND MONITORING THE EFFECTIVENESS OF ACTIVITIES CONDUCTED UNDER THE MANAGEMENT CONFERENCE APPROVED CCMP AND ANNUAL WORKPLAN. EXPANSION OF THE JAMES FARM SHORELINE MANAGEMENT PLAN, EXPANDING THE OUTREACH AND EDUCATION PLAN, BUILDING CAPACITY WILL ALL SUPPORT ENGAGEMENT OF STAKEHOLDERS AND INCREASE EDUCATION OF MANY INDIVIDUALS THROUGHOUT THE WATERSHED. RESILIENCE PLANNING, TERRAPIN SIGNAGE, AND A LOW IMPACT DEVELOPMENT STUDY WILL ALL INCREASE POSITIVE IMPACTS TO NATURAL RESOURCES, HABITATS AND USES. SUBRECIPIENT:SUB-AWARD FUNDS WILL BE USED TO SUPPORT A COST-SHARE PROGRAM FOR IMPLEMENTATION OF AGRICULTURAL BEST MANAGEMENT PRACTICES. SPECIFICALLY, THE RECIPIENT WILL PRODUCE ONE COMMERCIAL IN PARTNERSHIP WITH THE SUSSEX CONSERVATION DISTRICT PROMOTING CIB AND BEST MANAGEMENT PRACTICES AND WILL PRODUCE A MAILER TO SEND TO PRODUCERS HIGHLIGHTING THE USE OF BIL COST-SHARE FUNDS. OUTCOMES:THE ANTICIPATED DELIVERABLES INCLUDE PURCHASE OF A NEW PONTOON BOAT TO SUPPORT EDUCATIONAL TOURS OF THE BAYS ALONG WITH ACCESS TO PROJECTS, TRANSFER OF OLD OUTBOARD MOTOR TO CENTER SKIFF, ACQUISITION OF NEW TRUCK TO SUPPORT 'DON'T CHUCK YOUR SHUCKS' OYSTER SHELL RECYCLING PROGRAM, OUTREACH TO STUDENTS, HANDS ON PROGRAMS, 2 DAY EDUCATIONAL JOURNEY SUMMER PROGRAM, ASSESSMENT OF ENTIRE SHORELINE AND COASTAL ZONE OF JAMES FARM ECOLOGICAL PRESERVE, ESTABLISHMENT OF INTERTIDAL OYSTER REEF AT OLD BASIN COVE, OUTFITTED EDUCATION BUILDING TO SUPPORT ONGOING AND ENHANCED EDUCATION PROGRAMS, PRIORITY LIST OF RESTORATION AREAS, TECHNICAL REPORT WITH METHODOLOGIES AND RESULTS, DEVELOPMENT AND INSTALLATION OF 4 UPDATED TERRAPIN ROAD CROSSING SIGNS. THE EXPECTED OUTCOMES INCLUDE SUCCESSFUL ADMINISTRATION OF BIL FUNDS FOR CCMP PROJECTS, INCREASED UNDERSTANDING OF AGRICULTURE'S ROLE IN WATER QUALITY, REDUCED NUTRIENT AND SEDIMENT LOSS FROM FARMLAND, INCREASED IMPLEMENTATION OF BEST MANAGEMENT PRACTICES ON AGRICULTURAL LANDS, IMPROVED ACCESS TO WATER QUALITY MONITORING NETWORK, BETTER WORKING PLATFORM FOR TRANSFER OF OYSTER SHELLS, AND LIVE OYSTERS FOR OYSTER REEF AND LIVING SHORELINE PROJECTS, INCREASED CAPACITY TO COLLECT AND RECYCLE OYSTER SHELL, INCREASED CAPACITY TO CONDUCT ENVIRONMENTAL MONITORING, INCREASE PROGRAM PARTICIPANT'S ENVIRONMENTAL LITERACY BY PROVIDING INDIVIDUALS WITH SCIENTIFIC KNOWLEDGE OF NATURAL SYSTEMS AND INLAND BAYS ECOLOGY, AND WITH THE SKILLS AND MOTIVATION TO MAKE RESPONSIBLE DECISIONS TO PROTECT THE ENVIRONMENT, PROTECTION OF CRITICAL ECOLOGICAL COMMUNITIES WITH TIDAL MARSH; MARITIME FOREST; DUNE; BEACH; AND SUBAQUEOUS HABITATS IN THE ECOLOGICAL PRESERVE FOR PUBLIC USE, QUANTIFIABLE INCREASE IN WILD OYSTER POPULATIONS IN THE INLAND BAYS, ENHANCED ENVIRONMENTAL EDUCATION OPPORTUNITIES TO YOUTH AND ADULTS TO HELP IMPROVE ACADEMIC ACHIEVEMENT, ENCOURAGE ENVIRONMENTAL STEWARDSHIP, AND STRENGTHEN COMMUNITIES. THE INTEND

DESCRIPTION:THIS AWARD PROVIDES FUNDING THROUGH THE BIPARTISAN INFRASTRUCTURE LAW (BIL) (ALSO KNOWN AS THE INFRASTRUCTURE INVESTMENT AND JOBS ACT (IIJA)) FOR IMPLEMENTATION OF THE EPA APPROVED DELAWARE INLAND BAYS COMPREHENSIVE CONSERVATION AND MANAGEMENT PLAN (CCMP) UNDER SECTION 320 OF THE CLEAN WATER ACT (CWA), WHICH WILL HELP RESTORE AND MAINTAIN THE WATER QUALITY AND ECOLOGICAL INTEGRITY OF THE DELAWARE INLAND BAYS. THIS PROJECT OVERSEES THE IMPLEMENTATION OF PROJECTS OUTLINED UNDER DELAWARE INLAND BAY'S (CIB) WORKPLAN, THROUGH WHICH THE FEDERAL FUNDS AND OUTLINED ACTIVITIES IMPLEMENT THE NATIONAL ESTUARY PROGRAM'S (NEP) COMPREHENSIVE CONSERVATION AND MANAGEMENT PLAN (CCMP). THE PURPOSE OF THIS AWARD IS TO SUPPORT THE IMPLEMENTATION OF THE DELAWARE INLAND BAYS CCMP.ACTIVITIES:ACTIVITIES TO PERFORMED INCLUDE: AGRICULTURAL BMP COST-SHARE, CAPACITY BUILDING, COMPLETION OF DELAWARE INLAND BAYS HABITAT PLAN, CONTINUED DEVELOPMENT OF THE HYDRODYNAMIC AND WATER QUALITY MODEL, CREATION OF SUBMERGED GRAVEL WETLAND, AND CONSTRUCTION OF LIVING SHORELINES.SUBRECIPIENT:NO SUBAWARDS ARE INCLUDED IN THIS ASSISTANCE AGREEMENT.OUTCOMES:THIS AWARD FOCUSES ON SPECIFIC PRIORITY GOALS, INCLUDING: DECREASING NUTRIENT LOADING THROUGHOUT THE WATERSHED; PRESERVING AND PROTECTING MARSHES, SHORELINES AND NEAR-SHORE HABITATS; FACILITATING AND MONITORING CONSERVATION AND RESTORATION PROJECTS; AND, EDUCATING THE PUBLIC TO SUPPORT KNOWLEDGEABLE DECISION-MAKING FOR THE COMMUNITY AND ITS FUTURE. SPECIFIC ACTIVITIES TO BE PERFORMED UNDER THIS AWARD INCLUDE ACTIVITIES LIKE: COASTAL HABITAT RESTORATION, WATER QUALITY MONITORING, PUBLIC EDUCATION AND OUTREACH, CLIMATE CHANGE RESILIENCY EFFORTS, LIVING SHORELINE IMPROVEMENTS, STORMWATER INFRASTRUCTURE IMPROVEMENTS, SUPPORTING DISADVANTAGED COMMUNITIES, AND MAINTAINING CAPACITY TO IMPLEMENT CCMP GOALS. THE BENEFICIARIES OF THIS AWARD INCLUDE RESIDENTS, VISITORS, HABITATS AND WILDLIFE WITHIN THE DELAWARE INLAND BAYS STUDY AREA.

DESCRIPTION:THIS AWARD PROVIDES FUNDING THROUGH THE BIPARTISAN INFRASTRUCTURE LAW (BIL) (ALSO KNOWN AS THE INFRASTRUCTURE INVESTMENT AND JOBS ACT (IIJA)) FOR IMPLEMENTATION OF THE EPA APPROVED MARYLAND COASTAL BAYS COMPREHENSIVE CONSERVATION AND MANAGEMENT PLAN (CCMP) UNDER SECTION 320 OF THE CLEAN WATER ACT (CWA), WHICH WILL HELP RESTORE AND MAINTAIN THE WATER QUALITY AND ECOLOGICAL INTEGRITY OF THE MARYLAND COASTAL BAYS. THIS PROJECT OVERSEES THE IMPLEMENTATION OF PROJECTS OUTLINED UNDER MARYLAND COASTAL BAY'S (MCBP) WORKPLAN, THROUGH WHICH THE FEDERAL FUNDS AND OUTLINED ACTIVITIES IMPLEMENT THE NATIONAL ESTUARY PROGRAM'S (NEP) COMPREHENSIVE CONSERVATION AND MANAGEMENT PLAN (CCMP). THE PURPOSE OF THIS AWARD IS TO SUPPORT THE IMPLEMENTATION OF THE MCBP CCMP.ACTIVITIES:UNDER THIS AWARD, MCBP INTENDS TO IMPLEMENT ACTIONS RELATED TO 52 ACTIVITIES THAT SUPPORT THE IMPLEMENTATION OF VARIOUS GOALS WITHIN THEIR CCMP. THESE ACTIVITIES ARE DRIVEN BY SPECIFIC PRIORITY GOALS, INCLUDING: DECREASING NUTRIENT LOADING THROUGHOUT THE WATERSHED; PRESERVING AND PROTECTING MARSHES, SHORELINES AND NEAR-SHORE HABITATS; FACILITATING AND MONITORING CONSERVATION AND RESTORATION PROJECTS; AND, EDUCATING THE PUBLIC TO SUPPORT KNOWLEDGEABLE DECISION-MAKING FOR THE COMMUNITY AND ITS FUTURE. SPECIFIC ACTIVITIES TO BE PERFORMED UNDER THIS AWARD INCLUDE: COASTAL HABITAT RESTORATION, WATER QUALITY MONITORING, PUBLIC EDUCATION AND OUTREACH, CLIMATE CHANGE RESILIENCY EFFORTS, LIVING SHORELINE IMPROVEMENTS, STORMWATER INFRASTRUCTURE IMPROVEMENTS, SUPPORTING DISADVANTAGED COMMUNITIES AND HISTORICALLY BLACK COLLEGES AND UNIVERSITIES, AND MAINTAINING CAPACITY TO IMPLEMENT CCMP GOALSSUBRECIPIENT:SUBAWARDS WILL SUPPORT LOWER SHORE LAND TRUST FOR GRASSLANDS HABITAT INITIATIVE, OCEAN PINES ASSOCIATION FOR SOUTH GATE POND SOFT SHORELINE, TOWN OF OCEAN CITY FOR NORTHSIDE PARK SHORELINE RESTORATION DESIGN AND PERMITTING, SUPPORT OF TITLE I SCHOOLS IN WORCESTER COUNTY PUBLIC SCHOOLS FOR ENVIRONMENTAL EDUCATION INITIATIVES, RESEARCH MINIGRANTS FOR STUDENTS, AND CCMP REVISION ASSISTANCE. OUTCOMES:ANTICIPATED DELIVERABLES RELATED TO THIS AWARD INCLUDE THE RESTORATION OF NONTIDAL WETLAND HABITAT FROM AGRICULTURAL LAND, THE INSTALLATION OF NATURAL SHORELINE TO ERODED AREAS, THE IMPROVEMENT OF STORMWATER INFRASTRUCTURE IN UNDERSERVED AREAS, THE DESIGN OF VARIOUS HABITAT AND COMMUNITY IMPROVEMENT PROJECTS, AND THE DEVELOPMENT OF NEW AND STANDING ENVIRONMENTAL EDUCATION AND COMMUNITY GRANT PROGRAMS. OUTCOMES FROM THIS AWARD INCLUDE IMPROVED ENVIRONMENTAL LITERACY AND GROWTH IN ENVIRONMENTAL STEWARDSHIP IN THE WATERSHED, INCREASED COMMUNITY STEWARDSHIP AND BEHAVIOR CHANGE AROUND ENVIRONMENTAL ISSUES, AND THE PRESERVATION/ENHANCEMENT OF WATER QUALITY, CRITICAL HABITAT AND COASTAL RESILIENCE RESOURCES. INTENDED BENEFICIARIES OF THIS AWARD INCLUDE THE CITIZENS OF THE LOCAL WATERSHED, VISITORS TO THE EASTERN SHORE AND COASTAL BAYS, INDUSTRIES AND BUSINESSES THAT RELY ON THE COASTAL BAYS, STUDENTS AND FACULTY OF THE LOCAL SCHOOL SYSTEM AND OF UNIVERSITY OF MARYLAND EASTERN SHORES, AND THE LOCAL ECOSYSTEM AS A WHOLE.

DESCRIPTION:THIS AGREEMENT PROVIDES FUNDING UNDER THE INFRASTRUCTURE INVESTMENT AND JOBS ACT (IIJA) (PL 117-58) TO THE COASTAL BEND BAYS AND ESTUARIES PROGRAM (CBBEP). THE RECIPIENT WILL SUPPORT IMPLEMENTATION OF THE COMPREHENSIVE CONSERVATION AND MANAGEMENT PLAN (CCMP) AND STRATEGIC PLAN TO IMPROVE WATER QUALITY, PROTECT THE NATURAL HABITAT AND LIVING RESOURCES, AND SUPPORT SUSTAINABLE HUMAN USES. THE PROJECTS PROPOSED FOR FUNDING VIA THE BIPARTISAN INFRASTRUCTURE LAW (BIL) WILL LEVERAGE EXISTING EFFORTS.ACTIVITIES:IIJA SUBRECIPIENT PROJECTS: 1. AIRPORT KAYAK LAUNCH SITE IMPROVEMENTS, ARANSAS COUNTY - THE PRIMARY OBJECTIVE OF THE PROJECT IS TO CONSTRUCT A NEW BOARDWALK AND MAKE ROADWAY IMPROVEMENTS TO FACILITATE ACCESS TO THE KAYAK LAUNCH SITE, COASTAL BIRDING AND ACCESS FISHING OPPORTUNITIES. 2. MASTER PLAN FOR NEW WETLAND PARK, CITY OF PORT ARANSAS - THE PRIMARY OBJECTIVE OF THE PROPOSED PROJECT IS TO CONTRACT FOR ENGINEERING SERVICES TO DEVELOP A MASTER PLAN FOR A 6-ACRE TRACT OF LAND IN THE CITY OF PORT ARANSAS. THE MASTER PLAN SHOULD EXPLORE ADDING PUBLIC ACCESS, ENHANCING AND CREATING HABITAT, REDUCING STORMWATER QUANTITY AND IMPROVING STORMWATER QUALITY. 3. NUECES DELTA PRESERVE INFRASTRUCTURE ENHANCEMENTS, PHASE II - THE PROJECT OBJECTIVE IS TO ENSURE ACCESSIBILITY FOR ALL INDIVIDUALS TO THE EDUCATIONAL PROGRAMS OFFERED AT CBBEP'S NUECES DELTA PRESERVE BY PROVIDING AMERICANS WITH DISABILITIES ACT (ADA)-COMPLIANT TRAILS, BOARDWALKS, PIER, AND WILDLIFE OBSERVATION PLATFORMS. 4. ARANSAS WOODS WILDLIFE VIEWING FEATURES, PHASE I - THE PRIMARY OBJECTIVE OF THE PROPOSED PROJECT IS TO INSTALL UP TO FIVE (5) STRATEGICALLY-LOCATED WILDLIFE VIEWING BLINDS THAT WILL ALLOW FOR SAFE VIEWING, PHOTOGRAPHY, AND NATURE STUDY. 5. ARANSAS FIRST PROGRAMMATIC SIGNAGE - THE PRIMARY OBJECTIVE OF THE PROPOSED PROJECT IS TO DEVELOP UNIFIED PROGRAMMATIC SIGNAGE FOR ARANSAS FIRST PROPERTIES TO IMPROVE THE VISITOR EXPERIENCE AND INTERPRETIVE STRENGTH AND INSTALL SIGNS AT THREE (3) ARANSAS FIRST SITES. 6. PROTECTION OF THE GULF INTRACOASTAL WATERWAY (GIWW) SHORELINE AT THE ARANSAS NATIONAL WILDLIFE REFUGE (ANWR), PHASE II - THE PROJECT WILL PROTECT DEGRADED SHORELINE AND IMPROVE RESILIENCY TO FUTURE SEA LEVEL RISE WITHIN THE ARANSAS NATIONAL WILDLIFE REFUGE THROUGH THE INSTALLATION OF APPROXIMATELY 2.2 MILES OF NEARSHORE ROCK BREAKWATERS. THE SPECIFIC PROJECT OBJECTIVE INCLUDES COMPLETION OF FINAL ENGINEERING AND DESIGN AND BID DOCUMENT DEVELOPMENT FOR PRIORITY AREAS ALONG THE GULF COASTAL INTRACOASTAL WATERWAY. 7. PROTECTION AND RESTORATION OF MATAGORDA ISLAND WEST MARSH, ANWR, PHASE III - THE OVERALL PROJECT GOAL IS RESTORE THE INFRASTRUCTURE NEEDED TO FACILITATE WATER MANAGEMENT BY UNITED STATES FISH AND WILDLIFE SERVICE (USFWS) ON APPROXIMATELY 6,000 ACRES OF ESTUARINE WETLANDS IN THE WEST MARSH AREA. THE PROJECT OBJECTIVE IS TO REPAIR AND REPLACE LEVEES AND WATER CONTROL STRUCTURES ON THE MATAGORDA ISLAND FINAL LOCATION AND UPGRADE CULVERTS AT TWO LOCATIONS WHERE THE BREACH WAS PREVIOUSLY REPAIRED. 8. NEWCOMB BEND MARSH RESTORATION, PHASE II - THE OVERALL PROJECT GOAL IS TO CONTINUE EFFORTS TO CONSERVE AND RESTORE THE SHORELINE, EMERGENT MARSH, AND ASSOCIATED NEARSHORE AND UPLAND HABITAT, AND WILDLIFE DEPENDENT UPON THIS HABITAT AT NEWCOMB MARSH IN COPANO BAY. THE SPECIFIC PROJECT OBJECTIVE IS TO COMPLETE THE SEDIMENT SOURCE ASSESSMENT, PRELIMINARY DESIGN, STAKEHOLDER ENGAGEMENT, AND REGULATORY PERMITTING FOR RESTORATION OF THE NEWCOMB BEND MARSH AREA. 9. FLOODING RISK ASSESSMENT FOR NESTS OF IMPERILED SHOREBIRDS IN SOUTH TEXAS - THE PRIMARY OBJECTIVE OF THE PROJECT IS TO: (1) ASSESS THE RISK OF FLOODING TO NESTING SITES FOR SNOWY PLOVER AND WILSON'S PLOVER IDENTIFIED BY CBBEP MONITORING AND (2) IDENTIFY SUITABLE NESTING AREAS OUTSIDE THE CBBEP MONITORING SITES THAT HAVE LOW RISK OF NEST FLOODING AND RECOMMEND AREAS WHERE MANAGEMENT AND CONSERVATION BENEFITS WOULD BE HIGHEST. PROJECT MANAGEMENT: THE FY 2026 IIJA AN

DESCRIPTION:THIS AGREEMENT PROVIDES FUNDING UNDER THE INFRASTRUCTURE INVESTMENT AND JOBS ACT (IIJA) (PL 117-58) TO MARYLAND COASTAL BAYS PROGRAM. THE RECIPIENT WILL SUPPORT IMPLEMENTATION OF THE COMPREHENSIVE CONSERVATION AND MANAGEMENT PLAN (CCMP) AND STRATEGIC PLAN TO IMPROVE WATER QUALITY, PROTECT THE NATURAL HABITAT AND LIVING RESOURCES, AND SUPPORT SUSTAINABLE HUMAN USES. THE PROJECTS PROPOSED FOR FUNDING VIA THE BIPARTISAN INFRASTRUCTURE LAW (BIL) WILL LEVERAGE EXISTING EFFORTS. SPECIFICALLY, THE RECIPIENT WILL IMPLEMENT PROJECTS WITH ACTIVITIES THAT INCLUDE THE RESTORATION OF WETLAND HABITAT, ADDRESSING NONPOINT SOURCE POLLUTION, DEVELOPING AND DELIVERING COMMUNITY OUTREACH AND EDUCATION ACTIVITIES, WATER QUALITY MONITORING AND HABITAT SURVEYING AND ANALYSIS, PROFESSIONAL DEVELOPMENT AND EDUCATIONAL ENRICHMENT OPPORTUNITIES, ORGANIZATIONAL CAPACITY DEVELOPMENT, COMMUNITY AND COALITION BUILDING, AND MORE.ACTIVITIES:THE WORK TO BE ACCOMPLISHED IN THIS PROJECT INCLUDES RESTORATION OF WETLAND HABITAT, ADDRESSING NONPOINT SOURCE POLLUTION, DEVELOPING AND DELIVERING COMMUNITY OUTREACH AND EDUCATION ACTIVITIES, WATER QUALITY MONITORING AND HABITAT SURVEYING AND ANALYSIS, PROFESSIONAL DEVELOPMENT AND EDUCATIONAL ENRICHMENT OPPORTUNITIES, ORGANIZATIONAL CAPACITY DEVELOPMENT, COMMUNITY AND COALITION BUILDING, AND MORE.SUBRECIPIENT:ACTIVITIES THAT SUBAWARDS WILL SUPPORT THE GOALS OF THE CCMP AND COMMUNITY DEVELOPMENT EFFORTS THAT SUPPORT THE MCBP EQUITY STRATEGY AND CLIMATE RESILIENCY GOALS. RECIPIENTS AND THEIR ACTIVITIES INCLUDE TITLE 1 WORCESTER COUNTY SCHOOLS DEVELOPED ENVIRONMENTAL LITERACY AND STEAM EDUCATION PROGRAMMING, THE CITY OF OCEAN CITY AND THE CITY OF BERLIN FOR CLIMATE RESILIENCY AND STORMWATER MANAGEMENT ACTIVITIES, AND LOCAL NONPROFITS WHO WILL APPLY THROUGH RFP FOR RESEARCH FUNDING TO FURTHER CCMP AND EQUITY STRATEGY GOALS.OUTCOMES:THE ANTICIPATED DELIVERABLES AND OUTCOMES INCLUDE: 20+ ACRES OF RESTORED WETLANDS, INSTALLATION OF NONPOINT SOURCE / NUTRIENT REDUCTION BEST MANAGEMENT PRACTICES, MONITORING, ASSESSMENT, AND ANALYSIS OF WATER QUALITY FROM 70+ SAMPLING LOCATIONS THROUGHOUT THE COASTAL BAYS, HABITAT SURVEYS, INCREASED UNDERSTANDING OF CLIMATE STRESSORS ON THE COASTAL BAYS SYSTEM, INCREASED CAPACITY OF COMMUNITY MEMBERS TO UNDERSTAND AND RESPOND TO CLIMATE STRESSORS IN THEIR COMMUNITIES, INCREASED CAPACITY AND ENGAGEMENT AROUND CLIMATE SCIENCE AND ENVIRONMENTAL EFFORTS IN UNDERSERVED COMMUNITIES WITHIN THE EASTERN SHORE, DEVELOPMENT OF STEAM LEADERSHIP SKILLS IN STUDENTS AND PROFESSIONALS WITHIN THE EASTERN SHORE, AND INCREASED CAPACITY OF THE MCBP TEAM TO IMPLEMENT THE CCMP. THE INTENDED BENEFICIARIES OF THIS WORK AND THIS AWARD INCLUDE THE COMMUNITIES WITHIN THE EASTERN SHORE REGION, SPECIFICALLY WITHIN THE COASTAL BAYS WATERSHED, AND ADDITIONALLY THE STUDENTS, FAMILIES, AND EMPLOYEES OF TITLE I SCHOOLS SERVING THE AREA. THIS WORK ALSO BENEFITS VISITORS TO THE EASTERN SHORE AND COASTAL BAYS.

DESCRIPTION:THIS AGREEMENT PROVIDES FUNDING UNDER THE INFRASTRUCTURE INVESTMENT AND JOBS ACT (IIJA) (PL 117-58) TO THE COASTAL BEND BAYS AND ESTUARIES PROGRAM (CBBEP). THE RECIPIENT WILL SUPPORT IMPLEMENTATION OF THE COMPREHENSIVE CONSERVATION AND MANAGEMENT PLAN (CCMP) AND STRATEGIC PLAN TO IMPROVE WATER QUALITY, PROTECT THE NATURAL HABITAT AND LIVING RESOURCES, AND SUPPORT SUSTAINABLE HUMAN USES. THE PROJECTS PROPOSED FOR FUNDING VIA THE BIPARTISAN INFRASTRUCTURE LAW (BIL) WILL LEVERAGE EXISTING EFFORTS. SPECIFICALLY, THE RECIPIENT WILL COMPLETE THE FOLLOWING EIGHT PROJECTS: 1.LAMAR BURTON WETLANDS ENHANCEMENT AND ARANSAS WOODS 2. LAGUNA SHORES HIKE AND BIKE TRAIL AMENITIES, PHASE I 3. SHORELINE AND WETLAND PROTECTION AT COHN PRESERVE, PHASE II 4. TEMPORAL CHANGES IN ARAGONITE SATURATION STATE IN OYSTER REEFS 5. BAFFIN BAY WASTEWATER TREATMENT PLANT - AGUA DULCE ASSESSMENT 6. PROTECTION AND RESTORATION OF BENNY'S SHACK ISLANDS, PHASE II 7. NUECES DELTA PRESERVE INFRASTRUCTURE ENHANCEMENTS 8. RAIN TO RESOURCE PROJECT - RAINWATER HARVESTING AT THE SAN ANTONIO AND ARANSAS PASS RAILROAD DEPOTACTIVITIES:THE ACTIVITIES INCLUDE: 1.LAMAR BURTON WETLANDS ENHANCEMENT AND ARANSAS WOODS-LAMAR BURTON WETLANDS CATTAIL REDUCTION--ENHANCE WETLAND PRODUCTIVITY AND WILDLIFE VIEWING OPPORTUNITIES AT TWO SITES MANAGED BY ARANSAS FIRST. 2. LAGUNA SHORES HIKE AND BIKE TRAIL AMENITIES, PHASE I--PROVIDE THE FIRST STEP IN DESIGN AND CONSTRUCTION OF A HIKE AND BIKE TRAIL THAT WILL SERVE TO IMPROVE PUBLIC ACCESS FOR WILDLIFE VIEWING AND FISHING AT A SERIES OF PONDS LOCATED ALONG LAGUNA SHORES DRIVE. 3. SHORELINE AND WETLAND PROTECTION AT COHN PRESERVE, PHASE II--SLOW DOWN EXISTING EROSION AND ENABLE A MORE EFFICIENT, COST-EFFECTIVE, COMPLEMENTARY CONSTRUCTION OPTION OF THE SHORELINE PROTECTION DESIGN IDENTIFIED IN PHASE 1. 4. TEMPORAL CHANGES IN ARAGONITE SATURATION STATE IN OYSTER REEFS--IMPROVE THE UNDERSTANDING OF ARAGONITE SATURATION STATE (OMEGA;ARAG) IN THE MISSION-ARANSAS ESTUARY (MAE) AND ITS RESPONSE TO HYDROLOGICAL VARIABILITY AND BIOGEOCHEMICAL PROCESSES (RESPIRATION) AT A SERIES OF NATURAL AND RESTORED OYSTER REEFS ON A SEASONAL BASIS, INCLUDING PERIODS AFTER SIGNIFICANT FRESHWATER INFLOW. 5. BAFFIN BAY WASTEWATER TREATMENT PLANT - AGUA DULCE ASSESSMENT--IMPROVE WATER QUALITY IN PETRONILA CREEK AND BAFFIN BAY THROUGH THE IDENTIFICATION OF IMPROVEMENTS AT THE AGUA DULCE WASTEWATER TREATMENT PLANT (WWTP) AND COMPLETION OF A FUNDING APPLICATION TO IMPLEMENT IMPROVEMENTS. 6. PROTECTION AND RESTORATION OF BENNY'S SHACK ISLANDS, PHASE II--INCREASE THE AMOUNT OF NESTING HABITAT AVAILABLE FOR COLONIAL WATERBIRDS WITHIN THE LOWER LAGUNA MADRE BY PROTECTING AND RESTORING BENNY'S SHACK ISLANDS. 7. NUECES DELTA PRESERVE INFRASTRUCTURE ENHANCEMENTS--ENSURE ACCESSIBILITY FOR ALL INDIVIDUALS TO THE EDUCATIONAL PROGRAMS OFFERED AT CBBEP'S NUECES DELTA PRESERVE BY PROVIDING ADA-COMPLIANT TRAILS, BOARDWALKS, PIER, AND WILDLIFE OBSERVATION PLATFORMS. 8. RAIN TO RESOURCE PROJECT - RAINWATER HARVESTING AT THE SAN ANTONIO AND ARANSAS PASS RAILROAD DEPOT--IMPLEMENT A RAINWATER HARVESTING PROJECT AT THE HISTORIC SAN ANTONIO AND ARANSAS PASS RAILROAD DEPOT THAT PROVIDES WATER FOR THE SITE'S LANDSCAPING, WHILE ALSO SERVING AS A POWERFUL EDUCATIONAL TOOL THAT SHOWCASES THE BENEFITS OF RAINWATER HARVESTING. SUBRECIPIENT:THE FOLLOWING SUBAWARDS ARE INCLUDED IN THIS ASSISTANCE AGREEMENT: 1. LAMAR BURTON WETLANDS ENHANCEMENT AND ARANSAS WOODS 2. LAGUNA SHORES HIKE AND BIKE TRAIL AMENITIES, PHASE I 3. SHORELINE AND WETLAND PROTECTION AT COHN PRESERVE, PHASE II 4. TEMPORAL CHANGES IN ARAGONITE SATURATION STATE IN OYSTER REEFS 5. BAFFIN BAY WASTEWATER TREATMENT PLANT - AGUA DULCE ASSESSMENT 8. RAIN TO RESOURCE PROJECT - RAINWATER HARVESTING AT THE SAN ANTONIO AND ARANSAS PASS RAILROAD DEPOTOUTCOMES:THE ANTICIPATED DELIVERABLES INCLUDE: SEMI AND ANNUAL PROGRESS REPORTS, FINAL PROJECT REPORTS AND QUALITY ASSU

DESCRIPTION:THESE FUNDS FOR COASTAL BEND BAYS AND ESTUARIES PROGRAM (CBBEP) SUPPORT IMPLEMENTATION OF THE COMPREHENSIVE CONSERVATION AND MANAGEMENT PLAN (CCMP) AND ACCOMPANYING STRATEGIC PLAN TO IMPROVE THE WATER QUALITY, PROTECT THE NATURAL HABITAT AND LIVING RESOURCES, AND SUPPORT SUSTAINABLE HUMAN USES OF THE COASTAL BEND BAYS AND ESTUARIES. THIS AGREEMENT IS SUPPORTED BY FUNDING PROVIDED UNDER THE INFRASTRUCTURE INVESTMENT AND JOBS ACT (IIJA) (PL 117-58).ACTIVITIES:ACTIVITIES IN THE WORK PLAN FOCUS ON MAINTAINING, RESTORING, AND/OR IMPROVING WATER QUALITY AND HABITAT, AND ALSO INCLUDE PUBLIC ACCESS, OUTREACH, AND EDUCATION. THE ACTIVITIES TO BE PERFORMED BY THE CBBEP INCLUDE THE FOLLOWING: 1) MONITORING SUCCESS OF DREDGE MATERIAL PLACEMENT AT THE NUECES DELTA - THE OBJECTIVES FOR THIS PROJECT ARE (1) TO CONDUCT PRE- AND POST- ELEVATION AND VEGETATION SURVEYS RELATED TO AN UPCOMING DREDGE PLACEMENT PROJECT AT THE NUECES DELTA PRESERVE AND (2) TO DEVELOP AN ADAPTIVE MANAGEMENT PLAN THAT WILL ASSIST CBBEP IN THEIR LONG-TERM MANAGEMENT EFFORTS ASSOCIATED WITH THE DREDGE PLACEMENT PROJECT. 2) HANS AND PAT SUTER WILDLIFE REFUGE ENHANCEMENTS, PHASE I - THE SPECIFIC PROJECT OBJECTIVES INCLUDE: (1) CONVERSION OF TRAILS FROM ASPHALT TO AMERICANS WITH DISABILITIES ACT (ADA)-COMPLIANT CONCRETE TRAILS; (2) PROTECTION AND RESTORATION OF ERODING SHORELINE; AND (3) ENGINEERING AND DESIGN WORK RELATED TO BOARDWALK AND VIEWING STRUCTURE REPLACEMENTS. 3) HELD-MORAN SANCTUARY ACCESSIBILITY IMPROVEMENT AND TRAIL DEVELOPMENT, PHASE II - THE PRIMARY PROJECT OBJECTIVE IS TO CONTINUE IMPROVING THE ACCESSIBILITY TO HELD-MORAN SANCTUARY BY INSTALLING AN ADA-COMPLIANT TRAIL, INTERPRETIVE SIGNAGE, AND ESTABLISHING A FIRE BREAK ON THE SOUTHWEST BOUNDARY. 4) FLOUR BLUFF WETLANDS INVASIVE SPECIES CONTROL - THE OBJECTIVE OF THIS PROJECT IS TO PERFORM HABITAT RESTORATION ACTIVITIES, SPECIFICALLY, REMOVAL OF INVASIVE PLANT SPECIES, TO IMPROVE THE DIVERSITY OF NATIVE PLANTS AND WILDLIFE POPULATIONS AT THE WETLANDS LOCATED ON THE FLOUR BLUFF INDEPENDENT SCHOOL DISTRICT (FBISD) CAMPUS. 5) ON-SITE SEWAGE FACILITIES (OSSF) ASSISTANCE PROGRAM, PHASE II - THE PROJECT OBJECTIVE IS TO ADDRESS NUTRIENT AND BACTERIA ISSUES IN TARGETED WATERSHEDS BY INSPECTING, REPAIRING, AND/OR REPLACING ELEVEN OSSFS THAT ARE FAILING OR NON-EXISTENT, FOCUSING ON UNDERSERVED COMMUNITIES WITH LIMITED RESOURCES. 6) OCEAN ACIDIFICATION MONITORING IN ARANSAS SHIP CHANNEL - THE PRIMARY OBJECTIVE OF THIS PROJECT IS TO CONDUCT HIGH FREQUENCY MONITORING OF POTENTIAL OF HYDROGEN (PH) AND PARTIAL PRESSURE OF CARBON DIOXIDE (PCO2) IN THE ARANSAS SHIP CHANNEL USING TWO IN SITU SENSORS. ADDITIONAL WATER SAMPLES WILL BE ANALYZED FOR TOTAL ALKALINITY AND DISSOLVED INORGANIC CARBON (DIC). 7) GREEN STORMWATER INFRASTRUCTURE DEMONSTRATION PROJECT AT KEACH FAMILY LIBRARY, ROBSTOWN, TEXAS (TX) - THE PRIMARY PROJECT OBJECTIVE IS TO CONSTRUCT A DEMONSTRATION-SCALE RAIN GARDEN AND BIORETENTION AREA AT THE NUECES COUNTY'S KEACH FAMILY LIBRARY IN ROBSTOWN, TX. 8) 'UP2U PLUS' DISPOSAL FEES - THE PROJECT OBJECTIVE IS TO PROVIDE DISPOSAL FEES ASSOCIATED WITH DUMPSTER EVENTS FOR THE 'UP2U PLUS' PROGRAM, A PUBLIC AWARENESS CAMPAIGN PROVIDING NUMEROUS COMMUNITY CLEAN UPS AND FREE BULK WASTE COLLECTION EVENTS THROUGHOUT THE COASTAL BEND REGION THROUGH 2024. SUBRECIPIENT:THERE ARE FIVE PROJECTS THAT WILL UTILIZE SUBRECIPIENTS: 1) HANS AND PAT SUTER WILDLIFE REFUGE ENHANCEMENTS, PHASE I - THE SPECIFIC PROJECT OBJECTIVES INCLUDE: (1) CONVERSION OF TRAILS FROM ASPHALT TO ADA-COMPLIANT CONCRETE TRAILS; (2) PROTECTION AND RESTORATION OF ERODING SHORELINE; AND (3) ENGINEERING AND DESIGN WORK RELATED TO BOARDWALK AND VIEWING STRUCTURE REPLACEMENTS. 2) OSSF ASSISTANCE PROGRAM, PHASE II - THE PROJECT OBJECTIVE IS TO ADDRESS NUTRIENT AND BACTERIA ISSUES IN TARGETED WATERSHEDS BY INSPECTING, REPAIRING, AND/OR REPLACING ELE

WITH FUNDING THROUGH THE OVC 2024 INTEGRATED SERVICES FOR MINOR VICTIMS OF HUMAN TRAFFICKING BAYSTATE MEDICAL CENTER, INC LOCATED IN SPRINGFIELD, MASSACHUSETTS PROPOSES A PROJECT TITLED ONE MISSION: A COMPREHENSIVE SERVICE PROGRAM FOR VICTIMS OF HUMAN TRAFFICKING (ONE MISSION). THE PRIMARY PURPOSE IS TO EXPAND AND STRENGTHEN TRAUMA-INFORMED VICTIM-CENTERED SERVICES THAT INCLUDES COMPREHENSIVE SCREENING, INDIVIDUALIZED CASE MANAGEMENT, AND EVIDENCE-BASED THERAPEUTIC SERVICES FOR HUMAN TRAFFICKING VICTIMS. THE PRIMARY ACTIVITIES ARE TO 1) IMPROVE AND INCREASE THE TRAUMA-INFORMED SCREENING OF HUMAN TRAFFICKING VICTIM; 2) EXPAND ACCESS TO EVIDENCE-BASED, TRAUMA-INFORMED THERAPEUTIC AND CASE MANAGEMENT SERVICES; 3) INCREASE COMMUNITY-LEVEL ENGAGEMENT THROUGH TRAUMA-INFORMED TRAININGS TO RAISE AWARENESS OF HUMAN TRAFFICKING AND IMPROVE IDENTIFICATION AND REFERRALS FOR SERVICES; AND 4) PROVIDE AND ENHANCE OUTREACH AND INTERAGENCY COLLABORATIONS TO DELIVER A COORDINATED RESPONSE TO MEET TRAFFICKING VICTIMS NEEDS AND EXPAND THE AVAILABILITY OF SERVICES. THE EXPECTED OUTCOMES ARE AN INCREASE IN SCREENING PRACTICES, RESULTING IN A 10% INCREASE IN MALES AND LGBTQ+ VICTIMS IDENTIFIED; SERVING 100 VICTIMS IN YEAR 1 AND 115 VICTIMS IN YEARS 2 AND 3; PROVIDE 2500 SERVICES PROVISION UNITS THROUGH ONGOING CASE MANAGEMENT, ADVOCACY AND ACCOMPANIMENT, EXPLANATION OF BENEFITS AND SOCIAL SERVICE ADVOCACY, INFORMATION AND REFERRALS, EDUCATION, LIFE SKILLS BUILDING, AS WELL AS EMOTIONAL/MORAL SUPPORT; TRAUMA-INFORMED THERAPY OFFERED TO ALL VICTIMS IN NEED WITH A TARGET OF SERVING 30 VICTIMS A YEAR THROUGH INDIVIDUAL THERAPY/MENTAL HEALTH SERVICES, CRISIS INTERVENTION, AND SAFETY PLANNING; PROVIDING 10 TRAININGS A YEAR TO EDUCATE 1000 PROFESSIONALS OVER THE COURSE OF THE PROGRAM; AND PROVIDING TEN OUTREACH ACTIVITIES TO INCREASE AWARENESS OF SERVICES, WITH A SPECIAL FOCUS ON AGENCIES/ORGANIZATIONS THAT CAN BETTER SUPPORT MALES, LGBTQ+, AND LABOR TRAFFICKING. THE GEOGRAPHIC SERVICE AREA IS HAMPDEN COUNTY IN THE STATE OF MASSACHUSETTS WITH A TARGET AUDIENCE OF MINOR VICTIMS OF HUMAN TRAFFICKING AGES 0-17, AND THEIR FAMILIES, WITH FOCUS ON SPECIALTY POPULATIONS TO INCLUDE: MALES AND LGBTQ+ YOUTH, AND LABOR TRAFFICKING. THERE ARE NO SUBRECIPIENTS FOR THIS AWARD.

CONTEXTUAL FACTORS ASSOCIATED WITH IMPLEMENTATION EFFECTIVENESS WITHIN A QICOLLA

STAFFING FOR ADEQUATE FIRE AND EMERGENCY RESPONSE (SAFER)

SPOILER: TOWARDS SAFER PRESCRIBING OF LEGAL OPIOIDS FROM THE EMERGENCY ROOM

DE-IMPLEMENTATION OF LOW VALUE IMAGING IN PULMONARY EMBOLISM (DELVE PE) - 1 PROJECT SUMMARY 2 TWO PERCENT (2%) OF ALL 120 MILLION ANNUAL EMERGENCY DEPARTMENT (ED) VISITS IN THE UNITED STATES UNDERGO COMPUTED 3 TOMOGRAPHIC PULMONARY ANGIOGRAPHY (CTPA) FOR PULMONARY EMBOLISM (PE) EVERY YEAR. HOWEVER, MANY OF THESE ARE 4 AVOIDABLE. UNNECESSARY TESTING SUBJECTS PATIENTS TO ADDITIONAL COSTS, IONIZING RADIATION, AND RISK OF ANAPHYLAXIS FROM CONTRAST 5 MEDIA. FURTHER, BECAUSE FALSE POSITIVE CTPAS ARE COMMON (ESTIMATED AT 5-26%), OVERDIAGNOSIS AND OVERTREATMENT ARE 6 GROWING PROBLEMS IN THE UNITED STATES. DESPITE GUIDELINES RECOMMENDING THE REDUCTION OF LOW-VALUE IMAGING FOR PE, THE 7 VOLUME OF UNNECESSARY IMAGING STUDIES FOR PE IN US EDS CONTINUES TO RISE, EXPOSING PATIENTS TO HARM FROM OVERTESTING AND 8 OVERDIAGNOSIS. PRIOR STRATEGIES HAVE ATTEMPTED TO CLOSE THIS KNOWLEDGE-PRACTICE QUALITY GAP BUT ONLY HAD MODEST SUCCESS, 9 POSSIBLY BECAUSE CHANGING PROVIDER BEHAVIOR IS CHALLENGING AND MOST INITIATIVES FOCUSED ON ISOLATED STRATEGIES. WE PROPOSE 10 TO DEVELOP, PILOT, AND EVALUATE A MULTI-DIMENSIONAL `ENHANCED' AUDIT-FEEDBACK STRATEGY (EAF) TO DE-IMPLEMENT LOW-VALUE 11 IMAGING IN PE. THE CORE STRATEGY, AUDIT-FEEDBACK, WAS CHOSEN TO TARGET DRIVERS OF LOW-VALUE IMAGING IN PE DISCOVERED IN 12 OUR FOUNDATIONAL WORK: KNOWLEDGE, PEER PRESSURE, EMOTION, AND BELIEF ABOUT CONSEQUENCES. WE DESIGNED THE STRATEGY USING 13 A NOVEL AUDIT-FEEDBACK THEORY, THE CLINICAL PERFORMANCE FEEDBACK INTERVENTION THEORY (CP-FIT). THE AUDIT-FEEDBACK IS 14 `ENHANCED' BY COMPLEMENTARY STRATEGIES TO ASSIST IN ACTION PLANNING AND EMPOWER CLINICIANS TO CHANGE THEIR BEHAVIOR. THIS 15 INCLUDES AN AID FOR APPROPRIATE TESTING THAT GUIDES CLINICIANS THROUGH AN UNAMBIGUOUS ALGORITHM FOR EVALUATION OF PE, AN 16 EDUCATIONAL PODCAST, AND LOCAL CHAMPIONS. IN AIM 1, WE WILL DEVELOP, REFINE, AND OPERATIONALIZE THE DE-IMPLEMENTATION 17 STRATEGY COMPONENTS. WE WILL CONDUCT COGNITIVE TESTING OF THE PROTOTYPES OF THE AUDIT-FEEDBACK REPORTS, DEVELOP AN 18 ELECTRONIC HEALTH RECORD (EHR)-INTEGRATED AID, RECORD THE EDUCATIONAL PODCAST, AND IDENTIFY AND TRAIN LOCAL CHAMPIONS. IN 19 AIM 2, WE WILL PILOT ALTERNATIVE VERSIONS OF THE EAF STRATEGY IN 5 EDS TO EVALUATE ACCEPTABILITY AND APPROPRIATENESS. WE 20 WILL ALTER THE DELIVERY OF THE COMPONENTS OF FEEDBACK (LOCAL CHAMPION VERSUS DEPARTMENTAL CHAIR), EDUCATIONAL PODCAST (WITH 21 OR WITHOUT A REAL PATIENT NARRATIVE), AND THE AID FOR APPROPRIATE TESTING (STATIC VERSUS EHR-INTEGRATED AID) TO ASCERTAIN THE 22 ACCEPTABILITY, APPROPRIATENESS, AND ADDED VALUE OF THESE ITERATIONS. WE WILL PILOT DIFFERENT VERSIONS OF THE STRATEGY TO EVALUATE 23 ASPECTS OF CP-FIT INCLUDING COMPLEXITY, SOCIAL INFLUENCE, AND ACTIONABILITY, WHICH CP-FIT SUGGESTS DRIVE THE AUDIT-FEEDBACK 24 CYCLE AND, ULTIMATELY, BEHAVIOR CHANGE. WE WILL USE MIXED METHODS TO EVALUATE THE STRATEGY AND SELECT A REFINED STRATEGY FOR 25 A MULTI-CENTER TRIAL. IN THIS K23 APPLICATION, WE HAVE PROPOSED A DETAILED CAREER DEVELOPMENT PLAN IN WHICH I WILL GAIN 26 METHODOLOGICAL AND TECHNICAL EXPERTISE IN ADVANCED IMPLEMENTATION SCIENCE STRATEGIES, METHODS, AND TRIAL DESIGN. I AM WELL 27 SUPPORTED BY AN EXPERIENCED TEAM OF MENTORS AND ADVISORS. AT THE END OF THIS MENTORED CAREER DEVELOPMENT AWARD, I WILL 28 HAVE A ROBUST EMPIRICALLY-DERIVED AND THEORY-INFORMED STRATEGY AND WILL BE POSITIONED TO TEST THIS STRATEGY IN A MULTI-CENTER 29 TRIAL AS AN INDEPENDENT INVESTIGATOR. 30

DESCRIPTION:SECTION 320 OF THE CWA AUTHORIZES THE ADMINISTRATOR OF THE EPA TO CONVENE MANAGEMENT CONFERENCES TO DEVELOP COMPREHENSIVE CONSERVATION AND MANAGEMENT PLANS FOR ESTUARIES OF NATIONAL SIGNIFICANCE THAT ARE THREATENED BY POLLUTION, DEVELOPMENT, OR OVERUSE. THE AGREEMENT PROVIDES FUNDING TO THE DELAWARE CENTER FOR INLAND BAYS FOR NATIONAL ESTUARY PROGRAM (NEP) TO SUPPORT IMPLEMENTATION OF THE NEP COMPREHENSIVE CONSERVATION AND MANAGEMENT PLAN (CCMP) AND EPA'S PILLAR 1: CLEAN AIR, LAND, AND WATER FOR EVERY AMERICAN. WORK TO BE ACCOMPLISHED INCLUDES: EXPANDED BAYGRASS RESTORATION EFFORTS, ENHANCING AND RESTORING FISH POPULATIONS AND THEIR HABITATS, MAXIMIZING AMOUNT OF NATURAL SHORELINES, INCREASING REGULATORY PROTECTIONS FOR THE WETLANDS AND RESTORING PREVIOUSLY LOST WETLANDS, REDUCING POLLUTION FROM THE DEVELOPED LANDSCAPE, ENHANCING JAMES FARM ECOLOGICAL PRESERVE AND EDUCATION PROGRAM THROUGH THE CONTINUED EXPANSION OF THE CHILDHOOD EDUCATION PROGRAMS AND COMPLETION OF THE SUSAN K BALL EDUCATION CENTER, MAINTAINING ENVIRONMENTAL MONITORING PROGRAMS, ONGOING VOLUNTEER SCIENCE PROJECTS INCLUDING PROGRAMS FOR HORSESHOE CRABS, SHORE ZONE FISH AND BLUE CRABS, DIAMONDBACK TERRAPINS AND REFORESTATION PROJECTS, ADDING LEGACY DATA TO CITIZEN MONITORING PROGRAM DATA BASE, DEVELOPMENT OF THE STATE OF THE INLAND BAYS REPORT, AND MORE. ACTIVITIES:THE PROJECTS INCLUDED WILL SUPPORT ACTIVITIES THAT ADDRESS THE KEY CHALLENGES FACING THE ESTUARY INCLUDING ASSESSING TRENDS IN WATER QUALITY, HABITATS, NATURAL RESOURCES AND USES; COORDINATING IMPLEMENTATION OF THE CCMP BY THE NEP, ALONG WITH THE STATE, FEDERAL, LOCAL AGENCIES, STAKEHOLDERS, NGOS, CITIZENS, PARTNERS, AND OTHERS; AND MONITORING THE EFFECTIVENESS OF ACTIVITIES CONDUCTED UNDER THE MANAGEMENT CONFERENCE APPROVED CCMP AND ANNUAL WORKPLAN. WORK TO BE ACCOMPLISHED INCLUDES: EXPANDED BAYGRASS RESTORATION EFFORTS, ENHANCING AND RESTORING FISH POPULATIONS AND THEIR HABITATS, MAXIMIZING AMOUNT OF NATURAL SHORELINES, INCREASING REGULATORY PROTECTIONS FOR THE WETLANDS AND RESTORING PREVIOUSLY LOST WETLANDS, REDUCING POLLUTION FROM THE DEVELOPED LANDSCAPE, ENHANCING JAMES FARM ECOLOGICAL PRESERVE AND EDUCATION PROGRAM THROUGH THE CONTINUED EXPANSION OF THE CHILDHOOD EDUCATION PROGRAMS AND COMPLETION OF THE SUSAN K BALL EDUCATION CENTER, MAINTAINING ENVIRONMENTAL MONITORING PROGRAMS, ONGOING VOLUNTEER SCIENCE PROJECTS INCLUDING PROGRAMS FOR HORSESHOE CRABS, SHORE ZONE FISH AND BLUE CRABS, DIAMONDBACK TERRAPINS AND REFORESTATION PROJECTS, ADDING LEGACY DATA TO CITIZEN MONITORING PROGRAM DATA BASE, AND DEVELOPMENT OF THE STATE OF THE INLAND BAYS REPORT. SUBRECIPIENT:NO SUBAWARDS ARE INCLUDED IN THIS ASSISTANCE AGREEMENT.OUTCOMES:THE ANTICIPATED DELIVERABLES INCLUDE: CONDUCTING 14 RADIO/TV INTERVIEWS, DISTRIBUTING E-NEWSLETTER TO 10,000 PEOPLE ANNUALLY, COORDINATING ONE PUBLIC EDUCATION AND OUTREACH MEETING ANNUALLY, DEVELOPING AND PILOTING HOA ENGAGEMENT PROGRAM, COORDINATING COMMUNITY LAND OR WATER-BASED CLEANUPS, COLLECTING 1000 POUNDS OF TRASH AND DEBRIS ANNUALLY, CONDUCT AT LEAST 3 CLEANUPS ALONG ADOPT A HIGHWAY STRETCH ANNUALLY, DEVELOP AND DELIVER PUBLIC EDUCATION LECTURE SERIES FOCUSED ON MULTIPLE TOPICS IN THE CCMP, DEVELOP AND PILOT THE STUDENT ESTUARY ACTION AND STEWARDSHIP PROGRAM 2025, OFFER ONE DAY DEVELOPMENT OPPORTUNITY FOR FORMAL AND INFORMAL EDUCATORS, AND MORE. THE EXPECTED OUTCOMES INCLUDE FOSTERING MEANINGFUL RELATIONSHIPS WITH NANTICOKE TRIBE THROUGH A VARIETY OF EDUCATIONAL PROGRAMS, CONTINUING TO FOSTER AND DEVELOP NEW AND ONGOING RELATIONSHIPS WITH ADDITIONAL K-12 SCHOOLS THROUGH EDUCATION PROGRAMS ANNUALLY, PARTICIPATION IN MID-ATLANTIC NOAA MARINE DEBRIS ACTION PLAN WORKGROUP ANNUALLY, REACH 2,000 PEOPLE THROUGH OUTREACH AND PUBLIC EVENTS ANNUALLY, NEW, CALIBRATED HD/WQ MODEL FOR INLAND BAYS, ABILITY TO PREDICT CHANGES ON INLAND BAYS WATER QUALITY AND HABITAT, BETTER UNDERSTANDING OF HYDRODYNAMIC, GEOCHEMICAL, AND BIOLOGICAL PROCESSES IN THE INLAND BAYS, AND

DESCRIPTION:SECTION 320 OF THE CLEAN WATER ACT (CWA) AUTHORIZES THE ADMINISTRATOR OF THE ENVIRONMENTAL PROTECTION AGENCY (EPA) TO CONVENE MANAGEMENT CONFERENCES TO DEVELOP COMPREHENSIVE CONSERVATION AND MANAGEMENT PLANS FOR ESTUARIES OF NATIONAL SIGNIFICANCE THAT ARE THREATENED BY POLLUTION, DEVELOPMENT, OR OVERUSE. THE AGREEMENT PROVIDES FUNDING TO THE COASTAL BEND BAYS AND ESTUARIES PROGRAM FOR NATIONAL ESTUARY PROGRAM (NEP) TO SUPPORT IMPLEMENTATION OF THE NEP COMPREHENSIVE CONSERVATION AND MANAGEMENT PLAN (CCMP) AND EPA PILLAR 1: CLEAN AIR, LAND, AND WATER FOR EVERY AMERICAN. ACTIVITIES:THE PROJECTS INCLUDED WILL SUPPORT ACTIVITIES THAT ADDRESS THE KEY CHALLENGES FACING THE ESTUARY INCLUDING ASSESSING TRENDS IN WATER QUALITY, HABITATS, NATURAL RESOURCES AND USES; COORDINATING IMPLEMENTATION OF THE CCMP BY THE NEP, ALONG WITH THE STATE, FEDERAL, LOCAL AGENCIES, STAKEHOLDERS, NON GOVERNMENT ORGANIZATIONS (NGOS), CITIZENS, PARTNERS, AND OTHERS; AND MONITORING THE EFFECTIVENESS OF ACTIVITIES CONDUCTED UNDER THE MANAGEMENT CONFERENCE APPROVED CCMP AND ANNUAL WORKPLAN. INDIVIDUAL PROJECTS INCLUDE: - PROJECT #2601 COASTAL BIRD MANAGEMENT; THIS PROJECT WORKS TO CONTINUE COASTAL BIRD POPULATION RESTORATION EFFORTS THROUGH MANAGEMENT OF COLONIAL WATERBIRD NESTING SITES, INCLUDING HABITAT ENHANCEMENT, PROTECTION, PREDATOR CONTROL, AND REDUCTION OF ANTHROPOGENIC IMPACTS, DEVELOP AND IMPLEMENT PUBLIC EDUCATION AND OUTREACH PROGRAMS THAT PROMOTE AWARENESS AND STEWARDSHIP OF COASTAL BIRDS AND THEIR HABITATS, ASSIST PARTNERS IN EFFORTS TO OBSERVE AND MONITOR CHANGES IN COASTAL BIRD POPULATIONS FOR MANAGEMENT PURPOSES, AND PROVIDE RESOURCE AGENCIES, RESEARCHERS, AND OTHER STAKEHOLDERS WITH EXPERTISE ON COASTAL BIRD ECOLOGY, HABITATS, AND CONSERVATION NEEDS INCLUDING ASSISTANCE IN TAGGING MIGRATORY BIRDS FOR TRACKING. - PROJECT #2602 DELTA DISCOVERY; THIS PROJECT WORKS TO PROVIDE EDUCATIONAL FIELD TRIP OPPORTUNITIES FOR K-12 STUDENTS AND ALSO TO AID TEACHERS IN INCREASING THEIR KNOWLEDGE, SKILLS, AND RESOURCES AVAILABLE TO EFFECTIVELY TEACH SCIENCE TO STUDENTS IN LOCAL SCHOOLS. - PROJECT #2603 WASTEWATER TREATMENT PLANT ASSESSMENT; THE PROPOSED PROJECT WILL CONDUCT AN ENGINEERING ASSESSMENT OF THE WASTEWATER SYSTEM AND ASSIST THE COMMUNITY IN THE PREPARATION OF A FUNDING APPLICATION TO ADDRESS INFRASTRUCTURE NEEDS. - PROJECT #2609 LAND CONSERVATION AND STEWARDSHIP; THE PRIMARY PROJECT OBJECTIVE IS TO PROMOTE THE STEWARDSHIP OF COASTAL RESOURCES THROUGH THE IMPLEMENTATION OF RESPONSIBLE AND SUSTAINABLE ADAPTIVE MANAGEMENT TECHNIQUES ON COASTAL BEND BAYS AND ESTUARIES PROGRAM (CBBEP) PROPERTIES. SUBRECIPIENT:CONDUCTING AN ENGINEERING ASSESSMENT OF THE WASTEWATER SYSTEM AND ASSIST THE COMMUNITY IN THE PREPARATION OF A FUNDING APPLICATION TO ADDRESS INFRASTRUCTURE NEEDS. DELIVERABLES: FOR THIS PROJECT INCLUDE A CONTRACT WITH THE COASTAL BEND COG, REQUEST FOR PROPOSALS FOR ENGINEERING SERVICES, CONTRACT FOR ENGINEERING SERVICES, ASSESSMENT REPORT OF THE WWTP, AND APPLICATION FOR FUNDS NEEDED TO IMPLEMENT RECOMMENDATIONS. ADDITIONAL DELIVERABLES INCLUDE SEMI-ANNUAL PROGRESS REPORTS, DRAFT FINAL REPORT, AND FINAL REPORT. PROJECT OUTCOMES: THE EXPECTED OUTCOME OF THIS PROJECT IS IMPROVED WATER QUALITY IN THE COASTAL BEND CREEKS AND BAYS THROUGH LOAD REDUCTIONS OF BOTH BACTERIA AND NUTRIENTS.OUTCOMES:- PROJECT #2601 COASTAL BIRD MANAGEMENT; THIS PROJECT WORKS TO CONTINUE COASTAL BIRD POPULATION RESTORATION EFFORTS THROUGH MANAGEMENT OF COLONIAL WATERBIRD NESTING SITES, INCLUDING HABITAT ENHANCEMENT, PROTECTION, PREDATOR CONTROL, AND REDUCTION OF ANTHROPOGENIC IMPACTS, DEVELOP AND IMPLEMENT PUBLIC EDUCATION AND OUTREACH PROGRAMS THAT PROMOTE AWARENESS AND STEWARDSHIP OF COASTAL BIRDS AND THEIR HABITATS, ASSIST PARTNERS IN EFFORTS TO OBSERVE AND MONITOR CHANGES IN COASTAL BIRD POPULATIONS FOR MANAGEMENT PURPOSES, AND PROVIDE RESOURCE AGENCIES, RESEARCHERS, AND OTHER STAKEHOLDERS WITH EXPERTISE ON COASTAL BIRD ECOLOGY, H

DESCRIPTION:SECTION 320 OF THE CLEAN WATER ACT (CWA) AUTHORIZES THE ADMINISTRATOR OF THE ENVIRONMENTAL PROTECTION AGENCY (EPA) TO CONVENE MANAGEMENT CONFERENCES TO DEVELOP COMPREHENSIVE CONSERVATION AND MANAGEMENT PLANS FOR ESTUARIES OF NATIONAL SIGNIFICANCE THAT ARE THREATENED BY POLLUTION, DEVELOPMENT, OR OVERUSE. THE AGREEMENT PROVIDES FUNDING TO COASTAL BEND BAYS AND ESTUARIES PROGRAM (CBBEP) FOR NATIONAL ESTUARY PROGRAM (NEP) TO SUPPORT IMPLEMENTATION OF THE NEP COMPREHENSIVE CONSERVATION AND MANAGEMENT PLAN (CCMP) AND EPA STRATEGIC PLAN GOAL 5: ENSURE CLEAN AND SAFE WATER FOR ALL COMMUNITIES AND OBJECTIVE 5.2: - PROTECT AND RESTORE WATERBODIES AND WATERSHEDS TO IMPROVE THE WATER QUALITY, PROTECT THE NATURAL HABITAT AND LIVING RESOURCES, AND SUPPORT SUSTAINABLE HUMAN USES IN THE ESTUARY. THE MAJORITY OF THIS AWARD WILL ALLOW CBBEP TO IMPLEMENT PROJECTS WHICH CONTRIBUTE TO TOWARD THE IMPLEMENTATION OF THEIR CCMP AND THE REMAINING FUNDS WILL BE USED FOR PROGRAM ADMINISTRATION IN SUPPORT OF GRANT ACTIVITIES AND THE ESTUARY COUNCIL. ACTIVITIES:THE PROJECTS INCLUDED WILL SUPPORT ACTIVITIES THAT ADDRESS THE KEY CHALLENGES FACING THE ESTUARY INCLUDING ASSESSING TRENDS IN WATER QUALITY, HABITATS, NATURAL RESOURCES AND USES; COORDINATING IMPLEMENTATION OF THE CCMP BY THE NEP, ALONG WITH THE STATE, FEDERAL, LOCAL AGENCIES, STAKEHOLDERS, NON-GOVERNMENTAL ORGANIZATIONS (NGOS), CITIZENS, PARTNERS, AND OTHERS; AND MONITORING THE EFFECTIVENESS OF ACTIVITIES CONDUCTED UNDER THE MANAGEMENT CONFERENCE APPROVED CCMP AND ANNUAL WORKPLAN. THE ACTIVITIES TO BE PERFORMED BY THE CBBEP INCLUDE THE FOLLOWING ACTIVITIES: 1) CBBEP COASTAL BIRD MANAGEMENT - THE OBJECTIVES ARE TO 1) CONTINUE COASTAL BIRD POPULATION RESTORATION EFFORTS THROUGH MANAGEMENT OF COLONIAL WATERBIRD NESTING SITES, 2) IMPLEMENT EDUCATION AND OUTREACH PROMOTING STEWARDSHIP OF COASTAL BIRDS AND THEIR HABITAT, 3) ASSIST PARTNERS IN OBSERVATION AND MONITORING IN COASTAL BIRD POPULATIONS, AND 4) PROVIDE STAKEHOLDERS WITH TECHNICAL ASSISTANCE AND EXPERTISE ON COASTAL BIRD ECOLOGY AND CONSERVATION, INCLUDING ASSISTANCE WITH TAGGING MIGRATORY BIRDS. 2) DELTA DISCOVERY - THE OBJECTIVE IS TO PROVIDE EDUCATIONAL FIELD TRIP OPPORTUNITIES FOR KINDERGARTEN THROUGH TWELFTH GRADE (K-12) STUDENTS, AND TO AID TEACHERS IN INCREASING THEIR KNOWLEDGE, SKILLS, AND RESOURCES AVAILABLE TO EFFECTIVELY TEACH SCIENCE TO STUDENTS IN LOCAL SCHOOLS. 3) ENVIRONMENTAL DEOXYRIBONUCLEIC ACID (DNA) ASSESSMENT OF THE TEXAS DIAMONDBACK TERRAPIN-THE OBJECTIVE IS TO IDENTIFY THE DISTRIBUTION OF TEXAS DIAMONDBACK TERRAPIN (MALACLEMYS TERRAPIN LITTORALIS)AND POTENTIAL LOCATIONS OF NESTING HABITAT IN THE TEXAS COASTAL BEND BAYS AND ESTUARIES. THE PROJECT HAS THREE PRIMARY OBJECTIVES: (1) DETERMINE THE DISTRIBUTION OF TEXAS DIAMONDBACK TERRAPIN POPULATIONS IN THE COASTAL BEND BAY COMPLEXES USING ENVIRONMENTAL DNA SURVEYS; (2) DETERMINE IF SEASONAL PATTERNS OF TERRAPIN DISTRIBUTION EXIST; AND (3) IDENTIFY SUITABLE NESTING HABITAT SITES IN PROXIMITY TO IDENTIFIED TERRAPIN POPULATIONS. 4) TEXAS GULF REGION COOPERATIVE WEED MANAGEMENT AREA (CWMA)-TREATMENT OF BRAZILIAN PEPPERTREE-THE OBJECTIVE IS TO PERFORM HABITAT RESTORATION ACTIVITIES, SPECIFICALLY, REMOVAL OF INVASIVE PLANT SPECIES, TO IMPROVE THE DIVERSITY OF NATIVE PLANTS AND WILDLIFE POPULATIONS AT THE WETLANDS LOCATED ON LANDS OWNED BY TEXAS GULF REGION CWMA MEMBERS. 5) LAND CONSERVATION AND STEWARDSHIP - THE OBJECTIVE IS TO PROMOTE THE STEWARDSHIP OF COASTAL RESOURCES THROUGH THE IMPLEMENTATION OF RESPONSIBLE AND SUSTAINABLE ADAPTIVE MANAGEMENT TECHNIQUES ON CBBEP PROPERTIES. SUBRECIPIENT:ENVIRONMENTAL DNA ASSESSMENT OF THE TEXAS DIAMONDBACK TERRAPIN: THE SUBAWARDEE WILL IDENTIFY THE DISTRIBUTION OF TEXAS DIAMONDBACK TERRAPIN (MALACLEMYS TERRAPIN LITTORALIS)AND POTENTIAL LOCATIONS OF NESTING HABITAT IN THE TEXAS COASTAL BEND BAYS AND ESTUARIES. THE THREE PRIMARY OBJECTIVES ARE: (1) DETERMINE THE DISTRIBUTION OF TEXAS DIAMON

DESCRIPTION:SECTION 320 OF THE CLEAN WATER ACT (CWA) AUTHORIZES THE ADMINISTRATOR OF THE ENVIRONMENTAL PROTECTION AGENCY (EPA) TO CONVENE MANAGEMENT CONFERENCES TO DEVELOP COMPREHENSIVE CONSERVATION AND MANAGEMENT PLANS FOR ESTUARIES OF NATIONAL SIGNIFICANCE THAT ARE THREATENED BY POLLUTION, DEVELOPMENT, OR OVERUSE. THE AGREEMENT PROVIDES FUNDING TO COASTAL BEND BAYS AND ESTUARIES PROGRAM (CBBEP) FOR NATIONAL ESTUARY PROGRAM (NEP) TO SUPPORT IMPLEMENTATION OF THE NEP COMPREHENSIVE CONSERVATION AND MANAGEMENT PLAN (CCMP) AND EPA STRATEGIC PLAN GOAL 5: ENSURE CLEAN AND SAFE WATER FOR ALL COMMUNITIES AND OBJECTIVE 5.2: - PROTECT AND RESTORE WATERBODIES AND WATERSHEDS TO IMPROVE THE WATER QUALITY, PROTECT THE NATURAL HABITAT AND LIVING RESOURCES, AND SUPPORT SUSTAINABLE HUMAN USES IN THE ESTUARY. THE MAJORITY OF THIS AWARD WILL ALLOW CBBEP TO IMPLEMENT PROJECTS WHICH CONTRIBUTE TO TOWARD THE IMPLEMENTATION OF THEIR CCMP AND THE REMAINING FUNDS WILL BE USED FOR PROGRAM ADMINISTRATION IN SUPPORT OF GRANT ACTIVITIES AND THE ESTUARY COUNCIL. ACTIVITIES:THE PROJECTS INCLUDED WILL SUPPORT ACTIVITIES THAT ADDRESS THE KEY CHALLENGES FACING THE ESTUARY INCLUDING ASSESSING TRENDS IN WATER QUALITY, HABITATS, NATURAL RESOURCES AND USES; COORDINATING IMPLEMENTATION OF THE COMPREHENSIVE CONSERVATION AND MANAGEMENT PLAN (CCMP) BY THE NATIONAL ESTUARY PROGRAM (NEP), ALONG WITH THE STATE, FEDERAL, LOCAL AGENCIES, STAKEHOLDERS, NON-GOVERNMENTAL ORGANIZATIONS (NGOS), CITIZENS, PARTNERS, AND OTHERS; AND MONITORING THE EFFECTIVENESS OF ACTIVITIES CONDUCTED UNDER THE MANAGEMENT CONFERENCE APPROVED CCMP AND ANNUAL WORKPLAN. THE ACTIVITIES TO BE PERFORMED BY THE COASTAL BEND BAYS AND ESTUARIES PROGRAM (CBBEP) INCLUDE THE FOLLOWING ACTIVITIES: 1) CBBEP COASTAL BIRD MANAGEMENT - THE OBJECTIVES ARE TO 1) CONTINUE COASTAL BIRD POPULATION RESTORATION EFFORTS THROUGH MANAGEMENT OF COLONIAL WATERBIRD NESTING SITES, 2) IMPLEMENT EDUCATION AND OUTREACH PROMOTING STEWARDSHIP OF COASTAL BIRDS AND THEIR HABITAT, 3) ASSIST PARTNERS IN OBSERVATION AND MONITORING IN COASTAL BIRD POPULATIONS, AND 4) PROVIDE STAKEHOLDERS WITH TECHNICAL ASSISTANCE AND EXPERTISE ON COASTAL BIRD ECOLOGY AND CONSERVATION, INCLUDING ASSISTANCE WITH TAGGING MIGRATORY BIRDS. 2) DELTA DISCOVERY - THE OBJECTIVE IS TO PROVIDE EDUCATIONAL FIELD TRIP OPPORTUNITIES FOR KINDERGARTEN THROUGH TWELFTH GRADE (K-12) STUDENTS, AND TO AID TEACHERS IN INCREASING THEIR KNOWLEDGE, SKILLS, AND RESOURCES AVAILABLE TO EFFECTIVELY TEACH SCIENCE TO STUDENTS IN LOCAL SCHOOLS. 3) NATIONAL SPILL CONTROL SCHOOL 40-HOUR OIL AND HAZARDOUS SPILL RESPONSE COURSES - THE OBJECTIVE IS TO PROVIDE CUSTOMIZED OIL AND HAZARDOUS MATERIAL RESPONSE TRAININGS FOR DREDGE, VESSEL, AND TERMINAL OPERATORS IN THE TEXAS COASTAL BEND IN ORDER TO IMPROVE THE RESPONSE TIME DURING SPILL EVENTS AND LESSEN POTENTIAL ECOSYSTEM IMPACTS. 4) MONITORING SUCCESS OF DREDGE MATERIAL PLACEMENT AT THE NUECES DELTA - THE OBJECTIVES ARE TO (1) CONDUCT PRE/POST ELEVATION AND VEGETATION SURVEYS RELATED TO AN UPCOMING DREDGE PLACEMENT PROJECT AT THE NUECES DELTA PRESERVE, AND (2) DEVELOP AN ADAPTIVE MANAGEMENT PLAN THAT WILL ASSIST CBBEP IN THEIR LONG-TERM MANAGEMENT EFFORTS ASSOCIATED WITH THE DREDGE PLACEMENT PROJECT. 5) LAND CONSERVATION AND STEWARDSHIP - THE OBJECTIVE IS TO PROMOTE THE STEWARDSHIP OF COASTAL RESOURCES THROUGH THE IMPLEMENTATION OF RESPONSIBLE AND SUSTAINABLE ADAPTIVE MANAGEMENT TECHNIQUES ON CBBEP PROPERTIES. SUBRECIPIENT:NATIONAL SPILL CONTROL SCHOOL 40-HOUR OIL AND HAZARDOUS SPILL RESPONSE COURSES: SUBAWARDEES WILL PROVIDE OIL AND HAZARDOUS MATERIAL RESPONSE TRAINING FOR DREDGE, VESSEL, AND TERMINAL OPERATORS IN THE TEXAS COASTAL BEND. THE SUBAWARDEE WILL CONDUCT FOUR, 40-HOUR COURSES OVER THE COURSE OF ONE YEAR WITH UP TO 20 ATTENDEES IN EACH COURSE. COURSES WILL INCLUDE SAFETY AND OIL SPILL RESPONSE BASICS IN A CLASSROOM SETTING, AS WELL AS HANDS SPILL RESPONSE EXERCISES WITH BOATS IN COR

DESCRIPTION:SECTION 320 OF THE CWA AUTHORIZES THE ADMINISTRATOR OF THE EPA TO CONVENE MANAGEMENT CONFERENCES TO DEVELOP COMPREHENSIVE CONSERVATION AND MANAGEMENT PLANS FOR ESTUARIES OF NATIONAL SIGNIFICANCE THAT ARE THREATENED BY POLLUTION, DEVELOPMENT, OR OVERUSE. THE AGREEMENT PROVIDES FUNDING TO MARYLAND COASTAL BAYS PROGRAM FOR NATIONAL ESTUARY PROGRAM (NEP) TO SUPPORT IMPLEMENTATION OF THE NEP COMPREHENSIVE CONSERVATION AND MANAGEMENT PLAN (CCMP). THE CCMP COVERS FOUR THEMES OF WORK: PROVIDE HEALTHY WATERS; PROTECT FISH, WILDLIFE AND THEIR HABITATS; CREATE RESILIENT COMMUNITIES AND ECOSYSTEMS; AND DEVELOP PUBLIC ENGAGEMENT AND PARTNERSHIPS. THE WORKPLAN MEETS ALL PROGRAMMATIC REQUIREMENTS BASED ON MOST RECENT GUIDANCE. ACTIVITIES:THE PROJECTS INCLUDED WILL SUPPORT ACTIVITIES THAT ADDRESS THE KEY CHALLENGES FACING THE ESTUARY INCLUDING ASSESSING TRENDS IN WATER QUALITY, HABITATS, NATURAL RESOURCES AND USES; COORDINATING IMPLEMENTATION OF THE CCMP BY THE NEP, ALONG WITH THE STATE, FEDERAL, LOCAL AGENCIES, STAKEHOLDERS, NGOS, CITIZENS, PARTNERS, AND OTHERS; AND MONITORING THE EFFECTIVENESS OF ACTIVITIES CONDUCTED UNDER THE MANAGEMENT CONFERENCE APPROVED CCMP AND ANNUAL WORKPLAN. THIS GRANT WILL SUPPORT STAFF, TRAVEL, SUPPLIES, AND CONTRACTS TO PROTECT AND RESTORE WATER QUALITY AND HABITAT IN THE MARYLAND COASTAL BAYS THROUGH PROJECTS INCLUDING EDUCATION PROGRAMS, HABITAT RESTORATION PROJECTS, WATER QUALITY MONITORING, OYSTER GARDENING, AND GREEN SCHOLARSHIPS.SUBRECIPIENT:ONE SUBAWARD WILL GO TO UNIVERSITY OF MARYLAND CENTER FOR ENVIRONMENTAL SCIENCE (UMCES) TO CREATE THE COASTAL BAYS ANNUAL REPORT CARD ($17,500). THE SECOND SUBAWARD IS TO MARYLAND DEPARTMENT OF NATURAL RESOURCES FOR AERIAL SURVEY DATA COLLECTION TO SUPPORT RESTORATION OF SEAGRASS BEDS IN THE COASTAL BAYS ($9,000).OUTCOMES:THE ANTICIPATED DELIVERABLES INCLUDE ANNUAL REPORT CARDS, DATA ON HABITAT AND WATER QUALITY, COMMUNITY EVENTS AND EDUCATIONAL OFFERINGS, AND SEMI ANNUAL REPORTING TO EPA. THE EXPECTED OUTCOMES INCLUDE IMPROVED UNDERSTANDING OF CHANGES IN THE MCBP ECOSYSTEM INCLUDING WATER QUALITY AND HABITAT, INCREASED PUBLIC AWARENESS AND ENGAGEMENT, AND IMPROVED AND INCREASED HABITAT AND COASTAL RESILIENCE. THE INTENDED BENEFICIARIES INCLUDE LOCAL COMMUNITIES INCLUDING RESIDENTS AND VISITORS IN IN THE MARYLAND COASTAL BAYS WATERSHEDS AND THIS ESTUARY DIRECTLY BENEFIT FROM THIS PROJECT.

THIS PROJECT IMPLEMENTS RECOMMENDATIONS OF THE COMPREHENSIVE CONSERVATION AND MANAGEMENT PLAN (CCMP) REGARDING RESTORATION OF DISAPPEARING COASTAL HA

PARTNERS IN CARE: COMMUNITY-BASED IMPLEMENTATION OF EBT

HEALTH CARE AND OTHER FACILITIES

TAS::89 0222::TAS; NEW; PIONEER VALLEY LIFE SCIENCES INSTITUTE TRANSLATIONAL BIOMEDICAL RESEARCH; PAUL FRIEDMANN, PI

CRISFIELD COMMUNITY PREVENTION WORKS DRUG FREE COALITION

DESCRIPTION:THESE FUNDS FOR COASTAL BEND BAYS AND ESTUARIES PROGRAM (CBBEP) SUPPORT IMPLEMENTATION OF THE COMPREHENSIVE CONSERVATION AND MANAGEMENT PLAN (CCMP) AND ACCOMPANYING STRATEGIC PLAN TO IMPROVE THE WATER QUALITY, PROTECT THE NATURAL HABITAT AND LIVING RESOURCES, AND SUPPORT SUSTAINABLE HUMAN USES OF THE COASTAL BEND BAYS AND ESTUARIES. ACTIVITIES:ACTIVITIES INCLUDE ASSESSING TRENDS IN WATER QUALITY, NATURAL RESOURCES AND USES; COORDINATING IMPLEMENTATION OF THE CCMP BY THE STATE, AS WELL AS FEDERAL AND LOCAL AGENCIES; AND MONITORING THE EFFECTIVENESS OF ACTIVITIES CONDUCTED UNDER THE CCMP.SUBRECIPIENT:SUB-AWARDEES WILL BE MONITORING FOR HARMFUL ALGAL BLOOMS ALONG THE PADRE ISLAND NATIONAL SEASHORE, AND ASSESS THE PRODUCTIVITY (NEST SURVIVAL AND NUMBER OF FLEDGLINGS) OF FOUR PRIORITY COASTAL BIRD SPECIES (REDDISH EGRET, TRICOLORED HERON, GREAT EGRET, AND BLACK SKIMMER) AND TEST FOR DIFFERENCES IN PRODUCTIVITY AMONG ISLAND TYPES.OUTCOMES:DELIVERABLES INCLUDE SEMI-ANNUAL REPORTS, ALONG WITH PROJECT FINAL REPORTS WHICH INCLUDE, BUT NOT LIMITED TO, A SUMMARY REPORT DOCUMENTING THE IMPLEMENTATION OF THE RESOURCE MANAGEMENT AND PUBLIC EDUCATION ACTIVITIES, AN ASSESSMENT WITH AN IMPROVED UNDERSTANDING OF THE DEGREE TO WHICH DIFFERENT ROOKERY ISLAND TYPES PRODUCE FLEDGLINGS AND INCREASED CAPACITY FOR PRO-ACTIVELY MONITORING HABS AT PADRE ISLAND NATIONAL SEASHORE AND AN INCREASED AWARENESS OF HABS IMPACTS BY VISITORS OF THE PARK AND THE GENERAL PUBLIC. DIRECT BENEFICIARIES INCLUDE VISITORS AND RESIDENTS IN THE COAST BEND BAYS AND ESTUARY AREA.

DESCRIPTION:THIS ACTION APPROVES AN AWARD IN THE AMOUNT OF $750,000 TO THE PENSACOLA AND PERDIDO BAYS ESTUARY PROGRAM TO SUPPORT THEIR EFFORTS WITH IMPROVING THE WATER QUALITY OF THE GULF OF AMERICA. THE PURPOSE OF THIS AWARD IS TO FORM THE WATER QUALITY MONITORING COLLABORATIVE THAT WILL ESTABLISH A COMPREHENSIVE NETWORK OF SENTINEL SITES TO ASSESS WATER QUALITY STATUS AND TRENDS FOR THE PENSACOLA AND PERDIDO BAYS WATERSHEDS. ACTIVITIES:THE ACTIVITIES TO BE PERFORMED INCLUDE ESTABLISHING THE COLLABORATIVE (AGREEMENT); MONTHLY WATER QUALITY MONITORING FOR BACTERIA, NUTRIENTS, AND STANDARD PHYSICAL PARAMETERS AT 33 MONITORING SITES LOCATED ACROSS THE PENSACOLA AND PERDIDO BAYS WATERSHEDS IN FLORIDA AND ALABAMA; FINALIZING THE WATER QUALITY MONITORING PLAN; UPDATING THE 2027 AND 2029 STATE OF THE BAYS REPORT; AND CREATING A PUBLIC DASHBOARD FOR DATA. SUBRECIPIENT:SUBRECIPIENT ACTIVITIES INCLUDE LABORATORY ANALYSES FOR WATER QUALITY MONITORING AND SAMPLE COLLECTION ASSISTANCE FROM LOCAL GOVERNMENTS AND A TRIBE. OUTCOMES:THE ANTICIPATED DELIVERABLES (OUTPUTS) INCLUDE ESTABLISHMENT OF THE COLLABORATIVE, WATER QUALITY MONITORING DATA, UPDATED STATE OF THE BAYS REPORTS, AND PUBLICLY AVAILABLE WATER QUALITY MONITORING DATA VIA THE DASHBOARD. EXPECTED OUTCOMES ARE SUSTAINED MONITORING, ENHANCED UNDERSTANDING OF WATER QUALITY TRENDS, AND ADOPTION OF WATER QUALITY IMPROVEMENT PLAN. THE RESIDENTS AND COMMUNITIES IN PENSACOLA AND PERDIDO BAYS WATERSHEDS WILL BENEFIT FROM IMPROVED WATER QUALITY.

PER YOUR APPLICATION REQUEST DATED MAY 28, 2021, THIS COOPERATIVE AGREEMENT IS BEING AWARDED INCREMENTAL FEDERAL FUNDING IN THE AMOUNT OF $15,000 TO THREE BAYS PRESERVATION INC.. THESE FUNDS WILL ASSIST IN CONDUCTING ENVIRONMENTAL ACTIVITIES IN THE MARSTONS MILLS WATERSHED AS A PART OF THE SOUTHEAST NEW ENGLAND PROGRAM (SNEP) PILOT WATERSHED INITIATIVE AS OUTLINED IN THREE BAYS PRESERVATION INC.'S APPLICATION. THIS AWARD WILL ALLOW THE GRANTEE TO RESTORE AN ACTIVE CRANBERRY BOG USING NOVEL TECHNIQUES THAT WILL BOTH RESTORE HABITAT AND REDUCE THE AMOUNT OF NITROGEN LEAVING THE BOG INTO THE WATERSHED. THE GRANTEE WILL ALSO MONITOR WATER QUALITY IN THE AREA NEAR THE BOG AS WELL AS DOWNSTREAM IN THE RECEIVING WATERS AND SHARE BEST PRACTICES FOR THIS KIND OF RESTORATION PROJECT. THE PRIMARY GOAL OF SNEP PILOT WATERSHED INITIATIVE FUNDING IS TO DEMONSTRATE THE EFFECTIVENESS OF CONCENTRATED, COLLABORATIVE EFFORTS AND HOLISTIC (WATERSHED SCALE) PLANNING TO ADDRESS COMMON ENVIRONMENTAL CHAL

INTEGRATING A PARENTING INTERVENTION FOR MOTHERS WITH OPIOID USE DISORDERS INTO CHILD DEVELOPMENT SERVICES

RURAL RESIDENCY PLANNING AND DEVELOPMENT PROGRAM

DEFINING OPTIMAL CLINICAL STRATEGIES FOR CRITICALLY ILL HEART FAILURE PATIENTS

CONVERSATIONS CAN SAVE LIVES: TALKING ABOUT BUPRENORPHINE & METHADONE FOR OPIOID USE TREATMENT INITIATION (TALK ABOUT) - PROJECT SUMMARY IN THE PAST TWO DECADES, OVER HALF A MILLION PEOPLE IN THE UNITED STATES HAVE DIED OF AN OPIOID OVERDOSE, AND CURRENTLY NEARLY 3 MILLION AMERICANS STRUGGLE WITH OPIOID USE DISORDER. MEDICATIONS FOR OPIOID USE DISORDER (MOUD), SUCH AS BUPRENORPHINE AND METHADONE, ARE EFFECTIVE IN DECREASING A PERSON’S RISK OF DEATH AND DISEASE FROM OPIOID USE. HOWEVER, ONLY A SMALL MINORITY OF PEOPLE WHO WOULD BENEFIT FROM THESE MEDICATIONS HAVE ACCESS TO THEM. ALTHOUGH THIS TREATMENT GAP IS MULTIFACTORIAL, TREATMENT INITIATION LOCALES OUTSIDE OF THE CURRENT ADDICTION PARADIGM ARE NECESSARY TO ADDRESS THE INCREASING MORBIDITY AND MORTALITY OF THE OPIOID EPIDEMIC. EXISTING EVIDENCE DEMONSTRATES THAT BUPRENORPHINE DISPENSED FROM THE EMERGENCY DEPARTMENT (ED) INCREASES THE LIKELIHOOD A PERSON WILL BE IN TREATMENT AT 30 DAYS, AND TREATMENT ADHERENCE IS STRONGLY LINKED TO MORBIDITY AND MORTALITY. BASED ON THE KNOWN EFFECTIVENESS OF MOUD, THE AMERICAN COLLEGE OF EMERGENCY PHYSICIANS RECENTLY RELEASED A RECOMMENDATION THAT ALL APPROPRIATE PATIENTS BE OFFERED THESE MEDICATIONS WHEN SEEN FOR ED CARE. HOWEVER, MOST PATIENTS SEEN IN A US ED ARE NOT OFFERED THESE MEDICATIONS. RESEARCH DEMONSTRATES THAT INTERPERSONAL BARRIERS SUCH AS STIGMA AND MISTRUST MAY PRECLUDE EFFECTIVE CONVERSATIONS REGARDING THESE TREATMENT OPTIONS. SHARED DECISION-MAKING (SDM) – WHERE CLINICIANS SPECIFICALLY INVITE PATIENTS INTO CLINICAL DECISION-MAKING WHEN OPTIONS ARE AVAILABLE – HAS BEEN USED TO INCREASE THE PATIENT-CENTEREDNESS OF CARE IN NUMEROUS SETTINGS BUT HAS GENERALLY NOT BEEN EMPLOYED IN THE ED FOR PATIENTS WITH OPIOID USE DISORDER. THROUGH STAKEHOLDER ENGAGEMENT, OUR TEAM HAS CREATED AN INTERVENTION, TALK ABOUT IT, WHICH USES AN SDM FRAMEWORK TO FACILITATE CONVERSATIONS ABOUT MOUD IN THE ED. CONVERSATIONS CAN FOSTER EMPATHY, BUILD TRUST, DIMINISH STIGMA, AND HELP PEOPLE START THEIR PATH TO RECOVERY. ADDITIONALLY, U.S. POLICY REGARDING THE PRESCRIPTION OF MOUD RECENTLY CHANGED, VASTLY INCREASING THE NUMBER OF POTENTIAL PRESCRIBERS. THESE PROVIDERS, HOWEVER, WILL NEED TOOLS FOR THESE CHALLENGING CONVERSATIONS. OUR LONG-TERM GOAL IS TO INCREASE AND IMPROVE DISCUSSIONS ABOUT MOUD IN THE ED, INCREASING INITIATION AND ADHERENCE, AND DECREASING MORBIDITY AND MORTALITY. IN AIM 1 OF THIS R34, WE WILL REFINE OUR INTERVENTION VIA QUALITATIVE AND QUANTITATIVE FEEDBACK FROM CLINICIANS AND PATIENTS. IN AIM 2, WE WILL PILOT PROCEDURES FOR A FULLY POWERED MULTICENTER TRIAL. AIM 2 INCLUDES: A) A PILOT OF THE TRAINING INTERVENTION FOR CLINICIANS, INCLUDING THE COLLECTION OF BASELINE AND 12-MONTH DATA; B) PROSPECTIVE ENROLLMENT OF PATIENTS AND COLLECTION OF PATIENT- CENTERED OUTCOMES; C) ASSESSMENT OF CLINICAL OUTCOMES; AND D) A FEASIBILITY ANALYSIS OF STUDY PROCEDURES. THIS WILL BE THE FIRST STUDY TO USE THE PATIENT-CENTERED FRAMEWORK OF SHARED DECISION-MAKING TO ADDRESS THIS SUBSTANTIAL TREATMENT GAP – INCREASING THE ABILITY OF ED CLINICIANS TO MEANINGFULLY ADDRESS THE DEVASTATING MORBIDITY AND MORTALITY OF THE OPIOID EPIDEMIC.

SHARED DECISION-MAKING FOR THE PROMOTION OF PATIENT-CENTERED IMAGING IN THE EMERGENCY DEPARTMENT: SUSPECTED KIDNEY STONES

THE ROLE OF INSURANCE NETWORKS AND ORGANIZATIONAL FACTORS IN GUIDELINE-CONCORDANT CARE FOR SERIOUS MENTAL ILLNESS - PROJECT SUMMARY SERIOUS MENTAL ILLNESS AFFECTS MORE THAN 5% OF THE UNITED STATES POPULATION, BUT ONLY A SMALL PROPORTION OF THESE INDIVIDUALS RECEIVE ADEQUATE TREATMENT. SCHIZOPHRENIA IMPACTS ONE PERCENT OF THE POPULATION AND IS PARTICULARLY DEBILITATING. INDIVIDUALS WITH SCHIZOPHRENIA HAVE HIGH RATES OF POOR HEALTH AND SOCIAL OUTCOMES, INCLUDING PREMATURE MORTALITY, HOMELESSNESS, AND SUBSTANCE USE. INDIVIDUALS WITH SCHIZOPHRENIA ARE AT INCREASED RISK OF SUICIDE AND HAVE HIGH RATES OF COMORBID DISEASE. GUIDELINE-CONCORDANT CARE (GCC) – INCLUDING APPROPRIATE MEDICATIONS AND PSYCHOTHERAPY – IMPROVES OUTCOMES FOR INDIVIDUALS WITH SCHIZOPHRENIA, INCLUDING MORTALITY. HOWEVER, RATES OF GCC ARE LOW, WITH SIGNIFICANT VARIATION ACROSS PATIENT DEMOGRAPHIC GROUPS, CLINICAL CONDITIONS, AND CLINICIAN TYPES. ALTHOUGH SOME DIFFERENCES MAY BE EXPLAINED BY PATIENT PREFERENCES, SYSTEM FACTORS AT THE INSURANCE AND ORGANIZATION LEVELS LIKELY CONTRIBUTE TO LOW RATES OF GCC. BETTER UNDERSTANDING SYSTEM FACTORS – INCLUDING THE ROLE OF INSURANCE NETWORKS AND ORGANIZATIONS – THAT HELP GUIDE TREATMENT PATHWAYS TOWARDS GCC AND IMPROVE PATIENT OUTCOMES IS AN IMPORTANT CONTRIBUTION TO IMPROVING CLINICAL PRACTICE FOR INDIVIDUALS LIVING WITH SCHIZOPHRENIA. PURSUANT TO THE GOALS OF PAR-19-189, THE OBJECTIVE OF THIS PILOT SERVICES RESEARCH IS TO IDENTIFY MUTABLE HEALTH CARE SYSTEM FACTORS RELATED TO ACCESS AND QUALITY OF MENTAL HEALTH SERVICES. USING COMPREHENSIVE HEALTH INSURANCE ENROLLMENT AND CLAIMS DATA FROM MASSACHUSETTS WE QUANTIFY AND EXAMINE VARIATION IN INSURANCE NETWORKS FOR THOSE WITH SCHIZOPHRENIA, EXAMINE ASSOCIATIONS OF THESE NETWORK CHARACTERISTICS – INCLUDING SIZE AND COMPOSITION (REFLECTING AVAILABILITY OF MENTAL HEALTH CLINICIANS) – WITH PATIENT OUTCOMES OF GUIDELINE-CONCORDANT CARE RECEIPT AND SELF-HARM. AS A POTENTIAL MECHANISM FOR UNDERSTANDING HOW INSURANCE NETWORKS MAY INFLUENCE PATIENT OUTCOMES, WE EXAMINE ASSOCIATIONS OF ORGANIZATIONAL CHARACTERISTICS – ORGANIZATION SIZE AND PROPORTION OF MENTAL HEALTH CLINICIANS – WITH PATIENT OUTCOMES. WE CONDUCT SENSITIVITY ANALYSES LIMITING TO INDIVIDUALS WITH FIRST EPISODE PSYCHOSIS DUE TO THE CLINICAL URGENCY OF COMPREHENSIVE CARE AND POLICY INTEREST IN THIS POPULATION, AND ESTABLISH A CAUSAL RELATIONSHIP BETWEEN INSURANCE NETWORKS AND ORGANIZATIONS AND OUTCOMES USING A YOUNG ADULT SAMPLE. UNDERSTANDING FACTORS ASSOCIATED WITH GCC AND OUTCOMES WILL HELP IDENTIFY EFFECTIVE POLICY LEVERS TO IMPROVE CARE. FINDINGS FROM THIS PILOT STUDY WILL GUIDE FUTURE IMPROVEMENTS IN MENTAL HEALTH SERVICES DELIVERY, AS WELL AS IDENTIFY AVENUES FOR FUTURE RESEARCH ON POLICY CHANGES INFLUENCING CRITICAL SYSTEM CHARACTERISTICS.

THESE FUNDS FOR COASTAL BEND BAYS &AMPAND ESTUARIES PROGRAM (CBBEP) SUPPORT IMPLEMENTATION OF THE COMPREHENSIVE CONSERVATION AND MANAGEMENT PLAN (CCMP) AND ACCOMPANYING STRATEGIC PLAN TO IMPROVE THE WATER QUALITY, PROTECT THE NATURAL HABITAT AND LIVING RESOURCES, AND SUPPORT SUSTAINABLE HUMAN USES OF THE COASTAL BEND BAYS &AMPAND ESTUARIES. ACTIVITIES INCLUDE ASSESSING TRENDS IN WATER QUALITY, NATURAL RESOURCES AND USESAND COORDINATING IMPLEMENTATION OF THE CCMP BY THE STATE, AS WELL AS FEDERAL AND LOCAL AGENCIESAND AND MONITORING THE EFFECTIVENESS OF ACTIVITIES CONDUCTED UNDER THE CCMP. SUBRECIPIENT INCLUDES A LOCAL UNIVERSITY IN THE CORPUS CHRISTI AREA. DIRECT BENEFICIARIES INCLUDE VISITORS AND RESIDENTS IN THE COAST BEND BAYS AND ESTUARY AREA.

IDENTIFYING EFFECTIVE STRATEGIES TO IMPROVE PARTICIPATION IN CARDIAC REHABILITATION AFTER AN ACUTE CARDIAC HOSPITALIZATION

THIS PROJECT IMPLEMENTS RECOMMENDATIONS OF THE COMPREHENSIVE CONSERVATION AND MANAGEMENT PLAN (CCMP) REGARDING RESTORATION OF DISAPPEARING COASTAL HA

A COOPERATIVE AGREEMENT IS PROVIDED TO THE COASTAL BEND BAYS & ESTUARIES PROGRAM (CBBEP) TO SUPPORT IMPLEMENTATION OF THE COMPREHENSIVE CONSERVATION AND MANAGEMENT PLAN (CCMP) AND ACCOMPANYING STRATEGIC PLAN TO IMPROVE THE WATER QUALITY, PROTECT THE NATURAL HABITAT AND LIVING RESOURCES, AND SUPPORT SUSTAINABLE HUMAN USES OF THE COASTAL BEND BAYS & ESTUARIES. ACTIVITIES INCLUDE ASSESSING TRENDS IN WATER QUALITY, NATURAL RESOURCES AND USES; COORDINATING IMPLEMENTATION OF THE CCMP BY THE STATE, AS WELL AS FEDERAL AND LOCAL AGENCIES; AND MONITORING THE EFFECTIVENESS OF ACTIVITIES CONDUCTED UNDER THE CCMP.

STAFFING FOR ADEQUATE FIRE AND EMERGENCY RESPONSE (SAFER)

FINANCIAL ASSISTANCE AWARD

A COOPERATIVE AGREEMENT IS PROVIDED TO THE COASTAL BEND BAYS & ESTUARIES PROGRAM (CBBEP) TO SUPPORT IMPLEMENTATION OF THE COMPREHENSIVE CONSERVATION AND MANAGEMENT PLAN (CCMP) AND ACCOMPANYING STRATEGIC PLAN TO IMPROVE THE WATER QUALITY, PROTECT THE NATURAL HABITAT AND LIVING RESOURCES, AND SUPPORT SUSTAINABLE HUMAN USES OF THE COASTAL BEND BAYS & ESTUARIES. ACTIVITIES INCLUDE ASSESSING TRENDS IN WATER QUALITY, NATURAL RESOURCES AND USES; COORDINATING IMPLEMENTATION OF THE CCMP BY THE STATE, AS WELL AS FEDERAL AND LOCAL AGENCIES; AND MONITORING THE EFFECTIVENESS OF ACTIVITIES CONDUCTED UNDER THE CCMP.

THIS PROJECT IMPLEMENTS RECOMMENDATIONS OF THE COMPREHENSIVE CONSERVATION AND MANAGEMENT PLAN (CCMP) REGARDING RESTORATION OF DISAPPEARING COASTAL HA

THIS PROJECT IMPLEMENTS RECOMMENDATIONS OF THE COMPREHENSIVE CONSERVATION AND MANAGEMENT PLAN (CCMP) REGARDING RESTORATION OF DISAPPEARING COASTAL HA

THIS PROJECT FOCUSES ON THE IMPLEMENTATION OF THE COMPREHENSIVE CONSERVATION AND MANAGEMENT PLAN (CCMP) TO RESTORE AND MAINTAIN THE CHEMICAL, PHYSICAL AND BIOLOGICAL INTEGRITY OF THE ESTUARY THROUGH TASKS OUTLINED IN THE COASTAL BEND BAYS & ESTUARIES PROGRAM (CBBEP) WORK PLAN. ACTIVITIES INCLUDE COASTAL BIRD MANAGEMENT, MONITORING, PUBLIC EDUCATION AND PUBLIC AWARENESS.

THIS PROJECT IMPLEMENTS RECOMMENDATIONS OF THE COMPREHENSIVE CONSERVATION AND MANAGEMENT PLAN (CCMP) REGARDING RESTORATION OF DISAPPEARING COASTAL HABITATS OF THE COASTAL BEND ESTUARIES THROUGH TASKS OUTLINED IN THE COASTAL BEND BAYS & ESTUARIES PROGRAM, INC., (CBBEP) ANNUAL WORK PLAN.

THIS PROJECT IMPLEMENTS RECOMMENDATIONS OF THE COMPREHENSIVE CONSERVATION AND MANAGEMENT PLAN (CCMP) REGARDING RESTORATION OF DISAPPEARING COASTAL HA

THIS AWARD WILL PROVIDE FUNDING FOR IMPLEMENTATION OF THE DELAWARE INLAND BAYS EPA-APPROVED COMPREHENSIVE CONSERVATION AND MANAGEMENT PLAN (CCMP) UND

THIS PROJECT IMPLEMENTS RECOMMENDATIONS OF THE COMPREHENSIVE CONSERVATION AND MANAGEMENT PLAN (CCMP) REGARDING RESTORATION OF DISAPPEARING COASTAL HA

THIS PROJECT UNDER THE NATIONAL ESTUARY PROGRAM IMPLEMENTS RECOMMENDATIONS OF THE COMPREHENSIVE CONSERVATION AND MANAGEMENT PLAN (CCMP) TO RESTORE I

RESEARCH AND MENTORING IN COMPARATIVE EFFECTIVENESS AND IMPLEMENTATION SCIENCE

THIS PROJECT IMPLEMENTS RECOMMENDATIONS OF THE COMPREHENSIVE CONSERVATION AND MANAGEMENT PLAN (CCMP) REGARDING RESTORATION OF DISAPPEARING COASTAL HA

HEALTH CARE AND OTHER FACILITIES

COMPARING NONINVASIVE AND INVASIVE VENTILATION IN ACUTE RESPIRATORY FAILURE

PURPOSE: TO PROMOTE ECONOMIC REVITALIZATION AND COMMUNITY DEVELOPMENT THROUGH INVESTMENT IN AND FINANCIAL ASSISTANCE TO COMMUNITY DEVELOPMENT FINANCIAL INSTITUTIONS (CDFIS). PLANNED ACTIVITIES: FINANCIAL ASSISTANCE MUST BE USED FOR FINANCIAL PRODUCTS, FINANCIAL SERVICES (REGULATED INSTITUTIONS ONLY), DEVELOPMENT SERVICES, LOAN LOSS RESERVES, AND CAPITAL RESERVES (REGULATED INSTITUTIONS ONLY), IN AN ELIGIBLE MARKET OR THE RECIPIENT’S APPROVED TARGET MARKET. END GOALS: THE GOAL OF THE FINANCIAL ASSISTANCE IS FOR CDFIS TO BUILD THEIR FINANCIAL CAPACITY TO LEND TO ELIGIBLE MARKETS AND/OR THEIR TARGET MARKETS, IN ORDER TO SERVE RURAL AND URBAN LOW INCOME PEOPLE, AND COMMUNITIES ACROSS THE NATION THAT LACK ADEQUATE ACCESS TO AFFORDABLE FINANCIAL PRODUCTS AND FINANCIAL SERVICES. BENEFICIARIES: PROFIT ORGANIZATION, PRIVATE NONPROFIT INSTITUTION/ORGANIZATION, OTHER PRIVATE INSTITUTION/ORGANIZATION INVESTMENT AREAS AND TARGETED POPULATIONS, AS DEFINED IN 12 C.F.R. 1805. SUBRECIPIENTS: THERE ARE NO SUBRECIPIENTS FOR THIS PROGRAM. BROADBAND: SPECIFIC ACTIVITIES RELATING TO BROADBAND USAGE ARE NOT KNOWN AT THE TIME OF AWARD. REASON/PURPOSE OF MODIFICATION: THE RIEGLE ACT (P.L. 103 325), THE STATUTE WHICH AUTHORIZES THE CDFI PROGRAM, REQUIRES THAT FINANCIAL ASSISTANCE AWARDS, INCLUDING BASE FINANCIAL ASSISTANCE (BASE FA), DISABILITY FUNDS FINANCIAL ASSISTANCE (DF FA), AND PERSISTENT POVERTY COUNTIES FINANCIAL ASSISTANCE (PPC FA), BE MATCHED WITH FUNDS FROM NON FEDERAL GOVERNMENT SOURCES AND COMPARABLE IN FORM AND VALUE TO THE FA AWARD. MODIFICATIONS WOULD BE REQUIRED IF THERE IS A CHANGE IN THE FORM AND/OR AMOUNT ORIGINALLY OBLIGATED FOR THE AWARD, BASED ON APPROVED MATCHING FUNDS. NOTE: MATCHING FUNDS ARE REQUIRED ONLY FOR ORGANIZATIONS APPLYING AS CATEGORY II/CORE FA APPLICANTS UNDER THE CDFI PROGRAM. MATCHING FUNDS ARE NOT REQUIRED FOR ANY NATIVE CDFI APPLICANTS OR HOUSING PRODUCTION FINANCIAL ASSISTANCE AWARDS (HP FA). ADDITIONALLY, MATCHING FUNDS ARE NOT REQUIRED FOR SMALL AND EMERGING CDFI ASSISTANCE (SECA) FA APPLICANTS AND HEALTHY FOOD FINANCING INITIATIVES (HFFI) FA APPLICANTS, PENDING FINAL FY 2025 APPROPRIATIONS LANGUAGE.

STEPPED CARE VERSUS CENTER-BASED CARDIOPULMONARY REHABILITATION FOR OLDER FRAIL ADULTS LIVING IN RURAL MA - PROJECT SUMMARY CARDIAC REHABILITATION (CR) DECREASES MORTALITY AND BOTH CR AND PULMONARY REHABILITATION (PR) IMPROVE FUNCTION, QUALITY OF LIFE, AND DECREASE READMISSION RATES. DESPITE THEIR PROVEN EFFICACY, BOTH PROGRAMS ARE GROSSLY UNDERUTILIZED, WITH FEWER THAN 20% OF ELIGIBLE PERSONS PARTICIPATING. PATIENTS WITH HEART AND LUNG DISEASE LIVING IN RURAL COMMUNITIES HAVE EVEN LOWER RATES OF PARTICIPATION. THE OBJECTIVE OF THIS PROPOSAL IS TO TEST THE FEASIBILITY OF PERFORMING A FULL-SCALE RANDOMIZED CONTROLLED TRIAL (RCT) TO COMPARE THE EFFECTIVENESS AND VALUE OF A STEPPED CARE (SC) MODEL VERSUS TREATMENT AS USUAL (TAU) IN OLDER FRAIL ADULTS LIVING RURAL COUNTIES. TAU REFERS TO CENTER-BASED REHABILITATION (CBR). THE SC MODEL INCLUDES INITIAL ENROLLMENT INTO CBR FOLLOWED BY POSSIBLE STEP UP TO THREE INTERVENTIONS BASED ON PRESPECIFIED NON-RESPONSE CRITERIA: 1) TRANSPORTATION-SUBSIDIZED CBR, 2) HOME-BASED TELEREHABILITATION (TR), AND 3) COMMUNITY HEALTH WORKER-(CHW) SUPPORTED HOME-BASED TR. UNLIKE TRADITIONAL SC MODELS, THE INITIAL TREATMENT IN THIS MODEL, I.E. CBR, IS NOT THE LEAST RESOURCE INTENSIVE. CBR WAS CHOSEN AS THE INITIAL OPTION BECAUSE IT IS CURRENTLY CONSIDERED THE STANDARD OF CARE. WE WILL CONDUCT A PARALLEL, 2-ARM, RANDOMIZED CONTROLLED FEASIBILITY TRIAL. ELIGIBLE PARTICIPANTS WILL BE RANDOMIZED TO TAU (CBR) OR SC. BECAUSE OF THE URGENT NEED TO ADDRESS UNDERUSE OF BOTH CR AND PR IN RURAL REGIONS, THE PROPOSED FEASIBILITY TRIAL WILL ENROLL PATIENTS REFERRED TO EITHER CR OR PR. BOTH ARMS INCLUDE AN IN-PERSON INTAKE EVALUATION CONDUCTED BY A CERTIFIED REHABILITATION NURSE IN THE REHABILITATION CENTER TO DETERMINE EXERCISE TOLERANCE AND DESIGN A TAILORED 8-WEEK REHABILITATION PROGRAM. PATIENTS RANDOMIZED TO TAU PARTICIPATE IN TWO WEEKLY SESSIONS AT THE CENTER AND ARE ENCOURAGED TO EXERCISE AT HOME IN BETWEEN SESSIONS. PATIENTS RANDOMIZED TO THE SC ARM WILL ALSO BE ENROLLED IN THE CBR PROGRAM. THOSE WHO MEET PRESPECIFIED NON- RESPONSE CRITERIA WILL BE STEPPED UP TO TRANSPORTATION-SUBSIDIZED CBR. PROVIDING TRANSPORTATION MAY NOT BE SUFFICIENT FOR FRAIL OLDER ADULTS WHO ARE RELUCTANT TO LEAVE THEIR HOMES IN THE WINTER, UNFAMILIAR WITH EXERCISING, OR DO NOT WANT TO EXERCISE IN A GROUP SETTING. THUS, NON-RESPONDERS, WILL BE STEPPED UP TO HOME-BASED TR. HOME-BASED REHABILITATION WILL BE SUPPORTED BY CHANL HEALTH, A VIRTUAL PLATFORM THAT SUPPORTS EDUCATION AND SELF-MANAGEMENT, REMOTE MONITORING, AND COACHING BY REHABILITATION SPECIALISTS. NON-RESPONDERS WILL BE STEPPED UP TO CHW-SUPPORTED HOME-BASED TR. THE CHW WILL BE HELP PARTICIPANTS USE THE MOBILE APP, ACCESS EDUCATIONAL MATERIALS, CLARIFY EDUCATIONAL CONTENT, AND EXERCISE DURING BIWEEKLY IN-PERSON VISITS. IF THE FEASIBILITY TRIAL IS SUCCESSFUL, WE WILL PROCEED TO CONDUCT A PARALLEL, 2-ARM, SINGLE BLIND, MULTI-SITE SUPERIORITY RCT TO COMPARE THE EFFECTIVENESS AND VALUE (COST-EFFECTIVENESS) OF SC VERSUS TAU (CBR) IN OLDER FRAIL ADULTS LIVING RURAL COUNTIES. OUR LONG-TERM OBJECTIVE IS TO PROVIDE HOSPITAL SYSTEMS WITH HIGH QUALITY EVIDENCE ON HOW BEST TO OPTIMIZE UPTAKE OF CR AND PR FOR OLDER FRAIL ADULTS LIVING IN RURAL COMMUNITIES.

A COMMUNITY HEALTH WORKER INTERVENTION TO IMPROVE LUNG CANCER SCREENING UPTAKE IN COMMUNITY HEALTH CENTERS SERVING BLACK AND HISPANIC COMMUNITIES - PROJECT SUMMARY: LUNG CANCER IS THE LEADING CAUSE OF CANCER DEATH, AND LUNG CANCER SCREENING (LCS) CAN REDUCE LUNG CANCER- RELATED MORTALITY BY 20%. HOWEVER, ONLY 5-10% OF ELIGIBLE INDIVIDUALS HAVE RECEIVED AN INITIAL LCS EXAM, WITH BLACK AND HISPANIC INDIVIDUALS LESS LIKELY TO BE SCREENED AND MORE LIKELY TO SUFFER DELAYS IN DIAGNOSIS AND TREATMENT, CONTRIBUTING TO HIGHER MORTALITY FROM LUNG CANCER. COMMUNITY HEALTH WORKERS (CHWS) ARE AN EFFECTIVE STRATEGY TO PROMOTE SCREENING AND MITIGATE DISPARITIES IN OTHER CANCER SETTINGS. WHETHER CHWS CAN BE EFFECTIVE IN THE CONTEXT OF LCS AND ADDRESS KEY BARRIERS TO RECEIVING LCS REMAINS UNKNOWN. THE GOAL OF THIS STUDY IS TO DEVELOP AND PILOT TEST A FOUR-PART CHW INTERVENTION TO IMPROVE LCS UPTAKE AND MITIGATE DISPARITIES, WHICH INCLUDES: 1) PATIENT OUTREACH, 2) PATIENT-CENTERED SHARED DECISION-MAKING, 3) SMOKING CESSATION COUNSELING, AND 4) NAVIGATION OF LOGISTICAL BARRIERS. OUR CENTRAL HYPOTHESIS, BASED ON OUR QUALITATIVE WORK AND INFORMED BY THE EXPANDED HEALTH BELIEF MODEL, POSITS THAT CHWS CAN ADDRESS KEY MODIFIABLE FACTORS TO IMPROVE LCS AWARENESS, ENGAGEMENT, AND BARRIERS TO ACCESSING CARE, LEADING TO INCREASED LCS UPTAKE OVERALL AND AMONG BLACK AND HISPANIC COMMUNITIES. OUR AIMS ARE TO: JOINTLY “TRANSCREATE” A CHW INTERVENTION TO INCREASE LCS UPTAKE AMONG PATIENTS SERVED BY COMMUNITY HEALTH CENTERS (AIM 1); CONDUCT A PILOT RANDOMIZED CONTROLLED TRIAL OF THE CHW INTERVENTION (AIM 2A); AND OBTAIN EMPIRIC ESTIMATES OF EFFECT SIZE IN LCS AND TOBACCO TREATMENT UTILIZATION (AIM 2B). WE FIRST SEEK TO JOINTLY “TRANSCREATE” A CHW INTERVENTION WITH OUR COMMUNITY ADVISORY BOARD, COMPRISED OF KEY STAKEHOLDERS IN LCS AND PATIENTS WITH LIVED EXPERIENCE, APPLYING THE TRANSCREATION FRAMEWORK FOR COMMUNITY-ENGAGED BEHAVIORAL INTERVENTIONS TO REDUCE HEALTH DISPARITIES. THEN WE WILL CONDUCT A PILOT RANDOMIZED CONTROLLED TRIAL OF THE CHW INTERVENTION AT BAYSTATE HEALTH’S THREE COMMUNITY HEALTH CENTERS. WE WILL RANDOMIZE 80 LCS-ELIGIBLE INDIVIDUALS (40 IN EACH ARM) TO EITHER THE CHW-LED INTERVENTION OR ENHANCED USUAL CARE (I.E., MAILED LCS EDUCATIONAL MATERIALS AND USUAL LCS AS PER PRIMARY CARE PROVIDER). PRIMARY PILOT OUTCOMES ARE FOCUSED ON FEASIBILITY, INCLUDING PARTICIPANT RECRUITMENT, MEASURE COMPLETION, RETENTION, FIDELITY, AND ACCEPTABILITY. WE WILL ALSO CONDUCT AN EVALUATION OF SECONDARY TRIAL OUTCOMES, INCLUDING LCS AND TOBACCO TREATMENT UTILIZATION, AS WELL AS EXPLORE POTENTIAL MEDIATORS (E.G., KNOWLEDGE, FACILITATION OF LOGISTICAL BARRIERS). THE PROPOSED ACTIVITIES WILL PROVIDE ME CRUCIAL SKILLS IN HEALTH EQUITY RESEARCH, IMPLEMENTATION SCIENCE, AND CLINICAL TRIAL DESIGN, AND LAUNCH MY CAREER AS A CLINICIAN-SCIENTIST DEDICATED TO ADDRESSING HEALTH DISPARITIES. THIS WORK WILL ALSO LAY THE GROUNDWORK FOR A SUBSEQUENT R01 GRANT CONDUCTING A FULLY POWERED RANDOMIZED CONTROLLED TRIAL OF THE CHW INTERVENTION THAT DIRECTLY ADDRESSES TOP PRIORITIES FROM THE PRESIDENT’S CANCER MOONSHOT AND NCI’S MISSION TO DEVELOP MULTI- LEVEL INTERVENTIONS THAT FACILITATE EQUITABLE ACCESS TO CANCER SCREENING AND REDUCE LUNG CANCER MORTALITY.

THIS PROJECT IMPLEMENTS RECOMMENDATIONS OF THE COMPREHENSIVE CONSERVATION AND MANAGEMENT PLAN (CCMP) REGARDING RESTORATION OF DISAPPEARING COASTAL HA

ONE MISSION: A COMPREHENSIVE SERVICE PROGRAM FOR VICTIMS OF HUMAN TRAFFICKING (ONE MISSION)

PURPOSE: TO PROMOTE ECONOMIC REVITALIZATION AND COMMUNITY DEVELOPMENT THROUGH INVESTMENT IN AND FINANCIAL ASSISTANCE TO COMMUNITY DEVELOPMENT FINANCIAL INSTITUTIONS (CDFIS). PLANNED ACTIVITIES: FINANCIAL ASSISTANCE MUST BE USED FOR FINANCIAL PRODUCTS, FINANCIAL SERVICES (REGULATED INSTITUTIONS ONLY), DEVELOPMENT SERVICES, LOAN LOSS RESERVES, AND CAPITAL RESERVES (REGULATED INSTITUTIONS ONLY), IN AN ELIGIBLE MARKET OR THE RECIPIENT’S APPROVED TARGET MARKET. END GOALS: THE GOAL OF THE FINANCIAL ASSISTANCE IS FOR CDFIS TO BUILD THEIR FINANCIAL CAPACITY TO LEND TO ELIGIBLE MARKETS AND/OR THEIR TARGET MARKETS, IN ORDER TO SERVE RURAL AND URBAN LOW INCOME PEOPLE, AND COMMUNITIES ACROSS THE NATION THAT LACK ADEQUATE ACCESS TO AFFORDABLE FINANCIAL PRODUCTS AND FINANCIAL SERVICES. BENEFICIARIES: PROFIT ORGANIZATION, PRIVATE NONPROFIT INSTITUTION/ORGANIZATION, OTHER PRIVATE INSTITUTION/ORGANIZATION INVESTMENT AREAS AND TARGETED POPULATIONS, AS DEFINED IN 12 C.F.R. 1805. SUBRECIPIENTS: THERE ARE NO SUBRECIPIENTS FOR THIS PROGRAM. BROADBAND: SPECIFIC ACTIVITIES RELATING TO BROADBAND USAGE ARE NOT KNOWN AT THE TIME OF AWARD. REASON/PURPOSE OF MODIFICATION: THE RIEGLE ACT (P.L. 103 325), THE STATUTE WHICH AUTHORIZES THE CDFI PROGRAM, REQUIRES THAT FINANCIAL ASSISTANCE AWARDS, INCLUDING BASE FINANCIAL ASSISTANCE (BASE FA), DISABILITY FUNDS FINANCIAL ASSISTANCE (DF FA), AND PERSISTENT POVERTY COUNTIES FINANCIAL ASSISTANCE (PPC FA), BE MATCHED WITH FUNDS FROM NON FEDERAL GOVERNMENT SOURCES AND COMPARABLE IN FORM AND VALUE TO THE FA AWARD. MODIFICATIONS WOULD BE REQUIRED IF THERE IS A CHANGE IN THE FORM AND/OR AMOUNT ORIGINALLY OBLIGATED FOR THE AWARD, BASED ON APPROVED MATCHING FUNDS. NOTE: MATCHING FUNDS ARE REQUIRED ONLY FOR ORGANIZATIONS APPLYING AS CATEGORY II/CORE FA APPLICANTS UNDER THE CDFI PROGRAM. MATCHING FUNDS ARE NOT REQUIRED FOR ANY NATIVE CDFI APPLICANTS OR HOUSING PRODUCTION FINANCIAL ASSISTANCE AWARDS (HP FA). ADDITIONALLY, MATCHING FUNDS ARE NOT REQUIRED FOR SMALL AND EMERGING CDFI ASSISTANCE (SECA) FA APPLICANTS AND HEALTHY FOOD FINANCING INITIATIVES (HFFI) FA APPLICANTS, PENDING FINAL FY 2025 APPROPRIATIONS LANGUAGE.

ECONOMIC DEVELOPMENT INITIATIVE, COMMUNITY PROJECT FUNDING, AND MISCELLANEOUS GRANTS

ONE MISSION: A COMPREHENSIVE SERVICE PROGRAM FOR VICTIMS OF HUMAN TRAFFICKING

ARRA 14 1610 R2FA INDIAN POINT SALTMARSH RESTORATION NUECES COUNTY, TEXAS

ENHANCING DELIVERY OF PARENTING SUPPORT WITHIN A PEER RECOVERY SUPPORT SERVICE MODEL - PROJECT SUMMARY/ABSTRACT PARENTAL SUBSTANCE USE DISORDERS (SUDS) DISRUPT THE PARENT-CHILD RELATIONSHIP, RESULTING IN DETRIMENTAL EFFECTS FOR BOTH PARENTAL RECOVERY AND LONG-TERM CHILD HEALTH, BEHAVIOR, AND DEVELOPMENT. WHILE PARENTING STRESS MAY BE A POTENT TRIGGER FOR DRUG CRAVINGS AND RELAPSE AMONG PARENTS WITH SUDS, WITH ADEQUATE SUPPORT THE PARENT- CHILD RELATIONSHIP CAN SERVE AS A SOURCE OF JOY, PURPOSE, AND AN IMPORTANT MOTIVATOR TO SEEK RECOVERY. FAMILY- FOCUSED PEER RECOVERY SUPPORT SERVICE (PRSS) HAS EMERGED AS A POTENTIAL APPROACH FOR PROVIDING COMPREHENSIVE SUPPORT TO FAMILIES AFFECTED BY SUDS. HOWEVER, THE PRSS MODEL FACES CHALLENGES TO ACHIEVING THE FULL BIGENERATIONAL BENEFIT FOR FAMILIES BECAUSE PEER SUPPORT SPECIALISTS OFTEN STRUGGLE TO DELIVER PARENTING SUPPORT IN THIS CONTEXT. WE PROPOSE TAILORING AN IMPLEMENTATION STRATEGY BUNDLE AIMED AT IMPROVING DELIVERY OF EVIDENCE-BASED PARENTING SUPPORT FOR A PEER RECOVERY SUPPORT SPECIALIST AUDIENCE. THE MULTILEVEL IMPLEMENTATION BUNDLE, CALLED RELATIONAL HEALTH ENHANCED PARENTING SUPPORT (RHEP), INCLUDES TRAINING, CONSULTATION, AND IMPLEMENTATION BLUEPRINT MAPPING TO HELP OVERCOME BARRIERS TO THE DELIVERY OF PARENTING SUPPORT. BUILDING UPON A LONGSTANDING COMMUNITY-ACADEMIC PARTNERSHIP, WE WILL COLLABORATE WITH THE MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH (MDPH) AND THEIR SPECIALIZED HOME VISITING PROGRAM FIRST STEPS TOGETHER (FST) TO TEST RHEP. FST IS CENTERED ON THE FAMILY-FOCUSED PRSS MODEL AND IS DELIVERED AT SIX SITES ACROSS THE STATE. RHEP-ENHANCED IMPLEMENTATION OF PARENTING SUPPORT HAS THE POTENTIAL TO AMPLIFY THE ONGOING WORK OF FST PEER STAFF BY TRULY INTEGRATING PARENTING AND RECOVERY SUPPORTS WITHIN A SCALABLE MODEL. IN PHASE 1 (R61), WE WILL REFINE RHEP TRAINING AND CONSULTATION MATERIALS AND PROCEDURES FOR THE PRSS MODEL AND WORKFORCE WITH ENGAGEMENT FROM OUR COMMUNITY PARTNERS. FURTHERMORE, WE WILL CO-CREATE AN AGENCY-LEVEL IMPLEMENTATION BLUEPRINT FOR FST, OPERATIONALIZED VIA A TAILORED STAGES OF IMPLEMENTATION COMPLETION® TOOL TO EVALUATE THE IMPLEMENTATION PROCESS. IN PHASE 2 (R33), WE PROPOSE A HYBRID STEPPED-WEDGE CLUSTER RANDOMIZED DESIGN WITH SIX SITES TO TEST THE EFFECTIVENESS AND IMPLEMENTATION OF FST PLUS RHEP. WE WILL: (AIM 1) DETERMINE THE EFFECTIVENESS OF FST ALONE VERSUS FST PLUS RHEP TO IMPROVE PARENTING-RELATED FACTORS, SUD TREATMENT RETENTION, AND REDUCTION IN SUBSTANCE USE; (AIM 2) INVESTIGATE VARIATION IN THE IMPLEMENTATION PROCESS ACROSS SITES TO INFORM FUTURE DISSEMINATION; AND (AIM 3) EXAMINE THE UNIQUE IMPACT OF PEER STAFF ON IMPLEMENTATION AND EFFECTIVENESS OUTCOMES. UPON COMPLETION OF THIS STUDY, WE WILL HAVE GAINED KEY INSIGHTS INTO THE DELIVERY OF EFFECTIVE SUPPORT FOR PARENTS IN RECOVERY AND INTO CRITICAL FACTORS INFLUENCING PEER WORKFORCE DEVELOPMENT, AND WE WILL PRODUCE AN IMPLEMENTATION TOOLKIT TO FACILITATE DISSEMINATION OF PARENTING SUPPORT ACROSS PEER-LED NON-CLINICAL MODELS OF CARE. THIS STUDY IS PART OF THE NIH’S HELPING TO END ADDICTION LONG-TERM (HEAL) INITIATIVE TO SPEED SCIENTIFIC SOLUTIONS FOR THE OVERDOSE EPIDEMIC, INCLUDING OPIOID AND STIMULANT USE DISORDERS. THE NIH HEAL INITIATIVE BOLSTERS RESEARCH ACROSS NIH TO ADDRESS THE NATIONAL OPIOID PUBLIC HEALTH CRISIS AND IMPROVE TREATMENT FOR OPIOID MISUSE AND ADDICTION.

THIS ACTION PROVIDES FUNDING IN THE AMOUNT OF $422,857 TO THE COASTAL BEND BAYS AND ESTUARIES PROGRAM INC, OF TEXAS TO ASSIST IN THE DEVELOPMENT OF A LITTER PREVENTION PROGRAM TO IMPROVE WATER QUALITY IN THE GULF OF MEXICO WATERSHEDS.

IMPROVING PARTICIPATION IN PULMONARY REHABILITATION THROUGH PEER-SUPPORT AND STORYTELLING - ABSTRACT EXACERBATIONS OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) LEAD TO ROUGHLY 1.5 MILLION ED VISITS AND 700,000 HOSPITALIZATIONS ANNUALLY. RECOVERY IS SLOW, AND ACCOMPANIED BY HIGH LEVELS OF ACUTE CARE UTILIZATION AND MORTALITY. PULMONARY REHABILITATION (PR) IS A STRUCTURED PROGRAM OF EXERCISE AND SELF-MANAGEMENT SUPPORT THAT HAS BEEN SHOWN TO RELIEVE DYSPNEA AND IMPROVE QUALITY OF LIFE. CLINICAL GUIDELINES RECOMMEND PR FOR PATIENTS WITH STABLE COPD AND AFTER AN EXACERBATION. UNFORTUNATELY, EVEN WHEN REFERRED BY PHYSICIANS, OUR RESEARCH HAS SHOWN THAT FEW PATIENTS WHO MIGHT BENEFIT FROM PR EVER BEGIN TREATMENT. THE PRIMARY GOAL OF THIS PROJECT IS TO IDENTIFY EFFECTIVE STRATEGIES FOR PROMOTING AND SUSTAINING PARTICIPATION IN PR. PEER SUPPORT INVOLVES PAIRING A PATIENT WITH A TRAINED PEER FROM A SIMILAR BACKGROUND, AND FACING SIMILAR HEALTH CHALLENGES, WHO HAS COMPLETED PR. THERE IS A GROWING BODY OF EVIDENCE DEMONSTRATING THE FEASIBILITY, ACCEPTABILITY, AND EFFECTIVENESS OF TELEPHONIC PEER SUPPORT FOR CHRONIC DISEASE MANAGEMENT. NARRATIVE INTERVENTIONS, OR `STORYTELLING', ARE NOVEL APPROACHES FOR CHANGING ATTITUDES AND BEHAVIORS OF PATIENTS THAT INVOLVE CREATING AND DISSEMINATING VIDEOS NARRATED BY INDIVIDUALS WITH LIVED EXPERIENCE WITH THE SAME CONDITION OR FACING THE SAME TREATMENT. STORYTELLING INTERVENTIONS HAVE BEEN SHOWN TO HELP PATIENTS ACHIEVE BETTER BLOOD PRESSURE CONTROL, AND STORYTELLING IS BEING STUDIED IN A VARIETY OF OTHER CLINICAL CONTEXTS. IN THE R61 PHASE, WE WILL RECRUIT AND TRAIN A COHORT OF PEER COACHES IN BEHAVIOR CHANGE TECHNIQUES, AND WILL RECRUIT A DIVERSE GROUP OF STORYTELLERS, CAPTURE THEIR NARRATIVES ON VIDEO, AND CREATE A LIBRARY OF 6-8 POWERFUL STORIES. WE WILL FINALIZE OUR PROTOCOL, TRIAL INFRASTRUCTURE, AND PILOT OUR RECRUITMENT STRATEGY. DURING THE R33 PHASE, WE WILL RECRUIT 305 ADULTS TREATED FOR EXACERBATION OF COPD, AND RANDOMIZE THEM TO 1) ENHANCED “USUAL CARE” (EUC); 2) EUC + STORYTELLING; OR 3) EUC + PEER SUPPORT. WE WILL EVALUATE THE EFFECTIVENESS OF EACH STRATEGY COMPARED TO EUC, AND TO EACH OTHER, AT PROMOTING PARTICIPATION IN PR AT 6 MONTHS. USING A MIXED-METHODS APPROACH, WE WILL EVALUATE INTERVENTION ACCEPTABILITY, SUSTAINABILITY, AND COST, FROM THE PERSPECTIVES OF THE PATIENTS AND PEER COACHES AS WELL AS PR PROGRAM STAFF AND HOSPITAL LEADERSHIP. WE WILL USE THESE FINDINGS TO REFINE THE STRATEGIES AND TO DISSEMINATE AN IMPLEMENTATION PACKAGE THAT WILL ENABLE OTHER PR PROGRAMS TO ADOPT THESE APPROACHES. THIS PROJECT ENGAGES KEY STAKEHOLDERS IN STUDY CONCEPTUALIZATION, EXECUTION, AND DISSEMINATION, AND IS RESPONSIVE TO THE NHLBI/CDC COPD NATIONAL ACTION PLAN THAT CALLS FOR THE DEVELOPMENT OF STRATEGIES TO INCREASE THE NUMBER OF AMERICANS THAT BENEFIT FROM PR.

IDENTIFYING FACTORS ASSOCIATED WITH HIGH QUALITY PEDIATRIC PRIMARY CARE

THIS ACTION APPROVES AN AWARD IN THE AMOUNT OF $406,377 TO THE COASTAL BEND BAYS AND ESTUARIES PROGRAM, INC. OF TEXAS TO CREATE THE 'UP2U PLUS' PROGRAM, WHICH WILL PREVENT TRASH FROM REACHING TEXAS COASTAL WATERWAYS BY BUILDING UPON AN EXISTING SUCCESSFUL LITTER PREVENTION CAMPAIGN TO ENCOURAGE PROPER TRASH DISPOSAL AND REDUCE ILLEGAL DUMPING.

FINANCIAL ASSISTANCE AWARD

GULF COAST CONSERVATION INITIATIVE 2016

HEALTH CARE AND OTHER FACILITIES

COASTAL BEND BAYS & ESTUARIES PROGRAM

STAFFING FOR ADEQUATE FIRE AND EMERGENCY RESPONSE (SAFER)

BOATHOUSE ROAD

HEALTH CARE AND OTHER FACILITIES

GCCI- ENDANGERED SPECIES HABITAT ENHANCEMENT

VALUE- ADDED AGRICULTURAL PRODUCT MARKET DEVELOPMENT GRANTS

ASSIST THE CBBEP IN IMPLEMENTING 3 HABITAT RESTORATION PROJECTS ON MATAGORDA ISLAND

CBBEP-GULF COASTL CONSERAVTION INIATIVE

GULF COAST CONSERVATION INITIATIVE 2014

ENHANCING MIGRATORY SHOREBIRD HABITAT THROUGH PRIVATE LANDS CONSERVATION PLANNING ON THE TEXAS COAST

VIRTUAL REALITY AT THE POINT OF CARE TO INCREASE UPTAKE OF MOUD IN THE ED - PROJECT SUMMARY DESPITE THE WIDESPREAD EFFORTS TO CURB THE OPIOID EPIDEMIC, THE NUMBER OF DRUG OVERDOSE DEATHS INCREASED BY NEARLY 30% FROM 2019 TO 2020, OF WHICH APPROXIMATELY 75% INVOLVED AN OPIOID. NIH AND SAMHSA HAVE DIRECTED SIGNIFICANT FUNDS TOWARDS IMPROVING ACCESS TO INCREASE THE NUMBERS OF PERSONS WITH OPIOID USE DISORDER (OUD) RECEIVING TREATMENT. HOWEVER, THE TREATMENT GAP CONTINUES TO GROW, WITH ONLY A SMALL MINORITY OF ELIGIBLE PATIENTS TAKING OPIOID AGONIST THERAPY (OAT). ALTHOUGH CURBING THE EPIDEMIC WILL REQUIRE EFFORTS ACROSS MULTIPLE SECTORS, AN IMMEDIATE GOAL IS TO INCREASE ADOPTION OF STRATEGIES ALREADY PROVEN TO BE EFFECTIVE. INITIATING BUPRENORPHINE IN THE EMERGENCY DEPARTMENT (ED) IS AN IMPORTANT LOW THRESHOLD STRATEGY TO IMPROVE ACCESS, YET IT REMAINS GROSSLY UNDERUTILIZED. INTERVENTIONS AIMED AT DECREASING SYSTEM AND PROVIDER LEVEL BARRIERS HAVE NOT INCREASED UPTAKE. THEREFORE, INCREASING ED-INITIATED BUPRENORPHINE RATES WILL LIKELY NOT BE REALIZED UNLESS PATIENT LEVEL BARRIERS (I.E., PREFERENCES) ARE EXPLICITLY ADDRESSED. THE OBJECTIVE OF THIS PROPOSAL IS TO DEVELOP AND TEST A NOVEL APPROACH USING VIRTUAL REALITY (VR) TO INCREASE UPTAKE OF BUPRENORPHINE IN THE ED. WE HYPOTHESIZE THAT PARTICIPATING IN AN IMMERSIVE VR EXPERIENCE MAY BE MORE EFFECTIVE THAN CURRENTLY AVAILABLE COUNSELING APPROACHES AND DECISION AIDS BASED ON THE SUPERIOR ABILITY OF VR TO ACTIVATE EMOTIONAL RESPONSES COMPARED TO OTHER MEDIA OR MOTIVATIONAL APPROACHES. OUR INTERVENTION IS BASED ON THE EMOTION- IMBUED CHOICE MODEL WHICH DESCRIBES THE MULTIPLE EFFECTS OF EMOTION ON DECISION MAKING AND BEHAVIOR. FOR EXAMPLE, POSITIVE AFFECT ENHANCES FLEXIBILITY AND WILLINGNESS TO EXAMINE ALTERNATIVE OPTIONS, AND ACTIVATION OF POSITIVE AFFECT IS A CONSISTENT FINDING OF VR EXPOSURE IN HEALTH-RELATED APPLICATIONS. DURING THE R21 PHASE WE WILL EMPLOY A STAKEHOLDER-CENTERED AND USER EXPERIENCE ITERATIVE DESIGN APPROACH TO DEVELOP AND OPTIMIZE AN IMMERSIVE VR EXPERIENCE DESIGNED TO MOTIVATE PATIENTS WITH MODERATE TO SEVERE OUD TO AGREE TO TREATMENT WITH BUPRENORPHINE WHILE IN THE ED. DURING THE R33 PHASE, WE WILL CONDUCT A PARALLEL, 2-ARM, RANDOMIZED CONTROLLED FEASIBILITY TRIAL. THE DATA GENERATED FROM THE FEASIBILITY TRIAL WILL DETERMINE THE FEASIBILITY OF PERFORMING A DEFINITIVE FULL-SCALE RANDOMIZED CONTROLLED TRIAL (RCT) TO ASCERTAIN WHETHER VR- CHOICE INCREASES THE RATE OF ED-INITIATED BUPRENORPHINE COMPARED TO TAU. ELIGIBLE PARTICIPANTS WILL BE RANDOMIZED 1:1 TO VR-CHOICE OR TREATMENT AS USUAL (TAU). WE HYPOTHESIZE THAT THIS FEASIBILITY RCT WILL MEET PRESPECIFIED PROCESS CRITERIA JUSTIFYING A FULL-SCALE RCT. THE FIVE PROCESS INDICATORS ARE AVERAGE NUMBER OF ELIGIBLE PATIENTS RANDOMIZED PER MONTH, BASELINE MEASURE COMPLETION, PROPORTION RANDOMIZED TO THE VR-CHOICE ARM COMPLETING THE VR PROGRAM, PROPORTION IN VR-CHOICE ARM DEVELOPING VR-RELATED SYMPTOMS, AND ACCEPTABILITY OF VR-CHOICE. EACH OF THESE PROCESS INDICATORS WILL BE EVALUATED BY PRESET “STOP” AND “GO” THRESHOLDS. WE WILL CONCLUDE THAT A FULL-SCALE RCT IS NOT FEASIBLE IF ONE OR MORE PROCESS CRITERIA MEET THE STOP THRESHOLD.

CRISFIELD COMMUNITY PREVENTION WORKS FREE COALITION

BETTER TOMORROW (BT) IS A PROJECT OF BAYSTATE HEALTH (BH), IN COORDINATION WITH ROCA, THE SPRINGFIELD POLICE DEPARTMENT AND THE HAMPDEN COUNTY DISTRICT ATTORNEY.  BH IS SEEKING $999,998.40 IN SUPPORT OF AN INNOVATIVE COMBINATION OF HOSPITAL-BASED VIOLENCE INTERVENTION SERVICES, A COMMUNITY-BASED LONG-TERM COGNITIVE INTERVENTION MODEL, RESTORATIVE JUSTICE, AND COMMUNITY ORGANIZING TO REDUCE VIOLENCE IN SPRINGFIELD, MA’S BIGGEST HOTSPOTS FOR GUN VIOLENCE.  WHILE THE HOSPITAL-BASED COMPONENT OF BT WILL SERVE ALL OF HAMPDEN COUNTY, THE PROJECT WILL FOCUS ON ITS COMMUNITY-BASED CRIME PREVENTION EFFORTS IN THE FOLLOWING SPRINGFIELD COMMUNITIES, BRIGHTWOOD, FOREST PARK, SOUTH END, METRO CENTER, MEMORIAL SQUARE, SIX CORNERS, OLD HILL, AND MCKNIGHT (NEIGHBORHOODS ENCOMPASSED BY ZIP CODES 01103, 01104, 01105, 01108, AND 01109.)     THE BT PARTNERSHIP, WHICH ALSO INCLUDES A VARIETY OF THE CRIMINAL JUSTICE AND COMMUNITY-BASED SERVICE PROVIDERS, IS FOCUSED ON REDUCING GUN VIOLENCE.  THE BT PARTNERSHIP IS COMMITTED TO CREATING LONG-TERM SUSTAINABLE CHANGE, MEASURABLE THROUGH THE REDUCTION IN VIOLENCE WITH A SPECIFIC FOCUS ON THE REDUCTION OF RETALIATORY VIOLENCE, WHILE AT THE SAME TIME PROMOTING POSITIVE ALTERNATIVES TO VIOLENCE. BT WILL FOCUS ITS COMMUNITY-BASED WORK ON YOUNG PEOPLE BETWEEN THE AGES OF 18 AND 25 WHO ARE DRIVING VIOLENCE IN THESE CRITICAL HOTSPOTS.    HOSPITAL-BASED WORK WILL BE DELIVERED TO ALL GUNSHOT VICTIMS TREATED THROUGH BH’S TRAUMA UNIT, AND THE HOSPITAL-BASED TEAM WILL REFER ALL YOUNG PEOPLE BETWEEN 18 AND 24 TO OUR COMMUNITY BASED SERVICES.    BT WILL PROMOTE POSITIVE ALTERNATIVES TO VIOLENCE AND SUPPORT POSITIVE SOCIOECONOMIC CHANGES THAT PREVENT REINJURY AND FOSTER HOSPITAL, CRIMINAL JUSTICE SYSTEM, AND COMMUNITY COLLABORATION TO ADVANCE EQUITABLE, ANTIRACIST, TRAUMA-INFORMED CARE TO PATIENTS.  BT WILL SUPPORT COMMUNITY-BASED ENGAGEMENT IN VIOLENCE REDUCTION AND IMPROVED RELATIONSHIPS AND COMMUNICATIONS BETWEEN POLICE AND OUR TARGETED COMMUNITIES.  FINALLY, BT WILL WORK TO CREATE SYSTEMS CHANGE WITHIN OUR CRIMINAL JUSTICE PARTNERS, INCREASING THEIR EFFECTIVENESS IN WORKING WITH OUR HIGHEST-RISK YOUNG PEOPLE.   BH WILL EMPLOY A FULL-TIME COORDINATOR TO SUPPORT THIS PROJECT AND WORK WITH OUR COMMUNITY BASED AND CRIMINAL JUSTICE PARTNERS TO COORDINATE ALL OF OUR VIOLENCE PREVENTION WORK UTILIZING A DATA-DRIVEN PLAN THAT WILL RESULT IN A REDUCTION IN GUN VIOLENCE IN SOME OF OUR MOST TROUBLED COMMUNITIES.  DATA WILL BE USED TO NOT ONLY UNDERSTAND COMMUNITY-LEVEL IMPACTS BUT ALSO THE BEHAVIOR CHANGES AND CHANGES IN VIOLENCE RELATED HEALTH OUTCOMES FOR ALL INDIVIDUALS SERVED BY BT.  THE BT PARTNERS WILL COORDINATE OUR WORK WITH THE US ATTORNEY’S OFFICE AND ALL OTHER FEDERALLY FUNDED VIOLENCE PREVENTION PROJECTS.

THIS ACTION PROVIDES FUNDING IN THE AMOUNT OF $235,901 TO THE COASTAL BEND BAYS & ESTUARIES PROGRAM FOR THE PROJECT TO RESTORE CIRCULATION AND HYDROL

AS DIRECTED BY SECTION 320 OF THE CLEAN WATER ACT (CWA), THIS PROJECT, UNDER THE NATIONAL ESTUARY PROGRAM (NEP), IMPLEMENTS RECOMMENDATIONS OF THE M

DESCRIPTION:THIS ASSISTANCE AGREEMENT PROVIDES FUNDING TO THE DELAWARE CENTER FOR THE INLAND BAYS TO IMPLEMENT ITS PROJECT TO CONSTRUCT A SUBMERGED GRAVEL WETLAND FOR WATER QUALITY BENEFITS AS DIRECTED IN THE 2024 CONSOLIDATED APPROPRIATIONS ACT OR AS IDENTIFIED IN AN APPROVED TECHNICAL CORRECTION IF ONE HAS BEEN APPROVED FOR THIS PROJECT. ACTIVITIES:THE ACTIVITIES TO BE PERFORMED INCLUDE THE EXECUTION AND IMPLEMENTATION OF A WATER QUALITY PROTECTION PROJECT. WORKPLAN ACTIVITIES CONSIST OF: CONSTRUCTION OF A SUBMERGED GRAVEL WETLAND WITH A CHECK DAM TO DIVERT RUNOFF FROM STORMWATER DITCHES INTO THE WATER QUALITY PRACTICE, AND AN EMERGENCY OVERFLOW FOR HIGH FLOW CONDITIONS. THE PROJECT LOCATION WAS SPECIFICALLY SELECTED FOR THE DEVELOPED NATURE AND LAND USE OF UPSTREAM DRAINAGE AREAS. STORMWATER RUNOFF WILL BE TREATED BY THE SUBMERGED GRAVEL WETLAND, RESULTING IN A DECREASE OF SEDIMENT AND OTHER STORMWATER POLLUTANTS IN THE INDIAN RIVER BAY WATERSHED. SUBRECIPIENT:NO SUBAWARDS ARE INCLUDED IN THIS ASSISTANCE AGREEMENT.OUTCOMES:THE ANTICIPATED DELIVERABLES INCLUDE A SUBMERGED GRAVEL WETLAND WATER QUALITY PRACTICE. THE EXPECTED OUTCOMES INCLUDE IMPROVED RUNOFF WATER QUALITY. SPECIFICALLY, BY DIVERTING RUNOFF FROM SURROUNDING DEVELOPED AREAS COLLECTED BY A STORMWATER DITCH THROUGH THE CONSTRUCTED STORMWATER PRACTICE, THERE WILL BE A REDUCTION IN NUTRIENT AND SEDIMENT POLLUTION IN THE INDIAN RIVER BAY WATERSHED. THE INTENDED BENEFICIARIES INCLUDE THE RESIDENTS NEAR GEORGETOWN, DELAWARE.

FINANCIAL ASSISTANCE AWARD

PERIOPERATIVE USE AND OUTCOMES OF NONINVASIVE VENTILATION IN SLEEP APNEA

TARGETED TEMPERATURE MANAGEMENT EFFECTIVENESS IN THE ELDERLY: INSIGHTS FROM A LARGE REGISTRY

DRUG OVERDOSE OUT-OF-HOSPITAL CARDIAC ARREST EVENTS IN THE UNITED STATES: INSIGHTS FROM A LARGE DATA REGISTRY - PROJECT SUMMARY DRUG OVERDOSE OUT-OF-HOSPITAL CARDIAC ARREST (OD-OHCA) IS A SERIOUS AND GROWING PUBLIC HEALTH THREAT THAT IS WHOLLY UNDERSTUDIED. CURRENTLY, WE LACK A BROADLY-REPRESENTATIVE, CONTEMPORARY CLINICAL PROFILE OF OD-OHCA ACROSS AMERICA AND WE DO NOT KNOW THE RELATIVE SOCIETAL DISEASE BURDEN OF OD-OHCA. IN ADDITION, WE DO NOT HAVE A DIRECT COMPARISON OF OD-OHCA AND PRESUMED CARDIAC ETIOLOGY (C-OHCA) CONTROLS STATISTICALLY MATCHED BY AGE AND OTHER KEY CLINICAL FACTORS. FURTHER, THE OPTIMAL POST-RESUSCITATION TREATMENT FOR OD-OHCA EVENT SURVIVORS IS UNKNOWN. OUR RESEARCH WILL ADDRESS THESE KNOWLEDGE GAPS. OUR CENTRAL HYPOTHESIS IS THAT THERE WILL BE A SUBSTANTIAL PUBLIC HEALTH IMPACT FROM OD-OHCA RELATIVE TO OTHER HIGH-BURDEN DISEASES, STATISTICALLY SIGNIFICANT AND CLINICALLY IMPORTANT DIFFERENCES BETWEEN OD-OHCA AND PROPENSITY-MATCHED C- OHCA OUTCOMES, AND POTENTIAL THERAPEUTIC BENEFIT TO PROVISION OF TARGETED TEMPERATURE MANGEMENT (TTM) DURING POST-RESUSCITATION CRITICAL CARE. THE SCIENTIFIC PREMISE FOR THIS WORK IS THAT WE CURRENTLY DO NOT ADEQUATELY UNDERSTAND THE FULL SCOPE OF OD-OHCA IN AMERICA, AND THE CARDIAC ARREST REGISTRY TO ENHANCE SURVIVAL (CARES) DATASET IS THE LARGEST COLLECTION OF HOMOGENEOUS, CONTEMPORARY DATA ON THIS COHORT FOR ANALYSIS TO FILL THESE IMPORTANT KNOWLEDGE GAPS AND ACCELERATE THE PACE OF DRUG ABUSE RESEARCH IN THIS AREA. FROM CARES, WE WILL CREATE A BROADLY-REPRESENTATIVE, CONTEMPORARY CLINICAL PROFILE OF OD-OHCA ACROSS AMERICA, ESTIMATE THE PUBLIC HEALTH IMPACT OF OD-OHCA AS MEASURED BY DISABILITY-ADJUSTED LIFE YEARS LOST (DALY [INCLUSIVE OF MORTALITY AND MORBIDITY]), COMPARE OD-OHCA PATIENT OUTCOMES TO PROPENSITY-MATCH CONTROLS WITH C-OHCA, AND DETERMINE THE EFFECT OF POST-RESUSCITATION TTM ON PATIENT OUTCOMES AS MEASURED BY HOSPITAL DISCHARGE CEREBRAL PERFORMANCE CATEGORY (CPC) SCALE SCORES. THIS RESEARCH IS SIGNIFICANT BECAUSE CURRENTLY LITTLE IS KNOWN ABOUT SUBSTANCE USE DISORDER FROM THE PERSPECTIVE OF OD-OHCA IN THIS RAPIDLY GROWING SEGMENT OF SOCIETY, AND OUR FINDINGS CAN BE TRANSLATED DIRECTLY INTO CLINICAL CARE PROTOCOLS AND WILL POTENTIALLY MODIFY CARE GUIDELINES TO SAVE LIVES. OUR WORK IS INNOVATIVE IN THAT WE WILL BE ACCESSING AN ENORMOUS, BROADLY-REPRESENTATIVE REPOSITORY OF PROSPECTIVELY COLLECTED AND VALIDATED DATA FROM THROUGHOUT THE COUNTRY. FURTHER, THE HIGHLY CAPABLE RESEARCH TEAM HAS MEMBERS WITH PRIORITY ACCESS TO THE ACTIVELY EXPANDING CARES DATASET FOR THIS ANALYSIS, COLLABORATORS WITH CONSIDERABLE EXPERTISE IN OHCA AS WELL AS VAST EXPERIENCE IN PREDICTIVE MODELING USING LARGE DATASETS. THIS WORK WILL HELP ENABLE HIGH-QUALITY RESEARCH TO ADVANCE SCIENTIFIC KNOWLEDGE ON THIS POTENTIAL CONSEQUENCE OF ADDICTION AND DRUG USE TO DIRECTLY IMPROVE PATIENT CARE FOR THIS STIGMATIZED, VULNERABLE POPULATION.

A CONTEMPORARY SUBGROUP ANALYSIS OF COOLING AFTER NON-SHOCKABLE CARDIAC ARREST: INSIGHTS FROM A LARGE REGISTRY

SPECTRAL NEAR-INFRARED AND THERMAL INFRARED IMAGING FOR ADVANCED ESTIMATION OF THERMAL AND GEOCHEMICAL SOIL-PLANT -WATER PROPERTIES

THE COASTAL BEND BAYS AND ESTUARIES PROGRAM (CBBEP) IS APPLYING FOR FUNDING TO RESTORE AND MANAGE UPLAND AND ESTUARINE HABITATS IN THE TEXAS COASTAL BEND THROUGH THREE INDIVIDUAL SUBPROJECTS: 1) INVASIVE SPECIES REMOVAL AT FENNESSEY RANCH 2) WATERBIRD MANAGEMENT AND MONITORING ON ROOKERY ISLANDS AND 3) ESTUARINE CIRCULATION ENHANCEMENT IN WELDER FLATS. THE OVERALL PROJECT GOAL IS TO INCREASE THE ABUNDANCE AND QUALITY OF UP TO 1,230ACRES OF UPLAND AND ESTUARINE HABITATS IN THE TEXAS COASTAL BEND, BENEFITING THE FISH AND WILDLIFE THAT RELY ON THEM. A HEALTHY ECOSYSTEM IN TURN BENEFITS LOCAL RESIDENTS AND VISITORS BY IMPROVING WATER QUALITY AND SUSTAINING NATURAL RESOURCES THAT FUEL THE ECONOMY. SPECIFIC PROJECT OBJECTIVES INCLUDE:1) RESTORING 230-ACRES OF COASTAL PRAIRIE HABITAT THROUGH INVASIVE SPECIES REMOVAL. ACTIVITIES INCLUDE CONTRACTING WITH QUALIFIED SPECIALISTS TO IMPLEMENT FIXED-WING AERIAL TREATMENTS OVER MOST OF THE LANDSCAPE AND HACK-AND-SPRAY INVASIVE SPECIES REMOVAL IN SENSITIVE AREAS ALONG RIVERS AND CREEK BEDS.2) MANAGING AND PROTECTING 300 ACRES OF QUALITY HABITAT FOR WATERBIRD POPULATIONS. ACTIVITIES INCLUDE: 1) ENHANCE ROOKERY ISLAND HABITAT THROUGH THE REMOVAL OF EXOTIC INVASIVE PLANT SPECIES AND THE ESTABLISHMENT OF NATIVE PLANT COMMUNITIES 2) MONITOR AND MANAGE ROOKERY ISLANDS FOR PREDATORS 3) INSTALL PROTECTIVE SIGNAGE AROUND ROOKERY ISLANDS 4) PROMOTE WATERBIRD CONSERVATION AND PROTECTION THROUGH PUBLIC EDUCATION AND OUTREACH.3) IMPROVING UP TO 700 ACRES OF ESTUARINE HABITAT THROUGH INCREASED WATER CIRCULATION. ACTIVITIES INCLUDE: 1) CONTRACT WITH AN ENGINEERING FIRM TO PROVIDE DESIGN AND PERMIT ASSISTANCE 2) OBTAIN A NATIONWIDE PERMIT TO INSTALL THE CULVERTS 3) OBTAIN A LEASE FROM GLO AND 4) OBTAIN AN ACCESS LICENSE OR ACCESS PERMISSION FROM THE PRIVATE LANDOWNER THAT WILL PROVIDE ROAD ACCESS TO THE PROJECT SITE.

MEDICAID COVERAGE OF BEHAVIORAL HEALTH SUPPORTS FOR OPIOID USE DISORDER DURING POST-INCARCERATION REENTRY - AS OPIOID OVERDOSES CONTINUE TO OCCUR AT ALARMING RATES IN THE US, FORMERLY INCARCERATED INDIVIDUALS ACCOUNT FOR AT LEAST 9% OF OVERDOSE FATALITIES. THIS POPULATION HAS HIGH PREVALENCES OF OPIOID USE DISORDER (OUD) AND OTHER HEALTH CONDITIONS AND FACES MANY BARRIERS TO ACCESSING CRITICAL HEALTH SERVICES, SUCH AS MEDICATIONS FOR OUD TREATMENT. TO ADDRESS THESE MULTI-FACETED NEEDS, PROMISING MODELS OF POST-INCARCERATION REENTRY HEALTH SERVICES PROVIDE CARE NAVIGATION AND LINKAGE TO SOCIAL RESOURCES, BUT CRITICAL KNOWLEDGE GAPS REMAIN REGARDING THE IMPACTS OF REENTRY NAVIGATION SERVICES FOR OUD WHEN IMPLEMENTED AT SCALE. MEDICAID IS THE MOST APT POLICY LEVER FOR SCALING UP AND SUSTAINABLY FUNDING REENTRY SERVICES, AS 80-90% OF PEOPLE LEAVING CARCERAL FACILITIES ARE MEDICAID-ELIGIBLE IN MOST STATES. IN 2022, THE MASSACHUSETTS MEDICAID PROGRAM LAUNCHED ITS STATEWIDE BEHAVIORAL HEALTH SUPPORTS FOR JUSTICE-INVOLVED INDIVIDUALS (BH- JI) PROGRAM, WHICH CONTRACTS WITH COMMUNITY PROVIDERS IN EACH COUNTY TO COVER CARE NAVIGATION AND REENTRY SUPPORTS FOR RECENTLY INCARCERATED MEMBERS WITH BEHAVIORAL HEALTH NEEDS. THIS MENTORED RESEARCH CAREER DEVELOPMENT AWARD USES THE STATEWIDE IMPLEMENTATION OF BH-JI AS A NATURAL EXPERIMENT TO CONDUCT A MIXED METHODS STUDY WITH THE FOLLOWING SCIENTIFIC AIMS: (AIM 1) TO DETERMINE THE IMPACT OF BH-JI REENTRY CARE NAVIGATION SERVICES ON POST-RELEASE HEALTHCARE UTILIZATION, COSTS, AND OVERDOSE OUTCOMES FOR INDIVIDUALS WITH OUD RELEASED FROM INCARCERATION. THIS QUANTITATIVE AIM USES QUASI-EXPERIMENTAL STUDY DESIGNS AND THE MASSACHUSETTS PUBLIC HEALTH DATA WAREHOUSE, WHICH LINKS INDIVIDUAL-LEVEL DATA FROM AN ALL PAYER CLAIMS DATABASE TO MORE THAN TWENTY STATEWIDE DATABASES, INCLUDING HEALTHCARE, PUBLIC HEALTH, JAILS, AND PRISONS. (AIM 2) TO IDENTIFY THE PERCEIVED FACILITATORS AND BARRIERS TO STATEWIDE POLICY IMPLEMENTATION OF THE BH-JI REENTRY CARE NAVIGATION PROGRAM AND THE MECHANISMS THAT EXPLAIN ANY IMPACT ON CLIENT OUTCOMES. THIS QUALITATIVE AIM USES A POLICY-FOCUSED IMPLEMENTATION SCIENCE APPROACH AND IN- DEPTH INTERVIEWS WITH KEY INFORMANTS, INCLUDING STATE MEDICAID OFFICIALS, HEALTHCARE DELIVERY ORGANIZATIONS, BH-JI PROVIDERS, CARCERAL FACILITIES, AND BH-JI CLIENTS. LASTLY, A CONVERGENT MIXED METHODS ANALYSIS WILL INTEGRATE FINDINGS FROM BOTH AIMS. WITH THE EXCEPTIONAL MENTORSHIP TEAM ASSEMBLED IN THIS K08 AND THROUGH AN INTENSIVE COMBINATION OF FORMAL COURSES, TRAINING WORKSHOPS, FIELD EXPERIENCES, AND APPLIED RESEARCH, THE CANDIDATE WILL: (1) DEEPEN EXISTING SKILLS IN QUANTITATIVE METHODS; (2) CULTIVATE NEW SKILLS FOR POLICY-FOCUSED IMPLEMENTATION SCIENCE, INCLUDING QUALITATIVE AND MIXED METHODS; (3) ENHANCE THEIR ADDICTION MEDICINE AND CORRECTIONAL HEALTHCARE EXPERTISE; AND (4) DEVELOP THE PROFESSIONAL SKILLS OF AN INDEPENDENT PHYSICIAN- INVESTIGATOR. ACQUISITION OF THESE SKILLS WILL PROPEL THE CANDIDATE TO ACCOMPLISH THEIR LONG-TERM CAREER GOAL: TO BECOME A THOUGHT LEADER ON POLICY INNOVATIONS TO IMPROVE HEALTH CARE AND OUTCOMES FOR PEOPLE WITH SUBSTANCE USE DISORDERS AND CRIMINAL LEGAL INVOLVEMENT.

REAP RENEWABLE ENERGY SYSTEM (RES) GRANT UNRESTRICTED AMOUNT

SENIOR SAFETY THROUGH EDUCATION AND PREVENTIVE SERVICES (STEPS)

HEALTH CARE AND OTHER FACILITIES

SBIR PHASE I: A REAL-TIME INFRARED RAMAN-BASED MICROALGAL ANALYZER FOR MONITORING BIOFUEL PRODUCTION

REAP RENEWABLE ENERGY SYSTEM (RES) GRANT UNRESTRICTED AMOUNT

MIDCONTINENT SHOREBIRD CONSERVATION INITIATIVE

EMERGENCY RELIEF GRANT MONIES WILL BE DISTRIBUTED EQUALLY TO ELIGIBLE STUDENTS TO ASSIST WITH THE REQUIRED IN DIRECT COST OF EDUCATION SUCH AS: FOOD, TUITION, HOUSING, HEALTH CARE,OR CHILD CARE.

TECHNICAL ASSISTANCE AWARD

PLACEBO VS. EXTENDED RELEASE STIMULANT CROSSOVER TRIAL IN PRESCHOOLERS WITH ADHD

GULF COAST CONSERVATION INITIATIVE 2015

ASSISTANCE TO FIREFIGHTERS GRANT

REDUCTION OF GHOST FISHING FROM DERELICT BLUE CRAB TRAPS ON THE MID-TEXAS COAST

SHORELINE PROTECTION AND RESTORATION IN THE COASTAL BEND

READINESS AND EMERGENCY MANAGEMENT FOR SCHOOLS

COLLABORATIVE RESEARCH: PROCESS-CENTERED, ANALYSIS-DRIVEN SYSTEM DEVELOPMENT APPLIED TO HUMAN-INTENSIVE MEDICAL PROCESSES

VALUATION OF A SIMPLE TOOL FOR CHEST PAIN PATIENT RISK-STRATIFICATION IN NORTH AMERICA

RURAL ACCESS TO EMERGENCY DEVICES DI OPIOID OVERDOSE REVERSAL GRANT PROGRAM

CBBEP IS PROPOSING TO CONTRACT WITH LOCAL SCHOOLS TO INSTALL THREE OUTDOOR CLASSROOMS PER YEAR FOR A TOTAL OF 15 OUTDOOR CLASSROOMS OVER A FIVE YEAR PERIOD WHILE EVERY OUTDOOR CLASSROOM CONTAINS ITS OWN UNIQUE DESIGN CHARACTERISTICS, CBBEP WILL STRIVE TO ENSURE THAT THEY ALL OBSERVE THE FOLLOWING KEY ELEMENTS ECOLOGICALLY SOUND, BENEFIT WILDLIFE AND PEOPLE, INTEGRATED INTO CURRICULUM, DESIGNED TO ENCOURAGE LONG TERM STEWARDSHIP SCHOOLS WILL BE ENCOURAGED TO FOLLOW THE PROCESS DESCRIBED IN THE USFWS SCHOOLYARD HABITAT PROJECT GUIDE FOR THE DEVELOPMENT OF OUTDOOR CLASSROOMS, AND CBBEP STAFF WILL BE AVAILABLE TO ASSIST THEM WITH THIS PROCESS

PHYSICIAN PERSPECTIVES REGARDING THE USE OF SHARED DECISION-MAKING IN THE EMERGENCY DEPARTMENT

AFFORDABLE CARE ACT- HEALTH CENTER PLANNING GRANTS

COASTAL PRAIRIE CONSERVATION INITIATIVE 2017

THE PURPOSE OF THE SHORELINE AND WETLAND PROTECTION AT COHN PRESERVE PHASE 2 PROJECT IS TO IMPLEMENT AN EARLIER PROJECT TO ADDRESS ONGOING EROSION TO THE CURRENT COHN PRESERVE SHORELINE SOUTH OF THE EXISTING BREACH. THIS PROJECT CONSISTS OF DESIGN PERMITTING AND INSTALLATION OF RIP RAP OR OTHER SIMILAR PRODUCT AT THE MEAN TIDE LEVEL OF THE PRESERVE SHORELINE. THE COHN PRESERVE IS OWNED AND MANAGED BY THE NATURE CONSERVANCY TNC WHO IS CURRENTLY WORKING IN PARTNERSHIP WITH CBBEP USFWS TEXAS GENERAL LAND OFFICE GLO AND A PROJECT ENGINEER TO IMPLEMENT PHASE 1 OF THE PROJECT FUNDED FROM GLO CEPRA CYCLE 12 AND MATCHED BY CBBEP. PHASE 1 CONSISTS OF SITE DATA COLLECTION ALTERNATIVES ANALYSIS PRELIMINARY ENGINEERING DESIGN 30% AND PERMITTING FOR A LIVING SHORELINE PROJECT. HOWEVER EXPERIENCE HAS SHOWN THAT SECURING A US ARMY CORPS OF ENGINEERS USACE CONSTRUCTION PERMIT MAY TAKE MORE THAN TWO YEARS AND IN THE MEANTIME THE SITE CONTINUES TO ERODE AND LOSE SEDIMENT AT AN ALARMING RATE. A REVIEW OF AERIAL PHOTOGRAPHS FROM 2010 2015 AND 2020 INDICATE THAT OVER THE 10YEAR PERIOD THE SHORELINE ERODED BETWEEN 15 AND 90 FEET WITH THE LARGEST IMPACT BEING IN 2017 AT THE BREACH ALONG THE NORTHERN SHORELINE DURING HURRICANE HARVEY. FOR THIS REASON CBBEP AND TNC ARE PROPOSING A PHASE 2 EARLY PROJECT THAT CAN BE MORE QUICKLY PERMITTED AND IMPLEMENTED TO STOP THE PERSISTENT EROSION WHILE THE LARGER SHORELINE PROTECTION SYSTEM UNDERGOES REGULATORY COORDINATION. THE RIP RAP OR SIMILAR WILL BE PLACED ON APPROXIMATELY 2500 FEET OF THE PROJECT SHORELINE TO STABILIZE THE SHORELINE AND SLOW EROSION. WITHOUT THIS ADDITIONAL PROTECTION THE CONTINUED SHORELINE EROSION AND POTENTIAL NEW BREACHES WILL EXACERBATE ISSUES AND CAUSE SIGNIFICANT COST INCREASES FOR THE FINAL COMPREHENSIVE SHORELINE STRUCTURE.

RURAL HEALTH NETWORK DEVELOPMENT PLANNING GRANT PROGRAM

TO SUPPORT THE COASTAL BEND BAYS & ESTUARIES PROGRAM'S ANNUAL EFFORTS TO MANAGE AND PROTECT ROOKERY ISLANDS AND WATERBIRDS ALONG THE CENTRAL AND SOUTHERN COAST OF TEXAS. THE OBJECTIVE OF THIS PROJECT IS TO ENHANCE A MINIMUM OF 300 ACRES OF HABITAT FOR NESTING COLONIAL WATERBIRDS INCLUDING HERONS, EGRETS, TERNS, AND SKIMMERS.

BAYSIDE WETLAND RESILIENCE ON MUSTANG ISLAND - PHASE I

THIS ASSISTANCE AGREEMENT PROVIDES THE LIVING LOCAL PROJECT AGRICULTURAL AND ENVIRONMENTAL EDUCATION THROUGH THE DEVELOPMENT AND IMPLEMENTATION OF AN INTERDISCIPLINARY LEARNING MODULE, STUDENT EXPERIENCES, AND COMMUNITY WORKSHOPS THAT ADDRESS ENVIRONMENTAL AND HUMAN IMPACTS AFFECTING AGRICULTURE AND THE BENEFITS BEST FARM PRACTICES HAVE ON MARYLAND'S WATER RESOURCES COASTAL BAYS. PROJECT ACTIVITIES WILL PROMOTE A CULTURE OF ENVIRONMENTAL STEWARDSHIP AND LITERACY THROUGH HANDS-ON ACTIVITIES ON LOCAL FARMS AND SCHOOLS IN WORCESTER COUNTY, MARYLAND.

ADVANCED EDUCATION NURSING TRAINEESHIP

THIS PROJECT PROPOSES TO ESTIMATE THE RATES OF HISTORIC MARSH LOSS IN THE INLAND BAYS AND APPLY A REMOTELY SENSED INDICATOR OF MARSH CONDITION AS FOR

CBBEP TRIANGLE TREE AND CAUSEWAY

COASTAL BEND BAYS AND ESTUARIES PROGRAM

CAUSEWAY ISLAND EROSION PROTECTION

SEC. 9007 REAP-RENEW ENERGY SYS GRANTS (MAN)

THE AFFORDABLE CONNECTIVITY OUTREACH GRANT PROGRAM PROVIDES ELIGIBLE GOVERNMENTAL AND NON-GOVERNMENTAL ENTITIES WITH THE FUNDING AND RESOURCES NEEDED TO INCREASE AWARENESS OF AND PARTICIPATION IN THE AFFORDABLE CONNECTIVITY PROGRAM AMONG THOSE ELIGIBLE HOUSEHOLDS MOST IN NEED OF AFFORDABLE CONNECTIVITY.

INVASIVE SPECIES ARE A MAJOR THREAT TO COASTAL BIODIVERSITY. THEY CAN HAVE PROFOUND EFFECTS ON COASTAL ECOSYSTEMS, LEADING TO THE EXTINCTION OF NATIVE PLANTS AND ANIMALS, DESTROYING BIODIVERSITY, AND PERMANENTLY ALTERING HABITATS THROUGH DIRECT AND INDIRECT EFFECTS. THIS CAN RESULT IN HUGE ECONOMIC IMPACTS AND FUNDAMENTAL DISRUPTIONS OF ECOSYSTEMS AND ANIMALS, DESTROYING BIODIVERSITY, AND PERMANENTLY ALTERING HABITATS THROUGH BOTH DIRECT AND INDIRECT EFFECTS. IN 2014, A VOLUNTARY NETWORK OF PUBLIC AND PRIVATE PARTNERS IN THE TEXAS COASTAL BEND REGION FORMED THE TEXAS GULF REGION COOPERATIVE WEED MANAGEMENT AREA (CWMA). THE GOAL OF THE CWMA IS TO PROVIDE A MORE COORDINATED, REGIONAL APPROACH TO THE MANAGEMENT OF INVASIVE SPECIES, LEADING TO BETTER TREATMENT METHODS, MORE FUNDING FOR TREATMENT AND CONTROL ACTIVITIES, GREATER EFFICIENCY IN USE OF FUNDS AND STAFF TIME, AND EARLIER DETECTION AND MORE RAPID RESPONSE. THE CWMA INCLUDES REPRESENTATIVES FROM STATE AND FEDERAL AGENCIES (INCLUDING USFWS), LOCAL GOVERNMENTS, NONPROFITS, ACADEMIC INSTITUTIONS, AND MEMBERS OF THE COMMUNITY. TO DATE, THE CWMA HAS FOCUSED ON THE CONTROL OF BRAZILIAN PEPPERTREE ON BARRIER ISLANDS. BRAZILIAN PEPPERTREE IS AN INVASIVE, NOXIOUS, AND PROHIBITED SPECIES WITHIN TEXAS THAT CAN QUICKLY MODIFY HABITATS AND DEGRADE THE QUALITY OF ECOSYSTEMS THROUGH RAPID AND AGGRESSIVE GROWTH, AS WELL AS WITH ALLOPATHIC CHEMICALS. THE CWMA HAS REACHED THOUSANDS OF LANDOWNERS AND IMPROVED LAND MANAGEMENT PRACTICES ON CLOSE TO 10,000 ACRES OF PUBLIC AND MANAGED LANDS. IN ADDITION TO ITS INVOLVEMENT IN THE CWMA, CBBEPS LAND CONSERVATION PROGRAM ALSO WORKS ON A REGULAR BASIS WITH PARTNERS TO ENHANCE AND RESTORE HABITATS ON BOTH PRIVATE AND PUBLIC LANDS. FOR EXAMPLE, THE LAND CONSERVATION PROGRAM HAS RECENTLY PARTNERED WITH THE ARANSAS NATIONAL WILDLIFE REFUGE TO ASSIST WITH THEIR EFFORTS TO TREAT AND REMOVE INVASIVE SPECIES. THE COASTAL BEND BAYS ESTUARIES PROGRAM (CBBEP) IS REQUESTING FUNDS TO COLLABORATE WITH LOCAL COMMUNITIES WITHIN THE COASTAL BEND ON THE REMOVAL AND TREATMENT (INCLUDING RETREATMENTS) OF INVASIVE SPECIES, SUCH AS GUINEA GRASS AND SALT CEDAR BUT FOCUSING PRIMARILY ON BRAZILIAN PEPPERTREE. FUNDS ARE ALSO BEING REQUESTED TO ALLOW CBBEP TO PARTNER WITH THE ARANSAS NATIONAL WILDLIFE REFUGE ON THE AERIAL TREATMENT OF CHINESE TALLOW, SALT CEDAR, AND BAMBOO ON MATAGORDA ISLAND.

BLACK SKIMMER MIGRATORY PATTERNS AND IDENTIFICATION OF WINTERING SITES

RBDG RURAL BUSINESS COOP RURAL ENTERPRISE GRANT

WILL USE GRANT TO OBTAIN DISTANCE EDUCATION EQUIPMENT FOR BOTH SCHOOL AND STUDENT INCLUDING COMPUTER HARDWARE AND SOFT WARE PROGRAMS TO FOSTER DISTANCE LEARNING PROCESSES, OR FOR NEED BASE TO STUDENT.

THIS IS A FEDERAL GRANT UNDER THE GUIDELINES OF THE CARES ACT SECTION 18004(A)(1) OF THE CARES ACT, PUB. L. NO. 116-136 (MARCH 27, 2020) BAYSHIRE BEAUTY ACADEMY COMPLIES WITH THIS ACT FOR DISBURSEMENT

CBBEP ENVIROMENTAL EDUCATION

IN THE WESTERN HEMISPHERE, SHOREBIRD POPULATIONS CONTINUE TO DECLINE. AS A RESULT, SHOREBIRD CONSERVATION PLANSAT THE STATE, FEDERAL, AND INTERNATIONAL FLYWAY LEVELS ALL INCLUDE RECOMMENDED ACTIONS TO CURTAIL DECLINES. WHILESOME THREATS ARE LOCALIZED, MOST OCCUR AT THE LANDSCAPE LEVEL, WITH INSUFFICIENT HABITAT QUALITY AND QUANTITYUBIQUITOUSLY CITED AS THE PRIMARY CAUSE. SHOREBIRD SPECIES VARY CONSIDERABLY IN THEIR HABITAT, DIET, ANDMIGRATORY NEEDS, AND THUS THEY RESPOND DIFFERENTLY WHEN THERE ARE CHANGES IN THE ENVIRONMENT ESPECIALLY THEIRHABITAT. CONSISTENT MONITORING OF VARIOUS HABITAT USE IS CRITICAL TO UNDERSTANDING HOW BEST MANAGEMENT PRACTICESARE AFFECTING POPULATIONS, AND NECESSARY TO DEVELOP AND DELIVER OUTREACH ON HOW MANAGEMENT PRACTICES BENEFITSHOREBIRDS. WE PROPOSE TO BRIDGE THE GAP BETWEEN SHOREBIRD CONSERVATION INTENTIONS AND IMPLEMENTATION THROUGH THE ASSESSING SHOREBIRD HABITAT NEEDS AND OPPORTUNITIES IN TEXAS INITIATIVE. THE INITIATIVE WILL WORK TO INTEGRATESHOREBIRD HABITAT MANAGEMENT OBJECTIVES INTO UPCOMING PROJECTS ON A RANGE OF PUBLIC AND PRIVATE LANDS THROUGHTARGETED OUTREACH AND ENGAGEMENT (INCLUDING CONSERVATION PROPERTIES AS WELL AS AGRICULTURAL RANCH LANDS), ANDPROVIDE COMPREHENSIVE MONITORING TO ASSESS SHOREBIRD UTILIZATION, FOCUSING ON SHALLOW-WATER WETLANDS AND COASTALGRASSLANDS FOLLOWING PRESCRIBED FIRES. THE PROJECT HAS FOUR MAIN OBJECTIVES: (1) ASSESS THE EXTENT TO WHICHFRESHWATER WETLAND HABITAT DELIVERY PROGRAMS BENEFIT SHOREBIRDS THROUGH THE IMPLEMENTATION OF A MONITORINGFRAMEWORK (2) ASSESS USAGE OF EARLY SUCCESSIONAL POST-FIRE LANDSCAPES BY MIGRATORY SHOREBIRDS (3) MANAGE ANDMONITOR WETLANDS AND GRASSLANDS OF THE NUECES DELTA USING DELIBERATE BMPS TO ENHANCE SHOREBIRD USE AND (4)DEVELOP AND DELIVER OUTREACH ON HOW MANAGEMENT PRACTICES BENEFIT SHOREBIRDS. THE ULTIMATE RESULT OF THE PROJECTWILL BE THE IDENTIFICATION OF BMPS RELATED TO WETLAND MANAGEMENT AND PRESCRIBED FIRE THAT BENEFIT UPLANDSHOREBIRDS, INCLUDING RECOMMENDATIONS FOR HOW USFWS AND OTHER PARTNERS CAN INCORPORATE THESE INTO EXISTING ANDPLANNED HABITAT DELIVERY PROGRAMS.

CONTROLLING BRAZILIAN PEPPERTREE WITHIN THE TEXAS GULF REGION COOP. WEED MANAGEMENT AREA

COLONIAL WATERBIRD ROOKERY HABITAT ENHANCEMENT IN THE COASTAL BEND

COMMUNITY FACILITY GRANTS

SALT MARSH RESTORATION IS BECOMING A LARGER FOCUS OF THE RESTORATION COMMUNITY IN THE MID ATLANTIC ONE SUCH RESTORATION APPROACH IS TO USE LOW TECH, LOW COST, LOW DISTURBANCE TECHNIQUES TO SET THE MARSH ON A SELF HEALING TRAJECTORY THESE TECHNIQUES INCLUDE THE CREATION OF RUNNELS TO ALLOW WATER TRAPPED ON THE MARSH TO MOVE FREELY WITH THE TIDES AS WELL AS REMEDIATION OF DITCHES IN EXTENSIVELY GRID DITCHED MARSHES TO HELP DECREASE THE CHANNEL DENSITY TO PROMOTE A MORE NATURAL HYDROLOGIC FUNCTION WHILE THESE TECHNIQUES HAVE BEEN SHOWN TO BE SUCCESSFUL IN TERMS OF IMPROVEMENTS TO HYDROLOGY, ELEVATION, AND VEGETATION, LITTLE IS KNOWN HOW THE NEKTON COMMUNITY RESPONDS TO THESE TECHNIQUES MARSHES PLAY AN IMPORTANT ROLE IN THE LIFE CYCLE FOR MANY AQUATIC SPECIES, MANY OF WHICH ARE IMPORTANT FISHERIES SPECIES UNDERSTANDING HOW THESE SPECIES ARE INFLUENCED BY THESE TECHNIQUES WILL NOT ONLY INCREASE OUR UNDERSTANDING OF THE ECOLOGICAL RESPONSE TO RESTORATION, BUT WILL ALSO HELP ADDRESS CONCERNS FROM REGULATORY AGENCIES SUCH AS THE NATIONAL MARINE FISHERIES SERVICE WE INTEND TO INVESTIGATE HOW THESE RESTORATION TECHNIQUES AFFECT THE ABILITY OF NEKTON TO ACCESS DIFFERENT PORTIONS OF THE MARSH TO DO THIS, WE WILL BE DEVELOPING AND IMPLEMENTING AN APPROACH TO QUANTIFY THE CHANGES IN NEKTON COMMUNITY AND ABUNDANCE BY LOOKING AT ASSEMBLAGES BEFORE AND AFTER IMPLEMENTATION OF FUTURE RESTORATION PROJECTS THIS COOPERATIVE AGREEMENT PERTAINS TO DEVELOPING A PROTOCOL FOR ASSESSING THE NEKTON COMMUNITY, PARTLY IMPLEMENTING THAT PROTOCOL, AND ANALYZING DATA AND NOT THE RESTORATION ITSELF BECAUSE ONE OF THE MAIN OBJECTIVES OF THIS PROJECT IS TO ESTABLISH A MONITORING PROTOCOL TO FIND THE MOST INFORMATIVE METHOD OF CAPTURING ANY SIGNIFICANT CHANGES IN THE NEKTON COMMUNITY IN RESPONSE TO THE THESE TECHNIQUES, THE SPECIFIC METHODS, TIMING, AND FREQUENCY HAVE NOT YET BEEN DETERMINED HOWEVER, THE PROTOCOL WILL LIKELY INVOLVE SAMPLING APPROXIMATELY TWICE A MONTH THROUGH THE MONTHS OF MAY AND OCTOBER AT TO BE DETERMINED SALT MARSH SITES THROUGHOUT THE INLAND BAYS USING AN ARRAY OF MINNOW TRAPS, THROW TRAPS, AND OR DITCH NETS WE ANTICIPATE THIS EFFORT TO EXTEND THROUGH DECEMBER OF 2026 WITH EACH SITE BEING SAMPLED FOR AT LEAST TWO YEARS DURING THAT TIME

SMALL, RURAL SCHOOL ACHIEVEMENT PROGRAM

SMALL, RURAL SCHOOL ACHIEVEMENT PROGRAM