Mountain Comprehensive Health Corporation

HEALTH CENTER CLUSTER

HEALTH CENTER CLUSTER

AMERICAN RESCUE PLAN ACT FUNDING FOR HEALTH CENTERS

RESPIRATORY CLINICS OF EASTERN KENTUCKY

RESPIRATORY CLINICS OF EASTERN KENTUCKY

ARRA - CAPITAL IMPROVEMENT PROGRAM

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

FY 2021 ENDING THE HIV EPIDEMIC - PRIMARY CARE HIV PREVENTION - MOUNTAIN COMPREHENSIVE HEALTH CORPORATION (MCHC) IS AN FQHC (GRANT NUMBER: H80CS00367) WITH ITS HEADQUARTERS AND ALL SATELLITE CLINICS LOCATED IN THE MOUNTAINS OF EASTERN KENTUCKY. MCHC IS APPLYING FOR THIS PRIMARY CARE HIV PREVENTION GRANT BECAUSE IT IS DETERMINED TO HELP ERADICATE THIS DISEASE FROM THE UNITED STATES, BY DOING ITS PART TO TEST, PREVENT, DIAGNOSE AND TREAT ALL MCHC PATIENTS WHO ARE A PART OF THE TARGETED AND/OR HIGH-RISK GROUPS. MCHC WILL ACHIEVE THESE GOALS BY CLOSELY FOLLOWING THE BIDEN ADMINISTRATION’S NATIONAL HIV/AIDS STRATEGY AND THE REQUIREMENTS FOR THIS FUNDING OPPORTUNITY BY ACHIEVING THE FOLLOWING OBJECTIVES: INCREASE THE NUMBER OF PATIENTS COUNSELED AND TESTED FOR HIV MCHC WILL BEGIN THE “TESTING” PHASE OF THE PROJECT IMMEDIATELY BY STARTING TO TEST EVERYONE IN THE 13 TO 65 AGE GROUP FOR HIV ALONG WITH REGULAR BLOOD WORK. OF COURSE THERE WILL BE NOTIFICATION OF THIS TEST AND THE ABILITY TO OPT OUT BY SIGNING A FORM. GRANT FUNDS WILL BE USED TO MAKE THIS A ZERO COST TEST TO THE PATIENTS AFTER THE RESPECTIVE INSURANCE PROVIDERS PICK UP THEIR PART OF THE BILL. DR. FARES KHATER, MCHC’S INFECTIOUS DISEASE SPECIALIST, MAINTAINS THAT INCREASED TESTING WILL ALLOW MCHC TO DISCOVER UNREPORTED CASES AMONG THE TARGET GROUPS AND ESPECIALLY IN THE HIGH-RISK GROUP. MCHC PERFORMED A COMBINED TOTAL OF 6,954 HIV TESTS IN CALENDAR YEARS 2019 AND 2020. AFTER IMPLEMENTING ALL THE PROCEDURES NECESSARY TO MEET THE GOALS OF THIS GRANT, MCHC PLANS TO INCREASE THE NUMBER OF TESTS EACH YEAR, FOR A GRAND TOTAL OF APPROXIMATELY 20,000 HIV TESTS ADMINISTERED OVER THE COURSE OF THE GRANT PERIOD. INCREASE THE NUMBER OF PATIENTS PRESCRIBED PREP DR. KHATER SAYS THAT ALL PATIENTS WHO FALL INTO ONE OF THE HIGH-RISK GROUPS, WHICH INCLUDE BEHAVIORAL HEALTH PATIENTS AND SUBSTANCE USE DISORDER PATIENTS, COULD IMMEDIATELY BE STARTED ON PREP. GRANT FUNDS WILL HELP MAKE THIS A ZERO COST ACTIVITY FOR PATIENTS AFTER ALL INSURANCE COVERAGE AND ALL AV AILABLE PREP SUBSIDY PROGRAM FUNDING IS EXHAUSTED. THIS INCREASE IN THE NUMBER OF PATIENTS PRESCRIBED PREP SHOULD DRAMATICALLY DECREASE THE RATE OF HIV CASES IN THE AREA BY PUTTING THE PREVENTIVE MEDICINE INTO THE HANDS OF THE PEOPLE MOST LIKELY TO CONTRACT THE DISEASE. THESE ACTIVITIES WILL MAKE GREAT STRIDES TOWARD ACHIEVING GOAL 1 OF THE BIDEN ADMINISTRATION’S NATIONAL HIV/AIDS STRATEGY, WHICH IS TO “PREVENT NEW HIV INFECTIONS”. INCREASE THE NUMBER OF PATIENTS LINKED TO HIV CARE AND TREATMENT WITHIN 30 DAYS OF DIAGNOSIS MCHC IS FORTUNATE TO HAVE ITS OWN BEHAVIORAL HEALTH COUNSELORS AND AN INFECTIOUS DISEASE SPECIALIST IN-HOUSE. THIS WILL ALLOW TREATMENT AND SUPPORTIVE THERAPY TO BEGIN IMMEDIATELY UPON A DIAGNOSIS OF HIV, SOMETIMES EVEN ON THE SAME DAY. LINKING TO CARE AND TREATMENT WITHIN 30 DAYS OF DIAGNOSIS WILL BE AN EASY GOAL TO ACHIEVE SINCE MCHC ALREADY HAS ALL THE NECESSARY PLAYERS UNDER THE SAME ROOF. IN ORDER TO BREAK DOWN ONE OF THE PRIMARY BARRIERS TO CARE IN THE MCHC SERVICE AREA, TELEHEALTH CAN BE UTILIZED FOR BOTH TREATMENT AND THERAPY IN SITUATIONS WHERE A PATIENT WOULD HAVE A LONG DRIVE TO SEE DR. KHATER IN PERSON. GOAL 2 OF THE BIDEN ADMINISTRATION’S NATIONAL HIV/AIDS STRATEGY, “IMPROVE HIV-RELATED HEALTH OUTCOMES OF PEOPLE WITH HIV” WILL BE MET HERE, WITH IN-PERSON OR ELECTRONIC ACCESS TO TREATMENT IMMEDIATELY UPON DIAGNOSIS. PROJECT WILL FOCUS ON THE TARGETED GEOGRAPHIC LOCATIONS WITH THE ENTIRE STATE OF KENTUCKY BEING ONE OF THE TARGETED GEOGRAPHIC LOCATIONS FOR THIS GRANT, MCHC WILL HAVE NO PROBLEM FOCUSING ITS EFFORTS ON THE TARGET AREA. MCHC HAS BEEN PROVIDING PRIMARY HEALTH CARE SERVICES IN EASTERN KENTUCKY SINCE 1971. THIS FQHC NOW SERVES PATIENTS WITH ELEVEN COMMUNITY HEALTH CENTERS AND FOURTEEN SCHOOL BASED CLINICS LOCATED IN LETCHER, PERRY, HARLAN, OWSLEY, PIKE, KNOTT AND BELL COUNTIES. MCHC'S PRIMARY SERVICE INCLUDES 20 KENTUCKY COUNTIES AND IT IS UNIQUELY SITUATED TO PROVIDE HIV

HEALTH CENTER INFRASTRUCTURE SUPPORT

RESPIRATORY CLINICS OF EASTERN KENTUCKY

FY 2020 EXPANDING CAPACITY FOR CORONAVIRUS TESTING (ECT)

INTEGRATED SUBSTANCE USE DISORDER (SUD) TRAINING PROGRAM

**AWARDS ISSUED PRIOR TO JANUARY 20, 2025, WERE FUNDED UNDER PREVIOUS ADMINISTRATIONS AND MAY NOT REFLECT THE PRIORITIES AND POLICIES OF THE CURRENT ADMINISTRATION.** THE MCHC FARMACY PROGRAM WILL PARTNER WITH THREE FARMERS' MARKETS AND MULTIPLE OTHER FRESH PRODUCE VENDORS. THE FARMERS' MARKETS THAT WILL PARTNER FOR THE PROJECT ARE THE CITY OF WHITESBURG/LETCHER COUNTY FARMER'S MARKET, OWSLEY COUNTY FARMER'S MARKET, AND THE LEATHERWOOD/BLACKEY FARMER'S MARKET. THE FARMER'S MARKETS OPERATE FROM LATE MAY TO LATE SEPTEMBER EACH YEAR. THE FRESH PRODUCE VENDORS WILL HAVE VARIOUS HOURS AND DAYS OF OPERATION, WHICH WILL INCREASE ACCESS TO FRESH PRODUCE FOR THE PARTICIPANTS. THE FARMACY PROGRAM WILL NOT REQUIRE A SEPARATE PURCHASE TO EARN THE INCENTIVE. INTERESTED MCHC PATIENTS WHO ARE SNAP PARTICIPANTS WILL BE REFERRED TO THEIR PRIMARY CARE PHYSICIAN (PCP) TO RECEIVE BASELINE MEASUREMENTS AND A PRESCRIPTION FOR THE FARMACY PROGRAM. ALL ENROLLED PATIENTS MUST HAVE A DIAGNOSIS OF, OR BE AT RISK FOR (DUE TO FAMILY HISTORY OR SOCIAL DETERMINANTS OF HEALTH), TYPE 2 DIABETES, HYPERTENSION OR OBESITY.THE FINANCIAL INSTRUMENT USED FOR INCENTIVE DELIVERY WILL BE TOKENS. THE FARMACY PROGRAM PARTICIPANTS WILL PRESENT THEIR I.D. AND SNAP CARD TO THE PROGRAM MANAGER. THE PROGRAM MANAGER WILL THEN FIND THAT PARTICIPANT'S NAME ON THE ELIGIBILITY LIST, WHICH IS GENERATED WEEKLY. THE PROGRAM MANAGER WILL DISPERSE $30 WORTH OF TOKENS THAT ARE MARKED IN VALUES OF $1 AND $5 TO THE PARTICIPANT. THESE TOKENS CAN THEN BE SPENT, LIKE CASH, AT EACH VENDOR'S LOCATION, EITHER AT A PARTICIPATING FARMER'S MARKET OR A PARTICIPATING LOCAL FRESH PRODUCE VENDOR, TO PURCHASE FRESH, LOCALLY OR REGIONALLY GROWN FRUITS AND VEGETABLES.MCHC WILL PROVIDE THE SERVICES OF OUR DIETITIAN, ERIN GIBSON, MS, RD, LD AND OUR NURSE PRACTITIONER WHO SPECIALIZES IN DIABETES, FOR THE FARMACY PROGRAM. COOKING AND FOOD-PREP DEMONSTRATIONS WILL BE PROVIDED ON-SITE, TO TEACH PARTICIPANTS HOW TO INCORPORATE VARIOUS FRUITS AND VEGETABLES INTO THEIR DAILY MEALS.AS A FEDERALLY QUALIFIED HEALTH CENTER, MCHC IS CONSTANTLY SEEKING WAYS TO IMPROVE THE HEALTH OF OUR PATIENTS AND TO HELP IMPROVE THE ECONOMY OF THE COMMUNITIES THAT WE SERVE. WITH THE DEVELOPMENT OF OUR FARMACY PROGRAM AND THE FUNDING PROVIDED BY USDA NIFA FINI AWARD 2017-70025-26684, WE FOUND A WAY TO ACHIEVE BOTH OF THOSE GOALS SIMULTANEOUSLY. AS WE IMPLEMENTED OUR PRODUCE PRESCRIPTION PROGRAM (PRX FOR THE PURPOSES OF THIS APPLICATION), WE WERE THRILLED TO DISCOVER THAT OUR PATIENTS WERE ABLE TO CONTRIBUTE TO THE LOCAL ECONOMY BY USING THE INCENTIVES (TOKENS) THAT THE GRANT PROVIDED TO PURCHASE FRESH PRODUCE FROM VENDORS AT PARTICIPATING LOCAL FARMER'S MARKETS. THE INCENTIVES GAVE THESE SNAP RECIPIENTS UNPRECEDENTED ACCESS TO FRESH, LOCALLY GROWN PRODUCE FOR IMMEDIATE CONSUMPTION AS WELL AS THE ABILITY TO CAN AND FREEZE THE ITEMS FOR LATER USE. THESE ACTIVITIES PROVIDED A MARKED IMPROVEMENT IN THE OVERALL HEALTH OF THE PATIENT PARTICIPANTS AND HELPED THE PARTICIPATING FARMER'S MARKETS TO GROW AND PROSPER. WE COLLECTED BASELINE MEASUREMENTS OF VITAL SIGNS AND BLOOD SUGAR LEVELS UPON ENROLLMENT INTO THE PROGRAM AND AGAIN AT PROGRAMS END, TO DETERMINE THE OVERALL CHANGE IN HEALTH OUTCOMES DURING THE COURSE OF THE PROGRAM. ALL OF THE PARTICIPANTS LEARNED HEALTHY FOOD PURCHASING AND PREPARATION HABITS, AND SHOWED AT LEAST A MINOR IMPROVEMENT IN EACH HEALTH MEASURE, WITH MANY SHOWING VAST IMPROVEMENTS.COVID-19 SEVERELY IMPACTED OUR OUTREACH AND ENROLLMENT FOR 2020. IN ORDER TO KEEP OUR PATIENTS AS SAFE AS POSSIBLE, WE IMPLEMENTED A DRIVE THRU VERSION OF OUR PROGRAM TO SAFELY SERVE THE PATIENTS THAT WERE WILLING TO VENTURE OUT OF THEIR HOMES. FRESH PRODUCE WAS PACKED INTO BAGS AND BOXES BY THE VENDORS AND EACH PARTICIPANT WHO DROVE THROUGH THE PARKING LOT,RECEIVED A SET AMOUNT BASED ON FAMILY SIZE. THE PANDEMIC NEGATIVELY IMPACTED PARTICIPATION, BUT THE NECESSITY OF IMPLEMENTING SAFETY MEASURES AND BUILDING EFFICIENCY INTO THE PROCESS, GAVE US SOME GOOD IDEAS FOR EXPANSION AS SOME OF THE PANDEMIC RESTRICTIONS ARE LIFTED.WITH THE ADDITIONAL FUNDING, WE PLAN TODO MORE OUTREACH AND MARKETING DIRECTLY TO THE CONSUMER/PATIENT. WE ALSO PLAN TO EXPAND ENROLLMENT AT EACH LOCATION AND GIVE EACH PARTICIPANT A LARGER INCENTIVE AMOUNT. WE ALSO PLAN TO CREATE RELATIONSHIPS WITH A DIVERSITY OF VENDORS, SUCH AS LOCAL PRODUCE VENDORS WHO ACCEPT SNAP BENEFITS, AND GET THEM TO ACCEPT THE FARMACY TOKENS (INCENTIVES) FROM PROGRAM PARTICIPANTS FOR ELIGIBLE PRODUCE PURCHASES. THESE RELATIONSHIPS WILL INCREASE THE DAYS AND HOURS THAT PARTICIPANTS WILL BE ABLE TO USE THEIR INCENTIVES (TOKENS) TO GAIN ACCESS TO FRESH, LOCAL AND REGIONALLY GROWN PRODUCE. WE ALSO PLAN TO USE OUR APRN SPECIALIZING IN DIABETES, OUR DIABETIC EDUCATORS AND OUR REGISTERED DIETICIAN TO ASSIST OUR DIABETIC PARTICIPANTS IN USING THIS PROGRAM TO HELP WIN THE BATTLE WITH THEIR BLOOD SUGAR LEVELS. ALONG WITH SELF-EVALUATION, MCHC WILL PROVIDE ANNUAL REPORTS TO NIFA AND COLLABORATE WITH NTAE IN EVERY WAY, AS WELL AS PERIODICALLY PROVIDING THE NTAE CENTERS A CORE PROGRAM DATA SET TO ENSURE COMMON PROGRAM TRACKING AND ENABLE MEANINGFUL COMPARISONS ACROSS ALL PROJECTS.THESE EXPANDED PROJECT GOALS WILL ALLOW US TO SERVE MORE PARTICIPANTS THAT PROBABLY WENT A WHOLE YEAR WITHOUT ACCESS TO FRESH, LOCALLY AND REGIONALLY GROWN PRODUCE, DUE TO THEIR INABILITY TO ACCESS TRANSPORTATION BECAUSE OF PANDEMIC RESTRICTIONS, OR THEIR UNWILLINGNESS TO POTENTIALLY EXPOSE THEMSELVES TO THE VIRUS BY VENTURING OUT INTO THE COMMUNITY. THE EXTRA INCENTIVE (TOKENS) AMOUNT, COUPLED WITH THE ADDITIONAL HOURS AND ACCESS, WILL HOPEFULLY ALLOW THE PARTICIPANTS TO MAKE UP FOR WHAT THEY MISSED LAST YEAR AND GET BACK ON THE PATH TO A HEALTHY DIET AND GOOD OVERALL HEALTH. ADDITIONAL ENROLLMENT SPACES WILL ALLOW SOME PEOPLE TO ACCESS THE PROGRAM THAT WERE UNABLE TO BEFORE, THUS EXPANDING THE PROGRAM BENEFITS TO A BROADER SLICE OF THE COMMUNITY. ALL OF THE EXPANSION ACTIVITIES LISTED ABOVE WILL ADD UP TO AN INCREASED BENEFIT FOR THE LOCAL ECONOMY AS MORE DOLLARS ARE FILTERED INTO THE HANDS OF A LARGER GROUP OFFRESH PRODUCE VENDORS AND SUBSEQUENTLY PUT BACK INTO THE LOCAL ECONOMY AS THE VENDORS SPEND THEIR REVENUE ON OTHER LOCAL GOODS AND SERVICES.

FY 2023 EXPANDING COVID-19 VACCINATION

HEALTH INFRASTRUCTURE INVESTMENT PROGRAM

CAPITAL DEVELOPMENT

ARRA - INCREASE SERVICES TO HEALTH CENTERS

MCHC WILL BE RESEARCHING THE PROBLEM OF LOW-INCOME PEOPLE NOT HAVING ACCESS TO HEALTHY FOODS SUCH AS FRUITS AND VEGETABLES AND HOW THAT MAY AFFECT THEIR HEALTH. GREATER ACCESS TO HEALTHY FOODS FOR LOW-INCOME PEOPLE MAY LOWER COSTS FOR FOOD, HEALTHCARE, AND OTHER ASSOCIATED COSTS FOR ALL. MCHC WILL PROVIDE VOUCHERS TO LOW-INCOME FAMILIES THAT PRESENT WITH ONE OF THE FOLLOWING DIAGNOSES (TYPE 1 OR TYPE 1 DIABETES, PREGNANT, HYPERTENSION, AND OBESITY) TO REDEEM AT LOCAL FARMER'S MARKETS IN THREE EASTERN KENTUCKY COUNTIES FOR LOCALLY GROWN FRUITS AND VEGETABLES. MCHC WILL ALSO PROVIDE EDUCATION ON HEALTHY EATING AND THE BENEFIT OF GROWING YOUR OWN FRUITS AND VEGETABLES. THE ULTIMATE GOAL OF THE PROJECT IS TO IMPROVE EATING HABITS FOR LOW-INCOME PEOPLE WHILE ALSO IMPROVING THEIR HEALTH OUTCOMES. THE EXPECTED IMPACT WOULD BE A LOWER IMPACT ON HEALTHCARE COSTS BY THIS GROUP WITH IMPROVED HEALTH OUTCOMES.

AFFORDABLE CARE ACT (ACA) GRANTS FOR SCHOOL-BASED HEALTH CENTERS CAPITAL PROGRAM

TELEMEDICINE GRANT

AFFORDABLE CARE ACT PATIENT CENTERED MEDICAL HOME FACILITY IMPROVEMENTS GRANT PROGRAM

TELEMEDICINE GRANT

FY 2020 CORONAVIRUS SUPPLEMENTAL FUNDING FOR HEALTH CENTERS

FARMACY HEALTH IMPROVEMENT PROGRAM

FY 2023 BRIDGE ACCESS PROGRAM

TELEMEDICINE GRANT

FARMACY HEALTH IMPROVEMENT PROGRAM

HEALTH INFRASTRUCTURE INVESTMENT PROGRAM