Migrant Health Center

HEALTH CENTER CLUSTER

HEALTH CENTER CLUSTER

OP EARLY INTERVENTION SVCS W/RESPECT TO HIV DISEASE

OP EARLY INTERVENTION SVCS W/RESPECT TO HIV DISEASE

AMERICAN RESCUE PLAN ACT FUNDING FOR HEALTH CENTERS

MIGRANT HEALTH CENTER, WESTERN REGION, INC. CCBH PROGRAM - MIGRANT HEALTH CENTER WESTERN REGION, INC. (MHC) IS A COMMUNITY BASED 330 (G) (E) (H), NON-PROFIT, 501C3, PROGRAM. MHC IS REQUESTING FUNDING ($1,000,000 PER YEAR/4 YEARS) TO ESTABLISH A NEW CCBHC PROGRAM. THE PROPOSED PROGRAM WOULD BE CALLED CLINICA BIENESTAR (MHC WELLNESS CLINIC). THE OVERALL GOAL IS TO INCREASE ACCESS TO INTEGRATED CARE TO ENSURE CONSUMERS HAVE IMMEDIATE AND TIMELY ACCESS TO COMPREHENSIVE, COORDINATED AND EVIDENCE-BASED BEHAVIORAL HEALTH CARE THROUGH A SINGLE POINT OF ENTRY BY ESTABLISHING THE FIRST CCBHC PROGRAM IN THE WESTERN REGION OF PUERTO RICO (PR). THE POPULATIONS TO BE SERVED ARE INDIVIDUALS WITH SERIOUS MENTAL ILLNESS, SUBSTANCE USE DISORDER, INCLUDING OPIOID USE; CHILDREN AND ADOLESCENTS WITH SERIOUS EMOTIONAL DISTURBANCE; INDIVIDUALS WITH CO-OCCURRING MENTAL AND SUBSTANCE DISORDERS; AND INDIVIDUALS EXPERIENCING A MENTAL HEALTH OR SUBSTANCE USE-RELATED CRISIS IN THE WESTERN REGION OF PR. THE WESTERN REGION OF PR IS HOME OF 408,184 RESIDENTS, OF WHICH 99% ARE HISPANIC/LATINO AND NEARLY 55% LIVE UNDER THE FEDERAL POVERTY LEVEL. THERE IS A HIGH PREVALENCE OF SUBSTANCE USE AND MENTAL HEALTH CONDITIONS AMONG THE TARGET POPULATION AND OFTEN THESE CONDITIONS GO UNDIAGNOSED AND UNTREATED. THROUGH THIS FUNDING MHC WILL: 1) HIRE 22 ADDITIONAL LEADERSHIP, CLINICAL AND SUPPORTIVE STAFF TO EXPAND ACCESS; 2) IMPLEMENT COMPREHENSIVE ASSESSMENT UTILIZING VALIDATED SCREENING AND ASSESSMENT TOOLS, INCLUSIVE OF THOSE FOR ADVERSE CHILDHOOD EXPERIENCES (ACES), SUICIDE RISK, AND BEHAVIORAL HEALTH DISORDERS, AS INDICATED; 3) DEVELOP TAILORED SERVICE AND TREATMENT PLANS; AND 4) PROVIDE A RANGE OF EVIDENCE-BASED PREVENTION AND TREATMENT SERVICES THAT ADDRESS A COMBINATION OF IMMEDIATE AND LONG-TERM NEEDS. TO MEETS THE CCBHC CERTIFICATION CRITERIA, WITHIN ONE YEAR OF GRANT AWARD, MHC WILL PROVIDE AT LEAST FIVE OF THE NINE REQUIRED SERVICES BY THE 6 MONTH AFTER AWARD (SCREENING, ASSESSMENT, AND DIAGNOSIS; TREATMENT PLANNING; TARGETED CASE MANAGEMENT; PSYCHIATRIC REHABILITATION SERVICES; AND PEER SUPPORT COUNSELING SERVICES); AND PROVIDE ALL THE REQUIRED NINE CORE CCBHC SERVICES WITHIN TWELVE MONTHS (ADDING CRISIS MENTAL HEALTH SERVICES, OUTPATIENT MENTAL HEALTH AND SUBSTANCE USE SERVICES, OUTPATIENT CLINIC PRIMARY CARE SCREENING AND MONITORING, AND COMMUNITY-BASED MENTAL HEALTH FOR MEMBERS OF THE ARMED FORCES AND VETERANS). SOME OF THE EBPS EVIDENCE-INFORMED, THAT WILL BE USED AND THE PROPOSED CCBHC ARE: MOTIVATIONAL INTERVIEWING, SBIRT, PEER AND FAMILY SUPPORT SPECIALISTS, MEDICATION-ASSISTED TREATMENT, SOLUTION-FOCUSED THERAPY, COGNITIVE BEHAVIORAL THERAPY, AND TRAUMA-FOCUSED COGNITIVE BEHAVIORAL THERAPY, AMONG OTHERS. THE OBJECTIVES OF THE PROPOSED PROJECT ARE: 1) BY 9/29/27 THE PROJECT WILL HAVE PROVIDED SERVICES TO AT LEAST 1,500 (Y1 250, Y2 350, Y3 400, AND Y4 500) UNDUPLICATED INDIVIDUALS FROM THE WESTERN REGION OF PR. 2) BY 9/29/24 MHC WILL OBTAIN THE CCBHC DESIGNATION, COMPLYING WITH ALL CERTIFICATION CRITERIA ESTABLISHED IN THE COMPLIANCE CHECKLIST. 3) BY 03/31/24 THE PROJECT WILL HAVE CONDUCTED A COMMUNITY ASSESSMENT, PRESENTED ITS RESULTS TO SAMHSA, AND WILL BE PROVIDING AT LEAST 5 REQUIRED SERVICES. 4) BY 9/29/24 MHC WILL DEVELOP A SUSTAINABILITY PLAN TO SUPPORT DELIVERY OF SERVICES. 5) BY 12/31/23 MHC WILL HAVE HIRED ALL OF THE PROPOSED 22 CCBHC PROGRAM STAFF. 6) BY 9/29/27 THE PROJECT WILL HAVE INCREASED INITIATION AND ENGAGEMENT IN TREATMENT BY AT LEAST 25% (FROM BASELINE). 7) BY 9/29/27 THE PROJECT WILL HAVE REDUCED THE TIME BETWEEN SCREENING AND TREATMENT INITIATION BY AT LEAST 25% (FROM BASELINE). 8) BY 9/29/27 100% OF PROGRAM PARTICIPANTS WILL HAVE COMPLETED A COMPREHENSIVE INTAKE AND INTEGRATED TREATMENT PLAN DEVELOPMENT PROCESS. AND 9) BY 9/29/27 THE PROJECT WILL HAVE INCREASED THE NUMBER OF CONSUMERS INITIATED ON MEDICATION-ASSISTED TREATMENT BY AT LEAST 20% (FROM BASELINE).

INCREASE LINKAGE TO HIV CARE, REDUCE BEHAVIORAL HEALTH PROBLEMS, REDUCE HIV RISK AND INCIDENCE REDUCE TRAUMA RELATED CONDITIONS AMONG MSM, YMSM, GAY, BISEXUAL AND TRANSGENDER INDIVIDUALS.

COMMUNITY BASED TREATMENT SYSTEM FOR HISPANIC YMSM 18-29

COMPREHENSIVE HIGH-IMPACT HIV PREVENTION PROGRAMS FOR COMMUNITY-BASED ORGANIZATIONS - MIGRANT HEALTH CENTER, WESTERN REGION, INC. (MHC) IS A NON-PROFIT 501C3 CORPORATION ESTABLISHED IN PUERTO RICO (PR); THAT THROUGH ITS CDC FUNDED PROGRAM ?NUEVO HORIZONTE? HAS BEEN PROVIDING HIV PREVENTION SERVICES SINCE 1998 TO THE POPULATION OF PWIDS. FOR THIS FUNDING OPPORTUNITY (CDC-RFA-PS21-2102) MHC IS REQUESTING THE AMOUNT OF $470,000 PER YEAR FOR THE TOTAL OF PERFORMANCE LENGTH OF 5 YEARS TO CONTINUE TO PROVIDE A COMPREHENSIVE HIGH-IMPACT HIV PREVENTION PROGRAM SERVICES. THE PURPOSE OF THE PROPOSED PROGRAM IS TO ADDRESS THE HIV EPIDEMIC BY REDUCING NEW INFECTIONS, INCREASING ACCESS TO CARE, AND PROMOTING HEALTH EQUITY IN ACCORDANCE WITH THE ENDING THE HIV EPIDEMIC AND CDC?S HIGH-IMPACT PREVENTION APPROACH. MHC IS PROPOSING TO PROVIDE SERVICES FOR PEOPLE WITH AND AT GREATEST RISK FOR ACQUIRING HIV, PARTICULARLY PWIDS FROM THE WESTERN, NORTHWESTERN AND SOUTHWESTERN REGIONS OF PR. THE PROPOSED TARGET POPULATION IS HISPANIC, MALES AND FEMALES, OVER 18 YEARS OF AGE, WHO INJECT DRUGS. THE TARGET POPULATION IS ONE OF THE PRIORITIZED POPULATIONS IDENTIFIED IN THE PR INTEGRATED HIV PREVENTION AND CARE PLAN. MHC WILL INCREASE ACCESS TO HIV TESTING, REFERRALS TO PARTNER SERVICES, LINK PERSONS INTO HIV MEDICAL CARE AND ART, PROVIDE/REFER TO PREVENTION AND SUPPORT SERVICES, INCLUDING SUBSTANCE USE TREATMENT, FOR PERSONS WITH HIV AND HIGH-RISK HIV NEGATIVES. THE PROPOSED PROGRAM WILL PROVIDE ALL REQUIRED COMPREHENSIVE HIV PREVENTION CORE AND OPERATIONAL PROGRAM ACTIVITIES AND STRATEGIES THAT INCLUDE: 1) DIAGNOSE (TARGETED HIV TESTING, PROVIDE AND/OR REFER TO INTEGRATED SCREENINGS); 2) TREAT (LINKAGE TO HIV MEDICAL CARE, RE-ENGAGEMENT, PARTNER SERVICES REFERRAL, MEDICATION ADHERENCE TO ACHIEVE VIRAL SUPPRESSION); 3) PREVENT (REFERRALS TO PREP AND NPEP, HEALTH EDUCATION/RISK REDUCTION, CONDOM DISTRIBUTION); 4) RESPOND (SUPPORT FOR HEALTH DEPARTMENT CLUSTER DETECTION AND RESPONSE ACTIVITIES); 5) PROGRAM PROMOTION, OUTREACH, AND RECRUITMENT; 6) COMMUNITY E NGAGEMENT GROUP; AND 7) HIV PLANNING GROUP. THE PROJECT WILL ALSO PROVIDE ARTAS AS OUR LINKAGE-TO-CARE INTERVENTION, HIV NAVIGATION SERVICES FOR LINKAGE OR RE-ENGAGEMENT TO HIV MEDICAL CARE, PREVENTION AND ESSENTIAL SUPPORT SERVICES AND PROMISE AS OUR HIGH IMPACT PREVENTION RISK REDUCTION INTERVENTION FOR PERSONS WITH HIV AND PERSONS AT HIGH-RISK OF ACQUIRING IN A COMMUNITY LEVEL. THE PROPOSED AND EXPECTED SHORT-TERM OUTCOMES BY THE END OF THE 5 YEAR PROJECT PERIOD ARE: 1) INCREASED PERSONS FROM THE TARGET POPULATION AWARE OF THEIR HIV STATUS BY CONDUCTING AT LEAST 700 HIV TESTS (IDENTIFYING AT LEAST 8 NEWLY-DIAGNOSED, HIV-POSITIVE INDIVIDUALS) ANNUALLY; 2) INCREASED NUMBER OF RECIPIENTS OF INTEGRATED SCREENINGS SERVICES (TB, HCV AND STD TESTING) THROUGHOUT THE TARGET AREA BY OFFERING REFERRALS FOR SCREENINGS TO 100% OF PROJECT PARTICIPANTS, RESULTING IN AT LEAST 100 HCV RAPID TESTS CONDUCTED ANNUALLY; 3) INCREASE RECEIPT OF HIV MEDICAL CARE AND ART BY LINKING AT LEAST 90% OF ALL PERSONS WITH NEWLY-DIAGNOSED INFECTIONS INTO MEDICAL CARE AND ART WITHIN 30 DAYS OF DIAGNOSIS; 4) INCREASED RECEIPT OF HIV MEDICAL CARE AND ART BY RE-ENGAGING AT LEAST 90% OF ALL PREVIOUSLY DIAGNOSED, OUT-OF-CARE, HIV-POSITIVE INDIVIDUALS IDENTIFIED INTO HIV MEDICAL CARE AND ART; 5) INCREASED ACCESS TO PARTNER SERVICES (PS) BY REFERRING 100% OF PERSONS WITH NEWLY OR PREVIOUSLY DIAGNOSED HIV INFECTIONS TO PS, IN ACCORDANCE WITH PR STATE AND LOCAL REGULATIONS; 6) INCREASED ACCESS TO PREP AND NPEP AMONG MEMBERS OF THE TARGET POPULATION BY REFERRING AT LEAST 50 HIV-NEGATIVE PERSONS TO PREP AND/OR NPEP, ANNUALLY, AS APPROPRIATE; AND 7) INCREASED AVAILABILITY OF CONDOMS IN THE PROPOSED GEOGRAPHICAL AREAS BY OFFERING FREE CONDOMS TO 100% OF PROGRAM PARTICIPANTS, AND DISTRIBUTING AT LEAST 24,000 CONDOMS ANNUALLY. OUR PROJECT IS LOCATED AT AVE. DUNSCOMBE IN MAYAGUEZ AND SERVICES WILL BE PROVIDED IN AREAS OF HIGH INCIDENCE AND PREVALEN

PROVIDE HIV PREVENTION SERVICES FOR YMSM OF COLOR (13-24 YEARS) AND THEIR PARTNERS FROM THE WESTERN REGION OF PUERTO RICO.

RURAL COMMUNITIES OPIOID RESPONSE PROGRAM ? MENTAL AND BEHAVIORAL HEALTH - PROJECT TITLE: PUERTO RICO RCORP-BEHAVIORAL HEALTH REQUESTED AWARD AMOUNT: $500,000 PER YEAR APPLICANT ORGANIZATION NAME: MIGRANT HEALTH CENTER, WESTERN REGION, INC. (MHC) ADDRESS: 491 SOUTH RAMON E. BETANCES STREET P.O. BOX 190, MAYAGUEZ, P.R. 00681 APPLICANT ORGANIZATION FACILITY TYPE: FEDERALLY QUALIFIED HEALTH CENTER (COMMUNITY-BASED) PROJECT DIRECTOR NAME AND TITLE: DR. TANIA RODRIGUEZ, CHIEF EXECUTIVE OFFICER DIRECTOR CONTACT INFORMATION: PHONE: 787-831-5800 / EMAIL: MHC@MIGRANTSPR.COM DATA COORDINATOR: CHRISTIAN RAMIREZ, DATA COORDINATOR CONTACT INFORMATION: PHONE: 787-831-5800 / EMAIL: CHRISTIAN.RAMIREZ@MIGRANTSPR.COM EIN/DUNS NUMBER EXCEPTION REQUEST IN ATTACHMENT 8: NO LEARNED ABOUT THIS FUNDING OPPORTUNITY: GRANTS.GOV NUMBER OF CONSORTIUM MEMBERS & LIST OF CONSORTIUM MEMBERS: 6 MEMBERS MIGRANT HEALTH CENTER WESTERN REGION, INC. (EIN: 66-0427801); PUERTO RICO PRIMARY CARE ASSOCIATION (EIN: 66-0427801); CAMUY HEALTH SERVICES, INC. (EIN: 66-0428652); CENTRO DE SERVICIO PRIMARIOS DE SALUD DE PATILLAS (EIN: 66-0430826); CENTRO DE SALUD LARES, INC. (EIN: 66-0426506); AND HPM FOUNDATION, INC. (EIN: 66-0437924). PREVIOUS/CURRENT RCORP AWARD RECIPIENT: YES. PREVIOUS, FY20 RCORP-PLANNING APPLICANT ORGANIZATION INTENDS TO APPLY FOR FY22 RCORP- IMPLEMENTATION: YES DOES TARGET SERVICE AREA OVERLAP: NO. IN PUERTO RICO THERE IS NO OTHER RCORP RECIPIENT. TARGET SERVICE AREA: THE PROPOSED TARGET POPULATION IS RURAL COMMUNITIES FROM PUERTO RICO. THE TARGET SERVICE AREA, ACCORDING TO THE RURAL HEALTH GRANTS ELIGIBILITY ANALYZER IS COMPOSED OF TWENTY-ONE (21) MUNICIPALITIES (COUNTIES) OF WHICH NINE (9) ARE CONSIDERED FULLY-RURAL: (ADJUNTAS, COAMO, CULEBRA, JAYUYA, LAS MARIAS, MARICAO, SALINAS, SANTA ISABEL, AND VIEQUES) AND TWELVE (12) ARE DESIGNATED AS PARTIALLY-RURAL: (AÑASCO 72011810100, CABO ROJO 72023980000, CAMUY 72027320500, CATAÑO 72033980008 / 72033990201, CEIBA 72037160100, LARES 72081958300 / 72081958400, MAUNABO 72095951400 / 720959 51500 / 72095951600, OROCOVIS 72107954901, RIO GRANDE 72119992700, SAN JUAN 72127980300, UTUADO 72141956900 / 72141957200, AND YAUCO 72153750101).\ BRIEF DESCRIPTION OF THE TARGET POPULATION: THE PROPOSED TARGET POPULATION IS HIGH RISK RURAL COMMUNITIES FROM PUERTO RICO. A TOTAL OF 158,265 RESIDENTS WERE LOCATED IN DESIGNATED FULLY-RURAL MUNICIPALITIES AND 42,232 AMONG THE PARTIALLY-RURAL MUNICIPALITIES. THE POPULATION IS MOSTLY POOR AND IS COMPOSED PRIMARILY OF HISPANIC/LATINO INDIVIDUALS (98.7%). THE PROPOSED TARGET POPULATIONS ARE: 1) INDIVIDUALS AT RISK FOR SUD/OUD AND/OR CO-OCCURRING MENTAL DISORDERS; 2) INDIVIDUALS DIAGNOSED WITH SUD/OUD AND/OR CO-OCCURRING MENTAL DISORDERS; 3) INDIVIDUALS IN TREATMENT AND/OR RECOVERY FOR SUD/OUD AND/OR OTHER CO-OCCURRING MENTAL DISORDERS; 4) THEIR FAMILIES AND/OR CAREGIVERS; AND 5) COMMUNITY MEMBERS WHO RESIDE IN THE PROPOSED RURAL TARGET SERVICE AREA. THE PROJECT WILL PRIORITIZED TARGET POPULATIONS WHO HAVE HISTORICALLY SUFFERED FROM POORER HEALTH OUTCOMES, HEALTH DISPARITIES AND OTHER INEQUITIES AS COMPARED TO THE REST OF THE POPULATION, SUCH AS: HISPANIC/LATINO, PEOPLE WHO INJECTION DRUGS, PEOPLE WHO ARE PREGNANT, ADOLESCENTS AND YOUTH, LGBTQ+ INDIVIDUALS, VETERANS, FARMWORKERS, SOCIOECONOMICALLY DISADVANTAGED POPULATIONS, THE ELDERLY, AND INDIVIDUALS WITH DISABILITIES. THE FOLLOWING AREAS OF NEED WERE IDENTIFIED IN RURAL PR, AND WILL HENCEFORTH GUIDE THE PROGRAM ACTIVITIES: 1) INSUFFICIENT NUMBER OF BH/SUD HEALTH PROFESSIONALS IN RURAL PR; 2) LACK OF RURAL BH CARE SERVICES PROVIDED IN A COORDINATED AND INTEGRATED MANNER; 3) INSUFFICIENT NUMBER OF RURAL HEALTH CARE PROVIDERS UTILIZING EVIDENCE-BASED, TRAUMA-INFORMED SUD IN THE PROVISION OF BH CARE SERVICES; 4) STIGMA; AND 5) INSUFFICIENT TRAINING TO PROVIDE EVIDENCE BASED CARE FOR PATIENTS WITH SUD/AMI.

COMPREHENSIVE HIGH-IMPACT HIV PREVENTION PROJECTS FOR COMMUNITY-BASED ORGANIZATIONS

PS10-1003 HIV PREVENTION PROJECTS FOR CBO'S

HIV PREVENTION PROJECTS FOR THE COMMONWEALTH OF PUERTO RICO & U.S. VIRGIN ISLANDS

MIGRANT HEALTH CENTER, WESTERN REGION, INC. SAMHSA-CARIB PROJECT - MIGRANT HEALTH CENTER WESTERN REGION, INC. (MHC) IS A COMMUNITY BASED, 330 (G) (E) (H), NON-PROFIT, 501(C) 3, MHC IS FEDERALLY QUALIFIED HEALTH CENTER AND PATIENT CENTERED MEDICAL HOME PRIMARY AND PREVENTIVE HEALTHCARE FACILITY WITH A VAST ARRAY OF CLINICAL AND SUPPORT SERVICE STAFF MEMBER, DISTRIBUTED ACROSS ITS 13 SERVICE SITES LOCATED THROUGHOUT THE WESTERN REGIONS OF PUERTO RICO (PR). MHC PROVIDES PRIMARY, PREVENTIVE, AND SPECIALTY CARE, AS WELL AS SUPPORT SERVICES THAT INCLUDE HIV, HEPATITIS AND SUD PREVENTION/TREATMENT, GROUP THERAPY, TRANSPORTATION, CASE MANAGEMENT, HEALTH EDUCATION, GENERAL MEDICINE, PEDIATRICS, FAMILY MEDICINE, PSYCHOLOGICAL, PSYCHIATRIC SERVICES, ORAL HEALTH, OB/GYN, MAT, PREP, OPTOMETRY, RADIOLOGY, PHARMACY, LABORATORY, VACCINATION, NUTRITION, AND MORE. MHC IS REQUESTING $500,000 PER YEAR FOR 5 YEARS TO GIVE CONTINUITY TO THE CARIB PROJECT. MHC HAVE IDENTIFIED THE POPULATION OF UNDERSERVED LATINO YOUNG MEN WHO HAVE SEX WITH MEN (YMSM) AGES 15-34, AND OTHER HIGH-RISK POPULATIONS SUCH AS MEN WHO HAVE SEX WITH MEN (MSM) AGES 35 AND OLDER, GAY, BISEXUAL, AND TRANSGENDER INDIVIDUALS WITH SUBSTANCE USE DISORDERS (SUDS) AND/OR CO-OCCURRING SUDS AND MENTAL HEALTH CONDITIONS (COD) WHO ARE AT RISK FOR OR LIVING WITH HIV. THE PROPOSED CATCHMENT AREA IS THE WESTERN REGION OF PR, WHICH IS COMPOSED OF 17 MUNICIPALITIES. ACCORDING TO THE U.S. CENSUS BUREAU APPROXIMATELY 530,103 INDIVIDUALS RESIDE IN THE PROPOSED AREA, OF WHICH 98.8% ARE LATINO, 95% SPEAK SPANISH AS THEIR PRIMARY LANGUAGE, AND 40.5% LIVE UNDER FEDERAL POVERTY LEVEL. MHC WILL PROVIDE COMMUNITY OUTREACH, CASE MANAGEMENT, SUBSTANCE ABUSE COUNSELING, SUD/COD SCREENING, TREATMENT AND RECOVERY SUPPORT SERVICES, PATIENT NAVIGATION, PSYCHOLOGICAL AND PSYCHIATRIC SERVICES, HIV AND HCV TESTING, LINKAGE TO MEDICAL CARE, LINKAGE TO PREVENTION SERVICES AND PREP, SUPPORT GROUPS, AND HEPATITIS VACCINATION, AMONG OTHERS. THE INTERVENTIONS TO BE UTILIZED INCLUDE TRAUMA INFORMED CARE, SBIRT, PERSONALIZED COGNITIVE COUNSELING, ARTAS, COGNITIVE BEHAVIORAL THERAPY, MOTIVATIONAL INTERVIEWING, AND DIALECTIC BEHAVIORAL THERAPY, AMONG OTHERS. THROUGHOUT THE LIFETIME OF THE PROJECT MHC IS PROPOSING TO SERVE 1,200 PERSONS (FY1 – 240, FY2 – 240, FY3 – 240, FY4 – 240, AND FY5 – 240). THE PROJECT GOALS ARE1) INCREASE ACCESS TO HIV TESTING AND RISK REDUCTION SERVICES FOR INDIVIDUALS WHO ARE AT RISK AND INCREASE ACCESS TO TREATMENT FOR THOSE LIVING WITH HIV TO ANTIRETROVIRAL THERAPY (ART), AND LINKAGE TO CARE, REDUCING HIV RISK AND PREVALENCE. 2) INCREASE THE NUMBER OF INDIVIDUALS WHO ARE AT RISK FOR HIV WITH SUD/COD WHO ACCESS EVIDENCE-BASED SCREENING/ASSESSMENT, SUD/COD TREATMENT AND RECOVERY SUPPORT SERVICES. 3) INCREASE THE NUMBER OF INDIVIDUALS WITH SUD/COD WHO LIVE WITH HIV WHO ARE ON ART AND LINKED TO HIV CARE, REDUCING THE IMPACT OF BEHAVIORAL HEALTH PROBLEMS, REDUCING HIV RISK AND INCIDENCE, REDUCING TRAUMA RELATED CONDITIONS, AND INCREASING ACCESS TO RETENTION IN TREATMENT FOR INDIVIDUALS WITH CO-EXISTING BEHAVIORAL HEALTH, HIV AND HEPATITIS CONDITION AMONG THE TARGET POPULATION. THE ESTABLISHED OBJECTIVES ARE: 1) CONDUCT A COMMUNITY NEED ASSESSMENT; 2) ESTABLISH AT LEAST 10 MOAS ANNUALLY; 3) ANNUALLY LINK AT LEAST 20 INDIVIDUALS WITH SUD/COD TO TREATMENT AND/OR RECOVERY SERVICES; 4) ANNUALLY AT LEAST 100 PROGRAM PARTICIPANTS WILL BE LINKED TO PSYCHOLOGICAL OR PSYCHIATRIC SERVICES, AS NEEDED; 5) ANNUALLY AT LEAST 50 CLIENTS WILL RECEIVE CASE MANAGEMENT AND SUBSTANCE ABUSE COUNSELING SERVICES; 6) ANNUALLY AT LEAST 400 HIV TEST AND 300 HEPATITIS (C OR B) WILL BE PERFORMED; 7) ANNUALLY 100% OF INDIVIDUALS AT RISK FOR HIV RECEIVING PROGRAM SERVICES WILL BE SCREENED FOR HIV, SUD AND FOR THE PRESENCE OF CODS; 8) 100% OF HIV/HEPATITIS POSITIVE RESULTS WILL BE REFERRED/LINKED TO TREATMENT; 9) ANNUALLY AT LEAST 200 MEMBERS OF THE TARGET POPULATION WILL BE REFERRED TO PREVENTION AND ESSENTIAL SUPPORT SERVICES, INCLUDING PREP; AND 9) ANNUALLY AT LEAST 50 VIRAL HEPATITIS (B OR C) V

ARRA - CAPITAL IMPROVEMENT PROGRAM

RURAL COMMUNITIES OPIOID RESPONSE-IMPLEMENTATION - PROJECT TITLE: PUERTO RICO RCORP-IMPLEMENTATION REQUESTED AWARD AMOUNT: $1,000,000 APPLICANT ORGANIZATION NAME: MIGRANT HEALTH CENTER, WESTERN REGION, INC. (MHC) ADDRESS: 491 SOUTH RAMON E. BETANCES STREET P.O. BOX 190, MAYAGUEZ, P.R. 00681 APPLICANT ORGANIZATION FACILITY TYPE: FEDERALLY QUALIFIED HEALTH CENTER (COMMUNITY-BASED) PROJECT DIRECTOR NAME AND TITLE: HENDRYX MALARET (MHC SPECIAL PROJECTS COORDINATOR) DIRECTOR CONTACT INFORMATION: PHONE: 787-831-5800 / EMAIL: MHC@MIGRANTSPR.COM CURRENT FY20 OR FY21 RCORP-IMPLEMENTATION AWARD RECIPIENT: NO EIN EXCEPTION REQUEST IN ATTACHMENT 8: NO LEARNED ABOUT THIS FUNDING OPPORTUNITY: GRANTS.GOV NUMBER OF CONSORTIUM MEMBERS & LIST OF CONSORTIUM MEMBERS: 8 MEMBERS MIGRANT HEALTH CENTER WESTERN REGION, INC. (EIN: 66-0427801); PUERTO RICO PRIMARY CARE ASSOCIATION (EIN: 66-0427801); CAMUY HEALTH SERVICES, INC. (EIN: 66-0428652); CENTRO DE SERVICIO PRIMARIOS DE SALUD DE PATILLAS (EIN: 66-0430826); CENTRO DE SALUD LARES, INC. (EIN: 66-0426506); HPM FOUNDATION, INC. (EIN: 66-0437924); INICIATIVA COMUNITARIA DE INVESTIGACION, INC. (EIN: 66-0483960); AND INTERCAMBIOS PUERTO RICO, INC. (EIN: 66-0731885). PREVIOUS/CURRENT RCORP AWARD RECIPIENT: YES FY20 RCORP-IMPLEMENTATION APPLICANT. BRIEF DESCRIPTION OF THE TARGET POPULATION: THE PROPOSED TARGET POPULATION IS HIGH-RISK RURAL COMMUNITIES FROM PUERTO RICO (PR). A TOTAL OF 158,265 INDIVIDUALS RESIDES IN FULLY RURAL AND 42,232 WITHIN PARTIALLY RURAL DESIGNATED MUNICIPALITIES. THE POPULATION MAJORITY ARE HISPANIC/LATINX INDIVIDUALS (98.7%), PRIMARILY IMPOVERISHED POPULATIONS. THE PROJECT WILL PRIORITIZE TARGET POPULATIONS WHO HAVE HISTORICALLY SUFFERED FROM POORER HEALTH OUTCOMES OR HEALTH DISPARITIES, AS COMPARED TO THE REST OF THE TARGET RURAL POPULATION. THE FOLLOWING AREAS OF NEED WERE IDENTIFIED IN RURAL PR, HENCEFORTH GUIDING PROJECT ACTIVITIES: 1) INSUFFICIENT NUMBER OF ADDICTION TREATMENT SPECIALISTS; 2) INSUFFICIENT TRAINING TO PROVIDE EVI DENCE-BASED CARE FOR PATIENTS WITH OUD; 3) LACK OF EDUCATION ON HIGH-RISK COMMUNITIES RELATING TO PREVENTION, TREATMENT, AND RECOVERY; 4) THE PROVISION OF MEDICATION FOR OUD IS OFTEN NOT STANDARDIZED NOR INTEGRATED; 5) STIGMATIZING ATTITUDE TOWARDS PATIENTS WITH SUD/OUD; 6) POOR ACCESS TO REFERRALS FOR SPECIFIC SERVICES THAT MEET PATIENTS’ NEEDS; 7) NEED FOR TRAINING FOR MEDICAL STAFF IN RURAL AREAS (REGARDING SUD/OUD); 8) INCREASE AMOUNT OF ACTIVELY PRESCRIBING MAT PROVIDERS; 9) INCREASE THE NUMBER OF CULTURALLY COMPETENT SUBSTANCE USE PROVIDERS, SENSITIVE TO THE REALITIES FACED BY SUD/OUD PERSONS; 10) LACK OF STANDARDIZED AND CENTRALIZED DATA COLLECTION AND REPORTING EFFORTS REGARDING SUD/OUD; AND 11) INCREASE ACCESS TO NALOXONE FOR INDIVIDUALS, RELATIVES, AND AGENCIES. THE PRIORITY POPULATIONS IDENTIFIED BY THE PR-RCORP INCLUDE: LEVEL 1- PERSONS WHO INJECT DRUGS; LEVEL 2- SERVICE PROVIDERS, ON AN INDIVIDUAL LEVEL; AND LEVEL 3- AGENCIES, ACROSS ALL LEVELS OF THE ORGANIZATION. TARGET SERVICE AREA: THE PROPOSED TARGET POPULATION IS HIGH-RISK RURAL COMMUNITIES FROM PUERTO RICO. THE TARGET SERVICE AREA, ACCORDING TO THE RURAL HEALTH GRANTS ELIGIBILITY ANALYZER, IS COMPOSED OF TWENTY-ONE (21) MUNICIPALITIES AND COUNTIES, OUT OF WHICH NINE (9) ARE DESIGNATED AS FULLY RURAL (ADJUNTAS, COAMO, CULEBRA, JAYUYA, LAS MARIAS, MARICAO, SALINAS, SANTA ISABEL, AND VIEQUES) AND TWELVE (12) AS PARTIALLY RURAL (AÑASCO 72011810100, CABO ROJO 72023980000, CAMUY 72027320500, CATAÑO 72033980008 / 72033990201, CEIBA 72037160100, LARES 72081958300 / 72081958400, MAUNABO 72095951400 / 72095951500 / 72095951600, OROCOVIS 72107954901, RIO GRANDE 72119992700, SAN JUAN 72127980300, UTUADO 72141956900 / 72141957200, AND YAUCO 72153750101). DOES TARGET SERVICE AREA OVERLAP: NO. IN PUERTO RICO THERE IS NO OTHER RCORP GRANT RECIPIENT. THIS IS THE ONLY RCORP-FUNDED RECIPIENT, CURRENTLY AWARDED THROUGH PLANNING FUNDS EXCLUSIVELY.

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

HEALTH CENTER INFRASTRUCTURE SUPPORT

TO PROVIDE SERVICES TO LATINO YOUTH AGES 13 TO 24 AT HIGHEST RISK FOR HIV AND SUBSTANCE USE DISORDERS LIVING IN THE MUNICIPALITIES OF SAN JUAN, AGUADILLA, PONCE AND MAYAGUEZ WITH A NAVIGATION APPROACH - MIGRANT HEALTH CENTER, WESTERN REGION, INC. (HEREIN MHC) IS A RURAL FQHC COMMUNITY BASED 330 (G)(E)(B) PROGRAM, SAMHSA, CDC, AIDS UNITED AND HAB PROVIDER AND IS PATIENT CENTERED MEDICAL HOME NCQA CERTIFIED. THE CENTER BEGAN ITS OPERATION IN APRIL 1971, SERVING MIGRANT AND SEASONAL FARMWORKERS AND THEIR DEPENDENTS IN TWO (2) MUNICIPALITIES. IN 1986 THE PROGRAM WAS INCORPORATED AS A NON-PROFIT ORGANIZATION UNDER THE LAWS OF THE COMMONWEALTH OF PUERTO RICO (PR), WITH ITS OWN BOARD OF DIRECTORS, WHICH IS CURRENTLY COMPOSED OF 13 MEMBERS REPRESENTATIVES OF THE COMMUNITIES WE SERVE. MHC INC., SERVES MUNICIPALITIES IN THE WESTERN, NORTHWESTERN AND SOUTHWESTERN REGION OF PR, WITH 11 (11) CLINICS STRATEGICALLY LOCATED IN THE MUNICIPALITIES OF MAYAGUEZ, SAN SEBASTIAN, GUANICA, ISABELA, LAJAS, MARICAO, LAS MARIAS AND YAUCO SERVING OVER 30,000 PATIENTS. MHC PROVIDES: PRIMARY HEALTH CARE, DENTAL, PHARMACY, LABORATORY, FAMILY, INTERNAL, PEDIATRIC MEDICINE, OB/GYN, MENTAL HEALTH (MH) , NUTRITION, HEALTH EDUCATION, TRANSPORTATION, OUTREACH, CASE MANAGEMENT (CM), URGENCY CARE, AMONG OTHER. THE CENTER IS THE ONLY HEALTH CARE PROVIDER IN THE REGION THAT HAS EXPANDED ITS DELIVERY OF SERVICE PROVIDING SUBSTANCE ABUSE, MH AND HIV PREVENTION FOR YOUNG MEN WHO HAVE SEX WITH MEN (YMSM) AND TRANSGENDER YOUTH, FREE PRIMARY HEALTH AND DENTAL SERVICES FOR THE HOMELESS, HIV TREATMENT FOR PEOPLE LIVING WITH HIV/AIDS, MEDICALLY ASSISTED TREATMENT FOR PEOPLE WITH OPIOID USE DISORDERS AND HIV PREVENTION AND NEEDLE EXCHANGE SERVICES FOR INJECTING DRUG USERS (IDU), ALL UNDER ONE ROOF.OUR MISSION IS CENTERED ON PROVIDING HIGH QUALITY, EVIDENCE BASED, COMPREHENSIVE PRIMARY HEALTH CARE SERVICE THAT ARE ACCESSIBLE TO THE POPULATIONS WE SERVE IN A SENSITIVE, CULTURALLY COMPETENT AND COST EFFECTIVE MANNER BASED ON THE PATIENT’S NEEDS, REGARDLESS OF THEIR CAPACITY TO PAY. IN 2017, THE PR HEALTH AND ADDICTION SERVICES ADMINISTRATION CONDUCTED A STUDY TO MONITOR THE SUBSTANCE USE AMONG THE ISLANDS YOUTH. ACCORDING TO THE STUDY, THE SUBSTANCES MOST REPORTED WERE; ALCOHOL 44.5%; MARIHUANA 12.1%; TOBACCO 9%; SYNTHETIC MARIHUANA 5%; NON-PRESCRIPTION PILLS 4.2%; AND INHALANTS 3.9%. MALES REPORTED THE USE OF ALL SUBSTANCES MORE FREQUENTLY THAN FEMALES. IN ADDITION, ONLY 16.9% OF ADOLESCENTS WERE ASKED FOR IDENTIFICATION THE LAST TIME THEY WENT TO PURCHASE ALCOHOL. IN TERMS OF SEXUAL BEHAVIORS, 50.2% REPORTED HAVING HAD SEXUAL RELATIONS BEFORE THE AGE OF 15, WITH ONLY 25% REPORTING THE USE OF SOME TYPE OF PROTECTION. MHC IS PROPOSING TO PROVIDE SERVICES TO LATINO YOUTH AGES 13 TO 24 AT HIGHEST RISK FOR HIV AND SUBSTANCE USE DISORDERS LIVING IN THE MUNICIPALITIES OF SAN JUAN, AGUADILLA PONCE AND MAYAGUEZ. THE PROGRAM PROPOSES TO USE A NAVIGATION APPROACH (COMMUNITY HEALTH WORKERS, NEIGHBORHOOD NAVIGATORS, AND PEER SUPPORT SPECIALISTS) TO EXPEDITE SERVICES FOR THESE POPULATIONS. THE PROJECT WILL DEPLOY THE MOTIVATIONAL INTERVIEW AND TRAUMA INFORMED APPROACH EVIDENCE-BASED PRACTICE. THIS PRACTICE WILL BE SUPPORTED BY OTHER SERVICES THAT OUR PROJECT WILL PROVIDE SUCH AS; SUBSTANCE MISUSE PREVENTION EDUCATION, HIV PREVENTION, HIV AND VIRAL HEPATITIS TESTING, LINKAGE TO TREATMENT AND CARE, CONDOM DISTRIBUTION, COMMUNITY HEALTH FAIRS, AMONG OTHER. OUR MAIN GOAL IS TO PROVIDE SUBSTANCE ABUSE AND HIV PREVENTION ACTIVITIES AS WELL TO NAVIGATE AND LINK INDIVIDUALS TO CARE FOR HIV AND SUBSTANCE MISUSE. MHC PROPOSES TO SERVE 1,000 (200 CLIENTS IN A YEARLY BASIS) UNDUPLICATED TARGET CLIENTS IN THE ENTIRE PROJECT PERIOD. THROUGH THIS PROPOSAL, MHC, INC. IS REQUESTING THE AMOUNT OF $200,000 PER YEAR.

FY 2018 CAPITAL ASSISTANCE FOR HURRICANE RESPONSE AND RECOVERY EFFORTS

DLT OPIOID GRANTS

FY 2024 BEHAVIORAL HEALTH SERVICE EXPANSION - MIGRANT HEALTH CENTER WESTERN REGION, IN. (MIGRANT) PROGRAM GRANT NUMBER (H80CS00620) IS A COMMUNITY BASED, 330 (G) (E) (H), NON-PROFIT, 501(C3). MIGRANT PROVIDES INTEGRATED HIGH-QUALITY HEALTH SERVICES IN 15 CLINICS LOCATED IN THE WESTERN REGIONS OF PUERTO RICO (PR). MIGRANT PROVIDES PRIMARY CARE, BEHAVIORAL HEALTH, OB/GYN, ORAL HEALTH, NUTRITION, OPTOMETRY, MENTAL HEALTH, X RAYS, PHARMACY, LABORATORY, HIV PREVENTION AND TREATMENT, VACCINATION, AND SUBSTANCE ABUSE SERVICES, AMONG OTHERS. MIGRANT IS REQUESTING HRSA-24-078 FUNDING FOR TWO YEARS ($600,000 FY1 AND $500,000 FY2) TO INCREASE ACCESS TO BEHAVIORAL HEALTH SERVICES THROUGH EXPANDING MENTAL HEALTH AND SUBSTANCE USE DISORDER (SUD) SERVICES. MIGRANT IS PROPOSING TO USE UP TO $100,000 IN YEAR 1 FOR MINOR A/R COSTS NECESSARY TO MEET THE BHSE OBJECTIVES. THE POPULATIONS TO BE SERVED ARE HISPANIC/LATINO INDIVIDUALS WITH MENTAL HEALTH CONDITION OR AN SUD, INCLUDING OPIOID USE IN THE WESTERN REGIONS OF PR. THE WESTERN REGION OF PR IS HOME OF 408,184 RESIDENTS, OF WHICH 99% ARE HISPANIC/LATINO AND NEARLY 55% LIVE UNDER THE FEDERAL POVERTY LEVEL. THERE IS A HIGH PREVALENCE OF SUD AND MENTAL HEALTH CONDITIONS AMONG THE TARGET POPULATION AND OFTEN THESE CONDITIONS GO UNDIAGNOSED AND UNTREATED; RESULTING IN THE FACT THAT NOW MORE THAN EVER, UNDERSERVED POPULATIONS SEEK BEHAVIORAL HEALTH SERVICES IN PRIMARY CARE SETTINGS. SINCE 2017 PR HAS GONE THROUGH A SITUATION OF ECONOMIC INFLATION, HURRICANES IRMA, AND MARIA (2017), A SERIES OF EARTHQUAKES THAT CAUSED FURTHER INFRASTRUCTURE DAMAGE (2020), THE COVID-19 PANDEMIC (2020), AND HURRICANE FIONA (2022). ALL THESE EVENTS HAVE CREATED A DISRUPTION OF ROUTINE, ANXIETY, AND DISTRESS THAT HAS LED US TO SEE AN INCREASE IN MENTAL HEALTH AND SUD DISORDERS AMONG PUERTO RICANS. IN PR, REPORTS ESTIMATE THAT APPROXIMATELY 18.7% OF THE POPULATION BETWEEN 18 AND 64 YEARS OF AGE HAVE A MENTAL HEALTH DISORDER. WHEN INCLUDING PEOPLE WITH SUD, THE FIGURE RISES TO 23.7%. OF THESE, 7.3% HAVE A SERIOUS MENTAL ILLNESS. THE MOST COMMON DISORDERS IN THE ADULT TARGET POPULATION ARE ANXIETY DISORDERS (12.5%); MOOD DISORDERS (10.4%), SUD (11.5%), MAJOR DEPRESSION (9.7%); SOCIAL PHOBIA (6.3%), GENERALIZED ANXIETY (5.2%), AGORAPHOBIA (4.7%); AND BIPOLAR DISORDER (3.2%). IN ADDITION, THE SUICIDE RATE IS 287 PER YEAR (7.9 PER 100,000 INHABITANTS). ALTHOUGH IT IS REPORTED THAT BETWEEN 18.7% AND 23.7% OF THE ADULT POPULATION SUFFERS FROM A MENTAL HEALTH DISORDER AND/OR SUD, LESS THAN HALF RECEIVED TREATMENT. IN THE PROPOSED TARGET AREAS, AMONG THE MOST PREDOMINANT BARRIERS AND GAPS IDENTIFIED THAT IMPEDE ACCESS TO SERVICES MIGRANT CAN OUTSTAND POVERTY, WORKFORCE SHORTAGE, HIGH CRIME RATES, GEOGRAPHICAL BARRIERS, STIGMA AND DISCRIMINATION, EASY ACCESS TO ILLICIT DRUGS, AND LACK OF TRANSPORTATION, AMONG OTHERS. TO ADDRESS THE NEEDS IDENTIFIED MIGRANT IS PROPOSING TO HIRE 11.5 FTES TO INCREASE THE MENTAL HEALTH AND SUD WORKFORCE IN THE PROPOSED UNDERSERVED AREAS. THIS MULTI-DISCIPLINARY TEAM WILL JOIN THE EXISTING MIGRANT STAFF TO PROVIDE SERVICES AROUND THE MIGRANT'S 15 PRIMARY CARE CLINICS. THIS WILL BE A COMPREHENSIVE TEAM FOCUSED ON INCREASING THE NUMBER OF PATIENTS RECEIVING INTEGRATED MENTAL HEALTH, SUD AND MOUD SERVICES IN THE WESTERN REGIONS OF PR. THESE PERSONNEL WILL PROVIDE SERVICES BOTH IN PERSON AND VIA TELEHEALTH. THE PROPOSED STAFF TO BE HIRED WILL CONSIST OF 1 FTE CLINICAL SOCIAL WORKER, 2 FTE NURSES, 1 FTE SUD COUNSELOR, 1 FTE NON-CLINICAL CASE MANAGER, 1 FTE COMMUNITY OUTREACH WORKER, 1 FTE DRIVER, 2 FTE PSYCHOLOGISTS, 1 FTE RECEPTIONIST, 1 FTE PEER RECOVERY SPECIALIST, AND .5 FTE PSYCHIATRIST. THE PROPOSED PROGRAM GOALS ARE: 1) INCREASE THE NUMBER OF MIGRANT PATIENTS RECEIVING MENTAL HEALTH SERVICES BY 6% FOR THE YEAR 2025; AND 2) INCREASE THE NUMBER OF MIGRANT PATIENTS RECEIVING SUD SERVICES BY 16%, AND PATIENTS RECEIVING TREATMENT WITH MOUD BY 15% FOR THE YEAR 2025 FOLLOWING UNIFORM DATA SYSTEM DATA.

FISCAL YEAR 2023 CAPITAL ASSISTANCE FOR HURRICANE RESPONSE AND RECOVERY EFFORTS (CARE)

FY 2020 EXPANDING CAPACITY FOR CORONAVIRUS TESTING (ECT)

FISCAL YEAR 2025 EXPANDED HOURS. - MIGRANT HEALTH CENTER WESTERN REGION, IN. (MHC) PROGRAM GRANT NUMBER (H80CS00620) IS A COMMUNITY BASED, 330 (G) (E) (H), NON-PROFIT, 501(C3). MHC PROVIDES INTEGRATED HIGH-QUALITY HEALTH SERVICES IN FIFTEEN (15) CLINICS LOCATED IN THE WESTERN REGIONS OF PUERTO RICO (PR). MHC PROVIDES PRIMARY CARE, BEHAVIORAL HEALTH, OB/GYN, ORAL HEALTH, NUTRITION, OPTOMETRY, MENTAL HEALTH, X RAYS, PHARMACY, LABORATORY, HIV PREVENTION AND TREATMENT, VACCINATION, AND SUBSTANCE ABUSE SERVICES, AMONG OTHERS. MHC IS REQUESTING HRSA-25-084 FUNDING FOR TWO YEARS ($500,000 FY1 AND $500,000 FY2) TO EXPAND ACCESS IN THE MHC SAN SEBASTIAN SERVICE SITE BY INCREASING THE HEALTH CENTER OPERATING HOURS TO MEET IDENTIFIED PATIENT AND COMMUNITY NEEDS. MHC IS PROPOSING TO USE UP TO $150,000 IN YEAR 1 FOR MINOR ALTERATION/RENOVATION COSTS NECESSARY TO MEET THE PROPOSED EXTENDED HOURS (EH) OBJECTIVES. THE POPULATIONS TO BE SERVED ARE INDIVIDUALS RESIDING IN THE DESIGNATED MEDICALLY UNDERSERVED AREA MUNICIPALITY OF SAN SEBASTIAN. SAN SEBASTIAN IS HOME OF 38,183 RESIDENTS, OF WHICH 99% ARE HISPANIC/LATINO, 49% ARE REPORTED AS MALE AND 51% AS FEMALE, AND 52% LIVE UNDER THE FEDERAL POVERTY LEVEL. MHC PROVIDES PRIMARY HEALTH CARE SERVICES TO NEARLY 5,000 RESIDENTS OF THIS MUNICIPALITY. MHC PROPOSES TO EXPAND ITS HOURS OF OPERATION AT THE SAN SEBASTIAN CLINIC SITE DUE TO IDENTIFIED NEEDS. MHC UTILIZED OFFICIAL STATISTICAL DATA, UDS DATA, THE RESULTS OF THE CORPORATE NEEDS ASSESSMENT AND THE RESULTS OF THE QUALITY DEPARTMENT'S PATIENT QUESTIONNAIRES TO ENSURE THAT THE PROPOSED PROJECT IS RESPONSIVE TO THE NEEDS OF THE PATIENTS SERVED. THE PROFILE OF THE TARGET POPULATION LOOKS AS FOLLOWS: NEARLY 30% DO NOT COMPLETE HIGH SCHOOL; 24.8% OF THE POPULATION IS 65 YEARS OF AGE OR OLDER; 28.7% EARN LESS THAN $10,000 PER YEAR; THE UNEMPLOYMENT RATE IS REPORTED AT 14.9%; 13.5% HAVE NO VEHICLE OR MEANS OF TRANSPORTATION IN THEIR HOME; 26% HAVE NO ELECTRONIC DEVICES; 27% LIVE WITH SOME TYPE OF DISABILITY; 5.3% HAVE NO HEALTH INSURANCE COVERAGE; 1.6% ARE VETERANS; AND OF THE ACTIVE LABOR FORCE, 65% WORK IN THE PRIVATE SECTOR. IN THE PROPOSED TARGET AREAS, AMONG THE MOST PREDOMINANT BARRIERS AND GAPS IDENTIFIED THAT IMPEDE ACCESS TO SERVICES MHC CAN OUTSTAND POVERTY, WORKFORCE SHORTAGE, GEOGRAPHICAL BARRIERS, LACK OF HEALTH INSURANCE, STIGMA AND DISCRIMINATION, LACK OF RELIABLE ELECTRICAL ENERGY AND INTERNET ACCESS, LACK OF TRANSPORTATION, LACK OF AVAILABILITY OF APPOINTMENTS, AND INABILITY TO TAKE TIME OFF WORK TO ATTEND APPOINTMENTS, AMONG OTHERS. TO ADDRESS THE NEEDS IDENTIFIED MHC IS PROPOSING TO HIRE 6.0 FTES TO EXPAND THE HOUR OF OPERATIONS OF THE MHC SAN SEBASTIAN SITE. THESE PERSONNEL WILL PROVIDE IN-PERSON APPOINTMENTS. THE PROPOSED STAFF TO BE HIRED WILL CONSIST OF 1 FTE PHYSICIAN, 1 FTE NURSE, 1 FTE RECEPTIONIST, 1 FTE LICENSED PHARMACY MD, AND 2 FTE PHARMACY TECHNICIANS. MHC PROPOSES TO EXPAND MEDICAL AND PHARMACY SERVICES WEEKDAYS FROM 4:00 PM TO 8:00 PM MONDAY THROUGH FRIDAY, FOR A TOTAL INCREASE OF 17.5 ADDITIONAL HOURS OF SERVICE PER WEEK AT THIS LOCATION. AS A RESULT OF THE PROPOSED EH MHC IS EXPECTING TO SERVE AT LEAST 300 NEW UNDUPLICATED NEW PATIENTS FOR THE YEAR 2025 FOLLOWING UNIFORM DATA SYSTEM DATA. MHC WILL IMPLEMENT THE PROPOSED PROJECT AND INCREASE THE OPERATING HOURS WITHIN 6 MONTHS OF THE AWARD. THE NEW OPERATING HOURS WILL ALLOW PATIENTS TO RECEIVE CARE IN A PRIMARY CARE SETTING, REDUCING VISITS TO EMERGENCY DEPARTMENTS AND IMPROVING HEALTH OUTCOMES. THIS WILL REDUCE HEALTH CARE COSTS AND PRESERVE EMERGENCY DEPARTMENT CAPACITY FOR PATIENTS WITH ACUTE NEEDS. IN ADDITION, IT WILL MAKE IT POSSIBLE TO ADDRESS OTHER IDENTIFIED EMERGING NEEDS SUCH AS SCHEDULING BARRIERS THAT IMPEDE PATIENTS’ ABILITY TO ACCESS CARE DURING CURRENT OPERATING HOURS, INCLUDING PATIENTS’ NONTRADITIONAL WORK SCHEDULES, LACK OF SICK LEAVE, AND CHILDCARE NEEDS.

FY 2023 EARLY CHILDHOOD DEVELOPMENT

HEALTH CENTER PROGRAM SERVICE EXPANSION - SCHOOL BASED SERVICE SITES (SBSS)

RURAL HEALTH CARE SERVICES OUTREACH GRANT PROGRAM

FY 2023 EXPANDING COVID-19 VACCINATION

COMPREHENSIVE HIGH-IMPACT HIV PREVENTION PROJECTS FOR COMMUNITY-BASED ORGANIZATIONS

ARRA - INCREASE SERVICES TO HEALTH CENTERS

RURAL COMMUNITIES OPIOID RESPONSE (PLANNING)

RYAN WHITE TITLE III HIV CAPACITY DEVELOPMENT AND PLANNING GRANTS

RYAN WHITE TITLE III HIV CAPACITY DEVELOPMENT AND PLANNING GRANTS - APPLICANT: MIGRANT HEALTH CENTER, WESTERN REGION, INC. ADDRESS: 491 SOUTH RAMON E. BETANCES STREET, P.O. BOX 190, MAYAGUEZ, P.R. 00681 PROJECT DIRECTOR NAME: DR. TANIA RODRIGUEZ, PH.D. CONTACT PHONE: 787-831-5800 FAX: 787-832-0740 EMAIL: MHC@MIGRANTSPR.COM WEBSITE: WWW.MIGRANTSPR.COM PROJECT TITLE: FY 2022 RWHAP PART C CAPACITY DEVELOPMENT PROGRAM (HRSA-22-019) MHC IS A COMMUNITY BASED, 330 (G) (E) (H), NON-PROFIT, 501(C3). MHC PROVIDES HIGH-QUALITY HEALTH SERVICES IN AN INTEGRATED MANNER AT THEIR 12 CLINICS IN MAYAGUEZ, GUANICA, YAUCO, ISABELA, LAJAS, SAN SEBASTIAN, LAS MARIAS, MARICAO, AND CABO ROJO. MHC PROVIDE PRIMARY CARE SERVICES, OB/GYN, ORAL HEALTH, NUTRITION, OPTOMETRY, MENTAL HEALTH, X RAYS, PHARMACY, LABORATORY, HIV PREVENTION AND TREATMENT, VACCINATION AND SUBSTANCE ABUSE SERVICES IN THE WESTERN REGIONS OF PR. FOR FY 2022 RWHAP PART C CAPACITY DEVELOPMENT PROGRAM, MHC IS ELECTING TO APPLY UNDER THE CATEGORY OF INFRASTRUCTURE DEVELOPMENT. THE PROPOSED ACTIVITY IS TO ACQUIRE/PURCHASE TELEHEALTH EQUIPMENT FOR EXPANDING SERVICE CAPACITY. THE PURPOSE OF THE PROPOSED ACTIVITY IS TO STRENGTHEN THE MHC ORGANIZATIONAL INFRASTRUCTURE TO RESPOND TO THE CHANGING HEALTH CARE LANDSCAPE AND TO INCREASE CAPACITY TO ENHANCE AND EXPAND ACCESS TO HIGH-QUALITY HIV PRIMARY HEALTH CARE SERVICES FOR LOW-INCOME, UNINSURED, AND UNDERSERVED PEOPLE WITH HIV FROM THE WESTERN REGION OF PR. CURRENTLY, THE MHC'S RYAN WHITE PROGRAM SERVES A TOTAL OF 260 PERSONS WITH HIV ACROSS THE WESTERN REGIONS OF PR. THE PROGRAM PROVIDES HIV CARE ACROSS ALL 12 OF MHCS SERVICE SITES, YET ONLY HAS 4 HIV TREATERS AVAILABLE TO PROVIDE SERVICES FOR THESE FACILITIES. THIS MAKES IN-PERSON ENCOUNTERS, ESPECIALLY WALK-IN PATIENTS, ACROSS ALL SITES NEARLY IMPOSSIBLE. PATIENTS MAY NOT ALWAYS HAVE AN ON-CALL HIV TREATER AVAILABLE AT THEIR CLOSEST MHC FACILITY WITHOUT THE SUPPORT OF AN END-TO-END TELEMEDICINE INFRASTRUCTURES ACROSS THE RW PROGRAM. MHCS PROGRAM IS UNIQUE FROM OTHER HIV TREATMENT FACILITIES ON PR AS IT ACTIVELY RECEIVES REFERRALS TO CARE FOR HIV-POSITIVE ACTIVE INJECTABLE DRUG USERS AND HOMELESS POPULATIONS FROM THE AGENCIES 2 IN-HOUSE PROGRAMS (WHICH TARGET THESE POPULATIONS). MHC IS PROPOSING TO ACQUIRE A MOBILE VAN VEHICLE (MHC IN-KIND CONTRIBUTION) AND EQUIP IT WITH THE NECESSARY RESOURCES TO CONVERT IT INTO A TELEHEALTH VAN. TELEHEALTH VAN WILL BE THE FIRST AND ONLY VIRTUAL MEETING SERVICE IN PR THAT OPERATES A FLEET OF CUSTOMIZED, 5G-ENABLED VANS THAT DRIVE INTO RURAL, LOW INCOME, AND HOMELESS COMMUNITIES, ALLOWING FAMILIES TO STEP INSIDE AND MEET WITH THEIR DOCTORS, THERAPISTS, AND CASEWORKERS VIRTUALLY – FROM THE COMFORT AND SECURITY OF THEIR LIVING SPACES. ADDITIONALLY, FUNDING WILL BE USED TO MODERNIZE THE TECHNOLOGY AVAILABLE ON-SITE, WITHIN THE OFFICES OF THE AGENCIES RW STAFF AND HIV TREATERS, INCLUDING MENTAL HEALTH PROVIDERS. THROUGH THIS FUNDING OPPORTUNITY, MHC WILL BE REVAMPING THE ENTIRE RWHAP SERVICE SITE, ENSURING THAT THE ENTIRE HIV CARE INFRASTRUCTURE IS ADEQUATELY PAIRED TO THE NECESSARY TOOLS TO ATTEND AND OVERCOME THE BARRIERS THAT SOCIAL INEQUITIES CAN PRESENT, WHICH RESULT IN DISPROPORTIONATE HEALTH DISPARITIES FOR THE TARGET POPULATION. FOR THIS FUNDING OPPORTUNITY, MHC IS REQUESTING THE AMOUNT OF $150,000 FOR THE ONE-YEAR PERIOD OF PERFORMANCE. FOR THIS APPLICATION MHC IS REQUESTING FUNDING PREFERENCE. THE PROPOSED PROGRAM WILL PRIORITIZE THE PROVISION OF SERVICES THROUGH THE TELEHEALTH VAN TO INDIVIDUALS EXPERIENCING HOMELESSNESS. IN ADDITION, MHC PROVIDE PRIMARY CARE SERVICES IN THE DESIGNATED RURAL MUNICIPALITIES OF LAS MARIAS AND MARICAO; AND IN THE PARTIALLY RURAL MUNICIPALITIES OF ANASCO, CABO ROJO AND YAUCO. MHC PROVIDE PRIMARY CARE SERVICES TO UNDERSERVED POPULATIONS IN THE DESIGNED MEDICALLY UNDERSERVED AREAS OF ANASCO, CABO ROJO, LAS MARIAS, MARICAO, YAUCO, MAYAGUEZ, LAJAS, ISABELA, SAN SEBASTIAN AND GUANICA. PRIMARY C

RYAN WHITE TITLE III HIV CAPACITY DEVELOPMENT AND PLANNING GRANTS

RYAN WHITE TITLE III HIV CAPACITY DEVELOPMENT AND PLANNING GRANTS

RYAN WHITE TITLE III HIV CAPACITY DEVELOPMENT AND PLANNING GRANTS - MHC IS A COMMUNITY BASED 330 (G) (E) (H), NON-PROFIT, 501(C)3 PROGRAM THAT BEGAN ITS OPERATIONS IN 1971, CURRENTLY SERVING THE WESTERN, NORTHWESTERN, AND SOUTHWESTERN REGIONS OF PUERTO RICO (PR). AS OF 1995, THROUGH RYAN WHITE PART-C FUNDING, MHCS “SSIMA” PROGRAM HAS BEEN PROVIDING HIGH-QUALITY HIV CARE SERVICES THROUGHOUT THESE REGIONS. FOR THIS FUNDING OPPORTUNITY (HRSA-23-052), MHC IS REQUESTING THE TOTAL AMOUNT OF $150,000, TO FUND A 12-MONTH (1 YEAR) PERFORMANCE PERIOD (SEPTEMBER 1, 2023 - AUGUST 31, 2024) UNDER THE CATEGORY OF ‘INFRASTRUCTURE DEVELOPMENT’, WITH THE INTENT OF CONDUCTING ‘DENTAL EQUIPMENT FOR EXPANDING DENTAL SERVICE CAPACITY’ ACTIVITIES. THE PROPOSED TARGET POPULATION ARE HISPANIC/LATIN MALE AND FEMALE PERSONS LIVING WITH HIV/AIDS (PLWHA), RESIDING WITHIN THE WESTERN REGIONS OF PR, REGARDLESS OF AGE, RACE, OR ETHNICITY. THE PURPOSE OF THIS PROGRAM IS TO STRENGTHEN ORGANIZATIONAL CAPACITY TO RESPOND TO CHANGING HEALTH CARE LANDSCAPES AND INCREASE ACCESS TO HIGH-QUALITY HIV HEALTH CARE SERVICES FOR LOW-INCOME AND UNDERSERVED PLWHA. THE TARGET POPULATION IS A PRIORITIZED POPULATIONS IN THE PR INTEGRATED HIV PREVENTION AND CARE PLAN. THROUGH THIS AWARD, MHC WILL DEVELOP, ENHANCE, AND EXPAND ORAL HEALTH CARE SERVICES FOR PLWHA, BY OPTIMIZING ITS EXISTING MOBILE UNIT THROUGH THE PURCHASE AND INSTALLATION OF DENTAL EQUIPMENT THAT WILL MOBILIZE THE DENTAL FACILITY ACROSS THE TARGET REGIONS. SPECIFICALLY, THIS ACTIVITY INVOLVES THE ACQUISITION OF EQUIPMENT, SUCH AS DENTAL PATIENT CHAIRS, STERILIZATION UNITS, X-RAY IMAGING INSTRUMENTS, DENTAL OPERATING LIGHTS, OPERATORY CABINETS, HAND PIECES, AMONG OTHERS, AS NECESSARY (DETAILED IN ATTACHMENT 1). THE EXPECTED PROGRAM OUTCOMES ARE: 1) BY THE END OF THE BUDGET PERIOD, DENTAL EQUIPMENT WILL HAVE BEEN INSTALLED AND CONFIGURED; 2) BY THE END OF THE BUDGET PERIOD, MHC RWHAP STAFF WILL HAVE IDENTIFIED PATIENTS WHO CAN BENEFIT FROM THE NEW DENTAL MOBILE UNIT, WILL PROMOTE THESE SERVICES AMON G ELIGIBLE CLIENTS, AND BEGIN COORDINATING APPOINTMENTS; 3) BY THE END OF THE FY, AT LEAST 2 MOAS WILL BE ESTABLISHED WITH AGENCIES PROVIDING SERVICES TO THE TARGET POPULATION WITHIN THE IMPACT REGION; 4) BY THE END OF THE BUDGET PERIOD, AT LEAST 1 FOCUS GROUP AND/OR COMMUNITY ADVISORY BOARD (CAB) MEETING WILL BE HELD WITH RW PROGRAM PARTICIPANTS; 5) BY THE END OF THE BUDGET PERIOD, THE RW PROGRAM WILL HAVE INCREASED AT LEAST 5% OF PATIENTS RECEIVING ORAL HEALTHCARE SERVICES. THROUGH THE PROPOSED MOBILE DENTAL OPERATORY UNIT, AN EXPANSION OF PREVIOUSLY FUNDED ACTIVITIES, SSIMA CAN PROVIDE EARLY-INTERVENTIONS, HIV TREATMENT, AND COMPLEMENTARY ORAL HEALTH SERVICES TO PLWHA. THIS WILL BE ESPECIALLY HELPFUL IN ATTENDING THOSE PATIENTS MOST AFFECTED BY INFLUENTIAL SOCIAL DETERMINANTS OF HEALTH (SDOH), INCLUDING TRANSPORTATION AND GEOGRAPHIC DISTANCE BARRIERS. THE PROJECT WILL LARGELY TARGET HARD-TO-REACH, MEDICALLY UNDERSERVED, MARGINALIZED, SPECIAL NEEDS POPULATIONS (SUCH AS HOMELESS PERSONS AND/OR INJECTABLE SUBSTANCE USERS), AND THOSE RESIDING IN REMOTE AND/OR RURAL LOCATIONS. CONSIDERING SSIMA ALSO SERVES RESIDENTS FROM CITIES WHERE MHC DOES NOT HAVE A FACILITY SITE, MEETING PLWHA NEEDS FOR ORAL HEALTH IS A CHALLENGE. AS LACK OF TRANSPORTATION IS THE MOST FREQUENTLY REPORTED ACCESS BARRIER FOR PLWHA AND SSIMA HAVING ONLY A SINGLE DRIVER ON STAFF, GEOGRAPHIC DISTANCE REMAINS A LEADING DETERMINANT FOR ORAL HEALTH ENGAGEMENT AND RETENTION. MHC HAS REASSESSED ITS INFRASTRUCTURAL APPROACH, DECIDING TO MOBILIZE ITS ORAL HEALTH TEAM BY REMODELING AN EXISTING MOBILE UNIT VEHICLE. THIS WILL INCREASE ACCESS TO SERVICES, ALLOWING SSIMA TO MEET PLWHA WHEN AND WHERE THEY ARE NEEDED, RATHER THAN HAVING CARE PROVISION CONTINGENT UPON AN INDIVIDUAL’S ABILITY TO TRAVEL TO DENTAL OPERATORY SITES, THUS IMPROVING THEIR ENGAGEMENT IN QUALITY CARE AND PROMOTING POSITIVE OVERALL HEALTH OUTCOMES.

RYAN WHITE TITLE III HIV CAPACITY DEVELOPMENT AND PLANNING GRANTS

FY 2020 CORONAVIRUS SUPPLEMENTAL FUNDING FOR HEALTH CENTERS

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

FY 2023 BRIDGE ACCESS PROGRAM

FY 2018 CAPITAL ASSISTANCE FOR HURRICANE RESPONSE AND RECOVERY EFFORTS