Telehealth enhancement and expansion for northern new england - ppnne is a long-time recipient of title X funding in all three states

Subrecipients to the vermont department of health (VDH) in vermont and maine family planning (MFP) in maine. In new hampshire, previously as a subrecipient of the new hampshire department of health and human services (NH dhhs), then a title X grantee from 2012 until our withdrawal from the program in 2019. VDH, MFP and ppnne have applied to rejoin the title X program in april 2022 as title X grantees in vermont, maine, and new hampshire respectively. Ppnne has responded to the challenges of operating during a pandemic and the loss federal and state from title X program withdrawal by evaluating and developing new ways to ensure access to care for our patients. Telehealth has been crucial in providing care during the pandemic. As this application illustrates, we believe there is a growing demand for remote care in the largely rural communities we serve across northern new england and are committed to expanding our capacity to provide telehealth services. We apply for a oash / OPA title X telehealth grant to enhance the experience of our patients and clinicians, as we deepen and broaden our telehealth services. We will achieve this the same way we provide in-person services - by making visits easy, equitable and patient-centered. Ppnne's network of twenty-one health centers serve the state of vermont, southern and southwestern new hampshire, and southwestern maine. Our health centers are strategically located in communities of need and are easily accessible geographically and by public transport. However, a robust telehealth program will allow ppnne to expand the provision of services beyond our bricks and mortar health centers to all residents of the largely rural states we serve. 61% of the populations of maine and vermont living in rural areas, and 40% of the population of new hampshire. Rural populations across northern new england have significant health disparities. They often have higher incidence of disease and/or disability, increased mortality rates, lower life expectancies, and higher rates of pain and suffering. Risk factors that impact the health of rural communities include geographic isolation, lower socioeconomic status, higher rates of uninsured, higher rates of health risk behaviors, health care worker shortages, limited access to health care specialists and subspecialists, limited job opportunities and lack of access to reliable transportation. Ppnne is requesting $700,000 to build the capacity to provide high quality, same-day family planning telehealth services, increasing access to sexual and reproductive health and improving health equity in vermont, new hampshire, and maine. We would do this by: 1) implementing a robust, secure, and integrated telehealth service delivery platform at ppnne; 2) optimizing staff capacity for same-day telehealth service delivery; and 3) promoting our telehealth services to existing and new patients in their communities and through partners organizations. Telehealth services provide several benefits to patients, especially lower-income patients living in rural areas. Telehealth reduces the transportation burden of a visit, increasing convenience. Telehealth also increases access to specialty services, potentially not available in proximity of the patient. Remote care can also increase privacy in some cases. And from the provider perspective, telehealth can help address staffing limitations. Studies identify telehealth use and perceived benefits vary across race and ethnicities. Ppnne's telehealth program will strive to address important equity barriers to telehealth services - such as the digital divide, distrust and implicit bias, language justice and privacy - during the execution of this grant and beyond.