Fiscal Year 2023 Capital Assistance for Hurricane Response and Recovery Efforts (CARE) - Appalachian District Health District dba AppHealthCare (AHC) is a stable FQHC that is accredited by NCQA as a PCMH located in the northwest corner of North Carolina, AHC provides services to rural communities located in Ashe, Alleghany and Watauga counties. AHC is an outgrowth of the regional health department and received federal 330 funding in 2015. The organization was established in 1933 to provide public health services to the community and has worked closely with community leaders to evaluate and respond to the health care needs of vulnerable populations in the service area. AHC provides high quality medical, dental, and behavioral health (BH) services including programs for substance use, chronic disease management, nutrition counseling, and health education. The current Ashe Health Center is located at 413 McConnell Street in Jefferson, North Carolina. This is a comprehensive primary care, behavioral health, and ambulatory care substance use disorder treatment facility. In 2022, AHC served over 6,000 unique individuals through its sites, with the Ashe Health Center being a central location that has been integral to reaching people in the community who need quality healthcare. This proposal outlines the critical needs of addressing two key projects. First, the Ashe Health Center has been severely damaged due to burst water plumbing that was old and caused extensive damage to the flooring in the patient waiting area, clinic rooms, and registration area. This project proposes replacement of the damaged flooring and updating critical building infrastructure including fire and security systems, roofing, heating and air, and adding square footage to the space to include additional exam rooms, an updated laboratory, and more efficient workflow area to be equipped to serve additional patients. This will allow for more patients to be served given the demand. It will also allow for more adequate allocation of exam rooms to ensure infection control measures including use of exam rooms when possible rather than having individuals waiting in their personal vehicle when they exhibit respiratory symptoms. The second project is a Mobile Health outreach project. AHC continues to support transportation needs of clients through agreements and use of the area transportation authority services. Even still, transportation is a barrier for many patients. The transportation service has limitations in its capacity and staff firmly believe due to the rural nature of the communities served, a mobile outreach service using a mobile outreach bus unit will better serve those who may never visit the clinic. Currently, one of the biggest needs is comprehensive primary care and substance use disorder treatment and care for farmworkers and those with substance use disorder or facing homelessness being reached through the peer support services. The mobile unit will allow for a bathroom onsite for substance screenings and will include dental and medical procedure chairs, satellite connection for radiograph imaging and internet capabilities. It will also provide an avenue to reach people through churches, community centers, and farms. This project will serve the existing service area zipcodes and will expand to include Watauga County zipcodes with pending approval from HRSA to include this area. Both projects have available funding from other sources to leverage in order to maximize the investment by HRSA, including over $1 million in funds for Ashe Health Center and $300,000 in funds for the AppHealthCare Mobile Outreach bus. These will allow for greater reach and implementation of the agency health equity strategies to reach our most vulnerable populations.