Rural Health Care Services Outreach Grant Program - The Todu Guam Foundation (TGF) is committed to addressing the urgent healthcare needs of Guam’s underserved populations, particularly low-income, uninsured, and racial/ethnic groups. As a geographically isolated U.S. territory in the Western Pacific, Guam faces critical health disparities fueled by high rates of chronic diseases such as diabetes, hypertension, and cancer, as well as an alarming prevalence of mental health conditions and substance use disorders. Indigenous CHamoru, Filipino, and Pacific Islander communities are disproportionately affected, burdened by systemic barriers including limited transportation, language access challenges, and a fragmented healthcare infrastructure. As a federally designated Health Professional Shortage Area (HPSA) and Medically Underserved Area (MUA), Guam remains one of the most vulnerable regions in the nation, requiring innovative and targeted healthcare interventions. To address these challenges, TGF proposes to expand its proven mobile care clinic model to Guam’s most underserved communities through the Regular Track funding. The initiative is designed to improve access to comprehensive, integrated primary care by overcoming geographic, financial, and cultural barriers. Core services will include integrated primary and behavioral health care, cancer screenings and education (cervical, breast, and colorectal), case management, language interpretation, patient navigation, and food subsidies. The mobile care clinic will extend its reach to isolated villages across northern, central, and southern Guam, eliminating transportation barriers that often prevent timely access to care. This project will also focus on reducing structural barriers to healthcare and improving health literacy. The initiative is grounded in strong evidence-based frameworks. The study of the Mobile Health Map demonstrates the effectiveness of mobile clinics in increasing access to care for underserved populations, while The Community Guide provides evidence-informed strategies for behavioral health collaborative care and structural barrier reduction. These frameworks ensure a robust, sustainable approach to addressing health disparities and improving outcomes for Guam’s vulnerable communities. Expected outcomes include increased cancer screening rates for cervical, breast, and colorectal cancers, improved chronic disease management for diabetes and hypertension, and enhanced mental health services with higher screening and treatment rates for depressive disorders. The initiative also aims to reduce hospitalizations and emergency department visits while addressing food insecurity and improving nutritional health through food subsidies. Moreover, the project will expand access to culturally and linguistically appropriate care, helping to bridge language gaps and improve health literacy across Guam. TGF brings extensive expertise and capacity to serve rural and underserved populations, with a successful history of operating its mobile medical clinic since 2017. This model has consistently delivered critical healthcare services to hard-to-reach areas, building trust and fostering long-term relationships with vulnerable communities. TGF’s partnerships with consortium members such as Mane’lu and Guam Cancer Care further enhance its ability to deliver coordinated, whole-person care that addresses both health and social determinants. These collaborations ensure the implementation of effective, sustainable solutions that prioritize cultural competence and community engagement. TGF qualifies for funding preference by meeting all three criteria: operating in a federally designated HPSA and MUA, and focusing on primary care and prevention among populations disproportionately impacted by health disparities. With this initiative, TGF aims to reduce health inequities, improve health outcomes, and create a sustainable, community-based healthcare model that prioritizes the needs of Guam’s most vulnerable residents.
