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MAIN APPLICATION of all ages, including sliding -fee primary medical care with on -site laboratory, sliding -fee family dentistry, low -cost pharmacy, the WIC Supplemental Nutrition Program; care management, and outreach services including Health Insurance Marketplace enrollment assistance. Medical and dental visits are by individual appointment, with twice monthly group diabetes visits for those who prefer this group care option. There are two medical subspecialist clinics that occur at Carrboro CHC with contracted UNC medical specialists who see patients referred by their PHS primary care provider: a dermatology clinic on Friday afternoons and a cardiology clinic one evening monthly. All services are available in the Spanish language, with many staff bilingual in Spanish. The Center also offers full -time Burmese interpretation services to a large group of Burmese refugees. All staff receive cultural competency training as part of their orientation which includes best - practice training on creating an inclusive environment for the LGBTQ community. Please see Tables under sections a and h provide a precise picture of service delivery staff and hours of operation for all services described. In terms of additional special programming of the CCHC medical team, diabetic retinopathy screening services are provided in -kind by NC Prevent Blindness one morning monthly (same morning as Spanish group diabetes). Screening mammography is offered by the Rex Mobile Mammography which visits CCHC nearly monthly thanks to a grant from the Susan G. Komen NC Triangle Affiliate. Medical providers participate in the Reach Out and Read Program that provides new, age- appropriate books to children 0 -5 years at well child checks, and additionally distributes books provided by Book Harvest. The dental team outreaches to young children in WIC and the medical clinic to provide caregiver oral health education and fluoride varnish. c) Describe the local need or problem to be addressed in relation to the Consolidated Plan or other community priorities (i.e. Council /Board Goals). Cite local data to support the need for this program and the population being served. Pre -ACA it was estimated that 16.4% of the Orange County population age 0 -64 lacked health insurance. Low- income groups are much more likely with be uninsured than higher income groups (in NC approximately 60% of uninsured are low- income), with 34% of the Orange County population living below 200% of poverty (n= 43,668) in 2014. Despite the fact that more people have become insured since the implementation of the Affordable Care Act, there are still large numbers of low- income, uninsured people in Orange County who need access to sliding -fee medical care. Moreover, because North Carolina has elected not to expand Medicaid, many low income individuals are in fact "too poor" to qualify for insurance subsidies through the Healthcare Marketplace (i.e. they would have qualified for Medicaid under an expansion), or they are otherwise not qualified for coverage under the ACA (e.g. citizenship status). In addition to financial barriers, many individuals in the County face cultural /linguistic barriers to care, including a large Hispanic immigrant population (Orange County is now 8.4% Hispanic) and a significant growing Burmese refugee population ( >1,000 individuals) in Orange County that CCHC services seek to address. The low- income populations served by CCHC face significant documented disparities in health status (e.g. self- reported health status, cancer outcomes, chronic disease prevalence, smoking and obesity rates, low birth weight, dental caries) that can be positively impacted by a continuous relationship with a primary care home. d) Describe the population to be served or the area to benefit and indicate how you will identify beneficiaries. The Carrboro Community Health Center is open to all comers (subject to appointment availability for medical and dental visits) regardless of residency, citizenship status, or insurance status. As previously Revised November 20, 2014 Page 7 of 22 Pages