In a large pot, bring half & half to a simmer. Slowly whisk in the cheeses and add the Worcestershire and hot sauce. Whisk constantly until smooth. Add hot water as needed until the sauce is a smooth consistency. Fold in the cooked pasta, remove from heat and set aside.
Cook sausage in a large, saute pan over medium-high heat. Break up the sausage as it cooks. Cook until well browned – about 5 minutes. Drain any excess fat.
Place press over burner (or fire) and heat up. Remove and spray the insides of press with non-stick spray. To assemble sandwiches, place a slice of Provolone cheese on top of four pieces of bread. Top each with approx. 1/4 to 1/2 cup of mac n cheese mix (depending on size of your press) in center. Top each with 2 teaspoons of crumbled sausage. Place a second slice of bread on top then place in press and close. Cut any outside crust off by running a paring knife around the edge.
Place the press back over heat and cook for 2-3 minutes on each side until golden brown and crispy.
Remove the sandwich from the press and serve.