Rural Health Care Services Outreach Grant Program - This project will expand access to integrated health services, and will address social determinants of health faced by individuals in the rural, southern West Virginia counties of McDowell, Mingo, and Wyoming located in the heart of Appalachia. Consortium members include Logan-Mingo Area Mental Health dba Mountain Laurel Integrated Healthcare (MLIH), Mingo County Health Department, One Voice, and Tug Valley Wellness. The target population includes individuals of all ages who are underserved due to a variety of factors, including, but not limited to, poverty, insurance status, and health-related factors. This includes subpopulations that experience poorer health outcomes, health disparities, and other inequities. These include individuals with substance use disorders, people with disabilities, elderly residents, and individuals with limited health literacy. The service area faces significantly worse health and health-related outcomes compared with state and national averages. Project goals and objectives include: Goal 1: Create consortium foundation. The first year will focus on establishing the groundwork for the consortium that will be critical to achieving success. Objectives in year one include strategic planning among consortium members; hiring and training project personnel; purchasing telehealth, diagnostic, and other equipment and supplies; and informing the general public and stakeholders about the project. Goal 2: Initiate telehealth services and integrate Community Health Workers (CHWs) into care teams. Objectives in year two include deploying CHWs to screen for SDOH and assisting with patient navigation; increasing access to services by initiating telehealth to connect patients at One Voice and Tug Valley Wellness to MLIH behavioral health providers and to primary care providers for chronic disease management follow-up as needed; begin data collection. Goal 3: Expand integrated care services by placing a primary care provider (PCP) at One Voice, implementing tele-behavioral health services at Tug Valley Wellness, and deploying the mobile unit. The objectives for year three to enhance the ability of primary care providers to deliver integrated care, focusing on behavioral health and SDOH, and to expand access to preventive care, chronic disease management, and behavioral health services for individuals who live in the most remote areas via the mobile unit. The consortium will also seek to strengthen relationships with regional organizations to expand SDOH networks and mobile unit services will be promoted through a strategic outreach campaign. Goal 4: Evaluate the project’s impact and expand services to additional high-need areas. In year four, the consortium will undertake a comprehensive program evaluation using annual data compared to baseline data collected in year one. The objective of this goal is to determine the effectiveness of strategies implemented in the first three years and identify additional rural areas where these strategies can be replicated. The project will utilize the following evidence-based models: Protocol for Responding to and Assessing Patients’ Assets, Risks, and Experiences (PRAPARE), evidence-based clinical guidelines, and Trauma Informed Care. Outcomes to be achieved through this project include increased access to integrated health services, and access to supportive non-health and social services. With increased access to these services, we anticipate improved management of chronic illnesses, which are common among the target population and subpopulations. MLIH has more than 50 years’ experience providing care for the target population. MLIH began as 1 of 14 state-designated Community Mental Health Centers and in 2020 became a Federally Qualified Health Center Look-Alike in 2020, making it the first dually designated healthcare agency in the state. MLIH qualifies for two funding preferences. The service area includes several HPSAs and all counties are designated as MUAs.
