Pathways Center will build on its integrated behavioral health, substance use, and primary care services to better serve 568 individuals over four years in substantially rural Coweta and Heard Counties in west, central Georgia. The population of focus is youth (5-17) with serious emotional disturbances (SED) and/or substance use disorder (SUD), and adults (including veterans) with serious mental illness (SMI), SUD, and/or co-occurring disorders (COD). The population in the catchment area is 161,521 with 10,967 veterans; residents (78%) identify as White, .5% as Native American, 5.1% as Hispanic, 14.1% as Black, and 1.4% as Asian. In Heard, 16.4% and 8.6% in Coweta live at or below 100% of the federal poverty level. In Heard County, 18.3% and in Coweta County 14.3% are over age 65. In Coweta 20% and 16% in Heard under age 65 lack health insurance; of those insured about 11% rely on Medicaid (Census, 2020; Piedmont Newnan Hospital Community Health Needs Assessment, 2018). In a 2021 Gallup poll, 5.6% identify as LGBTQ.
Project goals and objectives are as follows: Goal 1: Expand and fully integration BH and primary care (PC) by adding credentialed providers. Objective 1-1: Within 12 months hire 1 Licensed Counselor (LC), and within 24 months hire a second LC, to increase children/adolescents with SED and SUD served by 20% and adults with SMI, SUD and/or COD, including veterans, served by 15% over baseline. Objective 1-2: Within 12 months, hire 1 Nurse (RN)/Licensed Practical Nurse (LPN), and within 24 months hire a second RN/LPN, to improve BH integration with PC by providing wellness checks, monitoring integrated treatment plans, and conducting physical health screens. Objective 1-3: Within 6 months, support the transition from inpatient (IP) to outpatient (OP) care by hiring 1 Targeted Case Manager (TCM) to improve retention from IP to OP by 15% over baseline. Objective 1-4: Within 6 months, hire 1 TCM for care coordination to provide wellness education and work with consumers needing integrated PC and BH care to ensure compliance with appointments and prescribed treatment plans. Objective 1-5: Within 6 months, hire 1 Insurance Benefit Specialist to assist all consumers in securing federal and state benefits, including VA benefits, as evidenced by expanded entitlements for 20% of consumers served. Goal 2: Strengthen infrastructure and expand training on evidence-based practice (EBP) to support seamless, fully integrated services. Objective 2-1: Within 6 months, expand EBP Seeking Safety training to 34 Clinical Counselors and TCMs to ensure trauma-informed care to all consumers as evidenced by a 10% reduction of dropping out. Objective 2-2: Within 12 months, train all (352) direct care staff company-wide and new hires going forward in EBP "Enhancing Clinical Competency through An Understanding of Military Culture" course through the Relias Learning Management System (LMS). Objective 2-3: Within 12 months, reduce staff vacancies, especially licensed clinical staff, by 30% through competitive market pay, better health, flex, retirement, and time-off benefits, and employee engagement programs. Objective 2-4: Within 12 months, install a new and/or enhanced EHR system with expanded functionality to support the integration of clinical and recovery-oriented services. Objective 2-5: Within 12 months, support sustainability by demonstrating expanded third-party insurance payments for 20% of consumers.
Pathways, established in 1972, is the primary provider of BH services in west central GA. A staff of 352 (321 clinical and 31 support) provides an array of clinical and support services to 8,000 adults and 2,500 children per year throughout the region. For the catchment area, service numbers are 3,419 including 2,488 adults and 961 youth.