Community Hub

 

 

Pathways Community Hub

Comm Hub logo 3 small version

 

The Hub works using three overarching principles to guide efforts, as outlined below:

Find

Identify those at greatest risk through a “no wrong door” approach.

Treat

Ensure that community members receive needed evidence-based healthcare and social services, while emphasizing empowering the Community Member.  This is done by assisting Community Members through the process of obtaining services, rather than completing the process for them.

Measure

Track the progress of Community Members.  We measure basic health status, including things like weight and blood pressure.  We also track the status of the specific interventions.  All of this is monitored on a database provided by Vistalogic.

 

Vital components of the Pathways Community Hub include:

Effective, collaborative partnerships with local providers and social service agencies to utilize existing resources available to community members.
Building the Pathways Community Hub at a neutral agency to streamline resources to care for individuals’ health as a whole.
NEON has trained over 80 Community Health Workers, and counting.  This workforce is integrated into the healthcare system, as well as within different social service agencies.  They work directly with Community Members, building relationships and encouraging empowerment and self-sufficiency.
The key to empowerment is education.  Community Health Workers work to link Community Members with classes such as Living Well, What To Do For Health, and Tai Chi.  These classes have a proven track record, and are available to all Community Members.
Data collection to improve quality of the Pathways Community Hub and measure the outcome and impact on community members.

*These principles are consistent with fundamentals of high-quality health care and with the principles of public health assessment, policy development, and service assurances outlined by the Institute of Medicine.  For more information about the standard of practice for community hubs, please go to: https://innovations.ahrq.gov/sites/default/files/guides/CommHub_QuickStart.pdf

WHO BENEFITS FROM IT?

Currently, NEON has funding to support Community Health Workers working with adults either diagnosed with, or at risk for developing a cardiac or diabetic conditions.  Community Members continue to visit their established doctors, but with the assistance of a Community Health Worker.  Healthcare providers find better engagement and responsiveness from the patients that are enrolled in the Hub.

For Community Members that lack a medical home, Community Health Workers will work to establish and engage Community Members with the medical system.  Ideally, healthcare providers will be able to initiate preventative health interventions before higher level care is necessary, such as emergency room visits.

HOW CAN I ENROLL OR REFER A FRIEND OR FAMILY MEMBER?

If someone you know is experiencing some barriers to health, contact the Hub Coordinator to discuss eligibility requirements.  This program is free to all Community Members that qualify.

Eric Griffith

Community Hub Coordinator

541-624-5101 ext. 3 or egriffith@neonoregon.org

HOW CAN I JOIN AS A PARTNER?

 NEON staff members are happy to discuss partnerships with the Pathways Community Hub.  The Hub is only as strong as the partnerships within the program.  There are three different types of partnerships:

1) Referring those that you and your organization serve to the Hub.  Organizations with this type of partnership recognize the benefits of the program, and want what is best for their patients.

2) Contracting with the Pathways Community Hub.  Partner Contracted Organizations employ Community Health Workers that work with Community Members.  NEON, as a neutral third party, pays these organizations for the services provided by the Community Health Worker.

3) Participation on the Pathways Community Hub governance board.  Many of the contracted organizations choose to participate on the governance board, which plays a big part in guiding the direction of the Hub through policy change and providing strategic input.  Each contracted partner is offered a seat on this board.

 

NEON developed the Pathways Community Hub through a Centers for Disease Control Small Community Transformation Grant.  As of October 2014, NEON moved into the roll-out phase of the Hub through a Health Resource Services Administration Network Development Grant, and a grant from the Meyer Memorial Foundation.

PATHWAYS MODELCOMMUNITY HEALTH WORKERSLIVING WELL AND WHAT TO DO FOR HEALTH CLASSES