Plan puts high-risk people on successful paths
Working alongside people charged with low-level crimes in Franklin County Municipal Court, Earl Lawson has discovered that it often comes down to putting food on the table.
People get caught stealing groceries, sometimes worth just $22, he said.
Lawson’s goal is to help guide those people along pathways that can help them avoid jail time and criminal records, and prevent them from breaking the law again.
Those pathways might involve finding stable housing, getting electricity turned back on or having a vehicle repaired to enable transportation to a job. And they often involve getting linked up with a food bank or pantry.
Lawson provides the connections and support as part of the expanded Central Ohio Pathways HUB, a community initiative designed to connect people with resources to improve their health and better their lives.
Through the Pathways HUB, community health workers like Lawson determine both the healthcare and social-service needs of people in vulnerable and high-risk situations. They then guide them through one or more of 20 pathways designed to address those needs.
Someone who smokes might travel a “smoking cessation” pathway, someone in need of work might go down an “employment” pathway, someone wanting a GED certificate might take an “education” pathway, and someone with no primary care physician might take a “medical home” pathway.
Carrie Baker is president and CEO of the nonprofit Healthcare Collaborative of Greater Columbus, which manages the hub. She said only about 20% of factors that impact health are clinically related, or based on what happens in your doctor’s office or a hospital.
“The other 80% is what we’re talking about with the hub. Are you healthy financially? Do you have education? Do you have food? Do you have transportation? Is your housing adequate? Do you have a job?” Baker said.
The hub kicked off March 1, and community health workers opened 1,443 pathways for 194 clients through June. About half of those pathways had been completed over that period and others were ongoing.
Lawson serves the hub as a community health worker employed by Wellness First, a program of the African American Alzheimer's & Wellness Association in Westerville.
It is one of six central Ohio “care coordination agencies” providing community health workers for the hub. The others are Franklin County Public Health; the Breathing Association, which promotes lung health; Celebrateone, which addresses infant mortality; the volunteer-based Physicians Careconnection; and Primaryone Health community health centers.
Franklin County Public Health finds clients in need of hub services by partnering with additional agencies and groups, such as the Columbus Metropolitan Housing Authority, the YWCA, St. Dominic Roman Catholic Church, Little Bottoms Free Store and immunization clinics.
The care coordination agencies currently are paid by Medicaid managed-care plans for completed pathways, and Baker hopes to also involve employers, private insurers and Medicare.
The Pathways HUB represents a “quadruple win,” helping people in need of services, providers who care for them, health and social-service agencies making connections and the community as a whole, which is able to address issues proactively, said Dr. Teresa Long, special adviser for community engagement at Ohio State University’s College of Public Health.
“It actually is a tool for us all in the community to understand what are the challenges and conditions people are struggling with and how can we collectively, I hope, go upstream,” said Long, a former Columbus health commissioner who serves on the board of the Healthcare Collaborative, a private-public coalition that seeks to address community health.
Jenelle Hoseus, executive director of the Pathways HUB, said the success of the program rests largely on relationships being built between community health workers and clients.
"There’s nothing else other than the desire to help someone get on a better path and have the resources and the tools ... to have a better life opportunity, a better life expectancy, a better health outcome," Hoseus said.
Workers can serve the role of cheerleader, friend or mother, said Rachelle Brown, a community health worker at Franklin County Public Health.
“We don’t just refer them to a service, we kind of hold their hand,” she said.
Some of the workers come to the program in a "pay-it-forward" fashion, Hoseus said, having received similar guidance in the past.
The hub model, developed by Drs. Sarah and Mark Redding in Mansfield, initially was used primarily to address infant mortality rates.
Hoseus said success has been achieved, as noted in a Buckeye Health Plan study of 3,702 deliveries from 2013 to 2017 in an area served by a hub operated by the Hospital Council of Northwest Ohio in Lucas County. It showed that high-risk mothers not exposed to hub resources were 1.55 times more likely to deliver babies needing special care than high-risk mothers who had received hub support. It also showed that, for every dollar spent on community hub activities, there was a savings of $2.36.
The local initiative represents the progression and expansion of a hub model managed by the United Way of Central Ohio, which focused on mothers and children.
Lawson, who works in the court diversion program in partnership with the Columbus city attorney’s office, said he tries to help make sure one-time slips don’t lead to a lifetime of consequences.
“The diversion program is designed to fill some of the barriers that may have caused them to steal or do something illegal," he said. "It’s really to have an individual, and also families, become stable."
jviviano@dispatch.com @Joanneviviano