Strengthening the Network: Overcoming Barriers to Health and Social Services in Bernalillo County, New Mexico Utilizing the Pathways Model

As Bernalillo County (greater Albuquerque area), New Mexico continues to explore different strategies to improve the health of its most disadvantaged citizens, it has partnered with community members and the University of New Mexico Health Sciences Center, Office of Community Affairs (OCA) and embarked on an exciting new demonstration project called Pathways to a Healthy Bernalillo County. This collaborative Project gives the community control in addressing the health needs of its most disconnected and disadvantaged populations. For an 8-year period, the equivalent of 1% of the University of New Mexico Hospital mill levy funds received from the County will be designated each year to support the Pathways Project. Guided by the community and managed by the Office of Community Affairs, Pathways channels resources to 15 local community-based organizations that employ community health workers (navigators) to help individuals and families "navigate" the health and social service system following a series of specific steps (pathways) and document systems barriers that hinder access to services. This session describes the background and assesses the first year of this innovative approach to community health improvement. The Pathways care coordination model originated in the late 1990s by two pediatricians in Ohio, Drs. Mark & Sara Redding, and has since been modified and replicated in twelve states with more than seventeen projects across the nation.