Project Term: 24 months; 2015-2017
Grant Amount: $93,000
High utilizers of the emergency department drive up costs unnecessarily and are not entering the healthcare system at an access point that is prepared to address their underlying needs. In an effort to improve care and health outcomes while lowering unnecessary costs to our healthcare system, Community Health Partners, the Park County Health Department, Livingston Mental Health Center and Livingston HealthCare have partnered to create the Park County Connect Program. Funds will support a social worker housed in the health department who will design and implement a community-based outreach program for existing emergency department high utilizers and those members of the community at risk for unnecessary utilization of the emergency department. The social worker will coordinate partner organizations to develop referral and tracking systems to ensure that interventions are documented and communicated, enhancing care coordination and improving outcomes. Performance indicators will be identified at both the patient and community level, and all partners will contribute data to the program evaluation process. This two-year project aims to identify relatively simple interventions that can positively affect overall community health and well-being using a model that could be easily replicated in other rural communities.