Delta Enterprise Community Rural Health Outreach Program

To address these needs, the White River Rural Health Center, a community health center located in the region, formed a consortium of organizations to create an outreachbased approach to increasing access to these services for lowincome individuals and families in the target service area.

The project activities focused on training and deployment of community outreach workers throughout the six-county region, health promotion and disease prevention programs, and linkages to health insurance coverage resources and human service agencies.

The project established a single point of contact for clients to the services available throughout the six-county region. The single point of contact was the outreach workers employed by the program. Community outreach workers received extensive training in health, mental health, and housing issues. Armed with this knowledge, they targeted individuals and families who were likely to need care, including low-income children, youth, and elderly. Once contact was initiated, the outreach workers encouraged families to access an interlocking system of care that offered services and supports. White River Rural Health Center conducted the initial screening and assessment of new clients and then linked clients to a case manager who worked with physicians and mental health professionals to facilitate additional assessments. Providers developed medical and mental health treatment plans and provided referrals to consortium and community resources.

Outreach workers attended meetings at area churches, civic groups, and workplaces. At these meetings, they explained the program’s services, distributed a packet of information about the program to new clients, and asked new clients to complete a referral slip that included contact information for the client. Sometimes, however, clients did not attend initial appointments, which meant that outreach workers had to attempt additional contacts to engage clients in care. Clients also were given a toll-free telephone number they could call to access services.

The transportation program is fully operational, and all newly identified clients are evaluated for eligibility for Medicaid. Five outreach workers are stationed in various clinics throughout the sixcounty region to identify new clients. The project also continues to employ two case managers. Outreach workers continue to visit local churches, civic groups, and employers to educate members of the community about the services available to them. The partner organizations also continue to provide and accept referrals for care. Case managers are actively involved in helping clients access community resources and, when eligible, to enroll in Medicaid. Project activities are funded by inkind contributions, other grant sources, and patient revenues.