Dear Bernalillo County Commissioners,
We are writing to urge you to ensure that the “Pathways to a Healthy Bernalillo County” program remains as a specific component of the Memorandum of Understanding between the County and the UNM Board of Regents for the public funds allotted to UNM Hospital through the mill levy tax. In addition, we insist that the Pathways program receive a higher funding level – a minimum of $2,000,000, annually - to build on the Pathways model’s success and more adequately serve all Bernalillo County residents. We believe this essential support will contribute to improved overall health in our community, as recent evidence is beginning to demonstrate.
The program is exemplary in its use of collaboration and partnership among local nonprofit organizations, UNM, the County, City of Albuquerque and several state agencies, starting from the design stage nine years ago, to today. Over the course of program implementation 22 community based organizations, including those that provide health care services, serve victims of domestic violence and persons experiencing homelessness, faith-based organizations, schools, those that serve persons reintegrating into our neighborhoods following incarceration, immigrants, refugees and our First Nations’ people, have been able to stretch their dollars with Pathways funding. Not only does the funding allow them to serve more people, Pathways funding supports the training, relationship-building and empowerment among frontline workers such as Community Health Workers and outreach workers. In their role as Community Health Navigators, they serve the County and the public as they engage daily in witnessing the effectiveness of our health and social safety net. The unique feature of the Pathways program that focuses on guiding participants to achieving multiple outcomes that are indicators of improved health status has demonstrated that the individuals served through the program feel better (75% of Pathways participants reported in August 2016 that their health had either ‘improved’ or ‘greatly improved‘ compared to when they began participating in in the program); barriers that impede progress toward outcomes become more clear and so that they can be addressed through collaboration; and resources are cost-effective in connecting participants to care.
Recently the Pathways program invested in a study to examine the Return on Investment (ROI) that could be associated with program activities. The news is good! See the full reports by clicking on the links below. A few highlights of the study that will be of interest to you are:
- Employment: Since 2010, completion of the Employment pathway has generated approximately $8.1 million in income for Pathways clients and the communities in which they live and work. Every $1 invested in administration of the Employment pathway produced almost $13 in additional income for extremely needy county residents. But even this high benefit-to-cost ratio doesn’t fully capture the Employment pathway’s potential benefits. Having a job has been shown to improve physical and mental health in ways that can’t be fully explained by the income employment produces.
- Medical debt: Since 2009, completion of the Medical Debt pathway has reduced participants’ medical bills by roughly $3.7 million. Clients who completed the Medical Debt pathway not only eliminated almost two-thirds of their outstanding medical debt, they reduced their (self-reported) hospitalizations and emergency department (ED) use by over 50 percent.
- Healthcare Home: Completion of the healthcare home pathway produced an estimated $2.4 million in health care cost savings, net savings of $1.7 million and a benefit-cost ratio of 3.47.
Click on the link to read the full article about Pathways, which appeared this month in the peer reviewed Progress in Community Health Partnerships: Research, Education, and Action Journal, from Johns Hopkins Press. “The Evolution of an Innovative Community-Engaged Health Navigator Program to Address Social Determinants of Health” describing the program model. The Pathways program has been presented in several national conferences with enthusiastic reception, and participates in a national effort to standardize the unique outcomes-based, collaborative health intervention model.
The public funding mechanism of the Pathways program is essential and it is appropriate; now it must be brought to scale so Bernalillo County can continue to become a healthier place for all taxpayers to live. Pathways enables a continuity of services at the community level like no other regional effort, and promotes public accountability within UNM and the County for use of taxpayer dollars. Most importantly, Pathways provides an ongoing and collaborative platform for understanding the critical issues that affect health improvement, empowering public and private programs to plan services so all community members can benefit from County and UNM resources.
To continue Pathways with status quo funding would jeopardize not merely program growth, but community capacity-building efforts driven by Pathways’ partner organizations who successfully reach hard-to-serve individuals who are most impacted by uncoordinated services delivery and financing. For example, stop-and-start timelines interrupt service provision while competing demands from multiple funders create administrative burdens and deter from collaborative approaches. These leave smaller, often more responsive organizations unable to do what they do best for our most marginalized County residents.
Pathways is an essential and successful program in our county. It will continue to contribute to improved individual health in our County and to inform us in our collaborative efforts to address health needs and conduct vital health planning. We ask you to ensure that public funding is secured for Pathways, and increased to a minimum of $2,000,000 annually, by ensuring that it remains as a specific section of the Memorandum of Understanding between the County and the UNM Board of Regents.
With sincere appreciation,
Community partners of the Pathways to a Healthy Bernalillo County Program