A Healthier Wisconsin

Jackson County Pathways Community Hub

Connecting residents of Jackson County to healthcare, social, and community-based services through community health workers

Full Project Name:Jackson County Pathways Community HubPrimary Community Organization:Great Rivers United WayPrimary Academic Partner:Leslie Ruffalo, PhD, Family MedicineAward Amount:$200,000
Award Date
Project Duration:18 months

Project Description Narrative:

The Pathways Community HUB will lay the workforce infrastructure to connect individuals in need to service systems in Jackson County through a hub model and engagement of community health workers (CHWs). Currently, services are provided in silos. Many families and community members enter the healthcare or social services system looking to address several needs. The family may be referred to multiple service providers, but the referral process varies and may become confusing or cumbersome for the family to navigate.

The Pathways Community HUB model was created to bridge the gap between healthcare delivery and social services. It leverages community health workers as a critical healthcare workforce to work alongside individuals to reach outcomes that will reduce the risk of poor health outcomes. The Pathways Community HUB model is an evidence-based and standardized model that has demonstrated success in improving health outcomes. Community health workers, being from the communities they serve, are also an evidence-based component of the intervention that has demonstrated impact in addressing health disparities.

Despite evidence demonstrating the efficacy of CHWs, they are a category of the workforce not available in all counties across Wisconsin, including Jackson County. Implementing the Pathways Community HUB model with CHWs as a workforce development strategy will connect and align the service networks in Jackson County and lead to a more efficient and effective process to provide holistic care to families in the community.

At present, the Pathways Community HUB model is only operational in a few predominately urban counties in the state. Jackson County would be one of the earlier rural counties to implement such a model (Monroe and Trempealeau counties are currently working with Great River HUB to operationalize their hubs). And with its success, researchers will be able to extend their findings and lessons learned to other rural counties across the state and assist in implementing a similar approach.

Community partners: Black River Memorial Hospital, Co-op Credit Union, Great Rivers HUB, Great River United Way, Jackson County Department of Health & Human Services, Jackson County Interfaith Volunteer Caregivers, MCW School of Pharmacy, School District of Black River Falls

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8701 W Watertown Plank Road,
Milwaukee, WI 53226-0509
(414) 955-4350