Best Practice

PASOS Health Connections

State/Jurisdiction: South Carolina
Setting: Community Clinical
Population: Perinatal/Infant Health,
Topic Area: Health Screening & Promotion,
NPMs: NPM 4: Breastfeeding NPM 11: Medical Home NPM 15: Adequate Insurance

PASOs was founded in 2005 after research showed that Latino families needed more support and information from a trusted source to address disparities and health inequities, and that our state’s support systems were not prepared to close the gaps. Simultaneously, health care systems and social service agencies have asked PASOs to help them better understand and reach this growing population in our state. PASOs became a bridge between Latino families and the resources they need, bringing families’ voices forward to speak to the inequities that challenge them, and delivering information to families in a culturally appropriate way. During its beginning years, PASOs was focused on perinatal health and primarily served pregnant women and infants. Through the years, and due to the increased trust and reliance the communities we serve began to develop, the PASOs Health Connections model emerged as our flagship program —addressing a full range of life course needs, with children, women and men, along with a focus on systemic inequities. The PASOs Health Connections model involves PASOs’ trained Community Health Workers (CHWs) work closely with members of Latino households including women, men, and children in a variety of settings including clinics and community-based locations. Because they are bilingual and are themselves Latino/a, the CHWs are able to build trust with immigrant families, even those who may otherwise be distrustful of institutions. From that position of trust, the CHW conducts intake screening, which includes health needs as well as social determinants, to determine the needs of the participant or family. Based on this intake, the CHW helps participants select an appropriate goal that works toward addressing the need with their support. Goals might include establish a primary care provider, apply for or renew health insurance including Medicaid, receive a chosen birth control method, learn how to use public transportation to get to work/school/appointments, receive food or clothing, connect with specialty care for a health need, and many more. Depending on the needs of the participant, and their level of urgency, CHWs will first educate them on the issue, inform them of available resources that they are eligible for, and work to refer and connect them with the resources they need to achieve their goal(s). The CHW follows-up with the participant to determine the outcome of the goal and whether the referrals made were successful.

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Implementation Handout

Maria Martin
Practice Website
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