Care Coordinating Agencies

What are Care Coordinating Agencies?

Care Coordinating Agencies are chosen by client preference, location, and other specific needs. Click the links to learn more about our current Care Coordinating Agencies:

Cowlitz County

Love Overwhelming

Lower Columbia CAP

Youth and Family Link

Grays Harbor County

Coastal CAP

SeaMar

Lewis County

Community Action Council

Gather Church 

Mason County

Community Action Council

Peninsula Community Health Services

Summit Pacific Medical Center

Pacific County

Coastal CAP

Thurston County

Community Action Council

Physicians of Southwest Washington

SeaMar

Wahkiakum County

Lower Columbia CAP

Our priority population include those who can answer YES to all three of these questions:

1. Does the person have a behavioral health concern?

• Mental health
• Substance use

2. Is there an additional concern?

• Pregnancy
• Chronic disease
• Co-occurring behavioral health

3. Are there additional risk factors?

• Housing insecurity
• Recent release from hospital
• Frequent need to use 911

Any person who can answer yes to these questions is eligible to work with a Care Coordinator.

1. Clients connect with Community CarePort by calling the referral line (800-662-2499) or by being referred by someone else.
2. The HUB assigns the client to a Care Coordinating Agency.
3. Care Coordinators help the client prioritize goals, access services, and become more engaged in their own well-being.

CPAA’s Community CarePort implements the Pathways Community HUB model developed by Dr. Sarah Redding in Ohio. The model has been successfully implemented across the United States and has demonstrated improved outcomes and savings in multiple settings. The research literature has documented specific positive outcomes with the at-risk pregnancy population, and Pathways implementation to serve a chronic disease population is currently being studied with promising initial results.

Care coordination services are an important aspect of care delivery because they connect people to resources that support the broader social determinants of health. Community CarePort specifically assesses all aspects that contribute to wellness and provides standardized Pathways that help people access and obtain the help they need. Examples include education, employment, and housing. The Pathways model also emphasizes that clients should set their own goals and be supported by care coordinators. This means that services are driven by the specific things that people need the most to make improvements in their own lives.

For more information, contact Michael O’Neill, Care Coordination Program Manager: oneillm@crhn.org