Project Name: Planning Community Health Care Coordination for Youth in the Juvenile Justice System in Savannah, Georgia

Project Overview: The Georgia Primary Care Association (GPCA) is a 34-member organization supporting 229 community health center sites covering 123 counties in the state of Georgia, and serving nearly 500,000 patients at the date of the project launch; today GPCA’s members serve more than 600,000 people. Together with Curtis V. Cooper Primary Health Care (CVCPHC), its oldest member agency which serves Georgia’s second-largest population center in Savannah (Chatham County) GPCA built upon an existing collaboration with the Chatham County Juvenile Court (CCJC or the Court) to develop a new pilot focused on coordinating comprehensive primary care referrals for vulnerable youth to CVCPHC.

Juvenile incarceration is associated with adverse health outcomes in later adulthood, but for many vulnerable youth, the problems start much earlier. Lack of access to consistent, comprehensive primary medical, oral, and mental health care is not only detrimental to long-term health, but impedes early development and exacerbates other social and economic stressors. GPCA received funding from the Centers for Disease Control and Prevention (CDC) to develop collaborative efforts between CVCPHC and the Court focusing on the referral of juveniles for family planning needs. For this initiative, GPCA built upon the foundation established through the CDC-funded effort to develop a program focused on addressing the under-utilization of primary care services by youth involved with the juvenile justice system.

A planning grant phase set the stage for a full-scale intervention in collaboration with the CCJC, aimed at engaging youth in a medical home offering screening and primary care, including behavioral health and oral health, and improving health and social outcomes for underserved teens.

Planning project objectives were to:

  • Enhance collaboration among the community partners including the Court and CVCPHC;
  • Enhance systems of referral/tracking and focus on quality of care through Improvement Teams;
  • Increase staff capacity at the Court through trainings, reciprocal site visits, use of training materials for staff and clients and their families; and
  • Increase the number of vulnerable youth referred by the Court (from 800 by 10%).
2018-2019 Project Activities:

2018-2019 Project Outcomes:

  • Building on an earlier collaboration, established foundation for primary-care focused referral program;
  • Delivered initial training for Court personnel addressing procedures for screening and referral, site visits, and adolescent health topics;
  • In conjunction with The Work Readiness Enrichment Program (WREP), juvenile Court-referred intervention program for high-risk youth, identified a cohort of 15 adolescents and their families as a trial group to test program concepts, engagement, and satisfaction of the participants and stakeholders; and
  • Completed initial assessment of the screening and referral procedures for primary health care and identified possible changes in forms, procedures, and staffing.
2019-2020 Project Activities:

2019-2020 Project Outcomes:

  • Deepened partnership with The Front Porch, a multi-agency resource center, and established relationships with alternative school programs, work readiness, and diversion programs for court-engaged youth, including Youth Intercept Program, Building Bridges Academy and Goodwill;
  • Increased the capacity of Chatham County Juvenile Court to refer youth for primary care services by creating and implementing an updated referral process and new streamlined medical referral form. A total of 89 referrals were made to CVCCHC during the second program year. For 27 active referrals, the Court Liaison arranged necessary appointments and transportation to the health center, if needed. For 62 passive referrals, the Court Liaison provided information and guidance to parents/caregivers on how and where to follow up for services; and
  • Increased parent/guardian awareness of available health services for teens and family members by developing and implementing youth health screening instruments, creating and sharing educational materials on adolescent health topics, and applying insights from surveys, interviews and meetings with youth and parents to improve program design.

Project Partners: Curtis V. Cooper Primary Health Care, Chatham County Juvenile Court.

About the Grantee

The Georgia Primary Care Association (GPCA) is a member service organization representing community health centers in Georgia through the provision of training, technical assistance and the development and implementation of strategies to expand and strengthen the CHC system. Additionally, GPCA is involved in the development and implementation of additional programs and services that will enhance the CHC health care delivery system. For more information, visit: