One-Stop Shop Model
The one-stop shop model combines multiple healthcare and/or human service providers in a single location to deliver services to rural families. Bringing together services in one location can benefit rural families in accessing healthcare, transportation, referrals, and services for children. To further improve access to care, program planners can also establish one-stop shops in easily accessible locations, such as in a mobile clinic or near a grocery store. These models typically go one step beyond co-location, for example, by bringing different types of providers under one umbrella organization or by using common intake forms and electronic health records.
One-stop career centers are one type of one-stop shop model. These centers focus on employment and workforce development, and offer services such as training referrals, career counseling, job listings, and other employment-related services. The Workforce Investment Act (WIA) created a framework for training and employment programs to support the needs of businesses and workers. WIA mandates that communities establish partnerships among multiple programs, such as Temporary Assistance for Needy Families (TANF) and Medicaid.
Examples of Rural One-Stop Shop Programs
- A network of rural organizations in Illinois developed a one-stop shop model called Florissa. This pediatric developmental center bridges organizational silos for children with behavioral, developmental, social, or emotional needs. Children can receive assessments and therapeutic services. This streamlines the care process and reduces the need for referrals to many different providers. The staff at the center include a pediatrician, early intervention providers, a behavioral health clinician, and speech and occupational therapists. Florissa also provides resources to parents, including support groups, forums, and linkages to other community services, and performs community outreach and trainings for school staff and healthcare providers.
- The Pacific Chronic Disease Council implemented the Pacific Care Model in order to address the fragmentation of health services in Pacific island nations. The Council includes representatives from American Samoa, Guam, the Northern Mariana Islands, the Federated States of Micronesia, the Republic of Palau, and the Republic of the Marshall Islands. The Pacific Care Model involves increased care coordination through improved information technology systems and one-stop shop care. The model has been successful at increasing diabetes self-management among participants and increasing screening rates for comorbid conditions.
- CommWell Health's Positive Life program provides a one-stop shop to support patients with HIV in six rural counties in Southeastern North Carolina. The program connects patients with caseworkers who address their healthcare and social needs, such as transportation access to and from the clinic. CommWell is co-located with oral health, behavioral health, and primary care providers, as well as a pharmacy and some social services
Considerations for Implementation
Strong partnerships or a network are critical to the success of the one-stop shop model, particularly for service providers that work with children. Community buy-in is essential for the success of this model because strong partnerships between local governance and community organizations form the foundation of one-stop shops. Rural one-stop shops may need to work closely with physicians or school staff for referrals and conduct community-wide education about the services offered at the one-stop shop. This may require marketing or outreach to facilitate a collaborative environment between the one-stop shop and other providers in the community.
One-stop centers may need to develop information systems that facilitate information sharing between health and human services providers and determine eligibility for all the programs offered through the one-stop shop. A common intake process or eligibility form can help to avoid duplication of effort and reduce the burden on the individual, who would otherwise be required to fill out applications for multiple programs. One-stop shops that offer clinical services can track the services that people receive through shared electronic health records.
One potential challenge in this model is satisfying the licensing requirements of each clinical provider participating in the one-stop shop. This challenge can be mitigated by developing a protocol in collaboration with the clinical team participating in the one-stop shop during the formative months of the project. Another challenge is coordinating the billing process when multiple providers are delivering services.
Attracting and retaining qualified professionals to work at the one-stop shop is another potential challenge. This can be addressed by hiring full-time staff or consultants who can deliver services via telehealth. Program planners may also hire part-time staff who can travel to the one-stop shop when needed.