Pathways to Recovery: Expanding Access to Integrated Care in Grayson County
The Project
Mount Rogers Community Services will expand comprehensive behavioral health and integrated primary care services in Grayson County, focusing on substance use disorders linked to trauma and poverty. Services will be delivered through home visits, telehealth, and a rural clinic, using a no wrong door approach to ensure accessibility. A full-time Registered Nurse (RN) will serve as a client navigator and service coordinator, improving access to psychiatric care, care coordination, addiction treatment, and integrated primary care services.
Work to be Conducted:
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Expand clinical capacity by hiring a full-time Registered Nurse by December 2024.
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Increase service availability in Grayson County from part-time to 4–5 days per week.
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Enhance telehealth accessibility by installing new equipment and training staff, ensuring behavioral health treatment access by October 31, 2025.
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Improve care coordination through RN-led navigation and integration of addiction treatment and primary care services.
Goals to be Achieved:
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Support 75 individuals in active addiction and long-term recovery.
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Increase patient engagement by reducing the no-show rate for appointments to below 25%.
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Improve treatment adherence through expanded services, coordinated care, and patient education.
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Measure success through patient outcomes, visit frequency, and retention rates.
Healthy Appalachia Institute Next Steps:
As this program unfolds, we aim to better understand how expanding behavioral health and integrated care services, may contribute to increasing treatment engagement and potentially improving long-term recovery outcomes. Mount Rogers Community Services plans to enhance telehealth access, hire key staff, and reduce the barriers to care which could impact substance use disorder treatment in Grayson County.​
We invite you to revisit this page as this project
is updated and as the evaluation
of the project continues
Evidence from Across Appalachia
Substance Use in Rural Central Appalachia: Current Status and Treatment Considerations
Addressing Substance Use Disorder in Appalachia
Project Updates
May 2025 – July 2025
Expanding Clinical Capacity – ​​This quarter, Mount Rogers Community Services successfully expanded care in Grayson County by hiring an internal candidate to serve as a Registered Nurse. Her familiarity with existing systems and practices allowed for a seamless transition into the role, and she officially began at the Grayson clinic on June 2, 2025. Since then, clinic operations have grown from one day to three days per week, with services already provided to 39 unduplicated individuals. As her caseload continues to build, plans remain in place to further expand services to 4–5 days weekly and include community-based home visits. This growth is expected to reduce travel burdens for clients who would otherwise seek care at locations in Galax or Wytheville.
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Telehealth Expansion & Equipment – The clinic’s ability to deliver remote services remained strong thanks to existing infrastructure and staff expertise. The newly onboarded RN is already trained in the use of telehealth technology, drawing on experience from larger Mount Rogers sites equipped with digital medical devices and conferencing tools. This readiness ensures that high-quality, remote care can continue while future equipment investments are planned.
February 2025 – April 2025
Expanding Clinical Capacity – ​​Mount Rogers Community Services made strong progress this quarter by filling the Registered Nurse (RN) position with an internal candidate, streamlining the onboarding process, and ensuring continuity of care. The use of trained floating nurse staff allowed for immediate service expansion while recruitment continued. Clinical services in Grayson County increased from a half-day to a full day per week, resulting in a rise in patients served from 47 to 57. Though geographic isolation continues to pose recruitment challenges, efforts remain active and ongoing, with the full-time RN scheduled to begin June 2, 2025. This strategic growth positions the clinic for eventual expansion to a four to five-day service week.
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Telehealth Expansion & Equipment – While no new telehealth equipment was purchased this quarter, Mount Rogers Community Services continued to support virtual care delivery by leveraging its experienced floating nurse pool. These staff members are already trained in telehealth protocols and technology, allowing for consistent, high-quality remote care. This strategic use of existing resources helped maintain service continuity and patient engagement, particularly in rural areas where access remains limited. Planning for future equipment procurement is ongoing and will align with broader staffing and clinic capacity developments.
November 2024 – January 2025
Expanding Clinical Capacity – ​​The RN position was actively marketed, generating two potential candidates for interviews, though the posting remained unfilled as of January 31st. Preparations for clinic expansion included identifying workspace, securing equipment, and refining workflows. Community outreach and stakeholder meetings increased awareness of available services, including behavioral health telehealth options.
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Telehealth Expansion & Equipment – Telehealth equipment procurement was identified and was undergoing final budget approval before purchase. Existing staff were already familiar with telehealth technology, and site-specific training was set to be provided once new equipment was installed.