Fulton County Leaders Discuss Closing Health Gaps and Strengthening Behavioral Health Systems

Fulton County, Georgia is tackling long-standing health inequities and behavioral health challenges through a mix of partnerships, innovation and strategic investment.

In a recent conversation with Managed Healthcare Executive, Pamela Roshell, Ph.D., chief operating officer for Fulton County Government, and LaTrina Foster, director of Behavioral Health and Developmental Disabilities for the county, shared how the large community of 1.09 million people is working to improve access and outcomes for residents.

Roshell shared that Fulton County has been forced to confront deep structural disparities—especially in South Fulton, where residents live an average of seven years less than those in the north. She traced the divide to “a significant impact on certain communities” from a health perspective due to COVID-19 and the closure of two major hospitals—which left certain parts of the community without reasonable drive-time access to an emergency room.

To prevent these challenges, the county partnered with Morehouse School of Medicine and Grady Health System to open new clinics and mobile wellness programs.

Through these partnerships, the county conducted the “Project Care” study, which examined the impact of gaps in healthcare access for Fulton County residents.

Roshell shared that the county added three primary care clinics, one in partnership with Morehouse School of Medicine in East Point, and through their board’s investment of $19 million, the county partnered with Grady Health System to offer a free-standing emergency room for South Union City.

“Restoring healthcare access points was one of the things that we did immediately,” she said.

On the behavioral health front, Foster expressed that partnerships and flexibility are central to meeting community needs—especially amid workforce shortages.

Fulton County contracts with multiple providers instead of relying solely on direct hires, which allows it to scale services and maintain staffing levels.

“When we find ourselves in need of additional capacity, we’re able to leverage one of our contracts to increase our presence in the community,” Foster said, adding that most agencies don’t often operate this way. “And I think that is the wave of the future—to have a collaboration with multiple agencies delivering a service to serve a community.”

Foster also highlighted the county’s trauma-informed approach and cross-sector collaborations with schools, courts and law enforcement.

“People need to be treated holistically,” she said. “So what we have done in response to that is that we’ve cultivated a really strong partnership with our judicial partners.”

For instance, Fulton County has expanded its behavioral health partnerships to include mental health and DUI courts, school-based therapy in 66 schools and a rapid-response text line connecting students to licensed clinicians. The county also collaborates with housing and jail programs to identify and support individuals with mental health needs early, reducing recidivism and promoting stable reentry into the community.

Together, Roshell and Foster’s strategies display a countywide commitment to rebuilding equitable healthcare where access, prevention and compassion drive long-term health improvement.