Accessing community resources like food, benefits, housing, and legal support can be incredibly difficult. It is a rare occurrence to be connected to the right resource at the right time. But thanks to our partnership with Unite Us, Public Health Solutions has developed a coordinated, accountable, and modern network of organizations, WholeYouNYC, that supports over 1,000 New Yorkers each month to access services in their community. Unite Us enables us to collaborate in real-time, deliver reliably and responsively, and provides the visibility we need to ensure no one slips through the cracks. . We hope that the coming investment through New York’s Medicaid Waiver program supports us to bring this infrastructure to scale.

Since New York’s previous 1115 Waiver, HWCLI has led the Health Equity Alliance of Long Island (HEALI), Long Island’s Social Care Network, to build a comprehensive and integrated social care system for the region. In preparation for the upcoming waiver, our coalition partners have utilized Unite Us as a critical referral and communication tool to connect social care services across Long Island. Unite Us has been a responsive and collaborative partner by providing a technology solution to build the social care infrastructure necessary for our vision for Long Island.

Our vision is to create a connected ecosystem of care across healthcare, government, and social care in the Hudson Valley to improve access to needed services for individuals and their families. Unite Us enables organizations in our region to better coordinate and collaborate in order to care for the whole person, through visibility into the status of referrals and ultimately what services are delivered. We look forward to scaling our work together under the New York 1115 Waiver to promote health equity in our region and beyond.

Northwell is proud to partner with Unite Us as we continue to expand our screenings for the social determinants of health to over one million. Unite Us is a thought leader that is fostering dialogue around best practices throughout our region and nationally. The upcoming 1115 Medicaid Waiver will help accelerate the work we are doing and forge new community partnerships that are committed to making a difference

The partnership with Unite Us has allowed the 360 Collaborative to begin preparation for social care payments, which is a critical component of the upcoming NYHER waiver. We have initiated a pilot that addresses food insecurity for individuals who have a Type II diagnosis. It has allowed us to have a better understanding of the resources dedicated for waiver implementation and partners are providing feedback in real-time on the support they need to make this social care delivery a success.

As organizations across New York move to implement the new 1115 Waiver, there will be an even greater need for effective and efficient integration of clinical and social supports. Through our collaboration with Unite Us, we have developed readily adaptable systems and processes to screen patients for social needs, initiate referrals, and connect with new and existing community partners. During and post-DSRIP, CCB has advanced programs and partnerships that improve quality of care and address social factors impacting the health of 1.2 million Medicaid recipients in Brooklyn. The 1115 Waiver offers a unique opportunity to connect health and social care providers across the State to affect whole person care.

As a Social Care Network and one of only 58 designated community care hubs in the nation, we at Healthy Alliance deeply understand the role a social care referral system plays in effectively connecting community members with health-related social needs (HRSN) to organizations that can help. Throughout our partnership, Unite Us has provided the technology infrastructure for our referral coordination center (RCC) and our network partners, enabling us to successfully connect thousands of people to services, such as healthy food, benefits counseling, housing, primary care, and workforce development, across a broad geography. With Unite Us, our RCC network partners have visibility into screenings, referrals, and case outcomes. Our partnership with Unite Us supports a shared goal and vision to create stronger, healthier, and more connected communities.