Patient-Centered Services

Improving health outcomes by putting people first.

All our programs and services are complementary, coordinated, and integrated to help people get the wraparound services they need, including medical, behavioral, dental, vision, specialty, and social services.

Meeting Clients Where They Are

Our diverse team of Community Health Workers is committed to helping people achieve their health goals, and we are proud of the difference we are making in the lives of our clients. We provide personalized and culturally responsive support to help individuals overcome barriers to care, connect to needed services and navigate complex systems.

Our team works in schools, hospitals, clinics, shelters, employment centers, jails, and more.

Improving Health Outcomes

0 Health and Hospital Navigation

services provided in 2021, including enrollment into Medi-Cal and Calfresh, scheduling appointments for primary and specialty care services, mitigating barriers to care like arranging transportation and language interpretation services, and connecting to community resources.

0 Field-Based

services provided in 2021 to support individuals experiencing homelessness and/or have complex health issues access and manage their health, behavioral health, housing and other social care.

0 Individuals Served

in 2021.

0 Total Services in 2021

Team-Based

In keeping with our whole-person care approach, all our Community Health Workers, who are part of different programs within our organization, have a wide variety of skill sets to work together to contribute to the client's complete health care.

Community Cafe

Located within walking distance of the Sacramento County Main Jail, our Community Cafe is a welcoming and safe place for individuals transitioning from incarceration to get help with connecting to health coverage, health services, housing support, and other health and social resources including obtaining an I.D. and cell phone.

Hospitals

We are partnered with all the major hospital systems in Sacramento county to support patients with post hospital/emergency department care and connect them to a medical home for all their health needs.

Our partnering hospitals are:

Mercy General Hospital
Methodist Hospital
Mercy San Juan Hospital
Mercy Folsom Hospital
Sutter General Hospital
UC Davis Hospital
Kaiser Permanente South Sacramento

Access to Food

We're committed to providing access to food and nutritious meals to those who need it most.

Since 2017, we have enrolled more than 1,000 individuals into CalFresh and provided nearly 600 referrals to local food programs and services.

In the first 10 weeks of the COVID-19 pandemic in 2020, we delivered more than 21,000 fresh meals to individuals who were medically vulnerable - both newly housed and experiencing homelessness.

Transportation

We know that, for many people, getting to and from medical appointments is incredibly important. Every second of the day matters, and we ensure our clients get all the support they need to get care.

In 2021, we scheduled more than 4,000 transportation services to help get clients to their medical, housing, and other health-related appointments.