Community-Based Social Care
Personalized social care, close to home
At the HEaL Trauma Program, social care services are an integral part of our whole-person care approach. Social care services focus on addressing the non-medical challenges that significantly impact a patient’s health and well-being.
How community health workers support healing
Our community health workers (CHWs) support patients in the community setting following hospital discharge. They collaborate closely with inpatient trauma social workers to identify social needs, offer personalized assistance, and ensure continuity of care. Using a patient-centered approach, CHWs actively listen to individuals, educate them about available services, and empower them to achieve sustainable, independent outcomes.
Services provided by community health workers
Assessing non-medical needs
CHWs identify the challenges that may interfere with a patient’s recovery, such as housing insecurity, food access, transportation and financial instability.
Navigating social and community services
Patients receive assistance in understanding and accessing community resources to meet their needs effectively.
Support with benefits and employment
CHWs guide patients through applications for public benefits, insurance coverage, and job opportunities.
Mental health and substance use resources
Patients are referred to appropriate programs to address mental health challenges and substance use concerns.
Ongoing follow-up care
To ensure a smooth recovery, CHWs maintain regular contact with patients, providing continued guidance and support.