Navigating the Social Care Maze


I first met Linda when she came in for a doctor’s appointment at our primary care center. My role as a Care Navigator at the health center is to screen patients for social determinants of health to inform their care plan and then to connect them to resources as necessary. In some cases, patients do not identify many needs, and these conversations can last less than 5 minutes. Other times, a patient in desperate need of resources finds themselves in the right place at the right time. This was the case for Linda. Within the first few minutes of our conversation, I learned that Linda was living in a shelter and had been trying for quite awhile to find a way to move into her own place. This proved more difficult without steady employment due to her disability status. On top of her unstable housing situation, Linda’s financial troubles also often prevented her from getting food and clothing when she needed it. All of these things posed significant risks to her health. And without the funds to get transportation to some doctor’s appointments, keeping up with her health proved a difficult task. Furthermore, Linda didn’t have a phone, so she often wasn’t able to be reached by doctors and other people trying to reach her to schedule appointments or offer resources. Thankfully, when Linda was connected with me at her doctor’s appointment, she was able to gain access to resources to meet all of these needs in one place through the Connect4Health platform. 

Using Connect4Health, I have been able to connect Linda to a myriad of community organizations and services to improve her situation in the three months since we first met. In particular, I have been able to continue to send her information about housing counseling resources, tenant’s rights classes, and legal aid for renters to improve her housing situation. While we are still working on finding her her own place, she is now in conversation with a team of people all over the city who are helping her to navigate the housing market. In addition, we were able to apply for a SEPTA disability pass and free government phone for Linda, so that she can get to her doctor’s appointments and be more easily reachable. We got her connected with some organizations that help with job search, and she now has information about several places in her area where she can get food and clothing when she needs it. As we continue to have conversations about meeting her needs, Connect4Health helps us to work together to keep track of what services she has been able to connect to and where she is still seeking further assistance. Because of Connect4Health, Linda now has the ability to access resources that can help her to live a healthier life with stable housing, steady supply of food and clothing, and improved transportation and communication.