Shared practical implementation considerations that can support health plans and provider groups in developing community-based models of care that use the strengths of social workers and community health workers.

Resources to help organizations plan and implement medical respite care programs, including program development guides, case examples, and implementation tools.

State investments in enhanced primary care for older and chronically ill individuals recently released from incarceration yielded a $2.55 return on investment for Medicaid and criminal justice combined.

Care management interventions for people transitioning from behavioral health inpatient care may be successful in decreasing readmissions if they address health-related social needs.

Housing needs assessment tool can help providers who work with people leaving incarceration to better understand their housing needs and risk of homelessness.

A hospital-based program showed that peer recovery coaching can be seamlessly integrated into the workflow of busy emergency departments to address the longer-term needs of people with substance use disorders.

Patients and community health workers (CHWs) share perspectives on the impact of CHW services provided within a primary care setting to address barriers to equitable care.

Guidance on developing a reentry program to support Native Americans who are reentering communities from jail or prisons.

A street medicine program increased post-hospitalization follow-up care for unsheltered individuals experiencing homelessness in Los Angeles.

Implementation insights from a permanent supportive housing diversion program in Los Angeles for people in the criminal legal system with serious mental illness point to the value of cross-sector, cross-agency partnerships.

A medical respite program for people experiencing homelessness shows evidence of reduced hospital readmissions and emergency department revisits.

Strategies, challenges, and opportunities in supporting the implementation and sustainability of community paramedicine programs in rural communities.

A comprehensive review of state mechanisms to reimburse for community health worker services.

Home-based program provided by a community health and social worker reduces acute care use and improves care for older adults with complex health and social needs.

An affordable housing program in Baltimore generates between $1.30-$1.92 of “social return” in the community for every dollar invested annually.

Discusses the benefits and challenges of tele-social care and offers practical tips for providers administering telehealth services for social care activities.

Home-based primary care programs enable care teams to gain insights on a variety of social factors that impact older adults’ health, which allows them to better tailor care to meet patient needs.

Demonstrates that a program assisting older adults with complex needs in navigating medical and social services may lower acute care utilization.

California’s Whole Person Care pilot can inform cross-sector initiatives to improve care for Medicaid enrollees with complex health and social needs.

Moving patients out of the ED and into community support.