A cross-cutting workforce solution for implementing community-clinical linkage models

Federal agencies have identified the need to foster integration between health care and social services to address the underlying role of social determinants of health and achieve health equity. Community–clinical linkage models are partnerships to help connect health care providers, community organizations, and public health agencies so that they can improve patients’ access to preventive, chronic care, and social services. Models for linkage have proliferated to tackle the complexity of addressing social needs from health care settings. Examples include using electronic community referrals systems to facilitate connections between patients and organizations that offer social services, creating medical-legal partnerships, and employing community health workers (CHWs) to navigate complex health systems and facilitate access to community resources such as affordable housing and food banks.