MLPB in a Medicaid ACO
About Our Partner
Brigham and Women’s Hospital is a member organization of Mass General Brigham ACO, which is accountable for high-quality, whole-person care delivery for MassHealth Medicaid-enrolled ACO members. One of the Brigham’s innovations is a Social Care Team (SCT) composed of Community Resource Specialists (CRSs), Community Health Workers (CHWs), Social Workers (SW) and Housing Resource Specialists (HRS) that work in tandem with a patient’s care team to address social determinants of health (SDOH) needs, and in particular, housing instability. The SCT uses a tiered approach to support any Brigham patient experiencing housing instability.
What We Do
MLPB recognizes that strengthening capacity on a care team is different from providing legal advice and representation to an individual or family. The Brigham recognizes this, too, and welcomes an MLPB team member into its SCT on a weekly basis. In this setting, we share prevention-focused legal information with the SCT that can guide effective problem-solving for patients experiencing unsafe housing conditions, housing instability, or homelessness. We also connect with several Housing Specialists and Community Health Workers outside of that setting to dive deeper into areas of problem-solving complexity they may be navigating.
Unlock Access for Your Team
MLPB is honored and energized to partner with communities of care who understand that human-centered care planning and high-quality delivery of social care must systematically account for people’s legal rights, risks, and remedies.