Social Determinants of Health

The initiatives in this domain support high-need patients and assist providers in providing care by addressing SDoH factors. The efforts include advancing health equity by working with sectors on the factors that influence health, including employment, housing, public safety and food access.

Foodlink Maternal Home Delivery Program

Food insecurity is a social determinant of health and a driving force of health inequities. The COVID-19 pandemic exacerbated the crisis of food insecurity, disproportionally affecting women and racial and ethnic minorities.

We partnered with Foodlink on an innovative program that promoted eating healthy and addressed food insecurity for pregnant women A healthy diet is very beneficial for both mom and baby throughout the pregnancy and after the baby is born. Foodlink collaborated with Excellus BlueCross BlueShield to enroll program participants and served over 150 expectant mothers in Monroe and Ontario counties.

This innovative program provided home delivery of nutritious food along with virtual cooking classes during the pregnancy and postpartum period. Cooking kits were provided that included an array of pots, pans, kitchen utensils, baking sheets, oils, and spices. To ensure a high level of customer satisfaction, Foodink leveraged routing and texting technology to manage the most efficient delivery routes and managed ongoing communication with program participants.

Our Community Partners

“The Finger Lakes IPA, a partnership of the region’s community health centers, six behavioral health organizations, and the S2AY Rural Health Network, is very excited to be a part of this important initiative by FLPPS to support the critical need for access to developmental screenings for young children in our rural communities. This program will give us the ability to provide access to services that are often not available due to geographic and other barriers to care experienced by our patients.”

Mary Zelazny, Chair of Finger Lakes IPA and CEO of Finger Lakes Community Health

“I am excited to see ‘equity in action’ through this partnership with FLPPS, who recognizes the importance of lived experience and elevating the parent and patient voice to bring change across our health and behavioral health systems.”

Sara Taylor, Founder of BIPOC PEEEEEEK

“For decades Regional Health Reach has been a leader in the community in providing healthcare and support services to those experiencing homelessness. Through our traditional clinic, mobile medical unit, and presence at shelters, our Healthcare for the Homeless program has touched thousands of lives. Health Reach is excited to partner with Finger Lakes Performing Provider System and MC Collaborative to expand our reach to unsheltered individuals, meeting them where they are, to provide the care they need.”

William E. Belecz, Executive Director of Regional Health Reach

“The key to the success of this menu of services is our ability to have a two-way dialogue with doctors and other medical professionals about both health and social support needs at home. We’ve proven this model can improve patient outcomes and reduce unnecessary ED visits and hospitalizations, and that’s a win for everyone. It also reduces both physician and patient/family caregiver frustrations.”

Ann Marie Cook, President and CEO of Lifespan

“By expanding our Person In Crisis teams to include certified peer specialists, we will be able to assist even more of our residents in need in a humane and compassionate manner. In addition, by assisting residents in this new way, we are expecting that there will be a reduced number of people calling the PIC team because they are getting connected to the services they need.”

Former City of Rochester Mayor Lovely Warren