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News Release Kendra Wheeler-Davis, media relations manager
216-436-2122, 216-849-4922 cell
For Immediate Release

United Way of Greater Cleveland receives $4.51 million grant
to implement social service assessment with four clinical partners
-Nonprofit was one of only 32 organizations selected nationally-

Cleveland (April 7, 2017) United Way of Greater Cleveland received a $4.51 million grant from
the Centers for Medicare and Medicaid Services (CMS) to establish the CMS Accountable
Health Communities (AHC) Model. Four clinical partners will adopt the model designed to
connect patients with social service resources – Cleveland Clinic for primary care and
emergency health service, MetroHealth for primary care, emergency health and labor and
delivery service, St. Vincent Charity Medical Center for behavioral health service and Care
Alliance Health Center for primary care. United Way is one of only two organizations selected in
the state of Ohio and one of 32 selected nationally.

“Currently, there’s a disconnect between health care and social services,” said United Way
President and CEO August Napoli. “Creating an AHC in Greater Cleveland will allow our health
system to build a bridge and holistically assess a patient’s wellbeing and refer them to proper
health care and social service agencies to address basic needs such as housing instability and
food insecurity.”

An AHC is a CMS model to address the health-related social needs of Medicare and Medicaid
beneficiaries through assessment, referral and community navigation services, leading to
improved care delivery, enhanced quality of care, reduction of the total cost of care and
inpatient and outpatient health care utilization.

“In this model, we will support community-based innovation to deliver local solutions that
address a broader array of health-related needs of people across the country,” said CMS
Deputy Administrator for Innovation & Quality Dr. Patrick Conway. “As a practicing pediatrician, I
know the power of a model like this to help address the health and social support needs of
beneficiaries and their families and caregivers.”

Over a five-year period, the $4.51 million grant will be used to embed United Way 2-1-1
community resource navigation specialists into seven Cleveland Clinic, MetroHealth, St. Vincent
Charity Medical Center and Care Alliance Health Center sites. The grant will create and support
community partnerships for technology, workflow design, evaluation and planning. Additional
dollars will be utilized for necessary equipment and supplies.

Cleveland with a poverty rate of 36 percent, East Cleveland at 42 percent and Warrensville
Heights at 19 percent have 209,000 residents who are Medicare and Medicaid beneficiaries;
these cities were selected as the AHC service areas.

Patients receiving health care at Cleveland Clinic South Pointe Hospital; MetroHealth’s Main
Campus, Broadway Health Center, Old Brooklyn Health Center and Thomas F. McCafferty
Health Center; St. Vincent Charity Medical Center and Care Alliance Health Center’s Central
Neighborhood Clinic will be screened for health-related social and basic needs such as housing
instability and quality, food insecurity, utility needs, violence and transportation barriers. The
screening will be followed by a community resource assessment and referral from United Way
2-1-1 community resource navigation specialists.

“United Way 2-1-1 is a free and confidential 24/7 help center with a robust database of more
than 4,000 organizations, providing nearly 25,000 services in our area,” said United Way 2-1-1
Director Diane Gatto. “Our specialists will create a customized plan to address patients’ health-
related social needs and then follow up to ensure the patient is able to implement the plan.”

The AHC grant allows for United Way to organize an advisory committee comprised of partners,
including clinical sites Cleveland Clinic, MetroHealth, St. Vincent Charity Medical Center and
Care Alliance Health Center, along with Better Health Partnership, CareSource, Case Western
Reserve University’s Center for Reducing Health Disparities and Center on Urban Poverty,
Cuyahoga County Board of Health, Hyland, creator of OnBase and Ohio Department of

The grant also allows for a one-year planning and training period to finalize the intervention,
organize and structure the advisory committee as well as hire and train staff, beginning May
2017. Starting in May 2018 through May 2021, the AHC will aim to serve 75,000 or more
Medicaid and Medicare beneficiaries per year.


United Way of Greater Cleveland is committed to addressing the effects of poverty throughout
our community. Through the work of our 128 funded programs and the generosity of our
community, United Way strives to ensure families and individuals are healthy and financially
stable; our children are well educated and on the road to reaching their greatest potential and
even those carrying tremendous burdens are safe and provided with resources to become self
sufficient. For more information, visit