OneWorld Social Services team members discuss their patients’ social determinants of health.
In addition to screening patients who are referred to social services or who walk-in to the social services office, the team screens prenatal patients during their first appointments and those coming in for a newborn visit. “These are two very vulnerable populations, and we want to make sure that prenatal patients have their basic needs met so they can focus on their pregnancy, and newborn babies are living in a safe living environment with heat, running water and electricity,” said Ramirez. After assessing each patient, the team connects them to OneWorld and community resources and provides case management as needed. Oftentimes, patients go to the social services team with one
need in mind, but the PRAPARE assessment reveals additional areas of need. “I have run into situations where families need rent assistance, and our screening will reveal that they also have limited food at home,” said Roman. “We are able to immediately help them with food access through our own small food pantry and then help them with food-assistance programs and community food pantries before they leave our office.” While the PRAPARE screening identifies areas of need, it also highlights the strengths of each patient and their personal goals. “We are a strengths-based profession,” said Jair Alvarez, Social Worker. “We look at education, employment and social connections to determine what community resources will
most benefit them and help them be self-sufficient.” Many of the patients the team works with have complex challenges, often due to systemic barriers. By offering support and actively helping patients, the OneWorld Social Services team empowers patients to overcome situations and gives them the skills and confidence they need to navigate challenges in the future to benefit their families. “Being the support for them changes their lives in the long- term,” said Ramirez. “Our team is here for patients, knowing that our services will positively change the lives of our patients and their families for generations to come, helping our community thrive.”
*Name changed to protect the patient’s privacy.
12 ANNUAL REPORT 2023
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