Doña Ana County launched Connect Doña Ana, a new closed-loop referral system to help residents in need receive healthcare and social services. The program is a partnership with Unite Us, a national cross-sector collaboration software company, the LC3 Behavioral Health Collaborative and Presbyterian Health Plan.

Along with local health and social services providers, Doña Ana County is building a network of more than 100 partners and community health workers, CHW, or navigators, and making it easier for local providers to refer patients or clients to each other.

“Connect Dona Ana makes it possible for each agency to welcome a client into Unite Us and seamlessly refer them to other agencies for additional help,” said Jamie Michael, Doña Ana County Health and Human Services Director. “For example, if someone visited Casa de Peregrinos for food, staff could also find an agency in the platform that provides housing, without the client having to provide their information a second time.”

By facilitating information-sharing and a seamless referral system, across the health and social services provider network, all providers are able to offer more efficient and effective services to individuals and families in need. The key to the system is CHW, who serve as navigators. CHWs, better known as promotores, are essential in helping people connect to resources, through Connect Doña Ana promotoras across the county can collaborate and better connect with services providers.

“Our partnership with Doña Ana County strengthens our partnership with other agencies throughout New Mexico, including Presbyterian Health Plan and the collaboration we are building across healthcare and wellness services,” said Monique N. Rodriguez, LCSW-P, LSAA, Community Engagement Manager at Unite Us. “We are aligned on a shared mission of improving the lives of individuals in Doña Ana County by supporting community-led systems of care, building trust in communities and accurately capturing the whole picture of a person’s health and the community’s needs.”

The County Health and Human Services Department is funding this referral platform from a combination of County funds and a grant called Agentes de Cambio. Agentes de Cambio is a program funded by the Centers for Disease Control and Prevention, CDC to help businesses build resilience through placement of CHWs. In its third year, the grant’s key deliverables include an expansion of the CHW workforce, training on COVID-19 and launching a referral system.

Connect Doña Ana expands the county’s network to more than 100 providers and streamlines referrals and follow-up opportunities with each individual, which amplifies the reach, efficiency and effectiveness of support throughout the County. It is also a secure, HITRUST-certified, HIPAA-compliant platform.

“Connect Doña Ana means more than speed and effective service delivery,” Michael said. “A seamless referral system enables all of us to identify gaps, see trends and make adjustments. More importantly, providers can follow-up and ensure referred clients did, in fact access and receive help. In summary, Connect Doña Ana enables us to bolster better health outcomes and foster an improved quality of life, throughout our community.”

About Presbyterian Health Plan
Presbyterian Health Plan is a locally owned health plan that exists to improve the health of the members we serve. Presbyterian Health Plan provides commercial, Medicaid, Medicare, and individual insurance. It is part of Presbyterian Healthcare Services, a not-for-profit healthcare system of nine hospitals and a multi-specialty medical group. Founded in 1908, Presbyterian Healthcare Services is New Mexico’s largest private employer, with more than 13,000 employees.
PHP Media Contact: Amanda Schoenberg, aschoenbe@phs.org

About Unite Us
Unite Us, the nation’s leading software company, enables cross-sector collaboration to improve people’s health and well-being, powers the coordinated care network Connect Doña Ana to address residents' health and social care needs. The network serves as a central point of contact where healthcare and social service providers can make and track secure, closed-loop referrals for patients and clients to get the help they need, when they need it. Unite Us developed the only end-to-end social care solution, bringing together government, healthcare and community partners to identify and address local needs and create a solid and vibrant car- coordination network.
Unite Us Media Contact: Jaquetta Gooden, jaquetta.gooden@uniteus.com

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The team behind Connect Doña Ana, from left: Monique Rodriguez, Unite Us Community Engagement Manger; from Doña Ana County: Prisma Harse, Program and Contract Manager, Norberto Godina, Program Operations Division Manager, Jamie Michael, Director, Health and Human Services, Anabel Canchola, Program Administrator.

Photo: Melinna Robinson-Denley.