SDOH Support Programs

Social Determinants of Health Support Programs for Healthcare Organizations

Trained outreach specialists who identify needs, connect patients with community resources, and document the work, so SDOH efforts move beyond good intentions.

Turning SDOH Awareness Into Action

Most healthcare organizations already understand that housing, food security, transportation, and other social factors shape patient outcomes as much as clinical care does. The harder problem is operational: identifying which patients have unmet needs, connecting them with the right community resources, and documenting the work consistently, all without adding another responsibility to an already stretched care team.

GetYourBots SDOH support programs provide trained specialists who conduct outreach, administer screenings, and help connect patients with housing, food, transportation, employment, and other community resources. Our teams work as an extension of your care coordination or social work function, following the protocols and priorities your organization sets.

This work is inherently conversational and often sensitive. A patient discussing housing insecurity or food access needs someone who can listen, ask the right follow-up questions, and know what resources are actually available in their community, not a static referral list. Our specialists are trained specifically for these conversations.

Where the work is more procedural, such as scheduling follow-up calls or logging screening results, AI-assisted workflows support our specialists to keep the program moving without adding administrative drag.

Why SDOH Programs Stall

Identifying social needs is the easy part. Acting on them consistently is where most programs struggle.

No Dedicated Outreach Capacity

Care teams identify needs but rarely have time to follow up on every referral.

Referrals That Go Nowhere

Patients are referred to community resources but never confirmed to have connected with them.

Inconsistent Screening

SDOH screening happens sporadically instead of systematically across the patient population.

Documentation Gaps

Work that does happen is not consistently logged, making it hard to show program impact.

How SDOH Support Works

We start by understanding your organization's SDOH priorities, whether that is housing, food security, transportation, or a broader set of social needs, and the community resources already available in the areas you serve. Outreach protocols are built around your specific patient population and existing referral relationships.

Trained specialists conduct outreach calls, administer health risk assessments and SDOH screenings, and follow up with patients to confirm whether they successfully connected with a referred resource. Where a resource connection did not happen, our team follows up rather than letting the referral quietly go cold.

All screening results, outreach attempts, and outcomes are documented consistently, giving your team visibility into what is actually happening across the patient population, not just what was referred.

This is educational and service-oriented support: our teams help identify needs, connect patients with resources, and document the process. We do not make claims about specific regulatory, reimbursement, or compliance outcomes; those determinations rest with your organization and its own compliance and billing functions.

What You Gain

Dedicated Outreach Capacity

Trained specialists handle SDOH outreach without pulling from your care team.

Consistent Screening

Systematic SDOH screening instead of sporadic, ad hoc identification.

Confirmed Resource Connections

Follow-up confirms whether patients actually connected with referred resources.

Complete Documentation

Consistent logging of screenings, outreach, and outcomes.

Visibility Into Program Activity

Clear reporting on what is happening across your patient population.

Scalable Support

Expand outreach capacity as your SDOH program grows.

Services Included

Housing Needs Outreach

Identifying and connecting patients with housing assistance resources.

Food Insecurity Support

Connecting patients with food access programs and resources.

Transportation Assistance

Helping patients access transportation resources for care and daily needs.

Employment Resource Referrals

Connecting patients with employment and workforce resources.

Utilities Assistance Referrals

Helping patients access utility assistance programs.

Health Risk Assessments

Administering standardized assessments to identify social needs.

Patient Surveys & Follow-up Calls

Structured surveys and follow-up to track needs over time.

Care Gap Outreach

Outreach to patients with identified gaps in social or clinical care.

How Engagement Works

STEP 1

Discovery Call

We learn about your SDOH priorities and existing community resources.

STEP 2

Program Design

We build screening and outreach protocols around your patient population.

STEP 3

Outreach & Screening Launch

Trained specialists begin outreach, screening, and resource connection.

STEP 4

Reporting & Optimization

We report on activity and outcomes, refining the program over time.

Who We Serve

HospitalsClinicsFQHCsACOsPhysician GroupsMSOsInsurance OrganizationsHealthcare Providers

Ad Hoc Referrals vs. Structured SDOH Support

Ad Hoc ReferralsWith GetYourBots
Systematic Screening
Confirmed Resource Connections
Consistent Documentation
Dedicated Outreach Capacity
Program Activity Reporting
Care Team Retains Oversight

Why Healthcare Organizations Choose GetYourBots

Healthcare-Trained Specialists

Specialists trained specifically for SDOH outreach and screening conversations.

Human + AI Support

AI-assisted workflows for procedural tasks, trained people for patient conversations.

Built Around Your Priorities

Programs designed around your specific SDOH priorities and community resources.

Privacy-Conscious Practices

Built with security and privacy best practices for healthcare workflows.

Frequently Asked Questions

Trained specialists conduct SDOH screenings, outreach calls, and follow-up to help connect patients with housing, food, transportation, employment, and other community resources, with consistent documentation throughout.

No. We provide educational and service-oriented outreach and documentation support. Determinations about regulatory requirements, reimbursement, or compliance rest with your organization and its own compliance and billing functions.

We build outreach protocols around the community resources and referral relationships your organization already works with, and incorporate any resource directories you want us to use.

Yes. Our specialists can be trained to administer whatever standardized health risk assessments or SDOH screening tools your organization uses.

You receive regular reporting on screenings conducted, outreach attempts, and resource connection outcomes, giving your team visibility into program activity.

Programs are built with security and privacy best practices in mind and designed to support healthcare workflows. We are happy to walk through specifics during a consultation.

Ready to Turn SDOH Awareness Into Action?

Talk to our team about building an SDOH outreach program around your priorities.

Built with security and privacy best practices • Enterprise-ready solutions