Harbor:Whole person care

***WPC program ended 11/30/21.*** However, below are some other available programs addressing social determinates of health:

• Re-entry (released from prison <6 months with medical, mental health, substance abuse, or social needs)
  • 844.804.5200 (24/7) and put patient on phone.

• Medically Complex Transitions of care (includes 3 visits to ED in past year)
  • ORCHID Message/Call/Text Rosario Aliviado - Social Work Supervisor. Please include MRN, pt phone number, and reason for referral.
    • 21x.294.8908. She will respond M-F 9:00-4:30 pm but you can ORCHID message/call/text/email anytime.

• Perinatal (high-risk pregnant mothers - homeless, mental health, substance abuse, domestic violence, no food) 844.376.2627

• Homeless ... social work can help facilitate housing
  • Refer to Social Work
    • Place order in ORCHID
      • Consult to Social Work: reason for referral: homeless

• Disabled and needs disability benefits (SSI)
  • Refer to Social Work
    • Place Order in ORCHID
      • Consult to Social Work: reason for referral: disability benefits

• Mental Health
  • Residential & Bridging Care (transition from mental health institution to community) 213.738.4775
  • Intensive Service Recipients (mental health with 2 or more admissions in year, recent DC from psych hospital) 844.804.5200

See Also

• Harbor:Main