It’s rare to find a state-federal partnership that actually works. But New York has one, and it’s quietly becoming the most important health care innovation in America: the Social Care Networks.
Launched under New York’s 1115 Medicaid waiver, the Social Care Networks are built on a simple truth: health doesn’t begin in a hospital, it begins at home with healthy food in the refrigerator, grab bars in the shower, asthma remediation for children, nutritional services for seniors.
That’s not just intuition. A federal report found that going to the doctor explains only about 20% of why some communities are healthier than others, while food, housing, and transportation explain up to 50%.
Thanks to Gov. Hochul’s leadership and the commitment of Health and Human Services Secretary Bobby Kennedy and the Centers for Medicare & Medicaid Services, New York is now home to the first food-is-medicine program operating at true scale.
And it’s working. The Social Care Networks have screened more than 1.5 million New Yorkers for the social needs that drive poor health: food insecurity, unsafe housing, unpaid utility bills, transportation gaps. That’s not a pilot. That’s a system.
The genius of the program is who delivers it: community-based organizations New Yorkers already know and trust. Met Council has served New Yorkers for more than 50 years and is one of the largest CBOs in the program.
When our staff knock on a door, they aren’t strangers with a clipboard. They’re the organization that delivered a kosher food package last Passover, helped a neighbor apply for benefits, built affordable housing for seniors, and answered the phone during a crisis. That trust is why the program reaches people the health care system misses — and why the interventions stick.
Susan is 82. She lives alone in Brighton Beach, and for the past year she was afraid to take a shower because her bathtub had no grab bar. For a senior, one fall can mean a broken hip — surgery, months of rehab, permanent nursing home placement, a cascade that can cost Medicaid more than a million dollars. All triggered by a missing $40 grab bar. We installed it.
Every fall prevented and hospitalization avoided costs a fraction of what Medicaid would otherwise spend. But to keep it going, the Social Care Networks need infrastructure funding — sustained investment in the screening technology, staffing, and networks that make the model work. This is exactly the kind of proven, efficient program that deserves it.
The waiver that makes all of this possible expires in March 2027. The state Department of Health under Commissioner Dr. James McDonald and state Medicaid Director Amir Bassiri has been an outstanding partner fighting to renew and expand this program.
Lead entities like Public Health Solutions, which anchors our network, are knitting hundreds of CBOs into a unified system. But a model built on CBOs only survives if CBOs can survive. Sustainable reimbursement isn’t a favor to the nonprofit sector, it’s the infrastructure that makes the whole program work. Today, fewer than 20% of our CBO partners can cover their costs through fee-schedule payments alone.
We urge Albany to pursue renewal aggressively — and our federal partners at HHS and CMS to say yes and treat New York as the national model for what Medicaid can be.
Government doesn’t get many wins like this: a program that keeps seniors in their homes, feeds the sick, strengthens communities, saves taxpayers money, and does it all through trusted local organizations rather than new bureaucracy.
The Social Care Networks are the best program of their kind in America. Let’s renew it. And then let’s scale it nationwide.
Greenfield is the CEO of Met Council.