One Family, One Point of Entry

Healthy Roanoke Valley Community Hub

To achieve our mission of elevating 10,000 families out of poverty by 2030, United Way is using new approaches that are more innovative and collaborative than anything we've ever done.

The HRV Community Hub uses a holistic, ground-breaking approach to address some of our community's age-old problems, right at their core. It uses a triple aim approach to family and community success: improve the individual's experience, boost the health of the entire community, and reduce the cost of health care for all.

At the heart of the Hub is the Community Health Worker (CHW), a specialist who helps families tear down the barriers they face - factors like income, education, ethnicity, and housing that can keep generations of families spiraling in a cycle of poverty. The CHW meets with the whole family, right in their own home if they want, and work to understand the services they need. From there, they will lead them down their own pathway to success. One family member at a time.

Through a network of Community Health Workers deployed across the community, accessing services and support care can be better coordinated across many organizations throughout the Roanoke Valley region, leading to a custom map of solutions and opportunities unique to each individual's needs and goals. And with so many agencies working together, it means smaller investments...all leveraged together for the best, most cost-effective measurable outcomes.

Who Is Eligible?

Community Hub CHWs deployed at various partnership sites will be addressing access to care and social determinants of health for Roanoke Valley residents meeting the following eligibility criteria including, but not limited to:

• High utilizers of Carilion Clinic Roanoke Memorial Emergency Department (ED) in the past 12 months (including related hospitalizations as a result of an ED visit) at minimum of 2 to 3 ED visits in the past 12 months.
• Uninsured adults between the ages of 18 and 64 years with the potential to expand to the publicly insured populations.
• Low income (ALICE population - those living at or below 300% of Federal Poverty Level).
• Preference will be given to individuals with chronic disease living in the cities of Roanoke and Salem, the town of Vinton, and the counties of Botetourt, Craig, and Roanoke with a focus on the Medically Underserved Areas of the City of Roanoke, however this should not be a limiting factor.

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