7:15am – 8:00am
Conference Registration & Networking Breakfast 

8:00am – 8:15am
Chairperson’s Opening Remarks 

8:15am – 9:00am
Effective Strategies to Address Social Determinants of Health
This session will explore the evolving research and programmatic enterprise addressing social determinants of health (SDOH) in a safety-net healthcare organization. Hear about how investing in SDOH initiatives can lead to improved health outcomes, reduced healthcare costs, and enhanced patient satisfaction. The speaker will also share examples of effective SDOH strategies and their positive impact on transforming the life course of the Nashville General Hospital patient population.

Alecia Malin Fair, DrPH
Chief Population Health & Research Officer
Nashville General Hospital 

9:00am – 9:45am
Improving Quality of Life Really Does Decrease Healthcare Costs
While Medicaid and Medicare health plans seek to address some aspects of SDOH, historic care management resources (either internal or outsourced) have struggled to effectively identify, assess and manage SDOH factors at the individual level. The inability to capture, assess and take action on a broader scope of a member’s needs are compromised by several factors, including the siloed nature of supporting resources, a lack of technology-based interoperability and the financial incentives are often not aligned with a more comprehensive approach. Because of this, critical factors such as SDOH can often slip through the cracks. Adobe Population Health developed a proprietary app called MASLOW to identify and provide solutions to SDOH needs in our communities we serve. Adobe’s partnership with health plans to improve health benefit ratios and quality of life in rural communities to affect population health outcomes.

Jayme Ambrose, DNP, RN, CCM
CEO
Adobe Population Health 

9:45am – 10:15am
Networking & Refreshments Break 

10:15am – 11:00am
Leveraging Partnerships to Address SDOH: Collaborating with Community Organizations
Addressing SDOH requires a collaborative approach that involves partnering with community organizations. This session will delve into the importance of building strong relationships with local partners to effectively tackle SDOH challenges. Attendees will learn about best practices for identifying potential collaborators, establishing mutually beneficial partnerships, and implementing joint initiatives that address the unique needs of their communities. The speaker will also share real-world examples of successful collaborations and the impact they have had on patient outcomes and organizational performance

Mitchell Cornet, MPP, MHSA
Vice President, Strategic Partnership, Public Health, and Community Vaccines
Northwell Health 

Hira Ruskin, MBA
Vice President, Operations
Northwell Health 

11:00am – 11:45am
Heals on Wheels (HoW), A Community Focused Case Study: Addressing SDOH and Health Equity in Patients with Chronic Pain
Minnesotans have suffered tremendously from the opioid epidemic, with 2021 data indicating a 35% increase in overdose deaths involving opioids since 2020. Compared to White Minnesotans, Native American Minnesotans are ten times and Black Minnesotans more than three times as likely to die from a drug overdose. Rural counties throughout MN have some of the highest overdose rates. Given the parallel crises of chronic pain in OUD, there is a need to shift our approach and address social determinants of health. There is strong evidence for the use of integrative mind/body therapies and Non-Pharmacological Pain Care (NPPC) strategies for people with OUD and/or chronic pain, with better outcomes and less harmful side effects than opioids

Hennepin Healthcare’s (HHS) innovative Heals on Wheels (HoW) Programming includes a collection of programs, all with the goal of up-, mid-, and down-stream prevention and treatment of Opioid Use Disorder (OUD) through reducing prescribing, offering evidence-based alternatives, and improving Integrative Pain Care (IPC) access. HoW addresses SDOH through: Addressing Health Disparities & Access, Empowering Healthy Lifestyles (Trauma and Social Justice Informed), Managing Stress, and Reducing Social Isolation.

Building upon the success of HoW, Hennepin Healthcare’s integrative health team is launching two new initiatives – Training, Learning, and Coordinating (TLC) Center for Wellness on Wheels (WoW) for the state of Minnesota, and two new Project ECHO’s (Extension for Community Healthcare Outcomes) series on IPC and Trauma Informed Care (TIC) for training the healthcare workforce. All community programs are financially supported through grant funding by the state legislature, and on-site patient facing programs are billable.

Arti Prasad, MD, FACP, CPE, CPDC
Chief Strategic Development Officer
Hennepin Healthcare
Director, ECHO Minnesota, Hennepin Healthcare
Professor of Medicine, University of Minnesota
Clinical Professor of Medicine, University of New Mexico
Board certified in Integrative Medicine (ABOIM)
Certified Professional Diversity Coach

Catherine Justice, PT, DPT, CST, C-IAYT, E-RYT, FAIHM,
Program Manager, Integrative Physical Therapist, Certified Yoga Therapist
Hennepin Healthcar 

11:45am – 12:30pm
Health Starts: Tennessee Medicaid’s Approach to SDoH
Health Starts is TennCare’s comprehensive effort to address social risk factors that have an outsized impact in driving poor health outcomes for TennCare Members. The Health Starts Initiative focuses on implementing evidence-based clinical supports, resources, and technological enhancements to meet social risk needs consistently for TennCare members. TennCare has implemented three workstreams which touch each portion of the population health ecosystem including the Managed Care Model of Care, Provider Care Delivery, and CBO Network. Through collective innovation, these workstreams provide avenues for TennCare to address social needs in a holistic manner. This presentation will discuss key learnings from implementing SDoH initiatives in the Medicaid landscape and tangible takeaways for other states as they embark upon addressing social risk in their population.

Karly Campbell, MPP
Chief Quality Officer
TennCare 

Nicolette E. Wise, MPH
Social Determinants of Health Director
TennCare 

12:30pm – 1:30pm
Luncheon 

1:30pm – 2:15pm
Addressing SDOH through Policy and Advocacy: Influencing System-Level Change
While healthcare organizations can make significant strides in addressing SDOH at the individual and community levels, system-level change often requires policy and advocacy efforts. This session will explore strategies for engaging in policy discussions, advocating for SDOH-related legislation, and collaborating with policymakers to drive broader change. 

Janelle Waldock
Director of Racial and Health Equity Policy
Blue Cross and Blue Shield of Minnesota 

2:15pm – 3:15pm
Panel: The Impact of SDOH on Employee Turnover and Burnout: Strategies for Supporting Your Workforce
Employee turnover and burnout are significant challenges facing healthcare organizations, and social determinants of health (SDOH) can play a crucial role in exacerbating these issues. This session will explore the complex relationship between SDOH and workforce well-being, highlighting how factors such as financial instability, housing insecurity, and lack of access to resources can contribute to increased stress, decreased job satisfaction, and ultimately, higher rates of turnover and burnout among healthcare employees. Attendees will learn about innovative strategies for supporting their workforce, including implementing SDOH screening and referral programs for employees, providing resources and benefits that address social needs, and fostering a culture of empathy and understanding. Panelists will also discuss the business case for investing in employee well-being, demonstrating how reducing turnover and burnout can lead to improved patient outcomes, enhanced organizational performance, and significant cost savings over time.

Mitchell Cornet, MPP, MHSA
Vice President, Strategic Partnership, Public Health, and Community Vaccines
Northwell Health 

Nicolette E. Wise, MPH
Social Determinants of Health Director
TennCare 

Itoco García Ed. D.
Superintendent
Canyon Elementary School District

3:15pm – 3:45pm
Networking & Refreshments Break 

3:45pm – 4:30pm
Leveraging Artificial Intelligence to Address Social Determinants of Health in Medicine
Artificial Intelligence (AI) is poised to revolutionize the healthcare industry by providing innovative solutions to long-standing challenges. One critical area where AI can make a significant impact is in addressing Social Determinants of Health (SDOH). SDOH, including factors such as socioeconomic status, education, neighborhood and physical environment, employment, and social support networks, play a crucial role in determining health outcomes. However, traditional healthcare systems often overlook these determinants, leading to gaps in care and persistent health disparities.

This presentation explores how AI can be harnessed to identify and address SDOH effectively, ultimately improving patient outcomes and advancing health equity. We begin by defining SDOH and discussing their impact on health. We then introduce AI and its current applications in healthcare, highlighting its potential to analyze diverse data sources, predict health outcomes, and assist healthcare providers in implementing tailored interventions.

We delve into case studies to provide an analysis of AI applications in addressing SDOH, discussing the challenges encountered and the solutions implemented.

Finally, we look towards the future, discussing emerging trends and potential innovations in AI and SDOH.

Alvaro “Andres” Macias. MD, MHA, FASA
Associate Professor of Anesthesia
Director of Anesthesia and Operating Room UCSD-East Campus
University of California San Diego  

4:30pm – 5:15pm
Addressing SDOH in Rural and Underserved Communities: Unique Challenges and Solutions
Rural and underserved communities often face unique challenges when it comes to addressing SDOH, such as limited access to healthcare services, transportation difficulties, and a lack of community resources. This session will explore the specific barriers these communities encounter and highlight innovative solutions that have proven effective in tackling SDOH in resource-limited settings. Attendees will learn about successful strategies, including telemedicine initiatives, mobile health clinics, community health worker programs, and partnerships between healthcare organizations, local government agencies, and community-based organizations. The session will also emphasize the importance of cultural competency, community engagement, and tailored, locally driven solutions when working in these settings, and will feature real-world examples and case studies to illustrate the impact of successful SDOH interventions in rural and underserved areas.

Saqi Maleque Cho, DrPH, MSPH
Vice President, US Programs
Americares 

6:00pm
End of Day One

8:00am – 8:15am
Chairperson’s Recap 

8:15am – 9:00am
Implementing a Successful SDOH Screening and Referral Program
In this case study, the speaker will share their experience implementing a comprehensive SDOH screening and referral program. The presenter will discuss the steps they took to design and launch the program, including selecting screening tools, training staff, and building partnerships with community organizations. They will also share key lessons learned and best practices for overcoming common challenges. Attendees will gain practical insights into how to develop and implement an effective SDOH screening and referral program within their own organizations.

Colleen Morley-Grabowski DNP RN CCM CMAC CMCN CMGT-BC ACM RN FCM FAACM
Associate Chief Clinical Operations Officer – Continuum Care
University of Illinois Health

9:00am – 9:45am
Addressing SDOH in Behavioral Health: Strategies for Integration
Behavioral health conditions are often closely intertwined with SDOH, making it crucial for healthcare organizations to adopt integrated approaches to care. This session will explore strategies for addressing SDOH within behavioral health settings, including screening for social needs, providing care coordination, and collaborating with community partners.

Ellen Fink-Samnick DBH MSW LCSW ACSW CCM CCTP CRP FCM
Adjunct Contract Faculty for the College of Health & Human Services
Social Work Department at George Mason University
Cummings Graduate Institute of Behavioral Health Studies

9:45am – 10:15am
Networking & Refreshments Break 

10:15am – 11:00am
Engaging Patients and Communities in SDOH Initiatives: Strategies for Building Trust and Buy-In
Engaging patients and communities are essential for the success of SDOH initiatives. This session will explore strategies for building trust, fostering meaningful partnerships, and securing buy-in from the populations healthcare organizations serve. Attendees will learn about effective communication techniques, community outreach approaches, and methods for incorporating patient and community perspectives into the design and implementation of SDOH programs. The session will also highlight the importance of cultural competency and the need for healthcare organizations to demonstrate a genuine commitment to understanding and addressing the unique needs and challenges faced by the communities they serve.

Adam L. Myers M.D., MHCM, FACHE
Transformation Leader and Advisor
Harvard 

11:00am – 11:45am
Addressing SDOH through Workforce Development: Investing in Community Health Workers
Community health workers (CHWs) play a critical role in addressing SDOH by serving as a bridge between healthcare organizations and the communities they serve. This session will explore strategies for investing in CHW programs, including recruitment, training and integration into care teams. 

Fiorella Vera, MHA
Social Determinants of Health Manager
Health Coalition of Passaic County- St. Joseph’s Health 

11:45am – 12:30pm
The Imperative for Action: Why Addressing SDOH is Essential for the Future of Healthcare
This session will underscore the urgent need for healthcare organizations to prioritize SDOH in their strategies and operations. Hear about the mounting evidence linking SDOH to health outcomes, healthcare costs, and health disparities, and make a compelling case for why addressing SDOH is not just a moral imperative, but a business necessity.

Angela Morton, MA, CFRS
Consortium Director
UPMC 

12:30pm
Conference Concludes

Workshop A:
Developing an SDOH Action Plan for Your Organization
In this interactive workshop, attendees will have the opportunity to apply the knowledge and insights gained throughout the conference to develop a customized SDOH action plan for their organizations. The workshop leader will guide participants through a step-by-step process for assessing their current SDOH efforts, identifying priorities and goals, and mapping out a strategic roadmap for implementation. Attendees will leave the workshop with a concrete plan and practical tools for advancing SDOH initiatives within their organizations.

Learning Objectives:

– Assess the current state of SDOH efforts within your organization and identify areas for improvement

– Develop a clear set of priorities and goals for addressing SDOH based on your organization’s unique needs and resources

– Create a strategic roadmap for implementing SDOH initiatives, including key milestones, timelines, and performance metrics

– Identify potential partnerships and collaborations that can support your SDOH efforts

– Develop a plan for engaging and communicating with key stakeholders, including leadership, staff, patients, and community partners

Caitlin Holcomb
Founder
Dwellness Communities 

OR

Workshop B
Integrating SDOH into Care Delivery Models: Strategies for Success
Integrating SDOH into care delivery models is essential for providing comprehensive, patient-centered care. This session will showcase successful strategies for incorporating SDOH into clinical workflows, care coordination, and patient engagement efforts. Attendees will learn about effective screening tools, referral processes, and care management approaches that can help address patients’ social needs and improve health outcomes. The speaker will also discuss the importance of training and supporting staff in delivering SDOH interventions.

Lauren Barca
Principal
LB Healthcare Consulting