NCServes joins forces with NCCARE360, bringing coordinated care and resources to North Carolina’s military community. Read the press release here



Community Health Workers (CHWs) are Utilizing NCCARE360

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When we think of health care, doctors and hospitals are likely the first thing to come to mind but health is affected by so much more than providers, clinics, or medication. Health is largely determined by our communities and all of the resources available—or unavailable—to us in these environments, as unmet non-medical social needs like food, housing, and transportation can cause negative health effects. For example, people who do not have access to grocery stores with healthy foods are less likely to have good nutrition, which raises their risk of health conditions like heart disease or diabetes. Positive health outcomes start in our communities. Who has the best knowledge of what communities need to achieve these positive outcomes than their own members? Fortunately, grassroot community health workers (CHWs) are leading the way.

CHWs are trained public health workers closing the gap between communities and health care systems. As trusted members of the communities they serve, CHWs provide critical services to those underserved and disproportionately impacted by public health threats, with one of the biggest threats right now being COVID-19. This trusting relationship allows CHWs to serve as a link between health and social services and the community in order to facilitate access to services and to improve the quality and cultural competence of service delivery. CHWs also “build individual and community capacity by increasing health knowledge and self-sufficiency through a range of activities such as outreach, community education, informal counseling, social support, and advocacy.” CHW activities include helping people complete applications to access health benefits, driving clients to medical appointments, or even providing health screenings. Now, NCCARE360 can support CHWs perform this important community health work.

NCCARE360 is the first statewide coordinated care network that helps providers electronically connect individuals with identified non-medical needs to community resources and allows for feedback and follow up. Now that NCDHHS has expanded the COVID-19 Community Health Worker program, bringing it statewide, CHWs are using NCCARE360 to make electronic referrals, communicate in real time, securely share client information, and track outcomes for our state’s most vulnerable populations.

This critical aid is happening all over North Carolina. At the beginning of August, Kinston, NC, achieved an above-average vaccination rate by making vaccine access a part of larger community-service efforts that utilized CHWs. NC COVID-19 vendors provided CHWs with tablets or laptops and mobile hotspots to leverage NCCARE360 and connect individuals and communities to traditional health care settings and organizations that address non-medical drivers of health.

CHWs are integral to connecting North Carolinians in underserved communities to medical and social supports. Since the CHW program started, more than 134,553 referrals have been made, connecting thousands of community members to needed services! The NCCARE360 implementation team is training and onboarding 350 additional CHWs to the NCCARE360 network this month so they can continue this critical work statewide.

If you have been impacted by COVID-19, or need help with vaccine support, please contact a CHW by reaching out to an organization in your county from this list.


About NCCARE360
NCCARE360 is the first statewide network that unites health care and human services organizations, assesses for and identifies unmet social needs, and enables a coordinated, community-oriented, person-centered approach for delivering care in North Carolina. NCCARE360 is the result of a strong public-private partnership between the NC Department of Health and Human Services (NCDHHS) and the Foundation for Health Leadership & Innovation (FHLI). The NCCARE360 implementation team includes United Way of NC, NC 2-1-1, Expound Decision Systems, and Unite Us.

For more information about NCCARE360, or any of its partner organizations, please send an email to

NCCARE360 Network Overview

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NCCARE360 is transforming care delivery in North Carolina. We recently spoke with a few key stakeholders about the network landscape, launch, and implementation progress. Watch our network video below to learn how partners across our state are working together to better connect health and human services providers and improve health for all North Carolinians.

“I see this as one of the most innovative and exciting things we’re doing in the state. I see it as a critical shared infrastructure for the state as we’re thinking about health transformation and we’re thinking about not just buying healthcare but buying health.” – Dr. Betsey Tilson, State Director and Chief Medical Officer, North Carolina Department of Health & Human Services

“We believe that health is owned and shaped by communities, and each community is uniquely different. NCCARE360 is designed to leverage the reality of people helping people and neighbors helping neighbors to improve health. NCCARE360 will also raise awareness to where resource gaps exist and hopefully help us all to fill those gaps. Health disparities will be narrowed, and we will be another step closer to achieving health equity.” – Anne Thomas, President and CEO, Foundation for Health Leadership & Innovation

Trailblazing in North Carolina: A 6 Month Reflection

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My name is Jimmy Fisher and I am the State Director, NCCARE360/Unite Us. Together, our team has been working hand in hand with communities across the state to help empower their efforts to provide individuals with more opportunities to achieve a greater level of health.  We believe in NCCARE360 and know it will truly transform North Carolina!

When our team began working in Guilford, Alamance, and Rockingham in January 2019, we couldn’t have predicted how truly amazing these communities are. Fast forward six months and they have helped us build a well-established coordinated network with strong partnerships across various sectors, truly weaving together services.

It takes an immense amount of fortitude and bravery to be trailblazers, and the people of Guilford, Alamance, and Rockingham counties have led the way for the state of North Carolina as the first regions to launch with NCCARE360.

When you are surrounded by people that lean on each other and keep an individual at the center of care, amazing things can happen. Through NCCARE360, we have seen individuals facing difficult situations receive support within hours. We were able to successfully integrate NCCARE360 into Cone Health’s Electronic Health Record (EHR) system, EPIC. The integration provides Cone Health clinical staff with a seamless way to make referrals and receive closed loop information directly to and from their EHR. The NCCARE360 network in these three counties has grown with new partners joining each week, and we are excited to see expansion in the coming years.

In June, we hosted our launch party for Guilford, Alamance and Rockingham counties and it was a great celebration! In those counties, the network has grown from 60 organizations to over 120 in very little time. Statewide, we have now onboarded over 300 organizations, connecting more individuals to resources they need to live healthier. Our team is so excited about the organic connections at the local level, as well as weaving together historically siloed sectors.

Continuing this momentum will take all of us committing to the work. If you have not yet joined NCCARE360, we need you and are here to support your organization throughout the process. For more information, visit Thank you!


Health Happens Locally – Welcome To NCCARE360 By Anne Thomas

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Together, we are changing the trajectory of health for all North Carolinians.

There is growing recognition that better coordination and investment in the non-medical drivers of health, like access to healthy food, safe and affordable housing and well-paying jobs, can improve health and decrease health care costs. Through NCCARE360’s groundbreaking, statewide coordinated network, health care and human services organizations are now united through a shared technology platform. NCCARE360 is a coordinated, community-oriented, person-centered approach for delivering care in North Carolina, and sets an example for the entire nation. In fact, this transformation is already underway in our state and rapidly expanding to support every person in North Carolina.

We have launched in 12 counties, with 9 counties in the implementation process. Over 1000 organizations have engaged in the socialization process and we look forward to working closely together.

NCCARE360 provides the infrastructure to connect all North Carolinians to community resources and has the potential to touch the lives and improve the health of all North Carolinians, including the commercially insured, Medicare, Medicaid, uninsured, military and veteran populations. NCCARE360 helps build a system of health that is focused on the person and helps them access the services and resources they need to be healthy. Together we’ve invested in both existing and new infrastructure to enable different types of organizations to connect people to health and social services in a way that makes the system more efficient. This provides visibility and accountability to help bridge the gap between health and social care.

Health happens locally, and NCCARE360 supports that important vision.

For more than 35 years, the Foundation for Health Leadership & Innovation has been developing programs and partnerships to improve health, and we are focused on addressing the needs of the whole-person through a whole community approach. We believe systems of care belong to and are shaped by the communities they serve. NCCARE360 will showcase the power of collaboration in our state as we work to ensure every partner delivering services in North Carolina is connected, knitting together our health care system and communities. Your support is instrumental in this process and we look forward to working together now and in the future!

Anne Thomas
President/CEO, Foundation for Health Leadership & Innovation