Addressing Social Needs Across Penn Medicine

May 19, 2020

COVID-19 Social Needs Response Team has been created to help any person that has concerns about their safety or the safety of others, that has any immediate social needs, and/or is experiencing distress during this pandemic.

If you or your patients have safety concerns or distress, or need assistance with resources, such as food or food delivery, transportation, medications, loss of health insurance or unemployment benefits, the Epic pool titled, “COVID-19 SOCIAL NEEDS” can help. The Department of Case Management and Social Work, with support from the Center for Health Equity Advancement (CHEA) and the Department of Psychiatry, has created this resource in order to ensure all Penn Medicine patients and employees have the support they need to be safe and well during this time. Patients and employees routed to this pool will have a response team of licensed social workers and trained professionals assist with their social needs. Importantly, this team will work closely with the Department of Psychiatry to effectively triage individuals with mental health concerns. Protocols are in place to also assist individuals that are not Penn Medicine patients. For questions please contact the COVID-19 Social Needs Response Team at 267-785-2019, Monday-Friday, 7am-9pm. All referrals will be responded to within 12 hours of request. Hours are subject to change based on need. After addressing any emergent needs, this team will refer to other care teams and programs for longitudinal services as needed.


Key Partnerships

This initiative reflects partnerships between the Penn Medicine Center for Health Equity Advancement (CHEA) and:

  • The Department of Case Management and Social Work to create, manage, and staff the pool and response team.
  • The Department of Psychiatry to guide the effective triage of those with mental health concerns and support referrals for employees requiring social needs assistance from behavioral health programs.
  • Perelman School of Medicine to provide MS3 and MS4 students opportunity to participate on this COVID-19 Social Needs Response Team for course credit in an effort to meet our service and educational missions at this unprecedented time.
  • The Center for Innovation to respond to community facing entry points (e.g. AI Chatbot) that identify social needs.
  • The Primary Care Service Line to provide a 4-item social needs screener for assessments and inform related workflows.
  • The Penn Center for Public Health Initiatives, Department of Emergency Medicine, and the Philadelphia Department of Public Health to perform contact tracing for Penn Medicine patients who test positive for COVID-19. The Penn COVID-19 Contact Tracing Team will refer patients with social health needs to the Social Needs Response Pool.



Led by our Director of Community Health Services and in partnership with the Penn Center for Public Health Initiatives, CHEA is actively engaged with the City of Philadelphia, the Children’s Hospital of Philadelphia, the Health Federation of Philadelphia, and several community-, state-, and nation-wide partners to share best practices and when applicable, share resources. CHEA will continue to support daily updates on several key resources below:



The COVID-19 Social Needs Response Team is accessible to employees and providers and provides a centralized resource, which leverages a robust existing social work infrastructure across the care continuum, to effectively address acute mental health and social concerns.

Additionally, community assessments revealed the need to support food banks in the area to distribute foods to our patient populations in a timely and safe manner. Through a partnership with SHARE Food Program and a caterer typically utilized by the University, CHEA is funding the COVID-19 Paths for Food Access Initiative which uses catering vans to deliver food to the homes of those most vulnerable and impacted by COVID-19 in our city. This increases the capacity of SHARE to reach those in need and provides income to individuals who were put out of work during this time.

CHEA remains agile in our response and continues to engage and collaborate with key stakeholders to understand the evolving landscape and adjust our strategies to meet the needs of our patients and employees.


Learn More


Learn More

“I am in need of additional assistance, including food, shelter or other life necessities. What resources are available to me?”

Penn Medicine is working collaboratively with the Children’s Hospital of Philadelphia and other regional partners to centralize up-to-date community resources for patients and families during the COVID-19 pandemic.

Learn more about Community Resource Connects*, a free website that provides information on community services and programs to support you and your family, including resources for food, transportation, housing and more.

*Disclaimer: By clicking the link above, you will be accessing a third-party site that is powered by Aunt Bertha, Inc. This site contains links to other websites that are not affiliated with Penn Medicine. Penn Medicine does not endorse third party websites and is not responsible for the privacy practices or content of such sites.

Key Partnerships