Partners with North Coast Health Improvement and Information Network, Humboldt County Dept. of Health and Human Services to Improve Homeless Health in Northern CA

Share Article’s Care Coordination Record™ will be used by a cross-sector team to help to reduce emergency department utilization and improve care coordination for homeless and housing-insecure residents., a national provider of team-based care coordination technology and services, today announced a partnership with the North Coast Health Improvement and Information Network (NCHIIN), a not-for-profit health information exchange and data aggregator serving Humboldt and Del Norte counties in Northern California.

In this partnership, NCHIIN, the Humboldt County Department of Health and Human Services (DHHS), and will focus on supporting the journey to self-sufficiency among the county’s chronically homeless families and individuals, with a goal to reduce emergency department utilization over the course of the two-year program.

“It is important that our vulnerable, underserved, and often stigmatized populations receive coordinated, whole-person care,” said Martin Love, CEO of NCHIIN and Humboldt Independent Practice Association. “To deliver that care, we need a community collaboration platform for the whole continuum, and has the experience to help us make this effort a reality.”

Collaborators and data exchange points include:

● Humboldt County DHHS, providing data from the Homeless Management Information System.
● Local Emergency Departments, as well as local federally qualified health centers, collectively providing real-time clinical event and encounter data.
● Humboldt Independent Practice Association, a physician membership organization working with health plans and care providers to ensure that medical care is provided in a manner that enhances public health and promotes access to quality care.
● Many other local programs and social service organizations engaged in the Continuum of Care for homeless people in Humboldt County.

DHHS’s Social Services team of case managers and social workers will use’s cloud-based and mobile-enabled platform, the Care Coordination Record, to understand when clients have had encounters with the healthcare system and to engage in rapid follow-up with clients after clinical encounters and other life events. They will be able to leverage the platform to communicate and collaborate with resources from the hospitals, FQHCs, and social service providers to drive holistic, coordinated care across the continuum.

“We know that people who experience chronic homelessness in America too often experience health disparities, disabilities, and stigma – all of which contribute greatly to high costs and complexity,” said Ted D. Quinn, CEO and Co-founder. “Community-based interventions that address medical, social, behavioral, and functional needs – such as this innovative partnership led by NCHIIN – are the key to making health happen in vulnerable and underserved populations.”

This NCHIIN project is funded by the Community Health Peer Learning Program, a national peer learning collaborative managed by AcademyHealth through a $2.2 million award from the Office of the National Coordinator for Health Information Technology (ONC). Within the Community Health Peer Learning Program, has also partnered with the Vermont Child Health Improvement Program.


With, everyone – clinicians, patients, families, and communities – can act together to make health happen, wherever they are.’s Care Coordination Record™ promises a better, safer, less expensive, and more flexible approach to managing healthcare’s complex tasks and achieving your organization’s goals. Headquartered in Boston, Mass., is privately held and venture-funded by the disruptive innovation investment firm, Rose Park Advisors. For more information, visit


North Coast Health Improvement and Information Network ( is a non-profit successor organization to a community quality collaborative. It is hosted by the Humboldt Independent Practice Association with the purpose of providing health information exchange and care improvement in Humboldt and Del Norte counties.

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