What is CATCH?
CATCH (Community Assistance and Transition Care of Houston) is a Community Care Hub (CCH) dedicated to building a stronger and healthier community by integrating health and social care. CATCH facilitates partnerships between healthcare providers and community-based organizations (CBOs) to address social determinants of health (SDOH), including housing, transportation, nutrition, and more.  
 
Community Assistance and Transition Care of Houston (CATCH) Mission: Build a stronger and healthier community for all 
 
CATCH Vision: Through innovation and collaboration, CATCH will improve the health outcomes of our clients through empowerment, education, and support  
 
CATCH facilitates a robust social care delivery system that includes: 
  • Nutrition Assistance: Providing meals, grocery support, and dietary education to combat food insecurity. 
  • Transportation Services: Offering reliable and accessible transit for medical appointments, grocery shopping, and other essential activities. 
  • Care Coordination: Helping individuals navigate complex health and social service systems through personalized support. 
Community Care Hubs (CCHs):  
 
  • Organize and support networks of community-based organizations (CBOs). 
  • Integrate health-related services into the healthcare continuum. 
  • Donate: Your contributions enable us to reach more individuals in need. 
  • Volunteer: Join our team and help make a difference in someone’s life. 
  • Partner: Collaborate with CATCH to expand our collective impact. 
  • Express Interest: Contact CATCH representatives via email at pdcatch@ibnsinafoundation.org, deboraha.moore@houstontx.gov or paula.johnson@houstontx.gov.  
  • Submit Required Information: Provide details about your organization, including your services, goals, and capacity for collaboration.  
  • Review Process: CATCH evaluates potential partnerships based on alignment with its mission and goals.  
  • Sign Agreement: Once approved, you will sign a Master Service Agreement (MSA) outlining roles, responsibilities, and terms. 
The onboarding process for community-based organizations (CBOs) includes: 
  
  • Orientation: CATCH provides an overview of the Community Care Hub model, goals, and expectations.  
  • Needs Assessment: Organizations complete a survey to identify how they address health-related social needs (HRSN) like food insecurity, housing, and transportation.  
  • Training: CATCH offers training in collaborative workflows, reporting requirements, and technology use.  
  • Integration: Your services are integrated into the larger CATCH network, enabling referrals and collaboration with healthcare partners.  
Medicare Advantage (MA) providers collaborate with CATCH by: 
  
  • Building Partnerships: Establish relationships with CBOs addressing SDOH, like providing nutritious meals, transportation, or home-based assistance.  
  • Shared Goals: Align efforts to improve health outcomes for Medicare beneficiaries by addressing non-medical drivers of health.  
  • Data Sharing: Participate in data exchange and reporting to track health improvements and demonstrate the impact of addressing SDOH.  
  • Value-Based Care: Leverage CATCH’s network to support value-based care initiatives by improving outcomes and reducing costs.  
  • For CBOs: Increased visibility, access to funding opportunities, and streamlined coordination with healthcare providers.  
  • For Medicare Advantage Providers: Improved health outcomes for beneficiaries, reduced healthcare costs, and compliance with SDOH-related performance metrics.  
  • For the Community: Enhanced access to integrated health and social services, fostering equity and sustainability.  

Sustainability is central to CATCH’s efforts. By building long-term partnerships, addressing systemic barriers, and leveraging resources efficiently, CATCH ensures that its initiatives create lasting improvements in health outcomes and community well-being.  

CATCH collaborates with: 
  
  • Houston Health Department  
  • Harris County Area Agency on Aging  
  • Ibn Sina Community Medical and Dental Clinics  
  • UTHealth School of Public Health in Houston  
  • Houston Health Foundation  
  • CommonSpirit Health / Freedman’s Health  
  • Aetna CVS Health  
CATCH focuses on key SDOH by: 
  
  • Providing nutritious meals.  
  • Ensuring transportation for medical appointments.  
  • Supporting vaccination accessibility.  
  • Assisting with daily activities and utilities. By addressing these non-medical drivers of health, CATCH helps reduce disparities and improve quality of life.