Connecting People, Programs, and Possibilities

At Elm & Oak Health, care begins long before someone enters a clinic. It begins in the community.

Our Community Programs meet people where they are and connect them to the care, housing, and support needed to move forward. Through outreach, peer advocacy, and hands-on coordination, our teams walk alongside individuals experiencing housing instability, behavioral health challenges, or complex life circumstances. With trusted partners across New York State, we bring stability, safety, and dignity to people who might otherwise fall through the cracks.

Community Support

Meeting People Where They Are and Supporting Them Where They Need It Most

Meaningful support often starts with someone who simply shows up ready to listen, ready to help, and ready to connect the dots. Our Community Support programs combine local presence with deep partnerships to deliver person-centered care that stretches beyond traditional models. We help individuals:

  • Navigate homelessness and housing instability
  • Build trust through peer engagement
  • Access critical community resources

Broome County Non-Medicaid Care Coordination Program

For individuals living with mental health challenges who do not qualify for Medicaid, this program delivers personalized, relationship-based care coordination modeled after our Health Home approach. We develop individualized plans and connect clients to behavioral health and social services that strengthen stability and well-being.

Adult CTI Program: Cattaraugus and Allegany Counties

Our Adult Critical Time Intervention Program supports people during vulnerable life transitions. In partnership with Olean General Hospital, we provide structured, time-limited assistance that helps adults with behavioral health needs stay connected to care and build long-term stability.

Peer Support

Our trained peer advocates use their own lived experience to support individuals navigating recovery, reentry, or complex systems. By building trust and offering credible guidance, peers help people take the next step toward stability with confidence and compassion.

Grant-Funded Initiatives

Across New York State, our grant funded programs strengthen local networks of care and expand access to essential services. These initiatives help communities address critical gaps and improve health outcomes for underserved populations.

OASAS Grant

We conduct utilization management reviews for adolescent residential substance use programs. This work supports high-quality care delivery by ensuring treatment plans are appropriate, timely, and aligned with best practices.

SOS and CTI Grants

Through Safe Options Support and Critical Time Intervention grants, our teams provide intensive outreach, engagement, and care coordination for individuals experiencing homelessness. By building trust and linking people to housing, medical care, and behavioral health supports, these programs create pathways to long-term stability.

Learn More About Safe Options Support

Social Care Network Screening and Navigation

Through regional Social Care Network collaborations, we connect individuals to essential resources that influence health outside the clinic, including housing, employment, food access, and transportation. By integrating these supports with healthcare coordination, we help Medicaid recipients and communities build greater stability.

Navigation Services (Coming 2026)

Guiding People Toward Long-Term Stability

Launching in 2026, Navigation Services will help individuals and families bridge the gap between healthcare, housing, and community-based supports. By coordinating across providers, organizations, and public agencies, this program will simplify access and keep people connected to the resources that sustain health and well-being.

Find Help Fast

Need to connect someone to food, housing, behavioral health services, or other community resources?

We partner with trusted directories for fast, accurate referrals:

Bring Support Into Reach

If you are a provider, case manager, or community advocate looking to connect someone to Elm & Oak Health community programs, we are here to help.

Contact Us