“Health doesn’t end at discharge. When families have food on the table, a safe place to sleep, and a way to get to follow-up care, children recover better, and families move forward with dignity.”

– Tim Curtin, Vice President, Community Services, Memorial Health System

For families receiving care at Joe DiMaggio Children’s Hospital, medical treatment is often only part of the challenge. Food insecurity, housing instability, transportation barriers, and financial strain can determine whether a child heals or returns to the emergency room.

To address these root causes, Joe DiMaggio Children’s Hospital Foundation launched The Community Pediatric HUB, an innovative model that integrates healthcare with social support. With support from the Health Foundation of South Florida, the Pediatric HUB connects families with the resources they need, from the bedside to long after discharge.

Before leaving the hospital, families are screened for key health-related social needs. Those facing multiple challenges are paired with a Community Navigator, who works one-on-one to coordinate services, complete applications, and ensure needs are addressed through a closed-loop referral system.

A Family’s Story

During the program year, a family receiving care through Memorial Healthcare System was discovered living in their car in Memorial Regional’s parking garage. With nowhere safe to return to after discharge, the family faced an immediate crisis, one that threatened both stability and health. Through the Community Pediatric HUB, the family was connected to coordinated support and resources to help them move from survival to a more stable path forward. With a Community Navigator guiding the process, the family received assistance designed to address urgent needs and reduce the risk of repeated emergency visits, while protecting the child’s recovery and the family’s dignity.

This is the heart of the Pediatric HUB: ensuring families are not navigating complex challenges alone, especially at their most vulnerable moments.

These outcomes matter for the families served. In 2023, 62% of Joe DiMaggio Children’s Hospital patients relied on Medicaid, and 3% had no insurance, underscoring how unmet social needs can shape health outcomes.

By embedding social needs screening into the hospital’s electronic health record and pairing families with a dedicated navigator, the Pediatric HUB is changing how pediatric care is delivered, linking medical excellence with real-world support.

With an estimated return on investment of $1.45 million, the Community Pediatric HUB demonstrates how integrating healthcare and social services can improve outcomes, reduce avoidable hospital use, and strengthen families.

For the Health Foundation of South Florida, this investment reflects our clear belief: when we care for the whole child and the whole family, health outcomes improve, and communities grow stronger.