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Fabric Health: Navigating Complex Health Care Systems Through Community Engagement


A social-impact startup, Pittsburgh-based Fabric Health is adept at using community engagement to help members and their families navigate the complex world of health care—meeting customers where they are at, knowing time is often their most valuable resource.

A social-impact startup, Pittsburgh-based Fabric Health is adept at using community engagement to help members and their families navigate the complex world of health care—meeting customers where they are at, knowing time is often their most valuable resource.

In this interview with Rachael Herbert-Nalevenko, outreach lead for Pittsburgh with Fabric Health, we discuss her motivation for helping her community and how this was influenced by her experience growing up in rural poverty, successes and difficulties the complex health care system continues to throw up, and why these systems need to adapt to better meet community needs.

Please also check out our interview with Fabric Health cofounder Allister Chang to learn more about the organization’s mission to meet families where they are.


Please introduce yourself and tell us about your role with Fabric Health.

My name is Rachael Herbert-Nalevenko. I am the outreach lead for Pittsburgh and I lead our team of outreach specialists here.

Can you describe your primary responsibilities and the communities you engage with?

It's meeting people where they're at, in the time they have, in laundromats, and helping them to navigate their health care needs in the laundromat.

What motivates you to foster these community connections?

I grew up every Saturday in a laundromat my entire childhood, and having services like this available to us in the laundromat would have been completely life-changing for my family. That's what drives me forward, especially with our model. It makes a really big difference in people's lives.

I grew up in rural poverty and we didn't have access or the means to navigate these really complex systems. A lot of times my family would apply for benefits and then give up because there are all these different paperwork things that you have to submit and there's not a lot of communication there and not a lot of help. So we went without a lot because we didn't have the help or the systems in place to help us navigate Medicaid and SNAP [Supplemental Nutrition Assistance Program] or anything like that.

Can you share memorable success stories from your outreach efforts?

Most recently, actually, I just worked with a UPMC [University of Pittsburgh Medical Center] member who had been trying to schedule a PCP [primary care physician] appointment since March and he was just getting confused and really struggling to find a PCP. So actually, we sat down and within 15 minutes, we had scheduled him a doctor’s appointment for the next week. We had called and gotten through. That's not always the case, let me be clear—sometimes, it's a little longer—but we had gotten him scheduled for the following week within about 15 minutes of us starting the call.

What are common difficulties you encounter when trying to help Fabric Health members?

These are just really complex systems. There are all these benefits that are available, right, and most people don't know how to access to them. They’re calling different numbers and they're getting transferred somewhere else or they're on hold with DHS [Department of Human Services] for 40 minutes. They don't have the time for that. Time is such a valuable resource for people. That's some of what we hear as feedback—and that's just within the health care plans, within DHS, and getting Medicaid and things like that.

We don't advertise because we believe that we need to adapt to people's lives; they don't need to adapt to meet with us, we need to adapt to work with them. You'll find us in your local laundromat.

What advice would you like to give other communities looking to set up similar programs?

I think one of the most valuable things or resources people have is time, and I think acknowledging that and knowing that people don't have time to call DHS and be on the phone for an hour, hoping to get someone that may help them. They don't have time to navigate all the complex health care systems or figure out what documentation is in. And if we can help people to navigate that and come to them rather than expecting them to not go to work and miss that paycheck, that sort of thing, that's how we're going to make a really big difference. It's adapting to their needs and not expecting them to adapt to the needs of the company.

What does health equity mean to you?

Keeping people healthy is one of the most important things that we can do. Your health completely affects the rest of your life, and if you're unhealthy or if you're unable to go to the doctor, it affects everything. You miss work, then you can't pay your rent, then you can't feed your family. So addressing health care concerns gets to the root of a lot of those issues and I think that's really important.

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