Background:
For over eleven years, Avanti has specialized in providing intense case management to at risk families of Miami Dade County. Avanti provides services to an average of 160 women per month and approximated 2000 per year. Of those, approximately 45% are Latina women. Overall, the Latino women served by Avanti are medically unprivileged and underserved, unmarried, undocumented, earn less than minimum wage, unable to read or speak English, and have little or no family support.

Objectives:
Avanti's main objective is to strengthen and enhance community systems of women's health, maternal and infant care. The areas we serve include those zip codes identified as having women at risk for chronic health conditions, preterm labor, low birth weight infants, and high infant mortality rates. Our primary focus is on participants that have been identified as hard-to-reach and requiring intensive services.

Methods:
Our primary method of service delivery is an outreach care model, and the development and maintenance of strong working partnerships with community based service providers. This approach has allowed us to open the door of opportunity to services and assistance to our families with needs. Our two-pronged facilitates access to services and support to our clients.

Results:
Our two-pronged outreach model has resulted in the “bridging” of families with services. Avanti has been able to meet the needs of over 90% of our enrolled clients. Even though street-level outreach requires more effort, energy and funding it is still the most effective manner to serve “hard-to-reach' and disenfranchised communities like Latina women.

Conclusion and implications for practice:
Years of experience have demonstrated that that outreach efforts are the best tool to increase awareness of services available as well as access to it. Participant's access services more effectively when these are offered in their communities. This intervention modality has dramatically increased the services we provide. Avanti has determined that by providing the participants with crucial information about resources and programs in their own environment, women are more likely to access those services.