Description
Inclusion Criteria:
- * Age \> 18
- * English speaking participants who completed SOCIAL-HF study surveys
- * Ejection Fraction \<=40% and eligible for at least one component of GDMT
- * Has at least some difficulty paying monthly bills (Somewhat Difficult and Very Difficult)
- * Annual household income \<130% Federal Poverty Limit
- * Have at least two additional social needs based on the following domains:
- * Cost-related nonadherence
- * Food Insecurity
- * Housing Instability
- * Transportation Difficulty
- * Unemployment
- * Household Crowding: Person/Room Ratio \>1
- * Rent Burden: Rent/Income Ratio \>30%
- * Low social support
- * Interpersonal Violence
- * History of Discrimination
Exclusion Criteria:
- * Unwilling to return for 1 and 2-month follow-up visits.
- * Currently in jail or prison
- * Primary residence outside Dallas County
- * Legal Blindness
- * Systolic blood pressure \<90 mmHg on screening
- * Contraindications or Intolerance all medications available for therapeutic drug monitoring (metoprolol, losartan, lisinopril, valsartan, and spironolactone)
- * Unable to answer orientation questions.
Ages Eligible for Study:
18 Years to 80 Years (ADULT, OLDER_ADULT)
Sexes Eligible for Study: ALL
Accepts Healthy Volunteers:
No