Children with medical complexity account for a relatively small percentage (0.4-0.7%) of children but approximately 15-33% of pediatric US healthcare spending. This is often attributed to recurrent hospitalizations that may be tied to social vulnerability. Few, if any, programs have effectively decreased utilization in this population. Novel Interventions in Children's Healthcare (NICH), an intensive community-based, family-focused intervention, was developed for youth experiencing suboptimal disease management due to social determinants of health.