Founded in 1989, BEST is a non-profit organization devoted to supporting the health and well-being of the backstretch community living and working at Saratoga Race Course and Belmont Park. BEST provides on-site counseling and primary healthcare services, access to health insurance, and case management assistance. Much of this work is accomplished by the dedicated BEST staff located at Belmont Park and Saratoga Race Course, with healthcare services provided by Saratoga Hospital and Northwell Health.

Underwood has directed BEST's efforts at Saratoga Race Course since 2014. During that period, BEST significantly expanded its presence and impact for the backstretch community living and working at Saratoga from April-November each year.

In 2023, BEST opened a new, modern health care clinic on the Oklahoma side of Saratoga Race Course. Funded by philanthropist John Hendrickson in memory of his late wife, Marylou Whitney, and Saratoga Hospital, the Saratoga Backstretch Healthcare Clinic is a state-of-the-art facility with six examination rooms, a lab for blood work and space for staff, education and on-site insurance specialists.

“BEST is successful because of the dedication of our staff, volunteers and healthcare providers,” said Underwood. “I am honored for the opportunity to lead this organization at a time when the future of Thoroughbred racing in New York State is so bright. I thank the BEST Board of Directors for their commitment to advancing our mission in the years ahead.”

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