Integrated Health Partnership options) 1. Explore Hospital/Clinics -Engage primary care Public Health providers (and others in Behavioral Health direct contact with individuals) in Services conducting screening Clergy and making referrals for these resources while using the model* (screen, counsel and referral to treatment) (such as chronic disease self- management programs*). -Computerized clinical decision support systems* -Reference Community Measures 2. Prepare and Plan How exactly will it work? -Motivational interviewing –patient shared decision making* on holistic health 3. Implement and monitor Reduce the 1. Explore - Increased Hospital/Clinics gaps in services network of systems Public Health and resources navigators Behavioral Health and increase Individuals in each Social/Human the utilization of agency increase Services services and access to and support resources. for utilizing resources to engage in healthy
Integrated Health Partnership options) 1. Explore -Engage primary care providers (and others in direct contact with individuals) in conducting screening and making referrals for these resources while using the model* (screen, counsel and referral to treatment) (such as chronic disease self- management programs*). -Computerized clinical decision support systems* -Reference Community Measures 2. Prepare and Plan How exactly will it work? -Motivational interviewing –patient shared decision making* on holistic health 3. Implement and monitor Hospital/Clinics Public Health Behavioral Health Services Clergy Reduce the gaps in services and resources and increase the utilization of services and resources. 1. Explore - Increased network of systems navigators Individuals in each agency increase access to and support for utilizing resources to engage in healthy Hospital/Clinics Public Health Behavioral Health Social/Human Services
PNM_CHS_Community_Health_Improvement_Plan_FINAL.docx