Strategies

Revise health care processes and provider roles to integrate mental health and substance abuse treatment into primary care; continue to refer patients with severe conditions to specialty care

Use a case management model for frail elderly patients living independently, coordinating aspects of long-term care (LTC) such as status assessment, monitoring, advocacy, care planning, etc.

Implement multi-component efforts that include coordination of health services by multidisciplinary teams of health care professionals, patient self-management, and patient education

Provide at-risk expectant parents and families with young children with information, support, and training regarding child health, development, and care from prenatal stages through early childhood via trained home visitors

Use specialized courts to work with parents involved in the child welfare system who may lose custody of their children due to substance abuse

Introduce a short-term family-based intervention therapy focused on strengths, protective factors, and risk factors for youth with delinquency, violence, or substance abuse problems, and their families

Support self-contained, homelike dwellings for 10-12 elderly adults who require nursing care; universal caregivers, usually CNAs, provide care and other supports while clinical teams visit for specialized care

Support a collaborative approach by a multidisciplinary team of professionals working to meet the full range of long-term care (LTC) needs for frail elderly patients living in community settings

Arrange full-time foster care by relatives or adults who are not a child’s parent but have a family relationship with the child when a child is removed from home due to a safety concern

Provide continuous, comprehensive, whole person primary care that uses a coordinated team of medical providers across the health care system