Strategies

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.

Engage professional or lay health workers to provide education, referral and follow-up, case management, home visiting, etc. for those who experience barriers in accessing health care; also called promotoras(es) de salud or community health representatives

Provide free and confidential counseling and service referrals via telephone-based conversation, web-based chat, or text message to individuals in crisis, particularly those with severe mental health concerns

Increase support for non-profit health care organizations and deliver comprehensive care to uninsured, underinsured, and vulnerable patients regardless of ability to pay; often called community health centers (CHCs)

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

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

Provide an 8 or 12 hour training to educate laypeople about how to assist individuals with mental health problems or at risk for problems such as depression, anxiety, and substance use disorders

Provide health care services on school premises to attending elementary, middle, and high school students; physical and mental health services provided by teams of nurses, nurse practitioners, and physicians

Coordinate access to services across delivery systems and disciplinary boundaries (e.g., housing, disability, physical health, mental health, child welfare, workforce services, etc.)

Deliver consultative, diagnostic, and treatment services remotely, especially for patients who live in areas with limited access to care or who experience transportation or mobility barriers; sometimes called telehealth