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Comprehensive Healthcare <br />GOAL: Screen and make relevant behavioral health referrals to all persons presenting with identified <br />behavioral health needs at the KVH emergency department and other hospital departments as <br />requested. <br /> Measures Data Source <br />Track number of people served, number and type of referrals made, number of <br />C-SSRS screenings completed, referrals made related to suicidal thoughts or <br />behaviors, number of ROI declinations, referral numbers by KVH department. <br />Internal Tracking <br />Sheet <br />Strategy #1: Screen all persons exhibiting suicidal thoughts or behaviors during <br />staffed program hours. <br />Measurable Objectives: <br /> Use the Columbia-Suicide Severity Rating Scale (C-SSRS) to screen all <br />persons exhibiting suicidal thoughts or behaviors. <br />Document and track all referrals made to address suicidal thoughts or <br />behaviors. <br />Strategy #2: Provide referral information to all assessed patients for behavioral <br />health resources or resources addressing Social Determinants of Health. <br />Measurable Objectives: <br /> Document and track specific referrals made. <br />Request release of information (ROI) to referral sources for the purpose <br />of monitoring follow through on referrals. Document and track each <br />request for ROI. <br />Document and track declination to sign ROI. <br />Strategy #3: Respond to referrals in all KVH departments. <br />Measurable Objectives: <br /> Track all referrals by KVH department to ensure 100% response to <br />referent that the referral was received. <br />SUCCESSFUL BENCHMARKS <br />NAME ONE ACTIVITY YOU WILL ACCOMPLISH FOR EACH REPORTING TIME INTERVAL <br />6 MONTHS <br />Staff is trained to use the C-SSRS and has developed and implemented a tracking system for <br />measuring all objectives. <br />12 MONTHS <br />Complete presentations to KVH departments and CHC Kittitas County staff about the CCM <br />program purpose and operation. <br />EXHIBIT “D” <br />SMART GOALS <br />Professional Services Agreement <br />Page 18