CCUIH's Six Levels of Integration Survey
CCUIH has culturally adapted the SAMHSA's Six Level of Integration Tool to include the specific needs of AI/AN community.

This survey assesses your clinic's level of collaboration/integration based on this adapted model. If you have any questions about the survey please contact April at april@ccuih.org.
Which CCUIH member organization do you represent? *
What is your job title? *
Does your Primary Care (PC), Behavioral Health (BH), and Traditional Healing (TH) take place at the same site? *
Clinical Delviery
Screening and assessment : *
Treatment Plans: *
Panel Management:
Clear selection
Evidence-Based Practices (EBP): *
Community Defined Practices (CDP): *
Patient Experience
Patient Health Needs: *
Patient referrals: *
Practice/Organization
Integration Leadership: *
Provider buy-in *
Coordination of care:
Clear selection
Tacking Referrals
Clear selection
Business Model
How separate is your funding for PC and BH?
Clear selection
Do PC and BH share resources?
Clear selection
Are your billing practices separate for PC and BH?
Clear selection
Traditional Healing
Rate your organization's support for collaboration with traditional healers:
No organizational support for collaboration with Traditional Healers
Organizational support for the implementation and success of a completely integrated model, where Traditional Healing is treated with the same value as Primary Care and Behavioral Health practices
Clear selection
Rate your practitioner's support for collaboration:
Primary and Behavioral Health Practitioners have limited experience with alternative/cultural forms of healing
All practitioners have been exposed to, understand and respect the value of traditional healing
Clear selection
How do community members access traditional healers?
Clear selection
What is communication with Traditional Healers driven by?
Clear selection
Are there operational systems in place for Traditional Healers?
Clear selection
Do Traditional Healers have access to EHR?
Clear selection
Are there systems in place to help Traditional Healers become HIPAA compliant?
Clear selection
Do practitioners understand community codes of privacy relating to traditional healing?
Clear selection
Do Traditional Healers participate in care planning?
Clear selection
Is there designated space for Traditional Healers at the clinic?
Clear selection
Are Traditional Healers solely responsible for supplying all components of their practices?
Clear selection
Do Traditional Healers have access to outdoor space?
Clear selection
Traditional Health Sustainability
How is Traditional Healing at your clinic funded?
Clear selection
Do Traditional Healers have access to resources that PC and BH have?
Clear selection
Are there billing practices for Traditional Healing?
Clear selection
How are Traditional Healers usually compensated?
Clear selection
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