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
Which CCUIH member organization do you represent? *
Your answer
What is your job title? *
Your answer
Does your Primary Care (PC), Behavioral Health (BH), and Traditional Healing (TH) take place at the same site? *
Your answer
Clinical Delviery
Screening and assessment : *
Treatment Plans: *
Panel Management:
Evidence-Based Practices (EBP): *
Community Defined Practices (CDP): *
Patient Experience
Patient Health Needs: *
Patient referrals: *
Integration Leadership: *
Provider buy-in *
Coordination of care:
Tacking Referrals
Business Model
How separate is your funding for PC and BH?
Do PC and BH share resources?
Are your billing practices separate for PC and BH?
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
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
How do community members access traditional healers?
What is communication with Traditional Healers driven by?
Are there operational systems in place for Traditional Healers?
Do Traditional Healers have access to EHR?
Are there systems in place to help Traditional Healers become HIPAA compliant?
Do practitioners understand community codes of privacy relating to traditional healing?
Do Traditional Healers participate in care planning?
Is there designated space for Traditional Healers at the clinic?
Are Traditional Healers solely responsible for supplying all components of their practices?
Do Traditional Healers have access to outdoor space?
Traditional Health Sustainability
How is Traditional Healing at your clinic funded?
Do Traditional Healers have access to resources that PC and BH have?
Are there billing practices for Traditional Healing?
How are Traditional Healers usually compensated?
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