"*" indicates required fields Your Name*Name of person completing this form. First Last Your Email Address*Please enter your current email address. An email confirmation with a validation link that must be clicked on prior to the form being processed will be sent to you. Enter Email Confirm Email Audience*Who is the recommended audience for this content? Check all that apply. Administrators Clinicians Support Staff Consent*Check to indicate "Yes" to the following statement. If you do not check this box, you cannot post this documentI am recommending this resource to be posted on to the Integrated Care DC website. I am aware of the policy and practices against posting copywritten or non-open source materials. This resource is publicly available and does not require permission, or I have the specific permission to post this publicly.Resource Title*This is the title that will show up on the site for users to click to access. If you are posting an article or document from another source, you can use the source title. When possible, please keep short and specific to use. If space allows, please add the source acronym such as NIH, SAHMSA, NIDA at the end or the title in parentheses so users know immediately.Source*This is who created the resource, such as HMA, SAMHSA, NIDA, etc. Option to add a link to the source website, not required.Resource Featured ImageMax. file size: 1 GB.Please check all spelling by using an in-browser spell checker such as Grammarly.Resource Description*This is the front-facing description, what users read when they access the resource. Please include a brief overview of the content, why important for integrated care, and how providers can use this information. If you created the document/resource, please add “Developed by or Presented by >”. Please be sure to review for spelling and grammar. If you are copying and pasting from another document, please be sure to paste as “Keep Text Only”If you want to add a video to your content (such as a webinar) use the upload field below. Do you want to add a featured image to this resource?*Please indicate Yes or No. When Yes is indicated, you will be asked to upload or add the associated resource. Yes No Featured Image*Accepted file types: jpg, png, jpeg, gif, Max. file size: 1 GB.Do you want to add a video to this resource?*Please indicate Yes or No. When Yes is indicated, you will be asked to upload or add the associated resource. Yes No Video File Upload*Only MP4 files are allowed.Accepted file types: mp4, Max. file size: 1 GB.Do you want to add an external link to this resource?*Please indicate Yes or No. When Yes is indicated, you will be asked to upload or add the associated resource. Yes No URL for Link* Do you want to add an audio clip to this resource?*Please indicate Yes or No. When Yes is indicated, you will be asked to upload or add the associated resource. Yes No Audio File Upload*Only MP3 files are allowed.Accepted file types: mp3, Max. file size: 1 GB.File Attachment UploadAccepted file types: pdf, ppt, xls, xlsx, doc, docx, jpg, jpeg, Max. file size: 1 GB.Provider Type or Setting*What provider types are recommended to reference/use this resource? Check all that apply.You may choose as many as apply by holding down the Command key on a Mac or the Control Key on a PC.Behavioral HealthLTSSMATPrimary CareLevel*Please indicate the level of resource content to support the implementation of integrated care. Choose oneFoundationalModerateAdvancedResource Topic*Please indicate what topic or subject area(s) are addressed through the resource. Check all that apply.You may select as many topics as apply. Behavioral Health COVID-19 Health Information Exchange (HIE) Medications for Addiction Treatment (MAT) Screening and/or Assessment Econsult/Telehealth Substance/Opioid Use Disorder Stigma Abatement Patient Engagement Care Team Optimization Other Select AllOther* Association with the Integrated Care DC Core Competencies (You may select as many apply).*All content should fall under at least one of the Core Competencies as part of the DHCF Framework for Practice Transformation. Integrated Care DC curriculum and progress is based on and measured by provider achievement according to the Core Competencies. Check all that apply. CC1: Deliver Patient-Centered Care Across the Continuum to Improve Patient Outcomes (includes screening, assessment, referrals, telehealth, patient engagement) CC2: Use Data and Population Health Analytics to Improve Care (includes MBC, registries, CRISP, claims data, quality) CC3: Engage Leadership to Support Person-Centered, Value-Based Care (includes strategy, staff training/hiring, reimbursement models, partnerships and relationships with MCOs/payers/external referral agencies) Is this a priority resource that should be posted within the next 10 days? Yes No EmailThis field is for validation purposes and should be left unchanged.
