The PHMI Social Health Framework and Approach describes how health centers can identify and address health-related social needs at both the individual and population levels. The framework covers assessing community needs and assets, screening patients, incorporating social needs into care plans, connecting patients with resources, following up on referrals, using data to understand population-level needs, partnering with community-based organizations, and strengthening community resources and referral infrastructure. Designed for flexible use based on each health center’s needs and capacities, the brief also explains how the framework aligns with the PHMI Equity Framework and Approach and the National Academies’ “5 As,” connects with CalAIM Community Supports, and informs PHMI training and technical assistance.
PHMI Social Health Framework
