Learning Center

  • Partner Training
  • Partner Resources

Welcome to the Partner Training area of the Learning Center. Please click on the boxes below to access the Partner Training modules. By selecting a training module, you will be directed to new webpage where you will be able to view and complete the educational module. Please note that supported browsers for these training modules include Chrome, Firefox, and Safari.

  • Cardiovascular Health & Diabetes Wellness & Self-Management
  • Care Coordination Methodology
  • Community Health Activation Program (CHAP) Training
  • Community Orientation
  • Compliance and HIPAA Program
  • Cultural Competency, Health Literacy
  • Skilled Nursing Facilities: INTERACT
  • Skilled Nursing Facilities: Long Term Care Performance Improvement Educational Series
  • Interventions for Tobacco Cessation
  • Partner Reporting Presentation DY4Q4
  • Promoting Asthma Self-Management
  • Performance Reporting and Improvement
  • Population Health
  • Primary & Behavioral Health Integrated Care
  • Screening, Brief Intervention and Referral to Treatment (SBIRT)
  • Value Based Payment (VBP)

Cardiovascular Health & Diabetes Wellness & Self-Management Programs Learning Module

This module reviews the evidence-based resources and treatment strategies being implemented to support the Cardiovascular Wellness and Self-Management Program and the Diabetes Wellness and Self-Management Program. You will learn about the Million Hearts® campaign, tools available to identify patients in need of follow-up care, how to successfully retrieve accurate blood pressure readings and teach self-monitoring blood pressure techniques, and methods to reduce tobacco use in patients. You will also learn about tools available to identify patients with diabetes or “at-risk” of developing diabetes, comprehensive diabetes testing methods and lifestyle recommendations. Finally, you will learn about documentation of patient self-management goals and how to refer patients to self-management education. DSRIP partners are expected to review each curriculum presentation and attest that they understand the training.

Cardiovascular Wellness & Self-Management Program

Learning Objectives:
  • Demonstrate the elements of the DSRIP Cardiovascular Wellness & Self-Management Program
  • Recall major strategies, goals, and tools of the Million Hearts® campaign
  • Recognize how a registry is used to identify and track hypertension patients
  • Summarize key points from guideline recommendations

Blood Pressure Measurement (practice-based or self-monitored)

Learning Objectives:
  • Summarize proper techniques and equipment for measuring Blood Pressure
  • Identify implications of performing blood pressure measurements incorrectly
  • State the impact of self-monitored BP programs (SMBP) in reducing risk of disability or death due to uncontrolled hypertension
  • Identify features to consider in guiding patient in selection of SMBP equipment
  • Review the validation process for automatic blood pressure measurement devices

Diabetes Wellness & Self-Management Program

Learning Objectives:
  • Review the impact of diabetes
  • Define the elements of the Diabetes Wellness & Self-Management Program
  • Apply the screening and treatment recommendations for patients with diabetes

Patient Self-Identified Goals and Diabetes & Chronic Disease Self-Management Education

Learning Objectives:
  • Formulate ‘smart goals’ in collaboration with patient
  • Illustrate Motivational Interviewing techniques to assist patients in setting health goals
  • Identify benefits of diabetes and chronic disease self-management education, components of self-management programs, and the various programs to which a patients can be referred

Care Coordination Methodology, Protocol & Treatment Plans Learning Module

This module provides an overview of Care Coordination and its place in the health care delivery system. Emphasis is placed on the importance of coordinated care throughout the continuum and how social determinants of health can impact a patient’s health outcomes. Participants will gain an understanding of who can coordinate care, how this is accomplished through transitions of care, and the importance of providing patients with effective, efficient, patient centered care.

Understanding the Basic Principles and Core Elements of Care Coordination

Learning Objectives:
  • Understand and define what it means to coordinate care
  • Describe those members of the care team that coordinate care and how they work as in interdisciplinary team
  • Understand the importance of coordinating care throughout the care continuum
  • Describe basic barriers to reaching optimal health outcomes and explain ways in which these barriers can be overcome
  • Understand the difference between care coordination and care management

Understanding the Purpose and Benefits of Successful Patient Hand-Offs

Learning Objectives:
  • Understand effective and ineffective transitions in care
  • Describe the root causes of ineffective transitions
  • Describe various models of transitions of care
  • Understanding a warm hand-off & benefits of warm hand-offs, referrals and transfers

Integrated Delivery System (IDS) 101

Learning Objectives:
  • Understand the definition and meaning of an Integrated Delivery System
  • Understanding the SCC Clinical Integration Strategy
  • Describe the various levels of care coordination occurring throughout the care continuum
  • Understand how the DSRIP projects enhance the ability for care to be coordinated
  • Identify and differentiate between care coordination and more specialized, complex care management occurring at various levels of the integrated delivery system

Community Health Activation Program (CHAP) Training Module

This learning module provides training for community health workers, health coaches, health care providers and clinicians on participating in the CHAP program and patient activation techniques. The CHAP program focuses on persons who are uninsured or low utilizers or non-utilizers of the health care system and works to engage and activate those individuals to utilize primary and preventive care services. Through evidence-based patient activation activities, you will identify individuals and measure and improve their health literacy and level of activation, thereby encouraging active management of their personal health. Participants of training will be introduced to the CHAP program requirements which includes administering the PAM Survey, the Wellness Coaching Model, and Community & Primary Care Provider Navigation. Participants are expected to review each curriculum presentation and attest that they understand the training though a few competency questions following each topic. Participants must complete all topics within the learning module to become a PAM Provider under the CHAP Program.

Becoming a Patient Activation Measure (PAM) Provider

Learning Objectives:
  • Learn about the Suffolk Care Collaborative, the Delivery System Reform Incentive Payment Program and the Community Health Activation Program.
  • Training in administering and documenting PAM surveys, including how to appropriately assist project beneficiaries using PAM.
  • Gain expertise in patient activation and engagement including shared decision making, motivational interviewing, techniques such as OARS, and measurements of health literacy and cultural competency.
  • Learn about the Coaching for Activation tools, techniques and content.
  • Understand the NYS Health Home Model and eligibility criteria for targeted populations.
  • Learn about Suffolk County’s areas of high need for targeted outreach and community navigation.
  • Training in connectivity to healthcare coverage, community healthcare resources and patient education.
  • Gains an understanding of Insignia Information Software.

Patient Activation Measure (PAM) and Wellness Coaching by Insignia Health

Learning Objectives:
  • List the three domains of “Activation”
  • List the two types of metrics associated with PAM.
  • Name behavioral characteristics of each of the four levels.
  • List ways that CFA can assist you in working with an individual.
  • Learn about the Coaching for Activation tools, techniques and content.
  • Gain expertise in patient activation and engagement including shared decision making, measurements of health literacy and cultural competency.

Community Orientation Learning Module

This module provides an overview of the Suffolk County Community, its needs and Suffolk Care Collaborative (SCC) initiatives. It explores how the SCC aims to focus multiple initiatives and strategies for the high priority needs in Suffolk County to prevent chronic disease, promote mental health and prevent substance abuse. Participants will gain a better understanding of the population characteristics and demographics, understand and learn about strategies to address areas of need, and also how the Suffolk Care Collaborative is connecting target populations and families to health and wellness services within the community.

Community Orientation

Learning Objectives:
  • Understand the population characteristics and demographics of Suffolk County
  • Identify and understand the priority areas/needs in Suffolk County community and the relationship to the chosen clinical projects through our Community Needs Assessment.
  • Identify areas of need in order to better target the intended recipients
  • Identify the individuals and communities where avoidable utilization of high-cost health care resources currently exist.
  • Learn about the SCC and HITE partnership

Compliance and HIPAA Program Learning Module

This module presents essential information about the SCC’s Compliance and HIPAA Program including information privacy and security, ethics, Code of Conduct, confidential reporting, the legal framework for compliance, and how to get more information when you need it. Attention is also given to the relationship between Coalition Partners and the SCC in the implementation of the Compliance Program.


Learning Objectives:
  • Understand the scope and requirements of the SCC Compliance Program and how to get information when you need it
  • Read and acknowledge the SCC Code of Conduct
  • Understand the duty to report compliance concerns and how to do so confidentially
  • Know that retaliation against good faith reporters is prohibited
  • For SCC personnel only: complete a Conflict of Interest disclosure form

HIPAA Privacy

Learning Objectives:
  • • Describe the Health Insurance Portability and Accountability (HIPAA) Privacy Rule
  • • Describe Individually Identifiable Health Information (PHI)
  • • Describe Protected Health Information (PHI)
  • • Understand the basic responsibilities of Business Associates (BAs)
  • • Understand Patient Rights under HIPAA

HIPAA Security

Learning Objectives:
  • Understand the Health Insurance Portability and Accountability (“HIPAA”) Security Rule and e-PHI
  • Describe the Health Information Technology for Economic and Clinical Health Act (“HITECH”)
  • Understand the basic responsibility of Business Associates (BAs)
  • Understand Administrator Requirements of the HIPAA Security Rule
  • Describe a Breach Notification/Assessment/Impact
  • Understand the basic responsibilities of Subcontractors
  • Understand investigations and consequences of HIPAA violations
  • Describe HIPAA case studies

Cultural Competency Health Literacy Learning Module

This module establishes an overview of concepts used to enhance both patients’ and providers’ understanding of the health care system. It emphasizes the terms cultural competency and health literacy. These terms enable the differing cultural needs of patients to be recognized while not overlooking a patients’ true understanding of their overall health and well-being. The social determinants of health will also be analyzed in order to further patients’ knowledge of their unavoidable risks with in the health care system.

Cultural Competency, Health Literacy 101

Learning Objectives:
  • Define health literacy and cultural competency
  • Discuss the scope and the challenges of health literacy and cultural competency and why it is important.
  • Understand how culture, health literacy and language access influence patient-centered care.

Cultural Competency & Health Literacy Training Program

The Suffolk Care Collaborative offers FREE Cultural Competency and Health Literacy (CCHL) Training for health, community based, and human service providers. The purpose of the interactive program is to assist providers in better serving diverse communities in Queens, Nassau and Suffolk Counties through promoting cultural awareness and creative communication strategies.

Through a partnership with Nassau-Queens Performing Provider System and Long Island Health Collaborative (LIHC), this training is offered in two different formats:

  • 2 Hour Workforce Staff Program
  • Full Day Train-the-Trainer Program

For training dates and more information on the CCHL Training Programs, Click Here.

Skilled Nursing Facilities: INTERACT Learning Module

This module provides an overview of the SCC INTERACT Program. It focuses on an introduction to INTERACT and describes implementation program and requirements. Participants will gain a better understanding of how to educate and train staff on the basics of the INTERACT Quality Improvement Program, INTERACT tools, and the Facility Champion roles and responsibilities that will facilitate and act as the INTERACT coach for each facility.

INTERACT Overview and Tool Highlights

Learning Objectives:
  • Understand current landscape of health care reform and funding that make the INTERACT QIP an essential initiative.
  • Understand the INTERACT Coaching Program/Facility Champion within your facility.
  • Understand key strategies that form foundation of the INTERACT QIP tools & resources.
  • Understand how to properly utilize: Stop & Watch Early Warning Tool & SBAR Communication Tool
  • Understand your Facility Champion will continue training on: Care Pathways & Clinical Tools &Advanced Care Planning Tools

INTERACT Quality Improvement & Assurance Program

Learning Objectives:
  • Understand current landscape of health care reform and funding that make the INTERACT QIP an essential initiative.
  • Understand the INTERACT QIP Quality Improvement tools related Rehospitalizations and RCA’s.
  • Understand key strategies that form foundation of the INTERACT QIP tools & resources to allow cultural transformation
  • Understand INTERACT QIP Advanced Care Planning tools

Skilled Nursing Facilities: Long Term Care Performance Improvement Educational Series Learning Module

This educational series provides learning topics to support skilled nursing facilities in performance improvement focus areas. Participating SNFs identified areas of improvement in their Quality Improvement Action Plans, including: Early Warning Signs of Sepsis/UTI, INTERACT Tools Implementation, Fall Reductions Initiatives, Advanced Care Planning/MOLST/eMOLST Initiatives and Alzheimer’s/Dementia Training. These will be the topics of focus for this educational series. Participants will gain a better understanding of each topic with a general overview, tools and resources to utilize and best practices and real-life examples to facilitate practical learning.

Early Recognition of Infection in Long Term Care Settings

Learning Objectives:
  • Highlight the importance of early recognition of infection in the long-term care setting.
  • Utilize real-life examples to further understand how to recognize the onset of infection.
  • Apply the INTERACT Tools to the practice of early infection recognition.
  • Understand the definition of Sepsis and early warning signs.
  • Provide first steps for treatment after identifying sepsis.

Interventions for Tobacco Cessation Learning Module

This module is intended to support trainees in understanding interventions for tobacco cessation to support the SCC’s clinical improvement programs and population-wide wellness initiatives. You will learn about Tobacco Cessation control methods endorsed by the Million Hearts® campaign as well as understanding the services provided through the NYS Smokers’ Quitline. You will also learn about tobacco use prevalence, tobacco dependence and the evidence based cessation treatments for individuals with mental illness and/or behavioral health disorders.

5 A’s of Tobacco Cessation Control and Referring to the NYS Quitline

Learning Objectives:
  • Summarize the 5 A’s of tobacco cessation counseling
  • Describe the services of the NYS Smokers’ Quitline and the referral process
  • Illustrate how Progress Reports are obtained and the information included in the reports
  • Discuss the role of patient-center communication in providing effective tobacco counseling
  • Provide evidence-based brief interventions in counseling tobacco users

Tobacco Dependence and Cessation Treatment in Individuals with Mental and/or Behavioral Disorders

Learning Objectives:
  • Identify strategies that individuals with mental and/or behavioral health disorders may use to support their efforts to quit using tobacco products.
  • Define the 5A’s for treating tobacco dependence as outlined in the US PHS Guideline Treating Tobacco Use and Dependence.
  • Identify the FDA approved medications used to treat tobacco dependence for patients who use tobacco products and increase the rate of successful quit attempts.
  • Evaluate various resources available to assist patients to quit.
  • Summarize the 5R’s to enhance motivation to quit using tobacco products.

Tobacco Dependence and Cessation Treatment: The Individual with Diabetes

Learning Objectives:
  • Define diabetes and summarize health effects of tobacco use in patients with diabetes.
  • Review the US Public Health Service Guidelines for treating tobacco use and dependence.
  • Identify the FDA approved medications to treat tobacco and nicotine dependence.
  • Define and relapse prevention strategies for patients struggling to remain smoke free.
  • Examine the various resources available to assist patients to quit tobacco use.

Partner Reporting Presentation DY4Q4

This presentation details reporting requirements for Patient Engagement for DSRIP Demonstration Year 4, Quarter 4. It outlines important information and timelines for Partner Data Requests due to the SCC on April 12, 2019.

Partner Reporting Presentation DY4Q4

Learning Objectives:
  • Describe the DSRIP Domain 1 Patient Engagement reporting requirements and commitments made to the Department of Health
  • Identify the SCC data request timeline and DOH reporting schedule
  • Explain the patient engagement data specs needed by DSRIP project
  • Discuss the strategy for transmitting Protected Health Information (PHI) to the Suffolk Care Collaborative to meet Patient Engagement Quarterly Reporting Requirements

Promoting Asthma Self-Management

The Home-Based Asthma Self-Management program is a component of the Promoting Asthma Self-Management Program (PASP). The home-based self-management program is designed for children and young adults under the ages of 26, with asthma. There are several organizations that provide this service within the PPS for eligible patients. Patients enrolled receive home visits from trained health care workers in order to learn how to better manage their asthma or their child’s asthma independently. This module provides an overview of the program as well as eligibility criteria.

Promoting Asthma Self-Management Program: Home-Based Self-Management

Learning Objectives:
  • Recognize the value of home-based asthma interventions
  • Become knowledgeable about PASP eligibility criteria
  • Understand the structure of a home visit
  • Become familiar with how nurses/community health workers can help patients
  • Learn how to make a referral to the appropriate home-visitation program

The American Lung Association’s Asthma Basics Course

Learning Objectives:
  • Recognize and manage triggers
  • Understand the value of an asthma action plan
  • Recognize and respond to breathing emergency
  • View the What is Asthma? Animation that shows the three primary changes in the airways during an asthma episode
  • Learn about comprehensive resources, including asthma medication devices and demonstration video downloads for patients
View What is Asthma? Animation and asthma medication devices and demonstration video by clicking on Resource button below:

Performance Reporting and Improvement Learning Module

This module provides an overview of the SCC Performance Reporting and Improvement Program. It focuses on an introduction to the SCC Performance Reporting and Improvement Program and describes the Domain 1 Patient Engagement Reporting Requirements. Participants will gain a better understanding of how to deploy PDSA cycles to conduct tests of change and utilize control charts to understand data variation.

The SCC Performance Reporting & Improvement Program

Learning Objectives:
  • Describe the purpose of the SCC Performance and Improvement Plan
  • Define the SCC approach to the Rapid Cycle Improvement
  • Discuss the performance reporting organizational structure and stakeholder roles and responsibilities
  • Identify the 11 DSRIP Projects the SCC is implementing across Suffolk County
  • Explain the performance reporting requirements for Domain 1 Patient Engagement, Domain 1 Project Engagement, and Domain II & III Performance Outcomes
  • Discuss the Pay-for-Reporting (P4R) and Pay for Performance (P4P) model and associated timeline
  • Explain the Gap-to-Goal improvement standards
  • Describe the SCC approach to data aggregation and analysis including the decision support tools used to support the performance reporting program
  • Explain the SCC action planning process
  • Describe the SCC recommended model for performance improvement (IHI Improvement Model)

IHI – An Introduction to the Model for Improvement

Learning Objectives:
  • Describe the Model for Improvement
  • Discuss how to use the Plan-Do-Study-Act (PDSA) cycle to conduct rapid tests of change
  • Explain the three questions that can help drive quality improvement work

IHI – Building Skills in Data Collection and Understanding Variation

Learning Objectives:
  • Describe how to evaluate data variation
  • Explain Common and special causes of variation
  • Identify data collection strategies

IHI – Using Run and Control Charts to Understand Variation

Learning Objectives:
  • Describe the history of how statistical processes control (SPC) methods evolved over time
  • Identify three key questions to construct and use a control chart
  • Explain how to select the appropriate control chart based on the types of data

Population Health Learning Module

This module provides an overview of the New York State’s Delivery System Reform Incentive Payment Program (DSRIP). It focuses on the overall goals of the program, provides an overview of the SCC structure and discusses the SCC Quality Improvement Agenda.


Learning Objectives:
  • Discuss the goals of DSRIP
  • Identify what a Performance Provider System is and its purpose
  • Describe the Suffolk Care Collaborative's Structure
  • Recognize the 11 SCC DSRIP Projects
  • Discuss the Suffolk Care Collaborative's Quality Improvement Agenda and Sustainability Plan

Primary & Behavioral Health Integrated Care Learning Module

This module provides a comprehensive look at the process of primary and behavioral health integration. Participants will gain a full understanding of the potential of this type of integration to improve the health outcomes of patients and what the steps will be to work towards this integration. For your convenience, this module is divided into three separate sections: Core Concepts, For Primary Care Providers and For Behavioral Health Providers.

Click on the headings below to access training topics in each section.

Core Concepts
This section provides the foundation for understanding primary care and behavioral health integration. The topics progress though understanding the core concepts related to integrating services, and the prevailing models on integration and their relation to population health, to preparing for integration, and finally to full implementation and documentation.

Basics of Integrated Care

Learning Objectives:
  • Describe the population based goals of integrated care
  • Describe the continuum of integrated care
  • Name the core competencies for providers in an integrated care approach

Basics of Bidirectional Integrated Care

Learning Objectives:
  • Describe the basic parameters of bidirectional programs
  • Identify the common goals of bidirectional interventions
  • Identify the core factors that make bidirectional programs effective

Primer on Evidence Based Models of Integrated Care

Learning Objectives:
  • Name and describe the three prevailing models of integrated care
  • Describe the meaning behind the constructs of levels of integration and population penetration
  • Describe the difference between models and programs

Rating Your Level of Integrated Care Using the MeHAF

Learning Objectives:
  • Describe the team members required for self-administering the MeHAF
  • Describe the core competencies of the MeHAF
  • Self-administer the MeHAF rating scale

Primer on Screening for Integrated Care

Learning Objectives:
  • Identify the typical tools used in primary care
  • Describe the concepts of screening, assessment and tracking
  • Describe implementation considerations for establishing screening pathways

Working with the Behavioral Health Clinics: The Warm Handoff

Learning Objectives:
  • Describe the function of a warm handoff
  • Describe the strategies often used to manage flow in a primary care setting
  • Describe a sample introduction that a primary care provider can use to introduce services to a patient

Documentation for Primary Care

Learning Objectives:
  • Describe the components of a primary care specific SOAP note
  • Describe elements that do not belong in a primary care record
  • Describe regulatory parameters that may influence the content of a SOAP note

Primer on the Primary Care Consult

Learning Objectives:
  • Describe the core components of a typical consult
  • Describe the content of an effective introduction
  • Describe the content of an effective functional analysis

Primer on the PCBH Model

Learning Objectives:
  • Describe the core attributes of the PCBH model
  • Describe the goals and core metrics of a PCBH service
  • Describe the core competencies of a BHC in this model

Registry Basics

Learning Objectives:
  • Describe the difference between a spreadsheet and a database
  • Describe the way in which registries are used to manage care
  • Describe considerations for implementing a registry based care pathway

Improving Screening and Identification in Pediatric Practices

Learning Objectives:
  • Name the percentage of children who have identifiable behavioral health conditions
  • Describe the components of the AAP Mental Health Toolkit
  • Describe the elements to consider when implementing screening

Primer on Pediatric Consults for Primary Care

Learning Objectives:
  • Describe the areas where primary care consultation can be effective
  • Describe the strategies for engaging pediatric patients
  • Describe the core competencies of a pediatric behavioral health consultant
For Primary Care Providers
This section has been specifically developed for our primary care partners. These topics were originally conducted as live, interactive webinars. The recordings of these live webinars are now archived in this section.

Update on PCBH through lens of Three World View

Learning Objectives:
  • Describe the components of the Three World View
  • Identify how each component of the Three World View impacts PCBH implementation

Implementing Team-Based Care

Learning Objectives:
  • Define Team-Based Care and its relationship to integrated behavioral health care
  • Explain the advantages of Team-Based Care
  • Review initial steps to helping practices form and maintain teams

Primary Care Behavioral Health (PCBH) Program Cost Analysis

Learning Objectives:
  • Define key finance terms and analyses for PCBH sustainability
  • Identify one financial metric that can be measured at own site
  • Identify two growth areas for improving sustainability practices at own site

Primary Care Behavioral Health (PCBH) Program Evaluation

Learning Objectives:
  • Explain the importance of program evaluation in PCBH
  • Identify program evaluation steps
  • Identify two components of own site to evaluate

An Introduction to Enhanced IC Pathways and Vertical Integration

Learning Objectives:
  • Define horizontal and vertical integration
  • Examine how vertical integration, as a strategy, could be applied in the practice setting for special populations

System to Local Transformation

Learning Objectives:
  • Review national and state/local initiatives related to PCBH implementation
  • Identify how PCBH implementation aligns with system-wide transformation of health care
For Behavioral Health Providers
This section was specifically developed for our behavioral health care partners. These topics were originally conducted as live, interactive webinars. The recordings of these live webinars are now archived in this section.

Getting Started in Integration: Your Mission, Vision, and Scope

Learning Objectives:
  • Identify specific language to include in a mission and/or vision that includes integrated care.
  • Understand the difference between vertical versus horizontal integration.
  • Understand factors to consider when defining the scope of services

Joint Treatment Planning

Learning Objectives:
  • Define joint treatment planning
  • Describe at least 2 logistical challenges of joint treatment planning
  • Identify 1 area of growth for joint treatment planning at your site

Workflow, Screening Processes, and Patient Flow Through the System

Learning Objectives:
  • Explain the purpose of implementing screening processes
  • Examine own site's workflow and identify opportunities for growth
  • Understand why standardized screening processes are important to work flow.

Integration Staffing competencies

Learning Objectives:
  • State at least three competencies for medical providers in bidirectional clinics
  • State at least three competencies for therapists in bidirectional clinics
  • Develop either a training or evaluation goal for assessing staffing competencies

Data and Registries

Learning Objectives:
  • Define registries
  • Explain the purpose of data registries
  • Develop 1 strategy for starting or improving registries at own site

Preparing for Healthcare Reform

Learning Objectives:
  • Explain the movement towards value-based care
  • Discuss the changes needed and current activities which support integration in a value-based environment
  • Develop one strategy for moving towards value based care

Screening, Brief Intervention and Referral to Treatment (SBIRT) Learning Module

This module will provide an overview of the Screening, Brief Intervention, and Referral to Treatment (SBIRT) program. SBIRT is a comprehensive, integrated, public health approach to the delivery of early intervention and treatment services for persons with substance use disorders, as well as those who are at risk of developing these disorders. Participants will gain an understanding of the SBIRT program and its components, as well as have the opportunity to become certified in SBIRT through a 4-hour, online, New York State Office of Alcoholism and Substance Abuse Services (OASAS) SBIRT training.

NYS SBIRT Introduction

Learning Objectives:
  • Outline the need for SBIRT in New York State
  • Define SBIRT and identify its defining characteristics
  • Understand how SBIRT can be utilized to screen for alcohol and/ or drug use
  • Examine how SBIRT can be implemented in the ED

CPI – 4-Hour SBIRT Training Program

Here you will connect to a free, online interactive SBIRT training for healthcare professionals offered by the Center for Proactive Innovations. You will need to create a username and Password to join the CPI’s Learning Community. Upon completion of this training, licensed health professionals will be certified to administer SBIRT.

If you need registration assistance/technical assistance, please directly contact CPI at (646) 774 – 8422 or E-mail: [email protected]

Learning Objectives:
  • Define the need for drug and/or alcohol screening for all patients
  • Identify the fundamental components of SBIRT
  • Gain and understanding of evidence based screening tools for drug and alcohol use, and how to administer and score them
  • Become familiar with Motivational Interviewing techniques
  • Describe best practices for referring patients to treatment

Value Based Payment (VBP) Training

This module provides a focus on Value Based Payment Education for participating partner organizations of the Suffolk Care Collaborative. It provides an overview of the country’s health care delivery system and the goals of healthcare payment reform. This module also focuses on new models of care and payment models through value based payment and it’s alignment to population health management. Participants will gain an understanding of the Triple Aim and how the system is being transformed in order to reach this goal. Training includes understanding VBP contracting models and risk sharing arrangements and understanding performance measurement and data analytics under VBP. Emphasis is placed on the importance of coordinated care throughout the continuum and how social determinants of health can impact a patient’s health outcomes. Additional topics include preparing and performing a VBP readiness assessment and strategies to implement and sustain VBP payment models.

Value Based Payment (VBP) 101 – Introduction to VBP Reform & a Focus on Population Health Management

Learning Objectives:
  • Describe Population Health Management and the role of the Suffolk Care Collaborative
  • Describe the Triple Aim and the benefits to broader health care initiatives
  • Summarize the current status of the US health care delivery system as an impetus for moving towards value based payment models
  • Identify the key elements of Value Based Payment (VBP) efforts, including NYS Medicaid goals/ progress and the NYS VBP Roadmap

Value Based Payment (VBP) 102 – A Deeper Dive Into Value Based Payment Models

Learning Objectives:
  • Describe the basics of VBP contract levels and arrangements
  • Review the increase in risk levels related to VBP arrangements and their financial implications
  • Describe provider considerations for each VBP arrangement

Performing a VBP Readiness Assessment

Learning Objectives:
  • Role, capabilities and tools for effective population health management, including role of care management, care coordination, technology and analytics.
  • Key success factors and capabilities in a VBP arrangement including the role of the patient and care team in population model.
  • Emerging trends and challenges related to the transition to VBP.

Value Based Payment Data & Analytics – Clinical Ambulatory Services

Learning Objectives:
  • Increase provider knowledge and use of performance data to drive VBP quality, performance measures and adopt appropriate changes to practice patterns
  • Introduction to DSRIP and other relevant quality metrics (HEDIS, QARR)
  • Key considerations such as attributed lives, upside/downside risk management, panel management, impact on quality measures
  • Performance measurement and improvement
  • Introduction to the purposes of provider data exchange and analytics in creating new practice behavior
  • Introduction to individual/group practice performance scorecards/reports

Value Based Payment Data & Analytics – Community Based Services

Learning Objectives:
  • Increase provider knowledge and use of performance data to drive VBP quality, performance measures and adopt appropriate changes to practice patterns
  • Introduction to DSRIP and other relevant quality metrics (HEDIS, QARR)
  • Performance measurement and improvement
  • Role of Community Based Organizations (CBO) and required contracting under VBP
  • Types of CBO contracts and strategies for VBP to address Social Determinants of Health

A glossary containing definitions and explanations of many of the terms and abbreviations within our site is available and regularly updated on New York’s Department of Health website.

View the Glossary

Welcome to the Partner Resources area of the Learning Center. Please click on the boxes in the left hand navigational panel to access authoritative resources and opportunities for continuing education.

  • Cultural Competency
  • Health Literacy
  • Patient Experience
  • NYS DOH DSRIP Program
  • Value Based Payment (VBP)

Cultural Competency

General Cultural Competency Information

  • HHS Action Plan to Reduce Racial and Ethnic Health Disparities – “outlines goals and actions the Department of Health and Human Services will take to reduce health disparities among racial and ethnic minorities.”
  • HHS Data Collection Standards – information regarding data collection standards set by HHS for race, ethnicity, sex, primary language, and disability status.
  • NIH Cultural Respect – provides NIH’s definition of cultural respect, explains its importance, outlines NIH projects, explains national CLAS Standards, and provides additional resources.
  • GNYHA – provides numerous cultural competency resources with an easy-to-use search function
  • National Center for Cultural Competence – “provides training, technical assistance, and consultation, contributes to knowledge through publications and research, creates tools and resources to support health and mental health care providers and systems, supports leaders to promote and sustain cultural and linguistic competency, and collaborates with an extensive network of private and public entities to advance the implementation of these concepts.”
  • Multi-Cultural Resources for Health Information - National Library of Medicine
  • The National CLAS Standards – “the National Standards for Culturally and Linguistically Appropriate Services in Health and Health Care aim to improve health care quality and advance health equity by establishing a framework for organizations to serve the nation's increasingly diverse communities”
  • CLAS Standards Fact Sheet
  • Center for Linguistic and Cultural Competency in Health Care (CLCCHC) – established by the Office of Minority Health (OMH) to address the health needs of populations who speak limited English
  • National LGBT Health Education Center – provides educational programs, resources and a variety of LGBT related trainings with the goal of optimizing quality, cost-effective health care for lesbian, gay, bisexual and transgender (LGBT) people. Many of the educational LGBT trainings offer free continuing education credits to health care professionals.

Certificate Courses


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Health Literacy

General Health Literacy Information

Health Literacy Resources



Click on the icons below to learn more about the
Continuing Educational Credit opportunities these organizations offer

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Patient Experience

Improving Patient Experience

To gain a better understanding of the uninsured and Medicaid population’s experiences with providers and office staff during the course of their care, two CAHPS Clinician and Group Adult 3.0 surveys (CG-CAHPS) are administered annually.

The below resources contain strategies to improve patient experience.


Resources and Quick Links offers tools for planning a path to NYS PCMH Recognition

SCC NYS PCMH Information Flyer


Value Based Payment (VBP)

NYS Department of Health VBP University

VBP University is designed to be an academic resource to raise awareness, knowledge and expertise in the move to VBP.

Watch New York State Medicaid Director, Jason Helgerson, give an overview of VBP University here.

VBP University Curriculum Freshman Year:
  • Semester 1 of VBP University is designed to be a foundational curriculum for VBP. This semester gives an overview of the different levels of risk within VBP and the different VBP contract arrangement types.
  • Semester 2 of VBP University is designed to explain topic specific information around categories of importance in VBP including governance, stakeholder engagement, business strategy, finance and data. The Semester 2 curriculum also includes provider specific information that details their role in VBP.
  • Semester 3 is designed to educate users on specific, important topic areas in the move to VBP. Topic areas include Social Determinants of Health, Community Based Organizations and Contracting VBP. The curriculum for semester 3 includes videos on each of the topics as well as detailed guidance document targeted towards MCOs, Providers and Community Based Organizations.

Click here to access Freshman Year.

VBP University Curriculum Sophomore Year:

  • Semester 1 of VBP University is designed to serve as a deeper dive into VBP fundamentals and includes, VBP Bootcamp course summaries, information on the Medicare Access & Children´s Health Insurance Reauthorization Act (MACRA), guidance for Chief Medical Officers (CMOs), and guidance for addressing social determinants of health through VBP.
  • Semester 2 of VBP University is designed to provide additional guidance related to Behavioral Health and Substance Use Disorder (SUD) in the context of Value Based Payments (VBP). Behavioral Health services and services to address SUD play critical roles in the strengthening of provider networks to improve health outcomes and create efficiencies. In many cases, strong links between physical health and Behavioral Health services, including SUD services, will establish provider networks that are truly capable of spanning the complete spectrum of care for an individual. The content contained within this release is intended to supplement VBP U's recent rollout and focuses on the five key principles of Behavioral Health.

Click here to access Sophomore Year.

True Population Health in the Context of Value Based Payment (VBP)

This material was presented by Ryan P. Ashe, Director of Medicaid Payment Reform at the NYS Department of Health, at Suffolk Care Collaborative’s Quarterly Project Advisory Committee meeting, September 20, 2018.

Learning Objectives:
  • Update on Value Based Payment progress
  • NYS VBP Model and Population Health
  • Social Determinants of Health / Community Based Organization VBP Roadmap Requirements
  • Considerations as VBP Moves Forward

Click here to view the PowerPoint Presentation.

Value Based Payment Quality Measures

As outlined in the VBP Roadmap, the State has established a common set of quality measures for each VBP arrangement based on national standards and the recommendations from the Clinical Advisory Groups, Technical Design Subcommittees and approved by the VBP Workgroup.

The following Quality Measure Sets provide the listing of measures for the 2019 VBP contracting year including all Category 1 and Category 2 measures.

VBP Bootcamp slide decks and supplemental materials presented at VBP Bootcamps can be found here.

VBP Bootcamp Webcast Recordings from the Albany session are available.
To access you must first register to view the recordings by clicking this link.

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