What is a Community Health Team?

Through your Community Health Team (CHT), you now have a variety of skilled health care professionals available to assist you with the tools and support you need to reach your personal health goals. Based on your individual needs, they work with you to assess your situation, develop plans, and establish attainable goals that move you in the right direction, one step at a time.

When you receive your care at one of our nationally certified medical homes, you gain access to a wide range of integrated health care services. This is especially helpful if you need assistance managing a chronic health condition.

In addition to your overall health needs, your CHT can help you in many other areas, including: financial, insurance, emotional, educational, substance abuse, transportation, and/or physical assistance.

James Leonard quote

Who is the Community Health Team at BMH?

Our team has experts in many areas who will work with you, one-on-one in the office and/or home. We also work closely with your primary care doctor. Team members include:

  • Behavioral Health Specialist – Provides behavioral health risk assessment and brief interventions to overcome barriers so patients can make healthier lifestyle changes. Helps with finding long-term therapy, if needed.
  • Care Coordinator, RN – Helps access services, manage medications, and makes sure that patients are getting the care that they need.
  • Certified Diabetes Educator, RN & RD – Provides education and support for patients managing diabetes.
  • Health Coach – Helps patients design and implement an individualized nutrition and exercise plan to help with weight loss and/or chronic disease management.
  • Registered Dietitian/Nutritionist – Provides nutrition and lifestyle counseling for diabetes, hypertension and high cholesterol, kidney disease, food allergies, food medication interactions (i.e., Coumadin), intestinal disorders such as irritable bowel, Crohn’s disease, colostomies, patients planning to undergo bariatric surgery and those with other complicating medical factors (e.g. feeding tubes, cancer nutrition therapy).
  • Pediatric Care Coordinator – Provides case coordination and refers children and their families to needed community services.
  • Scheduler/Assistant – Assists with scheduling initial patient appointments, any follow-up visits, or appointment changes.
  • Self-Management Coordinator – Helps patients quit smoking and manage chronic health conditions through topic specific workshops.
  • Clinical Social Worker – Helps connect patients with services they need, including disability benefits, housing, elder care, support for end of life issues, Medicare enrollment, legal referrals, transportation assistance, and stress reduction groups.

The Community Health Team offers the following services:

  • Chronic Disease Management
  • Connection to Community and Financial Resources
  • Diabetes Education
  • Health Education
  • Medication Management
  • Mental Health/Substance Abuse Assessments and Brief, Client Centered Treatment
  • Nutrition and Exercise Education and Counseling
  • Weight Management
  • And Many More!

Contact us today at 802-251-8604