activities · 21
what they do
direct service · 14
- Behavioral health services Integrated Behavioral Health ServicesOffers behavioral health care through provider referrals or patient self-referral, with initial intakes conducted by Behavioral Health Case Managers in 60–90 minute sessions to assess needs and coordinate ongoing care.
- Behavioral health services Integrated Behavioral Health ServicesOffers behavioral health care through provider referrals or patient self-referral, including 60–90 minute intake assessments conducted by Behavioral Health Case Managers to evaluate patient history and care needs.
- Behavioral health services and intake Integrated Behavioral Health ServicesOffers behavioral health services accessible via provider referral or patient request, with initial intake visits conducted by a Behavioral Health Case Manager lasting 60–90 minutes to assess patient history and care needs; supported by care management teams for scheduling and coordination.
- Chronic disease and care coordinationProvides care coordination led by Registered Nurse Care Coordinators at all sites, with a focus on managing chronic diseases and supporting patients after hospitalization.
- Community health and wellness centersOperates two wellness-focused health centers—HealthOn Broadway and HealthOn University—that deliver primary care, health education, and wellness coaching to the community.
- Community health navigationDeploys Community Health Advisors at all locations to help patients with registration, health insurance enrollment, and accessing social support services such as food, housing, and legal aid.
- Community health navigation and care coordinationDeploys Community Health Advisors at all locations to assist patients with registration, health insurance enrollment, and access to social support services, and employs Registered Nurse Care Coordinators to manage care for chronic diseases and post-hospitalization needs.
- HIV/AIDS and Hepatitis C specialty careOperates the largest HIV/AIDS medical and behavioral health care program in Southern Arizona and runs a dedicated Hepatitis C clinic offering medical treatment, education, and support groups.
- Integrated primary and preventive healthcare services Integrated Behavioral Health ServicesProvides comprehensive medical care including preventive and wellness services, acute sick care, and chronic condition management for adults aged 18 and older through multidisciplinary patient-centered teams that include medical, dental, behavioral health, and support staff.
- Integrated primary and specialty health services Integrated Behavioral Health ServicesProvides comprehensive medical, dental, behavioral health, and support services through multidisciplinary, patient-centered teams at multiple health center locations, including preventive care, acute sick visits, and chronic disease management for adults.
- Integrated primary and specialty health services Integrated Behavioral Health ServicesProvides comprehensive medical, dental, behavioral health, and support services through multidisciplinary, patient-centered teams at multiple health center locations.
- Operation of community health and wellness centersOperates two health and wellness centers—HealthOn Broadway and HealthOn University—that provide primary care, health education, and wellness coaching to community members.
- Patient support and care coordinationDeploys Community Health Advisors at all sites to assist with registration, insurance enrollment, and access to social services, alongside Registered Nurse Care Coordinators who manage post-hospitalization follow-up and chronic disease care.
- Specialty care for Hepatitis C and HIV/AIDSOperates a Hepatitis C clinic offering medical care, education, and support groups, and serves as the largest provider of HIV/AIDS medical and behavioral health care in Southern Arizona.
advocacy · 3
- Health advocacy leadership Healthcare Quality Recognition & AccreditationMaintains sustained advocacy engagement through the National Association of Community Health Centers Advocacy Center of Excellence (ACE) Program, achieving Gold status for commitment to health center advocacy.
- Health center advocacy leadership Healthcare Quality Recognition & AccreditationAchieved Gold status in the National Association of Community Health Centers Advocacy Center of Excellence (ACE) Program, reflecting sustained organizational commitment to health center advocacy at the national level.
- Organizational excellence and advocacy recognition Healthcare Quality Recognition & AccreditationAwarded Gold status by the American Medical Association’s Joy in Medicine program and the National Association of Community Health Centers Advocacy Center of Excellence, reflecting systemic achievements in staff well-being and policy advocacy.
capacity building · 4
- Capacity building through health center recognition and performance Healthcare Quality Recognition & AccreditationRecognized by HRSA as a Health Center Quality Leader and for Advancing Health Information Technology (HIT) for Quality, and received gold-level recognition from the American Medical Association’s Joy in Medicine program, demonstrating leadership in healthcare quality, technology, and organizational excellence.
- Health center quality and performance recognition Healthcare Quality Recognition & AccreditationRecognized by HRSA as a Health Center Quality Leader and for Advancing Health Information Technology (HIT) for Quality, demonstrating leadership in healthcare quality metrics and use of technology to improve outcomes.
- Health center quality and performance recognition Healthcare Quality Recognition & AccreditationRecognized by HRSA as a Health Center Quality Leader and for Advancing Health Information Technology for Quality, demonstrating leadership in clinical performance, data management, and health IT utilization.
- Organizational excellence and peer recognition Healthcare Quality Recognition & AccreditationAchieved gold-level recognition from the American Medical Association’s Joy in Medicine program and ranked above peers in areas including data management, population health, and patient engagement across nearly 48,000 U.S. healthcare facilities.
strategies · 18
how they think
Theories of action extracted from this org's own source material. Click any to see the full field of orgs running the same approach.
- Community-Based and Locally Led Care Delivery community-based care deliveryHealthcare services are brought directly into local neighborhoods through a community-based, locally governed model that emphasizes accessibility, cultural responsiveness, workforce development, and patient empowerment.
- Community-based care delivery and local empowerment community-based care deliveryIncreases access and engagement by bringing services directly into neighborhoods through a locally governed and operated model that emphasizes workforce development, economic sustainability, and patient empowerment.
- Community-based care delivery and local empowerment community-based care_deliveryIncreases access and engagement by bringing services directly into neighborhoods through a locally governed and operated model that emphasizes community stewardship, workforce development, and patient empowerment.
- Comprehensive Community Care Mission comprehensive_community_careImproves community health through accessible, affordable, quality, and compassionate care, reflecting a broad mission orientation without a distinct operational mechanism beyond other stated models.
- Comprehensive Primary Care integrated_primary_careProvides integrated adult primary care that includes preventive, acute, and chronic care services, forming the foundation of accessible, continuous, and quality health delivery.
- Comprehensive primary care model integrated_primary_careOffers integrated adult primary care that combines preventive, acute, and chronic care services within a patient-centered medical home framework to support long-term health outcomes.
- Comprehensive primary care with preventive focus integrated_primary_careOffers integrated adult primary care that combines preventive, acute, and chronic care services to support long-term health and early intervention.
- Integrated Care Model integrated_care_modelThe organization uses an integrated care model where primary care, behavioral health, and specialty services are co-located and collaboratively delivered to address the full spectrum of patients' physical, mental, and emotional health needs within a unified, patient-centered setting.
- Integrated, patient-centered care model integrated_care_modelDelivers comprehensive care by co-locating primary care, behavioral health, and specialty services in a unified, interdisciplinary setting to address physical, mental, and social health needs through coordinated, whole-person care.
- Integrated, patient-centered care model integrated_care_modelDelivers comprehensive care by co-locating multiple health services and disciplines, including primary care and behavioral health, in a unified setting to address the full spectrum of physical, mental, and emotional health needs through interdisciplinary teamwork and culturally responsive engagement.
- National Model for Healthcare Excellence national_model_healthcareThe organization aims to serve as a national model for high-quality healthcare delivery by demonstrating scalable, effective, and compassionate care practices.
- National model for healthcare excellence national_model_healthcareStrives to set a national standard for high-quality, compassionate healthcare delivery through innovation, accessibility, and comprehensive service integration.
- Patient-Centered Team-Based Care patient-centered_team_careCare is delivered through interdisciplinary, team-based approaches that prioritize patient goals, shared decision-making, and holistic assessments, with seamless escalation to specialty services when needed.
- Patient-centered, team-based care planning patient-centered_team_careEngages patients in collaborative goal setting and care planning using interdisciplinary teams, ensuring whole-person care with timely escalation to specialty services as needed.
- Specialty Behavioral Health Integration specialty_behavioral_healthSpecialty behavioral health services, including medication management and talk therapy, are embedded within the care model to support mental health and life challenge resolution as part of comprehensive care.
- Specialty behavioral health integration specialty_behavioral_healthProvides comprehensive mental health care through licensed professionals who deliver medication management and talk therapy as part of an integrated care system to resolve mental health conditions and life challenges.
- Specialty behavioral health integration specialty_behavioral_healthProvides comprehensive mental health support through licensed professionals who deliver medication management and talk therapy, embedded within primary care to ensure holistic treatment.
- Team-based, patient-centered care planning patient-centered_team_careEngages patients in collaborative goal setting and care planning using interdisciplinary teams that include primary care and behavioral health professionals, with access to specialty services when needed.
named programs · 7
what they call their work
Chronic Pain Management
Interdisciplinary approach to chronic pain including functional, clinical, emotional, and lifestyle assessments; participates in national innovatives for team-based care
Community Health Advisors (CHA) Program
Supports patients with insurance enrollment (AHCCCS, ACA), sliding fee scale, and access to social services including housing, food, legal aid, and domestic violence support
HIV/AIDS Care Program
Comprehensive medical and behavioral health services for people living with HIV/AIDS; largest provider in Southern Arizona
HealthOn Tucson
Integrated health and wellness collaboration with Tucson Medical Center offering primary care, health education, and wellness coaching at downtown and university locations
Hepatitis C Clinic
Specialized clinic offering treatment, education, and support groups for patients affected by Hepatitis C
Integrated Behavioral Health
Team-based care integrating primary care and behavioral health professionals to address mental health, substance misuse, chronic disease, and life stressors; includes Behavioral Health Consultants and Specialty Behavioral Health services
RN Care Coordination
Nurse-led care coordination for patients post-hospitalization or with chronic conditions to ensure follow-up care, medication management, and education
relationships · 6
who they work with
- American Medical Association Partner — Recognized by the AMA through its Joy in Medicine Health System Recognition Program with gold status.
- Health Resources and Services Administration Government — Recognized by HRSA as a Health Center Quality Leader and for Advancing HIT for Quality.
- National Association of Community Health Centers Network — Participant in the NACHC Advocacy Center of Excellence (ACE) Program, achieving Gold status.
- National Collaboratives Coalition — Participant in national collaboratives focused on innovative, team-based pain management practices.
- The Joint Commission Government — Accredited by The Joint Commission, reflecting adherence to national healthcare performance standards.
- Tucson Medical Center Partner — Co-founded HealthOn Tucson, a collaborative health and wellness initiative with El Rio Health.