1. Poster Session Instructions You may use your organization’s own PowerPoint template Limit the number of slides to a total of 9 Use the following slides as a template for content Submit slides in electronic format to hannahm@thenationalcouncil.org by May 2, 2012hannahm@thenationalcouncil.org CIHS staff will then prepare the poster boards for each grantee In addition, please bring an example of something you've developed as a result of the PBHCI program, such as an issue of a wellness newsletter, training materials or curriculum, a clinical workflow for how clients are recruited/referred into the program, program one-pager for new staff orientation, health history, etc. Please bring 64 copies so that each of your fellow grantees receive one. The materials should be given to CIHS staff when you check-in at the Grantee Meeting registration desk on Wednesday.

2. PBHCI Program Name/Title Grantee Organization Primary Care Partner (if applicable) Cohort Learning Community Region City/State Contact Information Slide 1

3. Please provide a brief description of your organization’s PBHCI initiative including the following: Integration model Strategies used to incorporate primary care Enrollment target Special populations served Whether you are in an urban, rural, or suburban setting Wellness services offered Use of peers EHR vendor Any other unique information Slides 2-3 About Our Program

4. Who We Are Please describe your staffing: Who makes up your team o Functions/roles o Disciplines Are team members employees or partners contracted to be part of team? Provide a picture of your team Slide 4

5. Successful Strategies From the topics below, choose up to 3 and describe a strategy within each topic you have found effective: Describe the strategy Describe the results/outcomes o If possible include data o Anecdotal stories may also be included Topics from which to choose: (please list the topic in the slide header) Enrollment/ReassessmentFinance/Sustainability HITTeam Building/Organizational Engagement TobaccoOther Wellness Engaging Peers Slides 5-8

6. Plans for the Future Please provide 1-2 next steps around the following areas: Sustainability o Clinical o Administrative o Financial Health Home activity (if applicable) Accountable Care Organization activity (if applicable) What you hope to accomplish within the next six months Slide 9