The SNV HUB:

• Pairs community members with certified CHWs trained in the Pathways Community HUB Institute® Model (PCHI Model) who meet regularly with clients, build relationships, and assess needs and risks based on 21 Standard Pathways. CHWs help clients develop a personalized care plan based on identified risks and needs and use Pathways Learning Modules to help clients learn how they can improve their health.
• Uses an outcomes-oriented framework for identifying and mitigating health-related social needs. Outcome criteria for each Pathway are defined within the PCHI Model, and Pathways remain open until a participant’s need is met according to the outcome criteria.
• Has established a care-coordination network in Clark County to streamline and coordinate referrals across agencies to ensure a “no wrong door” to services.
• Uses a standard approach to screening and data collection to support monitoring of risk factor mitigation and bidirectional communication.