University of San Francisco California
The Accountable Health Communities Health-Related Social Needs Screening Tool
Centers for Medicare & Medicaid Services
This tool was developed for use in the Center for Medicare and Medicaid Innovation's Accountable Health Communities (AHC) Model. The original version, published in May 2017, included 10 questions covering five domains: housing instability, food insecurity, transportation difficulties, utility assistance needs, and interpersonal safety. An updated and expanded version was released in January 2018 that modified the original questions slightly and added 8 supplemental domains: financial strain, employment, education, family and community support, physical activity, substance use, mental health, and disabilities.
The Accountable Health Communities Health-Related Social Needs Screening Tool. Baltimore, MD: Centers for Medicare & Medicaid Services; 2018. https://innovation.cms.gov/Files/worksheets/ahcm-screeningtool.pdf.