address conflicts and disincentives related to chronic care management and behavioral health management and differential treatment of inpatient and outpatient settings. (G) Mitigating the incidence of admission and readmission into psychiatric inpatient settings of chronically ill elderly patients through methods such as active inpatient management, variations in initial length of stay, enhanced discharge planning, and psychosocial interventions. (H) Delivering health behavior assessments and interventions to improve physical health outcomes for patients and aid in the management of chronic health conditions. (I) In coordination with law enforcement agencies and judicial entities, interventions targeted at providing mental and physical health services (including, as appropriate, substance use disorder services) to individuals convicted of criminal offenses for purposes of mitigating recidivism. (4) Innovations addressing social determinants of health The term innovations addressing social determinants of health means innovations implemented by an eligible hospital that seek to address social determinants of health that negatively impact the health outcomes of applicable individuals, including the following: (A) Improvements in electronic health records to better integrate mental health, medical care, and social care (such as screening for social factors, facilitated or closed loop referral, risk stratification, and shared records with community-based organizations). (B) Personnel-supported wrap around services for at-risk individuals with mental and physical health comorbidities (such as nutrition and diet counseling, social services referral, respiratory therapy, medical-legal assistance, financial counseling, consumer education, pharmacy education, asthma education, and referral to food resources such as referral to the SNAP program, the WIC program, a food bank, case management assistance, employment or education support, intimate partner violence, and behavioral health support). (C) Home and community-based