The PA SBIRT Initiative

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1 Issue 2, July 2018 PA SBIRT Newsletter Page 1: IN THIS ISSUE: The PA SBIRT Initiative Page 2: Progress Report Quarter Recap The PA SBIRT Website Page 3-4: Project Site Spotlight: Sharon Medical Group, Mercer County Page 5: SBIRT in the News Message from the Program Director Contact Information PA SBIRT is funded by the Substance Abuse and Mental Health Services Administration: SAMHSA, TI For more information: Dianne Schrode Welcome! Welcome to the second issue of the PA SBIRT Newsletter, a quarterly publication dedicated to the PA SBIRT initiative. In this and future issues, we will feature: progress reports, quarter recaps, PA SBIRT Project Site spotlights, and more. We hope that you find this information helpful and encourage you to share! The PA SBIRT Initiative (PA SBIRT) is a five-year initiative that will provide SBIRT services to over 20,000 patients throughout the Commonwealth. SBIRT is a comprehensive and integrated public health approach to the delivery of screening, early intervention, and treatment services employing empirically-based and clinically useful practices to circumvent harmful consequences from substance use. The PA SBIRT Vision: To ensure that every patient in our primary care clinics receives the right screening, brief intervention, and referral to treatment (SBIRT) services by the right providers every time. The project is directed by the Pennsylvania Department of Drug and Alcohol Programs (DDAP) and The University of Pittsburgh School Of Pharmacy, Program Evaluation and Research Unit (PERU). Funding for the project is granted through the Substance Abuse and Mental Health Services Administration (SAMHSA) Center for Substance Abuse Treatment (CSAT). All data is collected and reported in accordance with the Government and Performance Results (GPRA) Act of The PA SBIRT Team would like to thank the staff of participating project sites and SCAs, who dedicate their time and effort to ensure that every patient receives the right SBIRT services every time.

2 Progress Report To date, the PA SBIRT initiative has partnered with four healthcare sites in Pennsylvania, EMPOWER 3 Center for Health, Altoona Family Physicians, and UPMC Pregnancy Care Center in Blair County and Sharon Medical Group in Mercer County. Together, these sites have provided SBIRT services to a total of 4,134 unduplicated patients, conducted 839 brief interventions, and connected 167 patients to treatment services. The PA SBIRT Implementation Team is actively working to partner with additional healthcare sites, and SBIRT services will soon begin at Forbes Family Medicine in Allegheny County. Sharon Medical Group has provided 294 brief interventions and connected 13 patients to treatment. EMPOWER 3 has provided 503 brief interventions and connected 154 patientsto treatment. Altoona Family Physicians provided 40 brief interventions during its first two weeks of implementation. Quarter Recap UPMC Pregnancy Care Center provided 2 brief interventions during its first two weeks of implementation. Month Trainings Deliverables April 2018 May 2018 Sharon Medical Group Site Visit and Booster Training: SBIRT and Cannabis Use, Care Coordination EMPOWER 3 Site Visit: Strategic Planning Altoona Family Physicians (AFP) Site Visit: Clinical Training UPMC Pregnancy Care Center (PCC) Site Visit: Clinical Training March Monthly Data Report Sharon Medical Group Plan-Do-Study-Act Activity Tracker SAMHSA Semi-Annual Report April Monthly Data Report Sharon Medical Group Site Visit Report Policy Steering Committee Meeting Report AFP/PCC Organizational Health Assessment AFP/PCC SBIRT Workflow Protocols June 2018 EMPOWER 3 Site Visit Report AFP/PCC Site Visit Report May Monthly Data Report! THE PA SBIRT WEBSITE: PA SBIRT is developing a website that will expand the visibility of the initiative, encourage collaboration among project partners and experts in the field, highlight implementation and evaluation efforts, and share evidence-based educational materials and clinicaltools. Stay tuned for more information! 2

3 Project Site Spotlight: Sharon Medical Group Sharon Medical Group is a part of Primary Health Network (PHN) and is located in Mercer County. PHN has become one of the largest Federally Qualified Health Centers in PA, and each of its 37 sites are located in a designated health professional shortage area. One of PHNs strategic goals is to work towards integrating primary and behavioral health by utilizing SBIRT and other evidencebased practices. PHN and Sharon Medical Group are committed to changing attitudes, enhancing knowledge, modifying behaviors, and increasing awareness about substance misuse in primary care and community health settings. PHN and Sharon Medical Group are dedicated to a partnership with PA SBIRT, enabling the expansion of screening and brief intervention, and supporting cross-systems collaboration and coordination by making treatment resources readily available and increasing access to treatment. Sharon Medical Group began SBIRT services on September 5, Screening is conducted by the SBIRT Medical Office Assistant (MOA). The SBIRT MOA escorts the patient from the waiting room, and completes demographic information and initial screening questions in the EHR. A full screen with the Alcohol Use Disorder Identification Test (AUDIT) and/or the Drug Abuse Screening Tool (DAST-10) and/or the Cannabis Integration Screener (CIS) is completed in the electronic health record for all patients that score positive during the initial screen. Brief Interventions are conducted by the provider using the Brief Negotiated Interview (BNI). Referrals to specialty care are completed by the SBIRT Care Coordinator, hired through the Mercer County Behavioral Health Commission and co-located in the Sharon Medical Group facility. Due to dedication of the staff, the site regularly screens over 98% of patients each week. During the first nine months of implementation, Sharon Medical Group has screened 2,377 total patients (including duplicate screens). These screens align closely with the national average, as 86% of patients score within the screening and feedback range, 12% score in the brief intervention range, and the rest in the referral to treatment ranges. Sharon Medical Group has provided 294 brief interventions and 13 referrals to treatment. Partnership with Mercer County Behavioral Health Commission Sharon Medical Group has partnered with Mercer County Behavioral Health Commission (MCBHC) to facilitate referrals to treatment. Tracy Bornick, MCBHC s Central Intake Coordinator, remarked We are pleased about the SBIRT Project at Primary Health Network and the accomplishments thus far. It is my hope that substance abuse screenings can be implemented in every single primary care office, not only in Mercer County and Pennsylvania, but Nation-wide 3

4 Meet the Team: Sabrina Donner Meet the Team: Ronald Malmfeldt Sabrina Donner is a drug and alcohol case manager with Mercer County Behavioral Health Commission. She is currently serving as the SBIRT Care Coordinator at Primary Health Network Sharon Medical Group. Sabrina is a graduate of Pennsylvania State University with a Bachelor s degree in Human Development and Family Studies and of Youngstown State University with a Master s degree in Social Work. Sabrina has 4 years of experience as a drug and alcohol case manager where she assesses individuals to determine level of care recommendations and assists individuals in various stages of recovery in accessing community resources. Ronald Malmfeldt is a Medical Office Assistant with the Primary Health Network. He is currently serving as the SBIRT staff MOA for the Sharon Medical Group. Ronald is a graduate of Youngstown State University with a Bachelor s degree in Exercise Science. He has also recently completed DDAP Motivational Interviewing Training. Ronald has assisted with the implementation of the SBIRT program at PHN where he continues to assist patients in the beginning phase of their recovery. Story of Success: SUD Treatment Universal screening for substance use disorders at Sharon Medical Group has led to the successful connection of 13 patients to SUD treatment services. Sharon Medical Group strives to screen every patient at every visit, because they recognize that substance use behaviors can change at any time and that they must normalize the conversation surrounding substance use. By normalizing the conversation, they have seen patients open up to discussion over time. One patient shared I was just talking to my son about my alcohol use yesterday. I know I need to cut back. I am so thankful for this [SBIRT] today. This is another sign that it is time for me to get healthy and take my use [alcohol] seriously. I am thankful that there are programs like this that help intervene. The patient scored in the brief treatment range for alcohol use, was assessed by the Care Coordinator, and is now enrolled ina 1A-Outpatient level of care. 4

5 The Pennsylvania Department of Drug and Alcohol Programs (DDAP) Dianne Schrode PA SBIRT Project Officer and Drug and Alcohol Program Manager Terry Matulevich Director, Bureau of Administration and Program Support Jodi Skiles Director, Bureau of Treatment, Prevention and Intervention The University of Pittsburgh, Program Evaluation and Research Unit (PERU) Dr. Janice Pringle PERU Director Alexandra Nowalk SBIRT Program Director SBIRT in the News Screening, Brief Intervention, and Referral to Treatment in the Emergency Department: An Examination of Health Care Utilization and Costs While implementing SBIRT services in emergency departments has gained much interest, the literature remains inconclusive as to whether such services are effective in reducing health care costs and utilization. A recent study evaluated health care costs and utilization of patients who received SBIRT services in an ED located in Pennsylvania. Researchers employed a retrospective analysis of a quality assurance intervention, in which they compared a group of adult patients that received ED SBIRT services with three control groups that did not. It was found that patients who received SBIRT services experienced a reduction in health care costs and ED visits. Pringle, J. L., Kelley, D. K., Kearney, S. M., Aldridge, A., Dowd, W., Johnjulio, W.,... & Lovelace, J. (2018). Screening, Brief Intervention, and Referral to Treatment in the Emergency Department: An Examination of Health Care Utilization and Costs. Medical care, 56(2), Thank you merci 谢谢 شكرا gracias cảm ơn bạn The Implementation Team would like to thank the Vietnamese Student Association of the University of Pittsburgh as well as PERU employees (Ashley Narvaez, Ryan Stept, Reina Wang, and Vanessa Baaklini) who translated PA SBIRT material into Spanish, French, Chinese, Arabic, and Vietnamese. With these materials, we can ensure that every patient seen at PA SBIRT project sites receives the right SBIRT services every time. Abby Talbert PA SBIRT Project Coordinator alt108@pitt.edu Vanessa Baaklini PA SBIRT Research Specialist vab53@pitt.edu Alec Howard Research Specialist ajh178@pitt.edu Angelique Ogunsemowo PA SBIRT Research Assistant aao34@pitt.edu 5