Amy Pepin, MSW, LICSW, CPS JSI Research & Training, Inc. - PowerPoint PPT Presentation

Amy Pepin, MSW, LICSW, CPS JSI Research & Training, Inc. December 2 nd , 2015 Behavioral Health is Essential to Health Prevention Works | Treatment is Effective | People Recover

New Hampshire

First in the Nation “Nobody would know that, but New Hampshire has a huge heroin A Heroin Epidemic in problem.” “You have to educate and you have to do something New Hampshire Is very strong, but it does have a big problem, I’ve been hearing Our Best Chance to it from everybody.” – Donald Trump Get Politicians to “New Hampshire’s got its issues, but so Talk About Addiction does New Jersey and so does Iowa, and places I’ve been visiting have all been “You talk about New Hampshire for a experiencing the same thing. This is an moment. One of the stories that has not epidemic in our country,” – Governor been as reported nationally, is the fact Chris Christie that many of the people who today are “This is a disease, this is a chronic dependent on heroin, is because they condition that has to be interrupted and became dependent on prescription treated and prevented if possible.” – opiates,” Senator Marco Rubio Hillary Clinton

Strategic Planning

• Funding - Vision and Leadership • Conrad N. Hilton Foundation • Policy - Advocacy and education • Provider partners - 7 organizations • 15 primary care sites • Program - Training and Technical Assistance 6

Funding Parameters May be used to… May not be used to… Prepare for and implement Cover new or additional SBIRT: staff which will be devoted to ongoing SBIRT activities – EMR modifications that will continue beyond the – Workflow improvements or enhancement grant period – Cover staff time devoted to learning, business practice adjustments, and initial implementation

Participant Requirements • Form an interdisciplinary Implementation Team that meets regularly and participates in: • 4-6 hour face-to-face meetings 2-3 times/year • Monthly 1.5 - 2 hour webinars addressing SBIRT implementation issues • Share lessons learned • EMR in place • Integrated behavioral health/SUD services in place, or commit to develop partnerships • Quarterly data reporting

Participant Benefits • Member of a Community of Practice • Training and individualized TA • Sharing across grantees “Implementing SBIRT has not “It is really exciting to work on only helped our patients, but something like this that is so changed the way we practice: It needed in a community like has led to formalizing protocols ours.” and training and program evaluation agency-wide.”

Training and Technical Assistance • Action Learning Collaborative • Webinars • Teleconferences • Training • Consultation • Facilitation • Presentations • Annual Statewide Summit • Playbook • www.sbirtnh.org 10

Open-Source Webinar Series

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Screening Tools S2BI CRAFFT

Brief Intervention • BI is patient-centered – • A brief intervention is a your goal is dependent on short, motivating each patient’s conversation in response circumstances and to screening results - preferences – change is a typically 3-7 minutes. process over time. • BI utilizes motivational interviewing techniques , you do not need to be an • The patient has the best expert - primarily being idea in the room – listen. done by primary care providers.

Implementation Checklist 17

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Coverage • 7 Provider organizations o 15 primary care clinic sites o Pediatric practices o Family medicine practices o FQHCs • Screened 2,000 youth to date • On track to meet goal of 10,000 by 2017 19

Critical Success Factors & Challenges • Team • Patient Confidentiality • Role of the Primary Care Provider

Team • Buy in from key leadership • Representation across disciplines and clinical flow • Meet regularly for learning and decision making 21

• Perceived barrier • Actual barrier • Approaches • Tools and resources www.sbirtnh.org 22

• Crucial to flow of process • Ideally conducts BI • Creates environment to address alcohol and drug use as a health issue • Follows up • Screens across lifespan 23

Evaluation Measure Numerator Denominator % of youth who screened as no total # of youth who completed total # of youth aged 12-22 seen current use screen during wellness checkup (or for wellness checkup (or similar Components similar annual exam or visit) annual exam or visit) % of youth who screened as no # youth screened no current use # youth screened current use • on CRAFFT, “no” to all questions on Part A • Metrics were designed in • on S2BI, “never” to first three questions % of youth screened as being at risk # youth identified at risk through the # youth screened collaboration with Abt • on CRAFFT, any “yes” screening process answer on Part A • on S2BI, any answer greater Associates than “never” on the first three questions % at risk youth who received BI/BA # at risk youth who received BI/BA # youth identified as being at risk % at risk who need referral # at risk youth who need referral for # youth identified as being at risk • 9 metrics • CRAFFT score ≥2 on Part B treatment (line 11) • S2BI, weekly use of any substance For organizations with internal # at risk youth who received a # at risk youth who need referral • Patient Survey behavioral health services: referral for treatment to internal for treatment (line 17) behavioral health services % who need a referral who received a referral For organizations with internal # at risk youth who received a # at risk who need a referral to behavioral health services referral to external behavioral health treatment services % at risk who received a referral to external behavioral health services For organizations WITHOUT internal # at risk youth who received a # at risk youth who need referral behavioral health services: referral for treatment to external to treatment (line 17) % at risk who received a referral to external behavioral health services # At risk youth who received BI/BA N/A N/A were followed up by PCP # At risk youth referred for treatment N/A N/A who were followed up by PCP

Sustainability Categories • Social – Organizational buy-in – Provider champions • Environmental – Flow Modifications – EMR Modifications – “It’s just what we do” • Financial – Reimbursement

Active SBIRT Initiatives in NH Initiatives Target Population Sites Funders NH Youth SBIRT Youth and Young 7 grantees NH Charitable Foundation Initiative Adults organizations Conrad N. Hilton Foundation (ages12-22) x 15 sites Community • Adults (ages 18-65) 18 sites NH Bureau of Drug and Health Centers • Pregnant women Alcohol Services Inter- Health professions 11 institutions SAMHSA professional students – nursing, Education social work, medical Collaborative assistant, and (NH AHEC) doctor.

Questions?