National Screening, Brief Intervention & Referral to Treatment • Addiction Technology Transfer Center
Needs Assessment Report Dawn L. Lindsay, PhD April, 2016
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Prepared/Copyright @ 2015 by: National Screening, Brief Intervention, and Referral to Treatment Addiction Technology Transfer Center (National SBIRT ATTC); Institute for Research, Education and Training in Addictions (IRETA); 611 William Penn Place, Suite #403; Pittsburgh, PA 15219 This publication was prepared by the National SBIRT ATTC under a cooperative agreement from the Substance Abuse and Mental Health Services Administration’s (SAMHSA) Center for Substance Abuse Treatment (CSAT). All material appearing in this publication except that taken directly from copyrighted sources is in the public domain and may be reproduced or copied without permission from SAMHSA/ CSAT or the authors. Citation of the source is appreciated. Suggested citation: National SBIRT ATTC (2015). SBIRT Needs Assessment Report. Pittsburgh, PA Authors. At the time of publication, Pamela S. Hyde, JD, served as the SAMHSA Administrator. Daryl W. Kade, MA, served as Acting CSAT Director, and Suzan Swanton, MSW, served as the CSAT Project Officer. The opinions expressed herein are the views of the authors and do not necessarily reflect the official position of the Department of Health and Human Services (DHHS), SAMHSA or CSAT. No official support or endorsement of DHHS, SAMHSA or CSAT for the opinions described in this document is intended or should be inferred. Corresponding Author: Dawn Lindsay, PhD, IRETA.
[email protected]
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Behavioral Health is Essential to Health. Prevention Works. Treatment is Effective. People Recover.
Acknowledgements & Contributors The work reported in this manuscript was supported by the following cooperative agreement from the Substance Abuse and Mental Health Services Administration (SAMHSA): TI024239 (National SBIRT ATTC). Views and opinions are those of the authors and do not necessarily reflect those of SAMHSA or CSAT. The authors would like to acknowledge the collaboration between the National SBIRT ATTC and NORC at the University of Chicago (NORC) which contributed to the conceptual development of the Needs Assessment project. Tracy McPherson, PhD, Senior Research Scientist at NORC, provided content expertise in instrument development and data interpretation. The authors also wish to express their appreciation to the following members of the National SBIRT ATTC Advisory Board, who provided valuable feedback in the preparation of the needs assessment instrument: Daniel Kivlahan, PhD, David Lewis, MD, Richard Spence, PhD, and Rita Vandivort-Warren, MSW. Finally, we acknowledge the important contributions of Martha Wasik for graphics and layout assistance. Contributors from National SBIRT ATTC/IRETA: Holly Hagle, PhD (Director, National SBIRT ATTC) provided content expertise, and contributed to instrument development and editing of this report. Dawn Lindsay, PhD (Evaluator, National SBIRT ATTC) directed all aspects of the needs assessment project and served as the lead writer for this report. Piper Lincoln, MS conducted data collection and analysis, and contributed to the graphics in this report. Peter Luongo, PhD provided content expertise and data interpretation. Jessica Williams, MPH provided editorial and proofreading assistance.
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National SBIRT ATTC Needs Assessment Report In the summer of 2013, the National Screening, Brief Intervention and Referral to Treatment Addiction Technology Transfer Center (National SBIRT ATTC) launched a national Needs Assessment focusing on the implementation of SBIRT services. The purpose of the Needs Assessment was to assess the current use of SBIRT in a variety of settings and to examine SBIRT implementation models. The Needs Assessment will inform the development of the National SBIRT ATTC Strategic Plan and work plan in terms of development of training and technical assistance offerings focused on SBIRT implementation at the systems level. This report will summarize the findings of the Needs Assessment. The goals of the National SBIRT ATTC are to: (1) Serve as the national subject matter expert and key resource for SBIRT; (2) Broaden ATTC scope of implementation practices and system transformation for SBIRT through the development of an SBIRT suite of services; and (3) Develop strategies to expand the workforce(s) that utilizes SBIRT and work to ensure the consistent application of the SBIRT model to ensure fidelity and sustainability. The Needs Assessment addresses the third goal by applying the results to the Strategic Plan which, among other things, seeks to increase the number of settings that are utilizing SBIRT.
Methods Development of the Needs Assessment Instrument The Needs Assessment instrument was developed to gather information about current practices in SBIRT implementation, as well as identify needs for training and technical assistance. These identified needs are aligned with what the National SBIRT ATTC could provide, to increase the likelihood that the Needs Assessment would meaningfully impact future work plans and offerings. The draft Needs Assessment instrument was developed by members of the National SBIRT ATTC staff and reviewed by several individuals from the Advisory Board. The final version of the Needs Assessment instrument was translated to a survey on surveymonkey.com and disseminated to the sample.
Identification of Target Audience and Response Rate The target audience for the Needs Assessment was past and present SBIRT grantees, including SAMHSA, NIH, HRSA and other federal organizations. It was determined by National SBIRT ATTC staff that these individuals would be more likely to have the ideal circumstances (i.e., funding) to implement SBIRT, and having had substantial experience implementing SBIRT, would be most able to reflect on SBIRT needs for the future. The National SBIRT ATTC compiled the recruitment list from the database of present or past awarded grants with SBIRT as a keyword on grants.gov. The list was filtered for relevance and to delete duplicate entries. The final recruitment list was 182 organizations. Emails were sent to the last known contact person for those organizations, as well as three reminder emails before an organization was considered to be a non-responder. The response rate distribution is shown in Figure 1 below. After removing organizations for which there was no contact information available from the potential participants, the response rate was 38/162 or 23.5%. While somewhat low, this response rate was not unexpected. Response rates for unsolicited, online surveys tend to be quite low; rates as low as 10% have been reported even among health professionals (Braithwaite et al., 2003)1.
Figure 1: Response Rate Distribution
RECRUITMENT LIST (182)
RESPONSES: (42 or 23%)
NO RESPONSE: (120 or 66%)
BOUNCED/NO EMAIL (20 or 11%)
USABLE RESPONSES [>90% COMPLETED]: (38 or 21%)
1. Braithwaite, D., Emery, J., De Lusignan, S. & Sutton, S. (2003). Using the internet to conduct surveys of health professionals: a valid alternative? Family Practice, 20(5), 545-551.
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Results Figure 2. Respondent Geographic Distribution (N=34)
Description of Participant Organizations: The map (Figure 2) represents the distribution of the respondents by zip code. There was a good representation of organizations in the Eastern half of the country, as well as several responses from the Southwest and one from the Pacific Northwest. Figure 3 below summarizes respondents’ home organization type. About half of the respondents were from university or other educational institutions and about a quarter from Single State Authority or other government organizations. Responses to the “Other” category included three private nonprofit institutions and a nonprofit integrated healthcare system.
Figure 3. Respondents’ home organization (N=38) University or Other Educational Institution Single State Authority or Other Government Organization Public Nonprofit Private for Profit Other
0% 5% 10% 15% 20% 25%
Funding for SBIRT Activities: Because the target population was past and present SBIRT grantees, the National SBIRT ATTC was interested in describing respondents’ history with SBIRT funding. Figure 4 below summarizes respondent organizations’ current funding status for providing SBIRT services. About three quarters (N=28) of the respondents indicated that they are currently receiving funding to deliver SBIRT services.
Figure 4. Respondents’ current SBIRT grant funding status (N=38) Never Been Funded 5%
Not Currently Funded
Currently Funded
21%
74%
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Funding for SBIRT Activities (continued) The remaining portion of the results will focus on the 35 respondents who reported they received funding, either in the past or currently, to deliver SBIRT services. The sample size for each question on the survey is provided. Note that for most of the questions, respondents were asked to “check all that apply” so the number of data points in the figures are typically greater than the sample size. Figure 5 below summarizes the primary sources of funding to deliver SBIRT for the funding recipients. The majority of the respondents indicated their funding was from SAMHSA, including the State Cooperative Agreements and Medical Residency SBIRT programs, as well as other CSAT projects. Another large proportion of the respondents reported NIAAA and NIDA funding.
SAMHSA
Figure 5: Respondents’ primary source of funding (N=34)
SBIRT State Cooperative Agreements SBIRT Medical Residency Cooperative Agreements Other CSAT Project
OTHER
NIH
NIAAA NIDA Other Department of Transportation (NHTSA) Centers for Disease Control and Prevention (NCIPC) Other (State Health Dept.) 0
2
4
6
8
10
12
14
16
Figure 6 below summarizes the years in which the 35 funding recipients received grant funding for SBIRT. The figure shows that current or recent grantees were most highly represented in the sample. This is likely due to the fact that recently funded members of the target population were easier to reach because contact information in grant databases were more current.
Figure 6: Number of respondents receiving grant funding for SBIRT in years since 2004 (N=35)
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Funding for SBIRT Activities (continued) Figure 7 below summarizes how long respondent organizations have been funded to provide SBIRT services. Slightly over half of the respondents reported that they have been providing SBIRT services for 1-5 years, indicating their organization is likely to be in the early to medium-term stages of SBIRT implementation.
Figure 7: Respondents’ SBIRT service tenure (N=35)
We Do Not Currently Deliver Sbirt Services 17%
Less Than 1 Year 3%
Longer Than 10 Years 14% 1-5 Years 55% 6-10 Years 11% How Long Has Your Organization Been Delivering Sbirt Services? 0%
Figure 8 below summarizes the variety of settings in which respondents were funded to provide SBIRT services. Almost 75% of the respondents have provided services in more than one setting. Hospital and primary care settings were the most common location for providing SBIRT services for the respondents. Over half indicated that they had offered services in one or both of these settings. FQHCs and university or school settings were the second most popular location to provide services. One quarter of the respondents had offered services in one or both of these locations. Two respondents indicated via ‘Other’ that they have conducted SBIRT services in HIV clinics, which was not expected.
Figure 8: Respondents’ primary setting of SBIRT implementation (N=35) Hospital Primary Care Fqhc / Rural Health Center School / College / University Community Mental Health Center Military Workplace (Eap) Criminal Justice Setting Other
0% 5% 10% 15% 20% 25%
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Funding for SBIRT Activities (continued) Figure 9 below summarizes the primary SBIRT-related activities of the 35 funding recipients. Primary activites included training, clinical services delivery, and implementation at the organizational level. Responses under the “Other” category consisted primarily of research related activities.
Figure 9: Respondents’ primary SBIRT-related activities (N=35) Training Clinical Services Delivery Implementation at the Organization Level Sustainability Planning Curriculum Development Technical Assistance Other 0% 5% 10% 15% 20% 25%
Table 1 below summarizes the behavioral health items for which respondents reported conducting SBIRT services. All respondents reported conducting screening for risky alcohol use and nearly all (94%) reported conducting alcohol brief interventions. A substantial portion of respondents reported conducting both screenings and brief interventions for illicit drug use, and to a slightly lesser extent, prescription medication misuse. Almost two-thirds of the respondents reported screening for tobacco and nicotine use (63%), less than half reported continuing with a brief intervention (43%). Finally, the least likely behavioral health item to be endorsed was depression. Only 40% of respondents reported screening for depression and/or suicidality, and 20% reported conducting brief interventions for depression and/or suicidality.
Table 1: Behavioral health items for which respondents reported conducting SBIRT services (N=35)
Screening Conducted
Brief Intervention Conducted
Neither Conducted
Risky Alcohol Use
35 (100%)
33 (94%)
2 (6%)
Illicit Drug Use
30 (86%)
27 (77%)
4 (11%)
Prescription Medication Misuse
27 (77%)
24 (69%)
5 (14%)
Tobacco and Nicotine Use
22 (63%)
24 (43%)
4 (11%)
Depression/Suicidality
15 (43%)
7 (20%)
4 (11%)
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Screening: Figure 10 below summarizes the screening tools utilized by respondents. Most frequently endorsed were the AUDIT-C, AUDIT, DAST, and PHQ for alcohol, drug use, and depresion, respectively. Responses under the “Other” category included combination screens that had been developed for the site, and/or indicated that the screen used varied by situation. No respondents indicated that they used the T-ACE (Tolerance, Annoyed, Cut don, Eye-opener for prenatal alcohol use) or MAST (Michigan Alcohol Screening Test) which were listed among the options.
Figure 10: Screening tools utilized by respondents (N=35)
Quantity/ Frequency of Consumption Screen (e.g. AUDIT-C) AUDIT (Alcohol Use Disorders Identification Test) ASSIST (Alcohol, Smoking and Substance Involvement Screening Test) Single-Item Screen (e.g. NIAAA, NIDA) DAST (Drug Abuse Screening Test) Depression Screen (e.g. PHQ-2, PHQ-9) Tobacco Screen (e.g. CDC Single-Item) Other Mental Health Screen (Suicidality, Anxiety) Site or Project Specific Screen CAGE (Cut down, Annoyed, Guilty, Eye-Opener) CRAFFT (Car, Relax, Alone, Forget, Friends, Trouble) TWEAK (Tolerance, Worried, Eye-opener, Amnesia, K/Cut Down) NIAAA Youth Alcohol Screening Guide
Figure 11 below summarizes the professional role of the individual who conducts screening services. Surprisingly, a physician was the most frequently endorsed, followed by health educator, social worker, and behavioral health specialist. Responses under the “Other” category included research assistant, which was largely reported by the organizations conducting research.
Figure 11: Professional role of individual conducting screening services (N=35) Physician Health Educator Social Worker Behavioral Health Specialist Medical Assistant Registered Nurse Nurse Practitioner Psychologist Addiction Therapist Community Health Worker Research Staff Peer Specialist Other Not Applicable
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Brief Intervention: Figure 12 below summarizes the models of brief intervention utilized by respondents. By far the most frequently endorsed model was Motivational Interviewing. This may be due to the fact that MI is a component of some of the other models listed. Responses under the “Other” category included utilization of the NIAAA (MI) and WHO guides to SBIRT.
Figure 12: Brief intervention models utilized by respondents (N=35) MI (Motivational Interviewing) BNI (Brief Negotiated Interview) FRAMES (Feedback, Responsibility, Advice, Menu, Empathy, Self-efficacy) FLO (Feedback, Listen and Options) 5 A’s (Ask, Assess, Advice, Assist, Arrange) TTM (Transtheoretical Model of Change) BASICS (Brief Alcohol Screening and Intervention for College Students) Don’t know Other
Figure 13 below summarizes the professional role of the individual conducting the brief intervention; this list is similar to that for screening services.
Figure 13: Professional role of individual conducting brief intervention services (N=35) Physician Social Worker Health Educator Behavioral Health Specialist Registered Nurse Psychologist Addiction Therapist Community Health Worker Nurse Practitioner Medical Assistant Peer Specialist CEAP Health Coach Health Promotion Advocate Physicians Assistant Other Not Applicable
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Referral to Treatment: Figure 14 below summarizes the referral to treatment process endorsed by respondents. The majority of respondents indicated that if a person is in need of a referral to substance abuse treatment, referral information is given, and somewhat less frequently, a “warm hand off” is conducted. Responses under the “Other” category included “It depends”.
Figure 14: Referral to treatment procedures reported by respondents (N=35) Referral information given “Warm hand off” to treatment facility Treatment occurs in same location as SBIRT services Don’t know Other
Figure 15 below summarizes the professional role of the individual conducting the referral to treatment. In this case, the social worker was the most likely professional to conduct this service, followed by behavioral health specialist, health educator and physician.
Figure 15: Professional role of individual conducting referral to treatment (N=35) Social Worker Behavioral Health Specialist Health Educator Physician Psychologist Addiction Therapist Community Health Worker Other Registered Nurse Nurse Practitioner Peer Specialist CEAP Health Promotion Advocate Medical Assistant Physicians Assistant Other Not Applicable
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Billing and Reimbursement Figures 16 and 17 below summarize responses around billing for SBIRT. According to the first chart, only 5 out of 35 of the respondents indicated that they are billing for SBIRT services. This might be due to the fact that if they are currently grant funded to conduct SBIRT services, they would not need to bill for those services. All the respondents who indicated they were billing for SBIRT services did also indicate successful reimbursement for those services.
Figure 16: Respondent organizations that bill for SBIRT services (N=35)
NO: 85%
YES: 15%
Figure 17: Entities to which respondent organizations bill for SBIRT services (N=35)
Private Insurance Medicare Medicaid Unknown
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Needs Assessment: Figures 18 and 19 below summarize the results of the Needs Assessment. Respondents were asked to rate their needs for Training and Technical Assistance/Implementation support in a number of areas related to SBIRT implementation. All respondents rated these items regardless of funding history, meaning that N=37. Ratings were made on a 5-point Likert scale where 1= Don’t need any support in this area at all and 5=Definitely need support in this area. The top three identified areas of need for both training and technical assistance were “Reimbursement and coding for SBIRT,” “Sustainability of SBIRT,” and “Reporting Joint Commission performance measures”.
Figure 18: Need for Training support (1= Don’t need, 5=Definitely need) (N=35) Reimbursement and Coding for Sbirt Sustainability of Sbirt Reporting Joint Commission Performance Measures for Inpatient Settings Implementation of Sbirt With High Risk/High Cost Patients Use of Technology in Sbirt Implementation of Sbirt in a Specific Setting (e.g. School Systems) Documentation of Sbirt Training on Models of Brief Intervention Program Evaluation Training on Referral to Treatment Training on Validated Screening Measures
1 1.5 2 2.5 3 3.5 4
Figure 19: Need for Technical Assistance and Implementation Support (1= Don’t need, 5=Definitely need) (N=35)
Reimbursement and Coding for Sbirt Sustainability of Sbirt Reporting Joint Commission Performance Measures for Inpatient Settings Use of Technology in Sbirt Documentation in Clinical Record of Sbirt Implementation of Sbirt in a Specific Setting (e.g., School Systems) Implementation of Sbirt With High Risk/High Cost Patients Program Evaluation Technical Assistance on Brief Intervention Technical Assistance on Referral to Treatment Technical Assistance on Validated Screening Measures
1 1.5 2 2.5 3 3.5 4
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Other comments: At the end of the survey, respondents were given an opportunity to provide other comments, which are summarized here. • “SBIRT should be something that is done in clinical practice as part of care by those doing other care which has not been SAMHSA’s model, which is why it fails when funding dries up. The financing model should be rethought.” • “After our research study implemented SBIRT in 11 of our 47 medical facilities, our system adopted SBIRT in primary care in all 47 facilities.” • “I am glad to see that these types of efforts are being made to keep SBIRT up and running. It certainly has a lot of potential for many areas.”
Conclusions: The target of this initial national SBIRT Needs Assessment was organizations that are currently or have been funded to implement SBIRT services. The typical respondent was in a University setting and was currently funded either by SAMHSA or NIH to conduct training, clinical services, and/or implementation of SBIRT at a system level. The most commonly used screening instruments were the AUDIT-C, AUDIT, ASSIST, and DAST. The physician was the most commonly endorsed professional performing screening and brief intervention, which is likely to be a function of the setting and funding level of the organization. The most commonly used brief intervention model was motivational interviewing. For referral to treatment, respondents reported giving referral information and/or performing a warm hand-off. A large majority of respondents (85%) reported that they were not billing for SBIRT services, which is again likely because if the organization is currently grant funded to do SBIRT they would not need to bill. With respect to the needs assessment, the top three needs for both training and technical assistance/implementation support were (1) Reimbursement and coding for SBIRT; (2) Sustainability of SBIRT; and (3) Reporting Joint Commission performance measures for inpatient hospital settings. The results of this national SBIRT Needs Assessment will inform the National SBIRT ATTC Strategic Plan and work plan in terms of development of training and technical assistance offerings focused on SBIRT implementation at the systems level, and ultimately increasing the number of settings that are using SBIRT.
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Appendix 1: National SBIRT Needs Assessment Instrument Instructions: Thank you for participating in the first National SBIRT Needs Assessment! We are looking forward to reviewing the information you provide, in order to better tailor our offerings to meet the needs of the SBIRT community. This survey is being sent to organizations that either currently have or have previously received federal funding to implement SBIRT programs. For the purposes of this survey, we are asking about programs that are implementing full SBIRT programs, including screening, brief intervention, and referral to treatment. We realize that the individual completing this survey might be involved in several SBIRT-related programs. If this applies to you, we ask that you respond to this survey according to your role and the activities for the federally funded SBIRT project for which you have the most significant role in terms of time and effort. If you have any questions in the process of completing the survey, please do not hesitate to contact Dawn Lindsay, National SBIRT ATTC Evaluator, at 412-258-8571 or
[email protected]. Thank you for your contribution!
General Information: 1.
Name and contact information a) Name of person completing survey b) Facility or organization name with current or past SBIRT project c) Address d) Telephone e) Email f) Other (please specify)
2.
Which of the following best describe your organization? a) Single State Authority or other government organization b) University or other educational institution c) Private (for profit) organization d) Public (nonprofit) organization e) Other (please specify)
3.
Is your organization currently receiving grant funding for implementing SBIRT programs? a) Yes, we currently receive grant funding for SBIRT b) No, we do not currently receive grant funding, but we have in the past c) No, we have never received grant funding for SBIRT
4. If you responded a) or b) to Question 3, which years you have had funding? 5. If your organization has received grant funding for SBIRT, please indicate the source of funding. a) Substance Abuse and Mental Health Services Administration a. SBIRT State Cooperative Agreements b. SBIRT Medical Residency Cooperative Agreements c. SAMHSA-HRSA Center for Integrated Health Solutions d. Other CSAP project e. Other CSAT Project not listed above f. Other SAMHSA Project not listed above b) NIH a. NIAAA b. NIDA c. NIMH d. Other (please specify) c) HRSA a. Health Professions Program Area b. HIV/AIDS Program Area c. Maternal & Child Health Program Area d. Primary Health Care/Health Centers Program Area e. Rural Health Program Area
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d) e) f) g) h)
f. Healthcare Systems Program Area g. Other (please specify) CDC a. National Center for Injury Prevention and Control b. National Institute for Occupational Safety and Health (NIOSH) c. National Center on Birth Defects and Development Disabilities (Fetal Alcohol Spectrum Disorder Prevention) d. Other (please specify) AHRQ a. Office of Extramural Research, Education and Priority Populations b. Center for Outcomes and Evidence c. Center for Primary Care, Prevention, and Clinical Partnerships d. Center for Quality Improvement and Patient Safety e. Other (please specify) Department of Transportation (e.g., National Highway Traffic Safety Administration NHTSA) Department of Defense (DOD) Other (please specify)
6.
What are the primary SBIRT-related activities that you are or have been funded to do? (Please check all that apply) a) Training b) Technical Assistance (e.g., follow up coaching on specific SBIRT-related issues) c) Implementation at the organization level d) Clinical services delivery e) Curriculum development f) Sustainability planning g) Other (please specify)
7.
What SBIRT components do you currently provide in your program? (check all that apply) a) Screening for substance use disorders b) Brief Intervention c) Referral to Treatment d) None/NA
Please complete the following if your organization is currently funded to provide any SBIRT services: 8.
How long has your organization been delivering SBIRT services? a) Less than 1 year b) 1-5 years c) 6-10 years d) Longer than 10 years
9.
In what kind of setting is your organization funded to provide SBIRT services? (check all that apply) a) Primary care b) Hospital setting (e.g., ER, inpatient, etc) c) FQHC/Rural Health Center d) Community Mental Health Center e) Criminal Justice Setting f) School/College/University g) Workplace (e.g., EAP) h) Military i) Other (please specify)
10. For each behavioral health item, please indicate whether screening and/or brief intervention are included in the SBIRT services that you provide or fund? (check all that apply)
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Screening: 11. Which of the following screening tools do you use? (check all that apply) a) Single-item screen (e.g., NIAAA single-item, NIDA Single-item) b) Quantity/frequency (consumption) screen (e.g., AUDIT-C) c) CAGE (Cut down, Annoyed, Guilty, Eye-opener) d) AUDIT (Alcohol Use Disorders Identification Test) e) MAST (Michigan Alcohol Screening Test) f) DAST (Drug Abuse Screening Test) g) ASSIST (Alcohol, Smoking and Substance Involvement Screening Test) h) T-ACE (Tolerance, Annoyed, Cut down, Eye-opener for prenatal alcohol use) i) TWEAK (Tolerance, Worried, Eye-opener, Amnesia, K/Cut down) j) Tobacco screen (e.g., CDC single-item) k) Depression screen (e.g., PHQ-2/PHQ-9) l) Other mental health related screen (e.g., suicide, anxiety) m) I don’t know n) Other (please specify) 12. How is the screening delivered? (check all that apply) a) Face to face, as part of a clinical interview b) Telephone c) Web based d) Self administration via paper and pencil e) Self administration via computer, tablet, or handheld device f) I don’t know g) Other (please specify) 13. Which of the following professions perform SBIRT screening services in your organization? (check all that apply) a) Physician b) Nurse Practitioner c) Other Registered Nurse d) Medical Assistant e) Psychologist f) Social Worker g) Behavioral Health Specialist h) Health Educator i) Community Health Worker j) Addiction Therapist k) Peer Specialist l) Other (please specify)
Brief intervention: 14. What happens if a person has a positive screen for risky drinking but does not need to be referred to treatment? (check all that apply) a) Brief intervention is conducted by the same person who delivered the screen b) Brief intervention is conducted by someone other than the person who delivered the screen c) Person is contacted for a brief intervention after a self administered screen d) Screening results are noted, but no further intervention is done e) I don’t know f) There is no policy; positive screens are handled on a case by case basis g) Other (please specify) 15. What model of brief intervention is used? (check all that apply) a) 5 A’s (Ask, Assess, Advise, Assist, Arrange) b) BASICS (Brief Alcohol Screening and Intervention for College Students) c) BNI (Brief negotiated interview) d) FLO model (Feedback, Listen, and Options)
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e) f) g) h) i) j) k)
FRAMES model (Feedback, Responsibility, Advice, Menu, Empathy, Self-efficacy) MI (Motivational Interviewing) TTM (Transtheoretical Model of Change) No specific model of brief intervention is used N/A I don’t know Other (please specify)
16. Which of the following professions perform SBIRT brief intervention services in your organization? (check all that apply) a) Physician b) Nurse Practitioner c) Other Registered Nurse d) Medical Assistant e) Psychologist f) Social Worker g) Behavioral Health Specialist h) Health Educator i) Community Health Worker j) Addiction Therapist k) Peer Specialist l) Other (please specify)
Referral to treatment: 17. What happens if a person is in need of a referral to substance abuse treatment? (check all that apply) a) Referral information given b) “Warm hand off” (facilitated introduction) to treatment facility c) Treatment occurs in same location as SBIRT services d) Nothing e) I don’t know f) Other (please specify) 18. Which of the following professions perform SBIRT referral to treatment services in your organization? (check all that apply) a) Physician b) Nurse Practitioner c) Other Registered Nurse d) Medical Assistant e) Psychologist f) Social Worker g) Behavioral Health Specialist h) Health Educator i) Community Health Worker j) Addiction Therapist k) Peer Specialist l) Other (please specify)
Billing and Reimbursement: 19. Is your organization billing for SBIRT services? a) Yes b) No 20. If yes, which entities are you billing? (check all that apply) a) Medicaid b) Medicare c) Private insurance d) Other (please specify)
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21. Are you being reimbursed for SBIRT services? a) Yes b) No 22. If yes, which entities are reimbursing your organization for SBIRT services? (check all that apply) a) Medicaid b) Medicare c) Private insurance d) Other (please specify) Everyone please complete the following: 23. On a scale from 1 to 5, please rate your need for TRAINING support in the following areas, where 1= Don’t need training on this at all, and 5= Definitely need training on this) .....” a) Training on validated screening measures b) Training on models of brief intervention c) Training on referral to treatment d) Documentation of SBIRT e) Reimbursement and coding for SBIRT f) Reporting Joint Commission performance measures for inpatient settings g) Use of technology in SBIRT h) Sustainability of SBIRT i) Implementation of SBIRT in a specific setting (i.e., school systems) j) Implementation of SBIRT with high risk/high cost patients k) Program evaluation l) Other (please specify) 24. On a scale from 1 to 5, please rate your need for TECHNICAL ASSISTANCE and IMPLEMENTATION support in the following areas, where 1= don’t need technical assistance or implementation support on this at all, and 5= Definitely need technical assistance or implementation support on this) .....” a) Technical assistance on validated screening measures b) Technical assistance on brief intervention c) Technical assistance on referral to treatment d) Documentation in clinical record of SBIRT e) Reimbursement and coding for SBIRT f) Reporting Joint Commission performance measures for inpatient settings g) Use of technology in SBIRT h) Sustainability of SBIRT i) Implementation of SBIRT in a specific setting (i.e., school systems) j) Implementation of SBIRT with high risk/high cost patients k) Program evaluation l) Other (please specify) 25. Is there anything else you would like to add?
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611 William Penn Place, Suite #403 Pittsburgh, PA 15219 P: 412-258-8565 • F: 412-391-2528
[email protected] • www.ireta.org
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