Screening, brief intervention, referral and treatment services in multiple health care agencies: A public health approach. The California screening, brief intervention, referral and treatment program (CASBIRT)


Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

5085.0: Wednesday, December 14, 2005 - Table 4

Abstract #115947

Dennis Kelso, PhD and Karin Omark, EdM. Altam Associates, Inc., 9715 Carroll Centre Road, Suite 104, San Diego, CA 92126, 858-566-3709, k_omark@yahoo.com

Implementing and sustaining services in health care agencies has been slow and difficult.

This model integrates evidence-based substance use screening, brief intervention, referral and treatment services into routine medical visits in hospital emergency, trauma, and primary care centers. The CASBIRT program will provide SBIRT services to over 500,000 adult medical patients in 36 medical sites across three counties over five years.

It uses an external partner organizational relationship with each agency, working under contract, responsible for performance, operations, quality, communications, reporting and overall management. The package includes a direct patient services bundle – trained/certified staff, services protocols, QA procedures, reports and routine HR functions (scheduling, supervision, etc.). Services are delivered by specially trained peer health educators working as members of the medical team, who also transfer SBIRT information to medical staff -- who in-turn reinforce SBIRT staff actions and consider results in diagnosis and treatment. SBIRT staff also provides alternate services for intoxicated/overdosed patients and liaison with agency supportive staff (mental health, social workers, case managers, etc).

The model also includes: communication services to support operations -- for medical staff (OJT and utilization information), agency administrators and shared governance committees; rapid start implementation services for new sites; and, contract administration – including HIPAA, 42 CFR etc.)

This model overcomes the known organizational and practice barriers. It is also designed as public health model, expecting to achieve a cumulative population impact by providing sustainable, consistent, high quality services to a large number of patients in multiple settings clustered in geographic regions.

Learning Objectives:

At the end of this session, attendees should be able to

a) better understand the target population of non-dependent and dependent substance users; b) be familiar with how this model addresses and overcomes organizational and practice barriers to implementing and operating SBIRT services; c) recognize how the model addresses public health goals.

Keywords: Screening, Intervention

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commertial supporters WITH THE EXCEPTION OF Author is employed by Altam Associates, Inc., which provides SBIRT services under contract with California ADP and SAMHSA/CSAT..

Roundtable Discussions on Ethnicity, Gender and Drug Use

The 133rd Annual Meeting & Exposition (December 10-14, 2005) of APHA