Behavioral and Primary Care integration through SBIRT implementation in urban FQHC/CBO settings

Issues: Behavioral and primary health care providers have long faced the challenges of treating patients with co-occurring disorders. Integration of behavioral and primary care is a key component of health reform which pushes for an integration of services that is essentially non-existent. These issues, coupled with the knowledge that intervention at early stages for behavioral health conditions has proven to be cost effective, has lead providers to consider SBIRT as an effective model for service integration. Description: New Age Services is collaborating with FQHC's and a CBO to implement an SBIRT program in multiple urban clinic settings. The collaboration was designed to provide identified patients the SBIRT screening and receive a brief intervention and/or a direct referral in a single trip to the FQHC/CBO. The project will provide service to 940 patients annually. Lessons Learned: Integration of substance use and primary care through SBIRT resulted in reduced substance use and utilization of associated health services. Barriers to implementation were due to unforeseen issues raised through the blending of multiple service systems. Issues of confidentiality, liability and documentation of services were common obstacles, due primarily to the individual policies and regulatory requirements for which each provider is responsible. Recommendations: Early identification of barriers is key to ensuring efficient project implementation. Identified issues will be addressed as the project expands to new sites and new collaborative partners. This will enable the agency to comprehensively provide services along a continuum of care, addressing health disparity issues common in an urban environment.