H79TI084006

The UCSF SBIRT Collaborative Care Program - SBIRT-CCP develops, sequentially implements, and evaluates a multidisciplinary, team-based approach to screening, brief interventions, brief treatments, and referrals to specialty care for alcohol, opioid, and other drug use in both adult and adolescent primary care.

Universal pre-screening will occur annually using evidence-based instruments fully integrated into the electronic health record followed by a more in-depth assessment and brief intervention (BI) for individuals deemed at risk.

All at-risk individuals will be invited to join a clinical registry managed by patient care coordinators and multi-lingual advocates proficient in motivational enhancement and BI's.

Patients will be regularly re-assessed and triaged to varying intensities of collaborative care follow-up based on degree of risk, unmet social needs, patient readiness, and local clinic and treatment resources.

Qualifying patients will be referred to a centralized "Collaborative Care Team" comprised of behavioral health providers, social workers, psychiatric residents, nurse practitioners, and addiction medicine physicians for more in-depth assessments, brief treatment (BT), pharmacotherapy including medication-assisted treatment (MAT), and/or facilitated referrals to specialty care.

The SBIRT CCP and clinical processes will be developed and tested by the UCSF Office of Population Health in one adolescent and one adult primary care clinic in FY01 through collaborations with local SBIRT experts, implementation scientists, internal clinical champions, and community members.

Using continuous feedback for iterative improvements, SBIRT CCP will be sequentially implemented in 4 additional SF adult primary care clinics in FY02-03, in adult and family medicine at UC Davis in FY03-04, and at a large FQHC family medicine system in the Central Valley in FY05 (N=26 distinct new clinics).

Over 5 years, nearly 100,000 patients will receive annual pre-screens with an estimated 15,000 receiving at least one BI, 1,300 receiving BT, and 1,100 being actively referred to specialty care including MAT for opioid use disorders.

These goals will be achieved by expanding and cultivating a skilled workforce to deliver efficient, evidence-based interventions within structurally and administratively prepared clinics that have tailored the CCP approach to local circumstances using internal champions and community input.

Staff will be trained with in-person and distance-learning tools including X-Waiver trainings supplemented by regular case conferences and a "best practices" website.

Screening instruments will include the AUDIT, ASSIST, DAST, and CRAFFT and interventions will include motivational interviewing, the brief negotiated interview, cognitive-behavioral therapy, and MAT delivered by clinic staff, the CCP team, and/or contracted specialty programs.

Internal champions will use previous "lessons learned," an online implementation hub, and technical assistance to tailor the SBIRT-CCP approach, establish workflows, and collect data.

Quantitative and qualitative data will be used to assess clinical and implementation processes and outcomes, cost effectiveness, and program performance.

San Francisco Regents Of The University Of California

NOT APPLICABLE

93.243 - Substance Abuse and Mental Health Services Projects of Regional and National Significance

Division of Grants Management [HHS - SAMHSA]

San Francisco, California 941153011 United States

Single Zip Code

Screening, Brief Intervention, and Referral to Treatment (TI-21-008)

Amendment Since initial award the total obligations have increased 300% from $994,920 to $3,979,683.