H79TI084099

SBIRT at TTC - Tarzana Treatment Centers, Inc. (TTC), one of the largest integrated healthcare providers in Los Angeles County (LAC), will implement Screening, Brief Intervention, and Referral to Treatment (SBIRT) services for adolescents and adults in five (5) of TTC's Federally Qualified Health Center (FQHC) look-alike clinics located in diverse LAC communities (Northridge, Reseda, Palmdale, Lancaster, and Long Beach).

The overall purpose of TTC's SBIRT project is to reduce underage drinking, opioid use, and other substance use among a low-income, high-risk population of primary care patients in LAC. This will be achieved by integrating universal screening and SBIRT services in TTC's FQHC look-alike clinics, where TTC provides a full continuum of preventative, acute, and chronic medical care services across the lifespan.

In 2020, TTC provided primary medical care for 7,902 unduplicated patients. Of these, 8% were 0-17, 26% were 18-34, 17% were 35-44, 41% were 45-64, and 8% were 64+. Approximately 87% of patients were living under the Federal Poverty Level (FPL), with the remainder living at 100-138% FPL. More than half (54%) were female, at least 58% were racial/ethnic minorities (49% Latino, 14% White, 4% Asian/Pacific Islander, 4% Black, 1% American Indian, 28% other/unknown), and 22% were primary Spanish speakers.

The proposed project will address increased Substance Use Disorder (SUD) prevalence in LAC, including a 48% increase in accidental drug overdose deaths in LAC during the first five months of the COVID-19 pandemic compared to the same period in 2019. It will also address identified service gaps within TTC's integrated care system.

Specific goals and objectives will be accomplished by:

1) Building agency-wide awareness and commitment to SBIRT principles and evidenced-based practices.

2) Conducting a pilot phase to introduce SBIRT in two TTC clinics during year 1 before expanding to three (3) additional TTC clinics by the end of year 3.

3) Instituting universal screening for all primary care patients (ages 12 and older) for a total of 10,000 unduplicated individuals served during the 5-year project (Year 1: 1,600; Year 2: 2,400; Years 3-5: 2,000 each).

4) Integrating behavioral health (SBIRT) specialists into each clinic site to provide brief assessment, intervention, and treatment and ensure linkage to TTC's specialty SUD treatment programs for patients assessed with moderate to severe SUDs.

5) Developing a system (including modifying the agency's electronic health record) to track SBIRT services provided in the clinics and monitor outcomes achieved for each individual screening positive for risky use or an SUD.

TTC will utilize evidenced-based screening and assessment tools, including validated single-question pre-screeners for alcohol and drug use, AUDIT and DAST-10 for adults 18+, S2BI for youth 12-17, and brief assessment tools utilized as provisional referral tools for recommending American Society of Addiction Medicine (ASAM) levels of care.

Key outcomes of the project include increased abstinence or reduced use of alcohol/drugs, improved social connectedness, increased linkage to specialty SUD treatment services including Medications for Addiction Treatment (MAT) for opioid and alcohol use disorder, and a reduction in emergency department and hospital utilization for SUD.

Tarzana Treatment Centers

SAMHSA WAS GIVEN THE AUTHORITY TO ADDRESS PRIORITY SUBSTANCE ABUSE TREATMENT, PREVENTION AND MENTAL HEALTH NEEDS OF REGIONAL AND NATIONAL SIGNIFICANCE THROUGH ASSISTANCE (GRANTS AND COOPERATIVE AGREEMENTS) TO STATES, POLITICAL SUBDIVISIONS OF STATES, INDIAN TRIBES AND TRIBAL ORGANIZATIONS, AND OTHER PUBLIC OR NONPROFIT PRIVATE ENTITIES. UNDER THESE SECTIONS, CSAT, CMHS AND CSAP SEEK TO EXPAND THE AVAILABILITY OF EFFECTIVE SUBSTANCE ABUSE TREATMENT AND RECOVERY SERVICES AVAILABLE TO AMERICANS TO IMPROVE THE LIVES OF THOSE AFFECTED BY ALCOHOL AND DRUG ADDITIONS, AND TO REDUCE THE IMPACT OF ALCOHOL AND DRUG ABUSE ON INDIVIDUALS, FAMILIES, COMMUNITIES AND SOCIETIES AND TO ADDRESS PRIORITY MENTAL HEALTH NEEDS OF REGIONAL AND NATIONAL SIGNIFICANCE AND ASSIST CHILDREN IN DEALING WITH VIOLENCE AND TRAUMATIC EVENTS THROUGH BY FUNDING GRANT AND COOPERATIVE AGREEMENT PROJECTS. GRANTS AND COOPERATIVE AGREEMENTS MAY BE FOR (1) KNOWLEDGE AND DEVELOPMENT AND APPLICATION PROJECTS FOR TREATMENT AND REHABILITATION AND THE CONDUCT OR SUPPORT OF EVALUATIONS OF SUCH PROJECTS, (2) TRAINING AND TECHNICAL ASSISTANCE, (3) TARGETED CAPACITY RESPONSE PROGRAMS (4) SYSTEMS CHANGE GRANTS INCLUDING STATEWIDE FAMILY NETWORK GRANTS AND CLIENT-ORIENTED AND CONSUMER RUN SELF-HELP ACTIVITIES AND (5) PROGRAMS TO FOSTER HEALTH AND DEVELOPMENT OF CHILDREN, (6) COORDINATION AND INTEGRATION OF PRIMARY CARE SERVICES INTO PUBLICLY-FUNDED COMMUNITY MENTAL HEALTH CENTERS AND OTHER COMMUNITY-BASED BEHAVIORAL HEALTH SETTINGS

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

Division of Grants Management [HHS - SAMHSA]

Tarzana, California 913561411 United States

Single Zip Code

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

Amendment Since initial award the total obligations have increased 400% from $995,000 to $4,975,000.