La Maestra’s project is “Expanded Screening, Brief Intervention and Referral to Treatment for low-income, uninsured and underinsured transitional age youth (TAY) and adults in San Diego County California at risk of substance-abuse. For this project La Maestra will serve low-income, uninsured and underinsured individuals in central, east and south San Diego County, California. La Maestra will screen 8,000 annually/40,000 for the project period, unduplicated TAY and adult patients for drug, alcohol misuse and depression; provide brief interventions, brief treatment, and referral to treatment including onsite substance abuse and behavioral health counseling to at least 3,000 annually/15,000 during the project period, unduplicated TAY and adult patients; and provide onsite Medication-Assisted Treatment (MAT) services to at least 300 annually/1,500 unduplicated adult patients during the five year project period.
In 2017, La Maestra served 47,866 patients. According to 2017 clinic data, 77% of patients served are living at or below 200% of the federal poverty level, 22% of patients are uninsured and 80% are underinsured. In addition, 53% of patients are Hispanic/Latino and 60% prefer to be spoken to in a language other than English. In 2017, La Maestra conducted 7,019 SBIRT screenings, and diagnosed approximately 2,387 patients with substance use disorders including tobacco use and other mental health disorders.
However, according to UCLA’s 2016 California Health Interview Survey (CHIS), almost 43% of adults in the service area reported needing help for self-reported mental/emotional and/or alcohol-drug issues and did not receive treatment and 19% of teens reported needing help for mental health problems, suggesting a need for more integrated behavioral health and substance abuse services into primary care within the service area.
La Maestra will utilize evidence-based screening tools Alcohol Use Disorders Identification Test (AUDIT) and the Drug Abuse Screen Test (DAST-10) as well as the Patient Health Questionnaire-9 (PHQ-9) depression screening tool for all adult patients age 18 and older. For TAY, La Maestra will use the CRAFFT 2.0 to screen for high risk alcohol and other drug use disorders in youth as well as the DAST-20 adolescent version as recommended by the National Institutes of Health (NIH). All screening tools can be self-administered or administered by a clinician. La Maestra has a comprehensive and integrated behavioral health and onsite substance abuse treatment program that provides MAT. The organization is experienced at providing brief interventions, brief treatment and referrals to treatment. All providers are trained in the evidence-based practices of Motivational Interviewing (MI) and Cognitive Behavioral Therapy (CBT).
In addition, for this program, La Maestra will work with The University of San Diego (UC San Diego) Health Services Research Center (HSRC) a comprehensive research unit established in 1991. HSRC resides in the Department of Family Medicine and Public Health within the UC San Diego School of Medicine with offices in San Diego and Los Angeles. As a research-based, third party evaluator HSRC will provide Program Evaluation (PE) services for this important project.
