Tarrant County Hospital District (dba JPS Health Network) Utilizing Professional Liaisons for Intervention and Referral to Treatment (UPLIFT) program will increase identification and treatment of individuals with substance use disorder and/or use of alcohol and other drugs. The UPLIFT program will implement screening, brief intervention, and referral to treatment (SBIRT) services in two JPS Community Health Centers (CHC) in low-income neighborhoods and in JPS Hospital. JPS is the publicly supported safety-net health system in Tarrant County, Texas.
The populations to be served are adults in ZIP codes identified as high-risk for substance use disorder (SUD) and patients being admitted to JPS Hospital through the Trauma Department. More than two-thirds of the patients at the CHCs and JPS Hospital are BIPOC (Black, Indigenous, or People of Color), with the majority being Black or Hispanic. Five percent of patients served at JPS are persons experiencing homelessness. At JPS, opioid use disorder (OUD) was related to 302 admissions, 6,737 outpatient encounters, and 76 emergency room overdoses during a six month period of 2020. This project will allow SAMHSA to evaluate the effectiveness of enhanced and expanded SBIRT services among diverse high-risk populations and in a safety-net hospital.
Strategies and interventions include all grant-required activities. Infrastructure development includes build-out of JPS Epic Electronic Medical Record to integrate evidence-based screening tools (CAGE-AID, AUDIT, and DAST) and the ability to monitor and track program patients through treatment and follow-up. SBIRT services will be implemented in two JPS CHCs and JPS Hospital by hiring and training a Clinical Director who will oversee three full-time and one part-time Licensed Clinical Social Workers (LCSW). One full-time LCSW will be embedded in each CHC and one full-time and one part-time LCSW will be stationed at JPS Hospital. JPS Family Medicine physicians will partner with the Project Director, Clinical Director, LCSWs, JPS Behavioral Health Services, and JPS Bridge Clinic (MAT services) to provide a continuum of care for patients identified with SUD and/or AOD use. Evidence-based practices to be used include Motivational Interviewing, Cognitive-Behavioral Therapy, and Medication-Assisted Treatment (MAT). JPS will sub-contract with MHMR of Tarrant County to provide a 30-day intensive residential treatment program for 24 unduplicated patients needing more intensive services. MHMR will also provide outpatient treatment services for 60 unduplicated patients annually. JPS has built SBIRT services within its Trauma Department and this project builds on that success by enhancing and expanding SBIRT services within CHCs.
The goal of the UPLIFT program is to support the stabilization and community reintegration of individuals who present with substance use disorder in the JPS Health Network Community Health Centers and Hospital by providing them with a continuum of care from screening, brief intervention, brief treatment, and referral to services. Measurable objectives include: 1) Provide SBIRT services to 876 individuals over five years, 2) 20% of program participants will show a decline in substance use at 6-month follow-up, 3) 15% of participants will show reduced alcohol use at 6-month follow-up, 4) 20% of participants will show an improvement in their physical and behavioral health, and 5) Reduce JPS Hospital Emergency Department visits and costs for program participants.
The total unduplicated number of patients served is 876 over the grant period (108 patients in year 1, 192 patients in year 2 through year 5).