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 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+. Some 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, as well as identified service gaps within TTC’s integrated care system. Specific goals and objectives will be accomplished by: 1) building agencywide 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; and 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 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.
