Expanded Screening, Brief Intervention and Referral to Treatment (SBIRT) Services for Low-Income, Uninsured and Underinsured Transitional Age Youth (TAY) and Adults in San Diego County - La Maestra’s Expanded Screening, Brief Intervention and Referral to Treatment (SBIRT) Services for Low-Income, Uninsured and Underinsured Transitional Age Youth (TAY) and Adults in San Diego County project will implement the SBIRT public health model for children, adolescents, and adults with a focus on screening for underage drinking, opioid use, and other substance use. The organization will serve hard-to-reach, at-risk populations, including but not limited to low-income individuals living at or below 200% of poverty, racial and ethnic minorities, LGBTQ2S+, unhoused populations, immigrants, refugees, veterans, and previously incarcerated individuals. La Maestra will place a specific focus on ensuring that 50% of the patients served are ages 12-21.
The overarching goal of La Maestra’s SBIRT project is to deliver early intervention for individuals with risky alcohol and drug use, as well as the timely referral to more intensive treatment for those who have substance use disorders, with a focus on screening for underage drinking, opioid use, and other substance use. The organization expects to achieve this by fulfilling the following objectives: 1) Screen a minimum of 6,000 individuals, 50% of which will be children or adolescents, for underage drinking, opioid use, and other substance use annually (30,000 total over the five-year project period); 2) Engage a minimum of 60% of adults and 40% of youth with positive evidence-based tool screenings in brief intervention (BI), brief treatment (BT), or referral to treatment (RT); 3) Reduce alcohol and/or drug use (AOD) among program participants who participated in BI, BT, or RT by a minimum of 25% within the first six months of SBIRT enrollment; and 4) Connect at minimum of 50% of adults and/or youth participants to the full spectrum of La Maestra Circle of Care® services annually through comprehensive case management; 5) Ensure that all patients that screen positive and are referred for treatment will have a six-month follow-up rate of 80%.
In 2023, La Maestra served 44,489 patients. Patients were served across the age continuum, ranging from birth to nearly 100 years old. According to 2023 clinic data, 87% of patients served were living at or below 200% of the federal poverty level, 16% of patients were uninsured, and 80% were underinsured. In addition, 79% of patients belonged to a racial or ethnic minority, and 59% were best served in a language other than English. Among all clinic patients, 6% were Asian, 16% were Black/African American, 21% were Caucasian/White, 55% were Hispanic/Latino, and 2% were undisclosed or some other race.
Recent data shows that impoverished communities face significantly higher rates of addiction, with financial instability fostering stress and increasing the likelihood of addictive behaviors. Data from the University of Wisconsin Population Health Institute found that San Diego ranks among the worst places in California dealing with excessive alcohol use. In addition, the San Diego County medical examiner also noted an increase in the number of alcohol-related deaths among people ages 14-25 in 2020. Furthermore, La Maestra’s service area of central, east, and south San Diego saw opioid overdose hospitalization rates as high as 67.9 per 100,000 among Non-Hispanic Black populations and 20.4 per 100,000 among Hispanic populations, compared to the overall County average of 16.0 per 100,000.
La Maestra will adhere to current Evidence Based Practices and expand its Wellness Clinic to ensure that all patients seeking SBIRT services receive the comprehensive, culturally appropriate and linguistically competent care they require to achieve recovery. In addition, performance assessment services for this program will be conducted by Dr. Andrew Sarkin, Ph.D., a third-party evaluator from the UCSD’s Health Services Research Center, established in 1991. Dr. Sarkin has over two decades of evaluation experience in behavioral health and clinical psychology.
