**South Carolina SBIRT**

**Program Description**

South Carolina has implemented a much-needed screening, brief intervention, and referral to treatment (SBIRT) practice in five counties located in diverse areas of the state. The SBIRT practice will address alcohol, tobacco, and other drug use in patients at Federally Qualified Health Centers (FQHC), a Rural Health Clinic (RHC), a hospital clinic – and eventually other health care sites. By focusing on FQHCs and primary care practices, the SC SBIRT program will also support the nation’s shift to the integration of physical and behavioral health services.

The project, entitled SC SBIRT, will serve all adult patients at 10 FQHCs, one RHC, and one internal medicine clinic. These health care practices are located in both larger urban areas and small rural towns. The program design is guided by the need to reduce harmful and hazardous alcohol and drug use and related health care costs; and to close the large treatment gap in the state between residents who have a substance problem and those who receive services. The target population has health disparities due to lower-income status, lack of insurance and financial resources, and a lack of a regular source of care. This population is 36% male, 64% female, 52% white, 41% African American, and 10% Hispanic.

SC SBIRT will be implemented collaboratively by the local county alcohol and drug abuse authorities and health care providers (FQHCs, RHC, and private practice). The program addresses multiple barriers to the receipt of SBIRT services. Health Educators will be placed at provider sites, and will use evidence-based practices to conduct screening (using AUDIT and DAST-10), brief intervention, and brief treatment.  Patients screening positive for tobacco use will be referred to the successful South Carolina Tobacco Quitline service. Patient Navigators will provide care coordination, follow-up with patients, and collect data.  Patients who who are in need of additional services will be referred for treatment at the county alcohol and drug abuse authorities and will be provided with referral and treatment for for co-occurring disorders if necessary. Telemedicine will provide access to services in rural areas that are underserved by these specialists.

The project goals and objectives are: ***Goal 1***: To increase access to SBIRT for adults in primary care and community health settings, especially individuals who have been traditionally underserved in behavioral health care. The objectives are to train and place Health Educators and Patient Navigators in selected, high-need FQHC sites and family practice settings. ***Goal 2***: To ensure that SBIRT is utilized as the standard of care in South Carolina’s health care settings through state-level system and policy change. The objectives will standardize SBIRT as a sustainable health care practice within a continuum of care model, with a focus on policy and health information technology platforms. ***Goal 3***: To improve health and behavioral outcomes among adults with substance use disorders or substance use with co-occurring mental illness. The objectives are that 40% of adults screened and receiving brief intervention, and 30% of adults receiving brief treatment or referral to treatment, will show positive outcomes. The program will also refer clients who screen positive for tobacco usage to the South Carolina Tobacco Quitline.

The project will pre-screen 36,880 adults in year 1 and 53,430 adults annually thereafter, for a five-year project total of 250,600. Of this total, 60,108 will receive brief intervention.

Samantha Collins

Project Director

SC SBIRT

SC DAODAS

scollins@daodas.sc.gov

(803) 896-7387

2414 Bull Street

Columbia, SC 29201