**Florida Office of the Governor**

**Program Description**

The Substance Abuse and Mental Health Services Administration (SAMHSA), Center for Substance Abuse Treatment (CSAT), has awarded the Florida Department of Children and Families $2.8 million per year for 5 years to implement a substance abuse screening and intervention program for older adults by partnering with specialist and generalist providers who come into contact with individuals age 55 and older who are at risk for or experiencing substance abuse problems. Older adults are screened and provided brief interventions and/or brief treatment in settings such as primary and emergency health care and trauma centers, senior nutrition programs, public health clinics, and other aging services systems. Implementation of the SBIRT model broadened the base of an existing, evidence-based pilot program of brief interventions that specifically targeted older adults.

**Program Model**

**Screening**

A six-question pre-screen questionnaire is administered to identify potential clients for appropriateness and eligibility for services. If indicated by the pre-screen, program staff uses the Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST) and the Short Geriatric Depression Scale (SGDS) for screening.

Individuals who screen positive for substance-use related problems are invited to participate in either brief intervention or brief treatment, with the choice based on the client’s characteristics and needs and the Florida Brief Intervention and Treatment for Elders (BRITE) counselor’s judgment.

**Brief Intervention**

Program staff conduct short-term intervention (one to five sessions) based on the *Health Promotion Workbook*, published in SAMHSA TIP #26 and TIP #34. Sessions focus on reducing risk factors generally associated with the progression of substance use disorders.

**Brief Treatment**

Brief treatment consists of one to seven sessions and is directed toward helping a client resolve or manage a specific substance use issue. It is solution-focused and goal-oriented; concentrates on here-and-now issues; and follows the SAMHSA curriculum, Substance Abuse Relapse Prevention for Older Adults. 

**Referral**

Program staff may refer clients for specialized treatment services (outpatient or intensive outpatient only) at any point in the continuum of screening, brief intervention, or brief treatment services. Upon referral, the client will then receive an assessment, and placement according to the American Society of Addiction Medicine PPC-II.

**Service Features**

· Expands on the original BRITE pilot project.

· Implements services in conjunction with primary care, emergency services, and the publicly funded aging services' systems.

· Identifies and serves older adults considered at risk for or demonstrating problems with medication misuse, alcohol or other illicit drug use, and depression. In the absence of substance misuse, individuals needing treatment for depression are referred to the appropriate MH services.

· Supports linkages to aging services and in-home services to the extent possible to maintain the independence of those being served.

· Enables long-term management support (care management and recovery support systems). Has English/Hispanic bi-lingual staff and program materials (Haitian/Creole will be added).

**Collaborative Partners**

· Executive Office of the Governor

· Florida Office of Drug Control

· Florida Department of Children and Families

· University of South Florida, Louis de la Parte Florida Mental Health Institute

· AARP—Florida

· Area agencies on aging

· Florida Agency for Health Care Administration

· Florida Department of Health

· Florida Academy of Family Physicians

· Florida College of Emergency Physicians

· Florida Medical Association

· Geriatrics Society

· Florida Department of Elder Affairs

· Florida Hospital Association

· University of Miami Veterans Administration

**FL BRITE Integrated Services**

Sixteen (16) providers deliver BRITE services in these areas and settings: 

· Jacksonville (primary care and generalist)

· Orlando (specialist)

· Broward County (generalist and specialist)

· Tampa (generalist and specialist)

· St. Petersburg (generalist and specialist)

· Sarasota (specialist)

· Ft. Myers (generalist)

· Miami/Dade (primary care and generalist)

· Palm Beach County (primary care)

**Program Effectiveness**

As of July 3, 2008, a total of 1,592 patients have received services through this project. Of these, 35.1 percent (554) screened positive and received an intervention and/or additional services for substance use. 

FL SBIRT services as of July 3, 2008 

· Screened 950 patients

· Provided brief intervention to 554 patients

· Provided brief treatment to 77 patients

· Referred 11 patients to treatment

**Contact Information**

Vance Burns, Project DirectorSubstance Abuse Program OfficeDepartment of Children and Families1317 Winewood Blvd.Tallahassee, FL 32399-0700(850) 921-8495vance_burns@dcf.state.fl.us