**New Jersey Office of the Governor**

**Program Description**

The Substance Abuse and Mental Health Services Administration (SAMHSA), Center for Substance Abuse Treatment (CSAT) awarded the NJ Office of the Governor $1.5 million per year for 5 years to expand the existing continuum of care by institutionalizing screening, brief intervention, brief treatment and referral to treatment in primary care and community health settings – including a federally qualified health center, family medicine residency program, and emergency departments through the NJ SBIRT Project, administered by the NJ Department of Human Services, Division of Mental Health and Addiction Services.

**Program Model**

**Pre-Screening**

The pre-screen consists of the NIDA single-item question for drug use, and either the AUDIT-C or the NIAAA single-item question for alcohol use depending on the practice setting.  Pre-screens are universally administered to adult patients by medical assistants, medical residents or patient navigators depending on the practice setting.  

**Screening**

Adult patients screening positive on the pre-screen are administered the Alcohol Use Disorders Identification Test (AUDIT) developed by the World Health Organization, and/or the condensed Drug Abuse Screening Test (DAST-10) as indicated.  Screening is administered by Health educators, the minimum qualification of which is a bachelor’s degree, with most having master’s degrees in social work.

**Mental Health Screening**

The co-occurring assessment instruments include the 9-item Patient Health Questionnaire (PHQ-9), the 7-item Generalized Anxiety Disorder scale (GAD-7), and the Mental Health Screening Form-III depending on the practice setting.  Co-occurring assessments are administered by Health educators to all patients who screen at high risk for substance use.

**Brief Intervention**

Brief interventions (BI) are conducted by Health educators using motivational interviewing and the Brief Negotiated Interview (BNI) model for patients with moderate risk screening scores.  Brief interventions are conducted in-person and consist of one to five sessions.  BI sessions are documented in the electronic medical record for provider reinforcement of the intervention and improved continuity of care.

**Brief Treatment**

The brief treatment (BT) model consists of up to six sessions of motivational enhancement therapy and cognitive behavioral therapy by master’s level behaviorists for patients with high risk screening scores.  BT sessions are conducted in-person, and are documented in the electronic medical record for provider reinforcement of the intervention and improved continuity of care.

**Referral to Treatment**

Facilitated referrals to specialty treatment services are made for patients scoring at highest risk for substance use issues.  A network of licensed substance use treatment providers are under agreement with the project to accept direct referrals from the SBIRT practice sites.  Patient Navigators coordinate the referrals, and provide patient transportation to intake appointments.

**Special Features**

· Project staff is trained in cultural and linguistic competency.  The project is staffed with bilingual English/Spanish Health Educators and Patient Navigators.

· The project uses a real-time, web-based data entry system – the NJ Substance Abuse Monitoring System (NJSAMS) for GPRA data collection; with weekly upload to SAIS

· NJSAMS has canned and customized data reports for frequencies by site, SBIRT modality, etc.

· NJSAMS has download data functions

· NJSAMS allows for electronic referral to affiliated providers for RT clients

· All SBIRT service providers use a shared Health Information Exchange (HIE), which includes a SBIRT module for documentation of encounters, interventions, and follow-up

· Patient navigators assist RT clients with treatment initiation by providing transport to/from initial, intake appointments   

**Collaborative Partners**

· Henry J. Austin Federally Qualified Health Center

· St. Francis Medical Center

· Rutgers University, School of Social Work

· Capital Health System

· Trenton Health Team, Inc.

· Greater Trenton Behavioral Healthcare

· NJ Primary Care Association

· Mercer County Department of Human Services

· Mercer County Office on Addiction Services

· Rescue Mission of Trenton

· Catholic Charities, Diocese of Trenton

**Contact Information**

Lynn Kovich, Assistant Commissioner

NJ SBIRT Project Director

NJ Division of Mental Health & Addiction Services

222 South Warren St.

Trenton, NJ  08625

(609) 777-0702

Lynn.Kovich@dhs.state.nj.us