**Colorado Office of the Governor**

**Program Description**

The Substance Abuse and Mental Health Services Administration (SAMHSA), Center for Substance Abuse Treatment (CSAT) awarded the Colorado State Office of the Governor $2.8 million per year for 5 years to expand the existing continuum of care to include screening, brief intervention, and referral to treatment in medical and other settings; support clinically appropriate services for people at risk for or diagnosed with a substance abuse disorder; and identify and implement systems and policy changes to increase access to treatment in generalist and specialist settings in both urban and rural/frontier communities. Peer Assistance Services, Inc. was selected to manage the project. A Policy Steering Committee, chaired by José Esquibel, is responsible for developing a strategic plan for expansion and sustainability.

**Program Model**

**Screening**

Health educators conduct screening using the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) screening tool developed by the World Health Organization.

**Brief Intervention**

Health educators provide brief intervention, using motivational interviewing, for patients with moderate or high screening assessment scores and the medical staff members reinforce the intervention with a brief conversation about the results of the screening.

**Brief Treatment**

The brief treatment model consists of several sessions and includes motivational interviewing principles as well as principles of self-determination theory. Brief treatment organizations must utilize an approved model, such as the manual zed brief treatment for adolescent marijuana users.

**Referral**

There are three points in the SBIRT process when a patient may be referred to a more intensive or specialized treatment program: during the initial screening, after the motivational interview, and during or at completion of the brief treatment. A referral coordinator facilitates placing the patient in the right level and type of treatment option.

**Service Features**

· English/Spanish bilingual health educators from the local community provide screening and referral for treatment 

· Follow-up phone interviews may be conducted by the health educators. If it is determined that the individual is in need of additional services, the health educators will schedule an appointment or provide additional service information. 

· The follow-up interview also provides additional support, discusses relapse prevention strategies and resources, assists in accessing services, and provides education when needed.

· The program is being implemented in Emergency Departments and Trauma Centers, as well as HIV and STD clinics, women’s clinics, high school and college clinics, and community-based clinics.

· The Colorado Clinical Guidelines Collaborative will develop SBIRT guidelines to be distributed by the health care plans to every physician in Colorado.

**COLORADO SBIRT Sub-Recipient Communities**

The program is a statewide initiative serving both rural and urban communities. The program is currently located in Denver, Grand Junction, Vail, Frisco, Lamar, Littleton, and Gunnison.

**CO SBIRT Provider Programs**

· Arapahoe House

· Arapahoe/Douglas Mental Health Network

· Behavioral Health Services

· Centennial Mental Health Center

· Columbine Recovery Center

· Community Alcohol-Drug Rehabilitation and Education Center

· Denver Area Youth Services

· Jefferson County Health Department

· RESADA

· Servicios de la Raza

· Sobriety House

· The Council

· University of Colorado Health Sciences Center

· Crossroads Turning Point

· Southeast Colorado Drug Free Community

· Island Grove

· Pathfinders Clinic

· San Luis Valley Mental Health Center

**Program Effectiveness**

As of July 3, 2008, a total of 16,428 patients have received services through this project. Of these, 44.3 percent (7,280) screened positive and received an intervention and/or additional services for substance abuse.

CO SBIRT services as of July 3, 2008 

· Screened 8,697 patients

· Provided brief intervention to 7,280

· Provided brief treatment to 108 patients

· Referred 343 patients to treatment

**Contact Information**

Brie ReimannSBIRT Program ManagerPeer Assistance Services, Inc. 2170 S. Parker Road, Suite 229Denver, CO 80231(303) 369-0039 x214breimann@peerassist.org