Rhode Island SBIRT Summit November 2, 2015 Reducing Adolescent Substance Abuse Initiative (RASAI)

Welcome! State Leads Special Guests Learning Community Participants Introduction Name Role in RASAI Project Organization What You Hope to Get Out of Today’s Meeting

Agenda 9:15 – 9:30am Year 1 Review 9:30 – 10:15am Year 1 Roundtable Discussions 10:15 – 10:45am Keynote Speaker Address A. Kathryn Power, M.Ed. SAMHSA Regional Administrator 10:45 – 11:00am Break 11:00 – 11:30am Data, Data, Data 11:30 – 11:45am State Lead Policy Update Richard Leclerc, President at Gateway Healthcare 11:45 – 12:00pm Year 2 Overview: Sustainability and Scalability

Agenda (Cont.) 12:00 – 12:30pm Lunch 12:30 – 1:45pm “A” Breakout Sessions Breakout 1a: New Staff SBIRT Training – Pam Pietruszewski Breakout 2a: SBIRT Supervisors Retreat: Building Sustainable Protocols –Aaron Williams 1:45 – 2:00pm Break 2:00 – 3:15pm “B” Breakout Sessions Breakout 1b: New Staff SBIRT Training (cont.) – Pam Pietruszewski Breakout 2b: SBIRT Supervisors Retreat: Clinical Monitoring, Supervision, & Change Management – Nick Szubiak 3:15 – 4:00pm Action Planning 4:00 – 4:30pm Closing Remarks, Next Steps, Celebration, and Group Picture

Mental illness in adolescence increases risk for substance abuse 1 in 5 with ADHD 1 in 3 with bipolar disorder Prevention and early intervention with SBIRT is an excellent opportunity The National Council is well positioned for this work with more than 2,500 member organizations in community mental health and addiction treatment Mission is to advance our members’ ability to deliver integrated health care

Reducing Adolescent Substance Abuse Initiative Conrad N. Hilton Foundation, 2 year learning community Implementation of SBIRT in community behavioral health organizations (CBHOs) that serve adolescents in mental health care Structured and individualized training & TA to facilitate SBIRT implementation, financing, and sustainability Supports “state leads” to develop SBIRT sustainability strategies, or state policy-level changes to facilitate durable SBIRT programs RASAI is a three-year grant funded by the Conrad Hilton Foundation. As you saw from Alexa’s video, one of the Hilton Foundation’s priorities is really about entrenching early intervention and substance abuse prevention into the multiple systems that young people interface with. While introduced in other systems (juvy, child welfare, primary care) you all are PIONEERS As you know, one of their major prevention and early intervention strategies is SBIRT- an evidence-based protocol that screens young people for risky behaviors and offers them proactive support to prevent substance abuse disorders or specialty addiction care if they need it. This learning community will focus on how your organization can tailor and implement its own SBIRT protocol, and we’ll use training and technical assistance to get you there. Concurrent to situating SBIRT within your organization’s ecosystem, we’ll be supporting state leads to pursue the necessary policy changes to contribute to SBIRT’s real durability.

RASAI Learning Community Members 27 organizations spanning 6 states New York State Council for Community Behavioral Healthcare (State Lead) Astor Services for Children and Families Child & Adolescent Treatment Services Hillside Children’s Center ICL Northeast Parent & Child Society Peninsula Counseling Center   Rhode Island Council of Community Mental Health Organizations, Inc. (State Lead) Gateway Healthcare, Inc. Newport Community Mental Health Center The Providence Center     Tennessee Association of Mental Health Organizations (State Lead) Alliance Healthcare Services Carey Counseling Center, Inc. Frontier Health Helen Ross McNabb Center I wanted you all to get a visual of all the participants in this learning community. As you can see, we have participants that are really geographically diverse, spanning six different states. We think that’s really cool. In a learning community, differences and diversity enhance the learning experience, and create more opportunities for replicability, because different sites are implementing SBIRT and learning, so down the road, other sites have more of a chance of finding a site that’s similar to them. California Council of Community Mental Health Agencies (State Lead) Bill Wilson Center Hathaway-Sycamores Child and Family Services Hillsides Pacific Clinics Turning Point of Central California, Inc. Association of Community Mental Health Centers of Kansas, Inc. (State Lead) Central Kansas Mental Health Center Compass Behavioral Health Elizabeth Layton Center, Inc. Four County Mental Health Center South Central Mental Health Counseling Center The Center for Counseling & Consultation Colorado Behavioral Healthcare Council (State Lead) Community Reach Center Jefferson Center for Mental Health Mental Health Center of Denver San Luis Valley Behavioral Health Group

Guiding Principles of RASAI Incubates innovation Interconnects with our policy priorities Positions organizations for future opportunities Improves operational & administrative backbone for organizational change and innovation Leverages existing strengths and meets members where they are Improves patient outcomes Builds overall co-occurring & whole health capability Provides excellent & responsive customer service Exercises nimbleness and flexibility based on member needs Starts small and scales up The National Council convenes a number of learning communities, ranging from the criminal justice issues, the use of technology in treatment, and trauma-informed care. Basically learning communities emerge when members have interests, needs, innovations, best practices that necessitate convening opportunities to learn. Interconnected with policy priorities- as you can see with this learning community, the nuts and bolts of SBIRT implementation is linked with taking hold of new financing opportunities through the EPSDT benefit and supporting our system to develop more co-occurring capacity and more prevention focus. Driving values is high-touch- that innovation is always coupled with customer service Focused on pulling together subject matter experts and leveraging the expertise in the room. Future-focused- learning communities are the vehicle to take our system from its “as is” to it’s “to be” state. And obviously, enhancing infrastructure, protocols, leadership, relationships, etc. around SBIRT implementation will strengthen your organization globally.

Status Snapshot Incorporating CRAFFT or UNCOPE+ screen into EHR system Teams developing SBIRT action plans Redesigning programming and workflows Agency mission’s incorporating substance use as part of health Policies, procedures and clinical protocol revisions Robust collection of patient-level data Strong state partnerships OASAS/NY Kansas state trainings 400 Clinicians Trained 1,200 Training completions 1600+ Adolescents screened 100% sites implementing

Key Challenges Staff time limitations for completing trainings Staffing issues: turnover, under-staffing, etc. Tight timeline Comfort with brief interventions Questions about confidentiality EHRs and data collection

RASAI Activities 100% of sites are implementing SBIRT 100% of sites completed all program requirements 100% of sites regularly tracking and monitoring key performance indicators related to SBIRT 7 in-person presentations have occurred, with 230 staff in attendance 14 webinar trainings have been presented, with 1,200 training completions

Year 1 Data Highlights (as of June 2015) 61% white 37% have a depressive disorder 56% never smoked 54% no intervention needed 42% need BI or RT 89% accuracy of identifying at-risk adolescents 70% at-risk adolescents received BI or RT 48% who needed BIs received them 35% who needed RT received referral

Adding New Ingredients Brief Intervention Fidelity Calls No-Show Management SBIRT Survival Kits SBIRT Scoop State-Level partnerships Communication/Process Improvements EHR-specific TA

Roundtable Discussions What are you most proud of in year one? What was your biggest challenge in year one? What tools, resources, and/or consultation can the National Council provide to assist you in taking your program to the next level? What’s your number one priority in year 2?