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

2. 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

3. 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

4. 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

5. 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

6. 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.

7. 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

8. 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.

9. 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

10. 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

11. 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

12. 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

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

14. 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?