Reducing Adolescent Substance Abuse Initiative: Adolescent SBIRT Implementation in the Behavioral Health Setting: Final Report
In 2014, the Hilton Foundation provided funding to the National Council for Behavioral Health to develop the Reducing Adolescent Substance Abuse Initiative (RASAI). The initiative focused on prevention and early intervention of youth substance use and included implementation of SBIRT within community behavioral health settings and the facilitation of a learning community among sites. More specifically, RASAI’s objectives included training providers, lobbying for policy and regulatory changes, developing monitoring & evaluation processes, funding sustainable financial strategies, and disseminating project findings to the wider public health community. The final RASAI report indicates that staff shortages and turnover presented challenges, but can be balanced with ongoing SBIRT training. Additionally, increased SBIRT knowledge can reinforce a smooth referral process, but which may require building a strong external referral network. The financial landscape surrounding SBIRT provision is also varied, so the authors advise practices to seek state-specific funding sources (CCBHC’s, Medicaid Health Homes, Managed Care, State Innovation Model Grants) or to integrate SBIRT into other billable patient encounters. Incomplete Medicaid payment structures also impede data collection. Practice EHR’s should therefore be set up with behavioral health compatibilities to allow for in-house data collection and program monitoring.