Wisconsin Department of Health Services SBIRT Ad Hoc Committee Report Presentation to the State...

Wisconsin Department of Health Services

SBIRT Ad Hoc CommitteeReport

Presentation to the State Council on Alcohol and Other Drug Abuse

June 7, 2013


Thank you…

Duncan Shrout, ChairPamela BeanSteven DakaiMichael DavisNina EmersonJay FordTom FuchsShel Gross

Carol Hanneman-GaruzClaudia RoskaLarry MillerKevin MooreRich BrownJoyce O’Donnell and the

Planning & Funding Committee

Ashleah Bennett


Wisconsin has an alcohol problem:

70% prevalence of monthly drinking23% - 30% prevalence of binge drinking1 million meet criteria for risky drinking384,000 meet criteria for Alc Use Disorder1 out of 20 in need of treatment receive it$6.8 billion annual cost from alcohol


SBIRT can provide needed prevention, early identification,

intervention, and referral resources.


The SBIRT model:

• Screening brief assessment

• Brief Intervention (protocol-guided, ~15 minutes)

• Referral to Treatment


& Population Health

Normative Drinking

Risky Drinking

Problem Drinking

Likely Dependent


Wisconsin SBIRT (2006-2011)

• 113,642 screens ~ 3% of the primary care population• 16,950 brief interventions• 1,101 referral conversations


Wisconsin SBIRT (Outcome Study, N = 675)

• 20% reduction of risky drinking• 18% reduction of marijuana use• High patient satisfaction


20% risky drinking is linked to…

20% emergency visits33% injuries37% hospital admissions46% arrests50% automobile crashes


SBIRT saves costs

Medicaid ~ $170 millionBusinesses ~ $895 per employeeETF ~ $52 million


If SBIRT is so great, why aren’t health care providers delivering it?• Not enough time• Too many other initiatives - low priority• Lack of recognition that addressing

patient AOD use is important• Not a big money maker


What would need to happen if SBIRT were to achieve large-scale

implementation?

• Implementation factors• Focus of services• Workforce• Financing


Implementation factors

• Integrating SBIRT into clinic flow takes strategic planning• Robust quality improvement process• Implement quality and outcome

measures• Develop linkages with treatment

providers


Focus of SBIRT

• Alcohol*• Illicit Drugs*• Tobacco*• Depression*• Diet• Exercise

* Reimbursable service


A workforce is needed

• Current health care professionals don’t have time• Employing paraprofessional “health

educators” can be highly effective • Expanding the healthcare team• Training, education, and on-going

professional development


Financing SBIRT

• Medicaid – “effective reimbursement”• Commercial Insurance - ???• Health care reform codifies SBIRT• Financial incentives may be needed

(e.g., pay-for-performance)


Recommendations of the SBIRT Ad Hoc Committee relate to…

• Coordination • Providers• Purchasers• Payers• Dissemination


Motions1) SCAODA accept the SBIRT Ad Hoc Committee Report

dated May 1, 2013;2) SCAODA forward the accepted Report to the Wisconsin

Council on Mental Health and the Wisconsin Council on Public Health for their information and further action;

3) SCAODA forward the accepted Report to the Majority and Minority Leadership of the Wisconsin State Senate and Assembly for their information and further action; and

4) SCAODA forward the accepted Report to Governor Scott Walker for his information and further action.

Wisconsin Department of Health Services SBIRT Ad Hoc Committee Report Presentation to the State...

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Transcript of Wisconsin Department of Health Services SBIRT Ad Hoc Committee Report Presentation to the State...