GPRA Data Report: April 2020 · 1.2% Referral to Treatment, 1.5% Figure 1. Screening Score Distribution Report Summary • PA SBIRT project sites have provided SBIRT services to 14,866

GPRA Data Report: April 2020

Pennsylvania Screening, Brief Intervention, and Referral to Treatment (PA SBIRT) is a five-year initiative that will provide SBIRT services

throughout the Commonwealth through September 2021. Funding for the project is granted through the Substance Abuse and Mental

Health Services Administration (SAMHSA) Center for Substance Abuse Treatment (CSAT).

PA SBIRT aims to provide SBIRT services to 20,778 unduplicated patients during the grant period. All data is collected and reported in

accordance with the Government and Performance Results (GPRA) Act of 2010. The purpose of this report is to outline key findings and

recommendations based upon GPRA analyses for the PA SBIRT initiative to date.

6 Active Project Sites

14,866 Unduplicated Screenings

→ 17,629 GPRA Target

→ 84.3% Coverage Rate

→ 85.5% Scored “Negative” (Figure 1)

56,062 Total Screenings Conducted

4,303 Brief Interventions Conducted

797 Connections to Speciality Resources

Screening

and

Feedback,

85.5%

Brief

Intervention,

11.2%

Brief

Treatment,

1.2%Referral to

Treatment,

1.5%

Figure 1. Screening Score Distribution

Report Summary

• PA SBIRT project sites have provided SBIRT services to 14,866 (84.3%) of the 17,629 unique patients intended

to be served to date. This is a 0.81% increase since the month of March 2020.

• The overall follow-up enrollment rate is 9.94%, just below the 10% requirement. PERU will work with each site

to address this decrease. Patients continue to report significant decreases in days of use after SBIRT services.

• EMPOWER3 Center for Health (EMP – Pg. 3) provided 100% of the necessary brief interventions in April despite

workflow modifications. The site will work to increase the screening rate and move forward with opportunities

to promote sustainability.

• Altoona Family Physicians (AFP – Pg. 4) implemented screening during telehealth appointments in April. The

Pregnancy Care Center (PCC – Pg. 5) is exploring opportunities to increase the screening rate.

• Primary Health Network (PHN) sites convened a sustainability workgroup. Greenville Community Health

Center (GCHC – Pg. 7) is exploring opportunities to increase the screening rate and Sharon Medical Group

(SMG – Pg. 6) is exploring methods to improve patient connections to the Care Coordinator.

• Allegheny Health Network’s Forbes Family Medicine (FFM – Pg. 8) continues to maintain a high screening rate.

The site is working to improve the follow-up enrollment rate and expand screening efforts through telehealth

services.

Project to Date

2

The PA SBIRT initiative is committed to following-up with 10% of patients who score in the BI, EI, or RT ranges. CSAT requires grantees to

conduct a 6-month follow-up interview with at least 80% of these patients. Six-month follow-up interviews can be conducted between 5

and 8 months after initial patient intake.

23% increase in patients who report no use at follow-

up compared to reported use at intake (Figure 2).

28% 33%

32% 22%

33%

16%

14%

37%

0%

25%

50%

75%

100%

Intake (n=179) Follow-Up (n=179)

Figure 2. Substance Use at Intake &

Follow-Up

Alcohol Only Drugs Only

Both Alcohol and Drugs No Use

Patient Follow-Up

Focus of the Month

• The results reported on the left (Figure 3) show a decrease

in almost 2 and a half days of alcohol consumption and a

decrease in 5 and a half days of drug use when asked about

frequency of use in the past 30 days at follow-up.

• Complete and immediate abstinence is not always a

realistic strategy when decreasing substance use.

• This finding supports SBIRT services as a harm reduction

strategy to gradually decrease a change in use behavior

2 of 6 implementation sites have enrolled at least

10% of eligible patients in follow-up. 2,153 Eligible for Enrollment

→ 214 Paients Enrolled

→ 9.94% Enrollment Rate

198 Eligible for Interview

→ 179 Interviews Completed

→ 90.4% Completion Rate

17% decrease in patients who report poly-substance

use at follow-up compared to reported use at intake.

Patients who receive SBIRT services report

significant decreases in reported days of substance

use between the initial appointment and 6-month

follow-up interview.

6.7

10.67

4.38

5.19

0 2 4 6 8 10 12

Alcohol

Drugs

Figure 3. Average Days of Use in Last 30

Days, Including Abstentees (N=192)

Follow-Up Intake

3

16,076 Screens to Date

12.7% Eligible Patients

Enrolled in Follow-Up

Success from April Goal for May

EMPOWER3 Center for Health (EMP) began SBIRT implementation on March 6, 2017. The site has reached a steady state

of implementation, as clinical staff screened 90% of patients over the past month. The site continues to move forward

with conversations and actions to promote SBIRT sustainability.

Intervention Outcomes Services Completed Eligible Patients Completion Rate

Brief Intervention (BI) 1,129 1,223 92.3%

Early Intervention (EI) 38 142 26.8%

Referral to Treatment (RT) 383 163 235.0%

Monthly CQI Goal

• Increase the screening rate to 90% by the end

of May.

Area for Improvement

• The screening rate for April (82%) is lower

than the EMP average yet has shown signs of

improvement since the steep decline in March

(74%) (Figure 5).

Accomplishment

• The rate of completed brief interventions has

increased (100%) since a decline in services

during March 2020 (63%) (Figure 4).

Actions

• PERU will assist the site with ongoing

monitoring of rates and workflow

modifications due to COVID-19.

EMPOWER3 Center for Health PA SBIRT GPRA Data Report: April 2020

Lesson Learned

• Despite workflow modifications, strong

communication between the Site Champion

and Care Coordinator have allowed for the

continuation of SBIRT and successful patient

referrals.

60%

65%

70%

75%

80%

85%

90%

95%

100%

Figure 4. EMP Successful BI Rate

Completed BI Rate

Completed BI Target

Linear (Completed BI Rate)

70%

75%

80%

85%

90%

95%

100%

Figure 5. EMP Screening Rate

Screening Rate

Screening Target

Linear (Screening Rate)

4





Altoona Family Physicians (AFP) began full SBIRT implementation on June 11, 2018. Implementation calls increased to

weekly to evaluate the new changes in workflow. AFP quickly transitioned to screening during telehealth appointments

this month and is continuing to train staff in this process and adapt the workflow as needed.





Monthly CQI Goal

• Increase the screening rate to 90% by the end

of May.

Accomplishment

• During the month of April, the rate of

completed brief interventions increased from

45% to 82% (Figure 6).


• The site transitioned to telehealth rapidly and

worked to continue SBIRT screening during this

transition. However, the screening rate has

declined to 79% (Figure 7).

Actions




Altoona Family Physicians

Lesson Learned

• SBIRT services halted due to COVID-19, but the

site had a strong line of communication which

made the transition to screening via telehealth

and SBIRT implementation successful.

PA SBIRT GPRA Data Report: April 2020

70%

80%

90%

100%

Figure 7. AFP Screening Rate

Screening Rate

Screening Target


40%

50%

60%

70%

80%

90%

100%

Figure 6. AFP Successful BI Rate

Successful BI Rate

Successful BI Target

Linear (Successful BI Rate)

5





UPMC Pregnancy Care Center (PCC) began full SBIRT implementation on June 11, 2018. Biweekly calls continue to occur

with PERU to assess SBIRT services. PCC recently moved their office to a new location, but quickly began offering SBIRT

services.


Brief Intervention (BI) 353 457 77.2%



Monthly CQI Goal

• Increase the rate of accepted and completed

patient screenings to 80% of eligible patients by

the end of May.

Accomplishment

• The Care Coordinator was able to enroll a

patient into the follow-up pool during April

2020, maintaining the required 10% for the

4th month in a row this year (Figure 8).


• The rate of accepted screens has increased

since March 2020 (74%) but remains below the

goal of 80% (Figure 9).

Actions




UPMC Pregnancy Care Center PA SBIRT GPRA Data Report: April 2020

Lesson Learned

• With the PCC Care Coordinator working

remotely, open and constant communication

with the Site Champion has been an important

facilitator to the SBIRT process.

9.5%

10.0%

10.5%

11.0%

11.5%

12.0%

12.5%

13.0%

13.5%

Figure 8. PCC Follow-Up Enrollment Rate

Follow-up Enrollment Rate

Follow-up Enrollment Target

Linear (Follow-up Enrollment Rate)

60%

65%

70%

75%

80%

85%

90%

Figure 9. PCC Accepted Screening Rate

Accepted Screening Rate

Accepted Screening Target

Linear (Accepted Screening Rate)

6

9,761 Patients Served

to Date




Sharon Medical Group (SMG) implemented on September 5, 2017. Bi-weekly calls continue to occur with PERU to assess

SBIRT services and continue to monitor warm hand-offs between the providers and Care Coordinator.





Sharon Medical Group

Accomplishment

• SMG maintains a high BI completion rate

(100%) (Figure 10).

Lesson Learned

• SMG’s providers have normalized the

integration of brief interventions in the medical

appointment, and this allowed the providers to

build exceptional rapport with patients.


• Beginning in January, SMG experienced a

disruption in connecting patients to the Care

Coordinator using electronic referrals (Figure

11).

Monthly CQI Goal

• The team will work to increase the electronic

referral rate to 40% by the end of May.

Actions

• PERU will report this rate on a weekly basis

so that the Site Champion can explore gaps in

close to real-time and discuss barriers in

referrals with the site providers.

PA SBIRT GPRA Data Report: April 2020

75%

80%

85%

90%

95%

100%

Figure 10. SMG Successful BI Rate

Brief Intervention Rate

Brief Intervention Target

Linear (Brief Intervention Rate)

0%

10%

20%

30%

40%

50%

Figure 11. SMG Elctronic Referral Rate

Connection Rate

Connection Target Rate

Linear (Connection Rate)

7

250 Patients Served

to Date




Greenville Community Health Center (GCHC) implemented SBIRT on January 8, 2020. Bi-weekly calls continue to occur

with PERU to assess SBIRT services and discuss quality improvement opportunities. Network sustainability meetings are

scheduled to occur monthly.


Brief Intervention (BI) 10 21 48%

Early Intervention (EI) 2 4 50%

Referral to Treatment (RT) 1 2 50%

Monthly CQI Goal

• GCHC will aim to reach an 80% screening rate

by the end of May.

Accomplishment

• The distribution of SBIRT scores (Figure 12)

aligns closely with the expected distribution

during the beginning stages of

implementation (Figure 1).


• The screening rate for eligible patients is below

the 80% target (Figure 13).

Actions

• GCHC will continue distributing the

introduction flyer to patients who check in at

the clinic. The team will continue to explore

new opportunities to increase the eligible pool

of patients for screening.

Greenville Community Health Center PA SBIRT GPRA Data Report: April 2020

Lessons Learned

• PHN leadership met to discuss the opportunity

of implementing additional routes of

electronic screening through at-home check-

in procedures, which will increase patient

reach during a period of decreased in-person

visits.

Screening

and

Feedback,

90.8%

Brief

Intervention,

6.0%

Brief

Treatment,

1.6%

Referral to

Treatment,

0.8%

Figure 12. GCHC Screening Distribution

30%

40%

50%

60%

70%

80%

90%

100%

Figure 13. GCHC Monthly Screening Rate

January 2020-April 2020

Screening Rate Screening Target


8





Forbes Family Medicine (FFM) began SBIRT implementation on May 29, 2019. PERU is working with the Site

Champion to update the site's internal training materials. The site is exploring opportunities to transition

telehealth appointments and incorporate SBIRT screening. Currently, screening and brief interventions are

occurring for any in-person appointments.


Brief Intervention (BI) 223 261 85.4%



Monthly CQI Goal

• Decrease the rate of patients scoring negative

to 90% by the end of May.

Accomplishment

• The screening rate has remained above the

80% target, despite workflow modifications

due to COVID-19 (Figure 14).


• The rate of patients scoring negative has been

above the target over the first several months

of 2020 (Figure 15).

Actions

• PERU will complete an in-depth analysis of

contributing factors and propose actions to

the project site.

Forbes Family Medicine PA SBIRT GPRA Data Report: April 2020

Lessons Learned

• With the FFM Care Coordinator working

remotely, open and constant communication

has been an important facilitator to the SBIRT

process.

75%

80%

85%

90%

95%

100%

Figure 14. FFM Screening Rate

Screening Rate Rate

Screening Rate Target

Linear (Screening Rate Rate)

80%

85%

90%

95%

100%

Figure 15. FFM Negative Screening Rate

Negative Screening Rate

Negative Screening Target

Linear (Negative Screening Rate)

Documents

GPRA Data Report: April 2020 · 1.2% Referral to Treatment, 1.5% Figure 1. Screening Score Distribution Report Summary • PA SBIRT project sites have provided SBIRT services to 14,866