SBIRT Initiative

The New Hampshire Youth SBIRT Initiative of the New Hampshire Charitable Foundation is supported in partnership with the Conrad N. Hilton Foundation. This Initiative addresses a primary goal of the statewide strategic plan developed by the Governor’s Commission on Alcohol and Drug Abuse Prevention, Intervention and Treatment: Collective Action – Collective Impact. This strategic plan calls for the implementation of SBIRT in primary care throughout New Hampshire as an effective prevention, intervention and public health strategy. This vanguard Initiative is a timely response to the changing healthcare environment offering a mechanism for aligning healthcare and public health systems throughout the state.

The Foundations are committed to moving forward on youth prevention and intervention as a means to address root causes, avert the harmful lifetime consequences of substance misuse and addiction, and positively impact public health. More information on the Conrad N. Hilton Foundation’s national SBIRT strategy can be found on their website.

The Goal

The global aim of the New Hampshire Youth SBIRT Initiative is universal screening of adolescents and young adults across NH pediatric primary care practices as a proven strategy for reinforcing healthy behaviors; identifying problematic drug and alcohol use early; reducing substance misuse; and referring to treatment those who need it. This three-year initiative’s goal is the adoption of Screening, Brief Intervention and Referral to Treatment (SBIRT) as a sustainable practice in NH by expanding youth SBIRT in primary medical care settings – including hospitals and community health centers – addressing policy and financing barriers, and screening no less than 10,000 youth and young adults (ages 12-22) by 2017.

The Initiative

In the context of heightened awareness about the state’s opioid crisis and persistent high rates of alcohol and other drug use among NH young people, NH has been leading the way in adopting Screening, Brief Intervention and Referral to Treatment (SBIRT) as standard practice, with a special focus on adolescent and young adult patients as well as those served by community health centers.

sbirt-map-posterAt least 28 pediatric and primary care practice sites, serving tens of thousands of NH patients, have now incorporated SBIRT into routine patient care to help patients address and moderate their substance use, to identify referrals for counseling or treatment where needed, and to provide practitioners with essential information to inform good patient care. Over 300 of NH’s primary care providers, and many other staff across the state, have already received SBIRT training, and well over 12,000 NH youth and young adults have already been screened for substance use.

As health systems in NH move increasingly toward integration of primary care and behavioral health, medical professionals equipped with screening and intervention skills and best practice tools are well positioned to participate successfully, improving patient outcomes and reducing health care costs.

The NHH Charitable Foundation has funded three cohorts of grantees to date for SBIRT implementation.  The first cohort, which began its work in April 2014, includes:

  • Goodwin Community Health Center
  • Children’s Hospital at Dartmouth-Hitchcock (Lebanon)
  • Mid-State Health Center
  • Valley Regional Medical Center
  • Wentworth-Douglass Health System

The second cohort began its SBIRT implementation work in May 2015, and includes:

  • Dartmouth-Hitchcock (Bedford, Manchester, Plymouth)
  • Manchester Community Health Center
  • White Mountain Community Health Center

The third and final cohort was identified in December 2015, and includes:

  • Concord Hospital
  • Health First Family Care Center
  • Weeks Medical Center

As the initiative has progressed we have utilized lessons learned in coordination with 13 Federally Qualified Health Centers funded by the Bureau of Drug and Alcohol Services to implement S•BI•RT  into their primary care practices for adults ages 18 and over.  As a result of this collaboration, seven of these centers have expanded their target population to include adolescent patients ages 12 and older.  Thus the initiative has taken advantage of synergies to optimize both youth and adult S•BI•RT implementation into patient care across the state

In support of the Initiative, the NH Center for Excellence at the Community Health Institute provides technical assistance to grantees. New Futures provides policy and advocacy support to address identified legislative or regulatory barriers.

Look what our grantees are up to!

Daisy Goodman, CNM, DNP, MPH,  of the Perinatal Addiction Treatment Program, Dartmouth Hitchcock Medical Center and colleagues across the country were featured on the Institute for Healthcare Improvement’s (IHI) free “talk show” program that helps health care “improvers” keep up with the freshest and most robust thinking and strategies for improving patient care.  The subject of this program was “Nurturing Trust: Addiction and Maternal and Newborn Health”.