Appendices

Play 1: Forming a Team

Appendix A – S•BI•RT  Team Examples

Appendix B – Meeting Agenda

Play 2: Using a Change Model

Appendix C – Site Plan-Do-Study-Act (PDSA) Example

Appendix D – Clinical Microsystems: A Model for Improvement

Play 3: Developing a Plan, Goals and Strategies

Appendix E – Team S•BI•RT Plan

Play 4: Confidentiality

Appendix F – S•BI•RT: Federal Alcohol and Drug Confidentiality Overview

Appendix G – S•BI•RT: Health Centers and Confidentiality Overview

Play 5: Screening Tool(s)

Appendix H – S2BI Screening Tool

Appendix I – CRAFFT 2.0 Screening Tool

Play 6: Brief Intervention

Appendix J – Example Brief Intervention Dialogue

Appendix K – Brief Intervention Tools

Play 7: Referral to Treatment

Appendix L – NH Alcohol and Drug Treatment Locator

Appendix M – NH Addiction Crisis Line

Appendix N – Core Competencies For Licensed Behavioral Health Counselors

Appendix O – Release of Information Example

Appendix P – DSM-V Substance Use Disorder Diagnosis Overview

Play 8: Follow Up

Appendix Q – Screen Shots of NH S•BI•RT Initiative EHRs

Play 9: Flow

Appendix R – Flow Chart Examples

Play 10: Electronic Health Record (EHR) Modification

Appendix Q – Screen Shots of NH S•BI•RT Initiative EHRs

Play 11: Quality Improvement (QI) & Data Collection

Play 12: Billing/Reimbursement

Appendix S – NH S•BI•RT Billing & Coding

Appendix T – New Futures Medicaid EPSDT Overview

Play 13: Communications

Play 14: Training

Appendix U – S•BI•RT Learning Opportunities and Resources Available Through the Center for Excellence

Play 15: Reflection and Celebration


Appendix V – Annotated Bibliography

All Appendices