Expert Panel Nominations

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Draft Standards

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Standard 0001: Program routinely uses standardized verbal or written questionnaire screener to identify patients who require clinical intervention related to their substance use beyond routine education about prevention of relapse.

Performance Requirements for 0001

• 0001 - Percent of patients annually screened for risk of problems due to drinking or substance use (including non-medical use of prescription medications).

Numerator: Eligible adult patients with medical record documentation of screening for alcohol use with AUDIT-C or full AUDIT and the NIDA one question drug use screener.

Denominator: Adult patients admitted to the behavioral health program.

Scoring: numerator divided by the denominator multiplied by 100 to convert to a percent.

• 0002 - Percent of adult psychiatric emergency patients annually screened for risk of problems due to drinking or substance use (including non-medical use of prescription medications).

Numerator: Eligible adult emergency psychiatric patients with medical record documentation of screening for alcohol use with AUDIT-C or full AUDIT and the NIDA one question drug use screener.

Denominator: Adult psychiatric emergency patients.

Scoring: numerator divided by the denominator multiplied by 100 to convert to a percent.

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Standard 0002: Behavioral Health Program routinely provides brief motivational enhancement-oriented counseling for patients who screen positive for unhealthy alcohol or drug use to promote reduced hazardous use of alcohol and other drugs and prevent future complications or dependence.

Performance Requirements for 0002

• 0001 - Percent of adult behavioral health program patients who receive a brief intervention for unhealthy or dependent alcohol use or substance use (including non-medical use of prescription medications).

Numerator: Eligible adult behavioral health patients with medical record documentation of brief counseling for unhealthy alcohol and/or drug use.

Denominator: Adult behaivoral health progam patients.

Scoring: numerator divided by the denominator, multiplied by 100 to convert ot a percent.

Rationale: Brief intervention is a separate procedure from screening. Although the proportion of adults patients who receive a brief intervention depends on the prevalence of unhealthy and dependent alcohol and drug use (including prescription medication misuse) in the base population (e.g., geropsychiatric practices may have lower prevalence of unhealthy alcohol and illicit drug use but higher prescription pain medication misuse, compared with public community mental health programs with caseloads of major depression, bipolar disorder, anxiety disorders, where prevalence of unhealthy alcohol use may be greater than 30%), medical records documentation of brief interventions for substance use problems ought not be rare phenomena.

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Standard 0003: Behavioral Health Program monitors substance use and encourges reduction or abstinence.

Performance Requirements for 0003

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Standard 0004: For patients who are medically unstable (e.g., acute trauma, myocardial infarction, and stroke) or psychiatrically unstable (e.g., delirium and imminent risk of harm to self and/or others) or acutely intoxicated, the program makes appropriate referrals for urgent and specialty substance use care or secures substance use consultation to manage the acute episode, and to provide continued care management.

Performance Requirements for 0004

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Comments

23 Jul 08 22:38 | EricGoplerud said...:
At the policy meeting in early July of the National Council for Community Behavioral Health, there was strong support for routine screening for alcohol problems and provision of brief motivational counseling for patients patients presenting with mental illnesses for these community-based mental health programs.

16 May 08 09:28 | KayDoughty said...:
Brief interventions are highly effective, based on extensive research and my own experience with S-BIRT, particularly with Older Adults. Many individuals presenting at medical facilities are there because of their use of alcohol and other drugs. Frequently, these individuals are not asked the appropriate questions that will elicit this use. Time is always a consideration, yet given the ever increasing costs of deep end care, there is a good 'business' case for providing a mechanism to intervene early in the development of addiction or problem use.

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