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Washington State Screening, Brief Intervention, Referral and Treatment (WASBIRT)

Description: In the fall of 2003, the Washington State Office of the Governor was awarded funding from the U.S. Department of Health and Human Services, Center for Substance Abuse Treatment (CSAT) for a five-year cooperative agreement, titled the Screening, Brief Intervention, Referral and Treatment (SBIRT) Program. The Governor’s Office directed the Division of Alcohol and Substance Abuse (DASA) of the Department of Social and Health Services (DSHS) to implement the SBIRT Program in large hospital emergency departments across the state. The project will provide brief interventions, brief therapy, and, in some cases, chemical dependency treatment to emergency department patients who screen positive for substance use disorders. Over the course of the five-year project, an estimated 122,905 emergency department patients will be screened for these disorders, and about half of these are expected to receive at least a brief intervention to address their substance use disorder. Ninety percent of the $3.5 million invested annually by CSAT in this project is allocated directly to clinical services.

The project is designed to achieve the following goals:

• Maximize the number of emergency department (ED) patients with substance abuse problems who can be identified through screening.
• Deliver brief counseling, called “brief interventions,” to patients who screen positive for substance use disorders.
• Deliver brief outpatient therapy counseling at certified treatment organizations.
• Increase referrals of chemically dependent people from the generalist medical setting to specialist chemical dependency treatment agencies.
• Reduce subsequent emergency department use rates, medical costs, criminal behavior, disability, and death for patients with alcohol and drug problems of all severity levels.
• Examine the degree to which substance abuse services can be expanded to include early intervention.
• Improve the links between the medical and chemical dependency treatment communities so that providing screenings and interventions for substance use disorders can be sustained over time.

Hospitals in six counties with some of the largest ED patient loads are participating in the WASBIRT Project: Harborview Medical Center in King County; Southwest Washington Medical Center in Clark County; Providence Everett Medical Center in Snohomish County; Tacoma General and Allenmore Hospitals in Pierce County; Toppenish Community Hospital, Yakima Regional Medical and Heart Center, and Yakima Valley Memorial Hospital in Yakima County; and Providence St. Peter Hospital in Thurston County. To implement WASBIRT, the Division of Alcohol and Substance Abuse has joined forces with a number of partners, including the Governor’s Office, the DSHS Medical Assistance Administration, the Department of Health, participating counties and hospitals, chemical dependency treatment providers, and a broad range of policy makers who are represented in the WASBIRT Policy Steering Committee. The DSHS Research and Data Analysis Division will conduct an evaluation of the effectiveness of this project. In addition, DASA has contracted with nationally recognized trainers from the University of Washington’s Harborview Medical Center and the Northwest Frontier Addiction Technology Transfer Center to provide training on brief interventions and motivational counseling.

The evaluation of the WASBIRT Project being conducted by the DSHS Research and Data Analysis Division is based on a rigorous evaluation design that will examine the effectiveness of WASBIRT in producing favorable outcomes, including reduced substance use, fewer emergency department visits, lower medical costs for Medicaid clients, less involvement in criminal activities, and improved employment levels. The results of this evaluation will be used to inform state policy.

At its conclusion, this five-year initiative is expected to broaden the state’s continuum of care for substance use disorders to include brief intervention and brief therapy, as defined within the Washington State Administrative Code. Furthermore, DASA and the WASBIRT Policy Steering Committee will work to ensure the financial sustainability of these services over time.

Contacts:

Stephen O’Neil, WASBIRT Project Director, Division of Alcohol and Substance Abuse, telephone: (360)725-3718

Sharon Estee, WASBIRT Evaluation Project Director Research and Data Analysis Division, telephone: (360) 902-7655

Modified: Friday February 29 2008