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The federal confidentiality rules in 42 CFR Part 2 would not apply to primary care health homes in most cases because they do not normally meet the definition of a “program” (i.e., substance abuse treatment is not their principal practice) and do not hold themselves out as providers of alcohol and drug abuse treatment services:

Further, while the term “general medical care facility” is not defined in the definitions section of 42 CFR 2.11, hospitals, trauma centers, or federally qualified health centers would generally be considered “general medical care” facilities. Therefore, primary care providers who work in such facilities would only meet Part 2’s definition of a program if 1) they work in an identified unit within such general medical care facility that holds itself out as providing, and provides, alcohol or drug abuse diagnosis, treatment or referral for treatment, or 2) the primary function of the provider is alcohol or drug abuse diagnosis, treatment or referral for treatment and they are identified as providers of such services.  [Source:]

Of course, the lines in some cases are not clear, and any agency in question should seek legal counsel.

Division of Comprehensive Psychiatric Services
Division of Alcohol & Drug Abuse
Department of Mental Health
1706 E. Elm St.
Jefferson City, MO  65101
Phone (573) 751-9499
Fax (573) 751-7814  

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CHCs participating in the Missouri Primary Care Health Home Initiative will receive $30,000 in one time funding to cover the costs associated with start-up for the implementation of SBIRT  Permalink
Absolutely. Anyone with authorization to your patients' on eSBIRT can complete the process. Permalink
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  • Assists CHC in meeting five of the required performance measures for the Primary Care Health Home Initiative
    • Substance abuse screening utilizing a standardized tool
    • Reduce proportion of adults reporting use of illicit drugs
    • Reduce proportion of adults who drank excessively
    • Tobacco use assessment and cessation advice/treatment
    • Depression screening utilizing a standardized tool
  • $30,000 in additional funding to support substance use prevention efforts
  • Access to training and technical assistance for your behavioral health consultant
  • Opportunity to develop and/or enhance the relationship with your local alcohol and drug treatment providers
  1. In the past 3 months, how often do you have a drink containing alcohol?
  2. In the past 3 months, how many drinks containing alcohol do you have on a typical day when you are drinking?
  3. Females (and Males over 65): In the past 3 months, how often do you have 4 or more drinks on one occasion?
    Males: In the past 3 months, how often do you have 5 or more drinks on one occasion?
  4. In the last twelve months, did you smoke pot, use another street drug, or use a prescription painkiller, stimulant, or sedative for a non-medical reason?
Prescreen provider completed version (pdf) Permalink
The local ID number is whatever number you use to uniquely identify this patient in your EMR. It may be called a case number or patient ID. What is important is that this number is used to identify the patient each time they are admitted/seen by your site. Permalink
  • SAMHSA Grant awarded to the Department of Mental Health 
  • Grant is Administered by Missouri Institute for Mental Health on behalf of DMH 
  • Grant is designed to reduce risky alcohol and drug use to prevent problem substance use and reduce medical costs.
  • MPCA in partnership with MIMH and St. Louis Behavioral Medicine Institute will be providing training for the behavioral health consultants in April 2012.
    • Format of Training:
      • Face to face training at a central location in Jefferson City or Columbia for the behavioral health consultants
        • Topics:
          • Roles, responsibilities, and interventions for behavioral health consultants practicing in a primary care setting
          • SBIRT model, tools, and procedures (Screener, ASSIST, brief coaching/interventions, documenting in eSBIRT, evaluation, reporting requirements)
        • Webinar(s)
        • Face to face regional training likely in Columbia, Kansas City, Springfield, and St. Louis for the behavioral health consultants and nurse care managers provided by MIMH master trainers
          • Topic:
            • Motivational Interviewing
        • Learning Collaborative Learning Sessions
        • Site visits
        • Telephone technical assistance and consultation
To prevent unnecessary duplicate data entry, the PHQ2 is no longer entered in eSBIRT. Permalink
  • Conduct SBIRT screening with ALL patients 18 and older
  • Screening is designed to be completed once per year.
  • Seven questions (5 SBIRT and 2 Depression questions)
  • PHQ 2 Depression Screening will be added to SBIRT screener to allow ease in administering required yearly depression screening
  • CHC will need to create or adapt screens and/or templates in EMR according to MPCA recommendations to capture SBIRT pre-screen answers for reporting to FQHC, MOSBIRT, and MO HealthNet Division for the MO Primary Care Health Home Initiative (costs associated with creating/adapting screens or templates in the EMR will be the responsibility of the CHC).
  • MPCA is working with Arcadia and MIMH regarding the IT for the implementation of SBIRT and mapping/reporting to the data warehouse (mapping costs to the data warehouse will be covered by MPCA contract with MIMH)
  • Staff member rooming the patient asks the patient the SBIRT prescreen questions once per year
  • Answers are entered directly in the EMR (distinct data fields)
  • Positive screening results on the SBIRT questions require additional action.
    • Positive SBIRT requires the administration of the ASSIST assessment developed by the World Health Organization and ideally is performed by the behavioral health consultant to determine if further action is needed. This is done in the eSBIRT system.
  • Contract will be with Missouri Institute of Mental Health a division of the University of Missouri St. Louis
  • To start the contracting process, complete the collaborating agency portion of the new vendor form and return to Barbara Keehn at
DSS will not offset the funding on the cost report due to originating from a federal agency (Susan received e-mail confirmation from DSS) Permalink