Provider Alerts

Health Plan of San Joaquin (HPSJ) received All Plan Letter (APL) 21-014 from the Department of Health Care Services (DHCS) which clarifies the primary care requirement to provide Alcohol and Drug Screening, Assessment, Brief Interventions and Referral to Treatment (SABIRT) to members ages 11 years and older, including pregnant women. Clarification of these requirements are listed below, but can also be found on the DHCS website at: https://www.dhcs.ca.gov/formsandpubs/Documents/MMCDAPLsandPolicyLetters/APL2021/APL21-014.pdf

1. Providers are required to provide SABIRT services for all members 11 years of age and older, including pregnant women, along with ensuring that all applicable laws and regulations relating to the privacy of substance use disorders (SUD) records and the right of minors over age 12 are followed correctly.
2. Providers are required to conduct screening for unhealthy alcohol and drug use using the validated screening tools. Validated screening tools include, but are not limited to:
   • a. Cut Down-Annoyed-Guilty-Eye-Opener Adapted to Include Drugs (CAGEAID)
   • b. Tobacco Alcohol, Prescription medication and other Substances (TAPS)
   • c. National Institute on Drug Abuse (NIDA) Quick Screen for adults:
     • • The single NIDA Quick Screen alcohol-related question can be used for alcohol use screening
   • d. Drug Abuse Screening Test (DAST-10)
   • e. Alcohol Use Disorders Identification Test (AUDIT-C)
   • f. Parents, Partner, Past and Present (4Ps) for pregnant women and adolescents
   • g. Car, Relax, Alone, Forget, Friends, Trouble (CRAFFT) for non-pregnant adolescents
   • h. Michigan Alcoholism Screening Test Geriatric (MAST-G) alcohol screening for geriatric population.
3. When a screening is positive, providers are required to utilize validated assessment tools to determine if unhealthy alcohol use or SUD is present. Validated alcohol and drug assessment tools may be used without first using validated screening tools. Validated assessment tools include, but are not limited to:
   • a. NIDA-Modified Alcohol, Smoking and Substance Involvement Screening Test (NM-ASSIST)
   • b. Drug Abuse Screening Test (DAST-20)
   • c. Alcohol Use Disorders Identification Test (AUDIT)
4. For recipients with brief assessments that reveal unhealthy alcohol use, brief misuse counseling should be offered. Appropriate referral for additional evaluation and treatment, including medications for addiction treatment, must be offered to recipients whose brief assessment demonstrates probable AUD or SUD. Alcohol and/or drug brief interventions include alcohol misuse counseling and counseling a member regarding additional treatment options, referrals, or services. Brief interventions must include the following:
   • a. Providing feedback to the patient regarding screening and assessment results.
   • b. Discussing negative consequences that have occurred and the overall severity of the problem.
   • c. Supporting the patient in making behavioral changes.
   • d. Discussing and agreeing on plans for follow-up with the patient, including referral to other treatment if indicated.
5. Providers must maintain documentation of SABIRT services provided to members. When a member transfers from one primary care provider (PCP) to another, the receiving PCP must attempt to obtain the member’s prior medical records, including those pertaining to the provision of preventive services. Providers must ensure the following in included in member medical records:
   • a. The service provided (e.g., screen and brief intervention).
   • b. The name of the screening instrument and the score on the screening instrument (unless the screening tool is embedded in the electronic health record).
   • c. The name of the assessment instrument (when indicated) and the score on the assessment (unless the screening tool is embedded in the electronic health record).
   • d. If and where a referral to an AUD or SUD program was made.

Should you have any further questions, please contact our Customer Services Department at (209) 942‐6320. You may also visit https://www.hpsj.com/alerts/ for online access to the documents shared. The most recent information about Health Plan of San Joaquin and our services is always available on our website https://www.hpsj.com/.