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California Health & Wellness is no longer a Medi-Cal plan starting January 1, 2024. Regardless of the county you live in, your Medi-Cal service and benefits will not be impacted by the health plan changes since you will be assigned to a new health plan. The county you live in determines your new health plan. Learn more
California Health & Wellness is no longer a Medi-Cal plan starting January 1, 2024. Regardless of the county you live in, your Medi-Cal service and benefits will not be impacted by the health plan changes since you will be assigned to a new health plan. The county you live in determines your new health plan. Learn more

22-063 Updates to Screening, Brief Intervention and Referral to Treatment Services Requirements

Date: 01/31/22

Use the substance abuse screening tools to help members address alcohol and drug use

Screening, Assessment, Brief Interventions and Referral to Treatment (SABIRT) services must be provided to members ages 11 and older, including pregnant women.

Managed care plans (MCPs) and MCP-contracted providers must comply with all applicable laws and regulations relating to the privacy of Substance Use Disorder (SUD) records. Providers must also comply with state law concerning the right of minors over age 12 to consent to treatment, including, without limitation, Title 42 Code of Federal Regulations (CFR) Section 2.1 et seq., 42 CFR Section 2.14, and Family Code Section 6929.

Who can provide SABIRT services?

SABIRT services may be provided by providers within their scope of practice, including, but not limited to:

  • Certified nurse midwives.
  • Licensed midwives, clinical social workers, professional clinical counselors, psychologists and licensed marriage and family therapists.
  • Nurse practitioners.
  • Physicians.
  • Physician assistants.

Substance abuse screening tools

Members are allowed at least one alcohol and drug use screening per year. Additional screenings are allowed if medical necessity is documented.  Alcohol and drug use screenings must be conducted with the use of validated screening tools, such as the:

  • Alcohol use disorders identification test (AUDIT).
  • Alcohol use disorders identification test (Audit-C).
  • Car, Relax, Alone, Forget, Friends, Trouble (CRAFFT) for non-pregnant adolescents.
  • Cut down-annoyed-guilty-eye-opener adapted to include drugs (CAGE-AID).
  • Drug abuse screening test (DAST-10).
  • Drug abuse screening test (DAST-20).
  • Michigan alcoholism screening test geriatric (MAST-G) alcohol screening for geriatric population.
  • National institute on drug abuse (NIDA) quick screen for adults.
    • The single NIDA quick screen alcohol-related questions can be used for alcohol use screening.
  • NIDA-modified alcohol, smoking and substance involvement screening test (NM-ASSIST).
  • Parents, partners, past and present (4Ps) for pregnant women and adolescents.
  • Tobacco alcohol, prescription medication, and other substances (TAPS).

The substance abuse screening tools are available from the National Institute on Drug Abuse (NIDA).

Behavioral counseling interventions for alcohol and substance use disorder (AUD or SUD)

Behavioral counseling interventions are allowed if medical necessity has been determined. Members are allowed at least three behavioral counseling intervention sessions per year. Providers may combine the sessions in one or two visits, or administer as three separate visits. Brief interventions must include:

  • Feedback to the patient regarding screening and assessment results;
  • Discussion of negative consequences that have occurred and the overall severity of the problem;
  • Support for the patient in making behavioral changes; and
  • Discussion and agreement on plans for follow-up with the patient, including referral to other treatment if indicated.

Documentation requirements

Providers must maintain documents of SABIRT services provided to members. When a member transfers from one primary care physician (PCP) to another, the new PCP must attempt to obtain the member’s prior medical records, including the member’s history for preventive services. Member medical records must include:

  • Service provided (e.g., screen and brief intervention);
  • Name of the screening instrument and the score on the screening instrument (unless the screening tool is embedded in the electronic health record);
  • Name of the assessment instrument (when indicated) and the score on the assessment (unless the screening tool is embedded in the electronic health record); and
  • If and where a referral to an AUD or SUD program was made.

For more information about the SABIRT service requirements for MCPs, refer to All Plan Letter 21-014 from the Department of Health Care Services issued on October 11, 2021.

If you have questions regarding the information contained in this update, contact CHWP at 877-658-0305.