Screening, Brief Intervention, and Referral

to Treatment (SBIRT) Toolkit

This SBIRT Integration Plan and associated Toolkit has been created through the work of many state and local partners with a shared interest in providing coordinated and comprehensive behavioral health services to women before, during and after pregnancy. This Toolkit is intended to be utilized by Kansas Title V MCH programs and shared with local partnering providers* serving the same populations, in an effort to collaboratively develop an adequate system of care. Information contained in the Toolkit is based on sound research and recommendations from the U.S. Preventive Services Task Force (USPSTF) and the Substance Abuse and Mental Health Services Administration (SAMHSA) among others.

*Partnering providers might include: WIC; Title X Family Planning; clinical perinatal care providers; clinical mental health providers; home visitation and case management services; etc.

• Comprehensive Printable Toolkit (pdf)
   
• Information on Implementing Screening for Substance Use Disorders in Perinatal Populations (pdf)
   
• SBIRT Integration Plan (pdf)
   
• Perinatal Substance Use Screening Integration: Reference and Resource Guide for Providers (pdf)
   
• Screening Tools:
• NIDA Quick Screen (pdf)
• ASSIST (pdf)
• ASSIST Fact Sheet (pdf)
• Annual Universal Screen (pdf)
• AUDIT (pdf)
• DAST-10 (pdf)
   
• Workflows/Algorithms:
• ASSIST Algorithm (pdf)
• SBIRT Workflow (pdf)
• Referral Access Point Workflow (pdf)
• Crisis Intervention Workflow (pdf)
   
• Templates for Local Use:
• Authorization for Release of Information (word)
• Consent for Communication with Medical Providers (word)
• Refusal of Substance Use Assessment (word)
• Substance Use Community Resource Listing (word)
• SUD Screening Office Procedures and Policy Template (word)
• Sample MOU (word)
   
• Provider Resources:
• Provider Trainings
• Recommendations and Opinion Statements
• Provider Handouts
• Provider Educational Resources and Videos (word)
   
• Patient Resources:
• Patient Handouts
• Patient Educational Resources and Videos
   
• Opioid Specific Resources:
• Provider Resources
• Patient Resources

This Toolkit is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) as part of an award totaling $3,245,698 with no percentage financed with non-governmental sources. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by HRSA, HHS, or the U.S. Government. For more information, please visit HRSA.gov.