Blue Shield of California Promise Health Plan
SBIRT is the Screening, Brief Intervention, and Referral to Treatment for misuse of alcohol program, which is administered to Medi-Cal Managed Plan (MMP) members ages 18 or older who misuse alcohol.
To learn more about SBIRT, all providers must read the All Plan Letter (APL) 14-004, dated February 10, 2014. This letter outlines the purpose of SBIRT, training requirements and how to use the tools.
For all required training DHCS offers webinars, and reference materials on their website.
In May 2013, the United States Preventative Services Task Force (USPSTF) updated its alcohol screening recommendation. The USPSTF recommends that clinicians screen adults 18 years or older for alcohol misuse and provide persons engaged in risky or hazardous drinking with brief behavioral counseling interventions to reduce alcohol misuse and/or referral to mental health and/or alcohol use disorder services, as medically necessary.
Coverage of SBIRT services by the Medi-Cal program took effect January 1, 2014.
The Department of Health Care Services (DHCS), through the All Plan Letter (APL) 14-004, dated February 10, 2014.
Blue Shield of California Promise Health Plan will process your claim through its normal channels for claim reimbursement.
Blue Shield Promise Medi-Cal Members who are age 18 and older.
When a Blue Shield Promise Medi-Cal member, age 18 and older, answers "yes" to the alcohol question in the Staying Health Assessment (SHA) (considered a "pre-screen" in the APL 14-004), or at any time the PCP identifies a potential alcohol misuse problem, he/she must offer to administer the "Alcohol Use Disorder Identification Test" (AUDIT, not AUDIT-C). This is to be administered by the rendering provider, where the physician will ask the questions, and document the member's responses. The responses are then scored. If the score is 8 or above, there is in an indication that further discussion is to be had about alcohol use disorder and treatment recommendations.
The "AUDIT" screening tool can be found by clicking here.
In the event a member's needs are beyond the SBIRT or because the member refuses to do the SBIRT, a provider can and should refer the member to the Substance Use Disorder Services in the county the member lives in for treatment. To make referrals, click here for directories of SUD services in your area or by contacting the SUD Resource Center at (800) 879-2772