Touchpoints for Addressing Substance Use Issues in Home Visiting: Performance Measurement Pilot

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Overview

Information_SUD-1
SUD-1
Information_SUD-2
SUD-2
Example Screening Tools

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Sheet 1: Information_SUD-1

Screening for Substance Misuse (SUD-1)
Measure Definition The percentage of primary caregivers who were screened at least once in the measurement period for unhealthy alcohol use, nonmedical prescription drug use, and illicit drug use, using a validated tool.			PAPERWORK REDUCTION ACT OF 1995 (Pub. L. 104-13) STATEMENT OF PUBLIC BURDEN: Through this information collection, ACF will test the use of two new performance measures around substance misuse screening and follow-up among caregivers enrolled in Maternal, Infant, and Early Childhood Home Visiting programs (MIECHV). Public reporting burden for this collection of information is estimated to average .25 hours per grantee, including the time for reviewing instructions, gathering and maintaining the data needed, and reviewing the collection of information. This is a voluntary collection of information. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information subject to the requirements of the Paperwork Reduction Act of 1995, unless it displays a currently valid OMB control number. The OMB # is 0970-0355 and the expiration date is  05/31/2021. If you have any comments on this collection of information, please contact Melissa Azur; mazur@mathematica-mpr.com.
Numerator Number of primary caregivers enrolled in home visiting programs who were screened for unhealthy alcohol use and drug use, using a validated tool, within 30 days of enrollment.
Additional numerator information To meet the measure criteria, primary caregivers must have evidence of screening for both unhealthy alcohol use and unhealthy drug use. Measure criteria may be met by using one tool that screens for both substances or by using two separate screening tools.
Denominator Number of primary caregivers enrolled in home visiting for at least 30 days.
Exclusions Primary caregivers who were enrolled for less than 30 days.
Logic We have provided the logic for calculating the measure in case your agency would like to calculate performance for internal purposes. As part of the pilot study, you do not need to calculate the measure score.

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Sheet 2: SUD-1

Screening for Substance Misuse (SUD-1)

Instructions:

• Please list dates in the format mm/dd/yyyy. If date is unknown, leave the cell blank. • For questions asking for a yes or no response, please select Yes, No, or Unknown from the dropdown. • For questions asking for the name of the measurement tool, please type the name of the tool used or select an option from the dropdown menu.

Record ID #

Date of enrollment in home visiting program

Has the primary caregiver been enrolled for 30 days?

Was the primary caregiver screened for unhealthy alcohol use with a validated tool?

Date of alcohol screening

Did the screening occur within 30 days of enrollment?

Validated screening tool utilized (Note: Please type name of instrument if you do not see it in dropdown menu options)

Was the caregiver screened for unhealthy drug use with a validated tool?

Date of drug screening

Did the screening occur within 30 days of enrollment?

Validated screening tool utilized (Note: Please type name of instrument if you do not see it in dropdown menu options)

Reason(s) for missing data (if applicable)

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Sheet 3: Information_SUD-2

Follow-Up for Caregivers at Risk of Substance Misuse (SUD-2)
Measure Definition The percentage of primary caregivers with a positive screen for unhealthy alcohol use or drug use, as measured with a validated tool, who received a follow-up service with a behavioral health provider within 14 days of the positive screen.
Numerator Number of primary caregivers who met with a behavioral health specialist within 14 days of a positive screen for unhealthy alcohol use or drug use.
Additional numerator information To be included in the numerator, the primary caregiver must have met with a behavioral health specialist within 14 days of the date substance use screening took place. If a data sharing agreement has been established, receipt of services may be assessed by following up with the referral agency. Otherwise, receipt of services may be assessed through participant self-report. Behavioral health specialists include licensed clinical alcohol and drug counselors; licensed clinical social workers; master’s level counselors or social workers; physicians certified in addiction medicine or addiction psychiatry; physicians with certification of an accredited residency or fellowship in addiction medicine or addiction psychiatry, or certification in addiction medicine by the American Association of Addiction Medicine or American Board of Addiction Medicine; and addiction psychologists. Unless they also hold the above credentials, peer recovery coaches, leaders of self-help recovery groups, clergy members, law enforcement officials, and primary care providers do not meet the criteria for a behavioral health specialist for this measure.
Denominator Number of primary caregivers enrolled in home visiting who had a positive screen for unhealthy alcohol use or drug use, as measured with a validated tool, within 30 days of enrollment. (This equals the numerator for SUD-1.)
Exclusions Primary caregivers who are already receiving treatment for substance use.
Logic We have provided the logic for calculating the measure in case your agency would like to calculate performance for internal purposes. As part of the pilot study, you do not need to calculate the measure score.

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Sheet 4: SUD-2

Follow-Up for Caregivers at Risk of Substance Misuse (SUD-2)

Instructions:

• Please list dates in the format mm/dd/yyyy. If date is unknown, leave the cell blank. • For questions asking for a yes or no response, please select Yes, No, or Unknown from the dropdown.

Record ID #

Date of enrollment in home visiting program

Is the caregiver currently in treatment for a substance use problem?

Was the primary caregiver screened for unhealthy alcohol use with a validated tool?

Did the primary caregiver screen positive for unhealthy alcohol use?

Date of positive alcohol screen

Was the primary caregiver screened for unhealthy drug use with a validated tool?

Did the primary caregiver screen positive for unhealthy drug use?

Date of positive drug screen

Did the primary caregiver receive follow-up care with a behavioral health specialist* within 14 days of positive screen?

Date of follow-up care with behavioral health specialist

*Behavioral health specialistis include licensed clinical alcohol and drug counselors; licensed clinical social workers; master’s level counselors or social workers; physicians certified in addiction medicine or addiction psychiatry; and addiction psychologists. See tab "Information_SUD-2" for additional information.

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Sheet 5: Example Screening Tools

[Threaded comment] Your version of Excel allows you to read this threaded comment; however, any edits to it will get removed if the file is opened in a newer version of Excel. Learn more: https://go.microsoft.com/fwlink/?linkid=870924 Comment: It might be helpul to highlight or color code the screening tools by what they screen for (alcohol, drug, both) Reply: Updated. Examples of Validated Screening Tools*

Alcohol, Smoking and Substance Involvement Screening Test (ASSIST)

AUDIT Self Report for Alcohol Use

Alcohol Use Disorders Identification Test-Concise (AUDIT-C)

Brief Alcohol Screening Instrument for Medical Care (BASIC)

CAGE-AID

CUGE

Fast Alcohol Screening Test (FAST)

Frequency and Concern items (ASSIST-FC)

Kreek-McHugh-Schluger-Kellogg Scale (KMSK)

NIDA Substance Abuse Quick Screen

Standardized T-ACE Alcohol Consumption

Substance Use Risk Profile, Alcohol, Smoking, and Substance Involvement Screening Test

UNCOPE Plus

Voices of Indian Teens Survey

*These examples do not constitute an endorsement of any instrument by the authors, the publishers, or the U.S. Department of Health and Human Services. LIAs could use other standardized, validated tools not included in the list of examples. This list is not exhaustive.

Alcohol screening tool

Alcohol and drug screening tool