Certified Substance Abuse Counselor:
FLCH in partnership with Finger Lakes Addictions Counseling & Referral Agency (FLACRA), a regional substance abuse and alcohol treatment program, supported by Health Resources and Services Administration (HRSA) funding, allows us to have a Certified Alcohol/Substance Abuse Counselors (CASAC) come into our health centers to do substance abuse screenings on our farmworker patients. We use “Prime MD,” a mental health screening questionnaire suitable for cross-cultural situations. This tool asks the patient a set of questions about substance and alcohol use, domestic violence concerns, and depressive symptoms. The CASAC then scores the results, which go directly to the primary care provider.
The provider then is able to address the issues that arise from Prime MD. This gives primary care providers the ability to discuss concerns with the patient, but also to refer them quickly to the appropriate services. If the patient was found to have an issue with drinking, then the provider could refer the patient back to the CASAC for one-on-one counseling services or possibly to an appropriate group. The CASAC becomes part of our team and is able to provide the patient with services in a timely fashion. Our ongoing concern about referring patients to an outside agency for those services is now a thing of the past. We can literally walk the patient down the hall to the CASAC, introduce them, and get the process started.
Case Conferencing—Primary Care Providers and Substance Abuse Counselors
About four years ago, FLCH started providing Suboxone therapy to opiate-dependent patients, in conjunction with our regional alcohol/substance abuse agency, FLACRA. There was a demand for this treatment in an outpatient setting, and we all felt that it would be best to have it blended in with primary care services. The patients that were being referred to us were just out of jail, inpatient treatment centers, or other institutions and needed continuous care in addition to Suboxone treatment, as well as attention to their other primary care needs. This program has been very successful for our patients and very well received. We also addressed other issues. Oftentimes, when a new patient was referred to us, they would have no records or documentation listing their current medications, treatments, or medical issues. There was a lack of communication between the substance abuse case managers and our providers, who were trying to get the patient stable on Suboxone. To resolve this, we did two things. We had the substance abuse agency place a Certified Alcohol/Substance Abuse Counselor (CASAC) at the site where most of our referrals received their care. This gave us the ability to work directly with the CASAC to assure a smooth referral to counseling or ongoing outpatient treatment, while we handled the medical side. Also, our MD who oversaw the Suboxone patients began to attend case conferencing sessions with the substance abuse case managers on a biweekly basis, and more if necessary. This sharing of information made the transition into care for our patients much quicker and smoother. Medication lists, prior issues, and medical concerns were known by both the primary care provider and the substance abuse case manager. Everyone was on the same page, including and most importantly, the patient.
For more information you can call 315.531.9102.