Orange County SBIRT Collaborative  Screening Overview
Condition / Pre-Screen[1] / Score for Full
Pre-Screen / Screen / Assessment / Referral / Intervention
Age Group[2] / Risk Level / Action
anxiety / GAD-2 / 3 / GAD-7 / TAY /
  • Med (10)
  • High (15)
/
  • Yellow Flag: Psycho-education; Motivational Interviewing; Collaboration with MD; EMR
  • Red Flag: Same as above + Referral/warm handoff

Adult /
  • Med (10)
  • High (15)
/
  • Yellow Flag: Psycho-education; Motivational Interviewing; Collaboration with MD; EMR
  • Red Flag: Same as above + Referral/warm handoff

Older Adult /
  • Med (10)
  • High (15)
/
  • Yellow Flag: Psycho-education; Motivational Interviewing; Collaboration with MD; EMR; Refer to UCI IMPACT if functioning impaired and/or health affected by anxiety
  • Red Flag: Same as above + Referral to UCI IMPACT

depression / PHQ-2 / 3 / PHQ-9 / TAY /
  • Med (10)
  • High (15)
/
  • Yellow Flag: Psycho-education; Motivational Interviewing; Collaboration with MD; EMR
  • Red Flag: Same as above + Referral/warm hand-off

Adult /
  • Med (10)
  • High (15)
/
  • Yellow Flag: Psycho-education; Motivational Interviewing; Collaborationwith MD; EMR
  • Red Flag: Same as above + Referral/warm handoff

Older Adult /
  • Med (10)
  • High (15)
/
  • Yellow Flag: Psycho-education; Motivational Interviewing; Collaboration with MD; EMR; Refer to UCI IMPACT, if functioning impaired and/or health affected by depression
  • Red Flag: Same as above + Referral to UCI IMPACT

Orange County SBIRT Collaborative  Screening Overview
Condition / Pre-Screen / Score for Full
Pre-Screen / Screen / Assessment / Referral / Intervention
Age Group / Risk Level / Action
trauma / GAD-2 / 3 / PCL-C / TAY /
  • Med/High (25)
/
  • Psycho-education; Motivational Interviewing; Collaboration with MD; EMR; Referral/warm hand-off

Adult /
  • Med/High(25)
/
  • Psycho-education; Motivational Interviewing; Collaboration with MD; EMR; Referral/warm hand-off

Older Adult /
  • Med/High (25)
/
  • Psycho-education; Motivational Interviewing; Collaboration with MD; EMR; Refer to UCI IMPACT

alcohol / AUDIT-C (3) / Women- 3
Men- 4
(w/ 1+ pts from
Q’s #6 or 7) / AUDIT (10) / TAY /
  • Med
  • High
/
  • Psycho-education; Motivational Interviewing; Collaboration with MD; EMR; Referral/warm hand-off

Adult /
  • Med (8-19)
  • High(20)
/
  • Psycho-education; Motivational Interviewing; Collaboration with MD; EMR; Referral/warm hand-off

Older Adult /
  • Med (8-19)
  • High(20)
/
  • Psycho-education; Motivational Interviewing; Collaboration with MD; EMR; Referral/warm hand-off

other
drugs / Dr. Saitz’s1-Q / YES / DAST (28) / TAY /
  • Med/High(12)
/
  • Psycho-education; Motivational Interviewing; Collaboration with MD; EMR; Referral/warm hand-off

Adult /
  • Med/High(12)
/
  • Psycho-education; Motivational Interviewing; Collaboration with MD; EMR; Referral/warm hand-off

Older Adult /
  • Med/High(12)
/
  • Psycho-education; Motivational Interviewing; Collaboration with MD; EMR; Referral/warm hand-off

intimate partner violence / FWV 1-Q / YES / PVS (3) / TAY /
  • Med/High(1)
/
  • Identify reporting requirements; Psycho-education; Motivational Interviewing; Collaboration with MD; EMR; Referral/warm hand-off

Adult /
  • Med/High
(1) /
  • Identify reporting requirements; Psycho-education; Motivational Interviewing; Collaboration with MD; EMR; Referral/warm hand-off

Older Adult /
  • Med/High
(1) /
  • Identify reporting requirements; Psycho-education; Motivational Interviewing; Collaboration with MD; EMR; Referral/warm hand-off

[1]Total number of items: 9DRAFT 4/26/12

[2] Age groups: Transitional Age Youth (16 –25y), Adults (26-64y), Older Adults (65y +)