1. QUARTERLY NEWSLETTER
July 2015
Progress in North Carolina’s Tribal Communities
Talking Circles
NC SBIRT Awareness and Training
On April 25, 2015, the Coharie Tribe of North Carolina
helditsfirstTalkingCircleattheofficeoftheCoharieIntra-
tribalcouncilinClinton. OrganizedbyTribalAdministrator
Greg Jacobs and the tribe’s Health Outreach Coordinator
Tabatha Brewster, the Talking Circle revolved around
behavioral health issues affecting the community. Greg
Jacobs described the event as a momentous occasion in
the history of the Coharie Tribe marking the beginning
of a period of healing for the Coharie, the Waccamaw
Siouan and neighboring tribal communities. He opened
the Tribal Circle with a prayer that was followed by the
drumming and singing of War Paint, a renowned Lumbee
Drumming Group. Kim Pevia, an Indian American
behavioral health provider with multi-generational
trauma expertise, facilitated
the training. Chief Gene Jacobs
Two Feathers welcomed the
participants. TribalAdministrator
Jacobs presented an eagle
feather to Kaya Littleturtle, one
of the War Paint drummers for
his accomplishments. Another Talking Circle was held at
the Waccamaw Siouan Tribal Center in Bolton on May 23,
2015 with the Smokey River Drum Team. A third Talking
Circle took place at the Harnett County Coharie Building
in Dunn on June 13, 2015 with both the War Paint and
Smokey River drummers. Each Talking Circle had 25-35
people in attendance. All participants except for two
were members of tribal communities.
Maria (Ging) Fernandez, PhD, SBIRT Program Manager,
andTerrieQadura,MPH,TribalLiaison,gaveapresentation
on SBIRT at each talking circle and provided information
on local primary care practices implementing SBIRT and
other resources.
for health care providers in North Carolina (physicians,
nurses, physician assistants, psychologists) who are
American Indian or who serve in communities with
high concentrations of American Indians. The training
consisted of a conference that was held in Robeson
County,with 24providers in attendance,and an in-service
for health care providers on the Eastern Band of Cherokee
Indian reservation, with 33 providers in attendance.
Drs. Kristy Le and David Miller, faculty members in the
Department of Internal Medicine at WFSM and nationally
recognized experts in SBIRT conducted the trainings.
Additional activities included the development of print
resources focused on the dangers of substance abuse in
American Indian communities and the impact of SBIRT in
addressing this disparity.
Ms. Flo Stein, MPH, Deputy
Director of DMHDDSAS and
Co-Project Director for NC
SBIRT and Dr. Fernandez
presented an overview
of the NC SBIRT project
during an event “Veteran
Conversations” honoring Veteran Tribal members held on
June 26, 2015. At the event, Veterans also learned about
the treatment and recovery services for substance use
available through the NC Access to Recovery (ATR) project
from Martin Woodard, ATR Project Director. Reverend
Gary Deese, Command Sergeant Major, US Army Retired,
explained, “We are a proud people. We have to learn to
ask for and accept help.” The event had 120 people in
attendance, including Representative Garland Pierce and
former Representative Ronnie Sutton.
The North Carolina American Indian Health Board (NC
AIHB), in collaboration with the Northwest Area Health
Education Center (NW AHEC) and the Maya Angelou
Center for Health Equity (MACHE) at the Wake Forest
School of Medicine (WFSM), provided SBIRT training
Greg Jacobs, Tribal Administrator, described the event
as a momentous occasion in the history of the Coharie
Tribe marking the beginning of a period of healing for
the Coharie, the Waccamaw Siouan, and neighboring
tribal communities.
Inside this issue
● Progress in North Carolina’s Tribal Communities
● Practice Implementation
● Performance Assessment Infographic
● News from the Field
● Staff Announcements
● Save the Date! Upcoming FREE Webinars
● Faith Communities and SBIRT
● What is NC SBIRT?

2. NC SBIRT: PRACTICE IMPLEMENTATION
Community Care of the Sandhills
The more rural area in Sandhills faced more challenges in
SBIRT implementation compared with the urban area in
the northwest. Three sites withdrew from NC SBIRT after
less than a year of implementation. These were also sites
that had very low rates for SBIRT intervention modalities.
Pembroke Primary Care started screening in January 15,
2013 and withdrew in August 12, 2013. Southern Pines
Women’s Health Center started implementing SBIRT in
October 29, 2013 and stopped in June 5, 2014. Dr. Karen
Smith’s Private Practice has been practicing SBIRT in Hoke
County since July 2012.
Dr. Karen Smith Private Practice - Raeford, NC
Wanda Clark, Clinician
TBD, Care Ambassador
Robeson Health Care Corporation (RHCC)
Robeson Health Care Corporation, a federally-qualified
health center (FQHC), is implementing SBIRT in three
sites. The first FQHC site (Julian T. Pierce Medical Center)
in Pembroke began implementing SBIRT May 1, 2014.
The second FQHC (Montgomery Medical Center) site in
Montgomery County began implementing SBIRT June
3, 2014. The third site in Maxton County started June 1,
2015. The FQHC now has three substance abuse clinicians,
one for each site. RHCC currently uses nurses on staff to
fulfil the Care Ambassador role.
Maxton Medical Center - Maxton, NC
Christopher Bullard, Clinician
Julian T. Pierce Medical Center – Pembroke, NC
Melissa Seals, Clinician
Montgomery Medical Center – Star, NC
Tawanda Gonzalez, Clinician
Northwest Community Care Network
(NWCCN)
Community Care Center, a primary care practice in Forsyth
County, started implementing SBIRT services towards the
end of April 2012. In the latter part of June 2012, Wake
Forest University Baptist Medical Center (WFUBMC)
Family Medicine Clinic became the second primary
care practice to implement SBIRT in the NWCCN area.
Foothills Primary Care started delivering SBIRT services
on November 1, 2012. Three weeks later, Peace Haven
Family and Internal Medicine started delivering SBIRT
services. By the end of 2012, Northwest Community Care
Network had all of its targeted primary care practices
implementing SBIRT.
Community Care Center - Winston Salem, NC
Jim Thornton, Clinician
Dailen Celma, Care Ambassador
Wake Family Medicine - Foothills in Mt. Airy, NC
Holly Snyder, Clinician
Samantha Dollyhite, Care Ambassador
Wake Family Medicine - Piedmont Plaza in
Winston-Salem, NC
Michael Leone, Clinician
Benjamin F. Jackson, Care Ambassador
Wake Family Medicine - Peace Haven in
Winston-Salem, NC
Taylor Shannon, Clinician
Allison Greely, Care Ambassador

3. Mt. Airy Wake Family Medicine-Foothills
Winston-Salem Community Care Center
Wake Family Medicine-Peace Haven
Wake Family Medicine-Piedmont Plaza
Raeford Dr. Karen Smith Private Practice
Maxton Maxton Medical Center
Pembroke Julian T. Pierce Medical Center
Star Montgomery Medical Center
Performance Report
Data as of June 20, 2015 | Year 5 begins Sept 2015
Years 1-4 | At-a-glance
Screening, Brief Intervention and Referral to Treatment
POSITIVE OUTCOMES
Data collected at six months and at discharge
consistently show increased abstinence from
and decreased consumption of alcohol and
other drugs as well as improvements in health
and residential stability following intake.
Target Met
www.NCSBIRT.org
Produced by the Governor’s Institute on Substance Abuse for the NC SBIRT Grant
(TI-023453) with funds obtained by the DMHDDSAS of the NCDHHS from
CSAT_SAMHSA. Content is solely the responsibility of the authors and does not
necessarily represent the official views of the agency.
81%81%18,34918,349
patients screened of target met
Primary Care
Facilitie
88
primary care
facilities
765 patients
On-site grant-funded clinicians have
provided brief interventions and
treatment to
130and have referred
to more specialized
treatment.
Clinicians made a positive impact by
providing case management and
other services that went beyond
those specified in the grant.
ABOVE AND BEYOND
Administered the 9-item
Depression Screening Tool to
714 patients
who met the threshold for risky and
harmful use of alcohol.

4. NEWS FROM THE FIELD
A bulletin was released to announce recent changes to the Centers for Medicare & Medicaid Services (CMS) policy
regarding Medicaid payments for services provided without charge (including services that are available without charge to
the community at large, or “free care”).
The change gives providers the ability to bill only Medicaid and provide the service free to those who do not have alternative
coverage. In the past, providers could not bill Medicaid for services that they provided at no cost to other patients.
Therefore, if providers billed Medicaid for a specific service, they also had to bill patients who had private insurance. If that
service was not covered by their private insurance policies, those patients were subject to an out-of-pocket expense, which
could not be waived under the CMS rules.
The new ruling by the Departmental Appeals Board revises the previous policy and states:
During the June SBIRT Policy Steering Committee meeting, Bert Bennett helped to clarify MCO Communication Bulletin
#J134. He explained that it does in fact mean providers now have the ability to bill only Medicaid and provide the service
free to those who do not have alternative coverage.
To read the entire CMS publication regarding third-party liability and Federal Financial Participation (FFP) for Medicaid
services provided without charge, visit www.medicaid.gov/federal-policy-guidance/downloads/smd-medicaid-payment-
for-services-provided-without-charge-free-care.pdf.
If you have questions, please contact Kelsi Knick at Kelsi.knick@dhhs.nc.gov.
Nineteen NC SBIRT staff from DMHDDSAS, Centerpoint Human Services MCO, Community Care Network, and the
Governor’s Institute attended a retreat held in Asheboro on May 15, 2015. Facilitated by the MCO at Centerpoint, the
retreat was designed to be a forum where staff exchanged lessons learned, particularly those around changes in the
cultures of the primary and behavioral health care providers as SBIRT was implemented.
Pictured:
(Back row L-R) Michael Dublin,
James Harner, Paul Kelly, Jim
Thornton, Sam Young, Holly
Snyder, Michael Leone, Catherine
Anderson Arnold, Ray McBeth,
Maria (Ging) Fernandez,
Christopher Bullard, Judy
Harmon, Andrew Clendenin
(Front row L-R) Marie Kaswandik,
Tawanda Gonzalez, Kayla Stover,
Terrie Qadura, Pollen Williamson,
Ben Jackson
Medicaid Payment for Services Provided without Charge
NC SBIRT Idea Exchange
“Medicaid reimbursement is available for covered services under the approved state plan that are provided
to Medicaid Beneficiaries, regardless of whether there is any charge for the service to the beneficiary or the
community at large.”

5. STAFF ANNOUNCEMENTS
CONFERENCE CALLS
● Kellie Cosby, who served as our Grant Project Officer, has moved from SBIRT to a new role with the Health Resources
and Services Administration. With this change, Reed Forman, the Lead Public Health Advisor for SBIRT grantees, will
serve as our new Grant Project Officer.
● Tawanda Gonzalez joined the Federally-Qualified Health Center, Robeson Health Care Corporation (RHCC), as a new
Clinician serving in the Montgomery Medical Center.
● Melissa Seals joined the Federally-Qualified Health Center, Robeson Health Care Corporation (RHCC), as a new Clinician
serving in the Julian T. Pierce Medical Center.
● Pollen Williamson has joined the NC SBIRT team as a Program Coordinator to handle logistics for SBIRT trainings,
conferences and meetings and coordinate communication efforts for the SBIRT program.
Integrating Screening and Brief Intervention for Alcohol and Other
Drugs in Behavioral Health Settings Serving College Students
Date: Wednesday, August 19, 2015 from 3-4:30pm ET
Description: This free webinar will focus on the application of cutting-edge research on
integrating and applying the evidence-based practice of screening and brief intervention
(SBI) for alcohol and other drugs within primary health and mental health care settings
serving college student populations. Challenges associated with SBI implementation and
program sustainability in the clinical setting will be addressed. Participants will learn
innovative and creative strategies for making SBI more relevant and responsive to a
range of diverse college student target populations identified in the literature as being
at risk for alcohol and other drug abuse.
CE Credit: Approved by NAADAC (Approval #189), NBCC (Approval #5703), NASW (in
progress) and accredited by the American Probation & Parole Association for 1.5 free
CEs.
Register Here - http://bit.ly/1OebXKq
Reed Forman, our Grant Project Officer with SAMHSA, will answer questions and provide general project updates on the
second Tuesday of every other month from 2:30-3:00 p.m. The next call is scheduled for Tuesday, August 11, 2015.
Large state grantee calls with SAMHSA will take place the first Thursday of every other month from 3:30 – 4:00 p.m. The
next call is scheduled for Thursday, September 3, 2015.
For call details, contact Pollen Williamson, 919-715-2365 or pollen.williamson@governorsinstitute.org.
The Prevalence of Prescription Opioid Misuse: Doctor Shopping, Co-
ingestion and Exposure
Description: This self-paced online course covers important topics in prescription
opioid misuse. The three sections will introduce you to prescription opioids, the link
between multiple doctors and opportunities for misuse, and the prevalence of high-risk
use among adolescents (including mixing pills with other drugs). Opioids are here to
stay. Knowing and addressing risky behaviors associated with nonmedical use can help
prevent potentially grave consequences such as overdose and addiction.
CE Credit: Approved by NAADAC Approved for 2 CEHs, Social Work Approved for 2
CEUs
Take the Course - http://bit.ly/1SnARYq
SAVE THE DATE:
FREE WEBINARS

6. NC SBIRT is funded through a cooperative agreement between the NC Department
of Health and Human Services and SAMHSA-CSAT and is a project of the NC Division
of Mental Health, Developmental Disabilities, and Substance Abuse Services.
Pollen Williamson
NC SBIRT Program Coodinator
Governor’s Institute on Substance Abuse
(919) 715-2365 (direct)
Pollen.Williamson@governorsinstitute.org
Contact Us
WHAT IS NC SBIRT?
FAITH COMMUNITIES AND SBIRT
Faith communities across North Carolina have faced myriad problems addressing public health issues internally while
also serving the community at large.
As resources become less available to advocate for public health issues such as substance use disorders, awareness of
health-ministry user-friendly tools is a must for leaders seeking to address the needs of their congregants and those
served through outreach programs.
One of North Carolina’s progressive approaches has been to introduce Screening, Brief Intervention, and Referral to
Treatment (SBIRT) tools that allow faith leaders at any level be able to help congregants determine some level of use that
may or may not lead to a referral to treatment.
A free SBIRT app is now available (https://itunes.apple.com/us/app/sbirt/id877624835?mt=8) that will allow faith
leaders to utilize their iPads, Kindles, Nooks or any reading device to address congregants and others in a variety of
settings. Portability for faith leaders is essential in the electronic age.
The introduction of the SBIRT app is quite new and remains to be seen how effective it will be; anecdotal data indicate
the prognosis is good for expanded use leading to more screenings in otherwise hard to reach populations.
Written by Michael Dublin, MA, CSAPC, ICPS | Faith Works Together Coordinator
SBIRT is a public health approach to the delivery of early intervention and treatment services for people with substance
use disorders and those at risk of developing these disorders. Many different types of community settings provide
opportunities for early intervention with at-risk substance users before more severe consequences occur. NC SBIRT is
a cooperative agreement between the Division of Mental Health, Developmental Disabilities, and Substance Abuse
Services (DMHDDSAS), the Substance Abuse Mental Health Services Administration (SAMHSA), and the Center for
Substance Abuse Treatment (CSAT) to provide screening, brief intervention, and referral to treatment to adult patients
seen in primary care practices. The Division collaborates with Community Care of North Carolina (CCNC) and the
Governor’s Institute (GI) on Substance Abuse to implement the grant project.
The overall purpose of NC SBIRT is to reduce alcohol and drug misuse and addiction through a co-location model where
Care Ambassadors and Licensed Substance Abuse Professionals are stationed at primary care practices to provide
substance abuse screening, brief intervention, brief treatment, and referral to treatment as appropriate.
For more information on NC SBIRT, please visit www.ncsbirt.org.