The availability of alcohol, tobacco and other drug services for adults in New York State Community Health Centers

NY State community health center sites were surveyed in 2012 to assess the availability of alcohol, tobacco, and other drug services for the underserved. Surveys were completed from 156 of 251 adult primary care clinical sites (62% response rate). Seventy-one percent of sites had guidelines requiring screening for mental health problems while less than half (46%) had guidelines for substance use disorders. In practice, 55% of clinics reported nearly all adults were screened for mental health disorders compared to 32% of adults for substance use disorders (SUD). Forty three percent of sites that screened patients for SUD did not use a standard screening instrument. More than three quarters of sites offered tobacco cessation services while 17% reported offering SUD treatment. Findings from multi-level analyses suggested that FQHC organizations influence sites' SUD screening requirements but not the provision of on-site treatment. Analyses further suggested that neither geographic setting (urban/rural) nor the size of the FQHC organization influenced screening requirements or on-site treatment availability. Although more research is needed to explore differences between site and organizational level reporting, this study suggests that SUD screening rates remain low among FQHC primary care sites, but that FQHC organization could improve rates across sites by requiring SUD screening using a standard instrument.