STAR-SI in Action: South Carolina
By Rebecca A. Clay
 As a would-be client, Carl Kraeff posed as a distraught man seeking substance
abuse treatment at a local agency. His story: Because of his drug use and serious
drinking problem, his “wife” was leaving him. He couldn’t
pay his rent. His life was ruined.
But no matter how melodramatic he made his tale, the agency’s intake
staff didn’t seem interested.
“Everybody was very friendly and helpful, but every time I tried to
interject a comment, they would ignore me and go on to the next question,” said
Mr. Kraeff. In real life, he is a management consultant in South Carolina’s
Department of Alcohol and Other Drug Abuse Services. “They were trying
so hard to be efficient, but I felt like I was being processed. I wasn’t
treated like a person.”
Fortunately, the agency involved is 1 of 21 in the state currently participating
in SAMHSA’s Strengthening Access and Retention–State implementation
(STAR-SI) initiative (see Reducing Wait
Time Improves Treatment Access, Retention).
Both the state as a whole and individual agencies are identifying problems
like the one that concerned Mr. Kraeff, brainstorming solutions, and evaluating
the results in a rapid-fire process of quality improvement.
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Taking “Small Bites”
At the state level, one easy step was to streamline the intake forms that
the state’s network of treatment facilities are required to use.
Excessive paperwork was the number-one complaint of agency executive directors,
explained Mr. Kraeff. With tweak after tweak, the mandatory paperwork shrank.
By the time the process was over, the state had reduced the number of intake
forms by 85 percent. The amount of time the intake process took had been halved.
And the providers were happier.
But STAR-SI’s impact is even more dramatic out in the field. Consider
the example of the Lexington and Richland Alcohol and Drug Abuse Council (LRADAC),
the Behavioral Health Center of the Midlands in Columbia.
Broken appointments were the first problem the center set out to tackle: Forty-four
percent of would-be clients never made it to their first treatment session
after they’d been assessed.
Simple changes helped solve the problem. Training in motivational interviewing
techniques, for example, helped staff engage clients. The agency also made
the waiting room more private. And the staff produced an orientation packet
that included a welcome letter from the agency president, a “what to
expect today” piece, and a booklet about the treatment program. “STAR-SI
encourages you to take small bites,” said Change Leader Gayle
Aycock, M.Ed., Director of Quality Assurance at LRADAC.
For more information on STAR-SI, visit SAMHSA’s Web site at www.samhsa.gov. 
« See Part 1: Reducing Wait Time
Improves Treatment Access, Retention
« See Part 2: Reducing Wait Time Improves Treatment Access, Retention
« What Is NIATx?
« What Is Process Improvement?
See Also—Reducing Wait Time
Improves Treatment Access, Retention
STAR-SI Participants »
ACTION Campaign »
From the Administrator:
Striving for Quality…One Step at a Time »
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