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Accredited by the Commission on Accreditation of Rehabilitation Facilities (CARF) and the United Neighborhood Centers of America (UNCA) and is a member of the Fund for Community Progress

SSTAR Collaboration

March 2008

Collaboration with SSTAR brings reduction hospital emergency room visits by the uninsured

For the last two months, dozens of uninsured Rhode Island residents, including a large number of homeless adults, have been stabilized at the Co-occurring Crisis Stabilization unit. Licensed by MHRH, the unit is striving to reduce the number of uninsured adults appearing in hospital emergency rooms in need of acute psychiatric care.

For many years the Rhode Island Department of Mental Health, Retardation and Hospitals (MHRH) purchased acute inpatient care at Butler Hospital for the uninsured. Simultaneously, MHRH purchased detoxification services for adults with acute drug and alcohol problems and no insurance from STAR-RI (Stanley Street Alcohol Rehab).

Given the State budget problems, the Division of Behavioral Healthcare Services created a new competitive contract opportunity and requested proposals that would address both uninsured groups, including those with co-occurring mental health and substance abuse problems. Emphasis was placed on diverting some clients to non-hospital settings and SSTAR was awarded the contract.

SSTAR is a comprehensive behavioral health agency in Massachusetts and Rhode Island that has collaborated with NRICS on projects in the past. Since NRICS services focus strongly on hospital diversion, crisis stabilization, and integrated treatment of mental illness and substance abuse problems, we were a logical SSTAR subcontractor.

Following an intiial 5 bed program at NRICS' Wilson House for men, the two agencies created a 20 bed sub-acute co-occurring unit at SSTAR's Norht Kingston location. The project has helped the entire Rhode Island Mental health and substance abuse system begin to graple with several system issues:

The engagement of homeless adults with behavioral health problems in programs that will assist them in qualifying for Rhode Island Medicaid and/or subsidized housing vouchers
The engegement of sychiatrists and prescribing nurses in developing skills in treating co-occurring clients, including medication assisted approaches
The engagement of community hospitals and other key players in solving access problems for uninsured in need of inpatient psychiatric care
The engagemetn of State policy makers in shifting some State and Medicaid resources to hospital and nursing home diversion, acute care alternative, and the service needs of the uninsured

Richard Crino, RN, Vice President of Acute & Critical Incident Services at NRICS was designated as the unit manager. NRICS salaried and consultant MDs and Master's level nurse prescribers provide daily rounds. NRICS and SSTAR collaborated on the selection, training, and supervision of three shifts of metnal health and substance abuse treatment staff employed by SSTAR.

We are extremely grateful to the many agencies that have stepped up and given priority to assisting these clients with housing and/or behavioral health services.