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Hospitals Recognized for Standardizing Care to Treat Addiction and Overdose

Governor Gina Raimondo's Overdose Prevention and Intervention Task Force has recognized South County Health and CharterCARE Health Partners for their leadership in providing consistent, comprehensive care for opioid-use disorder in hospitals and emergency departments in Rhode Island.

The South County Health recognition took place at this morning's Task Force meeting. The recognition of CharterCARE Health Partners took place at the July meeting.

This recognition was based on treatment criteria met at Roger Williams Medical Center and Our Lady of Fatima Hospital (both CharterCARE facilities), and South County Hospital. These criteria were established in March by the Rhode Island Department of Behavioral Healthcare Developmental Disabilities and Hospitals (BHDDH) and Rhode Island Department of Health (RIDOH) in a document titled Levels of Care for Rhode Island Emergency Departments and Hospitals for Treating Overdose and Opioid Use Disorder. The aim of these first-in-the-nation standards is to ensure that best practices in the treatment of opioid-use disorder are in place at emergency departments (EDs) and hospitals throughout the state.

"We are pleased that hospitals have begun enacting Levels of Care for those suffering from overdose or opioid use disorder," said Director Rebecca Boss of the Rhode Island Department of Behavioral Healthcare, Developmental Disabilities & Hospitals. "Levels of Care standardizes treatment across all emergency rooms and hospitals to ensure a high level of care for people throughout the state. With these newly designated 'levels' we hope to lower the rate of overdose deaths by allowing emergency rooms to become one of the first steps towards recovery."

"Rhode Island is the leader in the nation for establishing qualifications, called Levels of Care, to treat people with opioid-use disorder in hospitals and EDs. CharterCARE Health Partners and South County Health are the first health systems in our state to be recognized for achieving Levels of Care designations, and we hope that the other healthcare facilities throughout the state follow their lead," said Director of Health Nicole Alexander-Scott, MD, MPH. "Every single overdose death is preventable. We need all EDs and hospitals in Rhode Island to attain Levels of Care designations so people have access at every possible opportunity to the treatment and recovery resources they need to live lives free of addiction."

The Levels of Care document established a three-tiered system. Designations are made through an application process submitted to RIDOH and BHDDH. All hospitals must qualify for at least a level three, with the expectation that many will attain higher designations, which involve expanded capacity to provide care for opioid-use disorder (i.e., medication-assisted treatment), recovery services, and more.

Roger Williams Medical Center and Our Lady of Fatima Hospital earned a level-one distinction, the highest distinction. This means that these hospitals are, among other steps, providing comprehensive discharge planning to all overdose patients, screening all patients for substance-use disorder, offering peer recovery support services, and maintaining the equivalent to a Center of Excellence where patients can receive treatment for opioid-use disorder.

South County Hospital was recognized for achieving a level-three designation. This means that the hospital is fulfilling the requirements of the 2016 Alexander C. Perry and Brandon Goldner Act, sponsored by Chairman Joshua Miller and Representative David Bennett. The hospital is also submitting the required reports of overdoses to RIDOH within 48 hours and testing routinely for fentanyl.

Work to build South County Hospitals's levels of care infrastructure was led by William Sabina, MD, Chief of Emergency Medicine, and Steven Juchnik, BSN, RN, CEN, Emergency Services Director.

"A lot of processes were already in place, and the Levels of Care requirements only strengthened our existing partnerships with South Kingstown Police Department, South Kingstown Partnership for Prevention, Narragansett Prevention Partnership, and The Providence Center's AnchorED," said Steven Juchnik. "The biggest success story from this is bringing all the factions together to address overdose and opioid-use disorder, including the Emergency Department, nurses, physicians, RIDOH/state agencies, law enforcement, the local prevention coalitions, and treatment and recovery facilities."

"It was a collaborative process where we were able to build partnerships with RIDOH and BHDDH along the way," said Rebecca Plonsky, LICSW, Regional Vice-President of Integrated Behavioral Health for CharterCARE Health Partners. "This engaged our team and ensured we were meeting the expectations of the state and adopting best practices. It was exciting to see our multidisciplinary teams come together to meet the necessary criteria and treat such an at-risk population. Through our continuum of care, we are ready to treat and support patients at any stage of their recovery."

On September 26, 2017, RIDOH's regulations will be updated to require all Rhode Island emergency departments to meet almost all level three requirements. This regulations update reinforces the 2016 Alexander C. Perry and Brandon Goldner Act that specifies discharge planning procedures in emergency departments and hospitals for patients with opioid-use disorder. This will include standardized screening evaluations; laboratory drug screenings to determine the cause of overdose; education on the risks and benefits of prescribed opioids, as well as safe storage and disposal; written policies that outline when a prescriber should dispense or prescribe naloxone to patients; education on the administration of dispensed or prescribed naloxone; opportunities to speak with peer recovery support specialists; information about treatment options; and, notification of a patient's emergency contacts and peer recovery support specialist.

A recovery hotline is available to connect people in crisis with treatment and recovery support. To access services through an English and/or Spanish-speaking counselor who is licensed in chemical-dependency and available 24 hours a day, 7 days a week, people should call 401-942-STOP.

Additional overdose data and resources are available at

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