Five Questions With: Rebecca Boss

REBECCA BOSS is acting director of the R.I. Department of Behavioral Healthcare, Developmental Disabilities and Hospitals, which recently received federal funds to combat the addiction crisis in Rhode Island. / COURTESY R.I. DEPARTMENT OF BEHAVIORAL HEALTHCARE, DEVELOPMENTAL DISABILITIES AND HOSPITALS
REBECCA BOSS is acting director of the R.I. Department of Behavioral Healthcare, Developmental Disabilities and Hospitals, which recently received federal funds to combat the addiction crisis in Rhode Island. / COURTESY R.I. DEPARTMENT OF BEHAVIORAL HEALTHCARE, DEVELOPMENTAL DISABILITIES AND HOSPITALS

Rebecca Boss, acting director of the R.I. Department of Behavioral Healthcare, Developmental Disabilities and Hospitals, has worked for more than 20 years in the field of addictions treatment. In 2004, she joined BHDDH and became the administrator for substance abuse treatment services.

Boss, who holds an undergraduate degree in psychology from the University of Rhode Island and a master’s degree in counseling/educational psychology from Rhode Island College, recently spoke with Providence Business News about the $1.658 million grant that Rhode Island received in November from the Substance Abuse and Mental Health Services Administration, the state’s initiatives to promote screening, brief intervention and referral to treatment programs, and how the grant will impact access to behavioral and mental health services in the state.

PBN: Explain the scope and purpose of this new grant, and how will the $1,658,375 be deployed in Rhode Island?

BOSS: Addressing the drug overdose crisis is one of Gov. Gina M. Raimondo’s most urgent priorities and the Rhode Island Department of Behavioral Healthcare, Developmental Disabilities and Hospitals is moving quickly with this grant. The U.S. Surgeon General, Dr. Vivek Murthy, recently issued a sweeping new report on the addiction crisis in America with one recommendation that primary-care providers step up screening. Rhode Island is ahead of the curve, with work already started. The Rhode Island Screening, Brief Intervention and Referral to Treatment program will pre-screen 250,000 Rhode Islanders over a five-year period.

- Advertisement -

The goals of SBIRT are to improve the behavioral health outcomes for adults with substance use disorders; partner with community health teams to increase screening services’ access for adults in primary-care/health clinic settings, emergency departments in at least six Rhode Island communities in need, as well as at the Department of Corrections; and sustain and expand the SBIRT program throughout Rhode Island by implementing policy and payment reform. Through a partnership with the State Innovation Model team, a request for proposals was issued to fund the combined work of SBIRT and the community health teams, and we are currently in the proposal review process. [The State Innovation Model team was developed after the state received late in 2014 a State Innovations Model grant – of $20 million over four years – from the Centers for Medicare & Medicaid Services, to develop innovative health care delivery systems.]

PBN: What impact will the funds have on nonprofit entities providing treatment and their clients/patients; will they be used to allow existing programs to support more patients, create new programs or something else altogether?

BOSS: We believe this program will be impactful. Universal screening is designed to identify any type of substance misuse, just as you would identify a chronic medical condition. The earlier you identify risk and intervene, the better chance for success. The screening is designed to identify individuals who may not otherwise be identified as persons at-risk or having a substance use condition. We believe this program will find more individuals at different stages of need. Helping people receive treatment in earlier stages of addiction is crucial to this epidemic.

The request for proposal that was issued allows for the incorporation of SBIRT-trained staff into community health teams and in other health care and community settings, in areas that have been identified as high need – where there is a high prevalence of overdose and substance use disorders. Another strong feature of SBIRT is that it ensures that individuals connect with recovery supports. If someone is identified as needing services, there is a link between the primary-care setting and the treatment setting. It’s not just a referral from a doctor’s office, it’s a referral to existing treatment programs in the individual’s community with a warm hand-off.

PBN: How quickly do you envision seeing progress in Rhode Island in meeting the goal, and what are your top priorities?

BOSS: We have hired a project director who will start in mid-December, and we are currently in the proposal review process. We hope to have a contract in place by January with community health teams established. Staff members will be trained in SBIRT, and assessments should begin immediately. With Gov. Raimondo’s leadership, the overdose crisis has led to unprecedented collaboration among state health officials, prescribers, insurers, health advocates and the family members of overdose victims. We are all working to ensure that community-based services are readily available for individuals being referred to treatment and that families and individuals are aware of available services. We want individuals and families to have the supports they need to recover. We are hopeful that this program will have an impact on increased access to services for every Rhode Islander in need.

PBN: Rhode Island was one of only eight entities across the country to receive these grant funds; why do you think Rhode Island received funding?

BOSS: Just months after taking office, the governor recognized the overdose and opioid crisis in Rhode Island and quickly established a comprehensive task force that submitted a strategic plan to her in December 2015. It laid out four strategies – prevention, rescue, treatment and recovery – that the SBIRT program complements. The grant application also demonstrated how SBIRT could easily be incorporated into several Rhode Island priority initiatives that had already been identified, providing a much-needed connection between physical and behavioral health care services. These initiatives include the R.I. Department of Corrections discharge planning, the State Innovations Model initiative and the Rhode Island Department of Health’s Health Equity Zones.

PBN: The grant announcement indicates that an additional $1.658 million may be available each year for up to five years, in total. How do you envision using those funds, if received?

BOSS: SBIRT will pre-screen 250,000 Rhode Islanders over a five-year period – approximately 30,000 in the first year and 55,000 every year for each of the next four years. The screening will cover tobacco, alcohol, marijuana and other drugs and will be delivered to individuals in primary care and health centers, at emergency departments and [at any of the facilities within the Rhode Island] Department of Corrections. Addressing Rhode Island’s overdose crisis and helping Rhode Islanders struggling with substance use disorder to access effective treatment and recovery programs remains one of the governor’s top priorities.

PBN: Do you have concerns that President-elect Donald J. Trump’s administration may eliminate or cut programs such as this one?

BOSS: It’s too early to predict what changes the president-elect will implement, but we will continue to closely monitor changes at the federal level and continue to work as hard as we can to ensure that every Rhode Islander is able to maintain access to affordable health care, including effective substance use disorder treatment.

No posts to display