RI Senators Urge "Urgent Action" On Children's Mental Health And Behavioral Needs

Joshua Miller Sandra Cano Alana DiMario Louis DiPalma Valarie Lawson

Five RI State Senators respond to May 13 findings of the Department of Justice that the state has violated the civil rights of children and adolescents “warehoused” in a psychiatric hospital because it failed to appropriate therapeutic treatment in the community.

By Senators Sandra Cano, Alana DiMario, Louis DiPalma, Valarie Lawson and Joshua Miller

“We are not meeting our shared obligation to some of Rhode Island’s most vulnerable children,” we wrote in 2021, in an opinion piece intended to highlight the urgent need to improve our treatment programs for youth with behavioral health issues, and particularly girls. “This is an emergency. It is also an equity issue that needs to be addressed as soon as possible.”

It is extremely troubling that those same words are just as applicable today as they were when we first wrote them.

On May 13, US Attorney Zachary A. Cunha described an “appalling failure” of our state to appropriately meet the needs of children with behavioral health issues, particularly girls. He outlined a situation in which hundreds of Rhode Island children were hospitalized, usually at Bradley Hospital, for unnecessarily lengthy periods of time.

We are failing these children, and, frankly, it is unjustifiable.

So again today, we are calling for urgent action to address this situation. We need to work together – all of us, the Legislature, Governor McKee, the Department of Children Youth & Families (DCYF), the Department of Education (RIDE) – to address the systemic failures that have led to this situation.

Firstly, it is important to say how much we value and respect the work taking place at the DCYF and RIDE. We appreciate the difficulty of the jobs they do and their dedication to the children and families in our state.

Let us all work together, with increased urgency, to provide sustained investments in supportive services throughout the continuum of care, including at home and at school – and in those services between counseling and hospitalization – to ensure our children receive the supports they need in the most appropriate settings.

These issues have been – and continue to be – priorities for us in the Senate. We have advanced legislation and conducted several oversight hearings with DCYF and RIDE in our efforts to improve treatment and to ensure that children are receiving quality education regardless of their placement. To that end, it is absolutely imperative that RIDE ensure all children, including those placed at Bradley, have an educational plan in place.

In the Senate, we have prioritized – and in 2022 the General Assembly provided $57 million to fund – two residential treatment facilities, one for psychiatric treatment and one for behavioral health treatment. While it is important that these facilities are brought online as expeditiously as possible, this will not be enough to solve the problems we are facing, as Mr. Cunha noted.

The General Assembly also appropriated $22.9 million in wage stabilization funds to help DCYF recruit and retain qualified staff. However, these funds were temporary by nature. Another critical step is for the department to enter into new contracts that increase reimbursement rates to providers. These contracts are long overdue, and we hope and expect that they will be awarded soon.

Additionally, we expect that the Senate will again pass legislation (S-2705) requiring DCYF to conduct periodic comprehensive needs assessments to determine whether the department’s programs and services meet the needs of children and families in their care, assess client accessibility, and collect data to develop goals and measurable objectives for new and existing programs and services. This data is an important step as we work to strategically improve our systems of care.

Finally, we need an Olmstead Plan.

The Supreme Court ruled in Olmstead v. L.C. that states must make services available to individuals with disabilities in the most integrated setting possible. That decision was in 1999. While this administration – and prior administrations – have worked towards compliance, we remain the only state in New England, and one of just a few in the nation, that lacks a plan.

Therefore, the Senate is scheduled to consider legislation (S-2618) that would create, by statute, an Olmstead Planning Commission to develop this long-needed plan to better serve people vulnerable to unnecessary institutionalization.

Too often, we have made decisions based on short-term budgetary pressures, and that has led us to the insufficient services in place today. However once in place, better care, in more appropriate settings, will not just benefit the individuals being served; it is also more cost effective.

The extremely troubling findings by the US Attorney are a reminder that we can and we must prioritize sustained investments throughout our continuum of care to better serve Rhode Island’s most vulnerable children and families.

Senators Sandra Cano (D-Dist. 8, Pawtucket), Alana DiMario (D-Dist. 36, Narragansett, North Kingstown, New Shoreham), Louis DiPalma (D-Dist. 12, Middletown, Newport, Little Compton, Tiverton) and Joshua Miller (D-Dist. 28, Cranston, Providence) are all committee chairpersons in the Rhode Island Senate. Sen. Valarie Lawson (D-Dist.14, East Providence) is Senate Majority Whip.

RI Senate Committee Gets a Taste of Complex Federal Consent Decree

Charles Moseley, independent federal Court Monitor, left, and RI. Sen. Joshua Miller, D-Cranston and Warwick, chat after Feb. 25 briefing on federal consent decree requiring community integration of people with developmental disabilities. 

By Gina Macris 

Members of a Senate committee began to grapple with the complexities of a federal court case that has the potential to require the state to allocate millions of dollars to reform its services to Rhode Islanders with disabilities.

For an hour on Feb. 25, The Health and Human Services Committee was briefed about a federal consent decree that requires the state to give those with disabilities a chance to work and do other meaningful activities in the community.

 After the briefing, committee chairman Joshua Miller, D-Cranston and Warwick, said it wasn’t clear to him whether the state agency responsible for services to adults with developmental disabilities needed to reorganize, or whether a greater overall allocation is needed to comply with the consent decree.

“At any point will the decree require minimum funding?” Miller asked Charles Moseley, the independent Court Monitor in the federal case.

 Moseley replied that “the consent decree requires minimum funding now.”

Moseley said the “minimum funding” relates to activities necessary to achieve compliance, like an official to coordinate employment services, so that more people who need supports can get “up and working” in the community.

He gave other examples, saying that the key areas are employment and other meaningful non-work activities.

A. Anthony Antosh, director of the Sherlock Center on Disabilities at Rhode Island College, presented statistics which show a smaller percentage of people with developmental disabilities were working in the community in 2015, a year after the consent decree was signed, than were in supported employment in 2011, the year the General Assembly enacted a 13 percent budget cut in services that support them.  

The employment figure decreased from about 23 percent to about 21 percent in four years’ time, according to Antosh’ figures.

“What has increased is the number of people who are essentially doing nothing” during the day, he said.

“Roughly 40 percent are 50 or over, and most of them have very little to do,” Antosh said.

Moseley said that “if the investment is not made now, (the goals) won’t be met in ten years,” the lifespan of the consent decree.

But Moseley did not provide Miller with a dollar amount. 

In a hearing before U.S. District Court Judge John J. McConnell Jan. 26, both Moseley and the lawyer for the U.S. Justice Department, Victoria Thomas, said flatly that the current state budget does not contain enough money to fulfill the requirements of the consent decree.

And a week later, Governor Gina Raimondo made the same categorical statement in her budget message to the General Assembly.

Raimondo’s budget proposal asks for an additional $8 million in in developmental disability funding funding in the current fiscal year, bringing the budget to $237.7 million by June 30. The increase is designed to shore up the developmental disabilities division in the Department of Behavioral Healthcare, Developmental Disabilities and Hospitals (BHDDH).

In the coming fiscal year, developmental disabilities would receive slightly less, $235.2 million under the governor's plan. However, the administration is proposing a way to sharply increase spending for community-based supports that are required by the consent decree without requesting another budget hike. Instead, the increase would be funded by savings that the administration hopes to achieve through major changes to residential programs, asking 500 adults with disabilities to move voluntarily from expensive group homes into shared living arrangements with families.