Rhode Island requires mobile crisis help for children and youth

The Department of Children, Youth and Families must run statewide mobile crisis services with the state Medicaid agency. Services cover children and youth up to age 21 across Rhode Island, regardless of insurance or Medicaid eligibility. Starting services requires no prior approval, referral, or clinical intake decision. Providers cannot deny or delay help because of insurance, the referral source, or screening rules that conflict with a family's description of a crisis. Services take place in homes, schools, or other familiar community settings when appropriate for the child's care.

The Department of Children, Youth and Families must license and oversee two or three providers serving assigned areas across the state. Only licensed providers may deliver these services. Providers must show willingness to help other licensed providers when needed. Clinical reasons may justify a different response. Crisis staff retain discretion over whether to send a team, the response method, and timing. Teams need at least two staff members, including a licensed behavioral health clinician, with access to clinical supervision and psychiatric advice around the clock. Providers must show expertise in children's care, respond to families' language and cultural needs, and make services accessible to people with disabilities. Providers coordinate with crisis lines and other care providers but keep independent clinical decisions. Sharing information with care providers requires appropriate consent. The child welfare department must report on service use, spending, and outcomes by January 1 each year.

The state Medicaid agency must cover mobile crisis response and short-term support for eligible children and youth. Coverage applies to Medicaid-eligible children and youth up to age 21, including Medicaid's child screening and treatment benefit. The agency must submit any needed applications for federal Medicaid approval. Medicaid may review service use or require prior approval to protect the program and meet federal requirements. A separate rule bars prior approval before crisis services start. The alternative Medicaid payment method requires federal approval. The Medicaid agency must report payment planning steps and costs to lawmakers on or before October 1, 2027. It must implement the alternative payment method no later than October 1, 2028, in accordance with federal approval.