Lawsuit alleges Rhode Island is denying mental health services to Medicaid-eligible children

A group of advocacy organizations filed a class action lawsuit Wednesday against the state of Rhode Island for denying Medicaid-eligible children access to mental health care. The 68-page federal lawsuit, brought by the American Civil Liberties Union of Rhode Island and advocacy groups Disability Rights Rhode Island and New York-based Children’s Rights, says this puts children at higher risk of being unnecessarily institutionalized. 

The lawsuit, filed Wednesday in U.S. District Court, was brought on behalf of Medicaid-eligible children under 21 years old who require intensive home and community-based services. The complaint says the state is in violation of the Medicaid Act, the Americans with Disabilities Act, and the Rehabilitation Act.

“The state’s current approach is not only a serious violation of federal law, it is very poor public policy,” Steven Brown, executive director of the ACLU of Rhode Island, said at a press conference Wednesday. “We’re hopeful that this lawsuit will begin to correct the serious harm that too many children and families in our state are facing.” 

The lawsuit alleges that over 20,000 children on Medicaid in Rhode Island have some sort of behavioral health disability, and that the state’s child institutionalization rate in 2022 was 50% above the national average.

Rebecca Almeida is the mother of four of the plaintiffs in the lawsuit. “This is inhumane. They are children. The state of Rhode Island is treating them as if they have committed a crime, as if they are in jail,” Almeida said at the press conference. “How can this be fair to a child who is not a criminal but suffering from an illness or lack of an appropriate placement to address their needs?” 

Almeida went on to say that one of her children, age 14, was hospitalized eight separate times in 2018. 

“She was in a hospital for a total of 542 days. She was recommended for a minimum of 10 hours of services in a week and she only got one hour a week,” Almeida said. “She also spent 322 consecutive days in residential treatment. That is almost two and a half years of her life.”

The suit says that, without access to behavioral health services, children are too often institutionalized and separated from their communities, leading in some cases to placement in out-of-state facilities. As of August 2024, at least 80 Rhode Island children have been placed in out-of-state residential psychiatric facilities across the country, some of which have been linked to abuse, understaffing, and deaths.

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