Why the ACLU is suing RI over children’s mental health care
PROVIDENCE – Hospital stays stretching more than a year. Children being forced to live in locked residential facilities hours from their homes and loved ones. Parents unable to find behavioral health care services to keep their child at home and in their community.
These are among the allegations advocates leveled Wednesday in a class-action lawsuit against the state Executive Office of Health and Human Services; EOHH secretary Richard Charest; the state Department of Children Youth and Families; and its leader, Ashley Deckert.
The 68-page federal lawsuit brought by Disability Rights Rhode Island, the American Civil Liberties Union of Rhode Island, and the New York advocacy group Children’s Rights is intended to force change after years of “glaring failures in Rhode Island’s behavior health system for children and youth.”
The lawsuit was brought on behalf of children on Medicaid ages 6 to 17, who they argue are languishing in an ill-equipped behavioral health system that fails to meet the needs of vulnerable children and their families. The lawsuit aims to get the state to address the dire state of the system, which they say fails to provide children and families with adequate services to keep their children at home and results in routine, lengthy institutionalizations.
“These children deserve a childhood with their families and the people who love them,” Kristine Sullivan, of Disability Rights Rhode Island, said at a news conference held via Zoom.
“It is EOHHS’s policy to not comment on pending litigation,” Kerri White, EOHHS spokeswoman, said in an email, when asked the state’s response.
A spokeswoman for DCYF also declined to comment.
‘Woefully and consistently inadequate’ response
According to the allegations, more than 20,000 Rhode Island children with behavioral health disabilities rely on Medicaid for critical behavioral health services but have been unable to get such services due to a “response that has been woefully and consistently inadequate.” As a result, they say, hundreds of young people continue to be denied timely access to services they desperately need and are entitled to under federal law.
They charge that the state’s failure to build an adequate behavioral health system for children and youth violates provisions of the Medicaid Act, as well as the Americans with Disabilities Act and the Rehabilitation Act.
Steven Brown, executive director at the ACLU, said the class-action suit was necessary because the state has not shown a willingness to reform the system, despite repeated red flags from the Office of Child Advocate, the U.S. Department of Justice and others.
DOJ: state ‘routinely and unnecessarily’ segregates children
It is the latest blow to the state mental health system, despite a deep crisis exacerbated by the pandemic.
In May, the U.S. Department of Justice concluded that the state had violated the federal civil rights of hundreds of children with mental health or developmental disabilities by “routinely and unnecessarily segregating” them at Bradley Hospital.
U.S. Attorney Zachary Cunha said the state’s Department of Children, Youth and Families has over-relied on hospitalizing children at Bradley for weeks, months and, in a few cases, more than a year, rather than placing youths with disabilities in intensive in-home or community-based programs.
Calling for community-based services
The lawsuit filed Wednesday echoed those concerns, faulting the state for failing to provide case management and planning services, in-home behavioral services, and mobile crisis services that respond to acute mental needs and keep families out of emergency rooms.
The Substance Abuse and Mental Health Services Administration has identified such services as being key to the children’s behavioral health system and proven to improve outcomes for children by treating them in more integrated settings in keeping with federal disability law, Sullivan said.
“Implementing the three services would give children access to consistent, comprehensive services between home, the community, and school, and reduce institutionalization,” Sullivan said. “We also hope that EOHHS and DCYF, along with the legislature, will prioritize funding to build and sustain these services, including increasing Medicaid reimbursement rates.”
Eighty children living out of state as far away as Idaho
According to the allegations, the lagging, underfunded system as of August resulted in at least 80 Rhode Island children being placed in out-of-state residential psychiatric facilities – with some as far away as Idaho.
Several of the facilities have been linked to abuse, understaffing and even deaths. The Office of the Child Advocate –which serves as a watchdog for children in DCYF care – can only visit the children once a year.
The number of children placed in out-of-state facilities grew by 30% between 2022 and 2024, the suit says, with the amount that DCYF has spent on that care rising by 2,000%, from $71,380 to $1.98 million over the same period.
“The Rhode Island system actually causes more harm,” Samantha Bartosz, deputy litigation director at Children’s Rights, said.
‘This is inhumane’
Rebecca Almeida, mother of four of the plaintiffs, spoke of repeated, lengthy hospitalizations. Two out of three of her 13-year-old triplets are now living in a residential facility in New Hampshire, meaning she must drive 2½ hours each way to see them and participate in their treatment.
“My kids have not been together in years. … This is inhumane,” said Almeida, of West Warwick.
Her 14-year-old daughter was hospitalized eight times in 2018 alone, she said. Overall, she was hospitalized for 542 days and spent 322 consecutive days in residential placement, amounting to 864 days, or nearly 2½ years, in out-of-home placements. All three of Almeida’s triplets have multiple diagnoses and are Medicaid eligible.
“The stress and trauma they have suffered … is indescribable,” she said, adding, “The time is now.”
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