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H 7591Children

State Affairs and Government - Licensing and Monitoring of Child Placing Agencies, Child Caring Agencies, Foster and Adoptive Homes, and Children's Behavioral Health Programs

Mandates out-of-state foster care facilities register as Medicaid providers, with exceptions allowed for emergency placements.

Introduced
Population
Affected
8
Email Legislator
Introduced Feb 6, 2026Committee House Finance

Plain-English Summary

This legislation amends existing laws regarding the licensing and monitoring of child-placing agencies. Specifically, it introduces a requirement for out-of-state foster care placements. The bill mandates that all facilities located outside of Rhode Island used for foster care must be registered as Medicaid providers with the state medical assistance program. It grants the director of the department the authority to waive this requirement in emergency situations if a child needs immediate placement and no registered Medicaid provider is available.

For younger readers

This law changes the rules for when the government sends a foster child to live in a home or building in another state. It says that the place the child goes to must be signed up to accept government health insurance, called Medicaid. This helps make sure medical bills get paid. If there is a big emergency and no places are signed up, the leader of the department can make a special exception to make sure the child has a safe place to stay immediately.

Who & Where It Applies

Impacted groups
Foster childrenDepartment of Children Youth and Families (DCYF)Out-of-state foster care facilitiesMedicaid program administratorsFoster parents
Impacted communities
All

Constitutional & Fiscal Check

None Likely

Estimated cost
Amount unknown
Estimated revenue
None

Bill Analysis

Both viewpoints
For Progressives
  • Ensures that vulnerable children placed out of state have guaranteed access to healthcare coverage through the Medicaid system, protecting their physical and mental well-being.
  • Increases financial accountability and oversight by requiring private out-of-state facilities to register with the state system, preventing public funds from flowing to unregulated or non-compliant entities.
  • Standardizes the quality of care and administrative requirements for foster children, ensuring those placed across state lines receive support comparable to those remaining within the state.
  • Could inadvertently limit the number of high-quality placement options available for children if specific specialized facilities refuse to navigate the bureaucracy of registering as a Rhode Island Medicaid provider.
  • The waiver provision allows the director to bypass the requirement, which could create a loophole where children are still placed in facilities that lack proper oversight or healthcare integration.
  • May cause administrative delays in placing children who are in crisis while the department verifies Medicaid registration status or processes waivers.
For Conservatives
  • Promotes fiscal responsibility by ensuring that out-of-state facilities accept standard Medicaid reimbursement rates rather than charging potentially higher private market rates to the state.
  • Establishes a clear legal framework for government contracts, ensuring tax dollars are only spent on providers that meet specific state registration requirements.
  • Reduces the likelihood of fraud or waste by requiring out-of-state vendors to be vetted and registered within the state's existing medical assistance tracking systems.
  • Imposes additional government regulations on private businesses in other states, potentially discouraging them from accepting Rhode Island children and limiting market competition.
  • Restricts the operational freedom of the department to make placement decisions based solely on the best interests of the child, prioritizing bureaucratic status over care quality.
  • Expands government bureaucracy by requiring the administration of cross-border Medicaid registrations, potentially increasing administrative overhead costs.

Votes

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Full Bill Text

Changes to existing Rhode Island law · 7 additions · 2 deletions

SECTION 1. Section 42-72.1-3 of the General Laws in Chapter 42-72.1 entitled "Licensing and Monitoring of Child Placing Agencies, Child Caring Agencies, Foster and Adoptive Homes, and Children’s Behavioral Health Programs" is hereby amended to read as follows: 42-72.1-3. Powers and scope of activities.

(a) The department shall issue, deny, and revoke licenses for, and monitor the operation of, facilities and programs by child-placing agencies, child caring agencies, foster and adoptive homes, and children’s behavioral health programs as defined in § 42-72.1-2 or assess administrative penalties under the provisions of chapter 72.11 of this title relating to licensed childcare centers, family childcare homes, and group family childcare homes.

(b) The department shall adopt, amend, and rescind regulations in accordance with this chapter and implement its provisions. The regulations shall be promulgated and become effective in accordance with the provisions of the administrative procedures act, chapter 35 of this title.

(c) The department through its licensing unit shall administer and manage the regulations pertaining to the licensing and monitoring of those agencies, and shall exercise all statutory and administrative powers necessary to carry out its functions.

(d) The administrator shall investigate complaints of noncompliance, and shall take licensing action as required.

(e) Regulations formulated pursuant to the foregoing authority shall include, but need not be limited to, the following:

(1) Financial, administrative and organizational ability, and stability of the applicant;

(2) Compliance with specific fire and safety codes and health regulations;

(3) Character, health suitability, qualifications of child-placing agencies, child caring agencies, foster and adoptive homes, and children’s behavioral health programs;

(4) Staff/child ratios and workload assignments of staff providing care or supervision to children;

(5) Type and content of records or documents that must be maintained to collect and retain information for the planning and caring for children;

(6) Procedures and practices regarding placing services to ensure protection to the child regarding the manner and appropriateness of placement;

(7) Service to families of children in care;

(8) Program activities, including components related to physical growth, social, emotional, educational, and recreational activities, social services and habilitative or rehabilitative treatment; and

(9) Investigation of previous employment, criminal record check and department records check.; and

(10) [Deleted by P.L. 2019, ch. 88, art. 4, § 21.]

(11) Out-of- state placements in foster care. All out-of-state foster care placement facilities shall be registered with the state medical assistance program as a Medicaid provider. The director may waive the Medicaid requirement on a case-by-case basis, if the director deems there is an emergency need for placement of a child in foster care at a facility that is not a registered Medicaid provider, and no Medicaid provider is available to provide placement.

(f) The administrator may:

(1) Prescribe any forms for reports, statements, notices, and other documents deemed necessary;

(2) Prepare and publish manuals and guides explaining this chapter and the regulations to facilitate compliance with and enforcement of the regulations;

(3) Prepare reports and studies to advance the purpose of this chapter;

(4) Provide consultation and technical assistance, as requested, to assist licensees in maintaining compliance; and

(5) Refer to the advisory council for children and families for advice and consultation on licensing matters.

(g) [Deleted by P.L. 2019, ch. 88, art. 4, § 21.]

(h) When the department is otherwise unsuccessful in remedying noncompliance with the provisions of this chapter and the regulations promulgated under it, it may petition the family court for an order enjoining the noncompliance or for any order that equity and justice may require.

(i) [Deleted by P.L. 2019, ch. 88, art. 4, § 21.]

(j) The department shall adopt, amend, and rescind regulations in the same manner as set forth above in order to permit the placement of a pregnant minor in a group residential facility that provides a shelter for pregnant adults as its sole purpose.

(k) Notwithstanding the transfer of licensing to and the licensing and monitoring of day and childcare facilities to the department of human services, pursuant to chapter 12.5 of this title, the department of children, youth and families will continue to be the agency responsible for investigating any complaint of abuse and neglect that is alleged to have occurred at a daycare or childcare facility. Any appeal of an investigative finding of abuse or neglect against a staff member, paid or otherwise, including managerial or contract personnel, or visitor may be appealed to the Rhode Island family court.

(l) The Rhode Island family court shall retain jurisdiction over those complaints investigated by the department of children, youth and families, pursuant to this chapter, regardless of whether licensing and monitoring is performed under chapter 12.5 of this title or this chapter.

SECTION 2. This act shall take effect upon passage.