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S3066BaaChildren

State Affairs and Government - Children's Mobile Response and Stabilization Services

This bill creates a 24/7 mobile behavioral health crisis response program for children and young adults under 21.

Introduced70 Yea0 Nay5 Not voting
Population
Affected
15
Email Legislator
Introduced Mar 12, 2026Committee Senate Health & Human Services

Plain-English Summary

This bill creates a statewide Mobile Response and Stabilization Services (MRSS) program for children and young adults up to age 21 who are experiencing behavioral health crises. The program provides 24/7, in-person crisis assessment, de-escalation, and short-term stabilization services within 60 minutes of a call. Services are delivered in the child's natural environment, such as their home or school, regardless of their health insurance status. The state will license two or three providers to cover specific geographic areas. The bill also requires Medicaid to cover these services and mandates annual reporting on the program's usage and outcomes.

For younger readers

This bill creates a special team of helpers for kids and young adults who are having a really tough time with their feelings or behavior. If a kid is very upset and needs help right away, these helpers will drive to where the kid is, like their house or school, any time of day or night. They promise to get there fast, usually within an hour. It doesn't matter if the kid's family has money to pay for it or not. The helpers will talk to the kid, help them calm down, and make a plan to feel better.

Who & Where It Applies

Impacted groups
Children and youth under 21Families of children in crisisBehavioral health cliniciansMedicaid administratorsCommunity-based behavioral health providers
Impacted communities
All

Constitutional & Fiscal Check

None Likely

Estimated cost
Amount unknown
Estimated revenue
None

Bill Analysis

Both viewpoints
For Progressives
  • Ensures 24/7 access to mental health crisis services for all children and youth regardless of their insurance status, expanding the social safety net and helping low-income families.
  • Mandates in-person responses in the child's natural environment (like home or school) within 60 minutes, providing generous and immediate public health services to those in need.
  • Requires culturally and linguistically responsive services and ensures accessibility for individuals with disabilities, promoting social justice and equity in healthcare delivery.
  • Limits the state to only two or three licensed providers, which could create monopolies, overwhelm the chosen agencies, and limit systemic reform by locking out smaller community-based organizations.
  • Allows the Medicaid agency to implement utilization management or prior authorization later on, which could eventually create bureaucratic barriers for poor and disadvantaged youth trying to access ongoing care.
  • Focuses heavily on crisis intervention and short-term stabilization rather than providing funding for long-term, systemic mental health care and preventative social services to address root causes.
For Conservatives
  • Includes provisions that allow the Medicaid agency to implement utilization management and prior authorization, helping to control state spending and prevent abuse of government assistance.
  • Requires the state to collect data on cost avoidance and emergency department diversion, emphasizing fiscal responsibility and measurable outcomes for taxpayer-funded programs.
  • Relies on contracting with private or existing community-based providers rather than creating a massive new government agency of state employees to deliver the services.
  • Mandates the provision of services regardless of a family's insurance status or ability to pay, significantly expanding government assistance and potentially increasing the burden on taxpayers.
  • Imposes strict government mandates on private providers, such as requiring a 60-minute in-person response time and specific team compositions, limiting corporate freedom and operational flexibility.
  • Requires no prior authorization or clinical intake determination for the initiation of services, which could lead to overuse of the system and wasteful government spending on non-emergencies.

Votes

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Full Bill Text

5 versions
Changes to existing Rhode Island law · 150 additions

SECTION 1. Title 42 of the General Laws entitled "STATE AFFAIRS AND GOVERNMENT" is hereby amended by adding thereto the following chapter: 42-72.13-1. Definitions. As used in this chapter:

(1) "Department" means the department of children, youth and families (DCYF).

(2) "Designated MRSS provider" means a community-based provider licensed or contracted by the department to deliver MRSS.

(3) "Medicaid agency" means the Medicaid program administered within the executive office of health and human services (EOHHS).

(4) "Mobile response and stabilization services" or "MRSS" means community-based behavioral health crisis services for children and youth up to the age of twenty-one (21), including:

(i) Rapid mobile crisis response;

(ii) Crisis assessment and de-escalation;

(iii) Short-term stabilization and follow-up services; and

(iv) Care coordination with families, schools, healthcare providers, and community-based organizations.

(5) "Natural environment" means homes, schools, childcare settings, and other community locations in which children and youth typically live, learn, or receive care. 42-72.13-2. Establishment of a statewide MRSS program.

(a) The department, in coordination with the Medicaid agency, shall establish and administer a statewide mobile response and stabilization services program, and shall ensure alignment with the Children's Behavioral Health Consent Decree that was ordered in United States v. State of Rhode Island, C.A. No. 24-cv-00531.

(b) The department shall establish standards for MRSS service fidelity.

(c) MRSS shall be available statewide, twenty-four (24) hours per day, seven (7) days per week, to all children and youth regardless of insurance status or Medicaid eligibility.

(d) The department shall license a minimum of two (2) MRSS providers and a maximum of three (3) providers for the entire State of Rhode Island.

(1) Each licensed MRSS provider shall be responsible to provide MRSS to all children and youth up to the age of twenty-one (21) to their agreed geographic region or catchment area as established by the department.

(2) Licensed MRSS geographic catchment areas shall be through the assignment of the specific cities and towns and ensure sustainability and community connection.

(e) No prior authorization, referral, or clinical intake determination shall be required for initiation of MRSS.

(f) Services pursuant to this chapter shall be delivered in the child's natural environment whenever clinically appropriate.

(g) All requests for MRSS shall be presumed eligible for response under a no wrong door standard, and services shall not be denied or delayed due to:

(1) Payer status;

(2) Referral source; or

(3) Clinical screening thresholds inconsistent with a family-defined crisis. 42-72.13-3. Service delivery standards.

(a) Response time. Designated MRSS providers shall provide in-person mobile response within sixty (60) minutes of initial contact, unless clinically contraindicated. Telephonic or virtual response shall not substitute for in-person response except where clinically appropriate and determined by MRSS staff.

(b) Service components. MRSS shall include, at a minimum:

(1) Crisis assessment and de-escalation;

(2) Family engagement and support;

(3) Short-term stabilization services of sufficient duration to support safe resolution of the crisis; and

(4) Transition planning and linkage to ongoing behavioral health, educational, and community supports.

(c) Designated provider MRSS teams shall consist of a minimum of two (2) staff, including at least one licensed behavioral health clinician qualified to conduct clinical assessments and one additional team member, which may include a peer support specialist, family partner, or other trained paraprofessional. Providers shall ensure access to clinical supervision and psychiatric consultation on a twenty-four (24) hour basis.

(d) Workforce composition. Designated MRSS provider teams shall include licensed clinicians and may include peer support specialists, family navigators, and other trained staff with demonstrated expertise in children's behavioral health.

(e) Cultural and linguistic competency. MRSS designated providers shall deliver services in a culturally and linguistically responsive manner and shall ensure accessibility for individuals with disabilities.

(f) Coordination with crisis lines. MRSS shall serve as the primary, mobile crisis response system for children and youth experiencing behavioral health crises. MRSS shall operate in coordination with, but remain clinically and operationally distinct from, the 988 Suicide and Crisis Lifeline (988) and other telephonic triage or referral lines, including Kids' Link RI. Referrals to designated MRSS providers shall originate from 988, Kids' Link RI, 911, schools, child welfare agencies, healthcare providers, law enforcement, families, or self-referral; provided, however, that 988 and other telephonic triage or referral lines may receive, assess, de-escalate, and route crisis contacts with applicable law, and designated MRSS providers shall retain clinical discretion in accordance with nationally recognized fidelity standards regarding deployment, response modality, and timing. Coordination with 988 and other crisis lines shall not result in unnecessary screening, triage delays, or redirection that substitutes telephonic intervention for in-person mobile response when MRSS is clinically appropriate. Nothing in this section shall permit 988 or any call center entity to control dispatch or clinical decision-making for MRSS services once a referral has been made. Nothing in this section shall be construed to require designated MRSS providers to operate or staff a call center, crisis hotline, or telephonic triage service.

(g) Coordination with certified community behavioral health clinics (CCBHC). Designated MRSS providers shall coordinate with CCBHCs and other behavioral health providers for purposes of referral, care transitions, information-sharing, and continuity of care when clinically appropriate and with appropriate consent.

(1) Designated MRSS providers may execute non-financial coordination agreements and/or designated collaborating organization (DCO agreements) with coordinating entities such as pediatricians, law enforcement, hospitals and other child and youth serving entities.

(2) Coordination shall not require MRSS to be operated by, embedded within, subcontracted to, or financially dependent upon a CCBHC, nor shall it limit the department's authority to contract directly with community-based designated MRSS providers. MRSS shall remain a distinct mobile crisis response and stabilization service with independent clinical decision- making authority.

(h) Child and family competency requirement. MRSS shall be delivered by designated MRSS providers with demonstrated expertise in child and adolescent behavioral health and family systems. Designated MRSS providers shall ensure that licensed clinical staff assigned to MRSS possess training and experience specific to children, youth and families, including child development, trauma-informed care, family engagement, and coordination with child-serving systems. Providers that primarily serve adult populations shall not deliver MRSS unless they demonstrate child-specific capacity, staffing, and supervision as required by this chapter. 42-72.13-4. Funding. On or before October 1, 2027, the Medicaid agency shall submit to the legislature a report outlining the necessary steps and activities required to complete an alternative funding methodology for Medicaid MRSS payments including any costs associated with implementation. Implementation of the alternative methodology shall occur no later than October 1, 2028 in accordance with federal approval. 42-72.13-5. Medicaid coverage.

(a) The Medicaid agency shall designate MRSS as a covered Medicaid service for eligible children and youth up to the age of twenty-one (21), including coverage pursuant to the early and periodic screening, diagnostic, and treatment (EPSDT) benefit.

(b) The Medicaid agency shall submit any necessary state plan amendments or waiver applications to the Centers for Medicare and Medicaid Services to implement this section.

(c) The Medicaid agency shall ensure compliance with all applicable EPSDT requirements for Medicaid eligible children and youth accessing MRSS.

(d) Nothing in this section shall prevent the Medicaid agency from implementing utilization management or prior authorization to ensure program integrity and compliance with federal Medicaid requirements. 42-72.13-6. Provider designation and contracting.

(a) The department shall license and oversee community-based designated MRSS providers. The department may enter into contracts as necessary for payment and administrative purposes; however, designation as an MRSS provider shall be based on licensure, not procurement status.

(b) In designating MRSS providers, the department shall prioritize:

(1) MRSS providers with demonstrated experience in children's behavioral health crisis services;

(2) Existing community-based providers currently delivering mobile crisis or stabilization services; and

(3) Geographic coverage sufficient to ensure statewide access.

(c) Designated MRSS provider contracts shall establish reimbursement rates, performance standards, reporting requirements, and care coordination expectations.

(d) The department shall establish a licensure category specific to children’s mobile response and stabilization services, including standards for clinical staffing, child and family expertise, and service delivery requirements. Each designated MRSS provider shall be responsible to provide MRSS to all children and youth up to the age of twenty-one (21) and demonstrate a willingness to provide services for the purposes of mutual aid to other licensed MRSS providers when needed.

(e) No provider shall deliver MRSS unless licensed pursuant to this chapter. 42-72.13-7. Oversight and reporting.

(a) The department shall collect data on MRSS utilization, response times, outcomes, and cost avoidance.

(b) No later than January 1 of each year, the department shall submit a report to the governor and the general assembly detailing:

(1) Program utilization and geographic coverage;

(2) Funding sources and expenditures;

(3) Outcomes related to emergency department and inpatient diversion; and

(4) Recommendations for statutory or budgetary changes. 42-72.13-8. Rulemaking authority. The department shall promulgate rules and regulations necessary to implement this chapter. The rules and regulations shall establish a statewide MRSS mutual aid framework to ensure coverage during periods of high demand, workforce shortages, or regional capacity constraints. 42-72.13-9. Severability. If any provision of this act is held invalid, such invalidity shall not affect other provisions of the act which can be given effect without the invalid provision.

SECTION 2. This act shall take effect upon passage.