Final Report - RI Department of Children, Youth & Families

CHAPTER 4: FINANCING THE SYSTEM OF CARE
and adults is a significant drain on our economy and devastating to individuals and
families. Enhancing coverage of mental health and substance abuse in private health
insurance programs can only serve to improve the quality of life for our children and
families and to support our economy. The State’s new mental health parity statute is a
first step in this direction. Credentialing issues create barriers in two ways: one, these
limit the array of professionals and para-professionals that can practice and get
reimbursed; two, the procedures are so arduous and onerous that providers often wait
long periods of time to receive approval and bear the burden of the cost of providing
services during this waiting period.
6. $ The DHS must continue its efforts to ensure that all children are covered by
health insurance through focusing on further reducing the number of uninsured
children in Rhode Island through expanded Medicaid/SCHIP access. To
accomplish this, DHS maintains RI Medicaid’s current definitions of medically
necessary services and assures that all Medicaid primary care providers deliver
all EPSDT services. DHS must continue to extend Medicaid benefits to children
and adolescents covered by SCHIP. In conjunction with the MHRH, the DHS
assures that parents of both Medicaid and SCHIP covered children receive
needed mental health and substance abuse treatment.
The DHS is nationally recognized for expanding access to Medicaid for eligible
children. This progressive approach has led to Rhode Island being the top state in
regard to the number of children covered by health insurance 19 . Rhode Island’s
Continuum of Care must continue this effort and support the DHS in expanding access
to Medicaid.
7. $ The DHS, in collaboration with other state agencies, must ensure that
Medicaid eligible children receive timely and appropriate assessments throughout
their development. The DHS must emphasize that primary care providers use
age appropriate screening for child/adolescent mental health and substance abuse
problems. The DOH, the DHS, and DCYF must work collaboratively to ensure
that children from birth to age three involved with DCYF are referred to Early
Intervention programs for screening, assessment, and treatment as needed.
There is a strong need for timely and quality assessments and evaluations for children
and youth at all stages of the developmental continuum. Recent changes in the Early
Intervention Program and the development of the CEDARR Family Centers show
promise in being able to increase access to these services. State agencies must
continue to work together in expanding this access and ensuring that a multidisciplinary
team approach be utilized.
8. It is important that the system of care include independent local providers (see
Appendix J) who may be able to intervene with children and families before
tragedies happen or the children need to be removed from their homes. The
Children’s Cabinet, through a designated agency or committee, must work with
19 According to the Annie E. Casey Foundation’s National KIDS COUNT data, only seven percent (7%) of
Rhode Island children are uninsured compared to a national average of fifteen percent (15%). 200l KIDS
COUNT Data Book Online at http://www.aecf.org/cgi-bin/kc2001.cgi?action=profile&area=Rhode+Island
System of Care Task Force Report (January 2003) 42