Purpose and Reason:
This revision updates and expands the existing Emergency Services (ES) regulations to incorporate licensure standards for Mobile Response and Stabilization Services (MRSS), consistent with recent statutory changes and statewide behavioral health system reforms. Key changes include:
• Expanded scope and purpose to implement R.I. Gen. Laws § 27-18-95 and 2025-H 5151 Substitute A, establishing MRSS as a licensed service and a Medicaid-covered benefit for children and youth ages two through twenty-one
• Creation of two distinct licensure levels: Emergency Services (ES) and Mobile Response and Stabilization Services (MRSS), with MRSS providers required to meet all ES standards plus additional MRSS-specific requirements.
• New definitions and clarified terminology, including detailed definitions related to behavioral health emergencies, child-family competency, MRSS service phases, warm handoffs, system of care, and designated collaborating organizations (DCOs).
• Detailed MRSS service delivery standards, including required response timeframes, staffing models, stabilization services, coordination with 988, and expectations for crisis de-escalation and follow-up care.
• Statewide service structure and accountability, establishing primary service areas aligned with CCBHC regions, mutual aid requirements across MRSS providers, and expectations for statewide coverage.
• Enhanced staffing, supervision, and training requirements, including QMHP staffing on mobile teams, supervision minimums, cultural and linguistic competency, and ongoing professional development.
• Expanded data collection, reporting, and quality improvement requirements, including fidelity measures, encounter data, and documentation standards.
• Updated licensure application, review, and enforcement provisions, clarifying application timelines, approval criteria, licensing actions, corrective action processes, and appeal rights.
• No substantive change to emergency hospitalization authority under R.I. Gen. Laws § 40.1-5-7, which remains excluded from these regulations.
Overall, the revisions modernize the regulatory framework to support a coordinated, community-based crisis response system for children and youth while maintaining existing emergency service requirements and protections.
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Comment(s) Received*