Clinicians | Children's
Intensive Services | Diagnostic Assessment
Services | Residential
Counseling Centers | Residential
Treatment | Psychiatric
Day Treatment | Alternate Living and Independent Living | Educational Services |
Purchase of Service | CEDARR Initiative
The Rhode Island Department of Children, Youth and Families (DCYF) provides publicly funded mental health services for children birth through 21. If the children have third party coverage, this must be used first. The Division of Children’s Behavioral Health and Education is responsible for the design, implementation, and monitoring of a continuum of therapeutic and clinical services to seriously emotionally/behaviorally disturbed children and youth, as well as providing programs aimed at maintaining healthy family functioning through an array of community-based therapeutic/supportive services. Children who are placed in the custody of the Department due to abuse, neglect, and dependency, as well as children who remain in the custody of their parents or legal guardians, are eligible for these services. Most of these services are delivered in community-based settings, and are accessed primarily through the eight Community Mental Health Centers.
The Department of Children, Youth and Families maintains a list of mental health clinicians who meet criteria developed by DCYF and the Division of Medical Services of the Department of Human Services, who provide mental health assessments and counseling services for children and youth in DCYF care and custody. DCYF caseworkers access these services for children and youth in their caseloads. These services are provided by psychiatrists, psychologists, licensed independent clinical social workers, registered nurses with a Master’s degree in nursing, licensed mental health counselors, and licensed marriage and family therapists.
The types of services provided through the Division of Children’s Behavioral Health include Children’s Intensive Services (CIS), which is an intensive community-based program for families with children at-risk for out-of-home placement. This program is geared toward preventing psychiatric or other residential placements, and is available for families who may or may not be involved with DCYF. The program typically is for six months; however, it may be extended for up to a year. These services must be accessed through the Community Mental Health Centers.
The DCYF provides Diagnostic Assessment Services (DAS) for youth referred through the Family Court to determine the appropriate level of service for disposition by the Court on wayward/disobedient petitions. The DAS is an inpatient program, up to two weeks, during which time children and youth are evaluated based on their presenting issues. This evaluation includes psychological and psychiatric assessments when necessary. The DAS program also does have out-patient services.
Residential Counseling Centers (RCC) provide services in graduated levels of care for children and youth who are leaving a psychiatric hospital setting, or in some cases for youth who must be placed out of the home for a short term crisis intervention, but not in need of inpatient psychiatric hospitalization. These services are provided in a community-based setting, offering short-term placement, providing acute and intensive treatment, and attempting to avert inpatient psychiatric hospitalization. Additionally, there is a Residential Counseling Center for youth in DCYF care between the ages of 5 and 12.
Residential Treatment services for seriously behaviorally disturbed youth provide around the clock treatment and care with programs tailored to individual, group and family therapy, behavior modification; special education and recreational therapy. There are two residential treatment programs in Rhode Island providing services for youth between the ages of 5 and 21.
Psychiatric hospitalization is the most expensive, closely supervised, restrictive service and the one with the highest percentage of medical staff. Bradley Hospital and Butler Hospital are the two psychiatric hospitals in Rhode Island providing services to children and youth. Such inpatient psychiatric hospitalization is usually reserved for extreme situations, such as short-term treatment and crisis stabilization for children in acute distress, comprehensive evaluations, and long-term treatment. In addition, Bradley oversees a short-term residential treatment program (6 month maximum length of stay) aimed at reunification with the family, and has a variety of partial hospitalization alternatives.
The Division of Children’s Behavioral Health also provides day treatment programs as a service provided through state funds, and through its federal Project REACH grant (Resources Effectively Allocated for Children). There are six day treatment programs which provide therapeutic, individualized educational instruction, four of which are funded federally through Project REACH. Over the past years, REACH funds have supported day treatment programs in the school departments of South Kingstown, Central Falls and Pawtucket, and at the Providence Center. There are also two state-contracted day treatment programs at the Groden Center and the Providence Center.
The Project REACH federal grant also provides funding for non-traditional wraparound services through local coordinating councils established in each of the eight Community Mental Health Center catchment areas. These local coordinating councils have evolved from the Child and Adolescent Service System Program (CASSP), which provided a community-based family-focused, inter-disciplinary model for providing care coordination for seriously emotionally disturbed children and youth. Additionally, these REACH funds have enhanced the service capacity within the CIS programs, providing more counseling and home-based services for children and families. The REACH federal grant was a five year $15.8 million research-based service implementation grant awarded in 1994 from the Center for Mental Health Services, providing the Division of Children’s Behavioral Health about $3-million annually.
The Department also provides alternate living and independent living services
for youth transitioning from DCYF care. Alternate living
is a therapeutic group home providing care in a single home located in the
community, involving an array of therapeutic interventions. The Newport
County Mental Health Center operates an alternate living program for DCYF
providing services to four youth.
The Providence Center operates an independent living program for the Division of Children’s Behavioral Health, providing services for 12 youth transitioning from DCYF care. Independent living services typically provide a range to assist youth make the transition from home or residential programs to independent living. Vocational training, work experience are emphasized along with training skills of independent living, such as managing financial, medical, housing, transportation, and recreation needs.
Children in the care of DCYF who are eligible for special education services, or are suspected of requiring such services, may be eligible for the appointment of an educational surrogate parent. Referrals to the Department of Education are coordinated through the Children’s Behavioral Health and Education Division. This division also monitors the delivery of educational services provided under the federal Individuals with Disabilities Education Act (IDEA), Part B and Title I to students in state-operated or state-supported community residences.
Purchase of Service (POS), including in-state and out-of-state residential placement is another expensive service cost to Rhode Island. These services typically are for specialized behavioral needs; e.g., sexual offender treatment program services. However, they also include therapeutic foster care services.
DCYF is collaborating with DHS and other agencies involved in services to children with special health care needs in the ongoing development and implementation of the CEDARR Family Centers