PROVIDENCE – ConvergenceRI can report, regrettably, that there is still no “sanity clause” when it comes to marshaling resources to address the significant increase in the demand for mental health and behavioral health services in Rhode Island.

In last week’s edition, ConvergenceRI detailed how “settlements” with the R.I. Office of the Health Insurer Commissioner related to the past “misdeeds” by the four major commercial health insurers were being used to fund a $ 5 million “COVID-19 Behavioral Health Fund, managed by the Rhode Island Foundation. [See link below to ConvergenceRI story, “New behavioral health fund financed by settlements from insurers past bad deeds.”]

The fund was being created to help “nonprofit organizations working to address Rhode Islanders behavioral health needs resulting from the COVID-19 crisis,” according to the news release that accompanied the announcement. A positive development.

Nonprofits were instructed to submit their applications to secure funds beginning on Monday, April 6.

But a funny thing happened on the way to the forum. A nonprofit enterprise run by Lifespan, Kids’ Link RI, apparently was able to jump the line, and by doing so, secured a grant before anyone else had officially applied. Exactly how much was handed out is not yet known, but the move was made with the full blessing of Gov. Gina Raimondo, according to sources.

On its website, Kids’ Link RI, a trademarked name, is described as follows: “a behavioral health triage service and referral network.” The program, the description continued, is “offered in collaboration with Gateway Healthcare, Lifespan, Hasbro Children’s Hospital and Bradley Hospital.”

Further, the services offered by Kids’ Link RI are “available 24 hours a day, seven days a week, to help triage children and youth in need of mental health services and refer them to treatment providers.”

When asked about the apparent preferential treatment, Chris Barnett of the Rhode Island Foundation explained what had happened.

“Bradley [Hospital, one of the portals for Kids’ Link RI] “did not receive [emphasis added] a grant before April 6,” Barnett said. “But, we were aware of the critical need to help kids struggling with urgent behavioral health demands in the time of COVID-19,” adding in a parenthetical comment, “You report on toxic stress extensively, so you know.”

Barnett continued: “Grant-making during a crisis takes different forms like responding to urgent, real-time needs. Surging demand is threatening to overwhelm the system's capacity to provide crucial services.”

Further, Barnett said, “The goal with all of our COVID-19-related funds is to move quickly to put the money to work helping people as soon as possible. That doesn't mean we don’t follow a process. Every member of the COVID-19 Behavioral Health Fund’s advisory committee reviewed and weighed in on Bradley’s application, just as they are doing and will do with every application we receive.”

Curious and curiouser
On Thursday, April 8, during the one-hour BHDDH Provider Engagement Conference Call, Kevin Gallagher, a top aide for Gov. Raimondo, spoke to the participants on the call, introducing the new role that Kids’ Link RI would be playing in delivering behavioral health and mental health service referrals as part of the response to the surging demand for behavioral health services for kids during the coronavirus pandemic.

Gallagher likened the role envisioned that Kid’s Link RI would play to that of BHLink, the 24/7 triage service coordinated by the R.I. Department of Behavioral Healthcare, Developmental Disabilities, and Hospitals – except the focus would be on the needs of kids.

The elevation of Kids’ Link RI to the front of the line for children’s services struck a number of participants on the conference call as “strange,” given that it was a “private” network.

Even stranger, according to one participant, was the fact that Gallagher “encouraged” other nonprofit service providers to make referrals to Kids’ Link RI, adding that, in an attempt to assuage the apparent conflict of interest in how referrals would be made for those who called into Kids’ Link RI, that referrals for services would be made to more than just Lifespan providers.

The biggest worries
The presentation by Gallagher about the new prominent role being given Kids’ Link RI was not among the biggest worries that were expressed by participants on the conference call.

The number-one concern was the lack of testing available for residents and staff in the group homes managed by behavioral health care providers, because it put both residents and the health care staff under increasing risk to contract the virus. The suggestion was made a number of times for the state to develop a mobile testing van to service the group homes, which Kathryn Power, the director of the R.I. Department of Behavioral Healthcare, Developmental Disabilities, and Hospitals, said that the state would consider pursuing.

[The question was asked by ConvergenceRI during the Governor’s daily news briefing a scant 15 minutes after the conclusion of the call: “Are you considering mobile testing for residential homes in the behavioral health system?”

In her response, Gov. Raimondo suggested that it was a lack of supplies that was preventing wider-spread testing.

A second major concern voiced was the need to ramp up hazardous pay for the workers involved for caring for residents that were living in group homes, with a number of participants expressing their worries about the difficulties of keeping staffing on the job.

A third major concern voiced was the continued lack of personal protection gear available to workers engaged with clients in face-to-face contact.