Mind and Body

Celebrating the art of connectedness in RI

What do you say when the state provides someone to talk to, someone to respond, and somewhere to go when you are in crisis?

Photo by Richard Asinof

State leaders -- Sen. Jack Reed, Sen. Sheldon Whitehouse, Gov. Dan McKee, House Speaker Joe Shekarchi, Director Kasim Yarn of the Office of Veteran Affairs, and Director Richard Leclerc Director of BHDDH -- gathered on Monday morning, May 20, to pay tribute to the extreme competence of of the leaders from the Community Care Alliance, including Benedict Lessing, President and CEO of BH Link, Community Care Alliance, Sydney Muraoka, 988 Call Center Manager, and Katie Anderson, Vice President of Acute Services at the Community Care Alliance, who have achieved a remarkable 98 percent response rate for all calls coming through the hotline, the highest response by any state in the nation.

By Richard Asinof
Posted 5/27/24
The great success story of the competence of the 988 suicide hotline, managed by Community Care Alliance, appears to have been drowned out by the failure of state leaders, including Gov. Dan McKee and House Speaker Joseph Shekarchi, to invest in increasing Medicaid rates for providers in the FY 2025 budget.
What is the best way to celebrate the management skills of community agencies such as the Community Care Alliance of RI in delivering care to Rhode Islanders in need of social services? What would be an effective billboard advertising campaign to champion the 988 Suicide Hot Line Call Center? How will state regulators – the Attorney General’s office and the state Department of Health – rule on the proposed purchase of Roger Williams Medical Center and Our Lady of Fatima hospitals by the Centurion Foundation? What fallout will the bankruptcy of Steward Health Care in Massachusetts have on the delivery of health care services in Rhode Island? How quickly will federal Medicare regulators move to reign in the abuses in the use of prior authorization by health insurers, and will legislators in Rhode Island also enact laws to restrict similar prior authorization rules by health insurers?
On Tuesday, May 28, the General Assembly will convene a “Rhode Island Healthcare Summit,” featuring discussions around key areas of concern within the state’s health care system. The three-hour session will feature a high-level discussion offering numerous perspectives.
Sen. Sheldon Whitehouse will provide the federal perspective on opportunities to help secure a cooperative local delivery system. Drs. Howard Schulman and Hub Brennan will talk about the impact of the primary care physician shortage. Care New England President and CEO Michael Wagner and Lifespan President and CEO John Fernandez will discuss the current state of affairs of hospitals.
A discussion about third-party payors/Medicaid perspective will feature Martha Wofford, President and CEO of Blue Cross and Blue Shield of RI, Richard Charest, EOHHS Secretary, Kristin Sousa, RI Medicaid program director, and Joseph Perroni, president and CEO of Delta Dental.
Attorney General Peter Neronha will then discuss his perspective on a Rhode Island health care system in crisis.
The summit will be opened by House Speaker Joseph Shekarchi and closed by Senate President Dominick Ruggerio.

EAST PROVIDENCE – This is a big story about competence – pure, unadulterated competence, demonstrated in the delivery of care to meet the urgent mental health needs of Rhode Islanders.

It is a success story about how those services are being delivered by the collaborative management team behind the 988 Suicide and Crisis Lifeline Call Center – the Community Care Alliance, the Horizon Healthcare Partners, BHLink, Child & Family, CODAC, Newport Mental Health, Thrive, Tides Family Services, and the Galilee Mission.

In a state seemingly awash with horrific news stories about gross incompetence when it comes to delivering behavioral health services – the warehousing of clients at Bradley Hospital, the continued breakdown at St. Mary’s Home for Children where clients are being removed because of poor conditions, the months-long wait time for children and their families seeking services through Early Intervention, and the increasing violence and even murder at the state’s nursing homes – a good news story that champions competence is a rarity.

Translated, the story of how and why “988 means help,” where crisis intervention services delivered through calls, texts, chats and in-person counseling is an important story worth championing and retelling.

What did you hear about this success story?    
The numbers clearly speak for themselves: Since its launch here in Rhode Island in July of 2022, the combined 988 Lifeline and BH Link hotline have answered more than 33,000 calls, including some 13,527 988 Lifeline calls, with a 98 percent average answer rate – the highest such rate in the nation.

Delving deeper into the numbers behind the phenomenal response rate, here are the metrics: the average response rate was two seconds; the average call duration was 17 minutes; some 15 percent of the 988 callers expressed thoughts of self-harm/suicide; 23 percent of the 988 callers said they were calling on behalf of someone else, and 3 percentmore than 400 calls to the 988 Lifeline – resulted in a community wellness check.

Translated, the crisis counselors at the 988 hotline “provide lifesaving support to Rhode Islanders in crisis,” said Sen. Sheldon Whitehouse.

The success of the 988 Suicide and Crisis Hotline Center was celebrated on Monday morning, May 20, at a news conference in the parking lot outside the hotline headquarters on 971 Waterman Avenue in East Providence, featuring a gaggle of VIPs – Sen. Sheldon Whitehouse, Sen. Jack Reed, House Speaker Joseph Shekarchi, Gov. Dan McKee, BHDDH Director Richard Leclerc, and Director Kasim Yarn from the RI Office of Veterans Services. [Sen. Jack Reed was the principal sponsor of the federal legislation to deliver the financial resources to support the 988 crisis intervention program nationwide.]

The speaking program also featured two “worker bees” behind the successful 988 Suicide and Crisis Lifetime Call Center – Sydney Muraoka, the 988 Call Center Manager for BH Link for the Community Care Alliance; and Katie Anderson, the Vice President of Acute Services at Community Care Alliance. [Benedict F. Lessing, Jr., President and CEO of BH Link and the Community Care Alliance, served as emcee at the news conference.]

“Crisis doesn’t have standard business hours,” Sydney Muraoka told the assembled crowd of news media and advocates gathered underneath a tent to protect against the threat of inclement weather. Muraoka said she had answered more than 1,000 crisis calls since 2022.

Horizon Healthcare Partners has contracted with the Community Care Alliance to run both BH Link and the 988 Call Center from its East Providence location, enabling a team of masters-level clinicians, nurses, peers, and frontline workers to offer 24/7 in-person assessment and referrals for people seeking immediate treatment.

What distinguishes Rhode Island from other states, Katie Anderson explained to the audience of more than 50 attending the news conference, was the model of the shared physical location of the two programs working collaboratively.

The biggest impediment to further success of the 988 Call Center, it seemed, was getting the word out. A 2023 survey conducted by BHDDH found that only 63 percent of Rhode Islanders knew about the 988 Call Center, said BHDDH Director Richard Leclerc.

Which meant that some 37 percent of Rhode Islanders were still dancing in the dark when it came to finding help.

A media advertising awareness campaign is planned for the summer months to promote the 988 Lifeline call center. [ConvergenceRI has offered to run advertisements for free about the hotline.]

But the bigger question is: Did you hear about the success story? Odds are, probably not, despite the impressive line up of speakers

Rattle and hum    
The location of the news conference on Waterman Avenue in East Providence provided a steady undercurrent of the whine of tires from the constant highway traffic traveling on Route 195, to and from the Washington Bridge.

And, the biggest driver of questions following the news conference about the success story of the 988 Suicide and Crisis Lifeline Call Center was yet another story about the alleged incompetence of state government – new billboards put up by gadfly Ken Block on Monday, May 20, which proclaimed, “If they had done their job you would be home already,” and “They knew in 2012.”

Gov. McKee was apparently petulant in his responses to questions about the billboards following the news conference, discounting the impact of the billboards, calling them “60 days too late.”

From ConvergenceRI’s perspective, the problem for Gov. McKee was that the billboards provided what amounted to effective messaging to a “captive audience” – the thousands of drivers caught in traffic each and every day. It was an audience that the Governor’s friendly talk radio hosts such as WPRO’s Dan Yorke could not compete with.

Budget shortfalls    
Another big omission from the questioning addressed to both Gov. McKee and House Speaker Shekarchi was the apparent failure by the news media to ask questions about pending legislation that would improve access to behavioral health services – in particular, legislation that would increase the Medicaid rates for providers in the FY2025 state budget.

A fact sheet in the press kit put together by Horizon Health Partners, “988 Means Help,” highlighted all the legislation that would increase access to behavior health services in Rhode Island. The top item on the list was HB 7591 sponsored by Rep. Tina Spears and SB 2553 sponsored by Sen. Lou DiPalma, legislation that would include the recommended increases in Medicaid rates for providers.

[Editor’s Note: Speaker Shekarchi somehow avoided talking about his position on the increased rates for Medicaid providers, although the next day, as one of the speakers at the inaugural summit of the R.I. Life Science Hub, Shekarchi announced that an $80 million bond would be in the FY 2025 state budget to support building a new life sciences building at URI.]

How important is the need for rate increases for Medicaid providers? Just ask the owners of Linn Health and Rehabilitation, a nonprofit nursing home owned by Aldersbridge Communities in East Providence, which notified the state Department of Health that it would be shutting its doors on July 20, after being in business for 53 years. The problem: the too-low Medicaid rates paid to nursing homes.

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