She is one of 10 plaintiffs and families who are part of a class-action lawsuit filed Wednesday by federally mandated protection and advocacy agency Disability Rights Rhode Island, the American Civil Liberties Union of Rhode Island, and the national advocacy organization Children’s Rights against the state of Rhode Island. The lawsuit claims that Medicaid-eligible children and youths are denied their right to appropriate mental health care.
Those families are “the tip of the iceberg,” said Kristine Sullivan, the legal director of Disability Rights Rhode Island. There are more than 20,000 youth in Rhode Island who are eligible for Medicaid and have been diagnosed with serious emotional disturbance, she said, and 4,000 of them have a developmental disability.
“Each of these children need and have a legal right to receive behavioral health services to thrive in their homes, to attend school with their peers, to have a childhood,” Sullivan said. “There are dire consequences for children whose behavioral health needs go untreated.”
The lawsuit, filed in US District Court in Providence, alleges that the state’s failure to build an adequate behavioral health system for children and youth violates provisions of the Medicaid Act designed to provide children with appropriate mental health services, as well as the Americans with Disabilities Act and the Rehabilitation Act.
The lawsuit seeks to compel the state Department of Children, Youth, and Families, and the state Executive Office of Health and Human Services to provide the children with medically necessary behavioral health services in a community-based setting. DCYF said Wednesday it cannot comment on pending litigation.
In a news conference Wednesday announcing the lawsuit, Almeida described the months and years that her children have been placed in hospitals and institutions, because of a lack of community-based services. “It has been a living hell trying to get the services my children need,” she said.
Donna Goulet-Truppi, whose grandchild Trevor is also part of the lawsuit, told the Globe that her family is also fighting for services. Trevor had lived at the psychiatric residential treatment facility in St. Mary’s Home for Children in North Providence for more than a year, where he suffered neglect, had access to sharp objects, and ran away twice.
Trevor and other children were finally removed from St. Mary’s in June, after DCYF and the state child advocate found abuse, neglect, and dysfunction at its psychiatric residential treatment facility. Goulet-Truppi said that DCYF has fallen short on promises that Trevor would have necessary community-based services.
Without them, Trevor faces being institutionalized again, probably somewhere far from home, she said. “There are no placements,” Goulet-Truppi said.
A Globe investigation this fall found that dozens of youths and young adults in the state child welfare system are being sent to residential treatment facilities outside of Rhode Island — including some places accused of abuse, neglect, and even deaths.
As of Nov. 1, 82 children and youths are being treated in out-of-state residential treatment facilities, according to DCYF. The numbers of children placed out of state have risen in the last two years, especially since the closure of St. Mary’s, which was the only psychiatric residential treatment facility in Rhode Island. The nonprofit closed in August.
Rhode Island has known about this problem for decades, said Steven Brown, the executive director of the ACLU of Rhode Island.
In 2010, the National Coalition for Child Protection Reform said Rhode Island’s institutionalization rate for children was among the worst in the nation. In 2021, the state child advocate said the lack of behavioral health services was at an “extreme level of desperation.” In 2022, the Rhode Island chapter of the American Academy of Pediatrics and other children’s health professionals declared a state of emergency in child and adolescent mental health.
Then in May, the US Department of Justice found that Rhode Island was over-hospitalizing children with behavioral disabilities in state care.
Samantha Bartosz, the deputy litigation director for Children’s Rights, said the nonprofit agency joined the lawsuit in order to get Rhode Island to focus on the urgent need to build an adequate mental health system and end the unnecessary institutionalization of children.
“The initially diagnosed mental health conditions sometimes worsen as kids wait for proper care,” Bartosz said. “Kids are institutionalized unnecessarily and remain too long because there is nothing available.”
Amanda Milkovits can be reached at [email protected]. Follow her @AmandaMilkovits.
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