The RI code of conduct needs improvement, experts testify

PROVIDENCE — In a sustained wave of support for sweeping reform of the state’s behavioral health and disability systems, attorneys, providers and the president of Butler Hospital testified Wednesday night before the House Oversight Committee, the last legislative body to deal with the issue in this session.

“As I prepared for this testimony, I pondered how best to describe Rhode Island’s approach to the behavioral health continuum and what we can do to address the many challenges we currently face,” said Mary Marran, President and CEO of Butler. “The short answer is that we have a lot more demand than we have the capacity to meet that demand.

“We also have a continuum of care with critical gaps in services and an exhausted and weary workforce. The result is that we both have patients who cannot get into hospitals when they need them and cannot get out when they are ready to leave office due to a lack of appropriate community housing and related services.”

“People die”

“The system is broken. The system is underfunded,” said John J. Tassoni, Jr., a former state senator who is now vice president of operations for RI’s Mental Health Leadership Council. “People are suffering. People die.”

Tassoni and others listed some of the factors contributing to what is being described by many as an unprecedented crisis in the care of people with behavioral and mental health needs and those with intellectual or developmental disabilities: a labor shortage, low wages, reimbursement rates Medicaid, which has not kept pace with inflation, long waiting lists for benefits, and too few beds and places to live for treatment and detoxification.

Richard Charest, director of the Department of Behavioral Health, Developmental Disabilities and Hospitals, outlined initiatives currently underway and included in BHDDH’s proposed 2022-2023 budget to improve services, including increased funding for existing programs, the opening of new programs and the Increase in wages of employees of the department -funded private agencies.

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But Charest acknowledged the depth of the problems, saying, “Service systems are facing significant challenges right now — challenges that predated the COVID-19 pandemic and have been significantly exacerbated by COVID-19.”

BHDDH Director Richard Charest

Susan A. Storti, President and CEO of RI’s Mental Health Leadership Council, began her statement by saying, “First, I would like to commend the Department of Behavioral Health, Developmental Disabilities and Hospitals. I think they are making every effort to try and address the situation we are currently facing in the behavioral health space. But I will tell you that despite their best efforts, the system is deteriorating.”

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“We need to revamp what we’re doing,” Storti said. “We need to review and implement programs that have proven to be successful, that have proven to be cost effective and efficient, and reduce duplication of effort.”

Susan Storti and John Tassoni Jr.

The roots of today’s editions go back years, as The Journal has long recorded. More recent revelations have reinvigorated advocates for change, and this year legislative hearings were held before other committees and a March State House rally drew large crowds.

A chance for change

Concluding, Butler Hospital, Marran director, who is also President and Chief Operating Officer of the Providence Center, said, “We are in a crisis, but we have a committed provider community that stands by. We may never again have such an opportunity to invest in our behavioral health continuum in a way that addresses both longstanding problems and new demands of care.

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“The pandemic has taught us that no one is immune from mental illness. We must recognize that addressing the behavioral health needs of our citizens will indeed improve the overall health and well-being of all Rhode Island residents. If we do this work properly, those who need our care will receive it when they need it, without delay. Fewer people need to be hospitalized. We will alleviate the suffering of those seeking help and, above all, save lives.”

Also testifying were Kevin Savage, director of the BHDDH Division of Developmental Disabilities; Christine Hathaway, executive director of behavioral health at Perspectives Corporation; and Joan Salhany, vice president of Gateway Operations.

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