BEHAVIORAL HEALTH SERVICES PROVIDER IN RHODE ISLAND

Fatumata Kaba
Oct 9
4 min read

PROMOTING EMOTIONAL WELL-BEING, MENTAL HEALTH STABILITY, AND RECOVERY THROUGH COMMUNITY-BASED BEHAVIORAL SUPPORTS

Behavioral Health Services in Rhode Island address the emotional, psychological, and psychiatric needs of individuals across the lifespan. These services are funded through Rhode Island Medicaid (including the 1115 Global Waiver), State Plan, and various federal initiatives. Providers support individuals with mental illness, substance use disorders, or behavioral challenges through therapeutic interventions, counseling, crisis stabilization, and recovery supports in home and community settings.

1. GOVERNING AGENCIES

Agency: Rhode Island Executive Office of Health and Human Services (EOHHS)

Role: Oversees Medicaid funding, behavioral health benefits, and provider enrollment.

Agency: Department of Behavioral Healthcare, Developmental Disabilities & Hospitals (BHDDH)

Role: Licenses mental health and substance use disorder providers and monitors behavioral service delivery.

Agency: Rhode Island Department of Health (RIDOH)**

Role: Regulates licensed mental health professionals and behavioral health facilities.

Agency: Centers for Medicare & Medicaid Services (CMS)**

Role: Sets national standards for behavioral health under Medicaid and HCBS programs.

2. BEHAVIORAL HEALTH SERVICES OVERVIEW

These services support people with mental health diagnoses, emotional disorders, or behavioral concerns impacting daily life. Services are person-centered, trauma-informed, and aligned with evidence-based practices.

Approved providers may deliver:

Individual & Group Therapy: CBT, DBT, trauma-focused therapy, and grief counseling.
Psychiatric Evaluation & Medication Management: Diagnosis, prescribing, and symptom monitoring by licensed clinicians.
Mobile Crisis Response & Crisis Stabilization: Immediate intervention in homes or community settings.
Behavioral Support Services (BSS): In-home behavior planning and coaching for individuals with IDD or dual diagnoses.
Peer Recovery Support: Peer mentoring for those in mental health or substance use recovery.
Case Management: Coordination of housing, transportation, medical care, and benefits.
Integrated Primary & Behavioral Health Care: Coordination between mental health and physical health providers.
Documentation & Billing: Behavioral health assessments, treatment plans, and encounter notes.

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register your business with the RI Secretary of State.
Obtain EIN and Type 2 NPI.
Secure BHDDH licensure for mental health or substance use treatment services (as applicable).
Enroll in Medicaid through the EOHHS provider portal.
Employ credentialed clinicians (LICSW, LMHC, PsyD, MD, etc.) and paraprofessionals (e.g., BSS).
Develop a Behavioral Health Services Policy & Procedure Manual covering service models, clinical protocols, safety, and documentation.

4. RHODE ISLAND PROVIDER ENROLLMENT PROCESS

Step 1: Form your legal business, obtain EIN, and NPI.

Step 2: Apply for BHDDH behavioral health licensure based on services (outpatient, residential, etc.).

Step 3: Submit Medicaid enrollment application with required credentials and manuals.

Step 4: Ensure staff meet professional and Medicaid requirements.

Step 5: Begin receiving referrals and service authorizations.

5. REQUIRED DOCUMENTATION

Business registration and licensure certificates
Medicaid and BHDDH enrollment confirmation
Staff licenses, background checks, and supervision logs
Insurance (liability, malpractice, workers’ comp)
Behavioral Health Policy & Procedure Manual including:
- Risk assessments, treatment plan formats, and diagnostic criteria
- Emergency response and suicide prevention protocols
- HIPAA compliance and participant rights documentation
- Crisis intervention procedures and de-escalation training
- Quality assurance, peer review, and staff supervision protocols
- Medicaid-compliant progress notes and billing documentation

6. STAFFING REQUIREMENTS

Role: Licensed Mental Health Clinician (LICSW, LMHC, LPC)

Requirements: Active RI license, clinical supervision plan (if required), Medicaid enrollment.

Role: Psychiatrist / Prescribing Provider

Requirements: RI licensure (MD or APRN), DEA registration, and psychiatric specialization.

Role: Behavioral Support Specialist (BSS)

Requirements: Experience in behavior plans, often supervised by licensed clinician.

Role: Peer Recovery Specialist

Requirements: State-approved peer training, lived experience, background check.

Role: Case Manager / Care Coordinator

Requirements: Bachelor’s degree or experience in human services, trained in system navigation.

All staff must complete:

HIPAA and documentation training
Trauma-informed care and cultural competence
Safety, abuse prevention, and crisis response
Treatment planning and evidence-based practice implementation
Mandatory reporting and emergency procedures

7. MEDICAID WAIVER PROGRAMS

Behavioral Health Services may be funded through:

Medicaid State Plan Services – Outpatient therapy, psychiatry, case management
1115 Global Waiver (HCBS) – Behavioral supports for adults and youth in community settings
BHDDH DD Waivers – Behavioral support for individuals with IDD
Katie Beckett/TEFRA – In-home therapy for children with complex needs
Crisis Intervention and Wraparound Programs – State-funded or braided with Medicaid

8. TIMELINE TO LAUNCH

Phase: Business Formation & Manual Development

Timeline: 1–2 months

Phase: BHDDH Licensing & Medicaid Enrollment

Timeline: 2–3 months

Phase: Staff Hiring, Credentialing & Clinical Setup

Timeline: 30–60 days

Phase: Service Authorization & Participant Intake

Timeline: Begins once staff are active and referrals are assigned

9. CONTACT INFORMATION

Rhode Island Executive Office of Health and Human Services (EOHHS)

Website: https://eohhs.ri.gov

Rhode Island Department of Health (RIDOH)

Website: https://health.ri.gov

Department of Behavioral Healthcare, Developmental Disabilities & Hospitals (BHDDH)

Licensing Portal: https://bhddh.ri.gov

Rhode Island Medicaid Provider Portal

Website: https://www.riproviderportal.org

Centers for Medicare & Medicaid Services (CMS)

Website: https://www.cms.gov

WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — RHODE ISLAND BEHAVIORAL HEALTH PROVIDER

WCG guides behavioral health providers through the compliance, clinical, and Medicaid setup process to launch trauma-informed, recovery-oriented services.

Scope of Work: