2025 -- S 0892

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LC002632

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     STATE OF RHODE ISLAND

IN GENERAL ASSEMBLY

JANUARY SESSION, A.D. 2025

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A N   A C T

RELATING TO BEHAVIORAL HEALTHCARE, DEVELOPMENTAL DISABILITIES AND

HOSPITALS -- CORE STATE BEHAVIORAL HEALTH CRISIS SERVICES SYSTEMS-988

     Introduced By: Senators Murray, DiPalma, Lawson, Tikoian, Felag, Gallo, DiMario,
Bissaillon, Lauria, and Valverde

     Date Introduced: March 27, 2025

     Referred To: Senate Finance

     It is enacted by the General Assembly as follows:

     SECTION 1. Legislative findings and purpose.

     The general assembly finds as follows:

     (1) It is in the public interest to improve the quality and access to behavioral health crisis

services; reducing stigma surrounding suicide, mental health and substance use conditions;

providing a behavioral health crisis response that is substantially equivalent to the response already

provided to individuals who require emergency physical health care in the state; furthering equity

in addressing behavioral health and substance use conditions; requiring parity in insurers' and

health plans' coverage of mental health and substance use disorder benefits; strengthening the crisis

response for children, youth, young people, and families; requiring protocols for 988 crisis

counselors, 911 responders, and law enforcement involvement; updating the name of the 988

Suicide Hotline; ensuring a culturally and linguistically competent response to behavioral health

crises and saving lives; requiring the state to pursue sustainable sources of funding; building a new

system of equitable and linguistically appropriate behavioral crisis services in which all individuals

are treated with respect, dignity, cultural competence, and humility; and for the purpose of

complying with the National Suicide Hotline Designation Act of 2020 and the Federal

Communication Commission's rules adopted July 16, 2020 to ensure that all citizens and visitors

of the state receive a consistent level of 988 and crisis behavioral health services no matter where

they live, work, or travel in the state.

     SECTION 2. Title 40.1 of the General Laws entitled "BEHAVIORAL HEALTHCARE,

DEVELOPMENTAL DISABILITIES AND HOSPITALS" is hereby amended by adding thereto

the following chapter:

CHAPTER 30

CORE STATE BEHAVIORAL HEALTH CRISIS SERVICES SYSTEMS

     40.1-30-1. Definitions.

     In this chapter, the following words have the following meanings:

     (1) "988" means the universal telephone number designated as the universal telephone

number within the United States for the purpose of the national suicide prevention and mental

health crisis hotline system operating through the 988 Suicide & Crisis Lifeline, or its successor

maintained by the Assistant Secretary for Mental Health and Substance Use under section 520E-3

of the Public Health Service Act (42 U.S.C. 290bb-36(c).

     (2) "988 administrator" means the administrator of the 988 national suicide prevention and

mental health crisis hotline 988 Suicide & Crisis Lifeline system maintained by the Assistant

Secretary for Mental Health and Substance Use under section 520E-3 of the Public Health Service

Act (42 U.S.C. § 290bb-36(a).

     (3) "988 contact" means a communication with the 988 Suicide & Crisis Lifeline system

within the United States operating through the National Suicide Prevention Lifeline or its successor

via modalities offered, including call, chat, or text.

     (4) "988 crisis center" or "988 suicide lifeline" means a state-designated center

participating in the 988 Suicide & Crisis Lifeline program to respond to statewide or regional 988

contacts.

     (5) "988 fee" means the surcharge assessed on commercial landline, mobile service,

prepaid wireless voice service, and interconnected voice over Internet protocol service lines created

under § 39-21.1-14 authority for communication law, regulation, and technological innovation.

     (6) "988 Suicide & Crisis Lifeline (988 Lifeline)" means the national suicide prevention

and mental health crisis hotline system maintained by the Assistant Secretary for Mental Health

and Substance Use under section 520E-3 of the Public Health Service Act (42 U.S.C. 290bb-36(c)).

     (7) "Behavioral health crisis services" means the continuum of services needed by an

individual experiencing a mental health or substance use crisis including, but not limited to, crisis

intervention, crisis stabilization, and crisis residential needs provided by 988 contact centers,

mobile crisis teams, and crisis receiving and stabilization service providers.

     (8) "Crisis receiving and stabilization centers" are facilities providing short term services

of up to twenty-four (24) hours with capacity for diagnosis, initial management, observation, crisis

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stabilization and follow up referral services to all persons in a home-like environment.

     (9) "Director" means the director of the department of behavioral healthcare,

developmental disabilities and hospitals (BHDDH).

     (10) "Federal Communications Commission" regulates interstate and international

communications by radio, television, wire, satellite, and cable in all fifty (50) states, the District of

Columbia and U.S. territories. An independent U.S. government agency overseen by Congress, the

Commission is the federal agency responsible for implementing and enforcing America's

communications law and regulations.

     (11) "State or related public health authority" means the department of behavioral

healthcare, developmental disabilities and hospitals.

     (12) "Substance Abuse and Mental Health Services Administration ("SAMHSA")" means

the agency within the U.S. Department of Health and Human Services that leads public health

efforts to advance the behavioral health of the nation.

     (13) "Veterans Crisis Line (VCL)" means Veterans Crisis Line maintained by the Secretary

of Veterans Affairs under 28 U.S.C. § 1720F(h).

     40.1-30-2. Crisis services systems established.

     (a) The director is hereby authorized to designate a 988 crisis center or centers to provide

crisis intervention services and crisis care coordination to individuals accessing the 988 suicide

prevention and behavioral health crisis hotline within Rhode Island twenty-four (24) hours a day,

seven (7) days a week.

     (b) The designated 988 Lifeline center(s) shall meet 988 Lifeline program requirements

and best practices guidelines for operational, performance and clinical standards.

     (c) The designated 988 crisis center shall provide data, report, and participate in evaluations

and related quality improvement activities as required by the 988 administrators.

     (d) The designated 988 crisis center shall coordinate crisis and outgoing services, access to

crisis receiving and stabilization services or other local resources as appropriate and consistent with

guidelines and best practices established by SAMHSA.

     (e) To facilitate the ongoing care needs of persons contacting 988, the state or related public

health authority shall ensure active collaborations and coordination of service linkages between the

designated center(s), mental health and substance use disorder treatment providers, local

community mental health centers (including certified community behavioral health clinics and

community behavioral health centers), mobile crisis teams, and community-based as well as

hospital emergency departments and inpatient psychiatric settings, establishing formal agreements

and appropriate information sharing procedures where appropriate.

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     (f) The state or related public health authority shall assure active collaborations and

coordination of service linkages between the designated center(s) and crisis receiving and

stabilization services for individuals accessing the 988 Suicide & Crisis Lifeline through

appropriate information sharing regarding availability of services.

     (g) The state or related, public health authority shall work in concert with the 988 Suicide

& Crisis Lifeline, for the purposes of ensuring consistency of public messaging about 988 services.

     (h) The designated 988 Lifeline center(s) shall meet the requirements set forth by the 988

Lifeline program for serving at-risk and specialized populations as identified by the Substance

Abuse and Mental Health Services Administration (SAMHSA) including, but not be limited to,

LGBTQ+ individuals, children, youth and young people, racially, ethnically, and linguistically

diverse populations, rural individuals, veterans, American Indians, Alaskan Natives, and other

high-risk populations as well as those with co-occurring substance use; provide culturally and

linguistically competent care; and include training requirements and policies for transferring a 988

Lifeline contact to an appropriate specialized center or subnetworks within the 988 Lifeline

program.

     (i) The designated 988 crisis center shall provide follow-up services to individuals

accessing the 988 Suicide & Crisis Lifeline consistent with guidance and policies established by

the 988 Lifeline program.

     (j) The state or related public health authority having primary oversight of suicide

prevention and crisis service activities and essential coordination shall provide an annual report of

the 988 Suicide & Crisis Lifeline's usage and the services provided to the general assembly and to

SAMHSA.

     40.1-30-3. Implementation-Advisory board.

     The director shall provide general oversight of and direction on the state's implementation

and operation of the 988 Suicide & Crisis Lifeline. During the course of the oversight, the director

shall create an advisory board to provide guidance to the 988 Suicide & Crisis Lifeline. The

advisory body, consisting of eleven (11) members shall include, but not be limited to, the following

members: One representative of the designated 988 Suicide & Crisis Lifeline center(s), one

representative of the 9-1-1 call centers, one representative appointed from the department of

behavioral healthcare, developmental disabilities and hospitals, one member from a state substance

use agency, one member of law enforcement, one nurse from a hospital emergency department,

one member of the judiciary appointed by the chief justice, one individual with lived experience

with suicide prevention or behavioral health crisis services usage and two (2) family members and

caregivers of patients of mental health facilities, and one behavioral health crisis services provider.

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     40.1-30-4. Collaboration with E-911 system.

     The director shall act in the public interest to enhance the public emergency response

system to ensure individuals in a behavioral health crisis are connected to the appropriate

behavioral health response by facilitating collaboration between 988 and E-911 services.

     SECTION 3. Section 39-21.1-14 of the General Laws in Chapter 39-21.1 entitled "911

Emergency Telephone Number Act" is hereby amended to read as follows:

     39-21.1-14. E-911 surcharge and first response surcharge. E-911 and 988 suicide

lifeline surcharge and first response surcharge.

     (a)(1) A combined monthly E-911 and 988 surcharge of fifty cents ($.50) is hereby levied

upon each residence and business telephone line or trunk, or path and data, telephony, internet,

voice over internet protocol (VoIP) wireline, line, trunk, or path in the state including PBX trunks

and centrex equivalent trunks and each line or trunk serving, and upon each user interface number

or extension number or similarly identifiable line, trunk, or path to or from a digital network (such

as, but not exclusive of, integrated services digital network (ISDN), Flexpath, or comparable digital

private branch exchange, or connecting to or from a customer-based or dedicated telephone switch

site (such as, but not exclusive of, a private branch exchange (PBX)), or connecting to or from a

customer-based or dedicated central office (such as, but not exclusive of, a centrex system but

exclusive of trunks and lines provided to wireless communication companies) that can access to,

connect with, or interface with the Rhode Island E-911 uniform emergency telephone system (RI

E-911) and 988 suicide lifeline. In each instance where a surcharge is levied pursuant to this

subsection (a)(1) there shall also be a monthly first response surcharge of fifty cents ($.50). The

surcharges shall be billed by each telecommunication services provider at the inception of services

and shall be payable to the telecommunication services provider by the subscriber of the services.

     (2) A monthly E-911 and 988 surcharge of fifty cents ($.50) is hereby levied on each

wireless instrument, device, or means, including prepaid, cellular, telephony, internet, voice over

internet protocol (VoIP), satellite, computer, radio, communication, data or data only wireless lines,

or any other wireless instrument, device, or means that has access to, connects with, or activates or

interfaces or any combination thereof with the E-911 uniform emergency telephone system and the

988 suicide lifeline. In each instance where a surcharge is levied pursuant to this subsection (a)(2)

there shall also be a monthly first response surcharge of seventy-five cents ($.75). The surcharges

shall be billed by each telecommunication services provider and shall be payable to the

telecommunication services provider by the subscriber. Prepaid wireless telecommunications

services shall not be included in this act, but shall be governed by chapter 21.2 of this title. The E-

911 uniform emergency telephone system and the 988 suicide lifeline shall establish, by rule or

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regulation, an appropriate funding mechanism to recover from the general body of ratepayers this

surcharge.

     (b) The amount of the surcharges shall not be subject to the tax imposed under chapter 18

of title 44 nor be included within the telephone common carrier's gross earnings for the purpose of

computing the tax under chapter 13 of title 44.

     (c) Each telephone common carrier and each telecommunication services provider shall

establish a special account to which it shall deposit on a monthly basis the amounts collected as

surcharges under this section.

     (d) The money collected by each telecommunication services provider shall be transferred

within sixty (60) days after its inception of wireline, wireless, prepaid, cellular, telephony, voice

over internet protocol (VoIP), satellite, computer, internet, or communications services in this state

and every month thereafter, to the division of taxation, together with the accrued interest. The E-

911 and 988 surcharge shall be deposited in a two (2) separate restricted-receipt account accounts

and each used solely for the operation of the E-911 uniform emergency telephone system and the

988 suicide lifeline. The first response surcharge shall be deposited in the general fund; provided,

however, that ten percent (10%) of the money collected from the first response surcharge shall be

deposited in the information technology restricted receipt account (ITRR account) established

pursuant to § 42-11-2.5(a). Any money not transferred in accordance with this subsection shall be

assessed interest at the rate set forth in § 44-1-7 from the date the money should have been

transferred.

     (e) Every billed subscriber-user shall be liable for any surcharge imposed under this section

until it has been paid to the telephone common carrier or telecommunication services provider. Any

surcharge shall be added to and shall be stated separately in the billing by the telephone common

carrier or telecommunication services provider and shall be collected by the telephone common

carrier or telecommunication services provider.

     (f) Each telephone common carrier and telecommunication services provider shall annually

provide the E-911 uniform emergency telephone system division, and 988 suicide lifeline or any

other agency that may replace it, with a list of amounts uncollected, together with the names and

addresses of its subscriber-users who can be determined by the telephone common carrier or

telecommunication services provider to have not paid the E-911 and 988 suicide lifeline surcharge.

     (g) Included within, but not limited to, the purposes for which the money collected from

the E-911 and 988 suicide lifeline surcharge may be used, are rent, lease, purchase, improvement,

construction, maintenance, repair, and utilities for the equipment and site or sites occupied by the

E-911 uniform emergency telephone system and 988 suicide lifeline; salaries, benefits, and other

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associated personnel costs; acquisition, upgrade, or modification of PSAP and 988 suicide lifeline

equipment to be capable of receiving E-911 and 988 suicide lifeline information, including

necessary computer hardware, software, and database provisioning, addressing, and non-recurring

costs of establishing emergency services; network development, operation, and maintenance;

database development, operation, and maintenance; on-premise equipment maintenance and

operation; training emergency service personnel regarding use of E-911 and 988 suicide lifeline;

educating consumers regarding the operations, limitations, role, and responsible use of E-911 and

988 suicide lifeline; reimbursement to telephone common carriers or telecommunication services

providers of rates or recurring costs associated with any services, operation, administration, or

maintenance of E-911 and 988 suicide lifeline services as approved by the division; reimbursement

to telecommunication services providers or telephone common carriers of other costs associated

with providing E-911 and 988 suicide lifeline services, including the cost of the design,

development, and implementation of equipment or software necessary to provide E-911 and 988

suicide lifeline service information to PSAPs and 988 suicide lifeline, as approved by the division.

     (h) [Deleted by P.L. 2000, ch. 55, art. 28, § 1.]

     (i) Nothing in this section shall be construed to constitute rate regulation of wireless

communication services carriers, nor shall this section be construed to prohibit wireless

communication services carriers from charging subscribers for any wireless service or feature.

     (j) [Deleted by P.L. 2006, ch. 246, art. 4, § 1.]

     SECTION 4. This act shall take effect upon passage.

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EXPLANATION

BY THE LEGISLATIVE COUNCIL

OF

A N   A C T

RELATING TO BEHAVIORAL HEALTHCARE, DEVELOPMENTAL DISABILITIES AND

HOSPITALS -- CORE STATE BEHAVIORAL HEALTH CRISIS SERVICES SYSTEMS-988

***

     This act would establish the 988 lifeline as part of a core state behavioral health crisis

services system, to be administered by the director of the department of behavioral healthcare,

developmental disabilities and hospitals. The systems would include establishing and administering

a 988 lifeline for suicide prevention and behavioral health crisis response, and expanding the use

of the 911 and first responder surcharges to include the 988 lifeline fee, on subscribers of

commercial land line telephone, mobile telephone and/or IP-enabled voice services.

     This act would take effect upon passage.

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