2025 -- S 0892
========
LC002632
========
S T A T E O F R H O D E I S L A N D
IN GENERAL ASSEMBLY
JANUARY SESSION, A.D. 2025
____________
A N A C T
RELATING TO BEHAVIORAL HEALTHCARE, DEVELOPMENTAL DISABI LITIES AND
HOSPITALS -- CORE STATE BEHAVIORAL HEALT H 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. 1
The general assembly finds as follows: 2
(1) It is in the public interest to improve the quality and access to behavioral health crisis 3
services; reducing stigma surrounding suicide, mental health and substance use conditions; 4
providing a behavioral health crisis response that is substantially equivalent to the response already 5
provided to individuals who require emergency physical health care in the state; furthering equity 6
in addressing behavioral health and substance use conditions; requiring parity in insurers' and 7
health plans' coverage of mental health and substance use disorder benefits; strengthening the crisis 8
response for children, youth, young people, and families; requiring protocols for 988 crisis 9
counselors, 911 responders, and law enforcement involvement; updating the name of the 988 10
Suicide Hotline; ensuring a culturally and linguistically competent response to behavioral health 11
crises and saving lives; requiring the state to pursue sustainable sources of funding; building a new 12
system of equitable and linguistically appropriate behavioral crisis services in which all individuals 13
are treated with respect, dignity, cultural competence, and humility; and for the purpose of 14
complying with the National Suicide Hotline Designation Act of 2020 and the Federal 15
Communication Commission's rules adopted July 16, 2020 to ensure that all citizens and visitors 16
of the state receive a consistent level of 988 and crisis behavioral health services no matter where 17
they live, work, or travel in the state. 18
LC002632 - Page 2 of 8
SECTION 2. Title 40.1 of the General Laws entitled "BEHAVIORAL HEALTHCARE, 1
DEVELOPMENTAL DISABILITIES AND HOSPITALS" is hereby ame nded by adding thereto 2
the following chapter: 3
CHAPTER 30 4
CORE STATE BEHAVIORAL HEALTH CRISIS SERVICES SYSTEMS 5
40.1-30-1. Definitions. 6
In this chapter, the following words have the following meanings: 7
(1) "988" means the universal telephone number designated as the universal telephone 8
number within the United States for the purpose of the national suicide prevention and mental 9
health crisis hotline system operating through the 988 Suicide & Crisis Lifeline, or its successor 10
maintained by the Assistant Secretary for Mental Health and Substance Use under section 520E-3 11
of the Public Health Service Act (42 U.S.C. 290bb-36(c). 12
(2) "988 administrator" means the administrator of the 988 national suicide prevention and 13
mental health crisis hotline 988 Suicide & Crisis Lifeline system maintained by the Assistant 14
Secretary for Mental Health and Substance Use under section 520E-3 of the Public Health Service 15
Act (42 U.S.C. § 290bb-36(a). 16
(3) "988 contact" means a communication with the 988 Suicide & Crisis Lifeline system 17
within the United States operating through the National Suicide Prevention Lifeline or its successor 18
via modalities offered, including call, chat, or text. 19
(4) "988 crisis center" or "988 suicide lifeline" means a state-designated center 20
participating in the 988 Suicide & Crisis Lifeline program to respond to statewide or regional 988 21
contacts. 22
(5) "988 fee" means the surcharge assessed on commercial landline, mobile service, 23
prepaid wireless voice service, and interconnected voice over Internet protocol service lines created 24
under § 39-21.1-14 authority for communication law, regulation, and technological innovation. 25
(6) "988 Suicide & Crisis Lifeline (988 Lifeline)" means the national suicide prevention 26
and mental health crisis hotline system maintained by the Assistant Secretary for Mental Health 27
and Substance Use under section 520E-3 of the Public Health Service Act (42 U.S.C. 290bb-36(c)). 28
(7) "Behavioral health crisis services" means the continuum of services needed by an 29
individual experiencing a mental health or substance use crisis including, but not limited to, crisis 30
intervention, crisis stabilization, and crisis residential needs provided by 988 contact centers, 31
mobile crisis teams, and crisis receiving and stabilization service providers. 32
(8) "Crisis receiving and stabilization centers" are facilities providing short term services 33
of up to twenty-four (24) hours with capacity for diagnosis, initial management, observation, crisis 34
LC002632 - Page 3 of 8
stabilization and follow up referral services to all persons in a home-like environment. 1
(9) "Director" means the director of the department of behavioral healthcare, 2
developmental disabilities and hospitals (BHDDH). 3
(10) "Federal Communications Commission" regulates interstate and international 4
communications by radio, television, wire, satellite, and cable in all fifty (50) states, the District of 5
Columbia and U.S. territories. An independent U.S. government agency overseen by Congress, the 6
Commission is the federal agency responsible for implementing and enforcing America's 7
communications law and regulations. 8
(11) "State or related public health authority" means the department of behavioral 9
healthcare, developmental disabilities and hospitals. 10
(12) "Substance Abuse and Mental Health Services Administration ("SAMHSA")" means 11
the agency within the U.S. Department of Health and Human Services that leads public health 12
efforts to advance the behavioral health of the nation. 13
(13) "Veterans Crisis Line (VCL)" means Veterans Crisis Line maintained by the Secretary 14
of Veterans Affairs under 28 U.S.C. § 1720F(h). 15
40.1-30-2. Crisis services systems established. 16
(a) The director is hereby authorized to designate a 988 crisis center or centers to provide 17
crisis intervention services and crisis care coordination to individuals accessing the 988 suicide 18
prevention and behavioral health crisis hotline within Rhode Island twenty-four (24) hours a day, 19
seven (7) days a week. 20
(b) The designated 988 Lifeline center(s) shall meet 988 Lifeline program requirements 21
and best practices guidelines for operational, performance and clinical standards. 22
(c) The designated 988 crisis center shall provide data, report, and participate in evaluations 23
and related quality improvement activities as required by the 988 administrators. 24
(d) The designated 988 crisis center shall coordinate crisis and outgoing services, access to 25
crisis receiving and stabilization services or other local resources as appropriate and consistent with 26
guidelines and best practices established by SAMHSA. 27
(e) To facilitate the ongoing care needs of persons contacting 988, the state or related public 28
health authority shall ensure active collaborations and coordination of service linkages between the 29
designated center(s), mental health and substance use disorder treatment providers, local 30
community mental health centers (including certified community behavioral health clinics and 31
community behavioral health centers), mobile crisis teams, and community-based as well as 32
hospital emergency departments and inpatient psychiatric settings, establishing formal agreements 33
and appropriate information sharing procedures where appropriate. 34
LC002632 - Page 4 of 8
(f) The state or related public health authority shall assure active collaborations and 1
coordination of service linkages between the designated center(s) and crisis receiving and 2
stabilization services for individuals accessing the 988 Suicide & Crisis Lifeline through 3
appropriate information sharing regarding availability of services. 4
(g) The state or related, public health authority shall work in concert with the 988 Suicide 5
& Crisis Lifeline, for the purposes of ensuring consistency of public messaging about 988 services. 6
(h) The designated 988 Lifeline center(s) shall meet the requirements set forth by the 988 7
Lifeline program for serving at-risk and specialized populations as identified by the Substance 8
Abuse and Mental Health Services Administration (SAMHSA) including, but not be limited to, 9
LGBTQ+ individuals, children, youth and young people, racially, ethnically, and linguistically 10
diverse populations, rural individuals, veterans, American Indians, Alaskan Natives, and other 11
high-risk populations as well as those with co-occurring substance use; provide culturally and 12
linguistically competent care; and include training requirements and policies for transferring a 988 13
Lifeline contact to an appropriate specialized center or subnetworks within the 988 Lifeline 14
program. 15
(i) The designated 988 crisis center shall provide follow-up services to individuals 16
accessing the 988 Suicide & Crisis Lifeline consistent with guidance and policies established by 17
the 988 Lifeline program. 18
(j) The state or related public health authority having primary oversight of suicide 19
prevention and crisis service activities and essential coordination shall provide an annual report of 20
the 988 Suicide & Crisis Lifeline's usage and the services provided to the general assembly and to 21
SAMHSA. 22
40.1-30-3. Implementation-Advisory board. 23
The director shall provide general oversight of and direction on the state's implementation 24
and operation of the 988 Suicide & Crisis Lifeline. During the course of the oversight, the director 25
shall create an advisory board to provide guidance to the 988 Suicide & Crisis Lifeline. The 26
advisory body, consisting of eleven (11) members shall include, but not be limited to, the following 27
members: One representative of the designated 988 Suicide & Crisis Lifeline center(s), one 28
representative of the 9-1-1 call centers, one representative appointed from the department of 29
behavioral healthcare, developmental disabilities and hospitals, one member from a state substance 30
use agency, one member of law enforcement, one nurse from a hospital emergency department, 31
one member of the judiciary appointed by the chief justice, one individual with lived experience 32
with suicide prevention or behavioral health crisis services usage and two (2) family members and 33
caregivers of patients of mental health facilities, and one behavioral health crisis services provider. 34
LC002632 - Page 5 of 8
40.1-30-4. Collaboration with E-911 system. 1
The director shall act in the public interest to enhance the public emergency response 2
system to ensure individuals in a behavioral health crisis are connected to the appropriate 3
behavioral health response by facilitating collaboration between 988 and E-911 services. 4
SECTION 3. Section 39-21.1-14 of the General Laws in Chapter 39-21.1 entitled "911 5
Emergency Telephone Number Act" is hereby amended to read as follows: 6
39-21.1-14. E-911 surcharge and first response surcharge. E-911 and 988 suicide 7
lifeline surcharge and first response surcharge. 8
(a)(1) A combined monthly E-911 and 988 surcharge of fifty cents ($.50) is hereby levied 9
upon each residence and business telephone line or trunk, or path and data, telephony, internet, 10
voice over internet protocol (VoIP) wireline, line, trunk, or path in the state including PBX trunks 11
and centrex equivalent trunks and each line or trunk serving, and upon each user interface number 12
or extension number or similarly identifiable line, trunk, or path to or from a digital network (such 13
as, but not exclusive of, integrated services digital network (ISDN), Flexpath, or comparable digital 14
private branch exchange, or connecting to or from a customer-based or dedicated telephone switch 15
site (such as, but not exclusive of, a private branch exchange (PBX)), or connecting to or from a 16
customer-based or dedicated central office (such as, but not exclusive of, a centrex system but 17
exclusive of trunks and lines provided to wireless communication companies) that can access to, 18
connect with, or interface with the Rhode Island E-911 uniform emergency telephone system (RI 19
E-911) and 988 suicide lifeline. In each instance where a surcharge is levied pursuant to this 20
subsection (a)(1) there shall also be a monthly first response surcharge of fifty cents ($.50). The 21
surcharges shall be billed by each telecommunication services provider at the inception of services 22
and shall be payable to the telecommunication services provider by the subscriber of the services. 23
(2) A monthly E-911 and 988 surcharge of fifty cents ($.50) is hereby levied on each 24
wireless instrument, device, or means, including prepaid, cellular, telephony, internet, voice over 25
internet protocol (VoIP), satellite, computer, radio, communication, data or data only wireless lines, 26
or any other wireless instrument, device, or means that has access to, connects with, or activates or 27
interfaces or any combination thereof with the E-911 uniform emergency telephone system and the 28
988 suicide lifeline. In each instance where a surcharge is levied pursuant to this subsection (a)(2) 29
there shall also be a monthly first response surcharge of seventy-five cents ($.75). The surcharges 30
shall be billed by each telecommunication services provider and shall be payable to the 31
telecommunication services provider by the subscriber. Prepaid wireless telecommunications 32
services shall not be included in this act, but shall be governed by chapter 21.2 of this title. The E-33
911 uniform emergency telephone system and the 988 suicide lifeline shall establish, by rule or 34
LC002632 - Page 6 of 8
regulation, an appropriate funding mechanism to recover from the general body of ratepayers this 1
surcharge. 2
(b) The amount of the surcharges shall not be subject to the tax imposed under chapter 18 3
of title 44 nor be included within the telephone common carrier's gross earnings for the purpose of 4
computing the tax under chapter 13 of title 44. 5
(c) Each telephone common carrier and each telecommunication services provider shall 6
establish a special account to which it shall deposit on a monthly basis the amounts collected as 7
surcharges under this section. 8
(d) The money collected by each telecommunication services provider shall be transferred 9
within sixty (60) days after its inception of wireline, wireless, prepaid, cellular, telephony, voice 10
over internet protocol (VoIP), satellite, computer, internet, or communications services in this state 11
and every month thereafter, to the division of taxation, together with the accrued interest. The E-12
911 and 988 surcharge shall be deposited in a two (2) separate restricted-receipt account accounts 13
and each used solely for the operation of the E-911 uniform emergency telephone system and the 14
988 suicide lifeline. The first response surcharge shall be deposited in the general fund; provided, 15
however, that ten percent (10%) of the money collected from the first response surcharge shall be 16
deposited in the information technology restricted receipt account (ITRR account) established 17
pursuant to § 42-11-2.5(a). Any money not transferred in accordance with this subsection shall be 18
assessed interest at the rate set forth in § 44-1-7 from the date the money should have been 19
transferred. 20
(e) Every billed subscriber-user shall be liable for any surcharge imposed under this section 21
until it has been paid to the telephone common carrier or telecommunication services provider. Any 22
surcharge shall be added to and shall be stated separately in the billing by the telephone common 23
carrier or telecommunication services provider and shall be collected by the telephone common 24
carrier or telecommunication services provider. 25
(f) Each telephone common carrier and telecommunication services provider shall annually 26
provide the E-911 uniform emergency telephone system division, and 988 suicide lifeline or any 27
other agency that may replace it, with a list of amounts uncollected, together with the names and 28
addresses of its subscriber-users who can be determined by the telephone common carrier or 29
telecommunication services provider to have not paid the E-911 and 988 suicide lifeline surcharge. 30
(g) Included within, but not limited to, the purposes for which the money collected from 31
the E-911 and 988 suicide lifeline surcharge may be used, are rent, lease, purchase, improvement, 32
construction, maintenance, repair, and utilities for the equipment and site or sites occupied by the 33
E-911 uniform emergency telephone system and 988 suicide lifeline; salaries, benefits, and other 34
LC002632 - Page 7 of 8
associated personnel costs; acquisition, upgrade, or modification of PSAP and 988 suicide lifeline 1
equipment to be capable of receiving E-911 and 988 suicide lifeline information, including 2
necessary computer hardware, software, and database provisioning, addressing, and non-recurring 3
costs of establishing emergency services; network development, operation, and maintenance; 4
database development, operation, and maintenance; on-premise equipment maintenance and 5
operation; training emergency service personnel regarding use of E-911 and 988 suicide lifeline; 6
educating consumers regarding the operations, limitations, role, and responsible use of E-911 and 7
988 suicide lifeline; reimbursement to telephone common carriers or telecommunication services 8
providers of rates or recurring costs associated with any services, operation, administration, or 9
maintenance of E-911 and 988 suicide lifeline services as approved by the division; reimbursement 10
to telecommunication services providers or telephone common carriers of other costs associated 11
with providing E-911 and 988 suicide lifeline services, including the cost of the design, 12
development, and implementation of equipment or software necessary to provide E-911 and 988 13
suicide lifeline service information to PSAPs and 988 suicide lifeline, as approved by the division. 14
(h) [Deleted by P.L. 2000, ch. 55, art. 28, § 1.] 15
(i) Nothing in this section shall be construed to constitute rate regulation of wireless 16
communication services carriers, nor shall this section be construed to prohibit wireless 17
communication services carriers from charging subscribers for any wireless service or feature. 18
(j) [Deleted by P.L. 2006, ch. 246, art. 4, § 1.] 19
SECTION 4. This act shall take effect upon passage. 20
========
LC002632
========
LC002632 - Page 8 of 8
EXPLANATION
BY THE LEGISLATIVE COUNCIL
OF
A N A C T
RELATING TO BEHAVIORAL HEALTHCARE, DEVEL OPMENTAL DISABILITIES AND
HOSPITALS -- CORE STATE BEHAVIORAL HEALT H CRISIS SERVICES SYSTEMS-988
***
This act would establish the 988 lifeline as part of a core state behavioral health crisis 1
services system, to be administered by the director of the department of behavioral healthcare, 2
developmental disabilities and hospitals. The systems would include establishing and administering 3
a 988 lifeline for suicide prevention and behavioral health crisis response, and expanding the use 4
of the 911 and first responder surcharges to include the 988 lifeline fee, on subscribers of 5
commercial land line telephone, mobile telephone and/or IP-enabled voice services. 6
This act would take effect upon passage. 7
========
LC002632
========