Unmet Needs: How This Rhode Island Funder is Addressing Behavioral Health

This past spring, we took a closer look at the impressive recent growth of the Rhode Island Foundation (RIF) and what’s been driving giving increases in this part of New England. Much of this growth has been due to key partnerships with organizations creating new RIF funds, such as the Jewish Federation Foundation. Along with that growth, we are also now seeing an expansion of grantmaking into new areas to address unmet local needs.

A case in point is RIF’s partnership with Blue Cross & Blue Shield of Rhode Island (BCBSRI) to create the Behavioral Health Fund in August 2018. The fund addresses both mental health and substance use in Rhode Island and attempts to help people with these issues before they are in crisis. Primary and secondary prevention measures, as well as better access to high-quality and affordable behavioral health services are the key targets of this fund.

Recently, RIF awarded its first $2.6 million through this fund to put BCBSRI’s $5 million behavioral health commitment to work. That sum is being split by six nonprofits serving communities that are disproportionately impacted by behavioral health issues. Each organization received between $200,000 and $600,000 to spend gradually over the next three years.

The first round of RIF Behavioral Health Fund grantees are the Center for Evidence-Based Practice at Bradley Hospital, Transformation Collaborative of Rhode Island/PCMH Kids, Clinica Esperanza, Coventry Public School District, Rhode Island Association for Infant Mental Health, and the Rhode Island College School of Social Work.

Considering that RIF received 62 funding requests, it is clear that the unmet needs here are significant. Behavioral health has emerged as a priority in Rhode Island, and even the state’s governor has been speaking out about the issue. In fact, behavioral health is one of Governor Gina M. Raimondo’s top priorities, especially with regard to making sure the state’s insurers are meeting the mental and behavioral health needs of Rhode Islanders.

Insurers are notorious for denying mental health coverage to people who truly need it in Rhode Island and elsewhere in the U.S. in spite of the nation’s growing mental health crisis. At least 47,000 Americans committed suicide and 70,000 died from drug overdoses in 2017 alone.

This particular fund was created from a financial settlement that BCBSRI agreed to pay for being “out of compliance” with federal and state mental health laws. The insurer was found to review inpatient care more often for mental health than physical health and also impose prior authorization requirements that led to impeded and delayed care. Instead of incurring a penalty, the insurance company chose to put $5 million into this fund for prevention and early intervention efforts at the local level. Other health insurance companies in Rhode Island, including Tufts Health Plan and UnitedHealthcare, have also been scrutinized in this way by the state commissioner of health insurance office.

So, what types of behavioral health programs will RIF be looking to fund in the future?

The program is not currently accepting applications, but the 2019 priorities addressed both general prevention and at-risk prevention for vulnerable populations, such as seniors and youth. The application process involves two steps and must be completed online for both steps. Although the RIF behavioral health fund is still in its early stages, it serves as an example of how community foundations can step up their giving for the behavioral health of local residents while also helping to keep local insurers accountable for their practices.

RIF is the largest funder of nonprofits in Rhode Island and awarded $52 million in grants last year.