CRANSTON, RI (WPRI) – The state agency that oversees Eleanor Slater Hospital on Tuesday announced plans to apply for a new license for a stand-alone mental hospital, a long-awaited move that could potentially alleviate some of the ailments of regulatory and financial head that have plagued the establishment for years.

RI’s Department of Behavioral Health Care, Developmental Disabilities and Hospitals has said it will seek a new license in an effort to separate Eleanor Slater’s Benton Institution in Cranston. If approved, Benton would become a 52-bed stand-alone mental hospital for so-called “forensic patients,” the term for people admitted to hospital, typically through the criminal justice system.

Eleanor Slater’s other units – including Zambarano in Burrillville – would continue under their existing license as a long-term care hospital, state officials say.

“This is an important step for the Eleanor Slater hospital,” said BHDDH director Richard Charest in a statement. “We know Rhode Island needs to treat its forensic patients, and we know the state needs a long-term care hospital, so it’s important that we find a model that best serves patients while maximizing opportunities with our federal partners. ”

Benton already serves as a de facto mental health facility for forensic patients, but he’s technically licensed under the broader umbrella of Eleanor Slater.

Rhode Island is the only state in the country that does not have an independent state-run mental hospital.

The existing licensing structure for Eleanor Slater has for decades allowed Rhode Island to claim tens of millions of dollars in annual Medicaid reimbursements for the hospital because of its medical patients, helping to offset the high cost of associated care. psychiatric patients, who are not eligible. for federal support.

But this funding program exploded in 2019 after several state employees expressed concern that the hospital was violating several federal requirements, including one that requires the hospital to always have more medical patients than patients. psychiatric patients to stay in compliance with Medicaid rules.

This requirement – known as the Institutional Mental Illness Exclusion, or IMD – has since cost the state tens of millions of dollars. The state is currently still not in compliance with the IMD rule, which will be reviewed again next month.

By creating a stand-alone mental hospital, Eleanor Slater could likely avoid breaching IMD in the future, since forensic patients would no longer be counted in the hospital’s total patient population.

State officials also argue that the new license could help with accreditation, as the Joint Commission would no longer consider conditions in Benton when considering the long-term acute care hospital. The national agency has threatened to revoke the hospital’s accreditation the last two times it interviewed Eleanor Slater, in 2017 and this year, and Benton has been cited for various issues.

“By doing this, we are providing the best possible patient care while being financially responsible to taxpayers,” said Charest.

However, the proposal could pose new financial challenges. Rhode Island taxpayers will likely have to foot the entire bill for a stand-alone mental hospital without much federal support. It is also unclear how having two separate facilities might affect overhead costs, and unions that employ these facilities may also push back to ensure their livelihoods are not disrupted by the change.

Obtaining a new license also requires overcoming a series of regulatory hurdles, starting with a request for a certificate of need to renew Benton’s license that the OHDDH will have to submit to the RI Department of Health. The state agency laid out a plan to first submit a letter of intent to the health ministry by Friday, followed by the full application in January.

“They would eventually present the proposal to the Board of Health Services,” Health Ministry spokesman Joseph Wendelken said in an email.

The main areas of review include examining the applicant’s background, whether there is a public need for the facility, the financial implications, and how this would affect health disparities, Wendelken explained.

“The Council makes a recommendation to the Director of Health, who makes the final decision,” he added.

The idea of ​​renewing Benton’s authorization as a stand-alone psychiatric facility has been debated for years, emerging as a proposal in a litany of reviews that have been commissioned to review the facility. The latest came from Health and Human Services Secretary Womazetta Jones, who released a report earlier this year saying the licenses needed to be reviewed.

“We knew it was important for the BHDDH to re-evaluate the license of Eleanor Slater Hospital, and by studying the licensing options, the department identified an important step to take as we move forward,” Jones said in a statement. “I am satisfied with the work that has been done on this issue and look forward to further progress.”