children’s psychiatric drugs in rhode island medicaid: rhode island’s own three numbers
rhode island told cms three things about its children in the 2025 reporting year: 47.4 percent of children aged 1 to 11 newly prescribed an antipsychotic had psychosocial care documented first, the fifth-lowest of the 50 states that reported it; 23.7 percent of children on two or more antipsychotics got both the glucose and the cholesterol test, 36th of the 49 states that reported it; 48.0 percent of children aged 6 to 12 starting an adhd medicine were seen again inside 30 days, 24th of the 51 states that reported it.[1]
across the whole age range, rhode island sits above the national median on the 30-day adhd follow-up and below the national median on psychosocial care before an antipsychotic. same state, same year, same children.
every row rhode island sent to cms
| measure | rhode island | denominator | rank | national median |
|---|---|---|---|---|
| APP-CHpsychosocial care first, 1 to 11 | 47.4 | withheld | 46 of 50 | 59.2 |
| APP-CHpsychosocial care first, 12 to 17 | 66.7 | withheld | 18 of 51 | 63.8 |
| APP-CHpsychosocial care first, 1 to 17 | 60.5 | 238 | 31 of 51 | 61.4 |
| APM-CHboth blood tests, 1 to 11 | 23.7 | withheld | 36 of 49 | 29.1 |
| APM-CHboth blood tests, 12 to 17 | 37.2 | withheld | 24 of 51 | 36.3 |
| APM-CHboth blood tests, 1 to 17 | 32.8 | 909 | 26 of 51 | 32.9 |
| APM-CHglucose alone, 1 to 17 | 48.5 | 909 | 42 of 51 | 54.4 |
| APM-CHcholesterol alone, 1 to 17 | 34.4 | 909 | 26 of 51 | 34.8 |
| ADD-CH30-day adhd follow-up, 6 to 12 | 48.0 | 1,366 | 24 of 51 | 47.6 |
| ADD-CHnine-month adhd follow-up, 6 to 12 | 51.2 | 381 | 33 of 49 | 55.5 |
rank 1 is the highest rate. how the ranks and the withheld cells work.[1]
talking treatment before the antipsychotic
for the youngest children, aged 1 to 11, rhode island reported 47.4 percent — 11.8 points below the national median of 59.2, and the fifth-lowest of the 50 states that reported it. put the other way round, 52.6 percent of the youngest children in rhode island who were started on an antipsychotic had no psychosocial care documented before it. for adolescents aged 12 to 17 the figure was 66.7 percent. across ages 1 to 17, 60.5 percent on 238 children, 31st of the 51 states that reported it. it reported 59.0 the year before on the same method, so this one moved 1.5 points up — the only one of the three where that comparison holds. either side of rhode island on that row: tennessee at 60.6 and north dakota at 60.4.
the two blood tests
rhode island reported that 23.7 percent of children aged 1 to 11 on two or more antipsychotic prescriptions had both tests — 36th of the 49 states that reported it, 5.4 points below the national median of 29.1. split into halves across ages 1 to 17, glucose ran 48.5 percent and cholesterol 34.4 percent, both on 909 children — 42nd of the 51 states that reported it on glucose, 26th of the 51 states that reported it on cholesterol. across ages 1 to 17 the both-tests rate was 32.8 percent. either side of rhode island on the both-tests row for ages 1 to 17: new jersey at 32.9 and georgia at 32.4.
the 30-day visit after a new adhd prescription
48.0 percent, on 1,366 children aged 6 to 12 who were newly prescribed an adhd medicine in rhode island — 24th of the 51 states that reported it, 0.4 points above the national median of 47.6. that leaves 52.0 percent of those children with no recorded prescriber visit in the month after the medicine started. over the nine months that follow, 51.2 percent had at least two more visits on 381 children, against a national median of 55.5 — 33rd of the 49 states that reported it. either side of rhode island on the 30-day row: wisconsin at 48.3 and connecticut at 47.7.
what medicaid paid for in rhode island in 2024
in 2024 medicaid in rhode island paid for 39,449 hydroxyzine prescriptions, $290,969 worth, and 68,501 benzodiazepine prescriptions, $542,187 worth — 57.6 hydroxyzine prescriptions for every 100 benzodiazepine ones. 151 of the 355 hydroxyzine rows and 680 of the 1,191 benzodiazepine rows for rhode island were suppressed, so both are floors.[2] our own sums of the federal file, which has no ages, so neither is a children’s number, and no rank.
four things to ask, with rhode island’s own numbers behind them
ask which drug it is, not which class
rhode island, 2024: 39,449 hydroxyzine prescriptions and 68,501 benzodiazepine prescriptions
hydroxyzine is an antihistamine; a benzodiazepine brings dependence and withdrawal. read the name on the bottle. why they get merged.
if an antipsychotic is being started, ask what came first
rhode island: 47.4 percent of children aged 1 to 11, the fifth-lowest of the 50 states that reported it
in 52.6 percent of these cases the answer is “none yet”. ask what was tried first, and ask for it in the notes.
if your child is on an antipsychotic, get the date of the bloodwork
rhode island: 23.7 percent of children aged 1 to 11 had both tests, 36th of the 49 states that reported it
missed 76.3 percent of the time in rhode island. ask when the glucose and cholesterol test is booked, and leave with a date.
if an adhd medicine has just been started, book the 30-day visit now
rhode island: 48.0 percent, 24th of the 51 states that reported it
this is where a dose gets checked and a wrong fit is caught, and rhode island misses it 52.0 percent of the time. book it before you leave the room.
how to read any of this
self-reported, on methods that differ by state, and process not outcome.[1] method and suppression rules; the national picture.
questions people ask
In Rhode Island, how many children get therapy before they get an antipsychotic?
In the 2025 reporting year Rhode Island reported 47.4 percent for children aged 1 to 11, against a national median of 59.2 percent — the fifth-lowest of the 50 states that reported it. For ages 12 to 17 it was 66.7 percent, and across ages 1 to 17 60.5 percent on 238 children.
In Rhode Island, do children on antipsychotics get the blood tests?
23.7 percent of children aged 1 to 11 on two or more antipsychotic prescriptions had both tests — 36th of the 49 states that reported it, against a national median of 29.1 percent. Across ages 1 to 17: glucose 48.5 percent, cholesterol 34.4 percent, on 909 children.
In Rhode Island, how often does the 30-day ADHD follow-up visit happen?
48.0 percent of the time, on 1,366 children aged 6 to 12 newly prescribed an ADHD medicine — 24th of the 51 states that reported it, against a national median of 47.6 percent. The nine-month measure, two further visits, was 51.2 percent in Rhode Island against a median of 55.5.
sources
- CMS Medicaid/CHIP Child Core Set, 2025 reporting year, Rhode Island rows, read 2026-09-28. APP-CH psychosocial care first, 1 to 11: 47.4 (denominator not publicly reported); APP-CH psychosocial care first, 12 to 17: 66.7 (denominator not publicly reported); APP-CH psychosocial care first, 1 to 17: 60.5 on a denominator of 238; APM-CH both blood tests, 1 to 11: 23.7 (denominator not publicly reported); APM-CH both blood tests, 12 to 17: 37.2 (denominator not publicly reported); APM-CH both blood tests, 1 to 17: 32.8 on a denominator of 909; APM-CH glucose alone, 1 to 17: 48.5 on a denominator of 909; APM-CH cholesterol alone, 1 to 17: 34.4 on a denominator of 909; ADD-CH 30-day adhd follow-up, 6 to 12: 48.0 on a denominator of 1,366; ADD-CH nine-month adhd follow-up, 6 to 12: 51.2 on a denominator of 381. Method and ranking scope: /medicaid-children. https://data.medicaid.gov/dataset/14bc26c3-5584-4032-9175-f3a0399cb206
- CMS State Drug Utilization Data 2024, Rhode Island rows, summed by product name, read 2026-09-28: hydroxyzine 39,449 prescriptions, $290,969, 151 of 355 rows suppressed; benzodiazepines 68,501 prescriptions, $542,187, 680 of 1,191 rows suppressed. Our sum, not a CMS statistic. https://data.medicaid.gov/dataset/61729e5a-7aa8-448c-8903-ba3e0cd0ea3c
all 51 states ranked · what the national numbers say
nothing here is a reason to start, stop or change a child’s medication. it is a set of questions to bring to the person who prescribes it.
adam