Human Services Provider Personal Protective Equipment (PPE) Request Form

The State of Rhode Island is accepting formal requests from health and human services providers that contract with or are funded by the State for personal protective equipment (PPE) during the coronavirus disease 2019 (COVID-19) response.

For three months, the State can provide a baseline of PPE to providers based on the number of clients/patients receiving direct care and the number of employees who provide direct care. Each organization should submit one comprehensive request that accounts for all of the direct services eligible for this program. The program will be reassessed after three months in partnership with providers.

Please note that submission of this form does not guarantee approval. All requests will be evaluated and fulfilled based on level of risk, stock availability, and number of outstanding requests. Due to continuous changes in the supply chain, the State cannot guarantee that supplies will be available. The State continues to expect providers to seek out other PPE suppliers for purposes of building an adequate inventory for their organization and/or to supplement PPE items not available through the State.

Please submit PPE requests at this link.

Eligible health and human services providers include those who offer the following programs and services:

  • Adult Day Care
  • Applied Behavior Analysis (ABA)
  • BH Link
  • BH Recovery Program
  • BHDDH – BH Community Based Intensive Supports (i.e. ES, ACT/IHH)
  • BHDDH Community Based Support (i.e. GOP, IOP, Recovery Centers)
  • BHDDH Congregate Care Settings (i.e. BH, CD, DD, SUD)
  • BDDDH Crisis Stabilization Unit (CSU)
  • BHDDH – DD Center Based Day Program
  • BHDDH – DD Community Based Day Program Services
  • BHDDH Detoxification
  • BHDDH Non-Congregate Care (i.e. SLA, Family Supports, Independent)
  • BHDDH Non-Congregate Residential Support (i.e. Recovery Housing, Supported housing)
  • BHDDH – Opioid Treatment Program (OTP)
  • BHDDH – Supported Employment Services
  • Child and Adolescent Intensive Treatment Services (CAITS)
  • Comprehensive Evaluation Diagnosis Assessment Referral and Re-evaluation (CEDARR)
  • DCYF Congregate Care
  • DCYF Homebased Providers
  • DCYF Specialized Foster Care Services
  • Early Intervention
  • Family Care Community Partnership
  • Family Home Visiting
  • Family Violence Prevention (DV)
  • First Connections
  • Healthy Families America
  • Home-based Therapeutic Services (HBTS)
  • KidsConnect
  • Non-Emergency Medical Transportation
  • Nurse-Family Partnership
  • OHA Case Management
  • ORS-Vocational Rehab
  • Parents as Teachers
  • Personal Assistance Services and Supports (PASS)
  • Refugee Resettlement
  • Respite
  • RI Community Food Bank
  • RI Works Providers
  • Senior Centers
  • SNAP E&T
  • Veterans Services
  • WIC