* Illinois Public Radio…

A lawsuit against Illinois’ Department of Healthcare and Family Services claims the state illegally withholds medically necessary services from children with severe mental health disorders. The case was settled in federal court this week.

Federal Medicaid law requires intensive home- or community-based services for children who need it. A class action lawsuit filed in 2011 claims Illinois violates that law.

Robert Farley, Jr., is the attorney on the suit. He says some Illinois families are so desperate to get treatment for their children, they bring them to a psychiatric hospital — and never come back for them.

“DCFS will then take custody of the child and then basically place the child residentially,” Farley said. “So you get residential services, but then you’ve given up custody of your child, which is, you know, barbaric. You have to give up your child to get something necessary.”

Data from the state shows some 18,000 children in Illinois have severe emotional or behavioral disorders. But only about 200 receive intensive treatment.

…Adding… Cost…

Farley estimates the changes could cost the state upwards of $400 million.

* Collins-Mandeville at the Illinois Collaboration on Youth explains…

The settlement requires the State “to design and implement a systemic approach through which Class Members will be provided with reasonable promptness the Medicaid-authorized, medically necessary intensive home- and community-based services, including residential services, that are needed to correct or ameliorate their mental health or behavior disorders.”

Even though the state had to pay court-ordered Medicaid services during the impasse, this new consent decree will actually require revamping the children’s behavioral health system and building up much needed service capacity, not just maintaining the status quo of Medicaid service delivery. As we all know, maintaining the status quo today compared to a status quo of two years ago will already be more expensive since the impasse toppled the community-based service system infrastructure.

The N.B. class is much larger than a variety of other consent decrees. It covers all Medicaid-eligible children under the age of 21 in the State of Illinois:

(1) who have been diagnosed with a mental health or behavioral disorder; and
(2) for whom a licensed practitioner of the healing arts has recommended intensive home- and community-based services to correct or ameliorate their disorders.

This settlement also comes on the heels of the Feds issuing a letter about pending and future 1115 waiver requests — something the Administration was counting on to draw down federal funds for services like those needed under the new consent decree.

Additionally, it should be noted that:

The federal court has increased oversight in the DCFS case (B.H. v. Walker), which now requires monthly status updates. Class counsel also filed a motion to enforce that consent decree alleging DCFS’ noncompliance (with clear cut, convincing evidence).

In October, the plaintiffs in Rash v. Baldwin (DOC consent decree) filed a motion to enforce their settlement agreement for timely and consistent mental health services. (The Administration agreed to that agreement and the court approved it in May 2016.)