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State agrees to a $400 million consent decree

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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.)

posted by Rich Miller
Friday, Jan 19, 18 @ 10:59 am

Comments

What I’m curious about is what “intensive” services are. As in, how broad is the class going to be? Is it going to be the 18,000 mentioned with severe emotional/behavioral problems? Is it going to be bigger? Smaller? What intensive services are going to be provided that aren’t now? Since they just signed it I’m sure they don’t have it fleshed out yet, but I’m curious.

Comment by Anonymous Friday, Jan 19, 18 @ 11:14 am
Looks like Rauner’s efforts to pare down the number of consent decrees is not working out so well. Maybe he should have focused on doing his job rather than simply killing the union.

Oh, I forgot he’s not in charge.

Comment by Norseman Friday, Jan 19, 18 @ 11:40 am
This will be GovJunk’s 2nd consent decree. First off was his sign off on a suit again PQ concerning mental health services in prison. Now this.
Wonder if this lures any of the mental health prs who bailed when GovJunk failed on budgets for 2 years?

Comment by Annonin' Friday, Jan 19, 18 @ 11:50 am
Sounds like this is going to be broader and more expensive than if the State had simply done it’s job in the first place. Another Rauner action that taxpayers will be paying for long after Rauner is gone from office.

Comment by RNUG Friday, Jan 19, 18 @ 12:00 pm
RNUG, Rauner should take some flak for this, but the original lawsuit was filed in 2011, and the problems began long before that.

Comment by Perrid Friday, Jan 19, 18 @ 12:03 pm
Countdown to Bruce “Take the Arrows” Rauner running from the arrows on this like he’s the Road Runner.

Comment by Precinct Captain Friday, Jan 19, 18 @ 12:07 pm
“RNUG, Rauner should take some flak for this, but the original lawsuit was filed in 2011, and the problems began long before that.” - That describes about every problem in the State. No one wants to change anything to right the State but just keep raising taxes and doing the same things that got you in the mess in the first place.

Comment by Stand Tall Friday, Jan 19, 18 @ 12:36 pm
Agree Stand Tall. This has been going on for a long, long time.

Comment by Anonymous Friday, Jan 19, 18 @ 12:50 pm
Sad you have me defending Rauner on this but —

Not much he could do on this one. The lawsuit was from 2011 and he if he did decide to “fix the problem” as some have suggested, then more money would be spent and guilt admitted. Two things we could not do.

This is an old HFS problem, not a Rauner problem.

Comment by MissBentohs Friday, Jan 19, 18 @ 2:39 pm
I stand corrected. But Rauner should have done what he could to manage the issue. Now there is a likely broader than expected order.

One more example of pay now or pay more later.

Comment by RNUG Friday, Jan 19, 18 @ 2:48 pm