On November 24, 2009, a class of Medicaid-eligible children with psychiatric and behavioral disorders living in Washington filed this lawsuit in the U.S. District Court for the Western District of Washington. Represented by public interest counsel, the plaintiffs filed this lawsuit to address the lack of community-based mental health services for Medicaid-eligible children in Washington state. The plaintiffs claimed that the state's system for providing Medicaid-funded services to children with mental health needs violated the federal Medicaid act (specifically the provisions of the Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) program, which require coverage of all "medically necessary" healthcare services available under Medicaid) and the Americans with Disabilities Act.
The plaintiffs claimed that as a result of the state's very limited mental health services for children, children with psychiatric disorders are often untreated or under-treated, which can lead to broad consequences such as involvement in the child welfare system, juvenile detention, or academic failure. Because available services in the community are so limited, these children must often go to institutions to receive care. The plaintiffs alleged that this violates the integration mandate of the Americans with Disabilities Act under the Olmstead precedent. The Plaintiffs were represented by Disability Rights Washington, the National Health Law Program, the National Center for Youth Law, and the law firm Perkins Coie.
On July 23, 2010, the court (Judge Thomas S. Zilly) granted the plaintiffs' motion for class certification. After a period of mediation, the parties entered an interim settlement agreement on March 7, 2010 (see press release
The interim agreement was scheduled to last through June 2013, but on June 28, 2013, the court agreed to a stipulation submitted by both parties to extend the interim agreement until the final Settlement Agreement was approved. The stipulation noted that both parties were cooperating and making good progress toward the final agreement. Under the interim agreement, the state began to restructure and expand mental health care programs for Medicaid-eligible children.
The plaintiffs submitted a motion for preliminary approval of class action settlement agreement on August 29, 2013, which described the final agreement. On December 19, 2013, the court granted the joint motion for final approval of the proposed settlement agreement and administratively closed the case. The court reserved the right to further monitoring. The defendants agreed to pay $3.1 million to the plaintiffs for attorneys' fees and costs.
The settlement noted that initializing immediate state improvement will be better than continued litigation for the child plaintiffs, who have a limited window to avoid institutionalization and access these medical services. Under this agreement, the state of Washington agreed to create a new care coordination program known as Wraparound with Intensive Services (WISe) to connect children with home and community-based direct services, crisis intervention services, and intensive care coordination that puts the child and their caregiver at the center of decision-making.
Under the agreement, the state will create a schedule to increase the number of children who can access services over the next five years, and submit a plan for fulfilling the rest of their obligations to the court. The state further agreed to give yearly status reports to the court. The agreement anticipated completed implementation at the end of June 2018. Beth Kurtz - 02/08/2013
Kate Craddock - 10/19/2015