On November 24, 2009, Medicaid-eligible children with psychiatric and behavioral disorders living in Washington filed this class-action lawsuit in the U.S. District Court for the Western District of Washington. Represented by Disability Rights Washington, the National Health Law Program, the National Center for Youth Law, and private counsel, the plaintiffs sued the Washington State Department of Social and Health Services under the Medicaid Act and the Americans with Disabilities Act 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 Medicaid Act’s Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) program, which required coverage of "medically necessary" healthcare services.

The plaintiffs claimed that as a result of the state's very limited mental health services, children with psychiatric disorders were often untreated or under-treated, which lead to consequences such as involvement in the child welfare system, juvenile detention, or academic failure. Because available services in the community were so limited, children often had to go to institutions to receive care. The plaintiffs alleged that such frequent institutionalization violated the integration mandate of the Americans with Disabilities Act under Olmstead.

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.

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 a class action settlement agreement on August 29, 2013. On December 19, 2013, the court granted the joint motion for final approval of the proposed settlement but retained jurisdiction to monitor compliance. Under the settlement, 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. The state also agreed 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 and pay $3.1 million to the plaintiffs for attorneys' fees and costs. The agreement was set to last until June 2018.

On November 16, 2015, the defendants submitted a status report on their progress towards accomplishing the goals of their settlement. The report claimed that some children were already having some success in WISe or "WISe-like" programs but that the program has not yet reached the scope required under the settlement agreement. As of November 16, 2015, 19 Washington counties offered the program. The goal was to equip all 39 of the counties with WISe programs before the agreement would be terminated in June of 2018.

On November 15, 2018, the defendants submitted another status report on their progress towards accomplishing the goals of their settlement, focusing on progress between 2017-18. The report noted that as of November 15, 2018, the state of Washington anticipated achieving substantial compliance by June 30, 2019, a delay from the original anticipated completion date of June 2018. As of June 2018, all of Washington’s 39 counties had started implementing WISe programs, and the state was meeting 88% of the monthly substantial compliance caseload target. But the state was still working to build sufficient provider capacity and to meet monthly caseload target numbers.

In 2019, the parties agreed to a one-year extension to June 30, 2020, because Washington was struggling to meet the existing deadline. On September 12, 2019, the defendants agreed to pay an additional $310,000 in attorneys’ fees for costs incurred over the prior year. The case is ongoing.

Beth Kurtz - 02/08/2013
Kate Craddock - 10/19/2015
Megan Brown - 11/06/2016
Tiffany Chung - 10/29/2019


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