On August 14, 2018, two children with mental health disabilities and University Legal Services, Inc. filed this lawsuit on behalf of themselves and a class of children with mental health disabilities in the United States District Court for the District of Columbia. The plaintiffs sued the District of Columbia under:

• The Americans with Disabilities Act (ADA), 42 U.S.C. §§ 12111 et seq.;
• Section 504 of the Rehabilitation Act, 29 U.S.C. § 794;
• The Protection and Advocacy of Individual Rights program, 29 U.S.C. § 794;
• Title XIX of the Social Security Act (Medicaid Act), 42 U.S.C. § 1396; and
• 42 U.S.C. § 1983.

The plaintiffs, represented by the National Center for Youth Law, the Bazelon Center for Mental Health Law, in-house counsel, and private counsel, sought declaratory and injunctive relief together with costs and attorney’s fees. The plaintiffs claimed that the District of Columbia failed to comply with mandates of the ADA, Section 504 of the Rehabilitation Act, and the Medicaid Act. Specifically, they claimed that the District of Columbia failed to provide medically necessary intensive community-based services (ICBS) to children with mental health disabilities.

Intensive community-based services consist of three components:

1. Intensive care coordination (ICC): designing and supervising a plan to provide and coordinate services to children that includes the child, the child’s family, and service providers;
2. Intensive behavior support services: individual therapy provided to the child where they live; and
3. Mobile crisis services: crisis response services that can provide care in a child’s home, school, or community.

In their complaint, the plaintiffs acknowledged that the District of Columbia provides some components of ICBS. For example, the District offers the “high fidelity wraparound” ICC program, “community-based intervention” services, and the Assertive Community Treatment (ACT) intensive support program. But the plaintiffs alleged that the District’s existing services “fail[] to provide medically necessary ICBS” for many children who need them.

The complaint did not name the putative class representatives. Instead, the plaintiffs moved that the minor plaintiffs be allowed to proceed anonymously. Chief Judge Beryl A. Howell granted this motion on August 14, 2018. Judge Howell determined that the plaintiffs have a “strong interest” in protecting “highly sensitive details” about their mental health that would be revealed in the litigation that outweighs the government defendants’ “minimal” interest in disclosure.

The District moved to dismiss the case on October 3. First, it argued that the two individual plaintiffs lack standing. The District claimed that the first individual plaintiff refused to use the District’s existing wraparound services, that the second would not be eligible for ICBS because she is in the custody of the Department of Youth Rehabilitation Services, and that the complaint does not allege sufficient facts to support a claim by University Legal Services alone. Second, it argued that the plaintiffs failed to state a claim under the ADA and Rehabilitation Act because the plaintiffs’ allegations involve the adequacy of care rather than where the District provides services. Finally, the District argued that the plaintiffs’ allegations that it violated Medicaid requirements were “threadbare . . . conclusory statements” that could not support a claim under Iqbal.

As of June 2019, the parties are engaging in a contentious discovery process, and the plaintiffs continue to seek class certification. The case is ongoing.

Timothy Leake - 06/01/2019


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