Michigan Department of Health and Human Services Settles 2018 Lawsuit Over Child Mental Health Care
The Michigan Department of Health and Human Services has agreed to settle a 2018 lawsuit filed by families who say their children were not provided adequate treatment for significant mental health issues.
Sad child; image courtesy of Alexas_Fotos via Pixabay, www.pixabay.com
The parties signed an interim settlement agreement in August and are now developing a plan to improve mental and behavioral health care for Michigan children who are enrolled in Medicaid and part of the child welfare system.
Michigan families continue to face hurdles getting mental care for children during crises, said Kyle Williams, Disability Rights Michigan director of litigation. He referred to a recent viral video in which a central Michigan father pleaded for help finding a psychiatric bed for his teenage son, who had spent over a week in an emergency room.
“It’s a story we hear with some regularity,” he said. “Kids are having a crisis, they don’t have what they need in order to support them in their home or support them in their community. Parents are left with two choices: you can take them to an emergency room or you can call the police.”
Williams is a lead attorney in the case, K.B. v. Lyon.
A central goal of the families involved in the lawsuit is to ensure kids have ready access to mental health treatment at home or in their communities, he said, instead of relying on jails, emergency rooms or psychiatric hospitals.
“If you can address those crises in the community and if you can give these kids what they need in order to be in the least restrictive setting, then your success…is going to be less kids in psychiatric hospitals,” he said. “And whenever they go into psychiatric hospitals they’re going to be spending less time there.”
According to the August agreement, the state has committed to providing an array of intensive home and community-based mental health services for children in need.
The state also will also develop a plan detailing how they will provide those services, including making sure there are enough providers throughout Michigan and measuring quality of care.
The implementation plan should be ready by April, according to a budget presentation DHHS officials gave to the House Appropriations Health and Human Services Subcommittee in early March.
Gov. Gretchen Whitmer’s executive budget plan for the upcoming fiscal year sets aside almost $91 million, with $30 million coming from the general fund, to address costs tied to the settlement and ensure better access to behavioral health services for children enrolled in Medicaid and involved in the child welfare system.
Department spokesperson Bob Wheaton said officials could not comment on the lawsuit, which remains in negotiation.
In 2018, the state moved to dismiss the lawsuit and successfully had some pieces of the original complaint tossed.
U.S. District Court Judge Thomas Ludington agreed to dismiss arguments, like plaintiffs’ contention the state had violated parts of the the U.S. Code, in 2019. He said the state still finances medical services even if those services aren’t provided, since the state contracts with Prepaid Inpatient Health Plans to administer Medicaid, and thus doesn’t violate the U.S. Code.
But Ludington determined the state is ultimately responsible for ensuring Medicaid recipients, including children with severe mental health needs, receive services, even if it hires contractors.
Because the children and young adults involved in the lawsuit were Medicaid recipients, the plaintiffs argued the state was bound by the Medicaid Act to screen them for health issues, including mental and developmental issues, and to identify services available to treat those issues during screenings.
The seven children involved in the lawsuit, which Williams said attorneys hope becomes a class action, were approved by the state to receive intensive home and community-based mental health services but were unable to actually get them.
Instead, the families went months or years without appropriate treatment for their children, who bounced between emergency rooms and their homes, where they risked harming themselves or their families.
A 20-year-old man from Ingham County with “significant mental health care needs” waited at least nine months for psychiatric services after the state approved his application for treatment. He had been bullied at school and, without the services, isolated himself “at home due to his anxiety and trauma,” the 2018 complaint reads.
A 12-year-old girl from Iron County who had been in and out of emergency rooms injured herself and her mother to the point of hospitalization at the time the lawsuit was filed.
Her mother had “repeatedly pleaded for intensive home and community-based services, but has either been denied, advised the services do not exist, or offered minimal services based on lack of availability or resources in the county,” the complaint reads. The girl’s mother had been advised to consider placing her daughter in foster care so she could get the services she needs.
Some of the children have aged out of Medicaid eligibility since the suit was filed, Williams said, but he argued they represent many other Michigan children and young adults in need of better service.