Today, Nebraska Appleseed and the National Health Law Program (NHeLP) filed a class action lawsuit in Lancaster County District Court against two officers of the Nebraska Department of Health and Human Services (HHS) on behalf of two children who have been denied necessary behavioral health treatment recommended by their doctors. The suit challenges an HHS Medicaid policy that excludes certain treatments for children with developmental disabilities as required by federal law.
The two children seek to represent a class of children who have been denied effective, research-based behavioral therapy.
“Every Nebraska child should have the support they need to grow up to be healthy and productive,” said Becky Gould, Executive Director of Nebraska Appleseed. “Early behavioral health services are very effective therapies for children, save money, and are required by the federal Medicaid Act.”
The suit was filed on behalf of two young children, K.D. and S.L., who each have several serious behavioral and mental health conditions. In both cases, the child’s treating provider determined that outpatient behavioral therapies, including Applied Behavioral Analysis (ABA) techniques, were medically necessary to address their needs. However, their doctors’ requests for these services under Medicaid were denied by HHS. The lawsuit alleges that these denials violate the federal Medicaid Act’s Early Periodic Screening Diagnosis and Treatment (EPSDT) provisions and Title II of the Americans with Disabilities Act (ADA). The suit requests that the court strike down HHS’s policy of denying necessary behavioral health treatment to children with autism and developmental disabilities.
“When HHS denies necessary services to these children, their problems often worsen over time, an effect that has far-reaching consequences for them, their families, and the community,” said Jane Perkins, Legal Director at the National Health Law Program.
In too many cases, HHS’ policy puts families in the untenable position of having to give up their child to the child welfare system in order to get the services they need. This tragic result can be avoided, and money can be spent more efficiently, if HHS provides the services children need as soon as possible, as federal law requires.
“Overly restrictive and illegal Medicaid policies by the State of Nebraska have widened gaps in the state’s children’s behavioral health system that are harmful to children,” Gould said. “These policies force heartbreaking choices on families and reverberate in other systems and our communities. This lawsuit asks the court to strike down HHS’ discriminatory policy, so that every Nebraska child has access to the behavioral health services they need and our children, families and communities are healthier and stronger.”
The plaintiffs, K.D. and S.L. and other children similarly situated, are represented by Becky Gould, James Goddard, Sarah Helvey and Robert McEwen of Nebraska Appleseed, and Jane Perkins and Sarah Somers of the National Health Law Program.
I currently know someone in foster care whom was in their families care and the caseworker denied each time asked if the child would qualify for medicaid if adopted and the caseworkers, each and everyone of them, said the child “might” qualify, the child has been diagnosed with a mood disorder and has other problems.