RELEASE – Court victory allows Children access to Vital Behavioral Health Treatments

***For Immediate Release***NE_Appleseed_Icons_Legal-128

July 1, 2015

 

Contact, Jeff Sheldon
Communications Director, Nebraska Appleseed
Office: (402) 438-8853
Mobile: (402) 840-7289
jsheldon@neappleseed.org

 

Court victory allows Children access to Vital Behavioral Health Treatments

Lancaster County District Court sides with Appleseed in important decision

 

LINCOLN — Yesterday, Lancaster County District Court Judge John Colborn issued an order protecting the rights of Nebraska children with autism and developmental disabilities to get vitally important behavioral health treatments through the Medicaid program.

The case, K.D. & S.L. v. Winterer, was filed on behalf of two Nebraska children who each have serious behavioral and mental health conditions, but had been denied coverage for necessary treatments recommended by their doctors.  The suit challenged a Nebraska Department of Health and Human Services’ (HHS) policy that excludes Medicaid coverage of certain treatments for children with developmental disabilities.  Yesterday’s decision granted the plaintiff children’s motions for class certification and summary judgment.  As a result of the judge’s order, HHS can no longer enforce these policies which have been determined by the court to be unlawful.  Part of the judge’s ruling was to certify the case as a class action, meaning the ruling applies to all children in a similar situation as the named plaintiffs.

“This ruling is an important victory for Nebraska families with children who have been wrongfully denied access to essential mental and behavioral health treatments that were recommended by their doctors,” said Sarah Helvey, Nebraska Appleseed Legal Director. “The Court’s ruling will allow more children to get the care they need to have the best possible future.

“Now that this order is in effect, we look forward to working with the Department to begin covering these vital treatments immediately for the hundreds of Nebraska children who need them.”

The children in this case were represented by Nebraska Appleseed, the National Health Law Program, and Husch Blackwell LLP.

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  3 Replies to “RELEASE – Court victory allows Children access to Vital Behavioral Health Treatments”

  1. Dr. Joe Evans
    07/01/2015 at 1:58 pm

    This is terrific news for children and families!!! In the past few years we have had a dual system of care in which families with financial means and/or great insurance could receive services while children with Autism who were disadvantaged or with Medicaid coverage were essentially excluded from necessary care. This was also the case for several years for children under the age of 5 under some rather bizarre interpretation of federal law by our Nebraska DHHS.

  2. Sarah Swanson
    07/01/2015 at 4:32 pm

    So glad to hear this news! Nebraska needs to start addressing and treating children that have autism. We have lots of data and research that clearly illustrates that Early Intervention and Treatment can completely change a child’s life trajectory, thereby decreasing their dependency on state programs. Nebraska needs policies that support families and needs to ensure that programs are accessible to individuals who need them and also needs to have a long-term approach to planning.

    Families that have children with disabilities who live in Nebraska should not have to move to another state, go bankrupt, or give up custody of their children simply to get services.

    The NE Medicaid program needs to be designed to provide for the needs of Nebraska families and also follow federal regulations. This is a clear victory! Thank you NE Appleseed!

  3. Dr. Judith Bothern
    07/01/2015 at 4:44 pm

    This is the BEST news I have heard in a very long time. Not only were children with a diagnosis of ASD excluded from mental health care for any issues related to ASD, they were turned down for all other behavioral health care as well. HHS had this outlook that if there was an ASD diagnosis, it trumped all other issues. Nebraska Appleseed has gifted the children of Nebraska with their long and arduous fight for these children – thank you!

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