Agreement ensures access to intensive home and community-based behavioral health services for children across the state
Detroit, MI – A settlement agreement was approved today by the federal district court in K.B. v. Michigan Department of Health and Human Services that will deliver sweeping improvements to the state’s Medicaid behavioral health system for children. The agreement resolves a class action lawsuit brought on behalf of Medicaid-eligible children with intensive mental and behavioral health care needs who experienced psychiatric hospitalizations and other institutional residential treatment settings, or involvement in the child welfare or juvenile justice system because they could not access the services they needed in their homes and communities.
Plaintiffs filed this lawsuit in 2018, alleging that Michigan violated the Medicaid Act’s Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) requirements, as well as due process requirements and the Americans with Disabilities Act and Section 504 of the Rehabilitation Act. They sought injunctive relief to require the state to provide the medically necessary mental and behavioral health services to which children are entitled under federal law.
The settlement agreement provides precisely that relief, requiring the Michigan Department of Health and Human Services (MDHHS) to make comprehensive systemic reforms, including:
- Ensuring access to intensive home and community-based services (IHCBS) statewide for children with significant behavioral health needs;
- Establishing a standardized eligibility and assessment process so that children are identified and connected with services consistently and equitably;
- Improving data collection and oversight to track services and outcomes; and
- Implementing continuous quality improvement measures to sustain progress.
“This settlement shows Michigan’s commitment to taking proactive steps to better serve children with significant behavioral health needs. By providing intensive home and community-based services, the state is better meeting the needs and wellbeing of children; it is also far more cost-effective than serving children in hospitals or institutions,” said Kim Lewis, Managing Director, California Advocacy and Practice Area Managing Director at the National Health Law Program. “Unfortunately, draconian federal Medicaid cuts passed as part of so-called ‘One Big Beautiful Bill Act’ threaten to hobble state budgets, reducing both coverage and services. States that want to spend their Medicaid funds on proven and effective services would do well to follow Michigan’s example and invest in home and community-based care.”
“This settlement will have a direct and meaningful impact on children and their families. Parents will no longer have to choose between surrendering their children to institutions or going without care altogether,” said Nick Gable, Interim Director of Litigation at Disability Rights Michigan. “Families across Michigan will have access to the supports that keep them safe, together, and thriving.”
“At its heart, this case has always been about fairness. Children with significant behavioral health needs deserve the same opportunity to grow up at home and in their communities as any other child,” said Dave Honignman, attorney at Mantese Honigman, P.C. “This agreement ensures that Michigan meets its obligations under the law and treats families with the dignity and justice they deserve. We are proud to have worked with the state to achieve a solution that invests in children, families, and the future of Michigan.”
Counsel for Plaintiffs include National Health Law Program, Mantese Honigman P.C., Disability Rights Michigan, and John J. Conway P.C.
NHeLP continues to secure critical victories for children and youth in Medicaid, even as federal policymakers impose massive Medicaid cuts and harsh new restrictions that threaten coverage and care for millions. In the past six months, we have helped achieve groundbreaking settlement agreements in Michigan, New York, and Iowa that ensure that children with significant mental and behavioral health needs will finally have access to intensive home and community-based services rather than being treated into hospitals or institutions. These cases reaffirm that Medicaid is not only a lifeline for children and families, but also a legal entitlement that NHeLP will continue to defend, state by state and child by child, against efforts to undermine it.
Michigan: In K.B. v. Michigan Department of Health and Human Services, NHeLP and partners secured final court approval of a settlement that requires the state to provide intensive home and community-based services to children with significant behavioral health needs, along with standardized eligibility, improved data practices, and ongoing quality improvement.
New York: A federal judge gave preliminary approval to a settlement in C.K. v McDonald that will overhaul the state’s Medicaid behavioral health system for children, requiring coverage of intensive care coordination, intensive home-based care, and mobile crisis services. Read more here. Read our press release.
Iowa: A final settlement in C.A. v. Garcia ensures that children in Iowa will have access to vital Medicaid mental health services, protecting their rights under federal law and keeping them connected to care in their homes and communities. Read our press release to learn more.
