G.A. et al v. Bimestefer, District Court of Colorado

Executive Summary

Plaintiffs are Disability Rights Colorado and three children on Medicaid who have serious behavioral health needs. As a result, the Children need intensive behavioral health service to remain safely at home and in their communities. Plaintiffs complain of gaps in Colorado Medicaid’s coverage of these services and, as a result, being unnecessarily segregated in residential treatment facilities and other settings, or at serious risk of institutionalization. Kim Bimestefer, in her official capacity as Executive Director of the Colorado Department of Health Care Policy and Financing (Colorado’s single state Medicaid agency), is the named defendant. The Amended Complaint alleges violations of the Medicaid Early and Periodic Screening Diagnostic, and Treatment requirements, 42 U.S.C. §§ 1396a(a)(10)(A), 1396a(a)(43)(C); 1396d(a)(4)(B), 1396d(r)(5); the Medicaid reasonable promptness requirement, 42 U.S.C. § 1396a(a)(8), the Americans with Disabilities Act, 42 U.S.C. § 12132, and Section 504 of the Rehabilitation Act of 1973, 29 U.S.C. § 794.