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Colorado must hire an outside consultant to examine its mental health services for children after a class-action lawsuit claimed the state’s policies are resulting in kids getting stuck in hospital emergency rooms and institutions.
Under the terms of the settlement of the 2021 case, the Colorado Department of Health Care Policy and Financing did not admit to violating federal or state laws but agreed to pay for an outside examination of its Medicaid policies. The consultant will review department data and individual case files to uncover flaws in the government insurance program’s behavioral health program, then propose improvements.
Colorado’s “weak and uncoordinated” system has relied far too much on institutions, resulting in hundreds of children sitting in hospitals and residential facilities, including out-of-state hospitals, the lawsuit said. When the children are released, they get little to no follow-up care, besides minimal medication and possibly counseling appointments that are inadequate for their intense issues, it claimed.
“Many children and families find themselves thrown back into a crisis, forced to repeat the cycle of institutionalization,” the lawsuit said.
The lawsuit from Disability Law Colorado also included three anonymous plaintiffs, all teenagers with acute mental health struggles.
A 15-year-old boy from Northglenn, called Plaintiff A.A., has cycled in and out of hospitals and residential facilities because of a history of aggressive and assaultive behavior toward his family and peers at school, the lawsuit said.
He spent a year and a half at Third Way Center, a Denver residential facility, a couple of weeks in Cedar Springs Hospital in Colorado Springs, and a couple of weeks at Children’s Hospital Colorado in Aurora. Each time he was released, he was not provided adequate mental health services to help him recover, which caused his mental health to deteriorate and lead to another institutionalization, the lawsuit alleged.
He has received some community-based services, but they were “fragmented, uncoordinated and sporadic,” according to the lawsuit.
The teen, whose condition is likely related to prenatal exposure to drugs, has been diagnosed with reactive attachment disorder, anxiety and disruptive mood dysregulation, among other diagnoses.
The three plaintiffs should have received intensive mental health services in their communities — an entitlement under federal law for children on Medicaid government insurance, the lawsuit said. The lack of services has led to children being unfairly “institutionalized,” the lawsuit said.
The case was settled after two and a half years after both parties “agreed that their time and efforts are better spent working to improve” the system “rather than litigating the case in court,” according to a joint news release.
The settlement requires the state Health Care Policy and Finance Department to develop a “robust” plan within the next year that will improve services for children who have Medicaid coverage. The state must put the plan in place within the next five years, the settlement says.
The plan must include intensive in-home mental health services, mobile crisis intervention and stabilization services. The department already was working toward improvements, and the settlement will improve upon those, said Robert Werthwein, the department’s senior advisor for behavioral health and access.
The exterior of Children’s Hospital Colorado in Aurora, photographed on Oct. 18, 2019. (John Ingold, The Colorado Sun)
The case is similar to major lawsuits filed in other states, including Illinois, which was forced to revamp its mental health system for children in a 2018 settlement. Robert Farley, the attorney handling the Colorado case, also handled the case against Illinois.
Farley previously told The Colorado Sun that he initiated the lawsuit after receiving various calls for help from families in Colorado.
The Illinois lawsuit, filed in 2011 and settled in 2018, was the impetus behind new programs in that state, including a uniform mental health assessment for children receiving Medicaid. Children in Illinois are assigned a mental health care coordinator, who works with a handful of kids and teens at a time to make sure they receive proper care.
Heidi Baskfield, CEO of Speak Our Minds and one of the original organizers of the lawsuit, called the settlement a “great first step” to “fix our broken youth mental health system.”
The plan worked out over the next year will “help keep our youth healthy and in their communities instead of emergency rooms and institutionalized,” she said.
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