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September 30, 2011
The Legal Team of Robert H. Farley, Jr., Michelle N. Schneiderheinze, Mary Denise Cahill and Alysha Briggs-Miller, have filed a Federal Class Action Lawsuit against the State of Illinois due to its failure to comply with Federal Laws which mandate that medicaid eligible children (up to the age of 21) who have behavioral or emotional disorders, receive intensive mental and behavioral services in order to correct or ameliorate their conditions.
The State of Illinois is aware that children (up to the age of 21) with severe developmental disabilities or severe mental illnesses or severe emotional disorders fail to receive the medically necessary home and community-based services to address their needs. In 2010, the State issued a report which identified over 18,000 persons through the age of 21 with severe mental illnesses and emotional disturbances and yet only 220 of these children received intensive community based services.
The State of Illinois failure to comply with federal laws, results in unnecessary repeated hospitalizations for some of the class members. Some of the class members are "locked" out by their parents and guardians in order to access State services. Some of the class members are on "Waiting Lists" for needed services. Some of the class members have been told to apply for "Individual Care Grants" and the reality is that most of these requests are denied as in one year only 81 grants were awarded out from over 1,000 requests for funding. Parents and caregivers are given the runaround and told to play the alphabetical soup game and seek services from "DMH" or "ICG" or "DHS" or "ODD" or "DRS" or "CRSA" or "PUNS" or "SAS" or "ISCA" or "ISBE" and the harsh reality is that at the end of the day (years), the needed services are not provided.
The United States Department of Justice in support of a similar federal class action in another State, wrote that "[t]he denial of EPSDT services results in significant harm to children with behavioral or emotional disorders, including exacerbation of their conditions, deterioration to the point of crisis, and unnecessary institutionalization in violation of the ADA."
FREQUENTLY ASKED QUESTIONS ABOUT THIS LAWSUIT:
Q. Do the children have to qualify for Medicaid?
Answer: Yes, and if the child is under the age of 18, then family income is considered. HOWEVER, if the child is 18 years or older (18-20), then family income is not considered and then you only look at the child's assets and income.
Q. Is my child, who I adopted through DCFS, eligible for intensive home based or residential treatment through EPSDT as part of the subsidy agreement regardless of my income?
Q. Can the State have a "Waiting List" for this program?
Answer: No. Every child who has a medical need for these services must be served.
Q. If my child has Medicaid and is on the PUNS list waiting services, is he or she legally entitled to immediate services?
Q. If my child has Medicaid and has been denied an ICG-Illinois Care Grant for intensive community based or residential treatment, can he receive these same services immediately through EPSDT?
Q. If a child qualifies for funding at age 18 and since the EPSDT program ends at age 21, will the child lose ongoing services?
Answer: Courts have ruled that if the child still needs the services, then the Americans with Disabilities Act (ADA) requires the State to continue to provide these services.
FOR MORE INFORMATION: Call Attorney Robert H. Farley, Jr., at 630-369-0103.