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Mental Health

Lawsuit Filed Against Colorado’s Medicaid Program

— September 22, 2021

Children are largely unsupported when it comes to mental health, new Colorado suit contends.

A new federal class action lawsuit filed this month accuses Colorado’s legislators of failing to adequately address children’s mental health across the state, especially for those who are disadvantaged.  Because it has not met its federally mandated obligations, according to the suit, children return time and again to emergency rooms, being discharged after a few days, and don’t receive longer term treatment.  The filing is aimed specifically at holding Colorado’s Medicaid program accountable.

The litigation includes, so far, three unnamed plaintiffs (identified only as A.A, B.B. and C.C in court documents), who are all teenagers and have, for a long period of time (from months to years) been sent to hospital emergency rooms for mental health crises.  They’ve been refused admission into residential treatment centers due to the capacity limits.

“Colorado needs a comprehensive mental health plan of care for these children, and there are significant gaps and missing links that need to be rectified,” said Robert Farley, the attorney for the plaintiffs who successfully challenged the state of Illinois in a similar suit. “These children have legal rights to get the necessary services.”

Lawsuit Filed Against Colorado's Medicaid Program
Photo by Karolina Grabowska from Pexels

Colorado’s current lawsuit states, “The three plaintiffs should have received intensive mental health services in their communities under federal law for children on Medicaid government insurance.”  The class action status is meant “to represent other children who have not received needed treatment.  The children have been unfairly institutionalized.”

One plaintiff is a 13-year-old boy “hospitalized at Children’s Hospital Colorado since March because the state has refused to pay for a less-restrictive residential treatment center,” the filing states. “The teen, who has reactive attachment disorder and other mental health issues, remains hospitalized due to the lack of other options.”

Another plaintiff, a 16-year-old girl “has been in the emergency department at Children’s Hospital Colorado since July 31.  The state has been unable to find a long-term residential program.”  Moreover, the filing alleges, “The teen, who is suicidal and has post-traumatic stress disorder and reactive attachment disorder, has been admitted to an emergency room 17 times.”

The third plaintiff is a 13-year-old Aurora girl diagnosed with “major depression and an anxiety disorder who has been hospitalized three times.  She’s living at home but needs to go to a residential treatment center, which the state has not provided.”

Under federal law, children who qualify for Medicaid are entitled to receive medically necessary mental health services.  The lawsuit names Colorado Department of Health Care Policy and Financing Executive Director Kim Bimestefer as defendants and seeks to enforce a broader range of care options.

Public data shows that roughly 2,300 children received intensive community-based services through the state Medicaid department’s Children’s Extensive Support Waiver program in the state of Colorado, but in order to qualify, children must have an intellectual or developmental disability.  Overall, 163 children received services through the state’s Children’s Residential Program, but to qualify, children had to have a diagnosed intellectual disability.

“The system is discriminatory when only certain children can qualify for residential care,” Farley said. “You just can’t flip a switch overnight and create a mental health system for children” but he hopes the lawsuit will get things moving in the right direction.

“It gets to the point where families become desperate,” Farley said. “They don’t see hope.  They don’t see progress.  They get to the point where we have to do something.”


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