Colorado violating Medicaid mandate by not providing mental health services to children, lawsuit alleges

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CO HHS is being sued for not providing long-term residential MH/BH programs to members seeking treatment in ERs.


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The suit was filed against the head of the sate Department of Health Care Policy and Financing

Colorado is violating a Medicaid Act mandate by not providing certain mental health services to eligible children at home or in their community, which in some cases has led to teenagers experiencing “unnecessary institutionalization,” a federal lawsuit filed Friday alleges.

The lawsuit was filed in U.S. District Court of Colorado against Kim Bimestefer, the head of the state Department of Health Care Policy and Financing, on behalf of three unnamed teenagers and their families, including one with a history of suicide attempts and self-harm who was in a metro Denver emergency room for about a month.

“Colorado has been ignoring their duty to provide mental health services to the children of Colorado for too long,” attorney Robert H. Farley Jr. said in a statement. “We hope this lawsuit will force the state to find a solution for providing care to all of Colorado’s children and youth who need it.”

Marc Williams, spokesman for the Department of Health Care Policy and Financing, declined to comment on the lawsuit, citing pending litigation.

The suit is also seeking class-action status on the behalf of people under the age of 21 who qualify for Medicaid and have been diagnosed with mental health or behavioral disorders and who have been recommended to receive Intensive Home and Community-based services.

The plaintiffs in the suit include a 16-year-old girl who was in an emergency room between July 31 to Aug. 24 because the state has been unable to find a long-term residential program in the state to help her get treatment. Another is a 13-year-old boy who has been hospitalized since March 9, according to the news release.

The third is a 13-year-old girl who is at home, but needs servers to help with her behavioral disorders. The teenager has been in a psychiatric hospital three times since March 22.

Updated 1 p.m. Sept. 3, 2021 This story has been updated to correct how long the 16-year-old was in a metro Denver emergency room. A news release contained incorrect information.

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