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Decision expected
in Rosie D. v. Romney case
(October
2005 Issue)
By Elinor Nelson
It's time that Massachusetts provides its most junior Medicaid
recipients with appropriate psychiatric services and treatment,
claim the plaintiffs in Rosie D. v. Romney, a class action lawsuit
argued before the U.S. District Court in August. A decision should
be imminent, states plaintiff attorney Cathy Costanzo, assistant
director of the Center for Public Representation, a public interest
law firm representing people with disabilities.
The aim of the lawsuit is to make sure that children with severe
psychiatric disabilities have a chance to grow up in their communities
and not in institutions. The case was brought in Oct. 2001 by nine
plaintiffs ages five to 16 who had been hospitalized or at risk
of hospitalization because of a lack of community mental health
services.
Plaintiffs charge that the state is violating federal law by failing
to abide by Medicaid's mandate to screen and diagnose eligible children
and furnish appropriate medically necessary preventative and rehabilitative
treatment.
"What we most want is to see things change for the children and
their families," says Costanzo, "and for them to get the services
they've needed and to which they're entitled. For many, the difference
will be living normal lives with their families at home or living
in institutions."
The class includes approximately 3,000 children who are Medicaid-eligible
and who suffer from emotional, behavioral or psychiatric disorders.
The diagnoses, Costanzo says, include pervasive developmental disorder,
mental retardation, developmental disabilities, bipolar disorder
and psychotic disorders.
The plaintiffs claim that hundreds of class members have been detained
inappropriately in psychiatric facilities, congregate care settings
or totally denied access to services and some children have been
boarded in hospital emergency rooms or pediatric wards.
The plaintiffs' fiscal expert says that Massachusetts wastes more
than $22 million per year on unnecessary hospitalization and suggests
that the Commonwealth could redirect available funding to serve
more than 1,000 children annually in home-based programs.
Plaintiffs are asking for home and community-based services including
trained behavioral staff to support a child at home, in school and
in after-school or treatment settings for as many hours as needed
to ameliorate the child's condition. Plaintiffs say that other states,
including Rhode Island, Vermont, Maine and New Jersey, fund such
services.
"Until children are four or five they get [such services from]
Early Intervention," explains Costanzo. "We would love to see a
model based on Early Intervention. They make determinations regarding
what a child needs to be successful for his or her physical, mental
or psychological development. The families' and child's needs for
services don't change - it's just the funding that changes." While
Massachusetts offers home and community-based services through two
programs, plaintiffs say that these projects are limited and fail
to serve children in 341 of the state's communities.
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