A new federal lawsuit alleges that New York “failed to provide children on Medicaid with the mental health care they are entitled to by law,” according to a recent report co-published by The City and ProPublica. Filed last week, the lawsuit, representing “hundreds of thousands” of children eligible for Medicaid, alleges that this failure resulted in the unnecessary suffering of children who wound up in “hospitals and residential treatment programs” to receive services they should have been able to receive at home.
Federal regulations stipulate that the state must deliver mental healthcare services to Medicaid-enrolled children “in kids’ homes, schools and other places a child would naturally be,” the report explains. But the state has allegedly fallen short of this standard, with children in need instead seeking inpatient treatment at hospitals and in other programs.
As a previous report by the same publications explains, these alleged failures stem from a “Transformation Plan” established in 2014 by then-New York Governor Andrew Cuomo. Under his plan, the state “cut nearly a third of state psychiatric hospital beds reserved for children, redirecting resources to “community-based and outpatient mental health programs” intended to provide services to children in their homes, eliminating the need for inpatient care. Unfortunately, an investigation by The City and ProPublica found “no evidence” the plan reached its goal, and young New Yorkers are facing increasing obstacles in their pursuit of hospital care for their mental health needs.
As one former health official explained to The City and ProPublica, one fundamental problem was that children in the state are unable to access those community-based programs until they’re “in crisis.” As a result, the first five years after Cuomo launched his plan saw a 25% increase in “mental health emergency room visits by young people on New York’s Medicaid program,” while “the rate at which Medicaid-enrolled kids were admitted to psychiatric hospitals essentially remained flat.” Staffing shortages at outpatient clinics make it difficult for young New Yorkers on Medicaid to obtain care, and even patients on private insurance “often” find that there are simply no providers in their networks available to treat them.
The lawsuit against the state alleges that officials have “long known” about the systemic failures for Medicaid-enrolled children seeking mental health care. The state’s Department of Health and its Office of Mental Health, whose commissioners are defendants in the lawsuit, declined to comment to publications.
More information on the lawsuit alleging New York failed to provide adequate mental healthcare services to hundreds of thousands of Medicaid-enrolled children is available via The City and the complaint itself.