Two Lawsuits Allege Iowa Medicaid Failed to Provide Adequate Mental Health Care

In the lawsuit, the advocates said the Medicaid program’s inadequate mental and behavioral health system disproportionately affects children and young people under age 21 who are from low-income families, LGBTQ youth and youth of color.

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In January, three patient-advocacy groups and a national law firm filed a lawsuit against Iowa’s Department of Health and Human Services (HHS), alleging that the state’s Medicaid program provided inadequate mental and behavioral health care to children on Medicaid. The children have serious emotional problems and need intensive home and community-based services, the groups charged.

HHS manages the two health insurers that delivered care to adults and children in the state’s Medicaid program last year.

Related: In Iowa, Audits and Lawsuits Plague Medicaid Managed Care

In the lawsuit, the advocates Disability Rights Iowa, of Des Moines; Children’s Rights, of New York; and the National Health Law Program, of Washington, D.C., said the Medicaid program’s inadequate mental and behavioral health system disproportionately affects children and young people under age 21 who are from low-income families, LGBTQ youth and youth of color, the patient advocates alleged on behalf of three unnamed children who are disabled and who have mental and emotional problems. In the suit, the plaintiffs are seeking class-action status on behalf of all children in the Medicaid program, a class that could include some 8,700 to 13,000 children, the lawsuit said.

The case is the second one that two of the patient advocacy groups (Disability Rights and Children’s Rights) filed against the Iowa’s Medicaid agency. In 2017, the two advocates filed a lawsuit against the state Medicaid agency alleging that the state failed to provide adequate mental health care to children with significant mental illness who were living at the Boys State Training School in Eldora, Iowa, according to court records. In the suit, the advocates and law firm charged that the agency administered dangerous psychotropic medication without adequate oversight or informed consent, and unlawfully subjected the children to solitary confinement and mechanical restraints as punishment for minor rule infractions.

In 2020, U.S. District Court Judge Stephanie M. Rose ruled in favor of the plaintiffs, saying she found the use of the mechanical restraints at the facility amounted to “torture.” She also appointed a juvenile-justice consultant to monitor conditions at the school and ordered the state to pay $4.9 million in fees to the plaintiffs’ attorneys.