Disability Rights North Carolina
In the nine years since it opened its doors as North Carolina's protection and advocacy system for people with disabilities, Disability Rights North Carolina has become a leading voice in protecting the legal rights of people with disabilities in the State. It is the only nonprofit organization in North Carolina dedicated to providing advocacy and legal services to people with all types of disabilities to protect their right to live independently with dignity in the communities of their choice. The mission of Disability Rights North Carolina is to protect the legal rights of people with disabilities through individual and systems advocacy. Its 16 staff attorneys and attorney managers conduct a wide range of legal advocacy services for people with disabilities, including the provision of direct legal representation to people with disabilities to protect their rights and ensure they receive the services to which they are entitled by law, bringing impact litigation, and acting as amicus curiae in disability-related cases
THE CASE
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Disability Rights North Carolina will use funding from the Barbara McDowell Foundation to file a complaint in the U.S. District Court for the Eastern District of North Carolina on behalf of all children and adolescents in North Carolina who are Medicaid eligible and who have been identified and diagnosed with complex behavioral, emotional, psychiatric, intellectual and developmental disabilities. These children are not being provided with appropriate medically necessary mental health services to treat their co-occurring conditions as required under the Early and Periodic Screening, Diagnostic, and Treatment (EPDST) provisions of Title XIX of the Social Security Act (Medicaid Act), 42 U.S.C. § 1396 et.seq. Defendants in the case are Governor Patrick McCrory and Secretary of the NC Department and Health and Human Services Patrick Brajer.
Disability Rights North Carolina began its investigation of this issue in 2009. During the investigation process, it reviewed the records of more than 100 children with co-occurring conditions and found that administration of the State's existing policies, procedures, and service delivery system for children with complex needs lacked effective case management, over-relied on institutional care, and failed to invest in effective community-based services and supports. While the percentage of children treated in out-of-home residential treatment facilities has fallen nationally, statistics show that North Carolina's children are not experiencing the same trend. North Carolina more than quadrupled the number of locked residential placements from 117 in 2005 to 494 in March 2010. In North Carolina, children and adolescents with complex needs experience cyclical hospitalizations (often stuck in emergency room beds for weeks because the hospital cannot find a place for them), are shipped out-of-state for treatment, suffer trauma and over-medication in inappropriate placements, and either are unable to access adequate services or receive no services at all.
Despite years of meetings with state policymakers and the direct legal representation of children with complex needs, the systemic denial of legally required Medicaid services continues. In response to a demand letter from Disability Rights North Carolina delivered in 2014 to the Governor and then NC DHHS Secretary Aldona Wos, NC DHHS staff convened a work group to promote resolution of these long-standing issues. The work group has made progress towards the systemic reform needed to develop a system that responds to the unique, complex needs of this population but has not reached a final agreement to resolve all the issues. The primary objective for this litigation is to make sure that every child and adolescent in North Carolina has access to the full scope of services required by the Medicaid Act, specifically medically necessary treatment by qualified providers, and prompt provision of services and supports designed to correct or ameliorate the child's condition in the right setting and at the right time.
CASE UPDATES SINCE GRANT YEAR
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Disability Rights N.C. v. Brajer
Reported results in the litigation they brought concerning the treatment of children with complex mental health issues residing in North Carolina state institutions and eligible to receive services under Medicaid’s Early and Periodic Screening, Diagnostic, and Treatment provisions. The suit alleged that these children had an intellectual disability and mental health diagnosis that, because of failures by the State, resulted in cyclical hospitalizations, long-term institutionalization in psychiatric facilities, or going without services.
The case was settled successfully with the State agreeing to develop and implement a process to identify children with complex needs to link them to diagnostic testing and appropriate services.
