Federal court approves settlement improving mental health care for children in Iowa

A federal court granted final approval Friday to a settlement agreement in a lawsuit against the Iowa Department of Health and Human Services that will expand and improve mental health services for children.

The settlement is in a 2023 lawsuit claiming the state had denied Medicaid-eligible children timely access to intensive community services and had failed to provide “intensive home and community-based services” for decades.

The lawsuit was filed by three Medicaid-eligible Iowa children under the age of 21, who were represented by advocacy groups Disability Rights Iowa, the National Health Law Program and Children’s Rights.

Part of the settlement agreement, which was approved by a federal judge in January, requires the development of a new array of services through the Responsive Excellent Care for Healthy Youth initiative, also called Iowa REACH, which is aimed at providing community-based services across the state.

Under the settlement agreement, Iowa Health and Human Services will be required to provide mental and behavioral health care services to Medicaid-eligible children in Iowa, including intensive care coordination, intensive in-home and community therapeutic services, and mobile crisis intervention and stabilization services.

The agency also will be required to adopt a new screening and assessment process to ensure eligible Iowa children under the age of 21 with serious emotional and behavioral health conditions are receiving the required services. The settlement includes a specific framework for establishing accountability systems and timelines for rolling out new services.

A statement issued by the co-counsel organizations — Disability Rights Iowa, the National Health Law Program, Children’s Rights and Ropes & Gray LLP — said the settlement will make sure children receive “the support they need without unnecessary separation from their homes and loved ones.”

“This Settlement will help ensure that every eligible child receives essential home and community-based mental health services and supports that enable them to grow up in the safety and support of their own home and community,” the statement said.

The groups worked with the Iowa Department of Health and Human Services and Iowa Gov. Kim Reynolds on an interim settlement agreement, which was initially agreed to in October 2023.

Erin Murphy of Gazette Des Moines Bureau contributed to this report.