Ohio Legal Rights files EPSDT Suit

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Dear Friend of ASO:

Information from the ARC of Ohio regarding a lawsuit filed regarding EPSDT - Early Periodic Screening Diagnosis and Treatment Program. FYI - please share.

Sincerely,

Barbara C. YavorcikPresidentAutism Society of Ohio701 S. Main St.Akron, OH 44311(330) 376-0211fax: (330) 376-1226email: askASO@...home: byavorcik@...web: www.autismohio.org Please note: This is provided for information purposes only. The ASO does not endorse or recommend any providers, methodologies or services. Providing this information should not be construed as an endorsement by the ASO, either explicit or impiled.

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The Ohio Legal Rights Service (OLRS), an independent agency charged by both state and federal law to protect the legal rights of Ohioans with disabilities, has taken action in federal court on behalf of children who are eligible for but are not receiving needed medical services under the state's Medicaid program. Many of these children had previously received services under the Community Alternative Funding System (CAFS) program, which the state voluntarily ended on June 30, 2005. According to Carolyn S.

Knight, Executive Director of OLRS, "EPSDT is a vital program for many children with disabilities who are in need of health care services. The purpose of this lawsuit is to assure that Ohio has a well-designed, fully implemented system in place where children with disabilities can apply for and receive needed treatment under the EPSDT program. The filing of this lawsuit is especially significant given the elimination of CAFS funding for important disability related services in schools and county programs for these children."

The class action complaint, filed on October 26, 2005 in United States District Court in Columbus, is brought against the director of the Ohio Department of Job and Family Services (ODJFS) on behalf of a class of Medicaid eligible children who are being denied the benefits of Ohio's Early Periodic Screening Diagnosis and Treatment (EPSDT) program.

Federal law requires that state officials periodically screen Medicaid eligible children for health problems. If a child's screening identifies health problems, the law also requires the EPSDT program to provide necessary health care, diagnostic services and treatment that will correct or improve the health problems, even if the services are not routinely covered by Ohio's Medicaid plan.

The class action alleges that the ODJFS violates federal law because it does not have a system in place that allows Medicaid eligible children to apply for and receive necessary treatment services from EPSDT.

OLRS filed the class action with the consent of its governing Commission after concluding that this violation of federal law significantly impacts health care for Ohio's children with disabilities, particularly in light of recent developments in health care service provision in this state.

The complaint asks the judge to order the director of ODJFS to provide medically necessary services for the named plaintiffs in the case, three children who have disabilities and, on behalf of the class, to develop policies and procedures that set up an effective and reasonable method for eligible children to access medically necessary services under EPSDT.

The lawsuit is assigned to U.S. District Judge D. Holschuh.

Read a copy of the class action complaint web page:

http://olrs.ohio.gov/other/EPSDTComplaint.pdf (PDF file) (Note: To view and print PDF documents, you need to have Adobe® Reader®, a free software program, installed on your computer. Download Adobe® Reader®)

For more information contact Kirkman, Legal Director, 1-800-282-9181 or 614-466-7264.