Federal Judge Rules Against Mental Health Agency
By Rose Hoban
A federal judge ruled today that people with mental health disabilities have a constitutional right to due process when it comes to questioning the amount of services they receive from state-funded providers.
“The sad thing is we had to go to court to make sure people were assured of their constitutional rights,” said Vicki Smith, executive director of Disability Rights North Carolina.
At issue was the case of L.S., K.C. and others who live in the area of North Carolina served by Piedmont Behavioral Health, a mental health service provider based in Salisbury, that serves Cabarrus, Davidson, Rowan, Stanley and Union counties.
L.S. and K.C. are part of the community alternatives program (CAP), that allows people with severe developmental, and sometimes, mental health disabilities, to live and get care at home rather than in an institution. Those services include things like bathing, dressing, feeding and other activities of daily living. About 700 people are eligible for the care in Piedmont’s service area.
Last year, Piedmont Behavioral Health told L.S. and K.C. and others in the CAP program that their services would be changed according to new method of calculating how much home service they needed.
“In K.C.’s case, services went down dramatically,” Smith said.
Piedmont sent letters informing people of their new service level. The letters told people they would be entitled only to specific dollar limits to their care and they also told to contact their case managers to reduce or modify their services to make them fit into the new budget limits.
The letters failed to tell people they had the right to appeal. Piedmont made the case in court that the agency had no obligation to give their service beneficiaries details on how decisions were made. In her ruling, federal district court judge Louise Flanagan tersely dismissed those arguments. She wrote, “plaintiffs were entitled to the notice and appeal rights outlined in the Medicaid regulations… as well as under general principles of due process.”
Flanagan also ruled that K.C. and L.S. are part of a larger ‘class’ of plaintiffs. This means that the ruling could apply to every person who participates in the CAP program around the state, about 10,000 people.
Smith said today the case is significant because as the mental health system changes statewide, the state law mandating those changes requires new mental health agencies to adhere to Piedmont’s model of doing business.