Court Finds Continuing Violation of Federal Law in Children’s Mental Health Case

February 13, 2019

In a strongly-worded decision, Judge Michael Ponsor denied the Commonwealth’s Motion for Substantial Compliance, refusing to terminate active court oversight and monitoring of the Massachusetts’ home-based service system created under Rosie D. v. Baker.  After extensive briefing and oral argument in 2018, the Court concluded that persistent delays in timely access to remedial services constituted a continuing violation of federal Medicaid law and the Court’s 2007 Judgment.

The Court’s opinion recognizes delays in timely access to services can have profound, negative consequences for class members and their families, including “violent physical outbursts, summoning of the police, removal from the home, and traumatizing unnecessary hospitalizations. “  The Court described a “protracted failure to improve timely access to home-based services,” like Intensive Care Coordination (ICC) and In-Home Therapy (IHT), and admonished the State for having no concrete plan, nor specific actions designed to “alleviate this glaring failure in compliance.”  As a result, the Court held that “[d]efendants have so far failed to provide these clinical services to a large portion of the Plaintiff class with anything approaching “reasonable promptness.”

Noting that both the final remedial Order, and the Medicaid access standard for ICC, were proposed by the defendants, the Court sent a strong message that the Commonwealth should be held accountable to these standards.  The decision concluded by stating that “[s]omething effective must be done, some credible plan adopted, something other than vague excuses must be offered, before court monitoring and oversight can be terminated.’’

Following Judge Ponsor’s retirement, continuing oversight of the 2007 Judgment will be transferred to Judge Richard Stearns, and the Federal District Court in Boston.

Visit CPR’s dedicated website,, for more information about the litigation and the briefings leading up to the Court’s decision.

Additional Resources:

Boston Globe: 2/9/19 – Federal judge: State fails to provide prompt mental health care to poor children, by Liz Kowalczyk.