April 14, 2016•Alerts
Families of Pennsylvania Children with Autism Spectrum Disorder are Invited to Attend Court Hearing to Approve Settlement Agreement
Families of Pennsylvania children with Autism Spectrum Disorder are invited to attend a court hearing to approve the settlement agreement in the class action lawsuit Sonny O. v. Dallas. Please see the Notice below and share with others.
If you require the notice or settlement agreement in an alternate format, other language, or require any other accommodations, please contact us 1-800-692-7443.
Las familias de niños Pennsylvania con trastorno del espectro autista están invitados a asistir a una audiencia en la corte para aprobar el acuerdo en el pleito de acción de clase Sonny O. v. Dallas. Para Espanol, haga clic aqui y compartir con los demás.
Si usted requiere el acuerdo o arreglo previo aviso en un formato alternativo, otro idioma, o requiere cualquier otro alojamiento, por favor en contacto con nosotros 1-800-692-7443.
IN THE UNITED STATES DISTRICT COURT
FOR THE MIDDLE DISTRICT OF PENNSYLVANIA
SONNY O., Jr., by his mother and Next :
Friend Maria G., DANIEL D., by his :
mother and Next Friend, Nadine D., and :
VALERIE H., by her mother and Next :
Friend, Liliya H., :
Plaintiffs, : Filed via ECF System
- : Civil Action No. 1:14-cv-01110
: (Judge Yvette Kane)
: (Magistrate Judge Carlson)
THEODORE DALLAS, in his official :
capacity as Secretary of Human : Class Action
Services of the Commonwealth :
of Pennsylvania, :
PLEASE READ THIS ENTIRE NOTICE CAREFULLY.
YOU ARE NOT BEING SUED, AND YOU DO NOT NEED TO DO ANYTHING.
YOUR CHILD’S RIGHTS MIGHT BE AFFECTED BY THE PROPOSED SETTLEMENT OF A CLASS ACTION LAWSUIT IN FEDERAL COURT IF
YOUR CHILD HAS AUTISM SPECTRUM DISORDER (“ASD”) AND IS OR WILL BE ENROLLED IN PENNSYLVANIA MEDICAL ASSISTANCE.
This notice is to inform you of the proposed settlement of a lawsuit and a hearing to be held by the Court to determine whether the settlement should be approved.
Background of the Lawsuit
In 2014, three children with Autism Spectrum Disorder (ASD) filed a class action lawsuit against the Secretary of the Pennsylvania Department of Human Services (DHS, formerly the Department of Public Welfare) claiming that DHS was violating federal law by not providing a critical therapy called Applied Behavioral Analysis (ABA) to treat their ASD. ABA is used to develop needed skills through the use of reinforcement, prompting, task analysis or other appropriate interventions. The lawsuit alleged that DHS did not provide the full scope of ABA, used medical necessity guidelines that were not designed to determine the need for ABA, did not require providers to have training in ABA, and did not allow qualified ABA providers to enroll in the Medical Assistance (MA) program. DHS denies that it is violating federal law.
The parties negotiated a Settlement Agreement on behalf of a class of children (under age 21) who, now or in the future, are receiving MA, are diagnosed with ASD, and request ABA from DHS’s behavioral health system.
The Court must decide whether to approve the Settlement Agreement after a public hearing that you may attend. At the hearing, the Court will decide if the proposed Agreement is fair, adequate, and reasonable. Below is important information about the Fairness Hearing and a Summary of the Agreement.
THE SETTLEMENT FAIRNESS HEARING: To decide whether the proposed Settlement Agreement is fair, adequate, and reasonable, the Court will hold a hearing at 9:30 a.m. on June 6, 2016 at:
Ronald Reagan Federal Bldg. & U.S. Courthouse
228 Walnut Street
Harrisburg, PA 17101
If you want to testify at or go to the hearing, you must send a letter or e-mail NO LATER THAN May 23, 2016 to:
Rachel Mann, Esquire or Koert Wehberg, Esquire
Disability Rights Pennsylvania
1315 Walnut Street, Suite 500
Philadelphia, PA 19107
You can also write a letter or e-mail with your opinion about the Settlement Agreement if you do not want to testify at or go to the hearing. Send the letter or email NO LATER THAN May 23, 2016 to Rachel Mann, Esquire or Koert Wehberg, Esquire at the address above, and they will give it to the Court.
Summary of the Proposed Settlement Agreement
ABA, which is provided through DHS’s Behavioral Health Rehabilitation Services, will have a separate designation.
With input from experts, DHS will issue new guidelines for deciding when ABA is medically necessary, consistent with the standard of care. After getting stakeholder input, DHS will issue a Bulletin that will provide information on ABA and the new guidelines. The Bulletin will explain, among other things, that ABA can be used to develop the skills necessary to perform activities of daily living if a child has an ASD-related deficit and that a child does not have to have negative behaviors in order for ABA to be approved.
By mid-July, 2017, DHS will issue new regulations that will include the training and experience required to provide ABA. Until the regulations are issued, DHS will require providers who wish to provide ABA to state in writing that they have licensed staff that have confirmed in writing that they have the needed knowledge, skills, and training to provide ABA as set out in a document (Exhibit A to the Settlement Agreement) and that their support staff are trained in the ABA interventions being used with children they serve. Each Behavioral Health Managed Care Organization (Perform Care, Value Behavioral Health, Magellan, Community Behavioral Health (CBH), and Community Care Behavioral Health (CCBH)) will be required to list qualified ABA providers in their provider directories.
DHS will allow a qualified ABA provider agency to enroll in the MA program whether or not it has a mental health license.
DHS will track both requests for ABA from families and the ability of the Behavioral Health Managed Care Organizations to deliver ABA by qualified providers. If a Behavioral Health Managed Care Organization does not have a qualified provider in its network to provide timely services for a child who needs ABA, it will have to contract with an out-of-network provider so that the child can receive ABA.
DHS will have a contact person for families who have concerns or complaints about access to or quality of ABA services.
If the court approves the settlement, the case will stay open either for two years after the Bulletin described above is issued, or eighteen months after the new regulations are in effect, whichever is later.
DHS will monitor the services of the three named Plaintiffs and pay Plaintiffs’ attorneys’ fees and costs.
The full agreement, including Exhibit A, can be found on Disability Rights Pennsylvania’s website at http://www.disabilityrightspa.org or can be requested in hard copy by calling Disability Rights Pennsylvania at 1-800-692-7443.
For more information about this lawsuit and the proposed Settlement Agreement, call Rachel Mann, Esquire or Koert Wehberg, Esquire at Disability Rights Pennsylvania at the number above.
DO NOT WRITE OR TELEPHONE THE COURT.
Dated: April 14, 2016