SETTLEIVIENT AGREENIENT 1'1 RISEVGER, SE A Civil Action No. 00- 116- B- (D. Me.) TAL. L11 May 3, 2002 WHEREAS, the plaintiffs Michael and Susan RiSinger, on behalf of their minor daughter, Jill Risinger, Annmarie Fitzpatrick, on behalf of her minor son, En'c Fitzpatrick, all on behalf of themselves and all others similarly situated, and the Disability Rights Center of Maine, Inc., and defendants Kevin Concannon, Commissioner of the Maine Department of Human Services and Duby, Commissioner of the Maine Department of Behavioral and Developmental Services desire that the pending litigation be resolved in a manner that will timely deliver services to the children of the State of Maine; The parties hereby agree as follows: l. The DHS and DBDS will develop and comply with the timeliness standards herein for the provision of medically necessary in?home behavioral health and case management services for children under the age of twenty-one (21) who are Medicaid eligible. ?In?home behavioral health services? mean services defined in Chapter II, Section and Section 24.01-2 of the Maine Medical Assistance Manual. ?Case management services? mean services defined in Chapter II, Section 13.12 of the Maine Medical Assistance Manual. 2. For the purpose of calculating the vat-ion agr 1?eed upon .1tra ions under those standards, the Start Date 1,1111 be deerned to be the later of: -arnilv. For .he purposes of this settlement, ?request -or screening services" rneans a request for a behavioral 11e 11.1 screen, a request for assista11cein1dentiying behavioral health needs or a request for-a behavioral health service for a child under the age of twenty-one, and any such request rnust be made to: a DBDS approve eda age thatis participating provider of Medicaid covered case management or in-home behavioral health services to c11ildren. The request can be made by a parent ora guardian, or a school district or a health care provider with the parent?s or gaardian?s permission; or The date upon which financial eligibility under 1 edicaid is determined which will nonnallv be the date of the letter to the clie ntir donning Uhe?hll?l?l of eliig ib 1ylt provided, however, that this date shall in no event be later than forty?11v (45) days from the date upon which a completed application for Medicaid isreceived by DHS, in accordance with 42 C.F.R. 435. 911, unless otherwise 111odified by federal law The time.iness st"ndards shall include: In accordance with 42 CPR. 441.56Ce), an Individual Treatment Plan for in-home behavioral health services will be prepared if the child has a medicaln eefod oar service thactcan be provided as a 11. edicaid covered service under MMAM, Chapter II, Section or ?2401-2. An Individual Treatment Plan which addresses that identi?ed need will be developed in accordance with reasonable behavioral healt. IQ practice, and in no case later than one hundred and twenty (120) days after the Start Date. Services consistent with the plan will commence in accordance with reasonable standards of behavioral health practice, generally within an outer limit of one hundred In accordance with 42 CPR. an Individual Support or Service Plan for case management will be prepared if the child has a medical'need for case management that can be provided as a Medicaid covered service under MMAM, Chapter II, Section 13.12. An Individual Support or Service plan which addresses that identified need will be developed in accordance with reasonable standards of case management practice, and generally within an outer limit of one hundred and eighty (180) days after the Start Date. The parties agree that when a new or different need for in-home support service or case management is identified for a child for whom there already is a Start Date under paragraph 2 of this Agreement, the Start Date for that identi?ed need for the new or different service shall be the date that the need is identified. 4. The foregoing timeliness standards are outside deadlines, gauged to be long enough generally to complete the determination and preparation of the Individual Treatment Plan or Individual Support or Service Plan, and the commencement of the delivery of services, thereunder. DBDS may develop other standards with respect to services, for example, medical eligibility for and the delivery of such services, but only if such standards do not change the requirements of this Settlement Agreement. LJJ LII When making a request for screening services the parent or guardian shall signa release that allows pron- ders to communicate with one another to facilitate the provision and tracking of services and avoid duplication of effort. In addition, the parent gear-liar: rennestia so; ee11ir1g sre 'vices shall be request ted to the pr "7"er at the time of the request of any other requests made on behalf of thee hild and thereafter shall rnalte good faith efforts to keep each provider informed of further requests made to other providers. T?lone of the rovisions in this par graph shall be considered a Medicaid eligibility criterion. In the ev ent t. parent or guardian of ac child requesting case management or in-horne behavioral heath services has been 11 tified of the availability of a qualified provider and has declined the offered service (other tha. for reasons related to .the safety or welfare of the family based on prior dealings wi th the offered prov1der . a 1 v.11. . Qtitt? W11 (D ernedto are its 01.1 1?li nation to provide Medicaid benefit? 1.) Wltu reasonable promptness. 6. In the event of an interruption in case management or in?11orne behavioral health services due to events outside the reasonable control of the recipien family (6.3., resignation or continued unavailability of a case manager or provider), a new case manager or provider will be supplied with due haste without recommencin any of the Lane periods specified herein. 7. Within one hundred and twenty (i 20) days of the date of this Agreement, DBDS W111 develop and implement 11 system that allows DBDS to identify rack each individual child under teh age of 2?1 for 1: 'horn a request has been made to an approved agency as defined in paragraph 2(a) above, in order to disclose whether, for that child, the timeliness standards specified in the foregoing paragraphs 2, 3, and 6, above have been complied with and in order to be able to generate data disclosing the nature and extent of compliance with the timeliness stand?rds set in this Agreement. The s" not track de minimis non?recurring interruptions in the provision of case management or in-home behavioral health services. 8. The DBDS will share with Plaintiffs? counsel on a quarterly basis for six quarters beginning With the quarter ending on September 30, 2002, data or reports generated by the foregoing system described in paragraph 7. The reports will be provided within forty-five (45) days of the end of the quarter and will include the following information: the names of children for whom the standards in paragraph 3 have not been met as well as each of their Start Dates, date of Individual Treatment Plan, commencement of services, interruptions and level of services. 9. Defendants will pay Plaintiffs? attorneys? fees in the amount of one hundred thousand. dollars and costs in the amount of eleven thousand one hundred fifty nine dollars for all of the work done to date and for those.? incurred in securing approval, giving notice of the Agreement, and for monitoring compliance with this Agreement. All such payment of fees will be to Maine Equal Justice Project, and all costs shall be paid to Pierce Atwood. U1 10. Theti 51111553 standards 11-111 05 adopted as an emergency rule by DBDS. A final 11115 w111 b5: adepted within 1115111115 periods established by the Administrative Procedures Act. 11. The Agreement will be subject to approval by the Court in ?ccordance with Federal Rule of Civii Procedure 23 12. The lawsuit will be dismissed with prejudice and Without costs based on the parties' settlement, with the Court retaining jun sdiction for the"11_11ited purpose of ntertaini aims that the Agreeme 5111 has been-violated 5.1- ought' by the parties brought no later than two years after the date of the Agreement. The ?date of the Agreement? sha11 be the date of entry of the Order of Dismissal. 13. P1aintiffs shall provide to defendants and the Attorney General reasonable notice in writing of an alleged violation of this Agreement prior to con?nnencing or ilin 1 any suit based upon such alleged violation. Absent circumsta at would warrant a need for relief in a shorter time period, ?reasonabie notice? is deemed to be 311113! (60) days. 1151 reasonabie written notice, the pa. ies shall engage in reasonable efforts to res oi ve any dispute prior tot iling any 5 1111 or motion. 14. The DHS and DBDS will provide a notice that has been jointly prepared with the Plaintiff?s counsei to all class members currently waiting in?horne behavioral health services as of April 16, 200-, and to case management agencies, and to the agencies providing services under section ?24 and section 65 to the ciass members, an4 such other notice as the Court might require. 1:3. This Agreement sets forth the full agreement between the parties, and any amendment hereof shall be In writing. Representations not contained in this A crr?eernent shall have no effect. On behalf of Plaintiffs. Dated:5"3 ?Ol- [Saw/1A i Willia HUI. Kadatta Pierce, Atwood One Monument Sq. Portland, ME 04101-4033 (207) 791?1100 Patrick F. Ende Maine Equal Justice Partners 5347 Augusta, NIB 04332?5347 (207) 621?8148 On behalf of Defendants: Dated: 5/9/02 Paul D. Stern Deputy Attorney General Office of the Attorney General Six State House Station Augusta, ME 0401 1 (207) 626-8368 W: .1 I .3 1 1 P3113112 E12 UNITED STATES DISTRICT comm 1315111 r121 r315 1.1.1.115 AND 51 R13 LNGER (EN BEHALF 23F THEIR MINOR DAL GHTER IELL RISLWGER: .-.NNMAR1.E FITZPATRECK. ON BEHALF 3F HER MINOR SON. ERIC FITZPATRECK. a: '1 on behalf 11! hamselvas and :11] similariy sikualed: and DISAB RIGHTS C5. OF MAINE. INCL. us Maine' 5 Prom: ItiCrr: and System. 1.11.4 Piainli-ff?s Cni?ACqu?xx?-m-?u-tib-n "1541? y? Era/a"? LEVIN CONCANNOH 1. 011.111.1135 QNER. MAINE DEPA RTMENT OF HLMAN AND LYNN DUHY. COMMISSIONER MA. C-F MENTAL. HEA LTH AND MEJNITAL RETARDATION AND SUE STAN CE ABUSE SEBA- ICES ORDER OF DISMISSAL Pursuant 19 Rd. R. Civ. P. 41(11)th) and 23ft). the: parties, by and thr?ugh their respective cumsci. 111W: agreed an Order dismissing this matter with prejudice and Without casts. This Court heraby dismisses this matter with prejudice and withuut costs subject an the fol low: ng conditions: 1. F01 lowing a pcrzod on" negotiations. the part-11:5 have executcd 21.512111131111311: 131ng: dated April 3.9. 2005.2. and the Court has upproved'thc Set: cment Agreement .1251 :11: ?1 111*: 155-111 21f :nc action pumumt 37:11.3. Ci?. Cc-ur: shat: rel-.1111 .gurisdictiun r' 31' 112-: Bimitcd purpose claim: that the [mi bun Inmated. but only if the claim is Draught 1331 a party no later than after the 12121:: 1 1. 1 . wan?1.1: 1111111111111 .11? has 0:ch of 131377113331}. Sea Ko?cmeu u. Guardian HEM-51. 4- insurance, 31 1 315 '10 lair-riffs aha? provide to d?rcndan - is and the Attorney Gencrai J'cascnx::ble notic: In ?nr'ln . 3T my mugged Holman. arch]: Agreem?nl Pn?ar o" ?iins 4 5? I a . Suit my. suhh 31:53:! s-mlatson. The par-mas shun engage in reasonabis eff-?ans to resolve an 3: dispute during rh?at period. 1, . . In order Ia rcsalvc drspure over utzcm?y3 fccs. and armour czonccdavg an? issue 5f law nr fact. Defendant: have agreed to pay Plainu' atromews' {has in the amount ofone hundred thousand doflnra ($100,000) and mats in the amount cf :huusmd one hundred ?ny nine duilurs ($11,1593fcr wars: dw- :a data: and for those incurrc-i in securing appmVal. giving notice of? the and for monimring ?(?ompiiancc with the Al the request of Piaintiffs' lead counsml. Picrc: Amend. all such payment of has wil! be made to Main: Equal Justice Panzer; Int. tha IDisabiIity Rights Gamer, Inc, and the Mariana! Health Law: ijcct. This amount includes any and all claims for fear. and can: gha: Pfainiit?? and Pinimiffa' mums! may he entitled to make under U.S.C- I988 ar any other stat: or federal swim: at ml: of jJ'racsdu": for all work dent and coats Expanded in litigation of this muttcr. ..- j. Apr I . Dated: :l?uql. 2/175". . Hen. Gen-c Carter Judge, LLS. District Cour: I imam?: I 15: 29 223752377; FINETREELEGAL PAGE as SETTLEMENT AGREEMENT RISINGER, v. MINE DEPARTMENT OF EUR-MN SERVICES, ETAL Civil Action Net wll?-B-C m. M3.) WHEREAS, the plaintiffs Michael and Susan 'Risinger. on behalf of their miner daughter. Jill His-linger! Annmatie Fiupatrick. on behalf of her minor son. Eric FitzPatrielt, all on behalf of themselves and all other: similarly situated. end the Disability Rights Center of Maine, rm. and defendants Xavin Concannon, Commissioner of the Maine Departinent of Human Services and Duby, Conmiissioner 6f the Maine Department of Behavioral and mvelopmentai Sea-vices desire that the pending litigaticm be resolved in a manner that will timely deliver services to the ,t fhildr?n of the State of Maine; The parties herebyiagree its follows: 1. The DHS and DBDS will deveicp and comply with the timeliness standards herein for the provision of medically necessary behavioral health and case management services for children under the age of twenty-em whe ere: Medicaid eligible. ?Tn-heme behaviorai health services? mean services de?ned in Chapter 11, Section. 55.04-30.13 and Section 24:01.2 of the Maine Medical Assistance Manual. ?Case management services? mean services de?ned in Chapter H. Section 13.12 the Maine Medical Assistance Manual. hails/28212 15:29 2375237771 PINEFREELEGAL PAGE as 2. For the purpose of calculating the various agreed upon durations under those standards, the Start Date'will be deemed to be the later of: A request for screening services by or on behalf of the family. For the purpoacs of this settlement, "request for screening services" means a request for a behavioral health screen. a request for assistance in identif? Ing behavioral heai :h needs or a request for a heha?iorai heaith service for a child under the age of twenty-one, and any each request must be made to: a DBDS~approved agency that is a participating provider of Medicaid covered case inanagement or in-home behavioral . The date upon whic. ?nancial eligibility under Medicaid is detcnninod which will nonnally be the date of the letter to the client informing hedhim of eligibilty pmVidcd, however. that this date shall in no event be later than forty-?ve (45) days from the date upon which a completed application for Medicaid is received by DHS, in accordance with 42 GER. 435.911, unless otherwise modi?ed by federal law. 3. The timeiineaa standards shall inciode: In accordance with 42 GER. an Individual Treatment Plan for in-horne behavioral health services will be prepared if the child has a medical need for a service that can be provided as a Medicaid covered service under m; Chapm 3. Section 6534?36-1) or 24.01-2. An Individual Treatment Plan which addresses that identi?ed need will be developed in accordance with reasonabie behaviorai health neglexzam 15:29 227?6237?5. INETREELEGAL PAGE 6? In accordance with 42 GER. an Illi??i'ldu?l Support or Service Plan tor case management wiil be prepared if the child has a medical need for case management that can be provided as a Medicaid covered service under WM. Chester the Smart Date. i" The parties age that when a new or different need for in?home support service or case'management is identi?ed for a' child for whom there already is a Start Date under paragra?h 2 of this Agreement. the Start Date for that identified need for the new or different service shall be the date that the need is identi?ed. '41. ?The foregoing timeliness standards are outside deadlines, gauged toge long enough generally to complete the determination and preparation of the Individual Treatment Plan or IndiVidual Support or Service Plan, and the commencement of the delivery of services, thereunder. BEDS ma}.r develop other standards with respect to services, for example. medical ell gibility for and the delivery of such services. but only if such standards do not ehenge the reqoirements of this Settlement Agreement. 38x 15/ 2882 1 5: 29 28752377 PAGE as provision and hacking of services and avoid duplication of effort. In addition. the parent or guardian requesting acre-"ting services shall be requested to inform the provider at the time of the request of any other requests made on behalf of the child and thereafter shall make good faith often: to keep each erovider in "canned of further requests made to other providers. None of the provisions in this paragraph shall be considered a Medicaid eligibility Criterion. In the event the parent or guardian of a child requesting case management or behavioral health services has been noti?ed of the availability of I t. a quali?ed provider and has declined the offered service (other than for reasons related to the safety or welfare of the family based on prior dealings with the offered pToVider). the State \vill be deemed to have ?ilfilled its obligation to provide Medicaid bene?ts with reasonable promptness. 6. In the event of an interruption in case management or in-home behavioral health services due to events ouuide the reasonable control of the recipient family (man. reSigrmtion or continued unavailability of a case manager or provider}. a new case manage:- or provide:- will be supplied with due haste without recommencing any of the time periOds speci?ed herein. Within one hundred and twenty (1201daya of the date of this Agreement, DBDS will develop and implement a system that allows 13an to identify and back will individual child under the age of 21 for whom a request ha; been mm to an approved 88/15/2592 15:29 2237523775-. PACE 39 agency as de?ned in paragraph 2(a) above, in Order to disclose whether. for that child, the timeliness standards speci?ed in the foregoing paragraphs 2, 3. and o" above have been complied with and in order to be able to generate data disclosing the nature and extent of commence with the timeliness standard: set forth'in this Agreement. The system need generated by the foregoing system described in paragraph 7. The rcports will be ?rovided within forty-?ve (45) day: of the end of the quarter and will include the following information: the names of children for whom the standards in paragraph 3 have not been met as well as each of their Start Dates, date of Individual Treatment Plan. commencement of services, mun-options and level of services. 9. Defendant: will pay Plaintiffs? attorneys? fees in the mount of one hundred thousand dollars and costs in the mount of eleven thousand one hundred ?fty nine dollars for all of the work done to date and for those incurred in seeming anpmval, giving notice of the Agreement. and for monitoring compliance with this Agreement. All such payment of fees will be to Maine Equal Justice Project, and all costs shall be paid to Pierce Atwood. 5 B?flsx2882 15:29 28762377} PAGE 18 Procedures Aet. 11. The Ageement will be subject to approval by the Court in accordance with Federal Rule of Civil Procedure 239:). 12. The iawsuit will be dismissed With mjuo?iee and Without costs baSe-d on shall be the date of eon-y of the Order of Dismissal. 13. Plaintiffs shall provide to defendants and the Amway General reasonable notice-fin wn'ting of any alleged violation of this Agreement prior to Wang or ?ling any suit based upon such alleged violation. Absent circumstances that would wan-ant a need for relief in a shorter time period, "reasOnable notice" is deemed to be sixty (60) days. \fter reasonable written notice, the parties shall engage in reasonable efforts to resolv'a any dispute plain: to oiing any suit or motion. 14. The DES and BEDS will provide a notice that has been jointly prepared with the Plaintiff?s counsel to all class members currently awaiting in-home behavioral- health-serous as of April i6. 2002. and to case management ageneiu, and to the agencies providing services under section 24 and section 65 to the class members. and such other notice as the Court might require. 69/}Ex2882 15:29 28762377? 15. This Agrecm amendment hereof shall bc in writing. Represcntations not contained in than have no effect. "C?rl Dated; 5/2/92 PINETREELEGAL PAGE 1 1 en: sets forth the full agrcemenr between the parties. And am} this Agnemnt On behalf cf PEaz'ntiffs: . mi Heme, Wood 0116 Monument Sq. Portland. ME 04101-4033 (207) 791-1100 - Panic}: F. End: Maine Equal Justice Putnam 13.0ch .5347 Augusta, ME 04332-5347 (207) 621-3143 On behalf of Defendants: inn} Stem - Deputy Attmy Gena-:1 Of?ce of the Atmmey Galen] Six State House Station Augusta. ME 04011 (207) 626-3563