In 2018, the State of Alabama signed a Settlement Agreement to provide a range of intensive home-based services to thousands of Medicaid-eligible youth with Autism Spectrum Disorder (ASD) or Serious Emotional Disorder (SED). The Agreement, entered in response to a demand letter and proposed ESDPT class action lawsuit prepared by the Alabama Disabilities Advocacy Program (ADAP) and the Center for Public Representation (CPR), requires the State to provide five home-based services are modeled after those ordered in the landmark EPSDT case, Rosie D. v. Romney. The Agreement also requires the State to make significant improvements to its EPSDT screening and assessment process, to eliminate access and eligibility restrictions on existing mental health services for children and youth with SED, to develop medical necessity and program specifications for each new home-based service, and to seek funding over the next two years to develop these new services.
When the State failed to fully implement all of the required remedial services as required, the parties signed two extensions of the Agreement to afford the State additional time to expand home-based services for children and youth with SED and ASD.