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N.B. Consent Decree
N.B. Consent Decree
The N.B. lawsuit was filed in 2011 on behalf of Medicaid-eligible children under the age of 21 in the State of Illinois seeking certain mental and behavioral health services under the Early and Periodic Screening, Diagnostic, and Treatment ("EPSDT") requirement of the Medicaid Act. On February 13, 2014, the United States District Court for the Northern District of Illinois certified the case as a class action for the following individuals: "All Medicaid-eligible children under the age of 21 in the State of Illinois: (1) who have been diagnosed with a mental health or behavioral disorder; and (2) for whom a licensed practitioner of the healing arts has recommended intensive home- and community-based services to correct or ameliorate their disorders." In January 16, 2018, the N.B. Consent Decree was approved by the Court.
N.B. Consent Decree Documents
N.B. Consent Decree Interim Relief
During initial Implementation of the N.B. Consent Decree, the Department will continue to address the needs of N.B. Class Members demonstrating medical necessity for a Psychiatric Residential Treatment Facility (PRTF) level of care on an emergent basis through the Interim Relief process described below. This process may be revised as appropriate, consistent with future Implementation processes or updates to the Implementation Plan.
Eligibility for Interim Relief Services
To receive Interim Relief Services, a youth must be an N.B. Class Member meeting the following requirements:
- Be under the age of 21;
- Be enrolled in Illinois Medicaid (eligible under Title XIX of the Social Security Act);
- Not currently be in the custody or guardianship of any State or Federal agency, including the Illinois Department of Children and Family Services (DCFS)
- Provide a letter of medical necessity for PRTF services from physician;
- Consent to Interim Relief Services;
- Provide required clinical documentation as requested; and
- Complete the Interim N.B. Interim Relief Application and Consent Form
To apply for Interim Relief Services
Step 1: Work with the youth's behavioral health provider to obtain a letter of medical necessity for Psychiatric Residential Treatment Facility (PRTF) services for the youth. The letter of medical necessity must be from a physician.
Step 2: Complete the N.B. Interim Relief Services Application and Consent Form.
Parents/guardians of youth who may be potential N.B. Class Members requiring PRTF services on an emergent basis may request Interim Relief Services by submitting a completed Interim Relief Application and Consent Form and a physician's letter of medical necessity to the HFS Bureau of Behavioral Health. The application can be found below.
Step 3: Submit your completed application and letter of medical necessity by mail, fax, or electronically.
Mail applications to:
Healthcare and Family Services
Bureau of Behavioral Health
Attn: Interim Relief Services
201 South Grand Avenue East, 3rd floor
Springfield, IL 62763
Fax applications to:
217-524-1221
Submit applications electronically to the following email address:
HFS.BBH-InterimRelief@illinois.gov. Applicants are strongly recommended to send any electronic submissions by encrypted email and any files or confidential information password protected.
Fax applications to:
Notification: HFS will review the application to make sure it is complete and verify whether the youth is a Class Member eligible to receive services through the N.B. Interim Relief process.
Notification:
The Department will provide written notification of this determination to the parent or legal guardian, or youth as appropriate. HFS has partnered with the University of Illinois at Chicago (UIC) Division of Specialized Care for Children (DSCC) to provide N.B. Interim Relief participants with care coordination and assistance in arranging appropriate services. The DSCC care coordinator will contact the parent or legal guardian, or youth as appropriate, to initiate the care coordination process and discuss options for locating appropriate services and providers to meet the youth's needs.
If the youth is determined to be a Class Member eligible for N.B. Interim Relief Services:
The Department will provide written notification of this determination to the parent or legal guardian, or youth as appropriate, and to N.B. Class Counsel.
If you have additional questions, please call 217-557-1000.