LAWSUIT: HAWAI‘I DEPARTMENTS OF HUMAN SERVICES (DHS) AND HEALTH (DOH) FAILING KEIKI WITH MENTAL HEALTH CONDITIONS

News Release from Lawyers for Equal Justice

HONOLULU, July 22, 2019 — The parents of Soleil “Kela” Feinberg held a press conference to discuss their civil rights lawsuit against the state for failure to provide necessary mental health services to their daughter. The state abruptly cut off prescribed, medically-necessary mental health services after Kela turned 18 even though federal law requires the state to continue services until age 21.

The lawsuit alleges that Kela needed intensive mental health services when she returned to Hawai‘i from a mainland facility where she was being treated. Instead of providing the prescribed treatment, officials from the Hawai‘i Department of Health’s Child and Adolescent Mental Health Division (CAMHD) told the family that Kela was no longer eligible for treatment from CAMHD because of her age. Although the state promised to provide mental health services through another program, the family said the services never materialized.

Unable to access the services she needed, Kela’s condition worsened; her family was forced to commit her to the Molokini mental health unit at Maui Memorial Hospital in July 2017. According to the federal court complaint, this began “a cycle of crisis, commitment to Molokini, initial improvement following discharge due to the intensive efforts of her family and support group, followed by another crisis and recommitment to Molokini.”

Ultimately, Kela was committed to the Hawai‘i State Hospital in Kāne‘ohe in late 2018. She remains in the hospital now following a court determination that she is incapable of participating in court proceedings.

“If Kela had gotten the treatment she needed, none of this would have happened,” said Kela’s mother, Victoria Feinberg. Feinberg sent a May 2017 email to the state in which she predicted that the state’s plan would “create a very high probability of another severe mental health crisis for Kela and her family.”

“The state basically ignored me and all the warning signs,” Victoria said.

“The system is failing our keiki and causing them significant long-term harm,” said Paul Alston of Dentons US LLP, co-counsel for the plaintiffs. “Failure to provide necessary mental health services during childhood and adolescence exacerbates mental health symptoms, results in repeated, avoidable hospitalizations and unnecessary juvenile detention, and reduces our keiki’s prospects of becoming productive adults.”

The family’s attorneys believe that Kela’s case is not an isolated one. “Although the law is clear that the state has to provide services until age 21, the state is routinely ending mental health services after age 18,” said Victor Geminiani, Executive Director of LEJ. “We believe that there are dozens or hundreds of other young people in Hawai‘i who are suffering because the state simply isn’t doing what the law requires.” This topic is the subject of a report released today by LEJ laying out findings about the lapse in care provided by the state. The report is available at hiequaljustice.org.

Geminiaini encouraged families who may be affected by the state’s practices to contact LEJ.

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Mental healthcare in Hawaii: Young minds at risk

The state of mental healthcare for Hawai‘i’s medicaid-eligible youth

“The State shall … provide for the treatment and rehabilitation of handicapped persons.” — The Constitution of the State of Hawai‘i, Article IX, Section 2.

EXECUTIVE SUMMARY — Every person has the right to live a dignified life. Essential to this dignity is the fulfillment of basic needs. Adequate medical care is one such need, but as a result of the high cost of healthcare in this country, it often goes unfulfilled. In an effort to ensure that low- and moderate-income people have access to care, our federal government created the Medicaid program. Medicaid is the only source of health insurance for millions of low-income families. More than 100,000 keiki in Hawai‘i get their healthcare through Medicaid.

However, the mental healthcare system for these children is broken. Patients, providers, and administrators alike agree that quality care is hard to come by—there is a catastrophic dearth of services for low-income youth. Thousands of the most vulnerable children among us live with untreated, severe mental illness, and the number only continues to grow.

This is not a new problem. In 2013, a Juvenile Justice Working Group created by the state of Hawai‘i issued a report highlighting deficiencies of the mental healthcare system in the context of the juvenile justice system. The report included the following findings:

• There is an “urgent need for enhanced access to mental health and substance abuse treatments,” especially at the early stages of a youth’s contact with the court.
• Wait times and administrative criteria inhibit or “severely delay” access to treatment and services.
• Even after a youth’s needs are identified, those needs may be left untreated, leaving the youth to “languish in the system.”
• There is a “significant deficiency in treatment resources across the state.”

In August 2016, Lawyers for Equal Justice (LEJ) met with the then-leaders of the Hawai‘i Department of Health (DOH) and Department of Human Services (DHS) to raise concerns regarding the mental health system surfaced by an extensive investigation involving the review of reams worth of public documents and interviews with service providers and others with knowledge of mental health services in Hawai‘i. While the state provided assurances that it was working to address the issues, nearly three years later, the problems persist.

Meanwhile, Hawai‘i’s children and youth who are struggling with mental health issues suffer the consequences. And all of Hawai‘i’s is left to deal with the lifetimes of adverse impacts that result from each child who doesn’t receive adequate mental health treatment when it matters most.

In this report, LEJ summarizes its findings with respect to the accessibility and quality of mental health care for Hawai‘i’s Medicaid-eligible youth. Many of the State’s practices violate the law. As detailed below, LEJ has filed suit in an effort to correct one of the clearest illegalities: the DOH’s failure to provide necessary mental health services to youth after they turn 18.

LEJ hopes that the State will take seriously the constructive criticisms set forth in this report; that the governor will direct the attorney general and the heads of DOH and DHS to take immediate action to address the problems identified; that the Hawai‘i State Legislature will provide appropriate funding; and that DOH and the Department of Education (DOE) will take advantage of opportunities to renew their dedication to helping boys and girls struggling with mental illness.

These issues will be best resolved through a proactive, cooperative approach rather than protracted and expensive litigation that will almost certainly end in court orders directing the state to provide the vital services required by federal law. But something must be done.

LINK >>> Download a PDF of the report