John B: A Primer
The John B Decree of March, 1998 was a consent decree between a group of children with TennCare (the plaintiffs) and the Tennessee Department of Health, the Bureau of TennCare, and the Department of Children's Services (the defendants) in the US District Court, Middle District of Tennessee. The plaintiffs argued they did not have appropriate access to health services under Medicaid's equal access provision. The defendants agreed to work to improve quality of, and access to, EPSDT services for kids with TennCare, and to continue to monitor progress in these areas.
January 2001: Seeing little progress in nearly three years, the plaintiffs file a motion to show cause why the defendants should not be held in contempt of court for failing to comply with the consent decree. The Court concluded the defendants were not in compliance and appointed a Special Master to oversee a compliance plan.
June 2004: Again, seeing little progress, the plaintiffs file a second Motion to Show Cause.
October 2004: The Court denied the motion, stating, "The State has made progress toward compliance in some areas. However, these efforts have not produced the results mandated by the consent decree six years ago." The Court's Special Master provides a comprehensive set of specific metrics and timeline for implementation
January 2007: The five appointed Monitors publish a report on progress toward compliance: "The State Defendants have failed to establish current, substantial compliance with the Consent Decree." The report went on to say, "Screening is only effective if it leads directly to treatment and diagnosis. The more important measure of the efficacy of the Defendants' efforts to comply with Medicaid law is whether children are appropriately diagnosed and treated."
