356 Holding Health Insurance Marketplaces Accountable 2015
ants and budget analysts in the Commonwealth and throughout the coun-
try.”142 The Center modeled their goals for the litigation explicitly on other
policy initiatives around the country, rather than on other litigation.143 The
spillover between litigation and legislative approaches, therefore, occurs at
both the front and back ends of structural reform litigation.
The case ultimately went to trial and the federal district court found the
state liable for violating the reasonable promptness and EPSDT require-
ments.144 The plaintiffs’ attorneys established a website cataloguing the implementation of the remedial plan.145 For example, after the implementation
of the remedial plan, the website reported that the percentage of children
receiving screens increased threefold within two years.146 The Rosie D. attorneys conscientiously designed the website to provide training materials
and outcomes data for legislative advocates to use in other states.147
Largely as a result of these efforts, the Rosie D. litigation had impacts
beyond Massachusetts; the case became an important part of an administrative and legislative campaign to increase mental health screening in Connecticut. First, the Center for Children’s Advocacy worked with the Connecticut’s state Medicaid agency to establish a new state program, the
Behavioral Health Screening Task Force, which had the specific goal of addressing the lack of mental health screening in Connecticut.148 Furthermore,
the data from the Rosie D. consent decree provided compelling evidence of
the efficacy of the Massachusetts-approach, resulting in legislation in Connecticut that mirrored the Rosie D. consent decree.149 In this way, structural
reform litigation not only results in further litigation, but can also spur more
142. Rosie D., Goals and Objectives, supra note 141.
143. See id. (“[Staff] investigated innovative programs that have successfully addressed
the emotional and psychiatric needs of children in community settings such as The Kaleidoscope Program in Chicago; Wraparound Milwaukee; and the Mental Health Services Program for Youth (MHSPY), a multi-state pilot program with a site in Cambridge.”).
144. Rosie D. v. Romney, 474 F. Supp. 2d 238, 239 ( D. Mass. 2007).
145. Rosie D: Reforming the Mental Health System in Massachusetts,
http://www.rosied.org (last visited Nov. 16, 2014); see also About Rosie D., supra note 141
(discussing Rosie D. case and how the site was a part of the remedial plan).
146. See TEEN SCREEN, NAT’L CTR. FOR MENTAL HEALTH CHECKUPS AT COLUM. U.,
ROSIE D. & MENTAL HEALTH SCREENING: A CASE STUDY IN PROVIDING MENTAL HEALTH
SCREENING AT THE MEDICAID EPSDT VISIT 1 (2010), available at
explaining that the percentage of children receiving screens increased “just over 14 percent [in
2008] to 58 percent by the fourth quarter of 2009”).
147. Rosie D., Training Materials, http://www.rosied.org/page-84569 (last visited Oct.
148. See JAY SICKLICK, CONN. PUB. HEALTH ASS’N. ANN. MEETING, PARTNERING TO
ADVANCE HEALTH POLICY: FROM BLIND SPOT TO MANDATORY SCREENINGS 11 (Oct. 25,
2013), available at http://c.ymcdn.com/sites/www.cpha.info/resource/resmgr/2013_
149. See id. at 15-20.