Iowa’s health agency will take steps to develop home and community-based services for children with severe mental and behavioral needs as part of an initial agreement with civil rights groups that filed a class action lawsuit.

The lawsuit was filed in January on behalf of three children. It alleges that Iowa has for decades failed to meet its legal obligations to Medicaid -eligible children who should have access to individualized and coordinated care plans, in-home therapy and emergency services.

The complaint includes children who have been institutionalized for services that they were previously recommended to receive — and say they were entitled to receive, given the Medicaid Act — in their communities or homes.

“There was a desperate need to build a statewide children’s health system with an effective array of services,” said Catherine Johnson, executive director of Disability Rights Iowa. “The complaint that we’ve filed alleges that these services are not available in anywhere in Iowa. They just don’t exist.”

Iowa’s Department of Health and Human Services agreed to consult at least monthly with groups that filed the lawsuit, including Disability Rights Iowa and Children’s Rights, as officials develop a plan to provide these services and manage oversight.

Kelly Garcia, the department’s director, said a “multi-year effort” on Medicaid services in Iowa was already underway prior to the initial agreement.

“Iowa HHS has spent the past several years honing its work to better support children and families,” she said in a statement.

The parties would have until July 1, 2024, to reach a final settlement, which must include a mutually agreed-to plan for implementation of these services and performance metrics.

Johnson is optimistic about the work over the coming months, but she added that “time is of the essence” for these children and families.

“They would like to have these services — well, they would have liked them years ago,” she said. “There is certainly an urgency to providing these services.”