Turner-York Health Settlement: Terms, Coverage, and Timeline

The C.K. v. McDonald settlement, given final approval on January 15, 2026, requires New York State to overhaul the mental health services it provides to Medicaid-eligible children under 21, guaranteeing statewide access to intensive home and community-based care rather than paying money damages to individual class members. The state has until July 15, 2027 to finalize the blueprint for that overhaul.

What New York Agreed to Provide

The settlement obligates the state to make four categories of services available across New York:¹

Intensive Care Coordination, meaning assessment, care planning, referral, monitoring, and crisis planning delivered through a child and family team. It can be provided through High Fidelity Wraparound, a second tier of intensive care coordination, or Youth Assertive Community Treatment.
Intensive Home-Based Behavioral Health Services, meaning therapeutic interventions delivered in the home or community to build functional skills.
Mobile Crisis Services, meaning around-the-clock intervention, de-escalation, and safety planning to prevent institutionalization.
Medicaid Home and Community-Based Waiver Services, including respite care, caregiver training, and specialty services for children with Serious Emotional Disturbance.

Beyond expanding those services, the state has to update eligibility criteria and service standards, review Medicaid reimbursement rates on a regular basis to ensure they attract enough providers, put statewide screening and assessment protocols in place, and run a public information campaign so families and referring providers actually know what exists.¹

Who Is Covered

Two certified classes benefit from the agreement.² The EPSDT Class covers all current or future Medicaid-eligible children in New York under 21 who have a mental or behavioral health condition not attributable to an intellectual or developmental disability, and for whom a licensed practitioner has recommended intensive home and community-based services. The ADA Class is a subset: children whose conditions substantially limit major life activities and who are institutionalized, segregated, or at serious risk of institutionalization.

No individual class member receives a payment. The relief is systemic, meaning access to services rather than compensation for past denials.

Timeline for Implementation

The settlement’s effective date is January 15, 2026, and the state has 18 months from that date, until July 15, 2027, to finalize a Unified Implementation and Improvement Plan.³ That plan is the operational blueprint covering service delivery, quality management, and accountability. It is being developed through monthly status meetings with plaintiffs’ counsel and an Independent Reviewer, with drafts subject to a 15-day feedback period before the final version goes to Judge Nusrat J. Choudhury for approval.⁴

How Compliance Will Be Monitored

Suzanne Fields serves as the Independent Reviewer, overseeing compliance, facilitating dispute resolution, and recommending subject matter experts.⁴ The state has to build a data-driven Quality Improvement Plan with performance indicators tracking the provision, timeliness, sufficiency, and effectiveness of services. A publicly available dashboard will let anyone check progress. The Quality Improvement Plan is updated annually and submitted for court approval, and audit protocols and corrective action procedures are built into the agreement. Disputes have to go through the Independent Reviewer before either side can seek court enforcement. Judge Choudhury dismissed the case with prejudice on January 15, 2026, but retained jurisdiction to enforce the terms.⁵

The Service Gap the Settlement Is Meant to Close

New York’s Medicaid program covers more than 2.2 million people under 21, and the case was brought on behalf of hundreds of thousands of eligible children. In 2017, the Office of Mental Health projected that over 200,000 children in Medicaid needed treatment and support services. By 2020, fewer than 16,000 were receiving them, less than 8% of those eligible. For intensive home and community-based waiver services, the state estimated 65,000 children needed them; only about one-tenth that number was enrolled.⁶

The complaint traced part of the shortage to a 2014 state plan that cut children’s psychiatric hospital beds by nearly a third. The intention had been to shift resources toward community-based care, but the outpatient alternatives never materialized, leading to longer waits for inpatient beds during mental health emergencies and families told repeatedly that programs were full or that assigned providers had disappeared.⁶ Late-2024 provider surveys confirmed waitlists across every region of the state, with the Citizens’ Committee for Children reporting families waiting “weeks, months, and even years.”⁷

The suit alleged violations of three federal laws: the Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) provisions of the Medicaid Act, which require states to cover all medically necessary services for enrollees under 21; Title II of the Americans with Disabilities Act; and Section 504 of the Rehabilitation Act.⁸ EPSDT services must “correct or ameliorate” physical and mental conditions, cannot be capped, and must be delivered in the least restrictive setting appropriate under Olmstead.⁹

Where Implementation Stands Now

As of mid-2026, the Office of Mental Health says work to improve access is “already underway” and that the settlement provides a “solid framework” for reform.¹⁰ The agency held an introductory webinar on March 25, 2026, and scheduled community stakeholder feedback sessions for the summer of 2026 to hear from families, youth, providers, and advocates before drafting the implementation plan.¹¹

Money is the immediate flashpoint. The “Healthy Minds, Healthy Kids” campaign asked for $200 million in the state’s fiscal year 2027 budget to reform Medicaid reimbursement rates and expand outpatient access, estimating that the investment could add 1,300 professionals and serve more than 26,000 additional children.⁷ Governor Kathy Hochul’s executive budget excluded the funding, and the enacted budget also left it out, providing only a 2.7% inflationary increase for human service providers. The campaign called the omission a failure to address “severe reimbursement rate challenges” and continues to push for legislation carving behavioral health services out of Medicaid managed care.¹²

The workforce shortage is the other unresolved obstacle. Advocates estimate the state needs nearly 6,300 additional workers in the youth mental health sector to meet demand, and chronically low reimbursement rates are widely cited as the main driver of turnover and provider shortages.¹⁰ The settlement’s requirement that the state set reimbursement rates “sufficient to enlist enough providers” carries no dedicated legislative funding behind it, and whether that language will translate into real rate increases is the open question that will define how quickly children on Medicaid actually see the services they were promised.⁷

1
Disability Rights New York. Notice of Proposed New York Class Action Settlement
2
GovInfo.gov. C.K. v. Bassett, No. 2:22-cv-01791 (E.D.N.Y.)
3
New York State Office of Mental Health. Introduction to the Children’s Mental Health Settlement Agreement Webinar
4
New York State Office of Mental Health. Proposed Settlement Agreement, C.K. v. McDonald
5
Children’s Rights. Opinion and Order Providing Final Approval of Class Action Settlement
6
Children’s Rights. NYS Failed to Provide Legally Required Mental Health Care to Kids
7
Citizens’ Committee for Children of New York. Building a Stronger Behavioral Health Workforce for NYS Children
8
New York State Department of Health. Proposed Class Action Settlement, C.K. v. McDonald
9
Medicaid.gov. State Medicaid CHIP Behavioral Health EPSDT Toolkit
10
Spectrum News. New York to Overhaul Medicaid Mental Health Care for Children Under Landmark Settlement
11
New York State Office of Mental Health. Children’s Mental Health Settlement
12
Citizens’ Committee for Children of New York. Campaign for Healthy Minds Healthy Kids Statement on New York State FY27 Budget