J.K. v. Humble (originally filed as J.K. v. Eden) challenged Arizona’s failure to provide mental health services to poor children, resulting in a landmark settlement reforming the state’s behavioral healthcare system for children. However, the glacial pace of implementation has led to a dispute-resolution process and renewed litigation in late 2009.

The class action suit is brought on behalf of over 20,000 Arizona children who seek Medicaid mental health services. The settlement is unique in its approach to reform because it spells out in a legal document a “vision” defining the purpose of children’s behavioral health services and a set of 12 principles for improving the quality of those services, to be incorporated in all aspects of the system’s operations.

The “Arizona Vision” is a fundamental shift in the way the state treats families and children who seek mental health treatment. It emphasizes respect for and partnership with families and children in the planning, delivery, and evaluation of services, and stresses collaboration among the various agencies that serve children, with the goal of enabling children “to achieve success in school, live with their families, avoid delinquency and become stable and productive adults.”

The settlement committed the state to a series of concrete steps, including the development of flexible wraparound supports and case management, child and family teams for all children, training and coaching for frontline staff and supervisors, a quality assurance program that measures fidelity to the principles, and specific improvements in the structure of the managed care arrangement. It anticipated implementation over six years and obliged the state to move “as quickly as is practicable” to make needed changes.

While progress has been made under the settlement agreement, the state did not move as quickly as it committed. In January 2006, the plaintiffs invoked the dispute-resolution provisions of the settlement agreement because of the state’s lack of sufficient progress. In November 2006, state officials agreed to a three-year extension of the terms of the settlement agreement and federal court supervision.


U.S. District Court for the District of Arizona






J.K., on Behalf of a Class of Arizona Children Seeking Mental Health Services


Will Humble, Interim Director of the Arizona Department of Health Services, et al



Technical Assistance Documents and Practice Improvement Protocols from the State

State Implementation Initiatives