8-24-05 - A federal judge has found the state in violation of an agreement meant to improve health care access for Medicaid-eligible children and young adults.

Following a class-action lawsuit by San Antonio attorney Susan Zinn claiming the state violated federal law by failing to inform poor families of available services, the state signed an agreement in 1995, saying it would improve health care access to indigent youths.

"In sum, (the state has) violated and continues to violate multiple ... provisions (in the agreement) without regard for the obligations contained therein, and the court finds that they have not exerted reasonable efforts to comply with all, or substantially all of the judgment," Senior U.S. District Judge William Wayne Justice said in the 112-page order signed Monday.

Zinn said she was pleased with the ruling but was concerned the state would continue its appeals. Zinn sued the state in 1998 for failing to comply. That resulted in a ruling by Justice in 2000 that the state failed to provide required services. Five years of appeals have brought the case back to Justice.

"I don't have great hope ... that it isn't to avoid their obligation," Zinn said.

The state has argued that it spends $16 million in its outreach program and meets federal guidelines.

However, the number of children on Medicaid who received no medical checkups has jumped from about 1 million in 1998 to 1.45 million in 2004.

The number of children "who should have received (medical) services but received none has actually increased since entry of the Consent Decree," Justice said.