MHAP for Kids Prevails at the Bureau of Special Education Appeals

The state's Bureau of Special Education Appeals (BSEA) is a key agency for protecting the rights of students with disabilities. In 2025, the BSEA received 426 due process hearing requests from across Massachusetts. BSEA hearing officers conducted full hearings resulting in 29 decisions. Of the 29 decisions, parents fully prevailed in only five. MHAP for Kids attorneys litigated two of the cases where parents fully prevailed. These two cases were the first in MHAP for Kids’ history to go to hearing. Both decisions resulted in significant victories for the families and the program.

In one of these cases, HLA Attorney Kendal Poirier represented a 19-year-old student with complex mental health and cognitive needs who was psychiatrically hospitalized for months due. Kendal advocated with the the school district and the Department of Developmental Services for a residential placement for the student to receive appropriate educational and cognitive support. When no parties were willing to take responsibility for the student’s placement and the student’s mental health continued to decline, Kendal filed at the BSEA, arguing that the student requires a residential placement in order to receive a Free and Appropriate Public Education (FAPE) and to support his complex mental health and cognitive needs.

The hearing officer decided the case in the student’s favor, stating that the student requires a residential placement to meet his mental health and cognitive needs and to make meaningful educational progress. This case is emblematic of how MHAP for Kids prevents youth with complex mental health needs from falling through the cracks of a fragmented system.

In the second BSEA victory, Attorney Shelagh O’Donnell represented a student who was sent juvenile court for missing school, but was not receiving services to support his learning disability and mental health. Shelagh filed at the BSEA, arguing that the school was denying the student a Free and Appropriate Public Education (FAPE). The hearing officer decided the case in the parent's favor, ruling that by not addressing his learning disability and mental health in his Individualized Education Plan (IEP), the school denied the student FAPE and he is entitled to additional services in his IEP. 

The decision in this case represents the core of MHAP for Kids’ mission: diverting youth with unmet mental health needs from juvenile court and helping them access the support they need to succeed in school. Read more about this case and Shelagh's advocacy in "Zion's Story" below.

Congratulations to our amazing MHAP for Kids team on these hard-won victories! The outcomes they achieved will have ripple effects for families across the Commonwealth fighting for children's rights to appropriate mental health and special education services.

Client Spotlights

Zion is a fourteen-year-old student who loves watching anime and playing video games, like many of his peers. Zion’s mom, Shirelle, noticed when he was in elementary school that he was more hyperactive than other kids. When he was around seven, Shirelle took Zion to receive testing and he was diagnosed with attention-deficit hyperactivity disorder (ADHD).

Zion received an Individualized Education Plan (IEP) that addressed his ADHD diagnosis, but he still had a hard time engaging in school and getting along with peers. Zion began to avoid going to school because he was struggling both academically and socially. His school filed a Child Requiring Assistance (CRA) petition in the juvenile court because of his absences.

As part of the CRA process, the court ordered a psychological evaluation for Zion. The psychologist who conducted the evaluation found that Zion had signs of additional diagnoses and a nonverbal learning disability related to reading. She recommended individual therapy and including the specific learning disability diagnosis in his IEP to provide more support for Zion in areas where he was struggling. She also recommended additional neuropsychological testing to explore other potential diagnoses.

After the evaluation, Zion’s school held a meeting to discuss an updated IEP. While his plan had some changes, Zion's nonverbal learning disability was not addressed, despite the evaluator's recommendations. Shirelle signed this IEP agreement, not thinking she had any other choice.

Over the summer, Zion went through neuropsychological testing. The neuropsychological testing revealed Zion had other diagnoses, including a specific nonverbal learning disability that caused a delay in his information retrieval skills. However, the school once again refused to include his learning disability and additional support for reading in his IEP. They claimed, based on their own screenings, the proposed IEP was sufficient.

“I was at a loss,” Shirelle said, describing how overwhelmed she was trying to fight for Zion.

Determined to get Zion access to the educational and mental health support he deserves, Shirelle reached out to a resource suggested by the court psychologist: the Mental Health Advocacy Program for Kids (MHAP for Kids) at Health Law Advocates. She was connected with MHAP for Kids Staff Attorney Shelagh O’Donnell.

Shelagh reviewed Zion’s records and evaluations and attended meetings at the school with Shirelle to advocate for Zion.

“Shelagh was incredibly helpful, she helped me to understand a lot of what was going on in those meetings and understand what my options were,” Shirelle said.

When the school still wouldn’t agree to follow the recommendations made by experts to address Zion’s learning disability in reading, Shelagh filed a hearing request at the Bureau of Special Education Appeals (BSEA), arguing that the school denied Zion his legal right to a Free Appropriate Public Education (FAPE).

After months of diligent preparation, Shelagh presented her case and witnesses at the BSEA hearing. In January, the hearing officer decided the case in Shirelle’s favor. The hearing officer agreed with Shelagh’s argument that the school was in fact denying Zion FAPE by not addressing his learning disability in his IEP.

“Significantly, [the psychologist] evaluated Student as part of a CRA filed by [the school district],” the hearing officer wrote in her decision, acknowledging the school district’s refusal to follow the clinical recommendations that arose because of their decision to involve Zion with the juvenile court.

The hearing officer concluded that Zion must receive additional services in his IEP and that he is entitled to compensatory services for the period of time when his IEP did not address his learning disability. After the decision was released, Shirelle and Shelagh met with Zion’s school to coordinate implementing the accommodations recommended by the evaluations.

This decision is a huge win for Zion and students like him who are at risk of getting involved in the juvenile court system because they lack the mental health and educational support to succeed in school. MHAP for Kids continues to divert youth from juvenile court involvement and connect them with mental health services they need to thrive in their schools and communities. 

Melissa is a long-time Massachusetts resident who is passionate about helping others. In 2017, Melissa was a healthy 38-year-old when she developed a rapidly disabling autoimmune neurologic condition following a viral illness. She experienced cognitive dysfunction, significant weight loss, a rapid pulse with constant adrenaline feeling, burning pain, hormone loss, damage to her tissues, and even the shutdown of her basic bodily functions. Because of the physical toll the illness took on her, she had to step back from her rewarding, almost 15-year career in human services.

After several months of rapid decline and struggling to get properly diagnosed, Melissa visited a neurologist in Boston who correctly diagnosed her illness and ordered an effective drug treatment. However, this treatment required prior authorization under her insurance plan. The prior authorization process, wherein Melissa’s doctor had to get approval from her insurance plan before providing the treatment, took months. The nature of her illness meant that waiting months for treatment resulted in a deterioration of her functioning and lasting damage to her nervous system.

Melissa with her dog during a home infusion of immunotherapy treatment.

However, a year later, when Melissa needed to find a new health insurance plan, her treatment abruptly ended. Melissa needed additional help with accessing treatment as her functioning was beginning to decline again. Her friend recommended she call Health Law Advocates (HLA). After doing an intake with one of HLA's paralegals, Melissa was connected with HLA Senior Supervising Attorney Wells Wilkinson.

“After starting to work with Wells, it felt like someone finally really cared and the help came at the moment I really needed it,” Melissa described.

Wells helped Melissa successfully transition to a ConnectorCare health plan. However, this new plan required a new prior authorization for her treatment. Wells communicated with Melissa’s providers and infusion company about trying to get her treatment approved. Her providers explained that the health plan was unclear about how to provide the information they needed to approve the prior authorization. Wells recognized that this was likely a way to delay the approval process. With the time-sensitive nature of Melissa’s illness, Wells decided to submit an appeal to the Office of Patient Protection (OPP) who reached out to the Department of Insurance (DOI). Once the DOI became involved, the health plan approved the prior authorization.

Wells’ tireless advocacy and meticulous coordination between providers and agencies secured coverage for one year of treatment for Melissa. Additionally, after working with Wells, it became easier for Melissa to get future prior authorization appeals approved and receive treatment.

Though Melissa still experiences flare-ups with her illness, she feels lucky that she is now able to access an effective treatment. She knows from speaking with fellow patients in her support groups that she is not the only one whose insurance plan denied effective treatments, but also some doctors will order less effective treatments to avoid the arduous prior authorization process.

In addition to individual advocacy, Wells has partnered with Melissa on legislative advocacy related to the prior authorization process. Melissa spoke at a press conference in support of Governor Maura Healey and DOI Commissioner Michael Caljouw’s proposed regulations that would standardize the prior authorization process and reduce unnecessary delays and administrative burdens. Melissa and Wells also submitted testimony in support of these regulations.

“I want to take my experience and use it to help others,” Melissa said, “If sharing my story is a way I can help, that’s what I want to do.”

Wells, Melissa, and Governor Healey at the press conference on January 14 announcing new prior authorization regulations. Photo courtesy of Office of Governor Maura Healey.

Map of 2025 HLA cases

In 2025, HLA represented clients in 1,697 cases. We recorded geographic data for 1,670 of those cases. The above map indicates the number of cases HLA handled in each town and city across the Commonwealth, with darker red shading representing more cases. Our team represented clients from 222 different towns and cities in 2025!

Interested in how many cases HLA worked on in your town? Check out the full list below:

·      Abington: 2

·      Acton: 3

·      Acushnet: 2

·      Adams: 4

·      Agawam: 8

·      Amesbury: 5

·      Amherst: 9

·      Andover: 5

·      Arlington: 9

·      Ashburnham: 1

·      Ashby: 1

·      Ashland: 12

·      Athol: 10

·      Attleboro: 14

·      Auburn: 1

·      Barnstable: 9

·      Bellingham: 3

·      Bernardston: 1

·      Beverly: 15

·      Billerica: 3

·      Bourne: 1

·      Boston: 185

·      Boxford: 2

·      Braintree: 15

·      Brewster: 2

·      Bridgewater: 3

·      Brimfield: 2

·      Brockton: 51

·      Brookfield: 1

·      Brookline: 11

·      Buckland: 1

·      Burlington: 7

·      Cambridge: 13

·      Canton: 7

·      Carver: 3

·      Charlemont: 1

·      Charlestown: 3

·      Charlton: 1

·      Chatham: 3

·      Chelmsford: 1

·      Chelsea: 34

·      Cheshire: 2

·      Chicopee: 10

·      Clinton: 2

·      Danvers: 6

·      Dartmouth: 3

·      Dedham: 2

·      Dennis: 7

·      Douglas: 1

·      Dracut: 6

·      East Bridgewater: 2

·      East Longmeadow

·      Eastham: 2

·      Easthampton: 2

·      Easton: 1

·      Edgartown: 1

·      Everett: 22

·      Fairhaven: 6

·      Fall River: 43

·      Falmouth: 5

·      Fitchburg: 18

·      Foxborough: 4

·      Framingham: 24

·      Franklin: 2

·      Gardner: 12

·      Gloucester: 10

·      Grafton: 1

·      Granby: 1

·      Great Barrington: 2

·      Greenfield: 2

·      Groveland: 3

·      Hadley: 2

·      Hamilton: 2

·      Hampden: 1

·      Hanover: 1

·      Hanson: 1

·      Harwich: 1

·      Haverhill: 27

·      Heath: 1

·      Holbrook: 5

·      Holden: 2

·      Holliston: 1

·      Holyoke: 23

·      Hopedale: 1

·      Hopkinton: 1

·      Hull: 1

·      Hyannis: 7

·      Kingston: 1

·      Lancaster: 1

·      Lanesborough: 1

·      Lawrence: 54

·      Lee: 3

·      Leicester: 3

·      Lenox: 1

·      Leominster: 13

·      Lexington: 3

·      Lincoln: 2

·      Longmeadow: 1

·      Lowell: 37

·      Ludlow: 4

·      Lynn: 33

·      Lynnfield: 1

·      Malden: 23

·      Mansfield: 7

·      Marblehead: 2

·      Marlborough: 19

·      Mashpee: 3

·      Mattapoisett: 2

·      Maynard: 1

·      Medfield: 2

·      Medford: 7

·      Medway: 3

·      Melrose: 8

·      Merrimac: 3

·      Methuen: 21

·      Middleborough: 6

·      Middleton: 1

·      Milford: 8

·      Millbury: 1

·      Millis: 1

·      Milton: 5

·      Montague: 5

·      Nashua: 1

·      Natick: 3

·      Needham: 1

·      New Bedford: 52

·      Newton: 13

·      Norfolk: 1

·      North Adams: 7

·      North Andover: 6

·      North Attleborough: 2

·      Northampton: 4

·      Northborough: 3

·      Northbridge: 1

·      Northfield: 1

·      Norton: 1

·      Norwood: 9

·      Orange: 1

·      Orleans: 1

·      Otis: 1

·      Oxford: 4

·      Palmer: 4

·      Paxton: 1

·      Peabody: 19

·      Pembroke: 3

·      Pepperell: 1

·      Pittsfield: 16

·      Plainville: 3

·      Plymouth: 7

·      Quincy: 17

·      Randolph: 9

·      Raynham: 4

·      Reading: 4

·      Rehoboth: 1

·      Revere: 29

·      Rockland: 5

·      Rockport: 2

·      Salem: 24

·      Sandwich: 3

·      Saugus: 10

·      Scituate: 1

·      Seekonk: 1

·      Sharon: 9

·      Sheffield: 1

·      Shirley: 2

·      Shrewsbury: 1

·      Somerset: 3

·      Somerville: 16

·      South Hadley: 3

·      Southbridge: 4

·      Spencer: 3

·      Springfield: 82

·      Sterling: 1

·      Stoneham: 3

·      Stoughton: 5

·      Sturbridge: 1

·      Sudbury: 1

·      Swansea: 2

·      Taunton: 25

·      Tewksbury: 5

·      Townsend: 2

·      Truro: 1

·      Tyngsborough: 4

·      Upton: 1

·      Uxbridge: 1

·      Wakefield: 3

·      Walpole: 4

·      Waltham: 19

·      Ware: 7

·      Wareham: 12

·      Warren: 2

·      Watertown: 7

·      Wayland: 1

·      Webster: 15

·      West Boylston: 1

·      West Bridgewater: 1

·      West Hampton: 1

·      West Springfield: 10

·      Westborough: 5

·      Westfield: 10

·      Westford: 1

·      Westminster: 1

·      Weston: 1

·      Westport: 1

·      Westwood: 1

·      Weymouth: 13

·      Whitinsville: 1

·      Williamstown: 1

·      Wilmington: 5

·      Winthrop: 5

·      Woburn: 9

·      Worcester: 49

·      Wrentham: 1

·      Yarmouth: 7

Dr. Elliott also reviewed a new study her team put together with feedback from Family Resource Center (FRC) staff about their collaboration with MHAP for Kids attorneys. A large majority (86%) of the FRC staff surveyed reported that the MHAP for Kids attorney at their FRC had a positive impact on their work (while none reported a negative impact). Dr. Elliott emphasized that the smooth integration of MHAP for Kids into the FRCs is rare for programs in this field.

Mahly Alejandro, the Program Director of the Worcester Family Resource Center, expanded on Dr. Elliott’s description of the partnership between MHAP for Kids and the FRCs. MHAP for Kids staff attorneys are based out of 15 of the FRCs. They provide trainings for FRC staff to build their capacity and legal knowledge, and connect directly with families who walk in the doors of the FRC.

“Partnerships like the one we have with Health Law Advocates allow us to provide families with critical knowledge, advocacy, and support in a setting that feels safe, welcoming, and accessible to families.” Mahly explained, “When families have access to the right information and the right resources at the right time, we strengthen not only individual families, but entire communities.”

To close the briefing, we heard from MHAP for Kids client Carmen, who worked with Staff Attorney Jessica Fried to access more effective special education services for her son, Anthony. Carmen described how Anthony was pulled out of his classroom and placed in a “safe room” for months by himself due to his behaviors instead of receiving appropriate mental health support. Jessica helped her understand the different options available for Anthony and navigate the process of finding a new placement that better suits his educational and mental health needs.

In addition to the briefing, Marisol Garcia has been meeting one-on-one with legislators to keep them updated about the work of MHAP for Kids in their districts and advocate for funding for the program. The briefing allowed us to dive deeper into the data from BUSPH and highlight personal experiences of our clients that support the efficacy of the program.

Thank you to Chair John Lawn for sponsoring the briefing and for his longstanding support of MHAP for Kids. Thank you to all our speakers who took the time to share their perspectives about MHAP for Kids.

You can view the full briefing below:

Training Roundup

Medical Debt Convening, October 2025

HLA’s Medical Debt initiative was formed to address unaffordable health care and has represented thousands of consumers in resolving unfair medical debt by appealing coverage denials, negotiating and invoking rights with providers, and other strategies. Yet medical debt remains a significant barrier to care for many. In fact, nearly one-third of Massachusetts residents point to incurring potential medical debt as the sole reason for foregoing treatment, according to the Center for Health Information and Analysis. Medical debt creates serious barriers not only to health care, but also to other basic necessities and long-term financial stability – especially for low- and middle-income residents and Black and Hispanic communities across the Commonwealth.

Each year, hundreds of individuals contact HLA’s intake line seeking help resolving medical debt. In 2024, a generous grant from the Atrius Health Equity Foundation enabled us to expand our Medical Debt Initiative. HLA partners with Health Care For All and Undue Medical Debt to provide training and resources for organizations rooted in the communities they and we serve. 

Last year, HLA began holding bi-monthly virtual “office hours” that provide an opportunity for community-based organizations to ask questions, get guidance, and learn more about identifying and resolving medical debt.

“We are equipping organizations with the tools and knowledge so that they can advocate with the community they work with every day,” said Alex Rhoades, a Medical Debt Advocate at HLA. “[These trainings] have had a ripple effect. Consumers are learning how to identify medical debt, dissect medical bills, and advocate for themselves.”

"At the community level, this work is helping reduce stigma around medical debt and increase access to resources that many clients were previously unaware of," shared Edily Vasquez, a Financial Coach at The Neighborhood Developers in Chelsea, one of HLA's community partners. "We are able to equip clients with education around medical billing, insurance, and debt relief options. This empowers them to better understand their statements and take action with greater confidence."

However, not all medical debt can be resolved by the consumer. Sometimes, they need help from, and know when to involve, a lawyer. "Our direct connection with HLA has also created a clearer pathway for clients who need legal or specialized assistance," said Ms. Vasquez. HLA saw a significant uptick in callers asking for help to resolve unjust medical debt within the past year. In 2025, HLA handled 384 cases – 130 were referrals from our community partners. Of the closed cases (106), HLA eliminated nearly 1.3 million dollars in medical debt, representing 73% of the total debt. 

“We’re seeing an increase in people asking for help, but we’re also hearing from our partners that consumers are resolving debt on their own. This is exactly what we want to see,” Alex reported. “We are trying to build a sustainable, effective movement towards resolving your own medical debt… It’s a scary thing to confront, but I think we’ve done a really good job instilling the confidence – along with the knowledge – to challenge unjust medical debt. We’re helping people understand what they’re capable of.”

While much work remains, particularly as unjust medical debt continues to burden health care consumers across Massachusetts, our office hours demonstrate the power of sharing expertise and partnering with community-based organizations. Together, we can reach more people, reduce harmful debt, and make a deeper impact statewide.

We are proud to partner with the following community-based agencies: Brazilian American Center (Framingham), Cambodian Mutual Assistance Association (Lowell), Immigrants’ Assistance Center (New Bedford), Lawrence Community Works (Lawrence), The Neighborhood Developers (Chelsea), NeighborWorks Housing Solutions (Quincy), Pinnacle Partnerships (Brockton), Women Encouraging Empowerment (Revere), and Urban Edge Housing Corp. (Boston/Roxbury).

Executive Director Matt Selig recently joined two podcasts to discuss HLA, its mission to improve health care access for Massachusetts, the current environment for low-income health care consumers, and the rewards and challenges of public interest law.

Staff Updates

Welcoming New Staff!

We're hiring!

HLA is now on Bluesky!

Health Law Advocates

70 Franklin Street, Suite 500 | Boston, MA 02110 | 617.338.5241 | www.healthlawadvocates.org