Equal Access to Mental Healthcare Still Eludes Foster Youth Placed “Out-Of-County”

Roughly one-in-five young people in California’s foster care system are transferred between counties after entering care. Even though as many as two-thirds or more of these youth have heightened mental health needs, data show that they often wait months, or even years, for appropriate mental health treatment. 

Many “out-of-county” foster youth are denied treatment altogether. To make matters worse, data show that foster youth who are sent out-of-county often have greater needs for mental healthcare than foster youth who are not.

Last week, the California Child Welfare Council heard testimony on this long-standing problem of foster youth’s unequal access to mental healthcare. Following years of delay and inaction, representatives from California’s Department of Health Care Services (DHCS) and Department of Social Services (DSS) committed to taking action to finally resolve this problem.

DHCS provided the Council with an update on a joint DHC/DSS concept paper intended to provide a solution to the out-of-county issue. Dina Kokkos-Gonzales, DHCS branch chief, reported that, while not yet finalized, the concept paper proposes a county collaboration team model. Kokkos-Gonzales acknowledged that feedback from stakeholders made it clear that the concept paper did not go far enough to resolve the problem and that greater detail is likely needed.

Young Minds’ President Patrick Gardner, a member of the Child Welfare Council, expressed frustration about the State’s ongoing delay and unmet commitments. Gardner testified that in December 2010 the Child Welfare Council had unanimously approved an action plan intended to resolve the problem.

Again, in June 2012, Health and Human Services Agency Undersecretary Michael Wilkening promised to promptly meet with stakeholders to identify what “work still needs to be done” to address access disparities faced by out-of-county foster youth, stating: “The goal will be to resolve this issue.”

Despite these commitments, Gardner observed that California appears no closer to fixing the problem than four years ago when the Child Welfare Council approved its action plan.

Fellow council member, DSS Foster Care Ombudsman Karen Grace-Kaho, echoed Gardner’s concerns. She pointed out that the problem of access disparities faced by out-of-county foster youth was identified as early as 1998 in a Code Blue report on California’s foster care system.

Grace-Kaho stated that that Departments’ failure to act over the course of the last two decades suggests that the problem “is not taken seriously.”

In response to concerns expressed by council members, representatives from DHCS and DSS both pledged to resolve the problem. DHCS Deputy Director Karen Baylor expressed that her department “is committed to moving forward” to find a solution. Similarly, DSS Deputy Director Peter Cervenka stated that his department was “committed to taking action.” Acknowledging out-of-county disparities as a long-standing issue, Cervenka recognized that the State needed to provide “action steps and timelines” for finally resolving this problem.

Pointing out that “this is an administrative problem that the State and the counties can solve,” Gardner said that the State must take action in a matter of “weeks, not months or years.” Continued delay,” he added, “is no longer an option.”

Wesley Sheffield is the associate attorney for Young Minds Advocacy Project.

Have you had, or heard of, problems getting access to mental healthcare as, or for, an out-of-county foster youth? Please contact Young Minds Advocacy Project at info@youngmindsadvocacy.org.

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Young Minds Advocacy is a nonprofit organization based in San Francisco, California that uses strategic advocacy and communications to help youths and their families to access mental health services and supports, and improve mental health system performance and accountability.