According to the most recent numbers (July 2014) shared by the California Child Welfare Indicators Project (CCWIP) at UC Berkeley, almost one in five California foster youth (13,147 out of 66,604) were sent to placements (a foster home, group home, etc.) across county lines or “out-of-county.”
Historically, foster youth placed out-of-county have faced significant disparities in access to mental health services. This problem was identified as early as 1998 and more recently analyzed in the 2011 Data Mining Project report, prepared for the California Child Welfare Council. The latter report found that out-of-county foster youth were 10 to 15 percent less likely to receive any mental health service than their in-county peers.
Among those foster youths who did receive mental health services, those in out-of-county placements received less care and less intensive treatment relative to what was provided to youth with in-county placements, even though they were also shown to have greater needs.
How many foster children do not receive adequate care because they are placed out-of-county is not documented. However, studies indicate that between half to two-thirds of foster youth need mental health services of some kind, so we can estimate the number of children that may be affected ranges between 6,573 and 8,769 at any point in time.
Recent data collected pursuant to the settlement agreement in Katie A. v. Bonta provides additional evidence that foster children placed out-of-county are seriously disadvantaged. Consider the following: the largest reported monthly number (to date) of children involved in the child welfare system who were provided Katie A. services is 6,698 for June 2014.
That same month, the number of out-of-county youth provided Katie A. services was 186. If out-of-county youth were served proportionately to in-county youth, the number would be 17.6 percent of 6,698, or roughly 1,180 children. Thus, in-county children are provided Katie A. services at a rate of more than six-and-a-half times the rate of out-of-county youth.
Stated another way, about 1,000 out-of-county youth likely are not receiving Katie A. services simply because they have been placed out-of-county.
Clearly, placing foster children out-of-county often imposes real hardships on children needing access to mental healthcare. The problem stems from a system design flaw in Medi-Cal’s mental healthcare waiver. Recognizing this, the California Child Welfare Council unanimously approved an action plan intended to resolve the out-of-county problem.
Although considerable delays have ensued since then, at a recent California Child Welfare Council meeting the State recommitted to taking quick action. As advocates for youth with mental health needs, we all have a stake in ensuring this issue is addressed, and soon.
If you or someone you know have had or have heard of problems getting access to mental healthcare for a foster youth sent out-of-county, please contact us at firstname.lastname@example.org.
Read YMAP and the National Center for Youth Law’s report (2011) regarding this issue here.
Patrick Gardner is the president of Young Minds Advocacy Project.