Lessons from Out of County, Calif.: Need for Numbers, Better Coordination

Last week, The Chronicle wrapped up “Out of County, Calif.,” a lengthy series focused on the significant portion of California’s foster youth who are cared for outside of the county they once called home.

Chronicle research produced for this series found that about one in five of the states’s foster youths are placed out of county. In the majority of cases, this is done to achieve what many believe to be the optimal placement: kinship care.

But that was not always the reason. More than a third of children placed in group homes are out of county, as are about a quarter of the kids placed with foster families by private contractors called foster family agencies.

These youth find themselves with strangers, some without foster parents, in a totally strange environment. Many will no longer attend the same school or see their old friends, because the majority of these placements are 11 miles or more from the child’s home.

Youth Services Insider encourages you to check out those stories, which you can find all in one place by clicking here. Following here are two takeaways from this series:

Out-of-County: A New Metric?

The Chronicle staff was able to produce out-of-county numbers in California because of the Child Welfare Indicators Project, an amazing supercollider of information created in partnership between the University of California at Berkeley and the California Department of Social Services.

It dawned on YSI while reading the series that placement proximity is not something the federal government has ever asked states to account for. About a fifth of California’s kids are handled outside of their home county. It sounds like a lot, but is it?

Aside from California, there are eight states where child welfare is administered without much in the way of state control: Colorado, Minnesota, New York, North Carolina, North Dakota, Ohio, Pennsylvania and Virginia.

Now logic would dictate that from an administrative standpoint, it would actually be more difficult to place out of county in one of those states. A state with a central administration would have no barrier to moving a child out of county, unless legislation or regulation put that barrier there.

So does California reflect the norm, are about a fifth of the country’s foster youth living away from their home county? Could be; or it could be the case that California is an outlier in either direction.

Tracking county placement is, admittedly, a bit arbitrary. After all, a kid living two blocks from the county line is closer to home if he’s in foster care three blocks away in another county, as opposed to on the far other side of his own.

But tracked on a state and national level, it could be a good barometer of placement proximity. Another consistent gauge of proximity could be changes in school.

Health Needs: Serve Now, Bill Later

One thing that really stood out from the series is that, when it came to accessing health services, moving a foster youth out of county throws a wrench into a machine that already works slowly.

In one part of the series, Melinda Clemmons tells the story of a Yolo County woman taking in her nieces and nephews from Solano County. A Solano clinic told her they could not treat the youngest child, and she’d need to visit a clinic in Yolo.

The clinic in Yolo told her that because the baby was still listed on her birth mother’s health insurance, she would need to be seen in Solano County.

Jeremy Loudenback tells a similar story about a teenager whose anti-depressant prescription ran out because the county her new foster parents lived in wouldn’t refill it. When those parents finally did connect their foster daughter with a therapist, the wait for an appointment was months.

It is totally understandable that one county would want to guard against increased fiscal burden coming its way from another county. So to the extent that counties pay for physical and mental health services, there is an appropriate level of wariness.

But that should not come at the expense of timely services for kids in crisis, who have been removed from their parents and are now being removed from any familiar surroundings.

California owes it to those kids to designate out-of-county youth as “barrier-proof;” there is no denial, they are accepted for services via Medicaid. The other end of that is a state-mandated system that guarantees reimbursement for the providing county.

As far as mental health goes, such a plan already exists; it’s called Assembly Bill 1299, and it continues to be stalled in the political pipeline. It would ensure both of those conditions.

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John Kelly, Editor in Chief, The Chronicle of Social Change
About John Kelly, Editor in Chief, The Chronicle of Social Change 1213 Articles
John Kelly is editor-in-chief of The Chronicle of Social Change. Reach him at jkelly@chronicleofsocialchange.org.