Mental Health Care for Students at Risk

Mental health care for about 30,000 of California’s most troubled schoolchildren has emerged as a highly charged issue as the state continues to struggle with budget shortfalls.

Already, counseling providers say, lack of state financial support has forced them to turn away an increasing number of students in need of treatment. And they fear more cuts could be ahead.

“We know there are many, many of these kids who are just waiting for services,” said Ari Levy, a director of the nonprofit Child and Family Center in Santa Clarita. “But we can’t go into bankruptcy.”

At issue is a recent proposal by Gov. Arnold Schwarzenegger to shift responsibility for providing treatment from counties to school districts.

The idea has alarmed parents, who fear a further erosion of services, and educators, who worry they will be left scrambling to provide millions of dollars in federally mandated services.

School officials “are in a state of panic,” said Paul Goldfinger, vice president of School Services of California, a firm that consults with school districts on financial issues. “No one knows what is going to happen or how to plan for next year.”

At stake is a wide range of psychological services for children with learning disabilities who also suffer from mental illnesses too pronounced to be treated by school staff. Many such students require intensive, one-on-one sessions with therapists or psychiatrists, and drug therapy, while the most seriously ill are treated at residential facilities.

The uncertainty is unsettling to parents such as Tess Matheny, whose son, Alex, 17, visits a therapist each week and a psychiatrist once a month to treat his anxiety disorder and depression.

“I’m a single parent, and this is something I couldn’t possibly afford,” said Matheny, who lives in North Hills. “This is so important not only for my kid, but for so many others.”

Under federal law, students diagnosed with learning disabilities are entitled to mental health treatment if it improves their learning abilities. Since the early 1980s, state law has required that California’s 58 counties provide a range of outpatient and residential programs for about 30,000 students a year.

Because counties were required to treat the students, they were entitled by California law to be reimbursed by the state. Last year, counties spent roughly $140 million on student mental health services -- three times more than any other mandated service for which the state reimburses counties.

Since 1999, lawmakers have failed to fully reimburse counties for the mental health services. In 2002, then-Gov. Gray Davis and legislators, faced with a multibillion-dollar budget deficit, allotted no money for the mental health program.

Under Schwarzenegger, the state has continued not to reimburse counties, but has covered some of the costs by redirecting $69 million in federal education funds.

Left largely on their own, counties have paid much of the treatment costs. In Los Angeles County, for example, supervisors have set aside $20.3 million from the general fund yearly since 2002 to maintain a program that serves about 6,200 students. In Orange County, supervisors say the state owes $53 million for services provided to about 3,500 students a year since 1999. By June, the amount is estimated to have grown to $64 million.

Statewide, the state owes counties about $450 million, according to the nonpartisan legislative analyst’s office.

Schwarzenegger is proposing to repay the money sometime over the next 15 years -- a pledge county officials have little confidence in.

“The counties cannot continue to pour in funds to pay for something that is a state responsibility,” said Dave Riley, assistant director of the Orange County Health Care Agency. “These kids have a right to these services. If we are going to be the one to provide them, we need to be paid.”

Since the state cut its funding, counties have struggled to pay the organizations -- such as Levy’s Child and Family Center -- that they contract with to treat mentally ill children, leaving many clinics reluctant to provide the services.

After struggling to get his bills paid by county officials, Levy said his agency had reduced the number of the special education students it treated by nearly half in two years.

Orange County supervisors voted last month to begin charging school districts for mental health services beginning this fall. The decision came after a similar move by San Diego County last summer.

The two counties joined Contra Costa and Sacramento counties and sued the state over the lack of student mental health funding last year.

In July, a Superior Court judge in Sacramento ruled that counties were not legally obligated to provide mental health services if the state did not reimburse them. The state did not appeal the decision.

San Diego County supervisors moved quickly to stop offering mental health treatment for 1,250 students, despite protests by educators and parents. The school districts eventually agreed to pay for services after the county exhausted its limited federal funding.

Contra Costa County officials are negotiating with school districts over payments for services next year. Sacramento County health officials plan to seek permission from county supervisors next month to begin negotiations.

Meanwhile, Schwarzenegger is lobbying lawmakers to suspend the counties’ mandate to treat mentally ill students. If his efforts succeed, the responsibility for paying the bill in the future would fall to school districts. Districts would have to decide whether to hire staff or contract with county offices or private providers to continue treatment.

To help schools pay for those services, the governor has earmarked $100 million in federal and local money for school districts -- at least $40 million short of what is needed, education officials say. Aides to the governor defend the allotment, saying that counties have inflated the costs of the program by seeking reimbursement for services beyond what is mandated by federal law.

Last month, the legislative analyst’s office advised lawmakers not to suspend, but to eliminate, the county mandate, saying that if school districts were responsible the program would be more cost-effective. The analysts, however, agreed with education officials on the cost of the services and called for lawmakers to redirect an additional $40 million in education funds.

With approval of the state budget not expected until this summer, the prospect of assuming control of the student mental health program weeks before the start of the school year has left some educators unnerved.

“To suddenly decide that educators can do a better job than the counties at providing mental health services isn’t logical or reasonable,” said Steve Morford, director of special education for the Riverside Unified School District. “If they gave me enough time and a modicum of resources, I could figure something out. But that isn’t happening.”