Foster Children’s Care Inadequate, Suit Says

The ACLU and five public interest law firms sued Los Angeles County and the state Thursday, claiming the governments for years have knowingly failed to provide mental health services for foster children in the county in violation of federal laws.

States that participate in the federal Medicaid program are required to provide certain services to children, but Los Angeles County and California have failed to follow those rules, the suit says. Federal and state money would cover almost all the costs involved, the plaintiffs said, because the vast majority of foster children are poor and thus qualify for Medi-Cal, the state version of Medicaid.

Some county officials acknowledged that they have made slow progress in their efforts to provide mental health services to foster children outside of psychiatric hospitals and confined group homes. Although the county has launched some pilot programs, they reach only a few hundred children; the county’s child welfare system serves about 50,000 young people overall.

“They are not getting sufficient mental health services. And the reason is because there isn’t a systemic approach” to assessing children’s mental health needs when they are first identified as victims of abuse or neglect, said Marv Southard, director of the county Department of Mental Health. “The average kid would get mental health services not as a preventative measure but only when they started having problems.”

Chief Administrative Officer David Janssen said the county has been targeting its efforts on the most seriously disturbed children in its foster care system with a program called Wraparound.

“The only thing that really matters is what we’re doing now,” he said. So far, 32 children have completed the Wraparound program. It recently was expanded to create space for 110 children, with plans to double that number by December. A similar, but less intensive, program serves almost 400 other children, he said.

The lawsuit cites the cases of five foster children, some of whom suffered from other disabilities. In each instance, lawyers for the children allege, the youngsters never received proper assessments or services and were moved around among dozens of homes and hospitals. One child, the lawsuit states, was moved 37 times in 10 years.

A 16-year-old, who was identified by a pseudonym, entered foster care after sexual abuse by an uncle and her stepfather. After she was moved between two foster homes, was hospitalized twice and lived for a month in the county emergency shelter, the girl’s social worker characterized her behavioral problems as “hormones acting up,” according to the lawsuit.

“This is child neglect on the part of the county,” Mark Rosenbaum, legal director of the American Civil Liberties Union of Southern California, said at news conference.

Standing behind him was a former foster youth who echoed the lawsuit’s allegations. Robert Kaiffie, 20, said he had been in the foster care system for as long as he can remember, moved from place to place, including psychiatric hospitals, and from medication to medication to control his behavior. None of it was tailored to his needs or helped him, he said.

“All this movement taught me to shut down, to close myself off, to be emotionally withdrawn,” he said, reading from a prepared statement. “I don’t know what child wouldn’t react this way.”

Rosenbaum said the county relies on restrictive group homes--such as the MacLaren Children’s Center in El Monte--for children with severe emotional and behavioral problems despite agreement among children’s mental health experts that those settings do more harm than good. Upfront, intensive services are not only more successful, but also cheaper, he said.

A recent grand jury report estimated that MacLaren spends about $270,000 per child per year.

“Perhaps what makes it most frustrating is that in the year 2002, we know what these children need,” said Lew Hollman, executive director of the Center for Law in the Public Interest. “They receive none of those things in the system we have today.”

The suit claims that the county has known about problems for years, citing critical reports from civil grand juries, the Little Hoover Commission and others.

Supervisor Mike Antonovich said he thinks the advocates raise legitimate issues and blamed bad management for the slow progress. “They address a very serious concern,” he said. “We need to have an accelerated program to address the needs of children in our care.”

Southard said he and the outgoing director of the county child welfare department proposed a year ago that the county begin performing the kinds of early assessments and treatment called for in the suit. Skeptical service providers have created obstacles, he said, and the program is still in the planning stages.