Today marks a significant anniversary in the landmark California youth mental health case, Katie A. v. Bonta. On December 20, 2002, attorneys representing thousands of foster youth with serious mental health needs filed a federal lawsuit against the State of California and Los Angeles County for failing to provide foster youth with necessary mental healthcare. Because the state was not providing these youth with adequate mental healthcare, many of them ended up in restrictive congregate care facilities, including psychiatric hospitals and juvenile halls. The advocates filed the case to prevent the needless institutionalization of young people by ensuring that they receive intensive, individually-appropriate mental healthcare in the most home-like settings possible. Fifteen years later, thousands of California youth are getting intensive mental health treatment in their homes and communities, and far fewer youth are being placed out-of-home. However, more work remains. Thousands more youth are eligible for Katie A. services than are provided care each year. We still have a long way to go to ensure that all young people in California are provided the effective community-based mental healthcare that they need.
While litigation with the state lasted for nearly a decade, an agreement was ultimately reached in 2011. The Settlement Agreement was an important milestone because it required that the state develop three types of previously unavailable community-based mental health services (“Katie A. services”) for child welfare-involved youth. Additionally, California agreed that foster youth and children at risk of out-of-home placement – who are Medi-Cal-eligible and need intensive home or community-based care – would be entitled by law to Katie A. services. As a result, tens of thousands of youth became eligible for services that are intended to reduce institutionalization and criminalization of abused and neglected young people.
In another significant victory, in early 2016, the state declared that counties were mandated to provide Katie A. services to all Medi-Cal youth in the state who qualified for intensive home and community-based services—regardless of whether they are child-welfare involved. The state’s announcement followed Young Minds Advocacy’s (YMA’s) efforts in 2015 to expand Katie A. to juvenile justice youth. The expansion of Katie A. to all eligible youth in California means that at least 20,000 additional youth are now entitled to care. Katie A. services are essential to preventing and reducing juvenile justice system involvement and other adverse outcomes, including low educational achievement and substance use challenges.
Key achievements resulting from the Katie A. lawsuit and related work by youth advocates:
- As a matter of federal law, California must ensure that approximately 40,000 underserved youth annually receive the intensive community-based mental health care that they need.
- Individual counties have invested millions of dollars in expanding Katie A. services to ensure that at-risk youth are not needlessly institutionalized in order to receive mental health care.
- In Fiscal Year 2016-17, California provided Intensive Care Coordination and/or Intensive Home and Community-Based services to at least fifteen thousand youth at a cost of greater than $200 million.
- Katie A. has served as a model for other states seeking to expand the array of legally required services provided to youth with mental health challenges. This will result in a substantial increase in the number of young people across the nation receiving services similar to Katie A. and who are able to avoid placement in group homes and other congregate facilities.
Going forward, YMA is dedicated to continuing our efforts to ensure that Katie A. services are provided to all youth who need them. Increased access to less restrictive mental healthcare will help young people succeed in school, build lasting relationships, and lead healthy, fulfilling lives. Please join us as we continue to advocate for the full implementation of Katie A. for all eligible youth in California!
If you’d like to learn more about Katie A., please check out our other blogs on the topic here: https://www.ymadvocacy.org/tag/katie-a/. The California Department of Health Care Services also has a Katie A. webpage, which you can view here: http://www.dhcs.ca.gov/Pages/KatieAImplementation.aspx.