When I joined the California Katie A. v Bonta litigation– regarding therapeutic foster care and other mental health services for at-risk youth – I remember the lead attorney quipped:
“California is like the Wild, Wild West; 58 counties doing what they damn well please!”
How true. Sadly, how very true.
But it isn’t a “California” problem alone; this problem is a national one. Basically, there is no guarantee that youth with identical needs will receive the same services from state to state or from county to county. It makes no difference whether or not these are federally “entitled” services, or even if it is morally and ethically reprehensible: unequal, disparate treatment of children and youth dominates the system of care for our children at every level.
This bad practice came into precise, clear view under the implementation of “ObamaCare.” In states like California, Pennsylvania, New York and even Kentucky, millions of children and youth were added to the ranks of the insured. On the other hand, children in Texas, Florida, Kansas and other “red” states continue to lack equal access to necessary health care services.
National health care reform is only the tip of the iceberg. Unequal delivery permeates every service delivered to children and youth. For instance, education varies not only from state to state, but from school district to school district. Students in adjacent towns or counties experience different quality of education, different availability of special education, athletics, extracurricular activities, and arts and culture.
Study after study covering multiple decades has also uncovered unequal treatment in juvenile justice, child protection, and mental health services. These disparities are distinguishable by geography, race, gender and socioeconomic status.
This is all part of a national problem that lawmakers and power brokers are unwilling to address. Let’s explore some of the fundamental contributors to this problem and what should be done.
First, and at the risk of stepping on a lot of people’s toes, I believe “states’ rights” and “local control” are huge detractors. Frankly, these slogans are code for “don’t tell us what to do; we’ll do as we damn well please because it’s none of your business.”
California is one of 13 states that basically relegates the care and treatment of youth to regionalized counties or municipalities. This type of system does not promote consistency, quality or equality. For example, a high-needs youth can live in a progressive, conscientious California county and receive an array of appropriate, effective services.
Another young person with similar needs living a few miles away in another county, would not have similar access. And these “58 counties doing whatever they “damn well please” infamously produces lawsuits (e.g., Katie A) with the state continually losing.
This framework is destructive to the cohesive fabric of our country. It is destructive and harmful to our children and youth, and I believe it flies in the face of the Equal Protection Clause of the 14th Amendment of the United States Constitution. There must be equal access to entitled federal services, but more importantly, there must be equal access to services which are absolutely necessary for the health, safety and wellbeing of all children and youth.
Second, I have come to the firm conclusion that most policymakers, legislators and power brokers could care less about the plight of children and youth until there is some dramatic crisis from which they can make political hay. Foster youth, commercially sexually exploited children, mentally ill kids, children failing school and high school dropouts don’t have paid lobbyists, nor can they write big checks to fund political machines.
Additionally, government bureaucrats charged with overseeing service delivery to our kids are all primarily a bunch of gutless wimps. It is rare to find a state or county director willing to make a strong stand for children and youth, especially with the body that writes their paycheck and guarantees their pension.
Third, funding is another huge obstacle to equal access to services. It’s okay to grant huge tax breaks to wealthy corporations that don’t need them, or to divert public funding to cover unfunded benefit packages granted for political gratuity, or squander billions on unvetted computer systems, the military industrial complex, high-speed rail and opulent public buildings.
But ask for chump change to serve children and youth? The answer is always, ‘Oh no, we can’t afford that.’ The term ‘cost neutral’ is the modern political vernacular for ‘it’s not important’.
Until we elect legislators and hire leaders with the right priorities, our most vulnerable children and youth will continue to be losers and unequally served. The wild, wild west indeed.